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Methodist Mansfield Medical Center Hosts New Patient Care Tower Topping Out
$118 Million Methodist Mansfield Patient Tower Two to open winter 2015 and bring 200 new jobs to area

northwest corner of the existing building.  The expansion will feature 34,000 square feet of additional operating rooms, cardiology and gastroenterology services and 64,000 square feet of additional support services including lab, pharmacy, materials management, biomed, sterile processing to name a few. The new tower will initially open with 86 beds, with shell space for an additional 32 beds. The expansion will employ 200 medical professionals.

“Methodist Mansfield Medical Center is eagerly anticipating the grand opening of our new patient care tower,” said John Phillips, FACHE, president Methodist Mansfield. “This new tower will ensure Methodist Mansfield’s ability to serve the future health care needs of this vibrant and rapidly growing region for years to come.”

Construction of the new patient tower is taking place concurrently with normal day-to-day hospital operations and is being integrated with existing infrastructure. Upon its completion, the hospital will advance cardiology services through electrophysiology cardiac care and cardiac rehabilitation, house a dedicated stroke inpatient unit, have additional inpatient cardiology capacity, expanded inpatient dialysis and offer a 14-bed intensive care unit.  The expansion will also include two new surgical suites dedicated to robotic minimally invasive surgery and advanced cardiac care as well as four gastroenterology suites, expanded outpatient cardiopulmonary testing area, as well as the laboratory, pharmacy, sterile processing, information technology, food services and a new two-story atrium lobby and community room.

“When considering the design of patient rooms, we’re including physician and employee input and focusing on clinical quality and patient satisfaction in every little detail including the wall color and lighting effects to the door size, flat screen TVs and charging stations for the latest mobile devices,” said Phillips. “We want our patients healing and comfort to be prime focus. The new tower is part of our ongoing investment in enhancing health care services and quality of life in Tarrant, Johnson, Ellis and southwest Dallas counties.” 

The new patient care tower is being supported by a $2 million capital campaign – the largest in the hospital’s history. The “Building Brighter. Shining Farther,” campaign is spearheaded by Jenny Conrad, president of Conrad Creative.

“Many individuals and organizations have generously supported Methodist Mansfield making this expansion possible,” said Conrad. “We are grateful for the backing of our community and invite others including individuals, companies and civic groups to join our tower campaign and make this tower special for our families.”  Please join the capital campaign and reinforce Methodist Mansfield standing as the community’s hospital for future generations. To donate, please contact the Methodist Foundation at 682-622-2085.

About Methodist Health System: Guided by the founding principles of life, learning and compassion, Methodist Health System (Methodist) provides quality, integrated care to improve and save the lives of individuals and families throughout North Texas. Methodist Dallas Medical Center, Methodist Charlton Medical Center, Methodist Mansfield Medical Center, Methodist Richardson Medical Center, and Methodist Family Health Centers are part of the nonprofit Methodist Health System, which is affiliated by covenant with the North Texas Conference of The United Methodist Church. Additional information is available at www.methodisthealthsystem.org. Connect with them through Facebook, YouTube and Twitter at www.methodisthealthsystem.org/socialmedia.
On Friday, December 5 at 10 a.m. Methodist Mansfield Medical Center will commemorate the halfway point of construction of its new patient care tower during a topping out ceremony. Scheduled to open in winter of 2015, the new $118 million, 110,000 square-foot patient care tower is located at the
Three from Methodist Health System Honored in D Magazine’s Excellence in Healthcare Awards

individuals in North Texas chosen for their excellence in health care from more than 175. 

Dr. Mansfield was honored as Outstanding Healthcare Executive. He is well known throughout the Metroplex for leading one of the fastest-growing health care systems in Texas. Not only has he led the hospital in clinical and financial performance, he has also shown commitment to the community he serves. Since the start of his leadership at Methodist in 2006, the health system has nearly tripled its revenue, operates eight hospitals and 27primary care centers, and serves 14,000 enrollees in its Accountable Care Organization. Dr. Mansfield was instrumental in leading the health system to pair with the renowned Mayo Clinic for collaborative care. He remains committed to Methodist’s mission of providing compassionate, quality care to every patient in a changing health care environment. Throughout his distinguished career, Dr. Mansfield has viewed his leadership role as a ministry to serve people from all walks of life.

Dr. Charles was named an Outstanding Healthcare Practitioner finalist. In addition to being a family medicine physician at Methodist Family Health Center – Mansfield North, he is the medical director for the Mansfield Independent School District Staff Clinic. He is a leader in his field of family medicine and is committed to establishing and maintaining a patient-centered model of care. His service exemplifies servant leadership. To help make a difference in the community, he was instrumental in assembling a team of physicians to conduct free sports physicals for student athletes and promotes health by participating in local walks and runs. 

Mrs. McCally was named an Outstanding Healthcare Volunteer finalist. She is an ambassador for Methodist Mansfield, giving thousands of hours of volunteerism. She is a founding member of the Auxiliary and has served on the Auxiliary’s board of directors for eight consecutive years. Since 2006, she has led fundraising efforts for the annual Holly Days, Style Show, and General Store at the hospital. 

“Dr. Mansfield, Dr. Charles, and Mrs. McCally are known for their leadership, expertise, and compassion for serving others,” says Levi Davis, chairman, Methodist Health System board of directors. “They are dedicated to our community and are well deserving of this honor.”

About Methodist Health System: Guided by the founding principles of life, learning, and compassion, Methodist Health System (Methodist) provides quality, integrated care to improve and save the lives of individuals and families throughout North Texas. Methodist Dallas Medical Center, Methodist Charlton Medical Center, Methodist Mansfield Medical Center, Methodist Richardson Medical Center, and Methodist Family Health Centers are part of the nonprofit Methodist Health System, which is affiliated by covenant with the North Texas Conference of The United Methodist Church. Additional information is available at MethodistHealthSystem.org. Connect with them through Facebook, YouTube and Twitter at MethodistHealthSystem.org/SocialMedia.
Stephen L. Mansfield, PhD, FACHE, Methodist Health System president and CEO; Darin Charles, MD, family medicine physician at Methodist Family Health Center – Mansfield North; and Jeannette McCally, Methodist Mansfield Medical Center volunteer, were honored in D Magazine’s Excellence in Healthcare Awards for 2014. These representatives are among the top 18
Texas Health Resources, CDC, NIH & others discuss Ebola prep (12.9 webinar)

the public. Follow the conversation on Twitter at #AdvisorLive.


Tom Talbot, MD, chief hospital epidemiologist, Vanderbilt University Medical Center
Daniel Varga, MD, chief clinical officer and senior executive vice president, Texas Health Resources
Neil Fishman, MD, associate chief medical officer, University of Pennsylvania Health System
David Henderson, MD, deputy director for clinical care and associate director for clinical quality, patient safety and hospital epidemiology, National Institutes of Health Clinical Center
Michael Bell, MD, deputy director of division of healthcare quality promotion, Centers for Disease Control and Prevention
Jeffrey Ashkenase, senior vice president, Greater New York Hospital Association Services
MODERATOR: Gina Pugliese, RN, MS, vice president, Premier Safety Institute®, Premier, Inc.


December 9, 2014, 2:00 pm - 3:30 pm ET
Register here: http://offers.premierinc.com/ALWBN2014-12-09Ebolapreparationandresponse.html
WHAT: Join tomorrow’s live presentation to hear from a panel of experts who have cared for patients with Ebola and developed comprehensive programs to prepare for and respond to their first cases. This event is free and open to
New Parkland hospital installing state-of-the-art imaging technology Improvements to enhance patient safety

strategically located between the emergency and trauma departments on the first floor and surgical services and labor and delivery on the third floor. To expedite patient care, X-ray and CT equipment is also located in the emergency and trauma department; an MRI is housed in the fourth floor neonatal intensive care unit for pediatric patients; and a CT on the hospital’s 16th floor will serve neuro ICU patients. The second floor Imaging Center encompasses nearly 136,000 square feet, and more than 141,000 square feet are devoted to imaging overall in the new hospital.

