From the time she was 13, Maloney, now 22, struggled with depression – cycling in and out of therapy and trying just about every anti-depressant on the market. Unable to cope or hold a job, she made several attempts on her life.

In March 2011, suicidal and desperate for help, Maloney voluntarily checked herself into Tampa General Hospital’s emergency room. This time, things would be different.

As a patient in the psychiatric services unit, Maloney came under the care of William Upshaw, MD, assistant professor in the Department of Psychiatry and Neurosciences at USF Health. She told him about her years-long battle with depression; about her family’s history of mental illness; about her inability to function; and the anti-depressants that never changed anything.

An alternative treatment option

Dr. Upshaw understood. He told her about a procedure that often works when other treatments have failed. During the procedure, called electroconvulsive therapy (ECT), electric currents are passed through the brain, deliberately triggering a brief seizure. While researchers do not fully understand how ECT works, they do know the seizure activity causes changes in the brain’s chemistry that can reverse the symptoms of certain neuropsychiatric illnesses, especially treatment-resistant depression, during the course of treatment.

For Sarah Maloney, ECT treatments were life changing.

“At first, I thought he was out of his mind; but then he explained it to me after I had calmed down,” Maloney recalls. “It sounded extreme, but at that point I was so desperate not to be depressed or suicidal.” 

ECT is the best-known of the neurotherapy procedures – procedures that stimulate areas of the brain using magnetic fields or electrical currents to relieve symptoms associated with certain mental health conditions. ECT was first introduced in the 1930s, and gained widespread use in the 1940s and 1950s. At the time, however, treatments were delivered without anesthesia, using high doses of electricity and often resulting in serious side effects. 

Today, ECT is a vastly different and safe procedure using lower doses of electricity administered under full anesthesia. According to Jamie Winderbaum Fernandez, MD, assistant professor and chief of the USF Electroconvulsive Therapy Program at Tampa General Hospital, the results are indisputable.
 
“ECT is unmatched for short-term relief of major depression. It gets people better when nothing else has,” she says. “There is nothing more satisfying than seeing people get their life back.”

Before consenting to the treatment, Maloney spoke to patients on her floor. “They told me it was great,” she says. And she spoke at length with her boyfriend; her sisters, one, a physician; her father, a nurse; and her mother, a nursing student. “They convinced me it was extremely safe and extremely humane. I was scared, but confident.”

Carefully controlled

ECT patients typically undergo an initial acute series of nine to 12 treatments administered three times a week over three to four weeks. After the initial acute phase, treatment is carefully tapered off over several months. Occasionally, patients will come back for infrequent treatments, called maintenance or continuation ECT, to maintain the benefits they received during treatment.  

During the procedure, which lasts about five minutes, the patient is given anesthesia to sleep as well as an intravenous muscle relaxant to paralyze the body. Stimulating electrodes are carefully placed on the scalp, leads are placed on the forehead and neck to monitor brain activity, and a blood pressure cuff, which restricts the flow of the paralytic to the foot, is placed on the lower leg, allowing the treatment team to monitor motor seizure activity. Next, a brief electrical charge is applied to the scalp inducing a seizure that lasts about a minute and is accompanied by a release of chemicals from neurons in the brain. Within about 20 minutes, the patient awakens.

Maloney with Dr. Jamie Winderbaum Fernandez,  chief of the
USF Electroconvulsive Therapy Program at Tampa General Hospital

For Maloney, the results were near-immediate.

“I was exhausted, but felt mentally better after the first treatment,” she says. “The deep pit in my stomach and heavy feeling in my chest that I had since I was 13, were gone. I wanted to live.”

Dr. Fernandez had seen it before. During the course of her professional career she has administered more than 1,000 ECT treatments. “I have literally seen it bring people back to normal life after years spent coping with debilitating, chronic mental illness,” she says. 

Even so, ECT treatment does have side effects, such as disorientation following the procedure, short-term memory loss and physical side effects including nausea, headache and jaw pain.

The treatment’s effectiveness is contingent on continuation therapy – antidepressants or other medications and/or psychological counseling. “You must do something to sustain the benefit,” Dr. Fernandez stresses.

New service at Tampa General

Dr. Fernandez joined USF Health in 2008 after receiving her medical degree from Cornell University Medical College and completing a residency in adult psychiatry at Stanford University Hospital and Clinics. She holds a Master of Science degree in Medical Sciences with a concentration in Clinical and Translational Research. She is board certified in adult psychiatry and certified in ECT.

Despite having a large psychiatry practice, Tampa General Hospital had no ECT service when Dr. Fernandez came on board. Convinced of the need and aware of the benefits, she teamed with her department chair, Francisco Fernandez, MD, and worked with her colleagues, Dr. Upshaw, Patrick Marsh, MD and Michael Bengtson, MD, to lobby TGH to make the treatment available.   

By September of 2010, the treatment was being offered at Tampa General Hospital. Since the service began, Dr. Fernandez estimates that she and her colleagues have administered about 1,200 ECT procedures to patients, many high-functioning adults who have battled depression for years. “There is a tremendous need for it in the area,” she says of the growing practice.

Candidates for ECT range in age from 18 to over 100 years, and suffer with conditions ranging from major depression, bipolar disorder and schizophrenia to catatonia, Parkinson’s disease and delirium. Some, Dr. Fernandez explains, have medical co-morbidities that preclude them from being on medications such as lithium. The treatment can be safely administered in all stages of pregnancy, and in fact, is considered safer than medications in the first trimester.

A new lease on life

For Maloney, the treatments have been life-changing. Today she is a full-time office secretary, lives in her own apartment and is planning a wedding with the boyfriend who stood by her side through it all. She has completed 25 ECT treatments since she first checked herself into Tampa General Hospital in March 2011. Her treatments now are scheduled monthly. 

Maloney is eager to talk about her experience. “I want to take away the feeling of embarrassment that people with mental health problems have. I want to help take away that stigma.”  

But most of all, she is eager to plan her future.

“For the first time in my life I am actively planning a future,” she says. It’s exciting to have a life and want to live it.”

Story by Ann Carney.  Photos by Eric Younghans/USF Health Communications

____________________________________________________________________

Improving the Symptoms of Depression and other Neurological and Mental Health Conditions

Electroconvulsive therapy (ECT) is one of four neurotherapy procedures – including transcranial magnetic stimulation (TMS), deep brain stimulation (DBS) and vagal nerve stimulation (VNS) – offered at USF Health’s Neurotherapies Clinic at Tampa General Hospital. The procedures stimulate brain cells electrically, rather than with medications, to treat depression and other mental health conditions.

TMS – Using pulsed magnetic fields, Neurostar TMS therapy stimulates the part of the brain thought to be involved with mood regulation. The short, non-invasive, non-systemic procedure is performed on an outpatient basis and typically consists of five treatments per week over a four- to six-week period. The treatment is an effective alternative for patients who cannot tolerate the side effect associated with anti-depressant medication. TMS therapy does not have the usual side effects including weight gain, sexual dysfunction and nausea. Patients are awake and alert throughout the entire 37-minute procedure, and can transport themselves to and from treatment.

DBS – Using a surgically implanted medical device, similar to a pacemaker, DBS delivers carefully controlled electrical stimulation to target areas of the brain, continuously or intermittently, to treat neurological disorders such as essential tremor and Parkinson’s disease (PD) and anxiety disorders such as obsessive compulsive disorder (OCD). The stimulation is delivered to areas of the brain that control movement, blocking the abnormal nerve signals that cause tremor and PD symptoms and helping reduce the symptoms associated with OCD.

VNS –  Approved for use in treatment-resistant epilepsy and treatment-resistant depression, VNS therapy uses an implanted pacemaker-like device to deliver mild, intermittently pulsed signals to the left vagus nerve, which in turn activates various areas of the brain. Stimulation to the left vagus nerve has been shown to induce widespread effects in areas of the brain thought to be responsible for seizures and mood disorders. The treatment is approved as an adjunctive therapy for reducing the frequency of seizures in adults and adolescents over age 12, and as an adjunctive, long-term treatment for chronic or recurrent depression for patients 18 years and older who are experiencing a major depressive disorder and have not had adequate response to other anti-depressant treatments.

To learn more about the USF Neurotherapies Clinic or to make an appointment, visit www.health.usf.edu/medicine/psychiatry/neurotherapy or call 813-259-0920.

“One of the ways we’re going to create jobs in Tampa during the coming years is by becoming one of the premier health innovation capitals in the United States,” Rep. Castor said as she stood on the sidewalk in front of CAMLS, with construction hammers pounding behind her. “This is going to build the jobs for the future in Tampa Bay.”

Rep. Castor hosted Monday’s press conference to announce that a $500,000 job creation grant that the Tampa Bay Partnership won in 2010 is now moving into the implementation phase. She held the press conference outside CAMLS, which will be completed next month, because it is an example of Tampa Bay’s future direction.

Castor described Dr. Stephen Klasko, CEO of USF Health and dean of the USF Health Morsani College of Medicine, as “a dynamo helping lift this area’s economic development prospects.”

The $30 million CAMLS project will bring health professionals from across the country to receive advanced training and assessment in surgical skills, team training and similar areas. The center will open next month, with its grand opening set for March 30th.

“What you see behind us represents the best example of how we create jobs in this area,” said Stuart Rogel, president and CEO of the Tampa Bay Partnership. “This is progress right before our very eyes.”

The Tampa Bay Partnership sees job growth in Tampa Bay focusing on four key industries, Rogel said: applied medicine, business and financial services, high-tech electronics, and marine environmental activities. Rogel sees Tampa Bay as set upon a “race to 500,000 jobs” in those four sectors.

Dr. Stephen Klasko, CEO of USF Health and dean of the USF Health Morsani College of Medicine, thanked Rep. Castor for her support of CAMLS.

“I would apologize for the hammers, but they are music to our ears to those of us looking for economic development in Tampa Bay,” Dr. Klasko said. “There is no community that has a greater champion for both economic development and health than Tampa Bay in Congresswoman Castor.”

CAMLS will help bring new business to Tampa Bay, Dr. Klasko said, while also becoming a national model for improving medical training and patient safety.

“This is going to be not only a beautiful building, but really a leader in healthcare transformation,” Dr. Klasko said.

Dr. Klasko pointed to two of the USF Health physicians who accompanied him Monday as examples of that leadership. Dr. John Armstrong, trauma surgeon and medical director of CAMLS, is the former leader of the U.S. Army Trauma Training Center. CAMLS already has won Department of Defense funding to help improve military training.

Also on hand was Dr. Richard Karl, former chair of the USF Department of Surgery and an expert on medical quality and safety. Also a pilot, Dr. Karl is working to help USF Health and CAMLS borrow training and assessment models used in the aviation world and apply them to health.

“This is the only place in the country that will start to assess, ‘Is this doctor, is this nurse competent,’ “ Dr. Klasko said.

CAMLS will start by adding 100 new jobs downtown, 45 of which will move from USF, said Deborah Sutherland, PhD, the CEO of CAMLS. CAMLS also expects to employ another 100 people on an as-needed basis, depending on what training programs are ongoing, she said.

CAMLS also is likely to act as a catalyst to create more jobs, as more health, aviation and other training partners bring business here, Dr. Klasko said.

- Story by Lisa Greene, USF Health Communications, and photos by Aimee Blodgett, USF Communications

But things got worse for the Zellwood, FL resident.

“There was more regurgitation, more heartburn,” Whidden recalls. “I started sleeping on two pillows; eventually I migrated to the chair.”

Joyce Whidden’s acid reflux got so bad she was afraid to eat.

A new doctor diagnosed the now 65-year-old Whidden with achalasia, a swallowing disorder that affects the ability of the esophagus to move food into the stomach. The only hope, he said, was a Heller myotomy, a complicated surgical procedure in which the muscles of the lower esophagus are cut to create an opening for food and liquids to pass.

Though desperate for relief, Whidden refused to consent to the procedure without more information – information her doctor was not able to provide.

“I wanted an explanation; this was a serious procedure,” she says. “I finally decided he wasn’t sure himself so I refused.”

But the condition was taking its toll. Whidden was losing her desire to eat, fearful of choking and increasingly aware of growing pressure and pain in her chest. More and more, liquids and solids were coming up into her mouth; none of the medications she was taking were working.

An answer in Tampa

Eventually Whidden was referred to the Joy McCann Culverhouse Center for Swallowing Disorders at USF Health. The nationally-renowned center had just come under the leadership of Joel E. Richter, MD, who joined USF in September from Temple University School of Medicine where he was chair of the Department of Medicine.

“I didn’t know I would be seeing Dr. Richter, but when I did, he put me at ease immediately,” Whidden recalls. “He explained to me in detail exactly how the condition went from minor to major. He explained why I felt this way, what could be done and what choices I had.”

And he told her about an endoscopic procedure that could prove to be the answer Whidden had sought for years. The outpatient procedure, called a pneumatic dilatation, involves inserting a sausage-shaped balloon into the narrowed ending of the esophagus and inflating it to create an opening for liquids and solid foods to pass into the stomach.

Dr. Joel Richter, the new director of the USF Swallowing Disorders Center,  told Whidden about an endoscopic procedure called pneumatic dilatation.

Over the course of his esteemed medical career, which includes 10 years as chair of the Department of Gastroenterology and Hepatology at the Cleveland Clinic Foundation, Dr. Richter has treated hundreds of patients with achalasia.

“A gastroenterologist in the community sees one or two cases a year; at USF, we see several in a week, ” he says. “We probably have the largest achalasia practice in the Southeast United States.”

Less than a week after Whidden’s visit to the USF center, Dr. Richter performed the pneumatic dilatation that would return her to a normal life.

“I had 100 percent confidence in him because of his experience and his explanation of why and when and how,” she says. “Within five days I was almost disease-free. All the heavy pressure and pain went away. I had the sensation of food moving down; I was absolutely thrilled.”

Achalasia is one of the complex swallowing and esophageal disorders Dr. Richter and his multi-specialty team treat at the stand-alone referral center. The center is part of the USF Division of Digestive Diseases and Nutrition which includes the university’s strong GI program.

Comprehensive treatment for complex disorders

Dr. Richter, the Hugh R. Culverhouse Chair for Esophagology at the USF College of Medicine, leads the division. He joined USF in the fall when H. Worth Boyce, MD, who built the university’s internally recognized swallowing program and led its clinical programs in digestive diseases, announced his retirement.

Today the division includes nine board-certified GI subspecialists and offers comprehensive care for patients with gastrointestinal disorders including gastrointestinal cancers, swallowing and esophageal diseases, irritable bowel syndrome, pancreatic biliary diseases, celiac disease and malabsorption, generalized GI motility disorders and women’s GI disorders.

The USF Health Division of Digestive Diseases and Nutrition’s multispecialty team offers comprehensive care for a wide array of gastrointestinal disorders.

Soohong Hong Chae, MD, joined the division in fall 2010 after completing a fellowship in gastroenterology at UCLA, Los Angeles. At USF, her practice is heavily focused on functional bowel diseases such as irritable bowel syndrome, small intestinal bacterial overgrowth, motility disorders such as pelvic floor dyssynergia, and inflammatory bowel disease. She has a strong interest in women’s gastrointestinal issues, particularly constipation.

Arthi Sanjeevi, MD, whose GI training was NIH-funded with a focus in GI motility disorders and neurogastroenterology, recently joined the division’s pancreatic biliary diseases group under the direction of Patrick Brady, MD. Her primary clinical interests focus on application of endoscopic ultrasound technology for improved diagnosis of gastrointestinal disorders and as an interventional tool in complicated pancreato-biliary disorders. In addition to routine endoscopy, Dr. Sanjeevi performs complex endoscopic procedures including endoscopic ultrasound, esophageal and enteral stent placements and deep enteroscopy.

Along with bringing new specialists to the program, Dr. Richter is introducing new technologies such as the Smart Pill, an ingestible capsule that uses sensor technology to measure motility (movement) from the stomach through the small bowel and into the colon. The pill, which collects information and sends it to a wireless receiver worn by the patient, is an alternative to gastric emptying scintigraphy which can take up to four hours. Breath tests that measure the presence of an ingested isotope in carbon dioxide, hydrogen or methane when a person exhales will also be available at the center to test for lactose intolerance and small bowel overgrowth motility.

Renewed focus on research

“We have a collegial group of physicians with a number of areas of interest and all doing research,” Dr. Richter says, adding that patient-oriented research is the greatest opportunity for advancing the program’s reputation.

“We have new treatments and new interventions because of USF research. The best clinical care is done in centers that are conducting cutting-edge, patient-oriented research.”

Dr. Richter says the best clinical care is done in centers, like USF’s, where leading-edge, patient-oriented research is a priority.

Dr. Richter’s career is steeped in the study of esophageal diseases. He has co-authored nearly 300 papers, 121 editorials and reviews, 11 books and 109 book chapters. In 1999, he developed the 48-hour Bravo pH test, a wireless pH test to measure acid coming up in the esophagus. Currently he is investigating new treatments for achalasia and eosinophilic esophagitis, a condition in which a certain type of white blood cells build up in the esophagus causing inflammation and injury. 

His colleagues at the center, Dr. Boyce and David Estores, MD, are investigating restorative endoscopy, a novel therapy for head and neck cancer patients with severe radiation damage to the upper esophagus. USF is one of only a handful of GI centers in the nation conducting research in this area.

Nationally recognized swallowing center

At the swallowing center, Dr. Richter and Dr. Estores, treat patients with swallowing and other esophageal problems such as acid reflux, chest pain, regurgitation, food sticking, and solids and liquids not going down. The center’s dedicated multi-specialty team — the largest dedicated, full-time staff of any swallowing center in the United States — includes surgeons, an allergist, speech and rehabilitative therapists, and an advanced registered nurse practitioner. Once a week the team gets together to talk about clinical issues and research projects.

“It gives patients the appropriate assurance that they are coming to a center that is really focused on their problem – from the beginning of swallowing all the way down to the end of the esophagus,” Dr. Richter says, calling the center “one of the oldest and best endowed swallowing centers in the U.S.”

Building on a legacy of excellence

The Joy McCann Culverhouse Center for Swallowing Disorders was founded in 1987 following a generous gift from Joy Culverhouse. Dr. Boyce, the center’s founding director, grew the center to national prominence until his retirement in September 2011.

Dr. Richter is optimistic about continuing the center’s legacy of excellence. Since receiving his MD from the University of Texas Southwestern Medical School and completing an internship at the Naval Regional Medical Center in Philadelphia, PA, as well as a residency and fellowship at the National Naval Medical Center in Bethesda, MD, he has directed swallowing centers at the University of Alabama Medical Center, Cleveland Clinic and Temple University.

