For years, Sarah Maloney’s definition of “planning ahead” meant figuring out how to get through another day.

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.

Maloney with Dr. Jamie Winderbaum Fernandez

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.

The robot-assisted cervical stitch surgery, performed through the abdomen, was a first for Tampa General Hospital

Tampa, FL (Oct. 26, 2012) – A long-delayed dream came true  this week at Tampa General Hospital when Cynthia Coniglio finally delivered a healthy baby girl at 38 weeks. Over the years, Coniglio, 38, struggled through lost pregnancies because her cervix was too short to close tight enough throughout pregnancy to keep the baby in place.

For years, surgeons have treated insufficiencies of the cervix in pregnant women with what’s called cerclage – a single stitch to hold the cervix in place and help prevent a miscarriage or preterm birth. Also known as “cervical stitch surgery,” the procedure is traditionally done through the vagina, but when this is technically difficult or impossible the cerclage can be done through the abdomen.

Cynthia Coniglio snuggles with her baby daughter Raven, just a few days old.

 Coniglio had already experienced a failed transvaginal cervical stitch surgery and lost part of her cervix to other previous complications when she sought out USF Health’s Maternal Fetal Medicine team at Tampa General.  Her 18-month-old daughter Clover was born several months prematurely, and requires special medical care.

“I just couldn’t to go through another emotional rollercoaster of a miscarriage or spending months in the neonatal intensive care unit,” said Coniglio, who lives in Brooksville, FL.  “I believed if anyone could save my pregnancy it would be physicians at a teaching hospital, because they try new things.”

Coniglio’s complex case lended itself to innovative thinking about how to best reduce risk to mother and baby. 

Valerie Whiteman, MD, interim director of Maternal-Fetal Medicine at USF Health, enlisted the help of  Urogynecology Director Lennox Hoyte, MD, an expert in laparoscopic gynecological surgery using the da Vinci robot.  In June, once Coniglio reached 12-1/2  weeks of pregnancy, Dr. Hoyte and Whiteman used the daVinci robot to create the cerclage through the abdomen, and seal the cervix long enough for Coniglio’s healthy delivery.

It was the first robot-assisted transabdominal cervical cerclage at Tampa General Hospital. 

USF Health’s Dr. Lennox Hoyte, left, and Dr. Valerie Whiteman, right, with patient Cynthia Coniglio and her new baby girl, at Tampa General Hospital.

“Cynthia’s cervix was so short that it was like keeping the baby in a house with no foundation,” Dr. Whiteman said. “Most cervical cerclages are still done transvaginally, but that wasn’t feasible here, so we decided to go in from above (with several small stitches through the abdomen).”

“When you’re negotiating the tight spaces of a pelvis, with a pregnant uterus and big blood vessels, there’s no room for error,” she said. “The beauty of the robot is that it can articulate in places that the surgeon’s hands can’t, thereby reducing potential risks.”

Laparoscopic, or minimally invasive surgery, involves the doctor making several small incisions used to slip in tiny cameras and specially designed surgical instruments to perform the procedure.  Surgeons manipulate these instruments inside the body remotely with devices similar joysticks, while visualizing what’s happening from video monitors near the operating table. 

Dr. Hoyte describes the process like “operating with chopsticks.” The integration of robotics into this process allows surgeons to precisely direct challenging procedures as if they were using their own hands and fingers. The dexterity and superior visualization of the robotic system helps complex surgical procedures, such as an advanced cervical cerclage, go more smoothly, he said.

But, Dr. Hoyte emphasized, the real story is not the technological advances but the happy outcome for all.

Coniglio’s cervix remained stable for the rest of her pregnancy. She delivered a full-term, 6-pound, 14-ounce, 20-inch baby girl, Raven, by C-section on Tuesday, Oct. 23.

“It’s amazing; I cried when she was born. She looked so big and healthy,” Coniglio said. “She wouldn’t be here without Dr. Whiteman and Dr. Hoyte.” 

-USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities.

-          Tampa General Hospital -

 Tampa General Hospital is a 1,018 bed acute care hospital and is the only Level 1 trauma center on the west coast of Florida. It is the primary teaching hospital for the University of South Florida College of Medicine. It also serves as the region’s only burn center, adult solid organ transplant center and provides specialized rehabilitation services. Tampa General has established centers of excellence in the following clinical areas: cardiac, neurosciences, digestive disorders, orthopedics, infectious disease, high risk and normal obstetrics, and pediatrics. 

Photos by Eric Younghans/USF Health Communications

Media contacts:
Anne DeLotto Baier, USF Health Communications, (813) 974-3303 or abaier@health.usf.edu
Ellen Fiss, Tampa General Hospital, (813) 844-6397 or efiss@tgh.org

Tampa, FL (Dec. 5, 2012) – Douglas A. Holt, MD, FACP, the Andor Szentivanyi Professor of Medicine, has been named director of  the Division of Infectious Disease and International Medicine in the USF Health Morsani College of Medicine Department of Internal Medicine.  His appointment began Dec. 1.

Dr. Holt, who joined the USF medical faculty in 1989, has been the associate director of the Division he will now lead since 2006.   He succeeds John T. Sinnott, MD, as Division Director.  Dr. Sinnott stepped up to become the new chair of USF’s Department of Internal Medicine.

Dr. Holt will continue to serve as director of the Hillsborough County Department of Health, responsible for assessing, maintaining and improving health and safety within Florida’s fourth most populous county. 

He is also vice chief of internal medicine and hospital epidemiologist at Tampa General Hospital, a major teaching affiliate of USF Health.

Dr. Douglas Holt

“We are lucky to have a leader like Dr. Holt,” said Dr. Sinnott, the James P. Cullison Professor of Medicine and chair of the Department of Internal Medicine.  “He is a thoughtful, effective and learned physician who inspires all of us to excel.”

“I have been blessed with a career that I love, and am fortunate to be part of an academic community with enthusiasm for learning and an appreciation for meaningful growth,” Dr. Holt said. “As Division Director, I am committed to inspiring and supporting every member of the team as we seize the opportunities that lie ahead.”

Dr. Holt earned his medical degree from the University of South Alabama in 1984. After completing a residency in internal medicine and a fellowship in infectious diseases and tropical medicine at USF, he joined the faculty of the USF College of Medicine as an assistant professor.

He was a member of the inaugural class of the USF Leadership Institute and served as secretary of the College of Medicine Faculty Council and the college’s Financial Oversight Committee.

Dr. Holt twice served as the acting deputy state health officer, from Sept. 2001 to Feb. 2002, and again from May to Sept. 2011.  This fall his outstanding record of public service and leadership was recognized by Gov. Rick Scott with a Distinguished Service to the State of Florida award.

Long recognized for his teaching excellence by students, residents and fellows, Dr. Holt has been the principal or co-principal investigator for more than 60 clinical research studies and authored 21 peer-reviewed publications and several textbook chapters.

A fellow of the American College of Physicians, he is an active member of many state and local organizations.  These include the Hillsborough County Medical Association, American Medical Association, Florida Public Health Association (past president), Public Health Leadership Society, Florida Medical Association, School Readiness Coalition, Hillsborough Community College Foundation Board of Directors, National Association of County & City Health Officials, Children’s Board Advocacy Committee, and the Healthy Start Coalition Board of Directors.

Dr. Holt led an initiative throughout the Hillsborough County Health Department to incorporate quality management and a co-creating philosophy that encourages more active involvement of the department’s customers in the development and improvement of its services. He recently chaired a statewide effort to redesign Florida’s system of care for tuberculosis.

 -USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities.

Media contact:
Anne DeLotto Baier, USF Health Communications
(813) 974-3303 or abaier@health.usf.edu

Jim  Burkhart becomes Tampa General Hospital’s new CEO on Monday, March 4, marking a new era  in USF Health’s longstanding partnership with its major teaching hospital.

Burkhart joins Tampa General  from Shands Jacksonville Medical Center, a private, not-for-profit teaching hospital affiliated with the University of Florida.  He was president and chief executive officer at Shands Jacksonville since 2010, after serving as president and adminstrator there since 2003. 

Jim Burkhart

“We welcome Mr. Burkhart to the Tampa Bay region, and we look forward to working with him,” said Stephen Klasko, MD, CEO of USF Health  and dean of the Morsani College of Medicine, who served on the search committee for Tampa General’s new CEO.

Under Burkhart’s leadership, the operations and financial position of Shands Jacksonville was successfully repositioned.  He also built collaborative relationships and alliances with both academic faculty and community-based physicians that significantly affected the recruitment of key additions to the medical staff and faculty.

“I believe Jim is the best choice to lead Tampa General into the future.  He has demonstrated strong leadership at a fully integrated academic medical center, and will be a great partner for USF Health at our primary teaching hospital,” Dr. Klasko said. “Once Jim has settled in, we will explore new ways in which USF Health and Tampa General can work together for the benefit of our patients and families.  We believe we can strengthen an already close relationship, and that our futures are aligned.”

The long-running and successful bariatric program at Tampa General Hospital entered a new phase when a red satin ribbon was cut April 22, signifying the opening of the Bariatric Center, a joint program of Tampa General Hospital and USF Health.

With expanded multidisciplinary services, the Center now provides a one-location approach to bariatric surgery that includes the critical peripheral services and long-term support each patient needs to succeed in their weight loss.  The Center’s comprehensive team of bariatric physicians, psychologists, dietitians and exercise physiologists will work together to create a customized weight management program for each individual.  Non-surgical weight loss programs will also be offered for those with serious medical issues.

