Be patient and listen to patients
17. 7. 2019
Dr. Ervin Kocjancic, urology professor and Director for the Division of Pelvic Health and Reconstructive Urology at the University of Illinois in Chicago, is a world-renowned expert in pelvic health, urinary incontinence, and reconstructive urology. He visited Brno at the invitation of The International Clinical Research Center of St. Anne's University Hospital. During his visit, he shared his experience at a public lecture with doctors and medical students from several hospitals and healthcare facilities in Brno. On that occasion, we asked him for a short interview.
What made you decide to become a doctor?
Simple question – simple answer… I think I was born with this idea. But seriously, to tell you the truth, I don't remember wanting to be anything else in childhood. The funny thing is that the reason for being a doctor was that my parents forced me to go to bed very soon. So I dreamed of a profession where I could go to sleep late, which I had somehow connected with medicine and doctors.
You studied in Trieste and are now in Chicago. Why the change - from Europe to the US?
I have worked at many university hospitals, both in Europe and America, and I must say that the style of work is vastly different. And the American one suits me. In Europe, especially in Italy, it is based on a hierarchy, so when you are not like seventy years old, no one is listening to you. While in the US it is just the opposite, if you have good ideas, then they will listen to you and give you a chance. You get what you need for research, not just material resources, but also freedom and independence. This is very important and that trust moves you forward. So it's not just about finances... An example – in Italy, we came up with the idea of how medicine could contribute to the development of new tools. But it was purely tied to our industry. If you are a urologist, treat prostate or kidney cancer, just examine this. While in the US with a good idea all doors are open to you, you don't just talk to your research team, but you work directly with developers, the commercial sector, programmers, designers, and other people, which is simply a priceless opportunity.
Do you generally see any developments in the health of society?
As the generation that emerged from baby boomers in the 1970s is getting older, for example the number of prostate cancer and associated complications, is growing significantly. This is actually a pretty good example and I will go back to the previous question to explain the further difference between seeing problems in the US and Europe. It is not in the quality of medical care, both in Europe and in the US are top doctors who can take care of a prostate cancer patient properly. The difference is something else. In Europe, you will get rid of the tumor, but secondary things are no longer in their care, so your complications are already your concern. Of course, if you know who to contact or have money for a private clinic, that's not the problem, but if you don't have one, then you're alone. While in the US it is very well organized. There is a Cancer Survivorship program, which includes, for example, special centers where everything is available to patients, so as to make it as easy as possible for them to return to life - whether as a wig for patients after chemotherapy or how to cope with incontinence after bladder cancer. In this program, experts from different areas work together - as a penis reconstruction specialist, I am in close contact with cancer experts to be available if necessary. We do not just focus on eliminating cancer, but on improving the quality of life in general. We try to listen to the patients, care for them does not end with a successful operation.
As you mentioned - you are an expert in penis reconstruction. What was your most complex case?
I remember one young man who could be about twenty years old. He was a victim of serious gunshot wounds, he had to be amputated with lower limbs, including genitals. However, he was young and wanted to lead a normal sex life as possible. Usually it is done by modeling it from skin tissues that are taken with the nerves and veins. However, this patient had the body so covered with scars that it was impossible and the only option for him was a penis transplant, which is only done in several centers in the US and South Africa. And it is precisely in this area that I would like to implement at the present time.
Is there still a milestone in this area that no one has ever achieved, and you would you like to?
Perhaps to grow or develop a penis in the lab and transplant it successfully… As far as I know, there are already some experiments in this area, but no one has finis hit yet. Then I also have ideas for developing new medical devices that would simplify our work, which are not such milestones, but if they improve patient care then it is also an important thing.
What is the composition of the patients who will come to you?
At present, there is a very high demand for operations of this type, which is related to the fact that we have already moved to a level where the outputs are really good. Recently, I have seen an increase in transgender patients, which is, of course, associated with a shift in their perception in society. Another group is patients suffering from disorders such as micropenis or overactive bladder. Last but not least, they are war veterans who have suffered severe injuries associated with genital mutilation. If you agree or not – penis is an important part of male identity, it's not just a cosmetic thing.
How do you relax in the operating room?
Basically, I'm a happy man because my work really enjoys me and I don't see it as a stressful thing. My other passion is classical music. Now I'm going back to my first answer, as I wished to be a doctor, so the musician was my next choice. They also don't have to go to sleep soon (laughs). I love classical music in any form, whether at concerts or just listening to it at home in my chair - one song from different artists and looking for subtle differences. I also played, but the problem is that if you don't practice for a while, it will signify a lot of quality. So I'm not playing anymore because I would be dissatisfied with myself… Frustrating when I can't play at the level I wish.
So a perfectionist?
A record number of projects is reported to AZV
16. 7. 2019
At the end of June, the public tender of the Ministry of Health for the support of applied medical research (AZV projects) was closed. Last year, twenty-seven projects were submitted, of which six were successful. This year, the researchers of the St. Anne's University Hospital were handed over total of 36 applications, including 16 under the International Clinical Research Center. The total amount of funds required exceeds four hundred million crowns. This would be able to support research not only in the fields of cancer, cardiovascular problems or Alzheimer's disease and other diseases from next year, but also new methods of using biomaterials, systems based on machine learning or genome sequencing.
The results of the tender will be published on 21 February 2020.
The CSM team received a new grant
8. 7. 2019
The CSM team (Cardiovascular System - Mechanobiology) will receive more than five million crowns for nanopeptides and nanosaccharides research. As one of the partners, he joined the PEPSA-MATE project (Nanopeptides and Nanosaccharides for Advanced and Sustainable Materials). The coordinator is University of Rome Tor Vergata and other institutions from Germany, Italy, Spain, Australia and Cuba are involved as a partners.
The objective of PEPSA-MATE is to turn biopolymers into sustainable products using innovative technologies. The result will be an alternative biomaterial to conventional, non-degradable synthetic polymers and inorganic materials. Three areas of research will be explored; firstly, phytoglycogenic nanoparticles to fabricate of bioadhesives, bioplastics and drug carriers, as well as ultrasonic fabrication of biofunctional nanopeptides as well as nanostructured saccharide microparticles as a universal platform to deliver of a wide range of therapeutic molecules. PEPSA-MATE includes interdisciplinary research on nanomaterials, polysaccharides and peptides, cell biology, biophysics, and computational modeling.
In terms of international impact, PEPSA-MATE will allow long-term collaboration between research teams not only in European countries (Italy, Czech Republic, Germany and Spain), but also in four non-EU countries (Australia, Brazil, Cuba and South Africa).
The grant is planned for 2019-2022.
Statement by Chair FNUSA-ICRC
5. 7. 2019
This week there were several press releases regarding International Clinical Research Centre (FNUSA-ICRC) of St. Anne’s University Hospital (FNUSA). FNUSA-ICRC has not been involved and it also does not have competencies to be involved in the matters reported by the press.
In recent years, we have worked hard together to build good relationships and gain a good reputation. We work in many areas and our common goal is satisfaction of patients. I do not want this mutual trust to be damaged by some articles.
On a separate note, I visited Minister of Health on May 28 to update him on recent successes of FNUSA-ICRC and to emphasise the need for a clear financial strategy beyond 2021 as mentioned to you in advance during the FNUSA-ICRC May 16 business meeting.
I personally do not know the rationale behind the press releases, which likely attempt to erode relationship between FNUSA-ICRC and the rest of FNUSA. Please rest assured that FNUSA-ICRC will continue working hard as a proud member of the FNUSA community.
FNUSA Director M.Pavlik and I have followed up and discussed the press release situtation carefully and stay united in our view and response.
I believe that these articles have not harmed the cooperation between FNUSA and FNUSA-ICRC part in the future and that we will continue to work together to help developing patient's care.
Gorazd B. Stokin, MD, PhD, FAAN
Chair - International Clinical Research Centre
Visit of Philips Director for Central and Eastern Europe
27. 6. 2019
At the end of June, Philips' Central and Eastern European CEO Reinier Schlatmann and several colleagues from the company's regional headquarters and the Prague office for the Czech Republic visited our center. Our center uses Philips technology in the areas of sleep medicine, magnetic resonance imaging for cardiology, heart failure, and circulatory diseases. The main topic of the visit was cooperation on the development of new technologies of the company. For several years our center has been involved in testing new technologies of the company in the field of sleep medicine.
Ondřej Ludka Appointed Professor
24. 6. 2019
Appointment letters to new professors were awarded by the Minister of Education, Youth and Sports Robert Plaga last week. The appointees received the highest academic degree in the Karolinum Large Assembly Hall, Prague. One of them was Ondřej Ludka, the Head of our Sleep Medicine research team, in the field of internal medicine.
Prof. Ludka's research focuses on the importance of risk factors, such as breathing disorders during sleep or its disruption - the so-called sleep apnea, and their association with obesity and other cardiovascular diseases including myocardial infarction. He is the leader of our Cardiovascular Sleep Center - one of the few institutions specializing in the diagnosis and treatment of sleep disorders in the EU in patients with cardiovascular disease. Prof. Ludka represents the Czech Republic in European sleep associations and participates in their activities. For example, since 2017, our center has been part of the European Sleep Apnea Database (ESADA). We have provided data on more than 700 patients and are now among two institutions with the highest number of patients included in the project each year. Thanks to Prof. Ludka's effort, we are going to host the ESADA European Sleep Research Society project meeting in January 2020. Therefore, for a few days, Brno will host experts from different parts of Europe whose research contributes to healthier sleep, which in turn decreases the risk of further health complications.