Leading Medicine Magazine, Vol. 5, No. 3, 2010 by Houston Methodist

A PUBLICATION OF THE METHODIST Hospital System®

LEADING MEDICINE VOLUME 5, NUMBER 3, 2010

LIVING PROOF

early detection saves lives Pictured: Monique James

When do you need antibiotics? CT scans: reducing radiation exposure Counselor fights heart failure and gangs

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METHODIST

5th Year in a Row

For the fifth straight year, The Methodist Hospital System earned a spot on FORTUNE magazine’s prestigious “100 Best Companies to Work For” list. Methodist, once again, is the highest ranked health care organization in the country and the only health care organization in Texas to be recognized. This is a tribute to Methodist’s physicians, nurses and employees whose dedication to our patients and each other make Methodist a great place to work. Join a leader. Visit methodisthealth.com/careers

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LEADING MEDICINE

Volume 5, Number 3, 2010

R.G. Girotto President & CEO Marc L. Boom, M.D.

Executive Vice President John E. Hagale, C.P.A.

Executive Vice President, CFO and Chief Administrative Officer Ramon “Mick” Cantu, J.D.

Executive Vice President, Chief Legal Officer, and Strategy and Business Development Officer

H. Dirk Sostman, M.D.

Executive Vice President, Executive Vice Dean and Chief Medical Officer Cynthia Colbert-Riley

Vice President for Development Erin Skelley

Director of Marketing Emma V. Chambers

Managing Editor

Denny Angelle Emma V. chambers Erin Fairchild Ami Felker Sheshe Giddens

2 CEO Message 3 THE METHODIST EXPERIENCE

Burke Watson

Contributing Writers ADCETERA

Design

Fantich Studio

Photography

Leading Medicine magazine is published by The Methodist Hospital System® Marketing Department for patients, physicians, employees and supporters. © 2010 The Methodist Hospital System All rights reserved. Materials may be reproduced with acknowledgement for noncommercial and educational purposes. Permission from the editor required for any other purpose. Send address corrections and letters to Leading Medicine, The Methodist Hospital System, Publications Department 1707 Sunset Blvd. Houston, Texas 77005 Tel.: 713-790-3333 or esource@tmhs.org If you wish to cancel your free subscription to Leading Medicine magazine, contact us at 713-790-3333 or esource@tmhs.org.

Personalizing service and safety

6 Cover Story: BREAST CANCER SCREENING

26 26 BRIDGE TO TRANSPLANT

11 CT SCANS

New technology reduces radiation exposure

14 DATA MINING

Research Institute scientist investigates new uses for existing drugs

18 ROBOTIC TECHNOLOGY

Methodist is first in the nation to use a robotic catheter for a procedure outside the heart

LVAD device allows counselor to continue her fight against gangs in Houston schools

30 NANOTECHNOLOGY

Early detection saves lives

George Kovacik Gale Smith

rthopedic surgeons devise novel O technologies for musculoskeletal and spinal disorders

33 CANCER CARE CLOSE TO HOME

Methodist’s network of community hospitals offers high-tech cancer care close to home

36 HEALTHY LIVING

When are antibiotics needed?

ACCOLADES

40 CLINICAL NOTES

21 LEADING CARE FOR WOMEN

Rep. Ellen Cohen tells her story of survivorship at women’s symposium

22 FOUNDATION OF SUPPORT

Honor Roll

Front Cover: At age 38, Monique James was diagnosed with breast cancer. Early detection saved her life.

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Officers of The Methodist Hospital Board of Directors

A Message From the CEO Dear Readers,

Ewing Werlein Jr. Chair John F. Bookout Senior Chair David M. Underwood Vice Chair

As you may know, Methodist’s physical landscape is changing dramatically. Expansion projects opening this year include our state-of-the-art Outpatient Center and the Research Institute, both in the Texas Medical Center, which will open in July and November, respectively.

Ernest H. Cockrell Vice Chair

Our fifth hospital in the Methodist network — Methodist West Houston Hospital — opens in December. This campus, like our other community hospitals, will offer the same high-quality care provided in the medical center. This $1.6 billion, five-year facility expansion program allows us to advance medicine and improve access to care for those we serve in the greater Houston area.

D. Gibson Walton Secretary

I am happy to report that once again The Methodist Hospital System® is ranked among FORTUNE magazine’s “100 Best Companies to Work For” in 2010. Ranked No. 17, this is our fifth consecutive year on the list, and we remain the highest ranked health care organization in the country.

Ronald G. Girotto President and CEO

Emily A. Crosswell Assistant Secretary Robert K. Moses Jr. Assistant Secretary Carlton E. Baucum Treasurer

This type of recognition is evidence of our commitment to creating a positive, caring environment, not only for patients, but for doctors and staff. We strive every day to make Methodist a great place to work and it takes the dedication of everyone to make it happen. Congratulations to every member of the Methodist family.

Board of Directors

In this edition, you will read how we are leading the way in utilizing new CT technology that lowers exposure to radiation and how renowned scientist Dr. Stephen Wong is studying new methods of using drugs, already on the market, to fight cancer and other diseases. We also highlight the Methodist Experience and how it is changing the culture of the hospital.

Connie Dyer

In keeping with our mission to promote good health through excellence in research, education and patient care, we are proud to provide this glimpse into the workings of The Methodist Hospital System. These stories are just a few of the exciting things under way as we forge ahead with our vision of building a world class academic medical center. I hope you enjoy this issue!

Morrie K. Abramson Mary A. Daffin

Gary W. Edwards James A. Elkins III Bishop Janice Riggle Huie Lawrence W. Kellner Rev. Kenneth Levingston Vidal G. Martinez Gregory V. Nelson Dr. Tom Pace Keith O. Reeves, M.D. Wade Rosenberg, M.D.

R. G. Girotto President Chief Executive Officer The Methodist Hospital System

Joseph C. “Rusty” Walter III Elizabeth Wareing Dr. Steve Wende Sandra Gale Wright, R.N., Ed.D.

Advisory Members Rev. Rick Goodrich Victor Fainstein, M.D.

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“ The Methodist Experience means that I’m actually making someone a little more comfortable than when they started out.”

The Methodist

experience

Methodist registered nurse Majorie Bolalin assists a patient.

By Nkem Okafor

Shaping each patient encounter into one that is unique to them is the driving force behind the Methodist Experience: A concept that individualizes patient care and engenders an environment of comfort and healing. “We ask patients on the first day of their visit if they are inter- ested in telling us more about themselves,” says Leticia Elizondo, a patient liaison who works with radiation oncology patients. “What do they like? What makes them comfortable?” The tidbits she gleans from these interactions are used to help comfort patients in stressful or painful situations. “It’s giving the patients something to feel, like ‘wow, I want to go back there. I want to tell the people I know that if you go to Methodist, you are not a number; you are an individual — a person, a friend, a family member,’” says Elizondo, who has worked at Methodist for nearly six years. “We build relationships with our patients. They feel like they are family to us, and we feel like we are family to them. … That’s what makes the difference.”

Fostering trust and empowerment What originated as a pilot program in 2005 has evolved into an outpatient and inpatient strategy that showcases exceptional, personalized care and service for patients in a safe environment. The Methodist Hospital’s vice president of

Human Resources, Carole Hackett, says promoting safety helps patients and employees feel secure and protected, enhancing the experience. “Paying attention to detail and reporting potential safety risks help protect our patients and colleagues and work to prevent high-risk events,” Hackett says. “All these elements coalesce to foster trust and empowerment.” In addition to patient interaction, physical environment is inherent to the Methodist Experience. Exam and procedure rooms have names like peace and perseverance, and artwork depicts nature themes with an emphasis on water — all designed to render a tranquil atmosphere. Last year, the hospital opened the Healing Garden, a serene, outdoor space for patients and their families (see page 5). Patients receive small, smooth stones with faith, strength, courage or believe printed on them — symbols of inspiration and hope. Tote bags and portfolios also are provided to assist patients during their visits. And their favorite snacks, drinks and music selections provide a boost and help pass the time.

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The

Methodist

experience

“ Methodist Experience makes it possible for each patient to feel at home.” Randy Kirk

Engaging employees As patients navigate the numerous buildings on the Methodist campus on any given day, it’s commonplace to see employees who do not hesitate to walk lost patients to their destinations, explain treatments and procedures, smile and greet guests consistently, and say, “My pleasure” and “How may I help you?” without second thought. Some may view these behaviors as common courtesies, but it’s more than that. It’s the Methodist Experience. Methodist Experience training begins on day one of employment. Last year alone, more than 5,300 employees received service training. “Methodist Experience makes it possible for each patient to feel at home,” says Randy Kirk, project specialist and head of Methodist Experience training. “It’s making sure our patients feel that they are in a place where they are loved and taken care of.” As the program unfolded throughout the hospital, patient and employee satisfaction scores soared. Yes, the program largely focuses on the patient experience, but it directly affects employees as well. “In order for any organization to

Dear Staff of the DeBakey Cardiovascular Center, I had two tests at your department. There was a preference page to fill in. I thought it wouldn’t be read immediately, but I was absolutely wrong. A lady brought me information I requested and water. When the nurse called me, he used my nickname. And wow, beautiful classical music was playing while I was having my test. You immediately responded to my requests. The staff that did the procedures was also very good, respectful and kind. Your grateful patient, Maria Cleofe V. Cinco 4/23/2010 4 methodisthealth.com

be successful, you have to have the people in the organization understand their alignment,” Hackett says. “You have to engage employees so they feel that they have a sense of purpose and can make a difference.” Kirk says the Methodist Experience is ingrained in the hospital’s culture. Simply put, it’s hardwired into what every employee lives and breathes every day. “I hear patients say that Methodist touched their lives,” patient care assistant Dewayne Bailey says. A Methodist employee who celebrated his eight-year anniversary at the hospital in March, Bailey assists nurses in the Methodist DeBakey Heart & Vascular Center. “They tried other hospitals, but when they come here, they say they received the attention that they needed,” he says. “The Methodist Experience means that I’m actually making someone a little more comfortable than when they started out. The Methodist Experience is a way of life. This is how you treat patients.” n

Dewayne Bailey and Leticia Elizondo

Photos courtesy Woodallen Photo-Houston

Methodist Outpatient Center

Healing Garden

The new Methodist Outpatient Center, opening July 13, is designed around the Methodist Experience – a patient-centered concept of healing and comfort that blends the science of medicine with the science of personalization.

