USF kidney expert Dr. Alfonso Campos guides the family and health care team, from diagnosis to transplant to success.

Twenty weeks into her pregnancy with her second child, Melissa Ranieri was told there was a problem with her baby and that he might not make it past birth.

The news hit hard. Their baby boy Evan had very small kidneys and would likely not be able to survive on his own. She and her husband Paul carried the weight every day, turning to family for support, turning to the internet for research and similar stories.

Evan Ranieri snuggles with his mom Melissa.

And turning to USF pediatricians for deeper answers and a second opinion.

That second opinion came from Alfonso Campos, MD, associate professor of pediatric nephrology and an expert on kidneys in children, especially in babies.

“The first diagnosis turned our family upside down,” Melissa said. “But Dr. Campos told us Evan had a much better chance of survival than that.”

“Otherwise healthy, Evan still had small kidneys and they weren’t working well,” Dr. Campos said. “In many newborns, the problem subsides as they grow – they grow out of it. But not for Evan. He wouldn’t require dialysis right away, and he would need medications to address function, such as acid in the blood, and a careful diet. But the prognosis was renal failure.”

Although it was better news for the Ranieris that Evan was strong enough to get by for a while, the reality remained that Evan’s kidneys would not support him long before he would need a transplant. Decisions were made, like delivering at Tampa General because they “needed to be at the best hospital,” and the comprehensive kidney care provided there, Melissa said.

“Dr. Campos and his team made sure we were prepared for what was to come,” Melissa said.

“They even preemptively showed us the NICU (neonatal intensive care unit) to acclimate us to the environment so we would be ready,” Paul added.

***

Evan was born in March 2011 at Tampa General surrounded by a team of highly trained pediatric surgeons, nephrologists, NICU physicians and nurses, and others working together, standing ready to react to whatever Evan presented.

“Evan was only hours old when doctors confirmed our worse fears,” Paul said. “His kidneys were failing.”

The newborn was immediately put in the Muma NICU at Tampa General Hospital and the conversation turned to next steps, the first being finding a kidney donor.

***

Evan runs from room to room of the Ranieri’s new house in Riverview. Having just moved in a few weeks earlier, several rooms remain empty as the family settles in. Evan, who is nearly 4 years old, is making use of the open space to chase his big sister Avery, who is 7.

Evan and his sister Avery.

The bonds are strong in this family, but none as literal as those between Melissa and Evan – mother and child.

About 18 months after being born – after spending several months in the NICU before coming home for the first time, followed by nearly daily trips to TGH for dialysis – Evan’s kidneys totally failed. He went from having dialysis to get by to needing a kidney transplant in order to live.

And it was one of his mother’s own kidneys that saved him.

***

In May 2013, the renal transplant team transplanted a kidney from Melissa into Evan. Probably the most obvious question is how does an adult kidney fit into a toddler?

“Kidneys are amazing – once in Evan, the kidney actually shrank a bit and will grow as Evan grows, growing back into an adult size kidney,” Dr. Campos said. “And for Melissa, as an organ donor, she lost a kidney so her remaining kidney grew to accommodate.”

Sister Avery and Dr. Campos visit Evan while he recuperates at Tampa General. Photo courtesy of the Ranieris.

The Ranieris are eager to say that it was finding the right team that has helped their family the most.

“We really are so grateful for the medical staff at both Tampa General and USF,” Paul said. “Everyone in the PICU, the NICU, the doctors and nurses at every level, were all so welcoming and positive. It was a very good experience, considering the circumstances.”

Mother and son. Two kidney transplant patients at Tampa General, one giving, the other receiving. Photo courtesy of the Ranieris.

Signs of recovery. Evan races the halls at TGH following his transplant surgery. Photo courtesy of the Ranieris.

“The standards are different with TGH and USF,” Melissa said. “We knew with Evan we would need to have a higher level of care. Even if we had lived in Miami, we would have come to Tampa General and to the doctors at USF for their pediatric transplant expertise.”

Now, at 26 months post-surgery, and having just celebrated his fourth birthday, Evan’s future is bright and he’s expected to have a healthy childhood. There will be rules with his diet and there will be no contact sports. He will take anti-rejection medications for the rest of his life, although the fear of his body rejecting his single kidney is constant. Melissa and Paul know that Evan will likely need additional transplants later in his life, repeating what they’ve told themselves since he was born: a transplant is not a cure.

***

The Ranieris: Evan, Paul, Avery and Melissa.

Like many families, the Ranieris shared their story across social media. In addition to keeping friends and family posted on Evan’s progress, the social media presence helped meet a bigger goal: build awareness of the need for organ donation. This crusade to urge others of the importance of organ donation built a lot of momentum and Evan’s Facebook page has more than 2,000 friends. Although the surgeries are in the past, the family is still active with campaigns and donating their time to push the endless need for donors.

“We want Evan to feel empowered,” Melissa said. “It’s his journey, his story. We hope his story will influence others of kidney diseases and organ transplantation. We are strong advocates, active in Life Link and the National Kidney Foundation, as well as with the team at TGH.”

.

“You might automatically think of older populations when you mention transplants,” Paul said. “But the reality is children need them, too. They have their whole life in front of them.”

And that includes Evan. He will likely need additional kidneys in his lifetime.

“I’m not a match, and Melissa can’t donate again,” Paul said. “He could need one to two more kidneys across his lifetime.”

.

Dr. Campos is optimistic for improved medications, maybe even an effective artificial kidney if Evan does need another kidney.

“Currently, there are several kinds of antirejection medications and today’s medications have much better results than those in the past,” Dr. Campos said. “But there could be new meds that come along for him. I’m optimistic they’ll find even better ones, or develop an artificial kidney that the immune system won’t reject.”

But the bottom line right now, Dr. Campos said, is to fill out that donor card.

“We need more organ donors and they must be willing, able, and a good match,” he said.

Melissa gives an even more straight forward answer.

“If you donate, eight people’s lives will be saved,” she said.

Then, hinting to her single kidney, she smiled and said, “I’ll only be able to save seven and a half.”

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Visit Evans ORGANizers page on Facebook.

Photography by Eric Younghans, USF Health Office of Communications

The academic partnership with a preeminent heart transplant group will help position the University as a national leader in cardiovascular care

Tampa, FL (June 15, 2015) —The USF Health Morsani College of Medicine has launched an academic partnership with one of the top heart and lung transplant surgery groups in the country to expand the university’s education and research opportunities in advanced cardiovascular care.

The affiliation comes at a time when interventional cardiology and cardiac surgery continue to merge as less invasive procedures for treating high-risk patients with heart disease.

L to R: Dr. Christiano Caldeira, president and CEO of Florida Advanced Cardiothoracic Surgery, with Dr. Charles Lockwood, USF Health senior vice president and dean of the Morsani College of Medicine, and Dr. Arthur Labovitz, chair of USF Cardiovascular Sciences, at the academic partnership agreement signing.

The alliance with Florida Advanced Cardiothoracic Surgery (FACT Surgery), led by Cleveland Clinic-trained cardiothoracic surgeon Christiano Caldeira, MD, represents the latest success for the college’s Department of Cardiovascular Sciences, which has grown and strengthened under the leadership of cardiologist Arthur Labovitz, MD, department chair and co-director of the USF Health Heart Institute.

The partnership opens the door for USF to work closely with FACT Surgery to create accredited fellowships in cardiothoracic surgery and subspecialties such as heart and lung transplantation and heart surgery – training opportunities not available at the medical school.

FACT Surgery, a private cardiothoracic surgery group, specializes in treating patients with heart and lung failure. In a typical year, the surgeons perform more than 600 heart and lung surgeries. The four-member group practices primarily at Tampa General Hospital, which has the highest-volume heart transplant program in Florida according to the Organ Procurement and Transplantation Network.

Dr. Caldeira in one of the cardiac operating rooms at Tampa General Hospital — USF’s primary teaching hospital where the FACT Surgery group performs most of their more than 600 heart and lung surgeries a year.

“We’re extremely pleased that such a pre-eminent group of cardiovascular surgeons will now be affiliated with us,” said Charles J. Lockwood, MD, senior vice president of USF Health and dean of the Morsani College of Medicine.  “USF and Florida Advanced Cardiothoracic Surgery will build academic excellence in cardiothoracic surgery and related interventional cardiology specialties that capitalize upon nearby state-of-the-art resources at our primary teaching hospital Tampa General, at the Center for Advanced Medical Learning and Simulation (CAMLS) and at the Tampa Bay Research and Innovation Center.”

Under the agreement, the FACT Surgery doctors will be appointed affiliate faculty members at USF so they can help train and supervise USF fellows, residents and medical students and conduct research and other scholarly activities.

USF cardiology faculty and FACT Surgery surgeons meet for weekly conferences at TGH to decide on the best course of treatment for patients with advanced cardiovascular disease.

“At FACT Surgery, we always work to give patients the best care possible, to be on the cutting-edge of technology and to conduct clinical research – but we want the ability pass on our advanced knowledge and skills to the next generation of cardiothoracic specialists,” said Dr. Caldeira, president and CEO of FACT Surgery and surgical director of the heart and lung transplant programs at TGH. “With this new collaboration USF cardiologists can learn from us and we can learn from them. It will make us both better.”

“The collaboration will help raise the level of care and improve health outcomes for patients with heart disease in the Tampa Bay region while positioning USF Health as a national leader in cardiovascular care,” Dr. Labovitz said.

“This is the future of cardiovascular medicine,” he added. “Ultimately, this academic partnership, adding top-level cardiothoracic surgery to USF’s existing expertise in cardiovascular medicine and interventional cardiology, will lead to optimal patient care.”

