Chances Of Surviving Cardiac Arrest Depend On Where Patients Are Treated
Efforts to fight the toll of cardiac arrest have typically focused on pre-hospital factors — bystander CPR education and improvement, public defibrillation programs, and quicker EMS response. But new research from the University of Pennsylvania School of Medicine reveals that the hospital where patients are cared for after being resuscitated plays a key role in their chances of survival following these incidents, which takes the lives of more than 300,000 Americans each year.
Patients in large, urban, and teaching hospitals are more likely to survive compared to those in small, often rural, non-academic hospitals, according to a study published recently in the journal Intensive Care Medicine. A second study, published in Resuscitation, suggests that patients who are cared for in the highest volume intensive care units after cardiac arrest are also most apt to survive. The findings points to a need to explore the development of specialized, regional post-cardiac arrest care centers modeled after those that treat serious trauma patients, says lead author Brendan Carr, MD, an assistant professor of Emergency Medicine and Epidemiology, and associate director of the Division of Emergency Care Policy & Research.
Carr’s findings also underscore the importance of the recent move by New York City to require ambulances to take cardiac arrest patients to hospitals that provide therapeutic hypothermia — the so-called “cooling” therapy that protects against damage to the brain and other organs in the crucial hours after the heart is restored to its normal rhythm — even if those facilities are further away.
“We are describing the variability that exists in cardiac arrest outcomes not at the level of the patient but at the level of the hospital. Hospitals with more resources and hospitals with higher volumes have better outcomes,” Carr says. “There are two possible implications: Either we need to get everyone up to speed on how to optimize survival, or we need to selectively transfer patients to hospitals that have expertise in the post-arrest period.”
The two studies, which examined a combined 115,000 cases in two different national datasets, also point to an overall improvement in cardiac arrest care. Over the course of the five years studied, the authors found a small reduction in mortality that translates to about 11,000 additional lives saved per year — a significant decrease for a condition that is typically fatal. Better survival odds are multifactorial, but likely related to advances in critical care, the recognition of the role of hypothermia, and the creation of national guidelines for post-cardiac arrest care.
“There has been a fundamental shift such that we now recognize the condition patients experience after cardiac arrest as a treatable disease,” says senior author Robert Neumar, MD, PhD, associate professor of Emergency Medicine and associate director of Penn’s Center for Resuscitation Science, and Chair of the Advanced Cardiac Life Support Subcommittee for the American Heart Association. “Among the patients that regain a pulse after cardiac arrest, only one out of three survive to hospital discharge, and there appears to be significant variability among hospitals. Further research is needed to determine if this variability in outcome is caused by the quality of post-cardiac arrest care. If it is, we need to identify best practices and develop mechanisms to deliver optimal care for all patients.”
Carr and his colleagues say further study of post-cardiac arrest care among these large, urban, and teaching hospitals will be crucial in mapping strategies that maximize a patient’s chances to be discharged without the neurological deficits that often plague cardiac arrest survivors. And he emphasizes that practitioners can learn lessons from the connections between the way hospitals care for patients with cardiac arrest and other emergent conditions.
“For me, cardiac arrest is the tip of the iceberg with respect to disparities in care for time-sensitive conditions,” Carr says. “Whether you’ve had a cardiac arrest, a stroke, or a heart attack, it is our job to build a system that promises you the best possible care no matter where you are, who you are, or what time of day it is.”
PENN Medicine is a $3.6 billion enterprise dedicated to the related missions of medical education, biomedical research, and excellence in patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System.
Penn’s School of Medicine is currently ranked #4 in the nation in U.S.News & World Report’s survey of top research-oriented medical schools; and, according to most recent data from the National Institutes of Health, received over $379 million in NIH research funds in the 2006 fiscal year. Supporting 1,700 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.
The University of Pennsylvania Health System (UPHS) includes its flagship hospital, the Hospital of the University of Pennsylvania, rated one of the nation’s top ten “Honor Roll” hospitals by U.S.News & World Report; Pennsylvania Hospital, the nation’s first hospital; and Penn Presbyterian Medical Center. In addition UPHS includes a primary-care provider network; a faculty practice plan; home care, hospice, and nursing home; three multispecialty satellite facilities; as well as the Penn Medicine at Rittenhouse campus, which offers comprehensive inpatient rehabilitation facilities and outpatient services in multiple specialties.
