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2009-10-07T10:17:00.000-07:00

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2009-10-07T10:08:00.000-07:00

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2009-10-07T09:45:00.000-07:00

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2009-10-07T09:32:00.000-07:00

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2009-10-07T09:30:00.000-07:00

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2009-10-07T02:19:00.000-07:00

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2009-10-06T09:32:00.000-07:00

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2009-10-05T10:04:00.000-07:00

ezy roller

2009-10-05T09:53:00.000-07:00

buy some give to your love

2009-10-05T09:07:00.000-07:00

Cavichi nap mats

2009-10-03T01:45:00.000-07:00

Sent Give For Your Love

2009-10-03T01:38:00.001-07:00

Reduce Your Mortgage Payments

2009-10-03T01:27:00.000-07:00

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2009-10-03T01:16:00.000-07:00

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2009-10-03T00:54:00.000-07:00

You can get this type of loan of $ 10K to $ 100K without warranty. It makes you feel more secure in getting this to the Personal Loans without collateral? Naturally! With AFS LOANS ONLINE is a great place for this type of loan. Financial institution is the number 1 in America when it comes to loans without collateral may be for business or Personal.Beside personal loans without collateral, it has also many other loan options that you can choose, as the line of business credit without collateral, credit cards without collateral, and loans without personal guarantees. Each option has its pros and cons. It all falls to you to determine what is good for you, and the most important thing is just to ensure you get the best offer. Consumers and lenders realize that it is not easy to get a loan approval, since conditions are so tight that must be collected by the plaintiffs. Therefore, many company are ready to provide loans without collateral. For those of you who have difficulty obtaining the approval of loan recently, this may be your solution. There are so many places to get information on them. One of them is here. For more details visit PERSONAL LOAN | AFSLOANSONLINE.

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2009-10-01T05:45:00.000-07:00

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2009-10-01T05:27:00.000-07:00

buy gifts for your best friends

2009-09-17T05:10:00.000-07:00

Well, if you seek the braid of the point of COM of the cheaper lane of plait of nap is the best group of Web sites of Internet. Narrowly throw a glance of the children personalized of various designs the 'dishes of S, him 's beautiful and accessible. You can choose the best models to adapt to your needs.

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the cones of the coats, cones decorated with a monogram out of glass and more.

Oh also offer the envelopes of the mint of the envelope of towel wrap, roller ezy, adding the lunch, the places of the snack, bags of duffle, the laundry bag, covers of baby, personalized the cups sippy, the dishes, the covers made on the ordering of fabric deeply and soft, the personalized cups, personalized stamps, ink and much more. He 'majority of S of the popular gifts for not only the family but also their friends.

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2009-07-29T05:36:00.000-07:00

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Exciting iPhone

2009-06-23T06:42:00.000-07:00

Get Your Personal Loan

2009-06-23T05:28:00.000-07:00

Eat Less! Ageless medicine .. .. | Obat awet Muda

2008-12-29T04:43:00.001-08:00

Young durable, .. is a word that is always on and connected perbincangkan people in every opportunity, both in arisan women, arisan family, meet with old colleagues and others. But whether we actually know very well-preserved is easily found if we are patient menjalaninya. There are some people make themselves into the ageless polesan make up, consumption of certain foods, full-blooded circulatory, plastic surgery and others. All the people certainly want to always look fresh and young and look beautiful. Any way you can go to well-preserved, rather than waste money buying products for the cosmetics or medicines that ageless better see the tips and do this in order to reach keiginan dihati. These tips from you will know that the delay appeared to penuaan easily done.
As Edward Weiss made by a researcher from the University of Saint Louis, United States conducted research on women and men aged 50-60 years who do not smoke, does not Obesity, and have a healthy lifestyle so detikhot quoted from MSNBC, Friday (1 / 8 / 2008), namely the capacity to eat where Feed automatically reduce calories in the body. The understanding here is the entry of food into our bodies every day with regularly but do not reduce the value of nutrition needed by the body. And the second is to avoid eating too satisfied that we can create a glut in the sick body to become weak and not forceful. Reducing food can also make our bodies to be ideal; calories there are in the thyroid hormone is one of the effect is accelerating metabolime body. When hormones are reduced the process penuaan also be slow.
Research was conducted over a year, divided into three groups and the three groups together have a decrease in cholesterol level, fat and body weight. However, the decreasing rate thyroid only the first group. The first average kalorinya to reduce the number of 300-500 per day, the researchers also menjelaska that the food is not only slow penuaan, the effects of calorie reduction berimbas also on the more healthy lifestyle, body shape and a good (ideal).