“The patients we see are scared to eat,” he says. They include patients like Whidden, who refers to the center as “where I found life.”

“I cannot begin to tell you the change in my life,” Whidden says, less than two months after undergoing the procedure at USF’s Morsani Center for Advanced Healthcare. “I cannot tell you how much better I feel – the joy I feel in my life. I will always sing Dr. Richter’s praises.”

A resource for community physicians

The gratitude comes from community physicians as well, physicians who refer difficult cases for evaluation and treatment. Recently, a patient from Arkansas was referred to the center for evaluation and treatment of lichen planus, a skin condition that can cause scar tissue in the lining of the esophagus, impairing a person’s ability to swallow. The referring gastroenterologist knew of the center’s reputation.

“As an academic referral center, we help demystify disease for practitioners in the community,” Dr. Richter says. “We are a place for consulting, diagnosis and treatment.” Typically patients return to their referring physician for follow-up care and continuing case management.

Untapped potential

As he settles into his new position at USF Health, Dr. Richter sees a program with tremendous untapped potential.

“My career has centered around building outstanding clinical care and research programs.  This program will be second to none.”

Story by Ann Carney, and photos by Eric Younghans/USF Health Communications

Marisa Belote joined the College as director of Center for Virtual Simulation and Clinical Education (VSCE), Erik Rauch is director of the Nurse Anesthesia Concentration and responsible for nurse anesthesia simulation, Alicia Rossiter is coordinator of Graduate Simulation, and Brittny Chabalowski is coordinator of Undergraduate Simulation, as well as director for the College’s Upper Division and Second Degree Nursing Programs.

The College’s expansion is also in tandem with the opening in March of the new facility for USF’s CAMLS, a state-of-the-art simulation center that will not only train doctors, nurses and other healthcare providers to work side-by-side, perfecting the teamwork and communication skills vital to top-quality medicine, but also train surgeons from around the country on how to perform robotic, computer-assisted, and image-guided surgeries. Rausch’s nurse anesthesia simulation program will be the first Nursing program, and perhaps the first education program within USF Health, going to CAMLS.

At a recent Ch. 28 Town Hall meeting held on the USF campus, Marisa Belote, director of the Nursing Center for Virtual Simulation and Clinical Education, demonstrates to reporters Baby Ryan, a patient simulator used to teach students normal, emergency and neonatal assessments.

The expansion comes a year after Rita F. D’Aoust, PhD, ANP-BC, CNE, FAANP, a nationally recognized educator and researcher in nursing education and simulation, joined USF as associate dean of Academic Affairs and director of Interprofessional Initiatives at the USF College of Nursing. Since joining USF, Dr D’Aoust has spearheaded the development of USF’s Center for Interprofessional Education and Simulation (CIPES) for the Center for Advanced Medical Learning and Simulation (CAMLS) and participated in the development and approval of interprofessional competencies for the five health professional colleges within USF Health.

“As our nursing programs and learning needs grow, we have recognized the need for additional leadership positions within our college to facilitate and expand our educational learning needs,” said Dr. D’Aoust of the College’s new faculty. “These positions complement the work of our VSCE and provide the operational duties associated with simulation learning, and will be a welcome component of CAMLS.”

Simulation, an educational focus at the College of Nursing and a USF Health initiative, is a vital supplement to clinical learning and complements direct patient care opportunities. Refining clinical skills without risk to real patients and learning to work in teams provides for improved safety and better outcomes. This specialized training prepares healthcare providers for the multidisciplinary challenges faced in real-life patient encounters.

The new 90,000-square-foot facility in downtown Tampa will greatly expand the simulation training USF offers, by bringing together under one roof the many programs housed in various departments throughout USF Health, as well as expand to offer surgical training and robotic training programs. Among the programs coming together are USF Health’s five simulation centers (USF Health Simulation Center at Tampa General Hospital, daVinci Center for Computer-Assisted Surgery, TEAMS Center, Center for Advanced Clinical Learning at the College of Medicine (CACL), and Center for Virtual Simulation and Clinical Excellence (VSCE) at the College of Nursing).

The building also will feature a 2,000 square-foot auditorium, a 6,000 square-foot laboratory for interdisciplinary research, and one floor for general purpose classroom space.

From left, Brittny Chabalowski, coordinator of undergraduate simulation at USF College of Nursing; Marisa Belote, director of the USF College of Nursing Center for Virtual Simulation and Clinical Education; Troy Hambrick, lab specialist for the USF College of Nursing/Teaching Simulation; Carson Chambers, reporter for Channel 28 ABC Action News; and Dianne Morrison-Beedy, PhD, RN, senior associate vice president of USF Health, and dean of the USF College of Nursing.

Story by Sarah Worth, USF Health Office of Communications
Photos by Aimee Blodgett, University Communications and Marketing

No hair? No problem. Some days she’d wear the wig. Other days, she would go bald.

And laugh about it.

But Gorr found some side effects of fighting leukemia more difficult to cope with. Barely 21, Gorr was devastated when she heard that treatment would leave her infertile.

“I want kids so bad. It crushed me,” she said. “It was like a slap in the face.”

Jackie Gorr’s mother, Karen Espinoza, has been by Jackie’s side during her battle with cancer.

But today, Gorr has hope – both for long-term cancer survival and that she will one day have a child. Gorr, who lives in St. Petersburg, had a bone marrow transplant to treat the leukemia that had invaded her body. But first, she went to USF’s Center for Fertility Preservation, where her eggs were retrieved, fertilized and frozen.

Three embryos are in cold storage, waiting for the day that Gorr – now 23 – is ready to become a mother.

Making fertility preservation available for cancer patients is a huge step towards preserving cancer survivors’ quality of life, said Dr. Celso Silva, assistant professor in Obstetrics and Gynecology and director of the USF Center for Fertility Preservation.

Dr. Celso Silva gave Jackie Silva hope that she may one day be able to have children.

“We have become excellent at treating cancers, and in many instances we can actually cure them,” Dr. Silva said. “But once patients wake up from this nightmare, and they find out that the treatment has rendered them infertile, a new reality sets in: establishing a family may still be one of the things that patients want to do with their lives.”

Sadly, if this realization comes after treatment, patients are likely to have fewer options for having children. And cancer patients often don’t hear about their choices before treatment.

That’s why it’s so important to Dr. Silva that patients like Gorr get the chance to make these decisions.

“Frequently they are not counseled ahead of time,” he said. “They are, unfortunately, in a scenario where they’re under a lot of pressure, and they want to make decisions about their diagnosis and treatment as soon as possible, and fertility preservation ends up becoming secondary.”

Although many patients still aren’t offered fertility preservation techniques, USF’s center is winning recognition that may help raise public awareness. The USF Center for Fertility Preservation is partnering with Moffitt Cancer Center, which was recently awarded a grant from the National Cancer Institute to develop a Fertility Reproduction and Cancer Training Institute for Oncology Nursing.

The USF Center for Fertility Preservation and Moffitt also have been recognized as a Center of Excellence by Fertile Hope, an initiative to promote reproductive information sponsored by Livestrong, a leading foundation supporting people affected by cancer.

“We’re the only cancer center which has an on-site reproductive endocrinologist, Dr. Silva, who’s on staff and can see patients,” said Gwendolyn Quinn, PhD, co-director of the Survey Methods Core Facility at Moffitt and a USF associate professor. “That’s so important. It’s usually up to the patient to find that person, so it often falls by the wayside. Early on, their goal is just about survival. We find patients who have a lot of regret and remorse when they didn’t consider options before treatment.”

That’s why Dr. Quinn and Dr. Silva are excited about the new NCI grant, which will fund training for oncology nurses to talk with newly-diagnosed patients about their options for fertility preservation. Since nurses spend the most time with these patients, Dr. Quinn and co-investigator Susan Vadaparampil, PhD, MPH, thought they could help bring this information to patients.

“These nurses not only understand them from a clinical view, but from a psychosocial point of view how to counsel and shepherd these patients through a very difficult time,” said Dr. Vadaparampil, associate professor in Oncologic Sciences and associate member at Moffitt.

Moffitt hopes to train 250 nurses over a five-year period in a 10-week, web-based training program. Dr. Silva is principal investigator for the USF grant site. The grant will recruit nurses nationally, but specify that at least two must come into the program from each institution, so that knowledge will be preserved if one nurse moves on. The nurses who go through the program will be taught to, in turn, train their colleagues.

Dr. Quinn and Dr. Vadaparampil also are writing a textbook that will serve as training material for the nurses. Dr. Silva has written a chapter for the textbook discussing the current options for fertility preservation.

Cryopreservation is one option that Dr. Silva uses.

Cancer treatments can increase the risk of infertility to both men and women. Some types of chemotherapy can kill male sperm cells or female eggs. Radiation to sexual organs can do the same. In some cancers, sexual organs may have to be surgically removed.

However, the risk varies, depending on the type of cancer and the treatment. Some forms of chemotherapy, for instance, are much less toxic to reproductive cells than others.

Choices to preserve fertility may include cryopreservation of eggs, sperm or fertilized embryos before the patient is treated. Other options include ovarian or testicular tissue cryopreservation and ovarian down regulation.

The Center for Fertility Preservation priority is to work close with the patient’s oncologists, making sure that if patients choose to undergo any of the fertility preservation options, this will not delay or interfere with their cancer treatment. To date, research has shown that when performed adequately, fertility preservation does not worsen cancer prognosis or change survival or recurrence rates, said Dr. Silva.

Sometimes, Dr. Silva said, a patient may hear about the fertility preservation options and decide they would rather focus their energies completely on the cancer treatment.

That’s okay, too. Just having had the discussion may really help them.

“Being educated about the potential detrimental effects of cancer therapy on reproduction is very powerful,” Dr. Silva said. “They may choose to go through the fertility preservation process, or they may decide it is not for them. But we have now empowered a patient to make their own decision.”

Originally from Brazil, Dr. Silva came to the U.S. to pursue his dreams of doing both research and patient care. He studied at Brown University and the University of Pennsylvania before coming to USF.

“I do consider myself a scientist, but I can’t do only science,” Dr. Silva said. “I like interacting with my patients. In this country, you can do both.”

He is passionate about giving patients who long to be parents a chance to have children.

“For many couples, when the ability to have a baby has been taken away, it is such a huge deficiency in their lives,” he said.

Jackie Gorr is grateful to both Dr. Silva and to see a program that gives more cancer survivors hope that they may have children one day. She got her first cancer diagnosis at 15, but after treatment, went into remission. As the months became years, she thought she was safe.

But then Gorr started losing weight for no reason. When she went to her job waiting tables, she found it hard to hold her trays. At her 21st birthday party, she had to force herself to eat.

Sometimes Gorr wears a wig…

A week later – just a week shy of making it to five years cancer-free – she was diagnosed with leukemia.

What hurt most came after she was told that she would need a bone marrow transplant. The radiation before the procedure would leave her unable to have children. She struggled with feelings of inadequacy and loss.

“God made women able to produce children,” Gorr said. “It’s like that was stripped from me.”

But then Dr. Silva offered her hope.

“This is very close to my heart,” Gorr said. “It means the world to me.”

Dr. Silva’s discussions with patients about fertility preservations are honest and frank. He spells out the risks, discomfort and possible complications – including ethical and legal questions that may go beyond the medical realm. But Gorr was willing to inject herself with hormone shots. After some discussion with her insurer, the company covered the egg retrieval procedure.

And, even though Gorr was young, she and her fiancé decided to preserve embryos fertilized with his sperm, rather than unfertilized eggs, to have the best chance of success.

…and sometimes she doesn’t.

Gorr knows there are no guarantees. The frozen embryos will be implanted in her body when she is ready to have children, but the process doesn’t always result in pregnancy. Still, having that hope allows her to look toward the future.

“I want two boys and one girl, that’s my dream,” Gorr said.

Not that she cares that much about particulars.

“If I get just one child from those embryos, I will be the happiest person,” she said. “I will be truly blessed.”

– Story by Lisa Greene, photos by Eric Younghans, USF Health Communications

The new Center for Memory C.A.R.E. reaches a whole new level in applying the latest technology and research to the diagnosis and treatment of Alzheimer’s disease, while helping ease the anxiety and difficulties of patients and their caregivers.

Guests had a chance to tour the distinctive $3.5-million second-floor center, where a multispecialty team will begin seeing new patients Dec. 1. Among the features that set it apart: An onsite PET scanner that will help diagnose patients with dementia earlier and a small-scale apartment to test the ability of patients to perform routine daily tasks like cooking and doing laundry.

Standing at a podium backed by shimmering strands of purple beads, the David Morgan, CEO of the USF Health Byrd Alzheimer’s Institute, served as the evening’s moderator. He thanked all who had helped to make the C.A.R.E, Center a reality and introduced the speakers.

What they said about the Center for Memory C.A.R.E. and Byrd Institute:

“I can’t tell you how ecstatic I am to have reached a day when we have something we can look at and touch – something tangible that shows the greatness this Institute has before it… We’ve already leveraged $1 million in basic science funding into 22 new research grants totaling more than $9 million over the next few years… Now, we’ll leverage this marvelous second-floor center to help move our clinical research forward.”

- David Morgan, PhD, CEO of USF Health Byrd Alzheimer’s Institute

“Wow, this is transformative… This is a new model in looking at Alzheimer’s as a disease that can be prevented and will eventually be a memory. The Byrd Institute is going to be the beginning of the revolution in making sure Alzheimer’s disease can be diagnosed and treated before anyone gets it.”

- Stephen Klasko, MD, CEO of USF Health and dean, College of Medicine

“Our goal in finding Alzheimer’s in the living brain is not to give people bad news early. It’s to develop treatments faster… The PET imaging upstairs today is leading the drug development. Someday, we’ll have the (new) drugs to treat people in ways we don’t have today… It’s not pie in the sky to say that Alzheimer’s disease will one day be a memory… Places like this will change things.”

- William E. Klunk, MD, PhD, distinguished professor of psychiatry and neurology and
co-chairman, Alzheimer’s Disease Research Center, University of Pittsburgh

“To have one place where you can go for patient assessment, diagnosis, treatment, clinical trial involvement, caregiver support and education. A beautiful, tranquil place where everyone knows your name and you need only to show up and enjoy the amenities. What a gift.”

- Sherrill Tomasino, caregiver and chair of Byrd Institute Board of Directors

“When my husband was diagnosed with Alzheimer’s we had just moved to Florida, and I had no family or friends here. It was a devastating time in my life… This will be a wonderful place for caregivers to come with their loved ones to learn how to care for them and to receive the emotional support that they need.”

- Francine Shebell, caregiver and donor to Peter and Francine Shebell Family Consultation Room

L to R: Johnnie B. Byrd, Jr, former board chair;  Dr. David Morgan, CEO, USF Health Byrd Alzheimer’s Institute; USF President Judy Genshaft; Dr. Amanda Smith, medical director,
Byrd Alzheimer’s Institute; and Dr. Stephen Klasko, CEO of USF Health and dean, College
of Medicine.

Dr. William Klunk, co-director of the Alzheimer’s Disease Research Center at
the University of Pittsburgh, was the featured speaker at the grand opening.

Sherrill Tomasino, board chair, USF Health Byrd Alzheimer’s Institute

The Eric Pfeiffer PET Imaging Center, named in honor of Dr. Pfeiffer (above),
houses the first onsite PET scanner in an Alzheimer’s facility in Florida.

A group tours the small-scale apartment  in the C.A.R.E. Center’s
Functional Assessments Facility.

 Story by Anne DeLotto Baier, and photos by Eric Younghans, USF Health Communications

Tampa, FL (Nov. 17, 2011) – The  University of South Florida today opens a distinctive center offering people with memory disorders and their families a full range of individualized, multispecialty services in one welcoming place.

The Center for Memory C.A.R.E. (Clinical Assessment, Research and Education), on the second floor of the six-story USF Health Byrd Alzheimer’s Institute, is designed to support patients and their caregivers while providing convenient access to the latest research, technology and care.

Among its distinctive features is a unique small-scale apartment used to assess the ability of patients with memory impairments to perform activities of daily living, such as boiling a pot of water or selecting weather-appropriate clothing. Just outside a simulator helps determine driving capabilities. And clinical features include an onsite PET scanner, or positron emission tomography, that helps diagnose dementia and support drug discovery.

“Other academic Alzheimer’s centers may have pieces of what we have here, but as far as we know USF is the first to put all the services together in a one-stop shop,” said David Morgan, PhD, CEO of the USF Health Byrd Alzheimer’s Institute.

Dr. Amanda Smith is medical director and Dr. David Morgan,
CEO, of the USF Health Byrd Alzheimer’s Institute.

“A challenge to all of us in the field of Alzheimer’s disease is bringing cutting-edge technology to bear on the assessment, diagnosis and treatment of our patients, while at the same time, recognizing the human aspects of the disease and helping ease the caregivers’ burden,” said geriatric psychiatrist William Klunk, MD, PhD, co-director of the Alzheimer’s Disease Research Center at the University of Pittsburgh.  “The Center for Memory C.A.R.E. reaches a new level in answering this challenge and is likely to quickly become the standard for and envy of other centers across the country.”

From the warm colors, soothing artwork and see-through aquarium in its spacious great room to a comfortable bistro where families can order in lunch while they wait, this place is not the traditionally institutional clinical fare. It’s also much more than a beautiful space.

“This is a great example of what makes USF Health and Tampa Bay unique,” said Stephen Klasko, MD, CEO of USF Health and Dean of the College of Medicine.  “C.A.R.E. combines our excellence in research, clinical care, education and simulation with our passion for preventing and curing Alzheimer’s disease.”

Multispecialty Medical Team

A person visiting the C.A.R.E. center will be seen by a multispecialty team, including a neuropsychologist, physician specializing in memory disorders and a geriatrician, and can undergo neuroimaging and laboratory tests at the same visit. After the comprehensive evaluation, the team makes a same-day diagnosis and recommends an individualized treatment and support plan.

Sherrill Tomasino, board chair of the USF Health Byrd Alzheimer’s Institute, says having that kind of resource one phone call away will prove invaluable for families. Tomasino, who cared for both parents after they were diagnosed with Alzheimer’s disease, recalled struggling to find specialists with expertise in memory disorders and then juggling multiple visits to separate doctors, imaging centers and labs.

“When a loved one is diagnosed with Alzheimer’s, you know it’s a tough road ahead,” she said. “So being able to come to one place to get everything done in one day, while the caregiver has some time to relax – that’s a huge gift.”

Sherrill Tomasino, board chair of the USF Health Byrd Alzheimer’s Institute,
cared for both parents after they were diagnosed with Alzheimer’s.

Living Skills Assessments

One of the biggest challenges families face when a loved one is diagnosed with Alzheimer’s is deciding whether the person can continue living alone, should move in with a caregiver, or if other options like assisted living or long-term care are needed.

