November 2009

Be Sure to Watch Mystery Diagnosis on Monday, November 23rd

11.20.2009 editor
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Be sure to watch the Discovery Health Channel show Mystery Diagnosis on Monday, November 23, 2009 at 10 p.m. to see an interesting new medical mystery about a rare neurological disease. This show features Jefferson Hospital for Neuroscience's own Andro Zangaladze, MD, PhD.

Dr. Weinstein Quoted in Philadelphia Inquirer on Mammogram Screening

11.20.2009 editor
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You may have heard the controversial news this week that the U.S. Preventive Services Task Force (USPSTF) now recommends against routine screening mammography in women aged 40 to 49 years who are not at high risk for breast cancer.  Instead, the panel advises biennial screening mammography for women aged 50 to 74 years.

Even more, the USPSTF recommends against teaching breast self-examinations.

Several physicians weighed in on the matter in a Philadelphia Inquirer story on the benefits and risks of mammograms, including Louis Weinstein, chair of obstetrics and gynecology at Thomas Jefferson University.

"A lot of this is not new," said Dr. Weinstein to the Philadelphia Inquirer, in reference to the average risk of a 40-something woman dying from cancer compared to a 50-something woman. Dr. Weinstein doesn't encourage women in their 40s to get screening because he knows that "the majority of findings under 50 tend to be false positives."

Read the full "The mammogram storm: Benefits vs. risks" story on philly.com.

Alzheimer’s Risk Factors You Can Control: Eat a Brain-Healthy Diet

11.19.2009 editor
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Feed your brain the foods it needs – and avoid the ones that may increase your risk.

Studies have shown that people who are obese in middle age face an increased risk of dementia in later life. The same holds true for individuals who have high blood pressure and high cholesterol.

To help reduce your risk of Alzheimer’s and other serious medical problems, adopt what the Alzheimer’s Association calls a “brain-healthy diet”:

  • Cut your intake of foods that have a lot of fat and cholesterol.
  • Choose dark-colored fruits and vegetables, which have the most antioxidants.
  • Consume beneficial omega-3 fatty acids.
  • In moderation, eat nuts – which are a great source of the antioxidant vitamin E.
  • Consider vitamins. According to the Alzheimer’s Association, there is some indication that vitamin E, or vitamins E and C together, vitamin B12 and folate may help lower your risk of developing Alzheimer’s disease.

Drs. Monti and Bazzan's 'The Great Life Makeover' Featured on Lifetime Television's Health Corner

11.19.2009 editor
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Doctors Daniel Monti and Anthony Bazzan of the Jefferson-Myrna Brind Center of Integrative Medicine were featured on Lifetime Television’s Health Corner on November 1 about their book The Great Life Makeover. In the piece, the doctors--along with two of their patients Bob and Beverly Kistler--explained how the middle years don't have to be a struggle and should actually be very fulfilling.

"These middle years, starting close to age forty, and through the 40s, 50s and 60s are great years and have the potential to be the best years, but there's issues that occur that often manifest themselves in decreased sexual function, problems with mood, weight distribution," says Dr. Monti.

"People can be comfortable starting anywhere in the book. You can start with making some dietary modifications. You can start with changing your activity level. But one thing everybody should start with is getting a snapshot in time of their current health status so they know and can think about their goals moving forward."

Lifetime Television has an audience of over 96 million in the United States.

You can view the segment now by visiting http://healthcorner.walgreens.com and clicking on Archive.

It will also air again on December 27, 2009 at 9:30 a.m. on Lifetime, so set your DVRs!

Put Fatty Fish on the Menu - eating salmon or other fatty fish just once a week can help

11.18.2009 editor
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Eating salmon or other fatty fish just once a week helped reduce men’s risk of heart failure, says a new study reported in the European Heart Journal. This study adds to growing evidence that omega-3 fatty acids are beneficial to heart health – and its findings represent one of the largest studies to investigate the association.

