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Mass. Panel Recommends Scrapping Doctors, Hospitals Payment System
The Boston Globe: "A state commission recommended yesterday that Massachusetts dramatically change how doctors and hospitals are paid, essentially putting providers on a budget as a way to control exploding healthcare costs and improve the quality of care. The 10-member commission, which includes key legislators and members of Governor Deval Patrick"s administration, voted unanimously to largely scrap the current system, in which insurers typically pay doctors and hospitals a negotiated fee for each individual procedure or visit. That arrangement is widely seen as leading to unneeded tests and procedures. Instead, the group wants private insurers and the state and federal Medicaid program to pay providers a set payment for each patient that covers all that person"s care for an entire year and to make the radical shift within five years" (Kowalczyk, 7/17).
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Web-Based Consultations May Reduce Referrals To Dermatologists
A Web-based system allowing general practitioners to confer with specialists regarding patients with skin conditions may reduce referrals to dermatologists by approximately 20 percent, according to a report in the May issue of Archives of Dermatology, one of the JAMA/Archives journals.
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MEDEC Commends The Ontario Government's Decision To Make PET Scans More Accessible To Patients In The Province
MEDEC - Canada"s Medical Technology Companies - applauds the Ontario Government for its recent decision to add Positron Emission Tomography (PET) Technology to the services covered by the Ontario Health Insurance Plan (OHIP) thereby ensuring that Ontarians have access to PET technology.
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Prostate Cancer-Derived Urine Exosomes: A Novel Approach To Biomarkers For Prostate Cancer

UroToday.com - In the online edition of the British Journal of Cancer, Dr. J. Nilsson and an international team of investigators report on a new biomarker methodology for prostate cancer (CaP). The authors explain that prostatic secretions contain two types of microvesicles; prostasomes (150-500nm) are produced by prostatic ductal epithelial cells that are a normal component of seminal fluid and participate in male fertility and exosomes which are specialized nanovesicles (30-100nm) with cup-shaped morphology and are actively secreted by normal and tumor cells. Exosomes are reported to be secreted in increased amounts in a variety of malignant fluids and can be enriched with certain RNA transcripts several hundred-fold compared to donor cells. Exosomes lack all ribosomal RNA and contains mostly mRNA and microRNAs. This means that exosomes are enriched with transcripts specific to tumor cells that may possibly be below the detection limit in the tumor cells themselves. The researchers used RT-PCR to evaluate urine from four groups of CaP patients; before and after prostatic massage in patients with CaP prior to treatment, undergoing androgen deprivation therapy (ADT), with bone metastases, and a subset selected for electron microscopy. Nested PCR was used to detect transcripts of TMPRSS2:ERG and PCA-3, both mRNA prostate cancer biomarkers. The mRNA transcripts for the fusion gene TMPRSS2:ERG were detected in 2 of 4 patients who had a high Gleason score and PSA levels, but not in 2 low risk tumors. PCA-3 transcripts were detected in all of the patients after mild prostate massage. Neither patients undergoing ADT nor those with bone metastases had detectable PSA mRNA levels or were positive for PCA-3or TMPRSS2:ERG. These findings are attributed to effective response to ADT and impaired/non-functional prostate tissue. Electron microscopy noted exosomes in the urine fractions of patients with a high-grade tumor, confirmed by anti-CD63 gold staining. The larger prostasomes were not present in the urine of CaP patients and exosomes were not present in the urine of patients without CaP. These data suggest that this technique of identifying biomarkers in the urinary exosomes of CaP patients may potentially be developed as a useful clinical test. Nilsson J, Skog J, Nordstrand A, Baranov V, Mincheva-Nilsson L, Breakefield XO, Widmark A Br J Cancer. 2009 May 19;100(10):1603-7 10.1038/sj.bjc.6605058 Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: www.urotoday.com Copyright © 2009 - UroToday


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