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Consult Winter 2011 | Only Ohio State
Contents 3 Epilepsy services and the new Epilepsy Monitoring Unit 7 Neuromuscular Medicine 13 Comprehensive Orthopaedic Services 15 Liver and Pancreatic Cancer 27 Neuro-oncology 33 News and updates from the Medical Center New clinical research and continuing medical education opportunities
Ohio State’s
Consult Winter 2011
The Ohio State University Medical Center
Comprehensive Epilepsy Program w Central Ohio’s only Level 4 Epilepsy Center w State-of-the-art Epilepsy Monitoring Unit w Comprehensive medical and surgical treatment
Ohio State’s Epilepsy Center Our program and team
Tammy had epilepsy for 30 years.
“We must offer hope to patients. Patients who come to us have had problems for a long time. Being able to offer them a broad range of options gives them hope,” J. Layne Moore, MD, a board-certified neurologist says. “Even if we aren’t able to control a patient’s seizures today, we will keep trying other methods.”
During that time, she wasn’t offered comprehensive evaluation of her brain activity or a surgical consultation. Her life was negatively affected by her inability to hold a job and keep her relationships on track. She felt isolated socially. Several years ago, her seizures were evaluated in the Epilepsy Monitoring Unit at The Ohio State University Medical Center. She was an appropriate candidate for surgery and, today, she is seizure free.
The Ohio State University Medical Center has the only adult level 4 Epilepsy Center in central Ohio as designated by the National Association of Epilepsy Centers. This ensures our program is equipped to provide patients with the most complex forms of epilepsy treatment, including:
“I got my life back,” she says, “I can drive, and I’m more connected with friends and family. My quality of life has changed drastically. It’s the difference between not being able to do anything and being able to live independently. I’m free now.”
• Intensive neurodiagnostics monitoring • Extensive medical, neuropsychological and psychosocial treatment • Complete evaluation for epilepsy and surgery, including intracranial electrodes and complex resective procedures
“Commonly, a patient who has been misdiagnosed with epilepsy suffers for an average of 10 years before a correct diagnosis is made,” says Bassel Shneker, MD, MBA, a board-certified neurologist and medical director of the EMU at The Ohio State University Medical Center, “To determine if the patient who has failed treatment with medication does indeed have epilepsy, it is necessary to have an evaluation in the EMU. That process will either confirm that the patient has intractable epilepsy or a condition other than epilepsy.”
In addition, Ohio State’s Comprehensive Epilepsy Program offers: • Treatment with FDA-approved medications • Clinical trials with investigative medications • Assistance from neuropsychiatry and social workers • Assistance understanding and complying with medications Our team of epileptologists are all board-certified in both neurology and neurophysiology, with one physician tripled-certified in neurology, neurophysiology and epilepsy. Each member of this team also has fellowship training in epilepsy.
Patients who have intractable epilepsy may be candidates for surgery.
This level of training helps to ensure your patients are cared for by specialists with expertise focused on epilepsy diagnosis, treatment and maximizing patients’ quality of life.
Features of the EMU include: • Eight beds in private rooms • State-of-the-art monitoring equipment
epilepsy monitoring unit
• 24/7 patient EEG monitoring
Pivotal to our Epilepsy Center is our state-of-the-art Epilepsy Monitoring Unit (EMU). The EMU at The Ohio State University Medical Center is the largest, most advanced unit in central Ohio, dedicated to diagnosing and treating adult patients who have epilepsy. In 2009, our EMU monitored more than 320 patients.
• Day room for socializing among patients and their visitors; equipped with TV and computers for patient use • Dedicated EMU staff to ensure patient safety during the stay The average length of stay on the EMU is three days. A stay can last as long as 14 days. Duration depends on the number and frequency of seizure-like events the patient has while being monitored. Patients are encouraged to have visitors while on the unit, including overnight visitors, to facilitate as normal an experience as possible.
This diagnostic process involves continuous monitoring of brainwaves (EEG). Patients’ medications are discontinued and stimulation is initiated to prompt seizures. When seizures occur, we evaluate EEG activity to determine if the events are due to epilepsy or other causes. 4
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Practice Tool
Determining if Your Patients are Candidates for the EMU
an operation to treat epilepsy is much less than the risk of continuation of seizures. In addition to health consequences, epilepsy has devastating quality-of-life consequences. There’s no time to waste getting patients on the road to a better quality of life.”
A patient is an appropriate candidate for the Epilepsy Monitoring Unit if he or she meets one of these criteria: • Has failed two or more antiepileptic medications
A new direct-admit scheduling system allows you to call one number to schedule a patient or complete and fax a referral sheet.
• Has epilepsy that has not been controlled for six months or longer • Has frequent events (at least one per week) “One word sums up the approach to epilepsy we advocate— aggressive,” Dr. Shneker says, “This approach begins with a precise diagnosis in the EMU, followed by state-of-the-art treatment, including surgery when appropriate. The risk of
Call 614-293-4661 for direct scheduling. OSU Medical Center University Hospital 10 East Rhodes Hall
our team J. Layne Moore, MD, MPH
Charles Hall, MD, PhD
Director, Comprehensive Epilepsy Program; Medical Director, EEG Lab The Martha J and Richard D. Denman Professor of Clinical Research in Epilepsy Board-certified in neurology, neurophysiology and sleep medicine Fellowship trained in epilepsy
Associate Professor of Neurology Board-certified in neurology and neurophysiology Fellowship trained in epilepsy 614-293-4969
Clinical Interests: Epilepsy, electrodiagnosis, surgical treatment of epilepsy and sleep disorders 614-293-4969
Sheri Hart, MD, PhD Medical Director, Autonomic Lab Board-certified in neurology and neurophysiology Fellowship trained in epilepsy 614-293-4969
Bassel Shneker, MD, MBA Medical Director, Epilepsy Monitoring Unit Board-certified in neurology and epilepsy Fellowship trained in epilepsy Clinical Interests: Epilepsy, status epilepticus, surgical treatment of epilepsy 614-293-4969
How to refer patients... Please contact 614-293-4969 to schedule an epilepsy consult. To schedule an admission to the Epilepsy Monitoring Unit, please contact: 614-293-4661 phone | 614-293-6266 fax The Ohio State University Medical Center, 10 East Rhodes Hall Visit http://medicalcenter.osu.edu/go/emu to learn more about our program. 5 epilepsy center
Clinical Trials Staff members at The Ohio State University Medical Center are involved in numerous clinical trials for anti-epileptic drugs. This involvement provides other medication options for patients who have not had success with drugs approved by the Federal Drug Administration, and allows Ohio State to help expedite the development of drugs to assist individuals who have epilepsy.
Our Promise to You We partner with referring physicians to provide specialty epilepsy care for your patients. We hope you will refer patients to us when you are no longer comfortable treating them and want more specialized care. We promise to communicate with you about your patients, provide feedback about their care and refer them back to you for ongoing care.
The Ohio State University Medical Center Comprehensive Epilepsy Program medicalcenter.osu.edu/go/emu
Š 2011 The Ohio State University Medical Center – 1 UHOS20100256-09
Ohio State’s
Consult Winter 2011
The Ohio State University Medical Center
Neuromuscular Medicine w One of the largest neuromuscular medicine divisions in the nation, with nearly 3,000 patients annually. w One of the few centers in the United States to offer every available neuromuscular medicine service w A reputation that attracts multi-center initiatives and leading-edge clinical trials w One of 12 centers in the United States designated as a Center of Excellence by the Neuropathy Association
Ohio State’s Neuromuscular Medicine Coordinated Care for Your Patients
Neuromuscular diseases are devastating to those affected. Individuals, their families and the physicians who treat them can take comfort in knowing that The Ohio State University Medical Center has a 30-year tradition of strength in neuromuscular medicine. This includes one of the largest neuromuscular medicine divisions in the United States, with one of the largest volumes of patients.
Patients who have neuromuscular diseases often require support from professionals in varied disciplines from across the Ohio State campus. Our multidisciplinary approach to care brings together the best from dietary services, respiratory care, social work, and occupational and physical therapy. Our specialists in neuromuscular medicine are foremost in their field. A significant number of neuromuscular medicine specialists practicing in the United States were trained at Ohio State. This reputation allows our university to participate in multi-center initiatives and leading-edge clinical trials.
Ohio State is one of the few centers in the United States to offer every available neuromuscular medicine service, including: • inpatient program • outpatient clinic
“We regularly see conditions and forms of disease that many neurologists may see once in their entire careers,” says John Kissel, MD, director of the Division of Neuromuscular Medicine at Ohio State. “Our patient volume, the longevity of our program and the expertise of our physicians gives us a clear edge in diagnostic and therapeutic capabilities.
• electrodiagnosis • muscle biopsy • skin biopsy • QSART (Quantitative Sudomotor Axon Reflex Test) • genetic testing
When you have a patient who presumably has a treatable disease but is not improving, we hope you will refer the patient to us for evaluation. When you have a patient you cannot diagnose to your satisfaction, we hope you will refer to us. When you have a patient diagnosed with a disease with a grim prognosis, we will make every effort to see your patient immediately to alleviate stress, panic and fears. If your patient’s condition is determined not to be neuromuscular, Ohio State has extensive clinical resources and we will collaborate with our colleagues in the appropriate area to ensure your patient receives the best possible care.”
In addition, Ohio State has specialized disease-specific clinics for: • ALS • inflammatory diseases • myasthenia gravis • muscular dystrophy • peripheral neuropathy • pediatric spinal muscular atrophy
Research/Clinical trials Ohio State’s strength in neuromuscular medicine translates into strength in research. “Our leadership in neuromuscular medicine research means that we’re involved in a multitude of clinical trials that offer options and hope for patients,” says John Kissel, MD. Research encompasses the basic, clinical and translational, and focuses on understanding the basic genetic mechanisms of neuromuscular diseases and applying the learning to patient treatment. Clinical trials in neuropathy include examining the factors that distinguish patients whose neuropathy progresses from those whose neuropathy does not, studying whether small fiber neuropathy and fibromyalgia are part of the same spectrum of disorders, researching the development of neuropathy after solid organ transplantation, and using immunoglobulin intravaneous (IGIV) therapy to treat multifocal motor neuropathy. 8 neuromuscular medicine
How to refer patients... Contact us for a neuromuscular or neuropathy consultation: 614-293-4969, option 3. Medical records can be faxed to 614-293-6111 or mailed to: Neurology Medical Records 395 W. 12th Ave. | 7th Floor Columbus, OH 43210 Our promise to you We partner with referring physicians to provide specialty neuromuscular and neuropathy care for your patients. We hope you will refer patients to us when you are no longer comfortable treating them and want more specialized care. We promise to communicate with you about your patients, provide feedback about their care and refer them back to you for ongoing care.
