Archive for the ‘Patients’ Category

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.

You Can Take Steps to Stop Congestive Heart Failure

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Hareeprasd Vongooru

Most of us are guilty of it. We’re not feeling well, but we can’t put our finger on it, so we put off going to the doctor. But when it comes to congestive heart failure, seeking treatment early on can have a big impact. Early and appropriate treatment may be able to stop the progression of congestive heart failure and improve your quality and length of life.

The key to managing congestive heart failure is intervening before you have reached progressive stages and require advanced therapies. Too often, we are finding patients are not receiving optimal medical therapy for heart failure beyond diuretics. Today, we have advanced diagnostic equipment that allows us to more effectively diagnose and monitor you so we can treat the underlying problem or administer advanced medications that allow us to manage your condition more effectively to prevent the need for a heart transplant or  left ventricular assist device (LVAD).

Dr. Vongooru is one of four board certified heart failure specialists at Nebraska Medicine. Brian Lowes, MD, Eugenia Raichlin, MD, and Ronal Zolty, MD, PhD, are the other heart failure certified specialists at Nebraska Medicine.

When should you see a heart failure specialist?

Dr. Vongooru recommends that you be referred to a heart failure specialist when you meet one or more of the following criteria:
•You have been classified with Class 3 or 4 heart failure and have limited exertional capacity.
•You have required two or more hospitalizations for your condition in the last six months.
•You require high doses of diuretics or have difficulty tolerating optimization of heart failure targeted medical therapy.
•You are have low blood pressure.
•You are having liver or kidney complications.

One of the largest areas of growth for the heart failure program has been the use of the LVAD. Traditionally, heart transplantation has been the gold standard of care for treating severe, end-stage heart failure. However, when transplantation is not a viable option due to advanced age, other concurrent medical conditions, or the increasing shortage of hearts suitable for transplantation, the LVAD has become a long-term option for many people with end-stage heart failure.

In a small, but growing number of people, use of the LVAD device has allowed them to recover from end-stage heart failure and forgo the need for a heart transplant.

The bottom line, no person is too sick or too healthy to be seen by our advanced heart failure cardiology team. There is a growing number of therapies available to help you no matter what stage of congestive heart failure you are in. We may be able to either slow the progression of the disease by optimizing the your medications or provide other interventions to extend your life.

Nebraska Medicine has the largest heart failure program in the state and the only United Network for Organ Sharing (UNOS) certified heart transplant center. Nebraska Medicine has also received certification for advanced heart failure and LVAD and is one of the top 10 programs in the country. The program performed 38 heart transplants in 2014 and 61 LVADs.

 

The Truth About Lung Cancer

Alissa_Marr

 

Alissa Marr, MD

There are many myths surrounding lung cancer, one of the deadliest of all cancers. While the death rate still remains very high for lung cancer, we are making tremendous strides in diagnosing and understanding the underlying genetic changes in the different types of lung cancer that are helping us provide new therapies that we hope will ultimately improve survival rates. Oncologist and lung cancer specialist Alissa Marr, MD, sheds some light on lung cancer.

Lung cancer is the number one cause of cancer-related deaths in both men and women.

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Each year in the United States, more people die from lung cancer than from colon, breast and prostate cancers combined. Of the approximately 228,000 cases that are diagnosed each year, almost 70 percent result in death.

You will know when you have lung cancer.
False

A lack of symptoms often allows lung cancer to go undetected until it reaches advanced stages. Symptoms such as chronic cough, coughing up blood, shortness of breath, chest pain and unexplained weight loss -may be some of the symptoms that result from lung cancer.

Anyone can get lung cancer.
True
While smokers have a 10 to 30-fold increased risk of developing lung cancer, 15 percent or more of cases occur in people who have never smoked. Approximately 23,000 deaths occur annually among non-smokers in the U.S. Smoking cigars and pipes and exposure to second-hand smoke also increase one’s risk. Other non-smoking causes include radon and possibly exposure to diesel fumes, lead, arsenic, grain dust, farming chemicals or home cleaning products.

You may have radon in your home and not know it.
True
Radon is a colorless, odorless gas that’s a decay product found in soil and rocks and can get trapped in houses and buildings. It is estimated that one in 15 homes in the U.S. will have high radon levels. In Nebraska, that number is even higher. Approximately one out of every two radon tests conducted in the state have elevated levels of radon. You can get your house tested for radon with an in-home kit or by a certified service provider.  Winter is a good time to do testing as you get the best results when a closed home is maintained for 12 hours prior to and during the test.

