1. science
2. medicine
3. surgery

Rounds
may/june 2010
The l atest news for primary care physicians from Clevel and Clinic
Inside
New Vascular Surgery CT
Suite Opens
Cleveland Clinic Recognized
as a Clinical Center of
Excellence in Prostate Cancer
Brain Tumor and Neuro-Oncology
Center Consolidates Care
Genetic Counseling Services
Now Available for Polycystic
Kidney Disease Patients
Cryoablation Offers Alternative
to Hysterectomy for Abnormal
Uterine Bleeding
Weekly Sarcoma Clinic Offers
Team Evaluation, Action Plan
Cleveland Clinic’s Brain Tumor and Neuro-Oncology Center has
established itself as an international leader in the diagnosis, treatment
and research of primary and metastatic tumors of the brain, spine
and nerves and their effects on the nervous system.
Staff Notes
The center’s multidisciplinary team records approximately 8,000 outpatient visits and
Spine Specialists See Patients
Throughout the Region
Coming Events
performs some 950 surgical procedures annually. The center’s staff includes neurosurgeons, neuro-oncologists, neurologists, medical oncologists, neuroradiologists,
radiation oncologists, pediatric oncologists, neuropsychologists, neuropathologists
and advanced practice nurses.
The Brain Tumor and Neuro-Oncology Center is part of Cleveland Clinic’s Neurological
Institute, and works closely with Cleveland Clinic Taussig Cancer Institute, the largest
cancer program in Ohio. The center utilizes the latest diagnostic and treatment services
to provide both adult and pediatric patients the most advanced care available, as well
as to extend hope for an improved quality of life. These services include innovations
such as laser interstitial thermal therapy (AutoLITT®) Gamma Knife® Perfexion™
radiosurgery, Novalis® stereotactic spine radiosurgery, advanced surgical navigation
and intraoperative MRI.
No matter what issues your patient presents with upon referral, we work toward a
seamless transition of care that continues throughout evaluation, diagnosis and treatment at the Brain Tumor and Neuro-Oncology Center. For more information on our
programs and services, please visit our website at clevelandclinic.org/braintumor.
To arrange for a consultation or refer a patient to the Brain Tumor and
Neuro-Oncology Center, call our referring physician line at 800.553.5056.
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General Patient
Referral
Services for Physicians
Re f e rrin g Ph ys i ci a n Ce n t e r
24/7 hospital transfers or
physician consults
800.553.5056
For help with service-related issues, information about our clinical
specialists and services, details about CME opportunities and
more, contact us at [email protected], or 216.448.0900 or toll-free
888.637.0568.
On the Web at clevelandclinic.org
C riti c a l C a re T r a n s port Worl dw id e
Cleveland Clinic’s critical care transport team and fleet of mobile ICU
vehicles, helicopters and fixed-wing aircraft serve critically ill and highly
Services for Patients
complex patients across the globe.
To arrange a transfer for STEMI (ST elevated myocardial infarction), acute
M e d i c a l C o n cie rg e
Complimentary assistance for
out-of-state patients and families
800.223.2273, ext. 55580, or
email [email protected]
G l ob a l Patie n t S e rv i ce s
Complimentary assistance
for national and international
patients and families
stroke, ICH (intracerebral hemorrhage), SAH (subarachnoid hemorrhage)
or aortic syndromes, call 877.379.CODE (2633). For all other critical
care transfers, call 216.444.8302 or 800.553.5056.
Req u e s t f or M e d i c a l Re cord s
216.444.2640 or toll-free 800.225.2273 ext. 42640
T r ac k Yo u r Patie n t ’ s C a re O n lin E
DrConnect offers referring physicians secure access to their patient’s
treatment progress while at Cleveland Clinic. To establish a DrConnect
account, visit clevelandclinic.org/drconnect or email [email protected].
001.216.444.8184 or visit
clevelandclinic.org/gps
Re m ot e C o n s u lt s
Online medical second opinions from Cleveland Clinic’s MyConsult
are particularly valuable for patients who wish to avoid the time
and expense of travel. Visit clevelandclinic.org/myconsult, email
[email protected] or call 800.223.2273, ext 43223.
O u tco m e s Data
View the latest clinical Outcomes book from many Cleveland Clinic
institutes at clevelandclinic.org/quality/outcomes.
