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Insurance Coverage May Drive Care Of Newborns With Congenital Defects
In a study that sheds light on how insurance coverage may drive health care and may reveal an unexpected result for the uninsured, a team of Yale School of Medicine and Yale-New Haven Children"s Hospital physicians has found that babies from uninsured families who are born with congenital defects are far more likely than those whose families have insurance to be transferred out of the large community hospitals where they are born and into children"s hospitals for corrective surgery.
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IPS Examines Legislative Measures To Fight HIV/AIDS
Inter Press Service examines several civil society organizations" argument that legislative measures aimed at fighting HIV/AIDS, "hurt more" than they "help." There are 58 countries with laws in place to "prosecute HIV transmission" and 33 others where such legislation is being considered, according to the International Planned Parenthood Federation.
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Dartmouth Studies Influence Administration, Even In Choice Of Venue
When President Obama chose Green Bay, Wis., to talk about the need for health reform, he did so in part because the area has achieved a high level of quality, and compared with other parts of the country, succeeded in restraining health care costs, National Public Radio reports. "They"re certainly spending a lot less money, and they are providing care that is equal or better than the care that is provided in many other communities around the country," Elliot Fisher, a researcher at the Dartmouth Institute for Health Policy and Clinical Practice told NPR in an interview. NPR says: "Some of the research the administration is relying on comes from the Dartmouth Institute for Health Policy and Clinical Practice," which focuses on variations in health quality and costs around the country.
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Amino Acid May Help Treat Patients With Hair-Pulling Condition

The amino acid N-acetylcysteine appears to reduce symptoms of compulsive hair-pulling in patients with a condition known as trichotillomania, according to a report in the July issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Trichotillomania has been described for almost 200 years and researched for more than two decades, but there is currently no approved treatment for the condition, according to background information in the article. "Trichotillomania is characterized by the following diagnostic criteria: the recurrent pulling out of one"s hair, which results in noticeable hair loss; an increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior; and pleasure, gratification or relief when pulling out hair," the authors write. "Psychosocial problems are common in individuals with trichotillomania and include significantly reduced quality of life, reduced work productivity and impaired social functioning." The amino acid N-acetylcysteine has previously shown promise in the treatment of repetitive or compulsive disorders and acts on the glutamate system, the largest neurotransmitter system in the human brain, the authors note. Jon E. Grant, J.D., M.D., M.P.H., and colleagues at the University of Minnesota School of Medicine, Minneapolis, conducted a 12-week, double-blind controlled trial of the medication among 50 individuals with trichotillomania (45 women and five men, average age 34.3 years). Twenty-five were randomly assigned to receive 1,200 milligrams to 2,400 milligrams of N-acetylcysteine per day for 12 weeks; the other 25 received placebo. After 12 weeks, patients taking the active medication had significantly greater reductions in hair-pulling symptoms than those taking placebo. "Fifty-six percent of patients "much or very much improved" with N-acetylcysteine use compared with 16 percent taking placebo," the authors write. "Significant improvement was initially noted after nine weeks of treatment." None of the participants reported adverse effects. The magnitude of improvement observed in patients taking N-acetylcysteine was higher than that seen with other medications and similar to that reported for cognitive behavior therapy alone or combined with medication, suggesting that N-acetylcysteine compares favorably with existing treatment options, the authors note. Its efficacy lends further support to the hypothesis that therapies manipulating the glutamate system (called glutamatergic agents) may target core symptoms of compulsive behaviors. "N-acetylcysteine is an amino acid, is available in health-food stores, is cheaper than most insurance co-payments and seems to be well-tolerated. N-acetylcysteine could be an effective treatment option for people with trichotillomania," the authors write. Future studies should evaluate long-term effects of the treatment as well as its efficacy when combined with behavioral therapy, they conclude. "As effective treatments for hair pulling emerge, it becomes increasingly important that physicians and mental health care providers screen for trichotillomania to provide timely treatment." Arch Gen Psychiatry. 2009;66[7]:756-763. Archives of General Psychiatry


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