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Celebrate Registered Dietitican Day
Wed, 03/10/2010 - 11:31By Jamie Strauss R.D., L.D.N.
Clinical Dietitian, Food and Nutrition Services, Sinai Hospital
Today health care and community organizations across the United States are celebrating the annual Registered Dietitian Day.
Registered Dietitian Day was created by the American Dietetic Association to increase the awareness of registered dietitians (RDs) as the critical providers of food and nutrition services. Today is the great day to reflect on how RDs, including those at LifeBridge Health, help people enjoy healthy lives.
Registered Dietitian Day and National Nutrition Month promote the ADA and registered dietitians. RDs educate the public and media as they provide valuable and credible information on food and nutrition.
Registered dietitians:
- are food and nutrition experts who provide a scientific basis for a health lifestyle.
- have degrees in nutrition, dietetics, public health or a related field from accredited colleges and universities. They have completed an internship and passed an examination.
- work in hospitals, schools, public health clinics, nursing homes, fitness centers, food management, food industry, universities, research, and private practice.
- use their nutrition expertise to help individuals make positive lifestyle changes and are advocates for advancing nutrition knowledge.
Guidelines for Prostate Cancer Screening Revised
Tue, 03/09/2010 - 10:19
by Sandra Crockett
When it comes to cancer screening, the process of early detection and treatment seem straightforward. But slightly revised guidelines from the American Cancer Society encourage physicians and patients to have a conversation about prostate cancer. The goal is to help men in their decision-making process regarding screening.
“We are now at the beginning of a very large conversation with the public over treatment of prostate cancer,” says S. Mark Redwood, M.D., Chief of Department of Uurology at Sinai Hospital.
The guidelines focus on men with no symptoms of prostate cancer who can expect to live at least 10 more years. These men are encouraged to discuss the uncertainties, risks, and potential benefits associated with prostate cancer screening with their physician, with the talks starting at age 50. Men with no symptoms who are not expected to live more than 10 years (due to their age or health conditions) should not be offered prostate cancer screening.
The risks or side effects of treatment may outweigh the benefits of treatment, the ACS says.
“What is new is the direct statement that if a patient has many (serious) conditions such as diabetes, heart disease, or other illnesses that would shorten his life, less aggressive approaches should be taken with respect to screening for prostate cancer,” Dr. Redwood says.
However, this opens another dilemma. “The problem arises in the judgment of what constitutes a serious co-morbid condition and what is less life threatening,” he says.
What also hasn’t changed is the ACS recommendation that African-American men, and men who have a father, brother, or son diagnosed with prostate cancer before age 65 begin discussing screening options at age 45. Men with multiple family members affected by the disease before age 65 can start at age 40.
Prostate cancers are now being classified into low, intermediate and high risk, Dr. Redwood says. If the man is still undecided after talking with their doctor, ACS recommends the doctor make the call based on his or her knowledge of the patient's health preferences and values.
“We are fortunate to have multiple modalities for prostate cancer treatment, including Cyberknife, prostatic brachytherapy, da Vinci Robotic Prostatectomy and cryoablation of the prostate at the the Alvin & Lois Lapidus Cancer Institute at LifeBridge Health,” Dr. Redwood says.
It would benefit the patient and his family to have these conversations with a LifeBridge physician who is comfortable with presenting all aspects of management.
“We provide comprehensive care of prostate cancer,” Dr. Redwood says.
For patient education and availability of comprehensive services for prostate cancer management, LifeBridge Health invites patients and their families to participate in this new dialogue now encouraged by the ACS guidelines.
To make an appointment with a urologist, please call 410-601-WELL (9355).
VSP Helps Employees Learn New Computer Skills
Mon, 03/08/2010 - 11:08by Holly Hosler
What if you could perform your job better all because you spent a scant six hours in front of a computer? Hundreds of LifeBridge Health employees have done just that by taking a computer course at VSP. VSP provides training, job assessment and business services to the Baltimore community.
“Our most popular class is Excel for Beginners,” says Tracy Piazza, a VSP technical skills trainer who teaches the computer courses. “It’s a very functional course as Excel does everything – it calculates budgets and inventories; it tracks data much like a database would; it allows users to create charts and tables; and it can be used to execute mathematical formulas that give managers good information.”
