A local pediatric optometrist wants to make sure that your back-to-school lists include more than notebooks, markers and glue.

A successful school year begins with good vision by having a comprehensive eye exam, which is one reason that August is Children’s Eye Health and Safety Month, said Dr. Nahrain Shasteen who is on staff with Vision Associates, which serves as The University of Toledo’s Department of Ophthalmology.

“If your child has never had a comprehensive eye exam, it is a good idea to schedule one to make sure everything is developing well,” Shasteen said. “Blurred vision can make it difficult to see the board in school. Eye coordination, eye focusing or visual perception problems can also impact learning.”

The American Optometric Association actually recommends that a child have his or her eyes examined at 6 months of age because vision development is rapid within the first year of life, Shasteen said. If normal, the next exam should be at 3 years old and then every year once a child is in kindergarten.

Dr. Nahrain Shasteen

The importance of early detection was recently popularized with a YouTube video that showed 10-month-old Piper seeing clearly for the first time with her new eyeglasses.

“She was a patient of the InfantSee® Program, which I participate in,” Shasteen said. “Doctors participating in the American Optometric Association’s InfantSee® program provide no-cost eye examinations to infants between 6 and 12 months of age.”

Shasteen said children with vision problems can’t often communicate the issue. They might not know what normal vision looks like or they want to please their parents so, when quizzed, they indicate they can see something far away.

Signs that a child might be struggling to see include red eyes, tearing eyes or squinting. More subtle clues are tilting or turning of the head, covering an eye, having difficulty paying attention in class, loss of place when reading or avoiding reading all together. Some children with vision problems have difficulty with eye-hand-body coordination and playing sports.

Shasteen said even if a child has good vision, the health of the eye needs to be protected. She recommends wearing sports goggles, which is not often emphasized in a school setting, and for parents to set a good example by wearing protective gear when mowing the lawn or working on home improvement projects. Sunglasses should be worn outside to prevent damage from ultraviolet light.

“Children learn best by what their parents are doing,” she said.

While it’s a myth that carrots will improve eyesight, Shasteen said an overall healthy diet is good for eye health because it prevents diabetes and other diseases that affect eyesight.

“As for video games, they are OK in moderation,” she said. “We actually found that video games used in vision therapy have a positive impact in improving lazy eye and other vision disorders.”

To schedule an interview, contact Brandi Barhite at 419.383.5376 or brandi.barhite@utoledo.edu.

Media Coverage
FOX Toledo (Aug. 14, 2015)
WTOL 11 (Aug. 14, 2015)

The University of Toledo Medical Center is now offering medication that could prevent a person from contracting HIV.

Multiple studies have demonstrated the effectiveness of taking pre-exposure prophylaxis (PrEP) for patients at risk for HIV infection through use of daily medication (emtricitabine/tenofovir). Patients can be evaluated at the Ryan White PrEP Clinic from 8 a.m. to noon every Thursday on the Health Science Campus.

Dr. Joan Duggan

“This is a very important part of HIV prevention,” said Dr. Joan Duggan, chief of infectious diseases at UTMC. “PrEP is highly recommended for people at risk for HIV, including people who are intimate with a partner who has HIV and men who are having sex with men. PrEP has also been proven to prevent HIV infection in injection drug users.”

Duggan compared the concept to women taking a daily birth control pill to prevent unplanned pregnancies. Just like birth control, though, nothing is a prevention guarantee, which is why UTMC also distributes condoms with all of its informational packets about PrEP.

“While use of the PrEP medication does decrease the risk of HIV, it does not eliminate the recommendation to use condoms to decrease the risk of HIV and it does not provide protection against any other sexually transmitted diseases or unplanned pregnancy,” Duggan said.

People might be concerned that PrEP could cause high-risk sexual behaviors, but studies show that isn’t the case, according to Dr. David Grossman, commissioner of the Toledo-Lucas County Health Department, which has been referring its patients who are at risk of getting HIV to UTMC for PrEP.

Grossman said a two-year study showed no increase in sexually transmitted diseases for the 545 participants, which indicates that the participants did not have more unprotected sex because they knew they were protected by PrEP.

“We have a good audience and hope we can refer a lot of people,” Grossman said. “We have people who come in for repeated HIV testing and we want to make sure they know about this option.”

