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GILLETTE, Wyo. - July 24, 2023 - Campbell County Health is pleased to share that Dr. Tyler Baldwin, MD, will begin working with the organization’s radiology department. Dr. Baldwin, who recently joined Gillette Medical Imaging as a radiologist, will read images for the patients of Campbell County Health. Gillette Medical Imaging has provided radiological services to Gillette and the surrounding communities for the past five decades. Through its partnership with GMI, CCH can offer quick turnaround times for image readings, enhance access to care, and have radiology expertise on-site at the hospital.

Originally from Riverton, Wyoming, Dr. Baldwin received his MD from the University of Washington School of Medicine as part of the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) program. He has always had a desire to live and work in his home state and participating in the WWAMI program further fueled his aspiration to practice medicine in Wyoming. After graduating from medical school, Dr. Baldwin completed his radiology residency at the University of Florida and completed his neuroradiology fellowship, also at the University of Florida.

Reflecting on his childhood aspirations, Dr. Baldwin shared, "I always knew I wanted to be a radiologist since I was very young, even though I didn't fully comprehend what that entailed at the time."

Dr. Baldwin was drawn to radiology because of the amazing technology and direct impact that imaging has on patient care.

"The ability to analyze and interpret images to quickly aid in diagnosis, treatment, and disease prevention is immensely rewarding," said Dr. Baldwin.

Outside of work, Dr. Baldwin first and foremost enjoys spending time with his wife and three children and enjoys fly fishing, fly tying, hunting, and camping.

Dr. Baldwin's expertise and dedication to patient care make him a valuable addition to Gillette Medical Imaging, Campbell County Health, and the wider community. He looks forward to utilizing his skills to provide dedicated and skilled radiology services to the patients of Campbell County Health.

About Campbell County Health (CCH): An affiliate of UCHealth, CCH includes Campbell County Memorial Hospital, an acute care community hospital in Gillette Wyoming; Campbell County Medical Group with nearly 20 clinics; The Legacy Living & Rehabilitation Center long-term care center and the Powder River Surgery Center. With around 80 providers, 1,200 total staff and over 20 specialties, CCH is committed to serving our community by providing a lifetime of care with dedication, skill and compassion.

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During this HCPLive interview, Hilary Baldwin, MD, spoke on recent treatment advances made for rosacea as well as the potential application of her team’s ‘Personalized Acne Treatment Tool’ for other conditions such as rosacea.

Baldwin is known for her work as the medical director of the Acne Treatment & Research Center in New York.

She first was asked about the distinctions between rosacea treatment in the present day compared to a decade prior, giving her views made on the recent advancements.

“It has changed it completely,” Baldwin said. “I’ve forgotten what the year was, but I want to say it was at least 15 or 16 years ago that we started the American Acne and Rosacea Society, and I remember very clearly at that first meeting, that I was about to go and give a talk, entitled ‘What's new with rosacea?’ And I asked the group sitting in front of me of all these acne and rosacea experts, what the heck is new and everybody said nothing.”

Baldwin then noted that after that meeting, the world of treatment advances leapt forward with the creation of modified release doxycycline.

“It was the first oral FDA-approved treatment for rosacea,” she said. “And then in the last couple of years, as you mentioned, the introduction of 3 brand new topicals, which are absolute game changers, compared to our older topical medications that we had. Highly more effective, very well tolerated. And very fast acting with the newest medication, the microencapsulated benzoyl peroxide, reducing 40% of lesions in the first 2 weeks.”

Later, Baldwin was asked about the possibility of applying her team’s recently-developed ‘Personalized Acne Treatment Tool’ for rosacea and other dermatologic conditions.

“I think it could be used, since the whole idea is personalized care, individual care for the patient sitting in front of you,” she explained. “It's not 1 size fits all for any dermatologic disorder. And we have to take the patient through skin care, how to cleanse, how to moisturize, what kind of sunscreens to use, when to use their medications, how to use their medications, and be very specific.”

She added that dermatologists must make sure to deal with the psychological aspects of the disease.