USF Health cardiologist Dr. Arthur Labovitz, left, with Dr. Robert Hooker, one of the heart surgeons at Florida Advanced Cardiothoracic Surgery.

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

Florida Advanced Cardiothoracic Surgery
Florida Advanced Cardiothoracic Surgery (F.A.C.T. Surgery) is committed to providing our patients and referring providers with the most clinically and technologically advanced cardio thoracic treatment for advanced cardiac and lung conditions. The physicians and support staff are committed to our patients by offering a dedicated, caring and compassionate environment that is intended to improve the quality of their lives and subsequently, their families.

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

Michael E. Erhard, Executive Director, Florida Advanced Cardiothoracic Surgery
(813) 844-3228 or merhard@factsurgery.com

Dr. Maureen Groer leads a group of USF Health researchers in a five-year study examining the connection between digestive tract microbes and health and development

Tampa, FL (June 18, 2015) –The National Institute of Nursing Research (NINR) has awarded more than $2.7 million to University of South Florida College of Nursing to study preterm infants’ gut microbiome and its effect on their growth and development.

Maureen Groer, PhD, Gordon Keller professor at USF College of Nursing, will lead a team of USF Health researchers to study “The preterm infant microbiome: Biological, behavioral and health outcomes at two and four years of age.” During this five-year research project, Dr. Groer and her team will study 100 low birth weight infants through age 4.

The microbiome is the DNA extracted from the population of bacteria and other microorganisms living in the human gut.

Maureen Groer, PhD, Gordon Keller professor at USF College of Nursing, is principal investigator of the study analyzing stool samples over time to test for any links between microbes in the digestive tract and preterm infants’ growth and health outcomes.

The USF study will help measure and evaluate the preterm babies’ development, health and growth over time to discover if there is a direct relationship to the gut microbiome. The researchers will analyze preterm babies’ stool samples, collected for a previous NIH-funded study on feeding and health outcomes led by Dr. Groer. That earlier study examined stool samples obtained over the infants’ six-week stays in the neonatal intensive care unit (NICU). For the new study, researchers will collect more samples from these same infants at ages 2 and 4.

“The gut microbiome is in most cases established at three years old – except in those who may have an abnormal gut microbiome,” Dr. Groer said. “Previous research shows that the gut microbiome has a direct relationship with brain neurochemistry, behavior, metabolism and the development of the immune system. So, there is a variety of behavior, allergic and autoimmune diseases including Crohn’s disease, autism, diarrhea and obesity that may be related to disruption of the gut microbiome.”

Dr. Groer will conduct the study with a leading team of USF Health researchers including Terri Ashmeade, MD, associate professor at the USF Health Morsani College of Medicine’s Department of Pediatrics and NICU director at Tampa General Hospital; Larry Dishaw, PhD, assistant professor at USF Pediatrics; Ming Ji, PhD, professor at USF Nursing; Kathleen Armstrong, PhD, professor at USF Pediatrics; and Elizabeth Miller, PhD, assistant professor at the USF Department of Anthropology.

The children’s microbiome samples will be measured at the Argonne National Laboratory (ANL) by Jack Gilbert, PhD, associate professor and environmental microbiologist at the ANL Department of Ecology and Evolution. Maternal stool samples will be analyzed in the USF College of Nursing’s state-of the-art bio-behavioral laboratory.

The latest NIH study will be conducted by a multidisciplinary team of USF researchers from across nursing, medicine and anthropology.

According to Center for Disease Control and Prevention, preterm births affect one out of nine infants born in the United States. Preterm births are the number one cause of death in infants and the leading cause of long-term neurological disabilities and developmental health problems in children.

“We’re excited to lead the way in this research,” said Dianne Morrison-Beedy, PhD, senior associate vice president of USF Health and dean of the College of Nursing. “I’m proud to be part of a college that conducts research that makes life better for people locally, regionally and nationally.”

The study is supported by NINR, part of National Institute of Health (NIH). NINR helps promote and improve the health of individuals, families and communities. NINR is part of NIH’s 27 institutes and centers that support and conduct clinical and basic science research on health and illness. For more information about NIH and NINR visit www.ninr.nih.gov. 

-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. For more information, visit www.health.usf.edu.

Media Contact:
Vjollca “V” Hysenlika, College of Nursing Communications
(813) 974-2017, or vhysenli@health.usf.edu

Three words: Safe. Team. Commit. That’s the message Charles Paidas, MD, urged more than 230 new resident physicians to take away from their recent all-day orientation, their official welcome to the USF Health Morsani College of Medicine (MCOM).

“If you remember nothing else about the next 15 minutes, I want you to remember those words,” said Dr. Paidas, professor of surgery and vice dean for Clinical Affairs and Graduate Medical Education at MCOM. “These are your goals for your residency. Graduate as a safe doctor, be able to work in a team, and commit to your obligations of lifelong learning, your patients your peers and students, your department, and the USF Health Morsani College of Medicine.”

The June 30 orientation at the USF Alumni Center and was likely be the only time the entire group will be in the same room together. The next day – July 1, the national start to residency training programs – the new-to-USF residents were deployed to the many clinical facilities and hospitals throughout the Tampa Bay area affiliated with the USF Health Morsani College of Medicine.

This year’s entering group includes 238 physicians, with 147 residents and 91 fellows. Of the residents, about half are entering their first year of residency. Called PGY1s (post graduate year 1), these physicians are experiencing the first day of their medical careers – they just graduated from medical school a few months ago. The other incoming residents are beginning the next step in their residencies, transitioning to a narrower focus within their specialty. Fellows have finished their residencies and are now conducting additional, more specialized training within their specialty. Fellowships are typically highly competitive positions in superior programs. While most of the new resident physicians are from MCOM (40), the rest are graduates of schools and programs from farther afield, including China, Colombia, Taiwan, Bangladesh, Thailand, and Mexico, among others.

The annual influx of new residents and fellows marks a significant moment for these doctors, but probably a bit more so for the PGY1s. It’s when the paradigm shifts, Dr. Paidas said.

“As a medical student, decision making was ‘virtual’ and practiced in the shadows of the care team,” he said. “Now, the responsibility shifts to the intern, or first-year resident. Although not completely in charge, the first-year resident has graded responsibility and team trust is earned and rewarded with more responsibility. The first-year is all about learning the drill.

“And it’s the very first time an office or hospital patient looks at you as one of their docs, begins to develop a relationship with you, and trusts what you say.”

One such resident is Lindsey Ryan, MD, a PGY1 from the University of Louisville in Kentucky. Her first day included making early rounds at Tampa General Hospital with a team from Pediatric Surgery.

Dr. Ryan, who is specializing in otolaryngology, said that USF’s program rose above others when she was interviewing residency programs.

“On interview day, you look for a program you will fit into,” Dr. Ryan said. “That’s a big thing. There are great programs all over, but it’s that extra piece you look for. I loved the program and the faculty here and I felt right at home.”

Fitting right in on rounds at TGH, Dr. Ryan walked in and out of pediatric patient rooms with the health care team that included more seasoned residents, a chief resident, an attending physician, a nurse practitioner, and a USF medical student. These are the first patients she is seeing as a physician, a realization she doesn’t miss.

“I’m having a very good day,” she said.

USF’s residency program has more than 80 residency and fellowship training programs with more than 700 trainees. The program is considered strong, Dr. Paidas said.

“It’s all about the depth and breadth of patient populations,” he said. “The USF affiliates attract a wealth of patients and provide the substrate for the maturation of the resident. Tampa Bay has historically been an attractive geographic locale. In addition, we have a superb clinical faculty able to balance their work with patient care and education. Think about it. Our affiliates include the Number One ranked hospital in the State, level 1 Pediatric and Adult trauma Center, Comprehensive Cancer Center, two VA’s, Family Health Clinics. Our affiliates give us an unbelievable depth of patients.”

This year’s residents and fellows totaled 238. About 45% are starting at Tampa General Hospital, 25% at the Haley VA Hospital, 15% at Moffitt Cancer Center, and the remaining are at various other sites. Internal medicine welcomed the largest number of new residents and fellows, with 73, followed by surgery, with 25.

Here is a breakdown of the entire group:

Dermatology, 5

Emergency Medicine, 10

Family Medicine, 10

Cardiology, 7

Internal Medicine, 73

Medicine / Pediatrics, 6

Neurology, 18

Neurosurgery, 4

Obstetrics & Gynecology, 7

Ophthalmology, 5

Orthopaedics, 7

Otolaryngology, 3

Pathology, 8

Pediatrics, 15

Preventive/Occupational Medicine, 2

Psychiatry, 13

Radiology,20

Surgery, 25

Story by Sarah Worth, and photos by Sandra C. Roa, USF Health Office of Communications. 

Closely huddled by attentive residents and students, USF physician Charles Edwards, MD, performs his daily rounds of patients inside Tampa General Hospital. Dr. Edwards is a hospitalist and as such, he and his team care for hospitalized patients until they are well enough to be discharged. Patient stays range anywhere from 12 hours to many months.

//www.youtube.com/watch?v=W-k7DXepKAc

Regardless of stay length or ailment, these in-house doctors known as hospitalists lead a team of other specialists such as physical therapists, nurses and pharmacists, to best provide safe and efficient patient care.

“We see every type of patient at this hospital so it’s hard to say that there is a typical pattern and that’s one of the unique challenges for a hospitalist,” said Dr. Edwards.

During patient visits, Dr. Charles Edwards takes time to connect with his patients to learn about their lives and individual challenges that may effect health outcomes.

The hospitalist role is fairly new in medical practice, just two decades since the position first began to appear. Its purpose was to eliminate needless transportation time for primary care doctors so they could focus more on office visits and so that the hospital can provide immediate personalized care to their patients. Currently there are 34 USF Health hospitalists working at Tampa General Hospital.

