HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY

 
 
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
Health Focus
                                                                  winter 2010

 A MEMBER OF THE NORTH SHORE-LIJ HEALTH SYSTEM + WWW.NORTHSHORELIJ.COM

                                    Team Provides Lifesaving
                                             Breast Services

                                                Magic Wand Ends
                                                   Heavy Periods

                                            DaVinci: Code for
                                      Prostate Cancer Surgery
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
Message from Anthony C. Ferreri, President & CEO

      Dear Friends,
      With the opening of the Elizabeth A. Connelly Emergency and            a medical library and a new
      Trauma Center this past summer, I realized just how blessed I          health literacy program.
      am to live and work in such a remarkable community.                      “You have to think about the
        After a summer filled with praise for those who have sup-            people that will take the reins as
      ported our dream, I once again say “thank you” for helping             the leading clinicians of tomor-
      Staten Island University Hospital (SIUH) obtain the emergency          row,” said Brahim Ardolic, MD,
      care it so desperately needed. The money donated by the peo-           chairman of Emergency
      ple of Staten Island and its surrounding area had an essential         Medicine at SIUH. “What better way to keep them on
      role in the completion of the center, and it is fully appreciated.     Staten Island than to train them here?”
        Thank you for establishing momentum for future fund-raising            The campaign to raise additional funds for the Regina M.
      efforts throughout the community. I look forward to your con-          McGinn, M.D. Education Center will need the support of the
      tinued philanthropic efforts in behalf of the Regina M. McGinn,        Staten Island family and those closest to us who will once
      M.D. Education Center.                                                 again raise the bar for healthcare standards. Know that your
        With the ED complete, we anxiously await the education               support will have a double impact, as all donations will be
      facility. The center will be a living tribute to an icon whose         matched by the Staten Island Foundation, up to $150,000.
      short life was lived in dedication to the ideals of medicine and         There is no easier way to turn $1 into $2.
      medical education. It will recognize an outstanding young phy-           As a resident of this borough, your knowledge of SIUH and
      sician and her commitment to education and quality medicine.           its impact on the community is key to your understanding of
        As Staten Island’s population continues to increase, so does         this project and what it means for the future.
      the demand for medical education, which the center will look
      to fulfill. The facility will serve as a focus for healthcare educa-
      tion for our growing community, which will include a diabetes
      education center; space for regional medical meetings,
      seminars, workshops and support groups; and headquarters for

Hand Sanitizers = Convenient? Yes. A Solution? No

C
         arrying an alcohol-based hand sani-       cleansing procedures with soap and water,”
         tizer is a trend that is catching on      added Ms. Minucci.
         these days. Sanitizers are found in          Ms. Minucci offers some tips on hand
purses, backpacks, offices, bathrooms and          sanitizers:
especially in hospitals, but shouldn’t be          ◾◾ Use a hand sanitizer only when needed,
seen as a way out of cleaning your hands           such as while traveling or where there is no
with good old water and soap.                      sink available.
   “People use a hand sanitizer instead of         ◾◾ Keep at least a 4:1 ratio of washing your
washing their hands, which is not a good           hands to using hand sanitizers.
practice,” said Dorothy Minucci, RN, asso-         ◾◾ Hand sanitizers can ravage the skin from
ciate vice president of Epidemiology at            constant use, so make sure to keep your
Staten Island University Hospital. “There’s        hands moist with lotion.
no reason to use a hand sanitizer when you         ◾◾ Teach your children proper hand
have a sink readily available. A hand sani-        cleansing techniques.
tizer should not take the place of proper

2   Health Focus I Winter 2010
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
Incentive to Quit
How Smoking Has Changed Over the Years, and Why It Pays to Butt It Out

I
      f you are a longtime smoker, you may       finally quit,” said Mr. Gillespie. “What used    Flavored cigarettes were targeted under the
      have seen some serious changes in the      to be a majority is now a minority. People       Tobacco Control Act in June 2009 when the
      way Americans — especially New             come to me and say, ‘Listen, I’m the last        FDA was given authority to rein in the tobacco
Yorkers — smoke over the years.                  one in my family who smokes; it’s just me.       industry by banning some types of cigarettes,
   Think back to when a cigarette was in the     I have to quit.’”                                including grape- and clove-flavored cigarettes.
hand of every actor and actress in a movie.         In addition to New York’s 2003 smoking        The ban did not include menthol-flavored
Remember when a pack of cigarettes didn’t        ban in restaurants, bars and clubs, the Food     cigarettes, which is where the FDA may
cost more than dinner? Remember when             and Drug Administration (FDA) has recently       have fallen short.
you could smoke during dinner or at a bar?       banned flavored cigarettes, which can be seen       “They didn’t ban menthol, which would
   Those times are gone and are part of the      as a “gateway” tool for minors to start puff-    have been a huge step,” Mr. Gillespie noted.
reason why smoking is at an all-time low of      ing and eventually lead to an addiction.         “About 50 percent of people who smoke
20 percent of the American population —             Studies have shown that teenagers are three   menthol cigarettes have a much harder time
with a seven percent drop in just the past       times more likely to smoke flavored cigarettes   quitting, possibly due to the ‘fresh’ taste
six years.                                       than adults older than age 25. Banning fla-      and smell.” 
   If the laundry list of chemicals and poten-   vored tobacco could help keep an average of
tial medical problems didn’t scare America,      3,600 teenagers per day from having their          FREE SMOKING CESSATION
something else did — a hit in the wallet and     first cigarette, according to the FDA.           HELP For more information on how to quit
a serious hassle of finding a place you could       Mr. Gillespie believes the ban was a “good    smoking, call the Center for Complementary
still smoke.                                     start, but not enough.”                          Medicine at (718) 226-6921.
   “Cutting down on places people could
smoke is a huge factor in the decrease
over the years. Between the increas-
ing price of a pack of cigarettes and
the inconvenience of finding a place
to exercise the habit, many people
have given up,” said Kerry Gillespie,
MS, director of the Center of
Complementary Medicine at Staten
Island University Hospital (SIUH).
   Mr. Gillespie explained, “People
looking for that last reason now have
it. Numerous employees have quit
recently with the final straw being the
walk across the campus to smoke.”
   At the beginning of 2009, SIUH
started a smoke-free campus cam-
paign to thwart smokers from light-
ing up on hospital property, and the
trend has caught on as countless
other hospitals have since imple-
mented the smoking ban.
   As of November 2009, New York
City has passed a law prohibiting
smoking on the grounds and near
the entrance of healthcare facilities,
including hospitals. In addition, Mr.
Gillespie said smoking is being pro-
hibited on all city property within
the next few years.
   “Over the past few years, I have
seen a huge influx of people coming
to me in the hope that they can