Points of excellence
scientific advances being made in the lab, and translate it into clinical trials and patient care,” says John Kissel, MD.
• Physicians in neuromuscular medicine at The Ohio State University are leaders in the areas of neuropathy and neuromuscular disease, ranking among the top 100 physicians nationwide in their subspecialty areas.
• Ohio State researchers are involved in a multi-center drug trial for ALS and, due to the university’s strength in neuromuscular medicine; it has twice as many patients enrolled than any other participating institution in the United States or Canada.
• Ohio State has a long history of excellence in neuropathy and is one of 12 centers in the United States designated as a Center of Excellence by the Neuropathy Association.
Peripheral Neuropathy Clinic
• Recognized by the Muscular Dystrophy Association as an ALS Center of Excellence.
Ohio State offers a specialized Peripheral Neuropathy Clinic to concentrate clinical efforts and facilitate clinical research projects. The projects are aimed at evaluating and challenging current standards of care and developing innovative approaches to understanding and treating neuropathy. Scientists from Ohio State’s departments of Immunology, Molecular Biology, Biochemistry and others collaborate to further research in the basic mechanisms behind the development of neuropathy.
• Ohio State has established a neuropathy database to collect clinical data on neuropathy patients in a continuous effort to improve the identification and diagnosis of neuropathy. • Ohio State is a leading center in the research of spinal muscular atrophy and the only center in the world with clinical trials for all three forms of the disease. All of the available information about the basic science of the disease was generated at Ohio State. Currently, Ohio State researchers are working on gene-based therapy for spinal muscular atrophy that appears to cure the disease in mice. The next step will be to translate that work into clinical trials with patients. “As we enter a new era of molecular genetics, we expand on and capitalize on the
“We are striving to find novel ways to examine what happens to nerves in the setting of peripheral neuropathy, which will set the stage for more work in the basic sciences,” says Stephen Kolb, MD, PhD, an NIH-funded investigator in the Division of Neuromuscular Medicine at Ohio State. 9
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Practice Tool
Management of the Neuropathy Patient Peripheral neuropathy is a common disorder, affecting as many as 20 million Americans. Therefore, most physicians will see neuropathy patients during their careers.
• Serum protein electrophoresis (SPEP) with immunofixation
While the disorder is common, the differential diagnosis is wide. Clinicians must consider more than 100 causes, many of which are treatable. Studies have shown that intensive investigation at a Peripheral Nerve Center leads to improved diagnostic accuracy, with only 20 percent of cases remaining idiopathic.
• Electromyogram (EMG) and nerve conduction studies
Specialized tests performed for improved diagnostic accuracy include:
• Quantitative sudomotor axon reflex test (QSART) • Skin biopsy • Nerve/muscle biopsy • Cerebrospinal fluid evaluation
Can Ohio State help you manage your patients?
• Genetic testing
Improved diagnostic accuracy means you can be assured of the best information on which to base decisions. We will help direct treatment of potentially reversible neuropathies and manage symptoms in patients with chronic problems. Improved diagnostic accuracy relies on specialized testing (below) in the setting of a sensorimotor neuropathy. The Ohio State University Department of Neurology established a Peripheral Neuropathy Clinic to address this need for specialty care. This clinic provides:
Pain-management strategies Patients who have peripheral neuropathy may request relief for pain. We recommend these steps: • Initiate symptom control with a neuropathic agent: Gabapentin, Pregabalin or Duloxetine • Escalate the dose as needed to efficacy or intolerable side effects • Adjust the dosing schedule to achieve the highest concentration of medication during the time of day in which pain is most noticeable
w Facilitation of specialized testing for better diagnostic accuracy w Improved cost effectiveness in the evaluation of the disorder w Direction of treatment for potentially reversible neuropathies w Management of symptoms in patients with chronic difficulties
• Add a bedtime tricyclic agent for sleep and potentiation of anticonvulsant effect
Evaluation of neuropathy
• Add a topical agent, such as lidocaine patches
Evaluation begins with a clinical assessment that establishes the pattern, time course and distribution of deficits. Patterns are based on principles of:
• Consider a breakthrough agent — Tramadol or Methadone
Identifying Urgent Referrals...
• symmetry — or lack thereof
If a patient has the following symptoms, an urgent referral is necessary:
• distribution — proximal versus distal • predominant fiber type — sensory, motor or autonomic
• Weight loss
Electrophysiologic examination enhances this initial step and is crucial for subsequent laboratory and specialized testing. The incorporation of associated signs and symptoms helps to suggest the presence of specific disorders.
• New systemic complaints including cough, hemoptysis, constitutional symptoms, abdominal discomfort • Focal neuropathies affecting one limb or region
Initial laboratory tests performed in the evaluation of common neuropathies include:
• Rapid progression of motor or sensory deficits
• Hemoglobin A1c
• Acute onset of weakness or functional deterioration
• 2-hour glucose tolerance test
Call us at 614-293-4969, option 3 to schedule a referral.
• B12 with methylmalonic acid and/or homocysteine 10 neuromuscular medicine
OUR TEAM W. David Arnold, MD
Victoria Lawson, MD
Board-certified physiatrist Assistant professor, Neurology
Board certified neurologist Co-Director, Peripheral Neuropathy Clinic Assistant Professor, Neurology
Clinical Interests: Nerve and muscle disorders; functional and rehabilitation aspects of neuromuscular disorders; EMG techniques including SFEMG, quantitative EMG and other unique nerve conduction studies.
Clinical and Research Interests: Neuromuscular disorders, particularly inherited neuropathies (Charcot-Marie-Tooth disorder) plexopathies and neuronopathies, small fiber neuropathies, post-transplant neuropathies and inflammatory neuropathies.
Bakri El-sheikh, MD Board certified neurologist Assistant Professor, Neurology
Steve Nash, MD
Clinical and Research Interests: Spinal muscular atrophy, muscular dystrophy, myasthenia gravis and other neuromuscular diseases
Clinical and Research Interests: Amyotrophic lateral sclerosis, nerve conduction studies and electromyography, neuromuscular disorders.
Associate Professor, Neurology
Miriam Freimer, MD Associate Professor, Neurology Board Certified, Neurology Director, EMG Laboratory
Adam Quick, MD
Clinical and Research Interests: Myasthenia gravis, chronic inflammatory demyelinating neuropathy, dermatomyositis neuropathies.
Clinical Interests: Neuromuscular disease, EMG, general neurology, neurological education
Wendy King, PT
Jerry Reynolds, PhD, RCP, RRT
Board-certified neurologist Assistant Professor, Neurology
Clinical Assistant Professor, Neurology
Associate Professor, Neurology
Clinical and Research Interests: Muscular dystrophies, motor neuron disease, spinal muscular dystrophy and peripheral neuropathies.
Clinical Interests: Pulmonary complications of neuromuscular disease
Cheryl Wall, RN, MS CNP
John Kissel, MD
Clinical Assistant Professor, Neurology
Board certified neurologist Professor of Neurology and Pediatrics Director, Division of Neuromuscular Medicine Co-Director, Neurology Infusion Suite
Clinical Interests: Neuromuscular disorders and muscular dystrophies
Clinical Interests: Neuromuscular diseases Research Interests: Peripheral nerve, muscle and anterior horn cell disorders, including spinal muscular atrophy; myasthenia gravis; facioscalpulohumeral muscular dystrophy and other muscular dystrophies and inflammatory myopathies.
Research Staff Amy Bartlett, BA, CCRC Sharon, Chelnick, MHSA, CCRC
Stephen Kolb, MD, PhD Board certified neurologist Assistant professor, Neurology Assistant professor, Molecular and Cellular Biochemistry Clinical Interests: Neuromuscular disorders, motor neuron diseases, hereditary neuropathies Research Interests: Studying molecular pathways that, when altered, result in diseases of the motor neuron and developing small molecule and gene-based therapies for these diseases 11 neuromuscular medicine
The Ohio State University Medical Center Neuromuscular Medicine www.medicalcenter.osu.edu
Š 2011 The Ohio State University Medical Center – 1 UHOS20100256-10
Ohio State’s
Consult Winter 2011
The Ohio State University Medical Center
Orthopaedics w Ranked by U.S.News & World Report among the nation’s best for five years. w Comprehensive capabilities in all areas of orthopaedics, with a faculty that has grown by 42 percent in the last two years and research funding that has increased by 483 percent. w The largest residency training program and the most fellowships in the region.
Ohio State’s Orthopaedics Program Under new leadership, the Department of Orthopaedics at The Ohio State University Medical Center has undergone extensive growth and restructuring, including several new facilities, in the past two years to re-establish itself as the region’s leading center for comprehensive orthopaedic services.
Spine Director: Ronald Wisneski, MD Spine surgery performed at Ohio State includes traditional and minimally invasive procedures for cervical, thoracic and lumbar spine diseases, covering adult degenerative, inflammatory, congenital, metabolic, neoplastic and traumatic spinal disorders. Our surgeons specialize in operative and non-operative solutions including discetomy and fusion, pharmaceutical therapy and rehabilitation.
New to our suite of orthopaedic services are: • Hand • Spine • Shoulder • Foot and ankle • Total joint reconstruction
Surgeons in the Spine Division exercise a conservative approach to surgery. “Only about 5 percent of patients who have back pain need an interventional procedure,” says Ronald Wisneski, MD. “Spine surgery certainly is appropriate for conditions that require reconstruction, but many conditions benefit from less invasive treatment. When we determine that a patient would benefit from surgery, you can be assured that we’ve evaluated every possible alternative.”
