Archive for the ‘Patients’ Category

New U.S. News rankings released

by John Keenan, UNMC public relations

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UNMC’s primary care program is the fifth best in the country, placing in the top five for the second consecutive year, according to the 2017 ranking of the nation’s top graduate schools by U.S. News & World Report.

In other new rankings, the UNMC College of Pharmacy was ranked 25th in the nation, and the College of Allied Health Professions’ physical therapy program was ranked 28th. The last time U.S. News ranked the College of Pharmacy, in 2012, it was 32nd in the country. The physical therapy program also improved in the new rankings, moving from 34th in 2012 to 28th this year.

College of Nursing had three programs ranked: the Master’s of Nursing program was ranked 46th in the country, while the Doctor of Nurse Practitioner program was ranked 54th. UNMC was ranked 73rd in Online Graduate Nursing Programs. U.S. News also ranked UNMC 63rd in research.

U.S. News sent surveys to 170 medical schools to compile its primary care and research lists. It ranked 259 schools for master of nursing, 149 for DNP, 125 for pharmacy and 217 for physical therapy.

“I’m pleased to see in the latest U.S. News rankings that UNMC retains a position among the top primary care programs in the country,” said UNMC Chancellor Jeffrey P. Gold, M.D. “In addition, the new national rankings for the College of Pharmacy and the physical therapy program, as well as our nursing programs, reflect the dedication and hard work of their faculty and students. These rankings should provide us a point of pride, but we also will continue in our efforts to ensure that UNMC delivers world-class education in every aspect of its medical, health care and nursing programs.”

U.S. News does not re-rank every program every year. In rankings compiled in 2015 and 2014, UNMC’s physician assistant program was ranked 9th, public health was ranked 39th and the university was ranked 93rd in biological sciences.

“The continued ranking of our primary care and physician assistant programs among the best in the country, as well as the improved rankings of our pharmacy and physical therapy programs, is a strong indication of the ongoing commitment and dedication of our faculty and staff to providing the best training opportunities to our students,” said Dele Davies, M.D., vice chancellor for academic affairs. “We are constantly striving to innovate in educational and clinical opportunities that enable us to help meet the health needs of all segments of the population.”

For information on the ranking methodology, click here.

Multidisciplinary Breast Cancer Clinic Provides Team Approach

Today, there are numerous choices available for breast cancer treatment and women want to be a part of that decision-making process. The Nebraska Medicine’s Multidisciplinary Breast Cancer Clinic at Village Pointe Cancer Center 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.

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Sarah Thayer, MD, PhD

“We believe that the best care plan is one that has been developed with the input and expertise of a multidisciplinary team of cancer experts,” says Sarah Thayer, MD, PhD, surgical oncologist at Nebraska Medicine and physician-in-chief at the Fred and Pamela Buffett Cancer Center. “Our multidisciplinary team of experts will help 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.

The multidisciplinary team includes medical oncologists, surgical oncologists, radiation oncologists, plastic and reconstructive surgeons, oncology nurses, geneticists and social workers who will work closely with each patient to provide a very personalized and patient-directed care experience.

The Seventh: Extraordinary Innovations and Emerging Trends in Transplantation and Oncology

July 12 – 13, 2016

Nebraska Medicine is co-sponsoring a two day conference with OPTUM Health that highlights advances in complex cancer treatment and transplants’ organ failure management. The structure of the Nebraska Medicine’s Multidisciplinary Breast Cancer Clinic will be reviewed, in addition to, key components in managing organ failure.

For more information about this continuing education series, visit optumhealtheducation.com.

As part of the evaluation, all outside films and mammograms are re-reviewed by a specialized breast radiologist. The clinic also offers the newest, most advanced form of mammograms, called 3-D mammography. “This new technology increases detection rates by 40 percent and is able to find the cancers at a smaller size — in all levels of density of the breast,” says Cheryl Williams, MD, radiologist at the Multidisciplinary Breast Cancer Clinic. “This is very important. The smaller a tumor is when we find it, the more likely it is that we’ll be able to cure it.”

