Tampa, FL (June 11, 2007) -- Rheumatologists substantially overestimate the physical disability of patients with rheumatoid arthritis – which may lead to inaccurate evaluations of the patient’s ability to work and need for lifestyle modifications, a new study found.

Researchers at the University of South Florida College of Medicine and James A. Haley Veterans’ Hospital found a clear physician-patient difference in assessment of the patients’ functional disability. The rheumatologists consistently rated their rheumatoid arthritis patients’ degree of difficulty in performing activities of daily living, such as walking, dressing and eating, higher than the patients themselves. This was particularly true for patients in advanced stages of the disease. The findings appear in the May 2007 issue of the Journal of Rheumatology.

“We flunked,” said co-first author John D. Carter, MD, assistant professor of medicine in the USF Division of Rheumatology. “The very physicians deemed to be experts in rheumatoid arthritis failed to make the grade when it came to determining their patients’ functional status.

“This discrepancy is important to correct because patients can rely on these assessments for their livelihood or other necessities to perform activities of daily living.”

Rheumatologists are frequently asked to complete functional disability reports by employers, disability attorneys, insurance companies and government agencies weighing a person’s eligibility for disability payments, employment, or assistive devices such as wheelchairs, walkers, braces and splints.

Using the Stanford Health Assessment Questionnaire-Disability Index (HAQ-DI), rheumatologists evaluated 223 patients during their regularly scheduled visits to the USF Rheumatology Clinics and James A. Haley Veterans’ Hospital. The effectiveness of the HAQ-DI, based on patient self-reporting of their disability status, has been validated in clinical studies. The questionnaire covers eight activities of daily living: dressing, arising, eating, hygiene, walking, reach, grip and outside activity.

Both physician and patient completed the HAQ-DI independently immediately following the visit and their respective scores were not shared.

The rheumatologists overestimated the degree of functional disability in 154, or 69 percent, of the 223 the patients. However, they were significantly more accurate at determining the degree of physical limitations in patients with less severe disease.

The reasons for the overestimation are unclear, but may include empathy and suggest that even patients with advanced rheumatoid arthritis adapt their activities to the progression of the chronic disease, Dr. Carter said. “We tend to associate visible joint deformities with incapacitated function, but patients may actually be more capable than we think.”

Rheumatologists typically determine functional disability based on the patient’s examination and medical history, but these impressions during routine care are inadequate, Dr. Carter said. The study points to the need for a formal, standardized evaluation, such as the HAQ-DI. “It needs to be reimbursable and include input from physical and occupational therapists who could add valuable insight to the process of evaluating disability,” he added.

Rheumatoid arthritis affects about 2.1 million Americans, or 1 percent of the population. Over the last decade new drugs have revolutionized the treatment of this debilitating inflammatory disease, but nearly all patients with rheumatoid arthritis eventually develop some degree of work or daily lifestyle disability, often severe.

Other authors of the study were Abdul B. Lohdi, MD (co-first author); Sonia R. Nagda; Louis Ricca, MD; Colleen Ward, DO; Erica Traina; Zachary J. Thompson; Yangxin Huang, PhD; Joanne Valeriano, MD; and Frank B. Vasey, MD.

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

It was an early start for the USF Health team of pediatricians and health professionals in Seffner on June 23rd. Parents and children of all ages turned out to the Antioch Redskins Facility, near Plant City, to get free “physicals”. The big draw: the redhead in the clown suit! Ronald McDonald is still King with the kids! No doubt about it!

“This was a fabulous opportunity to help out so many appreciative people”, said Jeff Konin, PhD, Executive Director of Sports Medicine & Athletic Related Trauma (S.M.A.R.T.) Institute at USF Health. Since January 2006, the Department of Pediatrics in the University of South Florida’s College of Medicine has been home to one of only 29 Ronald McDonald Care Mobiles in operation worldwide. It’s a distinction and responsibility, they don’t take lightly. Jeannette Fleischer, ARNP, is the Program Director. Dr. Lynn Ringenberg is the Medical Director. Both have worked hard to “grow it” and seventeen months later, the program is definitely in bloom!

“This (June 23rd) was the first time we’ve worked with S.M.A.R.T. members and it’s really great having them involved”, said Dr. Ringenberg. “They (S.M.A.R.T. faculty) do a comprehensive examination of the musculoskeletal system and vital signs- which frees up our doctors to do the remainder of the examination. It allowed us to see many more kids, much more efficiently.” In four hours, they saw approximately 85 children.


Combining the sports medicine and orthopedic expertise of faculty from S.M.A.R.T. created shorter wait times too. Children of all ages were examined from head-to-toe, including a “pre-participation physical examination”, and a check of heart, lungs, abdominal, hernia and more.

“The program strives to identify, treat and refer children with chronic or untreated health conditions, improve health outcomes, provide continuity of care, educated children and families, and screen and enroll eligible families in federal Medicaid or state insurance programs”, explains Dr. Ringenberg. “The USF Pediatrics Mobile Health Program also serves as a venue for training graduate medical residents to better care for underserved children, children with special needs and high-risk youth.” Last year, 70 USF Pediatric and Internal Medicine-Pediatric graduate medical residents participated in the mobile health visits that take place at 59 Title 1 schools throughout Hillsborough and Pasco counties. Title 1 schools are primarily located in underserved communities where a majority of the students qualify for free and reduced lunch.

“The service of providing pre-participation physical exams to underserved children in our community via the Ronald McDonald van exemplifies the model of inter-professional collaboration we have at USF Health”, said Barbara Morris, Assistant Program Director of S.M.A.R.T. “The June 23rd event showcases the working relationship between our pediatrics and S.M.A.R.T. athletic trainers from USF’s Department of Orthopaedic Surgery. In this interaction across departments and professions, the real winners are the kids of Tampa Bay.”

