Blending the Art & Science of Medicine • The University of Tennessee College of Medicine Chattanooga

THIS ISSUE AT A GLANCE Volume 13, Issue 3 • May/June 2012

1 Research Awards & Award Winners

5 Residency Reaccreditations

7 S T U D I E S

C-Section Study

Trauma Grant for MRSA Study

9 Army Medical Visit

Passed the Boards, Dr. Knowles

6F U N D R A I S E R S

Orthopedic Reunion Fundraiser

8 Continuing Medical Educ. Opportunities

3 Welcome to the 2012 Incoming Residents and Fellows!

R E S I D E N T S

New OB/GYN Resident Research Curriculum2

9 Publication & Presentations

11 Note to PI, Farewell from Sylvia Friedl

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Judges for the event were (left to right) Dr. Paul Stumpf, Professor, Chair & Residency Program Director for the UTCOMC Department of Obstetrics and Gynecology, Dr. Beth Choby, Associate Professor for the St. Francis Family Medicine Program in Memphis, and Dr. Matthew Good, Clinical Assistant Professor for the UTCOMC Department of Pediatrics and practicing physician with the Highland Pediatrics Group.

This event, which dates back to 1983, was the vision of Robert Coddington, MD, Chair of the Department of Orthopaedic Surgery, and the first Associate Dean for the Chattanooga Campus.

Details about each Research Project and Award are on page 2 »

2012 Research Awards (30th annual)The UTCOMC and Erlanger Health System presented this year’s Research Week from April 9-13, 2012. Research posters were on display in the Erlanger Medical Mall all week, and included 11 research projects, and 9 case reports. The Scientific Review Committee served as the abstract selection committee for this year’s presentations. Poster rounds and selected oral presentations were held on Friday, and the week culminated with the presentation of awards at dinner at the Walden Club on Friday evening.

Awards were presented by the UTCOMC Dean, David C. Seaberg, MD. The winner of the Best Overall Research Presentation and the Robert C. Coddington, MD Award for Research Excellence was Erik Martin, MD from the Department of Emergency Medicine for his presentation, “Improving Risk Stratification in Chest Pain Patients: The Erlanger HEARTS Score”.

Dr. Robert Coddington

2012 Award WinnersBack Row: (left to right) Erik Martin, MD, Michael Johnson, MD, and Hal Parker, MD. Front Row: Richa Sood, MD, Jennifer Hamm, MD, and Ralston Major II, MD.

See page 2 for more info on the awards and award winners »

7 Press Out Domestic Violence Fundraiser

6 A W A R D S

READ AwardYoung Investigator Contest Award

United Way Volunteerism Award

NEW!Click the article titlesto skip to those pages

Award Winner: Award: Title: Department:Erik Martin, MD

Coddington Award Best Research Presentation

Improving Risk Stratification in Chest Pain Patients: The Erlanger HEARTS Score

Emergency Medicine

Richa Sood, MD

2nd Place Research Presentation

High Flow High Humidity Nasal Cannula Therapy for Respiratory Failure in Infants with Bronchiolitis

Pediatrics

Hal Parker, MD

3rd Place Research Presentation

Feasibility of Pre-Hospital Transmission of the 12-lead ECG Using a Camera Capable Cellular Phone for Identification of ST-Segment Elevation Acute Myocardial Infarction

Emergency Medicine

Michael Johnson, MD

4th Place Research Presentation

Non-Operative Management of Retrocalcaneal Pain with AFO and Stretching Regimen

Orthopaedic Surgery

G. Ralston Major II, MD

1st Place Case Study

Use of CT Perfusion Imaging and CT Angiography in the Selec-tion of Hyperacute Stroke Patients to Undergo Emergent Carotid Endarterctomy

Surgery

Jennifer Hamm, MD

2nd Place Case Study

Medical Child Abuse: When a Father Suffocates His Child Pediatrics

Fernando Windemuller, MD

3rd Place Case Study

First Report of Biopsy Proven Acute Interstitial Nephritis Associated with Escitalopram

