Archive for the ‘Medical Professionals’ Category

Surgical Robot Less Invasive, Allows Quicker Recovery


Kolby Baber suffered from a rare digestive disorder that made it difficult, and sometimes impossible, for him to swallow. After trying several other treatments, Baber discovered Dmitry Oleynikov, MD. Dr. Oleynikov told Baber about a new surgical robot, the daVinci Xi, which would be the perfect way to fix his problem. The daVinci features two work stations for Dr. Oleynikov and one of his colleagues to work simultaneously on patients instead of one like the previous model. It also allows surgeons to work on a wider range of cases than they could previously.

See how Dr. Oleynikov used the first daVinci Xi in Omaha for the first time to make Baber’s problem disappear in this video.

New Technology Tapped to Teach Sepsis

Clinical Effectiveness Team Utilizes UNMC’s iEXCEL for Interactive Training

It’s an opportunity for our health care team to learn in a new way: utilizing state-of-the art technology. Our clinical educators are taking advantage of UNMC’s iEXCEL advanced visualization, experiential and learning hub to help our nurses learn about the origins of sepsis and its impact on the body’s organs.

The iEXCEL visualization hub inside the Sorrell Center features MultiTaction panels, often referred to as iWall, that generate an interactive display wall that can detect an unlimited number of fingers, hands and infrared pens to incorporate a level of experiential learning. The simulation and virtual reality training will enhance training of current and future health professionals.

Jessica Strickler, clinical educator for MICU and SICU and Sara Hooper, clinical educator for 8 Telemetry are one of the first to partner with Ben Stobbe, executive director for Clinical Simulation, iEXCEL, to use the technology for our staff training on sepsis.

“We met with Ben and three student workers and described what we wanted the education to look like,” says Strickler, who together with Hooper, researched much of the content of the education.

Micah Beachy, DO, Clinical Effectiveness medical director, provided his expertise on sepsis’ impact on the body’s organs. After four more meetings, the interactive training was ready to go.

This 30-60 minute iWall training, called “Sepsis iWall Education,” is encouraged for nurses, but not required. Nurses who complete it will receive one hour of CEU. To register for class time, log into Apollo. Classes are being offered before and after shifts. Review the training schedule here.

iEXCEL is the programmatic component of UNMC’s Global Center for Advanced Interprofessional Learning.

Jessica Strickler, clinical educator for MICU and SICU, is seen demonstrating the new sepsis education.

Jessica Strickler, clinical educator for MICU and SICU, is seen demonstrating the new sepsis education.

Breakthrough Treatment for Peripheral Artery Disease

We’re among the first in the United States to offer a new treatment recently cleared by the U.S. Food and Drug Administration (FDA) to provide relief for patients suffering from the painful symptoms of peripheral artery disease, or PAD – a condition caused by a build-up of plaque that blocks blood flow in the arteries of legs or feet.

The device, Avinger’s Pantheris™ lumivascular atherectomy system, is an innovative image-guided therapy that, for the first time ever, allows physicians to see and remove plaque simultaneously during atherectomy – a minimally invasive procedure that involves cutting plaque away from the artery and clearing it out to restore blood flow.

Because the Pantheris device incorporates real-time optical coherence tomography (OCT) imaging on a therapeutic catheter – like having a small camera on the tip of the device – physicians are able to remove this plaque more precisely than ever before, with less risk of damage to the artery walls which can result in aggressive scarring that greatly increases the risk of restenosis, or re-narrowing of the artery. In the past, physicians have had to rely solely on X-ray as well as touch and feel to guide their tools while they try to treat complicated arterial disease.

For patients, this safe and more-precise treatment may potentially reduce the need for follow-up procedures and stents.

“Peripheral artery disease greatly impacts quality of life, with patients experiencing cramping, numbness, discoloration and pain,” says vascular surgeon David Vogel, MD. “The Pantheris technology is on the front lines. Nebraska Medicine is the only hospital in the region using it. We’re helping lead the way.”

David Vogel, MD, is seen using this new device on a patient during atherectomy – a minimally invasive procedure that involves cutting plaque away from the artery and clearing it out to restore blood flow.

David Vogel, MD, is seen using this new device on a patient during an atherectomy – a minimally invasive procedure that involves cutting plaque away from the artery and clearing it out to restore blood flow.

