1) Robert Brewer suffered a severe traumatic brain injury after being hit by a vehicle while cycling. He was treated at MedStar Washington Hospital Center by Dr. Armonda and Dr. Aulisi using specialized neuromonitoring techniques.
2) After nearly three weeks of treatment, Brewer was discharged to a rehabilitation facility and made a nearly full recovery, returning to work within 4-1/2 months.
3) The document discusses the Hospital Center's expertise in treating traumatic brain injuries and neurosurgery patients, as well as two patient stories of recovery from brain injuries and a chronic digestive condition.
PELATIHAN PERAWATAN PALIATIF PADA STROKE - 16 maret 2020papahku123
This document discusses palliative care and end-of-life care for stroke patients. It outlines the seven principles of palliative care programs which focus on informed patient and family involvement, support for caregivers, a palliative approach to care, access to specialist palliative care, coordinated and integrated treatment, quality care from skilled staff, and community support. It also discusses assessing patient needs, managing symptoms, communication with patients and families, and the goals of palliative care for stroke which are to manage symptoms, provide counseling and support, and improve quality of life.
Tiffany Tran discusses her experiences in the Health Academy program. During the first week, they had an orientation that included a hospital tour and introductions. Tiffany then describes several clinical rotations, including in the CICU, operating room, NICU, burn unit, and NCCU. She observes various medical procedures and cares for patients. Tiffany finds the experiences fascinating and says Health Academy has exposed her to many healthcare career options. After high school, she plans to study pre-medicine in college with the goal of a career in healthcare on the west coast.
SHARE Presentation: Palliative Care for Womenbkling
Dr. Michael Pearl discusses supportive palliative care for women with cancer, how it differs from hospice care, and the New York Palliative Care Information Act. Dr. Michael Pearl is Professor and Director of the Division of Gynecologic Oncology in the Department of Obstetrics, Gynecology and Reproductive Medicine at Stony Brook University Hospital.
This document provides an overview of the book "Differential Diagnosis in Clinical Medicine" by R Deenadayalan MD. It discusses the book's contents, which are organized into sections on general examination, neurology, abdomen, and cardiology. The document also includes forewords from medical professionals who praise the book for providing a useful reference for diagnosing conditions based on clinical findings. The book is intended to help medical students and clinicians differentially diagnose common presentations by anticipating questions often asked during rounds.
The document discusses the education and career path of neurosurgeons. It describes how neurosurgeons must complete 4 years of medical school after obtaining a bachelor's degree, then undergo a 3-8 year residency training program due to the complexity of neurosurgery. Neurosurgeons treat various brain and spine conditions through specialized operations. The career requires strong problem-solving, communication, and stamina skills given the delicate nature of neurosurgery. However, the profession also carries risks of malpractice suits if surgeons fail to properly communicate risks to patients.
This document provides information about the Mild Cognitive Impairment (MCI) Symposium that will take place from April 13-14, 2007 in Miami Beach, Florida. The symposium, directed by Dr. Ranjan Duara, will focus on developing earlier diagnosis of Alzheimer's disease and feature experts in fields related to dementia. Over two days, speakers will present on topics such as the pathology of aging and prodromal Alzheimer's, diagnosis of early Alzheimer's in clinical and research settings, and algorithms for integrating elements to achieve earlier diagnosis. The goal is to promote better understanding of diagnosing Alzheimer's disease earlier in its progression.
PELATIHAN PERAWATAN PALIATIF PADA STROKE - 16 maret 2020papahku123
This document discusses palliative care and end-of-life care for stroke patients. It outlines the seven principles of palliative care programs which focus on informed patient and family involvement, support for caregivers, a palliative approach to care, access to specialist palliative care, coordinated and integrated treatment, quality care from skilled staff, and community support. It also discusses assessing patient needs, managing symptoms, communication with patients and families, and the goals of palliative care for stroke which are to manage symptoms, provide counseling and support, and improve quality of life.
Tiffany Tran discusses her experiences in the Health Academy program. During the first week, they had an orientation that included a hospital tour and introductions. Tiffany then describes several clinical rotations, including in the CICU, operating room, NICU, burn unit, and NCCU. She observes various medical procedures and cares for patients. Tiffany finds the experiences fascinating and says Health Academy has exposed her to many healthcare career options. After high school, she plans to study pre-medicine in college with the goal of a career in healthcare on the west coast.
SHARE Presentation: Palliative Care for Womenbkling
Dr. Michael Pearl discusses supportive palliative care for women with cancer, how it differs from hospice care, and the New York Palliative Care Information Act. Dr. Michael Pearl is Professor and Director of the Division of Gynecologic Oncology in the Department of Obstetrics, Gynecology and Reproductive Medicine at Stony Brook University Hospital.
This document provides an overview of the book "Differential Diagnosis in Clinical Medicine" by R Deenadayalan MD. It discusses the book's contents, which are organized into sections on general examination, neurology, abdomen, and cardiology. The document also includes forewords from medical professionals who praise the book for providing a useful reference for diagnosing conditions based on clinical findings. The book is intended to help medical students and clinicians differentially diagnose common presentations by anticipating questions often asked during rounds.
The document discusses the education and career path of neurosurgeons. It describes how neurosurgeons must complete 4 years of medical school after obtaining a bachelor's degree, then undergo a 3-8 year residency training program due to the complexity of neurosurgery. Neurosurgeons treat various brain and spine conditions through specialized operations. The career requires strong problem-solving, communication, and stamina skills given the delicate nature of neurosurgery. However, the profession also carries risks of malpractice suits if surgeons fail to properly communicate risks to patients.
This document provides information about the Mild Cognitive Impairment (MCI) Symposium that will take place from April 13-14, 2007 in Miami Beach, Florida. The symposium, directed by Dr. Ranjan Duara, will focus on developing earlier diagnosis of Alzheimer's disease and feature experts in fields related to dementia. Over two days, speakers will present on topics such as the pathology of aging and prodromal Alzheimer's, diagnosis of early Alzheimer's in clinical and research settings, and algorithms for integrating elements to achieve earlier diagnosis. The goal is to promote better understanding of diagnosing Alzheimer's disease earlier in its progression.
Basics of palliative care including symptom management: pain, dyspnea, nausea and constipation; family meetings, goals-of-care, end-of-life care, and artificial nutrition.
- 15-year-old Lewis Blackman underwent elective surgery for pectus excavatum (sunken chest) at an academic medical center.
- In the days following surgery, Lewis experienced worsening abdominal pain but nurses dismissed it as constipation and insisted he walk more.
- His condition deteriorated over several hours but nurses were busy preparing for an inspection and did not take his worsening vital signs seriously.
- It was not until Lewis said "It's going black" that a cardiac code was called, but he could not be resuscitated and died 31 hours after reporting the abdominal pain.
This document contains 70 questions and answers about human papillomavirus (HPV) and cervical cancer prevention. It discusses HPV vaccination, HPV transmission, HPV screening, and treatment of HPV and cervical lesions. The contributors are experts in gynecologic oncology from King Abdulaziz University and Dalhousie University who aim to increase awareness of cervical cancer prevention and evidence-based practices through answering common clinical questions.
Five priorities for care of the dying personMarie Curie
Dr Bill Noble, Medical Director of Marie Curie Cancer Care, speaks at the end of life sesion with Dr Adam Firth (RCGP Clinical Support Fellow for End of Life Care).
This session was chaired by Dr Peter Nightingale, Marie Curie and RCGP End of life lead at the RCGP Annual Conference, ACC Liverpool, 2-4 October, 2014.
For more information visit: mariecurie.org.uk/rcgp
This document provides information about the Mild Cognitive Impairment (MCI) Symposium that will take place from March 7-8, 2008 in Miami Beach, Florida. The symposium will focus on disease modifying treatments for Alzheimer's disease. It will feature expert speakers discussing biomarkers for measuring progression and treatment effects in Alzheimer's, pathogenic mechanisms of cognitive impairment, non-pharmacological treatments, and potential disease-modifying pharmaceutical agents. The target audience is medical professionals in fields related to neurology and geriatrics. The symposium will provide updates on the latest research and allow for discussion on improving diagnosis and treatment of early-stage Alzheimer's.
