Houston Medical Times by Rick Delarosa

A Special Recognition to National Nurses Week

HOUSTON

May Issue 2016

Inside This Issue

RESPIRATORY PROTECTION ESSENTIALS: Preparing health care employees for the next pandemic By Valerie N. Butera, J.D. Epstein Becker & Green, P.C.

Each Physician Generates an Average $1.56 Million a Year per Hospital See pg. 8

INDEX Healthy Heart................pg.4 Oncology Research......pg.6 The Framework..............pg.9 Age Well Live Well........pg.14

The Occupational Safety and Health Administration (“OSHA”) recognizes that the health care industry is among the most dangerous industries to work for in the United States. Health care employees are more likely to be exposed to various infectious respiratory illnesses spread through airborne and droplet routes, such as tuberculosis, influenza, and pandemics. Employees who work in or near areas where there are patients suspected of having a disease that can be spread by airborne transmission should be using proper respiratory

protection to minimize exposure of in health care facilities where airborne transmission of diseases is likely. The airborne diseases. findings of the study are alarming – In March 2016, the National evidence collected during the study Institute for Occupational Safety and indicated gaps in hospitals’ respiratory Health (“NIOSH”) published the protection policies and wide-spread results of a multi-year surveillance study failure by health care employees to use see RESPIRATORY PROTECTION page 20 examining the efficacy of respirator use

Advancing nursing education and practice in the U.S. and Peru Texas Woman’s University forms U.S. - Peruvian collaborations By Laura Byerley

Inflammation and Diet See pg . 16

nursing. Membrillo, now an operating room nurse at Clinica Santa Isabel Growing up in Lima, Peru, in Lima, Peru, hopes to improve the Nataly Membrillo saw the challenges outlook for Peruvian nurses. that her mother and aunt faced Through Texas Woman’s as nurse technicians — one-to-30 University’s Houston-based Center nurse-to-patient ratios, low salaries and for Global Nursing Scholarship, less respect than their U.S. counterparts. Membrillo and Tania Benavides, a Despite witnessing those difficulties, fifth-semester nursing student at Peru’s Nursing faculty and students from the Texas Membrillo says a love of service Nacional Pedro Ruiz Gallo University, Woman’s University Houston campus visited convinced her to pursue a career in had the opportunity to discuss Peru in 2015, where they participated in health forums, presented research and visited nursing Peruvian nursing education and schools and clinics as part the TWU Center for practice issues at the Texas Nursing Global Nursing Scholarship initiative with Peru. Students’ Association’s 68th annual Edwards says the Texas Nursing convention. The convention took place Students’ Association has begun earlier this year in Arlington. collecting textbooks to send to nursing At a breakout session facilitated schools in Peru, where textbooks are by Joan Edwards, Ph.D., director of often outdated. TWU’s Center for Global Nursing After this collaboration is Scholarship, they spoke about a future established, Edwards plans to initiate collaboration between the Peruvian further interaction with the Texas Nursing Students’ Association and the Nurses Association and Peruvian see Texas Woman’s University page 22 Texas Nursing Students’ Association.

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May 2016

Houston Medical Times

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PREPARING FOR DISASTER: A REALLIFE CATALYST FOR MASS CASUALTY PLANNING Future health care professionals gain valuable experience while dealing with a mock emergency

By Donna L. Oswald Texas A&M Health Science Center

Just one month after Hurricane Katrina devastated New Orleans in 2005, Hurricane Rita had Texas in its sights. As a result, more than 3 million Texas gulf-area residents were evacuated before the storm made landfall, making it the most extensive evacuation in the history of the United States. For six days in September 2005, the Large Animal Teaching Hospital on the Texas A&M University campus was transformed into one of the largest human hospitals in the state, housing more than 650 Houston and Galveston-area patients, their families and caregivers. Hundreds of faculty, staff, students and community members volunteered to assist in basic and medical care for these patients.

of patient care in altered environments.” Preparing for the worst Created by the Texas A&M College of Nursing, Disaster Day is a one day, student-led interprofessional event that brings together students from the Texas A&M Health Science Center Colleges of Nursing and Medicine, School of Public Health and the Irma Lerma Rangel College of Pharmacy, and hundreds of community volunteers. In the past, volunteers staged hurricane, chemical fire, explosion and wildfire scenarios with mass casualty simulations that bring interdisciplinary student teams together with community organizations to diagnose, treat and care for simulated patients (SPs). Now in it’s ninth year, this year’s “disaster” was a train derailment in downtown Bryan.

