|Volume 29 Number 6||Stony Brook, NY||< June 2018 >|
Academic Research Evening
James P. Dilger, PhD
Our annual Peter S.A. Glass Academic Research Evening was held on May 8. As the Keynote Speaker, Dr. Michale Roizen, Chief Wellness Officer at the Cleveland Clinic, informed and entertained a large audience! He showed us historical trends for life expectancy and extrapolated them to a century and beyond. And, we'll be working for more years, too! Don't get too attached to the idea of a single career in your lifetime - two or three will become the norm. Of course, long, healthy lives are not going to simply come our way! We have to stay active, be careful about what we consume and pinch our pennies. He gave us a whirlwind tour of his Fab 8+2 system. I don't know about you, but it left me breathless. If you missed Dr. Roizen's talk or need a refresher, you can always check out his latest book AgeProof: Living Longer Without Running Out of Money or Breaking a Hip.
Ten Research Posters were selected to be presented in two Moderated Poster Discussions.
Basic Research Session
• Richard Keegan, PhD Candidate, Department of Neurobiology and Behavior. “Cellular Labeling of Endogenous Viral Replication (CLEVR) Reporter: A Novel method for Endogenous Retrovirus examination.”
• Yung-Heng Chang, PhD, Postdoctoral Fellow, Department of Anesthesiology. “Glial cells actively kill neurons via retrotransposon/ERV expression in a Drosophila model of Amyotrophic Lateral Sclerosis.”
• Yujie Huang, PhD, Department of Anesthesiology. “Distinct effects of propofol vs sevoflurane on post-surgical metastases are associated with the angiogenesis switch.”
• Sheed Itaman, PhD Candidate, Department of Neurobiology and Behavior. “NMDA receptor antagonist memantine induces de novo division of adult neural stem cells.”
• Rany Makaryus, MD, Assistant Professor, Department of Anesthesiology. “Multiple Neonatal anesthesia suppresses neuronal proliferation in adults rodent hippocampus.”
Clinical Research Session
• Igor Izrailtyan, MD, Associate Professor, Department of Anesthesiology. “Establishing a Comprehensive Perioperative TEE CQI Program in the Anesthesiology Department: An Initial Experience.”
• Justin Smith, MD, CA-3 Chief Resident, Department of Anesthesiology. “Enhanced Recovery After Surgery (ERAS) Program in Patients Undergoing Lumbar Fusion.”
• Ramon Abola, MD, Associate Professor, Department of Anesthesiology. “Randomized Controlled Trial of Sugammadex vs. Neostigmine for Reversal of Neuromuscular Blockade: Impact on Measures of Early Postoperative Strength.”
• Ramon Abola, MD, Associate Professor, Department of Anesthesiology. “Prospective assessment of a preoperative carbohydrate beverage as part of an enhanced recovery after surgery (ERAS) program for gynecological surgery.”
• Ethan Kim, MD, CA-3 Resident, Department of Anesthesiology. “Comparison of Plasma D-Dimer Levels after Cardiac vs. Non-Cardiac Surgery.”
Three travel awards were presented: Dr. Ramon Abola (Best Clinical Science Poster), Mr. Sheed Itaman (Best Basic Science Poster), and Dr. Justin Smith (Best Resident Presented Poster). We thank Dr. Peter Glass for funding these awards.
The poster session in the lobby featured 26 research projects performed in our department.We are grateful to the School of Medicine faculty members who judged the poster discussions. Thomas V. Bilfinger, MD, ScD, FACS, FACC, FCCP, Professor of Surgery, Department of Surgery; Hal Skopicki, MD, PhD, FACC, FAHA, FHFSA, FACP, Chief of Cardiology; Lina M. Obeid, MD, SUNY Distinguished Professor of Medicine; and Yusuf A. Hannun, MD, Director, Stony Brook Cancer Center.
• Abola R, Lian X, Zhang J, Adsumelli R, Romeiser J, Blaber J, Griffen T, Gan TJ, Bennett-Guerrero E. Evaluation of an Enhanced Recovery After Surgery (ERAS) Program for Minimally Invasive Gynecological Surgery.
• Achonu J, Ackermann A, Iftikhar H, Gurevich M, Uddin S, Komatsu D, Kaczocha M. A Rat Model of Total Knee Arthroplasty.
• Adamo S, Dilger JP, Figueiredo J. Acetylcholine and Nicotine Potentiate Currents in Cells Isolated from the Sea Anemone Nematostella vectensis.