This document announces a symposium on Mild Cognitive Impairment (MCI) that will provide 15 hours of continuing education credits for physicians and psychologists, featuring experts who will present on the causes, detection, and treatment of early dementia; it discloses any relationships between faculty and industry sponsors, and provides contact information for the symposium.
Three hour slide deck for basics of palliative care including what is palliative care, symptom management (pain, dyspnea, nausea, constipation), goals-of-care, family meetings, comfort care, and issues around artificial nutrition.
1) The document discusses several key principles in medical ethics including autonomy, beneficence, non-maleficence, and justice as they relate to informed consent and treatment decisions.
2) It examines the concepts of medical negligence, duty of care, standards of care, damages, and proximate cause in medical malpractice cases.
3) It also addresses treatments for incompetent patients, the principles of patient autonomy and medical futility in end-of-life decisions around cardiopulmonary resuscitation.
This document provides an agenda for the 10th Annual Symposium on Mild Cognitive Impairment and the 1st Early Alzheimer's Diagnostic Workshop being held January 14-15, 2012 in Miami Beach, Florida. The symposium and workshop will focus on advances in the clinical diagnosis and progression of Alzheimer's disease and related disorders, with an emphasis on the early stages of the disease. Over the two-day event, there will be keynote speeches and panel discussions on topics such as atypical presentations of Alzheimer's, the prion-like progression of the disease, and new concepts in pathogenesis. The goal is to help clinicians more accurately diagnose Alzheimer's and related conditions earlier.
This document provides details of a 27-year-old pregnant woman's case. She presented with progressive lower limb weakness and was initially diagnosed with possible spinal cord compression or transverse myelitis. Further MRI scans revealed an intradural mass at C7. After delivery, she was scheduled for laminectomy and tumor excision but was undecided on the operation. She was discharged without surgery and never returned for follow up. Barriers to her care included her low socioeconomic status, lack of understanding of her illness, and lack of continuity of care. The document emphasizes the importance of a holistic and patient-centered approach to care.
This document provides information about an upcoming symposium on Mild Cognitive Impairment (MCI). It will take place February 24-25, 2006 at the Eden Roc Resort & Spa in Miami Beach, Florida. The symposium is sponsored by several Alzheimer's research centers and will feature over 40 expert speakers. The goal is to provide the latest information on diagnosing and treating MCI, as well as discussing related topics like cognitive reserve, genetics, and vascular/medical factors. The symposium offers 15 hours of continuing education credits for physicians and psychologists.
This case study describes the end-of-life care of Lorna, a 77-year old woman with metastatic renal cell carcinoma. Lorna originally presented with flank and abdominal pain and was diagnosed with advanced renal cell carcinoma in 2011. In 2014, the cancer recurred and metastasized to her spine, causing cauda equina syndrome with lower limb weakness and urinary/fecal incontinence. She was admitted to palliative care for pain and symptom management, where she received psychological support, medication via syringe pump, and focus on comfort. The document discusses renal cell carcinoma, cauda equina syndrome, medications, nursing interventions and compassionate end-of-life care.
This partnership is part of South Nassau's commitment to help enhance health care services and revitalize the network of community-based physicians available for the residents.
This document summarizes the agenda and objectives for the 2nd Annual Mild Cognitive Impairment Symposium being held on February 27-28, 2004 in Miami Beach, Florida. The symposium consists of an educational module on day one and a research module on day two. Both modules will focus on understanding and detecting mild cognitive impairment, with objectives around diagnosis, subtypes, biomarkers, imaging, and screening tools. The symposium is sponsored by Mount Sinai Medical Center and aims to promote early detection and treatment of dementia.
This document provides information about the 8th Annual Symposium on Early Alzheimer's Disease that will take place on March 12-13, 2010 in Miami Beach, Florida. The symposium will focus on mild cognitive impairment and preclinical Alzheimer's disease, with sessions on interpreting psychometric test results, biomarkers for early detection, and results from longitudinal studies. National experts will present the latest research. The target audience is medical professionals working with dementia patients. Registration information is provided.
This document is the June-August 2011 issue of the Australian Journal of Advanced Nursing, which is an international peer-reviewed journal of nursing research and practice. The issue contains 7 research papers and 5 scholarly papers on various topics related to nursing. It also provides information about the aims and scope of the journal, instructions for authors, production details, and the editorial review panel.
The document provides information about the 9th Annual Symposium on Mild Cognitive Impairment that will take place on April 29-30, 2011 in Miami Beach, Florida. It includes the agenda, list of distinguished faculty, registration information, and logistical details about the event. The symposium will focus on new criteria for prodromal and preclinical Alzheimer's disease, with sessions on risk factors, diagnosis and progression of mild cognitive impairment and preclinical Alzheimer's disease.
This study aimed to examine the impact of acupuncture on pain, nausea, anxiety and coping in women undergoing mastectomy surgery. The study involved a randomized controlled trial where women were assigned to either receive acupuncture post-surgery or usual care. Results found that acupuncture was effective in reducing anxiety, improving coping ability, and decreasing pain and nausea, with statistically significant differences between the acupuncture and usual care groups. Limitations included a small sample size and lack of diversity. Future research could involve a larger, more diverse population and exploring optimal timing of acupuncture interventions.
The document summarizes opportunities for physicians working at the VA. It highlights that the VA is the largest employer of physicians in the US, offering a wide range of specialty practice settings. Physicians can practice state-of-the-art medicine while benefiting from competitive salaries, excellent benefits, and opportunities for leadership, teaching, research, and rural practice. The VA prioritizes quality patient care and uses cutting-edge technology.
Palliative care is about providing well-being and the highest quality of life to patients with serious, progressive, chronic life-limiting illness, including during the dying process.
Методология управления показателями удовлетворенностиSvetlana Smirnova
Данная презентация является продолжением предыдущей работы по теме "Показатели удовлетворенности". В данной работу фокус сделан на управлении этим показателем на примере одного проекта
CBE16 - using technology to grow your businessCraftBev
Growth goes beyond the volume you produce. It is also about the manner in how well you produce and how your business functions. Using the tools of technology can help you focus beyond fermentation. Less chaos, more visibility, accurate accountability, promoting teamwork and collaboration are a few of the benefits when you take advantage of technology. Discover the possibilities of how technology can help you grow as a business.
Basics of palliative care including symptom management: pain, dyspnea, nausea and constipation; family meetings, goals-of-care, end-of-life care, and artificial nutrition.
- 15-year-old Lewis Blackman underwent elective surgery for pectus excavatum (sunken chest) at an academic medical center.
- In the days following surgery, Lewis experienced worsening abdominal pain but nurses dismissed it as constipation and insisted he walk more.
- His condition deteriorated over several hours but nurses were busy preparing for an inspection and did not take his worsening vital signs seriously.
- It was not until Lewis said "It's going black" that a cardiac code was called, but he could not be resuscitated and died 31 hours after reporting the abdominal pain.
This document contains 70 questions and answers about human papillomavirus (HPV) and cervical cancer prevention. It discusses HPV vaccination, HPV transmission, HPV screening, and treatment of HPV and cervical lesions. The contributors are experts in gynecologic oncology from King Abdulaziz University and Dalhousie University who aim to increase awareness of cervical cancer prevention and evidence-based practices through answering common clinical questions.
Five priorities for care of the dying personMarie Curie
Dr Bill Noble, Medical Director of Marie Curie Cancer Care, speaks at the end of life sesion with Dr Adam Firth (RCGP Clinical Support Fellow for End of Life Care).
This session was chaired by Dr Peter Nightingale, Marie Curie and RCGP End of life lead at the RCGP Annual Conference, ACC Liverpool, 2-4 October, 2014.
