sutures newsletter

PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY February 2017 | Archived Issues

Mark Your Calendar

81‐Year‐Old Man With Weakness and Edema (Case of the Quarter)
March 3

Into the Abyss: From Obamacare to Trumpcare (Ethics Noon Conference)
March 15

Harnessing Stress Management and Emotional Intelligence to Enhance Performance and Fulfillment: A Skills Lab for Healthcare Professionals
March 18

» See more meetings and events


Surgery Grand Rounds

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

» Read more


Grand Rounds

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


Education Schedule

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

Education Schedule - February 2017 (PDF)

Education Schedule - March 2017 (PDF)


Surgery Scheduling

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

» Read more

Symposium Identifies Research Needs in Brain Injuries

RMI 1 callout

Leading scientists and clinicians from around the country gathered recently at Cedars-Sinai for the 2017 Regenerative Medicine Institute Symposium to present their latest research and identify the most pressing areas for further study about traumatic brain injury and sports concussions.

» Read more

Sleep Apnea Center Involved in New Clinical Trial

The Cedars-Sinai Sleep Apnea Center is involved with a new clinical trial for obstructive sleep apnea patients who are CPAP intolerant. Using a pacemaker-like nerve stimulator, an electrode wrapped around the XII cranial nerve is stimulated to relieve the obstructing event in obstructive sleep apnea.

» Read more

Two Minutes With …

Truong, Adam

This question-and-answer feature will help you get to know some of the faculty in the Cedars-Sinai Department of Surgery. This month's installment features Adam Truong, MD.


» Read more

Illig to be Guest Lecturer at Vascular Day March 15

Karl Illig, MD, director of the Division of Vascular Surgery at the University of South Florida Morsani College of Medicine, will be a guest lecturer at Vascular Day at Cedars-Sinai on Wednesday, March 15. Illig's major clinical and academic areas of interest are thoracic outlet syndrome and arteriovenous access, including treatment of advanced problems.

» Read more

FDA Warns of Rare, Severe Reaction to Chlorohexidine Gluconate

The U.S. Food and Drug Administration recently issued a warning about a rare but severe IgE-mediated allergic reaction to chlorhexidine gluconate, a commonly used over-the-counter and prescription skin antiseptic product. The FDA safety communication is a reminder to always obtain and document patient allergies prior to administration of medication or topical agent.

» Read more

Research Day Highlights Hearts and Minds

Cardiologist Christine Seidman co

Christine and Jonathan Seidman lend new meaning to William Shakespeare's poetic paean to love: "the marriage of true minds." As co-directors of the pioneering Seidman Lab at Harvard Medical School, they are partners in both life and science. The Seidmans met in an undergraduate biology class at Harvard University and married in 1973. On Jan. 13, they shared their unique insights at an annual showcase of Cedars-Sinai's research achievements.

» Read more

Surgeon Writes about Healthcare Under Trump

David V. Cossman, MD

David V. Cossman, MD, co-director of Vascular Trauma and co-medical director of the Vascular Laboratory, wrote a piece for General Surgery News about what healthcare can expect from the Trump presidency.


» Read more

Circle of Friends Honorees for January

CoF

The Circle of Friends program honored 194 people in January. 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

CS-Link Tip: Updating Immunization Orders

cs-link logo

Here are some helpful tips to navigate CS-Link™ if you are updating immunizations, writing compounded medications and taking more than one set of vitals.

» Read more

Symposium Identifies Research Needs in Brain Injuries

RMI 1 480px

Ann McKee, MD, professor of Neurology and Pathology at Boston University School of Medicine, called for more research on brain trauma at the 2017 Regenerative Medicine Institute Symposium.

Leading scientists and clinicians from around the country gathered recently at Cedars-Sinai for the 2017 Regenerative Medicine Institute Symposium to present their latest research and identify the most pressing areas for further study about traumatic brain injury and sports concussions.

The two-day symposium, "Regeneration and Neurological Trauma: From the Playing Field to the Battle Field," was co-sponsored by the Cedars-Sinai Board of Governors Regenerative Medicine Institute, the Department of Surgery and the Kerlan-Jobe Institute, a Cedars-Sinai affiliate.

