Grand Rounds November on Memphis Medical News

Grand Rounds November

Member of Watkins Uiberall, PLLC Receives Outstanding Alumnus Award from the University of Memphis Fogelman College of Business and Economics Alumni Chapter

Ben Watkins, CPA, CMPA, Member of Watkins Uiberall, PLLC Certified Public Accountants, was recently announced as the 2009 recipient of the Outstanding Alumnus Award by the University of Memphis Fogelman College of Business and Economics (FCBE) Alumni Chapter.

Watkins, a 1978 graduate of the FCBE, was chosen for the award in recognition of his contributions to the college and the local community. In particular, he is heavily involved in fundraising for the college, including selling tables to various luncheons and events and setting up teams for the FCBE Alumni Chapter’s golf tournament. In addition, Watkins serves on the University of Memphis School of Accountancy Advisory Board for Director Dr. Carolyn Callahan. The Outstanding Alumnus Award is the highest honor the FCBE and Alumni Chapter bestows on its alumni. Watkins will officially be presented the award at the Alumni Day awards luncheon, held on October 28, 2009 at the Holiday Inn, University of Memphis.

Watkins joined Watkins Uiberall in 1988. As the member-in-charge of the firm’s Healthcare Group and Plan Administration and Consulting (PAC), he oversees all of Watkins Uiberall’s healthcare and pension-related engagements. Watkins concentrates his practice on healthcare assurance and accounting services, and he works with both for-profit and not-for-profit organizations.

Beyond his involvement with the FCBE Alumni Chapter, Watkins is a member of numerous professional organizations, including the American Institute of Certified Public Accountants (AICPA), Tennessee Society of CPAs (TSCPA), BKR International Healthcare Consulting Committee, Healthcare Financial Management Association (HFMA), Mid-South Medical Group Management Association (MS-MGMA), Comprehensive Medical Practice Analysis, Tennessee Association of the Homes and Services for the Aging (TNAHSA), Tennessee Hospital Association (THA) and Affiliated Healthcare Advisors (AHA).

Medtronic Starts Study Of Interventional Erectile Dysfunction Therapy

MINNEAPOLIS — Medtronic, Inc. (NYSE: MDT), announced recently the initiation of a feasibility study of an interventional treatment for erectile dysfunction (ED) that uses a specially‐designed drug‐eluting stent system. The study, called ZEN (Zotarolimus‐Eluting Peripheral Stent System for the Treatment of Erectile Dysfunction in Males with Sub‐Optimal Response to PDE5 Inhibitors), is being performed under an investigational device exemption (IDE ) issued by the U.S. Food and Drug Administration and is expected to enroll a total of 50 subjects at up to ten medical centers in the United States over the next year.

The link between erectile dysfunction and coronary artery disease has been well established; based on the evidence, researchers are investigating the use of stents in pelvic arteries to determine whether it may provide a new treatment approach and enable better response to drug therapies.

Understanding that in a large number of cases ED is caused by vascular disease due to the deterioration of the endothelium, and that Medtronic’s drug‐eluting stent (DES) preserves endothelial function of the native vessels, Medtronic’s DES technology is uniquely suited to be studied for this condition.

Medtronic is collaborating with urologists and interventionalists at each of the participating sites to design and execute the study in subjects who have had suboptimal response to PDE5 inhibitors, which include Viagra(r), Cialis(r) and Levitra(r). The study will evaluate the safety and improved erectile function of pelvic artery stenting, with results expected in 2011.

Methodist’s Dr. Miller Outstanding Internist

Stephen T. Miller, MD, FACP, has received the American College of Physicians (ACP) Tennessee Chapter Laureate Award for his many years of outstanding service to Internal Medicine and to the ACP.

The Laureate Award honors those Fellows or Master of the College who have demonstrated by their example and conduct an abiding commitment to excellence in medical care, education or research and in service to their community, their chapter and the ACP.

Dr. Miller is senior vice president of medical education and research at Methodist Le Bonheur Healthcare and a professor of medicine at the University of Tennessee Health Science Center.

