Archive for the ‘Medical Professionals’ Category

UNMC leading national study to test drug to treat life-threatening illness

Stem cell transplants have saved countless lives of patients with blood cancers and other diseases. But, a side effect of the life-saving treatment also can rob patients of quality of life and in some cases, their life.

Vijaya Bhatt, M.B.B.S., University of Nebraska Medical Center assistant professor of internal medicine and oncology/hematology, has received a grant for up to $1.2 million to determine if a drug called ruxolitinib, is effective for treating a certain type of graft versus host disease (GVHD) called sclerotic. The grant is funded by Incyte, a global biopharmaceutical company.

UNMC and its clinical partner, Nebraska Medicine, are world-renowned for their expertise in transplantation and are only one of the few centers nationwide testing the drug for the purpose of treating GVHD.

The drug, which reduces inflammation, has proven effective for other uses, and shows promise as a treatment for patients who develop GVHD after receiving an allogeneic transplant. An allogeneic transplant uses a matching donor’s cancer-free stem cells, which are then infused into the cancer patient.

Sometimes donor cells attack the recipient’s healthy tissues and organs, which can impair function and is a significant cause of medical problems, including death.

Dr. Bhatt, principal investigator of the study, said GVHD is difficult to treat since first line treatments often fail.

Finding another treatment is important because of an estimated 40,000 patients undergo allogeneic stem cell transplants every year and about 30 to 50 percent of patients develop acute GVHD and about 30 to 70 percent develop chronic GVHD. The research team will focus on the chronic GVHD, which comes on slowly and continues sometimes for years.

Dr. Bhatt and co-principal investigator, Stephanie Lee, M.D., at Fred Hutchinson Cancer Research Center in Seattle, will recruit 47 study participants from five centers: UNMC, Fred Hutchinson, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Fla.; University of Pittsburgh Medical Center, Hillman Cancer Center, Pittsburgh Cancer Institute; and the Cleveland Clinic Cancer Center, Cleveland, Ohio.

The UNMC study site also will involve Ram Mahato, Ph.D., professor and chairperson in the UNMC College of Pharmacy Department of Pharmaceutical Science, and Lynette Smith, Ph.D., assistant professor in the UNMC College of Public Health Department of Biostatistics.

“When I joined UNMC three years ago, I felt the need to work on improving care of patients with GVHD,” Dr. Bhatt said. “Since then, we’ve established a multidisciplinary team in which we work with other providers who are instrumental in helping treat our patients.”

He said patients who’ve been treated with the drug have experienced good results so far. “It seems to be effective and doesn’t have as many side effects as some of the other medications,” he said.” Our hope is that it will improve how patients feel and improve the quality of their life.”

We are Nebraska Medicine and UNMC. Our mission is to lead the world in transforming lives to create a healthy future for all individuals and communities through premier educational programs, innovative research and extraordinary patient care.

Bariatrics Center Earns Reaccreditation

The Bariatrics Center at Nebraska Medicine was recently awarded the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Center of Excellence.

“The MBSAQIP designation is an important program certification, because it shows our commitment to the care of the bariatric patient,” says Corrigan McBride, MD, Bariatrics Center medical director.

MBSAQIP works to advance safe, high-quality care for bariatric surgical patients through the accreditation of bariatric surgical centers. A bariatric surgical center achieves accreditation following a rigorous review process during which it proves that it can maintain certain physical resources, human resources and standards of practice. The hospital is reviewed every three years to ensure it has all the equipment, personnel and resources to care for patients.

“As part of the review process, we track all our patients for their quality outcomes,” says Dr. McBride. “The process shows our dedication to continuously improving the care of our bariatric surgery patients.”

Double-Lung Transplant Patient Brings Organ Donation Message to Corporate Cup

On a brisk Sunday morning in September, Eric Horpedahl woke early to do something he once thought was impossible – go for a two-mile walk. The 32-year-old joined more than 5,000 walkers and runners in Omaha for the city’s annual Fight for Air Corporate Cup event. The race marked a yet another milestone for Eric who underwent a double-lung transplant at Nebraska Medicine only eight months earlier.