“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 Dr. Thayer. “This model allows for enhanced communication between providers and the patient to ensure her goals and individual needs are met.”

When a patient arrives for her appointment, she sees all of the specialists required for that visit in one setting and one appointment. Not only does this save the patient time, but helps eliminate duplication of tests and services. “This streamlined approach to care provides a more comfortable and pleasant experience for the patient,” says Dr. Thayer.

Cheryl-WilliamsCheryl Williams, MD

The Village Pointe Cancer Center is 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:
•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’s 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

“Addressing a patient’s physical, educational, emotional and spiritual needs are important aspects of providing a more complete and holistic approach to care,” notes 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.

“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,” says Dr. Thayer.

To speak to a member of our multidisciplinary breast cancer team or to make a referral, please call 402-559-1600.

Virtual Incision mini-robots conduct first known human surgery

by Virtual Incision

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Dmitry Oleynikov, M.D., a UNMC professor of surgery, operates a surgical robot as in the background Shane Farritor, Ph.D., a UNL engineering professor, adjusts the camera on the surgical subject in this 2015 photo illustration. The two developed the robot for minimally invasive surgeries. Their startup company, Virtual Incision, announced March 1 the first use of its miniaturized robot in human surgery.

Virtual Incision Corp., a company founded by faculty members at the University of Nebraska-Lincoln and UNMC, has announced the successful first-in-human use of its miniaturized robotically assisted surgical device.

The device is designed for general surgery abdominal procedures, with an initial focus on colon resection, a procedure performed to treat patients with lower gastrointestinal diseases including diverticulitis, colon polyps that are too large to be removed endoscopically, pre-cancerous and cancerous lesions of the colon and inflammatory bowel disease.

“To the best of our knowledge, this is the first time an active miniaturized robot has performed complex surgical tasks with the robot inside a living human, which is a significant milestone in robotics and in surgery,” said Shane Farritor, Ph.D., a UNL professor of mechanical engineering who is Virtual Incision’s co-founder and chief technical officer.

The robotically assisted colon resection procedures were completed in Asunción, Paraguay, as part of the safety and feasibility trial for the technology. The surgeries were successful and the patients are recovering well, according to a news release from the company.

“Virtual Incision’s robotically assisted surgical device achieved proof-of-concept in highly complex abdominal procedures,” said head surgeon Dmitry Oleynikov, M.D., chief of minimally invasive surgery at UNMC and co-founder of Virtual Incision.

“Additionally, we verified that our extensive regimen of bench, animal, cadaver, biocompatibility, sterilization, electrical safety, software, human factors and other testing enabled the safe use of this innovative technology.”

Unlike today’s large, mainframe-like robots that reach into the body from outside the patient, Virtual Incision’s robot platform features a small, self-contained surgical device that is inserted through a single midline umbilical incision in the patient’s abdomen. Virtual Incision’s technology is designed to utilize existing tools and techniques familiar to surgeons, and does not require a dedicated operating room or specialized infrastructure.

Because of its much smaller size, the robot is expected to be significantly less expensive than existing robotic alternatives for laparoscopic surgery, Dr. Oleynikov said. Virtual Incision’s technology promises to enable a minimally invasive approach to surgeries performed today with a large open incision, he said.

The robotically assisted surgical device is an investigational device and is not commercially available. John Murphy, Virtual Incision’s CEO, said robotically assisted surgical devices are beneficial, but existing surgical robots have limitations that prevent pervasive use during certain surgeries, such as colon resection. The firm will build upon the positive completion of the feasibility study, as it works toward clearance for the system in the United States.

Honing in on new drug treatments for lung cancer

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APAR KISHOR GANTI, MD

Lung cancer has long been a mystery – as we didn’t know much, until the past decade, about the vast number of what we call “non-small cell lung cancers.”