Imaging is the key to diagnosis and treatment for most patients, whether they suffer from heart disease, trauma, strokes or any of hundreds of other conditions. In the medical community, radiologists are known as “the doctor’s doctor,” because they are the behind-the-scenes diagnosticians who interpret images that “see” into a patient’s body to locate the source of a health problem and recommend treatment. Radiologists also are clinicians, performing interventional procedures using guided imaging technologies that offer minimally-invasive treatments for many conditions.

“The accuracy of the diagnosis depends both on the skill of the radiologist and the quality of images they view,” said Travis Browning, MD, Director of Radiology Informatics at Parkland Health & Hospital System and Assistant Professor, Abdominal Imaging at UT Southwestern Medical Center. “That’s why access to the most advanced imaging technology is so important.”

According to Matthew C. Wied, clinical engineer at Parkland who leads the team installing and maintaining the imaging technology at the new Parkland hospital, “The tools of the radiologist’s trade are complex, powerful and expensive. They include X-ray and ultrasound, computed tomography (CT), nuclear medicine, positron emission tomography (PET) and magnetic resonance imaging (MRI).”

The new Parkland will have the most advanced imaging equipment available. State-of-the-art dual source multi-slice CT scanners, 3.0T MRIs and a new PET CT scanner, a technology that Parkland has not owned before, are among the upgrades. Digital portable X-ray and ultrasound equipment will be available throughout the facility.

Imaging modalities in the new Parkland facility will include four new Siemens Skyra MRI 3.0T machines, utilizing the most powerful magnets available. The current Parkland hospital has only one MRI with 3.0T. The new Imaging Center will also include two stress echocardiogram suites, two endoscopy suites and five nuclear medicine rooms.

In addition to equipping new Parkland hospital with state-of-the-art technology, imaging equipment will be deployed closer to the site of patient care.

“We will have X-ray modalities in the trauma bays of the emergency department, which is uncommon in most hospitals, so the patient can get X-rays performed in the same room where urgent care is being provided,” Dr. Browning said. “The CT scanner in the Neuro ICU will mean that critically ill patients will not have to travel through the hospital for imaging services.”

In the all-digital new Parkland, the Picture Archiving and Communication System known as PACS and electronic health record (EHR) are part of an integrated digital system that also will offer remote desktop shared conferences for electronic consultations between the treating physicians and radiologists.

“We’re improving not only the technology, but also the radiology workflow to assure faster, safer patient care,” Dr. Browning stated.

For more information about the new Parkland hospital, please visit www.parklandhospital.com
Advanced diagnostic imaging technology valued at millions of dollars, but priceless in terms of benefits to patients, is being installed and tested in the new Parkland hospital as staff prepare for the facility’s opening in mid-2015.

Most of the new 862-bed hospital’s second floor is dedicated to Imaging Services,
UT Southwestern scientist honored as rising star in Texas research

TAMEST presents four Edith and Peter O’Donnell Awards each year – in medicine, science, engineering, and technological innovation – to recognize Texas researchers whose work exemplifies excellence in advancing understanding of important unmet needs. Each award consists of a $25,000 honorarium, a citation, a trophy, and an invitation to speak at the conference.

“I am deeply honored to receive the O’Donnell Award in Science, which recognizes the work of many excellent students, postdocs and researchers in my laboratory,” Dr. Chook said. “I am grateful for the tremendous support from my colleagues in the departments of pharmacology and biophysics, especially Dr. David Mangelsdorf, Chairman of Pharmacology, and former Chair Dr. Alfred Gilman, Professor Emeritus of Pharmacology and 1994 Nobel Laureate in Physiology or Medicine, and for the very collaborative environment our leaders at UT Southwestern have built.”

“We admire the vision that led to the establishment of the O’Donnell awards, which annually highlight some of the most promising investigators in Texas,” said Dr. Daniel K. Podolsky, President of UT Southwestern Medical Center. “Dr. Chook’s efforts to understand the underlying basis of an uncommon disorder have led to profound new insights into a fundamental mechanism of cellular transport of broad biologic importance. Her advances are moving remarkably quickly from fundamental discovery to translational science with the potential to establish new paradigms for drug development for a range of disorders ,” added Dr. Podolsky, who holds the Philip O’Bryan Montgomery Jr., M.D., Distinguished Presidential Chair in Academic Administration, and the Doris and Bryan Wildenthal Distinguished Chair in Medical Science.

Advances from Dr. Chook’s laboratory have been instrumental to the development of potential therapeutics that are now the subject of nearly two dozen clinical trials for a variety of cancers, including those of the blood (leukemia), the brain (neuroblastoma), and the skin (melanoma).

Her studies combine structural biology, biochemistry, biophysics, and bioinformatics to investigate a class of molecules called nuclear transport receptors that carry protein cargo into (importins) and out of (exportins) the nucleus, the cell’s command center.

For proper cell function, each of the importer and exporter molecules must carry hundreds of different proteins in and out of the nucleus each day, she explained. Different sets of proteins are carried by specific nuclear transport receptors that recognize specific signals on the proteins. Dr. Chook compared the situation to buses carrying passengers through a tunnel (the nuclear pore complex through which protein cargoes enter and exit the nucleus) but only if the passengers (the proteins) have the proper tickets (signals) for travel.

When Dr. Chook began her work, only one kind of import signal had been identified. Dr. Chook identified the second class of import signals (named PY-NLS) 25 years after the discovery of the first one. The one she identified became recognized as central to the development of an uncommon, inherited form of amyotrophic lateral sclerosis (ALS), in which the Fused in Sarcoma protein cargo cannot properly enter the nucleus and aggregates in the cell’s cytoplasm surrounding the nucleus.

She later led an interdisciplinary team that provided the world’s first image of the structure of an exportin attached to its protein cargo, laying the foundation for drug development, explained Dr. Mangelsdorf, who led the committee that recruited Dr. Chook to UT Southwestern in 2001.

“Dr. Chook is an innovator in her field. But in addition to being a great scientist, she is a great role model and mentor to her trainees, and a constructive member of the UT Southwestern community,” said Dr. Mangelsdorf, who holds the Raymond and Ellen Willie Distinguished Chair in Molecular Neuropharmacology in Honor of Harold B. Crasilneck, Ph.D., and the Distinguished Chair in Pharmacology.

Dr. Chook earned a dual undergraduate degree in chemistry and biology from Bryn Mawr College in Pennsylvania and a doctorate in biophysics from Harvard University, where her mentor was 1976 Nobel Laureate in Chemistry Dr. William N. Lipscomb. She joined the UT Southwestern faculty as an Assistant Professor and Eugene McDermott Scholar in Biomedical Research following postdoctoral research at the University of Toronto/Mount Sinai Hospital in Canada and at New York’s Rockefeller University, where her mentor was the 1999 Nobel Laureate in Physiology or Medicine Dr. Günter Blobel.

The awards, first presented in 2006, are named in honor of the O’Donnells, who are among the state’s staunchest advocates for excellence in scientific advancement and STEM (science, technology, engineering, and mathematics) education. 

