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January 7, 2010

Research Notes

Wheelchair breakdowns common

A Pitt-led study published in the December issue of the Archives of Physical Medicine and Rehabilitation has shown that wheelchair breakdowns impact many people with spinal cord injuries. The researchers surveyed people with spinal cord injuries who use their wheelchairs at least 40 hours per week and found nearly half reported a wheelchair breakdown in the previous six months.

Out of 2,101 individuals who were able to recall the specific number of repairs completed on their wheelchairs in the previous six months, 20.3 percent completed one repair, 16.6 percent completed two or three repairs and 6.2 percent completed four or more repairs.

In addition, 19.7 percent of those who completed at least one repair reported a total of 262 adverse consequences resulting from their wheelchair breakdowns, including 140 reports of being stranded, 47 reports of having to cancel a medical appointment, 42 reports of getting injured and 33 reports of missing work or school.

Such breakdowns can negatively impact wheelchair users’ health and quality of life by threatening safety and decreasing community participation.

“Just imagine the outcry if half of all cars broke down every six months,” said study author Mike Boninger, chair of the School of Medicine’s Department of Physical Medicine and Rehabilitation.

“Many wheelchair malfunctions can be avoided by reforming health insurance reimbursement policies, mandating compliance with national wheelchair standards and improving patient and clinician education,” said Boninger, who also is director of the UPMC Institute for Rehabilitation and Research.

Additional contributors include Rory Cooper, a faculty member in the School of Health and Rehabilitation Sciences;  SHRS doctoral student Laura McClure, and Michelle Oyster and Jesse Lieberman of physical medicine and rehabilitation.

The study is available at

Stem cells drawn from umbilical cords

Stem cells that could one day provide therapeutic options for muscle and bone disorders can be harvested easily from the tissue of the umbilical cord, just as the blood that goes through it provides precursor cells to treat some blood disorders, reported School of Medicine researchers in the online version of the Journal of Biomedicine and Biotechnology.

Umbilical cord tissue cells can be expanded to greater number, are remarkably stable and might not trigger strong immune responses, said senior investigator Bridget M. Deasy, a faculty member in the Department of Orthopaedic Surgery. The cells are obtained from the gelatinous material in the cord known as Wharton’s jelly and from blood vessel walls.

“Our experiments indicate also that at least 21 million stem cells, and possibly as many as 500 million, could be banked from a single umbilical cord after the birth of a baby,” she noted. “So the cord could become an accessible source of a multitude of stem cells that overcomes many of the restrictions, such as limited quantity as well as donor age and donor sex issues, that come with other adult stem cell populations.”

Deasy and her team analyzed sections of 2-foot-long human umbilical cords that were donated for research, looking for cells in Wharton’s jelly and blood vessel walls that displayed the characteristic protein markers found in stem cells derived from other sources. The researchers then sought to find the best way to isolate the stem cells from the cords and tested them in the lab to confirm their ability to produce specialized cells, such as bone and cartilage, while retaining their ability to renew themselves.

Pitt co-authors included lead investigator Rebecca C. Schugar of Pitt’s Stem Cell Research Center and the Center for Cardiovascular Research at the Washington University School of Medicine; Steven M. Chirieleison, Yuko Askew, Jordan J. Nance and Joshua M. Evron of the Stem Cell Research Center; Kristin E. Wescoe and Benjamin T. Schmidt of the Department of Bioengineering, and Bruno Peault of the McGowan Institute for Regenerative Medicine and UCLA.

The research was supported by the National Institute of Arthritis and Musculoskeletal Research and Children’s Hospital.

Bradford co-op gets alcohol intervention grant

The Northwest Pennsylvania Adolescent Alcohol Research Cooperative has received a $3.2 million grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to test an intervention to reduce alcohol use among rural adolescents.

The cooperative is comprised of three Pitt centers: the Center for Rural Health Practice at Pitt-Bradford, the Pittsburgh Adolescent Alcohol Research Center and the University of Pittsburgh Center for Research on Health Care.

“Rural youth are at risk of having more alcohol-related problems and earlier, too,” said Youmasu Siewe, director of the Center for Rural Health Practice.

“Because of the bio-psychosocial roles that physicians play in their rural medical practice communities, this study will enhance teen-physician interaction in the clinical setting and allow better assessment of underage drinking, prevention of related psychosocial problems and fatal motor-vehicle crashes.”

Duncan Clark, principal investigator of the project and director of the Pittsburgh Adolescent Research Center at Western Psychiatric Institute and Clinic, said that work on this project began when the NIAAA was looking for plans to engage rural doctors in addressing underage drinking.

In 2006, the Pitt coalition was one of four groups nationwide chosen to receive funding to develop an approach with collaborating primary care practitioners. The Pitt group now has received a five-year grant to test the approach.

Through the Center for Rural Health Practice, primary care physicians in an eight-county region were surveyed. Researchers conducted focus groups of doctors, adolescents (those under 20) and parents to determine the extent of underage drinking.

They also asked the groups whether they would be receptive to using a computer survey to help identify problems with alcohol and use an Internet-based intervention.

The physicians indicated that they realize underage drinking is a problem and would like to perform some sort of intervention, but felt they had neither the time nor the training to do so, Clark said.

He proposed using adolescents’ comfort with technology to allow them to complete an alcohol assessment in a physician’s office waiting room that would be sent immediately to the physician along with a recommended prevention or treatment plan.

Three practices in Bradford, Warren and Punxsutawney have tested the computer survey and Internet-based intervention.

“About 500 adolescents from these three practices have participated so far,” Clark explained. “A psychiatric diagnosis of alcohol abuse or dependence was unusual in younger adolescents (about 2 percent for ages 12-14), but the percentage reached adult levels of 8 or 9 percent among those 15-20 years old. These statistics indicate that alcohol problems occur in many teens in our area.”

