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Nicotine Replacement Therapy Promotion Helps Thousands Kick Tobacco Addiction
More than 5,600 Louisiana tobacco users received free medication last month to help overcome their addiction to tobacco. The initiative was part of a statewide promotion to assist with tobacco cessation by providing a month"s supply of nicotine replacement therapy patches to residents trying to quit tobacco products.
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Reform Bill Details Emerge, Lobbyists Gear Up For Fight
Industry groups reacted "warily" this weekend to a draft of the Senate HELP (Health, Education, Labor and Pensions) Committee"s health overhaul plan. The first details emerged late Friday and lobbyists began speaking up, USA Today reports:
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Washington Post Column Examines Issues Surrounding Supreme Court Confirmation Hearings
"When a Supreme Court nominee such as Judge Sonia Sotomayor comes before the Senate for confirmation, she is promised a full, fair hearing," yet "every nominee"s path is booby-trapped by the history of previous confirmation battles," Washington Post columnist David Broder writes. Broder examines prior confirmation hearings, noting that the "[o]ne thing that may make it harder to forget the partisan and ideological battles of the past is that President Obama found reasons to oppose" Chief Justice John Roberts and Justice Samuel Alito while he was in the Senate.During Roberts" confirmation hearing, Obama said that although he was "sorely tempted to vote for Judge Roberts," he had issues with Roberts in cases where "precedent and rules of construction" are insufficient and where justice "can only be determined on the basis of one"s deepest values." Obama added that the rights of women and minorities are dependent on cases in which "the critical ingredient is supplied by what is in the judge"s heart." Obama said Roberts" record on women"s rights and other issues was not strong enough to quell doubts about Roberts" "deepest values."Broder continues, "Based on the Obama precedent, the White House can hardly complain if Republicans push beyond the question of Sotomayor"s qualifications and examine her values -- and her biases." He concludes, "Someday, the Senate may again be satisfied to examine only professional credentials, recognizing the uncertain dynamics of a nine-person bench," but while past precedents survive, "that is not likely" (Broder, Washington Post, 6/4).
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Ureteropelvic Junction Obstruction Secondary To Crossing Vessels-To Transpose Or Not? The Robotic Experience

UroToday.com - "Good judgment comes from experience, experience (unfortunately) comes from bad judgment." So the saying goes, but perhaps good judgment can (hopefully) come from carefully done reading of the "experiences" of others. In this excellent manuscript, the authors report on both the objective (i.e. renal scan) and subjective (i.e. analog pain scores) outcomes of 107 patients undergoing a robotic dismembered pyeloplasty for ureteropelvic junction obstruction (UPJO). Following the lead of Gill and colleagues, the authors noted that among the 45% of their patients who presented with UPJO and an associated crossing vessel, it was feasible to perform a tension free anastomosis with the standard repositioning of the pelvis anterior to the crossing vessel(s) in only one third of the cases (37.5%). In each of the patients in whom the vessels were not transposed, a standard dismembered robotic pyeloplasty was performed such that there was at least a 1 cm distance between the reconstructed ureteropelvic junction and the crossing vessel. The authors don"t mention whether they used any reconstructive measures to fix the vessels in a higher position (e.g. Hellstrom technique). The results were uniformly excellent with 100% radiographic and symptomatic rate of success. In both groups, differential function improved by 10%, T÷½ fell below 10 minutes, and mean pain scores were under 1.0 on a scale of 10. Of note, the mean follow-up was just over 1 year in both groups. The side story here is the 100% success rate in over 100 patients undergoing a dismembered pyeloplasty for UPJO. I am now seeing other groups reporting similarly high triple digit success rates for robotic pyeloplasty. One has to wonder, if the robot is providing the surgeon with better abilities than he or she would otherwise have in performing a reconstructive procedure? While further follow-up at 2 to3 years will be important, perhaps it is time to proceed with intrasurgeon comparisons for pyeloplasty, using a matched controlled retrospective analysis. The results could be most illuminating. Boylu U, Oommen M, Lee BR, Thomas R J Urol. 2009 Apr;181(4):1751-5. doi: 10.1016/j.juro.2008.11.114 Written by UroToday.com Medical Editor Ralph V. Clayman, MD 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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