Dr. Lennox Hoyte moved his finger ever so slightly, and the scalpel moved at his command, slicing a straight, clean cut right through the glistening skin…of a grape.

The grape was the patient at a press conference Monday to announce the opening of the USF Health da Vinci Center for Assisted Surgery. Dr. Hoyte, medical director of the center, and Dr. Alex Rosemurgy demonstrated how USF’s new robots can help surgeons perform intricate operations.

Peeling a grape is just the start of what the robots can do. USF is one of two centers in the country training doctors how to use the Si model of the da Vinci Surgical System. This robot, along with USF’s S  model of the da Vinci, can be used by specialists in many disciplines, including gynecology, urology and colorectal surgery.

The center spotlights USF’s commitment to improving medicine, in this case surgical skills, so that the best quality of care is easily accessible for patients, said Dr. Stephen Klasko, CEO of USF Health and dean of the USF College of Medicine.

“This is a symbol of what USF means to the health care of the future,” Dr. Klasko said. “It really blends two things I’ve talked about: innovation and education.”

Mayor Pam Iorio, Dr. Lennox Hoyte, Dr. Stephen Klasko and Commissioner Mark Sharpe at Monday's press conference.

At a press conference Monday to announce the opening of the new center, Dr. Klasko told Mayor Pam Iorio that he knows she likes to see patients travel to Tampa Bay so they can be treated by top-flight surgeons here.

“This is even better,” Dr. Klasko said. “We’re going to bring every surgeon to Tampa Bay.”

As many as 600 surgeons a year are expected to train each year at the center, a partnership between USF and Intuitive Surgical, Inc. It’s part of USF’s larger efforts to help improve surgical skills and medical training. The USF Simulation Center opened earlier this year at Tampa General Hospital, and Dr. Klasko told the crowd Monday that plans are being finalized on another project.

The new da Vinci center is the kind of project that helps boost Tampa’s reputation and increase its intellectual capital, said Mayor Pam Iorio.

“We will get the reputation, as a community, for being on the cutting edge of technology and innovation,” she said. “You really, Dr. Klasko, have a lot to be proud of.”

County Commissioner Mark Sharpe joked that new programs at USF Health have become routine.

“You’re going to help transform the county and our city,” he said. “You are the engine driving the change in healthcare all over the country.”

Surgeons who learn to use the robots can quickly improve their skills at performing minimally invasive surgery, Dr. Hoyte said. After about 20 procedures, their skill levels with the robots can match their abilities doing traditional, open surgery. He said many surgeons have to train for years in laparoscopic surgery to reach that same skill level.

“This is about a whole philosophy of medicine,” Dr. Hoyte said. “We have placed ourselves into the forefront of medical training.”

Dr. Lennox Hoyte and Dr. Renee Bassaly next to the da Vinci Si model.

When surgeons use the robots, patients can benefit. They have faster recovery and less pain than they would with many traditional open surgeries, Dr. Hoyte said. For example, after a traditional open hysterectomy, patients are hospitalized for 3 to 4 days. After a computer-assisted one, the patient can leave after a day or two.

That’s what one of Dr. Hoyte’s patients, Dr. Cheryl Jordan, found after she had a computer-assisted hysterectomy just 16 days ago.

“She is a living example of what a great assist the surgery is,” Dr. Hoyte said.

Dr. Jordan came to Monday’s press conference to tell the crowd that the surgery was “fabulous.” She had surgery on a Saturday and went to work for a few hours on Tuesday. She walked three miles the night before the press conference.

“I probably would have done it sooner if I had known about it,” she said.

Dr. Lennox Hoyte and his patient, Dr. Cheryl Jordan, at Monday's press conference.

Dr. Jordan joined reporters at the press conference in trying out the Si model for herself, doing her best to peel a grape. The Si model has a dual console, making it easier to train other surgeons, as well as for surgeons in different specialties to perform complex operations together.

Dr. Rosemurgy, USF’s associate dean for medical simulation and academic enrichment , said that, much as he likes the Si, he is pushing for the robots to become even better.

“Don’t think of this as the destination,” he said. “This is an ongoing journey.”

Despite the robot’s advantages, it can only do so much. Mayor Iorio tried it out and confessed that, even with the robot’s help, her surgical skills are lacking.

“The grape died, unfortunately, in my less than capable hands,” she joked.

Story by Lisa Greene, Photos by Eric Younghans and Klaus Herdocia, Video by Klaus Herdocia, USF Communications Office

L to R: Dr. Alexander Rosemurgy, Dr. Sharona Ross and Dr. Devanand Mangar

Tampa FL (July 24, 2009) -- Dr. Sharona Ross and Dr. Alexander Rosemurgy – both University of South Florida general surgeons and Dr. Devanand Mangar, anesthesiologist with Gulf-to-Bay Anesthesiology and Chief of Staff at Tampa General Hospital -- last week performed what they believe is the first single incision gallbladder removal without the use of general anesthesia.

Instead of fully sedating the patient as is traditionally practiced, they used an epidural in the thoracic area. The patient was able to converse with the medical team in the operating room. Epidurals are used for women delivering babies -- to reduce the pain during labor, but are inserted in a different part of the spine, the lumbar.

The 54 year-old patient, mother of two and grandmother of 10, returned to her Tampa home on Monday and is recovering well.

USF Health's Dr. Ross and her partners Alex Rosemurgy, MD, and Michael Albrink, MD, pioneered the first laparoscopic endoscopic single site "LESS" surgeries (one incision through the belly button) in Fall 2007 at Tampa General.

“Since the entire operation is performed through the belly button, it does not leave a visible scar like the traditional multi-port laparoscopic approach - which could be anywhere from three to six incisions”, Dr. Ross explains. “This new method benefits the patient by less post-operative pain, less blood loss, faster recovery time, fewer complications and better cosmetic results….with no visible scar.”

More than 300 physicians across the country have trained with USF/TGH and Drs. Ross, Rosemurgy and Albrink have traveled the world to teach the LESS method at conferences. To date, they have performed anti-reflux operations, appendix removals, small bowel resections, liver cysts resections, stomach tumor resections, inguinal hernia repair, removal of adrenal gland and recently the first pancreatic mass resection utilizing the LESS surgical approach - to name a few.

They have also performed combined operations in the same patient (i.e., a hysterectomy and a gallbladder removal, or a gallbladder removal and an anti-reflux procedure). They continue to refine the LESS approach to surgery, and are developing surgeries using natural orifices (vagina, anus, mouth). The physicians with the USF Digestive Disorders Center are hosting a CME LESS Course at Tampa General in November.

About USF Health
USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $360 million in research grants and contracts last year, USF is one of the nation’s top 63 public research universities and one of 39 community-engaged, four-year public universities designated by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.health.usf.edu

About TGH
Tampa General is a 958-bed acute care hospital on the west coast of Florida that serves as the region’s only center for Level I trauma care, comprehensive burn care and adult solid organ transplants. It is the primary teaching hospital for the University of South Florida College of Medicine. TGH is also one of only eleven comprehensive stroke centers in Florida and is a state-certified spinal cord and head injury rehabilitation center. For more information, visit www.tgh.org

Linda Nelson, ARNP, MSN (left), nurse manager for clinical operations at the South Tampa Center for Advanced Healthcare, and Valerie Williams, BSN, MBA, assistant director of nursing/clinical systems, greet visitors at the Neighborhood Care Center reception.

TAMPA, Fla. (June 22, 2009) – Tampa-based Sweetbay Supermarket continues to strengthen its home-grown roots by deepening its partnership with USF and collaborating on the Florida-based chain’s first in-store wellness clinic. USF Health Neighborhood Care Center, scheduled to open July 16 with two ARNPs, will be featured inside the store at its newest location in New Tampa.

“We are proud to offer the New Tampa community an in-store neighborhood care center where they can have convenient access to high-quality medical services that fit their needs,” notes Mike Vail, president and COO of Sweetbay Supermarket. “This service helps make our shoppers’ lives more convenient and the comprehensive quality of care that USF Health provides is exactly what we want to offer the New Tampa community.”

The USF Health Neighborhood Care Center will offer a variety of services through an advanced registered nurse practicioner. From common illnesses to camp physicals and vaccines, patients can visit the Neighborhood Care Center, and then be referred into the network of more than 350 doctors in the USF Physicians Group for further treatment if needed.

Dr. Stephen Klasko, far right, announces the opening of the USF Health Neighborhood Care Center inside the new Sweetbay Supermarket in New Tampa.

“This effort continues our exciting partnership with Sweetbay Supermaket, allowing USF Health to directly impact the health of residents in New Tampa and Wesley Chapel,” said Stephen K. Klasko, CEO of USF Health and Dean of the College of Medicine. “We are excited to bring our commitment to advanced, high-quality healthcare to this growing area in our community.”

Sweetbay’s new store location is 6425 County Line Road, Tampa FL 33647. Store hours are 7 am to 11 pm. Sweetbay operates pharmacies at USF Health's Morsani Center for Advanced Healthcare and the South Tampa Center for Advanced Healthcare.

About Sweetbay Supermarket
Sweetbay Supermarket provides a one-of-a-kind shopping experience, built from the ground up and developed from research in core markets to express the vibrant, exciting and diverse tastes, colors and aromas of food important to Floridians. Sweetbay offers outstanding value, quality and variety, routinely partnering with Florida growers, to bring shoppers the freshest food available in the state. Sweetbay Supermarket was launched in November 2004 in Largo and is headquartered in Tampa. Sweetbay has 103 stores in Florida.

About USF Health
USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $360 million in research grants and contracts last year, USF is one of the nation’s top 63 public research universities and one of 39 community-engaged, four-year public universities designated by the Carnegie Foundation for the Advancement of Teaching.

- Photos by Susanna Martinez Tarokh, USF Health Communications

The University of South Florida College of Nursing has partnered with Cerner Corporation to add the Academic Education Solution (AES), a fully integrated electronic medical record, to the College’s state-of-the-art human simulation lab. The AES is the only full clinical information system adapted to support academic curricula and classroom instruction. The system will enable students to use an interactive approach to learn evidence-based clinical practices, critical thinking skills, and data-driven decision making.

The USF College of Nursing’s adoption of electronic health records (EHR) into its curriculum and classroom instruction is part of a growing national movement to digitize the medical record-keeping process.

The complexity of care, volume of patients, and rapid growth of healthcare knowledge are beginning to push the physical and intellectual limits of healthcare professionals. Care providers need to quickly understand a patient’s complete past and present health information to apply the latest effective clinical practices for improving or managing the patient’s health. EHRs facilitate better access to this important information.

Improving Health Professionals’ Education

To address this evolution in patient care, the USF College of Nursing recognized the need to improve the methods of educating future healthcare professionals. The College plans to embed the EHR into the health professions’ curricula, as well as use it as a teaching and learning tool. The Academic Education Solution, coupled with the College’s simulation lab, enhances the faculty’s ability to teach the clinical process, critical-thinking and problem-solving skills and making evidence-driven decisions.

“By exposing students to the EHR early in the curriculum we are meeting two goals -- improving students’ healthcare information technology skills and, with that added skill set, increasing the market appeal our nursing graduates to our collaborating partners,” said Dr. Laura Gonzalez, director for the Center of Virtual Simulation at the USF College of Nursing. “New graduates will have had substantial training prior to employment, which will result in cost savings in terms of new hire training expenses.”

Paving the Way for Success

Healthcare technologies are widely recognized as an effective tool to counteract today’s crippling shortage of qualified healthcare providers. The USF College of Nursing’s students embrace technology as part of their education and training process, easing the transition from the academic to the professional setting. This translates into more efficient, confident new nursing graduates in increasingly automated healthcare environments where safety and accountability are driving forces.

- Story by Ashlea Hudak, USF College of Nursing Communications

USF SafetyFlorida, a workplace consultation program for Florida’s small businesses, is offering these enterprising teen workers a website dedicated to helping them remain safe on the job. The online workplace safety course, accessed through www.safeteenjobs.com, was developed under the direction of the National Institute for Occupational Safety and Health (NIOSH).

Through real-life stories and interactive games, teens will learn how to identify and reduce job hazards and know their rights in the workplace. For example, a teen working in a fast-food restaurant will be given techniques for avoiding burns and other kitchen hazards.

“Teens are highly susceptible to occupational injuries,” said Charlene Vespi, program director of USF SafetyFlorida. “They often lack the knowledge of workplace dangers. Safeteenjobs.com is an important resource for teens in understanding potential hazards and empowering them to make smart decisions while working this summer.”

Upon successful completion of the six-lesson course, participants receive a certificate of completion from USF SafetyFlorida. The cost is $39.95, and group rates are available through the American Safety Council, which hosts the website.

For more information, visit www.safeteenjobs.com

About USF SafetyFlorida
USF SafetyFlorida, headquartered in Tampa and with consultants across the state, is a workplace safety consultation program for Florida’s small businesses. It is funded by OSHA and the State of Florida and is operated as a service of the University of South Florida’s College of Public Health. The consultation program offers complimentary, confidential and comprehensive assistance throughout Florida. To help employers profit from a safer workplace, the program identifies workplace hazards, offers solutions for safety and health problems, provides training and education, and assists in creating safety and health management plans. To learn more about the USF SafetyFlorida Consultation Program or to request a confidential consultation, visit its website at www.usfsafetyflorida.com.

Program director Lennox Hoyte, MD, has begun seeing patients monthly at the offices of Physician Care Clinical Research, 1931 South Tuttle Ave, in Sarasota. Patients have access to the latest technology in urodynamics and bowel testing, cystoscopy and ultrasound and MRI imaging, which can help in diagnosing pelvic floor problems. Services include minimally-invasive and traditional surgeries for incontinence and prolapse, InterStim® therapy, an implantable device for difficult-to-treat urinary symptoms, and botox and pelvic floor physical therapy for severe pelvic floor pain syndromes.

Dr. Hoyte is associate professor and medical director of Urogynecology and Pelvic Reconstructive Surgery at USF Health. He is an attending obstetrician/gynecologist at Tampa General Hospital and specializes in all types of pelvic floor disorders, including childbirth-related injury and pelvic muscle dysfunction. He is skilled in the use of robotic-assisted, minimally invasive procedures to treat prolapse.

Dr. Hoyte received his MD degree from Stanford Medical School and completed a residency in obstetrics and gynecology at the Brigham and Women’s/Massachusetts General Hospital joint training program. He completed a fellowship in Female Pelvic Medicine and Reconstructive Surgery at Loyola University Medical Center. He is a board certified obstetrician and gynecologist, a fellow of the American College of Obstetrics and Gynecology, and a member of the Society of Gynecologic Surgeons.

For more information, please call (941) 957-1365 or go to www.usfurogyn.com

- USF Health -

USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $360 million in research grants and contracts last year, USF is one of the nation’s top 63 public research universities and one of 39 community-engaged, four-year public universities designated by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.health.usf.edu

Dr. Stuart Hart and Dr. Sharona Ross are among the USF physicians working to advance minimally invasive surgery to the next level.

USF Health surgeons recently removed the uterus and gall bladder of a 37-year-old woman, performing the combined operation through a single entry point – the patient’s belly button. The advanced minimally invasive procedure, known as Laparoendoscopic Single-Site Surgery or LESS, left virtually no scar and the patient went home the next day.

"To the best of our knowledge, this appears to be the first combined single incision procedure involving both a hysterectomy and cholecystectomy (gall bladder removal),” said Stuart Hart, MD, assistant professor in the USF Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology.

The USF surgeons have also successfully performed the first single-incision laparoendoscopic procedure to remove an adrenal gland tumor. They have used single incision laparoendoscopic techniques at Tampa General Hospital to remove the appendix and liver cysts, to repair hernias, and to treat acid reflux disease and achalasia (a disorder of the esophagus).

For the patient, LESS has the cosmetic advantage of virtually no scar since it requires only one tiny laparoscopic incision, typically in the navel, instead of several incisions spaced throughout the abdomen. Physicians say fewer incisions mean quicker recovery time, less pain and less risk for bleeding and infections.

The combined operation was performed in February at TGH. Alexander Rosemurgy, M.D; Sharona Ross, MD; and Kellie McFarlin, MD, all from the USF Health Division of General Surgery; initially removed the patient’s gall bladder. The uterus was then removed by Dr. Hart with the assistance of the General Surgery team. The entire case took approximately three hours.

Multiple instruments were passed through a specially-designed port inserted through the patient's belly button.

The surgeons operated by inserting a specially-designed laparoscopic port and laparoscopic camera to perform the surgical procedure. Since typically several ports are required to pass the laparoscopic instruments into the abdomen to perform the surgery, state-of-the-art instruments were required to make this surgical procedure possible. A specially designed port was placed through the belly button which allowed the surgeons to pass multiple instruments through one incision. The laparoscope, which has a miniaturized digital camera embedded in the tip, transmits high-resolution pictures of internal organs onto a video monitor. Once positioned inside the abdominal cavity, the camera can move in many directions, helping surgeons avoid unnecessary trauma to tissue and nearby vessels.

“With LESS, we can still do a lot of surgery while significantly minimizing the insult of surgery inside and outside the body,” said Dr. Rosemurgy, professor of surgery, associate dean of Simulation and Academic Enrichment at the USF College of Medicine, and surgical director of the Center for Digestive Disorders at TGH.

“Advances in surgical technology, including miniaturization of devices, has helped make all this feasible,” said Dr. Ross, assistant professor of surgery and director of Surgical Endoscopy.

Surgical skills must also adapt and advance to make minimally-invasive techniques even less invasive. “Performing LESS surgery requires advanced laparoscopic skills and represents the new frontier of minimally invasive surgery,” Dr. Ross said. “Laparoscopic surgeons must be trained to operate through a single incision with the scope and instruments working in parallel.”

USF Health physicians from General Surgery and OB/GYN worked together to perform the combined minimally-invasive procedure.

More than 150 surgeons from across the country have come to Tampa General to learn LESS from Dr. Rosemurgy, Dr. Ross and Dr. Michael Albrink. They are developing single-incision surgeries using natural orifices (vagina, anus, mouth) and working with industry leaders to help refine the equipment and tools needed to take minimally invasive surgeries to the next level.

Dr. Hart and Dr. Larry Glazerman, co-directors of USF Center for the Advancement of Minimally Invasive Pelvic Surgery, helped launch the inaugural Advanced Laparoscopic Gynecologic Surgery Conference at the new USF Health Simulation Center at Tampa General the weekend of March 28-30.

Pam Muma swings a hammer at the NICU wall-breaking ceremony.

The dream of building a world-class neonatal unit for Tampa Bay’s tiniest babies is well on its way to reality.

Donning hardhats and safety glasses, Pam and Les Muma swung their sledgehammers with gusto, creating two big holes in a wall to signal the beginning of construction on the Jennifer Leigh Muma Neonatal Intensive Care Unit at Tampa General Hospital. The $35-million project – a tangible sign of the partnership between USF Health and TGH to transform research and care for newborns – will completely redesign and expand Tampa General’s existing neonatal nursery. Construction is expected to be complete in early 2011.

