sutures newsletter

PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY May 2016 | Archived Issues

Mark Your Calendar


Surgery Grand Rounds

Click the "read more" to see information about upcoming Surgery Grand Rounds.

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Grand Rounds

Click here to view a schedule of all upcoming grand rounds.


Education Schedule

Click the PDF link below to see the Department of Surgery's education schedule.

Education Schedule - May 2016 (PDF)  


Surgery Scheduling

Click the "read more" for hours and contact information for surgery scheduling.

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Pilot Program Helps Decrease Antibiotic Overuse

A recent Cedars-Sinai initiative is already showing promise in combating a rising global health threat — drug-resistant infections, largely due to overuse of antibiotics. In four pilot programs, the Antimicrobial Stewardship team's two-pronged approach has led to a 35 percent drop in antibiotic therapies.

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Morgenstern Debate Tackles Physicians and Social Media

Morgenstern

This year's topic is "Physicians and Social Media: Threat to Professionalism or an Essential Part of Contemporary Medical Practice?"




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Cedars-Sinai Holds Free Head and Neck Cancer Screening

head and neck

More than a dozen physicians and dental residents from the Cedars-Sinai's Samuel Oschin Comprehensive Cancer Institute and Department of Surgery performed free head and neck cancer screenings for employees and the public on May 6.

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Circle of Friends Honorees for April

CoF

The Circle of Friends program honored 272 people in April. Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai.

» Read more

P & T Approvals; Changes in Warnings, Labels for Aripiprazole, Metformin, Fluconazole, Brintellix

Pharmacy Focus

See highlights of the April meeting of the Pharmacy and Therapeutics Committee. Also, the U.S. Food and Drug Administration issued a warning regarding reports of impulse-control issues with the use of aripiprazole, has revised the labeling for metformin and is evaluating a study that shows there is a possible increased risk of miscarriage with the use of oral fluconazole. And the agency has approved the name change of the antidepressant Brintellix to Trintellix

» Read more

Pilot Program Helps Decrease Antibiotic Overuse

A recent Cedars-Sinai initiative is already showing promise in combating a rising global health threat — drug-resistant infections, largely due to overuse of antibiotics.

The Antimicrobial Stewardship team is seeing initial success in its "Get Smart About Antibiotics" campaign to ensure antibiotics are used effectively at the hospital. The team's plan features best practice alerts in CS-Link and emphasizes delivering "the right antibiotic for the right patient at the right time."

In four pilot programs launched in December, the team has asked healthcare providers to reassess the need for continuing antibiotics for three days or more. If further antibiotic treatment is warranted, providers must be able to justify its use.

Another important part of the pilots involves the widening use of rapid diagnostic testing with timely physician notification. In less than two hours, test results can help determine how antibiotic treatments should be modified to meet the individual needs of the patient. This compares favorably to traditional methods where two or three days were required for results.

So far, the pilots have seen antibiotic therapies decrease by as much as 35 percent, exceeding the original goals.

"This is a big win," said Rehka Murthy, MD, medical director of the Department of Hospital Epidemiology. "It reflects a lot of work and coordination between prescribers, pharmacists, laboratory staff and other caregivers. Our focus is on getting the right antibiotic quickly to our patients; often, that involves stopping or narrowing antibiotics, but in many instances it includes escalating therapy when appropriate."

With the positive results, the team is considering expanding the program hospitalwide next year.

For more information on how to safely use antibiotics, visit the website of the Centers for Disease Control and Prevention.

Morgenstern Debate Tackles Physicians and Social Media

Morgenstern Leon 140px

Leon Morgenstern, MD, was the founding director of Surgery at Cedars-Sinai. He died in 2012.

The 13th Annual Dr. Leon Morgenstern Great Debates in Clinical Medicine Resident Competition will convene Friday, June 3, at 8 a.m. in Harvey Morse Auditorium.

This year's topic is "Physicians and Social Media: Threat to Professionalism or an Essential Part of Contemporary Medical Practice?" Ryan Spurrier, MD, will argue that social media represents a threat to professionalism, while Justin Steggerda, MD, will contend that it has become a necessary part of medical practice.

The winner will receive the Morgenstern Trophy and a cash prize.

Last year's event drew a standing-room-only crowd. The debate committee expects a similar response this year.

This one-hour event will anchor Cedars-Sinai's annual Founders Day.

Comments of questions about the Morgenstern Debate should be sent to Leo Gordon, MD, at leo.gordon@cshs.org.

Cedars-Sinai Holds Free Head and Neck Cancer Screening

 Head and Neck Screening

Allen Ho, MD, examines a patient during Cedars-Sinai’s free head and neck cancer screening event on May 6.