                                                                        SETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com            3
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
With Nowhere to Turn, Islander with Breast Cancer
    Thanks SIUH, Her “Family of Support”
“
    N
              o woman on Staten Island needs to          “Theresa was diagnosed with breast cancer         Theresa then underwent surgery for a bilat-
              go without lifesaving care for breast   in August of 2008, and through Ms. O’Brien’s      eral mastectomy with axillary node dissection
              cancer,” remarked Barbara O’Brien,      encouragement, arrived at the SIUH Breast         with Heather McMullen, MD, breast surgeon
    RN, administrator of the Cancer Services          Imaging Center many months later.                 and SIUH director of General Surgery.
    Program at Staten Island University Hospital         “I love her to death,” Theresa says of         Following her surgery, Theresa received radia-
    (SIUH), which operates with the support of        Ms. O’Brien.                                      tion therapy under the supervision of Phillip
    a state grant.                                       Ms. O’Brien recalled, “when Theresa            Vigneri, DO, chairman of Radiation
       To prove her point, Ms. O’Brien recounts       arrived at the Breast Imaging Center, we did a    Oncology.
    the near tragic plight of Theresa Barrese, a      complete workup on her. On the day of her            Theresa’s journey over the past year has been
    recent patient who views the SIUH care team       first appointment, a diagnostic mammogram         one of fear and hope. “I am naturally optimis-
    as “her family of support.”                       was scheduled, followed by an ultrasound.”        tic, but when I needed to be uplifted, Barbara
                                                         An MRI-guided biopsy was performed on          O’Brien was my cheerleader, and Maureen
                                                      Theresa by Carolyn Raia, MD, the director of      Caccese, my breast navigator, was always there
    “The women of Staten Island
                                                      the Breast Imaging Center and a board-certified   to hold my hand,” Theresa said.
    have no idea what they really                     radiologist specializing in breast mammography.      “The women of Staten Island have no idea
    have here. They are very                             Theresa didn’t realize how sick she was,       what they really have here. They are very
                                                      Ms. O’Brien reported. Her breast cancer had       fortunate.” 
    fortunate.”
                                                      become so advanced in the year since her
                                                      diagnosis that she required neo-adjuvant            Don’t Delay, Schedule a
      Ms. O’Brien learned of Theresa’s struggle       chemotherapy to shrink the tumor before           Mammogram Today! To arrange for
    through her daughter, Jennifer, who wanted        surgery could be performed.                       a mammogram, call the Breast Imaging
    her mom to have the treatment she needed,            Medical oncologist Marcel Odaimi, MD,          Center at (718) 226-1333.
    but was afraid to seek, because she did not       began Theresa’s chemotherapy on New Year’s
    have health insurance. “I had no hope,”           Eve, placing a portal for the treatments that
    Theresa recalled.                                 began on January 2, 2009.
                                                                                                            Breast Health
                                                                                                            Services at SIUH
                                                                                                            Managing breast health involves
                                                                                                            a team that includes a:
                                                                                                            • breast imaging radiologist;
                                                                                                            • breast surgeon (surgical
                                                                                                            oncologist);
                                                                                                            • radiation oncologist;
                                                                                                            • medical oncologist; and
                                                                                                            • plastic surgeon, if necessary.

