Division Chief Earns Echocardiography Accolade

Jonathan B. Mark, MDThe American Society of Echocardiography (ASE) has selected Duke Anesthesiology’s Jonathan Mark, MD, as the 2018 recipient of the Outstanding Achievement in Perioperative Echocardiography Award. The ASE Council on Perioperative Echocardiography recognizes Dr. Mark for his significant clinical, research, and/or educational contributions to the development of the field. He will be presented this award at the ASE Scientific Sessions in June.

Dr. Mark, professor of anesthesiology and assistant professor of medicine, is currently the chief of the Veterans Affairs Anesthesiology Service Division, known for its excellence in chronic pain management following traumatic injury. Anesthesiologists at the Durham Veterans Affairs Medical Center provide hospital-wide diagnostic transesophageal echocardiography (TEE) services, a procedure traditionally performed by cardiologists. Dr. Mark’s research focuses include new clinical applications of TEE and practicing guideline development, training and certification for perioperative TEE, pulmonary artery catheterization and cardiovascular monitoring.

Chris KeithDivision Chief Earns Echocardiography Accolade
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Dr. Maixner Receives Distinguished Scientist Award

William Maixner, DDS, PhDThe American Association for Dental Research (AADR) has selected Duke Anesthesiology’s William Maixner, DDS, PhD, as the 2018 recipient of the AADR Distinguished Scientist Award. A committee comprised of AADR past presidents chose Dr. Maixner as this year’s awardee for his significant contribution to the field of oral health research. He will be presented the award at the AADR Annual Meeting and Exhibition in March.

Dr. Maixner is currently the Joannes H. Karis, MD, Professor of Anesthesiology, the vice chair for research and the co-director of the Center for Translational Pain Medicine within Duke Anesthesiology. He was also instrumental in establishing Duke Innovative Pain Therapies, a first-of-its-kind multispecialty pain practice in the world, located in Raleigh.

His primary research focus is on biological, environmental and genetic factors involved in pain transmission and modulation. Notably, Dr. Maixner was the principal investigator on the National Institute of Dental and Craniofacial Research’s (NIDCR) $19 million, seven-year OPPERA study to examine pain produced by temporomandibular joint and muscle disorders. In 2012, the NIDCR awarded Dr. Maixner and his team an additional $16 million in funding to support the study (called OPPERA II) for an additional five-year period. Dr. Maixner considers chronic pain to be a “hidden epidemic” and has therefore campaigned for more research support amongst colleagues, sponsors, health organizations and congressional committees. He has published more than 200 manuscripts and book chapters and has been continuously funded by the National Institutes of Health since 1986.

Chris KeithDr. Maixner Receives Distinguished Scientist Award
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Chief of Pain Research Named Co-Director of CTPM

Ru-Rong Ji, PhD

We are pleased to announce that Duke Anesthesiology’s Ru-Rong Ji, PhD, and distinguished professor of anesthesiology in the Duke University School of Medicine, has been named the co-director of the Center for Translational Pain Medicine (CTPM), a novel entity aimed at transforming the way painful conditions are diagnosed and treated.

In his new role, Dr. Ji will work closely with his colleague, Dr. William Maixner, co-director of the CTPM and a world-renowned pioneer in pain research. Dr. Ji will continue to focus on basic science research in his Sensory Plasticity and Pain Research Laboratory where he and co-investigators strive to identify molecular and cellular mechanisms that underlie the genesis of chronic pain. Additionally, Dr. Ji will assist in organizing pain seminars and research symposia at Duke and abroad.

The CTPM launched in January of 2016, further expanding the department’s existing clinical and research program in innovative pain therapies by bringing together, under one umbrella, leading basic scientists, clinicians and clinical researchers who have a common core mission of unraveling the causes of painful conditions to better improve patient care.

“Our vision is to build one of the strongest pain research centers in the world,” says Dr. Ji. “The CTPM is unique because it’s an integration of basic science research, translational research and clinical management. Only a few places in the world can do this. It is a great honor to be appointed co-director and to work with leading scientists and clinicians on research initiatives with the goal of developing novel pain therapeutics.”

Please join us in extending congratulations to Dr. Ji on his new position.

Chris KeithChief of Pain Research Named Co-Director of CTPM
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Dr. Wischmeyer Awarded Perioperative Education Grants

Paul E. Wischmeyer, MD, EDICDuke Anesthesiology’s Paul Wischmeyer, MD, EDIC, has been awarded three grants totaling $179,772 for the following educational projects:

  1. “Nutrition in ERAS: What You Must Know” (education podcasts in perioperative nutrition)
    Funding Agency: Abbott Nutrition
    Grant Amount: $100,000 (DCRI)

This project is part of the Duke Clinical Research Institute (DCRI) Evidence to Practice Series, a multi-format educational program aimed at translating the latest research findings into clinical context through case driven discussions. In early 2018, DCRI will launch “Nutrition in ERAS: What You Must Know” as the latest topic in the Evidence to Practice Series line-up. The program will be directed by Dr. Paul Wischmeyer and will include six audio podcasts and a satellite symposium at Digestive Disease Week 2018.