Collierville Orthopedics and Sports Medicine Welcomes Dr. Tim Micek

The physicians and staff of Collierville Orthopedics and Sports Medicine have announced the addition of Dr. Tim Micek to their medical staff.

Dr. Micek comes to Collierville from Richmond, KY, which is located near Lexington. He managed the largest orthopedic practice in that area, including four off-site clinics and coverage of four hospitals. He was assisted by a physician assistant and nurse practitioner. The practice also included a full-time physical therapy department.

While working in Kentucky, Dr. Micek served as the team physician for four local high schools as well as Georgetown College, whose football team holds three NAIA national championship titles. Known in the Lexington area as “the shoulder guy,” he was referred to for numerous second opinions for the treatment of shoulder injuries, and was also one of the few physicians in the state of Kentucky who performed minimally invasive knee replacements.

Two St. Jude Faculty Elected to Institute of Medicine

Michael Kastan, M.D., Ph.D., and Mary Relling, Pharm.D., of St. Jude Children’s Research Hospital, have been elected to the Institute of Medicine (IOM), a prestigious branch of the National Academy of Sciences.

Kastan, the hospital’s Cancer Center director, and Relling, chair of St. Jude Pharmaceutical Sciences, are among 65 new members of the IOM this year. The election of Kastan and Relling brings the number of IOM members from St. Jude to six. St. Jude has one of the highest numbers of IOM members among U.S. children’s hospitals.

Kastan’s research focuses on DNA damage and repair, tumor suppressor genes and causes of cancer related to genetic disposition and environmental contributions. Relling’s research focuses on pharmacokinetics and pharmacodynamics in children and how genome variability influences a child’s response to cancer chemotherapy.

The IOM is an honorific organization that was established in 1970 to provide unbiased, evidence-based and authoritative advice concerning health and science policy concerning matters of biomedical science, medicine and health. A maximum of 65 new members are elected annually through a highly selective process that recognizes people who have made important contributions to the advancement of medical science, health care or public health. The approximately 1,600 current active members elect new members from among candidates nominated for their professional achievement and commitment to service.

Other IOM members from St. Jude are Nobel Laureate Peter Doherty, Ph.D., Michael F. Tamer Chair of Biomedical Research; current director and CEO William E. Evans; former hospital director Arthur Nienhuis, M.D.; and Charles Sherr, M.D., Ph.D., Howard Hughes Medical Institute Investigator and Genetics and Tumor Cell Biology co-chair.

Memphis Heart Clinic’s Echo Lab Receives National Accreditation for Outstanding Quality

Memphis Heart Clinic announced recently that its echocardiography laboratory was recently granted ICAEL accreditation. The laboratory is one of the first one thousand echocardiography laboratories in the United States, Canada and Puerto Rico to be so recognized for its dedication to high quality patient care and its provision of high quality diagnostic testing.

Echocardiography is a complex imaging technique used to evaluate the function of the heart muscle and relies on the expertise and training of both the physician and sonographer performing the test. Their interpretive and technical abilities determine the accuracy of an echocardiographic exam. The Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL) developed an accreditation program which evaluates the quality of these and other critical elements of an echocardiography laboratory.

As a Mid-South leader in cardiovascular care, Memphis Heart Clinic physicians have been recognized by the National Committee for Quality Assurance (NCQA) Physician Recognition Program for Heart/Stroke Care, a 3-year recognition awarded for excellence in cardiac care. Memphis Heart Clinic’s nuclear laboratory has also received accreditation from the Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories (ICANL) as one of the US best nuclear medicine laboratories.

Bill Breen Receives CMPE Certification

Bill Breen, CEO of Health Choice LLC, the exclusive managed care contracting organization for MetroCare Physicians and Methodist Healthcare, has met the requirements for the Certified Medical Practice Executive (CMPE) designation in the American College of Medical Practice Executives (ACMPE). This designation demonstrates expertise in medical practice management.

