HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
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Health Focus winter 2010 A MEMBER OF THE NORTH SHORE-LIJ HEALTH SYSTEM + WWW.NORTHSHORELIJ.COM Team Provides Lifesaving Breast Services Magic Wand Ends Heavy Periods DaVinci: Code for Prostate Cancer Surgery
Message from Anthony C. Ferreri, President & CEO Dear Friends, With the opening of the Elizabeth A. Connelly Emergency and a medical library and a new Trauma Center this past summer, I realized just how blessed I health literacy program. am to live and work in such a remarkable community. “You have to think about the After a summer filled with praise for those who have sup- people that will take the reins as ported our dream, I once again say “thank you” for helping the leading clinicians of tomor- Staten Island University Hospital (SIUH) obtain the emergency row,” said Brahim Ardolic, MD, care it so desperately needed. The money donated by the peo- chairman of Emergency ple of Staten Island and its surrounding area had an essential Medicine at SIUH. “What better way to keep them on role in the completion of the center, and it is fully appreciated. Staten Island than to train them here?” Thank you for establishing momentum for future fund-raising The campaign to raise additional funds for the Regina M. efforts throughout the community. I look forward to your con- McGinn, M.D. Education Center will need the support of the tinued philanthropic efforts in behalf of the Regina M. McGinn, Staten Island family and those closest to us who will once M.D. Education Center. again raise the bar for healthcare standards. Know that your With the ED complete, we anxiously await the education support will have a double impact, as all donations will be facility. The center will be a living tribute to an icon whose matched by the Staten Island Foundation, up to $150,000. short life was lived in dedication to the ideals of medicine and There is no easier way to turn $1 into $2. medical education. It will recognize an outstanding young phy- As a resident of this borough, your knowledge of SIUH and sician and her commitment to education and quality medicine. its impact on the community is key to your understanding of As Staten Island’s population continues to increase, so does this project and what it means for the future. the demand for medical education, which the center will look to fulfill. The facility will serve as a focus for healthcare educa- tion for our growing community, which will include a diabetes education center; space for regional medical meetings, seminars, workshops and support groups; and headquarters for Hand Sanitizers = Convenient? Yes. A Solution? No C arrying an alcohol-based hand sani- cleansing procedures with soap and water,” tizer is a trend that is catching on added Ms. Minucci. these days. Sanitizers are found in Ms. Minucci offers some tips on hand purses, backpacks, offices, bathrooms and sanitizers: especially in hospitals, but shouldn’t be ◾◾ Use a hand sanitizer only when needed, seen as a way out of cleaning your hands such as while traveling or where there is no with good old water and soap. sink available. “People use a hand sanitizer instead of ◾◾ Keep at least a 4:1 ratio of washing your washing their hands, which is not a good hands to using hand sanitizers. practice,” said Dorothy Minucci, RN, asso- ◾◾ Hand sanitizers can ravage the skin from ciate vice president of Epidemiology at constant use, so make sure to keep your Staten Island University Hospital. “There’s hands moist with lotion. no reason to use a hand sanitizer when you ◾◾ Teach your children proper hand have a sink readily available. A hand sani- cleansing techniques. tizer should not take the place of proper 2 Health Focus I Winter 2010
Incentive to Quit How Smoking Has Changed Over the Years, and Why It Pays to Butt It Out I f you are a longtime smoker, you may finally quit,” said Mr. Gillespie. “What used Flavored cigarettes were targeted under the have seen some serious changes in the to be a majority is now a minority. People Tobacco Control Act in June 2009 when the way Americans — especially New come to me and say, ‘Listen, I’m the last FDA was given authority to rein in the tobacco Yorkers — smoke over the years. one in my family who smokes; it’s just me. industry by banning some types of cigarettes, Think back to when a cigarette was in the I have to quit.’” including grape- and clove-flavored cigarettes. hand of every actor and actress in a movie. In addition to New York’s 2003 smoking The ban did not include menthol-flavored Remember when a pack of cigarettes didn’t ban in restaurants, bars and clubs, the Food cigarettes, which is where the FDA may cost more than dinner? Remember when and Drug Administration (FDA) has recently have fallen short. you could smoke during dinner or at a bar? banned flavored cigarettes, which can be seen “They didn’t ban menthol, which would Those times are gone and are part of the as a “gateway” tool for minors to start puff- have been a huge step,” Mr. Gillespie noted. reason why smoking is at an all-time low of ing and eventually lead to an addiction. “About 50 percent of people who smoke 20 percent of the American population — Studies have shown that teenagers are three menthol cigarettes have a much harder time with a seven percent drop in just the past times more likely