School of Medicine

Wayne State University School of Medicine
Resident contributes skills to medical mission trip to Dominican Republic
In Headlines on April 16, 2013
Pierre Rojas, D.O.

Pierre Rojas, D.O.

Drs. Claudia and Pierre Rojas are flanked by two other members of the recent medical mission trip.

Drs. Claudia and Pierre Rojas are flanked by two other members of the recent medical mission trip.

The Wayne State University School of Medicine and its Department of Physical Medicine and Rehabilitation - Oakwood are known for physicians who excel in bringing health and healing to patients. The residency program staff includes the example of one such generous physician, found in the gifts and skills of Pierre Rojas, D.O., a first-year resident who spent his winter break with his wife, Claudia Rojas, an Obstetrics and Gynecology resident, on a volunteer medical mission trip to San Pedro de Macoris, Dominican Republic.

Dr. Rojas joined a team of 15 health care provides based in of Toledo, Ohio, who packed medical supplies and pharmaceuticals, and then traveled to the Caribbean nation to provide vital medical care to those in need.

The physicians who volunteer their skills began conducting mission trips to Latin America in 1979. Based out of the Mercy Health Care system in Toledo, Ohio, the Midwest Regional Mission Team spends a week each winter in Santo Domingo providing the poor with surgical and medical treatments not readily available in the region. The team included a gynecologist, a general surgeon, an anesthesiologist, an obstetrics and gynecology resident, a nurse anesthetist, a student nurse anesthetist, a physician assistant, two scrub nurses, two recovery nurses, three circulators, a Spanish-expert volunteer and Dr. Rojas.

The Midwest Regional Mission Team traveled to the Dominican Republic the week of Feb. 15- 23, and performed 40 surgeries, mostly hysterectomies, cystectomies, cholecystectomies and hernia repairs. Patients were triaged for their medical procedures when the mission physician group arrived at the state hospital, Dr. Antonio Musa Regional Hospital, a 150-bed hospital with four operating rooms.

Members of the team who travel on medical missions enhance their clinical skills in ways they do not often get to experience in the United States. One of those is the art of communication in the doctor-patient relationship. Being a first-generation Colombian-American, Dr. Rojas’ first language was Spanish, so he was a valuable asset in communicating with patients during the trip.

Dr. Rojas said he learned significantly from his patients while in the Dominican Republic. “I had been there twice before, I knew the country pretty well and I identified a lot with the people,” he said. “My family had to go through a similar life before coming to the States.”

When asked why he used his vacation time on a volunteer medical mission trip, Dr. Rojas said, “I wanted to give back to a population and culture that means so much to me and that I love. It was like being home away from home.”

Dr. Rojas recommends that every resident have the opportunity during clinical training to join a medical mission trip. The mission allowed him to experience a broader world in the field of medicine, which he described as, “You step back and see how other people live, how health care is different in other countries. It makes you a better person, a better physician. It helps you not take things for granted.”

Dr. Rojas’ reflection upon his experience included a deeper appreciation for the medical resources available in the U.S. “As physicians and patients, we have all of this technology, labs, imaging and medicine,” he said. “Not everyone in the world has that luxury. You become better clinically. You think about the patient more because the care is simplified.”

Dr. Rojas described the difference in medical care as “more human” because of the limited medical resources available. This nurtures another level of human interaction with the patient. The communication between doctor and patient is more intimate.

“For the most part, patients in Latin America are incredibly grateful and appreciative of the care they are being provided,” he said. “They may view you as an extension of their family and may express their appreciation with hugs, homemade food or blessings, for example. And while they may not have much, the efforts are genuine.”

Dr. Rojas is considering another trip -- this time in the field of physiatry -- after he hones and perfects a new skill set as a Physical Medicine and Rehabilitation resident. He has his heart set on making a return to another country he knows well, Costa Rica, and offering services to a pediatric orphanage.
Discovery could improve life for congestive heart failure patients
In Headlines on April 12, 2013
Donal O'Leary, Ph.D.

Donal O'Leary, Ph.D.

New research from a study on chronic heart failure has the potential to dramatically improve quality of life for congestive heart failure patients fatigued by daily activities such as walking across a room.

Donal O’Leary, Ph.D., Wayne State University School of Medicine professor and director of Cardiovascular Research in the Department of Physiology, is the senior author of a paper that provides insight on how ventricular function could be improved during exercise by relieving vasoconstriction, the narrowing of blood vessels due to exaggerated sympathetic activity to the coronary arteries.

 “When we can relieve the vasoconstriction, we see a marked increase in the function of the heart. This could be used as a treatment for heart failure patients, especially if the blockage of nerves can be directed to the heart itself,” Dr. O’Leary said. “If we could get a significant improvement, going out and gardening could be possible. You could improve their heart function to where that doesn’t totally tire them out.”

