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A lot of surgeons who are "general surgeons" also perform bariatic surgery, so my answer would be yes.

Do you think a bariatric surgeon is qualified to perform colon cancer surgery?

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Atlanta Gastroenterologist Doctors physician directory – Learn about liver disease symptoms such as nausea, vomiting, abdominal pain, jaundice, weakness, and …Atlanta liver surgery from North Atlanta Surgical Associates, the best Atlanta surgeons.Featured Image. Picture of Psoriasis. A reddish, scaly rash often located over the surfaces of the elbows, knees, scalp, and around or in the ears, navel, genitals or …Home » transplant,transref Liver Transplant Program » Why Choose the Emory Liver Transplant Program. Liver Transplant Program Center. The first liver …Atlanta Liver Transplant Recipient Wins Silver Medal at 2008 U.S. Transplant Games 2008-09-23Located in Atlanta, Ga, offers medical and surgical care for liver transplant recipients and donors, delivered by experienced specialists in dedicated facility of …© 2011 Atlanta Gastroenterology Associates, LLC. All rights reserved.Flavors of Atlanta is an annual fundraising event that brings 25 of the area’s top chefs together for an evening of epicurean excellence to raise funds for liver …Atlanta Gastroenterology gastrointestinal Gastroenterologist best top metro Atlanta area liver specialists Gastric & Peptic Ulcers gi specialists in atlanta, ga …The Children’s Healthcare of Atlanta Liver Transplant program features surgeons with extensive experience in pediatric liver (reduced size, splits and living related …Immerse yourself in the human body. Explore. Understand. Live Healthy

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Stained clothing can be a bummer, but are there products out there that can remove even the nastiest grime? Consumer Reports recently tested out stain treatments applied before laundering, and found a couple that worked well on a variety of stains.Each stain treatment was evaluated for its effectiveness on coffee, blood, wine, sebum, motor oil and grass. CR Best Buy Resolve Laundry (10 cents per ounce) was the top-scoring treatment and worked well on all the stains. Shout Advanced Action (21 cents per ounce) was almost as good and can be applied up to a week before laundering. It worked well on all stains but wine.For its tests, CR's technicians took swatches of stained polyester/cotton fabric, applied the same amount of each stain cleaner, let the swatches sit for five minutes, and then washed them in a mediocre detergent. For comparison, they also washed the stained swatches in a highly rated detergent, using no pretreatment.The lowest-scoring treatment was also a Resolve product: Resolve Foaming Aerosol Laundry (15 cents per ounce). It only worked well on removing motor oil.Most laundry pretreatments do help somewhat: The top products, including old stain remedy Fels Naptha, which was made into a paste using one part Fels to four parts water, worked better than detergent alone. Scrubbing will probably improve stain removal, but may also damage fabrics.CR recommends that consumers use caution when considering products labeled "natural," because that word has no standard meaning in cleaning products. Nature's Source Natural (20 cents per ounce) and Green Works Natural (25 cents per ounce) only did a good job on a couple of the stains. Ecover (66 cents per ounce), the priciest choice, claims "plant based ingredients."nGO WITH YOUR GUT: TOP-RATED YOGURTSCan live microorganisms be tasty? Probiotics, beneficial bacteria that live in your intestines and in yogurts and supplements, can ease digestive woes and may lower cholesterol and strengthen immune systems.In separate taste tests, CR's trained panelists tried 11 yogurts (four of them Greek-style, generally thicker and higher in protein) and three smoothies: Dannon DanActive, Trader Joe's Organic Lowfat Probiotic and Stonyfield Organic Super. At an outside lab, testers measured the levels of three types of probiotic bacteria in those products and in four probiotic supplements. To ensure that the probiotics are made available to the body, the pills were also tested for disintegration.All of the yogurts contained very high levels of living, good-for-you bacteria, measured in colony forming-units (CFUs). More research is needed before recommended levels are established, but some research suggests 1 billion CFUs as a daily minimum for good health.Culturelle Digestive and Phillips' Colon Health had higher levels than the other two, Enzymatic Acidophilus Pearls Active Cultures and Align Digestive Care. All of the supplements disintegrated except for the Acidophilus Pearls product, which didn't do as well in the tests.Taste. Greek yogurts Fage Total 2 percent and Chobani Low-Fat were excellent; the other yogurts and smoothies were very good (including Dannon Fruit on the Bottom, Dannon Activia and Stonyfield Organic Low Fat Fruit on the Bottom) or good (including Yoplait Original and Stonyfield Organic Smooth and Creamy Fat-Free). In general, the Greek yogurts were much creamier than the regular ones and had more real fruit flavor.Nutrition. Yogurt is a good source of calcium and protein. (The Greek yogurts have 10 to 14 grams of protein per serving compared with 3 to 10 grams in the other yogurts and smoothies.) It's also fairly low in calories and fat.Bottom line. The regular yogurts and smoothies cost 66 cents to $1 per serving; the Greek yogurts, $1.15 to $2.10. Supplements are convenient for people who don't like yogurt, but at 53 cents to $1.07 per pill, they're not cheap. Align Digestive Care has fewer beneficial bacteria than the others and costs far more. Ask your doctor what product might work best for you.Visit the Consumer Reports Web site at www.consumerreports.org.

