Roychowdhury Rutgers
Sanjuana Gautam
Abstract: Cystic fibrosis (CF) patients suffer chronic infections in their clogged lung airways due to build up of excess mucus and fluid. The most prevalent bacterial infections in adult CF patients are Pseudomonas aeruginosa. Currently, tobramycin is the main drug used to treat Gram-negative lung infections in CF. As mucus clearance is inhibited in CF patients, drugs such as tobramycin that are normally effective against P. aeruginosa are not able to penetrate and eradicate the infection, a problem caused by the formation of bacterial biofilms within these mucus layers. Improved methods of administering the drugs may lead to better outcomes in treating these infections.
There are multiple ways to administer the drug, including IV or inhalation. Inhalation using aerosols seems to be the most promising for direct delivery of the drug to the site of infection. We used pharmacokinetic and pharmacodynamic (PKPD) modeling to understand better the interplay between formulation and administration strategies and bacteria populations in the planktonic, biofilm, and latent states. The pharmacokinetic model indicated that the aerosol would be the best administration of tobramycin. Furthermore, our pharmacodynamic model incorporated the drug cytotoxic effect on the bacteria via aerosol administration. This model indicated that, while successive doses of nebulized tobramycin killed off most of the planktonic bacteria, the bacteria persisted in the biofilm and latent states even after five daily administrations. Currently, we are in the process of incorporating nanoparticles into the model, where the nanoparticle will carry the drug to the lungs and release it in a sustained manner. In vitro and in vivo testing will be used to further validate these simulation results. These simulations are intended to contribute to the design of an aerosolized nanomedicine for improved treatment of lung infections in CF.
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Our Department of Radiology is comprised of the Clinical Radiology Department of the Robert Wood Johnson University Hospital and members of the University Radiology Group. The department consists of about 60 board certified radiologists providing expertise in all subspecialties of Diagnostic and Interventional Radiology. Each radiologist practices primarily in his or her subspecialty.
We are pleased you have chosen to visit the Department of Radiology web site. Please take this opportunity to learn more about our Department and Radiology services. The mission of the Department of Radiology includes commitment to clinical service, education, research and service to the community.
Over the last decade, Radiology has emerged as a leader in minimally invasive diagnostic and treatment modalities. With the advances in diagnostic imaging and minimally invasive treatment has come increasing sub-specialization. This sub-specialization provides patients with sophisticated practitioners who concentrate their activities to various specific areas within Radiology.
Our department is made of divisions of General Diagnostic Radiology, with sections including breast imaging, pediatric radiology, chest radiology, diagnostic ultrasound, musculoskeletal imaging, and body imaging with MRI and CT. The Division of Neuroradiology includes both a diagnostic and interventional section. The Division of Nuclear Imaging includes radionuclide imaging, therapeutic radiopharmaceutical administration and PET scanning. The Division of Interventional Radiology provides the full gamut of image-guided minimally invasive diagnosis and treatment. Finally, the Research Division concentrates its efforts in biomedical imaging and bioengineering.
Education is an important facet of the mission of our department. In addition to medical student education, the department conducts a large Residency Program in Diagnostic Radiology and a Independent Interventional Radiology Residency. As a service to the community the department hosts high school and college students in summer fellowships. Finally, the department is active in patient education.
Research is the final component of our academic mission. The Division of Radiology Research provides expertise in Biomedical Imaging as well as Bioengineering. The Department is involved in basic science research in both Bioengineering and Imaging analysis. Members of the Department engage in clinical research and clinical trials along subspecialty lines.
Feel free to peruse our website for information about our department, faculty, medical student education, the Diagnostic Radiology Residency Program, Independent Interventional Radiology Residency, and departmental research.
Our large Diagnostic Radiology Residency Program delivers an excellent balance between the academic and practical aspects of radiology. Daily educational conferences, some of which are multidisciplinary, provide residents with a firm academic foundation. In addition, the attending radiologists are dedicated to teaching and to resident success. As the vast majority of them are subspecialized, residents receive an excellent and comprehensive educational experience encompassing the different branches of radiology.
