sutures newsletter

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

Studying Ways to Prevent VTEs in Trauma Patients

By Russell Mason, PharmD, BCPS

As a critical care pharmacist, I collaborate with the teams involved in patient care in the Surgical Intensive Care Unit. One of my personal goals is to reduce the incidence of venous thromboembolism for our patients in the SICU.

» Read more

Sim Center Stages Accident for Teen Driving Program

Drunk Driving Simulation callout

Cedars-Sinai helped Beverly Hills High School stage a bloody car accident with two teen victims to demonstrate the dangers of drunk and distracted driving. Much of the scene was filmed inside the Women’s Guild Simulation Center for Advanced Clinical Skills and will be shown to high school students.

» Read more

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. This month's installment features Karen Zaghiyan, MD.



» Read more

Topics Sought for Morgenstern Debate

Morgenstern

The 14th annual Dr. Leon Morgenstern Great Debates in Clinical Medicine Resident Competition will convene on Friday, June 2. The debate committee is soliciting topics that are timely and relevant to all specialties.



» Read more

Here Is Your Chance to Honor a Deserving Nurse

In Hollywood, actors are nominated for an Oscar. At Cedars-Sinai, the best nurses are nominated for a Maggie. Online nominations for the 2017 Maggie Stempson-Carter Excellence in Caring Award for eligible nurses are open through Monday, April 3.

» Read more

Delivering Prescriptions for Student Success

Cedars-Sinai faculty members recently shared their expertise and enthusiasm for medicine during Career Day at John Burroughs Middle School in Hancock Park, interacting with nearly 500 students. Their visit was the first public outreach initiative coordinated by the newly minted Cedars-Sinai Faculty Diversity Ambassadors group.

» Read more

Study to Examine Opioid Use, Chronic Pain Patients

Opioid Use and Chronic Pain callout

Cedars-Sinai investigators are gearing up to study the most effective ways for doctors to discuss opioid use with chronic pain patients in an effort to reduce the impact of pain while curbing overuse of these addictive drugs. The research team has received $2 million from the Patient-Centered Outcomes Research Institute to conduct the study, which launches this year.

» Read more

Acker to Lecture on Cardiac Surgery March 31

Michael A. Acker, MD, will give a special lecture at Cedars-Sinai on "Transparency, Public Reporting and a Cultural Shift to Quality and Safety in Cardiac Surgery" at Cedars-Sinai on Thursday, March 31. Presented by the Department of Surgery, the hourlong lecture begins at 9 a.m. in the Advanced Health Sciences Pavilion PEC 5.

» Read more

Trauma Care Course Hosted by Cedars-Sinai

The Department of Surgery's Trauma Program hosted a Trauma Care After Resuscitation (TCAR) course in March. TCAR is a nursing trauma course designed specifically for acute, critical care and perioperative nurses.

» Read more

Reminder About Antimicrobial Use Guidelines

The Cedars-Sinai Antimicrobial Stewardship Committee publishes specific antimicrobial use guidelines, incorporating current literature and local resistance patterns. Resources include empiric treatment recommendations for frequently encountered bacterial and fungal infections, as well as recommendations for duration of antimicrobial therapy.

» Read more

Circle of Friends Honorees for February

CoF

The Circle of Friends program honored 179 people in February. 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

New Correction Factor for AST Coming in Core Labs

The Core laboratories in the Department of Pathology and Laboratory Medicine will be implementing a new correction factor for aspartate aminotransferase run on Ortho Vitros analyzers in April.

» Read more

Cortisol Announcement

The Core laboratories in the Department of Pathology and Laboratory Medicine will discontinue separate test codes for AM and PM cortisol (i.e., CORTAM, CORTPM) beginning Monday, April 10.

» Read more

Medical Library Has New Database

Do you need to find articles on healthcare administration or management? Want to read Harvard Business Review articles online? The publications can be accessed in Cedars-Sinai Medical Library's new database, Health Business Elite.