Duggan said the medication is expensive, but some insurance companies do cover it and the staff at the Ryan White Program can direct uninsured patients toward programs that offer financial help.

“Offering this medication is the right thing to do and it is something that will go a long way in the war against AIDS,” Duggan said.

Media Coverage
NBC 24 (Aug. 3, 2015)
The Blade (Aug. 4, 2015)
WTOL 11 (Aug. 4, 2015)
WTOL 11 and FOX Toledo (Aug. 4, 2015)
The Independent Collegian (Aug. 19, 2015)

A new state law giving easier access to the overdose reversal drug Naloxone will result in more lives saved, according to a University of Toledo pharmacy professor.

“It is definitely a proactive and positive move. This provides a new avenue to access a life-saving drug,” said Anthony Pattin, UT assistant professor of pharmacy practice. “With this new law, people can get Naloxone without having to get a doctor’s note or finding distribution centers, which are not widely available. This is potentially life-saving because people will have the antidote nearby in case of an overdose instead of waiting for an EMT to arrive and administer it.”

Anthony Pattin

House Bill 4, signed into law by Gov. John Kasich this month, authorizes a pharmacist or pharmacy intern to dispense Naloxone without a prescription as long as counseling and written education is provided. Opioids can slow or stop a person’s breathing. Naloxone helps the person wake up and continue breathing.

This law comes as the number of opiate-related deaths from prescription drugs and heroin in Ohio continue to climb; since 2000, there has been a 366 percent increase, Pattin said, making it the leading cause of accidental deaths in the state.

This new law will allow for a family member or a friend to get Naloxone for a loved one.

“People should always call 911 in conjunction with taking the antidote, but taking Naloxone as soon as an overdose is suspected is key for survival,” he said.

Despite concerns that making Naloxone more readily available will lead to more drug abuse, Pattin said pilot programs showed that did not occur. Also, Naloxone is safe if taken by someone who is not overdosing.

“This provides opportunities for pharmacists to offer a new service and show our value to health care,” Pattin said. “We have to provide counseling about opiate abuse when someone comes in for this antidote. They just don’t get it and leave.”

To schedule an interview, contact Brandi Barhite at 419.383.5376 or brandi.barhite@utoledo.edu.

Media Coverage
FOX Toledo (Aug. 3, 2015)

Many people dread getting a colonoscopy. They avoid it. They put it off. They say, “Maybe next year.”

Dr. Arun Baskara, UT assistant professor of surgery, will try to persuade those people that avoiding a colonoscopy could be a bad idea when he talks about colon cancer at 6 p.m. Thursday, July 16 in the Eleanor N. Dana Cancer Center.

The free, public lecture is part of the Tie One On Awareness Lecture Series hosted by UT Health’s Eleanor N. Dana Cancer Center.

Dr. Arun Baskara

“The most important point I am going to make is that prevention is better than trying to treat colon cancer,” he said. “People should get their colonoscopy at age 50 if they don’t have any family history. If colon cancer runs in the family, the screening may change based on what age the family member had colon cancer.

“I want to create an awareness in the community about colon cancer,” Baskara said. “It is common cancer that we come across in the community. If we can catch it at an early stage, the prognosis is good.”

Baskara understands that people can be scared or possibly embarrassed about getting a colonoscopy, so he talks to his patients about the fear and reassures them about the procedure.

“I make sure that my patients are asleep so they don’t feel or remember anything,” he said.

But the benefits of a colonoscopy should outweigh any trepidation on the patient’s part, he said.

“Certain cancers behave in a certain way, whether it is in the right side of the colon or left side of the colon,” Baskara said. “Some patients will have symptoms early; some patients won’t have any symptoms at all until the cancer grows larger. The colonoscopy will help because cancer doesn’t happen just like that. It starts as a polyp and then it can change into cancer. If we start picking it up at the polyp stage, we can prevent it from advancing to the cancer stage.”

Each person who attends the lecture will be entered into a drawing for tickets to an upcoming sporting event or a gift certificate for spa services. To reserve a spot, email christopher.kosinski@utoledo.edu.