Morgan Green, patient care associate in the Intermediate Care Unit at Sinai Hospital, took classes in both Word and Excel. She had some experience with Word in high school, but the VSP classes reacquainted her with the program, which she was using extensively for her job in dietary. Now that she’s a nursing student, Morgan finds the skills she gained invaluable to her school work and even uses Excel to make charts for her assignments.
“The teacher made the classes fun,” Morgan says. “Tracy was very helpful and even gave us her e-mail and phone number so that we could ask her questions outside of class.” Upon completion of a workshop, each student receives a user-friendly manual for the software and a quick reference card.
Jonathan Karanja, clinical systems coordinator at Levindale, also took the Word and Excel classes at VSP. Jonathan’s newfound knowledge of Excel allows him to use pivot tables for audits, which are a large part of his job. The computer classes have also made him the computer “go-to guy” at Levindale and Courtland Gardens.
“I love the fact that I can help others with what I know,” he says.
VSP offers Word and Excel courses (at beginner, advanced and expert levels) and PowerPoint (beginner and advanced), so no matter your existing knowledge of these computer programs, chances are there’s a class for you. For those who consider themselves computer-illiterate, there’s a Computer Fundamentals class, which teaches students the Windows operating system and how to use a mouse through a series of “mousercises.” And if figuring out the LifeBridge Health e-mail system is a puzzle for you, there’s a class on using GroupWise. Each two-session course meets for three hours during a workday morning or afternoon; and if the course relates to your job, many departments will even cover the $72 class fee.
Linda Bailey, recreation therapist at Levindale, was motivated to take the two PowerPoint courses so she could prepare a formal presentation, but she now applies her expertise to better serve the residents.
“Learning how to use PowerPoint has opened up a whole new world of activities for my residents and me,” says Linda. “Some of my residents have problems with the spoken word and require visuals to know what we are talking about. … With PowerPoint, the entire group can view the pictures at one time.” She also uses the software to play Jeopardy! games with the residents, which helps keep their minds active and memories sharp.
“I cannot say enough about how happy I am that through my employer I was able to update my skills in such a practical way,” concludes Linda. “My new skills benefit the people I work with.”
To learn more about VSP, call 410-358-8200.
New Guidelines for Prostate Cancer
Mon, 03/08/2010 - 10:09by Sandra Crockett
When it comes to cancer screening, the process of early detection and treatment seem straightforward. But new guidelines from the American Cancer Society encourage physicians and patients to have a conversation about prostate cancer. The goal is to help men in their decision-making process regarding screening.
“We are now at the beginning of a very large conversation with the public over treatment of prostate cancer,” says Dr. S. Mark Redwood, a urologist at LifeBridge Health.
The guidelines focus on healthy men with no symptoms of prostate cancer who can expect to live at least 10 more years. These men are encouraged to discuss the uncertainties, risks, and potential benefits associated with prostate cancer screening with their physician, with the talks starting at age 50. Men with no symptoms who are not expected to live more than 10 years (due to their age or health conditions) should not be offered prostate cancer screening.
The risks would likely be greater than the benefits, the ACS says.
“What is new is the direct statement that if a patient has many (serious) conditions such as diabetes, heart disease, or other illnesses that would shorten his life, less aggressive approaches should be taken with respect to screening for prostate cancer,” Dr. Redwood says.
However, this opens another dilemma. “The problem arises in the judgment of what constitutes a serious co-morbid condition and what is less life-threatening,” he says.
What also hasn’t changed is the ACS recommendation that African-American men, and men who have a father, brother, or son diagnosed with prostate cancer before age 65 begin discussing screening options at age 45. Men with multiple family members affected by the disease before age 65 can start at age 40.
If the man is still undecided after talking with their doctor, ACS recommends the doctor make the call based on his or her knowledge of the patient's health preferences and values. Men should also remember there are several effective options for treating prostate cancer.
“We are fortunate to have multiple modalities for prostate cancer treatment (including Cyberknife, prostate brachytherapy, da Vinci, the Alvin & Lois Lapidus Cancer Institute) at LifeBridge Health,” Dr. Redwood says.
It would benefit the patient and his family to have these conversations with physician.
“At LifeBridge Health, we provide comprehensive care of prostate cancer,” Dr. Redwood says.
To make an appointment with a urologist, call 410-601-WELL (9355).
Celebrate National Nutrition Month
Fri, 03/05/2010 - 11:38By Jamie Strauss R.D., L.D.N.