For more information visit: mariecurie.org.uk/rcgp
This document provides information about the Mild Cognitive Impairment (MCI) Symposium that will take place from March 7-8, 2008 in Miami Beach, Florida. The symposium will focus on disease modifying treatments for Alzheimer's disease. It will feature expert speakers discussing biomarkers for measuring progression and treatment effects in Alzheimer's, pathogenic mechanisms of cognitive impairment, non-pharmacological treatments, and potential disease-modifying pharmaceutical agents. The target audience is medical professionals in fields related to neurology and geriatrics. The symposium will provide updates on the latest research and allow for discussion on improving diagnosis and treatment of early-stage Alzheimer's.
This document announces a symposium on Mild Cognitive Impairment (MCI) that will provide 15 hours of continuing education credits for physicians and psychologists, featuring experts who will present on the causes, detection, and treatment of early dementia; it discloses any relationships between faculty and industry sponsors, and provides contact information for the symposium.
Three hour slide deck for basics of palliative care including what is palliative care, symptom management (pain, dyspnea, nausea, constipation), goals-of-care, family meetings, comfort care, and issues around artificial nutrition.
1) The document discusses several key principles in medical ethics including autonomy, beneficence, non-maleficence, and justice as they relate to informed consent and treatment decisions.
2) It examines the concepts of medical negligence, duty of care, standards of care, damages, and proximate cause in medical malpractice cases.
3) It also addresses treatments for incompetent patients, the principles of patient autonomy and medical futility in end-of-life decisions around cardiopulmonary resuscitation.
This document provides an agenda for the 10th Annual Symposium on Mild Cognitive Impairment and the 1st Early Alzheimer's Diagnostic Workshop being held January 14-15, 2012 in Miami Beach, Florida. The symposium and workshop will focus on advances in the clinical diagnosis and progression of Alzheimer's disease and related disorders, with an emphasis on the early stages of the disease. Over the two-day event, there will be keynote speeches and panel discussions on topics such as atypical presentations of Alzheimer's, the prion-like progression of the disease, and new concepts in pathogenesis. The goal is to help clinicians more accurately diagnose Alzheimer's and related conditions earlier.
This document provides details of a 27-year-old pregnant woman's case. She presented with progressive lower limb weakness and was initially diagnosed with possible spinal cord compression or transverse myelitis. Further MRI scans revealed an intradural mass at C7. After delivery, she was scheduled for laminectomy and tumor excision but was undecided on the operation. She was discharged without surgery and never returned for follow up. Barriers to her care included her low socioeconomic status, lack of understanding of her illness, and lack of continuity of care. The document emphasizes the importance of a holistic and patient-centered approach to care.
This document provides information about an upcoming symposium on Mild Cognitive Impairment (MCI). It will take place February 24-25, 2006 at the Eden Roc Resort & Spa in Miami Beach, Florida. The symposium is sponsored by several Alzheimer's research centers and will feature over 40 expert speakers. The goal is to provide the latest information on diagnosing and treating MCI, as well as discussing related topics like cognitive reserve, genetics, and vascular/medical factors. The symposium offers 15 hours of continuing education credits for physicians and psychologists.
This case study describes the end-of-life care of Lorna, a 77-year old woman with metastatic renal cell carcinoma. Lorna originally presented with flank and abdominal pain and was diagnosed with advanced renal cell carcinoma in 2011. In 2014, the cancer recurred and metastasized to her spine, causing cauda equina syndrome with lower limb weakness and urinary/fecal incontinence. She was admitted to palliative care for pain and symptom management, where she received psychological support, medication via syringe pump, and focus on comfort. The document discusses renal cell carcinoma, cauda equina syndrome, medications, nursing interventions and compassionate end-of-life care.
This partnership is part of South Nassau's commitment to help enhance health care services and revitalize the network of community-based physicians available for the residents.
This document summarizes the agenda and objectives for the 2nd Annual Mild Cognitive Impairment Symposium being held on February 27-28, 2004 in Miami Beach, Florida. The symposium consists of an educational module on day one and a research module on day two. Both modules will focus on understanding and detecting mild cognitive impairment, with objectives around diagnosis, subtypes, biomarkers, imaging, and screening tools. The symposium is sponsored by Mount Sinai Medical Center and aims to promote early detection and treatment of dementia.
This document provides information about the 8th Annual Symposium on Early Alzheimer's Disease that will take place on March 12-13, 2010 in Miami Beach, Florida. The symposium will focus on mild cognitive impairment and preclinical Alzheimer's disease, with sessions on interpreting psychometric test results, biomarkers for early detection, and results from longitudinal studies. National experts will present the latest research. The target audience is medical professionals working with dementia patients. Registration information is provided.
This document is the June-August 2011 issue of the Australian Journal of Advanced Nursing, which is an international peer-reviewed journal of nursing research and practice. The issue contains 7 research papers and 5 scholarly papers on various topics related to nursing. It also provides information about the aims and scope of the journal, instructions for authors, production details, and the editorial review panel.
The document provides information about the 9th Annual Symposium on Mild Cognitive Impairment that will take place on April 29-30, 2011 in Miami Beach, Florida. It includes the agenda, list of distinguished faculty, registration information, and logistical details about the event. The symposium will focus on new criteria for prodromal and preclinical Alzheimer's disease, with sessions on risk factors, diagnosis and progression of mild cognitive impairment and preclinical Alzheimer's disease.
This study aimed to examine the impact of acupuncture on pain, nausea, anxiety and coping in women undergoing mastectomy surgery. The study involved a randomized controlled trial where women were assigned to either receive acupuncture post-surgery or usual care. Results found that acupuncture was effective in reducing anxiety, improving coping ability, and decreasing pain and nausea, with statistically significant differences between the acupuncture and usual care groups. Limitations included a small sample size and lack of diversity. Future research could involve a larger, more diverse population and exploring optimal timing of acupuncture interventions.
The document summarizes opportunities for physicians working at the VA. It highlights that the VA is the largest employer of physicians in the US, offering a wide range of specialty practice settings. Physicians can practice state-of-the-art medicine while benefiting from competitive salaries, excellent benefits, and opportunities for leadership, teaching, research, and rural practice. The VA prioritizes quality patient care and uses cutting-edge technology.
Palliative care is about providing well-being and the highest quality of life to patients with serious, progressive, chronic life-limiting illness, including during the dying process.
Методология управления показателями удовлетворенностиSvetlana Smirnova
Данная презентация является продолжением предыдущей работы по теме "Показатели удовлетворенности". В данной работу фокус сделан на управлении этим показателем на примере одного проекта
CBE16 - using technology to grow your businessCraftBev
Growth goes beyond the volume you produce. It is also about the manner in how well you produce and how your business functions. Using the tools of technology can help you focus beyond fermentation. Less chaos, more visibility, accurate accountability, promoting teamwork and collaboration are a few of the benefits when you take advantage of technology. Discover the possibilities of how technology can help you grow as a business.
The document provides information about Earla Clark and the Triad Connections Team at Keller Williams Realty. It discusses their commitment to exceptional client service, their mission to keep clients informed throughout the home buying or selling process, and some of Earla Clark's qualifications, awards, and roles at Keller Williams. It also summarizes several marketing strategies and technologies available through Keller Williams to sell clients' homes, such as virtual tours, social media marketing, and listing properties on over 350 search websites through the Keller Williams Listing System.
Himview Holiday is a leading tour agency in Himachal Pradesh that provides affordable Manali tour packages from cities like Delhi, Chandigarh, Mumbai, and Gujarat. They offer hotel bookings, taxi services, and tours of popular destinations in Manali like Hadimba Temple, Vashisht Temple, Solang Valley, Rohtang Pass, and Gulaba. Their experienced guides provide trekking, skiing, and rafting packages at competitive rates.
Society is a consulting firm with 250 employees across 13 states that provides analytics, technology, and operations services. It helps clients compete on customer experience and delivers services including digital analytics, data platforms, data science, and flexible engagements. Society works with major brands in tech, media, retail, and other industries.
