Matt's Blog

Democratic Presidential Candidate Clinton To Announce Health Care Proposal at
Iowa Hospital
Democratic presidential candidate Sen. Hillary Rodham Clinton (D) on Monday
plans to announce the details of her proposal to provide universal health
coverage at a hospital in Des Moines, Iowa, Long Island Newsday reports.
According to individuals familiar with the proposal, the plan would:
a.. Require that all U.S. residents obtain health insurance;
b.. Require large employers to contribute towards coverage for employees and
provide tax subsidies to small businesses to aid in the cost of providing
coverage to workers;
c.. Establish large "purchasing pools" to reduce the cost of individual health
insurance and mandate that health insurers cannot deny coverage because of
pre-existing medical conditions (Thrush, Long Island Newsday, 9/16);
d.. Subsidize the cost of health insurance for lower-income residents
(Meckler, Wall Street Journal, 9/17); and
e.. Allow residents without health insurance or with inadequate coverage to
participate in a plan similar to Medicare or the Federal Employees Health
Benefits Program (Fouhy, AP/Miami Herald, 9/17).
Clinton would fund the proposal in part with the elimination of tax cuts
proposed by President Bush and approved by Congress for households with annual
incomes of more than $250,000, individuals familiar with the proposal said (Long
Island Newsday, 9/16). In May, Clinton announced a proposal to reduce health
care costs during a speech at George Washington University, and she announced a
plan to improve quality last month.
Comments
Kaiser Family Foundation President Drew Altman said that Clinton "starts off
with an edge ... not because the voters have scrutinized the details of anyone's
plans ... but just because they so closely associate her with the issue." The
paper cites a recent poll by the Kaiser Family Foundation showing that Clinton
is the candidate seen as best representing the views of Democrats on health care
(Feldman, Christian Science Monitor, 9/17).
Jonathan Cohn, author of "Sick: The Untold Story of America's Health Care
Crisis" and a fellow at the Demos network, said, "I don't think she's got a lot
to prove on health care at this point, she's already got a tremendous amount of
credibility on the issue. Clearly the lesson everyone has taken from 1994 is
that she was too ambitious, so I think she's not going to be as bold or
challenge people as much this time around."
Carol McDaid, a health care industry lobbyist said, "She first made a lot of
these proposals in 1993, and they were regarded as revolutionary. Now it doesn't
seem so revolutionary; it's in the mainstream" (Long Island Newsday, 9/16).
Karen Ignagni, CEO of America's Health Insurance Plans, said, "We're in a
different place than we were," adding, "I think that both sides are going to
have to be very, very careful. The sweet spot in the middle is trying to create
a workable program that individuals who currently have coverage believe is the
right direction and will not cause them to lose coverage" (AP/St. Petersburg
Times, 9/16).
A webcast of Clinton's speech will be available on health08.org later today.
Health Care as Campaign Issue
According to the New York Times, the "debate over health care on the
presidential campaign trail is increasingly ideological, as candidates woo their
core constituents on the right and the left." Republican candidates have
criticized the health care proposals of Democratic candidates as "nothing short
of socialism," and Democratic candidates "are moving toward an increasingly
populist attack on the big economic interests, like the insurance industry," the
Times reports (Toner, New York Times, 9/16).
Altman said, "There's no question there will be a lot of mud-slinging and
demagoguery" on the health care issues during the presidential campaign. He
added, "Already, we've heard the Republicans calling the Democratic approach
socialized medicine, and, for all we know, the Democrats will call the
Republican approach Dickensian capitalism. Beneath all that, there are actually
very different, sincerely held ideology and policy beliefs about which way
health care should go" (Christian Science Monitor, 9/17).
SEIU Endorsement
In other election news, presidential candidate and former Sen. John Edwards
(D-N.C.) has the support of more members of the Service Employees International
Union than any other candidate but does not have the support of the 60% of
members required to receive the endorsement from the union, SEIU President Andy
Stern said, Bloomberg reports. Stern said, "Edwards has done an awful lot with
leaders and members in our union."
About 2,000 SEIU leaders on Sept. 17 in Washington, D.C., will hear speeches
from most Democratic presidential candidates and take a straw poll to help
determine who will receive the endorsement from the union (Chipman/Przybyla,
Bloomberg, 9/14).
Broadcast Coverage
ABC's "World News" on Sunday reported on the expected announcement from
Clinton. The segment included comments from Clinton; Norman Ornstein, a
political analyst at the American Enterprise Institute; and presidential
candidate and former Massachusetts Gov. Mitt Romney (R) (Marlantes, "World
News," 9/16). Video of the segment is available online. Expanded ABC News
coverage is available online.
In related news, NPR's "All Things Considered" on Sunday included a discussion
with Bob Laszewski, a health care policy consultant, about the proposals of
presidential candidates (Adams, "All Things Considered," NPR, 9/16). Audio of
the segment is available online.
http://www.kaisernetwork.org/daily_reports/health2008dr.cfm?DR_ID=47542

Life and Death: Finding a Donor
One Man's Struggle to Find a Liver Donor
By JOHN DONVAN
Sept. 17, 2007
We first met Stephen Dziemian earlier this year. His wife, Corey, was with him
as he visited a series of doctors. And it was clear he was very sick.
Back in February, Dr. James Pomposelli told Dziemian that his chances of dying
from liver disease within three months were a little more than 10 percent.
On that first day we saw him, Dziemian's liver had been failing slowly for
years, and his skin was turning yellow. He had a disease called primary
sclerosing cholangitis.
Dziemian was finally at the point where he was going to need a new liver, and in
some ways, he wasn't ready to hear it. "I don't feel good, but I don't feel that
bad, though," he told ABC News. "I don't feel like I'm really at that point yet
where I'm worried I'm going to die, or anything. I certainly don't feel like
that."
At this point, Dziemian was 36, a dad with a 3-year-old daughter, Elizabeth. He
was employed in the printing center of Holy Cross College in Worcester, Mass. He
held a second job as a salesman at Pure Hockey, a hockey supply chain, because
hockey was his life, and he played all the time, even though he'd been sick
since 1992.
The prospect of going through a liver transplant seemed like something he could
put off forever.
But doctors told Dziemian it was literally do or die time.
Search for a Donor
The hard facts were that Dziemian needed a new liver fast, but the waiting list
was months long - possibly too long - to get one from the organ bank that is
supplied with organs from the deceased.
But there was another option to save his life. The doctors told him to look to
his family, and to his friends. In a sense, the people in the picture frames on
his own mantelpiece - one of them could be a possible donor - a living donor.
But in requesting a liver donation, Dziemian was asking his family and friends
to take a big risk, because the healthy donor in these cases routinely gets sick
- sometimes, sicker than the person who needs the liver.
Doctors explained to Dziemian that he needed to ask people close to him. "The
way it was explained to me was, 'We really would be more comfortable if you were
to ask family members, or ask friends, close friends,' he said. "I think the way
they said it was 'friends you have an emotional relationship with.'"
And in that category, of course, was Dziemian's wife.
But the doctors didn't want that, because the Dziemians had a young daughter.
"When we approached the doctors about it, they really kind of said, 'No. If your
daughter was a lot older, maybe we'd consider it, but with a 3-year-old
daughter, it's really not an option, because if something happens, she'd be left
without both parents," Corey said.
Corey, typically the tough one, was scared. "The thought of losing him is just,
you know, too much."
The next news was bad news for Dziemian, because the first people he had turned
to were his brothers. His older brother, Neil, had already proved to have the
wrong blood type. That left his younger brother, David, a 30-year-old
photographer.
When it came time to ask his brother for help, Dziemian found it difficult to be
direct. "I basically handed them a pamphlet and said, 'This is something the
hospital would like me to consider doing.' To this day, I haven't asked somebody
to do it. I don't know, it just feels funny to ask somebody to make that kind of
commitment, or life-altering, possibly life-altering change in their life."
But David got the point.
"I could see it in his eyes, how he asked me, that it was probably one of the
hardest things he's ever had to do," David said.
And so David stepped forward and went for the medical checks to make sure he was
a good match in all ways - not just blood type - but the more the doctors told
him, the more he worried about what he'd signed on for.
Dr. Elizabeth Pomfret at the Lahey Clinic in Burlington, Mass., told David that
"the estimated chance of dying or having a catastrophe that's quoted in this
circumstance is somewhere about a half a percent range. But as I say to people,
'You don't half a percent die. You're either alive or dead at the end of the
day, and the whole purpose of the evaluation is to be able to assess your
risk.'"
In the end, David did not have to make the difficult decision of putting his
life at risk. Tests revealed that his blood did not clot well enough to make him
a candidate. And David was partly relieved to hear that.
"[I] just kind of have some mixed emotions about that - a little bit sad, but a
little bit relieved at the same time," he said.
Stephen had much the same reaction. "In some ways, when I found out about my
brother, a little part of me was happy, because now he doesn't have to go
through this."
"[I] just kind of have some mixed emotions about that - a little bit sad, but a
little bit relieved at the same time," he said.
Stephen had much the same reaction. "In some ways, when I found out about my
brother, a little part of me was happy, because now he doesn't have to go
through this."
It was a generous response, but Dziemian was still in very serious trouble.
The Search Continues
But in one 24-hour period, Dziemian received three phone calls that gave him new
hope. Three different men - not members of his family - had heard about his
situation, and stepped forward to volunteer to be his liver donors. All three
went to the Lahey Clinic to fill out paperwork and get a preliminary
examination. They also - one-on-one - were briefed about the risks.
Then, in an awkward moment, they were asked as a group to make a huge decision.
The first candidate - Dziemian's stepsister's fiancé - had the same blood
clotting problem as David.
The second candidate - a former roommate of Dziemian's - decided not to go
through with it, because his wife was just one month away from giving birth.
That left only one last possibility - a man named Carlo Morrisey, who hardly
knew Dziemian (he's the uncle of a good friend of Dziemian).
And so, in this 17th week, Morrisey - a high school psychologist, who, at 56,
was, at first, told he was too old to volunteer - is now the candidate.
But, Pomfret had her doubts. "I told Carlo that he wouldn't be my first choice,
because of his BMI [body mass index]. We've got a very good likelihood that we'd
have some fatty infiltration in his liver."
But, with no one else stepping forward now, Morrisey proved to be a good enough
candidate.
So, on an early Wednesday morning, this man who barely knew Dziemian, went to
Lahey Clinic to save his life, which meant going under the knife. They were
going to need 60 percent of his liver.
Why would this man make a sacrifice like that?
In the preceding days, we had several conversations with Morrisey about it. We
saw him the afternoon before surgery, spending time with his wife and brother,
and one of the things he kept coming back to was his faith.
"I've been praying there would be a miracle and Steve recovers," he said.
"There's risks involved for me. There is going to be a long recovery. There's
going to be pain. Those are things I'd rather avoid. ... You know, two months
from now, I should be OK, and he should be OK, and that's great."
Risky Procedure
Less than an hour after Dziemian's surgery began, Pomposelli emerged to tell
Corey that the procedure had been effective.
Five weeks later, we looked in on Morrisey again. The doctors told him on a
follow-up visit that the 40 percent remnant of his liver was growing back, and
out in the world, was a man carrying a living piece of him.
Morrisey hates being called a hero. "I don't want to get at society - we're in
trouble. Like, people say, 'If it was my son, or my daughter, I'd do it.' I
don't know how people would make a call like that. 'Oh, it's somebody else? Let
them go.' It's just crazy in my mind."
That same afternoon we checked in with Dziemian in - of all places - a shopping
mall. His color was returning, and most important - he was going to live.
Dziemian - 23 weeks after the process of finding a new liver began - was
conflicted over the effect it had had on Morrisey. "It is tough, because he was
perfectly healthy. I hate to see anything go wrong with him, but even when he
talks to me, and I've got a few little bumps since the hospital, I know he's
really worried about how I'm doing."
Twenty-three weeks. That's what it took to save man's life. That, and a guy who
doesn't think it had anything to do with being a hero.
http://abcnews.go.com/Nightline/story?id=3614285&page=1
Comments posted at:
http://abcnews.go.com/Nightline/comments?type=story&id=3614285