New Vascular Surgery CT Suite Opens
Cleveland Clinic’s Miller Family Heart & Vascular Institute
•Private hydration rooms for patients with renal insufficiency,
recently opened a new, state-of-the-art Vascular Surgery CT
equipped with TVs and movies to provide greater comfort for
Suite to provide convenient, simplified visits for patients, and
patients who require additional fluid prior to the use of any
make new and follow-up visits markedly more efficient.
contrast agents.
Features of the new suite, which opened in February, include:
•A single location for all lab work, CT scans and office visits,
enabling one-stick visits during which patients have an IV
started and blood draws at the same time. This precludes
the need for multiple needle sticks and eliminates a visit to
the laboratory for tests.
•A state-of-the-art Siemens Flash CT Scanner, allowing
for precise cardiac imaging, as well as imaging of the aorta
“This new suite not only provides cutting edge technology, it
was designed with the patient in mind to enhance their experience and make their care seamless,” explains Cleveland Clinic
vascular surgeon Roy Greenberg, MD, who helped plan the CT
suite and streamline the patient experience. “Furthermore, it
helps to consolidate the working relationship between radiologists, cardiologists and surgeons by creating a space where
they can all evaluate patients together.”
in less than 4 seconds. The radiation dose required to
To refer a patient for endovascular CT imaging, call
obtain such images has been significantly reduced using
216.444.4508.
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new technology that couples the hardware advances with
software algorithms.
Alopecia Clinical Trial Open
Nationally recognized hair-loss expert Wilma Bergfeld, MD, Department of
Dermatology, is recruiting female patients ages 25 – 60 with androgenic alopecia for
a clinical trial of the HairMAX® LaserComb. The low-level laser phototherapy device,
FDA approved for use in men, has been proven effective to regrow hair in patients
with certain classes of androgenic alopecia. This study will assess the device’s
safety and effectiveness in female patients. The LaserComb will be compared to
a light comb with non-laser wavelengths. Each subject will make five visits to the
Dermatology Department and complete one phone evaluation over approximately six
months. Study treatment will consist of three eight-minute, at-home study treatments
per week for 26 weeks.
HairMAX® LaserComb
To refer a patient for this trial or for more information, please contact
Pamela Summers, MD, at 216.445.8347.
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Clevel and Clinic Rounds
Now Recruiting for
Blood Pressure Study
Recruitment is under way at Cleveland
Clinic for a blood pressure study that
will help find out if more frequent
interventions by a healthcare provider
will lead to better blood pressure
control and help those patients
with hypertension reach their blood
pressure goals in a timely manner.
Participants may be expected to
measure their blood pressure twice
daily at home for 15 weeks. The
blood pressure monitor and the
modem that transmits the measurements via wireless technology will
be provided to the participant for the
Cleveland Clinic Recognized as a
Clinical Center of Excellence in Prostate Cancer
course of the study. Participants do
NOT need a computer or a cell phone.
Compensation will be available.
For further details, contact
Carol Horner, RN, at 216.444.5228,
Gordon Iheme, MD, at
216.445.6045, or
Mohammed Rafey, MD, at
216.445.4926.
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Medical Economics magazine recently recognized Cleveland
Clinic as a “Clinical Center of Excellence in Prostate Cancer,”
making it one of only 13 hospitals in the country to receive this
distinction. The magazine selected “the prostate cancer programs
that are among the finest in the country” to be noted as Centers
of Excellence based on information received from key opinion
leaders in various specialties, through physician surveys and
self-reported data from each hospital.
Cleveland Clinic physicians treat more than 1,000 prostate cancer patients
each year and have a long history of innovation and leadership in urology
and medical oncology. A multidisciplinary team of urologists and medical
oncologists delivers personalized treatment options for every patient, including
open and laparoscopic prostatectomy, radiation, brachytherapy, cryotherapy,
hormone therapy and chemotherapy. In fact, Cleveland Clinic has one of the
world’s largest brachytherapy programs.
Additionally, many prostate treatment methods were pioneered at Cleveland
Clinic, providing patients with one of the world’s largest experiences in treating
localized cancer using surgical and non-surgical methods.