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Here's the down and dirty on stain treatments

Tags: Dannon DanActive, best buy, beneficial bacteria, polyester cotton

Zacks Equity Research, On Wednesday July 13, 2011, 2:15 pm EDT

We have initiated coverage of iCAD (ICAD) with a Neutral rating and $1.30 price target.  See below for free access to our full 20 page report on the company which includes an analysis of iCAD’s target markets and competition as well as our detailed financial model and valuation methodology.  While we are positive on iCAD’s fundamentals, we believe caution is warranted until there is more clarity on the potential and likely liability related to a recently filed product liability lawsuit.     

BUSINESS

Already established as a leading provider of advanced image analysis for mammography, MRI and CT, iCAD, Inc’s. (iCAD) December 2010 purchase of Xoft, Inc. (Xoft) expanded their capabilities beyond just cancer detection/diagnosis and into cancer therapy.  Management expects the acquisition to be a catalyst in transforming iCAD from “a leader in image analysis” to a company with “a broader portfolio of oncology solutions that provide targeted analysis, therapy and monitoring throughout the cancer cycle.”  Management looks for 2011 to be the front-end of this transformation and believes the company is now well positioned for long-term growth.    

iCAD is the world’s largest independent Computer-Aided Detection (CAD) company.  The company’s CAD imaging systems are used as an adjunct to mammography (digital radiography, computed radiography and film-based) screening to provide earlier detection of cancer and improve patient outcomes.  iCAD has placed approximately 4,100 systems since receiving FDA clearance of its first breast cancer detection product in January 2002.  The company continues to look to broaden its image analysis capabilities and in August 2010 its CAD technology became the first of its kind to receive FDA clearance for use with virtual colonoscopy in the detection of colonic polyps.  In July 2008 iCAD acquired CAD technology for use with Magnetic Resonance Imaging (MRI) which extended its reach into budding areas of interest in cancer detection including breast and prostate MRI.  

Xoft develops and sells the Axxent System, an electronic brachytherapy (eBxTM) device used primarily for the treatment of breast cancer.  iCAD closed on its $12.9 million acquisition of Xoft on December 30, 2010, marking iCAD’s initial foray into cancer therapy. The acquisition will bolt on roughly $7MM in additional annual revenue in the near-term but this is expected to ramp after intraoperative radiation therapy (IORT), Axxent’s sweet-spot, gains widespread insurance reimbursement (reimbursement  could be available by January 2012).  eBx directs high dose radiation to the cancerous site while sparing healthy surrounding tissue.  An isotope-free technology delivered in minutes during (and/or after) breast cancer surgery, eBx affords a safe, low cost and mobile alternative to traditional radiation therapy with no compromise in efficacy with the added benefit of significantly shorter treatment times.  Along with breast cancer, the Axxent System is FDA cleared for the treatment of other cancers including endometrial (gynecological) and skin cancers.    

