Impact March 2018

UTMB NEWSLETTER • MARCH 2018

Mentoring Matters: Lab Stewardship team focuses on patient safety, choosing tests wisely Shining a new light on Alzheimer’s disease Spotlight on Vivian Kardow, vice president of Human Resources and Employee Relations

Inspiring the next generation of researchers

Joel Ortiz, animal resource supervisor, and Amanda Heatherly, protocol advisor and liaison with UTMB’s Animal Resource Center, traveled to Cayo Santiago, Puerto Rico— also known as Monkey Island—during the December holidays to help with recovery efforts following Hurricane Maria. Monkey Island is a 38-acre rhesus macaque colony located off the eastern shore of Puerto Rico and is home to 1,300 primates. The island was deeply affected by Hurricanes Irma and Maria. The primates on Monkey Island are among the best studied primates anywhere in the world, as for 79 years and nine generations, the births, deaths and group dynamics have all been well charted. During their time there, Ortiz and Heatherly worked with a large group of volunteers to help remove debris, rebuild the animal care infrastructure and the housing of the animal caretakers, assess the quality of the water system, and work to replace the island’s floating dock.

Dr. Joan Nichols, professor of Internal Medicine and Microbiology and Immunology and the associate director of the Galveston National Laboratory, was honored at the 22nd Annual San Luis Salute, held Feb. 9 at the Galveston Island Convention Center. The gala, hosted

by Tilman and Paige Fertitta, celebrates Mardi Gras! Galveston by providing a charitable aspect to the city’s annual celebration. Each year, the Salute recognizes the extraordinary work of doctors and scientists and helps fund UTMB programs. This year’s event proceeds will support Nichols’ work bioengineering human tissues for testing and modeling in lung disease research, and the Jennie Sealy Hospital.

The Jennie Sealy Hospital Medical ICU (MICU) completed one year of zero catheter-associated urinary tract infections (CAUTI) on Feb. 19. In 2016, the MICU implemented a nurse-driven, evidence-based CAUTI reduction program to eliminate infections. This process included an assessment of the necessity of indwelling urinary catheters (based on CDC indications), CAUTI-prevention measures and care for patients requiring catheters, and shift rounding to assist staff with identifying opportunities for preventing catheter-associated urinary tract infections. UTMB President David Callender recently presented the MICU team with Way to Go Awards for their hard work and dedication to Best Care.

Katrina Lambrecht, vice president and administrator of the Angleton Danbury Campus, and vice president of Institutional Strategic Initiatives, was selected to join the America’s Essential Hospitals 2018-2019 Fellows Program. The program, which began more than 25 years ago, brings together leaders from around the nation to examine challenges, explore strategies and develop skills that can strengthen organizations and improve patient care. The program lasts about 10 months and includes three separate multi-day group sessions held in different cities. Activities include presentations from health care experts, case studies and group projects.

Dr. Tammy Cupit, director of nursing science and innovation, and Dr. Veronica Kwarteng-Amaning, director of patient care services and assistant chief nursing officer for Hospital Galveston, in collaboration with colleagues from Baylor College of Medicine and Texas Children’s Hospital, have been selected to receive grant funding from the Texas Medical Center Health Policy Institute for their proposal, “Policies and Practices Addressing the Needs of Children and Incarcerated Parents.”

As a winner of the 2018-2019 policy grant, they will receive more than $94,000 to help local leaders determine the best ways to support children whose parents are incarcerated. The policy research team will work with the Harris County Sheriff’s Office on the project. Researchers plan to ask those incarcerated about their children and the support they need. They also plan on conducting interviews with the people who take care of these children, to find out about the kids’ needs.

A textbook edited by Dr. Michael Leger, director of Quality and Healthcare Safety, recently received a first-place award in the American Journal of Nursing’s annual Book of the Year Awards.

The book, “Financial Management for Nurse Managers: Merging the Heart with the Dollar,” was the first-place winner in the “Nursing Management and Leadership” category. Several chapters in this fourth edition were written by UTMB Correctional Managed Care employees Gary Eubank, chief nursing officer, and Paul Brown, Region 3 director of nursing. The annual book awards honor exceptional texts for advancing health care quality. The list of winners appeared in the Jan. 2018 issue of AJN.

