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CONTENTS
The tragic loss of an Emory
stalwart: Dr. John Culbertson
Surgical resident balances
training in the U.S. with
socioeconomic activism in
Cameroon
Liver transplant survival rates
lower in black than white
pediatric patients
Multi-specialty studies put seed
grants to work for patients with
vascular disease
OMS resident to lead BMP
study
Faculty, staff, and resident
awards and achievements
Emory Bariatric Center receives
third ACS BSCN Accreditation
Welcome our new faculty
member: Dr. Susan Shafii
Call for abstracts: 13th Annual
Surgery Research
Symposium
Upcoming events
The tragic loss of an Emory stalwart: Dr. John
Culbertson
Dr. Culbertson (center) performing oncoplastic breast conserving surgery with surgical
oncologist Monica Rizzo (right) and former plastic surgery resident Wright Jones (left).
Dr. John "Jack" Culbertson, who joined the faculty of the Department of
Surgery of the Emory University School of Medicine in 1986, died on December
2, 2013, when the airplane he was piloting went down in North Georgia. The
circumstances surrounding the crash are still being investigated by the National
Transportation Safety Board.
Dr. Culbertson was an associate professor of surgery of the Division of Plastic
and Reconstructive Surgery and served as chief of plastic surgery at both
Emory University Hospital Midtown and Grady Memorial Hospital. He was a
member of multiple national societies, contributed to numerous publications and
textbooks, and lectured nationally and internationally.
Known for providing exceptional care to his patients, Dr. Culbertson would often
perform reconstructive procedures on children born with disfigurements that
seemingly had no solution. "He was always willing to handle the really difficult
problems that people frankly didn't know what to do with. That was Jack's
legacy," says Emory plastic surgery chief Dr. Grant Carlson.
Devoted to education and training for the next generation of plastic and
reconstructive surgeons, Dr. Culbertson mentored hundreds of plastic and
reconstructive surgery residents and was known for his genial and
unpretentious manner. "Dr. Culbertson insisted that we residents call him Jack
from the get-go,” says Emory plastic surgery resident Dr. Michael Golinko.
“’I've never met a faculty member with as humble, dedicated, and as pure a
spirit of joy and curiosity as he had. He had a vast knowledge of subjects both
inside and outside surgery. During an operation, he would seamlessly connect
the subtleties of ear reconstruction with some work he once did in Africa."
John Culbertson, 1951-2013
Dr. Albert Losken, program director of the Emory plastic surgery residency,
observed that Dr. Culbertson would take a resident to Shiprock Northern Navajo
Medical Center in New Mexico three times a year. He would spend a day
seeing patients and three more performing surgery. “Jack loved to help the
under-served,” Dr. Losken says. Dr. Culbertson received an Outstanding Health
Care Provider Award from the director of the Navajo Area Indian Health Service
in 1997.
Dr. Culbertson is survived by his wife, Elizabeth Culbertson; his mother, Grace
Culbertson of Morristown, N.J.; two daughters, Kirby Culbertson of Hartford,
Conn., and Katharine Culbertson of Atlanta; a son, John “Jake” Culbertson III of
Charleston, S.C.; and two sisters, Marian Burke of Watch Hill, R.I., and
Katharine Prentice of New York City.
The following is excerpted from the family-placed obituary that ran in the
Atlanta Journal Constitution on 12/5/2013:
"Jack was a teacher in all respects of life, sharing his knowledge and passion
for the world with his friends and family. He frequently spent time in the
outdoors and logged hundreds of hours flying to Maine and Telluride. His sense
of adventure was contagious to those closest to him, cultivating a wonder of the
world and a desire to see and learn from all experiences."
Surgical resident balances training in the U.S.
with socioeconomic activism in Cameroon
An image from the Foretia Foundation website that accompanied a post on the efforts
of the partnership platform Grow Africa to accelerate private sector investment for
sustainable growth in African agriculture.
Considering that he had just finished an all-night rotation at Grady Memorial
Hospital's trauma center, one could assume that Dr. Denis Foretia would have
rather gone to bed instead of talk on the phone. But as he spoke and the spirit
of his cause became clear, he didn't sound tired in the least.