“Muscle Metaboreflex-Induced Coronary Vasoconstriction Limits Ventricular Congratility During Dynamic Exercise in Heart Failure” is the featured article in the American Journal of Physiology: Heart and Circulatory Physiology’s April 1 edition. Associate Editor Fabio Recchia interviewed Dr. O’Leary for the journal’s accompanying podcast.

“I was really honored,” said Dr. O’Leary, a member of WSU’s Cardiovascular Research Institute. “There is usually only one article selected each month. This is the third we’ve had selected.”

Vasoconstriction occurs because of excessive activation of sympathetic nerves to the heart itself, he said, citing the spike in deaths during snow shoveling after a heavy snow fall as one example of the condition.

The latest publication from his group represents the culmination of more than 20 years of work, bringing together ventricular function and coronary blood flow control in one experiment. “It’s a great big project that we’re getting better and better at refining how we’re going to investigate these phenomena,” he said.

While previous studies showed that systemic therapies with nerve blockers could improve ventricular function during exercise, there are side effects, he said. “We need to find a way to directly target to the coronary vascular. With nanobiotechnology, we can absolutely see this within the clinical lives of our current students and residents,” he said.

He expects the answer is in a specialized delivery process.

The research and results, collected over two years served as the doctoral dissertation for WSU graduate Matt Coutsos, Ph.D., and is the second paper to be published from his work. The initial paper looked at the same phenomena in normal, healthy subjects, and another section of the study focuses on those with hypertension.

Dr. O’Leary is the principal investigator of the National Institutes of Health’s award R01HL055473-16, a $1.56 million four-year competing grant used to fund the ongoing study “Blood Pressure Control During Exercise in Heart Failure.”

“These experiments require a team. They’re highly complex. It has been through the great fortune I have had of having outstanding postdoctorates, students and technicians, that we’ve been able to do this work,” Dr. O’Leary said. “Each study builds on the next.”

The grant, in its 15th year, was renewed earlier this month by the National Heart, Lung and Blood Institute.

WSU computer science students' open source software benefits School of Medicine mission trips
In Headlines on April 11, 2013
A volunteer uses the EasyEMR software in Haiti.

A volunteer uses the EasyEMR software in Haiti.

A screenshot of EasyEMR shows the software's pharmacy component.

A screenshot of EasyEMR shows the software's pharmacy component.

The work of Wayne State University College of Engineering students is having an impact on underserved patients being cared for by WSU School of Medicine students thousands of miles from Detroit.

On a December 2012 trip to Haiti, the School of Medicine’s World Health Student Organization was the first group to test the EasyEMR program, an open source electronic medical record software designed as a class project by a group of Computer Science seniors.

School of Medicine student Erik Brown and recent WSU Biology graduate Sarah Draugelis initiated the creation of EasyEMR after experiencing the challenges of pop-up clinics set up on mission trips by organizations like WHSO. Both have volunteered on medical mission trips, including those organized by the WHSO and Africans in Medicine, another School of Medicine student organization.

“What we lacked is the ability to easily record, retain and access any data about the people we see when we visit these places,” said Brown, a sixth-year M.D./Ph.D. student completing his dissertation in Translational Neuroscience before beginning his third year of medical school in July. “Currently, we often use paper forms that help us on the day of the clinic but, at the end of the day they get discarded because we often have no effective method to organize them. If we could do this electronically, organization would be massively simplified.”

 “The two things that our patient population really needs are preventative care and continuity between visits, both of which are pretty much nonexistent,” Draugelis said. “We see close to 1,000 patients in under a week. Often, the people on the medical team are working together for the first time, which can be a hurdle in itself. The EMR system needs to be as error free as possible to keep the clinic running smoothly.”

The initial software was designed by students in a Fall 2012 senior project and computer ethics course taught by WSU College of Engineering Associate Professor of Computer Science Andrian Marcus, Ph.D. Additional testing and debugging will continue each class semester to improve essential functionality.

“My goal is to expose students to an environment where they can learn by doing, rather than by listening,” Dr. Marcus said. “In addition to the learning outcomes, and equally important, I want the students to work on real projects that are useful to organizations and companies from the Detroit area and beyond. It is one way for us to give back to the community.”

Building the software was a challenge, and came with plenty of specs from the medical students who would use it. It had to be easy and fast to use. Only the bare essentials were needed: vitals; history of present illness; a brief medical, social and family history; and past and present medication. Everything needed to be on one easy-to-use screen with as few clicks as possible. The system also needed to fit into the chaotic flow of the transient medical clinics, where hundreds of patients line up, often early in the morning.