Nursing patients with GLOMERULO NEFRITIS

2008-12-14T02:25:00.001-08:00

I. Definitions
Glomerulo nefritis acute is the term widely used, which refers to a group of kidney diseases in which inflammation occurs in glamerulus. (Brunner and Suddarth, 2001).
Glamerulo nefritis is peradanga and damage to the equipment filters the blood capillaries while kidney (Glamerulus), (Japaries, willie, 1993).
Glamerulus nefritis syndrome is a ditadai by inflammation of glemerulus followed by the establishment of several antigens (Engran, Barbara, 1999).

II.Etiologi
Streptococcus bacteria.
Communication with auto-immune diseases other.
Reaction drugs.
Bacteria.
Virus.

III.Manifestasi Clinic
Faringitis or tansiktis.
Fever
Headache
Malaise.
Pelvic pain
Hypertension
Anoreksi
Vomiting
Ederma acute
Oliguri
Proteinuri
Brown-colored urine.

IV.Patofisiologi
Prokferusi cellular (peningkata cell production endotel; is yag stucco glomerulus), infilaltrasi lekosit to glameruus, and penebalan membranes or membrane filbtrasi glamerulus basalt generate network kehilagan surface of the stomach and filters. In glamerulo nefritis acute kidney swell, swelling and congestion.
In fact the case, the reaction is the stimulation of infection by bacteria in the steeptococus A tengorok, which biasayang precede glomerulo nefritis intervals until 2 - 3 weeks. Product streptacocus act as antinge, bersirkulasi stimulating antibody that causes kidney injuries.

Dealing medical V.
Anti hipertensif
Anti dkurektik
Infection with antibiotics streptokokal set.
Anti-Biotic profilaktif during pemuliha
Enter and output.
TTV 2 - 4 hours.
Sodium restriction.

VI.Pemeriksaan diagnostic
Urinalisis (UA) shows gross hematnya, protein and dismonfik (not suited) human resources, leusit, and gypsum hialin.
Rows filtration glomeruslus (IFG) meurun, klerins kreatinin on unrin used as a gauge spesine urine and LFG gathered 24 hours. Samples of blood for kreatinin also be featured with the way games all around flow (midstream).
Blood urea nitrogen (BUN) and serum menigkat when kreatinin kidney function started to decline.
Albumin and serum total protein may be normal or slightly down (because hemodilusi).
Example eletrokoresisi to random urine protein mengidenti filaasi types of urine protein in the urine issued.
What electrolyte Sodium and shows improvement or increase the normal rates, and potassium chloride.

VII.Potensial complications
Hypertension.
Dekopensasi heart
GGA (Kidney Failure Akut)

Nursing VIII.Asuhan
Assessments.
1.Identitas patients.
2.Riwayat disease, first, and now the family.
3.Riwayat / of the risk factors.
a.Bagaimana frequency miksinya, whether there are:
b.Adakah aberration time miksi such as:
c.Apakah pain there is in the local area or in Unum.
d.Apakah disease arising after the peyakit the other.
e.Apakah there is nausea and vomiting.
f.Apakah there is oedema.
g.Bagaimana circumstances urinnya (volume, color, smell, weight, type, number of urie in 24 hours).
h.Adakah sekret or blood out.
i.Adakah hambantan sexual.
j.Bagaimana history, menstruation (menache, duration, many, sirkulasinya, keluhannya).
k.Bagaimana Historical pregnancy, arbortus, the use of kontrsepsi.
l.Rasa pain (location, identity, the emergence of pain).
m.Riwayat Maternity.
Bleeding n.Riwayat.
4. Physical data:
Inspection:
in general and specifically in the genital area palpasi:
daeraha on bdomen, jar, fold the thigh.
Auskultasi: blood abdomen.
Percussion: regional abdomen, kidney.
Keadaa general patients:
The level of awareness.
Eliputi vital high tension, pulse, temperature, breathing.

