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Dartmouth Studies Influence Administration, Even In Choice Of Venue
When President Obama chose Green Bay, Wis., to talk about the need for health reform, he did so in part because the area has achieved a high level of quality, and compared with other parts of the country, succeeded in restraining health care costs, National Public Radio reports. "They"re certainly spending a lot less money, and they are providing care that is equal or better than the care that is provided in many other communities around the country," Elliot Fisher, a researcher at the Dartmouth Institute for Health Policy and Clinical Practice told NPR in an interview. NPR says: "Some of the research the administration is relying on comes from the Dartmouth Institute for Health Policy and Clinical Practice," which focuses on variations in health quality and costs around the country.
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New Rapid 4th Generation Point Of Care HIV Test Identifies Acute Infection Earlier Than Antibody Only Tests
The new 4th generation rapid HIV diagnostic test - Determine® HIV 1/2 Ag/Ab Combo - from Inverness Medical is capable of detecting HIV infection several days earlier than HIV antibody only tests and is ideal to help diagnose and screen for early HIV infection. The ability of this test to enhance the diagnosis of those with acute HIV infection will provide additional benefits in HIV prevention programs and ultimately contribute to a reduction in the spread of HIV. Inverness Medical will be showcasing the new Determine Combo test at the International AIDS Society Conference 2009 in Capetown, South Africa, 19-22 July on stand #203.
Diagnostics

Lung Volume Reduction Surgery Shown To Prolong And Improve Life For Some Emphysema Patients

Lung volume reduction surgery (LVRS) can have a significantly beneficial effect in patients with severe emphysema, according to the first ever study to randomize emphysema patients to receive either LVRS or non-surgical medical care. "We found lung reduction surgery is good treatment alternative for selected emphysema patients since it not only improves survival but also meaningfully improves quality of life for a period of at least five years after the operation," said lead author of the study, Roberto Benzo, M.D., MSc. of the Mayo Clinic. "Patients who underwent LVRS, with the exception of those who had non-upper-lobe-predominant emphysema, had both a survival and quality of life benefit when compared to similar patients undergoing medical treatment only." The results of the National Emphysema Treatment Trial (NETT) study were reported in the August 1 issue of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society. The NETT group recruited 1,218 patients with severe emphysema and randomized them to either undergo LVRS or non-surgical medical treatment, which generally consisted of customized use of medication, oxygen support, smoking cessation and pulmonary rehabilitation. LVRS consists of removing a portion of emphysematous lung tissue in the patient. While removing lung tissue in patients whose breathing is compromised may seem counterintuitive, severe emphysema causes "air trapping", where the patient can inhale, but is unable to force the air back out of the lung. This is one of the main causes of shortness of breath in patients with emphysema. "By removing the section of lung that is primarily affected with severe emphysema, we can decrease air trapping and consequently the shortness of breath, which can thereby improve the patient"s perceived quality of life," explained Dr. Benzo. A total of 608 patients underwent LVRS and 610 received standard medical care. The patients were followed for five years or until they died. All endpoints except death were measured at six-month intervals. The primary outcome was a composite endpoint consisting of death or an "unquestionable and meaningful deterioration" in quality of life, defined as an 8-point or greater drop on the Saint George"s Respiratory Questionnaire, a widely used standardized measure of quality of life in patients with respiratory disease. In the total sample, the average time until a "composite event" either death or a serious decline in quality of life was one year for medically treated patients and two years for patients who had undergone LVRS. Patients whose emphysema was predominantly found in the upper lobes of their lungs about 65 percent of emphysema patients also showed quality of life and survival benefits greater than survival benefits alone, suggesting that they lived longer and better. However, LVRS has a small but inherent danger of perioperative mortality. "LVRS has risks that patients need to understand and acknowledge," said Dr. Benzo. "In NETT, close to five percent of the patients undergoing lung reduction died in the post-operative period. However, once the post operative period is over, the quality of life benefit comes right away." "NETT was landmark study: randomization was necessary at that point as we did not know the true benefits of the surgery," said Dr. Benzo. "We now know the individuals that benefit from it. Randomization would be unethical now in the group of individuals that we now know get benefit. This study shed light on the palliative (overall well-being) benefits of the surgery, which many patients consider as important as the survival benefit American Thoracic Society (ATS)


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