to smoke flavored cigarettes quitting, possibly due to the ‘fresh’ taste six years. than adults older than age 25. Banning fla- and smell.” If the laundry list of chemicals and poten- vored tobacco could help keep an average of tial medical problems didn’t scare America, 3,600 teenagers per day from having their FREE SMOKING CESSATION something else did — a hit in the wallet and first cigarette, according to the FDA. HELP For more information on how to quit a serious hassle of finding a place you could Mr. Gillespie believes the ban was a “good smoking, call the Center for Complementary still smoke. start, but not enough.” Medicine at (718) 226-6921. “Cutting down on places people could smoke is a huge factor in the decrease over the years. Between the increas- ing price of a pack of cigarettes and the inconvenience of finding a place to exercise the habit, many people have given up,” said Kerry Gillespie, MS, director of the Center of Complementary Medicine at Staten Island University Hospital (SIUH). Mr. Gillespie explained, “People looking for that last reason now have it. Numerous employees have quit recently with the final straw being the walk across the campus to smoke.” At the beginning of 2009, SIUH started a smoke-free campus cam- paign to thwart smokers from light- ing up on hospital property, and the trend has caught on as countless other hospitals have since imple- mented the smoking ban. As of November 2009, New York City has passed a law prohibiting smoking on the grounds and near the entrance of healthcare facilities, including hospitals. In addition, Mr. Gillespie said smoking is being pro- hibited on all city property within the next few years. “Over the past few years, I have seen a huge influx of people coming to me in the hope that they can SETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com 3
With Nowhere to Turn, Islander with Breast Cancer Thanks SIUH, Her “Family of Support” “ N o woman on Staten Island needs to “Theresa was diagnosed with breast cancer Theresa then underwent surgery for a bilat- go without lifesaving care for breast in August of 2008, and through Ms. O’Brien’s eral mastectomy with axillary node dissection cancer,” remarked Barbara O’Brien, encouragement, arrived at the SIUH Breast with Heather McMullen, MD, breast surgeon RN, administrator of the Cancer Services Imaging Center many months later. and SIUH director of General Surgery. Program at Staten Island University Hospital “I love her to death,” Theresa says of Following her surgery, Theresa received radia- (SIUH), which operates with the support of Ms. O’Brien. tion therapy under the supervision of Phillip a state grant. Ms. O’Brien recalled, “when Theresa Vigneri, DO, chairman of Radiation To prove her point, Ms. O’Brien recounts arrived at the Breast Imaging Center, we did a Oncology. the near tragic plight of Theresa Barrese, a complete workup on her. On the day of her Theresa’s journey over the past year has been recent patient who views the SIUH care team first appointment, a diagnostic mammogram one of fear and hope. “I am naturally optimis- as “her family of support.” was scheduled, followed by an ultrasound.” tic, but when I needed to be uplifted, Barbara An MRI-guided biopsy was performed on O’Brien was my cheerleader, and Maureen Theresa by Carolyn Raia, MD, the director of Caccese, my breast navigator, was always there “The women of Staten Island the Breast Imaging Center and a board-certified to hold my hand,” Theresa said. have no idea what they really radiologist specializing in breast mammography. “The women of Staten Island have no idea have here. They are very Theresa didn’t realize how sick she was, what they really have here. They are very Ms. O’Brien reported. Her breast cancer had fortunate.” fortunate.” become so advanced in the year since her diagnosis that she required neo-adjuvant Don’t Delay, Schedule a Ms. O’Brien learned of Theresa’s struggle chemotherapy to shrink the tumor before Mammogram Today! To arrange for through her daughter, Jennifer, who wanted surgery could be performed. a mammogram, call the Breast Imaging her mom to have the treatment she needed, Medical oncologist Marcel Odaimi, MD, Center at (718) 226-1333. but was afraid to seek, because she did not began Theresa’s chemotherapy on New Year’s have health insurance. “I had no hope,” Eve, placing a portal for the treatments that Theresa recalled. began on January 2, 2009. Breast Health Services at SIUH Managing breast health involves a team that includes a: • breast imaging radiologist; • breast surgeon (surgical oncologist); • radiation oncologist; • medical oncologist; and • plastic surgeon, if necessary. This team of doctors will work with the breast navigator to coordinate your care among the specialists. Inclusive of the breast imaging services available at SIUH are: • screening mammogram; • diagnostic mammogram; • breast ultrasound; • fine needle aspirations; • core biopsy; • vacuum-assisted biopsy; • breast MRI; and • MRI-guided biopsy. Continued on page 11 4 Health Focus I Winter 2010