About UT Southwestern Medical Center: UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. Numbering more than 2,700, the faculty is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. U Southwestern physicians provide medical care in 40 specialties to about 92,000 hospitalized patients and oversee approximately 2.1 million outpatient visits a year.
The Academy of Medicine, Engineering and Science of Texas (TAMEST) has selected Dr. Yuh Min Chook, Professor of Pharmacology and of Biophysics at UT Southwestern Medical Center, as the recipient of the 2015 Edith and Peter O’Donnell Award in Science.

Dr. Chook, a biophysicist known for her landmark studies into the fundamental process of protein transport into and out of the cell’s nucleus, will be honored Jan. 22, 2015, during TAMEST’s 12th annual conference in Houston.
Parkland clinic at forefront on treatment of liver cancer
Multidisciplinary approach improves outcomes

since launch of a multidisciplinary program that brings together a team of highly skilled specialists to develop a collaborative care plan for each patient.

“We looked at patients two years before the clinic opened and two years after it opened, and we found significant improvement in patient outcomes. With this multidisciplinary approach – oncologists, surgeons, hepatologists and interventional radiologists – we saw survival rates increase three-fold,” said Adam Yopp, MD, one of the two physicians spearheading the clinic.

“This collaborative approach helps us not only to get patients connected to treatment faster after being diagnosed, but it also helps us provide better treatment,” Amit Singal, MD, said. “We’re also able to evaluate people with suspected HCC faster and expedite the diagnosis.”

Drs. Yopp and Singal, the clinic founders, have devoted their careers to helping patients with this serious disease. Drs. Singal and Yopp serve as the Medical Director and Surgical Director of the Parkland Liver Tumor Cancer Clinic, respectively. Dr. Singal is a transplant hepatologist and Assistant Professor of Internal Medicine in the Division of Digestive and Liver Diseases at The University of Texas Southwestern Medical Center. Dr. Yopp is a surgical oncologist and Assistant Professor of Surgery in the Surgical Oncology Division of UT Southwestern Medical Center.

The clinic literally has been a lifesaver, said Ricardo Curiel, who was diagnosed with HCC in 2012. He underwent chemotherapy before having a liver transplant in March 2013.

“I’m a true believer. The team at Parkland was awesome,” Curiel said. “They are the reason I’m here.”

As soon as he could he went back to work, installing hardwood floors. Curiel, 60, said the teamwork at the Parkland Liver Tumor Cancer Clinic helped him through the difficult time. “I wasn’t sent from one doctor to another and forgotten; they were all working together,” he said.

Hepatocellular carcinoma is especially prevalent in Texas, which ranks second only to Mississippi in incidence of new cases. Among the factors for Texas’ high incidence is an aging population of people with Hepatitis C infection, and growing rates of fatty liver disease, both of which contribute to development of hepatocellular carcinoma.

A study by Dr. Yopp and Dr. Singal published in December 2013 in the Annals of Surgical Oncology is one of the first to show tangible positive outcomes from such a multidisciplinary clinic.

“This collaborative approach not only helps get patients connected to treatment sooner, but it also helps us provide higher rates of appropriate treatment with the best outcomes,” Dr. Singal said. “One goal of our Liver Tumor Cancer Clinic is early diagnosis, so we also help evaluate people with suspected HCC and expedite the diagnosis.”

The weekly clinic, which opened in October 2010, has grown from a handful of patients to now seeing 30 to 40 patients each week. For more information about the Parkland Liver Tumor Cancer Clinic call 214.590.5580. To learn more about liver cancer visit www.cancer.org/cancer/livercancer/index
It is the fifth most common cause of death worldwide and the fastest-growing cause of cancer-related deaths in the United States, and now hepatocellular carcinoma (HCC), a liver cancer, is the target of an innovative approach at Parkland Health & Hospital System.

The physicians of Parkland’s Hepatocellular Carcinoma Multidisciplinary Clinic, or Liver Tumor Cancer Clinic, have seen a significant improvement in survival rates among patients
UT Southwestern microbiologists discover how gut bacterial resources are hijacked to promote intestinal and foodborne illnesses

The UT Southwestern team discovered that EHEC uses a common gut bacterium called Bacteroides thetaiotaomicron to worsen EHEC infection. B. thetaiotaomicron is a predominant species in the gut’s microbiota, which consists of tens of trillions of microorganisms used to digest food, produce vitamins, and provide a barrier against harmful microorganisms.

“EHEC has learned to how to steal scarce resources that are made by other species in the microbiota for its own survival in the gut,” said lead author Dr. Meredith Curtis, Postdoctoral Researcher at UT Southwestern.

The research team found that B. thetaiotaomicron causes changes in the environment that promote EHEC infection, in part by enhancing EHEC colonization, according to the paper, appearing in the journal Cell Host Microbe.

“We usually think of our microbiota as a resistance barrier for pathogen colonization, but some crafty pathogens have learned how to capitalize on this role,” said Dr. Vanessa Sperandio, Professor of Microbiology and Biochemistry at UT Southwestern and senior author.

EHEC senses changes in sugar concentrations brought about by B. thetaiotaomicron and uses this information to turn on  virulence genes that help the infection colonize the gut, thwart recognition and killing by the host immune system, and obtain enough nutrients to survive. The group observed a similar pattern when mice were infected with their equivalent of EHEC, the gut bacterium Citrobacter rodentium. Mice whose gut microbiota consisted solely of B. thetaiotaomicron were more susceptible to infection than those that had no gut microbiota. Once again, the research group saw that B. thetaiotaomicron caused changes in the environment that promoted C. rodentium infection.

“This study opens up the door to understand how different microbiota composition among hosts may impact the course and outcome of an infection,” said Dr. Sperandio, whose lab studies how bacteria recognize the host and how this recognition might be exploited to interfere with bacterial infections. “We are testing the idea that differential gastrointestinal microbiota compositions play an important role in determining why, in an EHEC outbreak, some people only have mild diarrhea, others have bloody diarrhea and some progress to hemolytic uremic syndrome, even though all are infected with the same strain of the pathogen.”

The Centers for Diseases Control and Prevention (CDC) estimates that each year roughly 1 in 6 Americans (or 48 million people) gets food poisoning; 128,000 are hospitalized;, and 3,000 die of their foodborne disease. EHEC, which also caused a widespread outbreak in Europe in 2011, can lead to bloody diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome, which in turn can lead to kidney disease and failure. EHEC is among the top five pathogens contributing to domestically acquired foodborne illnesses resulting in hospitalization, according to the CDC. Outbreaks in 2014 were reported in California, Idaho, Massachusetts, Michigan, Missouri, Ohio, Montana, Utah, and Washington.

Other UT Southwestern researchers involved in the work include Dr. Ralph DeBerardinis, Associate Professor with the Children's Medical Center Research Institute at UT Southwestern, Eugene McDermott Center for Human Growth and Development, and Pediatrics, who holds the Joel B. Steinberg, M.D. Chair in Pediatrics and is Sowell Family Scholar in Medical Research; Dr. Zeping Hu, Assistant Professor with Children's Medical Center Research Institute at UT Southwestern and Pediatrics; and Claire Klimko, Research Technician. The work was carried out in collaboration with researchers at Kansas State University and supported by the National Institute of Health and the Burroughs Wellcome Fund.

About UT Southwestern Medical Center: UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. Numbering approximately 2,800, the faculty is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to about 92,000 hospitalized patients and oversee approximately 2.1 million outpatient visits a year.
UT Southwestern Medical Center microbiologists have identified key bacteria in the gut whose resources are hijacked to spread harmful foodborne E. coli infections and other intestinal illnesses.

