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Archive for June, 2010

Atlanta-area allergist Dr. George Gottlieb develops treatment for reactions to chemotherapy.

Tuesday, June 29th, 2010

George Gottlieb, M.D., FAAIA, FACA, Diplomate, American Board of Allergy and Immunology, in partnership with DeKalb Medical’s Kahn Outpatient Cancer Center, offers a rapid desensitization treatment program that allows cancer patients who are allergic to their chemotherapy medication to receive the drug that is most effective for their cancer diagnosis.

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Until recently, allergic reactions have prevented some cancer patients from getting the best treatment available for their cancer. Allergic reactions can cause symptoms ranging from excruciating pain to vomiting,� weakness or worse, anaphylactic shock a life-threatening condition that moves quickly, causing difficulty breathing, dizziness, swelling of the tongue and bronchial tubes, low blood pressure and heart failure. ��� Patients may then need to be switched to another cancer medication that is not as effective.

�When a patient develops an allergy to an essential drug needed for treatment, we have to find alternative drugs, says Betty Castellani, D.Min., Director of the Kahn Outpatient Cancer Center. Often, the other chemo drugs are less effective or more toxic than the preferred options. This new program offered by Dr. Gottlieb provides us with the means to continue treating a patient with the drug of choice.� We are very excited to � offer this protocol to patients who have been forced to halt a treatment because of a drug allergy,� adds Castellani.

As a board-certified Allergist and Immunologist, Dr. Gottlieb spends much of his time helping patients tolerate things they need but which cause them to have allergic reactions. And he’s always looking for new ways to help his patients.� Dr. Gottlieb believed he could offer a way to desensitize patients who are allergic to chemotherapy.� He created an outpatient program at DeKalb Medical to help cancer patients whose bodies have rejected the chemotherapy medications that they need to treat their cancer.� Over the past year, he has successfully completed over 60 of chemotherapy desensitizations.� These included desensitizations for a variety of drugs used to destroy cancer cells, including carboplatin, oxaliplatin, cisplatin, retuximab and paclitaxol.� Rapid desensitization sessions last a total of 6 to 8 hours.� Patients take gentle premedications that include oral antihistamines, ibuprofen and aspirin, before the sessions.

Dr. Gottlieb says, I’m very grateful to partner with the DeKalb Medical’s Kahn Outpatient Cancer Center and� work with the outstanding pharmacists and nurses there.� The work of the pharmacist is critical. The chemo ingredients can be toxic if they are inhaled or contact the skin. The mixture has to be prepared behind a glass enclosure by a highly skilled pharmacist wearing special gloves and protective clothing.� In addition, the Center has excellent nurses and advanced monitoring equipment that allows immediate intervention if the
patient starts having a reaction to the chemotherapy.

The chemo desensitization program at DeKalb Medical is available to patients and cancer specialists in the� Atlanta area.� Those interested can call (404)294-4761 for more information.

Dr. Gottlieb received his Bachelor of Chemical Engineering from the City University of New York. He attended� New York University School of Medicine and interned at Cornell Medical School.� Dr. Gottlieb is a Diplomat of� American Board of Allergy & Immunology, Fellow of the American Academy of Allergy & Immunology, and Fellow of� the American College of Allergists.

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ALS Clinical Trial

Sunday, June 27th, 2010

Emory University researchers are participating in a groundbreaking clinical trial to treat patients with Amyotrophic Lateral Sclerosis (ALS) using human neural stem cells.

The Phase 1 trial, approved in 2009 by the U.S. Food and Drug Administration, is studying the safety of stem cells, and the surgical procedures and devices required, for multiple injections of the cells directly into the spinal cord.

“This is the first U.S. clinical trial of stem cell injections into the spinal cord for the treatment of ALS,” says Jonathan Glass, MD, professor of neurology, Emory School of Medicine, and director of the Emory ALS Center and principal investigator (PI) of the clinical trial site.

“Our main goal in this early phase is to determine whether it is safe to inject stem cells into the spinal cord and whether the cells themselves are safe,” says Glass.

Scientists say the stem cells will not generate new motor neurons, but may help protect the still-functioning motor neurons and slow the progression of the disease.

Since the trial began in January, three patients with ALS have received injections. Up to 12 individuals will be enrolled in the first phase of the trial.

Nicholas Boulis, MD, assistant professor of neurosurgery at Emory School of Medicine, and a pioneer in developing surgical methods for delivery of therapeutics to the spinal cord, is performing the surgical procedures. Eva Feldman, MD, PhD, director of research at the University of Michigan Health System ALS Clinic, is the overall PI of the ALS clinical trials program.

“I am confident this study is taking therapies for the spinal cord to a new level,” says Boulis. “Depending on the success of this initial trial, there will be a follow-up phase II trial or a modified phase I trial that utilizes the techniques of surgical implementation.”

According to the ALS Association, approximately 30,000 Americans have ALS at any given time and patients with the disease usually die within two to five years of diagnosis.