With this in mind, USF integrated a Functional Assessments Facility into the center. This facility, including the small-scale apartment complete with kitchen, bathroom, bedroom and laundry area, sets the memory care center apart from others across the country, said Amanda Smith, MD, medical director of the USF Health Byrd Alzheimer’s Institute.  “It’s a place where occupational and physical therapists can test the cognitive and physical abilities of patients to perform routine daily tasks. The goal is to determine whether patients can safely live on their own.”

Therapists evaluate whether patients can independently complete tasks such as picking out clothes appropriate for the weather, boiling a pot of water and turning off the stove, transferring laundry from washer to dryer, and using appropriate settings on appliances.

The Functional Assessments Facility features a small-scale apartment where therapists can test the ability of patients to perform routine tasks like operating
a stove to boil water and doing laundry.

Outside the apartment, a computerized simulator recreates real-world driving conditions to measure whether it’s time for a person with Alzheimer’s to transition from driver to passenger. Some early-stage patients may drive safely for a limited time, Dr. Smith said, but the risk of driving increases as the disease advances, leading to greater memory loss, disorientation, and lapses in judgment.

Neurodegenerative changes can also greatly increase the risk of falling for people with Alzheimer’s, so a Falls Prevention Program is available to evaluate gait and balance.  If deficiencies are noted, patients can receive training at the nearby USF School of Physical Therapy.

Diagnostics Capabilities

The Eric Pfeiffer PET Imaging Center houses the first onsite PET scanner in an Alzheimer’s facility in Florida, Dr. Morgan said. The technology now allows physicians and researchers to view the build-up in the brain of toxic material known as amyloid plaques years before the first signs of memory loss appear.

Mounting evidence indicates that monitoring amyloid in the brain in this pre-symptomatic stage holds promise for screening those at high risk for Alzheimer’s disease, much like physicians now do for heart disease using biomarkers like cholesterol, Dr. Morgan said. It could be a useful tool for diagnosing Alzheimer’s earlier and more accurately than clinical evaluations alone, in addition to tracking whether newly developed treatments are working appropriately in the brain.

The center’s onsite PET scanner helps diagnose dementia and supports
drug discovery.

“We hope this will ultimately lead to the prevention of Alzheimer’s disease,” Dr. Morgan said. “Identify those at risk of Alzheimer’s before they show symptoms and find effective treatments to slow or reverse the amyloid accumulation, so they never get the disease.”

Along with staff’s expertise in science and technology that may lead to new discoveries, the center offers plenty of support for patients and families often overwhelmed by an Alzheimer’s diagnosis.

The Caregiver Education Resource Library provides print and online access to information like adult day care and social services near the patient’s home, caregiver support groups, elder law attorneys. At the nearby Partners in Research desk, patients and caregivers can learn about opportunities for joining clinical trials or other studies at the USF Health Byrd Alzheimer’s Institute and elsewhere on campus.  Both areas flank a colorful playroom with glass walls, to accommodate children accompanying a caregiver who brings a parent or other older family member to the center.

The supervised playroom accomodates caregivers with young children.

Stress-busting Design Features

Nearly two years in the making, the center was designed to diminish the stress and apprehension of people experiencing memory problems and their families.

Rather than a typical clinical waiting room, visitors gather in a casual great room with natural lighting from large windows, a tropical aquarium, artwork depicting restful nature scenes and landscapes, and an area for watching videos or listening to music.  Furniture was selected and arranged to create intimate clusters where patients and their family members can retreat between appointments and tests. Since patients in the later stages of Alzheimer’s are prone to pace, the center’s circular design even incorporates a pacing loop visible to caregivers and staff.

Jessica Banko, associate director of the USF Health Byrd Alzheimer’s Institute,
says the C.A.R.E. Center design is intended to help reduce the anxiety of patients and caregivers..

“Usually when you enter a healthcare facility, you feel anxious about what you’re going to find out. Maybe you don’t even want to be there and someone else persuaded you to come,” said Jessica Banko, PhD, associate director of the USF Health Byrd Byrd Alzheimer’s Institute. “The idea behind the center was to create a sort of ‘memory spa’ to evoke feelings of peace, serenity and comfort.  We wanted to make the experience as inviting and positive as possible for all who would be spending quite a bit of time here.”

USF School of Architecture students, working with faculty and staff of the USF Health Byrd Alzheimer’s Institute and consultants, created the initial design concept for the Center for Memory C.A.R.E.  The project was backed by research indicating that emphasizing the aesthetics of a clinical environment can help diminish anxiety, lift mood and may even improve patient outcomes.

- 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, Public Health and Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group.  Ranked 34^th in federal research expenditures for public universities by the National Science Foundation, the University of South Florida is a high impact global research university.

USF Health Communications media contacts:
Susanna Martinez Tarokh,  smartin1@health.usf.edu or (813) 974-2776
Anne DeLotto Baier, abaier@health.usf.edu or (813) 974-3303

Video by Amy Mariani, and photos by Eric Younghans, USF Health Communications

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=22953 0 http://hscweb3.hsc.usf.edu/health/now/?p=22443 http://hscweb3.hsc.usf.edu/health/now/?p=22443#comments Thu, 20 Oct 2011 21:19:31 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=22443 Company used a USF patent in helping to develop its therapies to treat cancer and infectious diseases

ST. PETERSBURG, Fla. (Oct. 20, 2011) – Officials with the city, state and University of South Florida Thursday announced that a clinical stage biotechnology company is moving its operations from New York to St. Petersburg’s Gateway Area – a significant new stage in its long-term partnership with USF.

IRX Therapeutics, Inc. is developing therapies to treat cancer and infectious diseases.  Its lead product, IRX-2, is an active immunotherapy that is designed to treat cancer by restoring the patient’s immune system and enabling an immune attack on the tumor.  To date, IRX has raised $90 million of capital to fund pre-clinical research, manufacturing and clinical development of IRX-2. 

“This announcement is a great example of the impact that an academic medical center has on the economic development of a community,” said Dr. Stephen Klasko, CEO of USF Health and dean of the College of Medicine.  “We’re bringing ideas, inventions and businesses to the region and that means jobs . . . and ultimately improving the lives of the citizens of the region.”

For more information, go to http://news.usf.edu/article/templates/?a=3845&z=119

The USF Health-Symbionix team is creating the first simulation product on the market for laparoscopic hysterectomy

USF Health physicians are an integral part of an international team developing the world’s first laparoscopic hysterectomy simulation module — an academic entrepreneurial partnership that may help change how future obstetrician-gynecologists learn.
 
Dr. Stuart Hart and Dr. Larry Glazerman, faculty members in the USF Health Department of Obstetrics and Gynecology, last month visited Israel to work with engineers from Simbionix™  on the project.  The partnership is funded by a two-year, $700,000 grant from the U.S.-Israeli Binational Industrial Research and Development (BIRD) Foundation.   Dr. Hart and Dr. Glazerman are principal investigators for the grant, which supports the creation of a laparoscopic hysterectomy simulation module for training GYN surgeons in advanced minimally-invasive surgery techniques.
 
“Our goal is to make the learning experience as close as possible to the real operation,” said Dr. Hart, assistant professor in the USF Health Division of Urogynecology and Pelvic Reconstructive Surgery. “We’re part of a team designing technology that will help transform the future of health care by making surgery safer and more efficient.”

USF Health’s Dr. Stuart Hart, left, and Dr. Larry Glazerman, experts in minimally-invasive gynecological surgery, visited the Simbionix Research and Development Center in Tel Aviv, Israel, to work on the simulation prototype with engineers.

Symbionix and USF Health plan to roll out the prototype laparoscopic hysterectomy simulation module in November at the American Association of Gynecologic Laparoscopists 40th Global Congress of Minimally Invasive Surgery in Hollywood, FL.  Those attending will have to opportunity to try out the prototype.
 
When the project is finalized this spring, the USF Health Center for Advanced Medical Learning and Simulation (CAMLS) will be the beta test site for the simulation module, allowing ob-gyn faculty, residents and practicing physicians to provide feedback on the new Simbionix product.

USF Health will also work closely with the American College of Obstetricians and Gynecologists (ACOG) to scientifically validate the module’s educational content so that it may be integrated into training programs in the future.

 

           The training module is designed to run on the Symbionix
           LAP Mentor simulator.

USF Health’s collaboration with Simbionix is the type of innovative project that will be encouraged by the Tampa Bay Research and Innovation Center (TBRIC), a center within CAMLS dedicated to advanced medically related engineering research and development, medical modeling and simulation, human factors analysis and medical device development, said Dr. Hart, the center’s TBRIC medical director.
 
“Partnering with a global company like Simbionix, obtaining the BIRD Foundation grant, and working with a national specialty society like ACOG to validate the performance metrics of this new simulation product epitomizes what CAMLS is all about,” said Deborah Sutherland, PhD,  associate vice president of USF Health and CEO of CAMLS. “We anticipate many similar projects once CAMLS opens in Spring 2012.”
 
During the visit to the Simbionix Research and Development Center in Tel Aviv, Israel, Aug.21 to 24, Dr. Hart and Dr. Glazerman worked directly with the development team to modify and refine the simulation module. This included performing multiple hysterectomy procedures using the prototype module and giving their input about the anatomic and surgical procedural improvements needed to create a realistic surgical simulation training experience. They also helped define the educational and training content for the hysterectomy module.

Dr. Glazerman moves the instruments while Simbionix product manager
Maya Bloch brings up an anatomical image on the  monitor. Sophia Slepnev
takes notes in the background.

 As in real life, the simulated laparoscopic operation is performed entirely by movements of the instruments and observation on a video screen. The surgeons operate while observing the movement of the instruments in a three-dimensional anatomical environment, created by the endoscopic camera on a monitor. Robots simulate the ports into which the laparoscopic instruments are inserted, allowing accurate spacial tracking in this three-dimensional surgical simulation.
 
The Israel trip followed a full year of preliminary work, which included videoconferences with the engineering team to design the prototype.  Simbionix product managers Sophia Slepnev and Maya Bloch visited USF Health this spring, observing and videotaping ob-gyn faculty and residents performing laparoscopic hysterectomies in the operating room. This helped the engineers in critically dissecting the entire procedure down to each step – including hand motions, positioning of instruments and visual landmarks used by the surgeon in navigating the peritoneal anatomy.
 
The Simbionix-USF Health team collaborated to make the simulated surgery not only visually accurate but feel life-like from start to finish. The module integrates haptic technology, which facilitates the sense of touch physicians experience when inserting instruments, grasping tissue, cutting, suturing or performing other procedures. So for instance, pushing a surgical instrument into the “virtual” uterus would yield the same initial give and then tension of uterine tissue.
 
“The collaboration between Simbionix and USF Health will ensure that the module incorporates all clinically relevant aspects of the procedure, including complications and objective performance analysis,” said William Lewandowski, vice president for U.S. business development at Simbionix USA Corporation.
 
Hysterectomy, removal of the uterus, is the second most common major operation among women in the United States. Approximately 600,000 hysterectomies are performed yearly in the United States at a cost of nearly $5 billion, according to the Centers for Disease Control and Prevention.

Dr. Hart, above, and Dr. Glazerman, below, try out the true-to-life, interactive training module using the simulator’s 3-D head tracking system.

 
While studies indicate that many hysterectomies could safely and successfully be performed using laparoscopic techniques, the majority of these surgeries are still done by making a large abdominal incision.  Despite laparoscopic surgery’s advantages in appropriately selected patients –  less postsurgical pain and complications, quicker recovery times and smaller scars — obstetrics and gynecology has lagged behind other fields in adopting this minimally-invasive procedure, said Dr. Glazerman, associate professor and director of minimally invasive gynecologic surgery at USF Health.
 
There is a great need for scientifically-validated advanced simulation training that will help practicing ob-gyns to transfer surgical skills used in “open” abdominal hysterectomies to the endoscopic camera and video monitor, as well as train residents in the latest techniques for laparoscopic hysterectomy, Dr. Glazerman said.
 
“The end product of our project will be a huge benefit in helping ob-gyns adopt minimally invasive hysterectomy in a way that improves patient outcomes.”

- Story by Anne DeLotto Baier, USF Health Communications

USF Health’s is the first and only such simulation program in Florida accredited by SSH.

The USF Health Simulation Consortium includes USF Health’s five simulation centers (USF Health Simulation Center at Tampa General Hospital, daVinci Center for Computer-Assisted Surgery, TEAM Education and Multidisciplinary Simulation (TEAMS) Center at 17 Davis, Center for Advanced Clinical Learning at the College of Medicine (CACL), and Center for Virtual Simulation and Clinical Excellence (VSCE) at the College of Nursing). The goal of the Consortium is to provide continuity and support to the various simulation centers throughout USF Health.

The SSH accreditation is the second endorsement for the Consortium since forming in April 2010. In January 2011, it was awarded full accreditation by the American College of Surgeons as a Level I Comprehensive Education Institute.

Dr. Laura Haubner

“These endorsements acknowledge the group’s quality of education and focus on patient safety for all areas offering simulation at USF Health,” said Laura Haubner, MD, clinical director for CAMLS and program director for the SSH accreditation. “This validation of our training programs helps us maintain our mission to define and assess competencies for the benefit of patient outcomes and improved patient care.”

USF’s accreditation committee was directed by Dr. Haubner and included Dawn Schocken, director of CACL; Deborah Sutherland, PhD, associate vice president of USF Health, associate dean for Continuing Medical Education, and director of ACS Education Institute; Beverly Hughes, administrator for Sim Center at TGH; John Armstrong, MD, medical director for CAMLS and surgical director for the ACS Education Institute; Christine Airey, MSN, RN, education coordinator for Sim Center at TGH; Susanna Odelskog, RN, education coordinator for the USF Dept. of Pediatrics TEAMS; Rita D’Aoust, PhD, associate dean of the College of Nursing; and Laura Gonzalez, PhD, administrator for VSCE for the College of Nursing. 

The SSH site visit team visited USF Health in May, touring USF Health’s simulation centers and interviewing faculty, administrators, students and leaders of the various simulation programs. In their final report granting accreditation, the site-visit team noted several strengths found at USF Health.

Strengths or outstanding practices identified by the Review Team

1. The value of the USF Health Simulation Consortium to the parent organization is clear. The value is evidenced by: a. The program’s ongoing collaboration between colleges and hospital entities b. The intimate involvement of the institutional CEO and Chief Administrative Liaison that facilitates the sustainability of the program c. Dedicated space created and reserved for the USF Health Simulation Consortium

2. The assessment activities demonstrated at CACL are robust and consistent with demonstrable quality education and learning.

3. The surgical technical training activities of the consortium appeared vigorous and stable   

The Society of Simulation in Healthcare was formed in 2004 to develop and promote standards of simulation-based practice, education, and research in the facilitation of patient safety. Now with more than 2,000 members, the group is a broad-based, multi-disciplinary, multi-specialty, international society with ties to all medical specialties, nursing, allied health paramedical personnel, and industry.

Story by Sarah A. Worth, photos by Eric Younghans, USF Health Office of Communications.

L to R: Jack Harris, Tampa Mayor Bob Buckhorn, and USF Health’s Dr. Stephen Klasko

Tampa Mayor Bob Buckhorn and 970 WFLA radio personality Jack Harris visited USF Health recently to talk about the new USF Health Center for Advanced Medical Learning and Simulation (CAMLS) and how it will have a global impact on the way health care is taught, making cutting-edge technologies safer for patients.

For a segment on City of Tampa Television (CTTV) show, The Mayor’s Hour, they interviewed guests Dr. Stephen Klasko, CEO of USF Health and dean of the College of Medicine; Deborah Sutherland, CEO of CAMLS; and Mark House, managing director of The Beck Group, the firm that designed and is building the state-of-the-art facility in downtown Tampa.

The interviews were interspersed with videoclips featuring the following USF Health physicians and student: Dr. John Armstrong, medical director of CAMLS; Dr. Larry Glazerman, assistant professor of obstetrics and gynecology and director of minimally-invasive gynecologic surgery; Dr. Jay Ryan Williams, resident; Dr. Luis Llerena, assistant professor of surgery; and Wilfredo Herrera, USF medical student.

Dr. Deborah Sutherland, CEO of  CAMLS, is interviewed about the transformative CAMLS training center, under construction in downtown Tampa.

Plans call for more than 60,000 health professionals to come to CAMLS each year for education and training activities, from courses on inter-professional team training and advanced surgical techniques (using state-of-the-art surgical robots and simulators), to research and innovation for the next generation of medical devices and simulation technology. CAMLS will facilitate the definition and assessment of competency across learners.

“USF is a huge economic engine for our community,” Buckhorn said. “With its vision and potential for the community, this (CAMLS) is one of the most exciting projects I’ve had the opportunity to be part of… You see can see opportunity, hope, aspirations – the kind of value-added jobs that will allow us to create real wealth.”

The Mayor’s Hour about CAMLS replays throughout August at the following times: Sundays at 1 p.m., Mondays at 7 p.m., Tuesdays at noon, Wednesdays at 9 p.m., Fridays at 3 p.m., and Saturdays at noon. The CTTV cable show airs on Ch. 15 (Verizon Fios) or Ch. 615 (Brighthouse Network).

To learn more about Mayor Buckhorn and The City of Tampa click here: http://www.tampagov.net/dept_mayor/index.asp

To learn more about City of Tampa Television (CTTV) click here: http://www.tampagov.net/dept_cable_communication/index.asp

Mark House is managing director of The Beck Group, the firm that designed and is building CAMLS.

Photos by Eric Younghans, USF Health Communications

What does an exploding whale have to do with the practice of medicine?

More than you might think. Identifying all the potential problems that could arise in getting rid of an 8-ton beached whale was actually an exercise in process management and improvement for the 18 USF medical students enrolled in this summer’s Business of Medicine Boot Camp.

Student Nerissa Moore hangs paper in preparation for a process management mapping exercise at the 2011 USF Business of Medicine Boot Camp.

During a recent weekday class, the students watched an early 1970s video newscast reporting how the state highway department was brought in to dispose of a dead-on-arrival gray whale washed up on the beach of an Oregon coast town. The workers decided on dynamite, figuring that a strategically positioned blast would disintegrate most of the whale and any small remaining pieces would be snatched up by seagulls and other scavengers. (More about the result later.)

College of Business instructor Ronald Satterfield, PhD, MBA, stopped the video before the “solution” was implemented. He led teams of students in an exercise designed to get them to identify and diagram all the relevant steps of the whale blasting project and then to think systematically about what problems might occur. They came up with several: What if the dynamite was improperly packaged or placed? What if the whale’s hide was tougher than expected? What if the explosion scared away scavengers? Were curious bystanders positioned far enough away from the blast site?

