Group Title: Post
Title: The Post
Full Citation
Permanent Link:
 Material Information
Title: The Post
Uniform Title: Post (Gainesville, Fla. 2001)
Physical Description: v. : ill. ; 28 cm.
Language: English
Creator: Office of News and Communications, UF Health Science Center
University of Florida -- Health Science Center
University of Florida -- Health Science Center. -- Office of Public Information
Publisher: HSC Office of Public Information,
HSC Office of Public Information
Place of Publication: Gainesville Fla
Publication Date: September 2009
Frequency: biweekly
Subject: Health occupations schools -- Periodicals -- Florida   ( lcsh )
Genre: government publication (state, provincial, terriorial, dependent)   ( marcgt )
periodical   ( marcgt )
Statement of Responsibility: The University of Florida Health Science Center.
Dates or Sequential Designation: July 27, 2001-
General Note: Title from caption.
 Record Information
Bibliographic ID: UF00073869
Volume ID: VID00049
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 47826372
lccn - 2001229452
 Related Items
Preceded by: Friday evening post (1989)


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On the Cover

Deprived of oxygen during birth, Sianna Marie
Acevedo was flown from a Tampa hospital to Shands
at UF medical center, where neonatologist Michael
Weiss, M.D., and his team in the neonatal intensive
care unit used a new cooling technique to help stave
off brain damage. This month, The POST describes
how health professionals and researchers across UF
are using new techniques and tools such as this to
help improve patient care and save lives.
Photo by April Frawley Birdwell

Table of Contents

SAdministration: Conflict of interest policy
SPatient Care: Acupuncture for animals
O Patient Care: Project Eastside
0 Education: Hendeles in Israel
* Education: Nurse without borders
0 Cover Story: Technology in health care
S5 Questions: Liver cancer
* Research: Vision research
Q Grants: Building dental research
@ Jacksonville: The advocate for kids
* Around the HSC: Organ donation
Profile: Doctors and brothers e ee... SSS SOO O OOOO OSSee .... SS OO OO OOO OOSSee.SS S SS OO O OOSO OSS ee.S SSS SS50000

Speaker in the house

riBl i

After receiving an armful of plaques a framed
stethoscope, a picture of the College of
Dentistry's junior class doing the Gator chomp, a
close-up of brain cells state Rep. Larry Cretul walked
from lab to lab inside the McKnight Brain Institute. He
listened closely as Kelly Foote, M.D., described deep-
brain stimulation. He asked questions when stem cell
researcher Brent Reynolds, Ph.D., explained an approach
his lab is working on that could stop tumor cells from
dividing. Cretul paid attention. Of course, this wasn't
much of a surprise to the UF leaders who organized the
event, which honored Cretul for years of support for UF
and health science programs in the state Legislature. Over
the years, Cretul has helped garner state funding for
medical schools, biomedical research and programs such
as the College of Nursing's Archer Family Clinic and the
Florida Center for Brain Tumor Research. And those are
just a few of the programs he has helped, although Cretul,
who has served as Speaker of the Florida House of
Representatives since 2008, was quick to point out he
hasn't done it alone. "I wish I was worthy of all this
recognition," he said. "This really is (a group effort). One
individual can't do anything by themselves."
-April Frawley Birdwell

Visit us online @ for he iciest news end HSC events



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Question: Which hospital did U.S. News & WorldReportrecently rank as one of
the country's 50 best hospitals for cancer treatment, urology, diabetes and
endocrine disorders, geriatrics, gynecology, and ear, nose and throat care, notto
mention heart care and heart surgery?

Answer: Yep, it was Shands at UF, which was ranked in seven specialties as part
of the publication's annual roundup of America's Best Hospitals. The hospital
secured the top ranking in Florida for heart and heart surgery, urology and
geriatrics. -AprilFrawley Birdwell






HSC, Shands ban

tobacco use on campus

By Melanie Fridl Ross
U F and Shands HealthCare are going Tobacco-Free
Together. As of Nov. 1, the use of cigarettes or other
tobacco products in any of the Health Science Center,
Shands HealthCare or UF Physicians buildings and parking lots, or
in vehicles in these areas, will not be permitted. UF plans to
implement the policy on its main campus in July 2010.
"Going tobacco-free on our health-care campuses is the right
thing to do for our patients and visitors and for each other," said
David S. Guzick, M.D., Ph.D., UF's senior vice president for
health affairs and president of the UF&Shands Health System.
The new rule mainly affects a few designated outdoor smoking
and tobacco-use areas and the properties surrounding Health
Science Center and Shands HealthCare facilities. Smoking and
tobacco use are already prohibited indoors.
"The decision to have tobacco-free campuses systemwide
supports our commitment to providing a healthy environment for
our patients and to improving health in our communities," said
Tim Goldfarb, chief executive officer of Shands HealthCare.
Tobacco dependence is the nation's most preventable cause of
death and disease, including cancer, heart disease and stroke.
Nationally, tobacco use is responsible for nearly one in five deaths
or an estimated 440,000 deaths per year, according to the Florida
Hospital Association. That's approximately 1,200 people each day
- more than deaths caused by alcohol, cocaine, crack, heroin,
homicide, suicide, car crashes, fires and AIDS combined.
Currently, one out of every seven adults hospitalized at Shands at
UF is treated for cancer or cancer-related illnesses.
Throughout Florida, more than 70 hospitals support the Florida
Department of Health's "Tobacco Free Florida" campaign and
have tobacco-free campuses. Shands Jacksonville and the UF
Health Science Center-Jacksonville went completely tobacco-free
last November.
The Health Science Center and Shands HealthCare are
providing information and resources to assist employees, patients
and visitors who would like to break the habit. A wide selection of
counseling services, self-help materials and medicines are available
to help smokers and tobacco-users quit successfully. More
information is available at O

Health privacy rules to get more stringent

his month, the U.S. Department of Health and Human Services is
implementing new regulations that require stricter reporting when
patients' health privacy is breached.
Beginning Sept. 23, any individual whose protected health information has
been compromised must be notified of the security breach within 60 days after
the violation is discovered. If the data includes a Social Security number, the
breach must be reported within 45 days, according to the state.
Media organizations also must be notified within 60 days if a privacy breach
affects 500 patients or more. This new rule affects all health-care providers and
organizations required to adhere to HIPAA regulations. If 500 or more patients
are affected, the rule goes a step further, too. Breaches of this size must be
reported annually to the Secretary of Health and Human Services within 60

aiBPl i

days of the end of the calendar year.
HHS will post on its Web site the names of all providers or agencies that
report breaches compromising the protected health information of 500 or more
patients. In addition, penalties for these violations will be enforced beginning
in October 2010. HHS is also required to report all breaches to Congress.
The new regulations were established to comply with the Health Information
Technology for Economic and Clinical Health Act, which was passed earlier
this year and requires more preventive measures to ensure that protected health
information is not put at risk.
All patient information breaches must be reported to the UF Privacy Office.
For more information or to seek help, visit or
call 352-273-5094. -April Frawley Birdwell

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HSC colleges adopting, developing policies to

monitor conflicts of interest

By Laura Mize

In May, UF's College of Medicine adopted
its "Policy on Industry Conflicts of Interest/
Industry Academic Relations," which regu-
lates interaction between representatives of
companies that make pharmaceuticals and
medical devices and the college's faculty,
staff, students and residents.
Under the policy, members of the college community are prohibited
from accepting gifts from industry representatives and must receive
permission to participate in educational opportunities hosted by the
companies. The policy requires "the disclosure of outside activities
and financial interests" by college employees.
The move is in keeping with a national trend to more closely moni-
tor how students and staff from medical institutions interact with rep-
resentatives from various industries.
"People are a lot more sensitive to the relationship between physi-
cians and the drug companies and device makers," said Tim Flynn,
M.D., the college's interim senior associate dean for clinical affairs.
Sen. Chuck Grassley, a Republican from Iowa, has been pushing for
more stringent regulation of conflicts of interest in medical and uni-
versity settings. In June, he sent letters to 23 medical schools, includ-
ing UF's College of Medicine, requesting information about their con-
flict of interest policies and money received from the National Institutes
of Health. Grassley also teamed up with Sen. Herb Kohl, of Wisconsin,
to sponsor the Physician Payments Sunshine Act. If passed, the bill
would require drug and device companies to report payments they
make to doctors and practices.
Flynn is also chair of a committee addressing the issue of industry
relations policies throughout the Health Science Center, helping other
colleges develop policies that will work well together. The College of
Dentistry has a policy in place, while other Health Science Center col-
leges are developing or awaiting approval of their policies.
"The real issue is transparency and having people to be able to an-

swer the public that says ... 'Which of your doctors are giving talks for
drug companies or receiving gifts from industry and are you sure that
they're insulated from decision making about buying?' Flynn said.
The College of Medicine's policy was distributed to employees and
students by e-mail. Flynn said people are receiving it "very positively"

"Eventually, we're going to

have to set up an office of

compliance ... to be able to

answer these questions."
-Tim Flynn, M.D., College of Medicine interim senior
associate dean for clinical affairs

and that he gets many e-mails with questions about specific scenarios.
"Eventually, we're going to have to set up an office of compliance ...
to be able to answer these questions," he said.
Flynn said the college's policy, and others like it across the nation,
are not meant to squash cooperation between medical institutions and
pharmaceutical companies.
"Clearly, there's a need to relate to industry. We're a country that's
built on innovation and entrepreneurship and that's a good thing,"
Flynn said. "In no way does this policy seek to destroy that relation-
ship and synergy between the investigators and the innovators here at
the University of Florida and the people that can bring things to mar-
ket and make things happen and improve health."
Flynn added that the goal of the policy "is to provide accountability and
transparency to assure our patients we have their best interest at heart."
To view information about the bill sponsored by Sens. Grassley and
Kohl, visit and Search for bill number S301.
To view the policy, visit O




Stick a needle in your ...

UF veterinary program uses acupuncture to heal anim

Rv Alvssa I aRenzi

petting him, Buddah allows several inch-long

needles to pierce his skin on the top of his

head and side of his face.

It's been a year and a half since the big, dark gray pit bull was attacked and
bit on the head by another dog, leaving him with nerve damage, muscle
atrophy and paralysis.
Since May 2008, Buddah has visited the UF Small Animal Hospital every
month for his acupuncture treatments. In the first month, his facial paralysis
subsided. Over the nine months of treatment, Buddah has regrown much of
the muscular tissue he lost.
A timid and friendly dog by nature, Buddah has gotten used to his
appointments. He doesn't seem to notice the very thin needles being hooked
up to a machine that sends electric signals, a measure used to augment the
normal acupuncture practice of needles stimulating points on the body.
Buddah's head starts to droop.
"Points on the head cause more sedation. He gets really sleepy fast," said
Carolina Medina, D.V.M., one of two faculty members in the Acupuncture
Program at the College of Veterinary Medicine.
Acupuncture rose in popularity for humans in the 1990s, though the idea of
needles in the body for healing purposes still hasn't reached full
understanding or acceptance in the Western world. Using the practice on
animals may seem a little out of the ordinary, but the ancient Chinese healing
technique first recorded more than 2,000 years ago was also performed on
Though the traditional practice is based on the release of energy through

points in the body, Medina explained the inner workings of acupuncture from
a more scientific view. For example, if you got a cut, your body sends signals to
the brain, which sends painkillers to the wound.
"What acupuncture does is basically speeding up that process and making
your brain release more substances than you could on your own," Medina said.
"It's kind of like your body's healing itself but faster than you could and
stronger than you could."
The UF program, founded about 10 years ago, is headed by Huisheng Xie,
Ph.D., a third-generation veterinary acupuncturist, often revered as the best
in the U.S. The clinic sees about 20 to 30 animals each week, Medina said.
Though mostly dogs, cats and horses receive the treatments, Xie and Medina
care for a variety of species.
Because of Xie's reputation, people and their animals will often travel to
receive services at the UF clinic. One man drove from Michigan with his old
dog. Another brought an elephant from the Northeast.
Lynn Sickinger makes the nearly six-hour round trip drive from Ponte
Verde Beach, Fla., once every two months with her beloved border collie,
Chutney, to see Xie.
When 10-year-old Chutney's high liver enzyme levels started to get out of
control, rising into the 2,000s, far above the normal level of 118, she tried
everything to help. Sickinger had experienced the benefits of acupuncture
herself, so she decided to bring Chutney to a nearby Jacksonville
acupuncturist. The blood workup from her regular veterinarian showed the
treatment had not helped.
After some research on the Internet, a Colorado man told her she had "the
best of the best in Gainesville." She immediately took Chutney to Xie, and the
dog's liver enzyme levels dropped for the first time in almost 10 years.
Sickinger said her neighbor's 11-year-old beagle has the same problem and
has tried only a Western medicine approach. Though not all cases are the

r og-og

Saving horses

UF veterinarians treat life-threatening

equine condition

By Sarah Carey
wo horses at risk for life-threatening bleeding caused by an uncommon
infection of the internal carotid artery were successfully treated
recently by UF veterinarians who used new technology to resolve the
problem faster and less invasively than traditional surgery would allow.
"The problem both of these horses had involved a disease called guttural
pouch mycosis, or a fungal infection in the guttural pouch," said Herb
Maisenbacher, V.M.D., an assistant clinical professor of cardiology at UF's
Veterinary Medical Center. "The infection can eat its way through the
tissues in the back of the throat, potentially rupturing the arteries."
Typical symptoms include bleeding from the nose, Maisenbacher said. UF
veterinarians treated the first horse in October 2008, and the second in May.
Lynne Kimball-Davis, of Wellington, Fla., recalled the late October
morning when she went to feed her horse, a Dutch warmblood named Upper
Class, and discovered him in his stall bleeding from the nose.
"It looked like he had been massacred," she said.

With the assistance of visiting professor Dr. Jose Zilberschtein, veterinary
acupuncturist Dr. Carolina Medina performs acupuncture on Buddah,
who receives monthly treatments. The treatments have helped the gray
pit bull recover much of the muscular tissue he lost when another dog
attacked him last year.

same, she said the differences between the two dogs are "day and night."
Acupuncture, herbs and other recommendations from Xie have given Chutney
a happier quality of life. She runs like a puppy (a common benefit of acupuncture
for dogs), her coat has improved and her liver enzyme levels are safely declining.
So when Sickinger heard that the program was on a list of possible budget cuts
for the college, she was devastated. She wrote a letter to the dean discussing
Xie's talent and reputation, the benefits of combining Eastern and Western
medicine and the forward thinking of UF by including the program in its
veterinary education.
Based on the success rate, popularity of the program and uproar from students
and faculty, the program wasn't in jeopardy long, said Jennifer Burroughs, a
third-year veterinary student.
Burroughs, who took acupuncture as a two-week summer elective, said she
became interested in acupuncture at a local barn where she rode horses. She saw
Xie's acupuncture treatments cure a lame horse.
Without the opportunity at UF, she doubts acupuncture would have crossed
her mind. The practice isn't really discussed in classes, but the elective fills up
quickly. Hoping to become an equine veterinarian, Burroughs said she plans to
take acupuncture courses to include the method in her own practice.
"This is our only chance to learn this," she said. "And it helps so many people
and animals."
Buddah, the sleepy pit bull, has made progress in regrowing muscles, a
difficult process that sometimes doesn't yield a result. After his 20-minute
session, he arose with a wagging tail, kissed the people who had surrounded him
and headed for the door.
Medina takes all her tools and fits them into a case no bigger than a child's
Buddah will be back again next month.
"He's still receiving treatments so hopefully one day his head will look
normal," Medina said. "But right now it is much better than it was last year." 0

r- 3- .. .. : ....

Kimball-Davis rushed her horse to Palm Beach Equine Clinic, where
veterinarians determined a referral to UF was necessary. Upper Class
returned home after about a week at UF, and has made steady progress since
then, she said.
Freeman, an equine surgeon, collaborated with Maisenbacher's cardiology
team to treat both cases. In each case, a device known as a vascular plug was
inserted to occlude the at-risk artery. Before that, surgeons access the carotid
artery through a small incision in the neck and use a contrast agent to find
the damaged vessels before blocking them off.
"The affected area is difficult to approach surgically, but it's been done
before," Maisenbacher said. "What made our approach unique is that we
were able to make the procedure go more smoothly by using newer devices to
achieve the same result."
The procedure takes between two and three hours, he added.
"Once the animals wake up from anesthesia, they are almost back to their
normal selves," he said. "The other advantage is that the devices offer the
ability to access vessels that by traditional methods are very difficult to get
to. Plus, there really is no other medical treatment for this condition." 0


00 14"


Project Eastside

UF clinic launches effort to improve health in East Gainesville


By April Frawley Birdwell

n a Saturday in June, tables strewn with
information about affordable insur-
ance, free health checks and prescrip-
tions were scattered throughout the Eastside
Community Practice. At one table, a volunteer
took the blood pressure of an elderly woman. At
another, a young man was checked for diabetes.

Outside the clinic, smoke curled from a barbecue, drawing a small crowd
of people lugging red bags stuffed with health information. Nearby, other
volunteers fitted children for safe bicycle helmets and checked the safety of
a new mother's car seat.
The event may have seemed like just another health fair to some attend-
ees. But to Kendall Campbell, M.D., medical director of the Eastside
Community Practice, having a packed house on a Saturday was a huge step
forward in an effort he launched at the clinic more than a year ago.
Located on Waldo Road just north of University Avenue, the Eastside
Community Practice sits in an area with the highest rates of cancer deaths,
infant mortality and sexually transmitted diseases in Alachua County, ac-
cording to the 2008 Alachua County Health Report Card. That's why
Campbell set out on a mission to improve prevention efforts in the commu-
nity, recruiting more patients and offering services geared toward taking