Pediatrics

2012 Resident Research Awards and Research Details

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UTCOMC OB/GYN Department Launches New Resident Research CurriculumThe practice of evidence-based medicine requires skills in understanding and interpreting published reports of research results. As the volume and complexity of research reports continues to increase, tomorrow’s physicians will need ever-more sophisticated skills to incorporate that research appropriately into clinical practice. With this aim, most Obstetrics and Gynecology Residency Programs in the United States require or encourage OBGYN residents to complete a resident research project as part of training. Often, however, these research obligations can seem more like a chore or a burden for the resident, rather than an enriching educational experience as is intended. Exacerbating this problem for the Obstetrics and Gynecology Residency Program at UT COM Chattanooga was the fact of little infrastructure or tradition within the residency for conducting clinical research in women’s healthcare. To address this issue, the UT COMC OBGYN Department decided to jump-start our research program by launching a new curriculum designed to teach, encourage and facilitate research by our OBGYN residents, supported by our faculty. This curriculum includes some didactic instruction in biostatistics and research design, but relies heavily on team-based learning, hands-on experience, self-directed study and one-on-one mentorship to advance the research effort.

Each of our in-coming OBGYN residents will complete self-directed on-line CITI (Collaborative Institutional Training Initiative) and will earn certification of competency in the research principles which protect human subjects. All our residents will organize themselves into teams consisting of four residents, one from each year of training in our program. Members of these teams help each other with their respective research projects, and will meet periodically to update the group on their progress. Our first-year residents will attend the annual “Nuts and Bolts Symposium” to learn about research design and execution. These topics will be explored further in regular didactic series with the help of an UT COMC epidemiologist, Visiting Professors, and colleagues from other UT COMC departments. Statisticians and a scientific writer are available to assist our residents, and faculty mentors provide one-on-one guidance and support in navigating the Scientific Review Committee and Institutional Review Board. Although this curriculum has barely started, there are already encouraging signs of increased interest and productivity in the research arena of women’s healthcare.

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2012 UTCOMC Incoming Residents and Fellows

Program: Name: Medical School: Degree:

Family Medicine Aguirre, Christina Marie Loma Linda University (CA) MD

Emergency Medicine Avila, Jacob O. Loma Linda University (CA) MD

Surgery (Categorical) Ballay, Nicholas Paul Louisiana State University in Shreveport (LA) MD

Surgery (Prelim) Bell, Christopher Michael University of Tennessee (TN) MD

Family Medicine Bernatowicz, Nicole Lynae Lake Erie College of Osteopathic Medicine Bradenton (FL) DO

Emergency Medicine Bevan III, Charles Albert (Chad) University of South Carolina (SC) MD

Internal Medicine Black, Whitney Kaylan Mercer University (GA) MD

Internal Medicine Castrilli, David St. George’s University (Granada, West Indies) MD

Pediatrics Chan, Albert St. George’s University (Granada, West Indies) MD

Surgery (Prelim) Chandra, Sahtish American University of the Caribbean (Netherlands Antilles) MD

Emergency Medicine Christensen, Clint Loma Linda University (CA) MD

Orthopaedic Surgery Cowart, Steven Justin Medical College of Georgia (GA) MD

Plastic Surgery Dale, Elizabeth Dale University of Oklahoma (OK) MD

Orthopaedic Trauma Dawson, John R. Baylor College of Medicine (TX) MD

Surgery (Prelim) de Grijs, Derek Paul University of Tennessee (TN) MD

Surgery (Categorical) Domingo, Fernando University of Louisville (KY) MD

Transitional Dunbar, Kristen Elizabeth Emory University (GA) MD

Transitional Durrani, Alia K. Vanderbilt University (TN) MD

Family Medicine Feliciano, Alexandra University of South Florida (FL) MD

Transitional Fyall, Katherine M. University of Miami (FL) MD

OB/GYN Garcia, Bobby Allen University of Texas Southwestern at Dallas (TX) MD

OB/GYN Gibbs, Shelly Lorn Ross University (Dominca) MD

Pediatrics Gilliam, Heather NiCoe Lincoln Memorial University Debusk College of Osteo-pathic Medicine (TN) DO

Internal Medicine Goins, Andrew D. Lincoln Memorial University Debusk College of Osteo-pathic Medicine (TN) DO

Emergency Medicine Gowder, Laura Catherine Medical College of Georgia (GA) MD

Surgical Critical Care Hagan, Joshua Dennis University of Tennessee (TN) MD

Vascular Surgery Harris, William Burton Arizona College of Osteopathic Medicine (AZ) DO

Internal Medicine Hartgrove, Nathan Elliott Lincoln Memorial University Debusk College of Osteo-pathic Medicine (TN) DO

Surgery (Categorical) Huddleston, Mary Kathryn University of Alabama (AL) MD

Transitional Jackson, John Clarke University of Tennessee (TN) MD

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2012 UTCOMC Incoming Residents and Fellows (continued)

