News & Events

"Inside Surgery", The Department of Surgery Newsletter, Summer 2012

This issue of Inside Surgery describes several exciting developments that are advancing our ability to provide outstanding care for a range of patients including the new Hepatobiliary Service, under the direction of  Carlos Corvera, M.D., which provides comprehensive, multidisciplinary care for patients with liver and bile duct disease. Other topics include updates on  Endocrine Surgery, San Fancisco General Hospital's Wraparound Project, and notable rankings of our surgeons within U.S. News & World Report annual update.

Code Red: Repairing Blood in the Emergency Room

UCSF/SFGH surgeon and trauma researcher, Mitchell J. Cohen, MD, has teamed up with researchers around the globe to change the way acute traumatic coagulopathy is treated.  His work is leading to a new understanding of the causes of and appropriate treatment for uncontrolled bleeding after trauma.

"It seems that sometimes major injuries trigger a problem with the blood-clotting process, causing blood to leak from the body faster than it can be stemmed. This clotting disorder affects as many as 1 in 4 major trauma victims. So Brohi and others have developed a way of treating people that prioritises fixing their blood over fixing their body. It's a radical departure from standard procedures, and one that is by no means widely accepted, but if they're right it could save thousands of lives every year worldwide, and a whole chapter of trauma care will have to be rewritten."

SFGH Trauma Surgeon Works to Prevent Injuries in San Francisco

"San Francisco General Hospital trauma surgeon Rochelle Dicker has treated many pedestrians who ended up in the emergency room after being struck by vehicles. She and her four-person research team have conducted an unprecedented analysis of the direct medical costs of auto-versus-pedestrian encounters in San Francisco. They also looked at where the incidents occurred, so that they could identify "high cost areas and high injury morbidity areas, or hot spots" and work with city officials to consider countermeasures that could save lives and money. The study, titled "Cost-Driver Injury Prevention: Creating an Innovative Plan to Save Lives with Limited Resources," was published in the Journal of Trauma in April."

Department of Surgery at SFGH Launches Cohen Lab Website

The Department of Surgery at SFGH is pleased to announce the launch of the Cohen Lab website. Led by Mitchell J. Cohen, M.D., Associate Professor of Surgery and Director of Acute Care Research at the San Francisco Injury Center, the site will highlight the application of translational discoveries to acute traumatic coagulopathy. The Cohen lab is focused on elucidating the biology of coagulation and inflammation after injury. Incorporating clinical, in vivo, in vitro, and in silico approaches, the research embodies a truly translational approach for investigating the causes of uncontrolled hemorrhage, the leading cause of (potentially preventable) death in both combat casualties and civilian injuries.

Walk Steady: Securing Safe and Walkable San Francisco Streets

At some point in our day, most of us are pedestrians walking the 7x7 swatch of land we know as San Francisco. The city's relatively small size, temperate weather, and inviting neighborhoods make San Francisco inherently walkable.

Yet statistics tell a very different story. San Francisco is one of the most dangerous cities for pedestrians nationwide with over 800 people hit by cars here each year--that's between 2 and 3 pedestrians a day.

In one of his last acts as Mayor, Gavin Newsom signed an executive directive setting ambitious goals for reductions in pedestrian injuries and fatalities over the next decade. As a result multiple city agencies have been tasked with coming up with a unified and coordinated approach to improving pedestrian safety that looks at re-engineering our streets, enforcing traffic laws for motorists and pedestrians alike to gathering data and raising public awareness.

We've gathered several of those individuals whose jobs it is to make San Francisco safer for pedestrians as we ask:

What makes a city that appears so walkable so unsafe? Are some neighborhoods more dangerous for pedestrians than others? What measures can be put into place to improve safety and encourage walking? How are local agencies responding to this issue?

Guests:

Dr. Rajiv Bhatia, Director of Environmental Health with the San Francisco Department of Public Health.

