Jose and Danielle Belen, founders of Esperanza Essentials, a combat veteran owned and operated business, at their Pompano Beach kick-off event. Esperanza Essentials is a full spectrum CBD product available now. Jose is also the founder and President of Mission Zero, an organization dedicated to ending veteran suicide.

 

 



Surgeons have treated a patient’s “dead” ankle bone with a custom, 3D-printed replacement for the first time at UHealth Tower and the University of Miami Miller School of Medicine.

It was a “Terminator-style, 21st Century approach” to helping the 24-year-old patient, said Amiethab Aiyer, M.D., a UHealth orthopedic surgeon specializing in foot and ankle surgery.
 
“We believe that bringing this treatment to UHealth shows how we are at the vanguard of innovation and early incorporation of the most exciting surgical developments from around the world,” said Stephen Quinnan, M.D., a trauma orthopedic surgeon at UHealth. The two surgeons collaborated on the case.
 
Blood flow to one of Gracia Sylla’s ankle bones became compromised because of sickle cell disease. The lack of blood, in turn, led to the death of her talus bone, a process known as avascular necrosis (AVN).
 
“She had significant pain from AVN associated with the talus,” Dr. Aiyer said. This is a major bone within the ankle, one that is “particularly important for loading and movement, and activities like walking and running.”
 
Non-surgical approaches were recommended first. However, the patient came back after failing conservative measures.
 
“I was skeptical at first,” Sylla said when asked about her reaction to getting a 3D-printed implant. “I wondered, would my body reject it or not?”
 
Dr. Aiyer referred her to Dr. Quinnan for further evaluation. “When I first evaluated the patient, it was for consideration of possible ankle fusion,” Dr. Quinnan said. “Fusion of the ankle would traditionally have been the best option available for this young woman. However, there are several serious drawbacks – including the inability to move the ankle and the need for a complex reconstruction to avoid having a leg length difference.”
 
“I didn’t want to get my ankle fused,” Sylla said. “I want to be able to move it up and down.”
 
“I had seen success while in Australia and similar reports from Japan using an exciting new solution to simply replace the talus bone with a 3D-printed talus bone,” Dr. Quinnan added. “Due to her young age and the still normal appearance of the distal tibia part of the ankle joint, I thought this innovate approach was worth consideration. I discussed this with Dr. Aiyer, who noted he had recently met a 3D printing orthopedic company at a conference and we agreed to work together to offer the patient this exciting new treatment option.”
 
“Sometimes we have to think outside the box,” Dr. Aiyer said. “The variety of pathology we are seeing at the University of Miami really facilitates our ability to be creative with regards to solutions.”
 
They took CT scans of Sylla’s ankle. Then the surgeons worked with a company in Durham, North Carolina, to create custom, 3D-printed metallic bones based on the size of her talus. During the surgery, they tried three different sizes.
 
“We wanted to use the one with the best fit and avoid stuffing the ankle, which could limit her mobility,” Dr. Aiyer said. “But it was good to have options, because sometimes when you go in there, you find changes in bone morphology or there are bone defects that are not well appreciated on imaging.”
 
The procedure puts the Miller School on the forefront of using 3D printing technology to create orthopedic solutions customized for individual patients. Drs. Aiyer and Quinnan estimate that fewer than 100 such bone replacements have been performed in the United States to date.


Kendall Regional Medical Center collected 7.5 pounds of opioid medications during its “Crush the Crisis” opioid take back day on September 7 to help combat the nation’s opioid crisis. Community members participated in the event by dropping off unused and expired prescription medications.

“Opioid addiction has been a growing concern not only in Miami-Dade County, but across our nation,” said Dr. Manuel Anton, Chief Medical Officer at Kendall Regional Medical Center. “We are proud to have taken part in an event that raised awareness of the dangers of opioid addiction and educated our community about the proper disposal of these medications.”


