Medical Staff Pulse Newsletter

FDA warnings on Pradaxa, Incivek

Pharmacy focus

The U.S. Food and Drug Administration recently warned that the blood thinner Pradaxa should not be used to prevent stroke or blood clots in patients with mechanical heart valves. The agency also has received reports of serious skin reactions, some fatal, in patients taking the hepatitis C drug Incivek (telaprevir) in combination with the drugs peginterferon alfa and ribavirin (Incivek combination treatment).

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Grand rounds

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Upcoming CME conferences

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Medical Staff CME Newsletter - January 2013 (PDF)

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Cedars-Sinai team expands mission in China

Amberlin and Jace are two of the orphans the Cedars-Sinai team operated on in 2011.

Philip Frykman, MD, (second from right) and others view X-rays

A laparoscopy draws a crowd.

In November 2011, when a pediatric surgery team from Cedars-Sinai traveled to Maria's Big House of Hope, an orphanage in Louyang, China, the focus of the mission was on the children. The future looked bleak for the infants and toddlers, born with anorectal malformations in a culture that believes such birth defects bring a family bad luck. They had all been abandoned by their parents within days of their birth.

Last year, following up on the success of that mission, in which 11 children had operations and several were adopted, the Cedars-Sinai team returned to Louyang. Led once again by pediatric surgeon Philip Frykman, MD, PhD, the group's mission expanded. They worked with the orphans again, but this time, they also educated the local surgeons about how anorectal malformations can be corrected.

On the 2011 mission, surgeries were conducted in the medical facility at the orphanage. Shiwei Zhai, MD, a local surgeon, scrubbed in on every case.

"This time, we did all of our surgeries at the local hospital, and we had a lot of interaction with the surgeons at that hospital," Frykman said. Surgeries included hernia repairs, anorectal reconstructions, colostomy repairs and several emergencies.

"Dr. Zhai was there again, and he has improved a lot and knows more what to do," Frykman said. "But when you have a city of 6.5 million, you have to have more than just one guy."

From left: Cecilia Lam, MSW, Jennifer Ross, RN, volunteer Sienna Dugan and Ramona Abney, RN

Surgical tech Claire Esguerra

Surgeons from throughout the region came to watch and work with the Cedars-Sinai team. For many, the concept that anorectal malformations can be repaired safely in infancy was a revelation.

"We did some laparoscopic surgeries for some of the more complicated disorders, and the local surgeons were fascinated," Frykman said.

The mission to China is organized by Mending Kids International, a Burbank-based nonprofit that sponsors medical missions throughout the world. The team for the China trip included pediatric anesthesiologist Keith Kimble, MD, several ICU nurses and a number of staff members. In addition to Frykman and Kimble, team members associated with Cedars-Sinai were senior surgical resident Seth Felder, MD; surgical tech Claire Esguerra; nurses Janet Kimble, Jennifer Ross and Ramona Abney; and Cecilia Lam, MSW.

The team performed 13 surgeries in five days, and taught new procedures to the local medical professionals.

Because the conditions the children suffer from are so grave, they can't be considered for adoption until they are completely healed.

"Four children we worked on last year were adopted, two of them to American families," Frykman said. "After this last mission, there are more on the launch pad. It's very gratifying."

The Cedars-Sinai team on the mission in China