College of Business instructor Ronald Satterfield, right, teaches the operations
module of the intensive 8-week summer program.

“I wasn’t sure at first, but it absolutely was a valuable experience that could be applied to medicine,” said student David Graham. “The process of mapping out how something works and pinpointing what could go wrong and why really helps you think creatively about how to fix a potential problem and the need for building in safety backups.”

Like most of his fellow students, Graham arrived at the boot camp with little business background.

Now in its second year, the intensive eight-week Business of Medicine Boot Camp is offered to medical students in the summer between their first and second years. Taught by faculty from the College of Business and USF Health, students get a comprehensive look at the business skills needed to be successful physician leaders and innovators who can invent new ways of diagnosing and treating diseases, ensure healthier communities and shape the system in which they are central players. They are introduced to organizational management, health care economics, finance, marketing, health care information technology and systems engineering, negotiation, and innovation and entrepreneurship – topics not typically covered in medical school.

After spending their initial year as medical students steeped mainly in the hard sciences, they are now wrapping their minds around new terminology and concepts. DRGs instead of DNA. Gross income instead of gross anatomy. Six Sigma instead of signal transduction.

They experience the give and take of building consensus and resolving conflicts as they work in groups to accomplish tasks more effectively. Every student gets the opportunity to be project leader for one team activity or another. They’re encouraged to problem solve and proactively look for opportunities to improve a process, service or product.

Team work, resolving conflict and building consensus are an integral part
of the boot camp.

“I felt so dumb the first week. It’s as though we were taught in four days what would normally take four weeks,” said Nerissa Moore, who blogged about surviving the first few weeks of Business of Medicine Boot Camp, otherwise known as the BOMB. “I’m challenging a different part of my brain than the part exercised in medical school – it’s difficult, but I love it. We learn life skills that are needed not only to be a successful doctor, but to be an accountable member of society.”

Connecting the Practice and Business of Health Care

The Business of Medicine Boot Camp was spearheaded in 2010 by William G. Marshall, Jr., MD, MBA, associate professor of pyschiatry and neurosciences with a joint appointment in surgery, and Courtney Bovee, who recently graduated from the college and had majored in business as an undergraduate. 

Before then, USF medical students could (and still can) pick a scholarly concentration in business to work around their demanding medical curriculum, but, Dr. Marshall said, it wasn’t enough. So when Stephen Klasko, MD, MDA, CEO for USF Health and dean of the College of Medicine asked Dr. Marshall what he needed, he said, “the number one thing is more time, because most of these students know nothing about business… It’s totally foreign to them.”

USF Health’s Dr. William G. Marshall, Jr., an assistant director of the USF Center for Entrepreneurship, teaches the medical students strategies for innovation and entrepreneurship.

With the enthusiastic support of Dr. Klasko and Dr. Frank Fernandez, chair of the Department of Psychiatry and Neurosciences, Dr. Marshall enlisted the help of several faculty from the College of Business who taught in USF’s Physician MBA Program. Faculty from the Colleges of Public Health and Engineering also teach at the boot camp. The program started with nine students, which doubled to 18 this summer with the help of funding from corporate and private donors.

“That tells me students recognize the value of this program,” said Dr. Marshall, who expects an even bigger turnout next year. “It’s a big commitment and they could be doing many other things with their time over the summer, like research, service or traveling.”

When you ask USF medical students why they wanted to spend their summer vacation in the boot camp, they express similar sentiments. Virtually all practicing physicians they’ve spoken with say they wish they learned more about the business aspects of medicine. The students recognize they’ll need more than clinical expertise in the brave new world of health reform; it will take business acumen, leadership and innovation to survive and thrive in an increasingly competitive and complex health care system.

That’s something that resonates with Dr. Klasko, who earned his MBA from the Wharton School at the University of Pennsylvania. A survey just completed by the USF College of Medicine indicated that 60 percent of physicians practicing three years or less feel that they did not learn what they most needed in practice.

“They learned biochemistry, anatomy, cardiology and internal medicine,” Dr. Klasko said. “But many did not learn how to creatively embrace change, effectively communicate or collaboratively negotiate. They learned to ‘become a doctor,’ but not how to make a patient happy, be a leader (or a good follower), be an individual who contributes positively to an organization or runs an effective meeting.”

Dr. Marshall, who ran his own cardiac surgery practice for 25 years, teaches the boot camp students strategies for innovation and entrepreneurship. He encourages the aspiring young physicians to seek new solutions to improve healthcare access, safety, quality, satisfaction and affordability.

“The fifth, affordability, is not the least of these,” he said. “No matter how much an individual or group wants to help people, they need the resources to make that happen. If you can’t deliver health care effectively and efficiently…. if you’re having trouble keeping the doors open and paying for electricity to run ventilators in the ICU and the instruments in the operating room, you can’t take care of patients.”

More than ever before, these students understand that the practice and business of medicine are intrinsically linked.

“The boot camp helped me become much more aware of all the external factors that affect patient care, such as government regulations, health insurance and how the cost of care is connected to its quality and safety,” said USF medical student Corey Reeves, who will graduate in 2013 and participated in the inaugural program last year.

Reeves, along with classmate Matt Tufts and Dr. Marshall, presented a paper in June on the Business of Medicine Boot Camp in Sweden. “It’s a new way of thinking about the environment in which we’ll be delivering health care,” Tufts said.

Building a New BRIDGE

Remember that exploding whale video? Well, the boot camp students found out that many potential consequences they mapped out did in fact happen.

At the end of class, they watched the news video finale in which bystanders ran for cover because the exploding pieces of whale blubber were larger than expected. One big chunk even damaged the roof of car parked more than a quarter mile from the blast site. And the explosion scared away seagulls and other scavengers, so much of the remaining whale had to be buried.

The students, with Dr. Satterfield, toured the Morsani Center space where the BRIDGE Clinic is expected to move later this summer.  Their boot camp capstone project involves writing a business plan for the clinic.

The video-inspired classroom activity in process management, along with other lessons learned in the boot camp, have been applied to the students’ capstone project – developing a business plan for the BRIDGE Clinic. The free, student-run clinic will move later this summer from the University Area Community Health Center to the USF Health Morsani Center for Advanced Healthcare.

Since June, different student groups have worked together to reassess how patient flow will be managed, determine roles and responsibilities of the clinic’s patient care and operations coordinators, and plan for introducing nursing, and eventually pharmacy, students into a staffing mix that now includes medical, physical therapy and social work students. They are formulating a budget and beginning to work out the logistics of transitioning medical records from a paper to electronic system. How to best attract donors for the clinic and market the new location to patients is also part of the project.

“It’s a big change, and they’re essentially starting from scratch,” said Dr. Satterfield, who is consulting with students on the business plan. “The goal is to use resources to their best advantage. Doing that will help improve the clinical learning experience for the students who volunteer at BRIDGE and increase the number of patients they can effectively handle, so they can deliver more care for the greatest good.”

Jason Patel is a member of the boot camp operations team integrating the finance, management, marketing and other pieces of the project into one comprehensive plan.

Student Jason Patel leads a discussion about logistics for the BRIDGE Clinic transition during an operations team meeting.

“We’ve drawn on many of the techniques we talked about in our negotiations class,” Patel said. “like the importance of patience and effective communication, framing an issue in a neutral way, putting ourselves in the place of the BRIDGE student directors and faculty mentors and getting everyone’s buy-in before making a change in the system. You find that you can’t expect everyone to jump on board just because you think something is a good idea.”

In addition to writing the BRIDGE business plan, some boot camp students are working on a marketing plan that will position the USF Health Center for Advanced Medical Learning and Simulation (CAMLS) as a brand and attract physicians across the country for advanced education and training at the state-of-the-art facility. The students are consulting with Paul Solomon, PhD, professor of marketing, and Deborah Sutherland, PhD, CEO of CAMLS.

Getting Noticed

Dr. Marshall says to the best of his knowledge, USF Business of Medicine Boot Camp is the first such program in the country. It continues to attract attention nationally and internationally.

In addition to a recent presentation in Stockholm, Sweden, at the annual meeting of the International Council on Small Businesses, the boot camp program has been shared with audiences at the Florida Medical Association annual meeting, the Association of American Medical Colleges national meeting in Washington, DC, and a conference of the U.S. Association for Small Business and Entrepreneurship.

L to R: Corey Reeves, Dr. Marshall, and Matthew Tufts recently presented a USF paper on healthcare innovation and entrepreneurship for medical students at a business conference in Sweden. Reeves and Tufts were in last year’s first boot camp program.

Completing the boot camp won’t turn medical students into CEOs, but Dr. Marshall hopes the graduates leave with a greater appreciation that today’s physicians need more knowledge and insight about the business of medicine and the health care industry.

“Every aspect of health care today has business applications and implications,” said USF’s Dr. Solomon, “The challenge for the future is to prepare physicians who can be good business managers and leaders as well as great practitioners of medicine.”

Story by Anne DeLotto Baier, and photos by Eric Younghans, USF Health Communications

The two-hour combined surgeries involved laparoendoscopic removal of the gallbladder, two ovarian cysts and pelvic scar tissue. All this was done with one incision through the belly button, compared to a possible 10 surgical sites if done through traditional methods. Sharona Ross, MD, director of Surgical Endoscopy at USF and TGH, and Shayne Plosker, MD, division director of IVF and Reproductive Endocrinology at USF Health, collaborated on the multidisciplinary surgery.

Patient Elizabeth Byrd, center, with Dr Sharona Ross of USF Surgery and Dr. Shayne Plosker of USF Obstetrics and Gynecology. 

The patient was 34-year-old Elizabeth Byrd of Tampa who works for a Tampa law firm and is a wife and mother of a 3-year-old boy. “I was impressed with the short recovery period – which allowed me to get back to daily activities….most importantly playing with my son,” Byrd said. “I hope that other women will benefit from this advancement in the medical field.

“This is not only a great cosmetic improvement with one single scar hidden in the belly button, but her discharge from the hospital within 24 hours attests to the potential for less post-operative discomfort,” Dr. Plosker said. “This approach shows great promise for many fertility-promoting reproductive surgeries.”

Dr. Ross concurred, “Single incision laparoscopy via the belly button is the ideal surgical approach for women, especially young women who need their gallbladder removed and/or any fertility-related procedure done. We leave no scar! This approach is safe and results in shorter recovery time, less pain, decreased risk of wound infections, less risk of hernias, and last but not least, better cosmetic outcomes.”

Single-site surgeries through the belly button have been performed by USF physicians at Tampa General since 2007.  Dr. Alexander Rosemurgy, Dr. Michael Albrink and Dr. Sharona Ross, who together pioneered the minimally-invasive technique, have trained surgeons worldwide in this innovative laparoendoscopic approach.

USF-TGH physicians continue to take surgery to the next level. A combined single-site surgery involving a hysterectomy and gallbladder removal was performed  April 26 by Dr. Sharona Ross, Dr. Larry Glazerman and Dr. Devanand Mangar using no general anesthesia, only a local nerve block.

The American Board of Medical Specialties (ABMS) recently voted to approve the FPMRS specialty nationally. This means that FPMRS fellowships are now formally recognized nationally, in the same way that Maternal Fetal Medicine, Gynecologic Oncology, and Reproductive Endocrinology specialties are recognized and approved. This means that women with prolapse, incontinence, bladder control problems and pelvic pain, can now receive care from FPMRS physicians who are specially trained and certified in this highly sub-specialized field of medicine.

In essence, graduating FPMRS fellows will be certified by the Board, Dr. Hoyte said.

In the United States, medical specialties and subspecialties are certified by the American Board of Medical Specialties (ABMS). As is typical for adding new specialties, the ABMS spent about 10 years monitoring the growing patient base for pelvic floor, bladder control and vaginal prolapse disorders, the three areas making up most of FPMRS care.

“Before the FPMRS era, physicians practicing ob/gyn and urology were each separately treating patients,” Dr.  Hoyte said.

“Those physicians, over time and extensive training, improved and soon realized that the area should be a subspecialty because of the increased knowledge required. Until now, a patient needing treatment for problems affecting her pelvic floor, bladder and vagina, might have to visit at least two doctors, an ob/gyn and a urologist. But she’s not three women. She’s one woman with three health issues. It became clear there should be a single specialty that meets all of her healthcare needs.” The FPMRS subspecialty was designed to train gynecologists and urologists to care for women with complex pelvic floor disorders.

The next step for the subspecialty certification is building an exam to assess competency, thus allowing appropriately trained physicians the opportunity to become board certified in FPMRS.

Dr. Hoyte completed formal fellowship training in FPMRS, and started the FPMRS fellowship training program at USF when he joined the faculty in 2006. The USF FPMRS program was approved by the Board in January 2011, and is one of 45 recognized FPMRS training programs nationally, and the only approved program in Florida.  In addition to Dr. Hoyte, faculty in the USF FPMRS training program include Drs Stuart Hart, and Raul Ordorica.

With the new designation from the ABMS, FPMRS fellows may graduate from a certified program and be recognized as board eligible. Once they pass a board exam, they will become certified as FPMRS sub-specialists.

Renee Bassaly, MD, is USF’s first such fellow, as well as the first certified FPMRS fellow to graduate in Florida. She will join the USF College of Medicine FPMRS faculty in August.  The other current FPMRS fellow is Mona McCullough, MD, who will begin the second of her three-year FPMRS training. Kristie Greene, MD, will start as USF’s first year FPMRS fellow in July 2011. Dr. Greene will graduate the USF residency training in OB/Gyn in June 2011.

Kevin Sneed, PharmD, dean of the College of Pharmacy, Robert Deschenes, PhD, chair of the Department of Molecular Medicine, and Shufeng Zhou, MD, PhD, chair of the Department of Pharmaceutical Science, traveled to Zhongshan, Shunde, Shaoguan, and Guangzhou and toured three major hospitals.

“We were very impressed with the commitment to research and patient care we saw at all of the hospitals,” Dr. Sneed said. “They understand the need for access to good healthcare, and they are working to meet those challenges.”

Among the things that impressed him, Dr. Sneed said, was the Hospital of Sun Yat-Sen University, Guangdong, which is one of the best cancer hospitals in China.

“They have outstanding research practices occurring in numerous areas, including biomarker identification and drug discovery initiatives. As their research and health care systems continue to grow, I want USF to collaborate right along with them.”

In appreciation for coming to facilities and for the educational relationships to come, hospital officials presented the team with two gifts for the university: a 24-karat gold-plated flower in a framed case from the Xiaolan Hospital, affiliated with the Southern Medical University, and a silk scarf from Xiao-Wu Chen, MD, PhD, president of the First People’s Hospital of Shunde Guangdong, also affiliated with the Southern Medical University.

Story by Sarah A. Worth, photos by Eric Younghans, USF Health Office of Communications

If you think tropical diseases like malaria are no cause for concern in the United States, think again.

In October a Jacksonville woman contracted malaria, despite not having traveled out of the country in a decade. Cases of dengue fever began appearing among tourists and residents in Key West in 2009 and continue to increase — the first reported dengue outbreaks since 1934. Health officials worry that more global travel, urbanization and changing climates mean mosquito-borne, once-tropical diseases such as dengue and West Nile virus are not only here to stay, but may be spreading.

To reduce Florida’s susceptibility to these emerging and re-emerging vector-borne diseases, researchers from the University of South Florida and the University of Florida want to create new drugs to combat vector-borne diseases and get those drugs to consumers faster. Last year, the two institutions were awarded a half a million dollars from the state’s Board of Governors to spur research in this area of drug discovery. The project is part of the New Florida Initiative, a program geared toward diversifying the state economy by funding innovation on university campuses. It is modeled after the Food and Drug Administration’s Critical Path Initiative, which provides guidelines for a fast track approach to help bring new treatments to market – everything from drug discovery and design, preclinical research in laboratory and animal models to clinical trials and FDA approval, to large-scale manufacture of a drug for sale.

Recently investigators from USF and UF as well as other state universities met with partners from biotechnology and pharmaceutical firms across Florida, and public health officials, to discuss how to better move new-line drugs and other therapies from the early research stages to the market. The conference, “Optimizing Detection, Prevention and Treatment of Vector-Borne Disease,” held Jan. 31 at the Sanford-Burham medical Research Institute, Lake Nona in Orlando, included presentations about malaria, dengue, equine encephalitis, West Nile virus and other pathogen-related diseases that Florida residents are somewhat at risk of contracting.

Dr. Glenn Morris (left), director of the UF Emerging Pathogens Insitute, and Dr. Wil Milhous, associate dean for research at the USF College of Public Health, moderated the discussion on building public-private partnerships to advance drug development.

“These vector-borne diseases are very complex. To solve the problems, you frequently have to bring researchers outside their normal comfort zones,” said J. Glenn Morris, MD, MPH&TM, director of the UF Emerging Pathogens Institute. “That means bringing together people from multiple universities who can look at the problem from different perspectives, as well as people from industry and government. Together, we can think about ways to take each of our pieces and integrate them into a whole that results in something meaningful – like the ability to effectively manage a disease like dengue fever.”

Scripps Florida, the Vaccine and Gene Therapy Institute, Nanotherapeutics and United Therapeutics were among the firms represented at the conference, the first of several to be held this year.

“To be successful in translating research into a commercially viable product, it’s very important for researchers in academic medicine to get to know and collaborate with those in industry who can help guide us in the drug discovery and development process,” said Wilbur Milhous, PhD, associate dean for research at the USF College of Public Health, who has contracted both malaria and dengue fever during his 28-year career developing antimalarial drugs. “Equally important, those in private industry need to appreciate the academic expertise available at the various colleges and schools in Florida.”

Among the conference speakers was Bill J. Baker, PhD, a USF chemistry professor and new director of the USF Center for Drug Discovery and Innovation. Umbrella organizations are needed in the state to more efficiently fight illness, and this conference was a first step in organizing people, databases and shared resources,” Dr. Baker said. “We can make sure people are talking across the state, focused on the same diseases.”

For the last four years, Dr. Baker has worked with Dennis Kyle, PhD, professor of global health at the USF College of Public Health. They’ve focused on isolating and testing chemical compounds derived from the natural world – plants, fungi and microbes – that may act against parasitic diseases like malaria. The compounds have been discovered within the biodiverse resources collected on Dr. Baker’s many research expeditions to Antarctica. Tapping into faster new technologies and procedures, such as mass spectrometry studies and magnetic resonance spectroscopy, the collaboration holds the promise of tapping the vast potential of ocean floors, glaciers and other marine environments.

“Nature is an excellent place to look for potential new drugs, especially marine environments, which have tended to be underexplored,” Dr. Baker said. “The NIH’s (translational research) model of bench to bedside really needs to incorporate the concept of the environment, including beach to bedside.”