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Southeastern Gynecologic Oncology Joins Saint Joseph’s Medical Group

Friday, June 25th, 2010

Southeastern Gynecologic Oncology, LLC (SEGO) recently announced it has joined Saint Joseph’s Medical Group (SJMG.) SEGO is the largest private practice in the nation focusing solely on Gynecologic Oncology services.  With nine locations in the greater-Atlanta area, the SEGO practice currently reaches 85-percent of GYN/Onc patients in North Georgia and sees referrals traveling from Alabama and Tennessee.

Recently, the SEGO partners decided to become employees of Saint Joseph’s Medical Group.  For several lead SEGO surgeons this is a return to Saint Joseph’s, where they were originally active members of the medical staff.

“Saint Joseph’s commitment to excellence and charity care were a perfect match for our group” says Gerry Feuer, M.D., SEGO partner.  “Robotics is the new, gold standard treatment for endometrial cancer, so Saint Joseph’s, with its advanced robotics reputation, is the natural partner for us.”  The practice includes 7 gynecological oncologists, 2 urogynecologists, and more than 130 employees.

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MAA Annual Dinner

Thursday, June 17th, 2010

June 17, 2010 at Capital City Club in Atlanta. For more information, visit the Medical Association of Atlanta.

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Local Docs Speak Out Against the Elimination of the Physicians Advisory Panel from the Centers for Medicare and Medicaid Services

Thursday, June 17th, 2010

Dr. Bruce Feinberg, president and CEO of Georgia Cancer Specialists (GCS) and Dr. Kay Kirkpatrick, co-president of Resurgens Orthopaedics are concerned about the elimination of the physicians advisory panel from the Centers for Medicare and Medicaid Services (CMS).

The 15-member panel, known as the Practicing Physicians Advisory Council, met with federal officials quarterly to discuss matters pertaining specifically to Medicare fee-for-service. It was quietly eliminated by a clause in the final health care reform package passed by Congress this spring.

“GCS is very concerned about the recent decision by Health and Human Services to dissolve the CMS physician advisory panel as a result of a clause in the final health reform legislation,” said Dr. Feinberg.

“We believe it is vitally important that community physicians and other health care professionals who are on the front lines of providing care for Americans have a voice for our seniors. CMS’s decision significantly silences physician input in the policies surrounding coverage of needed health services.”

The Practicing Physicians Advisory Council (PPAC) was created in 1992 by a provision in the Social Security Act. Since that time, the group has represented the views of physicians who provide direct patient care.

Without the council, doctors worry they will have less impact on Medicare and Medicaid regulations.

“The dismissal of the Practicing Physicians Advisory Council is disturbing but not surprising, since Congress frequently feels that they know more about what is best for health care than the people who take care of the patients,” said Dr. Kirkpatrick.

“This arrogant dismantling of private practice is one of the many frustrations that doctors have had as the government gets more involved with health care. We think this is bad for seniors and for doctors and will lead to even further interference with the doctor-patient relationship.”

The alternative platforms for physicians to express their concerns about Medicare rules and regulations are the Medicare Payment Advisory Commission and the Independent Payment Advisory Board (IPAB) created by the health reform law.

Dr. Kirkpatrick of Resurgens said of the IPAB, “the bill states that the 15 members appointed to the IPAB by the President ‘will include individuals with national recognition for expertise in health finance and economics, delivery, and organization.’ Their recommendations are set up to take effect automatically, taking physician groups completely out of the loop.”

The AMA responded to physicians’ concerns by noting that it communicates with CMS to relay physicians’ interests to those who need to consider them.

“It’s unfortunate that this physician advisory committee has been dissolved, but it’s important to note that AMA and its partners in organized medicine communicate with CMS officials on a regular basis to ensure that the voice and concerns of the physician community are heard loud and clear,” AMA President J. James Rohack, M.D. said.

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Clinical Trial: Image-Guided Radiosurgery for Spine Metastasis

Thursday, June 17th, 2010

The Winship Cancer Institute of Emory University is participating in a national clinical trial involving image-guided radiosurgery for spine metastasis.

Winship joins a select group of cancer treatment centers in offering this trial, including the Henry Ford Hospital in Detroit, Duke University, the University of Pittsburgh Medical Center and Thomas Jefferson University in Philadelphia.

“This is an important study that we hope will lead to more effective treatment for spinal metastases with fewer side effects,” says Walter J. Curran Jr, MD, executive director of Winship. “The impact on patients’ quality of life is a serious issue, and while previous studies have looked at partial pain relief, we hope the more advanced radiosurgery techniques will provide more effective and lasting pain control.”

Metastasis is the movement or spread of a cancer to a secondary site within the body. Spine metastases are a common complication of many types of cancer. While similar to other bone metastases, spine metastases have unique and problematic features, one of which is spinal bone pain.

An additional problem is that these metastases can present with a soft tissue mass resulting in epidural compression. Patients with spinal metastases have severe back pain, often with associated neurological problems.

Despite the prevalence of spine metastases, there have been few clinical studies on effectiveness of radiation therapy treatment. Part of the problem has been the difficulty in attacking tumor masses in such close proximity to the spinal cord.