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Partofthegame.tv Carlsberg

2008-12-02T07:39:00.000-08:00

V današnjem času, kot je to civilizacija in je bilo omrežje zelo hitro razvijajo,
tukaj smo pokazati primeru spletne online Programi TV, in smo potrebovali posebno na nogometnih Account Manager / Finance Manager.
V našem programu boste uživali dogodkov v živo ne sitnost gledaš za trde SportsCenter drugih omrežij včasih pogosto napako.
Zagotavljamo tudi različne druge programe, ki vam zabavo,
Več informacij obiščite kliknite tukaj Partofthegame.tv Carlsberg in spletna televizija. Pridružite se nam čim prej dobiš v primeru, da hočeš.

www.partofthegame.tv

http://metrowords.com/2008/08/mercenaries-2-commercial-song/

2008-08-21T12:18:00.000-07:00

2 up on Marketplace. The only gripe I have is seeing other people still. ‘Xbox mercenaries 2 commercial song Originals’ and. Quick GHIII question. Can I mod my regular Xbox so it will play
360 games ‘Xbox Originals’ and. Quick GHIII question. Can I mod my regular Xbox so it will play 360 games 2

health for heart

2008-08-16T23:51:00.000-07:00

Taking care of your heart

Coronary heart disease is the biggest killer in the UK. But medical advances mean that having heart disease is no longer a death sentence and there are lots of things that you can do to reduce your risk. Visit our useful contacts list for organisations that can help.

New Bullseye for Cancer Treatment: A Gene Called KRAS

2008-08-16T02:19:00.001-07:00

New Bullseye for Cancer Treatment: A Gene Called KRAS

Posted by Jacob Goldstein

Among the 5,000 studies being discussed by 30,000 oncologists at this weekend’s meeting of American Society of Clinical Oncology, listen for the buzz over a single gene.

It’s called KRAS, and a growing body of evidence suggests that cancers with the standard form of this gene respond better to an important class of cancer drugs than tumors with a common mutation of the gene. The class of cancer drugs, known as EGFR inhibitors, includes Imclone’s Erbitux and Amgen’s Vectibix, as well as several experimental drugs.

Data from one of the most eagerly awaited studies of the weekend will show how colorectal cancer patients with the KRAS mutation respond to Erbitux, compared to those whose cancer has the standard form of the gene. While those data haven’t been published yet, data from plenty of other KRAS studies on this weekend’s agenda were posted online a few weeks ago — including this one, which suggested Erbitux works better in patients who had the normal form of the gene.

Indeed, searching the ASCO abstracts for KRAS turns up nearly 300 results. (You can sort through them yourself here.

While studies of KRAS are continuing, the industry is already betting that the connection will hold up. In a recent phone interview, Pfizer’s Charles Baum, in oncology R&D, told the Health Blog that the company is testing an experimental drug that blocks EGFR (as well as a few other receptors) in patients who have the standard form of the gene.

And as Dow Jones Newswires notes, drug makers including AstraZeneca are also rummaging through the drawers looking for molecules that may work in patients who do have the KRAS mutation — and who may need alternatives to EGFR inhibitors.

Update: Just today, European regulators recommended that Erbitux be approved as first-line therapy for advanced colorectal cancer — but only in patients who have the standard form of the KRAS gene (sometimes referred to as “wild type”). Here’s the announcement from Merck KGaA, which markets Erbitux in Europe.

DNA image via Wikimedia Commons

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Medicare Expands List of ‘No-Pay’ Hospital Conditions

2008-08-09T08:38:00.000-07:00

Posted by Jacob Goldstein

The list of hospital treatments that Medicare won’t pay for is growing, but not by as much as the feds initially suggested it might.

