A new technique for transplanting the ovaries of women who have lost their fertility as a result of cancer treatment was outlined to the 25th annual conference of the European Society of Human Reproduction and Embryology. Dr. Pascal Piver, manager of the IVF Centre at Limoges University Hospital, Limoges, France, described a new, twostep method of ovarian transplant that has produced excellent results in women whose ovaries have been frozen because of cancer treatment. He said that his teams technique worked to restore ovarian function quickly and already one patient from his clinic had had a baby and another had become pregnant.

“On June 22, a baby girl was born to a mother who had been menopausal for two years as a result of treatment for sickle cell anaemia. After transplanting her own ovarian tissue she started ovulating in four months and became pregnant naturally six months after transplantation. Both mother and baby are doing well”, he said.

Dr. Piver and colleagues set out to tackle one of the biggest problems of ovarian transplantation the low response to stimulation caused by insufficient vascularisation of the transplanted tissue.

“In order for a woman to become pregnant, the ovaries need to be responsive to the action of hormones that cause them to release eggs each month,” he explained. “If the blood supply to the ovaries is insufficient, this will not happen, even though the transplant may look as though it has been successful.”

To overcome this problem they carried out a twostage procedure, first grafting small pieces of the frozen ovarian tissue in the ovarian and peritoneal areas three days before the real transplant. The first graft encourages the growth of blood vessels and paves the way for the ovary to become fully functioning in a shorter time scale than would be possible if all the tissue were to be transplanted at the same time.

The researchers have so far utilised this technique with two patients who had been treated for cancer and had their ovaries frozen. In addition to the first patient, treated for sickle cell anaemia, the second patient had been treated for periarteritis nodosa, an inflammation of mediumsized arteries, which become swollen and damaged from attack by rogue immune cells.

“She suffered menopause for eight and a half years before transplantation,” said Dr. Piver. “But after transplanting half of the frozen ovary, she recovered spontaneous ovulation in four months. Her right fallopian tube had been destroyed by the ovarian retrieval, and the function of the ovary and hence the chances of pregnancy are limited in time. Hence we decided to collect the highest number of eggs we could, and carry out an IVF procedure on this patient.

“Six months after the operation, we transferred two blastocysts. A total of 22 oocytes were retrieved and produced 16 embryos, which in turn produced seven blastocysts. Unfortunately the first time round this patient developed an ectopic pregnancy, but she is now pregnant again.”

The technique was developed by Dr. Piver and his team, he told the conference. “This is the first time that a pregnancy has been obtained after a ten year gap between ovarian cryopreservation and grafting. We believe that it represents a considerable advance on the methods of ovarian transplantation used until now, not least because we are able to obtain large numbers of oocytes. We hope that it will enable more young patients who have been cured of cancer to regain their reproductive health and become pregnant with their own children,” he said.

Source
Mary Rice
European Society for Human Reproduction and Embryology

The International Diabetes Federation (IDF) called for urgent assessment and responses from regulatory authorities into a possible link between the use of insulin glargine (an insulin analogue) and increased risk of cancer based on findings published on 26 June, 2009 in Diabetelogia, the journal of the European Association for the Study of Diabetes (EASD).

The online data published in Diabetelogia is based on four studies relating to a possible link between a longacting insulin analogue, insulin glargine and cancer. According to EASD, the findings are based on evidence from studies in Germany, Sweden, Scotland and the United Kingdom. The studies however, are not conclusive.

The International Diabetes Federation understands the concern about the Diabetelogia study findings but urges the diabetes community to wait for the current scientific information to be released and calls for urgent further scientific studies to be undertaken in other countries.

Less than onehalf of one percent (0.4%) of the 22 million people in the U.S. who are medically eligible for bariatric surgery actually get the surgery, and those who do are most likely to be white females with higher incomes and covered by private health insurance, according to a new study presented here at the 26th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).

In a retrospective analysis, the vast majority of the 88,000 people with morbid obesity who had bariatric surgery in 2006 were female (81%), white (75%), fell into higher household income categories (80%) and had private health insurance (82%) compared to those who were medically eligible for surgery, but did not have it.