Barriers to getting more drugs for vector-borne diseases into the drug development pipeline include lack of economic incentive for pharmaceutical companies to invest in rare and neglected diseases, often with poorly defined markets in underdeveloped countries.

But, USF’s Dr. Kyle, who oversees teams that have attracted research funding from the National Institute of Allergy and Infectious Diseases, the Bill and Melinda Gates Foundation and Medicines for Malaria Venture, told attendees that “you don’t necessarily need big pharma involved to be successful” in moving promising drug candidates into the pipeline.

The key, he said, is public-private partnerships that pull together the “right construct” of people and resources. For instance, he said, that may mean creating an entrepreneurial academic team with expertise in biology, chemistry, pharmacology, toxicology and other disciplines, which works well with scientists and engineers from smaller pharmaceutical or biotechnology companies. The state’s universities often conduct field research in locations where mosquito-borne diseases are endemic, providing an opportunity for testing promising drugs.

Dr. Kevin Sneed, dean of the new USF College of Pharmacy, says the college will work with other institution across the state to develop a curriculum that addresses emerging and infectious diseases.

Other USF speakers were Thomas Unnasch, PhD, professor of global health, and Kevin Sneed, PharmD, founding dean of the USF College of Pharmacy.

Dr. Unnasch shared his expertise on Eastern equine encephalitis, a rare but disabling and potentially deadly mosquito-borne disease that is reported more frequently in Florida than all other states combined. Surveillance is often relied upon detect mosquito-borne diseases and control their transmission, Dr. Unnasch said. “Unfortunately using surveillance strategies to try to knock down mosquito populations is a sledgehammer approach… we could likely do better with new prevention and treatment approaches.”

Dr. Sneed said that USF’s new College of Pharmacy will cultivate student and faculty interest in global health and work with other state’s colleges and schools to develop an interdisciplinary curriculum that addresses emerging and neglected infectious diseases.

Near the close of the conference hosted by USF and UF, the attendees brainstormed about the Florida’s strengths and weaknesses in diagnostics and drug development for vector-borne diseases. They also began prioritizing their disease focus and defining what next steps are needed to encourage drug development, including public-private partnerships that might advance economic opportunities.

The first conference was held at the Sanford Burham Medical Research Institute, an anchor facility at Lake Nona, Orlando.

- Video by Amy Mariani; story and photos by Anne DeLotto Baier, USF Health Communications
- Mosquito photo courtesy of University of Florida Emerging Pathogens Institute

(Feb 1, 2011) – The Jackson Laboratory and the University of South Florida have begun preliminary discussions with business and community leaders in Hillsborough County and Sarasota County about alternative locations for the proposed Jackson Laboratory – Florida.

“Last year Jackson Laboratory chose USF as its academic partner for a new and exciting venture in Florida,” said Karen Holbrook, USF Senior Vice President for Research, Innovation and Global Affairs. “We are now working to brainstorm potential ways to ensure that Jackson Laboratory establishes a biomedical presence in Florida, including Hillsborough and Sarasota Counties. Of course nothing has become a formal proposal yet.”

“Our partnership with USF Health is stronger than ever,” said Charles E. Hewett, Ph.D., Jackson’s executive vice president and chief operating officer. “We are encouraged by the interest shown by the citizens of Hillsborough and Sarasota counties. Together, we are exploring the opportunities for success in these communities.”

“USF and The Jackson Laboratory are committed to building a program that will improve the health of Floridians and the world,” said Stephen Klasko, MD, MBA, dean of the USF College of Medicine and senior vice president of USF Health. “We will consider any location that fulfills the interests of the program and the state and will follow Jackson’s lead in determining the best location.”

Hewett said Jackson has four criteria for siting the project: Synergistic partnerships, speedy development of the project, robust state support, and strong backing in the local community.

“All the communities we’re currently considering have distinct advantages and would be favorable locations for us,” Hewett said.

Jackson and USF have proposed to build a biomedical research facility that would combine Jackson’s expertise in cutting-edge genomics techniques and USF’s extensive capabilities in clinical medicine to explore new approaches to preventing, diagnosing, and treating the diseases that plague Floridians.

Jackson and USF plan to collaborate in three key areas: Research, education and clinical care.

Research. Jackson and USF researchers are exploring potential collaborations. Joint efforts in computational biology and bioinformatics as they apply to diseases such as cancer, Alzheimer’s and metabolic diseases are particularly promising opportunities. Researchers and clinicians will work together to bring the latest discoveries into clinical practice, with an emphasis on new medicine that is tailored to respond to the individual.

Education. Advancing technologies demand a different kind of education for the next generation of healthcare professionals. USF Health and Jackson are leaders in medical and scientific education. The partnership will lead the way in educating students in medicine, nursing, pharmacy and emerging health professions in the areas of personalized health, pharmacogenomics, and bioinformatics. The partnership also expects to develop continuing medical education programs to help teach doctors and other practicing health professionals about these new areas of medicine.

Clinical care. Jackson and USF Health will team with other health care organizations to develop a clinical campus that will provide the latest in cutting-edge personalized medicine and health care to patients in Florida and beyond. USF already is creating new models to help patients with chronic conditions live optimistically. The partnership will be ideally positioned to provide personalized medicine across a continuum of care, from home therapies to outpatient and inpatient services.

# # #

The Jackson Laboratory is an independent, nonprofit biomedical research institution and National Cancer Institute-designated Cancer Center based in Bar Harbor, Maine, with a facility in Sacramento, Calif. Its mission is to discover the genetic basis for preventing, treating and curing human diseases, and to enable research and education for the biomedical community.

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, pharmacy and public health; as well as the schools of biomedical sciences and physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $394.1 million in research grants and contracts in FY2009/2010, the University of South Florida is one of the nation’s top 63 public research universities and one of only 25 public research universities nationwide with very high research activity that is designated as community-engaged by the Carnegie Foundation for the Advancement of Teaching.

        It took six years for Tuesday to come.

        But construction finally began Tuesday on a building that will change both how healthcare is practiced and the face of downtown Tampa.

         “We will see a building right here that will be a global destination for the revolution in health care,” said USF President Judy Genshaft to a crowd of more than 200 physicians, public officials and business leaders who came to celebrate the groundbreaking event.

          A bold claim, perhaps – but President Genshaft isn’t the only one who sees a remarkable potential for the building that will become the Center for Advanced Medical Learning and Simulation, or CAMLS.

         “CAMLS is very good for the University of South Florida and excellent for Tampa,” said Dr. Sterling Williams, vice president for education of the American College of Obstetricians and Gynecologists. “What you don’t know is that it’s very, very good for the nation. What you’re doing here will set the paradigm for what everyone else is doing.”

          CAMLS also links USF’s campus on the north side of Tampa to downtown.

          “It makes sense for the university to have a whole city block, so they would have a presence downtown,” Mayor Pam Iorio told the crowd. “We can’t be a great city without a great university – and fortunately, we are a great city with a great university.”

       USF is a vital part of Tampa Bay’s economic future, Mayor Iorio said.

       “To the degree that the university brings the best and the brightest to Tampa, and we have this great intellectual center of great minds, then we produce great ideas,” she said. “And that is where economic development starts – with an idea.”

        Dr. Stephen Klasko, dean of the USF College of Medicine and CEO of USF Health, told the crowd that as a private pilot, his flying skills are regularly checked.

        “Sadly and amazingly, that’s not the case today in health care,” he said. “But we’re about to change all that.”

        CAMLS will be a 90,000 square foot, three story building that will offer training for surgeons and other health care professionals the ability to train on advanced surgical procedures, such as laparoscopic surgery, and on team-building and communications skills. It will house surgical robots, simulators and classrooms. Some 60,000 health care professionals are expected to visit Tampa each year to take advantage of training at the facility, which all will educate USF students.

       It will be located at 102 S. Franklin St, on the south side of downtown Tampa. Tuesday’s groundbreaking event was held in a clear tent on the site, complete with a hot breakfast, demonstrations of how surgery is performed on a da Vinci robot, and TV screens so that guests could see a “flyby” video of what the building will look like when it opens this December.

        CAMLS already is serving as a magnet to draw medical dollars and medical talent to Tampa Bay, Dr. Klasko said. He pointed to a few examples:

• Leading medical education and equipment companies, including CAE Healthcare and Symbionix, already have invested some $10 million in the facility before construction even has started.

• CAMLS has enabled USF Health to recruit top new faculty members, such as Dr. John Armstrong, who will be medical director of CAMLS. Dr. Armstrong ran the Army Trauma Training Center in Miami, a first-of-its-kind interprofessional training program. Dr. Armstrong, who holds various national leadership positions with both the American Medical Association and the American College of Surgeons, plans to expand on his Army simulator work with CAMLS.

• CAMLS is helping USF Health keep “home-grown” talent, such as Dr. Laura Haubner. Dr. Haubner, a neonatologist, will be clinical director of simulation at CAMLS. Dr. Haubner is the founder and director of the TEAMS Center, next to Tampa General Hospital. The Team Education and Multi-disciplinary Simulation Center brings residents, nurses, EMTs, respiratory therapists and other caregivers together to practice how to respond in emergency situations, honing their abilities to work and communicate as a team.

• CAMLS will be an incubator for some of USF Health’s most innovative researchers, such as Dr. Stuart Hart. Dr. Hart, who already has filed six provisional patents, is a urogynecologist who combines his medical knowledge with business and engineering to produce new medical devices. His projects include producing miniature laparoscopic instruments that are less than half the size of the smallest instruments used today – so small they’re about the size of a 16-gauge needle. “You’ll hardly know you had surgery,” Dr. Klasko said. Another project would monitor unexpected sounds during surgery, giving surgeons a tool to catch complications that often go undetected.

        At CAMLS, Dr. Klasko said, the tools will be put in place for these faculty members and others to make Tampa Bay a “super-site for quality and safety.”

        “We’re going to train surgeons so they know how to do the hardest procedures. What’s more, we’ll make sure they know, because we’ll test them on it,” Dr. Klasko said. “We’ll ensure that doctors have the opportunity to practice a procedure before they do it on you. We’ll recognize that doctors, nurses and other health care professionals work better as a team, and we’ll make sure they’re trained to do that.

        “It’s a great day for USF Health. It’s a great day for Tampa Bay,” he said. “It’s a great day for everyone who wants to see better patient care in America’s health care system.”

         President Genshaft called CAMLS a win-win for health care and Tampa’s economic future.

        “Thousands of caregivers will come to Tampa each year to learn the future of health,” President Genshaft said. “This will be a place where health care is created, learned, practiced and perfected.”

- Story by Lisa Greene, and video by Amy Mariani, USF Health Communications
-Photos by Aimee Blodgett, USF Communications

What are USF Health faculty members saying about CAMLS?

            “USF graduate medical education will utilize CAMLS for all levels of residency training, which includes everything from an introduction to even the most basic procedures to a critical Monday-morning quarterback evaluation of the most complex operations. We will be able to do this in a multi-disciplinary arena that’s not possible in most simulation centers. We look forward to CAMLS being a major draw for future residency programs.”

- Dr. Charles Paidas, associate dean for GME, executive associate dean for clinical and extramural affairs

         “CAMLS will set the standard for, in essence, how we educate and train in the behaviors of patient care. …The ultimate way we’re going to enhance patient quality and safety is by learning how to communicate. The glue that keeps people together is how they connect through communication. When we forget about that, we have to deal with the consequences.”

- Dr. John Armstrong, medical director of CAMLS, medical director for trauma and disaster education

         “It’s a huge step for USF. It’s such a unique center in that it combines medical teaching and training with technology, such as computerized medical and surgical simulators, to train the next generation of physicians. …It’s such a high-tech, well-designed center for medical education and simulation, allowing multiple disciplines to work together under one roof to develop state-of-the-art medical and anatomic computerized simulation and medical devices.”

- Dr. Stuart Hart, USF assistant professor and urogynecologist

           “I see CAMLS as a culmination of a lot of great activities that already occur at USF. It will bring a lot of people with dedication to teaching and safe patient care together in one place, to really maximize their productivity and capitalize on all the unshared resources.”

- Dr. Laura Haubner, neonatologist and clinical director of simulation at CAMLS

           “It’s a great opportunity for all of us to come together, and expand some of the work we are doing at Tampa General Hospital. …Deborah Sutherland and everyone is full of ideas and ready to collaborate.”

- Dr. Luis Llerena, assistant professor of surgery and winner of the iPad raffled off at Tuesday’s groundbreaking ceremony
 

Get a 360-degree view of the building’s exterior, and take a virtual walk-through tour
in this video produced by architectural firm The Beck Group.

Bar Harbor, Maine (Jan. 13, 2011) – The Jackson Laboratory and the University of South Florida have begun preliminary discussions with business and community leaders in Hillsborough County and Sarasota County about alternative locations for the proposed Jackson Laboratory – Florida. Jackson and USF officials indicated that their interest in a Collier County location remains strong.

In early January Jackson withdrew its application to Enterprise Florida for $50 million in state funds to build a research institute in eastern Collier County so it could open a fresh round of discussions about the project with newly elected Gov. Rick Scott.

“We remain intensely interested in locating the facility in Collier County, and our partnership with USF Health is stronger than ever.” said Charles E. Hewett, Ph.D., Jackson’s executive vice president and chief operating officer. “However, other Florida communities may offer advantages for our new institute, and we are certainly open to discussions with them.”

“USF and The Jackson Laboratory are committed to building a program that will improve the health of Floridians and the world,” said Stephen Klasko, MD, MBA, dean of the USF College of Medicine and senior vice president of USF Health. “We will consider any location that fulfills the interests of the program and the state and will follow Jackson’s lead in determining the best location.”

Hewett said Jackson has four criteria for siting the project: synergistic partnerships, speedy development of the project, robust state support, and strong backing in the local community.

“All three counties we’re currently considering have distinct advantages and would be favorable locations for us,” Hewett said.

Jackson and USF have proposed to build a biomedical research facility that would combine Jackson’s expertise in cutting-edge genomics techniques and USF’s extensive capabilities in clinical medicine to explore new approaches to preventing, diagnosing, and treating the diseases that plague Floridians.

Jackson and USF plan to collaborate in three key areas: research, education and clinical care.

Research. Jackson and USF researchers are exploring potential collaborations. Joint efforts in computational biology and bioinformatics as they apply to diseases such as cancer, Alzheimer’s and metabolic diseases are particularly promising opportunities. Researchers and clinicians will work together to bring the latest discoveries into clinical practice, with an emphasis on new medicine that is tailored to respond to the individual.

Education. Advancing technologies demand a different kind of education for the next generation of healthcare professionals. USF Health and Jackson are leaders in medical and scientific education. The partnership will lead the way in educating students in medicine, nursing, pharmacy and emerging health professions in the areas of personalized health, pharmacogenomics, and bioinformatics. The partnership also expects to develop continuing medical education programs to help teach doctors and other practicing health professionals about these new areas of medicine.

Clinical care. Jackson and USF Health will team with other health care organizations to develop a clinical campus that will provide the latest in cutting-edge personalized medicine and health care to patients in Florida and beyond. USF already is creating new models to help patients with chronic conditions live optimistically. The partnership will be ideally positioned to provide personalized medicine across a continuum of care, from home therapies to outpatient and inpatient services.

# # #

The Jackson Laboratory is an independent, nonprofit biomedical research institution and National Cancer Institute-designated Cancer Center based in Bar Harbor, Maine, with a facility in Sacramento, Calif. Its mission is to discover the genetic basis for preventing, treating and curing human diseases, and to enable research and education for the biomedical community.

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, pharmacy and public health; as well as the schools of biomedical sciences and physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $394.1 million in research grants and contracts in FY2009/2010, the University of South Florida is one of the nation’s top 63 public research universities and one of only 25 public research universities nationwide with very high research activity that is designated as community-engaged by the Carnegie Foundation for the Advancement of Teaching.

Dr. Terri Ashmeade, USF associate professor of pediatrics and TGH chief of pediatrics, welcomes infant Logan Brigandi, held by mother Amanda, to his new room in the Jennifer Leigh Muma Neonatal Intensive Care Unit.

Dec. 3, 2010 – Earlier this week, physicians, nurses and other members of the clinical deployment team moved 44 of Tampa General Hospital’s tiniest patients into their new home at the Jennifer Leigh Muma Neonatal Intensive Care Unit.  

The new facility, a partnership of USF Health and Tampa General, links the best and newest technology to care for sick and premature babies with a more comforting, nurturing environment for those babies and their families.

 The actual moving day, Nov 30, was preceded by an 18-month planning process involving the teamwork of the entire Medical and NICU staff, Respiratory Therapy, Biomed, IT/Communications, Facilities, Environmental Services and Nutrition Services, said Veronica Martin, vice president of Women’s & Children’s Services at TGH.

The first baby was successfully relocated at 7:37 a.m. on Tuesday, Nov. 30, and the last baby was wheeled into place at 1:59 p.m., Martin said. “We also had one new admission from Labor and Delivery to the new unit at 9:20 a.m. during the moving process.”

Once the second phase is completed in Summer 2011, the new unit will have 82 individual neonatal beds, as well as a separate 12-bed transitional area.

Among those who helped make moving day a success were Martin, NICU nurse manager Pam Sanders, and medical staff members Dr. Lewis Rubin, Dr. Terri Ashmeade, Dr. Laura Haubner and Dr. Holley.

Pamela Muma, right, with Dr. Ashmeade, stopped by during the move. The new $35-million unit is funded in part by a $6-million gift from the Mumas and named in memory of the their daughter Jennifer Leigh Muma, who died in a neonatal nursery.

Tampa General nurses, l to r, BeBe LeViner, Kathy Stroud and Andrea Marazzi wheel a premature baby to the new Muma NICU.

The move of 44 premature babies into the new NICU was a highly coordinated team effort involving physicians, nurses, respiratory therapists, and many other clinical and support staff.

Infant Logan Brigandi and mom Amanda, left, with Veronica Martin, vice president of Women’s & Children’s Services at Tampa General.

The new “high-tech, high-touch” patient rooms create a more home-like setting for the babies and their families.

Photos by Hugh Jones, Tampa General Hospital staff photographer

Co-developed by Dr. Richard Oehler, USF associate professor of medicine, and Dr. John T. Sinnott, director, Division of Infectious Disease and International Medicine, the original iPhone application (Ver. 1.0) permitted on-demand streaming of infectious disease-related podcasts to any iPhone or iPod touch through a Wi-Fi connection.

