MedicalResearch.com Interview with:
Jonathan S. Steinberg, MD
Director, SMG Arrhythmia Center
Summit Medical Group
Professor of Medicine (adj)
University of Rochester School of Medicine
Core Professor of Cardiology and Internal Medicine
Hackensack Meridian School of Medicine at Seton Hall U
Short Hills, NJ 0707
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The autonomic nervous system activity plays an important role in the onset and perpetuation of atrial fibrillation, particularly for AF that follows cardiac surgery.
Botulinum toxin (BTX) is a potent inhibitor of neural transmission. In a randomized placebo-controlled study of 60 patients undergoing coronary artery bypass graft surgery, patients who received intraoperative Botulinum toxin injections to the neural ganglia on the cardiac surface exhibited a sustained reduction in the incidence and overall burden of atrial fibrillation (AF) over 3 years of follow-up, accompanied by a reduction in need for hospitalization.
MedicalResearch.com Interview with:
Henry M. Spinelli, MD, PC
Plastic & Reconstructive Surgery
875 Fifth Avenue
New York, NY 10065
Medical Research: What are the main findings of the study?
Dr. Spinelli: Briefly, we polled approximately 26,000 plastic surgeons by way of membership in the International Society of Aesthetic Plastic Surgeons (ISAPS), American Society for Aesthetic Plastic Surgery (ASAPS) and American Society of Plastic Surgeons (ASPS) and collated this data and published it in Aesthetic Plastic Surgery (the Blue Journal), the official journal of ISAPS. This preliminary study was initiated given the current and past healthcare and cosmetic medical/surgical care climate both in the United States and worldwide. As a background, when it comes to injectables (botox and fillers) there is not a united consensus on a state by state basis in the USA and from country to country worldwide. Additionally, the regulations and laws governing the administration of botox and injectables is in a constant flux. For instance, the UK allowed beauticians in the past to administer these substances however they are now banned from legal administration of these products. Alabama, only allows physicians (dermatologists and plastic surgeons) to purchase and administer botox and injectables whereas the medical board of California states that physicians can perform the procedure or oversee licensed registered nurses, licensed vocational nurses, or physicians assistants. Similarly, dentists in some states are permitted to administer these agents. It would be a bad idea for any physician working with botox to take Advanced Botox Training to reduce the possibility of medical misdemeanors.
At the present time few studies have directly assessed the capability of various providers to administer cosmetic injections. When people schedule a consultation for plastic surgery, they are often looking for things like a younger face or a nicer body. The answer to the previous question will become more important as the demand for these procedures continues to grow and an increasing number of practitioners from a variety of backgrounds enter the field to meet demand. This study aimed to help define the role of various practitioners in an increasingly more competitive environment for injectables and to explore the relationship between patient and injectable provider in order to improve patient satisfaction and outcomes.
When asked to rank patients’ perceptions of various providers according to their expertise in administering Botox and dermal fillers, responders ranked plastic surgeons and dermatologists as most capable (96%) then nurses in plastic surgery and dermatology (3%). Gynecologists (<1%), dentists (<1%) and nurses in other fields (<1%) all received nearly equivalent numbers of “most capable” rankings. When asked to rank patients’ perception of various providers according to their inability to administer Botox and dermal fillers, nurses in other fields were most frequently ranks as least capable (63%) followed by dentists (26%), gynecologists (12%), plastic surgeons and dermatologists (2%) and nurses in plastic surgery and dermatology (1%).