News Article | May 12, 2017
"Nurses are at the center of delivering a quality, compassionate patient care experience. AMN Healthcare is honored to recognize the exceptional service of nurses throughout the world this week," said Susan Salka, AMN Healthcare President and CEO. "We are also very proud that some of the finest nurses in the country have or are currently working with the AMN team providing outstanding care for our clients. Their commitment to their profession and their advocacy for patients and their families is inspiring to us all." Per diem and travel nurses have always been an essential part of any effective healthcare system and are becoming increasingly important as the healthcare industry faces a growing nurse shortage and increased need for workforce flexibility. Research confirms that per diem and travel nurses provide quality of care that is equivalent to their permanent counterparts. The following four outstanding AMN travel nurses were chosen by a committee of AMN clients, clinicians and recruiters. These nurses showed an unwavering commitment to excellence in the nursing profession that goes far beyond their job requirements. The nominations were a testament to the high quality of nurses that AMN Healthcare has on assignment. The Innovation Award went to Jennifer Ordonez, RN BSN, an ICU Nurse on assignment in Palm Springs, CA, for her ongoing pursuit of personal and professional excellence through innovation and the advancement of patient care. As her nomination stated, "Jennifer goes beyond the care and comfort of the patient to provide life-changing care. This is the definition of excellence." The Passion Award for exemplifying the highest standards of professional excellence through leadership and extraordinary commitment to service throughout their healthcare community went to Allison Griffin, RN, BLS, CHEMO, PALS, PMD, a Pediatric Nurse on assignment in Boston, MA. Allison was selected because she "is able to impact the lives of the children and their families with her care and compassion in a meaningful way each and every day!" The Customer Focus Award for demonstrating an unwavering dedication to the improvement of patient care across all specialties and embodying the core values of the nursing profession in actions and words went to Sandra Shrago, RN, ACLS, BSN, an ICU Nurse on assignment at NewYork-Presbyterian/ Columbia University Medical Center in New York, NY. Sandra was nominated for this award because she "encompasses all that nursing should represent, going above and beyond what is standard, setting a bar for herself, for her care of others. Her amiable demeanor, warm smile and linguistic adeptness proves to be a pleasure and an asset." The Overall Commitment to Excellence Award for all of these qualities, and continually striving to improve patient care through education and innovation, displaying an unmatched passion for the profession was given to Sonia Washington, RN, ACLS, BLS, PALS, an ICU Nurse on assignment at Hilo Medical Center in Hilo, HI. "Sonia's respect of patients, families, physicians, and quick adaption to local culture make her shine," said Sonia's supervisors at Hilo Medical Center. "Sonia demonstrated the professional conduct and compassion our ICU Beacon Status department is known for and expects. Sonia has an outgoing personality, participates in our teamwork philosophy… and works above and beyond as a patient advocate." NewYork-Presbyterian NewYork-Presbyterian is one of the nation's most comprehensive, integrated academic healthcare delivery systems, whose organizations are dedicated to providing the highest quality, most compassionate care and service to patients in the New York metropolitan area, nationally, and throughout the globe. In collaboration with two renowned medical schools, Weill Cornell Medicine and Columbia University Medical Center, NewYork-Presbyterian is consistently recognized as a leader in medical education, groundbreaking research and innovative, patient-centered clinical care. For more information, visit www.nyp.org and on Facebook, Twitter and YouTube. Hilo Medical Center As the Big Island's leading provider of nationally recognized 4-star care, Hilo Medical Center (HMC) delivers a full range of services and programs. Our 20-acre campus consists of 276 beds located throughout the 137-bed acute hospital, 20-bed behavioral health unit and a 119-bed long-term care facility. We have over 1,000 employees and a medical staff comprised of 250 physicians, physician assistants and Advanced Practice Registered Nurses, representing 33 specialties. As a medical center, we have a network of nine outpatient clinics offering primary and specialty care. The hospital is a Level III Trauma Center which includes the second