A pair of TRMC newcomers bring a healthy dose of hope.

By Christine Gibbs

Not all that long ago, a diagnosis of liver or pancreatic disease would strike fear in the heart of a patient. Now there is hope on the horizon thanks to new treatment options, especially when an early diagnosis is involved. That hope is embodied in a pair of highly skilled surgeons that recently joined the Trinitas Regional Medical Center staff: Dr. Lloyd Brown and Dr. Baburao Koneru, both of whom are hepatopancreatobiliary (HPB) specialists.      

Dr. Koneru, came aboard as an attending surgeon at TRMC in 2015, has been practicing his specialty for 39 years. Dr. Brown has been on staff in the Surgery Department since early 2016. Both doctors are part of the Division of Liver Transplant and Hepatobiliary Surgery at University Hospital. In addition to their intense surgical responsibilities, they find time to share their expertise as professors at the Rutgers Medical School, in Newark. “The liver is the only organ that can regenerate itself, which is why live donors are acceptable for transplanting,” says Dr. Brown (left), who specializes in liver transplants and resections. “Only 30 percent of the liver is absolutely necessary to survive, making it possible to safely remove two-thirds of the liver of a living donor. And it takes only a few months for 75 to 80 percent of the organ to regenerate itself.”

Dr. Koneru (right) focuses on surgical treatments of 

both the liver and the pancreas. One of the procedures he uses on certain of his pancreatic cancer patients is the Whipple resection, where portions of the pancreas can be safely removed. When treating liver diseases, Dr. Koneru says that ablation as a technique is frequently recommended. Ablation involves surgical destruction of diseased tissue through a variety of procedures, including chemical ablations, microwave ablations (which employ heat energy), and radiofrequency ablations (which use high-energy radio waves to destroy cancerous cells). 

Dr. Brown and Dr. Koneru were drawn to HPB surgical careers for similar reasons.

“I have always had an interest in pursuing a profession requiring a high degree of medical skills that would help patients through a personal crisis in their life,” says Dr. Brown. “I believe that surgery is a fascinating life-long learning experience.” 

Dr. Koneru says that he too became fascinated with the opportunity to “manage treatment of highly complex disorders that require detailed patient information analysis and highly developed skills.” He also emphasized his commitment to “the challenge of providing the best post-surgical patient care possible.” 

Despite a relatively brief time at Trinitas, both doctors have positive things to say about the experience. Dr. Brown describes the environment in the Surgical Department as very collegial, with excellent channels of communication—which is critical to optimizing each surgeon’s performance. Dr. Koneru praises the efficiency of the operating room and intensive care units, as well as the quality of care provided by the regular nursing staff. He describes Trinitas as “simultaneously patient- and physician-friendly.” Dr. Koneru also appreciates the opportunity to provide expert care to patients in the greater Elizabeth area. 

As for the future of HPB surgery, the greatest strides, they agree, will be made in minimally invasive robotic-assisted surgery. “We have already begun to develop the minimally invasive and robotic-assisted Hepatobiliary surgery practice here at Trinitas,” points out Dr. Brown, who recently performed three robotic-assisted cases. He is convinced that Trinitas will continue its policy of acquiring the best and latest equipment—which will result in increased positive outcomes—and that Trinitas surgeons will continue to pursue the latest advances in surgical techniques. Dr. Koneru adds that, in addition to robotic techniques being used more widely, the number of surgeons with cutting-edge expertise in the field will increase: “That will make more of them available to join the staff of many smaller hospitals, which can then provide higher quality treatment locally.” 

Both doctors envision the success rates for HPB patient surgeries to continue to improve. 

HEP C

Today Hepatitis C, one of the viral infections that causes liver inflammation, has been receiving much media attention. Although there are five types of hepatitis—from A through E—it is Hep C that is having the greatest impact on the Boomer population. Statistics indicate that 1 in 30 Boomers is infected with Hep C, but not all of those infected know it. If left untreated, the disease can cause potentially fatal liver complications. 

A simple blood test during your next doctor appointment can determine whether you have Hepatitis C. If the result is positive, all you may need is a script for ribavirin, a drug recently approved by the FDA, which interrupts the virus’s ability to replicate. Clinical tests have shown a 98 percent cure rate—more than double that of the drugs it replaces.

Lloyd Brown, MD, MS
HPB Specialist
Assistant Professor of Surgery Division of Liver Transplant & Hepatobiliary Surgery
Rutgers New Jersey Medical School 973.972.2408

Baburao Koneru, MD, MPH HPB Specialist
Professor of Surgery
Division of Liver Transplant & Hepatobiliary Surgery
Rutgers New Jersey Medical School 973.972.2408

News, views and insights on maintaining a healthy edge.

The Hidden Costs of Strokes 

A recent study in England by the Stroke Association echoes what researchers here in the U.S. have been saying for years: Unless we change our eating, smoking and exercising habits—and manage blood pressure better—the number of first-time stroke victims will rise 50 to 60 percent over the next 20 years. And with more people surviving strokes, the “cost” of strokes to the economy could easily triple. High blood pressure is the number-one cause of strokes, and is also the most preventable cause. Yet by some estimates, four in ten people with high blood pressure may not be receiving appropriate treatment to manage the condition. And countless millions are unaware they have high blood pressure at all. What are the signs to look for to determine if you or a loved one are experiencing a stroke? “If a person notices any sudden onset of neurological symptoms that include numbness, difficulty walking, confusion, slurred speech or difficulty speaking, then 911 should be contacted immediately,” says  Dr. Nancy Gadallah,

Nancy Gadallah, MD
Neurology & Sleep Medicine
Trinitas Regional Medical Center, Edison 732.321.7010

a neurology specialist at Trinitas. “There is treatment for strokes, but it is time-sensitive.” Dr. Gadallah suggests visiting stroke.org for more information.

Postpartum Issues Beyond Depression 

Recently, Ivanka Trump revealed that she suffered bouts of postpartum depression after each of her three children were born. This triggered helpful and informative public discourse on the tangle of emotions that impacts roughly one in nine women in the U.S. Psychological issues are not the only thing new mothers need to be aware of, says

Abu Alam, MD
Chair, Obstetrics & Gynecology Trinitas Regional Medical Center Elizabeth, Westfield 908.994.5500

Dr. Abu Alam, Chair of Trinitas’ OB/GYN Department. “After giving birth, it is normal to experience some fatigue and soreness, but there are warning signs that may require additional medical care,” he says. “These include heavy bleeding, high fevers, elevated blood pressures, discharge and pain from any incision sites, pain when going to the bathroom, severe abdominal pain with vomiting, swelling in your legs, and feeling sadness for more than 10 days following delivery.” In these cases, it is vital that you contact your physician, he adds, and not be timid about dialing 911 in an emergency—for you and your baby.

Zika’s “Silver Lining” 

Does Zika have a silver lining? According to the Journal of Experimental Medicine, the mosquito-borne virus has shown an ability to selectively infect and kill cancerous cells in adult brains. A team of researchers from the medical schools at Washington University and UC–San Diego injected Zika into mice with aggressive cancers, such as glioblastoma, and were stunned to find that it shrank tumors while leaving other brain cells untouched. Similar experiments on donated human brains appeared to have the same results. This could lead to a game-changing treatment for diffuse brain cancers, which make it difficult to determine where cancer ends and healthy tissue begins—and which don’t always respond to chemo, radiation or surgery. 

Could Obesity be a Mental Illness?

A study completed last summer at Children’s Hospital in Los Angeles has added a new wrinkle to the childhood obesity discussion. Researchers used MRIs to explore whether there is a psychological difference between overweight and lean adolescents. They found that food stimuli activated regions of the brain in both groups equally, but that kids at an increased risk for obesity had less neural activity in parts of the brain that support self-regulation and attention. In other words, the risk for obesity isn’t driven exclusively by the absence or presence of urges to eat high-calorie foods, but also by the ability to control those urges. More than half of all adolescents in the United States are either overweight or obese, and two-thirds of children of overweight parents are (or are likely to become) overweight themselves.

Working Out Heart Attack Symptoms 

Regular workouts are among the top recommendations cardiologists give their patients. However, according to research presented at the 2017 meeting of the European Society of Cardiologists, about 5 percent of cardiac arrest cases are related to exercise. Cardiac arrest is different from a heart attack, but can often follow a heart attack. The Society recommended that gym-goers be aware of where the automated external defibrillator (AED) is located. Even in the hands of an “amateur” the device is a lifesaver. Just as important, it is important to recognize the first signs of a heart attack so that you can offer assistance or (if you are the victim) ask for help. Some very important signs and symptoms that need to be addressed right away are chest pain, unusual shortness of breath, chest tightness, unilateral leg swelling or pain, or drooping of one side of the body, according to

Vasyl Pidkaminetskiy, MD Internal Medicine
Trinitas Regional Medical Center Clark, Cranford, Elizabeth, Linden
732.499.9160

Dr. Vasyl Pidkaminetskiy, an Internal Medicine specialist at Trintias. “Although those are general, a person should seek medical attention if there are any unusual signs or symptoms going on with the body,” he says. “And remember—something that is atypical from the normal in an individual is nature’s way of telling a person that something may be wrong and further evaluation is needed.”

Does Natural Selection Still  Influence Human Evolution? 

A study published in PLoS Biology looked at the DNA of 215,000 individuals of European descent and offered the following answer: Yes. The genetic research looked for evidence of “evolution” over one or two generations by focusing on 8 million common mutations. They found evidence that life-shortening genes related to heart disease, Alzheimer’s and a predisposition to heavy smoking are being “weeded out,” presumably by some agent of natural selection. The researchers also noticed a trade-off between fertility and longevity that had been previously observed in animals but never in humans. 

Low-Dose Recommendation 

A recommendation in late-September from the U.S. Preventative Services Task Force got the attention of a lot of current and former smokers. The group is urging individuals ages 55 to 80 who are current pack-a-day smokers (or who quit within the last 15 years) to have an annual Low-Dose CT scan. Lung cancer can present several different symptoms, points out

Nancy Gadallah, MD
Neurology & Sleep Medicine
Trinitas Regional Medical Center, Edison 732.321.7010

Dr. Clarissa Henson, Chair, Radiation Oncology at Trinitas. “If you are suffering from a chronic cough, shortness of breath, weight loss and fatigue, these could be signs of an underlying lung cancer. Lung cancer is often rapidly growing and can present with metastasis to the bone or brain and often can present with worsening bone or back pain, and even headaches, vomiting or a change in speech or mobility when the cancer has spread to the brain.” A Low-Dose CT scan can detect lung cancer at a very early and highly curable stage. Trinitas offers a new low-dose Lung Screening Program that can detect traces of cancer within seconds. For more information on this program, call (908) 994-5051.

New Jersey’s newest ER has just had an $18.7 million expansion that has cut the wait by two-thirds.

By Yolanda Navarra Fleming

Seven years ago at Trinitas Regional Medical Center’s Emergency Department (ED)—Union County’s busiest Emergency Room—the median wait was about 65 minutes. But now, treatment space has doubled after the $18.7 million renovations and expansion, which has whittled down the median wait time to about 18 minutes. 

Gary S. Horan, FACHE, President & CEO at Trinitas, says he looks forward to September when the entire department will be completed and dedicated. “The physical space is very impressive, and is designed to more appropriately treat the families, children, and seniors who come to us for care,” says Horan. “Separate areas for each make the care very specialized and personal.”

Geriatric patients will be seen in a separate, more serene area—with cosmetic and practical improvements and additions, such as mobility aids, pressure-reducing mattresses, bedside commodes, bedside transition stools, and the use of non-slip socks and hearing aids. Even the clocks on the walls are larger. But not only seniors will benefit from improvements and the 18 additional beds—including five private Geriatric beds, six Transitional Care Unit beds, and seven Fast Track Treatment bays. According to Dr. John D’Angelo, Chairman of the Emergency Medicine Department, the Geriatric ED has more to do with the complexity of care and less to do with age. 

“Geriatric patients are not singularly defined,” says Dr. D’Angelo. “If a patient requires a multidisciplinary team to assist with preventing a hospital admission or facilitating a home care plan, they may find themselves in the Geriatric ED.”

For instance, a 50-year-old patient with advanced multiple sclerosis who requires full home care may benefit from Geriatric Care. In the ED, he or she may receive a physical therapy consult, a wound care consult, and a social worker, who reviews all home care needs. 

Trinitas’s ED ranks among the top urban-based facilities of its size, processing about 70,000 patients each year.

However, Dr. D’Angelo—who also serves as a tactical physician for the Union County Emergency Response Team and the SWAT Team—says, “Preparing for the unexpected is always a challenge. Patient arrivals on any given day at any given hour can be very dynamic. We are determined to answer the call through thoughtful staffing patterns and continued process improvement.”

