Women's Health News

Women who undergo bariatric surgery to treat obesity will reduce the risk of medical and obstetric complications when they become pregnant, according to a study by researchers from Ben-Gurion University of the Negev’s (BGU) Faculty of Health Sciences.

The study was recently published in the International Journal of Gynecology and Obstetrics by BGU Professor Eyal Sheiner and Dr. Adi Weintraub, also of the Department of Obstetrics and Gynecology at Soroka University Medical Center.

Between 1988 and 2006, 176 women had 301 (0.17%) deliveries that occurred before bariatric surgery and 354 women had 507 (0.28%) deliveries that occurred after bariatric surgery.

The study indicated that the risk of gestational diabetes alone drops by 60 percent when an obese woman has bariatric surgery before getting pregnant. There were significantly lower rates of hypertensive disorders in general and severe pre-eclampsia in particular, as well as lower rates of diabetes mellitus and anemia (defined as maternal hemoglobin less than 10 g/dL) following bariatric surgery.

The study did show, however, a significantly higher rate of cesarean births in women who had undergone bariatric surgery.

The prevalence of people who are overweight or obese has increased dramatically in high-income countries over the past 20 years. In the United States, for example, figures for 1999 through 2002 showed that some two-thirds (65.1%) of Americans aged 20 years or older had a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) greater than 25 and were considered overweight; one-third (30.4%) were considered obese (BMI greater than 30), and 4.9% were morbidly obese (BMI greater than 40). Between 1999 and 2002, close to one-third of women of childbearing age in the United States were classified as obese.

Notes:

About Ben-Gurion University of the Negev and American Associates

Ben-Gurion University of the Negev is a world-renowned institute of research and higher learning with 18,000 students on campuses in Beer-Sheva, Sede Boker and Eilat in Israel’s southern desert. It is a university with a conscience, where the highest academic standards are integrated with community involvement, committed to sustainable development of the Negev. Founded in 1972, American Associates, Ben-Gurion University of the Negev plays a vital role in helping the University fulfill its unique responsibility to develop the Negev, reach out to its local community and its Arab neighbors, and share its expertise with the world.

Source:
Andrew Lavin

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University of Minnesota School of Public Health researcher Ellen Demerath, Ph.D., is among an international group of researchers that has identified 30 new genes responsible for determining the age of sexual maturation in women. Many of these genes are also known to influence body fatness, obesity, and energy metabolism. Prior to the multi-institutional study, only four genes had been identified as contributing to the process.

The findings, which were reported in Nature Genetics, help to explain why girls who are obese tend to have earlier puberty: some of the same genes are involved in both outcomes. Early menarche, or the first menstrual cycle, is linked to a variety of chronic adulthood diseases, including breast cancer, cardiovascular diseases, and type 2 diabetes.

As a result of these discoveries, Demerath suggests that health care providers and other professionals pay particularly close attention to girls with a high risk of obesity (those who are overweight in childhood or who have a parental history of obesity) and intervene with them, as those girls are also genetically more susceptible to early menarche.

“Early menarche is caused by both genetics and environmental factors,” said Demerath. “We already knew that diet and physical exercise play a role in menarche, but now that we’ve identified more of the specific genes involved, this gives us clues about how to intervene on the process. By showing how hereditary and biological factors contribute to early menarche, we hope to one day allow health care providers to identify girls with increased risk of early menarche, and help them avoid the complications of early-onset puberty.”

In the large-scale, NIH-funded study, researchers from 104 institutions collected data from more than 100,000 women from the United States, Europe, and Australia. This includes women from the Twin Cities area enrolled in the Atherosclerosis Risk in Communities (ARIC) study. Not only were researchers able to identify these new genes, but they also found that many of them play a role in body weight regulation or biological pathways related to fat metabolism. The study findings also suggest that menarche is a result of a complex range of biological processes.

Today, girls are menstruating earlier than ever before. In the mid-1900s, the average age of menarche was 14-15 years. The average age today is 12-13 years.