Though many E. coli bacteria are harmless and critical to gut health, some E. coli species are harmful and can be spread through contaminated food and water, causing diarrhea and other intestinal illnesses. Among them is enterohemorrhagic E. coli or EHEC, one of the most common foodborne pathogens linked with outbreaks featured in the news, including the multistate outbreaks tied to raw sprouts and ground beef in 2014.
American Heart Association Recognizes Five Texas Health Resources Hospitals for Quality Achievement
Hospitals earn Mission: Lifeline quality achievement awards   

“This recognition is about much more than meeting criteria; it speaks to the quality care we deliver and represents our commitment to improving the well-being of our patients who suffer from a severe heart attack,” said Barclay Berdan, FACHE, CEO of Texas Health Resources.

“We’re honored that our hospitals and their dedicated caregivers have been recognized for their skill and numerous achievements in cardiac care. We appreciate the work of the American Heart Association, which I’m privileged to serve as chair of the Tarrant County chapter,” said Berdan.

Texas Health hospitals earning Silver, Silver Plus and Bronze Plus Receiving Quality Achievement Awards include:

·         Texas Health Heart & Vascular Hospital Arlington — earned Silver Plus Receiving Quality Achievement Award. Texas Health Heart & Vascular Hospital Arlington is a joint venture, physician investor-owned company between Texas Health Arlington Memorial Hospital and cardiologists on the medical staff.

Texas Health Presbyterian Hospital Plano — earned Silver Plus Receiving Quality Achievement Award.
Texas Health Harris Methodist Hospital Hurst-Euless-Bedford — earned Silver Receiving Quality Achievement Award.

Texas Health Harris Methodist Hospital Fort Worth — earned Bronze Plus Receiving Quality Achievement Award.
Texas Health Presbyterian Hospital Denton — earned Bronze Plus Receiving Quality Achievement Award.

           Silver Plus awardees met rigorous criteria during four calendar quarters, and Bronze Plus recipients met goals within one calendar quarter. The “Plus” designation is used to differentiate those facilities where at least 75 percent of STEMI patients were transferred to them for primary percutaneous intervention (PCI) in 120 minutes or less. When it can be performed in a timely fashion, Primary PCI is the American Heart Association’s recommended triage strategy for STEMI patients.

           Each year in the United States, approximately 250,000 people have a STEMI, or ST-segment elevation myocardial infarction, caused by a complete blockage of blood flow to the heart that requires time-sensitive treatment. To prevent loss of life, it’s critical to immediately restore blood flow, either by surgically opening the blocked vessel or by giving clot-busting medication.

           The American Heart Association’s Mission: Lifeline program helps hospitals, emergency medical services and communities improve response times so people who suffer from a STEMI receive prompt, appropriate treatment. The program’s goal is to streamline systems of care to quickly get heart attack patients from the first 9-1-1 call to hospital treatment.

           Texas Health hospitals earned quality achievement awards by meeting specific criteria and standards of performance for the quick and appropriate treatment of STEMI patients to open the blocked artery. Before patients are discharged, they are started on aggressive risk reduction therapies such as cholesterol-lowering drugs, aspirin, ACE inhibitors and beta-blockers, and they receive smoking cessation counseling if needed. Eligible hospitals must adhere to these measures at a set level for a designated period to receive the awards.

           “We commend Texas Health Resources for all five achievement awards, which reflect a significant institutional commitment to improve the quality of care for their heart attack patients,” said A. Gray Ellrodt, M.D., chair of the Mission: Lifeline committee and chief of medicine at the Berkshire Medical Center in Pittsfield, Mass.

           Texas Health Resources and the physicians on the medical staff, working through the systemwide Heart & Vascular Council, share a vision of making North Texas the vanguard of quality heart care for the state.  Composed of cardiac care specialists and Texas Health administrators, the Council works so that all patients in the system’s service area will receive the same quality care, regardless of their location. 
Five Texas Health Resources hospitals have earned the Mission: Lifeline quality achievement award for implementing specific quality improvement measures outlined by the American Heart Association for the treatment of patients who suffer severe heart attacks.
Parkland providers treat hundreds with shingles each year
Nearly 1 in 3 people will be diagnosed in their lifetime

suffering from shingles which is caused by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant in the body and for reasons that are not fully known, the virus can reactivate later, causing shingles.        

Shingles is a painful rash that develops on one side of the face or body. The rash forms blisters that typically scab over in seven to 10 days and clear up within two to four weeks. Before the rash develops, people often have pain, itching, or tingling in the area where the rash will develop. This may happen anywhere from one to five days before the rash appears.

“I’ve seen the commercials describing the pain associated with shingles, but didn’t give it a second thought until I was diagnosed with shingles,” said Cassandra Christopher, an HR Business Partner in Parkland’s Office of Talent Management. “The pain was excruciating. It’s not something I’d wish on anyone.”           

Most commonly, the rash occurs in a shingle stripe around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread and look similar to a chickenpox rash, according to the CDC.

“Shingles have been around for a number of years but with the increased publicity, people are becoming more aware of the virus,” said Noel Santini, MD, Medical Director for Parkland’s network of Community Oriented Primary Care health centers. “There are several antiviral medicines to treat shingles that will help shorten the length and severity of the illness. But to be effective, they must be started as soon as the rash appears.

“People who have or think they might have shingles should call their healthcare provider as soon as possible to discuss treatment options,” Dr. Santini added.

The only way to reduce the risk of developing shingles and the long-term pain is to get vaccinated. The CDC recommends that people aged 60 years and older get one dose of the shingles vaccine. People seeking the shingles vaccine are advised to call their neighborhood pharmacy or physician office and ask about its availability.

Shingles cannot be passed from one person to another; however, the virus that causes shingles can be spread from a person with active shingles to another person who has never had chickenpox. In such cases, the person exposed to the virus might develop chickenpox, but they would not develop shingles.

A person with active shingles can spread the virus when the rash is in the blister-phase. A person is not infectious before the blisters appear. Once the rash has developed crusts, the person is no longer contagious, Dr. Santini said.

If you have shingles, Dr. Santini advises to keep the rash covered, avoid touching or scratching the rash and wash your hands often to prevent the spread of the virus. Until the rash has developed crusts, avoid contact with pregnant women who have never had chickenpox or the chickenpox vaccine; premature or low birth weight infants; and people with weakened immune systems such as people undergoing chemotherapy, organ transplant recipients, and people with HIV.

“I never realized how many people I know were diagnosed with shingles until I was,” Christopher said. “I know my chances of contracting them again are low, but after suffering through a first round I hope there’s never a second.”

For more information about shingles, visit www.cdc.gov
Take a look at the people around you. The Centers for Disease Control and Prevention (CDC) estimates that nearly one in every three people in the United States will develop shingles in their lifetime and an estimated 1 million cases are diagnosed in this country every year. That means you, or someone next to you, could be at risk.

In fiscal year 2013 providers at Parkland Health & Hospital System treated 573 patients   
Real-time radiation monitor can reduce radiation exposure for medical workers, UT Southwestern cardiologists find

medical worker for a month and then sent off for the cumulative radiation dose to be read. In the other half, medical workers wore a device called Bleeper Sv, which beeps approximately once every 15 minutes in response to low background radiation, and beeps once every 20 seconds when exposure is higher, or continuously, if it is very high.  

               In settings where the medical workers wore the device that gives the real-time auditory feedback, radiation exposure was consistently decreased by approximately one-third.

               “Radiation is invisible,” said Dr. Emmanouil Brilakis, Associate Professor of Internal Medicine at UT Southwestern and senior author of the paper. “Use of a radiation detection device can provide real-time ‘visualization’ of radiation exposure, enabling operators to take actions to reduce radiation exposure.”

