February 2020 Issue 1
BPI CONNECTIONS RECOGNIZING STROKE SYMPTOMS COULD HELP YOU PREVENT LONGTERM DISABILITY Use ‘FAST’ to Remember Important Stroke Signs and Symptoms It is estimated that 795,000 people in the United States experience a stroke every year. A stroke can happen to anyone, and it occurs when a blood vessel in the brain is blocked or ruptured. With new findings suggesting that the rate of strokes is rising among younger people, Brown Neurology is highlighting signs and symptoms to be mindful of that can help you prevent long-term disability. Stroke symptoms can appear suddenly, and it is imperative that individuals experiencing these symptoms seek medical attention immediately, according to neurologists. “Patients who receive emergency treatment fast have a better chance of recovering,” said Dr. Karen L. Furie, a physician at Brown Neurology and Brown Physicians, Inc., and chair of the Department of Neurology at the Warren Alpert Medical School of Brown University. “Knowing the common stroke signs can help individuals recognize when immediate action is needed.” Checking for signs of a stroke is easier to remember if people refer to the FAST acronym, Dr. Furie says. FAST stands for the following:
F
A
S
T
FACE Individuals experiencing a stroke may have their face droop to one side.
ARMS Ask the person to raise both arms, and see if one is drifting downward.
SPEECH A stroke could cause individuals to slur their speech. Ask them to repeat a phrase.
TIME Call 911 if you notice or have any of the symptoms mentioned above.
Recovery from a stroke continues throughout a person’s life. Individuals who have already had a stroke face a greater likelihood that they could have another stroke, which is why it is important to be able to recognize the signs. Dedicated to researching and treating neurological diseases, Brown Neurology is one of six foundations that comprise Brown Physicians, Inc. If you think you are at a heightened risk for a stroke or would like to schedule an appointment with a Brown Neurology physician, you can call us at (401) 444-3032.
Emergency Medicine Studying Apple Watch to Prevent Falls A Call to Seniors for RI FitTest In October 2018, the Apple Watch series 4 was brought to market. Included in Apple’s updated watch was a fall algorithm that could alert family members and 911 if a fall occurred and the wearer was not responding. Dr. Elizabeth Goldberg, Associate Professor of Emergency Medicine, received a $1.2 Million grant from the National Institutes of Health to examine if the Apple Watch could be useful to help prevent falls and injuries in older adults who seek emergency care. In November 2019, the GAPcare II (the Geriatric Acute and Post-Acute Fall Prevention Intervention study) started recruiting patients from the Rhode Island and Miriam Hospital Emergency Departments. Adults 65 and older will now have the chance to wear the watch during their daily activities, perform memory and mobility tasks, and provide feedback to the research team about the watch and research app “RI FitTest” that was created to securely store and transmit data to Dr. Goldberg’s team. Their hope is that wearable technology will be useful to help researchers find ways to prevent falls – the leading cause for injury-related deaths in older adults. 1
REMAINING ACTIVE CAN REDUCE YOUR RISK FOR NONALCOHOLIC FATTY LIVER DISEASE Nonalcoholic fatty liver disease affects an estimated 80 to 100 million people in the United States, with many people unaware that they have the condition. Left unchecked, the condition could progress to a more lifethreatening disease called cirrhosis. Brown Physicians, Inc. spoke with Dr. Suzanne Chan to learn more about nonalcoholic fatty liver disease, and how to lower your risk for the condition. Dr. Chan serves as a gastroenterologist with Brown Medicine, which is one of six foundations that comprise Brown Physicians, Inc. According to Dr. Chan, nonalcoholic fatty liver disease can be diagnosed by a physician through blood tests, imaging scans, and, in some cases, liver biopsies. “This condition is often referred to as a ‘silent disease’ because it causes few or no symptoms,” stated Dr. Chan. While the affliction can
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progress to cirrhosis if left untreated, Dr. Chan emphasizes that people can reduce their risk for this disease by knowing important risk factors. “No one knows what causes nonalcoholic fatty liver disease, but it has been linked with certain risk factors such as genetic dispositions, high blood pressure, obesity, and Type 2 diabetes,” she said.