More than a dozen physicians and dental residents from the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute and Department of Surgery performed free head and neck cancer screenings for employees and the public on May 6.

As part of the screening, more than 115 participants underwent examinations of the skin, neck, head, throat and thyroid gland at the Samuel Oschin Cancer Center.

"It is always important to have a screening whether you feel healthy or not," said Kathleen Burgner, education program coordinator of nursing and obstetrics. "If it is available to you, then why not get ahead of your health."

Head and neck cancer is especially dangerous because patients often can go years without experiencing noticeable symptoms. Medical professionals recommend adults maintain regular screenings for the disease, which strikes more than 50,000 annually in the United States.

"This cancer is affecting everyone, not just smokers and alcohol drinkers," said Allen Ho, MD, director of the Head and Neck Cancer Program. "The symptoms often aren’t apparent, so patients often are diagnosed at an advanced stage."

The most common types of head and neck cancers are throat, larynx, tongue and thyroid, but it also can occur in the nasal cavity, sinuses, lips, mouth and salivary glands. While many cases are without symptoms, others can include a neck lump, persistent sore throat, hoarseness, pain when swallowing or unexplained weight loss.

Circle of Friends Honorees for April

The Circle of Friends program honored 272 people in April.

Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

Click here for more information about the program and for a list of past honorees.