The meeting highlighted several new studies that advanced understanding of how head trauma can temporarily, and sometimes permanently, alter brain physiology. While nodding to the promising new research, speakers called for additional work to expand the field’s still-limited knowledge about the brain.

"It’s the most complex organ in our body, and we know the least about it," retired U.S. Army Col. Dallas Hack, MD, former director of the Combat Casualty Care Research Program at Fort Detrick, Maryland, told the audience at Harvey Morse Auditorium on Friday, Feb. 10.

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Gretchen Thomsen, PhD, a research scientist at Cedars-Sinai, discussed her recent study that showed the lasting impact of repeated concussions.

In the symposium's keynote speech, Peter Rhee, MD, senior vice president and chief of trauma at Grady Health System in Atlanta, urged physicians to treat gunshot wounds to the brain more aggressively. Only about 10 percent of these patients typically survive, he said.

Rhee, who treated former U.S. Rep. Gabrielle Giffords after she was shot in the head in 2011, advocated a regimen that includes transfusion of blood products and treatment to control brain swelling. At the University of Arizona Medical Center in Tucson, this regimen raised the survival rate to 46 percent for brain-injured gunshot victims, Rhee said.

"If you manage these people with a different philosophy, you'll have a better outcome," he said.

Contact Sports, CTE and Concussions

In another lecture, Ann McKee, MD, professor of Neurology and Pathology at Boston University School of Medicine, widely viewed as one the nation’s top experts on chronic traumatic encephalopathy (CTE), discussed the progressive degenerative disease and its links to contact sports such as football, hockey and boxing. The disease, which can cause memory loss, explosive behavior, depression and dementia, has garnered vast media attention largely because of its potential impact on athletes in the National Football League.

CTE currently has no treatment or cure. The disease, which is characterized by deposits in the brain of an abnormal protein called tau, can only be diagnosed post-mortem.

"Let’s figure out a way to prevent this disease, a way to treat this disease," said McKee. "We want to give hope, inspiration and optimism to players who are worried they have it. Right now, we can’t."

While concern over concussions, especially for parents weighing whether to let their children play tackle football, has come to dominate the national conversation, the available evidence suggests the more pronounced danger may lay elsewhere. Rather than a single injury to the brain, it is repeated mild trauma over a period of years that appears to have the clearest relationship to future brain impairment, said McKee and other scientists at the symposium. About 16 percent of people with CTE never experienced a diagnosed concussion, she added.

Research about CTE is just beginning, said McKee, who offered a list of the most urgent questions, including:

  • How common is CTE?
  • Can anyone get CTE or is there a genetic susceptibility?
  • Are young brains more susceptible to CTE?
  • Once it starts, how does it spread even though there is no more trauma?
  • Does CTE provoke other neurodegenerative diseases?

Working to provide insight into CTE is Gretchen Thomsen, PhD, a research scientist at Cedars-Sinai. Thomsen discussed her recent findings that showed the lasting impact of repeated concussions. The study, which was done in collaboration with Eric Ley, MD, director of Cedar-Sinai’s Surgical Intensive Care Unit in the Department of Surgery, may help lead to models to test potential therapies.

In the Clinic and On the Football Field

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Ben Utecht, a former NFL player, (right) and Alecko Eskandarian, a former MLS player, talk about their experiences with concussions during an evening panel.

From a clinical perspective, Vernon Williams, MD, with the Kerlan-Jobe Institute, said it’s been challenging to educate athletes about what happens inside the brain during a concussion. It takes at least a couple of days for cerebral blood flow to return to normal, he explains to athletes. Force of will cannot reverse the physical symptoms of a concussion, he added.

"This is not something you can just shake off because you’re tough," said Williams. "The culture of sports is so strong, and so is the power of denial. People will either underreport, minimize or not report symptoms at all even though they know it might be in their best interests."

Few understand the difficulty of an athlete voluntarily stepping off the playing field more than Ben Utecht, a former NFL player who spoke at a symposium panel on Thursday, Feb. 9. Utecht, who suffered numerous concussions during his career and later wrote Counting the Days While My Mind Slips Away: A Love Letter to My Family, explained the game is a powerful source of identity for players that often transcends fame and money.