               Among actions that medical workers can take to reduce radiation exposure are reducing the frame rate (the number of X-ray images taken per second to create a “movie” of the coronary arteries), decreasing fluoroscopy time, repositioning the patient, repositioning the medical worker, adjusting the position of the radiation shield, and using additional shielding.

               “Using devices that provide real-time radiation-exposure feedback can help the operator adopt safer radiation practices,” said Dr. Brilakis, who is also Director of the Cardiac Catheterization Laboratories at the VA North Texas Health Care System. “In our study, this was achieved in a real-life setting among unselected patients using a low-cost device that can be used with any X-ray system.”

               Physicians and other medical workers on cardiac-catheterization teams will likely participate in hundreds of procedures a year. The dose limit for occupational exposure is 20 mSv per year for five years, but no dose is safe and all doses are considered to contribute to cancer risk.

               “It has been shown that people who are chronically exposed to radiation in cardiac catheterization labs are more likely to develop left-sided brain tumors,” said Dr. Brilakis. “The reduction in operator exposure observed in our study is likely to translate into a decreased risk for long-term adverse clinical events.”

The results of the RadiCure study appear in the Dec. 16 issue of Circulation: Cardiovascular Interventions.

               Other UT Southwestern researchers involved in this study are Dr. Anna Kotsia, Postdoctoral Researcher; Bavana V. Rangan, Research Scientist; Michele Roesle, RN; Dr. Atif Mohammad, Senior Research Associate; and Dr. Subhash Banerjee, Associate Professor of Internal Medicine.

               This study is supported by the Department of Veterans Affairs and the Dallas VA Research Corp. Dr. Banerjee received research grants from Gilead and the Medicines Company. Dr. Banerjee received consultant/speaker honoraria from Covidien and Medtronic, has ownership in MDCARE Global and intellectual property in HygeiaTel. Dr. Brilakis received honoraria/speaker fees from St. Jude Medical, Terumo, Asahi, Abbott Vascular, Somahlution, Elsevier, and Boston Scientific. He has a research grant from Guerbet.

About UT Southwestern Medical Center: UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. Numbering more than 2,700, the faculty is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to about 92,000 hospitalized patients and oversee approximately 2.1 million outpatient visits a year.
It’s a sound that saves. A “real-time” radiation monitor that alerts by beeping in response to radiation exposure during cardiac-catheterization procedures significantly reduces the amount of exposure that medical workers receive, UT Southwestern Medical Center researchers found.

In a randomized study, the researchers divided 505 patients undergoing either diagnostic coronary angiography or percutaneous coronary intervention, such as stent placement, into two groups. In half the procedures, medical workers used the current gold standard for radiation monitoring, which is a “dosimetry” badge that is worn by a
New Parkland design includes family-friendly features
Patient and Family Advisory Council input was a key to final look

More than two dozen people participated in the Patient and Family Advisory Council, providing valuable insight on how to improve patient care based on personal experiences. Early in the design process, the group met monthly and provided feedback on areas including the Emergency Department, Neonatal Intensive Care Unit and various inpatient units.

“There were several members of the group who were very engaged in the process,” said Kathy Harper, RN, Parkland’s Vice President of Clinical Coordination. “They provided information that was invaluable and much of their feedback was incorporated into the design of the new hospital.”

The patient-centered approach to design created a more healing environment with natural light and windows as well as more space for family and visitors.

Through the council, there was support for private patient rooms, specific family areas within patient rooms, improved directional signage throughout the hospital, as well as a vote to select basic color concepts and flooring that would support patient healing.

“Participating on the council was our way of giving back,” said Karen Marino. She and her late husband, Frank, who passed away earlier this year, served on the Patient and Family Advisory Council beginning in 2009. “Parkland saved Frank’s life years ago when he had a stroke. The people there were wonderful and kept me informed every step of the way. They were very cognizant of family being integral to a patient’s well-being.

“Serving on the council helped us give back to the community as well as the caregivers at Parkland,” Marino added. “I truly believe the council played an important role in the design of the patient rooms. As family members of those who were hospitalized, we could speak to how comfortable a room was, or wasn’t, and suggest improvements that would make things easier for family members as well as patients.”

Council members spent countless hours in mock rooms, testing details that led to subtle changes to enhance the patient and family experience. One change involved the toilet location in the private bathroom. While a “patient” sat on top of the commode, family members stood beside and demonstrated how they would assist in the care of their loved one.

“We originally had the commode located in a way that caregivers couldn’t easily assist the patient in the bathroom and then back to the bed,” Harper said. “The group talked it through and moved it so as to give caregivers a few extra inches in which to maneuver. The result is a win-win for patients, families and staff.”

The new 1.7 million square feet acute care hospital is scheduled to open in 2015. For additional information, please visit www.parklandhospital.org
When planning began in 2009, a key element in the design of the new Parkland hospital was to create a family-friendly environment with amenities that were not only aesthetically pleasing, but comforting as well. To that end, Parkland Health & Hospital System officials recruited former patients and family members to serve as an ad hoc advisory group to gather their input on everything from shelving height to placement of door openings.
UT Southwestern neuro-oncologists discover cancer cells can burn acetate for fuel

“We identified that glucose wasn’t the only fuel being burned,” said senior author Dr. Robert Bachoo, Assistant Professor of Neurology and Neurotherapeutics, and Internal Medicine, and a member of the Harold C. Simmons Cancer Center. “Acetate can be used to generate fuel and metabolites that can then be used to make other things that the cell needs to survive and multiply.”

Researchers began with specially engineered mouse models so that the tumors grown in the brain were very similar to human tumors, especially with respect to the molecular and metabolic characteristics. They then infused both 13C-acetate and 13C-glucose into the mice and were able to show that the tumors burn acetate as fuel.

“This is the first demonstration of acetate being used by the cell in this way. The striking finding was that all cancers we studied had the same ability to burn acetate,” said Dr. Elizabeth Maher, Associate Professor of Internal Medicine, and Neurology and Neurotherapeutics, and member of the Harold C. Simmons Cancer Center and the Annette G. Strauss Center for Neuro-Oncology, who holds the Theodore H. Strauss Professorship in Neuro-Oncology. “All the tumors we studied increased expression of ACSS2, the acetate metabolizing enzyme, and the gliomas appear to be dependent on acetate for growth.”

Researchers then validated their findings in two patients with glioblastomas and two patients with brain metastases (breast and lung cancer) who were undergoing surgical resection of their tumors.

“That analysis showed that the human tumors robustly burned acetate,” said Dr. Bachoo, a member of the Annette G. Strauss Center for Neuro-Oncology, who holds the Miller Family Professorship in Neuro-Oncology. “ACSS2 may thus be a therapeutic target for these very aggressive tumors that have limited therapies available.”

Combined with related research, an accompanying Preview article in the journal Cell suggested that “the insights provided by these studies position acetate metabolism as a potentially exploitable vulnerability in cancer metabolism.”