Program: Name: Medical School: Degree:

OB/GYN Kaeser, Carson Tyler Ross University (Dominca) MD

Internal Medicine Kahloon, Rehan Lahore Medical and Dental College (India) MD

Pediatrics Kuschel, Tarah Joy Rheinisch-Westfalische Technische Hochschule Aachen (Germany) MD

Plastic Surgery Landis, Lesley Vaughn Vanderbilt University (TN) MD

Emergency Medicine McAnnally, John-Ryan University of Alabama (AL) MD

Family Medicine McKenzie, Mary L. Ohio University ofCollege of Osteopathic Medicine (OH) DO

Emergency Medicine Meyer, Charles Loma Linda University (CA) MD

Pediatrics Mikail, Jonathan American University of the Caribbean (Netherlands Antilles) MD

Transitional Moore, Ryan D. Vanderbilt University (TN) MD

OB/GYN Motakef, Talla Rush Medical College (IL) MD

Colon & Rectal Surgery Nelson, Eric Charles Loma Linda University (CA) MD

Pediatrics Ngueyn, Grace Ross University (Dominca) MD

Surgery (Prelim) Patton, Andrew Garrett Louisiana State University in Shreveport (LA) MD

Surgery (Prelim) Perry, Alvin Paul Louisiana State University in New Orleans (LA) MD

Family Medicine Pigg, Richard William Ross University (Dominca) MD

Internal Medicine Pugh, William Matthew West Virginia School of Osteopathic Medicine (WV) DO

Orthopaedic Surgery Richardson, Nicholas Scott Medical College of Georgia (GA) MD

Orthopaedic Surgery Seales, Thomas Jacob University of Alabama (AL) MD

Orthopaedic Surgery Smith, Jarrod Russell Marshall University School of Medicine (WV) MD

Internal Medicine Smith, Mindy Wright Chicago Medical School at Rosalind Franklin University (IL) MD

Internal Medicine Smith, Rondell Alexis Brody School of Medicine at East Carolina (NC) MD

Surgery (Categorical) Soder, Brent Logan Medical University of South Carolina (SC) MD

Internal Medicine Swamy, Raksha Ross University (Dominca) MD

Pediatrics Tevatia, Richa Government Medical College Amritsar (India) MD

Family Medicine Thomas, Jessica Marie Mercer University (GA) MD

Internal Medicine Thomas, Shavonda Medical College of Georgia (GA) MD

Pediatrics Vasconcelos, Vanessa Ross University (Dominca) MD

Transitional Venkatesh, Sheila Lakshmi Medical College of Georgia (GA) MD

Pediatrics Ward, Chad Everett West Virginia School of Osteopathic Medicine (WV) DO

Surgery (Prelim) Wilks, Gavin University of Alabama (AL) MD

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Residency Reaccreditations

From David C. Seaberg, MD, FACEP, Dean for the UT College of Medicine Chattanooga to the entire UT College of Medicine Chattanooga Campus (residents, fellows, faculty, and staff), UTHSC Leadership, and Erlanger Leadership:

With great pride and pleasure, I extend my congratulations to the following residencies and one fellowship, their respective leadership, faculty and staff teams:

Family Medicine Residency and Hospice & Palliative Care Fellowship The Family Medicine residency was awarded Continued Accreditation with another maximum cycle of 5 years until the next site visit. The Hospice and Palliative Care Fellowship was awarded Continued Accreditation after its first official site visit with a cycle of 4 years until the next site visit. For a relatively new program, a 4-year cycle is a very positive sign from the RRC. Dr. J. Mack Worthington, Chair of the Department of Family Medicine, and Dr. Stephen Adams, Family Medicine Residency Program Director, as well as Dr. Valencia Clay, Hospice and Palliative Care Fellowship Program Director, and Dr. Mukta Panda, Chair of the Department of Medicine (sponsor of the HPC Fellowship), as well as Family Medicine Residency Coordinator, Sharron Skoretz, and Hospice and Palliative Care Fellowship Coordinator, Gigi Ellis, are all congratulated.

Ob/Gyn Residency To Dr. Paul Stumpf, Chair and Program Director for the OB/GYN Residency, and his entire Department (faculty, residents, and staff) on the recent ACGME RRC decision to award Continued Accreditation to the OB/GYN Residency with four years until the next site visit. Special thanks go to Dr. Paul Stumpf for all his hard work in leading the program through the process; Dr. Robert Fore, Associate Dean and DIO, for his guidance and oversight; Donna Gibson, Orthopaedic Surgery Coordinator, who served as an interim Coordinator for OB/GYN through the site visit; and Tammy Fite, GME Coordinator, who helped daily in the OB/GYN office through the site visit – especially with resident recruiting.