Tale of a death foretold
September 16, 2007
Though it was known that she suffered from hepatitis C, the sudden death of
Anita Roddick still came as a shock last week. Not least because the founder of
the Body Shop and doyenne of ethical beauty was such an energetic dynamo. In one
of her last interviews, she spoke to Sabine Durrant about intimations of
mortality.
There is a lot to ask Anita Roddick -- why she sold the Body Shop to L'Oréal,
what she's doing advertising their new cream for older skin, her announcement
she has hepatitis C -- but for the first five minutes of our meeting the agenda
is all hers. She has put a plastic folder of notes on the table and her head
keeps tilting in its direction.
"Let's start with women. As we get older we become more radical. We become
campaigners. We are the backbones of social movements. Storytelling is major,
and laughter, the company of other women, friendship." Her eyes do a quick scan.
"Life is like an onion. We care not a whit for this notion of an antidote for
ageing. Our happiness isn't a facile thing like a line-free face. We are free of
that pressure of sexual attraction."
I can read upside down so I know she is about to say that women are like
cheeses. I tell her it's fair enough being so upbeat at her age -- 64 -- but
that in anticipation, getting older all feels very depressing.
She leans forward and stares at me intently. For a moment I'm worried she's
offended. "Eyebrows," she says. "Eyebrows are everything. Eyebrows and tricks of
make-up. It's about how you make the depth lighter. Get rid of these," -- her
finger lunges for my eye socket -- "these dark circles. The rest is just
Polyfilla."
She leans back, her notes forgotten. "I can tell you're energetic. People don't
stare at your face. And you've got good teeth."
An encounter with Anita Roddick is akin to a game of tennis with different
incarnations of Roddick at each end, or even -- though one is loth to use
language with military connotations she would disapprove of -- to a bombardment.
She has opinions about everything -- the language of the young; gun culture in
London; the relationship daughters have with their mothers, versus sons; the
dangers of tattoos.
Even an idle enquiry as to whether she still likes Brighton -- the location of
her first shop in 1976 -- leads to a tirade against the collapse of the pier.
"The accumulated wealth there and the lack of community identity. Why the f***
did they let it go to pieces?" Some of her opinions are thought out, others are
off the cuff, but they are all delivered -- whether it's the irrelevance of a
line-free face or guidelines on how to get one -- with the same force of
conviction.
She has built a career and a fortune, not only on founding a
multi-million-dollar business (2,000 outlets, serving up to 80 million customers
in 41 countries) but on an assault (sorry, again) on our conscience. Over the
years, the Body Shop has fought to save the whale (1986) and the Brazilian
rainforest (1989). It has stood up against animal testing and intervention in
the Gulf. It has campaigned for orphanages in Romania and refugee camps on the
Thai/Burmese border. And all the while Roddick has come to represent more than
simply herself, standing also for ethical business practices, fair trade, human
rights, women in business, women ...
Over 31 years there has been so much information and opinion, sweeping
generalisation and pithy soundbite, it's not surprising she has laid herself
open to accusations of hypocrisy -- whether it's cradling African babies in ads
for American Express, or selling her business to L'Oréal, which is part-owned by
Nestlé and the subject of a consumer boycott because of its marketing of formula
milk in developing countries. L'Oréal also has links with two things she abhors:
the mythology of anti-ageing creams, and animal testing (though the company
insists that the Body Shop's "Against Animal Testing" policy will, "continue to
be applied rigorously across the product range"). Roddick has always soothed our
skin and got under it at the same time.
We meet at Home House, a private members' club in central London that is all
wood panelling and 18th-century chandeliers. It's the sort of place you might
expect her to rail against, but she darts around, looking for a corner to sit
in, as if she owns the place.
She is much smaller than you imagine -- positively minuscule, 5ft 2in in her
stockinged feet, though today she is wearing flat black boots. The other
surprising thing is how stylish she is. The bedrooms of her mock-Georgian home
outside Littlehampton on the English south coast are themed -- bordello,
Chinese, Shaker, African and Caribbean. Combined with the Body Shop's barrage of
flavours -- mango body butter to pomegranate lip balm -- this might encourage
you to imagine a rather baroque effect, but she is the epitome of understated
elegance in muted shades of brown. A ribbon gives her tweed skirt a contemporary
look, her voluptuous hair is calmed, and her green eyes are beautifully made up
behind rectangular glasses. She is wearing a watch that belonged to her
father-in-law, earrings she stole from her mother and a silver ring given to her
by one of her staff. She takes it off to show the inscription. "It says
well-behaved women never make history. True, eh?"
For all the Italian immigrant blood she bangs on about, Roddick looks rather
French and she buys most of her clothes in Paris. "I adore the shop Lilith. It's
ironic, though, that the obstacle for me now in terms of spending is the actual
shopping. You go in and there are no mirrors in the changing rooms -- you have
to go outside. I want privacy!" She stands and twists so I can read the label on
her skirt (size 10). "This is by an Australian designer. The other day I did a
fashion shoot and the stylist brought out all these cool clothes and I said, 'I
don't want to have bloody sleeves up there"' -- she makes cutting gestures at
the shoulder. "I've got batwing arms. My grandkids play with them. And I'm so
short. I want lines that work well. God, I'd love someone to take me up."
She is as unstoppable off her notes as on. Yes, she was surprised by the fuss
the L'Oréal deal created. "My first reaction was, 'Get a life,"' she says. "The
best I can do is be a Trojan horse and inculcate into that enormous company some
of the values I love that are to do with community trade. You want to talk about
poverty alleviation? Don't show me any more bloody plastic bangles. Show me you
can trade in epicentres of absolute economic despair, sit with marginalised
people, buy ingredients from them ... "
But is L'Oréal going to change its own practices? "Yes. And I think Boots will
follow suit, Procter & Gamble, Unilever ... I hate guys who say I've sold out. I
haven't sold out at all. The wealth I had was just sitting in bloody shares --
that doesn't make any sense to me. I'm 64.
"I don't know how long I've got to live. I want to start giving this stuff away.
I'm looking at areas that fascinate me to do with social justice. I don't want
to be defined by being in business. I'm an activist. The people who worked for
the Body Shop, who were part of my community, don't expect me to buy an island
or go around in a Learjet. They expect me do this."
I ask why she agreed to appear in adverts for the Body Shop's new Wise Woman
range -- which she is keen to point out encompasses not anti-ageing creams, but
creams for older skin. "Gosh. Um. Good question. Well, I was asked to. I thought
it would be a poor show to say no."
The announcement she has hepatitis C -- contracted in a blood transfusion after
she gave birth to her second child in 1971 -- is, she says, purely coincidental.
"Do you know, I don't know why I went public. I've known for 18 months. At first
I didn't have symptoms. But I had tests and they found scarification, fibrosis,
now cirrhosis. Next week I go for another test, and they'll look for tumours. If
they find them, I'll need a transplant.
"Years ago, I used to say to the kids, 'You know, girls, we're passing the
anniversary of our death and we don't know it.' They'd go, 'Oh, mother, for
Christ's sake.' But now that it's a real possibility, it certainly focuses the
mind. You eliminate the shits -- the things you don't want to do, the people you
don't want to speak to."
Despite the hepatitis C, she describes her life now as "like a flat plateau
without any landmarks". She may be giving a lot of her fortune away, but she has
time for small pleasures. She no longer drives a beaten-up Golf, but a sleek
green Mini Cooper ("Gordon [her husband] has a pious car -- a Prius"). She has a
flat in Shad Thames, in London, a house in Santa Barbara, which she shares with
her eldest daughter, Justine, and the mock-Georgian pile in Sussex.
When she is not campaigning for, say, the release of the two remaining Angola
Three, she takes pleasure in her family -- Gordon, her two daughters (Sam, the
youngest, runs the upmarket sex shop Coco de Mer), her three grandchildren, her
"fabulous" siblings, and her mother, Gilda, the "feisty matriarch" who shaped
many of Roddick's ideas. Gilda is 92 and still lives in Littlehampton where she
brought up her own four children.
Like Roddick, she never cared what people thought. She divorced her first
husband and was widowed by her second, his cousin -- who she later admitted had
been Roddick and her younger brother's father. Roddick says, "She taught me the
art of sabotage."
Roddick's own marriage has not been without its up and downs. An affair Gordon
had with a younger woman hit the tabloids in 2000. "Forty years," she interrupts
when I raise this. "When the shit hits the fan you measure love in different
ways. So with this hep C, this irritation you get, the bile in your veins, when
you wake up in the night scratching, Gordon never says, 'For God's sake, go back
to sleep.' He says, 'What can I get you?' You measure love by that ... that
sense of ... protection."
There's a momentarily lull, then she thrusts herself back in her chair as if
propelled by the G-force of her own thought processes. "You don't believe a word
of what I've said," she says. "You wait. When you reach my age you want to be
funny and interesting. You won't want to bonk every good-looking guy that comes
past." She roars with laughter then, showing her own perfect teeth. "It's quite
a sweet metamorphosis."
http://www.independent.ie/entertainment/news-gossip/tale-of-a-death-foretold-108\
1454.html

Organ Transplants Seen as Treatment in HIV/AIDS Patients
Associated Content - Denver,CO,USA
This figure is about the same as the survival rate in liver transplant patients
who do not have HIV. Because of the development of HAART and the research ...
http://www.associatedcontent.com/article/380774/organ_transplants_seen_as_treatm\
ent.html