More recently, one discovery after another has revealed the secrets. We now can identify certain categories of these tumors. We know that a large number — 40% — are a type called adenocarcinomas. Pemetrexed is a chemotherapy drug that seems to benefit patients with lung adenocarcinomas. Upwards of 30 percent of patients have a good response to it.

Within the group of adenocarcinomas, we have also identified many sub-types, the most common being K-RAS, EGFR and ALK.

We now have a very exciting tool called molecular tumor testing, which allows us to test a patient’s tumor to determine which type it is, and determine treatment based on that type.

This has revolutionized lung cancer treatment for some patients. But it hasn’t solved all our treatment problems. Let’s look at the three sub-types of lung cancer, and the drugs.

EGFR: EGFR (epidermal growth factor receptor) tumors. Patients with these tumors have had success with a drug named Iressa, introduced in the early 2000s. In one study, this drug eradicated the tumors within weeks – nearly a miracle!

Unfortunately back then, we did not know what caused this drug to work miracles in some patients, but not others. But research showed that patients who responded to these drugs had a mutation in the EGFR gene — and there are two drugs approved in the US for these patients; erlotinib and afatinib. Almost 55-60% of patients with these mutations will respond to these drugs, rates that are unheard of with conventional chemotherapy.

ALK: ALK, or anaplastic lymphoma kinase is a gene, which when activated, seems to promote the growth of lung cancers. Two drugs are used to treat this particular mutation: Crizotinib and Ceritinib. Up to 60 percent of patients have consistently responded to these drugs – almost double the response to conventional chemotherapy.

K-RAS: Former and current smokers with lung cancer tend to have the K-RAS sub-type, which is caused by a gene mutation. We are still working to understand this mutation. To date, we don’t have specifically targeted treatments for this subtype, but researchers are hard at work on this.

As you see, this growing body of knowledge has helped many patients. But we still have unanswered questions for many others—specifically, people who smoke.  Nevertheless, these advances give much more optimism.

I do not believe that we should accept that three quarters of patients will not respond to chemotherapy and do nothing about it. I always encourage those patients to enroll in a clinical trial. Why would you not, when a new treatment approach might give you a better chance? You’ll possibly help extend your own life – and you will certainly help advance our medical understanding of this disease.

At Nebraska Medicine, our service is designated by the National Cancer Center as a Lung Cancer Alliance Screening Center of Excellence. This reflects our team’s experience as well as our multidisciplinary program in managing patient care.

With this level of expertise, you will receive the treatment that specifically targets your lung cancer sub-type. We’ll stay with you every step of the way, making sure you’re getting excellent care.

Nebraska Medicine/UNMC, Nebraska DHHS Selected As Special Pathogen Treatment Center

The U.S. Department of Health and Human Services has selected nine health departments and associated partner hospitals to create a new network to respond to outbreaks of severe, highly infections diseases. The Nebraska Department of Health and Human services in partnership with Nebraska Medicine – Nebraska Medical Center is one of the nine facilities on the list.

Nearly $30 million of federal funding will be coming from HHS’ Office of the Assistant Secretary for Preparedness and Response (ASPR) to enhance the regional treatment centers’ capabilities to care for patients with Ebola or other similar illnesses. “This approach recognizes that being ready to treat severe, highly infectious diseases, including Ebola, is vital to our nation’s health security,” said Dr. Nicole Lurie, HHS assistant secretary for preparedness and response. “This added regional capability increases our domestic preparedness posture to protect the public’s health.”

“We are very grateful for the trust being shown to us by HHS in naming Nebraska Medicine as one of these regional centers,” said Jeffrey P. Gold, M.D., chancellor of the University of Nebraska Medical Center and chairman of the Nebraska Medicine Advisory Board. “Our track record in caring for Ebola patients is certainly a contributor toward achieving this goal, but this is also a credit to the countless individuals at Nebraska Medicine and UNMC who have continued to work tirelessly to ensure we continue to be at the forefront of the nation’s and world’s fight against the deadliest of diseases.”

