Solutions Magazine - Winter 2014

UNT HEALTH SCIENCE CENTER

Winter 2014 FOR A HEALTHIER COMMUNITY

INSIDE:

Battlefield instincts take overKeeping a cowboy in the saddle

On his feet again

When no one else could help

USAF Maj. Michael Carletti (TCOM '06)

2

When the call came last year that 150 seventh-graders at Morningside Middle School

couldn't start school until they received state-mandated vaccinations, Laura Standish, RN,

sprang into action.

Standish, Director of UNT Health Science Center’s mobile pediatrics program, obtained

vaccines, recruited volunteers and set up shop in the Morningside library. Soon, the seventh-

graders were cleared to begin classes.

Morningside officials praised the pediatrics program, operated with funding from the

Rainwater Charitable Foundation and one of the ways UNTHSC serves the community.

"Our kids need every minute in the classroom,” Assistant Principal Danny Fracassi said.

Kids get a shot in the arm to stay in school

The mobile pediatrics program becomes truly mobile early this year when a specially equipped mobile medical unit arrives for service. Although community funds have fully underwritten the cost of the unit, the Office of Institutional Advancement is seeking gifts to support continued outreach services. To learn how your gift can help, please contact Susan Smith at 817-735-2174.

Winter 2014 3

A HEALTHY SPORTING LIFE

What advice do you give people who are just starting a new sport to avoid injury?

Start low and go slow. Many

people who have been inactive for a

long time tend to try to pick up where

they left off, and end up injuring

themselves in the process. My

advice is to start with a reasonable

amount of activity. Don't lift too much

weight or go too much distance.

What advice do you give people who are looking to train for an event like the Cowtown Marathon on Feb. 23?

Take it seriously, as these are

events that one cannot simply decide

to do last minute. Start a training

regimen and stick to it. Discipline is

key, and you don’t want to over- or

under-train so you injure yourself

before or during the race.

Why is it important for people to have a concussion baseline conducted before engaging in a sport such as football?

Without baseline neurocognitive

testing, all we can do is compare

someone's mental and cognitive

status, as well as physical and

vestibular exams, with individual

databases of similar aged individuals

around the country. While this

is helpful, it's still not as good as

comparing someone after an injury to

how they were before their injury.

Daniel Clearfield, DO, Assistant Professor of Orthopaedic Surgery at UNT Health Science Center, served a two-week rotation last year at the U.S. Olympic Training Facility in Colorado Springs, Colo.

3 QUESTIONS

4

Better BP can prompt sweet dreamsHigh blood pressure and sleep problems:

The connection between the two keeps Ann Schreihofer, PhD, Associate Professor of Integrative Physiology, awake at night.

"People with sleep apnea have a greater risk for developing high blood pressure," Dr. Schreihofer said. "Blood pressure increases if the subjects live under conditions that mimic sleep apnea."

Dr. Schreihofer's lab focuses on how the brain regulates blood pressure and how high blood pressure disrupts breathing during sleep.

She hopes that her research may assist physicians who treat patients with hypertension to customize patient treatment and medications

aligned with the person's individual medical issues, rather than on the most cost-effective blood pressure medication available.

SAGE honored for work with older adults

UNT Health Science Center’s innovative mentorship program linking teams of medical and other health profession students with older citizens has been honored for its work in improving patients’ general health.

The Seniors Assisting in Geriatric Education (SAGE) program received the Mae Cora Peterson Healthy Aging Award from Senior Citizens Services, a nonprofit group dedicated to empowering older adults in Tarrant County to live with purpose, independence and dignity.

The award is named after Mae Cora Peterson, a patient of Janice Knebl, DO, Chief of UNTHSC's Division of Geriatrics and leader of the SAGE program.

SAGE students offer older patients advice and direction on such issues as home safety, the implications of medical history, the physiology of aging and medications.

Darrin D’Agostino, DO, MPH, Chair and Associate Professor of Internal Medicine,

says a healthy, balanced breakfast provides some important heart-protective effects, including:

Taking your time and chewing your food carefully also are beneficial. “Remember, balance is always the key,” he said.

“If everything in your life is in moderation and balance,

you’ll probably be very healthy.”