“We now know that hormone regulation, cell development, and other mechanisms are related to menarche,” said Demerath.

According to Demerath, the next step for researchers is to examine whether some of these genes also influence sexual development in males, whether the genes are related to general growth in size as well as development, the points in the life cycle when the genes are most powerfully expressed, and how environmental factors such as diet and physical activity can modify their effects.

Quotes

“Early menarche is caused by both genetics and environmental factors. We already knew that diet and physical exercise play a role in menarche, but now that we’ve identified more of the specific genes involved, this gives us clues about how to intervene on the process. By showing how hereditary and biological factors contribute to early menarche, we hope to one day allow health care providers to identify girls with increased risk of early menarche, and help them avoid the complications of early-onset puberty,” said Demerath.
“We now know that hormone regulation, cell development, and other mechanisms are related to menarche,” said Demerath.

Source:
Emily Jensen
University of Minnesota Continue reading →

Sanofi Pasteur, a joint company of Merck and Sanofi-Aventis, recently began selling Merck’s human papillomavirus vaccine Gardasil in Austria, Finland, Germany, Ireland, Sweden and the United Kingdom, Reuters reports (Reuters, 10/17). The European Commission late last month approved Gardasil for sale and marketing in the European Union. According to Merck, the vaccine in clinical trials has been shown to be 100% effective in preventing HPV infection with strains 16 and 18, which together cause about 70% of cervical cancer cases, in women who do not already have the virus, and about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases. Gardasil also protects against vaginal and vulvar cancers, two other gynecological cancers that are linked to HPV, according to a study presented in June at a meeting of the American Society of Clinical Oncology in Atlanta. In the U.K., the Joint Committee on Vaccination and Immunisation, an independent advisory committee for the U.K. Department of Health, will decide if the vaccine will be covered by the National Health System (Kaiser Daily Women’s Health Policy Report, 9/25). Sanofi Pasteur plans to launch sales of the vaccine in most E.U. countries by the end of 2006, but the vaccine will not be available in Italy, Greece or Spain until 2007. According to Reuters, Gardasil in the E.U. will cost between $565 and $753 depending on the country (Reuters, 10/17).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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A single receptor molecule can perform different functions in different cancer types, thereby complicating approaches to therapy. This was the key finding of a study recently published in the British Journal of Cancer (BJC)*. The study compared the functionality of the HER2/neu receptor in the cancer cells of breast and ovarian cancer tissue. Supported by the Austrian Science Fund FWF, the team of scientists involved have shown that the cellular process regulated by this receptor vary greatly between different cancer types. As HER2/neu is the target of successful breast cancer therapy, this result is of major significance for the treatment of ovarian cancer.

Breast and ovarian cancers can both be hereditary, can both be traced back to the same genetic defect and consequently can both possess a large number of HER2/neu receptors. Why therefore do both cancer types not react in the same way when this receptor is blocked? An approach that has proved to be the biggest success of the past 20 years in the treatment of breast cancer has proved unsuccessful in therapies for ovarian cancer. Dr. Dietmar Pils, a member of the laboratory headed by Prof. Michael Krainer, an oncologist at the Department of Internal Medicine I, Medical University of Vienna, has achieved a major breakthrough in finding an answer to this puzzling question.

One Receptor. Two Effects.

The team compared tissue samples from 148 ovarian cancers with results from breast cancer tissue samples and the available patient data. This comparison uncovered interesting differences between the two tissue types. While around 25% of ovarian cancer samples also exhibited a high occurrence of the HER2/neu receptor (a known fact), a different signal molecule (CXCR4) was unaffected in the ovarian cancer tissue. However, breast cancer cells, which exhibit elevated levels of HER2/neu, also produce greater amounts of CXCR4 than healthy cells. The CXCR4 molecule has been linked to the formation of metastases and it is assumed that HER2/neu induces the formation of CXCR4 while simultaneously protecting the molecule against degradation caused by enzymes, thus enabling the cancer to become more aggressive (i.e. metastasising). The results from the Medical University of Vienna now show that the signalling effect produced by HER/2neu is not involved in ovarian cancer.