Celebrating the natural, outdoor environment within an urban context, The Methodist Hospital’s Healing Garden opened last year to provide an intimate and calming retreat for patients and their families.

Rooted in its Leading Medicine vision, Methodist is elevating patient care to a one-of-a-kind experience for patients. The 1.6-million-square-foot facility offers a healing environment that caters to personal preferences, addressing the physical, emotional and spiritual needs of each patient. Special attention has been given to design elements that promote healing — muted lighting, soft curves, free flowing spaces, large windows facing scenic views and modern furnishings. No two patients are alike. And at Methodist, we treat each patient as an individual and strive to provide personalized and meaningful treatment no matter their condition. n

Designers of the 11,000-square-foot garden integrated a variety of textures, patterns and shapes inspired by nature. Metal, stone and glass, vibrantly colored plant material, and the movement and sounds of a water feature converge to form a serene milieu that engages all the senses. The garden, which was designed to promote healing, took 18 months to complete. The layout emphasizes openess and the free spirit of nature while providing a protected space for peaceful, private reflection. Located in the outdoor space between the Dunn and Fondren-Brown buildings, the Healing Garden can be accessed at the front of the hospital near Wiess Chapel or from the first floor of the Fondren-Brown building. n Volume 5, number 2

“ I know a lot of women whose breast cancer was detected early. … who are getting a chance to see their kids grow up and are living a full and great life.” Monique James

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early testing

saves breast cancer patient’s life By Sheshe Giddens

When new guidelines for mammography were announced last fall, they took Monique James’ breath away. She is living proof that screening before age 50 and breast self-examination save lives.

er daughter’s kindergarten graduation, her son’s first art contest, these are events James would have missed had she and her doctors followed the new screening guidelines. Fortunately, the 45-yearold breast cancer survivor doesn’t have to worry about whatifs. Diagnosed at 38, early detection saved her life.

“This increased survival is no doubt the result of early detection as well as advances in treatment.”

“This recommendation made me angry because I know a lot of women whose breast cancer was detected early — before age 50 — who are getting a chance to see their kids grow up and are living a full and great life,” James says.

Despite the task force’s recommendation, the Methodist Breast Center, National Cancer Institute and American Cancer Society all recommend women receive routine mammograms starting at age 40 and earlier if there is a family history of breast cancer.

The U.S. Preventive Services Task Force’s recommendation to only conduct routine breast cancer screenings in women ages 50–74 sparked controversy among physicians, breast cancer advocates and patients across the nation. The task force also advised against health care providers teaching women to perform breast self-examinations. But for women like James, beginning breast cancer screening at 50 would have been too late. “Since the onset of annual screening mammography in the 1990s, the mortality rate from breast cancer, which had been unchanged for the preceding 50 years, has decreased by 30 percent,” says Dr. Luz Venta, medical director of the Methodist Breast Center.

National cancer organizations respond

“I recommend a baseline mammogram at age 35 followed by annual mammograms starting at age 40,” says Dr. Eric Haufrect, James’ obstetrician/gynecologist. “Screening can begin even earlier in high-risk circumstances such as in the presence of positive genetic testing.” He also recommends breast self-exam to his patients. “They don’t need to know what it is that they are feeling. They simply should be familiar enough with their breasts so that they are more likely to feel a change in their self-exam,” he says.

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early testing

The Methodist Breast Center is recognized as a Breast Imaging Center of Excellence by the American College of Radiology and is accredited by the National Accreditation Program for Breast Centers. James’ story Haufrect insisted James have a baseline mammogram at 35. So when she detected a lump a year later, the radiologist was able to make a comparison. After a biopsy and excision, it was determined that the tumor was fibroadenoma, a benign tumor of the breast most commonly found in women during their childbearing years. Because of the fibroadenoma, James was scheduled for a routine mammogram the following year. In September, an MRI revealed cells that looked abnormal, but they proved to be noncancerous. Five months later, that all changed. “I was so grateful to Dr. Venta for taking the time to really explain what she saw on my ultrasound,” says James, who was diagnosed and treated at the Methodist Breast Center.

“She showed how one of the cells went from spherical in shape to not being very well defined. She told it me it looked like cancer and insisted that I have it biopsied that same day.” Two days later, it was confirmed that she had breast cancer. James later learned that the cancer had spread to one of her lymph nodes.

James was fortunate. Her cancer was detected early because of screenings and her ability to recognize changes in her breast.

Breast Cancer Detection Methods Screening mammogram

Used for routine screenings, compression is used to minimize X-ray radiation exposure.

Diagnostic mammogram

Used to investigate changes in the breasts and to clarify results of a screening mammogram.

Breast ultrasound

Determines if a lump or mass in the breast is filled with fluid or is solid tissue, which requires a biopsy.

Breast MRI

Highly sensitive test used in suspected cases of breast cancer and in dense breasts.

MRI-guided biopsy

MRI scan is used to guide a fine biopsy needle to the suspicious site to collect tissue samples.

Stereotactic biopsy

A mammogram (X-ray) view used to guide a core biopsy needle to the suspicious site to collect tissue samples.

Ultrasound biopsy

Ultrasound view used to guide a fine biopsy needle to the suspicious site. Used if the lesion is too small to be felt.

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“The idea behind these parties is to take the fear out of getting a mammogram and to prevent others from falling behind in getting their routine screenings.”

Talk with your doctor About 500 patients are diagnosed or treated with breast cancer each year at the Methodist Breast Center; about 21 percent of those are under age 50. “Nearly 50 percent of our patients with breast cancer last year fell outside the panel’s guidelines: younger than 50 years old and older than 75. This is a significant proportion of the women with breast cancer in our center,” Venta says. Although mammography continues to be the gold standard in breast cancer detection, the Methodist Breast Center utilizes additional state-of-the-art technology and services to aid in the diagnosis and treatment of breast cancer (see page 8). Patients should discuss any concerns and family history with their physician to determine when they should begin routine breast cancer screening. It is essential to know your family history and be aware of any changes in your breasts. After James’ breast cancer diagnosis, she grew concerned about whether she had a genetic predisposition toward developing breast cancer that might also affect her younger sister or her children. She had genetic testing for the BRCA1 or BRCA2 mutation, which, if present, highly increases a woman’s chance of developing breast and ovarian cancer. Fortunately for the rest of her family, the test came back negative. Now, James is focused on her family and her business. As the owner of two Beauty First franchises in Houston, she comes in contact with women from all walks of life, including cancer survivors. She understands better than most the toll the disease and treatment can have on a woman’s body and self-esteem. She herself used one of the product lines her store carries that encourages hair growth after she lost her hair during chemotherapy. So when women dealing with cancer visit her store — searching for a tiny bit of normalcy in the form of hair and beauty products — they can relate to James because she has been there — and survived. n

For more information about the Methodist Breast Center, call 713-441-PINK (7465).

Mammogram Parties

here’s a little-known after-hours spot tucked away in Upper Kirby, where a group of friends gather for pampering with relaxing spa treatments and refreshments after a long day at work. No, this isn’t an after-hours spa or a fresh twist on happy hour; it’s a mammogram party. Available at the Methodist Breast Imaging Center since last fall, this fun and unique concept provides a supportive atmosphere that eases the anxiety associated with having a mammogram. “The idea behind these parties is to take the fear out of getting a mammogram and to prevent others from falling behind in getting their routine screenings,” says Laura Zeisig, manager of the Methodist Breast Imaging Center at Upper Kirby. “A lot of time a woman’s schedule is too busy. This invites women to come after hours and get their screening mammogram without interrupting their daily schedule.” Mammogram parties are available to groups of six or more women who are due for their annual screening. The party also includes complimentary professional chair massages by Chrysalis, refreshments, education and giveaways. To host a party, call the Methodist Breast Imaging Center at 713-441-9740. Simply provide the name and contact information for each of your guests. The staff will assist everyone in obtaining the required doctor’s orders for the mammograms and will follow up with each guest. “We ease a lot of anxiety for patients coming in for a mammogram, ultrasound or biopsy. They can have the procedure, talk to their physician, ask questions and get their results all during the same visit,” she says. Physicians at the center also facilitate referrals, if needed. “This setting and personal, one-on-one care between physician and patient really sets us apart from other facilities that don’t provide this type of access,” she says. n

Ranked Specialty

Volume 5, number 3 9

G Methodist Willowbrook Hospital expansion opened The Methodist Hospital Outpatient Center opens The Methodist Hospital Research Institute scheduled to open Methodist West Houston Hospital scheduled to open

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New CT scanners

reduce radiation, cancer risk Employing newly developed software, the scanners use less radiation to produce images, then refine them to the clarity doctors need. By Burke Watson

n the past 18 months, research study findings and major television news reports have focused on radiation exposure from computed tomography (CT) scans. A valuable diagnostic tool, CT scans provide detailed views from deep within a patient’s body. But they require much higher radiation doses than conventional X-rays, creating growing concern among researchers that CT scans may contribute to an estimated tens of thousands of future cancer cases.

The Methodist Hospital System® has taken a leading role in adopting new technology that dramatically reduces the amount of radiation in CT scans while still producing the clear images doctors need to diagnose and treat many serious health problems. The Methodist Hospital adopted the latest advance in CT technology in late 2009 with new scanners by GE that experts say can reduce the radiation dose by 30 to 40 percent. Employing newly developed software, the scanners use less radiation to produce images, then refine them to the clarity doctors need.

Researchers study radiation dosage Two recent studies have reported that as CT scans have become more widely used in the United States — from about 3 million in 1980 to nearly 70 million in 2007 — the radiation dosage used tends to vary widely, depending upon the type of scan being done. This variation may contribute to a significant number of future cancer cases. Dr. Thomas Hedrick, medical director of Radiology for Methodist, says he understands the concern among researchers and patients. “I think it’s realistic for people to want to know more about this,” says Hedrick, who this summer will celebrate his 30th anniversary as a member of the Methodist medical staff. “Five years ago, patients almost never asked about the amount of radiation. In the past year to two years, the amount of concern has increased exponentially.” Publicity was generated about three years ago after the American College of Radiology decided to study the issue, Hedrick says. And, he adds, public interest has been further stoked by the news reports about radiation exposure from CT scans.

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New CT scanners

“Five years ago, patients almost never asked about the amount of radiation. In the past year to two years, the amount of concern has increased exponentially.”

New technology lowers exposure In response to growing concerns about radiation risks, CT manufacturers have made improvements that lower the radiation dose, while still providing physicians the sharp images they need for diagnosis, Hedrick says. The advances include a CT scanner that automatically adjusts the level of radiation used in a scan, depending on the area of the body that is being examined. For example, a lower dose is needed for the chest than for the abdomen, which has more soft tissue for the radiation to penetrate.

Photo courtesy GE Healthcare

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“If you didn’t have this software, you’d need significantly more radiation to get the same image,” Hedrick says. “We’ve had this technology on board since November and we haven’t seen any decrease in image quality.” Seven of the CT scanners with this capability are in operation at Methodist’s locations throughout the Houston area, and four more are scheduled to be in place by the end of this year. Hedrick says radiologists throughout The Methodist Hospital System conduct more than 150 CT scans per day. n

Heart Vascular

Screening Packages It’s quick, noninvasive and could save your life. Cardiovascular disease is the leading cause of death for men and women. Heart & Vascular Screening Packages at the Methodist Heart & Vascular Center can help you better understand your risk factors for cardiovascular disease. These scans are quick, noninvasive and could save your life. Screening could be covered by your insurance. For more information or to schedule a screening, call 713-DeBakey (332-2539) or visit debakeyheartcenter.com.

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Data Mining researchers unearth new uses for existing medications

By Burke Watson

tephen Wong has been called a lot of things in his storied career — engineer, developer of the first inkjet printer and the first and largest online trading site. But he has a new name to add to his myriad accomplishments — matchmaker. Employing computer skills to sort through the vast array of medical data that scientists have compiled digitally over the past decade, Wong and his research team at The Methodist Hospital Research Institute are working to match existing drugs with diseases they weren’t originally created to fight. The effort, still in its early stages, is drawing widespread attention as it raises the prospect of whittling down some major obstacles, including the staggering cost of bringing a new medication through its long series of clinical trials.

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Dr. Stephen Wong holds the John S. Dunn Distinguished Chair in Biomedical Engineering.

Wong’s team uses computer analysis and mathematical models to sort through databases, scientific literature and the FDA database.

“ A study published in 2006 reported that costs vary from $500 million to $2 billion to bring a new drug to market.” “When I come to a new place, I like to start something new,” says Wong, a Ph.D. who along with much of his research group was recruited to Methodist from Harvard University in 2007. He is director of the Center for Bioengineering and Informatics and director of the newly formed H.H. and W.F. Chao Center for Bioinformatics Research and Neurosciences Imaging. “The cost of making new drugs is ridiculous,” he says. “A study published in 2006 reported that costs vary from $500 million to $2 billion to bring a new drug to market. My philosophy is to look at the drugs we already have and see if we can find a new way to use them.”

Also, he said, so many drugs have been developed, it is becoming more difficult for researchers to identify new targets in the body. The U.S. Food and Drug Administration approved only 26 new drugs in 2009, compared with more than 100 a decade earlier. “The traditional way of drug development is running out of steam,” Wong says. “So we have a double whammy here and, basically, we have a drug drought.”

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Data Mining The U.S. Food and Drug Administration approved only 26 new drugs in 2009, compared with more than 100 a decade earlier. A pioneering spirit

Collaboration spurs advances

A Hong Kong native, Wong is an engineer, not a medical doctor, and has spent much of his career on the leading edge of rapidly advancing technology. In addition to his work on the automation of the inkjet printer and the online trading site Schwab.com, he helped develop the first 1 megabit VLSI (very large scale integration) computer memory chips and the first hospital-wide picture archiving and communication system (PACS). He is among the pioneers in bioinformatics, an emerging field that employs computers to store and analyze the enormous amount of genetic, imaging and clinical data now available online to scientists and physicians.

Wong’s process has led to two encouraging studies in breast cancer cases in partnership with Dr. Jenny Chang, medical director at the Lester and Sue Smith Breast Center at Baylor College of Medicine. Chang had conducted biopsies on the tumors of some patients whose cancers had remained confined to the breast and on others whose cancers had metastasized to the brain. That occurs in about 12 percent of breast cancer cases and is incurable, Wong says.

Since his arrival at Methodist, Wong’s team has mined a wealth of information, including databases on genetics, proteins, drug trials, scientific literature, and the FDA database on about 1,700 approved drugs and 3,800 experimental drugs in clinical trials. While the traditional approach to developing a drug involves focusing on a target, such as a gene, and determining whether it is the culprit, Wong uses mathematical models and computer analysis to sort through vast amounts of data and tries to match existing drugs — or combinations of them — to diseases for which they weren’t originally designed. The candidate drugs, identified by computer analysis, are further validated with carefully designed biological experiments. “It’s an upside-down way of approaching it,” Wong says. “We couldn’t have done this just a few years ago, but now the publicly available, NIH-funded clinical trial databases, as well as the advances in computers, enable us to sift through so much information.” Another major benefit of using existing drugs is the dramatically shorter time needed to get them into use if they prove successful. With new drugs, the FDA’s three-phase process of clinical trials can take as long as 10 years. With existing drugs, however, researchers can avoid the Phase I trials, which can take three to five years.

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Now, with computer modeling and analysis, Wong and his researchers are working to develop drug combinations that will be effective on specific types of tumors at different stages. Two drugs are in Phase II trials, and he also is conducting research on possible drug cocktails for cancers of the lung, prostate and brain. He compares the effort to directing an orchestra: managing many complex elements to achieve a harmonious outcome.

“It’s a new way of making drugs. We’re seeing a lot of good results.” Wong has more than $15 million in National Institutes of Health funding to improve diagnostics and patient outcomes in the areas of neurodegenerative diseases and cancer. The Methodist Hospital Research Institute was established in 2004 to conduct research in support of advancing patient care and raising medical practice standards. It now has more than 1,700 credentialed research team members, including more than 400 principal investigators conducting research in the most important areas of human disease. More than 700 active clinical trials are under way at the Research Institute, and that number is expected to double by 2012. Since its inception, the Research Institute’s federal research funding has grown six-fold, a testament to its success in recruiting national and international leaders in critical research and research support areas. n

NIH awards Wong $11.5 million research grant The Methodist Hospital Research Institute was awarded an $11.5 million Center Grant by the National Institutes of Health to study the best approach to attack deadly cancer stem cells to enhance treatments for breast cancer. Other members of the team include Baylor College of Medicine and the University of Texas Health Science Center at Houston.

“Targeting cancer stem cells, rather than cancer cells, is a completely new strategy for treating cancer,” says Stephen Wong, Ph.D., director of the Center for Bioengineering and Informatics at The Methodist Hospital Research Institute and principal investigator for the grant study. “By attacking the cancer stem cell, we hope to eliminate cancer’s ability to grow, recur or metastasize.” The NIH grant will enable Wong’s team to model breast cancer stem cells — or see what they look like and how they act — using advanced genetic, imaging and computer modeling techniques. Wong said once the cells are modeled in the lab and in real environments, the team will be able to predict the behavior of cancer stem cells, enabling them to test drugs that might kill the cells or prevent the cells from duplicating and metastasizing.

Cancer stem cells have the ability to resist drugs, become cancer cells, and split into a cancer cell and another stem cell. Traditional cancer treatments use chemotherapy to kill cancer cells but are not optimized to kill the stem cell. “Targeting the cancer stem cell is the new horizon for cancer research,” Wong says. “We have put together a very strong team of top experts in the field. We’re able to combine that talent with the technology at our disposal at Methodist, Baylor and UT. This is a formidable combination that has potential to achieve real breakthroughs in cancer research. It’s great to now have the backing of the NIH to help us move ahead.” Besides providing a basic framework for understanding breast cancer stem cell evolution, the models will allow the team to predict how the natural process of cancer development will play out in various circumstances. The ultimate goal is better, more effective treatment for eliminating breast cancer. n

Volume 5, number 3 17

Robotic Technology Eliminates need for surgery in transplant patient By Erin Fairchild

Charles Brennen

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harles Brennen received what felt like the most important phone call of his life. As he rushed to The Methodist Hospital two years ago, he reflected on how blessed he was to be granted a second chance on life — a new lung that would enable him to breathe normally. Something he hadn’t been able to do for years.

Spending his golden years doing what he loved most — working alongside his kids and their families at their Texas cattle ranch — was put in jeopardy 10 years ago when his lungs gave out due to asbestos poisoning. He spent three years on a transplant waiting list, desperately hoping he would live long enough to receive a new lung but also struggling with the notion that someone must die for him to live. And yet, that day had come. The new lung provided the 72-year-old retired marketing executive with strength and a newfound ability to enjoy life again, but shortness of breath started creeping back last year. After seeing his doctors, he learned that his pulmonary artery, which carries unoxygenated blood to his new lung, had narrowed. Diagnosis: pulmonary artery stenosis. “Brennen was growing weaker each day because his new lung wasn’t being fed the blood it needed to work effectively,” says Dr. Scott Scheinin, associate surgical director of Methodist’s Thoracic Transplant Program.