The Centers for Medicare and Medicaid Services said last year it would stop paying to treat certain complications it said were preventable with good care. (We described the initial list in this post.) Earlier this year, CMS said it could add nine more complications to the list.

CMS said yesterday that after considering public comments, it was adding three conditions:

Blood clots in patients after surgery for knee and hip replacements
Surgical site infections after certain elective procedures, including some orthopedic surgeries and bariatric surgery
Certain major problems that result from failing to control blood sugar levels after a patient is hospitalized

It’s pretty easy to agree that Medicare shouldn’t be paying for preventable errors, such as leaving items inside patients during surgery (one of the conditions on the initial no-pay list). But there are arguments from some quarters that the new items on the list aren’t always preventable, and therefore don’t belong on the no-pay list.

For example, even with the best treatment, blood clots remain relatively common in patients after knee and hip replacements, according to the Society of Hospital Medicine, a national group of hospital-based docs. What’s more, the new rules could add incentives for hospitals to over-use blood thinners in an effort to drive rates down, Patrcick Torcson, who chairs the society’s performance and standards committee, told the Health Blog today.

On the other hand, the blood sugar-related conditions are appropriate for the no-pay list because “complications from uncontrolled blood sugars in diabetics can be reasonably prevented” in hospitalized patients, Torcson said.

Health Blog Bonus Question: Do these three conditions belong on the Medicare no-pay list?

For Elderly, Prostate Cancer Screening May Harm More Than Help

2008-08-09T08:34:00.000-07:00

Posted by Jacob Goldstein

Men 75 and older shouldn’t be screened for prostate cancer because the risks associated with screening and the stress of false alarms outweigh the benefits of detecting the disease.

Those were the conclusions announced yesterday by the U.S. Preventive Services Task Force, an independent panel of experts convened by the feds to establish guidelines for screening tests and other kinds of preventive medicine.

Prostate cancer is very common, but the disease often progresses so slowly that men, especially older ones, die of other causes before the cancer causes any problems. So screening, usually with a test called PSA, for the disease means you wind up giving surgery and radiation to some men whose cancers would have been fine if left alone.

“People say, ‘What’s the harm in screening?’ ” Howard Parnes of the National Cancer Institute told the Washington Post. “In fact, there are several ways in which screening can actually be harmful,” he said.

The challenge is balancing the harm associated with cancer treatments — which can include incontinence, impotence and, in rare cases, death — against the benefits of preventing the spread of aggressive forms of the disease, which is the second leading cause of cancer death in men.

The guidelines apply only to screening for men who show no signs of the disease, and don’t apply to treatment for men who go to the doctor with potential symptoms, such as painful urination or blood in the urine or semen, the New York Times notes.

Some doctors rejected the recommendation, saying it smacked of ageism and cost control by insurers. “It sounds like a regulation promulgated by an HMO” to save money, Dudley Danoff, a Los Angeles urologist told the L.A. Times. “I don’t think it is fair to a guy who is 75. Yesterday’s 75 is not the 75 of the 1950s.”

Update: For more on the risks and benefits of screening for younger as well as older men, see this Health Blog post.

Image of prostate cancer cells via Wikimedia Commons

GAO Fakes Out Medicare in Undercover Equipment Scam

2008-08-09T08:33:00.002-07:00

Posted by Sarah Rubenstein

Medicare is pretty easily duped, we learned from a Government Accountability Office report out today on problems in the cost of wheelchairs and other supplies.

We have to say that we’ve read more than our fair share of wonky reports about health care, and probably found them more entertaining than we should have. But this one sets a new standard for unintentional fun.

The GAO was checking up on whether Medicare has enough safeguards in place to prevent fraudulent billing for durable medical equipment like wheelchairs and walkers. So the investigators for GAO went undercover and created two fake companies specializing in “DMEPOS,” a mellifluous acronym for “durable medical equipment, prosthetics, orthotics and supplies.”

