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Laparoscopic Radical Versus Partial Nephrectomy For Tumors >4cm: Intermediate-term Oncologic And Functional Outcomes
UroToday.com - Nephron-sparing surgery has become the well-accepted method for treating patients with localized tumor disease of the kidney. Laparoscopic partial nephrectomy (LPN) has evolved such that it is considered equivalent to open partial nephrectomy for tumors 4 cm. They had 110 patients with Stage T1b-T3N0M0 renal cell carcinoma treated with LRN (N=75) or LPN (N=35). As expected the LRN group had larger tumors and more T3a tumors with clear cell pathologic features. The median follow up was 57 months in the LRN group and 44 months in the LPN group. There was no difference between the two treatment groups with regards to overall mortality, cancer-specific mortality, or recurrence rates. However, the LPN group had significantly less reduction in estimated glomerular filtration rate compared to the LRN group. None of the LPN group patients developed second stage chronic kidney disease compared to 12% in the LRN group.
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Illinois Counties Facing Increases In STDs Among Teenagers; Bill Aims To Reduce Rates
Illinois health officials contend that images seen in the media, social influences, and a lack of "frank" discussion on STDs in schools, among other issues, might be contributing to increases in STD rates across the state, the State Journal-Register reports. "According to recently released data, new cases of chlamydia in Illinois reached an all-time high statewide in 2008 - 59,169 - while the number of gonorrhea cases outside Chicago has been rising in recent years and totaled 10,165 in 2008," the Journal-Register reports. In addition, about 35,000 state residents have HIV/AIDS, the article states. Charlie Rabins, chief of the STD program at the Illinois Department of Public Health, said a bill (SB 212) currently awaiting Gov. Pat Quinn"s (D) approval might help reduce STD rates. The bill "would allow what is called "expedited partner therapy," in which medical professionals who treat patients for gonorrhea or chlamydia can give those patients single-dose antibiotics to pass on to sexual partners without first examining the partners," according to the Journal-Register (Olsen, 7/27).
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Administration Officials Take Health Reform Reins In Obama's Absence

White House staff and administration officials are trying to maintain their visibility on health care reform this week with public events and meetings as President Obama travels, Roll Call reports. "In public statements and in private meetings with lawmakers, administration officials appeared to convey a sense of inevitability about the legislation in order to diminish worries that it is off track - and to try to get floor action in both chambers this month." Among those "leading the charge on Capitol Hill while Obama is away are White House Legislative Affairs Director Phil Schiliro and health czar Nancy-Ann DeParle. A heavy focus has been on the Finance Committee, where Democrats are struggling to strike a deal among themselves and with Republicans. ò€¦ An e-mail from [Organizing For America] Director Mitch Stewart asks members to combat "the lobbyists trying to block reform" with letters to the editor that emphasize what OFA says are Obama"s "three basic principles" for legislation: "Reduce costs by improving efficiency and investing in preventative care. Guarantee every American the right to choose their plan and doctor - including a public insurance option. Ensure quality, affordable care for every American."" (Koffler, 7/9). Roll Call, in a separate story, reports that Vice President Joseph Biden also led the charge, however, on Wednesday, with an announcement on cuts hospitals have agreed to make to drive down the cost of care in America. "Biden was emphatic in insisting that the health care reform effort itself remains healthy, saying multiple times that it is "on track" and that it will get done this year. "Reform is coming. It is on track, it is coming," Biden said. "We"ve never been as close as we are today, and we remain on track." He also repeated twice that President Barack Obama was "firm" in his goal of ensuring that the legislation is deficit-neutral" (Koffler, 7/8). White House Budget Director Peter Orszag upped the ante, Bloomberg reports, by "telling Democratic lawmakers a proposal they are considering "would perpetuate a system in which best practices are far from universal and costs are too high."" "While Orszag, 40, expressed "strong support" for many of the proposals to extend coverage to the estimated 46 million uninsured, he said it would be "desirable to build upon these measures with additional steps that will help make our health- care system sustainable for generations to come." "Among other points, he urged lawmakers to include further cuts in the Medicare and Medicaid payments that hospitals receive for treating the uninsured" (Donmoyer and Gaouette, 7/9). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org. © Henry J. Kaiser Family Foundation. All rights reserved.


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