“We are here, we are here 24 hours a day. Available immediately to see patients, if needed,” said Dr. Edwards who takes pride in connecting with his patients, “though [my care] may not continue, while they’re here [I’m] going to care for them as much as their primary care doctor does.”

On a typical morning you’ll find Dr. Edwards and his team reporting on their patients’ progress with details about medication, mental status and sleep or eating patterns. They will see between 15 to 20 patients throughout the day. However, patient care involves more than bedside visits. For physicians like Dr. Edwards, responsibilities extend into his personal life and he is passionate about it. He might read more about the symptoms of a patient he’s not sure about or catch up on the latest from his favorite medical journal.

Residents and students evaluate patients’ progress with Dr. Edward’s guidance.

Dr. Edwards’ profession is not just about patient care, it’s an “innate curiosity about medicine,” and a balance of at least four other roles. In addition to being the director of the Division of Hospital Medicine, vice-chairman for Clinical Operations in the Department of Internal Medicine and chief of staff at TGH, he is also an associate professor at USF Health’s Morsani College of Medicine.

Patient records are updated as Dr. Edwards and his team complete morning rounds.

“Without a doubt teaching is my main inspiration,” said Dr. Edwards. “The one thing I can do and enjoy, [is to] go around with my students, residents and my team to see our patients.”

Many doctors were inspired to pursue their profession by personal reasons, or wanting to do something important in life. Dr. Edwards had these reasons, but his active role as an educator is a daily reminder of the benefits of his kind of work.

“I’m constantly around other people who are learning,” said Dr. Edwards. I constantly have to try and teach younger physicians and that’s one of the best ways to learn, is to teach. They certainly keep you on your toes.”

Dr. Charles Edwards and his team provide non-surgical patient care throughout Tampa General Hospital.

Aside from his patients, mentorships and dedication to keep up with medical advancements, Dr. Edwards has his mind set on the future of hospital medicine.

“We’re constantly looking for ways to make the hospital safer,” said Dr. Edwards. He’s referring to the main challenge his profession faces: The transition of patient care.

Caring for patients has a multi-level set of tasks that include bedside visits, medical charting, preventing infections, avoiding unnecessary tests, not delaying patient stays, and the continuum of patient care beyond their hospital stay.

“One of the things that you must do is make sure you understand the challenges a particular patient is going to face when they’re discharged so that you can try to best address them,” said Dr. Edwards. “But it is often a source of anxiety when patients leave the hospital.”

The final stage of Dr. Edwards’ care involves updating the patient’s records and sharing the hospitalization charts with the primary doctor. Patient medical information is private and protected by federal HIPAA laws, which limit how hospitalists and primary doctors can exchange records.

Medicine, as most professional fields, has been increasingly harnessing the powers of technology. The transition of patient care is eased by the standardization of electronic health records and USF Health’s Physicians Group patients will benefit even more with its transition to EPIC– the same EHR used at TGH, thus providing a stronger continuity of care. With a unified records system, interdisciplinary caregivers can access thorough medical data about a patient. Hospitals, clinics and physicians can share details about their patient’s outcome and will help relieve the worry that hospitalists have when treating or discharging patients. But for Dr. Edwards, the best assurance has a personal touch.

“Technology will certainly play a big role in improving the transition of care in the future, but there’s no substitute for good old-fashioned verbal communication with fellow colleagues.”

Story and multimedia by Sandra C. Roa, USF Health Office of Communications. 

At nationally ranked Tampa General Hospital, USF physicians play leadership roles in eight of 10 medical specialties ranked top or high performing by U.S. News & World Report

U.S. News & World Report (U.S. News) has ranked Tampa General Hospital, USF Health’s primary teaching hospital, as one of one of the top 50 hospitals nationally in six medical specialties and the number three hospital in Florida for 2015-16.

USF Health academic partner Moffitt Cancer Center was ranked as the number one cancer hospital in Florida, and number 18 nationwide, based on the U.S News Best Hospitals for Adult Cancer Care rankings.

At TGH, where Morsani College of Medicine hospitalist Dr. Charles Edwards serves as chief of staff, USF Health doctors play a key leadership role in five of the six medical specialties recognized as top-ranked by U.S. News.  The six specialty areas, up from four top ranked last year, were: Cardiology & Heart Surgery, Gastroenterology & GI Surgery, Nephrology, Orthopaedics, Pulmonology, and Urology.

USF Health core faculty members with key leadership roles in these nationally ranked specialties at TGH include:

Cardiology:  TGH is USF’s primary cardiology practice site, where most of the university’s inpatient and outpatient cardiac services and all inpatient cardiovascular clinical trials are provided.  John T. Sullebarger, MD, Chief of Cardiology. Medical Directors: Arthur Labovitz, MD, (Chair of USF Cardiovascular Sciences), Non-invasive Cardiology and Atrial Fibrillation services; Michael Berlowitz, MD, and Fadi Matar, MD, Catheterization Laboratory (co-direct); and Joel Fernandez, MD, Cardiac Rehabilitation Program.

Gastroenterology & GI Surgery:  Patrick Brady, MD, Chief, and Haim Pinkas, MD, Vice Chief of Gastroenterology.  Medical directors: Dr. Brady, TGH Gastroenterology Center; John Gonzalvo, MD, and Michel Murr, MD, Bariatric Surgery (co-direct); John Jacobs, MD, Gastroenterology Quality; and Jorge Marcet, MD, Colorectal Surgery.

Nephrology:  Elias Doumit, MD, Vice Chief of Nephrology; and Alfonso Campos, MD, Medical Director of Pediatric Dialysis.

Pulmonology:  Mark Rumbak, MD, Chief of Pulmonology/Critical Care; Medical directors: William McDowell Anderson, Sleep Disorders Center; David Solomon, MD, Adult Step Down and Pulmonary Diagnostic & Respiratory units; Brice Taylor, MD, Medical Intensive Care Unit (MICU).

Urology: David Hernandez, MD, chief of urology.

In addition, Florida Orthopedic Institute President Roy Sanders, MD, chief of orthopaedic surgery at TGH, was recently named chair of the Morsani College of Medicine’s Department of Orthopaedics and Sports Medicine.

USF Health physicians also have a leadership presence in three of the four medical specialties that received “High Performing” ratings by U.S. News:

Cancer: Lawrence Berk, MD, chief or radiation oncology; Medical Directors: Dr. Berk, Radiation Oncology; and Mitchel Hoffman, MD, Gynecologic Oncology.

Geriatrics:  Medical Directors: Stephanie Taylor, MD, Acute Care for Elders (ACE); and Howard Tuch, MD, Palliative Care.

Neurology & Neurosurgery:  Rossitza Chichkova, MD, chief, and Derrick Robertson, MD, vice chief, of Neurology; Fernando Vale, MD, chief, and Donald Smith, vice chief of Neurosurgery. Medical directors: Siviero Agazzi, MD, Neuro Intensive Care Unit and Neuro Trauma Unit; Selim Benbadis, MD, Seizure Monitoring Center and Neurodiagnostic Laboratory; William Burgin, MD, Stroke Program; Dr. Chichkova, EMG Laboratory; Sarah Gaskill, MD, Pediatric Neurosurgery; David Rose, MD, Neuro Critical Care; Dr. Vale, Spinal Surgery; and Harry van Loveren, MD, Neurosurgery.
// // // //

All Children’s Hospital in St. Petersburg, the primary hospital partner for pediatrics training of USF medical students and residents, was nationally ranked in two categories – cardiology and heart surgery and pulmonology.

The national Best Hospitals rankings, now in their 26th year, recognize 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.

U.S. News evaluates hospitals in 16 adult specialties and ranked the top 50 in most of the specialties. Less than 3 percent of the nearly 5,000 hospitals that were analyzed for Best Hospitals 2015-16 were nationally ranked in even one specialty.

The full rankings are available at http://health.usnews.com/best-hospitals.

USF Health converted to Epic electronic health records (EHR) system at all its clinical sites Aug. 1, launching a new era of efficiency, improved patient care and safety, and a more cohesive system with Tampa General Hospital, its primary teaching hospital.

It may have set a record for one of the fastest transitions; typical changeovers take more than 18 months; USF Health did it in seven.

One week in since the Aug 1 Go-Live launch and many areas are already ramping up to refill schedules for patient appointments, which had been reduced to allow for fewer complications, said Patrick Gall, senior director of USF Health Applications and the technology lead for the USF Health Epic implementation project.

The USF Health transitioned to the Epic electronic health records system in seven months; the typical changeover takes more than 18 months.

The Aug. 1 Go-Live launch was set purposefully on Saturday– when only a few clinical areas see a few patients – so the true test came Monday, Aug. 3, when all clinical areas began seeing patients. On Monday, Aug. 3, the day began with an initial hiccup related to access security, an anticipated problem with most Epic launches so USF Health Information Systems was prepared and quickly remedied the issue, Gall said. There were a few other issues across the day, but mostly clinics ran smoothly, Gall said. In all, the Command Center – a room filled with dozens of support staff specially trained for Epic – took 581 calls Monday and by Wednesday calls were down to 315.

The transition continues for another couple of weeks, Gall said, and by the end of August, the Go-Live portion of the project will be complete. By then, two and half years’ worth of clinical data will have been transferred into Epic.

Next steps, he said, include customizing the system to each departments’ needs (starting Sept. 1) and the implementation of ICD-10 (starting Oct. 1), the international medical coding system. In January, all USF Health clinical sites and departments will receive consultation on workflow optimization within Epic to be more efficient with inputting patient data.

