ROUND-UP: SILICONE-GEL BREAST IMPLANTS
Following are experts who can discuss silicone-gel breast implants. Federal health advisers recommended allowing the implants to return to the U.S. market after a 13-year ban on most uses of the devices -- but only under strict conditions that will limit how easily women can get them:
**1. DR. GEORGE ORLOFF, chief of plastic surgery at PROVIDENCE SAINT JOSEPH MEDICAL CENTER: "The FDA Advisory Panel recommendation is supported by the facts. The risks regarding silicone implants are better delineated and, as a result, implants are being built better. The recommended restrictions of tracking patients, informed consents regarding the risk of silicone breast implants, and MRI scans at certain time intervals to evaluate the integrity of implants are all consistent with the facts that are available and supported by my patients. Board certification and additional physician training as recommended by the panel can only be more beneficial to both patient and physicians. It is only through the open cooperation between all parties involved in this debate that progress will occur and the proper information will be given to women so that they can make an informed decision and receive the best medical care."
**2. LAURIE CASAS, M.D., head of the division of plastic surgery at GLENBROOK HOSPITAL OF EVANSTON NORTHWESTERN HEALTHCARE and assistant professor at NORTHWESTERN UNIVERSITY's Feinberg School of Medicine, testified in Washington before the FDA panel as chair of the Communications Commission and national spokesperson for the American Society for Aesthetic Plastic Surgery: "Now the FDA has to evaluate the various conditions and work with plastic surgeons, women's advocacy groups and manufacturers to evaluate conditions that are appropriate for breast implants."
**3. MICHAEL H. ROSENBERG, trustee of the AMERICAN ACADEMY OF COSMETIC SURGERY and board-certified plastic surgeon: "This recommendation has been made without the proper information. Plastic surgery includes both reconstructive and aesthetic surgery, while cosmetic surgery is based upon aesthetics. This debate is rightly about the safety of the implants, rather than the specialty and qualifications of the surgeon."
**4. CLAUDE H. CROCKETT, JR., M.D., FACS, president of the AMERICAN ACADEMY OF COSMETIC SURGERY: "Although we do applaud the panel's decision to allow these implants to return to the general marketplace, this recommendation is not only discriminatory, but it will prove to be a huge loss for patients. People deserve quality care, and there is no proof that a board-certified plastic surgeon is better qualified to perform a breast augmentation with these implants than a board-certified cosmetic surgeon."
**5. ROBERT F. JACKSON, MD, FACS, past president of the American Academy of Cosmetic Surgery and renowned general surgeon: "Electing to have cosmetic surgery is ultimately about choice. To deny women the right to choose who is administering their implants is a clear violation of an individual's basic patient rights."
**6. JOHN A. GROSSMAN, M.D., director and founder of GROSSMAN PLASTIC SURGERY, has been a board-certified plastic surgeon since 1975 and calls the FDA's actions "a victory for science over fear and gossip": "I believe that silicone implants deserve final approval for general use. The FDA has at last accepted what many of us in the industry have known for some time. Silicone implants do not cause disease. It is true that silicone implants, as with any manmade device, can become worn and break with time, but the material inside is safe. Hopefully, this ruling will return science and research to the forefront of the approval process instead of politics."
**7. ARMANDO SOTO, M.D., co-director of the plastic and reconstructive surgery department at MERCY MEDICAL CENTER in Baltimore: "The data, at this point, is fairly overwhelming that the implants are a safe and superior product. Today's silicone implants are certainly much improved versus what was available years ago."
**8. ROD J ROHRICH, chairman of plastic surgery at UT SOUTHWESTERN MEDICAL CENTER AT DALLAS, is an internationally known plastic surgeon and innovative leader and educator in plastic surgery. Certified by the American Board of Plastic Surgery, Rohrich has been recognized as one of the "Best Doctors in America" by his peers, as well as by Good Housekeeping magazine. He has written more than 200 peer-reviewed articles and authored 30 textbook chapters and four textbooks/monographs in plastic surgery.