Dahianna Lopez, Prevention Director with the San Francisco Injury Center at UCSF.

Timothy N. Papandreou, Deputy Director of The SFMTA Sustainable Streets-Long Range planning and Policy.

Elizabeth Stampe, Executive Director of WalkSF, a member-based pedestrian advocacy organization.

UCSF Salutes Excellence at Founders Day Luncheon

UCSF Chancellor Susan Desmond-Hellmann, MD, MPH, joined the UCSF community for the 2011 Founders Day Luncheon when the University recognizes faculty, staff and students for their extraordinary contributions to advancing the mission of education, research and patient care.

The individuals, who celebrated the occasion with their friends, family members and colleagues, delivered heart-felt speeches about their work.  San Francisco Injury Center Prevention Director, Dahianna Lopez, received the Chancellor's Award for Public Service.

Oakland Organization Offers Help for Young Gunshot Victims

After Emergency Room doctors patch up a young gunshot victim, the patient is given time to recover from the physical wound. While time may heal, there is still the mental wound that lingers according to Anne Marks, the executive director of Oakland-based Youth Alive-an urban violence prevention organization.

Many young gunshot victims are experiencing Post Traumatic Stress Disorder (PTSD), something that was initially linked to soldiers. Violence prevention experts discussed ways to improve mental health care for these victims at the two day National Network of Hospital-based Violence Intervention Programs this week in Oakland.

Marks spoke about the problems of living in communities where victims see violence on a regular basis.

"You get shot on your block, in front of your house, you get treated and you go right back to that house in that same community. You don't know if someone's coming back to get you." she said.

Marks said the victim will likely suffer from what she calls, "Recurring Traumatic Stress Syndrome" Typically identified as Post Traumatic Stress Disorder.

Dr. Rochelle Dicker, a trauma surgeon at San Francisco General, runs a violence-prevention project that works directly with patients who've been shot stabbed or in some way physically assaulted.

Dicker said that PTSD is treatable, but that traditionally, "this particular population" has not wanted to seek mental health care because of the stigma attached. Now she's finding more youth are opening up to the idea of once they hear how it can help them cope with their trauma.

City’s Pedestrian Crash Toll Dwarfs Preventative Safety Costs

Two to three people are hit by cars every day on San Francisco's dangerously motorized streets, and researchers are beginning to paint a clearer picture of the economic toll. The more than 800 pedestrian crashes a year are racking up a $76 million bill for injuries, reports the Pedestrian Safety Advisory Committee (PSAC), and advocates say it's imperative the city invest in preventative measures.

"It has a huge impact on the economic stability of our residents," said PSAC member Dahianna Lopez of the San Francisco Injury Center, who highlighted that pedestrian injuries in the city cost $15 million per year in medical treatment alone and comprise a quarter of all traumatic injuries. Professionals from the Department of Public Health (DPH) and the University of California, San Francisco presented their findings to city supervisors at two hearings on pedestrian safety this past week.

The Gang War That Wasn't

Did the Mission avert a gang war?

At a community meeting last week at Mission Police Station, Capt. Greg Corrales for the first time offered details on the fatal shooting of Aldo "Trigger" Troncoso - the neighborhood's first homicide of the year - and the aftermath.

Stories of violence averted are not often told, but that's the story Corrales offered the assembled group, and repeated the following evening while delivering a special report to the Police Commission on gang violence in the Mission.

"Because of open communication," Corrales told the commission, "we were able to prevent more violence from happening."

Still, there was more trouble ahead. A shootout on March 2 left the intersection at 24th and Harrison littered with spent bullet casings and sent the victim to San Francisco General Hospital. Several people who attended the neighborhood meeting lived within a few blocks of the shooting. A few gave eyewitness accounts. "I do not," said one woman, "ever want to look out my window again and see a man crawling behind a car with blood coming out of his chest."