                                                                                                            This team of doctors will work
                                                                                                            with the breast navigator to
                                                                                                            coordinate your care among the
                                                                                                            specialists.
                                                                                                              Inclusive of the breast imaging
                                                                                                            services available at SIUH are:
                                                                                                            • screening mammogram;
                                                                                                            • diagnostic mammogram;
                                                                                                            • breast ultrasound;
                                                                                                            • fine needle aspirations;
                                                                                                            • core biopsy;
                                                                                                            • vacuum-assisted biopsy;
                                                                                                            • breast MRI; and
                                                                                                            • MRI-guided biopsy.
                                                                                                                        Continued on page 11

    4   Health Focus I Winter 2010
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
When a Mammogram Is Not Enough

W
              hen your genes, or family or personal history reveal a
              heightened risk for breast cancer, there may be more that
              can be done in the fight against breast cancer. Your doctor
may recommend annual MRI screening.
  “This is in addition to your yearly mammogram,” advised Carolyn
Raia, MD, director of the Breast Imaging Center at Staten Island
University Hospital (SIUH).
  Women who have undergone a genetic test and are found to carry a
specific mutation, or are the daughter or sister of a known gene carrier,
are definitely candidates for MRI screening, according to Dr. Raia.
  Dr. Raia and Heather McMullen, MD, a breast surgeon and the
SIUH director of General Surgery, agree that a genetic link to breast
cancer or convincing knowledge of strong family history of the disease
are justification for women to go for both screenings.
  Women in this category usually have a first-degree relative — a
mother or sister — diagnosed with breast cancer when they were
pre- or perimenopausal.

                          Genetic Testing Available
                          “If you fall into the high-risk category and
                          believe you would benefit from genetic
                          testing, we can help you schedule a test in
                          our office,” said Dr. McMullen.
                             “We test for BRCA1 and BRCA2, the
                          human genes that belong to a class of genes
                          known as tumor suppressors,” Dr. McMullen
                          explained. In normal cells, BRCA1 and
                          BRCA2 help ensure the stability of the cell’s
Carolyn Raia, MD
                          genetic material — the DNA — and help

                          Breast cancer is diagnosed
                          in 1.2 million men and women
                          globally every year.

                          prevent uncontrolled cell growth. Mutation
                          of these genes has been linked to the devel-      Women with Breast Cancer
                          opment of hereditary breast and ovarian           For women who already have had breast cancer, most are at moderate
                          cancer. Interestingly, men with harmful           risk of recurrence for cancer in the opposite breast. These women
Heather
McMullen, MD              gene mutations have also been found to be         should discuss the value of annual MRI testing with their doctors.
                          in a higher risk category for breast cancer.         Breast MRI testing is available at Verrazano Radiology, which is
                            Dr. McMullen shares the experience of a         adjacent to the Breast Imaging Center. The studies are interpreted
                          woman who tested at a high risk for breast        by radiologists who specialize in breast imaging and breast MRI. 
                          cancer. She used the information and opted
                          for an oophorectomy, having her ovaries               Schedule a Test Today! To arrange for a mammogram, call
                          surgically removed. This procedure is             the Breast Imaging Center at (718) 226-1333. To learn about Breast
                          known to decrease the amount of estrogen          MRI, call Verrazano Radiology at (718) 667-4700. For a genetic test
                          a woman’s body produces. Clinical evidence        for breast cancer risk, call Dr. McMullen’s office at (718) 226-1300.
                          suggests a correlation between excess estrogen    To learn more on breast health, or to see if you qualify for free
                          and breast cancer.                                services, call Barbara O’Brien, RN, the administrator of the Cancer
                                                                            Services Program, at (718) 226-6447.
Phillip Vigneri, DO

                                                      SETTING NEW STANDSETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com                  5
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
Island Physician’s Patent May Lead
to Breakthrough for Women’s Health

R
         esearch results and a new staining     is based on a technique that stains intact       contain viral parti-
         method hold future promise of pre-     HPV particles in biopsied cervical tissues.      cles with HPV
         dicting which women infected with         Surprisingly, a women’s lifetime risk of      DNA present in
the human papillomavirus (HPV) will develop     acquiring HPV is 80 percent. Most women          the nucleus.
precancerous lesions or cervical cancer. The    get better on their own. About 10 percent of        HPV viral particle
method developed to identify women at risk      women are not able to clear their bodies of      DNA was only pres- Mario Castellanos, MD
has earned an International Patent (PCT)        human papillomavirus and develop a precan-       ent in women with benign infections.
filing from the World Intellectual Property     cerous condition within two years.                  He concluded from his observations that
Organization.                                      While only a small percentage of women        cancer-prone women lacked viral particle
   The PCT patent application was submit-       actually develop precancerous lesions or cer-    DNA and that this method could identify
ted in July 2009 by Mario Castellanos, MD,      vical cancer from HPV, the question is:          HPV-infected cells that are undergoing
through Staten Island University Hospital       “Which women of the million new HPV              malignant transformation.
(SIUH) and the Feinstein Institute for          cases diagnosed each year will be the one?”         In patenting VIRION-Associated DNA
Medical Research of the North Shore-LIJ            Working with the support of staff in the      staining, Dr. Castellanos hopes to encourage
Health System. Dr. Castellanos is the direc-    SIUH Pathology Department, Dr. Castellanos’      further development.
tor of SIUH’s Medical Women’s Health            research findings came after microscopically        The goal, according to Dr. Castellanos, is to
Division and clinical director of research in   examining DNA from hundreds of HPV-              partner with a biotechnology company in
the Department of Medicine.                     infected women.                                  developing an easy-to-use test that can be
   Dr. Castellanos began his investigational       In HPV-infected women with precancerous       administered in hospitals and clinical laborato-
work 10 years ago as a young resident physi-    and cancerous conditions, Dr. Castellanos        ries to process cervical biopsy tissue in a faster
cian hoping to improve upon the standard        identified a fascinating fact. Abnormal cells    manner for a quick and accurate diagnosis.
Pap test. His goal was to win the annual        processed by his method had no intact viral         Dr. Castellanos’ stain could potentially
residents’ research competition. His love       particles and as a result they lacked HPV DNA.   improve on today’s major diagnostic tool —
of research took him further.                      This was in contrast to women with            colposcopy. Colposcopy is done as a follow-
   “The method,” as Dr. Castellanos calls it,   benign infection. Their viral lesions did        up to an abnormal Pap test. 