Survey Report: Medicare Out of Line in Refusing to Pay for Mistakes
By Marianne Mattera, Managing Editor, MedPage Today
September 14, 2007
Six out of every 10 respondents to a MedPage Today poll said Medicare's decision
not to reimburse hospitals for the extra costs of treating preventable injuries
is overly punitive.
Beginning a year from October, officials at the Centers for Medicare and
Medicaid Services say, Medicare will stop paying for the cost of treating
patient falls, pressure ulcers, urinary tract infections,
vascular-catheter-associated infections, mediastinitis, air emboli, removal of
objects left in the body during surgery, and injury caused by use of
incompatible blood products. (See: Medicare Buck Stops at Paying for Hospital
Mistakes)
The proposed rule change also prohibits hospitals from billing patients for "any
charges associated with the hospital-acquired complication."
The implications of that decision could be far-reaching, so we asked visitors to
MedPage Today whether the Medicare rule is overly punitive for often financially
strapped hospitals.
Only 40% of the 854 respondents felt the rule would provide a strong incentive
to beef up quality standards.
One respondent summarized the feelings of that minority, noting that a hospital
"should accept responsibility for its actions (or, inactions) like any other
business."
Many of those who came down on the side of the majority, however, took exception
to whether Medicare's list included truly preventable injuries.
One respondent, who has spent years doing quality-assurance work, said, "I came
to realize that patients were often accidents waiting to happen, set up for UTIs
and other problems before they even hit the door."
Even those who didn't take the patient's condition on admission into
consideration found problems with the definition of "preventable problems." Some
noted that accidents happen in all walks of life.
One noted many instances of unavoidable situations, including the "patient's
right to fall." Said she, "the rules against restraint use, coupled with
staffing issues and the family's inability or unwillingness to sit with
patients, also play into that one! Is the hospital responsible for that as
well?"
Hospital staffing levels were raised by a number of respondents. Said one,
"While I accept the likelihood that accidents can and do occur even when the
level of care is high, I'd be willing to bet that the preponderance of accidents
occur because the level of patient care and attention to detail by hospital
staff is lacking in many cases."
Said a nurse, "if staffing was better and we were allowed to do more nursing and
less paperwork, patients would get far superior treatment and the statistics for
complications would go way down."
A bigger nursing staff would, of course, come at a price. One respondent
recognized that: "This is a set-up for an inevitable increase in health care
costs as providers and hospitals institute non-evidence-based practices such as
increased antibiotic prophylaxis, and unnecessary preoperative/pre-admission
diagnostic testing/imaging in an attempt to identify pre-existing conditions. In
the end, Medicare will pay out more, not less."
"Having Medicare decide what is preventable is a recipe for disaster," said one
doctor. "About the only thing it will accomplish is to increase the number of
physicians and hospitals that opt out of the Medicare system, thereby limiting
patient access to health care and, in essence, making them sicker when they do
become hospitalized. Ultimately, the rule defeats its own whole purpose."
At least one respondent, however, had a solution that could satisfy both sides.
Recognizing that complications can occur naturally in spite of a hospital's best
efforts, he says, "I think the best solution would be for Medicare to pay a
fixed percentage of the costs associated with a condition based on estimates of
how often it could reasonably be prevented."
"So," he continued, "if it's estimated that 20% of UTIs could be prevented,
Medicare would pay 80% of the normal costs associated with UTIs when they're
contracted in hospitals."
http://www.medpagetoday.com/Surveys/Surveys/dh/6691

Meet the heroes of the lifeline
A quarter of us will need a blood transfusion at some stage in our lives -- yet,
only 4pc of those eligible actually donate. At the start of Blood for Life Week,
we hear how vital it is to make a donation
Monday September 17 2007
ASK MOST of us what we know about blood and we'll tell you that it's thicker
than water, which is true, and that it's red, which isn't always the case
because crabs have blue blood, starfish yellow, and earthworms and leeches have
green blood.
Some facts are equally less well known, but with today being the first day of
Blood for Life Week, the fact that one in four of us will need a transfusion at
some point, or that car-accident victims sometimes need up to 30 units of the
red stuff to save their lives, will hopefully become more familiar to us.
The unsung heroes are the 95,000 donors who give blood in Ireland each year.
They do so to save the lives of strangers they'll never meet.
Hugh Brett has donated blood no less than 100 times. He grew up in a family of
donors, and says that his wife sons and daughter are also donors.
This week, on turning 18, his triplet sons gave blood for the first time. Asked
why he has donated so often, Hugh says: "It's what we do in our family. It's who
we are."
Irish Blood Transfusion Service (IBTS) Chief Executive, Andy Kelly, says that
only 4.3pc of those who are eligible to donate do so.
"Interestingly, if that figure was increased to just 5pc, stock shortages would
never be a concern," he says.
"That said, while I don't recall any cases where we were without blood or
platelets for immediate requirements, in June 2005, some instances of elective
surgery had to be postponed"
In 2003, questions arose as to the efficiency or otherwise of the computer
system which was in place at the blood bank. That, and the fact that an
estimated ?650m has been paid out to victims of blood contamination, has done
little to inspire public confidence. But hard lessons have been learned.
In February 1994, the IBTS ceased manufacturing Anti-D -- a protein contained in
blood plasma -- in light of the discovery that batches had become infected with
Hepatitis C. As one of the women who received Anti-D from a contaminated batch
that year, I have to admit that I feel nothing but fortunate.
It's reassuring to know that Andy Kelly has every confidence in the system now
in place. "There are no risks whatsoever attached to giving blood," he explains.
To those concerned about the quality of receiving donations, he has this
message. "We have a quality management system in place which ensures that donor
screening and laboratory testing for a number of diseases, which include
Hepatitis B and C, are carried out to the highest possible standards.
"While there are no tests available for v-CJD, since 1999 we have been removing
white blood cells from all blood donations, to mitigate against the disease's
transmission.
"Screening is thorough, with those who lived in the UK for a year or more
between 1980 and 1996, and those who have had transfusions, ineligible to
donate."
Every day, people are diagnosed with cancer or suffer trauma. For them and
others, the availability of adequate bloods can mean the difference between life
and death.
Their lives are in our hands. I'm off to give blood. Are you?
Leah Halpenny
Secondary school student, Leah Halpenny (16), lives in Foxrock, Co Dublin, with
her parents Judith and Gerry and sister, Sarah (18).
"It was April 2005 when my leg became sore while I was playing tennis. My doctor
put me on medication, which had no effect.
"Then I tried physiotherapy, but again no joy, so the doctor sent me for further
tests which showed up a malignant tumour," she said.
Leah had to get blood transfusions when her blood count was low.
"Those who donate blood have no idea how much better we feel, having received
it. It makes the difference between feeling exhausted and feeling well.
"I also needed platelets to help my blood to clot, and thanks to the donors, it
was always there for me."
http://www.independent.ie/health/case-studies/meet-the-heroes-of-the-lifeline-10\
81811.html

Anti-war Vet Dave Cline Is Dead
by lao hong han
Sat Sep 15, 2007 at 03:54:51 PM PDT
Dave Cline died last night at his home in Jersey City, NJ.
In one sense it comes as no surprise to those of us who have worked closely with
Dave in recent years. He had lived for two decades with a severely compromised
immune system and had recently been battling both Hepatitis C and the Veterans
Administration health care system, which did a shitty job of treating it.
Stan Goff reached me first with the news, crying at the loss. I have been
surrounded by death recently--Stan's call came while I was sitting in a memorial
service for an old friend, longtime fighter for socialism and Black liberation
Vicki Garvin.
The news hasn't really sunk in yet, and I have no idea how it will hit when it
does, or how hard.
But I do want to say a few things right now to set some context for what will
surely be a great outpouring of sorrow and memory in weeks to come.
Dave Cline will someday, in a better world, stand recognized as one of the great
figures in the history of the United States since the Second World War. After a
tour in Vietnam as a grunt, where he was shot and shot at others, he returned to
become an early member and leader of Vietnam Veterans Against the War.
Through tireless organizing and dramatic events like Operation Dewey Canyon III,
where hundreds of vets threw their medals on the Capitol steps, and the Winter
Soldier Hearings into war crimes committed during the occupation of Vietnam,
VVAW did much to finally doom the U.S. government's murderous assault on the
heroic people of Vietnam.
I have here on my desk a 1969 flier from SDS (the original one, not version 2.0)
on the GI Revolt. It's an interview with Dave and another vet, fresh out of
uniform and into the anti-war struggle. I am reminded by it to recommend that
everyone reading this check out the recent documentary "Sir, No Sir!" Dave is
featured in it as a young vet and as a present-day fighter against the invasion
and occupation of Iraq.
And this last role is where Dave truly became great. He stayed active in VVAW
right up to the present day, but also joined another organization called
Veterans For Peace, which united vets from all eras in an essentially pacifist
oppostion to war, military recruitng, US aggression abroad and the neglect of
those who had served in the armed forces.
Dave Cline was in his first term as president of Vets For Peace when the attack
on the World Trade Center took place. He helped guided the small group through a
period of war fever and jingoism in this country and growing concern as the
Bush/Cheney regime prepared to attack Iraq--and did. Dave presided over the
rapid, severalfold growth of VFP and its conversion into a dynamic and leading
force against the war. He helped forge a tight alliance with Military Families
Speak Out and birth the Bring them Home Now! campaign. The handful of young men
and women just back from Iraq who initiated Iraq Veterans Against the War
consulted with Dave on a near-daily basis and grew to become the most dynamic
element in the alliance.
This alliance has played the role of spearhead in the movement to end the war in
Iraq and bring the troops home now. Without a sharp point, capable of cutting
through defenses, a spear is just a fat stick, but without the weight of the
spear, the whole anti-war movement, behind it, the spearhead lacks real
momentum. Just weeks ago I was discussing with him the role this force could
play in the Iraq Moratorium project.
Dave was the leader of this informal but vital alliance of forces with roots in
the "military community" or, it would be more accurate to say, he gave it
leadership. He could play this role because of his long experience, and because
of how he had summed up and internalized that experience. That was in no small
part a matter of style. Dave could be contentious but he had also become
genuinely humble and thoughtful, always trying to avoid repeating mistakes he
had made earlier in the struggle and also to help others avoid those mistakes or
sum them up quickly and move on.
One instance where the breadth of his contribution can be seen most clearly is
in the historic "Walkin' To New Orleans" march of veterans and survivors of
Hurricane Katrina from Mobile to New Orleans last year on the fourth anniversay
of the invasion. The conception of the march, linking the horrors of the war
with the horrors of Katrina and concretely working to bring the struggle of
Black people in the South closer to heart of the anti-war movement, that was
Dave's. And, with Stan Goff and a handful of others, he saw to the planning and
execution of the march as well.
Hell, there's so much more I could say about Dave, now the floodgates are open,
about his revolutionary stance until the day he died, of the arrogance of the
young Dave and the kindness of the older one, concerning the drinking and the
the clay feet, about the music.
But I will close by underlining my basic point: Dave Cline made a substantial
difference in the world. He did it by struggling against oppression and
militarism; he did it by drawing lessons from earlier battles and by living
those lessons, so he, and all who worked with him, could fight better in the new
struggles history presented us with.
Call it wisdom. Call it leadership. We have suffered a great loss, and those who
feel that loss are just going to have to step up and try to fill the hole.
http://www.dailykos.com/story/2007/9/15/184813/758