Other UT Southwestern researchers involved included co-first authors, Dr. Tomoyuki Mashimo and Dr. Kumar Pichumani, Senior Research Scientists;Dr. Bruce Mickey, Vice Chairman and Professor of  Neurological Surgery, Professor of Otolaryngology – Head and Neck Surgery and Radiation Oncology, and Director of the Annette Straus Center for Neuro-Oncology who holds the William Kemp Clark Chair of Neurological Surgery; Dr. Benjamin Tu, Professor of Biochemistry and W.W. Caruth, Jr. Scholar in Biomedical Research; Dr. Ralph DeBerardinis, Associate Professor with Children's Medical Center Research Institute at UT Southwestern, the Eugene McDermott Center for Human Growth and Development, and Pediatrics, Sowell Family Scholar in Medical Research, who holds the Joel B. Steinberg, M.D. Chair in Pediatrics; Dr. Samuel Barnett, Associate Professor of Neurological Surgery and Otolaryngology – Head and Neck Surgery, and  Co-director of the Comprehensive Skull Base Surgery Program; Dr. Kimmo Hatanpaa, Associate Professor of Pathology and a member of the Simmons Cancer Center and Strauss Center for Neuro-Oncology; Dr. Zoltan Kovacs, Assistant Professor with the Advanced Imaging Research Center; Dr. Chan Foong, Faculty Associate of Pathology;  Dr. Zhiguang Huang, Post Doctoral Researcher; Research Scientists Shyam Sirasanagandla, Suraj Nannepaga; Research Associate, Dr. Vamsidhara Vemireddy, former UT Southwestern researcher Dr. Dinesh Kumar Singh, and visiting scientist, Dr. Sara Piccirillo.

The work was supported by the Cancer Prevention Research Institute of Texas, National Institutes of Health, a Harold C. Simmons Cancer Center NIH support grant and philanthropic funds from the Annette G. Strauss Center for Neuro-Oncology, the Miller Family Fund in Neuro-Oncology, the Gladie Jo Salvino Fund for Glioblastoma Research at UT Southwestern Medical Center, and the Kenny Can Foundation in Dallas.

UT Southwestern’s Harold C. Simmons Cancer Center is the only National Cancer Institute-designated cancer center in North Texas and one of just 66 NCI-designated cancer centers in the nation. The Simmons Cancer Center includes 13 major cancer-care programs with a focus on treating the whole patient with innovative treatments, while fostering groundbreaking basic research that has the potential to improve patient care and prevent cancer worldwide. In addition, the Center’s education and training programs support and develop the next generation of cancer researchers and clinicians. The Simmons Cancer Center is among only 30 U.S. cancer research centers to be named a National Clinical Trials Network Lead Academic Site, and the only Cancer Center in North Texas to be so designated.

The Annette Strauss Center for Neuro-Oncology, the cornerstone of UT Southwestern Medical Center’s Neuro-Oncology Program, is comprised of multidisciplinary cancer professionals that are largely involved in innovative clinical research trials. Researchers are actively involved in projects aimed at creating new and improving existing treatments for childhood and adult brain malignancies. Its focus is to improve treatments available for patients, both inpatients and outpatients, and conduct research of tumors of the central nervous system, including benign and malignant brain and spinal-cord tumors.

About UT Southwestern Medical Center: UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. Numbering approximately 2,800, the faculty is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to about 92,000 hospitalized patients and oversee approximately 2.1 million outpatient visits a year.
UT Southwestern Medical Center researchers have discovered that brain tumors are capable of burning acetate for fuel, providing a new potential target for halting tumor growth.

Researchers have been struggling with what fuels cancer cell growth. For more than 75 years, researchers have known that cancer cells use glucose as the major fuel, but efforts to halt cancer growth by controlling glucose levels in the brain haven’t worked.
Scientists at UT Southwestern, Karolinska Institutet identify new and beneficial function of endogenous retroviruses in immune response

Center for the Genetics of Host Defense. “We have found that ERV fulfill at least one beneficial function critical to producing protective antibodies.”

Retroviruses are able to insert into the genomic DNA of cells they infect, including germ cells.  In this way, and by a process called retrotransposition, they have become a major part of the genome of each person. About 45 percent of a person’s DNA is of retroviral origin, and some of the better preserved copies are termed “endogenous retroviruses” (ERV). 

Writing in the journal Science, the researchers found that when B cells are activated by large polymeric antigens such as polysaccharides of bacteria, they rapidly produce protective antibodies in what is termed the Type II T-independent antibody response.  This response, central to the body’s defense against common bacterial and viral pathogens, is dependent on ERV. 

Within activated B cells, the ERV are driven to express RNA copies of themselves, which in turn are copied into DNA by an enzyme called reverse transcriptase. The RNA copies of ERV are detected by a protein called RIG-I, and the DNA copies are detected by another protein called cGAS.  These two proteins send further signals that enable the B cells to sustain their activated state, proliferate, and produce antibodies. 

Dr. Zhijian “James” Chen, Professor of Molecular Biology and the Center for Genetics of Host Defense and a Howard Hughes Medical Institute Investigator, discovered two of the key proteins examined in the study (MAVS and cGAS).

“These findings suggest that both the RNA and DNA sensing pathways play an important role in detecting ERV and activating adaptive immune responses,” said Dr. Chen, who is also an investigator of Howard Hughes Medical Institute and holds the George L. MacGregor Distinguished Chair in Biomedical Science.

Mice lacking elements of the RIG-I or cGAS pathways show diminished responses to type II T-independent antigens, and mice lacking both pathways show almost no antibody response at all.  Moreover, reverse transcriptase inhibiting drugs also partially inhibit the type II T-independent antibody response.

Dr. Ming Zeng, Postdoctoral Researcher in the Center for Genetics of Host Defense and lead author on the study, notes that mutations affecting an enzyme called TREX1, which normally degrades the DNA copies of retroviruses in the cytoplasm, are known to cause an autoimmune disease. 

“But it seems that the ability of ERV DNA to activate B cells is physiological:  it must happen for this type of T-independent antibody response to occur,” he said.

What about the good vs. bad dichotomy that we have come to hold dear where host vs. retroviral DNA are concerned?

“Once retroviruses have become part of the host germline, they are subject to selection for beneficial effects just like any other part of the genome, and their ability to activate an innate immune response seems to have been utilized to the benefit of the host,” said Dr. Gunilla Karlsson Hedestam, Professor at the Department of Microbiology, Tumor and Cell Biology at Karolinska Institutet.

Dr. Beutler questioned whether this will prove to be an isolated case of ERV being used for “good” purposes, and the possibility that not all may in fact be good.

“Perhaps the ‘physiological’ activation of ERV in B cells might represent a new link between inflammation and cancer,” said Dr. Beutler, who shared the 2011 Nobel Prize in Physiology or Medicine for discovering an important family of receptors that allow mammals to sense infections when they occur, triggering a powerful inflammatory response.

Dr. Beutler is a UT Regental Professor, and holds the Raymond and Ellen Willie Distinguished Chair in Cancer Research, in Honor of Laverne and Raymond Willie, Sr. The goal of the Center for the Genetics of Host Defense is to advance the fundamental understanding of the genetics of immunity to aid in the treatment of infection, disorders of immunity, and autoimmunity.

About UT Southwestern Medical Center: UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. Numbering approximately 2,800, the faculty is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to about 92,000 hospitalized patients and oversee approximately 2.1 million outpatient visits a year.

About Karolinska Institutet: Karolinska Institutet is one of the world´s leading medical universities. Its mission is to contribute to the improvement of human health through research and education. Karolinska Institutet accounts for over 40 percent of the medical academic research conducted in Sweden and offers the country´s broadest range of education in medicine and health sciences. Since 1901 the Nobel Assembly at Karolinska Institutet has selected the Nobel laureates in Physiology or Medicine.
Retroviruses are best known for causing contagious scourges such as AIDS, or more sporadically, cancer.

But researchers at UT Southwestern Medical Center and Karolinska Institutet in Stockholm, Sweden, found that endogenous retroviruses (ERV) also play a critical role in the body’s immune defense against common bacterial and viral pathogens.

