John Sinnott, MD, will step down July 1 from his role as chair of the Department of Internal Medicine in the USF Health Morsani College of Medicine.

Dr. Sinnott will continue service as the James Cullison Professor of Medicine.  Harry Van Loveren, MD, chair of the Department of Neurosurgery and Brain Repair, will serve as the interim chair as a national search for a new chair of Internal Medicine takes place.

Dr. Sinnott leaves behind a legacy as a renowned physician and dynamic teacher and mentor.  During his 10-year run as chair of USF Health’s largest department, he has ushered in a culture that has helped the department achieve unprecedented growth and achievement. Three internal medicine specialties are nationally ranked among the top 50 for Tampa General Hospital by U.S. News and World Report. The department has accumulated $46.4 million in NIH funding, placing them 35th nationally by the Blue Ridge Institute for Medical Research.

“It is difficult to tally Dr. Sinnott’s many contributions to the Morsani College of Medicine in his 40 years on our faculty and as an outstanding leader, physician, teacher and advocate,” said Charles J. Lockwood, MD, MHCM, executive vice president of USF Health and dean of the Morsani College of Medicine. “He is a tireless advocate of the Morsani College of Medicine and its mission. …We are deeply grateful for all that Dr. Sinnott has done for USF Health, the Morsani College of Medicine, his colleagues, his students, and his patients.”

Dr. Sinnott was only the third person in the college’s history to be the chair of Internal Medicine. As the largest department within the Morsani College of Medicine, his success came from his trust and confidence in all of his division directors and vice chairs.  When he first stepped into the role of department chair, one of his priorities was to continue to build on the successes of Allan Goldman, MD. Dr. Sinnott’s priority as department chair was to continue investing in faculty development and being patient-centered, he said. Having a patient-centered approach to their key missions of research, clinical and academic excellence was the catalyst to the department’s rise in national prominence and increase in the number of community-based programs established by internal medicine physicians.

“One thing I’m particularly proud of is a legacy of supporting parts of humanity that are often left behind,” Dr. Sinnott said, referencing the USF BRIDGE Healthcare Clinic, the department needle exchange program and other clinics for underserved populations started by physicians within the department. “We’re at a stratospheric level when it comes to teaching.  I have some of the best teachers in the world.  I love our commitment to absolute quality.  That quality is why I never stay awake at night worried about physicians making mistakes.  That quality is what has resulted in the rise in patients for the Morsani College of Medicine.”

Lynette Menezes, PhD, assistant vice president of USF Health International, with John Sinnott, MD, former USF Health Department of Internal Medicine chair.

Dr. Sinnott will continue to work with Lynette Menezes, PhD, assistant vice president of USF Health International. Starting July 1, Dr. Sinnott will take additional roles in that program. The program is committed to enhancing the health of populations worldwide through an interdisciplinary collaboration between the USF Health colleges and its international partners.  Drs. Sinnott and Menezes started the program in 2006.  According to the program’s 2020-2021 annual report, program participants took part in 92 collaborations across 38 countries.

Dr. Sinnott said his first step in his new role is listening, so that he gains an understanding about where the program is and where he wants to take the program, which has experienced great success under the leadership of Dr. Menezes.  In the future, he hopes to treat international patients who come to USF Health from their home countries, and continue to expand collaborative relationships to allow physicians to travel abroad and treat patients.

Dr. Sinnott’s interest in international medicine was sparked in the mid 1990s, as he began working with doctors who had immigrated from Latin America.  Additionally, Korea began pioneering advanced imaging technology, and France started to become a world leader in molecular biology. His interest in health care developments across the world helped him track medical innovations in other countries’ health care systems during the COVID-19 pandemic.

A specialist in infectious diseases, Dr. Sinnott became one of the resident COVID-19 experts who regularly spoke to media outlets during the pandemic.  In addition to the interviews with local, regional and national media outlets, he regularly kept in contact with his international colleagues to get a firm understanding of what was working for them and what wasn’t. The relationships between USF and its international colleagues were essential to the sharing of information.