Clinical Dietitian, Food and Nutrition Services, Sinai Hospital
What is National Nutrition Month? How did it start? Is there a different theme every year? These questions may be floating around in your mind if you have wandered into your facility’s cafeteria and saw a banner hanging or dietitians at a booth advertising good health.
National Nutrition Month is a nutrition education and information campaign created by the American Dietetic Association. The campaign, held each year in March, focuses attention on making informed food choices and developing better eating and physical activity habits.
Initiated in March 1973 as a long-week event, “National Nutrition Week” became a month-long observance in 1980 in response to growing public interest in nutrition. The American Dietetic Association (ADA) sponsors National Nutrition Month as part of its mission to promote optimal nutrition and well being for all people by advocating for its members.
Each year National Nutrition Month has a different theme with key messages. The theme for March 2010 is “Nutrition from the Ground Up." These messages include making it clear that eating right doesn't have to be complicated. A healthy eating plan emphasizes fruit, vegetables, whole grains, low-fat or fat-free dairy and includes lean meats, poultry, fish, beans, and nuts and is low in saturated fats, trans fats, cholesterol, salt and added sugars.
Nutritional health includes being aware of portion sizes. Even low-calorie foods can add up when portions are larger than you need.
You should make the most of family meal times. Eating meals together provides the opportunity to help children develop a healthy attitude toward food and enables parents to serve as role models, introduce new foods, and establish a regular meal schedule.
Finally, balancing physical activity with healthy diet is best for managing weight and promoting overall health and fitness.
Women's Heart Group Offered at Northwest
Thu, 03/04/2010 - 10:28Do you or someone you know have heart disease?
A partnership through Northwest Hospital and the National Coalition for Women with Heart Disease is now providing support for women living with heart disease. Heart disease can include coronary heart disease, congestive heart failure, and congenital heart disease. Each year, roughly 1.2 million Americans have a coronary attack, and about 452,000 will die.
Heart disease is the No.1 killer of women. The mission of WomenHeart is to improve the health and quality of women with heart disease and to be advocates.
A Baltimore County chapter of WomenHeart was recently formed. The first meeting will be Tuesday, March 9 at 11 a.m. in the Reisters Room on the Ground Floor of Northwest Hospital. Women who have heart disease or at risk for heart disease (for example, hypertension) are invited to attend. A heart-healthy brown bag lunch is encouraged.
For more information, call Cardiac Rehab's Lisa Gerberg at 410-701-4333.
Blog Subscription Winners
Wed, 03/03/2010 - 15:25Congratulations to Shanika Jones, practice manager in the Sinai Division of Gastroenterology, and Barbara Church, director of long-term care at Levindale. Shanika was our 100th subscriber to the LifeBridge Health blog, and Barbara was chosen at random as one of our other faithful subscribers. Thank you to everyone who has subscribed!
The Question of Organic Food
Wed, 03/03/2010 - 11:32By Sandra Crockett
So you want to eat healthy but are confused about all the different guidelines. It’s pretty clear to most people that trans fat is something to limit in your diet or stay away from altogether. The same is true of high fructose corn syrup (HFCS), although hard to do since it is in so much processed food products.
Perhaps going organic is the safer way to go. But what exactly makes any produce “organic?” And what if you have the choice of going to a grocery store and buying something labeled “organic” or going to a local farmers market and purchasing fresh produce without the “organic” label? It's clear that the road to good health, healthy eating, and being kind to the environment is not always easy.
A food label “organic” means the producer has been certified organic, says Laure L. Sullivan, resident district manager, Food and Nutrition Services for LifeBridge Health. The producer has to meet certain standards to gain certification, and it is not the same for all countries.
In the United States, a food labeled “organic” usually means only organic ingredients were used. Legally, if a food is 95 percent organic, it can be labeled organic.
That said, buying from a local farmer’s market whenever possible would be your best bet, Sullivan explains.
“Buy local at your local farmer’s market and support the farmers,” Sullivan says. Farmers at local markets can have organic produce without having the organic label. “Farmers’ produce can be chemical free but not all farmers can afford to get the certification,” she says.
“You can get organic strawberries from China. But then you have the whole carbon footprint question.”
LifeBridge Health buys as much seasonal produce from local farmers as possible, Sullivan says.
Like we said, living healthy and being environmentally aware is not always easy. However, if you love yourself and your planet, it is worth it.