FINANCIALS

Cash Position

Final payment for the Xoft acquisition (including ~ $1MM in transaction costs) was made in January 2011.  As of their most recent reporting period (3/31/2011) iCAD had $11.3MM in cash and equivalents.  The company has no preferred stock or debt outstanding.  While iCAD recorded a $5MM liability related to the Xoft acquisition, this represents an estimate of potential earn-outs and is contingent on iCAD hitting minimum pre-determined sales of Xoft products (Axxent and related consumables).

iCAD’s cash flow from operating activities was ($3.7) million in Q1 2011, the first full period with Xoft included.  The relatively high cash-burn can be attributed to the inclusion of Xoft.  This ($3.7) million compares to $103k in Q1 2010 and $207k for the full-year 2010, both of which had no contribution from Xoft.  iCAD filed an 8-K/A on 3/17/11 which included financial statements of Xoft (prepared by Xoft) for the full-years of 2008 and 2009 as well as nine months ending 9/30 for 2009 and 2010.  On a stand-alone basis Xoft’s operating cash flow had been consistently negative, although improving due to a consistent improvement in net loss.  In the nine months ending 9/30/10 Xoft used $7.3 million in cash from operations.  

While iCAD expects to eventually find some synergies with Xoft and reduce combined expenses and related cash burn, they indicated on recent earnings calls that there may not be much opportunity for this during the current year.  At the most recent quarter’s cash burn rate iCAD has about 9 months worth of cash on hand.  The level of cash burn should come down, however, especially as Xoft-related sales begin to accelerate – which should happen following the establishment of a CPT I code for reimbursement of IORT breast brachytherapy – which could happen during Q3 of this year.  

iCAD’s Q1 (3/31/11) 10-Q notes that they expect cash on hand and cash from operations to be sufficient to sustain operations for at least the next 12 months.  We expect that iCAD will be looking to raise cash by the early part of 2012.  While we have no insight into the likely source of additional financing, for simplicity our model incorporates an assumption that it comes from common stock issuance.        

Revenue

iCAD breaks out revenue into two categories; products and service/supplies.  Product revenue is further broken out into Digital & MRI CAD and Film-based CAD (beginning Q1 2011 Xoft revenue is also itemized by product and services revenue).        

…Saturation of Digital Mammography Hurts Product Revenue Growth

iCAD saw its product revenue grow from $10.3MM in 2006 to $26.7MM in 2009, largely as a result of an influx of new digital CAD mammography sales from the industry shifting from film-based to digital imagers.  iCAD’s product sales growth stalled in early 2009 and has fallen every quarter since Q2 2009 as digital imaging became more saturated and fewer digital imagers were being sold.  Digital / MRI CAD revenue peaked at $26.7MM in 2009 and fell to $15.4MM in 2010.    

iCAD’s film-based business, which is driven by customers converting their film images to digital, experienced a similar slide in sales as digital imagers became more commonplace than film.  iCAD’s film-based revenue peaked at $7.4MM in 2008.  It fell to $5.8MM in 2009 and $3.3MM in 2010.  

…Service / Supplies Revenue Holding Up

Service and supplies revenue mostly represents extended service warranties on iCAD’s products.  As iCAD’s products largely consist of sophisticated software, most customers will opt for these extended warranties.  Service / Supplies revenue has held up relatively well, growing from $3.3MM in 2008 to $4.0MM in 2009 to $5.8MM in 2010.    

OUTLOOK

Digital & MRI CAD

Digital & MRI CAD accounted for 82% of product revenue and 63% of total revenue in 2010.  While iCAD does not disclose the percentage of Digital & MRI CAD revenue that comes from digital CAD (i.e. – mammography CAD), management has indicated that it represents the vast majority.  Therefore, especially in the near-term, sales of iCAD’s mammography CAD products will have the greatest influence on growth in Digital & MRI CAD revenue.  Sales in international markets, which can be somewhat choppy, accounted for approximately 16% of total revenue in 2010.    

Despite film-based systems still accounting ~ 22% of all mammography instruments in the U.S., we expect Digital & MRI CAD revenue to continue to struggle in the near-term as a result of the continued slowing pace of film-to-digital conversions.  Mammography CAD sales in iCAD’s international markets was also soft in Q1 2011 despite the roll-out of SecondLook Premier in Canada and Europe during the period.  Economic softness hampered international mammography CAD sales which may be a recurring theme throughout the year.  Management recently indicated that sales of MRI CAD has been very strong as a result of new product launches in late 2010.  While MRI CAD should continue to show strength through the remainder of 2011 from the roll-out of new OEM agreements and the continued benefit of recent product enhancements, due to the relatively small contribution to overall revenue, growth in this segment will likely not be enough to offset declining mammography CAD sales.