HEALTHIER.COMMUNITIES

Ann Schreihofer, PhD

Mae Cora Peterson and Janice Knebl, DO

• Balancing certain hormones, including insulin.

• Reducing the temptation to overeat later in the day.

Starting the day off right

Winter 2014 5

Physician assistants have played an important role in the health care system since the 1960s. But as millions of Americans newly insured under the Affordable Care Act seek care, the PAs’ role will become even more crucial.

Good thing, then, that UNT Health Science Center’s Physician Assistant Studies (PAS) program is one of the best in the nation. In the last five years, 98 percent of its graduates passed their national certification exam on their first try. That’s 4 percent higher than the national average.

Said PAS student Ryan English: “We are able to help the patient, and we are able to help the health care system. More people are able to get care at a lower cost because of PAs.”

Learning from their mistakes College freshmen who drink too

much learn more from some mistakes than others, says Scott Walters, PhD, Professor of Behavioral and Community Health.

In a large national sample of incoming college freshmen, heavy drinkers who hurt themselves, damaged property or experienced other external harms were the most likely to take

precautions the next time they drank, Dr. Walters said. "Students who were older, non-white, or female

were the most likely to learn from their mistakes, regardless of what kind of problems they experienced," he said.

Physical consequences, such as a hangover, did not significantly influence students' drinking patterns, according to the study published online in Substance Use & Misuse.

The insight into student behavior could lead to intervention programs tailored to specific populations.

The best – and only – defense against measles

Prevention is not only the best defense but just about the only one for measles, a contagious disease that saw a recent unexpected resurgence in Tarrant County, says David Lar, MD, Assistant Professor of Pediatrics.

Children should receive vaccinations at their one-year checkup and then a

second dose between ages 4 and 6, Lar said.

"You've got to get immunized. Prevention is always the best medicine," he said. "There's isn't a good treatment once you have contracted measles."

PAS students Ana Maria Chaidez, Marianne Siebert, Stephen Saenz and Sarah Shuler with Instructor Tom Diver, PA-C (center)

Physician Assistants: A higher health care profile

Scott Walters, PhD

6

Nicotine: Enhancing brain performance?Nicotine usually is

associated with cigarette smoking and cancer. But Victor Uteshev, PhD, Associate Professor of Pharmacology and Neuroscience, also sees some good in nicotine.

Dr. Uteshev's research concentrates on the positive effects chemicals such as nicotine may have on the brain – as in enhancing cognitive performance and resistance to brain injury, particularly in aging patients and people who have high

risk for stroke and traumatic brain injury.

The detrimental effects of smoking are well known. But the chemical changes in the brain created when nicotine enters the bloodstream can be beneficial, in optimal doses.

"Some smokers can think more clearly for a few minutes or so after a cigarette," Dr. Uteshev said. "We are focusing on compounds that are similar to nicotine but can bring mostly positive effects.”

Shaping state health policy Andrew Crim,

Executive Director of Professional and Continuing Education, will help advise state policy makers on how to meet Texans’ health care needs.

Crim is a newly appointed member of the Statewide

Health Coordinating Council, one of only two university representatives on the 17-member council.

"The SHCC gives our university and our community a strong voice in how the governor and Legislature allocate health resources," Crim said.

The council's broad purpose is to ensure health care services and facilities are available to all Texans through health planning activities.

The holidays are over. You’ve over-indulged and under-exercised. Now what?

UNT Health Science Center health and nutrition specialists Kyle Pawlak and Chelsea Barron offer tips on how to get back on track.

•Have a plan: Schedule your workouts and put them on your calendar. Treat them as a priority.

•Do something active every day: Get moving for at least 30 minutes each day. Go for walks, play with the kids in the yard or turn on your favorite music and dance. Make chores more challenging by picking up the pace.

•Reward yourself: On days you’re active, reward yourself with a non-food item or activity that makes you feel good. Or create an activity reward savings jar – each time you work out, throw in a few dollars.

•Get some sleep: Lack of sleep increases hunger hormones, causes sugar cravings and aids in the accumulation of belly fat. Turn off the electronics and go to bed early.