When a Mammogram Is Not Enough W hen your genes, or family or personal history reveal a heightened risk for breast cancer, there may be more that can be done in the fight against breast cancer. Your doctor may recommend annual MRI screening. “This is in addition to your yearly mammogram,” advised Carolyn Raia, MD, director of the Breast Imaging Center at Staten Island University Hospital (SIUH). Women who have undergone a genetic test and are found to carry a specific mutation, or are the daughter or sister of a known gene carrier, are definitely candidates for MRI screening, according to Dr. Raia. Dr. Raia and Heather McMullen, MD, a breast surgeon and the SIUH director of General Surgery, agree that a genetic link to breast cancer or convincing knowledge of strong family history of the disease are justification for women to go for both screenings. Women in this category usually have a first-degree relative — a mother or sister — diagnosed with breast cancer when they were pre- or perimenopausal. Genetic Testing Available “If you fall into the high-risk category and believe you would benefit from genetic testing, we can help you schedule a test in our office,” said Dr. McMullen. “We test for BRCA1 and BRCA2, the human genes that belong to a class of genes known as tumor suppressors,” Dr. McMullen explained. In normal cells, BRCA1 and BRCA2 help ensure the stability of the cell’s Carolyn Raia, MD genetic material — the DNA — and help Breast cancer is diagnosed in 1.2 million men and women globally every year. prevent uncontrolled cell growth. Mutation of these genes has been linked to the devel- Women with Breast Cancer opment of hereditary breast and ovarian For women who already have had breast cancer, most are at moderate cancer. Interestingly, men with harmful risk of recurrence for cancer in the opposite breast. These women Heather McMullen, MD gene mutations have also been found to be should discuss the value of annual MRI testing with their doctors. in a higher risk category for breast cancer. Breast MRI testing is available at Verrazano Radiology, which is Dr. McMullen shares the experience of a adjacent to the Breast Imaging Center. The studies are interpreted woman who tested at a high risk for breast by radiologists who specialize in breast imaging and breast MRI. cancer. She used the information and opted for an oophorectomy, having her ovaries Schedule a Test Today! To arrange for a mammogram, call surgically removed. This procedure is the Breast Imaging Center at (718) 226-1333. To learn about Breast known to decrease the amount of estrogen MRI, call Verrazano Radiology at (718) 667-4700. For a genetic test a woman’s body produces. Clinical evidence for breast cancer risk, call Dr. McMullen’s office at (718) 226-1300. suggests a correlation between excess estrogen To learn more on breast health, or to see if you qualify for free and breast cancer. services, call Barbara O’Brien, RN, the administrator of the Cancer Services Program, at (718) 226-6447. Phillip Vigneri, DO SETTING NEW STANDSETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com 5
Island Physician’s Patent May Lead to Breakthrough for Women’s Health R esearch results and a new staining is based on a technique that stains intact contain viral parti- method hold future promise of pre- HPV particles in biopsied cervical tissues. cles with HPV dicting which women infected with Surprisingly, a women’s lifetime risk of DNA present in the human papillomavirus (HPV) will develop acquiring HPV is 80 percent. Most women the nucleus. precancerous lesions or cervical cancer. The get better on their own. About 10 percent of HPV viral particle method developed to identify women at risk women are not able to clear their bodies of DNA was only pres- Mario Castellanos, MD has earned an International Patent (PCT) human papillomavirus and develop a precan- ent in women with benign infections. filing from the World Intellectual Property cerous condition within two years. He concluded from his observations that Organization. While only a small percentage of women cancer-prone women lacked viral particle The PCT patent application was submit- actually develop precancerous lesions or cer- DNA and that this method could identify ted in July 2009 by Mario Castellanos, MD, vical cancer from HPV, the question is: HPV-infected cells that are undergoing through Staten Island University Hospital “Which women of the million new HPV malignant transformation. (SIUH) and the Feinstein Institute for cases diagnosed each year will be the one?” In patenting VIRION-Associated DNA Medical Research of the North Shore-LIJ Working with the support of staff in the staining, Dr. Castellanos hopes to encourage Health System. Dr. Castellanos is the direc- SIUH Pathology Department, Dr. Castellanos’ further development. tor of SIUH’s Medical Women’s Health research findings came after microscopically The goal, according to Dr. Castellanos, is to Division and clinical director of research in examining DNA from hundreds of HPV- partner with a biotechnology company in the Department of Medicine. infected women. developing an easy-to-use test that can be Dr. Castellanos began his investigational In HPV-infected women with precancerous administered in hospitals and clinical laborato- work 10 years ago as a young resident physi- and cancerous conditions, Dr. Castellanos ries to process cervical biopsy tissue in a faster cian hoping to improve upon the standard identified a fascinating fact. Abnormal cells manner for a quick and accurate diagnosis. Pap test. His goal was to win the annual processed by his method had no intact viral Dr. Castellanos’ stain could potentially residents’ research