The Tie One On Cancer Awareness Lecture Series continues this summer. Upcoming Thursday lectures will be:

• Aug. 20 — Dr. Krishna Reddy, UT assistant professor of radiation oncology, will discuss radiation oncology as a cancer treatment option.
• Sept 17 — Dr. Samay Jain, UT assistant professor and chief of the Division of Urologic Oncology, will discuss prostate cancer.
• Oct. 15 — Dr. Iman Mohamed, UT professor and chief of the Division of Hematology and Oncology, will discuss lymphedema.

The newest federal health regulation is warning people that anti-inflammatory pain relief pills such as Advil, Aleve and Motrin can increase the risk of heart-related problems and strokes.

Dr. Samer Khouri

But that doesn’t mean that these non-steroidal anti-inflammatory drugs (NSAIDs) need to be removed from your medicine cabinet altogether, especially if you are in otherwise good heart health, according to UT Health physicians.

Dr. Samer Khouri, professor of medicine and associate chief of cardiology at The University of Toledo Medical Center, said that ibuprofen, Naproxen and other NSAIDs should be taken in the correct dosage for the shortest amount of time.

“There is a risk and the risk is real,” Khouri said. “This new warning is a good idea because people sometimes think that over-the-counter pills don’t come with any risks because they can buy them so easily.”

The Food and Drug Administration’s new warning states that an increased risk of heart attack and stroke can occur even in the first few weeks of taking NSAID drugs. The current label only warns that high dose and/or long-term use can increase the risk of heart-related problems.

While Khouri supports the new label, he wants to make sure that the public knows that taking an aspirin like Bayer is still recommended for patient with heart disease or if you suspect you are having a heart attack or stroke. The new warning does not apply to aspirin, even though it’s technically an NSAID, he said.

“I think the public might be getting confused in this area because aspirin does not fall under this new FDA warning, although no drug is without risk,” he said. “Aspirin by itself can be an excellent medication to decrease cardiovascular disease, including heart disease and stroke, while also helping with headaches, fevers and arthritis.”

Dr. Rajesh Gupta

Dr. Rajesh Gupta, a cardiologist at UTMC and assistant professor of medicine, said it comes down to weighing the risks versus the benefits.

“If a 25-year-old person with tennis elbow or a sprained ankle wants to take an Aleve, then that is low risk while the treatment benefit is fairly good,” Gupta said. “However, for a 70-year-old with heart disease and a prior stent procedure, the benefits don’t outweigh the risks.”

If patients are already on a long-term naproxen treatment, for instance, they might want to consider finding an alternative treatment, he said.

“We have known for a many years that long-term NSAID use is associated with gastric ulcers, kidney disease and high blood pressure. This new FDA warning adds heart attack and stroke risk to this list,” Gupta said. “In general, these medications are not suited for long-term use, but the bottom line is each person should get individualized advice from his or her doctor because not every case is the same.”

To schedule an interview, contact Brandi Barhite at 419.383.5376 or brandi.barhite@utoledo.edu.

Media Coverage
Full Plate (July 26, 2015)

Avril Lavigne recently talked publicly about how she was bedridden for five months due to Lyme disease and thought she “was dying” because of not being able to eat, talk or move.

By studying the real-time immune response to the bacteria that causes the disease, a University of Toledo researcher is looking to help create better treatments so that fewer people have to experience what the songstress did.

“What we are trying to figure out is what “tricks” that the bacteria play so that our immune response can’t clear the infection on its own,” said Mark Wooten, PhD, UT associate professor of microbiology and immunology. “If we figure that out, we will have a better idea of what type of vaccine is needed to prevent this disease, which can be quite debilitating in some patients.”

Previously, when the bacteria was injected into mice, researchers were limited on what they could see and when. Wooten came up with the idea to make the bacteria fluorescent (glow green) so it could be studied in real-time using a high-tech multiphoton microscope.

Wooten uses special mouse strains with fluorescent immune cells, which are injected with the Lyme disease-causing bacteria called Borrelia burgdorferi, which is also fluorescent. He then uses high-powered microscopy to directly observe the fluorescent bacteria in the skin of the living mice and to see how they interact with the different immune cells.

Initial findings show that the immune system starts to fight the bacteria, but then the immune response backs down after a few days, even though large numbers of the bacteria remain. Figuring out why the immune system starts and then stops is crucial to finding a way to treat those infected by Lyme disease — the No. 1 vector-borne disease in the United States that sees an uptick this time of year during tick season.