Once you have been a smoker, you cannot reduce your risk for lung cancer.
False
It is never too late to quit. Smokers can gain an estimated six to 10 years of life by quitting smoking and will see a reduction in cancer risk within five years of kicking the habit and an estimated 80 to 90 percent risk reduction in 15 years.

There is no way to screen for lung cancer.
False
A low-dose CAT scan is offered at Nebraska Medicine. Screening CT scans can hopefully detect lung cancer at an early stage, when cure rates are much higher. The screening test is recommended for high-risk groups that includes individuals who are at least 55 years old; have a 30-pack history (equivalent to smoking one pack each day for 30 years or three packs each day for 10 years) and are either currently smoking or have quit within the past 15 years. Please discuss with your primary medical provider if you think you may qualify for this screening test.

Clinical trials may be the best treatment option.
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Clinical trials are carefully monitored research studies that may give you access to potentially life-saving treatment. Nebraska Medicine participates in many clinical trials for lung cancer. Talk with your doctor about whether a clinical trial is the right treatment decision for you.

To learn more or to schedule an appointment with a physician, call (800) 922-0000.

Stroke Center Receives Fifth Consecutive Recertification

For the fifth consecutive time, Nebraska Medicine’s Stroke Center has been recertified by the Joint Commission as a Primary Stroke Center. The program has been certified by the Joint Commission since 2005 and was the first nationally certified stroke center in the state.

“This certification signifies that the services we provide have the critical elements to achieve long-term success in improving outcomes,” says Matt Pospisil, executive director of Neurology and Orthopaedic Services. “Nebraska Medicine’s Stroke Center has more neurovascular provider expertise than any other health system in the region including two vascular neurologists, a neuro hospitalist, stroke APRN, a neuro intensivist and is the only facility in the area with two fellowship-trained endovascular specialists.”

Nebraska Medicine Named Best in State

U.S. News & World Report Releases 2015-16 Best Hospitals

It’s happened again. U.S. News & World Report has named Nebraska Medicine – Nebraska Medical Center the state’s top hospital. The annual U.S. News Best Hospitals rankings, now in their 26th year, recognize hospitals that excel in treating the most challenging patients.

In rankings by state and metro area, U.S. News recognized hospitals that perform nearly at the level of their nationally-ranked peers in one or more specialties, as well as hospitals that excel in multiple common procedures and conditions.

Nebraska Medicine’s Nephrology and Urology programs ranked 43rd and 44th respectively.

“It’s very rewarding for everyone at Nebraska Medicine to receive this kind of recognition,” says Lisa Runco, executive director of Cardiology and Digestive Disease and Kidney. “It really speaks to the quality of care provided across our entire system.”

U.S. News publishes Best Hospitals to help guide patients who need a high level of care because they may face a particularly difficult surgery, a challenging condition or extra risk because of age or multiple health problems. Objective measures such as patient survival and safety data, adequacy of nurse staffing and other data largely determined the rankings in most specialties.

The specialty rankings and data were produced for U.S. News by RTI International, a leading research organization based in Research Triangle Park, N.C. U.S. News used the same data, as well as the new Best Hospitals for Common Care ratings, first published in May, to produce the state and metro rankings.

The rankings are available at http://health.usnews.com/best-hospitals and will appear in the U.S. News “Best Hospitals 2016” guidebook, available in August from the U.S. News Store.

Nebraska Medicine Earns National Pancreas Foundation Center Designation, 1 of 30 Centers in the U.S.

Only Hospital in Nebraska to Receive the Distinguished Honor

Nebraska Medicine has been nationally recognized as a National Pancreas Foundation Center (NPF) by the National Pancreas Foundation, a nonprofit organization that provides support, research and education for those suffering from pancreatitis and pancreatic cancer. Nebraska Medicine is the only hospital in Nebraska to receive this prominent designation, joining 29 other institutions across the United States.

“Our team is thrilled to be named the only NPF Center in the state of Nebraska,” says Nebraska Medicine pancreatic surgeon Luciano Vargas, MD. “Our pancreas program provides multidisciplinary, patient centered care for patients with different pancreatic disorders. The program has been made possible by a strong commitment and support from Dr. Alan Langnas and the leadership at Nebraska Medicine.”

NPF_LogoNPF Centers are awarded after a rigorous audit review to determine that an institution’s focus is on multidisciplinary treatment of pancreatitis, treating the “whole patient” with a focus on the best possible outcomes and an improved quality of life.

“We are very humbled and proud of this achievement,” says Rosanna Morris, Interim CEO at Nebraska Medicine. “Having the NPF Center designation will help distinguish us as an institution whose focus is on providing the best and most innovative care possible for those suffering from pancreatitis.”

“Once an institution receives this designation, our foundation can recommend with confidence that patients will receive quality care at these designated Centers,” says Matthew Alsante, Executive Director of the National Pancreas Foundation.

An approved NPF Center has to meet the criteria that were developed by a task force made up of invited subject matter experts and patient advocates. The criteria includes having the required expert physician specialties such as gastroenterologists, pancreas surgeons, and interventional radiologists, along with more patient focused programs such as a pain management service, psychosocial support and more.

“It’s an honor for me to work with such a wonderful team of physicians,” says Sarah Ferguson, nurse coordinator for the Pancreas and Biliary Disorders Clinic at Nebraska Medicine. “Their dedication, expertise and compassion towards helping patients with pancreatitis is truly deserving of this national recognition.”

For a full listing of the criteria, please visit www.pancreasfoundation.org.

30 Designated National Pancreas Foundation Centers
•Allegheny General Hospital, Allegheny Health Network
•Banner University Medical Center
•Baylor University Medical Center
•Beth Israel Deaconess Medical Center
•Boston Children’s Hospital – Harvard Medical School
•Brigham and Women’s Hospital
•Dartmouth-Hitchcock Medical Center
•Geisinger Medical Center
•Hackensack University Medical Center/John Theurer Cancer Center
•Johns Hopkins Medical Institutions
•Mayo Clinic Florida
•Mayo Clinic Rochester
•Medical University of South Carolina
•Medstar Georgetown University Hospital
•Nebraska Medicine
•New York Presbyterian Hospital/Columbia
•Pancreas Care Center, Cincinnati Children’s Hospital
•Providence Portland Cancer Center
•Saint Louis University/ SLU Care Center for Pancreatic and Biliary Diseases
•Stanford University
•The Ohio State University Wexner Medical Center
•UMass Memorial Medical Center
•University of Alabama at Birmingham
•University of Chicago
•University of Florida/UF Health
•University of Miami, Leonard M. Miller School of Medicine
•University of Michigan
•University of Minnesota
•University of Pittsburgh School of Medicine
•Virginia Mason Medical Center

The Programs That Make Us Great

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News and World Reports recently ranked Nebraska Medicine as one of the best hospitals in the country for its expertise in six adult specialties: cancer care, gastroenterology and GI surgery, nephrology, neurology and neurosurgery, pulmonology and urology. This is the best performance for the hospital in terms of national recognition in these rankings.

In a series of blog posts, the experts from each nationally-ranked department will highlight what makes Nebraska Medicine a leader in providing care to its patients.

For the third year, U.S. News & World Reports ranked The Nebraska Medical Center as a “Best Hospital for Pulmonary Care.”

In our pulmonary division, we’ve worked hard to meet our patients’ needs throughout the region—eastern Nebraska, western Iowa, South Dakota, and Kansas. We handle a great deal of general pulmonary care, like chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis, bronchitis, shortness of breath, and cough.

Our national reputation is based on several well-established programs that are vital to treating patients with the most complex pulmonary problems, including:

Joseph-Sisson-Pulmonary
Joe Sisson, MD

Pulmonary Hypertension Program

Our pulmonary hypertension clinic, under the leadership of Austin Thompson, MD, is known nationally. We diagnose and treat very sick patients who need specialty care for this condition. Pulmonary hypertension (PAH) is shortness of breath during routine activities—caused by increased pressure in arteries that carry blood from your heart to your lungs.

Many people in this region suffer from PAH, and we are the primary regional referral center for these patients. Our nurse case manager works very closely with Dr. Thompson to treat each PAH patient. Also, our PAH patients are often enrolled in clinical trials, which is very important since these trials offer novel treatments to our patients who have not responded to conventional medications.

Adult Cystic Fibrosis Center

Our adult cystic fibrosis (CF) program, led by Peter (Jim) Murphy, MD, is unique in this region, as we handle growing numbers of adult patients. CF patients are living much longer today, thanks to excellent patient care. Now they’re having children of their own—and we can and often treat the whole family. We are a certified Adult CF center and are recognized by the National Cystic Fibrosis Foundation as a high performing benchmark program. In fact, our team travels to other CF centers in the nation to help improve their patient outcomes—in lung health maintenance as well as nutrition.

Critical Care Medicine (CCM)

At The Nebraska Medical Center, our intensive care units (ICU) are staffed with critical care specialists called intensivists. Many of our patients aren’t familiar with that term. Essentially, it means we are specialists in treating critically ill patients in the intensive care unit. Our CCM teams manage life-and-death situations—including talking with anxious patients and their families.