The 40 foot medical and dental office on wheels has a home at USF Health Pediatrics thanks to a collaborative relationship with Ronald McDonald House Charities of Tampa Bay. To keep it here, USF Health Pediatrics must raise $250,000 each year to cover operational expenses. Inspired by the number of kids they’ve served- approximately 1,500 since 2006 - the pediatrics team is “out on the van” five days a week on most weeks, except for school holidays. When school is out, they visit year round community facilities like Joshua House, The Spring, as well as school fairs and sporting events. Fundraising involves grant writing, contributions from foundations and individual donors. “One of the major challenges for a mobile access program is to sustain it. We’re constantly looking at ways to keep this mobile clinic for our children in Tampa Bay”, said Dr. Ringenberg. More than 50 per cent of the kids they see in the mobile unit are un-insured – their efforts in the Ronald McDonald Care Mobile are families’ only alternative to seeing a doctor at a hospital emergency room. See "Success Stories" below photo gallery.

The program has garnered national attention for what it achieves academically, as well. USF Health Pediatricians have presented at national meetings at the request of the American Academy of Pediatrics. “Our care mobile is academically focused with the intent not only to provide the highest level of health care, but to ensure that pediatric residents, medical students and nursing students are actively engaged in providing care on the mobile clinic. We are determined to have these students experience the unique environment of a mobile health care setting and gain a better understanding of the lack of health care access and other health disparities problematic to this population”, said Dr. Ringenberg.

For more information on upcoming visits by the Ronald McDonald Care Mobile or information on how to contribute to this program, click here
or contact (813) 259-8754.

Story by Lissette Campos
Photo Gallery Below.

SUCCESS STORIES FROM THE RONALD McDONALD CARE MOBILE

Since USF Health's Pediatrics Department received the Ronald McDonald Care Mobile January 13, 2006, they've served more than 1500 children across 14 different regions of Hillsborough and Pasco County- among them Plant City, Thonotosassa, East Lake, Sulphur Springs, and Palm River. What happens inside the Care Mobile is just part of the story. The 1:1 visits with pediatricians and residents from the USF College of Medicine have been especially critical for children who had undiagnosed illnesses until their visit to the care mobile. In other cases, acute health issues were caught "just in time".

Below are just a few of the stories shared with us by the pediatrics team involved with the Ronald McDonald Care Mobile program.

• A mother came to the van with her 13 year old child and husband requesting help for her child who has developmental issues. While the husband waited outside, the mother, who is Spanish speaking only, broke down and informed the nurse practitioner through an interpreter that she was “being abused by her husband”. After evaluating the child, the mother was given the phone number for The Spring, a domestic violence shelter in Tampa. After evaluating the child, and making recommendations, the mother left the van. We saw the mother with her child 2 weeks later when the USF Pediatric Ronald McDonald Care Mobile visited The Spring. She hugged everyone crying and thanking the van team for providing the information about The Spring. She reported that after seeing us on the van her husband again beat her. The police were involved and she made her way to The Spring, where she now feels safe. This woman could still be in an abusive relationship if the van not been at that particular school to provide care and information. Her child is now being followed by a school psychologist and doing ok.

• A 17 year old female student was evaluated on the Care Mobile for a sports physical. The student appeared very thin and sad and would not make eye contact with the provider. She would not freely talk to the provider and would only answer the provider’s questions in very few words. The provider noted that the student had a speech deficit and was unable to articulate clearly. The school nurse mentioned to the provider that the student had suffered an accident to her mouth five months ago and broken all her front teeth. She had been treated at an emergency room and given a referral to a dentist. Her mother mentioned to the provider that the dentist had charged her a lot of money to provide a prosthesis but she was still very upset about her appearance and her inability to talk clearly. Mom also said that her daughter had lost a lot of weight and was not interacting with any of her friends. The school nurse had referred the student to the school psychologist for depression and weight loss. The mom stated she had no health or dental insurance at the time. The student was then referred to a periodontal dentist who volunteered to examine the student and evaluate her dental condition. The student was seen by the periodontal dentist for two visits. The periodontal dentist replaced her prosthesis and suggested that she needed further evaluation by an oral surgeon in the future. The student was very pleased that she looked better & could talk better.

• A 14 year old at a middle school had been treated for hypertension with a medication but then lost his funding and was taking his grandmother’s medication intermittently for over a year. The school nurse called the Care Mobile asking for some help. The Care Mobile Program was able to evaluate the student and write a prescription for the medication the student was previously on and then find funding to pay for the prescription. Additionally, the van team helped the parent apply for further health care funding.

• Two female adolescents were evaluated on the Care Mobile for chronic abdominal pain. They were both found to have chronic pelvic inflammatory disease, which can lead to serious complications, to include sterility, if not properly treated. One of the students required hospitalization and then surgery. The other student was evaluated and treated by an adolescent pediatrician. Both students had funding but no access to a physician. The Care Mobile provided the needed access!

• An athletic 16 year old male who had such a painful knee that he was unable to participate in sports or even walk much. He had been using a knee brace to walk around school for over a year. The student was unaware of his funding status. The student was evaluated on the Care Mobile and his parent contacted. The student had funding so he was referred for knee x-rays and an orthopedic evaluation. He is no longer using the knee brace and participating fully in sport activities. Without this attentive care, his knee injury may have resulted in permanent damage.

• An 11 year old student was referred to the Care Mobile because of a chronic cough described as “barking”. The student had been seen by his pediatrician several times without any change in the student’s condition. The mother was very concerned and asked if the child could be evaluated on the Care Mobile. The student was evaluated and then because the student had funding, the student was referred to a pediatric ear, nose and throat doctor that day. The student’s coughing resolved and he is doing well.