» Read more

CS-Link Tip: Try UpToDate Feature

cs-link logo

You can navigate from CS-Link™ to UpToDate, which is accredited by the Accreditation Council for Continuing Medical Education. UpToDate is a point-of-care tool that allows clinicians to research clinical problems and earn credit for continuing medical education, continuing education and continuing professional development.

» Read more

Studying Ways to Prevent VTEs in Trauma Patients

By Russell Mason, PharmD, BCPS

As a critical care pharmacist, I collaborate with the teams involved in patient care in the Surgical Intensive Care Unit (SICU). My role is to meticulously evaluate medication regimens for efficacy, drug and disease state interactions, appropriate dosing and potential for adverse events.

I round daily with the SICU team and bring a pharmacist's unique perspective when assessing patients and their progress towards therapeutic goals, conveying my recommendations regarding medication regimens. In addition, I mentor pharmacy students and residents who are on rotation in the SICU. One of my personal goals is to reduce the incidence of venous thromboembolism (VTE) for our patients in the SICU.

Trauma patients are especially at increased risk of VTE due to the nuances of Virchow's triad, namely endothelial injury, hypercoagulability and stasis. Enoxaparin is the drug of choice for the prevention of VTE in trauma patients who do not have a contraindication to its use.

Cedars-Sinai researchers have previously demonstrated, by measuring trough anti-Xa levels, that the conventional prophylactic dose of 30 mg SQ q 12 hours may be inadequate for the prevention of VTE. Those trauma patients with levels less than 0.1 are at increased risk of VTE.

However, no studies evaluated whether adjusting enoxaparin dose to maintain adequate trough levels reduces VTE. So, in our most recent study, we evaluated whether adjusting enoxaparin to reach a goal anti-Xa trough level reduced VTE in trauma patients. We determined that a high percentage of patients (83.9 percent) had anti-Xa levels below goal and required dose adjustments to reach goal levels.

Furthermore, our study demonstrated a significant decrease in clinically diagnosed VTE rates when those patients with enoxaparin adjusted by anti-Xa were compared to those who were not (1.1 percent vs 7.6 percent, p=0.046). Bleeding, hematocrit or transfusion rates were comparable between groups, and the majority of the patients required enoxaparin 40 mg SQ q 12 hours for VTE prophylaxis.

Based on the results of this study, we now initiate VTE prophylactic dosing at 40 mg SQ q 12 hours in most trauma patients with normal renal function.

I continue to work with the SICU team to collect steady-state trough anti-Xa levels to be certain the enoxaparin is in the appropriate range, and I monitor trough anti-Xa levels weekly. In addition, the Department of Pharmacy Services is working with the trauma service to develop a pharmacist-driven protocol to ensure that enoxaparin is appropriately dosed by anti-Xa levels in trauma patients.

We are excited to collaborate with physicians to develop this protocol so that patients will receive appropriate medication dosing and monitoring. If you are interested in this project or other collaborations, please stop by the SICU and say hello.

Sim Center Stages Accident for Teen Driving Program

Drunk Driving Simulation 480px

Cedars-Sinai hosted students from Beverly Hills High School who participated in a staged accident to promote better driving habits.

Two bloodied teenagers from Beverly Hills High School arrived in a pair of ambulances at Cedars-Sinai on a recent Monday morning. Firefighters placed the injured teens on stretchers and rushed away the victims of a drunk driving accident.

It was a terrifying scene — until someone yelled, "Cut."

Fortunately, the accident was staged and the teenagers had been professionally made up with fake wounds and blood. The scene was part of a high school program called "Every 15 Minutes," which graphically re-creates the dangers of drunk and distracted driving.

The two teens were brought into the Women’s Guild Simulation Center for Advanced Clinical Skills, where doctors and nurses role played. They intubated the patients and performed other emergency procedures.

