February 2013 Newsletter

Department of Medicine eNewsletter
February 2013
:: Interview
:: Department News
:: Department Events
:: Leadership Council Minutes
Best Doctors in America 2013

Over 60 Department of Medicine faculty members were named "Best Doctors in America." Congratulations to our physicians!


Cardiovascular Medicine
Mauricio Arruda, MD
Marco Costa, MD, PhD
Michael Cunningham, MD
Barry Effron, MD
James Fang, MD
Michel Farah, MD
Robert Goldstein, MD
Lloyd Greene, MD
Arthur Halle III, MD
Brian Hoit, MD
Richard Josephson, MD
Joseph Krall, MD
Joseph Lassar, MD
Judith Mackall, MD
Sri Krishna Madan Mohan, MD
Carl Orringer, MD
Aaron Proweller, MD, PhD
Jayakumar Sahadevan, MD
Daniel Simon, MD
Bruce Stambler, MD
Albert Waldo, MD

Thomas Wilson, MD


Clinical & Molecular Endocrinology

Baha Arafah, MD

David Aron, MD


Gastroenterology & Liver Disease
Amitabh Chak, MD
Fabio Cominelli, MD, PhD
Gregory Cooper, MD
Ashley Faulx, MD
Gerard Isenberg, MD
Jeffry Katz, MD
Sapna Thomas, MD

Richard Wong, MD


Hematology & Oncology
Joseph Baar, MD, PhD
Erica Campagnaro, MD
Matthew Cooney, MD
Brenda Cooper, MD
Marcos de Lima, MD
Afshin Dowlati, MD
Stanton Gerson, MD
Joseph Gibbons, MD
Lyndsay Harris, MD
Henry Koon, MD
Smitha Subramanyan Krishnamurthi, MD
Hillard Lazarus, MD
Nathan Levitan, MD
Jane Little, MD
Neal Meropol, MD
Charles Nock, MD
Alvin Schmaier, MD

Paula Silverman, MD

Gregory Warren, MD


Infectious Disease & HIV Medicine
Keith Armitage, MD
Barbara Gripshover, MD
Michael Lederman, MD

Robert Salata, MD


Internal Medicine & Geriatrics
Carla Harwell, MD
Debra Leizman, MD
Sally Namboodiri, MD


Nephrology & Hypertension
Thomas Hostetter, MD
Donald Hricik, MD
Michael Smith, MD

Jay Wish, MD


Pulmonary, Critical Care & Sleep Medicine
Rana B. Hejal, MD
Reena Mehra, MD
Hugo Montenegro, MD

Kingman Strohl, MD



Douglas Flagg, MD

Mathilde Pioro, MD

Richard Stein, MD


Recent Grand Rounds Recordings

"Residual Immune Dysregulation Syndrome (RIDS) in Treated HIV Infection" by Michael Lederman, MD


"EVAR, TEVAR, and TAVR: The Alphabet Soup of Endovascular Treatment of Aortic Pathologies" by Vikram Kashyap, MD, FACS


"Colon Cancer Screening: Accomplishments, Barriers and Potential Solutions" by Gregory Cooper, MD

Leadership Council
February 2013

Chair ::

R. Walsh


Present ::

B. Arafah

K. Armitage

A. Askari

R. Bonomo

R. Chandra

F. Cominelli

F. Creighton

J. Fang
S. Gravenstein
D. Hricik
N. Meropol
R. Schilz
D. Simon
R. Walsh
J. Wright



Recorded by ::
A. Staruch
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department interview

Lyndsay Harris, MD, Diana Hyland Chair in Breast Cancer, Medical Director of the Breast Cancer Program at University Hospitals Seidman Cancer Center and international authority on breast cancer treatment and research, shares her perspective on effective translational research, importance of being an active member of professional organizations, and the future of breast cancer treatment and patient care.



You are the Medical Director of the Breast Cancer Program at University Hospitals Seidman Cancer Center. What are you plans for growing the program this year?


Since I joined the Department of Medicine in March 2012, we've had a lot of forward movement in the development of the program. We have developed a strategic plan and designed several new initiatives that are underway. The most recent initiative was NAPBC accreditation - this is a national accreditation for breast centers and we just had our site visit which went very well. We hope to be fully accredited through our sites at main campus, Westlake and Chagrin Highlands this quarter. Receiving NAPBC accreditation would mean that our centers have passed the highest quality standards for diagnosing and treating patients with breast cancer.


This year we will be concentrating our efforts on a few main areas. One of them is the Risk Assessment and Prevention Program that performs clinical and genetic evaluation of women who are thought to be at risk for breast cancer in a one-stop-shop approach. The program is led by Robert Shenk, MD and Gladys Stefanek, MD; it focuses on screening women who are at higher risk for breast cancer with new radiology techniques and innovative genetic profiling methods. Another initiative we are launching this year is the Personalized Medicine Program where individuals diagnosed with breast cancer will be able to have their tumors evaluated by next generation sequencing methods to identify the best treatment for their specific type of cancer.