Dr. Foretia's enthusiasm is fueled by dual but complementary drives. "When I
came to Emory, I wanted to be a thoracic surgeon, but I quickly began feeling
like something was missing. I talked to people like Dr. Keith Delman and Dr.
Daniel Miller, and they helped me realize that I needed to do international
work as well. I rebooted my educational plan and decided to split my passions
between general surgery and international health."
Denis Foretia
Following a two-year sabbatical dedicated to obtaining his MPH at Johns
Hopkins Bloomberg School of Public Health and his MBA at Hopkins' Carey
Business School, Dr. Foretia has returned to Emory for the 4th clinical year of
his general surgery residency. Simultaneously, he is also deep into the second
year of establishing the Denis & Lenora Foretia Foundation, a non-profit,
socioeconomic improvement organization co-chaired with his wife and based in
their native Cameroon in west Central Africa. Lenora Foretia has an MBA from
Georgia State University with a focus on business operation and strategies,
and has worked extensively for such corporate powerhouses as Exxon Mobil in
the UK.
The formation of the Foretia Foundation was inspired by a trip the couple took
through West Africa. They encountered various grass-roots, community-based
organizations that were working to remedy the same types of conditions that
exist in Cameroon: high inflation, unemployment, vast poverty, tribal conflicts,
insufficient healthcare, and infant and maternity mortality. "That's when we
realized that you didn't have to move mountains to make a difference, and the
idea for forming the foundation was born."
The mission of the Foretia Foundation is to catalyze Cameroon's economic
transformation through programs that foster social entrepreneurship, stimulate
advancements in science and technology, influence innovation, spearhead
public health initiatives, and implement progressive policies that make economic
opportunities accessible to all. "While Cameroon is our current focus, we hope
to expand to other African countries in the future," says Dr. Foretia.
The foundation's central office is located in Yaounde, Cameroon's capital, and
is staffed by seven full-time employees and several volunteers. The Foretias
currently coordinate foundation business from Atlanta, though they visit the
home office as often as possible. When Dr. Foretia completes his surgical
training, he plans to practice in the US and spend approximately three months
a year in Cameroon.
Currently, three of the foundation's various programs and partnerships have
priority in terms of immediately addressing the core impediments to Cameroon's
rejuvenation:
Nkafu Policy Institute: Planned as an economic policy think-tank, the institute
hopes to provide independent, comprehensive, and insightful policy
recommendations that advance the Cameroonian economy and, ideally, the
economies of other sub-Saharan countries.
Small Business and Entrepreneurship: Successful private sector businesses
are virtually non-existent in Cameroon. The Foretia Foundation plans to
become a small business resource by providing real-time information about
business opportunities, facilitating collaboration with financial backers,
improving access to market prospects, providing consultation and training
services, and generally promoting an environment that nurtures small business
growth.
Health Initiative: "Right now, the best medical and surgical care one can find
in Africa is from mission hospitals," Dr. Foretia says. "African hospitals should
also be providing excellent care." To help achieve this aim, the Health Initiative
will focus on childhood illnesses, food security, the critical human resource
shortage, and advocacy for innovative health policy strategies.
The Foretia Foundation will become fully operational when more volunteers
have enlisted. "We welcome experts in virtually anything; they just need to be
professionals with strengths and formal training that want to share their
knowledge. They can be from Emory, Atlanta, anywhere."
In March 2014, Dr. Foretia will be leaving the Atlanta campus for Emory's
Soddo Hospital rotation in Ethiopia, the centerpiece of the Department of
Surgery's Global Surgery Program. The rotation, directed by Dr. Jon Pollock,
allows residents to work alongside African doctors in a region where there is
limited healthcare available for a population of more than three-million people.
The hospital also partners with the Pan African Academy of Christian Surgeons
(PAACS) as a center for training national doctors over a five year surgical
residency program, the primary stipulation being that graduating residents must
agree to practice in-country for a period of five years.
"The PAACS agenda is almost identical to the Foretia Foundation's health
goals. The biggest impact I can have is to eventually open a foundationsponsored surgical center in Cameroon. It is important for folks like me who
understand the lay of the land, for those of us from Cameroon and Africa in
general, to return and use what we have learned to help our country. It is our
duty. "
For more information on the Denis & Lenora Foretia Foundation, please visit
www.foretiafoundation.org. Those interested in volunteering are encouraged to
contact [email protected].
