1 Innovations in Care Directorate for Medicine Annual Report 2016
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- Bu səhifədəki naviqasiya:
- Current Collaborative Research Aims to Improve the Lives of Patients Suffering From Lupus and Rheumatoid Arthritis
- USU Researches Insights into Autoimmunity
- Rheuma tology William R Gilliland, MD
- Quality Improvement Initiatives Reduce Unneeded Use of the Lupus Anticoagulant Test and Improve Gout Management
- Opposite page: Polarized light microscopic evaluation of synovial fluid reveals
Michael P Keith, MD Chief, Rheumatology CAPT
MC
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USN WRB
Under the leadership of Dr. Michael Keith, the Rheumatology Service continues its tradition of clinical excellence in patient care, medical education for fellows, residents and medical students, and clinical and translational research. In
partnership with
the Rheumatology Service at
Fort Belvoir
Community Hospital (FBCH), Walter Reed Bethesda Rheumatology delivers expertise in musculoskeletal, autoimmune and inflammatory disorders across the National Capital Region. The Rheumatology Service employs the most recent advances in patient care, including the full spectrum of targeted biologic drugs and
musculoskeletal ultrasonography. The Physician Staff and the Fellowship
The medical staff of the Walter Reed Bethesda Rheumatology Service consists of five active duty military physicians. All staff physicians are board-certified in internal medicine and rheumatology and all hold clinical privileges at both WRB and FBCH. The Service also enjoys the support of two affiliate staff physicians from the Uniformed Services University who provide unique academic perspectives for our fellowship program. Two staff rheumatologists at FBCH round out the regional team.
The cornerstone of our academic endeavors is the National Capital Consortium’s rheumatology fellowship program, led by program director Dr. Jess Edison. The fellowship is currently comprised of five fellows from the Army and Navy, with 3 second-year fellows and 2 first-year fellows. This is the largest fellowship program in the Military Health System, and it has a proud history of a 100% rheumatology board examination pass
rate and
national recognition of two of its graduates (including the current service chief) by the American College of Rheumatology as Distinguished Fellows. It
has produced military rheumatologists since the late 1970s.
The Service has a successful research program that affords our fellows opportunities for scholarly activities. It maintains collaborative research relationships and active protocols with the University of Nebraska, University of Colorado, the Oklahoma Medical Research Foundation (OMRF) and USU. Current research efforts
focus on
preclinical autoimmunity in the context of systemic lupus erythematosus (SLE) in collaboration with OMRF and rheumatoid arthritis in partnership with the University of Nebraska.
The Rheumatology Division at USU expands the research portfolio of our service. The work of the division’s full-time researchers serves to enhance our understanding of autoimmunity through research, collaboration and
dissemination.
Dr. Teo-Doru Brumeanu has been developing monoclonal human antibodies to influenza and other viruses in collaboration with Dr. Sofia Cas a res at the Walter Reed Army Institute of Research (WRAIR), the largest DoD biomedical research facility.
Associate Dean, Medical Education, USU; Director, Rheumatology USU
Dr. Chantal Moratz has been analyzing the role of complement and the coagulation pathway function in ischemia/reperfusion tissue injury in autoimmunity, with a focus on systemic lupus erythematosus, and the role of neuro-modulation of inflammation. She has served as a research mentor to many rheumatology fellows over the past decade.
Drs. Aihong Zhang and David Scott have developed engineered human regulatory T- cells to control adverse immune responses as they relate to autoimmunity (e.g., multiple sclerosis) and
hemophilia. They
are collaborating with the Multiple Sclerosis Clinic at Walter Reed Bethesda.
The Rheumatology Service is highly active in teaching through multiple venues. At Walter Reed Bethesda, the Service hosts rotating residents from multiple specialties. We have also hosted radiology residents from Naval Medical Center Portsmouth and family medicine residents from Naval Hospital Jacksonville, expanding our educational presence beyond the confines of our immediate geographic region. The Service develops targeted educational content and delivers 6-8 academic half-day sessions per academic year to the internal medicine residency program.
Rheumatology is also very active in undergraduate medical education through its relationship with USU. Each staff physician and fellow holds an academic appointment at USU. Over the last academic year the Service provided over 500 contact hours to medical students at USU of all levels of training. Teaching activities include case discussions in the pre-clinical modules, musculoskeletal examination instruction and proctoring OSCEs (all at the USU campus). They also include small group preceptors, outpatient clerkship attendings, inpatient clerkship attendings, and Bone and Joint—a hands-on learning experience for second
year students preparing to transition to clinical rotations (WRB campus).
Our fellows are actively involved in quality improvement (QI) efforts as a requirement of their training program. Rheumatology has two active QI projects that are fellow-driven with the mentorship of staff. For the first project, we have partnered with the lab to reduce unneeded use of the Lupus anti- coagulant test. Data collection has been completed, and once the test is given a new name in AHLTA/CHCS, post-implementation data collection will be performed to see if appropriate use of this test increases.
The second project will be implemented in partnership with primary care patients in internal medicine. The aim is to improve gout management in primary care through targeted patient and physician education. Baseline data for this project are currently being collected.
polarized light microscopy, which allows them to make point-of- care diagnoses for crystalline arthritis (most commonly gout).
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