Clinical results confirm that the technology is safe and effective: a 130-patient study showed a target lesion revascularization rate of just 8 percent, and not a single event of vessel perforation, clinically significant dissection or late aneurysm resulted from Pantheris. In addition, this radiation-free technology may help minimize radiation exposure to clinicians and patients by decreasing use of fluoroscopy.

KMTV recently featured one of our patients who underwent the procedure.

Peripheral artery disease affects nearly 20 million adults in the U.S. and over 200 million people globally. PAD is caused by a build-up of plaque in the arteries that blocks blood flow to the legs and feet. Often dismissed as normal signs of aging, symptoms of PAD include painful cramping, numbness or discoloration in the legs or feet. PAD can become so severe and difficult to address with traditional treatments that patients and physicians often resort to undergoing invasive bypass surgeries, which can result in even higher health risks and lengthy, painful recoveries. In severe cases, patients often face amputation, the worst-case scenario associated with PAD.

Atherectomy is a minimally invasive treatment for PAD in which a catheter-based device is used to remove plaque from a blood vessel. Lumivascular technology utilized in the Pantheris system allows physicians, for the first time ever, to see from inside the artery during a directional atherectomy procedure by using an imaging modality called optical coherence tomography, or OCT. In the past, physicians have had to rely solely on X-ray as well as touch and feel to guide their tools while they try to treat complicated arterial disease. With the lumivascular approach, physicians can more accurately navigate their devices and treat PAD lesions, thanks to the OCT images they see from inside the artery.

Multidisciplinary Breast Cancer Clinic Offers Comprehensive, Convenient and Personal Care


Conveniently located at 175th and Burke St., just west of the Village Pointe shopping center, the Multidisciplinary Breast Cancer Clinic offers easy access with care provided in an intimate and comfortable environment.

Conveniently located at 175th and Burke St., just west of the Village Pointe shopping center, the Multidisciplinary Breast Cancer Clinic offers easy access with care provided in an intimate and comfortable environment.

Today, there are numerous choices available for breast cancer treatment. The new Multidisciplinary Breast Cancer Clinic at Nebraska Medicine – Cancer Center at Village Pointe, provides a very personalized and comprehensive approach to breast cancer care based on a patient’s individual needs and wishes as well as the expertise and careful assessment of a team of breast cancer specialists.

“Patients benefit from getting not just one opinion, but a comprehensive plan developed by a multitude of breast cancer experts using the most recent studies,” says Sarah Thayer, MD, PhD, surgical oncologist at Nebraska Medicine and physician-in-chief of the Fred & Pamela Buffett Cancer Center. “This model allows for enhanced communication between providers and the patient to ensure her goals and individual needs are met.”

Conveniently located at 175th and Burke St., just west of the Village Pointe shopping center, the Multidisciplinary Breast Cancer Clinic offers easy access with care provided in an intimate and comfortable environment. Patients can receive an array of cancer services in one convenient location including:

  • Comprehensive care plan developed by a multidisciplinary team of experts
  • Consultative services or second options from cancer experts in medical oncology, surgical oncology, radiation oncology and plastic and reconstructive surgery
  • Infusion services within private infusion rooms
  • Radiation treatment center
  • Women Imaging Center with state of the art 3D-mammography and MRI capabilities
  • Amenities and supportive services including wig fittings, a free wig bank, prosthetic and bra fittings, yoga, massage therapy, skin care and make-up lessons specifically geared for people with or recovering from cancer

Multidisciplinary, Personalized Care Plan

Sarah Thayer, MD, PhD

Sarah Thayer, MD, PhD

The multidisciplinary team of experts includes medical oncologists, surgical oncologists, radiation oncologists, plastic and reconstructive surgeons, geneticists and social workers. The team helps each patient navigate through the many decisions available in breast cancer treatment including lumpectomy, mastectomy, chemotherapy, radiation therapy, targeted therapies and breast reconstructive surgery in a collaborative approach that is based on a woman’s personal choices.

“When a patient arrives for an appointment, they will see all of the specialists required for that visit in one setting and one appointment,” says Dr. Thayer. “Not only is this saving our patient’s time but it helps eliminate duplication of tests and services.”

Providing 3-D mammography for all patients is another benefit that will be provided at the clinic and is expected to be available by early summer. “Studies have shown that 3-D mammography when used with standard digital mammograms can bump up breast cancer detection rates and reduce callbacks,” says Dr. Thayer.

