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New Democrat Coalition Proposes Independent Panel To Oversee Comparative Effectiveness Research
Members of the moderate New Democrat Coalition on Tuesday proposed legislation (HR 2502) that would establish a non-governmental, independent office to oversee research efforts to compare the effectiveness of medical treatments, CQ HealthBeat reports. The bill would create the Health Care Comparative Effectiveness Research Institute, which would use money remaining from the $1.1 billion included in the economic stimulus package for comparative effectiveness research and additional funding from fees on Medicare and private insurers. HCCERI would be overseen by a 21-member board -- appointed by the U.S. Comptroller General -- that would include HHS officials, patients, physicians, private insurers and others (Norman, CQ HealthBeat, 5/19). In contrast, a panel to oversee comparative effectiveness research established by a provision in the stimulus bill would be made up of government health experts (Mundy, "Washington Wire," Wall Street Journal, 5/19). According to CQ HealthBeat, some people have raised concerns that comparative effectiveness research funded by the stimulus bill would result in research that could be used to deny coverage for certain treatments and that cost would factor disproportionately in such decisions. Rep. Kurt Schrader (D-Ore.), who introduced the bill, said HCCERI"s goal would be to ensure that medical decisions remain between physicians and patients and that both doctors and patients have the most understandable information possible to make such decisions. HCCERI also would make public its methods for deciding which research projects to approve, as well as any links the institute has to industry, its research protocols and the names of researchers. HCCERI would accept public comment before creating new research guidelines, and all research would be subject to peer review. In addition, HCCERI in commissioning studies would take steps to account for differences in patients" gender, race, age and ethnicity (CQ HealthBeat, 5/19).Schrader said that the bill "will bring patients, along with health care providers, physicians and industry, to the decision-making process," adding, "By having a seat at the table, the American people will help drive the direction of research based on what is most important to them" ("Washington Wire," Wall Street Journal, 5/19). Rep. Allyson Schwartz (D-Pa.) said that New Democrats seek to lower costs and improve quality of care, so "the most important thing we can do is to incentivize innovation and to provide that information on the best practices and best interventions and get that information out to providers." Industry Reaction
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House Committee Approves Reform Bill; Full House Debate Scheduled For After August Recess
The House Energy and Commerce Committee on July 31 approved its health care reform bill (HR 3200) by a 31-28 vote that was mostly along party lines, the AP/Seattle Times reports. Among the many amendments considered during the markup, the committee rejected an amendment offered by Reps. Joe Pitts (R-Pa) and Bart Stupak (D-MI) to prohibit government subsidies to any insurance plans that offers abortion coverage, effectively prohibiting abortion coverage for customers eligible for public premium assistance. The amendment was rejected by a 27-31 vote. Another provision approved on July 30 would neither require nor prohibit insurance companies from providing coverage for abortion services.The approved bill includes provisions limiting how much insurers can increase premiums and gives the federal government the power to negotiate with drug companies for lower prices under Medicaid. The provisions were part of an effort by Democrats on the committee to reconcile the demands of liberals and conservatives, the AP/Times reports. The bill also would require insurance companies to sell coverage to anyone seeking it, regardless of pre-existing conditions. The government would provide subsidies to lower-income families to help them afford policies. In addition, the legislation would establish health insurance exchanges offering a variety of insurance plans, where consumers with or without subsidies could purchase health insurance (Espo/Werner, AP/Seattle Times, 8/1).Five of the committee"s Democrats joined all 23 Republicans in opposing the measure, the Washington Post"s "Capitol Briefing" reports. The five Democrats who voted against the bill were Reps. John Barrow (Ga.), Rick Boucher (Va.), Jim Matheson (Utah), Charlie Melancon (La.) and Bart Stupak (Mich.) (Kane, "Capitol Briefing," Washington Post, 7/31).The committee was the last of three House panels to take action on the legislation, although the vote comes several weeks after the White House and Democratic leaders originally wanted, the AP/Times reports. The full House is expected to vote on the bill after policymakers return from their August recess.Although the House"s agenda has moved slower than party leaders had hoped, it still was faster than the action in the Senate, according to the AP/Times (AP/Seattle Times, 8/1). Senate Finance Committee Chair Max Baucus (D-Mont.) on July 30 announced that the panel will not mark up a health care reform bill this week after Republican negotiators urged that the speed of discussion in the Senate be slowed, the Post"s "44" reports. The announcement means that health care reform legislation will not be out of committee in both chambers before the summer recess (Pershing, "44," Washington Post, 7/31).Catholic Bishops Say That House Bill Could Expand Abortion Coverage In related news, the U.S. Conference of Catholic Bishops in a letter to members of the House Energy and Commerce Committee voiced its opposition to the reform bill, arguing that it could be used to require private health insurance plans to cover abortion services, the Post reports. The bill has been opposed by conservative Christian groups for weeks, with the groups arguing that it could be used to expand abortion rights, the Post reports.In the letter, Cardinal Justin Rigali -- chair of the Committee on Pro-Life Activities -- said the bill could increase federal funding for abortion services because some government funding would not be covered by the Hyde Amendment, which currently bans the use of federal Medicaid funds for abortion services. Rigali also said the bill could overturn state laws that restrict access to abortion services, such as parental notification laws. In addition, Rigali said the bill should continue to ensure provider conscience rights to protect Catholic health care workers who refuse to provide abortion services based on their religious or moral beliefs (Washington Post, 8/1).
