MUSC Catalyst

August 19, 2011

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 30, No. 1

InsIde AntioxidAnt Benefits

3

Dr. Ashley Cowart researches how olive oil can reduce type 2 diabetes.

Above, Dr. Jay Morris studies green tea polyphenols. Right, Dr. Michael Wargovich visits Kankan, Republic of Guinea, where he collected 15 medicinal plants.

RoBotiC suRgeRy

Rooting out natural treasure By dawn Brazell Public Relations

I

ndiana Jones, move over. MUSC has its own globe trotter searching for international finds. With a treasure trove of barks, plants and fruit extracts stashed on shelves in his laboratory, Michael J. Wargovich, Ph.D., loves roaming the globe in pursuit of natural plants and products that may hold clues to prevention and treatment of cancer.

The ethnobotanist, who recently finished submitting six grants in two weeks, is a professor of cell and molecular pharmacology at MUSC, and has a wait list of students who want to work in his laboratory. Arriving at MUSC four years ago after 15 years at MD Anderson Cancer Center in Houston, Wargovich has been a chemoprevention researcher for more than 20 years. He started with pharmaceutical drugs and then moved to dietary compounds after noticing interesting associations with what people eat in other

Researchers Vondina Moseley, Dr. Jay Morris, Becky Weber and Dr. Michael Wargovich strike a pose in their lab. areas of the world and lower incidences of cancer.

His work studying West African plants for specific kinds of anticancer activity, especially COX inhibition, on colon cancer cell lines recently was featured in the latest National Cancer Institute’s overview of promising research in complementary and alternative medicine.

Wargovich’s interest in ethnobotany got a boost when he went to the Republic of Guinea, West Africa in 1999-2000 because

of research being done by his wife, Joan Cunningham, Ph.D., a breast cancer researcher and epidemiologist who now works at MUSC. While there, he met a traditional healer who had a detailed book of all the medicines they had derived from natural plants in that region.

“I felt like Indiana Jones who had been given the key to the city. I asked them if it would be possible to get some of those plants, and they said sure, no problem, and that started it. We brought some of those plants back,“ he said pointing to bins stored in his lab. “One plant we found has a natural pain reliever and those are strongly associated with reduced risk for cancer.”

The hope is that some of these natural compounds can reduce inflammation with the effectiveness of nonsteroidal antiinflammatory drugs but without the toxicity and side effects that have required the drugs to be pulled off the market or be limited in use because of side effects. The bark of the See natural on page 8

6

Dr. Harry Clarke reconstructs a new bladder using the da Vinci Surgical System.

2 Meet Sarah Currents

4 11

Classifieds

t h e C AtA ly s t online http://www. musc.edu/ catalyst

2 the Catalyst, August 19, 2011

Medical Center

‘Making a difference every day’ Employees of the Month Lisa Jackson, Department of Surgery “I first spoke with Lisa Jackson in February when I contacted her regarding my application for bariatric surgery. During the last five or more months, Lisa has been extremely kind and patient. She was constantly in a great mood and made me feel comfortable in asking my questions. She responded to my emails within the same day, usually within the hour. She's the first person I spoke to in the MUSC Bariatric Program, and she made an outstanding impression on me. It's obvious to me that Lisa loves her job.”

Nominated by Laura Newkirk

Shannon Gray, 9E

“First, let me say that all your professionals at MUSC have been wonderful, caring and from my eyes, well-trained. However, Shannon Gray, R.N., has gone the "extra mile." My wife was in the ICU three weeks before coming to 902 East with a brain aneurysm. Yesterday I observed and assisted Shannon in giving my wife a complete shampoo and conditioning. She also used her own products for this. Shannon is an asset to you and she is a true professional, caring person.“ Nominated by Charles Hesson

Julie Heckman, Pediatric Emergency Department “Julie Heckman, nurse manager of the Pediatric Emergency Department, was headed to the Ambulatory Care Services Admin building/Rite Aid building. As she looked up, this distraught young guy looked at her and said, “You are in scrubs and must know how to get to the emergency department.” Julie asked him what happened. He told her that he had cut the tip of his finger off while at work. He had a bloody finger wrapped up in paper towels and the tip of his finger in his other hand. He was scared but Julie calmed him down and got him to the adult ED. This is what Excellence is all about; she always goes the extra mile.”