University of Pennsylvania School of Medicine
3535 Market St., Mezzanine
Philadelphia
PA 19104
United States
http:// www.med.upenn.edu
Intestinal Lymphatic Tissue Important For The Absorption And Spread Of The Scrapie Prion
Scrapie is a transmissible, degenerative and ultimately fatal disease of the nervous system of sheep. The cause of the disease is a prion protein, and absorption from the intestine is assumed to be the natural route of infection. Lymphatic tissue associated with the intestine is important for the early accumulation of prion protein and its subsequent spread to the central nervous system.
Transmissible prion diseases occur in both animals and man, two well-known ones being mad cow disease of cattle and Creutzfeldt Jacobs disease of man. These diseases produce symptoms in the central nervous system, with classical scrapie being characterised by intense itching with subsequent loss of wool, smacking of the lips, abnormal gait, and eventually collapse.
Protein molecules may show different properties when their structures become altered, for example, proteins in egg white are hardened by heat treatment. The assumed cause of prion diseases is that the structure of the normal prion protein (called PrPC) becomes altered. The abnormal, disease-associated form of the prion protein (called PrPSc) is assumed to be the infectious agent.
Infection most likely occurs across the intestine, and one first sees an accumulation of PrPSc in the lymphatic tissue associated with the intestine, especially in areas of the small intestine called Peyer’s patches. The infection then spreads to the central nervous system and the brain, where, in the final stages of the disease, one sees an accumulation of PrPSc and also structural changes such as sponge-like “holes” in the brain mass.
We understand as yet very little of just how the infectious PrP is absorbed from the intestine. It is assumed that infection requires the presence of the normal form of the protein PrP, and it is known that the gene for PrP is active in a series of different types of cells and tissues.
For his doctorate, Lars Austbø investigated the activity of the gene for prion protein (PrP mRNA) by looking at where in the intestinal tissue it is formed and in what quantity. He also identified other genes of possible significance for the early phase of scrapie.
Austbø used advanced gene technology and molecular biology to study both prion gene activity (PrP mRNA) and the presence of the protein PrPC in the Payer’s patches of the small intestine and in the spleen – two organs where lymphoreticular tissue is assumed to be important for the absorption of the infective substance (PrPSc) and its spread to the brain.
Austbø and his colleagues have compiled new knowledge of the tissues that the PrPC protein and its mRNA is expressed in and the degree to which the gene is active. In addition, the study has shown that accumulation of the disease-related prion protein (PrPSc) is not necessarily associated with high levels of the normal prion protein. This conflicts with earlier assumptions and may force a re-evaluation of earlier theories on the absorption and distribution of the disease-related prion protein.
In addition, Lars Austbø worked with the identification of other genes that may play a role in the development of scrapie. Many genes contribute to, or are affected by, any disease progression. By mapping such genes, one can gain a better impression of the processes that are initiated and thereby a better understanding of disease development.
Cand. scient. Lars Austbø defended his Ph. D. thesis, entitled “Studies on gene expression during the lymphoreticular phase of scrapie in sheep”, on June 26, 2008. The work for the thesis was done at the Department of Basal Sciences and Aquatic Medicine, the Norwegian School of Veterinary Science.
NORWEGIAN SCHOOL OF VETERINARY SCIENCE
Ullevalsveien 72
http://www.veths.no
Investigation Of Urodynamic Characteristics And Bladder Sensory Function In The Early Stages Of Diabetic Bladder Dysfunction In Type 2 Diabetes Women
UroToday.com – For decades, scientists believed that the diabetic cystopathy is a result of vesical sensory dysfunction. But, how could the vesical sensory dysfunction affect the emptying function in diabetic patients? The overdistention due to sensory loss of the bladder filling in diabetes is the most popular explanation. Is it true? There is little evidence in human research to suggest it is. The other question is the role of C fiber neuropathy in the pathophysiology of the diabetic bladder dysfunction. In humans, the physiological function of vesical C fiber is still unclear. Traditionally, urologists only can evaluate the vesical C fiber neuropathy by ice water test and thus obtain a rough result. Most neurourologists could support the notion that activation of C fiber is contributed to detrusor overactivity in some pathophysiological conditions. Could the sensory loss of vesical C fiber in diabetes impair the emptying function or not? It is an interesting question.