“Health care is a global initiative and the University of South Florida is a global university,” he said. “I feel that our international programs have had reciprocal benefits for our student and international partners. Our students and physicians have the opportunity to gain a multitude of perspectives of how different countries practice medicine. Our international students and physicians who spend time with us are able to take some of our best practices back to their countries.”

Dr. Sinnott said he is a person who truly bleeds green and gold.  He earned his master’s degree at USF and attended residency and fellowship at USF Health after he graduated from the University of South Alabama’s medical school. Between his graduate education, residency and fellowship, as well as his faculty service, he has been a presence at USF Health for approximately 45 years, he said.  He’s held several high-level leadership roles within the college, including director of the Division of Infectious Disease, and co-director of the Interdisciplinary Program in Allergy, Immunology and Infectious Disease.

His interest in spending his career at USF stemmed from the dedication of College of Medicine leaders to developing future leader. Dr. Sinnott always felt that he was able to advance within the organization.  He is known for a humble and warm presence that extends into all aspects of his life, accompanied by a firm belief that no one gets where they are without tremendous support.

“I want to thank my students, my trainees, my faculty, my directors and people in senior administration,” Dr. Sinnott said. “What I am today is a product of all these people’s efforts.  This is not my success; this is very much their success.  USF has provided me with a career beyond my wildest dreams.  If you’re going to pick an institution to stay with, USF is the place to stay.”

What others have to say about Dr. Sinnott:

“As a teacher and mentor, Dr. Sinnott is unmatched.  For him, every interaction is a teaching moment for the mentor and the mentee, each learning from each other. Always an innovator, Dr. Sinnott continues to be extremely creative, brimming with new ideas and always being one step ahead of a new innovation.  He taught me about ChatGPT before I could get around to it. As the founding associate dean of international, Dr. Sinnott expanded the global footprint of USF tremendously and inspired me and many other faculty to choose global health as a career path. He has continued to support countless students, residents, fellows and faculty engaged in global activities.  It’s been an honor to work with him and I look forward to his continued support and engagement in our global efforts at USF Health.” – Lynette Menezes, PhD, assistant vice president of USF Health International

“John, I speak for many in thanking you for your friendship and support professionally and personally.  You’ve had such a profound impact on the lives of so many. My experience began one summer on a tennis court in 1967.  Besides tennis, you taught us the joy of reading, respect for others and an open mind.  You challenged us to set high expectations and, with hard work, to exceed them. Over the years, this story has been repeated…changing the lives of countless others.  You have received many awards…even having the award for the best clinical teaching faculty named after you.  The best news is that your contributions are continuing.” – Douglas Holt, MD, FACP, FIDSA, professor of medicine, USF Health Department of Internal Medicine

A USF Health study finds that a screening test for major blood clots in the lungs, originally validated in seriously ill non-COVID patients, works as well for COVID patients

Human lung tissue with pulmonary embolism under a microscope

TAMPA, Fla. (Oct. 26, 2021) — A screening blood test originally validated in seriously ill patients without COVID-19 is still clinically useful for ruling out pulmonary embolism in patients hospitalized with the coronavirus, a University of South Florida Health (USF Health) Morsani College of Medicine research team reports.

Principal investigator Asa Oxner, MD, and USF Health colleagues published a single-center, diagnostic study Oct. 8 in JAMA Network Open investigating how well D-dimer testing performed at excluding pulmonary embolism in patients hospitalized with COVID-19. Doctors who suspect pulmonary embolisms routinely rely on widely available D-dimer screening to rule out the potentially life-threatening blood clotting disorder – most commonly in surgical patients immobilized for long periods and patients admitted to intensive care units.

D-dimer is a simple blood test that measures protein fragments of blood clots floating in the bloodstream. D-dimer levels, normally undetectable or detectable at very low levels, rise sharply when the body is breaking down the clots.