“In the last two years, the department’s faculty has grown by 42 percent and research funding has increased by 483 percent ,” says Jason Calhoun, MD, chair of the Department of Orthopaedics. “We committed to growing this Department and successfully recruited surgeons who are leaders in their fields and who have led surgical departments at other prominent medical centers. Today, there is no area of orthopaedic surgical care we cannot provide.”
Adult Reconstruction Director: Andrew Glassman, MD
Points of excellence
Ohio State now has a fully comprehensive adult reconstruction/total joint replacement surgical program, directed by Andrew Glassman, MD, who completed a fellowship and practiced with Charles Engh, MD, one of the most prominent total joint replacement surgeons in the world.
• Hand surgeons in the Department performed more than 1,200 surgeries, treatments and procedures in 2009. • Thomas Ellis, MD, has successfully performed more than 600 hip arthroscopies—more than any other surgeon in Ohio. • Andrew Glassman, MD, has performed several thousand hip replacements and several thousand knee replacements. He has participated in the design of more than a dozen total hip prostheses and two total knee replacements.
“Our program is multidisciplinary, which has significant benefits for patients,” says Dr. Glassman. “We see patients for post-traumatic arthritis, avascular necrosis, osteoarthritis, rheumatoid arthritis and a wide variety of congenital, developmental and metabolic disorders. Many patients have significant co-morbidities, including systemic arthritis, lupus and joint destruction due to renal failure or immunosuppression. Patients are better cared for in a setting with disciplines to address all of those conditions.”
• Jason Calhoun, MD, an internationally recognized expert in the prevention and treatment of infection and osteomyelitis research, received a $1.6 million Department of Defense grant, “Modification of an Accepted Animal Model of Osteomyelitis to Simulate and Evaluate Treatment of War Extremity Wounds.”
“We are happy to evaluate any patient who may be a candidate for reconstructive or joint replacement surgery,” shares Dr. Glassman. “We tell patients to consider joint replacement when they have more bad days than good days and their quality of life is diminished.”
• Christopher Kaeding, MD, Co-director of Sports Medicine Institute at Ohio State, is co-investigator in the first National Institutes of Health grant-funded ($1.3 million) large multicenter prospective study of functional outcomes following ACL reconstruction.
The program is developing a comprehensive approach to total joint replacement surgery for morbidly obese patients. “Our goal is to thoroughly evaluate these patients who have a high rate of complications and help them become healthy enough to have successful surgery,” explains Dr. Glassman.
• Joel Mayerson, MD, medical director of Orthopaedic Oncology, is a pioneer in the application of expandable total femoral implants designed to keep up with the growth of pediatric bone tumor patients. 14
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Hand and Upper Extremity
The hip arthroscopy program focuses on providing relief to patients who had thought their only treatment option was full hip replacement. Typically, these patients are young and otherwise healthy. Arthroscopic hip surgery is an excellent option for patients who have labral tears, loose bodies of cartilage, certain cartilage damage or hip impingement.
Director: Michael Ruff, MD Ohio State has five orthopaedic surgeons who have dedicated their careers to the study, research and treatment of injuries and disorders of the hand, wrist, arm, elbow and forearm. Our surgeons are fellowship trained in hand and upper extremity surgery and microsurgery.
This procedure uses several small incisions around the hip, into which a small camera and surgical instruments are inserted. Arthroscopic surgery allows patients a shorter hospital stay—typically overnight—less scarring and a shorter recovery time. Surgeons collaborate with Ohio State colleagues in physical therapy to provide hip arthroscopy patients with pre- and post-operative therapy.
Our comprehensive program brings together physicians, surgeons and clinicians associated with orthopaedic and plastic surgery, physical medicine and rehabilitation, anesthesiology, sports medicine and outpatient rehabilitation services. These professionals work as a patient-care team to monitor patients’ progress and coordinate care for complete hand and wrist repair.
“Younger patients who have hip problems should delay joint replacement as long as possible because replacements will not last forever,” says Thomas Ellis, MD. “With arthroscopic surgery, we preserve the patient’s bone and joint and delay major open surgery for as long as possible.”
Medical and surgical options available include microsurgery, reconstructive surgery and joint replacement surgery. Specific conditions treated include arthritic fingers, severed hands, carpal tunnel syndrome, distal radio-ulnar conditions, joint replacement, crush injuries, fractures, tendon lacerations, trigger finger, thumb joint pain, severed nerves and dislocations.
Fragility Fracture Director: Laura Phieffer, MD Fragility is the most common cause of fractures among seniors. Fractures due to osteoporosis are 62 percent more common than heart attack, stroke and breast cancer combined. The consequences of hip fracture are significant— with 20 percent of those affected dying within one year, 30 percent having permanent disability and 40 percent being unable to walk independently.
While the services are multidisciplinary, drawing on professionals from across our campus, all services—from evaluation and diagnosis to treatment and rehabilitation—are provided in a single location for patient convenience.
Foot and Ankle Director: Ian Alexander, MD
“Fragility fracture patients whose surgery is expedited have decreased morbidity, decreased mortality, shorter length of stay in the hospital and an increased likelihood of returning to their pre-injury status,” says Laura Phieffer, MD. “Traditionally, few fracture patients receive evaluation and treatment of osteoporosis, which is the underlying cause of most fragility fractures. Our program strives to prevent fractures, with comprehensive patient education and discharge planning.”
Ohio State’s foot and ankle surgeons care for patients with complex foot and ankle problems along with routine conditions, such as bunions. “Many patients wait to come to Ohio State until they have severe problems, and we are glad to help those patients. But we’d rather see them sooner in the process so that earlier interventions can help prevent more serious conditions,” says Ian Alexander, MD. Dr. Alexander emphasizes that the Foot and Ankle Division specializes in treating patients who have persistent pain after a foot surgery or who have had prolonged treatment without success for a foot problem. “Just because a patient has ongoing pain after foot surgery or a treatment does not mean there is no hope. We commonly treat and help patients who have been in this predicament.”
Through its Fracture Fragility Program, Ohio State offers a multidisciplinary approach to inpatient management of fracture patients whose injuries are due to fragility. Fragility fracture patients are identified immediately upon admission, and their care follows protocols to expedite surgical care within 24 hours, ensure early mobility post-surgery and facilitate rehabilitation and recovery. Involved in care are orthopaedic surgeons, physicians, physician assistants, nurse practitioners, registered nurses, physical therapists, occupational therapists, nutritionists and case managers.
Hip Preservation Director: Thomas Ellis, MD
Ohio State also offers patient education, fracture prevention, medication recommendations and pre-planning of fracture care to patients who have osteoporosis or lowbone density through its outpatient Osteoporosis Clinic.
This division specializes in younger patients who have hip pain, with treatment including hip arthroscopy, pelvic and femoral osteotomies and hip replacement. 15
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Orthopaedics
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Practice Tool
Helping Patients Select a Joint Reconstruction Surgeon Total joint reconstruction has become highly specialized in the last decade, making the choice of surgeon selection even more important. This tool includes updates on the factors that should be considered when selecting a joint reconstruction surgeon. When Complications Arise in the Reconstruction Patient Many general orthopaedic surgeons are capable of performing straightforward joint replacement. When patients develop complications however, more specialized surgeons are required. “I regularly see patients who had joints replaced elsewhere, a problem arises and the surgeons don’t feel comfortable taking care of the complications,” says Andrew Glassman, MD, orthopaedic surgeon and director of Ohio State’s comprehensive Adult Reconstruction/ Total Joint Replacement Surgical Program.
When a Patient Has Co-morbidities Dr. Glassman says a practice that is solely devoted to joint reconstruction is even more important when the patient has co-morbidities. “The technical requirements are greater and the likelihood of complications is higher if the patient has had prior surgery, such as knee osteotomy or hip fracture repair, has a deformity, is morbidly obese or has a metabolic illness or another significant medical co-morbidity,” says Dr. Glassman. “These patients are best served by a short operation. One advantage of a fellowship-trained joint replacement surgeon is that the operation will be correct and faster. A surgeon who performs joint replacement only occasionally may have technical accuracy but may take twice as long, which is not beneficial for an older patient who has cardiopulmonary disease and does not tolerate anesthesia for a long time, for example.”
“We highly recommend that referring physicians ask surgeons being considered for their patients’ joint replacements questions such as, ‘What happens if the patient develops a complication? Will you have to find another surgeon to take care of the patient?’ It isn’t the optimal continuity of care for the patient to start over, usually in an emergency situation, with a new physician.”
Advances in
Joint Replacement “We believe in using components that have been available for at least 10 years to ensure the quality of the device. We are studying alternative bearings that may make hip replacements last longer. We also are providing compartmental replacement—partial knee replacements and hip resurfacing. These techniques are geared toward a younger population,” says Matthew Beal, MD, an orthopaedic surgeon at Ohio State’s Medical Center.
Dr. Glassman also points out that a high-quality joint construction subspecialist will educate patients about what to watch for in terms of complications and what action to take if they occur. And, he says, patients should have easy, immediate access to the surgeon’s office. “It should be a red flag to you, the referring physician, if your post-surgical patients call you asking, ‘My hip [or knee] is doing this. Is it normal?’,” says Dr. Glassman. “They should feel comfortable calling the surgeon.”
“Patients do not need to be concerned about the ‘latest and greatest’ implants, which may not actually be great or proven.” He urges physicians to help patients select the best surgeon rather than a specific device or technique. “Experienced subspecialists keep abreast of advances in the field— studying, taking part in research, serving on editorial review boards,” says Dr. Beal. “Patients look to their primary care physicians for medical guidance. We hope these tips are helpful when your patients require joint reconstruction.”
Indicators of a complication after joint reconstruction include: w w w w w w w w
Intractable pain Wound drainage Warmth around the wound Fever Chills Calf tenderness Shortness of breath Chest pain 16
orthopaedics
Research/Clinical Studies Basic research is investigating the genetic identification of tumor markers as a tool for predicting severity and prognosis. Clinically focused research includes studies in foot and ankle, sports medicine, trauma and musculoskeletal oncology. The Department of Orthopaedics conducts clinical and basic science research focused on the prevention and treatment of musculoskeletal injuries and infections. Our programs include investigations into new antibiotics, new implants designed to facilitate healing, treatments for osteoarthritis and biomechanical testing. For more information on current research and clinical studies, visit www.medicalcenter.osu.edu/go/ortho.
