Why Some Treatments Rescue Aging Skin

Fine wrinkles, deeper creases, saggy areas around the mouth and neck the sights in the mirror that make baby boomers wince are not inevitable. They result from a structural breakdown inside the skin that some existing treatments effectively counteract by stimulating the growth of new, youthful collagen, University of Michigan scientists say.

The researchers report an emerging picture of collagen collapse and possible renewal, based on more than a decade of studies, in the May issue of Archives of Dermatology.

The article draws on dozens of studies since the early 1990s, conducted primarily by U-M dermatologists, to explain why three types of available skin treatments are effective: topical retinoic acid, carbon dioxide laser resurfacing and injections of cross-linked hyaluronic acid.

These treatments all improve the skin’s appearance and its ability to resist bruises and tears by stimulating new collagen. Collagen is a key supporting substance, plentiful in young skin, that’s produced in the sub-surface layer of skin known as the dermis. The U-M findings show that the breakdown of the dermis’ firm, youthful structure is a very important factor in skin aging a much more straightforward thing to fix than genetic factors that others theorize may be involved.

“Fibroblasts are not genetically shot,” says John J. Voorhees, M.D., F.R.C.P., chair of the Department of Dermatology at the U-M Medical School and the article’s senior author. Fibroblast cells in the skin are the key producers of collagen.

“We have shown that if you make more collagen go in, it provides an environment in which fibroblasts recover and make more collagen.”

Voorhees and co-authors Gary J. Fisher, Ph.D., U-M professor of dermatology, and James Varani, Ph.D., U-M professor of microbiology and immunology and of pathology, hope the findings will help people make intelligent decisions amid the hype of the multi-billion-dollar anti-aging products industry. Fisher directs the U-M Photoaging and Aging Research Program.

“We want to educate clinicians about what’s been found, and what it means in terms of how we may improve the appearance of people,” says Voorhees, the Duncan and Ella Poth Distinguished Professor of Dermatology at U-M.

Young vs. old skin

Collagen formation and breakdown takes place in the dermis or inner skin the thicker, firm layer of skin that lies beneath the paper-thin outer skin or epidermis, much as a mattress lies beneath a sheet. Collagen consists of proteins that make up a supporting structure surrounding the skin cells. In youthful skin, collagen is firm, taut and abundant, like a new mattress. In older skin, the collagen structure begins to fall away, says Voorhees.

Just as a foam mattress over time becomes flatter in places and creased as its structure breaks down, aging skin begins to sag and wrinkle when its collagen is diminished and fragmented. The cycle of events involved in collagen loss is complicated.

As skin ages, reactive oxygen species, associated with many aspects of aging, lead to increased production of the enzyme collagenase, which breaks down collagen. Then fibroblasts, the critical players in firm, healthy skin, lose their normal stretched state. They collapse, and then more breakdown enzymes are produced. People in their 80s have four times more broken collagen than people in their 20s.

“What it’s doing is dissolving your skin,” Voorhees says. “What you’ve got is a vicious cycle. You have to interrupt it, or aging skin is just going downhill.”

In the elderly, in whom the dermis has lost two-thirds or more of its youthful thickness through collagen loss, skin tears and bruises easily. Collagen-building interventions thus have potential for reducing basic health problems such as bed sores, in addition to improving appearance.

A growing body of evidence

The U-M researchers base their conclusions on past studies in which they have explored why certain anti-aging treatments are effective. A 2007 study looked at Restylane, marketed as a dermal filler, and found that injections of the product caused fibroblasts to stretch, promoting new collagen, and also limited the breakdown of collagen.

In another 2007 study, the U-M team tested lotions containing retinol, a form of Vitamin A found in many skin-care products, and found it significantly reduced wrinkles and skin roughness in elderly skin by promoting new collagen. Other U-M studies have shown why some laser treatments work and some less powerful ones do not. Carbon dioxide laser resurfacing is effective because it removes the aging dermis; in the three-week regrowth process, new, young collagen is produced.

Voorhees and his colleagues say they provide needed, independent research on the effectiveness of available and future treatments to counteract skin aging. They have no ties to the manufacturers of products they study. Funding has come from the National Institutes of Health and U-M.