“For the first time we are seeing what the bacteria does in the mice and how the immune cells respond to them,” Wooten said. “We can see where the deficiencies are, which in return, allows us to figure out how to improve the immune response in humans.”

Wooten said people getting bitten by an infected tick is a growing problem in the Midwest and Northeast because humans are increasingly living in close proximity to the animals, such as deer, that carry the bacteria.

Not only are the numbers in the New England states continuing to rise,” he said, “but the bacteria now can be found throughout much of Ohio.”

More than 300,000 cases are believed to occur each year; however, it is estimated that only 10-20 percent of Lyme disease cases are actually reported.

“Our latest findings indicate that the bacteria can literally outrun our immune cells within the host,” Wooten said. “We figured they would get in the skin and go hide from our immune response. Actually, we are finding that they don’t hide. They continue to move for months or years, and our immune system isn’t clearing them. Why is that? That is what we hope to unravel.”

To schedule an interview, contact Brandi Barhite at 419.383.5376 or brandi.barhite@utoledo.edu.

Dr. Blair Grubb of The University of Toledo Medical Center will be surrounded by grateful patients when he is lauded this weekend for his medical expertise and bedside manner.

In particular, Laura Ruszczyk will get to thank Grubb publicly when Dysautonomia International presents him with the 2015 Physician of the Year Award in his specialty, an honor that she nominated him for, at its annual conference in Washington, D.C., from July 17-20.

Ruszczyk nominated Grubb because of a life-changing operation she received to implant a BIOTRONIK EVIA pacemaker that works well for her because it responds to both heart rate and blood pressure.

“You hear his name, see it throughout the research on dysautomomia and expect a giant when you finally meet him,” Ruszczyk, 51, said. “He walked into my exam room and greeted my husband and me with a warm handshake and smile. He listened, explained the autonomic nervous system to us, examined me and gave answers and hope that we would — together — find a treatment plan that gave me a better quality of life.”

Her dysautomomia was diagnosed in August 2011, but it wasn’t until she secured an appointment that she began to hope life with an autonomic nervous system disorder was manageable.

She waited 16 months to meet the world-renowned autonomic specialist who has a wait list of more than 600 people. The distance did not matter. She drove 300 miles from Buffalo, New York to Toledo.

“This award means a lot to me because of all the work that I have done in creating this subspecialty of medicine,” said Grubb, Director of Electrophysiology Services at UTMC and Distinguished University Professor of Medicine and Pediatrics. “However, this award isn’t about me. It is about patients and changing their lives. My nurse practitioner and I do what we can for our patients. It is one day at a time with our huge waiting list. We wish we could do more.”

Dysautonomia affects the nerves that carry information from the brain and spinal cord to the heart, bladder, intestines, sweat glands, pupils and blood vessels. Symptoms can include rapid heart rate or slow heart rate, excessive fatigue, thirstiness, shortness of breath, blood pressure fluctuations and bladder problems.

Because many of the sufferers are women, Grubb said he has seen that their concerns can be not taken as seriously and they are told to rest or drink more water.

Kim Pearch of Monroe, Michigan, said her symptoms were not validated until she met Grubb.

“When he comes into the exam room, you feel like you are the only who exists,” Pearch said. “I know I am not the only one who feels this way. Dr. Grubb understands and values the importance of treating the whole patient and not just the illness.”

Dan Barbee, vice president of clinical services at UTMC, said Grubb is a testament to UTMC’s approach to putting the patient first. His waiting list is indicative of how much his expertise and compassion is valued. Patients come from Canada, Australia, Saudi Arabia, Israel and Great Britain.

“He’s regarded, literally, as the global leader in his field and patients came from all around the world to see him here at UTMC,” he said. “We are proud that Grubb is one of our own.”

The University of Toledo Medical Research Society is awarding its first grant to a professor working to develop a life-saving ovarian cancer treatment.

The $50,000 grant to Dr. Kathryn Eisenmann, assistant professor in the College of Medicine and Life Sciences, will support her research to develop a drug that will allow cancer-fighting treatments to more effectively penetrate tumor cells.