Researchers used the National Health and Nutrition Examination Survey (NHANES), a nationally representative health database administered by the Centers for Disease Control and Prevention (CDC), to identify the number of people eligible for bariatric surgery in 20052006 and the 2006 Nationwide Inpatient Sample (NIS) to identify those that had bariatric surgery in 2006. The NIS is the largest allpayer inpatient care database in the U.S. sponsored by the Agency for Healthcare Research and Quality (AHRQ), another government agency.

“When the disparities between groups are this large, socioeconomic status is clearly playing a more significant role than medical status in determining who gets bariatric surgery and who does not,” said Matthew J. Martin, MD, lead author of the study and Assistant Professor of Surgery at Madigan Army Medical Center in Tacoma, WA. Coauthors include Alec Beekley, MD, Randy Kjorstad, MD, and James Sebesta, MD, also from the Madigan Army Medical Center.

Researchers note socioeconomic disparities in health care are not uncommon and have been documented in areas such as cancer and cardiovascular treatments, but theirs is one of the first major studies to identify and examine the relationship between socioeconomics and surgical treatment of morbid obesity.

People were considered eligible for surgery if they were overweight with a body mass index (BMI) of over 40, or a BMI of 35 to 40 with an obesityrelated disease such as Type 2 diabetes, heart disease or sleep apnea; criteria established by the National Institutes of Health (NIH).

The NHANES database showed that being morbidly obese was associated with significant adverse economic and healthrelated issues. More than onethird of people with morbid obesity were either uninsured or underinsured and 15 percent had incomes below the poverty level. Compared with the general population, people with morbid obesity had significantly lower family incomes (35% vs. 28%) and less health insurance. In addition, the morbidly obese population has more women (62% vs. 49%) and AfricanAmericans (18% vs. 12%) and fewer men (38% vs. 51%).

The morbidly obese group is also in poorer health than the general population. Metabolic syndrome, defined in this analysis as morbid obesity plus the presence of at least two of the following conditions hypertension, diabetes and/or hyperlipidemia, was present in 58 percent of the morbidly obese population. Nearly 30 percent of those who actually had bariatric surgery also had diabetes (29%), hypertension (52%) and chronic pulmonary disease (19%). The morbidly obese group had twice as many sick days (5.4 vs. 2.8), missed more work days (8 vs. 5) and was more underinsured (20% vs. 8%).

The NIS database found four times as many women as men (81% vs. 19%) had bariatric surgery despite findings that morbidly obese women outnumber men by a much smaller margin (62% vs. 38%). And, while whites represent 67 percent of the morbidly obese population, about 75 percent of those who had surgery were white. Whereas AfricanAmericans represent 18 percent of the morbidly obese population and only 11 percent went on to have surgery. Inpatient mortality following bariatric surgery for all groups was 0.1 percent.

“These disparities represent significant nonmedical barriers for someone needing bariatric surgery,” commented Dr. Martin. “There is an over representation of white and female patients who had surgery and a corresponding underrepresentation of black and male patients with little or no insurance. Increasing access and breaking down the socioeconomic barriers to bariatric surgery among the underserved population has the potential to significantly impact the health and well being of millions of people throughout the U.S. The current debate about universal healthcare must take into consideration these two related epidemics morbid obesity and the increase in uninsured and underinsured persons.”

The study found significant disparities in income and insurance status. About 15 percent of the morbidly obese population was identified as being uninsured and only 0.3 percent of the uninsured went on to have bariatric surgery.

According to the ASMBS, it is estimated that 220,000 people had some form of bariatric surgery in 2008. The most common methods of bariatric surgery are laparoscopic gastric bypass and laparoscopic adjustable gastric banding.

A variation in a gene that is active in the central nervous system is associated with increased risk for obesity, according to an international study in which Albert Einstein College of Medicine of Yeshiva University played a major role. The research adds to evidence that genes influence appetite and that the brain plays a key role in obesity.

