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Quelling the Storms of Seizures in People with Epilepsy

Posted on Nov 1, 2019 in Affiliates, California Pacific Medical Center, Innovation, Neuroscience, Quality, Research, Scroll Images, Sutter Medical Center of Santa Rosa, Sutter Medical Center, Sacramento, Transformation, Uncategorized

SAN FRANCISCO, Calif. – An electrical “storm” in the brain causes seizures in people with epilepsy, producing symptoms that may include lapses in consciousness, twitching or jerking movements, weakened or limp muscles, spasms, blurred vision, experiencing unusual smells or tastes, and changes in sensation or emotions.

Epilepsy—a neurological disorder caused by abnormal electrical activity in the brain—impacts almost 3.4 million nationwide.1 Despite advances in epilepsy treatment, approximately one-third of adults with the illness experience recurrent seizures.2

Epileptic seizures are generally categorized into three main groups: generalized (affecting both sides of the brain), focal (seizures that start in one area of the brain), and those that could start anywhere.

The stormy weather of seizures can clear with medications called anti-epileptic drugs (AEDs). AEDs can to stop seizures from occurring, but they do not always lead to a remission or cure epilepsy. With the right AEDs, up to 70% of people with the illness may remain seizure-free, and sometimes may “outgrow” seizures or go into remission. For other people whose seizures are uncontrolled with conventional AEDs, other treatments including surgery may be an option. Surgery may involve removing part of the brain that causes the seizures.

Michael Chez, MD

“Knowing where seizures start in the brain provides us clues into what occurs during a seizure, what other conditions or symptoms may be seen, how they may affect someone and, most importantly, what treatment may be best for that seizure type,” says Michael Chez, M.D., a pediatric neurologist and epileptologist, and Sacramento regional director of pediatric epilepsy and research at the Sutter Neuroscience Institute.

“Life without seizures and improved quality of life is what specialists aim to provide epilepsy patients, through a treatment plan personalized to their particular type of epilepsy and seizures,” says Dr. Chez.

Two Sutter hospitals, California Pacific Medical Center and Sutter Medical Center, Sacramento are renowned for providing patients specialized Level 4 epilepsy care— a designation by the National Association of Epilepsy Centers—guided by leading-edge research. Sutter researchers are uncovering new clues about how epilepsy develops and how it can be treated more effectively.

Sutter examining new ways to ‘map’ and monitor brain activity

Epilepsy is usually diagnosed with magnetic resonance imaging (MRI) and electroencephalogram (EEG) testing. Those techniques are also used to regularly monitor brain activity in people with the illness. Sutter researchers are studying the use of novel neuroimaging techniques to visualize and track the brain’s electrical activity in people with epilepsy.

For patients with refractory epilepsy (in whom medications are not adequately controlling seizures), a new “high-density” EEG machine is being tested to locate precisely where a patient’s seizures originate in the brain.

“Use of these high-density or high-array EEG machines can help dramatically accelerate research and patient care by identifying the focal point of a seizure,” says Kenneth Laxer, M.D. a researcher in the Sutter Pacific Epilepsy Program at Sutter’s California Pacific Medical Center (CPMC).

With more than 40 years’ experience in epilepsy research, Dr. Laxer is renowned for studying neuroimaging techniques including magnetic resonance spectroscopy for the evaluation and management of the illness. With high-density EEGs, the patient wears a net over their head, and the brain’s electrical activity is recorded from 250-plus electrodes. The recordings are combined with the patient’s own high-resolution MRI scan to help localize the seizure focus. Surgeons use these precise images to remove the section of the brain that’s causing the seizures.

“If we pinpoint that abnormal area, we can remove a smaller portion of the abnormal brain tissue and therefore decrease the risk of serious complications from the surgery,” says Dr. Laxer. He notes that 50-70% of patients who undergo a focal resection may become seizure free. “Most of these patients remain on seizure medications, frequently at reduced dosages; however, the goal of surgery is to bring the epilepsy under control—not to stop epilepsy medication use. Patients who undergo such surgeries typically experience improved quality of life.” Stay tuned later this month for Part 2 of this series on Sutter epilepsy research, which will include information on neuromodulation and anti-epileptic medications.

Stay tuned later this month for Part 2 of this series describing epilepsy research at Sutter.