The University of Nottingham in the British Midlands Announces Development of
Possible Hepatitis C Vaccine
Monday September 17, 9:00 am ET
Britain's University of the Year Announces Potential Breakthrough in the Fight
Against Hepatitis C.
CHICAGO, Sept. 17 /PRNewswire/ -- The British Midlands Development Corporation
today announced that the University of Nottingham in the British Midlands has
released a statement promoting the development of a possible Hepatitis C
Vaccine.
The United Kingdom is home to Europe's largest biotechnology sector, generating
revenues in excess of $8.6 billion per year. In central England is the British
Midlands region, which is at the heart of the UK's biopharma and medical device
industries.
The British Midlands is one of Europe's premier locations for the advancement of
medicine and life sciences. All of the region's 18 universities have unique
areas of scientific expertise, which fuel the region's record of innovation in
the field.
Some of the twentieth century's most important innovations in medicine took
shape in the British Midlands. Magnetic resonance imaging (MRI) was invented by
The University of Nottingham's Sir Peter Mansfield. The Birmingham Children's
Hospital leads the field in treatments for congenital heart disease and
developed the world's smallest successful heart pacemaker in a three-day old
infant.
Just last week, another potential breakthrough was announced by the British
Midlands' University of Nottingham, which released a statement claiming the
discovery of a possible vaccine which can be used in the treatment of Hepatitis
C.
Dr. Alexander Tarr, a Research Fellow at Nottingham's Institute of Infection,
Immunity and Inflammation, presented a paper titled 'Human Antibodies to
Hepatitis C Virus - Potential for Vaccine Design', at the Society for General
Microbiology's 161st meeting which was held at The University of Edinburgh two
weeks ago.
The research group had recently analyzed antibodies that can successfully
prevent infection with many diverse strains of Hepatitis C virus in laboratory
models.
Dr. Tarr made a statement saying, "The clinical potential of this work cannot be
overstated. Historically, successful vaccines against viruses have required the
production of antibodies, and this is likely to be the case for Hepatitis C
virus. Identifying regions of the virus that are able to induce broadly reactive
neutralizing antibodies is a significant milestone in the development of a HCV
vaccine, which will have distinct healthcare benefits for hepatitis sufferers,
and could also help us design vaccines for other chronic viral diseases such as
HIV."
"We are also currently exploring the possibility of improving liver
transplantation success rates by passively infusing people with these
antibodies," said Dr. Tarr, "Additionally we are using the information gained by
identifying and characterizing the antibody responses to Hepatitis C virus to
design new ways of making vaccine candidates. If the antibodies we have
discovered can be reproduced by vaccination, control of the disease might be
possible."
The Hepatitis C virus affects over 180 million people worldwide. Infection with
the virus can lead to liver cancer, and is the most common reason for liver
transplantation in the United States and the United Kingdom.
About The British Midlands Development Corporation
The British Midlands Development Corporation is the North American economic
development agency for central England. The Midlands region is located just one
hour north of London and includes the major commercial centers of Birmingham,
Nottingham, Coventry and Northampton.
As an agency funded by the UK Government, The British Midlands Development
Corporation provides specialist advice and support to North American companies
seeking to establish a presence or expand a current operation in the region. The
British Midlands Development Corporation provides access to business networks,
details about sources for grants and funding, business support services, and
information to help companies identify opportunities to develop and grow.
The British Midlands Development Corporation is based in Chicago with branch
offices in Boston, Washington DC and San Jose.
For more information, please visit our website at
www.thebritishmidlands.com
Press Contact
Shirar O'Connor-Mugler
shirar@...
646 496 7668

Idera Pharmaceuticals Initiates Phase 1 Trial of IMO-2125 in Hepatitis C
Monday September 17, 8:30 am ET
CAMBRIDGE, Mass.--(BUSINESS WIRE)--Idera Pharmaceuticals (AMEX: IDP - News)
today announced that the first patient has been dosed in a Phase 1 trial
evaluating IMO-2125 for the treatment of patients with hepatitis C virus (HCV)
infection. IMO-2125 is a novel agonist of Toll-like Receptor (TLR) 9.
"IMO-2125 is a TLR9 agonist that Idera designed to induce endogenous
interferon-alpha along with other immune response factors to treat hepatitis C,"
said Sudhir Agrawal, D. Phil., Chief Executive Officer and Chief Scientific
Officer. "IMO-2125 is the second novel TLR9 agonist from our portfolio to enter
the clinic following IMO-2055 for cancer. We generated both of these drug
candidates using our chemistry-based drug discovery approach which allows us to
design TLR-targeted drug candidates which act as agonists for TLR7, 8 or 9 or as
TLR antagonists for a broad spectrum of indications."
"The preclinical data that we have generated, including data demonstrating
potency in the HCV replicon assay of cytokines and chemokines present in the
blood of non-human primates treated with IMO-2125, provides a strong rationale
for evaluating IMO-2125 in patients with HCV infection," commented Robert Karr,
M.D., President.
The Phase 1 trial evaluating IMO-2125 is being conducted in HCV patients who
have failed to respond to previous combination therapy with ribavirin and
pegylated interferon-alpha. The trial is designed to assess the safety and
tolerability of IMO-2125 at different dose levels as well as determine the
effect of IMO-2125 on HCV RNA levels and parameters of immune system activation.
Four doses of IMO-2125 are being investigated. IMO-2125 will be administered
subcutaneously once a week and treatment will continue for four weeks. The
target enrollment for the trial is 40 patients with ten patients per cohort. Of
the ten patients per cohort, eight are randomized to receive IMO-2125 treatment
and two are randomized to receive placebo treatment. The trial is expected to be
conducted at five or more U.S. sites. The lead investigator of this trial is
John McHutchison, M.D., Associate Director, Duke Clinical Research Institute and
Director, GI/Hepatology Research Program and Professor of Medicine, Division of
Gastroenterology, Duke University School of Medicine.
About IMO-2125
IMO-2125 is a novel DNA-based TLR9 agonist being evaluated for the treatment of
HCV. IMO-2125 was designed to induce endogenous interferon-alpha along with
other immune response factors to treat hepatitis C. In preclinical studies,
IMO-2125 induced high levels of endogenous interferon-alpha, as well as other
cytokines and chemokines, in non-human primates and in human immune cell
cultures. The cytokines induced by IMO-2125 in human immune cell cultures and in
non-human primates have shown potent activity in inhibiting HCV replication in
an in vitro assay (HCV replicon assay).
About Idera Pharmaceuticals, Inc.
Idera Pharmaceuticals is a drug discovery and development company that is
developing drug candidates to treat cancer and infectious, respiratory, and
autoimmune diseases, and for use as vaccine adjuvants. Idera's proprietary drug
candidates are designed to modulate specific TLRs, which are a family of immune
system receptors. Idera's pioneering DNA chemistry expertise enables it to
identify drug candidates for internal development and creates opportunities for
multiple collaborative alliances. Idera's most advanced clinical candidate,
IMO-2055, is an agonist of TLR9 and is currently in a Phase 2 trial in oncology
and in a Phase 1/2 chemotherapy combination trial in oncology. Idera's second
TLR9 agonist, IMO-2125, is currently in a Phase 1 trial for the treatment of
hepatitis C virus infection. Idera is collaborating with Novartis International
Pharmaceutical, Ltd. for the discovery, development, and commercialization of
TLR9 agonists for the treatment of asthma and allergy indications. Idera is also
collaborating with Merck & Co., Inc. for the use of Idera's TLR7, 8 and 9
agonists in combination with Merck's therapeutic and prophylactic vaccines in
the areas of oncology, infectious diseases, and Alzheimer's disease. For more
information, visit www.iderapharma.com.
Forward Looking Statements
This press release contains forward-looking statements concerning Idera
Pharmaceuticals, Inc. that involve a number of risks and uncertainties. For this
purpose, any statements contained herein that are not statements of historical
fact may be deemed to be forward-looking statements. Without limiting the
foregoing, the words "believes," "anticipates," "plans," "expects," "estimates,"
"intends," "should," "could," "will," "may," and similar expressions are
intended to identify forward-looking statements. There are a number of important
factors that could cause Idera's actual results to differ materially from those
indicated by such forward-looking statements, including whether results obtained
in early clinical studies or in preclinical studies such as the studies referred
to above will be indicative of results obtained in future clinical trials or
warrant additional trials; whether products based on Idera's technology will
advance into or through the clinical trial process on a timely basis or at all
and receive approval from the United States Food and Drug Administration or
equivalent foreign regulatory agencies; whether, if the Company's products
receive approval, they will be successfully distributed and marketed; whether
the Company's collaborations with Novartis and Merck will be successful; whether
Idera's cash resources will be sufficient to fund product development and
clinical trials; and such other important factors as are set forth under the
caption "Risk Factors" in Idera's Quarterly Report on Form 10-Q filed on August
1, 2007, which important factors are incorporated herein by reference. Idera
disclaims any intention or obligation to update any forward-looking statements.
Contact:
Idera Pharmaceuticals, Inc.
Kelly Luethje, 617-679-5519
kluethje@...
or
MacDougall Biomedical Communications
Chris Erdman, 508-647-0209
cerdman@...