Market segmentation involves dividing the overall market into distinct subgroups of customers with common needs or characteristics that may require separate products or marketing strategies. The key steps in market segmentation are to select the target customer group, determine how to segment them based on attributes like demographics, behaviors or needs, decide on a value proposition to offer that targeted group, differentiate your product or service for that segment, and position it in a way that creates value for the customers in that segment.
CBE16 - Content Marketing: The Not so Secret Weapon of CraftCraftBev
Consumers are savvy – they don’t believe advertising. They want an authentic, quality brand who they can trust. Content marketing provides an opportunity for you to provide meaningful, memorable connections with your customers which will in turn, produce quality leads for your business. Understand how to tell your story, create a voice for your brand, and inform and entertain as you position yourself as a leader in the industry all while influencing the decision makers who buy craft brands. Join Alyssa and Julia, two powerhouses in beer and wine, as they talk you through their effective techniques that get noticed.
Zeeshan Masroor has over 14 years of experience in operations management roles in logistics, facilities management, and distribution. He has a track record of improving processes and metrics like productivity, accuracy, and costs. Masroor's skills include project management, process improvement, developing and motivating teams, and achieving operational goals.
Sales Force - Carnegie Mellon Today Article by Jonathan SzishJonathan Szish
Monte Zweben is the chair and cofounder of SeeSaw Networks, a one-year-old media company that operates a network of 14,000 digital advertising screens. Zweben has a background in artificial intelligence and has started other multi-million dollar tech companies. He graduated from Carnegie Mellon University in 1985 with degrees in computer science and industrial management. Throughout his career, he has applied artificial intelligence to solve real-world problems and commercialize intelligent software.
Este documento clasifica diferentes tipos de señales de tránsito en cuatro categorías: preventivas, reglamentarias, informativas y señales horizontales, longitudinales o de piso. También menciona señales elevadas y otros dispositivos como semáforos.
FINAL IN NORWIN WITH COVER AND TOC - MARCH 2016Jonathan Szish
This document provides a quarterly report from the Norwin School District covering events and accomplishments from the 2015-2016 school year. It includes summaries of various school productions, sports team achievements, volunteer efforts, and the dedication of a new veterans memorial outside the high school. Recognition is given to students and staff for their contributions to the district.
1) The document provides information about New York Spine and Brain Surgery, UFPC, which is part of the Department of Neurological Surgery at Stony Brook Medicine.
2) It details the mission and services provided, including treating over 1200 surgeries and 4500 new patients annually for various neurological and spine conditions.
3) Brief biographies are given for several of the neurosurgeons on staff, highlighting their specialties, experience, and leadership roles within the department and medical center.
Mental Health Services in Northwest OhioAvaWilson88
The goal of establishing school-based mental health (SBMH) programs at Williams County school districts is to benefit students who need mental health services but face barriers like travel or cost. To overcome those barriers, Community Hospitals and Wellness Centers (CHWC) has partnered with local school districts to bring mental health professionals right into the schools themselves. For more details, visit: https://bit.ly/2ZkcMgE
This document discusses Alberto Gomez's experience receiving an LVAD (Left Ventricular Assist Device) to treat his advanced heart failure at MedStar Washington Hospital Center. It describes how Alberto had faith and hope even when diagnosed, and was determined to make his LVAD treatment work despite challenges. It highlights how LVADs have revolutionized heart failure treatment by providing an alternative to transplant. It also notes how Alberto now supports other heart failure patients by sharing his experience and offering prayer.
This document summarizes a conference on psychiatric issues across the lifespan. The conference objectives are to educate mental health professionals about clinical challenges and issues across different life stages. Topics to be covered include bipolar disorder and ADHD in youth, adult ADD diagnosis and treatment, psychiatric disorders during childbearing years, non-narcotic pain management, and dementia diagnosis and ethics. Two keynote speakers are highlighted who are experts in women's mental health and psychotropic medication during pregnancy/lactation.
This document summarizes a story about a married couple, June and Ralph Henderson, who underwent a living kidney donation transplant. June's kidney function had been deteriorating and she was put on dialysis. Tests showed that Ralph was a match and was willing to donate one of his kidneys. Despite their advanced ages of 77 for June and 75 for Ralph, the transplant surgery was successful. Both have since recovered well and June's quality of life has significantly improved since receiving the donated kidney from her husband. The story highlights how age is not necessarily a barrier to living kidney donation.
This document contains a list of positive words and values related to healthcare such as caring, dedicated, experienced, and excellence. It introduces Richmond University Medical Center as a nonprofit provider of healthcare services on Staten Island including emergency, acute, primary, behavioral health, and medical services. It aims to promote the highest satisfaction among patients, families, physicians, and staff. The values of the hospital are welcoming, energized, compassionate, advocacy, respect, and excellence as summarized by the acronym WE CARE.
HMRI Searcher Newsletter Autumn 2014.
The latest health and medical research news from the Hunter Medical Research Institute (HMRI).
Featured research includes ovarian cancer, stroke, organ failure, smoking cessation, melanoma, leukaemia and breast cancer, as well as the latest fundraising and event updates.
Karen Luchini's life was saved twice by UMass Memorial - first after sustaining life-threatening injuries in a cycling crash in 2011, and then in 2013 when she was diagnosed with and treated for leukemia. Darlene Renaud expresses gratitude to the doctors and nurses at UMass Memorial for saving her life after being diagnosed with and treated for lung cancer in 2014. Richard Townsend feels that the doctors and medical professionals at UMass Memorial saved his life by treating his prostate cancer through radiation therapy.
- Medical schools teach students about death through lectures on ethics of body donation and commemorative services for donated bodies. This helps highlight the moral and social dimensions of dying alongside physical dimensions.
- Physicians often develop close relationships with patients and may experience grief when patients die. Common coping mechanisms include expressing emotions in a healthy way, taking time for self-reflection, embracing a "we" perspective to avoid feelings of personal failure, and defining one's role as providing comfort rather than solely focusing on curing.
- Surgeons describe coping with patient loss by developing relationships with families, sending condolence letters, and viewing death as a natural part of life rather than a failure, though it remains a difficult experience. Open
A recipient of the ACS CoC Outstanding Performance Award, Dr. Shahriyour Andaz is board-certified in both thoracic and general surgery and specializes in complex chest cancer procedures and robotic-assisted surgery.
The document provides an overview of the Canadian Consensus Document on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). It summarizes the development of the consensus document, which was spearheaded by the National ME/FM Action Network of Canada in response to the need for a clinical case definition and guidelines for diagnosis and treatment of ME/CFS. An expert panel of 11 clinicians and researchers with experience treating over 20,000 ME/CFS patients was selected to develop the consensus document. The panel held a funded workshop to reach consensus on a clinical case definition, diagnostic guidelines, and treatment guidelines for medical practitioners dealing with ME/CFS patients.
The document provides information about new services and specialists available at Wooster Community Hospital (WCH). It discusses the hospital's new interventional cardiology program that will allow patients to receive angioplasties and stents locally instead of having to travel to other hospitals. It highlights WCH's wound care center and the successful treatment of radiation ulcer patients. It also mentions the hospital's affiliation with The James Cancer Network, which will provide local access to immunotherapy treatments for cancers like melanoma, kidney cancer, and lung cancer.
Dr. Lim Hwee Yong is an oncologist who was drawn to the field due to the intense human interactions and vast research opportunities. He finds his work rewarding despite the challenges, such as bearing difficult news and the risk of burnout. Through dedication and compassion for his patients, he provides life-saving care and hope. He also aims to educate the public and reduce the stigma around cancer by emphasizing improved survival rates with early detection and treatment. While the work is demanding, Dr. Hwee Yong finds renewal through family, skiing, running and advocating for continued progress in cancer research.
