Macaluso's research aims to prevent cat scratch disease and other illnesses

In this file photo from fall 2019, Kevin

Macaluso, Ph.D., works in the lab.

Kevin R. Macaluso, Ph.D., professor and Locke Distinguished Chair of Microbiology and Immunology at the University of South Alabama College of Medicine, is among the authors of a research article accepted for publication in Microbial Pathogenesis.

The article, “A non-coding RNA controls the transcription of a gene encoding a DNA binding protein that modulates biofilm development in Bartonella henselae” will be included in an upcoming edition of the peer-reviewed journal.

Bartonella henselae (B. henselae) is a bacterium that can infect humans and cats. It is transmitted by the cat flea from one cat to another and to humans by the scratch of a cat. This bacterium causes cat scratch disease and other serious health conditions including bacterial, bloodstream and heart valve infections.

More than 12,500 people are diagnosed with cat scratch disease in the United States annually, according to a 2016 Centers for Disease Control and Prevention study. The incidence of cat scratch disease during the study period was highest in children between the ages of 5 and 9. The CDC estimates the annual medical cost for cat scratch disease in the U.S. to be nearly $10 million each year.

The research article describes how the bacterium B. henselae persists in both humans and cat fleas in a structure known as a biofilm. Understanding new genetic mechanisms by which bacteria, including B. henselae, initiate biofilm formation is critical for understanding how it causes disease in humans, according to the authors.

Biofilms are a collective of one or more types of microorganisms that can grow on different surfaces. Microorganisms that form biofilms include bacteria and fungi.

The report, authored by Udoka Okaro, Sierra George, Sabrina Valdes, Macaluso and Burt Anderson, will enable further studies to optimize efforts to prevent the initial steps in which bacteria aggregate to form a biofilm. This could help prevent the transmission of the bacterium from one cat to another and from cats to humans. 

Data presented within the article, according to the scientists, are the first to identify and experimentally characterize a transcriptional regulator and RNA responsible for biofilm formation in B. henselae. The work was done in collaboration with researchers at the University of South Florida School of Medicine.

Microbial Pathogenesis is an international journal which publishes original contributions and reviews about the molecular and cellular mechanisms of infectious diseases. It covers microbiology, host-pathogen interaction and immunology related to infectious agents, including bacteria, fungi, viruses and protozoa. It also accepts papers in the field of clinical microbiology.

Richards performs surgeries, provides medical education in Ecuador

William Richards, M.D., professor and chair of surgery at the USA College of Medicine, and surgeon Esteban Moscoso, M.D., performed surgeries together in Ecuador. 

William Richards, M.D., recently traveled to Ecuador to perform a resection on a rare tumor, helping a long-time friend gain experience with the procedure. While there, he performed other surgeries and spoke to local medical groups to provide education.

Richards, professor and chair of surgery at the University of South Alabama College of Medicine and director of the USA Surgical Weight Loss Center, has traveled to Ecuador five times since 1995 to give presentations to the Ecuadorian Society of Laparoscopic Surgery as well as students at the medical school there. He has also performed a number of operations during his visits.

Richards visits Ecuador in part because of his long-time friendship with Esteban Moscoso, M.D., a surgeon and a fellow of the American College of Surgeons. The two met in 1992 when Moscoso asked if he could observe Richards perform laparoscopic surgeries. According to Richards, these types of surgeries are as important in Ecuador as in the United States because they help people return to work quicker. The pair have also operated together to give Moscoso experience with various other types of surgery.

Richards’ most recent trip was to help Moscoso operate on a man with an adrenal tumor, which was causing severe hypertension, that could lead to a stroke or heart attack if not removed. Moscoso did not have a great deal of experience resecting this type of tumor, so he reached out to his friend. Richards said adrenal tumors are fairly rare, but the case went well, and the patient no longer has hypertension.

Ironically, the patient was someone that Richards had met during a previous visit to Ecuador 20-years prior. The two share a love of collecting butterflies, and the patient had shared some of his butterfly collection with Richards not knowing that they would meet again under different circumstances.

During his most recent visit, Richards spent eight days in Ecuador,  operated on several additional patients and gave lectures to medical students, surgeons, and residents.

“Besides being a surgeon, I also have the opportunity to help patients indirectly as a medical educator,” Richards said. “While in Ecuador, I helped a friend learn how to do a more advanced cases and provide more surgical options for his patients.

Now, he’s teaching other surgeons how to do these procedures.”

Hermance joins USA department of microbiology and immunology

Meghan Hermance, Ph.D., assistant professor of microbiology and immunology, examines arthropod-borne viruses.

A passion for research and a strong desire to share knowledge with others led Meghan Hermance, Ph.D., to a career in the basic sciences within academic medical centers. She joined the faculty of the University of South Alabama College of Medicine in May as an assistant professor in the department of microbiology and immunology.

Basic science research helps contribute to better ways to predict, prevent, diagnose and treat diseases.

“Dr. Hermance is an excellent addition to our faculty, bringing expertise in virology and immunology that will strengthen the research and teaching mission of the university,” said Kevin R. Macaluso, Ph.D., professor and Locke Distinguished Chair of Microbiology and Immunology at USA’s College of Medicine.

Hermance trained in one of the leading U.S. laboratories examining unique aspects of emerging arthropod-borne viruses, Macaluso said. Arthropod-borne viruses, also known as arboviruses, are transmitted to humans primarily through the bites of infected mosquitoes, ticks, sand flies or midges, all of which are all prevalent throughout the Gulf Coast region.

Hermance most recently served as a research scientist in the department of microbiology and immunology at State University of New York (SUNY) Upstate Medical University in Syracuse, New York. Her postdoctoral fellowship was completed at the University of Texas Medical Branch in the department of pathology in Galveston, Texas.