"You can take away the millions of dollars and many players would still want to play," said Utecht, who once testified at a congressional hearing about the long-term effects of concussions.

Still, extensive media attention about concussions and CTE has produced an unexpected consequence that Williams observed is playing out with increasing frequency in his clinic. Amid the swirl of highly publicized tragedies linked to CTE, some young athletes who have suffered a concussion are catastrophizing their relatively minor symptoms.

"I’ve had patients fill in the new-patient history form, and in the chief complaint section it doesn’t say headaches or dizziness," said Williams. "It says CTE."

Sleep Apnea Center Involved in New Clinical Trial

By Narine Vardanyan, MHA

The Cedars-Sinai Sleep Apnea Center is involved with a new clinical trial for obstructive sleep apnea patients who are CPAP intolerant. Using a pacemaker-like nerve stimulator, an electrode wrapped around the XII cranial nerve is stimulated to relieve the obstructing event in obstructive sleep apnea.

The hypoglossal nerve is stimulated cyclically and continuously during sleep to maintain muscle tone of the tongue and upper airway during sleep. Stimulation is generated by a programmable, multi-current source, implantable neurostimulator and delivered to the hypoglossal nerve by a lead with a multicontact cuff electrode (lead).

The five-year study began in December 2015, and so far more than 400 patients have been screened and five patients have undergone the procedure at Cedars-Sinai. The procedure is available for patients who cannot wear CPAP, as well as several exclusion and inclusion criteria.

The Sleep Apnea Center consists of a multidisciplinary team including otolaryngologists, pulmonologists, dentists, medical and surgical weight-loss specialists, sleep professionals and technologists, as well as allied healthcare professionals who treat patients who have failed with CPAP therapy. Other services of the Sleep Apnea Center include drug-induced sleep endoscopy, robotic tongue surgery and Inspire XII nerve stimulation surgery.

Physicians within the center meet regularly and participate in a quality assurance program assessing urinary and sexual health and obstructive sleep apnea.

For more information, please contact Arash Shamsian, clinical coordinator, at 310-779-8657 or email cedars.sinai.sinus@gmail.com.

Two Minutes With …

This question-and-answer feature will help you get to know some of the faculty in the Cedars-Sinai Department of Surgery.

Adam Truong, MD, general surgery resident

Where did you grow up?

In the voice of Guy Fieri, I grew up in sunny Huntington Beach, California, where the sand was hot and the waves were cool.

Why did you decide to specialize in surgery?

It is a privilege to diagnose and treat patients medically. Furthermore, the capability to physically reshape their pathology is a gift.

What is the most rewarding aspect of your job?

The inherent apprenticeship model of surgical training allows me to interact with so many residents and attendings whom I idolize.

What did your parents always tell you that now you have to admit was correct?

There is nothing better than a hot bowl of pho during a post-call day.

If you could spend the day doing one thing, what would it be?

I would be pedaling on two wheels at 30 miles per hour, gazing at nothing but open road in the distance.

If you were not a physician, what other career would you choose?

Taco Bell taste tester. I would want to be the first to try the next genius product from the company that made cool ranch Doritos a taco shell.

Illig to be Guest Lecturer at Vascular Day March 15

Karl Illig, MD

Karl Illig, MD, director of the Division of Vascular Surgery at the University of South Florida Morsani College of Medicine, will be a guest lecturer at Vascular Day at Cedars-Sinai on Wednesday, March 15.

Illig's major clinical and academic areas of interest are thoracic outlet syndrome and arteriovenous access, including treatment of advanced problems. He has published over 100 peer-reviewed manuscripts, 40 chapters, multiple invited reviews and commentaries, and two books, including a multiauthor textbook on thoracic outlet syndrome.

Illig also helped develop the concept that the venous thoracic outlet plays an important role in many patients with arteriovenous access dysfunction. He has surgically treated over 90 people with this condition, using a procedure that is increasingly being performed elsewhere in the world.