This was the first time in the United States that a robotic catheter was used outside the heart.

Unclogging the pipeline Physicians use stents (mesh tubes) to prop open clogged arteries and restore blood flow to the lungs. But in Brennen’s case, a stent could not be used because his artery was too twisted to maneuver a catheter (used to carry and deploy the stent) up from the groin to the damaged artery. Furthermore, the placement of the stent was hampered by the rhythmic motion of the heart as it distributes blood through the artery to the lungs. “In the old days we would have to take a patient back to surgery to repair a narrowed pulmonary artery. It’s a difficult spot to reach — a long, winding course under ideal circumstances,” Scheinin says. “But now, new robotic technology helps physicians navigate to the right spot and, more important, eliminates the need for transplant patients to undergo another surgery.” In a first-of-its-kind procedure, Dr. Alan Lumsden, chair of the Department of Cardiovascular Surgery at Methodist, and Dr. Miguel Valderrábano, chief of the Division of Cardiac Electrophysiology, used a robotic catheter to place a stent in Brennen’s pulmonary artery and save his transplanted lung. “The new stent carries more blood to my lungs, keeping them healthy and replenished with the oxygen they need, so I have more stamina,” says Brennen, a father of five and grandfather to four girls. “Now I can get back in shape, get out to the ranch, feed the cattle and see if we have any new calves running around.” Lumsden and Valderrábano used a Sensei Robotic Catheter System designed by Hansen Medical for use inside the heart to successfully reach the narrowed part of the pulmonary artery.

So flexible it can wrap around a dime, the Artisan Extend™ Control Catheter improves access to complex anatomy.

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Robotic Technology

“The robot helped us maneuver through a complicated series of twists and turns in Mr. Brennen’s vascular anatomy,” Valderrábano says. “It also helped compensate for the motion of the beating heart so we could place the stent safely and accurately, providing his new lung with a ready flow of oxygenated blood.” With successful implantation of the stent, Brennen avoided being placed again on the lung transplant list. This was the first time in the United States that a robotic catheter was used outside the heart. Valderrábano used 3-D guided imaging to direct the robotic catheter to precisely the right spot to place the stent. The team performed the procedure in a catheterization lab at a workstation console next to where the patient was lying on the table. A high-tech joystick allowed Valderrábano to manipulate the catheter from a puncture hole in the patient’s groin, through the vascular system and into the pulmonary artery that connects the heart to the lungs. The joystick mimicked Valderrábano’s hand movements to control the catheter in a natural, intuitive way. Once the catheter reached its destination, Lumsden placed and deployed the stent in its final resting place.

Expertise and training Valderrábano is one of the country’s foremost experts in the use of a robotic catheter, having completed more than 125 procedures using the robot, primarily to treat atrial fibrillation (irregular heartbeat). He has worked with Hansen to improve quality and reliability of procedures using the robot, and the manufacturer recently moved its international training center to the Methodist DeBakey Heart & Vascular Center. Physicians come from around the world to learn and hone their skills at Methodist’s new Vascular Research Laboratory, where they use the Sensei, other robotic technology and simulation suites to research new, more effective and safer methods of performing cardiac and vascular surgery. Valderrábano says experience brings improved outcomes for patients. “Physician training is of utmost importance to ensure patient safety when using a new robotic device rather than manual manipulation of a catheter,” he says. “We provide experience, plus the tools and simulation environments necessary to bring physicians who are new to this technology up to speed without ever ‘practicing’ on a live patient.” As for Brennen, he’s breathing normally and back on track with renewed vigor. Not eight feet from his front door sits a gift from his son, a top-of-the-line treadmill. “I guess I can’t avoid exercising anymore,” he says. “You walk right into it when you open the door.” n

“ Robotic technology helps physicians navigate to the right spot and, more important, eliminates the need for transplant patients to undergo another surgery.”

Seated at the workstation, the physician’s hand motion is translated to the control catheter located inside the patient.

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Equipment photos courtesy of Hansen Medical.

“I’m sorry, Mrs. Cohen. It’s malignant.”

Ellen Cohen

Leading care for women By Burke Watson

merging from the fog of anesthesia, Ellen Cohen looked around the room in a Montreal hospital to see if the doctor could be speaking to another Mrs. Cohen. He wasn’t. This 20-something wife and mother of two small children had been diagnosed with breast cancer.

Known as an advocate for women’s health issues, as well as public education, air quality and other concerns, Cohen was elected to the Texas House of Representatives in 2006, representing the district that includes the Texas Medical Center, and was re-elected in 2008.

After enduring a radical mastectomy, her doctor asked if she had any questions. Only a few hundred, she replied. How long might she expect to live? How was this dramatic change in her body going to affect intimacy with her husband?

Citing such health threats as heart disease, stroke and diabetes, Cohen urged those attending the symposium to learn all they can and be assertive about getting the care they need. In addition to her remarks and a welcome from Ron G. Girotto, president and CEO of The Methodist Hospital System ®, the symposium featured breakout sessions hosted by Methodist physicians and other health professionals on a wide range of topics.

“Well, maybe you’d like to speak to my wife,” the doctor told her. She wasn’t a physician and had never had cancer, he acknowledged, “But she’s a woman.” “I didn’t need a woman to talk to. I needed a young mother, a breast cancer survivor, to talk to,” Cohen told about 200 listeners at The Methodist Hospital’s second annual Leading Care for Women Symposium. Now a 40-year cancer survivor and a state representative from Houston, Cohen recounted that frightening, frustrating experience during her keynote address at the daylong symposium. The gatherings are organized to provide information about health concerns affecting women, as well as issues that affect both women and men — but which often are diagnosed in women too late, or not at all.

Morning breakout sessions included presentations on heart disease, diabetes and arthritis in women, as well as discussions on cardiovascular surgery, acid reflux and treatment of spinal fractures caused by osteoporosis. After lunch with physicians in the hospital’s Crain Garden, another breakout session covered topics including dermatology, breast cancer care and the Methodist Institute for Technology, Innovation & Education. n

Volume 5, number 3 21

Foundation of Support

Aramco Services Company

strides for stroke By Gale Smith

Aramco Services Company stepped up to serve as the presenting sponsor of The Methodist Hospital System’s 2010 Stride4Stroke 5K Walk/Run. The company partnered with Methodist in support of its efforts to increase stroke awareness and prevention throughout the local community.

Living its values … corporate citizenship One of Aramco Services Company’s core values is citizenship. With this in mind, the company actively seeks opportunities to participate in a variety of community outreach programs, which this year included sponsorship of the Methodist Stride4Stroke 5K Walk/Run. Aramco Services sponsored this important event because it promotes community wellness through stroke awareness and education, and it also provides an opportunity for Houstonians to enjoy a fun-filled day of activities with their family members and friends. The Aramco team of employees is committed to giving back to the communities in which they live and work. The company is involved in a variety of projects to help advance quality education, safer neighborhoods, affordable housing, a cleaner environment, improved health care and more. Volunteers often say that the teamwork between their colleagues and community members makes each project especially meaningful and brings a high level of personal and professional reward. Company volunteers participate in at-capacity numbers for annual projects with Houston Habitat for Humanity to help build new homes so local families can realize their dream of home ownership. The company also digs in to the task of planting trees to help beautify the city through the Trees for

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Houston program and supports public broadcasting by providing volunteers to help answer calls and accept pledges during the Houston PBS, KUHT-TV Channel 8 telethon. Aramco Services also provides volunteers to help educate, mentor and inspire students to achieve financial literacy through specialized Junior Achievement programs, and supports organizations such as Crime Stoppers to help ensure safer neighborhoods. Headquartered in Houston for more than 35 years, Aramco Services is the U.S.–based subsidiary of the world’s leading energy provider, Saudi Aramco. It serves as a vital link between Saudi Aramco and North America to help facilitate the safe and reliable delivery of energy to customers around the world. n To learn more about Aramco Services, please visit aramcoservices.com.

Photos courtesy Carson Photos.

Stroke campaign spreads awareness statewide The hunger for knowledge SM

“I’ve traveled throughout Houston and the state of Texas, talking about stroke symptoms, prevention and treatment options, and I can tell you that people are hungry for this knowledge,” says Flewelling, a registered nurse. “The stories they share with me of loved ones affected by stroke remind me that what I teach impacts lives. Knowing that I may be helping people I’ll never meet — that is most gratifying, and it never gets old.”

Every time Jan Flewelling steps in front of an audience, she’s racing against the clock because she knows that for every person she meets, she’s increasing awareness about a disease that strikes every 40 seconds — stroke.

Now in its fourth year, Strides4Stroke has raised more than $2 million for stroke education and increased stroke awareness by educating and training thousands of health care providers in hospitals and health organizations throughout Texas.

“People need to know the signs of stroke so they can act fast,” says Flewelling, a stroke outreach program coordinator at The Methodist Hospital. Through The Methodist Hospital System Taking Strides4Stroke: Community Awareness Campaign, she and her colleagues strive to beat the odds — educating more than 14,000 Texans about stroke during the past three years.

Flewelling has assisted more than a dozen Texas hospitals in enhancing their stroke care programs. Many are now certified Primary Stroke Centers by The Joint Commission or are in the process of becoming certified.

Established in 2007, and led by the Methodist Neurological Institute’s Eddy Scurlock Stroke Center, the goal of this fiveyear campaign is to create a stroke education program model that can be used by other urban hospitals and communities.

Stroke is the third leading cause of death in the United States and the fourth leading cause of death among Hispanics. Because of the prevalence of stroke in this community and the growth of the Strides4Stroke campaign, Methodist hired a second outreach coordinator in 2009 to focus primarily on Houston’s Spanish-speaking population.