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Eric Horpedahl proudly displays his medal after finishing the Corporate Cup.

As a child, Eric was diagnosed with cystic fibrosis, an incurable disease that causes extensive lung and breathing problems. For most of his life, Eric was largely unaffected by his condition. But in July 2017, his health quickly began to decline. He found it difficult to walk even a few feet without struggling for air.

Eric traveled from his home in Sioux Falls, South Dakota, to Nebraska Medicine where he sought the help of Aleem Siddique, MBBS, and the lung transplant team. In January 2018, the team put Eric’s name on the transplant waiting list. A short three weeks later, a donor was found and Eric underwent surgery to receive two new lungs.

After being discharged from the hospital, Eric remained in Omaha to begin rehabilitation. He worked with physical therapists at Nebraska Medicine to rebuild his lung strength and improve his overall fitness. Once he was ready to go home, the physical therapists recommended that he continue an exercise program to keep his health in check.

And he listened. Eric joined a gym and began a new routine that now includes five workouts a week consisting of cardio and strength training. Eric says he wasn’t active before his lung transplant, but he has new motivation to go the gym.

Eric is also motivated to spread the word about organ donation. His participation in this year’s Corporate Cup wasn’t just about exercise. Although exercise is now key to his life, Eric’s walk was about the opportunity to raise awareness of organ donation. Organ donation is a cause that is near and dear to his heart – and lungs – and he hopes to use his story to inspire others to give.

New Heart Procedure Helps Mitral Regurgitation Patients

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For 78-year-old Viola Foley, nothing brings a bigger smile to her face than talking about family, country music or Nebraska Medicine.

“I tell everyone that the nicest doctors in the world work here,” she says. “They saved my life more than once.”

After raising nine children in Springfield, Neb., Foley underwent a liver transplant at Nebraska Medicine – Nebraska Medical Center and battled breast cancer twice.

“I was diagnosed with breast cancer six years before my liver transplant, then again four years later. It’s amazing how far I’ve come.”

Once Foley passed the 10-year mark for her transplant, she started having serious breathing problems. Walking across the living room was almost impossible. In September, she made an appointment with Nebraska Medicine cardiologist Thomas Porter, MD.

“Dr. Porter did an echocardiogram,” remembers Foley. “He discovered that my heart and liver were working against each other. One of my heart valves wasn’t opening and shutting the right way.”

In September, Foley was diagnosed with mitral regurgitation (MR), a condition that affects four million people in the United States. The heart’s mitral valve leaflets don’t close tightly, causing blood to flow backwards from the heart’s left ventricle into the left atrium. It makes the heart work harder at pushing blood through the body, leading to shortness of breath, fatigue and worsening heart failure. For many patients, open-heart mitral valve surgery is generally recommended, but for Foley, surgery wasn’t an option.

“She currently has a life threatening blood disorder that prohibits her from having any open surgical procedures,” says Michael Moulton, MD, chief of cardiothoracic surgery at Nebraska Medicine. “Her only shot was to have the MitraClip procedure, which was recently approved by the U.S. Food and Drug Administration.”

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The MitraClip procedure is a new option for patients diagnosed with MR, who have too high a risk for surgery. The procedure consists of implant catheters and the MitraClip device, which is a permanent implant that attaches to the mitral valve leaflets, reducing the leakiness of the valve.

On October 1, Foley became the first patient to undergo the procedure at Nebraska Medicine. With the help of a catheter, Nebraska Medicine chief of interventional cardiology, Gregory Pavlides, MD, inserted the MitraClip device through a blood vessel in Foley’s groin, guiding it to her heart. The surgical team could watch in real time on the echo machine if the mitral regurgitation was appropriately reduced. Once the MitraClip device was in place, the catheter was removed.

“This procedure requires a lot of skill from interventional cardiology, imaging cardiology and anesthesia,” explains Dr. Pavlides. “Not many places in the area have the infrastructure to offer the MitraClip procedure as well as we can; based on our experience with the mitral valve and our superb imaging and cath lab skills.”