Liver transplant survival rates lower in black than
white pediatric patients
“Racial and Socioeconomic Disparities in Pediatric and Young Adult Liver
Transplant Outcomes,” published in the December edition of Liver
Transplantation, describes racial and socioeconomic disparities among pediatric
liver transplant patients and graft and patient survival rates that were higher in
white children than minorities. The study is the first to investigate the impact of
race and socioeconomic status on graft and patient survival among white and
minority children.
Rachel Patzer
Emory transplant and epidemiology researcher Rachel Patzer, PhD, was
senior author of the study, and Rekha Thammana, MD, a second-year Emory
internal medicine resident in the primary care tract, was first author.
The researchers reviewed data from 208 pediatric and young adult patients,
aged 22 or younger, who received a liver transplant at Children’s Healthcare of
Atlanta between 1998 and 2008 and were followed through 2011. The team
looked at information on individual race, clinical, demographic, and
socioeconomic factors from hospital records, referrals to Georgia Transplant
Foundation, and United Network for Organ Sharing (UNOS) data.
Results showed that 51% of transplant recipients were white, 35% were black,
and 14% were other races or ethnicities. Graft and patient survival was higher
among whites vs. minorities at one, three, five, and 10 years post-transplant.
The 10-year graft survival was 84% for white, 60% among black, and 49% for
the remaining minority patients. Patient survival at 10 years post-transplant was
92%, 65%, and 76% among whites, blacks, and other races, respectively.
Further analyses show that graft failure and mortality rates remained higher
among minority groups compared to white children after accounting for
differences in demographic, clinical, and socioeconomic factors.
“It is unclear why these racial/ethnic disparities exist in this pediatric population,
and it is unknown whether these disparities are concentrated in the Southeast
or persist across the nation,” concluded Dr. Patzer. “Further investigation of the
reasons for racial and ethnic differences is necessary to identify interventions
that may help reduce disparities in pediatric liver transplantation.”
Multi-specialty studies put seed grants to work
for patients with vascular disease
Emory vascular surgeon-scientist Luke Brewster, MD, PhD, is collaborating
with other esteemed investigators at Emory and the Georgia Institute of
Technology on two vascular studies that underscore the benefits of multidisciplinary cooperation in research.
Luke Brewster
In an effort to avert premature onset of atherosclerosis in morbidly obese
adolescents, Dr. Brewster and a team of investigators from Emory (biomedical
engineer Hanjoong Jo, PhD), Emory/Children's Healthcare of Atlanta (pediatric
surgery division chief Mark Wulkan, MD, and Department of Pediatrics faculty
members Stephanie Walsh, MD, and Ritu Sachdeva, MD), and Georgia Tech
(Don Giddens, PhD, and Lucas Timmins, PhD) have obtained seed grant
funding from the Children's Healthcare of Atlanta (CHOA) Center for
Cardiovascular Biology to investigate the role of weight stabilization/weight loss
on arterial health in this vulnerable patient population.
This study seeks to identify changes in arterial function by non-invasive
ultrasound and blood sampling in adolescents who have stabilized their weight
or had significant weight loss, and will identify likely therapeutic targets that can
help promote vascular health and prevent premature cardiovascular disease.
"I want to credit Allan Kirk, MD, PhD, the Department of Surgery's vice chair of
research, for introducing this collaboration between Dr. Wulkan and myself,"
says Dr. Brewster. "Strong, collaborative groups investigating translational
science hold great promise for team growth and future funding."
In the second study, Dr. Brewster and his colleagues Ian Copland, PhD,
laboratory director of the Emory Personalized Immunotherapy Center, and
Todd McDevitt, PhD, director of the Stem Cell Engineering Center at Georgia
Tech, have received a second year of funding from the joint Emory/Georgia
Tech Regenerative Engineering Medicine Center (REM) to test a new cellular
delivery vehicle for the treatment of critical limb ischemia. The work will support
an Investigational New Drug (IND) Application to the FDA that will extend
promising cellular therapies for the prevention of amputation to patients with
critical limb ischemia at Emory. According to Dr. Brewster, "Our hope is to bring
forward a phase I clinical trial for at risk patients in the next 18 months."