Physicians, nurses and other clinicians, hospital and university officials, and construction team members gathered March 31 on the fourth floor of Tampa General’s West Pavilion for the construction kick-off. They nibbled cookies with pink and blue icing in the shape of baby booties and sipped on non-alcoholic champagne. They reviewed the tabletop model of the 53,000 square-foot unit, which will increase the current NICU from 52 beds grouped in open areas to 82 beds in private rooms and a 12-bed transitional nursery.

The new NICU is being funded in part by the Mumas’ generous $6 million gift to USF Health – a donation in memory of their daughter Jennifer Leigh Muma, who died in a neonatal nursery. Their gift, one of the largest in Florida to support research and care for newborns, has a total impact of $14 million after eligible state and internal USF matches. It supports a USF-TGH initiative to build research and medical teams, laboratories at USF Health and an expanded NICU to advance the care and well-being of premature babies.

In addition, the TGH Foundation capital campaign, “Tiny babies. Big Priority,” has raised more $7.6 million towards the NICU renovation. That includes more than $170,000 brought in by a physician campaign led by Robert Nelson, MD, chair of USF Pediatrics; David Keefe, MD, chair of USF Obstetrics and Gynecology; and Thomas Bernasek, MD, vice chair of the TGH Medical Staff.

Dr. Lewis Rubin, who holds the Pamela S. and Leslie M. Muma Endowed Chair in Neonatology at USF, says the redesigned NICU will be family-centered while employing the latest technology.

“Everyone here today is part of the team that will make this dream happen,” Pam Muma said. “We want to help any family who experiences a situation similar to ours and do all we can to make sure these smallest, sickest children go home healthy.”

“This day is special and there is also an emotional aspect,” Les Muma said. “We wanted our daughter’s name to live on, and she will live on through this.”

Lewis Rubin, MD, who joined USF to fill the Pamela S. and Leslie M. Muma Endowed Chair in Neonatology, said the new NICU has been planned with the latest research on NICU design and environment in mind. Input was solicited from physicians, nurses, respiratory therapists, housekeeping staff, traffic engineers, interior designers and focus groups were held with the parents of premature babies to create a place that will be welcoming for families and maximize the comfort and well-being of fragile infants in need of critical care.

“Of the three neonatal intensive care units I’ve helped plan, this one by far has been the best at involving in its design all the people who will be using the space,” said Dr. Rubin, medical director of TGH’s NICU. “The Jennifer Leigh Muma Neonatal Intensive Care Unit will absolutely be a world-class newborn center. It will be baby and family friendly, while taking advantage of the latest technology in telecommunications and bioinformatics.”

Jim Warren, Chairman of the Board of the Florida Health Sciences Center, thanked attendees for the work they do everyday "to take care of this very vulnerable patient population."

The redesigned NICU will join a growing trend in the care of premature babies – private rooms that strive to replicate the relatively quiet, nurturing environment of the mother’s womb and emphasize family-centered care whenever medically possible. Traditionally, NICUs have been modeled around life-saving equipment with isolettes in one big room leaving little privacy for parent-infant bonding or confidential medical discussions.

Evidence is mounting to suggest that premature babies thrive better in private rooms than in group areas with harsher lights, louder noises, more traffic and other excessive stimuli, Dr. Rubin said. The private rooms in the redesigned NICU will include a place for parents to sleep, ambient lighting, and noise kept low enough for babies to recognize parents’ voices. Windows will allow nurses to see into the rooms, and hand-held PDAs will let them monitor infants and communicate with other team members from anywhere in the NICU. At the same time, the unit will incorporate common areas where parents can gather to socialize and support one another, and siblings can play.

L to R: USF Pediatrics Chair Dr. Robert Nelson, Dr. Lewis Rubin, TGH NICU nurse manager Pam Sanders, Dr. Laura Haubner and Dr. Terri Ashmeade look over the construction model.

Since the Mumas’ gift was announced two and a half years ago, USF Health has opened the Lisa Muma Weitz Advanced Microscopy and Cell Imaging Core, a state-of-the-art laboratory with applications for basic and translational research in neonatology, pediatrics and perinatology. USF has also recruited key members of the research and medical team, including Dr. Rubin and recently Michael Fant, MD, PhD, professor of pediatrics with research expertise in fetal growth and placental development.

Stephen Klasko, MD, MBA, CEO for USF Health and dean of the College of Medicine, said the Mumas’ vision and leadership will create a brighter future for premature babies receiving care in the Tampa Bay area. Their gift will help translate research into the best evidence-based treatment for newborns, he said.

"It shows that when a university and a hospital are committed to excellence in education, research and clinical care, they can achieve so much more together than either could do alone,” Dr. Klasko said. “This kind of partnership is what makes communities great.”

Pam and Les Muma's generous gift in memory of their daughter has been a catalyst in the USF-TGH partnership to transform newborn research and care.

- Story by Anne DeLotto Baierr, USF Health Communications
- Photos by Eric Younghans, USF Health Communications

http://www.health.usf.edu/nocms/publicaffairs/now/FLV/Simulation_Center.flv

See video above. Click here for Photo Gallery.

Tampa, FL (March 2, 2009) – The University of South Florida this week held the grand opening of its comprehensive USF Health Simulation Center at Tampa General Hospital – the only one of its kind in the Southeast, university officials say. The new $1.5-million, 2,800-square-foot facility is expected to draw physicians and other health professionals from across the state and nationally to learn and practice advanced techniques for a wide range of medical procedures and to hone critical clinical decision-making skills – all in a realistic environment without risk to patients.

USF-TGH physicians and nurses and community physicians and healthcare leaders were invited March 2 to 4 to tour the new center and try out the simulators.

The new advanced clinical training center houses more than a half-dozen simulators that mimic the look and feel of minimally-invasive surgical procedures.

The center houses more than $600,000 worth of virtual-reality simulators that mimic the look and feel of actual endovascular and surgical procedures such as cardiac catheterizations, laparoscopic hernia repairs, laparoscopic hysterectomies or colonoscopies. The apprenticeship model of “see one, do one, teach one,” has been stretched by advances in surgical technology and the development of minimally-invasive techniques that spare patients major surgery and shorten recoveries. Computer-based simulation complements traditional training by helping health professionals gain hands-on experience before performing complex procedures or using new devices on real patients in operating rooms and other clinical settings.

“With this new center, USF Health is truly at the forefront of the evolution in clinical and surgical training,” said Stephen K. Klasko, MD, MBA, CEO for USF Health and dean of the College of Medicine. “In partnership with Tampa General Hospital and several of the world’s leading innovators of advanced simulation technology, we have created a center that emphasizes patient safety, reducing medical errors and improving efficiency. All this is directed toward achieving our ultimate goal – better patient care.”

“This collaborative partnership will bring increased prominence to Tampa as one of the major medical centers in the United States committed to the improvement of patient health in a safe clinical environment,” said Ron Hytoff, CEO of Tampa General Hospital.

The USF Health Simulation Center at TGH, available to all healthcare facilities and professionals in Florida, is positioned to have a major impact on the quality of care in the state, said Deborah Sutherland, PhD, associate vice president for Continuing Professional Development at USF Health.

“What makes this center unique in the Southeast is the comprehensive variety of high-end surgical and interventional simulators that can be used by students, residents and practicing healthcare professionals,” Dr. Sutherland said. “This allows for individual training in complex, high-risk procedures and team training for managing challenging patient cases in areas like the cardiac catheterization lab, operating room, critical care and emergency department.”

A growing body of evidence indicates that simulation shortens the learning curve for mastering technical skills and is valuable in measuring how well surgical teams solve problems when confronted with complications such as abnormal bleeding, heart attacks or strokes, or anatomical obstacles. Boards that certify physician specialists have expressed increased interest in using simulation to help assess and maintain the clinical competence of their members.

The Simulation Center also houses a Surgical Skills Laboratory with five fully-equipped stations, where physicians can practice minimally-invasive procedures. In the coming months, the Center plans to open a 4-D Ultrasound Center where physicians can learn the latest real-time imaging technology for diagnosing and assessing pelvic floor disorders such as urinary incontinence, pelvic pain, and vaginal, uterine or bladder prolapse.

USF is working with the following companies in developing the USF Health Simulation Center at Tampa General Hospital: GE Medical Systems, Laerdal, Olympus, Simulab Corp., SimSuite Medical Simulation Corporation, Stryker, Simbionix and VirtaMed.

- About USF Health -

USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $360 million in research grants and contracts last year, USF is one of the nation’s top 63 public research universities and one of 39 community-engaged, four-year public universities designated by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.health.usf.edu

-About Tampa General Hospital -

Tampa General is a 958-bed acute care hospital on the west coast of Florida that serves as the region’s only center for level I trauma care, comprehensive burn care and adult solid organ transplants. It is the primary teaching hospital for the University of South Florida College of Medicine. TGH is also one of only 10 comprehensive stroke centers in Florida and is a state-certified spinal cord and head injury rehabilitation center.

Related stories:

St. Petersburg Times, March 5, 2009, "New USF life-like simulators respond like patients in surgery"

USF Magazine, Winter 2009, "Clinical Practice"

Dr. Larry Glazerman, director of Minimally Invasive Gynecologic Surgery at USF Health, teaches fellow OB-GYN faculty member Dr. Amanda Alvelo-Malina how to use the new hysteroscopic simulator.

The USF Health Simulation Center at Tampa General Hospital recently added a state-of-the-art hysteroscopy simulator to its growing collection of high-fidelity simulators that allow physicians and other health professionals to practice clinical skills in a controlled setting, without risk to patients.

“USF Health now has the only hysteroscopy simulator in North America,” said Deborah Sutherland, PhD, associate vice president for USF Health and associate dean of the Continuing Professional Development Program.

Larry Glazerman, MD, assistant professor of obstetrics and gynecology and director of Minimally Invasive Gynecologic Surgery at USF Health, will use the new VirtaMed HystSim system to help teach hysteroscopic procedures to OB-GYN residents and physicians at USF. He will also train other physicians who come to the USF Health Simulation Center for continuing medical education courses, including the Inaugural Advanced Laparoscopic Gynecologic Surgery Conference in March. USF Health will collaborate with VirtaMed to conduct validation studies investigating the value of simulation training in improving endoscopic surgical skills.

The VirtaMed HystSim, a comprehensive hands-on training system for hysteroscopy, lets physicians look inside the uterus to diagnose and treat certain problems such as intrauterine fibroids and polyps, adhesions and abnormal bleeding. Hysteroscopy is performed without incisions -- using a thin, lighted tube inserted into the vagina to examine the cervix and inside of the uterus. If diagnostic hysteroscopy detects a problem, the physician may be able to insert small instruments through the hysteroscope to correct the abnormal condition (known as operative hysteroscopy).

The physicians practice removing a fibroid from inside the uterus.

“This simulator allows gynecologists and residents to learn and practice hysteroscopic techniques and receive objective performance feedback before applying these diagnostic and therapeutic techniques to patients,” Dr. Glazerman said.

VirtaMed, a Swiss start-up company with an interdisciplinary background in medicine and engineering, provides medical professionals a state-of-the-art training tool for endoscopic surgery with the ultimate goal of improving the quality of patient care.

When fully equipped this spring, the USF Health Simulation Center will house a comprehensive variety of advanced simulators, including those offering hands-on training for individuals or teams in endovascular, laparoscopic, GI and endourologic procedures. For more information or training on any simulators at the new center, please contact Stephanie McKown, RN, at (813) 844-3436 or Stephanie.Mckown@medsimulation.com.

Dr. Glazerman prepares for the surgical simulator training demonstration as, left to right, Dr. Alvelo-Malina, Stephanie McKown, RN, and Stefan Tuchschmid, CEO for VirtaMed, observe.

- Story by Anne DeLotto Baier, USF Health Communications
- Photos by Eric Younghans, USF Health Communications

“For four years we’ve envisioned a successful entrepreneurial practice of academic medicine, and this is the perfect example of that vision in action,” said Stephen K. Klasko, MD, MBA, CEO of USF Health and Dean of the College of Medicine. “It will raise the bar for health care in this community by creating an academic base for advanced health care. Our patients deserve the best, and they’ll get the best.”

In addition, the new academic affiliation will strengthen the existing clinical agreement, where Radiology Associates will continue as the radiologists for the USF physicians practicing at Tampa General Hospital and USF’s outpatient Centers for Advanced Healthcare.

“We’ve had a very strong and long standing relationship with USF and we’re happy to solidify our partnership now and for many years to come,” said Raul R. Otero, MD, USF Clinical Associate Professor in Diagnostic Radiology and Neuroradiolgy.

The result is an entrepreneurial, but academic, model of learning and patient care, which breaks down the town-gown wall between university and private physicians.

- USF Health -

USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $360 million in research grants and contracts last year, USF is one of the nation’s top 63 public research universities and one of 39 community-engaged, four-year public universities designated by the Carnegie Foundation for the Advancement of Teaching.

SimSuite Clinical Education Specialist Stephanie McKown, RN (pointing), prepares a stent evaluation-with-angiogram scenario for, left to right, Dr. Murray Shames, USF vascular surgeon; UM medical student Aurelia Thibbonier; and Dr. Patrick Austin, USF vascular surgery fellow.

Denver, CO, Nov. 10, 2008 -- Medical Simulation Corporation (MSC) announces a new partnership with the University of South Florida (USF) to provide simulation training and education services for USF Health hospital partners and for local and national health professionals seeking continuing medical education. The MSC SimSuite Education Center is located at Tampa General Hospital, a major teaching affiliate of USF Health.

“MSC is excited to partner with USF Health to offer its hospital affiliate team members and other health professionals new opportunities to enhance their skills in a risk-free environment,” says Bill Younkes, MSC President and CEO. “Our SimSuite Education System provides a broad spectrum of tools to help USF Health advance its commitment to patient safety, high-quality care and excellence in education.”

“At USF Health we are transforming the way we educate the next generation of health professionals and challenging the way we practice healthcare,” said Stephen Klasko, MD, MBA, CEO for USF Health and Dean of the College of Medicine.

“The new SimSuite Education Center fits in with our creation of an
innovative curriculum that strives for excellence in clinical skills development, with the goal of promoting patient safety and preventing medical errors," Dr. Klasko said.

“A wide range of health professionals will have access to all sorts of high-level, virtual reality simulators designed to give them the sensation of touch when working on such skills as intubation, central line placement and endoscopy,” said Deborah Sutherland, PhD, Associate Dean of the nationally prominent USF Health Continuing Professional Development Program. “The training scenarios can mimic the potential unpredictability of patient outcomes as care unfolds.”

Stephanie McKown (photo above) and Dr. Murray Shames (below) inject contrast dye into the kidney arteries of Simantha, a virtual patient simulator that allows distinct experiences for each practitioner based on individual response times, actions and decisions.

“This project demonstrates how our relationship with USF Health can raise the level of health care we provide to residents of this community,” said Sally Houston, MD, chief medical officer for Tampa General. “Young physicians will develop not just clinical dexterity, but also critical thinking skills as they deal with unexpected scenarios that mimic medical complications in the real world.”

The placement of the 2,800-square-foot simulation suite at Tampa General made strategic sense because nearly half of USF’s 650 resident physicians practice there and virtually all residents and medical students rotate through the affiliate hospital at some time in their training, said Peter Fabri, MD, PhD, Associate Dean for Graduate Medical Education at USF. “Simulation-based training is intended to transfer knowledge from the educational environment to the clinical workplace. It’s very important for us to work with our hospital partners to develop state-of-the art simulation facilities and equipment so our younger physicians can repeatedly practice using what they’ve learned in a controlled setting – before performing procedures on patients.”

Photo above: Loading a balloon catheter to open a blockage in the left kidney artery. Photo below: The monitor displays the renal angiogram, a test used to examine blood vessels leading to kidneys and evaluate whether the arteries have become narrowed or blocked.

Simulators “absolutely shorten the learning curve” for mastering surgical skills, said Alexander Rosemurgy, MD, Professor of Surgery and Medicine at USF. “In addition to training individuals, the simulators help teach team coordination and emergency protocols. Simulation is a very valuable tool for evaluating how well a surgical team communicates and manages decisions when confronted with an unexpected problem or crisis situation.”

The USF Health SimSuite Education Center offers courses for all levels of healthcare professionals, including medical students, resident physicians, fellows, attending physicians, nurses, therapists and technologists. SimSuite courses provide hands-on training using best demonstrated practices to improve both cognitive decision making and technical skills. Course offerings include ahighly-efficient Advanced Cardiac Life Support recertification program and curriculum for providers working in vascular surgery, cardiology, interventional cardiology and radiology, general surgery; and emergency, critical care and general medicine units.

Simulation is quickly becoming a mainstream teaching tool in endovascular diagnosis and therapy. Simantha, a high-fidelity simulator, is so realistic that physicians can "feel" lesions in blood vessels and the resistance of a catheter. Dr. Shames (below), who directs the Vascular Surgery Residency at USF Health, will use Simantha for training medical students and new physicians.

The SimSuite curriculum features Quality Initiative Programs that are designed to help USF hospital partners meet and exceed national patient safety goals set by several reporting and regulatory organizations. The SimSuite Sepsis, Ventilator-Associated Pneumonia and Central Line Infection and Management Programs focus on early identification and effective treatment of these widely recognized and costly conditions to improve the confidence and competenceTM of all healthcare providers.

Dr. Shames discusses educational value of patient simulation technology.

Stephanie McKown on use of the MSC SimSuite Education Center.

Related story:
Nursing's Virtual Patients

About USF Health
USF Health is dedicated to creating a model of health care based on
understanding the full spectrum of health. It includes the University of South
Florida’s colleges of medicine, nursing, and public health; the schools of
biomedical sciences as well as physical therapy & rehabilitation sciences; and
the USF Physicians Group. With more than $360 million in research grants and
contracts last year, USF is one of the nation’s top 63 public research universities
and one of 39 community-engaged, four -year public universities designated by
the Carnegie Foundation for the Advancement of Teaching. For more
information, visit www.health.usf.edu

About Medical Simulation Corporation
Medical Simulation Corporation (MSC) is the recognized healthcare industry
leader in providing full-service simulation training and education services to
healthcare personnel, medical societies and medical product manufacturers.
MSC’s patient safety solutions are designed to strengthen the competence and
confidence™ of nurses, physicians and technologists. Because real-life clinical
scenarios are simulated, no patients are at risk while healthcare professionals
advance their technical and cognitive skills. For more information about MSC,
visit www.medsimulation.com.

- Photos by Eric Younghans
- Video by Jean Rinvil

The USF Health Surgery and Endoscopy Center opened recently on the second floor of the Carol & Frank Morsani Center for Advanced Healthcare, and already the facility is receiving accolades from USF Physicians who have performed some of the first cases at the new facility.

“It has been really exciting and gratifying to do surgery at our new ambulatory surgery center,” said Rob Pedowitz, MD, PhD, Professor and Chair for the Department of Orthopaedics and Sports Medicine. “The equipment is state of the art, the operating rooms are very comfortable and ergonomic, and staff members are well trained and anxious to do great work.”