competition. His love particles and as a result they lacked HPV DNA. improve on today’s major diagnostic tool — of research took him further. This was in contrast to women with colposcopy. Colposcopy is done as a follow- “The method,” as Dr. Castellanos calls it, benign infection. Their viral lesions did up to an abnormal Pap test. Caring for Today. Planning for Tomorrow. The North Shore-LIJ Health System Foundation’s new Web site features an attractive, user-friendly design. Visit www.NorthShoreLIJ.com/foundation today for: ◾◾ a variety of opportunities to support North Shore-LIJ: donate to building projects or individual hospitals, make a gift in honor of a loved one and more; ◾◾ regularly updated campaign pages with news about exciting changes throughout the health system; ◾◾ expanded coverage of Foundation and health system events, including the opportunity to purchase event and raffle tickets online; and ◾◾ photo albums featuring our supporters. 6 Health Focus I Winter 2010
Putting an End to Heavy Periods O n a recent episode of the TV show treatment of menorrhagia,” “The Doctors,” a Los Angeles gyne- Dr. Schirripa explained. cologist used his “magic wand” to Considered good candi- put an end to his patient’s painful and horrifi- dates for endometrial abla- cally heavy periods. The painless procedure tion are women who are took 90 seconds, and the perky 45-year-old finished having children mother of three reported going out to dinner but have not yet completed that evening. menopause. They usually Staten Island women now have access to have several more years of the same procedure, according to Michael producing natural hor- Schirripa, MD, a board-certified obstetrician mones from their ovaries. and gynecologist experienced in the NovaSure Endometrial ablation is System of endometrial ablation. not recommended for those “Using my own ‘magic wand’ — a gold- at a high risk for endome- plated mesh wand — I’ve safely delivered trial cancer. radio-frequency energy to gently remove the endometrial lining, helping hundreds of The Procedure women,” Dr. Schirripa said. Published NovaSure is an outpatient reports show the FDA-approved technique is procedure that is done vagi- proving 95 percent effective in doing its job. nally, generally under local anesthesia. The cervix is Candidates for NovaSure slightly dilated and the slen- Women who are candidates for NovaSure der wand — premeasured may have tried hormone therapy that proved to the individual’s dimen- ineffective in stopping their excessive men- sions — is inserted through strual bleeding. the cervix into the uterus. These are women struggling to cope with A triangular mesh array is periods that: extended through the wand ◾◾ last longer than seven days; where it expands to conform to the dimen- Staten Island women now have ◾◾ produce bleeding so heavy they go sion of the uterine cavity. Radio frequency is access to a procedure that eliminates through 20 or more sanitary napkins or then delivered into the uterus for approxi- heavy periods. To find out if you are tampons in a single day; or mately 90 seconds. a candidate, contact Dr. Schirripa ◾◾ change tampons or napkins as often as Stacey Inchausti, a patient of Dr. at (718) 966-7333. twice an hour. Schirripa, hasn’t experienced any bleeding Coping with heavy bleeding every month or spotting since undergoing the procedure. becomes lifestyle disruptive and some “I still experience the symptoms like I am women are coping with considerable pain as going to have a period — but there is Follow Us on Facebook well. “Many women are not candidates for, no blood and I don’t have to take Studies have shown that Internet or do not tolerate, hormonal therapy, as a hormones.” users check their Facebook accounts, on average, more than twice as much as they check their e-mail. So why not take a minute to add SIUH’s new Meet Michael Schirripa, MD exciting page to your profile? Simply Michael Schirripa, MD, trained in obstetrics and gyne- go to www.facebook.com/siuhospital cology at Brooklyn Hospital Center, where he became and add us! It’s that easy! chief resident. Dr. Schirripa is board-certified in obstet- rics and gynecology and holds membership in the American College of Obstetrics and Gynecologists, American Medical Association, American Society of Michael Schirripa, MD Colposcopy and Cervical Pathology and American Institute for Ultrasound in Medicine, among others. SETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com 7
SIUH Expert Treats KTS, a Commonly Missed Vein Disorder T o many people, professional golfer pressure on my veins,” said Ms. Straschnowa. difference within a Casey Martin is a household name, Dr. Giangola describes KTS as a “serious week,” reported Ms. but the condition he suffers medical condition.” “The leg in some of these Straschnowa. from is not. patients becomes quite enlarged, disfigured “Our goal is to Klippel-Trenaunay Syndrome (KTS), and very symptomatic, so it can be very prob- relieve pain and Gary Giangola, MD commonly misdiagnosed as varicose veins, lematic. Most people who have this condition heaviness and to give limited Martin’s ability to participate in the don’t want to treat it for cosmetic reasons; patients an active, productive life,” Professional Golfers’ Association (PGA) due they just want to feel better.” said Dr. Giangola. to the swelling and pain he suffered in his After