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Foundation of Support

“ People need to know the signs of stroke, so they can act fast.” Methodist stroke community educators Jan Flewelling and Marta Cortes dedicate their time whenever and wherever they are needed to teaching what is known as the FAST assessment:

Face: Does one side of the face droop? Ask the person to smile.

Arm: Does one arm drift downward? Ask the person to raise both arms.

Speech: Does their speech sound slurred or strange? Ask the person to repeat a simple phase.

Time: If you observe any of these signs, then it’s time to call 9-1-1.

Targeting minority populations

Grant brings campaign to East Texas

In addition to teaching stroke awareness in Houston’s Latino community, Marta Cortes is working with the city’s Chinese community to provide an avenue for needed screenings and education that it would not otherwise receive.

In 2008, a $5.8-million-dollar, three-year grant from the T.L.L. Temple Foundation allowed Methodist to partner with Memorial Health Systems of East Texas to bring an advanced stroke program to this region, where stroke mortality is four times the national average. Through this grant and the ongoing Strides4Stroke campaign, Methodist is assisting Memorial Medical Center — Lufkin to advance their stroke program.

She’s also reaching across the U.S. border into Mexico, where she is working with hospitals in Mexico City to build and enhance their stroke programs, so they can apply for international stroke certifications. Cortes, a registered nurse who previously worked with heart patients says, “It doesn’t matter what language you speak when it comes to teaching people how to save lives. “Explaining a brain attack in any language is huge. If we can impress upon them that stroke is an emergency and teach them how to seek help, we’re one step closer to reducing the incidence of this disease.”

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Physicians at MMC-L are treating more stroke patients, and the hospital expects to apply for Primary Stroke Center certification with The Joint Commission this summer. The partnership is another step in turning Methodist’s goal of creating a stroke education program that can be successfully replicated by other hospitals into reality. “I know the deadly power of stroke,” Flewelling says. “But I also know that by teaching others, we have strength in numbers against this disease.” n

Society for Leading Medicine The Methodist Hospital Foundation appreciates members of the Society for Leading Medicine who are helping transform The Methodist Hospital through contributions of $10,000 or more each year. The following list recognizes the benevolent visionaries of the society in 2009. Their generosity not only allows Methodist to provide the very best in patient care, but also advances its vision of becoming an academic medical center of the first rank. If you wish to know more about how you can ensure the health of future generations by joining the Society for Leading Medicine, please contact Meredith Stasny at 832-667-5838.

Anonymous (7)

DermSurgery Associates, P.A.

The Methodist Hospital Auxiliary

Dr. and Mrs. Bobby R. Alford

The Doré Family Foundation

Mr. and Mrs. John S. Moody

The Alkek and Williams Foundation

Mr. and Mrs. Charles W. Duncan Jr.

The Moran Foundation

Alliant Insurance Associates

Peggy and Gary Edwards

Mosbacher Foundation, Inc.

American Society of Echocardiography

The Elkins Foundation

Mr. and Mrs. Gregory V. Nelson

Dr. Hiram P. Arnold* and Mrs. Gloria R. Arnold

Marvy Finger Family Foundation

Joe Niekro Foundation

Jerry and Nanette Finger Foundation

Orthopaedic Research & Education Foundation

Astros In Action Foundation Dr. and Mrs. Thomas D. Barrow Dr. Barbara L. Bass and Mr. Richard S. Marshall, Esq. Mr. and Mrs.Carlton E. Baucum M.R. Bauer Foundation Carolyn and John Bookout The Bowers Family Fund of the Texas Methodist Foundation

The Fondren Foundation Drs. A. Osama and Lillian Gaber Mr. George B. Geary Dr. Leonard H. Goldberg Golfers Against Cancer Mr. and Mrs. Herbert I. Goodman The Blanche M. Green Fund Mr. and Mrs. John E. Hagale

Breg, Inc.

The Hamill Foundation

The Brown Foundation, Inc.

Hobby Family Foundation

Mr. Charles R. Burnett III

Mr. and Mrs. Charles E. Hollier

Mrs. Judy Campbell

Houston Endowment

Mr. and Mrs. William A. Carpenter Jr.

Houston Texans

Mr. and Mrs. Philip J. Carroll

Karl Storz Endoscopy-America, Inc.

The P and C Carroll Foundation

Mr. and Mrs. I.H. Kempner III

Catch 25 Foundation Inc.

Mr. Ajay Khurana and Dr. Sapandeep K. Singh

Mr. and Mrs. Albert Y. Chao

The Oshman Foundation Ms. Chloe R. Pounds The George A. Robinson IV Foundation Roche Laboratories Inc. Mr. Rob Schanen Drs. George and Lynn Schroth Scurlock Foundation Vivian L. Smith Foundation Dr. H. Dirk Sostman and Ms. Maria Preka Ms. Sharon Werlin Staton Cynthia and Don Stevenson T.L.L. Temple Foundation Taub Foundation Texas Arrhythmia Institute Ms. Ann G. Trammell Mr. and Mrs. David M. Underwood

Mr. Balwant S. Khurana

Ray Walsh Foundation

Mr. and Mrs. Gregory A. Kozmetsky

Joseph C. “Rusty” Walter

The Cockrell Foundation

Carole Walter Looke

Martha and Gib Walton

Competitor Group, Inc.

M.D. Anderson Foundation

Mr. and Mrs. Michael M. Cone

MacDonald Family Foundation

The Honorable Ewing Werlein Jr. and Mrs. Werlein

Mr. and Mrs. M. Samuel Daffin

Mr. Clarence E. Mayer Jr. and Mrs. Jill Mayer

Ting Tsung and Wei Fong Chao Foundation

DePuy Mitek, Inc.

* Deceased

Volume 5, number 3 25

Bridge to

transplant

By Ami Felker

hayla Hendricks combats her debilitating heart disease much the same way she confronts gangs that threaten her community — head on, with persistence, determination and patience.

As a gang intervention counselor for the City of Houston, Hendricks approaches her work from every angle to stop and prevent gang infiltration in the city’s youth. When she’s not at work, the young career woman is fighting another battle. In 2003, at just 23, Hendricks was diagnosed with stage 4 Hodgkin’s lymphoma and an inoperable tumor on her lungs. After several months of chemotherapy and countless infections and other complications, she finally entered remission.

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“Chemotherapy was the worst experience of my life, but I took it like a young person,” Hendricks says. “It was rough, but I beat it.” Sadly, she won the battle, but the war had just begun. Four years later, Hendricks suffered from severe shortness of breath and an abnormal heart rhythm, after which she received a pacemaker and was diagnosed with congestive heart failure. “I knew my heart was eventually going to deteriorate as a side effect of the chemo,” she says. “I just thought I would be older. I never imagined I would be so young.” The next three years were full of hospital stays, and her heart eventually became so weak she could no longer walk the

“I look forward to getting back to a normal life. … just a normal life.” Shayla Hendricks

short distance from the car to her back door without becoming short of breath and being forced to stop and rest. Then, she suffered a stroke last year. Her heart could not survive on its own much longer. Just days after her stroke, surgeons at The Methodist Hospital implanted a left ventricular assist device, or LVAD, into her chest. The device helps pump blood through her weakened heart.

The only option “Shayla’s situation was not one we took lightly because of her age and the severity of her heart disease,” says Dr. Jerry Estep, a transplant cardiologist at Methodist. “Only an LVAD or heart transplant could save her, and with her cancer history, transplant was not yet an option.”

Hendricks received a third generation LVAD, the most advanced device available. Third generation LVADs are smaller, just 10 ounces, last longer than older pumps, and have continuous flow, which means fewer moving parts that have potential for wearing out. In contrast to older pumps that typically lasted about a year and weighed about two pounds inside a person’s chest, newer pumps can fit in the palm of a hand and last for years. Patients with LVADs are required to carry a bag that holds backup batteries for their devices at all times. Methodist has been a pioneer in LVAD innovation since Dr. Michael E. DeBakey and his team implanted the world’s first LVAD in 1967. Surgeons at Methodist were the first in the

Volume 5, number 3

Bridge to

transplant region to implant a patient with a third generation LVAD, and the team is currently participating in several clinical trials. “Our goal is to support Shayla’s heart with an LVAD until she has been in remission for a few years and transplant becomes the best treatment for her,” says Dr. Matthias Loebe, surgical director of thoracic transplant at Methodist. “We have remained at the absolute forefront of this technology, and we offer a comprehensive program for heart failure patients through our multidisciplinary approach,” he says. “We meet and decide as a team the best therapy for each patient who comes to us.” In addition to medical care, the LVAD program at Methodist requires that all patients and their families meet regularly with a nurse coordinator and social worker to ensure they have all the available information. Their medical teams are always updated on their lives. “Patients with LVADs need a lot of support when they are home from the hospital, so we really emphasize the importance of family,” Estep says. Heart failure treatment options at Methodist include medical therapies, temporary devices that can rescue patients from Drs. Jerry Etep and Matthias Loebe

acute issues or serve as a bridge to permanent LVADs and heart transplants. For patients who do not want or do no qualify for heart transplant, an LVAD is the most aggressive treatment for their disease. “Our inpatient heart failure unit is another unique component of Methodist’s program, where patients stay on a dedicated floor with nurses who are specially trained in medical and device heart failure care,” Estep says. A designated LVAD clinic provides the Methodist team the opportunity to use imaging expertise through echocardiograms to determine proper pump settings and adjust more advanced devices.

“ Only an LVAD or heart transplant could save her. … Transplant was not yet an option.” Methodist continues to lead the way in LVAD development and heart failure care, offering more than 10 types of LVADs and participating in numerous research studies that may eventually lead to earlier detection of heart disease and minimize disease progression.