busiest emergency room in the state that provides 24-hour care to nearly 48,000 patients annually. In 2016, the Centers for Medicare & Medicaid Services (CMS) ranked HMC 4 stars for Overall Hospital Quality, putting our hospital in the top 20% in the nation, among the top 5 hospitals in the state, and named HMC the only 4-star hospital on Hawaii Island. Also in 2016, our Intensive Care Unit was designated as a bronze level for Beacon Award of Excellence – only the second ICU in the state to receive this designation. HMC received the 2016 American Heart Association Gold Plus Award for heart failure. HMC has also been recognized for quality long term care by Providigm for Quality Assurance & Performance Improvement Accredited Facility and Embracing Quality Award for the Prevention of Hospital Readmissions. Our long term care met the requirements for the American Health Care Association's Three Tier Level Quality Initiative Recognition Program. HMC ranks in the top 2% of hospitals in country and best in the state of Hawaii for preventing Hospital Acquired Conditions, according to CMS in 2015. The hospital is also a recipient of the 2015 Healthgrades Patient Safety Excellence Award™ and a past recipient of the Mountain Pacific Quality Health's Quality Achievement Award. HMC received the HIMSS Nicholas E. Davies Award for Excellence in 2015 for demonstrating EMR utilization to improve quality of care and financial management. We are part of the Hawaii Health Systems Corporation, a public entity established in 1996 by the State of Hawaii to fulfill the promise to provide quality, hometown healthcare. For more information, go to: www.hilomedicalcenter.org. About AMN Healthcare AMN Healthcare is the leader and innovator in healthcare workforce solutions and staffing services to healthcare facilities across the nation. The Company provides unparalleled access to the most comprehensive network of quality healthcare professionals through its innovative recruitment strategies and breadth of career opportunities. With insights and expertise, AMN Healthcare helps providers optimize their workforce to successfully reduce complexity, increase efficiency, and improve patient outcomes. AMN delivers managed services programs, healthcare executive search solutions, vendor management systems, recruitment process outsourcing, predictive modeling, medical coding and consulting, and other services. Clients include acute-care hospitals, community health centers and clinics, physician practice groups, retail and urgent care centers, home health facilities, and many other healthcare settings. For more information about AMN Healthcare, visit www.amnhealthcare.com. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/national-nurses-week-amn-healthcare-commitment-to-excellence-awards-recognize-importance-of-nurses-in-patient-care-300456603.html
News Article | May 8, 2017
"Juicing" Th17 cells with FDA-approved small molecule β-catenin and p110δ inhibitors during in vitro expansion for adoptive T cell therapy (ACT) profoundly improves their therapeutic properties, report investigators at the Medical University of South Carolina (MUSC) in an article published online ahead of print on April 20, 2017 by JCI Insight. ACT involves harvesting T cells, rapidly amplifying and/or modifying them in the laboratory to boost their cancer-fighting ability, and then reinfusing them back to the patient to boost anticancer immunity. One challenge for ACT has been that the rapid expansion of T cells in the laboratory can cause them to age and wear out, decreasing their longevity after reinfusion. "Juicing" Th17 cells with the FDA-approved small molecules enhanced their potency, function and stem-like (less differentiated) quality, suggesting that they would persist better after reinfusion into patients, and also reduced regulatory T cells in the tumor microenvironment, which can blunt the immune response. These findings highlight novel investigative avenues for next-generation immunotherapies, including vaccines, checkpoint modulators, and ACT. "This is exciting because we might be able to overcome some of the delays and disadvantages of rapid expansion in the laboratory," explains senior author Chrystal M. Paulos, Ph.D., associate professor of immunology and Endowed Peng Chair of Dermatology at MUSC and a member of the MUSC Hollings Cancer Center. "We might be able to use fewer cells (for ACT) because we can pharmaceutically 'juice' these T cells to make them more fit in the oppressive tumor microenvironment." Building upon their previous findings that ICOS costimulation is critical for generating human TH17 cells and for enhancing their antitumor activity, an MUSC research team led by Paulos and including postdoctoral fellow Kinga