The USF Health Surgery Center offers eight operating rooms and five endoscopy suites, all equipped with the latest technology, including integrated ORs, which will allow physicians to broadcast to and communicate with individuals at other locations.

Lennox Hoyte, MD, Associate Professor and Director of Female Pelvic Medicine and Reconstructive Surgery at USF, recently performed cystoscopy with retrograde pyelogram, a procedure to evaluate a woman with an abnormal connection between the bladder and vagina.

“Morsani Center staff was outstanding, friendly, highly competent, knew their stuff, got the patient in and out of the OR quickly, and scheduling was a breeze,” Dr. Hoyte said. “I was able to start my case at 7:30 a.m., and be done quickly so I could get back to clinic.”

Physicians schedule cases beginning at 7 a.m. with the last patients recovering and leaving the facility around 7 p.m. As family members and friends wait for patients undergoing surgery, they can pass the time in the first floor café or patient education center. Family members are given pagers to notify them when their loved ones are out of surgeryand recovering and when they’re able to go home.

Michael Shereff, MD, Director of the Division of Foot and Ankle Surgery and Professor for the Department of Orthopaedics and Sports Medicine, was the first USF Health physician to perform surgery in the new center.

“The facility is magnificent,” Dr. Shereff said. “With the absolute cutting-edge technology and most up-to-date equipment available, the new Morsani surgery center is a fabulous resource for the Tampa Bay community and a credit to USF Health."

On the first floor of the Morsani Center, the in-house imaging area offers fully digital diagnostic imaging including, 3T MRI, 64-slice CT, mammography, ultrasound, bone densitometry and basic x-ray. Fluoroscopy, nuclear medicine, and other services will open in the coming months.

Sweetbay Pharmacy allows USF Health patients instant access to over-the-counter and prescription medication with their in-house service on the 1st floor. USF physicians and other practitioners have the ability to send all prescriptions electronically from exam room to computers directly in the downstairs pharmacy, making the entire healthcare visit all-inclusive.

David Leffers, MD, Associate Professor and Director of the Division of Sports Medicine for the Department of Orthopaedics and Sports Medicine, has performed several arthroscopic procedures at the new ASC.

"It is state of the art in terms of equipment, and the staff they have assembled is the best," Dr. Leffers said. "The patients have been impressed by the quality of care and their surgical experience.”

The Morsani Center offers over 50 clinic exam rooms, a patient outreach and education center and full service eatery, Camille’s Sidewalk Café, on the first floor featuring healthy options for patients and staff. The facility was completed with funding from the state, the community, and a bond from the USF Physician’s group at a total cost of $67 million.

- Story by Susanna Martinez Tarokh, USF Health Communications
- Photos by Eric Younghans, USF Health Communications

Dr. Alexander Rosemurgy and Dr. Sharona Ross

Dr. Alexander Rosemurgy, professor and director of General Surgery for USF Health, and Dr. Sharona Ross, a GI endoscopy and minimally invasive surgeon at USF-TGH, were recently featured on a Fox-13 News health segment about Laparo-Endoscopic Single Site Surgery (LESS). The procedure helps eliminate surgical scars and speed recovery after surgery.

In the story, the USF-TGH surgeons were filmed performing the LESS technique to repair a constricted esophagus for a patient with achalasia. Two cameras -- one inserted through the mouth and the other through the belly button -- allowed them to maneuver surgical tools and make the repair with one tiny incision at the navel instead of several. The technique can also be used to remove gall bladders and appendixes.

The single incision heals quickly with virtually no scar.

Surgeons from across the country come to TGH weekly to learn the single incision endo-laparoscopic techniques from Dr. Rosemurgy, Dr. Ross and Dr. Michael Albrink. They are also developing surgeries with single incisions using natural orifices (vagina, anus, mouth), and evaluating the surgical tools used for these minimally-invasive techniques.

Newsbrief by Anne DeLotto Baier, USF Health Communications
Photo by Eric Younghans, USF Health Communications

L to R: Members of the Rothman Neuropsychiatry Center are Dr. Steve Pence, Omar Rahman, Dr. Aldea Adina, Dr. Jane Mutch, Dr. Eric Storch, Dr. Tanya Murphy, Danielle Bodzin and Jeannette Reid.

With the addition of a highly respected team of child neuropsychiatrists and clinical psychologists, USF Health recently launched the Rothman Center of Neuropsychiatry at All Children’s Hospital in St. Petersburg.

Tanya Murphy, MD, professor and Rothman Endowed Chair of Developmental Pediatrics in the Departments of Pediatrics and Psychiatry, oversees the new multidisciplinary clinic, for children, adolescents and adults with obsessive-compulsive disorder (OCD) and other anxiety disorders, Tourette’s syndrome, autism spectrum disorders and learning disabilities.

The center’s team includes faculty members Eric Storch, PhD; Steven Pence, Jr. PhD; Adina Aldea, PhD; and Jane Mutch, PhD, who provide comprehensive evaluation and individualized treatment. They offer virtually all services in one location, including medication management; cognitive-behavioral therapy, which safely exposes patients to a dose of what they fear to help prevent a compulsive response; habit reversal training, an intervention for managing tics or hair pulling-behaviors; parent training; occupational therapy; speech therapy; and audiology.

Dr. Storch, associate professor of pediatrics and psychiatry, directs the center’s OCD Program – one of few in the Southeast. Previously considered a rare condition among children and adolescents, obsessive-compulsive disorder (OCD) has become one of the most common pediatric psychiatric illnesses.

The condition is characterized by intrusive, troubling thoughts and repetitive behaviors intended to alleviate the anxiety brought on by the unwanted, obsessive thinking. It can be tricky to identify in youngsters, who can normally seem obsessed with one thing or another, including bedtime and mealtime routines, their appearance, and repetitive play. The Rothman Neuropsychiatry Center offers both intensive daily outpatient treatment and the more standard weekly cognitive-behavioral therapy program for OCD.

“We are rehabilitating the mind,” Dr. Murphy. “Children have such plastic brains that you can often change the way the brain functions through behavioral therapy rather than just throwing medication at the problem. You can teach them skills to modulate their anxiety or depression in everyday life so it doesn’t develop into a long-term neuropsychiatric disorder.”

The USF Health clinical psychologists have extensive experience using intensive outpatient cognitive-behavior therapy to help reduce or eliminate a child’s obsessions and compulsions. Therapy sessions involve exposing patient to what they fear in graduated doses in an attempt to decrease their anxiety over time and prevent a compulsive response. It’s the psychiatric equivalent of immunotherapy, or allergy shots, which gradually reduce a patient’s sensitivity to the allergens that trigger their symptoms by exposing them to graduated doses of the substances.

Clinical studies have shown that this integrated treatment approach -- behavior therapy alone or combined with medication when needed -- helps 80 percent of patients improve. “Most children with straightforward OCD, without complicating conditions like autism or ADHD, have tremendous recoveries with cognitive-behavioral therapy alone,” Dr. Murphy said.

Dr. Murphy and Dr. Storch, long-time collaborators, came to USF this summer from the University of Florida, where they helped establish a Child OCD Treatment Program in 1999.

They edited the Handbook of Pediatric Obsessive-Compulsive Disorder, published over 200 articles and book chapters between them, and together bring to USF more than $3 million in research funding, including grants from the National Institutes of Health, the National Alliance for Research on Schizophrenia and Affective Disorders and the Obsessive-Compulsive Foundation.

Dr. Murphy was chief of the Division of Child and Adolescent Psychiatry and directed the Child Anxiety and Tic Disorder Clinic at UF. Her research interests include investigating the role of infections in the onset of childhood psychiatric disorders and medical and psychological treatments for Tourette’s syndrome and OCD. She is a member of the National Tourette’s Syndrome Association Medical Advisory Board and the Regional Obsessive-Compulsive Foundation Scientific Advisory Board.

Dr. Storch was director of Cognitive-Behavior Therapy Research at UF. He is a licensed clinical psychologist with expertise in the psychological treatment of OCD, Tourette’s syndrome, trichotillomania and anxiety disorders. His research interests include cognitive-behavioral therapy for OCD, augmenting therapy for patients who do not respond to treatment, and symptom assessment.

The clinic, open 8 a.m. to 6 p.m. Monday through Friday, is located on the Fourth Floor of the Children’s Health Center at All Children’s Hospital.

For more information or to schedule an appointment, please call (727)767-8230 or email NeuropsychClinic@health.usf.edu.

- Story by Anne DeLotto Baier, USF Health Communications

The new Parkinson Research Foundation Center of Excellence at USF Health is staffed by, l to r, Dr. Juan Sanchez-Ramos; Kelly Sullivan, MSPH; Lisé Casady, MSCN, ARNP-C; and Dr. Theresa Zesiewicz.

Tampa, FL (Sept. 22, 2008) -- The Parkinson’s Research Foundation will establish a new PRF Center of Excellence at USF Health to expand research, programs and services for Parkinson’s patients and their caregivers, primarily in the greater Tampa Bay area. The center has already received funding and future commitments for $175,000 from PRF.

“Parkinson’s is so tricky to treat effectively, and unfortunately too many patients with this age-related neurodegenerative disease don’t have the opportunity to see neurologists who specialize in movement disorders,” said Larry Hoffheimer, chairman and founder of the Sarasota-based PRF. “We want to work with USF to reach out to a wider patient community and improve their quality of life through education and the highest standard of care. That includes research to determine what medications and therapies work best.”

The grant will allow USF Health to increase clinical services, conduct more clinical trials and further support basic and translational research on its North campus. The PRF Center of Excellence’s daily Parkinson’s clinics are expected to move into the Carol and Frank Morsani Center for Advanced Healthcare by the end of the year.

The PRF Center of Excellence’s core members Juan Sanchez-Ramos, PhD, MD, professor of neurology and the center’s medical director; Theresa Zesiewicz, MD, professor of neurology and the center’s director of clinical research; Lisé Casady, MSCN, ARNP-C, an adult nurse practitioner specializing in Parkinson’s disease; and Kelly Sullivan, MSPH, a neuroepidemiologist and associate in research.

“Because of our state’s elderly population, the numbers of people with Parkinson’s disease in Florida, particularly mid-Florida, continues to grow by leaps and bounds,” said Dr. Sanchez-Ramos, the Helen Ellis Endowed Chair in Parkinson’s Disease Research at USF. “USF has a wealth of expertise in movement disorders. With this PRF award, we now have the resources to complement the existing Center of Excellence on our South campus and offer convenient access to patients in North Tampa.”

“As the daughter of a mother who is severely affected by Parkinson’s disease, as well as a neurologist, I am grateful to the PRF for supporting USF in this endeavor,” Dr. Zesiewicz said. “The PRF Center of Excellence will allow us to provide outstanding care and clinical research to Parkinson’s disease patients in the north Tampa Bay and mid-Florida area.”

"We are extremely grateful for this generous support from the PRF and very proud of their designation of this center as a PRF Center of Excellence, which is an acknowledgement of the excellent clinical care and research in Parkinson's disease being done by two of our outstanding faculty members, Drs. Juan Sanchez-Ramos and Theresa Zesiewicz, on the North Campus of USF Health,” said Cliff Gooch, MD, professor and chair of the Department of Neurology. “This support is critical for us to expand our work in Parkinson’s disease, and will help ensure a brighter future for patients with this disease in Florida and beyond."

This will be the second privately-funded Parkinson’s Disease Center of Excellence for USF. The USF Parkinson’s Disease and Movement Disorders Center, directed by USF neurology professor Robert Hauser, MD, has been a National Parkinson’s Foundation Center of Excellence since 2005. Located at Harbourside Medical Tower on the USF Health South campus, it is one of the country’s leading sites for testing new medications to combat movement disorders and evaluates new surgeries and innovative cell-based therapies that may offer hope for patients who no longer benefit from drug therapy.

The new award will help establish a PRF Mid-Florida Chapter co-directed by Dr. Sanchez-Ramos and Dr. Zesiewicz. The chapter will support and educate patients and their families, providing the latest information about Parkinson’s disease care and research.

The PRF Center of Excellence will host the first in a series of patient conferences, “Parkinson’s Disease: What does the Future Hold?” 10 a.m. to Noon, Saturday, Oct. 25, at the Byrd Alzheimer’s Institute, 4001 E. Fletcher Ave. The inaugural meeting of the chapter’s patient support group will be noon to 2 p.m. Wednesday, Oct. 29, at USF Health’s Morsani Center for Advanced Healthcare, 13330 USF Laurel Drive.

The award will also fund a post-doctoral research fellowship to train future generations of Parkinson’s disease experts. The PRF Center of Excellence is recruiting its first physician-scientist for the position. The fellow will see patients with Dr. Sanchez-Ramos and Dr. Zesiewicz and work in the laboratory of Dr. Sanchez-Ramos, who studies neurodegeneration, neurotoxicity, and the potential of adult stem cell therapies to delay or prevent Parkinson’s and other neurodegenerative diseases.

For more information on the PRF Center of Excellence at USF, click here.

About the Parkinson Research Foundation
PRF is a nonprofit health organization providing Parkinson’s disease research, information and advocacy. PRF is an IRS-recognized 501c3 organization and contributions are tax-deductible to the extent permitted by law. The mission of the organization is to cure Parkinson’s disease and to improve the lives of all people affected by the disease.

About USF Health
USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $360 million in research grants and contracts last year, USF is one of the nation’s top 63 public research universities and one of 39 community-engaged, four-year public universities designated by the Carnegie Foundation for the Advancement of Teaching.

From L to R: Dr. Linda Whiteford, Associate VP, Global Strategies, Office of President; Dr. John Sinnott, Associate Dean of International Affairs, College of Medicine; Dr. Ashley Ansara, CEO of Regency Holding, Florida; USF President Judy Genshaft and Provost Ralph Wilcox.

On August 24, 2008, the Morsani Center for Advanced Healthcare on the campus of USF Health welcomed a delegation of dignitaries from the Middle East in a special event to foster collaboration. The group of dignitaries was hosted by USF President Judy Genshaft, Senior Vice President & Dean Dr. Stephen Klasko, Provost Ralph Wilcox, Associate Vice President of Global Strategies and International Affairs Dr. Linda Whiteford, and the Associate Dean of International Affairs for the College of Medicine Dr. John Sinnott. Visitors included Ashraf El-Ghamrawy, CEO and Managing Director of the Egyptian Saudi Finance Bank, Cairo, Egypt and Dr. Ashley Ansara, CEO of Regency Holding, Florida, and other Egyptian dignitaries.

Under the auspices of a new exploratory initiative, USF Health and Regency Holding are in discussions to initiate a collaborative health project in Jeddah, Saudi Arabia. Mr. Ashraf Al-Ghamrawy and Dr. Ansara toured the Morsani Center. Mr. Ghamrawy was impressed by the state-of-art Morsani Center and said that it would be valuable to replicate parts of this model in Jeddah, Saudi Arabia.

Faculty from several departments including the department of obstetrics and gynecology, neurology, neurosurgery, infectious disease, allergy and immunology and orthopedics, were on hand to represent USF Health’s investment and leadership in state-of-the-art healthcare. Dr. Ansara’s leadership and experience in clinical research, healthcare, and real estate development will add tremendous value to the proposed program.

Collaborative Projects with Ain Shams University, Cairo, Egypt
In a separate project, discussions for the development of an international medical student exchange are underway with Ain Shams University, in Cairo, Egypt. Discussions were led by Sinnott, who is also the Director of Infectious Disease & International Medicine, USF College of Medicine, and Dr. Lynette Menezes, Director of International Affairs for the College of Medicine, with Dr. Ashley Ansara, CEO of Regency Holding and Dr. Magdy Osman, Professor of Neurosurgery, Ain Shams. Dr. Ansara and Dr. Osman pledged $50,000 each from the Ansara and Osman Foundations respectively to establish this exchange program for medical students from Ain Shams University. As an initial step a collaborative agreement has been signed between Ain Shams and USF.

The collaboration proposal
• Establishing an International Student Exchange Center for students from a developing country participating in a clinical rotation at USF
• An online medical curriculum certificate program
• Two 4th year medical students/interns visiting USF for one month of clinical rotation with approximately 10 – 12 students per year
• Collaborative interdisciplinary research projects between faculty from USF and Ain Shams
• Exchange of faculty, faculty training in research
• Training of nurses, laboratory personnel, and other technicians
• Hospital infection control protocol

Other links:
International Programs, USF College of Medicine.

Carol & Frank Morsani Center for Advanced Healthcare.

Newsbrief by Julian Corvin, USF Division of Infectious Disease & International Medicine
Photos by Julian Corvin, Karina D’Souza, Office of International Affairs, College of Medicine

PHOTO GALLERY:

From L to R: USF President Judy Genshaft and Dr. Madgy Osman, Professor of Neurosurgery, Ain Shams University in Cairo, Egypt.

From L to R: Dr. Ashley Ansara, CEO of Regency Holding, Florida; Mr. Medhat and Mr. Ashraf El Ghamrawy, CEO and Managing Director of the Egyptian Saudi Finance Bank, Cairo, Egypt.

From L to R: Dr. Nagwa El-Badri (Dajani), Director of Women's Health Graduate Program & Asst. Professor, Neurosurgery, USF College of Medicine and Dr. Ashley Ansara, CEO of Regency Holding, Florida.

At bottom left: Richard Green, Chief Operating Officer, USF Health Centers for Advanced Healthcare, conducting the tour of the Morsani Center for the delegation from Egypt and joined by faculty members from USF Health.

It’s official. Kids across the Tampa bay area will be heading back to school in just one week. What’s a kid to do with these last few days of freedom? Just one look at USF Health Pediatrics tells the story. Most will be heading to the doctor.

“Oh yes! This is always our busiest time! I think we all go to sleep dreaming of the blue and yellow forms!” says Linda Nelson, ARNP, Assistant Director of Clinical Operations at the USF Health South Tampa Center. The “blue and yellow forms” she's talking about are the annual Health Department forms listing a child’s immunizations.

No forms, no school. No exceptions.

It’s the same every year with most families squeezing their kid’s back-to-school physical exams into the last two weeks of summer vacation. USF pediatricians know the routine well. After all, the crew of specialists includes its fair share of moms & dads too. Since July 1st the pediatrics department has been working a sixth day to fit in as many kids as possible. From now until September 30th, they’re doing school physical exams on Saturdays, and yes, Holidays, from 8:00 AM – 11:30 AM. For working parents, the office opens as early as 8:00 AM weekdays and sees its last patient around 5:30 PM. No “lazy days of summer” here, but no one’s complaining.

“Well, I’m a parent too,” says Dr. Carmen Alfaro, smiling sheepishly. “A lot of us always wait for the last 2 weeks before school starts.” Dr. Alfaro is the Medical Director of the Pediatric Ambulatory Clinic at the USF Health South Tampa Center and Assistant Professor of Pediatrics in the USF College of Medicine. Visiting with her and the pediatrics team one afternoon, the office is quite the ‘happening’ place.

“I love working with kids,” says Alfaro. “When they come in, they recognize me and play with me. Sometimes they pull my hair a little or touch my glasses, but they’re smiling the whole time,” she says happily. “Then, when I leave the room they wave at me and give me a kiss! That makes me really happy!!”