Back on the job Hendricks was released from the hospital a month after receiving her LVAD. She returned to work just two months later. “Shayla is a striking young woman,” Loebe says. “Despite being so sick, she is eager to have a productive life. She couldn’t wait to be back working with young people. She’s remarkable.” For now, the 30-year-old Hendricks focuses her efforts on taking every step necessary to qualify for a heart transplant. “I feel so much better since getting my LVAD,” she says. “I was missing work like crazy; I was tired all the time. Today, I’m back at work and I enjoy time with my family.” Relying on teachers and other adults to notify her when they recognize gang identifiers in middle school students, she spends her time presenting to groups, working one-on-one with students and even making home visits. “I have a heart for at-risk kids,” says Hendricks, who has a bachelor’s degree in criminal justice with a focus on juvenile justice. “They’re impressionable, and I know they have a future. I can scare them straight, make a difference in their lives and set them on the right path. “I am truly blessed. Now I look forward to getting back to a normal life. … just a normal life.” n

To learn more about Methodist’s LVAD program, call 713-441-8900. 28

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What is a left ventricular assist device? A left ventricular assist device (LVAD) is a pump that helps the beating heart to propel more blood to vital organs of the body while also unloading the left ventricle of the heart. The device is surgically implanted with sternotomy, a type of open heart surgery. An LVAD is a more permanent type of support, which allows the patient to be discharged and return home. Ventricular assist devices can be utilized as bridge to transplant, meaning that the LVAD provides support until the patient can receive a transplant; or destination therapy, meaning that the LVAD would be a permanent support.

LVAD Benefits n

What is an LVAD made of? It is made of titanium, which carries no risk for rejection or allergic reaction to the materials. The blood is propelled out of the LVAD to the body through a Dacron graft connecting the LVAD to the patient’s aorta.

How does an LVAD work? Blood is brought into the LVAD from the left ventricle of the heart through an inflow tube. This blood then passes through the body of the pump and is released into the aorta through an outflow tube and graft. The oxygenated blood travels through the aorta to the organs and the rest of the body. Most new LVADs use an impeller or rotor to operate, similar to the functioning of a jet propeller.

The LVAD is implanted through open-heart surgery under general anesthesia. A dime-sized area of tissue is removed from the heart’s left ventricle, and the inflow tube of the LVAD is then inserted through this space. The LVAD and outflow tube and graft are attached to the ascending aorta (the first section of the aorta leading from the heart). The LVAD fits under the left ventricle within the left rib cage. The percutaneous lead, also known as the lifeline, is run under the skin to the right side of the abdomen/chest area where another small incision is made for it to exit the body. That line is connected to a controller or transistor that controls functions of the LVAD and transmits alarms. Two power lines connect from the controller to either two batteries or to a central cord that then connects to a direct electrical source. n

Relief from CHF symptoms including shortness of breath, abdominal swelling, and swelling of the legs, ankles and feet Freedom from the need for IV use at home Potentially, correction of kidney failure, which is due in part to the improved blood flow provided by the LVAD Improvement and correction of pulmonary hypertension (high blood pressure within the lungs). The patient’s care team also will check for a decrease in heart size as the workload is reduced on the left ventricle. In some cases, if there is complete recovery with LVAD support, the team will discuss and evaluate the patient for possible removal of the LVAD.

Risks n

How is an LVAD implanted?

Freedom from hospitalization or recurrent hospital admissions for congestive heart failure (CHF)

Bleeding before, during or after the surgery Stroke, cerebral bleeding or hemorrhage due to blood thinners (a risk reduced with newer and more efficient LVAD support and astute monitoring of anticoagulation at home) Renal (kidney) failure; infection Need for prolonged ventilation support (which is reversible) Risk of death

left ventricular assist device

Volume 5, number 3

Nanotechnology: Accomplishing big things by thinking small By Denny Angelle Drs. Harvey Smith and Bradley Weiner

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Nanotechnology

Accomplishing big things by thinking small

Imagine standing on the moon, peering down at the bright blue planet in the middle of a black sky. You put a magnifying glass to your eye, and suddenly you can see the faces of everyone on earth. You can pick out your friends and see what they’re wearing and what they’re doing.

wing your gaze over to Houston, focus on The Methodist Hospital, and you may well see some doctors and researchers who hope to accomplish big things by thinking small.

They work in the world of nanoscale, measuring things smaller than the speck in a fly’s eye, so tiny that molecules swirl around like bright planets in a black sky. They get to this world by using microscopes nearly as powerful as your imaginary magnifying glass on the moon. Dr. Bradley Weiner, section chief of orthopedic spine surgery at The Methodist Hospital, calls this nanomedicine — treating disease or repairing damaged tissues of the human body on the molecular level. Weiner, chief of spine surgery at Methodist, is also codirector of the Spine Advanced Technology Laboratory, the first of its kind in the United States. He and codirectors Dr. Harvey Smith and scientist Christopher Loo are conducting a number of basic research initiatives (occurring in a laboratory setting) that may one day revolutionize orthopedic medicine. “We are shrinking everything down to a whole new level,” Weiner says.

How small? To give you an idea of how small, nano means billionth, which makes a nanometer one billionth of a meter. An average American male might be six feet tall, or about two meters. So he would be two billion nanometers tall. On the same scale, the page on which these words appear would be about 100,000 nanometers thick. Let’s get small: your average bacteria might be around 200 nanometers long, and a protein inside your body might be about 10 nanometers long. A single atom might be 0.1 nanometer wide, while its nearest neighbor does its own atomic thing about 0.15 nanometers away.

“When we get down into this level, it’s another world,” explains Smith, who is an orthopedic surgeon. “When we can get down to the nanoscale, we’re at the level of the basic building blocks of the body, of disease and understanding why things happen the way they do.” Then doctors like Weiner and Smith, with the help of scientists like Loo, can implement technologies — nanotechnologies — to treat diseases and repair damaged tissue. “The use of nanomedicine to detect disease early, deliver medication and treat disease, or to repair and heal bone, cartilage, muscle and nerves, will make our work safer and more effective,” Weiner adds. One project they are working on is a method to more effectively deliver medication. “Currently, we give large doses intravenously and the result is systemic, which means it goes throughout the body and can have side effects on the liver or kidneys,” Weiner says. “One of the promises of nanomedicine is that we can deliver much smaller doses to the exact place where they are needed.” The idea of using a so-called nanocapsule to deliver medication is not exactly new, and in fact, researchers are investigating similar delivery techniques to treat cancer. “But we are just beginning to understand and realize the possibilities of how this might benefit the world of orthopedics,” Weiner explains. A medication with nano-sized modification could go directly to an affected area, bypassing other tissue and organs. Doctors could deliver an injection and use sophisticated nano-mapping to send it accurately into musculoskeletal tissue — like the spine — and deliver the medication right where it is needed. “Working on the nanoscale gives us new avenues of intervention, such as a way of delivering anti-inflammatory or pain medications,” Weiner says. Weiner primarily performed clinical research (involving human volunteers) until a few years ago, when he became involved

Volume 5, number 3

Nanotechnology

Accomplishing big things by thinking small

with the work of scientist-researcher Mauro Ferrari, Ph.D., at the University of Texas Health Science Center at Houston. Ferrari’s group was investigating nanomedical solutions to problems in molecular medicine, and their work fascinated Weiner. “This group was seeking potential applications for cancer, and I was invited to be the clinical lead for similar research in orthopedics,” Weiner says.

Connecting technology and medicine The work of the Spine Advanced Technology Laboratory began in earnest this past January at Methodist, with clinicians and scientists working in collaboration with the University of Texas under the auspices of The Methodist Hospital Research Institute. Smith describes himself as a “clinician scientist” who connects the medicine and the technology resulting from research in the Spine Lab. He does this by determining a way for theories and observations, which are tested on the nanoscale, to lead to a therapy or treatment that could be used on patients. “This is really a huge field, even though the work is at the smallest level,” he says. “For the first time, we are able to get down on the same level where changes and chemical reactions take place,” Smith says. “Many diseases are protein-based, which means that proteins manipulate the body’s DNA to make changes that result in disease.”

Proteomics could eventually give physicians a way to deliver individualized treatment, specific medications, or techniques developed to work on a specific person for maximum efficiency. “Not only could you treat a problem early, you also would be confident it’s the precise type of treatment a patient needs,” Smith adds.

“ For the first time, we are able to get down on the same level where changes and chemical reactions take place.”

Nanomedicine research at the Spine Lab also can yield better and stronger bone implants and prosthetics, and reveal new compounds that can speed bone growth and healing. The lab also will develop a database of patients who may be biologically inclined to not have a good outcome during or after surgery.

The study of proteins or proteomics came after the largescale study of the human genome that took place in the 1980s and 1990s. Studying the changes in proteins caused by organisms or injury is difficult because proteins vary from cell to cell. They change over time and, more important, can be very different from one person to the next. “Another one of our aims is to study these proteins at a focused level,” Smith explains. “We can see how they react when a chemical or a compound is introduced so that we can target disease just as it’s taking hold in the body.”

“Once we determine why this happens, we can develop screening processes for these patients and give them treatment early, which may help them avoid surgery altogether,” Weiner says. Weiner and his colleagues believe nanomedicine will one day lead not only to better treatments and more effective surgery, but also to materials that can be implanted and last the remaining life span of a patient. A few of the research projects will soon grow out of the nanoscale phase into a stage where they can be tested on a clinical level. Smith predicts other investigations may take up to a decade before they can be tested on humans. “We have the tools to move in a number of directions,” Weiner says. “It’s exciting, because this is the future of medicine.” n Ranked Specialty

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Community hospitals offer quality care and convenience By George Kovacik

Cindy Dworaczyk’s life turned upside down when she heard the word. “Incurable.” She thought she was going to die within a couple of months. Now, two years later, Zworaczyk reflects on that life-changing moment and says her faith, determination and the expert medical care she received at Methodist Sugar Land Hospital are what saved her. For two months after being diagnosed with inflammatory breast cancer, a rare and aggressive form of the disease, Dworaczyk stopped at Methodist Sugar Land Cancer Center on her way to work where she received a dose of radiation. “I had the opportunity to go to a hospital in the medical center for treatment early on, but the care and compassion I received at Methodist Sugar Land was second-to-none,” she says. She calls the conveniences of Methodist Sugar Land Hospital a blessing. From free proximal parking to avoiding Houston traffic — these all-important amenities lessened her stress at a time when her cancer fueled enormous anxiety. “I never would have made it through the treatments if I would have had to drive to the Texas Medical Center every day,” she says. “The stress alone would have killed me before the cancer did.” Dworaczyk and thousands of patients around the greater Houston area have learned that The Methodist Hospital System®’s network of community hospitals — Methodist Sugar Land,

Methodist Willowbrook and San Jacinto Methodist — offer patients the ability to receive state-of-the-art care close to home. Last year alone, the three hospitals collectively logged nearly 400,000 patient visits.