Surgery Residency To Dr. R. Phillip Burns, Chair of the Department of Surgery, Dr. Joseph Cofer, Surgery Program Director, and their entire Department on the recent RRC (Residency Review Committee) decision to award Continued Accreditation to the Surgery Residency with the maximum possible cycle of 5 years until the next site visit. Special thanks not only to Dr. Burns and Dr. Cofer, but to the two Associate Program Directors, Drs. Richard Moore and Benjamin Dart, all Surgery Faculty, Surgery Residents and Fellows, and the Surgery Program Manager, Cindy Rudolph, and her staff (Maggie Hamblen, Beverly Gay, Alissa Cobb, Paula Roberts, and Gwen Fryar). I also acknowledge Dr. Robert Fore, Associate Dean and DIO, for his guidance and oversight of the accreditation process. This accomplishment represents an enormous amount of hard work by Residents, Fellows, Faculty, and Staff in these departments.

These continued accreditations listed above are evidence of the quality of the programs and confidence of the RRC in the stability of the educational process of the Surgery, OB/GYN, Family Medicine, and Hospice & Palliative Care Fellowship programs, their residents and leadership. In addition, these accomplishments represent a great deal of guidance and oversight from our Associate Dean and DIO, Dr. Robert Fore.

Please join me in saying, “Job well done,” to all those involved in continuing successfully our institutional and programs accreditation. The institution and all programs at the UT College of Medicine Chattanooga hold favorable accreditation. Great work!

- David C. Seaberg, MD, FACEP, Dean, UT College of Medicine Chattanooga

Dr. Phillip Burns

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Dr. Paul Stumpf

Dr. Mack Worthington

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RadCare Honors UTCOMC’s Chair of Radiology with Prestigious READ AwardDr. Kent Hutson, Chair of Radiology for the University of Tennessee College of Medicine Chattanooga received the prestigious READ Award. This award (Radiology Excellence and Dedication) is given each year by RadCare, Erlanger’s radiology services management company. RadCare’s CEO Phil Heckendorn, “From a leadership point of view, he really exemplifies the qualities that we look for, both in a chair as well as in a general radiologist.” According to Dr. Hutson, “It’s good to be honored by your peers for the effort you put forth. For me, the READ Award is a recognition of the last five years that I’ve really put into RadCare, Erlanger, and UTCOMC.”

READ Award winners are selected through a nomination and voting process conducted by EmCare (RadCare’s radiology service line of Emcare, a leading physician management services company). Back to Index ↑

NLA Young Investigator Contest AwardJerry Walkup, MD, second year resident in Pediatrics, won 3rd Place Award at the National Lipid Association (NLA)’s Young Investigator Contest for his poster entitled: “The Triglyceride/HDL-Cholesterol Ratio as a Tool to Predict Insulin Resistance in Obese Pediatric Patients”. Fellow pediatric resident Dr. Kendra Simpson also worked on this project; both were mentored by UT COMC faculty members Drs. Marielisa Rincon-Subtirule and MihailSubtirelu. Back to Index ↑

Dr. Walter Puckett receives United Way Volunteerism AwardDr. Walter Puckett, volunteer medical director of Project Access and Clinical Associate Professor for the Department of Medicine UTCOMC, was honored by the United Way as Healthcare Volunteer of the Year. Dr. Puckett was recognized at a dinner in April as part of National Volunteer Month activities. Project Access is a referral network that makes health care more available to low-income, uninsured residents of Hamilton County. Dr. Puckett has been the volunteer medical director of PA since its inception in 2004. As medical director, Dr. Puckett reviews Project Access cases to ensure appropriate referrals, recruits partners to specific cases, and provides day-to-day direction for the Project Access staff. Back to Index ↑

First-Ever UT COMC Orthopedic Resident and Faculty Reunion Raises $567,000Source: Chattanoogan.com, Accessed June 20, 2012

More than 50 current and former orthopedic residents from across the United States reunited on the Erlanger campus to rekindle friendships from their years in Erlanger’s orthopedics residency program. The first-ever resident and faculty reunion, billed as the “Road to $1 Million Campaign,” also raised $567,000 to help fund the Chattanooga Orthopedic Education and Research Foundation (COERF). Local orthopedic surgeon and UT COMC’s Chief of Reconstructive Orthopedic Surgery and Arthroplasty, Dr. Paul Apyan, who served as chairman of this year’s fund-raising event, said that the 2012 contributions will be used to purchase equipment, specimens for the on-campus Bioskills Lab and iPad textbooks for orthopedic residents.