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Some highlights of the USF Health Epic implementation and of the first week for Go-Live include:

* Executed in 7 months (average is 18 months)

* Rolled out electronic charge capture (a first for USF Health providers, who formerly used paper)

* Ensuring ICD-10 compliance

* Became the largest ever “practice connect” Epic deployment

* Trained more than 1,700 users in a 6-week timeframe

* Partnered with TGH’s Epic system while creating a support model where USF Health can support its own users

* Built ~160 Epic Departments (four times the amount TGH had in their Epic environments prior to USF Health)

* Deployed and tested over 1,100 end point computing devices before Go Live

* Manually migrated over 60,000 appointments in one weekend

* Ensured the EHR interfaces effectively with GE Billing and all ancillary systems (ASC, Radiology, etc.)

* Trained entire EHR support team on a new technology while building it

* Developed and deployed a super user program with over 100 super users and over 40 provider champions

* Migrated all patient data from the last 2.5 years into Epic and connected to TGH records

* Deployed Kaleidoscope-specific system for Ophthalmology within the same timeframe

Hundreds of people from various departments have been involved in the project including: USF Health Administration, USF Health Information Systems, Revenue Cycle, Clinical Operations, Patient Access, provider champions, TGH Administration, TGH analysts, Epic consultant analysts, consultant trainers, consultant support, USF System Information Technology and USF Health Communications.

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Photos by Sandra Roa, USF Health Communications and Marketing

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

USF kidney expert Dr. Alfonso Campos guides the family and health care team, from diagnosis to transplant to success.

Twenty weeks into her pregnancy with her second child, Melissa Ranieri was told there was a problem with her baby and that he might not make it past birth.

The news hit hard. Their baby boy Evan had very small kidneys and would likely not be able to survive on his own. She and her husband Paul carried the weight every day, turning to family for support, turning to the internet for research and similar stories.

Evan Ranieri snuggles with his mom Melissa.

And turning to USF pediatricians for deeper answers and a second opinion.

That second opinion came from Alfonso Campos, MD, associate professor of pediatric nephrology and an expert on kidneys in children, especially in babies.

“The first diagnosis turned our family upside down,” Melissa said. “But Dr. Campos told us Evan had a much better chance of survival than that.”

“Otherwise healthy, Evan still had small kidneys and they weren’t working well,” Dr. Campos said. “In many newborns, the problem subsides as they grow – they grow out of it. But not for Evan. He wouldn’t require dialysis right away, and he would need medications to address function, such as acid in the blood, and a careful diet. But the prognosis was renal failure.”

Although it was better news for the Ranieris that Evan was strong enough to get by for a while, the reality remained that Evan’s kidneys would not support him long before he would need a transplant. Decisions were made, like delivering at Tampa General because they “needed to be at the best hospital,” and the comprehensive kidney care provided there, Melissa said.

“Dr. Campos and his team made sure we were prepared for what was to come,” Melissa said.

“They even preemptively showed us the NICU (neonatal intensive care unit) to acclimate us to the environment so we would be ready,” Paul added.

***

Evan was born in March 2011 at Tampa General surrounded by a team of highly trained pediatric surgeons, nephrologists, NICU physicians and nurses, and others working together, standing ready to react to whatever Evan presented.

“Evan was only hours old when doctors confirmed our worse fears,” Paul said. “His kidneys were failing.”

The newborn was immediately put in the Muma NICU at Tampa General Hospital and the conversation turned to next steps, the first being finding a kidney donor.

***

Evan runs from room to room of the Ranieri’s new house in Riverview. Having just moved in a few weeks earlier, several rooms remain empty as the family settles in. Evan, who is nearly 4 years old, is making use of the open space to chase his big sister Avery, who is 7.

Evan and his sister Avery.

The bonds are strong in this family, but none as literal as those between Melissa and Evan – mother and child.

About 18 months after being born – after spending several months in the NICU before coming home for the first time, followed by nearly daily trips to TGH for dialysis – Evan’s kidneys totally failed. He went from having dialysis to get by to needing a kidney transplant in order to live.

And it was one of his mother’s own kidneys that saved him.

***

In May 2013, the renal transplant team transplanted a kidney from Melissa into Evan. Probably the most obvious question is how does an adult kidney fit into a toddler?

“Kidneys are amazing – once in Evan, the kidney actually shrank a bit and will grow as Evan grows, growing back into an adult size kidney,” Dr. Campos said. “And for Melissa, as an organ donor, she lost a kidney so her remaining kidney grew to accommodate.”

Sister Avery and Dr. Campos visit Evan while he recuperates at Tampa General. Photo courtesy of the Ranieris.

The Ranieris are eager to say that it was finding the right team that has helped their family the most.

“We really are so grateful for the medical staff at both Tampa General and USF,” Paul said. “Everyone in the PICU, the NICU, the doctors and nurses at every level, were all so welcoming and positive. It was a very good experience, considering the circumstances.”

Mother and son. Two kidney transplant patients at Tampa General, one giving, the other receiving. Photo courtesy of the Ranieris.

Signs of recovery. Evan races the halls at TGH following his transplant surgery. Photo courtesy of the Ranieris.

“The standards are different with TGH and USF,” Melissa said. “We knew with Evan we would need to have a higher level of care. Even if we had lived in Miami, we would have come to Tampa General and to the doctors at USF for their pediatric transplant expertise.”

Now, at 26 months post-surgery, and having just celebrated his fourth birthday, Evan’s future is bright and he’s expected to have a healthy childhood. There will be rules with his diet and there will be no contact sports. He will take anti-rejection medications for the rest of his life, although the fear of his body rejecting his single kidney is constant. Melissa and Paul know that Evan will likely need additional transplants later in his life, repeating what they’ve told themselves since he was born: a transplant is not a cure.

***

The Ranieris: Evan, Paul, Avery and Melissa.

Like many families, the Ranieris shared their story across social media. In addition to keeping friends and family posted on Evan’s progress, the social media presence helped meet a bigger goal: build awareness of the need for organ donation. This crusade to urge others of the importance of organ donation built a lot of momentum and Evan’s Facebook page has more than 2,000 friends. Although the surgeries are in the past, the family is still active with campaigns and donating their time to push the endless need for donors.

“We want Evan to feel empowered,” Melissa said. “It’s his journey, his story. We hope his story will influence others of kidney diseases and organ transplantation. We are strong advocates, active in Life Link and the National Kidney Foundation, as well as with the team at TGH.”

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“You might automatically think of older populations when you mention transplants,” Paul said. “But the reality is children need them, too. They have their whole life in front of them.”

And that includes Evan. He will likely need additional kidneys in his lifetime.

“I’m not a match, and Melissa can’t donate again,” Paul said. “He could need one to two more kidneys across his lifetime.”

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Dr. Campos is optimistic for improved medications, maybe even an effective artificial kidney if Evan does need another kidney.

“Currently, there are several kinds of antirejection medications and today’s medications have much better results than those in the past,” Dr. Campos said. “But there could be new meds that come along for him. I’m optimistic they’ll find even better ones, or develop an artificial kidney that the immune system won’t reject.”

But the bottom line right now, Dr. Campos said, is to fill out that donor card.

“We need more organ donors and they must be willing, able, and a good match,” he said.

Melissa gives an even more straight forward answer.

“If you donate, eight people’s lives will be saved,” she said.

Then, hinting to her single kidney, she smiled and said, “I’ll only be able to save seven and a half.”

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Visit Evans ORGANizers page on Facebook.

Photography by Eric Younghans, USF Health Office of Communications

The academic partnership with a preeminent heart transplant group will help position the University as a national leader in cardiovascular care

Tampa, FL (June 15, 2015) —The USF Health Morsani College of Medicine has launched an academic partnership with one of the top heart and lung transplant surgery groups in the country to expand the university’s education and research opportunities in advanced cardiovascular care.

The affiliation comes at a time when interventional cardiology and cardiac surgery continue to merge as less invasive procedures for treating high-risk patients with heart disease.

L to R: Dr. Christiano Caldeira, president and CEO of Florida Advanced Cardiothoracic Surgery, with Dr. Charles Lockwood, USF Health senior vice president and dean of the Morsani College of Medicine, and Dr. Arthur Labovitz, chair of USF Cardiovascular Sciences, at the academic partnership agreement signing.

The alliance with Florida Advanced Cardiothoracic Surgery (FACT Surgery), led by Cleveland Clinic-trained cardiothoracic surgeon Christiano Caldeira, MD, represents the latest success for the college’s Department of Cardiovascular Sciences, which has grown and strengthened under the leadership of cardiologist Arthur Labovitz, MD, department chair and co-director of the USF Health Heart Institute.

The partnership opens the door for USF to work closely with FACT Surgery to create accredited fellowships in cardiothoracic surgery and subspecialties such as heart and lung transplantation and heart surgery – training opportunities not available at the medical school.

FACT Surgery, a private cardiothoracic surgery group, specializes in treating patients with heart and lung failure. In a typical year, the surgeons perform more than 600 heart and lung surgeries. The four-member group practices primarily at Tampa General Hospital, which has the highest-volume heart transplant program in Florida according to the Organ Procurement and Transplantation Network.

Dr. Caldeira in one of the cardiac operating rooms at Tampa General Hospital — USF’s primary teaching hospital where the FACT Surgery group performs most of their more than 600 heart and lung surgeries a year.

“We’re extremely pleased that such a pre-eminent group of cardiovascular surgeons will now be affiliated with us,” said Charles J. Lockwood, MD, senior vice president of USF Health and dean of the Morsani College of Medicine.  “USF and Florida Advanced Cardiothoracic Surgery will build academic excellence in cardiothoracic surgery and related interventional cardiology specialties that capitalize upon nearby state-of-the-art resources at our primary teaching hospital Tampa General, at the Center for Advanced Medical Learning and Simulation (CAMLS) and at the Tampa Bay Research and Innovation Center.”

