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Merkel cell carcinoma is a tumor of the skin that is well known for its metastatic potential. Because of its scarcity, no trials have been reported. Poulsen and colleagues from Australia conducted a unique multi-institutional Phase II prospective trial of concomitant chemoradiation for patients with high-risk disease and concluded that their regimen resulted in disease control and survival rates that are better than those reported in the literature.
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Munger and colleagues reviewed a database of 187,563 women enrolled in the Nurses Health Study, which longitudinally surveyed participants aged 25-55. There were 173 women with probable or definite multiple sclerosis (MS). Vitamin D intake was determined through the study questionnaire and 4 1-week diet records.
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Hepatocellular carcinoma is one of the most common malignancies worldwide, and, for those with advanced disease, treatment responses have been dismal. The current report of a trial of gemcitabine and oxaliplatin offers some hope. Using 2 different schedules of these agents, this study found an approximate 20% objective response rate with stable disease occurring in an additional 50%.
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In the year 2000, Health Care Financing Administration (now known as the Centers for Medicare & Medicaid Services) issued its National Coverage Determination (NCD) extending Medicare coverage to routine costs of qualifying trials, as well as those items and services made necessary to diagnose or treat complications arising from clinical trial participation.
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Patients with elevated bilirubin treated with irinotecan have an increased risk of toxicity, and a dose reduction is recommended. Patients with elevated AST, creatinine or prior pelvic radiation do not appear to have increased sensitivity to irinotecan, but the data are not adequate to support a specific dosing recommendation.
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In this simple yet elegant, single-blind, placebo-controlled, crossover study, 12 patients with McArdles disease were given a sucrose, or artificially sweetened placebo load, prior to aerobic exercise to determine if this might improve exercise tolerance. Average age of the 7 men and 5 women was 37 years, and all had lifelong exercise intolerance, episodic muscle cramps, and myoglobinuria triggered by exercise.
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When patients dont show up for their appointments, the natural first step for many practices is to penalize the patient. But the problem might not lie with the patient, and if it doesnt, charging the patient a missed-appointment fee or kicking him or her off the patient roster wont improve the clinics no-show and cancellation rate.
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A predictive modeling program is just the first step in identifying members for a comprehensive disease management program, says Michael Cousins, PhD, manager of health informatics for Health Management Corp. (HMC), based in Richmond, VA.
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Great-West Healthcares disease management approach won the Denver-based company the award of best disease management program in a national PPO for 2002-2003 from the Disease Management Association of America (DMAA).