Robert Kaplan, Ph.D., associate professor of epidemiology & population health, helped direct the international study, which involved 34 research institutions and is published online in PLoS Genetics. Dr. Kaplan and his U.S. and European colleagues found that people who have inherited the gene variant NRXN3 have a 1015 percent increased risk of being obese compared with people who do not have the variant.

The researchers examined data from eight studies involving genes and body weight. These studies included more than 31,000 people of European origin, ages 45 to 76, representing a broad range of dietary habits and health behaviors.

After analyzing more than two million regions of the human genome, the researchers found that the NRXN3 gene variant previously associated with alcohol dependence, cocaine addiction, and illegal substance abuse also predicts the tendency to become obese. Altogether, researchers found the gene variant in 20 percent of the people studied.

“Weve known for a long time that obesity is an inherited trait, but specific genes linked to it have been difficult to find,” says Dr. Kaplan. “A lot of factors the types and quantity of foods you eat, how much you exercise, and how you metabolize foods, for example affect your body shape and size. So we are looking for genes that may have a small role to play in a complex situation.”

NRXN3 is the third obesityassociated gene to be identified. The fact that all three genes are highly active in encoding brain proteins is significant, says Dr. Kaplan. “Considering how many factors are involved in obesity, it is interesting that research is increasingly pointing to the brain as being very important in its development,” he said.

Identifying obesity genes could help in preventing the condition and lead to treatments for it. “Someday we may be able to incorporate several obesity genes into a genetic test to identify people at risk of becoming obese and alert them to the need to watch their diet and to exercise,” Dr. Kaplan said. “Also, we may eventually see drugs that target the molecular pathways through which obesity genes exert their influence.”

Since NRXN3 is active in the brain and also implicated in addiction, these traits may share some neurologic underpinnings. “Although we dont have data to suggest a direct connection between drug abuse and obesity, we can indirectly infer a link because both traits have this gene in common,” Dr. Kaplan said.

The paper, “NRXN3 is a Novel Locus for Waist Circumference A Genomewide Association Study from the CHARGE Consortium,” appears online in PLoS Genetics on June 26th.

Other lead collaborators who worked with Dr. Kaplan on the study included Nancy L. HeardCosta and L. Adrienne Cupples of Boston University; M. Carola Zillikens, Ben A. Oostra and Cornelia M. van Duijn of Erasmus Medical Center; Keri L. Monda and Kari E. North of the University of North Carolina at Chapel Hill; Åsa Johansson of Uppsala University; Tamara B. Harris and Caroline S. Fox of the National Institutes of Health; Mao Fu and Jeffrey R. OConnell of the University of Maryland; Talin Haritunians of CedarsSinai Medical Center; Mary F. Feitosa and Ingrid B. Borecki of Washington University School of Medicine; and Vilmundur Gudnason of the University of Iceland. Drs. Fox and North are the corresponding authors.

About Albert Einstein College of Medicine of Yeshiva University

Albert Einstein College of Medicine of Yeshiva University is one of the nations premier centers for research, medical education and clinical investigation. It is the home to some 2,000 faculty members, 750 M.D. students, 350 Ph.D. students (including 125 in combined M.D./Ph.D. programs) and 380 postdoctoral investigators. Last year, Einstein received more than $130 million in support from the NIH. This includes the funding of major research centers at Einstein in diabetes, cancer, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Through its extensive affiliation network involving five hospital centers in the Bronx, Manhattan and Long Island which includes Montefiore Medical Center, The University Hospital and Academic Medical Center for Einstein the College runs one of the largest postgraduate medical training program in the United States, offering approximately 150 residency programs to more than 2,500 physicians in training.

Kidney injury that can arise after undergoing certain medical imaging procedures increases a patients risk of having a stroke or heart attack over the next year or two, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). The findings indicate that seemingly minor and reversible kidney damage from these common clinical procedures is a serious health threat.

Medical imaging often uses contrast agents, substances such as iodine and barium that enhance the contrast of structures or fluids within the body. For example, contrast agents may be used during cardiac angiography and computed tomography procedures to visualize blood vessels and changes in tissues. Exposure to contrast agents can injure the kidneys, but patients are often told that this is only a temporary side effect. Recent research has suggested that such contrastinduced kidney damage may actually be more serious, although no thorough studies have looked into the hypothesis.