Learn More About the Innovative MitraClip Procedure
Are you a candidate? Connect with a member of the heart care team regarding the MitraClip by calling 800.922.0000 or visiting our website.

Foley’s procedure took approximately one hour and 30 minutes. She spent a little over three days in the hospital before going home. Since then, she’s regained her strength, is able to walk up and down the stairs and feed her pets without feeling fatigued. She’s excited for the next chapter in her life, which includes watching her great-grandson attend the University of Nebraska Medical Center with the hopes of becoming a cardiologist.

“I am forever grateful,” says Foley. “I wouldn’t be here today if I didn’t have this option. I’m really proud to be the first patient at Nebraska Medicine to have the MitraClip procedure. Couldn’t have asked for a better crew or a better place.”

 

Extraordinary Care – Our Patients Agree

Nebraska Medical Center has earned a 2017/2018 Consumer Loyalty Award from Lincoln, Nebraska–based patient experience firm NRC Health.

The award recognizes hospitals across the country that garner extraordinary loyalty from their patients. This is the award’s inaugural year, which gives its winners a singular distinction. Nebraska Medical Center was No. 6 out of 100 award recipients that were selected based on results from NRC Health’s Market Insights survey, the largest database of health care consumer responses in the country.

“This type of recognition is especially meaningful because it comes from the patients we serve,” says Nebraska Medicine CEO Jim Linder, MD. “This is the kind of result that comes from dedicated physicians and staff working together for the benefit of their patients.”

NRC Health surveys more than 310,000 households in the contiguous U.S., measuring their engagement with health care brands in their communities. Organizations that win the Consumer Loyalty Award score exceedingly well on seven different measures of patient loyalty, including access, engagement, experience and net promoter score.

 

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

Orthopaedics study will impact artificial knee design

Hani Haider, Ph.D.

A study by a team of researchers in the UNMC Department of Orthopaedic Surgery has challenged a doctrine surrounding knee replacement design.With science and medicine helping people live longer, people now often outlast the life of their joint cartilage.

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Dr. Haider receives the Adult Reconstructive Knee Poster Prize at the American Academy of Orthopaedic Surgeons Annual Meeting in March.

“Technologists and surgeons have designed artificial knees which can alleviate pain and permit almost normal motion for daily living activities. In fact, good knee replacement designs can now last the lifetime of a patient,” said Hani Haider, Ph.D., professor and principal investigator of the study.

“In the evolution of knee replacements since the 1970s, designers focused on stress reduction in the bearings to reduce wear, which should be avoided for many reasons,” Dr. Haider said. “They did so by increasing contact area of the bearings to spread the load, which was vital for the older generation of bearing materials and early designs of the artificial joint.”

The team’s study — “For Lower Wear of Total Knee Replacements, Is Higher or Lower Contact Area Better?” — was awarded the best poster prize in the category of Adult Reconstructive Knee at the recent American Academy of Orthopaedic Surgeons Annual Meeting in New Orleans March 6-10. Ten first-place posters were awarded from 7,000 entries.

Using test data from UNMC’s Biomechanics and Advanced Surgical Technologies Laboratory, Dr. Haider and colleagues found that increasing contact area to reduce stress with contemporary joint materials is like a law of diminishing returns. When taken too far, larger total knee replacement sizes and contact area can actually increase wear with modern designs and materials. This was confirmed by eight separate studies in Nebraska contracted with UNMC by multiple companies from the orthopaedic industry.

“Working closely with multiple companies from industries worldwide makes our results meaningful, relevant and makes them translate to tangible benefits,” Dr. Haider said. “In this case, our results were described to shine a new beacon for artificial knee designers everywhere.”

Bone and joint health problems are the leading cause of disability in the U.S., accounting for more than half of all chronic conditions in people over the age of 50, according to the American Academy of Orthopaedic Surgeons. The organization projects that the demand for knee replacements will increase by 674 percent between the years 2012-2030.

“This is yet another tremendous achievement by our faculty, and we wish to thank all who have supported this research resulting in further international recognition,” said Kevin Garvin, M.D, professor and chair of the Department of Orthopaedic Surgery and Rehabilitation.