We sought to validate the hypothesis that vesical sensory dysfunction can directly affect the emptying function without the overdistention process in diabetes. We designed this cross-section study by using urodynamic studies along with intravesical current perception testing to examine the early stages of diabetic bladder dysfunction. Because the mean age of diabetic patients in developed countries is around 60 years, we avoided the confounder of benign prostatic hyperplasia and selected the diabetic woman as our study population. Our study design was based on the concept that unrecognized and compensated diabetic bladder dysfunction is in the early stages. In the section of materials and methods, the phrase “had not sought treatment for DBD” is an exclusion criterion to exclude the patients in the late stage of diabetic bladder dysfunction.
Our study proved the concept that vesical C fiber as well as Aδ fiber neuropathy could cause the detrusor underactivity directly without the process of overdistention. Therefore, the C fiber in the human bladder may have its physiological role in initiating micturition. In addition, we suggest that the intravesical current perception testing is an appropriate technique to evaluate the progression of diabetic bladder dysfunction.
Written by Wei-Chia Lee, MD as part of Beyond the Abstract on UroToday.com
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Copyright © 2008 – UroToday
PSA Response Signatures – A Powerful New Prognostic Indicator After Radiation For Prostate Cancer?
UroToday.com – This study suggests that it may be possible to identify, prior to treatment, a large sub-group of men with locally advanced prostate cancer whose treatment outcomes are so satisfactory after radiation alone that neo-adjuvant or adjuvant androgen deprivation need not be considered.
We are working on it!
We are also interested in the potential prognostic value of PRS typing during neo-adjuvant androgen deprivation. We will learn more about this issue from the successor trial to 96.01, known as RADAR . It includes six months neo-adjuvant leuprolide plus radiation in the control arm of this trial.
Experimental arms include an additional year of leuprolide and/or 18 months of zoledronate.
Written by J. W. Denham, MD as part of Beyond the Abstract on UroToday.com
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Copyright © 2008 – UroToday
Significance Of LVI In TURBT And Cystectomy Specimens On Survival Of Patients With Urothelial Bladder Cancer
UroToday.com – Lymphovascular invasion (LVI) in urothelial cancer has recently gained interest in the urology community. Several papers have been published emphasizing the poor prognostic significance of this finding both on TURBT (transurethral resection of bladder tumor) and cystectomy specimens.
We performed a retrospective review of bladder cancer patients and found that patients with LVI in their TURBT specimens had shorter disease-specific survival, especially patients with stage I and II, which may reflect an element of understaging. When we evaluated the patients who subsequently had a cystectomy, patients with LVI on TURBT tended to be understaged (compared to those without LVI) although that was not statistically significant and could be due to the small numbers we had, which is one of the limitations of the paper.
Perhaps the presence of LVI should upstage the cancer, as is the case with testis cancer. Patients with LVI in cystectomy specimens had higher cancer recurrence and were more likely to die from their disease compared to those without LVI ( HR 2.92). Patients undergo TURBT at diagnosis, which provides the clinical staging that we base our subsequent treatment on. More pathologists are documenting the presence or absence of LVI in TURBT specimens and alerting pathologists to the significance of this finding is paramount.
There are limitations to documenting the presence of LVI as we found in our study that it is 79% sensitive. Perhaps the addition of immunohistochemical staining ( CD31 and CD34) could help further improve the sensitivity.
Neoadjuvant chemotherapy has been shown to improve survival in patients with locally advanced bladder cancer. As patients with LVI seem to have worse prognosis, these patients may benefit from neoadjuvant chemotherapy. This needs further study and preferably in a prospective fashion. These findings provided us with an opportunity to evaluate the mechanism of lymphovascular invasion and perhaps a therapeutic intervention to block this process.
Written by Fadi N. Joudi, MD, FRCSC as part of Beyond the Abstract on UroToday.com.
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Adherence To AAP Practice Guidelines For Urinary Tract Infections At Our Teaching Institution
UroToday.com – A study by Dr. Lopa Shah et al. evaluated the adherence to the American Academy of Pediatrics (AAP) practice guidelines for urinary tract infections (UTI). The AAP developed guidelines to better direct clinicians in the workup. This retrospective study evaluated the uniformity of adherence to these guidelines. A total of 104 charts were reviewed, and data were collected based on the parameters outlined by the AAP. At the authors’ teaching institution, they found that there is at least 70% adherence to the recommendations for the method of urine collection and 97% adherence for the performance of urinalysis. However, imaging workups of first-time UTIs had only a 61% adherence rate.
In my opinion, it would be important to get imaging on a first-time febrile UTI. This is important before the potty training age. Typically after potty training, if there is an element of constipation or dysfunctional voiding, we would obtain voiding diaries and possibly an abdominal x-ray prior to any invasive testing.
Shah L, Mandlik N, Kumar P, Andaya S, Patamasucon P
Clin Pediatr (Phila). 2008 Nov;47(9):861-4.
doi:10.1177/0009922808319962
Written by UroToday.com Medical Editor Pasquale Casale, MD
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Adult Urethral Stricture Disease After Childhood Hypospadias Repair
UroToday.com – A study by Dr. Shou-Hung Tang et al. evaluated the incidence of adult urethral stricture disease after childhood hypospadias repair.
The group performed a retrospective chart review from 2002 through 2007 that included 9 consecutive adult patients who had current urethral strictures and had undergone childhood hypospadias surgeries. All adult urethral strictures were managed by a single surgeon. Mean patient age was 38.9 years old. The lag time of urethral stricture presentation ranged from 25 to 57 years after primary hypospadias surgery, with an average of 36 years. Stricture length ranged from 1 to 17 cm (mean: 10.3 cm). Open graft-based urethroplasties were performed in 4 of 9 cases. Salvage perineal urethrostomies were performed in 2 of 9 cases. Another 3 cases chose to undergo repeat urethrotomies or dilatations – none of these patients were cured by such treatment. Complications included 1 urethrostomy stenosis and 1 urinary tract infection.
They found that urethral stricture may occur decades after initial hypospadias surgery. It can be the most severe form of anterior urethral stricture and may eventually require salvage treatment such as a perineal urethrostomy.
The group concluded that patients undergoing hypospadias surgery should receive lifelong follow-up protocol to detect latent urethral strictures.
In the pediatric population, it is very difficult to obtain long-term follow-up through adulthood, as these patients move away for school or work as they get older. Nonetheless, it is imperative that a database be maintained where frequent contacts on a yearly basis are performed with these patients and families to ensure that there is proper follow-up. If voiding symptoms can be evaluated earlier, it is possible that the stricture length might decrease causing less morbidity in these patients.
Tang SH, Hammer CC, Doumanian L, Santucci RA
Adv Urol. 2008:150315. Epub 2008 Nov 4.
doi:10.1155/2008/150315
Written by UroToday.com Medical Editor Pasquale Casale, MD
UroToday – the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.
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Dr. Francis Lee Recognized For Developing Genetic Test To Guide The Treatment Of Depression
Dr. Francis Lee, a psychiatrist and scientist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, has received a commendation by the president of the United States in the form of a Presidential Early Career Award for Scientists and Engineers (PECASE), the highest honor bestowed by the White House Office of Science and Technology Policy for outstanding scientists and engineers in the early part of their independent research careers.
The award represents the second consecutive year a NewYork-Presbyterian/Weill Cornell psychiatrist has been so honored: Dr. Bruce McCandliss received a PECASE in 2007.
Dr. Lee was the sole nominee from the National Institute of Neurological Disorders and Stroke (NINDS), and as one of only 12 awardees to represent the National Institutes of Health (NIH), Dr. Lee joins a select group of scientists and engineers who were invited to Washington, D.C., for the PECASE awards ceremony and reception at the White House on Dec. 19.
The award recognizes Dr. Lee’s research into the molecular and neural mechanisms of depression, anxiety disorder and other mental illnesses. In particular, he identified that a genetic variation, or SNP (single nucleotide polymorphism), in the gene for a growth factor called brain-derived neurotrophic factor (BDNF) may predict patients’ responses to drug treatment. This new approach, known as pharmacogenetics, could lead to diagnostic testing to guide the treatment of depression, replacing the current “trial-and-error” method. Dr. Lee’s research with mice suggests that those with the BDNF polymorphism are more prone to anxiety and respond less successfully to a class of common antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which include fluoxetine (Prozac™), citalopram (Celexa™), paroxetine (Paxil™) and sertraline (Zoloft™).
Dr. Lee is applying this research toward treatment of survivors of the 9/11 terrorist attack and veterans of the Iraq and Afghanistan wars that suffer from post-traumatic stress disorder (PTSD). Working in collaboration with his NewYork-Presbyterian/Weill Cornell colleague Dr. JoAnn Difede, Dr. Lee screens patients for the BDNF polymorphism. They hypothesize that patients with the polymorphism may not respond as well to SSRIs, but may respond better to novel treatment approaches (that do not rely on BDNF function) such as cognitive enhancers like D-cycloserine (DCS) combined with Dr. Difede’s virtual-reality exposure therapy. According to Dr. Lee, approximately 30 percent of patients test positive for the BDNF polymorphism.
Dr. Lee is an associate professor of psychiatry and pharmacology at Weill Cornell Medical College and a practicing psychiatrist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
His research has been supported by grants from NARSAD (National Alliance for Research on Schizophrenia and Depression), Burroughs Wellcome Fund, DeWitt Wallace Fund of the New York Community Trust, Sackler Institute, National Institute of Mental Health (NIMH), and the National Institute of Neurological Disorders and Stroke (NINDS).
Dr. Lee received his undergraduate degree with high honors in psychology from Princeton University. He then went on to obtain an M.D. and Ph.D. from the University of Michigan, followed by psychiatry residency training at what is now known as NewYork-Presbyterian Hospital/Weill Cornell Medical Center. He obtained further postdoctoral training in molecular neuroscience at the Skirball Institute, New York University, and at the University of California, San Francisco.
The Presidential Early Career Award for Scientists and Engineers, established in 1996, honors the most promising researchers in the nation within their fields. Selection for the award is based on innovative research at the frontiers of science and technology and community service.
NewYork-Presbyterian Hospital/Weill Cornell Medical Center
NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances — from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial for gene therapy for Parkinson’s disease, the first indication of bone marrow’s critical role in tumor growth, and, most recently, the world’s first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. NewYork-Presbyterian, which is ranked sixth on the U.S.News & World Report list of top hospitals, also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children’s Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian Hospital/The Allen Pavilion. Weill Cornell Medical College is the first U.S. medical college to offer a medical degree overseas and maintains a strong global presence in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar. For more information, visit http://www.nyp.org and http://www.med.cornell.edu.
Advocacy Groups Express Dismay At Final Attempt By CMS To Promote Privatization Of Medicare
Organizations that represent Medicare beneficiaries are dismayed by the CMS release today of the Medicare Advantage/Prescription Drug Plan Call Letter. The Call Letter, which provides instructions to the private insurance companies that want to contract with Medicare to provide drug and health coverage in 2010, was released two weeks earlier than last year, and two months earlier than the previous year. Beneficiary organizations see the early release as an attempt by the Centers for Medicare & Medicaid Services (CMS) to assure continued leniency in the oversight of private plans for at least another year and as a last-ditch effort to promote private Medicare Advantage plans.
“The draft Call Letter issued today is another example of how CMS has failed to properly oversee private Medicare plans that receive billions of dollars above traditional Medicare without providing the extra benefits they tout,” Judith Stein, Executive Director of the Center for Medicare Advocacy says. “For example, the CMS Call Letter does not require private Medicare plans to coordinate care and sets no standards for those that purport to do so.”
