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May 16, 2002

RESEARCH NOTES

Research seeks to identify genes related to pancreatic cancer

Katherine Pogue-Geile, a research associate in the Center of Genomic Sciences at Pitt's School of Medicine, was awarded a grant from the Lustgarten Foundation for Pancreatic Cancer Research to study "Functional Identification of Pancreatic Tumor Suppressor Genes."

This $100,000-per-year-award will continue through December 2003. Pogue-Geile's study seeks to identify the genes that play a critical role in the development of pancreatic cancer, the fifth-leading cause of death due to cancer in industrialized countries.

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Test identifies patients at risk for severe organ rejection

According to Pitt studies of pediatric heart and adult lung transplant patients, a simple blood test called ELISA (enzyme linked immunosorbent assay) does a better job of identifying patients with sensitized immune systems than a widely used, conventional test called PRA.

ELISA takes much of the guesswork out of predicting who is at risk for severe organ rejection, the study results show.

"Screening with ELISA is a reliable, cost-effective method that may allow the identification of lung transplant recipients at high risk for persistent and recurrent cellular rejection, a known risk factor for chronic rejection," said Alin Girnita, a Pitt transplant immunology fellow who participated in the lung transplant study.

With chronic rejection, air cannot pass through the lungs' bronchioles. Because it is difficult to treat, chronic rejection is considered to be one of the most serious complications in lung transplantation.

Adriana Zeevi, professor of pathology and surgery at Pitt's Thomas E. Starzl Transplantation Institute and an author on both studies, added: "As the results indicate with the pediatric heart patients, this test is clearly useful before transplantation, but we should also consider making ELISA more routine after transplantation. Some patients will develop anti-donor antibodies within weeks or months after transplantation. Using the ELISA method, we can discriminate between the different types of antibodies, which can help guide therapy."

For more information on the ELISA studies, see "Research Notes" in the May 2 University Times.

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UCIS gets grant to study participation in international education

Pitt's University Center for International Studies (UCIS) has received a $75,000 grant from the National Security Education Program (NSEP) for a one-year research project on participation in international education by underrepresented groups.

The UCIS proposal, submitted last year, was one of six from U.S. institutions of higher education recently given grants by NSEP. The grants are for international education initiatives that focus on less-commonly studied regions of the world.

The UCIS project, "Access International Education: Resources on Underrepresented Groups in International Education," is designed to help overcome curricular constraints affecting student participation in study and work opportunities abroad, disseminate innovative models of overseas study and language/cultural knowledge acquisition to institutions of higher education, and create informational aids for department advisers and faculty.

Led by Wolfgang Schlsˇr, associate director of UCIS, the project will focus on underrepresented racial groups (African Americans, Native Americans and Hispanics), underrepresented disciplines (engineering, math and computer sciences), and students with disabilities.

The project builds on an existing effort at UCIS, Access International Education, an on-line database of projects and programs on underrepresented groups in international education, available at www.ucis.pitt.edu/aie

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Researchers report findings at American Geriatrics meeting

Researchers from the Division of Geriatric Medicine at Pitt's School of Medicine presented findings from several studies at the American Geriatrics Society Annual meeting May 8-12. Presentations included:

* Cardiovascular disease carries modestly higher risk of dementia, Alzheimer's, vascular dementia

People with cardiovascular disease have a modestly elevated risk of developing dementia, Alzheimer's disease and vascular dementia, according to a study presented May 9.

"We found that those with cardiovascular disease had a modest increased risk of dementia of about 30 percent, only partially explained by stroke," said Anne B. Newman, a geriatrician at Pitt's School of Medicine and an associate professor of medicine and epidemiology. "Although the relative risk was moderate, the high prevalence of cardiovascular disease coupled with the high incidence of dementia would yield a high attributable risk of cardiovascular disease as a cause of dementia."

The risk of vascular dementia was highest in those participants with peripheral artery disease. A less-than-20 percent increase in the risk of Alzheimer's disease in those with cardiovascular disease cannot be ruled out. It is possible that the competing risk of death due to cardiovascular disease may be masking the effect of cardiovascular disease on the incidence of Alzheimer's.

* Rules for treating urinary incontinence among nursing home residents should be re-thought

Current federal rules for treating urinary incontinence among nursing home residents should be re-thought, giving residents more freedom of choice, according to a study presented May 9. Treatment is currently mandated without asking residents, assuming they cannot reliably express an opinion but that they desire the preventive methods.

Pitt researchers, led by Neil Resnick, professor of medicine and chief of the geriatrics division, surveyed 80 nursing home residents to test their decision-making abilities and their preferences regarding the baseline requirement of regular toileting by nursing home staff.

They found that nearly three-quarters of the residents were capable of expressing an opinion about their treatment. Of this group, more than one-third would not desire the sometimes-intrusive incontinence care. By contrast, many would prefer a medication.

"Our survey showed that you cannot presume that the resident is incapable of expressing an opinion. The physician must discuss preferences with the resident and the family," Resnick said. "Guidelines should be re-thought rather than forced indiscriminately on residents and staff."

* Men on androgen deprivation therapy for prostate cancer at risk for osteoporosis

Men who are androgen deprived while undergoing treatment for prostate cancer for long periods may be at increased risk for osteoporosis-related injury, according to a study presented May 10.

Androgen deprivation is the most effective systemic therapy for prostate cancer, but long periods of hypogonadism are associated with an increased risk of osteoporosis and osteoporotic fractures, according to study senior author Susan Greenspan, professor of medicine in the divisions of endocrinology and metabolism and geriatric medicine at Pitt's School of Medicine.

The study evaluated 96 men divided into four groups: men with no prostate cancer (control group), men with prostate cancer but no androgen deprivation, men with androgen deprivation for less than six months and men with androgen deprivation for more than six months.

Results of the study showed that androgen-suppressed men had a significantly increased percent of body fat compared with lean body mass, lower bone densities at all skeletal sites examined and higher levels of bone turnover markers compared to the healthy controls.


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