l llIBPi1

care of patients year-round, not just when they're sick.
"What we're essentially trying to do is not be the 'doc in the box,"' Campbell
said. "We want to be more proactive and go out in the community."
Because of the unique challenges in the community, the Eastside Community
Practice doesn't operate like a typical clinic. It's an interdisciplinary effort -
family doctors team with pharmacists, pediatricians, mental health counselors,
nurse practitioners, nurses and a social worker to help patients. It has a diverse
patient population, too. Some patients have insurance. Some don't. For these
folks, the help doesn't end there. The clinic's social worker works with patients
who are unemployed to help them find jobs or even training so they can get a
better job with insurance.
"It's more of a one-stop shop for people here, to help get them on their feet and
not continue in their state of helplessness and hopelessness," Campbell said.
"We're saying 'You can do this thing, and I'm going to help you.'"
To reach out to new patients, clinic staff members have performed health screen-
ings at community locations such as Wal-Mart or local churches. Staff members
help potential patients figure out if they qualify for programs such as CHOICES, a
county program that gives the working uninsured access to needed health services.
Campbell has also started a medication voucher program using donations.
In November, the clinic is teaming with the department of urology to raise
prostate cancer awareness. And they aren't just sitting back and waiting for the
patients to come to them, they're take the message into the community, to min-
isters and to barbershops. The clinic received a grant from the U.S. Department
of Women's Health to help train people in the community how to fight child-
hood obesity.
Eventually, Campbell said he plans to use a mobile unit for screenings and
other health services.
The clinic is also implementing a wellness program to prevent health prob-
lems and ensure that patients are following doctors' orders even when they don't
have appointments. A big part of this effort is a disease management registry
Campbell and his staff have developed.
The registry will allow the clinic to easily keep track of patients who have
conditions such as diabetes or asthma and will categorize them based on how
they're managing the disease, Campbell said. This will allow clinic staff mem-
bers to focus on specific patients who need to be followed more closely.
"The thing we have to do first is start the data-gathering process," Campbell
said. "How many diabetics are here? How many of our kids have up-to-date im-
Overall, Campbell's biggest goal is to increase health-care opportunities for
people in East Gainesville. He would like to keep the clinic open later so under-
insured workers who can't leave their jobs during the day can come to Eastside
after hours when they're sick instead of going to a hospital emergency room for
primary care. He also hopes to collaborate with physicians in the department of
emergency medicine to encourage homeless and uninsured East Gainesville
residents to go to the clinic instead of using emergency services as primary care.
Of course, these goals require money, Campbell says. He's working with UF
development officers to raise money for the clinic and has hired a grant writer to
work on securing grants for the clinic. The clinic also receives funding through
the Alachua County Area Health Education Centers. Every dollar or collabora-
tion helps.
"We have a lot of educating to do," Campbell said. "We have a lot of work to
do on health care in East Gainesville." 0

Visit us online @ for he latest news and HSC events I


College of Pharmacy professor Leslie Hendeles, recently took a sabbatical to teach in Israel.

By Alyssa LaRenzie

Though Leslie Hendeles, Pharm.D., had visited Israel three times
before, this was his first time living there on an extended stay. Almost

every evening, he set out from his Jerusalem apartment, walking

down a different path with his wife to choose a restaurant for dinner. Far

from home, Hendeles had also set out on a different path in his career.

Time off for research or writing is common
for professors taking a sabbatical, but Hendeles
took time off to teach.
Hendeles, a professor of pharmacy and
pediatrics, took a break from a group of about
1,200 Doctor of Pharmacy students at UF to
teach the eight students who make up Israel's
first Pharm.D. class at the Hebrew University.
Though the Pharm.D. has become the
standard to practice pharmacy in the United
States, most pharmacists in Israel hold a
bachelor's degree in pharmacy. At UF, most
students take two years of undergraduate classes
before entering a four-year Pharm.D. program.
The new program at Hebrew University involves
a four-year bachelor's degree followed by a
three-year Pharm.D. program that also includes
a research project.
The Pharm.D. program was designed to give
students the opportunity to be better clinical
pharmacists those who work in hospitals and
clinics alongside physicians.
Invited to teach for the full spring semester,
Hendeles decided to stay two months so he
wouldn't miss too much time from the Asthma
Lab at UF. His classes focused on his

specialties: drugs for asthma and allergies.
He taught for the degree program's first class,
which included five Jews and three Arabs.
"I was really impressed with how these Arab
students and the Jewish students were
collaborative and working together and helping
each other in the midst of rockets being fired in
the Gaza Strip," he said.
Hendeles served as a career role model for the
aspiring students, since no one has yet earned a
Pharm.D. degree in Israel, said Amnon
Hoffman, the head of the clinical pharmacy
program at Hebrew University.
During his short visit, Hendeles became a
close colleague and a mentor in the new degree
endeavor, giving Hoffman a connection to a
university that has offered the Pharm.D. degree
for more than 30 years.
"It is encouraging for me to know that there is
a group of people who can help," Hoffman said.
For Hendeles, teaching didn't stop in the
classroom. He took his areas of expertise to
Hadassah, the hospital that Hebrew University
partners with, teaching the pediatric doctors
about improving the delivery of asthma
medications to children.

"The chief of pediatrics recognized that the
pediatric residents were not getting enough
training from the pediatric pulmonologists, and
yet they graduate from the program and have to
go to clinics where they take care of asthma
patients," Hendeles said. "So he saw this as an
opportunity to capitalize on me being there."
As Hendeles has done much of his research on
inhaled asthma medications, he cued in quickly
on a common problem. In the hospital, a less
effective medicine was still being used to treat
asthma and doctors often didn't give inhaled
medications for patients to take home. Because
many children didn't have these at home or
know when to use them, several children were
admitted to the hospital for asthma attacks,
which often can be avoided with a few steps.
Based on written instructions for identifying
and diagnosing asthma patients used in
Gainesville and on the Web, a pediatric health
educator wrote similar instructions in Hebrew
for the hospital in Jerusalem with the help of
Hendeles and the chief of pediatrics.
Though Hadassah has some advanced
technologies that Shands doesn't yet have,
Hendeles said his experience with the pharmacy at
the hospital in Jerusalem gave him a new
admiration for how pharmacy is practiced in
hospitals in the U.S.
"In the time that I've become a pharmacist,
we have come so far," he said. "What I've
realized is how much more pharmacists are
involved in improving the use of drugs in
patients in this country and at this health center
and in our state." 0



Two UF communication science departments move forward as one

ByJill Pease

wo UF communication science departments have joined to form the largest
academic program of its kind in Florida.
The merger of the department of communication sciences and disorders in
the College of Liberal Arts and Sciences with the department of communicative
disorders in the College of Public Health and Health Professions was announced in
May as part of a series of university cost-cutting measures.
Now, the newly created department of communicative disorders is moving for-
ward with a broad base of academic and clinical research programs.
"We worked closely with the dean of the College of Liberal Arts and Sciences and

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the chairs of the respective departments to develop a plan that would eliminate du-
plication, reduce costs and produce a merged department with a stronger focus on
research and Ph.D. education," said Michael G. Perri, Ph.D., interim dean of the
College of Public Health and Health Professions.
The expanded department, located in the College of Public Health and Health
Professions, has 45 faculty members. U.S. News and World Report ranks the depart-
ment's Doctor of Audiology program sixth in the nation and the master's in speech
pathology 12th. The newly merged department offers a Ph.D. program in areas of
speech, language and hearing science.
The department also delivers a full range of speech and hearing clinical services
and partners with Shands HealthCare for rehabilitation services.
"We couldn't be more excited to be in the College of Public Health and Health
Professions and the Health Science Center, where the flexibility and clinical re-
search focus allows us to maximize growth," said Christine Sapienza, Ph.D., who
was named chair of the newly expanded department after serving as the chair of the
department of communication sciences and disorders in the College of Liberal Arts
and Sciences since 2005. "We are now next to our colleagues in PHHP and down the
road from the College of Medicine, allowing us to optimize the clinical training
model that should be going on at a university like UF." 0

Students file into the HPNP Complex for the College of Public Health and
Health Professions' student welcome ceremony. The college recently
received five-year accreditation as a school of public health by the Council
on Education for Public Health.

Another PHHP milestone

College receives public health accreditation

ByJill Pease

he College of Public Health and Health
Professions has been awarded five-year accred-
itation as a school of public health by the
Council on Education for Public Health, an indepen-
dent agency recognized by the U.S. Department of
Education. The college joins only 41 U.S. universities
that have received accreditation in public health at
the college level.
"Our college has developed a unique educational
model that promotes collaboration across public
health and health professions disciplines, two areas
that have traditionally operated independently of
each other," said Michael G. Perri, Ph.D., interim
dean of the college. "By combining the public health
focus on populations and prevention with the indi-
vidual treatment perspective of the health profes-
sions, we have created important synergies in educa-
tion, research and service."
The collaborative missions of the College of Public
Health and Health Professions are critical to the fu-
ture ofUF's entire health-care enterprise, said David
S. Guzick, M.D., Ph.D., senior vice president for
health affairs and president of the UF&Shands

Health System.
"Research in the college epidemiologic, biosta-
tistical, behavioral and health services is especial-
ly pertinent to the national focus on improving
health-care access and quality in a cost-effective
manner, and the training of health professionals in
key areas of need promotes high-quality care at
Shands and at other health-care facilities in the
state," Guzick said.
To develop a new public health enterprise, the col-
lege established departments of epidemiology and
biostatistics; environmental and global health; and
behavioral science and community health. The col-
lege also added two Ph.D. programs, one in epidemi-
ology in conjunction with the UF College of Medicine
and the other in biostatistics. The college expanded
the Master of Public Health degree and added a dis-
tance-learning certificate in public health, and an
online M.P.H. degree is in the works. These pro-
grams complement the college's existing academic
programs, including three Ph.D. degree programs,
two professional doctoral programs, three master's
degrees and a bachelor's degree in health science. 0

Doctor of Audiology program graduate Sinah
Seoke fits patient Cindy Normand with a hearing
aid. The College of Liberal Arts and Sciences
department of communication sciences and
disorders and the College of Public Health and
Health Professions department of communicative
disorders recently joined to form the largest
program of its kind in Florida.