Paul Precht, Director for Policy and Communications at the Medicare Rights Center explains further, “Advocacy groups have asked CMS to strengthen the Call Letter admonition regarding discriminating against beneficiaries with greater health care needs by charging higher cost sharing for services such as home health care, chemotherapy and durable medical equipment. Yet this Call Letter fails to address the problem, even though discriminatory pricing for more costly services continues.”
MedPAC and other organizations have determined that Medicare Advantage plans are paid, on average, 14% more than the same services would have cost under traditional Medicare. These extra payments, plus leniency in how the money is allocated and benefits are provided, have resulted in increased participation by private health plans in the Medicare program without any proof that they provide better health care.
“We are dismayed that the current administration of CMS has failed to issue a Call Letter that protects beneficiaries and taxpayers by describing in detail what is expected by private Medicare plans,” says Kevin Prindiville, staff attorney with the National Senior Citizens Law Center. “We ask the incoming administrator of CMS to rescind the current Call Letter and issue a new document that demonstrates that CMS will exercise appropriate oversight over private insurance plans.”
http://www.medicareadvocacy.org
Anesiva Announces FDA Approval Of Supplemental New Drug Application To Expand Zingo(TM) Indication
Anesiva, Inc. (Nasdaq: ANSV) announced that the U.S. Food and Drug Administration (FDA) has approved Anesiva’s supplemental New Drug Application (sNDA) to expand the indication for Zingo(TM) to treat the pain associated with blood draws to include adults. Zingo (lidocaine hydrochloride monohydrate) powder intradermal injection system was previously approved to treat the pain associated with peripheral IV insertions and blood draws in children three to 18 years of age. The notification was received according to PDUFA deadlines.
As announced in November 2008, Anesiva ceased Zingo commercial activities to focus on the development of Adlea(TM), its novel non-opioid, long-acting analgesic drug candidate for the management of acute pain following orthopedic surgeries. Anesiva is seeking to license Zingo as well as the underlying drug delivery technology and intellectual property.
About Anesiva
Anesiva, Inc. seeks to be a leader in the development and commercialization of novel pharmaceutical products for pain management. Anesiva’s lead product candidate is Adlea, a novel small molecule formulation of capsaicin that is currently in development for the management of acute pain following orthopedic surgeries. Adlea has been shown in clinical trials to provide extended pain relief after only a single administration in multiple indications for site-specific, acute and chronic, moderate-to-severe pain.
In December 2008, Anesiva announced that a Phase 3 trial of Adlea achieved its primary efficacy endpoint of reduced post-surgical pain versus placebo (p=0.03) following total knee arthroplasty (TKA, or total knee replacement surgery) at four to 48 hours after surgery. The trial also met its key secondary endpoint with Adlea demonstrating a highly significant reduction in opioid medication consumption compared to placebo (p=0.005).
The Phase 3 TKA trial, known as ACTIVE-2 (Assessment of highly purified Capsaicin To ImproVE pain management after orthopedic surgery), also showed that Adlea’s safety profile of adverse events, wound healing, and wound sensory function were similar to placebo over the study duration.
Anesiva is based in South San Francisco, CA. For more information, go to http://www.anesiva.com.
Forward Looking Statements
This press release includes “forward-looking statements” within the meaning of the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Words such as “seek” and similar expressions are intended to identify such forward-looking statements. Forward-looking statements in this press release include matters that involve known and unknown risks, uncertainties and other factors that may cause actual results, levels of activity, performance or achievements to differ materially from results expressed or implied by this press release. Such risk factors include, among others: the nature and extent of additional Adlea clinical trials that may be required by the FDA prior to Anesiva’s submission of an application for approval to market Adlea, whether any clinical trials will be successful, and the ability to identify and successfully complete a strategic transaction for the assets related to Zingo. Actual results may differ materially from those contained in the forward-looking statements in this press release. Additional information concerning these and other risk factors is contained in Anesiva’s annual report on Form 10-K for the year ended December 31, 2007, and its most recent filing on Form 10-Q.
Anesiva, Inc.
http://www.anesiva.com