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Erectile Dysfunction Might Be Associated With Chronic Periodontal Disease: Two Ends Of The Cardiovascular Spectrum
UroToday.com - Together with Drs. Heruti, Bechor, Justo and Galor, we studied 815 Israeli male adults of whom 305 had complete data and were included in the statistical analysis. In the analyzed population, 2.1% of people without erectile dysfunction (ED) had advanced periodontal disease (defined as recession of periodontal bone of 6 mm or more) in comparison to 9.8% of the mild ED and 15.8% of the moderate/severe ED populations, respectively. However, due to the relatively small groups, we could not present the odds ratio. We are now planning a large-scale study to further establish the association between the two conditions.
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MDC Researchers Unravel Key Mechanism In Pathogenesis Of Osteoporosis

Osteoporosis, or bone loss, is a disease that is most common in the elderly population, affecting women more often than men. Until now, it was not clear exactly how the disease develops. Researchers of the Max DelbrÃøck Center for Molecular Medicine (MDC) Berlin-Buch, Germany, have now elucidated a molecular mechanism which regulates the equilibrium between bone formation and bone resorption. Dr. Jeske J. Smink, Dr. Valérie Bégay, and Professor Achim Leutz were able to show that two different forms of a gene switch - a short isoform and a long isoform - determine this process. The MDC researchers hope these findings will lead to new therapies for this bone disease. (EMBO Journal)*. In osteoporosis, excessive bone resorption occurs. The bones lose their density and are therefore prone to breakage. Even minor falls can lead to serious bone fractures. The interplay between two cell types determines bone density: bone forming cells (osteoblasts) and bone resorbing cells (osteoclasts). The equilibrium between these two cell types is strictly regulated to prevent the formation of either too much or too little bone. LAP and LIP maintain the balance Dr. Smink, Dr. Bégay, and Professor Leutz have now elucidated a complicated mechanism which maintains the equilibrium between bone formation and bone resorption. Here, the gene switch C/EBPbeta plays a major role. It exists in different forms, differing in length and number of building blocks. LAP is the term researchers use to denote the full-length isoform of C/EBPbeta, and LIP is the term for the short isoform. LAP activates another gene switch (MafB) which suppresses the formation of bone resorbing osteoclasts. In contrast, LIP, suppresses this gene switch and thus enhances the proliferation and activity of the osteoclasts. As a result, the osteoclasts resorb more bone substance than is built by the osteoblasts. The researchers suspect that imbalance in the ratio between LAP and LIP plays a role in osteoporosis. The activity of a signaling molecule - mTOR - determines which of the two isoforms LAP and LIP is formed. The abbreviation mTOR stands for mammalian Target of Rapamycin. The drug rapamycin inhibits mTOR and thus suppresses the formation of bone resorbing osteoclasts. Unfortunately, rapamycin has severe side-effects on the immune system. "In the future, it may be possible to develop new drugs that regulate the activity of mTOR and, thus, remedy the disturbance in osteoclast function," Professor Leutz said. *Transcription factor C/EBPβ isoform ratio regulates osteoclastogenesis through MafB Jeske J. Smink1,4, Valérie Bégay1,4, Ton Schoenmaker2, Esta Sterneck3, Teun J. de Vries2, and Achim Leutz1 * Max Delbrueck Center for Molecular Medicine, Berlin, Germany. * Departments of Periodontology and Oral Cell Biology, Academic Centre of Dentistry Amsterdam, Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands. * National Cancer Institute, Center for Cancer Research, Frederick, MD 21702, U.S.A. * these authors contributed equally to this work Barbara Bachtler Helmholtz Association of German Research Centres


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