GAO went so far as to use undercover bank accounts and rent commercial offices for the companies, which purportedly sold “commodes, diabetic supplies, surgical dressings, urinals and bedpans, walkers and canes, and manual wheelchairs.” It then tested whether they could get Medicare billing privileges despite their having no customers and no products in stock.

A Medicare contractor that screens suppliers visited the companies’ offices, and Medicare initially denied their applications in part because the vendors had no inventory. The GAO then fabricated contracts with nonexistent wholesale suppliers. And it left a contact number for those contracts that rang at an “unmanned undercover telephone in the GAO building,” the report says. When Medicare’s contractor left a message there requesting more info, a GAO investigator left “a vague message in return” pretending to be the supplier.

Voila! Medicare billing number granted.

“Once criminals have similarly created fictitious DMEPOS companies, they typically steal or illegally buy Medicare beneficiary numbers and physician identification numbers and use them to repeatedly submit claims,” GAO said.

Read the lurid cat-and-mouse tale in its entirety here.

Medicare spokesman Jeff Nelligan told the Health Blog that Medicare has started a new program requiring accreditation of such suppliers, and it’s led to revocations of some suppliers’ billing privileges. (The program will be fully rolled out by September 2009.)

Medicare is also implementing rules that will, among other things, require that suppliers keep supporting paperwork from doctors and limit the use of cellphones and pagers as a primary business number. Nelligan also noted that Congress recently delayed a competitive-bidding program for durable medical equipment.

Photo: iStockphoto

Clinton on AIDS: ‘We Should Do More At Home’

2008-08-09T08:33:00.001-07:00

Posted by Jacob Goldstein

Bill Clinton, who has made fighting AIDS in the developing world a central theme of his post-presidency, called for more effort to fight the disease in the U.S.

He spoke yesterday at the big international AIDS conference on now in Mexico City.

Earlier at the conference, the CDC said it had been radically undercounting the number of new HIV infections per year in the U.S. — raising its estimate to more than 56,000 per year, from 40,000 per year. (Click on the video at left for more on that issue.)

That revision “should be a wake-up call,” Clinton said. “We should do more at home, and I intend to do so.”

Speaking to an audience of thousands, Clinton said “AIDS is a big dragon … [that] must be slain by millions and millions of foot soldiers.”

Clinton didn’t provide specifics on how he intends to focus more on AIDS in the U.S., the Washington Post says.

But one idea being discussed at the conference is taking some of the $50 billion the U.S. has allocated for fighting AIDS abroad and spending it domestically, to shore up gaps in care and improve prevention, especially among hard-hit minority groups, the WSJ reports.

In Canada, Doctors Use Lottery to Drop Patients

2008-08-09T08:31:00.000-07:00

Posted by Jacob Goldstein

Canada’s medical system is radically different from ours, but there’s at least one thing we have in common: a shortage of primary care doctors.

Now comes word from up north that a few overwhelmed primary care docs are using lotteries to kick patients out of their practices, while others are drawing names to choose new patients.

One family physician got rid of about 100 patients in two separate draws, Canada’s National Post reports. Ken Runciman, based in Powassan, Ontario, recently bought the 2,000-patient practice, which he says was busier than he’d been led to believe. He concluded that keeping all the patients wouldn’t have allowed him to spend enough time with each.

A new family practice in Newfoundland held a lottery last month to pick patients from thousands of applicants, the Post says. An Edmonton doctor used a lottery to cut 500 people from his heavy caseload. And Ontario regulators have received several reports of similar drawings.

Some five million Canadians don’t have a primary care doctor, the article says.

“There is only a certain number of people I can see in a day. My day is already 11 hours and I don’t care for it being longer,” Runciman told the Post. “I realize that, at 47, I can’t run my ass off like I did 20 years ago.”

Bonus Drawing: Health lotteries aren’t uniquely Canadian. Oregon recently held a lottery to determine which lucky residents would win state-subsidized insurance.

As Urgent Care Grows, Watchdogs Circle

2008-08-09T08:30:00.000-07:00

Posted by Jacob Goldstein

The number of emergency rooms has been falling in recent years, as the number of people heading into the ER has been climbing.

Urgent care centers — doc-in-a-box outfits that handle urgent health problems that aren’t life-threatening — have been growing to take up some of the slack.

But, this morning’s WSJ notes, urgent care has remained largely unregulated. Urgent care doctors and nurses do have to be licensed the same as health care providers anywhere else, but there are no national standards for what urgent care centers should offer, or what quality measures they should meet.

That looks likely to change. The Urgent Care Association of America recently made a deal with the Joint Commission, the group that accredits the nation’s hospitals, to accredit urgent care centers and publish national quality standards by 2010.

While many insurers already pay for some urgent care services, accreditation could lead to better reimbursements. “We’d look far more favorably at an urgent-care clinic that was accredited than one that wasn’t,” Troy Brennan, chief medical officer at Aetna, tells the WSJ. “[I]t means an organization is taking a hard look at a variety of safety issues that should be involved in caring for someone who is acutely ill.”

Lingering Pain from the Anthrax Attacks: Cipro Side Effects

2008-08-09T08:29:00.001-07:00

Posted by Jacob Goldstein

In 2001, John Angell was working as staff director for Max Baucus (D-Mont.) in the powerful Senate Finance Committee. Like hundreds of other Senate workers, he started taking the antibiotic Cipro as a preventive measure against anthrax after letters laced with infectious spores arrived at senators’ offices.

A few days later, he felt pain in both his Achilles tendons. A week after that, the pain had grown so bad that he talked to a doctor, who switched him to another antibiotic. But the pain didn’t go away, and nearly seven years later, Angell still walks with a cane and can’t hike or play tennis the way he used to.

Like the rest of America, the Health Blog has been reading a lot about anthrax this week, but until we chatted with Angell we hadn’t thought to connect the 2001 attacks with the tendon problems the drug causes in rare cases. Indeed, Angell told us he wasn’t aware of any other Senate staffers having problems associated with Cipro.

Only last month that the FDA told makers of Cipro and other drugs in its class, known as fluoroquinolones, to add a black-box warning to flag the risk of tendinitis and tendon rupture associated with the drugs.

Bayer sells branded Cipro; the drug is also available generically as ciprofloxacin. In a statement emailed to the Health Blog, a Bayer spokesman said that “Bayer believes Cipro is well tolerated and effective in all approved indications when used in accordance with current product labeling, and that it has a positive benefit-risk profile in all approved indications.”

Angell says his problem grew so bad that he became largely immobile, and missed a lot of work. He spent a week in a rehab hospital, where he was “either in bed, in a wheelchair or in a swimming pool.” The swimming did seem to help, and he now hits the pool at least three times a week.

Missing all that work, he was unable to keep his old job, and now he serves as a senior adviser to the committee. Despite the impressive-sounding title, his new job is less senior than his role as staff director.

“I can go to work, I can swim, I can go to the grocery store,” he says. “I have a life, but I don’t have the life I used to have.”

Associated Press photo of workers outside the Hart Senate Office Building, November 2001

AIDS Anthology Reveals Another India

2008-08-09T08:27:00.000-07:00

Posted by Marilyn Chase

At every International AIDS Conference, set apart from the meeting halls where science and politics battle, there’s a place called the Global Village.

It’s a fleeting community where HIV-positive people and their advocates create a week-long DMZ free of stigma. The vibe is equal parts cultural exhibition and carnival sideshow. Giant strolling condoms are perennial mascots.

The village in Mexico City this year also featured a literary lounge where visitors could hear readings from the book: “AIDS Sutra: Untold Stories from India.” The pungent chili-colored hardcover I reviewed contains 16 pieces– essays, stories and poetry - by contributors including Salman Rushdie, Kiran Desai and Vikram Seth.

There’s an introduction by Bill and Melinda Gates, whose foundation-funded Avahan India AIDS Initiative organized the book. It’s being published by Random House. Proceeds from the book will go to a fund to support children affected by the epidemic.

