Categories
Cardiovascular
Diagnostics
Endocrinology
Health Insurance
Medical Devices
Mental Health
Nutrition
Oncology
Public Health
Sexual Health
Popular Articles
Cellulite Cream

Baltimore Sun Examines Debate Over Howard County, Md., Health Program
About 200 uninsured people have enrolled in the Howard County, Md., Healthy Howard program since it began on Oct. 1, 2008, county health officer Peter Beilenson told a county council budget panel, the Baltimore Sun reports. Healthy Howard is a network of local doctors who charge members between $50 and $115 monthly for comprehensive medical coverage. The program uses health coaches to improve residents" overall health and seeks to lower costs related to emergency care over time. Beilenson had set a goal of enrolling 2,000 people in the program"s first year. According to Beilenson, "The biggest problem with all this is me. I made the definition of success this arbitrary 2,000 number." His new prediction is for 908 enrollees by July 2010. He said, "I think it"s very clear people just don"t know about it." He added that some residents are hesitant to pay even a small monthly charge during the continuing recession. County council member Greg Fox questioned if the enrollment level justifies a second county outlay of $500,000 for the program in fiscal year 2010, adding that he supports cutting county funding in half for the program in that year. Supporters of the program, however, say it needs more time and money in order to succeed, noting that enrollees have been seeing doctors through the program only since January. Commonwealth Fund President Karen Davis said the program "seems like it"s off to a great start" compared with similar local programs nationwide. She added that the program has helped 2,500 county residents, including children, find coverage through state and federal insurance programs, in part thanks to an electronic enrollment system that identifies programs they are eligible for. Howard Health Department Director of Policy and Planning Glenn Schneider said, "None of those applications would have happened without announcing the (Healthy Howard) program" (Carson, Baltimore Sun, 5/18).
generic viagra online
One Size Does Not Fit All: A New Look At Therapies
Statins, a commonly prescribed class of drugs used by millions worldwide to effectively lower blood cholesterol levels, may actually have a negative impact in Multiple Sclerosis (MS) patients treated with high daily dosages.
News of the day
New UIC Center To Eliminate Health Disparities Established With $7M Grant
The University of Illinois at Chicago has been awarded a $7.2 million federal grant to establish the UIC Center of Excellence in Eliminating Health Disparities.
Public Health

For HCV-Positive Liver Transplant Recipients, Some Donor Factors Affect Outcomes

Two new studies address donor factors that could affect outcomes for liver transplant recipients, particularly those with chronic hepatitis C (HCV). One found that donor steatosis, or fat in the liver, does not affect liver disease progression or three-year survival in recipients with or without HCV. However, transplants from people higher on the Donor Risk Index did adversely affect the outcomes of HCV-positive recipients more than recipients without HCV. These studies are in the June issue of Liver Transplantation, a journal published by John Wiley & Sons. The article is also available online at Wiley Interscience (http://www.interscience.wiley.com). HCV is a common cause of end-stage liver disease. It accounts for almost half of the patients awaiting a liver transplant, 15 percent of whom will die before an organ becomes available. To address this critical shortage, researchers have searched for ways to expand the pool of potential donors. They have tried living donor liver transplantation, partial liver transplants, and the use of grafts from donors who may be less than ideal. Sub-optimal donors might include those of advanced age or with other medical conditions such as hepatic steatosis, also known as fatty liver disease, which is common in overweight individuals. Researchers led by Patrizia Burra of Padova, Italy examined the impact of donor livers with steatosis on recipients with and without HCV. They included 116 consecutive liver transplants on 56 HCV-positive and 60 HCV-negative recipients and followed-up with liver biopsies at 6, 12, 24 and 36 months. "There was no correlation between donor graft steatosis and fibrosis after liver transplantation, irrespective of the etiology of liver disease," the authors report. They also found no evidence that steatosis affected patient survival up to three years post-transplant. In another study, researchers led by Daniel Maluf of Virginia Commonwealth University performed a retrospective analysis of 16,678 patients who received a liver transplant between January 2000 and June 2006. They examined the impact of the donor risk index (DRI) on patient outcomes. "Increasing DRI was associated with a statistically significant increase in the relative risk of graft failure and patient death for both HCV-positive and HCV-negative individuals," they report. "However, HCV-positive recipients demonstrated a significantly higher increase in relative risk of patient and graft loss as a function of the DRI than HCV-negative subjects, even after adjustment for several recipient factors including MELD." Donor age was the most significant, but not the only, factor that correlated to worse outcomes. The authors concluded that high DRI grafts should be used carefully in HCV-positive patients. In an accompanying editorial, Sandy Feng of the UCSF Medical Center, supports the findings of these new studies, and highlights the need to focus on survival benefit for liver transplant recipients in a time of donor organ shortage. "It is now possible to create an allocation algorithm that can systematically and objectively account for the variable impact of donor characteristics on liver transplant outcomes within the context of recipient diagnosis and disease severity," she concludes. "I believe that this would be the most equitable and transparent way to distribute the differential risk posed by the donor pool to individual transplant candidates." Article: "Impact of the Donor Risk Index in the Outcome of HCV+ Liver Transplant Recipients." Maluf, Daniel; Edwards, Erick; Stravitz, R.; Kauffman, H. Liver Transplantation; June 2009. Article: "Donor Livers with Steatosis are Safe to Use in HCV-Positive Recipients." Burra, Patrizia; Loreno, Massimiliano; Russo, Francesco; Germani, Giacomo; Galligioni, Alessandra; Senzolo, Marco; Cillo, Umberto; Zanus, Giacomo; Fagiuoli, Stefano; Rugge, Massimo. Liver Transplantation; June 2009. Editorial: "Increased Donor Risk - Who Should Bear the Burden." Feng, Sandy. Liver Transplantation; June 2009. Sean Wagner Wiley-Blackwell


Add your comment:
Name:
Site address: http://
Your message:
Enter today\\\\'s date, 2 digits
(spam protection):

© Copyright 2009