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Suburban Research Associates On The Forefront Of Clinical Research And Patient Care For Major Depressive Disorder
With appointment waiting periods stretching as long as three-months to see a psychiatrist, Delaware County patients often don"t know where to turn for "best in class" mental health services. This barrier to care is further compounded by the fact that 67 percent of primary care physicians nationwide have trouble accessing mental health services on behalf of their patients.
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Sotomayor Calls Roe 'Settled Law,' Says Health Of Woman Must Be Considered
During the second day of her Senate Judiciary Committee confirmation hearings, Supreme Court nominee Sonia Sotomayor said she views the 1973 Roe v. Wade decision legalizing abortion in the U.S. as settled law reaffirmed by subsequent Supreme Court rulings, the Washington Post reports (Goldstein et al., Washington Post, 7/15). At Tuesday"s hearing, lawmakers pressed Sotomayor on her views regarding abortion rights and Supreme Court precedent, the New York Times reports. She told committee members that the contraception rights case that is the foundation for Roe was "the precedent of the court, so it is settled law." She also said the 1992 ruling in Casey v. Planned Parenthood "reaffirmed the core holding of Roe," adding, "That is the precedent of the court and settled law in terms of the holding of the court" (Savage, New York Times, 7/15). Sotomayor said that "there is a right of privacy" and that the Supreme Court "has found it in various places in the Constitution." She cited the Fourth Amendment protection against unreasonable search and seizure and the 14th Amendment guaranteeing equal protection of the law (AP/Yahoo! News, 7/14).Sen. Orrin Hatch (R-Utah) asked Sotomayor if she considered the 2007 ruling in Gonzales v. Carhart an example of settled law. In the case, the court voted 5-4 to uphold the Partial-Birth Abortion Ban Act of 2003. The ruling was the first time since Roe that the court upheld an abortion restriction that made no exception for the health of the woman, the Times reports. In her response, Sotomayor said that "[a]ll precedent of the Supreme Court I consider settled law, subject to the deference the doctrine of stare decisis would counsel," although she did not address the health exception component of the Gonzales case.Sen. Dianne Feinstein (D-Calif.) later pressed Sotomayor to elaborate on her views on Gonzales. Feinstein noted that at least seven Supreme Court rulings prior to the 2007 case stated that abortion laws "cannot put a woman"s health at risk." She added that Gonzales "essentially removed this basic constitutional right for women." Feinstein asked Sotomayor, "When there are multiple precedents and a question arises, are all the previous decisions discarded, or should the court re-examine all the cases on point?" Sotomayor replied that she does not consider Gonzales to be a precedent making it settled law that health exceptions for abortion laws are constitutionally unnecessary. She said, "That was, I don"t believe, a rejection of its prior precedents," which are "still precedents of the court." Sotomayor added that the "health and welfare of a woman must be -- must be a compelling consideration." Feinstein pressed Sotomayor to clarify that she meant that it is still settled that abortion restrictions must have health exceptions. Sotomayor said, "It has been a part of the court"s jurisprudence and a part of its precedents. Those precedents must be given deference in any situation that arises before the court" (New York Times, 7/15).Sen. Lindsey Graham (R-S.C.) asked Sotomayor if the Constitution prohibits Congress or state legislatures "from defining life or regulating the rights of the unborn or protecting the right of the unborn in the first trimester?" Sotomayor began to cite the 14th Amendment to answer the question. Graham interrupted, asking, "[I]s there÷ anything in the document written about abortion?" Sotomayor said the "word "abortion" is not used in the Constitution, but the Constitution does have a broad provision concerning a liberty provision under the due process" clause (Holman, "NewsHour with Jim Lehrer," PBS, 7/14).Graham also asked Sotomayor about her work with the Puerto Rican Legal Defense and Education Fund, which had submitted legal briefs in the past that supported public funding for abortion coverage for low-income women. Sotomayor served on the group"s board from 1980 to 1992. She said that she "wasn"t aware of what was said in those briefs." She noted that she had served on the board but was not a lawyer for the gro
News of the day
First Ten-Year Follow-Up Shows That Treatment With AVONEX® Leads To Long-Term Benefits In Early Multiple Sclerosis Patients
Biogen Idec (NASDAQ: BIIB) announced data results from the CHAMPIONS (Controlled High-Risk AVONEX® (interferon beta-1a) Multiple Sclerosis (MS) Prevention Study In Ongoing Neurologic Surveillance) study, an open label follow-up to CHAMPS (Controlled High Risk Subjects AVONEX MS Prevention Study). Based on the CHAMPS study, AVONEX was granted approval for use in patients who experienced their first clinical MS episode with MRI findings. The CHAMPIONS ten-year follow up showed that patients treated immediately after their first episode had significantly less chance of experiencing a second attack versus those patients with delayed treatment. These results at ten years also indicate that 80 percent of patients taking AVONEX were below an expanded disability status scale (EDSS) score of three. These data were presented as a poster at the Annual American Academy of Neurology (AAN) meeting.
Cardiovascular

The Necessity Of Adrenalectomy At The Time Of Radical Nephrectomy: A Systematic Review

UroToday.com - We undertook a systematic review of the literature in reference to the use of ipsilateral adrenalectomy at the time of radical nephrectomy for the treatment of renal cell carcinoma. Important in the understanding of this is accurately defining.. ..the incidence of solitary, synchronous, ipsilateral adrenal involvement ..the ability of preoperative imaging to detect this ..the morbidity of removal of the adrenal ..the likelihood of identifying preoperative risk factors for adrenal involvement ..survival outcomes with and without adrenalectomy While quoting levels of supporting evidence we attempted to systematically investigate these aspects of the debate. We found that the historical benefit of ipsilateral adrenalectomy does not support it as a standard practice in all patients. The incidence of solitary, synchronous, ipsilateral adrenal involvement, which is potentially curable with ipsilateral adrenalectomy at the time of nephrectomy, is much lower than previously thought at 1 - 5%. Cross-sectional imaging in the current era is accurate in ruling out adrenal involvement but does carry a significant likelihood of false positives. Imaging outcomes are likely to improve with technical advances in imaging. The morbidity and mortality of ipsilateral adrenalectomy are generally minimal, but in those with metastatic disease, especially those developing metachronous contralateral adrenal metastasis, the impact of adrenal insufficiency can be devastating. In direct comparison, disease-specific and overall survival for individuals undergoing radical nephrectomy, with or without adrenalectomy, are similar. Those with multiple high-risk primary tumor features, including high stage/large lesions, upper pole location, multifocality and/or venous invasion may be considered for concomitant adrenalectomy because of the increased prevalence of adrenal metastasis. However, identifying all of these factors preoperatively may be difficult. The survival of those with lymph node positive or metastatic disease is poor regardless of whether adrenalectomy is performed. In these individuals, decisions regarding adrenalectomy should be based upon the desire or indication for cytoreduction. If nephrectomy is warranted, then adrenalectomy could be considered depending on the normality of the adrenal on preoperative imaging, but the benefit should be weighed against the risk of adrenal insufficiency. There is evidence for a survival advantage in patients with isolated adrenal metastasis. This group comprises no more than 2% of patients undergoing surgery for renal cancer. Written by Rebecca O"Malley, MD and Samir S. Taneja, MD as part of Beyond the Abstract on UroToday.com 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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