Version 2.0 greatly improves upon the original application, released in May, 2010, by being universally compatible with iPhone, iPod touch, and iPad devices, adding support for the iPhone 4 and fourth generation iPod touch’s high-resolution “Retina” display, and having full portrait and landscape modesupport on iPad devices with a scrolling onscreen index and iPad friendly menu accessibility. The appis now available as a free download from the app store, permitting users to enjoy more than 100 hours of infectious diseases educational content almost anywhere within range of a Wi-Fi connection.

“The original ID Podcast mobile viewer was a tremendous success. In a little over 5 months since it was made available on the app store, we introduced almost 1,000 iPhone/iPod touch owners in
50 countries to the spectacular teaching we do here at USF,” Dr. Oehler said. “However, with the release of the iPhone 4 and the iPad, we knew that our users wanted us to take full advantage of the latest devices. The iPad has been the most widely adopted non-phone electronic product ever, far surpassing the original iPhone and even the DVD player. Some 7.5 million units will be sold in its first 6 months. The iPad is the future of mobile computing, and to be one of the first infectious disease applications for this groundbreaking device is truly gratifying.”

“The iPad is truly the best mobile experience for watching podcasts,” Dr. Oehler said. “The display adapts to whichever way you hold it. You can access the most recent podcast selections from the
lower portion of the screen or switch to a full index categorized by title, author, or subject. Podcasts play in a small window for complete menu access or full screen, taking advantage or the device’s gorgeous 9.7-inch display.”

For on-the go viewing, ID Podcasts Mobile Viewer 2.0 now has full support for the iPhone 4 and fourth generation iPod touch’s “retina” display, an astounding 326 pixels per inch — the most ever for a smartphone, bringing USF’s dynamic teaching into the sharpest focus possible.

The USF Health Division of Infectious Disease partnered and developed the application with Tampa Bay area company Absolute Mobile Solutions, a leading provider of mobile strategy design and execution.

“We feel privileged to continue to develop applications that serve health care providers and work in partnership with the physicians and educators that make up USF Health,” said Alfred Goldberg, president of Absolute Mobile Solutions.

The IDPodcasts Mobile Viewer application can be downloaded from the iTunes app store (keyword is “id podcasts”). For more information, please contact USF’s Dr. Richard Oehler at Richard.oehler@va.gov or call (813) 972-2000, ext. 6184.

Dr. Hoyte wrote Robotic Hysterectomy, a patient guide to hysterectomy with less pain and faster recovery, along with Dr. Abraham Shashoua, director of minimally invasive and robotic gynecological surgery at Advocate Illinois Masonic Medical Center.

Dr. Lennox Hoyte

One in three women in the U.S. will undergo a hysterectomy, or surgical removal of the uterus, before age 60. Reasons for hysterectomy include reproductive cancers, prolapse, fibroids, and abnormal bleeding. The book outlines the reasons for surgery and different ways to perform a hysterectomy with an emphasis on robotic surgery as an alternative to traditional open surgery and conventional laparoscopic hysterectomy. It also covers the anatomy of the uterus, ovaries and tissues related to hysterectomy, as well as how to prepare for, and recovery from robotic surgery, frequently asked questions, and the advantages of the da Vinci robotic surgical system.

Dr. Hoyte was the first physician on the Tampa General Hospital robotic surgery team to be listed on the da Vinci Surgery national website. He is the medical director of the USF Health da Vinci® Center for Computer Assisted Training in Tampa, and has trained many surgeons in the use of the da Vinci Surgical System.

The da Vinci system enables surgeons, including those performing minimally invasive gynecologic, urologic and other surgeries, to perform even the most complex and delicate procedures through very small incisions with precision.

Dr. Hoyte maintains an active urogynecology practice, where he treats women with pelvic organ prolapse, urinary and fecal incontinence and bladder control problems. His practice website is located at www.usfurogyn.com

For more information on Robotic Hysterectomy, click here.

See media coverage of announcement at end of this story

          The citizens of Florida will have better odds of surviving the worst accidents and injuries, thanks to a new trauma partnership announced Tuesday between USF Health and HCA, say officials with the two institutions.

         “What you’ll be hearing about is an opportunity to make Floridians safer,” said Stephen Klasko, MD, MBA, dean of the USF College of Medicine and CEO of USF Health.

        USF Health and HCA are forming a statewide trauma network dedicated to improving access to quality trauma care and services in Florida. The joint initiative will enable five HCA hospitals in underserved areas to provide trauma care.

         Florida residents also will benefit from centralized statewide data collection for trauma research and coordination of services not readily accessible in underserved areas of the state.

L to R: Chuck Hall, president, and Mike Marks, CFO, both of the HCA Eastern Group; Dr. Jonathan Perlin, HCA chief medical officer; and Stephen K. Klasko, CEO for USF Health and medical dean.

        The agreement also marks the kind of out-of-the-box thinking that is needed as the nation’s health system moves into a time of profound change as a result of healthcare reform and a changing medical landscape, Dr. Klasko said.

        “These kinds of consolidations and collaborations with two great organizations for the right reasons are really what will make healthcare reform and healthcare transformation work,” Dr. Klasko said. “At USF Health, we try to get together with great partners. To act boldly, think creatively, and work cooperatively to find new agreements and new pathways to improve healthcare.

        “We believe that this is an area, trauma, where we will be able to do just that, and fulfill our mission to the state and to people throughout the country.”

         Today only about 38 percent of trauma patients in Florida receive treatment in a designated trauma center, below both the national average and the state’s goal to have 65 percent of trauma patients treated in a Florida licensed trauma center.

Dr. Stephen K. Klasko, CEO for USF Health and Dean, College of Medicine

     “Getting a patient to a trauma center within the first hour of injury, or golden hour, drastically increases their chance of survival,’” said Jonathan Perlin, MD, PhD, MSHA,FACP, FACMI, president clinical services and Chief Medical Officer for HCA. “Research supported by the Centers for Disease Control shows trauma mortality is reduced when a seriously injured patient is treated at a trauma center versus a non-trauma hospital.“  

       In Florida, the leading cause of trauma injury is motor vehicle crashes, accounting for 42.8 percent of all injuries in 2008.  Motor vehicle injury fatality rates are strongly associated with distance from trauma center to the site of the injury event, according to A Comprehensive Assessment of the Florida Trauma Center, conducted by USF and UF for the Florida Department of Health.  The assessment further noted that a county’s overall mortality rate is higher if a trauma center is not present.

     “It is absolutely critical that we expand access to trauma care to state-designated trauma service areas not currently being served,” said Dr. Perlin.  “Trauma centers deliver superior outcomes for their patients and we are excited to have USF join us as we work to improve the access to quality trauma care in Florida.”

Dr. Jonathan Perlin, HCA Chief Medical Officer

      The new network’s focus on quality patient care and expanded research initiatives will help improve trauma care across Florida, Dr. Klasko said.

    “Our goal is to have Florida be the safest state in the nation,” Dr. Klasko said. “This network will provide the state’s trauma patients with consistent and state-of-the-art care.”

     The network will provide an invaluable source of trauma research data, said David J. Smith Jr., MD, chair of the USF Department of Surgery. As part of the affiliation agreement, the HCA hospitals will convey data to a centralized analysis center at USF Health — the new Florida Trauma Research and Analysis Center (TRAC).

      “Trends that might not be identified by looking at one hospital’s data may show up by looking at five,” Dr. Smith said. “Florida TRAC will help doctors learn how to better treat trauma patients, whether they are injured in car crashes or suffering from heart attacks.”

      The trauma network also will be poised to respond quickly in the case of a major disaster in various areas of the state, Dr. Smith pointed out. Because the trauma surgeons at each center will undergo credentialing and follow the same procedures at each place, they will be more mobile in the event of a hurricane or other mass casualty event.

      The combination of breadth of services at HCA throughout Florida with the research and education capabilities of one the fastest growing research medical schools will serve to make the citizens of Florida healthier and allow Florida to take a leadership role in the future of healthcare.

Dr. David J. Smith, Jr., USF Chair of Surgery

      “It will be increasingly important for health care providers throughout the state to collaborate and consolidate, especially in the areas of research and education,” said Charles Paidas, MD, MBA, associate dean for graduate medical education. “Working with HCA will allow us to expand our areas of excellence, and the end result will be a healthier community.”

      USF will name a chief trauma medical director to oversee the network and appoint a medical director of trauma at each hospital, as well as helping to recruit needed specialists. USF expects to hire at least five trauma surgeons at each hospital, Dr. Smith said.

       HCA expects to invest about $20 million in building costs to provide trauma centers at the five hospitals, said Mike Marks, chief financial officer for HCA’s Eastern Group.

      The new trauma network will strengthen USF’s existing relationship with Tampa General Hospital, a Level One trauma center in which USF trauma surgeons provide care, Dr. Klasko said.

      “We’re very proud of the work we do (at Tampa General) and we think we’re one of the best in the country,” Dr. Klasko said. “We believe this will significantly strengthen that effort.”

       It also increases USF Health’s statewide impact on health care.

       “This is another example of USF Health doing what it does best around outcomes research, education and excellent clinical activity and being able to move it statewide,” Dr. Klasko said. “It’s a way to extend a Tampa Bay brand throughout the state.”

        The affiliation agreement will provide for USF’s collaboration and expertise at these five HCA facilities: Blake Medical Center (Manatee County), Kendall Regional Medical Center (Dade County), Lawnwood Medical Center (St Lucie County), Orange Park Medical Center (Clay County) and Regional Medical Center Bayonet Point (Pasco County).  All have applied for Level II Trauma Center designation. Lawnwood already is approved and operating, and the other four hospitals are in various stages of the application process.

        In May 2009, Lawnwood Regional Medical Center opened a trauma program that has already served close to 1,000 patients.  According to Perlin, the program has far exceeded anticipated benefits, not only for trauma patients but for the community as a whole.

        “All patients benefit from the collaboration, energy and medical expertise a trauma program brings to a hospital and to a community,” Dr. Perlin said.

        The affiliation agreement is an example of how USF Health is working to help improve the health of all Florida residents, Dr. Klasko said.

        “In a time of great healthcare transformation, it’s more important than ever that the state’s top medical schools work with hospitals throughout the state to provide the best care,” Dr. Klasko said. “This affiliation agreement will be a major step in that direction.”

- Story by USF Health and HCA Offices of Communication; photos by Eric Younghans; video production by Amy Mariani, USF Health Communications

Media coverage of USF and HCA trauma network announcement:

USF/HCA partnership will bring trauma care to under-served areas in Florida

St. Petersburg Times

USF partners with HCA to create Florida trauma care network

Tampa Tribune

USF and HCA envision trauma network

Sarasota Herald-Tribune

Hospital Chain and USF team up on Florida trauma center network

Sarasota Herald-Tribune: BLOG

USF Health – HCA detail trauma affiliation

Tampa Bay Business Journal

Blake to join statewide trauma network

Bradenton Herald

Trauma care closer to home

WUSF

University of South Florida to affiliate with HCA for trauma care

Becker’s Hospital Review

USF helping hospitals expand trauma care

Lakeland Ledger

HCA trauma care network to expand in Florida

Health Leaders Media

         “You’re a big girl,” he told her as she stared back with wide, curious eyes.

         She is, indeed – thanks to Dr. Rubin and his colleagues. Olivia weighed only 1 pound, 1 ounce when she was born in her mother’s 23rd week of pregnancy. She was among the sickest and most fragile of babies. Dr. Rubin, who holds USF’s Pamela S. and Leslie M. Muma Endowed Chair in Neonatology, knew she faced long odds to survive.

Now nine months old, Olivia Munoz, here with dad Roberto Munoz and mom Jasmine Brito, is up to 11 pounds, 12.1 ounces.

         But nine months after her birth, Olivia is thriving. And so she returned Tuesday to Tampa General Hospital for a celebration: a tour of the new Jennifer Leigh Muma Neonatal Intensive Care Unit, a partnership of USF Health and Tampa General that will give more babies like Olivia the best possible chance at a healthy life.

        “We truly look at this as a remarkable day for the NICU, as well as the greater Tampa Bay community,” Dr. Rubin told the crowd. “We will not only provide excellent care for newborns, but we’re also focused on research and improvement of that care.”

         “High-tech, high-touch” is how Dr. Rubin, medical director of the NICU, likes to describe the new unit: a facility that links the best and newest technology to care for sick and premature babies with a more comforting, nurturing environment for those babies and their families.

Dr. Lewis Rubin says Olivia, born in her mother’s 23rd week of pregnancy, is doing remarkably well.

         Once the unit opens, it will have 82 individual neonatal beds, as well as a separate 12-bed transitional area. The facility is designed to help babies stay in a quiet, dark, stress-free environment. Rooms have dimmer switches, rubber floors and calm blue and green tones. Pull-out recliners will allow parents to spend more time with their babies. A separate lounge area will have a laundry, showers and a kitchen.

        Two special “Caroline’s Rooms” are designed to allow parents and friends to go for family meetings, quiet time, or prayer.

        Technology is designed to help the babies as well. A large room can support three babies who need to go on heart-lung bypass or hemodialysis. Patient care providers will carry their own wireless communication devices. Babies will be continually monitored.

The private rooms in the new NICU allow babies to rest in a more soothing environment. A few rooms are equipped with moveable walls for families with twins.  

      Most of the unit, with 68 beds, will open Nov. 30. The rest will open soon after.

         The $35 million new unit was is funded in part by a $6 million gift from the Mumas, who made the donation in memory of their daughter, Jennifer Leigh Muma, who died in a neonatal nursery.

         “The Mumas have given not just funds and support, but their hearts and their time,” said Deana Nelson, chief operating officer of Tampa General Hospital, at Tuesday’s tour.

          Pamela Muma said she’s excited to see the project so close to completion.

         “It’s been a passion of mine for over 20 years,” she said. “I am so excited that together with Tampa General and USF Health, we were able to put this together, and put in a new NICU, and bring in one of the finest neonatologists in the country with Dr. Rubin.”

          Her goal, she said, is to have the entire 55,000 square feet unit provide a more comfortable and hopeful space – from the mural of children on the walls to the quieter and more spacious, private surroundings.

        “We’re hoping it will become the finest in the Southeast and hopefully in the U.S.,” Pam Muma said. “It’s just going to be a healthier environment for the sickest babies and their families.”

Lakeland resident Linda Walther Snavely, an artist and children’s book illustrator, puts the final touches on a mural for the NICU.

       For Dr. Robert Nelson, USF professor and chair of pediatrics, the difference between the private rooms of the new NICU and the cramped open bay of the old one is stark.

         “I’ve been here almost 18 years, and it’s been all of our dreams over that time that we could have what we’re going to have in a few weeks,” Dr. Nelson said. “The quality of care, the experience of the families will be steps above what is possible in the old unit. It almost makes me wish I was at the beginning of my career.”

         The day Olivia was born, she was only 10 1 /2 inches long and her skin was paper-thin.  Her mom, Jasmine Brito, still carries a picture of her first day of life, showing how her little body was dwarfed by a diaper nearly as big as she was, a blindfold to protect her delicate eyes and a tangle of tubes. Dr. Rubin explained all the problems Olivia could face to her parents.

Dr. Rubin talks with the press about his hopes for the new NICU and thanks the Muma family.

        “Dr. Rubin was in the picture since day one,” Brito said. “He was always so open with us, and quick to explain everything for us, right up until the day she was discharged. He’s amazing.”

         Now, months after Olivia finally got to go home, the family has returned, snapping photos and inspecting the new NICU.

         “We are truly honored and grateful to have Olivia and excited to see the NICU,” Brito said.

- Story by Lisa Greene, photos by Eric Younghans, USF Health Communications

With heartfelt excitement, dozens of supporters, faculty and patients gathered at USF Health Oct. 27 for a ribbon cutting that signified the long-awaited opening of Central Florida’s first major clinic focusing solely on patients with amyotrophic lateral sclerosis (ALS) – also known as Lou Gehrig’s disease.

The opening ceremony, held at USF Health’s Carol & Frank Morsani Center for Advanced Healthcare, included some of the Tampa Bay area’s strongest advocates in the fight against ALS.

“So many in this room have been touched by ALS,” said Clifton Gooch, MD, professor and chairperson of the USF Department of Neurology and an ALS specialist. “This clinic is the perfect symbol of what can happen at USF Health, to be able to advance the fight against this disease.”

Dr. Clifton Gooch, left, and Dr. Stephen Klasko cited the university-community partnership between USF and The ALS Association for helping make the new multidisciplinary ALS Clinic a reality.

“The opening of this USF Health ALS Clinic is the beginning of a wonderful relationship, and it’s the beginning of the end for this horrible disease,” said Stephen Klasko, MD, MBA, CEO of USF Health and dean of the USF College of Medicine, acknowledging the partnership between USF Health and the ALS Assocation Florida Chapter that made the clinic possible.

ALS is a neuromuscular disease that progressively paralyzes its victims, attacking nerve cells and pathways in the brain or spinal cord. Patients are robbed of the ability to walk, eat, speak, and eventually breathe. The average lifespan from the time of diagnosis is just two to five years. There is currently no known cause or cure for ALS.

Central to the new ALS clinic is the ability to build a team that can address in one location the multiple and diverse needs of ALS patients.

“Research has shown that a multidisciplinary approach to care prolongs the lives of ALS patients and improves their quality of life,” Dr. Gooch said.

Left: ALS patient Matt June and friend Jackie Loiselle listen as USF neurologist Dr. Lara Katzin leads a tour of the new clinic. Right: Local media covered the event.

The specially trained healthcare professionals at the new USF Health ALS Clinic will include neurologists, a physical therapist, occupational therapist, respiratory therapist, nurse, registered dietician, psychologist or psychiatrist, speech and language pathologist, and social worker. In addition, the clinic will offer patient education and have a research component. Directing the new clinic is Tuan Vu, MD, professor of neurology and director of Neuromuscular Division at USF Health.

Benefiting most from the opening of the clinic are the victims of ALS, like Matt June, who moved to Tampa from Ohio after learning this past summer about the opening of the USF Health ALS Clinic.

The clinic at USF “offers a glimmer of hope,” said June, 38. “The clinic simplifies things so much and keeps me from having to run from doctor to doctor. An entire team will discuss my needs and what is best for me.”

June is a military veteran with three teenage children. Veterans are two times more likely than the general population to get ALS.

This USF Health ALS Clinic was made possible by an initial $100,000 donation from Stephen Blume and his fiancée Jennifer Leavengood. Blume’s father died from ALS. The gift, presented in July, is part of the USF: Unstoppable Campaign, a comprehensive fundraising effort by USF to celebrate the energy, vision and future of one of the country’s most exciting and engaged universities. A portion of Blume’s gift was put to immediate use in hiring a nurse coordinator for the clinic, a critical point person for ALS patients in coordinating all their care across multiple specialties and in helping to administer clinical studies of investigational therapies.

