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Thursday, November 9, 2006

Doctors Often Don't Talk Cost

Doctors discuss the cost of drugs only about one-third of the time when they prescribe them to patients, researchers reported yesterday.

Doctors also failed to discuss issues such as refills, generic options and insurance coverage, the researchers report in the American Journal of Managed Care.

A research team led by Derjung Tarn of the University of California at Los Angeles looked at patient and doctor surveys and transcripts of 185 audiotaped patient visits at two health-care systems in California.

In only 33 percent of the cases did the doctors talk about cost, insurance, generic or brand name, logistics, supply or refills. Patients asked about costs or insurance in only 2 percent of the cases.

Malaria Drug Effective Again

A crucial malaria drug that lost its punch in most countries because of germ resistance appears to be highly effective again in one African nation -- a startling shift with implications for other resistant microbes.

It appears to be the first time a drug widely used against a killer disease has regained effectiveness after a break in use.

"We didn't expect to see this," said researcher Christopher Plowe of the University of Maryland School of Medicine. "I'm not aware of any case where a drug wasn't working clinically and was withdrawn and now is 100 percent effective again."

The drug, chloroquine, was for many years the standard for treating malaria because it is cheap, effective and safe. But in 1993, doctors stopped using it in the African nation of Malawi, because it was no longer effective in fighting most malaria cases.

In recent years, researchers saw signs of genetic shifts in malaria that suggested it again might be vulnerable to chloroquine.

University of Maryland researchers tested it in 105 malaria-infected children at a clinic in Malawi. An astounding 99 percent were cured, they reported in today's issue of the New England Journal of Medicine.

HIV Strain in Gorillas a Hazard

A strain of the virus that causes AIDS may be widespread in wild gorilla populations in Africa and poses a risk to humans who hunt the animals for food or medicinal use, a study reports.

Researchers found that feces from three wild gorillas contained an HIV-1 strain that was more similar to the human AIDS virus than any of the related viruses found in apes in the past, the researchers write in today's issue of the journal Nature.

Humans, especially those who eat gorilla meat or use it in traditional medicines, may risk contracting HIV, said lead author Martine Peeters, a virologist at the Institute for Development and Research at the University of Montpellier 1 in France.

The Group-M strain of HIV-1 found in chimpanzees caused the AIDS pandemic when it was transmitted to humans. No primate source of the Group-O strain recently discovered in gorillas had previously been identified.

Researchers examined the fecal matter of 378 chimpanzees and 213 gorillas living in remote forest regions of Cameroon. They were surprised to find that six of 213 fecal samples from gorillas tested positive for HIV.

Scientists concluded that chimpanzees may have transmitted the so-called "SIVgor" strain to gorillas and humans independently or they may have given the virus first to gorillas, which then infected humans who butchered them.

-- From News Services


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