Dr. Gold also said Nebraska Medicine and UNMC’s continuing effort in training hundreds of other medical experts from around the country and around the world in the best practices for handling patients with highly infectious diseases played a role in the selection.

“Our agency has partnered with Nebraska Medicine – Nebraska Medical Center for more than 10 years. They have the facility and the expertise to provide specialized care to people with highly infectious diseases like Ebola,” said Jenifer Roberts-Johnson, deputy director of the Division of Public Health for the Nebraska Department of Health and Human Services. “We’re pleased to continue our work together to further increase our level of preparedness and help protect the health of our citizens.”

Each awardee will receive approximately $3.25 million over the full five-year project period. This funding is part of $339.5 million in emergency funding Congress appropriated to enhance state and local public health and health care system preparedness following cases of Ebola in the United States stemming from the 2014 Ebola epidemic in West Africa.

The facilities announced today will be continuously ready and available to care for a patient with Ebola or another severe, highly infectious disease, whether the patient is medically evacuated from overseas or is diagnosed within the United States.

The nine awardees and their partner hospitals are:
•Massachusetts Department of Public Health in partnership with Massachusetts General Hospital in Boston, Massachusetts
•New York City Department of Health and Mental Hygiene in partnership with New York City Health and Hospitals Corporation/HHC Bellevue Hospital Center in New York City
•Maryland Department of Health and Mental Hygiene in partnership with Johns Hopkins Hospital in Baltimore, Maryland
•Georgia Department of Public Health in partnership with Emory University Hospital and Children’s Healthcare of Atlanta/Egleston Children’s Hospital in Atlanta, Georgia
•Minnesota Department of Health in partnership with the University of Minnesota Medical Center in Minneapolis, Minnesota
•Texas Department of State Health Services in partnership with the University of Texas Medical Branch at Galveston in Galveston, Texas
•Nebraska Department of Health and Human Services in partnership with Nebraska Medicine – Nebraska Medical Center in Omaha, Nebraska
•Colorado Department of Public Health and Environment in partnership with Denver Health Medical Center in Denver, Colorado
•Washington State Department of Health in partnership with Providence Sacred Heart Medical Center and Children’s Hospital in Spokane, Washington

The regional facilities are part of a national network of 55 Ebola treatment centers, but will have enhanced capabilities to treat a patient with confirmed Ebola or other highly infectious disease. Even with the establishment of the nine regional facilities, the other 46 Ebola treatment centers and their associated health departments will remain ready and may be called upon to handle one or more simultaneous clusters of patients.

The facilities selected to serve as regional Ebola treatment centers will be required to:
•Accept patients within eight hours of being notified,
•Have the capacity to treat at least two Ebola patients at the same time,
•Have respiratory infectious disease isolation capacity or negative pressure rooms for at least 10 patients,
•Conduct quarterly trainings and exercises,
•Receive an annual readiness assessment from the soon-to-be-established National Ebola Training and Education Center, composed of experts from health care facilities that have safely and successfully cared for patients with Ebola in the U.S., and funded by ASPR and the Centers for Disease Control and Prevention, to ensure clinical staff is adequately prepared and trained to safely treat patients with Ebola and other infectious diseases,
•Be able to treat pediatric patients with Ebola or other infectious diseases or partner with a neighboring facility to do so, and,
•Be able to safely handle Ebola-contaminated or other highly contaminated infectious waste.

Proposals from these facilities were reviewed by a panel of experts from professional associations, academia, and federal agencies and were selected based upon extensive criteria published in the funding opportunity announcement released in February.

To be eligible for consideration as an Ebola and other special pathogen treatment center, facilities also had to be assessed by a Rapid Ebola Preparedness team led by the CDC prior to Feb. 20, 2015.