Prior to joining Case Western Reserve University you were an Associate Professor at Yale University. How would you rate your initial impression of UH Seidman Cancer Center? How does the approach toward patient care differ between UH Seidman Cancer Center and Yale?


UH Seidman Cancer Center is a state-of-the-art facility that was specifically designed to appeal to patient needs. The focus on clinical research is exemplary as it truly communicates the mission of the academic center. In addition, UH Seidman Cancer Center is community-oriented and integrated. These key advantages position UH Seidman Cancer Center ahead of the game when compared to other institutions. These positive features made an impression on me when I first visited the facility as they showed the true vision of the institution.


I am hopeful that with time we can further develop translational research, genomics, personalized medicine and investigator-initiated studies to further differentiate UH Seidman Cancer Center from the competition.



In your opinion, what are some of the advantages of translational research in oncology as opposed to clinical and basic research? Do you believe medicine is experiencing a paradigm shift toward a team approach? Or is the team approach strictly oncology-related?


Though oncology takes a forefront in translational research because of the complex nature of the disease, I believe the shift toward a team approach is taking place in all medical specialties. If we look at the big picture, basic science research has been going strong for decades whereas clinical research was lagging behind until recently, when doctors realized the need to improve patient care through research. Oncology has been very research-oriented because of the complex nature of the disease and toxicity of treatment. Therefore, the need for translational research in oncology developed sooner than it did in other disciplines.


The idea of translational research in oncology implies taking things discovered in the laboratory setting and making them applicable to the clinic, while taking findings from the clinic and moving them into the laboratory. This bidirectional flow of information is a discipline in and of itself, as it requires the knowledge of basic science and clinical medicine, and a particular expertise in how to conduct trials with human specimens.



What are some key practices when assembling an effective team collaborating on studies and grants together? How do you ensure productive communication in translational research?


The key is to facilitate communication among team members while keeping the big picture in sight. It is essential to recognize that every team member has an important role to play even though initially people may be uncomfortable stepping out of their element. It is equally critical to be sensible to the behavior of team members as uncooperative behavior is often a sign of fear of failure.


In addition to people management skills, it is key to change the investigator-centered mentality to a team-centered approach. It is important to encourage open communication and learning environment through grant funding and adequate infrastructure to carry out the research. One of the key elements in motivating people is, as surprising as it may sound, appealing to their altruistic nature. It is crucial to realize that even though basic scientists and clinicians have different skill sets, both sides are equally dedicated to improving our ability to fight cancer.



Through your career you have held leadership roles in a variety of national and international organizations, including American Society of Clinical Oncology, Cancer and Leukemia B, Eastern Cooperative Oncology Group, Pan American Cancer Trial Network and others. What is the importance of being a part of these organizations today? How have they influenced your career?


I believe joining the organizations was a great fit for my personality, as I am a team player by nature. I enjoy generating new approaches to treatments through communication with other professionals. I find it stimulating to be a part of the process of finding an answer to a problem through the exchange of opinions, ideas and expertise. When I realized that I wanted to help cure breast cancer, it was clear that working with national and international groups of smart people with the same goal was an important part of that. It was a natural step for me to start working in committees in the cooperative group level where the smartest minds in the field are leading the charge in finding better ways to treat cancer.


The key to being successful in such large organizations is patience and tenacity. Even though you may witness a difference of opinions in the room, you have to keep an open mind and refrain from taking things personally as well as believe in yourself enough to keep things moving forward. Ultimately, working in national and international organizations helped me work on things I feel passionate about and meet mentors who helped me in my professional career.



How do you see breast cancer research and patient care developing in the future?


One of the most revolutionary facets in oncology is the understanding of human genome and cancer genome. In the span of five years, we will be sequencing our patients' tumors and deciding on the most effective therapy based on the intrinsic characteristics of the cancer and individual patient genetic traits. This is the ultimate in personalized care. Like all medical disciplines, oncology needs to become more cost-effective. I believe the personalized medicine will help address this issue by increasing effectiveness of treatment and reducing the toxicity for patients who do not benefit from that treatment.

department news report

Division of Cardiovascular Medicine

Marco Costa, MD, PhD, along with his co-PIs Robert Salata, MD, and Chris Longenecker, MD, were awarded a Medtronic Foundation Grant in the amount of $1,372,500 for their work entitled "Bridging the Treatment Gap for Rheumatic Heart Disease in Sub-Saharan Africa: A Uganda - Case Western Reserve University Partnership." This project will bring clinical, research, and educational efforts in collaboration with the Ugandan government, Mukerere University, Mulago Hospital and the Joint Clinical Research Center to address Medtronic Foundation's Global Initiative for Rheumatic Heart Disease.
In addition, Dr. Costa provided his expertise on a minimally invasive heart surgery procedure performed using a Parachute device to ABC's medical drama series, "Grey's Anatomy."

David Zidar, MD, PhD, and Goutham Narla, MD, PhD, were selected to serve as Associate Scientific Advisors for Science Translational Medicine.