One advantage to the computer-administered assessment, research associate Tony Sowers noted, is that adolescents often feel more comfortable answering sensitive questions this way instead of face-to-face with a physician.

Research associate Nickole Egger, who worked with Warren Pediatric Associates to test its patients, agreed. “Kids are engaged in the process,” she said. “They like that it’s confidential, and some parents said they are glad because someone will talk with their children about alcohol.”

Sowers, who worked with a physician in Punxsutawney, said he also received a lot of positive feedback from parents as well as physicians.

After reviewing the assessment, physicians can recommend a confidential, customized Internet-based prevention program that has been used successfully at the high school and university level.

Physicians also could recommend traditional addictions treatment for the patient, if needed.

Having tested the method in a small number of rural practices with success, the second phase of the project will involve 2,000 adolescents in 10 practices.

HIV microbicide research funded

The Graduate School of Public Health has received a five-year, $7.2 million grant from the National Institute of Allergy and Infectious Diseases to develop microbicides against HIV transmission. Microbicides are designed to prevent or reduce the sexual transmission of HIV when applied topically. Several currently are being tested, but none has been proven effective. Testing of many products likely will be required before finding one that is safe and effective against HIV, as well as easy to use and acceptable to both sexual partners.

The grant will allow Pitt to test two formulations: a film and ring that release the active ingredient over time. The project will involve cell culture and animal studies of two microbicides, RC101 and CSIC, which target different stages of virus growth. RC101 inhibits entry of the virus into a cell, while CSIC works to inactivate an enzyme that the virus needs to grow after it has entered a cell.

Researchers also plan to test the microbicides in the presence of other sexually transmitted diseases and bacterial vaginosis, a common vaginal infection.

Principal investigator Phalguni Gupta, assistant chair of infectious diseases and microbiology, said: “In developing countries, HIV is most often spread through unprotected heterosexual intercourse, creating a great need for new ways to prevent transmission beyond the condom whose use is often at the discretion of men. If proven effective, microbicides could have particular impact among women in developing countries, giving them the power to prevent sexually transmitted diseases,” said Gupta.

Among the co-investigators is Michael Parniak, whose primary appointment is in the School of Medicine’s Department of Microbiology and Molecular Genetics.

Breast cancer research presented

Researchers from the University of Pittsburgh Cancer Institute (UPCI) presented breast cancer study results at the recent 2009 San Antonio Breast Cancer Symposium.

Drug combo aids survival

UPCI researchers report that patients who are being treated for a certain type of advanced breast cancer for the second time may get better results if a drug that interferes with the blood supply to tumors is added to their therapy.

Bevacizumab, also known as Avastin, works by inhibiting the formation of new blood vessels that would supply tumors with oxygen and nutrients needed to grow, explained Adam Brufsky, associate director of clinical investigations at UPCI and director of the Comprehensive Breast Cancer Center at Magee Womens Hospital.

“Adding bevacizumab to standard chemotherapy improved the survival, or at least the progression-free survival, of women with metastatic breast cancer,” said Brufsky. “We hope that this combination can serve as another possible treatment option for patients when their first line of treatment is unsuccessful, but first we need to consider the results of the trial in terms of how best to use these drugs against this type of cancer.”

The study included 684 patients at 211 sites in 19 countries. Patients were randomly assigned to receive chemotherapy in combination with either bevacizumab or a placebo.

Two prior studies have shown the benefit of adding bevacizumab to chemotherapy as an initial treatment for advanced breast cancer. This particular trial was designed to see if the treatment would be safe and effective as a second treatment option.

The trial was sponsored by Genentech.

Bone loss prevention studied

UPCI researchers found that breast cancer patients who are being treated with aromatase inhibitors may be able to prevent bone loss side effects by adding zoledronic acid to their treatment plan.

Aromatase inhibitors lower the presence of estrogen in the body to slow the growth of some cancers in postmenopausal women, but increase the risk of osteoporosis.

Zoledronic acid works by binding tightly to the bone to prevent it from losing calcium, maintaining bone strength and helping to prevent fractures, Brufsky said.

The study included 602 postmenopausal women who were diagnosed with stage one, two or three estrogen or progesterone receptor-positive breast cancer. The participants were randomized to either immediate or delayed treatment with zoledronic acid. After five years, patients in the immediate treatment group had a 6.2 percent increase in bone density while those in the delayed group had a decrease of 2.4 percent.

This study was sponsored by Novartis.

Knowledge is power over weekend, holiday dining

The holidays can be challenging for even the most diligent dieters. But are weekends just as detrimental? Researchers at Pitt and Quinnipiac University found that weekend eating patterns change significantly.

J. Jeffrey Inman, Pitt professor of marketing and associate dean for research in the Katz Graduate School of Business, and Quinnipiac marketing professor Adwait Khare studied two years’ worth of data on consumers’ eating behavior and found that the quantity and quality of foods eaten during a meal and over the course of the day differ considerably on weekends and holidays.

Just as important as the daily caloric increase on weekends and holidays is the nutritional value of the food consumed, according to the research, which was published in the fall 2009 issue of the Journal of Public Policy & Marketing.

Labor Day barbecues and Thanksgiving feasts focus on family and friends bonding over tables of high-calorie foods. Because the quantity and quality of food consumed change during these times, Inman suggests that the U.S. Department of Agriculture incorporate recommendations for holiday and weekend eating into its food pyramid guidelines.

Understanding eating patterns and knowing that a weekend can be just as dangerous to the diet as a holiday dinner can arm consumers, doctors and nutritionists with more knowledge to fight obesity, says Inman.


The University Times Research Notes column reports on funding awarded to Pitt researchers as well as findings arising from University research.

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