Under the agreement, the FACT Surgery doctors will be appointed affiliate faculty members at USF so they can help train and supervise USF fellows, residents and medical students and conduct research and other scholarly activities.

USF cardiology faculty and FACT Surgery surgeons meet for weekly conferences at TGH to decide on the best course of treatment for patients with advanced cardiovascular disease.

“At FACT Surgery, we always work to give patients the best care possible, to be on the cutting-edge of technology and to conduct clinical research – but we want the ability pass on our advanced knowledge and skills to the next generation of cardiothoracic specialists,” said Dr. Caldeira, president and CEO of FACT Surgery and surgical director of the heart and lung transplant programs at TGH. “With this new collaboration USF cardiologists can learn from us and we can learn from them. It will make us both better.”

“The collaboration will help raise the level of care and improve health outcomes for patients with heart disease in the Tampa Bay region while positioning USF Health as a national leader in cardiovascular care,” Dr. Labovitz said.

“This is the future of cardiovascular medicine,” he added. “Ultimately, this academic partnership, adding top-level cardiothoracic surgery to USF’s existing expertise in cardiovascular medicine and interventional cardiology, will lead to optimal patient care.”

USF Health cardiologist Dr. Arthur Labovitz, left, with Dr. Robert Hooker, one of the heart surgeons at Florida Advanced Cardiothoracic Surgery.

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

Florida Advanced Cardiothoracic Surgery
Florida Advanced Cardiothoracic Surgery (F.A.C.T. Surgery) is committed to providing our patients and referring providers with the most clinically and technologically advanced cardio thoracic treatment for advanced cardiac and lung conditions. The physicians and support staff are committed to our patients by offering a dedicated, caring and compassionate environment that is intended to improve the quality of their lives and subsequently, their families.

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

Michael E. Erhard, Executive Director, Florida Advanced Cardiothoracic Surgery
(813) 844-3228 or merhard@factsurgery.com

Dr. Maureen Groer leads a group of USF Health researchers in a five-year study examining the connection between digestive tract microbes and health and development

Tampa, FL (June 18, 2015) –The National Institute of Nursing Research (NINR) has awarded more than $2.7 million to University of South Florida College of Nursing to study preterm infants’ gut microbiome and its effect on their growth and development.

Maureen Groer, PhD, Gordon Keller professor at USF College of Nursing, will lead a team of USF Health researchers to study “The preterm infant microbiome: Biological, behavioral and health outcomes at two and four years of age.” During this five-year research project, Dr. Groer and her team will study 100 low birth weight infants through age 4.

The microbiome is the DNA extracted from the population of bacteria and other microorganisms living in the human gut.

Maureen Groer, PhD, Gordon Keller professor at USF College of Nursing, is principal investigator of the study analyzing stool samples over time to test for any links between microbes in the digestive tract and preterm infants’ growth and health outcomes.

The USF study will help measure and evaluate the preterm babies’ development, health and growth over time to discover if there is a direct relationship to the gut microbiome. The researchers will analyze preterm babies’ stool samples, collected for a previous NIH-funded study on feeding and health outcomes led by Dr. Groer. That earlier study examined stool samples obtained over the infants’ six-week stays in the neonatal intensive care unit (NICU). For the new study, researchers will collect more samples from these same infants at ages 2 and 4.

“The gut microbiome is in most cases established at three years old – except in those who may have an abnormal gut microbiome,” Dr. Groer said. “Previous research shows that the gut microbiome has a direct relationship with brain neurochemistry, behavior, metabolism and the development of the immune system. So, there is a variety of behavior, allergic and autoimmune diseases including Crohn’s disease, autism, diarrhea and obesity that may be related to disruption of the gut microbiome.”

Dr. Groer will conduct the study with a leading team of USF Health researchers including Terri Ashmeade, MD, associate professor at the USF Health Morsani College of Medicine’s Department of Pediatrics and NICU director at Tampa General Hospital; Larry Dishaw, PhD, assistant professor at USF Pediatrics; Ming Ji, PhD, professor at USF Nursing; Kathleen Armstrong, PhD, professor at USF Pediatrics; and Elizabeth Miller, PhD, assistant professor at the USF Department of Anthropology.

The children’s microbiome samples will be measured at the Argonne National Laboratory (ANL) by Jack Gilbert, PhD, associate professor and environmental microbiologist at the ANL Department of Ecology and Evolution. Maternal stool samples will be analyzed in the USF College of Nursing’s state-of the-art bio-behavioral laboratory.

The latest NIH study will be conducted by a multidisciplinary team of USF researchers from across nursing, medicine and anthropology.

According to Center for Disease Control and Prevention, preterm births affect one out of nine infants born in the United States. Preterm births are the number one cause of death in infants and the leading cause of long-term neurological disabilities and developmental health problems in children.

“We’re excited to lead the way in this research,” said Dianne Morrison-Beedy, PhD, senior associate vice president of USF Health and dean of the College of Nursing. “I’m proud to be part of a college that conducts research that makes life better for people locally, regionally and nationally.”

The study is supported by NINR, part of National Institute of Health (NIH). NINR helps promote and improve the health of individuals, families and communities. NINR is part of NIH’s 27 institutes and centers that support and conduct clinical and basic science research on health and illness. For more information about NIH and NINR visit www.ninr.nih.gov. 

-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. For more information, visit www.health.usf.edu.

Media Contact:
Vjollca “V” Hysenlika, College of Nursing Communications
(813) 974-2017, or vhysenli@health.usf.edu

Three words: Safe. Team. Commit. That’s the message Charles Paidas, MD, urged more than 230 new resident physicians to take away from their recent all-day orientation, their official welcome to the USF Health Morsani College of Medicine (MCOM).

“If you remember nothing else about the next 15 minutes, I want you to remember those words,” said Dr. Paidas, professor of surgery and vice dean for Clinical Affairs and Graduate Medical Education at MCOM. “These are your goals for your residency. Graduate as a safe doctor, be able to work in a team, and commit to your obligations of lifelong learning, your patients your peers and students, your department, and the USF Health Morsani College of Medicine.”

The June 30 orientation at the USF Alumni Center and was likely be the only time the entire group will be in the same room together. The next day – July 1, the national start to residency training programs – the new-to-USF residents were deployed to the many clinical facilities and hospitals throughout the Tampa Bay area affiliated with the USF Health Morsani College of Medicine.

This year’s entering group includes 238 physicians, with 147 residents and 91 fellows. Of the residents, about half are entering their first year of residency. Called PGY1s (post graduate year 1), these physicians are experiencing the first day of their medical careers – they just graduated from medical school a few months ago. The other incoming residents are beginning the next step in their residencies, transitioning to a narrower focus within their specialty. Fellows have finished their residencies and are now conducting additional, more specialized training within their specialty. Fellowships are typically highly competitive positions in superior programs. While most of the new resident physicians are from MCOM (40), the rest are graduates of schools and programs from farther afield, including China, Colombia, Taiwan, Bangladesh, Thailand, and Mexico, among others.

The annual influx of new residents and fellows marks a significant moment for these doctors, but probably a bit more so for the PGY1s. It’s when the paradigm shifts, Dr. Paidas said.

“As a medical student, decision making was ‘virtual’ and practiced in the shadows of the care team,” he said. “Now, the responsibility shifts to the intern, or first-year resident. Although not completely in charge, the first-year resident has graded responsibility and team trust is earned and rewarded with more responsibility. The first-year is all about learning the drill.

“And it’s the very first time an office or hospital patient looks at you as one of their docs, begins to develop a relationship with you, and trusts what you say.”

One such resident is Lindsey Ryan, MD, a PGY1 from the University of Louisville in Kentucky. Her first day included making early rounds at Tampa General Hospital with a team from Pediatric Surgery.

Dr. Ryan, who is specializing in otolaryngology, said that USF’s program rose above others when she was interviewing residency programs.

“On interview day, you look for a program you will fit into,” Dr. Ryan said. “That’s a big thing. There are great programs all over, but it’s that extra piece you look for. I loved the program and the faculty here and I felt right at home.”

Fitting right in on rounds at TGH, Dr. Ryan walked in and out of pediatric patient rooms with the health care team that included more seasoned residents, a chief resident, an attending physician, a nurse practitioner, and a USF medical student. These are the first patients she is seeing as a physician, a realization she doesn’t miss.

“I’m having a very good day,” she said.

USF’s residency program has more than 80 residency and fellowship training programs with more than 700 trainees. The program is considered strong, Dr. Paidas said.

“It’s all about the depth and breadth of patient populations,” he said. “The USF affiliates attract a wealth of patients and provide the substrate for the maturation of the resident. Tampa Bay has historically been an attractive geographic locale. In addition, we have a superb clinical faculty able to balance their work with patient care and education. Think about it. Our affiliates include the Number One ranked hospital in the State, level 1 Pediatric and Adult trauma Center, Comprehensive Cancer Center, two VA’s, Family Health Clinics. Our affiliates give us an unbelievable depth of patients.”

This year’s residents and fellows totaled 238. About 45% are starting at Tampa General Hospital, 25% at the Haley VA Hospital, 15% at Moffitt Cancer Center, and the remaining are at various other sites. Internal medicine welcomed the largest number of new residents and fellows, with 73, followed by surgery, with 25.

