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Study Finds Noninvasive Blood Test For Liver Fibrosis May Alleviate Need For Liver Biopsies For Some Patients With Chronic Hepatitis C
A study in the June issue of Clinical Gastroenterology and Hepatology, published by Elsevier, demonstrates that the Hepascore(TM) liver fibrosis blood-serum test panel may help physicians more accurately diagnose and stage liver fibrosis in patients with chronic hepatitis C (HCV), potentially alleviating the need for liver biopsy, the standard of care for staging fibrosis, in a particular subset of patients. The Hepascore test panel is provided exclusively by Quest Diagnostics Incorporated (NYSE: DGX), the world"s leading provider of diagnostic testing, information and services.

What Is The Difference Between Hip Resurfacing And Total Hip Replacement?
If hip resurfacing is an option, the surgeon will simply reshape the damaged surface of the femoral ball and then cover it with a round metal cap. The limitation here is that the procedure only works for bone that is not too damaged by arthritis. Generally speaking, surface replacements are not performed on patients with serious arthritic conditions, because if the bone is not strong enough, there is a small but real risk of fracturing. Therefore the average age of resurfacing patients may be 50 years or younger. Statistically, the resurfacing operation is an option for about 7 out of a 100 patients.
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Recent Studies And Surveys
Georgetown Policy Report: Long-Term Care in Health Care Reform: Policy Options to Improve Both - Policy - Long-term care reform belongs in health care reform -- "The well-being and financial security of families depend not only on access to affordable medical services, but also on access to affordable, reliable long-term care - the daily assistance and supports that many individuals need because of serious medical conditions or disabilities." This policy brief presents four policy options that merit serious consideration in the current health care reform discussion. ... The first two options would improve long-term care for people with low incomes and limited financial res. These options would modernize Medicaid in important ways, tailoring services better to individual needs and using res more effectively. The third and fourth options aim to strengthen long-term care protections for the broader population; one with better coordination of medical and long-term care for Medicare enrollees; the other by establishing insurance protection for people of all ages and incomes" (Komisar, Tumlinson, Feder, Burke, 7/16). (Note: KHN"s coverage of aging and long term care issues is supported by a grant from The SCAN Foundation.)
Sexual Health

Common Cancer Drug May Increase Risk Of Deadly GI Perforations

Cancer patients treated with the widely used drug bevacizumab (Avastin) in combination with chemotherapy are at greater risk of life-thereatening gastrointestinal (GI) perforations. This is the conclusion of Shenhong Wu, M.D., Ph.D., Principal Investigator, and colleagues at Stony Brook University Medical Center, in a study published online and in the June print issue of The Lancet Oncology. Bevacizumab is an angiogenesis inhibitor that slows down the growth of tumors by cutting off their blood supply. The agent has been shown to be effective in treating many forms of cancer, including colorectal cancer, renal cell cancer, non-small cell lung cancer and breast cancer. There has been concern about the use of bevacizumab and GI perforations, which are dangerous holes that develop in the stomach, small intestine or large bowel. The U.S. Food and Drug Administration has issued a black-box warning to discontinue bevacizumab in patients with GI perforations. However, a link between the use of bevacizumab in cancer patients and GI perforations had not been established until the SBUMC study results. "Our study establishes a significant association between the use of bevacizumab in cancer patients and the risk for GI perforations, one in which the risk of GI perforations was double that in those taking the medication compared to those taking a control medication," says Dr. Wu, Assistant Professor of Medicine in the Division of Hematology/Oncology. "We hope the study results will help to identify a subset of patients receiving bevacizumab at high risk of bevacizumab-associated perforation." In "Risk of gastrointestinal perforation in patients with cancer treated with bevacizumab: a meta-analysis," Dr. Wu and colleagues completed a systematic review and meta-analysis of 17 randomized controlled trials involving 12,294 patients with various types of solid tumors to assess the role of bevacizumab in GI perforation. The overall incidence of GI perforation among patients receiving bevacizumab was 0.9%. Of those patients with a GI perforation, the mortality rate was extremely high at 21.7 percent. The study results revealed that risk varied with bevacizumab dose and tumor type. The higher the dose of the agent, the greater the risk for GI perforation. Patients taking 2.5 mg/kg per week of bevacizumab were 61 percent more likely to have a perforation. Patients receiving the highest dose (5 mg/kg per week) had a 167 percent higher risk. The highest risks for GI perforation were found in patients with advanced colorectal cancer and renal cell cancer. The lowest risk was in patients with pancreatic cancer. The authors believe that because bevacizumab is extensively used in routine cancer treatment and the risk for GI perforation is significant in patients, it is increasingly important to recognize symptoms indicating perforation and intervene to reduce morbidity and mortality. In addition, they recommend further studies to "investigate risk reduction, and the possible use of bevacizumab in selected patients who have recovered from GI perforation." Dr. Wu"s co-authors at SBUMC include Sanjaykumar Hapani, M.D., and David Chu, M.D. The study was funded in part by the Stony Brook University Research Foundation. Stony Brook University Medical Center


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