Patients will also be given the opportunity to participate in breast cancer clinical trials offered through the University of Nebraska Medical Center as part of their treatment program.

Personal Care Needs

A host of amenities and supportive services are also available to help address a patient’s physical, educational, emotional and spiritual needs providing a more complete and holistic approach to care and includes wig fittings, a free wig bank, prosthetic and bra fittings, yoga, massage therapy, skin care and make-up lessons specifically geared for people with or recovering from cancer.

“The Multidisciplinary Breast Cancer Clinic is designed to provide patients the most oncologically-sound plan in an environment that is more personal, private and positive,” notes Dr. Thayer.

Hope for Stroke Patients: Recent Treatment Advances Offer Better Chances for Recovery

brain 4

Stroke is a severely debilitating disease that can permanently change the lives of patients and their families. Everyone knows a family member or a friend whose life has been permanently changed by stroke. Stroke is a very common disease around the world. Every year more than 795,000 people in the United States will suffer a stroke and more than 130,000 will die as a consequence of stroke. In Nebraska, stroke is the fourth leading cause of death and more than 36,000 people live with stroke. Despite these frightening numbers there is hope for stroke patients.

Stroke prevention

The best way to prevent a stroke is to take care of  you health. More than 90% of strokes are the result of poorly controlled medical conditions. Avoid tobacco, control your weight, watch your diet, exercise and follow up regularly with your primary care physician. Work closely with your doctor to control your high blood pressure, diabetes, high cholesterol or heart disease. Just by reducing your blood pressure by 10 points you can decrease your chance of having a stroke by one-third. Controlling the other risk factors will decrease your chances even further.

Sudden signs of stroke: remember them easily with “FAST”

Stroke can present in many different ways: confusion, severe headache, dizziness, double vision, facial droop, difficulty swallowing, arm or leg numbness or weakness, sudden loss of balance, inability to speak and slurred speech all are symptoms of stroke. One easy way to remember the sudden signs of stroke is by using the F.A.S.T. acronym. F is for facial droop, A is for arm weakness, S is for speech difficulties and T is for time to call 9-1-1. If you think you or a loved one is having a stroke, the best course of action is to call 9-1-1. Patients who call 9-1-1 arrive faster to the nearest hospital capable of treating stroke and have better chances of receiving treatment.


Stroke types and treatments

There are two major types of strokes: ischemic and hemorrhagic. Ischemic strokes are by far the most common type in the United States and in Nebraska. An ischemic stroke is usually the result of a blockage in a blood vessel, whereas a hemorrhagic stroke is due to a blood vessel rupture. Treatment is different for each type; however rapid treatment is essential in both.

Since 1996, the only FDA approved treatment for acute ischemic stroke has been to administer alteplase. This is a medication that is given to patients with an ischemic stroke who arrive to the Hospital within 4 ½ hours from the onset of symptoms. Patients who receive this drug have a 33% increased chance of being independent or less disabled at three months after their stroke, when compared with people who did not receive the drug. In the last year there have been significant advances in the treatment of acute ischemic stroke. Five new studies show that patients who suffered a large stroke and were treated with new devices called stent retrievers – within 6 hours of onset, in an experienced stroke center – have a 33% to 71% percent chance of regaining independence or experiencing less disability at three months.

New, advanced treatment options available at Nebraska Medicine

Nebraska Medicine has the capacity to offer these novel treatments to stroke patients who qualify. To make these crucial advancements in stroke treatment available to more people in Nebraska and neighboring states we launched the Nebraska Medicine Tele Stroke Network. Tele Stroke brings stroke neurology expertise to the bedside of community hospitals. Working together, the neurologist and emergency department physician collaborate on the most appropriate treatment for the stroke patient. This program provides local and rural emergency rooms with 24- hour access to stroke neurology expertise and the advanced treatment options available at Nebraska Medicine.

Dr. Kalil is lead author on new pneumonia guidelines

By Stephanie Goldina, Infectious Diseases Society of America


Andre Kalil, M.D.

ARLINGTON, Va. — Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) — which account for 20 to 25 percent of hospital-acquired infections — should be treated with shorter courses of antibiotics than they typically are, according to new guidelines released by the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) and published in the journal Clinical Infectious Diseases. In addition, the Society of Critical Care Medicine (SCCM), the American College of Chest Physicians (CHEST), and the Society for Healthcare Epidemiology of America (SHEA) endorsed these guidelines.

