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About 75% Of People In Rwanda Who Have Experienced Discrimination Are HIV-Positive, Survey Finds
A recently released survey on stigma in Rwanda indicates that at least 74% of people in various segments of society who have experienced discrimination are HIV-positive, the New Times/AllAfrica.com reports. The discrimination often is in the form of isolation from family and physical harassment, according to the survey. The study was conducted by the Association of Vulnerable Widows Infected and Affected by HIV and AIDS in conjunction with the Network of People Living with HIV and UNAIDS Rwanda. It found that although 87% of respondents reported never having been denied health services, 88% reported being denied other social services, such as family planning, because of their HIV status. An estimated one-third of respondents reported that their rights had been abused because of their HIV-positive status. Chantal Nyiramanyana, AVVAIS president, said, "We conducted this survey as a way of providing basis for advocacy, policy change, and programmatic interventions by the government and other interested bodies to address stigma and discrimination related to HIV." The survey found that other groups experiencing stigma in the country include commercial sex workers and asylum seekers (Kwizera, New Times/AllAfrica.com, 5/27).
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Senate Minority Leader McConnell Says He Will Oppose Sotomayor As Other Republicans Back Nominee
Senate Minority Leader Mitch McConnell (R-Ky.) on Friday announced that he will oppose Supreme Court nominee Sonia Sotomayor, even as increased Republican support seemed to ensure that she would be confirmed, the New York Times reports. McConnell said that he would not support Sotomayor"s nomination because her "record of written statements suggests an alarming lack of respect for the notion of equal justice, and, therefore, in my view, an insufficient willingness to abide by the judicial oath." McConnell intends to deliver the remarks to the Senate on Monday. Meanwhile, Republican Sens. Richard Lugar (Ind.), Mel Martinez (Fla.) and Olympia Snowe (Maine) said that they would support Sotomayor. The Times reports that the senators" backing of Sotomayor -- combined with her "solid Democratic support" -- shows that she should receive "strong confirmation approval" (Hulse, New York Times, 7/18). Senate Judiciary Committee Chair Patrick Leahy (D-Vt.) and ranking member Jeff Sessions (R-Ala.) would not predict how many Republicans could vote for her confirmation. Sessions said that Republicans are seeking a committee vote on Sotomayor on July 28, one week later than the date sought by committee Democrats. During that week, Republicans hope to review her record, her answers from her confirmation hearings and other responses to questions (AP/Boston Globe, 7/20).
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Asthma Mucus Myth Slammed
As the winter cold and flu season tightens its grip, the National Asthma Council Australia is concerned that Australians may be incorrectly pointing the finger at milk as the mucus-causing culprit.
Oncology

Dosimetric Equivalence Of Nonstandard HDR Brachytherapy Catheter Patterns

UroToday.com - Robotic and medical imaging technology has made leaps and bounds over the past few decades, and the practice of brachytherapy should take advantage of these advances. Of course, any new technology cannot be implemented in the clinic without a scientifically validated foundation, which must be established in order to justify the move away from tried-and-true methods. With this in mind, we present this paper as a peek into the future -- alternative, potentially useful implant catheter patterns. Brachytherapy places concentrated s of radiation inside the body inside cancerous tissues and organs using an external template of fixed positions to help the physician guide the insertion needles or catheters. Studies have shown that placing radiation s close to cancer cells results in less damage to healthy tissues than surgery or external beam radiation and does not require multiple hospital visits for treatment [1]. In terms of survival rate, brachytherapy is a highly successful method for treating prostate cancer [1,2,3], but it is a surgical procedure that can produce negative side effects due to the insertion of brachytherapy needles. [4,5,6]. The needle insertion process can be made less invasive by employing robotic brachytherapy, which can take full advantage of the plethora of information that is available when using imaging technologies like MRI to allow the physician to achieve a near-perfect implant. By near-perfect, we mean an implant that