Five residents were chosen to receive the Thayer Award for Excellence in Teaching.

The five were selected by Osler Student Scholars in the John P. McGovern Academy of Oslerian Medicine. The residents are chosen for exemplifying sound scientific knowledge, compassion toward patients and dedication to learning and teaching. This year’s winners are Dr. Pablo Padilla, surgery; Dr. Michael Gillespie, psychiatry and behavioral sciences; Dr. Keyan Mobli, surgery; Dr. Dominique Washington, obstetrics and gynecology, and Dr. Taylor Herzog, psychiatry and behavioral sciences. Thayer was Sir William Osler’s first resident at Johns Hopkins during the late 1880s. Osler was one of the founding professors of Johns Hopkins Hospital and is regarded as the “Father of Modern Medicine.”

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From the President Welcome to the latest issue of Impact. This edition highlights many of our people and initiatives that make UTMB a leader in defining the future of health care in Texas and around the world.

M A RC H 2 0 1 8

I’d like to thank everyone who has attended the Mondays in March sessions or viewed remotely. The annual sessions provide an opportunity for you to hear from UTMB executive leaders about plans and progress in the Academic Enterprise, the Health System, and Business and Finance. This year’s series concludes on March 26 with a panel discussion among the executive vice presidents and myself. If you aren’t able to attend, each session will be posted to the Mondays In March website at www.utmb.edu/mondays-in-march.

Best Care: Lab Stewardship Page 4

As graduation season nears, this edition of Impact includes a “Day in the Life” of one of our graduate students, Elizabeth Jaworski. Not only is she working toward a PhD in biochemistry and molecular biology, she also is passing on her love for science to local high school students.

Jaworski has been a mentor with the Bench Tutorials Program for the last three years, helping young students discover their passion as they conduct real research in a UTMB lab.

A day in the life of a graduate student

Other stories in the March issue include: • A profile of Vivian Kardow, vice president of Human Resources and Employee Services • A Best Care in Action segment highlighting UTMB’s Lab Stewardship Program • How the extension of the 1115 Medicaid Waiver will impact UTMB and patients across Texas • A research study that has found near-infrared light may be the key to stopping the terrible effects of Alzheimer’s disease.

• Six myths about colonoscopies by Dr. Praveen Guturu, gastroenterologist and assistant professor of Internal Medicine • A fun history “UTMB Trivia” question to test your knowledge and enter your name for a chance to win a UTMB swag bag • Numerous accomplishments and kudos in the Working Wonders column and throughout the newsletter I hope you enjoy reading this issue. If you have any story suggestions for future editions, please let the Impact team know.

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Spotlight on Vivian Kardow, vice president of Human Resources and Employee Services Page 10

UTMB research shines a new light on Alzheimer’s disease Page 11

Dr. David L. Callender UTMB President

Impact is for and about the people who fulfill UTMB’s mission to improve health in Texas and around the world.

We hope you enjoy reading this issue. Let us know what you think!

ON THE COVER: Elizabeth Jaworski (left), UTMB graduate student in biochemistry and molecular biology, mentors Gabriela Martinez, a local high school student, as part of UTMB’s Bench Tutorials Program. The program gives exceptional Ball High School students the rare opportunity to work one-on-one in the lab with a graduate student or postdoctoral fellow conducting real-world research. (Photo taken by Mark Kinonen) P R INT E D B Y U T MB G R A P H IC D ES IG N & P RIN TIN G S ERVICES

Vice President Marketing & Communications Steve Campbell Associate Vice President Marketing & Communications Mary Havard Editors KirstiAnn Clifford Stephen Hadley Shannon Porter Art Director Mark Navarro

CONTACT US Email: impact.newsletter@utmb.edu Phone: (409) 772-2618 Campus mail route: 0144 U.S. Postal address: UTMB Marketing & Communications

301 University Boulevard

Galveston, TX 77555-0144

B EST CA R E I N AC T I O N

Laboratory Stewardship Team focuses on appropriate medical testing, improving patient safety

BY KIRSTIANN CLIFFORD

THOUSANDS. That’s how many different laboratory tests physicians may choose from when diagnosing, screening or monitoring a patient. It’s a vast menu—including common tests that measure glucose levels or specialty tests that screen for Zika virus.

Lab tests play a crucial role in patient care, as they influence up to 70 percent of medical decision making. However, growing evidence shows that just because a test is available, doesn’t mean it’s a good idea to have it done.

“About 30 percent of inpatient lab tests are unnecessary or wasteful,” said Dr. Todd Masel, assistant professor of neurology and director of UTMB’s Laboratory Stewardship Program. “In fact, they can even harm the patient. For example, studies have shown that excessive blood lab draws can cause hospital-acquired anemia—which could have serious consequences, especially for patients with cardiorespiratory diseases.”

inappropriate use of less commonly ordered high-cost studies. The delivery of high-value care and teaching these principles to the next generation of physicians are top priorities at UTMB.” In addition to clinicians, laboratory scientists have a seat at the stewardship table to help determine what labs are ordered most often and the appropriateness of both common and expensive orders.

“UTMB is one of the few hospitals that is taking the lab perspective into account in addition to the clinical perspective, which is really beneficial,” said Dr. Mayukh Sarkar, a laboratory scientist and member of the Lab Stewardship Team. “While many people know clinical lab scientists sit in a lab performing tests and interpreting results, they don’t know we can offer 24/7 expertise about what tests may be needed—or not needed.”

The Lab Stewardship Team includes (back row L-R) Dr. Todd Masel, Dr. Matthew Mrazek, Morgan McClure, Mary Feldhusen, Juan David Garcia, Dr. Chris Zahner, Dr. Mayukh Sarkar, Kassandra Larson and Jenny Ulloa. (Front row, L-R) Dr. Chad Botz, Nicole Young, Dr. Judy Trieu and Amy Davis. Not pictured: Dr. Luba Frank, Barbara Bowers, Tho Nguyen, Dr. Mohamed Morsy and Elizabeth Rodriquez.

Charged with improving patient safety, Masel and members of the interdisciplinary Lab Stewardship Team are now looking at ways to ensure the appropriate selection of tests at the right time for each patient. It’s one of five focus areas that builds upon the Best Care initiative to help UTMB become a high-value practicing organization.

As lab testing options continue to grow and become more complex, Sarkar says interprofessional collaboration is more important than ever. He points to UTMB’s Diagnostic Management Teams as an example of effectively bringing pathologists and lab scientists to the bedside, helping physicians order the correct tests for their patients, and then using the results to select a treatment plan.

“The truth is, it’s become so easy to order a lab test—just a click of a mouse— that often it takes less time to do that than it does to spend the time thinking about whether it really needs to be ordered,” said Masel. “We need to put more of a focus on teaching the importance of being judicious and only ordering tests out of necessity rather than habit.”

Recent research done by Sarkar and the Coagulation DMT showed significant room for improvement when it comes to test selection. The study evaluated 200 cases of patients being evaluated for bleeding or blood clotting issues from throughout UTMB’s Health System—and found test selection errors in 77 percent of the cases.

For example, when a patient is first admitted to the hospital, it may be necessary “Part of the problem was our ordering system had multiple names for the same to order a daily complete blood count (CBC) test every eight hours, but when test or the test was labeled in a confusing way,” said Sarkar. “We’ve been the patient’s condition starts to improve, it may only be needed every 24 hours. working to address that issue, and I have started reaching out to ordering However, Masel sees many cases where these tests continue to be ordered residents or physicians to offer myself as a resource. I’m already seeing fewer every eight hours, although test results don’t change—often because the test and fewer errors as a result—and many physicians feel comfortable calling is set to be ordered automatically. me up to discuss specific patient cases.”

“We will be looking into redesigning the electronic system used for ordering tests so that it creates ‘hard stops’ or makes it not quite as easy to order repeat labs,” he said. “Not only will these efforts lead to improved patient outcomes and satisfaction, they will also help control health care costs.”

Dr. Matthew Mrazek, assistant professor of general and internal medicine added, “Inappropriate utilization of laboratory resources is a multi-faceted problem with major financial and patient care implications. Our stewardship team is targeting the use of low-value studies, over-utilization of common ‘daily’ labs, as well as

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Masel agrees that it will take a combination of approaches including educational campaigns, decision support tools, order requisition redesign, provider feedback—and most importantly, a team approach—to be more responsible stewards of lab testing. In the coming months, he hopes to see a movement across the institution, with all members of the health care team “choosing wisely”—not out of habit, but out of necessity. n For more information about UTMB’s efforts to become a high-value practicing organization, visit intranet.utmb.edu/best-care.

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PAT IENT CARE

1115 Waiver, Version 2.0

Five-year extension allows for continued critical services, evolution from project-based to population-based initiatives

BY KIRSTIANN CLIFFORD

WITH JUST DAYS TO SPARE, UTMB leaders and participating health care providers were informed that a program providing funding for critical services for underserved patients will be extended another five years.

As the program enters this new phase, Kovacevich said UTMB will take the lessons learned over the last six years from specific DSRIP projects and apply them institution-wide to influence a broader range of outcomes among a larger population.

The various larger-scale initiatives, known as DSRIP “bundles,” will group together metrics that share a unified theme, such as chronic disease management, maternal safety or integration of behavioral health in a primary care setting.

Texas’ 1115 Medicaid Waiver program, which was set to expire on Jan. 1, will now continue through Sept. 30, 2022. The agreement reached between the Texas Health and Human Services Commission and the federal Centers for Medicare and Medicaid Services includes $25 billion in Medicaid funding over “The original projects-based waiver was really an incubator for larger-scale transforthe next five years to continue providing innovative patient care across the state. mation,” said Kovacevich. “For example, we had DSRIP projects focused on controlling diabetes in specific clinics or with specific subsets of our patient population, but “Financially, the waiver is important to all providers, UTMB included—but it’s that will now be evolving. Under the new waiver, we will be taking the best practices more than just the dollars at stake,” said Craig Kovacevich, UTMB’s associate learned from those specific projects and embed them system-wide to improve health vice president for Waiver Operations and Community Health Plans. “The waiver of patients with diabetes. It’s no longer a siloed approach.” as a whole has given organizations like UTMB the ability to really influence health outcomes and expand programs that, without this waiver, they would In the coming months, UTMB will be convening a multidisciplinary advisory group have never been able to do. When you look at the number of folks who have to select five to seven bundles that will have the largest impact on the patient population across the institution. Kovacevich said care management and patient been impacted, it’s incredible.” navigation, while no longer continuing as DSRIP projects, will influence and The waiver was originally granted to Texas as a five-year program in 2011, enhance every larger-scale initiative. providing $29 billion in incentives to health care providers for improving patient care for all, with a special emphasis on Medicaid and uninsured patients. In “It’s critical for us to look at the ‘whole’ patient, including social aspects that may 2016, it was extended an additional 15 months while negotiations took place hinder their access to care,” said Kovaceivch. “Our patient navigation DSRIP projects regarding a longer continuation of the program. UTMB serves as the anchor proved that helping patients with things like transportation, housing and other issues institution for Region 2, which comprises 16 counties in east and southeast Texas. influences overall health outcomes. Care management and patient navigation will continue to grow and will touch every single bundle we choose to pursue.”

Kovacevich said the waiver has two big parts: funding for uncompensated care to help providers offset the cost of providing care to uninsured or low-income With the change from project-based to system-wide initiatives, Kovacevich said patients, and funding for hundreds of Delivery System Reform Incentive Payment accurate data collection and reporting will be crucial for tracking progress and (DSRIP) projects—many of which have already proved successful by helping receiving federal match payments. Providing education on the new waiver and patients control chronic diseases, reduce hospital readmissions and much more. its rules to providers and staff across UTMB will be another key to its success.

“The DSRIP projects have been a big success for UTMB—we’ve achieved While there will be challenges, Kovacevich said there is a huge opportunity to upwards of 90 percent of our metric goals, which is incredible,” said Kova- build upon the hard work that’s already been done in hopes of true transformation. cevich, noting that the waiver has contributed $56 million to UTMB’s efforts Like with Best Care—which is focused on delivering the best care to every patient, through the end of FY17. “But I’m most proud of how the waiver has brought every time—it will take everyone working together. people together as part of a learning collaborative to work toward the ‘triple “This is no longer something that physicians can do alone—or that the support aim’ of health care: to improve the experience of care, improve the health of staff in a clinic can do alone,” said Kovacevich. “It really takes everyone getting populations and reduce per capita costs of health care.” on board, understanding the initiative and asking themselves, ‘What is my role and how can I influence and help the organization reach its goals?’” n

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BY KIRSTIANN CLIFFORD

Ever since she can remember, UTMB graduate student Elizabeth Jaworski has had “a thing” for science.

“I love it so much! I really do. It can be a huge challenge but it’s fun—you’re at the forefront of discovery, which is really exciting,” she says.

After writing a paper on genetics in high school, Jaworski’s passion for science steered her toward an undergraduate degree in biology, and now, a PhD in biochemistry and molecular biology at UTMB. She’s currently a fifth-year graduate student and research assistant in Dr. Andrew Routh’s lab, studying the evolution of viruses.

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“We’re looking specifically at RNA viruses—including viruses like the rhinovirus, which is the most frequent cause of the common cold, and Coxsackievirus which causes hand, foot and mouth disease—and how they mutate over time,” explains Jaworski. “I think viruses are super cool because they are not technically alive, but they still somehow have such a huge impact on any organism—they are this crazy scientific anomaly.”

Jaworski hopes to pass on her curiosity and enthusiasm for biomedical research by mentoring younger students. When I meet up with her on a mid-week afternoon in the Truman G. Blocker Medical Research Building on the Galveston Campus, she’s prepping for the next step of an experiment that she and a local high school senior have been working on together since September. It’s Jaworski’s third year as a mentor with UTMB’s Bench Tutorials Program, which gives exceptional Ball High School students the rare opportunity to work one-on-one in the lab with a graduate student or postdoctoral fellow conducting real-world research.

“This is these students’ first experience in a lab—it makes a huge impression on them,” says Jaworski. “I’ve been lucky to have had good mentors along the way. As much as people say a person’s success is their own responsibility, a mentor that lets you grow and pushes you to develop in the direction you want to go is really important.”

As Jaworski reflects back on her first lab experience in college—she worked with insects such as bed bugs and termites—her mentee, Gabriela Martinez arrives. The two chat about Martinez’s college acceptance letters as they put on purple lab coats, safety glasses and gloves. Then, they walk over to a large sixth-floor window that overlooks campus and which is covered in dry erase marker.

“These are my lists of things I have to do—it’s like an extra-large white board,” laughs Jaworski, pointing at the window. “I map out my experimental designs on here and then make lists of tasks so I can glance at it quickly and know what I have to do next.

To say there’s always something to do is a total understatement.”

Jaworski motions toward the board and quizzes Martinez about what they did in their last session together and what they need to do moving forward. Martinez explains how they are studying the evolution of what are called “defective interfering viral RNA genomes” of an insect virus called Flock House. They’re working to understand how changes to its genome affect the virus’ ability to replicate. It’s a complex concept for those without an advanced science background, but Martinez is able to confidently describe how they previously transfected—or inserted virus genomes—into fruit fly cells. Today, they will be collecting samples from the cell cultures.

“Bingo! Good job,” Jaworski says to Martinez, adding, “Every year, these kids blow me away. They just keep getting better each year, too. I’m like, how is this even possible?

I’m so incredibly impressed every time.”

The two head into an adjacent room with three different tissue culture “hoods,” which look like work benches with a protective glass barrier. The hoods are designed to filter air in a way that provides a sterile work environment to protect both the researcher and the materials they are working with. But first, they must spray all equipment with ethanol and label tubes that will hold the harvested cells.

“This is the not-so-fun part of science,” says Jaworski with a smile. “But it’s crucial—if something isn’t clean or labeled right, it could ruin an experiment.”

While Jaworski makes sure Martinez understands the importance of the “boring stuff ” like cleaning, labeling and learning the fundamentals of pipetting, she also makes sure Martinez gets hands-on experience helping with critical research.

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“Gabby is helping with real research that could someday help predict future

virus outbreaks or lead to possible vaccines—we hope to finish this project and publish our findings in a scientific journal,” says Jaworski. “She’s not here to do grunt work or wash beakers; it’s so much more than that.”

Jaworski watches as Martinez pulls several cell culture plates from an incubator and takes a look at them under the microscope. Together, they move the cells to the hooded area, where Martinez carefully uses a pipette to extract cells and place them in various tubes. They are collected based on when the transfection took place—24, 48, 72 or 96 hours before. Every step is recorded in a notebook so Jaworski can replicate the experiment if needed.

It’s a tedious process that takes a steady hand and attention to detail, but Jaworski patiently coaches Martinez through each step. As the afternoon turns into evening, Jaworski and Martinez wrap up for the day. When they meet again, they will be ready to start running experiments on the collected cells to see how the virus responds under certain conditions.

Martinez says she always looks forward to the two days a week that she gets to spend in the lab with Jaworski.

“I love it, actually” says Martinez, who will be the first in her family to attend college and is thinking about pursuing both an MD and PhD. “Elizabeth breaks everything down into a way that I can understand. Being able to work with her has been a great opportunity. It’s not like we are repeating something that another scientist has already done. We are doing new stuff that will actually help people in the future.”

After Martinez leaves, Jaworski will stay in the lab for several more hours, working on her thesis (she hopes to graduate this May), collaborating with lab mates, writing papers, preparing for conferences or designing and running other experiments— searching for the next “aha” moment.

“Sometimes a finding might be really small or not what you expected, but at that point in time, you’re the only person on the planet that knows that one thing… and eventually all those little pieces come together and you get these great findings and discoveries,” says Jaworski. “That’s what’s so exciting and makes every struggle along the way worth it.” n

DID YOU KNOW? For the last 21 years, the Bench Tutorials Program has paired more than 250 high school students with UTMB graduate students and postdoctoral fellow mentors with guidance from a faculty advisor. The purpose of the yearlong program is to afford dedicated and academically talented high school juniors and seniors the opportunity to participate in cuttingedge scientific research. “Bench” is made possible through a partnership among UTMB’s Center in Environmental Toxicology, the Sealy Center for Environmental Health & Medicine, and Galveston’s Ball High School, and with generous support from the Dr. Leon Bromberg Charitable Trust Fund and Rob Brasier Memorial Fund. For more information, visit www.utmb.edu/coec/home/bench. n

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LEA D E R S POT L I GH T

Vivian Kardow, vice president of Human Resources and Employee Services

Vivian Kardow joined the UTMB family in October 2017 as vice president of Human Resources and Employee Services. In this role, she is responsible for partnering with executive leadership to provide overall strategic planning and management of UTMB’s human resource services and programs.

Kardow came to UTMB as an accomplished certified human resources executive, with nearly 30 years of progressive leadership experience at Memorial Hermann Health System in Houston. Most recently, she served as regional vice president of Human Resources and System Employee Relations for Memorial Hermann, leading HR operations for a region including three community hospitals, 142 ambulatory sites and about 6,000 employees.

Kardow received a bachelor’s degree in business administration with a specialization in human resources management from the University of Houston–Clear Lake.

She is currently working toward a master’s degree in business administration from the University of Texas at Tyler and expects to graduate next summer.

Vivian Kardow and her husband, Jack, enjoying vacation in Napa Valley, California.

We recently celebrated UTMB’s tremendous success with Best Care.

What are your thoughts on how UTMB can maintain its five-star performance long-term?