“Patients may be surprised to know that by simply engaging in a healthier lifestyle they can significantly reduce their risk for this disease.” Patients at high-risk for nonalcoholic fatty liver disease can access specialized care and treatment options at Brown Medicine. Once the diagnosis is confirmed, physicians work with the patient to design a customized weight-loss plan. “The hope is that patients would heed our medical advice and begin to eat healthier, exercise more, and make a commitment to maintain a healthier weight,” Dr. Chan concluded.
Dr. Chan completed a residency at the teaching hospital of Harvard Medical School, and specializes in gastrointestinal diseases, liver disease, and pre-and post-liver transplant care. As part of Brown Physicians, Inc., Brown Medicine works with foundation partners to offer comprehensive patient care, covering all medical needs. Those partners include Brown Dermatology, Brown Emergency Medicine, Brown Neurology, Brown Surgical Associates and Brown Urology. Through this partnership, patients can receive a holistic approach to preventative care that is unmatched when compared to a traditional hospital setting. You can learn more about Brown Medicine’s specialties at brownmed.org, or connect with one of our physicians by calling (877) 771-7401.
BROWN DERMATOLOGY ANNOUNCES THE OPENING OF ITS NEWEST LOCATION IN SOUTH KINGSTOWN The new office is located at The Village at South County Commons, 59 South County Commons Way, 2nd Fl. in South Kingstown, RI. At just over 6,800 square feet, the new space has 12 exam rooms and 6 procedure rooms. The Dermatology team will offer general/medical dermatology services, Mohs Surgery as well as Laser and Aesthetic procedures there. Drs. Arianne Kourosh and Carlos Wambier along with Marjon Vatanchi and Ariana Parker (PA-C) began scheduling patients at the new location in December. Brown Dermatology is committed to providing the most comprehensive and advanced care with dedicated physicians, knowledgeable staff, and convenient locations throughout Rhode Island. Brown Dermatology cares for patients of all ages with highly specialized services and cosmetic procedures. All of the physicians at Brown Dermatology are on the faculty of The Warren Alpert Medical School of Brown University. For an appointment, call (401) 444-7959 or visit our website at brownderm.org.
Brown Dermatology is part of Brown Physicians Inc., a community-based, not-forprofit multi-specialty practice group founded and led by faculty affiliated with The Warren Alpert Medical School of Brown University. Its mission is to provide outstanding patient care, exceptional medical education, and groundbreaking advances in research to
promote better health for the people of Rhode Island and its surrounding communities. Brown Physicians Inc. is composed of six foundations, which include Brown Dermatology, Brown Emergency Medicine, Brown Medicine, Brown Neurology, Brown Surgical Associates and Brown Urology.
UNIVERSITY SURGICAL ASSOCIATES CHANGES ITS NAME TO BROWN SURGICAL ASSOCIATES University Surgical Associates, the largest multidisciplinary surgical group in Rhode Island, has changed its name to Brown Surgical Associates, effective January 1, 2020. “This name change reflects our commitment to strengthening our affiliation with Brown University’s Warren Alpert Medical School,” said Dr. William Cioffi, President of Brown Surgical Associates. “This name change also aligns with our goal of bringing world class surgical care to all of Rhode Island and Southern New England.” As one of six foundations that comprise Brown Physicians, Inc., Dr. Cioffi stated, “The decision to change our name supports the overarching mission to integrate care across the state and throughout Southeastern New England.” All
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of the physicians in Brown Surgical Associates are part of the teaching faculty of the Warren Alpert Medical School and serve as teachers and mentors to the next generation of medical professionals. About Brown Surgical Associates Brown Surgical Associates (BSA), formerly University Surgical Associates, is Rhode Island’s largest multidisciplinary surgical group. All 55 surgeons are on the teaching faculty of Warren Alpert Medical School of Brown University. Brown Surgical Associates is one of six medical practices that comprise Brown Physicians, Inc. Brown Surgical Associates offers consultative, diagnostic and therapeutic inpatient and outpatient services for all surgical disorders from pediatric surgery through adult
specialized services. Brown Surgical Associates encompasses a variety of specialties that include, bariatric, breast, endocrine, colorectal, general, hepatobiliary, pediatric, surgical oncology, thoracic, transplant surgery and vascular surgery. For more information on Brown Surgical Associates, visit brownsurgicalassociates.org.