To investigate the issue, Richard Solomon, MD (University of Vermont), and his colleagues studied 294 patients with kidney disease who were exposed to contrast agents during cardiac angiography. Patients in the CARE (Cardiac Angiography in REnally Impaired Patients) trial were randomly divided to receive one of two contrast agents iopamidol or iodixanol. After following patients for at least one year, the researchers found that 92 (31%) of the patients experienced negative health effects. Thirtyeight (13%) of the patients experienced a major event, such as death, stroke, heart attack, or endstage renal disease. Individuals who developed contrastinduced kidney injuries had twice as many longterm negative health effects compared with patients whose kidneys were not damaged. In the absence of contrastinduced kidney injury, there was no difference in the incidence of longterm negative health effects between patients taking iopamidol or iodixanol. However, the investigators found that patients taking iopamidol had reduced incidences of both kidney damage and longterm negative effects. These parallel decreased incidences support the theory that contrastinduced kidney injury causes longterm negative effects.

The CARE trial findings should prompt investigators to design additional studies on the longterm negative health effects of contrastinduced kidney damage.

This work was supported by Bracco Diagnostics, Inc., which manufactures iopamidol. Dr. Solomon serves as a consultant for Bracco Diagnostics, Inc. Study coauthors who received research funding from Bracco Diagnostics, Inc. include Madhu Natarajan, MD (Hamilton Health Sciences, Canada), Serge Doucet, MD (Montreal Heart Institute, Canada), Richard Katholi, MD (Prairie Educational and Research Cooperative), Cezar Staniloae, MD (St. Vincents Hospital Manhattan and Medical Center), Samin Sharma, MD (Mt. Sinai Medical Center), Marino Labinaz, MD (University of Ottawa Heart Institute, Canada), and Joseph Gelormini, MD (Buffalo Heart Group). Coauthors Roxana Mehran, MD (New YorkPresbyterian Hospital/Columbia University Medical Center) and Brendan Barrett, MD (Memorial University of Newfoundland, Canada) report no financial disclosures.

Founded in 1966, the American Society of Nephrology (ASN) is the worlds largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its worldrenowned meetings and firstclass publications, disseminates information and educational tools that empower physicians.

While Ontario women live longer than men, a majority are more likely to suffer from disability and chronic conditions, according to a new womens health study by St. Michaels Hospital researcher Dr. Arlene Bierman. Whats more, lowincome women have more chronic conditions, greater disability and a shorter life expectancy than women in highincome groups.

While inequities in health among men and women have been well documented, the findings strongly suggest that the size of the inequities among women is often larger than the overall differences between men and women.

“Women with less education and low income were found to experience a greater burden of illness overall compared to men and women with higher incomes,” said Dr. Bierman. “While we already knew these inequities exist, we are quite startled by just how large the gap is among different groups of women. The good news is that there is much that can be done to close this gap. The inequities we found are associated with chronic disease, so by focusing on chronic disease prevention and management, and improving the living and working conditions that increase the risk of chronic disease, we can improve health outcomes for all women and men.”

The joint study, titled POWER (the Project for an Ontario Womens Health EvidenceBased Report), from St. Michaels Hospital and the Institute for Clinical Evaluative Sciences (ICES), is the first in Ontario to provide a comprehensive overview of womens health in relation to gender, income, education, ethnicity and geography. POWER reports on indicators of population health and of how well the health system is performing. Policymakers and healthcare providers may use these research findings to improve access, quality and outcomes of care for Ontario women. The POWER Study was funded by Echo Improving Womens Health in Ontario, an agency of the Ontario Ministry of Health and LongTerm Care.

Key findings released include

Chronic conditions

* The majority of women and men in Ontario have at least one chronic condition and many have two or more.

* Thirtynine per cent of low income women have two or more chronic conditions compared to 28 per cent of women in the highest income group and 21 per cent of higher income men.