Caring for Today.
Planning for
Tomorrow.
The North Shore-LIJ Health System
Foundation’s new Web site features an
attractive, user-friendly design. Visit
www.NorthShoreLIJ.com/foundation
today for:
◾◾ a variety of opportunities to support
   North Shore-LIJ: donate to building
   projects or individual hospitals, make a
   gift in honor of a loved one and more;
◾◾ regularly updated campaign pages with
   news about exciting changes
   throughout the health system;
◾◾ expanded coverage of Foundation and
   health system events, including the
   opportunity to purchase event and
   raffle tickets online; and
◾◾ photo albums featuring our
   supporters.

6 Health Focus I Winter 2010
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
Putting an End to Heavy Periods

O
           n a recent episode of the TV show       treatment of menorrhagia,”
           “The Doctors,” a Los Angeles gyne-      Dr. Schirripa explained.
           cologist used his “magic wand” to          Considered good candi-
put an end to his patient’s painful and horrifi-   dates for endometrial abla-
cally heavy periods. The painless procedure        tion are women who are
took 90 seconds, and the perky 45-year-old         finished having children
mother of three reported going out to dinner       but have not yet completed
that evening.                                      menopause. They usually
   Staten Island women now have access to          have several more years of
the same procedure, according to Michael           producing natural hor-
Schirripa, MD, a board-certified obstetrician      mones from their ovaries.
and gynecologist experienced in the NovaSure          Endometrial ablation is
System of endometrial ablation.                    not recommended for those
   “Using my own ‘magic wand’ — a gold-            at a high risk for endome-
plated mesh wand — I’ve safely delivered           trial cancer.
radio-frequency energy to gently remove the
endometrial lining, helping hundreds of            The Procedure
women,” Dr. Schirripa said. Published              NovaSure is an outpatient
reports show the FDA-approved technique is         procedure that is done vagi-
proving 95 percent effective in doing its job.     nally, generally under local
                                                   anesthesia. The cervix is
Candidates for NovaSure                            slightly dilated and the slen-
Women who are candidates for NovaSure              der wand — premeasured
may have tried hormone therapy that proved         to the individual’s dimen-
ineffective in stopping their excessive men-       sions — is inserted through
strual bleeding.                                   the cervix into the uterus.
   These are women struggling to cope with         A triangular mesh array is
periods that:                                      extended through the wand
◾◾ last longer than seven days;                    where it expands to conform to the dimen-           Staten Island women now have
◾◾ produce bleeding so heavy they go               sion of the uterine cavity. Radio frequency is   access to a procedure that eliminates
through 20 or more sanitary napkins or             then delivered into the uterus for approxi-      heavy periods. To find out if you are
tampons in a single day; or                        mately 90 seconds.                               a candidate, contact Dr. Schirripa
◾◾ change tampons or napkins as often as              Stacey Inchausti, a patient of Dr.            at (718) 966-7333.
twice an hour.                                     Schirripa, hasn’t experienced any bleeding
   Coping with heavy bleeding every month          or spotting since undergoing the procedure.
becomes lifestyle disruptive and some              “I still experience the symptoms like I am
women are coping with considerable pain as         going to have a period — but there is               Follow Us on Facebook
well. “Many women are not candidates for,          no blood and I don’t have to take                   Studies have shown that Internet
or do not tolerate, hormonal therapy, as a         hormones.”                                          users check their Facebook accounts,
                                                                                                       on average, more than twice as much
                                                                                                       as they check their e-mail. So why
                                                                                                       not take a minute to add SIUH’s new
                                 Meet Michael Schirripa, MD                                            exciting page to your profile? Simply
                                 Michael Schirripa, MD, trained in obstetrics and gyne-                go to www.facebook.com/siuhospital
                                 cology at Brooklyn Hospital Center, where he became                   and add us! It’s that easy!
                                 chief resident. Dr. Schirripa is board-certified in obstet-
                                 rics and gynecology and holds membership in the
                                 American College of Obstetrics and Gynecologists,
                                 American Medical Association, American Society of
      Michael Schirripa, MD      Colposcopy and Cervical Pathology and American
                                 Institute for Ultrasound in Medicine, among others.