"It felt so real, it was shocking," said Maia Yosef, a Beverly Hills High School student who played one of the victims. In the scenario, she was pronounced dead at the hospital.

The event was filmed and will be shown to other students as part of a safe driving campaign.

"I wanted to be a part of this because I know it saves lives," added Yosef. Her message to students: "Be responsible, be safe and make good decisions."

The Geri and Richard Brawerman Nursing Institute and the Department of Surgery’s Trauma Program once again collaborated with Beverly Hills High School this year to help present the awareness program.

"Along with supporting our community, our participation in this events helps Cedars-Sinai meet the requirements for ongoing certification as a Level 1 trauma center and supports our mission to improve the health status of the community we serve," said Brett A. Dodd, BSN, RN, a trauma education, injury prevention and outreach coordinator with the Department of Surgery.

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.

Karen Zaghiyan, MD

Karen Zaghiyan, MD, colorectal surgeon


Where did you grow up?

I grew up in Glendale, a Los Angeles suburb with the second-largest Armenian population in the world. My family and I moved there after immigrating to the United States in the 1980s. My parents and brother still live there, and I spend much time in Glendale on the weekends with my husband, kids and extended family at the local parks, restaurants and the Americana at Brand.

How would your best friend describe you to someone who doesn't know you?

Goofy. I'm incredibly serious and focused at work, but quality time with some of my closest and oldest friends typically includes laughing hysterically about the silly things we would do in our teens and college years. I'm not afraid to embarrass myself!

What is the funniest thing a patient has ever said to you?

In my line of work, you can only imagine the number of inappropriate jokes I hear. I have plenty of punchlines and comebacks myself. My favorite is:

Patient: "Doctor, I wanted your opinion on my recent sleep disturbances and nightmares."

Me: "OK, do you have a colon, rectal or anal problem? Shouldn't you be seeing a psychiatrist?"

Patient: "Oh, aren't you an analist?"

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

Absolutely nothing! I'd lounge around the house with my husband and kids. Maybe take a walk to the park or horse around some more at home. Then I'd put the kids to sleep early, and finish the night with takeout and a movie with the hubby — and fall asleep on the couch watching it!

Is there something or someplace you have never seen that you would like to see soon?

This list is really miles long, but traveling outside the United States with a 5-year-old and an 18-month-old is impossible. However, a few on the top of the list are Greenland, Bali, an African safari and Tokyo. In the more immediately feasible realm, the list would include Sequoia National Forest, Disney World and maybe a family cruise.

Topics Sought for Morgenstern Debate

Morgenstern Leon 140pxThe 14th annual Dr. Leon Morgenstern Great Debates in Clinical Medicine Resident Competition will convene on Friday, June 2. The debate committee is soliciting topics.

The chosen topic must cut across all specialties and must be of timely importance to the Cedars-Sinai community.

Please send suggestions to Leo Gordon, MD, Morgenstern Debate coordinator, at leo.gordon@cshs.org.

Last year's debate is available for viewing. Contact Gordon for access.

Here Is Your Chance to Honor a Deserving Nurse

In Hollywood, actors are nominated for an Oscar. At Cedars-Sinai, the best nurses are nominated for a Maggie. Online nominations for the 2017 Maggie Stempson-Carter Excellence in Caring Award for eligible nurses are open through Monday, April 3.

Only members of the medical staff may submit a nomination for this award, which recognizes nurses who exemplify professionalism, clinical excellence and caring. Originally known as the Excellence in Caring Award, this annual recognition was renamed in 2005 in honor of the late Maggie Stempson-Carter, RN, who won the award in 2004.

Other award recipients include:

  • Peachy Hain, RN
  • Jean Eskenazi, RN
  • Bernice Coleman, PhD, ACNP
  • Betty Nersesian, RN
  • Paula Anastasia, RN
  • Tess Constantino, RN
  • Naomi Tashman, RN
  • Monette De Leon, RN
  • Raji Gandhi, RN
  • Rema Pendon, RN
  • Grace Romulo, RN
  • Joan Kirschner, RN

Nominations can be submitted via the intranet or the internet.

