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May 31, 2001

RESEARCH NOTES

NASA grant awarded

NASA's Mars Global Surveyor Data Analysis Program has awarded a $207,000 grant to David A. Crown, an adjunct assistant professor in Pitt's Department of Geology and Planetary Science and a research scientist at the Planetary Science Institute in Tucson, Ariz.

The objective of this new NASA program is to enhance scientific return from data acquired by Mars Global Surveyor, an orbiting spacecraft that is returning high-resolution images of the Mars surface and obtaining detailed measurements of Martian topography.

Crown's investigation, a three-year study entitled "Highland Degradation in the Hellas Region of Mars," was one of 47 selected for funding. Crown's research will include analyses of surface environments in, and the geologic history of, an ancient highland region of Mars as well as field studies of potentially analogous landforms in the Canadian Arctic.

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Community centered work stabilization programs help homeless with substance abuse

A community-supported work stabilization program promotes sustained decreases in substance use, criminal behavior and health care utilization among homeless people in Pittsburgh, according to a presentation at the May 5 Society of General Internal Medicine Meeting by Pitt physician Adam Gordon.

The project evaluated a community-based work stabilization program that integrated health care providers, managed care providers, social service agencies, members of the private sector and charitable organizations to treat homeless people with substance abuse problems.

"The people we studied were a very vulnerable population. What we were looking for, and may have found, is the best method to help them," said Gordon, of the School of Medicine's internal medicine department. He also is a member of the Center for Research on Health Care and VA Pittsburgh Center for Health Services Research.

Past studies in Pittsburgh indicate that 63 percent of homeless people have received health care in the previous six months, indicating that they are using health care services. Yet the age-mortality rate nationwide for the homeless is 3.7 times that of the general population. This indicated that there was something missing from the care they were receiving, according to Gordon. "This population may need a comprehensive approach to health and social care, encompassing not only detoxification and other health services but long-term rehabilitation and continued support from their communities," he said.

One hundred twenty participants of the Salvation Army's Public Inebriate Program were enrolled in the work stabilization program. Participants received temporary, skill-building employment at Goodwill for three months as well as monitoring of their abuse problem. The program also provided them with a checking account, housing assistance, free medical care and vocational training.

Almost half of the participants completed the program. Of these, 95 percent found employment. While participating in the work component, 84 percent were arrest-free, 87 percent attended medical appointments, 69 percent reported career skill improvement, 47 percent improved their housing status and 40 percent abstained from drugs and alcohol.

Six months after completing the program 33 percent maintained full-time employment, 39 percent further improved their housing situation and 36 percent remained abstinent of substance abuse. Over 90 percent reported that their medical and psychiatric needs were met.

The study was funded through a grant from the Birmingham Foundation and sponsored by Pitt's Program for Health Care to Underserved Populations and Center for Research on Health Care, the Salvation Army Public Inebriate Program and Johns Hopkins University. Community participants included the Salvation Army, Goodwill Industries, Mellon Bank, Pitt, the Birmingham Foundation and the South Side community of Pittsburgh.

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Paclitaxel plus carboplatin safe, effective in patients with advanced lung cancer

New data show that patients with advanced lung cancer may have a safer chemotherapy treatment option.

The use of paclitaxel plus carboplatin, administered in a novel weekly regimen, offers a safe and effective treatment option for patients with advanced lung cancer, according to research presented recently at the 37th annual meeting of the American Society of Clinical Oncology. Safety and tolerability are of critical importance in patients with advanced lung cancer.

"These data show that the use of weekly paclitaxel plus carboplatin provides a tolerable treatment for patients with advanced lung cancer," said Chandra Belani, lead investigator of the study from Pitt's School of Medicine and the University of Pittsburgh Cancer Institute.

The study enrolled patients with untreated advanced non-small cell lung cancer. It was designed to evaluate three different regimens of weekly paclitaxel plus carboplatin.

An estimated 169,500 new cases of lung cancer will be diagnosed in 2001, accounting for 13 percent of cancer diagnoses, according to the American Cancer Society. Non-small cell lung cancer accounts for 80 to 85 percent of all lung cancer cases.

Lung cancer will claim the lives of more than 157,000 men and women this year, accounting for 28 percent of all cancer deaths. Since 1987, more women have died each year from lung cancer than breast cancer, which, for over 40 years, was the major cause of cancer death in women. It is estimated that 67,300 women will die from lung cancer and 40,200 women will die from breast cancer in 2001.

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Geriatrics wins clinical research award

Pitt's division of geriatric medicine has won the clinical research award from the international Society for Urody-namics and Female Urology (SUFU), one of the world's leading societies in the field of voiding dysfunction and incontinence. The award was presented for a study of urinary incontinence in those over the age of 60.

SUFU is the largest American society dealing with dysfunction of the lower urinary tract, including urinary incontinence, prostatism, cystoceles/rectoceles and urinary retention.

