Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Dec. 4, 2015 | Archived Issues

Meetings and Events


Grand Rounds

Click here to view upcoming grand rounds.


Upcoming CME Conferences

Click below to view a complete list of all scheduled Continuing Medical Education conferences.

CME Newsletter - December 2015 (PDF)  


Milestones

Do you know of a significant event in the life of a medical staff member? Please let us know, and we'll post these milestones in Medical Staff Pulse. Also, feel free to submit comments on milestones, and we'll post the comments in the next issue. Click here to email us your milestones and comments.

Dec. 8 Event Honors Geiderman as Top Alumnus

Geiderman

Joel M. Geiderman, MD, has been named the winner of the Howard I. Wilner, MD, Alumnus of the Year Award. The award will be presented Tuesday, Dec. 8, at 6:30 p.m. in Harvey Morse Auditorium.

» Read more

CS-Link Tip: Undo

If you don't already know this, it will rock your world. No longer will you painstakingly highlight with a shaky hand to delete or mutter as you have to retype that which you just mistakenly erased in CS-Link™. The great undo exists.

» Read more

Physician Develops App for GI Patients Everywhere

GI App

A new mobile application developed by a Cedars-Sinai physician is changing the way patients and physicians are tracking and caring for gastrointestinal disease.

» Read more

Female Angina Linked With Abnormal Blood Flow

Noel Bairey Merz

Research from the Cedars-Sinai Heart Institute showed that chest pain in female-pattern heart disease is linked with abnormal heart blood flow, although medication did not alleviate symptoms in patients with moderate coronary microvascular dysfunction. The study, led by Noel Bairey Merz, MD, was presented at American Heart Association Scientific Sessions.

» Read more

Genetic Study Could Lead to Better IBD Treatments

Genetic variation in patients with inflammatory bowel disease appears to play a major role in determining how sick they will become and could provide a roadmap for more effective treatments.

» Read more

Dec. 8 Event Honors Geiderman as Top Alumnus

Joel M. Geiderman, MD

Joel M. Geiderman, MD, has been named the winner of the Howard I. Wilner, MD, Alumnus of the Year Award.

The award will be presented Tuesday, Dec. 8, at 6:30 p.m. in Harvey Morse Auditorium. The event includes a buffet dinner and a program called "A Musical Taste," featuring musical theater and opera performed by cantors Marcus Feldman of Sinai Temple and Nathan Lam of Stephen Wise Temple.

The annual award, bestowed by the Cedars-Sinai Alumni Association and medical staff, honors a physician's accomplishments and contributions to medicine.

Geiderman is a professor of Emergency Medicine and co-chair of the Cedars-Sinai Emergency Department.

Seats at the event are $50 each, and reservations are required.

Send reservation form and check, payable to CSAA, to:

Cedars-Sinai Alumni Association
Attn: Alumnus of the Year Reservations
8797 Beverly Blvd., Suite 210
Los Angeles, CA 90048

For more information, email cedarsalumniassn@gmail.com.

Alumnus of the Year Dinner - Reservation Form - Dec. 8, 2015 (PDF)  

CS-Link Tip: Undo

If you don't already know this, it will rock your world. No longer will you painstakingly highlight with a shaky hand to delete or mutter as you have to retype that which you just mistakenly erased in CS-Link™. The great undo exists.

Just type Ctrl Z. This will undo the last action, restore a deleted block of text, or undo your selection in a SmartList. You can use this repeatedly to undo more than one action.

Shouldn't have undone that last action after all? You can type Ctrl Y to redo the last action you undid.

Physician Develops App for GI Patients Everywhere

My GI Health

Using the My GI Health app, patients with gastrointestinal disease can track their symptoms, prepare for appointments and report their medical histories using their smartphones.

A new mobile application developed by a Cedars-Sinai physician is changing the way patients and physicians are tracking and caring for gastrointestinal disease.

The free My GI Health app, created by Brennan Spiegel, MD, MSHS, in partnership with William Chey, MD, at the University of Michigan, is available to patients at Cedars-Sinai and elsewhere. It aims to facilitate more effective communication between doctors and their patients. The first version of the app was released to the public on iTunes in late October, with enhanced features soon to follow.

"We have to reach out to where people live, work and play," said Spiegel, director of Cedars-Sinai Health Services Research. "That's the idea behind mobile health and what drove the development of My GI Health."

Using the app, patients with gastrointestinal disease can track their symptoms, prepare for appointments and report their medical histories using their smartphones. A series of carefully selected questions also helps patients generate personalized, physician-grade reports, which are then sent to their doctors.

The personalized reports, as well as links to further research and "education prescriptions," help patients understand their GI symptoms from virtually anywhere.

All of the materials generated by My GI Health also go to patients' email, allowing them to revisit or update their symptoms anytime.

"The mission of My GI Health is to enable patients by providing their physicians with the information needed at the point of care; that way we can better take care of our patients and hopefully enhance their satisfaction with the care they receive," said Spiegel, who also directs the Cedars-Sinai Center for Outcomes Research and Education.

The mobile health app is part of the center's goal of developing innovative digital health strategies to reimagine the dialogue between patients and doctors, and ultimately to improve the value of healthcare provided at Cedars-Sinai and beyond.

The app is available for Apple devices.

Female Angina Linked With Abnormal Blood Flow

Noel Bairey Merz
Noel Bairey Merz, MD

Chest pain in female-pattern heart disease is linked with abnormal heart blood flow, according to tests of a drug commonly used to alleviate chest pain in patients with coronary artery disease. The drug was found to be ineffective in patients with moderate female-pattern heart disease but may offer some relief for sicker patients, a new Cedars-Sinai Heart Institute study shows.

