Des Moines University Clinic

Hologic’s Discovery A™ system with dual X-ray bone densitometry technology provides “significantly more information” and does so more accurately than the 10-year-old equipment it replaced, says Jean Schuster, radiology manager.

The new system enables the clinic’s certified DXA technologists to assess bone health, including structural geometry of the hip and existence of vertebral fractures. This information allows providers to diagnose and monitor patients with such fractures and osteoporosis.

“By detecting low bone density and vertebral fractures, the patient can begin treatment and avoid further complications,” Schuster says. “It’s exciting to be able to provide that information.”

Identical to the unit featured on NBC’s “The Biggest Loser,” the equipment will aid researchers exploring bone density, nutrition and exercise. It accurately measures fat mass, lean mass and total body mass for the entire skeleton as well as individual parts of the body.

The Hologic DXA unit can accommodate patients ranging from infants to adults up to 450 pounds. An additional bonus for patients and staff: The equipment generates information painlessly, non-invasively and quickly. “The longest scan takes 60 seconds,” Schuster notes.

Learn more about Des Moines University Clinic’s Radiology department.

Elizabeth Trausch, D.P.T. DMU Clinic

Wetting one’s pants after sneezing. Discomfort while sitting. Painful intercourse. Millions of women are believed to suffer these and other pelvic floor disorders along with the physical, emotional and social nightmares they create. Many suffer silently, too embarrassed to discuss these issues even with their physicians.

DMU’s Physical Therapy Clinic can offer solutions, however. Its specially trained staff use manual techniques along with computer technology, called EMG biofeedback, to evaluate and measure length, tone and strength in the pelvic floor muscles. This technology helps the therapist analyze the problem and propose treatment.

“If the pelvic floor muscles are weak or uncoordinated, a woman can have incontinence issues and/or pain. There may be trigger points and tightness in these muscles, just like any other muscle in the body,” says Elizabeth “Libby” Trausch, D.P.T.’08, a DMU Clinic therapist trained to treat patients using EMG biofeedback. “Women with pelvic floor muscle disorders may experience frequent urination or leaks, which may cause them to avoid social settings. They may experience pain during intercourse, a poorly localized ache between the legs, feel like they’re sitting on a golf ball or even experience low back pain that does not seem to be improving with other interventions. Resolving those issues can make a big difference in women’s lives.”

Pelvic floor disorders, as well as pelvic organ prolapse, are caused by several factors, including pregnancy and vaginal delivery or C-section, injury, pelvic surgeries and resulting scar tissue, heavy lifting, obesity and heredity. Pelvic organ prolapse is a condition in which female pelvic organs protrude downward into the vaginal area, causing pressure and pain.

EMG biofeedback provides an immediate visual representation of contractions in pelvic floor muscles, indicating their strength, endurance or lack thereof. That feedback augments other findings and assists the therapist and patient in identifying solutions.

“Patients can see how much or how little their physical efforts contract their muscles,” Trausch says. “It’s wonderful motivation for them to work harder on specific exercises that can address the problem. A study has indicated that 40 percent of women perform Kegel exercises incorrectly, so physical therapy intervention can be a tremendous help in identifying the correct muscles and using them effectively.”

Trausch also works with patients to “retrain” their bladders with diaries, exercise, diet and nutrition, giving them greater control and longer periods between trips to the bathroom.
“We work with patients in a physical therapy environment that analyzes their posture, strength, core and hips as well as pelvic issues,” she says. “We combine education with private, gentle, effective care.

“I’m excited about how we can help patients in this way,” she adds. “A woman may have been dealing with incontinence, discomfort and pain, never realizing something could be done. We can help.”

When medical missionary and longtime DMU friend Jim Blessman, M.D., observed a high prevalence of vision problems among poor children in South Africa, he thought vitamin A deficiency could be the cause. He didn’t have a feasible way to test that, however, in the poverty-stricken areas he serves.

Enter DMU: After a conversation at commencement between Blessman and Bryan Larsen, Ph.D., dean of university research and biomedical graduate studies, Larsen approached DMU student Tyler Mayo, D.O.’12, who was interested in doing research relating to the eye. As a result, Mayo began seeking a way to test for vitamin A deficiency that was portable and less expensive than the prevailing method, high-performance liquid chromatography (HPLC).

“If we can determine whether vitamin A deficiency is causing blindness among people, their diets can be supplemented to address that,” Mayo says.

That would be no small step: According to the World Health Organization, an estimated 250 million preschool children – mostly in poverty-stricken areas – are vitamin A deficient, a condition that can lead to blindness, severe illness and death. An estimated 250,000 to 500,000 vitamin A-deficient children become blind every year, half of them dying within 12 months of losing their sight.

In his research, Mayo came across the Bessey Lowry method, developed in the 1940s but eventually replaced by HPLC. The method uses a spectrometer, an instrument that used to be large and expensive but “now is smaller than a laptop,” he says. “I got the equipment put together so it could fit in a backpack or duffel bag.”

Jim Blessman, M.D.

Mayo modified the method and is now testing its accuracy and consistency. He is comparing blood samples tested for vitamin A levels using his method and, by an external laboratory, using HPLC. If successful, the method could develop into a larger-scale study – and, eventually, be used by backpack-toting health care providers in poor areas around the world.

“The best part of research is problem-solving – to play with different approaches and come up with a solution that can be immediately used,” Mayo says. “The challenge is the tedious work of getting to that point.”

Virginia Tonelli, Denise Hill and John Retzlaff say health and law often cross paths.

In the intertwined worlds of health care and the law, knowledge isn’t just power; it’s imperative. To help its students gain that knowledge, in addition to course offerings, last fall DMU became the first master of health care administration program to sign an alliance agreement with the American Health Lawyers Association (AHLA), the nation’s largest nonpartisan educational organization devoted to legal issues in health care with more than 10,000 members.

Cost of the student membership is $15 per year – a bargain, says Assistant Professor Denise Hill, J.D., M.B.A., the faculty adviser to the new student group.

“As a full-time professor teaching health law and ethics to health professionals, I can think of no better way to expose my students to realities of health law than to open access to the resources and events available through membership with AHLA,” she says.

M.H.A. student John Retzlaff, co-founder of the DMU group, says the alliance will build upon the relationship between DMU and Drake University Law School by bringing together students and faculty of both. In 2008, DMU and Drake created a partnership to allow DMU’s M.H.A. and master of public health program students and Drake law students to transfer up to 18 academic credits between the two institutions.

“The club vision is to lead efforts in creating the opportunity for education and discussion among and between students with career impact upon the legal and health fields,” Retzlaff says.

That will enrich the diversity in DMU’s M.H.A. and M.P.H. programs and students, says group co-founder and M.H.A. student Virginia Tonelli. Designed for working professionals, both programs can be completed through on-campus courses, online courses or a mix of both.

“Not only am I learning the practical side of health care administration from professionals in the field around my schedule,” Tonelli says, “I have been able to meaningfully interact with students from diverse backgrounds around the world.”