Ms. Straschnowa gave birth to her “The worst part of having KTS is the leg from the condition. last child she wanted to have her leg treated heaviness and pain when my leg is swollen,” Martin made headlines in 2001 for suing again. “I looked at my MRI from my last said Mary DeFranco, 21, Roseto, PA. the PGA for their “no cart rule,” limiting his procedure and it said I had KTS! They never When Ms. DeFranco was born they told ability to play. Martin won the suit under told me I had KTS!” Like many sufferers of her parents she had a hemangioma (port the Americans with Disabilities Act and was KTS, patients are not even aware they have wine stain) and varicose veins. able to compete with the use of a golf cart. the syndrome and are treated as having only “Once I got older, the varicose vein started varicose veins. to come out, so I went to a local vein treat- KTS, A rare vascular Disorder “I’m amazed KTS is still misdiagnosed,” ment center, but they said it was too Klippel-Trenaunay Syndrome is a rare explained Dr. Giangola, “because there are advanced to perform treatment. congenital vascular disorder affecting one or more well-trained vascular surgeons than Doctors at her local vein center told her more limbs. Documented in 1900, French there were in the past. that her deep veins never actually developed physicians Klippel and Trenaunay described Ms. Straschnowa searched for doctors who and that was the cause of her varicose veins. this syndrome as having three major treat KTS and was relieved to find Dr. Giangola. Ms. DeFranco explains how she finally symptoms. These main symptoms, often learned of her condition. referred to as the “triad,” consist of vein New Treatment for KTS “I saw a procedure done by Dr. Milton anomalies, varicose veins; hemangiomas, or A new approach for treating KTS developed Waner on the Discovery Channel to treat strawberry/port wine stains; and elongation by Dr. Giangola, along with his assistant, hemangioma and went to see him for treat- of the bones. Krista Frasier, BS, RVT, is being performed ment. Dr. Waner referred me to Dr. Giangola “The exact cause of KTS is unknown,” and is giving patients greater quality of life. for vein treatment, and that’s when I found stated Gary Giangola, MD, chairman of “I came for treatment about every two out I had KTS.” Vascular Services at Staten Island University weeks, and after each treatment, I noticed a “When I started treatment, I noticed a Hospital (SIUH). “It is a true malformation difference right away. The swelling was of the venous system, a fluke of nature. It’s down and my leg looked great,” said Ms. not inherited from parent to child, and DeFranco. there’s no family history.” As a result of SIUH’s success in treating “I was born with varicose veins,” explained KTS, doctors all over the region are referring Rita Straschnowa, 36, of Woodmere, N.Y. patients to Dr. Giangola. “My mother took me to a vein doctor when I was 10. The doctor advised me to treat the Vein wellness center to open veins after I had children.” Within the year, SIUH will open a Vein After having two children, Ms. Straschnowa Wellness Center, headed by Dr. Giangola. decided to have her veins treated. “I went to The center will be able to treat a wide range a vein treatment center, and the doctor said of vascular conditions. In addition, the Vein he had to perform vein stripping,” a com- Wellness Center will also be teaching the mon procedure for treating varicose veins. vascular specialists of tomorrow through its “He took out some veins and my legs got a residency and fellowship programs. little bit better from that treatment.” A short time after her first varicose vein Are vascular problems causing treatment, Ms. Straschnowa had two more swelling and pain? To find a vascular children. “My leg swelled from the weight I specialist at SIUH, call (718) 226-6800. put on during the pregnancy and it put a lot of 8 Health Focus I Winter 2010
Da Vinci Robot for Prostate Cancer Surgery W ith its computer and robotic arms, Staten Island University Hospital’s newly arrived da Vinci SI model HD surgical system would fascinate Leonardo. “The da Vinci system allows the hospital’s urology team to perform innovative robotic- assisted laparoscopic prostatectomy,” according to Nachum Katlowitz, MD, Staten Island University Hospital director of Urology, and Nicholas Karanikolas, MD, the hospital’s director of Urologic Oncology. More than 243,000 American men are diagnosed with prostate cancer each year, and for some, the disease is life threatening. Prostatectomy — surgical removal of the prostate — is considered one of the most effective treatments for prostate cancer, but the operation can be a cause of anxiety for the patient because of associated risks to urinary control and sexual function. With the da Vinci robot, urologists are able to offer patients a minimally invasive approach. Employing use of the robot’s state-of-the-art technology, the da Vinci allows urologists to perform complex surgery From left: Urology teammates Michael Savino, MD, Nachum Katlowitz, MD, and Nicholas Karanikolas, MD. through tiny openings. While Leonardo’s vision found expression in art and science, the With the aid of the da Vinci, patients and their doctors are report- robot bearing his name offers surgeons superior visualization in the ing less blood loss, less pain and faster return to normal