Division of Hematology & Onclology

Stan Gerson, MDStanton Gerson, MD, was featured in an article published in Cleveland Magazine. Dr. Gerson shared his perspectives on common misconceptions patients have on clinical trials and cancer treatment decisions. He also discussed the uniqueness of the Case Comprehensive Cancer Center in development and delivery of new therapies.









Division of General Internal Medicine & Geriatrics

Elizabeth Fine Smilovich, MD, presented a national webinar through the Geriatric Research and Education Clinical Center. Dr. Fine Smilovich's talk was entitled "Falls: A Culmination of Risks."
Clifford Packer, MD, was awarded an American College of Physicians Invited Fellowship. Fellowship recipients are selected based on the recognition from their peers for personal integrity, superior competence in internal medicine, professional accomplishment and demonstrated scholarship.





Division of Infectious Diseases & HIV Medicine


Amy Hirsch, MD, PhD, and her colleagues Yngve Falck-Ytter, MD, and Renee Lawrence, MD, will be recognized with a 2012 Scholarship in Teaching Award from the School of Medicine for the project entitled "Developing an Education Curriculum and Tools to Improve Learner and Provider Confidence in Management of Hepatitis C (HCV)."

Marion Skalweit, MD, PhD, published a study entitled "N152G, -S and -T Substitution in CMY-2 β-lactamase increases catalytic efficiency for cefoxitin and inactivation rates for tazobactam" in Antimicrobial Agents Chemotherapy. Dr. Skalweit's work reveals a new type of beta-lactamase that contain mutations that improve its ability to break down cephalosporin antibiotics, but make it more sensitive to inhibition by the beta-lactamase inhibitor, tazobactam. This study has implications for novel combinations of cephalosporins and tazobactam in the treatment of resistant Gram negative bacteria.





Division of Pulmonary, Critical Care & Sleep Medicine


Robert Schilz, DO, PhD, was appointed Acting Division Chief of Pulmonary, Critical Care & Sleep Medicine.








department conferences & events

Medicine Grand Rounds

Location: Lakeside, 5th Floor, Kulas Auditorium

Time: Tuesday, 12:00 - 1:00 p.m.

  • March 5 - "Influenza" by Stefan Gravenstein, MD, Division of Geriatrics
  • March 12 - "Evidence-Based Approaches to Managing Alchohol Withdrawal" by Theodore Parran, MD, Department of Internal Medicine
  • March 19 - "Symplicity HTN-3 Trial Presentation" by Sahil Parikh, MD, PACC, FSCAI, Division of Cardiovascular Medicine
  • March 26 - "Update on Atrial Fibrillation" by Albert Waldo, MD, Division of Cardiovascular Medicine

Morbidity and Mortality Conferences

Location: Lakeside, 5th Floor, Kulas Auditorium

Time: Friday, 12:00 - 1:00 p.m.

  • March 8 - A case of a 35-year-old patient with Crohn's Disease status post multiple bowel resections with multiple admissions for hidradenitis suppurativa found to have cutaneous Crohn's Disease.
  • March 15 - A case of a 40-year-old male with a previous medical history of surgically corrected right ventricle double outlet syndrome presenting post arrest treated with therapeutic hypothermia and found to have a VSD.
  • March 22 - A case of a 68-year-old female with a complicated course after an ERCP with new liver lesions of uncertain etiology.
Research Day 2013
Date: Friday, May 3, 2013
Time: 12:00 - 5:00 p.m.
Location: Wolstein Research Building
department leadership council minutes

Leadership Council

Dr. Walsh reminded Leadership Council members to encourage their faculty to attend both Medicine Grand Rounds and Morbidity and Mortality conferences.


Leadership Council
Dr. Walsh thanked council members for attending the Department of Medicine Research Retreat which was very successful. Retreat leaders will be composing white papers which will be distributed to the Leadership Council.

Leadership Council

Dr. Walsh updated council members on the current recruitments for the Chairs of Genetics, Epidemiology and Biostatistics and Ophthalmology at Case Western Reserve University/University Hospitals Case Medical Center as well as the search for the new University Hospitals Health System Chief Operating Officer and openings at Case Western Reserve University for a Vice Dean for Education and an Associate Dean for Graduate Studies. Dr. Walsh announced that Dr. Robert Schilz has been appointed Acting Division Chief for the Division of Pulmonary, Critical Care & Sleep Medicine.

Leadership Council

Dr. Walsh presented information on the clinical mission of the Department of Medicine with a 2012 budget variance overview. Data was reviewed on revenue; expenses; divisional performance, 2012 net operating income to budget and % contribution to overall net revenue (collections); and Department of Medicine 2013 growth initiatives.


Dr. Walsh discussed the University Hospitals Strategic Planning process. In addition to a Strategic Plan Parent Committee, of which Dr. Walsh is a member, committees have been formed for the following: Quality & Patient Experience, Market Share & Volume Growth, Innovation Initiatives, Operational Excellence and Physician Development/Independent Physician Initiative. Dr. Walsh encouraged Leadership Council members to participate in these committees.


Leadership Council

Dr. Armitage reported that the Internal Medicine Residency Match meeting is taking place this evening. The department interviewed a record 433 applicants.