References: 1. Centers for Disease Control and Prevention. https://www.cdc.gov/epilepsy/about/fast-facts.htm 2. Epilepsy Foundation. https://www.epilepsy.com/learn/types-seizures/refractory-seizures SAN .

Preparedness Tips for Power Shutoffs

Posted on Oct 31, 2019 in Scroll Images, Uncategorized

Many Northern California communities have been impacted by PG&E’s Public Safety Power Shutoffs (PSPS) throughout the last month.

When PSPS plans are announced, we work with PG&E to identify facilities located in potential outage areas and implement preparedness protocols to minimize potential impacts. Sutter is also able to leverage the strength of our integrated network to help keep patients connected to care.

As additional shutoffs are announced, or you prepare for colder winter weather, consider these personal preparedness tips to help safely manage power outages.

  • Make sure you and your family are prepared for an outage at home, helpful information can be found at: prepareforpowerdown.com
  • Have emergency supplies, food and water.
  • Consider a backup plan for your refrigerated and frozen foods. Buy ice at the grocery store and place needed items and prescriptions in coolers.
  • Have a plan for child and pet care, should school or work places be affected, or your normal schedule change.
  • Fill up your gas tank in advance of known power outages.
  • Allow for extra travel time as traffic signals may be out, and limit travel when possible.
  • Be cautious when using open flame light/heating sources and generators, as they can be dangerous.
  • If you receive home healthcare support, ensure your provider has contact information to reach you, as well as your emergency contacts.

Find out more about the shutoffs at pge.com or call PG&E at (866) 743-6589

Five Sutter Medical Network Organizations Achieve IHA Honors

Posted on Oct 31, 2019 in Scroll Images, Uncategorized

SACRAMENTO, Calif. —Integrated Healthcare Association (IHA) has recognized four Sutter Medical Network (SMN) organizations for achieving top marks on quality and patient experience measures while effectively managing cost of care for Commercial HMO patients in 2018.

Excellence in Healthcare Award
In keeping with the national imperative to reduce healthcare costs while delivering high-quality care, IHA’s Excellence in Healthcare Award recognizes physician organizations in California making progress to that end. Sutter Medical Group, part of Sutter Medical Foundation, was one of just 28 physician organizations statewide to receive a 2019 Excellence in Healthcare Award from IHA. This award recognizes physician organizations that perform in the top 50th percentile across three domains: clinical quality, patient experience and total cost of care.

Of the nearly 200 physician organizations statewide participating in the Align. Measure. Perform. program, fewer than one in five attained an Excellence in Healthcare Award this year.

Exemplary Performance
IHA also recognizes physician organizations that demonstrated exemplary domain-specific performance. Mills-Peninsula Medical Group and Palo Alto Foundation Medical Group, both affiliated with the Sutter Palo Alto Medical Foundation, achieved high performance (top 10th percentile) in the clinical quality and patient experience domains. Two more Sutter-affiliated physician organizations, Sutter Medical Group and Gould Medical Group, achieved high performance (top 10th percentile) in the patient experience domain only.

Most Improved
IHA also recognizes eight physician organizations—one from each region— that demonstrate the greatest year-to-year improvement in clinical quality and patient experience domains. Gould Medical Group and Brown & Toland Physicians each earned the Ronald P. Bangasser Most Improved honor for making the greatest improvements in quality and patient experience from 2017-2018 among all physician organizations in the Central Valley and Bay Area regions, respectively. Brown & Toland Physicians contracts with Sutter Health affiliates to provide patient care.

SMN is part of Sutter Health’s not-for-profit network of care, which proactively implements programs across its system that continuously improve the quality and value of healthcare for patients. Integration across Sutter’s regions, clinical settings and data environments is delivering care models with some of the best clinical outcomes in the nation.

Lucky Landing: Mobile Stroke Unit Treats Traveler at SFO

Posted on Oct 28, 2019 in Expanding Access, Innovation, Mills-Peninsula Health Services, Neuroscience, Quality, Research, Scroll Images, Uncategorized

BURLINGAME, Calif. – It was a 9-1-1 response three years  in the making.