Public health student Juan Santiago (back, standing) observes a Dominican health promoter teaching a cardiovascular health education class.

Dr. Wayne Westhoff and Dr. Jaime Corvin of the Department of Global Health, USF College of Public Health, traveled to the Dominican Republic this May on a yearly academic and field study with public health students Brian Cull, Juan Santiago and Rebecca Sorenson. The course was Global Health Challenges, and this year students experienced some common challenges faced by researchers working globally.

The students first received training in the United States in two health promotion programs: cardiovascular health education classes and breast self-exam training. Then they worked with community partners in the Dominican Republic in collaboration with Fundación Familia Sana – Dominican Republic, a non-profit organization active in the Dominican Republic, Venezuela and Tampa.

Students learned the importance of community-based work, participating in a train the trainer program and working side-by-side with community partners to implement an eight-session health education program, Dr. Corvin said. While the students have since returned to USF, community partners continue the Ama tu Corazon (Love your Heart) cardiovascular health education program — promoting cardiovascular health, educating about risk factors and strategies to reduce risk, using culturally appropriate and language-sensitive materials.

“For me, this experience was great.. The students did a tremendous job," Dr. Corvin said. "We talk about community-based work, implementation techniques and pitfalls in the classroom. However, getting your feet muddy (literally) is where you really learn!”

Dominican promatura, or health promoter, Altagracia (second from left) with USF public health students (left to right) Brian Cull, Rebecca Sorenson and Juan Santiago.

Students learned some of the challenges of fieldwork first hand and were forced to make their own decisions when faced with the unexpected, Dr. Corvin said. Additionally, they learned the importance of working closely with the community, she added.

"Compared to the United States, the Dominican Republic has higher rates of poverty, higher rates infectious diseases, lack of housing, lower access to clean water among a plethora of public health issues," said student Rebecca Sorensen. "But despite the health challenges that face the population, they embrace life with courage, determination and a fierce commitment to their family and friends. What I will most remember about my time spent in the DR is the warmth of the people and how I was accepted into their homes and lives; it is a rare and precious gift."

The group also initiated a breast health education campaign with community health workers to educate on early detection of breast cancer. As a Mammacare specialist, Dr. Corvin also trained two physicians and three nurses in the MammaCare method of breast examination, an advanced technique used by health professionals during clinical breast exams and for teaching patients breast self examination.

Left to right: Dr. Wayne Westhoff and Dr. Jaime Corvin, both of the Department of Global Health, USF College of Public Health, with Doctora Flavia Garcia, Secretary of State of Women in the Dominican Republic.

Drs. Westhoff and Corvin met with Doctora Flavia Garcia, the Secretary of State of Women, to discuss the MammaCare project. Drs. Westhoff and Corvin were invited by Dr. Garcia to submit a proposal to expand breast self-examination training in the country.

Fundación Familia Sana–Dominican Republic expressed their thanks to USF faculty and students for working side-by-side with them on some important health challenges. The organization also works with other public health issues, such as school programs, HIV/AIDS, disaster management, and domestic violence, in collaboration with Fundación Familia Sana in Tampa.

Dr. Westhoff later returned to the Dominican Republic for meetings with Washington University, the Ministry of Education, and Fundación Familia Sana to begin planning a USF project on adolescent suicide.

Story by Susan James and Dr. Jaime Corvin
Photos by Dr. Jaime Corvin

Dr. Edwin Weeber uses a multidisciplinary approach to help understand the brain's wiring

Tampa, FL (June 20, 2007 ) -- Edwin Weeber, PhD, a neuroscientist who studies the molecular mechanisms underlying learning and memory, has joined USF Health’s Department of Molecular Pharmacology and Physiology as an Associate Professor. Dr. Weeber’s work focuses on how neurodegenerative and neuropsychiatric disorders, such as Alzheimer’s disease, schizophrenia and bipolar disorder, affect human cognitive ability.

He came to USF Health from Vanderbilt University Medical Center in Nashville, TN, where he was an assistant professor at the Department of Molecular Physiology and Biophysics and the John F. Kennedy Center for Research in Human Development.

Dr. Weeber is the principal investigator for a $1.2-million grant from the National Institute on Aging. He is studying the role that the protein Reelin plays in regulating and changing nerve cell connections in the hippocampus – a region of the brain where new memories are formed.
“There is a clear commitment here to expand scientific research and the opportunity to be part of that process made USF an especially attractive institution,” Dr. Weeber said.

“Dr. Weeber brings a strong scholarly record to USF Health,” said Bruce Lindsey, PhD, professor and chair of Molecular Pharmacology and Physiology. “He is exceptionally skilled at using the latest genetic techniques to study cognition at the molecular, cellular and behavioral levels, and with his multidisciplinary background and research interests he has built strong collaborations with colleagues from around the world.”

“Dr. Weeber is a rising star in the field of learning and memory, and we’re very fortunate to have attracted him at this point in his career,” said David Morgan, PhD, co-director of the Signature Interdisciplinary Program in Neurosciences and director of the Alzheimer’s Research Laboratory in the Department of Molecular Pharmacology and Physiology. “We look forward to working with him on new approaches to solving the problems of Alzheimer’s and Parkinson’s disease.”

“Dr. Weeber’s work is particularly exciting because his discoveries may lay the foundation for new treatments for patients with neurologic and psychiatric diseases," said Robert A. Hauser, MD, co-director of the Signature Interdisciplinary Program in Neurosciences and director of the Parkinson’s Disease and Movement Disorders Center. “He will further strengthen the bridge from basic to clinical research here at USF.”