At a glance

•Seven days of antibiotics are effective for most hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) infections, according to the new guidelines published by the Infectious Diseases Society of America and American Thoracic Society.
•The new guidelines also recommend that each hospital develop an antibiogram to determine which strains are causing infection and ensure the right antibiotics are used for treatment.
•HAP and VAP cause 20 to 25 percent of hospital-acquired infections, and these may be fatal 10 to 15 percent of the time.

The recommendation of seven or fewer days of antibiotics for most of these infections reflects a change from previous guidelines to ensure safe and effective treatment while limiting the development of antibiotic resistance.
Created by a multidisciplinary panel led by infectious diseases, pulmonary and critical care specialists, the new guidelines also recommend that each hospital develop an antibiogram, a regular analysis of the strains of bacteria causing pneumonia infections locally as well as which antibiotics effectively treat them.

When possible, the antibiogram should be specific to the hospital’s intensive care unit patients, according to the guidelines. Antibiograms should be updated regularly, and the most appropriate frequency should be determined by the institution, the guidelines note.

“Once clinicians are updated regularly on what bugs are causing VAP and HAP in their hospitals as well as their sensitivities to specific antibiotics, they can choose the most effective treatment,” said Andre Kalil, M.D., lead author of the guidelines, professor of medicine in the Division of Infectious Diseases and director of the Transplant Infectious Diseases Program at UNMC. “This helps individualize care, ensuring patients will be treated with the correct antibiotic as soon as possible.”

Published in 2005, the previous guidelines recommended different lengths of treatment time for antibiotic therapy based on the bacterium causing the infection.

The 2016 guidelines recommend seven days or fewer for all bacteria. Newer evidence suggests that the shorter course of treatment does not reduce the benefits of therapy, Dr. Kalil said. In addition, he said this can reduce antibiotic-related side effects, the risk of Clostridium difficile, a serious diarrheal infection, antibiotic resistance and costs. In some cases, such as when a patient doesn’t improve or worsens, longer treatment may be necessary.

Mechanical ventilators help patients breathe. They are used when a patient is having surgery with general anesthesia or for those who suffer from impaired lung function. One of every 10 patients on a ventilator gets VAP, which is fatal about 10 to 15 percent of the time.

VAP also increases: the amount of time patients remain on a ventilator — from 7.6 to 11.5 days on average — and length of hospital stay — from 11.5 to 13.1 days on average.

While HAP typically is a less severe infection than VAP, half of patients have serious complications, including respiratory failure, fluid in the lungs, septic shock and kidney failure.

How Breast Cancer Research Saved My Life

In September 2015, Janet Tinney was diagnosed with breast cancer.

In September 2015, Janet Tinney was diagnosed with breast cancer.

As you listen to the news, read the paper, check Facebook or talk to others, you’re frequently made aware of someone that’s been diagnosed with cancer. You think about them often, pray for them and their family, but then go on with your day-to-day life. Until that one day, when you’re the one receiving the devastating phone call. Where they ask you to come back in – because something doesn’t look right.

Janet at her chemotherapy treatment.

Janet at her chemotherapy treatment.

Over the years, due to very dense breast tissue, I’ve had many calls asking me to return for further testing following a mammogram. I’ve even had a couple biopsies and other procedures. Fortunately, each time the extra tests were performed, I received a phone call with good news that everything was benign – until September of 2015. That’s the year I received a phone call, informing me I had breast cancer.

For the first few minutes, I was stunned and speechless. Then the tears came. My emotions got the best of me. Until you’re the one getting that phone call, you never truly know what it’s like. My father passed away due to cancer. I spent nearly two years going to appointments and treatments, waiting through every surgery. Even though the experience with my dad was unpleasant in the end, I knew I had been given the knowledge and strength to deal with my own cancer battle.

As a caregiver, my first thoughts were about my husband and children. I knew this situation would be tremendously stressful for them. At the time, I felt helpless, but knew my family and friends would be my rock.

The day I was diagnosed with cancer, I was sent to a local surgeon in North Platte, Nebraska. He was incredible, but knew I needed to see the very best.

I was referred to Nebraska Medicine surgical oncologist Edibaldo Silva-Lopez, MD, PhD. During the first visit with Dr. Silva in Omaha, I barely let him speak before peppering him with questions about my future. Did I need to get my things in order? If so, how long did I have? He looked me straight in the face and said, “that is not even a concern for you.” He was certain I would survive. My heart danced!

