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For America's Aged, Surgery At Any Price?
When doctors decide whether or not to go ahead with an expensive surgery, "age is no longer the deciding factor, even for invasive treatment such as open-heart surgery," The Philadelphia Inquirer reports. One question is "whether this never-too-old approach is an example of U.S. medical progress, or an example of why Medicare -- federal health insurance for people over 64 -- is headed for insolvency. The answer, experts say, is both. Which is why the current debate over expanding federal coverage to all uninsured Americans is an ethical and economic minefield. "Forty years ago, it was taken for granted that the elderly were not good candidates for organ transplantation, dialysis, or advanced surgical procedures. That has changed," Daniel Callahan, cofounder of the Hastings Center, a bioethics research institute in Garrison, N.Y., wrote recently. "Under the best of circumstances, age should be irrelevant in the Medicare program. But so far, the cost of care has not been considered, and it can hardly remain irrelevant in a program strapped for money.""

New Mexico Department Of Health Prepares For Influenza Mass Vaccination Clinics Department Continues To Monitor H1N1 Cases
The New Mexico Department of Health is planning for influenza mass vaccination clinics that will take place this fall to protect people against the novel H1N1 strain of influenza (earlier referred to as swine flu) and against seasonal influenza. The Department of Health is also ensuring that the State and its local partners are prepared to deal with the possibility of an increase in severity of H1N1 influenza cases, including a potential pandemic in New Mexico.
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Policies On Organ Donation After Cardiac Death Vary Considerably Among Children's Hospitals
Although a large number of children"s hospitals have developed or are developing policies regarding organ donation after cardiac death, there is considerable variation among policies, including the criteria for declaring death, according to a study in the May 13 issue of JAMA.
Medical Devices

Is P90RSK A New Therapeutic Target For Liver Fibrosis?

Cirrhosis is a world wide, bad prognosis liver disease and characterized by excessive collagen deposition and liver function damage. In our previous work, p90RSK is observed significantly up-regulated in association with elevated collagen type I levels in rat liver fibrosis. But detail mechanism of this phenomenon is still unknown. Now, there is a research article published on May 7, 2009 in the World Journal of Gastroenterology that addresses this problem. The research team led by Professor Zhu from Department of Gastroenterology, Jinling Hospital observed the mechanism between p90RSK and collagen type I in vivo and in vitro. In fibrotic liver tissue, p90RSK was over-expressed and located in activated HSC, which had a significant positive correlation with collagen type I levels. In HSC-T6 cells transfected with RNAi targeted to p90RSK, the expression of collagen type I was down regulated according with that of p90RSK. However, collagen type I promoter activity was not alternated with up-regulation or down-regulation of p90RSK expression. Otherwise, p90RSK RNAi inhibited the proliferation of HSC significantly. These results indicate that P90RSK was a critical element in activation of HSC, which is primarily responsible for excessive collagen expression via the initiation of HSC proliferation during liver fibrosis. Lacking of the knowledge about pathological proceeding of liver fibrosis results in the lack of effective method to prevent and treat liver fibrosis. These results prefer a new view of p90RSK on liver fibrosis, and thus may provide a new therapeutic target to liver fibrosis. Reference: Yang MF, Xie J, Gu XY, Zhang XH, Davey AK, Zhang SJ, Wang JP, Zhu RM. Involvement of 90-kuD ribosomal S6 kinase in collagen type ò…  expression in rat hepatic fibrosis. World J Gastroenterol 2009; 15(17): 2109-2115 http://www.wjgnet.com/1007-9327/15/2109.asp Correspondence to: Ren-Min Zhu, Professor, Department of Gastroenterology, Jinling Hospital, Second Military Medical University, Zhongshan East Road 305, Nanjing 210002, Jiangsu Province, China. Lin Tian World Journal of Gastroenterology


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