The award recipient will be selected by the Excellence in Caring Award Medical Staff Selection Committee and will be announced at the annual Nursing Awards Ceremony on May 3.

If you submitted a nomination last year and would like your nominee to be considered again this year, email chris.ng@cshs.org.

Delivering Prescriptions for Student Success

Diversity

Sixth-graders raise their arms in "power poses" led by Zuri Murrell, MD, during Career Day at John Burroughs Middle School.

Zuri Murrell, MD, stood before a classroom of bright sixth-graders at the school that he attended decades ago. The Cedars-Sinai faculty member could still recall the childhood hopes and dreams of many of his former classmates at John Burroughs Middle School.

"Anybody want to go into sports?" he asked the class. Several hands shot up.

In fact, Murrell told the honors class, numbers suggest they would have a better chance of becoming brain surgeons than NBA or NFL players. There are about 3,500 U.S. brain surgeons, versus 2,200 total NBA and NFL players.

"I love what I do," Murrell told the class.

Murrell was one of seven Cedars-Sinai faculty members who shared their expertise and enthusiasm for medicine during Career Day at the Hancock Park school, interacting with nearly 500 students in 16 classrooms.

The March 3 visit was the first public outreach initiative by the newly minted Cedars-Sinai Faculty Diversity Ambassadors group. Backed by the Office of Faculty Development, the ambassadors support underrepresented groups in medicine and science, on campus and in the surrounding community.

Murrell has strong roots in the Hancock Park community, having graduated from John Burroughs in 1989. "Coming to this school was the beginning of what made me successful in life," he told the sixth-graders, crediting caring teachers for his success. It was during this period that he decided to become a doctor after his mother was first diagnosed with breast cancer. Years later, the disease took her life.

"I wanted to be a superhero," Murrell said. "I was that kid that kept breaking his arm jumping off the roof because I didn't learn I couldn't fly. Two broken arms later, I finally realized I couldn't fly. But I still wanted to try to save people's lives."

Today, Murrell is achieving his childhood goal by serving as a colorectal surgeon and medical director of the Colorectal Cancer Program at the Samuel Oschin Comprehensive Cancer Institute. "I love what I do," he told the students. "Every day I wake up, after I send my kids off, it's an adventure."

He urged the students to take the same attitude. "Come to school with a good breakfast and an open mind," he said. Throughout the day, he added, eat foods full of fiber and vitamins — like vegetables, fruits and oatmeal — which can help prevent colorectal cancer.

Students peppered Murrell with questions about junk food, smoking, drinking, obesity and other health issues. "It was good to see kids participate who don't usually raise their hands," said their teacher, Eurie Kim. "Dr. Murrell was talking about something they could relate to: their health."

At the end of class, Murrell led the students in "power poses," with arms high and fists clenched like racers on a victory lap, to charge up for the day.

In another classroom, filled with eighth-graders, Christopher Harris, MD, associate professor and director of Pulmonary Pediatric Medicine at Cedars-Sinai, was cataloging the enormous variety of healthcare professionals, from occupational therapists to pharmacists. "For anybody in this classroom, succeeding in life is possible," he said.

Harris was inspired to help organize the Faculty Diversity Ambassadors by Sarah Kilpatrick, MD, PhD, associate dean for Faculty Development and professor and chair of the Department of Obstetrics and Gynecology. Kilpatrick sent an email to faculty suggesting such a group about a year ago. "We know there is bias in the healthcare field, as it relates to underrepresented groups, and this is something we want to address," Harris said.

One way to fight this bias is to encourage more Latinos, African-Americans and other young people from diverse ethnic and racial groups to pursue medical careers. "You can't be what you can't see," Harris said. "Children need to have a complete understanding that medical providers come from backgrounds like theirs and that they can succeed in this profession."