Molecular Diagnostics Optimise Therapy

Prof. Krainer on the significance of these results: “For almost ten years we have been able to identify hereditary breast cancer using molecular diagnostics and rely on monoclonal antibodies for therapy. The first antibody to be approved for use as a medicine blocks precisely the HER2/neu receptor, thus impeding the cancer’s growth. This is a perfect example of a tailor-made approach to therapy. Our work now reveals just how important it is to carry this differentiation further forward in the development of cancer therapies. After all, in the case of ovarian cancer cells, although the same monoclonal antibody fits this receptor, it has little effect. My laboratory is using findings such as these to create a basis for optimizing the treatment of cancer and to discover where therapies are going wrong. We are very grateful for the support we have received from the FWF, particularly since the potential including the financial potential that fundamental research offers for the health system seems not to have been fully recognized yet.”

This study, supported by the FWF Austrian Science Fund, clearly demonstrates just how important results from fundamental research can be for state-of-the-art cancer therapy. Furthermore, studies such as this also enable health professionals to choose the optimum treatment for each individual patient from a vast range of therapies. After all, there is no one-size-fits-all treatment for cancer.

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Levels of hemoglobin A1c — or HbA1c, a measure of blood sugar control — in healthy middle-aged and older women can be an independent predictor of type 2 diabetes, according to a study published in the August issue of the American Journal of Medicine, Reuters reports.

Aruna Pradhan of Brigham and Women’s Hospital and colleagues examined 26,563 Women’s Health Initiative participants to determine whether baseline HbA1c levels can predict type 2 diabetes and first cardiovascular events. The study participants were at least age 45 at the beginning of the study and did not have type 2 diabetes or cardiovascular disease. The study found 1,238 cases of type 2 diabetes and 684 cardiovascular events among the participants during the follow-up period, which lasted an average of 10 years.

The researchers found a graded increase in risk of diabetes and heart-related events as levels of HbA1c increased, according to Reuters. When adjusting for other factors, HbA1c remained a strong predictor for type 2 diabetes but not heart disease, the researchers said. According to the researchers, it is uncertain if slight increases of HbA1c could provide prognostic information on the risk of type 2 diabetes or heart disease among people at “usual risk” for the diseases. The researchers concluded that although the study “did not support the use of HbA1c as a single measure of diabetes risk,” the results “suggest that the prognostic significance of elevated HbA1c may warrant a greater emphasis in primary prevention” (Reuters, 9/6).

An abstract of the study is available online.

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

Some insurers are denying individual coverage to women who have given birth via caesarean section because they are likely to undergo the procedure again, the New York Times reports. According to the Times, a c-section on average costs about $2,700 more than a vaginal birth.

According to the Times, it is unknown how many women have been denied individual coverage because of a prior c-section. The Times reports that the number is “likely to increase” because the number of people seeking individual health insurance has been steadily growing. Meanwhile, the proportion of births by c-section is at a record-high 31.1%, with more than 1.2 million performed in the U.S. in 2006. According to researchers, about 500,000 women annually who undergo c-sections have previously had the procedure. According to the Times, women who have had a c-section can safely deliver vaginally later, but many physicians have begun requiring women to have c-sections because of a small risk of uterine rupture, a potentially fatal complication.

Pamela Udy, president of the International Caesarean Awareness Network, said, “Obstetricians are rendering large numbers of women uninsurable by overusing this surgery.” She added that women feel pressure to have c-sections that they might not want or need and then be denied coverage for the surgery.

According to Susan Pisano of America’s Health Insurance Plans, insurers’ rules on c-sections vary by company and state, depending on state regulations. Pisano added that some insurers do not factor a prior c-section into coverage decisions, while other insurers consider it a pre-existing condition. Some insurers include a rider that states coverage for a c-section is excluded for a certain period of time, according to Pisano. Pisano added that insurers who do accept women who have had the procedure typically charge higher premiums.