minimizes the number of needles inserted (to pierce as few as possible of the sensitive healthy structures around the targeted tissue) and still deliver radiation that conforms to the geometry of the diseased target tissue. For example, an MR image of the prostate region allows us to see the neurovascular bundles, the seminal vesicles, and the penile bulb-information entirely unutilized during a standard transrectal ultrasound-template guided implant procedure. In fact, we can also delineate the main substructures of the prostate: the peripheral zone, the transition zone, and the central zone. A robot would expand the number of possible needle/catheter paths and allow for the placement without the need for the fixed template of needle positions. The ability to see the prostate substructure and perhaps the tumor allows for more optimal placement of needles/catheters for therapeutic treatment. The optimal placement of radiation relies on two factors: seeing where to go and going there. Imaging technology helps us see where we want to go and robot technology will help us in going there. Just as on any given day, there may be a different optimal commute to work due to traffic and weather conditions, the method of driving radiation where it needs to go depends on the conditions of the anatomy of any given patient. And while trains are an excellent mode of transportation, they lock us into pre-defined routes just as template-based brachytherapy (with its restriction to grid-based and parallel needle patterns) doesn"t have the flexibility to access all parts of the prostate while avoiding sensitive tissues. The work presented in this paper shows that by using alternative methods of going there we can still deliver a standard dose distribution that has been shown to be clinically successful. This is key because it shows that alternative catheter patterns made available by robotic devices, combined with dose optimization, can allow us to deliver dose while, at the same time, avoiding the puncture of sensitive non-diseased structures. To some, the benefit of eliminating trauma to critical structures may seem obvious, but nevertheless, it is not clinically proven and it will not be possible until such technology becomes available in the clinic. A full report of this work is available in PDF format for free at the online science archive, arXiv.org: http://arxiv.org/abs/0904.2358. The original journal article appears in the Medical Physics Journal: Cunha et al., "Dosimetric equivalence of nonstandard HDR brachytherapy catheter patterns ," Med. Phys. 36 (1), pp 233-239, January 2009. References: 1. I. Thompson, J. B. Thrasher, G. Aus, A. L. Burnett, E. D. Canby-Haginoa, M. S. Cookson, A. V. D"Amicoa, R. R. Dmochowski, D. T. Etona, J. D. Formana, S. L. Goldenberga, J. Hernandeza, C. S. Higanoa, S. R. Kraus, J. W. Moul, C. M. Tangena, and Prostate Cancer Clinical Guideline Update Panel, "Guideline for the management of clinically localized prostate cancer: 2007 update," J. Urology, vol. 177, no. 6, pp. 2106-2131, 2007. 2. L. Potters, C. Morgenstern, E. Calugaru, P. Fearn, A. Jassal, J. Presser, and E. Mullen, "12-year outcomes following permanent prostate brachytherapy in patients with clinically localized prostate cancer," J. Urology, vol. 173, pp. 1562-1566, May 2005. 3. J. C. Blasko, T. Mate, J. E. Sylvester, P. D. Grimm, and W. Cavanagh, "Brachytherapy for carcinoma of the prostate: techniques, patient selection, and clinical outcomes," Seminars in Radiation Oncology, vol. 12, no. 1, pp. 81-94, 2002. 4. C. Vargas, M. Ghilezan, M. Hollander, G. Gustafson, H. Korman, J. Gonzalez, and A. Martinez, "A new model using number of needles and androgen deprivation to predict chronic urinary toxicity for high or low dose rate prostate brachytherapy," J. Urology, vol. 174, pp. 882-887, Sept. 2005. 5. L. Eapen, C. Kayser, Y. Deshaies, G. Perry, C. E, C. Morash, J. E. Cygler, D. Wilkins, and S. Dahrouge, "Correlating the degree of needle trauma during prostate brachytherapy and the development of acute urinary toxicity," Int. J. Radiat. Oncol., Biol., Phys., vol. 59, no. 5, pp. 1392-1394, 2004. 6. S. K. Kang, R. H. Chou, R. K. Dodge, R. W. Clough, H.-S. L. Kang, M. G. Bowen, B. A. Steffey, S. K. Das, S.-M. Zhou, A. W. Whitehurst, N. J. Buckley, J. H. Kim, R. E. Joyner, I. Sarmina, G. S. Montana, S. S. Ingram, and M. S. Anscher, "Acute urinary toxicity following transperineal prostate brachytherapy using a modified Quimby loading method," Int. J. Radiat. Oncol., Biol., Phys., vol. 50, no. 4, pp. 937-945, 2001. Written by J. Adam M. Cunha, PhD as part of Beyond the Abstract on UroToday.com 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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