“USF and USF Health have made a strategic commitment to continue to enhance their research capacity and to create an environment that facilitates interdisciplinary research. Recruitment and retention of outstanding faculty and students is critical for our success and Dr. Weeber epitomizes the quality of NIH-funded faculty that USF Health is recruiting.”

-- Abdul S. Rao, MD, MA, DPhil, senior associate vice president, USF Health, and vice dean for research and graduate affairs, College of Medicine.

In a study detailed in the March 2007 issue of Nature Neuroscience, Dr. Weeber and colleagues essentially cured mice with the mutation that causes Angelman syndrome, a rare genetic disorder characterized by mental retardation, movement and balance problems, and seizures. They reversed all the animals’ neurological deficits by preventing the inhibition of CaMKII, an enzyme critically involved in learning and memory functions at synapses. Their findings may point to new therapeutic targets for the debilitating disorder, which affects approximately one in 15,000 children.

Dr. Weeber holds a PhD in neuroscience from the University of New Mexico College of Medicine in Albuquerque, NM, and completed a post-doctoral fellowship at the Baylor College of Medicine’s Division of Neuroscience. He has received several national awards, including the National Alliance for Research on Schizophrenia and Depression Young Scientist Award and the American Federation for Aging Research Award. He has published more than 40 papers and several book chapters, and serves as
a special study section grant reviewer for the National Institute of Neurological Disorders and Stroke.

Dr. Weeber can be contacted by calling (813) 396-9995 or e-mailing eweeber@health.usf.edu

- USF Health -

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

Story by Anne DeLotto Baier

Team science award focuses on nanotechnology to diagnose and treat cancers

Tampa, FL (June 20, 2007) -- Several researchers at USF Health will receive more than $1.3 million in funding through the Florida Department of Health’s 2007-08 James and Esther King Biomedical Research Program. The King Program supports biomedical and behavioral research for the prevention, diagnosis, treatment and cure of tobacco-related diseases, including cancer, heart disease and stroke.

This year the King program, selecting from 55 proposals, competitively awarded 23 research grants worth more than $8.3 million to Florida scientists across the state. The funding begins July 1. USF Health researchers received three of the King Program grants – including one of two team science project grants and two of seven bridge grants:

• Shyam Mohapatra, PhD, Division of Allergy and Immunology, Department of Internal Medicine, “Engineered Nanoparticles for Biomarker Detection and Targeted Drug Delivery,” $939,184, two-year team science project grant. Other team members include Subhra Mohapatra, PhD, Department of Interdisciplinary Oncology, the Moffitt Cancer Center; and Shekhar Bhansali PhD, College of Engineering, Nanomaterials and Nanomanufacturing Research Center. This grant requires a 25-percent match from USF, which will bump the amount to $1.2 million.

• Eric Bennett, PhD, Department of Molecular Pharmacology and Physiology, “Role of Non-Peptide Domains in Sodium Channel Function,” $188,000, one-year bridge grant

• Alison Willing, PhD, Department of Neurosurgery, Center for Aging and Brain Repair, “Splenic Mechanisms of Cord Blood Induced Brain Repair,” $188,000, one-year bridge grant.

Team science grants, which support interdisciplinary group projects, are designed to make Florida institutions more competitive in applying for high-level grants offered by the National Institutes of Health. Bridge grants provide interim support for promising investigator-initiated projects that were highly rated in recent NIH peer-reviewed competitions, but not funded due to federal budgetary constraints.

“Our faculty have had unprecedented success this year in obtaining grants from this very important source of competitive funding in the State,” Abdul S. Rao, MD, MA, DPhil, senior associate vice president for USF Health and vice dean for research and graduate affairs at the College of Medicine. “This accomplishment underscores the fact that in light of NIH funding challenges, investigators have to seek alternative sources of extramural support to continue to grow their research capacity.”

The Power of Small: Finding new ways to detect and destroy cancer

Dr. Shyam Mohapatra will work with faculty members Dr. Subhra Mohapatra at Moffitt Cancer Center, and Dr. Shekhar Bhansali at the College of Engineering, on harnessing the power of nanotechnology to detect and treat lung and prostate cancers. Nanotechnology involves the study and synthesis of exceedingly tiny things (1 nano is one-millionth the size of a pinhead) – including particles so small that they can carry therapeutic genes or drugs into specific tumor cells.

“It’s really an interdisciplinary team technology project intended to advance our understanding of the fundamental biology of lung and prostate cancers and translate these findings from the laboratory to the clinic,” said Dr. Mohapatra, the Mabel & Ellsworth Simmons Professor of Allergy and Immunology. “The grant will help us develop the research infrastructure and preliminary data needed to attract federal nanomedicine grants down the road.”

Dr. Mohapatra directs basic science research for the Joy McCain Culverhouse Airway Diseases Center. His laboratory has already shown that nanoparticles made of chitosan, a naturally biodegradable substance found in shellfish, can safely and effectively deliver therapeutic genes into cells lining the lungs and reverse ongoing asthma in mice.

The Florida team grant will fund three areas of nanotechnology research, and expand training of undergraduate, medical and postdoctoral students in this new translational field.

The first project teams Dr. Bhansali of Engineering with Arun Kumar, PhD, and Prassana Jena, PhD, both from Internal Medicine. The researchers will develop “microfluidic” chips to detect and analyze proteins from lung and prostate cancer cells. These gold nanowire wafers -- essentially miniscule diagnostic labs on chips the size of dimes – may one day allow a physician to deposit a drop of a patient’s urine, saliva, mucous or blood on the chip and detect cancer genes in a matter of minutes instead of days. Such nanotechnology could help oncologists begin treatment sooner, design individualized therapy, and even monitor how well that therapy is working, Dr. Mohapatra said.

