Division of Infectious Diseases

Can Social Media Revolutionize Academic Medicine?

As we approach our first anniversary in the blogosphere, it was fitting that our very own Dr. Kelly Cawcutt was invited to write a commentary on  a recent publication in the journal Infection Control & Hospital Epidemiology that explored the use of Twitter messaging at four major Infectious Diseases/Infection Control conferences worldwide.

Dr. Cawcutt’s commentary, entitled Twitter Me This—Can Social Media Revolutionize Academic Medicine? was published in December 2017 in Infection Control & Hospital Epidemiology.   The articles reviewed the influence of Twitter on increasing public engagement in academic conferences, particularly in spreading the reach and impact of the conferences beyond just the attendees.

Our @unmc_id twitter account went live last fall at #IDweek2017, and we’ve been having a ball tweeting and retweeting. We were very active in the #USAAW2017 for the #beantibioticsaware campaign, and plan to continue ramping up our online presence.

Gone are the days where acquisition of medical knowledge was limited to hard copy journals, and if you missed a conference you missed the action altogether.  Today, in the era of online access journals, Twitter, Facebook and podcasts, we can be at every conference, anywhere in the world;  stay updated on current hot topics, and use hashtags to connect with others who have similar interests.

So can Social Media revolutionize Academic Medicine?

YES.

It’s time to join the revolution of #unmcid. Follow us on Twitter @unmc_id, and subscribe to our blog for more updates!


 

Dr. Marcelin on “Why I Love ID”

Why I Love ID:

“The patients I encounter as an Infectious Diseases specialist are so fascinating. Because we are interested in all aspects of a patient’s history, ID docs get to learn some cool things from their patients. I once had a patient who trained animals for show competitions, and another who taught me how to polka! I love the fact that we still get opportunities to build lasting relationships as we journey with patients, but also have the ability to truly cure disease through antibiotics. Finally, I love ID because it is a routine part of our day to be educators (of patients, trainees, nurses, etc), and the best way to fall in love with something more is to talk about it all the time!”

– Dr. Marcelin

See more about Dr. Marcelin and the UNMC ID Division here.


 

Erin Van Surksum, PA on “Why I Love ID”

Why I Love ID – 

“I love ID because it is never boring. There are so many microorganisms that can cause infection, so many medications we can use to treat, so many side effects to monitor, and so many factors that play a role in patient’s developing these infections. No wonder there are so many sub-specialties within ID!”

-Erin Van Surksum, PA with Transplant Infectious Diseases

See more about UNMC ID here.


 

UNMC ID Division Retirement Announcement

The UNMC Division of Infectious Diseases extends our best wishes to Elaine Litton, who retired from the University on January 5th. Elaine has been valued member of the Division of Infectious Diseases with 13 years of service as our Division Administrative Assistant.

The Division hosted a Retirement Tea for Elaine on January 5th 2018. It was well attended as several came to celebrate Elaine’s service and wish her well as she begins this new chapter in her life.

Good luck Elaine, thank you for your service!


 

Effect of variations in clinical practice on blood culture volumes

Blood cultures obtained from central venous catheters (CVC) contain a significantly greater volume of blood than those obtained via peripheral venipuncture.  This is the main finding from a study recently published by investigators at the University of Nebraska Medical Center (UNMC) (Jones RL, Syles HR, Fey PD and Rupp ME).  “Effect of Clinical Variables on the Volume of Blood Collected for Blood Cultures in an Adult Patient Population”, Infection Control Hospital Epidemiology, 2017, available at: http://dx.doi.org/10.1017/ice.2017.230.

The study involved measuring the volume of blood collected on a representative population, extracting clinical data from the electronic medical record, and then performing linear model analysis to determine clinical variables that influenced volume recovery.  Although the conclusion that CVC drawn blood cultures contain a greater volume may seem insignificant, it has profound implications for patient care.  The sensitivity of blood cultures is highly volume dependent with a decreased yield of approximately 3-4% for each milliliter the blood culture is “shorted”.  It was observed that CVC drawn blood cultures contained on average 2.5mL more blood than peripheral drawn cultures, which would equate to an 8.4% decrease in sensitivity – or missing approximately 220 bacteremic patients per year at our institution.  Undoubtedly, this phenomena is active at other medical centers.