Health care professionals gain valuable experience while dealing with a mock emergency

Margaret Bosenbark was one of those volunteers. In Bosenbark’s second week of nursing school, one of the elderly patients got out of her cot, stood and then collapsed. She suffered a cardiac arrest. Margaret and a few of her classmates began cardiopulmonary respiration (CPR) as other volunteers searched for an automated external defibrillator (AED) and called for an ambulance. The patient was not responding to CPR, the AED could not be located and volunteers were unsure of where to instruct the ambulance medics to enter the building. “We were there to provide basic patient care. There were no procedures or plan on how to respond to medical emergencies within this setting,” said Bosenbark, who is now a clinical assistant professor and co-faculty advisor of the Texas A&M Health Science Center College of Nursing’s Disaster Day. “The ambulance arrived and transported the patient, but that experience started the conversation on how we can prepare to apply our knowledge to support all levels

All SPs receive training on how to convey information about the specific injuries and illnesses that they have been assigned, and makeup is applied to create mock injuries so the cases seem more realistic. Students learn about working together on an interdisciplinary team, how to prioritize cases and how to treat patients under less-than-ideal conditions. “Disaster Day gives students an opportunity to engage in large-scale scenarios where structure has been diminished and resources are scarce,” said Martin Mufich, clinical assistant professor at the Texas A&M College of Nursing and co-faculty advisor of Disaster Day. “It helps all participants, from students to health professionals to think about how we can improve patient outcomes, even when we and our systems are overwhelmed.” “The scenario, the individual simulated cases and the realism in how the injuries are mocked-up create a very real experience for students,” Bosenbark see PREPARING FOR DISASTER page 22

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Healthy Heart

FIVE F.A.S.T. THINGS YOU SHOULD KNOW ABOUT STROKE By Apiyo Obala Director of Communications, American Heart Association

For American Stroke Month this May, the American Stroke Association’s Together to End Stroke initiative, nationally sponsored by Medtronic, offers five things everyone should know to be a Stroke Hero and stop the nation’s No. 5 killer in its tracks. Stroke is largely preventable and treatable. The best way to beat a stroke is to never have one – about 80 percent of strokes are preventable. The second best way to beat a stroke is to identify one immediately when it occurs and call 911. 1. Anyone Can Have a Stroke (Even Superheroes)Some stroke patients don’t “look the part” and they may not have traditional stroke risk factors like high blood pressure. Stroke is more common in older people, but young adults, teens, children, babies and even the unborn can be victims.

May 2016

2. High Blood Pressure is Public Enemy # 1 for Stroke About 80 million Americans have high blood pressure, yet about half with the condition do not have it under control. Three out of four people who have a first stroke report blood pressure higher than 140/90 mm Hg, making blood pressure the most important controllable risk factor for stroke. Locally, the American Heart Association has a free blood pressure management program called Check. Change. Control. Visit www.heart360.org/houston to take control today! 3. Stroke Targets by Color While stroke is a leading cause of death for all Americans, African-Americans are at an increased risk. Blacks are twice as likely to have a stroke compared to whites, and are more likely to have a stroke at a younger age. 4. Stroke is Largely Treatable Clot-busting drugs and medical devices like stent retrievers have made stroke largely treatable, but most patients need to get to an appropriate hospital to be

evaluated and treated within 3 to 4.5 hours of the first symptom. With nearly 2 million brain cells dying every minute during a stroke, there’s no time to phone a friend, take a nap, or wait until Uber stops surging. Calling 911 is the best call for stroke. 5. Friends Usually Save Friends from Stroke You’ve heard the saying “Fast friends”. If you’re having a stroke, that’s exactly who you need nearby. Two out of three times, it’s a bystander making the decision to call 911 or seek treatment on behalf of someone suffering a stroke. To remember the most common stroke warning signs and what action to take, learn F.A.S.T. If you see F-Face drooping, A-Arm weakness or S-Speech difficulty, it’s T-Time to call 911. The American Stroke Association, a division of the American Heart Association, launched Together to End Stroke with inaugural sponsor Covidien, now Medtronic, in 2013 to elevate the message that stroke is largely preventable, treatable and beatable. “Like the American Heart Association and American Stroke Association, Medtronic is committed to improving the lives of stroke patients,” said Brett Wall, President, Brain Therapies, Medtronic. “Over the past three years, Together to End Stroke has helped boost stroke warning sign

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recognition, which leads to more people getting to treatment in time. We are happy to continue our support of this important initiative to raise awareness of stroke.” For more information about stroke and to learn how to be a Stroke Hero for American Stroke Month, visit www. StrokeAssociation.org. The American Heart Association has great resources available online that can provide more information on health and wellness, risk factors of heart disease, stroke, and managing your blood pressure. To sign please visit www.heart360.org. Find out more about stroke, risk factors and symptoms at www.strokeassociation. org. Be sure to join the conversation online on Instagram, Twitter, Instagram and Facebook at @ahahouston #strokehero #houstonheart.