Edibaldo Silva-Lopez, MD

Edibaldo Silva-Lopez, MD

Dr. Silva’s recommended treatment plan for me was newly approved, but research showed the results were very positive. Within the next couple weeks, we began treatment at the cancer center in North Platte. Everything started to happen just like Dr. Silva said it would. He anticipated my cancer journey would be about a year long, barring any complications.

But, after two rounds of chemotherapy, we were in for quite a surprise. During an ultrasound of my breast, the tumor was nowhere to be found. My radiologist was completely shocked. What a happy day!

I completed two more rounds of chemo, followed by a regimen of drugs. In January, Dr. Silva performed surgery, removing a margin of tissue where the tumor once was, along with 17 lymph nodes. About a week later, I received a phone call from Dr. Silva’s nurse, Carol, telling me all the tests performed on the removed tissue and lymph nodes were negative for the cancer! The treatment plan Dr. Silva gave me worked.

When this journey began, my husband and I both prayed for a miracle. That miracle was not for the cancer to just go away, but for me to be directed to the right physicians with the knowledge to cure my disease. In my opinion, my prayers were answered and my miracle was granted. Without cancer research and the dedication of physicians who put it to use, who knows where my journey would have led. But, because we are fortunate enough to have these services in Nebraska, I am able to look forward to a bright future.

I now pray for a financial miracle so that breast cancer research can continue to evolve at the Fred & Pamela Buffett Cancer Center for many, many years to come. I am living proof that this research does make a difference.


Computer Aided Detection: New tools to help your doctor find cancer

Neil Hansen, MD

Neil Hansen, MD

Prostate and breast cancer are two of the most common cancers around. Unfortunately, most people know someone who has one of these. Many doctors have spent their careers trying to design screening tests to find these tumors at an early stage when they are still curable. This usually means finding them when they are really small. That sometimes means smaller than a pea.

So, how do we find these cancers? For breast cancer, the standard screening exam for years has been mammography – taking an x-ray of the breast and looking for cancer. Recently, Nebraska Medicine Radiology has adopted a fancier version of this – tomography—which is a 3D x-ray. On mammography, finding cancer can be tough. It can be seen as only a few tiny dot sized areas of calcium—little blips of white on the screen. To help find these doctors use computer aided detection (CAD). This is a computer program that takes the mammogram and identifies these calcifications. Studies have shown that these programs allow doctors to find earlier cancers better, especially younger and less experienced doctors.

While CAD has been used in mammography for years, it is relatively new for looking at prostate cancer. Screening for prostate cancer has been controversial, but traditionally has relied on physical exam (the finger / glove test frequently dreaded by men) and a lab test called Prostate Specific Antigen (PSA). If one of these is abnormal, that leads to a biopsy. In the prostate, biopsies are often randomly aimed because we don’t know where the cancer is. If one of the biopsies is positive then you know there is prostate cancer, but not necessarily its stage. If the biopsy is negative, then the tumor might have just been missed. This is where prostate magnetic resonance imaging (MRI) comes into use.

Prostate MRI uses a powerful magnet to take pictures of the prostate. It is sometimes hard to differentiate cancer from an old infection on MRI. This is where CAD is used. We recently acquired DynaCAD at Nebraska Medicine Radiology. It is a new tool where a computer program helps us identify cancer based off of blood flow in the prostate and other imaging parameters. A similar program has been in use for breast MRI, and we just acquired the latest software package for this as well. Our use of these doesn’t cost patients anything extra. The goal in the future is to use this program to do targeted prostate biopsies of suspicious areas and avoid randomly missing tumors.

These exciting new products will help us find early stage curable cancers. They aren’t perfect though and still require an expert radiologist to interpret their findings. At Nebraska Medicine Radiology, our specialty trained radiologists are committed to apply our expertise and all tools available to provide extraordinary care to our patients.

Mother Hears Son’s Heart Beating for First Time in Three Years

April is National Donate Life Month, a time to raise awareness about organ donation and celebrate those who have given the ultimate gift of life. On April 1, a unique event took place at Nebraska Medicine – Nebraska Medical Center involving heart transplant patient Terry Hooper and his donor’s family.