                                                                             SETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com       7
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
SIUH Expert Treats KTS, a Commonly
Missed Vein Disorder

T
         o many people, professional golfer       pressure on my veins,” said Ms. Straschnowa.       difference within a
         Casey Martin is a household name,           Dr. Giangola describes KTS as a “serious        week,” reported Ms.
         but the condition he suffers             medical condition.” “The leg in some of these      Straschnowa.
from is not.                                      patients becomes quite enlarged, disfigured           “Our goal is to
   Klippel-Trenaunay Syndrome (KTS),              and very symptomatic, so it can be very prob-      relieve pain and         Gary Giangola, MD
commonly misdiagnosed as varicose veins,          lematic. Most people who have this condition       heaviness and to give
limited Martin’s ability to participate in the    don’t want to treat it for cosmetic reasons;       patients an active, productive life,”
Professional Golfers’ Association (PGA) due       they just want to feel better.”                    said Dr. Giangola.
to the swelling and pain he suffered in his          After Ms. Straschnowa gave birth to her            “The worst part of having KTS is the
leg from the condition.                           last child she wanted to have her leg treated      heaviness and pain when my leg is swollen,”
   Martin made headlines in 2001 for suing        again. “I looked at my MRI from my last            said Mary DeFranco, 21, Roseto, PA.
the PGA for their “no cart rule,” limiting his    procedure and it said I had KTS! They never           When Ms. DeFranco was born they told
ability to play. Martin won the suit under        told me I had KTS!” Like many sufferers of         her parents she had a hemangioma (port
the Americans with Disabilities Act and was       KTS, patients are not even aware they have         wine stain) and varicose veins.
able to compete with the use of a golf cart.      the syndrome and are treated as having only           “Once I got older, the varicose vein started
                                                  varicose veins.                                    to come out, so I went to a local vein treat-
KTS, A rare vascular Disorder                        “I’m amazed KTS is still misdiagnosed,”         ment center, but they said it was too
Klippel-Trenaunay Syndrome is a rare              explained Dr. Giangola, “because there are         advanced to perform treatment.
congenital vascular disorder affecting one or     more well-trained vascular surgeons than              Doctors at her local vein center told her
more limbs. Documented in 1900, French            there were in the past.                            that her deep veins never actually developed
physicians Klippel and Trenaunay described           Ms. Straschnowa searched for doctors who        and that was the cause of her varicose veins.
this syndrome as having three major               treat KTS and was relieved to find Dr. Giangola.      Ms. DeFranco explains how she finally
symptoms. These main symptoms, often                                                                 learned of her condition.
referred to as the “triad,” consist of vein       New Treatment for KTS                                 “I saw a procedure done by Dr. Milton
anomalies, varicose veins; hemangiomas, or        A new approach for treating KTS developed          Waner on the Discovery Channel to treat
strawberry/port wine stains; and elongation       by Dr. Giangola, along with his assistant,         hemangioma and went to see him for treat-
of the bones.                                     Krista Frasier, BS, RVT, is being performed        ment. Dr. Waner referred me to Dr. Giangola
   “The exact cause of KTS is unknown,”           and is giving patients greater quality of life.    for vein treatment, and that’s when I found
stated Gary Giangola, MD, chairman of               “I came for treatment about every two            out I had KTS.”
Vascular Services at Staten Island University     weeks, and after each treatment, I noticed a          “When I started treatment, I noticed a
Hospital (SIUH). “It is a true malformation                                                          difference right away. The swelling was
of the venous system, a fluke of nature. It’s                                                        down and my leg looked great,” said Ms.
not inherited from parent to child, and                                                              DeFranco.
there’s no family history.”                                                                             As a result of SIUH’s success in treating
   “I was born with varicose veins,” explained                                                       KTS, doctors all over the region are referring
Rita Straschnowa, 36, of Woodmere, N.Y.                                                              patients to Dr. Giangola.
“My mother took me to a vein doctor when
I was 10. The doctor advised me to treat the                                                         Vein wellness center to open
veins after I had children.”                                                                         Within the year, SIUH will open a Vein
   After having two children, Ms. Straschnowa                                                        Wellness Center, headed by Dr. Giangola.
decided to have her veins treated. “I went to                                                        The center will be able to treat a wide range
a vein treatment center, and the doctor said                                                         of vascular conditions. In addition, the Vein
he had to perform vein stripping,” a com-                                                            Wellness Center will also be teaching the
mon procedure for treating varicose veins.                                                           vascular specialists of tomorrow through its
“He took out some veins and my legs got a                                                            residency and fellowship programs. 
little bit better from that treatment.”
   A short time after her first varicose vein                                                           Are vascular problems causing
treatment, Ms. Straschnowa had two more                                                              swelling and pain? To find a vascular
children. “My leg swelled from the weight I                                                          specialist at SIUH, call (718) 226-6800.
put on during the pregnancy and it put a lot of

8 Health Focus I Winter 2010
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
Da Vinci Robot for Prostate Cancer Surgery

W
              ith its computer and robotic arms, Staten
              Island University Hospital’s newly arrived
              da Vinci SI model HD surgical system
would fascinate Leonardo. “The da Vinci system allows
the hospital’s urology team to perform innovative robotic-
assisted laparoscopic prostatectomy,” according to
Nachum Katlowitz, MD, Staten Island University
Hospital director of Urology, and Nicholas Karanikolas,
MD, the hospital’s director of Urologic Oncology.
   More than 243,000 American men are diagnosed
with prostate cancer each year, and for some, the
disease is life threatening. Prostatectomy — surgical
removal of the prostate — is considered one of the
most effective treatments for prostate cancer, but the
operation can be a cause of anxiety for the patient
because of associated risks to urinary control and
sexual function.
   With the da Vinci robot, urologists are able to offer
patients a minimally invasive approach. Employing
use of the robot’s state-of-the-art technology, the da
Vinci allows urologists to perform complex surgery         From left: Urology teammates Michael Savino, MD, Nachum Katlowitz, MD, and Nicholas Karanikolas, MD.
through tiny openings.
   While Leonardo’s vision found expression in art and science, the              With the aid of the da Vinci, patients and their doctors are report-
robot bearing his name offers surgeons superior visualization in the           ing less blood loss, less pain and faster return to normal activities. 
operative field.
   With an amazing degree of depth perception, the da Vinci sharp-                To learn more about minimally invasive treatment for
ens views of the prostate and its network of surrounding nerves and            prostate cancer, contact Dr. Katlowitz at (718) 226-6461 or
tissues. Da Vinci’s arms become an extension of the surgeon’s own              Dr. Karanikolas at (718) 226-6031.
hands with the added benefit of a 360-degree range of motion not
possible with the human hand alone.