The Center is the first partnership between USF Health and Tampa General Hospital since TGH President and CEO Jim Burkhart, DSc, MSHHA, FACHE, arrived two months ago, a connection USF President Judy Genshaft emphasized in her remarks at the ribbon-cutting ceremony.

“Today, we mark another milestone in the fantastic partnership that has existed between Tampa General and USF for many years, and one that illustrates the power of our collaboration,” she said.

“Tampa General Hospital and USF have long been leaders in bariatric surgery and weight management. We have worked hard to build what is already recognized as one of the best programs in the country.  But we truly believe the people of Tampa Bay region deserve nothing less than the latest and best medical care available, and today we take another step forward to make that happen.”

Dr. Burkhart underscored the TGH/USF partnership, citing it as his main reason for joining TGH.

“Tampa General Hospital is the number one hospital in Florida and is the reason I’m here, and the relationship between USF and Tampa General is the reason I’m here,” Dr. Burkhart said.

USF’s Doctors of USF Health CEO Jeff Lowenkron, MD, agreed.

“We have a strong partnership in which we keep patients at the center of care and then build something around it to help,” Dr. Lowenkron said. “A center like this wouldn’t happen if we didn’t collaborate.”

Michel Murr, MD, director of the Bariatric Center.

Having already earned certifications for quality and designations as a Center of Excellence and already considered the busiest bariatric hub in the southeast –helping nearly 4,000 patients – the bariatric program has been long considered a leader in the Tampa Bay area. In 2005, the TGH bariatric program became the first in the nation to receive disease-specific certification from the Joint Commission on Accreditation of Health Care Organizations.  And in 2007, the program was designated a Bariatric Center of Excellence by the American Society of Bariatric Surgery.

“Fifteen years ago, we asked how do we stem the obesity epidemic and what practical solutions can we offer to those afflicted with obesity on a day-to-day basis,” said Michel Murr, MD, professor of surgery at the USF Morsani College of Medicine and director of Bariatric Surgery at Tampa General Hospital.

“Today, we offer a new patient-centered approach, integrating service lines for obesity and providing them total care, right here.”

L to R:  USF and TGH officials who spoke at the opening included USF President Judy Genshaft; Jim Burkhart, TGH president and CEO; Jeffrey Lowenkron, MD, CEO for the USF Physicians Group; and Deana Nelson, TGH executive vice president and chief operating officer.

In addition to Dr. Murr, surgical procedures are performed by John Paul Gonzalvo, DO, assistant professor of surgery and associate director of the USF/TGH Bariatric Surgery Fellowship Program.

The new Center, a 5,500-square-foot facility in the Harbourside Medical Tower on the Tampa General campus, features examination rooms and education rooms where patients will work with Center staff as they progress through the program. Anyone interested in bariatric surgery must attend one of the informational sessions held at the Center each month. Patients admitted to the program then spend about six months learning the nuances of what bariatric surgery means – the life-long commitment and dietary regimen they face – before surgery is performed.

Meghann Scholl, RD, dietician for the Bariatric Center, with the props she uses to educate patients on making smart food choices, including a model of fat (left) and smooth muscle.

The new Bariatric Center offers several procedures, including gastric bypass, sleeve gastrectomy, adjustable gastric banding, and revisional bariatric surgery. Most of the time, the procedures are performed under general anesthesia and laparoscopically.  Expected weight loss is 43 to 65 percent of the excess weight, depending on which procedure is performed.

But the biggest story, Dr. Murr said, is the improved health.

“People with clinically severe obesity have a much higher mortality rate than those of normal weight,” Dr. Murr said. “Bariatric surgery significantly decreases the incidence of obesity-related diseases, and it considerably improves the quality of patients’ lives.”

Studies indicate that bariatric surgery can improve various  chronic, debilitating health conditions, including diabetes, hypertension, sleep apnea, congestive heart failure, fatty liver disease, hyperlipidemia, heartburn, asthma, arthritis, and infertility.

Bariatric Center patients receive follow-up care and guidance from team dieticians and psychologists as long as they need the assistance to continue with the behavior modifications that help maintain weight loss.

The celebration also included a sports connection with the announcement of a new initiative between the Bariatric Center and retired professional football players.  Working with the Living Heart Foundation, the National Football Players Association, and Covidien (a healthcare products and medical devices manufacturer) the newly opened Center will collaborate on a project called HOPE (Heart, Obesity, Prevention and Education).  This national health screening program for high school and college athletes recently expanded to include current and retired professional football players.

Left to right: Dr Joseph Diaco, Tampa Bay Bucs team doctor for 33 years; Hiram Green, director of USF Health Community Engagement; USF President Judy Genshaft; Jerry Bell, former NFL player and president of the Tampa Chapter of the NFL Players Association; Tyrone Keys, former NFL player; and Dr. Arthur (Archie) Roberts, former NFL player, retired cardiothoracic surgeon and founder of Living Heart Foundation/HOPE (Heart Obesity Prevention Education).

“Our Center will certainly help those retired players who are afflicted with obesity and joint damage, and who have severe limitations for exercise.  They will have access to our expertise for a range of behavior modification techniques,” Dr. Murr said.

The HOPE Program is a comprehensive obesity research initiative designed to promote healthy lifestyles and weight-management among former professional football players. These former players, when compared to smaller-sized men, are more likely to have cardiovascular problems and other health issues associated with being overweight. The HOPE Program was launched in October 2012 at Temple University Hospital.

For more information about the program, visit www.tgh.org/weight.htm or call (813) 844-7473.

- Photos by Eric Younghans, USF Health Communications

Tampa General Hospital’s state-designated Level 1 Trauma Center, led by USF Health physicians, is the first and only one in Florida to earn national recognition from the American College of Surgeons for the quality of both adult and pediatric trauma care.

The hospital’s partnership with the USF Health Morsani College of Medicine was critical for ACS verification of the trauma center.  The center had to demonstrate it met patient care, research and education criteria – all required to fulfill an academic medical center’s mission — to ensure optimal trauma care capability and performance in serving both adults and children. 

The verification followed an extensive review by the ACS Committee on Trauma, which was established to improve all phases of patient care in trauma centers and to prevent injuries before they occur.

“Verification is a very difficult and challenging process that reviews the entire spectrum of care from the moment trauma patients hit the emergency room through the rehabilitation process,” said USF Health’s Dr. David Ciesla, associate professor of surgery at the Morsani College of Medicine and medical director of the TGH adult trauma program.

“The fact we are the only trauma center in Florida to earn this distinction reflects the high quality of care provided by our physicians and surgeons and the hospital’s clinical staff.”

More than 60 percent of the patients at Tampa General are treated by USF Health physicians.

When a subject line of an email reads “your patient Heather Glenday — Univ. of Tampa Swimmer” you pause.

Could this be sad news?

Luckily, it was wonderful news when Karl Illig, MD, professor of surgery and director of the USF Division of Vascular Surgery, opened such an email from his patient’s mother.

***

Photo by Andy Meng, UT

Last year, Heather Glenday, a swimmer for the University of Tampa, had a national title on the line when an odd feeling in her right arm slowed her training. A team trainer knew immediately by the swelling that the UT swimmer needed to get to the emergency room right away. At Tampa General Hospital, it was USF vascular surgeon Karl Illig, MD, who knew that Heather was experiencing Paget-Schroetter syndrome, a condition that causes a vein to be pinched off at the collarbone and upper rib. If left untreated, the vein could potentially clot off as the bone continues to crush the vein. For Heather, immediate surgery was necessary, which included removing that first rib.

Also called venous thoracic outlet syndrome (VTOS) and effort thrombosis, the uncommon condition affects only about 5,000 Americans every year, but is more common in high-performance athletes.

“It’s not unusual, and there is great success after treatment,” Dr. Illig said. “Surgery corrects the problem, with 95 percent of patients living a symptom-free life.”

***

After her surgery last year, Heather spent her summer recuperating at home in New York.

“I’m incredibly lucky to have connected with Dr. Illig, who had already treated patients with this,” she said. “When I went for follow-up exams back home to check the incisions, the doctor there said ‘Oh, you’re the first patient I’ve seen with Paget-Schroetter’s,’ which wasn’t too comforting. I’m so lucky to have found Dr. Illig.”

By fall, Heather returned to UT – she’s a junior studying accounting – and was back in the pool.

And that brings us back to Dr. Illig’s email.

Heather’s mother, Maureen Glenday, was sharing the good news with Dr. Illig that the young swimmer had not only recovered and returned to the pool, but that she was fast enough to help UT earn four NCAA trophies: two for relays and two for individual events.

Here’s what Maureen wrote to Dr. Illig in March.

***

Heather saw Dr. Illig’s this April at the Morsani Center for Advanced Healthcare for her one-year follow-up exam. The ultrasound showed all was well and he gave her a full release, although annual check-ups for the next couple of years are expected.

As a thank you, Heather presented Dr. Illig with a University of Tampa Spartans hat.

***

As if a story of a patient succeeding in life isn’t enough, another caveat is that Heather’s story ties together so many areas of expertise found in Tampa. It’s a story of a community of expert institutions coming together and providing the best care possible. Here are players:

- University of Tampa has a title-winning swim team.

- Well trained athletic trainer recognizes symptoms and acts quickly to get the student to emergency room.

- Tampa General Hospital is affiliated with the USF Morsani College of Medicine, the region’s only academic medical center.

- Dr. Karl Illig has seen and treated this condition before in his training at academic medical centers.

***

To see Heather Glenday winning a 800 yard freestyle relay title for UT post-surgery, check out this video.  Choose the 2013 DII Swimming & Diving Day 3, Evening Session: Full Replay (2:47:18) option and go to about 132/167.1.