* Among women aged 65 and older, 70 per cent of lowincome women have two or more chronic conditions compared to 57 per cent of higherincome women and 50 per cent of higherincome men.

Disease risk factors

* Overall, more than half of Ontario adults age 25 years and older reported physical inactivity (51 per cent) and inadequate fruit and vegetable intake (57 per cent), 53 per cent were overweight or obese and 22 per cent were current smokers

* Women are less physically active than men, but eat more fruits and vegetables, and are less likely to be overweight or obese and smoke than men.

* While rates of smoking have decreased over time, 28 per cent of women with less than a high school education report smoking compared to eight per cent of women who had a university degree or higher.

Length of Life

* Lowincome women and men are more likely to die prematurely.

* Twentysix per cent of women and 41 per cent of men in the lowest income range die before age 75 compared to 19 per cent of women and 28 per cent of men in the highest income bracket.

Pain

* Thirtyfive per cent of low income women age 65 and older say their activities are limited by pain compared to 18 per cent of higher income women in this age group.

* Among women age 2564, 26 per cent of low income women, and 10 per cent of higher income women report their activities are limited by pain.

Disabilities

* More than half of lowincome women age 65 and older have a disability that requires the help of another person to carry out routine daily activities such as grocery shopping, housework and meal preparation.

* Older women are also about 50 per cent more likely than older men to be admitted to hospital for a fallrelated injury, which can result in longterm disability and health problems.

Low income

* Across all age groups, women are more likely to live in lowerincome households than men, with gender differences in income greatest among those age 65 years and older.

* Fortyfour percent of women age 6579 and 52 per cent of those aged 80 and older reported lower income compared to 33 per cent and 35 per cent of men in these age groups, respectively.

Common modifiable risk factors such as smoking, diet, and lack of exercise are responsible for much of the chronic illnesses present in both women and men. Chronic diseases are estimated to account for 87 per cent of disability in Canada.

According to the researchers, socioeconomic factors including income, education, housing, and environment as well as health behaviours must be addressed to eliminate the gap and improve population health. The POWER Study recommends

* A comprehensive chronic disease prevention and management strategy that involves both communitybased and healthsector interventions

* Better coordination of populationbased health promotion, communitybased services and clinical care services aimed at improving health among Ontarians

* Incorporation of gender and equity into health indicator reporting and monitoring to reduce disparities in health and health care.

“We must improve our knowledge of the diverse health needs of Ontario women. The POWER Study is a huge step in that direction,” said Pat Campbell, CEO of ECHO. “By monitoring our progress in improving health outcomes and reducing disparities, there will be better care for women and more equitable care to all Ontarians. The findings of the study will provide strong evidence to inform priority setting and provide a baseline from which to measure progress in womens health.”

Notes

For more information on the POWER Study and to access the burden of illness report, visit powerstudy.ca.

Dr. Arlene Bierman is a researcher in the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michaels Hospital, a scientist at ICES and Echos Ontario Womens Health Council Chair in Womens Health at St. Michaels Hospital and the University of Toronto (Lawrence S. Bloomberg Faculty of Nursing).

Source
Julie Saccone

The following summarizes selected womens healthrelated blog entries.

~ “Anonymous Republican Senator Obstructs Resolution To Condemn Clinic Violence,” Jodi Jacobson, RH Reality Check On Thursday, an unnamed Republican senator “used his power to put a hold” on a resolution (S.R. 187) “condemning violence against womens health providers, thereby blocking any vote on the resolution,” Jacobson writes. She adds, “So much for agreeing on at least a basic premise in the debate about choice, reproductive rights or even reproductive health.” Such holds, which senators can submit anonymously and without explanation, allow Republicans to “get away with sorrowful expressions to the media on violence” without having “to be put to the test of actually voting to denounce the violence against” abortion providers like George Tiller, Jacobson writes. Sens. Jeanne Shaheen (DN.H.), Barbara Boxer (DCalif.) and Amy Klobuchar (DMinn.), who introduced the resolution, “intended [it] to be noncontroversial,” but the “condemnation of violence is apparently too much for some Republicans to bear,” Jacobson continues. She adds that the House unanimously passed a resolution (H.R. 505) last week condemning violence in places of worship. The three senators who introduced the Senate resolution “decided to move forward with their resolution” without the Houses language because they “feel condemning violence against womens health care providers and agreeing not to use violence as a means of resolving differences are not objectionable viewpoints,” Jacobson writes. She concludes, “Apparently, there is no common ground in the Senate on not using violence where womens health is concerned” (Jacobson, RH Reality Check, 6/19).