The researchers followed 39,367 Swedish men between the ages of 45 and 79 from 1998 to 2004. They recorded details of the men’s diet and tracked the men’s outcomes through Swedish inpatient hospital registers and cause-of-death registers. During this period, 597 men in the study (with no previous history of heart disease or diabetes) developed heart failure. Thirty-four men died.

Analysis of their numbers showed that the men who ate fatty fish – such as herring, mackerel, salmon, whitefish and char – once per week were 12 percent less likely to develop heart failure compared with men who ate no fatty fish. The researchers found the strongest link with the intake of marine omega-3 fatty acids, which are found in cod liver and other fish oils.

Incorporating fatty fish into your diet
The American Heart Association recommends eating fatty fish not once but twice per week. And while many sit-down restaurants offer fatty-fish entrees, you may be uncertain how best to prepare these dishes at home.

Time Widens for Giving Clot-Busting Drug for Stroke

11.18.2009 editor
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Earlier this year, an advisory committee of the American Stroke Association/American Heart Association issued a recommendation that the window of time for tissue plasminogen activator (tPA) therapy be extended.

The new analysis shows that the medication, which is given intravenously, can safely be used to treat strokes 4.5 hours after symptoms begin. Until this year, tPA had to be given within three hours of symptom onset.

As Jefferson Vascular Neurologist Carissa Pineda, MD, explains, tPA is the only FDA-approved drug for treating the 80 percent of strokes caused by ischemic clots. (The other major type – hemorrhagic stroke – is caused by ruptured blood vessels in the brain. Hemorrhagic stroke cannot be treated with tPA and has a much higher mortality rate than ischemic stroke.)

“tPA can be thought of as a ‘clot buster,’” Dr. Pineda notes. “Once it reaches the clot, it bursts it – limiting the areas of the brain that would have been affected.”

But as Dr. Pineda notes, the original guidelines required the clot-busting drug to be administered within three hours of the onset of symptoms. Even in top-performing hospitals, less than 5 percent of stroke patients are treated in that timeframe.

The new guideline – based on analysis of clinical studies – enables emergency-room physicians and stroke specialists to give tPA up to 4.5 hours after the onset of symptoms.

TJUH Investigators Find PET Imaging Before Radiation Therapy Not Ideal for Determining Higher Radiation Doses

11.17.2009 editor
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Positron emission tomography (PET) imaging is a radiology procedure that is used to identify certain conditions and evaluate the effectiveness of a cancer treatment. Recently, a team of researchers at Jefferson found that PET imaging of non-small cell lung cancer prior to receiving radiation therapy should not be the basis for determining areas that may benefit from higher doses of radiation to control the cancer.

"Investigators are looking to PET imaging to find ways to predict if any part of the tumor would benefit from a higher radiation dose,” said Nitin Ohri, MD, a resident in Radiation Oncology at Thomas Jefferson University Hospitals. "I wanted to see if residual activity on a scan after treatment correlates with the activity pattern on a scan done before treatment."

Some studies suggest that areas that have the highest amount of hypermetabolic activity on PET scan before treatment are the areas most likely to have increased activity after treatment, according to  Dr. Ohri.

Dr. Ohri looked at the PET scans of 43 patients, of which 15 had significant activity on the scans both before and after treatment. He set up a coordinate system that divided tumors into nine regions or 17 regions for larger tumors. He then correlated the activity in the regions both before and after treatment.

Jefferson the First Healthcare Facility in the Region to Offer Innovative CT Scanning Technology

11.16.2009 editor
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What does that mean for patients? First, the test is quicker -- the entire heart is imaged in less than five seconds. It also exposes the patient to much less radiation, compared to other cardiac imaging studies like a nuclear stress test or cardiac catheterization.

Jefferson Researchers Find Specialized Radiation Therapy Reduces Vision Loss in Patients with Optic Nerve Sheath Meningiomas

11.12.2009 editor
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Optic nerve sheath meningiomas are rare tumors that are traditionally treated with surgery, which is typically a blinding procedure. However, researchers from Thomas Jefferson University Hospitals have found that a specialized type of radiation therapy offers the same local control, with fewer adverse effects on vision. The investigators presented their data at the 51st ASTRO Annual Meeting (Abstract #2676B-261).