Joe DiMaggio Children’s Hospital, part of Memorial Healthcare System in Florida has joined the Cerebral Palsy Research Network (CPRN). Heather Spader, M.D., a pediatric neurosurgeon and Monica Arroyo, M.D., a pediatric neurologist, will be the site principal investigators (PIs) representing Joe DiMaggio Children’s Hospital in the network. The mission of CPRN is to improve outcomes for people with cerebral palsy through high quality clinical research and quality initiatives. Adding Joe DiMaggio Children’s Hospital marks the first hospital to join the prestigious network in South Florida and adds to the diversity of patient population in the cerebral palsy registry.

“Being accepted for membership into the CPRN is an important milestone for the spasticity program at Joe DiMaggio Children’s Hospital,” said Dr. Spader. “With our current and continued institutional growth, the CPRN is an additional way to participate in high-quality research alongside other large institutions that are leaders in the field of spasticity.”
 
Dr. Spader’s research and publication of “Risk factors for baclofen pump infection in children: a multivariate analysis” in the Journal of Neurosurgery in 2016 was developed in conjunction with the PI of CPRN’s quality improvement initiative, Dr. Robert Bollo, to reduce intrathecal baclofen pump infections. Dr. Spader is the sixth neurosurgeon to join CPRN as a principal investigator and will contribute to the CPRN clinical registry’s capture of neurosurgical interventions for children with cerebral palsy.
 
Dr. Arroyo joins a growing segment of pediatric neurologists in the network as CPRN expands its research into epilepsy, dystonia and neonatal brain development issues in CP.
 


The latest in a series of videos by VITAS® Healthcare, the nation’s leading provider of end-of-life care, chronicles the advances in hospice technology—from handwritten intake forms detailing patient information to today’s use of virtual/augmented reality therapy for patients—and shows the many ways the company has innovated care at the patient bedside over the last four decades.

In the four-minute video, long-tenured VITAS team members acknowledge the extensive transformation in the tools used to deliver quality end-of-life care to patients and their families. While VITAS Healthcare’s mission remains the same, the tools available to us have changed considerably over the years.
 
In the early days, staff relied on analog solutions for nearly everything, from case management to communication to patient intake and documentation and record keeping were done manually. Clinical teams expressed skepticism over the reliability of early computer systems, and the notion of clinicians using handheld devices during patient visits was simply unimaginable.
 
“As new technology arose in our early years, it allowed us to grow with it, leveraging the power of computers to develop our digital infrastructure from the ground up,” recalls Bob Miller, a former VITAS chaplain 30 years ago who is now executive vice president and chief compliance officer. “The transition paid off in the form of a world-class patient management system.”
 
The new system – and the eventual adoption of mobile devices by our clinical teams – virtually eliminated any disconnect between data collection and the application of that data. Previously isolated teams could now communicate instantly, ensuring fewer gaps in patient care and a safer “workplace” for our hospice teams, whose cars often served as secondary office space.
 
Some of VITAS’ most exciting technological leaps occurred in the last decade. In 2012, VITAS launched a hospice referral app for mobile devices, closing the gap between referral sources and our admissions staff, and ensuring more timely care transitions for hospice-eligible patients. The next generation of the app will further streamline referral and hospice eligibility queries.
 
Just last year, VITAS announced a collaboration with AT&T to explore the potential of 5G mobile networking technology in hospice settings. Using 5G and virtual/augmented reality, VITAS and AT&T are reducing chronic pain and anxiety in appropriate patients.
 
“I look at where we are today and realize how far we’ve come,” says Maggie Macfarlane, senior director of medical claims review and 31-year veteran of VITAS. “[We’re] more efficient and we can still be with the patients and families.”
 
Perhaps most importantly, the new technology didn’t create a barrier between VITAS clinicians and their patients, but rather fostered more interaction with patients and families to meet their needs, and less time completing cumbersome paperwork.
 
Throughout VITAS’ four-decade history as a hospice leader and into the next decade, VITAS raises the bar on what hospice can be by integrating compassionate, patient-focused care with cutting-edge technology. While VITAS’ philosophy of care remains the same, the technology used to deliver that care never stops evolving.