UF medical student, John Martino (center), translator, Sana (right) and a nurse at the Royal Victoria Teaching Hospital in Banjul talk to a mother (not pictured) who's child is suspected of having malaria.

Last summer, seven UF College of Medicine students headed to the Gambia with six suitcases of supplies, ready to volunteer and collect data for a research project. Today, they are working hard to make that experience possible for future classes of medical students.

Last year, Menna Haider, then a first-year medical student, became interested in creating a clinical and research project in the Gambia when she heard about a similar opportunity with the Shands Arts in Medicine program. After checking the feasibility of such a program and putting together a group of interested students, Haider and the new group began to work out the details of their research project and made plans to go to the Gambia.

After months of planning and faculty guidance, second-year medical students Haider, Ryan Gerrity, Archna Eniasivam, Janeen Aladina, John Martino, and Kunjal Gandhi and fourth-year medical student Raj Mehta found themselves in the Gambia. The medical students visited a small village called Kubeneh, a mid-sized hospital in Brikama, and the Royal Victoria Teaching Hospital in Banjul to collect data for their research. Their project focuses mainly on trauma care in the third world and how their triage systems work. They were able to shadow physicians in the hospitals and interact with medical students at the 5-year old medical school at Royal Victoria. They brought supplies everywhere they went, and the people seemed incredibly grateful, Haider said.

The medical students also set up a day clinic in a small village to provide health care and medications to those who came. The students were amazed at how excited the people were to see them.

“We were going to a place that had never seen any medical-related staff whatsoever so there were just a plethora of complaints and issues that we had to deal with,” Gerrity said.

After a month, the seven students returned home, but not without fond memories, new friends and endless data to be analyzed.

Although they intend for this to be an ongoing research project available for future students to continue working on, they have come to some basic conclusions. Most important, unfortunately, is that the Gambia’s triage system is not nearly developed as it is here. The major problem is a lack of records. Prescriptions are written on scraps of paper and records are kept with the patients, not the hospitals.

“They might be trained to deliver care, but they aren’t trained to record everything they need to so that the next person to take care of that patient has all the information they need,” Haider said.

Although the triage system may be a mess, there are some positive aspects of the Gambian health-care system. They have a much better vaccination system than the United States and offer health care at a very low cost, the students say. A trip to the doctor is only $1, and that includes prescriptions and treatments. They also provide free HIV treatment, something that costs thousands in the United States.

In making this a sustainable project, the group wants to work continuously with the contacts they made. The physicians and medical directors are very interested in what the UF medical students will find through their research, and are appreciative of any suggestions for improvement. Haider said the group will give Royal Victoria the data and analysis when it is complete.

After making friends and speaking with medical students at Royal Victoria, a group of Gambian medical students are trying to come to UF next summer for six weeks. Many of the UF students hope to return to the Gambia, as well.

“All of the people were so accepting while we were there,” Haider said. “They still write to us by e-mail and ask us when we are coming back.”

Kunjal Gandhi (left), Janeen Alidina and Archna Eniasivam make origami for the children of Senegal.

(Left to right) Nina Stoyan-Rosenzweig, director of the College of Medicine’s medical humanities program pictured in the Gambia with Nghi Lam and seven second-year medical students; John Martino, Kunjal Gandhi, Menna Haider, Archna Eniasivam, Janeen Alidina, Mariana Khawand and Ryan Gerrity.

Photo by Sarah Kiewel

The UF College of Medicine department of otolaryngology has taken in Camysha Wright, M.D., a fifth-year ear, nose and throat resident from UTMB in Galveston, Texas, until she is able to return home.

“I’m really happy they agreed to let me come here because they didn’t have to,” Wright said.

Wright’s classmates have dispersed to other hospitals in the country until UTMB is able to take them back. The medical branch was flooded through the first floor during the storm and is not estimated to reopen for another one to three months while repairs are being made. Because of the extensive damage, the price tag for recovery is steep, about $710 million when lost revenues and evacuation costs are added in to the price of rebuilding, according to university estimates.

Patients at UTMB were evacuated before the storm, and the hospital is currently only open for emergencies. The doctors at surrounding hospitals have taken on more patients to help, Wright said.

Wright’s transition to Shands at UF has been relatively smooth, but she has encountered some difficulties. She has to learn a new computer system and find her way around a new medical center.

“Everyone has been great here, though, so that makes it easier,” Wright said.

Even though she is settling into her new surroundings, Wright is still dealing with hurricane issues back home. Her house was flooded, and she and her husband lost many of their belongings, including their car. Since he is still working in Texas, it is hard for her to be away from him and have to watch the rebuilding process from afar.

While she is in Gainesville, Wright is staying with fellow resident, Sonia Deshmukh, who has been a great help, she said.