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

USF Health and Tampa General Hospital are moving forward together to improve health for Tampa Bay with the approval of a new affiliation agreement.

Tampa General Hospital and Florida Hospital’s Tampa Bay Network also announced Tuesday that they have agreed to jointly develop new clinical programs and services throughout the Tampa Bay region.

Read a memo from Dr. Harry van Loveren, interim dean of the Morsani College of Medicine, on Tuesday’s events here:

Dear Colleagues,

Today marks an important day for the USF Health Morsani College of Medicine, for Tampa General Hospital, and for the future of health care in Tampa Bay.

This morning, the Tampa General Hospital Board of Directors agreed to a new long-term affiliation agreement with the College of Medicine. TGH also announced a new affiliation agreement with Florida Hospital’s Tampa Bay Network.

Today is the day we reaffirm our commitment to Tampa General Hospital, our primary hospital partner and the heart of our teaching program. We are confident that this framework offers us both the flexibility and the strength to carry our partnership forward.

The new agreement is evergreen. It automatically renews each year, so that we never again have to walk “to the edge of the cliff” and face a deadline negotiation. We can now put some of the recent uncertainties behind us and focus on what both our institutions do best: provide incredible care for our patients and teaching and training opportunities for our residents and students.

With these agreements, Tampa General is creating a healthier future – not just for itself, but for all of Tampa Bay. Tampa General is Tampa Bay’s only adult safety net hospital. It is Tampa Bay’s only Level 1 Trauma Center. It is Tampa Bay’s only quaternary hospital. In short, Tampa Bay cannot live without Tampa General. For many of our patients, that is literally true.

Given the dizzying pace of healthcare change, and the recent spurt of hospital mergers and acquisitions, we all recognize that Tampa General needs to grow beyond Davis Islands. We are ready to expand with them. Where they go, we will go. Our mission – to train the best doctors and health professionals for tomorrow – is vital to Tampa General’s future. After all, half of Tampa General’s staff and half of its patients come from USF Health. Together, we can both become stronger.

In choosing Florida Hospital’s Tampa Bay Network as their new partner, Tampa General has chosen an excellent hospital system whose mission aligns with its own. We are fortunate to already count Florida Hospital as a partner, and appreciate both their commitment to nonprofit care and their recognition that academic medicine elevates health care.

We are already working with Florida Hospital Tampa Bay Network in key areas, notably including neurosurgery and cardiovascular care. We look forward to the continued growth and development of this valued partnership.

Please let me know if you have any questions or thoughts about how we can help support Tampa General, and join me in congratulating them.

Harry van Loveren, M.D.

As 2013 winds down and USF Health  moves into 2014,  we reflects on some highlights and accomplishments over the past year.

And, we look ahead in the New Year to renewing our commitment and efforts to improve life in the Tampa Bay area and around the world — through education, research, service and patient care.

The University of South Florida broke ground for its USF Health Heart Institute, a $50-million proposed facility that will combine advanced research and technology with the best cardiovascular care to benefit patients with heart disease, diabetes and stroke.  USF Health will continue working with governmental, hospital and community partners to make the institute a reality.

The USF Health Center for Advanced Medical Learning and Simulation (CAMLS), the world’s largest freestanding center of its kind, passed its first year with more than 14,000 learners from all 50 states and more than 60 countries. CAMLS completed a feasibility study with Panama to build a CAMLS-like facility and is also exploring expanding its academic entrepreneurial business model to Brazil, Mexico and Lebanon.  Healthcare professionals and students aren’t the only beneficiaries of CAMLS’  leading-edge, extensive resources for simulated learning.   In December, the USF Health doctors at CAMLS teamed up with the Florida Aquarium to help diagnose an injured sea turtle, Freud.

The USF College of Nursing continued to attract international attention for its research and education to benefit veterans and service members.  Recently published research by a USF Nursing faculty team suggests accelerated resolution therapy (ART), a brief new therapy to ease symptoms of psychological trauma, may be an option for veterans who do not respond optimally to conventional therapies endorsed by the Department of Defense and VA.  The college began its fourth and largest ART study, which will recruit 200 veterans and service members to study the cost-effectiveness of the therapy and further examine how and why it works. The college also received the largest of nine federal grants to help veterans with healthcare skills earn a bachelor of science degree in nursing.

The Florida Covering Kids & Families program at the Chiles Center for Healthy Mothers and Babies, USF College of Public Health, this summer received the largest navigator grant in Florida – and second largest in the country.  The one-year $4.2-million federal grant to help eligible uninsured individual get health care through the Health Insurance Marketplace drew widespread media attention to the USF navigators and their partners statewide. National coverage included stories in the News York Times, the Washington Post, the New Yorker, Associated Press, TIME magazine, The Huffington Post, Los Angeles Times, and the Wall Street Journal’s MarketWatch.

The USF Health Diabetes Home for Healthy Living opened in August, ushering a new approach to diabetes care.  The new one-stop facility in the Westshore area of Tampa offers diabetes patients a relaxing, home-like environment with every aspect of care to successfully and proactively manage their chronic condition.  The medical home is the newest addition to USF’s leading research, education and clinical care initiatives making life better for those with chronic illnesses like diabetes.

USF President Judy Genshaft appointed Donna Petersen, ScD,  and Harry van Loveren, MD, interim leaders of USF Health after healthcare innovator Stephen Klasko, MD, MBA, dean of the USF Health Morsani College of Medicine and CEO of USF Health, was named to lead a prominent Philadelphia university and hospital system.   Dr. Petersen, dean of the USF College of Public Health, serves as interim CEO of USF Health, and Dr. van Loveren, chair of the Department of Neurosurgery, as interim dean of the Morsani College of Medicine, while the national search for USF Health’s next CEO and medical school dean continues.

The USF College of Pharmacy continued to advance on a fast track as it grows toward a projected complement of 400 students. The incoming College of Pharmacy Class of 2017 represented the largest class in the highly competitive school’s short history – with 107 students selected from among 800 applicants. This past summer the college — with an innovative, rigorous curriculum emphasizing a collaborative approach to patient care and research — was awarded accreditation status by the Accreditation Council for Pharmacy Education.

The Doctors of USF Health campaign introduced this spring informed patients and families across the region that the region’s only academic medical center provides access to the most advanced health care available.  The brand identity linked to USF Health’s launch of a newly designed patient care website with access to nearly 400 highly specialized healthcare professionals.

The first class of USF SELECT students, having completed their first two years of learning at the Morsani College of Medicine, moved to Allentown, PA, to begin two years of clinical education at Lehigh Valley Health Network.  The innovative program, which welcomed its charter class in Fall 2011,  gives students unique training in leadership development, intense coaching, and the scholarly tools they need to become empathetic, passionate physician leaders who will be catalysts for change.

Construction began in March on the USF Health Specialty Care Center in The Villages, setting the stage for a new era and range of health care for residents of “America’s Healthiest Hometown,” the nation’s largest community of people over 55. A ribbon-cutting ceremony will be held Jan. 24, 2014, for the 25,000-square-foot facility, designed as a collaborative complement to The Villages’ expanding primary care network. USF Health doctors representing several specialties will provide high-level care at the new center,

A new master’s degree program in Physician Assistant Studies, based in the Morsani College of Medicine, was approved by the USF Board of Trustees in March 2013. The first class for the interprofessional, two-year PA program will start Summer 2015, initially accepting 24 students, with plans to increase that capacity. The program is an important step forward in addressing the state’s increasing shortage of primary care practitioners.

Tampa General Hospital approved a new long-term affiliation agreement with the USF Health Morsani College of Medicine. The “evergreen” agreement automatically renews each year.  The strengthened partnership will help Tampa Bay’s only quaternary hospital and its only academic medical center to enhance what both institutions do best:  provide leading care for patients and teaching and training opportunities for residents and students.

The USF School of Physical Therapy & Rehabilitation Sciences and the University of West Florida announced a physical therapy partnership program that will offer a Doctor of Physical Therapy (DPT) degree in Pensacola. The collaborative program, approved by the Florida Board of Governors in January 2013, will start in Summer 2014.  It will expand access to UWF students interested in pursuing a DPT and help meet a state-identified need for more physical therapists in a largely rural region of the state.  USF Physical Therapy also continues to lay the foundation for a new PhD program in Rehabilitation Sciences, which was approved by the USF Board of Trustees in December.

The USF College of Public Health greeted new students this fall with a record number of online offerings. Demand for the college’s online public health degree programs has exploded this year — with enrollment more than doubling since the middle of the last decade. The college’s advances in distance learning have been noted in the Guide to Online Schools, which uses data compiled by the National Center for Education Statistics to rank colleges with the best quality and most affordable online programs. USF Health is home to the nation’s first online master’s degree in health informatics and to seven online master’s degree programs in public health.

Photos by Eric Younghans, USF Health Communications

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Top 10 USF Health news and social media hits of 2013

Tampa General Hospital is among the first in the region to offer the new high-tech catheter device

 Tampa, FL (April 1, 2014)  –Tampa General Hospital is among the first in Tampa Bay region to offer a new high-tech catheter device that can improve the outcomes of patients treated for atrial fibrillation, or Afib, the most common sustained irregular heart rhythm. The ThermoCool® SmartTouch® catheter, recently approved by the U.S. Food and Drug Administration, enables doctors to accurately control the amount of contact force applied to the heart wall during radiofrequency catheter ablation procedures.

The FDA has also approved the device for two other types of heart rhythm disorders, ventricular tachycardia and atrial flutter.