[Joining forces]

rllr-ol i




or ers

Globetrotting student part of new
Doctor of Nursing Practice program

By Tracy Brown Wright

In a span of seven years, Sara Nowlis has
provided nutrition workshops to rural
villagers in West Africa as a member of
the Peace Corps, worked in an oncology
ward of a Jacksonville hospital, served as the
tuberculosis case manager in the Anchorage,
Alaska, health department and worked with
an interdisciplinary health team in Uganda
providing care for AIDS patients also suffering
from TB.
She also found time to obtain her nursing degree, which was her
second bachelor's degree in four years.
Nowlis now finds herself back in Gainesville, site of her alma mater,
where she received her bachelor's degree in health science education in
2001. She is a pioneering member of this year's inaugural class of the
BSN to DNP program in family nursing.
Nowlis, who joined the Peace Corps immediately after her
graduation from UF in 2001 and served for two years, found herself
wanting to provide more than just education to people in need.
"There was so much that was lacking in terms of primary care for
these people, and I wanted to be in a position where one day I could
travel to places like this and help provide this care, which is so
desperately needed," Nowlis said.
After the Peace Corps, Nowlis found her way to the University of
North Florida's accelerated BSN program in her hometown of
Jacksonville. After a short stint in an oncology ward at a local hospital,
she felt the itch to move on to something else. And for Nowlis, that
meant somewhere not exactly around the corner like Anchorage.
Even while she enjoyed her experience there, she wanted to return to
the humanitarian care that she had provided while in the Peace Corps.
She applied for Doctors Without Borders, an international medical
humanitarian organization created by doctors to assist both Third
World countries and those that have suffered great catastrophe. Within
five months, Nowlis found herself in Uganda treating HIV/AIDS
patients with a team of health-care professionals.
But Nowlis' journey was far from over. While in Uganda, she
decided to apply for the UF DNP program to begin in fall 2009. This
involved studying for and taking the GRE overseas, but like her other
endeavors, she was up for the challenge.


Sara Nowlis is one of the first 152 students in a new College of Nursing
program that allows bachelor's degree-trained nurses to earn the Doctor of
Nursing Practice degree. Before coming to UF, Nowlis served in the Peace
Corps, worked with tuberculosis patients in Alaska and worked with HIV
patients in Uganda.

"I always knew I wanted to advance my education and I wanted to
go to the best program in Florida," said Nowlis, who is a full-time
student. "UF's nursing program is very well-respected, and I had a
great experience at UF as an undergrad."
And it is appropriate that Nowlis is part of the first class of BSN to
DNP students, as she has never been afraid to venture down
unknown paths or parts of the world.
"It is kind of exciting to be at the start of something new in the
nursing profession," Nowlis said.
As for the future, Nowlis is happy to stay in Gainesville for the
time being pursuing her degree. But after that, who knows?
Global and humanitarian health care is a passion of hers, and she
would like to try another stint with Doctors Without Borders. But
eventually, she would like to stay in one place and be settled, perhaps
in a private practice.
"This degree will open up a lot of doors for me," Nowlis said.
"Even if I do settle somewhere, I know that my heart will lead me to
working with underprivileged groups in need of health care here in
the United States. It's truly been my calling." 0

About the BSN to DNP program:
Nowlis is one of the first 152 students in a new UF program that allows people who
have bachelor's degrees in nursing to enter directly into study for the Doctor of
Nursing Practice degree. UF is one of the first nursing schools in Florida and across
the country to have a program like this. The U.S. Health Resources and Services
Administration Department of Health and Human Services awarded more than
$900,000 to the college to facilitate transition of its advanced practice nursing
education program from the master's to the doctoral level. This strategic move will
increase availability of primary health-care providers in underserved areas and help
address the critical nursing faculty shortage.


O FZ NS M, T L. S A /D


alipay Acevedo wasn't
due to have her baby for
another month, when one
sleepy Sunday morning
recently she felt her
stomach drop. No pain. No
contractions. She was just
gushing blood.

Her husband, Miguel, called the ambulance to their Tampa home. Kalipay passed out on the
way to the hospital.
She had had a placental abruption, a condition in which the placenta detaches prematurely
from the uterus. The resulting loss of oxygen and glucose to the baby's brain caused a condition
called hypoxic-ischemic encephalopathy.
Doctors quickly delivered baby Sianna Marie Acevedo by Caesarean section. But she wasn't
breathing. In fact, she didn't breathe for about 14 minutes. Her little heart pumped at just 30
beats a minute much slower than the 100 to 160 beats a minute considered normal for new-
borns. She was pale and wasn't moving.
"I broke down. I thought I had lost my child," Miguel Acevedo says.
Within the hour, Sianna was on her way by helicopter to Shands at UF. There, neonatologist
Michael Weiss, M.D., and his team in the neonatal intensive care unit have been using a body
cooling technique to try to stave off damage to the brains of babies like Sianna.
Weiss and his team started quickly to carry out the procedure, called systemic hypothermia.
They placed the baby on a pad attached to a temperature control machine, cooling her body to

121^ i


Visit us online @ for he latest news and HSC events

about 7 degrees Fahrenheit lower than normal body temperature for 72
hours. EEG electrodes attached to her head allowed monitoring of her brain
activity patterns that could give clues about how she will fare after the treat-
ment. A cerebral saturation monitor, connected to the lead on the baby's
forehead, gave Weiss an idea of blood flow to the brain. UF is one of the few
institutions to use this monitor and one of the few in the state to offer the
cooling procedure.
Before 2004, when babies with diagnoses like Sianna's came in, all doc-
tors and nurses could offer was "supportive care" such as monitoring the
baby's blood pressure and glucose levels, checking that the kidneys are
working properly and stanching any bleeding.
"There was nothing we did that was geared at minimizing the amount of
injury the brain had," Weiss says.
Now, even though the cooling procedure is available, it is not universally
used. Weiss is trying to change that by teaching colleagues at other hospi-
tals about the technique.
He and other health professionals and researchers at UF and Shands con-
tinuously seek out new ways to help patients, often when there are no alter-
natives. In so doing they help to make UF and Shands a fertile ground for
development and use of new medical technologies, whether it's using brain-
saving cooling protocols, developing new vaccines or exploring new appli-
cations for robot-assisted surgery.
"I think UF has a lot of highly intelligent investigators who are working
to get new therapies to patients," says Johannes Vieweg, M.D., chair of the
department of urology, which has a division of robotics and minimally in-
vasive surgery. "We want to be known as a hub for innovative therapies."
New initiatives such as UF's Clinical and Translational Science Institute
and the Florida Innovation Hub serve to foster a culture of technology and
invention and speed new discoveries to patients.
Weiss has treated 10 babies with the cooling procedure in the two years
since he started offering it. Now, he is trying to help even more babies
around the state. He is applying for a grant from the CTSI to develop the
Florida Neurologic Network, a collaboration among the UF and Shands
hospital system and other academic and private hospitals in North Central
Florida that aims to improve the hypothermia technique, instruct other
doctors on its use and make it more widely available.
"To me that's really exciting to be able to get it out to more people," says
Chris Batich, Ph.D., associate director of the CTSI, who works to bring
physicians into collaborations with engineers, scientists and other experts
who can turn research ideas into technologies that can help even the littlest
of patients, like Sianna, and bring them into widespread use.
Whether it's in caring for newborns or helping people struggling with
infertility, new technology at UF is giving people hope.

Robot-assisted surgery, which came into use in the United States in 2001,
has enhanced treatment offerings and outcomes for patients. Robotic sur-
gery allows surgeons to operate through small incisions in the body. That
helps reduce recovery time, blood loss, postsurgery pain and scarring com-
pared with so-called "open surgery" in which large incisions are made in
the body to remove diseased tissues and organs.
In robotic surgery, the surgeon uses joysticks to operate the robot re-
motely from a console a few feet away. The surgeon also "drives" the robot
using gearshifts and foot pedals, making surgical movements that the robot
mimics. The four arms hold small surgical and monitoring instruments.
With its many mechanical joints, the computer-driven robot allows easier
access to hard-to-reach areas of the body. The machine eliminates hand
tremor and excessive movement by refining the surgeon's wrist movements,
scaling them down to one-fifth of the normal motion.

contc/ied oH page

Miguel Acevedo spends a few minutes with his daughter. Sianna. in
the neonatal intensive care unit at Shands at UF.

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Robot-assisted surgery gives surgeons a high-definition view that
can be magnified up to 12 times. The robot also allows surgeons to
make more precise cuts.