For information on treatment options for more advanced disease, as well
as a listing of selected clinical trials, call Melissa Mason at 216.448.1037
and request the Cleveland Clinic Treatment Guide for Prostate Cancer.
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Clevel and Clinic Rounds
Executive Health Exams Ensure that Caregivers Take Care of Themselves
Physicians need to be as
vigilant about their own health
as they are about the health
of their patients. An Executive
Health Physical examination at
Cleveland Clinic will put you in
the best possible position to care
for your patients.
Cleveland Clinic Executive Health
Besides an in-depth history and
Physicians may choose to see any of
physical, and comprehensive lab work,
our four Executive Health physicians:
examinations may include:
Richard S. Lang, MD, MPH, Vice Chair,
•Cardiovascular health evaluation
Wellness Institute and Chair, Preventive
•Auditory assessment
Medicine; Raul J. Seballos, MD, Vice
Chair, Preventive Medicine; Anita D.
•Pulmonary health evaluation
Misra-Hebert, MD, Head, Women’s
•Colonoscopy
Executive Health Program; or John P.
• Bone densitometry
Campbell, MD.
•Nutrition consult and assessment
The health and wellness strategies
examinations are designed to uncover
•Mammography
potential health problems and to target,
•Vision screening, glaucoma testing
reduce and eliminate risk factors.
and funduscopic photography
Wellness is an integral part of
•Vaccination review and administration
our program.
•Fitness assessment
Evaluations are tailored to meet the
needs of individuals whose time is
at a premium. Visits take place on a
single day and are streamlined by prescheduling individual consultations and
gained from our Executive Health
examinations will enhance your ability
to deliver optimal care and will provide
peace of mind for your loved ones.
•Stress management consult
Executive Health Physical
If any specific medical issues are identi-
by calling 216.444.5707
fied, we facilitate prompt referral to our
or 800.223.2273, ext. 45707.
renowned specialists.
For more information, visit
Examinations may be scheduled
clevelandclinic.org/executivehealth.
confirming with a pre-visit call.
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Genetic Counseling Services Now Available
for Polycystic Kidney Disease Patients
Genetic counseling services are now available at the Polycystic Kidney Disease
Center in the Glickman Urological & Kidney Institute. Indications for referral
are polycystic kidney disease, familial focal segmental glomerulosclerosis
and Alport syndrome.
For more information or to make an appointment, please call
216.445.5686 or 800.998.4785.
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Clevel and Clinic Rounds
Twinsburg Family Health
and Surgery Center
Now Under Construction
Cleveland Clinic is building a new
state-of-the-art healthcare facility in
Twinsburg, at the intersection of Route
91, just south of I-480, and Darrow
Road. The center will bring a wide
range of healthcare services and
300 jobs to the city.
The 190,000-square-foot center will
house a 24-hour emergency department with a helipad, four operating
rooms, two procedure rooms and two
endoscopy suites. Besides primary care,
services offered will range from allergy
to vascular surgery. The site also
Cryoablation Offers Alternative to
Hysterectomy for Abnormal Uterine Bleeding
includes land for future expansion.
Cleveland Clinic already offers several
services in the area in the Twinsburg
Medical Offices on Edison Boulevard,
including obstetric and gynecology,
neurology, oncology, pain management,
rheumatology and vascular surgery.
General surgeons James Malgieri, MD,
and William O’Brien, MD, recently began
seeing patients in Twinsburg. Dr. Malgieri
also practices at Hillcrest Hospital, and
Dr. O’Brien sees patients at Hillcrest and
Marymount hospitals. Both physicians
FDA approved and endorsed by the American College of Obstetrics and Gynecology
for the management of abnormal bleeding, endometrial ablation has been shown
to be as effective as hysterectomy with fewer complications. Cleveland Clinic
specialize in gastrointestinal surgery,
breast surgery, thyroid/parathyroid surgery
and laparoscopic surgery.
experts now offer Her Option® Office Cryoablation Therapy, a safe and effective
treatment that uses sub-zero temperatures to destroy the endometrium. The treatment is performed on an outpatient basis and requires minimal anesthesia and
analgesia, enabling patients to return to daily activities quickly.
To refer a patient to the Twinsburg
Medical Offices, call 330.888.4000.
