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July 26, 2001


Grants awarded to researchers

The National Institute of Mental Health has granted $391,824 to Carol Anderson of the psychiatry department for a project aimed at facilitating mental health research careers of social work faculty.

Research to Prevent Blindness (RPB) has awarded $300,000 to the medical school's Department of Ophthalmology to fund the Jules and Doris Stein RPB Professorship.

The department has recruited biochemist James L. Funderburgh for the endowed position. Department officials said the funding and Funderburgh's recruitment will enhance research in corneal wound healing and corneal response to disease.

Kinedyne Corp. has awarded $278,029 to Douglas Hobson of the School of Health and Rehabilitation Sciences to continue work on the scientific and technical feasibility of an auto-docking device for securing wheelchairs in public vehicles.

The National Institute of General Medical Sciences has granted $391,517 to Linda Jen-Jacobson of the biological sciences department for research on sequence-specific DNA-protein interactions.

Steven L. Kanter, senior associate dean of the medical school, has been awarded $327,655 in federal funds through Penn State for the planning, development and operation of a statewide system of health education centers.

Pennsylvania Interest on Lawyers Trust has awarded $250,000 to Martha M. Mannix of the law school for legal services to indigent families, primarily through the school's Civil Practice Clinic.

Trevor Orchard of the Graduate School of Public Health has been granted $586,400 by the National Institute of Diabetes and Digestive and Kidney Diseases for further study of the epidemiology of diabetic complications.

Psychiatry professor Charles Reynolds has been granted $704,056 by the National Institute of Mental Health for continuing study of late-life mood disorders.

The U.S. Department of Education has awarded Lauren Resnick of the Learning Research and Development Center $624,474 for research on developing and implementing high-performance learning communities.

The project will establish in one urban school district an institutional structure and professional norms that result in improved learning, deploy tools to support continuous professional development, document and analyze the work and its effects on student achievement, and begin a process of helping other districts to use the principles and tools developed through the project.

The National Cancer Institute has granted $319,768 to David Townsend of the medical school's radiology department for work on a methodology for oncology imaging with a PET/CT scanner.

The American Heart Association has awarded $300,000 to Flordeliza Villanueva of the medical school's Cardiovascular Institute.

Villanueva's research will build upon the institute's in vitro observations and further develop the science and method for tissue-specific ultrasound imaging in vivo.

David Vorp of the medical school's surgery department has been granted $352,510 from the National Heart, Lung and Blood Institute for a biomechanical evaluation of abdominal aortic aneurysm.

AAA is an enlargement of the infrarenal aorta which, if left untreated, will gradually expand until it ruptures.


Liver cancer moving from inoperable to outpatient treatment

Patients diagnosed with inoperable primary liver cancer–cancer that starts in the liver and stays there–face grim treatment options: external beam radiation, chemotherapy and its vicious side effects, and an average of only 1-1.5 years of life after diagnosis.

Pitt doctors are testing a new treatment option that's done on an outpatient basis and eliminates side effects. The Food and Drug Administration says the treatment is safe for patients, and doctors are evaluating its effectiveness.

The treatment, called TheraSphere, delivers millions of microscopic glass beads embedded with the radioactive element yttrium-90 directly into the artery that feeds cancerous liver tumors known as hepatocellular carcinoma (HCC). Cancer in the liver is often at an advanced stage when diagnosed, making surgical removal of tumors impossible. Life expectancy of someone with HCC ranges from four months to about 1.5 years.

According to Brian Carr, professor and director of the liver tumor service at UPMC, TheraSphere offers the best chance for patients with inoperable liver cancer because TheraSphere allows doctors to deliver a much higher dose of radiation– up to five times the maximum possible dose with external beam radiation.

Healthy tissue is spared despite the high concentration of radiation in the beads, according to Carr, because the beta radiation travels only an average of 2.5 mm in tissue. The ability to localize the treatment contributes to the lack of side effects.

TheraSphere is an outpatient procedure that lasts from 30 to 40 minutes in the hospital's interventional radiology room. Doctors guide a catheter through the femoral artery in the thigh up through the hepatic (liver) artery that feeds the tumor its supply of blood. Once the catheter is at its destination, the doctors release the TheraSphere and let the blood carry the beads into the tumor, where they remain active with a half-life of 64.2 hours. The beads are prevented from being swept from the tumor into other parts of the body because they are too big to fit through the liver's capillary system.

HCC kills up to 500,000 people each year, primarily in Africa and Asia due to the high prevalence of hepatitis in those regions. Hepatitis is the leading cause of primary liver cancer. In the United States, about 15,000 cases are diagnosed annually. However, the number of cases may be underestimated, due to the increasing incidence of hepatitis C.


Medical faculty study chronic pain in elderly

Clinicians at Pitt's School of Medicine are beginning a study to determine the effects of chronic pain on the elderly.

Although it is estimated that chronic pain plagues at least half of adults in the community, the full impact of chronic pain has not been well-studied in older adults.