Victor Uteshev, PhD

Andrew Crim

Winter 2014 7

competition for admission to UNT Health Science Center’s five schools and colleges is intense. Those who make the cut have the relentless drive – and the superior scores – to succeed. High-quality students, when matched with high-quality programs, become high-quality graduates who bring their best to their chosen fields. That’s at the heart of what we mean when we say we’re Creating Solutions for Healthier Communities.

VITAL STATS

With far more DEMAND than SUPPLY,

2012 – 2013

79%

24%7% 6%

57%8%

ADMISSIONS APPLICANTSTEXAS COLLEGE OF

OSTEOPATHIC MEDICINEGRADUATE SCHOOL OF BIOMEDICAL SCIENCES

SCHOOL OF PUBLIC HEALTH

SCHOOL OF HEALTH PROFESSIONS/ DOCTOR OF PHYSICAL THERAPY

SCHOOL OF HEALTH PROFESSIONS/ MASTER OF PHYSICIAN ASSISTANT STUDIES

UNT SYSTEM COLLEGE OF PHARMACY

8

For more than seven decades, J.W. Stoker, 86, was a cowboy’s cowboy, a rodeo legend who began trick roping and riding at 12 and is a member of the National Cowboy and Western Heritage Hall of Fame and the Pro Rodeo Hall of Fame.

But when his advancing

years threatened to rob him

of the work he loved most,

Janice Knebl, DO, a

geriatrics expert at UNT

Health Science Center,

used a multi-disciplinary

approach to help the colorful

Stoker stay in – or at least near

– the saddle.

Two of Stoker’s main

health concerns included

cardiovascular issues

and a pinched nerve

Keeping a legendary cowboy in the saddle

8

Janice Knebl, DO, and J.W. Stoker

Winter 2014 9

in his back. Dr. Knebl, working

closely with other specialists,

is helping Stoker stay active

by ensuring blood pressure

medications are administered

correctly and by improving his diet for overall heart

health.

“She takes care of business,” said Stoker of Dr.

Knebl, holder of the Dallas Southwest Osteopathic

Physicians Endowed Chair in Clinical Geriatrics.

“She pays close attention and is genuinely

interested in all her patients. She is full of life.”

For the past few years, he’s trained The All

American Cowgirl Chicks, a group of women who

travel around the world entertaining crowds with

their fast-paced drills and daring trick riding. He

accompanies them to the Rose Bowl every year,

rides a horse during the half-time show and credits

Dr. Knebl for his energy and overall good health.

Said Dr. Knebl, “In December 2012, my husband

and I attended the Rose Bowl, and we saw J.W. during

the halftime show. It made me excited seeing him out

there riding on his horse looking so happy. My goal with

every patient is to help them lead a healthier life so they

can continue doing the activities they love.”

To contact Dr. Knebl or any of our geriatric providers,

please call 817-735-DOCS (3627).

Winter 2014 9

10

You’ve seen them – sleek and insanely powerful

F-16 Fighting Falcons dancing an aerial ballet as they arc

through a sunlit sky at neck-snapping speeds. They’re

the Thunderbirds, the U.S. Air Force’s Air Demonstration

Squadron. Also known as “America’s Ambassadors in

Blue,” this 120-plus-member team of precision-obsessed

professionals regularly thrills millions with its aerobatic

skills.

But for one member in particular, the opportunity to

serve was all too tragically earthbound.

As team flight surgeon, USAF Maj. Michael Carletti

(TCOM ’06) accompanies the Thunderbirds to all

events. Saturday, Feb. 23, 2013, found him at Florida’s

Daytona International Speedway for a race-day flyover at

NASCAR’s biggest event, the world-famous Daytona 500.

With its mission complete, the team settled in to watch

the festivities. But with just one lap to go, a massive crash

sent a vehicle flying into the barrier separating cars from

fans. Large pieces of debris, including a tire, sprayed into

the stands.

