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What's in the news: Jun. 18 -- Isotope alternatives not as safe

Isotope alternatives not as safe: doctors
With fewer and fewer radioisotopes available to nuclear medicine specialists, some doctors are turning to older diagnostic scanning methods.

Robert Atcher, the president of the US-based Society of Nuclear Medicine (which held meetings this week in Toronto), said that alternative scanning techniques and materials are less safe and less effective than the molybdenum-99 that is now in short supply globally. [CBC News]

Some Canadian nuclear medicine experts are complaining publicly that the government should have consulted them before appointing Dr Alexander McEwan the new radioisotope-shortage adviser to the health minister. "We feel the nomination of an individual without proper consultation infringes on his ability to speak freely to the government, and we feel that if he was nominated by his peers and if he had to respond to his peers, he would have to do a better job," Dr Norman Laurin, the president of the Canadian Association of Nuclear Medicine, said. "If you've been picked personally by a minister and not the object of a formal recommendation, you are somehow indebted to that minister." [CBC News]

And, in what is perhaps an unnecessarily obvious observation, the Toronto Star's editorial board bemoaned the fact the government has much, much more to do to solve the problems the radioisotope shortage has posed. "This crisis will not be solved by wishful thinking in Ottawa." Drat! [Toronto Star]

C-sections not always needed in breech births
At its annual meeting in Halifax, the Society of Obstetricians and Gynecologists of Canada announced that its latest guidelines on delivering babies in the breech position will state that C-sections are not always necessary. [SOGC guidelines (PDF)]

"Breech pregnancies are almost always delivered using a caesarean section, to the point where the practice has become somewhat automatic," Dr Robert Gagnon, one of the authors of the guidelines, said in a release. "What we've found is that, in some cases, vaginal breech birth is a safe option, and obstetricians should be able to offer women the choice to attempt a traditional delivery."

Of course, as is true in all medical specialties, changing guidelines is no guarantee that many practitioners will be changing practices. But SOGC president Dr André Lalonde has acknowledged as much. "The onus is now on us as a profession to ensure that Canadian obstetricians have the necessary training to offer women the choice to deliver vaginally when possible." [SOGC news release]

But in the current issue of the Journal of Obstetrics and Gynecology Canada Dr Andrew Kotaska, from the Northwest Territories, questioned how useful it will be to put the effort in to teach obstetricians how to avoid caesarean sections. [JOGC (PDF)]

Treatment and travel
The June issues of Parkhurst Exchange and Doctor's Review magazines are now available online.

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  1. sharon19 June, 2009 9:31 AM

    RE: Robert Atcher

    I think the CBC reporting on this is "skewed" in favor of "reactionary" :b

    I use this "paste" from the article referenced here to get a more comprehensive view ( in terms of physician and payor concerns) of what Robert Atcher has to say:


    [DM: What new product or procedural trends are you seeing in the molecular imaging community?]

    RA: The shift to using positron emission tomography (PET) technology. It's a different radioactive decay process and it enables us to do pretty precise quantitation. It gives us an opportunity to look at differences before and after therapeutic intervention. This is where the real excitement is in terms of molecular imaging in the field of nuclear medicine. We're able to put cancer patients, for example, who have non-Hodgkin's lymphoma on therapeutic protocol and tell within a week or so whether it's working or not. We can potentially avoid having those patients who aren't responding well from going through an entire course of therapy at an additional expense and potentially additional toxicity to the patient.

    The sale of instruments is also down pretty dramatically. There's a lot of nervousness after the Deficit Reduction Act of 2005 [in effect since 2007]. They focused on reimbursement for imaging and actually proposed cuts in the reimbursement. People doing imaging for a living have been a little more gun-shy about going out and buying new equipment. And then there is the issue of where we're going to be in a year or two if health care reform goes through. Are we going to be able to adequately charge for the services we provide?



    ( in terms of patient concerns )

    Molybdenum and her two isotope babies are differentiated in terms of half-life in the patients'
    body ( 66 hours for molybdenum down to 6 hours for technetium-99 ) means a lot to the human assaulted with nuclear waste.