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Archive for June, 2018

Northside Hospital Atlanta Completes New Eight-Story Patient Tower

Monday, June 25th, 2018

Northside Hospital has completed the first major expansion of its Atlanta campus in more than a decade with the opening of a new eight-story patient tower.

The new 84-bed East Tower expands the hospital’s inpatient capacity from 537 to 621 and includes more beds for pulmonary/thoracic, oncology, blood and marrow transplant and medical/surgical patients. This is the first major construction project on Northside’s Atlanta campus since the expansion of the Women’s Center in 2007.

“Northside Hospital continues to see strong growth across many of our services and this project was very important for us to continue to effectively and efficiently meet the health care demand in this area,” said Steve Aslinger, director of facilities planning, Northside Hospital.

Northside Hospital Atlanta opened its doors in 1970 and was the first hospital constructed on what is now commonly referred to as “Pill Hill”. The hospital campus served more than 2 million patient encounters in 2017.

Northside opened the new patient tower on a staggered timeline, beginning Feb. 12. The building’s main entrance and motor lobby opened last on June 11 and feature several art installations from local artists. The crown jewel is a 2,000-square-foot mural by Atlanta artist Ryan Coleman that surrounds a cement column in the center of the tower’s motor lobby.

The mural and additional art were provided by donations made to the Northside Hospital Foundation in memory of Lynn Teague, a past Northside cancer patient.

The mural incorporates the golden color of sunflowers, Lynn’s favorite flower, and photos of sunflowers also are installed in the building. Lynn’s family hopes the “virtual garden” will create a calm, serene and inspiring place of rest for patients and their families away from the patient’s room.

In addition to the new patient tower, Northside is expanding, renovating and reconfiguring some of the clinical and ancillary services (Food Services, Surgery, Labor & Delivery and Critical Care) within the existing hospital building. That work is still underway and is expected be completed in 2019.

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PCOS: Alternative Management and Long-Term Risks

Monday, June 25th, 2018

By Desiree’ M. McCarthy-Keith, MD, MPH

Most practitioners are able to recognize the classic features of PCOS: obesity, androgen excess and irregular menstrual cycles. However, many patients will have few features or a subtler presentation. Despite varying degrees of the condition, all women with PCOS are at risk for metabolic and endocrine sequelae. Women’s health providers should understand that the metabolic complications of PCOS do not resolve after menopause, and for some women they may worsen.

Lifestyle Modications
Women with PCOS may be normal weight or lean, but the majority of women with PCOS in the United States are obese. Obesity may worsen the presentation of PCOS and increase the risk for insulin resistance (IR), impaired glucose tolerance (IGT), type 2 diabetes (T2D) and dyslipidemia. Weight loss, achieved through diet modification and exercise, is first-line management for obese women with PCOS. A 2011 Cochrane review concluded that exercise, with or without dietary modification, reduces total testosterone, hirsutism, weight, waist circumference and fasting insulin levels in women with PCOS.1 Diets high in fiber and low in trans fatty acids were significant predictors of weight loss and metabolic improvement.2 Both high-protein and normal protein diets produce comparable metabolic benefits.3

Adjunctive Treatment in PCOS
While lifestyle modification is first-line therapy for PCOS, insulin sensitizing medications are often prescribed to remedy the metabolic complications. Metformin is the standard medical treatment for IR in PCOS, but it’s effectiveness is limited due to poor tolerance and limited compliance by patients. Acupuncture is a favorable alternative treatment, due to its relative safety and lower incidence of adverse effects compared to conventional medical therapies. In Traditional Chinese Medicine, specific abdominal acupuncture points correspond to metabolic, endocrine and reproductive function and stimulation of these points can improve the effects of PCOS. One randomized study comparing daily acupuncture to standard metformin therapy found reduced BMI, reduced waist-to-hip ratio and improved clinical androgen effects in both groups. Lipid profile, glucose and insulin values were also improved in both groups, with greater improvement in menstrual frequency in the abdominal acupuncture group.4

Dietary supplements may be a useful adjunct or alternative to metformin therapy. Myo-inositol demonstrates effective insulin sensitizing activity, comparable to metformin, with potentially greater tolerability.5 Both inositol isoforms, D- chiro-inositol and myo-inositol, improve ovarian function and metabolic parameters in patients with PCOS.6 There is some evidence that N-acetyl cysteine (NAC), derived from the amino acid L-cysteine, also improves fasting glucose, fasting insulin and lipid parameters in women with PCOS when compared to metformin.7 Limited data also suggest that cinnamon supplements may regulate menstrual cycles and co- enzyme Q10 (CoQ10) supplementation improves glucose metabolism and lipid parameters in women with PCOS.8,9

The Older PCOS patient
In younger women, the management of PCOS is primarily focused on the reproductive aspects of the condition. As women with PCOS enter their late 30s and 40s, the metabolic and cardiovascular risks become more significant. The greatest long-term health risks for women with PCOS are for development of T2D, cardiovascular disease (CVD) and metabolic syndrome. The progression from normal glucose tolerance to IGT or T2D occurs more rapidly in women with PCOS and the deterioration in glucose tolerance is more signficant in obese women and those with first degree relatives with T2D.10

The risk for CVD in women with PCOS is the result of longstanding metabolic dysfunction, and risk is further compounded by aging. Long-term studies identify several cardiovascular risk factors, including diabetes, hypertension, obesity and elevated cholesterol. Women with PCOS also exhibit more severe carotid-intima media thickening and coronary artery calcification compared to women without PCOS.11 In addition, women with a history of premenopausal menstrual irregularity and androgen excess experience more cardiovascular events and atherosclerotic CVD compared to controls.12,13

The menopausal PCOS phenotype is difficult to describe, since the diagnostic criteria for PCOS are generally not applicable after menopause. The menstrual irregularities of PCOS are no longer observable and the natural course of androgen excess is unknown. Women with PCOS demonstrate higher prevalence of obesity, T2D and CVD risk factors and these conditions are expected to worsen as women transition through menopause. All peri- and postmenopausal women should be routinely screened for IGT, T2D and CVD and history of PCOS, prior irregular menses and hirsutism should be considered in their risk assessment.
To avoid missed opportunities for intervention, look beyond the typical PCOS phenotype in your patients. Always consider lifestyle modification, with diet and regular exercise, as the foundation of PCOS management and consider adjunctive therapies, including acupuncture and dietary supplementation as useful alternatives to standard medical therapy. Lastly, remember that the metabolic, endocrine and cardiovascular consequences of PCOS do not subside when reproductive function ends.


References

1. Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011 16;(2).

2. Nybacka A, Hellstrom PM, Hirschberg AL. Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement in overweight polycystic ovary syndrome-Substudy of randomized trial between diet, exercise and diet plus exercise for weight control. Clin Endocrinol 2017;87(6):680-688.

3. Toscani MK, Mario FM, Radavelli-Bagatini S, Wiltgen D, Matos MC, Spritzer PM. Effect of high-protein or normal-protein diet on weight loss, body composition, hormone, and metabolic profile in southern Brazilian women with polycystic ovary syndrome: a randomized study. Gynecol Endocrinol. 2011;27(11):925-30.

4. Zheng YH, Wang XH, Lai MH, Yao H, Liu H, Ma HX. Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome: a randomized controlled trial. J Altern Complement Med. 2013;19(9):740-5.
5. Tagliaferri V, Romualdi D, Immediata V, De Cicco S, Di Florio C, Lanzone A. Metformin vs myoinositol: which is better in obese polycystic ovary syndrome patients? A randomized controlled crossover study. Clin Endocrinol 2017;86(5):725-730.

6. Pizzo A, Laganà AS, Barbaro L. Comparison between effects of myo-inositol and D-chiro-inositolon ovarian function and metabolic factors in women with PCOS. Gynecol Endocrinol 2014;30(3):205-8.

7. Javanmanesh F, Kashanian M, Rahimi M, Sheikhansari N. A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome. Gynecol Endocrinol 2016;32(4):285-9.

8. Kort DH, Lobo RA. Preliminary evidence that cinnamon improves menstrual cyclicity in women with polycystic ovary syndrome: a randomized controlled trial. Am J Obstet Gynecol 2014;211(5):487.e1-6.

9.Samimi M, Zarezade Mehrizi M, Foroozanfard F, Akbari H, Jamilian M, Ahmadi S. The effects of coenzyme Q10 supplementation on glucose metabolism and lipid profiles in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol 2017;86(4):560-6.

10. [Celik C, Tasdemir N, Abali R, Batsu E, Yilmaz M. Progression to Impaired glucose tolerance or type 2 diabetes mellitus in polycystic ovary syndrome: a controlled follow-up study. Fertil Steril 2014;101(4):1123-8.

11. Cibula D, Cifková R, Fanta M, Poledne R, Zivny J, Skibová J. Increased risk of non-insulin dependent diabetes mellitus, arterial hypertension and coronary artery disease in perimenopausal women with a history of the polycystic ovary syndrome. Hum Reprod 2000;15(4):785-9.

12. Shaw LJ, Bairey Merz CN, Azziz R, Stanczyk FZ, Sopko G, Braunstein GD, et al. Postmenopausal women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: results from the National Institutes of Health—National Heart, Lung and Blood Institute sponsored Women’s Ischemia Syndrome Evaluation. J Clin Endocrinol Metab 2008;93 (4)K:1276-84.

13. Krentz AJ, von Mühlen D, Barrett-Connor E. Searching for polycystic ovary syndrome in postmenopausal women: evidence of a dose-effect association with prevalent cardiovascular disease. Menopause 2007;14:284-92.

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Fertility Treatment for the PCOS Patient

Monday, June 25th, 2018

By Kathryn Calhoun, M.D.

Chronic anovulation is a hallmark of Polycystic Ovary Syndrome (PCOS), so the vast majority of women with PCOS will require fertility treatment to conceive.

In a young PCOS patient with no obvious barriers to conception (other than anovulation), it is reasonable to start ovulation induction medicines before evaluating her uterus/tubes or her partner’s semen analysis. If the woman/ couple has not conceived after three successful ovulations, then a hysterosalpingogram (HSG) and semen analysis should be performed.

In contrast, an older woman (> 35 years) or a couple with risk factors for pelvic disease or sperm problems should have an HSG and a semen analysis before proceeding with ovulation induction therapy. Examples of risk factors for pelvic disease include a prior history of infections, surgery, pain, broids, endometriosis or pregnancy loss. Examples of risk factors for an abnormal semen analysis include changes in strength/libido, erectile dysfunction, obesity, sleep apnea, diabetes or cardiovascular disease.

Until recently, the first-line medication for ovulation induction in women with PCOS was clomiphene citrate (Clomid). Clomid is a selective estrogen receptor modulator (SERM) that blocks estrogen feedback on receptors throughout the body. At the brain (hypothalamic-pituitary) level, this perceived low estrogen state results in altered hormone (FSH/LH) signaling to the ovaries.

In 80 percent of PCOS women, this change in FSH/LH levels will result in ovulation.1 Side effects of Clomid are due to this reduced estrogen signaling and include headaches, hot ashes, mood changes, decreased cervical mucus, vaginal dryness and a temporary thinning of the uterine lining. Rarely, women may experience changes in vision, and this is a reason to discontinue Clomid use. The risk of twins is ~8 percent per cycle, the risk of triplets is < 1 percent. No causal relationship has been established between ovulation induction medicines and birth defects, miscarriage or ovarian cancer.1

A recent study followed women with PCOS for up to five treatment cycles and reported better rates of ovulation (61.7 percent vs 48.3 percent) and live birth (27.5 percent vs 19.1 percent) with Letrozole (Femara) rather than Clomid.2 Thus, Femara is now the first choice for ovulation induction in PCOS patients. Femara is an aromatase inhibitor that blocks the conversion of androgens to estrogens, thereby actually lowering estrogen levels in the body. The effect on the brain is similar to Clomid, though the side effects (hot ashes, headaches, thinning of uterine lining) are often less. Though it was underpowered to detect a significant difference, the risk of twins in this study was lower with Femara (3.9 percent) than Clomid (6.9 percent).2

Both Femara and Clomid are taken daily for 5 days at the start of a menstrual cycle. Progesterone may be used to induce a menstrual period, if necessary. Ovulation most often occurs 5-12 days after the last pill, and the patient should begin ovulation predictor kits (“OPKs”) and regular intercourse (if possible) during this interval.1 An ultrasound is performed to check ovarian response, to evaluate the uterine lining and to help the couple plan further intercourse and/or intrauterine insemination (IUI). If the ovaries are not responding, dosing can be immediately adjusted at this visit.

If Femara is unsuccessful at inducing ovulation, the dose can be increased, the duration may be extended or the patient can then try Clomid. Adjunct medications are sometimes used, such as low-dose Dexamethasone or Metformin, though these may yield minimal additional benefit.

Using Metformin alone has demonstrated lower rates of ovulation, live birth and twin pregnancy than Clomid.3 If the patient demonstrates continued resistance to oral medications, the importance of lifestyle modification (weight loss, if applicable) is reinforced and ovarian drilling (surgery to reduce the androgen-producing stromal portion of the ovary) may be considered. After six months of therapy, the chance of pregnancy drops significantly despite ovulation.1

If oral medications are unsuccessful, the next step may be injectable gonadotropins (FSH/LH.) Women with PCOS have a very high follicular/egg count, so these medicines may be risky if combined with intercourse or IUI. The chance of over-response, ovarian hyperstimulation syndrome (OHSS) or higher-order multiple gestations (triplets+) can lead to canceled cycles, treatment delays and disappointment.

For PCOS patients who do not succeed with lesser therapies, in vitro fertilization (IVF) represents a safe and effective next step. For the youngest PCOS patients, per cycle pregnancy rates can approach 70 percent. In an IVF cycle, a woman administers injectable gonadotropins (FSH/LH) for 9-12 days in order to mature a high percentage of her monthly egg group. The eggs are then retrieved with a short outpatient surgical procedure, then fertilization and early embryo development occur in the laboratory. An embryo is replaced in the uterus to begin the pregnancy.

Women with PCOS require special IVF care due to their robust egg count. The focus of treatment is to safely recruit a moderate-size group of eggs without significant OHSS. OHSS causes fluid shifts and third-spacing that can lead to symptomatic ascites and intravascular depletion. In addition to illness, OHSS can also result in lower-quality eggs/embryos. PCOS IVF protocols should employ lower doses and different combinations of medicines, as well as adjunctive therapies (i.e Metformin), to ensure an optimal and safe response.4 Even with appropriate treatment, at the end of the stimulation, most PCOS patients will have hormone levels that are too high for ideal implantation. To ensure the highest pregnancy rates, and a safe and healthy pregnancy overall, embryos are often frozen and transferred in the next cycle as a frozen embryo transfer (FET).

The good news is that most PCOS patients will conceive and enjoy a low-risk pregnancy. This is especially true for those patients with singleton gestations and no other comorbidities (i.e. obesity, insulin resistance/diabetes, hypertension). It is possible that the observed increased risks of pregnancy loss and late pregnancy complications in PCOS are most common in women with those additional risk factors.


REFERENCES
1. Fritz, Marc A.; Speroff, Leon. Clinical gynecologic endocrinology and infertility. 8th ed. Philadelphia: Lippincott Williams & Wilkins; c2010.

2. Legro RS, Kunselman AR, Brzyski RG, Casson PR, Diamond MP, Schlaff WD, Christman GM, Coutifaris C, Taylor HS, Eisenberg E, Santoro N, Zhang H; NICHD Reproductive Medicine Network. The Pregnancy in Polycystic Ovary Syndrome II (PP- COS II) trial: rationale and design of a double-blind randomized trial of clomiphene citrate and letrozole for the treatment of infertility in women with polycystic ovary syndrome. Contemp Clin Trials. 2012 May;33(3):470-81. doi: 10.1016/j.cct.2011.12.005. Epub 2012 Jan 13.

3. Legro RS, Barnhart KH, Schlaff WD, etc al. Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med. 2007; 356: 551-566.

4. Practice Committee of the American Society for Reproductive Medicine. Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: a guideline. Fertil Steril. 2016; 106: 1634-1647.

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Emory, Kaiser Strike Agreement for Collaboration

Thursday, June 21st, 2018

Emory Healthcare, the clinical arm of Emory University, and Kaiser Permanente will collaborate to develop a new care model that provides Kaiser Permanente members with a fully integrated health care experience, and in the process advances patient- and family-centered care in metro Atlanta and beyond. Emory University Hospital Midtown and Emory Saint Joseph’s Hospital will become the primary hospitals for Kaiser Permanente physicians and members.

In announcing their formal agreement, the two organizations underscore their shared values in quality, innovation, education, affordability and service. Building on each other’s strengths, Kaiser Permanente and Emory will expand and improve their capabilities in population health management, ambulatory and hospital care, research and academics, and improving the health of the communities they serve.

Highlights of the agreement include:
• The collaboration will include development of infrastructure and joint capacity planning, and the implementation of collaborative processes on physician staffing, enhanced technology, care coordination, active engagement of patients and families, and ongoing evaluation of performance measures.
• The Southeast Permanente Medical Group (TSPMG) physicians, who care for Kaiser Permanente members, will treat their patients at Emory University Hospital Midtown and Emory Saint Joseph’s Hospital. These physicians will oversee their members’ care experience with active engagement of Kaiser Permanente’s care managers and with support from Emory providers.
• Kaiser Permanente will maintain some existing service affiliations, including labor and delivery services, which will continue to be provided at Northside Hospital.
• Emory Healthcare will continue its existing relationships with all of its affiliated health plans and will continue to serve their members and all existing patients without a change in service or access.

In anticipation of this agreement, Kaiser Permanente has provided a capital contribution toward expansion of both hospitals to accommodate the new and existing patients while maintaining outstanding quality, service and access.

Both organizations anticipate caring for Kaiser Permanente members at Emory University Hospital Midtown and Emory Saint Joseph’s Hospital in October 2018.

“The long-term benefits of this collaboration will serve as a national model for other health systems and extend beyond our two organizations,” says Jonathan S. Lewin, CEO of Emory Healthcare and Executive Vice President for Health Affairs of Emory University.

“This unique collaboration will combine the highly complementary strengths of Kaiser Permanente and Emory Healthcare, both of which have rich histories in medical excellence, exceptional service, research and quality,” says Jim Simpson, Georgia President, Kaiser Permanente. “Our joint focus will be to create a premier, integrated care and coverage model committed to improving health and affordability for our members, and better addressing health disparities, while working collaboratively to increase the number of people and communities who benefit from what our organizations can accomplish together.”

The two organizations, including their physician and clinical leadership, will also work to improve community health, address health care disparities, make health care more affordable, and enhance education for skilled and compassionate health care professionals. The agreement commits both organizations to create an integrated care and coverage model for Kaiser Permanente members at Emory University Hospital Midtown and Emory Saint Joseph’s Hospital.

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McGahan Named Chief Medical Officer of Emory Saint Joseph’s Hospital

Thursday, June 21st, 2018

Thomas P. McGahan, M.D., chairman of the Department of Medicine at Emory Saint Joseph’s Hospital, was recently named chief medical officer of the facility. In this role, he will serve as the senior administrative physician on the Emory Saint Joseph’s Hospital administrative team and work collaboratively with Emory Healthcare (EHC) operating units and the Office of Quality and Risk to achieve quality and safety initiatives.

McGahan has been a member of the medical staff at Emory Saint Joseph’s since joining Metro Atlanta Gastroenterology in 1994, where he will continue to be available to see patients. A leader in the field of gastroenterology, McGahan has been instrumental in advancing patient-centered care at Emory Saint Joseph’s. He was one of the first physicians to perform endoscopic ultrasound, making Emory Saint Joseph’s the first healthcare facility in North Atlanta to offer this service for patients. McGahan also expanded Emory Saint Joseph’s GI medical conferences, and serves as moderator of the semimonthly abdominal tumor conference.

McGahan currently holds a variety of leadership positions including serving as a member of the EHC and Emory Saint Joseph’s Hospital boards, EHC marketing executive advisory committee, and the Saint Joseph’s Health System Board of Trustees.

In addition to these roles, McGahan is the 2014 recipient of the annual Burson Award, Emory Saint Joseph’s highest honor for physician service. Recipients are selected for their leadership as a member of the medical staff, contributions to the quality of medicine and adherence to the Mercy philosophy and contribution to the Mercy mission in Atlanta.

McGahan received his undergraduate degree from the University of Notre Dame and medical degree from Emory University. He completed his fellowship in digestive diseases at the University of Cincinnati.

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Patrice A. Harris, M.D., New President-Elect of the American Medical Association

Thursday, June 21st, 2018

Patrice A. Harris, M.D., a psychiatrist from Atlanta, was elected as the new president-elect of the American Medical Association (AMA) by physicians gathered at the Annual Meeting of the AMA House of Delegates in Chicago.

Dr. Harris has diverse experience as a private practicing physician, public health administrator, patient advocate and physician spokesperson. During her entire career, Dr. Harris has been a leader in organized medicine to ensure the voice of physicians and patients is represented in health care transformation.

“It will be my honor to represent the nation’s physicians at the forefront of discussions when policymaker and lawmakers search for practical solutions to the challenges in our nation’s health system. I am committed to preserving the central role of the physician-patient relationship in our healing art,” said Dr. Harris. “The American Medical Association has well-crafted policy concerning the changing health care environment in this country and I look forward to using my voice to help improve health care for patients and their physicians.”

Dr. Harris is the first African-American woman to hold the office.

First elected to the AMA Board of Trustees in 2011, Dr. Harris has held the executive offices of AMA board secretary and AMA board chair. Dr. Harris will continue to serve as chair of the AMA Opioid Task Force, and has been active on several other AMA taskforces and committees on health information technology, payment and delivery reform, and private contracting. She has also chaired the influential AMA Council on Legislation and co-chaired the Women Physicians Congress.

Prior to her AMA service, she was elected to the American Psychiatric Association Board of Trustees and president of the Georgia Psychiatric Physicians Association. She was also the founding president of the Georgia Psychiatry Political Action Committee. In 2007, Dr. Harris was selected Psychiatrist of the Year by the Georgia Psychiatric Physicians Association.

As former chief health officer for Fulton County, Ga., Dr. Harris spearheaded efforts to integrate public health, behavioral health and primary care services. Dr. Harris has also served as medical director for the Fulton County Department of Behavioral Health and Developmental Disabilities.

Currently, Dr. Harris continues in private practice and consults with both public and private organizations on health service delivery and emerging trends in practice and health policy. She is an adjunct assistant professor in the Emory Department of Psychiatry and Behavioral Sciences.

Dr. Harris received her medical degree from the West Virginia University School of Medicine and completed a psychiatry residency and child psychiatry fellowship at Emory University School of Medicine. She was inducted in 2007 to the West Virginia University Academy of Distinguished Alumni.

Following a year-long term as AMA president-elect, Dr. Harris will be installed as the AMA president in June 2019.

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Northside Hospital Cancer Institute Treating Blood Cancer Patients with Cell-Based Immunotherapy

Thursday, June 21st, 2018

Northside Hospital Cancer Institute is among select centers in the country to offer chimeric antigen receptor (CAR) T-cell therapy, a type of immunotherapy, for adult patients with certain types of non-Hodgkin lymphoma.

Yescarta is the first-ever, FDA-approved CAR T-cell therapy to treat adults with certain types of large B-cell lymphoma, who have not responded to or who have relapsed after at least two other kinds of treatment. The treatment is one of several therapies available from Northside Hospital Cancer Institute’s newly launched Immunotherapy Program.

Immunotherapy works by taking immune cells, genetically modifying them to be better tumor-fighting immune cells, multiplying them to great numbers (tens of thousands), and then infusing them into the patient where they can find and attack cancer.

“At Northside Hospital, we have been doing immunotherapy for decades in the form of allogeneic stem cell transplantation, in which a donor’s bone marrow or blood is engineered and transplanted into a patient to cure aggressive blood cancers,” said Scott Solomon, medical director of Northside’s Blood and Marrow Transplant (BMT) Matched Unrelated Donor Program and Stem Cell Processing Laboratory.

Northside Hospital is nationally recognized for leukemia treatment and stem cell transplantation. For nine consecutive years, the BMT Program at Northside has exceeded expected one-year survival outcomes for allogeneic transplants and is one of only two centers in the country (the only center in the Southeast) to do that.

Such transplants represented the first definitive proof of the human immune system’s capacity to cure cancer. Now, through studying CAR T-cells, cancer researchers are developing new ways to strengthen and empower a patient’s own immune system.

“It’s really just been over the last 5-10 years that tools are becoming available where we can think about stimulating a patient’s own immune system to attack cancer,” said Dr. Solomon, who added that CAR T-cell therapy is one of the most exciting and most promising cell-based immunotherapies and is giving hope to patients who previously didn’t have it.

“We’re targeting CAR T-cell therapy now to patients who have failed multiple rounds of conventional therapy,” said Dr. Solomon. “These patients historically have had very poor outcomes, very low chances of even brief remissions and certainly no chances of a cure prior to CAR T-cell therapy. And now many of them are alive months or years after therapy.”

To date, Kite Pharma, Inc., which makes Yescarta®, has certified approximately 45 cancer centers nationwide to offer its new treatment. Northside is one of just two facilities in Georgia that has the capacity and facilities to manage the toxicity of immunotherapy agents and that is certified to offer Yescarta®.

Although CAR T-cell therapy only just became available commercially in 2017, Northside participated in novel CAR T-cell therapy clinical trials for years and has the experience to care for patients who may develop mild to severe immunological side effects.

In May 2018, the hospital expanded its state-of-the-art BMT unit from 36 to 56 beds to accommodate anticipated growth of the hospital’s Immunotherapy Program.

“I think we’re just at the beginning of tapping the role of immunotherapy in the treatment of cancer,” said Dr. Solomon. “Any cancer can theoretically be targeted with immunotherapy, but there are many new drugs, agents and cell-based therapies that we have now which can target a whole array of different cancers, blood cancers and solid tumors.”

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Arthritis & Total Joint Specialists in Woodstock Welcome Dr. Don Beringer

Thursday, June 21st, 2018

Dr. Don BeringerDr. Don Beringer has joined Dr. Brian Seng and Arthritis & Total Joint Specialists in Woodstock. Board certified in orthopedic surgery, Dr. Beringer uses the latest in minimally invasive surgery including anterior hip replacement, robotic assisted hip and knee replacement, total and partial knee replacement and shoulder and reverse shoulder replacement.

In addition to providing patient care, Dr. Beringer is dedicated to advancing the understanding of complex surgical techniques and has published his research extensively. He serves as an associate editor for Clinical Orthopaedics and Related Research and has served as an assistant professor in the Department of Surgery at Mercer University School of Medicine.

Arthritis & Total Joint Specialists specializes in the diagnosis and treatment of arthritis and chronic joint pain of the hip, knee and shoulder and offers outpatient total joint replacement.

With the addition of Dr. Beringer, the practice is expanding its services to offer total shoulder replacement.

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Dr. Chaudhry joins Pulmonary and Critical Care of Atlanta

Thursday, June 21st, 2018

Dr. Abubakr ChaudhryPulmonary and Critical Care of Atlanta has hired Dr. Abubakr Chaudhry as the newest physician at its practice in Sandy Springs. Dr. Chaudhry joins a team of medical professionals who are trained in internal medicine, pulmonary and critical care.

Dr. Chaudhry pursued an academic position at University Hospitals Cleveland Medical Center, where he helped build the Critical Care Ultrasound Program for the physicians in training. In addition to his clinical work, Dr. Chaudhry is committed to pursuing research that will advance the future of pulmonary care and his work has been presented at national conferences and published in premier academic journals.

His interests include management of pulmonary hypertension, endobronchial ultrasound, bronchoscopy transbronchial lung biopsy and cardio-pulmonary exercise testing with regimented physical health optimization. In addition, he treats asthma, COPD, interstitial lung disease and pulmonary embolic disease.

“Atlanta has had a special place in my heart ever since I completed my fellowship training at Emory University,” he said. “The people here have warm hearts and a genuinely welcoming nature. There is nothing better than southern hospitality. I felt at home from the moment I came back.”

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Dr. Esther Dorzin joins North Georgia OB/GYN Specialists in Towne Lake

Thursday, June 21st, 2018

Dr. Esther Dorzin has joined the staff at North Georgia OB/GYN Specialists at the group’s office at the Northside Cherokee/Towne Lake Medical Campus in Woodstock.

Dr. Dorzin completed her medical degree at Warren Alpert Medical School of Brown University in Providence, RI, followed by OB/GYN residencies at SUNY Upstate Medical University in Syracuse, NY and Northwell Health System/Hofstra School of Medicine in Hempstead, NY.

Dr. Dorzin says that she enjoys the variety of both obstetrics and gynecology, and has particular clinical interest in preventive medicine, gynecologic surgery, advanced laparoscopy, adolescent health and high-risk pregnancy.

“I enjoy being able to serve and educate women; providing them with tools that will help them take control of their lives and health,” said Dr. Dorzin. “I ensure when I see my patients that I couple undivided attention with sound medical judgment.”

Dr. Dorzin joins Drs. Angela Falany, Michael Hulse and Najia Lawrence. Together, they offer a full range of maternity care, from preconception counseling and infertility care to high-risk obstetrical management.

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