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5 QUESTIONS WITH SIMONE THAVASEELAN, MD Q: Does familiarizing people with new treatment methods take the “scare” out of visits to the urologist?
public about preventative care as it directly relates to urology.
A: It is exciting for us, as urologists, to show what a equipment like a ureteroscope looks like and how we maneuver it to see into the urinary tract.
Also, routine screening for urology cancers, such as prostate cancer through a blood test and a physical exam can also have a significant impact in early detection and prevention of advanced disease.
These types of demonstrations illustrate how we diagnose and fix a kidney stone in a way that is easy to understand for everyone. Ideally, individuals who have urologic disease will take what they’ve learned from this experience to seek more answers and healthcare services from a urologist, who have received extensive training in preventing and treating common conditions of the urinary tract. Q: How has technology contributed to better modes of treatment for urological conditions? A: Urologists have always been at the forefront of integrating technology into real advances in patient care. These medical advances in techniques and surgeries have played an important role in improving outcomes for patients. Using open or traditional incisional surgery, as well as endoscopic, microsurgical, laparoscopic, and robotic-assisted technology techniques, urologists have advanced the process of caring for patients and reduced recovery times for millions of patients. In my area of expertise, advances in miniaturized scopes have allowed us to offer minimally invasive procedures without the need to “open” up a patient. Through small incisions, we can remove painful kidney stones and help patients feel better, more quickly. Q: Is there enough focus on preventative treatment when it comes to urology? A: Preventative treatment for urological conditions is challenging. The main challenge could be tied to the difficulty of distinguishing between healthy habits and tips that are specifically related to urology health. For instance, everyone knows that drinking water is healthy for you. Urologists would also recommend drinking plenty of water as a way to help prevent kidney stones. Another challenge stems from physicians’ inability to provide the same recommendation to everyone. Every person’s body works differently. While some people will be encouraged to cut out certain foods from their diets, it may not be necessary for someone else. Physicians in our field have done a good job in delivering individualized care to patients. However, more could be done to remind the 4
Q: What is one thing that people can do better to improve their urological health? A: We take for granted how our urinary systems work all the time. As long as people are eating and drinking regularly, individuals are unlikely to give their urinary system a second thought. It is usually after men and women experience pain or discomfort that they consider improving their urology health, or meeting with a urologist. Speaking broadly, individuals can maximize their urinary function by staying hydrated and using the bathroom in recurring intervals. In the simplest terms, our kidneys filter out blood to make urine and the bladder stores it. The real process is far more complex, and when the urinary system is not working properly, a variety of obvious and silent symptoms may emerge. With this in mind, people can improve their urological health by scheduling an appointment with their doctor who might refer them if they have a problem with their urinary or reproductive system. Q: Is the field of urology attracting enough young physicians in Rhode Island? Urology is an extremely small surgical subspecialty that trains about 350 urologists a year. With an increasing population that is aging, we are witnessing an increase global burden of urology disease as conditions such as prostate cancer, prostate enlargement, bladder cancer, incontinence and erectile dysfunction are common in the aging population. There are still independent organizations, and there will likely continue to be practices that specialize in urology. For instance, Brown Urology has many generalists and subspecialists that focus on treating urologic diseases. Our practice provides access to pediatrics, female pelvic floor medicine, urologic oncology, endourology, male infertility and andrology, and reconstruction surgical services. Physicians in these specialties receive advanced training to care for some of the most complex conditions — which can be very rewarding for doctors who want to make a difference in the lives of patients.
WE’RE CHANGING THE MEDICAL LANDSCAPE IN RHODE ISLAND. By joining together to become one of the largest physician groups in Southern New England, Brown Physicians is providing a better patient experience with coordinated care across a wide range of medical specialties. For more information about Brown Physicians, visit our website or contact one of our 6 specialty groups: Brown Dermatology (401) 444-7959 Brown Emergency Medicine (401) 519-0330 Brown Medicine (877) 771-7401 Brown Neurology (401) 444-3032 Brown Surgical Associates (401) 272-1800 Brown Urology (401) 272-7799
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