25 julho 2008

HPP quer comprar SAMS

CGD quer comprar hospitais dos bancários

A CGD propôs a aquisição de 51% do SAMS ao sindicato dos bancários, que está aberto a negociar, avançou ontem o Expresso Online. O negócio inclui o Hospital dos Olivais e o Centro do Bairro Azul.

A CGD propôs a aquisição de 51% do SAMS ao sindicato dos bancários, que está aberto a negociar, avançou ontem o Expresso Online. O negócio inclui o Hospital dos Olivais e o Centro do Bairro Azul.A Hospitais Privados de Portugal, o braço do grupo da Caixa Geral de Depósitos para a área da saúde, quer entrar no capital dos SAMS. Segundo avança o Expresso Online, o acordo prevê a possibilidade de a HPP ficar com posições maioritárias nas instalações do hospital e postos médicos detidos pelos SAMS, assumindo ao mesmo tempo o controlo da gestão dos mesmos. Em contrapartida, os bancários filiados no sindicato poderão passar a ir a todos os hospitais da HPP, no caso de o acordo se consumar.Contactada pelo “Diário Económico”, que avança a mesma notícia na edição de hoje, a empresa não fez comentários, mas de acordo com as informações recolhidas pelo jornal, já foi entregue uma carta de intenções à administração dos SAMS, na qual se explica que o objectivo da parceria é que a HPP fique com 51% do capital da SAMS, incluindo o hospital dos Olivais e o centro médico do Bairro Azul, em Lisboa.O presidente do Sindicato dos Bancários do Sul e Ilhas (SBSI), Delmiro Carreira, adiantou ao DE que, por enquanto, apenas existe “uma declaração de intenções” por parte da HPP para negociar uma parceria. “O SBSI respondeu que estava disposto a negociar e agora vão começar as negociações que poderão dar origem a um protocolo e a um eventual negócio”, acrescentou Delmiro Carreira dizendo que "ainda não se falou de valores".


24 julho 2008

Novo Drug Eluting da Abbott

O tão anunciado drug eluting da Abbott a dar os primeiros passos.

FDA Approves Abbott's Everolimus Eluting Stent

The FDA has issued approval to the XIENCE V everolimus eluting stent from Abbott, a product that the company supposedly has demonstrated in clinical trails to perform better that Boston Scientific's TAXUS.

The FDA approved XIENCE V based, in large part, on superior results from the 1,002 patient SPIRIT III U.S. pivotal clinical trial, in which XIENCE V demonstrated statistical superiority to TAXUS on the study's primary endpoint of in-segment late loss (vessel renarrowing) at eight months, with a statistically significant 50 percent reduction (mean, 0.14 mm for XIENCE V vs. 0.28 mm for TAXUS). XIENCE V also demonstrated statistical non-inferiority to TAXUS in the co-primary endpoint of target vessel failure (TVF, cardiac events related to the stented vessel) at nine months, with an observed 20 percent reduction (7.2 percent for XIENCE V vs. 9.0 percent for TAXUS). TVF is a composite clinical measure of safety and efficacy outcomes defined as cardiac death, heart attack (myocardial infarction or MI) or target vessel revascularization (TVR).

In May 2008, Abbott presented two-year data from the SPIRIT III trial demonstrating that XIENCE V continues to deliver positive clinical benefits for patients. At two years, the XIENCE V demonstrated the following key results:

- A 45 percent reduction in the risk of major adverse cardiac events (MACE) compared to TAXUS (7.3 percent for XIENCE V vs. 12.8 percent for TAXUS, p-value=0.004)*. MACE is an important composite clinical measure of safety and efficacy outcomes for patients, defined as cardiac death, heart attack (MI) or ischemia-driven target lesion revascularization (TLR, repeat procedures driven by lack of blood supply).

- A 32 percent reduction in the risk of TVF compared to TAXUS (10.7 percent for XIENCE V vs. 15.4 percent for TAXUS, p-value=0.04)*.