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WHO Calls Upon Asia To Fight Smoking

Concluding a five-day conference on key health issues for Asia World Health Organisation officials called smoking a “deadly epidemic” and called for an all-out-war against tobacco use in Asia.

Shigeru Omi, WHO’s regional director for the Western Pacific, told the conference on South Korea’s Jeju Island that a few member states have met the requirements of the agency’s Framework Convention on Tobacco Control and that others are making good progress in implementing the convention’s provisions.

“No country will be alone when facing the tobacco industry to protect the continued spread of this deadly epidemic, there is strength in numbers” Omi said.

He repeated that the region has one-third of the world’s smokers, the highest percentage of male smokers and the fastest increase of smoking among children and young women.

WHO statistics estimate that each day 3,000 people die as a result of smoking.

Tobacco control was one of the central topics at the 58th meeting of the WHO Regional Committee for the Western Pacific, which includes China, Malaysia, the Philippines and other countries as well as large areas of Oceania.

“The region will continue to aggressively promote evidence-based strategies such as tax and price measures, the expansion of smokefree policies, comprehensive bans on advertising and promotion, and stronger health warnings on tobacco products,” Omi said Friday.


Laparoscopic Radical Nephroureterectomy For Upper Tract Transitional Cell Carcinoma: Oncological Outcomes At 7 Years

UroToday – In this recent article from The Journal of Urology, Dr. Andre Berger and associates reported on the long-term oncological outcomes following laparoscopic nephroureterectomy for upper tract transitional cell carcinoma.

One hundred patients underwent laparoscopic nephroureterectomies for upper tract transitional cell carcinoma between December 1997 and August 2005. 50% of patients had muscle invasive disease or more with 28% having non-invasive disease. High-grade lesions were present in 58% of patients, multifocal disease was present in 23% and lymphovascular invasion was present in 9%. Positive surgical margins occurred in 7 patients (7%). At 2, 5 and 7 years overall survival was 81%, 59% and 50%, cancer specific survival was 91%, 77% and 72%, and recurrence-free survival was 66%, 50% and 36%, respectively. Five-year cancer specific survival by stage was 80% for pTis/Ta, 70% for pT1, 68% for pT2, 60% for pT3 and 0% for pT4. On univariate analysis non-organ confined disease and lymphovascular invasion affected cancer specific survival (p = 0.01 and 0.04, respectively). On multivariate analysis, only non-organ confined disease was a significant factor (p = 0.04). Concomitant bladder tumor at diagnosis was associated with poor recurrence-free survival on univariate and multivariate analysis (p = 0.02 and 0.01, respectively).

The authors suggest that a laparoscopic nephroureterectomy for upper tract transitional cell carcinoma has similar long-term oncological outcomes and appears comparable to those of open surgery. Certainly, patient selection factors and comparison to historical results for open nephroureterectomy complicate any accurate comparison between the two surgical approaches.

Berger A, Haber GP, Kamoi K, Aron M, Desai MM, Kaouk JH, Gill IS
J Urol. 2008 Jul 15. (Epub ahead of print)

Reported by UroToday Contributing Editor David P. Wood, MD

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Improving Quality Of End-Of-Life Care

Researchers have evaluated improvements in the end-of-life care in intensive care units (ICU) and have shared their findings in a special supplement to Critical Care Medicine, the journal of the Society of Critical Care Medicine. The supplement is dedicated entirely to end-of-life care in the critical care setting.

“Improving the quality of care received by critically ill and dying patients in the ICU remains an ongoing challenge,” explains guest co-editor J. Randall Curtis, M.D., M.P.H., professor of medicine at the University of Washington in Seattle. “Over the past five years there have been encouraging signs of improvement in end-of-life care in the ICU. Interventions have been developed, evaluated, and published to improve the care that patients and their families receive relating to the end of life in the ICU.”

Approximately one in five deaths in the United States now occurs in the ICU or shortly after receiving intensive care. The ICU is likely to remain an important setting for end-of-life care because of the severity of illness in these patients and because many families and patients with chronic, life-limiting diseases will opt for a trial of intensive care.