activities. operative field. With an amazing degree of depth perception, the da Vinci sharp- To learn more about minimally invasive treatment for ens views of the prostate and its network of surrounding nerves and prostate cancer, contact Dr. Katlowitz at (718) 226-6461 or tissues. Da Vinci’s arms become an extension of the surgeon’s own Dr. Karanikolas at (718) 226-6031. hands with the added benefit of a 360-degree range of motion not possible with the human hand alone. Gain Control Over Your Prostate Cancer Risk W hat men eat may affect their risk research has found Vitamin E also might be includes jogging or playing basketball. for prostate cancer. So could beneficial. You’ll find it in vegetables, nuts Consult your healthcare provider before other lifestyle choices. What can and egg yolks. Research continues on the starting a vigorous exercise program. you do to lower your risk? Research suggests effects of antioxidants and prostate cancer ◾◾ Ask your doctor about taking aspirin. the following actions may help: prevention. Older men who regularly used aspirin had ◾◾ Go lean. Choose lean meats or vegetable ◾◾ Lose those extra pounds. In one study, fewer cases of prostate cancer, researchers dishes instead of meals high in animal fat, men who had lost at least 11 pounds in the found. However, aspirin also can increase which has been linked to prostate cancer. past 10 years enjoyed a lower risk for pros- your risk for internal bleeding, so be sure ◾◾ Choose high-nutrient foods. Foods such tate cancer. Overweight older men also were to ask your doctor first. as rice, wheat and seafood contain selenium. much likelier than normal-sized men to A few studies have shown that this antioxi- develop a more serious form of the disease. To learn more about your own risk for dant may help prevent prostate cancer or slow ◾◾ Exercise regularly. A recent study found prostate cancer, take the interactive quiz at the growth of prostate tumors, although other that, compared to couch potatoes, men ages http://understandingrisk.cancer.gov/ studies have shown no benefit. Lycopene also 65 and older who exercised vigorously at a_prostate/00.cfm. may reduce a man’s risk for prostate cancer. least three hours a week had about a 70 per- It’s abundant in raw or cooked tomatoes, cent lower chance of being diagnosed with pink grapefruit and watermelon. And some advanced prostate cancer. Vigorous exercise SETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com 9
Mastering a Mystery Disease A daring diagnosis has saved the life of untold numbers of patients currently misdiag- minute in terms of a young reporter, while a 16-year-old nosed with uncontrollable mental disorders our ability to measure is rescued from hospitalization in a and for those lost and dying without ever it with current psychiatric unit. being diagnosed. MRI or imaging With amazing medical acumen, Souhel technology,” Dr. Najjar, MD, Staten Island University Hospital A Disease in Hiding Najjar explained. (SIUH) director of Neurology, a neuropathol- Dr. Najjar convinced Ms. Cahalen’s parents Ms. Cahalen started Souhel Najjar, MD ogist and attending New York University that a brain biopsy was necessary. “This is on the road to recov- physician, has combined personal courage not an easy step, but I knew I needed a tis- ery with a regimen of IV immune with medical conviction as he sleuthed a sue sample from the limbic section of Ms. globulin and then steroidal medications mystery disease. Cahalen’s brain in order to confirm the diag- to reduce the inflammation. Drawing upon his skill as a physician and nosis I strongly suspected,” Dr. Najjar said. Fully recovered, she is again a happy having the drive of a detective, Dr. Najjar is Sure enough, clinical results came back and healthy young adult. diagnosing a “new” disease that still leaves positive for rare antibodies called anti-N- most doctors baffled. methy-Daspartic acid receptor, or anti- Dr. Najjar Gives Mystery Susannah Cahalen knows only too well. NMDAR encephalitis. Disease a New Name The 24-year-old wrote her own story in the “Ms. Cahalen’s brain was under attack,” In classifying anti-NMDAR and GAD anti- New York Post’s Sunday, October 4, edition. said Dr. Najjar. The receptors in the frontal bodies, Dr. Najjar is terming the resulting con- The young urbanite reported on how she lobe of the brain — the area responsible for ditions autoimmune encephalitis. The group of went from happy and healthy to suddenly cognition — and the limbic system, the emo- antibodies was first identified in 2003, accord- stricken: suffering a month of madness, tional center of the brain, were under assault ing to Dr. Najjar. “The lesions they create are psychotic behaviors, paranoia and seizures. by her immune system. in reality a psychiatric manifestation, psychiat- No one, no test uncovered the cause of her ric symptoms of a neurologic disease,” Dr. problem until Dr. Najjar took her hand and Swelling Under the Najjar asserted. with calm confidence announced, “I am going Radar for MRI to find out what this is, and I am going to fix “Even though brain biopsy results demonstrate For more information on neurologic it.” Fix it he did as he is preparing to do for inflammation, the swelling is significant but diseases, call Dr. Najjar at (718) 683-3766. Staten Island Program Enhances Child Development T he Staten Island Early Childhood