Robotic Thyroid Surgery Now Offered at Nebraska Medicine

 

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After being diagnosed with thyroid cancer, 24-year-old Katie O’Callaghan of Hastings, Nebraska, underwent a robotic thyroidectomy at Nebraska Medicine. The incision was made behind her earlobe. 

Katie O’Callaghan was working the checkout line at her parents’ grocery store in Hastings, Nebraska, when a customer noticed a lump on O’Callaghan’s neck. The 24 year old, who was four months pregnant with her first child, brought it up at her next OBGYN appointment. A biopsy later revealed she had thyroid cancer.

“I couldn’t believe it,” says O’Callaghan. “Being pregnant with my first child was intimidating enough, let alone discovering I had cancer.”

Wanting a second opinion, O’Callaghan was referred to Estelle Chang, MD, a former Otolaryngology Head and Neck surgeon at Nebraska Medicine, who completed a six-month Advanced Robotic Head and Neck Endocrine Surgery Fellowship at Severance Hospital of the Yonsei University Health System in Seoul, South Korea. During her fellowship, Dr. Chang studied the latest, minimally invasive, thyroid and parathyroid surgery techniques.

“Traditionally, thyroidectomy has been performed using a 4 to 8 cm incision in the front of the neck, which can leave a visible scar,” explains Dr. Chang. “Robotic thyroidectomy is a minimally invasive surgical technique that is used to remove all or part of a thyroid gland without leaving a visible scar. This is the future and we should be at the forefront.”

At Nebraska Medicine, three robotic thyroidectomy approaches are offered for patients:

  • Underarm

  • Facelift (behind the earlobe)

    • If the patient wants a complete facelift at the end of the procedure, that’s a possibility

  • Through the mouth

“We can tailor to the patient, depending on the size of the tumor and the patient’s physical characteristics,” explains Dr. Chang. “This type of surgery is a great option for Caucasians who tan easily, African Americans and Asians. They all tend to have a difficult time with scarring.”

 

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Estelle Chang, MD

Not wanting a scar on her neck, O’Callaghan opted for Dr. Chang to perform the facelift approach. For the safety of the baby, surgery was put on hold until after O’Callaghan gave birth to her son. On May 22, O’Callaghan became the first patient to undergo a robotic thyroidectomy at Nebraska Medicine. Dr. Chang made the incision behind O’Callaghan’s earlobe and surgery took approximately three hours. O’Callaghan was kept overnight for observation and released the next day.

“I knew I was in good hands at Nebraska Medicine,” says O’Callaghan. “Currently, I have no cancer in my body and I feel great. By looking at me, you’d never know I had thyroid surgery. I’m really happy with the outcome.”

Thyroid nodules are very common and occur in approximately 30 percent of all people in the United States. By the age of 60, more than half of women will have a thyroid nodule. The vast majority of the nodules are benign, with about 5-10 percent being cancerous. Symptoms of thyroid cancer can involve swollen lymph nodes in the neck, difficulty swallowing or breathing – but most patients don’t experience any symptoms.

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Abbey Fingeret, MD

“While thyroid cancer can be seen in people of any background, age or gender, most cases occur in women, people less than 55 years old, and those with Caucasian or Asian backgrounds,” says Nebraska Medicine surgical oncologist Abbey Fingeret, MD. “Fortunately, in most cases, it can be completely cured with surgery.”

Dr. Fingeret is currently the only Endocrine Surgery Fellowship trained surgeon in the state of Nebraska. She completed her fellowship at Harvard University and Massachusetts General Hospital, performing more than 500 thyroid operations. Dr. Fingeret also finished a three-month Advanced Robotic Endocrine Surgery Fellowship in South Korea. This summer, she looks to perform her first robotic thyroidectomy at Nebraska Medicine.

 

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Not wanting a scar on her neck, O’Callaghan opted for the facelift approach. “By looking at me, you’d never know I had thyroid surgery. I’m really happy with the outcome.”

