Augusta, Ga. (WJBF) — The Medical College of Georgia at Augusta University has brand new leadership, although it is a very familiar face. We sat down with the new dean to talk about the future of the medical college as well as his groundbreaking research involving strokes.
Brad Means: We’re gonna talk to the brand new dean, now, of the Medical College of Georgia at Augusta University, he’s been there a while now, he is in charge at MCG at AU, he is Dr. David Hess. Dr. Hess, thank you for being here. Congratulations on the job.
Dr. David Hess: Thank you, Brad. Thanks for having me here.
Brad Means: Well, you’re more than welcome any time. How do you like it so far? Are things going well?
Dr. David Hess: I love it. It’s the best job in the world.
Brad Means: Are you going to get rid of anything that we might notice, or add anything that we might notice? Any headline making things in the works?
Dr. David Hess: Well, some of those things are still under development. But we’re doing a search for the new Cancer Center director, so that’s kind of exciting. We’re searching for a number of new chairs, new department chairs. For example my old chair in Neurology, we’re doing a search there, so, a lot’s going on with our campuses. You know, we have a number of regional campuses. We’re the 8th largest medical school in the country, and the 13th oldest, and so we have campuses all throughout Georgia, we’re really statewide, even though our headquarters are here in Augusta.
Brad Means: You got the size, how do we get the prestige? How do we get MCG rattled off the top of someone’s mind, when they think best schools in the country? Which we already know, how do we get them to know?
Dr. David Hess: Right, well that’s mostly driven by rankings, which are heavily weighted towards NIH funding. So the idea is to get the top 50 in NIH funding, so we’re presently about 70, so I think the next step is to get into the 60s. And that’s by recruiting and retaining great researchers.
Brad Means: Do we know anybody at the National Institute of Health, do we have any pull up there?
Dr. David Hess: Yeah, we do, we all serve on study sections, but it’s very competitive as you know. Most of the funding is at the 8th to 15th percentile, which means you have to be in the top 15%, usually, to get funded. So it’s very competitive.
Brad Means: It is, it is, and I know that you’ll be in the top 20, 25 at least soon. I was looking at a list today, it’s heavy Ivy League, I know we can slip in there. What about the Cancer Center and its ongoing quest to get National Cancer Institute designation so that we can be an NCI designated cancer center. Any closer to that? And is that what you want out of the new guy, or lady?
Dr. David Hess: Well, we do, the timeline we’re not sure of. I think it’s unrealistic to say we’re going to be there in three years, or five years, or even seven years. It’s a very high bar to get. You basically have to displace somebody to become an NCI designated cancer center, so I think our new Cancer Center director who we’re searching for now, that will be something we’ll ask them to look at and do. But exactly how many years, I can’t say. The important thing is to be on the right trajectory.
Brad Means: What happened to Dr. Khlief, he was a frequent guest on The Means Report, and seemed like he had y’all on the right track.
Dr. David Hess: Well he was a great researcher, but for whatever reasons, you know, things don’t always work out, but he was a great researcher from NCI, but now we’re gonna go in a little different direction.
Brad Means: We, speaking of research, have been following your efforts on the front of stroke, and not only helping to try to prevent stroke, by spotting it early, but by treating those who have had a stroke. How is your research going there and will it stop now that you have so many other things to do?
Dr. David Hess: No, Dr. Keel assured me I could still do some research, so part of my effort is still submitting NIH grants and trying to do research. We just had a study published in the journal Lancet Neurology about our big stem-cell trial. We just completed the largest stem-cell trial, actually, in the world in stroke. And it was named the Masters trial of all things. So these were a type of stem-cell you give through the veins, we give ’em intravenously, and the stem-cells are actually harvested from someone’s bone marrow. So actually we take it from their hip and we expand it. We work with a company called Athersys up in Cleveland, so that’s a good example of a medical school/pharmaceutical company partnership.
Brad Means: Did it prevent someone from having a stroke? Or did it diminish the effects?
Dr. David Hess: It was mostly looking for recovery, it was promoting recovery, so when we looked at people, it seemed to promote recovery up to a year, not at 90 days, and it seemed to work especially well in people who were treated in a certain time window of 18 to 36 hours, or 24 to 36 hours. So we’re gonna do two more trials, one’s actually going on in Japan, and one will be starting here in North America, hopefully in the fall of this year.
Brad Means: So I know a lot of stroke patients, and their family’s ears probably perked up when you talked about that. So is it possible right now for someone who has a stroke who gets to you within that window and says please give me those stem-cells, quickly?
Dr. David Hess: Well, this is part of a clinical trial. The FDA would not let us do that. We have an IND and so you have to be in a clinical trial, and you have to meet certain criteria.
Brad Means: What about the effort to prevent strokes? Any gains on that front? Whether it’s through encouraging lifestyle changes or medicine we can take?
Dr. David Hess: You ask a great question. And we are in the stroke belt. We have the highest incidence and prevalence of stroke in the country. And some in the world, and it’s particularly the coastal plain of Georgia and South Carolina. Particularly bad as you get to the coast, and below I-16. So what we know about stroke is that the best way to prevent it is to control your blood pressure. And we have a lot of uncontrolled blood pressure, particularly in the southeast. The other thing you can do is exercise. Exercise is probably the best that you can do after controlling your blood pressure. So as what’s happened is people adopt a sedentary lifestyle. You know, video games. We’re not out in the field, we’re not working. We’re a more sedentary society, and it actually increases your stroke risk, your heart attack risk, everything bad. Even your cancer risk, is increased if you’re sedentary. So being a couch potato is like the new smoking. And we’ve got to get people up and get ’em to exercise.
