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Republicans Playing 'Abortion Card' On Health Reform, American Prospect Opinion Piece States
The "religious right and its Republican enablers" are "playing the abortion card" with health care reform legislation by contending that "federal government dollars will pay directly for abortions," according to an American Prospect opinion piece by Dana Goldstein, an associate editor for the magazine. It is "unlikely" that federal money would be used this way, but the groups "want grassroots conservatives to believe it will, hoping the resulting outcry will scuttle attempts to reform our expensive health care system," Goldstein continues. She writes, "This rhetoric is beyond hyperbolic -- it is downright deceptive."Goldstein quotes Adam Sonfield, a senior policy associate at the Guttmacher Institute, who said discussion of family planning in federal law ""never includes abortion."" She adds, "In actuality, "family planning" language refers exclusively to contraceptive services, in part because of the Hyde Amendment," which bars the use of federal Medicaid dollars for abortion. She also notes that reproductive health issues are "so politicized ... that even to offer birth control to poor women who do not meet Medicaid"s strict eligibility requirements, individual states must apply for a waiver from the federal government." About half of states have done so, she says. In "choosing what services to cover under any potential public insurance plan," the HHS secretary "will likely be bound by all of the existing laws that prevent the federal government from financing abortion," according to Goldstein. She adds, "None of these restrictions would be explicitly overturned by any of the health reform proposals currently being considered in Congress."Antiabortion-rights Senate Republicans have said they will oppose any health reform bill "that subsidizes abortion coverage or even includes, in the proposed health insurance exchanges, private insurers that cover abortion," Goldstein writes. She adds that 87% of existing health plans include some abortion coverage, meaning that most women would lose coverage under the Republicans" demands. "The result would be a near-blanket restriction on women"s access to insurance-subsidized abortion, one far more radical than the Hyde Amendment," Goldstein says. Meanwhile, women"s health advocates have said that overturning the Hyde Amendment is not currently their top priority because "they are simply too busy playing defense on health reform" and do not have the votes, Goldstein writes.According to Goldstein, by "playing the abortion card, the real goal of anti-choicers is not only to maintain existing restrictions on abortion access, but to use health reform as a vehicle to expand them to the majority of American women." She writes, "If such efforts lead to legislative impasse, many conservatives will be delighted." She concludes, "After all, they"ve never really put any political muscle behind fixing our inadequate health care system" (Goldstein, American Prospect, 7/14).
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New Diagnostic Method For Gout: Dual Energy Computed Tomography Instead Of Joint Aspiration
The most reliable method of diagnosing gout is to aspirate the joint in order to obtain fluid to verify the presence of monosodium urate crystals (uric acid). Up to now, computed tomography (CT) has played a limited role in the evaluation of gout, since conventional CT systems cannot reliably verify deposits of uric acid. However, a current study at the Vancouver General Hospital in Canada gives rise to speculation that dual-energy computed tomography (DECT) could radically change the diagnosis of this disease. DECT enables fast, noninvasive examinations and, based on initial evaluations, has the potential to surpass the invasive gold standard and clinical examination in terms of reliability. Investigations have confirmed the high sensitivity of the DECT method in detecting uric acid deposits. The Canadian scientists used the SOMATOM Definition computed tomography (CT scanner) from Siemens for their investigation. This system is the only CT scanner worldwide that features two X-ray tubes capable of simultaneously producing different energies.
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Hodgkin Lymphoma Survivors Have Increased Risk Of Stroke And Transient Ischemic Attack
Patients treated for Hodgkin lymphoma with radiation therapy have a substantially higher risk of stroke, according to a new study published June 17 online in the Journal of the National Cancer Institute.
