A NEWSLETTER FOR THE DEPARTMENT OF SURGERY

at McGovern Medical School at UTHealth Houston

Progesterone Study Offers Insights into Inguinal Hernia Development

Approximately 27% of men will develop an inguinal hernia in their lifetime, and this translates into one million inguinal hernia repair surgeries in the United States annually and an estimated 20 million worldwide. While the development of an inguinal hernia is generally felt to be either congenital or developed through trauma, Jonah J. Stulberg, MD, PhD, MPH, FACS, associate professor and vice chair of research for the Department of Surgery, is collaborating with researchers at Northwestern to investigate what physiologic processes could also be driving hernia formation. They hypothesized that “enhanced progesterone (P4)/progesterone receptor (PGR) signaling in P4-sensitive lower abdominal muscle (LAM) fibroblasts drives their proliferation, fibrosis, and muscle atrophy, leading to hernia formation,” which they successfully studied in mouse models. They were able to use their knowledge of this pathway to induce hernias in these mice, and interestingly, when they treated the mice with progesterone antagonists, they prevented hernia development.

In the current phase of their study, they are using human tissue samples from men with inguinal hernias to examine their molecular signatures and compare them to those of the mice. The Lyndon B. Johnson (LBJ) Hospital has been the primary site for the human arm of their study. Their hope is that by investigating and better understanding these mechanisms for P4/PGR-derived muscle fibrosis, their work might inform the development of future therapeutics in the field.



Stulberg and his team were awarded more than $3M of ongoing funding by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) through an R01 to continue their research to better understand the physiologic mechanisms underlying hernia development and recurrence.

Eisenberg Presents Research at STS

The Society of Thoracic Surgeons was founded in 1964, and is one of the largest cardiothoracic surgical organizations in the world, with thousands of members from more than 100 countries. Their 60th Annual meeting was held this month in San Antonio, from Jan 27th to 29th.



Michael Eisenberg, MD, a general surgery resident on his research sabbatical with the MD Anderson Thoracic Surgery group, gave an oral presentation at the meeting. His project was titled "Does Occult Nodal Disease Following Sublobar Resection for Clinical T1a-b Non-Small Cell Lung Cancer Necessitate Conversion to Lobectomy".  

2024 ASRM Annual Conference

The American Society of Reconstructive Microsurgery (ASRM) annual conference was held on the beautiful island of Nassau, Bahamas, from January 12th-16th, 2024. The conference features innovative research, educational workshops and conferences, and countless networking events, all centered around complex reconstructive microsurgery. Mohin Bhadkamkar, MD, and Klara Sputova, MD, assistant professors and complex reconstructive surgeons in the Division of Plastic & Reconstructive Surgery were among the hundreds of experts from all over the world present at the conference. Also in attendance were current UTHealth Houston Plastic Surgery fellows David Hopkins, MD, and Shuyan Wei, MD, as well as former fellows Paul Deramo, MD, and Christopher Goodenough, MD, MPH. Hopkins presented his work on "An Algorithmic Approach to Lower Extremity Free Flap Re-Elevation," while UTHealth Houston Plastics research fellow Chioma Obinero, MD, presented her project about "Improving Racial Disparities in Immediate Breast Reconstruction." 

Moore Presents Innovative Trauma Solutions at Hokkaido Conference

Laura Moore, MD, FACS, professor in the Department of Surgery, was an invited speaker at the 15^th International Hokkaido Trauma Conference in Rusutsu, Hokkaido, Japan. Her invited lecture was entitled “Decreasing Time to Hemostasis: Tales of a Trauma Hybrid OR” and focused on the unique advances in trauma resuscitation and hemorrhage control that have been developed by the trauma surgeons at UTHealth Houston. The conference was attended by over 600 physicians from Australia, New Zealand, and Japan.

Eastern Association for the Surgery of Trauma (EAST) Annual Scientific Assembly

The 37^th EAST Annual Scientific Assembly was held January 9th-13th in Orlando, Florida, with excellent representation from our UTHealth Houston Department of Surgery, Division of Acute Care Surgery faculty, fellows, residents, and cherished alums. Highlights of this meeting included numerous podium presentations, paper discussions, an educational symposium, and multiple valuable mentorships and networking events for trainees. These note-worthy activities are described in greater detail (and captured photographically) below.

Thaddeus J. Puzio, MD, FACS, assistant professor in the Division of Acute Care Surgery and Associate Program Director of the Acute Care Surgery Fellowship, presented ‘Whole Blood Resuscitation in Critically Injured Older Adults: Can Less be More?’ (Thaddeus J. Puzio, J. Michael VanGent, Thomas Clements, Carter Kaminski, Bryan A Cotton).