~ “Supporting MAMAs,” Amie Newman, RH Reality Check Under President Obama, who is calling for “an exploration of common ground in the abortion debate and is spearheading the fight for health care reform, we have an opportunity to reexamine the gamut of womens reproductive and sexual health care in order to improve access to all care,” Newman writes. She continues that the Midwives and Mothers in Action campaign, a collaboration of advocacy and consumer groups, is working “to ensure that health care reform remembers midwifery.” The group is lobbying for federal recognition of certified professional midwives as a means to increase womens access to affordable, quality obstetrical care and working to ensure that “Medicaid coverage for certified professional midwives is included in any health care reform,” Newman writes. According to Newman, in 25 states “it is illegal to choose the care provider or setting for your birth because certified professional midwives are outlawed as birth facilitators.” She continues, “As we work towards immense health care reform, the question for all reproductive health advocates should be How much longer will we tolerate a system in which womens and babies health and lives are compromised, costs to the consumer are rising, access to childbirth care remains inequitable and certified professional midwives must fight for their livelihood?” Newman concludes, “Access to abortion care, contraception and childbirth care should be seen as concentric circles they are all connected and all part of the continuum of [womens] reproductive and sexual health care with which reproductive [health] and rights advocates should be concerned” (Newman, RH Reality Check, 6/22).

~ “Roe Protects Pregnant Women, Too,” Rachel Roth, RH Reality Check “Roe v. Wade stands for womens reproductive selfdetermination for the right to have an abortion and the right to have a baby,” Roth writes. She adds, “Both dimensions of Roes promise are critical to womens lives, yet most people are far more familiar with one than the other.” Roth continues that although most people know that Roe “recognized womens constitutional right to an abortion,” those rights “are not absolute.” According to Roth, “Roe did not establish a contest between womens rights and fetal rights; rather, it recognized a state interest in the potential life of the fetus, because fetuses are not persons with rights or interests of their own under the Constitution.” She continues, “Over time, the [Supreme Court] has given greater deference to state interests in potential life, allowing more restrictions on womens abortion rights throughout pregnancy, but the court has always been clear that the final decision rests with women, and that a womans health and life always come first; this is why women can have abortions after viability, when their health or life is at stake.” However, some individuals and courts have misinterpreted Roe to “argue that after a womans pregnancy reaches the stage of viability, the state can intervene not only to stop a woman from having an abortion but to dictate how she should live as well,” according to Roth. She continues that senators during Supreme Court nominee Sonia Sotomayors confirmation hearing should ask “whether she believes there is a point in pregnancy at which women lose their civil rights, and, if so, on what basis they lose them” (Roth, RH Reality Check, 6/23).

~ “Pregnant With Potential,” Kristen Day, RH Reality Check Day, executive director of Democrats for Life of America, writes that the organization is “proud to stand with the president, groups and individuals who are truly committed to finding areas of agreement” on reducing the need for abortion. “Unfortunately, there are still some who will want to set up roadblocks before common ground proposals in order to maintain a perceived political advantage by perpetuating the stale argument over who is right and wrong on the issue of abortion,” according to Day. She continues that the Pregnant Women Support Act is “the first truly bipartisan bill” to help reconcile issues on both sides of the debate. Day writes that PWSA “addresses areas of agreement,” such as prohibiting health insurance companies from denying coverage to pregnant women by classifying pregnancy as a “preexisting condition,” and increasing support for pregnant women who are “forced by a boyfriend or husband to undergo an abortion because the men want to avoid the financial responsibility.” PWSA also would increase support for WIC and “provide grants to colleges and universities to establish pregnant and parenting student service offices so women do not have to choose between having a baby or completing their education,” according to Day. DFLA “recognize[s] that people on both sides of the abortion debate may have concerns about certain provisions of the PWSA,” including the bills cost, provisions related to the Childrens Health Insurance Program and funding of “life support centers,” Day writes. She concludes that DFLA is “ready to try to address these concerns with any and all who are willing to put progress over partisanship and work toward a common ground solution” (Day, RH Reality Check, 6/19).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