Fractionated stereotactic radiotherapy is a more precise, targeted type of radiation therapy that allows an effective dose of radiation to the tumor, but helps spare other structures around it. In the case of optic nerve sheath meningiomas, the eye lens and brain cells are spared, according to Robert Den, MD, a resident in Radiation Oncology at Thomas Jefferson University Hospitals.

“Fractionated stereotactic radiotherapy is beneficial because it is a non-invasive means to achieve disease control, while allowing patients to continue with their daily lives without being hindered by a major surgical procedure,” Dr. Den said.

Dr. Den and colleagues conducted a retrospective analysis of 58 patients with optic nerve sheath meningiomas who were treated with fractionated stereotactic radiotherapy between 1996 and 2006. They reviewed patient charts for technical radiotherapy information and for treatment outcomes, which included local control, visual acuity and acute and late toxicity related to treatment. The median follow-up was 70 months.

Jefferson Spine, Hip and Knee Programs Receive Blue Designation

11.12.2009 editor
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We are pleased to announce that Thomas Jefferson University Hospitals have been designated a Blue Distinction Center for Spine Surgery and a Blue Distinction Center for Hip and Knee Replacement.

Family and Community Medicine Receives Exceptional Rating from National Center for Quality Assurance

11.11.2009 editor
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The Department of Family and Community Medicine recently received word that its practice, Jefferson Family Medicine Associates, has achieved the highest recognition (Level 3) for Physician Practice Connections – Patient Centered Medical Home (PPC-PCMH) from the National Center for Quality Assurance (NCQA). The NCQA is a not-for-profit organization dedicated to improving the quality of healthcare nationwide.

This NCQA recognition is widely accepted as an indicator that an organization is well-managed and delivers high quality patient care and service. Less than 50 practices nationwide have received this NCQA designation, with roughly only half of those achieving a rating equivalent to Jefferson ’s.

“This is a very significant accomplishment for our group that has required a lot of effort and dedication from staff,” says Richard Wender, MD, Chair of the Department of Family and Community Medicine. “We believe that Jefferson is one of the first practices to receive a Level 3 rating that has a residency and student program embedded within it. We’re also the largest single site practice in the nation to achieve this status for its Pa tient-Centered Medical Home model.”

Free Lunchtime Program: The Medical Management to Weight Loss

11.10.2009 editor
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Join us for a free lunchtime program

Topic: The Medical Management to Weight Loss

Date: Thursday, November 12, 2009

Where: 925 Chestnut, 2nd floor conference room. Get Directions.

Speaker: Dr. Janine Kyrillos.

Time: 12:00 p.m. to 1:00 p.m.

You must register for this program. RSVP to 1-800-JEFF-NOW or online.

Dr. Stephen Silberstein Discusses New Migraine Remedy on 6ABC

11.04.2009 editor
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Stephen Silberstein, MD, head of the Jefferson Headache Center, tells 6ABC that "patients with migraine have trouble with absorption, and during a migraine attack, it gets worse. They will tell you 'food hangs in my stomach, I'm sick to my stomach.'"

Dr. Silberstein explains that up to half of all migraine sufferers get frequent nausea. Of every 10 patients who start on the triptan class of drugs, only one or two stay on them.

Gabriella Iacovetti, a patient of Dr. Silberstein's, was introduced to a new option that's now being tested. It's called the Zelrix patch.

Watch the 6ABC video to learn more about the migraine patch.

How Diabetic Kids Can Still Enjoy Halloween Treats

11.02.2009 editor
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Diabetic children may feel left out when it comes to Halloween and eating candy.

Martha Zeger, MD, a Jefferson pediatric endocrinologist , was quoted in a USA Today article about how diabetic children and their families can deal with the difficulties of Halloween.

Dr. Zeger recommended that “kids can save their candy for the Halloween Fairy, who will magically leave a toy in the place of the candy.”

A patient of Dr. Zeger's was also featured in the story.

Read the full USA Today article.