Because she is able to continue her residency while UTMB is being restored, Wright is still on track to complete her training on time in June 2009. She hopes to go into general ENT private practice with a focus on allergies.

It is with immense pride that we commemorate the 50th Anniversary of the UF Urology Department’s academic program. Prior to 2005, UF Urology was a division of General Surgery. The establishment of a Department of Urology was a key step by the College of Medicine to define and recognize urology as an independent field of medicine; it was, as well, a critical step toward accomplishing our goal of becoming a top 10 national program that provides the citizens of Florida with unsurpassed, state-of-the art urologic health care, research and education.

Recognizing that history serves as an inspiration for the future, UF Urology will continue to raise the bar and create new standards of excellence over the ensuing years. Despite our successes, however, we must also be mindful of the future challenges and hazards that reach beyond the national economic crisis and constraints of major budget cuts.

Urology today is undergoing a major transformation. New technologies and molecular therapies are emerging, and daily revelations that continue to fill in the map of the human genome are providing unprecedented opportunities to improve the prevention, diagnosis and treatment of patients with urologic disease. In this rapidly changing environment of 21st-century health care, it is imperative not only to recognize the complexities of these new discoveries, but also to efficiently implement them into our daily practice. Only then will we remain competitive in an ever-changing marketplace and stay in the forefront of academic discovery and innovation.

Further challenging the field of urology are the increasing needs of an aging patient population; a population that expects and demands the safest and most effective therapies that avoid the side effects typically seen with contemporary care. Urologists today have at their disposal an increasing information stream derived from advanced imaging techniques, novel biomarkers, and genome-based risk assessment. But, mastering these new developments requires a new breed of urologic surgeon; one who rejects complacency and the status quo and, with an eye to the future, makes a commitment to the advancement of medicine through superb education, research and collaborative patient care.

Fortunately, what I have described is exactly what I see as the greatest potential of our incredible faculty here in the University of Florida Department of Urology. Their collective contributions over the past years have solidified our department’s national reputation as not only one the best programs in Florida, but also one of the top programs in the entire Southeastern United States.

As we commemorate the department’s history and past successes, we accept that we must not only look back, satisfied with a rich and eloquent past. History has not ended, and the mission of UF Urology is not yet complete. We must continue to challenge ourselves to think big thoughts, dream big dreams, and look forward with anticipation to the not-even-yet imagined achievements of the next 50 years of UF Urology.

Shands at UF and its senior management team were recognized for being one of 100 hospitals making the greatest progress in improving hospital-wide performance over five consecutive years, 2002-06. Hospitals listed in the 2007 Thomson Reuters 100 Top Hospitals: Performance Improvement Leaders study have set national benchmarks for the rate and consistency of improvement in clinical outcomes, safety, hospital efficiency and financial stability. Findings from the study appear in the Aug. 11 issue of Modern Healthcare magazine.

“Receiving the Performance Improvement Leaders award is a tribute to the UF physicians, Shands nurses, technicians and other staff who consistently work to strengthen the hospital’s performance and to provide excellent service to our patients,” said Georgiann Ellis, Shands at UF vice president of operations. “It serves as further reinforcement that we are on the right path as we strive to improve patient-care outcomes, and ultimately, enhance the quality of life for the residents living in the communities we serve.”

Shands at UF is one of eight hospitals in Florida to make the 2007 list. The academic medical center is Florida’s leader for healthcare referrals, serving patients from every county in the state, throughout the nation and from more than a dozen countries. Shands at UF earned top-50 rankings in 11 specialties in U.S.News & World Report’s 2008 edition of America’s Best Hospitals. Other recent achievements include earning American Nurses Credentialing Center’s “Magnet” status – the nursing profession’s most prestigious national honor for excellence – and being designated a “primary stroke center” by the Florida Agency for Health Care Administration. Additionally, Shands HealthCare won the 2008 Governor’s Sterling Award – the state’s top honor for performance excellence.

“This study identifies superior leadership, based on the success of hospital executive teams’ long-term strategies for strengthening performance,” said Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals programs at Thomson Reuters. “These are true ‘good to great’ leadership teams that have focused on improving quality, efficiency, use of evidence-based medicine and financial stability in order to better serve their patients and communities.”

The Thomson Reuters 100 Top Hospitals: Performance Improvement Leaders study analyzed acute-care hospitals nationwide using empirical performance data from years 2002-06. The study rated hospitals on eight factors — patient mortality, medical complications, patient safety, length of stay, expenses, profitability, cash-to-debt ratio and use of evidence-based medicine. Researchers evaluated 2,867 short-term, acute-care, hospitals grouped into five categories: major teaching hospitals, other teaching hospitals, large community hospitals, medium-sized community hospitals and small community hospitals.

Additional information about the study is available at www.100tophospitals.com.