The study's results were presented Nov. 11 as a late-breaking trial at the American Heart Association Scientific Sessions in Orlando, Florida. The study was published online Nov. 11 by the European Heart Journal and will appear in an upcoming print edition of the journal.

The drug, ranolazine, generally is prescribed for patients with angina, an often painful sensation of chest pressure common in coronary artery disease. Coronary artery disease develops when the major blood vessels that supply the heart with blood become damaged, often because cholesterol plaque clogs the heart's major arteries and decreases blood and oxygen flowing to the heart.

Coronary artery disease typically affects men. In women, cholesterol plaque tends to spread more evenly into thousands of tiny blood vessels that surround the heart muscle. Women with this condition, called coronary microvascular dysfunction, often undergo tests for coronary artery disease, which fail to reveal coronary microvascular dysfunction. As a result, many women go undiagnosed although they are at high risk for a heart attack.

"Most standard treatments for heart disease were developed after being tested exclusively on men," said Noel Bairey Merz, MD, director of the Barbra Streisand Women's Heart Center in the Cedars-Sinai Heart Institute. "For too long, physicians treated women's heart disease the same way they treated heart disease in men. We wanted to test if the symptoms experienced in these patients are related to coronary microvascular dysfunction by using a medication known to be effective in chronic angina, to see if this treatment could be helpful to women with microvascular or female-pattern heart disease."

Bairey Merz, who also is professor of Medicine, led the double-blind, placebo-controlled study as part of the National Heart, Lung, and Blood Institutes' Women's Ischemia Syndrome Evaluation study. The multiyear, multicenter research initiative is aimed at improving diagnosis and developing treatments for microvascular heart disease.

In the study conducted at the Cedars-Sinai Heart Institute and at the University of Florida, 128 coronary microvascular dysfunction patients — 96 percent of them women — were given 500 to 1,000 milligrams of ranolazine twice daily for two weeks and a placebo pill daily for two weeks. Neither patients nor their physicians knew which pill group patients were assigned at which time.

During both investigational segments, the patients were assessed and tested, using the Seattle Angina Questionnaire and a test to measure the blood flow through the heart.

Results included:

  • Whether taking the medication or taking the placebo, patients experienced no statistical difference in angina or blood flow.
  • Change in angina directly correlated with change in heart blood flow. Patients who experienced an improvement in increased blood flow also reported an improvement in angina.
  • The subgroup of patients with severe coronary microvascular dysfunction had significantly less angina along with improved blood flow through the heart and more satisfying quality of life.

"Although ranolazine was not effective in the general population of coronary microvascular dysfunction patients, we did find that patients with more severe dysfunction did experience some benefit," Bairey Merz said. "We also were pleased to be able to show that symptoms are related to the blood flow through the heart."

The study was supported by the National Heart, Lung, and Blood Institute under award number 5R01HL090957 and by Gilead Sciences Inc., a biopharmaceutical company that produces ranolazine and markets it under the brand name Ranexa.

Genetic Study Could Lead to Better IBD Treatments

Genetic variation in patients with inflammatory bowel disease (IBD) appears to play a major role in determining how sick they will become and could provide a roadmap for more effective treatments.

The findings of an international study of 35,000 patients with the two most common forms of the illness, Crohn's disease and ulcerative colitis, appears in The Lancet. Investigators compared the clinical records of IBD patients with data collected from analyzing their DNA in what is considered the largest study of its kind.

A Cedars-Sinai physician is co-senior author of the study.

The genetic information provided new insights into the progression of IBD and the rate at which the disease develops. Researchers said the findings showed that IBD actually may be an array of bowel disorders.

"This new research strongly suggests that we are dealing a number of different diseases hidden within Crohn's disease and ulcerative colitis, constituting a large spectrum of inflammatory bowel disease," said Dermot McGovern, MD, PhD, director of Translational Medicine in the F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute at Cedars-Sinai.

IBD is caused when the body's immune system attacks the gastrointestinal tract, causing chronic and damaging inflammation. An estimated 1.6 million people in the United States have the disease, including as many as 80,000 children, according to the Crohn's and Colitis Foundation of America.

Surgery and medications that can repair the immune system are considered the most effective treatments. Researchers found that genetic analysis could potentially identify which patients might benefit from earlier intervention with more aggressive therapy.

"We have very effective therapies for IBD if we use them sooner in the disease, especially for those patients who are at risk for developing a serious form of illness," said McGovern, co-senior author of the study. "We want to understand what the important, singular, genetic signature is for each individual patient because they may respond to available therapies very differently, even with the same IBD diagnosis."

The research provides an important pathway to improve patient care.

"Genetic research of this magnitude of sample size provides critical information about IBD that takes us farther down the road to providing personalized diagnosis and care to our patients with complex disorders," said Shlomo Melmed, MD, executive vice president of Academic Affairs and dean of the medical faculty. "Individualizing treatment approaches will help ensure we are getting the most appropriate treatment to the right patient at the correct time."

McGovern pointed out that while the study is an important step, it also raises new questions. He said that genes associated with IBD also are connected to other autoimmune diseases, including spondylitis and psoriasis. As such, the research has implications for managing those conditions.

"For many of our patients, these new genetic insights could be very beneficial," McGovern said. "But we also need to look more closely at some of the sickest IBD patients in hopes of providing more effective treatment and disease management."