According to the Times, “to people familiar with the rough and tumble world of individual insurance, the companies’ practices are no surprise.” Insurers “say they need these strategies to protect themselves, because some customers apply only after they get sick or pregnant, skewing the pool toward people with high expenses,” according to the Times. In addition, the Times reports that insurers “often accuse women and obstetricians of scheduling unneeded Caesareans for their own convenience — to deliver the baby at a certain time or to avoid labor.”

The article profiles Peggy Robertson, a 39-year-old woman who was denied coverage by the Golden Rule Insurance Company, owned by UnitedHealthcare, because of a prior c-section (Grady, New York Times, 6/1).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

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ACCESS PHARMACEUTICALS, INC. (OTCBB: ACCP), announced positive safety and efficacy results from its Phase 2 monotherapy clinical study of ProLindac(TM) in late-stage, heavily pretreated ovarian cancer patients. In this monotherapy study 66% of patients who received the highest dose achieved clinically meaningful disease stabilization according to RECIST criteria. No patient in any dose group exhibited any signs of acute neurotoxicity, which is a major adverse side-effect of the approved DACH platinum, Eloxatin, and ProLindac was well tolerated overall. The maximum tolerated dose of ProLindac was established as well as the recommended dose levels for future combination studies.

“We are very pleased with these results. ProLindac was well tolerated in an absolute sense and relative to commercially-available platinum therapies. We saw significant DACH platinum activity and efficacy in patients at the highest dose levels which is very encouraging given that this study involved monotherapy in a heavily pretreated patient population that typically only respond to an aggressive drug combination,” commented Dr. David Nowotnik, Access’ Senior Vice President R&D. “The DACH platinum activity level seen benchmarked favorably with published studies of monotherapy oxaliplatin in similar but less heavily pre-treated patient populations. Having achieved the recommended dose for future combination studies, we look forward to moving ahead in the clinic ourselves and with our regional partners.”

This 26 patient Phase 2 study explored 3 different dose levels and 2 dosing regimens of ProLindac as a monotherapy treatment for advanced ovarian cancer, to provide data on the monotherapy anticanceractivity and safety of ProLindac. Of patients eligible for evaluation according to standard RECIST criteria, clinically-meaningful disease stabilization was achieved in 42% of all patients, and 66% of all patients in the higher dose groups. Sustained and significant reductions in Ca-125, the established specific serum marker for ovarian cancer, were also observed in several patients.

“We are delighted that the results from this study support our belief that ProLindac is an active platinum agent with a favorable side effect profile,” stated Jeffrey B. Davis, Access’ President & CEO. “These data provide us with a strong incentive to continue the clinical development of ProLindac. As previously announced, we are currently planning a number of combination trials, looking at combining ProLindac with other cancer agents, such as taxol and gemcitabine, in multiple solid tumor indications including colorectal and ovarian.”

Access has previously announced that it has licensed ProLindac to Jiangsu Aosaikang Pharmaceutical Co., Ltd. (“ASK”) for the Greater China Region and to JCOM, Ltd for South Korea. Under these agreements both of these partners will be conducting Phase 2 combination studies with ProLindac in specific tumor types at their expense based on these results. Access is currently in discussion with potential partners for development and commercialization of ProLindac in additional territories.

About ProLindac(TM):

ProLindac is a novel DACH platinum prodrug which has been shown to be active in a wide variety of solid tumors in both preclinical models and in human trials. Access believes that ProLindac’s unique molecular design potentially could eliminate some of the toxic side effects seen in the currently marketed DACH platinum, Eloxatin, which has sales in excess of $2 billion.