A distinguished academic fellow of the Society for Vascular Surgery, Illig is a past president of the Vascular and Endovascular Surgical Society and a member of the American Surgical Association. He also serves on the Vascular Surgery Board of the American Board of Surgery, where he has been a senior board examiner for the past nine years.

To learn more about Vascular Day, a continuing medical education activity supported by the Sanford Rosenbaum Endowed Lectureship, click the PDF link below.

Vascular Day 2017

FDA Warns of Rare, Severe Reaction to Chlorohexidine Gluconate

The U.S. Food and Drug Administration recently issued a warning about a rare but severe IgE-mediated allergic reaction to chlorhexidine gluconate, a commonly used over-the-counter and prescription skin antiseptic product.

The FDA safety communication is a reminder to always obtain and document patient allergies prior to administration of medication or topical agent.

Chlorhexidine, found in such products as Peridex and Hibiclens, has been widely used for decades and allergic reactions are exceptionally rare. To date, no such severe reactions have occurred at Cedars-Sinai.

The FDA safety communication does not change the evidence-based, guideline-supported role of chlorhexidine-based products in prevention of various hospital-acquired infections.

Patients who develop signs or symptoms of an allergic reaction should have the product discontinued immediately. As with any severe drug-related reaction, please report any occurrence through MIDAS.

The FDA website has more information.

Research Day Highlights Hearts and Minds

Cardiologist Christine Seidman

Cardiologist Christine Seidman, MD, of Harvard Medical School lectures at Research Day VIII.

Christine and Jonathan Seidman lend new meaning to William Shakespeare's poetic paean to love: "the marriage of true minds." As co-directors of the pioneering Seidman Lab at Harvard Medical School, they are partners in both life and science. The Seidmans met in an undergraduate biology class at Harvard University and married in 1973.

Their longtime partnership has produced three children and reams of breakthrough research about the genetic causes of cardiovascular disease, including congenital heart malformations and cardiomyopathies — diseases of the heart muscle.

Research lab assistant Lizbeth Sanchez

Research lab assistant Lizbeth Sanchez discusses her research poster with Robin Shaw, MD, PhD (blue shirt), and Eugenio Cingolani, MD.

On Jan. 13, they shared their unique insights at an annual showcase of Cedars-Sinai's research achievements. Cardiologist Christine Seidman, MD, and geneticist Jonathan Seidman, PhD, delivered back-to-back keynote presentations at Research Day VIII to a capacity crowd in Harvey Morse Auditorium. Their talks were followed by a poster session displaying scores of collaborative research studies at Cedars-Sinai.

In introducing the Seidmans, Kenneth Bernstein, MD, director of Experimental Pathology and professor of Biomedical Sciences and Pathology and Laboratory Medicine at Cedars-Sinai, shared a comment by Christine Seidman about the duo's dual roles: "It's fun to have a good idea over the weekend and be able to go and talk to your closest scientific collaborator right then and there."

Jonathan Seidman chronicled the pair's investigations of congenital heart disease, the most common birth defect. "We wanted to understand its genetic basis," he said. Numerous Seidman-spearheaded studies and collaborations point to a genetic disruption during development of the embryonic heart as a cause of this disease.

The research also found that neurocognitive issues are common among children with severe congenital heart disease. These issues are attributable, in part, to genetic mutations that alter critical pathways for both heart and central nervous system development, they have shown.

"The same genes that cause congenital heart disease in kids also affect development of their neurologic systems," Jonathan Seidman said.

As Christine Seidman took her turn at the lectern, she acknowledged her husband’s role in the genetics of congenital heart disease. "As an adult cardiologist," she continued, "I spend much more time thinking about the community of individuals who are born with a perfectly normal heart that deteriorates over time."

The Seidmans' research has prompted a major shift in views of one type of deterioration, dilated cardiomyopathy, a condition that reduces the heart's ability to pump blood. For a long time, this condition was thought to be caused by an infection or toxins. Skeptical of this view, the Seidman team turned its attention to an extremely important, but at the time largely uninvestigated, protein called titin.

Titin is the largest human protein, containing more than 30,000 amino acids. The Seidman Lab became the first to take on the titanic task of sequencing the gene that codes this super-sized protein.