A telescopic binocular lens gives surgeons a sharp, high-definition 3-D live
view that is magnified up to 12 times. That allows them to anticipate bleeding
earlier and minimize blood loss. They can also cut more carefully in a way
that preserves muscles, nerves and other tissues near the surgical area.
"The way to think about robotic surgery is as an extension of a skill set
surgeons already have," says Li-Ming Su, M.D., chief of robotic and mini-
mally invasive urologic surgery in the College of Medicine. "If we can see
better, then we can perform better and more precise surgery."
Robotic surgery is employed in a variety of disciplines, including pediat-
rics, cardiology and gynecology. But it's urology where the technology seems
to have taken off, sprouting a host of applications. UF's urology department
has five surgeons with advanced fellowship training in robotic surgery.
Sijo Parekattil, M.D., for example, uses the robot for microsurgical treat-
ments intricate surgery on small body structures in applications such
as testicular sperm extraction, tying off varicose veins within the testicles,
vasectomy reversal and treating chronic testicular pain. He has performed
more than 100 robotic microsurgical procedures.
Parekattil, director of male infertility and microsurgery in the urology
department, is presenting his work later this year at the World Congress of
Urology in Munich.
In women, robotic surgery can help correct vaginal prolapse a condi-
tion in which organs such as the bladder, bowels or uterus protrude into the
vaginal canal because of the failure of support structures within the pelvis.
That can occur as a result of childbirth, pregnancy, aging or other factors.
Through five small incisions in the abdomen, Louis Moy, M.D., director of
female urology and reconstructive surgery, robotically creates new support
f.. the vagina and pelvic organs with a synthetic mesh anchored to the bony
part of the pelvis.
"It's really no different from open abdominal surgery, just less invasive,"

A/ the better
Robots have dramatically improved surgeons' ability to see what they are
doing. Su is taking the technology a step further in order to improve the
visibility of hard-to-see tumors deep within the kidneys.
"If you can't see it, where do you cut?" Su says.
He's trying to solve that riddle using a technique called augmented vir-
tual reality, which involves creating 3-D images of the kidney from MRI
and CT scans, and overlaying them in real time on the surgeon's robot-eye
field of vision.
"It essentially provides a road map of where to cut," he says.
Now, he is trying to develop collaborations with UF mechanical and bio-
engineers to establish a multidisciplinary team to bring the idea to fruition.
To give gastroenterologists a live camera view rather than an indirect
X-ray view in difficult procedures involving narrowing or large stones in
the gallbladder, bile ducts, pancreas, and liver, Peter Draganov, M.D., and
Chris Forsmark, M.D., chief of the division of gastroenterology, hepatology
and nutrition, collaborated with Boston Scientific during development of a
technique called direct visualization cholangioscopy. UF was the first in
the nation to have it after its 2006 FDA approval.

While robotic surgery and other minimally invasive surgical techniques
aim to make small incisions and leave the smallest scars possible, other
techniques aim to leave no scars behind.
When it comes to avoiding scars, a new technology called the NanoKnife
is a master. Applied in the treatment of conditions such as liver, lung and
kidney disease, it kills lesions in soft tissue without damaging surrounding
structures such as blood vessels and nerves. Only about 20 institutions
around the world offer this technology, and UF has been given the option
to have it too.
NanoKnife surgery involves shocking cells of lesions with electrical cur-
rents supplied by tiny electrodes. That causes the cells to open and lose the
key components needed for life. Those cells die a natural death and are
cleared away and replaced by the body's healing processes, leaving no scars.
"This technology has much less collateral damage than other techniques
that we use, and in addition, it's faster," says James Caridi, M.D., chief of
the division of vascular and interventional radiology.
Another UF gastroenterologist is researching no-scar surgery through al-
ready existing body openings such as the mouth, rectum, vagina or urethra.
This "natural orifice" surgery involves making incisions inside the gas-
trointestinal or reproductive tract to get to other organs. That goes against
traditional medical training and practice.
"'Don't make a hole that's what we've been taught and that's what's in
our textbooks, but now that may change," says Mihir Wagh, M.D., an assistant
professor in the department of gastroenterology, hepatology and nutrition.
Unintentional perforations in the GI tract can be dangerous, causing its
contents to leak into the chest or abdomen.
But in animal studies, Wagh has intentionally made holes in the stomach
and colon to remove the uterus, ovaries and gallbladder, then closed the holes
from inside, leaving no external scars. Wagh has presented his work at na-
tional and international meetings in October he will present in Germany.
Many questions medical and otherwise surround the technique.
Who should perform it a gastroenterologist? A gynecologist? A surgeon?
How would practitioners be trained? And would insurers cover the novel

11 44

aIl 00

Visit us online @ for he latest news and HSC events I

UF neonatologist Dr Michael Weiss used a new cooling technique
on newborn Sianna Acevedo. who was deprived of oxygen during
birth, to help stave off brain damage. The white pad underneath
her is used to regulate her temperature.

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The rise of

liver cancer

By Czerne M. Reid
Treating liver cancer can be tricky be-
cause physicians have to watch out for un-
derlying liver disease at the same time.
Hepatologist Roniel Cabrera, M.D., M.S., an
assistant professor of gastroenterology,
hepatology and nutrition, is part of a
unique multidisciplinary initiative at UF in
which physicians of various specialties
meet to discuss the appropriate course of
treatment for such patients. He talks with
The POST about rising liver cancer rates
and UF's unique multidisciplinary liver

cancer clinic.

How many people does liver cancer affect?
Liver cancer is a major global health problem. It is the fifth most common cancer
in the world and the third leading cause of cancer-related deaths. There are more
than 600,000 new cases a year worldwide, and nearly the same number of related
deaths, despite new therapies. That tells us we have a long way to go to influence
the natural history of this disease.

Liver cancer rates are rising while other cancers
are declining why?
Liver cancer is the most rapidly rising cancer and this is directly attributable to the
epidemic of chronic hepatitis C-related cirrhosis. About 4 million people in the United
States are infected with chronic hepatitis C up to half of those are undiagnosed
and untreated. Most got infected 20 or 30 years ago while using intravenous drugs,
but it takes that long for the virus to cause cirrhosis. Eighty to 90 percent of patients
with liver cancer also have cirrhosis, which is the main risk factor. Other risk factors
are hepatitis B infection and alcoholic cirrhosis. However, in the U.S. the rates of
hepatitis B and alcohol-related liver cancer have remained unchanged for decades.
Given the epidemics of obesity and diabetes in the United States, it is very likely that
the metabolic syndrome, including nonalcoholic steatohepatitis, or NASH in which
fat accumulation in the liver causes inflammation and cirrhosis over time will be
a major emerging risk factor for liver cancer. In fact, both obesity and diabetes have
been shown to be independent risk factors for chronic liver disease and liver cancer.

Can people reduce their risk for liver cancer?
Yes, and the first step is to recognize the risk factors for chronic liver disease includ-
ing exposure to viral hepatitis B or C via unprotected sex with multiple sex partners,
sharing needles, blood transfusions particularly before 1990 obesity, diabetes,
and family history of liver disease or liver cancer. Individuals with those risk factors
should have bloodwork done to check if they have viral hepatitis or other conditions
that cause chronic liver disease. Treatment can decrease the risk of developing cir-
rhosis and liver cancer in up to half of all cases of hepatitis C. Checking for cirrho-
sis by physical exam, bloodwork and/or an imaging study is also important.
People with cirrhosis have a 3 percent to 5 percent chance a year of developing liver
cancer and should be monitored with an imaging study every six months.

Tell me about treatment for liver cancer.
Treatment can be overwhelming for patients, since most who have liver cancer also
have underlying cirrhosis and the conditions are very complex to manage. Both
must be considered during treatment. By the time most patients present with liver
cancer they are at advanced stages beyond eligibility for curative treatment such
as liver transplantation or resection. Treatment options are then limited and mostly
palliative. That might include embolizations which block blood flow to tumors,
but which have the potential to worsen the cirrhosis. In 2008 the FDA approved the
first pill shown to improve survival in advanced liver cancer. While this is a major
step forward, treatment with the pill called sorafenib improved survival by three
months compared with placebo, so we need to do better.

What aresome innovations in liver cancer treatment
at UF?
One of the unique things we've done at Shands at UF is create a one-stop shop, liver
cancer clinic to streamline patients' diagnosis and individualize their treatment plan
according to the extent of the tumor and the severity of the cirrhosis. Physicians from
multiple disciplines hepatobiliary surgeons, radiologists, hepatologists, patholo-
gists and oncologists sit together in one room to come up with a personalized
plan. That prevents patients from having to visit each doctor individually, which
could take months and delay treatment. We have been doing this clinic for over
two years and have presented our experience with this clinic at the 2008 annual
American Society of Clinical Oncology gastrointestinal cancer meeting. 0


l llIBPi1

Visit us online @ for he latest news and HSC events I

Gaining insightt

Vision researchers make unexpected discovery in blindness trial

ByJohn Pastor
scientists have discovered that even in adults born with extremely
impaired sight, the brain can rewire itself to recognize sections of the
retina that have been restored by gene therapy.
The discovery of the brain's surprising adaptability comes a year after three
blind volunteers received doses of corrective genes to selected areas of their
retinas at Shands at UF.
Now, more than a year later, researchers say tiny portions of the patients'
retinas that have received gene therapy have kept their restored function, as
much as 1,000-fold increases for day vision and 63,000-fold for night vision.
But in an unexpected finding, scientists writing in The New England Journal
of Medicine Aug. 13 say the treated parts of the retinas may have acquired
enough image-processing strength to rival the retina's normal center for visual
perception, called the fovea, for the brain's attention.
The discovery suggests that even in adults with mature visual circuitry, the
brain can find new ways to process optical information, say researchers with
the UF Powell Gene Therapy Center and the Scheie Eye Institute at the
University of Pennsylvania.
"When one patient came back for her 12-month visit, she said she could read
the digital clock in her parents' car with her treated eye something she was
never able to do before," said William W. Hauswirth, Ph.D., a professor in the
ophthalmology department at the UF College of Medicine. "That prompted us
to measure where her gaze was fixed while looking at a variety of dim targets.
This showed that she now has two preferred centers of vision rather than one,
depending on the brightness of the object."