XTL Biopharmaceuticals Presents a New Class of Highly Potent Small Molecule
Inhibitors of Hepatitis C Affecting the NS5A Target at an International
Scientific Conference
Monday September 17, 7:22 am ET
VALLEY COTTAGE, N.Y., Sept. 17 /PRNewswire-FirstCall/ -- XTL Biopharmaceuticals
Ltd. (Nasdaq: XTLB; LSE: XTL; TASE: XTL) announced today that on September 13,
2007, it presented a new class of novel and highly potent small molecule
inhibitors of hepatitis C affecting the NS5A target at the 14th International
Symposium on Hepatitis C Virus & Related Viruses in Glasgow, Scotland
(http://www.hcv2007.com).
In an oral latebreaker presentation, the Company described a family of
pre-clinical compounds with highly potent activity against the hepatitis C
virus. Potency of these compounds was evaluated in a replicon assay which is
known to have good correlation with clinical efficacy and is the current gold
standard for pre-clinical testing of inhibitors of Hepatitis C. In the replicon
assay, the Company's most advanced compounds had single-digit nM (nanomolar)
potency against hepatitis C genotype 1b and low double-digit nM potency against
genotype 1a. Genotypes 1a and 1b represent 75% of the U.S. hepatitis C
population, according to the American Liver Foundation. These replicon potencies
are superior to the most advanced clinical-stage small molecule protease
inhibitors of Hepatitis C, which to date have reported triple-digit nM potency
against 1a and 1b replicons.
Data presented by the Company implicated the viral protein NS5A as the direct
target of the compounds. NS5A is essential for RNA production and is distinct
from the protease and polymerase -- the viral targets of the more advanced
Hepatitis C inhibitors in clinical development. As such, inhibitors of NS5A are
considered promising candidates for the treatment of Hepatitis C. As a
relatively new target, only one NS5A inhibitor has entered clinical trials to
date -- A831 -- which is presently in a phase 1 clinical trial. A831 was
developed by Arrow Therapeutics, which was recently acquired by AstraZeneca.
Based on data presented at the conference, the Company's leads appear to be over
10 times more potent than A831 in the replicon assay.
In rodent studies, when administered orally, the Company's compounds
demonstrated preferential accumulation in the liver to concentrations that were
orders of magnitude above those required to block viral replication as predicted
by the replicon assay, with half-lives consistent with twice a day dosing
regimen, and toxicological tolerability at multiple doses.
The Company also presented data indicating an additive effect with interferon
(the current standard of care) and with the protease inhibitor VX- 950 and
retained potency against protease- and polymerase- inhibitor resistant mutants
in the replicon assay. These findings are supportive of the potential role of
the Company's compounds in combination with interferon and other small molecules
currently in clinical development.
Dr. Ira Jacobson, Professor of Clinical Medicine and Chief of the Division of
Gastroenterology and Hepatology at Weill Medical College of Cornell University,
and an advisor to the XTL-DOS program commented: "Chronic hepatitis C represents
a tremendous unmet medical need with millions of patients seeking safer and more
efficacious treatment options. Future treatment regimens are likely to include
combinations of novel small molecules with interferon and ribavirin, which may
eventually be replaced by cocktails of several small molecules employing
complementary mechanisms of action. The preclinical data presented by XTL
suggest that the Company's compounds could prove, with appropriate testing in
clinical trials, to be very attractive candidates for incorporation into future
treatment regimens in combination with interferon-based therapy and/or other
small molecules presently in clinical development."
The molecules presented by the Company emerged from the Company's DOS program,
aimed at discovering novel hepatitis C inhibitors applying a unique chemistry
technology called Diversity Oriented Synthesis. The DOS program was acquired by
the Company in late 2005.
About Hepatitis C
There are approximately 3 million people infected with hepatitis C in the U.S.
alone. Hepatitis C significantly increases the infected person's risk of
developing chronic liver disease, cirrhosis and liver cancer, and is the leading
cause of liver transplantation in the Western World. Hepatitis C remains a major
unmet medical need as the current standard of care (interferon-based therapy)
achieves success in only 50% of patients infected with genotype 1 of the virus
(genotype 1 affects 75% patients in the U.S.), and has significant side affects
associated with it.
About XTL Biopharmaceuticals Ltd.
XTL Biopharmaceuticals Ltd. ("XTL") is engaged in the development of
therapeutics for the treatment of neuropathic pain and hepatitis C. XTL is
developing Bicifadine, a serotonin and norepinephrine reuptake inhibitor, for
the treatment of diabetic neuropathic pain. XTL is also developing several novel
pre-clinical hepatitis C small molecule inhibitors. XTL also has an active
in-licensing and acquisition program designed to identify and acquire additional
drug candidates. XTL is publicly traded on the NASDAQ, London, and Tel-Aviv
Stock Exchanges (NASDAQ: XTLB; LSE: XTL; TASE: XTL).
Cautionary Statement
Some of the statements included in this press release, particularly those
anticipating future performance and prospects of our pre-clinical compounds for
hepatitis C from our XTL-DOS program may be forward-looking statements that
involve a number of risks and uncertainties. For those statements, we claim the
protection of the safe harbor for forward-looking statements contained in the
Private Securities Litigation Reform Act of 1995. Among the factors that could
cause our actual results to differ materially are the following: our ability to
successfully complete the pre-clinical development DOS program; our ability to
clinically develop candidates from the DOS program; and other risk factors
identified from time to time in our reports filed with the Securities and
Exchange Commission and the London Stock Exchange, including our annual report
on Form 20-F filed with the Securities and Exchange Commission on March 23,
2007. Any forward-looking statements set forth in this press release speak only
as of the date of this press release. We do not intend to update any of these
forward-looking statements to reflect events or circumstances that occur after
the date hereof. This press release and prior releases are available at
http://www.xtlbio.com. The information in our website is not incorporated by
reference into this press release and is included as an inactive textual
reference only.
Contact:
Ron Bentsur
Chief Executive Officer
Tel: +1-845-267-0707 ext. 225

New Blood Test Detects Liver Cancer Early Enough for Treatment
Friday September 14, 2007
A new blood test can detect liver cancer early, and coupled with the
alpha-fetoprotein blood test, or AFP, it can recommend treatment before
symptoms, reports the Flanders Institute for Biotechnology and Ghent University
in Belgium. Liver cancer often is too advanced to treat when symptoms appear,
experts said.
The new test detects changes in sugars attached to proteins and distinguishes
whether tumors are in early or late stages, researcher Chitty Chen told Reuters
news service in discussing work published in the journal Hepatology.The amount
of two particular sugar groups in the proteins also indicates the size of
tumors, Chen said.
The new test is particularly important for Africa and Asia, where high rates of
hepatitis infections lead to liver cancer, the killer of 700,000 people a year
worldwide, according to Chen.
http://news.nurse.com/apps/pbcs.dll/article?AID=/20070914/NEWSTRENDS/70907072

Liver cancer in Bexar County a puzzle
Web Posted: 09/16/2007 12:06 AM CDT
Don Finley
Express-News Medical Writer
Vilma Moran seemed an unlikely candidate for cirrhosis of the liver, which her
doctor said explained her swollen abdomen and yellowing eyes. In her 60 years of
life, she had consumed probably 10 alcoholic beverages. She didn't smoke, didn't
have hepatitis.
She was diabetic, which is a risk factor. But when it was found later that she
had liver cancer, the surgeon asked if she'd ever worked in a chemical plant.
The type of cancer she had suggested a chemical exposure, he said. No, she told
him, she worked with special education children at Lowell Middle School.
Then she and her husband recalled a letter they had received four years earlier,
inviting them to a neighborhood meeting to discuss a plume of contaminated
groundwater linked to the shuttered Kelly AFB. They had ignored the invitation.
She had lived near Kelly almost all her life. Her father had maintained the base
golf course.
In February 2006, Moran attended another neighborhood meeting from her
wheelchair. She listened as Tim Aldrich of East Tennessee State University, an
expert in cancer clusters, announced he had been hired to look into reports of
elevated liver cancer in neighborhoods surrounding Kelly.
Last month, Aldrich's report was quietly released to the San Antonio City
Council. A planned meeting to announce the results to people living in those
neighborhoods never was held.
The report noted that while 14 ZIP codes that roughly encompass the plume of
polluted groundwater indeed did have high rates of liver cancer, so did all of
Bexar County. In fact, when adjusted for age differences, the liver cancer rates
in those 14 ZIP codes over several years actually were lower than for the county
as a whole.
"Whatever is the process for Bexar County to think about its liver cancer risk,
in my opinion they must keep in mind that they have more communities with
elevated liver cancer risk than just the one near" Kelly, Aldrich said by phone.
Despite those findings, the high rates in those 14 ZIP codes fit the definition
of a cancer cluster, Aldrich said. Examine them over shorter periods of time, or
in other ways, and they do stand out. That justifies a more in-depth look
comparing the cases in those ZIP codes with a comparison group somewhere else.
The ZIP codes are 78201, 78204, 78205, 78207, 78211, 78214, 78221, 78224, 78225,
78226, 78227, 78228, 78237 and 78242.
Local, state and federal health officials have criticized the report and its
conclusions. Although they agree the rates in those neighborhoods are high
compared with the state and the nation, they disagree with Aldrich that a major
study of liver cancer cases in those 14 ZIP codes is feasible - noting only five
survivors were willing to be interviewed.
And they strongly disagree with one particular statement in the report: that
after statistically excluding the other possible causes - hepatitis,
alcohol-related cirrhosis, smoking and diabetes - 11.5 percent of the liver
cancers in those 14 ZIP codes "may be attributable to residing over the Kelly
... plume."
A cancer puzzle
For years, experts have puzzled over Bexar County's high rates of liver cancer,
particularly the large number of cases that plague the modest neighborhoods to
the south and west of downtown.
Between 1999 and 2002, Bexar ranked no lower than seventh each year in liver
cancer death rates among all 254 Texas counties, for both men and women,
according to the Texas Cancer Registry. Hispanics ranked no lower than fourth.
Only much smaller counties had higher rates.
There was good reason for concern. No cancer drug is FDA-approved for liver
cancer. Most patients are diagnosed with advanced disease, when surgical options
- including a liver transplant - often have a poor prognosis.
Worldwide, liver cancer is the fourth biggest cancer killer, with 80 percent of
new cases taking place in developing countries. The most common causes in those
countries are hepatitis B and food-borne toxins - primarily aflatoxin, a mold
that grows on corn, peanuts and other grains.
In fact, while rates for many cancers have declined, liver cancer rates have
gone up in the United States and other wealthy nations, fueled instead by
hepatitis C, alcohol consumption and diabetes.
Some experts warn the worst lies ahead.
"That's the way we view it," said Dr. Melanie Thomas, assistant professor of
gastrointestinal medical oncology at the University of Texas MD Anderson Cancer
Center in Houston. In a 2005 paper, she and a co-author described liver cancer
as "a looming epidemic for which the medical oncology community is largely
unprepared."
The federal Agency for Toxic Substances and Disease Registry first identified
liver cancer as a major concern in 1999 after studying the neighborhoods around
the base at the request of the late U.S. Rep. Frank Tejeda.
Residents had a laundry list of health complaints that many blamed on
contamination from the base. A number of studies since then have confirmed high
rates in those neighborhoods and countywide.
Health officials have argued the polluted shallow aquifer beneath the
neighborhoods wasn't used for drinking or watering lawns, and people weren't
exposed. They noted the lag time between exposure and cancer can be decades.
Aldrich points out that the 14 ZIP codes in his study share another
characteristic besides the plume. Nearly half of Bexar County's Hispanic
population lives in them. Across the country, Hispanics - particularly Hispanic
men - are more prone to liver cancer than other groups.
Hispanics are slightly more likely to have hepatitis C, and some research has
shown the virus progresses more rapidly in Hispanics. Diabetes, an epidemic in
the Hispanic community, causes a condition known as fatty liver disease, which
can progress to a form of cirrhosis called NASH - non-alcoholic steatohepatitis
- and liver cancer. Having diabetes doubles the risk of liver disease and liver
cancer.
Then there's the question of alcohol use. A 2004 study in the American Journal
of Public Health, which looked at survey data from the late 1990s, found San
Antonio had the highest percentage of binge drinking among 120 U.S. cities.
Twenty-four percent of adults here - and more than a third of all men - had
consumed five or more alcoholic beverages in one occasion within 30 days of
being asked. Nationwide, the median was 14.5 percent. Those researchers found no
statistically significant differences between racial or ethnic groups. Those
with lower education levels were slightly more likely to be binge drinkers.
With funding from the Air Force, the Metropolitan Health District commissioned a
feasibility study through HealthCare Resolution Services Inc. of Laurel, Md.,
which hired Aldrich as a consultant. The study was to examine rates of primary
liver cancer - cancer that began in the liver, excluding cancer that might have
begun in another part of the body and spread to the liver - in those 14 ZIP
codes to see if a large, comprehensive study might be justified.
With the help of Metro Health staff, the study grew beyond its initial scope -
including a survey of neighborhood veterinarians to see if they had diagnosed
liver cancer in dogs, which might suggest an environmental cause. They hadn't.
In his report, Aldrich estimates that when you apply Bexar County's rates of
hepatitis, smoking, diabetes and other causes to those ZIP codes, that still
would leave 11.5 percent of cases unexplained. He's unapologetic for stating
those cases "may be" related to living over the plume, saying the report was
written to guide the health department as it considers studying the matter
further.
"I'm trying to explain to the health department, if they do a study, how many of
the people they've studied will they be able to say, it looks like your liver
cancer was the result of living over this plume," Aldrich said. "Their study
should be designed to find this many cases."
"We do not agree," said Dr. James Wittmer, a local environmental health
consultant to the Metropolitan Health District. "It's a firm conclusion of all
the people who have read this report, the professionals and the reviewers, that
this is an unfounded statement."
Other possible causes
In any case, health officials are looking at other causes. A still-unpublished
study of 800 liver cancer death certificates between 1996 and 2005 by the health
district and University of Texas Health Science Center researchers found little
they didn't already know. Hepatitis was more common in Hispanics than in Anglos,
but about the same as in blacks. Diabetes - probably the least understood cause
of liver cancer - was much more common in Hispanics who died of liver cancer.
"Was diabetes a contributing factor in the progression to cirrhosis? We couldn't
make that conclusion," said Roger Sanchez, an epidemiologist with the health
district.
In 2004, Houston researchers published the strongest evidence to date on
diabetes and liver cancer involving more than 800,000 VA hospital patients.
They estimated diabetes doubles the risk of liver disease and liver cancer.
While the link had been known, some had questioned whether diabetes caused liver
disease, or the other way around.
Under way is still another study, and perhaps the biggest long shot yet. Some
researchers looking at the high Hispanic rates have wondered whether food-borne
toxins might play a role, as they do in other parts of the world.
Aflatoxin and fumonisins contaminate corn, peanuts and other grains.
Contamination levels can rise and fall depending on seasonal weather patterns
that put stress on plants - drought in particular. And South Texas is drought
prone.
Hispanics might consume more corn, the theory goes, and they might buy less
expensive corn products, which might be more prone to contamination.
A lot of mights. Researchers at Texas A&M and Texas Tech universities, together
with the health district, are targeting three ZIP codes with some of the highest
liver cancer rates - 78207, 78228 and 78237, which lie north of U.S. 90 on the
West Side. The researchers have sophisticated tests that can detect byproducts
of the toxins in blood and urine going back a year from ingestion.
The study is hoping to recruit 500 residents - a number that would provide the
strongest statistical evidence of a cause. About 100 have volunteered so far. To
learn more about the study, call (210) 434-0077.
For Vilma Moran, it's less important to find what caused her own liver cancer
than it is to prevent it from developing in someone else.
"I've already gone through it, however bad it was," she said. "But maybe it will
be helpful for someone else. I'm concerned for my son and the other people in
the area."