“I truly believe in the mission of Nebraska Medicine,” says Dr. Fingeret. “We are here to offer state-of-the-art care, where the patient always comes first. It’s my honor and privilege to be part of this exceptional team of ancillary staff, clinicians and researchers.”

“Nebraska Medicine treats all aspects of thyroid ailments and endocrine-related disorders,” adds Harris Frankel, MD, chief medical officer at Nebraska Medicine. “We have a large and experienced multidisciplinary team, which includes physicians from ENT, Endocrinology, General Surgery and Cancer Services. When you walk in the door, you can be seen by an endocrinologist and thyroid surgeon on the same day.”

Nebraska Medicine is one of a few academic medical centers in the country offering robotic thyroidectomies. Patients with multiple medical problems who shouldn’t be under anesthesia for extended periods of time are not ideal candidates. Robotic surgery can also be used to remove other benign masses of the neck, such as lipomas and thyroglossal duct cysts.

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

Unique Treatment Crafted for Multiple Myeloma Patient

Muhamed Baljevic, MD, is seen with patient Vincenzo Neri. Dr. Baljevic and his team were able to respect his religious beliefs and perform a bloodless stem cell transplant.

For the first time at Nebraska Medicine, a bloodless stem cell transplant has been performed on a Jehovah’s Witness.

“I’m surprised, excited, relieved and thankful they respected my beliefs and I congratulate them for helping me through this difficult time.”

Vincenzo Neri was diagnosed with ultra-high risk multiple myeloma and needed an autologous stem cell transplant to survive. Autologous transplantation is a process where the patient’s own stem cells are collected and reinfused. During the transplant process, most patients depend on red blood cells and platelets to protect themselves against infection, bleeding and organ failure. Jehovah’s Witnesses don’t believe in accepting any blood products, so Neri’s case was more difficult in many ways.

“He can’t get any of the red blood cells or platelets – normally, every patient depends on these products during the transplant process because red blood cells can go very low and platelets can go very low,” says Muhamed Baljevic, MD, multiple myeloma specialist. “However, we cannot depend on these blood products in this patient’s case because he’s a Jehovah’s Witness and his religious beliefs don’t allow him to accept any blood products.”

Through sign language interpreters, Dr. Baljevic explained in detail how Neri’s transplantation would work.

“We modified almost every single step in the transplantation process for him and his needs,” says Dr. Baljevic. “We had these plans in place where we used particular medicines, to try to prevent him from bleeding, where we stimulated his own bone marrow with stimulating medicine and building blocks for red blood cells as much as we could – such that we avoided all together the need for any blood products.”

Neri’s recovery went extremely well and he was discharged one week earlier than expected. Only a few health systems across the country perform stem cell transplants on Jehovah’s Witnesses. Nebraska Medicine is now one of them.

“In looking back when I was first diagnosed with cancer, I went down quickly, but now I feel freedom – the sick body is gone – I feel healthy again, active to do anything – makes me feel built up and excited,” says Neri. “Everyone here respected my religion and I’m impressed that everyone was respectful of my faith.”

“We hope other patients, who share same believes, other Jehovah’s Witnesses, or patients who cannot get blood products, know that we are very committed to provide top quality care, multidisciplinary care and care that can meet the biggest challenges of modern medicine – and this is certainly one of them,” says Dr. Baljevic.

Watch more of this amazing story in this video below.

 

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

WATCHMAN Device Offers Breakthrough Treatment for Atrial Fibrillation Patients

After suffering five strokes in a matter of months, Tom Keeling and his wife Sandy began to wonder if life would ever be normal again.

The 65-year-old Keeling suffered from a type of irregular heartbeat called atrial fibrillation. Atrial fibrillation can lead to the formation of dangerous clots that increase your risk for stroke. Keeling’s condition was doubly serious because doctors were also having difficulty regulating his blood thinners, which are critical to helping reduce clot formation.

Keeling recently became one of the first handful of people at Nebraska Medical Center to receive an implant device called the WATCHMAN™, an alternative to long-term blood thinners for people with atrial fibrillation. Since having the device implanted several months ago, Keeling’s strokes have come to a screeching halt.