It’s the kind of dedication that keeps patients coming back and new patients arriving. In May alone, the team of USF pediatricians saw close to 1,460 kids. June brought in another 1,394. While the official number of pediatric visits for July is still being tallied, the jump in patients is so significant they’re just 200 visits shy of reaching last year’s total of 18,000. With 5 months left in the year, the team is certain to set a new record in patient visits.
(From January 1 – June 30, 2008 = 17, 826 USF pediatric visits.)

“We have tried very much to make the schedule adaptable to working parents and early morning appointments,” says Nelson. “We’re starting about 30 – 45 minutes earlier in the morning. We have free valet parking so it’s easier for parents, particularly with young children. They’re not crossing busy streets. They’re in and out.” The supervisor of clinical operations for the entire facility, not just pediatrics, notes that once inside, families get the “one-stop-shopping” experience. “We have a pharmacy in the building. We can do shots, visits, whatever…We have an “immunization room” so that kids can have their immunizations quicker. We’re adapting our practice to what’s more appropriate to working parents as well as parents who are traveling long distances to see us.”

The Patient Experience…
Walking in to the exam room where 10 year old William Crawford and 7 year old Anthony White are sitting, Dr. Dan DesRochers is all smiles. “Hi. I’m ‘Dr. Dan’ You must be Antonio,” says the resident physician in Internal Medicine and Pediatrics. Turning to the boy’s older brother, he says “And you must be William,” extending his hand for a shake, “What grade are you starting?”

Sitting down at the computer desk with the boys’ immunization records on the display screen, he quickly scans the list of ‘shots’ while the boys check-out the squirrel embroidered on the doc’s white socks. “Okay guys, looks like you’ll need the chicken pox vaccination today,” he says, turning to mom Catherine White for the okay. “They’ve been eating all summer,” she says with a smile. “I’m ready for them to go back to school!”

Immunizations….
William and Anthony are just two of the many kids USF pediatricians saw on the day our cameras visited. The “blue and yellow forms” – proof of immunizations - were in practically every parent’s hand as they exited, even for parents with babies and pre-schoolers. Pre-kindergarten centers, preschools and day cares also require immunization records for incoming kids.

Required shots for students in grades Kindergarten – 12th include MMR, DTP and Hepatitis B. Children starting kindergarten must have two chicken pox vaccinations. “…and seventh graders will need the ‘T-dap’ this year,” says Dr. Alfaro. It’s quite the alphabet soup for most parents to keep up with. Luckily, the pediatrics team knows them all by heart.

Back in the shot room, Dr. Lynn Ringenberg is with William and Anthony as they end their doctor’s visit for the day. Mom treated the boys to I-Hop before coming, hoping to sweeten the deal. “It’s tradition for the older brother to go first, so hop on here,” says Ringenberg to William. “It is?” says the 10 year old, a little bummed. Seven-year old Tony is up next. “Aw!!!!......” says Tony, eyes & mouth springing wide open as nurse Bridgette Holloway sinks her skiny needle in his arm.

Afterwards, both boys mug for the camera showing off their bandaid-clad muscles - determined not to let a little chicken pox vaccine get in the way of being cool. It’s a moment that never gets old for Ringenberg – a pediatrician for 28 years.

“It’s hectic, but it’s fun because everybody is excited about going back to school. We stress to the families that we’ve got to get these shots in, but the truth is we’re here for these guys 24 – 7, not just for school physicals. We’re here all the time for the kids, including weekends and we need to make sure that our families know that,” says Ringenberg, Professor and Division Chief of General Pediatrics. “Any questions, CALL US. ‘Should I bring my child in? At what ages do they need what shots?’ Just call or come by and visit with us. We’re happy to answer questions anytime. We have an open access clinic so you can get in.” she says as she quickly heads off to see more kids.

No time to rest…tick tock, tick tock…the first day of school is almost here.

Video tour of Pediatrics @ USF Health South Tampa Center. Meet Mom Catherine White and her sons- 10 year old William and 7 year old Antonio.

USF Health en Español: Dr. Carmen Alfaro Interview

Story by Lissette Campos, USF Health Communications
Photo gallery by Eric Younghans / Video tour by Jean Rene Rinvil – USF Health Media Center

OTHER LINKS:
PHOTO GALLERY
Division of General Academic Pediatrics at USF Health
Vaccines & immunizations by age group - Centers for Disease Control & Prevention
Florida Dept. of Health - Immunization Guidelines Effective July 2008
Overview of all Pediatric Services at USF Health

BACK TO SCHOOL PHYSICALS – FOR a USF HEALTH PEDIATRICS’ LOCATIONS NEAR YOU:

USF Health South Tampa Center
2 A Columbia Drive, Tampa, FL 33606
(813) 259-8700
Mon – Friday Open 8:00 AM – 5:30 PM
Saturdays Open 8:00 AM – 11:30 AM

North Site
12901 Bruce B. Downs Blvd.
Tampa, FL 33612
(813) 974-2201
Call for clinic hours

Genesis Pediatric Clinic
5802 North 30th Street
Tampa, FL
(813) 236-5100
Call for clinic hours

Read full news release...

- Academic entrepreneurial model teams USF Health with hospital partners -

Dr. W. McDowell Anderson (second from left), program director of USF Health's new Sleep Medicine Fellowship, with the program's first fellows, left to right, Dr. Robert Geck, Dr. Ali Bozorg and Dr. Natarajan Subramanian.

The first physicians in USF Health’s new Sleep Medicine Fellowship program were introduced July 22 at a special presentation recognizing the interdisciplinary Sleep Medicine Program.

This month Ali Bozorg, MD; Robert Geck, MD; and Natarajan Subramanian, MD, started the one-year sleep medicine fellowship training program, which is accredited by the Accreditation Council for Graduate Medical Education (ACGME). The postdoctoral program is directed by W. McDowell Anderson, MD, professor of medicine, and brings together faculty from the Departments of Medicine, Neurology, Pediatrics, Psychiatry and Otolaryngology and the College of Public Health. The fellows, whose training is supported by Tampa General Hospital and James A. Haley Veterans’ Hospital, will rotate through sleep laboratories at TGH, the Haley VA, and University Community Hospital.

“Our Sleep Medicine Program is an excellent example of the positive synergy that can result when different departments within USF Health work well together and with our hospital partners,” said Stephen K. Klasko, MD, MBA, dean of the USF College of Medicine and senior vice president for USF Health.

“This is an academic entrepreneurial model that can be both profitable and scholarly.”

Sleep medicine was only officially recognized as a separate medical subspecialty by the ACGME in 2003, and the organization began accrediting sleep medicine fellowship training programs in 2006. USF is now one of four sites in Florida with such fellowships; the University of Florida, the University of Miami and the Mayo Clinic in Jacksonville are the others.

The demand for physicians with specialized training in sleep disorders -- everything from obstructive sleep apnea and insomnia to narcolepsy and circadian rhythm disorders -- continues to grow.

For example, the number of USF physician consultations requested for sleep disorders at the Haley VA Hospital doubled within five years, from less than 700 in 2000 to more than 1400 in 2005.

“It’s a huge unmet public health need. Less than 20 percent of patients with sleep problems are appropriately diagnosed because many physicians are not trained to identify and treat these disorders,” said Dr. Anderson, medical director of the TGH Sleep Disorder Center. “To give you some idea of the patient numbers we’ll be seeing in the next few years, there are now more patients with obstructive sleep apnea in the United States than those with diabetes.”

Researchers have linked sleep disorders with snoring; diabetes, stroke and other cardiovascular problems; weight gain, depression; anxiety; memory impairment; and behavioral problems, to name a few.

“The costs in terms of lost productivity, poor health and even accidental deaths associated with falling asleep while driving or operating machinery are staggering," Dr. Anderson said.

Dr. Anderson, who joined the USF College of Medicine in 1992, helped expand the sleep laboratories at Tampa General and the Haley VA Hospital and started a consortium with experts in pediatric, adolescent and adult sleep disorders across the Tampa Bay area. In recent years, he has helped to build a comprehensive USF Sleep Center, collaborating with colleagues at the USF Psychiatry Center to start an Insomnia Clinic and at the USF Ear, Nose and Throat Center to develop a Sleep Apnea Clinic.

The annual “Current Concepts in Sleep” conference sponsored by USF and its affiliated hospitals, including this year’s Aug. 29-30 meeting, features the latest advances in the research and treatment of sleep-related medical disorders.

This year a Sleep Medicine Education & Research Fund was established to support the training and research activities of the USF Sleep Medicine Program. Dr. Anderson said he would like to establish a sleep technologist training program to meet the growing demand for professionals qualified to conduct sleep studies.

For more information, please visit the USF Sleep Center website at www.health.usf.edu/medicine/sleep

- Story by Anne DeLotto Baier/USF Health Communications
- Photo by Eric Younghans/USF Health Media Center

Head Ambulatory Nurse Anita Fischer, RN, rushed around the third-floor pod at the Carol and Frank Morsani Center for Advanced Healthcare on Monday morning. After all, there was plenty to be done at their inaugural Orthopaedics and Sports Medicine clinic in the new multi-million dollar facility.

“It’s spacious, it’s professional. Every room is standardized, and that makes a big difference for the staff – and for patients,” Fischer said.

The Department of Orthopaedic Surgery and Sports Medicine was the first USF Health division to move and set up shop on the third floor in the Morsani Center, as it’s called. The six-story, 194,400 gross-square-feet structure, located at the corner of USF Holly and Magnolia Drives, serves as the gateway to the USF Health quadrant of the USF Tampa Campus.

Morsani Center Video Tour (10minutes 37seconds)

More than 20 Orthopaedics faculty and staff members were buzzing around the new clinic, excited to share the experience with patients. Dozens of athletic training students served as volunteers, lining the hallways throughout the clinic to guide patients towards rows of pristine new exam rooms.

“It’s truly been a team effort,” said Robert Pedowitz, MD, chair of USF’s Department of Orthopaedic Surgery and Sports Medicine. “We had doctors, residents, medical students and staff working together to move our entire clinic over the weekend. That coupled with the outstanding support of the Information Systems staff made this transition run very smoothly.”

And staff members are also noticing what an impression the new digs have had on their patients.

“We saw our first patient at 7:55 a.m. He walked in with a smile, and after his appointment he walked out with a smile,” said Fischer. “And that’s what is most important.”

“The whole concept surrounding the Morsani Center is to make the experience patient centric,” said Rick Green, Executive Director, USF Physicians Group & COO, Centers for Advanced Healthcare. “Designed around a one-stop shopping experience, patients will be offered convenient, high-quality healthcare with an emphasis on customer service.

“Our goal with this new facility is to provide world-class health care and education, with the most sophisticated medical equipment in the region,” Green said.

Perhaps the most defining element of the Morsani Center is the new Ambulatory Surgery Center (ASC) on the 2nd floor, with eight operating rooms and five endoscopy suites. USF Health Physicians will offer outpatient care in a number of specialties including Breast Surgery, Ear, Nose and Throat, General Surgery, Gynecology, Orthopaedics, Physical Therapy and Plastic Surgery. The ASC is scheduled to open in mid to late August.

The first floor showcases the Imaging Center with some of the most advanced equipment in the region, including fully digital diagnostic imaging, 3T MRI, 64-slice CT, and basic X-ray. Women’s diagnostics featuring mammography and ultrasound, fluoroscopy, nuclear medicine, and bone densitometry services will open in the coming months.

USF pharmacy partner Sweetbay Supermarket will move into the Morsani Center in a few months, and Armark’s new restaurant called Camille’s will move into the first floor by the end of the year. USF Health’s School of Physical Therapy and Rehabilitation Sciences will move its clinics into the Morsani Center next week.

Back on the third floor, Dr. Pedowitz shows the staff how he can pull up images of a patient X-ray from any desktop computer in the building, rather than attaching an X-ray film to an old light box used in previous clinics.

“The Morsani Center exemplifies USF's opportunity to provide the best possible patient-centric clinical care,” Dr. Pedowitz said. “As a health care provider, I am excited because the Morsani Center is truly going to be a fantastic place to work. But the bottom line, and the most important thing -- patients will find the care provided at the Morsani Center to be safe, efficient, and comfortable. The facility is designed to meet their needs.”

Click here for more on USF Health Centers for Advanced Healthcare

Story by Susanna Martinez, Photography by Eric Younghans & Videography by Jean Rene Rinvil, USF Health Communications

Click here to read full Tampa Tribune story...

WUSF-FM story...

Saundra Saint Laurent opens the gift wrapped box and the second she sees the red, white and blue it feels as if the whole room erupts with joy. "Ah, so bu-tea-ful!” - C'est si beau! - the words dripping with an unmistakable and wonderfully French accent. "Le Américain Sweetheart" reads Saundra aloud, her fingers touching the words embroidered on the baby bib. "Ah yes! That is what she is."

The ‘American Sweetheart’ is 12 day old Leonie Saint Laurent. Weighing in at 7 pounds and 9 ounces, she is their miracle baby.

Thirty-three year old Saundra and 37 year old Brice Saint Laurent thought they might never be able to have more children. Thanks to a gestational carrier in Tampa and the team at USF IVF,
4 1/2 year old Margot Saint Laurent is now a grande soeur – a big sister.

Devastating complications during childbirth in 2006 left Saundra without a uterus. It was then, during the birth of their second child, Paul, that the baby died and Saundra was near death. Doctors would have to remove her uterus to save her. "I was very afraid of dying this night," she says. "On the morning after, I felt that if I was still here, it was for me to do something good with my life."
Q: That God had a plan for you?
A: "Yes, otherwise He would have take me."

But on this sunny day in May, far from their hometown in Tarbes, France that sorrow is forgotten. The heartbreak is eclipsed by the presence of Baby Leonie now sleeping comfortably in Saundra’s arms.

Pointing to the new dress embroidered with stars and stripes, Nurse Joy Taylor says "A gift from all of us." "Something Leonie can wear on the airplane ride home!" interjects Nurse Christine Kilfoyl, program manager of USF IVF. Saundra and Brice smile at the doctors and nurses, Saundra’s eyes welling up with tears. The couple reaches for words in English and French trying to communicate their overwhelming gratitude on this, their last visit with the USF IVF team before heading home to France. "Oh my gosh...LOVE her," says Dr. Shayne Plosker, Division Chief of USF IVF, "Have a good life," he says, gazing at baby Leonie, still asleep.

"I still remember the transfer," says Kilfoyl, "We had Saundra on the phone." "What do you mean?" I ask and with that the group launches down memory lane. At the gestational carrier's request, we are identifying her only as "Dawn".

"For the frozen transfer, Saundra was not here. She was in France," explains Kilfoyl. "So the day of the transfer, Dawn was here with her husband, Dr. (David) Keefe and myself. We had Saundra on the phone - it was the phone on the wall. We’re trying to reach it...and of course the important part was to make the transfer, but we wanted to include her. We had the call and we were saying to her 'This is what is happening now,' remembers Kilfoyl in vivid detail. "People on the fourth floor of Tampa General (hospital) were looking at us thinking 'This is too weird!'" Then, mimicking her own response to onlookers that day, Kilfoyl whispers "The parents are in France!"

Attitudes changed - every time.

Inter-Continental Pregnancy...
Nurse Taylor fast forwards in a flash - "Then, when the gestational carrier came in for the first ultrasound, we also had the Saint Laurents on the phone," says Taylor, "Saundra heard the heart beat over the phone, right along with us!" "Yes...and I cried," says Saundra. "It was sooooo beautiful! We were all crying!" interjects Taylor.

The inter-continental pregnancy is the stuff that movies are made of. The child is biologically Saundra’s and Brice’s, but carried, for 9 months, in the uterus of a Tampa mom they connected with online.

"The whole thing was incredible because it was a frozen embryo," says Saundra.
"I didn’t believe that it would work so when I had the results of the first lab test...It was Christine (Kilfoyl) on the telephone... I was in an airport...just before taking the plane. It was magic to know that! She (Leonie) had only a 20 per cent chance of being there (inside the womb) and here she is today."

"My husband and I have five children," explains Leonie’s gestational carrier. "I love being pregnant and I love children. I wanted to help someone else who can’t have children."

The French couple and the gestational carrier connected via a website run by an advocacy organization for surrogacy. The women both admit to an instant connection. Dawn, not a serial surrogate for hire, is an appraiser in the Tampa Bay area. At age 39, she says she felt a calling to help someone else have a child and found that 'someone else' in Saundra, living all the way in France near the border with Spain.

Why USF IVF?
"The beginning of our story is that we met each other and knew that it was going to be in Tampa because this is where Dawn lives," says Saundra. They landed on USF IVF after a European website on surrogacy told them about Dr. David Keefe, Chair of Obstetrics and Gynecology at the USF College of Medicine and an internationally renown researcher in fertility.

"It was amazing. I sent him (Keefe) an email on a Saturday and about 3 hours later, I had an answer. 'Okay, I am ready...I work with you...no problem' recalls Saundra. "He wrote 'Call my secretary on Monday and we give you appointment.' I called," says Saundra, "and 15 days later, we were here for the appointment."
Q: You came all the way from France for that one appointment?
A: "Yes, yes. Dr. Keefe explained to us...for very long time... during one hour and thirty minutes all the process...we felt his interest. We felt comfortable here and were sure that one day this would work," she says.

Saundra’s eggs and Brice’s sperm were extracted and fertilized in vitro thanks to the expertise of Dr. Ying Ying, Director of the USF IVF laboratory. “We did three cycles- two fresh cycles and one frozen cycle,” says Dr. Ying. That first attempt resulted in a pregnancy but early miscarriage, followed by a second unsuccessful attempt. For the third and final try, it was Dr. Ying’s work under the microscope that helped make that miracle happen for the Saint Laurents. “In the first fresh cycle, we recovered nine eggs, eight of them were normally fertilized and two embryos were transferred on day 3…the other six embryos were cultured for three more days, and one of them developed to blastocyst and frozen… and is the baby Leonie,” explains Ying.

USF IVF statistics.....
For the USF IVF team this is not the first time a patient case involves surrogacy. Since the start of the program in September 2006, the team has had seven patients who have used gestational carriers, including another French couple. "The program also works with couples from Canada where it is illegal to pay donors," says Plosker, himself Canadian-born. Canada's law makes it virtually impossible for anyone without a willing family member or friend to use a gestational carrier.

Looking at the overall numbers for USF IVF, not just cases involving gestational cases, USF IVF has done a total of 134 retrievals and 110 transfers. Sixty-one resulted in pregnancies - a 55% success rate. Pregnancies from frozen embryo transfers, as in the case of baby Leonie, pose the most difficulties for IVF experts nationwide. Based in Tampa, Florida, USF IVF stands well above the national average. Its overall clinical pregnancy rate from embryo transfers stands at 43%. The national average is only 27%.

All that modern science and statistical data, while appreciated by the Saint Laurents, remain second to the humanity of the folks involved. "For me, she is even more than a sister," says Saundra of her gestational carrier. "..Dawn is like...me, only on the other side of the ocean Atlantic," Saundra explains, reaching over to touch Dawn, standing by her side, visibly moved.