Direction Center (ECDC) has assisted the families of more than 11,000 children with special needs between the ages of birth through five years, as they searched for appropriate educational evaluations, programs and services. The ECDC has linked parents and professionals to a variety of medical, therapeutic, and social service supports to enhance the lives and development of our borough’s youngest children. The ECDC has also trained thousands of parents and professionals on topics including child development, preparing for kindergarten, and understanding preschool special education and kindergarten special education services. Participation in quality early childhood experiences and educational programs is important for all children so they may reach their full potential. Early intervention and preschool special education has had a positive impact on the successes we see in children today. A myriad of family education and support programs are available on Staten Island that form a wide community of interest for the benefit of families and their children To learn more about services available through the Early Childhood Direction Center, please contact Laura Kennedy at (718) 226-6304 or lkennedy@siuh.edu. The ECDC can be reached SIUH President and CEO Anthony C. Ferreri accepts the Proclamation from Ken Mitchell, (R), former NYC Councilman. at (718) 226-6670 or ECDC@siuh.edu. 10 Health Focus I Winter 2010
Electronic Health Records to Connect 13 Hospitals, Up to 7,000 Physicians T hroughout the healthcare landscape, it’s being referred to as a who receive the 85 percent subsidy from North Shore-LIJ will agree “gamechanger” — an initiative so bold that other hospitals to use the EHR to report and share their performance data, allowing and health systems have to rethink their approaches to them to compare it against a set of nationally recognized measures implementing electronic medical records. This past fall, the North for superior care and outcomes. Shore-LIJ Health System announced plans to subsidize up to 85 per- cent of the cost of implementing and operating an electronic health Real-Time Patient Care Support records (EHR) system in the offices of its more than 7,000 affiliated The EHR program will provide real-time situation-appropriate care physicians in New York City (including those at Staten Island plans, clinical alerts and preventive care. For example, when a physi- University Hospital) and Long Island. cian indicates a patient’s problem, he or she is provided with a list of The initiative is part of a $400 million investment North Shore- diagnostic tests and possible therapeutic interventions that are con- LIJ is making to strengthen the quality of care throughout the region sidered best practices to help support the decision-making process. by automating inpatient and outpatient records in all medical set- The system also suggests a long-term individualized plan for ongoing tings, including Staten Island University Hospital’s North and South monitoring of the patient. Divisions and 11 other North Shore-LIJ hospitals. In implementing the largest EHR program in the New York metropolitan area and For more information on the electronic health record one of the largest in the nation, North Shore-LIJ will system, visit www.NorthShoreLIJ.com/EHR. provide physicians with individual subsi- dies of up to $40,000 over five years. Continued from page 4 The North Shore-LIJ electronic health record, breast Health Navigation powered by Allscripts, is embedded within auto- Breast health navigators are nursing professionals who are mated care guides that specially trained to coordinate the patient’s care involving will help improve social workers, support group, nutritional needs and clinical clinical care, prevent ill- trials as appropriate. ness and avoid medical Radiation services are available for breast cancer and drug errors. patients. The philosophy of the department is to individualize the therapy for the patient’s individual stage. Improving Outcomes “While leaders in Washington are still negotiating a comprehensive For early stage patients, options include: healthcare bill, the essence of real health reform is going to happen ◾◾ partial breast irradiation (following the ASRO consensus) at the local level by optimizing technology and involving physicians using balloon brachytherapy with either the MammoSite who are directly involved in delivering care to the communities we or Contura balloons; and serve,” said Michael Dowling, president and chief executive officer of ◾◾ whole breast irradiation — supine or prone, 3D/conformal the North Shore-LIJ Health System. “We’re not going to measure or IMRT. our return on investment in terms of dollars and cents; rather, we will measure our successes in our ability to improve patient out- For intermediate stage patients, options include: comes.” As the federal government continues to move toward a ◾◾ whole breast irradiation — supine or prone, 3D/conformal system in which provider payments are based on performance, Mr. or IMRT; and Dowling said, the financial subsidies tied to the EHR will assist ◾◾ whole breast and nodal irradiation — supine, 3D/ North Shore-LIJ physicians in providing patients with a full conformal or IMRT. continuum of care, addressing all chronic conditions through evidence-based treatment protocols. For advanced stage patients: North Shore-LIJ will subsidize either 50 percent or 85 percent of ◾◾ whole breast or chest wall irradiation with nodal areas each physician’s implementation cost and monthly operational fees, using a 3D/conformal or IMRT technique. with a maximum incentive of $40,000 over five years. In addition to the subsidies they receive from the health system, physicians may be To find a breast health navigator, please call eligible for up to $44,000 in Medicare incentives over five years as (718) 226-8447. part of the American Recovery and Reinvestment Act. Physicians SETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com 11