Dr. D’Angelo has been with Trinitas for the past five years. He attended Muhlenberg College and earned his bachelor’s degree in science before graduating from the Philadelphia College of Osteopathic Medicine. As chief resident in the Emergency Medicine Residency Program at Mount Sinai Beth Israel in New York City, he received both Resident and Researcher of the Year awards. After his residency, he moved to Florida and worked as an attending physician at regional trauma centers in South Florida. He also served as the Assistant Medical Director at several EMS agencies in Broward County.

The project includes three new state-of-the-art Intensive Care Unit rooms These rooms will help with the quick movement of patients who have been admitted to Trinitas through the Emergency Department.

Empathy has played an important part in his career.

“Part of it is to see yourself within your patients,” he explains. “I see you; I am you. That’s critical in the delivery of the healthcare delivery system—to see yourself in the individual who is struggling.” 

Delivering the same elevated level of healthcare to those who can’t afford it also drives him. “It’s always been my passion,” he says. “Top-notch care should be available to everyone. I urge those who can afford healthcare to support the mission and to help those who have less.”

“Fast Track,” or “Prompt Care,” is essentially an urgent-care or office visit, he says. “Our goal is to treat and release a patient in less than 90 minutes. Many patients find it challenging to find a primary care physician who accepts Medicaid, but we see any patient regardless of ability to pay.”

A 128-Slice CT scanner, located within the new Emergency Department, improves quality and further reduces wait time.

Patients with behavioral health or substance abuse issues can rely on the Transitional Care Unit (TCU) at Trinitas. For instance, a patient with Bipolar disorder co-occurring with opioid addiction is better served in the more controlled environment of the TCU, designed for patients who may have mixed disorders. Such patients may be considered “friendly faces,” says Dr. D’Angelo, “which are common in many urban emergency departments.”

The recovery specialist reaches out to such patients in the Trinitas ED and offers help and encouragement. Recently, a “friendly face” who struggles with alcohol addiction kept returning to the ER. 

“Our recovery specialist encountered the patient when he was sober,” Dr. D’Angelo recalls. “They made arrangements to meet at a McDonald’s for a free breakfast and coffee. The patient’s only obligation was sobriety.”

The result of that happy meal has since turned into 15 days of recovery for the patient, who is continuing to do well. “To some that may not seem like a long time, but it’s a lifetime to this patient and more importantly a second chance.”  

John D’Angelo, DO

Chairman/Emergency Medicine

Trinitas Regional Medical Center

News, views and insights on maintaining a healthy edge.

Four Months or Twelve? 

A study published in the June edition of Pediatrics appears to be at odds with long-accepted recommendations by the American Academy of Pediatrics concerning how long infants should sleep in the same room as their parents. The new study indicates that four months may be the ideal cut-off. Beyond that point, babies sharing the same room get less sleep and sleep for shorter stretches. Also, the study suggests that between four and nine months, parents may be more likely to engage in unsafe sleep practices associated with sleep-related deaths. More than 3,500 infants die in sleep-related deaths in the U.S. each year. The lead author of the new study, Dr. Ian Paul, has an explanation for the difference between the two recommendations: AAP’s is based on a consensus of expert opinions, while the four-month cutoff is based on data from the study’s 230 families. He adds that moving a child out of the parent’s bedroom at one year is impractical for another reason—this tends to be a peak period of separation anxiety for children.

Home Care of Alzheimer’s Patients On the Rise      

According to a June report by the CDC, the number of deaths in the U.S. attributed to Alzheimer’s disease more than doubled between 1999 – 2014, from 44,536 to 93,541. The startling rise can be attributed to a number of factors, including greater longevity and aging Baby Boomers, as well as better diagnosis of the neurodegenerative condition. What’s most troubling about the results of the CDC report is that an increasing number of Alzheimer’s deaths are occurring at home as opposed to in hospitals or long-term care facilities. This suggests that families are having to assume the burden of caregiving, presumably for financial reasons. The long-term economic and mental health impact of this trend further complicates the Alzheimer’s picture. 

Is Vaping Worse for You Than Smoking? 

The ongoing debate around the growing use of e-cigarettes has some concerning new data, courtesy of a University of Connecticut study that appeared recently in ACS Sensors, a publication of the American Chemical Society. A team of UConn chemists looked specifically at DNA damage and found that electronic cigarettes loaded with nicotine-based liquid were potentially as harmful to DNA as unfiltered cigarettes like Lucky Strikes, while non-nicotine e-cigarettes carried the same risk as smoking traditional filtered cigarettes. The team focused on cellular mutations caused by DNA damage, which can lead to cancer. The concerning results were attributed primarily to the number of chemical additives in e-cig vapors, including propylene glycol, glycerin and nicotine, as well as flavorings.

Oh, Baby: Screen Time Linked to Delayed Speech 

Are smartphones making kids dumber? The Hospital for Sick Children, located in Toronto, asked nearly 1,000 families to track the screen time of their young children, from six months to two years old. About one in five children 18 months or older used a tablet or smart phone for an average of 28 minutes a day. Within that group, every 30-minute increase in screen time was associated with a 49 percent increase in delayed speech. The American Academy of Pediatrics advises that children under 18 months have zero screen time, aside from video-chatting with family members.

Easy On the Knees 

Go ahead and add one more benefit from fiber. An article published in the Annals of the Rheumatic Diseases reported that individuals who consumed a high-fiber diet had a dramatically lower incidence of knee arthritis. The article referenced two recent studies covering a total of 6,064 subjects. One found a 30%difference in osteoarthritis of the knee between the people who had the highest fiber intake and the lowest, while the other showed a 61% drop! There doesn’t appear to be a direct fiber-knee link; instead, researchers believe the benefit is related to weight control and inflammation associated with some lower-fiber diets. Of course, high-fiber diets have been directly linked to improved cardiovascular health, as well as a reduced risk of diabetes.

Pedaling Toward Happiness 

Low pay, high pressure and shifting office politics can make for a toxic mix in our jobs. Indeed, nearly one-third of U.S. workers report suffering from chronic stress directly related to their employment, while 36% of those reporting stress say their company offers nothing in the way of stress management. A recent article in the International Journal of Workplace Health Management offered one solution: cycling to work. Those who bike—as opposed to commuting by car or public transportation—reported a significantly lower amount of workplace stress. According to the Harvard Health Letter, additional benefits of cycling to and from work include building a wide range of muscles and increasing bone density, as well as a providing an aerobic workout that’is easy on the joints. 

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By serving the underserved, Trinitas helps promote the power of pink. 

By Christine Gibbs

In 1977, Susan Goodman Komen was diagnosed with breast cancer at the age of 33.  She died three years later. Her younger sister, Nancy Goodman Brinker, in honoring a promise made to Susan to promote the fight against breast cancer, fulfilled that vow by starting a foundation in her sister’s name, in 1982. Later the name was changed to Susan G. Komen for the Cure with the ambitious goal to end breast cancer forever. Today, the organization is often simply referred to as Susan G. Komen or simply Komen. More than 100,000 volunteers work at the more than 120 Komen affiliates active in more than 18,000 communities across the country—which have awarded more than $93 million in community grants to bring needs-based screening and treatment resources to women most in need of them. In addition to the generous grants, Komen invests tens of millions of dollars to further ongoing research.      

Nearer to home, one of the Komen Affiliates—Susan G. Komen of North Jersey—has just celebrated the 20th year of its dedication to fulfilling the national organization’s mission. As part of the network of Komen affiliates, Komen North Jersey has awarded more than $16 million in community grants to qualifying non-profit organizations in their nine-county territory. Among them is Trinitas Regional Medical Center, which has received a total of more than $1 million in grants. 

Deborah Q. Belfatto (left), with husband Joseph, daughter Lindsay Tabani and son-in-law Marcus Tabani.

In early April of this year, the Affiliate hosted its signature Pink Tie event, honoring its original founders, Deborah Q. Belfatto, Lisa Herschli and Kathy Hubert-McKenna. As a breast cancer survivor, Belfatto—founder and former Executive Director of Komen North Jersey—takes their responsibilities very personally and very seriously. Belfatto worked tirelessly to establish a Komen Affiliate in North Jersey after learning that 75% of all money raised would stay local. She says she became “hooked on the Komen formula” as a perfect fit for the greater North Jersey area.

Why Trinitas? Belfatto recognized the medical center’s dedication to “serving the underserved.” Trinitas, she adds, over the years has continued to over-deliver on its services to a blended population relative to their grant promises.

The TRMC Commitment

Trinitas provides one-stop breast cancer resources through its Women’s Imaging Center, a $3.8 million investment in radiologic imaging. Included among the services are FDA-approved low-dose mammography, minimally invasive stereotactic breast imaging, and ultrasound-guided aspiration/biopsy. The emphasis at Trinitas is to extend much-needed help to women with limited or no resources in getting through their battles with breast cancer. Given that their missions are so closely aligned, the Trinitas/Komen partnering has flourished for almost 16 years. Their ongoing relationship is a tribute to the Komen belief in the value of networking and partnership within the local community.

Much has changed since Belfatto first got involved in the fight against breast cancer. Back in the 1980s, she recalls, treatment was a “one-size-fits-all” approach. Thankfully today, treatment regimens are highly personalized and more specific to particular cancers. As a result, the survival rate for breast cancer has improved dramatically—although sadly 1 out of every 8 women in her lifetime in the U.S. will still confront a breast cancer diagnosis. Progress has been made, but much work remains to be done. As for her approach to the Komen cause and to life in general, Belfatto sums it up in four words: persistence, perseverance, passion and patience. And she never takes No for an answer. 

In recognition of Deb Belfatto’s participation in the grant review process of Komen North Jersey—and her continued support of Trinitas as a consistently worthy grantee—she was invited to join the Trinitas Health Foundation Board in 2013. She reciprocated by extending her own ultimate compliment in noting that Trinitas is “one of the most selfless hospitals with whom I have ever worked.”

Event Horizon

Kathi Edelson Wolder. Who heads up Marketing and PR for Komen North Jersey, is another example of a totally committed member of the Komen support network. She was recently named a Komen Angel and her portrait hangs in the gallery of Komen’s Journey of Courage. Wolder parlayed her professional marketing experience into furthering the success of Komen North Jersey affiliate events. Most recently, she was instrumental in marking the 20th anniversary celebration of Komen North Jersey with one of the most successful “Pink Tie” gala celebrations. Starting in 1997, there have been 16 Pink Tie Balls that have contributed to the total $23 million that Komen North Jersey has invested in lifesaving research and local community grants. The most successful affair was sponsored in 2005 by Continental Airlines and held in Newark Airport—with 1,400 guests attending and $2.1 million raised. Wolder and Belfatto say it was “magical, like make-believe in the glory days” of formal extravaganzas.

Recently, the Pink Tie Ball underwent a name change. It is now known as the Pink Tie Party. The younger generation is less formal, Wolder explains, although pink bow ties were as always the neckwear of choice on the dance floor. She is busy focusing on helping to cultivate “a new regime” among the up-and-coming younger generation, who bring the limitless possibilities of the digital age to the Komen communication and publicity efforts. Whether it’s called a “ball” or a “party,” a fun atmosphere prevails and successful fundraising is accomplished. The latest event was attended by almost 500 supporters and grossed $500,000, which will soon be put to good use through Komen grants.

What powers the efforts of Belfatto and Wolder? Their belief in the future of the fight against breast cancer through the support of what they have labeled “Merging of the Ages”—i.e., young and energized Gen-X and Millennial supporters. Belfatto says it’s like being “surrounded by rock stars in the breast cancer community.”  EDGE

Editor’s Note: Nothing makes Deb and Kathi happier or more hopeful about keeping the movement strong than to look into the faces of the future within Komen North Jersey and beyond. They continue to encourage survivors and co-survivors of all ages to continue their support of Susan G. Komen North Jersey and its events, including the Race for the Cure, which takes place each May.

MILESTONES 

1969 Mammogram invented

1980 Susan G. Komen dies at age 36

1982 Nancy Brinker establishes the Susan G. Komen Breast Cancer Foundation

1984 Nancy Brinker is diagnosed with breast cancer and survives

1986 First Breast Cancer Awareness Month

1991 Komen pink ribbon becomes national symbol

1995 Race for the Cure events are held in 57 U.S. cities

2002 More than 1.3 million participate in 100 Race for the Cure events worldwide

2008 25th anniversary of Race for the Cure

2017 More than 3.1 million breast cancer survivors in the US today 

2026 Target date to reduce deaths by breast cancer by 50%

TAKING NOTHING FOR GRANTED

Komen North Jersey works with professionals and community leaders to perform a comprehensive needs assessment, the Community Profile, every 5 years as the basis for grant application. Funds awarded from Komen grants are restricted in that the money must be used to provide vital breast health services and treatments and are never comingled with general operating funds. 