Showing a slide that encapsulated five years of work, Christine Seidman explained that the lab's study uncovered titin mutations. "These mutations are really driving dilated cardiomyopathy. That's the titin story, and it's something new and ongoing," she said. The Seidmans are further credited with demonstrating that all cardiomyopathies have a genetic cause.

"I hope we've provided evidence that genetics is incredibly important in human heart formation," Christine Seidman said. "With that insight, we are very optimistic that there's going to be a wealth of new therapeutics. In the future, if we can begin to recognize early those who have these mutations, then we can prime them with drugs that limit the mutations' development."

After the Seidmans' tag-team talks, attendees strolled through several aisles of research posters focusing on myriad medical topics, including epithelial ovarian cancer, hip disease, multiple sclerosis, non-small cell lung cancer, Parkinson's disease, prostate tumors and renal cancer.

The exhibit space buzzed with collegial conversations. A poster submitted by Lizbeth Sanchez, a research lab assistant in the Marbán Laboratory, for instance, sparked a lively discussion about converting heart ventricular cells into pacemaker cells and potentially using them to replace implanted electronic pacemakers.

Graduate student Kellee Murayama was interested in a research poster from fellow student Rachel Baum, whose study identified a decrease in the protein cBIN1 as a potential marker for advanced heart failure.

"It's good to walk around and see what other people are studying," Murayama said. Baum agreed: "Seeing all of the different studies also gives you ideas for possible collaborations," she said.

Three prizes were awarded for the best research posters:

  • First prize — Shirley Cheng, research lab assistant, for "Bio-Competition-based Smart NanoVelcro Chip for Isolation and Expressional Analysis of Circulating Tumor Cells from Prostate Cancer Patients," from the laboratory of Edwin Posadas, MD, medical director of the Urologic Oncology Program at the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute.
  • Second prize — Eugenia Lin, clinical research coordinator for GI-Motility in the Cedars-Sinai Department of Medicine, Division of Gastroenterology, for "Examination of the Effects of Breath Hydrogen Levels on EC/IR II," from the laboratory of Mark Pimentel, MD, director of the GI Motility Program and GI Motility Laboratory.
  • Third prize — Graduate student Mecca Madany for "Delineating the Role of ZEB1 Loss in the Chemo and Radioresistance of Glioma Stem Cells," from the laboratory of Beth Karlan, MD, director of the Women's Cancer Program at the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute.

Capacity crowd fills Harvey Morse Auditorium for the Research

A capacity crowd fills Harvey Morse Auditorium for the Research Day VIII keynote speeches.

Surgeon Writes about Healthcare Under Trump

David V. Cossman, MD, co-director of Vascular Trauma and co-medical director of the Vascular Laboratory, wrote a piece for General Surgery News about what healthcare can expect from the Trump presidency.

Here's an excerpt from the article that ran with the headline Make Surgery Great Again:

The language of campaigns is hyperbolic and metaphoric. Trump doesn't need to physically build a wall between the United States and Mexico to enforce immigration laws already on the books, just as Obama didn't need to shutter Guantánamo Bay to pursue a foreign policy radically different from his predecessors.

The ACA might be hard to kill even with a willing president and Congress. It survived two Supreme Court challenges, and has some popular features, such as providing insurance for 20 million previously uninsured, preventing cancellation for pre-existing conditions and allowing children to stay on a parent's policy until age 26. Having mocked Obama for five years for promising the ACA would allow you to keep your policy if you liked it, the Republicans run a big risk if they turn around and rescind the newly acquired insurance of 20 million Americans.

To read the entire article, see the website of General Surgery News. (To access the article, you must create a login, which is free.)

Circle of Friends Honorees for January

The Circle of Friends program honored 194 people in January.

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.