Nominated by Sonja Muckenfuss

9/11 observance, commemorative lecture to be held Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425.

843-792-4107 Fax: 843-792-6723 Editor: Kim Draughn catalyst@musc.edu Catalyst staff: Cindy Abole, aboleca@musc.edu Dawn Brazell, brazell@musc.edu

The Catalyst is published once a week.

Paid adver tisements, which do not represent an endorsement by MUSC or the State of South Carolina, are handled by Island Publications Inc., Moultrie News, 134 Columbus St., Charleston, S.C., 843-849-1778 or 843-958-7490. E-mail: sales@moultrienews.com.

In observance of the 10th anniversary of 9/11, MUSC will commemorate the events that took place in New York, Pennsylvania and the Pentagon from 11 a.m. to 1 p.m. Sept. 9 at St. Luke’s Chapel. The chapel will be open for a time of reflection with music provided by harpist Susie Hyman, and a series of framed pictures with photographs of those who perished on 9/11 will be on display.

A 9/11 Commemorative Lecture,

with David Prezant, M.D., chief medical officer of the New York Fire Department, will speak on his experiences in providing medical care at the World Trade Center site on 9/11/2001 from noon to 1 p.m. Sept. 20 at Storm Eye Institute Auditorium.

Prezant will also present a summary of long-term health effects related to the disaster and new medical and public health initiates that have resulted from the disaster. A poster session and reception will follow.

the Catalyst, August 19, 2011 3

Researcher finds link between oil, insulin resistance

By CIndy aBole

Public Relations For centuries, Greeks and people from other Mediterranean cultures have prized olive oil for its use in cooking, fuel, and culinary and medicinal medicine.

Olive oil makes a positive impact on health and offers other benefits such as lowering the risk of heart disease and cancer as well as preventive effects for people diagnosed with diabetes and other illnesses.

These findings are of special interest to biochemist L. Ashley Cowart, Ph.D., and her colleagues.

Cowart, assistant professor in the Department of Biochemistry and Molecular Biology, has focused her research on characterizing how saturated fat affects sphingolipid metabolism in diabetes and the metabolic syndrome since 2005.

Cowart Sphingolipids are a class of lipid molecules that have been shown to regulate signaling pathways that mediate cell growth, cell death and cell aging. Specifically, the sphingolipid ceramide has been shown to cause insulin resistance in muscle cells.

In 2009, Cowart and Wei Hu, Ph.D., broadened

the scope of her research to investigate not only how saturated fats drive ceramide synthesis, but how unsaturated fats, specifically oleate, can prevent ceramide synthesis. Her findings were published in the Journal of Biological Chemistry and in an editorial comment on the Nature Publishing Group's Lipodomics Gateway April 27.

For this project, Cowart's team aimed to determine how fats regulate ceramide synthesis and insulin resistance and the role this process might play in Type 2 diabetes. She found that while saturated fat increased ceramides and caused insulin resistance, oleate could completely block ceramide generation that resulted from saturated fat, and this prevented saturated fatinduced insulin resistance.

"While monounsaturated fats such as oleate benefit human health in multiple ways, this work demonstrated that perhaps one of the most important benefits could be the prevention of insulin resistance that would result from a diet high in saturated fat," said Cowart.

According to Cowart, the prevention of ceramide production may serve as a key mechanism by which dietary oleate benefits human health. She and her team are currently evaluating mice-fed diets that reflect different fatty acid compositions to determine ceramide production levels and obesity-induced

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insulin resistance. Based on these models, a diet high in saturated fats (including palmitate, which occurs at high levels in dairy) produces high insulin resistance compared to a diet high in monounsaturated fats, including oleate. According to Cowart, the body can make fatty acid, but dietary fat serves important roles in health and disease.

Olive oil is composed of up to 80 percent monounsaturated fatty acids and other natural antioxidants that resist oxidation better than polyunsaturates. Other beneficial effects of monounsaturated fatty acids include helping to keep the body's high-density lipid protein (HDL) or good cholesterol levels up and low-density lipid protein (LDL) or bad cholesterol down.

Cowart's research will promote further study in the mouse-diet induced obesity model aimed at understanding the impact of dietary fat on tissues including the liver, heart and adipose. Her work is funded through the Department of Veterans affairs and also supported by a Center for Biomedical Research Excellence grant, which allowed her to collaborate with others including specialists at MUSC's Lipidomics Core Facility. This facility allowed her team to conduct lipid measurements using cutting-edge high-throughput mass spectrometry methodology.

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4 the Catalyst, August 19, 2011

Currents Aug. 16 People–Fostering employee pride and loyalty Employees of the Month Shannon Gray, R.N., 9E , Lisa Jackson, Department of Surgery, and Julie Heckman, R.N., Pediatric emergency Department.

HR update q Performance evaluations: Due Aug. 31; Planning stage forms are due Sept.

30; Employees hired on or after April 1 will not receive an evaluation this review period; Employees who have left or are leaving the organization prior to Aug. 31 or are currently on leave and will not be present for their evaluation, contact Kim Duncan, duncanki@musc.edu or Michelle Foreman, formann@musc.edu. q FY2012 Pay Plan key elements: Increases effective Oct. 9; Increases will be automatically adjusted and reflected in Nov. 2 payroll check (provided available funding); No PEARS for other transactions with same effective date will be accepted. q Status change letter: Employees who reduce hours must sign a status change letter; Letters must be attached to the PEARs; An employer must provide an employee seven days notice in writing of any wage reduction in accordance with South Carolina law (SC Stat. 41-10-30); Form located at http://mcintranet. musc.edu/hr/documents/hrforms/ statuschangeletter.doc. q Education verification reminder: Share with new hires that MUHA HR verifies education prior to employment; Length of time, especially for high school diplomas, may be up to two weeks; Length of time is increased when candidates provide: incorrect graduation date, school name, name at time of graduation, SSN, birth date and states graduated but has a GED; HR has been provided falsified diplomas from diploma mills and diplomas substituted from family members. q Annual Service Awards ceremony (2:30 p.m., Sept. 19, Basic Science

Auditorium); Medical center and university will have separate ceremonies to accommodate number of people in attendance; Employees will receive invitations; Managers will receive an email of employees in their areas being honored.

Culture of Safety & Employee Partnership Joan Herbert, director of organizational performance, and Pat Gaylor, patient safety & quality specialist, spoke to managers about plans for simultaneous rollout activities for Culture of Safety and Employee Partnership action plans. Gaylor discussed the April Culture of Safety Survey results. The organization's action plans will focus on the lowest scores of the survey: non-punitive response to error.

As part of the action plan, information and resources will be provided regarding a "just culture" approach to managing error and adverse events. Gaylor explained that “just culture” is not a blame-free culture but is one that recognizes that competent professionals can make mistakes. There are three major categories of human behavior (human error, at-risk behavior and reckless behavior) and each category requires a different response in the management of error and adverse events.

Herbert reviewed results from the Employee Partnership Survey. She noted that the survey's lowest scores came in the systems and leadership section and are in three areas — "Asking for opinions before decisions are made," "Ability to influence policies and decisions that affect work," and "Leaders really listening to employees." The organization's action plans will focus on "Leaders really listen to employees" with two major focus areas: assuring that leaders are rounding effectively with their staff and following up on what they hear and exploration of a mechanism to collect employee ideas, act on them and report on those actions.

This year, all work groups are being asked to also develop action plans for these two priorities: "Leaders really listen to employees" and "Non-punitive response to errors." Work groups will

To Medical Center Employees At the Aug. 16 communications meeting Joan Herbert, director and coach, Organizational Performance, and Pat Gaylor, Safety & Quality specialist, updated the management team on the action plans for Employee Partnership and Culture of Safety surveys. The purpose of the action plans are to focus on opportunities or priorities indentified by the survey findings.

For the past six years the medical center has developed organization-wide and departmentbased or work group action plans for the Employee Partnership survey. This year, we are combining the action plans for the Employee Partnership and Culture of Safety surveys.

Tool kits, training and individual consultation sessions will be provided to managers to help with formulation of department-based action plans. The status of all action plans will be reviewed at least quarterly by department leaders and hospital administration. We will also report progress at our town hall meetings. Additional details are included in this newsletter.

On another matter, Melinda Anderson, director of Parking Management, reminded the management team that an expanded shuttle service (operated by Meducare) for employees began Aug. 1. This pilot shuttle service is in response to interest expressed by employees and provides a transportation link between employee worksites and on-campus employee parking locations from 5 to 7 a.m. and 7 p.m. to midnight weekdays throughout August.

The planned stops include Clinical Sciences Building ramp, Bee Street garage, ART and Courtenay garages and others stops on demand. To date, there has been very limited use of this expanded shuttle service and I want to be sure that word gets out.

After 30 days the pilot will be evaluated for expansion, modification or cancelation. The existing shuttle bus service linking the campus with off-site parking locations operated by University Transportation and the Public Safety Escort program will continue to operate as usual. Anyone with questions should contact Debby Humbert at 792-6760 or humbertd@ musc.edu.

W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center also have the opportunity to identify and generate action plans specific to their group.

A tool kit is available to leaders online to assist with rolling out results and action planning with their work groups. Additionally, leader training sessions are being scheduled and individual consultation will be offered.

Documented action plans are due to supervisors by Sept. 30. Work group action plans and MUHA organizational action plans will be reviewed at least quarterly to assure effective follow through and in-house pulse surveys will be conducted to assess progress.

Radiation Service Excellence Ray Shingler, Radiology patient satisfaction chair and a member of the Service Excellence steering committee, gave an overview of the successes and best practices in Radiology's Excellence program and services provided at Rutledge Tower, ART, Hollings Cancer Center and university hospital. Shingler

reviewed the department's best practices by using applause cards; AIDET hardwired with staff; radiologists and technologists collaborate for a seamless patient experience; empathetic and genuine concern for all patients; use of business cards when available; managing up staff and radiologists and acknowledge and assist all patients.

Direct performance observations are conducted by coordinators and managers to provide feedback and coaching when necessary.

Quality—Providing quality patient care in a safe environment

Pam Arnold, R.N., MUHA Diabetes Program manager, reported that MUSC has Joint Commission certification for

See Currents on page 9

the Catalyst, August 19, 2011 5

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6 the Catalyst, August 19, 2011

Robotic surgery helps coach return to fields

Jim Hoshour, right, with son, Chad Hoshour and grandson, Jackson. With 11 grandchildren, Hoshour said he wanted to be proactive in seeking the best treatment for his bladder cancer that would keep him active.

Adaptation of technology pushes envelope on the complexity of cases handled by da Vinci Surgical System By dawn Brazell Public Relations Jim Hoshour teaches business classes as Sumter High School, captures film footage as the video coordinator for the football team, coaches the prestigious American Legion Baseball P-15 team and loves to spend time with his 11 grandchildren.

When he found out he had muscleinvasive bladder cancer, he didn’t just want to know if he could fight it, he wanted to know how to fight it and still have an active and good quality of life.

Harry Clarke, M.D., Ph.D., associate dean for graduate medical education and Clarke urologist, knew he had the perfect candidate for what would be MUSC’s first robotic cystoprostatectomy,

or the removal of the bladder and prostate that included taking a part of Hoshour’s bowel to reconstruct a new bladder called a neobladder. If all went well, the neobladder would mean Hoshour would not have to wear a bag or use a catheter.

“He has done really well and has been able to void on his own. It’s the best of all worlds as far as his outcome. I counsel patients who 8 out of 10 will be able to void on their own, but 2 out of 10 will have to use a catheter.”

Hoshour thought those were good averages, and said he didn’t mind being MUSC’s first patient to have this procedure done using the robotic da Vinci Surgical System. A photographer and videographer, he’s comfortable with high-tech equipment and had confidence in Clarke’s decision, he said.

The da Vinci Surgical System, developed by the U.S. Department of Defense, was introduced to MUSC in May 2008 by Andre Hebra, M.D.,

Hoshour coaching the P15 American Legion team this month. director of the Division of Pediatric Surgery. Since then, the use of the system has spread to a variety of specialties, including urology. The challenge now is competing with other specialties to find time on the machine, Clarke said.

He likes the versatility of the machine, especially with the new devices that have been developed to expand its uses. “I think in the next 10 years or so, we’ll be doing more and more things robotically.

We’ve already seen that evolution with laparoscopy. We’re doing more things laparoscopically then we ever thought we’d be able to do. Certainly, we’ll do more things robotically.”

The robotic system features four interactive robotic arms equipped with instruments designed with seven degrees of motion, which allows various surgical functions such as clamping, suturing and tissue manipulation. A camera and light is mounted on one arm providing

high-definition, 3D videos that are displayed throughout the operating room. Surgeons sit at a console where they can manipulate all four robotic arms via hand and foot controls.

“We’ve started in the past couple of years doing more and more cases with the da Vinci robot. As we’re getting more and more comfortable, we’re able to push the envelope a little bit,” he said, explaining how it allows them to take on more complicated cases. “This is the first one in South Carolina where we’ve done a neobladder.”

Robotic surgery has received some negative criticism lately by health professionals concerned that it’s being over-marketed. Some research suggests the robotic procedure reduces hospital stays and blood loss, compared with regular surgery, but studies have also shown that robotic surgery offered no See roBotIC on page 10

The Catalyst, August 19, 2011 7

Improvements to fracture care

Operating room nurses Evie Peters, from left, and Roger Pittmon listen as orthopaedics specialist Dr. Bill McKibbin discusses plating techniques with a Synthes instrument to nurse colleagues Angie Cassell and Caitlyn Miller. Right photo: Nurse Terri Pittman holds a Synthes Power Driver and demonstrates placing a K-wire into a model of a tibia and fibula. The nurses assembled July 8 for a continuing education event in which nursing staff were oriented to a variety of specialty instruments used in surgical fracture treatments. Equipment was supplied by Synthes and taught by orthopaedic surgeons Drs. Harry Demos and Langdon Hartsock.

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8 the Catalyst, August 19, 2011

natural

Continued from Page One

Senegal mahogany tree, for example, has a natural compound that works similar to Celebrex, and he hopes to secure funding to get the bark from Australia for study.

Wargovich said it’s interesting to note that many research studies suggest that advanced, affluent nations have increased risks for cancer.

“I don’t believe that’s entirely true, but what is true is that many of the cultures that we believe are protected from cancer and other major diseases may be protected because naturally in their diet and culture are anti-inflammatory compounds. We’re not built to handle the high calorie and high carbohydrate foods we take in every day, so this sets up a long period of inflammation.”

dIet ConneCtIon

Researchers are excited about making the link between this longterm inflammation and how it sets the stage for such diseases as cancer, heart disease, obesity, Alzheimer’s disease and basically any disease that has an “itis” at the end, he said. He has talked with his international colleagues who live in places that naturally have diets rich in anti-inflammatory compounds. His colleagues worry that as their cultures westernize and more fast-food options arrive that certain disease will increase.

They have reason to worry. “All the diseases I mentioned before are on a huge upswing.”

Asked routinely what foods cause cancer, Wargovich said the more interesting question to him is what have we removed from our diets that was potentially protective during the last 100 years. One research area he’s excited about is investigating how green tea and vitamin D act in conjunction as combatants against inflammation.

There is a relationship with some diseases and how far north a population lives, such as in the case of colitis or inflammation of the colon that affects 2 million Americans each year, he said. The farther North, the more the prevalence. What researchers are finding is that patients who have this disease generally have very low levels of vitamin D in their blood.

“As our culture has moved indoors

5

top tips fRom WARgoviCh to CReAte A CAnCeR pRevention diet

1. Go Local.

We’re really driving home the vegetable-based diet and locally grown. We depend too much on things coming from all over the world and who knows how long it has been in transit.

2. Go Natural.

Take advantage of anything that is natural – especially beverages.

From a chemistry point of view, any kind of tea is good. Try different fruits and look for color.

3. Spice it Up.

Really think about herbs and spices. These are outrageously high in antioxidants and antiinflammatories. Garlic and cinnamon and clove – turmeric – all those things that have a little bit of buzz and a taste to them – that’s a chemical signal over the years, most of us are chronically low. Vitamin D is the lock and key that controls inflammatory processes.

Everything in molecular biology seems to be a switch. It’s on or it’s off. For instance, in cancer cells, they corrupt this inflammatory pathway to survive.

They do that by turning off the genes that control inflammation. The discovery we’ve made in this lab is that one of the compounds in green tea can actually turn the control genes back on to control inflammation.”

Wargovich compares it to a car that has lost its brakes. Cancer cells use gene silencing to be able to cut through the brakes and accelerate through the body.

“What green tea does is put the brake system back on line, to put it simply, which is a very exciting hypothesis that we’re pursuing in the lab. We think if the green tea compounds make the vitamin D receptor more capable, then it’s going

that there’s something pretty potent in them.

4. Take the Long View.

There’s no quick fix here. When I talk about exposure to teas and vegetables, that needs to be daily. The preventative effect of food comes from long-term, consistent exposure to healthy foods.

5. Find Balance.

It’s OK to enjoy the foods you like to enjoy, but balance it off knowing there’s a cost to it. If you enjoy yourself today and you know those foods aren’t that healthy, then tomorrow do something else. For those of us who study cancer, the whole disease is something out of balance. It breaks all the regulatory bonds that keep it from spreading. to be more receptive to having vitamin D coming in from other sources.”

Another promising area involves exploring food extracts from South American fruits that few Americans have even seen. He holds up a sheet with some of his favorites, including pitahaya, carambolo, borojo, uchuva, naranjilla and others. Many South America areas have diets that feature native fruits and juice drinks that are packed with anti-inflammatory compounds. “A lot of them are in the passion fruit family.

They are the most remarkable, wonderful tasting fruits you could ever imagine.”

Garden delIGhts

Down the road, Wargovich hopes to work as part of a team to develop a cancer prevention cuisine, a “culinary experience” for outpatient cancer patients featuring food that is loaded with herbs and spices. People will not

Wargovich holds up a bin of Khaya senegalensis leaves and bark.

Known as mahogany tree, the plant may contain anit-inflammatory agents. To view a video on Wargovich, visit http://bit.ly/ MUSC_Wargovich. change their diets to reflect a developing world’s type of diet, but they will take the bits and pieces that they like, he said.

The concept is let’s put these things into something that people will find readily acceptable with scientifically proven compounds.

“I think it’s a great concept. Imagine if you came to a cancer center and instead of being told to eat healthy, you’re given an actual meal plan with ingredients that have been studied scientifically.

There’s a spice from the Indian culture that’s extremely exciting called tumeric.

Why not have stews or hamburgers with turmeric in them? Why not have a chef’s mind go wild in creating a culinary experience with turmeric?”

An avid gardener, Wargovich glows as he describes the idea. Everyone in Wargovich’s lab participates in community-supported agriculture and Wargovich looks for ways to adopt the healthy habits of other cultures. He grows stevia, perilla, basil, mint and other plants at home and drinks tea every day, he said.

“I love gardening, but I’m a cancer researcher, so this field lets me marry them together.”

the Catalyst, August 19, 2011 9

Prolonged sitting could be health risk

Health at work

risk for chronic disease.

Researchers from the American Cancer Society compared a large group of long-time sitters to people who sat less than three hours a day and controlled for factors like smoking. Death from heart disease was the biggest risk associated with prolonged sitting, and women were more vulnerable. Women who sat more than six hours a day faced a 33 percent higher risk of early death from cardiovascular disease compared with women who sat fewer than three hours a day. Men who sat for long periods had an 18 percent increased risk of premature death from heart disease.

Although some offset a sedentary workday with regular exercise, new studies are now suggesting that it may not be enough to reduce health risks of prolonged sitting. Studies have found that the health risks of a sedentary day are not reduced by adding daily exercise no matter how intense it is. Failing to exercise plus sitting for long stretches proved even more hazardous. The combination of little physical activity and long periods of sitting was linked to a 94 percent higher risk of premature death for women and a 48 percent higher risk for men compared with those who sat the least and exercised the most.

What can make a difference in the health risks of a sedentary work day is to incorporate frequent

activity breaks from the seated position. Non-exercise activity is defined as activity that is incidental to normal life such as walking down the hall, taking the stairs or even just standing. For instance, a “standing” worker might burn approximately 1,500 calories while on the job compared to a person behind a desk expending only 1,000 calories. Email musc-empwell@ musc.edu for information.

Employee Wellness events q Wellness Wednesday: Desk exercise: Exercise bands for fitness.

Visit MUSC Employee Wellness and the Wellness Center staff from 11 a.m. – 1 p.m. Aug. 24 outside the Ashley River Tower cafeteria to learn how a 10 minute exercise band workout performed at a workstation can lead to better health and fitness.

Free exercise bands while supplies last. q Lunch & Learn – Yoga at Work: Learn how yoga poses done while at work can create better health and wellness. The class is held from 12:15 - 12:45 p.m. Aug. 24 in Room 107, Colbert Education Center & Library. Register at musc-empwell@ musc.edu. q Worksite screening: The next screening will be held Aug. 25.

Register at http://www.musc.edu/ medcenter/health1st.

For information, email johnsusa@ musc.edu.

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The challenge for many is that their job responsibilities require them to be seated for most if not all of their work hours.

A new program is being developed by MUSC Employee Wellness and the Wellness Center to provide equipment, training and support for desk workouts. These programs will include group and one-onone sessions on workouts Susan Johnson that can be done while at the work station and include yoga, fitness ball and exercise bands.

The average day for most Americans begins with a sit down breakfast or coffee while reading the paper, followed by a commute to work either sitting in a car or some type of mass transit. Once at work most people spend a minimum of six to eight hours sitting at a desk with maybe a break to eat lunch sitting at the desk or in a restaurant, and possibly a seated meeting.

So what are the health risks associated with a seated lifestyle?

Common effects include weight gain, poor posture, eye strain, poor circulation, muscular weakness and of even more concern, increased

Currents Continued from Page Four the four months. This report will be submitted to Joint Commission by December.

Announcements q Julie Floyd has joined the staff at hospital administration. q Details about Office of Parking Management’s expanded pilot shuttle service, employee parking and annual parking renewal program may be found at http://academicdepartments.musc.edu/vpfa/ operations/Parking. q The Lowcountry Heart Walk will occur from Sept.

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inpatient diabetes management. She thanked medical center staff for working together in this achievement.

Arnold announced one room for improvement issue—point of care (POCT) testing for blood glucose (if greater than 70 mg/dL, treat immediately with following hypoglycemia protocol) and recheck of POCT blood glucose within 30 minutes of first test.

The hospital's response is to provide a plan that outlines policy updates, staff re-education and communications, education rollout committee, forms committee, nursing informatics (alert to nursing care organizer), updating badge cards and POCT boxes and review of QC Manager hypoglycemic events daily with feedback to managers, 70 random hypoglycemic events will be audited per month with a goal of 90 percent for

10 the Catalyst, August 19, 2011

Dr. Harry Clarke uses the da Vinci surgical console, which has hand and foot pedals to operate four mechanical arms. Right, one of the video monitors during a recent procedure with a video link at http:// bit.ly/MUSCdaVinciSurgicalSystem. Hoshour’s procedure was the first continent orthotopic neobladder done robotically at MUSC. the vessels, it makes it easier to do.”

Clarke, who’s pleased to see how added benefit or worse results. well Hoshour is doing, said he was an As with any medical procedure, each ideal candidate because he was active case needs to be decided on its own and healthy. Clarke took a 45 cm merits, said Clarke. Robotic surgery segment of small intestine, the ileum, may not be the best choice of approach and constructed a pouch that retains for some patients given their medical its blood supply from the bowel, and history and condition. Clarke’s advice when brought down and attached to to patients is to not the urethra, acts as a Scale of the size assume the newest bladder. of one of the and latest equipment Hoshour, who found robotic tools. and/or procedure is his cancer in January the best for them, but 2010 after going for a to ask questions. run and coming home For certain to discover a massive procedures, Clarke said he has amount of blood in his urine, said he found there is less fluid loss when wanted to try for the option that would done robotically, and he has found require the least change in lifestyle. recovery time tends to be quicker. The After getting his diagnosis, he received magnification the da Vinci allows and its immunotherapy and then had surgery in manipulative arms allow surgeons to get April when he received the neobladder. around difficult areas easier, he said.

Glad he didn’t wait to seek treatment, “In certain situations the anatomy is Hoshour, 65, said he’s back to his loves such that the robot is very helpful. The of sports, coaching and photography. magnification, dissecting the nerves – all “There’s no use in sitting around. Life’s those things are better done. Certainly too short,” Hoshour said. “I have 11 when there’s a deep pelvis and to tie off grandkids to keep up with.”

Continued from Page Six

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