- Low rates of stent thrombosis between one and two years, defined as very late stent thrombosis, per Academic Research Consortium (ARC) definition of definite/probable stent thrombosis (0.3 percent for XIENCE V and 1.0 percent for TAXUS) and per the SPIRIT III protocol (0.2 percent for XIENCE V and 1.0 percent for TAXUS). The ARC definition of late stent thrombosis was developed to eliminate variability in the definitions across various drug eluting stent trials.

For more thought about the business behind the device, check out Jacob Goldstein's post over at the WSJ's Health Blog: Abbott Gets to Join Troubled Stent Market ...


Press release with video: FDA Approves Abbott's XIENCE™ V Drug Eluting Stent ...

Product page: XIENCE V ...

Link: www.medgadget.com

17 julho 2008

TC Crânio em doentes com AIT

Estudo que incide na análise de TC de Crânio a doentes com AIT de evolução inferior a 1 hora e mostra a não existência de alterações evidentes. Apresentado no 18th Meeting of the European Neurological Society (ENS).

Cranial Computer Tomography Unreliable in Depicting Underlying Cause in Transient Ischaemic Attacks Lasting Less Than 1 Hour: Presented at ENSBy Judith Moser, MD



NICE, France -- June 10, 2008 -- In the early phase after the onset of stroke-like neurological symptoms, cranial computer tomography (CCT) can neither depict nor rule out strokes in a reliable manner, according to the findings of a study presented here at the 18th Meeting of the European Neurological Society (ENS).

Transient ischaemic attacks (TIA) are defined as neurological symptoms lasting less than 24 hours without evidence of infarction. However, the risk for developing major strokes is increased in these patients and therefore necessitates immediate diagnostic work-up. Usually CCT is initially performed with the aim of ruling out other aetiologies such as haemorrhage, tumours, and major stroke.

"In order to justify exposure to radiation, the CCT should be sensitive enough to depict the underlying cause of symptoms," said principal investigator Stephan Ulmer, MD, Institute of Neuroradiology, University Hospital of Schleswig-Holstein, Kiel, Germany, in a poster presentation on June 9. "We assessed whether CCT scans are a sufficient imaging modality for monitoring TIA and whether the defined time window is applicable."

The researchers reviewed all CCT scans that were requested in patients with transient neurological symptoms at their clinics in a 1-year period. All studies that were requested for patients presenting with TIA were further analysed. Computed tomography scans (multirow-detector scanners), emergency notes, charts, and other performed imaging modalities such as magnetic resonance imaging were reviewed.

Patients that turned out to have experienced seizures with Todd paralysis rather than a TIA or other conditions that would require emergency imaging were excluded from the study.

Among 3,580 patients who underwent CCTs in the study period, 350 had been assessed due to transient neurological symptoms and were included in the study. 148 of these patients had experienced symptoms for less than 1 hour.

The researchers re-assessed the CCT images of this subgroup against the background of the final diagnoses. With initial CCT, 1 pathological finding was depicted in a case without ischaemia, whereas in 2 other cases the method failed to depict lesions which were definitely there. This resulted in a sensitivity of 50.0%, with specificity being 98.7%.

In contrast to the common recommendations, haemorrhage did not seem to be a matter of concern in this patient group. "There was not a single case of a haemorrhage when symptoms were confined to 1 hour," Dr. Ulmer emphasised. Only patients with symptoms beyond this time window were diagnosed with haemorrhagic strokes.

"We think that CCT is not a sufficient imaging method in patients whose symptoms resolve within 1 hour," Dr. Ulmer concluded. "Also, there might be a need to come up with a new definition of the TIA in terms of the defined time window."

He noted that these findings need to be confirmed on a larger scale, therefore a multicentre trial is being planned by the investigators.

[Presentation title: Is a Cranial Computer Tomography (CCT) Indicated in All Patients Suffering From Transient Ischemic Attack (TIA)? Abstract P350]