“Our hope is that through learning tools used by our faculty, residents and medical students, we will be able to inspire and educate the next generation of orthopedic surgeons coming through Erlanger’s doors,” said Dr. Richard G. Alvarez, Chair of Orthopedic Surgery at UT COMC. Among those attending the physician reunion was 86-year old Dr. Iquball Singh, who joined the orthopedic residency program in 1952.

“These are the physicians who have been taking care of the people of Hamilton County for the past 60 years,” Dr. Apyan told 160 attendees during a dinner ceremony, which included city and county mayors, Jim Coppinger and Ron Littlefield.

Receiving the Distinguished Alumnus award at the reunion was Dr. Robert Coddington, who was presented with a Tree of Life sculpture, which represents the term “orthopedics.” Other former residents recognized at the reunion were Drs. Channappa Chandra, David Bruce, Martin Redish, Marshall Jemison, Thomas Currey, Mark Freeman, Richard Pearce, Dale Ingram and Hugh Brown.

20 former Erlanger orthopedic residents who went on to practice in other parts of the country came to the reunion from Oklahoma, Florida, Georgia, Alabama, and North Carolina. “They came back home – for friendship, fellowship and education,” said Dr. Apyan, noting that the alumni group voted to return to Chattanooga every other year for a reunion. Back to Index ↑

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New UTCOMC Faculty Member Examines Reasons for Rising C-Section RateA C-Section, also called Caesarean section or Caesarean birth, is a surgical procedure in which incisions are made through a mother's abdomen and uterus to deliver a baby. Although uncommonly done in the past, today Cesarean Section is one of the most frequently performed surgeries in many parts of the world. In the United States, the C-Section rate rose from around 4% of all births in 1965 to over 30% by 2010. Complications from this procedure range from increased cost to maternal death. Even seemingly routine C-Sections can lead to life threatening complications in future pregnancies.

To understand the reasons for increased C-Sections within our own community, Dr William Gist, Assistant Professor of Obstetrics and Gynecology at UTCOM Chattanooga, is launching a detailed study of two years of birth experience at Erlanger Medical Center in Chattanooga. With his co-

investigators, Stacia Moyer, MD, an UTCOMC OBGYN Resident, and Beth Ann Gist, MSN, a Certified Nurse Midwife, Dr Gist will analyze the records of about 1,000 primary Caesarean births to determine the factors leading to that method of delivery. Dr Gist hopes to establish patterns that offer opportunities to improve practice guidelines for maternity care.

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Heavy Lifting -- “Press Out Domestic Violence” Fundraiser The Transitional Year Program held their Seventh Annual Press Out Domestic Violence fundraiser this past spring. This weight lifting competition was held in the Erlanger Medical Mall and raised over $1,500 for the Partnership for Families, Children and Adults of Chattanooga. There was very healthy competition among all of the departments, but the real winner was the Partnership for Families, Children and Adults of Chattanooga. Awardees were as follows:

Individual winners:Women: Elizabeth Hartmann (surgery) --135 lbsMen: Adam Leland (emergency department) -- 380 lbsWomen resident: Elizabeth Hartmann (surgery) -- 135 lbsMen resident: Bradley Allen (transitional year) -- 300 lbsWomen faculty: Mukta Panda (Internal medicine) -- 45 lbsMen faculty: Rob Hamilton (Emergency department) -- 245 lbs

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Team winners: 1. Emergency medicine team: 1,300 lbs2. Orthopedic surgery team: 950 lbs3. Lift team: 690 lbs

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William Gist, MD

National Trauma Institute Grants Funds for MRSA StudyRobert A. Maxwell, MD, Professor of Surgery, University of Tennessee College of Medicine Chattanooga, and Chasen Croft, MD, former Critical Care Fellow, now with University of Florida, received a grant from the National Trauma Institute for a study entitled, “Methicillin-Resistant Staphylococcus aureus in a Trauma Population: Does Decolonization Prevent Infection?” The authors have previously shown a MRSA colonization rate of 10% in the critically injured trauma population at hospital admission. Of those patients, approximately 30% will develop an invasive MRSA infection during their hospitalization.