“Many dermatologic diseases have a great deal of psychological overlay,” Baldwin said. “So we have to think of the disease, the severity, but also the issues and the concerns of the patients from start to finish, and make sure that we're following them at an adequate rate, so that we're encouraging them to continue to be adherent with their therapy. So yeah, I think what applies to acne in that regard or certainly applies to rosacea, and applies as well probably to atopic dermatitis and psoriasis as we move forward with the treatment.”

To find out more about Baldwin’s views on this topic, view the interview segment above.

The quotes contained in this description were edited for clarity.

Hilary Baldwin, MD, recalls the first meeting of the American Acne and Rosacea Society in May 2012.

“I had a rosacea talk coming up titled, ‘What’s New in Rosacea,’ and I had nothing,” Baldwin joked to HCPLive. “I asked everybody in the room, ‘Do you have something for me?’ And we really didn’t have a whole heck of a lot.”

Twelve years later, that script has flipped.

In an interview with HCPLive during the Maui Derm 2023 NP + PA Summer Conference in Colorado Springs this week, Baldwin, medical director of the Acne Treatment & Research Center in New York, discussed the boom of topical and disease-targeting agents that have come to define modern rosacea management. In fact, in a dozen years, the field has progressed from dormancy to becoming “one of the easiest diseases for me to take care of.”

“We have wonderful new topicla medications, we have our oral medications for the treatment of the papules and pustules of rosacea, we have 2 drugs that work well for the erythema, we have lasers that work well for the erythema and telangiectasias,” Baldwin said. “I’m a happy girl.”

Baldwin particularly highlighted the advent of topical therapies including ivermectin, minocycline, and a new formulation of benzoyl peroxide in the last decade—“all of them far more efficacious and also more tolerable” than their predecessors metronidazole and azelaic acid.

Still, rosacea treatment buy-in and adherence remain a persistent challenge for patients. Baldwin said the length of the chronic disease is generally what will dictate a patient’s waning commitment to topical treatment. Additionally, the severity of disease may ebb and flow during a treatment regimen; patients may believe they can discontinue treatment during a period of well-managed disease, only for it to flare again.

“Fortunately—although it’s a cosmetic emergency—it’s not a medical emergency,” Baldwin said. “They go back on their medication and it works once again.”

Dermatologists are also challenged to convince patients that “better is not really what we’re going for.” New drugs have provided new goals.

“We have ample evidence now that if you go all the way to clear (skin), your chances of staying clear and being able to go on a drug holiday are much improved,” Baldwin said. “In fact, with our newer topical medications, we have some evidence that the recurrence rate across the board is less. There are patients who never seem to have rosacea again, and we just never saw that before.”

by Bill Snyder

Steroids are commonly given to infants during open-heart surgery to reduce inflammation, but whether the drugs significantly improve patient outcomes has not been settled — until now.

Results of the STeroids to REduce Systemic Inflammation After Infant Heart Surgery (STRESS) trial, co-led by investigators from Vanderbilt University Medical Center, were published Nov. 6 in The New England Journal of Medicine, and presented Nov. 8 at the American Heart Association Scientific Sessions 2022 in Chicago.

Approximately 40,000 operations for congenital heart disease are performed annually in the United States, the majority in infants younger than 1 year of age. Congenital heart disease surgery in infants is a high-risk procedure, with death and complications often directly related to severe systemic inflammatory response syndrome after cardiopulmonary bypass.

The randomized STRESS study, the largest prospective clinical trial ever conducted in the field of pediatric cardiology, compared methylprednisolone to inactive placebo in 1,200 infants under 1 year of age who underwent elective cardiac surgery with cardiopulmonary bypass at 24 U.S. congenital heart disease centers, including VUMC.

Compared to placebo, methylprednisolone did not reduce the likelihood of “worse outcomes,” including death during hospitalization or within 30 days after surgery, heart transplantation during the hospitalization, and a long postoperative hospital stay. Steroid use also was associated with a higher likelihood of hyperglycemia (high blood glucose) requiring insulin treatment.