This annual report from University Hospitals provides an overview of their accomplishments in 2014 and reaffirms their commitment to providing high-quality care to their community. Some key points:
- UH earned national recognition, being ranked among the top hospitals in the country by U.S. News & World Report.
- They expanded their network by integrating two community hospitals and increased access to care through programs like their Medical Access Clinic.
- Donations to their capital campaign exceeded expectations, bringing them close to their $1.5 billion goal as they approach their 150th anniversary in 2016.
- Stories of patients like Maggie Gleason and Laurie Duncan illustrate how UH is changing lives through innovative treatments and rapid response to emer
Ohio Osteopathic Association | 2013 MENTOR HOFOhioDO
This document summarizes the recipients of the Mentor Hall of Fame and Mentor of the Year award from the Ohio Osteopathic Association (OOA). It provides short biographies on 22 mentors who are being recognized for their commitment to mentoring and supporting osteopathic medical students and residents. The mentors come from specialties including family medicine, surgery, anesthesiology, dermatology, neurology, and internal medicine. They are praised for exemplary teaching, compassion for patients, and devotion to the osteopathic philosophy.
Dr. Herman is a 2015 “New York Super Doctor.” No more than 5% of physicians in the New York metro region achieve this designation, which is given by Key Professional Media, a leading research and medical ranking organization.
This document provides a summary of research and developments at the Eye Institute at the University of California, Irvine. It discusses Dr. Kenney's research into diabetic retinopathy at the cellular level to find safer treatments. It also discusses Dr. Lerner's stem cell research for age-related macular degeneration using a patient's own stem cells. Additionally, it highlights the role of the Institute's researchers in clinical trials that helped bring the drug Lucentis to market for treating wet macular degeneration.
Similar to WHC_CenterScope_Spring 2015_FINAL_LoRes (20)
1. SPRING 2015
NEWS AND INFORMATION FOR FRIENDS
OF MEDSTAR WASHINGTON HOSPITAL CENTER
On the Frontlines
of Traumatic
Brain Injury
2. 2 CENTERSCOPE | SPRING 2015 MEDSTARWASHINGTON.ORG 3
Riding All the Way Back
It all started last May when Brewer decided
to enjoy the spring evening by renting a
bike and peddling home from work. Near
Union Station, a speeding vehicle crashed
into the helmetless Brewer, knocking him to
the ground and fleeing the scene. A good
Samaritan immediately called 9-1-1 and
paramedics rushed Brewer to MedSTAR, the
Hospital Center’s Level I Trauma Center.
On-call that night was Edward Aulisi, MD,
chief of neurosurgery, who cared for Brewer
during his first critical hours. But the next
day, Brewer’s condition worsened, a serious
but common occurrence after a traumatic
brain injury. Dr. Aulisi called in his colleague,
Rocco Armonda, MD, neurosurgeon
and also the Hospital Center’s director of
Neuroendovascular Surgery since 2013.
After 31 years in the military, including a
deployment to the Middle East,
Dr. Armonda had seen a lot of patients
with severe brain injuries. But Brewer was
among the worst and, ultimately, luckiest
Dr. Amonda had treated in his career.
“The force of the impact was so great that
it broke the densest bone in the body, the
petrous portion of the skull base,” says
Dr. Armonda. “Just about every part of
Robert’s brain was affected with swelling and
bleeding. He was unresponsive, in a coma
and, quite frankly, we didn’t know if he’d
make it or — if he did — what his quality of
life would be.”
Region’s Most Sophisticated
Neuromonitoring Capabilities
Fortunately for Brewer, the Hospital Center
treats some of the most severe brain, spine,
spinal cord and peripheral nerve disorder
patients in the mid-Atlantic region. As
such, it features a multidisciplinary team
of specialists in neurology, neurosurgery,
orthopedics and related fields, as well as
specially trained nurses and other healthcare
professionals. A 14-bed Neuro Intensive
Care Unit combines the region’s most
sophisticated neuromonitoring capabilities
with subspecialty critical care staff,
contributing to the neuro program’s high
quality outcomes—and its standing as the
busiest and most experienced in the area.
The team used two specialized techniques
to treat Brewer. First, Dr. Armonda inserted
a highly sensitive probe that monitors
brain pressure, oxygen and temperature
simultaneously and minute by minute.
“The monitor gives us an accurate real-time
indication of what’s going on inside the
brain, removing a lot of the guess work from
deciding the best treatments and when
to intervene,” Dr. Aulisi explains. “It helps
us achieve superior results, while avoiding
unnecessary surgeries.”
Second, the team gave Brewer’s brain time
to rest and heal by rapidly lowering his
body’s temperature—effectively slowing
down all bodily processes. Brewer was kept
in this state of suspended animation for
five days, under constant watch in the ICU.
When Brewer turned the corner, the team
started gradually warming him back up, an
especially delicate undertaking, which lasted
for three more days.
Thankfully, Back to Work and
Loving Life
Nearly three weeks later, Brewer graduated
from MedStar Washington Hospital Center to
its sister facility, the equally renowned MedStar
National Rehabilitation Hospital, to begin the
arduous task of learning how to talk, walk and
otherwise function all over again.
While Brewer has no recollection of the
accident or his critical care stay, bit by bit, the
rest of his memories and faculties returned.
His mother, Beth, wrote a heartfelt letter to
the 2H neuro ICU team at the Hospital Center,
which in part read: “Our family collectively
believes Robert is with us because of each
of you: the best of the best. We were so very
fortunate and blessed that Robert received
the most special, amazing, and healing care
possible. Now that the critical moments
have passed, and I can look at Robert in total
amazement, I become weepy.”
In September 2014—only four-and-a-half
months after the accident—Brewer was back
at work.
Today, Brewer is again managing a full
portfolio of federal and private sector clients
as a senior consultant for Deloitte. He is also
back on a bike, albeit with a heighted sense
of caution, a tremendous appreciation for
the people who saved his life…and a helmet.
“I was so fortunate that Dr. Armonda—
someone who knows all there is about
traumatic brain injury from first-hand
battlefield experience—was a member of
the wonderful team that cared for me,”
Brewer says. “Thanks to him, Dr. Aulisi and
everyone else at MedStar Washington
Hospital Center, I can do the vast majority of
what I did before and continue to pursue the
life I love.”
If you or a loved one could benefit
from our neurosurgery treatments,
call 202-877-DOCS (3627).
TURNING THE CORNER AND HEALING AFTER A TRAUMATIC BRAIN INJURY
R
obert Brewer became one of the most
critically ill neurological patients that
MedStar Washington Hospital Center has
ever treated. But thanks to the team’s depth
of expertise and experience, the 30-year-
old survived and regained his previous life.
“WE WERE SO VERY
FORTUNATE AND
BLESSED THAT
ROBERT RECEIVED
THE MOST SPECIAL,
AMAZING AND
HEALING CARE
POSSIBLE.”
—BETH BREWER
3. C
ollege is supposed to be the time of
your life. For Ashley Donald, though,
the college experience has involved
a lifetime of changes. Yet, thanks to her
positive outlook, it has also opened up a
lifetime of opportunities.
This smart, charismatic 22-year-old Howard
University student is living with a chronic
autoimmune condition called Crohn’s
disease, which causes inflammation of the
digestive tract.
Donald, a radio-TV-film major, was
diagnosed with Crohn’s in December 2012,
and despite medication and repeated
surgeries, her disease was uncontrolled.
“Crohn’s disease is very challenging
to treat,” explains Thomas Stahl, MD,
regional director of the MedStar Colorectal
Surgery Program and interim chair of
the Department of Surgery at MedStar
Washington Hospital Center. “Multiple
surgeries are the norm. This is a chronic,
lifelong disease. But the more proactive
and involved patients are, the better they
can cope.”
Proactive and involved are words that
describe Ashley Donald to a “t.”
As a patient of the colorectal surgery
program at the Hospital Center, Donald
had access to a team of fellowship-
trained, board-certified surgeons who
specialize in minimally invasive surgery
to reduce pain and speed up recovery
time. These surgeons work closely with
gastroenterologists to provide the most
appropriate, coordinated medical and
surgical care for all patients.