The Department is working with state health officials and hospital executives in HHS Region IX, which includes Arizona, California, Hawaii, Nevada and the Pacific island territories and freely associated states, to identify a partner hospital awardee.

HHS is the principal federal department for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. ASPR leads HHS in preparing the nation to respond to and recover from adverse health effects of emergencies, supporting communities’ ability to withstand adversity, strengthening health and response systems, and enhancing national health security.

To learn more about the department’s efforts to protect against Ebola, visit www.cdc.gov/Ebola and for more information on the Department’s emergency preparedness and response efforts for all hazards see www.phe.gov.

A New Lease on Life for the New Year

1-6-free-hip-and-knee-Brenda-BosticBrenda Bostic and Curtis Hartman, MD, right before Bostic’s procedure.

While many of us take for granted our daily mobility, millions of Americans are living with excruciating hip and knee pain that cripples them, their lifestyles and their ability to work or provide for themselves or their families. There are physical and psychological tolls. Most of all, they just want their lives back.

The solution is often hip and knee replacement surgery. But what happens to those individuals who desperately need new joints to minimize pain and regain mobility and can’t have access to them due to lack of insurance coverage, financial or other constraints?

Through Operation Walk USA 2015, two Nebraska Medicine patients received free joint replacements from orthopaedic surgeon, Curtis Hartman, MD. In mid-December, 59-year-old Brenda Bostic of Bellevue, Neb., and 63-year-old Randy Robins of Blair, Neb., underwent surgery at the med center. Bostic worked in receiving at Walmart most of her adult life, and was very aware of the arthritis and pain in her knee. For 20 years, she tried to minimize the discomfort with cortisone shots, frequent doctor visits and other procedures. But, in October, she thought her knee was going numb. She was rushed to the emergency department and was told she needed knee replacement surgery. When Bostic mentioned to the med center physicians that she didn’t have insurance, they recommended Operation Walk USA. She applied and was accepted.

“I was absolutely ecstatic,” says Bostic. “I want to be able to jump up and down and run along the field to support my grandchildren at their sporting events. Being a grandmother is the joy of my life.”

1-6-free-hip-and-knee-Randy_Robins_IMG_0905-690x460Randy Robins smiles with second year orthopaedic surgery resident Tyler Larson, MD, and orthopedic surgeon Curtis Hartman, MD.

Bostic, who is also legally blind, underwent a total left knee replacement on Dec. 15, under the care of Dr. Hartman. That same day, Dr. Hartman performed a left hip replacement on Robins, who enjoyed a long career at Union Pacific Railroad. Over the years, Robins has met life’s challenges head on. Twelve years ago, his youngest daughter was diagnosed with cancer. Five years ago, he came down with a rare form of cancer himself. Then, came Robins’ left hip. He’d been feeling discomfort for years, but after his recovery from cancer, the pain was excruciating.“I’m a pretty tough guy. Always have been,” says Robins. “But, the pain was so bad that I couldn’t walk.”

Given the physical nature of his work, Robins was forced to retire early. He had little insurance and was still paying off his cancer bills. His eldest daughter had read about Operation Walk USA and applied on his behalf without him knowing it.

“I’m very emotional about it,” says Robins. “I’ve been an unselfish man all my life and told my case worker that I don’t want to take an opportunity away from somebody else. I consider myself a fortunate man just to be here. I want to live again. I want to work again.”

Operation Walk USA provides all aspects of treatment – surgery, hospitalization, and pre-and post-operative care ─ at no cost to participating patients who may not qualify for government health coverage, have insurance or afford surgery on their own. Operation Walk USA takes place annually in early December to allow for greater hospital, surgeon and medical staff participation – and as a holiday gift to the patients it treats.

Team Performs First Lung Transplant

Stress-surgery-photo1-690x412Serious Medicine

Back in November, we announced that Nebraska Medicine has re-implemented its Lung Transplant Program after a 17-year hiatus.

Transplant team members recently performed the first lung transplant on a patient in need of this life-saving procedure. This marks the first time the procedure has been performed here since the relaunch of the program.

Our patient has requested privacy during recovery, so this is all we are able to share at this time. Learn more about our lung transplant program in this video.

Lung Transplant Program Begins at Nebraska Medicine

One of a Few Institutions Nationwide Offering All Solid Organ Transplants

Nebraska Medicine is home to one of the most reputable and well-known organ transplant programs in the country. In the decades since the first transplant in 1970, its nationally and internationally renowned specialists have performed thousands of heart, liver, kidney, pancreas and intestinal transplants. After years of planning and preparation, the organization is launching a comprehensive Lung Transplant Program. The addition makes Nebraska Medicine one of a few institutions nationwide to offer all solid organ transplants under one roof.

“We are thrilled to offer this lifesaving treatment,” says Heather Strah, MD, medical director of lung transplantation. “The addition of lung transplantation takes Nebraska Medicine’s already elite solid organ transplant program and elevates it to the highest level in the country.”

Nebraska Medicine first offered a lung transplant program in 1995, which remained in operation until 1998. The program now looks to once again shape the field of patient care, offering a multidisciplinary team of surgeons, physicians, respiratory therapists, psychologists, social workers, dietitians, nurses and others. Professionals will provide patients support from pre-evaluation to long-term follow-up care.

“A transplant program requires a large team of people pulling in the same direction,” says lung transplant surgical director Aleem Siddique, MD. “This program is the product of a great deal of hard work. It will allow us to provide world-class care to the people of Nebraska and surrounding states.”

Patients will no longer need to travel hundreds of miles for treatments of end-stage lung disease. Nebraska Medicine’s program will also assume the care of appropriate patients who received lung transplants at other institutions.

“Patients who have been transplanted far from Omaha often have a tremendous burden on them,” says Dr. Strah. “The time and financial resources required to receive follow-up care can be astonishing. With our new program, patients will have expert care close to home while ensuring superior care coordination with their transplant center. In addition, patients who were too ill to travel and receive a transplant may now be candidates locally.”

Nebraska Medicine’s Lung Transplant Program will offer single lung, double lung and heart-lung transplants. Although the transplant process is very unpredictable, clinicians hope to evaluate 20-30 patients and transplant 10 patients in the first year. Some diseases that may require a lung transplant include cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, pulmonary hypertension and many other chronic lung diseases.

“Patients who survive their first year after transplant are typically expected to survive seven or eight years,” says Dr. Strah. “But, there are lots of patients I follow who were transplanted 10, 15, 20 years ago and are still enjoying relatively good health. That’s what we want for everyone. We want nothing more than to provide the best treatment possible for those who walk through our doors.”

Along with extraordinary patient care, the program will provide lung education, research and innovation. Clinicians will also work to promote the importance of organ donation.

“Nationally, it’s estimated that 18 people die every day while waiting for organ transplants,” says Dr. Siddique. “A single donor may save up to eight lives. For the donor or their family, it’s an opportunity for altruism that may be deeply rewarding.”

To register as an organ donor, visit www.donatelifenebraska.com. To learn more about the Lung Transplant Program at Nebraska Medicine, visit NebraskaMed.com/Transplant.

 

Experimental treatment regimen effective against HIV

University of Rochester public relations

Gend0421UNMC’s Howard Gendelman, M.D.

Protease inhibitors are a class of antiviral drugs that are commonly used to treat HIV, the virus that causes AIDS. Scientists at UNMC designed a new delivery system for these drugs that, when coupled with a drug developed at the University of Rochester School of Medicine and Dentistry, rid immune cells of HIV and kept the virus in check for long periods.