“Most scientists have become used to the view that retroviruses are generally harmful,” said Nobel Laureate Dr. Bruce Beutler, Professor and Director of UT Southwestern’s
How to handle the holiday blues and keep your sanity during the season
By Angel Biasatti
Director Public and Community Relations/Methodist Mansfield Medical Center

staff at Methodist Mansfield Medical Center. “Keep your focus on family and the friends you enjoy being with. Reach out to old acquaintances and reconnect. Above all, have fun and take care of yourself,” she says. “The holiday season is a festive time, but it’s not enjoyable if you are completely exhausted and your stomach is in knots.”

You can help to minimize stress by controlling your time. “Don’t think you need to attend every party. When hosting guests, consider catering and takeout to save time on cooking, and try not to be a perfectionist,” Dr. Georgekutty says.

Family is also a common stressor. “Don’t sweat the relatives,” she advises. “You don’t get to choose your family. If a relative gets under your skin, just be polite and try to let it roll off your back.” Dr. Georgekutty encourages us to do what we want this time of year. “Plan ahead with a few special activities with those whose company you enjoy.”

When planning your gift-giving, set a budget and avoid buying gifts you can’t afford — this will stress you out long after the holidays are over. “Consider making gifts that are less expensive but more meaningful,” she says.

In the midst of holiday preparations and activities, Dr. Georgekutty reminds us to take care of ourselves by getting plenty of rest, eating healthy, and exercising.

“If you’re feeling too stressed, take a break,” she says. “Napping, walking the dog, or taking time to view holiday lights can help you feel better.”

While it’s tempting, avoid overindulging in food and alcohol but do allow yourself to enjoy some of your favorite treats in moderation. “Trying to diet during the holidays can make you feel deprived and may cause you to overeat,” she explains.

“When faced with an array of foods, choose wisely. Decide which foods you really want to eat and which ones you can do without. Cakes, pies, and all the other goodies can be part of a healthy eating plan as long as you practice portion control,” Dr. Georgekutty says. “And keep in mind that ‘stressed’ is just ‘desserts’ spelled backwards,” she quips.

When stress feels overwhelming, instead of binging on cookies, try turning your focus outward. “Do something nice for someone else. Get out of the house and walk with family and friends, go to the park, or take your family ice-skating or caroling. Contact someone who is alone or someone with whom you have lost touch. These simple things can help you feel better,” Dr. Georgekutty suggests.

This holiday season, think positively, exercise patience, and commit to staying within the realistic goals you’ve set. The peace of mind you get will go a long way toward keeping joy, laughter, and cheer in the holidays.
Are those jingling bells giving you a nagging headache? If so, you’re not alone. Too much holiday stress can take the fun out of the season. Many of us feel a lot of pressure this time of year with parties to attend, meals to cook, presents to wrap, in-laws on their way, and a house to clean. So how can you take time to enjoy the holidays?

Consider readjusting the expectations that you place on yourself. “There are only so many hours in the day. If the house isn’t decorated or you need to skip a holiday event, its okay,” says Nancy Georgekutty, MD, an independently practicing family medicine physician on the medical
National trial first to focus on long-term complications associated with chronic kidney disease, diabetes, hypertension

hospitalizations, readmissions, cardiovascular events, and mortality. About 14 percent of the adult population in the U.S. have chronic kidney disease, about 10 percent have diabetes, and about 33 percent has hypertension. Moreover, about half of those with CKD have diabetes, and a large proportion have hypertension.

“Most of the prior studies have focused on each disease in isolation, which is not the real world for clinicians. Many people have kidney disease plus diabetes plus high blood pressure or other issues. We want to study what are the most effective treatments for patients with multiple coexistent diseases,” said Dr. Miguel Vazquez, principal investigator for the national trial, Professor of Internal Medicine, Clinical Director of Nephrology, and Medical Director of Kidney Transplantation at UT Southwestern. “The idea is to make findings from this study applicable to as many patients as possible. We want to identify the patients that could benefit from these interventions, then implement a model of integrated health care delivery based on best clinical practices.”

Key to this model is delivery of evidence-based interventions in collaboration with primary care practitioners in the community setting where patients receive most of their care.

“Dr. Vazquez’s project puts UT Southwestern on the playing field with the most prestigious academic health centers conducting clinical and translational research anywhere in the world.  This innovative research project to improve outcomes in these three crippling chronic diseases using cutting edge information technology is real “meaningful use” of the electronic health record,“ said co-principal investigator Dr. Robert Toto, Associate Dean for Clinical and Translational Science, and Professor of Internal Medicine and Clinical Sciences, who holds the Mary M. Conroy Professorship in Kidney Disease.

The project, called Improving Chronic Disease Management with PIECES (ICD Pieces), will be primarily overseen by the National Institute of Diabetes and Digestive and Kidney Diseases and secondarily by the National Heart, Lung, and Blood Institute. It is one of three recent research awards totaling up to $19.4 million over five years and supported by the NIH Health Care Research Collaboratory to address the growing proportion of the U.S. population that has multiple chronic medical conditions.

The study relies on a novel information technology platform called PIECES, developed by Dr. Ruben Amarasingham, President and Chief Executive Officer of the Parkland Center for Clinical Innovation (PCCI) and a co-investigator on the study. The PIECES platform will utilize electronic health record data for data collection, early disease detection and monitoring and care coordination for patients with chronic medical conditions. PIECES extracts data from electronic health records to identify and sort in real time patients at high risk for adverse clinical events. This process helps providers improve patient safety and care quality by allocating resources to the right patients at the right time.

“We are thrilled to be collaborating with such high-caliber health care systems,” said Dr. Amarasingham, Associate Professor of Internal Medicine and Clinical Science at UT Southwestern. “The unique opportunity to work in partnership to use research and technology to improve the health of patients is humbling.”

The four participating systems — Parkland Health & Hospital System, Texas Health and Resources System, VA North Texas Health Care System, and ProHealth Physicians, Inc. — were selected to make the results broadly applicable across various patient populations and various types of health care systems, including safety net hospitals, facilities caring for veterans, accountable care organizations, and private hospital systems.

“Texas Health Resources continues to benefit from our collaboration with PCCI and UT Southwestern,” said Dr. Ferdinand Velasco, Chief Health Information Officer for Texas Health Resources. “We believe this project, which leverages our investment in health information technology, will help us enhance care for patients with chronic diseases. The study aligns well with Texas Health’s focus on physician-directed population health that helps our patients live healthy and productive lives.”  

ProHealth Physicians of Connecticut cares for an outpatient population of approximately 350,000, including 90,000 with hypertension, 26,000 with diabetes, and 25,000 with kidney disease, said John Lynch, Vice President of Research and Government Affairs at ProHealth.

“In order for us to provide optimal patient-centered care, it is essential to identify disease at its earliest stages, segment our population by predictable risk, identify the optimal interventions by risk category, and adjust care plans for patient-specific circumstances, especially accounting for interactions for those with multiple chronic conditions, and achieve the triple aim – appropriate access, highest quality, at lowest possible cost,” said Mr. Lynch.

Currently 8,404,602 veterans are enrolled in the VA system nationally. The prevalences of CKD, diabetes and hypertension are 20 percent, 34 percent, and 68 percent, respectively, which are all higher than corresponding percentages of patients enrolled in Medicare.

“We are so excited that the VA North Texas Health Care System is included as a site as the VA is the largest integrated health care delivery system in the U.S. that provides care to CKD patients,” said Dr. Susan Hedayati, Associate Professor of Internal Medicine at UT Southwestern Associate Director of the Nephrology Fellowship Training Program, nephrologist at the VA North Texas Health Care Center, and co-investigator on the study at the VA. “Although effective treatments for these three conditions have been established, the challenge remains in widely translating such treatments to clinical practice and affecting clinical outcomes. Effective treatment of these three comorbid conditions by primary care physicians in turn may lessen the rate of progression to end-stage renal disease and use of specialized health care resources, such as nephrology, interventional radiology, and vascular surgery, and lead to not only decreased morbidity and mortality, but also overall decreased health care costs.”