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Oncology Research

Emerging strategies in the immunotherapy of Acute Lymphoblastic Leukemia (ALL) By Jorge Augusto Borin Scutti, PhD Houston Medical Times

Childhood acute lymphoblastic leukemia or also called ALL (Acute Lymphocytic Leukemia) is a fast-growing cancer in which bone marrow makes a plenty of immature lymphocyte cells (a type of white blood cells). In physiologic patterns normal lymphocytes helps your body to fight against infections by destroying infected cells or producing antibodies. In ALL context the lymphocytes don’t fight infections because they are so immature to realize their functions – they are cancerous cells (leukemic blasts). Thus these cells grow quickly and crowd out the bone marrow, preventing it from making the normal red blood cells, white blood cells, and platelets that your body needs. Each year, approximately

6,000 people in the United States are diagnosed with ALL and it is the most common type of leukemia in children under age 15. However, it can affect people of any age. The cause of ALL is unknown but the following factors may play a role in the development of ALL: genetic translocations (in which some genes on a chromosome may be shuffled or swapped between a pair of chromosomes). The most common genetic translocation in ALL is called Philadelphia (Ph) chromosome, where DNA is swapped between chromosomes 9 and 22. It occurs in about 20 - 30% of adults and 3 - 5% of children with ALL. Furthermore, another common translocation in ALL is 12;21, which is referred to as TEL-AML1 fusion occurring in about 20% of patients with ALL; past treatment with chemotherapy drugs, receiving a bone marrow transplant, exposure to radiation, including X-rays before birth, some viral infections

and toxins such benzene. The ALL diagnose is based on several test including: physical examination, blood tests (blood cell count), bone marrow biopsy, spinal tap, cytochemistry, flow cytometry, immunocytochemistry, and immunophenotyping tests are used to identify and classify specific types of leukemia and cytogenetics and fluorescent in situ hybridization (FISH) are used for genetic analysis (if bone marrow examination confirms ALL). The results of cytogenetic, flow cytometry, immunophenotyping tests can help providing information on types and subtypes of ALL cells. The particular subtype of cell can aid in determining prognosis and treatment. An older classification system called the French-American-British (FAB) classification grouped ALL into L1, L2, and L3 subtypes but today we have a newer classification system that classifies ALL B cells or T cells based on their stage of maturity. B cell ALL subtype classification: Early pre B, common ALL, Pre-B ALL and mature B-cell ALL (Burkitt leukemia) and T-cell ALL subtype classification: Pre-T ALL and mature T-cell ALL. ALL can also spread to the brain and

spinal cord. Classically, there are 3 strategy of treatments used for ALL: Chemotherapy, radiation and bone marrow transplant. Extensive progress has been made in the treatment of acute lymphoblastic leukemia, but recurrent disease remains a leading cause of death in children. Several clinical trials have been observed in small numbers of patients with ALL treated with immunotherapy using T cells genetically engineered to express chimeric antigen receptors (CARs) targeting CD19, CD22, JCAR015 and KTE-C19 — have demonstrated remarkable response rates in refractory ALL; monoclonal antibodies as Blinatumomab (Blincyto®) and tyrosine kinase inhibitor Ponatinib (Iclusig®). Blincyto is an example of immunotherapy see Oncology Research page 22 ©2014 Tiff’s Treats

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Each Physician Generates an Average $1.56 Million a Year per Hospital By Phil Miller Vice President Communications Merritt Hawkins

While physicians are the primary providers of medical care at The nation’s hospitals, a new survey suggests they also remain key drivers of hospital revenue. According to the survey, a single physician generates an average $1,560,688 a year in net Revenue on behalf of his or her affiliated hospital.

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Orthopedic surgeons topped the list of physicians examined in the survey. A full time orthopedic surgeon generates an average of $2,746,605 a year on behalf of unaffiliated Hospital, an invasive cardiologist $2,448,136, a neurosurgeon $2,445,810 and a general surgeon $2,169,693. It is not just surgical specialists who generate high dollar volumes for hospitals, the survey indicates. Family physicians generate an average of $1,493,518 in net revenue annually for their

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Conducted by Merritt Hawkins, a national physician search firm and anAMN Healthcare company, the survey asked hospital chief financial officers to quantify how much revenue physicians in 18 specialties generated for their hospitals in the previous 12 months. This included both net inpatient and outpatient revenue derived from patient referrals, tests, prescriptions, and procedures performed or ordered in the hospital.

Affiliated hospitals, while general internists generate $1,830,200. The average revenue for all medical specialties included in the survey ($1,560,688) is up from $1,448,458 in 2013, the last year Merritt Hawkins conducted

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the survey. Revenue generated by 11 of the 18 medical specialties increased compared to 2013. “The value of physician care is not only related to excellence in patient outcomes and patient experience,” said Merritt Hawkins President Mark Smith. “Physicians also drive the financial success of hospitals, even in a healthcare system that is evolving away from volume-based payments and toward value-based payments. “The survey also provides a cost/benefits analysis showing which physicians provide the best return on investment by comparing salaries in medical specialties to revenue generated on behalf of hospitals. Family physicians, for example, averaged a starting salary of $198,000 in 2015, while generating 7.5 times that much in hospital revenue. Orthopedic surgeons averaged $497,000 in salary while generating 5.5 times that much in hospital revenue. Primary care physicians such as family physicians and general internists represent an excellent return on investment, which is one reason they have been our number one and number two searches respectively for the last nine years” Smith said.