The purpose of the study is to evaluate the efficacy of decolonization techniques and the subtypes of subsequent MRSA infections developed during their hospital stay after major trauma. Patients will be randomized to standard soap baths and petroleum jelly to the nares or 4% chlorhexidinegluconate baths with nasal mupirocin ointment for five days. At the end of the treatment, patients will be retested for colonization and followed for thirty days or to discharge for subsequent infections. Any MRSA infections will be subtyped to determine if the invasive infection was caused by the original subtype of MRSA or a new strain.

Evaluating the efficacy of decolonization techniques will have a direct impact on patient care practices. Subtyping the strain isolated from an MRSA infection will produce novel scientific data on the etiology of nosocomial MRSA infection.

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Continuing Medical Education Opportunities

Erlanger Grand RoundsGeneral and Pediatrics Tumor Board ConferenceFridays, 12:00-1:00 pmContact: Kim Wicks, (423) 778-6357

Gynecology Tumor Board Conference3rd Tuesday of each month, 7:30-8:30 amContact: Kim Wicks, (423) 778-6357

Internal Medicine Grand Rounds2nd and 4th Thursday of each month, 8:00 amProbasco AuditoriumContact: Becky Swanson, (423) 778-2611

Pediatrics Grand RoundsWednesdays, 8:00-9:00 amChildren’s Massoud Building, Room 140Contact: Annette DeVilbiss, (423) 778-8074

Surgery Grand RoundsWednesdays, 7:00-8:00 am - Probasco AuditoriumContact: Gwen Fryar, (423) 778-7695

Surgery, Morbidity & Mortality Grand RoundsThursdays, 7:00-8:00 am - Probasco AuditoriumContact: Gwen Fryar, (423) 778-7695

Upcoming Conference

Nuts & Bolts Research Methods SymposiumFriday, August 24, 2012 - 8:00am - 4:00 pm - University Center, UTCTopics include: Mentoring, from the Physician’s Perspective, The IRB from the Chair’s Perspective, Research from an Investigator’s Perspective, Research from a Data Perspective, & Scientific Review Committee Research Fundamentals Writing Workshop. Visit www.utcomchatt.org/cme/nutsandbolts for more info and to download the brochure.

Report on 2012 Family Medicine UpdateThe 2012 Family Medicine Update was held on June 13-16, 2012 at the Chattanoogan Hotel. 28 physicians presented on different topics and there were 83 attendees. Topics included:

Smoking cessationVaccine updateAcute pancreatitisThyroid diseasePrimum non nocereEvaluation of sexual dysfunction

Bladder dysfunctionPain management in hospice & palliative care

ADHDSuboxone useBariatric bi-pass surgery,The Business of medicineAbnormal uterine bleeding

Breast cancerMammmographyAlzheimer’s

Refractory hypertensionEvaluation of lung nodules

Renal issues in childrenEvaluating sensory deficits

Physician prescriving & monitoring of schedule drugs

Concussion guidelinesAnkle ligament examSupplements in athleticsEvidence-based integrative medicine

Current concensus guidelines in diabetes

Lower extremity edemaHyperbaric treatment applications

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COMmunicator 9

U.S. Army Medical Representatives Visit Erlanger Health SystemSource: http://news.erlangerhealth.org/author/erlangerhealth/ Accessed 6/21/2012

Erlanger emergency room staff and University of Tennessee College of Medicine Chattanooga (UTCOMC) medical residents attended a Grand Rounds session earlier this morning which featured Col. Ian S. Wedmore, MD, emergency medicine consultant to the U.S. Army Surgeon General.

In his presentation, Col. Wedmore described tactical combat casualty care and explained the medical science of pre-hospital care and how it is improving patient outcomes. Some of the topics discussed included providing an airway to a wounded patient through surgical advances while troops are under fire, new products to decrease bleeding and enhance blood clotting, how to “seal” chest wounds, caring for patients with hypothermia during helicopter transport and pain control on the field.

After Grand Rounds, Col. Wedmore and SSG Robert Santarsiero, Army Healthcare Recruiter, presented Erlanger Health System Interim Chief Medical Officer, Director of Emergency and Disaster Services Program and Director of Emergency Medicine Residency for UTCOMC , James Creel, MD, with a certificate of appreciation for the partnership between Erlanger and the U.S. Army. The partnership allows Army healthcare providers to share their experiences with other medical specialists and assists Army physicians and nurses to stay abreast of best practices in the civilian sector. The professional exchange results in the highest of standards of care for both civilian patients and our nation’s defenders. Back to Index ↑

From L-R: Harry Severance, MD, Col. Ian Wedmore, MD, emergency medicine consultant to the U.S. Army Surgeon General; Warren Eng-lish, MD; James Creel, MD, Hal Parker, MD, Erik Martin, MD, Brian Smith, MD and SSG Robert Santarsiero.