Majchrzak report for the first time that repurposing FDA-approved small molecule drugs that inhibit two ICOS-induced pathways greatly enhances the antitumor potency of T cells. Several biologic properties of the Wnt/ β-catenin and P13Kδ pathways led the team to suspect that they supported the antitumor activities of Th17 cells. For example, these pathways are active in both regulating T cell cytokine production during the immune response and in promoting self-renewal of hematopoietic stem cells (HSCs) and sustaining HSCs in an undifferentiated state. So, they designed a series of experiments to determine whether these two pathways were also active in enhancing Th17 antitumor memory and effectiveness. To test this idea, they pharmaceutically inhibited PI3Kδ and β-catenin in Th17 cells (using idelalisib [CAL-101] to block the PI3Kδ pathway and indomethacin [Indo] to inhibit β-catenin)-anticipating that this would weaken Th17 cells' antitumor activity. To their surprise, the exact opposite occurred. ICOS-stimulated Th17 cells that were treated in vitro with CAL-101 plus Indo elicited a more potent antitumor response against melanoma in mice. "My post-doc student came to me and said, 'I think I made a mistake because the data are going in the opposite direction to what we originally predicted!" says Paulos. "So, she repeated the experiment several times but we kept getting the same result. The data showed that using drugs to inhibit these pathways actually made the Th17 cells even better at killing tumors." The team found that Th17 cells treated with CAL-101 express less FoxP3, suggesting that the drug suppresses Treg conversion while sustaining central memory-like Th17 cells. This finding is highly important because the phenotypic plasticity of Th17 cells in vivo allows their conversion to Tregs or Th1 cells with weak antitumor properties. These data suggest that treatment with CAL-101 can halt the development of these poorly therapeutic phenotypes and, thus, enhance the T cells' antitumor activity. While the findings were initially counterintuitive and perplexing from a mechanistic perspective, in retrospect Paulos sees that they make sense. "Essentially, the T cells are younger," explains Paulos. "We know that T cells used for ACT age and wear out over time. Somehow these drugs sustain their youth and function. They're able to keep all the properties of their youth-they expand better and they're more functional and handle the oppressive tumor microenvironment better." The discovery that existing FDA-approved drugs that block p110δ and β-catenin can make T cells more efficient tumor killers in vivo is an exciting prospect for Paulos' team. "From a clinical standpoint, this finding indicates that the therapeutic effectiveness of ACT could be improved by simple treatments with readily available drugs. It opens a lot of new investigative avenues for next-generation immunotherapy trials," she says. "This research offers tremendous promise for the treatment of patients with serious forms of skin cancer," says Dirk M. Elston, M.D., chair of the Department of Dermatology and Dermatologic Surgery at MUSC. Paulos has a patent on ICOS signaling in adoptive T cell transfer therapy (US 9133436), and Paulos, Majchrzak, and J.S. Bowers have a patent on pharmaceutical drug combinations or genetic strategies that instill durable antitumor T cell memory and activity (patent application P1685). Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 13,000 employees, including approximately 1,500 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $2.2 billion. MUSC operates a 750-bed medical center, which includes a nationally recognized Children's Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (a National Cancer Institute designated center) Level I Trauma Center, and Institute of Psychiatry. For more information on academic information or clinical services, visit musc.edu. For more information on hospital patient services, visit muschealth.org. The Hollings Cancer Center at the Medical University of South Carolina is a National Cancer Institute-designated cancer center and the largest academic-based cancer research program in South Carolina. The cancer center comprises more than 120 faculty cancer scientists with an annual research funding portfolio of $44 million and a dedication to reducing the cancer burden in South Carolina. Hollings offers state-of-the-art diagnostic capabilities, therapies and surgical techniques within multidisciplinary clinics that include surgeons, medical oncologists, radiation therapists, radiologists, pathologists, psychologists and other specialists equipped for the full range of cancer care, including more than 200 clinical trials. For more information, visit http://www.