  • Gabrielle L. Adem, BSN, RN
  • Nelli A. Akopyan, RN
  • Michael J. Alexander, MD
  • Paula J. Anastasia Davis, MN, RN, AOCN
  • Ronald M. Andiman, MD
  • Lilia G. Ayap
  • C. Noel Bairey Merz, MD
  • Guita Balakhane, MD
  • Ilana Banafsheian
  • Garen Barani
  • Paula A. Barondess
  • Joanne Belgarde, MD
  • Robert M. Bernstein, MD
  • Keith L. Black, MD
  • Eileen G. Brown, OCN, RN
  • Kerri M. Brown, RN
  • Miguel A. Burch, MD
  • Kathleen A. Cantos
  • Ilana Cass, MD
  • Rhona M. Castillo, RN
  • Dorrie Chang, MD
  • Kirk Y. Chang, MD
  • Cheryl G. Charles, MD
  • Ray M. Chu, MD
  • Sumeet S. Chugh, MD
  • Susan B. Clark, RN
  • Donald S. Cohen, MD
  • Jason S. Cohen, MD
  • Steven D. Colquhoun, MD
  • Stephen T. Copen, MD
  • Stephen R. Corday, MD
  • Kenneth A. Corre, MD
  • Alice C. Cruz, MD
  • Moise Danielpour, MD
  • Azadeh Dashti, MD
  • Lloyd W. Davis Jr.
  • Robert W. Decker, MD
  • Josef A. Degendorfer
  • Kelly A. Delarosa Vardanian
  • Premal J. Desai, MD
  • Alice R. Dick, MD
  • Suhail Dohad, MD
  • Noam Z. Drazin, MD
  • Julie A. Dunhill, MD
  • Fardad Esmailian, MD
  • Richard Essner, MD
  • Joy S. Feld, MD
  • Edward J. Feldman, MD
  • Carrie E. Fishman, CN
  • Phillip R. Fleshner, MD
  • Katherine J. Fogg
  • Charles A. Forscher, MD
  • Rebecca Freeman, MD
  • Maria Rowena Garcia
  • Ivor L. Geft, MD
  • Mitch Gheorghiu, MD
  • Armando E. Giuliano, MD
  • Richard N. Gold, MD
  • Jeffrey S. Goodman, MD
  • Gelsey Lauren Goodstein, MD
  • Stephen L. Graham, MD
  • Robin Gryczman Rosen
  • Paul B. Hackmeyer, MD
  • Antoine Hage, MD
  • Jennifer Hajj, RN
  • David S. Hallegua, MD
  • Omid Hamid, MD
  • Michele A. Hamilton, MD
  • Donald R. Henderson, MD, MPH
  • Andrew E. Hendifar, MD
  • Timothy D. Henry, MD
  • Jeremy R. Herman, MD
  • Shao-Jung A. Hu (Angel), CNIII
  • Leonel A. Hunt, MD
  • Mariko L. Ishimori, MD
  • Laith H. Jamil, MD
  • Christine M. Johnson, RN
  • Amy M. Jones, RN
  • Nicole E. Jones, LVN
  • Stanley C. Jordan, MD
  • Peter Julien, MD
  • Daniella Kamara
  • Saibal Kar, MD
  • Beth Y. Karlan, MD
  • Jane Y. Kauffman, MD
  • Walter F. Kerwin, MD
  • Mehran J. Khorsandi, MD
  • Chae Young Kim, MD
  • Hyung L. Kim, MD
  • Asher Kimchi, MD
  • Jon A. Kobashigawa, MD
  • Molly Koehler, DO
  • Vicky L. Lees-Kim
  • Madeline S. Lerman, BSN, RN
  • Keren Lerner, MD
  • Ronald S. Leuchter, MD
  • Michael M. Levine, MD
  • Michael S. Levine, MD
  • Andrew J. Li, MD
  • Michael C. Lill, MD
  • Milton Little, MD
  • Simon K. Lo, MD
  • Patrick D. Lyden, MD
  • Raul A. Maclang
  • Rajendra Makkar, MD
  • William J. Mandel, MD
  • Malcolm L. Margolin, MD
  • Cynthia M. Martin
  • David N. Matsumura, MD
  • Philomena McAndrew, MD
  • Dermot McGovern, MD, PhD
  • Gil Y. Melmed, MD, MS
  • Tamar Meszaros, MD
  • Richard J. Metz, MD
  • Margo Minissian, MSN, RN, NP, ACNP-BC, CLS-BC, CNS
  • Monica M. Mita, MD, MDSc
  • Cyrus Mody, MD
  • Avinash Mondkar, MD