If you want to learn more about how sustainable food practices, several hospitals in Maryland and D.C. are being recognized tomorrow night for improving nutrition, maximizing carbon footprint and purchasing sustainable-produced meat through the Balanced Menu Challenge.
The “Balance Meets Taste” event kicks off National Nutrition Month for March 2010. It is being organized by Maryland Hospitals for a Healthy Environment.
If You Go
What: Balance Meets Taste
When: Thursday, March 4
Where: Pier 5 Hotel, Baltimore Inner Harbor, 711 Eastern Avenue, Baltimore, MD
Time: 6:30 - 10 p.m.
Cost: $100 (hors d’oeuvres and cocktail hour, four-course meal including wine. Proceeds donated to Future Harvest – Chesapeake Alliance for Sustainable Agriculture.
For More Information: 410.706.1924 or click here. You can also e-mail Lmitc001 (at) son.umaryland.edu
LifeBridge Health Wins Social Responsibility Award
Tue, 03/02/2010 - 09:21
LifeBridge Health has won the 2010 Communitas Award for Green Initiatives, under the category of Excellence in Corporate Social Responsibility.
Communitas winners are recognized for specific programs involving volunteerism, philanthropy or ethical, sustainable business practices; and nominees are evaluated based on the extent and effectiveness of their programs. The size and potential scope of the nominee is also taken into consideration.
The green initiatives at LifeBridge Health include waste reduction, composting, non-toxic chemicals, green construction, and the reduction of energy use. By switching to compact fluorescent lighting in operating rooms, cafeterias, and parking garages, LifeBridge Health saved nearly $400,000 in fiscal year 2009. LifeBridge Health is the only Maryland-based health care system on the list of 2010 winners.
The Communitas awards are an outgrowth of the pro bono recognition program of the Association of Marketing and Communication Professionals, a group that honors creative achievement and fosters partnerships with charities and community organizations.
Colon Cancer Screenings Save Lives
Mon, 03/01/2010 - 09:24by Sandra Crockett
Talking about colorectal cancer may make you wince. But discussing it with your physician is a key to good health. In fact, it may save your life.
March is National Colorectal Cancer Awareness Month, and a good opportunity to discuss colon cancer screenings, which are relatively painless. For African Americans, the recommended age for screening is now 45.
“For uncertain reasons, African-Americans often have more advanced cancers at the time of diagnosis, hence the modified guidelines,” says John C. Rabine, M.D. The recommended age to begin screenings for other ethnic groups remains 50.
Rabine, a gastroenterologist at Sinai Hospital, points out that colon cancer is the third most common cancer in this country.
“And – depending on which study is cited - a colonoscopy reduces that risk by 65-90 percent," he says.
Colonoscopies are powerful tools that only needs to be done every 8-10 years in patients who are considered "average-risk" for colon cancer. Cancer of the colon or rectum causes an estimated 55,000 deaths each year, according to the American Journal of Gastroenterology. More than 138,000 new cases of colorectal cancer are diagnosed annually, and men and women are equally susceptible to the disease.
Sudhir K. Dutta, M.D., head of Sinai’s Division of Gastroenterology, and Rabine’s preferred method of screening for cancer is the colonoscopy. A colonoscopy allows a doctor to look inside the entire large intestine. The procedure, which enables the physician to see things such as inflamed tissue, abnormal growths (polyps) and ulcers, is most often used to look for early signs of cancer in the colon and rectum.
“It is somewhat of a misnomer to call it a screening test, as it is really intended to remove polyps and be a preventative test,” Rabine says.
All colon cancers arise from polyps, which are benign growths that can occur in several locations in the gastrointestinal tract. They vary in size and look like small bumps growing from the lining of the bowel. If identified at a very early stage, they can be removed before they become cancerous, usually while the doctor is examining the large intestine during a colonoscopy.
“Polyps are very common in adults,” says Dutta, who explains that there is an increased chance of developing them as you age. He adds that with appropriate screening like the colonoscopy, “we should be seeing fewer cases of colon cancer.”
The Endoscopy Center at Sinai Hospital is the principal site of GI diagnostic work, providing endoscopic procedures of the gastrointestinal tract including the esophagus, stomach, duodenum and colon. Using state-of-the-art equipment, medical specialists can provide a quick and accurate diagnosis of a GI problem.
To schedule an appointment or learn more, call 410-601-WELL (9355).