Pitt's geriatric medicine division recently was named a national Center for Geriatric Excellence by the Hartford Foundation.

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Cholesterol, blood pressure goals for type1 diabetics proposed

Researchers at Pitt's Graduate School of Public Health have proposed the first-ever blood pressure and cholesterol goals for people with type 1 diabetes, a group that is at high risk for coronary artery disease and premature death.

Research findings will be published in the June issue of Diabetes Care, a journal of the American Diabetes Association.

"For reasons that are unclear, people with type 1 diabetes have more than double the risk of cardiovascular disease than do those without diabetes, but no guidelines exist to help set goals for two of the most important risk factors for the complications for this disease — lipids and blood pressure," said senior investigator Trevor Orchard, professor of epidemiology, medicine and pediatrics.

Orchard's study, funded by the National Institutes of Health, indicates that people with type 1 diabetes should vigorously control these two risk factors, aiming for goals as strict or stricter than those currently in place for people with cardiovascular disease.

Investigators set the goals based on their analysis of data from the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study, a 10-year prospective study of 589 adults with childhood-onset type 1 diabetes. Study subjects had been diabetic for an average of 20 years.

Based on their analyses, Orchard and his colleagues suggest the following levels for men and women ages 18-55 with type 1 diabetes: LDL cholesterol, less than 100 mg/dl; HDL cholesterol, more than 45 mg/dl; triglycerides, less than 150 mg/dl; blood pressure, less than 120/80.

Guidelines set by the American Diabetes Association and the National Cholesterol Education Program generally apply to type 2 diabetes, according to Orchard.

"Goal-setting for patients with type 1 diabetes is more complex because of the higher occurrence of microvascular complications that we have shown to be related to blood lipids and blood pressure levels as well," Orchard said. "Additional complications are caused by the relationship between renal disease and coronary artery disease in people with type 1."

Also, because people with type 1 often have had diabetes and the accompanying risk factors since childhood, resulting diseases are more likely to manifest themselves over time in these patients than in people with type 2, who normally develop diabetes in adulthood.

During the study, 67 subjects died, 105 developed coronary artery disease, 92 developed lower-extremity arterial disease, 52 developed overt nephropathy, 120 developed distal symmetrical polyneuropathy, and 148 developed proliferative retinopathy. Adjustments for age/gender were generally minor.

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Grants awarded to researchers

Clareann Bunker of the University of Pittsburgh Cancer Institute has received $576,271 from the National Cancer Institute to study "Molecular Epidemiology of Prostate Carcinogenesis."

The project involves a molecular epidemiology study of prostate cancer among men aged 40-49 on the Caribbean island of Tobago.

The U.S. Department of Energy has awarded $269,212 to James Cobb of Pitt's Department of Chemical and Petroleum Engineering for his study, "Urban Wood Coal Co-Firing in the NIOSH Boilerplant."

The National Institute for Occupational Safety and Health (NIOSH) at the Pittsburgh Research Laboratory will be a host demonstration site for Phase I scientific evaluation of construction and demolition wood waste co-firing in an industrial stoker coal boiler.

Linda Frank of the infectious diseases and microbiology department has received $2.3 million from the HIV/AIDS Bureau to fund the Pennsylvania Mid-Atlantic AIDS Education and Training Center, operated by a consortium of universities including Pitt.

The Commonwealth of Pennsylvania has granted $971,623 to Hassan Karimi of information science and telecommunications to maintain and extend the Technology Resources Database, the Technology Atlas, the Technology Opportunity Model and Mapping system and to provide related consulting on telecommunications and technology infrastructure in Pennsylvania.

Layton Bioscience has awarded $459,871 to Douglas Kondziolka of neurological surgery for a "Dose Escalation Study of LBS Neurons Implanted Into the Basal Ganglia of Patients."

The study's primary objective is to evaluate the relative safety and efficacy of three doses of LBS neurons compared to no-implantation control in patients with fixed motor deficits following strokes involving the basal ganglia.

The Buhl Foundation has granted $651,264 to education school Dean Alan Lesgold for a study, "Bringing Learning Technologies Completely Into Education."

The project involves infusing learning technologies into the initial training and professional development of teachers and school leaders.

Harold Pincus of psychiatry has been awarded $625,822 by the Robert Wood Johnson Foundation for a "National Program on Depression in Primary Care."

Pincus will establish a national program office at Pitt to provide leadership, coordination and technical assistance for a program designed to increase the use of effective strategies and treatments in primary care settings in order to reduce the disease burden from depression.

The National Institute of Mental Health has granted $361,048 to Daniel Shaw of psychology for "A Family-Based Prevention for Early Conduct Problems."

The project will test a family-based preventive intervention with 2-year-old children at risk for developing significant conduct problems, providing pilot data to test the model's efficacy.


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