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Stroke Patient on Integrated Health Network: ‘This Is How Medicine Should Work’

Posted on Oct 25, 2019 in California Pacific Medical Center, Innovation, Neuroscience, Novato Community Hospital, Quality, Scroll Images, Uncategorized

When Patricia Mosier had a stroke, she was worried she wouldn’t be able to stay active. However, the integrated network of care from her community hospital in Novato to the more advanced neuroscience services at San Francisco’s California Pacific Medical Center got her back doing the activities that she loves. “This is how medicine should work,” she says about the continuum of care she received from Sutter’s integrated network. See her story in the following video:

For more on Sutter’s integrated network and how it leads to healthier communities, go to www.sutterhealth.org/newsroom/can-expect-integrated-network.

Sutter Funds Study of SacRT’s Free Ride Program for Youth

Posted on Oct 1, 2019 in Community Benefit, Scroll Images, Transformation, Uncategorized

SACRAMENTO, Calif. – The Sacramento Regional Transit District (SacRT) announced at in front of CK McClatchy High School that the public transit agency is waiving fares for youth in the SacRT service area beginning today. The program aims to decrease truancy and eliminate obstacles for young people to get to school, after-school activities, sports, clubs and jobs.

A research brief released in November 2018 that recounts the findings of a travel survey administered to students in three Sacramento City Unified School District (SCUSD) schools found that about 1 in 4 students report missing at least one day of school in the six weeks prior to the survey because of transportation barriers.

“What we’re doing here is filling an important gap,” said Henry Li, SacRT General Manager/CEO. “We’re offering universal access all day, every day during regular service hours for all Sacramento area youth that live in or attend school in our service area. It is another way SacRT works to deliver clean, safe, and accessible transportation to all Sacramento residents.”

A grant from Sutter Health will fund a yearlong study to be conducted by an external evaluator, who will provide insight on the benefits of the fare-free transit initiative for youth.

“We know by conducting Community Health Needs Assessments that lack of access to basic services is among the top health indicators affecting disadvantaged communities,” said Keri Thomas, Vice President of External Affairs for Sutter Health. “Unfortunately for many that includes barriers getting to school and other life enriching activities for young people. This program can make a huge difference in changing that trajectory.”

Affordable student transit programs have been rolled out in numerous cities across the state and nation, including Tempe, Baltimore, Minneapolis, Portland and Stockton. If other communities are any indication, SacRT anticipates promising results with potential of providing nearly 1,000,000 new trips to area youth during the year.

“We’re providing an equitable investment in receiving an education,” said Jay Schenirer, District 5 City Councilmember and SacRT Board Director. “By eliminating transportation barriers, we’re increasing chances for more young people to succeed in school, career and life.”

RydeFreeRT waives youth fares on bus, light rail, and SmaRT Ride microtransit service across SacRT’s service area, which includes the cities of Sacramento, Folsom, Citrus Heights, and Rancho Cordova and parts of Sacramento County. Approximately 220,000 students in grades TK through 12, home-schooled students, and foster and homeless youth are all eligible.

“Free RT is a game changer for many hardworking Sacramento area students and families. The exciting new program will make transportation to and from school, work, and activities, much more reliable and accessible for thousands of students in the region,” said SCUSD Board of Education President Jessie Ryan. “Sacramento City Unified School District is proud to partner to launch a free ride program that will help reduce absenteeism and improve student success in our high poverty district.”

Students enrolled in schools in SacRT’s service area have already been issued their 2019-2020 student ID card, which displays a special sticker for free SacRT ridership. Youth not enrolled in school can receive a RydeFreeRT card at a Sacramento library or at SacRT’s Customer Service and Sales Center located at 1225 R Street (adjacent to the 13th Street Station).

Partners and participating school districts include Sacramento Public Library, Center Unified School District, Elk Grove Unified School District, Folsom Cordova Unified School District, Natomas Unified School District, Robla School District, Sacramento City Unified School District, Sacramento County Office of Education, San Juan Unified School District, Twin Rivers Unified School District, City of Citrus Heights, City of Folsom, and City of Rancho Cordova.

RydeFreeRT is set to run for one year with an extension planned depending on program success and is financially supported by the City of Sacramento, other cities and school districts within SacRT’s service boundaries, and a funding grant from Sutter Health for a ridership study. Parents and students interested in more information about SacRT’s fare-free youth program can visit www.RYDEFreeRT.com.