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Adult Brain Changes With Unsuspected Speed
The human brain can adapt to changing demands even in adulthood, but MIT neuroscientists have now found evidence of it changing with unsuspected speed. Their findings suggest that the brain has a network of silent connections that underlie its plasticity.

Rep. Stupak Signals Willingness To Compromise On Abortion Coverage In Health Reform Legislation
Rep. Bart Stupak (D-Mich.) on Monday said that he and House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) are negotiating to resolve the concerns of antiabortion-rights Democrats who want to exclude abortion coverage from the House health reform bill (HR 3200), Dow Jones reports. Stupak said that the compromise would affect how state abortion laws are handled under the bill (Yoest, Dow Jones, 7/20.). According to the AP/Atlanta Journal-Constitution, Stupak did not give details on the negotiations, and aides said that no final deal has been reached (Werner, AP/Atlanta Journal-Constitution, 7/21).Stupak said that he and Waxman"s staff discussed the compromise over the weekend. According to Stupak, a compromise could be voted on this week as an amendment during the committee"s markup of the bill. According to Dow Jones, Stupak holds a key vote on the health bill, which faces opposition from some other conservative Democrats on the panel over costs. His comments on Monday suggest "an easing of tensions" between antiabortion-right Democrats and supporters of the bill, Dow Jones reports. Stupak and 19 other House Democrats last week sent a letter to party leaders stating that they "cannot support a health care reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health plan." They also stated that they want to ensure that a health benefits advisory council created under the bill "cannot recommend abortion services be included under covered benefits or as part of a benefits package." The advisory council would make recommendations to the HHS secretary, who would make final determinations on what public and private plans would be required to cover in a health insurance exchange. Stupak said that the two sides are "working in good faith" and that other members of the committee should not push their own abortion-related amendments (Dow Jones, 7/20). On Monday, committee voted 20-35 to reject an amendment, offered by Rep. Nathan Deal (R-Ga.), that would have eliminated a provision requiring states to adhere to minimum benefits requirements that employer-sponsored insurance must include. Deal said that states could be required to cover abortion or "out of mainstream" services. Stupak responded, "I hope we"re not going to start using reproductive rights as a red herring on every amendment that comes up." Panel Approves Sex Education AmendmentThe panel voted 33-23 to approve an amendment that would authorize $250 million through 2014 for "evidence-based" sex education programs for teenagers. Rep. Lois Capps (D-Calif.), who offered the amendment, said that abstinence-only programs would not be excluded if they are proven effective. Following debate on Capps" amendment, Rep. Lee Terry (R-Neb.) offered an amendment that would reauthorize the Title V abstinence-only sex education program. Committee Chair Henry Waxman (D-Calif.) said that Title V "has been a failure," adding that 25 states refused to accept the money through the program because it is ineffective. Terry"s amendment was rejected 26-29.The committee also voted 36-23 to adopt an amendment that would provide $150 million in grants through 2014 to state and local governments and not-for-profits for educating residents in "medically underserved" areas on various topics, including sexual behavior (Wayne, CQ Today, 7/21).
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Blogs Comment On Appeals Court Ruling On Virginia Abortion Ban, German Abortion Law, Other Topics
The following summarizes selected women"s health-related blog entries.~ "Another Abortion Case Developing," Lyle Denniston, SCOTUSblog: The decision by the full U.S. Court of Appeals for the 4th Circuit to uphold Virginia"s 2003 law banning what abortion-rights opponents call "partial-birth" abortion -- known medically as intact dilation and extraction -- could send a new abortion-rights case to the U.S. Supreme Court, Denniston writes. He continues that if the case, Richmond Medical Center v. Herring, is appealed to the U.S. Supreme Court, it could be a "sequel" to the court"s 2007 ruling in Gonzales v. Carhart, which upheld a federal ban on the procedure. Denniston notes that the 4th Circuit Court panel twice struck down the Virginia law. A "key factor" in those rulings was that the state law "differs in some significant respects from the federal ban," he writes. Denniston continues that the full appeals court in its opinion said that the Virginia law "is "somewhat different" from the federal ban, but still "provides sufficient clarity as to what conduct is prohibited to enable a doctor of reasonable intelligence to avoid criminal liability under it."" According to Denniston, "The most significant difference between the Virginia ban and the federal ban is that, under the Virginia law, a doctor who intends to perform an abortion that does not violate the law, but the fetus accidentally is delivered intact to a significant degree, and if the mother"s life is not at stake, the doctor has committed a crime" (Denniston, SCOTUSblog, 6/24).~ "More Restrictive Law on Late-Term Abortions Comes to Germany," Anna Wilkowska-Landowska, RH Reality Check: Pregnant German women seeking abortions after the first trimester of pregnancy "will face stringent consultations and will be required to undergo a waiting period of at least three days before a physician can make a final decision allowing the abortion" under a new German law, Wilkowska-Landowska writes. According to a 1995 German law, an abortion performed during the first three months of pregnancy is considered an unlawful act but not a punishable offense if a pregnant woman first visits a counseling center, though the woman is not required to give a reason for seeking the procedure. German law allows abortion after 20 weeks" gestation if there is a risk to the physical or mental health of the pregnant woman. In May, the lower house of the German parliament enacted a law requiring women seeking the procedure after the first trimester to wait at least three days before a physician can make the decision to perform an abortion. Women also must undergo a psychological evaluation. In addition, parliamentarians voted to increase "consultations and support for families with handicapped children considering termination," Wilkowska-Landowska writes. She continues that the medical and psychological consultation requirements are aimed at reducing the number of abortions performed after the first trimester. According to Wilkowska-Landowska, church representatives and lawmakers began discussions on the issue in 2005,when it was reported that the number of abortions performed later in pregnancy were increasing (Wilkowska-Landowska, RH Reality Check, 6/25).~ "Jon Stewart and Mike Huckabee on Abortion," Jim Wallis, Sojourners" "God"s Politics": Wallis writes that he was surprised to see that The Daily Show handled a discussion on abortion between host Jon Stewart and former Republican presidential candidate and former Arkansas Gov. Mike Huckabee with such "nuance and respect" for the topic. According to Wallis, although Stewart and Huckabee "didn"t solve the issue, ... the depth of their dialogue and their respect for the other"s core values and opinions was clear." Wallis writes they "never quite reached common ground, but their dialogue was a great example of the type of civil discourse our country needs to be engaged in." Wallis also includes video clips of the interview (Wallis, "God"s Politics," Sojourners, 6/24).~ "George Tiller: Health Care P
Cardiovascular