Congratulations to Dr. Paul KnowlesDr. Paul Knowles, faculty member for UT COMC’s Department of Pediatrics, passed the boards given by the American Board of Psychiatry and Neurology in Sleep Medicine in November 2011. He is now seeing pediatric patients with sleep issues at the Erlanger North Sleep Center. Back to Index ↑

Publications and PresentationsBariola JR, Perry P, Pappas PG, Proia L, Shealey W, Wright, PW, Sizemore JM, et al. Blastomycosis of the central nervous system: a multicenter review of diagnosis and treatment in themodern era. Clinical Infectious Diseases, 2010, 50(6):797-804.

Bosu D, Feg H, Min K, Kim Y, Wallenfang MR, Kipreos ET. C. elegans CAND-1 regulates cullin neddylation, cell proliferation and morphogenesis in specific tissues. Developmental Biology, 2010 Oct 1;346(1):113-26. Epub 2010 Jul 24.

Cesari WA, Vaikunth SS, Lewis JB, Panda M. Know Your Audience: Analysis of Chief Complaints at Clinica Esperanza, a Student-Run Free Clinic in Memphis, Tennessee. Journal of Primary Care &Community Health, first published on April 19, 2012

Fields JD, Lutsep HL, Rymer MR, Budzik RF, Devlin TG, Baxter BW, Malek R, et al. Endovascular mechanicalthrombectomy for the treatment of acute ischemic stroke due to arterial dissection. Interventional Neuroradiology, 2012, 18(1):74-79.

Heath GW, White-Woerner S.New Urbanism and Its Impact on Active Living among Inner City Children/Youth. Circulation, 2012;125:AP267. Also presented as a paper at the American Heart Association Council on Epidemiology and Prevention and the Council on Nutrition, Physical Activity, and Metabolism’s Annual Scientific Sessions, San Diego, CA, March 13-16, 2012.

Kafle P, Malakoff GL. Coexistence of systemic lupus erythematosus and thrombotic thrombocytopenic purpura: a case report. Tennessee medicine: Journal of the Tennessee Medical Association, May 2012;105(5):37-38.

Kapadia AS, Panda M. A young male with coexisting astrocytoma and renal cell carcinoma. Tennessee medicine: Journal of the Tennessee Medical Association, May 2012;105(5):39-40.

Continued...

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Publications and Presentations (continued)Lamb AN, Rosenfeld JA, Neill NJ, Talkowski ME, Blumenthal I, Girirajan S, Keelean-Fuller D, Fan Z,Pouncey J, Stevens C, Mackay-Loder L, Terespolsky D, Bader PI, Rosenbaum K, Vallee SE, Moeschler JB, Ladda R, Sell S, Martin J, Ryan S, Jones MC, Moran R, Shealy A, Madan-Khetarpal S, McConnell J, Surti U, Delahaye A, Heron-Lnge B, Pipiras E, Benzacken B, Passemard S, Verloes A, Isidor B, Le Caignec C, Glew GM, Opheim KE, Descartes M, Eichler EE, Morton CC, Gusella JF, Schultz RA, Ballif BC, Shaffer LG. Haploinsufficiency of SOX5 at 12p12.1 is associated with developmental delays with prominent language delay, behavior problems, and mild dysmorphic features. Human Mutation, 2012 Apr;33(4):728-40.

Molitoris BA, Okusa MD, Palevsky PM, et al (Tumlin JA). Design of Clinical Trials in AKI: A Report from an NIDDK Workshop. Trials of Patients with Sepsis and in Selected Hospital Settings. Clinical Journal of American Society of Nephrology, Mar 2012.

Okusa MD, Molitoris BA, Palevsky PM, et al (Tumlin JA). Design of Clinical Trials in Acute Kidney Injury: A Report from an NIDDK Workshop--Prevention Trials. Clinical Journal of the American Society of Nephrology, Mar 2012.

Palevsky PM, Molitoris BA, Okusa MD, et al (Tumlin JA). Design of Clinical Trials in Acute Kidney Injury: Report from an NIDDK Workshop on Trial Methodology. Clinical Journal of the American Society of Nephrology, Mar 2012.