**9. DR. MARILYN LEITCH, professor of surgical oncology and medical director of the Center for Breast Care at UT SOUTHWESTERN MEDICAL CENTER AT DALLAS, is a nationally recognized breast-cancer and breast-screening expert whose primary clinical interests are the diagnosis and treatment of breast cancer. She has been one of the country's leading voices in promoting the continuation of routine screening practices in women aged 40 to 50. She is a national recipient of the American Cancer Society Volunteer Leadership Award. She also is a board member and assembly member of the national American Cancer Society and past president of its Texas division.
**10. DR. LEONARD TACHMES, cosmetic surgeon at THE MIAMI INSTITUTE FOR AGE MANAGEMENT & INTERVENTION, is a specialist in aesthetic surgery of the body. His technique involves targeted liposculpting of the abdominal skin flap and the areas surrounding the umbilicus. Certified by the American Board of Plastic Surgery and National Board of Medical Examiners, Tachmes is in his 12th year of private practice. He completed his Fellowship in Plastic Surgery of the Breast at Memorial Sloan-Kettering Cancer Center in Manhattan. Miami Institute is involved in a clinical trial for the silicone breast implants.
**11. LARRY LICKSTEIN, M.D., board-certified plastic surgeon with CLEVELAND CLINIC FLORIDA NAPLES, participated in the clinical trials of silicone breast implants for both Mentor and Inamed. He is a proponent of the silicone implants, and is available for comment.
ROUND-UP: NEW DIETARY GUIDELINES (continued)
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**1. MARILYN TANNER, MHS, RD, LD, a pediatric dietitian at ST. LOUIS CHILDREN'S HOSPITAL, is available to comment on the USDA's new dietary guidelines: "The new food guidance system unveiled by the USDA is a good approach to help Americans live healthier lives. The individualized approach will provide everyone with their own information, emphasizing that that one size does not fit all. We must remember to eat a variety of foods from every group in balance and in moderation. The focus on calorie consumption and the incorporation of achieving balance between food and regular physical activity is very important." Tanner can offer nutrition, exercise, healthy lifestyle and recipe tips to help the general public follow the new recommendations.
**2. LISA KATIC is a registered dietician, food and nutrition expert, advisory board member for the AMERICAN COUNCIL FOR FITNESS & NUTRITION and consultant to the new Arnold Smart & Healthy 100% Whole Wheat Bread line. Katic can discuss and make sense of the new dietary guideline graphic. In particular, she can speak to the increased importance of whole grains.
ROUND-UP: PROS AND CONS OF CHEESEBURGER BILL (continued)
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**1. NAN ANDREWS AMISH, business health care contrarian and faculty member of health care economics and marketing at the UNIVERSITY OF SAN FRANCISCO: "Should the food industry continue to profit as the costs of health care are soaring, in part because of their strategic choices? While lifestyle, lack of exercise and overeating contribute to the fatness of any person, or nation, can we claim we care about health, want to control the cost of health care, and still support actions by our food providers, which are designed to increase our eating too much, eating poorly and eating addictions? This is an economic issue."
ROUND-UP: INCREASE IN PRE-DIABETES (continued)
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**1. HOWARD STEINBERG is CEO and founder of DLIFE, a multi-faceted information resource for the 18.2 million people living with diabetes and the many millions more in the high-risk category, as well as the family members and caregivers who support those living with the disease. dLife includes a weekly TV show on CNBC called "dLifeTV," which he executive produces, syndicated radio interstitials (dLifeRadio), a newsletter (dLifeConnect) and a Web site (http://www.dlife.com). Steinberg was diagnosed with diabetes at age 10 and can discuss prevention, as well as how to best manage the disease.
**1. DERMATOLOGY: NEW TREATMENTS FOR TREATING SUN DAMAGE. MICHAEL J. COLUMBUS, M.D. of THE PLASTIC SURGERY GROUP: "For many of us who spent our youth in the sun, the temptation to tan is tempered by the effects that include wrinkles, hyperpigmentation and fine lines. Patients can treat sun damage painlessly and with no downtime with new treatments that are now available."