Critical care researchers are taking the lessons learned from previous observational studies and using them to develop and test generalizable interventions that improve the quality of ICU end-of-life care. The Critical Care Medicine supplement includes 20 articles evaluating end-of-life issues, including palliative care in the ICU, attitudes toward withholding and withdrawing life support, ethical and legal issues, quality indicators, communications between physicians and nurses, interventions for children at the end of life, and promising future directions.

“We believe this supplement documents the tremendous progress that has been made in the past decade and represents the state of the art for assessing and improving end-of-life care in the ICU,” comments guest co-editor Mitchell Levy, M.D., professor of medicine at Brown University School of Medicine in Providence, R.I.

Quality End-of-Life Palliative Care

A paper by Ira Byock, M.D., a professor at Dartmouth Medical School and director of palliative medicine at Dartmouth Hitchcock Medical Center in Lebanon, N.H., describes recent developments in the integration of palliative and critical care.

Palliative and end-of-life care in the ICU is an appropriate and under-developed area for quality assessment and improvement, according to Richard Mularski, M.D., M.S.H.S., from the Veterans Affairs Greater Los Angeles Healthcare System. Dr. Mularski and a number of the other contributors to this supplement combined forces to develop an article that provides a practical framework for examining processes of care that might be quality measures. This article proposes 18 candidate quality measures that could be implemented in ICUs tomorrow. Dr. Mularski and colleagues suggest that further work also is needed to demonstrate such measures are valid and reliable.

End-of-Life Interventions

Considering that 20% of deaths in the United States occur in ICUs and that the quality of life in an ICU at the end of life often is rated as poor, improving the quality of end-of-life care in this setting is seen as an important endeavor. In an article on measuring quality improvement, Dr. Curtis and co-author Ruth A. Engelberg, Ph.D., from the University of Washington in Seattle, examine data supporting potential process and outcome measures that could be used to evaluate the success of interventions designed to improve end-of-life care in the ICU.

Dr. Levy notes that this supplement documents a need for additional research and quality improvement in order to realize the potential for improving the care delivered to critically ill patients at the end of life as well as the care provided to their families.

The supplement resulted from the conference, “Improving the Quality of End-of-Life Care in the ICU: Interventions that Work,” which was funded by the Robert Wood Johnson Foundation and hosted by the Society of Critical Care Medicine on February 17-19, 2006, in Miami, Fla.


Critical Care Medicine is the official journal of the Society of Critical Care Medicine. It is the premier peer-reviewed, scientific publication in critical care medicine. Each issue presents critical care practitioners with clinical breakthroughs that lead to better patient care, the latest news on promising research, and advances in equipment and techniques.

Contact: Thomas Joseph

Society of Critical Care Medicine

Plans To Replace Most Polluting Trucks In The Mid-Atlantic States

Four Mid-Atlantic States are teaming up to offer one of the nation’s most generous programs aimed at replacing old, highly polluting trucks.

Led by the University of Maryland and the Mid-Atlantic Regional Air Management Association (MARAMA), the new program will target the so-called short-haul “drayage” fleet that shuttles between their major ports, warehouses and local stores.

The effort seeks to double the impact of a federal cash-for-clunkers-style program with public and voluntary private contributions.

The Mid-Atlantic Dray Truck Replacement Program will offer $15,000 to short-haul truckers to cover the down-payment on a new vehicle. The program is also helping arrange financing for the truckers. Over the next two years, it could replace hundreds of the most polluting delivery trucks in the region.

“We no longer want our ports to be the place where old trucks go to die,” says the director of the University of Maryland Environmental Finance Center, Joanne Throwe, which is coordinating the new effort. “It’s not just the air around the port that suffers – it’s the routes the trucks follow throughout the region.”

The Ports of Virginia, Baltimore, Wilmington and Philadelphia, with support from their states, are chipping in to add dollars to a $3.3 million base grant from the U.S. Environmental Protection Agency (EPA). Private industry has also expressed interest in supporting the effort financially.

All together, the program will match the EPA support dollar-for-dollar with a combination of public and private money. Already, the organizers have lined up more than $400,000 in public support. More is pending, and they are expecting financial commitments from the industry as well.