A foreword by Nobel Prize-winning economist Amartya Sen tries to make sense of the vast and shifting estimates of AIDS’ impact on the world and India. He tartly observes the CIA’s wildly off base National Intelligence Estimate of 20 million cases of AIDS in India by 2010 “showed how easily an organization dedicated to intelligence can fail to give much evidence of it.” The UN’s 5 million estimate for HIV/AIDS in India was halved last year to between 2 and 3 million, he adds.

The writers here offset the numbing anonymity of numbers with portraits of stunning particularity. In Nikita Lalwani’s “Mister X Versus Hospital Y,” we meet Toku, a quiet physician who cares for AIDS patients and went to court to fight for the right to confidentiality of HIV test results — his own.

In “Love in the Time of Positives,” Nalini Jones introduces Jayanthi, a young woman who was rushed into an arranged marriage with an older tractor driver who left her an HIV-positive widow. Jayanthi and her peers talk about courtship, remarriage and family with the virus as a permanent houseguest.

In “The Half-Woman God,” Salman Rushdie educates us about the hijras, India’s gender-bending demi-deities who offer blessings at family celebrations and blend ancient tradition with 21st Century risk.

Vikram Seth, author of “A Suitable Boy,” contributed a poem as time capsule of AIDS in the 1980s called “Soon.” The speaker isn’t Seth, he stresses in an accompanying essay, noting he’d been relatively chaste, tested negative, and observant of safe behavior ever since. Seth’s patient, tethered by tubes to a metal hospital bed, considers his imminent death by HIV. Like Thom Gunn’s “The Man With Night Sweats,” Mr. Seth couples love and grief in the era before effective treatment.

Now in India, as elsewhere, there is better testing, medical treatment, and a vibrant prevention movement that treats people not as passive recipients of care but as participants in it.

The writing in the anthology is by turns tortured and beautiful as writers show us the people behind stereotypes.

Author Sonia Faleiro, told me in an interview that she worked months to report and write her harrowing story “Maarne Ka, Bhagane Ka,” (”Beat them, kick them out”), profiling Savita, a streetwalker bludgeoned by railway police for distributing protection to her coworkers in the trade that gives them “frail armour against destitution.”

This is a world I glimpsed in 2004 when I reported a story from Delhi and Mysore truck stops and brothel-based clinics opened by the Gates Foundation. I didn’t meet Savita but her sister in the trade, Prathima, who was sold into the life by a dishonest job broker. From living on a sidewalk, she raised herself to become a community leader. Under a saffron sunset, I accompanied her team inviting women soliciting on street corners to the clinic.

In “AIDS Sutra,” I took a refresher course in the lessons she taught.

Photo: Random House

Cleveland Clinic Clamps Down on Boston Scientific Stents

2008-08-09T08:26:00.000-07:00

Posted by Jacob Goldstein

Not only do stent giants Boston Scientific and Johnson & Johnson have to contend with weak sales of drug-coated stents, they also have to worry about next-generation stents from Medtronic and Abbott Labs.

We were reminded of the tough market for stents again this morning, when we read that Boston Scientific stents were apparently frozen out from the Cleveland Clinic, which is among the nation’s most prestigious cardiology centers. Dow Jones Newswires has the story.

J&J, Medtronic and Abbott all said they’ll be selling stents to the Cleveland Clinic, which wants its doctors to sample a range of devices–other than Boston Scientific’s. After the test period, the Clinic expects to narrow the field to one or two products, an official told Dow Jones.

Boston Scientific, which in 2006 inked an 18-month deal to be the clinic’s preferred vendor, wouldn’t comment.

The Medtronic and Abbott stents were both approved earlier this year. Boston Scientific is working to get a next-generation version of its Taxus stent approved for sale in the U.S., Dow Jones notes.