“I was very proud to be able to say we helped,” says Kilfoyl of the entire experience. “We live in a great county!”

French laws on surrogacy...
For the Saint Laurents, Leonie is only the beginning of their efforts in surrogacy. Earlier this year, Saundra, a stay at home mom, testified before members of the French parliament. She and husband Brice, a grocery story chain executive, are actively involved with the Maia Association, an advocacy group working to repeal the 1991 French law banning surrogacy - this summer their group meeting with the Health Advisor to French President Nicholas Sarkozy.

"In France my husband is considered Leonie’s father. Biological paternity is recognized but not the maternity....In France maternity is decided when you deliver the baby," says Saundra, her voice starting to break. "In France, I am not considered her mother. I am nothing to her."

According to French law, Leonie is considered an American and, as such, will require a U.S. passport to remain in France with her parents. The child's U.S. passport will have to be renewed every five years until Leonie turns 18 years old and can legally apply for French citizenship herself. Asked how she feels about that, Saundra exclaims "I am proud that Leonie is considered Américain becauze France - my own country - was not very nice to me."

"Good bye...Au revoir… Merci… Dr. Ying, you are perfect baby maker," says Saundra as she bids farewell. And to the delight of everyone, baby Leonie begins to wake up as the adults move towards the door for their parting hugs.

Leonie stretches...slowly opens one eye...then back to sleep.

Oui. Un Bien-aimé américain - an American Sweetheart.

Story by Lissette Campos, USF Health Communications
Photos by Eric Younghans, USF Health Media Center

Other Links...

May 15, 2008 PHOTO GALLERY

USF IVF Research: Looking for a few good egs

USF IVF Homepage

Some call it a good business model while others say it’s an idea that just makes good sense.

Either way, one of the medical profession’s newest specialties (only about 15 years old) has become well entrenched and fully embraced by both physicians and medical administrators.

The specialty is called hospital medicine and the physicians who practice it are called hospitalists. Historically, they are physicians whose primary job is to take care of the hospitalized patients of other physicians. Once discharged, the patients return to their regular physicians for care.

USF physician Charles Edwards, MD, is one of six USF hospitalists based at Tampa General Hospital. He said he sees many advantages to the arrangement. In the days of old, he said, a typical day for physician would have included early rounds at the hospital, followed by patient appointments at their offices, and probably ending with another set of hospital rounds. This made for very long days for physicians who struggled to simultaneously care for their patients at their offices and those in the hospital.

Dr. Charles Edwards

“Physicians were trying to see more patients in clinic and having to deal with increasingly sicker patients in the hospital,” Dr. Edwards said. “By working with hospitalists, today’s private practice physicians now spend more time seeing patients at their own offices and less time commuting between office and the hospital.”

As a specialty, Dr. Edwards highly recommends hospital medicine as a career path.

“From a medical standpoint, taking care of the sicker patient population seen in the hospital setting provides constant stimulation and reward. From a practical standpoint, a hospitalist does not have the typical strains associated with running a typical medical practice. In addition, it offers great variability, a flexible lifestyle and compensation above that for a traditional office-based internist.”

Dr. Edwards said he has found only a few downsides to the specialty, including the transition of care.

“Because I’m not their primary care physician, I don’t have same kind of follow up, so there is not the satisfaction that might be found in the long-term care of patients,” he said. “Also, sometimes there is a sense of mistrust from patients because they don’t know me like they know their regular doctor. Finally, although dealing with the sicker patient population is rewarding, it can result in periods of stress and the possibility of burn-out.”

Dr. Edwards said that although hospital medicine is an established specialty, there are only a few non-accredited fellowships for it.

“While there will likely be further development of hospitalist fellowships, the training your average internal medicine resident receives is mainly hospital-based, so there is probably not a great need for further specialize training,” Dr. Edwards said.

Besides the physicians and hospital administrators enjoying the cost-effective advantages of using hospitalists, patients also appreciate the quick response and on-site access they gain with them.

“Only a few patients don’t understand why it’s not their own doctors,” Dr. Edward said.

But Dr. Edwards sees only continued use of hospitalists.

“The profession is here to stay,” he said. “The outpatient doctors like it, the hospitals like it and patients seem to like it. While there is room for continued improvement, it’s an efficient model of care that, when practiced appropriately, delivers high quality care more efficiently and cost-effectively.”

In addition to Dr. Edwards, the USF team at TGH includes Erika Able, MD, Michael Flannery, MD, Deborah Humphrey, DO, Kanchan Kamath, MD, and Cuc Mai, MD.

Story by Sarah Worth, USF Health Communications

Program Director Shayne Plosker, MD, sees patients weekly at 1931 South Tuttle Ave., where USF IVF - Sarasota is open Monday through Fridays for patient consultations, ultrasound monitoring and blood drawing for patients in treatment.

Dr. Shayne Plosker

USF works with patients to maximize coverage of infertility treatment.

Dr. Plosker is an associate professor and director of the Reproductive Medicine and Infertility Division at the USF College of Medicine. He received his MD degree from The University of Western Ontario in London, Canada, where he completed a residency in obstetrics and gynecology. His fellowship in reproductive endocrinology and infertility was conducted at the University of California, San Francisco.

Dr. Plosker has published peer-reviewed papers and book chapters on optimizing embryo transfer technique, improving outcomes in intrauterine insemination, polycystic ovary syndrome and early pregnancy loss.

USF IVF is a member of the Society for Assisted Reproductive Technology. For more information, please call (941) 361-6889 or go to www.usfivf.com.

- USF Health -

USF Health is a partnership of the University of South Florida’s colleges of medicine, nursing, and public health; the schools of basic biomedical sciences and physical therapy & rehabilitation sciences; and the USF Physicians Group. It is a partnership dedicated to the promise of creating a new model of health and health care. One of the nation's top 63 public research universities as designated by the Carnegie Foundation for the Advancement of Teaching, USF received more than $310 million in research contracts and grants last year.

News release Anne DeLotto Baier, USF Health Communications

Entrevista con el Dr. Celso Silva en Español. 11 minutos.

At the University of South Florida, fertility experts are involved in a daily race against time and in many patient cases, enemy number one is the woman’s biological clock. More and more women may be postponing pregnancy until their 30’s and 40’s, and more men may be fathering children well into retirement age but a woman’s biological clock remains unchanged! Like it or not, and despite modern medicine, there is a finite window of time when the female reproductive system can achieve pregnancy. For Hispanic patients, in particular, this race against time can be dramatically cut by language and cultural differences.

“Being afraid of not being understood, not speaking the English language, that’s all very real to them,” says Celso Silva, MD, fertility specialist at USF IVF. Even in cases of bilingual patients, he notes that many prefer to speak in their native tongue when it comes time to discuss deeply personal topics like sex, reproduction and family. The result: patients remain in limbo, continously searching for a specialist they feel more comfortable with, unable to overcome feelings of awkwardness during doctor visits. “That will delay treatment! And in our field, after a certain age and depending on the diagnosis, this is critical...the delay may completely change a couple’s chance of achieving their goal,” says Silva who speaks three languages, Portugese, English and Spanish.

Patient's perspective...
40 year old Ana Barrios and her husband Alejandro are examples of that delay in treatment caused by language and cultural differences. The couple has been living in the Tampa Bay area for three years and has been trying to get pregnant for approximately 8 years. Over time, they've visited a cadre of doctors, but admit they never got very far in the process because of the language barrier. “A few months ago, I had this wonderful ‘Anglo’ doctor,” says Ana, a realtor in Tampa. “...but I just didn’t feel comfortable because I always had to have an interpreter with me to help translate.” The doctor's medical explanations were, at times, beyond the scope of Ana’s command of the English language she later explained and also admitted she and her husband found it ‘emotionally’ difficult to talk about their sex life and reproduction in English, no matter how pertinent the information was to her case.

She found Silva in January 2008 thanks to a Colombian compatriot working at Tampa General Hospital. He recommended she try the doctors at USF IVF. She did and says that her hopes for the future have been restored. “I am so happy now,” says Barrios in rapid fire Spanish. “I am in love with this man! Well, I mean medically speaking,” she says with a nervous laugh. Embarrassed by her choice of words Ana explains, “He’s a professional in every sense of the word. He's very respectful, but at the same time he's very warm & friendly and I like that!”

Language barrier just the tip of the iceberg...
For Silva it is an interesting choice of words. Being ‘professional’ for one group of patients may be considered cold or indifferent by another. The language barrier is just the 'tip of the iceberg', so to speak. The Brazilian born physician says cultural differences can have significant impact too, noting the differences in the way patients receive medical information. In a significant number of his cases, for example, the non-Hispanic patient prefers to hear prognosis and details of care alone vs. the Hispanic patient who prefers to receive the information accompanied by relatives.“It’s very interesting and absolutely true,” says Silva. “I’ve had Hispanic couples come to their appointment with extended family members – not just the husband and wife, but the future grandmother too.” Not allowing a patient to bring extended family or encouraging them to do so can result in injured sensitivities for either group.

“For me, it’s not just the language. When a patient comes in, it’s not just for me to address the physiological aspects of her inability to conceive. There are also emotional, sociological aspects of the case to be addressed,” says Silva, explaining that his intent is not to fuel stereotypes, but rather share patterns he's experienced with patients over the years. “In the Latin culture, many couples feel pressured by society – their relatives, friends – to have children. They are constantly bombarded with nagging questions like ‘What’s wrong with you?’ and ‘Why don’t you have children?’ That one act of not having a child, in this culture, can come with some negative connotations,” says Silva.

Silva's cultural sensitivities also extend to his explanations of success rates and data. “We use our success rates, percentages, disease-free intervals, but sometimes a ‘matter of fact’ tone can be viewed as a lack of connection or empathy,” says Silva. Not paying attention to details like these can hurt patients’ sensitivities, he says, navigating in a patient care system that is definitely not a 'one-size-fits-all'.

USF IVF above the national average...
Given USF IVF's results, the data is impressive no matter what style it's communicated in. The specialty practice has a clinical pregnancy rate above the national average. Since the start of USF IVF in September 2006 thru December 2007, the team treated 89 patients with In Vitro Fertilization (IVF) cycles that included egg retrieval and sperm collection. To date, the USF IVF clinical pregnancy rate stands above the national average, with a rate of 50 percent vs. the national average of 40 percent for women under the age of 35.

Clinician and Researcher...
When he's not talking babies, bebes & nenems with patients, Silva is conducting research in the laboratory, studying the impact of aging on fertility. Specifically, he investigates the ability of stem cells to generate oocytes - the eggs which decrease dramatically in numbers and/or quality among older patients. From the laboratory to the clinic, Silva focuses on this issue of aging & fertility determined to give everyone a fighting chance to achieve pregnancy. The clinician and researcher is a recent arrival to USF IVF, having completed his residency in obstetrics and gynecology at Brown University and his fellowship in Reproductive Endocrinology & Infertility at the University of Pennsylvania.

"I guess it would make for a better story if I were to say 'Yes, we (he & wife) went through this and I decided to know more about it.' but no, it did't happen that way. I developed an interest in this field even before we went through infertility as a couple. I have always been very technology oriented...and IVF was a relatively new field then, very cutting edge."

'I have been there'...
Silva and his wife are established fertility experts from Brazil. His wife, Vanessa Silva, is an embryologist. Ironically, when it came time to start their own family, they battled infertility. They arrived in the U.S. twelve years ago, and thanks to modern medicine are the proud parents of three children - 9 year old twin boys and 8 year old daughter. “We lived through this in a very significant way,” says Silva. “We went through all the basic treatments and none of them worked for us. Ultimately, we had to do In Vitro Fertilization. That gave me the opportunity to see what happens across the desk,” says Silva pointing to the patient chair facing him. “It’s very different when you have been on the other side. When patients ask me ‘How difficult is it going to be for me to go through this cycle…all the injections, the medications, the monitoring, how is that going to be for me?’ When you can say 'You can do it. I have been there. ’ it’s something powerful. When you’ve gone through this with your own wife - the injections, everything - it gives you a different perspective… a level of understanding that is hard to explain in words,” say Silva.

Entrevista en Español con el Dr. Celso Silva de la Universidad de South Florida, Tampa Bay. El Dr. Silva, nativo de Brazil, se especialisa en Medicina Reproductiva. Ademas de ejercer como profesor en la escuela de medicina, es un investigador cientifico. En los centros medicos del USF IVF, el Dr. Silva atiende a pacientes de habla Español, Portugese e Ingles. Para mas informacion en Español, llamar al 813-259-0962.

OTHER LINKS:
Dr. Celso Silva Credentials
Welcome to USF IVF
USF IVF in Sarasota
USF Psychiatry in Español
USF Pediatrics in Español

Story by Lissette Campos, USF Health Communications
Photography by Eric Younghans, USF Health Media Center

USF Psychiatry in Español

University of South Florida, College of Medicine, Tampa Bay. The Department of Psychiatry & Behavioral Medicine is led by Dr. Francisco Fernandez. His team of clinicians and scientists sees patients in various locations across the Tampa Bay area. As part of this ongoing series,USF Health en Español , below is a listing of professionals in Psychiatry & Behavioral Medicine who are also available to patients who prefer doctor visits in Spanish.

Departamento de Psiquiatría en Español...
El Departamento de Psiquiatría en la Universidad del Sur de la Florida esta dirigido por el Dr. Francisco Fernandez. Nuestro equipo de especialistas atienden a pacientes en varios sitios a traves del condado de Hillsborough en el area de Tampa. Como parte de nuestra serie especial, USF Health en Español, les brindamos esta lista de profesionales medicos en el Departamento de Psiquiatría disponibles a pacientes que quieran consultas medicas en Español.

- Francisco Fernandez, MD, Profesor y Catedra de Psiquiatría, Jefe del Instituto de Investigaciones Psiquiatrica- USF Institute for Research in Psychiatry

- Jean Fils, MD, Profesor Asistente y Clinica de Memoria- USF Health Memory Disorder Clinic

- Barbara Lubrano, MD, Profesora Asistente, Directora de Practicas Psiquiatricas y Psiquiatría de Enlace- Hospital Tampa General

- Humberto Nagera, MD, Profesor y Jefe de la Clinica ADHD - Deficit de Atencion, y Director del Centro Medico Carter Jenkins

- Carlos Santana, MD, Profesor Asociado y Jefe de la Clinica Psiquiatrica - UPC Outpatient Clinic, y Director de Trastornos Cognitivos- Cognitive Medicine

Para mas detalles sobre el Departmento de Psiquiatría y sus servicios medicos, visite la pagina web. Telefono de USF Department of Psychiatry & Behavioral Medicine: (813) 974-8900.

USF Pediatrics in Español

University of South Florida, College of Medicine, Tampa Bay. The Department of Pediatrics is led by Dr. Robert M. Nelson, Jr. His team sees patients in various locations across the Tampa Bay area, including Hillsborough and Pinellas Counties. As part of this ongoing series, USF Health in Espanol, below is a listing of pediatricians who are also available for patient-doctor visits in Spanish.

Pediatria en Español...
El Departamento de Pediatria en la Universidad del Sur de la Florida esta dirigido por el Dr. Robert Nelson. El equipo de especialistas atiende a pacientes en varios sitios medicos a traves del area de Tampa Bay, incluyendo los condados de Hillsborough y Pinellas. Como parte de nuestra serie especial, USF Health en Español , les brindamos esta lista de pediatras disponibles a pacientes que quieran consultas medicas en Español.

- Dr. Carmen Alfaro, Pediatria General
- Dr. Al Campos, Especialista en Pediatria Renal
- Dr. Frank Diamond, Especialista en Endocrinologia & Diabetes Juvenil
- Dr. Francisco Flores, Especialista en Pediatria Renal
- Dr. Jorge Lujan, Especialista en Enfermedades Infecciosas
- Dr. Luis Maldonado, Pediatria General
- Dr. Chuck Paidas, Cirugano en Pediatria
- Dr. Ever Rivera, Pediatria General
- Dr. Carina Rodriguez, Especialista en Enfermedades Infecciosas
- Dr. Lisa Rodriguez, Pediatria General

25 de abril del 2007, Tampa, FL. El Dr. Robert Nelson, al centro, rodeado por miembros de USF Health Pediatrics. El grupo, incluyendo pediatras y empleados administrativos, participaron en un evento especial en vispera de la apertura del nuevo centro medico USF Health South Tampa Center situado al lado del hospital Tampa General.

Para mas informacion sobre el Departamento de Pediatria, llamar al (813) 259-8700 o visitar la pagina web de USF Health Pediatrics.

Mas sobre USF Health en Espanol...
USV IVF en Espanol
Dr. Celso Silva Credentials
USF IVF Program

USF neurosurgeons Dr. Fernando Vale, left, and Juan Uribe perform minimally-disruptive spine surgery at Tampa General Hospital.

USF Health neurosurgeons at Tampa General Hospital are performing a new minimally disruptive spinal fusion surgery to provide relief to patients suffering from back pain. Dr. Juan Uribe, Dr. Fernando Vale and Dr. Donald Smith are among the first in the region to perform this procedure, called XLIF® (eXtreme Lateral Interbody Fusion).

An estimated 10 million adults suffer from chronic back pain annually, a condition that can limit their activities. Until recently, adults with back pain have undergone traditional or “open” spine surgery, requiring weeks or months of recovery.

The XLIF surgical procedure employs NuVasive®’s minimally-disruptive instrumentation. This technology allows surgeons to perform a wide range of conventional spine procedures through a minimally invasive approach that causes less musculature disruption and enables faster recovery. Additionally, surgeons can perform surgical procedures using instruments that are similar to those used in conventional procedures, but through significantly smaller incisions.

“This surgical procedure offers a safe and effective, less invasive alternative to traditional or open spine surgery,” said Dr. Uribe, assistant professor of neurosurgery at USF Health. “This approach provides greater access to the spine, better visualization during surgery, less tissue disruption and blood loss, and faster patient recovery times. Another benefit is that patients are often walking within a few days, with a typical four to six-week recovery, rather than the six-plus months of recovery following traditional back surgery. And the best part is that they are no longer suffering from back and leg pain. It is a win-win approach for all -- the patient, surgeon and hospital.”

NuVasive’s MaXcess® surgical retractor allows the surgeon maximum access with minimal disruption of surrounding tissue, while the NeuroVision® JJB system uses electromyography, or EMG, to enable the surgeon to avoid nerves during spine surgery.

The USF neurosurgeon’s offices are at the USF Health South Tampa Center for Advanced Healthcare, 2A Columbia Drive in Tampa, FL 33606. They can be reached at (813) 259-0965.

- Story by Ellen Fiss/Tampa General Hospital
- Photos by Hugh Jones/TGH Photography

Abigail Perez, 11, is one of the pediatric patients helped by the USF Cystic Fibrosis Clinic's Nutrition Action Plan. She shares a light moment with clinic coordinator Allyson Casey, right.