Presciptions in Pregnancy
Fri, 02/26/2010 - 10:33It’s a common fear: a woman becomes pregnant and starts worrying about the medications she is taking.
According to Michael Carson, M.D., who presented at Sinai Hospital Grand Rounds yesterday, internists need to become more familiar with the impact of disease on a pregnancy, and what medicines are safe. Carson is an assistant clinical professor in the Departments of Medicine and Obstetrics at the UMNDJ – Robert Wood Medical School and the director of research and outcomes at the Jersey Shore University Medical Center.
“Women of childbearing age bear children. You need to address pregnancy with your patient before she becomes pregnant,” he told the group of Sinai physicians. “Fifty percent of pregnancies are unplanned.”
It’s estimated that anywhere from 14 to 45 percent of women beginning prenatal care in the United States have medical problems. Physicians should talk about resources and options available for the patient, Carson said. According to a study published in the International Journal of Gynecology and Obstetrics, pregnant women ingest an average of three difference prescription medications during pregnancy. The most common are antimicrobial (to treat infections), antiemetics (to treat nausea), tranquilizers (to treat stress) and analgesics (to treat pain).
“Medication use is not a yes/no issue,” Carson said. “You have to weigh the risks and benefits.”
Patients and physicians also need to discuss what is realistic. For example, a smoker may not be able to go cold turkey, but she can use a nicotine patch. A woman who is depressed may be able to cut back on her medication, but needs to be able to function.
There's a tendency to undermedicate during pregnancy, Carson says. The bottom line is internists need to make sure they're looking at the whole picture.
“The best thing for a healthy kid is a healthy mom,” Carson says.
Orthopedic Surgeon Reflects on Haiti Experience
Thu, 02/25/2010 - 12:05
Following the devastating earthquake in Haiti, several LifeBridge Health employees have volunteered their time and services to earthquake victims. Among these are physicians Shawn Standard and Albert Aboulafia.
An orthopedic surgeon and co-director of sarcoma services at the Alvin & Lois Lapidus Cancer Institute, Aboulafia traveled to Haiti from Feb. 3-7 to work with Project Medishare. Before he left, fellow orthopedic surgeon John Herzenberg sent over 50 pounds of donations that included soap and blankets.
An estimated 300,000 Haitians were injured in the 7.0 earthquake. Once Aboulafia arrived, there were roughly 140 adults and 65 children and adolescents in the Medishare tents who were awaiting treatment.
He worked at a breakneck pace, estimating that he performed 50 operations over a two-day period, including wound care, skin grafts, amputations and fracture realignments. When a severe wound is left untreated, infection can develop, leaving no choice but to amputate.
“I think we did a lot of good,” he says. “There, you could really make an impact. Would I fix a fracture different in Baltimore? Yes. But there were no lab tests, no blood. We did the best possible care that we could under the circumstances.”
One patient who sticks in his mind is a 90-year-old woman with a femur fracture.
“She understood the risks of surgery, and we were able to help her,” he says. “She had a place to go home to, and we were able to get her thigh fixed, put her into a wheelchair, and send her with relatives to go home.”
Aboulafia said he was lucky to have physical therapists, nurses, physician assistants, and volunteers who were dedicated to helping treat patients.
“Lots of times it was the people who were very much out of their element who excelled,” he says. “It was a tense and emotional time, but you saw a lot of people who were at their best.”
He hopes to return soon. To learn more about Project Medishare, click here.
Subscribe to Our Blog
Wed, 02/24/2010 - 15:29We appreciate everyone who reads the LifeBridge Health blog. We are close to having 100 people who subscribe to it, and we're offering a $10 Target gift card to our 100th subscriber.
It's just our way of saying thank you for reading!
A reminder: when you subscribe via the link at the right, please make sure to double check that you have spelled your e-mail correctly and verified it.
Battling the Winter Blues Through Fitness
Wed, 02/24/2010 - 11:00
by Tim Hyland
(The following is an excerpt from an article appearing in the 2010 Md.MD for Life, available now.)
Matt Carlen knows a thing or two about the winter blues.
Growing up in not-so-sunny Sweden, Carlen became all-too-well acquainted with that Nordic nation's long, gloomy, dark winters. Cold, too. Put it this way: By comparison, Maryland winters (even this one) are paradise.