From left, Drs. Mark Atkinson, Mike Haller, Desmond Schatz and S. Robert Levine

Washington, DC, June 13, 2008 — Mary Tyler Moore, the Juvenile Diabetes Research Foundation’s international chairman, and her husband, S. Robert Levine, M.D., presented the sixth annual “Excellence in Clinical Research Award” to a team of UF College of Medicine scientists at JDRF’s annual conference today in Washington, DC.

The recipients of this year’s prestigious honor are Mark Atkinson, Ph.D., director of the JDRF Gene Therapy Center for Diabetes and Diabetic Complications at the University of Florida and University of Miami; Michael Haller, M.D., a professor of pediatrics and a researcher; and Desmond Schatz, M.D., medical director of the UF Diabetes Center of Excellence and associate director of the General Clinical Research Center.

The three researchers are involved in several innovative JDRF-funded studies to accelerate the development of a cure for type I diabetes, including using umbilical cord blood stem cells as a potential therapy and investigating drug treatments used in tandem to provide immune suppression while boosting the regeneration of insulin-producing cells.

“We are honored to present JDRF’s 2008 Excellence in Clinical Research Award to Drs. Schatz, Haller and Atkinson. Their willingness to challenge conventional wisdom and consequent ground-breaking work in translating novel scientific insights into new, potentially life-changing therapies and cures represents the sort of leadership we value most. Their pioneering research in the area of preservation and restoration of pancreatic beta cell mass and function in type 1 diabetes has moved us many steps closer to a cure,” stated Mary Tyler Moore and S. Robert Levine MD.

Dr. Atkinson has spent 25 years in the field of type 1 diabetes research. An internationally recognized authority in several research fields and a past JDRF chair for medical science research, his work focuses on disease prediction and prevention, environmental factors in the onset of the disease and the study of gene therapy to cure diabetes and prevent its complications.

Dr. Haller has committed his career to developing safe and effective therapies to prevent and reverse type 1 diabetes. The recipient of several prestigious awards for his work, he is an active investigator in TrialNet Research funded by the National Institute of Health and chairs the Clinical Implementation Committee of the TEDDY study, which focuses on determining the role of environmental factors in the development of diabetes.

Dr. Schatz has been involved in type 1 diabetes research since the 1980s, focusing on prediction, natural history, genetics and prevention of the disease, as well as the management of children and adolescents with type 1 diabetes. The author of more than 170 manuscripts, he is the principal investigator on several JDRF and NIH projects and co-principal investigator on a JDRF-funded project studying the origin and development of type 1 diabetes.

The annual “Excellence in Clinical Research Award” recognizes outstanding scientists who are pursuing research toward finding a cure for type 1 diabetes and its complications. Presented each year at JDRF’s conference, it is named for Moore and Levine in honor of their longtime extraordinary efforts and commitment to JDRF’s mission to find a cure for diabetes and its complications through the support of research.

“Regulatory Myeloid Suppressor Cells in Health and Disease” will be held March 12 to 15 in Clearwater Beach, Fla. The four-day conference will bring together – for the first time – investigators in fields such as cancer, trauma, autoimmunity and chronic inflammation, who are studying what appears to be similar populations of these immature myeloid cells, which arise from the bone marrow and have the capability to modify the immune system.

“The goals are to learn why the numbers of these cells expand so dramatically during these diverse diseases, what are the common mediators that drive the expansion of these cells, whether these cells in cancer patients are similar to those seen in other inflammatory diseases, and whether therapeutic efforts to modulate these cells in one disease can be applied to other diseases,” said organizing committee co-chair Lyle L. Moldawer, Ph.D., vice chairman of research for the UF department of surgery.

Organizing committee chair Dmitry I. Gabrilovich, M.D., Ph.D., a professor immunology at Moffitt, said as always with new, emergent fields there are concerns and confusion, so the best way to resolve these issues is to meet and discuss discoveries and resolve questions.

“We want to put together a more cohesive picture of the role of regulatory myeloid suppressor cells in pathology and so that we can then develop therapeutic strategies to block their negative role in disease.”

He added, very often we need to know how to control the cells – we don’t know how to do this yet.

Researchers do know that the number of these cells expand dramatically during infection and inflammation. In cancer, the cells are thought to suppress the anti-tumor activities of the host immune system, allowing the tumor to grow faster and metastasize. In addition, they appear to interfere with current therapeutic approaches aimed at stimulating the patient’s own immune system to attack and kill the tumors.

“The allure is that if we can prevent their expansion in tumors or sepsis then we can prevent the immune suppression that accompanies these diseases, resulting in therapies working more effectively for tumors and a decline in secondary infections for sepsis patients,” concluded Dr. Gabrilovich.

Initial funding to support the symposium has come from the UF College of Medicine and Moffitt Cancer Center.

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