Brad Means: Are you talking about a certain age group? Can young people, do young people need to be worried? Those are the people who play the video games in large part.
Dr. David Hess: It’s true. Well, young people need to worry, but actually as you get older, the rate of exercise drops. ‘Cause you have joint problems, hard to get out, you may have arthritic conditions that prevent you from exercising. But it is at all-range. And it tends to be higher socioeconomic classes tend to exercise. So worry about the people in the lower classes, socioeconomic class, who don’t have a job, that don’t exercise, and they’re really increased risk.
Brad Means: What about some sort of, and I know you probably hate this question, pill we can take? That would just bust those clots, either if they exist, or prevent the clots from forming? And really help ward off stroke. Is that out there?
Dr. David Hess: Well, that’s not out there, but something close to it. We, we’re trying to develop exercise-in-a-box. Because we know not everybody’s gonna exercise, so actually if you put a blood pressure cuff on your leg or arm, blow it up for five minutes ’til your hand tingles, release it, do that four cycles, we call that remote conditioning. And we think it’s equivalent to exercise. So in the future, you could be in your easy chair, we prefer you to exercise, but if you can’t, you go in your easy chair, push a button and this cuff will blow up, repeatedly deflate, and that may give you the exercise effect.
Brad Means: OK, wait a second, is that on the market now? Because that sounds highly appealing.
Dr. David Hess: Not yet. We have an IDE with the FDA, though, to eventually get it on the market. We have to show that it works, first. It works in mice very well.
Brad Means: We know it’s gonna work. How far out ’til we can buy the box, put it on and just chill, yet exercise?
Dr. David Hess: Well if you go to Canada you can get it. Or if you go to China you can get it. But you can’t quite get it in this country, yet.
Brad Means: What about the effort, and I love this part of what you are doing over there, because you talk about something that’s gotten worldwide attention. Your efforts via Reach. That is to go to areas where people don’t necessarily have access to medical care, especially stroke patients, and serve them. Tell us how things are going with Reach?
Dr. David Hess: So Reach is a remote evaluation of stroke, it’s about basically telemedicine. And it’s a way to connect us anywhere we are, I could even log on here if I had a computer and internet access, which I’m sure I have here, and I could literally connect to 30 hospitals that we cover in Georgia and South Carolina. So we tend to cover very, very small hospitals, where there’s no neurologists. And via Reach, we can give TPA to stroke patients, and importantly now, we can fly them here to a comprehensive stroke center and pull the clot out, we can pull the clot out mechanically, and that’s been shown to work. The trouble is you can only pull the clot out in Georgia, in Atlanta and Augusta. So our big challenge now is to identify the patients, get the helicopter at them, fly them up here, ’cause we only have a few hours, and then we take the clot out here at the Augusta University Medical Center. We’re a comprehensive stroke center. And the only ones in Georgia are in Atlanta, where there’s three or four, and in Augusta.
Brad Means: So, by using the Reach technology, is it physician talking to physician and then you go from there, or can the patient get in front of that camera? And be diagnosed online?
Dr. David Hess: Both. So we actually go to the patient and the family who’s there. So they’re usually lying on a stretcher, we ask ’em how they’re doing, the physician may be busy doing other things. We often have a nurse, and then we have the family, so we talk to the family to find out when the stroke started, because many stroke patients can’t speak and are not aware of when it started. And we have to know when it started to know how much time we have. So that’s why it’s important to talk to the family and the patients. So we do that, talk to the doctor, give them TPA or not, and then we helicopter them up here as fast as we can get them up.
Brad Means: Is there a big connection between stroke and dementia?
Dr. David Hess: Yes, there is. In fact, probably 30 to 50% of dementia is caused by small strokes.
Brad Means: Strokes that we might not know we’ve had.
Dr. David Hess: Exactly, silent strokes. As we get older, we have silent strokes we’re not even aware we’ve had. They don’t affect your ability to move, or maybe speak, but they affect your ability to remember and think. So we call that vascular dementia which is a growing worldwide problem.
Brad Means: What should one do to make sure that’s not happening? Or can you even detect a silent stroke?
Dr. David Hess: It’s hard to detect. We can detect it by doing some MRI imaging, some imaging, by doing bedside exams, bedside cognitive testing, and so that’s really important. And then the best thing to do, again, treat your blood pressure and exercise. ‘Cause exercise is probably the most effective way to reduce your risk of dementia.
Brad Means: Probably my last question, have you all learned anything when it comes to forestalling dementia? Buying families and patients maybe an extra year or two before it really sets in?
Dr. David Hess: Well there’s no drug that can do that unfortunately, now all these drugs that we thought would work by targeting amyloid and this TAU protein have not been effective so far. So as you know the NIH is very interested in that, Obama signed a piece of legislation that’s increased funding to do this. That’s everybody’s search now. How do you forestall dementia? I personally think exercise is the way to forestall it. And maybe even use remote conditioning if you can’t exercise yourself, put this device on.
Brad Means: Well, we’re going to continue to root for the approval of the remote conditioning, exercise-in-a-box, and we appreciate all of your efforts, Dr. Hess, and your time, today, for sure.
Dr. David Hess: Thanks for having me, I appreciate you having us.
Brad Means: Any time. Dr. David Hess, brand new dean of the Medical College of Georgia at Augusta University, continuing his research, continuing to help all of us.