“Because Ashley is so young, we wanted to
try every option before considering another
surgical approach—an ileostomy,” says her
colorectal surgeon, Anjali S. Kumar, MD,
MPH, academic director of the MedStar
Colorectal Surgery Program. An ileostomy,
or ostomy, diverts waste from the body
when the colon or rectum does not work
properly. This waste is removed through a
surgically created opening in the abdomen,
called a stoma, and into an external pouch.
“But when Ashley didn’t respond to
medication or other surgeries, we discussed
her complex case as a team and all agreed
that the ostomy approach was best,” says
Dr. Kumar. She counseled Donald and her
mother about the decision, explained the
procedure itself, and through many phone
calls and emails, they worked around
Donald’s busy college schedule.
Donald was appreciative. “Dr. Kumar always
made me feel comfortable and the Hospital
Center’s nursing staff took care of me with a
smile on their faces.”
“Psychologically, a diagnosis of Crohn’s
disease is difficult for anyone. Ashley has a
positive attitude that really shines through,”
say Dr. Kumar.
A Warm Welcome for
Stella the Stoma
During the course of her care, Donald kept
up this positive attitude—and has even
gone so far as to give her stoma a name:
Stella. She is also now reaching out to
others to serve as a resource and to provide
support, particularly for young people.
Donald started her own blog called, Stella
the Stoma (stellathestoma.wordpress.com),
writing about what it’s like to deal with
Crohn’s as a young person and covering
topics such as how to find cute clothes—
even two-piece swimsuits—that cover her
stoma.
“I sent a link to my blog to some of my
professors and they couldn’t believe what
had been happening the entire semester,”
recounts Donald. “The blog helped
me let them know my situation without
having an awkward conversation. Many
of them were proud of me for making it
through the semester. I will be graduating
on time in May, thanks to the support of
my professors, Dr. Kumar and MedStar
Washington Hospital Center.”
Leading the Way and
Improving Lives
The MedStar Colorectal Surgery Program’s
colorectal surgeons treat hundreds of
patients from throughout the mid-Atlantic
who have Crohn’s, along with other
diseases of the digestive tract, including
colorectal cancer. All of the surgeons work
collaboratively with physicians in other
disciplines to evaluate every treatment
option and develop a comprehensive,
integrated and coordinated care plan
together with each patient. The program
provides a high level of care and treats
patients with the most advanced, complex
diseases and disorders of the colon, rectum
and anus.
If you experience digestive tract pain
or have any of the symptoms, please
call the MedStar Colorectal Surgery
team for an appointment at
202-877-DOCS (3627) or visit
MedStarWashington.org/Colorectal.
EXPERT CARE, SUNNY
OUTLOOK INSPIRE
STUDENT TO BLOG
ABOUT DELICATE TOPIC
MEDSTARWASHINGTON.ORG 5
Every month—and at least weekly during the summer—
MedStar Washington Hospital Center’s neuro team cares
for a pedestrian or cyclist injured by a run-in with a vehicle.
Fortunately, the Hospital Center’s depth of knowledge and
expertise gives traumatic brain injury patients the best chance
to survive and thrive.
Nick Nguyen knows that first-hand. On November 4, 2013, six
months before Robert Brewer’s accident (see story, page 2-3),
a driver ran a red light and hit Nguyen as he jogged across a
street in Chinatown. The impact threw the 25-year-old into the
air, onto the car’s roof and then to the ground.
“Nick had an epidural hematoma—the same type of brain bleed
suffered by actress Natasha Richardson,” says Rocco Armonda,
MD, director of Neuroendovascular Surgery at MedStar
Washington Hospital Center. “Within minutes of arriving,
he went from being agitated and confused to a coma—an
indicator of a dangerous, complex series of internal events
that, if not stopped in time, is fatal in 90 percent of cases.”
Dr. Armonda immediately performed surgery to relieve the
mounting pressure on Nguyen’s brain, and keep him from
deteriorating further. Next followed 10 days of advanced
medical treatment in the Hospital Center’s specialized Neuro
Intensive Care Unit as Nguyen’s brain healed. He was then
transferred to MedStar National Rehabilitation Hospital for
extensive therapy. Six months later, Nguyen returned to his
career in international disaster relief. And a mere 363 days
after he almost lost his life, Nguyen marked the anniversary
by running the New York City Marathon—his first ever.
“I’m a grateful, lucky guy, and running lets me celebrate
being alive,” says Nguyen from his current assignment in the
Philippines. “I’m so thankful to everyone at the Hospital Center.
I wouldn’t be here without them.”
Edward Aulisi, chief of neurosurgery and a member of the
team that cared for Nguyen, agrees. “The brain can continue to
improve for three to four years after severe trauma. Recovery
from brain injury is a marathon, not a sprint.”
1993
2013
Nick Nguyen Celebrates Being Back in the Race
Marathon Runner Nick Nguyen
ShiningThroughDespite Crohn’s
4 CENTERSCOPE | SPRING 2015
4. J
ennifer Pinder, a Washington, D.C., native, was 26 years old
when she noticed a small lump in her gums. Although it wasn’t
causing pain, she promptly paid a visit to her dentist.
“I’ve always been diligent about my oral health,” says Pinder. “As
soon as I noticed that something was different, I knew I should have
it checked out.”
Pinder’s dentist was concerned, so he referred her to Dr. George
Obeid, DDS, chairman of the Department of Oral and Maxillofacial
Surgery at MedStar Washington Hospital Center. The department’s
surgeons are highly trained in the latest techniques to diagnose
and treat conditions and injuries of the mouth, jaws, neck, face and
skull. Dr. Obeid performed a biopsy, which revealed Pinder had a
rare type of tumor known to be aggressive and with the potential to
invade the rest of her jaw. The only treatment option was to remove
it through surgery.
Dr. Obeid was struck by Pinder’s strong ability to face the challenge.
“I told this young, attractive woman that the only treatment is to
remove part of her jaw with the potential disfiguring effect on her
face. Yet, Jennifer never flinched, accepted the recommendation
and was always upbeat
and optimistic about
the future.”
“For me, the hardest
part was that I was 26
at the time,” Pinder
says. “I felt like I was
supposed to be having
a good time like all
of my friends – but
instead, I had to have
a serious surgery and
there were a lot of
unknowns ahead
of me.”
A Jaw Fit for Cheeseburgers
The one thing that was certain was that Pinder’s quick action when
she noticed something wrong prevented the tumor from becoming
even more serious. Without prompt medical treatment, the tumor
could have grown and seriously affected her ability to chew and talk.
Over the next five years, Pinder had a series of procedures to
remove the tumor and rebuild her jaw using bone from her hip.
She lost five teeth in the initial surgery, and she spent almost a year
subsisting on a liquid diet.
“I love to eat, so that part of the ordeal was tough for me,” Pinder
explains. “I mostly ate noodles, soup and milk shakes. The food
I dreamed of eating most was a juicy cheeseburger.”
Though her journey was difficult, Pinder got through it thanks to her
strong support system and faith.
“Dr. Obeid’s bedside manner is the gold standard,” says Pinder.
“He treated me like a family member. The Hospital Center was so
great—I couldn’t imagine being cared for by anyone else.”
Though her medical issues took a toll, Pinder still tried to maintain
the routine of her life. She kept her job as a researcher at a not-
for-profit housing agency, taking a week off for each surgery. She
traveled, visiting Rio de Janiero for Carnival shortly before her most
complicated surgery. “I tried not to look at it like I was a victim,”
Pinder says. “I tried to look for the lesson and the opportunity to
grow as a person.”
Vigilance Paves Path to Full,Active Life
Today, Pinder, now 38, is tumor-free and living her life to the fullest.
She is an avid runner, having completed six half-marathons and one
full marathon. She enjoys cooking, traveling and spending time
with her family, especially her two nephews and four godchildren.