This project utilizes a newly developed large animal model of critical limb
ischemia to test the safety, retention, and efficacy of autologous mesenchymal
stem cells delivered in a novel biogel. The goal is to promote cell retention and
viability in the challenging environment of ischemic limbs.
OMS resident to lead BMP study
Lisa Tran, DDS, MD, an Emory oral and maxillofacial surgery resident in the
first general surgery year of the program's integrated six-year MD/oral surgery
training track, has received a 2014-2015 research support award from the Oral
and Maxillofacial Surgery Foundation. The grant will fund "BMP Delivery
Strategies for Bone Defects in the Pediatric Patient." Dr. Tran's co-PIs for the
study are Robert Guldberg, PhD, director of the Institute for Bioengineering
and Bioscience, Georgia Institute of Technology, and Steven Roser, DMD, MD,
chief of the division of oral and maxillofacial surgery of the Emory Department
of Surgery.
Lisa Tran
Research support grants of the OMS Foundation are one-year awards that
allow oral and maxillofacial surgery trainees to serve as principal investigators,
with the stipulation that qualified oral and maxillofacial surgeons will be co-PIs.
The awards are also intended to further the development of experienced
scientific investigators who are committed to problems related to oral and
maxillofacial surgery, and to encourage promising lines of research and clinical
investigation.
Dr. Tran's study will focus on determining the safest and most effective levels
of bone morphogenetic protein (BMP) delivery in pediatric patients to regenerate
bone. Combinations of natural or synthetic scaffold delivery platforms, bone
grafting materials, and bioactive molecules such as BMPs are currently the
most common technology used to achieve advanced bone regeneration.
However, the use of BMPs, especially in higher doses, has been associated
with reports of heterotopic bone formation, increased inflammation, osteolysis
(dissolution of bone), and possible increased cancer risk.
"Presently, there is no data available on appropriate BMP doses in younger
people," says Dr. Tran. "We hope to develop advanced spatiotemporal delivery
strategies that use lower and therefore potentially safer doses of BMP to
effectively regenerate large bone defects resulting from injury, tumor resection,
or congenital deformity in pediatric patients."
Faculty, staff, and resident awards and
achievements
Lisa Carlson
Lisa Carlson, MPH, MCHES, director of academic
affairs for the Department of Surgery, was elected
executive board chair of the American Public Health
Association. The organization unites professionals from
all disciplines of public health to share ideas, promote
the latest research, and advocate for federal policy to
achieve progress in health for all communities. Ms.
Carlson has been a member of the APHA for 20 years,
since she was a MPH student at Emory.
"Although I am committed to the APHA for many reasons, the most important
is because the group is the voice for public health every day," she says. "A
central call to board members is to better APHA so that we can collectively
take action to meet our goal of creating the healthiest nation in one
generation."
Craig Coopersmith
Craig M. Coopersmith, MD, associate director of the
Emory Critical Care Center, has been elected to the
American Society for Clinical Investigation (ASCI), one
of the nation's oldest and most respected medical
honor societies. Membership in the ASCI requires an
outstanding record of scholarly achievement in
biomedical research. New members must be 45 years
of age or younger at the time of their election and have
achieved major accomplishments relatively early in
their careers.
Dr. Coopersmith has established himself as one of the top investigators of
sepsis and shock in the country. His current research activity includes an NIH
T32 training grant and two NIH R01 grants, one of which is a collaborative
study of the interplay between cancer and sepsis with Emory transplant
immunologist Mandy Ford, PhD.
Keith Delman, MD, surgical oncologist and program
director of the Emory general surgery residency, has
received the prestigious 2013 Shipley Award for
presentation of the best scientific paper at the annual
meeting of the Southern Surgical Association (SSA).
Recipients of the award must be within the first two
years of their membership in the SSA. Dr. Delman was
Keith Delman
the principal author and presenter at the meeting of
"Oncologic Outcomes after Videoscopic Inguinal
Lymphadenectomy for Stage III Melanoma."