Here is a breakdown of the entire group:

Dermatology, 5

Emergency Medicine, 10

Family Medicine, 10

Cardiology, 7

Internal Medicine, 73

Medicine / Pediatrics, 6

Neurology, 18

Neurosurgery, 4

Obstetrics & Gynecology, 7

Ophthalmology, 5

Orthopaedics, 7

Otolaryngology, 3

Pathology, 8

Pediatrics, 15

Preventive/Occupational Medicine, 2

Psychiatry, 13

Radiology,20

Surgery, 25

Story by Sarah Worth, and photos by Sandra C. Roa, USF Health Office of Communications. 

Closely huddled by attentive residents and students, USF physician Charles Edwards, MD, performs his daily rounds of patients inside Tampa General Hospital. Dr. Edwards is a hospitalist and as such, he and his team care for hospitalized patients until they are well enough to be discharged. Patient stays range anywhere from 12 hours to many months.

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Regardless of stay length or ailment, these in-house doctors known as hospitalists lead a team of other specialists such as physical therapists, nurses and pharmacists, to best provide safe and efficient patient care.

“We see every type of patient at this hospital so it’s hard to say that there is a typical pattern and that’s one of the unique challenges for a hospitalist,” said Dr. Edwards.

During patient visits, Dr. Charles Edwards takes time to connect with his patients to learn about their lives and individual challenges that may effect health outcomes.

The hospitalist role is fairly new in medical practice, just two decades since the position first began to appear. Its purpose was to eliminate needless transportation time for primary care doctors so they could focus more on office visits and so that the hospital can provide immediate personalized care to their patients. Currently there are 34 USF Health hospitalists working at Tampa General Hospital.

“We are here, we are here 24 hours a day. Available immediately to see patients, if needed,” said Dr. Edwards who takes pride in connecting with his patients, “though [my care] may not continue, while they’re here [I’m] going to care for them as much as their primary care doctor does.”

On a typical morning you’ll find Dr. Edwards and his team reporting on their patients’ progress with details about medication, mental status and sleep or eating patterns. They will see between 15 to 20 patients throughout the day. However, patient care involves more than bedside visits. For physicians like Dr. Edwards, responsibilities extend into his personal life and he is passionate about it. He might read more about the symptoms of a patient he’s not sure about or catch up on the latest from his favorite medical journal.

Residents and students evaluate patients’ progress with Dr. Edward’s guidance.

Dr. Edwards’ profession is not just about patient care, it’s an “innate curiosity about medicine,” and a balance of at least four other roles. In addition to being the director of the Division of Hospital Medicine, vice-chairman for Clinical Operations in the Department of Internal Medicine and chief of staff at TGH, he is also an associate professor at USF Health’s Morsani College of Medicine.

Patient records are updated as Dr. Edwards and his team complete morning rounds.

“Without a doubt teaching is my main inspiration,” said Dr. Edwards. “The one thing I can do and enjoy, [is to] go around with my students, residents and my team to see our patients.”

Many doctors were inspired to pursue their profession by personal reasons, or wanting to do something important in life. Dr. Edwards had these reasons, but his active role as an educator is a daily reminder of the benefits of his kind of work.

“I’m constantly around other people who are learning,” said Dr. Edwards. I constantly have to try and teach younger physicians and that’s one of the best ways to learn, is to teach. They certainly keep you on your toes.”

Dr. Charles Edwards and his team provide non-surgical patient care throughout Tampa General Hospital.

Aside from his patients, mentorships and dedication to keep up with medical advancements, Dr. Edwards has his mind set on the future of hospital medicine.

“We’re constantly looking for ways to make the hospital safer,” said Dr. Edwards. He’s referring to the main challenge his profession faces: The transition of patient care.

Caring for patients has a multi-level set of tasks that include bedside visits, medical charting, preventing infections, avoiding unnecessary tests, not delaying patient stays, and the continuum of patient care beyond their hospital stay.

“One of the things that you must do is make sure you understand the challenges a particular patient is going to face when they’re discharged so that you can try to best address them,” said Dr. Edwards. “But it is often a source of anxiety when patients leave the hospital.”

The final stage of Dr. Edwards’ care involves updating the patient’s records and sharing the hospitalization charts with the primary doctor. Patient medical information is private and protected by federal HIPAA laws, which limit how hospitalists and primary doctors can exchange records.

Medicine, as most professional fields, has been increasingly harnessing the powers of technology. The transition of patient care is eased by the standardization of electronic health records and USF Health’s Physicians Group patients will benefit even more with its transition to EPIC– the same EHR used at TGH, thus providing a stronger continuity of care. With a unified records system, interdisciplinary caregivers can access thorough medical data about a patient. Hospitals, clinics and physicians can share details about their patient’s outcome and will help relieve the worry that hospitalists have when treating or discharging patients. But for Dr. Edwards, the best assurance has a personal touch.

“Technology will certainly play a big role in improving the transition of care in the future, but there’s no substitute for good old-fashioned verbal communication with fellow colleagues.”

Story and multimedia by Sandra C. Roa, USF Health Office of Communications. 

At nationally ranked Tampa General Hospital, USF physicians play leadership roles in eight of 10 medical specialties ranked top or high performing by U.S. News & World Report

U.S. News & World Report (U.S. News) has ranked Tampa General Hospital, USF Health’s primary teaching hospital, as one of one of the top 50 hospitals nationally in six medical specialties and the number three hospital in Florida for 2015-16.

USF Health academic partner Moffitt Cancer Center was ranked as the number one cancer hospital in Florida, and number 18 nationwide, based on the U.S News Best Hospitals for Adult Cancer Care rankings.

At TGH, where Morsani College of Medicine hospitalist Dr. Charles Edwards serves as chief of staff, USF Health doctors play a key leadership role in five of the six medical specialties recognized as top-ranked by U.S. News.  The six specialty areas, up from four top ranked last year, were: Cardiology & Heart Surgery, Gastroenterology & GI Surgery, Nephrology, Orthopaedics, Pulmonology, and Urology.

USF Health core faculty members with key leadership roles in these nationally ranked specialties at TGH include:

Cardiology:  TGH is USF’s primary cardiology practice site, where most of the university’s inpatient and outpatient cardiac services and all inpatient cardiovascular clinical trials are provided.  John T. Sullebarger, MD, Chief of Cardiology. Medical Directors: Arthur Labovitz, MD, (Chair of USF Cardiovascular Sciences), Non-invasive Cardiology and Atrial Fibrillation services; Michael Berlowitz, MD, and Fadi Matar, MD, Catheterization Laboratory (co-direct); and Joel Fernandez, MD, Cardiac Rehabilitation Program.

Gastroenterology & GI Surgery:  Patrick Brady, MD, Chief, and Haim Pinkas, MD, Vice Chief of Gastroenterology.  Medical directors: Dr. Brady, TGH Gastroenterology Center; John Gonzalvo, MD, and Michel Murr, MD, Bariatric Surgery (co-direct); John Jacobs, MD, Gastroenterology Quality; and Jorge Marcet, MD, Colorectal Surgery.

Nephrology:  Elias Doumit, MD, Vice Chief of Nephrology; and Alfonso Campos, MD, Medical Director of Pediatric Dialysis.

Pulmonology:  Mark Rumbak, MD, Chief of Pulmonology/Critical Care; Medical directors: William McDowell Anderson, Sleep Disorders Center; David Solomon, MD, Adult Step Down and Pulmonary Diagnostic & Respiratory units; Brice Taylor, MD, Medical Intensive Care Unit (MICU).

Urology: David Hernandez, MD, chief of urology.

In addition, Florida Orthopedic Institute President Roy Sanders, MD, chief of orthopaedic surgery at TGH, was recently named chair of the Morsani College of Medicine’s Department of Orthopaedics and Sports Medicine.

USF Health physicians also have a leadership presence in three of the four medical specialties that received “High Performing” ratings by U.S. News:

Cancer: Lawrence Berk, MD, chief or radiation oncology; Medical Directors: Dr. Berk, Radiation Oncology; and Mitchel Hoffman, MD, Gynecologic Oncology.

Geriatrics:  Medical Directors: Stephanie Taylor, MD, Acute Care for Elders (ACE); and Howard Tuch, MD, Palliative Care.

Neurology & Neurosurgery:  Rossitza Chichkova, MD, chief, and Derrick Robertson, MD, vice chief, of Neurology; Fernando Vale, MD, chief, and Donald Smith, vice chief of Neurosurgery. Medical directors: Siviero Agazzi, MD, Neuro Intensive Care Unit and Neuro Trauma Unit; Selim Benbadis, MD, Seizure Monitoring Center and Neurodiagnostic Laboratory; William Burgin, MD, Stroke Program; Dr. Chichkova, EMG Laboratory; Sarah Gaskill, MD, Pediatric Neurosurgery; David Rose, MD, Neuro Critical Care; Dr. Vale, Spinal Surgery; and Harry van Loveren, MD, Neurosurgery.
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All Children’s Hospital in St. Petersburg, the primary hospital partner for pediatrics training of USF medical students and residents, was nationally ranked in two categories – cardiology and heart surgery and pulmonology.

The national Best Hospitals rankings, now in their 26th year, recognize 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.

U.S. News evaluates hospitals in 16 adult specialties and ranked the top 50 in most of the specialties. Less than 3 percent of the nearly 5,000 hospitals that were analyzed for Best Hospitals 2015-16 were nationally ranked in even one specialty.

The full rankings are available at http://health.usnews.com/best-hospitals.

USF Health converted to Epic electronic health records (EHR) system at all its clinical sites Aug. 1, launching a new era of efficiency, improved patient care and safety, and a more cohesive system with Tampa General Hospital, its primary teaching hospital.

It may have set a record for one of the fastest transitions; typical changeovers take more than 18 months; USF Health did it in seven.

One week in since the Aug 1 Go-Live launch and many areas are already ramping up to refill schedules for patient appointments, which had been reduced to allow for fewer complications, said Patrick Gall, senior director of USF Health Applications and the technology lead for the USF Health Epic implementation project.