USF Health cardiologist Dr. Bengt Herweg in the TGH Electrophysiology Lab with a 3-D color map display of an arrhythmia. The heart rhythm disorder’s site of origin, displayed on the monitor in red, guides the doctor to the target that needs to be ablated to eliminate the heart’s irregular electrical signals. The contact force of the ablation catheter also displays on the map when the device is in use.

Catheter ablation is a minimally-invasive procedure that involves inserting a therapeutic catheter through a small incision in the groin and maneuvering it up to the heart through a blood vessel. Once it reaches the heart’s left upper chamber (atrium), the doctor uses radiofrequency energy to burn away selected areas of tissue with the tip of the catheter. This produces a scar, or lesion, to block the faulty electrical signals triggering atrial fibrillation.

The new contact-force technology relays to the physician the precise angle of the catheter and how hard it is pushing against the beating heart wall. The information, displayed on a monitor as a 3-D graphic, helps doctors steer the catheter to areas where ablation is needed and apply targeted treatment.

“The new device provides critical contact force information to help confirm that we are consistently applying the intended amount of pressure with the catheter throughout the procedure, so that optimal outcomes can be achieved,” said Bengt Herweg, MD, associate professor of medicine at the USF Health Morsani College of Medicine and director of Electrophysiology at USF Health and Arrhythmia Services at Tampa General.

“Without this technology, doctors must estimate the amount of force being applied to the heart wall through other indirect measures that have been shown not to be as effective.”

Studies indicate poor tissue contact with the catheter may cause incomplete lesion formation that could require additional treatment, while too much contact force may cause tissue injury, which may lead to complications.

One-year results from a clinical trial testing the safety and effectiveness of the device in patients with Afib showed that patients experienced a 74-percent overall success rate after treatment with the ThermoCool® SmartTouch® catheter, compared to 63 percent for patients treated with a traditional catheter. Data from the trial showed higher success rates the longer physicians stayed within a targeted contact force range, with one-year results showing an 88-percent success rate when the targeted range was maintained 85 percent of the time or more.

An estimated 3 million Americans suffer from Afib, a progressive disease that increases in severity and frequency if left untreated, and can lead to chronic fatigue, congestive heart failure and stroke.

 While most Afib patients are treated with drugs, about half are unable to control their abnormal heart rhythm with drugs or cannot tolerate the side effects. When medication does not work, the American College of Cardiology and the American Heart Association suggest catheter ablation be considered as a safe and effective treatment option.

                                                                                                                                                       -Tampa General Hospital-

Tampa General is a 1018-bed academic medical center on the west coast of Florida that serves as the region’s only center for Level l trauma, comprehensive burn care, and adult solid organ transplants. It is the primary teaching hospital for the USF Health Morsani College of Medicine. TGH is a comprehensive stroke center and a state-certified spinal cord and brain injury rehabilitation center.

                                                                                                                                -USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a Top 50 research university in total research expenditures among both public and private institutions nationwide, according to the National Science Foundation. For more information, visit www.health.usf.edu

Photo by Ellen Fiss, Tampa General Hospital

 Media contacts:
Ellen Fiss, Tampa General Hospital, (813) 844-6397, or efiss@tgh.org
Anne DeLotto Baier, USF Health Communications, (813) 974-3303, or abaier@health.usf.edu

Tampa is only site on Florida’s west coast for the large-scale, NIH-funded clinical trial

Tampa, FL (June 9, 2014) – A new clinical trial at USF Health is evaluating the ability of a common antibiotic, doxycycline, to slow the growth of small abdominal aortic aneurysms, possibly preventing or delaying the need for surgery.

USF Health is one of only two sites in Florida, and 16 nationwide, participating in the $12.2-million study sponsored by the National Institutes of Health.  The other Florida site is Baptist Health Medical Center in Miami.

“The intent is to test if doxycycline — which is widely available, relatively inexpensive, and has minimal side effects — can reduce inflammation in the abdominal aorta and prevent small aneurysms from becoming larger,” said local principal investigator Murray Shames, MD, a vascular surgeon at USF Health Morsani College of Medicine and Tampa General Hospital.

“If drug treatment can do that, we could potentially improve care and reduce the costs of surveillance and operations needed to fix large aneurysms.”

USF Health/TGH vascular surgeon Dr. Murray Shames leads the local NIH-sponsored trial testing the effects of the common antibiotic doxycycline on the growth of abdominal aortic aneurysms.

An abdominal aortic aneurysm is a ballooning or bulge in the lower part of the aorta, a major blood vessel running from the heart through the center of the chest and abdomen. Since the aorta is the body’s main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding.  If an aortic aneurysm bursts, it is fatal more than half the time.

When aortic aneurysms are small and low risk, less than 5 cm. or about the size of a plum, doctors closely monitor with ultrasound any changes in the aneurysm’s size and rate of growth.  Surgery is performed to fix the aneurysm only when it reaches a size at which the risk of rupture outweighs the risk of surgery.

USF expects to enroll 25 patients, ages 55 and older who have been diagnosed with small abdominal aortic aneurysms, in the local trial.  Nationwide, 248 men and women will be enrolled.

Abdominal aortic aneurysms typically grow slowly, no more than a half-centimeter each year, and predicting which ones will enlarge rapidly is difficult, Dr. Shames said. “Right now we watch and wait until the aneurysm gets bigger to intervene, because there’s nothing else to do. That waiting can create a lot of anxiety for patients.”

Bernard Remas, 82, of Fort Myers, was one of the first patients enrolled in the randomized, double-blind, placebo-controlled trial at USF Health.  Remas’s abdominal aortic aneurysm was diagnosed about two years ago.  Like many people, he experienced no symptoms and his aneurysm was diagnosed by doctors when he underwent an imaging test for another reason.

Patients are randomized to receive either two doses of doxycycline a day, or a placebo. They will be followed for two years, getting their blood drawn and CT scans every six months.

Remas doesn’t know if he’s taking the tested drug or a placebo, but he says “the study seemed like a good thing to do…it’s pretty easy and painless.” If taking a medication could safely help him avoid an operation to repair an aneurysm, that would be preferable, he said.

USF Health’s Dr. Shames was involved in some earlier rat studies showing that doxycycline and similar anti-inflammatory drugs helped block the enzymes that weaken aortic walls.  Now, he’s part of a comprehensive trial that will determine whether the promising data gained from years of animal studies for slowing aneurysm growth can be replicated in humans.

“If treatment with this medication proves effective, it could become the gold standard for treating small abdominal aortic aneurysms,” he said.

Adominal aortic aneurysm is more common in men and those age 65 or older. Risk factors include family history, smoking, high blood pressure, high cholesterol and atherosclerosis (hardening of arteries).  The U.S. Preventive Services Task Force recommends ultrasound screening for abdominal aortic aneurysms for men ages 65 to 75 who have ever smoked, even if they have no symptoms.

For more information about the Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial at USF Health, please contact Stephenie Yapchanyk, vascular surgery research coordinator at (813) 259-0683, or Syapchan@health.usf.edu

  -USF Health-
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a Top 50 research university in total research expenditures among both public and private institutions nationwide, according to the National Science Foundation. For more information, visit www.health.usf.edu

-Tampa General Hospital-
Tampa General is a 1018-bed academic medical center on the west coast of Florida that serves as the region’s only center for Level l trauma, comprehensive burn care, and adult solid organ transplants. It is the primary teaching hospital for the USF Health Morsani College of Medicine. TGH is a comprehensive stroke center and a state-certified spinal cord and brain injury rehabilitation center.

Media contacts:
Anne DeLotto Baier, USF Health Communications, (813) 974-3303, or abaier@health.usf.edu
Ellen Fiss, Tampa General Hospital, (813) 844-6397, or efiss@tgh.org

Photo by Eric Younghans, USF Health Communications

USF Health physicians lead six of the 12 recognized specialty areas at TGH, named top hospital in
Tampa-St. Petersburg metro area

U.S. News & World Report has ranked Tampa General Hospital, the USF Health Morsani College of Medicine’s major teaching hospital, as the number two hospital in Florida and the best hospital in the Tampa-St. Petersburg metro area for 2014-2015.  USF Health partners Moffitt Cancer Center and All Children’s Hospital also made the top-50 list for their respective rankings as cancer  and pediatric hospitals.

USF Health faculty physicians lead six of the 12 specialty areas at TGH recognized in the latest U.S. News Best Hospitals rankings.

Now in its 25^th year, the list recognizes hospitals that excel in treating the most challenging patients — those whose illnesses pose unusual challenges due to underlying conditions, procedure difficulty, or other medical issues.  Many of the top-ranked hospitals are affiliated with academic health centers.

TGH was listed as one of the top 50 hospitals nationally in the following four medical specialties: Cardiology & Heart Surgery, Nephrology, Orthopedics and Urology. Dr. John T. Sullebarger, chief of cardiology at TGH, and Dr. Stephen Rifkin, chief of nephrology at TGH, are full-time USF Health faculty members.

In addition, TGH received “high performing” ratings in eight medical specialties: Cancer; Diabetes & Endocrinology; Ear, Nose & Throat; Gastroenterology & GI surgery; Geriatrics; Gynecology; Neurology & Neurosurgery; and Pulmonology.  USF Health faculty members lead four of these TGH high-performing specialty areas – Dr. Yasser Saloum, chief of gastroenterology; Dr. Tapan Padhya, chief of otolaryngology (ENT)/head & neck surgery; Dr. Karen Bruder, chief of obstetrics & gynecology; and Dr. Rossitza Chichkova, chief of neurology, and Dr. Fernando Vale, chief of neurological surgery.