Dr. Pedro Cordero is the ultimate one-man show.

By Yolanda Navarra Fleming

For Dr. Pedro Cordero, a Roselle-based General and Vascular Surgeon, the expression “going out on a limb” has daily significance. In his practice, during the course of more than 35 years, he says, “I’ve saved hundreds and hundreds of legs.” Among other things, he treats dialysis patients and those with vascular problems including non-healing ulcers of the feet or lack of circulation, and specializes in laser surgery for vein treatments for varicosities, spider veins, and  carotid surgery in the Ambulatory Surgery Center at Trinitas Regional Medical Center.      

“I’m not on the teaching circuit or doing research or anything else,” Dr. Cordero reiterates. “I’m doing what I love: saving limbs.”

By any measure, his work is impeccable. 

“The results I’ve gotten over the years,” he confirms, “are better than the national average.”

Indeed, Dr. Cordero is proud of the fact that he has performed more than 800 carotid endarterectomy surgeries, with very few complications and zero deaths. In addition to a high success rate, it’s worth noting that his is a solo practice in a corner of the world where group practices are more common.

“As a solo practitioner, I am unique,” he explains. “There are different boards in surgery, and if you want to distinguish yourself, you specialize and join a group, and that’s all you do. You can’t be good at everything. But if you go to a group practice nowadays, you may not see the same doctor twice. As a patient, I like to see the same doctor because there’s a level of trust and comfort that develops over time.”

Dr. Cordero was born in Cuba in 1950. At the age of 9, he immigrated with his brother and parents to the Union City/West New York area. As a student at Emerson High School he was called to the medical profession by his favorite teacher.

“Mrs. Zippo made biology come to life,” he says, noting that he didn’t let his weak math skills stop him from pursuing his passion. “She was a really great biology teacher who inspired me to want to go into medicine.”

Thirty-five years later, while attending a surgical conference, he sat across the lunch table from another doctor whose nametag said “Dr. Zippo from Union City, Kentucky.”

“I thought it was such an odd coincidence that he had the same last name as my teacher from Emerson High

School in Union City. I told him, ‘the reason I’m sitting here in front of you is because of a teacher by the same name who taught at my high school in Union City, New Jersey.’ The man nodded knowingly and said, ‘That was my mother.’”

Dr. Cordero didn’t have an easy time in school: “Everything was tough for me coming from an inner city school. The educational system is not the same that the kids get in suburbia. So I had to make up ground in college.”

He began at Rutgers University for pre-med and went on to SUNY Buffalo Medical School. During that time, another teacher pointed him toward becoming a surgeon. 

“Dr. Lee at Buffalo was a great anatomist; I enjoyed his anatomy class so much that I decided I had to become a surgeon,” he recalls, adding that part of his fascination was the artistry of the human body. “Everything has a purpose, everything is placed so perfectly. It’s a perfect machine.”

At SUNY Buffalo, Dr. Coredro also met his future wife. He went on to do his residency at Montefiore Medical Center in the Bronx.

“Since the first few letters in our last names were similar, we were paired off in our histology lab and had to use the same microscope, so we became friends,” he recalls. “Finishing medical school together, we were matched as interns at Montefiore/Albert Einstein.”

They worked dogged hours, often more than 140 per week. Upon graduation, he established both solo and group practices in Union, while she went on to become an internist with a sub-specialty in adolescent medicine. Now with his main practice in Roselle Park, he is affiliated with multiple hospitals in the area, including Newark Beth Israel Medical Center, where he completed a fellowship under Dr. Bruce Brener, and Trinitas Regional Medical Center, which he joined during its inception.    

In 2005, he was invited by a fellow doctor on a medical mission trip to the Philippines. 

“I saw the need these people had for not only medical equipment, but surgical care,” he says. “There was an extreme lack of medical care and the urgent need for items that are routinely discarded by hospitals in the United States. We realized the usefulness of these items in the places we visited.”

By 2007, Dr. Cordero had co-founded Mano-A-Mano International Relief Organization. Mano-A-Mano routinely ships out containers of medical supplies donated by hospitals to Third World countries including Venezuela, Haiti, Dominican Republic, Ivory Coast, Grenada, and Guyana, in addition to the Philippines. Medical missions are designed to provide immunizations, health education, disease prevention, dental screenings and treatments, eye examinations, and free reading glasses. Most recently, Mano-A-Mano is opening a small charitable surgical center in Pierre Payen, Haiti. He plans to teach surgery in underdeveloped countries when he retires, and offer mobile cancer screenings for women where there is a high breast cancer mortality rate. 

“It makes me feel great to be able to go to other countries and treat people who would never be able to be treated because they have no money and no access to care,” says Dr. Cordero. “They are so appreciative and you can feel that appreciation for taking care of them.” 

The only compensation is the joy he gets from the look on their faces.

Pedro Cordero, MD, RVT, FACS Chair of the Periop 

Value Analysis Committee

908.241.2401

A unique collaboration puts healthy choices within reach of a “growing” population. 

By Yolanda Navarra Fleming

At roughly 125,000 residents, Elizabeth ranks as New Jersey’s fourth-largest city. According to the Centers for Disease Control, 37.96 percent of its residents are classified as overweight and 28.71 percent are obese—particularly in the Bayway, Elizabethport, and Midtown areas. Complicating matters is the fact that 17 percent of Elizabeth’s population lives below the poverty line, and that many residents do not have easy access to grocery stores because of physical distance or immobility.      

For people like Brandy Rumola, her husband, and two children, who live in the Mravlag Manor housing project, Elizabeth’s Mobile Market program—sponsored by Groundwork Elizabeth and The Foodbank, and organized by the Shaping Elizabeth coalition—offers more than a hand-out.

“Eating healthy is one of those things I’ve been meaning to do, but had a hard time with,” says Rumola, a 36-year-old stay-at-home mom whose children are 13 and 10. “The Mobile Market is such a help because we get fresh vegetables and fruits, which means a few less dollars I have to spend. But they also give us recipes…and I’ve learned about portions, saturated fat, and things I didn’t know before.”

In 2013, a group of organizations known as the Shaping Elizabeth coalition came together to mastermind a plan to stem the spread of chronic disease with a combination of health screenings and services, nutrition education, food distribution, and community gardening. They began with a grant from Shaping NJ (the state partnership for nutrition, physical activity and obesity prevention), and support from the Gateway Family YMCA.

Members of Shaping Elizabeth announce the publication of the eighth annual County Health Rankings by Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The event was held at the Gateway Family YMCA’s Elizabeth Branch.

Catherine J. Hart, deputy executive director of the Housing Authority of the City of Elizabeth (HACE), which helped establish the Mobile Market program, says it’s not just about the food.

“It brings residents together,” she says. “HACE has enlisted a team of resident volunteers who distribute the food, which means they get out and meet one another directly. They look out for each other. The young people help the seniors in carrying items back to their houses. If someone can’t [physically] make the distribution, residents volunteer. There’s a tremendous amount of communication between staff and residents enabling HACE to bring in other forms of assistance and support.”

Alane McCahey, project manager of Shaping Elizabeth and Senior Director of Community Initiatives at The Gateway Family YMCA, adds that eventually residents will be able to be trained in food handling, which could also mean future job opportunities.

“Our guiding principle is to bring the resources to the people, versus trying to get people to come to us,” McCahey explains. “We’re much more apt to get people to make changes in their lives that way. We want people to be part of the solution so it’s more of a partnership. It’s one thing to have food handed to you, and another to know how to best use it. We’ll also offer education by a nutritionist from Trinitas.”

Recently, the coalition received another grant from the Robert Wood Johnson Foundation, involving NJ County Health Rankings and Road Map, one of the RWJ’s subsidiaries, as well as the City of Elizabeth, and Proceed Inc.

A program called Play Streets—sponsored by Gateway Family YMCA, City of Elizabeth, The Shaping Elizabeth Community Health Initiatives, and the Community Food Bank of NJ—creates a block party atmosphere to welcome residents in various neighborhoods to engage in activities that speak to their specific needs through children’s activities, health screenings, and more. Last year, through the Safe Kids Program at Children’s Specialized Hospital, free bike helmets were given out to kids who attended.

Early on, Trinitas organized the One Flight Up, Two Flights Down campaign to encourage walking for physical fitness. But the hospital also conducted a walkability audit of the city to determine what improvements could be made.

“We’ve come a significant way,” says Joseph L. McTernan, Sr. Director of Community and Clinical Services at Trinitas Regional Medical Center. “We focus on putting our community first. We have put a lot of work, time and effort into ensuring that the groups learn to work together as a team. The groups are structured for strong collaboration and sharing information between partners. We’re working well together even as we tackle some of the harder topics.”

With the help of Jonathan G. Phillips, executive director of Groundwork Elizabeth, residents take matters into their own hands by growing produce in community gardens. “We are involved in so many ways,” says Phillips. “We’re proud to be part of the coalition working with NJ Health Initiatives to build a culture of health in Elizabeth.

As for Brandy Rumola, she wonders if the Mobile Market is a benefit that’s here to stay—because it’s one of those things that just seems too good to be true.

“I genuinely hope they keep the program going,” she says. “I know other families that depend on it because there isn’t a grocery store close by. Not everyone has a car or has money to take a cab. It benefits the whole community.”

Hart offers comfort by adding, “At a time when funding is limited and opportunities are scarce, the Shaping Elizabeth collaboration has been—and will continue to be—beneficial not only for the agencies but for the people we serve: They will benefit from the services that as a group we can provide.”  

News, views and insights on maintaining a healthy edge.

Crunch Time 

Do loud eaters make you crazy? Then you may be suffering from Misophonia. A small percentage of people experience a strong fight-or-flight response when they hear lip-smacking, chip-crunching or liquid-gulping sounds. A recent study published in Current Biology looked at 42 individuals—20 of whom were misophonic and 22 of whom were not—who listened to noises ranging from neutral to annoying while they were in an MRI machine. Researchers observed that the 20 misophonics had significant activity in the insular cortex, which links senses and emotions. In most cases, the result was a strong feeling of anger as opposed to disgust, which is how most people respond to eating noises. Fortunately, misophonia is fairly rare, according to Dr. Rodger Goddard, Chief Psychologist at Trinitas. “It’s a problem that usually occurs between the ages of 9 and 13 and is more common in girls, and is believed to involve brain functions and not one’s ears,” he says. There is a Misophonia Foundation, which can provide guidance for people suffering from this difficulty. 

Rodger Goddard, PhD
Chief Psychologist, Trinitas Regional Medical Center Director of Wellness Management Services
908.994.7334

Dr. Goddard adds that getting upset, stressed, anxious or annoyed at a variety of things is common for many of us.  We need to always look at the frequency, duration and intensity of any problem. If we have an emotional difficulty that occurs on a regular basis, lasts for a significant amount of time when it occurs, or is intense in its effect on us, then it is probably time to take action and seek professional help from a doctor or therapist.   

Into the Woods 

Have you planned your annual spring camping adventure yet? If not, perhaps you should. A study conducted at the University of Colorado in Boulder suggests that a weekend in the great outdoors can reset the body clock—a boon to those of us who have trouble waking up in the morning or shaking the wintertime blues. More time spent outside in bright light, and less time exposed to artificial light at night, improved alertness, mood and even strength in a group of volunteers who went on weeklong camping expeditions. The results were almost as good for campers who spent just two days in the great outdoors.

Rodger Goddard, PhD
Chief Psychologist, Trinitas Regional Medical Center Director of Wellness Management Services
908.994.7334

This type of activity can be a great boost to one’s health, confirms Dr. Rodger Goddard, Chief Psychologist for Trinitas. “Paradoxically, there is a psychiatric disorder called SAD, or Seasonal Affective Disorder,” he adds. “Some people, when sunlight is decreased or restricted, become depressed.” Indeed, light—particularly sunlight—plays an important role in our health. In addition to increased exposure to sunlight, the silence, oxygen, social connection and vacation from the technology overload can do wonders for mental health.

Cervical Cancer’s “Racial Divide” 

Since reaching an all-time high in 1991, the number of cancer deaths in the U.S. has come down steadily and is now 25 percent lower than it was a quarter-century ago. That includes cervical cancer deaths, which are now largely preventable with proper screening and regular monitoring. Yet, according to a study by the Bloomberg School of Public Health at Johns Hopkins, the death rate from cervical cancer is higher than previously estimated. Much of the disparity is attributable to high rates among African-American women, who are as likely to die from the disease as someone in a developing country. Their mortality rate from cervical cancer is more than double that of white women. The study did not get into the reason for this disparity, but an article in Gynecologic Oncology suggested that the relationship between income and access is the likely cause. 