And while Carlen isn't a doctor, he says he's picked up tidbits over the years, both in Sweden and here in the United States, about how long stretches of dark weather can lead directly to dark moods - a condition that doctors now call seasonal affective disorder (SAD). He's also learned how to fight off those winter blues.
"I'm not a scientist," says Carlen. "I can't tell you if the link between exercise and reduced seasonal affective disorder has been proven or not. But I know that I grew up in Sweden, and it's dark for four months a year there. But by being active, by exercising, that definitely helps."
There is an increasing body of evidence indicating that exercise may be among the most effective means of staving off SAD. Simply put, says Carlen, exercise does more than keep your body well. It also keeps your mind well.
That's one of the main messages Carlen delivers as executive director of LifeBridge Health & Fitness, one of the Baltimore area's finest health and fitness centers. Carlen truly believes that regular exercise can make for a better life, and he says he sees more poof of that every day at his club. There, on the rows of treadmills and stationary bikes and elliptical machines, people of all ages and all abilities find fitness, relaxation and happiness in their daily workout - even during the darkest days of winter.
To read more, click here. To learn more about LifeBridge Health & Fitness, call 410-484-6800.
Cardiac Rehabilitation Can Lead to Better Outcomes
Tue, 02/23/2010 - 12:02
By Paul A. Gurbel, M.D.
Director of Cardiovascular Research at the Center for Thrombosis Research at Sinai Hospital
Results of a recent study published in Circulation reveal that patients who complete a full complement of 36 cardiac rehabilitation sessions reduced their risk of suffering a heart attack and lived longer lives. The results drive home the importance of cardiac rehabilitation in the continuum of care for patients with heart disease and illustrate the importance of doctors prescribing and encouraging this vital practice.
Conducted by researchers at Duke University School of Medicine and Jefferson Medical College, the study examined the medical histories of more than 30,000 Medicare patients (ages 65 and older) who took part in at least one cardiac rehabilitation session during a five-year span. People who took part in all 36 sessions, which were reimbursed by Medicare, had a 14 percent lower risk of death and a 12 percent lower risk of a subsequent heart attack than those who attended 24 sessions. These percentages increased when compared with patients who took part in 24 sessions or less.
Perhaps the most dramatic finding was that patients who attended all 36 sessions had a 47 percent lower risk of death and a 31 percent lower risk of subsequent heart attack compared to patients who only attended one session.
As a cardiologist, I have continually observed that patients who complete a full cardiac rehabilitation program end up experiencing better outcomes, feel better physically, and have a good chance of continuing a regular exercise routine after rehabilitation concludes.
The patients we treat for heart disease at Sinai Hospital and the other facilities throughout the LifeBridge Health are fortunate to have access to a world-class cardiac rehabilitation program.
The LifeBridge Health Cardiac Rehabilitation Program is housed in a new state-of-the-art facility at Northwest Hospital under the direction of Program Manager Lisa Gerberg, RN. Lisa is also the Vice President of Maryland Association of Cardiovascular Pulmonary Rehabilitation. Through her close affiliation with this program, she keeps her finger on the pulse of the latest rehabilitation techniques and shares the insights with her outstanding staff and our patients to improve the rehabilitation process and improve outcomes.
The LifeBridge Health Cardiac Rehabilitation Program is tailored to fit each patient’s needs and physical abilities and includes counseling about cardiovascular disease, nutrition, reducing stress and proper use of medications.
This recent study should serve as a strong reminder to physicians and caregivers to educate patients on the importance of starting a cardiac rehabilitation program as soon as possible after surgery and maintaining it for the full 36 sessions. Doctors also need to pay attention to the cardiac rehabilitation reports during follow up appointments and offer continued positive reinforcement to the patient about their progress. This type of encouragement goes a long way towards improving patient outcomes and as this study shows, can save lives.
To learn more about the cardiac rehabilitation program, call 410-601-WELL (9355).
Sinai Hospital: A CyberKnife® Leader
Mon, 02/22/2010 - 10:56Since opening the CyberKnife® Center at the Alvin & Lois Lapidus Cancer Institute in 2003, Sinai Hospital has become recognized as a national leader in the treatment of pancreas, lung, spine, liver, brain and prostate tumors. More than 1,200 CyberKnife procedures have been performed at Sinai, where physicians from all over the country are trained in how to use the cancer treatment technology.