The grants are funded through the National Institutes of Health’s (NIH) Health Care Systems (HCS) Research Collaboratory, which engages health care systems as research partners in conducting large-scale clinical studies. The HCS Research Collaboratory, created by NIH in 2012, currently supports five large-scale clinical trials with partnering health care systems across the United States and a Collaboratory Coordinating Center at Duke University. The funds are managed through the NIH Common Fund, which encourages collaboration and supports a series of exceptionally high-impact, trans-NIH programs. 

About UT Southwestern Medical Center: UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. Numbering approximately 2,800, the faculty is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to about 92,000 hospitalized patients and oversee approximately 2.1 million outpatient visits a year.
UT Southwestern Medical Center – in collaboration with Parkland Health & Hospital System, Texas Health Resources, VA North Texas Health Care System, and ProHealth Physicians, Inc. of Connecticut – will lead the first National Institutes of Health-funded, multicenter, clinical trial to address interventions for patients with multiple chronic conditions centered around kidney disease.

The five-year study will look at individuals with three commonly associated diseases – chronic kidney disease (CKD), diabetes, and hypertension – across a variety of healthcare settings, to determine which practices are most effective in reducing
Holidays present potential fire, burn hazards around the home
Parkland experts give tips for staying safe this winter

“Every year we have many patients with injuries as a result of space heaters,” said Sue Vanek, RN, Burn Program Manager at Parkland. “Placing heating equipment too close to items such as upholstered furniture, clothing, mattresses or bedding is a leading factor in home heating fire deaths.”

According to the National Fire Protection Association, between 2007 and 2011, portable and stationary space heaters caused one third of home heating fires and four out of five deaths from such fires. The Consumer Product Safety Commission says that more than 25,000 residential fires every year are associated with the use of space heaters. More than 300 people die from these fires and about 6,000 people are treated at emergency departments.

Established in 1962, the Parkland Burn Center is one of the largest civilian burn centers in the nation. The center houses a Burn Intensive Care Unit, a Burn Acute Care Unit and a Burn Care Outpatient Center. More than 700 adult and pediatric patients are admitted to Parkland each year for burn injuries.

“With all the distractions of the holidays, it’s important for people to stay alert,” Vanek said, noting that seconds could be critical should a fire occur.

Shelli Stephens-Stidham, director of the Injury Prevention Center of Greater Dallas (IPC), housed at Parkland, cautions that people should also be careful with holiday decorations. “While decorating your home be aware of potential fire hazards and take appropriate safety precautions,” she said.

Here are a few tips from the IPC to keep your holidays injury-free:

Space Heaters:
Only use a space heater that has been tested to the latest safety standards and is certified by a nationally recognized testing lab. Always follow the manufacturer’s directions.
Place the heater on a level, hard, nonflammable surface, such as a ceramic tile floor.
Keep the heater at least three feet away from any flammable material such as bedding, drapes or furniture.
Keep children away from space heaters. 
Make sure the space heater is off if you leave the area. 

Christmas Decorations:
When purchasing an artificial tree, look for the label “fire resistant.”
If buying a live tree, check for freshness. A fresh tree’s green needles are hard to pull from branches and when bent between your fingers, needles do not break. The trunk butt of a fresh tree is sticky with resin and when tapped on the ground, the tree should not lose many needles.
Place the tree away from fireplaces, radiators or portable heaters.
Cut a few inches off the trunk of the tree to expose the fresh wood, which allows for better water absorption.
Be sure to keep the stand filled with water.
Check all holiday indoor and outdoor lights. Make sure all the bulbs are in good working order and there are no frayed wires, broken sockets or loose connections.
Turn off all lights before going to bed or leaving the house.

For more information about holiday fire safety, call the Injury Prevention Center of Greater Dallas at 214.590.4455 or visit its website at www.injurypreventioncenter.org
Being home for the holidays may be ideal, but unanticipated dangers there can turn the holidays into tragedy. During this time of year homes can be especially vulnerable to fires from hazards such as space heaters and even Christmas decorations. That’s why experts at Parkland Health & Hospital System’s Regional Burn Center urge people to be aware of potential dangers and take steps to ensure the holidays are happy and safe.
Methodist Mansfield Medical Center Earns Top Performer Recognition From The Joint Commission

The hospital achieved a performance grade of 95 percent or above on a single, composite score that includes all the accountability measures for which data is reported to The Joint Commission, an independent, not-for-profit organization whose accreditation and certification is recognized nationwide. Methodist Mansfield also met or exceeded a 95 percent performance target for each and every accountability measure for data reported in 2013.

“Receiving this designation from The Joint Commission is truly a testament to the hard work and dedication of our valued employees,” says John Phillips, FACHE, president of Methodist Mansfield. “We understand that what matters most to patients is safe, effective care, and our goal is to always provide compassionate, quality health care to our patients. This designation proves our commitment to that goal.”

The Top Performers on Key Quality Measures program is designed to be an incentive for achieving excellence on accountability measures and support organizations in their quest to improve performance. It also provides an opportunity for all recognized hospitals to celebrate their achievement.

“Methodist Mansfield is honored that our team of employees and independently practicing physicians were recognized by The Joint Commission as one of the Top Performers on Key Quality Measures,” said Phillips. “The key to our success is providing positive patient outcomes through evidence-based care and exceeding our patients’ expectations. Methodist Mansfield is one of 1,224 hospitals in the U.S. earning the distinction for attaining and sustaining excellence in accountability measure performance.”  

Methodist Mansfield was also recognized as a Top Performer in the 2012 and 2011 calendar years for achievements with heart attack, heart failure, pneumonia, and stroke measure sets.

“Delivering the right treatment in the right way at the right time is a cornerstone of high-quality health care. I commend the efforts of Methodist Mansfield for their excellent performance on the use of evidence-based interventions,” said Mark R. Chassin, MD, FACP, MPP, MPH, president and CEO, The Joint Commission.

Methodist Mansfield is also recognized on the quality check website (qualitycheck.org).

About Methodist Health System: Guided by the founding principles of life, learning, and compassion, Methodist Health System (Methodist) provides quality, integrated care to improve and save the lives of individuals and families throughout North Texas. Methodist Dallas Medical Center, Methodist Charlton Medical Center, Methodist Mansfield Medical Center, Methodist Richardson Medical Center, and Methodist Family Health Centers are part of the nonprofit Methodist Health System, which is affiliated by covenant with the North Texas Conference of The United Methodist Church. Additional information is available at MethodistHealthSystem.org. Connect with them through Facebook, YouTube and Twitter at MethodistHealthSystem.org/SocialMedia.

About The Joint Commission: Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission accredits and certifies more than 20,500 health care organizations and programs in the United States, including hospitals and health care organizations that provide ambulatory and office-based surgery, behavioral health, home care, laboratory, and nursing home services. An independent, not-for-profit organization, The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care. The Joint Commission has two nonprofit affiliate organizations: The Joint Commission Center for Transforming Healthcare aims to solve health care’s most critical safety and quality problems and Joint Commission Resources (JCR) provides consulting services, educational services and publications. Joint Commission International, a division of JCR, accredits and certifies international health care organizations. Learn more about The Joint Commission at www.jointcommission.org.
Methodist Mansfield Medical Center was named among the Top Performers on Key Quality Measures® by The Joint Commission for achieving exemplary performance in using evidence-based clinical processes that are shown to improve care for certain conditions. The clinical processes focus on care for heart attack, heart failure, pneumonia, and stroke.