But Is It An Organ? 

Gray’s Anatomy (the book, not the TV series) lists 78 organs in the human body. Is there a 79th? According to scientists at the University of Limerick in Ireland, the tissue that connects the intestines to the abdominal wall—known as the mesentery—should be considered an organ because it performs a specific body function. Namely, the tissue works as one entity to prevent the intestines from jigging around. Which means you couldn’t survive without it. There is an actual “advantage” to being classified as an organ. It means that medical researchers are likely to pay much more attention to it. In the case of the mesentery, that could translate into progress in the understanding and treatment of abdominal disorders such as Crohn’s disease.

Real-Time Concussion Detector 

With football increasingly in the crosshairs of the medical community, it was only a matter of time before equipment measuring concussions in real-time started finding its way onto the field. A new “smart” mouthguard should be available to players nationwide by 2018. The device, manufactured by Prevent Biometrics, calculates a player’s risk of concussion after a hard hit. That information is sent instantly to coaches, team doctors and parents, who can pull a player out of the game if need be. This is a critical decision—study after study has shown that players who stay on the field after a concussive hit take twice as long to recover compared to those who leave immediately. The mouthguard was developed with the help of the famed Cleveland Clinic.

Kevin Lukenda, DO Chairman, Family Medicine Department 908.925.9309

Dr. Kevin Lukenda of Linden Family Medical Associates thinks a computerized Bluetooth mouthguard could be a valuable tool to objectively gauge whether a player is injured and to what degree he may be concussed. “Right now, we depend on referees, coaches, parents, teachers, school physicians and even the student athletes themselves in the diagnosis of concussions,” Dr. Lukenda points out. “Many times these voices go unheard because of the consequence of limiting the student athlete’s ability to play—despite jeopardizing their health. Though there are objective measures to determine a concussion, often times the decision becomes very subjective.”

Early Detection for Autism 

Roughly one in every 100 babies born in the U.S. ends up diagnosed on the autism spectrum between the ages of two and four. According to a study published earlier this year in Nature, brain scans can now detect the origins of autism in the first year of life. Researchers at the University of North Carolina did brain scans on a group of children at high risk of autism (their older siblings were autistic) at 6, 12 and 24 months. The scans showed early differences in the cerebral cortex—which is responsible for high-level functions— in the children who went on to be diagnosed with autism. The study should lead to new tests for autism and, hopefully, opportunities for early behavioral therapies. It also provides a compelling argument against claims that autism is caused by the MMR (measles-mumps-rubella) vaccine, which is typically given after 12 months of age. “The idea that autism is caused by vaccination has been disproved,” conforms Lucille Esralew,

Lucile Esralew, PhD, NADD-CC, CDP
Clinical Administrator for Trinitas CARES and S-COPE
908.966.3033

PhD, NADD-CC, CDP, the Clinical Administrator for Trinitas’s CARES and S-COPE outreach programs. “There is no credible scientific evidence that link the two.” Until such time as brain scans are widely available, pediatricians can detect signs of autism using the Modified Checklist for Autism in Toddlers-Revised (MCHAT-R) as early as 18 months, while psychologists use the Autism Diagnostic Observation Schedule—the gold standard for assessment with children beginning as young as age three. “The Autism Diagnostic Inventory (ADI-R),  a comprehensive review of a child’s early social, communication, behavioral and adaptive skills history is also utilized in assessment.” April, adds Dr. Ersalew, has been designated as Autism Awareness Month. 

The Connie Dwyer Breast Center comes to Trinitas.

By Mark Stewart

Connie Dwyer knows how lucky she is. Lucky to have lived through the ordeal of breast cancer, to be sure. And lucky to have had the emotional and financial support she needed to make it through a double-mastectomy, reconstructive surgery and chemotherapy after being diagnosed in 1999. But it was during her chemo sessions, Dwyer recalls, that she came to understand just how lucky she was.

“I underwent treatment in a room with several other people,” she says. “There was one young woman in particular who took a bus to get there, and then had to take two more buses to get to her job, where she was an hourly worker. She had two children at home that she had to provide for. Chemotherapy is such a shock to your system, physically and mentally. I often think back to the courage she demonstrated, and about how traumatic it would have been for me without the support of my husband, Bob, and our three wonderful daughters. I know it sounds like a cliché, but I wanted to give back.”

Above: A detailed floor plan for the new Conniee Dwyer Breat Senter, which willl be unveiled the Fall.

And so she did. 

In 2004, the Dwyers began working to raise funds for St. Michael’s Medical Center in Newark. They saw a specific need—uninsured women without access to critical services—that was being addressed by the hospital, and created a fund that eventually grew into many millions of dollars

In 2016, St. Michael’s was purchased by Prime Healthcare, a for-profit medical corporation. Legally, their charitable organization could no longer be affiliated with the hospital, so the Dwyers created the Connie Dwyer Breast Cancer Foundation and began looking for a new home

Long story short: later this year, Trinitas will open the $3 million Connie Dwyer Breast Center

“We spoke to a number of places that would have loved to have had us come,” says Dwyer, “but at our very first meeting with Trinitas we were so taken with Nadine Brechner, Gary Horan and all the doctors we met—they were all ‘from-the-heart’ kind of people. You could tell how much they cared about their patients and the women in the surrounding communities. It was an immediate connection. Bob and I felt very comfortable with them, and our board agreed that Trinitas was the best place for us to go.”

Janet Lesko, who has worked with Dwyer since 2004, now serves as the Director of the Connie Dwyer Breast Cancer Foundation. Lesko confirms that they “fell in love” with the people at Trinitas, and adds that Dwyer herself remains the organization’s driving force

Photo by L.A. Brown

“Connie’s vision, leadership and dedication has enabled us to help so many women receive breast cancer screening, diagnosis, and treatment in our community,” she says. “We are delighted to now have the opportunity to expand our reach through a partnership with Trinitas Regional Medical Center.”

“Thanks to Connie’s empathy, sensitivity and generosity, the patients of our region will have a state-of-the-art facility designed for best possible outcomes and compassionate care,” says Nadine Brechner, Executive Director of the Trinitas Health Foundation. “We are most thankful for her partnership.”

“Our missions are actually a perfect match,” points out Trinitas President and CEO Gary Horan, FACHE. “We provide excellent, compassionate healthcare to all the people we serve, including those among us who are poor and vulnerable. We appreciate Connie’s confidence and trust in Trinitas to help further the loving mission of her foundation

As for Dwyer’s newly-independent organization, she says it is laser-focused on its mission to provide breast care and education to uninsured women. The experience has also provided another, unexpected, benefit: Many of her 12 grandchildren have gotten involved.

“By helping me with this work,” she says, “it has made an important impression on them. They have a real sense of what you can do for others in life.”

EDITOR’S NOTE: Connie Dwyer is being honored at the Trinitas Health Foundation Annual Gala on May 4, 2017 at The Venetian in Garfield, NJ. For tickets or sponsorship information, please call (908) 994-8249 or e-mail nbrechner@trinitas.org. For more information on the Connie Dwyer Breast Cancer Foundation, log onto cdbcf.org. 

High-tech mannequins keep Trinitas nursing students on the cutting edge.

By Diane Alter

Remember the Mannequin Challenge, the viral phenomenon that swept the nation in 2016?Well, that was nothing new to the Trinitas School of Nursing (TSON). Mannequins have been teaching and challenging TSON students since 2005, when the first high-fidelity patient simulator arrived. It was called SimMan and it was developed by Laerdal Medical Corporation. Since then the nursing school’s population of high-fidelity patient simulators has steadily grown. The school’s faculty has become increasingly adept at using these medical mannequins to demonstrate key aspects of safe patient care and teach students how to respond to emergency situations.      

TSON’s Learning/Simulation Center is currently equipped with 23 high, medium and low-tech patient simulators.

Seven are high-fidelity computer-operated mannequins that have heartbeats, can breathe, talk, sweat and simulate a wide range of medical conditions and responses to treatment. Two are birthing simulators that can simulate the birth of a baby and the complications of pregnancy and childbirth. Also featured in the lab are part-task simulation trainers. These are smaller simulation pieces of equipment that mimic specific parts of the human body. They are used to practice delicate procedures, such as intravenous therapy, urinary catheterization and colostomy care. 

“The benefits of using the mannequins for teaching are many,” Donna Penn, Dean of the Trinitas School of Nursing, says. “The students practice skills and techniques. They also learn how to communicate, problem-solve, and engage in critical thinking—all in a very safe and controlled environment. The mannequins provide an interactive environment that permits hands-on experience where students can make mistakes and learn and grow from them.” 

Assistant Deans Monina Franco-Tantuico and Rose Santee explain that the mannequins also allow students to reflect and think back on what they did right or wrong, and change their behavior as needed. The devices also allow teachers to create scenarios that students will hopefully never see, but if and when they do, they will have received training on how to react. 

“It is a very effective and modern way to teach,” says Franco-Tantuico. 

“It makes all of us think more, and it keeps us all on our toes,” adds Santee.

The Learning/Simulation Center also includes a digital audio-visual system that transmits and records situations in a simulated environment to facilitate learning. Control rooms for the simulation area permit instructors and computer specialists to remotely operate the mannequins. An adjacent debriefing room enables instructors and students to review the video recording of the simulated scenario and engage in a reflective discussion of what occurred during that simulation. The Learning/Simulation Center is just one more example of how TSON continues to enhance students’ learning environment and promote professional growth. 

The school’s commitment to excellence is continually recognized and rewarded. TSON was yet again designated as a National League for Nursing Center of Excellence (COE) for 2015-2020 in the category of “Creating Environments that Enhance Student Learning and Professional Development.” This marks the third consecutive COE designation in this category since 2008. 

Editor’s Note: The TSON’s Learning/Simulation Center has been filmed by The National League for Nursing, the premier organization for nurse faculty and leaders in nursing education.

Trinitas launches a new telehealth initiative. 

By Ghilianie Soto 

In the healthcare business, it’s all about follow-up. Heading into 2017, Trinitas established Project ECHO to build on the successes of Crisis Assessment Response and Enhanced Services (CARES) and Statewide Clinical Outreach Program for the Elderly (S-COPE)—two of its most innovative outreach initiatives. CARES, a statewide funded program by the NJ Division of Mental Health and Addiction Services, is a crisis response team for community dwelling adults with intellectual and developmental disabilities and co-occurring mental health and behavioral disorders. S-COPE provides a similar service to older adults in long-term care. The monitoring, coaching and regional training offered by the CARES and S-COPE teams were strictly on-site.

Project ECHO extends these vital offerings via the Internet.

Project ECHO—which stands for  Extension for Community Healthcare Outcomes—uses virtual conferencing via a platform called Zoom to hold sessions with guests and partners, including group homes, day programs, hospitals, nursing homes, and clinicians who manage cases for CARES and S-SCOPE. Partners can participate via smartphone, laptop, desktop or tablet. Family members of an individual diagnosed with behavioral health issues can also submit cases for review by Project ECHO experts

A few of the members of “the Hub” at Trinitas’ New Point Campus. From left to right: Phillip Caruso, LPC (Clinical Supervisor, CARES), Mobin Chadha, LCSW (Clinical Coordinator, S-COPE), Lucille Esralew Ph.D., NADD-CC, CDP (Clinical Administrator, CARES & S-COPE) and Bonny Uchenna Life, MA,MPP (Program Coordinator, CARES).

“Our motto is ‘Move the right knowledge to the right place and to the right people,’” says Lucille Esralew, Ph.D., Clinical Administrator of CARES and S-COPE, who oversees Project ECHO. “Instead of transporting individuals with complex needs long distances to specialists, we can now provide specialty consultation at the primary point of care. Partners can essentially conference in from the comfort of their own homes if they so choose.” 

The aim of Project ECHO is to equip providers, families, and clinicians with best-practice approaches to serve individuals with complex problems. Where extreme solutions are often offered by an agency or provider that could potentially be more detrimental to the overall mental health of a client, Project ECHO provides a space to fully review the case and offer alternative solutions with the client’s best interest. Project ECHO also serves as a tool to train community providers, facility providers as well as students in social work, nursing, psychiatry, professional counseling and psychology. 

Each Project ECHO session includes two case presentations and a brief exercise or didactic on a related topic. All client information is kept confidential. The sessions last approximately 1.5 hours and consist of an inter-professional team known as “The Hub.” The Hub of the Project ECHO team includes psychologists, advanced practice nurses (APNs), social workers, behaviorists and professional counselors. The client never appears during the session, nor are the sessions intended to be a method for delivering treatment. The intent is to increase the number of professionals involved in providing care and services to a particular client

Project ECHO was originally developed in 2003 by Sanjeev Arora, MD, and his team at the University of New Mexico. The program was initially designed to train and mentor local providers in rural New Mexico in the care of HIV patients due to the scarcity of specialists and the difficulty in accessing specialty care. Dr. Esralew—along with several Trinitas staff members including Leone Murphy, APN (S-COPE), Bonny Uchenna Life (CARES), Phil Caruso LPC (CARES), and Mobin Chadha (LCSW)—attended a five-day training session in Albuquerque in late 2015.  

Project ECHO sessions are held twice a month for S-COPE and CARES, and are broadcast out of Trinitas’ New Point Campus in Elizabeth. Another specialty project involving developmental disabilities and dementia was recently added. This program is funded by an HRSA Geriatric Workforce Enhancement Project, through which Trinitas partners with Rowan University School of Osteopathic Medicine.

Although Project ECHO’s telehealth format is used worldwide, current applications and resources for behavioral health with vulnerable adults remain limited in New Jersey. While some parts of the state are heavily populated—with competent psychiatrists and behavioral health experts—other areas are in real need of critical guidance. 

Bonny Uchenna Life, MA, MPP (left), and Phillip Caruso, LPC, launch an ECHO session with the rest of “the Hub” team conferencing in via Zoom.

“There will never be enough specialists, but we can train and incentivize those who do exist,” explains Dr. Esralew. “There has to be a mechanism that matches the needs of each client with a provider in order to make changes to the system of care for these individuals.”

With over 1,000 cases seen by CARES in the state of New Jersey in 2016, Project ECHO is poised to make a profound difference in a lot of lives in 2017.  

For more information on Project ECHO contact:

Mobin Chadha, LCSW

Clinical Coordinator, S-COPE mchadha@trinitas.org

For more information on CARES  call 1-888-393-3007. For information on  S-COPE call 1-855-718-2699.

News, views and insights on maintaining a healthy edge.

Colorectal Cancer Rates: Good News, Bad News     

Seventeen years ago, President Bill Clinton officially set aside March as National Colon Cancer Awareness Month. On the 3rd of the month this year, you’ll see a lot of blue stars around; that Friday is Dress in Blue Day (dressinblueday.org). The good news is that, since 2000, there has been a marked drop in colorectal cancer incidence—more than 30 percent among Americans 50 and older. The distressing news is that,

Samiappan Muthusamy, MD
Past Chief of Gastroenterology/Endoscopy, Trinitas

according to several recent studies, over the next 15 years, the number of colon and rectal cancer cases among adults 20 to 34 is projected to practically double. Cases among adults 35 to 49 are also expected to increase. “The plummeting rates in adults 50 and over were attributable to greater awareness of the importance of screenings and colonoscopies,” says , past Chief of Gastroenterology/Endoscopy at Trinitas. “However, because there are no set guidelines for screenings

of younger Americans, these types of cancers—though relatively unusual between ages 20 and 50—may go undetected. If you have a family history of colon cancer, especially a close family member who was diagnosed before the age of 60, then a colonoscopy is recommended by the time you turn 40.”  

The Popsicle Cure 

Over the remaining few weeks of winter, there’s a good chance that someone will bring a bug into your home or workplace. If you catch it, one of the symptoms is likely to be a sore throat. In case it’s been a while since you’ve had to deal with this kind of dryness and pain, there are a few important things to remember. According to the National Institutes of Health, keep your throat moist. That means drinking lots of fluids, and having saliva-producing lozenges or hard candies handy. You can even treat yourself to an occasional popsicle. These will help with dryness. Throat sprays and either acetaminophen, ibuprofen or aspirin are good pain-reducers. If soreness persists beyond the normal length of a cold—or if it is accompanied by a fever—see your physician and make sure it’s not strep or tonsillitis.

Networking Error 

Facebook took a lot of heat for propagating “fake news” during the past election, but according to researchers at Lancaster University, there’s something even more depressing: Facebook itself. In a survey of 35,000 people between the ages of 15 and 88, the Lancaster study found that Facebook users who compared themselves negatively with others were at increased risk of depression. Those at greatest risk were individuals who “friended” former partners, made frequent negative status updates or felt intense envy when they observed the “life highlights” of others. The research did point out that social media engagement could also help with depression—when used as a mental health resource or to enhance social support.   

Engineering Marvel 

When doctors can’t solve a problem, it’s not a bad idea to let the engineers have a crack at it. A case in point is a breakthrough in hemophilia treatment. Researchers at the Cockrell School of Engineering at The University of Texas at Austin have come up with a special capsule that will soon be able to deliver treatment for those who suffer from the hereditary bleeding disorder. The capsule releases micro- and nano-particles that carry a protein therapy that treats hemophilia B. Hemophilia B is caused by a missing or defective factor IX, a clotting protein. Currently, hemophilia treatment is painful and expensive, and is often unavailable in remote regions of the world. As a result, hemophiliacs in developing countries often die in childhood. “Our new oral delivery of factor IX can now overcome these issues and improve the worldwide use of this therapy,” says Sarena Horava, the study’s lead author. 

Wait…What? 

More and more women are becoming mothers in their late 30s and 40s than ever before. Although there are certain health risks associated with later pregnancies, researchers at the University of Southern California report that women who have their final baby at age 35 or older appear to have an advantage later in life. The USC study looked at 830 post-menopausal women and noticed that those who had their last baby at age 35 or older had sharper cognitive skills at age 60 than women who stopped bearing children earlier on. Dr. Roksana Karim, who led the study, noted that she would not advise women to wait and have their final child after age 35.

The study also found that women who had been pregnant twice or more had better cognitive skills later in life than those who had only been pregnant once. More work is needed to explain these links, but researchers suspect they are related to exposure to higher levels of estrogen.

Digging New York 

While medical researchers brave the wilds of the Amazon and other remote regions of the world to look for new medicines, researchers from Rockefeller University have discovered promising microbes a bit closer to home: in the dirt of New York City parks. According to the Proceedings of the National Academy of Sciences, researchers tested 275 samples and found genetic evidence of bacteria capable of producing a wide array of compounds that can be harnessed for new medicines for cancer, as well as for bacterial and fungal infections. “The sheer diversity we saw suggests there are many more potentially valuable compounds out there awaiting discovery,” says Professor Sean Brady, who heads up Rockefeller’s Laboratory of Genetically Encoded Small Molecules. “Even in a place as mundane as urban soil.” One sample from Brooklyn contained genes that encode 25 molecules that are being studied for potential use as antibiotics and other types of medicines.

Walk Before You Run 

So your big New Year’s resolution was to try your first 5K run this spring? Where there’s a will, there’s a way as they say. But you may need to do more than buy a

Jim Dunleavy, PT DPT MS Director, Rehabilitation Services 908.994.5406

new pair of running shoes. According to the American Council on Exercise, you’ll need to give yourself at least

five weeks to prepare. At the start, it’s important to walk and run about 25 minutes four days a week—and then gradually increase the distance and duration, as well as varying the workout. Also, have a high-carb snack before you workout, and drink lots of water.

Before entering your first 5K, or when starting any exercise program check with your medical doctor first—especially if you have any chronic conditions such as a cardiac, lung or blood condition, says Dr. Jim Dunleavy PT DPT MS, physical therapist and Director of Rehabilitation Services at Trinitas. “Also, remember to set reasonable distance and time goals and slowly build up to your ultimate goal in order to avoid joint, muscle and tendon issues.” Finally, check out the course so there are no surprises on race day.

Vision becomes reality with a groundbreaking behavioral health partnership.

By Mark Stewart

The future of healthcare is a topic of considerable debate in this country. Experts will argue endlessly the pros, cons and particulars of the various industry sectors, and consumer advocates will probably be battling with insurance companies until the end of time. Interestingly, there is one thing everyone seems to agree on: Integration of services is the key to any real progress. It was against this backdrop that Trinitas Regional Medical Center and St. Joseph’s Regional Medical Center in Paterson forged an Integrated Behavioral Health Network—one of the largest and most comprehensive in the region. The partnership was announced in late 2016.   

Both hospitals offer behavioral health programs, services and treatment centers on their main campuses and satellite facilities in their respective counties (Union and Passaic). Both have points of access in Essex County, as well. With the Trinitas-St. Joseph’s Behavioral Health Network, patients in all three counties can get the specialized care they need throughout the entire Trinitas–St. Joseph’s system. 

Maria V. Padron, MD, Medical Director, Child Adolescent Outpatient Unit at Trinitas Regional Medical Center.

The goal of the initiative is to promote behavioral health by making the process seamless and less stigmatizing for the patient, says Dr. James McCreath, the Network’s Executive Director.

“We’re looking for ways to bring behavioral health to the primary care office,” Dr. McCreath explains. “For example, if your doctor is treating you for a heart condition and notices signs of depression, we want it to be easier for you to arrange that evaluation or consult right then and there—without having to make a lot of frustrating phone calls or hunting for information on web sites. This integration of services recognizes how mental health impacts other health issues, and vice versa.”

The genesis of the Network was a discussion between Gary Horan, President and CEO of Trinitas, and Kevin Slavin, his counterpart at St. Joseph’s, about how their hospitals could provide integrated services. The obvious first step was to have one Chair of Psychiatry oversee both sites. Trinitas had a chairperson retiring, while St. Joseph’s was in the process of hiring one. The individual they chose to manage the entire system was Dr. Carlos Rueda. It made sense to integrate on the administrative side as well, so the two hospitals agreed to share the management expenses. 

Dr. Carlos Rueda Regional Chairman of Psychiatry/Behavioral Health
Trinitas-St. Joseph’s Behavioral Health
Network

“One of the great challenges facing patients with mental health needs is getting into the right program that offers the greatest benefit,” says Dr. Rueda. “Our vision for the integration at a system level was to be able to offer uniform services over larger geographical areas. So, for instance, patients with an emergency visit in Elizabeth who want to follow up with a Paterson doctor can be managed with a simple release. That convenience factor of having a system large enough to provide all the services a person might need has myriad benefits.”   

This is especially true in cases where one hospital has a particular strength or specialized service. For instance, St. Joseph’s offers psychiatric services for the hearing impaired. If a hearing-impaired patient of a Trinitas physician needs mental health services, that office can make an immediate referral, rather than just handing them a phone number. Likewise, if St. Joseph’s doctors see elderly patients dealing with anxiety issues, they can set up appointments with the Trinitas program that sends staff out to the homes of the elderly. The Network is likely to have a major impact on children and adolescents in need of psychiatric care who come to St. Joseph’s. Before, their doctors had to call around to locate a bed. Now there is a protocol to have those patients admitted to Trinitas, which excels in this area.

There are significant benefits to the two hospitals, of course. In addition to creating a system that promotes better patient outcomes, Trinitas and St. Joseph’s put themselves in a stronger position to negotiate and be a more active partner with insurance companies.

Dr. James McCreath Executive Director
Trinitas-St. Joseph’s Behavioral Health
Network

“From the consumer side, dealing with the healthcare system can be very complex at a stressful time,” Dr. McCreath says. “Getting authorizations and approvals is difficult. But having a system large enough so that you can go through us to identify resources—rather than dealing with the insurance companies—relieves a lot of that stress.”

“It’s not just about being bigger,” adds Dr. Rueda. “It’s about offering greater access to people who may not have known where or how to get these critical services.” 

THE NETWORK

The Trinitas-St. Joseph’s Behavioral Health Network brings together more than 700 employees and staff members with an annual budget of $50 million. Patients will have access to more than 40 psychiatrists. The Network will provide more than 350,000 outpatient contacts in 2017 and over 3,000 inpatient admissions. 

DID YOU KNOW?

In 1933, Elizabeth General (the precursor to Trinitas) created the first inpatient psychiatric program east of the Mississippi. In 1972, the hospital opened the first community mental health center in the state.

What you don’t know can hurt you. 

By Alison Hemstitch

Over the next couple of months, Spring Break stories will be taking up a lot of bandwidth. College students and 20-something singles will be invading beach towns around the country for a week of drinking and debauchery. Lost in the blur of bikini parties is the fact that a huge number of young families also fly south to catch a week of sunshine before the first whispers of spring.      

Unfortunately, a certain percentage of vacationing families will be victims of illness, accidents and other mishaps. The better prepared you are and the clearer you are in terms of your actions and options, the less likely they are to be vacation-killers.

“Spring vacation is a great time for families,” says Yelena Samofalov, MD, of the Trinitas Pediatric Health Center.“

Making it safe is just as important as making it memorable. Before you travel, find time to visit your family doctor to make sure you and your kids receive any necessary vaccines. For instance, flu season might be over here in New Jersey, but in other parts of the world it could still be a factor.”

Most warm-weather vacation problems start at—where else?—the water’s edge. The obvious ones involve the sun. Keep in mind that your kids have probably been dealing with a New Jersey winter for several months and that they will burn quickly and easily. A lot of families will check in to their hotel, tear off their travel clothes and sprint toward the water, making up for lost time, as it were. An hour frolicking on the sand or at a resort pool is all you need to get a bad burn. 

