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Archive for November, 2017

Nebraska Medical Center Verified as State’s Only Level I Trauma Center

Trauma Shoot 1When Nebraska Medicine leadership announced a change to Omaha’s trauma system in August 2014, the announcement was made with an eye on the future. The goal: to expand its trauma services, provide 24/7/365 care and become a nationally recognized, Level I Trauma Center. Today, that goal has officially been met, with the American College of Surgeons (ACS) verifying Nebraska Medical Center as a Level I Trauma Center, recognizing the trauma center’s dedication to providing optimal care for injured patients.

Previously, only a state-designated Comprehensive Trauma Center, achieving the ACS verification means Nebraska Medical Center not only provides the hospital resources necessary for trauma care, but also the entire spectrum of care to address the needs of all injured patients. Nebraska Medical Center is now the only ACS-verified Level I Trauma Center in the state, with the nearest other facilities being in Des Moines, Iowa, Kansas City, Missouri and Denver, Colorado.

“This was all done with the citizens of our region in mind,” says P.J. Schenarts, MD, trauma medical director. “We set out three years ago to raise the bar for trauma care in our community by expanding our resources and infrastructure to align our services with a national standard. This achievement means we have the capacity and capability to treat any patient’s injury, no matter their age, at any time of the day or night.”

There are five separate levels of verification in the ACS program, each with its own set of thorough criteria that must be met to achieve ACS verification. A team of experienced reviewers also conducts an on-site review and evaluates the criteria against the hospital’s actual performance.

“Meeting the rigorous criteria for Level I ACS trauma verification speaks to the commitment and quality of our trauma program,” says Karen Saxton, MSN, RN, trauma program director.

“We often don’t think of it this way, but trauma is an epidemic,” says Dr. Schenarts. “It affects everyone and it’s the leading killer of Nebraskans under the age of 44 and the third leading cause of death in our older citizens. But research shows that treatment at a Level I Trauma Center reduces the risk of death by 25 percent.”

ACS verification means the medical center provides the full breadth of trauma services to the community via 10 dual-board certified trauma surgeons, all who live in the Omaha community.

Nebraska Medical Center currently employs more than 50 subspecialty physicians who are experts in trauma surgery, neurosurgery, reconstructive surgery, thoracic surgery, vascular surgery, orthopedics, oral maxillofacial surgery, urology, hyperbaric oxygen therapy, otolaryngology (ear, nose and throat) and ophthalmology. The hospital also has a dozen physicians certified in pediatric critical care and pediatric surgery.

“This is more than a plaque you hang on your wall,” says CEO Dan DeBehnke, MD, MBA. “This marks years of hard work on behalf of our trauma team to provide the highest level of trauma care possible. We sincerely hope you never need us, but people who live in Omaha and the surrounding communities should feel comfortable in knowing we’re here to help you and your family during life’s most traumatic moments.”

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

Lab Sleuths Solve Mystery for World’s Benefit

Lab Identifies New Species Kathy Talmon working in lab

A new discovery made by Nebraska Medicine and UNMC researchers has been named after retired colleague, Kathy Talmon, who was a lead technologist in the tuberculosis lab when she retired in 2014.

Team Discovers a New Bacterium Species

Laboratory sleuths at Nebraska Medicine and UNMC have discovered and named a disease-causing bacterium that was previously unidentified.

Discovering, naming and publishing a new organism is a big deal in the world of microbiology. Characterization of a new species helps health professionals around the world identify and appropriately treat infected patients. The new species was recognized as causing respiratory infections in patients with suppressed immune systems.

Lab Indentifies New Species - Mycobacterium talmoniae

A vile of Mycobacterium talmoniae

The organism, Mycobacterium talmoniae, is named to honor Kathy Talmon, a laboratory technologist who worked for the state public health laboratory in Lincoln before the lab’s move to the Nebraska Medical Center campus. She was a lead technologist in the tuberculosis lab at Nebraska Medicine when she retired in 2014.

“Kathy’s expertise was in tuberculosis detection,” says Peter Iwen, PhD, director of the Nebraska Public Health Laboratory at UNMC. “She also helped in the identification of other Mycobacterium species which led to the discovery of this new species. The honor of naming this organism for her highlights her contributions to the public health and TB laboratories.

“It was quite a surprise,” says Talmon. “I was astonished and really couldn’t believe it at first. It’s a great honor. In microbiology most names come from famous researchers.”

The case started when the new organism, detected from a patient with respiratory symptoms, did not identify with the usual tests used. Comparison using new tests led to the discovery of a new species. Additional comparisons also showed the organism to be identical to an unnamed organism reported in 2000 by an out-of-state lab.

In 2012, Dr. Iwen initiated the complicated process of validating a new species with colleagues at National Jewish Health in Denver, Colorado and Colorado State University in Fort Collins, Colorado.

“We worked hard to process through the tedious steps for species validation,” he says. “As a final step, the organism was recently published in the International Journal of Systematic and Evolutionary Microbiology. The newly discovered strain of mycobacterium is now part of roughly 170 officially recognized species within the mycobacterium genus.”