  • Kenneth Adashek, MD
  • Massoud H. Agahi, MD
  • Michael J. Alexander, MD
  • Howard N. Allen, MD
  • Neel A. Anand, MD
  • Paulina Andujo, RN
  • Alagappan Annamalai, MD
  • Jose C. Araujo
  • Joel-Ryan A. Armamento, RN
  • Esther Baik, MD
  • C. Noel Bairey Merz, MD
  • Mark Bamberger, MD
  • Babak R. Bamshad, MD
  • Eli Baron, MD
  • Sarah B. Barukh
  • Benjamin Basseri, MD
  • Jane L. Bawayan, RN
  • Gary S. Bellack, MD
  • Michael Bernardo
  • Satinder J. Bhatia, MD
  • Diana Breyshtrus
  • Earl W. Brien, MD
  • Barry J. Brock, MD
  • Philip G. Brooks, MD
  • Michael Broukhim, MD
  • Eileen G. Brown, OCN, RN
  • Neil A. Buchbinder, MD
  • Blessie M. Bulaon
  • Christiane Michele J. Burnison, MD
  • Karen K. Butterworth, MD
  • Erica Cabrera
  • Noel M. Cajulis, CRT
  • Breta Carroll, MD
  • Julie Castillo, RN
  • Dorrie Chang, MD
  • Kirk Y. Chang, MD
  • Cheryl G. Charles, MD
  • Henry G. Chou, MD
  • Alice P. Chung, MD
  • Arnold C. Cinman, MD
  • Brittney Clark, RN
  • Susan B. Clark, RN
  • Stephen T. Copen, MD
  • Stephen R. Corday, MD
  • Ram C. Dandillaya, MD
  • Catherine M. Dang, MD
  • Dudley S. Danoff, MD
  • Sharice E. Davis Deans
  • Premal J. Desai, MD
  • Suhail Dohad, MD
  • Gregory Dondanville
  • Noam Z. Drazin, MD
  • Julie A. Dunhill, MD
  • Cheryl L. Dunnett, MD
  • Leslie Duran, BSN, PCCN
  • Elitzafan Ebrahim Doost, RN
  • Karyn Eilber, MD
  • Asher Emanuel, MD
  • Shervin Eshaghian, MD
  • Fardad Esmailian, MD
  • Claudia Espinoza, LVN
  • Richard Essner, MD
  • Mariana Fayman, PA
  • Kristen M. Feldkamp, BSN, RN, CBN
  • Edward J. Feldman, MD
  • David E. Fermelia, MD
  • Marshal P. Fichman, MD
  • Carrie E. Fishman, CN
  • Cherry L Fos, BSN, RN, CMSRN
  • Stuart Friedman, MD
  • David M. Frisch, MD
  • Larry Froch, MD
  • Gerhard J. Fuchs, MD
  • Angel M. Fuentes
  • Clark B. Fuller, MD
  • Viliam Furdik, MD
  • Ramin Gabbai, MD
  • Srinivas Gaddam, MD
  • Steven S. Galen, MD
  • Anita B. Gattenuo
  • Ivor L. Geft, MD
  • Joel M. Geiderman, MD
  • Alexander Gershman, MD
  • Armando E. Giuliano, MD
  • Richard N. Gold, MD
  • Jay Goldberg, MD
  • Marie L. Gomez
  • Jeffrey S. Goodman, MD
  • Leo A. Gordon, MD
  • Steven B. Graff-Radford, DDS
  • Stephen L. Graham, MD
  • Violette G. Gray, MD
  • Abe Green, MD
  • Leland M. Green, MD
  • Lloyd B. Greig, MD
  • Denise Griggs, RN
  • Paul B. Hackmeyer, MD
  • Behrooz Hakimian, MD
  • Myron L. Hall, DPM
  • David S. Hallegua, MD
  • Solomon I. Hamburg, MD
  • Michele A. Hamilton, MD
  • Julius P. Har
  • Donald R. Henderson, MD, MPH
  • Andrew E. Hendifar, MD
  • Shaynan Hill, PharmD
  • David M. Hoffman, MD
  • Lalima A. Hoq, MD, MPH
  • Arash A. Horizon, MD
  • Joel T. Howard, RN
  • Gabriel E. Hunt Jr., MD
  • Fatouma Idris
  • Josefina N. Inocentes, RN
  • Jacqueline Jones, RN
  • Neel R. Joshi, MD
  • Kristina B. Juliano, RN
  • Steven Kamara, MD
  • Saibal Kar, MD
  • Sousan Karimi, MD
  • Beth Y. Karlan, MD
  • David Kawashiri, MD
  • Mehran J. Khorsandi, MD
  • Ali Khoynezhad, MD, PhD
  • Howard H. Kim, MD
  • Hyung L. Kim, MD
  • Asher Kimchi, MD
  • Cord Kirshner, RN
  • Michelle M. Kittleson, MD, PhD
  • Ellen B. Klapper, MD
  • Keith L. Klein, MD
  • Dee Dee L. Klute-Evans, MSN, RN, CIC
  • Jon A. Kobashigawa, MD
  • Anita P. Kovacic, MD
  • Michael A. Kropf, MD
  • Tamara Lay, RN
  • Gary E. Leach, MD
  • Madeline S. Lerman, BSN, RN
  • Keren Lerner, MD
  • Michael M. Levine, MD
  • Michael I. Lewis, MD
  • Richard A. Lewis, MD
  • Eric Ley, MD
  • Andrew J. Li, MD
  • Michael C. Lill, MD
  • Daniel E. Ling, MD
  • Peter G. Lopez
  • Shelly C. Lu, MD
  • Joan E. Lutz, RN
  • Hooman Madyoon, MD
  • David P. Magner, MD
  • Rajendra Makkar, MD
  • Adam N. Mamelak, MD
  • Philomena McAndrew, MD
  • Robert J. McKenna Jr., MD
  • Bridget D. McLoughlin, RN-BC, MSN, CCTC
  • Sharron L. Mee, MD
  • Karla L. Melendez
  • Dorothy T. Melvin
  • Edgar Mendoza
  • Alberto Mercado
  • Kiarash Michel, MD
  • Margo Minissian, MSN, RN, NP, ACNP-BC, CLS-BC, CNS
  • Nancy Moldawer
  • Alejandro Molina
  • Jaime D. Moriguchi, MD
  • Ariella A. Morrow, MD
  • Candice T. Myhre, MD
  • Mary C. Nasmyth, MD
  • Ronald B. Natale, MD
  • Reza Nazemi, MD
  • David G. Ng, MD
  • Mary Nhieu, RN
  • Julia K. Nicholls
  • Nicholas N. Nissen, MD
  • Paul W. Noble, MD
  • Arshia M. Noori, MD
  • Donald F. Nortman, MD
  • Adrian G. Ostrzega, MD
  • Shi-Hui Pan, PharmD
  • Maury D. Panameno
  • Ronald L. Paquette, MD
  • Dorothy J. Park, MD
  • Jignesh K. Patel, MD, PhD
  • Rajan M. Patel, MD
  • Chirag G. Patil, MD
  • Mark P. Patungan
  • Brad Penenberg, MD
  • Anne L. Peters, MD
  • Surasak Phuphanich, MD
  • Edwin M. Posadas, MD
  • Zosil Noemi Quilnet, RN
  • Danny Ramzy, MD, PhD
  • Alexandre Rasouli, MD
  • Edward Riceberg, MD
  • Madison F. Richardson, MD
  • Renee Z. Rinaldi-Ballard, MD
  • Miranda Ripper, RN
  • Kevin Robertson, PA
  • Joseph L. Robinson, MD
  • Rafael Rodriguez
  • Digna E. Romero
  • Robert M. Rose, MD
  • Sonja Louisa Rosen, MD
  • Barry E. Rosenbloom, MD
  • Fred P. Rosenfelt, MD
  • Howard L. Rosner, MD
  • Theresa O. Rumould
  • Ruth "Virginia" Russell, MD
  • Stephen A. Sacks, MD
  • Vivian L. Salle, RN
  • Bernadette T. Samuel
  • Jose Manuel Sarmiento, MD
  • Gregory P. Sarna, MD
  • Kevin Scher, MD
  • Payam Shadi, MD
  • Prediman K. Shah, MD
  • Aryanoosh A. Shakernia, RN
  • Kathryn L. Shameklis, MSN, RN
  • Bahman Shamloo, MD
  • Omid A. Shaye, MD
  • Michael M. Shehata, MD
  • Randolph Sherman, MD
  • Allan W. Silberman, MD, PhD
  • Alan G. Silverman, MD
  • Richard Sokolov, MD
  • Igor Spanic
  • Andrew Ira Spitzer, MD
  • Theodore N. Stein, MD
  • Jerrold H. Steiner, MD
  • Valentine Stewart, RN
  • Daniel J. Stone, MD, MPH, MBA
  • Leslie Stricke, MD
  • Ronald Sue, MD
  • Pamela J. Swan
  • Charles D. Swerdlow, MD
  • Steven Sykes, MD
  • Lillian Szydlo, MD
  • Steven W. Tabak, MD
  • Michele Tagliati, MD
  • Stephan R. Targan, MD
  • Melissa K. Tauer, RN
  • David B. Thordarson, MD
  • Gerardo Torres
  • Shirin Towfigh, MD
  • Tram T. Tran, MD
  • Alfredo Trento, MD
  • Elizabeth Rose Tria
  • Stefan A. Unterhalter, MD
  • Mark K. Urman, MD
  • Charisma S. Van Sickle, RN
  • Eric Vasiliauskas, MD
  • Swamy R. Venuturupalli, MD
  • Robert A. Vescio, MD
  • Ronald G. Victor, MD
  • Oksana Volod, MD
  • Olga Voroshilovsky, MD
  • Christine S. Walsh, MD
  • Jonathan M. Weiner, MD
  • Janet Y. White, MD
  • John Williams III, MD
  • Sandra K. Wilson, RN
  • Donald A. Wiss, MD
  • Albert P. Wong, MD
  • Clement C. Yang, MD
  • Michael C. Yang, MD
  • Payam R. Yashar, MD
  • Keyvan Yousefi, MD
  • Run Yu, MD
  • Amir Zadaka DNP, FNP-BC
  • Phillip C. Zakowski, MD
  • Raymond Zimmer, MD
  • Zachary Zumsteg, MD