Her research interests are centered on the interface between the arthropod and mammalian host, identifying the factors essential for transmission of pathogens and subsequent illness. Focusing on emerging or potentially introduced viral pathogens, Hermance's research, Macaluso said, will help lay the groundwork for the development of diagnostic and interventional strategies for emerging arboviruses.

“I’ve always hoped to have the opportunity to be in a research and teaching environment with the ability to research, teach courses and train students,” Hermance said. “Training the next generation of scientists is so important.”

USA Health surgery resident wins regional paper competition

Richard Rieske, M.D., a surgery resident and postdoctoral research fellow in the University of South Alabama department of surgery, recently won the American College of Surgeons Regional Resident Paper Competition for Region 4. USA has won the regional competition four times in the past six years.

Rieske’s research highlighted the work conducted in a year spent in the lab with Jon Simmons, M.D., associate professor of surgery and pharmacology at the University of South Alabama College of Medicine.

Rieske’s research examined the blood of trauma patients and discovered that those patients with elevated DAMPs (molecules that trigger inflammatory responses via pattern recognition receptors) in their blood were more likely to die or have serious injuries. From this, they tried to understand where DAMPs come from and how they impact the survival of trauma patients. The work found that blood products contain unrecognized cellular contamination, and this could be a source of harmful DAMPs in trauma patients who receive multiple blood products.

“We learned that plasma, which physicians typically regard as a blood product that doesn't contain blood cells, contains significant numbers of white blood cells,” Rieske said. “This is a problem because these cells can interact with the immune system in the patient or may lead to inflammatory reactions.”

Since blood transfusions are an essential part of trauma care, Rieske says that they don’t yet fully understand all the implications of what they have discovered about giving large amounts of white blood cells to trauma patients.

“This research helps us ask important questions about how we produce blood products and how we ensure the safest use of blood products in trauma patients,” Rieske said.

Rieske was one of two USA Health residents to win at the state level and then compete at the regional competition in South Carolina. He was scheduled to present at the national competition in March, but this has been rescheduled due to concerns about COVID-19.

“This is the most prestigious resident research award for trauma from the American College of Surgeons,” said Michael Chang, M.D., chief medical officer for USA Health. “Participating in the national competition will be a wonderful opportunity for him to get exposure for the great work he’s doing, and sends the message that the research that Simmons’ group is doing is cutting-edge in the resuscitation of injured trauma patients internationally.”

YouTube channel goes behind the scenes of emergency medicine

Larry Mellick, M.D., professor and vice chair of emergency medicine at the USA College of Medicine, is the creator of a YouTube channel for medical education. 

A ring stuck on a swollen finger, a dislocated shoulder, a foreign body in the nose – these are a few reasons people might seek emergency treatment. They are also video topics of a popular YouTube channel that goes behind the scenes of emergency medicine to support medical education.

Larry Mellick, M.D., professor and vice chair of emergency medicine at the University of South Alabama College of Medicine, created the channel in 2010. At the time, he worked at the Medical College of Georgia in Augusta. The videos served as an additional resource to teach medical students and residents about scenarios they might encounter in the emergency department.

“It became a much better way to teach procedures,” said Mellick, who also serves as division chief of pediatric emergency medicine at USA Health. “Having a real patient involved – not just a simulation or a PowerPoint presentation – is so much more powerful from an educational perspective.”

Screenshot of Dr. Larry Mellick's YouTube channel

When he joined USA Health in February 2018, Mellick started a new YouTube channel. However, he couldn’t replicate the success of his existing channel, which already had a loyal following. Mellick worked with USA Health’s legal team, compliance officers, and marketing and communications to rebrand his original channel to USA Health.

Before being uploaded to YouTube, each video is vetted through a peer and compliance review process, Mellick said. In addition, all patients and family members featured in the videos have given signed consent to be filmed and have their stories shared.

“We greatly respect and care about our patients’ rights and privacy,” Mellick said. “People are making personal sacrifices to allow these videos to be made for education purposes. I feel sincere gratitude to patients who have made that sacrifice because of the impact it has had on learners all over the world.”

The videos are popular with a spectrum of learners including medicine, paramedicine, nursing, respiratory therapy, coding and billing, as well as practicing clinicians, Mellick said.

“The importance is to be real. This is real medicine,” he said.

Mellick said the videos also attract viewers who are searching for information about a recent diagnosis or who are awaiting a procedure in the emergency department.

“Patients will go to YouTube and look up what their doctor is talking about following initial conversations,” he said. “They also search for answers about a specific diagnosis and related treatment.”

Mellick said the videos have even saved some lives. “I personally have had several patients reach out to me in the comments and I advised them that they needed to go to the ER immediately. A week or two later I found out through the patient that they had undergone emergency surgery,” he said. “I have also had occasional testimonials from physicians about how the information in the videos helped them save a life.”

The channel has 333,000 subscribers, and 26 videos uploaded to the channel have more than 1 million views each. The channel’s most popular video to date demonstrates the management of a nail gun injury. Appropriately titled “Finger Nail,” the video has more than 22 million views.

Mellick said the videos have a broad appeal because of the lay public’s fascination with medicine and the videos’ human interest component. He has seen an increase in views over the past two months, which he attributes to people being at home and watching more videos during the coronavirus quarantine.

The channel is monetized, and Mellick donates all proceeds to the USA Health Emergency Medicine Residency Program to support training and education in emergency medicine.

Mellick edits the videos on his own time, usually late at night. “Sometimes I need a break from my academic endeavors to explore my artistic side,” he said.

Visit Dr. Larry Mellick's YouTube channel to watch or subscribe to USA Health emergency medicine training videos.