News Article | May 12, 2017
To qualify for the Target: Stroke Honor Roll Elite, hospitals must meet quality measures developed to reduce the time between the patient's arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke. If given intravenously in the first three hours after the start of stroke symptoms, tPA has been shown to significantly reduce the effects of stroke and lessen the chance of permanent disability. Long Beach Memorial earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These quality measures are designed to help hospital teams follow the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. "A stroke patient loses 1.9 million neurons each minute stroke treatment is delayed," says Angie West, RN, MSN, CCRN-K, SCRN, ANVP, director, Comprehensive Stroke Center, Long Beach Memorial. "This recognition further demonstrates our commitment to delivering advanced stroke treatments to patients quickly and safely. Long Beach Memorial continues to strive for excellence in the acute treatment of stroke patients. The recognition from the American Heart Association/American Stroke Association's Get With The Guidelines - Stroke further reinforces our team's hard work." The MemorialCare Neuroscience Institute also is recognized as the 3rd Joint Commission Certified Comprehensive Stroke Center in Los Angeles County, demonstrating compliance with stroke-related standards as a Primary Stroke Center and meet additional requirements, including those related to advanced imaging capabilities, 24/7 availability of specialized treatments and providing staff with the unique education and competencies to care for complex stroke patients. "The American Heart Association and American Stroke Association recognize Long Beach Memorial for its commitment to stroke care," says Paul Heidenreich, M.D., M.S., national chairman of the Get With The Guidelines Steering Committee and Professor of Medicine at Stanford University. "Research has shown there are benefits to patients who are treated at hospitals that have adopted the Get With The Guidelines program." Get With The Guidelines - Stroke puts the expertise of the American Heart Association and American Stroke Association to work for hospitals nationwide, helping hospital care teams ensure the care provided to patients is aligned with the latest research-based guidelines. Developed with the goal to save lives and improve recovery time, Get With The Guidelines - Stroke has impacted more than three million patients since 2003. According to the American Heart Association/American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds, someone dies of a stroke every four minutes, and nearly 800,000 people suffer a new or recurrent stroke each year. About Long Beach Memorial Named among the top 12 hospitals in the Los Angeles Metro area by U.S. News and World Report, Long Beach Memorial has been providing compassionate care with the latest state-of-the-art technology for more than 100 years. Long Beach Memorial is the region's first choice for comprehensive care in virtually every medical and surgical specialty. Long Beach Memorial is at the forefront of patient care with the MemorialCare Todd Cancer Institute's 64,000 sq. ft. Todd Cancer Pavilion, which houses all outpatient cancer services under one roof. Also, the MemorialCare Heart & Vascular Institute recently opened a Hybrid Imaging Suite, which features advanced imaging technology, combining the diagnostics and capabilities of a catheterization laboratory with the surgical functions of an operating room. Additional Centers of Excellence include the MemorialCare Rehabilitation Institute, MemorialCare Orthopedic Institute, MemorialCare Neuroscience Institute, Comprehensive Stroke Center, MemorialCare Joint Replacement Center, Emergency Department and Regional Trauma Center. About Get With The Guidelines® Get With The Guidelines® is the American Heart Association/American Stroke Association's hospital-based quality improvement program that provides hospitals with tools and resources to increase adherence to the latest research-based guidelines. Developed with the goal of saving lives and hastening recovery, Get With The Guidelines has touched the lives of more than 6 million patients since 2001. For more information, visit heart.org. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/long-beach-memorial-receives-get-with-the-guidelines---stroke-gold-plus-quality-achievement-award-with-target-stroke-honor-roll-300456666.html
News Article | May 22, 2017