Gain Control Over Your Prostate Cancer Risk

W
            hat men eat may affect their risk         research has found Vitamin E also might be           includes jogging or playing basketball.
            for prostate cancer. So could             beneficial. You’ll find it in vegetables, nuts       Consult your healthcare provider before
            other lifestyle choices. What can         and egg yolks. Research continues on the             starting a vigorous exercise program.
you do to lower your risk? Research suggests          effects of antioxidants and prostate cancer          ◾◾ Ask your doctor about taking aspirin.
the following actions may help:                       prevention.                                          Older men who regularly used aspirin had
◾◾ Go lean. Choose lean meats or vegetable            ◾◾ Lose those extra pounds. In one study,            fewer cases of prostate cancer, researchers
dishes instead of meals high in animal fat,           men who had lost at least 11 pounds in the           found. However, aspirin also can increase
which has been linked to prostate cancer.             past 10 years enjoyed a lower risk for pros-         your risk for internal bleeding, so be sure
◾◾ Choose high-nutrient foods. Foods such             tate cancer. Overweight older men also were          to ask your doctor first.
as rice, wheat and seafood contain selenium.          much likelier than normal-sized men to
A few studies have shown that this antioxi-           develop a more serious form of the disease.             To learn more about your own risk for
dant may help prevent prostate cancer or slow         ◾◾ Exercise regularly. A recent study found          prostate cancer, take the interactive quiz at
the growth of prostate tumors, although other         that, compared to couch potatoes, men ages           http://understandingrisk.cancer.gov/
studies have shown no benefit. Lycopene also          65 and older who exercised vigorously at             a_prostate/00.cfm.
may reduce a man’s risk for prostate cancer.          least three hours a week had about a 70 per-
It’s abundant in raw or cooked tomatoes,              cent lower chance of being diagnosed with
pink grapefruit and watermelon. And some              advanced prostate cancer. Vigorous exercise

                                                                                SETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com                   9
HEALTH FOCUSWINTER 2010 - TEAM PROVIDES LIFESAVING BREAST SERVICES MAGIC WAND ENDS HEAVY PERIODS DAVINCI: CODE FOR PROSTATE CANCER SURGERY
Mastering a Mystery Disease

A
          daring diagnosis has saved the life of   untold numbers of patients currently misdiag-     minute in terms of
          a young reporter, while a 16-year-old    nosed with uncontrollable mental disorders        our ability to measure
          is rescued from hospitalization in a     and for those lost and dying without ever         it with current
psychiatric unit.                                  being diagnosed.                                  MRI or imaging
    With amazing medical acumen, Souhel                                                              technology,” Dr.
Najjar, MD, Staten Island University Hospital      A Disease in Hiding                               Najjar explained.
(SIUH) director of Neurology, a neuropathol-       Dr. Najjar convinced Ms. Cahalen’s parents           Ms. Cahalen started Souhel Najjar, MD
ogist and attending New York University            that a brain biopsy was necessary. “This is       on the road to recov-
physician, has combined personal courage           not an easy step, but I knew I needed a tis-      ery with a regimen of IV immune
with medical conviction as he sleuthed a           sue sample from the limbic section of Ms.         globulin and then steroidal medications
mystery disease.                                   Cahalen’s brain in order to confirm the diag-     to reduce the inflammation.
    Drawing upon his skill as a physician and      nosis I strongly suspected,” Dr. Najjar said.        Fully recovered, she is again a happy
having the drive of a detective, Dr. Najjar is        Sure enough, clinical results came back        and healthy young adult.
diagnosing a “new” disease that still leaves       positive for rare antibodies called anti-N-
most doctors baffled.                              methy-Daspartic acid receptor, or anti-           Dr. Najjar Gives Mystery
    Susannah Cahalen knows only too well.          NMDAR encephalitis.                               Disease a New Name
The 24-year-old wrote her own story in the            “Ms. Cahalen’s brain was under attack,”        In classifying anti-NMDAR and GAD anti-
New York Post’s Sunday, October 4, edition.        said Dr. Najjar. The receptors in the frontal     bodies, Dr. Najjar is terming the resulting con-
The young urbanite reported on how she             lobe of the brain — the area responsible for      ditions autoimmune encephalitis. The group of
went from happy and healthy to suddenly            cognition — and the limbic system, the emo-       antibodies was first identified in 2003, accord-
stricken: suffering a month of madness,            tional center of the brain, were under assault    ing to Dr. Najjar. “The lesions they create are
psychotic behaviors, paranoia and seizures.        by her immune system.                             in reality a psychiatric manifestation, psychiat-
    No one, no test uncovered the cause of her                                                       ric symptoms of a neurologic disease,” Dr.
problem until Dr. Najjar took her hand and         Swelling Under the                                Najjar asserted.
with calm confidence announced, “I am going        Radar for MRI
to find out what this is, and I am going to fix    “Even though brain biopsy results demonstrate        For more information on neurologic
it.” Fix it he did as he is preparing to do for    inflammation, the swelling is significant but     diseases, call Dr. Najjar at (718) 683-3766.