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Tom Keeling and his wife, Sandy, celebrate after a successful surgery reduced Tom’s stroke risk.

The Nebraska Medical Center is the first hospital in Omaha to offer patients the WATCHMAN implant. The device reduces the risk of stroke by closing off an area of the heart called the left atrial appendage. This helps keeps harmful blood clots from forming here, entering the bloodstream and potentially causing a stroke. Over time, patients should also be able to stop taking blood thinners.

“This new device provides doctors with a breakthrough stroke risk reduction option for patients,” said Andrew Goldsweig, MD, interventional cardiologist at Nebraska Medicine. “Blood thinners are one of the biggest challenges for managing people with atrial fibrillation. Although patients need blood thinners to help prevent clot formation, blood thinners can cause bleeding as well as other adverse reactions or interactions with other medications. Forty-five days after the WATCHMAN is implanted, patients should be able to stop taking blood thinners while receiving stroke protection from the device that is equivalent to a full-dose thinner.”

Atrial fibrillation is the most common type of arrhythmia. It increases with age and occurs in as many as one in 10 people over 80. As the disease progresses, it can significantly increase your risk for stroke and congestive heart failure. In fact, people with atrial fibrillation are five times more likely to have a stroke than the general population.

To implant the device, the doctor inserts a small needle in the upper leg, followed by a narrow tube, similar to a standard stent procedure. The doctor then guides the device into the left atrial appendage of the heart. Patients commonly stay in the hospital overnight and leave the next day.

Nebraska Medicine has a specialized clinic established to evaluate if WATCHMAN is the right course of treatment.

“This gives us another tool to elevate our already high level of cardiac care,” says Jessica Delaney, MD, Nebraska Medicine cardiac electrophysiologist.

“We are both looking forward to getting back to a life of normalcy again,” says Sandy. “We’re still young. I thought we still had a lot of time to do things in our lives.” Since Tom’s surgery, Sandy says planning a cruise is back on the bucket list. “We are so grateful for all of the care we’ve received at Nebraska Medicine. Everyone was so nice and put us at ease. The care was wonderful.”

This article was first featured in Advancing Health, a quarterly magazine from Nebraska Medicine with information about innovative treatment options, prevention tips and making better choices for a long healthy life. Sign up below to join our mailing list and receive the next edition of Advancing Health straight to your mailbox.

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

Dr. Zhen Named an American Society for Radiation Oncology Fellow

Weining “Ken” Zhen, MD

Weining “Ken” Zhen, MD, radiation oncologist at Nebraska Medicine and professor of radiation oncology at UNMC, has been named an American Society for Radiation Oncology Fellow.

The society is the world’s largest society for radiation oncology professionals. The ASTRO Fellows designation, or FASTRO, honors individuals who have significantly added to the field of radiation oncology in the areas of research, education, patient care or service and leadership.

Dr. Zhen will receive his FASTRO designation at an awards ceremony Oct. 23, during ASTRO’S 60th Annual Meeting in San Antonio, Texas.

“The honor really goes to all faculty of our department of radiation oncology and the excellent cancer program at UNMC and Nebraska Medicine,” says Dr. Zhen.

Charles Enke, MD, chair of the Department of Radiology, was complimentary of Dr. Zhen’s latest achievement.

“Dr. Zhen is an internationally recognized expert in head and neck oncology, although his clinical skills go well beyond a single disease site,” says Dr. Enke. “Ken has contributed significantly to the education of residents and practicing radiation oncologists, and he has worked with ASTRO and SANTRO (the Sino-American Network for Therapeutic Radiology and Oncology) to optimize the delivery of radiation therapy for patients in China. We are fortunate to have Ken at UNMC and Nebraska Medicine.”

Awarded annually since 2006, the ASTRO Fellows program recognizes individuals who have made significant contributions to radiation oncology through research, education, patient care and/or service to the field. Since its inception, the FASTRO designation has been awarded to just 327 of ASTRO’s more than 10,000 members worldwide; the 2018 class of Fellows comprises 35 individuals.

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

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