NASHVILLE, Tenn. & GREENWOOD VILLAGE, Colo.--(BUSINESS WIRE)--Envision Healthcare Corporation (NYSE: EVHC) today announced that Envision Physician Services acquired Gwinnett Emergency Specialists, P.C. (“GES”), an emergency medicine physician group practice located in Lawrenceville, Georgia. GES consists of more than 40 physicians and 30 advanced practice practitioners who provide patient care at two hospitals in Gwinnett County: Gwinnett Medical Center Lawrenceville, a Level II Trauma Center; and Gwinnett Medical Center Duluth. Annual patient volume for the group exceeds 150,000 patient encounters. GES has provided service at the Lawrenceville hospital since the physician group was founded in 1991. “We’re excited to be part of a growing national provider group that is committed to supporting physicians caring for patients in their local communities,” said Phillip Cannon, M.D., President of Gwinnett Emergency Specialists. “We have a long and successful record of service to patients at Gwinnett Medical Center and across this rapidly growing community, and we are excited about the vital infrastructure that Envision brings to our group to support our growth.” Many physician organizations across the country are responding to new reimbursement models that impact physician care, as well as hospital and health system care models. GES was drawn to Envision Physician Services’ comprehensive offerings that align providers and health systems around achieving quality outcomes in a cost-effective manner. “We’re pleased to be joining an organization that provides our physicians and clinical professionals with the resources to effectively migrate toward emerging reimbursement models that will recognize the value we bring to patient care,” said Carlton Buchanan, M.D., Medical Director of Gwinnett Emergency Specialists and President of the Medical Staff of Gwinnett Medical Center’s Lawrenceville and Duluth facilities. “Physician-led care teams have tremendous influence over health system resource utilization, including effectively managing episodic care as well as transitions of care that will lead to better patient outcomes and demonstrated value to patients, health systems and payors.” Following the acquisition of GES, Envision Physician Services staffs eight hospital-based emergency medicine departments in North Georgia, including the Atlanta metropolitan area. “We continue to expand our presence in attractive markets across the country as we demonstrate our position as trusted partners to physicians, health systems and patients in those communities,” said Robert J. Coward, President of Envision Physician Services. “We are excited about the addition of the clinical professionals of Gwinnett Emergency Specialists to our growing presence in Georgia.” Envision Healthcare Corporation is a leading provider of physician-led services and post-acute care, and ambulatory surgery services. At March 31, 2017, we delivered physician services, primarily in the areas of emergency department and hospitalist services, anesthesiology services, radiology/tele-radiology services, and children’s services to more than 1,600 clinical departments in healthcare facilities in 45 states and the District of Columbia. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies. As a market leader in ambulatory surgical care, the Company owns and operates 264 surgery centers and one surgical hospital in 35 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopaedics. In total, the Company offers a differentiated suite of clinical solutions on a national scale, creating value for health systems, payors, providers and patients. For additional information, visit www.evhc.net. Certain statements and information in this communication may be deemed to be “forward-looking statements” within the meaning of the Federal Private Securities Litigation Reform Act of 1995. Forward-looking statements may include, but are not limited to, statements relating to Envision’s financial and operating objectives, plans and strategies, and all statements (other than statements of historical facts) that address activities, events or developments that Envision intends, expects, projects, believes or anticipates will or may occur in the future. These statements are often characterized by terminology such as “believe,” “hope,” “may,” “anticipate,” “should,” “intend,” “plan,” “will,” “expect,” “estimate,” “project,” “positioned,” “strategy” and similar expressions, and are based on assumptions and assessments made by Envision’s management in light of their experience and their perception of historical trends, current conditions, expected future developments, and other factors they believe to be appropriate. Any forward-looking statements in this communication are made as of the date hereof, and Envision undertakes no duty to update or revise any such statements, whether as a result of new information, future events or otherwise. Forward-looking statements are not guarantees of future performance. Whether actual results will conform to expectations and predictions is subject to known and unknown risks and uncertainties, including: (i) risks and uncertainties discussed in the reports and other documents that Envision files with the Securities and Exchange Commission; (ii) general economic, market, or business conditions; (iii) the impact of legislative or regulatory changes, such as changes to the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010; (iv) changes in governmental reimbursement programs; (v) decreases in revenue and profit margin under fee-for-service contracts due to changes in volume, payor mix and reimbursement rates; (vi) the loss of existing contracts; (vii) risks associated with Envision’s ability to realize the anticipated benefits of the merger of AmSurg Corp. and Envision Healthcare Holdings, Inc., including successful integration, synergies and ongoing business relationships; and (viii) other circumstances beyond the Company’s control.