He says as a part of the validation process, the organism was “deposited” or registered in two culture collections, one located in Germany at one of the largest biological resource centers in the world, and the other in the U.S. at the American Type Culture Collection.

“Our new species, Mycobacterium talmoniae, adds to the literature of nontuberculous Mycobacterium and complements previous studies that led to the naming of another new species in 2004, Mycobacterium nebraskense,” he says.

Alison Freifeld, MD, and Sara Buss, MD also participated in the project.

Nebraska Medicine Now a Comprehensive Stroke Center

 

William Thorell, MD, endovascular neurosurgeon
William Thorell, MD, endovascular neurosurgeon

Nebraska Medicine was recently certified as a Comprehensive Stroke Center by Joint Commission, in collaboration with the American Heart Association/American Stroke Association’s Brain Attack Coalition — the highest level of stroke certification available.

This advanced designation by the nation’s largest independent health care evaluation body means that Nebraska Medicine is equipped to handle the most complex stroke cases. Nebraska Medicine is the only medical center in the region to receive this certification.

“This establishes by a respected third-party reviewer that we are the place to be for stroke care,” says William Thorell, MD, endovascular neurosurgeon at Nebraska Medicine. “Nebraska Medicine meets the standards that no other institution does in this region for the treatment of all types of stroke patients.”

Nebraska Medicine has the only stroke team in the area capable of providing specialized around-the-clock treatment, 24 hours a day, seven days a week. We are also the only hospital in the region with three fellowship-trained endovascular neurosurgeons trained to surgically treat hemorrhagic strokes and ischemic strokes that affect blood vessels in the brain using innovative, less invasive techniques. Andrew Gard, MD, and Daniel Surdell, MD, are also fellowship-trained endovascular neurosurgeons trained to surgically treat hemorrhagic strokes and ischemic strokes.

Need an Expert Opinion?
To schedule an appointment with one of our neurologists or neurosurgeons, please call us at +1 (402) 559-3090.

“Endovascular and cerebrovascular neurosurgery are highly specialized fields that allow us to provide options for complex stroke patients that otherwise would not be available in the region,” says Dr. Thorell. “When it comes to treating stroke, immediacy and experience is crucial. These are cases in which every second counts in delivering the most appropriate and expert care.”

The management of medical stroke is also key to improving patient outcomes in stroke.  Nebraska Medicine has the largest fellowship-trained vascular neurology group in the region. Pierre Fayad, MD, Marco Gonzales-Castellon, MD, Michael Pichler, MD, along with neurointensivist Daryl Gress, MD, and neurohospitalist Scott Diesing, MD, work alongside the endovascular neurosurgeons to ensure that best practice stroke care is provided throughout the patient’s hospitalization.  In addition to the expertise of providers during the acute hospitalization, Nebraska Medicine’s stroke program also includes a specialized outpatient stroke clinic dedicated to furthering stroke recovery and secondary stroke prevention with access to sub-specialists in rehabilitation, movement, memory and neuropsychology.

The dedicated personnel of the Nebraska Medicine stroke team also includes a specialized Neurosciences Intensive Care Unit and a state-of-the-art stroke unit with highly trained staff specializing in stroke care. “The Comprehensive Stroke Center certification represents the integration of specialists and staff across multiple areas of expertise that distinguish Nebraska Medicine as the destination for stroke care,” says Daryl Gress, MD, neurointensivist at Nebraska Medicine.  “To truly be a comprehensive center it is not about any one component of care, it is about a team of individuals that are diligently focused on improving patient outcomes.”

The requirements to be a Comprehensive Stroke Center must include:

  • Having a dedicated neurosciences intensive care unit beds for complex stroke patients that provide neuro-critical care 24  hours a day, seven days a week
  • Use of advanced imaging capabilities
  • Annually provide care to 20 or more patients with a diagnosis of subarachnoid hemorrhage; perform 15 or more endovascular coiling or surgical clipping procedures for aneurysm; and administer IV tPA to an average of 15 or more eligible patients
  • Use of a peer-review process to evaluate and monitor the care provided to patients with ischemic stroke and subarachnoid hemorrhage
  • Participating in stroke research

It has been established that those patients who are treated within a few hours of an acute stroke using specialized treatments and medications at the hands of a dedicated and coordinated team experience the most positive outcomes.

“Our skilled and comprehensive stroke team will ensure patients receive the most advanced and comprehensive stroke care from the moment of arrival through recovery,” says Dr. Thorell.

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

Adult congenital heart disease program accredited

 

Image with caption: Shane Tsai, M.D.

Shane Tsai, M.D.