About Access:

Access Pharmaceuticals, Inc. is an emerging biopharmaceutical company that develops and commercializes propriety products for the treatment and supportive care of cancer patients. Access’ products include ProLindac(TM), currently in Phase 2 clinical testing of patients with ovarian cancer, and MuGard(TM) for the management of patients with mucositis. The company also has other advanced drug delivery technologies including Cobalamin(TM)-mediated targeted delivery and oral drug delivery, its proprietary nanopolymer delivery technology based on the natural vitamin B12 uptake mechanism; Angiolix(R), a humanized monoclonal antibody which acts as an anti-angiogenesis factor and is targeted to breast cancer; Prodrax(R), a non-toxic prodrug which is activated in the hypoxic zones of solid tumors to kill cancer cells; Alchemix, a chemotherapeutic agent that combines multiple modes of action to overcome drug resistance. Access is also developing Phenylbutyrate (“PB”), an HDAC inhibitor and differentiating agent currently a Phase 2 clinical candidate. Access recently announced the acquisition of MacroChem Corporation. This acquisition provides Access with three additional late-stage product candidates. Pexiganan, a novel topical anti-infective for the treatment of diabetic foot infection, has already completed two Phase 3 trials. EcoNail is a topically applied econazole lacquer based on Access’ proprietary SEPA polymer technology, for the treatment of onychomycosis, a condition commonly known as nail fungus. Thiarabine is a new generation nucleoside analog which has demonstrated both pre-clinical and clinical activity in certain cancers. For additional information on Access Pharmaceuticals, please visit our website at accesspharma.

This press release contains certain statements that are forward-looking within the meaning of Section 27a of the Securities Act of 1933, as amended, and that involve risks and uncertainties. These statements include those relating to: clinical trial plans and timelines and clinical results for ProLindac and product candidates acquired in the MacroChem transaction, our ability to execute licensing agreements in the future, Access’ plans to continue and initiate clinical trials, the value of its products in the market, its ability to achieve clinical and commercial success and its ability to successfully develop marketed products. These statements are subject to numerous risks, including but not limited Access’ need to obtain additional financing in order to continue the clinical trial and operations and to the risks detailed in Access’ Annual Reports on Form 10-K and other reports filed by Access with the Securities and Exchange Commission.

Access Pharmaceuticals, Inc.
accesspharma

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The Portuguese Parliament on Thursday by a majority vote approved a bill that legalizes abortions during the first 10 weeks of pregnancy, Reuters/Washington Post reports (Reuters/Washington Post, 3/9). Abortion is illegal in Portugal except when necessary to protect the life or health of a woman or if a woman becomes pregnant as a result of rape. The country in 1998 held a referendum on the issue, but only 32% of registered voters cast a ballot. The Portuguese Parliament in October 2006 approved a government proposal to hold the referendum in February. It asked voters: “Do you agree with the decriminalization of the voluntary interruption of pregnancy, in the first 10 weeks, in a legally authorized health establishment?” Voters approved the referendum, but it was deemed invalid because fewer than half of the country’s registered voters cast a ballot (Kaiser Daily Women’s Health Policy Report, 2/12). The bill would require a mandatory three-day “reflection period” before a woman can choose to receive the procedure, the AP/CNN reports. The measure now goes to Portuguese President Anibal Cavaco Silva, who has 20 days to ratify it (AP/CNN, 3/9).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

Hispanic women with hypertension and coronary artery disease respond better to drug regimens aimed at controlling high blood pressure than non-Hispanic white women, University of Florida researchers report.

A UF study described in the current issue of the Journal of Women’s Health revealed that when treated with either of two commonly prescribed medication strategies, Hispanic women achieved greater blood pressure control and were half as likely as white women to suffer adverse outcomes such as heart attack, stroke or death from any cause. The findings provide new data on a population of ethnic women who have been all but absent from such research.

“The study is unique in that we enrolled a substantial number of women and a substantial number of Hispanic patients from a variety of different Hispanic regions. As a result, we have data that enabled us to really fully evaluate the treatment of hypertension in this ethnically diverse group,” said Rhonda Cooper-DeHoff, Pharm.D, M.S., a research assistant professor of medicine and associate director of the clinical research program in cardiovascular medicine at UF’s College of Medicine.

UF researchers studied 22,500 patients enrolled in the landmark International Verapamil SR-Trandolapril study, known as INVEST, and tracked a subgroup of 5,017 Hispanic and 4,710 non-Hispanic white women who were randomly assigned to a drug strategy containing either a sustained release form of the calcium antagonist verapamil or the beta-blocker atenolol.