"We do know who the shooter was," Corrales told the group of neighbors. "We may not get him for that. But we'll get him for something." The victim, Corrales said, was a known Norteño, and a victim in four previous shootings.

A few hours after the shooting at 24th and Harrison, Corrales got word that a Sureño had just been shot in the Bayview. When police realized that he too was headed for SF General, where the waiting room had filled with angry Norteños, they asked the Community Response Network for help.

Corrales credits Project Wraparound, a follow-up program for the victims of violence run by SF General, for defusing the situation at the hospital. "There was not violence," he told the commission, "though there was huge potential. This is why there is such an incentive for open communication with community groups."

Local hospitals seeing drop in gun violence

Gun-related injuries and deaths have declined drastically, saving taxpayers nearly half a million dollars in medical costs annually.

San Francisco General Hospital officials released a report this week showing that gunshot wounds dropped from 175 in 2005 to 134 last year. The number of gun-related deaths also sharply declined from 45 in 2006 to 17 in 2009, according to the annual report.

"It's absolutely phenomenal," said Patti O'Connor, a trauma program manager nurse at San Francisco General Hospital.

Officials are hoping the new trend remains, adding that in the first six months of 2010, the hospital admitted 55 gunshot victims; six of those were fatal.

The drop in gun violence doesn't only represent lives spared, it is also money saved. Taxpayers shell out $60,000 for every gunshot victim treated at San Francisco General Hospital, said Rochelle Dicker, assistant professor of surgery at UCSF and a trauma surgeon at SFGH.

M. Margaret Knudson, MD, FACS Wins National Safety Council Surgeon's Award

M. Margaret Knudson, MD, FACS  (center) was awarded the 2010 National Safety Council Surgeon's Award for Service to Safety at the Trauma Reception at the AAST Annual Meeting in Boston, MA.

The award states, "For your visionary leadership in injury prevention and control, we commend your lifelong commitment to the care of injured patients.  Your work has saved countless lives."

The award was presented by L.D. Britt, MD, FACS, ACS President and President of the American Association for the Surgery of Trauma (left) and Michael F. Rotondo, MD, FACS, Chair, Committee on Trauma.

Grant Supports UCSF Research in Lead Cause of Trauma Deaths

Mitchell Cohen, MD, UCSF assistant professor of surgery, has received a $225,000 research grant from the National Trauma Institute to investigate the timing and mechanism of traumatic coagulopathy.

Stopping Violence, One Injury at a Time

Sitting in her office at San Francisco General, Dr. Rochelle Dicker remembers the young man who sparked the idea for the Wraparound Project. The year was 1995 and Dicker was fresh from medical school; armed with a white coat and pager, she set out to meet the gurneys bearing the city's grievously wounded into San Francisco General's emergency room. On one of her first days on the job, a young man, just 16 years old, was wheeled through the sliding doors with a gunshot wound to the abdomen.

As Dicker helped care for the young man through his recovery, she came to know him. He told her stories of gang life and the brutality of the drug trade, and Dicker grew concerned. He would survive his injury, but how much time would that buy him before his already marginal luck ran out again?

UCSF Trauma Surgeon Treats Haitian Earthquake Victims

M. Margaret Knudson, M.D., F.A.C.S., noted trauma surgeon, Professor of Surgery, and Executive Director of the San Francisco Injury Center for Research and Prevention, travelled to earthquake-ravaged Haiti to treat survivors of the tragedy that struck the country on January 12, 2010.

Dr. Dicker is Honored with Chancellor's Award

Dr. Rochelle Dicker, Assistant Professor in the Department of Surgery, was selected to receive the 2010 Chancellor's Award for Public Service in the faculty/academic category.  She received the award in recognition of her work as Director and Founder of the Wraparound Project for Comprehensive Rehabilitation, an outstanding violence prevention program that has developed a new approach to the care of the violently injured by instituting a program, based on the public health model of injury prevention, to reduce injury recidivism.