In the first year, Throwe hopes to raise approximately $1.5 million in public and private money to extend the impact of the EPA grant.

As an example of the private enthusiasm the organizers hope to tap, Throwe points to today’s announcement by the EPA and the Coalition for Responsible Transportation (CRT), whose members make up some of the largest shippers and distributers from around the country. The CRT will contribute financially to help extend EPA dray replacements nationwide.

“Businesses along the supply chain understand that they and their employees benefit by maintaining as clean a footprint as possible,” Throwe says. “Helping truck drivers – mainly from small businesses – to afford cleaner, greener trucks is a goal the private sector can embrace.”

“This is a great example of how a government and industry partnership should work. The program goals are admirable – reducing emissions from mobile sources at the Mid-Atlantic ports to promote clean air for everyone’s benefit, and the government is giving private industry the tools needed to achieve those objectives,” says Louis Campion, president of the Maryland Motor Truck Association, Inc.

The Mid-Atlantic program is based on other clean truck efforts springing up around the country, including programs at the ports of Los Angeles, Long Beach, Oakland, Seattle, Tacoma, Virginia, Houston; and more recently the Port of New York and New Jersey.

Of all these programs, the Mid-Atlantic is the only one using a multi-state collaboration designed to boost the level of financial support to truckers.

The Port of Virginia was the first to open its own dray replacement initiative – the Green Operator Program – to the Mid-Atlantic partnership (in March 2011). The Port is leveraging the new regional effort with a $300,000 contribution. Virginia has a waiting list of approximately 150 applicants, with 24 applications ready to receive approval for funding.

The Port of Baltimore, Maryland anticipates contributing financially as well. Over 75 short-haul truckers operating at the Port of Baltimore have expressed interest in applying for replacement support.

The Ports of Philadelphia and Wilmington are set to open their replacement initiative in July and already have had considerable interest from dozens of carriers and sponsors.

The EFC is one of ten university-based centers across the country providing communities with the tools and information necessary to manage change for a healthy environment and an enhanced quality of life.

Neil Tickner

University of Maryland

Ten Steps Identified To Successfully Manage Mild Traumatic Brain Injuries Common In Youth Sports

Traumatic brain injury expert Gerard Gioia, PhD, Chief of Neuropsychology at Children’s National Medical Center and director of the Safe Concussion Outcome, Recovery and Education (SCORE) Program, has published a successful concussion management program for children based on his pioneering work in this area. The program is one of the first of its kind. Currently, most concussion management programs for youth sports lag behind collegiate and professional sports, despite the serious consequences of brain injury on a developing brain.

Dr. Gioia’s “ten steps” to a successful concussion management process are detailed in the latest edition of Brian Injury Professional (Vol. 4, Issue 4, pp14-15).

“Implementing an effective sports concussion management program is essential to safeguard young participants and reduce long term risks,” writes Dr. Gioia. “Management of this serious injury must consider the various effects in the home, school, social and sports environments.”

The “ten steps” of mild traumatic brain injury (TBI)/concussion management is a translation of the neurocognitive testing model currently used in professional athletes who have suffered from a mild TBI. This work, funded by the Centers for Disease Control and Prevention (CDC), uses computer-based testing and standardized parent/ teacher reports of the student athlete’s neurocognitive functioning to better guide recovery after a mild TBI.

Research into mild traumatic brain injury, and education about proper treatment of mild TBI, helps change the mindset among young athletes, parents, coaches, teachers, and physicians about the seriousness and long term effects of these injuries, and assists in defining more accurately when it is safe to return to the field – and the classroom. Dr. Gioia is a primary author of the CDC tool kit that instructs physicians on proper diagnosis and management of concussions, also based on this research. The toolkit employs the Acute Concussion Evaluation (ACE), developed by Dr. Gioia and his colleague, Dr. Micky Collins, to improve the physician’s initial identification and treatment of mild TBI.