Maj. Carletti’s medical and military training for mass

casualty events kicked in. Plunging into the chaos almost

without thinking, he helped organize triage efforts and

coordinate first responders. Global sports network ESPN

WHEN BATTLEFIELD INSTINCTS TAKE OVERTCOM GRAD’S CARING COMPOSURE AT DAYTONA DISASTER

Michael David Carletti (TCOM ’06)

Major, United States Air Force, Medical Corps

Flight Surgeon for Air Demonstration Squadron “Thunderbirds”

Age: 35

Birthplace: Anchorage, Alaska

TCU graduate: Bachelor’s degrees in mathematics, chemistry

Winter 2014 11

“On that terrible day, Major Carletti demonstrated the sacred commitment that embodies the best of who we are at UNTHSC. His actions speak to all of us about a higher calling and sense of purpose as well as supreme bravery, service and dedication.”

~Dr. Michael R. Williams (TCOM ’81), UNTHSC President

To see the video, go to YouTube and search “Thunderbird 9 NASCAR Feature for ESPN.”

caught footage of him amid the devastation and produced

a 4-minute feature praising his quick thinking and

calm, assured response. In all, 33 people were injured.

Fortunately, everyone survived.

When asked about his experience, the usually voluble

Maj. Carletti turns quiet. But his dark eyes still betray a

deep pain. He has yet to see the ESPN video and doubts

he ever will.

“I just don’t want to relive that day,” he says in a near

whisper.

Carletti, in dark blue jumpsuit, helps carry a victim from the stands.

Q&A WITH MAJ. CARLETTIHow did you wind up with the Thunderbirds?

It’s all about timing. I was fortunate enough to have a very well-rounded military/medical first assignment at Tinker Air Force base in Oklahoma with diverse training exercises and deployments. All that allowed me to be competitive for the Thunderbird Flight Surgeon application process and here I am! There are lots of great surgeons in the Air Force serving airmen worldwide. I was fortunate to be selected to represent them on the team.

Regarding the Daytona race accident, what were you thinking when you went into the stands?

Actually, I wasn’t really thinking. I just went into auto-pilot mode. I focused on stabilizing and prioritizing the patients and resources we had. It’s the way Air Force physicians are trained: Help however you can. What I did is no different than our medics serving in deployment settings or helping others in humanitarian crises overseas.

Clearly, the accident affected you.

It was difficult afterward, wondering if we did enough or could we have done things better or should we have done things differently. But the folks at Daytona had a great team of first responders, and I was happy to hear that many of the people affected by the accident are doing well.

You're third-generation Air Force. Your father and grandfather are 20-year men. Do you anticipate serving that long, too?

Well, I have seven years of active duty service in addition to five years of time in the Reserves, but I would eventually like to come back to Fort Worth to sub-specialize and then stay to practice.

12

ON HIS FEET AGAINLance Thornhill, 61, a

general contractor and carpenter, is the definition of an active man. He spent years as a safety inspector for the city of North Richland Hills and relished remodeling his home and hardscaping his backyard with a gazebo and waterfalls.

But out of the blue, when he

woke up the day after Halloween

2012, he couldn’t move his right leg.

When he tried to sleep at night, the

pain was so bad, “my wife, Trudee,

held me while I bawled,” he said.

She took him, limping all the

way, to his primary care provider and

a neurologist, among others, who

offered various incorrect diagnoses,

“all fatal,” she said, including spinal

tumors and Lou Gehrig’s disease.

The best they could get: a diagnosis

of “foot drop,” which makes it all but

impossible to lift the front part of

the foot.

Then he met Ryan Seals, DO,

Assistant Professor of Osteopathic

Medicine, who practices at UNT

Health’s Patient Care Center on the

UNTHSC campus. After just two

treatments, Thornhill was moving

almost normally. Today, he’s walking

vigorously for exercise and receives

treatments from Dr. Seals every

three weeks.

“I’m pleased that he’s making

progress,” Dr. Seals said. “The

dropped foot has resolved, and now

we’re working on back pain and

sensory issues.”

“The first doctor in this whole

sorry mess to really care was Dr.

Seals,” Thornhill said. “He got me

functional and back in the race as a

human being.”

Lance Thornhill works on a home project.

Winter 2014 13

To make an appointment with a UNT Health

physician, please call 817-735-DOCS (3627).

Foot dropWhat it is: The inability to raise the front part

of the foot because of weakness or paralysis of the muscles that lift the foot.