The second project, conducted by Dr. Shyam Mohapatra and Wilson Xu, PhD, of Internal Medicine, will investigate chitosan nanoparticles modified to release anticancer genes or drugs into the diseased area of the lung as needed in response to a tumor-specific cellular trigger, while sparing healthy tissue. Mohapatra describes the approach as similar to that of a heat-guided missile designed to seek and destroy only its target on command. The intended result is safer, more effective treatment than conventional chemotherapy, which kills healthy cells as well as cancerous ones with its blanket-bombing approach.

In the third project, Moffitt’s Dr. Subhra Mohapatra will test the safety and effectiveness of nanoparticles in treating prostate cancer. The researcher aims to establish “proof of concept” for a prostate-specific targeting strategy, which will deliver a novel small molecular drug cocktail using chitosan-conjugated nanoparticles to prostate tumors in mice. Multifunctional nanoparticles provide the unique opportunity to combine two drugs that can be jointly targeted to the same cell for the maximal therapeutic effect, Dr. Shyam Mohapatra said. If successful, he said, the approach would aid significantly in the development of a new treatment for metastatic prostate cancer, particularly androgen-independent prostate cancers, for which no effective life-prolonging therapy is available.

Getting to the heart of cardiac arrhythmias

Cardiac arrhythmias, or heart rhythm disorders, are a leading cause of sudden death and the risk of these deadly rhythm disturbances increases in smokers suffering from heart failure. Eric Bennett, PhD, associate professor of Molecular Pharmacology and Physiology, studies the regulation of heart rhythms and how they become irregular in diseased hearts. With the Florida bridge grant, Dr. Bennett and colleagues propose a new model for regulating the heart’s electrical system, which could lead to new therapies for preventing deadly cardiac arrhythmias.

Every beat of the heart is orchestrated by an elaborate synchronization of electrical signals across all cells in the heart. The work of ion channels is essential for coordinating electrical impulses and maintaining normal heart rhythms. These protein pores in the cell membrane selectively regulate ion flow into and out of the cell.

Sugars play a key role in cardiac ion channel function and may also change the electrical system that controls the heart’s ability to contract and pump blood. Dr. Bennett’s team will investigate how altering sugars attached to the ion channel protein may impact electrical impulses among chambers of the heart in neonatal and adult mice. If the electrical impulses are disrupted, the susceptibility to deadly heart rhythm disorders would likely increase.

Exploring the brain-spleen connection in stroke recovery

Alison Willing, PhD, associate professor of neurosurgery at the USF Health Center for Aging and Brain Repair, has demonstrated that intravenously administering human umbilical cord blood (HUCB) cells to rats following a stroke greatly reduces the brain’s inflammatory response and stroke size, and improves recovery. These studies also indicated that the spleen’s typical reaction to stroke – reduced size and increased inflammatory response – is inhibited following HUCB transplantation. Based on these early observations, Keith Pennypacker, PhD, associate professor of Molecular Pharmacology and Physiology, has shown that the inflammatory response after stroke is a major component of the disease.

In the bridge grant study, Dr. Willing will work with Dr. Pennypacker and Paul Sanberg, DSc, PhD, professor and director of the Center for Aging and Brain Repair. They will test the hypothesis that HUCB’s ability to promote recovery in the brain is critically dependent upon inflammatory and anti-inflammatory changes these cells trigger in the spleen, a major immune system organ. The researchers will evaluate stroke recovery in rats without spleens – both those administered HUCB and those without HUCB treatment.

Their work may lead to a better understanding of how the body’s entire immune response impacts brain damage after stroke and how cord blood cells intervene to help protect the brain and restore function. The research may also help identify other potential targets for treatment of stroke, the third leading cause of death and number one cause of disability, Dr. Willing said.

- USF Health -

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

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

"(EXER)GAMING FOR FITNESS"
Courtesy: USF Magazine

“While conducted here in Tampa, the outcome of this research has global implications", says Abdul Rao, Senior Associate Vice President USF Health.

Childhood obesity is a national epidemic, according to alarming reports regularly released by fitness experts at colleges and universities across the country. Video games, according to some studies, are part and parcel of a sedentary childhood lifestyle that can lead to weight problems and, ultimately, serious health issues for children.

But is it possible that certain types of interactive video activities can be part of the solution, an innovative, effective method of combating childhood obesity?

That's what Stephen Sanders, director of the USF School of Physical Education, Wellness and Sport Studies, hopes to determine via research being conducted at the XRKade Research Lab, the nation's first interactive fitness research lab for children.

The lab, which opened its doors in January, is the result of a unique partnership between the USF School of Physical Education & Exercise Science (in the USF College of Education) and iTECH Fitness of Denver, Colo. Among the technology driven activities installed in the lab are Dance, Dance, Revolution; Cateye game bikes; X-board; 3-Kick; and Cybex Trazer.

"Some of these activities have become part of our American culture", Sanders says. "Video games are not going away. These games require that children must be physically active in order for the game to work. For example, the faster a child pedals the game bike the faster the car will go on the video screen. Or, the more a child jumps while wearing the Cybex Trazer belt the more points he or she can score in the video game. The physical activity possibilities are endless."

Interactive fitness, also known as "exergaming", the use of technology-based interactive activities (including video games) in order to raise physical activity levels in children, is increasingly being used by public school systems, YMCAs, recreational centers and private fitness clubs across the United States to help children of all ages increase physical activity levels and maintain a healthy weight. Although exergaming has increased in popularity, little research is available to suggest the kind or degree of impact that these interactive activities have on fitness and activity levels.