Patients with Depression prior to Hepatitis C Treatment Are Half as Likely to
Achieve Sustained Virological Response
Depression is a common side effect among people taking pegylated interferon plus
ribavirin to treat chronic hepatitis C. Depression may interfere with good
adherence and leads some people to stop treatment prematurely.
As reported at the 47th Interscience Conference on Antimicrobial Agents and
Chemotherapy (ICAAC) this week in Chicago, researchers conducted a study to
assess the effect of depression on sustained virological response (SVR), defined
as undetectable HCV viral load 6 months after the end of treatment. They also
looked at the effect of SVR on the development of depression.
The investigators performed a retrospective chart review of 694 hepatitis C
patients treated with pegylated interferon (brand not specified) plus ribavirin
at the University of New Mexico Health Sciences Center Hepatitis C clinic. The
analysis included 108 patients who met the inclusion criteria.
All analyzed patients were being treated for the first time, were receiving
full-dose pegylated interferon plus ribavirin, were not coinfected with HIV, and
had 6 months of post-treatment follow-up. In this group, the mean age was 46
years, 60% were men, 55% were of Hispanic descent, and 63% had HCV genotype 1.
Information about demographics, HCV viral load, and the presence or absence of
depression was extracted from patients' medical charts. The Center for
Epidemiological Studies Depression Scale (CES-D) was used to determine the
presence and development of depression. Multiple logistic regression analysis
was performed to assess the relationship between SVR and depression.
Results
. 24% of the analyzed patients had depression at baseline.
. Among those not depressed at study entry, 41% developed depression during
the course of treatment.
. Regression analysis showed that patients with baseline depression were less
likely to achieve SVR.
. The odds of achieving SVR were 50% lower in depressed compared with
non-depressed patients, after adjusting for patient demographics.
. Conversely, among those without depression at baseline, achievement of SVR
was an important determinant in the development of depression.
. Individuals who achieved SVR had 27% lower risk of developing depression.
Conclusion
In conclusion, the investigators wrote, "The impact of depression is important
for the clinician to assess when evaluating a patient's eligibility for HCV
treatment as depression may diminish chances of optimal clinical response."
University of New Mexico Hospital, Albuquerque, NM.
09/18/07
Reference
R Cullen, N Khan, A Sanjeev, and others. Depression and Sustained Virologic
Response in Hepatitis C Patients. 47th Interscience Conference on Antimicrobial
Agents and Chemotherapy. Chicago, September 17-20, 2007. Abstract V-1898.
http://www.hivandhepatitis.com/2007icr/icaac/docs/091807_d.html

Nightline Daily E-Mail
Tonight on 'Nightline'
Sept. 17, 2007
'Life and Death'
Would you risk your own life and undergo major surgery if it could save someone
else's life? As one patient in need of a liver donor found out, few would. Even
members of his own family hesitated to go under the knife for him. In this
special "Nightline" half-hour, ABC's John Donvan traces one man's struggle to
get the liver transplant he needs to survive.
We hope you'll join us.
The "Nightline" Staff

Interim Efficacy and Resistance Data from a Phase II Study of Telaprevir
(VX-950) Plus Pegylated Interferon and Ribavirin in Previously Untreated
Patients with Hepatitis C
By Liz Highleyman
Telaprevir (formerly VX-950) is an HCV protease inhibitor being developed by
Vertex. The PROVE 1 study (also known as VX05-950-104) is an ongoing randomized,
placebo-controlled Phase II study of telaprevir plus pegylated interferon
alpha-2a (Pegasys) and ribavirin in people who have not previously been treated
for hepatitis C.
Results from a planned interim analysis of PROVE 1, as well as preliminary HCV
sequencing data, were presented this week at the 47th Interscience Conference on
Antimicrobial Agents and Chemotherapy (ICAAC) in Chicago.
In this study, 263 treatment-naive participants with genotype 1 HCV were
randomized into 4 groups. The first 3 groups all received 750 mg tipranavir
every 8 hours plus 180 mcg/week pegylated interferon plus 1000-1200 mg/day
ribavirin for 12 weeks. This was followed by either 0 (n=20), 12 (n=80), or 36
(n=82) weeks of pegylated interferon plus ribavirin without telaprevir. A
control group (n=81) received standard therapy with pegylated interferon plus
ribavirin for 48 weeks.
The interim analysis was performed when all treated subjects had completed 12
weeks of dosing. Samples were collected for viral sequencing at baseline and at
each HCV viral load assessment.
Results
. The proportion of subjects with undetectable HCV RNA (limit of detection 10
IU/mL) at Week 4 was 79% in the combined telaprevir/pegylated
interferon/ribavirin arms, compared with 11% in the control group (P<0.001).
. At Week 12, the corresponding percentages were 70% and 39%, respectively
(P<0.001).
. In the telaprevir combination therapy groups, 12 of 175 subjects experienced
virological breakthrough (defined as an increase of
RNA nadir) and had evidence of previously described telaprevir-resistant
variants.
. In the group receiving 12 weeks of telaprevir, 6 of 9 subjects (66%) with
rapid virological response (RVR) at Week 4 who completed 12 weeks of therapy had
undetectable HCV RNA 20 weeks after the end of treatment (sustained virological
response is typically measured 24 weeks after the end of treatment).
. 3 subjects experienced viral relapse after completion of treatment and also
had telaprevir resistant variants.
. Discontinuations due to adverse events were more frequent in the telaprevir
combination therapy arms compared with the standard therapy control group (11%
vs 3%).
. Rashes, gastrointestinal symptoms, and anemia were more common - and rashes
were more severe - in the telaprevir groups.
Conclusion
"Significantly more subjects receiving a telaprevir-based regimen achieved
undetectable HCV RNA at Weeks 4 and 12," the investigators concluded. "Viral
breakthrough and relapse are associated with the selection of telaprevir
resistant variants."
They added that, "Shorter treatment durations appear feasible for genotype 1 HCV
in a subset of patients achieving RVR."
Johns Hopkins University, Baltimore, MD; Duke University Clinical Research
Institute, Durham, NC.
09/18/07
Reference
MS Sulkowski and JG McHutchison. Interim Analysis Results and Preliminary Viral
Variant Evaluation from a Phase 2 Study of Telaprevir with Peginterferon alfa-2A
and Ribavirin in Treatment-Naïve Subjects with Hepatitis C. 47th Interscience
Conference on Antimicrobial Agents and Chemotherapy. Chicago, September 17-20,
2007. Abstract V-1383.
http://www.hivandhepatitis.com/2007icr/icaac/docs/091807_c.html