Sinai Hospital’s CyberKnife Center ranks in the top 10 worldwide in total volume of patients treated for pancreas, lung and other soft tissue tumors. To support the center’s continued growth and to pioneer new therapies, Sinai Hospital acquired a second CyberKnife. Only four other centers in the world have this capacity.
CyberKnife stereotactic radiosurgery is a frameless, linear accelerator-based system mounted on a robotic arm. Because there are no surgical incisions, anesthesia is not required.
The CyberKnife’s computer-guided tracking system is so precise that doctors use it to treat inoperable tumors and cancers that have failed to respond to other types of radiation, including radiotherapy. This is especially advantageous near the spinal cord or other vital organs. Additionally, new tracking systems for the CyberKnife allow it to recognize the shape of a patient’s spine and thus increase the degree of precision. Sinai has the largest reported experience with malignant tumors of the spine. Patients from across the country with complex spinal tumors are referred here for treatment.
Over the last six years, physicians have demonstrated CyberKnife’s ability to perform revolutionary, noninvasive procedures to eradicate soft tissue tumors in the pancreas, liver and lungs. Mukund S. Didolkar, M.D., has achieved survival results with patients with inoperable pancreatic cancers not previously possible. Sinai was also one of the first centers to acquire a new program for lung tumors that tracks the patient’s breathing motion, ensuring individual lung tumors are treated. Lynne A. Skaryak, M.D., head of Sinai’s division of thoracic surgery, uses the CyberKnife to treat lung cancers in patients not able to undergo surgery.
Prostate cancer also is now treatable without surgery with the CyberKnife. Research has shown patients undergoing CyberKnife treatment for certain prostate cancers have a lower rate of side effects.
The CyberKnife Center at Sinai also is one of the few CyberKnife centers in the United States to treat children. Tumors of the eye socket and other unique conditions are also treated here. In select instances, patients with pain syndromes or benign tumors that otherwise would require complex surgery (such as acoustic neuroma) also may be candidates for stereotactic radiosurgery.
The CyberKnife Center at Sinai is an integral part of the Alvin & Lois Lapidus Cancer Institute and the Sandra and Malcolm Berman Brain & Spine Institute. For more information about the CyberKnife Center at Sinai, call 410-601-WELL (9355).
Breast Health Question and Answer
Fri, 02/19/2010 - 13:54
(The following is an excerpt from the 2010 MdMD for Life, out this month.)
Breast surgeon Dawn Leonard, M.D., is the medical director of the Herman & Walter Samuelson Breast Care Center at Northwest Hospital. She answered some questions about the center's approach to breast health.
What can a woman expect when she visits a specialized breast center?
Our general philosophy is to provide comprehensive, state-of-the-art, individualized and multidisciplinary care. When there is a problem, our job as physicians and health care providers is to provide an unbiased opinion about options.
Why would a woman need to see a breast surgeon?
Women may be referred by their primary care physician after there is a suspicious finding on a mammogram. When I am with a patient, I discuss the best type of biopsy for the patient, whether it is image-guided or surgical, and we go from there. Even if the biopsy is benign, a good surgeon will discuss risk assessment and whether the patient needs more frequent follow-up exams.
If the biopsy reveals a malignancy, then you begin discussing the surgical options such as lumpectomy or mastectomy. Whenever possible, you want to provide the opportunity for breast preservation.
What are your feelings on prophylactic mastectomies?
That is now an option for patients who are high risk, such as those with genetic mutations of BRCA1 or BRCA2. It’s a very personal decision.
To read more, click here.
The Benefits of Aspirin After Breast Cancer
Thu, 02/18/2010 - 09:42By Deb Kirkland, RN, BSN, MPH
Nurse Navigator, Herman & Walter Samuelson Breast Center at Northwest Hospital
A study conducted at Brigham and Women’s Hospital and Harvard Medical School, “Aspirin Intake and Survival After Breast Cancer,” suggests there is an associated decreased risk of distant recurrence of breast cancer and breast cancer death in women who were taking aspirin. The study results were published February 16 in the Journal of Clinical Oncology.
The 4,164 subjects were breast cancer survivors participating in the Nurses’ Health Study (NHS); these women were from all over the U.S., diagnosed with stage I to III breast cancer between 1976 and 2002, and were followed until June 2006 (or their death, whichever came first).