Left: Local businessman and USF alum Stephen Blume, with fiancee Jennifer Leavengood, donated $100,000 to help launch the clinic. Right: Nancy Baily, president of ALS Association Florida Chapter.

“Until we find a cure, we have to do whatever we can to make people with ALS comfortable,” Blume said. “USF is the perfect location, with resources, databases, and clinical trials. We have an unbelievable homerun.”

“To help make the dream of a clinic a reality, it needed funding,” said Nancy Baily, president of the ALS Association Florida Chapter. “The tipping point was the gift from Stephen and Jennifer, a gift to his alma mater and in his father’s memory.”

The clinic will initially operate the first Friday of each month, and is expected to add days as patient volume grows.

For more information or to schedule an appointment, please call (813)396-9478.

Story by Sarah Worth, photos by Eric Younghans, USF Health Office of Communications

Patricia A. Kruk, PhD, a USF Health professor of pathology and cell biology whose promising research could lead to a simple, more sensitive screening test for ovarian cancer, received a University of South Florida 2010 Excellence in Innovation Award.

Dr. Kruk was one of two faculty members presented with the award Oct. 12 at the USF Academy of Inventors luncheon, a part of the week’s ResearchOne activities. She was recognized for her exceptional achievements in innovation and translational research achievements in the field of ovarian cancer. Donald Haynie, PhD, of the Department of Physics, the other recipient, was recognized for his exceptional work in the field of nanotechnology and bioengineering.

Dr. Kruk studies molecular changes responsible for early stages of ovarian cancer – a deadly disease with vague symptoms and no sufficiently accurate early screening test. She has worked with colleagues at USF and Moffitt Cancer Center to develop urinary biomarkers for cancer detection. They found that the level of an anti-apoptotic protein in urine, called Bcl-2, is 10 times higher in women with ovarian cancer than it is in healthy women. A patent is pending for her method to detect ovarian cancer by measuring urinary levels of Bcl-2.

Patricia Kruk, PhD

“It is truly an honor to be recognized by the National Academy of Inventors founded here at USF,” Dr. Kruks said. “The Academy and its members are an important resource whose guidance I will rely on in the translation of this technology to clinical application and, thereby, hopefully help reduce the mortality of ovarian cancer, the deadliest gynecologic cancer.”

“Dr. Kruk is an enthusiastic scientist, a team player and an internationally recognized expert on the cell biology of sporadic and familial ovarian cancer,” said Santo Nicosia, MD, distinguished USF professor and chair of the Department of Pathology and Cell Biology. “A remarkable asset to this University, she will continue to contribute with high distinction to basic and translational research.”

After receiving her PhD in Medical Sciences in 1992 from the University of British Columbia, Canada, Dr. Kruk pursued a postdoctoral fellowship at the National Institute on Aging at the National Institutes of Health. When she joined the USF College of Medicine in 1996, Dr. Kruk was already known for originating a successful technique to isolate and culture ovarian surface epithelial cells, including those derived from women with inherited ovarian cancer.

At USF she developed a research project focused on the molecular regulation and biological consequences of reactivation of the enzyme telomerase in ovarian cancer. Her laboratory demonstrated for the first time that vascular endothelial growth factor regulates telomerase activity in non-vascular cells and is a new molecular target for lysophophatidic acid in cancer cells. She and colleagues also showed that telomerase not only promotes cancer cell survival but also confers resistance to chemotherapy by boosting expression of the protein Bcl-2. This work led to the development at USF by Dr. Kruk of a test for early detection of ovarian cancer using a patient’s urine sample. USF is actively pursuing a licensing partner for this technology.

Dr. Kruk has attracted more than $1.6 million in American Cancer Society and U.S. Department of Defense grants. She is the author of more than 40 peer-reviewed publications and four book chapters, and has presented at 14 invited seminars, including the prestigious Telomeric Instability in Ovarian Cancer at the University of British Columbia. She is a member of the Florida Center of Excellence for Biomolecular Identification and Targeted Therapeutics.

Story by Anne DeLotto Baier and photo by Eric Younghans, USF Health Communication

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Outstanding faculty research rewarded

The USF Concussion Center brings together experts in neurology, neurocritical care, neurosurgery, neuropsychology, psychiatry, audiology, pediatrics, neuro-otology, ophthalmology, neuroradiology, athletic training, sports medicine and physical therapy.

“A concussion doesn’t have to knock you out to leave lasting effects,” said Gianluca Del Rossi, PhD, ATC, associate professor of orthopaedics and sports medicine at USF Health and director of the USF Concussion Center. “Even mild ones need to be recognized and managed to avoid potentially devastating complications.”

Most concussions resolve on their own within a week or so with medical attention and rest, Del Rossi said, but some patients with mild head injury develop a troubling set of symptoms known collectively as postconcussive syndrome, or PCS, which last longer than three months.

The syndrome can be challenging to evaluate and manage because many of its symptoms are associated with other potential disorders unrelated to head injury, Del Rossi said. “At times, it can be difficult to tie some of the behavioral and emotional changes that often accompany PCS – like irritability, anxiety, impaired memory or judgment, and depression — back to the concussion that may have occurred months earlier.”

For more information about the new USF Concussion Center, click here: http://www.USFConcussionCenter.com

It’s a partnership that could help transform Naples and Southwest Florida, as well as help people received personalized care, designed for their unique genetic makeup, when they are sick.

Jackson is launching a biomedical research and education village in Collier County, and USF is its first medical partner.

“For us to be part of this wonderful, wonderful opportunity in Collier County, to be part of the things that are going on with the Jackson Laboratory, is truly something we think is very special, very important,” said Karen Holbrook, PhD, USF’s senior vice president for research and innovation. “It is a very significant commitment for the University of South Florida.”

Dr. Karen Holbrook, USF senior vice president for research and innovation, answers press questions about the new partnership.

The new partnership can help provide a pipeline of doctors, nurses, pharmacists and other health professionals for Southwest Florida, said Dr. Stephen Klasko, dean of the USF College of Medicine and CEO of USF Health. It will also provide the area with tremendous health and economic benefits, he said.

“It’s not hard to envision a day that with Jackson Laboratory expertise, USF Health’s creativity and this great county and area’s energy, that this biomedical village will become the center for personalized health in the country,” Dr. Klasko said.

USF Health’s strong research environment and academic entrepreneurial model will be assets for Jackson, said Charles E. Hewett, PhD, Jackson’s vice president and chief operating officer.

“USF Health looks toward the future of health care,” Dr. Hewett said. “Whether it’s researching the secrets of deadly diseases; helping doctors join the electronic age or teaching surgeons how to use high-tech robots, USF Health keeps pushing the boundaries of medicine forward. As we build our partnership, that forward-thinking philosophy will help us deliver on the promise of personalized medicine.”

In turn, Dr. Klasko pointed to Jackson’s world-wide reputation for expertise in research in mammalian genetics and pharmacogenomics. Jackson and USF Health share important philosophies, he said.

“The ability to think into the future, the ability to be collaborative, the ability to be flexible, creative and passionate all are clearer there in Jackson Laboratory,” Dr. Klasko said.

Dr. Stephen Klasko, dean of the USF College of Medicine and CEO of USF Health, called Jackson the “ideal partner” for USF, one of the fastest-growing biomedial research universities in the nation.

An OB/GYN, Dr. Klasko has delivered more than 2,300 babies. He compared launching the partnership to delivering a baby, and meeting Dr. Hewett to his first date with his wife. The jokes went over well; the Naples audience gave him a standing ovation.

Naples business leaders who came out to support the venture praised the partnership. Alan Horton, retired Scripps newspaper executive and a leading supporter of the Jackson plan, called the venture – rich in potential for our community.

“We can see some of the meat on the bones for the biomedical village concept now, I think,” Horton told the audience. “And we can see that fully fleshing this out will take some years, lots of planning and cutting-edge experience and brainpower.”

Dolph von Arx, a Naples civic leader who is the former chairman, president and CEO of the Planters Lifesavers Co., has been named the first chair of the village’s Biomedical Leadership Council. “The biomedical venture represents a tremendous, tremendous diversification opportunity for Collier County,” von Arx said.

“We’ve got a great partnership,” von Arx said. “We are all very excited.  We’re gonna go get ‘em.”

Naples business leaders who came out to support the venture praised the partnership, which will launch a biomedical research and education village in Collier County.

Jackson and USF plan to collaborate in three key areas: research, education and clinical care.

• RESEARCH. Jackson and USF researchers will collaborate on work in such endeavors as computational biology and bioinformatics; cancer; Alzheimer’s disease and the neurosciences; metabolic diseases; and a host of other diseases. Researchers and clinicians will work together to bring the latest discoveries into clinical practice, with an emphasis on new medicine that is tailored to respond to the individual.

• EDUCATION. Advancing technologies demand a different kind of education for the next generation of healthcare professionals. USF Health and Jackson are leaders in medical and scientific education. The partnership will lead the way in educating students in medicine, nursing, pharmacy and emerging health professions in the areas of personalized health, pharmacogenomics, and bioinformatics. The partnership also expects to develop continuing medical education programs to help teach doctors and other practicing health professionals about these new areas of medicine.

• CLINICAL CARE. Jackson and USF Health will team with other health care organizations to develop a clinical campus that will provide the latest in cutting-edge personalized medicine and health care to patients from Collier County and beyond. USF already is creating new models to help patients with chronic conditions live optimistically. The partnership will be ideally positioned to provide personalized medicine across a continuum of care, from home therapies to outpatient and inpatient services.

• Those initiatives will further increase the economic impact of the research and education village planned for eastern Collier County.  An economic analysis performed by the Washington Economic Group predicts that within 10 years, the research and education village will generate 7,500 jobs and $500 million in annual economic activity in cumulative economic impact in Collier County, and even more across the southwestern Florida region. The partnership with USF Health will accelerate these economic benefits.

• “Collier County’s vision of building a biomedical cluster, and its determination to become a key player in the biomedical revolution are very powerful incentives for USF Health to act now,” said Dr. Klasko.

• Noting that Edison State College has already committed to creating a charter high school in the research and education village, Dr. Hewett said: “There will be many more announcements like this one. We look forward to welcoming scientific, educational and medical partners from around the world.  We will also see a growing number of commercial ventures locating here.”

“This is a great day for the citizens of Collier County and southwest Florida as well as for us,” Dr. Hewett said. “Together, we will transform the economy of this region, and help southwest Floridians lead longer, healthier lives.”

– Story by Lisa Greene, USF Health Communications

Tampa, FL (July 8, 2010) — The University of South Florida’s Department of Neurosurgery and Brain Repair has been granted a patent for a cell transplantation procedure combining human umbilical cord blood (HUCB) cells and a sugar-alcohol compound called mannitol that may make a big difference in treating life-threatening neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis and stroke, among others.

The technology administers the neuroprotective effect of umbilical cord blood cells along with mannitol to permeabilize the blood-brain barrier, allowing for the increased entry of therapeutic growth factors. Saneron CCEL Therapeutics, Inc., a biotechnology R&D USF spin-out company located at the Tampa Bay Technology Incubator, has licensed the technology.

Approximately 750,000 strokes occur every year in the United States, and nearly one third of them are fatal, said Saneron’s President and Chief Operating Officer Nicole Kuzmin-Nichols, MBA. “Given the devastating effects of stroke, it is imperative that we develop new therapies to minimize damage to the brain as well as repair the damage. We are excited about this new technology and its potential to help us develop a variety of new products and therapies to do just that.”

While transplanted HUCB cells may benefit several neurological diseases, getting them past the blood-brain-barrier has presented a problem. The blood-brain barrier separates circulating blood and cerebral spinal fluid in the central nervous system. The newly patented technology is based on mannitol acting as a blood-brain barrier permeabilizer to help get the therapeutic substances secreted by HUCB cells past the blood-brain barrier and into the central nervous system. Mannitol, which temporarily shrinks the tight cells that make up the barrier, allows HUCB cells, via their secreted factors, to reach the site of injury or disease.

Human umbilical cord blood contains a high percentage of stem cells that when intravenously administered can survive and differentiate into neurons in the damaged brain.  Equally appealing is their ability to secrete beneficial molecules that potentially promote behavioral recovery, said Dr. Cesar Borlongan, co-inventor and a USF neuroscientist and professor and consultant for Saneron. “Because the blood-brain barrier regulates the entry of many blood-borne substances into the brain, it may exclude potentially therapeutic substances.”

“The use of stem cell therapy as a treatment for neurodegenerative disorders shows exciting promise, though several hurdles must be overcome and getting the cells correctly positioned is one of those,” said Kuzmin-Nichols. “This technology provides the means to deliver the HUCB cells directly to the damaged brain to maximize their effect.”

About USF Center of Excellence for Aging and Brain Repair

The mission of the University of South Florida Center of Excellence for Aging and Brain Repair is to develop new therapeutic strategies to promote repair and regeneration of aging and diseased brain. Building on a foundation of excellence in basic and clinical research, the Center focuses on translating innovative ideas into industrial partnerships, educational and clinical services to address key needs of the community and those suffering from brain injury and disease.

About Saneron CCEL Therapeutics, Inc.

Saneron is a biotechnology R&D company, focused on neurological and cardiac cell therapy for the early intervention and treatment of several devastating or deadly diseases, which lack adequate treatment options. Saneron, a University of South Florida spin-out company is located at the Tampa Bay Technology Incubator. An affiliate of Cryo-Cell International, Inc., Saneron is committed to providing readily available, non-controversial stem cells for cellular therapies and has patented and patent-pending technology relating to our platform technology of umbilical cord blood and Sertoli cells.

For further information, please contact:

Saneron CCEL Therapeutics Inc.,
Nicole Kuzmin-Nichols, MBA
3802 Spectrum Blvd., Suite 147
Tampa, FL 33612
Phone: 813-977-7664 x2
nkn@saneron-ccel.com

Word is spreading about a time-saving improvement to traditional Mohs surgery, a specialized outpatient method for treating certain skin cancers.

Since his break-through article (published last summer in the journal Dermatologic Surgery) revealed an improved technique that reduced the time for the immunostaining component of Mohs surgery from an hour to 19 minutes, USF’s Basil Cherpelis, MD, has seen a steady increase in the number of patients seeking Mohs surgery at the USF Health clinic. He has also seen an increase in the number of inquiries from other physicians around the country about the procedure.

“Physicians are calling from all over the U.S. to get more information about the protocol so they can offer this new technique in their own practices,” said Dr. Cherpelis, who is assistant professor of dermatology, chief of Dermatologic Surgery at USF, and associate director of the USF Dermatology Residency Program.

USF Mohs Surgeon Dr. Basil Cherpelis.

Mohs micrographic surgery was developed in the 1930s by Dr. Frederic Mohs as an innovative technique for completely removing certain skin cancers, such as basal and squamous cell carcinomas. Mohs surgery differs from other skin cancer treatments in that it allows for complete microscopic examination and mapping of the removed tissue to ensure removal of all cancerous cells. The result is a cure rate that is nearly 100 percent for skin cancers that have not been treated before.

Typically, patients needing Mohs surgery will spend several hours at the doctor’s office because of the time needed for staining each tissue sample to determine if cancer cells are present. The day is a series of repeated procedures, during which the surgeon removes a thin layer of skin at the site of the visible tumor along with a narrow rim of normal skin, stains and prepares the tissue sample, maps the locations of remaining cancer cells, and then returns to the patient to remove another section.

This continues until the tissue is cancer free. Sometimes special stains, called immunostains, are needed to visualize the cancer cells. Since the processing of immunostains takes an additional hour, in addition to the standard stains that are performed the entire procedure can easily take several hours, Dr. Cherpelis said. That is why patients and physicians alike are encouraged by Dr. Cherpelis’ rapid immunostain technique, which requires only 19 minutes for the tissue staining.

“I think the patients are the ones who are most excited about this reduced time, and that’s understandable,” Dr. Cherpelis said.

Currently, Mohs surgery is most beneficial to patients with basal and squamous cell carcinomas, but Dr. Cherpelis said that his practice is working to expand the procedure to include lentigo maligna melanoma.

“For lentigo maligna melanomas, it is difficult to identify the melanoma cells using standard stains and to determine distinguish between where the cancer starts and stops in the healthy tissue,” he said.

“It’s an area worthy of more research since melanomas are far more deadly.”

Dr. Cherpelis, who left private practice five years ago to join USF and open its first Mohs Surgery Unit, is a fellow of the American College of Mohs Surgery.

Titled “Innovative 19-Minute Rapid Cytokeratin Immunostaining of Nonmelanoma Skin Cancer in Mohs Micrographic Surgery,” the article was published in the July 2009 issue of Dermatologic Surgery, the journal of the American Society for Dermatologic Surgery. Co-authoring the article with Dr. Cherpelis is Logan Turner, MD, Sharron Ladd, BS, Frank Glass, MD, and Neil Fenske, MD.

For more information about USF’s Mohs Surgery program, visit USF Dermatology’s website or call 813-974-4744.

Story by Sarah A. Worth, USF Health Communications
Photos by Norman Weeks

Co-developed by Dr. Richard Oehler, USF associate professor of medicine, and Dr. John T. Sinnott, director of the Division of Infectious Disease and International Medicine, the application permits on-demand streaming of infectious disease-related podcasts to any iPhone, iPod touch, or iPad through a WiFiconnection. A version compatible with either a WiFi or 3G connection should be released in the near future. The app is now available as a free download from the app store, permitting users to enjoy more than one hundred hours of infectious diseases content almost anywhere within range of an internet connection.

“Since 2007, our web site, IDPodcasts.net, has been a premiere remote learning resource for infectious diseases (ID) on the web. Having developed more than one hundred podcasts over the last three years, we are now a comprehensive resource for clinicians and students who are interested indeveloping their knowledge base in infectious diseases and public health,” said Dr. Oehler. “Though our website receives several thousand hits per year and is already a leading infectious disease podcast series on the iTunes store, the IDPodcasts Mobile Viewer will bring the exceptional teaching of our USF ID and guest faculty to a whole new group of mobile users who will appreciate the capability to learn about infectious diseases anywhere on-the-go. The IDPodcasts Mobile Viewer will become an indispensableeducational resource.”

The USF Health Division of Infectious Disease partnered and developed the application with Tampa Bay area company Absolute Mobile Solutions. “I have long followed and admired the innovative vision of USF College of Medicine Dean (Stephen) Klasko. He has a real vision for the integration of technology and healthcare encompassing everything from education to patient care.” said Absolute Mobile Solutions President Alfred Goldberg.

The IDPodcasts Mobile Viewer application can be downloaded from the iTunes app store (keyword is “id podcasts”). For more information, please contact Dr. Oehler at Richard.oehler@va.gov, or call (813) 972-2000, ext. 6184.