The study was the first description by an academic medical center of
videoscopic inguinal lymphadenectomy (VIL) for melanoma. Data were
prospectively collected on all (40) VILs performed for melanoma from 20082012 at Emory and compared with a retrospective cohort of 40 open inguinal
lymphadenectomies from 2005-2012. Continuous variables were analyzed with
Student's t-test, binomial variables with chi-square, and survival curves using
log-rank comparison. The team concluded that VIL is associated with similar
oncologic outcomes compared to open surgery and markedly reduced wound
complications, and that the minimally invasive procedure may be the preferred
method for inguinal lymphadenectomy in melanoma.
Christopher Dente
Christopher Dente, MD, was named to the 2014
Woodruff Leadership Academy. Established in 2003,
the academy combines classroom sessions, off-site
team projects, and weekend retreats to motivate
professionals and managers within The Robert W.
Woodruff Health Sciences Center to develop, exercise,
and strengthen their leadership potential. Each year’s
class of fellows is an extraordinary group of
researchers, physicians, educators, and administrators.
Dr. Dente led the four-year process of developing and implementing the
massive transfusion protocol now in place at the level I trauma center of
Grady Memorial Hospital. He is currently PI of a DoD-funded pilot wound
closure study based at Grady, the first of its kind in the country at a civilian
medical center, and co-PI of the Grady-site of a multi-center trial studying the
effectiveness of ultrasound measurements of inferior vena cava dimensions in
gauging shock and response to resuscitation.
Rachel Medbery
Rachel Medbery, MD, a third-year clinical resident
who recently finished a two-year research sabbatical,
received the 2013 Hawley Seiler Residents Award for
her presentation of “VATS Lobectomy Cost Variability:
Implications for a Bundled Payment Era” at the
Southern Thoracic Surgical Association‘s 60th Annual
Meeting. Dr. Medbery was first author of the study and
Emory CT surgeon Felix Fernandez, MD, was senior
author.
In order to minimize the impact of the Centers for Medicare and Medicaid
Services’s recent Bundled Payments for Care Improvement Initiative, the study
team posited that surgeons must be able to predict which patients might be at
greater risk for more costly care so that bundled payments are in accordance
with those costs. As a model for adapting to this new system, the team
identified factors driving variability in hospital costs associated with videoassisted thoracic surgery (VATS) lobectomy for lung cancer by querying
Emory University Hospital’s STS data for all 149 patients that underwent
VATS lobectomy for lung cancer during fiscal years 2010-2011. After
compiling and interpreting this data, the team calculated an average overall
cost per patient as well as the additional costs per patient of various risk
factors and unplanned events. Dr. Medbery and her colleagues concluded that
multiple patient and perioperative factors independently affected the variability
of hospital costs for VATS lobectomy, and that knowing these variables was
necessary for surgeons to implement quality improvement initiatives and focus
resource utilization to reduce costs.
Emory Bariatric Center receives third ACS BSCN
Accreditation
The Bariatric Surgery Center Network of the American College of Surgeons
(ACS BSCN) has once again granted full approval to the Emory Bariatric
Center at Emory University Hospital Midtown as an ACS Level 1 Accredited
Bariatric Center. This third endorsement reaffirms that the center provides the
highest quality care for its patients.
Using the best available data in quality, ACS BSCN focuses on three key
principles for accreditation: a threshold volume of surgery, appropriate
equipment to care for the morbidly obese working in conjunction with a
multidisciplinary team, and the reporting of outcomes to a national registry.
The center's physicians include medical director Dr. Arvinpal Singh, surgical
director Dr. Edward Lin, and additional Emory surgeons Drs. S. Scott Davis,
Ankit Patel, Jahnavi Srinivasan, John Sweeney, and Mark Wulkan. In
addition to these extraordinary physicians, the success of the center has been
shaped by its staff: Stanley Chapman, PhD; Melinda Kane, MS-HCM;
Meagan Moyer, RD, LD; Deidra Sampson; and Dan Watkins, PA-C, MBA.
In April 2012, ACS and the American Society for Metabolic and Bariatric
Surgery (ASMBS) unified their respective accreditation programs and formed
the Metabolic and Bariatric Surgery Accreditation and Quality Improvement
Program (MBSAQIP). All existing ACS BSCN and ASMBS accredited centers
were then grandfathered into the unified program and began reporting their
outcomes data to the existing ACS Bariatric Data Registry Platform.
Multiple drafts of the MBSAQIP’s unified accreditation standards have been
worked through, and the final standards are expected to be announced in early
2014. During the transition phase, ACS BSCN-accredited centers and ASMBSaccredited centers are adhering to their respective, existing standards.
