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Medicare Revamps Competitive Bidding Program
The Centers for Medicare & Medicaid Services is preparing to revive competitive bidding program for durable medical equipment that industry members helped sink last summer when it was originally scheduled to take effect, CQ HealthBeat reports. The agency had anticipated a 26 percent savings for wheelchairs, oxygen tanks and other pieces of equipment through the program. But a lobbying group for the suppliers, the American Association for Homecare, successfully urged Congress to shut down the program before it went into effect.
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Focusing On The More Lethal Form Of The Cancer Rhabdomyosarcoma
Rhabdomyosarcoma (RMS) is an aggressive muscle cancer that mostly affects children. The most common forms of RMS are embryonal rhabdomyosarcoma (ERMS) and alveolar rhabdomyosarcoma (ARMS). Although ARMS is less common than ERMS, it is associated with a much higher rate of mortality. A therapy tailored to the ARMS form of RMS is therefore badly needed. A team of researchers, at the Hospital for Sick Children, Toronto, and Monash Institute of Medical Research, Australia, has now provided hope that it might be possible to develop such a therapy by showing that the protein ILK promotes the growth of ARMS cells, whereas it suppresses the growth of ERMS cells.
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New Lab Test Helps Predict Kidney Damage
Acute kidney injury (AKI) is a frequent complication in patients in intensive care. A new laboratory test called urine neutrophil gelatinase associated lipocalin (NGAL) helps predict if patients will develop acute kidney injury, reports an upcoming study in the Journal of the American Society of Nephrology (JASN). "As a stand-alone marker, urine NGAL performed moderately well in predicting ongoing and subsequent AKI," comments T. Alp Ikizler, MD (Vanderbilt University).
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Sedatives May Increase Suicide Risk In Older Patients

Sleeping tablets have been associated with a four-fold increase in suicide risk in the elderly. Researchers writing in the open access journal BMC Geriatrics have shown that, even after adjusting for the presence of psychiatric conditions, sedatives and hypnotics were both associated with an increased risk of suicide. Anders Carlsten and Margda Waern from Gothenburg University carried out a case control study to determine whether specific types of psychoactive drugs were associated with suicide risk in later life. According to Carlsten, "Sedative treatment was associated with an almost fourteen-fold increase of suicide risk in the crude analyses and remained an independent risk factor for suicide even after adjustment for the presence of mental disorders. Having a current prescription for a hypnotic was associated with a four-fold increase in suicide risk in the adjusted model". The researchers speculate that the drugs may raise suicide risk by triggering aggressive or impulsive behavior, or by providing the means for people to take an overdose. They also point out the possibility that these drugs may merely be markers for some other factor related to suicide risk, such as somatic illness, functional disability, alcohol use disorder, interpersonal problems, lack of social network or sleep disturbance. Carlsten said, "Persons with these problems might be more likely to seek health care and perhaps more likely to receive prescriptions for psychotropic drugs. However, given the extremely high prescription rates for these drugs, a careful evaluation of the suicide risk should always precede prescribing a sedative or hypnotic to an elderly individual". Reference: Are sedatives and hypnotics associated with increased suicide risk in the elderly? Anders Carlsten and Margda Waern BMC Geriatrics (in press) http://www.biomedcentral.com/bmcgeriatr/ Graeme Baldwin BioMed Central


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