In recent years, radiosurgery or stereotactic radiation has emerged as an innovative treatment thanks to improvements in technology and techniques. Emory recently marked its 20th anniversary of delivering radiosurgery for patients with brain tumors.

This clinical trial, sponsored nationally by the Radiation Therapy Oncology Group, is known as RTOG 0631, and is divided into two phases. The first will assess the experience and efficacy of spinal radiosurgery for patients with spinal metastases.

The second component will seek to determine whether spinal radiosurgery improves the treatment outcome – specifically pain control – better than traditional radiotherapy techniques. The study will test the frequency of complete or partial pain relief at the treated site over a three-month period. Established quality of life measures will be used to define the level of pain control.

For more information on this clinical trial, contact: Doshia James, Clinical Research Coordinator, at 404-778-5162.

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GMC Breaks Ground on Heart & Vascular Center

Thursday, June 17th, 2010

Gwinnett Medical Center (GMC) broke ground for its Heart & Vascular Center on June 16.  The new center is slated to open in early 2012 and is planned as a 40,000 square foot facility at a cost of $33 million.

With the community’s support, GMC secured approval from the State to launch its open heart program in Gwinnett County, the largest county in the nation without an open heart surgery program.

“This will be a state-of-the-art center, infusing the latest technologies,” said Manfred Sandler, MD, director of cardiology at GMC. “For the professionals who will work here, it will be a dream.  Physicians and staff have been involved in the planning and design process, and the result is the creation of facilities that are optimally configured – providing the best possible environment to focus on the task at hand.”

While open heart surgery has been the focal point of the project, the program does encompass other advanced cardiovascular services, including coronary angioplasty and stenting procedures. These new services add to a cardiac program that includes an accredited chest pain center in the emergency department, a cardiac wellness program certified by the American Association of Cardiovascular and Pulmonary Rehabilitation and a full range of cardiac diagnostic services.

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Dr. David Armstrong Pioneers Treatment for Hemorrhoid Ligation

Wednesday, June 16th, 2010

David Armstrong, M.D., FRCS, FACS, FASCRS, invented a new technology for hemorrhoid litigation that maximizes patient benefits.

In a procedure called rubber band ligation, the most widely used treatment for internal hemorrhoids, a rubber band is placed around the base of the hemorrhoid, which cuts off circulation. The hemorrhoid then withers within a few days.

Dr. Armstrong invented the TriView anascope, which allows visualization of three internal hemorrhoids at the same time as opposed to just one. The development of the TriView anascope and the ShortShot, a multi-band hemorrhoid ligator, allows for patients to have three internal hemorrhoids ligated at the same time, which provides quicker, easier and more accurate banding of the hemorrhoids.

With this new non-surgical technique, patients experience less discomfort, require fewer pain medications and have improved outcomes as compared to other conventional methods. The procedure does not require a hospital stay, allowing the patient to get back to his or her regular routine sooner.

“By avoiding surgery and minimizing discomfort and time off work, this technique is simple and cost-effective,” said Dr. Armstrong. “Studies have shown that rubber band ligation of hemorrhoids is more effective than other non-surgical treatments.”

Dr. Armstrong, a Gwinnett Medical Center physician, is board certified in colon and rectal surgery.

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Atlanta AMGMA Meeting

Thursday, June 10th, 2010

June 10, 2010 at the The Retreat at Dunwoody.  For more information, visit AMGMA’s web site.

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SILS Training at Northside

Thursday, June 10th, 2010

Covidien, a global healthcare products company, is bringing its mobile training center to Northside Hospital on June 17-18 to train surgeons, residents and staff on Single Incision Laparoscopic Surgery (SILS) using their products and procedures.

Fifteen-year-old medical prodigy Tony Hansberry, who perfected his SILS technique in 2009 during a two-day session through the University of Florida, will be on hand Thursday, June 17, to demonstrate his innovation.  His method simplifies the closure stitching after a hysterectomy and reduces the risk of complications that sometimes arise after a hysterectomy.  Other procedures to be demonstrated during the training sessions in the mobile center will include gall bladder removal, cyst/tumor removal, Splenectomy, Lap-Band® Surgery, and numerous other gastro surgeries.

Hansberry’s friends and classmates Adam Olsen and Zoe Sieber will accompany surgeons both days in the 85-foot tractor-trailer’s mobile operating rooms to learn the innovative post-surgical stitching technique.  Olsen and Sieber both have mastered the endostitch which surgeons use to repair the patient’s abdominal area after a hysterectomy, but will further refine their technique with their classmate’s single-incision method.

The innovative laparoscopic techniques to be demonstrated in the Covidien mobile training center proportionally benefit more women than men, primarily because of their utility in hysterectomies.  The techniques taught during the training sessions in the mobile center’s state-of-the-art operating rooms help make these internal surgeries safer and recovery faster with less scarring.

Now, in the 10th grade, Hansberry, Sieber and Olsen’s skills are being compared to some first-year residents.  These students currently attend the first magnet school for medicine in the country Darnell-Cookman Middle/High School in Jacksonville, Florida.

Northside surgeons Dr. Ceana Nezhat and Dr. John Daly, who have used SILS also will be in attendance, as well.

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