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Hospital Newspaper 1 Ardmore Street New Windsor NY 12553



January, 2013

Hospital Newspaper - NJ

Lou Scott Alta Bates Summit Medical Center Berkeley & Oakland, CA

Security Can Be the Best Kind of Care At AlliedBarton, we understand healthcare organizations face unique security challenges. From specially trained ambassadors like Lou Scott to Chairman and CEO Bill Whitmore, you can be assured AlliedBarton knows what it takes to meet these challenges and create a safe, secure facility. Download the FREE eBook, Potential: Workplace Violence Prevention and Your Organizational Success, for insight into how healthcare facilities can reduce security risks and stay focused on their core mission. Security that makes a difference.

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Hospital Newspaper - NJ January, 2013

XPERIENCE Transforming EDs into Centers of Excellence for 30+ Years Put EMA’s experienced emergency physicians to work for you: Unparalleled service and patient satisfaction Nationally recognized physician leaders known for clinical excellence Long-term partnerships with its emergency physicians and hospital clients Strong track record of success

The Sign of Excellence in Emergency MedicineÂŽ


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January, 2013

Hospital Newspaper - NJ

2012 HPMSNJ PERCY AWARD WINNERS The 33rd Annual Meeting of the Healthcare Planning and Marketing Society (HPMSNJ) took place on December 7th at the National Convention Center of East Windsor. Since 2008 the society's annual PERCy Awards has been presented during the HPMSNJ event. Hosting the presentation was Norman Tessell, Chair of the PERCy Awards, Immediate Past President of HPMSNJ and Director of Business Development of Atlantis Worldwide. The PERCy recognizes the best in hospital Planning, Marketing and Public Relations. Best Use of Social Media

Best Video Spot





Best Hospital Marketing and Best Use of Social Media-Large Hospital

photos provided


Hospital Newspaper - NJ January, 2013

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H.E.L.P. Program becomes popular quickly In only its first month, the Sun Homes Loans Hospital Employee Loan Program (H.E.L.P) is already gaining popularity. Why? Simple. Let’s crunch the numbers: On average, H.E.L.P. clients save between $250 and $500 per month refinancing with the enterprising initiative. Sun Home Loans and Hospital Newspaper came together to bring the emergency services community an unprecedented mortgage opportunity. Whether purchasing a new home or refinancing an existing one, the Sun Home Loans H.E.L.P. program is offered to members of the hospital community and their families. “When we introduced the program, we knew it would be popular. It’s really a no-brainer as far as the savings,” said Steve Testa, Vice President Regional Sales Manager of Sun Home Loans. “It’s exciting to get this kind of response so early in the process. That’s why we created the program, to help the hospital community. These men and women, doctors, nurses, supports staff, the list goes on and on, help us every day. This program was designed specifically for them. I’m confident that those who are currently in the market for a mortgage will discover that the Sun Home Loans Hospital Employee Loan Program exceeds what they are able to find elsewhere in the marketplace.” The H.E.L.P. program provides discounted mortgage rates designed for hospital employees and prequalifications to shop for your next home. In addition, there are many more benefits available to the emergency services community through this program – including a complimentary evaluation of your particular financial situation, and credit repair if needed. You may take advantage of these other products and services, though they are offered separately from the H.E.L.P. “The popularity of this program has us all excited and we feel the sky‘s the limit,” said Joe Belsito, Publisher of Hospital News. "It’s a mortgage opportunity that just makes sense. What I’m most proud of is who we are serving. Members of the hospital community are part of the core fabric of this country. Putting together such a unique and value-added program for them to benefit from is a great way for us to leverage our newspapers’ brand to communicate it." Sun Home Loans, a division of Sun National Bank, and Hospital Newspaper are both proud to serve the hospital community, who dedicate their lives serving the rest of us. Clients enjoy unmatched customer service and attentiveness throughout the process – from their initial inquiry – to closing. However, after closing, the staff is there to address other financial needs. Working with its own resources and Federal government programs, Sun National Bank develops solutions that open the path to home ownership. Sun National Bank provides a full-range of banking products and services, delivered by experienced bankers. Personal attention merges with world-class service and competitive products that meet the needs of today’s consumers and businesses. Sun National Bank believes that doing business in the community means being a part of it. To receive more information about the program and its benefits, Sun Home Loans has established a direct telephone number exclusively for members of the hospital community call 1-973-805-4156. When you call you will speak to a live program specialist who will discuss your needs and explain how the Sun Home Loans Hospital Employee Loan Program can H.E.L.P. you. To receive more information about the program and its benefits, contact Steven Testa at or call 973-615-9745. Sun National Bank Home Loans and Hospital Newspaper are not affiliated. All loans subject to approval. Certain conditions and fees may apply. Mortgage financing provided by Sun National Bank Loans, Equal Housing Lender.

Win an iPad! If you are a member of the hospital community, now is your chance to enter Sun Home Loans and Hospital Newspaper's contest to win a free iPad. Just to go our website at and fill in the entry form. Once you complete it, you will receive an email that requires you to confirm your email address. Once you do that you are entered. Hospital Newspaper will also be accepting applications at all conventions that it attends. A total of Five iPads will be given away so your chances to win are excellent. Sign up today to win today!

Hospital Employee Loan Program

Sun Home Loans, a division of Sun National Bank,


is proud to serve the heroes in our community who dedicate their lives to serving the rest of us: doctors, nurses and other hospital employees.

We understand that the current economic environment has created

That is why we teamed up with Hospital News to create the Hospital Employee Loan Program (HELP). With a competitive mortgage rate and discounted

the path to home ownership.

fees, this program helps our community heroes purchase new homes or refinance existing homes. Plus, the program comes with our pledge to get hospital employees in their new homes by their contract dates.

challenges to home ownership. Working with our own resources and Federal government programs we will create a solution that opens

The Hospital Employee Loan Program delivers these advantages: » A competitive mortgage rate, available specifically for hospital employees » Discounted fees » Personal service from program specialists » Our pledge to have you in your home by the contract date

COMMUNITY FOCUS Sun National Bank, a full-service provider of banking products and services, is dedicated to playing an active part in the communities we serve. We support a variety of organizations, events and programs whose goals are to make our neighborhoods a better place to live and work and improve the lives of those living around us. Hospital News is the leading provider of local news and information for doctors, nurses and other hospital staff.

Learn More To find out more about our Hospital Employee Loan Program, email or call 973-615-9745 to talk with our program specialist, Steve Testa (NMLS #460176), who will discuss your need and explain how the program could benefit you. Sun Home Loans, Sun National Bank, and Hospital News are not affiliated. All loans subject to approval. Certain conditions and fees may apply. Mortgage financing provided by Sun Home Loans, a division of Sun National Bank, member FDIC. Equal Housing Lender.

NMLS #429900


January, 2013

Hospital Newspaper - NJ




AkrimAx / Nitromist


AlliedBarton Security Services


Bergen regional medical Center






GNYHA Services


High Point Safety & insurance mgt Corp


Less Stress instructional Services


matheny School and Hospital


meadowlands Hospital medical Center 17 7

medExcel NorthWest Seminars


resource Directory

28, 30

Sheridan Healthcare


St. Peter’s University


Sun Home Loans




Trinitas regional medical Center


U.S. Navy



Let Hospital Newspaper make 2013 your best year! Thanks to our valued readers, online members and clients, 2012 was our most successful year! Hospital Newspaper readership has grown and our new digital edition has expanded across the industry! Our advertisers have helped hundreds of consumers find the best hospitals for medical care and rehabilitation and guided hundreds of seniors to the best care at home and the best facilities when the next step is needed! Our career center has guided loyal readers to the best educational and career opportunities in the industry! Hospital Newspaper has promoted major conventions and special events throughout the year!

We wish you the very best Holiday season and a Healthy New Year! Please share your stories with us: Jim can be reached at 845-534-7500 ext. 219 and via email at




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January, 2013

Hospital Newspaper - NJ

Ask An Expert Christopher J. O’Connor Executive Vice President, GNYHA Ventures, Inc., President, GNYHA Services, Inc. and President, Nexera, Inc.

AIM for Cost, Quality, Outcomes and Achieve a Top-Performing Supply Chain As the passage of health reform and the re-election of President Obama have affirmed, healthcare is at a pivotal crossroads. America cannot continue to stay its current course of ever-rising costs with a fragmented delivery system. Supply chain will be critical to the transformation of healthcare. However, these professionals first need to take control of the intersection of cost, quality, and outcomes in order to help hospitals and physicians shift to a patient-centered service model with performance-based reimbursement. To do this, supply chain executives must broaden their focus from prices to collaborative, evidence-based procurement processes. So, how can supply chain professionals drive institutional goals and patient outcomes? At GNYHA Services, we use a customized program called AIM. AIM represents our service model, a four-step custom strategy to: 1. 2. 3. 4.

Align your organization’s broadest strategic objectives. Identify the GNYHA Services business solutions that can be used to achieve those objectives. Implement strategic solutions as your supply chain partner. Manage your results to ensure long-term success.

Each GNYHA Services member is assigned a dedicated service team to explore organizational goals, the supply chain’s involvement in cost, quality, and patient outcomes, and the ways we can support this role while elevating supply chain performance. The service teams use our exclusive AIM strategy to assess needs and develop a strategic action plan to help achieve goals. Supply chain management can reach its potential only when it is part of an institution-wide strategy. Forward-looking supply chain managers understand the big-picture implications of their decisions. By working with your GPO to align supply chain management with financial goals, hospital procurement departments can go beyond comparing contract pricing to guide their organizations toward aggressive cost-saving and patient care targets. Once savings goals have been decided, hospital supply chain professionals can engage their GPO partners in implementing and executing programs (like blood management, value analysis, or committed-volume strategies) to achieve organizational objectives. Sweeping healthcare reform has placed added pressure on hospitals to lower costs while improving quality and outcomes. The supply chain presents a powerful opportunity to thrive under these growing challenges. But to do so, the supply chain needs to be empowered—and needs to take the initiative—to align purchasing decisions with system-wide hospital goals. For this to happen, fiscal and quality goals should be integral to every organization’s culture, with everyone working toward the same cost, quality, and outcome objectives. This collaborative environment sets the stage for the supply chain of the future to transcend departments and engage all hospital staff in evidence-based, outcome-focused strategic savings. Christopher J. O’Connor is Executive Vice President of GNYHA Ventures, Inc., the for-profit arm of the Greater New York Hospital Association, and President of two GNYHA Ventures companies: GNYHA Services, Inc., an acute care group purchasing organization, and Nexera, Inc., a healthcare consulting firm. Mr. O’Connor is Chair-Elect of the Association for Healthcare Resource & Materials Management (AHRMM).

Hospital Newspaper - NJ January, 2013

$ Ready. AIM. Fire. No two health systems are alike. That’s why GNYHA Services has designed AIM (Align, Identify, Implement, Manage), an exclusive service strategy customizable to meet each hospital’s unique needs and produce long-lasting, meaningful results. GNYHA Services uses AIM to align hospitals’ organizational goals and identify and implement the best business solutions to meet their needs—such as benchmarking technology, blood management, clinical savings analyses, expense management solutions, and much more. Hit your mark for 2013. Call GNYHA Services at (212) 246-7100 to learn more about AIM today.

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January, 2013

Hospital Newspaper - NJ


Mir acles of Rehab Katherine Gaudio in her walker, assisted by physical therapist Erin Meineke

From Wheelchair to Walker: A Surprising Breakthrough By Sanford Josephson While virtually all of the Matheny Medical and Educational Center’s students and patients spend most of their lives in wheelchairs, they often spend time in a walker during physical therapy to increase their endurance and strengthen their muscles. Occasionally, a surprising breakthrough occurs during these physical therapy sessions. Katherine Gaudio is an 11-year-old student who decided she didn’t want to return to her wheelchair and expressed her desire to make her posterior walker her main mode of mobility. “She is her own best advocate,” said Erin Meineke, DPT, her school physical therapist. “She made her opinion known that this was really going to be good for her.”

Katherine has used the walker on trips to Wal-Mart and to her Girl Scout meetings. And she’s also riding a regular bicycle with training wheels. She can safely transfer in and out of her walker, with supervision; and she can also safely sit in a regular chair, without a safety belt, in class or in the dining room or her bedroom.

Walking Always Goal .“Walking is something the therapists are always working on,” said Meineke, “but it’s usually walking with an aide. Katherine didn’t want to be done walking after a therapy session. The whole transition actually took a couple of years, but she has always been a strong advocate for herself. She broke all the rules.” Physical therapy at Matheny provides therapeutic interventions to help Tapping Energy The hardest adjustment for Katherine, according to her therapist, was tran- students and patients attain their optimal level of function. PTs take a personal sitioning from a physical therapy session to utilizing the walker all day long. and client-specific approach to addressing each person’s individual needs. “When she would walk in therapy for 30 to 45 minutes,” Meineke ex- Students and patients may receive services such as gait training, balance trainplained, “she didn’t realize how much energy it would take to use it all day ing, mobility training and therapeutic exercise. They may also benefit from long. In the beginning she was very tired. She’s had her walker now for standing, adaptive tricycle riding and a variety of alternate position programs three months, and she’s stronger and more confident and not as tired at the developed by the therapy staff. Matheny is a special hospital and educational end of the day.” facility in Peapack, N.J., for children and adults with developmental disabilities.

Hospital Newspaper - NJ January, 2013

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education Dr. Linda A. Carrick honored by UMDNJ School of Nursing Linda A. Carrick, PhD, RN, CNAA, Senior Vice President for Patient Care Services and Chief Nursing Officer for the Kennedy Health System, has been awarded the Visionary Leader Award by UMDNJ-School of Nursing. A member of Kennedy’s leadership team since 2006, Dr. Carrick was honored for “advancing the profession of nursing through outstanding contributions in healthcare, education, community and public service� at a special event held December 10th, at Mayfair Farms in West Orange, NJ. Dr. Carrick – who oversees Kennedy’s Department of Nursing and Clinical Operations at its three acute care hospitals and numerous ambulatory facilities – also has leadership responsibilities in the areas of patient care outcomes management, service excellence and patient safety.

Dr. Carrick has held numerous academic and leadership positions in her more than 30 years in nursing. Prior to joining Kennedy, she had served as Associate Director of Healthcare/Nursing Administration and Health Leadership at the University of Pennsylvania Graduate School, as a Healthcare Consultant for the Genesis Healthcare Corporation of Kennett Square, PA, and as Regional Chief Operating Officer for Mercy Health System. Dr. Carrick also maintains an adjunct faculty position at the University of Pennsylvania School of Nursing. She presently serves on the Nursing Advisory Board of Rutgers University School of Nursing and Gannett Regional Healthcare. Dr. Carrick is also a Wharton J&J Nurse Executive Fellow and served as a Faculty Mentor for the 2006 - 2011 National Maternal-Child Health Nursing Leadership Acad-


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emy. In December 2007, she was named one of the New Jersey Institute for Nursing’s “Divas and Dons,� for her extraordinary impact on the profession and the community. In 2011, Dr. Carrick was named one of South Jersey’s “Superwomen� by South Jersey Magazine, in recognition of her many professional accomplishments. Dr. Carrick earned both her Doctorate degree in Healthcare Administration and her Master’s of Science degree in Nursing from the University of Pennsylvania. She resides in Philadelphia, PA. Kennedy is a health services delivery system serving the communities of southern New Jersey. Kennedy University Hospital is the Principal hospital of the University of Medicine & Dentistry of New Jersey – School of Osteopathic Medicine. Kennedy is also a member of the Penn Cancer Network.


January, 2013

or nfo f i t s e Lat s and

nursdeents stu

Hospital Newspaper - NJ

Nurse’s Viewpoint

By Alison Lazzaro

Hospital Newspaper Correspondent

New Year's Resolutions for Nurses It is becoming a yearly tradition. January rolls around and we find ourselves making the same commitments. Your list might include the usual New Year's resolutions to lose weight or to eat less chocolate. Maybe you decide this time you will raise your grade point average. Perhaps you promise that you will go to bed earlier or spend less time watching television. Or maybe you decided that somehow you will make more time to get to the gym. This year, I'd like to propose to you an opportunity to switch up your routine New Year's Resolutions. Nurses can individually make contributions to the profession and strengthen patient care. With that in mind, why not make your New Year's Resolutions making a promise to becoming a better professional? You might be wondering how you can make easy changes to develop your profession. First off, if eligible, you can commit to getting a certification this year. For instance, if you are an oncology nurse, take the Oncology Certification in Nursing. This validates your competencies in your chosen field. Moreover, your employer may recognize this achievement in your evaluation and it improves your facility's Magnet status. Another great resolution could be to read a scholarly nursing journal article weekly. Without taking up a lot of your time, this resolution will make you well-versed in evidence based practice nursing. This could help you in your practice and with patient education. Many articles are available for free on the internet and discuss a variety of subjects. For a fun way to improve the nursing profession, grab a few of your best nursing friends and register to attend a convention anywhere in the world. You can learn about new developments in nursing through speakers and visit the exhibit hall. This can be a way to meet other nurses, travel, and bring your knowledge back to your facility. Another great way to advance our health care is to make a resolution to brush up on literature for the latest medications. Keep yourself up to date on new drugs that are always changing. Resolutions do not have to be extensive, but adding a few of these changes can make you a better nurse for your patients and for your workplace. Remember that you need to care for your own health as well as others. Make sure you find ways to help relieve stress. Add some exercise to your day easily by taking the stairs at work. Try to stay positive and smile more. Rather than facing the whole year head on, try to at least make a commitment to a new resolution each Monday. In this case, each week you can feel like you are starting fresh. Instead of saying you will lose those last 5 pounds for the 10th year in a row, try adding one of these nursing related promises to your routine and you will enhance nursing.

Hospital Newspaper - NJ January, 2013

education Community Medical Center to host two education programs for patients with diabetes The Center for Diabetes at Community Medical Center offers an American Diabetes Association certified Self Management Series for individuals with diabetes. This education series is taught by certified diabetes educators and consists of four two-hour classes. Convenient morning, afternoon or evening sessions are offered and classes are available on an ongoing basis. Participants learn everything they need to know about diabetes, how it affects the body and how to manage their disease. In addition, participants will gain an understanding of their blood sugar numbers and their medicines and helpful nutrition information. The Center for Diabetes also offers a ‘Diabetes Refresher Class—Making Sure You’re on the Right Track.’ This program is designed to help anyone who has already taken the Diabetes Self Management Series, but would like more information and the opportunity to review what was learned in class. The Diabetes Refresher Class meets one time for two hours. It includes hands on demonstrations of portion sizes and label reading. Learning how to estimate carbohydrate portions of restaurant foods is also reviewed. Updates on glucose meter accuracy and exercises that can be done anywhere at any time are also discussed. Daytime and evening classes are available. A prescription from a physician is required in order for either of these classes to be covered by insurance. Participants are welcome to bring someone with them to the classes. All classes are held at 591 Lakehurst Road in Toms River. Convenient free parking is available. Registration is required to attend. Please call 732-349-5757 for further information and upcoming dates and times of classes. The Center for Diabetes at Community Medical Center offers education and support to people, of all ages, with diabetes and to those who care for and about them. Nurses and Dietitians, who are Certified Diabetes Educators, provide educational sessions to meet the needs of all those withdiabetes. Education includes a Self Management Series, monthly Support Groups, a Support Group for Parents of Children with Diabetes, an Insulin Pump Support Group, Individual Education for diabetes management, Weight Management and Community Education. For more information or to register, please call 732-349-5757.

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January, 2013

Hospital Newspaper - NJ

career guide Career OppOrtunity!

Rehabilitation Counselor NYC. Master Degree required Send resume to:

212-371-2250 Back & Body Medical Care PC.

UNIQUE RECRUITMENT OPPORTUNITY Hospital Newspaper believes that high school students should be informed about potential healthcare careers. Special career sections will be placed in your local high schools, medical schools, colleges and nursing schools.

This is your opportunity to display opportunities for: Faculty/Physician Nursing Administrative Support Positions Clinical Care Medical Assistants Counselors Medical Imaging Dieticians

Please contact Jim Stankiewicz for more information. tel: 845-534-7500 x219

When Patients Turn to You, You Can Rely on AdCare® Career Opportunities at AdCare® Hospital, Worcester, MA Hospitalist. Full Time to offer medical care in inpatient and outpatient settings in addiction medicine. The qualified candidate must be a Massachusetts licensed physician or eligible for a license in Massachusetts, and ABAM or ASAM certified or eligible. Director of Nursing. FT will be responsible for providing leadership and direction to the development, implementation and evaluation of processes which ensure compliance with DPH, Joint Commission and other regulatory standards, improves quality and safety of patient care, facilitates and enhances professional nursing practice and ensures the highest of quality customer service in accordance with AdCare's Standards of Excellence. BSN required; Master's preferred; current RN license by the MA Board of Nursing. A minimum of 3 years in a nursing administrative/supervisory role; 3/more yrs. behavioral health experience. Experience using electronic medical record systems. Case Manager/Discharge Planning Full Time: To ensure, through direct coordination, individualized quality treatment to patients at the most appropriate level of care that safely addresses the acuity of the patient through the expedient, cost effective application of services and insurance benefits. Rounds with the treatment team daily. Qualified candidate must be familiar with managed care reviews for continued stays; knowledge of discharge planning; psych and substance abuse knowledge preferred. Education: Licensed RN preferred, LICSW acceptable. Two years utilization experience preferred. Skills: Ability to organize, manage and review appropriate treatment from both Managed Care and Utilization Review perspective. Ability to problem solve and coordinate treatment from a benefits perspective. Strong interpersonal skills. Familiarity with insurance benefits and national levels of criteria of care. Ability to document using electronic systems (EMR) and Microsoft Applications. For further job information and to apply please see AA/EEOC AdCare Hospital of Worcester Inc. is a 114 bed hospital equipped to meet the treatment needs of alcohol and drug abuse patients at all stages of addiction. AdCare’s staff is comprised of the region’s most highly qualified. At the heart of our acute care philosophy is recognition of the need to stabilize acute symptoms and to motivate the patient to continue receiving substance abuse treatment post inpatient discharge. AdCare is accredited by the Joint Commission and has been recognized as one of the 100 Best Treatment Centers for substances in the United States.


Visit our website to view current employment opportunities

Hospital Newspaper - NJ January, 2013

careers Mt. Laurel resident and Lourdes Cardiologist earns Board-Certification in Cardiology Mt. Laurel resident Hafeza Shaikh, DO, who recently joined the cardiology team at South Jersey Heart Group, an affiliate of Lourdes Cardiology Services, became board-certified in Cardiology. This certification is in addition to her being board-certified in Internal Medicine, Echocardiography and Nuclear Cardiology. Dr. Shaikh is the only female cardiologist on staff with South Jersey Heart Group. She has a special interest in women’s cardiovascular disease. Her other areas of interest include vascular sonography, preventative health and echocardiography. Born and raised in Flemington, New Jersey, Dr. Shaikh completed her undergraduate degree at Rutgers-New Brunswick in 2002 before graduating from New York College of Osteopathic Medicine with a degree in medicine in 2006. In 2009, she completed her residency in internal medicine at Lenox Hill Hospital, a major center for cardiac care in New York City. That same year, she entered the University of Medicine & Dentistry of New Jersey -- School of Osteopathic Medicine (UMDNJ-SOM)/ South Jersey Heart Group Cardiology Fellowship Program, of which she graduated last month. For the past two years, she has volunteered her time at the Osborn Family Health Center across from provided Our Lady of Lourdes Medical Center, providing noninvasive cardiac testing including stress testing and echocardiography for the underserved of Camden. Dr. Shaikh is a member of the American College of Cardiology, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the American College of Physicians and the American College of Osteopathic Internists.

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January, 2013

Hospital Newspaper - NJ


H of the Month

Meadowlands Hospital Medical Center

The Command Center worked what could be called miracles coordinating events especially when the electricity and computers went down. This was no easy task but it was handled professionally. Considering the circumstances, operations went along seamlessly. Hurricane Sandy affected 24 states, including the entire eastern seaboard from Florida to Maine and west across the Appalachian Mountains to Michigan and Wisconsin, with particularly severe damage in New Jersey and New York. Its storm surge hit New York City on October 29, flooding streets, tunnels and sub-

way lines and cutting power in and around the city. Damage in the US is estimated at over $63 billion. During the heaviest storms of Hurricane Sandy, MHMC saved the life of a 38-year-old Trinidadian male. The patient, a local Secaucus resident, sought medical attention in the emergency room, presenting complaints of severe and crushing chest pain, vomiting, and sweating. During this time, all other hospitals in Hudson County were closed and patients were being diverted to MHMC. Despite the Emergency Department being overwhelmed, it turned out to be this patient’s lucky day. A

photos provided

During Hurricane Sandy and her aftermath, we heard and – unfortunately– witnessed several tragic stories about the devastation left in the storm’s wake. It will take months to recover. But we will rise again. We couldn’t do it without good people, courageous first responders and selfless citizens. We couldn’t do it without hospitals such as Meadowlands Hospital Medical Center. To borrow a phrase from the facility, every great accomplishment is only the sum of its parts. For Meadowlands Hospital Medical Center, that couldn’t be any closer to the truth. During Hurricane Sandy every medical and non-medical staff member committed themselves to serving those who needed help, swapping between roles like handing out sandwiches to wheeling beds room to room. There was no time to waste. Every employee of the hospital from the administration to the medical staff rolled up their sleeves and helped patients on the front lines, helping direct traffic and even lending a hand to help patients make it from the fierce winds and rain outside. Because of the actions of every able-bodied Physician, Accountant, Laboratory Operator, Maintenance Man and Security Guard and many others acting as runners, sitters, cafeteria volunteers and lifters, what could have been a chaotic and desperate scene turned out to be an extremely well coordinated operation. Don’t forget the EMS team and their ongoing coordination with the ER department to make sure everyone arrived here safety and swiftly.

Cardiologist, Dr. Peter Tsenovoy, happened to be helping facilitate patient care in the ER at a time of significantly increased activity. The patient's history was promptly taken and an electrocardiogram ordered. Minutes later, it became evident that the patient was suffering from a deadly ST segment elevation myocardial infarction (STEMI), which occurs when a coronary artery is totally occluded or blocked by a clot. This prompted the need for additional, immediate medical care. Because of the severe flooding and road blocks, arrangements were made for the patient to be airlifted

by helicopter to a nearby facility with cardiac stenting capabilities. The time from diagnosis of the heart attack to treatment with balloon angioplasty - "door to balloon time" - fell just under 90 minutes. Even in the midst of the worst hurricane in American history, MHMC was able to provide the patient with care consistent with national cardiac guidelines. Even during the wrath of Sandy, there was never a doubt that this operation would be a resounding success -- thanks to a dedicated, tireless and hard-working MHMC staff coming together as one.

Hospital Newspaper - NJ January, 2013

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January, 2013

Hospital Newspaper - NJ

News in Emergency Medicine

patella dislocations among females in an ED database. And contrary to the hypothesis, gender differences decreased after puberty. Additionally, the occurrence of patellar dislocations in females did not increase over the study time period.

Allegra and Salo presents Research at American College Emergency Physicians (ACEP) John Allegra, MD, PhD, FACEP, and David Salo, MD, PhD presented at the 2012 American College of Emergency Room Physicians scientific assembly, held Oct. 8-11 in Denver.

Dr. Allegra and Dr. Salo are partners of Emergency Medical Associates and attending emergency department physicians with Morristown (N.J.) Medical Center. Dr. Allegra is the chairman of the Emergency Medical Associates Research Foundation.

Drs. John Allegra and David Salo presented "Gender Differences in the Occurrence of Patellar dislocations.” The goal was to examine gender differences in the occurrence of patella dislocations in a large emergency department database. They hypothesized there would be an increased occurrence of dislocations in females, and as a result of gender specific musculoskeletal differences after puberty, the gender differences would be higher after puberty. The study found a small but statistically significant greater occurrence of

education pathways, traditions, hierarchies, job expectations, and regulations. Dr. Stuhlmiller examined how to measure quality, and agree on approach to achieve total quality management.

Stuhlmiller gives Lecture at 2012 Air Medical Transport Conference David Stuhlmiller, MD, FACEP, CMTE, lectured at the 2012 Air Medical Transport Conference, held Oct. 22-24 in Seattle. Dr. Stuhlmiller presented "TQM: Total Quality Management for Dummies (From One).” The goal of the presentation was to assess the challenges of achieving “total quality management” for the Commission on Accreditation of Medical Transport Systems. There are multiple facets that are instrumental when assessing quality control of air medical transport. Each discipline has its own

Dr. Stuhlmiller is a partner of Emergency Medical Associates and chairman of the department of emergency medicine at Newton Medical Center, Newton, N.J. About Emergency Medical Associates Emergency Medical Associates (EMA), headquartered in Parsippany, N.J., is a physicianled, physician-owned medical practice that specializes in emergency, hospitalist and urgent care medicine. Dedicated to providing exceptional solutions for the measurable success of our hospital partners, EMA is recognized for clinical excellence, quality service and sustained improved patient satisfaction. For more information, please visit, or

Calello presents Research at North American Congress of Clinical Toxicologists (NACCT) Diane P. Calello, MD, FAAP, presented several symposia at the North American Congress of Clinical Toxicology at Cosmopolitan Hotel in Las Vegas Oct. 1- 6. Dr. Calello organized and moderated the pre-meeting symposium entitled "Vanity and Vice: Toxicology in the Sin City.” She presented "Epidemiology of Pediatric Poisoning Fatalities: Response from Pediatric Toxicologists" and also moderated the Year in Toxicology symposium on the revised Center for Disease Control guidelines for asymptomatic pediatric lead poisoning. Dr. Calello is a board-certified pediatrician, pediatric emergency physician and medical toxicologist. She is an attending physician with Morristown Medical Center and Goryeb Children’s Hospital, both in Morristown, N.J, and a medical toxicologist at the New Jersey Poison Information and Education System (NJPIES).

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Details: Provide us 40-80 words in a Word document, 1 photo, website url, phone, contact information and address.

Contact: Jim Stankiewicz - General Manager Tel: (845) 534-7500 Ext. 219 Fax: 845-534-0055 E-mail:



Hospital Newspaper - NJ January, 2013

Page 19

For the Best in Cancer Care

Look to a Comprehensive Cancer Center that is first to offer the latest technology…

Clarissa Henson, MD Chair of Radiation Oncology

Look to Trinitas Comprehensive Cancer Center. eing first with ground breaking technology is a hallmark of Trinitas Comprehensive Cancer Center, which was the first cancer center in New Jersey to provide patients with the Varian Trilogy radiation therapy system in 2005. Trilogy’s ultra-precise robotics accurately tracks and adjusts for tumor movements at the moment of treatment, then targets cancer and neurological lesions with sub-millimeter accuracy. No other facility in New Jersey has more experience with Varian Trilogy than Trinitas.


Trinitas was also the first in New Jersey to offer women the new Accuboost radiotherapy technology – a highly effective, non-invasive treatment for breast cancer that is more accurate than standard breast radiotherapy. In addition, Trinitas is a leader in radiosurgery – which uses precisely-focused beams of radiation to treat tumors anywhere in the body. Ground breaking technology, and the expertise to use it - that’s the Trinitas Comprehensive Cancer Center.


Behavioral Health • Cancer Care • Cardiology • Diabetes Management Maternal & Child Health • Renal Services • School of Nursing • Senior Services Sleep Disorders • Women’s Services • Wound Healing & Hyperbaric Medicine

Trinitas Regional Medical Center is a Catholic teaching institution sponsored by the Sisters of Charity of Saint Elizabeth in partnership with Elizabethtown Healthcare Foundation.


January, 2013

Hospital Newspaper - NJ


Nursing Home of the Month

Long Term Care at Bergen Regional Medical Center 230 East Ridgewood Avenue Paramus, NJ 07652 201.967.4073

Quality of Care and Quality of Life For more than 80 years, families have trusted Bergen Regional Medical Center to provide comprehensive, high-quality long term care services for their loved ones. As a full service, accredited medical center, Bergen Regional provides nursing care, as well as access to specialized onsite physicians 24 hours a day, 365 days a year. Because the facility has an on site acute care hospital, if long term care residents experience medical emergencies day or night, the comprehensive medical care they need is always just an elevator ride away. The Long Term Care Division at BRMC is accredited by the Joint Commission. Less than 6% of LTC facilities nationwide pursue and receive Joint Commission accreditation. The Long Term Care Division at Bergen Regional Medical Center is the largest licensed nursing home in the state of New Jersey. Tours are given 7 days a week. Valet parking is available. Specialty Services The dedicated staff of professionals at BRMC provides the highest level of care to our residents and helps to create a home- like atmosphere to serve each individual. In addition to our talented and professionals staff, we are proud to offer the following specialty services: photos provided

• • • • • • • • • • • • • • • • • • • • • •

Rehabilitation services, including physical therapy, occupational therapy and speech therapy In-house respiratory therapy services 12-bed ventilator unit Surgical care Tracheostomy care Professional dietitians and chefs who can accommodate most food preferences and therapeutic diets Hospice services which, if elected, is provided in addition to the care offered by our professional nursing, social work and other staff Several high medical acuity units are available. Intravenous therapies, gastrostomy tube feeding and advanced respiratory support services are available A comprehensive wound care program Respite program Secure Alzheimer/Dementia units Multi-faith pastoral care provided at bedside and in our interfaith chapel. A personal care salon on site. Services offered in the salon or in the privacy of a resident’s room Diversified Recreational Therapy activities for all functional levels including horticultural therapy in the BRMC Greenhouse, arts and crafts, music programs, cooking programs, variety shows, dances, birthday parties, and many other dynamic interactions designed to allow our residents to enjoy life to its fullest Regular community outings including trips to movie theaters, restaurants, shopping centers, parks, sporting events and museums Flat Screen TV’s and Wii Entertainment Systems in dayroom areas Greenhouse Library Game room Kosher meals provided upon request Dedicated Korean Program that meets the cultural needs of our Korean community

Hospital Newspaper - NJ January, 2013

Page 21

Johns Hopkins surgeons implant first brain ‘Pacemaker’ for Alzheimer’s Disease in United States as part of a clinical trial designed to slow memory loss Researchers at Johns Hopkins Medicine in November surgically implanted a pacemaker-like device into the brain of a patient in the early stages of Alzheimer’s disease, the first such operation in the United States. The device, which provides deep brain stimulation and has been used in thousands of people with Parkinson’s disease, is seen as a possible means of boosting memory and reversing cognitive decline. The surgery is part of a federally funded, multicenter clinical trial marking a new direction in clinical research designed to slow or halt the ravages of the disease, which slowly robs its mostly elderly victims of a lifetime of memories and the ability to perform the simplest of daily tasks, researchers at Johns Hopkins say. Instead of focusing on drug treatments, many of which have failed in recent clinical trials, the research focuses on the use of the lowvoltage electrical charges delivered directly to the brain. There is no cure for Alzheimer’s disease. As part of a preliminary safety study in 2010, the devices were implanted in six Alzheimer’s disease patients in Canada. Researchers found that patients with mild forms of the disorder showed sustained increases in glucose metabolism, an indicator of neuronal activity, over a 13-month period. Most Alzheimer’s disease patients show decreases in glucose metabolism over the same period. The first U.S. patient in the new trial underwent surgery at The Johns Hopkins Hospital, and a second patient is scheduled for the same procedure in December. The surgeries at Johns Hopkins are being performed by neurosurgeon William S. Anderson, M.D. “Recent failures in Alzheimer’s disease trials using drugs such as those designed to reduce the buildup of beta amyloid plaques in the brain have sharpened the need for alternative strategies,” says Paul B. Rosenberg, M.D., an associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, and site director of the trial’s Johns Hopkins location. “This is a very different approach, whereby we are trying to enhance the function of the brain mechanically. It’s a whole new avenue for potential treatment for a disease becoming all the more common with the aging of the population.” Some 40 patients are expected to receive the deep brain stimulation implant over the next year or so at Johns Hopkins and four other institutions in North America as part of the ADvance Study led by Constan-

tine G. Lyketsos, M.D., M.H.S., a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, and Andres Lozano, M.D., Ph.D., chairman of the neurology department at the University of Toronto. Only patients whose cognitive impairment is mild enough that they can decide on their own to participate will be included in the trial. Other sites performing the operation, supported by the National Institutes of Health’s National Institute on Aging (R01AG042165), are the University of Toronto, the University of Pennsylvania, the University of Florida, and Banner Health System in Phoenix, Ariz.

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The medical device company, Functional Neuromodulation Ltd., is also supporting the trial. “We are very excited about the possibilities of this potentially new way to treat Alzheimer’s,” says Lyketsos, director of the Johns Hopkins Memory and Alzheimer’s Treatment Center in Baltimore. experimental for While Alzheimer’s patients, more than 80,000 people with the neurodegenerative disorder Parkinson’s disease have undergone the procedure over the past 15 years, with many reporting fewer tremors and requiring lower doses of medication afterward, Lyketsos says. Other researchers are testing deep brain

stimulation to control depression and obsessive-compulsive disorder resistant to other therapies. The surgery involves drilling holes into the skull to implant wires into the fornix on either side of the brain. The fornix is a brain pathway instrumental in bringing information to the hippocampus, the portion of the brain where learning begins and memories are made, and where the earliest symptoms of Alzheimer’s appear to arise. The wires are attached to a pacemaker-like device, the “stimulator,” which generates tiny electrical impulses into the brain 130 times a second. The patients don’t feel the current, Rosenberg says.

For the trial, all of the patients will be implanted with the devices. Half will have their stimulators turned on two weeks after surgery, while the other half will have their stimulators turned on after one year. Neither the patients nor the doctors treating them will know which group gets an early or later start. “Deep brain stimulation might prove to be a useful mechanism for treating Alzheimer’s disease, or it might help us develop less invasive treatments based on the same mechanism,” Rosenberg says. For more information: /psychiatry/specialty_areas/memory_center/research.html

Congratulations! BRMC named 2012 NJ BIZ Healthcare Heroes Nursing Home of the Year

2012 g Home Nursin ea r of the Y


Quality of Care and Quality of Life For more than 80 years, families have trusted Bergen Regional Medical Center to provide comprehensive, high-quality long term care services for their loved ones. Access to specialized on-site physicians 24 hours a day, 365 days a year. Because our facility has an on-site acute care hospital, if our residents experience medical emergencies day or night, comprehensive medical care is always just an elevator ride away. Our Long Term Care Division is accredited by the Joint Commission. Less than 6% of LTC facilities nationwide pursue and receive Joint Commission accreditation. Many specialty services are available: Rehabilitation, Horticultural Therapy, Multi-Faith Pastoral Care, Pet Therapy, Diversified Recreational Therapy, Respite Care

201 967 4073 201.967.4073 230 East Ridgewood Avenue Paramus, New Jersey, 07652


January, 2013

Hospital Newspaper - NJ

Saint Peter’s launches 2-plus-year-long project to expand, modernize emergency department Pediatrics area one of largest in N.J. include a redesigned visitors’ area, a new area for walk-in patients, and a new and expanded entrance for ambulances that will also increase ambulance parking. The first stage of the project is targeted for completion in the early part of 2013. Phase 2 This portion of the project will be devoted to the completion of pediatric and adult “fast-track” rooms. Phase 2 will also create additional treatment beds.


Saint Peter’s University Hospital has launched a two-and-half-yearlong building project to enlarge its emergency department and expand emergency services. When completed the emergency department will feature one of the largest pediatrics emergency department in New Jersey, special treatment bays for women’s health, acute care and rapid-treatment patients, a geriatricfriendly design, and a redesigned entranceway for ambulances, among numerous significant enhancements.

“When completed, the Saint Peter’s emergency department will have grown in size from its current 18,000 square feet to approximately 29,000 square feet,” said Michael Hochberg, M.D., chairman, department of emergency medicine, Saint Peter’s Healthcare System. “The new emergency department will be large enough to easily treat 70,000 to 75,000 patients a year. This means that the new, larger ED will be big enough to meet the needs of the hospital – and its surrounding community – for many years to come.”

Work will be completed in five separate stages and no service will be disrupted at any time, Hochberg said, noting that as each stage is completed those newly designed areas will be open and operational immediately. Construction will proceed as follows: Phase 1 Saint Peter’s will construct a new and expanded pediatrics emergency department as well as a new front entrance for the emergency department. The new front entrance will

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Phases 3, 4 and 5 Each of these stages will expand and enhance the main ED. Key improvements are: - Additional treatment space will be added in each phase of operations. - The renovations will create three treatment “pods,” each of which will focus on separate treatment areas: acute care: women’s health, and rapid-treat patients. The acute-care bay will be designed to treat emergency situations such as heart attack and stroke. The women’s health pod will respond to conditions such as early pregnancy complications and OB/GYN emergencies. The rapid treatment section will provide accelerated services such as IV fluids and brief imaging, enabling patients to return home quickly and safely. The new ED will hold 56 beds the vast majority of those four-wall private rooms. A small number of others – so-called “curtained rooms” – will be in the fast-track area.

What are some of the special features and advantages of the new ED? - The pediatrics ED, one of the largest in N.J., will feature 14 beds plus minor care. - The entire emergency department – from equipment to flooring – will be brand-new. - The emergency department will be “geriatric friendly,” meaning it will feature softer lighting, softer colors, less noise, more comfortable mattresses, and easier to use beds, and the entire layout and design will feature greater accessibility for older patients. - The floor plan will enhance the process of more rapid and efficient patient care. What are some of the other key takeaways? - Planning and design of the emergency department was in the works for two years. - No treatment space will be lost during any phase of the construction process. - Patient care will remain unaffected throughout each stage of construction. - Construction walls – or “noiselimiting walls”- will hide work from patients. As a result, the transition to a new emergency department will appear seamless to patients. For more information about Saint Peter’s Healthcare System, please visit or call 732-745-8600.

Hospital Newspaper - NJ January, 2013


Full Circle 2012: Unexpected Art

photos provided

Matheny president Steve Proctor presents a special plaque to Erica Schonhorn Gorman and Max Gorman. Arts Access artist Michael Martin with, from left, Anthony and Sarah Plesh, Michael’s parents Alan and Linda Martin, and Michael’s aunt Virginia Carlson. Behind them is Michael’s untitled pigment print.

When Robert Schonhorn was president of the Matheny School and Hospital (now the Matheny Medical and Educational Center) in 1993, he posed the question: “Can people with disabilities create fine art?” Schonhorn, who died earlier this year, recognized the creative possibilities that were trapped inside the bodies of people with disabilities. Nineteen years after he posed that question, it is clear that the answer is an unqualified “Yes!” Full Circle 2012: Unexpected Art, the annual celebration of Matheny’s Arts Access Program, was held on Saturday, December 1, in the Robert Schonhorn Arts Center

and was dedicated to the man, who along with then medical director Gabor Barabas MD, conceived of and created this unique program, which enables people with disabilities to create fine art, assisted by professional artist-facilitators. Matheny is a special hospital and educational facility in Peapack, NJ, for children and adults with medically complex developmental disabilities. “My father would have been so proud,” said Erica Schonhorn Gorman, Schonhorn’s daughter, as she and his grandson Max Gorman, accepted a special plaque from Steve Proctor, Matheny president and CEO. Guests at Full Circle attended

Choreographer Philip Fisher, center, with volunteer Michael Berberich and dance facilitator Corey Bliss.

a visual arts exhibit, curated by Madison-based artist Dan Fenelon, and a reception in the gallery before viewing a stage presentation that included a video tribute to Schonhorn as well as several examples of prose, poetry, drama and dance created by Arts Access artists. A dessert reception followed. Corporate sponsors were: The Provident Bank Foundation, Day Pitney, LLP, Affinity Federal Credit Union and The Angeletti Group. Food and beverage donors were: Café Azzurro and cocoLuxe fine pastries, Peapack; Gladstone Tavern, Gladstone; 3West, Basking Ridge; and Village Office Supply, Somerset.

Dancer/choreographer Dion Alston, performing “Every Teardrop is a Waterfall” with dance facilitator Elizabeth Zelesny.


January, 2013

Hospital Newspaper - NJ

Consultants Corner

Bulimia: The Secret Disease By Stuart Koman, Ph.D.

"I know this rigidity, this feeling that if you eat one thing that's wrong, you're full of self-loathing and then you punish yourself, whether it's one cookie or a stick of gum that isn't sugarless, that I would sometimes beat myself up for that." Katie Couric, ABC News In some ways, bulimia nervosa is the most insidious of the three major eating disorders. Bulimia is a secret disease. Because bulimics feel shame about their disorder, they typically try to hide it. It is not unusual for those who have it to hide the condition even from their immediate family for years. They can hide it, because individuals with bulimia look very much like everyone else. A person with bulimia may have a normal body weight and may look as healthy as Katie Couric, who recently talked about her struggles with bulimia during her talk show. Conversely, a patient with anorexia nervosa is typically thin to the point of looking starved and those with bingeeating disorder are often, although not always, obese. While it’s been many years since Ms. Couric had bulimia, the disorder had a lasting impact on her, as it does on millions of others. The definition of bulimia is evolving, but symptoms include regularly binging by eating an excessive amount of food, feeling a lack of control over the binging and compensating to prevent weight gain by “self-induced vomiting; misuse of laxatives, diuretics or other medications; fasting, or excessive exercise,” according to the American Psychiatric Association. Possibly Deadly Perhaps because those with bulimia look like everyone else, there is a tendency for some not to take bulimia seriously. Yet, like other eating disorders, it can be deadly. Purging can result in the loss of minerals the body needs to function properly, resulting in an electrolyte imbalance. This imbalance can result in irregular heartbeats, increasing the potential for heart failure. Those who use drugs to stimulate vomiting, bowel movements or urination also increase the risk of heart failure. Frequent vomiting can cause other health problems, such as inflammation or tearing of the esophagus, and swollen glands. Acid from vomit can wear down the protective enamel on a person’s teeth. Those with bulimia often have irregular menstrual periods and lowered interest in sex. In addition, a majority of bulimia patients have other psychiatric disorders, such as depression, anxiety or obsessive-compulsive disorder. The incidence of drug or alcohol abuse among bulimics is also high. Further complications arise because not everyone who binges and purges is considered bulimic. A majority of people with bulimia symptoms do not meet the precise clinical definition and are considered to have an eating disorder not otherwise specified (EDNOS).

The American Psychiatric Association is modifying the definition of bulimia as part of its DSM-5, the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, which is scheduled to be published next spring. Recognition DSM-5 will recognize binge eating as an eating disorder for the first time and patients who do not purge may be defined as having binge-eating disorder instead of anorexia. In addition, the incidence of binging and purging necessary to be classified as bulimia is expected to decrease from at least twice a week for at least three months to just once a week. The National Institute of Mental Health (NIMH) estimates that 1.1 percent to 4.2 percent of females have bulimia at some point in their lives. Bulimia is still rare among males, but the numbers have been increasing. It is most common in women who are teens, but it is increasingly common in pre-teens and can affect seniors, too. Bulimia statistics are imprecise, not only because the definition of bulimia is imprecise, but because of the secrecy around the condition. Because bulimics hide the disease, the numbers may be even higher than the NIMH estimate. While bulimia is not as apparent as other eating disorders, medical professionals can learn to diagnose the disease fairly quickly. Typically, the first medical professional to know when a person has bulimia is the patient’s dentist, because of the impact of purging on a person’s teeth. Severely bruised or calloused knuckles are another sign, since a person who consistently sticks her hand down her throat to induce vomiting will suffer some damage. Medical professionals who suspect that a patient has bulimia should try to discuss weight issues with the patient. Do not, for example, outright ask the patient, “Are you bulimic?” or “Do you binge and purge?” Because individuals with bulimia are typically ashamed of their actions, they will be evasive if confronted. Diagnosing Bulimia Instead, begin by asking the patient, “Do you worry about your weight?” and follow up with, “Do you do a lot of dieting?” Those who diet frequently are much more likely to develop bulimia than those who eat acceptable amounts for three meals a day. During the discussion, assuming the patient responds that she is worried about her weight, ask her whether she purges or takes laxatives. Once you’ve engaged the patient, you’ll usually get an honest answer. Research into the chemistry of the brain has shown that bulimics have a similar neurochemical response to foods

that addicts have to drugs and alcohol. Given that the patient’s dependence on binging and purging resembles an addiction, it is difficult to stop he cycle. However, bulimia is more treatable than anorexia. Patients often recover, but frequently revert to past behavior when they are under stress. While in-patient treatment is necessary in the most severe cases, bulimia can often be overcome with aggressive outpatient treatment that combines medication, behavioral therapy and nutritional therapy. There is no medication approved specifically for treating bulimia, but high doses of the antidepressant Prozac can moderately decrease binging and purging episodes. It’s important to know that a dosage of 40 milligrams – twice as high as the dosage typically prescribed for depression – is needed. Treating Bulimia Topamax, which is typically used to treat seizures and prevent migraine headaches, can also help control binging and purging, and promote weight loss. Pharmacotherapy is more effective when used in conjunction with cognitive behavioral therapy, which seeks to change the way a person thinks. Professional nutritionists are also important to the treatment process. Typically, those with bulimia restrict their eating during the day in an attempt to lose weight. This increases their compulsion to binge at night, which then results in purging. Dietary modifications can help prevent the uncontrollable urge to binge that typically takes place at night. Constant monitoring of electrolytes is also important, given that heart failure can result from an electrolyte imbalance. When co-occurring disorders exist, it is essential that they be treated concurrently. In a person with multiple disorders, if treatment concentrates on just bulimia or any one disorder, the patient may show improvement with whatever is being treated, but other disorders typically will worsen. Treatment of bulimia can be complex and recovery takes time, so be certain to involve professionals who had experience treating the disorder. Bulimia is a secret disease, but it’s a secret that needs to be told. Bulimia, and the shame and medical issues that it causes, can be overcome, but the first step is recognizing that the disorder exists. Stuart Koman, Ph.D. is president and chief executive officer of Walden Behavioral Care in Waltham, Mass. He can be reached at

Hospital Newspaper - NJ January, 2013

PAgE 25

Elks Motorcycle Committee of New Jersey delivers toys and Santa to pediatric patients at Children's Hospital of New Jersey The 14th Annual Charity Motorcycle Run recently held a holiday party and fundraiser for the Children's Hospital of New Jersey (CHoNJ) at Newark Beth Israel Medical. Over 75 motorcyclists delivered toys for pediatric patients. The Elks Motorcycle Committee (MC) of New Jersey and Vinnie's Bar & Grill in Harrison join together each year to have riders brighten the lives of the children with the gift of toys delivered to them by Santa, and a festive holiday party. This year the Elks organization used a drawing from a pediatric patient, Denisse Herez, age 11, to create T-shirts for sale to raise money for a donation to the hospital.

The Elks annually donate close to $3,000 to CHoNJ to buy supplies for the Child Life Department. This year the Harrison East Newark Elks club individually made a $500 donation to Child Life. “Each year at the holidays the Elks group donates their energy and time to hold a wonderful party for our pediatric patients,” says Anne Reilly, Director of Child Life at CHoNJ. “We are grateful for their efforts and the children love the donated toys.” Children's Hospital of New Jersey, located at Newark Beth Israel Medical Center and part of the Barnabas Health, is the state's premier hospital caring for children, with specialized services to treat ill

and injured children from newborn to adolescent years and has the most comprehensive pediatric cardiac

care program in the region as well as preventive programs that promote wellness in the community.

For a referral to a pediatrician or pediatric specialist, please call 1-888-SBHS-123.

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Patient Ateesha Quinn, from Orange, age. 11.

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The Elks MC visits Children’s Hospital of New Jersey.


January, 2013

Hospital Newspaper - NJ






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Contact Jim Stankiewicz GM for more information • Phone: 845-534-7500 *219 • Email: A sneak peak at the editorial calendar for the first half of the year…

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Professional development and recruitment

Senior Care facilities

Cancer Care and Recovery

The best providers of cardiovascular and pulmonary services

Emergency Medicine and Transportation

Pediatric Care

Heart Care

Top ER Management and Transportation

Behavioral Health

Rehabilitation and Recovery

Nursing Student Convention

RN Convention Edition

Education & Recruitment opportunities

Education & Recruitment opportunities

The Top Education and Recruitment Opportunites

Long Term Care CEO Vision for Patient Care in 2013!

Children’s Health and Rehabilitation

Top Nurses Recognized National Nurse Week Education & Recruitment opportunities

Boomers & Beyond Senior Care

Hospital Newspaper - NJ January, 2013

Page 27

Atlantic Health System ranked among nation’s Top hospitals for security Atlantic Health System was ranked 4th in a list of 81 hospitals selected by Security Magazine in its annual survey of companies throughout the United States with the best security programs. Each year, Security ranks 500 companies, broken down by business sector. In the magazine’s recently released 2012 rankings, Atlantic Health System was the only New Jersey-based organization in the list of companies in the hospitals/medical centers category. This is the fifth consecutive time Atlantic Health System has been named to the Security 500, and the third time it has been named among the top 10 hospitals/medical centers. Atlantic Health System outranked many nationally-recognized hospitals whose security programs have staffs two to five times larger than that of Atlantic Health System. Only the Cleveland Clinic, the University of Texas at Houston and Massachusetts General were ranked higher, while Atlantic Health System outranked other hospitals such as Brigham & Women’s Hospital and New York Presbyterian Hospital. Alan Robinson, director of protection and security services and emergency management for Atlantic Health System, noted that the magazine rankings were based on the efficiency and preparedness of each security program, despite size. “It all comes down to the staff, planning and the training you build into a security program,” Robinson said. “Being ranked among such prestigious organizations is high recognition of the quality and effectiveness of our security staff and program.” The protection and security services department’s “Red Cell” program, which was recognized by the Joint Commission this year among a list of best practices in health care security, is among the examples of the department’s preparedness initiatives. The program includes regular infiltration testing, in which undercover security agents attempt to gain unauthorized access to sensitive areas of Atlantic Health System facilities, in order to identify and prevent potential breaches. Aggressive training extends not only to security staff, but hospital staff as well. In an industry in which 70 percent of the workforce is female, and homicide is the leading cause of death, Atlantic Health

System has taken the lead in training staff, such as nurses in self-defense, self-escape and other preventive measures. The protection and security services department has also created plans for a number of crisis scenarios, and holds drills with both security and health care staff to prepare for those possible events. “Health care is an industry that is ever-changing but always highrisk,” Robinson said. “Extensive planning is important, but only through training and drilling at all levels do those plans truly make a difference.”

Atlantic Health System’s security force oversees approximately nine million square feet of facilities throughout New Jersey, primarily located at Morristown, Overlook and Newton Medical Centers and Goryeb Children’s Hospital. The department has a senior staff with 300plus combined years of experience in law enforcement, investigation, security, fire safety, regulatory compliance and emergency management, and utilizes state-of-the-art technology to keep staff, patients and visitors safe. For more information about Atlantic Health System, please visit

Optimal performance.

For hospitals, it begins with a need for balance. At Sheridan, we understand your need to drive performance without compromising patient care and satisfaction. As your dedicated partner, we help you master this complex balancing act.





“Sheridan” includes Sheridan Healthcare, Inc., its subsidiaries, affiliates and managed entities.

855-225-4089 s

PagE 28

January, 2013

Hospital Newspaper - NJ


Bernstein & associates, architects Founded in 1990, Bernstein & Associates, Architects, specializes in the design and construction of hospital and healthcare facilities. Our focus: high-quality design, excellent service, and client satisfaction. We have worked for over 100 hospitals and another 200 private healthcare facilities, across the United States. Our project types have included all hospital and healthcare service groups, including: Adult Day Care, Alcoholism Treatment Facilities, Ambulatory Surgery Centers, Assisted Living, Cancer Centers, Cardiac Cath, Cardiology, CCU/ICU, Clinics, Coronary Care, Dental, Dermatology, Dialysis Clinics, Doctors Offices, Drug Treatment Facilities, Elder Care, Employee and Student Health Support Services, Emergency Departments, Emergency Preparedness, Endoscopy, ENT, Expert Witness, Group Practices, Hospices, Hospitals, Infectious Disease, Information Systems, Intensive Care, JCAHO Survey, Joint Commission Survey, Laboratories, Master Plans, Medical Offices, Medical Equipment, Medical Libraries, Medical Records, Neurology, Nursing Homes, Ophthalmology/Eye Center, OB/Gyn, Orthopedic, Pain Care Facilities, Pathology, Patient Safety Consulting Services, Pediatric, Pharmacy, Physical Fitness and Sports, PT/OT, Primary Care Programs, Psychiatric, Radiology, Rehabilitation, Senior Citizen Facilities, Sleep Centers, Social Services, Statement of Conditions, Surgical Suites and Ambulatory Surgery Centers, Urgent Care Centers, and USP 797 Consulting Services. The firm's projects have won design awards from Progressive Architecture, Architectural Record, and the Architectural Woodworking Institute, and have been published in Advance, Health Facilities Management, Medical Technology Today, Bio/Technology, Progressive Architecture, Architectural Record, Design Solutions, Hospitality Design, Sound and Communication, Contract Design and Hospital Newspaper. Architectural Services include: programming, planning, design, construction documents, bidding and negotiation, and construction administration. The firm also offers sustainable or “green” healthcare design. The firm has a number of LEED-accredited professionals, has successfully completed numerous green healthcare projects, and has published articles on “Greening the Healthcare Environment”. Project Management (or Owner’s Representative Services) is offered as a stand-alone service through our affiliated project management company, Empire Projects, Inc. ( Bernstein & Associates, Architects - PLLC 1201 Broadway - #803, New York, NY 10001 Contact: William N. Bernstein, AIA Managing Principal Tel: 609-309-7005 Fax: 609-309-7006 NEW YORK - HARTFORD - PRINCETON

BaRiatRiC EQuiPmEnt & PRoDuCtS tSk PRoDuCtS TSK Products is dedicated to helping Healthcare facilities meet the unique needs and challenges of treating obese patients. We offer a complete line of Bariatric equipment; from Room-Lobby Chairs, to Lifts, Walkers, Beds, Commodes, Stretchers, Exam Tables… even Bed Pans and Blood Pressure Cuffs. Call us today for more information.

12 Windsor Drive Eatontown, NJ 07724

CliniCal outSouRCing/ EmERgEnCy mEDiCinE SolutionS

Connect with leading Healthcare Recruiters Join BlueSteps, the executive career management service of the Association of Executive Search Consultants Healthcare executives are in demand. Are you being considered for the top leadership jobs? Join BlueSteps today to put your resume and confidential careerprofile at the finger tips of over 8,000 of the world’s top executive recruiters, including hundreds who specialize in healthcare and life sciences recruiting. In addition to a unique connection to the executive search community, BlueSteps also provides a suite of proactive career management tools including: • a free resume review and career consultation • access to the International Executive Search Firm Directory • exclusive information on hundreds of active executive searches • online brand management tools • career management content and events specifically for senior-level executives As a service of the Association of Executive Search Consultants, you can rest assured that your career details will be confidentially and securely managed within BlueSteps. Unlike other mass job boards, only the highest caliber executive search consultants (all members of the AESC) will have access to your BlueSteps profile. Each year, AESC members recruit for over 70,000 of the highest level executive positions globally, many of which are never advertised publically.

Emergency Medical Associates (EMA) is a physician-led, physician-owned medical practice that specializes in emergency, hospitalist and urgent care medicine. Dedicated to providing exceptional solutions for the measurable success of our hospital partners, EMA is recognized for clinical excellence, quality service and sustained improved patient satisfaction. For more information, visit, or

Contact to learn more or for assistance getting started!

When nurses, administrative staff and technicians speak a different language than patients and their families: •

Patients may not be able to understand simple questions or directions.

• Hospital staff may not be able to give or get important information from caregivers or family members. • Employees may not understand proper protocol and procedures. On your site on your schedule: • Spanish for Healthcare

Emergency Medical Associates (EMA) 3 Century Drive Parsippany, NJ 07054

• Accent Reduction (Pronunciation Improvement) • Communicating Across Cultures

Contact: Debbie Harris Director of New Business Development & Marketing Tel: (866) 630-8125 Fax: (919) 620-6064

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ContRaCt/PRaCtiCE managEmEnt SERViCES

Language Directions can help doctors, nurses, technical, and administrative staff to communicate more effectively between each other, patients, and their families

mED★EXCEl uSa Providing Emergency Medicine Excellence for over 20 years EMERGENCY MEDICINE CONTRACT MANAGEMENT Physician Owned and Managed Award winning Customer Relations Program Continuous Quality Improvement Risk Management Innovations Cost Containment Measurable Outcomes EMERGENCY MEDICINE SERVICES CONSULTATION SERVICES Customer Satisfaction TeamBuilding/Staff Development Conflict Mediation ED Systems Analysis PRACTICE MANAGEMENT SERVICES Hospital and Physician Billing/Coding/Auditing/Consultation mED★EXCEl uSa

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Phone: (732) 982-1090 Fax: (732) 389-9044 Email:

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Please contact Marie Buchanan at 800.563.6384 Ext. 249 all inquiries are confidential

Online Directory available at

• Sign Language • ESL (Basic/Advanced) ...and more Contact Donna Clark 1-888-554-8848

Language D rect ons S



“Removing language and cultural barriers to effective communication”

Contact Jim Stankiewicz to find out how your organization can be featured in our Resource Directory.

845-534-7500 ext.219 Fax: 845-534-0055

Hospital Newspaper - NJ January, 2013

Page 29

Lourdes goes Mobile: Health System launches Smartphone App to connect mobile users with vital health information iTriage mobile app gives patients instant access to symptoms, diseases and Lourdes-specific service information In an effort to make pertinent health information readily accessible, Lourdes Health System has partnered with iTriage, a free consumer healthcare application, to link consumers via a smartphone to vital medical information and local medical services from virtually anywhere. iTriage provides mobile device users quick and easy access to medical symptom information, possible causes and treatments, along with GPS-based directions to the closest and most appropriate medical facility for their particular condition. Lourdes iTriage users will be able to find out detailed information about Lourdes Health System services. “Lourdes understands the importance of patients having access to medical care and information as quickly as possible,” says Alexander J. Hatala, President and CEO of Lourdes Health System. “Lourdes partnership with iTriage is part of a larger investment we are making in technology. iTriage gives our patients greater access to resourceful medical information and enhances the quality and delivery of the services we provide.” U.S. smartphone ownership is at 43 percent and rising. Consumers can use their mobile devices to access health information online now more than ever. Built by emergency room physicians, iTriage aggregates healthcare information. “Information is available in a structured and actionable way,” says Dr. Alfred Sacchetti, chief of Emergency Medicine at Our Lady of Lourdes Medical Center. “It closes the information gap between doctors and patients.”

iTriage users can access: • Medical symptoms • Possible causes and treatment options • Medication information for treatment of a specific condition • Detailed information about Lourdes Health System such as services, specialties, hours of operation and facility locations and directions “When healthcare providers put useful medical information into the palm of their patient’s hands with iTriage, consumers are empowered to make informed decisions about where they will seek care for a medical condition,” says Dr. Peter Hudson, co-founder of iTriage, LLC. “We live in a new world that requires patients to be more informed and responsible for their health and iTriage allows them to play a larger role in their healthcare.” The iTriage application can be accessed free of charge from the app stores for iPhone® or Android® devices, or through any Internet-enabled device at

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September 23-26 Las Vegas, Nevada

March 31-April 7 7-Day Eastern Caribbean Cruise

November 4-8 Maui, Hawaii

Approved by the American College of Emergency Physicians for a maximum of 20 hour(s) of ACEP Category I credit.


January, 2013

Hospital Newspaper - NJ

RESOURCE DIRECTORY ExTENdEd CARE & ASSiSTEd LiviNG dAUGHTERS OF iSRAEL Daughters of Israel is a multi-faceted, stateof-the-art skilled nursing facility offering the most modern and comprehensive services available including: • • • • • •

Sub-Acute Rehabilitation Long-Term, Skilled Nursing Care Alzheimer’s Care Hospice & Palliative Care Respite Stays The Charles Bierman Home Senior Housing with Assistance • The Sarah & Aaron Franzblau Institute for Continuing Education Our team of skilled and dedicated professional staff deliver the highest quality of care for our 300+ residents. Services provided include: round-the-clock professional nursing care; 24hour medical coverage by board-certified geriatricians; on-site synagogue with full-time rabbinical services; a full range of stimulating and innovative recreational activities; on-site beauty salon, barber shop, work activity center, gift shop and coffee shop; spacious dining rooms, auditoriums, lounges and outdoor patio areas. Our sub-acute rehabilitation facility, which functions as a separate unit within the Home, features a spacious gym with state-of-the-art equipment and comfortable recovery suites with luxury amenities. Semi-private and private rooms are available at Daughters of Israel. The facility is covered by Medicare, Medicaid, commercial insurances and private payment. Daughters of Israel is a beneficiary agency of United Jewish Communities of MetroWest, N.J. 1155 Pleasant Valley Way, West Orange, NJ 07052 Contact: Adena Twersky, Director of Admissions Tel: 973-400-3307 Fax: 973-731-8364

HOSPiTALS BERGEN REGiONAL MEdiCAL CENTER, L.P. Located in Paramus, Bergen Regional Medical Center is the largest hospital in New Jersey dedicated to serving the residents of Bergen County and surrounding communities. With 1000+ beds and 1,500 staff members, the hospital specializes in Behavioral Health Services, which include child and adolescent, adult and geriatric psychiatric treatment. Long Term Care Services provides a scope of services, which far exceeds that offered in a standard nursing home. As a full service accredited medical center, we provide wound care, surgical care, cardiac care, rehabilitation services, respiratory care unit which includes ventilator dependent residents, Korean care services and an acute care unit all under one roof for our residents. The hospital excels in the treatment of substance abuse. The hospital offers detoxification, 21-day rehabilitation program, outpatient services, and treatment for the mentally ill and chemically addicted. Our Acute and Ambulatory Services offers same day surgery, medical and specialty clinics and state-of -the-art operating suites. Tel. 201-967-4000

HOME MORTGAGES Gateway Funding specializes in mortgage options to the healthcare industry. We understand the nuances involved with obtaining mortgages for physicians, nursing staff, residents, or general staffing. You’re busy, we know it. Your unique, we get it. You need financing for a home, we provide it. One call or email to our experienced, licensed and fully trained loan officers, will put your mind at ease. We can provide No Cost Pre-Approvals prior to looking for a home, and highly competitive rates and fee’s once you do find your dream home!

Frank Mancino, Branch Manager NMLS#133472 3564 Quakerbridge Rd Hamilton, NJ 08620 877-583-3562

Contact Jim Stankiewicz to find out how your organization can be featured in our Resource directory.

845-534-7500 ext.219 Fax: 845-534-0055

MEdiCAL BiLLiNG Cape Medical Billing (CMB) is your single source billing provider for curing undetected “revenue leakage” that plagues today's healthcare practices. CMB has been in business for 22 years and is uniquely qualified to help your medical practice reverse “revenue leakage” with fast, efficient, innovative and customized billing programs. We offer personalized and cost effective service with 92.9% of charges paid upon the first submission! We accomplish this everyday by utilizing our “state of the art” billing software and paying close attention to critical detail used to match and process data. We also pride ourselves on significantly reducing days in accounts receivable by deploying aggressive and consistent follow-up procedures. Our technology, expertise and personal approach drive our billing practices and produce unparalleled results for our clients. Are you currently doing billing in house and considering outsourcing? No problem, we can integrate our technology with your current EMR software package and help you convert your medical services to consistent cash flow! Our billing specialties: Cardiology, Internal Medicine, Podiatry, Family Practice, General Surgery, Pathology, Infectious Disease, Gastroenterology, OB/GYN, Neurosurgery, Urology, Trauma Surgery, PT/OT, Mental Health and Ambulance. We're the experts...STOP risking your money and profit by collecting it yourself, or utilizing a billing company with less experience. We collect the HARD Stuff and we do it every day! Call for a FREE Billing Analysis to detect and solve your revenue leakage! Contact: Richard Papperman, CEO/President of Cape Medical Billing Office: 609-465-8900 or Sherrii Brentari Director of Sales and Marketing Cape Medical Billing 609-465-8900 HQ Location: Cape Medical Billing 5 Locust Lane P.O. Box 670 Cape May Court House, NJ 08210 Office: 609-465-8900 Fax: 609-463-8106

internet address directory apparatus Campbell Supply company

hospitals Children’s Specialized Hospital

expositions Abilities Expo

Hackensack Hospital and Medical Center

financial Institutions Healthcare Employees Federal Credit Union

Matheny Medical & Educational Center Meridian Health


NO Calibration & NO Drops Icare® Tonometers for measuring Intraocular Pressure (IOP) with unique, patented rebound technology which enables quick and painless measurement with no drops or air. Quick, easy to use and patient friendly. The technology requires no calibration. From beginning to end the test takes under 60 seconds. Icare® has over 32,000 satisfied users in over 50 countries. Contact: Bob Goldbacher (609) 412-2134

WORKERS’ COMPENSATiON HOSPiTAL WORKERS HAvE YOU BEEN iNJUREd ON THE JOB? Learn What You Must Do To Protect Your Workers' Compensation And Disability Rights! Do Not Make These Mistakes That Can Cost You Benefits

1. You must report the accident or injury as soon as possible, even if you might not lose time from work or need immediate medical care. 2. Report all injuries to all body parts, no matter how minor they may seem. If you do not report it and the injury gets worse over time, the job may deny benefits. 3. Remember, you are entitled to treatment and benefits even if you have previously injured the same body part in a prior accident. Do not let the job tell you different. 4. Your doctor controls the treatment, not risk management. If you need an MRI and the job will not approve it, the experienced attorneys at BAGOLIE FRIEDMAN can fight to get it approved at no cost to you. 5. When you are released from treatment, you may be entitled to money for your injury and disability. You may also collect for repetitive stress, cumulative trauma, cancer, hearing loss & hepatitis. 6. Contact Attorneys Ricky Bagolie or Alan Friedman now for a confidential and free consultation and to discuss your workers' compensation and disability rights. There is no fee if there is no recovery CALL TOLL FREE 1-866-333-3529 (After Hours / Emergency Number 201-618-0508) BAGOLiE FRiEdMAN, LLC Workers' Compensation & disability Attorneys The Five Corners Building 660 Newark Avenue - Jersey City, NJ 07306 (201) 656-8500 790 Bloomfield Avenue - Clifton, NJ 07012 (973) 546-5414

home care specialists Comprehensive Home Care

medical equipment & products TSK Products, Inc.

healthcare consultants Medco Consultants, Inc.

rehabilitation Kessler Institute for Rehabilitation

Online Directory available at

Hospital Newspaper - NJ January, 2013

Page 31





Visit us at one of our locations: 19 Bradhurst Avenue Suite 700 Hawthorne, NY 10532 (914) 593-7800

15 North Broadway 2nd Floor White Plains, NY 10601 (914) 428-6000

5 Coates Drive Suite 2 Goshen, NY 10924 (845)294-1234

30 Greenridge Avenue Suite 207 White Plains, NY 10605 (914)328-8555

180 East Hartsdale Avenue 3 Michael Frey Drive Suite 1E Eastchester, NY 10709 (914) 337-3500 Hartsdale, NY 10530 (914)725-2010

688 White Plains Road Suite 210 Scarsdale, NY 10583 (914) 723-3322


January, 2013

Hospital Newspaper - NJ

Calling All Emergency Responders

When every second counts... Count on NitroMist


NitroMist provides fast, effective symptom relief. NitroMist provides a consistent dose with each metered spray.* NitroMist offers secure storage, ensuring potency for up to 36 months from date of manufacture.† Available in 90 & 230 spray bottles. For product samples, patient educational material, and the NitroMist ER Box (Shown), Go to: Now covered on UnitedHealthcare. Check with your GPO for low contract pricing. For additional information, please contact us at BRIEF SUMMARY NitroMist® (nitroglycerin) lingual aerosol Rx Only INDICATIONS AND USAGE– NitroMist is indicated for acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease. CONTRAINDICATIONS– PDE5 Inhibitor Use: Administration of NitroMist is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), as PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates. Severe Anemia: NitroMist is contraindicated in patients with severe anemia. Increased Intracranial Pressure: NitroMist is contraindicated in patients with increased intracranial pressure. Hypersensitivity: NitroMist is contraindicated in patients who have shown hypersensitivity to it or to other nitrates or nitrites. Skin reactions consistent with hypersensitivity have been observed with organic nitrates. WARNINGS AND PRECAUTIONS– Tolerance: Excessive use may lead to the development of tolerance. Only the smallest number of doses required for effective relief of the acute anginal attack should be used. As tolerance to other forms of nitroglycerin develops, the effect of sublingual nitroglycerin on exercise tolerance, although still observable, is reduced. Hypotension: Severe hypotension, particularly with upright posture, may occur even with small doses of nitroglycerin. The drug should therefore be used with caution in patients who may be volume-depleted or who, for whatever reason, are already hypotensive. Hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris. The benefits of NitroMist in patients with acute myocardial infarction or congestive heart failure have not been established. If one elects to use NitroMist in these conditions, careful clinical or hemodynamic monitoring must be used because of the possibility of hypotension and tachycardia. Hypertrophic Cardiomyopathy: Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy. Headache: Nitroglycerin produces dose-related headaches, which may be severe. Tolerance to headaches occurs. ADVERSE REACTIONS– Headache, which may be severe and persistent, may occur immediately after nitroglycerin use. Flushing, drug rash and exfoliative dermatitis have been reported in patients receiving nitrate therapy. Postural hypotension, as manifest by vertigo, weakness, palpitation, and other symptoms, may develop occasionally, particularly in erect, immobile patients. Marked sensitivity to the hypotensive effects of nitrates (manifested by nausea, vomiting, weakness, diaphoresis, pallor, and collapse) may occur at therapeutic doses. Syncope due to nitrate vasodilatation has been reported. DRUG INTERACTIONS – PDE5 Inhibitors: Administration of NitroMist is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates. The time course and dose dependence of this interaction have not been studied, and use within a few days of one another cannot be recommended. Appropriate supportive care for the severe hypotension has not been studied, but it seems reasonable to treat this as a nitrate overdose, with elevation of the extremities and with central volume expansion. The use of any form of nitroglycerin during the early days of acute myocardial infarction requires particular attention to hemodynamic monitoring and clinical status. Antihypertensives: Patients receiving antihypertensive drugs, beta-adrenergic blockers, and nitrates should be observed for possible additive hypotensive effects. Marked orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used concomitantly. Labetolol blunts the reflex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If labetolol is used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur. Aspirin: Coadministration of aspirin and nitroglycerin has been reported to result in increased nitroglycerin maximum concentrations by as much as 67% and AUC by 73% when administered as a single dose. The vasodilatory and hemodynamic effects of nitroglycerin may be enhanced by concomitant administration of aspirin. Tissuetype Plasminogen Activator (t-PA): Intravenous administration of nitroglycerin decreases the thrombolytic effect of tissue-type plasminogen activator (t-PA). Plasma levels of t-PA are reduced when coadministered with nitroglycerin. Therefore, caution should be observed in patients receiving nitroglycerin during t-PA therapy. Heparin: Intravenous nitroglycerin reduces the anticoagulant effect of heparin. Activated partial thromboplastin times (APTT) should be monitored in patients receiving heparin and intravenous nitroglycerin. It is not known if this effect occurs following single nitroglycerin doses. Ergotamine: Oral administration of nitroglycerin markedly decreases the first-pass metabolism of dihydroergotamine and subsequently increases its oral bioavailability. Ergotamine is known to precipitate angina pectoris. Therefore, patients receiving sublingual nitroglycerin should avoid ergotamine and related drugs or be monitored for symptoms of ergotism if this is not possible. USE IN SPECIFIC POPULATIONS– Pregnancy: Pregnancy category C: Animal reproduction and teratogenicity studies have not been conducted with NitroMist or nitroglycerin sublingual tablets. It is also not known whether NitroMist can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. A teratogenicity study was conducted in the third mating of F0 generation female rats administered dietary nitroglycerin for gestation day 6 to day 15 at dose levels used in the 3-generation reproduction study. In offspring of the high-dose nitroglycerin group, increased incidence of diaphragmatic hernias and decreased hyoid bone ossification were seen. The latter finding probably reflects delayed development rather than a potential teratogenic effect, thus indicating no clear evidence of teratogenicity of nitroglycerin. There are no adequate and well controlled studies in pregnant women. NitroMist should be given to a pregnant woman only if clearly needed. Nursing Mothers: It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when NitroMist is administered to a nursing woman. Pediatric Use: The safety and effectiveness of nitroglycerin in pediatric patients have not been established. Geriatric Use: Clinical studies of NitroMist did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other rep-

Not Actual Size

orted clinical experience has not identified differences in responses between elderly (greater than or equal to 65 years) and younger (less than 65 years) patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. OVERDOSAGE– Signs and symptoms of hemodynamic effects: The effects of nitroglycerin overdose are generally the results of nitroglycerin’s capacity to induce vasodilatation, venous pooling, reduced cardiac output, and hypotension. These hemodynamic changes may have protean manifestations, including increased intracranial pressure with any or all of persistent throbbing headache, confusion, and moderate fever; vertigo; palpitations; tachycardia; visual disturbances; nausea and vomiting (possibly with colic and even bloody diarrhea); syncope (especially in the upright posture); dyspnea, later followed by reduced ventilatory effort, diaphoresis, with the skin either flushed or cold and clammy; heart block and bradycardia; paralysis; coma; seizures; and death. No specific antagonist to the vasodilator effects of nitroglycerin is known, and no intervention has been subject to controlled study as a therapy of nitroglycerin overdose. Because the hypotension associated with nitroglycerin overdose is the result of venodilatation and arterial hypovolemia, prudent therapy in this situation should be directed toward increase in central fluid volume. Passive elevation of the patient’s legs may be sufficient, but intravenous infusion of normal saline or similar fluid may also be necessary. The use of epinephrine or other arterial vasoconstrictors in this setting is not recommended. In patients with renal disease or congestive heart failure, therapy resulting in central volume expansion is not without hazard. Treatment of nitroglycerin overdose in these patients may be subtle and difficult, and invasive monitoring may be required. Methemoglobinemia: Methemoglobinemia has been rarely reported with organic nitrates. The diagnosis should be suspected in patients who exhibit signs of impaired oxygen delivery despite adequate arterial PO2. Classically, methemoglobinemic blood is described as chocolate brown, without color change on exposure to air. If methemoglobinemia is present, intravenous administration of methylene blue, 1 mg/kg to 2 mg/kg of body weight, may be required. NONCLINICAL TOXICOLOGY– Carcinogenesis, Mutagenesis, Impairment of Fertility: Animal carcinogenicity studies with sublingually administered or lingual spray nitroglycerin have not been performed. Rats receiving up to 434 mg/kg/day of dietary nitroglycerin for 2 years developed dose-related fibrotic and neoplastic changes in liver, including carcinomas, and interstitial cell tumors in testes. At the highest dose, the incidences of hepatocellular carcinomas was 52% compared to 0% in untreated controls. Incidences of testicular tumors were 52% vs 8% in controls. Lifetime dietary administration of up to 1058 mg/kg/day of nitroglycerin was not tumorigenic in mice. Nitroglycerin was found to have reverse mutation activity in the Salmonella typhimurium strain TA1535 (Ames assay). A similar mutation in S. typhimurium strain was also reported for other NO donors. Nevertheless, there was no evidence of mutagenicity in an in vivo dominant lethal assay with male rats treated with oral doses of up to about 363 mg/kg/day or in ex vitro cytogenic tests in rat and dog tissues. In vitro cytogenetic assay using Chinese hamster ovary cells showed no chromosomal aberrations. In a 3-generation reproduction study, rats received dietary nitroglycerin at doses up to about 408 mg/kg/day (males) to 452 mg/kg/day (females) for 5 months (females) or 6 months (males) prior to mating of the F0 generation with treatment continuing through successive F1 and F2 generations. The highest dose was associated with decreased feed intake and body weight gain in both sexes at all matings. No specific effect on the fertility of the F0 generation was seen. Infertility noted in subsequent generations, however, was attributed to increased interstitial cell tissue and aspermatogenesis in the high-dose males. PATIENT COUNSELING INFORMATION– Interaction with PDE5 Inhibitors - NitroMist should not be used in patients who are using medications for erectile dysfunction such as sildenafil, vardenafil, and tadalafil. These products have been shown to increase the hypotensive effects of nitrate drugs such as NitroMist. Administration - Patients should be instructed that prior to initial use of NitroMist Lingual aerosol, the pump must be primed by pressing the actuator button 10 times to ensure proper dose priming. If the product is not used for more than 6 weeks, the bottle can be adequately re-primed with 2 sprays. NitroMist is meant to be sprayed on or under the tongue at the beginning of angina or to prevent an angina attack. Treatment with nitroglycerin products such as NitroMist may be associated with lightheadedness on standing, especially just after rising from a laying or seated position. This effect may be more frequent in patients who have consumed alcohol, since alcohol use contributes to hypotension. If possible, patients should be seated when taking NitroMist. This reduces the likelihood of falling due to lightheadedness or dizziness. Headache - Headaches can sometimes accompany treatment with nitroglycerin. In patients who get these headaches, the headaches may indicate activity of the drug. Tolerance to headaches develops. Flushing - Flushing, drug rash and exfoliative dermatitis have been reported in patients receiving nitrate therapy. Container information - The NitroMist bottle should not be forcefully opened. Because NitroMist contains a highly flammable propellant (butane), do not have the container burned after use and do not spray directly towards flames. While the container is in the upright position, if the liquid reaches the top to middle of the hole on the side of the container, a new supply should be obtained. When the liquid reaches the bottom of the hole, the remaining doses will have less than label content. Manufactured for Akrimax Pharmaceuticals, LLC E Cranford, NJ 07016 by Dynamit Nobel GmbH, Leverkusen, Germany E Marketed and Distributed by: Akrimax Pharmaceuticals, LLC, Cranford, NJ 07016 USA NitroMist is a registered trademark of NovaDel Pharma Inc., used by permission. 141B002 10/2012

*Priming NitroMist: After receiving a new prescription or refill, patients should remove the plastic cap, place forefinger on actuator button, and press 10 times. NitroMist is now primed for 6 weeks and ready to use. If not used for more than 6 weeks, the NitroMist bottle can be adequately reprimed with 2 sprays. † Store at room temperature (25°C, 77°F); excursions permitted to 15-30°C (59-85°F). NitroMist is a registered trademark of NovaDel Pharmaceuticals, LLC., used by permission.

©2012 Akrimax Pharmaceuticals, LLC., Cranford, NJ 07016 October 2012 NTR-145T

Hospital Newspaper  
Hospital Newspaper  

New Jersey - Dec. 2012