“ Our collaborative approach is personalized to meet each patient’s needs.” “Patients who go to Methodist’s community cancer centers are treated by oncologists and staff with years of training and experience,” says Dr. Kathy Shadle, medical director of the Methodist Willowbrook Cancer Center, located in northwest Harris County. “Our collaborative approach is personalized to meet each patient’s needs. From wellness programs focused on nutrition and stress relief to advanced medical therapies, patients benefit from our comprehensive services.” San Jacinto Methodist’s cancer center, which is located in Baytown, offers a number of support programs — Road to Recovery, Reach to Recovery, Look Good Feel Better and Dialogue Support Group — and provides a complementary consultation with ancillary staff such as dietitians and hospital clergy.

Volume 5, number 3

A Commission on Cancer accredited program, the hospital recently added a patient navigator to assist patients in overcoming barriers and connecting to appropriate cancer-related services. Issues the patient navigator may address include language and cultural barriers, transportation issues, lack of financial resources, insurance difficulties, and coordination between multiple health care providers. “All of the Methodist cancer centers strive to provide the same level of care and support you would find in the Texas Medical Center,” says Halena Hellums, San Jacinto Methodist’s director of radiation therapy.

Standardized care

The Methodist Hospital

Methodist has made a concerted effort to standardize cancer care throughout all of our community hospitals, says Dr. Brian Butler, chairman of Radiation Oncology at The Methodist Hospital. “The goal is to be able to provide all of our patients with every piece of technology that’s available in the Texas Medical Center, and we are on our way to accomplishing that.” “There is close communication with the cancer team to ensure patients receive personalized care, not cookie-cutter treatment dictated by protocols,” says Dr. Clive Shkedy, director of Radiation Oncology at Methodist Sugar Land. Access to electronic medical records gives doctors throughout the network the ability to collaborate and discuss cases.

Methodist Willowbrook Hospital

For example, Shadle says she had a lung cancer patient who required very specialized care. She consulted with a surgeon at The Methodist Hospital and devised a comprehensive treatment plan. “Because the images were computerized, we were able to view them simultaneously at two different locations. In this instance, we determined the best course of care to be surgery in the medical center and therapy at Methodist Willowbrook,” she says. Every Friday doctors from all four hospitals hold a teleconference where they present their cases, and they are able to garner opinions about treatment plans. “Many times when a patient is sent from a community facility to a bigger hospital for surgery or other treatment, they will see a different doctor and never come back,” Shkedy says.

“ I never would have made it through the treatments if I would have had to drive to the Texas Medical Center every day.” Methodist Sugar Land Hospital

“We have the luxury of sending the patient to The Methodist Hospital for very specialized treatment and having the patient come back to us to continue their care. It’s less stressful for the patient trying to find a new team of doctors.”

Bright future The quality of care at Methodist Sugar Land’s cancer center helped Cindy Dworaczyk beat her cancer. After undergoing a double mastectomy and enduring 22 months of treatment, doctors told her she was cancer-free. They called her recovery nothing short of a miracle. “The convenience of not having to worry about parking and being able to get my treatment on the way to work made it easy for me to tell them that ‘I’m sticking with Methodist.’” n

San Jacinto Methodist Hospital 34

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Methodist’s Family of Cancer Care Hospital

IMRT

IGRT

SBRT

SRS

Cone-Beam CTS

Partial Breast Irradiation

High Dose Rate Brachytherapy

Chemo

The Methodist Hospital Methodist Willowbrook Hospital Methodist Sugar Land Hospital San Jacinto Methodist Hospital

Cancer Care Technology Intensity-Modulated Radiation Therapy (IMRT)

Pioneered at Methodist in 1994 and now used all over the world, this advanced mode of highprecision radiotherapy utilizes computer-controlled linear accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor. Image-Guided Radiation Therapy (IGRT)

This 3-D technology provides precise and exact information on the specific location of any softtissue or skeletal target. Having more precise location information

means a smaller radiation field can be used, so there is less chance the radiation will affect healthy tissue near the tumor. Stereotactic Body Radiotherapy (SBRT)

A form of stereotactic radiosurgery that uses a linear accelerator to deliver highly focused radiation with extreme accuracy to treat tumors in specific parts of the body such as the spine, lung and liver. Stereotactic Radiotherapy (SRS)

A highly precise form of radiation therapy primarily used to treat tumors and other abnormalities of the brain.

Cone-beam CTs

A machine generates a 3-D CT image before treatment is initiated that helps properly position the patient for radiation. Partial Breast Irradiation

A targeted radiation therapy developed for patients with early-stage breast cancer who have had a lumpectomy. It delivers high-dose radiation directly to the site where the tumor was removed, targeting the spot where cancer would most likely recur. Treatment time is five days vs. five to seven weeks.

High Dose Rate Brachytherapy

Placement of a radioactive source in or near the area to be treated, HDR brachytherapy delivers a large dose of radiation in a short period of time, so treatment delivery takes only a few minutes. The radiation dose is shaped by a computer, which changes the position of the source in catheters or specialized devices. Chemotherapy

Specific chemical agents or drugs selectively destruct malignant cells and tissues.

Volume 5, number 3

By Emma V. Chambers

Do you have a sore throat, persistent cough or the flu? No problem, just ask your primary care physician for an antibiotic. Not so fast. Antibiotics won’t help. Colds, flu and other common illnesses are caused by viruses, and antibiotics don’t kill them. In fact, there are no medications that kill these viruses. If you have a virus, it must run its natural course — usually in two weeks. Antibiotics are used to treat infections caused by bacteria, fungi and some parasites. They are commonly used to treat pneumonia, sinus infections, strep throat, ear infections, skin infections, acne, urinary tract infections and some sexually transmitted diseases. So how do you know if your illness is caused by a virus or bacteria or if you need an antibiotic? Leading Medicine editor Emma Chambers sat down with Methodist chief of infectious diseases Dr. Victor Fainstein to discuss these and other antibiotic-related questions.

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Healthy Living

Q: What are antibiotics? Antibiotics are a class of drugs, also called antimicrobials, which fight bacterial infections. Penicillin, which was the first antibiotic, was discovered in the late 1920s, but it wasn’t used to treat infections until the 1940s. A number of antibiotics are currently on the market and each class affects different types of bacterium.

Q: How do I know if I need an antibiotic? You should contact your health care provider to discuss your illness and its symptoms. In some cases, he or she will ask you to come in for an appointment. At other times, the telephone conversation will suffice. However, only your health care provider should determine if and what type of antibiotic you need.

Q: Even if my doctor says I don’t need an antibiotic, should I ask for one to be on the safe side? No. Taking an antibiotic if you don’t need it will not help. It won’t make you feel better. In fact, it may extend your illness and cause unnecessary side effects.

Q: If you feel better, is it safe to stop taking the prescribed antibiotic?

Q: Can I take expired antibiotics?

No. Just because the symptoms subside, it doesn’t mean that the bacteria have been killed. You should complete the prescribed course of treatment. If not, some bacteria may survive, and you may relapse.

No. You should not take expired medications of any kind. All medications have a shelf life. After that date, the medication loses its potency. Taking expired medications can prolong your illness and produce unwanted side effects.

Q: Is it safe to take someone else’s antibiotics?

Q: What is antibiotic resistance?

No. Only take antibiotics that have been prescribed for you. There are many antibiotics on the market, and they can’t be used interchangeably. Taking the incorrect antibiotic may prolong your illness or allow bacteria to multiply.

Antibiotic resistance has been called one of the world’s most pressing public health problems. Every time a person takes antibiotics, bacteria are killed. However, some germs are resistant to the antibiotic and may be left behind. These bacteria multiply and can cause harm. Repeated or improper use of antibiotics is the primary causes of antibiotic resistance.

Q: Are there any side effects to antibiotics? Antibiotics, as with all medications, have potential side effects. Some of the common side effects include nausea, diarrhea and stomach pain. If the patient is really bothered by the effects, they should contact their health care provider to see if there is another one they can take. Also, some women may develop yeast infections as a result of taking antibiotics. In rare instances, antibiotics can cause an allergic reaction that can require medical attention.

Q: What is the best way to prevent antibiotic resistance? First and foremost, talk to your health care provider about your illness and its symptoms. If possible, have your health care provider take a culture to determine if the illness is caused by a virus or bacteria. Don’t take an antibiotic for a viral infection. Decreasing the inappropriate use of antibiotics is the best way to prevent resistance. n

Antibiotic Quiz c. Cold d. Strep throat 4. I nfections can become resistant to antibiotics. a. True b. False 5. I can prevent antibioticresistant infections when I (more than one may apply): a. Don’t take an antibiotic for a viral infection b. Don’t save an antibiotic for the next time I am sick

Source: Centers for Disease Control and Prevention

c. D on’t take an antibiotic prescribed for someone else d. T ake my antibiotic exactly as my health care provider tells me 6. W hat can happen if I get an antibiotic-resistant infection (more than one may apply)? a. I may have a longerlasting illness b. I may have to visit my doctor more

c. I may require hospitalization d. I may need more costly medicine that may cause side effects 7. A ntibiotic resistance has been called one of the world’s most pressing public health problems. a. True b. False

Answers: 1. b 2. b 3. d 4. a 5. a, b, c, d 6. a, b, c, d 7. a

1. A ntibiotics fight infections caused by: a. Viruses b. Bacteria c. Viruses and bacteria 2. Bacteria are germs that cause colds and flu. a. True b. False 3. W hich of these illnesses should be treated with antibiotics? a. Runny nose b. Flu

Volume 5, number 3

Accolades

he Methodist Breast Center is the first in Houston and the third in Texas to receive a three-year full accreditation designation by the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons.