One in four women experience menorrhagia, most often between
the ages of 35 and 50. Cleveland Clinic gynecologists offer comprehensive evaluation and treatment of abnormal bleeding in
the Center for Menstrual Disorders, Fibroids and Hysteroscopic
Services in the Ob/Gyn & Women’s Health Institute. For women
who fail medical therapy and have completed childbearing,
endometrial ablation may provide an attractive alternative to
hysterectomy.
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Women see results within the first three months following the treatment, with
varying decreases in bleeding. Patients often report a reduction in PMS symptoms such as fatigue, irritability and cramping.
To refer a patient for evaluation and treatment of abnormal bleeding,
call 216.444.6601.
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Clevel and Clinic Rounds
Spine Specialists See Patients Throughout the Region
Each year, 16,000 adults from around the world turn to Cleveland
Clinic Neurological Institute’s Center for Spine Health for specialized
treatment of spinal disorders, from frequent complaints such as low
back pain to complex conditions, including spinal deformity, stenosis
and tumor.
These patients and their referring physicians find a multidisciplinary team of medical
and surgical specialists that offers the most advanced diagnostic capabilities and
appropriate treatment modalities, with the goal of relieving pain and restoring function to the maximum degree possible.
From periodic monitoring to intensive surgical correction, the team provides state-ofthe-art management for back and spine problems. When you refer to the Center for
Spine Health, you ensure your patient the benefits of skilled, experienced specialty
and subspecialty care and access to the latest technologies. Among the many therapeutic options offered at the Center are:
• medical spine evaluation and treatment
• spine surgery
• mature spine care
• spine wellness
• spine injury prevention
• interventional spine therapies
• rehabilitation and physical therapy
Located at Lutheran Hospital, the Spine Research Laboratory incorporates a technologically advanced spine biomechanics laboratory, computational simulation
laboratory and tissue engineering facility. The research laboratory’s focus includes:
• innovative strategies for improving spinal instrumentation
• new technologies for in vivo monitoring and measurement of biomechanical
and physiological properties of the intervertebral disc
• development of artificial disc technologies to preserve spinal motion
• development of biologic approaches to spinal cord regeneration after
traumatic injury
Adult spine patients are seen at Cleveland Clinic’s main campus; at Hillcrest,
Lutheran and Marymount hospitals; the Broadview Heights, Solon, Westlake and
Willoughby Hills family health centers; and the Strongsville Family Health and
Surgery Center.
Cleveland Clinic’s Center for Spine Health offers same-day appointments.
To refer a patient, please call 216.636.5860 or 866.588.2264.
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Clevel and Clinic Rounds
Weekly Sarcoma Clinic Offers Team Evaluation, Action Plan
Cleveland Clinic’s Sarcoma Multidisciplinary Clinic offers convenient, compassionate team evaluation
and treatment recommendations for patients who present with newly diagnosed or recurrent sarcomas.
Multidisciplinary collaboration leads to better outcomes for patients with typical and atypical soft-tissue sarcomas and osteosarcomas.
Your patient will benefit from seeing musculoskeletal tumor surgeons Steven A. Lietman, MD, and Michael
J. Joyce, MD, medical oncologist G. Thomas Budd, MD, and radiation oncologist John Greskovich, MD.
They share an active interest and extensive experience in sarcoma management. Together, they will determine the most favorable treatment regimen for your patient.
Both patients and families appreciate the convenience of seeing multiple specialists at our main campus on
a single day – and from receiving our team’s feedback and action plan without delay.
All sarcoma cases are reviewed in weekly multidisciplinary conferences with input from world-renowned
pathologists and radiologists, as well as the social workers, nurse practitioners, physical therapists and
physiatrists on the team. This unified approach has fostered the development of new diagnostic criteria and
treatments that further advance the care of sarcomas.
Cleveland Clinic’s Sarcoma Clinic is held every Monday at our main campus. To refer a patient to this
clinic, please call the Taussig Cancer Institute at 216.444.7923 or 866.223.8100.
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Surgical Treatments Available for Obstructive Sleep Apnea and Snoring
Otolaryngologist Alan Kominsky, MD, FACS, is now board-
To refer a surgical candidate to Dr. Kominsky, call
certified in sleep medicine and available to provide surgical
216.444.6691 or 800.223.2273, ext. 46691. To refer an
treatments for obstructive sleep apnea and snoring. He sees
adult or child for sleep evaluation in the Sleep Disorders
patients at Cleveland Clinic’s main campus, Beachwood Family
Center, call 216.444.2165 or 800.223.2273, ext. 42165. n
Health and Surgery Center, and the Sleep Center at Fairhill.