Profile of Patients Triply Infected with HIV, HBV, and HCV in the HAART Era
By Liz Highleyman
Due to overlapping transmission routes, a proportion of people with HIV are also
coinfected with hepatitis B virus (HBV), hepatitis C virus (HCV), or both.
At the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy
(ICAAC) this week in Chicago, Marina Nunez, MD, presented data on individuals
triply infected with HIV, HBV, and HCV.
The researchers identified all HIV positive patients with detectable anti-HCV
antibodies and hepatitis B surface antigen (HBsAg) at 5 HIV clinics in Europe
and North America. They collected data about levels of HIV RNA, HCV RNA, and HBV
DNA, presence of hepatitis B "e" antigen (HBeAg), HBV and HCV genotypes, and
antibodies against hepatitis delta virus (HDV), which occurs only in conjunction
with HBV.
Results
. 67 patients were identified who were triply infected with HIV, HBV, and HCV.
. 84% were men, 82% were injection drug users, and the median age was 44
years.
. The median CD4 cell count was 333 cells/mm3, 73% were on HAART, and 59% had
HIV viral load below 50 copies/mL.
. 52% had detectable HCV RNA.
. 37% had detectable HBV DNA.
. 32% had positive HBeAg.
. 28% had positive HDV antibodies, indicating possible quadruple infection.
. CD4 cell counts tended to be higher among patients with undetectable HCV
RNA, regardless of whether they were taking anti-HIV therapy (447 vs 321
cells/mm3; P=0.05).
. In a multivariate analysis, HDV antibody positivity predicted undetectable
HCV RNA (RR 20.1; P=0.01).
. Predictors of undetectable HBV DNA were absence of HBeAg (RR 13.73; P=0.001)
and use of anti-HBV therapy (RR 8.85; P=0.006).
. Neither HBV nor HCV levels or genotypes had an impact on the replication of
the other virus.
. Further details regarding anti-HBV treatment are shown in the table below:
HCV RNA+
HCV RNA neg
All
Current
HBV DNA+
4 (9%)
5 (11%)
9 (20%)
anti-HBV
HBV DNA-neg
19 (41%)
18 (39%)
37 (80%)
treatment
All
23 (50%)
23 (50%)
46 (100%
No current
HBV DNA+
8 (42%)
7 (37%)
15 (79%)
anti-HBV
HBV DNA-neg
3 (16%)
1 (5%)
4 (21%)
treatment
All
11 (58%)
8 (42%)
19 (100%)
All patients
HBV DNA+
12 (18.5%)
12 (18.5%)
24 (37%)
regardless of
HBV DNA-neg
22 (34%)
19 (29%)
41 (63%)
anti-HBV Rx
All
34 (52.5%)
31 (47.5%)
65 (100%)
Conclusion
Based on these findings, the investigators concluded:
. About half of patients with markers for HBV/HCV/HIV triple infection had
undetectable HCV RNA.
. This was significantly more frequent among HDV antibody positive patients.
. The absence of HBeAg and the presence of anti-HBV therapy were the factors
determining undetectable HBV DNA.
. A direct impact of active HBV or HCV replication on the replication of the
other virus was not found.
Inst. Malattie Infettive, Sassari, Italy; Hosp. Carlos III, Madrid, Spain; Hosp.
Virgen de la Macarena, Sevilla, Spain; Hosp. de Especialidades CRM SXXI, Mexico
DF, Mexico; Wake Forest Univ. Hlth. Sci., Winston Salem, NC.
09/18/07
Reference
I Maida, M Rios, L. Perez-Saleme, and others. Profile of Patients Triply
Infected with HIV and the Hepatitis B and C Viruses in the HAART Era. 47th
Interscience Conference on Antimicrobial Agents and Chemotherapy. Chicago,
September 17-20, 2007. Abstract V-1901.
http://www.hivandhepatitis.com/2007icr/icaac/docs/091807_e.html

HCV and HIV Infection Stimulate Distinct Immune Response Patterns
About one-third of HIV positive people in the U.S. are estimated to be
coinfected with hepatitis C virus (HCV), and HIV-HCV coinfection has been linked
to more rapid progression of liver fibrosis and poorer response to treatment
with pegylated interferon plus ribavirin.
As reported at the 47th Interscience Conference on Antimicrobial Agents and
Chemotherapy (ICAAC) this week in Chicago, researchers from the National
Institutes of Health examined the molecular and immunological basis for host
immune responses to HIV and HCV.
Using Affymetrix U133A gene chips, they analyzed gene expression profiles in
peripheral blood mononuclear cells (PBMCs) from 33 patients:
. 7 HIV negative;
. 7 HCV monoinfected and viremic;
. 8 HIV monoinfected and viremic;
. 5 HIV-HCV coinfected;
. 6 HIV positive and non-viremic.
A SAM algorithm was used to determine the genes that were differentially
expressed across the different patient groups. Validation of DNA microarray data
was performed using a bDNA multiplex assay, flow cytometry, and ELISA.
Results
. Gene expression profiles in PBMCs showed that HIV viremia upregulates genes
associated with immune activation, while HCV viremia upregulates genes
associated with immunoregulatory pathways.
. HCV viremia was associated with abnormalities in non-T-cells, suggesting a
global effect of HCV on the immune system.
. Ingenuity function analysis revealed distinct pathways of innate immune
activation involved in HCV and HIV infection.
. Interferon-induced genes were expressed at a higher level in PBMCs from HIV
positive individuals (P<0.01).
. Functional assays confirmed enhanced immunoregulatory activity among HCV
infected individuals, resulting in an inability to mount an effective anti-HCV
immune response.
Conclusion
"HCV and HIV infection leave distinct genetic imprints of immune activation
profiles in PBMCs," the investigators concluded. "Of note, HIV viremia induces
an immune activated state whereas HCV infection induces immunoregulatory
pathways resulting in immunologic quiescence."
They added that, "Aberrant type-I interferon response seen exclusively in
HIV-infected individuals may be responsible for poor therapeutic response seen
in HIV-HCV coinfected patients to current standard of care [for hepatitis C]."
National Institutes of Health/National Institute for Allergy and Infectious
Diseases, Bethesda, MD.
09/18/07
Reference
MY Yan, KN Reitano, J Yang, and others. Chronic HIV and Hepatitis C Infection
Induce Distinct Immunologic Imprints that Relate to Pathogenesis of Liver
Fibrosis and Therapeutic Response to Interferons. 47th Interscience Conference
on Antimicrobial Agents and Chemotherapy. Chicago, September 17-20, 2007.
Abstract V-1384.
http://www.hivandhepatitis.com/2007icr/icaac/docs/091807_f.html

HepCinglesThis is just a test through my complicated email set up to
see if
this post comes through without HTML tags, sorry for the
inconvenience.
Dennis near Seattle

Woman to sue Peru Govt over HIV-infected blood
Posted 11 hours 47 minutes ago
A Peruvian mother of three children has announced she is suing the Peruvian
Government after being infected with HIV at a state-run hospital.
Judith Rivera, 44, is one of four people - including an 11-month-old infant -
who may have been infected through HIV-tainted blood administered at the Daniel
Carrion hospital in April.
"I will not be dissuaded from this lawsuit for indemnity for life from the
state, to which I am entitled," she told reporters.
Her case unleashed a scandal which prompted Health Minister Carlos Vallejos to
declare an emergency at all blood banks until an inspection can be completed.
This is not the first time patients have been infected at state facilities. In
2004, five newborns were infected with HIV at Lima's maternity hospital.
Some 30 persons were recently shown to have been infected with hepatitis C at a
state-run dialysis centre.
Health Vice Minister Jose Calderon denied any negligence on behalf of the
hospital, saying that the blood had probably been donated by a person carrying
HIV before it had caused any symptoms, the same explanation officials gave in
2004.
Mr Calderon said Ms Rivera would be eligible for life-long medical care gratis.
Ms Rivera also received 28 bags of adult diapers for incontinence caused during
the same operation in which she was infected, when her bladder was perforated
during the hysterectomy.
"These diapers show a lack of respect," Ms Rivera said.
"They made a commitment to give me medicine, but I need to support my three
children," said Ms Rivera, who lives in a neighbourhood on the northern
outskirts of Lima.
"Now I'm going to have to spend money that I don't have on a lawsuit, but I'm
going to fight for that compensation."
The HIV and hepatitis C scare are black marks on Peru's public health services,
already overwhelmed by a powerful August 15 earthquake that killed 519 and left
some 200,000 people homeless.
Health authorities have placed Peru's 240 blood banks under close scrutiny.
"All the blood banks in Peru will undergo a more exhaustive evaluation than the
one we have been carrying out since the start of the year, which allowed us to
close 30 centres," Mr Vallejos said.
The scare unleashed widespread panic. Mr Vallejos had to issue a special appeal
to the public to trust the country's public health services.
- AFP
http://abc.net.au/news/stories/2007/09/15/2033804.htm?section=justin

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FONT-WEIGHT: bold}The link doesn't work, I did a google search to see what this
is about and NONE
of the various www.alligator.org urls are working. (it's a college newspaper
in Gainsville FL) Next I'll check the local weather and see if ya'll is havin' a
hurrican' or storm that took out the power Cougars Posted by: "PeachStatePam"
figment@... figment_4 Fri Sep 14, 2007 6:00 pm (PST)
http://www.alligator.org/media/cougars/
I want some head bumps! I want one :-)
His course sounds very intersting.
Peace and Love

U.S. man first to turn to India for liver transplant surgery
BY CHRIS NELSON
CONCORD, Calif. - When Kevin Stewart's doctor told him late last year that he
had advanced cirrhosis of the liver and would need a transplant or face certain
death, Stewart never thought that his salvation existed half a world away in
India.
That changed when Stewart, a resident of Big Pine Key, Fla., learned of the cost
to have the procedure done in the United States - about $350,000 - and after the
federal government and public and private hospitals repeatedly rejected his
pleas for financial assistance.
Stewart, his options exhausted, discovered almost by accident WorldMed Assist
LLC, a California company that arranges high-end medical treatment abroad for
its clients at prices that are far less-expensive than what they would pay in
the United States.
Concord-based WorldMed Assist took Stewart on as a client and arranged for him
to travel to India earlier this summer for a liver transplant surgery. His
sister, Jo-Ann Hall of Ottawa, Canada, donated a portion of her liver to Stewart
- a procedure known as live-donor liver transplant. Subhash Gupta, a
liver-transplant specialist with Indraprastha Apollo Hospital in New Delhi and
the chief of the hospital's liver surgery unit, performed the transplantation.
Stewart paid approximately $55,000 for his surgery and hospitalization -
$275,000 less than what it would have cost to have it done in the United States.
"Having this surgery in the [United States] would have wiped me out," Stewart
said. "Having someone help me get the transplant I needed in India - with
top-notch doctors in a great hospital, at a fraction of the cost - saved me so
much money that I flew my girlfriend and Jo-Ann's husband to India to help us
recuperate. This surgery has given me back a life I thought was lost."
WorldMed Assist was founded in October 2006 by Wouter Hoeberechts, 37, a Dutch
entrepreneur with a background in management consulting, who recognized the need
for low-cost, quality health-care options for Americans.
"At the start of 2006, I read an article about [medical tourism]. Ever since I
arrived in the U.S. from the Netherlands, I've known that improvements to the
U.S health-care needed to be made," Hoeberechts said. "My wife's father is an
internationally renowned urologist and professor in Turkey and I became
fascinated with the strides that country was making in the delivery of
high-quality, affordable care. I started following advances made in other
countries like India, Belgium, Mexico and realized North Americans have viable
low-cost alternatives that are of high quality."
WorldMed charges a flat fee of $300 for its services (separate from any medical
costs). Hoeberechts, who prefers to call himself a logistical coordinator rather
than a medical tourism provider, has connected 14 U.S. residents with physicians
and hospitals in India, Turkey and Belgium since last October.
"We create alternatives for our clients," Hoeberechts said. "Many of the people
who contact us have run out of options - they are uninsured or underinsured -
and we connect them to high-quality hospitals outside the United States where
they will receive excellent care for much less than what they would pay in
America."
WorldMed's executive board is comprised of Hoeberechts, the company's chief
executive officer; his wife Gulbin Muftuoglu-Hoeberechts, WorldMed's marketing
manager; Dr. Paul Kim, WorldMed's chief medical officer; and Dr. Orkun
Muftuoglu, an ophthalmologist and WorldMed's medical advisor for Turkey.
Stewart stumbled upon WorldMed when he looked up medical tourism on the
Internet.
"In early June, I hit the Internet, and eventually landed on the words 'medical
tourism.' I searched several firms, saying, 'I need a liver transplant.' Several
responded, but I kept coming back to WorldMed Assist," Stewart said. "By late
June, they had me on my way to India, and my surgery was finished July 11.
Pretty amazing - I heard I was the first American to have a liver transplant in
India."
Interestingly, Hoeberechts almost declined to accept Stewart as a client because
of the risks associated with liver transplants. "I was initially reluctant to
take Kevin on as a patient," he said. "Live liver transplants are extremely
risky, no matter where in the world they're done. But I knew of Dr. Subhash
Gupta at one of WorldMed Assist's contracted hospitals (Apollo in New Delhi); we
did our research and gathered references - Dr. Gupta has done 120 live liver
transplants with a long-term survival record that surpasses the Mayo Clinic's,
the U.S.'s gold standard for liver transplants."
Gupta, who received his surgical training in the United Kingdom, pioneered the
practice of "bloodless surgery," an approach that involves the delivery of
medical and surgical care without the transfusion of blood products. The
technique has long been applied to Jehovah's Witness patients, but it is now
experiencing widespread popularity with other patients due to the lessened risk
of infection and immunologic complications.
"We were blown away by Dr. Gupta," Hoeberechts said. "I don't think you'll find
a better-qualified liver-transplant surgeon anywhere."
Stewart returned to the United States Aug. 24 after spending two months in
India. He is currently recuperating at his house in the Florida Keys, and says
he feels "wonderful."
"I feel great - I haven't felt this good in years," he said via telephone.
"Every day is better than the one before it, and I'm constantly wearing a smile.
I can't say enough about what Wouter and WorldMed Assist have done for me."
http://www.indusbusinessjournal.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=\
Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=E33B28F\
A121F48DC84AF88DFB91F397E