BURNING LOVE 

Needless to say, any time spent under an open sky demands sunscreen with a minimum 30 SPF. Most adults can go 20 minutes before having to cover up. However, on a hot, sunny day a child with sensitive skin can start burning in less than 10 minutes without protection. If kids sweat or go swimming, you’ll have to reapply. So either travel with a plentiful supply of sunscreen or make sure you can buy it easily where you’re staying. If you rent a car, it’s a good idea to take an extra container and throw it in the glove compartment. Okay, so now your child is beet-red and in excruciating pain. First of all, know when it’s time to seek medical attention. As a rule, a temperature of 101 or more is the tipping point. And a severely burned baby (one year or younger) should generate a call to the doctor, because sunburns are extremely dehydrating. By definition, this is an emergency.

For older children, hotel-room treatments and remedies are fairly straightforward. The first move is a cool (not cold) shower or bath. No soap. No rubbing dry. Next, a visit to the ice machine. Wrap a handful of cubes in a damp hand towel and apply it to the reddest areas. If pure aloe vera gel is in your survival kit, apply it liberally and often—it speeds healing and moisturizes. You can also soak a washcloth in milk and use it as a compress. Milk will create a kind of protein film that will reduce the heat. Also, monitor how often your patient is urinating. You’ll want to give them water and juice to keep them hydrated for then next few days. 

DON’T EAT THAT!

Another source of vacation misery is food poisoning. Many families will try to save time or money by packing sandwiches for the beach and tossing them in a cooler. Be aware that anything involving meat, cheese, mayo and other condiments may spoil quickly and cause problems later. Better to plan a day at the beach between meals and bring dried fruit or cookies to keep up the energy of the little ones. 

Of course, most of your vacation meals will be prepared by someone else. So there is no telling how diligent they are about food safety. And then there is the resort buffet, where your fellow guests have an opportunity to contribute their germs to the mix.

Should your child develop nausea, a stomach ache, diarrhea or start vomiting, don’t panic. Food poisoning is ugly but it is not a total vacation-killer. In many cases, with enough rest, the kid will bounce back in two or three days. The key is to avoid dehydration—this happens in a child much faster than in an adult. Make sure they consume (and keep down) five ounces of clear liquid per hour. And station them close to the bathroom. If abdominal cramping is severe, a heating pad on the stomach will provide much-needed relief. 

Once the nausea and diarrhea have stopped, reintroduce food gradually. Bananas are ideal in a vacation setting. A room service order might include toast, noodles or rice and eggs. One mistake parents make is to give milk to a recovering child. The enzymes in their small intestine have been wiped out and they may not be able to process the lactose. 

The good news is that what appears to be food poisoning might not be food poisoning at all. Sometimes, on vacation a child will try some unfamiliar food and discover he or she has some kind of intolerance. Also, babies and toddlers have been known to eat sand. Yeah, that happens. In both cases, evacuation is usually fast and furious and your vacation won’t miss more than a half-beat.

SKIN DEEP

Less likely to ruin a vacation but more common are the scratches, scrapes and cuts a child will suffer in an unfamiliar environment. The same is true of insect bites and stings.  Skin cuts and abrasions get the same treatment on vacation as at home. Wash them thoroughly with soap

under running water for several minutes, and make sure to gently scrub away dirt with a washcloth. Cover the wound with a bandage and some Polysporin, and change the dressing once or twice a day, or more often if it gets wet. Better yet—especially if you’re on vacation near a body of water—use a liquid bandage product. You may get through the entire vacation with a single application.

With bug stings and bites, it is very important to monitor your child’s reaction. If you already know your child is allergic to, say, bee stings, then you are familiar with the immediate action steps—an Epinephrine injector is a must. If not, then facial swelling, a severe rash, dizziness, labored breathing—or any combination—are signals to locate a doctor ASAP. Remember, in a vacation setting you may encounter an entirely new creature. In Mexico, for instance, baby scorpions are known to hide in all sorts of odd places. 

Pain, itchiness and swelling are typical results of insect encounters. Without an allergic reaction, though, they are rarely causes for panic. If an area becomes infected, however, that can turn serious. It is important to treat stings and bites quickly and intelligently. Wash the site with soap and water, apply ice on and off 5 to 10 minutes at a time, and feel free to use children’s ibuprofen or acetaminophen. Calamine lotion can also keep the site from itching. In a pinch, a baking soda paste will work just as well. An antihistamine cream is a good option, though not for infants and toddlers.

BRING IT

So how best to fill one’s survival kit? Responsible parents will bring knowledge, experience and an arsenal of emergency remedies. According to Dr. Samofalov, don’t leave home without the following:

• Thermometer to check for fevers
• Sunscreen SPF 30 (x2)
• Children’s Tylenol or Advil to control fever or pain
• Instant cold pack for minor injuries
• Antihistamine spray for insect bites
• Adhesive bandages for cuts and scrapes, including a large patch-size
• Polysporin to prevent cuts from getting infected
• Calamine Lotion or A and D ointment
• Aloe Vera Lotion
• Insect repellant spray or wipes (use on clothing to avoid skin irritation)
• Heating Pad
• Liquid bandage

You’d think these Spring Vacation survival essentials would be available at your destination, day or night. You’d be wrong, cautions Dr. Samofalov.

“Getting sick on vacation is never part of the plan,” she adds, “but if it happens, don’t be shy about visiting a doctor or emergency room. Remember, it’s better to be safe than sorry.”  EDGE

PLANE SPEAKING

For some families, a spring vacation can “go South“ at the end of the jet way. Follow these three rules and at least you’ll get to your destination unscathed.

• Put kids at the window or in the middle seats. Aisle seats can be hazardous to little fingers and toes—and heads. Adults stumbling to the rest room or fumbling with the overheads are accidents waiting to happen. And then there are those drink carts. Imagine spending a week at Disney World nursing your kid’s crush injury.
• Keep kids belted. Sudden turbulence can send a small body flying. You may have a vague recollection from high school physics class about how this works. Just as important, belted children are less likely to annoy the passengers directly in front of them.

Think big. Most/many airlines still allow a “lap child” under the age of two at no charge. If you can afford the extra seat, buy it. Bookending your vacation with a screaming, squirming infant is the definition of sheer misery. Same goes for a toddler. This is the beauty of car seats. Check to see if yours hooks into airline buckles.

GO-TO SPOTS

According to Travel Channel, these warm-weather destinations are among the hottest family vacation targets for Spring ’17:

Club Med • Dominican Republic

South Seas Island Resort •

Florida

Kauai Surf School • Hawaii

Loews Coronado Bay • San Diego

Sandy Lane • Barbados

Paradise Island Resort • Bahamas

Yelena Samofalov, MD Trinitas Pediatric Health Center 908.994.5750

When drugs won’t work for depression, what’s the next move?

By Yolanda Navarra Fleming

According to the Centers for Disease Control, 1 in 30 people in America will deal with major depression this year. The prevalence of major depressive episodes increases with age, with the rate climbing to 1 in 20 for people between the ages of 46 and 64. Over 65, the number of severe cases declines, but about 10 percent of American adults over 65 will develop what could be considered “mild depression”—which is a gentle way of saying it’s a diagnosable depressive disorder.

Overall, women are at least 50 percent more likely to report a significant depressive episode. Roughly 11 percent of adolescents will deal with a depressive disorder by the age of 18, while 30 percent of college students report that they felt sad or depressed to the degree that it affected their ability to function in school.

You can quibble with these numbers—they rise and fall depending on clinical criteria and also who’s doing the studies—but there is no arguing that depression has a crippling effect on almost every aspect of the pursuit of happiness in America. On one end of the spectrum, it may involve temporary sadness (aka “the blues”). On the other end, it can last indefinitely, profoundly diminishing quality of life to the point of complete dysfunction. According to the Anxiety and Depression Association of America, depression is the leading cause of disability worldwide. People with depression may also suffer from anxiety disorders, which are different, but share similar symptoms—including insomnia, the inability to concentrate, nervousness, and irritability.  

The good news is that doctors have an ever-growing arsenal of pharmaceutical solutions. These medications have changed the game for millions of sufferers. The not so- good news is that a high percentage of individuals—as many as half of the 15 million people experiencing depression—either cannot tolerate or do not respond to these drugs.

Enter Transcranial Magnetic Stimulation (TMS), an FDA cleared non-invasive treatment that uses magnetic fields similar to an MRI to stimulate the brain. The treatment has no systemic side effects and requires no hospitalization or anesthesia. To date, the therapy has been proven in more than 60 clinical trials worldwide.

The Trinitas-St. Joseph’s Behavioral Health Network has partnered with HPR Treatment Centers (a division of TMS Centers of America) to offer BrainsWay Deep TMS at two treatment facilities in Essex County, followed by another six sites throughout Northern New Jersey over the next year.

Despite being a newer treatment for depression, TMS is a proven option with impressive efficacy rates and research results.

“TMS is indicated for the treatment of adults with major depression who have not responded to at least one antidepressant,” says Dr. Carlos Rueda, Chairman of Psychiatry for the Trinitas-St. Joseph’s Behavioral Health Network. “We are excited to bring this therapy option to the residents of New Jersey, offering new hope for a complex condition.”

“This partnership allows us to work with two of the leading medical institutions in the state to provide a comprehensive continuum of care to treat those suffering from depression,” adds Ben Klein, Founder and CEO of HPR Treatment Centers. “We have been offering TMS to patients across the country and know firsthand the significant impact the treatment has on patients. We have seen people with depression—who have lost hope— regain it when they achieve remission through TMS.”

“Depression is believed to be caused by electrical dysfunction of one region of the brain, known as the dorsolateral prefrontal cortex,” explains Dr. Rueda. “Through a highly focused and targeted magnetic stimulation, we’re able to boost the function of the brain in this region, allowing for a remission of the depression.” Because TMS is a non-drug, non-invasive treatment, patients are awake during the procedure and can get back to daily activities, including driving, immediately following the session.

“We look forward to working with HPR Treatment Centers to help Trinitas and St. Joseph’s deliver optimal mental health solutions to their patients and partner with them in this initiative that will address a growing challenge in treating mental health patients,” says Joe Perekupka, Vice President at BrainsWay. “HPR Treatment Centers have demonstrated true leadership in increasing access to Deep TMS for patients across the country. By providing the tools necessary to help these facilities treat patients who are suffering from mental disorders, we are enabling better outcomes for patients.”

Trinitas Expands Behavioral Services to Bayonne

Elizabeth-based Medical Center assumes ownership of Bayonne Community Mental Health Center The healthcare world is in a rapid state of transformation where new opportunities often arise to elevate the level of care. Such an opportunity presented itself in 2017, when the Board of Trustees of Bayonne Community Mental Health Center (CMHC) elected to have Trinitas Regional Medical Center assume ownership of the CMHC. “This transition to ownership by Trinitas promises to be as seamless as possible. There are no plans for any interruption or major changes in the name, services, personnel, hours, location or anything else that would impact the clientele or the community,” explained Joseph M. Kadian, Psy.D., President and CEO of the CMHC. 

According to Gary S. Horan, FACHE, President & CEO of Trinitas, “In line with Trinitas’ historically strong leadership role in mental health and substance abuse treatment, the Bayonne community can expect to receive the highest level of care it has come to know and rely on during the span of the Center’s 46 years of service. Trinitas plans to upgrade important elements of administration, including electronic medical records, computerized registration and billing software, and high-speed telecommunications equipment.”

Questions can be directed to Dr. James McCreath at 908-994-7060 jmcreath@trinitas.org.

THE ROOTS OF TMS

The field of Electrophysiology (of which Transcranial Magnetic Stimulation is a part) is nothing new. In fact, it dates back centuries. Near the end of the 18th century, Luigi Galvani first performed the same experiment you probably did in high-school Biology: noting that the legs of a dead frog twitched when touch by an electrical current. Galvani’s name is still with us today (galvanization). Several decades later, another giant in the history of science, Michael Faraday, did groundbreaking work in electromagnetism and electrochemistry, which established the foundation for research on brain stimulation through electricity and magnetism. By the mid-1900s, electroconvulsive therapy was widely used to treat major depression and other forms of mental illness. The first use of magnetic fields on electric signaling in the brain began in the 1980s, primarily for diagnostic purposes. By the early 2000s, however, researchers started noting the therapeutic possibilities of TMS.

Editor’s Note: BrainsWay Deep TMS was developed in collaboration with the National Institute of Health (NIH) and is FDA and CE cleared to treat patients with depression who are not currently responding to medication. The treatment is widely covered by most insurance payers. For more information or to make an appointment, call (631) 807-5759.