  • Ronald B. Natale, MD
  • Tsegie Negussie
  • Nicholas N. Nissen, MD
  • Arshia M. Noori, MD
  • Sara Oliva, BSN, RN, OCN
  • Katayoun Omrani, DDS
  • Shi-Hui Pan, PharmD
  • Jignesh K. Patel, MD, PhD
  • Deborah J. Payne, RN
  • Rachel C. Pearl, MD
  • Brad Penenberg, MD
  • Brian Perri, DO
  • Andrea Perry
  • Edward H. Phillips, MD
  • Charles Pollick, MD
  • Edwin M. Posadas, MD
  • Maricar L. Posadas, RN
  • Dale Prokupek, MD
  • Soroush A. Ramin, MD
  • Tania K. Ranasinghe, RN
  • Jon Rasak, MD
  • Ali Rezaie, MD
  • Tracie L. Richardson
  • Renee Z. Rinaldi-Ballard, MD
  • Dawn K. Robertson, LCSW
  • Sonja Louisa Rosen, MD
  • Barry E. Rosenbloom, MD
  • Howard L. Rosner, MD
  • Jeremy D. Rudnick, MD
  • Howard M. Sandler, MD, MS
  • Marikit Villafranca Santiago, BSN, RN
  • Gregory P. Sarna, MD
  • Jay N. Schapira, MD
  • Kevin Scher, MD
  • Prediman K. Shah, MD
  • Kathryn L. Shameklis, MSN, RN
  • Michael M. Shehata, MD
  • Jeffrey H. Sherman, MD
  • John L. Sherman, MD
  • Vivian N. Shirvani, MD
  • Nancy L. Sicotte, MD
  • Allan W. Silberman, MD, PhD
  • R. Kendrick "Ken" Slate, MD
  • Ann E. Smith
  • Andrew Ira Spitzer, MD
  • Theodore N. Stein, MD
  • Jerrold H. Steiner, MD
  • Gayane Stepanyan, RN
  • Leslie Stricke, MD
  • Ronald Sue, MD
  • Steven W. Tabak, MD
  • Stephan R. Targan, MD
  • Danielle M. Tate, CN I
  • Jeffrey B. Tirengel, PsyD
  • Analisa Traba, RN
  • Tram T. Tran, MD
  • Alfredo Trento, MD
  • Mark K. Urman, MD
  • Michael B. Van Scoy-Mosher, MD
  • Eric Vasiliauskas, MD
  • Anabel Vazquez
  • Yvette Velazquez
  • Robert A. Vescio, MD
  • Daniel J. Wallace, MD
  • Xunzhang Wang, MD
  • Alan Weinberger, MD
  • Maria Fe M. White, MSN, RN, NP, ACNP-BC, FNP-BC
  • Ravyn Williams, NP
  • Matthew T. Wilson, MD
  • Robert N. Wolfe, MD
  • Jennifer S. Won, RN
  • Clement C. Yang, MD
  • Evan M. Zahn, MD
  • Christopher Zarembinski, MD
  • Raymond Zimmer, MD
  • Millard H. Zisser, MD

CS-Link Tip: Updating Immunization Orders

Here are a few tips for navigating CS-Link™ in the new year:

  • When it comes to updating immunizations that are ordered and not given, the option to defer immunization orders will no longer be available. Please use the "delete" option and reorder the vaccination as needed at a future date.
  • When writing compounded medications, remember they cannot be e-prescribed. For nonscheduled compounded medications ordered as an outpatient prescription, the order class will now be defaulted to "normal," which will automatically e-fax the medications to the pharmacy. For scheduled medications, the default will be "no print," and will require a written prescription. (Compounded medications are not eligible for EPCS and controlled substances cannot be e-faxed.)
  • When taking more than one set of vitals, use the link: vitalsmultiple. This link will display the comments and is useful for orthostatic vitals.

If you have questions, email groupeisphysicians@cshs.org.