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Needle Exchange Programs Could Save Texas 'Millions Of Dollars,' Opinion Piece Says
Needle exchange programs (NEPs) "are an inexpensive public health intervention, especially when compared with the social costs of treating individuals with HIV or hepatitis-related chronic liver disease," Maureen Trotter, a pathologist and president of the Taylor-Jones-Haskell County Medical Society, writes in the Abilene Reporter News. She adds that legislation introduced this year in the Texas Legislature "to allow public health departments and organizations to establish disease control programs that provide for the anonymous exchange of used hypodermic needles and syringes for sterile ones, offer education and substance abuse treatment and blood-borne disease testing" failed to come to a floor vote. Trotter further discusses NEPs, citing data on outcomes of NEPs, and writes, "The costs of preventing one case of HIV is estimated between $4,000 and $12,000 via NEPs. The medical cost of treating a person infected with HIV is about $200,000," adding, "These programs, if implemented, could save Texas millions of dollars" (7/12).
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San Mateo County, Calif., HIV/AIDS Services Could Be Impacted By Proposed State Budget Cuts, Official Says
A San Mateo County, Calif., program that provides in-home case management services for people living with HIV/AIDS, as well as other programs that assist people living with the virus, could be eliminated, forcing patients to obtain more expensive outpatient care, if proposed state budget cuts are approved, the San Francisco Examiner reports. John Conley, director of public health programs for San Mateo County, said case management services are alternatives to hospitalization or nursing facility care, which are more expensive. "Additionally, the state"s AIDS office will not allow municipalities to make reductions to case management activities or other requirements such as client/staff ratios, according to county officials," the Examiner reports. Conley said, the state is paying half the costs of the program, but the program is "becoming very, very expensive to run" (Koskey, 7/23).
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Gene For Deadly Inherited Lung Disease Identified By Scientists
A rare, deadly developmental disorder of the lungs called alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) that usually kills the infants born with it within the first month of life results from deletions or mutations in the FOXF1 transcription factor gene, said a consortium of researchers led by Baylor College of Medicine (www.bcm.edu) in a report that appears in the American Journal of Human Genetics.
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Chicago Team Uses Artificial Intelligence To Diagnose Metastatic Cancer

When doctors are managing care for women with breast cancer, the information available to them profoundly influences the type of care they recommend. Knowing whether a woman"s cancer has metastasized, for instance, directly affects how her doctors will approach treatment -- which may in turn influence the outcome of that treatment. Determining whether a tumor has metastasized is not always straightforward, however. Radiologists often start by using diagnostic ultrasound to non-invasively probe the nearby lymph nodes -- tissues where cancer cells first migrate once they metastasize. But in the early stages of cancer, lymph nodes often appear completely normal even if the cancer has metastasized. Now a team of researchers at the University of Chicago has designed a computer program that uses artificial intelligence to analyze the features of ultrasound images in order to help doctors predict earlier whether a woman"s cancer has metastasized. The team will discuss the first preclinical results obtained using this program at the upcoming meeting of the American Association of Physicists in Medicine (AAPM), which takes place from July 26 - 30, 2009 in Anaheim, California. Currently there are no automated methods approved by the Food and Drug Administration for diagnosing cancer, but on Wednesday the team will report the results of a preliminary pilot study that retrospectively reanalyzed the diagnostic ultrasounds of 50 women with suspected breast cancer who all had lymph nodes that appeared normal in the ultrasound -- suggesting that their cancers had not metastasized. All 50 women later underwent surgery to remove their cancers and axillary lymph nodes, and tissue biopsies of the lymph nodes revealed that 20 of them had metastatic cancer and 30 of them had cancer that remained localized at the time of surgery. The pilot study aimed to determine if the computer would have accurately identified the 20 metastatic cases based on analyzing the ultrasound images of the tumors. The program performed promisingly well, says medical physicist Karen Drukker, a research associate and assistant professor in the department of radiology at the University of Chicago, who will be presenting results in Anaheim that demonstrate the program"s potential for diagnosing metastatic disease. "We discovered that a computer analysis of breast ultrasound could potentially predict with promising accuracy which patients had metastasis and which did not," says Drukker. Next they plan to start an observer study in which several radiologists will use the computer program to see if it enhances their ability to diagnose metastasis -- again, based on retrospective cases for which the answer can later be revealed. ABOUT MEDICAL PHYSICISTS If you ever had a mammogram, ultrasound, X-ray, MRI, PET scan, or known someone treated for cancer, chances are reasonable that a medical physicist was working behind the scenes to make sure the imaging procedure was as effective as possible. Medical physicists help to develop new imaging techniques, improve existing ones, and assure the safety of radiation used in medical procedures in radiology, radiation oncology and nuclear medicine. They collaborate with radiation oncologists to design cancer treatment plans. They provide routine quality assurance and quality control on radiation equipment and procedures to ensure that cancer patients receive the prescribed dose of radiation to the correct location. They also contribute to the development of physics intensive therapeutic techniques, such as the stereotactic radiosurgery and prostate seed implants for cancer to name a few. The annual AAPM meeting is a great re, providing guidance to physicists to implement the latest and greatest technology in a community hospital close to you. ABOUT AAPM The American Association of Physicists in Medicine (AAPM) is a scientific, educational, and professional organization of more than 6,000 medical physicists. Headquarters are located at the American Center for Physics in College Park, MD. Publications include a scientific journal ("Medical Physics"), technical reports, and symposium proceedings. American Institute of Physics (AIP)


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