Brown and Draugelis initially sought donations for existing EMR software more than a year ago, but “quickly realized that this system didn't exist and needed to be built from the ground up,” Brown said.

For December’s pilot trip to Haiti, the computer science students who designed the software were available nearly 24/7 for virtual troubleshooting. They included WSU Computer Science senior Tom Hickman, the student team representative, who remotely signed in to make modifications on the fly.

"Our first impression of this project was very bittersweet,” Hickman said. “On the face of it, it appeared to be a set of very daunting requirements, but would give us the ability and experience of helping real people with the potential of saving lives. It seemed like a lot of pressure as well as being a great opportunity.”

The biggest challenge, he said, was deploying the software to computers with poor system configurations and old hardware. The new class goal is to restructure the system to a central database on a server, so all computers remain in sync from the creation of each patient record, update of patient information and update of user information, Hickman said.

“We were very impressed with the students' ability to take on a very difficult project with limited resources,” Brown said. “They were a force. Indeed, in the final week, the night before the medical students were to leave for Haiti, we discovered that only one of the eight (donated) computers was working. Several of the (computer) students worked very late into the night and got three more computers up and running just in time to make the flight.  The medical team left with four laptops running the software.”

Their hard work was appreciated, said Samantha Bruni, a second-year medical student and the Haiti trip’s lead organizer. “I think that having the ability to look back on the patient population that we saw and being able to evaluate the prescriptions that we filled is invaluable for WHSO. Bringing EMR on a trip is a huge step toward the future of WHSO providing more sustainable medical care,” Bruni said. “On future trips, the patients will receive better care, as we have records of their previous treatments and past medical history. Also, the EMR can be used for research purposes, as we have the ability to analyze our past care, which can enable us to provide better care on future trips.”

The system served its initial purpose: collecting basic medical data on patients in Haiti that can be later retrieved and utilized to improve continuity of care between the transient clinics, Brown said.

“I appreciate everyone who thought it was a cool idea and wanted to try it,” Brown said.

He hopes to secure new laptops, netbooks or tablets with longer-lasting batteries, a must because electrical outlets aren’t always available in the remote clinics. “Clearly, this costs money. We are looking into grants and searching for donors to help fund the purchase of the necessary hardware,” Brown said. “As long as it has a web browser, it will work.”

If interested in supporting the project, contact Brown at ecbrown@med.wayne.edu.
Class of 2015ís Buzz it for Boards charity event is April 19
In Headlines on April 10, 2013
In 2012, Lazaros Yiannos, Class of 2014, smiled for cameras as 18 months of hair growth was shaved off within minutes.

In 2012, Lazaros Yiannos, Class of 2014, smiled for cameras as 18 months of hair growth was shaved off within minutes.

The Wayne State University School of Medicine’s Class of 2015 has bravely embraced a hairy year-end tradition established four years ago by the Class of 2011.

Buzz it for Boards, set for 11 a.m. to 1 p.m. April 19 in the Scott Hall cafeteria alcove adjacent to room 1358, is an annual charity event organized by second-year medical students. The fifth annual fundraiser allows M2s to let loose, relieve some stress and either buzz, cut and donate, or dye their hair for a good cause before taking the United States Medical Licensing Examination Step I in June. Other class years, faculty and staff are invited to attend and participate as well. Haircutting and head shaving will be performed by professional hair stylists.

“I think we all look forward to the event because it is another way to give back to charity and the community. Sometimes we can get so caught up in studying, classes and exams that we may forget why we are actually doing all of this work. This event is a great reminder of why we are here,” said Matthew Falkiewicz, Class of 2015 Student Senate president. The second-year medical student will be buzzing his already short hair, he said.

“As physicians, we will be dedicating our lives to service and bettering our communities through health awareness and quality care. It is very important to get involved in the community, especially in cities like Detroit,” he added.

The 2013 Buzz it for Boards will benefit Alternatives for Girls, a Detroit-based nonprofit serving homeless and at-risk girls and young women since 1987. Services include shelter, street outreach, educational support, vocational guidance, mentoring, prevention efforts and counseling, all designed to empower young women to make positive choices. The charity was chosen by the Class of 2015, which wanted Buzz it for Boards’ donations to stay in Detroit. For more information, visit www.alternativesforgirls.org.

“We really liked their message of prevention, outreach and shelter for a specifically vulnerable population in Detroit,” Falkiewicz said. “They do a number of things for at-risk females in Detroit, including health awareness, shelter, increasing self-esteem, helping with school, safe rides to different areas and more. All of these can be life changing, and will allow these at-risk females to live healthier, safer and more productive lives.”