Pinder hopes that others will learn from her story and recognize the
importance of paying attention to changes in their health.
“Even if it’s the most minor thing, have someone take a look at it,”
she says. “I think sometimes people are scared their doctor will
think they’re paranoid. But if you’re concerned about your health,
you should absolutely talk to your doctor. That conversation might
save your life.”
Take Jennifer Pinder’s advice if you have any
sudden mouth or jaw symptoms (see sidebar). For an
appointment with an oral and maxillofacial specialist,
call 202-877-DOCS (3627), or visit MedStarWashington.org
and search oral surgery.
6 CENTERSCOPE | SPRING 2015
EARLY DETECTION CAUGHT HER TUMOR. ADVANCED ORAL SURGERY REBUILT HER JAW.
Not Just Another Pretty Face
“THE HOSPITAL
CENTER WAS
SO GREAT—
I COULDN’T
IMAGINE BEING
CARED FOR
ANYWHERE ELSE.”
—JENNIFER PINDER
Oral Health:
When to Visit
Your Healthcare
Provider
MEDSTARWASHINGTON.ORG 7
Everyone should visit the
dentist twice a year to ensure
good oral health. But if you
notice any of the following
signs or symptoms, don’t
wait—make an appointment
right away:
Jaw Tumor Signs and
Symptoms
• New or suspicious lumps in
your mouth or throat
• Jaw pain
• A swollen or misshapen jaw
• Difficulty chewing or
swallowing
• Difficulty moving the jaw or
tongue
Mouth Cancer Signs and
Symptoms
• Lesions that do not go away
within two weeks
• White or red patches
anywhere in your mouth
• New or suspicious lumps in
your mouth or throat
• Bleeding gums
• Consistently sore gums
• Difficulty chewing or
swallowing
• Difficulty moving the jaw or
tongue
• Ear pain
• A chronic sore throat or
hoarseness
• Unexplained numbness in
your face
“I HOPE THAT OTHERS WILL LEARN
FROM MY STORY AND RECOGNIZE THE
IMPORTANCE OF PAYING ATTENTION TO
CHANGES IN THEIR HEALTH.”
—JENNIFER PINDER
5. MEDSTARWASHINGTON.ORG 9
T
hroughout his long life, 98-year-old Bennett Boskey—
attorney, legal scholar, writer and all-around Renaissance
man—has probed for answers. Only these days, the
people he questions are more likely seeking charitable
support than judicial fairness.
Among them are Ron Waksman, MD, director of
Cardiovascular Research and Advanced Education, MedStar
Heart Vascular Institute and Stephen E. Epstein, MD,
executive director of the Cardiovascular Research Institute
who have questions of their own: What causes plaque in
blood vessels to rupture? With new approaches, can stem
cell treatments live up to their potential to improve symptoms
and outcomes? Can nanoparticles deliver therapies directly to
targeted sites?
Until 2001, however, such lines of inquiry held little attraction
for Boskey. With a wide-ranging intellect and equal number of
interests, he has been a generous and loyal donor to causes
and institutions dear to him and his family for many years.
But medical research wasn’t one of them.
Then, at age 85, he underwent emergency quadruple bypass
surgery at MedStar Washington Hospital Center.
After 32 days in the hospital, Boskey showed his appreciation
and gratitude with a six-figure gift, his first ever to the Hospital
Center. In turn, hospital leadership presented him with various
funding options; he chose cardiovascular research.
Fourteen years later, he’s still funding the program that
pursues a deeper understanding of heart disease, healing
and, ultimately, how to improve patient care. Today,
Boskey’s nearly $3 million in support, including a major
gift toward the new Heart Hospital, are leading the way to
future achievements.
“The MedStar Heart Vascular Institute already had a
reputation for doing innovative research when we first
came to Bennett’s attention,” says Dr. Epstein, a cardiologist,
cardiovascular investigator and frequent recipient of Boskey’s
support. “But he’s given us the ability to advance to the next
level. Thanks to him, the work we’re doing now will have a
major impact on cardiovascular research worldwide.”
Dr. Waksman is another beneficiary of Boskey’s support.
With his backing, the interventional cardiologist started a
center to study platelets, a blood component, four years ago.
Today, it is one of the leading research centers in the nation
devoted to the study of platelet reactivity—determining
how well, and how quickly, blood cells clot under
different circumstances.
“Mr. Boskey gave us the seed money we needed
and helped get us off the ground,” Dr. Waksman says.
“Now, we’re recognized for our expertise, and able
to attract substantial grants to further our efforts.”
Such progress pleases the results-oriented Boskey.
Donations do help save lives. Make a difference by
contributing to the work of MedStar Washington
Hospital Center. Reach out to the Washington
Hospital Center Foundation at 202-877-6558.
“I WANT MY GIFTS TO BE
USED IMMEDIATELY—
TO HELP MAKE SOMETHING
HAPPEN NOW.”
— BENNETT BOSKEY
FORMER PATIENT FAITHFULLY FUNDS HEART RESEARCH
Paying it Forward
8 CENTERSCOPE | SPRING 2015
Patients First
Above all:
C
ritical thinking and quick action helped Elizabeth Swanson,
RN, “connect the dots” to answer her question: Why was her
patient’s condition continuing to deteriorate?
A man was transferred to MedStar Washington Hospital Center
with a diagnosis of “cold foot,” which is usually linked to a blood
flow issue caused by a clot. Swanson, a nurse on unit 4F, became
increasingly concerned, though, when his condition worsened
and his symptoms did not fit with a common blood clot diagnosis.
When she received the lab report from the transferring hospital,
she realized he was already suffering from sepsis, but she also saw
something in the report that she did not recognize—the words
vibrio vulnificus.
Recognizing that something was clearly wrong, Swanson reached
out to the hospital’s epidemiologist, Dr. Ligia Pic-Aluas, who
happened to be on the unit at the time. Vibrio vulnificus is actually
a type of flesh-eating bacteria that occurs naturally in saltwater.
Together, Swanson and Dr. Pic-Aluas went immediately to talk with
and examine the patient.
Sure enough, he had been fishing in the Chesapeake Bay the
day before.
“Being from Colorado, it’s not something I’d seen before,” says
Swanson, “but nurses have to advocate for patients when they
notice a change and I was concerned that he might not be on the
best antibiotics for this bacteria.”
When Dr. Pic-Aluas confirmed the lab’s report, she set in motion
emergency surgery to remove the infected tissue and ordered
the correct antibiotics. Thanks to Swanson’s nursing instincts and
persistence in finding a solution, the man still has his leg, and his life.
“It makes my job worth doing and this is why I come to work each
day: I not only love to care for the patients but I absolutely love
putting all the pieces together so they can get back to their
loved ones.”
Nurse’s Persistence Saves
Patient’s Leg—Possibly Life
Enjoy a video featuring Elizabeth and more team
members who put our patients first, above all else.
Visit us at MedStarWashington.org and click on the
YouTube link.
6. 10 CENTERSCOPE | SPRING 2015 MEDSTARWASHINGTON.ORG 11
ECMO Works
Hard While
Hearts Rest
Like the heart-lung machine, the
Extracorporeal Membrane Oxygenation
system (ECMO) uses a pump, ventilator and
tubes to temporarily assume the function of
either or both organs. The medical devices
work by diverting blood away from the heart
and/or lungs, re-oxygenating it and then
re-circulating the replenished fluid throughout
the body. The chief differences lie in when and
how each system is used.
Invented in the mid-1950s, the heart-lung
machine is restricted to the operating room.
It completely bypasses the heart and lungs to
create a motionless and bloodless operating
field. Most procedures that require the heart
to be stopped during surgery would be
impossible without the heart-lung machine.
ECMO was designed 20 years later for
longer-term use in the neonatal intensive
care unit. With ECMO, the heart is never
stopped, allowing for an unlimited treatment
period. The life-support device takes over
much, but not all, of the heart’s and/or lungs’
function, lightening the organs’ workload and
buying important time for specialists to treat
underlying causes.