Eating to Live: USF team is motivating kids with cystic fibrosis to gain weight

Abigail Perez can’t lose even one ounce. When the 11-year-old goes for her doctor’s appointment, she’s always told to eat more — more pizza, more cake, more red meat, more whole milk. For eating more, she gets little rewards … and the one big reward of staying alive.

For some it may sound like a dietary dream, but Abigail knows she needs to gain weight to help combat the effects of cystic fibrosis, a hereditary disease that injures the lungs, digestive tract, and other glands and organs. Abigail was diagnosed with the illness at birth, and has been a patient at the Cystic Fibrosis Clinic in the Pediatric Pulmonary Division at USF since she was two weeks old.

Cystic fibrosis (CF) affects the body's ability to move water and salts in and out of cells, causing the lungs and pancreas to secrete a viscous mucus. This mucus obstructs different passageways in the body, preventing them from performing normally. When this happens in the pancreas, enzymes needed for digestion cannot get out of the organ and food passes through the stomach while nutrients are not absorbed. For CF patients, this means a lifetime battle against malnutrition, anemia, and loss of appetite.

Abigail undergoes a lung function test.

“With them, losing an ounce can be horrific,” says Sara McCready, an administrative specialist, and Abigail’s mom. “The weight thing is really huge, because they stop growing and then it affects everything.”

At nine years old, Abigail lost several pounds due to complications with her gall bladder, and McCready feared a major downward spiral. But then Abigail began the “CF Rewards System,” a specialized nutrition program developed at the clinic and administered by clinic coordinator Allyson Casey, ARNP, and nutritionist Nancy Newkirk. The results have been impressive, with Abigail gaining back her weight, and more.

“Our strategy is to engage the child and the parent in order to improve health,” says Casey.

The clinic is a Cystic Fibrosis Foundation (CFF)-accredited affiliate center for the care and treatment of children with CF from birth to age 21. As such, USF is recognized as offering the highest quality of specialized therapy and support for those with CF. Care is provided using a team approach to tackle the complex nature of the disease, and the group includes a pulmonologist, a pediatrician, an ARNP, a registered dietician, a social worker, a respiratory therapist and a medical assistant.

Patients who reach their weight-gain goals can choose among several rewards, including a favorite snack.

The rewards program begins with a team member explaining the process to the parents and child. A mutually agreed upon weight-gain goal is established, with the potential for a reward (candy, gift certificate, movie tickets, etc) if the goal is achieved in the interval leading up to the next visit.

To facilitate the system, a “Nutrition Action Plan” (NAP) tracks a comparison of the previous visit’s height, weight, body mass index and weight-gain goal, to the current measurements. Body mass index (BMI) is placed in one of 3 color-coded categories based on the colors of a traffic light with red being the lowest and green the best result. Within each category, recommendations on how to gain weight and improve health are offered.

In a pilot study of the plan conducted by Casey, more than 70 percent (15) of the 21 patients included demonstrated an improvement in their BMI with use of the NAP.

Abigail's moms says she has thrived under the CF clinic's rewards system.

“An atmosphere of fun and competition has developed in many families after starting the program, whereas in the past they may have been much more apathetic about seeing us,” says Casey. “The children now pay close attention to their weight when they come for follow-ups and are thrilled when they achieve their goal and win their reward.”

McCready says such has been the experience for Abigail as well, keeping her motivated by recognizing the positive strides she’s made. “She’s a child that thrives on a reward system,” notes McCready. “And she likes knowing that she’s doing everything possible on her own to keep from going backward with this illness.”

It’s an added benefit, says McCready, that the staff at the clinic is sincerely interested in Abigail not only as a patient but rather as a whole person as evidenced by their continued encouragement on a daily basis. Each member of the team has been quick to offer support and education whenever needed.

“They worry about her like she’s one of their own kids,” observes McCready, “and that is so important because you have a child here with an illness that is never going to get better, and you really need to have people there to pick you up and help support you.”

Nutritionist Nancy Newkirk reviews Abigail's goals with her.

Newkirk, the nutritionist, says that support includes helping families set realistic, attainable goals so they are not discouraged by occasional setbacks. Parents, who prepare meals and manage their children’s routines, are key to helping maintain the child’s motivation and reinforcing positive behavior at home, she adds. “We work really hard to make the parent a member of our team. If Mom or Dad doesn’t buy into the plan, then the child isn’t going to gain weight.”

For instance, Abigail, like some other patients, did not like to eat breakfast. Because children with CF need to complete 20 to 45-minute breathing treatments as soon as they awake, families are hard-pressed to squeeze in breakfast and get to school and work on time. So, Newkirk encourages parents to provide foods like breakfast bars, muffins, nutritional supplement drinks, or even peanut butter and jelly sandwiches, that the child can take along in the car or bus and consume on the way to school. Or, she may encourage them to investigate qualifying for or purchasing school breakfasts for their children.

Another challenge is getting parents who are trying to lose weight to keep encouraging their kids to gain weight. “They complain that it’s not easy to keep preparing all these high-fat foods for the child with CF, while the rest of the family is trying maintain a healthy lifestyle by avoiding high-fat, high-calorie foods,” Newkirk says. So Newkirk offers easy-to-prepare single recipes that can be made ahead. She suggests strategies like giving whole milk to the child with CF while the rest of the family drinks skim, and adding butter to the child’s vegetables after cooking instead of cooking everyone’s vegetables with butter.

Casey, left, and Newkirk are key members of the USF Cystic Fibrosis Clinic's interdisciplinary team, which also includes physicians, a social worker and respiratory therapist.

The USF CF team travels to locations in Tampa, Lakeland, Sarasota, Fort Myers and Naples to see patients. Each patient is seen at least three times a year, and some are seen every month. Visits include meetings with the nutritionist, social worker and a health care provider. Patients also undergo pulmonary function testing and respiratory cultures to monitor the organisms colonizing in the lungs. Blood work and X-rays are done yearly.

For more information about the program, or to make an appointment, call 813-259-8767.

- Story by Sheryl Kay
- Photos by Eric Younghans/USF Health Media Center

USF Health physicians looking to help their patients quit smoking can now refer them to a comprehensive smoking cessation program within USF Health.

Called Breathing E-Z, the 8-week program provides techniques, tips and support for stopping one of the most addictive behaviors, smoking.

“We offer a full-range of group and peer motivation tools, but mostly we just want to take care of our own patients and help them succeed,” said Janice McCaskill, director of the program within Internal Medicine’s Division of Pulmonary, Critical Care and Occupational Medicine.

Among the program’s features is a base-line breathing test called an FEV 1, which estimates the true age of a smoker’s lungs and invariably shows them to be several decades ahead of the person’s actual age, McCaskill said. In addition, frequent monitoring of the patient’s CO levels, which measures carbon monoxide reveals if a patient has smoked or not.

“The CO monitoring helps keep them honest,” McCaskill said.

Signatures of success -- Patients are eager to sign a poster board that announces their success in quitting.

Smoking Cessation Program Director, Janice McCaskill, proudly displays messages of thanks and celebration.

The program also offers useful tips for battling urges, identifying withdrawal symptoms and preventing relapse. If a patient needs the additional help of prescription cessation aids, such as nicotine patches, McCaskill simply contacts the patient’s USF Health doctor for a prescription.

“Providing this program within USF Health is the perfect way to customize the care for our patients,” she said.

To help physicians identify patients, McCaskill provides them with an intervention tactic called the 5A’s, a systematic approach used to identify smokers, assess their readiness to quit, and assist the smoker with cessation.

The 5A’s are ASK about smoking status, ADVISE the patient to quit, ASSESS willingness to make a quit attempt within the next 30 days, ASSIST by offering patient the smoking cessation program, and ARRANGE for follow-up.

USF’s AHEC program received tobacco funding to spread the word throughout their service area about ways to stop smoking, including helping promote the USF Health’s Breathing E-Z cessation program.

For more information or to make a referral, please call 813-974-5377.

Story by Sarah Worth, USF Health Communications

Additional Links and Resources:

Smoking Cessation

Quit Smoking Now: USF Employee Assistance Program

Notes on program:
Sponsored by the Area Health Education Center (AHEC)
Groups will meet in the EAP Conference Room (SVC 2130) from 12:00 – 1:00 p.m. for six consecutive Thursdays starting in October.
For more information, contact EAP at 974-5469 or visit http://usfweb2.usf.edu/counsel/casa/quitnow/

The Florida Quit-For Life-Line is a toll-free telephone based tobacco use cessation service. Any person living in Florida who wants to try to quit smoking can use the QuitLine. The following services are available through the QuitLine: Counseling sessions; Self help materials; Counseling and materials in English and Spanish; Translation service for other languages; Pharmacotherapy assistance; and TDD service for hearing impaired. To contact the QuitLine, call 1-877-U-CAN-NOW (1-877-822-6669).

For tobacco-related educational materials and smoking cessation materials, please contact the Area Health Education Center (AHEC) at 974-2180.

The lights were positioned in the studio just right…the canvas backdrop had been smoothed to perfection... and photographer John Lofreddo was standing by with his Nikon. Was the baby here yet?

On January 11th, the stage was set for a one-of-a-kind reunion - the sweetest kind. The centerpiece of the photo shoot would be a 4 month old baby boy, surrounded by his mom, dad and the team of doctors who made their dream of becoming a family come true.

“Here’s our hero!” exclaimed Donald Archambault the second he saw embryologist Dr. Ying Ying. Moments later, more laughter and smiles from Donald and his wife Dawn, brought together with the team of doctors who worked on their case from USF IVF – the In Vitro Fertilization & Reproductive Endocrinology program at USF Health.

“Oh my goodness, look how big he is”, said Dr. Shayne Plosker, “The last time you saw him, Ying, he was only 5 to 8 cells!” jokes Dr. Plosker, Division Director. “I love those little shoes he’s got on!” said Dr. David Keefe, smiling at his namesake. “Without him, David wouldn’t be here so we thought it was appropriate to name our baby after Dr. Keefe”, says Dawn.

It’s not your every day encounter between doctor and patient, but for the Archambaults this warm and familial exchange comes as no surprise.

“With them, you’re not just another number, like in other offices’, said Donald, “They remembered our first names, even remembered how many frozen embryos we had left”. The couple put their fate as parents in the hands of USF IVF, after undergoing two costly IVF procedures elsewhere, a devastating miscarriage, and almost paralyzing fear of ever trying again.

Finding Hope...
In late 2006, they found hope in a newspaper article about Dr. David Keefe. Keefe had just moved to Florida to lead the USF College of Medicine’s Department of Obstetrics & Gynecology. “We read the article on him…and someone who had a baby through artificial insemination. It intrigued us”, recalls Dawn, “My husband encouraged me, had to convince me to do it because I had given up hope at that point.”

What followed was a battery of tests to identify what was medically wrong with the reproductive systems of both husband and wife. Donald underwent a vasectomy, years earlier, during his first marriage. Dawn was diagnosed with two unique conditions involving folic acid and blood clotting.

What USF Health doctors did next, inspires them to this day. For several months, Dr. Keefe focused on treating the causes of the couple’s infertility before giving them hope with another run at IVF. “After all the tests, Dr. Keefe spent an hour with us and explained everything in detail, what the obstacles were”, recalls Dawn, “He’s very meticulous about everything.”

With A Fighting Chance...
For Dawn, motherhood finally came within her reach in December 2006. “I remember the exact dates!” she says, “On December 13th the embryos were taken out. December 18th, they put ‘em back in”. Dr. Plosker retrieved the eggs from Dawn’s ovaries. Dr. Ying, Director of the IVF Laboratory, spent hours under the microscope searching for the healthiest sperm to inject directly into each of Dawn’s egg. He used a specialized procedure called ICSI – short for Intracytoplasmic sperm injection. The final step was left to Dr. Keefe – transferring the embryos (developing fertilized eggs) into Dawn’s uterus.

Several weeks later, success.

“I couldn’t wait”, says Dawn. “I kept testing at home to see if I was pregnant yet. I went through six of them!” she says, referring to home pregnancy tests. “I still feel like I’m living in a dream.”

Baby David was born on September 4th by cesarean section, after 16 hours of labor for Dawn.

Not Just a Number...
“We feel really lucky, really fortunate to have had a chance to work with this beautiful family, which is now a little bit bigger than when they came to us”, said Dr. Keefe, standing alongside the family on the campus of USF Health. “I also feel lucky to work with our colleagues. It really is a special place, there’s a culture of caring.”

“Infertility treatment is different than many other kinds of treatment in the sense that it’s very prolonged and involves many different steps”, explains Dr. Keefe, “We try to help families understand as much as we do about it, so that they go through it and really become experts in their own care. That not only helps them get through it, because they have a sense of control over it, but we think it also helps it work better…they’re less likely to make the wrong choice, there’s a kind of positive energy that goes with that.”

“All of us, I think as people, feel that this is the way WE want to be treated when we’re patients needing healthcare”, says Dr. Plosker, “We all have the same philosophy. It’s wonderful to hear from our patients, that what we wanted to achieve as a team is getting across.”

Above the National Average...
USF IVF began in September 2006. From September 2006 thru December 2007, the team treated 89 patients with IVF cycles that included egg retrieval and sperm collection. To date, the USF IVF clinical pregnancy rate stands above the national average for women under the age of 35. Its clinical pregnancy rate is 50 percent vs. the national average of 40 percent.

“We’re now seeing our first patients, who’ve completed IVF cycles, come back to visit us with their babies”, says Christine Kilfoyl, RN, the program’s nurse coordinator, “We probably have about 20 live births, to date. Baby David is one of our early ones. We’re just starting to get the Christmas cards, pictures and all that great stuff!”

Yearning for that Happy Ending...

Gathered all together on this January morning, it’s a baby fest – 6 adults all competing for baby’s attention, gushing, “coo”-ing, and “awe”-ing in equal amounts.

Baby David in the arms of USF IVF Doctors Ying Ying, David Keefe & Shayne Plosker.

“We love this”, says Dr. Plosker, “We’re so used to looking under the microscope and saying ‘Yes, these are good embryos. Let’s put these embryos back inside mom.’ But to be able to see this little guy, here and laughing, see his personality, we don’t get to see this that often! I know it’s a cliché, but this makes it all worth while, just to see a little guy like this!”

Truth be told, not every story comes with a happy ending. At USF IVF, the journey to potential pregnancy is made with reverence. The team of doctors, coming together from across the country, is squarely focused on patients as human beings in need, not paying customers.

“When you go through infertility treatments, the sad reality is not everyone gets pregnant”, admits the program’s nurse coordinator. “For me, as a nurse, the goal is to help people through this very emotional & sometimes overwhelming process and to have them feel confident it was completed at the highest standard of excellence”, says Nurse Kilfoyl, “ We all, of course, hope for each patient to have a baby to take home, but even if they don’t, they still feel in their heart that they gave it their best shot”.

A Special Commitment...
For the Archambaults, USF IVF gave them a fighting chance – one that has changed their life forever.

Standing near the couple and the photographer clicking away with his camera, Dr. Ying is content just to look at baby. He remarks, almost in a whisper, “From the lab point of view, this was a tough case.” Asked what he thought at first site of the infant, he responds without hesitation. “I was thinking like he’s my baby!” eyes sparkling, smile broad. “I feel the pressure of the family’s hopes and dreams when I’m in the lab doing my work”, says the Chinese embryologist, “and I try my best.”

It’s that kind of commitment that has moved the Archambaults to try again. In the coming weeks, they’ll try for their second child with the help of specialists at USF IVF. “Don’t give up hope!” is their message to couples in distress, “Believe! If you want any chance of a baby, this is where you should go”, says Donald.

Click here to see PHOTO GALLERY......

Story by Lissette Campos, USF Health Communications
Photography by John Lofreddo, USF Health Media Center

For more on USF IVF click here.

In most cases, it comes on slowly, like tiny needles pushing against your skin. At first, it’s a tingle here or there, easily ignored. But over time, those imaginary needles feel as if they’re multiplying – pushing harder and longer into your skin. For a countless number of Americans, tingling in their hands and feet are part of daily life. These abnormal sensations can occur throughout the day, but for some, nighttime can be the most troublesome.

“This is not part of the normal process of aging”, says Lara Katzin, M.D., neurologist and specialist in neuromuscular disease at USF Health, “It’s not uncommon to wake up with tingling in your hand. If you cross your legs, you may also get tingling, but it should go away. That’s normal. But if you have persistent numbness or tingling in your hands, feet and toes, that should prompt you to see a doctor.”

Dr. Lara Katzin, USF Health Neurologist

Common Causes
Numbness and tingling can be symptoms of disease in the entire nervous system. The most common cause, known as peripheral neuropathy, usually occurs in people in their 50’s, 60’s or older and involves damage to the peripheral nervous system - the vast communications network that transmits information from the brain and spinal cord to every other part of the body. Symptoms can make the sensory nerves so sensitive that, in some cases, patients complain that the mere touch of bed sheets can "bother their toes.” According to the National Institute of Neurological Disorders and Stroke, more than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms.

“The nerves are like insulated wires. You have the wires and the insulation around it. The axon is the part of the nerve that is similar to a wire. Myelin is the insulation”, explains the USF Health physician. “When neuropathies affect the axon, the nerves die off. It can be produced by metabolic causes, like diabetes or a vitamin B12 deficiency. It can also be caused by toxins like alcohol”, says Dr. Katzin, “We’re talking about chronic alcohol abuse, not your glass of wine every now and then.” Certain drugs used in chemo therapy, can also produce axonal neuropathies. Neuropathies which affect the myelin are usually caused by an autoimmune process in which the body’s immune system attacks itself.

“Neuromuscular medicine has undergone revolutionary changes. The flood gates of information have been opened because we have a much better understanding of the molecular basis for many diseases”, says Dr. Katzin.

Helping Doctors Help Patients
Dr. Katzin, a faculty member at the University of South Florida’s College of Medicine, teaches medical students and residents what key questions to ask patients who come in complaining of numbness and/or tingling. Among the queries: When did it start? How did it start? Did it start in your feet and slowly work its way up? Is it associated with weakness? How quickly are the symptoms progressing over time?

“I ask patients ‘What other medical problems do you have?’ so that I can see if the patient may have conditions that can be associated with neuropathies”, explains Dr. Katzin. The answers help to unravel the mystery of what’s happening in the nervous system. Diagnosing peripheral neuropathy, in particular, is often difficult. The reason: its highly variable symptoms. A thorough neurological examination is usually required for diagnosis and involves taking an extensive patient history. What Dr. Katzin teaches her residents can make a world of difference to the patient – sparing them years of pain without an accurate diagnosis and effective medications.

Fascinated by Neurology
“I guess I picked neurology because I find the nervous system so fascinating. I think it is the one field in medicine in which the patients have the most fascinating manifestations of their illnesses. I also like the fact that I can examine someone and trace back where the lesion is in the nervous system. That’s so interesting to me”, said Dr. Katzin.

The new arrival to the university’s neurology department is among the bay area specialists performing nerve conduction studies/ electromyography, better known as “EMG”. The technology is used to test the function of the peripheral nerves and muscles. By stimulating the nerves and testing their response, the doctor can determine whether the nerves are diseased and whether it is the axon or myelin that is affected. The EMG part of the exam examines the muscles by using a small needle. The electrical activity produced by the muscles are recorded by the needle and that data can be analyzed to determine whether the muscles are diseased.