The USF Health transitioned to the Epic electronic health records system in seven months; the typical changeover takes more than 18 months.

The Aug. 1 Go-Live launch was set purposefully on Saturday– when only a few clinical areas see a few patients – so the true test came Monday, Aug. 3, when all clinical areas began seeing patients. On Monday, Aug. 3, the day began with an initial hiccup related to access security, an anticipated problem with most Epic launches so USF Health Information Systems was prepared and quickly remedied the issue, Gall said. There were a few other issues across the day, but mostly clinics ran smoothly, Gall said. In all, the Command Center – a room filled with dozens of support staff specially trained for Epic – took 581 calls Monday and by Wednesday calls were down to 315.

The transition continues for another couple of weeks, Gall said, and by the end of August, the Go-Live portion of the project will be complete. By then, two and half years’ worth of clinical data will have been transferred into Epic.

Next steps, he said, include customizing the system to each departments’ needs (starting Sept. 1) and the implementation of ICD-10 (starting Oct. 1), the international medical coding system. In January, all USF Health clinical sites and departments will receive consultation on workflow optimization within Epic to be more efficient with inputting patient data.

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Some highlights of the USF Health Epic implementation and of the first week for Go-Live include:

* Executed in 7 months (average is 18 months)

* Rolled out electronic charge capture (a first for USF Health providers, who formerly used paper)

* Ensuring ICD-10 compliance

* Became the largest ever “practice connect” Epic deployment

* Trained more than 1,700 users in a 6-week timeframe

* Partnered with TGH’s Epic system while creating a support model where USF Health can support its own users

* Built ~160 Epic Departments (four times the amount TGH had in their Epic environments prior to USF Health)

* Deployed and tested over 1,100 end point computing devices before Go Live

* Manually migrated over 60,000 appointments in one weekend

* Ensured the EHR interfaces effectively with GE Billing and all ancillary systems (ASC, Radiology, etc.)

* Trained entire EHR support team on a new technology while building it

* Developed and deployed a super user program with over 100 super users and over 40 provider champions

* Migrated all patient data from the last 2.5 years into Epic and connected to TGH records

* Deployed Kaleidoscope-specific system for Ophthalmology within the same timeframe

Hundreds of people from various departments have been involved in the project including: USF Health Administration, USF Health Information Systems, Revenue Cycle, Clinical Operations, Patient Access, provider champions, TGH Administration, TGH analysts, Epic consultant analysts, consultant trainers, consultant support, USF System Information Technology and USF Health Communications.

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Photos by Sandra Roa, USF Health Communications and Marketing

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Fifth graders taking part in their Junior Achievement (JA) field trip to the Muma JA BizTown in north Tampa on Sept. 29 had a new ‘storefront’ to staff and visit – a health care setting sponsored and created through the partnership of USF Health and Tampa General Hospital.

With cheers and applause from dozens of Carrollwood Elementary School fifth graders, a ceremonial ribbon was cut by BizTown “Mayor” Justin Allen and “CEO” of USF Health/TGH Maddie Newton, both Carrollwood Elementary students, along with USF President Judy Genshaft, Tampa General President Jim Burkhart, and USF Health Morsani College of Medicine Dean Dr. Charles Lockwood.

A ribbon-cutting ceremony made it official.

The new USF Health/TGH space was open for business and young doctors, nurses, pharmacists, administrators and nutritionists filled the space and got to work as fellow classmates filed in.

Based in the Bill Poe Junior Achievement Center near the University of South Florida, the Pam and Les Muma JA Biztown offers a well-coordinated program that allows young students to get to know the business world by working in storefronts sponsored by companies. Students come dressed professionally, some even in suits and bowties, ready to take on their assigned roles.

The new USF Health/TGH health care ‘facility’ offers the young ambitious students a team-based, highly interactive experience and exposes the young students to the fields of medicine, nursing, public health, pharmacy, physical therapy and other health professions, inspiring them to consider careers as practitioners in these disciplines or as health care executives.

The Carrollwood Elementary School fifth-graders who were among the first to staff the USF Health/TGH health facility.

The health care experience offers five stations that represent key areas from USF Health, including a patient simulator in an operating room, a pharmacy and a nutrition and wellness center.

Setting the tone of celebration and calling the new space a great opportunity, Pam Muma told the students that they are among the more than 128,000 fifth graders to rotate through  JA BizTown since it opened in 2005.

Pam Muma welcomes Carrollwood Elementary to JA BizTown.

“As you know, Junior Achievement gives you the skills needed to be successful in the future,” Pam Muma said. “Today is your day and marks the grand opening of a new storefront of two very special partners. It’s a space to learn, but to have fun, as well.”

“We hope thousands of you come and visit this new space and learn all about how we work together at USF Health and Tampa General,” Pres. Genshaft said. “So we’re pleased that you’re here and we’re very happy to have USF Health and Tampa General together. We work together as partners all the time. So welcome to your new storefront.”

Speaking of a long-time successful partnership with USF Health, TGH President Jim Burkhart said he “was particularly proud to co-sponsor this storefront to provide a connection for students between working hard and personal success.”

TGH President and CEO Jim Burkhart urges students to succeed.

Junior Achievement is the world’s largest organization dedicated to giving young people the knowledge and skills they need to own their economic success, plan for their future, and make smart academic and economic choices. JA programs are delivered by corporate and community volunteers, and provide relevant, hands-on experiences that give students from kindergarten through high school knowledge and skills in financial literacy, work readiness and entrepreneurship. Last year, Junior Achievement of Tampa Bay reached 92,660 students in the Tampa Bay area.

Gabriel registers USF President Judy Genshaft and puts on identification bracelet.

Checking the heart of a ‘patient’ with some coaching.

From left, Robin DeLaVergne (TGH Foundation), Les and Pam Muma, Mike Gorsage (TGH Strategy and Business Development), USF President Judy Genshaft, Dr. Rocky, TGH President and CEO Jim Burkhart, USF Health MCOM Dean Dr. Charles Lockwood, and Chief Operating Officer and USF Health Vice Dean Dr. Edmund Funai.

Dr. Rocky D. Bull welcomed everyone to Muma JA BizTown.

Photos by Eric Younghans, video by Sandra C. Roa, USF Health Communications.

TAMPA, Fla. (Feb. 29, 2016) – The University of South Florida announced today that it has received a $3.5 million gift from Tampa General Hospital for the USF Health Morsani College of Medicine. The gift will be used to establish an endowed faculty chair in cardiovascular sciences and to create a neurosciences research fund to examine brain and nervous system diseases through the Morsani College of Medicine and its Byrd Alzheimer’s Institute.

Tampa General Hospital is USF Health’s primary teaching hospital and primary cardiology practice site.

Tampa General Hospital has served as USF’s primary teaching hospital since the medical school first opened in 1971, and hundreds of students from USF’s medical, nursing and physical therapy programs receive clinical training at Tampa General each year.

“Over many decades, USF and TGH have been dedicated partners in medical research and education; this donation underscores how deeply committed we are to improving the health and well-being of our community,” said USF System President Judy Genshaft.

“This gift highlights the continued investment in the Morsani College of Medicine that we’ve seen from the community, state and our philanthropic partners during the USF: Unstoppable campaign,” said Joel Momberg, CEO of the USF Foundation. “There is so much promise and possibility in this transformative project that began with the generosity of Carol and Frank Morsani, and continues with the support from the health care professionals at Tampa General Hospital.”

Dr. Charles J. Lockwood, senior vice president for USF Health and dean of the Morsani College of Medicine, said we are deeply grateful to Tampa General Hospital for their incredible generosity that will help fund and strengthen our key initiatives in cardiovascular sciences and neurosciences.

“By establishing an endowed chair in our Heart Institute, this gift will not only enable us to explore all aspects of cardiovascular health including sorting out the differences in heart disease between men and women, but also it will provide life-saving preventions and treatments for heart disease and other cardiovascular disorders,” Dr. Lockwood said. “We are also pleased that this gift will advance our research efforts in neurosciences at the Byrd Alzheimer’s Institute.”

Tampa General Hospital has been recognized by U.S. News & World Report as the top-ranked cardiology and heart surgery practice in Tampa Bay, and the specialty is ranked #35 in the nation. Tampa General is USF’s primary cardiology practice site, where most of the university’s inpatient and outpatient cardiac services are provided and all inpatient cardiovascular clinical trials are conducted. The hospital is also the flagship affiliate for USF’s department of neurosurgery and brain repair.

“We’re working with the Morsani College of Medicine every day to improve the heart and brain health of patients across Florida,” said Jim Burkhart, president and CEO of Tampa General Hospital. “With this gift, we want to help USF Health expand its research efforts and help ensure that our patients receive the most innovative care possible.”

The USF Health Heart Institute integrates innovative biomedical research with advanced clinical care to find new ways to prevent cardiovascular diseases, tailor personalized treatments for patients, and improve the heart health of the Tampa Bay community. The institute will be co-located in the new USF Health Morsani College of Medicine building in downtown Tampa. The Byrd Alzheimer’s Institute is another premier academic research center at USF Health, dedicated to the prevention, treatment and cure of Alzheimer’s disease and related disorders.

– 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 Physical Therapy and Rehabilitation Sciences, and the USF Physicians 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 health.usf.edu.

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The USF: Unstoppable Campaign is a comprehensive fundraising effort by the University of South Florida System to celebrate the energy, vision, and future of one of the country’s most exciting and engaged universities. Our people and programs, our ideas, our research, and our solutions comprise an ambitious plan to enhance healthcare, science, technology, education, business, the arts, and global partnerships.