In June 2003, Hooper was diagnosed with cardiomyopathy, a disease of the heart muscle in which the heart loses its ability to pump blood effectively. In April 2005, doctors at Nebraska Medicine discovered Hooper’s aortic valve was leaking – something that had probably gone undetected since birth. He underwent an aortic valve replacement, but his heart was still only functioning at 30 percent. By August 2012, his heart function had declined to 5 percent and he was placed on the transplant waiting list in October of that year. After being on the list for 52 days, Hooper received a heart transplant on Dec. 10, 2012.

Lisa and Terry Meet
On April 1, Lisa Swanson met Terry Hooper, the Nebraska Medicine patient who received her son’s heart.

At the time, Hooper had no idea his donor was 18-year-old Levi Schulz of Horace, N.D. Levi was killed in an automobile accident Dec. 7, 2012. His body was kept on life support so that his organs could save others.

In the spring of 2013, Hooper wrote a letter to his donor family. That May, he received a letter from Levi’s mom, Lisa Swanson. Over the years, they continued to correspond, but never spoke on the phone or met face to face.


On Friday, April 1, Hooper met Levi’s mom and twin brother, Shelby Schulz, for the first time.

The family got to see and hear Hooper’s heart beating through an echocardiogram. At the end of the meeting, Hooper surprised Swanson with a HeartBeat Bear that had a recording of his heartbeat.

Nebraska Medicine is home to one of the most reputable and well-known organ transplant programs in the country. It’s one of a few institutions nationwide to offer all solid organ transplants under one roof.

Nature study suggests pathway to possible HIV-1 cure

Kalani Simpson

Fletcher011Courtney Fletcher, Pharm.D.

An international team of scientists – among them Courtney Fletcher, Pharm.D., dean of the University of Nebraska Medical Center College of Pharmacy – this week published a study in the journal Nature, which shows findings that suggest a pathway to a possible cure for HIV-1 infection. The print edition of the journal hits newsstands today (Thursday).

The work builds upon a 2014 publication in the Proceedings of the National Academy of Sciences, of which Dr. Fletcher was first author, which investigated the question of why, despite being driven to undetectable levels in blood by powerful antiretroviral drugs, HIV is never fully wiped out in patients with the disease.

In that study, Dr. Fletcher and colleagues found that a much lower concentration of the drugs made it to lymph node and lymphoid tissues, allowing viral replication – and persistence – of reservoirs of HIV in those tissues.

Finding out why low levels of HIV were hanging on, “for the first time allowed us to have a scientific-based conversation about a cure – is it possible?” Dr. Fletcher said.

This latest study takes it a step further – and finds that while the levels of drug concentration that make it to those tissues are too low to wipe out HIV, the virus also has not developed a resistance to those drugs, as might usually be expected. In the current paper, the authors suggested this is likely because the levels of the drugs are so low, there was no reason for the virus to develop resistance.

“In simple terms, we think there is no evolutionary advantage to have developed a resistance,” Dr. Fletcher said.

And if it has no drug resistance, the scientists may have found a pathway to a possible cure.

“Can we deliver more drug to these tissues and see if we can shut down replication?” Dr. Fletcher said. That’s the next problem to solve.

“Will this cure HIV? No one knows,” Dr. Fletcher said. “But it is a very rational, evidence-based approach.

“This is a problem that we are extremely well positioned here at Nebraska to address. We think this problem of ongoing viral replication in lymphoid tissues may be solved by enhanced drug delivery, and that’s something that we here at UNMC are really good at.”

Already, Dr. Fletcher has a significant grant application in with the National Institutes of Health, and he is optimistic that UNMC will be tasked with finding a way to deliver enough drugs to the hard-to-reach places where the last remaining bits of HIV hide out.

“We believe we are one of the few places in the country – with some help from experts in virology around the country,” he emphasized – “to do this work.”

An international collaboration

Dr. Fletcher stressed that it took an international collaboration of top-notch academic medical centers, each bringing its own world-class expertise, to take on a project like this.

For example:
• Investigators at the University of Minnesota, with which Dr. Fletcher has long collaborated, recruited the patients into the original study, obtained the plasma and tissue samples, and measured the amount of virus in the tissues;
• Northwestern University researchers explored the evolution of the HIV virus;
• University of Oxford scientists took the lead on the mathematical side; and
• Researchers at the University of Edinburgh, in Scotland, brought to life the story of how the virus changes its genetic makeup.

Investigators at the Fred Hutchinson Cancer Research Center, in Seattle, the University of Porto, in Portugal, the University of California, San Diego, Korea National Institutes of Health, and King’s College London also made crucial contributions.