How to Keep Yourself and Your Children H1N1-Free This Winter S wine flu has been the top health story for home until at least 24 hours what has felt like a decade. after they are free of fever Believe it or not, the first highly (100°F [37.8°C]), or signs of a publicized outbreak — which started at fever without the use of fever- St. Francis Preparatory School in Queens, reducing medications. one of the country’s largest Catholic high “Basically, on Sunday I started schools last year. to feel ill. Monday was worse, Nevertheless, parents are still worried and Tuesday was just awful. about their children’s well-being. On Tuesday I was definitely a “This is not a time to panic, but it’s certainly wreck,” said Staten Islander a time to be cautious,” said Cynthia Chang, Salvatore Mazzone, 23, who MD, FAAP, at Staten Island University was diagnosed with H1N1 Hospital. “Keeping strict hygiene on a daily while on a business trip to basis is the first step to a healthy season.” Minnesota last fall. “Aching, sneezing and serious nausea What can I do to stay healthy? was what it was like, but it got As with the seasonal flu, keeping clean can better quick. By Friday, I’d say mean the difference between getting sick I was back to normal, but I and staying healthy. still rested for a week.” When you touch your eyes, nose or He continued, saying, “To mouth, you are rapidly spreading the chance me it was just a normal sick- of infection. This is why keeping your hands ness; I didn’t really think much clean by washing them frequently and using of it, but I went to the doctor alcohol-based sanitizers (when a sink is not because it’s been all over the for children (older than age 2) as the minimal available) is a huge step as your hands are news, especially where I had been traveling.” side effects include a runny nose, headache the most common route of contamination. and mild fever. The injection’s side effects are What are the Symptoms of H1N1? just as they are for the seasonal flu shot, which Which groups are most at Risk? Common H1N1 symptoms are cough, sore is the possibility of a sore arm and redness at The symptoms are “extremely similar” to throat, high fever (101°F and above), body the site of injection for a short period of time. that of the seasonal flu, advised Dr. Chang, aches, runny nose, headache, fatigue, and Dr. Chang warns parents to discuss the but information analyzed by the Centers vomiting and diarrhea. vaccination with their pediatrician if their for Disease Control and Prevention (CDC) If you have trouble breathing/shortness of child has any egg allergies, history of supports the conclusion that 2009 H1N1 breath, pain or pressure in the chest or Guillain-Barré syndrome or any prior flu has caused greater disease burden in abdomen, sudden dizziness, confusion or reaction to an influenza vaccine. people younger than 25 years of age than in persistent vomiting, go to the emergency older people. H1N1 has seemed to target room immediately. In children, some “emer- pregnant women and young adults, and it is gency warning signs” are fast breathing or unknown why. trouble breathing, bluish skin color, not H1N1 Updates If you or your child begins to feel sick, drinking enough fluids and not waking up Look for H1N1 updates on stay home. You are contagious beginning 24 or not interacting. www.SIUH.edu and hours before symptoms begin and for several Dr. Chang strongly recommends the H1N1 www.facebook.com/siuhospital. days after that. The CDC recommends that vaccine, which comes in two forms: intranasal people with influenza-like illness remain at and as a regular injection. The intranasal is ideal Health Focus Michael J. Dowling, President and CEO, North Shore-LIJ Health System Printed on Anthony C. Ferreri, President and CEO, Staten Island University Hospital Recyclable Paper John P. Demoleas, Vice President for Development, Community Relations Arleen Ryback, Director of Public Affairs, Department of Hospital & Community Relations, Staten Island University Hospital; Editor Health Focus is published by the Department of Hospital & Community Relations of Staten Island University Hospital (718) 226-2483. The information within this publication is intended to educate readers about subjects pertinent to their health and is not meant to be a substitute for consultation with a personal physician. Produced by StayWell Custom Communications, Evanston, IL. © 2010. Printed in USA. 625 NORTH SHORE-LIJ HEALTH SYSTEM HOSPITALS NORTH SHORE UNIVERSITY HOSPITAL • LIJ MEDICAL CENTER • SCHNEIDER CHILDREN’S • ZUCKER HILLSIDE • FRANKLIN • GLEN COVE • SYOSSET • PLAINVIEW • SOUTHSIDE • HUNTINGTON • FOREST HILLS • STATEN ISLAND UNIVERSITY HOSPITAL • AFFILIATE: NASSAU UNIVERSITY MEDICAL CENTER
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