http://www.alligator.org/media/cougars/
I want some head bumps! I want one :-)
His course sounds very intersting.
Peace and Love
(`'·.¸(`'·.¸ ¸.·'´) ¸.·'´)
«´¨ *Pam* ¨`»
(¸.·'´(¸.·'´ `'·.¸)`' ·.¸)
¸.·´
( `·.¸
`·.¸ )
¸.·)´
(.·´
`*.
*.
Mahatma Gandhi put it well: "Be the change you want to see in the
world." It always begins with one person.

4 Best and Worst Health Habits
What are the best and worst things you can do for your health?
By Jeanie Lerche Davis
WebMD Feature
Reviewed by Louise Chang, MD
If you're committed to healthy living, check out the little things you do each
day. Is breakfast a donut or two? Is lunch a burger and fries? At home, do you
park yourself on the couch -- after sitting all day at work? Are you always
keyed up, and just can't shake a constant feeling of stress?
There's no getting around it: Your worst and best habits greatly affect your
heart, mind, and overall health.
"People don't realize that heart disease develops over a long period of time,
and a pill won't erase the damage caused by a lifetime of bad habits," says
Leslie Cho, MD, medical director for preventive cardiology and rehabilitation at
the Cleveland Clinic.
Your mental state is a big part of your overall health picture, Cho tells WebMD.
"Research shows that depression causes heart disease, and so does stress. Dick
Cheney, Ken Lay, and Slobodan Milosevic all had heart attacks when under stress.
Only Cheney survived his. When the body is in a constant state of heightened
alert, heart disease and heart attack can occur."
What habits are worst and best for your heart, mind, and body? Here's Cho's
list:
Worst Habits for Healthy Living
Which of these habits describe you?
Smoking. You know you should quit, but... Face it, smoking is absolutely the
worst thing you can do. Smoking causes heart attack, stroke, lung cancer, and
mouth cancer.
Fast food and red meat. Your diet is the fast-food menu -- full of salt, fat,
cholesterol, and calories. Red meat is a mainstay; fried anything is your
favorite treat. And you love those Danishes and donuts for breakfast, and
cookies or chips when the afternoon drags.
Too much sitting. You work long hours, with a good-sized commute that eats up
your day. The longest trek you take is from garage to kitchen to couch.
Never seeing a doctor. You just don't think to get your cholesterol checked --
much less anything else.
Best Habits for Healthy Living
Eating the good stuff. You eat cereal -- even oatmeal -- for breakfast. You're
eating more fresh produce: apples, tomatoes, bananas, oranges, grapes, green
salads, broccoli, spinach, sweet potatoes. You've switched from white bread to
whole-wheat, from steaks to salmon. You've seen the light!
Walking. You've found the secret to getting off the couch -- turning off the TV.
You start walking after work. You park your car away from your office building,
to get some extra steps. You take the stairs once in awhile. You may start slow,
and do a little -- but you try to get a little exercise every day. Any exercise
is better than no exercise.
Annual doctor visits. You see a doctor every year, and get the basic tests --
cholesterol, blood pressure, diabetes. You see specialists when necessary. You
take all preventive measures necessary, as advised by your doctor.
Relaxing. You have found ways to cope with stress. You have a dog, a good
walking partner. You try yoga, meditation, or praying regularly. You have a
hobby, an interest outside your work. You join a social group, a church, or a
temple, and make friends. All these things help to lower stress -- and that
reduces your risk of heart disease and heart attack.
http://www.webmd.com/content/article/133/118775.htm?ecd=wnl_smk_091407

New hepatitis C virus findings from the United States and Italy detailed
Studies from the United States and Italy have provided new information about
hepatitis C virus.
Study 1: Scientists discuss in "Hepatitis C virus induces proteolytic cleavage
of sterol regulatory element binding proteins and stimulates their
phosphorylation via oxidative stress" new findings in hepatitis C virus.
"Hepatic steatosis is a common histological feature of chronic hepatitis C.
Hepatitis C virus (HCV) gene expression has been shown to alter host cell
cholesterol/lipid metabolism and thus induce hepatic steatosis," researchers in
the United States report.
"Since sterol regulatory element binding proteins (SREBPs) are major regulators
of lipid metabolism, we sought to determine whether genotype 2a-based HCV
infection induces the expression and posttranslational activation of SREBPs. HCV
infection stimulates the expression of genes related to lipogenesis. HCV induces
the proteolytic cleavage of SREBPs. HCV core and NS4b derived from genotype 3a
are also individually capable of inducing the proteolytic processing of SREBPs.
Further, we demonstrate that HCV stimulates the phosphorylation of SREBPs. Our
studies show that HCV-induced oxidative stress and subsequent activation of the
phosphatidylinositol 3-kinase (PI3-K)-Akt pathway and inactivation
(phosphorylation) of PTEN (phosphatase and tensin homologue) mediate the
transactivation of SREBPs. HCV-induced SREBP-1 and -2 activities were sensitive
to antioxidant (pyrrolidine dithiocarbamate), Ca(2+) chelator
1,2-bis(aminophenoxy)ethane-N,N,N',N'-tetraacetic acid-tetra(acetoxymethyl)
ester (BAPTA-AM), and PI3-K inhibitor (LY294002)," wrote G. Waris and
colleagues, University of California, Division of Infectious Diseases.
The researchers concluded: "Collectively, these studies provide insight into the
mechanisms of hepatic steatosis associated with HCV infection."
Waris and colleagues published their study in the Journal of Virology (Hepatitis
C virus induces proteolytic cleavage of sterol regulatory element binding
proteins and stimulates their phosphorylation via oxidative stress. Journal of
Virology, 2007;81(15):8122-30).
For additional information, contact G. Waris, University of California,
University of California, Division of Infectious Diseases, San Diego, 9500
Gilman Drive, La Jolla, CA 92093 USA..
Study 2: According to a study from the United States, hepatocyte nuclear factor
(HNF) 1 and hepatocyte nuclear factor (HNF) 4 mediate hepatic multidrug
resistance protein (MRP) 2 up-regulation during hepatitis C virus (HCV) gene
expression.
"HCV is known to induce hepatic oxidative stress that is implicated in the
up-regulation of MRPs. The relationship between increased prooxidant production,
MRPs, and HCV has not been investigated.
"Here, we report that a homeodomain-containing transcription factor, HNF 1,
plays a central role in liver gene regulation during HCV gene expression and/or
subgenome replication," wrote I. Qadri and colleagues, University of Colorado.
"MRP2 protein and mRNA expression were increased and MRP2 promoter activity was
increased 7-fold. Mutations within the putative HNF1 binding site of the human
MRP2 promoter abrogated HCV-induced activation, implicating HNF1 in the
induction of MRP2 by HCV. The mechanism by which HNF1-mediated activation occurs
seems to be transcriptional, because the regulated expression of HNF4, which is
known to control HNF1 expression, was also increased. Consistent with this
finding, HNF1 mRNA was increased 10-fold.
"A promoter-luciferase construct of the human HNF1 gene was activated in an
HNF4-dependent manner, and a mutant construct lacking the HNF4 binding site was
not activated in HCV-positive cells. Consistent with this hypothesis, HNF4
protein and mRNA levels as well as HNF4 promoter activity and DNA binding
activity were increased," the investigators reported.
The authors concluded, "The expression of HNF1 seems to play a critical role in
the induction of hepatic MRP2 secondary to HCV subgenomic replication. The
ability of HCV to induce HNF1 and HNF4 is attributed to 1) increased oxidative
stress and 2) direct protein-protein interactions between HCV nonstructural
component (NS) 5A and HNF1, leading to enhanced HNF1 DNA binding."
The researchers further noted, "We describe a novel mechanism by which HCV gene
expression may induce adaptive responses involving MRP2 via HNF1 activation.
This may constitute, in part, the cellular detoxification task force during HCV
infection."
Qadri and colleagues published the results of their research in Molecular
Pharmacology (Hepatocyte nuclear factor (HNF) 1 and HNF4 mediate hepatic
multidrug resistance protein 2 up-regulation during hepatitis C virus gene
expression. Mol Pharmacol, 2006;70(2):627-636).
For additional information, contact I. Qadri, University of Colorado, Health
Science Center, Department of Pediatrics, Mail Stop 8106, 12801 E 17th Avenue,
L-18-7403, RC-1 S, Aurora, CO 80045, USA.
Study 3: According to a study from Italy, oxidative stress inhibits
IFN-alpha-induced antiviral gene expression by blocking the JAK-signal
transducer and activator of transcription (STAT) pathway.
"Unresponsiveness t