GLG News by Cardiologists who Implant TAXUS Stents (US)

Forrest RubensteinCardiac, Thoracic and Vascular SurgeonST. MARY'S HOSPITAL, STREATOR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS

Preventing Bariatric Surgery Deaths

January 25, 2008

Analysis of:Pinning Down Mortality Rates After Bariatric Surgery | www.medscape.com

 Bariatric surgery is a major operative procedure that caries significant morbidity and mortality risks due to the comorbid diseases seen in this patient population.  This procedure is increasing in frequency as more patients are willing to have it and more surgeons are becoming proficient. The mortality rate is ~ 1 % at 1 year and 6% at 5 years which is greater than the population at large.

Ramin EbrahimiDirector of Cardiac Catheterization LabWadsworth VA Medical Center

Risk Versus Benefit

November 23, 2007

Analysis of:Study Shows Weight-Loss Drug Rimonabant is Associated with Severe Adverse Psychiatric Events | pharmalive.com

The pooled analysis of Rimonabant trials point to a significant increase in psychiatric disorders. These studies also point to significant improvements in markers of cardiovascular risk. Risks versus benefits must be considered before the final decision is made on this class of medications.

John HewettPartnerPacific Interventional

Speech Recognition in it's Adolescence

September 4, 2007

Analysis of:Philips SpeechMagic Used In Largest Deployment Of Front-End Radiology Speech Recognition In The UK | www.medicalnewstoday.com

Despite large advances in the utility of speech recognition in medicine, the stated benefits are not fully achieved at this time.  The development of this technology promises significant cost savings and improvements in efficiency especially in the radiology department.  The maturation of this technology will be an important symbiosis to the maturation of imaging and other workflow technologies in radiology.  The key to successful use of speech recognition is judicious implementation.

Ramin EbrahimiDirector of Cardiac Catheterization LabWadsworth VA Medical Center

Good device but not much improvement.

August 31, 2007

Analysis of:St. Jude Medical Announces Japanese Approval Of The Angio-Seal STS Plus Vascular Closure Device | www.medicalnewstoday.com

The repositioning of the hole, also present with the VIP version is a mild improvement to decrease sheath manipulation. Otherwise the device has not changed much in the past few years. While a very good device in general, its primary limitaions listed below still remain. 1. not allowing re-access at the previous access site within 90 days of the index procedure  2. inability to promote means for primary healing of the arteriotomy site (primary healing results in much less scar formation and secondary healing that angioseal provides) and 3. relying on an intravascular component for deployment that stays within the vessel for weeks prior to its resolution  Newer devices such as the STARCLOSE that also are easy to deploy, rely on no intravascular components and potentially provide much better healing process may be the way of future.   

Forrest RubensteinCardiac, Thoracic and Vascular SurgeonST. MARY'S HOSPITAL, STREATOR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS

CMS regulations penalize hospitals for taking care of sickest patients

August 28, 2007

Analysis of:New Medicare Regulations Adopted To Reduce Certain Hospital Infections And Medical Errors | www.medicalnewstoday.com

This article presents the new CMS guidelines that deny higher payments for the additional costs associated with treating patients for certain hospital - acquired infections and medical errors. While these are laudable goals, to assume that all infections are the result of poor medical practice is an oversimplification. The development of nosocomial infections also has to do with the patients disease processes such as diabetes, morbid obesity, immunosuppression, tobacco abuse, etc. While few physicians would argue against enforcing these rules for documented mistakes (medication errors, transfusion mistakes, and objects left in patients bodies), most recognize there is a certain baseline of these other infections which cannot be avoided. Hospitals should only be penalized when their risk adjusted incidence exceeds a standardized baseline.

Forrest RubensteinCardiac, Thoracic and Vascular SurgeonST. MARY'S HOSPITAL, STREATOR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS

Retail drugstore clinics - filling a niche ?