In recognition of its expertise in serving adults with congenital heart disease (CHD), Nebraska Medicine and Children’s Hospital & Medical Center’s joint Adult Congenital Heart Disease (ACHD) program has received accreditation from the Adult Congenital Heart Association (ACHA), a nationwide organization focused on connecting patients, family members and health care providers to form a community of support and network of experts with knowledge of CHD.Individuals with CHD, the most common birth defect diagnosed in one in 100 births, are living longer. There are now 1.4 million adults in the U.S. living with one of the many different types of congenital heart defects that range from simple to complex. The Nebraska Medicine/Children’s program annually treats around 1,500 ACHD patients from across the region at both institutions.

“Already home to Nebraska’s only board certified experts in ACHD, the program is now one of the country’s first to be nationally accredited in comprehensive care,” said program co-director Shane Tsai, M.D., cardiologist and congenital heart disease specialist. “This distinction reflects our ability to provide extraordinary multidisciplinary services, and patients can feel confident that they are receiving the highest quality of care in the region.”

The joint program received accreditation by meeting ACHA’s criteria, which includes medical services and personnel requirements, and going through a rigorous accreditation process, both of which were developed over a number of years through a collaboration with doctors, physician assistants, nurse practitioners, nurses and ACHD patients.

“This accreditation recognizes not only that we provide exceptional cardiac care, but also comprehensive expertise and support for ACHD patients at every stage,” said Jon Cramer, M.D., pediatric and adult congenital cardiologist and program co-director. “We offer support for a teen’s transition to adult care, a pregnant patient in need of increased monitoring, unique OB/GYN care, specialized anesthesia services and all aspects of cardiac treatment and intervention. The ACHA acknowledges that this breadth of services leads to better patient outcomes and experiences.”

“There are now more adults than children in the U.S. with CHD,” said Mark Roeder, president and CEO of ACHA. “Accreditation will elevate the standard of care and have a positive impact on the futures of those living with this disease. Coordination of care is key, and this accreditation program will make care more streamlined for ACHD patients, improving their quality of life.”

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

Promising New Cancer Treatment Offered at Nebraska Medicine is Approved by the FDA

Amy%20and%20Dr.%20Vose.jpg
Dr. Julie Vose visits with Amy Cheese during a clinic appointment at Nebraska Medicine in early 2017. When Amy first arrived, she had a tumor inside her chest the size of a grapefruit. Today, Amy is in remission and back to teaching.  

It’s the fifth most common type of cancer in U.S. adults. For years, traditional therapies to treat non-Hodgkin lymphoma (NHL) have included chemotherapy, radiation and a stem cell transplant. But after several years of clinical trials, a promising new option has been approved by the U.S. Food and Drug Administration and will soon be commercially offered at Nebraska Medicine.

“This clinical trial has been unbelievably successful in patient populations where they have failed every other type of treatment, so this is a big home run,” says Julie Vose, MD, hematologist and medical oncologist.

On Oct. 18, the FDA approved Yescarta, a cell-based gene therapy, used to treat adults with certain types of relapsed B-cell lymphomas. Chimeric Antigen Receptor (CAR T-cell therapy) is a way of taking the patient’s own immune system and modifying it to attack the cancer.

To schedule an appointment with a lymphoma specialist at Nebraska Medicine, call 402.559.5600.

“T cells are white blood cells that help our bodies fight infection and cancer,” explains Dr. Vose. “In lymphoma patients, these cells have gone haywire. They don’t fight the cancer properly. This clinical trial has allowed us to take the patient’s own T cells outside the body and restimulate them to be able to fight their own lymphoma.”

Amy Cheese of Fort Collins, Colorado, was out of options before coming to Nebraska Medicine for the clinical trial. The kindergarten teacher had a grapefruit-sized tumor in her chest when she first met Dr. Vose. After receiving CAR T-cell therapy, Cheese is now in remission and back to teaching.

“I can’t stop smiling,” she said. “I am so thankful that I was able to participate in this clinical trial. I think of the people who will not have to hear the words, ‘There is nothing else we can do.’ I am just so thankful.”

Nebraska Medicine was one of the first hospitals in the Midwest to open the clinical trial, and attracted patients from all over the region. Other health care systems include Memorial Sloan Kettering Cancer Center in New York, University of Washington Medical Center in Seattle, and the Hospital of the University of Pennsylvania in Philadelphia.

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Chimeric Antigen Receptor (CAR T-cell therapy) is a way of taking the patient’s own immune system and modifying it to attack the cancer.

“The places that participated in the clinical trials will be the first places to have it commercially available,” says Dr. Vose. “Eventually, it will spread out to other medical centers,” says Dr. Vose. “Because it’s so specific on how it needs to be given, large transplant centers will be the places that can do this.”

Dr. Vose expects the therapy to be commercially available within three to six months. Until then, Nebraska Medicine still has a few clinical trial spots open.

“Clinical trials are very important, especially when it comes to cancer,” explains Dr. Vose. “That’s the way we discover new treatments. Everything we have today is because of patients who participated in clinical trials in the past. Without patients on clinical trials, we wouldn’t have any cancer treatments today or tomorrow.”.

 

To schedule an appointment with a lymphoma specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

 

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