Staten Island Program Enhances Child Development

T
         he Staten Island Early Childhood Direction Center (ECDC)
         has assisted the families of more than 11,000 children with
         special needs between the ages of birth through five years, as
they searched for appropriate educational evaluations, programs and
services. The ECDC has linked parents and professionals to a variety
of medical, therapeutic, and social service supports to enhance the
lives and development of our borough’s youngest children. The
ECDC has also trained thousands of parents and professionals on
topics including child development, preparing for kindergarten, and
understanding preschool special education and kindergarten special
education services.
   Participation in quality early childhood experiences and educational
programs is important for all children so they may reach their full
potential. Early intervention and preschool special education has had
a positive impact on the successes we see in children today. A myriad
of family education and support programs are available on Staten
Island that form a wide community of interest for the benefit of
families and their children

   To learn more about services available through the Early
Childhood Direction Center, please contact Laura Kennedy at
(718) 226-6304 or lkennedy@siuh.edu. The ECDC can be reached               SIUH President and CEO Anthony C. Ferreri accepts the Proclamation from Ken
                                                                           Mitchell, (R), former NYC Councilman.
at (718) 226-6670 or ECDC@siuh.edu.

10 Health Focus I Winter 2010
Electronic Health Records to Connect 13
Hospitals, Up to 7,000 Physicians

T
         hroughout the healthcare landscape, it’s being referred to as a    who receive the 85 percent subsidy from North Shore-LIJ will agree
         “gamechanger” — an initiative so bold that other hospitals         to use the EHR to report and share their performance data, allowing
         and health systems have to rethink their approaches to             them to compare it against a set of nationally recognized measures
implementing electronic medical records. This past fall, the North          for superior care and outcomes.
Shore-LIJ Health System announced plans to subsidize up to 85 per-
cent of the cost of implementing and operating an electronic health         Real-Time Patient Care Support
records (EHR) system in the offices of its more than 7,000 affiliated       The EHR program will provide real-time situation-appropriate care
physicians in New York City (including those at Staten Island               plans, clinical alerts and preventive care. For example, when a physi-
University Hospital) and Long Island.                                       cian indicates a patient’s problem, he or she is provided with a list of
   The initiative is part of a $400 million investment North Shore-         diagnostic tests and possible therapeutic interventions that are con-
LIJ is making to strengthen the quality of care throughout the region       sidered best practices to help support the decision-making process.
by automating inpatient and outpatient records in all medical set-          The system also suggests a long-term individualized plan for ongoing
tings, including Staten Island University Hospital’s North and South        monitoring of the patient.
Divisions and 11 other North Shore-LIJ hospitals. In implementing
the largest EHR program in the New York metropolitan area and                  For more information on the electronic health record
one of the largest in the nation, North Shore-LIJ will                      system, visit www.NorthShoreLIJ.com/EHR.
provide physicians
with individual subsi-
dies of up to $40,000
over five years.                                                                Continued from page 4
   The North Shore-LIJ
electronic health record,                                                       breast Health Navigation
powered by Allscripts, is
embedded within auto-                                                           Breast health navigators are nursing professionals who are
mated care guides that                                                          specially trained to coordinate the patient’s care involving
will help improve                                                               social workers, support group, nutritional needs and clinical
clinical care, prevent ill-                                                     trials as appropriate.
ness and avoid medical                                                             Radiation services are available for breast cancer
and drug errors.                                                                patients. The philosophy of the department is to
                                                                                individualize the therapy for the patient’s individual stage.
Improving Outcomes
“While leaders in Washington are still negotiating a comprehensive              For early stage patients, options include:
healthcare bill, the essence of real health reform is going to happen           ◾◾ partial breast irradiation (following the ASRO consensus)
at the local level by optimizing technology and involving physicians               using balloon brachytherapy with either the MammoSite
who are directly involved in delivering care to the communities we                 or Contura balloons; and
serve,” said Michael Dowling, president and chief executive officer of          ◾◾ whole breast irradiation — supine or prone, 3D/conformal
the North Shore-LIJ Health System. “We’re not going to measure                     or IMRT.
our return on investment in terms of dollars and cents; rather, we
will measure our successes in our ability to improve patient out-               For intermediate stage patients, options include:
comes.” As the federal government continues to move toward a                    ◾◾ whole breast irradiation — supine or prone, 3D/conformal
system in which provider payments are based on performance, Mr.                    or IMRT; and
Dowling said, the financial subsidies tied to the EHR will assist               ◾◾ whole breast and nodal irradiation — supine, 3D/
North Shore-LIJ physicians in providing patients with a full                       conformal or IMRT.
continuum of care, addressing all chronic conditions through
evidence-based treatment protocols.                                             For advanced stage patients:
   North Shore-LIJ will subsidize either 50 percent or 85 percent of            ◾◾ whole breast or chest wall irradiation with nodal areas
each physician’s implementation cost and monthly operational fees,                 using a 3D/conformal or IMRT technique.
with a maximum incentive of $40,000 over five years. In addition to
the subsidies they receive from the health system, physicians may be               To find a breast health navigator, please call
eligible for up to $44,000 in Medicare incentives over five years as            (718) 226-8447.
part of the American Recovery and Reinvestment Act. Physicians