Pereyra F, Jia X, McLaren PJ, Telenti A, de Bakker PI, Walker BD, Ripke S, et al. (Sizemore JM, Jr.) The major genetic determinants of HIV-1 control affect HLA class I peptide presentation. Science, 2010, 330(6010):1551-1557.

Youngblood L, Dooley J. A typical cause of stroke in a 27 year old male. American Journal of Case Reports, 2012; 13CR 75 - 78.

Zema MJ. Poor R wave progression revisited. American Journal of Cardiology, Feb 2010;105(3):422-423.

Zema MJ. Routine physical examination and the squatting maneuver. American Journal of Medicine, Apr 2012;125(4):e11; author reply e13.

Zema MJ. ST-segment elevation in electrocardiogram lead aVR. American Journal of Cardiology, Apr 2012;109(7):1082.

Papers presented by Dr. Marielisa Rincon at ENDO 2012: The Endocrine Society’s 94th Annual Meeting & Expo, June 23-26, 2012, Houston, TX:

1. title: “Yolk sac tumor as a cause of vaginal bleeding in a 15 month old girl” authors: Melissa Carlucci MD, Avery Mixon MD, Marielisa Rincon MD

2. title: “The effect of parental type 1 diabetes on glycemic control in children with type 1 diabetes” authors: Alexandra Martin MD, Michael Johnson PhD, Whitney Brown MD, Marielisa Rincon MD

3. title: “Diabetic ketoacidosis with alkalemia presenting with a picture of superior mesenteric artery syndrome” authors: Heba Ismail MD, Marielisa Rincon MD

4. title: “Congenital adrenal hypoplasia initially presenting with aldosterone deficiency in a child conceived with a donated egg; a case report and ethical delimma.” authors: Heba Ismail MD, Marielisa Rincon MD

5. title: “Hyperinsulinism due to an activating glucokinase mutation presenting as severe hypoglycemia in late adolescence.” authors: Marielisa Rincon MD, Melissa Carlucci MD, Whitney Brown MD

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COMmunicator 11

Note to Principle Investigator The UTCOMC/EHS IRB recently passed a policy that will allow investigators to use a short form consent when seeking to enroll a subject who does not speak English. This form should be used only in the event that there is an unanticipated need for consent in this subject’s language. The preferred consent policy is that an investigator use an IRB-approved translated full consent form in the language of the subject.

The IRB-approved Spanish short form and the updated IRB Policies and Procedures are available on the IRB website (http://www.utcomchatt.org/subpage.php?pageId=833). The short form explains the basic requirements of the consent. Once the principal investigator or the protocol-approved designee has printed this form, he/she then explains the study in detail using the IRB-approved study consent in English as a script and using a certified translator in the appropriate language. The investigator signs the English version, the translator signsboth the English version and the translated short form, the subject signs the short form in his/her native language, and the subject is given signed copies of the short form and the English consent. If the translator is in the room, he/she may serve as the witness. If a phone interpreter is used, there needs to be a separate witness to the process in the room. All of this is explained on the first page of the short form.

At this time, the short form is available only in Spanish. If you feel there is need for a translation in another lan-guage please contact Stacey Hendricks in the IRB office.

I will be retiring at the end of June and so need to say goodbye. Over the past ten years it has been my honor to work with the College of Medicine Chattanooga and Erlanger Health System helping to promote a “culture of compliance” in the research community. Through educational offerings like the Coordinator Forum, the Nuts and Bolts Symposium, Research Week, the Ethics Quarterly and annual compliance conferences, we’ve explored many challenging research-related issues. I know how hard you work to provide quality care for southeast Ten-nessee, and that clinical trials are just one part of the mission to improve the health of our population. I applaud all of you who are looking for answers, working with device manufacturers, pharmaceutical companies, the Scientific Review Committee members, and the Institutional Review Board. Your work is difficult and not often rewarded, but it’s truly important. Thank you for your support and friendship, and best wishes to you all.

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Comments, articles and announcements for the UTCOMmunicator can be submittedin a publishable format to Langhorne.Waterhouse@Erlanger.org

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CreditsSylvia FriedlResearch Compliance Officerlanghorne.waterhouse@erlanger.org

Langhorne WaterhouseGrants Writer & Information Specialistlanghorne.waterhouse@erlanger.org

Bill Reynolds, MBADirector of Continuing Medical Educationbill.reynolds@erlanger.org

Abigail OverstreetCME Assistantabigail.overstreet@erlanger.org