The oneyearold Floridabased organization Sistas Organizing to Survive on Saturday held a rally in Orlando that sought to raise awareness of HIV among black women and encourage them to be tested, the Orlando Sentinel reports. According to Debbie Tucci, coordinator for the Orange County Health Departments HIV/AIDS program, one in 68 black women in the state is living with HIV/AIDS and many are unaware they are infected. AIDS has been a leading cause of death for black women ages 25 to 44 in the state for the past 15 years, the Sentinel reports (Ruano González, Orlando Sentinel, 6/21).

A federal grand jury yesterday indicted Pamela Arrey, age 48, of Glenelg, Maryland, for health care fraud and aggravated identity theft, announced United States Attorney for the District of Maryland Rod J. Rosenstein.

According to the 13 count indictment, Arrey owned and operated two pharmacies trading as the Medicine Shoppe, on Liberty Road and Reisterstown Road in Baltimore. From January 2003 to July 2008, Arrey allegedly claimed reimbursement from health care benefit programs for purported “refills” of prescriptions which patients had never requested and for which no prescription drugs were ever dispensed to customers. The indictment seeks forfeiture of property obtained by Arrey as a result of the scheme, including $350,000 and residential property located in Glenelg, Maryland.

The indictment also alleges that Arrey used the identity of patients to carry out the health care fraud scheme. Arrey faces a maximum sentence of 10 years in prison for each of the 12 counts of health care fraud and a mandatory minimum of two years in prison consecutive to any other sentence for aggravated identity theft. No court appearance has been scheduled.

An indictment is not a finding of guilt. An individual charged by indictment is presumed innocent unless and until proven guilty at some later criminal proceedings. United States Attorney Rod J. Rosenstein thanked the Department of Health and Human Services Office of Inspector General and the Food and Drug Administration Office of Criminal Investigations for their investigative work. Mr. Rosenstein commended Assistant United States Attorneys Sandra Wilkinson and Tonya Kelly Kowitz, who are prosecuting the

New plans to improve the support and care for individuals and their families living with dementia were announced by Health Minister Edwina Hart.

Statistics from Alzheimers Society show that there are currently more than 37,000 people with dementia in Wales, and this is set to rise to almost 50,000 within 20 years. One in three people over 65 are expected to die with a form of dementia, according to the charity.

The Assembly Government asked a group of experts led by Ian Thomas, the Director of Alzheimers Society, to develop a Dementia Action Plan for Wales and this is now being issued for a 12 week consultation.

The plan draws together current policies and strategies and proposes a series of actions for Wales to meet the challenges of planning and delivering better services for people with dementia.

Mrs Hart said

“Dementia is a distressing and debilitating condition for the individual and can be equally as distressing for their loved ones. It will affect us all in one way or another in our lifetime.

“The National Dementia Action Plan has drawn together current policies and strategies and proposes a number of actions to be taken in Wales over both the short and long term to help us meet some very major challenges.

“I hope that people will read the groups document and through this consultation exercise let us know what their views are so that the Welsh Assembly Government can develop and provide improved dementia services that meet the needs of the people of Wales.”Ian Thomas, said

“This is an unrivalled opportunity for people to give their views on how we can change the lives of families living with dementia in Wales. The numbers of people with dementia are set to soar and this action plan takes us closer to making sure that everyone affected receives the vital support they need, both now and in the future.

“With the right leadership and proper investment, this plan has the potential to change lives. Alzheimers Society, will continue to work closely with Welsh Assembly Government to ensure it becomes a reality.”