"We don't really know the long-term impact of exergaming", Sanders says. "The XRKade is really the only university lab like this, with 15 different types of activities that can be used by children, and observed by researchers. Other schools mostly have looked at single pieces of equipment.
We¹re going to experiment with all of the different types of equipment and find out how children feel about the activities. Are they fun or not? Which ones are they most excited about?"

The mission of the XRKade Research Lab is threefold, according to Sanders.
First, the lab will be a resource for working elementary and middle school teachers, as a place to obtain reliable information on exergaming and its benefits. Secondly, the lab will help to prepare undergraduate education majors to prepare for their roles in the work force, in terms of helping future students with physical-fitness regiments. The lab will also be a center for research, to be conducted by several departments within the College of Education, and in collaboration with pediatric physicians at the College of Medicine and researchers from other departments across campus.

Robert Nelson, MD, Chair of the USF Department of Pediatrics College of Medicine says the effort is especially in sync with what's happening with kids today. "I am convinced that ideas like these that show an understanding of children and uses that understanding to improve children's overall lifestyle will be a tipping point to achieve the goals. Further, multi/interdisciplinary efforts demonstrated by this project are the type of activity that I very much want to encourage and support."

"While conducted here in Tampa, the outcome of this research has global implications", says Abdul Rao, MD, MA, DPhil, Senior Associate Vice President USF Health and Senior Associate Vice President for Research USF. " This type of research brings physicians, health care providers, educators, and students together as a team to enhance physical activity in children while they are having fun. Early intervention is the key to successfully overcoming childhood obesity."

What are the implications of the increased use of exergaming equipment among children? Does exergaming actually increase children's fitness levels? What are the social and academic benefits of interactive gaming activities? Are there benefits for special needs students? Which types of interactive fitness games are most appealing to children, and why? Researchers at the XRKade lab will investigate these questions and others over the coming months and years.

"The big picture on all of this is that as educators, we're trying to create a culture of physical activity", Sanders says. "Typically, there is time in schools set aside for children to be physically active. We want to make sure that qualified teachers are available to help kids reach their fitness goals."

The XRKade lab was funded through donations from iTECH Fitness and their corporate partners, who together will support the USF lab¹s research for a period of as long as five years.

"We are extremely excited to be working with USF on this project and we believe that the research will only help solidify the positive effects we have seen throughout the country in exergaming fitness clubs", said Michael G. Hansen, COO and co-founder of iTECH Fitness.

Courtesy of USF Magazine. Story by Philip Booth.
Photography by Joseph Gamble

Six professors recommended by their peers have been selected for a new USF Health-wide awards program. The charter group of Distinguished University Health Professor (DUHP) honorees is comprised of Michael Barber, PhD; Carol Bryant, PhD; Mary Evans, PhD; Jeffrey Krischer, PhD; Bruce Lindsey, PhD; and Richard Lockey, MD -- all recognized for their substantial achievements in research, teaching or clinical care.

The DUHP program, initiated by Stephen K. Klasko, MD, MBA, dean of the College of Medicine and vice president for USF Health, mirrors the campus-wide Distinguished University Professor (DUP) program. USF Provost Renu Khator, PhD, recently announced this year’s three DUP recipients -- from Medicine, Engineering and Marine Science – including Santo Nicosia, MD, professor and chair of the Department of Pathology and Cell Biology.

“Like the Distinguished University Professorship, the Distinguished University Health Professor award, through its process of rigorous external peer review and internal recommending review, identifies those holding it as outstanding members of their profession,” Dr. Klasko said. “They are to be congratulated for this achievement.”

Nominees for DUP were recommended to Dr. Khator, while nominees for DUHP were forwarded to Dr. Klasko.

As leading experts in their fields, the DUP and DUHP faculty members attract millions of dollars a year worth of federal research to USF, publish in prestigious journals, mentor students who have earned top spots as health leaders in their disciplines, and share their time and talent with the community.

• Dr. Nicosia is professor and chair of the Department of Pathology and Cell Biology in the School of Biomedical Sciences, College of Medicine. He is a world-renowned leader in the reproductive biology, and, most recently in the biology of ovarian cancer. Dr. Nicosia has brought more than $10 million in external funding to USF and has led a multidisciplinary team of USF-Moffitt researchers working to shed light on the formation of ovarian cancer, the deadliest gynecological cancer.

• Dr. Barber is professor of Molecular Medicine and Interim Associate dean for Postdoctoral and Graduate Affairs, College of Medicine. He has an outstanding record as a mentor and leader in developing and implementing interdisciplinary and cross disciplinary graduate programs at all levels (PhD, Masters and Graduate Certificate). He has had external grant support from the National Institutes of Health and other sources totaling approximately $5 million.

• Dr. Bryant is professor of Community and Family Health and co-director of the Florida Prevention Research Center, College of Public Health. Through the annual Social Marketing in Public Health Conference and Field School, the FRPC, the Graduate Certificate in Social Marketing and her consultations to national, state and local organizations, Dr. Bryant helped put USF on the map as a vital sponsor of cutting-edge health social marketing programs. Over the last five years, Dr. Bryant and the FPRC have been awarded nearly $6 million in competitive grants and contracts.

• Dr. Evans is professor and associate dean for Research and Doctoral Study, College of Nursing. She has been instrumental in substantially increasing external funding for the College of Nursing. An internationally recognized expert in children’s psychiatric problems, Dr. Evans has received funding of more than $13 million over her career, primarily from the National Institute of Mental Health.