Dr. Kominsky, a staff member of the Head & Neck Institute, is
joint-appointed in Cleveland Clinic’s Sleep Disorders Center.
The center, a part of the Neurological Institute, is a multispecialty, comprehensive program dedicated to the diagnosis and
treatment of sleep and awake disorders in children and adults.
The center, which is accredited by the American Academy of
Sleep Medicine, comprises specialists in neurology, pediatrics,
pulmonary medicine, internal medicine, psychiatry, psychology, otolaryngology and dentistry. More than 6,000 sleep
studies are performed each year.
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Clevel and Clinic Rounds
Staff Notes
New Staff
Keith McCrae, MD
Department of Hematology and
Medical Oncology
Armida Parala-Metz, MD
Solid Tumor Oncology
S PE C IALT Y IN T E RES T S :
pain and symptom management,
immune thrombocytopenia (ITP),
palliative medicine, cancer pain,
antiphospholipid antibody syndrome,
geriatric syndromes
platelet disorders, hematologic disorders
of pregnancy, hemophilia, bleeding
disorders
P H O NE :
216.445.7809
S PE C IALT Y IN T E R ES T S :
PH O NE :
216.445.9074
Email:
[email protected]
Email:
[email protected]
Raj Sindwani, MD, FACS, FRCS(C)
Section Head, Rhinology, Sinus and
Skull Base Surgery
Michael Nemunaitis, MD
Regional Medical Oncology
S PE C IALT Y IN T E R ES T S :
S PE C IALT Y IN T E RES T S :
and chronic sinus infections and nasal
gastrointestinal malignancies, lung
polyps; minimally invasive endoscopic
cancer, genitourinary malignancies,
skull base surgery for tumors of the
clinical research, melanoma
nose and sinuses; endoscopic orbital
Dr. Nemunaitis sees patients at Hillcrest
Hospital, Beachwood Family Health
and Surgery Center and Twinsburg
Medical Offices
P H O NE :
216.839.3000
endoscopic sinus surgery for recurrent
surgery including orbital and optic nerve
decompression and dacryocystorhinostomy (DCR); nasal and sinus disorders
PH O NE :
216.444.6691 (main campus)
216.839.3740 (Beachwood Family
Health and Surgery Center)
Email:
[email protected]
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Clevel and Clinic Rounds
Staff Notes
New Staff (continued)
New Location
Kevin Stephans, MD
Radiation Oncology
Gaurang Shah, MD, FRCS
Glickman Urological & Kidney Institute
S PE C IALT Y IN T E RES T S :
S PE C IALT Y IN T E R ES T S :
prostate cancer, lung cancer, pancreatic
cancer, liver malignancies, GU malignancies, stereotactic body radiotherapy,
kidney stone disease, erectile dys-
radio protectors
P H O NE :
function, kidney cancer, laparoscopic
surgery, adrenal cancer, prostate/BPH,
ureteropelvic junction obstruction,
prostatitis
216.445.8285
Dr. Shah now sees patients only at
Email:
[email protected]
Lorain Family Health and Surgery
Center
PH O NE :
440.204.7400
Innovation weighs in.
Obesity, Diabetes & the Metabolic Crisis
2010
Medical Innovation Summit
The Medical Innovation Summit provides an unrivaled
perspective on the newest obesity and diabetes
technologies and their financial drivers.
Join 1,000 senior executives, investors, entrepreneurs
and clinicians. Speakers include CEOs of Johnson
& Johnson; Sanofi-aventis, Lilly, Amgen, McKesson,
Medtronic, Stryker, Covidien, CR Bard & more.
November 1-3, 2010 | InterContinental Hotel, Cleveland, Ohio • www.ClevelandClinic.org/Summit • (216) 445.5004
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Clevel and Clinic Rounds
Coming Events – www.clevelandclinicmeded.com
CME Opportunities: Live and Online Cleveland Clinic’s Center for Continuing Education’s website, clevelandclinicmeded.com,
offers convenient, complimentary learning opportunities, from a virtual textbook of medicine (Disease Management Project) and
a medical newsfeed refreshed daily, to myCME, a system for physicians to manage their CME portfolios. Many live CME courses
are hosted in Cleveland, an economical option for business travel.