- USF Health -

USF Health (www.health.usf.edu) 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 $380.4 million in research grants and contracts last year, the University of South Florida is one of the nation’s top 63 public research universities and one of only 25 public research universities nationwide with very high research activity that is designated as community engaged by the Carnegie Foundation for the Advancement of Teaching.

Dr. Richard Oehler, and Dr. John Toney, faculty in the Division of Infectious Diseases and International Medicine, Department of Internal Medicine, along with Dr. Kevin Smith, an USF Internal Medicine resident, co-authored the invited article. The authors note that the growing popularity of the online application service, or “App” store, by medical users, has proven to transform pocket resources for clinicians.

Apple’s iPhone and its sister device, the iPod Touch, with more than 500 million users and more than 200,000 downloadable applications, have become the leading handheld platform for healthcare practitioners to access personal information, medical reference, clinical data and medically-oriented “apps” on the go. These mobile devices have recently been joined by the tablet-sized iPad.

“With its growing adoption in the medical community, third-party developers of medical software have responded by making a number of paid and free applications available for medical iPhone users,” the authors write.

Among the select infectious disease-specific applications reviewed by the authors are clinical reference applications like the 5-Minute Infectious Diseases Consult, a comprehensive quick guide to the clinical diagnosis, laboratory tests and appropriate treatments for infectious diseases.

Drug information databases include Epocrates, constantly updated free access to information on thousands of drugs, including dosing, adverse reactions, formularies, pricing and pill reproductions as well as a medical calculator and the latest medical news and information. For a fee, the premium version adds disease information with images, information on herbal and over-the-counter medicines, and treatment guidelines with the option to search infectious disease syndromes by “bug” or drug class. FDA Drugs, one of the newest drug databases, has the unique ability to search all drugs with a specific active ingredient along with therapeutically equivalent generic alternatives.

Another category of medical apps target epidemiology and human and animal infection-related outbreaks, like the following three free offerings: Outbreaks Near Me, Swine Flu Tracker Map, and H1N1 (Swine Flu) Update.

The authors comment on future directions in medial apps, noting that the Food and Drug Administration is monitoring the iPhone operating system’s latest software that allows it to synchronize with medical devices such as glucose meters, obstetrical equipment, and blood pressure gauges. They envision a day when the smartphone transforms from a “geek gadget” to an FDA-approved hand-held medical machine.

The USF Division of Infectious Diseases and International Medicine is currently developing an IDPodcasts Mobile Viewer for the iPhone. Since 2007, the division’s website, IDPodcasts.net, has become a leading remote learning resource for infectious disease clinicians and medical students, with more than 100 podcasts on topics ranging from MRSA and the H1N1 flu pandemic to viral hepatitis.

Story by Anne DeLotto Baier, USF Health Communications

The multi-faceted agreement will provide for internships for pharmacy students and volunteer teaching by CoreRx Inc. scientists, said Kevin B. Sneed, PharmD, dean of USF’s School of Pharmacy.

“The opportunity for our students to spend time with a firm that is at the front end of prescriptions is invaluable,” Dr. Sneed said. “And it is only the beginning of what will be a varied educational experience for our students, who will ultimately have a keener understanding of the drug-making process. This knowledge will help our graduates take leading roles in managing and delivering technologically-advanced pharmaceutical care in tomorrow’s patient-centered practice. This affiliation also affirms our commitment to create innovative academic-entrepreneurial partnerships.”

“We’re thrilled to offer this affiliation with USF and to offer a hands-on learning opportunity for its pharmacy students,” said Todd R. Daviau, PhD, CEO and co-founder of CoreRx Inc.

“We are excited about the fact that CoreRx will continue to play a role in furthering the development of pharmacy students.”

Dr. Kevin Sneed (left) and Dr. Todd Daviau.

Among the key concepts pharmacy students will learn through CoreRx Inc. will be the early development stages of pharmaceuticals, how tablets and capsules are made (with hands-on instruction), and the functionality of additional ingredients found in modern-day drugs. In addition, students will learn hands-on processes utilized in the manufacture of a wide range of pharmaceutical dosage forms.

This is not the first time CoreRx Inc. has connected with USF’s education mission. They have hosted USF chemistry students on paid internships for nearly two years.

CoreRx Inc. was founded in 2006 and is a contract pharmaceutical development and manufacturing organization that helps pharmaceutical and biotechnology companies bring new drugs to the clinic quickly and efficiently.

Dr. Sneed championed and was the major architect of the proposal for USF’s four-year Doctor of Pharmacy (PharmD) program, which was approved by the Florida Board of Governors in January 2009. Housed within the USF College of Medicine, the USF School of Pharmacy plans to admit its first class of student in August 2011.

For more information about CoreRx Inc., visit www.corerxpharma.com.

Story by Sarah A. Worth, USF Health Office of Communications
Photos by Eric Younghans, USF Health Office of Communications

USF psychiatrist Dr. Patrick Marsh positions the Neurostar TMS device to the correct location on patient Lindsey Underwood’s head.

Lindsey Underwood has battled depression before.

     But this time, it was worse. Blackness took over his world and sucked the joy from his life.

     “It permeates every aspect of your life,” Underwood said. “It was very debilitating. I didn’t have the energy to get out of bed.”

     And this time, when depression struck last year, anti-depressants didn’t help.

      Underwood, a 44-year-old paralegal, was so desperate for help that he said good-bye to his wife and 2-year-old daughter in eastern Washington State and traveled across the country to get help from USF psychiatrists.

      To be honest, Underwood said, he had doubts about the new treatment that USF doctors would give. Trans-cranial magnetic stimulation, or TMS, uses pulsed magnetic waves to stimulate cells in the brain. 

      “I was somewhat skeptical,” said Underwood.  “Because the treatment sounds a little bit odd.”

       Dr. Patrick Marsh, USF assistant professor in psychiatry, has heard such questions before. 

      “Everybody says, ‘Oh, that sounds like electroshock,’ ” he said. “So the TMS studies are fairly rigorous.”

       Despite that frequent reaction, TMS has more in common with a completely different, and more familiar, technology: an MRI machine. And studies done so far show that TMS helps about half of patients tested feel significantly better. That track record is slightly higher than the percentage of people who are helped by anti-depressants, Dr. Marsh pointed out.

      The patients who have been studied are those who, like Underwood, weren’t helped by anti-depressant drugs. The FDA approved the device, called the NeuroStar TMS Therapy System, to treat these patients in late 2008.

      Underwood is among the converts. He’s still undergoing treatment, but said that TMS already has helped him. He began noticing a change after about 10 days of treatment, he said.

       “I feel like the cloud of depression seems to have lifted,” Underwood said. “It doesn’t seem to color my every thought anymore.”

Trans-cranial magnetic stimulation, or TMS, uses pulsed magnetic waves to stimulate cells in a part of the brain linked to depression.

      Dr. Francisco Fernandez, chairman of USF’s psychiatry department, is pleased by the results so far. With TMS, the department has added a powerful weapon to help patients who have no other alternative, he said.

      “For patients with depression, the prognosis has not significantly improved in decades,” he said. “With TMS and other neuromodulation therapies, we hope to optimize treatment options and improve clinical outcomes for all.”

      While the treatment is new, the idea is not. Doctors first experimented with treating depression  by passing a magnetic coil over the brain in the early 1900s, Dr. Marsh said.  Modern experiments with magnetic treatment began about 20 years ago, with the technology improving during that time.

      The device uses magnetic pulses that are similar to those of an MRI machine. The treatment isn’t invasive, and patients don’t need anesthesia for treatment. It also has few known side effects.

      “It’s the only treatment for depression that doesn’t include an FDA ‘black box’ warning,” noted Dr. Marsh.

     The FDA requires that any drug that has the potential to cause a life threatening or serious adverse effect carry a warning by way of a black box. Antidepressants  carry a ‘black box’ warning on the label informing patients that they may result in an increased risk of suicidal thoughts and behavior.

      The Neurostar is made by Neuronetics, Inc., a privately held company based in Pennyslvania that has licensed a magnetic coil technology patented by Emory University. Dr. Marsh estimates that USF is one of about five places in Florida now offering TMS therapy.

        “When you come to an academic medical center, you expect to be on the front lines of what is working,” Dr. Marsh said.

        Making new treatments available and helping patients who haven’t been able to get help is a vital part of USF’s mission, said Dr. Fernandez.           

       “The mission of the department is to achieve excellence by delivering new treatments to enhance patient care,” Dr. Fernandez said. “We rely on the unique clinical expertise of our faculty and staff applying next-generation research and technology to improve the quality of life of our patients. By developing the Neurotherapies Clinic, and specifically with the use of TMS, USF has set a new standard of care for depression in our community.”

        To receive TMS treatment, patients sit in a padded chair that looks like a dentist’s chair. A padded coil at the back holds the head steady. Treatments are aimed at a part of the brain that has been linked to depression, the left prefrontal cortex.

         The psychiatrist finds this spot by first locating the motor strip of the brain, a narrow segment that runs roughly above the ear. The psychiatrist aims the NeuroStar TMS at the part of the motor strip that controls the thumb. The first time a patient receives treatment, it’s clear when this spot is located and stimulated: the thumb beings an involuntary, painless twitching.  

          The psychiatrist then moves the device forward on the head to locate the prefrontal cortex. Sometimes, patients find the sensation makes their scalp feel itchy or uncomfortable, but not painful. Patients get so accustomed to the feeling that some doze off during treatment, said Ruta Dimaite, director of the Neurotherapies Program.

        Most patients receive 30 treatments, with five treatments each week for six weeks. Each treatment takes about 40 minutes.

        For most people, the treatment has one big obstacle. Each session costs $350, and most insurance companies still don’t cover it.

         “I have calls daily, and the biggest deterrent is the cost,” Dimaite said.

         Both she and Dr. Marsh hope that insurance companies will begin to cover TMS as a treatment for depression.

         “Depression is the most costly disease in terms of lost productivity,” Dr. Marsh said. “In a practical sense, that’s why there’s a big push to get insurance to cover it.”

          For Underwood, the journey to find help has been worth it. While he misses his wife and daughter, his mother lives in Tampa, so he has been able to have a family member here during treatment.

          Underwood has felt well enough to resume a regular exercise routine. He’s started reading again, and recently tackled Tom Wolfe’s novel A Man in Full. Both changes have made him feel even better.

        It’s hard for people who have never experienced clinical depression to realize how difficult the condition is to cope with, he said.

        “The general public thinks it’s ‘just a little blue,’ ” he said. “They don’t realize how profound it can be…It’s a sadness akin to trauma, like going through the death of a loved one, but it just won’t lift.”

        Underwood decided to talk about his experience because he wants more people to learn that there are other treatment options available.

        “It’s an alternative to medicine, to things that aren’t responding, and it’s not invasive,” he said. “It really can help.”

Dr. Marsh supervises a TMS treatment, a painless, non-sedating procedure that typically takes 40 minutes in an outpatient setting.

If you feel you, a friend or loved one may benefit from TMS Therapy, or you would like to refer a patient, please contact the Neurotherapies Program at (813) 259-0920 or email neurotx@health.usf.edu. Also, for more information, please visit: http://health.usf.edu/medicine/psychiatry/neurotherapy/.

– Story by Lisa Greene, photos by Eric Younghans,USF Health Communications

iUSFHealth is the new connection to USF Health from your iPhone or iPod Touch. The application, created as a collaboration between the practice plan and USF Health Information Services, can be downloaded directly from iTunes.

The first application, know as Profound, searches more than 400 healthcare providers from the University of South Florida by name or medical specialty. Our providers serve Tampa Bay at various hospitals and clinics throughout the area, representing more than 100 sub-specialties.

Profound can help potential patients looking for a physician and physicians interested in referring their patients to a USF Health practitioner.

In the near future, iUSFHealth will serve all three key missions at USF Health: Clinical, Research, and Education.

Juan Uribe, MD, assistant professor of neurosurgery at USF Health, treated the first patient, a 43-year old female, at Tampa General on Feb. 22.

USF neurosurgeon Dr. Juan Uribe

The lateral approach may minimize or avoid the risk of potential complications such as vascular injury, major bleeding, intestinal injury, ureteral injury, sexual dysfunction, and postoperative back muscle pain.

“The minimally invasive extreme lateral total disc replacement is a great alternative for the management of select patients with degenerative disc disease,” Dr. Uribe said. “The procedure is performed through the patient’s side.  This approach provides the least amount of tissue disruption to muscles, ligaments, blood vessels, and abdominal organs, compared to traditional posterior (back) or anterior (front) approaches.” 

The clinical trial to evaluate XL TDR will include over 200 patients across an estimated 15 clinical investigation sites. The trial is expected to last 12 to 18 months.

About XL TDR

XL TDR is a metallic prosthetic joint or total disc replacement that replaces a degenerative intervertebral disc. Like fusion, total disc replacement supplants the primary function of the disc – to maintain vertebral spacing to protect the nerves and spinal cord. Unlike fusion, though, total disc replacement seeks to maintain the secondary functions of the disc – providing motion of the spine. Once implanted between the vertebrae, XL TDR is designed to restore height and to replicate the motion characteristics of an intact healthy disc.

     The device was implanted Wednesday morning by Dr. Murray Shames, associate professor of surgery in the USF College of Medicine, at Tampa General Hospital. The patient is part of a clinical trial of the CVRx Rheos System, a pacemaker-like device designed to improve how a failing heart functions.

    Dr. Shames holds up a Rheos device fastened around a model carotid artery.

      In patients with heart failure, the heart can’t pump enough blood to supply the body. Patients become short of breath because fluid fills their lungs. Their legs, ankles and feet can swell. They tire easily. Most people with heart failure die within five years.

      “This device, which works on the brain to help regulate cardiovascular function, appears to be a promising new therapy for a very bad, life-limiting disease,” said Dr. Shames, surgical director of the trial’s Tampa site.

     Current treatments for diastolic heart failure call for medications to lessen the symptoms of the disease, such as fluid in the lungs and swelling in the legs, ankles and feet. Dr. Shames pointed out that such drugs don’t treat the underlying problem.

     “There’s nothing really that helps cure the heart,” he said. “Theoretically, this may allow the heart to recover.”

     The CVRx Rheos System is implanted in the chest, with wires attaching to the carotid baroreceptors. The baroreceptors regulate blood flow. When the system is in place, the baroreceptors should send signals to the brain, causing the brain to tell the body to relax its arteries, slow its heart rate and reduce fluid build-up.

     This trial will enroll more than 500 patients at up to 70 sites around the U.S. and in Europe. In Tampa, Dr. Fadi Matar, USF affiliate assistant professor of medicine and medical director of  Tampa General’s cardiac intensive care unit, is the principal investigator.

     Dr. Shames has already implanted about a dozen of the devices for a separate trial of the system to see how well it treats uncontrolled high blood pressure. But, on Wednesday, he operated on the world’s first patient to receive an implant of the Rheos device for heart failure, CVRx representatives said.

     Wednesday’s surgery went well, Dr. Shames said. Now doctors are waiting to see whether the patient shows signs of improvement.

     Photos by Eric Younghans, Story by Lisa Greene, USF Health Communications

George Cohen, MD, assistant professor in the USF Department of Dermatology and Cutaneous Surgery, specializes in skin of color and hears from patients every day their frustrations for finding someone who understands their unique needs.

USF’s Dr. George Cohen specializes in skin of color.

“Many blacks, Asians, and Latinos have concerns about their skin and appearance and would like to have their specific problems treated, but are not sure if treatment is safe or where to turn.” Dr. Cohen said.

“They have been told for years that they cannot have laser and other cosmetic procedures when, in fact, they can. The key is finding the expert who knows their skin.”

Dr. Cohen, who joined USF this past July, is certified by the American Board of Dermatology and has published several articles in medical journals on dermatologic issues affecting ethnic skin. Prior to coming to USF, he was chief of dermatology at the Veterans Affairs Medical Center in Washington, DC, where Dr. Cohen trained physician residents. In addition, he has presented his work at national medical conferences, as well as at community meetings for local physicians, where he explained the nuances of diagnosing and treating skin of color. As one of very few dermatologists in the Tampa area with this expertise, Dr. Cohen has been interviewed by local media, including Tampa’s ABC Action News.

One of the main reasons people of color require specialized skin care is because most any kind of trauma – a burn from a laser, inflammation from an acid peel, or even an insect bite – can cause light or dark patches to form on their skin. Specialized training by physicians and new generations of gentler lasers have helped expand offerings to some extent, but maybe not enough to keep up with this growing population.

While Hispanics, Asians, African-Americans, and American Indians accounted for about one-third of the American population in 2000, they are projected to represent almost half by the year 2050, according to the Census Bureau.

“It can still be difficult to find a dermatologist who knows skin of color and isn’t just guessing how treatments designed for people who aren’t of color are going to work,” he said.

Dr. George Cohen with USF residents Ronald Johnston and Donald Stranahan.

Dr. Cohen said that, while cosmetic procedures can improve the appearance and self esteem in all people, many of the available options are not the right choices for people of color. Some key issues affecting people of color are keloids, vitiligo, unwanted facial hair, and dark spots. 

Keloids are raised hard and sometimes painful growths often seen on the ears and chest.  They represent an overgrowth of scar tissue and can be unsightly as well as physically disturbing.  They can be treated with steroid injections and other medications but many times the best treatment is surgical removal.  Any treatment requires a physician experienced in managing keloids and a commitment on the patients part to complete all follow up visits, Dr. Cohen said.

Unwanted facial hair in woman can be unattractive and cause unsightly ingrown hair bumps. The hair can be safely removed via laser treatments and the skin tone will dramatically improve.  Usually three to four treatments are needed to reduce the unwanted hair. Razor bumps are common in black men but can be safely and effectively treated by laser. There is no reason for men or women of color to be bothered by unsightly hair bumps or unwanted body hair, he said.

Botox and a wide variety of “fillers” can be used to erase wrinkle lines and give the face a more youthful and vibrant appearance. There is no reason for people with skin of color not to take advantage of these medical “fountains of youth,” Dr. Cohen said.

Loss of hair on the sides of the scalp is an extremely common disorder. Not having hair in this area limits a woman’s choice of hair style because of the need to cover the bald spots. In many cases the hair can be permanently replaced by a hair transplant procedure. This is a simple outpatient surgery that can restore one’s appearance and self esteem. People of color have often shied away from this procedure because of a fear of scarring or keloid formation. However, hair transplantation along with laser surgery and chemical peels can be safely performed on people of color by a physician who has the experience and skill, Dr. Cohen said.

Story by Sarah A. Worth, USF Health Communications

Photos by Norman Meeks

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

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