“Our study found that clinicians can feel confident interpreting the D-dimer levels the same in COVID patients as they do in every other patient; we don’t need a special (different) value for COVID patients,” said Dr. Oxner, associate professor and vice chair of USF Health Internal Medicine. “So, in hospitalized COVID patients, we can appropriately rule out a pulmonary embolism if d-dimer levels are low.”

Pulmonary embolisms occur when blood clots that form in another part of the body (often the leg), travel through the bloodstream, and lodge in the blood vessels of the lung, decreasing blood flow and causing low oxygen levels.

Research indicates COVID-19 patients are three to 10 times more likely to develop pulmonary embolisms than other hospitalized patients, even when they are not as seriously ill or immobilized, Dr. Oxner said. Scientists are still investigating why, but it appears the COVID-19 virus may create a cellular environment that promotes clotting by making the inside of blood vessels uneven, irritated, and prone to microtears.

Asa Oxner, MD, is as associate professor and vice chair of USF Health Internal Medicine.

A negative D-dimer test (one that rules out pulmonary embolism) can help patients avoid more expensive, invasive diagnostic tests, like a computed tomography pulmonary angiogram, or CTPA. “CPTA can be dangerous because the patient, who potentially has a blood clot, must lay immobile in the CT scanner for quite a while to capture (pulmonary artery) images. The test also requires injection with IV contrast, which carries a greater risk of kidney damage when you’re very sick,” Dr. Oxner said.

The USF Health researchers wondered if the increased risk for blood clotting in COVID-19 patients, and uncertainty of diverse D-dimer values found in earlier smaller studies, reduced the existing screening tool’s ability to correctly rule out pulmonary embolism in COVID patients. The conventional thinking was that D-dimer levels would almost always be high in COVID-19 patients, therefore the test as originally validated (in non-COVID patients) would not be accurate at differentiating COVID patients without clots, Dr. Oxner noted.

The retrospective study looked at the records of 1,541 patients hospitalized with COVID-19 at Tampa General Hospital from Jan. 1, 2020, to Feb. 5, 2021. They compared plasma D-dimer concentrations with CTPA, the criterion for diagnosing pulmonary embolism, in 287 of those patients. All COVID-19 patients with CTPA evidence of pulmonary embolism had D-dimer levels of 0.05 μg/mL or greater, as did the majority (91.2%) of patients without CTPA evidence of pulmonary embolism. (Concentrations of 0.05 μg/mL and higher are considered positive for pulmonary embolism, while anything below that D-dimer level is negative.)

The researchers also analyzed whether changing the cutoff levels defining positive or negative D-dimer test results specifically for the COVID patient population might improve the test’s performance. “We did not find that to be statistically significant; however, we may have been able to identify a different cutoff level if the study had more COVID patients,” Dr. Oxner said.

Within the limitations of this single-center study, setting higher D-dimer thresholds was associated with improved specificity – but at “the cost of an increased false-negative rate that could be associated with an unacceptable patient safety risk,” the study authors wrote.  A false-negative result means that the test does not detect a pulmonary embolism when the serious blood clotting problem is very likely present.

Doctors who suspect pulmonary embolisms routinely rely on widely available D-dimer screening to rule out the potentially life-threatening blood clotting disorder.

While clinicians must maintain heightened suspicion for pulmonary embolisms when evaluating symptoms in COVID-19 patients, the overall USF Health study results indicate that the currently available D-dimer test adequately screens for the likelihood of pulmonary embolism in hospitalized COVID patients, Dr. Oxner said. “The mechanisms of developing pulmonary embolisms may differ for COVID patients, but the resulting physiology is the same for all patients. The little fragments of (undissolved) blood clots are still detectable with D-dimer.”

USF Health internal medicine resident Constantine Logothetis, MD, was lead author for the study.