News, views, and insights on maintaining a healthy edge.

A New Line in the Sand 

Is it possible to develop high blood pressure without seeing your blood pressure rise? The answer is yes. A team of experts assembled by the American College of Cardiology and the American Heart Association has concluded that the new cutoff should be 130-over-80. That immediately puts more than 30 million people in the U.S. into high blood pressure category. The most-affected group is men under the age of 45; the number of men who are “over the line” now triples. The good news is that the new cutoff does not mean that these folks will have to go on medication. The 130-over-80 number will more accurately identify individuals who are at a higher risk for stroke and heart attack—and hopefully a wake-up call to smokers and people who don’t get regular exercise.

Danger Alert for TV Binge Watchers 

Doctors have been telling us for years to “get up off the couch” and exercise. Now they are telling us that this won’t do much good if we simply return to the couch. A study conducted by the University of Vermont on the TV-watching habits of more than 15,000 people has found those who say they watch “very often” are 1.7 times more likely to develop dangerous deep-vein blood clots. That in and of itself is hardly surprising. The eye-opening part of the study concerned middle-aged subjects; heavy TV-watchers in that age range who also got 150 minutes of exercise a week appear to have a slightly higher risk of DVT. Bad news for binge-watchers. Bad news for Netflix!

Now Hear This 

Surgically implanted hearing aids have had a spotty history. Often they fail for the simplest reason: the middle ear is not a one-size-fits-all environment. At a December meeting of the Radiological Society of North America, researchers presented an exciting breakthrough that combines CT scans with 3D printing to produce custom-design implants for the middle ear, where three tiny bones (ossicles) transmit vibrations from the eardrum to the cochlea. Damaged ossicles are reconstructed with prostheses made of stainless steel and ceramics, which have a high failure rate. Dr. Jeffrey Hirsch, who authored the study, points out that the odds of getting a perfect fit are less than 1 in 1,000. In its first trial run, the CT+3D method had spectacular results. “This study highlights the core strength of 3D printing,” says Hirsch of the ability to very accurately reproduce anatomic relationships in space to a  sub-millimeter level. “With these models, it’s almost a snap fit.”

Is Chocolate a  “SAD” Solution? 

As spring creeps ever closer, the light is at the end of the tunnel for those who suffer from Seasonal Affective Disorder, aka SAD. To make it through these last few weeks, science offers some tools to keep up your spirits. Helping others can be a surprisingly uplifting experience, even if it’s not something you usually do. While volunteerism is at its peak around the holidays, by February and March there is a need for help at local shelters, food pantries, etc. Another option is 30 to 60 minutes of strenuous exercise, such as fast walking or aerobics. Exercising outdoors, even in cold weather, can boost your focus and reduce stress. New research also suggests that exercising under bright lights will have similar benefits. Even when not exercising, exposing yourself to bright light (such as a light box) for a half-hour a day has been shown to be effective for some people as anti-depressants. Here’s the best news: eat high-quality chocolate. It’s a proven mood booster and can relieve anxiety. We’re not talking about candy bars here—they may give you a quick pop, but may also contribute to negative feelings as you come back down.

Double Trouble 

One of the many ways social media has changed our lives is through the spread of information on alternative cancer therapies. But has it changed our lives for the better? According to a study published in the Journal of the National Cancer Institute, people who choose alternative treatments for commonly curable cancers may double their risk of death. The authors defined “alternative” as a medical treatment administered by a non-medical person. Conventional therapies include chemo, radiation, and surgery. Patients who pursue non-medical options run the risk of allowing their cancers to spread to other parts of the body, including the lymph nodes. The study offers the example of stage-one breast cancer. With traditional treatment, a patient’s five-year survival rate is almost 100 percent. If that cancer is allowed to reach stage four, that survival rate is reduced to 25 percent. The study covered the most common cancers and looked at outcomes of 280 patients who chose alternative medicine versus the outcomes of 560 patients who went the traditional route.     

Is That Cigarette Really  Worth Seven Years?  

Whether we admit it or not, we all keep score as we age. We weigh our bad habits against our good ones and temper those estimates with what we know about our genetics. It’s an inexact science, to be sure…yet not as much as it used to be. University of Edinburgh researchers looked at the genetic makeup of 600,000 individuals from three different continents, zeroing in on genes related to lifestyle choices, including smoking, drinking, overeating and substance abuse. They were able to come up with a fascinating scoring system. For instance, people live an average of two months less for every kilogram they are overweight. Pack-a-day smokers shave off an average of seven years. The study also found that people live an average of 11 months longer for every year of schooling they have. Genes related to cholesterol levels and the immune system also appear to have a dramatic impact on life expectancy. The conclusion drawn by the researchers was that genes play a major role in determining life expectancy, but our lifestyle choices have a far greater impact than most people imagine.

In the halls of the Trinitas Wound Center, sounds of success.

By Yolanda Navarra Fleming

Among the many iconic lines from the 1946 holiday classic It’s A Wonderful Life, perhaps the most memorable is “Every time a bell rings an angel gets his wings. That’s a matter of faith, of course—and also, why not “her wings” am I right? In the Wound Center at Trinitas, there is no question about the meaning of a ringing bell. It signals that yet another patient has been healed.

Since a past director of the Wound Center found the bell in her garage and offered it to help celebrate patients being discharged, there have been thousands of among them some of the daunting, chronic cases. The Wound Center’s Clinical Coordinator, Kimberly Lee, CRN, MSN, CWCN, (left) vividly recalls a young girl being treated for a diabetic foot wound.

“She was so delighted that day that she made a video call to her father so he could watch her ring the bell,” says Kim, who has worked at the Wound Center for 13 years. “They were very close, so it meant as much to him as it did to her. They were both crying. They took pictures with the staff and we were all teary-eyed.

“Hearing the bell also gives patients in the waiting room a boost of hope that they might be the next to ring it.”

A Comprehensive Approach

The award-winning Wound Center has a 95 percent healing rate thanks to the latest technologies and years of intense study and hands-on experience. Lee’s team includes Dr. John Pepen (right, top), Dr. Georgios Kotzias (right, middle) and Dr. Morteza Khaladj, DPM, FACPPM (right, bottom)—all skilled in a wide range of healing strategies, including Vacuum-Assisted Closure (VAC) and Hyperbaric Oxygen Therapy.

VAC removes infectious material and promotes the growth of new blood vessels to prepare for grafting. The Apligraf Living Skin Device creates a biological dressing for limb-threatening venous leg ulcers and other wounds that don’t heal easily. Hyperbaric Oxygen Therapy treats an array of clinical conditions that require increased exposure to oxygen, such as diabetic foot ulcers, pressure ulcers and venous leg ulcers.

“It’s an adjunctive treatment for patients with complicated wounds that are not responding to conservative treatment,” says Dr. Pepen, Wound Care and Hyperbaric Medicine specialist, who also performs acute care surgery. Inside the Hyperbaric chamber, he explains, a patient breathes 100 percent oxygen. This improves the elimination of certain poisons, such as carbon monoxide, as well as strengthening the body’s response to infection and supporting tissue growth and wound healing.

Many patients are diabetic and acquire wounds as a result of neuropathy, which is nerve damage that can make the hands and feet numb, adds Lee.

“Most diabetic patients have neuropathy and can’t feel things on their feet because of it,” she says. “If there’s a wound on the bottom of the foot, it often gets worse before they even know it’s there. Then the wound becomes infected and spreads to the toes; the patient doesn’t notice it until their toes are black. If they’re swollen from fluid overload, all they have to do is bang into something and they have another wound.”

After two weeks of hyperbaric treatments, the doctor re-evaluates. But hyperbaric treatment works best when other aspects of a patient’s care plan are closely tended to, including not missing treatments. Next-day appointments are an option for all patients.

For diabetics in particular, regulating blood sugar levels and good nutrition are crucial. That’s why Michelle S. Ali, MPA, RD, Director of Food & Nutrition Services has joined the wound care team.

“Some patients live on a fixed income and don’t have the ability to shop or prepare elaborate meals, which means they are not eating adequately,” she says, adding that it takes a physical assessment to determine the nutritional risk of such patients, and then to attempt to guide them on food selections to make improvements. “It may be as simple as adding a cup of milk to a meal or adding peanut butter to a milkshake, in a case where the patient is consuming adequate protein but needs to increase their overall caloric intake when significant weight loss is identified.”

According to Ali, recommendations of vitamins and mineral supplements may also be essential to a patient’s healing process.

Every Day a New Challenge

Newark resident Theresa Billings, a 53-year-old with Multiple Sclerosis and poor circulation, has been a patient of the Wound Center since 2017. Her dependence upon a motorized wheelchair to get around means that for most of the day, she’s sitting with her feet down, which makes her prone to leg wounds.

“Theresa came to us with very large venous stasis ulcers,” says Wound Center Clinical Coordinator Kimberly Lee. “We have gotten them a lot smaller, but sitting all day does not help venous disease. The legs are supposed to be elevated when not walking.”

“I’m healing slowly,” says Theresa. “Dr. Pepen has tried to stay a step ahead and it’s finally getting to where he wants it to be.”

Although getting to appointments during the winter has posed a challenge, Theresa doesn’t mind going for treatment. 

“It’s pleasant,” she says. “Everyone is very friendly and professional and respectful, but also funny. They work so well together and treat each other like family. I’ve never been in a hospital like that. I like everybody on the whole team because they treat patients with integrity and understanding, and they have a lot of empathy. I love that.”

Trinitas Wound Healing and Hyperbaric Medicine Center

The center is located in the Medical Office Building, 240 Williamson St., Elizabeth.

For more information, call 908.994.5480 or visit WoundHealingCenter.org.

My long road back to Capoeira.

By Chelsea Gould

Nearly 15 years have passed since my first encounter with Capoeira. I was taking a walk on the beach in Siesta Key on one of those gentle, lazy days on the Gulf Coast of Florida. My attention was drawn to a group of men and women, dressed in white, gathered at the water’s edge. There was singing and clapping and music and shouts of joyous encouragement. They had formed a circle around two women who looked as if they were dancing or sparring, or possibly something in between. They moved with incredible grace—jumping, spinning, kicking, cartwheeling in the sand.

This was clearly a martial art, I remember thinking, but with a definite emphasis on art.

The participants ranged widely in age and body type. I had no idea what I was watching but I wanted to get involved. I worked out who the leader was, began asking questions and, a week later, I walked into a nearby studio and attended my first Capoeira class.

I am a former dancer. I am graceful and athletic and adventurous. Alas as luck (and genetics) would have it, I did not keep my dancer’s body past my 20s. I had tried yoga and aerobics classes to stay in shape, but they weren’t a good fit. I could sense the other women judging me. I felt excluded. The space felt unkind. My first Capoeira class was an inclusive experience: The group was genuine and warm and welcoming. They walked me through some of the basic steps and were gentle and supportive the first time I entered the roda (circle) to “play” a classmate. Capoeira was part dance, part game—they actually call the confrontations “games.” I kept coming back and learning and playing and feeling more and more comfortable in my own skin. And I began to notice small changes in how my clothes fit.

Life throws you curve balls. Just as I was finding my groove on the laid-back west coast of Florida, I had to relocate to New Jersey. I went through some career changes, health issues and personal stuff (etc., etc.) and never pursued Capoeira after coming north. Besides, I was in the land of cross-fit now—the thumping, screaming, grunting, snorting, sweating, tire-chucking craze that transforms Garden State housewives into stronger (and often scarier) version of themselves.

When in Rome, right? So yes, I went all-in and, you know what? Cross-fit was good for me. I shed 80 pounds in two years and could probably have handled myself in a bar fight. It was maybe a little too competitive for my personality, but I certainly couldn’t argue with the results. Cross-fitting gave me an outlet for my frustration and pushed me beyond my comfort zone. I enjoyed working out in a group and cheering everyone on.

In 2012, I was living with family near the ocean about 18 inches above sea level when Hurricane Sandy pushed six feet of water through our house. We scattered and coped as best we could, relocating thousands of miles apart. My life, which was never particularly predictable (thanks to a bipolar condition) was turned completely inside-out. I bounced around and actually spent more than a year in a halfway house situation. It was imperfect at its best and nightmarish at its worst. And you can probably guess what happened: In the years that followed, those 80 pounds returned, and then some. Five-foot-five and 185 pounds had been far from ideal, but it was doable. I was now 5’5” and 275.

And then one day I rediscovered Capoeira.