• Amelchenko E, Castaneda RM, Osten P, Enikolopov G. Neuronal Activation Induced by Ketamine: Visualization Using High Throughput Whole-Brain Imaging.
• Brown A, Fleischer L, Richman D. 23 and You: How Genetics Can Impact Your Anesthetic and Your Life.
• Elmes MW, Deutsch DG, Kaczocha M. Fatty-Acid-Binding Proteins Regulate Phytocannabinoid Metabolism.
• Fischl A, Georges R, Hua B, Josma J, Khmara K, Kim E, Sharma A, Smith J, Weng M, Tito M, Steinberg E, Abola R. An Educational Video on Epidural Analgesia to increase Patient Satisfaction on the Labor and Delivery Unit.
• Georges R, Wang E, Schabel J. Synconvulsion in a Preeclamptic Patient.
• Gupta R, Romeiser J, Gan TJ. Enhanced Recovery after Surgery Program Shortens Hospital Length of Stay and Reduced Opioid Consumption in Colorectal Surgical Patients.
• Gupta R, Romeiser J, Gan TJ. Surgery Related to the Fasting Experiences Prior to and After Implementation of an Enhanced Recovery Pathway.
• Gupta R, Romeiser J, Rizwan S. Survey of ERAS Provider Practices Across North America and Europe.
• Lauzadis J, Yong L, Puopolo M. Role of T-type calcium channels in spontaneous firing of nociceptors following Spinal cord injury.
• Lauzadis J, Yong L, Puopolo M. Serotonin inhibition of transient receptor potential vanilloid type 1 (TRPV1) channels in dorsal root ganglia neurons.
• Li R, Huang Y, Liu H, Dilger JP, Lin J. Reducing Lung metastasis in a Tail Vein Injection Mouse Model by Combination Treatment of NSAID and β-blocker.
• Li R, Li M, Liu H, Huang Y, Dilger JP, Lin J. Comparing volatile and intravenous anesthetics in a syngeneic mouse model of breast cancer metastasis.
• Li R, Xiao C, Liu H, Huang Y, Dilger JP, Lin J. Effects of local anesthetics on breast cancer cells viability and migration.
• Liu H, Li R, Dilger JP, Lin J. Potential Effects of Lidocaine on Breast Cancer Cells: Role of Transient Receptor Potential Melastatin 7 (TRPM 7).
• Maloney LM, Yin W, Lu W-H, Frame MD, Chandran L, Fleit HB, Iuli RJ, Page CR. Early Collaborative Education of Undergraduate Biomedical Engineering and Medical Students in Medical Innovation.
• Ni S, Liu Y, Hua B, Schabel J. Ephedrine induced Myoclonus
• Palati S, Varghese E, Pentyala S, Monastero R, Mustahsan V, Hurst L, Pentyala S. Rapid Gout Detection Kit.
• Pentyala S, Komatsu D, Cappellino A, Udin S, Chitjian R, Savitt A, Anaganti S. Comparison of Calcitonin Receptor Fragment Peptide to Teriparatide for the Prevention of Ovariectomy-Induced Bone Loss.
• Peunova N, Mikhailik A, Michurina T. Tracheal Ciliated Cells’ Response to Anesthetics.
• Shanawaz MA, Mago S, Stekol A, Rebecchi MJ, Dilger JP. Glycine Receptor Oligomerization Characterized by Number and Brightness Analysis.
• Shih M-F, Davis FP, Chang Y-H, Henry GL, Dubnau J. RNA-seq profiling of Drosophila mushroom body subtypes.
• Thalappillil R, Scott B, Seifert F. Resource utilization, Postoperative mortality and morbidity in Octogenarians: Our experience 10 years later.
• Wetcher A, Bacon J, Azim S, Beg T. Pulmonary and Brain Fat Embolism Syndrome.
Special thanks go to Ms. Christine Fogarty for all of her efforts in organizing this Evening! Her able assistants were Sabeen Rizwan, Darcy Halper, Kentaro Sugimoto, Yong Lu, Keith Studholme, Jean Abbott, ShellyAnn Noriega and Joan Claeson.
View more photos from the event.
Srinivas Pentyala, PhD
It is with great pleasure that I inform you about our 15th Annual “Science And Research Awareness Series” (SARAS) that will take place in July (9-27). Our department started this summer program in 2004 with 21 students and 1 faculty member. It was an opportunity for students to learn about cutting edge technologies and novel findings in the field of Biomedical research. Interest in the program grew rapidly and now students from all over the country attend this 3-week program at Stony Brook Medicine. This year we have 128 students officially registered in the program and another 40 international students will join us for few sessions. More than 80 experts from clinical sciences, basic sciences, translational sciences, administration, law and business have volunteered to educate, excite and inspire the students. Please check out the program details by going to the SARAS website .