Tampa General, was joined on the U.S. News Best Hospitals list by two other USF Health partners for teaching and research.

Moffitt Cancer Center made the top 10 list of Florida’s best hospitals (6^th). In addition based on the U.S  News ranking for top cancer hospitals, Moffitt was listed as the number one cancer hospital in the Southeast.  All Children’s Hospital in St. Petersburg was ranked as one of the top 50 pediatric hospitals in three specialties: cancer, cardiology and heart surgery, and orthopedics.

U.S. News evaluates hospitals in 16 adult specialties. In most specialties, it ranks the nation’s top 50 hospitals and recognizes other high-performing hospitals that provide care at nearly the level of their nationally ranked peers.

Just 3 percent of the nearly 5,000 hospitals analyzed made the list in at least one specialty.

U.S. News publishes Best Hospitals to help guide patients who need a high level of care because they face particularly difficult surgery, a challenging condition, or added risk because of other health problems or age. Patient survival and safety data, the adequacy of nurse staffing levels and other data largely determined the rankings in most specialties, according to U.S. News..

The specialty rankings and data were produced for U.S. News by RTI International; a leading research organization based in Research Triangle Park, N.C. Using the same data, U.S. News produced the state and metro rankings.

The rankings are available online at http://health.usnews.com/best-hospitals and will appear in the U.S. News “Best Hospitals 2015” guidebook, available August.

Forehead buried in a surgery console, Savannah Summy, 16, appeared intent on tying a knot in the suture thread using micro-movements of the robotic instruments she controlled remotely. Nearby, interactive robot arms outfitted with graspers and needles were poised over a small cushion holding the surgical string.

Dr. Lennox Hoyte, professor of obstetrics and gynecology and director of robotic surgery at the USF Health Morsani College of Medicine and Tampa General Hospital, demonstrated the twisting wrist action that could help Summy loop the string by guiding the robot arm.

“It’s like you’re turning a key,” said Summy as Dr. Hoyte’s keyhole analogy clicked.   “There’s definitely a learning curve, but it’s very cool.”

Savannah Summy, 16, seated at the surgery console, concentrates on operating the robotic arms nearby to tie surgical string, with encouragement from a fellow USF Stem Academy student.

Summy got an enthusiastic high-five from a fellow student after successfully completing the precision task with step-by-step coaching from Dr. Hoyte, a pioneer in urogynecologic robotic surgery.

A student at Clearwater High School, Summy was one of 22 rising junior and senior high school students across Florida, including one from Georgia, who participated last week in the STEM Academy on Diabetes & Medicine, a USF Pre-College summer program. Another group of 18 students completed the program this June.

Both groups visited TGHwhere they were provided the opportunity for some supervised hands-on practice with one of the hospital’s state-of-the-art surgical robotic systems.

This robotics session led by Dr. Hoyte scored as “a major wow factor” with students, said Richard Pollenz, PhD, professor of cell biology and director of USF’s Office for Undergraduate Research, who develops and manages the STEM Academy program.

One of the supervised exercises students practiced at Tampa General Hospital was using the robot to flip a penny.

The academically intensive six-day residential program immerses students in scientific inquiry, creative activities and hands-on research, with the intent of fanning the flames of their interest in the critical STEM fields – science (including the health sciences), technology, engineering and math. USF and other public universities are working to boost the number of students selecting and graduating with hard-core science and technology majors.

Now in its third year, the USF STEM Academy has demonstrated some early success. Ten students from the course’s 2012 and 2013 sessions enrolled at USF and several are pursuing STEM disciplines in the Honors College, Dr. Pollenz said.

In addition to trying their hands at manipulating the robot arms to tie knots and flip pennies, the students practiced a simulation exercise in which they cauterized tiny blood vessels.

Other activities last week included extracting DNA from their own cheeks to perform a DNA gel electrophoresis, conducting field research at Fort DeSoto Park with USF College of Marine Science faculty and students, visiting several university research centers to network with faculty, working in groups to problem solve, and interacting with STEM Academy mentors to develop creative solutions to a Grand Challenge Problem on diabetes.

Dr. Lennox Hoyte, director of robotic surgery at USF Health and Tampa General Hospital, coaches a student (not pictured) guiding the robot to flip a penny, while some USF STEM Academy students observe. The group watches the procedure in real time on a monitor above (not pictured).

One morning the students toured the USF Diabetes Center with Clinical Director Dr. Henry Rodriguez to learn about the education and research conducted there. They pricked their fingers to draw their own blood, just like people with type 1 diabetes do several time a day to test their blood sugar. The next day they used high-end digital pipettes to conduct an ELISA assay to measure the amount of insulin in their blood.

“These are experimental procedures typically carried out by college sophmores and juniors,” Dr. Pollenz said.

For Summy, who has type 1 diabetes, the laboratory exercise was a fascinating glimpse into the basic science underlying management of the chronic disease.

“I’m interested in doing something in the diabetes field, but I’m trying to determine whether I want to work in patient care or in a research laboratory,” she said. “Do I want to be a pediatric endocrinologist, or help develop the science and technology that may lead to advances or a cure?”

Giving students the opportunity to explore career options available to those with STEM degrees is an important aspect of the program, along with promoting scientific inquiry, relationship building and teamwork.

“Students who enter college with exposure to state-of-the-art STEM research are uniquely positioned to engage in undergraduate research activities that will enhance their academic performance and provide them with a competitive advantage in the job market and admission to graduate and professional programs,” Dr. Pollenz said.

“My goal is to inspire them to keep their scientific minds alive — to ask meaningful questions and think about how technology can be developed to solve complex human problems,” Dr. Hoyte said.

“It’s all about teaching these students how to collaborate and apply their knowledge.”

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Savannah Summy

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Photos by Eric Younghans, USF Health Communications

Tampa, FL (July 27, 2014) – Long-time Tampa cardiologist Xavier E. Prida, MD, joined the USF Health Morsani College of Medicine, Aug. 1 as an assistant professor in the Department of Cardiovascular Sciences where he will play a vital role in clinical education and care.  He comes to USF Health from St. Joseph’s Hospital, where he practiced nearly 27 years.

Dr. Prida will help teach medical students and residents and see patients at USF Health’s south and north campus locations – the South Tampa Center for Advanced Healthcare adjacent to Tampa General Hospital and the Morsani Center for Advanced Healthcare on the USF Tampa campus.  He plans to join the TGH medical staff, providing consultative services and performing procedures in the hospital’s cardiac catheterization laboratory.

Interventional cardiologist Dr. Xavier Prida joins USF Health from St. Joseph’s Hospital, where he practiced for nearly 27 years.

“Dr. Prida is one of the most well-known and respected cardiologists in the Tampa Bay region.  We are fortunate he joined us,” said Arthur Labovitz, MD, chair of the Department of Cardiovascular Sciences and an acting director of the USF Health Heart Institute. “His addition to the department will help advance our primary mission to elevate the level of cardiac care across the region.”

Dr. Prida specializes in consultative cardiology, which offers comprehensive analysis of an individual’s cardiovascular condition and related diseases to help the patient and doctor jointly develop the best treatment plan.  He is an expert in interventional procedures, such as cardiac catheterization, angioplasty and stenting, with a special interest in managing acute coronary syndromes, studying health and disease outcomes, and improving quality of care.

“We have added a superbly trained interventional cardiologist in Dr. Xavier Prida,” said Sally Houston, MD, executive vice president and chief medical officerwith Tampa General Hospital. “He is a welcome addition to our team and will only enhance the outstanding cardiac care we deliver every day at Tampa General.”

Dr. Prida is a fellow of three premier professional societies – the American College of Cardiology, the Society of Cardiovascular Angiography and Intervention, and the American College of Chest Physicians.

At St. Joseph’s since 1987, he held positions as director of the coronary care unit, chief of the Department of Cardiology, director of medical education and quality outcomes, and, most recently, medical director of the adult cardiac catheterization laboratories.

As regional co-director of the American Heart Association’s Mission Lifeline Accelerator program, Dr. Prida was instrumental in helping integrate local systems of care to improve outcomes for patients who suffer a life-threatening type of heart attack known as STEMI, out-of-hospital cardiac arrests, or both.

“Dr. Prida played a key role in working with the community and EMS to get patients into hospital cardiac catheterization labs faster, reducing the time it takes to open blocked arteries,” Dr. Labovitz said.

Dr. Prida received his MD degree from the University of Miami Miller School of Medicine in 1980.  He completed residency training in internal medicine at New York Hospital/Weill Cornell Medical College, and served as assistant chief resident at Memorial Hospital/Sloan Kettering Cancer Institute. Following a fellowship in cardiology at Shands Hospital/ University of Florida College of Medicine, he was appointed instructor of medicine/chief resident in the Department of Medicine there.

Dr. Prida says he looks forward to returning to an academic health center after many years in private practice.

“Students and residents ask questions from different, independent perspectives, and that often opens new avenues of inquiry and discovery,” Dr.  Prida said.  “I’m thankful to the all the patients, institutions, physicians and staff who have educated me over the years.  In this next stage of my career, I want to pass on what I’ve learned from others to help educate the next generation of physician leaders.”

He sees a bright future for USF’s growing clinical cardiology group – the largest in Tampa at the region’s only academic health center.

With Dr. Labovitz’s leadership over the last few years, Dr. Prida said, the USF Health Department of Cardiovascular Sciences “has become a flagship program increasingly relevant to the community it serves.”