The new region is more sensitive to light, but it is not as precise as the fovea
for making bright images sharp.
The patients have a rare, incurable form of blindness called Leber congenital
amaurosis type 2, the most common cause of blindness in infants and children. In
the type 2 form, photoreceptor cells cannot respond to light because a gene called
RPE65 does not properly produce a protein necessary for healthy vision. O

One cell leads to another

UF scientists program blood stem cells to become vision cells

ByJohn Pastor
U F researchers were able to program bone marrow stem cells to repair
damaged retinas in mice, suggesting a potential treatment for one of the
most common causes of vision loss in older people.
The success in repairing a damaged layer of retinal cells in mice implies that
blood stem cells taken from bone marrow can be programmed to restore a
variety of cells and tissues, including ones involved in cardiovascular disorders
such as atherosclerosis and coronary artery disease.
"To our knowledge, this is the first report using targeted gene manipulation
to specifically program an adult stem cell to become a new cell type," said
Maria B. Grant, M.D., a professor of pharmacology and therapeutics at UF's
College of Medicine. "Although we used genes, we also suggest you can do the
same thing with drugs but ultimately you would not give the drugs to the
patient, you would give the drugs to their cells. Take the cells out, activate
certain chemical pathways, and put the cells back into the patient."
In a paper slated to appear in the September issue of the journal Molecular
Therapy, scientists describe how they used a virus carrying a gene that gently
pushed cultured adult stem cells from mice toward a fate as retinal cells. Only
after the stem cells were reintroduced into the mice did they completely
transform into the desired type of vision cells, apparently taking
environmental cues from the damaged retinas.
After studying the cell-transformation process, scientists were able to bypass
the gene manipulation step entirely and instead use chemical compounds that

ti -,--

mirrored environmental conditions in the body, thus pointing the stem cells
toward their ultimate identities as vision cells.
"This work applies to 85 percent of patients who have age-related macular
degeneration," Grant said. "There are no therapies for this devastating
disease." 0



Exergame away the pain?

New UF study to examine effect of health
games on exercise, chronic pain

New hope for rare

U F researchers
have safely given
new, functional
genes to patients with a
hereditary defect that can
lead to fatal lung and
liver diseases. Three
patients were able to
produce trace amounts of


the protective form of a
protein called alpha-1 MARK L. BRANTLY, M
antitrypsin for up to one
year, said College of Medicine researcher Mark L.
Brantly, M.D., first author of the study. This could be
a potential step toward a gene therapy for about
100,000 Americans with alpha-1 antitrypsin
deficiency, a condition that leaves patients vulnerable
to infection and life-threatening lung disease. The
results of the clinical trial were reported in August in
the online early edition of the Proceedings of the
National Academy of Sciences.


A new study combines physical activity with interactive video games to examine pain
levels of women with knee osteoarthritis. Peggy Smith, recruitment coordinator for the
Aging and Rehabilitation Research Center at UF, tries out the bike as Rida Laeeq,
student volunteer research assistant, watches.

By ill Pease

Leukemia's genetic links
A ulticenter
team of
cancer researchers has
discovered two genetic
variations linked to an
increased risk for acute
lymphoblastic leukemia,
or ALL, the most
common childhood
cancer in the United
States. Because these
genetic glitches point to MEENAKSHI DEVIDAS, PH.D.
a specific subtype of the
disease, identifying them in children who already
have leukemia could improve treatment, says UF
epidemiologist Meenakshi Devidas, Ph.D., a
co-author on the study published recently in Nature
Genetics. Children with this specific subtype of ALL,
known as B-hyperdiploid, tend to respond well to
chemotherapy. Led by St. Jude Children's Research
Hospital scientist Mary Relling, the research resulted
from a genomewide association study to check for
genetic variations linked to the common cancer.

If exercise is fun, could it distract you from the pain of aching

That's a question UF researchers hope to answer with a new study that will examine pain
levels of women with knee osteoarthritis as they participate in "exergaming" physical activity that
combines interactive video games.
The study is supported by a $113,000 grant from the National Institute on Aging to UF's Claude D.
Pepper Older Americans Independence Center.
"Arthritis is one of the leading causes of pain," said lead investigator Bridgett Rahim-Williams,
Ph.D., M.P.H., M.A., a research assistant professor in the College of Public Health and Health
Professions' department of behavioral science and community health. "Physical activities, such as
walking, swimming and cycling, have been shown to have significant benefits, including reducing
pain and improving quality of life for persons with arthritis. We hope to learn from this study the
impact of pain on physical activity and if participants who enjoy the exercise will report less pain."
The most common type of arthritis, osteoarthritis, is caused when joint cartilage wears down. The
Arthritis Foundation estimates that 27 million Americans have osteoarthritis, with knee and hip
joints most frequently affected by the disease.
During the study, the women will ride a stationary bike that is connected to a popular car racing
video game. Riders control the car on the screen with their pedaling as they compete against other
virtual cars. Participants will cycle for 15 minutes with and without the game and will be asked to rate
their pain levels at five-minute intervals.
"If women find a physical activity that is fun, perhaps they will do it even in the face of pain, and
when people are more physically active their health outcomes improve," Rahim-Williams said.
Researchers are seeking African-American and Caucasian women who are between the ages of 50
and 70 and have a diagnosis of knee osteoarthritis to participate in PPAAS: the Pain, Physical
Activity, Aging and Arthritis Study. The one-time visit will last up to two hours and participants will
receive a $50 gift card as compensation. For more information, please call 352-273-6091. O

18 ;I

_ ----I r- II -'-~-`-I~y_-2



College of Dentistry researcher Shannon
Wallet (left) obtained funding for her research
from a $2 million grant the college received to
bolster translational science. Dr. Luciana
Shaddox's team (below) works with Wallet to
uncover why a population of children in
Tallahassee has aggressive periodontitis.



By Laura Mize

Shannon Wallet, Ph.D., joined the College of
Dentistry faculty in 2007, thanks to a grant
focused on improving research efforts at dental
schools from the National Institute for Dental and
Craniofacial Research.
She came to UF without her own funding or experience running a lab.
Now she holds three grants that pay her salary, outfit her lab and fund her
"They (the NIDCR) were concerned that the infrastructure for research in U.S.
dental schools was starting to erode a bit, and numbers supported them," said Robert
Burne, Ph.D., chair and a professor of oral biology.
A report evaluating the college's research efforts revealed some positives and one
main negative: low funding to clinical departments.
Burne said the report called for "a plan to strengthen our basic sciences, where
appropriate, and then to enhance the pool of researchers who could conduct
translational and clinical research."
"Translational research" can easily be applied to clinical practice, offering new
solutions for providers and patients. Burne said it was lacking at the college before
the NIDCR grant.
"I think people were really frustrated because they're doing very basic science ...
but it was really hard to find the clinicians to collaborate with," he said.
The college submitted a plan to the NIDCR to fix these problems. It called for
hiring new research faculty to focus on working with clinicians and for providing
research training for some of the college's faculty.
UF's plan won a $2 million grant, as did plans from five other institutions. The
college and the division of sponsored research matched the NIDCR funds, and
Douglas Barrett, M.D., then senior vice president for health affairs, promised the
college 12,000 square feet of additional space.
Enter Wallet and six other new faculty members: Seunghee Cha, D.D.S., Ph.D., an

Grant fuels years of progress in
College of Dentistry

assistant professor of oral and maxillofacial surgery and oral diagnostic services
and oral biology; Ozlem Yilmaz, D.D.S., an assistant professor of periodontology;
Lakshymma Kesavalu, B.V.Sc., M.Sc., an associate professor of periodontology;
David Culp, Ph.D., a professor of oral biology; Scott Grieshaber, Ph.D., an assistant
professor of oral biology; and Lorena Baccaglini, D.D.S., Ph.D., an assistant
professor of community dentistry and behavioral science.
The college recruited some existing faculty members for research training.
Burne said there is more cooperation now between research and clinical
departments and between the college and people working in other areas on campus.
"If five years ago you said, 'What does Florida do?' most people would have said,
'They're really good at oral infectious diseases and host response, and they do some
pain work,"' Burne said. "Now it's expanded to oral and systemic health
More faculty members are receiving grants, too. In fiscal year 2007, UF's College
of Dentistry received $6.6 million from the NIDCR and was ranked ninth among
U.S. dental schools for money received from the institution. In fiscal year 2008, the
NIDCR gave the college $8.1 million, moving it to the No. 4 spot.
The money from the NIDCR is paying off for about 45 kids in Tallahassee, too.
Wallet is working with other faculty members, including principal investigator
Luciana Shaddox, D.D.S., Ph.D., to determine why the children have aggressive
The disease causes swelling in the mouth, severe bad breath and bone and tooth
loss. Cases of aggressive periodontitis in children are rare.
The researchers want to understand why so many children in such a small area
have the disease which is caused by an inflammatory response and how to
best treat it. The work is a perfect example of the translational research the college
has been promoting, Burne said.
Shaddox runs the clinical team. Wallet and her employees test blood and tissue
samples to determine which bacteria cause the patients' extreme inflammatory
responses. Meanwhile, the patients take antibiotics and receive deep cleaning
every three to six months. For those who follow the plan, the results are exciting.
"We have been able to save a lot of teeth from extraction just by keeping this
regimen strictly, so we're very happy with the results," Shaddox said. O




Professor's work bridges academic

medicine, public health and child advocacy

By Betty Poole

ead almost any Florida Times-Union

newspaper from the past 15 years and
chances are you'll spot the name of UF
pediatrician Jeff Goldhagen, M.D., M.P.H. as

a news source, newsmaker or letter writer. To
him, it's just another way of helping children.