However, the odds of postoperative bleeding requiring a second operation were lower in the methylprednisolone group, and patients undergoing less-complex operations were more likely to benefit from steroid administration.

These findings are particularly relevant to congenital heart surgery centers, said Scott Baldwin, MD, director of the Division of Pediatric Cardiology at Vanderbilt, and the study’s co-principal investigator. Roughly half of these centers give steroids during surgery, he said.

“This unprecedented study has settled an important question in the surgical treatment of congenital heart defects,” said Prince Kannankeril, MD, MSCI, who directs the Vanderbilt Center for Pediatric Precision Medicine. “While the results are nuanced, they suggest that further study and patient stratification could lead to a more personalized medicine approach to this difficult problem.”

Kannankeril, who holds the Richard B. Johnston Jr. MD, Chair in Pediatric Research, and Baldwin, the Katrina Overall McDonald Professor of Pediatrics, were among three co-authors from VUMC. The third was David Bichell, MD, chief of Pediatric Cardiac Surgery and William S. Stoney Jr. Professor of Cardiac and Thoracic Surgery.

Clinical trials, particularly those involving young children, have been hampered by the limited number of patients at a single institution and the high cost of patient recruitment.

STRESS utilized the Society for Thoracic Surgeons database, which includes 98% of congenital heart disease surgeries performed in the United States and Canada. By identifying patients through registries, the cost of conducting this study was cut by about two-thirds, compared to traditional clinical trials with similar enrollment.

“Using the ‘trial within a registry’ model, it was the cheapest per patient cost,” Baldwin said. “This is important because even though our final end point showed no definitive benefit, we could figure that out without a spending a fortune.”

Kevin Hill, MD, MS, chief of Pediatric Cardiology at Duke University Medical Center, and a former Pediatric Cardiology fellow and graduate of the Master of Science in Clinical Investigation program at Vanderbilt, is the paper’s first and corresponding author.

The trial was co-sponsored by the Duke University/Vanderbilt University Trial Innovation Center and supported in part through the Pediatric Trials Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Family tradition and the passion to learn more about the science behind disease laid the foundation for Xavier Baldwin’s career as a physician.

Baldwin graduated cum laude from The University of Alabama in Huntsville (UAH) in 2013 with a Bachelor of Science degree in biology and chemistry, and a minor in mathematics. He learned about UAH from his high school basketball coach who knew Baldwin was interested in playing college hoops without sacrificing a good educational experience.

"I started playing basketball at the age of five and have loved the game ever since. I only play one to two games per month now, due to surgery training," said Baldwin. While playing guard for the UAH Chargers, Baldwin was known by two nicknames, "X" and "Doctor." No matter the name, everyone knew Charger #25 intended to become Dr. Xavier Baldwin.

While achieving basketball success at UAH, Baldwin delved deeper into another passion, acquiring medical knowledge. "I found I could still love basketball without going on to play at the highest level (professional basketball)."

Baldwin keenly remembers his UAH professors, especially Dr. Debra Moriarity, Professor Emeritus and Department Chair of the Biological Sciences Department. "Dr. Moriarity encouraged me the most. Laboratory testing included breast cancer research, growing cancer cells and testing them against potential cytotoxic oils/plant compounds.

"The academic rigor at UAH prepares you adequately for most avenues of post graduate training. I knew I was interested in medicine following the biology/science courses and help from several peers pursuing the same career path," he added.

Baldwin is a second year general surgery resident at The University of North Carolina Hospital System. "Healthcare is consistently evolving and changing with the influence of government, technology, and an aging population. It’s hard to make a prediction on healthcare years from now, but as I finish training, I hope to have a lasting impact."

Baldwin said a career in medicine could be a rewarding one. "I would encourage interested students to research and look into the multitude of careers available. Just remember, whatever path you choose, the training will be difficult, but the impact is what will truly matter."

Baldwin now joins his mother, a physical therapist, one sister, an anesthesiologist, and two other sisters, nurses in the medical field.