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Study Looks At Efficacy, Cardiovascular Risks Of Two HIV Treatments
Patients taking Boehringer Ingelheim"s HIV drug Viramune have a lower risk of developing cardiovascular disease than those taking Bristol-Myers Squibb"s treatment, Reyataz, according to a study released on Monday at the 5th International AIDS Society conference in Cape Town, South Africa, Reuters reports. "The drug trial, involving 569 participants, yielded that Viramune, while being as effective at suppressing HIV as Bristol Myers" blockbuster Reyataz, had a more favourable effect on patients" cardiovascular risks, as measured by certain blood lipids," the article states. The study found that "Viramune-treated patients ò€¦ had more than twice the level of HDL cholesterol, known as "good cholesterol" for its benefitial effect on blood vessels, than those on Reyataz, Boehringer said in a statement," Reuters reports. The article adds that advances in antiretroviral drugs have helped make HIV a "treatable chronic condition," and "as a result, patients are growing older, bringing other symptoms of an HIV infection, such as cardiovascular diseases, to the fore" (Burger, Reuters, 7/20).

British Medical Association Comment On Announcement On NHS Treatment Centres
The Department of Health announced that the terms offered to independent providers of treatment centres in the NHS in England will in future be more similar to those offered to NHS providers.
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Sen. Baucus Says Health Care Overhaul Will Cover About 95% Of Citizens, Will Not Cover Undocumented Immigrants
Senate Finance Committee Chair Max Baucus (D-Mont.) on Thursday said that Congress" health care overhaul plan would cover 94% to 96% of the population but not undocumented immigrants, the AP/Las Vegas Sun reports (Alonso-Zaldivar, AP/Las Vegas Sun, 5/21). In remarks at a briefing sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business, Baucus said, "There are always going to be some people ... you just can"t find" to enroll, adding that "we"re going to try to get as close as we can (to 100% coverage) and we"re working hard to accomplish that." He added, "[W]e"re not going to cover undocumented workers. That"s too politically explosive" (Reichard, CQ HealthBeat, 5/21). According to an analysis by the Center for Immigration Studies and the U.S. Census Bureau, undocumented immigrants make up between 15% and 22% of the estimated 47 million U.S. residents without health coverage. Baucus said, "I don"t have a good answer yet to undocumented workers, illegal aliens," adding, "There will still be charity care " (Landers, Dallas Morning News, 5/22). Baucus said that the bill his committee is working on and that he expects to mark up in mid-June will include "incentives" and possibly requirements for employers to pay for employee health insurance. Baucus mentioned the possibility of including an individual mandate and establishing a health insurance exchange (AP/Las Vegas Sun, 5/21). Baucus also noted that the plan most likely will include a public health insurance option in some form (Tumulty, "Swampland," Time Magazine, 5/21). "Everything"s on the table," Baucus said, warning that "because this is so big, so complex, there are going to be a lot of trade-offs. ... This is just so large" (CQ HealthBeat, 5/21). He said that he is very optimistic about the prospects of bipartisan support for the legislation, placing the odds at between 75% and 80% ("Swampland," Time Magazine, 5/21).
Public Health

Carbon Monoxide Reverses Diabetic Gastric Problem In Mice

Mayo Clinic researchers have shown that very low doses of inhaled carbon monoxide in diabetic mice reverses the condition known as gastroparesis or delayed stomach emptying, a common and painful complication for many diabetic patients. The findings were presented on June 1 at Digestive Disease Week in Chicago. "This is a significant finding, as it shows that loss of the enzyme that makes carbon monoxide is the actor in this process and that it provides us with a clear approach toward a possible new therapy for this condition," says Gianrico Farrugia, M.D., Mayo Clinic gastroenterologist and lead investigator on the study. Gastroparesis occurs when the stomach retains undigested food for long periods. When that food eventually passes into the small intestine, insulin is released. Because the passage of food out of the stomach becomes unpredictable, maintaining a proper blood glucose level -- critical for controlling diabetes -- also becomes difficult. Gastroparesis can cause pain, nausea, vomiting, stomach spasms and weight loss due to inability to ingest enough nutrients. In some patients with diabetes, the abnormally high blood glucose levels cause chemical changes in nerves and in pacemaker cells, which regulate digestive processes in the gut, and damage blood vessels that carry oxygen and nutrients to cells. Previous studies by the Mayo team showed that gastroparesis is associated with the loss of up-regulation of heme oxygenase-1 (HO1) and an increase in oxidative stress. It also causes a loss of Kit, a marker for the pacemakers cells called interstitial cells of Cajal, which regulate muscle contraction in the digestive tract. When the team induced HO1 production, signs of oxidative stress dropped and gastroparesis was restored along with Kit. The metabolite that normalized gastric functioning was not known. Suspecting carbon monoxide, the Mayo investigators studied ten mice with diabetes that had exhibited delayed gastric emptying. Five mice were given carbon monoxide by inhalation (100 parts per million) for six hours daily. Within three weeks gastroparesis reversed, oxidative stress decreased and Kit expression increased, all without increasing HO1 expression. The study was funded by the National Institutes of Health and Mayo Clinic. Other members of the Mayo team were Purna Kashyap, M.B.B.S.; Kyoung Moo Choi, Ph.D.; Matthew Lurken; Nirjhar Dutta; Joseph Szurszewski, Ph.D.; and Simon Gibbons, Ph.D. Amy Tieder Mayo Clinic


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