NOTE: All courses are at the spectacular state-of-the-art InterContinental Hotel & Conference Center on the Cleveland Clinic
campus in Cleveland, OH, unless otherwise noted.
J u n e 2010
M ay 2010
10-14 Gamma Knife Perfexion Radiosurgery
Training Course
Cleveland Clinic Gamma Knife Center
11
Interventional Pericardiology – Heart Rhythm
Society Satellite Symposia
4
Ventilator Summit
6-11
Intensive Review of Internal Medicine
10-11 Long Term Control of Secondary Brain Mets
Ritz-Carlton Hotel, Cleveland, OH
Denver, CO
11
Mellen Center Regional Symposium on
Multiple Sclerosis
12
11-18 Cardiovascular CT Training Program
Implementation of Quality Care in Every EP Lab –
Heart Rhythm Society Satellite Symposia
Denver, CO
13
15th Annual May Day Therapy: Dermatology
Bunts Auditorium, Cleveland Clinic
13-14 3rd Annual Advanced Management Issues
in HIV Medicine
Renaissance Cleveland Hotel, Cleveland, OH
14-15 Update in Headache Management
14-15 2nd Annual Single-Port Laparoscopy, Robotics,
NOTES Surgery: A Multidisciplinary Hands-On Course
15
Pediatric Saturday Series: Updates on Pediatric
Emergencies in the Community (Pediatric Intensive Care Medicine)
25-26 Patient Experience Summit: Transforming Healthcare through Empathy and Innovation
12
ABIM Medical Knowledge Modules
Lerner Research Institute, 5th Floor Amphitheater
13-17 American Society for Stereotactic and
Functional Neurosurgery Biennial Meeting
Marriott Downtown Hotel, New York, NY
16-19 Mitochondrial Medicine 2010
JW Marriott Camelback Inn Resort,
Scottsdale, AZ
17-20 National Hydrocephalus Association Meeting
19
Update on Minimally Invasive Solid Organ Surgery:
Laparoscopic Ultrasound, Liver Ablation Techniques, Laparoscopic Resection and Robotics
24-25 Lung Summit: Update in Pulmonary and Critical
Care Medicine
25
Update on Alzheimer’s Disease
Cleveland Clinic Lou Ruvo Center for Brain Health,
Las Vegas, NV
J u ly 2010
7-13
Cleveland Spine Review
Lutheran Hospital, Cleveland, OH
16-17 Cardiovascular Physicians Roundtable
The Cleveland Clinic Foundation
9500 Euclid Avenue / AC311
Cleveland, OH 44195
Rounds | may/june 2010 | The l atest news for primary care physicians from Clevel and Clinic
One Isn’t Like the Others
Given the number — and complexity — of the issues
technology with various, time-related incentives leading to
involved in our national healthcare conversation, it is easy to
2014, when all healthcare providers will be encouraged to
understand how all of the pieces of the larger puzzle could
use health information technology systems as they care for
begin to look alike. And while federal officials, healthcare
their patients.
professionals and the general public continue working to
discern the relative importance and appropriate alignment
of the hundreds, if not thousands of considerations that
comprise the contemporary healthcare model, one component clearly stands out as different from all the others: the
“meaningful use” of health information technology in clinical
practice. This is because “meaningful use” is not part of the
debate. Instead, it is part of the American Recovery and
Reinvestment Act, also known as the “stimulus” bill, which
was passed into law in February 2009.
Among its other provisions, the stimulus bill promotes the
broad adoption of integrated electronic medical record
Among the many systems available for your consideration,
MyPractice Community stands above the rest and already
has been adopted by hundreds of your physician colleagues.
This comprehensive electronic medical record is a customized extension of the same system used in all Cleveland
Clinic facilities.
Before choosing an electronic medical record system
for your practice, you can experience the MyPractice
Community difference for yourself by calling 216.738.4617.
To learn more about MyPractice Community please visit
clevelandclinic.org/transform.
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MyPractice Community:
when it comes to health
information technology for
the physician in private
practice, one solution
stands out from the rest.
10-CCR-005