Our training program is unique as it provides our IR/DR resident access to a large volume of cases across a broad spectrum of interventions under the mentorship of experienced fellowship-trained interventional radiologists. This exposure is facilitated by our affiliation with the Rutgers Cancer Institute of New Jersey the Bristol-Myers Squibb Children's Hospital and the Children's Specialized Hospital. Our primary teaching facility is also a level one trauma center, level one stroke center, and the teaching site for residencies and fellowships of Robert Wood Johnson Medical School. Adjacent to the hospital is an outpatient interventional radiology facility housing our vein clinic.
We also have a diagnostic radiology residency, early specialization in interventional radiology (ESIR), and rotating medical students. The IR/DR resident has ample opportunity to teach along with being taught. Combined with unparalleled hands-on experience, the IR/DR resident has exposure to research, the liver multidisciplinary group, the vascular malformation clinic, the vein clinic, the pulmonary embolism response team, an outpatient clinic, and dedicated rotation time with vascular surgery, surgical oncology, neuro-interventional, and ICU. The IR/DR resident is mentored by an experienced program director and teaching faculty with decades of experience and a proven track in training successful and accomplished interventional radiologists.
When I was a medical student, I only met two radiologists during those four years, thus receiving only minimal contact with the field. My mother was an X-ray technologist, so I did know a little bit about what radiologists do.
Since Radiology is not a standardized core clerkship, we have created electives which will familiarize you with the field and its importance in the management of your patients. These electives are not only intended for students who are thinking about Radiology as a career, but for all medical students, as you will use imaging/Radiology in whatever field of Medicine you are thinking about.
Alumni Association sponsored events are attended by Radiology residents and faculty to give information to medical students about both the overall field of Radiology, and information regarding careers in Radiology.
Mentors will help you with making a decision about your career, advise you on your strengths and weaknesses, when to take your USMLE II, how to get the best LORs (Letters of Recommendation), how to construct a PS (Personal Statement), where to apply, how to prepare for interviews, etc.
Learn in dynamic environments where medical education, leading-edge research, and outstanding patient care converge. Our principal teaching hospital, Robert Wood Johnson University Hospital, and clinical affiliations with RWJBarnabas Health and numerous hospitals and ambulatory care sites across New Jersey provide extraordinary opportunities to hone your skills under the guidance of renowned mentors and clinicians.
Rutgers is located in central New Jersey in the city of New Brunswick and across the Raritan River in Piscataway. Middlesex-Somerset-Hunterdon counties rank fourth in per capita income nationwide. It is a manufacturing center, agricultural center, high-tech corporate center, and small-town America rolled into one.
The QI Resident Director is a position on the same level as chief resident. This resident provides a leadership role and given opportunities to enhance education regarding the intricacies of QI activities. This resident assists in the education of other residents regarding QI.
The selected resident is given financial support to attend a national meeting with a focus on QI. Upon his or her return, the resident provides a summary of the meeting to the other residents in the program.
This resident completes a substantial QI project and submits the resulting manuscript to a major peer-reviewed radiology journal. The presentation of the project at a national meeting is encouraged. The project selected is be designed to enhance departmental QI activities. Mentorship from faculty is provided from Dr. Basak, Dr. Kempf, and Dr. Schonfeld.
The resident QI director serves as the contact person for junior residents to help them deal effectively with adverse events or quality issues that may impact them. The resident QI director is involved in the formulation of the monthly QA conferences run by an attending and another resident. The resident QI director lectures on QI topics derived from suggestions and recommendations from residents, issues identified at the department QA conference, and self-selected topics. This resident works closely with Dr. Schonfeld, the QI program director, and the associate program director in enhancing QI opportunities and education for the residents in the program. Furthermore, this resident serves as a liaison between the residency program and the University Radiology Group's QA Committee.
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