About Children’s Safe Concussion Outcome, Recovery & Education (SCORE) Program:

The SCORE program is the only program in the region that specializes in the evaluation and management of concussions/ TBIs in children. The SCORE clinics see over 700 children each year. The clinic is staffed by neuropsychologists and neuropsychology fellows who specialize in precise identification, monitoring, and management of children and adolescents ages 4 -18 who have sustained a concussion. The SCORE program instructs physicians, public health, and school officials, athletic coaches, and parents about concussions through seminars, workshops, in-services, and consultations.

Children’s National Medical Center, located in Washington, DC, is a proven leader in the development of innovative new treatments for childhood illness and injury. Children’s has been serving the nation’s children for more than 135 years. Children’s National is proudly ranked among the best pediatric hospitals in America by US News & World Report and the Leapfrog Group. For more information, visit childrensnational/.

Source: Janiene Torch

Children’s National Medical Center

One Million Tobacco Deaths A Year In India During The 2010s

India is caught in the midst of a catastrophic smoking epidemic, which is causing one in five of all male deaths in middle age and will cause about one million deaths a year during the 2010s. Seventy percent of these deaths (600,000 male and 100,000 female) will be between the ages of 30 and 69.

The findings are from the first nationally representative study of smoking in India as a whole. The research, a collaboration between India, Canada and the UK, is published in the New England Journal of Medicine.

The study found that, among men, about 61 percent of those who smoke can expect to die at ages 30-69 compared with only 41 percent of otherwise similar non-smokers. Among women, 62 percent of those who smoke can expect to die at ages 30-69 compared with only 38 percent of non-smokers. This means that smoking accounts for most of the difference in premature deaths between men and women in India.

Professor Sir Richard Peto, of the Medical Research Council Clinical Trial Service Unit at the University of Oxford and one of the co-authors on the paper, said: “We were surprised by just how dangerous smoking was for Indian populations. But while smoking kills, stopping works. British studies show that stopping smoking is remarkably effective. At present, however, only 2 percent of adults have quit in India, and often only after falling ill.”

The study found there were no safe levels of smoking, but while the hazards of smoking even a few Indian roll-ups (bidis) a day were substantial, the dangers of smoking just a few cigarettes a day were even greater, corresponding to almost a doubling of the risk of death in middle age.

Sir Leszek Borysiewicz, Chief Executive of the Medical Research Council, said: “This research demonstrates the scale of the problem. It also shows that smoking kills in different ways in rural and urban India. In rural India, smoking mainly kills by causing death from TB. In Indian cities it mainly kills by causing heart attacks. This suggests a high risk of smoking-related cardiovascular disease among South Asian populations around the world. However, be it in Delhi or Derby, the same thing works: quitting. This is why the MRC is a founding member of ‘Grand Challenges in Chronic Non-Communicable Diseases’ which has as one of it aims to assist in smoking cessation initiatives worldwide.”

Jean King, director of tobacco control at Cancer Research UK, added: “Smokers in India have twice the non-smoker cancer rate and are twice as likely to die in middle age as non-smokers. Cancer deaths in India will continue to rise unless concerted action is taken to reduce smoking rates. It’s clear that the best way for smokers to reduce their risk of cancer, and many other life threatening diseases, is to stop smoking entirely. Over the past 30 years UK smoking rates have declined and we have seen the world’s biggest decrease in lung cancer deaths, particularly among men.”


A Nationally Representative Case-Control Study of Smoking and Death in India. New England Journal of Medicine, published online 10pm GMT 13 February.

A copy of the research paper, international press release in English and regional Indian languages, a video news release in English (and dubbed versions in Indian regional languages), quotes from noted scientists, FAQs, and PowerPoint slides of the key results are on ctsu.ox.ac/indiatobacco.

The UK involvement with the origins of the study and with the final report was led by Professor Sir Richard Peto of MRC Clinical Trial Service Unit at the University of Oxford which receives its core funding from Medical Research Council, Cancer Research UK, and the British Heart Foundation.

Medical Research Council

Study Of Relationship Between Statins And Cognitive Decline

Previous explorations of a link between statins, a cholesterol lowering medication, and cognitive decline have produced inconsistent results. New research reveals that the relationship between statin use and cognitive decline appears even more complex than had been thought.