Welcome our new faculty member: Dr. Susan
Shafii
Division of Vascular Surgery and Endovascular Therapy
Susan Shafii
(Assistant Professor of Surgery) Susan Shafii, MD, received her MD in 2006 at
the University of South Florida College of Medicine, remained at USF to
complete her general surgery residency, and did her vascular surgery
fellowship at the Cleveland Clinic Foundation from 2011-2013. Her clinical
specialties are aortic disease, limb salvage, and venous disease, and her
research interests include aortic aneurysm and dissection in African-Americans.
Dr. Shafii will treat a wide range of vascular disease at The Emory Clinic, focus
on venous disease at the Emory Aesthetic Center at Paces, and treat vascular
trauma at Grady Memorial Hospital, where she will join Dr. Ravi Rajani,
director of Grady’s vascular and endovascular surgery program. She will also
assist in developing Grady’s vascular surgery service and see patients at
Grady’s vascular clinic.
Call for abstracts: 13th Annual Surgery Research
Symposium
The 13th installment of the Annual Surgery Research Symposium of the Emory
Department of Surgery will be held on April 17, 2014, and will showcase the
basic and clinical science work of the Department’s students, postdocs,
residents, and fellows.
All trainees in dedicated laboratory rotations should submit their research,
though the call for abstracts in both basic and clinical science categories is
open to all trainees. All submissions will be considered for both oral and poster
presentation. The submission deadline is midnight, January 16, 2014.
Since the symposium is not a national or regional meeting, previously
presented talks are admissible. However, previously published work must fall
within the past two years.
The highest scoring abstracts in each category will be selected for a 10 minute
oral presentation. Additional highly ranked abstracts will be allotted slots for
poster presentation. Cash awards for first and second place in oral
presentations in both clinical and basic science categories will be given, as well
as awards for the top poster in each category. All winners will be invited to
dinner with faculty immediately following the symposium.
Download the official symposium announcement for abstract and submission
requirements. Questions or concerns should be addressed to Griselda
McCorquodale at [email protected].
Upcoming events
EVENT
DATE/TIME
LOCATION
SURGICAL GRAND
7:00 - 8:00 a.m.,
ROUNDS
January 9, 2014
The Electronic Medical
Record: Are We Happy
Now?
Presented by Melissa DeVito,
MD
– Chief Resident, Department
of Surgery, Emory University
School of Medicine
EUH auditorium
SURGICAL GRAND
ROUNDS
Topic to be confirmed
Presented by Brian Kogon,
EUH auditorium
7:00 - 8:00 a.m.,
January 16, 2014
MD
– Associate Professor of
Surgery, Division of
Cardiothoracic Surgery,
Department of Surgery, Emory
University School of Medicine
– Associate Director,
Congenital Cardiac Surgery
Fellowship, Emory
– Surgical Director, Adult
Congenital Heart Disease
Program, Emory University
Hospital
– Chief, Pediatric Cardiac
Surgery, CHOA
The Martin Luther King, Jr. 4:00-7:00 p.m.,
Holiday Observance at
January 21, 2014
Emory University
Presenter:
Dr. C.T. Vivian
Activist, minister, author, and
recipient of the Presidential
Medal of Freedom, Dr. Vivian
is considered a living icon of
the Civil Rights Movement.
Winship Ballroom, 3rd
floor, Dobbs
University Center
EUH Perioperative Services 7:00 - 8:00 a.m.,
Performance Day
January 23, 2014
A quarterly review and
analysis of surgical services
performance among
anesthesia, surgery, and OR
staff of Emory University
Hospital.
EUH auditorium
A Cell Autonomous Loss of 12:00 - 1:00 p.m.,
Muscle Stem Cell Function January 28, 2014
during Aging
Presenter:
Dr. Bradley Olwin
– Professor, Department of
Biology, University of
Colorado
5052 Rollins
Research Center
SURGICAL GRAND
7:00 - 8:00 a.m.,
ROUNDS
January 30, 2014
Immortality, Immorality and
the Price of Progress
Presented by Jennifer Avise,
MD
– Chief Resident, Department
of Surgery, Emory
EUH auditorium