The INVEST study enrolled more Hispanic patients than any other hypertension trial to date, Cooper-DeHoff said, and included Hispanic participants from the mainland United States, Puerto Rico, Cuba, Mexico, Canada, Guatemala, Panama and El Salvador.

After 24 months of follow-up, researchers found that both treatment strategies worked — and worked better in the Hispanic women.

Blood pressure control, defined at less than 140/90 mmHg, was achieved in 75 percent of Hispanic women and 68 percent of non-Hispanic white women.

And despite having a higher prevalence of diabetes at baseline, only 5.7 percent of Hispanic women suffered from adverse cardiovascular outcomes, compared with 12.3 percent of non-Hispanic white women.

Cooper-DeHoff attributed the low incidence of adverse outcomes to the fact that Hispanic women enrolled in the study were younger. If follow-up had continued over a longer period of time, adverse outcomes in the Hispanic women may have increased, she said.

However, these women remained at a lower risk for these outcomes even after statisticians adjusted for age and other factors. Still, she warned that problems associated with diabetes are likely to show up in these patients down the road.

“Diabetes in and of itself imparts significant future adverse cardiovascular outcomes,” she said. “These women should be well-monitored under the care of a physician so that they can prevent future cardiovascular morbidity and mortality related to hypertension and diabetes. Importantly, because the Hispanic population is the fastest-growing ethnic minority in the United States, Hispanics — especially women — should be included in future cardiovascular research in order to further our understanding of these high-risk diseases in Hispanic patients.”

High blood pressure is becoming more prevalent in women across all ethnic groups, Cooper-DeHoff said. And although it is thought to actually be less common in Hispanic women, fewer Hispanics have been included in hypertension studies.

“The INVEST findings are important because they demonstrate that this treatment for Hispanic women really pays off,” said Thomas G. Pickering, M.D., D. Phil., director of the Center for Behavioral Cardiovascular Health at Columbia University Medical Center. “They’ve got something really interesting with this study, and it wasn’t something that could have been expected.”

Source: Amelia Beck

University of Florida

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The result of a ballot initiative to uphold or reject a South Dakota law (HB 1215) banning abortions except to save a woman’s life will “set the tone” for the outcome of similar measures being considered in nearly 12 states, some advocates supporting and opposing the measures say, the New York Times reports (Davey, New York Times, 11/1). The South Dakota Campaign for Healthy Families — a coalition of opponents of the law — blocked the July 1 enactment of the law by gathering enough signatures to put the issue on the November ballot (Kaiser Daily Women’s Health Policy Report, 10/26). “I think there’s some sense that ‘By golly, if they can do it [in South Dakota], we’re going to do it here,’” Nancy Keenan — president of NARAL Pro-Choice America, which opposes the ban — said. If the law is not upheld by the voters, “[t]here’s fear that legislators elsewhere would see what happened there and try to play it safer,” Daniel McConchie — vice president of Americans United for Life, which supports the ban — said. He added that potential legislation, such as mandated waiting periods or parental notification for minors seeking abortions, might be jeopardized if voters reject the ban. The latest poll — conducted by Mason-Dixon Polling and Research and published on Sunday in the Sioux Falls Argus Leader — found that 52% of state voters would vote against the ban, 42% would vote to sustain the law and 6% were undecided. The poll had a margin of error of four percentage points (New York Times, 11/1).

CNN’s “Anderson Cooper 360″ on Monday examined how the initiative might affect abortion rights in the U.S. The segment includes comments from state Rep. Roger Hunt (R), the ban’s sponsor; former state Sen. Clarence Kooistra (R), who voted against the ban; Casey Murschel, executive director of NARAL Pro-Choice South Dakota; state Rep. Elaine Roberts (D); and Leslee Unruh, campaign manager for the antiabortion group VoteYesForLife (Crowley, “Anderson Cooper 360,” CNN, 10/30). The complete transcript of the program is available online.

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →