March is Colorectal Cancer Awareness Month - Surgery

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Physician Assistants Aid UC Surgeons According to the American College of Surgeons, many positions in general surgery residency programs went unfilled in 2001 and 2002. In addition, the Accreditation Council for Graduate Medical Education (ACGME) announced that effective July 1, 2003, more than 100,000 residents (including surgical residents) in the United States will be limited to a maximum of 24 hours per shift and no more than 80 hours per week. In an effort to meet these resident work hour restrictions, the Department of Surgery has begun to utilize Physician Assistants. While PA's are not intended to replace residents, when a resident is unavailable the service will be covered by PA's or other mid-level providers. The PA's are intended to augment the resident staff to help reduce their work-loads and allow them additional quality education time. Michael Bowen, MA, RN, PA-C, has joined the Department to manage and oversee the development of the PA program. Michael has been a practicing PA for 25 years with extensive experience in Graduate Medical Education and PA education, and serves on the PA Policy Committee to the State Medical Board of Ohio. Several institutions have demonstrated that surgical PA's provide high-quality, cost-effective care as house officers. In addition to assisting in surgery, the surgical PA frequently takes the admitting history and performs the physical examination, writes orders, interprets preoperative tests, educates the patient and obtains informed consent, dictates the operative report, manages patient care on the wards, handles discharge planning, and performs follow-up care. There are 132 accredited physician assistant educational programs in the United States, located at medical colleges and universities, teaching hospitals, and the Armed Forces. All PA educational programs are accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). Prior to admission, the typical PA student has a bachelor's degree and 45 months of health care experience. PA education typically is 111 weeks in length. PA students will spend 400 hours in basic sciences, 70 hours in pharmacology, 150 hours in behavioral sciences, and 550 hours in clinical medicine. In addition, the PA student will spend over 2000 hours on clinical rotations, with emphasis on primary care in ambulatory clinics, physicians' offices, and acute/long-term care facilities. To practice, the PA must pass a national certification examination developed jointly with the National Board of Medical Examiners and administered by the National Commission on Certification of Physician Assistants (NCCPA). Following a successful certifying examination, the PA must obtain an individual license from the state medical board or PA regulatory committee. The Department of Surgery currently has five PA’s: Doug Knight, Trauma; Joseph Konys, Cardiothoracic; Susan Hatfield, Burns; Glenda Updyke, Transplant; and Michael Bowen. We anticipate additional PA's for Trauma/Critical Care, Vascular, General Surgery, Cardiothoracic, and Transplantation. For additional information, please contact Michael Bowen at (513)- 558-1759; e-mail: Michael.Bowen@UC.EDU. Left to right: Susan Hatfield, PA-C; Doug Knight, PA-C; Joseph Konys, PA-C; Michael Bowen, PA-C; and Glenda Updyke, PA-C.
New Clinical Trials J. Wesley Alexander, M.D., Division of Transplantation: NIH-funded study at University Hospital and Christ Hospital: “A randomized trial of immunomodulating diets with arginine and omega-3 fatty acids in renal transplant recipients.” This study will evaluate the plasma and blood cell membrane absorption levels of amino acids and fatty acids in renal transplant patients receiving special transplant dietary supplements and will determine potential beneficial effects of decreased rejection episodes, decreased incidence of acute rejection, improved long-term allograft survival, reduced cardiac and vascular complications, reduced infectious complications, and improved quality of life. Internally funded study at University Hospital and Christ Hospital: “A pilot study of relationships of gastrointestinal hormones and appetite following gastric bypass.” This study will measure hormones which may be associated with loss of appetite following gastrointestinal bypass. Changes in the hormones after the procedure will be correlated with changes in appetite, the amount of weight loss and technical features of the operation, such as the size of the remaining gastric pouch and the lengths of the intestinal limbs that are a normal part of the operation. NIH-funded grant for the development of new technologies for studying the mechanisms of graft acceptance or dysfunction following renal transplantation. The study, approved by the IRBs at University Hospital and Christ Hospital, is currently underway. For further information, please call (513)-558-6006. Recent Publications Cuschieri J, Gourlay D, Garcia I, Jelacic S, Maier RV. Modulation of endotoxin-induced endothelial activity by microtubule depolymerization. J Trauma 54:104-112, 2003. Giglia JS, J Ollerenshaw, P Dawson, K Black, WM Abbott. Cryopreservation prevents arterial allograft dilation. Ann Vasc Surg 16:762-767, 2002. Johannigman JA, Miller SL, Davis BR, Davis K, Campbell RS, Branson RD. Influence of low tidal volumes on gas exchange in acute respiratory distress syndrome and the role of recruitment maneuvers. J Trauma 54:320-325, 2003. Kitzmiller J. Non-invasive skin measurements after CO 2 and Erbium laser resurfacing. Aesthetic Surgery Journal 23:20-27, 2003. Song JC, Rangachari PK, Matthews JB. Opposing effects of PKCalpha and PKC-epsilon on basolateral membrane dynamics in intestinal epithelia. Am J Physiol (Cell) 283(5):C1548-C1556, 2002. Yoo J, Nichols A, Song JC, Mammen J, Calvo I, Worrell R, Cuppoletti J, Matlin K, Matthews JB. Bryostatin-1 attenuates TNFinduced epithelial barrier dysfunction: Role of novel PKC isozymes. Am J Physiol (GI/Liver), Dec. 27, 2002. Visiting Professors Dr. Jeffrey L. Ponsky to Visit as John and Elizabeth McDonough Visiting Professor on April 8-9 The Section of General Surgery will sponsor a visit by Jeffrey L. Ponsky, M.D., Professor of Surgery and the Director of Endoscopic Surgery at The Cleveland Clinic Foundation. Dr. Ponsky will speak at Surgical Grand Rounds on Wednesday, April 9, on “Therapeutic Pancreatico- Biliary Endoscopy: A Surgical Viewpoint.” At the Cincinnati Surgical Society that evening, Dr. Ponsky will speak on “New Horizons in Surgical Endoscopy.” Jeffrey L. Ponsky, M.D. ****** Dr. Gerald Buckberg to Lecture as Visiting Professor on May 13-14 In honor of John B. Flege Jr., M.D., Professor of Surgery, and establishment of the Flege Chair in Surgery, the Section of Cardiothoracic Surgery will host Gerald D. Buckberg, M.D., Professor of Surgery, Division of Thoracic and Cardiovascular Surgery, at UCLA. Dr. Buckberg's visit will include teaching activities as well as two lectures: “The Helix and the Heart” at Surgical Grand Rounds and “New Geometric Surgical Approaches Gerald D. Buckberg, M.D. to Congestive Heart Failure” at the Cincinnati Surgical Society. Upcoming Guest Speakers: May 21, 2003 - Frame Lectureship (Trauma/Critical Care): Rao R. Ivatury, M.D., Professor of Surgery, Medical College of Virginia - “Towards Optimal Resuscitation After Trauma” June 4, 2003 - Barrows Visiting Professor (Surgical Oncology): Douglas Evans, M.D., Professor of Surgical Oncology, MD Anderson Cancer Center - Topic to be announced Area physicians are invited to attend these lectures. Please contact Gilda Young at 513-558-4206 for further information. ******
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March is Colorectal Cancer Awareness Month - Surgery

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