We model a rebound in Digital & MRI CAD sales growth beginning in 2012 due to a combination of factors.  The declassification of digital mammography from PMA to 510(k) that happened in late 2010 has sparked a resurgence in activity from several OEM’s, a number of which are in various stages of bringing new digital mammography systems to market.  The major catalyst to Digital / MRI growth in 2012 should be the launch of SecondLook in the U.S. – if all goes well a 510(k) filing will happen later this year and the product will hit the U.S. market by mid-2012.  And finally, CAD for CTC, breast MRI and prostate MRI could all see an uptick in demand.  CTC (VeraLook) should benefit from the recent agreement with Vital Images and new potential deals with GE and Philips materializing in 2012.  Revaluation of the ACRIN study should be completed and published and potentially lead to eventual Medicare reimbursement – if that happens iCAD’s CTC CAD sales could ramp quickly.  Prostate MRI (VividLook), while still struggling to gain acceptance despite proven benefits against PSA, may experience slow but steady growth.  iCAD has seen some success in terms of sales of VividLook through education about the benefits of prostate MRI CAD which should continue to be the case in 2012.  Breast MRI (SpectraLook), which remains a significant growth category in Europe, could reverse the recent slide in international sales, especially with strengthening in world economies.      

Film-based CAD

Film-based accounted for 18% of product revenue and 14% of total revenue in 2010.  We model film-based sales to continue to decline going forward as a direct result of the slowing conversion rate of film to digital mammography.  

Xoft

Xoft revenue was approximately $5.5MM in 2010 (prior to iCAD’s acquisition).  Xoft product revenue, which includes sales of the Axxent controller, in Q1 2011, the first full quarter under iCAD, was $960k.  Xoft service and supplies revenue, which includes sales of the x-ray source, disposables and extended warranties, was $360k.  iCAD/Xoft announced the recall of the FlexiShield in early February 2011.  Management indicated that the recall has stunted Axxent sales as customers have been hesitant to buy the system until a replacement shield is available.  The new shield has since been submitted for FDA clearance and could be available in the market in Q3 of this year.

We model total (Axxent controller and supplies/services) Xoft sales of $7.0MM in 2011, with the majority of revenue weighted towards the back half of the year.  Going into 2012 we think Xoft sales could begin to show a significantly greater rate of growth predicated on the assumption that a CPT I code (with a favorable relative value) for IORT brachytherapy is assigned and active by the early part of that year.  This also assumes that there are so significant lingering hangovers from the shield recall.  Our Xoft-related revenue forecasts assume Axxent’s penetration of the brachytherapy-appropriate breast cancer market (currently ~ 110k annual procedures) is approximately 4% by year-end 2012, 10% in 2013 and 15% in 2014, the market grows at 2% per year and 3 procedures per unit per week.  Our model also includes only marginal revenue contribution from Xoft for indications other than breast cancer (i.e. – skin, endometrial, etc.) as we currently view these as more ancillary applications.           

Revenue and EPS Estimates

Management’s revenue guidance as of 5/3/2011 for 2011 is $32MM – $35MM.  This was revised lower from $34MM – $38MM following the recall of FlexiShield.  We more conservatively model revenue of $28.7MM in 2011.  With management’s focus on the integration of Xoft and growing the top-line, we do not expect much in the way of cost-cutting redundant expenses in 2011.  We model of  EPS of ($0.31) in 2011.  

We look for revenue to grow to $38.2MM in 2012 and $83.2MM in 2014 and also expect iCAD to begin to realize some much more substantial operating leverage going into 2012.  We model EPS of ($0.22) in 2012 and approximately break-even EPS in 2014.    

For a free copy of the full research report, please email scr@zacks.com with ICAD as the subject.

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ICAD INC (ICAD): Read the Full Research Report

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iCAD, Inc: Initiating Coverage at Neutral

Tags: patient outcomes, breast cancer, independent computer, cad technology

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