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The Framework

Memorial Hermann IRONMAN Sports Medicine Institute Opens Doors in Sugar Land The Sugar Land community now has access to a dynamic array of sports medicine experts and comprehensive testing and training for competitive and recreational athletes of all ages with the opening recently of the Memorial Hermann IRONMAN Sports Medicine Institute on the campus of Memorial Hermann Sugar Land Hospital. The opening marks the fourth Memorial Hermann IRONMAN Sports Medicine Institute – the leading authority in sports medicine in the greater Houston region. “Since 2007, Memorial Hermann IRONMAN Sports Medicine Institute has been treating athletes throughout the city, and bringing this comprehensive Institute to the Sugar Land area allows us to expand our reach into one of the fastest growing areas in Houston,” said Jim Brown, Senior Vice President and CEO, Memorial Hermann Ambulatory Services and Orthopedics. “With a

comprehensive orthopedic network that includes sister sites in the Texas Medical Center, Memorial City and The Woodlands and will offer physician services, physical therapy, human performance training and testing, and sports nutrition counseling. Consistent with the other Institutes in Houston, it will also be staffed by UT Physicians who are fellowship-trained orthopedic surgeons who serve on the faculty of UTHealth. “Patients can expect the highest quality service and treatment at the IRONMAN Sports Medicine Institute,” Carola Ross, Chief Sales Officer said. “This Institute is designed to serve all types of athletes, at all ages, with various levels of ability. We know that these athletes want to get back to doing what they love as soon as possible and with this new facility, we are able to help them do just that.” The facility in Sugar Land will also have a brand new state-of-the-art outdoor sports field which will allow

population that continues to grow, expansive public school districts as well as universities and the Sugar Land Skeeters baseball team, we hope to continue to be a valued partner and asset to the communities we serve.” The new 15,000 square-foot, cutting-edge facility, is located in Memorial Hermann Sugar Land’s new Medical Plaza 2 building at 17520 West Grand Parkway South, Suite 100. The building recently opened as part of a $93 million campus expansion. “What truly sets this facility apart in Sugar Land is the variety of services that are offered,” said Dr. Walt Lowe, Chairman of Orthopedic Surgery at The University of Texas Health Science Center at Houston (UTHealth) and Medical Director of the Memorial Hermann IRONMAN Sports Medicine Institute. “From treating sports-related injuries and concussions, to offering guidance on nutrition, our convenient and comprehensive sports medicine is unmatched in the area.” The Institute in Sugar Land will join Memorial Hermann’s

for the most efficient physical therapy, rehabilitation, return-to-play, and sports performance training and testing. As Sugar Land and the surrounding communities continue to grow we want to be growing right along with them to not just meet but exceed expectations to provide safe, high-quality, care through state-of-the-art facilities,” said Greg Haralson, Senior Vice President and CEO, Memorial Hermann Sugar Land Hospital. “Opening the Memorial Hermann IRONMAN Sports Medicine Institute in Sugar Land allows us to expand and continue diversifying our offerings to the community.” Memorial Hermann provides some of the areas most qualified and experienced staff which includes head team physicians for the Houston Rockets, Houston Texans, the University of Houston Cougars and many area public and private high schools. The Institute also provides a diverse selection of orthopedic services including: knee, hip and shoulder, foot and ankle, spine and back, elbow and hand and wrist care.

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In Honor of National Donate Life Month, Transplant Recipients at Memorial Hermann Heart & Vascular Institute Gather to Show Appreciation for their Organ Donors

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Scores of transplant patients recently gathered at Memorial Hermann-Texas Medical Center (TMC) to celebrate their health and thank the organ donors who made it possible for them to be there.

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In honor of National Donate Life Month, Memorial Hermann Heart & Vascular Institute-TMC (HVI) hosted its first ever “Celebrating the Gift” event for more than 140 heart transplant patients and their families in a show of appreciation for those who give the gift of life.

In Texas, there are 13,000 people awaiting organ transplants, according to LifeGift, and 819 lives were saved last year across the organization’s regions. “This is really about the donors. This is really about the people who through their love of mankind and their desire to help others, let their families know or let someone know that if they ever die an untimely death, they would want their spirit of selflessness to move on,” said Elizabeth Mosele, social work manager at HVI. In an emotional ceremony in the waiting room of the Center for Advanced Heart Failure at HVI, transplant recipients wiped tears from their face as they shared their deeply personal stories about long illnesses, organ failures and the gifts from strangers that gave them a fresh chance at life.