Makoplasty速 is Here MAKOplasty速 partial knee resurfacing is an innovative treatment for early to mid-stage osteoarthritis in either the medial, patellofemoral or the lateral compartment of the knee. It can also be performed as a bicompartmental procedure on both the medial and patellofemoral portions of the knee. The procedure is performed using the RIO速 Robotic Arm Interactive Orthopedic System. Surgeons use system to pre-operatively plan and map the diseased bone to be removed. During surgery, 3-dimensional visualization and the robotic arm provide the surgeon with visual, tactile and auditory feedback so that only the diseased portion of the knee is resurfaced, sparing healthy bone stock and tissue. For more information, please visit medicalcenter.osu.edu.
How to refer patients... Please call 614-293-2663 (BONE) or 1-888-861-8081 for patient referral. For referral to the Hand and Upper Extremity Center, call 614-366-4263 (HAND). Our promise to you We partner with referring physicians to provide specialty orthopaedic care for your patients. Our policy is to accept all patients referred to our department. If we determine that a referred patient would be better served by another specialty, we will arrange that visit for your patient. We hope you will refer patients to us when you are no longer comfortable treating them and want more specialized care. We promise to communicate with you about your patients, provide feedback about their care and refer them back to you for ongoing care. 17 orthopaedics
Department of Orthopaedics The Department of Orthopaedics at The Ohio State University Medical Center is dedicated to providing both innovative services for patients with musculoskeletal disorders and superior education for future orthopaedic surgeons. We serve hospitals and clinics across the region. Our surgeons are fellowship-trained.
Adult Reconstruction & Total Joint
Andrew Glassman
Matthew Beal
Trauma
Laura Phieffer
Thomas Ellis
Shoulder
Oncology
General
John Roberts
Jeffrey Granger, MD, and John Roberts, MD, cover a wide array of common problems within the musculoskeletal system, and can help determine if patients need referral to one of our sub-specialists.
Corey Van Hoff
Our orthopaedic trauma team is a key service at many central Ohio hospitals and serves patients from across the region. Laura Phieffer, MD, directs our orthopaedic trauma program. She is joined by Michael Quackenbush, DO, and Corey Van Hoff, MD. Other department specialists also are called upon to evaluate and treat emergencies and help heal traumatic orthopaedic injuries.
We perform hip and knee surgeries at University Hospital East and University Hospital. Many difficult casesare referred to us by other surgeons, including revision surgeries. Our total joint service is staff ed by physicians Andrew Glassman, MD, director of the Total Joint and Adult Reconstruction Center; Matthew Beal, MD; and Thomas Ellis, MD, who directs the hip preservation service.
Jeffrey Granger
Michael Quackenbush
Joel Mayerson
Thomas Scharschmidt
Our oncology physicians serve patients from across the region at the Comprehensive Cancer Center- James Cancer Hospital and Solove Research Institute and also Nationwide Children’s Hospital. Joel Mayerson, MD, directs orthopaedic oncology and works with Thomas Scharschmidt, MD, as well as a multidisciplinary team of medical oncologists, radiation oncologists and pathologists focused on early detection cancer and treatment.
Julie Bishop
Bryan Butler
Our shoulder specialists treat common upper extremity joint problems such as fractures and damage to soft tissue. We also perform joint replacements. Julie Bishop, MD, is director of our shoulder division. She is joined by Bryan Butler, MD.
Infection Jason Calhoun, MD, Chair, Department of Orthopaedics, works alongside infection specialist Meredith Deutscher, MD, and surgeon Jeffrey Granger, MD, to prevent and treat musculoskeletal infections. They often consult with specialists in other areas to address the most challenging cases. They perform research to develop new antibiotics and methods aimed at preventing orthopaedic infection. Jason Calhoun Chair, Department of Orthopaedics orthopaedics 18
Meredith Deutscher
Jeffrey Granger
Sports Medicine
Christopher Kaeding
Thomas Ellis
Julie Bishop
David Flanigan
Grant Jones
Robert Najarian
John Sharkey
Our physicians provide care for The Ohio State University Buckeyes athletic teams as well as for area colleges, high schools and other organizations. We are a full-service sports medicine department, with a certified athletic trainer, and provide services in areas such as radiology, casting and pharmacy. We also work closely with specialists in other medical departments, such as family medicine and rehabilitation. OSU Sports Medicine’s orthopaedics are led by Christopher Kaeding, MD, the co-director of Sports Medicine for OSU. He is joined by specialists David Flanigan, MD; Julie Bishop, MD; Grant Jones, MD; Thomas Ellis, MD; Robert Najarian, MD; and John Sharkey, MD.
Hand and Upper Extremity
Michael Ruff
Bryan Butler
Hisham Awan
Dick Coleman
Brian Janz
Ryan Klinefelter
Christopher Litts
Our hand center team is led by Michael Ruff , MD. He is joined by Hisham Awan, MD; Bryan Butler, MD; Dick Coleman, MD; plastic surgeon Brian Janz, MD; Ryan Klinefelter, MD; and Christopher Litts, MD. Services are provided at the new Hand & Upper Extremity Center at 915 Olentangy River Road.
Spine
Ronald Wisneski
Foot and Ankle
Ronald Lakatos
Ian Alexander
Our physicians specialize in operative and nonoperative solutions, including discetomy and fusion, pharmaceutical therapy and rehabilitation. The division is led by Ronald Wisneski, MD. He is joined by Ronald Lakatos, MD.
Said Atway
Alan Block
Jason Calhoun
Erik Monson
Ian Alexander, MD, directs this service, which treats deformity, arthritis and painful soft tissue conditions of the foot and ankle as well as problems associated with diabetes. Jason Calhoun, MD, leads our infectious service and also serves as chairman of the department. He is an internationally recognized expert and researcher in orthopaedic infections and in the use of external fixation devices to treat fractures and other injuries to the lower extremities. They are joined by podiatrists Said Atway, DPM; Alan Block, DPM, MS; and Erik Monson, DPM.
Referrals: 614-293-BONE (2663) | ortho.osu.edu 19 orthopaedics
The Ohio State University Medical Center Orthopaedics www.medicalcenter.osu.edu/go/ortho
Š 2011 The Ohio State University Medical Center – 1 UHOS20100256-06
Ohio State’s
Consult Winter 2011
The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Liver and Pancreatic Cancers w A comprehensive, multidisciplinary approach to treatment, individualized for each patient w Specialized tumor clinics offering comprehensive, aggressive treatment options w Clinical trials for liver and pancreatic malignancies w One of the most active research programs for pancreatic and hepatobiliary cancers in the nation
Ohio State’s Liver and Pancreatic Cancers A diagnosis of liver or pancreatic cancer often leaves patients and providers feeling overwhelmed. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) is home to multidisciplinary teams of liver and pancreatic cancer experts dedicated exclusively to the study and treatment of these complex cancers.
Why Choose OSUCCC-James for Your Patients with Liver or Pancreatic Cancers? • OSUCCC-James is the only hospital system in central Ohio approved by the NCI to conduct both phase I and II clinical trials. The liver and pancreatic cancer teams at OSUCCC-James have a very active clinical trials program studying all stages of cancer care.
Time is of the essence with liver and pancreatic cancers. Prompt referral for comprehensive treatment by an experienced and surgically proficient team is critical. Since our team is solely focused on the study, treatment and management of liver and pancreatic cancers we handle a large volume of cases, giving us the depth of experience to treat even the most complex cases.
• Our multidisciplinary teams are dedicated to the treatment of the whole disease – beginning with prevention and continuing through all stages of treatment. • OSUCCC – James is a high-volume surgical center for pancreatic cancer, completing more than 120 pancreatic operations per year. We are one of the top three pancreas transplant centers in the nation.
Cancer does not present itself in the same manner for every patient, which makes the multidisciplinary team approach all the more critical – to get the opinions of experts from the full spectrum of cancer care, from evaluation and treatment through clinical trials. Our teams discuss every patient and work together to create a personalized plan of care for that patient. You can be assured that patients you refer to us benefit from the most thorough recommendations about how best to approach their disease.
• OSUCCC – James accepts pancreatic cancer patients considered to be high-risk: those who have underlying health issues, are not perceived to be good surgical candidates or are elderly. “A bad heart or bad lungs should not mean these patients are denied a chance for a cure,” says Mark Bloomston, MD, Ohio State surgical oncologist. “Our surgical outcomes in patients 80 and older are just as good as for our younger patients. Our surgeons willingly take on high-risk patients.” • Our surgeons are experienced at aggressive surgical approaches, such as portal vein resection, vascular reconstructive techniques and intraoperative radiation. • Our surgeons are testing an innovative way to image the pancreas from inside the pancreatic duct, using an instrument the width of a few strands of hair. This technique is being used with patients at high risk for pancreatic cancer. The device is used to check the lining of the duct for abnormal cells. This process will help determine if this new method of imaging is an accurate diagnostic tool.
Ohio State’s Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute is one of only 40 Comprehensive Cancer
• OSUCCC – James offers advanced endoscopic ultrasound (EUS). This noninvasive ultrasound technology produces superior images and is useful for diagnosis and more accurate staging of cancer. EUS also helps to detect cystic neoplasms, precancerous lesions in the pancreas that can develop into cancer.
Centers in the United States, as designated by the National Cancer Institute. The OSUCCC James is ranked among the top cancer hospitals in the nation by U.S.News & World Report. The OSUCCC – James is one of only seven funded programs in the country approved by the NCI to conduct both phase I and phase II clinical trials. 22
Liver and pancreatic cancers
Advances in Liver Cancer
OSUCCC – James has a multidisciplinary approach to pancreatic cancer that brings together surgical oncology, radiation oncology, interventional radiology, gastroenterology and medical oncology for preoperative, intraoperative and postoperative care.
Hepatocellular carcinoma (HCC, or primary liver cancer) is the fastest-growing cause of cancer-related mortality in men in the United States, and incidence of the disease is projected to increase. Though considered by many to be a fatal cancer with few treatment options, liver cancer actually has many therapies available to extend life and improve quality of life. Some of these treatment options are available only at large tertiary care centers like OSUCCC – James.