The work we’ve done with Best Care really differentiates UTMB from other organizations in its discipline and focus on quality execution. To sustain performance, I look to the process that got us here in the first place—a compelling shared vision, talented people, personal ownership of outcomes and leadership. We didn’t treat Best Care as an event, but rather a way to care for our patients—and each other. It’s who we are. We’re keeping it in front, at all times, in everything we do.

What are your goals for HR in the coming year?

We have incredibly talented people in HR with exceptional expertise. We’ll be rolling out a new service delivery model in the next year that will enable us to better engage that expertise and support our priorities, our leaders and employees.

More to come on that!

they knew to make that happen. When we received permission from the Cuban government to emigrate, our family of five headed to the airport, but, because my father was a physician, he was denied exit. In that moment, my parents had to make the difficult decision to put my mother and the three of us on the airplane, not knowing when we’d all be back together again. They had a plan—and confidence it was the right one—and they kept moving toward the goal, regardless of obstacles along the way. My father was able to join us a month later. Courage has been an important and recurring theme for me.

What’s the best advice anyone has ever given you?

Don’t accept ‘no’ for an answer if you’re really passionate about something. Commit and find the way.

What has been your greatest achievement?

Aside from a wonderful marriage and raising a strong and talented daughter, I’ve truly enjoyed the opportunities to lead human resource teams and develop HR professionals. I’ve been fortunate in having great mentoring relationships and it’s very rewarding to pay that forward.

You joined the UTMB family in October and moved to Galveston. How do you like island life so far?

Describe yourself in three words.

I have always loved the island. We are a beach family Perhaps I can describe myself in words I aspire to be— and my parents had a house in Sea Isle growing up, happy, sincere, and above all, kind. so I’ve had a very long relationship with Galveston.

What’s something people would be surprised to I’m enjoying getting reacquainted and getting the Then and now: (Top photo) Vivian Kardow (middle) learn about you? scoop on everyone’s favorite restaurants and local with her siblings and parents after emigrating to the shops. I welcome recommendations.

I’m not so sure how surprised people would be, but I U.S. (Bottom photo) Kardow (second from right) and truly love dogs. I’ve been guilty of going to Petco for dog her family today.

You moved to the U.S. from Cuba as a child food and coming home with a rescue. My husband says, with your mother and siblings. What was “Thank goodness the subdivision only allows us to have that experience like and how has it shaped you into the person you three at a time!”

I have three: Bandit, Sammie and Scooter, a small 12-pound are today? lovable disaster who claimed me as his. My daughter shares my passion for Living under a communist regime and emigrating to the U.S. as a child gave dogs—she recently adopted a deaf Hurricane Harvey rescue she named Lucy. me a unique perspective. My parents have always been my role models. They wanted better for their family and were willing to leave everything and everyone 10

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RE SEARCH

Shining new light on halting the progression of Alzheimer’s disease

BY DONNA RAMIREZ

A LIGHT T HAT I S BA R E LY VI SIBL E

to the human eye could be the key to stopping the terrible effects of Alzheimer’s disease.

A new UTMB study shows that using near infrared light on the heads of mice can effectively reduce vulnerability to the damaging effects of a toxic chemical in the brain known to be involved with the onset of Alzheimer’s. The findings are detailed in Scientific Reports.

UTMB researchers have previously found evidence that amyloid beta protein pieces may underlie the early stages of Alzheimer’s. These proteins disrupt the communication between brain cells, driving the first noticeable cognitive deficits. So, preventing this dysfunction within the brain would be an effective therapeutic strategy for the disease.

between brain cells, thus decreasing the susceptibility to the toxic proteins.”

In this study, the researchers shined a near infrared LED light for up to 90 seconds a day, five days per week for a month on the heads of regular mice and a separate group of mice that were genetically engineered to have brain abnormalities seen in Alzheimer’s. They found that the toxic proteins wreaked less havoc on all of the lighttreated mice compared with the genetically engineered Alzheimer’s-like mice.

“We looked closely at the ability of the near infrared light to mitigate the toxic binding of amyloid beta to the points of communication between brain cells,” said Michele Comerota, doctoral candidate in neuroscience.

“Our findings provide evidence that near infrared light can “Preventing the toxic chemical from taking hold in the brain may serve as a new means of protecting against make the brain more resistant to the damaging effects of Alzheimer’s, ” said Dr. Balaji Krishnan, assistant professor amyloid beta,” said senior author Dr. Giulio Taglialatela, in the Department of Neurology. neurology professor and director of the Mitchell Center for Neurodegenerative Diseases at UTMB. “Near infrared light This study was supported by the National Institutes of therapy increases the health of the points of connection Health and the Amon Carter Foundation. n impact

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Six myths about colonoscopies

by Dr. Praveen Guturu, gastroenterologist and assistant professor of Internal Medicine If the idea of getting a colonoscopy makes you grimace, you’re not alone. However, the procedure may not be as bad as you think— and it could save your life. Colorectal cancer is the No. 2 cancer killer in the U.S. Early detection and regular screenings are key to avoiding this deadly disease.

Here are the facts regarding six of the most common myths about colonoscopies: Myth #1: I don’t have any symptoms so I don’t need colonoscopy.

Fact: Colon polyps and even early cancer can be growing in the lining of the colon without causing any symptoms. If cancer causes symptoms, it likely means it’s in more advanced stages. Early detection is key.

one day in order to clean out the colon. Drinking that much liquid could be challenging. Now, it can be taken in a split dose (i.e. half the night before the procedure and half on the morning of the procedure). However, your doctor can discuss and prescribe the most appropriate preparation method for you. As far as dealing with the salty taste of the prep solution, patients may mix it with ginger ale, Gatorade or other physician-suggested liquids to make it more palatable.

Myth #4: Colonoscopy only detects cancer, it doesn’t prevent it.

Fact: Colonoscopy not only detects early cancer (which is potentially curable), it also ‘prevents’ cancer by removing precancerous polyps and avoiding subsequent development of cancer. It’s estimated that more than 75 percent of colorectal cancer can be prevented through early removal of polyps.

The American College of Gastroenterology recommends getting a colonoscopy every 10 years beginning at age 50, and age 45 for African Americans. Colonoscopy may be recommended at a younger age if you are in a higher risk group for developing colon cancer. Consult your physician if you have a personal history of colon polyps, a family history of colon cancer or inherited forms of colorectal polyps, or if you have a predisposing chronic inflammatory condition of the colon such as inflammatory bowel disease.

Fact: Colonoscopy is the preferred test for screening, as it detects more cancers, examines the entire colon and can be used to diagnose and remove precancerous polyps at the same time. However, there are other options, such as a stool test, that may be appropriate for certain situations. Ask your doctor to be sure.

Myth #2: Colonoscopies are painful.

Myth #6: Only men get colon cancer.

Fact: During the procedure, you will be asleep and comfortable with the help of safe sedative medications. The actual procedure takes about 15 to 30 minutes and you may resume normal activities the next day.

Fact: Both men and women have a similar risk of colon cancer, and it affects all races. The number one risk factor for colon cancer is age.

Myth #5: Colonoscopy is the only way to screen for colon cancer.

Myth #3: Preparing for a colonoscopy is terrible.

Preventive care services for UTMB employees and retirees, including routine colonoscopies, are covered 100 percent by the UT Select Health Plan.

Fact: Until recently, patients were asked to drink a gallon of preparation solution in

For more information, visit utmbhealth.com/colorectal. w

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UTMB TRIVIA In 1895, a German scientist chanced upon a form of radiation capable of “seeing through” most solid objects, rapidly transforming the practice of medicine. The photo to the left is a replica of the first X-ray machine in Texas, made in 1896 by UTMB founding faculty member Dr. Seth Morris.

Within months of its completion, Morris and a colleague X-rayed a nurse’s hand and produced the state’s first-ever medical image. Parts of what household machine were used to make this technology possible?

Send your answer to impact.newsletter@ utmb.edu and be entered into a drawing to win a UTMB swag bag. Good luck!

Answer to the February trivia question: Dr. Thomas N. James Congrats to Rabiah Shabazz Houston, mental health manager, Jester I, Vance, and Jester III Units, UTMB Correctional Managed Care, who won the Feb. drawing!