In addition, the difference in blood volume between CVC-drawn and peripheral-drawn cultures can also impact the ability to correctly diagnose CVC-associated blood stream infection if the “differential time to positivity” test is used to discern whether the CVC is the source of bacteremia.

The take home message- small variations in clinical practice can have a big effect on our diagnostic tests and our care of patients.

It should be noted that this important study was led by a UNMC medical student- Logan Jones, who is now pursuing Internal Medicine training at the Oregon Health Science Center.  Congratulations to Logan on a job well done!  We hope his interest in ID will continue to grow and who knows – maybe we’ll see him back for ID Fellowship.

Content courtesy Dr. Mark Rupp

Policies, Principles and Pragmatism: Are We Following Evidence or Emotion Regarding Infection Control in the OR

In this recent invited article in Clinical Infectious Diseases, our surgical colleagues highlight the ongoing debate regarding what surgical attire should be worn in the operating room.  Highlighted issues are what type of hats should be donned, including those noted in the picture of skullcap versus bouffant, whether or not scrubs are safer or more likely to spread bacteria (hence the title catch phrase of ‘Naked Surgeons?’), the value of protective eye wear and the discordant recommendations of the different organizations regarding whether arms should be bare or covered. Many of our current practices are be based on written guidelines and regulations, which may not have a robust evidence base.

The thought provoking, non-systematic review of the literature, does raise the question of whether we are truly making recommendations and hospital policies that are actually evidence-based and yet practical, or if we are responding more so to the emotional attachment to tradition, our perceptions of risk that may be unproven, our believed principles of how infection is likely spread in the OR and the ease of not shifting patient expectations.

Perhaps it is time to reconsider the how and why of what we implement in Infection Control – and how we can truly improve to practical, evidence-based, regulations, guidelines and effective, infection control programs.

ID Administrator completes MBA degree as Distinguished Graduate

The University of Nebraska Medical Center Division of Infectious Diseases would like to congratulate our Division Administrator Jonathan Nguyen who recently successfully completed his MBA program at University of Nebraska.

In recognition of his hard work,  Jon was singled out for honors by being selected as the Distinguished Graduate of his class by the business school faculty.

Congratulations on a terrific achievement Jon! Also, congratulations to Jon’s family who have had to sacrifice while Jon completed coursework and various projects.

We look forward to the application of Jon’s newly acquired skills and knowledge in the management of the ID Division.

Content courtesy Dr. Mark Rupp MD, Infectious Diseases Division Chief

Nebraska AIDS Projects’ Night of A Thousand Stars – Under the City Lights: A Gala with a Mission

As December, and our HIV awareness posts come to an end, we want to celebrate one of Nebraska Medicine’s partners that works closely with our Specialty Care Center to provide HIV care, and creates inclusive and safe spaces for diverse communities across Nebraska.

The Nebraska AIDS Project (NAP) is a non-profit organization established in 1984 in response to the early AIDS crisis when less was known about HIV and AIDS and there were fewer treatment options. NAP serves the entire state of Nebraska with offices in Omaha, Lincoln, Norfolk, Kearney, and Scottsbluff, reaching approximately 350-400 people living with HIV at any given time in Case Management and Supportive Services (social support, financial assistance, linkage to care and treatment). NAP also provides free and confidential testing across the state of Nebraska, performing approximately 2,000 tests annually and provides free access to condoms and safe sex counseling.

On Saturday December 2, 2017, the Nebraska AIDS Project put on a gala with a mission: The Night of a Thousand Stars.  This is an annual event targeted to raise around $100k to support the programs of the Nebraska AIDS Project. The Stars gala has raised over two million dollars since the fundraiser began in 1998, and on December 2, in 2017, they raised $86,000 for their programs.