Baptist Nurse Reak Receives Daisy Award

Debbie Reak, a nurse working in the myleosuppression unit at Baptist Memorial Hospital-Memphis, recently earned the DAISY Award for Extraordinary Nurses, given in appreciation of the work nurses do.

Reak was nominated by the mother of one of her patients after she showed a helpful and comforting attitude towards the patient.

Debbie treated us as if we were her family, the patients mother wrote in her nomination form. Her knowledge of her job is extraordinary, and she did everything she could to make sure my daughter was comfortable.

Each month, Baptist Memphis nursing administrators accept nominations and select a nurse to receive the DAISY Award.

At a presentation in front of the nurses colleagues, physicians, patients and visitors, the honoree receives a certificate and a sculpture called A Healers Touch, hand-carved by artists of the Shona Tribe in Africa.

Debbie is an exceptional and gifted nurse who knows how to comfort both the patient and the family during their time of need, said Dana Dye, chief nursing officer for Baptist Memorial Hospital-Memphis. She is truly one of a kind. The not-for-profit DAISY Foundation is based in Glen Ellen, Calif., and was established by family members in memory of J. Patrick Barnes. Barnes died at 33 in late 1999 from complications of idiopathic thrombocytopenic purpura, an auto-immune disease. The care Barnes and his family received from nurses while he was ill led to the creation of the DAISY Award. All the nurses in Reaks unit received Cinnabon cinnamon rolls because while Barnes was in the hospital, he once asked his family to bring enough cinnamon rolls for him and all the nurses in his unit.

The Baptist Memphis campus includes the 706-bed hospital that is the flagship of the Baptist Memorial Health Care system.

CDC-Authorized H1N1 Confirmatory Test Offered by Local Molecular Laboratory

A variety of diagnostic tests are available to detect the presence of influenza viruses in respiratory specimens. The most widely available tests are referred to as rapid influenza diagnostic tests (RIDT). These tests can be performed in a clinical setting, and results are typically provided within 30 minutes. However, these tests are not very sensitive (10-70%) for specific detection of 2009 H1N1 influenza, so a negative RIDT result does not rule out influenza virus infection. Furthermore, an RIDT is unable to distinguish between influenza A subtypes (i.e., 2009 H1N1 vs. seasonal H1 and H3 viruses).

According to the CDC, if rapid identification of 2009 H1N1 influenza virus infection is required, testing with a rRT-PCR assay specific for 2009 H1N1 influenza should be performed. Several rRT-PCR assays have been evaluated and authorized by the FDA under an emergency use authorization to diagnose 2009 H1N1 influenza virus infection. Genetic Assays, a Nashville-based molecular diagnostics laboratory that specializes in PCR-based infectious disease testing, recently added a 2009 H1N1 influenza rRT-PCR assay to its test menu. The FDA-authorized test is performed using CDC provided reagents and procedures.

In certain situations, influenza diagnostic testing of patients who are not severely ill may help inform decisions regarding clinical care, infection control, or management of close contacts. Testing specifically for 2009 H1N1 influenza may be important for patients with certain high-risk conditions, such as pregnancy, immunosuppression, heart disease, asthma, and diabetes. The CDC recommends that rRT-PCR tests be prioritized for hospitalized patients and immunocompromised persons with suspected influenza where RIDTs are negative. They should also be used to determine influenza A virus subtype in patients who have died from suspected or confirmed influenza A virus infection.

Genetic Assays performs another test cleared by the FDA as an effective aid in the detection of 2009 influenza A/H1N1 - the xTAGR Respiratory Viral Panel from Luminex Corporation. Initially approved for marketing by the FDA in January 2008, the xTAGR RVP uses multiplex PCR to detect and identify 12 different respiratory viruses and viral subtypes from a single patient sample. Its ability to detect the hemagglutinin gene of the seasonal strains of H1 and H3 is what enables the RVP to differentiate between common subtypes and the novel 2009 H1N1 strain.