As an associate professor and chief of the division of community
pediatrics at the UF College of Medicine-Jacksonville, Goldhagen
develops and oversees programs that enhance the health of all children
in the community, particularly those with special needs. His team of 15
UF faculty members cares for children and their families at clinics,

hospitals and in communities across Jacksonville. Through its
integration with the Duval County Health Department and other
community partners, the division serves patients, trains residents,
conducts research and works to develop systems of care to reach the
most marginalized children and families.
Like all UF physicians, Goldhagen excels at multitasking. You
might find him on his BlackBerry discussing funding for mental
health programs while a colleague from the United Kingdom rings his
desk line. Meanwhile, he writes on his laptop, acknowledging a
pediatric medical resident who has arrived for one-on-one training.
Papers stacked around his desk represent projects aimed at improving
children's health.
Goldhagen is particularly proud of the academic-public health
partnership between UF and the DCHD, which has received national
recognition and generated millions of dollars in contracts and grants
on behalf of children's health. DCHD's pediatric network, staffed in
part by UF clinicians, is the largest in Florida.
"We are contributing to the future definition of community
pediatrics here in Jacksonville," Goldhagen said. "We've created a
model where the general practitioner of the past has morphed into the
community pediatrician of the future who will focus on marginalized
communities of children by addressing their specialized health-care
needs as well as social and environmental determinants."
A huge challenge facing pediatricians is improving the standards of
children's health and well-being in the U.S., which consistently ranks
lowest of all developed nations, especially in the South, Goldhagen said.
"We mistreat children more than any other developed country
physically, economically and educationally, as a matter of public
policy," he said, citing the aftermath of Hurricane Katrina as an
example of child suffering resulting from unmet health needs,
separation from families and disruption of school and child care.
Goldhagen has worked worldwide to advocate for children's rights
and equity. In the past year he has traveled from Canada to the West
Bank to train child health professionals on these issues. Most recently,
he coordinated an international videoconference on the effects of
global climate change on children's health.
After earning his medical and Master of Public Health degrees,
Goldhagen practiced medicine in underserved communities ranging
from poor neighborhoods in Minneapolis to refugee camps in Thailand.
He helped develop child health programs in Ethiopia, Guatemala,
Romania and the Dominican Republic from the mid-1980s to the early
1990s, when he said the children's rights movement took hold.
In 2006, Goldhagen and a handful of colleagues founded the Society
for Equity in Child Health, a U.S.-based organization to advance the
principles and practices of children's rights, social justice and equity.
In December, he spent a week in Turkey training child health
professionals from countries such as Greece, Iraq, Azerbaijan, Serbia
and Bulgaria, then traveled to the West Bank to explore opportunities
to introduce the training into Israel and Palestine.
In a recent letter to the editor of the Times-Union, Goldhagen urged
heath-care professionals to be informed and use the tools of advocacy
and public policy to effect change in Gaza, where the impact of war on
children is deplorable, he writes.
"We hope that at some point we can use children's rights to bridge a
group of professionals who have not worked together ... for children's
health and well-being," he said.
He may be a doctor and an advocate, but Goldhagen says the role
that has taught him the most about children is actually "dad."
"I learned that they are who they are at birth," said the father of four
daughters and one son. "Just point them in the right direction and get
out of their way." 0

rllot-lg i

201 1


Fitness 2.0

UF developed Web site to help

improve physical fitness in kids

a,,,1',,i ....ii ti t a It f l i

mnmflLU I q.. y~

By April Frawley Birdwell
surrounded by Gov. Charlie Crist and star athletes such as former Tampa
Bay Buccaneer Derrick Brooks and tennis star Jennifer Capriati, state
leaders on Aug. 20 unveiled a UF-developed Web site aimed at
increasing physical activity in children.
UF informatics specialists teamed with the state Department of Health,
Crist and other agencies to expand and improve the Web site for the
Governor's Fitness Challenge, an eight-week program that allows children
and schools to earn awards and recognition for their progress and involvement
in physical activities.
The interactive site made its debut at the Governor's Council on Physical
Fitness meeting in Tampa.
Complete with online tools, statistics and even healthy recipes from star
chef Emeril Lagasse, the new and improved Governor's Fitness Challenge
Web site should allow more children than ever to participate in the program,
says Narayan Raum, assistant informatics manager for the UF Clinical and
Translational Research Informatics Program in the College of Medicine
department of epidemiology and health policy research.
"To actually be involved in a project that could potentially help a lot of kids
get even just an extra 10 minutes of exercise a day is very exciting," said
Raum, whose team developed the site. "With the overall positive impact this
could have on many children, there is nothing to lose here. Even if 10 kids get
healthier because they were involved, it makes it worthwhile."
Prior to the new site, students and schools had to send forms and written
charts of activity to the state in order to participate. Now, children and
teachers can log in to the Web site, where they can track their time and even
view live statistics.
The program starts Sept. 1 for elementary schools and Nov. 18 for middle
schools. Although the challenge is school-based, homeschooled children and
students in schools that do not participate can take part in the program, too.
Led by project manager Erik Henrikson, UF's Clinical and Translational
Research Informatics Program software engineering specialists began
developing the site in January.
For more information and to view the site, visit www. 0



State launches new online organ
donor registry

By April Frawley Birdwell
A year ago, Kris DenBesten knew little about organ donation and
transplants. He knew they happened, but it just wasn't something he
thought about. Ever.
That changed Dec. 24 when his then 9-year-old daughter, Gracyn, was
rushed to the emergency room at a hospital near their Orlando home. A virus
was attacking her heart. By Dec. 27, she was flown to Shands at UF, where UF
surgeons would implant a Berlin Heart, a biventricular assist device, in her to
keep her going until she could undergo a heart transplant.
On April 15, Gracyn got a new heart.
"She is a healthy 10-year-old that loves to sing and run around with her
friends. We are so thankful," said DenBesten who shared his story in the
Shands at UF Atrium during an event geared to encourage Shands employees
to register to be organ donors. "She's a miracle. If there is anything she can do
to promote (donation), she wants to do it. We want to do it."
The Shands event took place just a few days after the state officially
launched the Joshua Abbott Organ and Tissue Donor Registry, Florida's new
online donor registry, in Tallahassee.
The new site, which is linked to the Department of Motor Vehicles, now
allows potential donors to register online, state their wishes and access facts
about donation, said Kathleen Giery, a spokeswoman for Donate Life Florida,
which runs the state registry.
For Karen Deeter, the launch of the new registry was another bittersweet
victory for her son, Joshua Abbott, a 30-year-old Gainesville man who died in
November 2006 after a lifelong battle with cystic fibrosis.
By speaking to the Florida Legislature, Abbott had helped change a law
that prohibited Medicaid from paying for adult lung transplants. After his
own double lung transplant in 2005, he planned to continue his advocacy
work for organ donation and transplantation, but died almost a year later after
complications. His healthy organs were donated to other patients.
Abbott had grown close to state Rep. Larry Cretul and Sen. Steve Oelrich,
who led passage of the registry bill. Cretul asked that the registry be named
for Abbott.
"He told one of his doctors that speaking with legislators would be his
legacy," Deeter said. "My husband and I decided to take up his cause since he
is no longer here." 0



a clinical assistant professor
of prosthodontics, recently
received the Florida Dental
Association's Dental Educator
Award. Echeto was nominated
by UF student members
based on her "outstanding
contributions to the quality of Luisa F Echeto
dental education." Echeto serves as the college's
Predoctoral Prosthodontics Program director.


M.D., M.P.H., an assistant
professor of medicine, has
been named the Stop Heart
Disease Researcher of the
Year by the Florida Heart
Research Institute. Board-
certified in internal medicine,
cardiovascular medicine and Anthony A. Ba
interventional cardiology, Bavry
has already authored numerous peer-reviewed
articles, written seven book chapters and edited
his own textbook, Acute Coronary Syndromes in
Clinical Practice, and is currently editing two more.

associate professor of surgery,
was appointed the college's
assistant dean for simulation
and medical education.
Cendan has been a member
of the UF College of Medicine
since 2001. He also serves as
the clerkship director for the Juan Cen
department of surgery and
the medical director for the Harrell Professional
Development and Assessment Center, a facility
that allows medical students to practice their skills
during sessions with patient-actors.

a professor of psychiatry,
has been elected president
of the Research Society on
Alcoholism. Nixon is director
of the Biobehavioral Core at
UF's Clinical and Translational
Science Institute, as well as
chief of addiction research in Sara Jo Ni:
the department of psychiatry.
She is known for her work researching substance
abuse and its effects. She will serve as president
of the Research Society on Alcoholism for a
one-year term. The society is an international
organization based in Austin, Texas, that has more
than 1,600 members.

an associate professor
of neurosurgery, recently
received the Atena Onlus
Association research award
from the Catholic University
in Rome and the university's
teaching hospital, the Gemelli


Manuel Arreola

Robert Pelaia

University Polyclinic. Reynolds was honored for
work that began while he was a graduate student
at the University of Calgary, where he helped
discover that mice continue to produce brain
cells throughout their lives. The finding drastically
changed scientists' perception of the brain and its
ability to repair itself.


the college have received
2009 Opportunity Funds
Awards from the UF Division
of Sponsored Research.
an assistant professor of
medicinal chemistry, received
$86,000 for his research, "In
vivo target identification and
antitumor efficacy of novel
anticancer agents." SIHONG
SONG, PH.D., an associate
professor of pharmaceutics,
received $80,000 for his
research, "Alpha 1 antitrypsin
for treatment of lupus."