Image from Abbott

How to Take Your Food Allergies Out to Dinner

2008-08-09T08:25:00.001-07:00

Posted by Scott Hensley

A tony restaurant can be a health obstacle course, filled with hidden dangers for people with food allergies. Worries about the allergens that may lurk in an innocuous-looking dish are enough to dissuade some allergy sufferers from eating out at all.

The WSJ’s Beckey Bright reports on options and precautions for diners who can’t tolerate some common foods and ingredients. War stories include the touch of soy sauce that quickly led one allergic woman to feel itching like ants were crawling up her pants.

“First of all you have to recognize that the fear is real,” says Sloane Miller, president of Allergic Girl Resources. “However, there are ways to manage that fear.”

Miller’s allergic to tree nuts, salmon, eggplant and most tropical fruit. She founded Worry-Free Dinners, a club for people with food allergies that arranges special meals in New York and beyond.

Rule No. 1 for worried diners: Make sure the waiter understands and respects what you’re talking about. If you have any doubts, get up and walk out of the restaurant, top chefs told Miller. If the waiter doesn’t get the message, the folks in the kitchen never will.

Wider Use of AIDS Drugs Could Curb HIV Infections

2008-08-09T08:23:00.000-07:00

Posted by Marilyn Chase

Setbacks in the quest for a vaccine against AIDS are leading researchers to think about other ways to cut HIV infections.

Julio Montaner

Some drug experts at the 17th International AIDS Conference in Mexico City say countries should vastly expand drug treatment to all in need. Not only because relief from suffering is a human right, but because using drugs to lower the amount of HIV in infected people’s blood on a massive, population-wide scale may lower transmission, Vancouver researcher Julio Montaner tells the Health Blog.

Drugs as a shield against AIDS is already a hot topic around the PrEP trials, which seek to keep some 20,000 uninfected volunteers around the world from becoming infected with HIV, an intervention called primary prevention.

But what Montaner has in mind is secondary prevention: keeping HIV-positive folks from passing on the virus by making sure everyone who needs them gets powerful antiviral drug cocktails to push their HIV burdens to undetectable levels.

Preliminary studies in Taiwan and Vancouver offer hope for this, says Montaner, incoming president of the International AIDS Society. But few here go as far as a Swiss report in January suggesting AIDS drugs could obviate the need for condoms if couples agree. That’s a gamble far too risky in the view of most experts here who promote a prevention toolkit that includes testing, treatment, behavior change, condoms and more.

The World Health Organization’s top AIDS official Kevin De Cock tells us he’s waiting for data to validate drugs as preventatives. “There’s biological plausibility,” he told us, “but not proven efficacy.”

Photo from HIV Resistance Response Database Initiative

UK Says Kidney Cancer Drugs Aren’t Worth the Cost

2008-08-09T08:16:00.000-07:00

Posted by Jacob Goldstein

Is extending life by a few months worth $50,000? No, says the UK’s National Institute for Health and Clinical Excellence.

In a report out today, the group concluded that several new drugs for advanced kidney cancer aren’t cost-effective.

In the past few years, Pfizer’s Sutent, Wyeth’s Torisel, Nexavar from Onyx and Bayer and Avastin from Roche and Genentech have been shown to slow the progression of kidney cancer and, in some cases, to extend patients’ lives for a few weeks or months on average. (Avastin has been approved in the EU for kidney cancer, but not in the U.S.)

But giving the drugs costs £20,000 to £35,000 (roughly $40,000 to $70,000) per patient per year in England, the Times of London reports.

That high price isn’t worth the benefit conferred by the drugs, NICE concluded, and buying the drugs would force the National Health System to deny patients other treatments that are a better bang for the pound. The cost-effectiveness limit for NICE is £30,000 per good-quality year of life gained, the Times says.

One cancer doctor told the Times the decision was “an outrage” and a “devastating blow to the kidney cancer community.”

Today’s report, a draft guidance, won’t be the final word on the issue. After a meeting later this year, NICE will issue a final ruling. But even that can be challenged in court; Pfizer and Esai recently won on appeal when they challenged NICE’s rejection of the Alzheimer’s drug Aricept.

Kidney via Wikimedia Commons