As a whole, Buzz it for Boards has raised more than $10,000 for charities since 2009, including $6,100 last year. Donations will be accepted at the event. To donate to the cause in advance, visit http://www.razoo.com/team/Wayne-State-Buzz-It-For-Boards-2013.

The USMLE is a comprehensive national medical exam that tests medical students on everything they’ve learned during years one and two of medical school. Students begin studying for it as early as the fall before, and ramp up studying after completing coursework in May. It’s one of three exams required to become a licensed practicing physician in the U.S. Students must pass it to move on to clinical years three and four of medical school.
Aesculapians invite volunteers to join them for Grand River Creative Corridor cleanup
In Headlines on April 9, 2013
The Wayne State University School of Medicine’s Aesculapians Honor Society will once again team with Motor City Blight Busters for another community cleanup in the Grand River Creative Corridor.

The Aesculapians invite fellow students to join them April 20 for a shift or the whole day.

The non-profit GRCC is an art corridor and neighborhood revitalization project concentrated on Grand River Avenue between Rosa Parks Boulevard and Warren Avenue in Detroit. It features more than 50 murals on 15 buildings, an outdoor art gallery at a bus stop and free-standing art installations. The GRCC project involves more than 45 volunteer artists from Michigan, Ohio, California, Germany, France and New Zealand, and is an ongoing effort to transform Detroit’s Grand River Avenue into a creative hub that will attract tourists, artists, small businesses, entrepreneurs and investors.

Volunteers are needed to help with trash pickup, clearing weeds from sidewalks, lot clearing, tree trimming, sweeping, grass cutting and painting. Work will be done in two shifts, the first from 9 a.m. to noon, and the second from 1 to 4 p.m. A lunch break will be held from noon to 1 p.m. Those interested in volunteering are welcome to come for the entire day or a single shift. Volunteers should bring any equipment they have to help with the cleanup, including work gloves and lawn equipment. Participants should wear closed-toe shoes.

Volunteers will meet at the 4731 Gallery, located at 4731 Grand River Ave.

To sign up for the event, visit https://docs.google.com/forms/d/1Ksw5Mjj7vg02FRPvLXjJzSBhOKZo2DIZU8ls_VMrFcI/viewform?pli=1.

For more information about the event, visit https://www.facebook.com/#!/events/139730502871644/.

The Aesculapians Honor Society is a School of Medicine student organization devoted to giving back to the City of Detroit through a variety of community programs and activities. Past work includes service projects and fundraising for The Do Foundation, The Greening of Detroit and Gleaners Community Food Bank.
Bio-IT World Conference features WSU School of Medicine, College of Engineering faculty
In Headlines on April 9, 2013
Leonard Lipovich, Ph.D.

Leonard Lipovich, Ph.D.

Xue-wen Chen, Ph.D.

Xue-wen Chen, Ph.D.

The Wayne State University School of Medicine’s Center for Molecular Medicine and Genetics and the WSU College of Engineering’s Department of Computer Science are participating in parallel tracks at the Cambridge Healthtech Institute’s Bio-IT World Conference and Expo 2013, going on today through Thursday at the World Trade Center in Boston.

School of Medicine Assistant Professor of Molecular Medicine and Genetics Leonard Lipovich, Ph.D., will present his lab’s work at this high-profile industry meeting, speaking as part of the conference’s Track Nine, Drug Discovery and Informatics. Xue-wen Chen, Ph.D., department chair and professor of Computer Science, will chair Track 11 of the conference, on Collaborations and Open Access Innovation, Data Sharing.

Dr. Lipovich will present “Beyond ENCODE: Placing Long Non-Coding RNA Genes into Regulatory Networks for Therapeutics” in a 25-minute invited talk Thursday.

In 2012, the ENCODE (Encyclopedia of DNA Elements) Consortium revealed an abundance of long non-coding RNA, or lncRNA, genes in the human genome. Dr. Lipovich, with members of his laboratory, analyzed the transcriptome of three human systems – two cancers (breast cancer and melanoma) and the in-vivo human epileptic brain – and validated lncRNA functions by reverse genetic tools. The results demonstrate that certain primate-specific lncRNAs, antisense to protein-coding genes, directly and specifically regulate those genes.

Dr. Lipovich will present these results and a computational model that places these non-conserved lncRNAs into therapeutically targetable disease networks.

“I am excited about this speaking engagement because Bio-IT World is a major industry forum focusing on the direct potential of bioinformatics and genomics research to impact clinical work and human health. I am delighted to introduce this audience to our computational and wet-lab studies of lncRNA in three diseases,” he said.

The industry event, in its 12th year, is a flagship annual conference organized by the Cambridge Healthtech Institute, a life science network for researchers and business experts from pharmaceutical, biotech and academic organizations.

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