• Dr. Krischer is professor and chief of the Division of Bioinformatics and Biostatistics, Pediatric Epidemiology Center, Department of Pediatrics, College of Medicine. With more than $20 million yearly in National Institutes of Health funding, Dr. Krischer ranks in the top 5 percent of all NIH-funded investigators over the last 30 years. He is internationally known as a leader in the field of Type 1 Diabetes epidemiologic and preventive research and, most recently, rare disease research. He has been a key influence in USF Health achieving the distinction of Top 10 NIH-funded Pediatrics Departments among U.S. medical schools.

• Dr. Lindsey is professor and chair of Molecular Pharmacology and Physiology, College of Medicine. A world-renowned leader in computational neuroscience, he is helping define the connectivity of brainstem respiratory neurons involved in the peripheral and central regulation of breathing. Dr. Lindsey has received continuous NIH funding as a principal investigator for more than 20 years, including his most recent Javits Neuroscience Investigator Award – a prestigious, seven-year, multimillion dollar grant from the National Institute of Neurological Disorders and Stroke. He was instrumental in establishing an interdisciplinary research team with one of the world’s most advanced laboratories for studying brainstem neural networks.

• Dr. Lockey is professor of Medicine, Pediatrics and Public Health, and Director of the Division of Allergy and Clinical Immunology, College of Medicine. He has developed an Allergy and Immunology Division internationally known for its research, academic productivity and residency program. The Clinical Research Unit he oversees attracts numerous pharmaceutical grants and is a member of the American Lung Association’s Asthma Clinical Research Center, one of 20 such centers across the United States.

In addition to receiving a $5,000 base salary adjustment, honorees will be invited to give either a University-wide or USF Health address during the academic year, and granted the State University System title of Distinguished Professor.

Dr. Nicosia will be formally honored during the Fall 2007 Faculty Honors and Awards Ceremony next semester. Dr. Klasko will hold a USF Health reception to recognize each of this year’s DUHP scholars. A commemorative medallion will be created for the DUHPs, similar to the one now given to DUPs to wear at graduations and other academic ceremonies. A Distinguished USF Health Professor Annual Lecture Series will be established to give honorees an opportunity to speak at the annual Research Day, convocation or the commencement of each academic year.

-- Story by Anne DeLotto Baier

- USF Health-

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

Story by Anne DeLotto Baier

On June 13, 2007, the Tampa Tribune newspaper published the following editorial on approval of the USF Orthopaedics Surgery Residency Program.

USF Health Scores Significant Win With New Orthopedics Program
June 13, 2007
Tampa Tribune Editorial

The approval of an orthopedics residency program at USF Health is a big deal for three reasons:
First, it sends a signal that our community medical school is committed to growing excellence and attaining national stature - a good as well as our economy.
Second, the new residency program includes a training segment at the University of South Florida’s primary teaching hospital, Tampa part of the bid until the 11th hour.
And third, it creates a new-style training program for doctors interested in the musculoskeletal system because it allows them to rotate that specialize in the treatment of children, veterans, cancer patients, trauma victims and the challenges of a general orthopedics practice.
Many people deserve credit for getting this deal done, starting with Dr. Steven Klasko, the vice president of USF Health, who has raised school since his arrival three years ago.
Klasko knew the medical school couldn’t attain prominence without orthopedics, which it lost in 1990 when the faculty walked out dean. The surgeons formed Florida Orthopedics Institute, which today performs about a quarter of the surgeries done at Tampa General.
Determined to restore orthopedics at USF, Klasko last October hired Dr. Robert Pedowitz, a renowned orthopedic surgeon from the Diego, to become chairman.
And that changed everything.
Before, the surgeons at Tampa General were willing to train orthopedic residents if they - not the medical school - supervised the program. an orthopedics chair, it was clear that Klasko was serious about controlling the training program and growing the college’s stature.
So when Tampa General refused to join its bid for an orthopedics residency program, the dean solicited other hospital partners - a The medical school long has done most of its training at Tampa General, the James A. Haley Veterans Hospital and the H. Lee Moffifi of orthopedics, it will also partner with All Children’s, University Community, Lakeland Regional and the Shriner’s Hospital for Children.
Because his orthopedics department is new, Klasko knew he faced an uphill battle with the accreditation agency. Without Tampa General’s had a 50-50 chance of approval.
So in the days before the deadline, USF President Judy Genshaft and USF Board of Trustees Chairwoman Rhea Law met with Tampa Mullis and made one last pitch for the greater good.
Tampa General’s board is one of the strongest in town. Its members understand that the hospital’s success is inextricably tied to the does hospital administrator Ron Hytoff, who had done his best to strike a compromise.
Hours before the bid was due, Pedowitz, the newcomer, met with Dr. Roy Sanders, the highly successful head of Florida Orthopedics worked out a deal that put Tampa General in the bid package. It calls for residents to spend six months of their fifi ve-year training program center.
On seeing the complete bid, the accreditation agency approved the residency program.
You might say that Tampa General, which has long held the upper hand, blinked. Certainly, the medical school emerges a stronger But the real winners are the people of Tampa, who want a medical school that attracts the best and brightest, and a teaching hospital and financially healthy.
As the starting pitcher, Klasko deserves to score a win. But the closers in this game - Genshaft, Law, Hytoff, Mullis, Pedowitz and most our heartiest congratulations and thanks for doing the right thing for all.

Sports Medicine faculty members continue to garner kudos for USF Health with two new textbooks at the national level.

Jeff Konin, PhD, PT, assesses the knee stability of 7-year-old Christopher Konin.

Jeff Konin, PhD, ATC, PT, associate professor of orthopaedic surgery and executive director of the Sports Medicine and Athletic Related Trauma Institute (SMART), is the guest editor for Clinics in Sports Medicine: Behind the Scenes as a Team Physician. Dr. Konin is also featured on the book’s cover, assessing the knee stability of his son Christopher Konin, 7, who donned a football uniform for the photo.