Every year NAP recognizes individuals in the community who have publicly demonstrated dedication to serving the community. This year’s Shining Star Award Winners at Stars were Brenda Council and Dr. Jay Irwin and the honorary chair was State Senator Adam Morfeld.

  • Brenda Council was on the original NAP board, and has served on the Omaha Public School Board, on the Omaha City Council, in the Nebraska Legislature, and nearly became the mayor of Omaha TWICE in 1994 and then again in 1997, losing by a narrow margin both times. More recently, she drives the Adolescent Health Project (AHP) effort for Douglas County and she continues to perform public service in a number of different ways, most passionately linked to reducing unplanned and/or unwanted teen pregnancies. Her role as the AHP Program Director enables her to work on teen pregnancy AND reduction of STI’s among young adults as well.
  • Jay Irwin is a well-respected community member who represents inclusion of all types of identities within his primary role as a professor at UNO, but also as an elected member to Ralston’s Public School board. Jay has a unique tie to an audience of young folx in our community (“folx” is a term that refers to a generic group but with intentional inclusion of non-binary people, similar to “Latinx”).  Young folx are a demographic targeted by NAP for education/testing services and NAP embraces the active voices in the community that speak to this audience. Jay was the first openly-trans man to be elected to a publicly held office in the state of Nebraska (elected to RPS school board in 2016) and is also a part of the Midlands Sexual Health Research Collaborative.
  • State Senator Adam Morfeld was this year’s Night of a Thousand Stars honorary chair– similarly selected by overall values and initiatives that are in line with the NAP mission, Adam is continually pushing social justice issues in the unicam and is the acting Executive Director of Nebraskans for Civic Reform (NCR).

Nebraska AIDS project would like to thank Nebraska Medicine, one of the Night Under The Stars’ Gold sponsors, and all sponsors who contributed to making this event a success.

Content provided by London Woolman, Interim Executive Director, Nebraska AIDS Project

 

Faculty and Staff of the UNMC/Nebraska Medicine Specialty Care Center at the Night of A Thousand Stars Gala Event on December 2, 2017

Photo courtesy Justin Barnes and Nebraska AIDS Project

Research in HIV Medicine…charting a path to longer lives and ending HIV transmission

Research has long been an important part of the mission of the HIV Team at UNMC’s Specialty Care Center For many years, clinic patients clinic have had the opportunity to take part in a variety of projects including interventional treatment for HIV, the study of comorbid conditions and opportunistic infections, and trials targeted towards HIV prevention.

Currently, our team has patients enrolled in eleven active studies:

  • Five trials currently involve providing innovative treatment for HIV through long-acting injectable medications given either every four or every eight weeks.
  • The addition of pharmacists to our staff has enabled us to initiate pharmacist-led studies, including prevention of HIV through pre-exposure prophylaxis (PrEP), increasing medication adherence by using telehealth services in rural areas, and the study of pharmacokinetics in transgender women receiving both PrEP and feminizing hormone therapy.
  • Teaming with the UNMC Department of Pharmacology and Experimental Neuroscience, we are examining the brain basis of HIV-associated neurocognitive disorder using MEG and MRI technology coupled with neuropsychological evaluation. An extension of this study involves looking at marijuana consumption and its effects on the brain in those living with HIV infection.
  • Working with the AIDS Clinical Trial Group of the NIH, the REPRIEVE study looks at using pitavastatin as a medication to prevent cardiovascular events in people living with HIV who are otherwise not at high risk for cardiac disease.

We feel fortunate to be a part of an institution that supports research and gives our patients the chance to be a part of the most up-to-date science in HIV care.

 

For more information about ongoing research studies at the HIV Clinic, contact Maureen Kubat, RN, BSN at mo.kubat@unmc.edu or Jen O’Neill, RN, BSN at jloneill@unmc.edu

Content courtesy Mo Kubat and Jen O’Neill

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