Besides Harris and Murrell, faculty members who participated in Career Day were Rodrigo Alban, MD; Miguel Burch, MD; Ruchira Garg, MD; Nicolas Melo, MD; and Ueli Rutishauser, PhD.

"Cedars-Sinai's participation was priceless," said Steve Martinez, EdD, principal at John Burroughs, where most of the nearly 1,800 students are from groups that are underrepresented in medicine.

In the future, Harris said, the Faculty Diversity Ambassadors would like to extend their work with the school to include science classes and other endeavors. "It is vitally important that we, at Cedars-Sinai, show our commitment to our neighbors," he said.

In that regard, Melo pointed the way: He went straight to John Burroughs for Career Day after completing his overnight shift as a trauma surgeon at Cedars-Sinai.

For more information about the Faculty Diversity Ambassadors, or to participate in future events, contact denise.gallagher@cshs.org or 310-248-8642.


"For anybody in this classroom, succeeding in life is possible," Christopher Harris, MD, said during his Career Day talk to eighth-graders.

Study to Examine Opioid Use, Chronic Pain Patients

Opioid Use and Chronic Pain 480

A new Cedars-Sinai study will use computer alerts to prompt doctors to speak with other patients before renewing opioid prescriptions.

Cedars-Sinai investigators are gearing up to study the most effective ways for doctors to discuss opioid use with chronic pain patients in an effort to reduce the impact of pain while curbing overuse of these addictive drugs.

The research team has received $2 million from the Patient-Centered Outcomes Research Institute to conduct the study, which will launch this year.

The new research effort comes as patients, doctors, law enforcement authorities and others struggle with an opioid overdose epidemic in the U.S. that claimed more than 33,000 lives in 2015, according to the Centers for Disease Control and Prevention. Opioid-related deaths have quadrupled since 1999, driven partly by overdoses from prescription pain relievers in a country where more than 100 million people suffer from chronic pain.

"More people die of drug overdoses in the U.S. than car accidents or guns. This sobering statistic reveals a massive, nationwide epidemic of opioid addiction that is costing lives and money," said Brennan M. Spiegel, MD, director of Cedars-Sinai Health Services Research, who will lead the team. "Our study will test whether we can use the electronic health record to disrupt how pain treatments are discussed and managed between patients and providers, with the goal of reducing inappropriate overuse of opioids."

When aiming to limit opioid use, most studies may rely on prescription claims data to gauge results. The Cedars-Sinai project is different because it also will use patient feedback, which is critical for successful management of chronic pain.

Working with patients, consumer advocates, addiction specialists and primary care providers, the team will spend a year comparing the effectiveness of two established communication strategies used by doctors who treat chronic pain patients. Educational material will be shared with some of the patients prior to office visits, while computer alerts will prompt doctors to speak with other patients before renewing opioid prescriptions.

Investigators will survey all patients one month after their visits to gauge their quality of life, overall health (including pain, fatigue, energy and concentration) and how well communications with their doctors have worked. The study also will capture pain medication use through electronic health records and pharmaceutical claims data. Program direction will be overseen by Michelle S. Keller, MPH.

"Incorporating patients' perspectives into the study design ensures that the findings will be relevant to real people in general medical practices, and not just some highly selected sample," said Itai Danovitch, MD, MBA, chair of the Department of Psychiatry and director of Addiction Psychiatry at Cedars-Sinai. "The focus on assessing quality of life means the study will extend beyond evaluating symptoms and will tell us whether the interventions impact health in a way that patients themselves find meaningful."

The Patient-Centered Outcomes Research Institute is an independent, nonprofit organization authorized by Congress in 2010 to fund research that will provide patients, their caregivers and clinicians with evidence-based information needed to make better-informed healthcare decisions.

Acker to Lecture on Cardiac Surgery March 31

Michael A. Acker, MD, will give a special lecture on "Transparency, Public Reporting and a Cultural Shift to Quality and Safety in Cardiac Surgery" at Cedars-Sinai on Thursday, March 31.

Presented by the Department of Surgery, the hourlong lecture begins at 9 a.m. in the Advanced Health Sciences Pavilion PEC 5.

Acker is chief of the Cardiovascular Surgery Division and director of Penn Medicine Heart and Vascular Center at the University of Pennsylvania School of Medicine in Philadelphia.

The William Maul Measy Professor of Surgery, Acker is recognized as a national leader in the use of mechanical assist devices as a bridge to transplantation or as permanent therapy for end-stage heart failure.

Acker maintains an active surgical practice and focuses on patients with end-stage heart failure, coronary artery disease and valvular disease. In addition, he has special expertise in mitral valve repair for advanced myxomatous disease or in patients with end-stage heart failure.

Trauma Care Course Hosted by Cedars-Sinai

The Department of Surgery's Trauma Program hosted a Trauma Care After Resuscitation (TCAR) course in March.

TCAR is a nursing trauma course designed specifically for acute, critical care and perioperative nurses. The course was instructed by Teresa T. Goodell, PhD, RN, CNS, CWCN, ACNS-BC, TCRN, who serves as a nurse leader in trauma intensive care.

The event was attended by dozens of Cedars-Sinai intensive care nurses as well as nurses from surrounding hospitals. Programs such as TCAR help the trauma program meet the educational and outreach requirements of a Level I trauma center.

Additionally, it helps support the mission of Cedars-Sinai by providing quality education to the nurses so they may continue to provide excellent care to our patients.

Reminder About Antimicrobial Use Guidelines

The Cedars-Sinai Antimicrobial Stewardship Committee publishes specific antimicrobial use guidelines, incorporating current literature and local resistance patterns. Resources include empiric treatment recommendations for frequently encountered bacterial and fungal infections, as well as recommendations for duration of antimicrobial therapy.

These resources can be accessed through CS-Link™ via Web Activities > Medication Guidelines, or directly from antimicrobial orders, via a reference link found below the drug product.

The guides are available on the Cedars-Sinai intranet.

Assistance with antimicrobial recommendations is available from antimicrobial stewardship pharmacists Monday through Friday, 8 a.m.-5 p.m. The pharmacists can be reached at 310-423-5352.

Circle of Friends Honorees for February

The Circle of Friends program honored 179 people in February.

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.