Keith W. Burczak, DO, PGY-5 general surgery resident, and Captain, MC, US Army, presented ‘Risk Factors for Progression of Traumatic Intracranial Hemorrhage After Initiation of VTE Chemoprophylaxis: An Evaluation of 1390 TBI Patients’ (Keith W. Burczak, J. Michael Van Gent, Devi Bavishi, Thomas Clements, Thaddeus J. Puzio, Bryan Cotton).

Research from J. Michael Van Gent, DO, FACS, LCDR MC US Navy, Staff Physician in the Division of Acute Care Surgery and Trauma Surgeon at Brooke Army Medical Center and Bryan Cotton, MD, MPH, FACS, professor in the Division of Acute Care Surgery and Program Director of the Acute Care Surgery Fellowship, was presented by Brittany A. Hout, BASc, DHSc, Physician Assistant, US Navy, titled ‘Does Whole Blood Resuscitation Increase Risk for Venous Thromboembolism in Trauma Patients? A Comparison of Component Therapy vs. Whole Blood in 3468 Patients’ (BA Hout, JM Van Gent, TW Clements, RC Rausa, CW Kaminski, T Puzio, JA Rizzo, BA Cotton).

Michael Wandling, MD, MS, FACS, assistant professor in the Division of Acute Care Surgery and Assistant Trauma Medical Director, was the Discussant on a paper titled “Effect of CPR on Perfusion in a Porcine Model of Severe Hemorrhagic Shock” from LSUHSC-New Orleans. 

Wandling was also chosen to receive the prestigious 2024 EAST Leadership Development Workshop Scholarship, facilitating his annual participation in the valuable pre-conference EAST Leadership Development Workshops and further contributing to his continued professional growth.

Cotton spearheaded an Educational Symposium on “The VTE Puzzle: Missing Pieces in Severe Trauma “alongside Jessica C. Cardenas, PhD, former assistant professor in the Department of Surgery, and Michael D. Goodman, MD, a graduate of UTHealth Houston Acute Care Surgery Fellowship and current Director of General Surgery Research and Associate Director of Critical Care Fellowship and General Surgery Residency Programs at the University of Cincinnati. This comprehensive talk from experts in the field was incredibly well-attended, with standing-room only.

Alongside these excellent presentations and exciting research from colleagues around the country, attendees also made time for valuable networking within and outside designated conference activities. The highly anticipated “No Suit, No Problem: Fostering Relationships and Building Careers” event, organized by the EAST Development Committee, facilitates small-group mentorship, networking, career planning, and advice for acute care surgery fellows and surgical residents nearing graduation. Overall, it was an incredibly successful EAST Assembly with fantastic UTHealth Houston representation and even greater inspiration for future research endeavors.

Thaddeus Puzio’s Podium Presentation: ‘Whole Blood Resuscitation in Critically Injured Older Adults: Can Less be More?’

Bryan Cotton, Michael Wandling, and former UTHealth Houston ACS fellows Timothy Donahue and Christopher ‘Cameron’ McCoy.

Keith Burczak’s Podium Presentation: ‘Risk Factors for Progression of Traumatic Intracranial Hemorrhage After Initiation of VTE Chemoprophylaxis: An Evaluation of 1390 TBI Patients.’

Bryan Cotton, Michael Van Gent, and former UTHealth Houston ACS fellow Rushabh Dev with current fellow Gabrielle Hatton.

Michael Wandling in his role as Discussant on a paper titled, ‘Effect of CPR on Perfusion in a Porcine Model of Severe Hemorrhagic Shock.’

Keith Burczak, Michael Van Gent, and Brittany Hout network with other EAST members between conference presentations.

Donalisio de Silva Performs Groundbreaking HoLEP Procedures

Rodrigo Donalisio de Silva, MD, an associate professor in the Division of Urology, achieved a significant milestone on January 31, 2024, by successfully performing the first two procedures of Holmium laser enucleation of the prostate (HoLEP) at Memorial Hermann TMC. HoLEP is a minimally invasive laser surgery utilized in the treatment of benign prostatic hyperplasia (BPH). This transurethral procedure employs a laser beam to precisely remove prostate tissue obstructing urinary flow, offering patients an excellent alternative to traditional open or robotic prostatectomy for benign conditions. Notably, HoLEP boasts faster recovery times, requires no incisions, and is suitable for a wide range of prostate gland sizes, making it a highly versatile and patient-friendly option.