If you find any of the topics interesting (or never had a clue as to what these topics and clinical or research areas are), you are more than welcome to attend the program in Lecture Hall 5, Level 3, and in the Med Student Lab -161 on Level 2. This is “our” program being organized by “our department”, so drop by during the program and see what goes on in SARAS. Thanks for all your support in making this program one of the most sought-after summer programs in Biomedical Sciences.
Our “Clinical Skills’ workshop takes place on July 23 (Monday) from 1:30 PM to 4:00 PM in our Clinical Skills Center. Each year, several of our colleagues take time to help run this Workshop. Still, we desperately need additional experts to interact with SARAS students this year. If you (Faculty/Residents/Nursing and Nurse Anesthetist Staff) are interested (and are available on July 23), we welcome your help. WARNING: you will become an instant “ROCK STAR” and “ROLE MODEL” for these enthusiastic kids! If you are interested, please let me know.
Research News - Gout Detection Patent
Srinivas Pentyala, PhD
Gout is a type of arthritis that occurs when uric acid crystals accumulate in the joints. Polarized microscopy imaging of synovial fluid is performed in diagnostic labs to identify gout. This technique is expensive, time consuming and also requires trained technicians. Hence, we developed a novel point-of-care method and device that can detect uric acid crystals colorimetrically. A smart phone or a tablet with a portable microscope adapter takes images of the uric acid crystals and saves them to patient records. This novel gout detection method and kits can be used in office based physician practices and hospital settings to rapidly detect gout and aid the healthcare giver provide quality care immediately. Based on preliminary studies, a provisional patent application was filed with the US patent office in May 2017. After reviewing proof of concept studies, Stony Brook’s Office of Technology Licensing and Industry Relations (OTLIR) has converted the provisional application to a Patent Cooperation Treaty (PCT) International application on May 11, 2018 for protection of the intellectual property related to Rapid Gout detection in 152 countries worldwide. I will be giving a talk about this project on June 19 (see June Calendar).
Meeting News – SOAP
Ramon Abola, MD
This year, the annual SOAP (Society for Obstetric Anesthesia and Perinatology) was held in Miami, Florida. Our setting was the beachside Lowes Hotel on Miami Beach with 78 degree sunny skies. We were a short walk from South Beach and the Art-Deco Architectural district, which is unique to Miami.
SOAP was celebrating its 50th annual meeting. The first SOAP meeting was held in the Admiral’s Lounge at the Chicago O’Hare airport. There were six people in attendance who have become known as the “Chicago 6.” The meeting was 3 hours long and represents the birth of an anesthesia subspecialty. Richard Clarke, one of the original Chicago 6, accidentally became an obstetric anesthesiologist, as this was the only faculty position available for him at Arkansas, his home state. At the time, anesthesiologists were reluctant to go to the labor and delivery suite. Most cesarean sections were done under general anesthesia, and mothers were heavily sedated (narcotic-scopalamine) during labor. Anesthesia accounted for 3-10 percent of all maternal mortality.
This year’s distinguished service award was given to David Chestnut, perhaps best known for the excellent textbook – Chestnut’s Obstetric Anesthesia. A video tribute was presented which celebrated the life and work of Gertie Marx, the mother of obstetric anesthesia. A pamphlet was distributed at the 40th annual SOAP meeting which celebrates her life, SOAP, and other pioneers in obstetric anesthesia.
The keynote speak of the conference was Jerome Adams, the United States Surgeon General. Dr. Adams is an anesthesiologist and was previously the Indiana State Health Commissioner. Dr. Adams motto as surgeon general has been “Better health through better partnership.” He views his role as surgeon general as leading through science to promote better health for all Americans. His talk focused on the opioid epidemic that we are currently confronting. The recent surgeon general advisory recommends that more individuals should carry the naloxone for the reversal of opioid overdose. Other suggestions included evaluating our opioid prescription practices and creating opioid take back programs for patients. Dr. Adams challenged all in attendance to become part of the solution to the opioid crisis.
An interesting study found that patients reported similar rates of pain control whether they were prescribed a standard 30 oxycodone pills after c/section or a personalized amount (average 20) based on inpatient use. Patients took on average 2/3 of their opioids prescriptions after c/section regardless of how much they were prescribed. Almost no patients properly discarded of their left over opioids after surgery.