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James DeGarmo, who recently received a lung transplant as part of the Center for Advanced Heart Failure’s newly launched Lung Transplant Program, said he was beyond grateful for the new organ and that he feels an obligation to live his life to the fullest in honor of his donor. “It’s been my goal to give the donor’s family the best treatment of the gift they gave me,” he said. “I’m so grateful for

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James DeGarmo shares his experience of being a lung transplant recipient at Memorial Hermann Heart & Vascular Institute-Texas Medical Center.

them.” Not all transplant recipients get the opportunity to meet the relatives of their organ donors, but for those who are able to connect, the bonds they create are extremely special and can last a lifetime. Jimmie Brooks Bolton, 75, attended the ceremony with his donor’s mother, Karen Morales. The two first connected not long after Bolton received her son’s heart, and they have grown close since, meeting each other’s families and forging an instant kinship. “All I can say is thank you, thank you, thank you,” Bolton said at the ceremony. “It’s made my life possible. It’s made it possible for me to hold my grandchildren, hold my greatgrandchildren, and continue with my life. All I can say is thank you.” At the close of the ceremony, transplant recipients recited a pledge thanking organ donors and were given long-stemmed red roses to hand to their donor families or, if they hadn’t connected with their donor families, to another person for whom they were grateful. Morales walked away with a bouquet of flowers from recipients in the room expressing their appreciation for her son’s gift. “I’m just so thankful that I was able to fulfill my son’s wishes,” she said. Learn more information about Memorial Hermann’s transplant program, or register to become a donor through Donate Life Texas.

Houston Medical Times

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TIRR Memorial Hermann Adult Hotwheels Wheelchair Basketball Team Win National Championship The TIRR Memorial Hermann Adult Hotwheels basketball team is the National Champion of the National Wheelchair Basketball Association’s Division III. The adult Hotwheels defeated the Fort Lauderdale Sharks 60-33 Sunday to claim the title in Louisville, Ky.

year’s national championship game in the varsity division.

“Our junior Hotwheels played an incredible game and we’re so proud of each one of our players and the contributions they made throughout the season,” says Skrabanek. “It’s not easy to repeat as “This is a great win for our adult a national champion and we came Hotwheels and a real testimony to very, very close.” There were more accolades all the hard work they’ve put in this season after finishing sixth at for the junior Hotwheels as head last year’s national tournament,” coach Trice Ham was named the says Ava Skrabanek, coordinator, Coach of the Year by the National

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adaptive sports program, TIRR Wheelchair Basketball Association. TIRR Memorial Hermann Junior Memorial Hermann. Hotwheels senior Abraham The team arrived at the National Hausman-Weiss was selected as the Wheelchair Basketball Association’s tournament’s most valuable player. National Championship Hausman-Weiss will attend the Tournament as the number one University of Alabama in the fall seed in their division and defeated as a scholarship athlete with the teams from Tennessee, Indiana, school’s men’s wheelchair basketball North Carolina, and Florida to team. earn the title. This is the first The adult and junior Hotwheels national championship for the basketball teams are part of the TIRR Memorial Hermann Adult adaptive sports program at TIRR Hotwheels. Memorial Hermann. For more The TIRR Memorial Hermann information or to participate in any Junior Hotwheels fell just a few of the adaptive sports programs points short of defending their title. available through TIRR Memorial The Junior Hotwheels lost to the Hermann please email TIRRTR@ Minnesota Junior Timberwolves memorialhermann.org or call 53-50 in what was a rematch of last 713-797-5928.

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Age Well Live Well Eat Right, Exercise: Rx for All Ages By Jeff Carmack, Managing Editor, Texas Department of Aging and Disability

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30-year-old. “So the key here is matching caloric intake with caloric expenditure,” she said. Eating Habits and Nutrition

While part of our population suffers from obesity, Glenn said that seniors can face being undernourished We’ve all heard about eating wisely for a number of reasons. Eickhoff said and diet’s effect on health. We’re told that a declining sense of smell can affect to eat lots of fruits and vegetables, our sense of taste, which in turn can limit our consumption of fried foods, make food less appealing. Additionally, cut back on salt and sugar, and get a some medications can affect the way reasonable amount of exercise. food tastes. But does a one-size-fits-all approach When food isn’t appealing, seniors to nutrition work for seniors? Will a may suffer from poor nutrition. To diet that suits a 30-year-old work as well make food more appealing, Eickhoff for a person twice as old? said that seniors can boost the taste, Dr. Robin Eickhoff is a smell, sight and feel of foods by using board-certified family practitioner and herbs, spices and lemon juice—not WellMed Medical Director in San just salt or sugar—to make foods more Antonio. WellMed, a physician-led appealing. She also recommends foods company that provides healthcare to that look good and foods that have a

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people who are eligible for Medicare, partners with the Texas Department of Aging and Disability Services (DADS) to promote the DADS “Age Well, Live Well” program. Age Well, Live Well helps local communities prepare for the growing number of aging Baby Boomers to help them stay healthy and active longer. Eickhoff says that, for the general population, eating healthy and exercising is appropriate for all ages.

variety of textures and temperatures. However, she said that many older adults just aren’t hungry. Many factors—including digestive problems, certain medications, depression or loneliness—can influence appetite. “Seniors, especially those who are at risk of losing weight, should eat foods that they enjoy and there is no reason to eliminate anything from their diet unless there are specific health issues that prohibit it,” Glenn said. “Even the richest dessert can be had in small portions within the confines of a calorie guideline for those who do not need to gain weight. Eating represents hospitality, friendship, family and sustenance.”

“I wouldn’t recommend anything different for my healthy seniors versus my younger patients,” Eickhoff said. “For the general population it is all about eating healthy—fresh fruits and vegetables and lean protein, plus lots of whole grains. And, of course, I want Exercise and Seniors them to include regular exercise in their As we age, our metabolism daily routine.” inevitably slows down. Many older Dr. Lisa Glenn, a board-certified people are not as active as they once family medicine physician at DADS, were, and this means they need fewer said that caloric needs are based calories to provide the energy they need. more on activity levels than age, so an However, she said she recommends active 60-year-old might actually need that seniors stay active and exercise more calories than does a sedentary regularly. May 2016

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ANAHUAC Poncho Street | $2.1+mil 5/3.5+ - ±4,684 sf waterfront home with lighthouse on ±2 acres Marlene Jacobs | 713.321.8891

BELLAIRE Holt Street | $1.6+mil 5/5.5+ - ±5,511 sf gorgeous new construction | convenient location Hedley Karpas | 713.444.5721

CHAMPIONS Lapeer Court | $940s 6-7/6.5+ - ±6,353 sf custom home in Champion Woods Estates | 2 masters Debbie Callan | 713.558.2270

BAYOU BEND TOWERS Westcott Street | $790s 3/3.5 - ±2,867 sf spacious apartment | prestigious building in Rice Military Pene Moore | 713.558.3221

ARTESIAN LAKES Robin Hood | $760s 4/3.5 - ±2,480 sf gated community | lakefront log home | fishing pier Joann Lammons | 713.824.4185

MAGNOLIA Edgewater Drive | $690s 5/4.5 - ±4,318 sf waterfront property in gated community | fine finishes Kecia Haseman | 713.515.4948

LAKE CONROE Lake View Drive | $480s 3/2.5 - ±2,269 sf waterfront townhome with extra lot | open plan | pool/spa Kecia Haseman | 713.515.4948

ARTESIAN LAKES Robin Hood | $170s ±1.02 acres secluded property on Oak Lake | cul-de-sac lot | must see Manley Nolen | 832.493.0300

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Page 16

Nutrition Corner A NEW LOOK. A NEW EXPERIENCE.

Inflammation and Diet

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Inflammation is a natural and essential response to injury, irritation, and infection. When the inflammatory response does not shut off over time, the condition is considered chronic and can impose harmful degenerative effects on the body. These effects can result in diseases such as atherosclerosis, diabetes, arthritis, and dementia to name a few. Commitment to an anti-inflammatory lifestyle is the first line of defense in fighting off inflammation.

and DHA have an overall effect of dilating blood vessels, minimizing blood clotting, and reducing inflammation. Good sources of DHA and EPA include cold-water fish, such as albacore tuna, stripped sea bass, and wild salmon. To benefit from the positive effects of these fats, one needs to consume one gram of both DHA and EPA per day or 8 to 10 ounces of fish per week. Another type of omega 3 is the plant-based source ALA. When consumed, ALA is converted to EPA and DHA. The only drawback is that the body is not effective at converting all of the ALA to DHA or EPA. Because of this, you must consume 3 to 4 times as much ALA to equal

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An anti-inflammatory lifestyle the amount found in a 3-ounce involves the following: serving of fish. The amount you need is 1.1 grams per day, which Healthy fats comes out to about ½ tablespoon Fruits and vegetables of chia seeds. Lean proteins Focusing on getting adequate Whole grains amounts of these beneficial omega Probiotics 3 fatty acids is a great start to achieving an anti-inflammatory Adequate sleep & fluids lifestyle. Stay tuned for more Weight Management recommendations toward this Exercise dietary approach. Stress Reduction Healthy fats, specifically, the omega 3 fatty acids EPA May 2016

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that offers culinary cuisine, enriching programs, luxurious apartment homes, individualized services and signature amenities. The Village distinctive lifestyle is centered around you and the life you deserve.

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May 2016

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Page 18

Ibn Sina Foundation’s Mission of Serving Those in Need The Ibn Sina Foundation, a non-profit organization that operates six clinics throughout Houston and Port Arthur, Texas, is taking the lead in providing Medical and Dental services for those in need as the cornerstone of the Foundation’s mission.

Dear Doctors and Staff, Let us take the guesswork out of fracture referrals. No more waiting for appointments!

With clinics located at 11226 South Wilcrest Drive, 5012 North Shepherd Drive, 16345 South Post Oak Road, and a new Children's Clinic opening April 28 at 11220 South Wilcrest Drive, all in Houston, as well as clinics at 15132 Old

We at the Orthopedic Care Center wish to offer your patients and staff easy scheduling of patients. Our office has extended office hours on Fridays to accommodate patients with fractures. On behalf of the Orthopedic Care Center

Health Care Program and the Expanded Primary Health Care Program, with funds from the State of Texas. Among the services that are being provided are well child exams, sick visits, school physicals, sports physical, immunizations, family planning services, gynecology visits, EKG tests, Well Woman exams, Well Man exams, medical consultations, prescriptions, x-rays, and laboratory tests, as well as dental checkups, dental cleanings, dental fillings, extractions, and root canals.

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ORTHOPEDIC CARE CENTER 2121 OAKDALE HOUSTON, TX 77004

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Galveston Road in Clear Lake and 8599 9th Avenue in Port Arthur, Texas, the Foundation has several programs that serve children up to age 21 as well as adults. While providing services for more than a decade, Ibn Sina Foundation has served more than 25,000 children with primary care issues. The Foundation’s Healthy Kids Program that is currently in operation provides free access to health care services for those who have no other avenue to obtain quality care. This mission is being expanded with the opening of the new Children’s Clinic adjacent to the Ibn Sina Foundation Medical Clinic at 11226 South Wilcrest, Houston. FINALLY A WEBSITE DESIGNED SPECIFICALLY FOR MEDICAL PROFESSIONALS BY MEDICAL PROFESSIONALS SEEKING TO CONNECT, NETWORK, AND SOCIALIZE PARTICIPATE IN A MEDICAL FORUM AND GAIN INSIGHT FROM MEDICAL BLOG

The current clinics provide many free and low-cost services to the communities which Ibn Sina Foundation serves. Free and low-cost medical care is provided to children up to age 21 who are uninsured or are members of low-income working families in the area. The clinics provide service to those with no insurance, CHIP, Medicare, Medicaid and major insurance PPOs. Ibn Sina Foundation also helps non-citizens as well as U.S. citizens. These services are provided through the Healthy Kids Program, the Primary

May 2016

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Our mission of serving those in need includes the tireless efforts of many highly qualified doctors, nurses, medical assistants, dentists and dental assistants, some of whom generously donate their time to the Ibn Sina Foundation’s work. The goal of the Ibn Sina Foundation is to help eliminate or significantly reduce health issues in the local communities of its area of service. Among the health issues are cardiovascular disease, diabetes, obesity, and others. For example, Ibn Sina Foundation’s diabetes prevention and control program’s goals are: increasing early identification of those at high risk of developing diabetes, providing education, promoting behavioral changes that prevent complications, increasing early diagnosis and helping patients manage the disease. If patients are unable to pay the very low minimal fee for medical services, special arrangements and exceptions can be made to serve them. By building valued customer relations, Ibn Sina Foundation works diligently to educate its patients about the importance of Medical and Dental care. The non-profit organization provides educational sessions on topics ranging from respiratory diseases to proper diet and nutrition.

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Page 19

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RESPIRATORY PROTECTION Continued from page 1

respirators correctly, even in hospitals with satisfactory respiratory protection policies. More specifically, the NIOSH study revealed that many employees were confused about when to use a respirator and how to properly use one and opted to simply use a surgical mask for protection instead. But respirators and surgical masks are designed to protect against very different hazards. Whereas a surgical mask protects patients from an employee’s respiratory secretions and protects employees against large-droplet splashes or spray of bodily fluids from patients, a respirator is designed to protect employees by providing a tight seal against the skin and filtering out a wide size range of airborne particles. The study also found that a number of employees wore ill-fitting respirators. To be effective, the wearer of a respirator must wear one that minimizes air leakage into the facepiece. OSHA regulations require respirator fit testing before an employee is permitted to wear a respirator. Because the fit of a respirator depends on a number of different factors, such as face shape, employers should provide a variety of models and sizes to try during the fit testing process. Fit testing must

be repeated annually, when a different respirator must be used, and where there has been a change in the employee’s facial structure such as extreme weight loss or dental work.

∙

training on respirator use, fit, and how to properly don and doff the respirator has been provided and periodic refresher training scheduled;

Finally, about 50% of the hospitals studied were deemed to have ineffective respiratory protection programs. But even where good programs were in place, many employees used improper practices, including improper strap placement, failing to perform a user seal check, and improper donning and doffing of the respirator.

∙

employees check their respirators regularly and know to immediately report to management should the respirator begin to deteriorate, fail to function properly, or no longer fit well; and

∙

employees receive new fit tests and respirators as needed.

So how can health care employers correct this issue before tuberculosis or the next pandemic hits? Employers should ensure that: ∙

∙

they have a complete understanding of OSHA’s respiratory protection standard and are in compliance with its requirements; all employees working in areas where they may exposed to airborne illnesses have been timely fit-tested for a respirator and understand how and when to use it;

Importantly, health care employers need to know that they must do more than merely comply with OSHA’s respiratory protection standard to ensure that they are offering sufficient respiratory protection to protect their employees, reduce the risk of spreading infectious diseases in health care settings, and avoid receiving an OSHA citation for failing to provide sufficient respiratory protection. In May 2015, OSHA and NIOSH published a joint guidance document called the Hospital Respiratory Protection Program Toolkit (the “Toolkit”). The Toolkit provides a useful

guide for hospitals working to come into compliance with OSHA’s standards, and is available on OSHA’s website. But the Toolkit clearly states that should OSHA come to a health care facility to conduct a respiratory protection inspection and find that the workplace is not following all guidance published by the Centers for Disease Control and Prevention, and any state or local public health requirements for respiratory protection, health care employers should expect to receive a General Duty Clause citation (OSHA’s catch all provision which imposes a general duty on all employers to provide safe work and a safe workplace to all employees) for failing to maintain a satisfactory respiratory protection program sufficient to protect employees regardless whether the workplace is in compliance with OSHA’s respiratory protection standard. Employers in health care face a heightened standard when it comes to protecting employees with proper respiratory protection. It behooves health care employers to stay up to date with all applicable guidance in this area to ensure employees are safe and to reduce the possibility of receiving an OSHA citation.

D I S T R I C T

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May 2016

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Page 21

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Page 22

Texas Woman’s University Continued from page 1

pediatrics.

Nurses Association.

“The undergraduate classes at TWU were amazing, because that level of learning is only seen at the master or doctoral level in Peru,” Membrillo said. “The conference also was amazing and full of new things for me. The Texas In addition to speaking about Nursing Students’ Association is a well international collaborations, organized and a serious association Membrillo gave a keynote presentation that has faculty support. And I’m on the history of nursing education in pointing this out because the Peruvian Peru, which opened its first nursing Nursing Students’ Association doesn’t school in 1907. Today, Peruvian receive the same support." Benavides said she was impressed nursing students study five years and then defend a thesis to obtain a by TWU’s Institute of Health Sciences-Houston Center, located in bachelor of nursing degree. Benavides’ presentation provided the world-renowned Texas Medical an overview of the Peruvian Nursing Center.

Published by Texas Healthcare Media Group Inc.

“The goal is to set up mutually beneficial collaborative relationships with colleagues in Peru and be able to learn from each other and advance the profession of nursing in both our countries,” Edwards said.

Students’ Association, which was founded in 1997. Its mission is to provide tools for the empowerment and leadership of future nursing professionals. Membrillo and Benavides also toured TWU’s Houston campus and attended undergraduate classes in psychiatry, women’s health and

Editor Sharon Pennington Director of Media Sales Richard W DeLaRosa Texas Woman’s University Houston nursing faculty and students visited a community health clinic in Peru to gain an understanding of the delivery of primary care to vulnerable populations in the country.

Peru in May of 2015. They attended a Peruvian Ministry of Health forum that celebrated the International Day of Nursing, met nurses and nursing students, presented research and “In my opinion, the TWU volunteered at hospitals and high Houston campus is very beautiful and sophisticated with all the technology,” schools. Benavides said. “It is unmatched by The Center for Global Nursing the Peruvian education.” Scholarship is preparing to host In addition to hosting Peruvian another Peru trip in May of 2016 students on campus, TWU’s Center for Global Nursing Scholarship took with a total of 32 nursing student and a group of TWU nursing students to faculty participants.

PREPARING FOR DISASTER Continued from page 3

said. “After an exhausting, emotional time participating and observing throughout the day, we debrief with students so they can reflect on how they and their classmates responded. It is rewarding to hear how the exercise made them think differently about their roles, how to work with others and how to prioritize what is truly important when there is overwhelming need.” From simulation to application From the vantage point of a registered nurse working on the orthopedics

floor at Memorial Hermann Memorial City Medical Center in Houston, Alexis Cooper ’15, the 2015 Disaster Day incident commander, credits her participation in the simulation for developing skills that are useful in her everyday nursing practice. “It certainly helped me to develop better communication skills, the ability to work interprofessionally with various team members and personalities and to understand the importance of delegating,” Cooper said. “It also allowed me to develop the courage to speak up,

as a patient advocate, when something important is being overlooked or if there are perspectives that are not in the patient’s best interest.” “Having a wide range of community members participate also provided them with an opportunity to think about their individual roles in responding to emergencies,” Cooper said. “When dealing with a large-scale disaster, it is important for all of us to think about self-sufficiency and helping our neighbors until help and resources become available.”

Oncology Research Continued from page 6

and it is the first approved drug that engages the body’s T-cells to destroy leukemia cells. The drug acts as a connector between a protein called CD19, which is found on the surface of most B-cell lymphoblasts, and CD3, a protein on T-cell lymphocytes. It is intended for patients whose cancer returned after treatment (relapsed) or did not respond to previous treatment (refractory). According Dr. Richard May 2016

Pazdur director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research “Immunotherapies, especially Blincyto with its unique mechanism of action, are particularly promising for patients with leukemia and recognizing the potential of this novel therapy, the FDA worked proactively with the sponsor under our breakthrough therapy designation

HOUSTON

program to facilitate the approval of this novel agent.” Immunotherapy represents a novel and promising approach for targeted therapy of cancer patients and clinical trials have already shown clinically significant antitumor activity in neuroblastoma, melanoma, pancreatic tumors, chronic lymphocytic leukemia, acute lymphoblastic leukemia and B cell lymphoma. Are we closer to a cancer cure?

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Creative Director Lorenzo Morales Distribution Vincent DeLaRosa Accounting Liz Thachar Writers Jorge Augusto Borin Scutti, PhD Denise Hernandez MS,RD,LD Office: 713-885-3808 Fax: 281-316-9403 For Advertising advertising@medicaltimesnews. com Editor editor@medicaltimesnews.com

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