Our Division’s critical care specialists, in partnership with intensivists from anesthesia, lead three CCM teams who work closely with heart surgeons, neuro surgeons, neurologists and other specialists to manage their critically ill patients while they require intensive care. The CCM teams guide the patient’s overall care including supporting lung function with ventilators, administering IV fluids & medications, providing nutrition and getting patients up and walking. This proactive and team-based approach to the care of critically ill patients helps prevent infections, blood clots, pneumonia and other complications. That is why our shared patients have very good outcomes—and a key part of why our hospital ranking is high.

But that’s not all…our allergy, sleep and pulmonary services are growing.

Allergy

Our well-established allergy program is growing. We have a nationally recognized allergy specialist, Jill Poole, MD, who is an expert at developing region-specific allergy testing and treatments for adults. We will expand our allergy program in the summer of 2015 when a second allergist joins Dr. Poole allowing us to reach more adult and pediatric patients with our allergy clinics.

Sleep

Our busy sleep laboratories and clinics will soon be more visible in the Omaha community, as we expand our sleep program. Our sleep patients typically suffer from complex problems, and that’s where our sleep medicine experts excel. With our certified sleep laboratory, continued program development, and collaboration with other specialties such as otolaryngology, we are investigating new and innovative solutions for these complex sleep disorders.

Lung Transplantation

We will add lung transplantation to our portfolio in early 2015. This is especially exciting because no other facility in our region can provide this option for their severely ill pulmonary patients. Lung transplantation will be an important new dimension for our other pulmonary programs and will round out the types of organ transplantations offered at The Nebraska Medical Center.

As you can see, our Pulmonary, Critical Care, Sleep and Allergy division is rising in the U.S. News & World Report “Best Hospitals” rankings for good reasons. We’re proud of the progress we’re making.

New Radiosurgery Technology Provides Improved Speed and Accuracy

Advancements in radiosurgery technology continue to improve the speed and accuracy in which radiation treatment can be delivered to treat challenging malignant cancer tumors. Nebraska Medicine recently became the first in the region to adopt the Varian TrueBeam STx radiosurgery system, which opens the door to new possibilities for the treatment of difficult to treat cancers like those in the brain, spine, lung, liver, pancreas and prostate.

Charles-Enke

“This technology is designed to do stereotactic radiosurgery and stereotactic body radiation therapy with greater speed and precision than possible with other systems,” says Charles Enke, MD, radiation oncologist at Nebraska Medicine. “This is two generations beyond our current Novalis stereotactic system with accuracy measured in increments of less than a millimeter. While most radiosurgery systems use up to two targeting systems, our institution has added a total of four additional targeting technologies to improve treatment accuracy.”

The TrueBeam STx can deliver treatments up to four times faster than other radiosurgery systems. Radiosurgery treatments that may typically take 30 to 60 minutes to administer, may now take just five to 20 minutes, depending on the type and location of the tumor being treated, notes Dr. Enke. This provides a more comfortable experience for the patient and less chance for tumor movement during the treatment. “Ongoing studies are showing that higher doses per treatment delivered over fewer treatments may be more effective,” says Dr. Enke, “especially in areas such as prostate and lung cancer.”

For tumors that are subject to movement such as in the lung, liver and prostate, the system offers a respiratory-gated treatment feature that allows the machine to deliver a continuous treatment of radiation while rotating around the patient and compensating for movement of the tumor while the dose is being delivered. The radiation beam is shaped and reshaped as it is continuously delivered from many different angles, improving accuracy and reducing treatment time. It also uses a more sophisticated method of calculating radiation dose which is much more accurate than current dose calculation algorithms. This is very important when treating sensitive areas such as in the head and lung.

“While we offer single fraction intraoperative breast radiation for appropriately-selected patients, this is an excellent option for women with left-sided breast cancers who are not eligible for intraoperative breast radiation,” advises Dr. Enke.

The system also provides other benefits to breast cancer patients. Not only can TrueBeam STx shorten the treatment course by half, but it also offers a dependent breast positioning technique that allows the patient to lay on her stomach rather than her back. This enables the system to deliver radiation while the breasts are falling away from the patient, which can help minimize radiation to healthy tissues and organs like the heart and lungs, says Dr. Enke.

“The TrueBeam STx represents a significant advancement in radiation technology this is specifically designed for to deliver radiation very quickly and in fewer treatments with greater precision than we have ever had at our disposal,” says Dr. Enke. “We believe this will result in better outcomes for our patients.”

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