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Editorial, Opinion Piece Discuss Issues Related To Routine HIV Testing
A recent directive to streamline the HIV testing consent process in Massachusetts as well as consent forms "no longer hav[ing] to accompany test specimens to the lab," are bringing "the state closer to a CDC recommendation that clinicians provide HIV screening on an opt-out basis," according to a Boston Globe editorial. "The opt-out provision is at the heart" of legislation sponsored by state Sen. Patricia Jehlen (D) that would end the state"s requirement of written consent for HIV testing "and instead have healthcare providers inform patients verbally that the test is planned but that they can decline it," the editorial states, adding, "The Jehlen bill would help destigmatize HIV testing itself" (7/6).
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Geriatrician Available To Discuss New Research On Falls In Older Adults
Each year in this country, one of every three people over age 65 suffers a fall, resulting in nearly 16,000 deaths. The federal government estimates that 1.8 million older adults who fall are treated each year in hospital emergency rooms for nonfatal injuries - including bruises, fractures and head trauma - and that 433,000 of those individuals need to be hospitalized because of their injuries. Research published this month in the Journal of the American Geriatrics Society has found that a significant number of those falls - an average of 129 per day - involve the use of walkers and canes, the very devices on which millions rely to help them avoid the dangers posed by falling.
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JHPIEGO's Dr. Harshad Sanghvi Receives International Health Award - Global Health Council Present Award For Best Practices In Global Health On May 28
Jhpiego, an international non-profit health organization affiliated with Johns Hopkins University, is pleased to announce that Dr. Harshad Sanghvi, Vice President and Medical Director of Jhpiego, has been awarded the 2009 Award for Best Practices in Global Health from the Global Health Council.
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Winter- And Spring-Onset RA Patients Have Worse 6 Month Outcomes Than Those With Summer Onset

When a patient"s first symptoms of rheumatoid arthritis (RA) occur in winter, the severity of their RA (as measured by the modified Total Sharp Score, mTSS, an assessment of erosion and joint space narrowing) was rated more severe at six months, when compared to patients whose RA first became symptomatic in summer (Odds Ratio (OR) =2.82 [1.14;7], p=0.0255). Furthermore, RA patients with their first symptoms in spring showed poorer radiographic outcome compared to summer-onset patients (OR=2.83 [1.10;7.37], p=0.0322), according to the results of a new study presented today at EULAR 2009, the Annual Congress of the European League Against Rheumatism in Copenhagen, Denmark. Similarly, patients" mTSS after six months was worse if their first symptoms had occurred in winter (OR=2.61 [1.20; 5.71], p=0.0158) or in spring (OR=2.63 [1.13; 6.14], p=0.0025) versus autumn as the reference season. This effect was not however observed at 12 month follow up, which the study authors suggest could suggest that these initial environmental factors exert less of an effect on longer term radiographic progression. Dr Gaç«l Mouterde, Immuno-Rheumatology Department, Lapeyronie Hospital, Montpellier, France who led the research, said: "During our study of predictors of radiographic progression, we have unveiled a distinct relationship between RA progression and seasonal onset and postulate that this could be as a result of either a vitamin D deficiency or environmental factors, such as winter viruses, influencing protein citrullination. Anti-citrullinated protein antibodies (ACPAs) are often found in the immune systems of RA patients. This finding may assist towards the identification of RA patients at a higher risk of developing structural damage, in order to propose early intensive therapy and minimise disease progression." Of the 736 patients from the multicentre French ESPOIR cohort analysed in the study (48÷±12 years of age, females 77%, mean disease duration 103+/-53 days, DAS28 5.11÷±1.31, HAQ score 0.97÷±0.68, CRP 21.9÷±32 mg/l, HLA-DRB1*01 or 04 57.5%), those found to have anti-CCP antibodies (total n=290) were also likely to have experienced increased radiographic disease progression (defined by an increase of at least 1 point of the mTSS), than those without anti-CCP antibodies, both after six months (OR=3.73 [2.04;6.82], p


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