                                                                           SETTING NEW STANDARDS IN HEALTHCARE I www.northshorelij.com            11
How to Keep Yourself and Your Children
H1N1-Free This Winter

S
       wine flu has been the top health story for          home until at least 24 hours
       what has felt like a decade.                        after they are free of fever
          Believe it or not, the first highly              (100°F [37.8°C]), or signs of a
publicized outbreak — which started at                     fever without the use of fever-
St. Francis Preparatory School in Queens,                  reducing medications.
one of the country’s largest Catholic high                    “Basically, on Sunday I started
schools last year.                                         to feel ill. Monday was worse,
   Nevertheless, parents are still worried                 and Tuesday was just awful.
about their children’s well-being.                         On Tuesday I was definitely a
   “This is not a time to panic, but it’s certainly        wreck,” said Staten Islander
a time to be cautious,” said Cynthia Chang,                Salvatore Mazzone, 23, who
MD, FAAP, at Staten Island University                      was diagnosed with H1N1
Hospital. “Keeping strict hygiene on a daily               while on a business trip to
basis is the first step to a healthy season.”              Minnesota last fall. “Aching,
                                                           sneezing and serious nausea
What can I do to stay healthy?                             was what it was like, but it got
As with the seasonal flu, keeping clean can                better quick. By Friday, I’d say
mean the difference between getting sick                   I was back to normal, but I
and staying healthy.                                       still rested for a week.”
   When you touch your eyes, nose or                          He continued, saying, “To
mouth, you are rapidly spreading the chance                me it was just a normal sick-
of infection. This is why keeping your hands               ness; I didn’t really think much
clean by washing them frequently and using                 of it, but I went to the doctor
alcohol-based sanitizers (when a sink is not               because it’s been all over the                                        for children (older than age 2) as the minimal
available) is a huge step as your hands are                news, especially where I had been traveling.”                         side effects include a runny nose, headache
the most common route of contamination.                                                                                          and mild fever. The injection’s side effects are
                                                           What are the Symptoms of H1N1?                                        just as they are for the seasonal flu shot, which
Which groups are most at Risk?                             Common H1N1 symptoms are cough, sore                                  is the possibility of a sore arm and redness at
The symptoms are “extremely similar” to                    throat, high fever (101°F and above), body                            the site of injection for a short period of time.
that of the seasonal flu, advised Dr. Chang,               aches, runny nose, headache, fatigue, and                                Dr. Chang warns parents to discuss the
but information analyzed by the Centers                    vomiting and diarrhea.                                                vaccination with their pediatrician if their
for Disease Control and Prevention (CDC)                      If you have trouble breathing/shortness of                         child has any egg allergies, history of
supports the conclusion that 2009 H1N1                     breath, pain or pressure in the chest or                              Guillain-Barré syndrome or any prior
flu has caused greater disease burden in                   abdomen, sudden dizziness, confusion or                               reaction to an influenza vaccine. 
people younger than 25 years of age than in                persistent vomiting, go to the emergency
older people. H1N1 has seemed to target                    room immediately. In children, some “emer-
pregnant women and young adults, and it is                 gency warning signs” are fast breathing or
unknown why.                                               trouble breathing, bluish skin color, not                                   H1N1 Updates
   If you or your child begins to feel sick,               drinking enough fluids and not waking up
                                                                                                                                       Look for H1N1 updates on
stay home. You are contagious beginning 24                 or not interacting.
                                                                                                                                       www.SIUH.edu and
hours before symptoms begin and for several                   Dr. Chang strongly recommends the H1N1
                                                                                                                                       www.facebook.com/siuhospital.
days after that. The CDC recommends that                   vaccine, which comes in two forms: intranasal
people with influenza-like illness remain at               and as a regular injection. The intranasal is ideal

Health Focus
                                                      Michael J. Dowling, President and CEO, North Shore-LIJ Health System                                                        Printed on
                                                      Anthony C. Ferreri, President and CEO, Staten Island University Hospital                                                    Recyclable Paper
                                                      John P. Demoleas, Vice President for Development, Community Relations
                                                      Arleen Ryback, Director of Public Affairs, Department of Hospital & Community Relations, Staten Island University Hospital; Editor

                                                      Health Focus is published by the Department of Hospital & Community Relations of Staten Island University Hospital
                                                      (718) 226-2483. The information within this publication is intended to educate readers about subjects pertinent to
                                                      their health and is not meant to be a substitute for consultation with a personal physician. Produced by StayWell Custom
                                                      Communications, Evanston, IL. © 2010. Printed in USA.                                                                                  625

                                                         NORTH SHORE-LIJ HEALTH SYSTEM HOSPITALS
              NORTH SHORE UNIVERSITY HOSPITAL • LIJ MEDICAL CENTER • SCHNEIDER CHILDREN’S • ZUCKER HILLSIDE • FRANKLIN • GLEN COVE • SYOSSET •
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