What causes it:

• Multiple sclerosis• Stroke• Cerebral palsy• Polio• Lou Gehrig’s disease• Nerve root injury• Charcot-Marie-Tooth disease• Peripheral neuropathy• Peroneal nerve damage• Muscular dystrophy• Myositis

Source: National Institute of Neurological Disorders and Stroke

Thornhill credits Dr. Seals with making him mobile again.

“Everyone at UNT Health cares about the patient – nurses and

receptionist included. And the doctor actually

listens to you.”~Lance Thornhill

14

WHEN NO ONE ELSE COULD HELP

Breana Marin, 17, was afraid she’d never find

anyone who could tell her why she hurt. For four

years, she experienced pain in her chest that

radiated to her back, neck and shoulders.

Her mother, Lorena, took her to

several physicians, but none were

able to diagnose the pain.

A few months later, Lorena started working at

the UNT Health Science Center. While reading an

issue of Solutions magazine, she came across

an article about a teenager named Kylie Ducat

who was helped by Albert Yurvati, DO (TCOM

'86), Chairman and Professor of Surgery at UNT

Health, the physicians group at UNTHSC.

Lorena immediately realized that her

daughter and Kylie shared the same symptoms,

and she made an immediate appointment with

Dr. Yurvati.

His diagnosis? Breana had suffered an

injury to the xiphoid process, the lower portion

of the sternum.

"It was the first thing I thought of," Dr.

Yurvati said. "It was pressing on the sac

enclosing her heart. That's why she couldn't

breathe and why it was so painful.

“UNT Health currently has the most experience

in the treatment for this problem,” he added. “Our

approach has yielded consistent success with

excellent post-operative function for these patients.”

Within two weeks of her surgery, Briana felt well

enough to go on a church mission trip to the Dominican

Republic.

“Dr. Yurvati changed my life,” she said. “I’m now able

to play volleyball and run for long distances again. I’m so

grateful to have my life back.”

Lorena Marin said of Dr. Yurvati, “He really listens

and cares for his patients. I feel so fortunate to work on a

campus with doctors like him.”

To schedule an appointment with Dr. Yurvati, or any UNT

Health surgeon, contact 817-735-DOCS (3627).

Albert Yurvati, DO, gives new lease on life to suffering teen

Winter 2014 15

Giving is all in the family

Clayton Royder, DO (TCOM ’84); James Royder, DO; and Katarina Royder

James Royder, DO, has always

made every minute count. From

serving in the U.S. Naval Reserve

to running a successful medical

practice, even walking away from a

small plane crash while on a medical

mission to Mexico, he’s a believer in

forward momentum.

That sense of impetus

apparently runs in his family.

Recently, he handed over day-to-

day management of the James

O. Royder Scholarship to his son,

Clayton Royder, DO (TCOM ’84), and

granddaughter Katarina.

The three of them are cheerfully

dedicated to – in the scholarship’s

parlance – “honoring and supporting

the advancement of the osteopathic

philosophy and practice of health

care” for second-year TCOM

students.

“I believe in the osteopathic

tradition,” asserted Dr. Royder

senior, who also served as a TCOM

professor from 1976 to 1981. “I’m

proud of the school and proud that

my son and granddaughter will

perpetuate that tradition through this

scholarship.”

“Our relationship with TCOM

really is a family affair,” Clayton

said. “There’s dad’s relationship, of

course, and my wife, Mona, received

her Master's at the University of

North Texas. Our daughter, Katarina,

who’s in her senior year at TCU,

is strongly considering applying to

TCOM for 2015.

“I guess the place just gets in

your blood!” he laughed.

Spencer Septien (TCOM ’16) is the latest recipient of the Royder family’s generosity. In a thank-you letter, he said, “I’ll continue to work hard to ensure that the next generation of osteopathic physicians, my generation, will grow and expand the awareness and understanding of the osteopathic profession.”

16

WHEN SCIENCE STEPS IN to help Alzheimer’s patients and their caregivers

… to diagnose Alzheimer’s disease: a brain autopsy. But what if a quick, simple, routine blood test could render a much more timely diagnosis? Such a test might help caregivers determine better methods of treatment and potentially even transform geriatric medicine.