The results appear in the journal Nanomedicine: Nanotechnology, Biology and Medicine. While current HIV treatments involve pills that are taken daily, the new regimens’ long-lasting effects suggest that HIV treatment could be administered perhaps once or twice per year.

Howard Gendelman, M.D., professor and chair of the UNMC Department of Pharmacology and Experimental Neuroscience, designed the investigational drug delivery system, a so-called “nanoformulated” protease inhibitor.

The process

The nanoformulation process takes a drug and makes it into a crystal, like an ice cube does to water. Next, the crystal drug is placed into a fat and protein coat, similar to what is done in making a coated ice cream bar. The coating protects the drug from being degraded by the liver and removed by the kidney.

When tested together with URMC-099, a new drug discovered in the laboratory of UR scientist Harris (“Handy”) Gelbard, M.D., Ph.D., the nanoformulated protease inhibitor completely eliminated measurable quantities of HIV. URMC-099 boosted the concentration of the nanoformulated drug in immune cells and slowed the rate at which it was eliminated, thereby prolonging its therapeutic effect.

“The chemical marriage between URMC-099 and antiretroviral drug nanoformulations could increase drug longevity, improve patient compliance, and reduce general toxicities,” said Dr. Gendelman, lead study author, who has collaborated with Dr. Gelbard for 24 years. “We are excited about pursing this research for the treatment and eradication of HIV infections.”

The two therapies were tested together in laboratory experiments using human immune cells and in mice that were engineered to have a human immune system. Drs. Gendelman and Gelbard believe that the nanoformulation technology helps keep the protease inhibitor in white blood cells longer and that URMC-099 extends its lifespan even more.

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Harris Gelbard, M.D., Ph.D.

Dr. Gelbard, director of UR’s Center for Neural Development and Disease, developed URMC-099 to treat HIV-associated neurocognitive disorders or HAND, the memory loss and overall mental fog that affects half of all patients living with HIV.

He tested it with several protease inhibitors, including the nanoformulated version developed by Dr. Gendelman, as any patient prescribed URMC-099 would also be taking antiretroviral therapy. The goal was to determine whether the drugs could be safely administered together. Much to the surprise of Drs. Gelbard and Gendelman, URMC-099 increased the effectiveness of the nanoformulated drug.

“Our ultimate hope is that we’re able to create a therapy that could be given much less frequently than the daily therapy that is required today,” Dr. Gelbard said.

From refugee to M.D.: Dr. Nguyen and his family come to America

Posted by Kalani Simpson
immigrant-stories-013z-1024x707During UNMC International Week, Dr. Nguyen told the story of his family’s immigration to the U.S.
Dr. Quan Dong Nguyen’s first step toward becoming an American began when his father went in to report to the new communist government and disappeared for the next 42 months.

During the early 1970s, despite the Vietnam War, Dr. Nguyen’s family lived a relatively normal life in South Vietnam. But after the fall of Saigon on April 30, 1975, when Dr. Nguyen was 8 years old, things changed. The North Vietnamese communist army invited those who were working with the government of the Republic of South Vietnam, like Dr. Nguyen’s father, a physician, and his uncle, who was a provincial chief of police, to come and “meet the new government to learn about the new policies.”

They didn’t see his father again for three and a half years.

When the family finally reunited, they decided they needed to escape. They were among the millions who fled Vietnam during the decade following the fall of South Vietnam.

Dr. Nguyen, professor and McGaw Memorial Endowed Chair in Ophthalmology, and inaugural director of the Stanley M. Truhlsen Eye Institute, told his story as part of UNMC’s International Week.

To make their escape, the Nguyen family – Dr. Nguyen, his parents and his three brothers – piled into a fishing boat, filled mostly with the elder Dr. Nguyen’s patients, many of whom were Chinese. The Nguyens attempted to pass themselves off as Chinese, too.

They picked the stormiest time of year to make the journey. A time when even the murderous pirates they were hoping to avoid would rather stay on dry land. Only about two of every 10 boats making these types of escapes made it, Dr. Nguyen said.