Publications of Note

Cox CS Jr, Notrica DM, Juranek J, Miller JH, Triolo F, Kosmach S, Savitz SI, Adelson PD, Pedroza C, Olson SD, Scott MC, Kumar A, Aertker BM, Caplan HW, Jackson ML, Gill BS, Hetz RA, Lavoie MS, Ewing-Cobbs L. Autologous bone marrow mononuclear cells to treat severe traumatic brain injury in children. Brain. 2024 Jan 5:awae005. doi: 10.1093/brain/awae005. Epub ahead of print. PMID: 38181433.

Dodwad SM, Mueck KM, Kregel HR, Guy-Frank CJ, Isbell KD, Klugh JM, Wade CE, Harvin JA, Kao LS, Wandling MW. Impact of Intra-Operative Shock and Resuscitation on Surgical Site Infections After Trauma Laparotomy. Surg Infect (Larchmt). 2024 Feb;25(1):19-25. doi: 10.1089/sur.2023.010. Epub 2024 Jan 3. PMID: 38170174; PMCID: PMC10825266.

Schellenberg M, Owattanapanich N, Emigh B, Van Gent JM, Egodage T, Murphy PB, Ball CG, Spencer AL, Vogt KN, Keeley JA, Doris S, Beiling M, Donnelly M, Ghneim M, Schroeppel T, Bradford J, Breinholt CS, Coimbra R, Berndtson AE, Anding C, Charles MS, Rieger W, Inaba K; AAST VTE Prophylaxis Study Group. (Cotton BA) When is it safe to start venous thromboembolism prophylaxis after blunt solid organ injury? A prospective American Association for the Surgery of Trauma multi-institutional trial. J Trauma Acute Care Surg. 2024 Feb 1;96(2):209-215. doi: 10.1097/TA.0000000000004163. Epub 2023 Oct 24. PMID: 37872669.

Tonna JE, Boonstra PS, MacLaren G, Paden M, Brodie D, Anders M, Hoskote A, Ramanathan K, Hyslop R, Fanning JJ, Rycus P, Stead C, Barrett NA, Mueller T, Gómez RD, Malhotra Kapoor P, Fraser JF, Bartlett RH, Alexander PMA, Barbaro RP; Extracorporeal Life Support Organization (ELSO) Member Centers Group (Cox CS). Extracorporeal Life Support Organization Registry International Report 2022: 100,000 Survivors. ASAIO J. 2024 Feb 1;70(2):131-143. doi: 10.1097/MAT.0000000000002128. Epub 2024 Jan 5. PMID: 38181413.

Zadorozny EV, Lin HS, Luther J, Wisniewski SR, Cotton BA, Fox EE, Harbrecht BG, Joseph BA, Moore EE, Ostenmayer DG, Patel MB, Schreiber MA, Tatebe LC, Todd SR, Wilson C, Gruen DS, Sperry JL, Martin-Gill C, Brown JB, Guyette FX. Prehospital Time Following Traumatic Injury Is Independently Associated With the Need for In-Hospital Blood and Early Mortality for Specific Injury Types. Air Med J. 2024 Jan-Feb;43(1):47-54. doi: 10.1016/j.amj.2023.09.013. Epub 2023 Nov 28. PMID: 38154840.

Alumni Spotlight

UTHealth Houston Alumnus Named to Order of Canada

Richard K Reznick, MD, a graduate of the McGovern Medical School at UTHealth Houston’s residency training program in colon and rectal surgery, was recently appointed to the Order of Canada (Canadian equivalent of British Knighthood). The Order of Canada recognizes people across all sectors of society who have made extraordinary and sustained contributions to Canada. Dr. Reznick’s appointment celebrates his impact as an innovator in medical and surgical education.

Reznick completed his medical degree at McGill University and later graduated from the general surgery training program at the University of Toronto. He completed a Master of Education at Southern Illinois University and then did a fellowship in colorectal surgery at McGovern Medical School. 

Dr. Reznick has had an impressive career as an educator and a physician, including recently serving a term as the 46th President of the Royal College of Physicians and Surgeons of Canada. He is also the former chair of the Department of Surgery at the University of Toronto and Dean Emeritus of Queen’s University of Health Sciences.

Dr. Reznick has been active in both colorectal surgery and research in medical education. He was instrumental in developing a performance-based examination, which is now used for medical licensure in Canada. He ran a research program on assessment of technical competence for surgeons and supervised a fellowship program in surgical education. 



Editorial Team: Dr. Lillian S. Kao, Dr. Casey B. Duncan, Dr. Peter A. Walker, and Dr. Elias A. Chamely

For content submissions, email Sophia.M.Solis@uth.tmc.edu.