“Many anti-cancer drugs work poorly because they do not penetrate tumors. Tumor cells are packed so tightly that drugs cannot easily pass through these cells,” Eisenmann said. “My research is going to look at a new drug that blocks tumor cells from binding so tightly together. If successful, combining this new drug with current drugs used to treat ovarian cancer will allow more of the cancer-fighting drugs to enter the tumor and kill the tumor.”

This research is vital because ovarian cancer is the fifth-leading cause of cancer deaths in American women. About 200,000 women in the United States live with this cancer and 55 percent of women diagnosed die within five years.

“I am so thankful to receive this funding because it is a highly innovative idea that could lead to novel therapies for this deadly disease,” Eisenmann said.

Dr. Kathryn Eisenmann

Howard Newman, UT associate vice president for development, said the Medical Research Society met June 11 to review three faculty proposals. The society, which consists of 20 individuals representing community and medical leadership, selected Eisenmann’s proposal because she had potential to secure additional funding and make a significant difference in the fight against ovarian cancer.

The society’s founding member Marianne Ballas, the owner of Ballas, Buick GMC and a member of the UT College of Medicine Advisory Council, founded the Medical Research Society in 2014 to help junior faculty who are just starting their scientific career. Since then, the society has already gained 20 members who made $25,000 commitments and garnered a $1 million matching donation from The University of Toledo Physicians (UTP).

“Junior faculty need the most encouragement,” Ballas said. “The funding environment is so difficult these days. This is geared toward scientists who have developed their research, but need some more money to develop it further before applying for a larger grant.”

Newman said the National Institutes of Health used to fund more than 30 percent of the grants applied for by junior faculty, but in recent years the number has decreased to 10 percent due to reduction in federal funding. Having this grant will better position Eisenmann to apply for federal funding to further advance her work, he said.

Dr. Christopher Cooper, executive vice president for clinical affairs and dean of the College of Medicine and Life Sciences, was one of the first members of the society.

“I was extremely pleased at the quality of presentations offered by the faculty, the perceptive questions asked by the members of the Medical Research Society and the passion for excellence that these individuals bring to The University of Toledo College of Medicine and Life Sciences,” he said.

UT Health is opening a new family medicine center in newly renovated space just off the Health Science Campus.

The UT Health Family Medicine Center will reunite the family medicine practice now located in the Ruppert Center and the family medicine residency practice that has been located on the St. Luke’s Hospital campus since 2007. It will also include a Geriatric Medicine Center relocated from Lutheran Homes at Wolf Creek.

The ribbon-cutting ceremony will be 10 a.m. Tuesday, June 30 at the building now called Glendale Medical East, 3333 Glendale Ave.

“Bringing these three groups together will enable us to provide excellent patient access in a building that will see a new purpose,” said Dr. Linda Speer, chairperson of the Department of Family Medicine. “We will continue to provide primary care for people of all ages from birth to the end of life in a setting that is physically up to date and attractive.”

Glendale Medical East is the former Veterans Affairs Outpatient Clinic that was located on Glendale Avenue. The $3.6 million capital project included renovations for 28,000 square feet of the building with the remaining being shelled for future renovations. The project took six months.

The Geriatric Medical Center will be housed initially with family medicine and eventually in a separate space within the building as capital funds become available to renovate additional space.

Speer said the UT Health Family Medicine Center will be convenient for patients, while also fulfilling the public’s demand for more primary care access including same day access. New patients are being accepted.

The trend in the recent past has been for everyone to see specialists, according to Steve Bailey, clinic manager of the UT Health Family Medicine Center. Therefore, patients have a lot of specialists, but they don’t have a primary care physician to tie it all together, he said. Family physicians handle preventive care, chronic illness care, acute illness and injury care and minor procedures.

The opening of the center at Glendale Medical East coincides with the return of the UT Family Medicine Residency Program to UT Health. The program accepts four new residents each year.

“We are so glad to have the residency program fully integrated within the UT family,” said Dr. Christopher Cooper, senior vice president for clinical affairs and dean of the College of Medicine and Life Sciences. “Resident often stay in the community, opening a practice or joining a hospital. It is critical that we attract the highest quality students for our residency programs and work to retain them here in Northwest Ohio.”

Media Coverage
The Blade (June 26, 2015)