In a foreword to the text, consulting editor and University of Virginia orthopedic surgeon Mark D. Miller, MD, writes: “Dr. Jeff Konin, who is a truly superlative athletic trainer and physical therapist… has put together an outstanding issue of Clinics in Sports Medicine, focusing on advice for the team physician. He has assembled an all-star team of physicians, athletic trainers, and physical therapists in a no-holds barred treatise for the Team Doc. This is a great read for team physicians at all levels of experience and for coverage of all levels of teams.”

Dr. Konin writes the lead chapter “Communication: The Key to the Game,” which covers communication skills physicians need to forge successful working relationships with athletic trainers and other key people on the healthcare team. Also writing chapters were SMART Director Larry Lemak, MD, “Financial Implications of Serving as Team Physician” and Charles Nofsinger, MD, assistant professor of orthopaedic surgery, “Negotiating Contractual Relationships.”

Clinics in Sports Medicine: Behind the Scenes as a Team Physician is published by W. B. Saunders Co. For more information go to http://nursingawards.elsevier.com/product.jsp?isbn=9781416042976

A second text Sports Emergency Care: A Team Approach features a chapter on “Emergency Care Considerations for the Pediatric and Youth Athlete” written by Dr. Konin. The chapter covers the epidemiology of youth sports emergencies, the importance of prevention through proper use of equipment, safe playing fields, emergency action plans and pre-participation physicals, as well as the prevalence and management of acute emergencies.

Sports Emergency Care: A Team Approach is published by Slack Incorporated Publishing. For more information go to http://www.slackbooks.com/view.asp?slackCode=47980

Lastly, the May 2007 issue of NATA News, the news magazine of the National Athletic Trainers’ Association, features a comprehensive story about SMART and its initiatives to improve the sports safety standards in Florida. The article “SMART: Immediate Care, Long-Range Benefits” quotes Dr. Konin and Dr. Lemak. NATA News reaches some 35,000 athletic trainers across the country.

David Vesely, MD, PhD

A pioneer in the field of heart hormone research, David Vesely, MD, PhD, is a 2007 Finalist for the Career Achievement Medal awarded by the Partnership for Public Service (PPS). Dr. Vesely is a professor of Medicine and Molecular Pharmacology and Physiology at USF Health and chief of Endocrinology, Diabetes and Metabolism at the James A. Haley Veterans’ Affairs Medical Center in Tampa.

Dr. Vesely is one of three finalists competing in the PPS category for Career Achievement Medal, an award recognizing a lifetime of accomplishments in public service by a federal employee. Honorees are chosen based on their commitment and innovation, as well as their work’s impact on addressing the needs of the nation. Medal winners are announced each September at the Service to America Medals (Sammies) awards ceremony in Washington, D.C. See 2007 Finalists—Career Achievement Medal.

In the last 25 years, Dr. Vesely has discovered three hormones made by the heart that, because of their ability to lower blood pressure and promote the excretion of excess salt, may significantly benefit the treatment of congestive heart failure, kidney failure and cancer. Within in a 24-hour timeframe, the cardiac hormones are capable of eliminating in test tubes as many as 97 percent of human pancreatic, prostate, breast, colon, and kidney adenocarcinomas.

Many of the most common forms of cancer -- breast, colon and prostate cancers -- are adenocarcinomas. These cancers, which begin in cells that line certain internal organs, have gland-like properties. Pancreatic adenocarcinoma is the most lethal of all cancers. Even with surgery and current cancer chemotherapy, patients with pancreatic cancer are expected to live only four months after the disease takes hold.

Dr. Vesely’s work, published earlier this year in the journal In Vivo, has shown that up to 80 percent of human pancreatic adenocarcinomas growing in laboratory mice can be cured. Even in human pancreatic cancers that are not cured, the tumor volume decreases to less than 10 percent of that in untreated mice. In this case, Dr. Vesely found, the mice do not succumb to cancer, but rather continue to live a normal lifespan.

The death of Dr. Vesely’s wife, Clo, in 2002 from breast cancer spurred him to expand his research beyond pancreatic cancer. As a result, Dr. Vesely found that two of the cardiac hormones he discovered eliminated two out of every three human breast carcinomas growing in mice, with the third hormone eliminating 50 percent.

Dr. Vesely’s path of discovery can be traced back to his home state of Nebraska, where he was a member of Creighton University’s class of 1967. Next, he pursued an MD and PhD at the University of Arizona, completing the two degrees in three years. In 1969, he received a prestigious National Institute of Health scholarship, which at the time was awarded to only two people.

The Tampa VA medical center, where Dr. Vesely works, cares for more than 1.5 million patients each year, making it the nation’s busiest outpatient veterans’ medical center. It has earned national distinction as a Diabetes Center of Excellence, one of only two in the entire VA medical system.

Dr. Vesely had been a faculty member at the USF College of Medicine since 1989. He helped establish and directs the USF Cardiac Hormone Center, a multidisciplinary center with faculty from Molecular Medicine, Internal Medicine, Obstetrics and Gynecology, and Molecular Pharmacology and Physiology.

Throughout his career, Dr. Vesely has been recognized as an outstanding supervisor, teacher and mentor to medical and graduate students, residents, fellows and postdoctoral fellows. He has compiled an impressive portfolio, with 296 peer-reviewed scientific publications and three books to his credit. He received the Outstanding Teacher Award three times and has frequently been the featured speaker at major national and international scientific conferences.

Dr. Vesely plans to begin a clinical trial further testing the heart hormones in patients with congestive heart failure, and continues to seek partners for clinical trials with cancer patients.