Mitchell Watsky, PhD, Named Associate Dean for Graduate Health Sciences in the College of Medicine, Memphis Campus, at UTHSC

Steve J. Schwab, MD, interim chancellor and executive dean for the College of Medicine at the University of Tennessee Health Science Center (UTHSC), and Cheryl Scheid, PhD, UTHSC vice chancellor for Academic, Faculty and Student Affairs, and interim dean for the College of Graduate Health Sciences, named Mitchell Watsky, PhD, as associate dean for Graduate Health Sciences in the College of Medicine, Memphis campus.

This appointment reflects the cooperation and interdependence of the College of Medicine and the College of Graduate Health Sciences in the vital task of advanced health science education.

Dr. Watsky obtained his PhD in 1989 from the Medical College of Wisconsin. He completed his postdoctoral fellowship in physiology and biophysics with the Mayo Foundation under the tutelage of James Rae, PHD. Dr. Watsky joined UTHSC in1992 as an assistant professor in the Department of Physiology, and has since been awarded tenure as full professor within the department.

He has garnered numerous awards and honors throughout his career. With more than 50 publications in peer reviewed journals, he has served as principal investigator on numerous current and past grant awards. Dr. Watsky chaired the Physiology Department Graduate Committee from 1995 to present, and has had significant involvement in the Graduate Interdisciplinary Program as a track director and member of various advisory committees.

The search committee was led by Charles Handorf, MD, PhD, chair for the UTHSC Department of Pathology and Laboratory Medicine. The search committee also included chairs from all four basic science departments along with representation from St. Jude Children’s Research Hospital and the Graduate Student Executive Committee. Dr. Watsky emerged as an ideal candidate to lead graduate studies in the College of Medicine.

St. Jude named top 10 best places to work by The Scientist magazine

St. Jude Children’s Research Hospital has been listed among the top 10 “Best Places to Work in Academia” by The Scientist magazine—this year’s seventh place ranking is the fourth straight year the institution has placed in the top 10.

The Scientist provides print and online coverage of the latest developments in the life sciences including trends in research, new technology, news, business and careers. Survey participants ranked research resources at St. Jude as a top factor in determining workplace satisfaction.

“We are pleased that we continue to be seen as an outstanding place to do research, as this helps to ensure that we continue to recruit and retain the best and brightest researchers,” said Dr. William E. Evans, St. Jude director and CEO. “The serious nature of the diseases we treat requires nothing but the best if we are to continue to make discoveries that advance cure rates.”

The Scientist posted a Web-based questionnaire and invited those who identified themselves as life scientists with a permanent position in an academic, hospital, government or research organization. Respondents were asked to assess their working environment according to 38 criteria in eight areas by posing positive statements with which the respondent was asked to agree or disagree. Respondents were also asked to rank the perceived importance of each factor.

The magazine received 2,355 valid responses. Represented in those responses were 119 institutions—94 from the U.S. and 25 internationally. About 47 percent of respondents were from non-medical universities or colleges. Complete survey results are published in the November issue of The Scientist.

New chromosomal abnormality identified in leukemia associated with Down syndrome

Researchers identified a new chromosomal abnormality in acute lymphoblastic leukemia (ALL) that appears to work in concert with another mutation to give rise to cancer. This latest anomaly is particularly common in children with Down syndrome.

The findings have already resulted in new diagnostic tests and potential tools for tracking a patient’s response to treatment. The research, led by scientists from St. Jude Children’s Research Hospital, also highlights a new potential ALL treatment. Clinicians are already planning trials of an experimental medication targeting one of the altered genes.

This study is published in the October 18 online edition of Nature Genetics.

A substantial proportion of children with ALL lack one of the previously identified, common chromosomal abnormalities. Also, children with Down syndrome have an increased risk of ALL, but the reasons why are unclear, according to Charles Mullighan, M.D., Ph.D., assistant member in the St. Jude Department of Pathology. Mullighan is senior author of the study, which involved scientists from 10 institutions in the U.S. and Italy.