Unsolved Mysteries
But in many cases of tingling and numbness a complete evaluation may not reveal the cause for the neuropathy. “It’s not that there is no cause, we just haven’t been able to figure out what it is”, admits Dr. Katzin. These cases are called idiopathic peripheral neuropathy. “This can be very frustrating for patients who want to know why this has happened to them. Even though we may not be able to identify a cause many times, we can still help our patients with medications to manage their symptoms.”

“I hope that within my generation, we will be able to identify more causes. Researchers are working hard to unravel the mystery of idiopathic peripheral neuropathy”, says Dr. Katzin.

About Dr. Lara Katzin:

• USF Health Neurology: (813) 974-4115 for appointments

Story by Lissette Campos, USF Health Communications

In the USF Motion Analysis Lab, physical therapist Jason Highsmith, right, uses sensors and special cameras to track movements of the computerized prosthetic limb worn by Iraq War veteran Ed Salau.

TAMPA, Fla. (Nov. 30, 2007) – Forget running 60 miles-per-hour or jumping 20 feet straight up into the air. Those feats of cyborg superheroes like The Six-Million Dollar Man are not what people look for when selecting mechanical replacement limbs.

For those who’ve lost a leg above the knee, they just want to be able to get up from a chair without assistance or contortions, or to simply climb a flight of stairs, said M. Jason Highsmith, a visiting assistant professor at the University of South Florida’s School of Physical Therapy & Rehabilitative Sciences.

“Right now, we’re not at the point of superhuman abilities,” said Highsmith, who is performing tests on the Ossur Power Knee with help from College of Engineering graduate students. “We just want to restore function.”

Highsmith is studying how well the Power Knee mimics the movements of a real knee.

The Power Knee is being compared to four other prosthetic knees to see how well it helps the user stand up, sit down or walk stairs. Those activities most people take for granted can be an incredible chore that puts strain on the remaining parts of the body.

“When we stand or sit, we keep our bodyweight more or less equal,” Highsmith said, demonstrating how a person with both legs rises and sits. “But traditionally, a person with a prosthetic leg would have to shift to their sound side in order to get up or sit down.”

Favoring one side over the other can cause problems in the long run. One side will atrophy while the other becomes over-developed, increasing the risk for injury. Also, there will be increased wear-and-tear to the remaining leg, Highsmith said, potentially causing an early onset of arthritis.

The Power Knee works by means of pressure sensors hidden in the sole of the shoe on the sound leg and in an ankle bracelet on that same leg. When the amputee sits or rises, the sensors send a message to the prosthetic leg telling it to move, Highsmith said.

Ed Salau, front, walks down a flight of stairs while Randy Thran waits his turn.

One of those Power Knee users taking part in the test is Ed Salau, the east coast area director for the Wounded Warrior Project, an organization that helps veterans injured in Iraq or Afghanistan settle back into a normal life. Salau, a 37-year-old from New Bern, N.C., lost his left leg three years ago outside Tikrit, Iraq, when a rocket-propelled grenade struck his vehicle.

“This leg is unique,” Salau said. “It’s the only leg that powers me around. The other legs are great products, but they’re very passive. I have to move them.” While it’s not perfect, Salau said he’s glad to be able to take part in testing that may contribute to a new generation of prosthetics.

Highsmith said this research has other implications besides improving the prosthetic. Insurance companies have been reluctant to pay for Power Knees because they are considered “experimental.” With a price tag of $100,000 to $125,000, these new prosthetics are five to six times as much as the current mechanical legs that cost around $20,000.

“Until we can prove their efficacy, the insurance companies are not onboard,” he said.

Another test subject, Randy Thran, 45, lost his right leg as a result of injuries he incurred as a police officer in Savannah, GA. During his career, he’d endured 14 operations on his knees which suffered repeated beating on the job. But it was the last beating that cost him his leg.

“He was just a drug suspect,” Thran recalled. “I was trying to apprehend him and my legs were hitting these big chunks of asphalt. Then he gave me a good sidekick to the leg and snapped it right in half.” Thran said his doctor told him there was no way to save the leg and it would have to be amputated.

Like Salau, Thran said getting a Power Knee has helped him. “It’s got good qualities, like for getting up stairs,” Thran said. “And if you have to do a lot of longer walking, it doesn’t tire you out as much.”

USF's testing is supported by a $1-million grant from the Department of Education. Highsmith expects to publish the results of the prosthetic knee study in early 2008.

- Story by Sean Ledig/USF University Relations
- Photos by Eric Younghans/USF Health Media Center

The USF Health South Tampa Center for Advanced Healthcare represents a strategic new vision for health powered by the partnership between USF and the community

More than 100 faculty, staff and community leaders gathered last evening, Nov. 15, at the USF Health South Tampa Center for Advanced Healthcare for an opening reception celebrating the new facility. The event, hosted USF Town and Gown Society, was followed by faculty-led tours of the new building, which reflects USF Health’s strategic vision for a model that will transform the delivery of healthcare.

Tampa Mayor Pam Iorio presented USF President Judy Genshaft and Stephen Klasko, MD, MBA, dean of the College of Medicine and vice president for USF Health, with a proclamation citing Nov. 15 as “USF Health in South Tampa” Day.

Town and Gown Society President Lyris Newman presented President Genshaft and Dr. Klasko with a portrait of the South Tampa Center and surrounding Tampa General Hospital campus.

The Center is supported by funding from the Florida Legislature, Tampa General Hospital led by President and CEO Ron Hytoff and his board, and the USF Health physicians, who took out a bond to support their vision.

A summary of some of the night’s comments follows:

"We are delighted you have chosen Davis Islands as the location to create the future of healthcare. And we’re delighted that you’ve made adult women’s health such a high priority so that we can enjoy your services too!”

-- Lyris Newman, president, USF Town and Gown Society

“With the USF Health South Tampa Center, USF is making a bold statement. Our goal is to transform how healthcare is taught and practiced. We will work with the community to be the engine for the future standard of care for patients throughout Tampa Bay. We will bring students to learn about health across our colleges of medicine, nursing and public health. And we will develop models of research-based healthcare that can be applied anywhere in the world.”

-- USF President Judy Genshaft

“This building is a terrific symbol of the partnership between USF and all of Tampa Bay. It’s a symbol of the finest in health care. It’s a symbol of learning for our students and patients. And it’s a symbol of the incredible partnership among people dedicated to improving the health of our community.”

-- Rhea Law, chair of the USF Board of Trustees

L to R: USF President Judy Genshaft, USF Health VP Dr. Stephen Klasko, Tampa Mayor Pam Iorio, and TGH President and CEO Ron Hytoff with the city's proclamation of "USF Health in South Tampa" Day.

USF Health urogynecologist Dr. Lennox Hoyte, far left, leads Rhea Law, chair of the USF Board of Trustees, and her husband Wayne Williams on a tour of the new building.

The hit show on NBC "The Biggest Loser" is creating a new spin on the phrase. As Americans try new ways to get healthy and lose excess pounds, Dr. Denise Edwards, in USF Health Pediatrics, is giving faculty and staff a fun way to become "big losers" too.

While many formal diet programs offer the framework, support and socializing we need to successfully lose weight, many times it’s the tips and success stories from friends and coworkers that really turn on our drive to finally make the right choices.

Denise Edwards, MD, assistant professor of pediatrics and internal medicine, is exactly that kind of resource.

Sure she’s an expert on diet and nutrition. Sure she runs the department’s Healthy Weight Clinic. And sure she’s a walking poster child for the healthy lifestyle cause. But she is also completely sincere in her willingness to help others see the benefits of good health, so much so that she is taking on a departmental cause, of sorts.

Like most workplaces, there are several people in the Department of Pediatrics who are trying to lose weight. So Dr. Edwards is sharing her knowledge with this group and helping her coworkers understand the day-to-day, easy-to-apply choices they can make to successfully lose weight. She is turning them on to a healthier lifestyle.

“There’s a lot of misinformation and confusing messages out there,” Dr. Edwards said.

“Just as I do with our patients, I try to clarify that information and help people apply it to their everyday lives with their families and in work situations.”

The effort started simply enough, with conversations in the hall and break room. But the quick chats have turned into slightly more formalized lunch-time gatherings a couple of times each month.

Pulling from her arsenal of health information, Dr. Edwards provides valuable tips, diet data, nutrition advice, and even recipes. She gently encourages increasing physical activity and doesn’t lecture or reproach when efforts are stalled or derailed.

In addition to her informal informational sessions, Dr. Edwards is part of a new Lunch N Learn Series called Healthy & Fit for Life to be held in November and December. Click here to learn more.

Perhaps her greatest fan in the group is Pediatrics Chairman Robert Nelson, MD, who has applied Dr. Edwards’ tips and successfully lost 25 pounds.

At Center: Dr. Robert Nelson, Chairman of USF Health Pediatrics, surrounded by his team.

“Her diet hints really struck a chord for me to make life-long changes,” Dr. Nelson said.

“And she helped my wife and me easily adapt healthy options to our routines and food preferences.”

Dr. Nelson said he found her ideas different than typical weight-loss programs because they were so flexible. In addition, being the methodical physician type, Dr. Nelson said he appreciated her organized approach to the ultimate goal of losing weight.

Although not quite at his goal of dropping 40 pounds, Dr. Nelson said that he can easily see it coming off in time.

“The goal is realistic and with Dr. Edwards’ gentle prodding and cheering, I know I can stay on track.”

Check out Dr. Edwards on iTunes U Whadda ya love? Let's Make It Healthier

Story by Sarah Worth, USF Health Communications
Photography by Eric Younghans, USF Health Media Center

Tampa, FL (Oct. 30, 2007)-- The Florida Covering Kids and Families Initiative, based at the University of South Florida’s Lawton and Rhea Chiles Center for Healthy Mothers and Babies, has partnered with the grocery chain Albertsons LLC to promote Florida KidCare, the State Children’s Health Insurance Program.

Albertsons has placed Florida KidCare advertisements in its prescription bags to create consumer awareness of Florida’s low-cost or free healthcare coverage for children and is distributing Florida KidCare applications and brochures to each of its 93 Florida stores.

“We are excited about our participation in the Florida KidCare program in all of our locations,” said Jeff Carlen, Division Pharmacy Manager of Albertsons LLC Florida Division. “Florida KidCare is a very worthwhile program and Albertsons believes it is critical that all eligible children without health insurance apply for Florida KidCare.”

Florida Covering Kids and Families, under contract with the Agency for Health Care Administration, is conducting an integrated, statewide outreach campaign for Florida KidCare, in cooperation with Gov. Charlie Crist’s office and the state agencies responsible for administering the program. During the back-to-school period, Florida Covering Kids and Families organized news conferences, enrollment fairs, and provided statewide technical assistance to events intended to raise awareness of Florida KidCare and to enroll eligible families. These efforts included forming partnerships with several nationally-recognized businesses. Albertsons LLC is the latest to join the Florida Covering Kids and Families team.

“We are very happy that Albertsons LLC is taking such an active role to inform families about Florida KidCare. Getting businesses involved in promoting Florida KidCare is an essential part to a successful outreach effort,” said Jodi Ray, director of Florida Covering Kids and Families.

Florida has the second highest number of uninsured children in the United States. Approximately 700,000 Florida children have no health insurance, while around 500,000 of these children may be eligible for Florida KidCare.

For more information on becoming a Florida KidCare business partner, please contact Patrick Cannon at (813) 974-8272 or pcannon@health.usf.edu.

For more information on Florida KidCare, call 1-888-540-5437 or visit www.floridakidcare.org.

- Belly-button access reduces number of skin incisions and improves patient outcomes -

Dr. Alexander Rosemurgy, left, and Dr. Michael Albrink

Tampa, FL (Oct. 15, 2007) -- Tampa General Hospital and Covidien, a leading global provider of healthcare products, announced the completion of the first reported Single Incision Laparoscopic Nissen Fundoplication procedure, eliminating any visible scar in the patient’s abdominal wall.

This procedure, for treatment of esophageal reflux disease (known as “GERD” or gastric reflux), was performed at Tampa General by Alexander Rosemurgy, MD, professor of surgery at USF Health. Also at Tampa General, Michael Albrink, MD, associate professor of surgery at USF Health, completed two single incision laparoscopic cholecystectomies -– gallbladder removal procedures. Dr. Rosemurgy and Dr. Albrink are among the first surgeons in the country to have performed the single incision procedure for these two types of laparoscopic surgeries.

Dr. Rosemurgy and Dr. Albrink safely performed the procedures through a single skin incision in the patients’ navels. Customized solutions are also forthcoming to enable similar single incision laparoscopic procedures for other general surgery, urologic, gynecologic, and bariatric surgery applications.

Laparoscopic surgery typically results in less pain, quicker healing and improved cosmetic results, and fewer complications such as infection. Most patients can be discharged on the same or following day as the surgery and return to work within about a week.

Single incision laparoscopy, like the advent of multi-port laparoscopy back in the late 1980’s, represents one of the next major advances in minimally invasive surgery.

- USF Health -

USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With $308 million in research funding last year, USF is one of the nation’s top 63 public research universities and one of Florida’s top three research universities.

One-stop shopping concept in healthcare, centers around our patients

Tampa, FL (Aug. 27, 2007) -- USF Health opened the doors this morning to the South Tampa Center for Advanced Healthcare on Davis Islands, changing the way healthcare is delivered in the Tampa Bay area.

“The goal of USF Health is to transform the way that care is delivered to the community,” said Stephen K. Klasko, MD, MBA, vice president for USF Health and dean of the College of Medicine. “This new center is the first shot in that revolution.”

The 126,000 square foot, seven-story medical office building is designed for USF Health faculty, staff and students from the Colleges of Medicine, Nursing and Public Health to work in healthcare teams; bringing services directly to the patient at one location.

For example, a patient who schedules an appointment with our Department of Obstetrics and Gynecology could receive an annual exam, undergo mammography and ultrasound services in our state-of-the-art diagnostic imaging center during that same visit, and in the future, receive all the results on the same day. He or she could end the visit by picking up the prescribed medications at USF’s in-house pharmacy, operated by SweetBay Supermarket.

“There’s no reason a woman should wait almost 10 days for a mammogram result, which is the average in Florida,” Dr. Klasko said. “Test results should be part of her decision-making with her physician, at one time.”

Marlene Brewer-Alvarez leads a crew from the Ob/Gyn Department into their new quarters at the STC.

The South Tampa Center (STC) will replace the majority of existing outpatient clinics currently located at Harborside Medical Tower and 17 Davis, both located on Davis Islands.

With 94 exam rooms and 187 faculty offices, the STC will be “paperless”, with physicians and staff using a sophisticated $15 million electronic medical record system for all patients. The first floor diagnostic imaging center will allow patients to move easily from an exam room to receive an MRI, CT scan, mammography, ultrasound, fluoroscopy, bone densitometry, nuclear medicine or basic X-ray.

"By providing a one-stop shopping concept to our patients, we will maximize their time by taking advantage of some of the most advanced technology in the Tampa Bay region” said Rick Green, Chief Operating Officer of the Centers for Advanced Healthcare and Executive Director of the USF Physicians Group. “Our partnership with GE will provide our patients with access to state-of-the-art equipment, which only enhances our commitment to superior care and quality medicine."

The USF Health Departments of Cardiology, Internal Medicine, Neurology, Neurosurgery, Obstetrics and Gynecology, Ophthalmology, Orthopaedics, Otolaryngology, Pediatrics, Surgery and Vascular Surgery will practice in the new building. In addition, USF Health will operate a patient education center, run by faculty and staff in our College of Public Health, offering counselors who will guide patients in finding more information about their healthcare diagnosis.

The seven-story medical office building is designed for USF Health faculty, staff and students to work in healthcare teams.

Funding for the $33 million STC comes from a multi-million dollar bond taken out by the USF Physicians Group, including funding from Tampa General Hospital, state grants and additional community support.

USF Health will open its second advanced healthcare facility, the Carol and Frank Morsani Center for Advanced Healthcare located on the USF campus, in the spring of 2008.

Learn more at USF Health at www.myhealthcare.usf.edu

See more South Tampa Center Opening Day Photos Below:

-About USF Health-

USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With $310 million in research funding last year, USF is one of the nation’s top 63 public research universities and one of Florida’s top three research universities.

Few projects benefit across the board.

But it seems that all the constituents of the USF College of Medicine – patients, faculty, students, staff and residents – will benefit with the switch from paper to electronic health records.

“This is one of those endeavors that is truly worth the effort,” said Bryan Bognar, MD, interim vice dean for Educational Affairs for the College of Medicine and probably the longest standing champion of the electronic health records effort at USF.

“EHR improves the quality of care we can give our patients, including increased safety and continuity of care.”

Medical records are files that include medical histories, test results and treatment reports for patients. These paper-filled folders crowd large rooms (and many storage facilities) for most medical practices and each patient’s file must be located and physically brought to the clinical site for each appointment.

Electronic health records, or EHR, are electronic versions of these files. They are called up on computers in examination rooms, at nurse stations and even on physicians’ home computers. But more than just mirror images of their paper kin, EHR also taps into real-time technology, offering an interface among physicians, nurses, schedulers, laboratory staff and other health care professionals. The result is an all-encompassing approach to managing a patient’s course of treatment that is not only more efficient, but increases patient safety and quality of care.

EHR at USF is not all that new. For more than 10 years, USF physicians have had access to some level of technology for dictation, test results and other medical data. And five years ago, medical students began using PDAs (personal digital assistants) as reference tools in their internal medicine clerkships.

But now EHR is mandatory at USF Health, a move that helps USF Health keep pace with the strong national trend.

"EHR is another beautiful example of how USF is pushing medical education," said Stephen K. Klasko, MD, MBA, dean of the USF College of Medicine and vice president for USF Health.

"Not only are we incorporating leading technology into our own medical practice to benefit our patients, but we're teaching medical students EHR in their first year with us, giving them an incredible advantage when they enter their residencies and start practicing. Few medical schools give their students this kind training and it will, in the end, give our graduates the edge."

More and more clinics and hospitals are implementing EHR so exposing and training residents and students early will increase their effectiveness in a paperless environment and negate the need to change established habits.

“The EHR train left the station with debit cards and electronic banking,” said Jay Wolfson, DrPH, JD, coordinator of USF’s interconnectivity efforts with the community and one of four members of the executive management team for Tampa Bay Regional Health Information Organization (RHIO). The RHIO is one of several national collaborations implementing health care data exchange programs so patient information can be securely stored in the local community, but is electronically accessible to those providing care in another community.

“Health care has been a generation behind the quality and use of essential data that are routinely used in care and services,” said Dr. Wolfson, Distinguished Service Professor at USF and associate vice president for USF Health.

“Some physicians will balk and some support staff will feel they will not be able to adapt. But all of the evidence indicates that the transition will be less complicated than any naysayer claims. Physicians will recognize the value that EHR brings to improved safety, quality and outcome management and malpractice liability management.”