  • Emelia Achampong
  • Tatiana Aguilar
  • Maryam Ahmadian, MSN, RN, NP
  • Sandra P. Alarcon
  • Farin Amersi, MD
  • Neel A. Anand, MD
  • Nabulungi Anderson, RN
  • Joel A. Aronowitz, MD
  • Claudia Arrue, RN
  • Arash Asher, MD
  • George Baghdassarian
  • Mark Bamberger, MD
  • Tina G. Ban, RN
  • Leon I. Bender, MD
  • Robert M. Bernstein, MD
  • Page A. Bertolotti, BSN, RN, OCN
  • Satinder J. Bhatia, MD
  • Keith L. Black, MD
  • Vivien S. Bonert, MD
  • Andrew M. Braun, RN
  • Irene Breceda
  • Earl W. Brien, MD
  • Michael Broukhim, MD
  • Neil A. Buchbinder, MD
  • Cathy Buehler
  • Christiane Michele J. Burnison, MD
  • Rachel Burrows, RN
  • Michael A. Bush, MD
  • Allison H. Canavan, MD
  • James L. Caplan, MD
  • Rhona M. Castillo, RN
  • David H. Chang, MD
  • Timothy Charlton, MD
  • William W. Chow, MD
  • J. Louis Cohen, MD
  • Stephen R. Corday, MD
  • Ram C. Dandillaya, MD
  • Irena Deadrick, RN
  • Alice R. Dick, MD
  • Sonia M. Divakaran, RN
  • Noam Z. Drazin, MD
  • Josefina B. Dy
  • Thelma N. Erive
  • Richard Essner, MD
  • Jose A. Estrada
  • Mariana Fayman, PA
  • Charles A. Forscher, MD
  • Yelena Fridman, RN
  • Stuart Friedman, MD
  • Clark B. Fuller, MD
  • Ivor L. Geft, MD
  • Suzanne Gilberg Lenz, MD
  • Armando E. Giuliano, MD
  • Lindsey Robyn Glucksman, MD
  • Richard N. Gold, MD
  • Martin N. Gordon, MD
  • Leland M. Green, MD
  • Pavani Sai Guntur, MD
  • David S. Hallegua, MD
  • Solomon I. Hamburg, MD
  • Michele A. Hamilton, MD
  • Michael D. Harris, MD
  • Allen S. Ho, MD
  • David M. Hoffman, MD
  • Randi Jackson, RN
  • Titus Jackson, PA
  • Juliette Johnson
  • Danielle Jones, RN
  • Stanley C. Jordan, MD
  • David Y. Josephson, MD
  • Katherine Kang, RN
  • Saibal Kar, MD
  • Ronald P. Karlsberg, MD
  • Harold L. Karpman, MD
  • David Kawashiri, MD
  • Ilan Kedan, MD, MPH
  • Tami Kendra-Romito
  • Ali Khoynezhad, MD, PhD
  • Chae Young Kim, MD
  • Hyung L. Kim, MD
  • Terrence T. Kim, MD
  • Wendy J. Kim, MD
  • Michelle M. Kittleson, MD, PhD
  • Jon A. Kobashigawa, MD
  • Cherryl S. Lacsa, RN
  • Letitia Lau, MD
  • Susie K. Lee, NP
  • Madeline S. Lerman, BSN, RN
  • Keren Lerner, MD
  • Ronald S. Leuchter, MD
  • Jeffrey Robert Lewis, MD
  • Michael C. Lill, MD
  • Karla Lopez, RN
  • Ezra Maguen, MD
  • Rajendra Makkar, MD
  • Eve Louise Makoff, MD
  • Adam N. Mamelak, MD
  • William J. Mandel, MD
  • Claire Manning, RN
  • Malcolm L. Margolin, MD
  • Jennifer Marsh, RN
  • David N. Matsumura, MD
  • Peggy Mays
  • Philomena McAndrew, MD
  • Robert J. McKenna Jr., MD
  • Gil Y. Melmed, MD, MS
  • Richard J. Metz, MD
  • Stewart Middler, MD, PhD
  • Margo Minissian, MSN, RN, NP, ACNP-BC, CLS-BC, CNS
  • Monica M. Mita, MD, MDSc
  • Joel D. Mittleman, MD
  • Melvin T. Monsher, MD
  • Jaime D. Moriguchi, MD
  • Youram Nassir, MD
  • Ricardo Navas, MD
  • Norman J. Nemoy, MD
  • Christopher S. Ng, MD
  • Nicholas N. Nissen, MD
  • Ivy L. Njoloma, RN
  • Clyde R. Obsequio, RN
  • Bernadette O'Donnell, RN
  • Asako B. Oshiro
  • Adrian G. Ostrzega, MD
  • Guy D. Paiement, MD
  • Jignesh K. Patel, MD, PhD
  • Chirag G. Patil, MD
  • Alice Peng, MD
  • Tiffany Perry, MD
  • Mark Pimentel, MD
  • Edwin M. Posadas, MD
  • David S. Ramin, MD
  • Soroush A. Ramin, MD
  • Stephanie Rice, RN
  • Christopher R. Richardson, CP
  • Bobbie J. Rimel, MD
  • Julia Y. Rodriguez
  • Sepehr Rokhsar, MD
  • Robert M. Rose, MD
  • Howard L. Rosner, MD
  • Amy S. Rutman, MD
  • Wendy L. Sacks, MD
  • Jeanne M. Safford, RN
  • Vivian L. Salle, RN
  • Marjorie Sanchez, CN III
  • Wouter I. Schievink, MD
  • Samy M. Sharobeem, MD
  • Omid A. Shaye, MD
  • Michael M. Shehata, MD
  • John L. Sherman, MD
  • Allan W. Silberman, MD, PhD
  • Amanuel Sima, MD
  • Steven M. Simons, MD
  • Flora Sinha, MD
  • Sharon Sloan
  • Karyn Morse Solky, MD
  • Daniel J. Stone, MD
  • Ronald Sue, MD
  • Joseph Sugerman, MD
  • Andrea D. Sutherland, RN
  • Kazu Suzuki, DPM
  • Charles D. Swerdlow, MD
  • Steven W. Tabak, MD
  • Michele Tagliati, MD
  • Natalie L. Terterian, RN
  • Hitoshi "Tommy" Tomizawa, MD, MPH
  • Scott S. Topiol, BSN, RN, CEN
  • Tram T. Tran, MD
  • Alfredo Trento, MD
  • Richard Tuli, MD, PhD
  • Mark K. Urman, MD
  • Eric Vasiliauskas, MD
  • Robert A. Vescio, MD
  • Ayanna Miyako Walden, MD
  • Jonathan M. Weiner, MD
  • Clement C. Yang, MD
  • John S. Yu, MD
  • Hong Zhou, NP
  • Raymond Zimmer, MD
  • Zachary Zumsteg, MD