EFE ODIA, a second-
year doctoral student in
pharmaceutical outcomes
and policy, has been awarded
a Health Science Student
Fellowship from the Epilepsy
Foundation for her research
proposal, "Cost and quality of
care in epilepsy: An episode of
care approach." This fellowship
provided $3,000 to support
the project.

Sihong Song


professor and chair of the
department of clinical and
health psychology, was elected
president of the International
Society, the largest scientific
organization in the field. Bauer
is the fourth UF faculty member Russell M. Bauer
to be elected to the presidency
of INS in its 42-year history. Paul Satz, Ph.D.,
Kenneth Heilman, M.D., and Leslie Gonzalez-
Rothi, Ph.D., previously held the office. Bauer is
board-certified by the American Board of Clinical
Neuropsychology and is past president of the
Clinical Neuropsychology Division of the American
Psychological Association.

JEL ARREOLA, Ph.D., an assistant professor of
logy in the College of Medicine, and ROBERT
A A, J.D., senior university counsel for health affairs in
sonville, recently completed the university's 2008-09
Level Leadership program. The UF-centered leadership
ram includes a series of events over nine months for 15
going leaders. "We talked about change management,"
a said. "We talked about diversity issues. We explored
discussed numerous leadership competencies. We had
opportunity to meet with several leaders who are very
up in the university administration."

a professor of communicative
disorders, was elected president-
elect of the American Academy
of Audiology, the world's
largest professional audiology
organization. Her duties include
board liaison oversight of the
government affairs, coding and Patricia B. Kricos
reimbursement, and finance
committees, as well as the practice policy advising
council. Kricos' one-year term as the academy's
president begins in July 2010.

in the master's in health
administration program,
received a Foster G. McGaw
Graduate Student Scholarship
from the American College of
Healthcare Executives. Walker
received $5,000 to help offset
tuition costs, student loans and
other expenses. Whitney Walker


Med., Ph.D., chair of the
department of small animal
clinical sciences, has been
named an honorary fellow
of the Royal College of
Veterinary Surgeons. Burrows,
who also serves as chief of
staff of UF's small animal Colin Burrows
hospital, is a board-certified
veterinary internist, specializing in the study of
canine and feline gastrointestinal, hepatic and
pancreatic disease. His research focuses on
canine gastrointestinal motility in health and
disease, and on the relationship between diet and
gastrointestinal disease.

a professor of small animal
medicine, will soon assume
a new administrative role as
special assistant to the dean.
Schaer, a member of UF's
veterinary faculty since 1979,
has served as associate chief
of staff of UF's Small Animal
Hospital and as chief of small Michael Schaer
animal medicine. In his new post,
Schaer will work with the Office for Students and
Instruction to help advise and orient veterinary
students. He will also work with the Office of
Development and Alumni Affairs and will remain
involved in programs for interns and residents.


r og-og



liSl 1

FULLUlJ L/al15

UF recruits two all-star siblings with roots in Saigon

By Elizabeth Connor

N am Dang, M.D., Ph.D., newly named professor and deputy chief
of UF's division of hematology and oncology, has decades of
professional awards and accomplishments. But the one he wants
to tell you about is the unexpected standing ovation he received as
valedictorian of Highland Park High School in Dallas.

"We were complete outsiders to Highland
Park and my focus while at HPHS had been
academic, not necessarily social. The standing
ovation meant to me that my family and I were
accepted by the close-knit HP community, with
its very high respect for education and academic
achievement. We were no longer outsiders."
Nam arrived as a freshman at Highland Park
High School in 1977 with virtually no English,
after almost two years of nomadic life in
California refugee camps. He and his family had
left Saigon in the belly of a C-130, just days
before the fall of the city in April 1975.
But Nam's arc from immigrant to academic
all-star was just the beginning and in the
Dang family, not even unique. After high school,
Nam and his brother Long, younger by 11
months, blazed a trail in stunning lockstep:
magna cum laude at Harvard College, Ph.D. in
immunology at Harvard University, M.D. at
Harvard Medical School.
Nam is one of nine new hematology and
oncology faculty members arriving at UF this

summer, a staggering influx of intellectual talent
that also includes Long, an associate professor
in hematology and oncology. Their
appointments follow decades of separate
professional lives Nam most recently at M.D.
Anderson Cancer Center and the Nevada Cancer
Institute, Long at Johns Hopkins University and
the University of Michigan. Both are delighted
that UF has both broadened their professional
opportunities while drawing more closely their
personal ties.
"In this country, it is not that common that
families are together, but in Vietnam, it is," Nam
Nam and Long are in adjoining offices.
Among the unopened boxes and yet-to-be-hung
coat hooks are clinic notes and other evidence
the brothers already are consulting each other
about their respective patients Nam in
lymphoma and Long in gastrointestinal cancers.
Their research paths have branched off in
separate directions. For virtually all of his
research career, Nam has focused on the role of

CD26, a significant player in T-cell lymphoma
and other cancers, and key in the body's ability
to regulate the immune system, complete
signaling pathways and carry out the routine
death and disposal of cells.
"I'm thinking about getting a vanity plate that
says, 'CD26,"' Nam quipped.
Long's interest is in the development of the
vasculature of tumors, a field broadly known as
angiogenesis. He remembers a mentor at
Harvard, the late Judah Folkman, M.D., and
was attracted to UF by the opportunity to work
with hematology and oncology department
division chief Carmen Allegra, M.D. UF's
growing emphasis on translational research also
is a draw, Long says.
"Under Dr. Allegra's guidance, this is a good
opportunity to interface between the preclinical
and the clinical," he said.
Allegra emphasizes the individual
accomplishments of the brothers, noting they
are each "outstanding translational scientists as
well as outstanding care providers."
For the Dang brothers, however, the line does
not have to be so sharply drawn. When asked to
identify what drew him to UF, Long slides into
the first-person plural, comfortably speaking for
both himself and his brother.
"We're thankful to be able to translate from
bench-to-bedside and bedside-to-bench, and
thankful to have the opportunity to care
for our patients," he said. 0



UF trauma medical director Dr. Lawrence Lottenberg helps fourth-year
medical student Robert Weir find the correct location to insert a chest
tube on the department of surgery's new simulator, TraumaMan.
TraumaMan, which consists of synthetic human tissue, enables students
to practice a wide variety of advanced surgical procedures.

During a recent visit to Shands at UF, heart transplant recipient
Alexzander Wood visited with pediatric and neonatal respiratory
therapist Timothy Bantle. The pair became buddies in 2006
during Wood's stay at the hospital. Wood was the first patient to
receive the Berlin Heart, a biventricular assist device that kept
him alive while he waited for a new heart. Bantle describes
Wood as "the little brother I never had."

On July 29, kindergarteners through eighth-graders enrolled in
Gainesville's 02B Kids summer camp were invited by the department of
urology to operate the the da Vinci robotic surgery system in the Shands
at UF Atrium. Dr. Sijo Parekattil, who has performed more than 100
surgeries using the robot, explains the system to the children.

Published by
UF Health Science Center
Office of News & Communications
Senior Vice President,
Health Affairs; President,
UF&Shands Health System
David S. Guzick, M.D., Ph.D.
Interim Director,
News & Communications
Melanie Fridl Ross

April Frawley Birdwell

Senior Editors
Melanie Fridl Ross, John Pastor
Mickey Cuthbertson
Staff Writers
Kandra Albury, April Frawley Birdwell,
Jennifer Brindise, Tracy Brown Wright,
Sarah Carey, Elizabeth Connor,
Karen Dooley, Linda Homewood,
Laura Mize, John Pastor, Jill Pease,
Betty Poole, Czerne M. Reid, Karen
Rhodenizer, Melanie Fridl Ross,
Priscilla Santos, Christine Velasquez

Contributing Writers
Alyssa LaRenzie

Photo Editor
Sarah Kiewel
Support Staff
Cassandra Mack, Beth Powers,
Kim Smith

The POST is the monthly internal
newsletter for the University of
Florida Health Science Center, the
most comprehensive academic
health center in the Southeast,
with campuses in Gainesville

and Jacksonville and affiliations
throughout Florida. Articles feature
news of interest for and about HSC
faculty, staff and students and
Shands HealthCare employees.
Content may be reprinted with
appropriate credit. Ideas for stories
are welcome. The deadline for
submitting items to be considered
for each month's issue is the 15th
of the previous month. Submit to
the editor at
or deliver to the Office of News
& Communications in the
Communicore Building, Room

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