Maternal mortality in increasing over the past 15 years in the United States, and the US has a higher maternal mortality rate compared to other industrialized nations. Cardiovascular disease is the leading cause of maternal mortality. Two patient populations with high rates of mortality are mothers with prosthetic valves and mothers with congenital heart defects. Prosthetic valve patients pose the challenge of balancing the risk of anticoagulation, postpartum hemorrhage, and risk of thrombosis off anticoagulation. Many patients who had congenital heart defects corrected in the 1980s and 1990s are now reaching childbearing age and optimal management needs to consider where to delivery (cardiac OR vs L&D), how to delivery (C/section vs vaginal), what anesthesia to use (GA vs epidural) and what are the specific hemodynamic goals for each patient.
Postpartum hemorrhage continues to be a leading cause of maternal mortality. Tranexamic acid should be considered as an adjuvant therapy during postpartum hemorrhage. The WOMAN trial randomized 20,000 women in low resource countries and found decreased risk of death from hemorrhage with 1g of tranexamic acid versus placebo in the setting of postpartum hemorrhage. Thromboelastrogram represents a point of care tool that can identify coagulopathy or fibrinolysis and guide transfusion therapy in the setting of hemorrhage. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is another technique that can be used in the setting of massive hemorrhage. Dr. Daryn Moller stated that vascular surgery could provide similar services currently here at Stony Brook Medicine.
There were several presentations concerning ERAS after c/section. The institutions that have implemented ERAS programs emphasized the importance of collaboration between the many medical services that are involved in childbirth including obstetrics, anesthesia, midwives, nursing, pediatrics, social work, and lactation consultants. It was identified that patient education represented an easy area to improve care: detailing what to expect on the day of c/section and what to expect in the postpartum period.
We had good representation from the department at SOAP this year: Drs. Joy Schabel, Tracie Saunders, Ana Costa, Michelle Delemos and myself. We even saw our former resident, Dr. Aylin Gonzalez at SOAP, who works close by in South Florida. We are expecting a new update to the SOAP website with resources for patients and clinicians. Please consider becoming a SOAP member if you are not one already. Next year’s meeting will be in Phoenix.
Synaptic CommunicationJames P. Dilger, PhD
When I last wrote about Sarah Adamo April issue of SleepTalker, she had just blown away the competition at the New York State Science and Engineering Fair. Sarah has been working in my lab since last summer when she performed the first patch clamp recordings on cells from the sea anemone Nematostella vectensis. In May, Sarah and her teacher Dr. Joanne Figueiredo traveled to Pittsburgh for ISEF, the International Science and Engineering Fair (May 13-18). Well, Sarah did it again! She scored a First Award in the Animal Sciences category for her project "Acetylcholine and Nicotine Potentiate Currents in Cells Isolated from Sea Anemone Nematostella vectensis"! In addition, Sarah won two special awards. The First Award from the American Physiological Society. And an award from the China Association for Science and Technology. Wow!
I am always awed by the accomplishments of high school students who have worked with me, but Sarah is quite special. She took on a project that she knew might not lead to a guaranteed success. She had to find a way to isolate cells from the animals that could be studied with patch clamp electrophysiology. She had to hope that the cells she isolated contained some currents worth studying. And, she had to hope that these currents were modified by nicotine - a hypothesis that arose from her behavioral studies on the anemones during the previous summer. As is usually the case in science, hard work, a bit of luck, and more hard work are required. Sarah was certainly up to the task! Sarah will attend Northeastern University in the fall, where she will major in Biomedical Engineering. Congratulations Sarah!!
Sheena Mago, who worked with Mario Rebecchi and me as a Stony Brook undergraduate, just graduated from New York College of Osteopathic Medicine (NYCOM) at NYIT! She will be pursuing an Internal Medicine residency at the University of Connecticut. Congratulations Dr. Mago!
Where on Campus is That?James P. Dilger, PhD
Monthly Muscle Chillaxant
SleepTalker, the Stony Brook Anesthesiology Newsletter is published by the Department of Anesthesiology
Stony Brook Medicine, Stony Brook, NY
Tong Joo Gan, M.D., M.H.S., F.R.C.A., M.B.A., Chairman
Editorial Board: James P. Dilger, Ph.D.; Stephen A. Vitkun, M.D., M.B.A., Ph.D.; Marisa Barone-Citrano, M.A.; Richard Tenure, M.D.