New Correction Factor for AST Coming in Core Labs

The Core laboratories in the Department of Pathology and Laboratory Medicine will be implementing a new correction factor for aspartate aminotransferase (AST) run on Ortho Vitros analyzers in April.

The move, which impacts medical staff in the Emergency Department and the Samuel Oschin Comprehensive Cancer Institute, is designed to produce results that better match the primary method used in the main laboratory that are run on Roche P modules.

AST on Ortho Vitros runs about 15 percent higher than AST on Roche Modular. While the difference may often not be clinically significant, especially for more elevated values, the goal is to provide results that are as consistent as possible across all three labs.

As such, a correction factor to better match Vitros to Roche values will begin Monday, April 10. The graph below shows that the correlation between both AST methods is strong despite this small, but persistent bias.

If you have questions, please contact Kimia Sobhani, PhD, at kimia.sobhani@cshs.org, or Holli Mason, MD, at holli.mason@cshs.org.

Cortisol Announcement

The Core laboratories in the Department of Pathology and Laboratory Medicine will discontinue separate test codes for AM and PM cortisol (i.e., CORTAM, CORTPM) beginning Monday, April 10.

The move is being undertaken due to low usage and potential confusion in ordering. The single test code for serum cortisol will be (CORT), which includes both morning and evening ranges:

Cortisol Reference Intervals (CORT)
Morning: 6.0 — 18.4 mg/dL
Afternoon: 2.7 — 10.5 mg/dL

If you have questions, please contact Kimia Sobhani, PhD, at kimia.sobhani@cshs.org, or Holli Mason, MD, at holli.mason@cshs.org.

Medical Library Has New Database

Do you need to find articles on healthcare administration or management? Want to read Harvard Business Review articles online?

The publications can be accessed in Cedars-Sinai Medical Library's new database, Health Business Elite. There you can find full-text journal and trade articles from more than 500 publications that cover business-related healthcare topics. Individual journals are listed in the library's A-Z list and catalog.

CS-Link Tip: Try UpToDate Feature

You can navigate from CS-Link™ to UpToDate, which is accredited by the Accreditation Council for Continuing Medical Education.

UpToDate is a point-of-care tool that allows clinicians to research clinical problems and earn credit for continuing medical education, continuing education and continuing professional development.

To get to UpToDate, go to "Web Activities," then click "UpToDate." If you have not signed up yet, you can do so by clicking the link to register.

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