                                                                                                                                      -USF Health-
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a Top 50 research university in total research expenditures among both public and private institutions nationwide, according to the National Science Foundation. For more information, visit www.health.usf.edu

USF Health Communications media contacts: 
Lisa Greene, lgreene@health.usf.edu, or (813) 974-4312
Anne DeLotto Baier, abaier@health.usf.edu, or (813) 974-3303

Jeana Hadley considers herself a decent example of good health – she eats right, exercises and maintains a healthy weight. But that model of healthy living is worlds away from the path she was on five years ago, when she weighed 300 pounds.

Jeana Hadley said the desire to live for her family when confronted with an obesity-related heart scare motivated her to commit to weight-loss surgery and a new healthy lifestyle.

What caused her to turn things around, to stop overeating, to stop secretly eating, and to finally be able to stick to (at least most of the time) common sense food choices and serving sizes?

Hadley doesn’t hesitate with an answer. It’s because of bariatric surgery. More specifically, its’ because of the team of experts at the TGH+USF Bariatric Center who, well before her surgery, looked at every aspect of her struggle with obesity: her co-morbid conditions, her eating and exercise habits, and her tendencies and associations with food.

“The bariatric surgery saved my life, but it was the entire team who helped me to succeed with keeping the weight off for these five years,” Hadley said.

****

Obesity is complicated and can only be treated successfully when a high level of attention is given to every issue that surrounds it.

That’s why the TGH+USF Bariatric Center has grown to be so successful – it is staffed with experts trained to address every issue related to the patient’s obesity. Those issues not only include the secondary health problems that haunt obese patients, such as diabetes, sleep apnea and hypertension, but the other aspects of obesity that have kept these patients from keeping their weight down in the past, such as the psychological reasons for overeating and the physical issues of exercise.

“We are looking at the patient as a whole and helping them with every area that is keeping them from succeeding,” said Michel Murr, MD, professor of surgery at the USF Health Morsani College of Medicine and director of TGH+USF Bariatric Center.

Dr. Michel Murr

USF has been offering bariatric surgery since 1998 and has gained a national reputation for its integrated and comprehensive approach. In 2013, the team moved into a 5,500-square-foot facility in the Harbourside Medical Tower on the Tampa General campus. The expanded space features examination rooms and education rooms where patients work with Center staff as they progress through the program. Anyone interested in bariatric surgery must attend an informational session held at the Center weekly. Patients admitted to the program then spend three to six months learning the nuances of what bariatric surgery means – the life-long commitment and dietary regimen they face – before surgery is performed.

USF President Judy Genshaft and Dr. Murr, center left and right, with officials from Tampa General Hospital and USF Health, at the grand opening last year of the TGH+USF Bariatric Center.

At its core, Dr. Murr said, the TGH+USF Bariatric Center offers patients a truly interdisciplinary approach to treating obesity.

“When we started this program in 1998, we knew the value of an interdisciplinary approach to treating patients,” he said. “It’s used extensively and successfully in the treatment of cancer. And we know the importance of continued follow-up care, the very same idea used so successfully in cardiac rehabilitation.”

But in the management of obesity, these approaches tend to be absent, he said.

The team at the USF Bariatric Surgery Program offers patients surgeons, dieticians, psychologists, internists, exercise physiologists, among others. Basically, there is an expert for every health issue facing obese patients, Dr. Murr said.

“Patients are successful because we help them with every roadblock and issue they are likely to face,” he said.

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Jeanna Hadley vividly remembers the day she decided to pursue bariatric surgery. It was in 2007.

She had already faced doctors diagnosing her with high-blood pressure, acid reflux, ulcers, and prediabetes. And her family history made her realize she could die young – Hadley’s father died of a heart attack at age 56. Her grandfather died in his 40s.

The clincher, however, – the moment that awakened something unstoppable inside of her – was when she had her own heart scare at age 40. Knowing her family history helped elevate the panic she felt when doctors prescribed a round of heart tests.

“I was a single mom and I realized no one else would raise them like a mother could,” she said. “I realized I needed to live.”

Hadley’s bariatric surgery was on June 29, 2010.

“There was a little pain, but overall, totally manageable,” she said. “Of all the improvements this surgery provided, what happened fastest was that my high blood pressure returned to normal immediately after surgery. It really worked! Now I don’t have to take these stupid blood pressure pills anymore.”

In addition to reversing her high blood pressure, the surgery also caused Hadley’s sugars, triglycerides and cholesterol numbers to improve, dropping by half.

“Body-wise, the surgery was like a chemical re-set button,” she said.

Because success depends a lot on the individual, Hadley was adamant with herself to stay on track, starting with some of the “techniques” even before the surgery.

“I followed the guidelines to the letter,” Hadley said. “I figured I had made the monumental decision to have the surgery and I actually had the surgery, so why would I do something to screw things up and keep the surgery from helping me succeed.”

She even started her routines before surgery, measuring foods to get a feel for the right amount and keeping a food journal, Hadley said.

Post-surgery, starting in the hospital, compliance meant a clear liquid diet for three days, followed by a few days of a full liquid diet that included protein shakes, then four weeks of soft, pureed foods, mostly protein based.

“They said I could eat strawberries after six weeks but I didn’t have any for six months, that’s how obsessed I was with doing this right,” she said. “I pureed everything. The mini food processor and I got really close those first few months.”

Central to every step, though, was protein.

“Protein has to be a focus and includes supplements,” said Erica Govsyeyev, MS, RD, LDN, clinical nutrition specialist and a dietitian for the TGH+USF Bariatric Center. “There is no wiggle room when you’re eating such small amounts so it’s important to get as many nutrients as possible with each meal.”

While most people should aim for 45 to 60 mg of protein each day, Govsyeyev said, bariatric patients should nearly double that, aiming for 60 to 80 mg each day.

Today, Hadley still eats very small meals focusing on healthy choices, including lean proteins (fish, skinless chicken and lean beef).

Her 5-year path from surgery to this point went something like this:

• Her weight went from a peak of 300 pounds to 285 prior to surgery to a low of 133 a year later, a weight she realized was too low so now she hovers in the low 150’s (she’s 5’6” tall). She weighed herself every day for several years, but now only every few days.
• Post-surgery was a six-week gradual increase in food density: a liquid diet to soft foods to regular food (only about three ounces at each meal). Today, she eats four to six meals each day, each about four to five ounces, depending on the density of the food.
• Pre-surgery and immediately post-surgery, she could barely walk a mile. By four months after surgery was able to walk five miles. Then she started running. And now is running regularly and racing in marathons.
• Since the surgery, she takes daily supplements of specialized multi-vitamins, calcium and vitamin D, gets B12 shots twice a month and an iron infusion once a year for anemia, a side effect for some bariatric patients.

*****

USF’s Bariatric Surgery Program is standing out nationally, not just for its team approach for treating patients, but also because the team tracks each patient’s progress both during the program and for more than five years after surgery. The goal is to pinpoint what is working and what is not working for the patients, Dr. Murr said.

“We are evidence-based and outcome-driven,” he said.

That kind of data is what Dr. Murr is publishing in journals and sharing with colleagues around the globe. The results are showing that bariatric surgery works and there are immediate and long-term improvements to the co-morbid conditions of obesity, such as diabetes, hypertension, sleep apnea and stress urinary incontinence.

Some of Dr. Murr’s newest research is showing that bariatric surgery can also result in significant improvement in nonalcoholic fatty liver disease (NAFLD), resolving liver inflammation and reversing early-stage liver fibrosis, the thickening and scarring of liver tissue, by reducing fat deposits in the liver.

Data are also showing that, because of the intense team approach, these patients are successful in keeping their weight under control.

Team Approach

The process is this.

First, patients undergo an initial evaluation and are provided with information about the surgery, which lays out what their realistic expectations should be.

Then patients attend several support groups and an orientation program that describes the surgery, its outcomes, its long-term effects and who qualifies for it. This gives them a realistic snapshot of what surgery is and what it means for the rest of their lives.

Next is an extensive psychological evaluation, where patients and psychologists really delve into a patient’s perception of health, the surgery and the life-long commitment it requires.

If patients have passed muster to this point, they then meet with team members to set up a personalized plan for post-operative care and follow-up, including extensive input from dieticians and exercise physiologists.

“Surgery doesn’t fix everything,” dietitian Govsyeyev said.

Govsyeyev meets with bariatric patients like Hadley long after their surgeries, using realistic food props to help illustrate portion size and a meal’s health components.

“You’re still going to have challenges and stresses,” she said. “We work to define areas where they may struggle to help set them up for success.”

In addition, many secondary problems are addressed: high blood pressure is under control, sleep apnea is under control, etc.

Only at this point do they undergo bariatric surgery.

The entire process can take six weeks or more, but that pace is a good thing, Dr. Murr said.

“Each patient has to have all of the information necessary to make such a huge decision and to be completely sure that surgery is right for them and that they know full bypass is not reversible,” he said. “They have to have realistic expectations of the surgery. I want them to be ready and not rush to a decision.”

This extensive process offers the best outcomes with the fewest complications, he said.

The team approach is so powerful that many times a patient will not require surgery in order to successfully manage their weight. Many times, it’s during that intense evaluation that a patient’s core problems are addressed, and a plan is defined that will help the patient succeed without having to go to the extreme of bariatric surgery, Dr. Murr said.

****

At home, Hadley is straightforward with her boys.

“Before the surgery, I told them ‘This is what Mommy is doing and I need your support,’” she said.

Her boys, ages 15 and 17, never had a problem going along with her new health and food regime.

“They were great,” she said. “They never told me ‘I’m not eating that!’ And the boys are healthier because I’m paying so much more attention to healthy foods. They are so much healthier than I was at those ages. But I tell them they still need to watch. They still have our family genes.”

For Jeana Hadley, the surgery saved her life. She even continues attending the educational sessions at the Bariatric Center, although this time she brings the post-operative patient perspective.

“Now I’m sharing my success story with people considering the surgery,” she said. “I tell them ‘I was where you are now,’ because I know how great it is to talk to someone who has already gone through the journey.”

“And the USF team was great and was in touch with what my individual needs were.”

To hear more about the TGH+USF Bariatric Center, please call (813) 844-7473.

Notes from Jeana Hadley

- Form good habits: start a food log and measure food before the surgery. Better yet, start before the education sessions. “We’re all creatures of habit, so establishing habits ahead of time makes it much easier after surgery.”

- Make the best use of the education sessions. Keep attending to reinforce the information and tips.

- Your taste buds will change. Everything will taste differently. “Diet drinks now taste sour.”

- Know your limit: Always measure because, while one piece should satisfy, more will make you sick.

Photos by Eric Younghans, USF Health Office of Communications

Tampa, FL (Sept. 18, 2014) – Tampa General Hospital and the USF Health Morsani College of Medicine moved to further strengthen their relationship by giving the chief executives of both institutions a voice in each institution’s operational and strategic decision-making process.

Tampa General CEO Jim Burkhart, DSc, and Charles Lockwood, MD, dean of the Morsani College of Medicine and senior vice president of USF Health, will now participate in each other’s senior executive meetings. Each will receive an additional title to reflect the increased level of collaboration between the two institutions.

In addition to president and CEO, Dr. Burkhart is now also the senior associate dean, Morsani College of Medicine at the University of South Florida. Dr. Lockwood has added the title of executive vice president, chief academic officer at Tampa General.

The new titles reflect the desire to give each institution greater access into the decision-making process.

“This gives us a new level of integration that will help the hospital and medical school create much closer ties,” Dr. Burkhart said. “This is critical as we embark on our plan to deliver health and medical services throughout the Tampa Bay area.”

“We look forward to building upon our longstanding partnership with Tampa General Hospital,” Dr. Lockwood said. “Moving forward, we will both benefit from greater collaboration and coordination that improves health care delivery for our patients.”

USF Health’s Charles Lockwood, MD, right, and Tampa General’s Jim Burkhart, DSc

Since it became a private, not-for-profit in October 1997, the hospital’s governing board has reserved a seat for the USF President or designee. The dean now will have a seat at meetings of the hospital’s senior executive team and medical executive committee. Dr. Lockwood will also work with the hospital’s leadership and medical staff to further develop academic programs and expand research capabilities.

As senior associate dean, Dr. Burkhart will participate in the strategic planning activities of USF Health. He will work with vice deans to enhance clinical training for students, residents, and faculty. He also will participate in physician recruiting for the medical school and work with community leaders and health professionals to support the medical school and its mission.

-Tampa General Hospital-
Tampa General is a 1018-bed academic medical center on the west coast of Florida that serves as the region’s only center for Level l trauma, comprehensive burn care, and adult solid organ transplants. It is the primary teaching hospital for the USF Health Morsani College of Medicine. TGH is a comprehensive stroke center and a state-certified spinal cord and brain injury rehabilitation center. For more information, go to www.tgh.org.

-USF Health-
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a Top 50 research university in total research expenditures among both public and private institutions nationwide, according to the National Science Foundation. For more information, visit www.health.usf.edu 

Media contacts:
John Dunn, Tampa General Hospital, (813) 844-7357 or jdunn@tgh.org
Lisa Greene, USF Health, (813) 974-4312 or lgreene@health.usf.edu

USF stroke experts staff the TGH Stroke Center, providing patients in the Tampa Bay region with 24/7 access to more specialized stroke care, including on-site neurosurgeons and medical teams trained in neurocritical care.

TAMPA, FL (Dec. 8, 2014) – Tampa General Hospital is the first hospital on the west coast of Florida to be awarded Comprehensive Stroke Certification, the highest national designation from the Healthcare Facilities Accreditation Program, a national certification organization recognized by the federal Centers for Medicare and Medicaid Services.

The new state-of-the-art Bayshore Pavillion at TGH has a dedicated Stroke Unit, a Trauma Resuscitation Unit and full capability CT and MRI scan in the Emergency Department; dedicated neuroangiography suites; and a Neurosciences Intensive Care Unit, which is one of the largest in the country.

This elite designation means the hospital meets the highest standards for safety and quality and can treat patients 24 hours a day with the most complex state-of-the-art stroke care.  Tampa General earned the national designation by meeting 21 evidence-based measures of complex stroke care. Continuous on-site neurologists, neurosurgeons, diagnostic radiologists and medical teams trained in neurocritical care are ready to treat emergencies immediately with highly trained and qualified nursing staff. Studies show that stroke patients have better outcomes when these standards are met.

“This provides an external validation for what we’ve known for a long time,” said Dr. W. Scott Burgin, director of Tampa General’s Comprehensive Stroke Center and professor of Neurology and chief of the Cerebrovascular Division at the USF Health Morsani College of Medicine.

“We are providing the highest level of care for our patients at Tampa General. Every stroke is different, and sometimes there are complications that require extremely specialized care that can only be found at comprehensive centers with a team on hand 24 hours a day who are trained to handle those complications.”

USF Health’s Dr. Scott Burgin directs the TGH Comprehensive Stroke Center.

Tampa General is the fourth hospital in the state to receive this national designation for its stroke program. It also is one of 34 Florida hospitals designated as a state Comprehensive Stroke Center, and one of 124 that the Joint Commission certifies as a Primary Stroke Center.

“This certification signifies that Tampa General Hospital has demonstrated and is clearly committed to advancing stroke treatment through innovation and best practice – placing them amongst world leaders,” said Michael Zarski, chief executive officer of HFAP. “Hospitals that have established stroke centers have demonstrated improved treatment, better patient outcomes, and reduced costs. In addition, Comprehensive Stroke centers are a resource to both the community and neighboring hospitals who are not equipped to offer the same level of care.”

Strokes occur when blood flow is disrupted in the brain. A clot can block a blood vessel, or bleeding can occur. If brain cells can’t receive blood and oxygen, they start to die, causing permanent damage. About 795,000 Americans have a stroke each year, making stroke the 4th leading cause of death in the U.S.

A stroke requires immediate emergency treatment and every minute counts. You can use the “FAST” acronym to recognize warning signs of a stroke: “Face drooping, Arm weakness, Speech difficulty, Time to call 911.”

-Tampa General Hospital-

Tampa General is a 1018-bed academic medical center on the west coast of Florida that serves as the region’s only center for Level l trauma, comprehensive burn care, and adult solid organ transplants. It is the primary teaching hospital for the USF Health Morsani College of Medicine. TGH is a comprehensive stroke center and a state-certified spinal cord and brain injury rehabilitation center. For more information, go to www.tgh.org.

Tampa, FL (Dec. 12, 2014) – The USF Health Morsani College of Medicine is conducting a clinical trial comparing the effectiveness of a new rapid-onset anticoagulant medication known as Apixaban with the standard anticoagulant drug warfarin in stroke patients with atrial fibrillation, the most common type of abnormal heart rhythm.

The investigator-initiated study is part of a $2.2 million research award from Bristol Myers Squibb awarded to Arthur Labovitz, MD, professor and chair of the Department of Cardiovascular Sciences for the USF Health Morsani College of Medicine and director of Non-Invasive Cardiology at Tampa General Hospital.

USF Health cardiologist Dr. Arthur Labovitz, principal investigator for the AREST study.

Dr. Labovitz is the principal investigator for the study, which is called “Apixaban for Early Prevention of Recurrent Embolic Stroke and Hemorrhagic Transformation,” or AREST. The study is the part of the USF Health Heart Institute, which is co-directed by Dr. Labovitz.

Anticoagulant therapy lowers the risk of strokes caused by embolisms (blood clots) in patients with atrial fibrillation, but its use is associated with potentially deadly bleeding. The new randomized trial will evaluate whether early treatment with Apixaban, an alternative requiring less monitoring and re-dosing than warfarin, can prevent recurrent strokes and reduce the risk of brain bleeding in patients who have suffered a first embolic stroke.

“Current guidelines suggest delaying treatment for patients with atrial fibrillation who have had a stroke, often times for two weeks or more,” Dr. Labovitz said. “This commonly results in poor outcomes in these individuals. The AREST study will more aggressively treat these patients earlier, sometimes within 24 hours of symptoms, in order to improve their outcomes. The protocol tests the hypothesis that one of the newer blood thinners, Apixaban (Eliquis), will be safe and effective in this regard.”

Early research showing that the risk of intracranial bleeding is markedly reduced (50 percent) with the new oral anticoagulant prompted him for initiate and develop the AREST study, Dr. Labovitz said.

In the USF AREST study, researchers will give either warfarin or Apixaban to 120 adult patients admitted to Tampa General Hospital with a transient ischemic attack (TIA) or small to medium ischemic stroke, who also have a history of, or current diagnosis of, atrial fibrillation. Atrial fibrillation is a common cause of stroke.

Patients will be randomly given the medications within 48 hours of stroke symptom onset and then followed for 180 days to compare the incidence of recurrent stroke, death or intracranial hemorrhage.

USF Health’s Dr. Scott Burgin directs the TGH Comprehensive Stroke Center and is a co-investigator for the AREST study.