**2. FITNESS: RESISTANCE TRAINING GIVES ELDERLY A NEW LEASE ON LIFE. WANEEN W. SPIRDUSO, Ed.D., professor at the UNIVERSITY OF TEXAS: "What type of strength exercises should older adults do? Before the 1990s, exercise recommendations by professional organizations, such as the American College of Sports Medicine and the American Heart Association, emphasized aerobic or endurance exercise, such as walking, swimming or cycling, as the main component of a fitness program, with scarcely a word about muscular strength and power. However, the latest exercise recommendations for all ages, including older adults, include resistance training for muscle strength and power on equal footing with endurance exercises."
**3. HEALTH: ATHLETE CONCERNS FOR HYPONATREMIA AND DEHYDRATION. BOB MURRAY, Ph.D., FACSM, director of the GATORADE SPORTS SCIENCE INSTITUTE, is available to discuss how an athlete can take the right measures to prevent both dehydration and hyponatremia during an endurance event, as well as provide insights into appropriate fluid intake, in response to the recently published New England Journal of Medicine Study on hyponatremia and athletes: "The fact is both heat illness and hyponatremia are serious conditions for endurance athletes. Athletes can prevent life-threatening situations by understanding the warning signs and taking the appropriate measures during trainings and on race day."
**4. HEALTH: DON'T BE A DRIP THIS ALLERGY SEASON. STEFANIE P. FERRERI, Pharm.D., CDE, clinical assistant professor at the School of Pharmacy at the UNIVERSITY OF NORTH CAROLINA and consultant to Cepacol sore throat products: "Spring allergies are making the rounds, and with all this comes an abundance of sneezing, runny noses and scratchy throats, which means post- nasal drip won't be far behind. According to a survey by the makers of Cepacol, 30 percent of adults suffered from post-nasal drip in the past year. While post- nasal drip is not an infection itself, the tonsils and other tissues in the throat often swell, causing discomfort."
**5. HEALTH MANAGEMENT: BADLY BEHAVED DOCTORS CAN WREAK HAVOC AT WORK. TIMOTHY J. KEOGH, professor of health systems management at TULANE UNIVERSITY, can discuss the steps health care executives must take to manage disruptive physicians: "There is no magic bullet. The ability to minimize disruptive behavior must be built on a foundation of supporting policies and structures." According to a survey by Keogh, a small, but significant minority of physicians engage in difficult behaviors, including yelling, throwing things, insulting staff and being generally disrespectful. Keogh provides advice to managers dealing with these doctors about the most effective steps to take to handle the situation.
**6. PUBLIC HEALTH: A PRESCRIPTION FOR A HEALTHY NATION. THOMAS FARLEY, M.D., Ph.D., chair of the community health sciences department at the TULANE UNIVERSITY Health Sciences Center and author of the newly released book "Prescription for a Healthy Nation": "Just as poor sanitation caused infectious diseases in the 19th century, an unhealthy physical and social environment is causing major killers like heart disease, cancer and AIDS today. Changes can include public transportation systems to reduce reliance on cars, free condoms in high schools and at-risk neighborhoods, limiting portion sizes, banning alcohol ads on TV and making neighborhoods safer for exercise."
**7. TREATMENT: NEW PERSPECTIVE IN PCOS TREATMENT. RONALD FEINBERG, M.D., Ph.D., co-founder of PCOSTRATEGIES and author of "Healing Syndrome O": "Polycystic Ovarian Syndrome (PCOS), is a severely underdiagnosed condition that affects 15 percent of all women and is the number-one cause of infertility. New research suggests that metformin is the best treatment option for some patients. Another suggests that low adiponectin levels may predict those at high risk for developing type 2 diabetes. Patients and the medical community are missing the boat on an important point -- PCOS is being caused by overconsumption, and the underlying metabolic disorder can only be cured through diet and exercise."