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150 Days: Obama's Silence On AIDS Remains Deafening
On the observation of President Obama"s first 150 days in office, AIDS Healthcare Foundation (AHF), the nation"s largest AIDS organization, is continuing its "Change AIDS Obama" campaign with the release of a new online advocacy video chastising the president for his ongoing-and baffling-silence on AIDS.

Kansas Becomes Central Battleground In Abortion-Rights Debate
Kansas has become "perhaps the fiercest battleground" in the abortion-rights debate with mass protests, prosecutions, lawsuits and the recent murder of abortion provider George Tiller, the AP/Washington Post reports. Kansas State University political scientist Joe Aistrup said, "There"s a very prominent vein in Kansas politics that tends toward moral righteousness." He said that this contributes to that unending debate and has produced extremists on both sides of the issue in the state.Peter Brownlie, CEO of Planned Parenthood of Kansas and Mid-Missouri, said that the majority of those who maintain the intense debate on abortion rights are political leaders. "There is a very clear and growing gap between the general public and the political leaders who are committed to this being such a constant and volatile issue," he said. Brownlie added that on issues relating to abortion, sex education and family planning, "Kansans" views are not markedly different from most Americans, but there are political forces at work, some of them well beyond the state borders."The Post reports that Kansas is different than most states where either supporters or foes of abortion rights dominate. According to the AP/Post, Kansas often sways between having key lawmakers who support abortion rights and those who oppose them. For example, a Republican-dominated Legislature over the past six years passed several bills to restrict abortion access, but much of the legislation was vetoed by former Gov. Kathleen Sebelius (D). The result has triggered frustration in groups opposing abortion rights, and they continue to feed widespread opposition to abortion in the state, the AP/Post reports.According to Burdett Loomis, a University of Kansas political science professor, there even is a split among Kansas Republicans in regard to abortion rights, as some Republicans in the state are evangelical Christians who oppose abortion rights, while others are moderates who support such rights. He said the split "might pop out in gun laws, home schooling, evolution, but it starts and stops with abortion" (Crary/Hanna, AP/Washington Post, 6/3).Wall Street Journal Examines Abortions Later in PregnancyIn related news, the Wall Street Journal on Thursday examined how Tiller"s clinic in Kansas became a battleground in the abortion-rights debate particularly because some of his patients were in the second and third trimesters of pregnancy. According to the Journal, even though the subject of abortion later in pregnancy is the of "a deep cultural divide," both sides agree that it is "anguishing." Fewer than 1% of all abortions in the U.S. are performed in the second or third trimesters, and most states prohibit abortions late in pregnancy but include exceptions for the woman"s life and health.The Journal reports that abortion procedures performed later in pregnancy often carry increased health risks, are more expensive and are emotional. The Guttmacher Institute reports that 8.9 maternal deaths occur during every 100,000 abortions performed later in pregnancy, compared with 7.1 deaths per 100,000 births. The article also profiled women who chose to undergo abortions later in pregnancy at Tiller"s clinic, as well as arguments from abortion-rights opponents (Simon, Wall Street Journal, 6/4).
News of the day
Swine Flu Might Infect 40% Of The US Population In The Next 24 Months
Health authorities in the United States have voiced concern that 40% of the country"s whole population could be infected with the swine flu (H1N1) virus over the next 24 months. The estimates are based on data gleaned from the 1957 flu pandemic which killed nearly 70,000 people in the country. That pandemic was not as severe as the 1918-1919 Spanish flu one. If one hundred and twenty million people caught swine flu this time round, and vaccine campaigns were not successful, the eventual death toll could be in the hundreds of thousands.
Cardiovascular

Underweight And Very Severely Obese Patients At Risk Following Liver Transplantation

A recent study by doctors at the University of Washington explained that patients who are significantly underweight or very severely obese prior to liver transplantation are at increased risk of death following transplantation surgery. These findings, from the largest known observation of liver transplantation at the extremes of BMI, are published in the August issue of Liver Transplantation, a journal published by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases. The research team led by AndrÓ© A. S. Dick, M.D., Department of Surgery, Division of Transplantation, University of Washington investigated the impact of pre-transplantation Body Mass Index (BMI) on post-liver transplantation patient survival. The doctors hypothesized that individuals at the extremes of BMI were at increased risk of death following liver transplantation. In this study, patients with BMI 40 kg/m2. Previous studies show that diabetic patients are at increased risk of infectious complications after surgical procedures, and supplemental immunosuppressive medication may further exacerbate this process. "An appropriate weight-based immunosuppressive regimen, careful management of severely obese patients" co-morbidities (diabetes, hypertension) and aggressive facilitation of weight reduction can optimize the health of these patients and potentially improve patient outcomes," suggest the researchers. For patients who are severely obese, past protocol was to resolve their co-morbidities and help them achieve weight loss prior to transplantation. "A better approach might be to transplant these patients sooner by not requiring weight loss or working with the United Network for Organ Sharing (UNOS) for a policy change to assign additional Model for End-Stage Liver Disease (MELD) points for severe obesity, as is done for patients with hepatocellular carcinoma," concluded the authors. "Aggressive management of the patients" co-morbid factors and posttransplantation weight loss is a must." The researchers also recommend a posttransplantation immunosuppressive regimen favoring less immunosuppressive medications without steroids and low dose tacrolimus based on the ideal body weight. In patients who are underweight the authors recommend "close follow-up with a nutritionist. If the patients are unable to meet their caloric intake prior to transplantation, they should then be admitted to the hospital for aggressive nutritional supplementation such as tube feedings. This aggressive regimen is continued after transplantation." The doctors also suggest a more aggressive immunosuppressive regimen with higher doses of tacrolimus and mycophenolate mofetil. "Liver Transplantation at the Extremes of Body Mass Index," AndrÓ© Dick, Austin Spitzer, Catherine Seifert, Alysun Deckert, R.L. Carithers, Jorge Reyes, James Perkins, Liver Transplantation, August 2009. Dawn Peters Wiley-Blackwell


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