In January, three sections within the USF Department of Internal Medicine went “live” with EHR: general internal medicine, orthopedics, and cardiology. In March, the USF Department of Surgery took its turn.

Much of the schedule for the rollout has been based on the completion of the Centers for Advanced Healthcare. Those divisions to go live first were those going into the South Tampa Center next to Tampa General Hospital on Davis Islands, which is opening next month. Thus, General Internal Medicine, Cardiology, and Orthopaedics within the Department of Internal Medicine, the Department of Surgery, the Department of Ob/Gyn and the Department of Pediatrics were up first. All are live except Pediatrics, which is still being trained. Coming up next will be those going into the Morsani Center on the USF campus and the USF Medical Clinic.

If all goes according to schedule, all clinical departments should be live by next summer.

How is the transition going? Truth be told, the switch to EHR holds trepidation for some: Change isn’t always easy. But hands-on training for faculty, staff and students, and universal usage are keeping apprehension to a minimum.

“There is a strong learning curve but, overall, the response has been really pretty good,” Dr. Bognar said.

Charles Nofsinger, MD, assistant professor of orthopaedics and sports medicine, who was part of the surgery team that went live earlier this year, said that the benefits of EHR are exceeding his expectations.

“The documentation is available at any place, to any (credentialed) physicians, at any time,” Dr. Nofsinger said.

“Ordering is accurate, as opposed to paper legibility issues. Ordering can be tailored to the diagnosis making implementations of pathways practical and efficient. And data collection for research is much improved.”

So what’s the downside? “There are many challenges as well, such as patient interaction and the time overhead to use the EHR,” he said.

The bottom line is that patients are benefiting the most with EHR, Dr. Bognar said.

“When we tell patients about EHR and explain why we’re using a computer during their appointments, their responses are very positive,” he said. “They say they see it as greater access for them anytime, anywhere, regardless of the clinical site.”

In addition to that access, Dr. Wolfson said, “EHR means less redundancy, more uniformity and completeness of clinical and demographic data; reduced loss of records, charts, test results and films; and greater continuity of care within and between providers.”

Beyond to recording patient visit information, the system can be used to send electronic prescriptions directly to pharmacies, send lab orders directly to laboratories, set up health maintenance reminders for flagging tests when they come due, and even provide warnings for prescription dosage mistakes and conflicts.

-- Story by Sarah Worth

Patients who elect to go this route will receive a 50-percent discount on physician fees for all cosmetic procedures, including breast augmentation, liposuction, rhinoplasty and face lifts. Patients can also receive injectibles, peels, dermabrasion and other cosmetic enhancements.

Dr. David Smith, Director of Plastic and Reconstructive Surgery

“It allows our chief residents, who will be practicing on their own in a year, to learn cosmetic surgery under the direct supervision of a board-certified plastic surgeon in a program approved by the Accreditation Council of Graduate Medical Education,” said David J. Smith, MD, professor and division director. “The attending faculty surgeon oversees every aspect of the surgery.”

Cosmetic surgery is typically not covered by health insurance.
“Our program offers patients who might not otherwise be able to afford cosmetic surgery, an opportunity for the services,” Dr. Smith said.

The USF College of Medicine began its plastic surgery residency program three years ago, and now has a full contingent of 18 residents in training.
In 2006, surgeons completed nearly 11 million cosmetic surgery procedures in the United States, up 7 percent from 2005, according to the American Society of Plastic Surgeons.

For more information of the reduced-fee program, please call the Division of Plastic Surgery at (813) 259-0964 or (813) 259-0842.

OB/GYN Dept. moving August 6th- 27th
Pediatrics Dept. moving August 27th - September 4th
Surgery Dept. moving September 4th - 10th

With the grand opening of the USF Health South Tampa Center for Advanced Healthcare just weeks away, faculty orientations and customer service training began July 9th. During the entire month, sessions are planned to train the hundreds of USF Health faculty and staff who will be working at the new facility on the campus of Tampa General Hospital.

"Move Meetings" for faculty and staff are scheduled from August 8 - September 12th. Faculty and staff will learn details involved in the physical move to the new facility. Among the topics, phone contacts, transfer of computer equipment, what office items and how to pack them, as well as how to interface with representatives from the moving company.

"Move Meetings" On:
- August 8, 10am - 11am, Location: HMT 536
- August 15, 10am - 11am, Location: HMT 547
- August 22, 10am - 11am, Location: HMT 536
- August 29, 10am - 11am, Location: HMT 536
- September 6, 10am - 11am, Location: HMT 547
- September 12, 10am - 11am, Location: HMT 536

In his letter to faculty and staff, Richard Green, MBA, Chief Operating Officer of the Centers for Advanced Healthcare said "We're transforming Healthcare and YOU are at The Center!" Green, who was recently named Executive Director of USF Physicians Group, has been holding town hall meetings about the $33 million construction project since 2006.

Among the unique attributes of the USF Health South Tampa Center for Advanced Healthcare is the Electronic Medical Records (EMR) system. With EMR, patients don't have to fill out any paperwork; and they can request appointments, send email messages to doctors and request prescriptions online. The Center will also provide concierge customer service. In line with USF Health's multidisciplinary approach, the Center will combine professionals from all three colleges of medicine, nursing and public health to focus on the entire continuum of health- from birth to end-of-life issues, from treatment to prevention.

DID YOU KNOW?

South Tampa Center for Advanced Healthcare will have:
- 126,000 gross square feet
- 90 clinic exam rooms in its outpatient facilities
- Patient Outreach and Education Center
- Pharmacy

Specialties to include:
- Pediatrics
- Brain Health (Neurosurgery, Neurology, Psychiatry)
- Cardiology
- General Surgery
- Vascular Surgery
- Disgestive Disorders
- Internal Medicine
- Obstetrics & Gynecology

Additional Components:
- Diagnostic Imaging (fully digital)
- MRI and CT
- Women's Diagnostics (mammography & ultrasound)
- Fluoroscopy
- Basic X-ray
- Nuclear Medicine

Earlier this summer, employees across all departments involved in the move south, had the following sessions to choose from for orientations.
July 11th, Wednesday - 4:00pm to 6:00pm @ Ingram Library, HMT 536
July 16th, Monday - 7:30am to 9:30am @ Ingram Library, HMT 536
July 19th, Thursday - 7:30am to 9:30am @ Ingram Library, HMT 536
July 20th, Friday - 7:30am to 9:30am @ McInnes Auditorium, TGH
July 20th, Friday - 9:30am to 11:30am @ McInnes Auditorium, TGH
July 20th, Friday - noon to 2:00pm @ McInnes Auditorium, TGH
July 30th, Monday - 4:00pm to 6:00pm @ Ingram Library, HMT 536
July 31st, Tuesday - 11:30am to 1:30pm @ Ingram Library, HMT 536

Magellan will team with USF scientists Drs. Dennis Kyle and Alberto Van Olphen of the Department of Global Health, College of Public Health, and Dr. Bill Baker of the Department of Chemistry, College of Arts and Sciences. The grants will support a multidisciplinary drug discovery collaboration to identify novel anti-malarial drugs from Magellan’s and Dr. Baker’s diverse marine microbial collections.

This collaboration will bring together Magellan’s unique collection of marine-derived microorganisms and their natural product chemistry expertise with Dr. Kyle’s anti-malaria screening technologies, and Dr. Baker’s natural product discovery expertise. The Magellan-USF team will characterize lead candidates from Magellan’s collection by using bioassays and will optimize novel chemicals into preclinical drug candidates. Magellan’s expertise in various chemistry technologies will stimulate and accelerate early discovery efforts.

Dennis Kyle, PhD, the Malaria Foundation International's inaugural Scientist of the Year, is a USF Health researcher with expertise in malaria combination therapy and antimalarial drug resistance.

“We are excited to initiate this drug discovery collaboration with the University of South Florida that will further validate our capabilities as a provider of novel small molecules and develop Magellan into a preferred First Class Drug Discovery Company,” said Dr. Todd R. Daviau, CEO of Magellan. “USF’s scientific and technological approach powered by their highly qualified and organized research team constitutes a significant opportunity for the discovery and development of new anti-malaria candidates.”

“Malaria is a major public health threat, with over 2 million children dying of the disease every year in Africa,” said Dr. Dennis Kyle, Professor of Global Health. “New drugs are urgently needed to combat multi-drug resistant malaria.”

About Magellan:
Magellan BioScience Group, Inc., based in Tampa, Fla., is a privately held innovative biotechnology company focused on the discovery of novel classes of therapeutic candidates. Magellan is using its integrated platform technologies to isolate and identify new biologically active compounds. The company believes that its library of marine microbes will be the next source of drug discovery for the pharmaceutical industry. Magellan aims to develop and optimize drug candidates to treat cancer, infectious diseases, and inflammation. For additional information, please refer to the company’s web site at www.magellanbioscience.com.

About the University of South Florida:
The University of South Florida is among the nation's top 63 public research universities and one of 76 community engaged universities as designated by the Carnegie Foundation for the Advancement of Teaching. USF was awarded more than $310 million in research contracts and grants last year. The University offers 217 degree programs at the undergraduate, graduate, specialty and doctoral levels, including the doctor of medicine. The University has a $1.6 billion annual budget, an annual economic impact of $3.2 billion, and serves 44,038 students on campuses in Tampa, St. Petersburg, Sarasota-Manatee and Lakeland. USF is a member of the Big East Athletic Conference.

On June 28th, the USF Health Leadership Institute held it’s mid year review on campus. The 2 day retreat was filled with thought provoking commentary on how best to lead people in what experts predict may be “the Perfect Storm”- a combination of rising job dissatisfaction and demographic trends that predict labor shortages, skill and knowledge deficits, creating intense difficulties engaging and retaining workers.

The data, although heavy and, at times, gloomy, was delivered with creativity and humor by keynote speaker Jay Jamrog, a self described “futurist”, Senior Vice President of Research for the Institute for Corporate Productivity based in St. Petersburg, FL and Executive Director of the Human Resource Institute.

His audience included the first USF Health Leadership Institute class to include representation from all three colleges of nursing, medicine, and public health. The inaugural "L.I. Class of 2006" consisted exclusively of College of Medicine faculty. Also present with “students of leadership” were more than a dozen faculty and USF Health leaders who are serving as mentors to the Class of 2007.

By all accounts, the most thought provoking discussions came as the group navigated one of this decade’s most dynamic trends in the workforce – four generations of workers in the labor force at the same time. According to experts who study generational markers, there are shared human experiences that create fundamental differences in the values, views of leadership, work ethic and more. Managing and effectively leading four generations of workers in the same office or business, is no small task. Jamrog says leaders must accept this dynamic and adapt. Those who don’t cost businesses millions of dollars in re-training a revolving door of new employees – and ultimately lose their own job.

Referring to the Baby Boom Generation, which most of the room fell into, Jamrog said “You’re the biggest whiners! You never thought you’d be working this long and this hard in your life!", which was met with instant laughter. "You’re ticking people off because you’re not going anywhere! ", he quickly continued. “The younger generation says you’re holding them back! So get ready for a generational war!”

For Paula Knaus, Associate Dean of Faculty & Staff Affairs in the College of Public Health, the discussion is near and dear to her heart. Knaus has witnessed many changes during her 30 + year career in the industry of human resources. "In USF Health, we have four generations represented among our faculty and staff", she said. "We have the challenge of creating human resource policies that allow everyone to reach their full potential while contributing to the strategic directions of the various Colleges and Schools – not an easy thing to do, but critical if we are to attract and retrain the best talent possible. When considering human resource policies and practices, 'one size does not fit all' in the workplace and employers must understand this in order to attract and retain the best talent possible."

"In a recent study by the Human Resources institute, they found that 70% of the reasons strategy execution fails is due to leadership", noted Mohammad Kasti, Executive Director of the Centers for Transformation & Innovation (CTI). Asked why this particular presentation on generational difference was important to the faculty, he said "For USF Health to pursue its strategy to achieve excellence in patient care, research and education requires that we develop our leadership teams today, as well as our next generation of leaders. This program was designed to equip our leaders with the know-how to deal with the different values, attitudes and unique needs of four generations in the academic workforce."

Below is a sample of the data that left many faculty laughing, sharing stories of their own kids, and wondering "what happens next?”.

(Data below from Institute For Corporate Productivity.)

Four Generations:
- Depression Generation: born from 1927 to 1945.
- Baby Boom Generation: born from 1946 to 1964.
- Baby Bust Generation: born from 1965 to 1983.
- Baby Boomlet Generation: born from 1984 to 2002.

Generational Markers:
- Depression Generation: Great Depression, electricity, World War II and Cold War.
- Baby Boom Generation: Civil Rights, war on poverty, race to space, assassinations, Vietnam War and impreachment.
- Baby Bust Generation: AIDS, video games, Berlin Wall, technology, diversity, latchkey kids and downsizing.
- Baby Boomlet Generation: violence, Columbine school massacre, 9-11 attacks & terrorism, electronically wired and medicated.

Characteristics of Generations on organizational values, view of leadership and authority:
- Depression Generation: loyal to organization, views leadership by hierarchy, and is respectful of authority.
- Baby Boomers: value organization based on profitability, view leadership by consensus, have a love/hate view of authority.
- Bust Generation: value organization based on stimulus, balance and feedback they receive, view leadership by competence, and are unimpressed & not easily intimidated by authority.
- Boomlet Generation: value an organization by the “diverse environment” it provides and the support system present, views leadership by pulling together – there’s a shared attitude, and are polite in the face of authority.

Characteristics of Generations on work ethic and view of feedback:
- Depression Generation: work ethic is summed up as “work hard, save money, little time to play. In terms of how they feel about feedback, have the basic attitude that “no news is good news”.
- Baby Boomers: work ethic is summed up as “work hard, play hard, worry about money”. With regard to feedback, have basic attitude that “once a year with documentation” is fine.
- Baby Bust Generation: work ethic is summed up as “work hard as long as it doesn’t interfere with play, save money”. Regarding feedback, they generally interrupt and aren’t shy about asking how they’re doing.
- Boomlet Generation: work ethic is summed up as “good grades, make others pay and save money”. Regarding feedback, they want it often and at the touch of the button.

"The goal of the Leadership Institute is to invest in our best assets, our people", said Kasti. "We are creating an environment where the best, brightest and most creative talent are drawn in, retained and, most importantly, allowed to unleash their creative talents to the maximum of their abilities."

Photo Gallery:

For more information, contact the Centers for Transformation and Innovation (CTI) at USF Health, Mohamad Kasti at 813-974-3674.

Dr. Denise Edwards, director of the USF Healthy Weight Clinic, discusses food options with a patient and his mother.

Tampa, FL (June 1, 2007) -- Vanessa Waterson* wanted her 17-year-old granddaughter, Lorie*, who has high blood pressure and prediabetes, to lose weight for her health. She soon realized that adopting a healthier lifestyle would need to become a family affair.

“It was hard for Lorie to stick to eating fruits, vegetables and lean meat if the rest of us were eating pasta and bread, so we all started changing our eating habits and reducing our portions,” said Waterson, admitting she loved to cook Southen style and keep a well-stocked cupboard for her husband and four grandchildren. “Doing this together is helping us all become healthier.”

This type of family involvement is particularly important in helping reverse the growing obesity epidemic because lifelong habits of physical activity and nutritious eating – or lack of these – are developed in childhood and adolescence, says Dr. Denise Edwards, assistant professor of pediatrics and internal medicine at the University of South Florida. “It’s never too late to make these changes in lifestyle, but the earlier you intervene the better.”

The family-centered approach is emphasized at the USF Healthy Weight Clinic in Tampa, which Dr. Edwards directs. The program treats a comprehensive array of pediatric eating disorders, from obesity to anorexia and bulimia. In addition to medical assessment and supervision, the multidisciplinary outpatient program – one of few in the Tampa Bay area -- includes nutritional counseling, psychological evaluation and behavior modification, and even access to physical therapy and a YMCA staffer who can help with customized exercise plans. No weight-loss medications are FDA approved for young children. Although some options are available for teenagers, Edwards seldom prescribes them. “I think medication detracts from the idea that achieving and maintaining a healthy weight requires lifestyle changes by the entire family,” she says.

In the long run, 80 percent of overweight or obese adolescents will grow into obese adults. Genetics play a role -- studies have shown that children with overweight or obese parents have a greater risk for obesity. But, Dr. Edwards says, many environmental causes of obesity that interact with a person’s genetic predisposition, like too little exercise and too many high-calorie foods, can be altered.

Although the prevalence of childhood obesity has risen dramatically in the last several decades (nearly one in five U.S. children is obese), the condition is still underdiagnosed and undertreated, Dr. Edwards says.

The consequences of avoiding or delaying treatment can be steep – both physically and emotionally. As they develop into teens and young adults, overweight children are at greater risk for Type 2 diabetes, cardiovascular disease, joint problems, sleep apnea, asthma, gall bladder disease and other illnesses usually associated with middle-age or senior adults. Treating these obesity-related conditions over a person’s lifetime will be an increasingly costly proposition, Dr. Edwards says.

Obesity can lead to lifelong emotional distress as well as medical complications and reduced life expectancy. Excess weight has been associated with low self-esteem, depression and social withdrawal, particularly in adolescents, said Perry Kaly, a clinical psychologist who works with families at the clinic. “Studies have shown that kids as young as age 4 and 5 exhibit negative biases toward their overweight peers – identifying them as lazy, stupid and undesirable playmates.”

Dr. Edwards helps families develop weight management plans they can live with for the long haul, setting incremental goals for a healthier lifestyle rather than focusing on losing a specific number of pounds. In Lorie’s case, the family decided to initially work on three areas – reducing carbohydrates, eating lower calorie snacks, and increasing physical activity.

Lorie’s grandmother virtually eliminated rice, pasta and bread from the family’s diet and started using more spices instead of butter and salt to season her meals. She got rid of cookies and cakes, and stocked the refrigerator with snacks like fat-free yogurt and low-sugar jello. In addition, Lorie began daily 1 to 2-mile walks with her sisters. After three months, Lorie has lost 18 pounds, her blood pressure is dropping and she reports having more energy. She’s also eager to buy some new clothes before she leaves for college in August. “Now that I see the weight coming off and other people are saying ‘you look good,’ I’m even more motivated,” Lorie says.

The healthy weight clinic for children and adolescents fits into a series of USF initiatives making the prevention and treatment of obesity a priority. Last year, USF received a one-time appropriation from the Florida legislature to educate healthcare professionals on early recognition and treatment of obesity. The university is seeking additional support to establish a comprehensive center that would include research to better understand factors contributing to childhood obesity and evaluation of interventions promoting good nutrition, self-esteem and physical fitness among children in schools and the community.

For more information on the USF Healthy Weight Clinic, call (813) 259-8700

* Name changed.

Story by Anne DeLotto Baier
Photos by Eric Younghans ]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=151 http://hscweb3.hsc.usf.edu/health/now/?p=149 http://hscweb3.hsc.usf.edu/health/now/?p=149#comments Wed, 30 May 2007 17:05:00 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=149