“The ocean,” he said, “usually wins.”

He was seasick, and afraid. That first night, two of the boat’s four engines broke down. The next night, another engine, gone. They were all but drifting on the open sea.

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Dr. Nguyen’s father, Dong So Nguyen, at Pulau Bidong, a refugee camp in Malaysia, in 1979. The elder Dr. Nguyen was president of the camp, his son said. He later resumed his medical practice in Virginia.
People died on that boat. Dr. Nguyen was just a kid: “You just have to let it go in your mind,” he said. The bodies were released into the ocean so that the journey could continue.

At last, they saw land – an island in Malaysia. He can still remember the relief.

It was an uninhabited island. They didn’t know what would happen next. All they knew was, where they were now was better than where they had just been.

After three days, Malaysian police found them. They went to another Malaysian island, Pulau Bidong, which has been set up as a refugee camp, to live among thousands and thousands of fellow Vietnamese refugees. “The life was rough,” Dr. Nguyen said. “But for the first time, people felt like they had freedom again.”

At the refugee camp, emissaries from other countries came to see if they could take in some of the refugees. Germany, Dr. Nguyen said, would take engineers. Australia wanted farmers. Denmark welcomed orphans and kids who had left family behind.

Dr. Nguyen’s parents spoke French. Their educations were French. France would surely take them.

But, no. They wanted to go to the place which would be least likely, in all the world, to turn Communist.

“We didn’t want to escape a second time,” Dr. Nguyen said.

They applied to come to America.

When young Dr. Nguyen settled in the U.S., in northern Virginia, in 1980, he was going into the eighth grade. Though his father was a physician and his mother was an attorney, they were starting over, from scratch, with nothing. They were on food stamps and welfare for the first year, and that was difficult – but they were grateful for the kindness that they received.

“You always remember,” he said, “the first (secondhand) table that people gave to you.”

At school … how to put this politely? “Young teenagers are very nice,” Dr. Nguyen said, “but they also can be quite unfriendly.”

Looking back, the adult Dr. Nguyen forgives those kids. They were just young children, and their new classmate may as well have been from outer space.

But at the time, he thought to himself: how could he be on even ground with them? How could he be the kid in class who wasn’t behind everyone else? In learning a foreign language! And in that, he excelled.

(To this day, if he lectures in South America, for example, he’ll do some of it in Spanish as a sign of cultural respect.)

He went to Phillips Exeter Academy, Yale, Penn, Harvard and Johns Hopkins. He became a doctor.

Now he lives in Omaha, Neb.

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Nguyen and Do in front of the Truhlsen Eye Institute at UNMC.
He married another Vietnamese American, Dr. Diana Do, the daughter of his father’s medical school classmate. Dr. Do is also a professor of ophthalmology and visual sciences at the Truhlsen Eye Institute. Their three children are Vietnamese Americans. Dr. Nguyen and Dr. Do are teaching their children both Vietnamese and American cultures.

He will tell anyone who will listen that despite “many different things in this country that, yes, can make one feel angry,” we should also know this is the greatest country on earth, with many generous, philanthropic citizens and numerous opportunities.

So, after all of these years, does he consider himself truly, fully American?

Well, maybe not quite 100 percent: “I still do not understand all of the jokes yet,” he said (showing that of course he does).

But as a member of the audience said emphatically, “No, Dr. Nguyen, you are an American.”

Most of us are Americans through sheer luck, an accident of birth.

Dr. Nguyen earned his (red and white) stripes the hard way.

Langnas family also shared stories

Frieda Langnas, mother of Alan Langnas, D.O., professor and chief of transplantation, and Dr. Langnas’ sister, Susan Feber, also spoke via teleconference at the presentation. They told the story of how Frieda and her husband separately, as children, emigrated to the U.S. as their families were refugees who escaped the Nazis before and during World War II.

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