It was a Facebook pop-up, an ad for a women’s roda. I don’t know why but in my post-Sandy haze I had forgotten how much I loved Capaoeira and how good it had been for my body and soul. I enrolled in a local class and re-experienced that amazing, welcoming environment. I still had the muscle memory from my Florida days and felt comfortable relearning the steps. I had been too embarrassed about my weight to join an exercise class, but in Capoeira class we worked out ways to kick and dodge and move my large body without injuring myself. I stopped worrying about whatan athlete should look like. When I got winded I took a break and learned the instruments and songs the group played. I was home again. Why did I ever leave?

According to Kasey Sanders (above), who has taught Capoeira in New Jersey for nearly a decade, its appeal is tied to its status as a non-violent martial art. “It allows the players to work out their aggression, but in a fully expressive way. People come to Capoeira to experience its many flavors—it’s partially that it’s a martial art, but also that it encompasses dance, music, health and wellness, and also community building.”

Those who view Capoeira as a New Age workout trend get the vibe, but they shouldn’t gloss over the history. As a martial art it goes back to 16th century Brazil, when slaves had to camouflage their fighting practice to look like dance. Its rhythmic roots, meanwhile, stretch back even further, to ancient times. Fast forward to the present, where suddenly Capoeira is ubiquitous, having gained great momentum internationally in the past 30 years. It is now the fighting style of choice for movie superheroes from Black Panther to Daredevil to Spider-Man. You’ve seen it perhaps without even knowing it.

I won’t be appearing in a Marvel blockbuster anytime soon, so my interest in Capoeira is more about its less heroic benefits. The movement style engages your core, as all the abdominals are firing during a workout. The most basic step in Capoeira is ginga (sway in Portuguese). It’s an escape move from which most of the other steps flow. It’ll be the first thing you learn. It activates the quads, calves and glutes. The biceps, traps and delts are fired up by the overhead movements, such as headstands, handstands and cartwheels. Ginga alsoimpacts your balance by controlling how your weight shifts back and forth. Capoeira promotes strength, stamina, coordination and fitness with every movement sequence. And it offers a superior level of cardio, burning approximately 700 calories per one-hour class.

That is not to say you’ll want to fast-track your way to the most strenuous stuff. According to Jim Dunleavy, PT, DPT, MS, Doctor of Physical Therapy and Director of Rehabilitation Services at Trinitas, like all types of movement activities, a person needs to first find out what his or her body will safely do.

“As we age, our joints and muscle get less flexible,” he warns. “We also lose a small percent of our muscle tissue each year due to the aging process. Anyone who wants to try a martial art such as Capoeira should check with their doctor and get a functional examination from a physical therapist to ensure that it would be safe to engage in such an activity.”

As you push yourself beyond traditional movements, with time, you can feel your confidence grow as your skill level improves. The roda is part martial arts arena and part circular support system, creating positive community with your classmates as you demonstrate progress in your skills and learn from your fellow capoeiristas.

For me, Capoeira also helped reduce stress. It is a unique workout. The euphoria I’ve felt after class is indescribable. The added bonus is that I enjoy the artistic and cultural components of Capoeira almost as much as the physical ones. You are immersing yourself in an intriguing part of Brazilian music and history in a joyous, playful way that teaches self-defense skills and yet, at the same time, promotes unity and non-violence. Not always easy to understand as an outsider, but what’s not to like, right?

I should mention that newbies are not expected to pull off Black Panther moves on the first day of class. It takes a while before the handstands and cartwheels come. If you are a natural athlete or have dance training, that can speed the process along. Either way, you will feel the physical and spiritual benefits after your first couple of classes. Even skeptics admit there is something different about getting into Capoeira. And they are correct. It’s not just about the cool fighting moves. A true capoeirista is someone who embraces the culture, learns the songs and ultimately can play all the instruments.

Looking back, it makes cross-fit seem practically barbaric.

Make Your Move

As you gain experience and proficiency in Capoeira, your style will be your own. It will reflect your unique personality in ways no other martial arts can. A year or so after you start, you will be good enough to earn your first belt grade, or corda. It can take a decade or more to attain mestre (master) status, but capoeiristas are qualified to teach before reaching that level, usually after seven years or so of training and study. If you are thinking about joining a class, ask about the level of training the teacher has.

Fish skin is making a splash in the battle against wounds.

By Jim Sawyer

Wound healing specialists are learning to appreciate fish skin as a useful tool in their medical practices as opposed to just a delicacy served in sushi restaurants. Two years ago dried fish skin was approved by the FDA for the first time as a wound care treatment, which isn’t so strange, considering pig-intestine and fetal cow skin compounds have also been approved for medical use.

Fish skin, however, is special because it’s high in Omega3 fatty acids, which offer natural anti-inflammatory properties. Since millions of years of evolution have made fish skin resistant to bacterial colonization, it functions as a natural matrix for human skin that requires little processing. Some fish species are better suited to this technology than others. Kerecis Ltd., an Icelandic supplier that has been producing fish skin for wound treatment since the early 2010s, uses Atlantic cod exclusively. Cod has also been the fish skin of choice at the Wound Center at Trinitas Regional Medical Center in Elizabeth for patients with venous and arterial wounds.

“It’s perfect for a deep wound that’s not level with the rest of the skin, for instance, a dog bite,” says Dr. Georgios Kotzias, DPM, AACFAS, who specializes in, among other things, foot/ankle surgery, minimally invasive surgery, sports medicine, diabetic wound care, and diabetic limb salvage at the Trinitas Wound Center. “The fish skin covers the wound and fills in any missing tissue to reduce soft tissue deficit, which allows your body to heal more naturally, and evens out the scar. The graft enables drainage, allowing for faster healing. Cod skin happens to be thicker and more resilient. It holds better and for a longer period of time.”

The need for skin substitutes may arise depending on the location and depth of a wound, the likelihood of infection, and the availability of a human donor (i.e. cadaver skin). Before it can be used, says Dr. Kotzias, “the cod skin is processed and dried, then sterilized and processed without damaging the growth factors. They soak it in saline and then secure it to the wound with a special dressing and adhesive tape that is perforated to allow the wound to properly drain.”

Not surprisingly, one of the first groups to field-test fish skin was the U.S. military. Medics used fish skin for initial treatment of battlefield injuries and burns before transferring soldiers to full-service hospitals.

In the United States, more than six million people are being treated for chronic wounds at any given time. Most are diabetics or suffer from vascular disease, but the number also includes a wide range of traumatic injuries and burns, as well as unexpected complications from routine procedures. The number of chronic wound patients is likely to grow as the population ages. Individuals who fall into this category face profound uncertainty: the five-year survival rate is a tick above 50 percent, as compared with breast cancer, which has seen its survival rate climb to more than 85 percent.

The more complicated the wound, the more effective the “fish solution” maybe, as it permits the ingrowth of fibroblasts (the most common cells of human tissue) and keratinocytes (the skin cells that produce keratin), which help to bind a patient’s own skin cells around persistent, chronic wounds. The hope is that the wider use of fish skin will bring the survival rates up, as the traditional graft options do not perform well in infected areas—in part because pigs and cows are biologically close to us and therefore susceptible to similar infections. We split off from fish on the evolutionary tree a half-billion years ago, which has obviously worked out well for us in innumerable ways.

For now, the wide use of fish skin in wound healing faces an upstream battle. Insurance companies are slow to embrace (and cover) costly, new procedures, while hospitals tend to be super-cautious about changes in areas where infections are being aggressively treated. That being said, the initial goal in wound treatment is to reduce inflammation; it is the first step in turning a chronic wound into a treatable injury. If fish skin continues to prove its worth in this regard, it may become a more common tool in the medical tackle box. 

Editor’s Note: Yolanda Navarra Fleming contributed to this article.

By Jim Sawyer

Eureka Moments are few and far between in the world of medicine. Typically, they come at the tail-end of years of research and rigorous testing and re-testing—at which point one of two things happens: They become headline-making stories or, more often, trickle out to the medical community and go almost completely unnoticed by regular people. 

Among the stories that deserved a little more ink in 2019 were advances in immunotherapy, chemotherapy, inflammatory diseases, nanotechnology, and the common cold. Whether they lead to game-changing drugs or therapies, well, perhaps it’s too early to say. But they are definitely stories worth following in 2020 and beyond.

Immunotherapy: Not Just for Cancer Anymore 

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The immune system plays a role in the function of every organ and in a variety of health conditions. In 2019, researchers began a concerted effort to explore the benefits of immunotherapy—which is transforming cancer care—beyond the realm of oncology. Studies are currently being conducted to determine other ways in which stimulating the body’s immune system might prevent tissue rejection in transplant patients, as well as combating autoimmune diseases. Dermatologists at Penn Medicine have begun human trials using re-engineered T-cells to treat a skin disease called pemphigus. A pemphigus sufferer’s immune system produces antibodies that fight the proteins that hold the skin together, which causes painful blistering. The strategy is to “teach” the T-cells to go after the immune cells that make the antibodies. Previously, researchers had focused on neutralizing the antibodies, without much success. 

The Common Cold: On the Endangered List? 

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In 2019, biologists at Stanford University reported finding the source of a protein essential to the function of numerous enteroviruses—which include the rhinoviruses we call the common cold. In human cells, enteroviruses cannot replicate without this particular protein—sort of like a copier with no paper left in its tray. The work at Stanford paves the way for antivirals that will cure most cases of the common cold, and also sheds light on how viruses use a host’s cell proteins to thrive. This, in turn, may impact other illnesses caused by enteroviruses—including those linked to heart inflammation and myelitis. The development of a drug that targets the protein in question is the next step. The hope is that it will do its job without being toxic to humans in some other way. 

Jan Homann

It’s a Small World After All: New Nanolaser with Big Potential 

Researchers at Northwestern and Columbia Universities recently developed a microscopic nanolaser that is about one-thousandth the thickness of a human hair. In theory, it is small enough to go inside living tissue and provide imaging for doctors without damaging the tissue (because it does not require UV light to operate). The nanolaser uses photon “upconversion,” a process in which low-energy, bio-friendly photons are absorbed and converted into a higher-energy, visible laser beam. The shorthand here is that the new nanolaser can safely produce biological imaging where current ones can’t—including inside the human brain, where it could detect disease biomarkers, or even treat deep-brain disorders, such as epilepsy. 

Andy Bowen

Indivisible: Hair Loss Fix for Chemo Patients 

One of the most distressing side effects of cancer treatments is total hair loss. Researchers at the University of Manchester (right) in England have been trying to understand why hair follicles respond so poorly to chemotherapy. In 2019, they announced a breakthrough. Focusing on the damage caused by taxanes—the family of cancer drugs that cause permanent hair loss—the scientists found that the specialized dividing cells at the base of hair follicles, which are critical for producing hair (and the stem cells that produce them) are especially vulnerable to taxanes. They tried a new class of drugs called CDK4/6 inhibitors, which halted cell division in the follicles. Moving forward, the hope is that a cream or ointment can be made that will suspend this cell division temporarily, during chemo. The work at Manchester may also open the door to a treatment that will restore hair in patients who have already undergone cancer treatment.

Clever Cleaver: Redefining “Strip Steak”

Jeremy Keith

The debate over the health effects of consuming red meat are likely to last as long as there are steaks sizzling on summer grills. Last October, yet another major study came out on the subject—this time finding there are no conclusive links between a red-meat diet and serious disease-causing most health professionals to lose their minds! Overlooked in the furor was a September news item out of UC-San Diego Medical School concerning Neu5Gc.

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It’s a carbohydrate made by most mammals (including cattle), but not by humans. Whenever you eat red meat, a little Neu5Gc is absorbed into your tissue and, as it builds up, your immune system attacks it. This is believed to be the reason why diets heavy in red meat are linked to chronic inflammation, which can trigger an array of serious medical conditions, including colon cancer and atherosclerosis. The scientists at UC San Diego have found that sialidases—a type of bacterial enzyme produced in the gut—have the ability to cleave Neu5Gc from human tissue. This is exciting because, taken a step further, sialidases could actually be used to “scrub” Neu5Gc out of red meat before it even gets off the fork. In studies done on humanized mice, a sialidase enzyme made by carbohydrate-loving bacteria was shown to get Neu5Gc off of cells. Researchers also exposed meat purchased from a grocery store to sialidase that was generated in the lab and found that most Neu5Gc came off of the meat. If all goes well, the goal is to create a probiotic (or prebiotic) that would reduce the risk of inflammatory diseases for lovers of burgers and steaks.

What Can Brown Do for You? 

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Although it doesn’t qualify as a medical breakthrough, a program called Flight Forward—which began a test run less than a year ago—promises to change the way many people receive life-saving medicine, supplies, and testing. The autonomous drone program was the brainchild of UPS and navigated enough obstacles to get the thumbs-up from the FAA for more extensive trials in 2020—flying tissue, urine and blood samples between a limited number of U.S. hospitals. UPS is not the first to try this; a company called Zipline has been delivering medical supplies via drone to remote villages in Ghana and Rwanda for a year.