  1. “Improving Physician and Provider Education on Perioperative and Hospital Malnutrition”
    Funding Agency: Abbott Nutrition
    Grant Amount: $50,000 (Duke Anesthesiology)

The overall goal of this project is to conduct an exploratory clinical trial to address the following questions: 1) what is the effect of a prebiotic (Nutriflora scFOS via Vital AF) containing enteral flora on longitudinal gut, oral and skin microbiome in critically ill neurological injury trauma patients and 2) does an alteration in microbiome correlate with a signal of changed clinical outcomes such as GI acquired infections (like Clostridium Difficile and antibiotic associated-diarrhea) and ventilator associated pneumonia? This proposal will link Dr. Wischmeyer’s long-standing interest in enteral nutrition delivery to improve outcome and nutrition critical care trial expertise using novel methodology via microbial community profiling with high-throughout sequencing of the 16S rRNA gene. This initial trial will establish the feasibility of conducting larger scale trials and collect the first data on the role of prebiotic fiber (Nutriflora scFOS) on microbiome profiling. It may allow for identification of patients who will benefit from prebiotic formulas and provide an objective method to drive the use of prebiotic containing formulas like Vital AF.

  1. “Improving Provider Education on Optimal Use and Placement of New IRIS Camera Guided Feeding Tube”
    Funding Agency: Cardinal Health
    Grant Amount: $29,772 (DCRI)

The goal of this project is to create provider educational materials and videos to instruct clinicians in the use of new camera-guided enteral feeding tube placement technology to increase patient safety and delivery of nutrition.

Chris KeithDr. Wischmeyer Awarded Perioperative Education Grants
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Dr. Davison Awarded ASPEN Grant to Improve Critical Care Outcomes

James Davison, PhD

James Davison, PhD

The American Society of Parenteral and Enteral Nutrition (ASPEN) Rhoads Research Foundation has awarded Duke Anesthesiology’s James Davison, PhD, a lab research analyst and director of The Wischmeyer Lab, a $25,000 grant (with potential second-year funding of an additional $25,000) for his project, titled “Modulation of Organ Injury by Faecalibacterium Prausnitzii in Critical Illness.” Dr. Davison’s long-term research objective is to establish nutritional and probiotic therapies that support organ function and improve outcomes in critical care patients.

According to the project’s abstract, intensive care unit (ICU) admission is associated with a loss of “health promoting” bacteria and a rapid dysbiosis of the intestinal microbiota. Specifically, a recent multi-center ICU microbiome clinical trial from The Wischmeyer and Knight (UC San Diego) Labs demonstrated a significant loss of the probiotic microorganism, Faecalibacterium prausnitzii, which generates metabolites and anti-inflammatory peptides that support intestinal function and attenuate local inflammation in experimental colitis models. Based on the clinical findings and the known roles of F. prausnitzii in attenuating local inflammation, Dr. Davison and his project mentor, Dr. Paul Wischmeyer, have developed this central hypothesis: F. prausnitzii and/or its metabolites attenuate systemic inflammation, improve organ function and reduce morbidity/mortality in sepsis. Thus, their two project aims include 1) directly addressing the working hypothesis that oral supplementation of F. prausnitzii protects intestinal and extra-intestinal organ function during sepsis. Using the accepted cecal-ligation and puncture model of sepsis, they will test if F. prausnitzii attenuates systemic inflammation and promotes extra-intestinal organ function. They will also utilize next-generation sequencing to determine if F. prausnitzii mediates metabolic and inflammatory transcriptional responses of organs in septic mice, and 2) directly addressing the working hypothesis that peptides and metabolites derived from F. prausnitzii suppress systemic inflammation. Using protein and metabolite mass spectrometry, they will test for enrichment of serum metabolites and peptides that are only present in mice that receive F. prausnitzii. They will synthesize peptides that are unique in the serum of mice that receive F. prausnitzii and will test if oral gavage or tail-vain injection of these synthesized peptides have the capacity to reduce inflammation in septic mice.

Drs. Davison and Wischmeyer believe that this project addresses a significant obstacle that prevents wider use of probiotic therapies (and other nutritional therapies) in critical illness – and that the lack of understanding of the molecular mechanisms mediate probiotic contributions to human health. They predict that their translational research plan will support their long-term research objectives in identifying novel mechanisms that mediate probiotic organ protection in illness, leading to new therapies to prevent and treat sepsis and critical illness.

Chris KeithDr. Davison Awarded ASPEN Grant to Improve Critical Care Outcomes
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