“Pancreas surgery has many risks. Ohio State is one of the only hospital systems in the state to perform it,” says Dr. Bloomston. “We not only take on these complex procedures, but we make it as convenient as possible for patients, with our specialists converging in a single location to provide efficient, timely patient care.”
OSUCCC – James offers a specialized clinic for the diagnosis, evaluation and management of primary and secondary liver tumors, including all available therapeutic options. This Liver Tumor Clinic brings together the disciplines of surgical oncology, interventional radiology, medical oncology, liver transplantation and transplant hepatology.
“Each of our liver and pancreatic cancer surgeons specializes in these two cancers,” says Tanios Bekaii-Saab, MD, Ohio State medical oncologist. “This high level of specialization allows for greater focus on the specific cancers and their treatment.” A full range of surgical treatment options for pancreatic cancer includes minimally invasive and robotic procedures, and capabilities to resect tumors that others may consider unresectable.
“We approach treatment aggressively. We want to help patients control their cancer as long as possible,” says Carl Schmidt, MD, Ohio State surgical oncologist. “Liver cancers are complex, and patients often have other medical issues. We provide a team approach to address those needs. We deal with liver cancer and liver diseases every day. We’re compassionate and are concerned solely with moving forward and improving the patient’s quality of life.”
Research and Clinical Trials Research studies are available to patients for every stage of disease, using every type of therapy available. “In areas of disease that have no standard of care, we work to develop one. When a standard of care exists, we strive to enhance it,” says Dr. Saab.
Patients who are not surgical candidates may be appropriate for other treatments including: • Chemoembolization • Radioembolization
OSUCCC-James is involved in all areas of liver and pancreatic cancer research: basic science, new treatment modalities and advanced interventional techniques. These range from state-of-the-art liver-directed therapies, to viral-mediated vaccines, to cytotoxic chemotherapy and novel treatments.
• Portal vein embolization – a technique to help the liver regenerate before resection surgery • Radiofrequency or microwave ablation – Ohio State is one of the few centers in Ohio to offer this treatment
Clinical trials at OSUCCC – James for liver and pancreatic cancers include assessing new treatment agents for early, intermediate and late-stage disease. Few other centers in the nation have open trials for all stages of liver and pancreas disease.
• External beam radiation therapy In addition to treating liver cancers, the clinic treats a broad range of liver diseases and performs liver transplants.
For example, Ohio State is leading a multi-institution phase I pancreatic cancer trial in which an attenuated virus is injected into tumors that have not yet metastasized. The virus is treated with an oral antiviral medication before the patient has surgery. This is followed by subsequent reinjection of the virus into the resection bed at the time of surgery, treating disease that may have escaped from the pancreas.
Advances in Pancreatic Cancer Pancreatic cancer is the fourth most common cause of cancer death in men and women in the United States. Pancreatic cancer surgery is complicated, and often patients are unhealthy prior to surgery. Many require lengthy hospital stays after their surgery. This makes the need for not only surgical experts but also expert support staff critical to the recovery and well-being of the patient. We have assembled an experienced team of surgeons, residents, nurses, discharge planners and outpatient clinicians to provide that full complement of care to our patients.
To learn more about our clinical trials, please call The James Line at 614-293-5066 or 800-293-5066, or visit our Web site, cancer.osu.edu.
23 Liver and pancreatic cancers
Liver and Pancreatic Cancers
|
Practice Tool
How to Recognize the Early Warning Signs of Pancreatic Cancer Pancreatic cancer is characterized by vague symptoms in a well-hidden organ. The disease spreads quickly, often within months. Usually, by the time the disease is diagnosed, treatment options are limited and the prognosis is poor. Early recognition of symptoms is critical so treatment can begin as soon as possible. Primary care providers should be aware of these suspicious symptoms: w Painless jaundice w Unexplained abdominal pain w Unexplained weight loss
Jaundice is the key symptom. Patients who have this symptom of pancreatic cancer have a blockage in the right side of the organ. This form of the disease is the most treatable. When a patient exhibits jaundice or one of the other symptoms, the only test needed to check for a pancreatic mass is a computerized tomography (CT) scan. Other tests – magnetic resonance imaging (MRI), biopsy, endoscopic retrograde cholangiopancreatography (ERCP) – may be useful but not until the patient has a surgical consultation.
How to refer patients... Contact us for an oncology consultation by calling The JamesLine 614-293-5066 or 800-293-5066. Contact our Liver Tumor Clinic by calling 614-293-8936 or e-mail LiverTumorClinic@osumc.edu. Our promise to you We partner with referring physicians to provide specialty oncology care for your patients. We promise to communicate with you about your patients, provide feedback about their care and refer them back to you for ongoing care. 24 Liver and pancreatic cancers
Our team Scott Melvin, MD
Maher Azzouz, MD
Board certified surgeon Professor Director, General and Gastrointestinal Surgery Director, Center for Minimally Invasive Surgery
Board certified gastroenterologist and transplant hepatologist Associate Professor Medical Director, Gastroenterology and Endoscopy Clinical interests: Hepatology, Therapeutic Biliary Endoscopy
Peter Muscarella II, MD Board certified surgeon Associate Professor
Tanios Bekaii-Saab, MD Board certified medical oncologist Associate Professor Medical Director, Gastrointestinal Oncology
Clinical interests: Gastrointestinal surgery, laparoscopic splenectomy, pancreatic cysts, incisional hernia repair, pancreatic cancer, pancreatitis; hepatobiliary surgery
Clinical and research interests: Gastrointestinal malignancies
Research interests: Pancreatic cancer genetics and novel targets for therapy
Mark Bloomston, MD Board certified surgical oncologist Associate Professor
Jeffrey Rose, MD Board certified medical oncologist Assistant Professor
Clinical interests: Management of cancers of the liver, biliary tree, pancreas and neuroendocrine cancers
Clinical interests: Hepatocellular, gastric and esophageal cancer
Research interests: Molecular biology of pancreatic cancer
Research interests: Neoadjuvant therapies for esophageal cancer and localized therapies for unresectable hepatocellular carcinoma
Gail Davidson, RN, BSN, OCN Disease Management Coordinator, Surgical Oncology
Carl Schmidt, MD Board certified surgical oncologist Assistant professor Clinical and research interests: Hepatobiliary and gastrointestinal oncology
Samer El-Dika, MD Board certified gastroenterologist Assistant Professor Clinical interests: endoscopic ultrasound and procedures
Jon Walker, MD
E. Christopher Ellison, MD
Clinical interests: endoscopic ultra sound and procedures
Board certified gastroenterologist Assistant Professor
Board certified surgeon Professor Chair, Department of Surgery Chair, OSUP Board of Directors
Lynn Weatherby, RN, OCN
Clinical interests: pancreatic and hepatobiliary surgery
Disease Management Coordinator, Medical Oncology
Research interests: pancreatic cancer, adhesion formation
James Hanje, MD Board certified gastroenterologist Assistant Professor Medical Director, Hepatology Clinical and research interests: gastroenterology, hepatology
25
Liver and pancreatic cancers
7
Liver and Pancreatic Cancers cancer.osu.edu
© 2011 The Ohio State University Medical Center – 1 UHOS20100256-07
Ohio State’s
Consult Winter 2011
The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Neuro-Oncology w New patients seen within the same week of referral
w The region’s most experienced team with two dedicated neuro-oncologists, a leading spine tumor expert, a nationally recognized neuroradiation oncologist and nationally and internationally renowned neurosurgical oncologists w Access to research and clinical trials performed nowhere else in the nation
Ohio State’s Neuro-Oncology A Total Focus on Brain and Spine Tumors
• Ehud Mendel, MD, FACS, is one of the few nationally and internationally recognized neurosurgeons with expertise in the management of spine tumors. He is a member of the International Spine Oncology Study Group, selected to develop study guidelines for spine tumors. He has implemented significant advances in surgical approaches to the spine.
The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) has a leading multidisciplinary team of physicians solely dedicated to the treatment of brain and spine tumors. Each of our physicians is an expert in his or her field, providing Ohio with the best care and access to the most advanced brain and spine tumor clinical trials available in the United States.
• Mario Ammirati, MD, MBA, is one of a few neurosurgeons specializing in skull base tumors who successfully uses open, endoscopic and radiosurgical techniques to remove tumors.
“In clinical medicine, repetition is good. The more you do it, the better you are. Our neuro-oncology program is 90 percent focused on brain tumors. If your patient has a brain tumor, you will not find better care available.”
• Daniel Prevedello, MD, works with ENT to approach complex tumors of the skull base, including pituitary tumors, using endoscopes that eliminate the need for incisions in the scalp or in the brain.
E. Antonio Chiocca, MD, PhD Chair of the Department of Neurological Surgery
• John McGregor, MD; Simon Lo, MB ChB; and John Grecula, MD, utilize gamma knife radiosurgery to treat brain, spine and skull-base tumors.
Our multidisciplinary neuro-oncology tumor board reviews each case to arrive at a comprehensive, collaborative treatment plan.
• OSUCCC – James researchers discovered how brain tumor cells adapt to their surroundings and survive conditions that might fatally starve them of energy. A molecule called miR-451 coordinates the change between high and low energy in cell behavior. This molecule might serve as a biomarker to predict how long patients with the brain tumor gliobastoma multiforme will survive, and may be a target to develop drugs to fight these tumors.
points of excellence • OSUCCC – James has a team of nationally and internationally renowned neurosurgical oncologists, in addition to a nationally recognized spine tumor expert and neuroradiation oncologist. We have the only two neurooncologists in central Ohio.
• Arnab Chakravarti, MD, is vice chair of the Radiation Therapy Oncology Group (RTOG) Clinical Brain Tumor Committee and chair of the RTOG Brain Tumor Translational Research Committee. Dr. Chakravarti was awarded the 2004 Simon Kramer Award by the RTOG for his contributions to the field. Dr. Chakravarti was elected to the Board of Directors of the International Society of Radiation Neuro-Biology in 2010.
• Two-thirds of neurosurgeons treating brain tumors in central Ohio were trained in neurosurgery at Ohio State. • E. Antonio Chiocca, MD, PhD, received the 2008 Farber Award from the American Association of Neurological Surgeons and the Society for Neuro-Oncology. The award recognizes promising investigators who are achieving significant results early in their careers. • Herbert Newton, MD, has published the Handbook of Brain Tumor Chemotherapy and the Handbook of NeuroOncology Neuro-Imaging. Both books are the most comprehensive single-volume references of their kind in neuro-oncology literature.
28 neuro-oncology
Brain Tumors
Neurosurgical Oncology
Director of Medical Neuro-Oncology: Herbert Newton, MD
Director: E. Antonio Chiocca, MD, PhD
Brain tumors are relatively rare. That underscores the importance of physician super-specialization. Physicians who are dedicated to brain tumors and are current on state-ofthe-art treatment produce better outcomes.
Nationally and internationally renowned neurosurgical oncologists are right in your backyard at OSUCCC – James. The alignment of our neurosurgery and neuro-oncology teams means that your patients can expect a treatment plan tailored to their unique needs. And because we have one of the most experienced teams in the region, your patients also get the benefit of true specialty expertise.
“We understand the day-to-day implications of having a brain tumor, which are distinct from other cancers and can be devastating,” says Robert Cavaliere, MD. “Half of brain tumor patients have seizures, which requires specialized social support and familial involvement. Our multidisciplinary program provides medical management of the disease, radiation, surgery, chemotherapy, neuropsychology and social work in one convenient location. We take care of the patient and the family, not just the disease.”
“In clinical medicine, repetition is optimal. The more you do of a procedure, the better you are at it,” says Dr. Chiocca. “Our neurosurgical oncologists, who hail from high-profile medical institutions, are highly specialized — focusing 90 percent of their time on brain tumors. The breadth of experience in this area is remarkable.”
Specialty capabilities offered include intraoperative MRI and craniotomies with patients awake during the procedure. Brain tumor patients at OSUCCC – James also have access to research studies, most of which are not available elsewhere in the United States.
Dr. Chiocca is a well-known leader in neurosurgical oncology and brain tumor research who holds distinguished posts in numerous national brain tumor organizations. OSUCCC – James neurosurgical oncologists work hand-inhand with neuro-oncologists to provide seamless patient care, from the initial evaluation to surgery, from clinical trials to supportive family care.
OSUCCC – James offers a professionally facilitated Brain Tumor Support Group for patients, family members and caregivers. In addition, the Department holds a caregiver conference in the spring and a brain tumor awareness and survivor celebration in the fall of each year. This year, Victoria Reggie Kennedy, wife of the late Sen. Ted Kennedy, spoke at the annual meeting to convey her experiences as a caregiver.
“Everyone involved in Neuro-Oncology is collegial and team-oriented for the benefit of the patient,” says Dr. Chiocca. “When the team is united and feels fortunate to care for patients, it shows.” Among the specialty neurosurgical oncology services offered at OSUCCC – James are:
Spine Tumors
Awake craniotomy — Uses global positioning system technology to add precision to brain surgery performed while patients are awake. Mapping and imaging technologies indicate the location of a brain tumor down to the millimeter, reducing disruption to normal brain tissue. Patients’ risks for neurologic deficits are lower when they are awake during surgery.
Director: Ehud Mendel, MD OSUCCC – James is one of very few centers in the world to offer a multidisciplinary approach to treating tumors that originate in or spread to the spine. Surgical treatment, including minimally invasive options, aims to alleviate pain, preserve neurological function, prevent worsening of the condition, establish spine stability and even extend the patient’s life expectancy. These complex surgical cases bring together experts in oncology, anesthesia, thoracic and surgical oncology, plastic surgery and ENT. In addition to surgery, treatment options include observation, radiation therapy and chemotherapy.
Intra-operative MRI — Allows surgeons to perform procedures with greater efficiency, reducing the chance of a return to the operating room for removal of a tumor mass that was initially overlooked. We have designed an operating room specifically for the MRI used in this procedure.
“Each patient receives a tailored, individualized treatment plan unique to the patient,” says Dr. Mendel, an internationally recognized authority on spinal tumors. “We are exceptionally skilled at reconstructing the spine and reestablishing the patient’s biomechanics after the tumor has been removed, improving patient’s quality of life,” 29 neuro-oncology
Brain Metastases
|
Practice Tool
Applying the Newest Guidelines to Your Patients
w No chemotherapy regimens were recommended for routine use. Routine chemotherapy after whole brain radiation therapy doesn’t improve survival and is not recommended for patients without exquisitely chemosensitive tumors, such as germinomas metastatic to the brain. However, benefit cannot be ruled out in tumor histologies other than non-small cell lung cancer and breast cancer. Some trials have shown improvements in response rate with the addition of chemotherapy.
More than half a million people with cancer develop brain metastases each year, most often from the breast or lung. Brain metastases cases outnumber primary brain tumor cases combined, by more than 4 to 1. Treatment options, including surgery, radiosurgery, localized brain radiation, whole brain radiation, chemotherapy and combinations of these, have been applied, but there has not been a global evidence-based approach to determining the best course of action until recently.
w Treatment of melanoma brain metastases with whole brain radiation and the chemotherapy agent temozolomide is reasonable.
Mario Ammirati, MD, was part of a 20-member panel that drafted the first national evidence-based multidisciplinary treatment guidelines for brain metastases patients. These guidelines were published in the Journal of Neuro-Oncology in December 2009.
w Some patients may benefit from the use of temozolomide or fotemustine in the therapy of brain metastases. w There is no evidence to support the routine use of new or existing interstitial radiation, interstitial chemotherapy or other interstitial modalities outside of approved clinical trials.
Dr. Ammirati’s participation in the development of this groundbreaking work is a testament to his expertise in brain and skull cancers and to the nationally recognized strength of OSUCCC – James in neuro-oncology research and the treatment of brain metastases.
w The use of epidermal growth factor receptor inhibitors may be of use in the management of brain metastases from non-small cell lung carcinoma. w Unequivocal recommendation cannot be provided to use the currently available radiation sensitizers motexafin gadolinium (MGd) and efaproxiral (RSR 13).
“Ten to 15 years ago, the diagnosis of brain metastases was accompanied by a universally grim prognosis. Today, we can give hope to these patients,” says Dr. Ammirati. “These new guidelines provide a more evidence-based way of looking at the options available to patients with brain metastases.”
w Corticosteroids can be used to provide temporary symptomatic relief of central nervous system symptoms. Dexamethasone is the corticosteroid of choice, largely due to its limited mineralocorticoid effects. Steroids should be slowly tapered over two weeks or longer in symptomatic patients to avoid rebound symptoms. Dosage should be started at 4 to 8 mg per day or higher doses such as 16 mg per day for severe symptoms.
The new guidelines for adults with brain metastases conclude that: w Combination treatment for brain metastases — either surgery or stereotactic radiosurgery followed by whole brain radiation — is the preferred option. Neither radiation nor resection is recommended as a standalone strategy for patients who are candidates for both.
w Routine prophylactic use of anticonvulsant drugs is not recommended to prevent seizures in adults with solid brain tumors but no prior seizures.
w Changing the dose and fractionation schedule from the standard 30 Gy in 10 fractions doesn’t improve survival, disease control or neurocognitive outcomes.
“Even when no recommendation has been made, it is appropriate to encourage patients to enroll in properly designed and conducted clinical trials of new treatment modalities and agents,” says Dr. Ammirati. “Only then can we learn the true value of new treatments.”
w Stereotactic radiosurgery can be substituted for conventional resection with the same survival benefit when given with whole brain radiation. Candidates are generally those with lesions less than 3 cm in diameter and minimal mass effect, defined as less than 1 cm of midline shift.
If you would like to learn more about the new treatment guidelines, please call 614-293-1970 or 614-366-8705 or e-mail Dr. Ammirati at Mario.Ammirati@osumc.edu. 30
neuro-oncology
Our Team Mario Ammirati, MD, MBA
Ehud Mendel, MD
Board certified neurosurgeon Professor, Neurological Surgery and Radiation Oncology Director, Stereotactic Radiosurgery Director, Skull Base Neurosurgery Director, Dardinger Microneurosurgical Skull Base Laboratory
Board certified neurosurgeon Professor, Neurological Surgery Director, Spinal Neurosurgery Clinical and research interests: Surgical management of spinal tumors
Clinical interests: Skull-base surgery, benign and malignant brain tumors, radiosurgery, spine metastases, degenerative spine disease
Herbert Newton, MD Board certified neurologist Professor, Neurology, Neurosurgery and Oncology Director, Division of Neuro-Oncology Esther Dardinger Endowed Chair in Neuro-Oncology Co-director, Dardinger Center for NeuroOncology and Neurosciences
Robert Cavaliere, MD Board certified neurologist Assistant Professor, Clinical Neurology Clinical interests: Neuro-oncology, signal transduction, quality of life in cancer patients
Clinical interests: Brain tumors, spinal cord tumors, chemotherapy, neuro-imaging, molecular neuro-oncology
Daniel Prevedello, MD
Arnab Chakravarti, MD
Assistant Professor Director, Minimally Invasive Cranial Surgery Program
Board certified radiation oncologist Professor, Radiation Oncology Chair and Medical Director, Department of Radiation Oncology Co-director, Brain Tumor Program Max Morehouse Chair of Cancer Research
Clinical interests: Minimally invasive brain tumor surgery; Endoscopic endonasal approaches for Pituitary tumors; skull based tumors; meningiomas; osteomas; olfactory neuroblastomas; schwannomas. Chordomas, craniopharyngiomas, as well as craniotomies and CSF leak repair.
Clinical interests: Brain and spinal cord tumors, prostate and bladder cancers
E. Antonio Chiocca, MD, PhD Board certified neurosurgeon Professor, Neurological Surgery Chair, Department of Neurological Surgery Medical Director, Neurology Signature Program Co-director, Viral Oncology Shared Resource at Ohio State’s Comprehensive Cancer Center Co-director, Dardinger Center for NeuroOncology and Neurosciences Dardinger Family Professor of Oncologic Neurosurgery
How to refer patients... Contact us for a neuro-oncology consultation. We see referred patients within the same week you contact us.
Clinical interests: Brain, spine and nerve tumor therapies; degenerative spinal disorders; peripheral nerve surgery; neurofibromatoses; schwannomas
Consultations and referrals line: 614-293-4448
James Elder, MD
Our promise to you We partner with referring physicians to provide specialty neuro-oncology care for your patients. We promise to communicate with you about your patients, provide feedback about their care and refer them back to you for ongoing care.
Assistant Professor, Neurological Surgery Clinical interests: Neurological surgery
31 neuro-oncology
Neuro-Oncology cancer.osu.edu
© 2011 The Ohio State University Medical Center – 1 UHOS20100256-08
Ohio State’s
Consult | Winter 2011 |
Faster Recovery for Corneal Transplant Patients
N
ew advances in how physicians at The Ohio State University Medical Center perform corneal transplants are reducing recovery time and impact on day-to-day life. Corneal transplants are usually performed on patients whose vision cannot be fixed any other way. Often times a cornea problem is directly related to: • • • •
Infection Trauma Congenital problems Dystrophy and degeneration
Andrew Hendershot, MD, assistant clinical professor at Ohio State’s Havener Eye Institute, says that corneal transplants are only performed as a last resort, when all other options have been eliminated. “As recently as a few years ago, a patient needing a corneal transplant would need to have their entire cornea replaced,” says Dr. Hendershot, “but now we have the ability to see exactly which parts of a patient’s cornea are damaged and can often replace only the outer or inner portion of the cornea.” By replacing only a small portion of the cornea, recovery time is reduced and patients are able to resume normal activities more quickly. Unlike organ transplants, corneas do not have to be matched to the recipient, although most physicians will try to find a young cornea for younger patients, increasing the length of time the cornea will function properly. Most cornea surgeries are performed on an outpatient basis, although patients always have the option to stay in the hospital overnight. “We find that many of our senior patients prefer to stay overnight, rather than trying to manage on their own at home.”
Research Ohio State’s Havener Eye Institute is actively involved in research studies for a variety of conditions, including macular degeneration, cataracts, corneal keratoconus, diabetic retinopathy and severe headaches. Ohio State also offers patients the most advanced equipment in central Ohio,
which provides patients with an exact diagnosis more quickly, allowing treatment plans to begin sooner. Most recently, glaucoma patients have benefited from a cutting-edge imaging machine that screens patients for glaucoma – identifying subtle changes in those who already have glaucoma and providing an earlier diagnosis for those who are at risk for developing glaucoma.
Communicating with the Referring Physician All patients seen at Ohio State’s Havener Eye Institute continue to be followed by the physician that referred them to the Institute. “We always send a summary letter to each patient’s referring physician, so they are aware of what treatment plan has been implemented,” Dr. Hendershot says. Ohio State’s Eye and Ear Institute, located at 915 Olentangy River Road, is designed to provide patients with one convenient location for evaluation, diagnosis and treatment. This allows for greater patient satisfaction and, with a multidisciplinary team, it allows for better patient outcomes as well. Get Started: For referrals, please contact: Ohio State’s Havener Eye Institute 614-293-8116
33
New Specialty Available for Your Patients: Urologic Trauma Services At a Glance: Fellowship-Trained Specialist Provides first
required with congenital abnormalities, spinal cord injuries and after urologic cancer surgeries.
Urologic Trauma and Reconstructive Services in the Area The Department of Urology welcomes Christopher McClung, MD, a specialist in urologic trauma and reconstruction.
Christopher McClung, MD
Dr. McClung received his medical degree from the Jefferson Medical College and completed his residency training at Loyola University Medical Center and a one-year fellowship in Reconstructive Urology and Urologic Trauma at the University of Washington.
Dr. McClung treats common problems in urologic trauma, including the management of injuries to the kidney, bladder, urethra and external genitalia. The goal of dealing with any one of these problems is to restore the urinary tract to its state prior to injury so that urine can drain appropriately.
Get Started: To refer a patient for a urologic trauma evaluation with Dr. McClung, call 614-293-3648.
When the injured urinary system cannot be managed with conservative or non-operative measures, urologic reconstruction is necessary. Urologic reconstruction may also be
Neurological Surgery Department Expands to Add New Services At a Glance: Innovations in stroke care include an
ship at the University of Wisconsin. Dr. Powers is the only dual trained neurosurgeon in central Ohio.
advanced surgical suite and highly specialized surgeons Led by E. Antonio Chiocca, MD, PhD, Ohio State’s Department of Neurological Surgery has grown with the recruitment of specialists in all elements of the discipline, including trauma, movement disorders, spine surgery and vascular disorders.
Ciaràn Powers, MD, PhD Dr. Powers treats patients in our innovative surgical suite designed specifically for the treatment of brain and spinal cord injuries.
Eric Sauvageau, MD, recently joined the Neurovascular Program at The Ohio State University Medical Center as Associate Professor of Neurosurgery and Surgical Director of the Ohio State’s Stroke program. He is a neurosurgeon specializing in endovascular and skull base neurosurgery.
One of the most recent additions to the Neurovascular team is Ciaràn Powers, MD, PhD. Specializing in both open and endovascular surgery, Dr. Powers sees patients who need critical neuroendovascular care. Dr. Powers graduated cum laude from the MD/PhD program at Georgetown University Medical School and completed his general surgery fellowship, neurological surgery fellowship and a neuroendovascular fellowship at Duke University Medical Center. He completed a second neuroendovascular fellow-
Regional Outreach Team...
Here to Serve You
The Neurovascular Program treats patients with vascular diseases of the brain, neck and spinal cord, including cerebral and carotid aneurysms and arteriovenous malformations. To schedule a patient appointment or for questions, call 614-293-0689.
Our Regional Outreach team is here to assist you in accessing the resources, education and patient referral information you need most from OSU Medical Center. Call on your Regional Outreach Coordinator at any time for information such as:
• Access to CME and clinical research opportunities Franklin County: Noreen Palmer | 614-366-6680
• Help with referring patients
East/Southeast Ohio: Karen Mitchell | 614-293-4352
• Requests for visits/calls with OSU physicians
North/West Ohio: Bill Cox | 614-293-2824
• Requests for patient materials 34
Advanced Wound Treatments for Your Patients
Clinical Breakthrough: Ohio State Clearing Heart Blockages Through the Wrist
Benefits at a Glance: • The most advanced treatments for your patients from Ohio’s only academic center of excellence in wound care
At a Glance: • Breakthrough surgery minimizes risk, speeds up patient discharge and recovery
• Comprehensive therapies for wound care and hyperbaric medicine • Research translated to bedside care
Ohio State’s Comprehensive Wound Center brings research breakthroughs to the bedside to offer patients the most advanced wound healing therapies available. We offer inpatient and outpatient wound care services at two convenient locations: University Hospital East and OSU Martha Morehouse Medical Plaza. Both facilities have free surface parking and are conveniently accessed from major freeways.
While coronary artery stenting through an incision in the upper thigh has been a standard practice to treat blocked heart arteries for many years, very few patients in the United States have the procedure performed through an artery in the wrist. Fewer still have it performed as an outpatient procedure.
Wounds we treat include but are not limited to: • Diabetic and pressure ulcers • Bone infections
The Ohio State University Medical Center’s Richard M. Ross Heart Hospital is one of the first hospitals in the country to offer a new clinical initiative to carefully selected patients who don’t have any other chronic health problems. This new approach minimizes the risk of complications and allows patients to go home the same day.
• Venous/arterial ulcers
“By using the puncture site in the wrist, we dramatically reduce the risk of bleeding and other complications, allowing us to discharge selected, low-risk patients the same day,” says Dr. Quinn Capers IV, an interventional cardiologist at Ohio State’s Ross Heart Hospital.
Wound healing therapies include but are not limited to:
“The prospect of fixing a potentially deadly heart blockage through the wrist, and sending the patient home the same day has the potential to establish a new paradigm in the treatment of heart disease,” adds Capers. “Shorter recovery times and fewer bleeding complications will result in greater comfort and safety for our patients, and while we don’t yet have specific data, we believe it will also significantly reduce costs.”
• Growth factors therapy
• Postoperative infections • Surgical wounds • Gangrene/necrosis • Late effects of radiation
• Hyperbaric oxygen therapy • Negative pressure therapy • Transcutaneous oxygen monitoring
• Topical oxygen therapy • Skin substitutes Get Started: To refer a patient or schedule a free wound consultation, call 614-293-4811 or 888-340-3163.
Get Started: To refer a patient, call 614-293-ROSS (7677) or 1-888-293-7677. 35
New Center Treating Patients with Cranial Base Disorders Benefits at a Glance: • One of the few centers of its kind in the country • Personalized management of cranial base disorders • Full range of minimally invasive and traditional approaches • Consolidation of visits for your patients
The new OSU Cranial Base Center offers a highly experienced, multidisciplinary team of neurosurgeons and head and neck surgeons dedicated to the treatment and care of cranial base disorders. Endoscopic Endonasal Approach (EEA) EEA is a minimally invasive neurosurgical technique that gives surgeons access to the base of the skull, intracranial cavity and top of the spine by operating via the nose and paranasal sinuses. EEA provides access for management of the following conditions: • Benign intracranial tumors (pituitary, adenoma, meningioma, craniopharyngioma, schwannoma)
Benefits of EEA: • Allows surgeons to treat many tumors that are difficult to reach, including those previously considered to be inoperable through conventional methods. • No facial incisions or scarring • Less trauma to the brain and nerves • Fewer side effects • Quicker recovery times
• Malignant cranial base tumors (chordoma, chondrosarcoma, olfactory neuroblastoma) • Benign cranial base disorders (encephaloceles, mucoceles, cerebrospinal fluid leak, osteomas) • Benign sinonasal tumors (inverted papilloma, nasal polyps) • Malignant sinonasal tumors (squamous cell carcinoma, adenocarcinoma)
The center is led by Daniel Prevedello, MD, director of Ohio State’s Minimally Invasive Cranial Surgery Program and assistant professor of the Department of Neurological Surgery. Dr. Prevedello is one of only a handful of neurosurgeons in the world who is not only trained in minimally invasive approaches like EEA and endoscopic brain surgery, but has helped to pioneer the technology and techniques used here at Ohio State. To refer a patient: 614-293-7190 To learn more: cancer.osu.edu/go/cranialbase
StudySearch: A Search Tool for
Ohio State Research & Clinical Trials
The Ohio State University Center for Clinical and Translational Science (CCTS) has launched StudySearch, the first comprehensive search tool for Ohio State research and clinical trials. With this user-friendly Web search tool, anyone can easily find basic information on research being conducted at Ohio State. StudySearch promotes The Ohio State University Medical Center’s research mission among patients and healthcare professionals. Visit StudySearch at http://ccts.osu.edu/studysearch.
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Water Program Offered to Maintain Results of Physical Therapy Benefits at a Glance: • Reduces pain and increases functionality for pain sufferers • Helps your patients sustain physical therapy results
Referring Physician Callback System in Place at Emergency Department
• Three class levels to meet individual needs
The OSU Center for Wellness and Prevention is now accepting patient referrals for its Warm Water Pool Program. Classes are designed to help reduce pain and increase functionality for individuals with musculoskeletal problems, obesity and other physical problems. Many individuals attend warm water classes to sustain results after completing physical therapy.
Paul Beery II, MD, MS, FACS, assistant professor of Clinical Surgery in the Division of Critical Care, Trauma and Burn at Ohio State’s University Hospital, recognizes the importance of collaboration and communication with referring physicians. For this reason, Dr. Beery started the physician callback system, so that physicians who transfer a patient to the University Hospital Emergency Department receives a follow-up phone call. “We don’t ever want a referring physician to feel like we’re not communicating with them after a patient has come to our Emergency Department for treatment,” says Dr. Beery.
Level 1 Water Movement This 45-minute class is designed for individuals with arthritis, obesity and other musculoskeletal or physical problems who want to keep the body moving at a slow pace. Intermediate Water Movement This 45-minute class is similar to Level 1 but applies a slightly faster pace. The arthritis-based exercises are performed to uplifting, upbeat music to help motivate and make the class fun. This class is intended to improve function but not to be an aerobic workout. Maintanance - Open Pool
“Our goal is to collaborate
This 45-minute class is for those who would like to enjoy the benefits of warm water exercise but do not desire any formalized instruction. During this time, participants have access to aquatic equipment with a staff member on hand to answer questions and supervise the area. This session is ideal for people who have completed aquatic physical therapy and would like to continue their program on their own.
with referring physicians so
Learn More: Physician referral for participation is required. Phone: 614-293-2800 Fax: 614-293-4280 All classes take place at Martha Morehouse Medical Plaza Pavilion, 2050 Kenny Road. Classes cost $130 for three months.
they can continue to provide treatment after the patient has returned home.”
The Emergency Department physician callback system allows a referring physician to communicate directly with the doctor who treated their patient. This provides better continuity of care and gives referring physicians a contact name and telephone number should any issues with the patient arise in the future. Most calls are made within two hours of a patient’s arrival. Call 614-293-8333 for more information.
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Help Your Patients Avoid the
Dangers of Grease Fire Burns Grease fires are the second most common way people get burned in the home. At this time of year we see a dramatic increase in the number of grease fire burns at our Adult Burn Center. Grease fires cause severe burns because the grease or oil bonds to the skin, trapping in heat to create deeper burns. Patients should be reminded of how to handle grease fires:
Nursing Excellence at Ohio State
1. Never add water to a grease fire. 2. Never attempt to move a pan or pot containing a grease fire. 3. Cover a grease fire with a lid to eliminate the oxygen source from the fire.
We are proud to announce that the staff of the Medical Center’s 8 Rhodes Progressive Care Unit has achieved the Beacon Award for Critical Care Excellence. The Beacon Award exemplifies high-quality patient care and dedication to evidence-based practice.
If a patient has suffered a grease burn, an accurate history of the burn is very important. Was the burn from the grease or from the flame? Did the patient’s clothes catch fire? Ohio State’s Medical Center is home to central Ohio’s only adult burn center. Our multidisciplinary team specializes in treating many types of burns. As part of a Level I Trauma Center, the Burn Team includes physicians, nurses, physical and occupational therapists, social workers, psychologists and dietitians who specialize in the treatment and management of burn patients. The OSU Burn Center cares for both inpatients and outpatients. Our outpatient clinic is held three days each week and is located on the main campus of The Ohio State University Medical Center.
Get Started: To refer a patient to Ohio State’s Burn Center, please call 614-293-BURN (2876). 38
Ohio State Physicians
In The News
John Byrd, MD, has been awarded a five-year, $6.25 million Specialized Center of Research (SCOR) grant renewal from The Leukemia & Lymphoma Society, making us the only institution to receive both a SCOR and SPORE in leukemia research. Dr. Byrd and his team will use the funds to further their work in developing experimental therapeutics for the treatment of adult leukemia. Dr. Byrd, who is the holder of the D. Warren Brown Family Designated Professorship in Leukemia Research at the OSUCCC – James, has also recently been named director of the new Division of Hematology in Ohio State’s Department of Internal Medicine.
Richard Nelson, MD, has been named presidentelect of the American Board of Emergency Medicine (ABEM). Dr. Nelson has been involved with ABEM since 1983 and has served on the board of directors since 2004. He chairs the Board’s Initial Certification Task Force and Test Development Committee. Dr. Nelson also represents ABEM to the American Board of Medical Specialties. Richard White, MD, FACR, FACC, FAHA, FSCCT, has been named as professor and chair of Ohio State’s Department of Radiology and director of the Ohio State’s Imaging Signature Program. Dr. White joins The Ohio State University Medical Center after serving more than four years as professor and first chair of the Department of Radiology for the University of Florida College of Medicine-Jacksonville at the UF Shands Medical Center/Jacksonville in Florida.
Michael A. Caligiuri, MD, director of The Ohio State University Comprehensive Cancer Center and CEO of the James Cancer Hospital and Solove Research Institute (OSUCCC – James), is one of only four scientists nationwide this year to receive a prestigious MERIT Award from the National Cancer Institute (NCI) for his extensive research focusing on manipulating the immune system to prevent and treat cancer. William Carson III, MD, has been named to the board of directors of the National Comprehensive Cancer Network (NCCN). Dr. Carson is a surgical oncologist who serves as associate director for Clinical Research at The Ohio State University Comprehensive Cancer Center (OSUCCC) and co-leads the Center’s Innate Immunity research program.
Ali Rezai, MD, professor in the Department of Neuroscience, has been elected president of the American Society for Stereotactic and Functional Neurosurgery (ASSFN). The main goals of ASSFN are to improve patient care, support clinical research and offer leadership in undergraduate and graduate education. Rezai’s areas of expertise include severe movement disorders, psychiatric conditions, chronic pain and brain injuries.
Mitchell Henry, MD, has been selected as presidentelect of the American Society of Transplant Surgeons (ASTS). He will take office in May 2011. Dr. Henry, professor of Surgery, is director of Surgical Services at Ohio State’s Comprehensive Transplant Center. In addition, Henry serves as president of the Vascular Access Society of the Americas.
The board of trustees of the Air Medical Physician Association (AMPA) has selected Howard Werman, MD, professor of Emergency Medicine, the 2010 AMPA Medical Director of the Year. The award is in recognition of his contributions as MedFlight’s current medical director and the overall success of the transport program.
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Tools You Can Use: Mobile Physician Referral Guide We’re making it easier than ever before to get the information you need to refer patients to Ohio State’s Medical Center. We have recently created our Physician Referral Guide in a mobile format for your smart phone. Now you can find listings of our medical services and patient referral information right on your phone. You’ll also be able to search our physician database. Access it by visiting www.medicalcenter.osu.edu from your smart phone and it will automatically display.
Your Resources DocLink healthsystem.osu.edu Web-based program allowing referring physicians access to their patients’ OSU Medical Center visit-specific treatment results
Physician-to-Physician Consultation Line 800-293-5123, option 1 Consult with an OSU Medical Center physician, discuss specific patient-related cases, appointment referral, transfer a patient
Referring Physicians medicalcenter.osu.edu/referringphysicians Referring physician information, links, downloads and forms, patient education materials, maps and directions
Physician Relations 800-293-4326 or mdrelations@osumc.edu Physician Relations supports the needs of community physicians and their staff as they interact with OSU Medical Center
The Ohio State University Comprehensive Cancer Center– Arthur G. James Cancer Hospital and Richard J. Solove Research Institute The James Line: 614-293-5066 cancer.osu.edu Patient referral center, clinical trials and research information, patient education materials
OSU Regional Outreach Program Franklin County, Noreen Palmer....................614-366-6680 East/Southeast Ohio, Karen Mitchell..........614-293-4352 North/West Ohio, Bill Cox..............................614-293-2824 Outreach provides access to OSU Medical Center services, specialty physicians, continuing medical education and other Medical Center programs Physician Directories To request a copy of our physician directory or to request updated sections for your existing directory, please call your Regional Outreach Coordinator (above).
Continuing Medical Education ccme.osu.edu Continuing Medical Education programs, including Category I CME offerings online through OSU MedNet21, traditional lecture series and Grand Rounds
UHOS20100256-04
Physician Referral Guide To request a copy of the Physician Referral Guide, call your Regional Outreach Coordinator or visit medicalcenter.osu. edu/referringphysicians to access an online version. 40
Physician Resources
Contact
DocLink healthsystem.osu.edu
Web-based program allowing referring physicians access to their patients’ OSU Medical Center visit-specific treatment results
OSU Medical Center medicalcenter.osu.edu Referring physician information, patient education materials, maps and directions The Arthur G. James Cancer Hospital and www.cancer.osu.edu Richard J. Solove Research Institute
Patient referral center, clinical trials and information, patient education materials
OSU Medical Center http://ccme.osu.edu Center for Continuing Medical Education
Web site featuring Continuing Medical Education programs including: Category I CME offerings online through OSU MedNet21, traditional lecture series and Grand Rounds
Physician-to-Physician 1-800-293-5123; option 1 Consultation Line
Consult with an OSU Medical Center physician, discuss specific patient-related cases, appointment referral, transfer a patient
Physician Relations 1-800-293-4326
Physician Relations supports the needs of community or mdrelations@osumc.edu physicians and their staff as they interact with OSU Medical Center
OSU Regional Outreach Program Franklin County: 614-366-6680 East/Southeast Ohio: 614-293-4352 North/West Ohio: 614-293-2824
Outreach provides referring physicians with access to OSU Medical Center services, specialty physicians, continuing medical education and other medical center programs
www.medicalcenter.osu.edu/referringphysicians