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CDC Issues Fact Sheet On Oral Sex, HIV Transmission
The CDC has released a fact sheet informing people that there is some risk of transmitting HIV to others through oral sex, even though it is much lower than the risk of transmission from vaginal or anal intercourse, the Lakeland Ledger"s "Robin"s Rx: Medical Blogging in Polk County" reports. According to the CDC, many people believe that oral sex is safe or has no risk of transmitting disease. The CDC fact sheet said that abstaining from any sexual activity or engaging in mutual monogamy where both partners are uninfected are the only ways to completely prevent HIV transmission, but that condoms and other barriers between the mouth and genitals can reduce the risk of transmission through oral sex (Adams, "Robin"s Rx: Medical Blogging in Polk County," Lakeland Ledger, 6/4).

Insight Into Early Schizophrenia May Aid Understanding Of Disease Development, Diagnosis And Treatment
Significant and widespread cognitive problems appear to exist in schizophrenia in its earliest phase, making it very hard for people with the disorder to work, study or be social, according to a new study published by the American Psychological Association.
News of the day
Massachusetts Health Insurance Law Has Increased Access To Care, Though Residents' Ability To Obtain Treatment Hampered By Provider Supply, Study Find
Since the implementation of the Massachusetts health insurance law in 2006, more residents have health coverage and increased access to care, but rising health care costs combined with the current economic recession could undermine some of the law"s successes, according to the third annual "Update on Health Reform in Massachusetts" report by the Urban Institute, the Boston Globe reports. The study was funded by the Blue Cross and Blue Shield of Massachusetts Foundation, the Robert Wood Johnson Foundation and the Commonwealth Fund, and published in the journal Health Affairs.For the report, Sharon Long of the Urban Institute and colleagues surveyed about 4,000 Massachusetts adults in 2007 and 2008 and compared their health care habits with those of residents surveyed in 2006 -- just after the law went into effect. Researchers found that although there were initial gains in health care affordability, there are now some signs that an increasing number of state residents are reporting problems paying for medical bills, and an increasing number of people -- especially lower-income residents -- not seeking care because of costs (Lazar, Boston Globe, 5/28). One in five adults reported being told in the past 12 months that a physician or clinic was not accepting new patients or would not see patients with their type of insurance (Sack, New York Times, 5/28). Lower-income residents had more difficulties finding a physician than higher-income residents, with 24% of residents enrolled in state-subsidized health plans, saying they were told that a physician did not accept their insurance, compared with 7% of residents with private coverage (Boston Globe, 5/28). Additional Findings
Diagnostics

Lifestyle Program For Patients With COPD Is Health And Cost Effective

Patients with moderate COPD were randomized to receive "usual care" or to undergo an interdisciplinary, community-based program (INTERCOM) that offered an intensive lifestyle moderation phase of four months, during which patients were instructed in detail to perform two 15-minute intervals of pleasurable walking or cycling, and offered instruction in other lifestyle changes such as nutrition and smoking cessation. After the four-month introductory period, there was a less intensive 20-month maintenance during which patients were offered guidance but not intensive intervention. Researcher Carel van Wetering, from the Department of Respiratory Medicine at the Maxima Medical Centre and colleagues randomized patients with mild to moderate COPD to receive "usual care" or undergo an interdisciplinary, community-based program (INTERCOM) that offered an intensive lifestyle moderation phase of four months, during which patients were instructed in detail to perform two 15-minute intervals of pleasurable walking or cycling, and offered instruction in other lifestyle changes such as nutrition and smoking cessation. After the four-month introductory period, there was a less 20-month maintenance period. The study results will be presented at the 105th international conference of the American Thoracic Society, taking place in San Diego from May 15-20. After two years, the researchers found that, compared with patients who had gotten the usual care, those who had undergone the INTERCOM program showed significant improvements in health status (SGRQ); exercise capacity, and dyspnea. Improvements were seen at four months with respect to disease-specific quality of life, walk distance, exercise capacity, dyspnea, handgrip force and fat free mass index. After two years improvements in exercise capacity remained significant, as were improvements over the entire period in dyspnea (MRC) and disease-specific quality of life. Furthermore, perceived effectiveness the patients" subjective evaluation of the benefits of the program highly favored the INTERCOM program. While overall costs for the two year period were €2,751 (about $3686) more per patient for the INTERCOM group, the researchers point out that the expense of the INTERCOM program is "front-loaded" and that maintenance costs were minimal. After exclusion of five patients who were referred to in-patient pulmonary rehabilitation, the difference in costs between INTERCOM and usual care groups was reduced to €909 (about $1218) over two years. The cost for patients with a low muscle mass who participated in the additional nutritional intervention hospital admission were €4724 (about $6330) lower per patient in the INTERCOM group compared with the muscle wasted usual care group. "This is the first randomized controlled trial showing that community-based pulmonary rehabilitation is feasible and effective, even for patients with less advanced airflow obstruction and that the INTERCOM program improves functional exercise capacity and health related quality of life during 24 months relative to usual care at acceptable costs.," said Annemie Schols, Ph.D., professor of nutrition and metabolism in chronic diseases at Maastricht University in the Netherlands. "The INTERCOM program is based upon an integrated view on pulmonary and extra pulmonary manifestations of chronic obstructive pulmonary disease resulting from smoking, suboptimal diet, inactivity and disease susceptibility. These new findings from the INTERCOM trial could lead to a shift in clinical medicine and public health towards personalized lifestyle intervention." American Thoracic Society (ATS)


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