P & T Approvals; Changes in Warnings, Labels for Aripiprazole, Metformin, Fluconazole, Brintellix

Pharmacy Focus

Highlights of the April meeting of the Pharmacy and Therapeutics Committee are summarized in the PDF link below. Also, the U.S. Food and Drug Administration issued a warning regarding reports of impulse-control issues with the use of aripiprazole, has revised the labeling for metformin and is evaluating a study that shows there is a possible increased risk of miscarriage with the use of oral fluconazole. And the agency has approved the name change of the antidepressant Brintellix to Trintellix.

P and T Approvals - April 2016 (PDF)  

FDA: Impulse-Control Problems Possible With Aripiprazole

The FDA issued a warning regarding reports of impulse-control issues (urges to binge eat, shop, gamble and have sex) with the use of the antipsychotic aripiprazole. These uncontrollable urges were reported to have stopped when the medicine was discontinued or the dose was reduced.

The FDA is recommending that healthcare providers alert patients and caregivers of these potential effects. Prescribers should consider reducing the dose or stopping the medication if patients develop these compulsive behaviors.

The FDA website has more information.

FDA Revises Metformin Warnings for Patients With Reduced Kidney Function

The FDA has revised the labeling for metformin regarding patients with impaired renal function.

The FDA concluded, from its review of studies published in the medical literature, that metformin can be used safely in patients with mild impairment in kidney function and in some patients with moderate impairment in kidney function. FDA is requiring changes to the metformin labeling to reflect this new information and provide specific recommendations on the drug's use in patients with mild to moderate kidney impairment.

The FDA website has more information.

FDA Evaluating Use of Oral Fluconazole in Pregnancy

The FDA is evaluating a study that shows there is a possible increased risk of miscarriage with the use of oral fluconazole (Diflucan) for yeast infections.

Until FDA's review is complete and more is understood about this study and other available data, FDA advises cautious prescribing of oral fluconazole in pregnancy.

The FDA website has more information.

Brintellix Changes Name to Trintellix to Avoid Confusion With Brilinta

The FDA has approved the name change of the antidepressant Brintellix to Trintellix to avoid confusion with Brilinta (ticagrelor). Prescribers are advised to include generic names to avoid confusion in the interim. Trintellix tablets will look the same as the previously named Brintellix tablets but will have a new NDC number.

The FDA website has more information.