News Article | May 18, 2017
Women Opt To Skip Pelvic Exams When Told They Have Little Benefit This is a story about conflicting medical advice. One group of doctors, represented by the American College of Obstetricians and Gynecologists, recommends yearly pelvic exams for all women 21 years of age and older, whether they have symptoms of disease or not. But the American College of Physicians, representing doctors of internal medicine, says that potential harms of the exam outweigh benefits and recommends against performing pelvic examinations unless a woman is pregnant or has symptoms of disease such as bleeding, pain or signs of infection. In March, the influential U.S. Preventive Services Task Force concluded there just wasn't adequate evidence to recommend for or against annual exams. A study published Thursday says that when women were told that one prominent medical association strongly recommends against yearly exams, the number of women opting to have the exam dropped from 82 percent to 39 percent. "This is a dramatic, enormous effect for a five-minute education intervention," says Dr. George F. Sawaya, an obstetrician-gynecologist at the University of California, San Francisco one of the study authors. Saway and his colleagues wanted to know whether a woman's decision to have a pelvic exam might be influenced by knowledge about a particular medical society's recommendations. They showed 190 women visiting health clinics at UCSF and Zuckerberg San Francisco General Hospital and Trauma Center illustrations of a pelvic examination. Then they were randomly assigned to review the summary of one of the two medical groups' recommendations. The summary by the ACP noted there are no known benefits of the exam, and included information about the potential for false-positive test results which could lead to unnecessary follow-up surgery. Sawaya says this typically means discovery of an enlarged ovary and possible removal of the ovary. The summary by ACOG noted no known benefits of the exam, but did not mention the possibility of false alarms and unnecessary surgery. The study was published in the American Journal of Obstetrics & Gynecology. The pelvic exam is typically performed by an obstetrician-gynecologist or other primary care provider and is done to manually check the overall health of a woman's reproductive organs, including the vagina, cervix, uterus, fallopian tubes and ovaries. Sawaya says the reason most physicians give for the yearly exam is to detect ovarian cancer. But the ACP says there's no good evidence the exam actually picks up ovarian cancer. ACOG, however, stands by its recommendation that yearly pelvic exams are warranted for all women 21 years of age and older. Every year, millions of women have pelvic exams. "Given the potential public health impact of our findings, we think there is a pressing need for improving patient counseling concerning this exam," says senior study author Miriam Kuppermann, a UCSF professor in the departments of obstetrics, gynecology and reproductive sciences, and epidemiology and biostatistics. The vast majority of women in the study, more than 90 percent, said that potential benefits and harms should routinely be discussed with patients prior to the examination. But most doctors "probably don't discuss pros and cons of the exam with their patients," says Sawaya, adding that will likely change as debate about the value of the exams becomes more public. "I think this whole thing is going to go the way of extinction," he says. "We're just going to stop talking about it and stop doing it." However, there is one recommendation both medical groups and federal health officials agree on: Every woman age 21 to 65 who has a cervix should get a Pap smear every three to five years. Sawaya says there is good evidence that the periodic Pap test (which is often done in conjunction with a pelvic exam), can be a highly effective screening test for cervical cancer.
News Article | May 19, 2017
Chronic pancreatitis (long-standing inflammation of the pancreas) (CP) is a challenging disease for health care practitioners because it is difficult to diagnose and treat. Although its annual incidence rate in the United States is low (5 to 12 per 100,000 persons), hospital admissions due to CP are on the rise. CP is characterized by severe abdominal pain and irreversible damage to the pancreas. In the past decade new medical and surgical treatments have emerged that enable multidisciplinary teams to better recognize and manage this disease. In 2014, gastrointestinal specialists at the Medical University of South Carolina (MUSC), led by David B. Adams, M.D., professor of surgery and an expert in CP, organized the first international exchange of information on these advancements. The "2014 International Symposium on the Medical and Surgical Treatment of Chronic Pancreatitis" brought together experts from the fields of medicine, surgery, psychology, physiology, pharmacology and genetics. Last month, a textbook covering the information that came out of that meeting was published (Wiley-Blackwell, April 2017). "Pancreatitis: Medical and Surgical Management" (ISBN: 978-1-118-91712-1) covers acute pancreatitis (sudden inflammation that lasts a short time) as well as CP. Adams is the chief editor. Co-editors are Peter B. Cotton, M.D., professor of medicine at MUSC; Nicholas J. Zyromski, M.D., associate professor of surgery at Indiana University School of Medicine; and John A. Windsor, MBChB, M.D., professor of surgery at Mercy Hospital in New Zealand. The book provides gastroenterologists and gastrointestinal surgeons with an evidence-based approach to the most recent developments in the diagnosis and clinical management of pancreatitis. In addition to new surgical procedures such as endoscopic biliary intervention and minimally invasive necrosectomy, these advances include medical therapies, such as antiprotease, lexipafant, probiotics and enzyme treatment. "This book is the latest information from international experts in all of the relevant disciplines of medicine," says Adams. "This represents the first time all of these experts have come together to share their knowledge and experience." MUSC will host a second international CP symposium in 2018 in Charleston, South Carolina. International experts from the fields of medicine, surgery, psychology, physiology, pharmacology and genetics will confer and exchange ideas to identify the direction, trends and developments in the diagnosis and management of CP that are needed to enhance clinical effectiveness, encourage adoption by healthcare providers, and engage patients in best practice and cost-effective care. Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 13,000 employees, including approximately 1,500 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $2.2 billion. MUSC operates a 750-bed medical center, which includes a nationally recognized Children's Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (a National Cancer Institute designated center) Level I Trauma Center, and Institute of Psychiatry. For more information on academic information or clinical services, visit musc.edu. For more information on hospital patient services, visit muschealth.org.
News Article | May 22, 2017
A new genetic approach in worms provides a roadmap for the mesenchymal-to-epithelial communication that drives human cancer, report researchers at the Medical University of South Carolina Hollings Cancer Center in Developmental Cell Some major cell-to-cell communication networks were first studied in worms. Now those worms, Caenorhabditis elegans, are being used to understand the influence of cancer mutations on those networks, report researchers at the Medical University of South Carolina (MUSC) in the May 22, 2017 issue of Developmental Cell. Because many genes involved in cell communication are often conserved across species, C. elegans is an ideal organism to study the genes that influence them. This makes the worm a very useful genetic tool for exploring the basis of human cancer, according to Gustavo Leone, Ph.D., director of MUSC Hollings Cancer Center and the Grace E. DeWolff Endowed Chair in Medical Oncology. "If the genetic network within tumor cells or epithelial cells is similar among C. elegans, mice and humans, the communication of neighboring cells with epithelial cells in tumors at some level might also be similar," explains Leone. Leone is corresponding author on the study along with his colleague Helen Chamberlin, Ph.D., a C. elegans expert in The Ohio State University Department of Molecular Genetics. The two laboratories collaborated to approach a big-picture question about cancer. A number of important individual cancer genes have been discovered by Leone and many others, but is there a way to identify all of the genes-a genetic signature-involved in cell-to-cell communication in cancer? In particular, Leone sought to identify which genes within the neighboring cells that make up the tumor microenvironment could control tumor and epithelial cell proliferation. Yet determining networks of cell-to-cell communication requires a genome-wide screen that tests genes individually, an approach that is impractical in mice. This was where C. elegans became so essential to answering the group's question. Part of the tumor microenvironment is supported by mesodermal cells, which send molecular signals to epithelial cells that tightly control their proliferation. This mesodermal-epithelial communication is needed in normal conditions, such as during pregnancy and wound healing, but is disrupted in cancer. Similar communication exists between those cells in the egg-laying organ of C. elegans called the vulva. When similarly disrupted during worm development, this network can unleash epithelial cell proliferation that causes a multivulva, or Muv, feature. This feature, which becomes prominent when adult worms reach one millimeter in length, is easily visible under a microscope. First author Huayang Liu, Ph.D., was a student in Leone's laboratory who helped design and build the genome-wide screen to identify which mesoderm genes worms need to prevent such Muv defects. Very importantly, the worms were also given a human cancer mutation in the gap-1 gene to sensitize their epithelial cells to communication signals that encourage proliferation. In this way, the screen was designed to test the influence of each of the nearly 20,000 C. elegans genes on the proliferation of epithelial cells carrying a common cancer-sensitizing mutation. From the entire C. elegans genome, the screen uncovered 39 worm mesoderm genes that, when reduced in expression, encouraged microscopic Muv defects suggestive of epithelial cell proliferation. Thirty-three of those genes are conserved in humans. The identities of those genes were unexpected, according to the authors. They are not involved in 33 random processes that control cell behavior. Rather, many of them converge on hubs of regulation that control major gene expression signatures. It appeared that the mesodermal-epithelial communication network containing this 33-gene signature could be fundamental to cell behavior in worms. Yet was it relevant in higher animals? The group tested three of these 39 genes in female mice and found that reducing their expression within fibroblasts (another mesodermal-type cell) encouraged proliferation in mammary epithelial cells. There was a final need to prove the relevance of this work to human cancer. Tests were performed in the stroma-part of the microenvironment-of tumor samples taken from human breast cancer patients. As suspected, the expression of those 33 genes was very different between normal and tumor stroma. In further experiments, depletion of 22 of these genes in human fibroblasts encouraged proliferation of breast tumor epithelial cells. The group had confirmed a genetic signature of mesodermal-epithelial communication unique to cell proliferation in cancer. This study uncovered a small sector of the network that allows mesodermal and epithelial cells to communicate. Yet the screen is designed to work with many cancer-sensitizing genes other than gap-1, which can reveal more of the network. Leone's group has repeated the screen using another genetic mutation that seems to influence completely different cellular processes involved in cell-to-cell communication. A complete roadmap will guide new cancer therapies, according to Leone. "This provides an avenue to understand why drugs work or don't work, and it provides new targets that we can now begin to drug," says Leone. Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 13,000 employees, including approximately 1,500 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $2.2 billion. MUSC operates a 750-bed medical center, which includes a nationally recognized Children's Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (a National Cancer Institute designated center) Level I Trauma Center, and Institute of Psychiatry. For more information on academic information or clinical services, visit musc.edu. For more information on hospital patient services, visit muschealth.org. The Hollings Cancer Center at the Medical University of South Carolina is a National Cancer Institute-designated cancer center and the largest academic-based cancer research program in South Carolina. The cancer center comprises more than 120 faculty cancer scientists with an annual research funding portfolio of $44 million and a dedication to reducing the cancer burden in South Carolina. Hollings offers state-of-the-art diagnostic capabilities, therapies and surgical techniques within multidisciplinary clinics that include surgeons, medical oncologists, radiation therapists, radiologists, pathologists, psychologists and other specialists equipped for the full range of cancer care, including more than 200 clinical trials. For more information, visit http://www.
News Article | April 17, 2017
The University of North Carolina (UNC) Medical Center and its partner, Roundtable Analytics, Inc., have recently launched a full-spectrum analytics program to support the flagship emergency department (ED) in Chapel Hill, NC. As an academic, Level I Trauma Center, UNC’s main ED faces the challenge of seeing nearly 70,000 patients annually all while educating its resident physicians. But this tremendous operational challenge is now being approached with analytics, from a comprehensive understanding of past and current performance to predictive simulation modeling to routinely support key management decisions such as staffing, treatment area utilization, and much more. Working closely with UNC’s ED leadership team, Roundtable Analytics, Inc., customized its data reporting, visualization and predictive analytics suite to meet UNC’s needs. Roundtable’s full analytics offering leverages the Epic data UNC already collects and stores each day in Epic’s Clarity database, with no need to integrate into the live electronic medical record (EMR). To ensure accuracy and consistency, Roundtable Analytics statisticians customize an automatic processing layer that checks, cleans and standardizes the daily data. Roundtable’s automated data processing is essential for gaining accurate insights from ubiquitous EMR data, and serves as the basis for powerful, on-demand analytics. “It’s fantastic. We have access to data we’ve never seen before, whether it’s yesterday’s performance or last year’s metrics,” said Dr. Jane Brice, chair of UNC Emergency Medicine. “My entire leadership team can interact with the data one minute and then simulate potential management changes for our emergency department in response to what we see.” Roundtable Analytics, Inc. provides consulting and comprehensive data analytics for emergency departments, including easy-to-use, site-specific simulation models. Securely leveraging each ED’s unique data resources, Roundtable Analytics delivers its data services via SaaS to ED managers who can quickly assess the state of their ED and simulate the impact of key management changes using Roundtable’s Emergency Department Strategy Lab, or EDSL. This approach eliminates the risks of suboptimal patient care and financial losses that can occur during costly trial-and-error periods. Funded by a combination of National Science Foundation grants and private equity, the company created research partnerships with two major medical research universities, which led to the development of its analytics services and technology. Roundtable Analytics launched EDSL commercially in 2016.