In a three year epidemiological study, researchers from the Indiana University School of Medicine and the Regenstrief Institute, Inc. have found an association of statin use with less cognitive decline in elderly African Americans and report that, surprisingly, the association is even stronger for those who had discontinued use than for continuous users. Their findings are published in the Nov. 6 issue of Neurology.

In 2001 and again in 2004, the IU School of Medicine researchers evaluated 1146 African Americans aged 70 and older living in Indianapolis testing them in various cognitive areas including language, attention and calculation, memory and orientation. The researchers also compared use of statins and whether, if used, they were taken consistently. While cognitive decline in statin users was less than those who did not take statins, those who continued to take statins from 2001 to 2004 had greater cognitive decline than those who were taking statins in 2001 but were no longer taking them in 2004. Study participants who discontinued statin use did not differ from those who continued to use statins in any other health, demographic, clinical or biochemical characteristics.

If statin use were directly associated with a reduction in cognitive decline, continuously taking statins would presumably produce the greatest effect. The study authors say that in light of their findings that the association between statins and decreased cognitive decline is more complex than previously realized, carefully designed randomized clinical trials of statins are needed to provide definitive answers to their potential role in dementia prevention.

“Statin use plays an important role in the prevention of cardiovascular disease. And there may be a link between cardiovascular risk factors and risk factors for cognitive decline and Alzheimer disease. This is just one area that needs to be explored,” said Kathleen S. Hall, Ph.D, senior author of the study. A psychiatric epidemiologist, she is an associate professor of psychiatry at the IU School of Medicine and an affiliated scientist of the Regenstrief Institute.

Dr. Hall is the principal investigator of the Indianapolis — Ibadan comparative epidemiological project, a study designed to identify potentially modifiable risk factors for Alzheimer disease by comparing the disease in two populations from a developed and developing country–African Americans living in Indianapolis and Yoruba living in Ibadan, Nigeria.

“We know that taking statin medication can protect against cardiovascular events such as heart attacks by lowering blood cholesterol. The question at hand is what effects do these medications have on brain function. Our study along with others shows promising results but larger controlled studies are needed,” said Stanley Szwast, M.D., a fourth year psychiatry resident at the Indiana University School of Medicine and first author of the study.


In addition to Dr. Hall and Dr. Szwast, other authors of the Neurology study are Hugh Hendrie, MB, ChB; DSc of the IU School of Medicine and the Regenstrief Institute, Kathleen Lane, M.S.; Sujuan Gao, Ph.D.; Stanley Taylor, M.A.; Frederick Unverazgt, Ph.D.; Jill Murrell, Ph.D.; Mark Deeg, M.D., Ph.D; and Martin Farlow, M.D. of the IU School of Medicine and Adesola Ogunniyi, M.D. of the University of Ibadan, Nigeria.

The study was funded by the National Institute on Aging.

Source: Cindy Fox Aisen

Indiana University

New Clinical Data Shows AMS’ Minimally Invasive Treatment Options Effective At Restoring Female Pelvic Health

American Medical Systems® (AMS) (NASDAQ: AMMD), a leading provider of world-class devices and therapies for both male and female pelvic health, announced the results of three major clinical studies that each point to a high degree of efficacy and patient satisfaction with AMS’ minimally invasive treatment options for female stress urinary incontinence (SUI) and vaginal prolapse. Alongside these positive outcomes, the studies also revealed that each treatment resulted in minimal post-operative pain for patients and a low incidence of adverse events. The results were first presented at the American Urogynecological Society’s 30th Annual Scientific Meeting held Sept. 24-26 in Hollywood, FL.

“We are pleased to share these results that underscore our commitment to providing clinical data on our treatment solutions for patients with troubling pelvic health issues,” said Anthony Bihl, president and chief executive officer at American Medical Systems. “Based on these results, we hope that physicians and patients alike will feel confident in choosing AMS’ products to restore their pelvic health and their quality of life.”

The multiple-center studies independently evaluated three AMS products – the MiniArc® Single-Incision Sling System for treating female SUI, the Elevate® Prolapse Repair System and the Perigee® Prolapse Repair System.