“This study could answer a question that has long been undefined, and that is the optimal timing for giving anticoagulant medication after having an acute stroke,” said W. Scott Burgin, MD, professor of neurology and chief of the USF Cerebrovascular Division in the USF Health Morsani College of Medicine, director of the HFAP Certified Comprehensive Stroke Center at Tampa General Hospital, and a co-investigator for the AREST study.

“This new anticoagulant medication is already showing a greater effectiveness and a higher safety profile so starting the medication sooner than the standard 14 days could improve outcomes for stroke patients.”

Dr. Labovitz (left) and co-investigator Dr. David Rose stand in the heart of the Neurosciences Intensive Care Unit at TGH. The researchers will track stroke patients taking the new anticoagulant for the AREST study.

Co-Investigators for the USF AREST study, who are all USF Health faculty, are Dr. Burgin; David Rose, MD, assistant professor of Neurology and medical director, Neuro-ICU at TGH; Sanders Chae, MD, JD, assistant professor of cardiology; Michael Fradley, MD, assistant professor of cardiology; Theresa Beckie, PhD, professor in the USF Health Morsani College of Medicine and the USF College of Nursing; Waldo R. Guerrero, MD, assistant professor of vascular neurology; and Ryan Martin, MD, a fellow in the USF Department of Cardiovascular Sciences.

For more information about the AREST clinical trial at USF Health, please contact Bonnie Kirby, MSN, RN, research administrator for USF Cardiovascular Sciences, at bkirby@health.usf.edu or call (813) 259-8543.

About USF Health

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a Top 50 research university in total research expenditures among both public and private institutions nationwide, according to the National Science Foundation. For more information, visit www.health.usf.edu

From left, former Buccaneer and Eagles offensive lineman Rob Taylor, former Patriot and Raiders offensive lineman Brian Holloway, Lions and Chiefs linebacker James Harrell, Dr. John Paul Gonzalvo, former Buccaneers defensive lineman Jason Maniecki and Dr. Michel Murr pose for a photo following a news conference at the Tampa General Hospital and USF Health Bariatric Center, following a six-month study of weight management in former professional football players.

By Lisa Greene, Tampa General Hospital News

When Rob Taylor was an offensive lineman, he ate everything in sight.

Rob Taylor talks about his experience losing weight as Brian Holloway and Jason Maniecki stand by.

“You’ve got to gorge yourself,” said Taylor, who played for the Tampa Bay Buccaneers from 1986 to 1993. “You get paid to be big.”

But when he retired and slowed down, his eating habits didn’t. By last year, Taylor’s weight had soared to 340 pounds. He had an irregular heartbeat, he snored loud enough to wake his wife, and he had given up believing that he could change.

“I was at that place where I was going to be a big guy, an obese guy, for the rest of my life,” Taylor said.

But then he, along with three other former NFL players living in the Tampa Bay area, joined a six-month research study at the Tampa General Hospital + USF Health Bariatric Center. The study was designed to promote weight loss in former NFL athletes.

Read full story….

The Lane family visits USF Health Pediatrician Dr. Cristina Pelaez (left) for a check up, and a flu shot.

It is unlikely that Tim and Angel Lane will ever move from Tampa. At least, not in the next couple of decades.

Their proximity to a network of experts who care for their son Jameson is too important to risk trying to find something similar elsewhere.

Jameson has a genetic form of hypotonia, meaning he has muscle weakness throughout most of his body. Both he and his twin brother Walker were born with hypotonia, turning their expected healthy birth – albeit an early one – into a dire emergency. Having little to no muscle control at birth meant the babies could not breathe on their own or suck or swallow.

“There was a great deal of stress from the get-go,” Tim said, recalling the intensity of everyone in the delivery room. “Neither boy could suck or swallow. Neither could blink.”

“We were all on pins and needles, even the doctors,” Angel said.

***

The Lanes’ first experience with the Doctors of USF Health was when their twin boys were transferred to the Muma Neonatal Intensive Care Unit (NICU) at Tampa General Hospital when they were 3 months old. They were in need of more advanced care and it was in the Muma NICU that the Lanes met a team of experts from the USF Health Morsani College of Medicine.

USF maternal-fetal medicine specialists, neonatologists, pediatric surgeons, pediatric radiologists, pediatric cardiologists, pediatric neurologists, geneticists, and many other health care specialists surrounded the twin boys over the many months they stayed in the NICU, followed the boys as they progressed to the pediatric intensive care unit, and there the many times the Lanes brought them to TGH’s emergency room. Even for ongoing visits, it’s a team of USF Health pediatricians who check progress and address issues.

By connecting with USF Health, the Lanes found an integrated team of experts within one group, providing seamless care to Jameson and Walker. But what the Lanes also found was a medical home – a patient-centered approach to delivering primary care that allows families to rely on only one group of health care providers.

Young Jameson sits patiently for Dr. Cristina Pelaez during a recent check up.

“USF’s medical home concept made caring for our boys so much better,” Tim said.  “There is an entire team of professionals here who knew the nuances of their condition. We have to be advocates for our children, who needed very specialized care. And to do that, we need help from top experts in uncommon conditions, as well as an integrated approach. That level of coordinated care means Jameson’s history is known by everyone on the team.”

“We were new parents, so to have doctors and nurses already aware of our entire story made every visit so much more seamless,” Angel said. “Without that transition from NICU to USF Health, I don’t know how successful we would have been in caring for our boys.”

Angel Lane.

“Our goal with acting as a medical home for patients really starts with the needs of the patients and their families,” said Cristina Pelaez, MD, assistant professor of pediatrics and director of the Medical Home Program for USF Health Pediatrics. “Medical homes provide families with a support system of experts who work with each other and talk with each other. In a broader sense, a medical home can also reduce medical costs in the long term, help children have better access to health care and improve health care use patterns, thus preventing disease for these children.”

***

Many different diseases and disorders cause the symptoms of hypotonia. But diagnosing the disease or disorder causing the problem can be challenging. It could be one of as many as 500 different conditions, Dr. Pelaez said.

For the Lanes, not knowing the underlying problem meant they had to take it day by day, with round-the-clock monitoring of their breathing and oxygen intake and feeding them through a feeding tube.

Tim Lane.

“They were amazing and prepared us before we took the boys home,” Tim said. “When we were discharged from the NICU, went home with a full entourage. That’s the scariest thing you face, is leaving. Before discharge came along they started working with us, showing how to use the pulse ox (pulse oximetry, used for monitoring oxygen saturation) and how to suction to clear their airways. We needed to suction the boys 30 to 40 times a day.”

But even with that level of attention, Walker succumbed to pneumonia from influenza and died in February 2013, just shy of his second birthday. The Lanes, still unaware of the root cause of the hypotonia, weren’t sure what the future held for Jameson.

Tim and Angel Lane hear details of on-going care from Dr. Cristina Pelaez, as Jameson and his older brother Braden play.

For two years, Jameson remained undiagnosed while doctors took blood samples and biopsies to conduct tests that ruled out the many possibilities of underlying conditions, including cerebral palsy, muscular dystrophy, among others.

It took a specially trained metabolic geneticist to finally determine Jameson’s root problem. Amarilis Sanchez-Valle, MD, is assistant professor of pediatrics in the USF Health Morsani College of Medicine and the only board-certified medical biochemical geneticist in the region.

What Dr. Sanchez-Valle found for the Lanes was that Jameson has nemaline myopathy, a congenital, hereditary neuromuscular disorder. Children born with nemaline myopathy often gain strength as they grow, and those with mild forms eventually walk independently, although often at a later age than their peers.

The firm diagnosis for the Lanes means they will worry a bit less — nemaline myopathy is not progressive so Jameson’s condition will not worsen – and are in a better position to help their son grow.

***

Jameson is walking. He’s even running around and playing, chasing his older brother Braden. Physical and occupational therapy are helping him learn to swallow and helping with his speech. Individuals with NM are usually highly sociable and intelligent, so on-going therapy will help him thrive.

“Jameson continues to flourish,” Tim said. “He would not be without help from TGH, and USF, and Dr. Pelaez.  She really took our boys under wing. We did not want for anything. Here, we are listened to, we are heard, and get to weigh in on decisions. The team put us in the best possible position for success.”

Jameson needs comfort from Dad after getting his flu shot.

And then, tearfully, accepts his well-earned sticker from pediatric nurse Rafael Uribe

The Jennifer Leigh Muma Neonatal Intensive Care Unit

Thousands of babies who are born too early benefit from the generosity of Pam and Les Muma. In 2009, the Mumas provided $6 million to USF Health to establish a highly specialized neonatal intensive care unit in the heart of Tampa General Hospital’s Children’s Medical Center. Their gift, one of the largest in Florida to support research and care for newborns, resulted in $14 million with eligible state and internal USF matches.

Named after their daughter who died in a neonatal nursery, the Jennifer Leigh Muma Neonatal Intensive Care Unit (NICU) was created to provide leading-edge treatment, training and research. With more than 50,000 square feet, the entire space is designed with a baby’s family in mind, from the colors of the corridor walls to the placement of telephones in each patient room. The NICU features 80 single-family rooms, a procedure room, and a semi-private area for 12 transitional babies. Light switches are placed strategically and bulbs angled to ensure the babies will not be startled by unintended bright light in the softly lit atmosphere. Even the hallways keep babies in mind with acoustic ceiling tiles that absorb excess noise.

Teaching and research are also key components of the NICU mission and environment, transforming patient care here, as well as advancing the study of neonatology in medical and academic institutions around the world. Neonatology fellows, pediatric residents and nurse practitioner students learn together, with a majority of teaching taking place bedside, patient to patient. The partnership between TGH and USF is the key to those efforts.

The Lane family, from left, Braden, Angel, Tim and Jameson.

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