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

University of South Florida neonatologist Akhil Maheshwari, MD, and his team advance research to understand, detect and identify novel treatments for necrotizing enterocolitis, or NEC, a life-threatening inflammatory bowel disease that may afflict premature newborns.

“As we’ve become better at controlling lung disease in premature infants, NEC has emerged as the single largest killer of premature babies,” said Dr. Maheshwari, a physician-scientist who holds the Pamela and Leslie Muma Endowed Chair in Neonatology in the Department of Pediatrics,  USF Health Morsani College of Medicine. Dr. Maheshwari also serves as medical director of the Jennifer Leigh Muma Neonatal Intensive Care Unit (NICU) at Tampa General Hospital.

Akhil Maheshwari, MD, holds the Pamela and Leslie Muma Endowed Chair in Neonatology in the USF Health Department of Pediatrics.

   Listen to Dr. Maheshwari talk about the impact of NEC.

The serious gastrointestinal disorder happens when the small or large intestine becomes inflamed and the lining of the intestinal wall starts to die off.  In the United States, it affects up to 10 percent of extremely low birth weight infants (less than 3.5 lbs.), with a mortality rate of 50 percent. Among premature infants in developing countries, such as India or China, NEC is more common.

With advances in technology and best clinical care practices, more extremely preterm infants are surviving with fewer complications, but NEC remains one of the most challenging diseases confronting neonatologists and pediatric surgeons. The causes of the dreaded condition remain unclear, and there is no treatment.

Translational research enlightened by clinical experience

Caring for tiny, fragile patients in Tampa General Hospital’s NICU adds perspective to the research Dr. Maheshwari conducts in his laboratory at the Morsani College of Medicine. “The vantage point I have as a neonatologist lets me observe NEC in the clinical setting, and I strive in the laboratory to translate this information to understand its pathophysiology,” said the USF Health professor of pediatrics, molecular medicine, and public health.

Over the last decade, Dr. Maheshwari’s group, and others, have found that a third of all instances of NEC in extremely premature infants occurs within 48 hours of receiving a blood transfusion.  He was recently awarded a five-year, $1.5-million R01 grant from the National Heart, Blood and Lung Institute, National Institutes of Health, to understand how blood transfusions may cause bowel injury in premature infants and develop new ways to prevent or treat this condition.

The newborn patients treated at Tampa General Hospital’s Muma Neontal Intensive Care Unit by Dr. Maheshwari, the unit’s medical director, are the among the most fragile and sickest.

In the U.S., necrotizing enterocolitis, or NEC, affects up to 10 percent of extremely low birth weight infants (less than 3.5 lbs.), with a mortality rate of 50 percent.  Causes of the life-threatening inflammatory bowel disease, a focus of Dr. Maheshwari’s research, remain unclear.

   Dr. Maheshwari discusses his latest NIH grant.

Supported by the latest NIH grant, Dr. Maheshwari will use a newborn mouse model to test whether red blood cell transfusions induce intestinal injury, whether the underlying anemia present in almost all premature newborns aggravates this injury, or whether both play a role in causing NEC. The USF researchers will also evaluate whether several standard blood bank practices — longer red blood cell storage, red blood cell washing to remove potentially hazardous electrolytes, and irradiation of transfused blood to help reduce risk of infection — can alter the severity of intestinal injury.

While many critically ill premature infants are stabilized within their first two weeks in the neonatal intensive care unit, within the second to third week a small proportion experience rapid onset of NEC without warning. “I see infants in the unit who were doing well and then die suddenly,” Dr. Maheshwari said. “The impact of this disease can be devastating, both emotionally and in terms of health care costs.”

There is no definitive diagnostic test to identify the disease in its earliest stages; abdominal X-rays can only diagnose when NEC has progressed to severe intestinal damage, including sometimes bowel perforation or peritonitis, Dr. Maheshwari said. Consequently, clinicians err on the side of caution if they suspect NEC — monitoring the condition with X-rays and extensive bloodwork, halting regular feedings, administering IV fluids and antibiotics and counseling an anxious family about what to expect if a NEC diagnosis is confirmed.

“The number of infants in the NICU who undergo testing for NEC is about 10 times more than the number who actually have the disease,” he said.

Half of the babies with confirmed NEC require surgery to excise the damaged intestinal tissue, and 50 percent who go to the operating room die, Dr. Maheshwari said. “The other half who survive end up with anatomically short intestines, so they depend on IV nutrition and often develop nutritional and developmental deficiencies that can affect brain growth.  They are at risk for lifelong complications.”

Mohan Kumar Krishnan, PhD, a research associate in Dr. Maheshwari’s laboratory, uses quantitative real-time polymerase chain reaction (PCR) to monitor amplification of gene expression. The technique helps the researchers determine how the immune system is responding to bacteria in the gut.

Key findings of Dr. Maheshwari’s laboratory

Researchers now believe that three things must all be present in the premature infant’s gut for NEC to occur:  bacteria, inflammation, and a unique signature of white blood cells (monocytes and macrophages) not found in adults with inflammatory bowel diseases.

In addition to the study of red blood cell transfusion-associated NEC, Dr. Maheshwari’s team focuses on two other lines of investigation — determining whether modifying the premature infant’s feedings can alter the immature, hyper-inflammatory nature of macrophages and identifying how the bowel’s inflammatory response in a premature infant differs from that in an adult, so the macrophages might be modified to prevent or treat NEC. The researchers hypothesize that the aggravated inflammatory response seen in the bowels of preterm infants happens because these very small babies with immature immune systems have not yet formed the adaptive mechanisms needed to tolerate the bacteria in their guts.

Dr. Maheshwari (center) with his research team, from left to right: Mohan Kumar Krishnan, PhD, research associate; Tanjing Song, PhD; senior biological scientist; Chitra Palanivel, PhD, postdoctoral research scholar; Kopperuncholan Namachivayam, PhD, research associate; and Thais Queliz Pena, MD, neonatology fellow.

Among some of their most significant findings:

• First to show that premature infants may be at risk of NEC because of a lack of the protein known as transforming growth factor-β2 (TGF-β2), which suppresses inflammatory responses.

• Demonstrated that infants whose bowel injury escalates to NEC have low blood levels of TGFβ2 since birth. “TGFβ2 is the first biomarker that can be obtained on day 1 to help predict which infants are most likely to develop NEC. Its 60-percent accuracy rate is still a six-fold improvement over the way we predict NEC now – by degree of prematurity,” Dr. Maheshwari said.

• While mothers who deliver preterm infants produce breast milk containing a large amount of TGF-β2, Dr.Maheshwari found that the beneficial growth factor in the mothers’ milk is largely biologically inactive. The USF researchers are investigating ways to activate the mother’s milk-borne TGFβ2 – in essence stimulating the milk to undergo the maturation needed to suppress unnecessary inflammation and protect the baby against NEC.

• Discovered that an acute drop in monocyte count in premature infants could be used as a diagnostic test to differentiate NEC from more benign causes of feeding intolerance like prematurity itself. A study led by Dr. Maheshwari found that 70 percent of premature infants with NEC experienced more than a 20-percent drop in monocytes in their blood.

• Recently identified a unique subtype of monocyte, formed in the newborn’s liver, which infiltrates the intestine of premature infants and may promote bowel injury. The subtype could be a new target for treating NEC.

   Dr. Maheshwari gives an example of how a laboratory discovery may change clinical practice.

Dr. Maheshwari was recently awarded a five-year, $1.5-million R01 grant from the NIH’s National Heart, Blood and Lung Institute to study how blood transfusions may cause bowel injury in premature infants and develop new ways to prevent or treat this condition.

In addition to his NIH-supported NEC research, Dr. Maheshwari has a $143,000 American Heart Association grant to study ways to block systemic inflammation and multi-organ dysfunction in very ill babies put on a treatment known extracorpeal membrane oxygenation (ECMO), which uses a heart-lung bypass machine.

“Dr Maheshwari’s work is highly innovative and has relevance well beyond the field of neonatology,” said Patricia Emmanuel, professor and chair of pediatrics at the USF Health Morsani College of Medicine.  “He brings great curiosity and passion to his research and is a wonderful role model for fellows and residents.”

Endowment key to  research benefitting tiniest newborns

The endowment by Pam and Les Muma to advance USF-TGH research and care for the sickest newborns helps support the infrastructure of Dr. Maheshwari’s highly specialized laboratory, including a machine that can measure a drop of a blood so tiny it fits on the head of a pin.

“Endowments are so critical,” Dr. Maheshwari said. “The equipment needed for the type of research we do is very specific for premature newborns, and doesn’t exist in most universities.”

Dr. Maheshwiari came to USF in 2014 from the University of Illinois at Chicago (UIC), where he was an associate professor pediatrics and chief of the Division of Neonatology. Prior to his tenure at UIC, he was an assistant professor at the University of Alabama at Birmingham and received several young investigator awards, including the American Gastroenterological Association Research Scholar Award and the Procter and Gamble GI Scholar Award.

The Muma endowment supports highly specialized equipment in Dr. Maheshwari’s neonatal research laboratory, including a machine that can measure a drop of a blood so tiny it fits on the head of a pin.

Dr. Maheshwari is a member of the editorial board of Maternal Health, Neonatology and Perinatology and several other professional journals and served on several grant review panels. He holds six provisional patents for new anti-inflammatory agents.

He earned his medical degree from the Institute of Medical Sciences, Varanasi, India, completed a pediatrics residency at the University of Florida, and received fellowship training in neonatology at USF.

Dr. Maheshwari with research associate Kopperuncholan Namachivayam, who works at a hematology analyzer that counts and separates various blood cell types including immune cells the researchers are interested in studying.

Photos by Eric Younghans, USF Health Communications