MiniArc Sling System Delivers 91 Percent Success Rate

In a 6-month prospective evaluation of AMS’ MiniArc Single-Incision Sling System for surgical treatment of female SUI, the device was found to provide a 91 percent success rate at six months post-op using an objective measure of negative cough stress test (CST) among patients with a positive baseline CST.

The study derived at 16 treatment centers in North America and Europe concluded that MiniArc results in minimal estimated blood loss, minimal length of hospital stay and involves short operative times. The most common complications were reported in less than 2% of patients with no reports of bowel, urethral, bladder or major vessel perforations.

“The preliminary results of this study show that the MiniArc is highly effective at restoring urinary continence and quality of life for many women with a minimally-invasive, single-incision approach”, said Dr. Michael Kennelly, principal investigator on the study. “We will continue to assess the long term durability up to 24 months”.

Elevate Prolapse Repair System 94.5 Percent Effective at 6 Months

In the single-arm, prospective, multi-center trial encompassing 139 patients with Stage II or greater prolapse at 16 U.S. and European sites, the Elevate Apical and Posterior total transvaginal prolapse repair system demonstrated efficacy rates of 94.5 percent in posterior treatment and 95.1 percent in apical treatment, with minimal mesh extrusion rate of 5.8% at 6 months.

The study also found that patients implanted with the Elevate total transvaginal prolapse repair system had a very low .3 mean pain score on the Wong-Baker scale at three months post-op, and 97.7 percent of patients felt they had achieved improvement in their prolapse symptoms at six months post-op. These study results were further substantiated in a patient survey, where 93.8 percent of patients in the trial reported feeling moderately, very or extremely satisfied with their results, and 99.2 percent said they would recommend the device and procedure to a friend.

“The Elevate apical and posterior prolapse repair system performed well in the trial. We are very pleased with the anatomic success rate of 95% for both apical and posterior vaginal wall prolapse”, said Dr. James Lukban, principal investigator on the study. “Significant improvement in quality of life was also observed”.

88.5 Percent Success Rate with Perigee Prolapse Repair System

AMS’ Perigee Prolapse Repair System delivered excellent anatomical results in 88.5 percent of cases in a 24-month study of 114 patients implanted with the system in a prospective, single-arm; multi-center trial conducted at 8 U.S. sites. Not only did the study reveal a high anatomic success rate but it also reported a significantly improved quality of life.

AMS’ portfolio of female SUI and vaginal prolapse treatment solutions help to restore urinary continence and normal vaginal anatomy through minimally invasive procedures.

American Medical Systems

P.A.D. Coalition Launches Multimedia Workbook On Managing Peripheral Arterial Disease

September is Peripheral Arterial Disease (P.A.D.) Awareness Month, a time to communicate the seriousness of the disease as well as share new tools to help patients with the disease live better. P.A.D. – or clogged arteries of the legs – affects approximately 9 million Americans and can lead to heart attack, stroke, amputation and death.

To help patients with P.A.D. live better with their disease, the P.A.D. Coalition has launched the Interactive Workbook on P.A.D. This new tool works like an online booklet, with turning pages, narrated text, videos, graphics, printable handouts and quizzes. It covers P.A.D. risk factors, symptoms and diagnosis and the key components of disease management to improve cardiovascular health and walking ability. The workbook also reviews what to expect if you require surgery or other special procedure for P.A.D.

“The Interactive Workbook is an essential resource for patients living day to day with P.A.D.,” stated Marge Lovell, RN, Chair of the P.A.D. Coalition and clinical trials nurse at the London Health Sciences Centre in London, Ontario. “The unique format not only engages and empowers patients to learn more about managing P.A.D., but it also urges patients to take charge of their health and be better informed when talking to health care professionals.”

The workbook can be accessed online here.

Development of the Interactive Workbook on P.A.D. was supported by the Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership; The Cordis Cardiac and Vascular Institute; Abbott Vascular; AstraZeneca; Bard Peripheral Vascular; Cook Medical; Ev3, Inc.; W.L. Gore & Associates, Inc.; and BioMedix, Inc.


Peripheral Arterial Disease (P.A.D.) Coalition

Vascular Disease Foundation