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Initial Therapy With Janumet™ Provided Significantly Greater Blood Sugar Lowering Compared To Metformin Alone In Type 2 Diabetes

New data presented at the American Diabetes Association (ADA) 69th Annual Scientific Sessions showed that initial treatment with "Janumet"* (sitagliptin/metformin) provided significantly greater blood sugar improvements in drug-naç¯ve** patients with type 2 diabetes, compared with metformin alone.[i] "In this study, initial combination therapy with the fixed-dose combination sitagliptin and metformin for the treatment of type 2 diabetes helped patients achieve blood sugar goals more effectively than metformin alone," said Barry J. Goldstein, M.D., Ph.D., Vice President of Clinical Research, Diabetes and Obesity, Merck & Co., Inc. Maintenance of combination therapy may not be appropriate for all patients. These management options are left to the discretion of the physician. *Note, initial therapy with "Janumet" is not currently licensed and the fixed-dose combination drug is not currently available in some countries, such as the UK. Sitagliptin is a highly selective, once-daily DPP-4 inhibitor that enhances a natural body system called the incretin system, to help regulate blood sugar by increasing blood levels of active GLP-1 and GIP hormones; it inhibits DPP-4 over 24 hours.[ii] The fixed dose combination of sitagliptin and metformin targets all three key defects of diabetes: insulin deficiency from pancreatic beta cells, insulin resistance, and overproduction of glucose by the liver.[iii] Sitagliptin is the first approved medicine in the DPP-4 inhibitor class of oral treatments. It has been approved in over 80 countries and to-date, there have been more than 11.1 million prescriptions dispensed worldwide.[iv] Initial therapy with a fixed dose sitagliptin and metformin*1 This large, randomised, double-blind study of initial therapy with a fixed dose combination of sitagliptin and metformin, compared to metformin alone, involved 1,250 drug-naç¯ve patients** with a mean HbA1c*** baseline of 9.8 percent. Patients were randomized to sitagliptin/metformin (50/1,000 mg twice daily) or metformin (1,000 mg twice daily) for 44 weeks. The primary study hypotheses were addressed after 18 weeks. After 18 weeks, patients taking fixed dose combination of sitagliptin and metformin as initial therapy achieved mean HbA1c reductions from baseline of 2.4 percent (n=560), compared with 1.8 percent for patients taking metformin alone (n=566), a significant between-group difference of 0.6 percent (pAbout sitagliptin/metformin The combination of sitagliptin, a DPP-4 inhibitor, and metformin, a mainstay of diabetes therapy is indicated as an adjunct to diet and exercise to improve glycaemic control in patients with type 2 diabetes inadequately controlled on diet and exercise plus metformin alone or those already being treated with the combination of sitagliptin and metformin. The drug combination is also indicated for use in combination with a sulfonylurea (SU) as an adjunct to diet and exercise in patients inadequately controlled on metformin and an SU. The dose of antihyperglycaemic therapy with sitagliptin/metformin should be individualised on the basis of the patient"s current regimen, effectiveness, and tolerability while not exceeding the maximum recommended daily dose of 100mg sitagliptin.3 Sitagliptin/metformin is contraindicated in patients with: hypersensitivity to the active substances or to any of the excipients; diabetic ketoacidosis or diabetic pre-coma; moderate and severe renal impairment or abnormal creatinine clearance, acute conditions with the potential to alter renal function; acute or chronic disease which may cause tissue hypoxia; hepatic impairment; acute alcohol intoxication; alcoholism and lactation. This drug combination should not be used in patients with type 1 diabetes.3 Patients taking sitagliptin/metformin in combination with a sulfonylurea, a medication known to cause hypoglycaemia, may be at a higher risk of hypoglycaemia to those patients taking sitagliptin/metformin alone. Therefore, a reduction in the dose of the sulfonylurea may be required.3 References [i] Reasner C, Olansky L, Seck TL et al. Initial therapy with the fixed-dose combination of sitaglitptin and metformin (Janumet™) in patients with type 2 diabetes mellitus provides superior glycemic control and hemoglobin A1C goal attainment with lower rates of abdominal pain and diarrhea versus metformin alone. Data presented at ADA Congress 2009, New Orleans. [ii] JANUVIA European Public Assessment Report (EPAR), Product Information, 19/09/2008 Januvia-H-C-722-N-06. [iii] JANUMET European Public Assessment Report (EPAR), Product Information, 10/12/2008 Janumet BMS-H-C-861-IA-05. [iv] IMS Health, NPA™ Weekly, TRxs, week-ending October 20, 2006 through week-ending May 22, 2009. Data on file, Merck & Co., Inc. Merck, Sharp & Dohme


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