August 28, 2007

Analysis of:Drugstore Clinics Spread, and Scrutiny Grows | www.nytimes.com

   Several large drugstores are establishing retail medical clinics within their stores much as eyeglass stores have had optomitrists on site.  There is no problem with these clinics per se as long as they practice within the scope of the practitioners license and skill.  There are concerns that those clinics staffed by non physicians will be practicing inferior medicine beyond the scope of the practitioner.  As these clinics become more widespread, they will certainly come under greater scrutiny.

Forrest RubensteinCardiac, Thoracic and Vascular SurgeonST. MARY'S HOSPITAL, STREATOR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS

The drug patent "shell game"

August 28, 2007

Analysis of:New antihistamine gets FDA green light.(RX CARE)(Levocetirizine (Xyzal) by UCB Inc. and Sanofi-Aventis ) | www.therapeuticsdaily.com

   Zyrtec (cetirizine) is a second generation nonsedating antihistamine that has enjoyed wide popularity.  Zyrtec will become available generically in late 2007 and the generic form is expected to be significantly cheaper.  To virtually extend the patent, the manufacturer is marketing the active enantiomer, levocitirizine (Xyzal) as a replacement for Zyrtec. This required only a fraction of the R&D costs that developing a new drug would entail.  While this could be a boon to the pharmaceutical companies involved in the release, patients have little to benefit from the increased cost.

Forrest RubensteinCardiac, Thoracic and Vascular SurgeonST. MARY'S HOSPITAL, STREATOR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS

FIRE STAR™ Rx PTCA Dilatation Catheter - an incremental improvement, not disruptive technology

August 21, 2007

Analysis of:Cordis Corporation Introduces FIRE STAR™ Rx PTCA Dilatation Catheter | www.medicalnewstoday.com

   Cordis introduced the FIRE STAR™ Rx PTCA Dilatation Catheter to the European market.  This catheter reportedly has a lower profile than other devices on the market which enables it to cross highly stenotic or tortuous lesions.  There are no controlled studies showing device this offers any significant advantage for most angioplasty procedures.  The Fire Star device will likely become a part of the armamentarium of interventionalists but will not be the workhorse catheter unless a true outcome advantage can be demonstrated or the price is competitive with the devices currently available.

Forrest RubensteinCardiac, Thoracic and Vascular SurgeonST. MARY'S HOSPITAL, STREATOR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS

Bariatric surgery is a useful adjunct in the management of obese diabetics

July 6, 2007

Analysis of:Bariatric surgery - possible treatment for type 2 diabetes mellitus | www.news-medical.net

   Type II diabetes and the metabolic syndrome are highly correlated with obesity. These diseases are epidemic in our society.  Weight loss has been definitively shown to reduce morbidity and mortality in these patients with complications from their obesity.  Bariatric surgery is a highly effective strategy for treating morbid obesity. It reliably produces greater weight loss than any other treatment.   As these procedures do have risks and potential complications, they should be considered a part of the treatment plan along with diet, exercise, and risk factor reduction.  No single strategy is best for all patients so this therapy needs to be individualized.

Forrest RubensteinCardiac, Thoracic and Vascular SurgeonST. MARY'S HOSPITAL, STREATOR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS

Non-stimulant treatment for ADHD - a new alternative

July 6, 2007

Analysis of:Shire Receives Approvable Letter from FDA for INTUNIV(TM) (guanfacine) Extended Release, a Nonstimulant for the Treatment of ADHD | www.pipelinereview.com

   Shire PLC received an approvable letter from the FDA for its nonstimulant treatment for ADHD - Intuniv (guanfacine)   Most of the treatments for ADHD are stimulants (amphetamine derivatives) that can have potentially serious cardiovascular side effects. Unfortunately, to date, no nonstimulant medication has been found to be as effective in controlling the symptoms of ADHD as the stimulants are.   This medication will find a place in the treatment of this very prevalent (and possibly overdiagnosed) disease but its effectiveness for the vast majority of patients has not yet been proven.

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