I ran the gauntlet that is the holiday season and came out in the end, relatively unscathed. Now it is going to get interesting...
January 2011 posts
Objectives: At the conclusion of this session, attendees will have an increased ability to:
- Discuss the options for hearing restoration using osteointegrated implants and cochlear implants
- Describe the role of auditory brainstem implants
- Outline the indications for cochlear implants and auditory brainstem implants (ABI)
SNI Grand Round Series is every 1st and 3rd Thursday of each month.
FROM BRAINWAVES: Since its introduction in 1982, transcranial doppler ultrasound (TCD) has evolved into a portable, multimodality, noninvasive method for real-time imaging of intracranial vasculature. The detection of cerebral microemboli is among the more remarkable capabilities of TCD. Emboli create countable signals in the ultrasound display due to the higher reflection of sound waves compared to the blood cells. Experimental models have shown a high sensitivity and specificity for detection of a variety of substrates, including thrombotic, platelet and atheromatous emboli.
Microembolic signals (MES) within the intracranial vasculature are most frequently identified in patients with large-vessel atherosclerotic disease, such as carotid stenosis. They have also been reported in intracranial arterial stenosis, arterial dissection, cardiac disease and atheroaortic plaque. Additionally, they have been seen in arteries distal to coiled aneurysms.
There is strong evidence that MES detection predicts future ipsilateral stroke risk in patients with symptomatic carotid stenosis (Markus HS, et al.; King A, et al.). A recent study of patients with asymptomatic carotid stenosis demonstrated that MES predicted subsequent ipsilateral stroke and TIA, and also ipsilateral stroke alone, and that it is helpful in selecting patients who will benefit from carotid endarterectomy.
Health care is one of the most pressing and talked about issues of our time. Not a day goes by when the topic isn’t in the news. The cost and quality of health care, access to it, the overall health of the American population, etc., are all subjects of endless debate and political rancor.
My team and I started this series, Perspectives, to help make sense of the rhetoric and share our point of view on what it all means for our local community. We’ve explored the topic from different angles, from why electronic health records matter to the importance of end-of-life planning. Each letter has generated thoughtful questions and comments from many of you. I’ve appreciated and enjoyed the dialogue, and I encourage you to keep sharing your thoughts and opinions as the series continues.
Elevating the dialogue
Another way we’ve tried to elevate the conversation is by bringing leading thinkers in health care to the Seattle area. Through a partnership with Seattle Arts & Lectures (SAL), we’ve had the privilege of hosting some brilliant writers on the subject, including author and New Yorker contributor Atul Gawande, M.D., and Washington Post and NPR correspondent T.R. Reid. Both are gifted communicators who challenged us to think in new and different ways about health care. Thank you to everyone who was able to join us for these lectures. We hope you got as much out of it as we did.
We are bringing two more authors to the community this year in conjunction with SAL. Siddhartha Mukherjee, M.D., will present at Town Hall on Jan. 12. His new book “The Emperor of all Maladies: A Biography of Cancer,” was named as one of the 10 best books of the year by the New York Times. Then on March 2, we have the great honor of hosting Tracy Kidder, author of several books including Mountains Beyond Mountains, the story of Paul Farmer’s work in Haiti and other forgotten parts of the globe.
The lecture series is one way we chose to commemorate Swedish’s 100th anniversary. Rather than throwing parties to celebrate our centennial, we felt we could have more of an impact by creating opportunities for meaningful dialogue around the very complex and nuanced topic of health care.
Our 100th anniversary symposium: how to fix health care through innovation
The capstone of our centennial year was a national symposium on how to fix health care through innovation. The two-day event was held in October and drew 41 distinguished speakers from around the globe, including chairman and CEO of General Electric, Jeffrey Immelt, as well as thought leaders from Mayo Clinic, Johns Hopkins and Dartmouth to name a few. More than 500 people from the community attended the event, including business and community leaders, health-care providers, health advocates and educators.
We concluded the symposium with 12 specific action items that individual communities could implement to improve health care at the local level. A few of those action items are summarized below and were part of an opinion piece I wrote for the Seattle Times this fall. I thought I’d share those findings with you in this letter as well.
Here are some of the main ideas that emerged from the symposium: