Pulse Magazine Fall 2016 by Rutgers New Jersey Medical School

pulse Volume 14 Number 2

Meet Testable Study App Created by Student Entrepreneurs

PLUS: HEAD AND NECK SURGERY ‘DREAM TEAM’ NEW WORLD OF HIV PREVENTION • TOUGH CHOICE: OLYMPICS VS. ORIENTATION

Fall 2016

message from the dean

pulse VOLUME 14 NUMBER 2 FALL 2016 RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY Dean

Robert L. Johnson, MD, FAAP’72 The Sharon and Joseph L. Muscarelle Endowed Dean Chief Operating Officer

Walter L. Douglas, Jr. Business and Circulation Manager

Iveth P. Mosquera Photo Editor

LaCarla Donaldson Senior Editor, Pulse

Mary Ann Littell Contributing Writers

Maryann Brinley Ty Baldwin Genene W. Morris Design

Sherer Graphic Design Principal Photographer

Keith B. Bratcher, Jr. President NJMS Alumni Association

Paul J.P. Bolanowski, MD ’65 ALUMNI FOCUS

Director

Dianne Mink Assistant Director

Emily Birkitt KEEP IN TOUCH

Pulse is published twice a year by Rutgers New Jersey Medical School. We welcome letters to the editor and suggestions for future articles. Send all correspondence to: LaCarla Donaldson Marketing and Communications Rutgers New Jersey Medical School Medical Science Building, Room C -595 185 South Orange Avenue Newark, NJ 07103

The Gold Standard for Medical Education F

or two intense weeks in August, thousands of Olympians from around the globe (including first-year Rutgers New Jersey Medical School student Anastasia Bogdanovski) converged on Rio de Janeiro with lofty goals of besting their personal times, breaking world records and, perhaps along the way, scoring coveted medals for themselves and bragging rights for their respective nations. As these elite athletes swam, ran, jumped, leapt, and fought their way to glory, they exhibited monumental passion, discipline, focus and courage. These traits are very familiar to us at New Jersey Medical School, for they are the bedrock upon which our success as an institution is built. These qualities are found in our physicians who provide expert care to their patients. They are seen in our scientists who puzzle over experiments designed to unlock mysteries that could lead to life-saving treatments, medications and even cures. And they are present in our students whose years of hard work and dedication have led them to our school’s doorsteps in the hope of realizing long-held dreams of becoming physicians and scientists themselves. In this issue of Pulse magazine, you can read about our faculty, students and alumni whose efforts have helped to make our school a world-class institution. As riveting as the Olympic Games were, they were not the only major event that caught our attention at New Jersey Medical School. This year we joined Rutgers, The State University of New Jersey, in commemorating the school’s 250th anniversary. We also shared in the city of Newark’s exuberance as it celebrated its 350 years of existence. We salute these pioneering entities on their historic milestones. Just as importantly, in a time when our nation is grappling with matters that promote divisiveness and discord, it is refreshing to be able to celebrate the things that bring us together. It is in this spirit that we also salute our faculty and students who serve as the Michael Phelpses, Simone Bileses, Usain Bolts, and Katie Ledeckies of our medical school. While they might not earn Olympic gold medals, their passion, discipline, focus and courage help to make our institution the gold standard for medical education, patient care and research.

or via email to njmsmarketing@njms.rutgers.edu

In health, ON THE COVER Dan Nguyen and Gerard D’Onofrio, MD/MBA candidates, 2018, put their heads together to develop Testable, an app for group study that also promotes learning. P H O T O B Y K E I T H B . B R AT C H E R , J R .

Robert L. Johnson, MD, FAAP’72 The Sharon and Joseph L. Muscarelle Endowed Dean Rutgers New Jersey Medical School

pulse FA L L 2 0 1 6

FE ATURES

Head and Neck Surgery and Technology: Perfect Together

The NJMS team performs complex procedures, including microvascular reconstruction, using next-generation surgical tools and 3D modeling.

Be a Sport

This orthopedic surgeon, a former college tennis champ, excels both on the court and in the operating room.

Going the Extra Mile for Her Students

A new T32 training grant will support something near and dear to this NJMS TB researcher: her students.

Easing Agonizing Facial Nerve Pain

Minimally invasive endoscopic surgery and a tiny Teflon implant provide relief for trigeminal neuralgia.

DEPART M E N T S

FYI

A CLOSER LOOK

12 NJMS/GSBSâ&#x20AC;&#x2030;PEOPLE 29

ALUMNI FOCUS

ENDPAGE

Notable

FYI HITTING THE ROAD TO TEST FOR HIV AND STIs This summer the Division of Adolescent and

For the first time in more than 10 years, DAYAM is providing HIV and STI testing in a

Young Adult Medicine’s (DAYAM) Spend Time on

brand-new mobile van for residents of Newark and surrounding communities. Above, DAYAM staff

Prevention (STOP) program launched its brandnew, state-of-the-art mobile testing unit. The van provides testing for HIV and other sexually

members at the ribbon cutting with DAYAM medical director Dominga Padilla, MD (second from left), and NJMS Dean Robert Johnson, MD (third from left).

transmitted infections (STI) throughout the Essex County area. Certified HIV counselors, a nurse practitioner and case managers are on board to

This year marks the 40th Anniversary of DAYAM,

est include pain management and safe medica-

provide services five days a week. Anyone who is

a division of the NJMS Department of Pediatrics.

tion use, particularly opioids. At NYU, he chaired

interested can be tested.

DAYAM provides culturally competent, compre-

the Pharmacy and Therapeutics and Medication

hensive medical and psychosocial services to

Safety committees and taught several sessions

youths in specialized programs, ambulatory clin-

of undergraduate pharmacology. At Bellevue, he

ics, and inpatient services at University Hospital

collaboratively developed a consultation program

The mobile testing unit, funded by the New Jersey Department of Health, made its debut at a ribbon-cutting ceremony in August. The event featured an appearance by a Hot 97 DJ. That afternoon 19 individuals were tested. One person tested positive for HIV and was linked to medical care. Additionally, several attendees

and NJMS. For more information call DAYAM

on the management of

medical director Dominga Padilla, MD, at 973-

difficult cases of alcohol

972-3921. For a schedule of the mobile unit’s

withdrawal and saw the

stops, call 973-972-8216 or 800-249-7750.

ICU admission rate cut by more than half.

learned about PrEP (Pre-exposure Prophylaxis), a prevention program for those at high risk who test negative for HIV (see page 9).

Nelson speaks and

NEW CHAIR OF EMERGENCY MEDICINE AT NJMS

writes extensively about opioid abuse overdose, emerging drugs of

Lewis Nelson, MD, is the inaugural chair of emergency medicine at NJMS, taking the helm from a series of dedicated interim chairs.

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abuse, and medication safety. He is an editor of the textbook Goldfrank’s Toxicologic Emergencies and author of more than

Before coming to NJMS he was professor and

200 peer-reviewed papers and 30 book chapters.

vice chair of emergency medicine at New York

He’s also the lead author of a book on poisonous

University School of Medicine and attending

and injurious plants, an interest which comes

physician at both NYU Langone Medical Center

from, in his own words, “a quirky passion for

and Bellevue Hospital Center. His areas of inter-

gardening.”

T O P A N D L E F T: K E I T H B . B R AT C H E R , J R .

A NOTABLE HONOR J.P. Sánchez, MD, MPH, associate professor of emergency medicine and assistant dean for diversity and inclusion at NJMS, has been invited to serve on the National Institutes of Health’s (NIH) Sexual and Gender Minority Research Working Group. This group provides advice to the NIH director on opportunities for sexual and gender minority (SGM)-related research. “I’m truly honored to be working with the NIH on these initiatives,” says Sánchez.

STUDENTS GAIN LAB EXPERIENCE IN SUMMER RESEARCH PROGRAM What better way to get a taste for research than

of an academic career in medicine, and gain an

by spending quality time in a lab with an out-

appreciation of the value of biomedical research

standing mentor? Each year the NJMS Summer

to tomorrow’s physicians.

Student Research Program partners with the school’s basic and clinical health scientists to give first- and second-year medical students the opportunity to do just that.

Throughout his career Sánchez has worked to promote diversity and inclusion in medicine. He

This year’s program included seminars held by NJMS faculty members. At the program’s conclusion, students displayed their research projects at a poster symposium and prizes were awarded

Throughout the eight-week program, the stu-

to students Marielle Torres and Nishant Vatsa.

dents conduct independent research under the

The summer research program was supported

direction of established scientists. Participants

by the New Jersey Health Foundation, NJMS

have the opportunity to evaluate the possibility

alumni, and the NJMS Faculty Organization.

Department of Family Medicine Celebrates Two Anniversaries

serves as president of Building the Next Genera-

It’s an exciting time for the Department of Family Medicine. This year the department celebrates

tion of Academic Physicians, Inc., (BNGAP),

its 25th anniversary of providing top-quality care for underserved residents of the Newark

an organization to prepare medical students

community. Under the leadership of its interim chair, Chantal Brazeau, MD, the department is

and residents for academic medicine careers.

dedicated to excellence in education, research and advocacy for the greater Newark community,

BNGAP will host its 5th National LGBT (Les-

and strives to continually expand the quality of primary care through education and collaboration

bian, Gay, Bisexual, and Transgender) Health

with students, patients, and colleagues. Watch for more news about the Department of Family

Workforce Conference in April 2017. At NJMS he

Medicine in the next issue of Pulse.

led integration of LGBT content into the medical

Next year, the department’s Student Family Health Care Center (SFHCC) will also celebrate an

curriculum. In 2015 the National Latino Medical Student Association created the J.P. Sánchez Scholarship on LGBTQ Research in recognition of his research.

L E F T: L A C A R L A D O N A L D S O N

anniversary: its 50th. This student-run clinic, formed by students after the 1967 Newark riots, provides free medical care to the Newark community. SFHCC is planning special events and will celebrate the anniversary at the annual faculty appreciation dinner. For more information, contact familymed_NJMS@njms.rutgers.edu or kinalshah1@gmail.com.

RUTGERS NEW JERSEY MEDICAL SCHOOL

Notable

FYI

NJMS ALUM NAMED FAMILY PHYSICIAN OF THE YEAR One of NJMS’s own, Maria Ciminelli, MD’96, received the New Jersey Family Physician of the Year award from the New Jersey Academy of Family Physicians at a NJAFP’s Scientific Assembly held in June. This award is presented each year to a physician who demonstrates compassionate, comprehensive care. Ciminelli is an assistant professor of family medicine at Rutgers Robert Wood Johnson Medical School (RWJMS) and program director of the RWJMS family medicine residency program at CentraState Medical Center, an acute care hospital in Freehold, NJ. She completed her family medicine residency at RWJMS. Her spe-

BIOENGINEERED VESSEL EVALUATED IN RESEARCH STUDY Vascular surgeon Michael Curi, MD, MPA, suc-

can damage a patient’s blood vessels, so synthet-

cessfully implanted a bioengineered blood vessel

ic grafts are often necessary. “Synthetic grafts

in a 40-year-old male patient with kidney failure

are commonly used and can cause patients great

as part of a Phase III clinical research study. The

difficulty because they frequently become in-

surgery was performed at Newark’s University

fected and are prone to clotting,” says Curi, who

Hospital (UH) in August 2016.

is an associate professor of surgery at NJMS and

This implant, called a human acellular vessel

chief of UH’S Division of Vascular Surgery.

(HAV), is generated from human tissue. To make

Curi says the bioengineered vessel offers several

the implant or vessel, vascular cells from human

advantages over the synthetic one. “Over time

donors are grown in tissue culture

the patient’s own cells will grow into

and then placed on a degrad-

the bioengineered vessel,” he ex-

able frame or scaffold. As the

plains. “We think this HAV will

tissue grows, the scaffold

last longer, cause fewer com-

cial interests include curriculum development, evidence-based medicine, adolescent medicine, pediatrics, chronic disease management and practice management.

Rutgers Cancer Institute of New Jersey Expands Reach to Newark A new partnership between Rutgers Cancer Institute of New Jersey and University Hospital (UH) will result in the expansion of National Cancer Institute (NCI)-designated Comprehensive Cancer Center services to Newark. This new entity, called Rutgers Cancer Institute of New Jersey at University Hospital, held its official launch on

degrades. This tissue is

plications, and significantly

then cleansed so that it

improve the quality of life

contains no human cells.

for dialysis patients.” The

The multidisciplinary service line at the UH

The end product is a

UH patient came through

cancer center includes care provided by Rutgers

bioengineered acellular

the procedure well. He’ll

Cancer Institute oncologists, which augments

blood vessel that can be

continue to have hemodi-

radiation oncology services that have been

alysis and will be monitored

provided by the Institute for the past seven

implanted in patients. Patients with kidney failure require dialysis several times a week to filter waste, salt, and extra fluids from

closely by physicians. This multicenter study is anticipated to be the largest of any bioengineered vascu-

the blood to maintain a healthy balance. Ongoing

lar tissue to date. Biotech company Humacyte,

dialysis involves frequent needle sticks which

Inc. manufactures the HAV.

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September 20.

years, and surgical oncology services provided by NJMS faculty members. Among the new care options are additional clinical trials and increased screening, treatment and education, with a special focus on underserved populations.

B O T T O M L E F T: L A C A R L A D O N A L D S O N

NJMS NEWS BY THE NUMBERS It’s been a banner year for research at NJMS. Here is a look at total research funding, as well as a few individual grants of note.

$2.2 million Walter Zahorodny, PhD, assistant professor of pediatrics, received a four-year grant from the Centers for Disease Control and Prevention for “Enhancing public health surveillance of autism spectrum disorder and other developmental disabilities through the autism and developmental disabilities monitoring (ADDM) network.”

$3.5 million David Alland, MD, MSc, DTM&H, professor of medicine and associate dean of clinical research, and co-investigators at Johns Hopkins and the University of San Francisco, were awarded a fiveyear grant from the National Institutes of Health for “Novel biomarkers to shorten TB treatment.”

$2,270,000 $4 million Pranela Rameshwar, PhD, professor of medicine, received funds through a research agreement with Advanced ReGen Medical Technologies, LLC, for “Reprogramming aging stem cells.”

Mark Siracusa, PhD, a Chancellor Scholar and assistant professor, Center for Immunity & Inflammation, received two grants from the National Institutes of Health: a five-year award of $2 million for “Innate immune regulation of helminth-induced inflammation” and an additional $270,000 for “Interrogating innate immunity to helminth parasites.”

$2.2 million Debukumar Pain, PhD, professor of pharmacology and physiology and neuroscience, along with co-investigators at the University of Pennsylvania and Wayne State University, received a four-year National Institutes of Health grant for a study titled “Mitochondria-cytoplasm interactions for cytosolic Fe-S cluster assembly.”

$85,600,458 Total research funding for NJMS in FY 2015

C E N T E R L E F T: N AT I O N A L I N S T I T U T E O F A L L E R G Y A N D I N F E C T I O U S D I S E A S E S , N AT I O N A L I N S T I T U T E S O F H E A LT H

RUTGERS NEW JERSEY MEDICAL SCHOOL

a closer look at three rising research stars

Investing in Innovative Science KAREN EDELBLUM

Looking Inside The Gut

Amariliz Rivera, PhD, Mona Batish, PhD, and Karen Edelblum, PhD, are all young researchers on the rise.

Private foundation funding keeps the research dreams of young investigators moving forward. Just ask three Rutgers New Jersey Medical School winners of Feldstein Medical Foundation (FMF) grants how important these gifts can be. Karen Edelblum, PhD, Amariliz Rivera, PhD, and Mona Batish, PhD, were each awarded between $60,000 and $75,000 by FMF, a private foundation created to promote and advance neglected areas of medical research. With a particular focus on promising junior investigators who are taking innovative routes in areas with maximum beneficial health impact or significant advancement of scientific knowledge, FMF couldn’t have found better investments than these three remarkable young women.

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BY MARYANN BRINLEY

iagnosed with Crohn’s disease, an inflammatory bowel disease (IBD) at age 13, Karen Edelblum has made her search for a cause and a cure a personal mission. More than 1.6 million Americans battle this gastrointestinal nightmare. “All of my career decisions were put into motion by my diagnosis and my involvement in the IBD community,” she says. Since last year when she arrived in Newark as a Rutgers Biomedical and Health Sciences Chancellor Scholar at the Center for Immunity and Inflammation (CII), this assistant professor of pathology and laboratory medicine has been looking at the synergy between immunological, epithelial and microbial factors in the gut. She focuses on gamma delta intraepithelial lymphocytes (IELs), “a poorly understood set of T cells,” she explains. “These cells work like surveillance, effectively patrolling for pathogens. When they find something, like Salmonella, they hone in on the area near the bacteria, acting like bloodhounds and migrating toward the epithelial cells where the pathogen is attached. We have made progress in the last year discovering what signals are involved in this process. There are particular ones that are downstream of the bacterial response and now we are starting to see the different mechanisms.” Keep in mind that in someone with IBD, the gut is responding to trillions of different bacteria. Understanding how and why the protective gamma delta T cells work is a critical first step in the potential development of therapeutics to prevent gutassociated inflammatory responses. The $75,000 grant from FMF, announced in June 2016, expanded her ability to actually see the microbial molecular patterns using time-lapse intravital microscopy and technology that she developed herself to “watch the behavior” inside living mice. Edelblum K E I T H B . B R AT C H E R , J R .

likes science she can see, “as opposed to just looking at proteins on a blot.” And this work is not just about IBD. Her gut research has a far wider reach. “Over the last several years, evidence indicates that defective microbial recognition of the bacteria normally found in the intestine by the immune system may be contributing to the development of a number of diseases, including inflammatory bowel disease, cancer, obesity, diabetes, asthma, Parkinson’s disease and autism.” AMARILIZ RIVERA

Understanding Fungal Infections

esearch on bacteria and viruses abounds but what about “all these fungal organisms growing indoor and outdoors? We don’t know how they may be affecting human health,” insists Amariliz Rivera, assistant professor and researcher at NJMS’s CII. “Fungi are present all around us and could be the cause of unexplained illnesses and symptoms. I think this is a very exciting area of research,” she says. Breathing in pollen, dust, infectious microorganisms and moldy spores won’t automatically lead to illness but for people who are immune-compromised or genetically susceptible, the results can be disastrous. In fact, the number of patients susceptible to invasive fungal infections across the world continues to rise at an alarming pace. With antifungal drugs often inadequate, immune-based interventions hold the promise of improved outcomes. Grants, including $60,000 from FMF in 2013, have supported her investigations into how the immune system fights fungal infections. A large NIH grant ($1.25 million) announced last year and a new prestigious Burroughs Wellcome Fund Investigators in the Pathogenesis of Infectious Disease Award have also been critical to Rivera’s breakthrough research. The goal of her investigations has been to understand two types of immune cells: monocytes and neutrophils that work together and are essential in fighting fungal infections. Her lab discovered that these two innate cells communicate with

one another for optimal fungal pathogen eradication. “In the absence of monocytes, neutrophils are less capable of inactivating fungal cells,” she says. “And in the absence of neutrophils, monocytes are less capable of eliminating fungal cells.” The Feldstein Foundation “made it possible for us to start taking these findings from animals to human immune cells,” she says. “I see our research program feeding into an understanding of how immune cells respond to fungi. We are looking for very specific signatures of an anti-fungal response. Potentially, patients could be determined to have certain biomarkers, a pattern of X, Y and Z factors, indicative of fungal exposure.” A graduate of the University of Puerto Rico, Rivera earned her PhD at UMDNJ, now Rutgers Graduate School of Biomedical Sciences in Piscataway. Her interest in fungal infections began at Memorial Sloan Kettering Cancer Center. But in 2010, when William Gause, PhD, director of the Rutgers Institute for Infectious and Inflammatory Diseases (i3D), invited her to bring her research back to New Jersey, she jumped at the chance. “I brought my mice and my program and he gave me everything else I needed to take my research to the next level.” MONA BATISH

Making Genetic Sense of Cancers

o really understand certain kinds of cancer, brilliant researchers like Mona Batish, assistant professor of microbiology and molecular genetics at NJMS, have developed tools for the detection of tumorcausing alterations in chromosomes. Batish has focused on Ewing’s sarcoma (ES), a softtissue tumor found mainly in teenagers and young adults and caused by a chromosomal translocation and fusion of two otherwise separate genes. The result is a gene mix-up that sends out all the wrong signals, factors, and unregulated activation and could lead to the uncontrolled cell growth in cancer. In fact, gene fusions are turning out to be responsible for other soft tissue sarcomas,

prostate cancer, lung cancer and certain other solid tumors. But this list keeps growing, which is why Batish is on a perfect research path, an award-winning journey she began back in India as a microbiology student at Panjab University in Chandigarh. After earning her Master of Science there with honors in 2005, she traveled to the U.S. and earned a PhD at UMDNJ, now Rutgers Graduate School of Biomedical Sciences, in 2011. In 2012, while a postdoctoral researcher, her career got a fast-track boost when she won an NIH Director’s Early Independence Award of $1.25 million for five years, which is only given to young scientists who show creativity, intellectual maturity and enough leadership to allow them to skip right into a faculty position. Her Feldstein grant was one more plank in her pathway to understanding the molecular mechanisms within these genetic mutations. “Normally when you get cancer, it is caused by a cumulative effect of many things, but not in this case. ES occurs in an otherwise stable genome. This chromosomal translocation and the resulting fusion is the cause of the cancer.” Batish has adapted a method called single molecule fluorescence in situ hybridization (smFISH) to develop a new technique called “Fusion-FISH” so she can visualize the products of two fusing chromosomal areas at single molecule resolution. “We are taking what has always been known in this field, the key players in sarcoma, and connecting the dots,” she explains. Only by understanding “this abnormal thing” (the product of fused gene) completely, can you predict the cancer’s progression or identify targets for therapy. A talented graduate student in her lab, Fatu B. Markey, is optimizing Fusion-FISH for use on real patient tissue samples. “Our overarching goal is to understand the interactions among key known players and also uncover new partners in crime who have escaped the attention so far.” Empowered with these high-resolution single molecule imaging techniques, the Batish lab hopes to develop early diagnosis and new therapeutic options for sarcomas and other incurable cancers. ● RUTGERS NEW JERSEY MEDICAL SCHOOL

a closer look at new thinking in obstetrics

Natural Delivery After C-Section BY JEFF TOLVIN

hough the myth “once a cesareansection, always a cesarean-section” was shattered years ago, rates of U.S. births involving the surgical procedure have not diminished significantly. Many women who have delivered a child by C-section — and who are deemed healthy candidates for vaginal delivery for subsequent births — choose to deliver again by C-section, often because they fear the pain of contractions associated with natural delivery or want the convenience of scheduling their births, which elective C-sections allow. A different dynamic is playing out in Newark, where obstetricians at Rutgers New Jersey Medical School (NJMS) are countering that trend, counseling women who have had a C-section about the benefits and risks of vaginal delivery for their next child. “If the mother is a strong candidate, a vaginal birth offers significant advantages: shorter recovery time and much less risk than with a cesarean delivery, which increases risks of injuries to the bowel or bladder, blood loss and infection,” says Lisa GittensWilliams, MD, associate professor, of obstetrics, gynecology and women’s health. While New Jersey’s overall cesarean delivery rate — approximately 40 percent—ranks among the highest in the country, the NJMS obstetricians are delivering by C-section 30 percent of the time. In 2015, they performed 83 vaginal deliveries for women who previously had undergone C-sections. Generally, the trial of labor after C-section success rate is about 70 percent. Hesitancy over attempting vaginal births after cesarean section is likely responsible for the overall cesarean birth rate remaining high, Gittens-Williams says. According to the Centers for Disease Control and Prevention, the cesarean birth rate was 32.2 percent of all births in 2014 and 32.7 percent in 2013. 10

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The belief that a woman was destined to have all babies by C-section if she previously delivered that way, was disproved in the 1980s, aided by research, when repeat C-section rates started to fall, she says. However, concerns about uterine rupture gained momentum in the 1990s, pushing the number of repeat C-section births upward. A uterine rupture is a tear in the wall of the uterus, most often at the site of a previous C-section incision, and the consequences can be dire for the mother and baby. “Yes, there is that risk,” Gittens-Williams says, “but in appropriately selected candidates we believe are healthy for labor, that risk is approximately 0.8 percent. For many women, the benefits of a vaginal birth outweigh the risks with a C-section.” Multiple repeat C-sections increase the risk of complications during C-section surgery, including the risk of the placenta attaching itself too deeply into the uterine

wall, a condition known as placenta acreta. Vaginal birth after cesarean section reduces this risk, Gittens-Williams says. Last month, Christine L. (not her real name) chose to try a vaginal delivery, anticipating a much less painful experience than when she gave birth previously by C-section. “This was nothing like the pain from a C-section,” she said, just hours after GittensWilliams delivered a healthy baby boy. “The first time, I had to be hospitalized for five days. And this time I did not have to worry about the surgery.” Gittens-Williams says her team encourages the parents to share in the decision-making. “If we evaluate expectant moms and find them candidates to try a vaginal birth, we give them that option. We explain what to anticipate with surgery vs. natural birth and the risks and benefits of each,” she says. ● Article reprinted by permission from Rutgers Today.

Lisa Gittens-Williams, MD, and her team counsel expectant mothers on the risks and benefits of vaginal birth after C-section.

NICK ROMANENKO

a closer look at an njms team combatting aids

Leading the Way in HIV Prevention BY MARY ANN LITTELL

daily pill preventing HIV infection. A vaginal ring containing antiretroviral medication. Long-lasting injectable drugs protecting against HIV transmission. Longlasting antibodies given by infusion. These are a few of the groundbreaking developments on the horizon in HIV prevention. “As science develops some amazing tools for HIV prevention, it’s an exciting time to be working in this field,” says Shobha Swaminathan, MD, associate professor of medicine and medical director of the Infectious Diseases Practice (IDP) and Rutgers New Jersey Medical School’s Clinical Research Center. Swaminathan and her team treat a range of conditions, from hepatitis B and C to HIV. “We serve as a one-stop shop, treating patients and trying to provide everything we can to prevent infection, using existing medications and testing other medicines in clinical trials,” she says. Antiretroviral therapies reduce HIV viral load, the level of HIV virus in the blood. IDP has been tracking HIV viral load since 2005. “Today we are able to bring about a much greater reduction than we were when we started, with >80% of patients reporting a low viral load,” explains Swaminathan. “Reducing viral load is highly effective at preventing sexual transmission. We’re proud of this success.” “We’ve also received funding to be able to provide HIV PrEP (Pre-Exposure Prophylaxis),” says Swaminathan. “It is a pill only for those who test negative for HIV and must be taken every day to be effective. And whether you are on PrEP or not, it’s still vitally important to practice safe sex, always using barrier protection and condoms.” Staying

JOHN EMERSON

Shobha Swaminathan, MD (left), and members of her team are fighting HIV on many fronts.

healthy begins with getting tested, and HIV testing is offered at various locations at University Hospital. “We have greatly expanded our testing services and can test someone for HIV and connect them to care that same day,” Swaminathan adds. She is site leader for the NIH-funded Clinical Trials Unit at NJMS. “With high rates of HIV in the Newark community, the need is great here and we’re well-positioned to help,” she observes. “We are the only site in New Jersey funded by the NIH to do HIV prevention studies. They’re conducted through the HIV Prevention Trials Network (HPTN), which is global in scope.” The IDP is participating in an exciting new prevention trial that’s received quite a bit of attention: Antibody Mediated Prevention, or AMP study. This study will test the prevention benefit of an antibody against HIV in men who have sex with men and among transgender men and women. The antibody being studied is VRC01, which binds onto HIV and prevents it from infecting the body’s T-cells. In laboratory studies this antibody, VRC01, was found to block

HIV in 90% of the blood samples tested. The AMP study’s strategy is unique, taking HIV vaccine research a step further. In traditional HIV vaccine studies, participants are given a vaccine and researchers observe whether antibodies are produced in response. In the AMP study, the vaccine step is eliminated and participants are given antibodies directly through an intravenous fusion. The study is being conducted by HPTN and the HIV Vaccine Trials Network at several sites throughout the world. IDP is involved in other HIV prevention studies as well. One recently completed study compared different medications for HIV prevention in high-risk women. A second trial examines the safety and efficacy of a long-acting injectable medication, rilpivirine, for women at low risk. There is another planned study protocol to compare the effectiveness of a new injectable medicine compared to an oral medication in a population at high risk for HIV infection. To learn more about the HIV prevention studies please contact the team at ruampnj@ njms.rutgers.edu or 844-782-6765. ● RUTGERS NEW JERSEY MEDICAL SCHOOL

a closer look at two tech entrepreneurs

Studying for Exams? There’s an App For That

MD/MBA students Dan Nguyen and Gerard D’Onofrio with Testable, their new studying app.

BY TY BALDWIN

an Nguyen and Gerard D’Onofrio (MD/MBA candidates, 2018) didn’t matriculate at Rutgers New Jersey Medical School (NJMS) with the intention of becoming tech entrepreneurs. But thanks to the Distinction Program in Entrepreneurship and Innovation, the mentorship of George Heinrich, MD, and their own hard work, that’s what’s happened. Their app, Testable, which offers students a social, competitive way to study for exams, rolled out on the iOS platform this past spring. “The idea for Testable came from being medical students,” Nguyen says. “Trying to learn all this medical content in a short time forces you to get creative with your study habits. One of the most effective ways for me to review is in groups with my friends. We ask each other questions because we’ve found that being able to explain the correct answers to each other reinforces the material.” Nguyen and D’Onofrio first discussed creating an app in February 2015, when they were preparing for their Step 1 exam. “It’s regarded as the most influential test score that will determine your placement in residency,” D’Onofrio explains. “Like any good medical students, Dan and I were studying ahead of time, constantly going over the review books and doing review questions, and we devel-

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oped a study method where we would throw questions at each other. We recognized pretty quickly that there was a game-like quality to it.” But a funny thing happened en route to the App Store: med school got in the way. “From April to the end of May, Dan and I had to really buckle down and study for the Step 1 exam,” D’Onofrio says. “At the end of May, we started our third year on the floors, which was very time intensive and entirely new to us. It required a lot of acclimation that the classroom setting of the first two years didn’t. So the app got put on the back burner for a while. In December 2015 we started talking about it again.” Nguyen and D’Onofrio wanted their app to recreate the social atmosphere of studying with your friends. “By making it competitive,” Nguyen says, “and allowing students to go head-to-head against other students, and answer real test-like questions, the app not only gives you practice, it also forces you to study actively. We wanted to make it

personal, because when you’re playing against your friends, or other students, you have some skin in the game. Your pride and your ego are involved and you tend to perform better.” Students can use Testable to challenge each other to games of five multiple-choice questions. “If I challenge you,” D’Onofrio explains, “then I complete my five questions on my own time, and you complete your questions on your time. When we’ve both finished, we see who did better. The score, and the winner, is determined first on accuracy and then on time.” Once the game ends, students can review thorough explanations for each of their answer choices. “That’s something that sets us apart,” he adds. “Not only is our content geared toward education, but Testable encourages students to really learn the material. If you get it wrong, you don’t just go to the next game without thinking about it. You have the opportunity to go over each answer until it’s clear.” By early 2016, Nguyen and D’Onofrio had hired a software developer and, with the help of four seniors from the New Jersey Institute of Technology’s Capstone Program, they had a viable product ready for the App Store by spring. “The original idea was to K E I T H B . B R AT C H E R , J R .

focus on medical content,” says Nguyen. “It would be for first- and second-year medical students preparing for the USMLE Step 1 board exams. However, we thought the changes in the 2016 SAT exam provided an easier entry into the test prep market and would put the other resources on the market on a clean start with us.” More than a thousand students across New Jersey used Testable in its first two weeks, Nguyen says, but there was a small problem. “We quickly found that high school students don’t like to study unless they have to, so getting them to use resources other than what their school had provided was a bit of a challenge. We got great feedback from

teachers, and from the students who did use it, but we realized that it might be better to focus on a smaller market: specifically, medical students. They’re inherently competitive and have to study all year round.” There’s reason to think Nguyen and D’Onofrio are on the right track: Testable has already been a hit with NJMS students. “We teamed up with Dr. Devashish Anjaria, the director of the surgery clerkship, to provide NJMS students a study application,” D’Onofrio says. “We put 210 questions that were specific to the Surgery Shelf Exam into our application.” The Surgery Shelf is a National Board of Medical Examiners standardized exam that medical students must pass to

Program Tracks Let Students ‘Think Outside the Box’ The Distinction Program at NJMS allows students the opportunity to explore interests beyond the traditional four-year medical school curriculum. George Heinrich, MD, associate dean of admissions, directs the Innovation Track of the program. “It’s an opportunity for students to participate in additional scholarly activity,” he says. “They generally take a year to advance some academic program, from research to international experience to pursuing a dual degree. It’s not limited. The Distinction Program gives students the flexibility to look at different ways to enhance their education and careers.” Students participating in the program may take a fifth year to earn their degrees. “They don’t take part in the medical school curriculum during that year,” Heinrich says, “but that doesn’t mean that they won’t do extra activities that relate. We’ve had students go to the NIH, or take time to focus on research in other labs.” The Distinction Program offers an extra academic credential for students interested in pursuing focused studies in areas such as service, global health, urban health, and entrepreneurship and innovation in medicine. The program grew out of the commitment NJMS has to each individual student, Heinrich says. “Our faculty are very much interested in personally advising students in accord with their own particular traits and potential. I happen to work with Dan and Gerard because they’re interested in innovation, and that’s an area with which I’m very much involved. But there are other students who work with faculty members who support research, for example, or global health. The goal is to leverage the interaction between the faculty and students so that we can really customize each student’s education and experience to maximize their future.”

fulfill their third-year surgery requirement. Scoring above 90 percent merits honors for the surgery rotation. “We distributed it in a beta form to all of the NJMS surgery students who had a compatible device. Dan and I actually used our own app to study for the Surgery Shelf, which was really cool.” With the benefit of hindsight, the success of two hard-working medical students might seem inevitable (if not exactly easy). Still, having an idea for an app is one thing, bringing it to fruition is something else altogether. Fortunately for Nguyen, who grew up in Warren and graduated from The College of New Jersey, and D’Onofrio, who hails from Chatham and graduated from The University of Scranton, NJMS not only encourages creativity, it also offers students the opportunity to explore their ideas. “Gerard and I are part of the Distinction Program in Entrepreneurship and Innovation,” Nguyen says. “We’ve been very fortunate to have a great mentor in Dr. George Heinrich. He was my mentor when I first thought about this idea, before we even developed it, and his advice about what the next step should be, or how to approach a certain problem, has been really valuable.” Nguyen and D’Onofrio will spend the next 12 months earning MBAs at Rutgers and developing their business. “We plan to increase Testable’s medical content,” D’Onofrio says. “Our long-term goal is to have almost every standardized exam on our application for easy and convenient use.” “Our experience with this app really shows how much the NJMS administration and faculty care about their students and want them to succeed,” Nguyen says. “Just the fact that they were willing to let Gerard and me take on such a big task to try to create a company and obtain a dual degree is amazing. Everyone I’ve spoken to about Testable has been extremely supportive. NJMS will let students find their own path, and I think that’s unique to our program. I don’t know many other medical schools that would give their students this kind of freedom.” ●

RUTGERS NEW JERSEY MEDICAL SCHOOL

njms /gsbs people…do you know? AM IT CH AU D HARI

In Drug Translation, Asking: “Can We Do Better?” BY MARY ANN LITTELL

t takes 15 to 20 years for a new drug to travel from the bench to clinical application—where it is actually used to benefit patients. That’s a long time for someone to wait for a cure or a lifesaving medication. “My goal is to find ways to move innovative research to the bedside more quickly,” says NJMS MD/PhD student Amit Chaudhari. “That way we can make a difference in people’s lives now, not 15 years later.” This physician-scientist in training is heading in a direction to bring about this change. In May 2016 he was awarded a prestigious American Association for the Advancement of Science (AAAS) Science & Technology Policy Fellowship. He will take a year off from his medical studies to serve in the National Center for Advancing Translational Sciences/Division of Clinical Innovation. “This center focuses on transforming

and accelerating the translational research process,” he explains. “They’re all about getting more medical treatments to more patients.” Chaudhari is doing this fellowship year as part of NJMS’s Young Scholars Program, which allows for the option to explore outside interests as part of career building. The AAAS program, in partnership with the National Institutes of Health (NIH), provides one- to two-year science and technology policy fellowships as part of a mandate to advance science and serve society. The fellows serve in federal agencies and congressional offices to learn about policymaking and implementation. The aim is to foster evidence-based policy and practice by engaging scientists, social scientists, medical professionals, and engineers to apply their knowledge and analytical skills. After the fellowship, some fellows return to their

Amit Chaudhari is taking a year off from NJMS to participate in an NIH fellowship program. His career goals include finding ways to speed drug development.

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previous institutions or pursue careers in industry and nonprofit organizations. Others remain in policy, working at the federal, state, regional, or international levels. “I’m looking forward to learning to navigate the NIH and other executive agencies in the policy-making, regulatory, and grants administration processes,” says Chaudhari. “This experience will help me understand the various stakeholders who advance human health and health policy.”

“New approaches and changes in policy are needed to speed drug discovery without sacrificing quality and safety.” — Amit Chaudhari

He hopes someday to work in the area of drug translation, the process of turning findings from the laboratory, clinic, and community into interventions that improve health. “Developing a new drug is such a long and arduous process that many scientists, for a variety of reasons, don’t see it through to the end,” he says. “Even when a drug is developed and tested and found to be effective, many more years pass before it’s actually used on patients. New approaches and changes in policy are needed to speed this process without sacrificing quality and safety. ” With three years of medical school behind him, Chaudhari, who also holds an undergraduate degree from Rutgers (Rutgers College’10), obtained his PhD in neuroscience. Following his fellowship year in Bethesda, MD, just outside of Washington, DC, he’ll return to NJMS to finish his final year. He says, “I’d like to advance my scientific and medical training through a rigorous residency program,” rounding out the skill set he needs to shape drug policy. “This fellowship for me is an opportunity to better serve my purpose of enhancing human health by finding ways to leverage our basic science discoveries into innovative medical applications,” he adds. ● K E I T H B . B R AT C H E R , J R .

njms people…do you know? AN A S TA SI A B O G D AN O VS K I

Olympics vs. Orientation:

Why This Swimmer Had to Choose

BY MARYANN BRINLEY

n August 8, 2016, Anastasia Bogdanovski woke up in Rio de Janiero, Brazil, approximately 4,784 miles from where she should have been that morning. This first-year Rutgers New Jersey Medical School (NJMS) student was nervous…but not about missing White Coat ceremonies and her first week of orientation. School administrators had given her a bypass on that obligation. Two dreams had come true and one of them was scary. “Medical school had been a dream of mine for longer than going to the Olympics,” she says. But Bogdanovski had received the official invitation to compete in the World Olympics weeks before and she was about to swim the race of her life in the 200-meter freestyle event representing Macedonia, where her parents were born. “I was so nervous,” she admits. A dual citizen of the U.S. and Macedonia, Bogdanovski grew up in Fanwood, NJ, but had been competing for years representing this former Yugoslavian state. “Then I got a call from my brother Dorian,” she recalls. Elated, he told her, “I just got accepted into New Jersey Medical School and I’ll be starting next year.” “That news was so great. Immediately, I wasn’t nervous anymore about my race. It was like: no matter what happens today, it’s already a good day,” she recalls. In fact, it was a good day. At her noon race, “I accom-

plished what I set out to do,” she says. As the top-ranked swimmer in Macedonia, “I set a national record for myself and got my best time,” placing just a few spots behind the American gold medal winner Katie Ledecky. “It was a wonderful experience, walking out there, hearing everyone cheering and seeing so many people there to support the top athletes. Her parents, Dorian, and a college friend arrived the day after those opening ceremonies. Bogdanovski skipped the closing ceremonies to fly back to Newark for the first day of classes on August 15. “Yes, school is hard now but there are so many people here to help you,” she says. She’s treasuring her study group sessions where everyone talks back and forth. In the patientcentered medicine class, “We are already learning how to talk to patients and take histories. It makes me realize why we are here. This is not just about sticking your head in a book and learning.” She was drawn to NJMS because of this hands-on approach and hopes to start working in the studentrun clinic soon. A public health studies major at Johns

T O P : K E I T H B . B R AT C H E R , J R . ; I N S E T C O U R T E S Y O F A N A S TA S I A B O G D A N O V S K I

Hopkins University, Bogdanovski led the varsity women’s swim team to place third nationally. She graduated from Union County Magnet High School, playing sports in high school. It was during a high school swim meet that the idea of representing Macedonia first gained momentum. Her uncle back in Macedonia had sent her a swim cap with the country’s red and yellow design. Wearing it during races made her feel proud of her family’s heritage. It also made the Macedonia Olympic swim coach take notice of her spectacular wins. “When he asked me to swim for the country’s team, it was like a dream,” she says. She hopes to go into sports medicine: “I want to help athletes maximize their potential and not be held back by injuries.” In the meantime, she’s discovered that there is a pool on the Rutgers University–Newark undergraduate campus. Soon enough she’ll be back in the water. Right now, she’s taking the kind of break all swimmers need after such an Olympic season. ● RUTGERS NEW JERSEY MEDICAL SCHOOL

njms people…do you know?

What Does it Take to Be a Favorite Kids’ Doc? BY GENENE W. MORRIS

That is the question Pulse magazine posed to the Rutgers New Jersey Medical School (NJMS) physicians whose names appear in the December 2016 issue of New Jersey Family magazine under the heading: “New Jersey’s Favorite Kids’ Docs.” Among the honored doctors are Evelyne Kalyoussef, MD, of the Department of Otolaryngology–Head and Neck Surgery, and Tolga Taneli, MD, of the Department of Psychiatry. The list also includes all of the pediatricians — Chitra R. Reddy, MD; Dominga Padilla, MD; Hanan A. Tanuos, MD; Joseph V. Schwab, MD, MPH; and Madolene A. Aliparo, MD — who make up NJMS’s University Pediatrics, a faculty practice that logs more than 16,000 patient visits a year. “This is a big deal,” notes New Jersey Family publisher Cindy Mironovich in a letter to these distinguished doctors following a poll the magazine conducted seeking nominations from parents. “Your patients’ parents took time to honor you with a nomination because they think you’re extraordinary.” Here, these physicians reveal what they believe it takes to be a Favorite Kids’ Doctor.

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CHITRA REDDY, MD

It takes compassion

o be a Favorite Kids’ Doctor, Chitra Reddy, MD, believes it requires compassionate care. “You dedicate yourself to being compassionate to the parents and to the children, to understand their needs, and to provide support.” Reddy, who grew up and went to medical school in India, is an assistant professor of pediatrics. She has been with the NJMS faculty for more than 30 years. For her, showing genuine concern and getting involved in the lives of patients are what make all the difference. When she sees her pediatric patients grow up, go to college and realize some degree of success, “I’m proud,” says Reddy, adding that three of her former patients have become pediatricians as well. But just as gratifying as watching patients blossom into responsible adults is the impact that she has on NJMS pediatrics residents. Reading through letters and cards from past residents, she quotes phrases like “I just wanted to say thank you for everything you have done for me in the past three years.” “I’m very lucky to have had you as my attending.” “I appreciate your dedication.” For Reddy, these notes show her that she’s not only having an impact on the patients she treats, but on future pediatricians. “People ask me, ‘Why aren’t you in private practice?’” she says. Reddy’s answer is simple: “I choose to be here because I want to make a difference.”

EVELYNE KALYOUSSEF, MD

It takes patience and an easy smile

“I

think what parents and kids seem to appreciate is patience and an easy smile,” says Evelyne Kalyoussef, MD, assistant professor of otolaryngology. “When you are enjoying your day and enjoying your patients…that comes out.” As a generalist, she is an ear, nose and throat doctor who treats pediatric and adult patients, alike. “I can help out with almost everything,” says Kalyoussef, who earned her medical degree from Rutgers Robert Wood Johnson Medical School. That is something that she believes is beneficial for pediatric patients, especially those who have rare conditions involving the ear, nose or throat. “Whenever I do have a child with something out of the ordinary (whether removing salivary gland stones, treating congenital neck masses or caring for a patient with head and neck cancer), I feel very comfortable taking care of that condition.” Receiving the distinction of a Favorite Kids’ Doc—her third time in four years— “means the world,” Kalyoussef says. “It’s super sweet. I think if you ask anyone in my office, they know, regardless of the type of day I’m having, the minute I’m with a patient, I’m all there. It means my patients think highly of me and I think just as highly of them.”

MADOLENE ALIPARO, MD

It takes being accessible

hen Madolene Aliparo, MD, began treating patients at University pediatrics some six years ago, she wanted to make sure that the parents of her patients—especially anxious first-time parents, moms of

preemies or difficult adolescents, and naïve teen mothers—had direct access to her to ensure that all their questions were answered and concerns were met. So this assistant professor of pediatrics took the unusual step of giving out her personal cell phone number. It was a move that took the term “going above and beyond” to a different level because it, essentially, put her on call 24/7. Aliparo’s commitment to her patients and their families sometimes has her seeing them in the clinic after hours for “family conferences” when parents find themselves at wit’s end with their rebellious teenage children. A native of the Philippines, Aliparo is their backup, like a respected family member who the teens don’t want to disappoint. As a Favorite Kids’ doctor, she says, “This is so heartwarming. Pediatrics is an interesting specialty because you’re making a difference in the life of a kid until they become responsible adults.”

so precious. I value that trust,” says Padilla, an assistant professor who also serves as the medical director of the Division of Adolescent and Young Adult Medicine at NJMS. To keep the lines of communication open, she provides parents and even teenage patients her cell number so they can call or text whenever they have questions. “I take care of children as if they are my own family. I want to be there for their milestones. I want to help them transition into healthy adults.” One of four girls, Padilla was raised by a single mother in Jersey City, NJ. Her “humble beginning,” she says, is what brought her to Newark in the first place and is what allows her to connect with adolescent and pediatric patients as well as their families. “I see myself in these individuals. My experience growing up in poverty and not being able to access health care as often as I wanted to, it was part of the decision, ultimately, to go to medical school and become a pediatrician.”

DOMINGA PADILLA, MD

HANAN TANUOS, MD

It takes seeing yourself in the patients and treating them like family

It takes empathy

ominga Padilla, MD, says that when she rotated through pediatrics as a medical student at NJMS, “it was like Cinderella and her glass slipper. It was the perfect fit.” The former science teacher says she would spend hours as a medical student in the pediatric ward at University Hospital in Newark—even when she didn’t have to be there. “I didn’t want to go home. If somebody wasn’t doing well, I wanted to stay there with them.” Today, as a pediatrician, she appreciates her patients and the families that entrust her with their care. “I always thank them for selecting me to take care of something

s a Rutgers New Jersey Medical School assistant professor of pediatrics and the medical director of H.E.A.L. (Health, Education, Advocacy and Law), a joint interdisciplinary program of NJMS’s Department of Pediatrics and Rutgers School of Law– Newark, Hanan A. Tanuos, MD, teaches medical students and residents that when it comes to providing care, one needs to consider more than just the medical facets of their patients’ lives. “Medicine is not just medicine,” says the pediatrician. “There are many social aspects that may prevent patients from getting adequate care.” Continued on page 28

RUTGERS NEW JERSEY MEDICAL SCHOOL

Blake Norton’s PET/CT showed aggressive tumors on his tongue and throat. Head and neck surgeon Soly Baredes, MD, was able to perform most of Norton’s surgery with the aid of high-technology tools, resulting in excellent outcomes and no change in Norton’s appearance.

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HEAD AND NECK SURGERY AND TECHNOLOGY

P ERF ECT T OGETH ER BY M ARY ANN LIT T E L L

Blake Norton is eternally grateful to his dentist for detecting the throat cancer that ultimately became quite serious. “That was in 2003,” says the 71-year-old sound engineer, who won his first of many Emmy Awards for technical work on the beloved children’s show “Sesame Street.” Initially he was treated by a community otolaryngologist near his home in Bloomingdale, NJ. But the lesions kept returning. “My doctor said he was sending me to his ‘guru’ — a super-specialist in Newark— for more advanced care,” says Norton. That would be Soly Baredes, MD, professor and chair of the Department of Otolaryngology-Head and Neck Surgery at Rutgers New Jersey Medical School (NJMS). The department specializes in the treatment of cancers and other disorders of the ear, nose, mouth, throat, neck, face and voice. Self-effacing and quiet, Baredes is nonetheless a visionary. He’s assembled a ‘dream team’ of specialists who go beyond general otolargynology to offer the latest interventions, including surgical oncology, skull base cancer surgery, otology/neurotology, pediatric otolaryngology, transoral robotic surgery via the da Vinci system, and microvascular reconstructive surgery. The practice is known throughout New Jersey and beyond as the state’s major destination for tertiary (superspecialty) clinical care. Technology defines the future of surgery. Next-generation tools allow surgeons to perform complicated procedures in hard-to-reach areas that previously could be accessed only through open surgery. New tools—robots, lasers, endoscopes, minuscule cameras, 3D printers, and more—widen the boundaries for minimally invasive surgery and reconstruction. The technology lends itself particularly well to head and neck surgery, which poses unique challenges. In addition to correcting a

defect or removing a lesion, a primary concern is preserving the ability to breathe, speak, and eat. The patient’s appearance must also be considered. How do you recreate a face that’s been ravaged by trauma or a malignancy that required the removal of part of the jaw? Surgeons do this and more with the help of amazing new tools and techniques. “There’s so much to learn. I’ve had a whole education since my training,” Baredes says only half-kiddingly. “The main advantage to this technology is the option of operating minimally invasively, through the oral cavity. We avoid splitting the jawbone and that’s much easier on patients. Procedures can be performed more precisely, safely, quickly, and with less pain, resulting in better outcomes.” He adds a caveat: “As great as these tools are, they can’t be used on all patients all the time. Many tumors require more radical techniques. So we look for the right situations, tailoring the approach to each individual.” Blake Norton fit the criteria perfectly. For several years Baredes had treated him for recurrent small tumors. But in 2013, the cancer became worse. “I felt a lump in my throat, which I never had before,” notes Norton, who admits he was once a smoker. Some 62,000 people are diagnosed with head and neck cancer each year in the U.S. Norton had aggressive growths in the base of the tongue and the cancer had spread to his lymph nodes. “He needed extensive surgery. Fortunately we were able to do much of it robotically,” explains Baredes. “Before the robot these tumors would have required cutting through his jaw.” RUTGERS NEW JERSEY MEDICAL SCHOOL

Norton is Baredes’ only patient to undergo two separate robotic procedures for two separate tumors, both at University Hospital. The first was in May 2013, when a large lesion on the tongue was removed. In a second procedure in October, another tumor was removed from the tongue robotically and a selective neck resection was performed—open surgery to remove malignant nodes. He had chemotherapy and radiation. While recovery was difficult, Norton feels and looks great and has no loss of function. Now semi-retired, he works as a sound engineer on the Metropolitan Opera’s live-to-theater broadcasts. It’s a rigorous schedule, particularly for someone who’s survived cancer. A selfconfessed ‘techie,’ he’s thankful he could benefit from robotic surgery— so thankful that he had T-shirts made for himself and Baredes that say “da Vinci Groupie.” Surgical resection of head and neck cancer can result in significant disfigurement. Advances in microvascular reconstruction, however, have ushered in a new era for reconstruction. Using tiny tools and microscopes, surgeons “rebuild” parts of the body by transferring bone, and tissue and blood vessels—called flaps—from one area to another. While microvascular reconstruction has been done for many years, the 20

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Above: The NJMS head and neck surgery ‘dream team’ (left to right): Richard Chan Woo Park, MD, Soly Baredes, MD, and Evelyne Kalyoussef, MD, are trained in robotic surgery. Left: Cancer patient Blake Norton’s excellent outcome prompted him to have t-shirts made for himself and his physician.

newest techniques use evolutionary, three-dimensional (3D) modeling to precisely map the surgery. In visionary mode, Baredes added this new dimension to his team, bringing Richard Chan Woo Park, MD, on board in 2013. Park, an assistant professor, specializes in head and neck microvascular reconstruction. As an added bonus, he’s become adept at using 3D modeling to plan facial reconstructions. Park is the only otolaryngologytrained surgeon in New Jersey combining these techniques to do transformative work. “Previously people with head and neck cancers were left with holes or defects — missing bone, tissue, tongue or throat,” says Park, who’s also fellowship-trained in head and neck oncology and surgery. “I wanted to be a one-stop shop where I could not only remove tumors but also fix the defect.” A crucial step in this type of reconstruction is connecting the free flap artery and vein to the neck. “Think of free flap microvascular surgery as an organ transplant,” adds Park. “However, instead of transplanting someone else’s liver or kidney we’re transplanting a patient’s own bone from the leg to the jaw.” In June 2016 Baredes and Park teamed up to treat Wendy Hoffman, who’d had several recurrences of cancer of the tongue. The cancer had TOP: JOHN EMERSON

invaded her mandible, the bone in her jaw. In a complex procedure, Baredes removed the cancerous section of the mandible and a large section of her tongue. Park reconstructed the mandible using bone from her lower leg, and even used a section of skin to recreate part of the tongue. Park explains how 3D modeling is used to plan the surgery. First he gets CT scans of the face and leg and uploads them. He shares the scans with a team at 3D Systems Healthcare, a company specializing in 3D printing, and they meet online to virtually plan the procedure. “The CT scans are used to prepare a detailed plan, like a map,” Park says. “Customized cutting guides show us exactly where to make the cuts both in the fibula and jaw. They’re like cookie cutters.” The company even provides a custom, pre-bent titanium plate to which the fibula is attached. “In the old days you had to bend this by hand,” says Park. “It took a lot of trial and error to try and get it right. This saves time and ensures a good cosmetic and functional outcome.”

U SI N G VI R T U AL 3 D R E MO D E L I N G F O R FAC I AL R E C O N S T R U C T I O N Sam Nyamwange sustained serious injuries to his right cheek, cheekbone, and hard palate from a gunshot wound. Presurgical planning with 3D remodeling was instrumental in restoring function and appearance. Everything was done in a single operation. Top: Preoperative CT scan shows this patient’s missing right upper jaw. Bottom: Postoperative CT scan shows reconstruction with bone from the patient’s fibula (shown in turquoise) and dental implants (shown in red).

HIGH-TECH IN TE RV E NTION FO R SALIVARY S TONE S Think of a tool so small that it can be guided through the mouth into the natural opening of the salivary glands. What’s more, there’s a tiny camera on the end of this tool, which is a narrow endoscope. This brand-new, minimally invasive procedure, sialoendoscopy, is used to diagnose and treat salivary gland obstructions (shown at right). Few surgeons are trained in this procedure and assistant professor Evelyne Kalyoussef, MD, is one of them. While not ‘life-or-death,’ stones in the salivary glands have been difficult to manage. “These stones cause pain, inflammation, and swelling and may lead to permanent narrowing of the salivary ducts,” says Kalyoussef. The endoscope, no wider than a thread, is passed right through the salivary gland opening. Saline solution is infused through the endoscope, and if stones are detected they are retrieved with a tiny wire basket. Kalyoussef specializes in general and pediatric otolaryngology (see “Favorite Kids’ Docs,” page 15), and head and neck oncology, with a special interest in thyroid cancer. “Many of these patients are treated with radioactive iodine ablation after surgery,” she explains. “The salivary glands take up this iodine and some patients develop inflammation from it. With sialoendoscopy, we’ll flush out the glands and infuse steroids to decrease the inflammation. It’s great to have the tools to treat these patients holistically.”

Now a few months post-surgery, Hoffman is finishing radiation. Her appearance is good and she’s able to swallow and speak well, says Park. She will return to the hospital for dental implants. Another patient who’s happy to share his story is Samuel Nyamwange. This Kenyan émigré was working in a Newark parking garage in February 2015 when he was shot in the face during a robbery. The bullet entered his right cheek, shattering his teeth and the right side of his cheekbone and hard palate (the roof of the mouth). He had an opening between the nasal and oral cavities and was unable to speak or eat. Nyamwange was lucky to be brought to a place with the technology and surgical expertise to put him back together. Again, Park planned the surgery with virtual 3D modeling. In an eight-hour procedure he reconstructed the hard palate using a section of the fibula bone from Nyamwange’s right leg. With the help of Shahid Aziz, DMD, MD, associate professor of surgery at NJMS and professor of oral surgery at Rutgers School of Dental Medicine, they were able to position dental implants during the same operation. It was a true, one-stop shop, resulting in one delighted patient. “The procedure went flawlessly,” says Park. “This advance planning pays off. Post surgery he’s doing well, he looks great and he can chew and swallow without issues. It’s very rewarding to be able to help patients in this way.” ● RUTGERS NEW JERSEY MEDICAL SCHOOL

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Sport BE A

By Ty Baldwin

Balazs Galdi, MD, assistant professor of orthopaedic surgery at Rutgers New Jersey Medical School (NJMS), almost didn’t become a doctor at all. “I took AP biology my senior year of high school,” he says. “I absolutely hated it and dropped out after two days. Then, as a college freshman, I took biology to fulfill a science requirement and did well in it.” Galdi kept taking science classes, and kept doing well, so that, by junior year, when he had to declare a major, he picked biology. “But then I thought, what am I going to do with a biology degree? That’s how I ended up in medical school.” Galdi, who grew up in North Bergen, NJ, was born in Budapest, Hungary, where both his parents were professors of geography and social science. After the family emigrated to the U.S. in 1986, Galdi’s father worked in a shipping company and his mother became a fulltime homemaker. For his part, the young Balazs spent a good deal of time on the tennis courts— enough so that he was recruited by several colleges. He ultimately chose Rutgers (though he hadn’t been recruited there), because it was closer to home and “had the big-school feel I was looking for.” He walked on for tennis tryouts freshman year, made the team, played all four years of his college career, and was named captain and most valuable player during his senior year. “Tennis was the best thing for me,” Galdi says. “We practiced six days a week, so my time was very regimented. I had class from eight in the morning until two in the afternoon. I’d practice from two-thirty to five-thirty, then take a shower, go to the cafeteria, and go to study hall or the library from six-thirty until ten o’clock.”

K E I T H B . B R AT C H E R , J R .

He continues, “In college, people have a lot of free time because the classes are so spread out, and you end up procrastinating. You’re always saying, ‘I’ll study later,’ but later never pans out. I didn’t have any free time, but it worked out for me.” You might say so. Galdi made the Dean’s List all eight semesters of his college career, received the Rutgers College Scholastic Excellence Award, the Rutgers University President’s Award, and the Big East Conference Scholar-Athlete Award. He was named an NCAA Division One Academic All-American, inducted into Phi Beta Kappa, and graduated summa cum laude. And, oh yeah— he got into med school. In the summer of 2003, before his senior year at Rutgers, Galdi was visiting family in Hungary and decided to give professional tennis a try. “I took a twelve-hour train ride to Romania and played a Futures event there,” he says. (The Futures are akin to the minor leagues for young tennis players.) “It wasn’t large, but it was a professional-level tournament. I lost in the first round of qualifying, something like 6 –2, 6 –1, and I realized that maybe professional tennis wasn’t something I should be pursuing at that point. Going into medicine looked like a better idea.” (Then again, by all accounts, Roger Federer isn’t a worldclass orthopaedic surgeon.) Galdi received his medical degree at the Albert Einstein College of Medicine in 2008 (where he was named a Golding Distinguished Scholar and inducted in the Alpha Omega Alpha Honor Society), and then came to NJMS for his residency in orthopaedic surgery Continued on page 25

RUTGERS NEW JERSEY MEDICAL SCHOOL

going the extra mile for her students

By Maryann Brinley

s a successful, world-recognized TB researcher, Padmini Salgame, PhD, has a list of National Institutes of Health (NIH)-funded research grants that is already long and impressive, but a new five-year $835,160 award will support something near and dear to her: students. “My TB research is going very well and that makes me happy,” she says. “But for me, a big part of being in science is my passion for teaching and mentoring— something I inherited from my mother, who was an economics professor. When students first start research programs, they don’t really know the significance of what they are doing. Then, one day, they walk into my office and after having read a paper they can link to their own research, I see the excitement in their eyes and think: Okay, this is what I am here for.” Salgame teaches graduate students in the Integrated Program in Infection, Immunity and Inflammation (I3), one of the three PhD tracks in the Rutgers Graduate School of Biomedical Science (GSBS). The GSBS faculty members are all affiliated with Rutgers New Jersey Medical School (NJMS). She wants to foster nothing less than a new generation of investigators who will develop novel diagnostics, vaccines and therapies for infectious disease. “To win this global battle against infectious diseases, which remain major afflictions on health and wellbeing worldwide, we must prepare these new scientists to be leaders in their chosen fields as well as collaborators who understand and speak the clinical language,” she says. “We are not immune here in this country from infections like tuberculosis. TB is still a huge problem and with international travel, no one is immune: TB anywhere is TB everywhere. Things like Ebola get a lot of attention because people die right away. 24

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TB doesn’t get the same kind of press coverage because people don’t die immediately but it does kill someone every minute.” No one was better poised to put together the pieces for this highly competitive NIH funding than Padmini Salgame, who is known for pulling all-nighters to complete projects. “I try not to do that as much anymore,” she laughs. And just having returned from a vacation in Italy with 30 family members, she is relishing the laid-back pace over there. “It was so relaxing and wonderful. We traveled from the U.S., Canada and India to spend the time together and I didn’t think of work for a whole week.” Thinking about this special T32 training grant application and what had to be considered and included, she says, “Many other schools already have this kind of NIH funding for training so I just had to take the initiative to make sure we got it too. The credit really goes to our faculty, who are all amazing, as well as to our pool of students.” Outof-state applicants are coming from as far away as the Imperial College and University of Leicester in the United Kingdom, as well as Thomas Jefferson, McGill University, University of Notre Dame, UCLA at Berkeley, Rochester Institute of Technology, Howard University and Drexel. “The NIH was quite impressed that we are already training a lot of under-represented minority students,” Salgame says. “Our strength is not necessarily in having the top GPA scores here but in taking rough diamonds and preparing them to become successful, ever-curious scientists. The students we recruit and train have innate, untapped potential and our dedicated faculty provide opportunities that allow them to excel.” K E I T H B . B R AT C H E R , J R .

RUTGERS NEW JERSEY MEDICAL SCHOOL

Padmini Salgame, PhD

This cadre of graduate student trainees will receive lots of laboratorybased research experience in immunology, inflammation, immunity and molecular microbiology, fully integrated with clinical, epidemiological and translational science. “There is a lot to think about when you start a new program,” she explains, “but I wanted the students in this training program to shadow real doctors, to work in real HIV clinics and to get real-world experience from researchers.” The grant reviewers liked the fact that well-respected NJMS researchers like David Alland, MD, the developer of a rapid TB diagnostic test that is commercially available and endorsed by the World Health Organization, and Sanjay Tyagi, PhD, the co-inventor of molecular beacons, a technology that has revolutionized diagnostics worldwide, would be key participants in students’ training. Four students for each of the five-year grant period will be chosen from the I3 track of GSBS in Newark and from the MD/PhD Program. (See box, page 25.) “You really need to pick students who are working in labs that are already well-funded so the grant is not necessarily the only support for this particular student,” she explains. NIH wants to support students “who would stay in academia and eventually become productive researchers and faculty members. Traditionally this academic route is what the NIH has looked for.” The entire infectious disease community at NJMS was undoubtedly a factor in the grant review. Salgame points to the extensive expertise 26

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in viral, bacterial, fungal, and parasitic organisms as well as to all the translational programs in diagnostics, drug discovery and vaccine development. Always busy in her own lab at the Center for Emerging Pathogens, in the Institute for Infectious and Inflammatory Diseases (I3D), Salgame is a professor in the NJMS Department of Medicine, Division of Infectious Diseases. But pieces of the award-winning puzzle that made this grant possible also include the Center for Immunity and Inflammation (CII) led by William Gause, PhD, the Public Health Research Institute (PHRI), led by David Perlin, PhD, and GSBS, led by Andrew Thomas, PhD. Teaching, reviewing papers for scientific journals, problem-solving with staff and students and interacting with her co-investigators on several worldwide research projects here in the U.S. as well as in Brazil, South Africa and India ensures that her days are long and complicated. That’s why she relies on Theresa Policastro, senior grants administrator and director of the Research Grant Support Core, and Patricia Dalton, director for research policy. “These are administrative people who help me but never get credit for these things,” says Salgame. The graduate school’s administrative assistant, Beatrice Suffrant, was also written into the proposal and will be tracking the trainees. The Executive Committee for the T32 grant consists of George Yap, PhD, Christine RohowskyKochan, PhD, and David Lukac, PhD, who have an excellent track record of mentoring. Along with Salgame, the Executive Committee members are responsible for the oversight, planning, development reporting and evaluation of the training program. Another charge of this committee is recruitment of trainees. In conjunction with the training grant, two new courses specifically designed for the program have also become part of Salgame’s tothink-about list: Introduction to Clinical Infectious Diseases and Translational Medicine, An Introductory Look. In Newark, month-long opportunities to experience clinical encounters in an ambulatory care infectious disease practice and the inpatient infectious disease service will “let the trainee develop a familiarity with clinical protocols and challenges,” Salgame explains. The practical aspects of running clinical trials, including protocol development, IRB approval, recruiting and retaining participants, regulatory requirements, the fundamentals of human subjects protection and writing report analyses will be priceless on the road to creating a well-rounded infectious disease expert. A graduate of Bombay University in India, Salgame earned her PhD in immunology in 1984 but has never lost her own zeal. Her TB investigations are supported by millions in grant funding from the NIH and the National Institute of Allergy and Infectious Diseases. “We actually got a very large, prestigious, $21 million grant called the TB Research Unit Grant. I don’t want to sound boastful but this is really huge. I’m the principal investigator with David Alland here and Dr. Jerrold Ellner (Boston Medical Center) and when we got that, it was wow. Amazing.” The human side of her research is focused on finding biomarkers for TB and its progression. “TB is fascinating and I say that not just K E I T H B . B R AT C H E R , J R .

because I work with it.” Because of several large cohort studies around the world, Salgame’s team has been able to categorize people who have been exposed to this bug. “There is a whole range of things that can happen after exposure. Some people become infected but never get the disease and go to their graves not getting it. Some reactivate the bug for various reasons and progress to the disease within a year. And there are some people who are exposed and never get infected even with latent TB.” The goal, of course, is to find out which group you are in and what course of action to take. “We want to be able to tell patients, ‘You are going to be very resistant to TB. You need drugs right away. Or you are going to cure your own latent TB infection.’” Working with co-investigators like Alland and Ellner, as well as Sylvia Christakos, PhD, and Rodrigo Ribeiro Rodrigues, PhD (NDI, Vitoria, Brazil), she is also trying to understand the kind of immune system that provides this ultimate protection in order to make a better vaccine. “Our three big grants are addressing these questions. We won’t have answers tomorrow but it’s all fascinating.” ●

And the Winners Are… The four students chosen to receive funding for this first year of the NIH T32 grant are (left to right): Samuel Maldonado, Orchi Dutta, Courtney Veilleux, and Samantha Leong. Chosen from the Integrated Program in Infection, Immunity and Inflammation (I3) track at GSBS, Dutta and Veilleux are PhD students while Maldonado and Leong are studying for MD / PhDs. Already at work in the labs of their individual mentors, these students are thrilled to have this extra financial support for their research efforts.

K E I T H B . B R AT C H E R , J R .

Galdi Continued from page 21

(2008–2013). “I interviewed at several different programs,” he says. “I chose NJMS because I liked the mix of being in a city environment at a big academic hospital and Level I trauma center. I also liked that the residency at NJMS also allows students to go to other sites in the community, places like Hackensack and Overlook, so you get a feel for general bread-and-butter community orthopaedics. NJMS had a very good balance. It just felt like the perfect fit.” The NJMS residency taught a spirit of self-reliance, Galdi says. “Probably the best thing about residency was that it taught you to work hard and that you’re never too good for any one particular job. For example, if you needed an urgent X-ray, or you needed blood work done right away, you just did it yourself instead of relying on other people to do it. It taught you to be self-sufficient and, ultimately, to be able to do everything.” During the fourth year of his residency, Galdi was awarded the prestigious Charles Neer Fellowship in Shoulder, Elbow, and Sports Medicine at Columbia University. “I was fortunate to get that and it was a really great experience,” Galdi says. “I learned so much. We treated the Yankees too, which was a lot of fun.” Of course, the strictures of doctor-patient privilege prevent his discussing specifics, but Galdi can say several high-salaried starting players were treated in the office at Columbia for a “combination of various sports injury surgeries on the shoulder, elbow, and knee.” Returning to NJMS “was the easiest choice to make,” says Galdi. “I loved my time here as a resident, and always hoped I could come back here. I love teaching and being around residents, doing research, and having that access to academic medicine. I interviewed at several private practice jobs before I was offered this one, and as soon as they offered, I signed on the dotted line that day— it was an absolute no-brainer.” Among Galdi’s favorite surgeries are shoulder replacements. “You take somebody with a really bad arthritic shoulder, somebody who’s been living in severe pain for five years, with terrible, end-stage boneon-bone arthritis. You give them a new shoulder, and the day after surgery they say that bone-on-bone pain is gone. They are so happy with the outcomes.” He also enjoys ACL reconstructions “to help teenagers get back to soccer or basketball or football. It’s very fulfilling because so much of the time they do very well. I chose orthopaedic surgery because of my sports background. I wanted to treat athletes. I do a lot of that now, and it’s fun.” Galdi himself doesn’t get out on the tennis courts much these days. He and his wife have a fifteen-month-old daughter and a second child on the way. “As soon as I walk through the door, my second job starts,” he says, laughing. “It starts right away and it doesn’t end, ever. I still love to play tennis, and I do so as much as I can. But being a dad is my full-time hobby, and my second job.” ● RUTGERS NEW JERSEY MEDICAL SCHOOL

A: Photograph of the trigeminal nerve being compressed by the superior cerebellar artery.

B: A microvascular decompression has been performed where the offending artery has been mobilized away (decompressed) from the trigeminal nerve, held in place by a Teflon sponge.

Article reprinted by permission from Rutgers Today.

Easing Agonizing

By Dory Devlin

Facial Nerve Pain F

or more than a year, Surujdai Kalladeen suffered excruciating pain in her face that left her unable to work or do anything for long stretches of time. After seeking help from several doctors, including a neurologist who prescribed anti-seizure medication, she was exhausted from the side effects. Researching her symptoms, her son Mark thought she might be suffering from trigeminal neuralgia, a chronic pain condition that affects the trigeminal, or fifth cranial nerve, which provides sensation in the face and powers motor functions such as biting and chewing. “It’s sometimes called ‘suicidal pain syndrome’ because it’s so bad. It’s like you go crazy,” says Kalladeen, a Hillside resident. “It’s hard to explain it, but the feeling is, ‘I don’t want to live like this.’” The pain is caused by a blood vessel that pinches the trigeminal nerve, and as the blood vessel pulsates with every heartbeat, so does the pain. It occurs in about 12 per 100,000 people a year, mostly over age 50, though it can occur at any age. It’s more common in women than men. “Someone with this pain experiences a stabbing, electric shock in the face. There’s really no good long-term relief with medication,” says James Liu, MD, associate professor of neurological surgery at Rutgers New Jersey Medical School (NJMS) and director of the Center for Skull Base and Pituitary Surgery at Rutgers Neurological Institute of New Jersey. The road to diagnosis can be long and confusing. The pain is often mistaken for dental problems, and some patients have teeth removed before trigeminal neuralgia (also called tic douloureux ) is diagnosed, Liu says. The pulsating pain causes repetitive damage to the nerve, which intensifies the excruciating pain. The flashes of pain can be triggered by vibration or simply by brushing teeth, eating, drinking, talking, or being exposed to the wind. “I had one patient who came in and was just totally disheveled because she was depressed and embarrassed to be in public because of the pain,” Liu says. “She was afraid to open her mouth because the minute she began to talk, she would experience the shock.” Kalladeen’s worried son, then a Rutgers University–New Brunswick student, told his mom: “If you want me to finish college, you’ve got to do something.” In October 2014, Liu performed the procedure, called endoscopicassisted microvascular decompression. Making a small incision behind JOHN EMERSON

the ear in the skull, Liu uses a high-powered microscope and a highdefinition endoscope to look deep into the tiny structures at the base of the skull. “There’s a natural corridor we can go through without violating any of the brain and we can find the vessel, move the vessel away from the nerve, and then I put in a little cushion — a Teflon implant — that prevents the artery from pinching the nerve,” Liu explains. When Kalladeen awoke after the surgery, the pain was gone. “I didn’t feel pain and didn’t need medication anymore,” she says. Liu says of the 200 skull-base surgeries he performs a year, about 20 are microvascular decompressions. What’s unique about his approach is that by using the endoscope he is able to perform the procedure without using a brain retractor. The results: A majority — 95 percent— of patients experience facial pain relief without further medications, and no patients have experienced facial nerve weakness, hearing loss complications, or cerebrospinal fluid leakage. “We have a very high success rate with a low complication rate,” he said, and patients leave the hospital after an average two-day stay. A research paper authored by Liu on trigeminal neuralgia was published in Neurosurgery Clinics of North America in July and he presented his surgical outcomes at the Congress of Neurological Surgeons 2015 annual meeting. Liu became fascinated with the base of the skull early in his medical education. “This is where all of the critical, vital structures of the brain enter and exit to give function to everything,” he explains. “It allows us to move our eyes, to have sight, to chew on food, to speak.” Microvascular decompression is one of many skull-base surgeries Liu performs. He is among the few in the country who perform cerebrovascular bypass, a technically demanding procedure which brings additional blood flow to the brain by threading a healthy blood vessel within the scalp into the skull and connecting it to a blood vessel on the brain that’s in dire need of more blood flow. Liu also removes pituitary tumors through the nose via minimally invasive endoscopic endonasal surgery. Two years after the surgery, Kalladeen is continuing to work as a medical assistant in a medical practice without fear of debilitating facial pain. She watched her son graduate from Rutgers this year. “I do everything I want to do,” Kalladeen says. “Dr. Liu gave me a new life.” ● RUTGERS NEW JERSEY MEDICAL SCHOOL

“So when they see a patient in the office, at least they have some insight into what a patient’s life is like. It helps future doctors become doctors who treat the whole person.”

JOSEPH SCHWAB, MD, MPH

It takes getting to know the ‘whole child’… and having an excellent staff

Favorite Kids’ Docs Continued from page 15

It is this level of care that allows her to bond with her own patients, says Tanuos. “I don’t just get involved in the medical. I also get involved in their social and educational progress. When they go to college, I’m proud just like their parents. I have three children of my own, but I feel I have thousands here.” A native of Egypt who grew up in Jersey City, NJ, Tanuos advises her students to delve into their patients’ lives in a culturally sensitive way to discover: “What are the problems that affect their health? How can we help? Why did a patient not keep an appointment? How does the parent perceive his or her child’s illness? Did they understand what you told them about the illness?” These are the questions that help the aspiring doctors to be thorough and to become the kinds of physicians trusted by parents and their children. For those students and residents who take part in the H.E.A.L. collaborative, which combines law, medicine, and social work expertise to help children and their families, Tanuos encourages them to ride a city bus or spend a day at a welfare office with a client. 30

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or Joseph V. Schwab, MD, MPH, associate professor of pediatrics, getting to know the “whole child” means, getting to know them in the context of family, education, and friends. By looking at the overall health of a child, not just the physical, but also the emotional and intellectual health, only then do you treat the whole child. “I think when you approach it that way, you allow parents the time they need to express their concerns and then for the child to raise their own concerns. Parents appreciate the time we’re able to spend with them and the openness we have when answering all their questions.” Since his days as a medical student at NJMS, Schwab, who joined NJMS’s faculty in 1995, says he always enjoyed the developmental aspect of pediatrics which entailed “seeing the kids grow and learn.” While honored that he was singled out as a Favorite Kids’ Doc, he was especially happy to see that every other doctor in the practice received the distinction as well. “It really shows that it’s not just any one of us. It’s the norm for how we as a group see our practice. We’ve always tried to make this a practice that’s as much like a private practice for our patients as possible and not as a clinic.” The honor is one that he says the entire practice shares with the staff. “I don’t think that any nomination or award that we might get could happen without the patients feel-

ing comfortable and happy with their entire experience.” TOLGA TANELI, MD

It takes recognizing children as people with their own needs, hopes and demands

ike a docent in a museum who guides visitors through tours of ancient artifacts, sharing information, and providing them with perspective on what they are viewing, so too should doctors guide patients through their illnesses to give them greater insight into what ails them, says Tolga Taneli, MD, assistant professor of psychiatry and the director of the Division of Child and Adolescent Psychiatry at NJMS. “I think good doctors tend to have that kind of formulation to their work,” says Taneli. “They draw attention to things, give choices as opposed to making choices, and recognize that the child is part of that choice as well, so there’s buy-in.” A faculty member with NJMS since 2005, the child psychiatrist treats cases ranging from obsessive compulsive disorder and attention deficit hyperactivity disorder to mood disorders, autism, and Tourette syndrome. The son of psychiatrist parents who served as his professors while he was in medical school in Turkey, Taneli teaches students to understand that in a field like psychiatry, “You give and if you give it’s a great experience for patients…” As a training director, Taneli prides himself on giving future doctors “pearls of wisdom,” One of which is: “Don’t be in the business of taking away hope.” As a Favorite Kids’ Doc, Taneli says the honor represents the “highest order of recognition” because it comes directly from patients and their parents. “It’s lovely to be recognized in that manner. It’s worth more than any other accolade.” ●

ALUMNI FOCUS

news of special interest to njms and gsbs graduates

Message from the

Alumni Association President

PAUL BOLANOWSKI, MD’65 ALUMNI ASSOCIATION PRESIDENT

Dear fellow alumni,

lumni donations increased more than ten percent this past year. Thanks to your generosity the Association provided continued support to many student programs, including orientation, Career Night, Match Day and the Student Council, as well as our Scholarship Awards Dinner. While we remain focused on the many ways we can provide financial support and enhance the student experience, I would like to highlight other opportunities for alumni to make a difference and connect with the school. The Alumni Association is proud to support the annual Career Night, part of the Careers in Medicine program for secondyear medical students. At Career Night, students engage in informal discussions with physicians from different specialties. Every January and February the Alumni Association reaches out to faculty and alumni for ANDREW HANENBERG

volunteers for this event. If you are interested in participating please contact Dianne Mink or Emily Birkitt in the Alumni Office and they will register you for one of the sessions. The Student Family Health Care Center, our studentrun clinic, seeks volunteers to serve as attending physicians. Two nights per week students volunteer at the clinic, providing free basic health care services and screenings. If you are interested in volunteering or would like more information, please contact Dr. Michael Gerstmann (gerstmma@njms.rutgers. edu; 973-972-8219). You also might find the eight-week Pre-Medical Honors Program of interest. It is for high school students interested in pursuing careers in medicine or other health-related fields. Participants experience a medical school education as they attend physician-led lectures, seminars, and small group discussions. For more information, please visit http://njms.rutgers.edu/ education/pre-medical/info.cfm. Other volunteer opportunities include participation in the Clinical Observership Elective, offering students the chance to observe physicians at work. You can also serve as an admissions interviewer or speak at an admissions seminar, pursue a position as a volunteer faculty member, or give lectures to specialty student-interest groups. As president of the Alumni Association I encourage all alumni to become more involved. Let us lead by example and show future alumni the value of volunteerism. For information about any of these opportunities, please contact the Alumni Office at 973-972-6864. ●

Alumni share their experiences as physicians at Career Night.

Join the Alumni Association of

New Jersey Medical School General Membership

$75.00

Resident in Training

$15.00

Lifetime Membership

$1,000.00

Visit njms.rutgers.edu/alumni, click on Alumni and Alumni Association and then Online Membership Payment to pay your membership online. The Lifetime Membership is being offered to our alumni as a means to perpetuate the goals of the Alumni Association and enable its members to sustain their support in a more meaningful way. All categories of membership will afford you the opportunity to keep connected with us. You will continue to receive all membership benefits, including Pulse magazine, information about upcoming events and reunions, and on-site library privileges. Alumni Association of NJMS, 185 South Orange Avenue, MSB–B504, Newark, NJ 07101–1709. Photos are welcome. You can also send your news via e-mail to: njmsalum@njms.rutgers.edu or fax us at 973-972-2251.

RUTGERS NEW JERSEY MEDICAL SCHOOL

ALUMNI PROFILE

The Power of Mentoring BY TY BALDWIN

maida C. Velazquez, MD’91, can’t recall a time when she wasn’t focused on a career in medicine. “My dad worked for the Cuban Red Cross for many years,” she explains. “His work was similar to that of an EMT and he was involved with many life-and-death situations. Just hearing him talk about his job piqued my interest and I would try to get my hands on books on medicine.” Velazquez, who was recently named chair of the DeWitt Daughtry Family Department of Surgery at the University of Miami Miller School of Medicine, grew up in Pinar del Rio, Cuba, and emigrated to the U.S. with her family in the 1980 Mariel exodus. She arrived speaking no English, and to many people, including her parents, her dream of becoming a doctor seemed, if not farfetched, then maybe just a bit ambitious. “My parents were very supportive of schooling in general,” Velazquez says. “But they were a little skeptical in that it was a big challenge to come from another country, not knowing the language or the culture, and to begin schooling in the 10th grade with the goal of getting into medical school.” The family settled in Union City, NJ, and Velazquez enrolled at Union City High School, where she met “a wonderful teacher” named Nadia Makar. “Nadia was instrumental in pointing me in the right direction in so many ways,” Velazquez says. “Summer research programs, Head Start programs. Even just supporting the idea that I could go to medical school. Most people I interacted with had some doubts. But Nadia said, ‘If you love it, you can do it.’” Makar encouraged Velazquez to take extra science and math courses and to keep up with her English-language study. She also steered Velazquez to the Stevens Institute of Technology (where she took her undergraduate degree) and then to Rutgers New Jersey

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Medical School (NJMS), where Velazquez received a scholarship (and graduated valedictorian of her class). At NJMS, Velazquez worked in the lab of Michael Lea, PhD, on a project studying methylation changes in the genetic code that may influence cancer development. “I was the most junior, inexperienced person in the lab, but it was a great learning environment and a lot of fun,” she says. “Dr. Lea was an amazing mentor, and he ran his laboratory in a way that was very cohesive and conducive to collegial, interpersonal relationships. I really learned to appreciate biomedical research, and that’s still a part of my life and my career.” To this day, Velazquez says, she’s influenced by some of the philosophies Lea taught. “He used to emphasize the need to stay steady and to appreciate the little things in life. For instance, if there’s a science seminar and they happen to have food, well, enjoy the seminar and enjoy the food. Every blessing counts.” After finishing her MD at NJMS, Velazquez went on to do an internship, residency, research fellowship, and vascular surgery fellowship at the University of Pennsylvania. She joined the faculty at Penn in 1999 and served there until she was recruited to the University of Miami in 2007. Velazquez is one of the few women in the U.S. to hold a surgery chair, and she says that, today, her work is inspired by the unsolved clinical problems she encounters in her practice. “I’m a vascular surgeon by clinical training and specialty, and I see patients who have a problem with the circulation to their legs, or to other important organs. That disease is called peripheral vascular disease, and it’s one of the many manifestations of atherosclerosis, which is a thickening or an inflammation of the arteries. It’s the number one killer in the U.S. and the western world,

and it’s growing in Asia. My focus is on understanding the underlying mechanisms for atherosclerosis and how the body compensates to make new blood vessels to reroute around arterial blockages.” In her free time, Velazquez likes to read theoretical physics (she received the physics award at Stevens when she was an undergrad) and dystopian novels. And, when time permits, she travels with her family or goes to the beach. She and her husband (a pediatric anesthesiologist at Nicklaus Children’s Hospital) have two children: a son who recently graduated from Caltech started at Google in the fall, and a 9-year-old daughter who, Velazquez says, is very interested in science and medicine. “I’m hoping that she’ll fall in love with the profession,” she adds, “but we’ll have to see.” If pressed, Velazquez will concede that her success owes a good deal to perseverance and hard work, but she’s quick to add a note of thanks. “A great deal of what’s been possible for my life and my career is because of my family and friends, and the good luck of finding that guardian angel, or mentor, who pointed me in the right direction at the right time. Without those people in my life, I think it would have been very difficult, for anybody, no matter how motivated or hardworking.” ●

CLASS NOTES 1960s Robert Dolan, MD’69, published Death to Death, a book that examines the financial, ethical, emotional, and societal ramifications created by the death penalty and offers insight into alternative solutions. Marinos Petratos, MD’60, has served for years with the Veteran Corps of Artillery of the State of New York (VCASNY), a historic military command comprised mostly of veterans. Major Petratos served in Germany with the U.S. Army and NATO as a captain in the Medical Corps during the occupation of Germany after WWII. He serves as surgeon for the VCASNY with the rank of major.

1970s Rudolph Wagner, MD’78, appeared on CBS NY to introduce the new Flying Eye Hospital for ORBIS International, a nonprofit organization that fights blindness around the world. This third-generation Flying Eye Hospital is the world’s only mobile ophthalmic teaching hospital on board an MD-10 aircraft.

1990s Shondell Bouie, MD’98, is a partner in Pathology Medical Laboratories Diagnostics Services in Melbourne, FL. We wish to acknowledge Warren M. Klein, MD’72, whose name did not appear on the NJMS Honor Roll 2015–2016 as a generous donor to the Founder’s Club.

IN M EM O R I AM Arthur N. Hoagland, MD’65, of Florham Park passed away on September 18, 2016. He was born May 7, 1933, in Brooklyn, NY, and grew up in Cranford. After earning his medical degree from NJMS, he completed his residency at St. Michael’s Medical Center in Newark. He opened an internal medicine practice in Florham Park in 1969 and practiced until retiring in 1996. He was a devoted father of Nicholas M. Hoagland and his wife Regina of Florham Park, loving grandfather of Gloria Raquel Hoagland and brother of William E. Hoagland of Tufronboro, NH, and Annette L. Tyson Rockwell, TX.

Reynard J. McDonald, MD, passed away on August 27, 2016. Although not an alumnus, Dr. McDonald spent his entire career NJMS. After earning an MD degree from Meharry Medical College, he completed a fellowship in pulmonary medicine. Following

his service in the U.S. Army Medical Corps at Fitzsimons Army Hospital, CO, from 1971 to 1973, he joined the NJMS faculty. He became director of the Global TB Institute in 1994, a position he held until his retirement. Dr. McDonald’s lifelong dedication to training students and residents and treating tuberculosis, and his humanistic approach to patient care, did not go unrecognized. He earned many awards, including the Leonard Tow Humanism in Medicine Award, presented by the Arnold P. Gold Foundation, and a Lifetime Achievement Award from the Department of Medicine. The First Annual Reynard J. McDonald, MD, World TB Day Lecture was held in 2008. This annual event is endowed by a grateful patient to acknowledge Dr. McDonald’s compassion, empathy, and humanism. Dr. McDonald leaves a legacy of compassionate service to patients and great commitment to the study and treatment of TB.

Revolutionary for 250 Years In honor of Rutgers’ 250th Anniversary, Lionel Corporation has produced a limitededition, functional trolley motorized with bumper-controlled back-and-forth operation. Features include interior lighting, maintenance-free motor, traction tire, operating LED headlights, window silhouettes and two adjustable trolley poles on roof. The purchase supports NJMS student scholarships. To purchase the train, visit: http://250.rutgers. edu/shop.

Alumni Scholarship Awards The NJMS Alumni Association held its annual Scholarship Awards Dinner on October 26, awarding 122 medical students with scholarships totaling more than $200,000. We would like to thank all alumni and friends who have generously donated over the years. With your support, we can continue to award even more scholarships next year.

RUTGERS NEW JERSEY MEDICAL SCHOOL

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’Tis Equally Good to Give and to Receive BY GENENE W. MORRIS

Since 1979, the Alumni Association of Rutgers New Jersey Medical School has awarded more than $1 million in financial support to aspiring physicians. This fall alone, the association presented 122 deserving second-, third-, and fourthyear medical students with more than $205,000 in scholarships ranging from $1,000 to $5,300. Today, the association administers 54 Endowed Scholarships — which begin with a minimum donation of $50,000 — and 36 Founders’ Scholarships (formerly known as Named Scholarships) — which start with a minimum donation of $2,000. This is welcome assistance considering that medical school debt today totals an average of $180,000. Here is the story of an alum who answered the association’s appeal for help, and the scholarship recipient who is resolute in a desire to give back. We’ll include more such inspiring stories in future issues of Pulse.

Dennis O’Neill, MD’79/ Kiran Mahmood, MD’13

or Dennis O’Neill, MD’79, creating the Dennis Quinlan, Sr., MD Endowed Scholarship represented an opportunity to accomplish three things: 1. Thank the medical school for providing him a quality education. 2. Send a message to fellow alumni that they, too, should consider giving back to the school. And 3. Acknowledge Dennis Quinlan, Sr., MD’69, for excellence in teaching. “He’s the teacher you wanted to emulate,” says O’Neill, who was a student of Quinlan’s during an internal medicine rotation back in 1978. Describing Quinlan as demanding yet compassionate, O’Neill adds, “He stands out as a person who cared deeply for students and wanted us to learn and become good physicians. And he cared about the patients too. He was just the perfect physician.”

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An associate professor and deputy chairman in the Department of Medicine at NJMS, Quinlan also serves as chief of medical service at the Department of Veterans Affairs New Jersey Health Care System in East Orange, NJ. O’Neill ultimately moved to Manchester, CT, and became a pathologist. But all these years later, Quinlan’s influence is still very much a part of O’Neill. By providing students monetary assistance, O’Neill says the scholarship is a way of continuing Quinlan’s legacy of excellence in education. Continuing this legacy is Kiran Mahmood, MD’13, the 2011 recipient of the Quinlan scholarship, which was created in 2003. As the daughter of two physicians who valued their profession, Mahmood knew at an early age that she wanted to be a doctor. “I think medicine really allows you to work with other people and see the benefits right in front of you.”

Receiving the scholarship certainly offered welcome financial assistance, says Mahmood, who attended The College of New Jersey as part of the seven-year accelerated medical program. But, she adds, “Being recognized for doing well in medical school holds maybe a greater satisfaction.” Now a cardiology fellow at Thomas Jefferson University who recently completed her residency in internal medicine at Washington University in St. Louis, MO, Mahmood is gaining just as much satisfaction in giving. “In itself, giving is an accomplishment because it says you’ve made it through. You’re on the other side where people look up to you.” That alone, says O’Neill, is heartening. “To help students like Dr. Mahmood, who is now in a cardiology fellowship program, that’s really what it’s about: recognizing those who taught us and continuing to promote the education of those who come after us. We owe it to each other to ensure that we have good physicians taking care of patients in the future. We are all going to eventually become patients and we want to be taken care of by competent physicians.” ●

UNIVERSITY HOSPITAL THE PRINCIPAL TEACHING HOSPITAL FOR RUTGERS NEW JERSEY MEDICAL SCHOOL EXCELLENT MEDICINE. EXCELLENT CARE. UNIVERSITY HOSPITAL IS PROUD TO BE RANKED A TOP HOSPITAL IN NEW JERSEY AND TO RECEIVE SPECIAL RECOGNITION FOR THE TREATMENT OF n

Breast Cancer

n Congestive Heart Failure

n High Risk Pregnancy & Birth

n Pediatric Cancers

n Neurological Disorders

n Stroke

n Hip & Knee Replacement Surgery

n Coronary Artery Bypass Surgery

n Prostate Cancer

IN ADDITION, WE HAVE BEEN INDEPENDENTLY RECOGNIZED FOR EXCELLENCE By the American Heart Association/American Stroke Association for Performance Achievement for the treatment of Stroke and Heart Failure n By HealthGrades® with a 5-Star rating and its Neurosurgery Excellence Award n

In Trauma Care as northern New Jersey’s Level 1 Trauma Center

n As one of only two sites in the State for Liver Transplantation n For treatment of the deadliest form of Heart Attack by our

EMS, the only such recognition in the State

We’re very proud of this recognition and what it means for the care of our patients. It also means an exceptional opportunity for the education of the next generation of physicians in our role as the flagship teaching hospital for Rutgers New Jersey Medical School and the other schools of Rutgers Biomedical and Health Sciences. This partnership ensures highly trained professionals to meet the healthcare needs of New Jersey and beyond. For more information about University Hospital, please call us at 973-972-4300 or go to our website at: www.uhnj.org 1

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185 South Orange Avenue Newark, New Jersey 07103

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GROW THE

R EVOLUTION

New Jersey Medical Schoolâ&#x20AC;&#x2122;s outstanding neurosurgical team offers unparalleled care. They are highly experienced in using the latest technology and minimally invasive techniques to provide the most advanced and effective treatment plans.

LOOK TO INCREASE YOUR LEGACY IN MEDICINE Your Gift Planning Team Can Help Contact us for more information about naming New Jersey Medical School as a beneficiary of your estate plan, retirement account, or other financial instrument. If you have already included New Jersey Medical School in your will, trust, or estate plan, please let us know, as we would like to thank you and provide

CONTACT: BLAKELY SLATER, ASSOCIATE DIRECTOR

OFFICE OF GIFT PLANNING

peace of mind that your gift will be used exactly as you intend.

SUPPORT.RUTGERS.EDU/GIFTPLANNING (888)782-3666

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Pulse Magazine Fall 2016

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