UK Patients To Benefit From Access To Innovative Lung Cancer Treatment

The National Institute for Health and Clinical Excellence (NICE) have today published their recommendation for the use of the innovative chemotherapy pemetrexed (Alimta), in combination with cisplatin - a platinum based chemotherapy, as a 1st-line treatment for patients with adenocarcinoma or large-cell carcinoma non-small cell lung cancer* (NSCLC)1 within their Final Appraisal Determination (FAD). Final Guidance on the use of pemetrexed and cisplatin within this indication is anticipated to be published in September 2009 as a result of the FAD. Lilly welcomes this FAD decision which means that UK patients with adenocarcinoma and large cell carcinoma NSCLC are to benefit from publicly funded access to the combination as 1st line treatment. Lung cancer is the UK"s biggest cancer killer2 and the second most common cancer in the UK after breast cancer2, accounting for one in 20 of all deaths nationwide. Treatment with pemetrexed and cisplatin represents a significant development in non-squamous NSCLC treatment as it has shown to extend life beyond one year in certain patients**3. In addition, pemetrexed with cisplatin offers improved tolerability for non-squamous NSCLC patients3 when compared to the most widely prescribed treatment combination, gemcitabine and cisplatin. In clinical trials comparing the two treatment combinations, patients receiving pemetrexed and cisplatin required fewer transfusions, experienced lower incidence of neutropenia (a disorder leading to a low white blood cell count) and half the number of patients encountered hair loss.3 Professor Nick Thatcher, Professor in Medical Oncology at The Christie NHS Foundation Trust said: "This decision is truly significant and is fantastic news for lung cancer patients in the UK and the clinicians who have been campaigning for access. "It is NICE"s first FAD incorporating the use of histology. A histological diagnosis, the microscopic analysis of a tumour biopsy, allows the determination of exactly which type of NSCLC is present***, thereby allowing treatments to be more targeted and therefore more effective. "This "targeting" of patients has helped NICE confirm that pemetrexed and cisplatin is a clinically and cost effective treatment in patients with a confirmed diagnosis of adenocarcinoma or large-cell carcinoma." "The decision reflects the advancement pemetrexed in combination with cisplatin brings, with clinicians being able to target the right patients with the right treatment based on histological diagnosis. NICE should be commended on allowing UK patients to be the first to have funded access to this combination for the 1st line treatment of non-squamous NSCLC. "We now need to work hard to ensure that there is equitable access to this medicine throughout the UK." Pemetrexed and cisplatin are administered as an infusion every three weeks, providing an additional benefit of reducing the frequency of hospital visits and medication when compared with other treatments.4 The full FAD documentation can be found on the NICE website www.nice.org.uk. Final guidance on the use of pemetrexed and cisplatin for the 1st line treatment of locally advanced or metastatic non-squamous NSCLC is expected in September 2009 and will also be published on the NICE website. Notes * For patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) ** In patients with adenocarcinoma *** Of the three types of NSCLC, pemetrexed has been shown to be more effective in two types, adenocarcinoma and large cell carcinoma (referred to as non-squamous NSCLC). These two types of NSCLC represent approximately 55% of all NSCLC cases References 1 - National Institute for Health and Clinical Excellence. Pemetrexed for the 1st line treatment of non-small cell lung cancer. Final Appraisal Determination: http://guidance.nice.org.uk/TA/Wave18/25 2 - Cancer Research, UK. Cancer Stats, Key Facts on Lung Cancer and Smoking. http://info.cancerresearchuk.org/cancerstats/types/lung/ (Accessed July 2009) 3 - Scaglotti GV et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol; 2008 Jul 20;26(21):3543-51. Epub 2008 May 27 4 - Alimta SmPC Eli Lilly and Company Limited


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