By the mid-2000, MedStar Washington
Hospital Center was at the forefront of using
ECMO on critically ill adults with pneumonia,
respiratory failure, heart attack, swine flu and
other serious pulmonary conditions. Today,
its specialists also use ECMO as a bridge to
ventricular assist devices or heart transplant
or—as in Sharon Allen’s case—to give respite
to a damaged heart.
ECMO requires 24/7 monitoring by highly-
trained perfusionists to regulate flow, volume,
pressure and other critical measures. As such,
it is only found in the most advanced heart
centers like MedStar Washington Hospital
Center, which boasts six mobile units for use
anywhere in the hospital. Last year alone,
approximately 50 adults benefitted from the
highly specialized service.
three of Allen’s coronary arterials walls
disintegrated in front of their very eyes.
They quickly did what they could to
stem the progression and prepare
Allen for the ride of her life: immediate
transfer by helicopter to MedStar
Washington Hospital Center—hub
of the 10-hospital system’s Heart
Vascular Institute, affiliate of the
renowned Cleveland Clinic, and Allen’s
best hope, more than 20 miles away.
“Allen’s condition—spontaneous
cardiac arterial dissection—was
extremely rare, severe and potentially
catastrophic,” Dr. Ellis explains.
“Basically oxygen-starved, some
of her heart tissue was already
suffering, putting her at risk for a
massive heart attack.”
While Allen was still airborne, Dr. Ellis
was already plotting out her approach:
Get Allen to the OR, perform open-
heart surgery and then hook her
up to the hospital’s ECMO. Only
available in top-tier heart centers,
the “Extracorporeal Membrane
Oxygenation” device can take over
both cardiac and respiratory functions,
giving damaged organs precious
time—up to several weeks—to rest
and regain the strength required to
resume their duties.
After undergoing a triple bypass
procedure, Allen’s heart needed
ECMO’s extra help for five days.
Less than a week later, she was
discharged to a rehab center, then
home. While she damaged some heart
tissue during her ordeal, she’s once
again feeling fine, living her life and
raising her five kids.
Such sophisticated technology,
techniques and high outcomes for
even the most critical conditions
contribute to MedStar Washington
Hospital Center’s ranking among
U.S.News World Report’s top 50
cardiac programs—the only heart
program in the metropolitan region
to earn this national recognition.
“The newest, most cutting-edge
procedures and devices—the things
you read about as ‘coming soon’—
are already available at MedStar
Heart Vascular Institute,” says
Dorian. “It’s a testament to their
expertise and leadership.”
So, too, is Allen’s recovery.
“The girls and I could have lost her,”
Dorian says. “Dr. Ellis is our hero.”
Join Sharon Allen by living a
full life with your loved ones!
Have your heart heath
examined by experts at MedStar
Heart Vascular Institute.
Call 202-877-DOCS (3627) to
schedule an appointment and
for more information, visit
MedStarHeartInstitute.org.
S
haron Allen was tired. But then again,
the 40-year-old had just given birth to
a baby girl—her fifth child—and was
trying to readjust to a busy family life at
home. Ten days later, when her shoulders
started to ache as well, Allen thought
maybe the flu was partially to blame.
But that night, breathlessness and a
gnawing sense of unease woke her up
repeatedly through the night. By morning,
she felt terrible.
Unbeknownst to Allen, she was showing
some of the classic signs of heart disease
in women.
“Women’s symptoms are often different
than men’s, more subtle and harder
to discern,” says Jennifer L. Ellis, MD,
cardiac surgeon at MedStar Heart
Vascular Institute at MedStar Washington
Hospital Center, the region’s nationally
recognized leader in advanced cardiac care.
“Furthermore, many women still consider
heart disease a ‘man’s disease,’ and are
reluctant to think that their heart might be
the cause of their symptoms. Yet women
account for more than half of all heart
fatalities each year.”
Like Allen, her husband Dorian was also
unaware of those facts. But the look on his
wife’s face telegraphed that something was
drastically wrong. “I saw panic,” he says,
recalling how he rushed his wife to the new,
free-standing health center that, fortunately,
had just opened a block away.
The center’s staff quickly determined
their young patient needed much more
urgent care than they could provide and
immediately sent her to the nearest hospital
emergency room. There, technicians, nurses
and experienced physicians alike reached
the same conclusion as, one by one, all
Mother of Invention
CARDIAC SURGEON, ECMO TECHNOLOGY SAVE YOUNG MOM’S LIFE
The ECMO system assumes much of the heart’s and/or lungs’ function, enabling the organs to rest
while specialists treat underlying problems.
7. 12 CENTERSCOPE | SPRING 2015
CenterScope is produced by
the Public Affairs Marketing
Department of MedStar
Washington Hospital Center
110 Irving St., NW
Washington, DC 20010.
MedStar Washington Hospital
Center, a valued member of
MedStar Health, is committed to
putting our patients first, above
all else, with a focus on providing
high-quality, safe care with
compassion for all.
MedStar Washington Hospital
Center, a private, not-for-profit
hospital, does not discriminate on
grounds of race, religion, color,
gender, gender identity, physical
handicap, national origin or sexual
preference.
John Sullivan, President
MedStar Washington Hospital Center
Theresa Dupart, Chair
MedStar Washington Hospital
Center Board of Directors
Kenneth A. Samet, FACHE
President and CEO
MedStar Health
Donna Arbogast, Vice President
Public Affairs Marketing
MedStar Washington Hospital Center
Barry Eisenberg, Managing Editor
Public Affairs Marketing
MedStar Washington Hospital Center
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What should you do if you think you are having a
heart attack? Call 9-1-1. Unfortunately, many people
think the answer is to call family or friends.
According to MedStar Heart Vascular Institute
researchers, calling 9-1-1 first will speed access to
lifesaving treatment. In a new study, researchers
found that patients transported to the hospital by
first responders were treated faster than those who
used their own transportation.
“We want people to trust their care to medical
professionals and call for help at the first warning signs of a heart attack,” says Lowell F. Satler, MD, the
study’s co-author and director of the Cardiac Catheterization Laboratory at MedStar Heart Vascular
Institute at MedStar Washington Hospital Center. “Our message is simple. Don’t call a relative or
friend or drive yourself or others to the hospital. Calling 9-1-1 first can be the difference between life
and death.”
The study showed that 83 percent of heart attack patients who used emergency medical services
(EMS) reached the Cardiac Catheterization Laboratory in fewer than 90 minutes—the gold standard—
compared to 54 percent of self-transported patients.
Another benefit of calling 9-1-1 first: EMS personnel can begin treatment immediately on-site and en
route to the hospital, expediting timely communication of critical medical information directly with
hospital personnel before a patient arrives.
An entire floor of the new Heart Hospital at MedStar Washington
Hospital Center was dedicated in January by MedStar Heart
Vascular Institute medical staff, associates and administrators.
The opening of the new 60-bed unit marks the completion of
Phase I of four phases in the construction of the first dedicated
Heart Hospital in the nation’s capital.
At 35,000-square-feet, the new fourth floor features both private
and semi-private patient rooms with the most current technological monitoring devices and equipment.
“This new facility and its structure will allow patients with similar medical issues to be together on single-
care units that have dedicated teams of cardiologists, cardiac and vascular surgeons, nurse practitioners
and nurses, to more efficiently deliver the highest quality cardiovascular care,” says Stuart F. Seides, MD,
physician executive director, MedStar Heart Vascular Institute.
Once all phases of construction are completed, the new Heart Hospital will consolidate all
cardiovascular care in the Hospital Center’s North Addition, covering more than 160,000
square feet. The 164-bed facility is projected to be completed in the
spring of 2016.
Don’t Phone a Friend!
Study Reconfirms: Call 9-1-1 First
Phase 1 of New State-of the-Art
Heart Hospital Opens
Lowell Satler, MD
What’s New