Sid O’Bryant, PhD, Interim Director of the Institute for Aging and Alzheimer’s Disease Research at UNT Health Science Center, is the lead investigator in developing such a test,

which measures the presence of key proteins that indicate whether a patient has Alzheimer’s.

“Our research is focused on developing low-cost, useful tools that primary care physicians can use in clinical settings,” he says.

Next steps: create standards that can be used globally in collecting blood for Alzheimer’s analysis.

James Hall, PhD

Right now, there’s just one definitive way …

Winter 2014 17

Depression and Alzheimer’s disease …

… often go hand in hand. Lending a helping hand are UNTHSC researchers, who have identified a specific subset of depressed patients that is at greater risk of developing mild cognitive impairment (MCI) or Alzheimer’s disease.

Leigh Johnson, PhD, was first author, in collaboration with James Hall, PhD, and Dr. O’Bryant, on a study that appeared in PLOS One, a peer-reviewed journal published by the Public Library of Science.

The UNTHSC researchers found that positive answers to five specific questions correlated to an increased risk of cognitive problems such as MCI and Alzheimer’s. The questions addressed memory problems, “feeling blue,” feeling worthless, frequently crying and trouble concentrating.

“We know there is a relationship between depression and Alzheimer’s disease,” said Dr. Johnson, Assistant Professor of Internal Medicine. “But we tried to determine what type of symptoms put someone at greatest risk for cognitive problems.”

Cholesterol plays a role …

… as a major predictor of neuropsychiatric symptoms among men with Alzheimer’s disease.

In a study written by UNTHSC researchers, with Dr. Hall, as first author, cholesterol is identified as the major predictor of neuropsychiatric symptoms among men with Alzheimer’s.

These symptoms – apathy, depression, psychosis, agitation and disturbances of sleep – are major factors in nursing home placements for patients and the top cause of stress and burnout for caregivers. Men with dementia who have lower cholesterol are less likely to experience those symptoms, according to the study, which appeared in the Journal of Alzheimer’s Disease.

“Cholesterol is the single best predictor we see in men for developing these symptoms,” said Dr. Hall, Professor of Psychiatry and Behavioral Health.

Sid O'Bryant, PhD, Leigh Johnson, PhD, and James Hall, PhD.

18

A LEGENDARY EVENING AT THE BASSOn a cool evening last November, country-music

legend Clint Black entranced a crowd at Bass Performance Hall with an intimate acoustic concert. Black, a consummate performer, delighted the audience with his songs and on-stage banter. The event raised thousands of dollars to fund the important work of world-class medical researchers at UNT Health Science Center and to create scholarships for the next generation of health care providers.

Winter 2014 19

PLATINUMAnn & Michael Williams

GOLDDrs. Janice Knebl and Thomas Fairchild u Elena and Tom Yorio u University of North Texas

FRIENDSTim Doke u Michele and Fred Reynolds u The Ryan Foundation

SILVERCantey Hanger LLP u Cash America International, Inc. u Dewberry u Paul Dorman and Arnie Gachman u JACOBS u Elaine and Myron Jacobson u Kelly Hart & Hallman LLP u Legend Healthcare u Jude and Don Peska u Pinnacle Bank u Texas Christian University u Texas Health Resources u Dr. and Mrs. Albert Yurvati

ADDITIONAL SPONSORSMr. and Mrs. Edward P. Bass u The Center for Cancer and Blood Disorders u Four Star Café u Firestone & Robertson Distilling Co. u UNT System Board of Regents

MEDIA360 West u Fort Worth Business Press u Star-Telegram u 94.9 KLTY u WBAP AM/FM

An Evening with a Legend“An Evening with a Legend”

celebrated more than

40 years of partnership

between UNT Health

Science Center and the

Fort Worth community.

T H A N K YO U T O O U R S P O N S O R ST H A N K YO U T O O U R S P O N S O R S

Winter 2014 19

TITLE SPONSOR

Walsh FoundationTECHNOLOGY SPONSOR

PRESENTING SPONSOR

VALET SPONSOR AIRLINE SPONSOR

RECEPTION SPONSOR

Solutions Magazine - Winter 2014

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