What can we conclude from this study? Women who took a simple baby aspirin 2 to 5 days per week had a 60 percent risk reduction of their cancer spreading distally and a 71 percent reduced risk of breast cancer death. Women who took aspirin 6 to 7 times per week lowered the risk of distal recurrence by 43 percent and had reduced risk of breast cancer death by 64 percent. Overall, these women taking aspirin had a 50 percent reduced risk of distal recurrence and 50 percent reduced risk in breast cancer death.
This was an observational study, which means it suggests a relationship, but is not designed to prove a cause and effect link. What we do know is that there is an association present between aspirin and a lower risk of recurrence or death. It is believed the aspirin’s anti-inflammatory properties are what contribute to the benefit.
What does this mean if you have had breast cancer? It's important to remember that in the study, the women started aspirin one year post-diagnosis. Aspirin is not indicated for patients currently undergoing chemotherapy or radiation. Women need to be aware there is associated risk involved with taking aspirin, such as bleeding and stomach problems, such as ulcers.
However, if you are a breast cancer survivor and you are taking aspirin for protective cardiac measures, there may be a benefit in reducing breast cancer recurrence. Data suggest further studies, such as clinical trials that include aspirin and other anti-inflammatory drugs, are needed to discover if there is a direct cause and effect link. Currently, there are various studies with the use of COX 2-inhibitors and other non-steroidal anti-inflammatory drugs in breast cancer. Studies have indicated these anti-inflammatory drugs may also reduce the risk of colon cancer.
Coughs and Colds Build Immunity
Wed, 02/17/2010 - 11:46by Kristin Lemmert
(The following is excerpted from Md.MD for Life 2010, out this month.)
You know the cough – the one from down the hall that wakes you in the middle of the night. Whether your child is 6 months or 6 years old, you start your assessment as soon as you hear it.
But before you hit your doctor’s number on speed dial, Sinai Hospital pediatrician Michael L. Zollicoffer, M.D., recommends that you take a deep breath.
Exposure is Good
Zollicoffer is sympathetic: as a parent, your agenda is to have a healthy child, he says. Like most moms, you want your kid better - now.
But 90 percent of the time, a cough is a just a cough – the frequent dance partner to a cold. With over 200 different cold viruses, gaining exposure to these viruses is a good thing. Zollicoffer even tells parents that their child should have a cold every day from birth to 3 years old. Congestion is normal, he says, which is tough for many parents to hear.
Children strengthen their immune system through repeated exposure to germs and viruses, he says. For exposed children, the “slow down” in colds occurs at the age of 3. For nonexposed kids, it starts when they begin school and typically takes three years.
When “Something’s” Different
When should you contact your child’s pediatrician about a cough? According to Dr. Zollicoffer, the answer varies from child to child. As long as children are active, let them process the cold. For example, a wet or dry cough is fine if your child is at her normal level of activity.
Instinctively, you know what is normal for your child, explains Zollicoffer. So, when you feel uncomfortable about your child’s condition and you recognize that something is different, contact your pediatrician.
These alerts include gasping for air, wheezing, high fever, lethargy, and refusal of all liquids and food. The most severe complications require a call to your doctor or urgent care cent immediately (e.g., being “hungry” for air), while lesser ones may be handled with an office visit. Better-known cold viruses include RSV, croup, and pneumonia.
For more information, request a copy of MdMD. You can visit us at www.lifebridgehealth.org or call 410-601-WELL.
Seasons Hospice at Northwest Hospital
Tue, 02/16/2010 - 10:44Hospices provide quality, compassionate care to those who are facing a life-limiting illness or injury. However, sometimes patients need the capabilities of a hospital.
That's where the partnership between Northwest Hospital and Seasons Hospice and Palliative Care of Maryland comes in. In February 2008, Northwest Hospital became the first hospital in Maryland to open a fully dedicated inpatient hospice unit. An article on the collaboration recently appeared in ADVANCE for Nurses.
The demand for hospice care is growing. The National Hospice and Palliative Care Organization states that 1,450,000 hospice patients were served in 2008, up from 1,060,000 in 2004. Another change has been the shift from hospice patients with cancer to other diseases. Today, cancer patients in hospice make up almost 39 percent, while other common diagnosis for patients admitted in 2008 include heart disease, lung disease and dementia.
At Northwest, the Seasons unit has soothing earth tones, flat-screen televisions, a communal kitchen and other amenities designed to make it feel homey. Therapy dogs, volunteers, and musicians are all used to provide comfort.
To learn more about Seasons at Northwest, call 410-601-WELL (9355).