The Methodist Breast Center is now the only location in Houston with the NAPBC accreditation and recognition as a Breast Imaging Center of Excellence by the American College of Radiology Commission on Quality and Safety, and the Commission on Breast Imaging. Full accreditation is the highest level granted by the NAPBC, and is only given to those centers that have voluntarily committed to provide the highest level of quality breast care and that undergo a rigorous evaluation process and review of their performance. The NAPBC is a consortium of professional organizations dedicated to the improvement of the quality of care and monitoring of outcomes of patients with diseases of the breast. n

Pharmacy resident Joshua Swan, Ph. D., was named recipient of the American Society of Health System Pharmacists Research and Education Foundation’s 2009 Student Research Award. The award is one of five given annually as part of the ASHP Foundation’s Literature Awards Program.

The Methodist Hospital System® is ranked No. 17 among FORTUNE magazine’s 2010 “100 Best Companies to Work For,” making the list for the fifth year in a row and remaining the highest ranked health care organization in the country. Only three companies in Texas are in the top 20. Methodist ranked No. 5 in the category of large companies, No. 3 for the hiring of minorities and No. 16 for the hiring of women. Methodist was selected based primarily on a confidential survey sent to randomly selected employees, who were asked questions on the level of trust, pride and camaraderie within their workplace. Methodist also submitted documentation about its work environment, from benefits to corporate policies to employee demographics. n

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The research paper, “Systematic Review and Meta-Analysis of Immunosuppressant Therapy Clinical Trials in Membranous Lupus Nephritis,” was written and researched while Swan was completing his doctorate in pharmacy at the University of Mississippi’s School of Pharmacy. He joined The Methodist Hospital’s pharmacy residency program in 2009. n

Frederick Macapagal, a registered nurse and clinical mentor on the Fondren cardiac care unit at The Methodist Hospital, has been named the Brown Foundation Inc. Outstanding Nurse for 2009. He is the 20th nurse to receive this honor. Macapagal has been a nurse for 29 years; he has worked at Methodist since 1984. Coworkers who nominated him for the annual award described him as “a dedicated leader, who serves as a great resource to new and veteran staff nurses.” n

accolades

Cathy Easter has been appointed president and chief executive officer of Methodist International. She has been a member of the MI executive team since 2007. She was instrumental in opening the Middle East office in Dubai Health Care City and The Dubai Mall Medical Center, which includes a 45-physician clinic; and procedure and comprehensive radiology center. In her new role, Easter will provide oversight of international patient services and expand the Methodist brand by providing high-quality patient services in international markets such as Latin America and the Middle East through business development and consulting services. n

Dr. Bin S. Teh, a radiation oncologist at The Methodist Hospital, was named recipient of the Ministry of Health Singapore Health Manpower Development Plan Award. Teh is a leading expert in pioneering new technology in radiation oncology such as intensity modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), brachytherapy as well as combined radio-genetherapy. This award honors Teh’s significant contribution and leading role in implementing new technology, radiation oncology, translational and clinical research, and teaching. n

Dr. Gustavo C. Román, an internationally recognized expert in vascular dementia, has joined the Methodist Neurological Institute to continue the quest to find a cure for Alzheimer’s disease. He holds the Jack S. Blanton Distinguished Chair for the Study of Neurological Disease and leads the Methodist Alzheimer and Dementia Center. He will develop a multidisciplinary team that will treat patients using cutting-edge therapies and advance a translational research program on memory disorders and the relationship between brain circulation and dementia. Román was previously professor of neurology at the University of Texas Health Science Center’s School of Medicine in San Antonio, where he founded the UT Medicine Memory Disorders Clinic. Prior to UTHSC, he served as chief of the neuro-epidemiology branch at the National Institutes of Health, where he led a team in producing the currently used diagnostic criteria for research studies in vascular dementia. n

Dr. William Zoghbi, the William Winters Endowed Chair in Cardiovascular Imaging at The Methodist Hospital, was named vice president of the American College of Cardiology (ACC). His term went into effect in March, and he is slated to become president of the ACC in 2012. Founded in 1949, the ACC now boasts 37,000 members in the United States and around the world. It is the guiding force in the cardiology community for education, research, and setting quality and practice standards. Zoghbi is a leader in the field of echocardiography and Doppler ultrasound for heart disease. n

Volume 5, number 3

Clinical Notes Dr. Guillermo Torre-Amione, a heart failure specialist at the Methodist DeBakey Heart & Vascular Center, has been approved by the FDA to conduct the first study of neurostimulation as a treatment for heart failure.

Neurostimulation, which is currently used to treat certain forms of pain, activates nerves in the spine to create changes in blood flow, potentially improving the heart’s ability to pump effectively. This stimulation may improve blood pressure and reduce the number of fatal cardiac arrhythmias.

Dr. Orlando Diaz, an interventional neuroradiologist with the Methodist Neurological Institute, is the first in Houston to treat a brain aneurysm with a recently FDAapproved liquid material instead of traditional open skull surgery or platinum coils.

Diaz performed the two-and-a-half-hour procedure on a 68-year-old woman using a minimally invasive technique. He then administered the Onyx HD 500 liquid to the aneurysm, instead of using traditional coiling.

Dr. James Musser, The Fondren Endowed Distinguished Chair and codirector of The Methodist Hospital Research Institute, recently discovered a simple gene mutation that decreases the chance people will get a flesh-eating disease called necrotizing fasciitis. Further, they proved that inactivating this section of the gene lessens the devastating disease in humans.

Necrotizing fasciitis is rare but serious. It is lethal in approximately 30 percent of those who develop it. The most common cause is the group A Streptococcus (GAS) bacteria, the same bacteria that causes step throat. The research was funded by the National Institutes of Health and the American Heart Association. Results appeared in Proceedings of the National Academy of Sciences. n

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Historical data shows connections between the brain, nervous system and heart, but no one has attempted to harness this relationship for therapeutic results, according to Torre, who serves as principal investigator. He and his team will study whether they can control this process and improve patients’ symptoms and outcomes by stimulating the nerves that activate the release of hormones. n

Once the liquid makes contact with blood inside the bulging aneurysm, it becomes a firm pudding-like substance and works like concrete to stabilize the aneurysm and prevent more blood from entering and causing it to rupture. The treatment is most effective with irregularly shaped intracranial aneurysms where open surgery or coiling alone isn’t sufficient. n

Many thanks to our sponsors for making the

4th annual Stride4Stroke 5K Run & Walk a huge success. Presenting Sponsor

Department Chair

Section Chief Wilson Architectural Group Yetter, Warden & Coleman L.L.P.

Fellow McGlinchey Stafford, P.L.L.C. Vaughan Nelson Investment Management, L.P. Texas Annual Conference of the United Methodist Church Thompson & Knight, L.L.P. Resident Akin Gump Strauss Hauer & Feld

Deloitte & Touche USA, LLP

KODE-FM

Amegy Bank of Texas

KHOU-TV Channel 11

Lapin & Landa, LLP

BrivicMedia, Inc.

KODA-FM

Vinson & Elkins L.L.P.

Medical Student Andrew Delaney Foundation

Fidelity Investments

Microsoft Corporation

CME Printing, Inc.

Hogan & Hartson, LLP

National Stroke Association

Dunn Exploration Company, LLC

Lodge Lumber Co., Inc.

Tradition Bank

Non-Profit Org. U.S. Postage PAID Houston, Texas Permit No. 6311

6565 Fannin Houston, TX 77030 A Founding Member of the Texas Medical Center

LEADING MEDICINE The Methodist Hospital System ®

Hospitals The Methodist Hospital

6565 Fannin Houston, TX 77030 713-790-3311

Methodist Sugar Land Hospital

16655 Southwest Freeway Sugar Land, TX 77479 281-274-7000

Methodist Willowbrook Hospital

18220 Tomball Parkway Houston, TX 77070 281-477-1000

San Jacinto Methodist Hospital

4401 Garth Road Baytown, TX 77521 281-420-8600

Methodist West Houston Hospital

18500 Katy Freeway Houston, TX 77094 Coming in 2010

Research The Methodist Hospital Research Institute 6565 Fannin Houston, TX 77030 713-441-1261

Imaging Methodist Breast Imaging Center

2615 Southwest Freeway Suite 110 Houston, TX 77098 713-441-PINK (7465)

Methodist Imaging Center

8333 Katy Freeway Houston, TX 77024 713-793-XRAY (9729)

Emergency Care Methodist Emergency Care Center

2615 Southwest Freeway at Kirby Houston, TX 77098 713-441-ER24 (3724)

Physician Referral/ Health Information 713-790-3333 Health information via the Internet methodisthealth.com

Wellness Methodist Wellness Services 713-441-5978

Philanthropy The Methodist Hospital Foundation 1707 Sunset Blvd. Houston, TX 77005 832-667-5816

Leading Medicine Magazine, Vol. 5, No. 3, 2010

Articles inside

HEALTHy LIVING

CLINICAL NOTES

CANCER CARE CLOSE TO HOME

ACCOLADES

NANOTECHNOLOGy

ROBOTIC TECHNOLOGy

CT SCANS

BRIDGE TO TRANSPLANT

FOUNDATION OF SUPPORT

COVER STORy: BREAST CANCER SCREENING

DATA MINING

LEADING CARE FOR WOMEN

THE METHODIST EXPERIENCE