"Clinically, older adults with chronic pain often indicate that they experience pain when performing functional tasks or that the pain curtails their activity involvement," said Thomas Rudy, principal investigator of the study and professor in the anesthesiology, psychiatry and biostatistics departments. "Because of its adverse effects on physical, psychosocial and neuropsychological function, each of which may lead to progressive functional decline, the impact of chronic pain on the older adult can be devastating.

"The results of this study will ultimately lead to the development of tailored, efficient treatment programs designed to ease the suffering of this vulnerable population," Rudy said.

The study will enroll 400 people between the ages of 65 and 84. Half of them will have at least a three-month history of low back pain while the control group will be pain free. All study participants will undergo a comprehensive assessment of their psychosocial and neuropsychological function using measures that have particular relevance to older adults. These include pain intensity, mood, pain-related fear of activity, sleep habits and perceptions of health and well-being. Physical function also will be assessed. Participants will be recruited from various UPMC clinics.

"This study represents the first well-controlled, comprehensive examination of the effects of chronic pain on individuals who may be most threatened by the risk of functional decline, that is, community-dwelling adults," said Debra K. Weiner, co-principal investigator and assistant professor in the Division of Geriatric Medicine. "It will directly evaluate the association between cognitive coping and performance on physical capacity in older adults."


G&PS adjunct prof elected

David A. Crown, adjunct assistant professor in the Department of Geology and Planetary Science and a research scientist at the Planetary Science Institute in Tucson, Ariz., has been elected to the Board of Trustees of Chicago's Adler Planetarium and Astronomy Museum.

Crown specializes in planetary geology with a focus on understanding the geologic history of the surface of Mars. He is principal investigator of several NASA-funded research projects and is a co-investigator of the EventScope Project, an educational tool for interactive learning in the earth and space sciences that is based at Carnegie Mellon University.

The Adler Planetarium, founded in 1930, was the first planetarium in the western hemisphere and houses StarRider Theater, the world's first digital interactive planetarium theater.


Researcher provides 1st definition of HIV-associated lipodystrophy

An AIDS researcher from Pitt's Graduate School of Public Health (GSPH) has proposed the first definition of HIV-associated lipodystrophy syndrome (HIV-LS) — the set of physical and metabolic changes that many individuals develop primarily while on HIV drug therapy.

"Because there has been no formal definition of the HIV-associated lipodystrophy syndrome up to this point, the prevalence of reported cases of this condition have varied widely — from less than 10 percent of HIV-infected persons to more than 80 percent," noted Lawrence Kingsley, associate professor of infectious diseases and epidemiology at GSPH. "We are proposing a description of the syndrome that can guide physicians and other health care providers in properly diagnosing their patients."

HIV-LS involves changes in fat distribution throughout the body, along with cholesterol and glucose abnormalities, in HIV-infected individuals taking highly active antiretroviral therapy or antiretroviral therapy, and in some people who are not on drug therapy but who have long-term HIV infection. The body-shape changes experienced by patients are dramatic and anxiety provoking, while the changes in lipids and glucose metabolism may increase their long-term risk of cardiovascular disease.

Signs of HIV-LS are a wasting, or a reduction in fat (lipoatrophy), in the face, arms, legs and buttocks; and an increase in fat (lipodystrophy) in the abdomen, back of the neck and breasts. The added abdominal fat is primarily visceral fat, which accumulates within the abdominal cavity, around the organs.

Kingsley's proposed definition of HIV-LS follows:

* Peripheral Lipoatrophy only — moderate or greater subcutaneous fat loss in two or more of the following areas: arms, legs, buttocks or face scored as mild, moderate or severe.

* "Mixed" Lipodystrophy — peripheral lipoatrophy plus moderate or greater increased fat accumulation in the abdomen or breasts, with or without additional fat at the back of the neck.

* Peripheral Lipoatrophy or Mixed Lipodystrophy along with metabolic abnormalities of glucose metabolism or lipids.

In monitoring HIV-infected individuals every three to six months, Kingsley suggests that health care providers keep track of changes in height, weight, body-mass index, arm, thigh, waist, hip and waist-to-hip ratio using the standardized protocol.

Kingsley's recommendations are based on clinical information gathered through the Multicenter AIDS Cohort Study (MACS), a National Institutes of Health-funded epidemiological study of HIV infection in homosexual men.

GSPH is one of four sites nationwide participating in the MACS. Kingsley is co-principal investigator of the Pittsburgh site.


Pitt AIDS researchers receive awards

AIDS researchers from Pitt's School of Medicine have received grants from the American Foundation for AIDS Research (amfAR) for work that is aimed at finding new approaches to combating the human immunodeficiency virus (HIV), the virus that leads to AIDS.

Professor of medicine Michael A. Parniak received $230,351 for a project that singles out a new target — the viral protein ribonuclease H (RNase H) — and a novel screening method that may enable researchers to identify a new class of anti-HIV drugs targeting this "orphan" gene.

Because these potential therapies would take an entirely different route to destroying HIV, they would provide fresh options for people who have developed resistance to current HIV drugs. RNase H is essential for HIV replication, but because of the cumbersome nature of methods currently used to gauge the activity of this protein, researchers have been unable to develop agents that can inhibit its activity.

Parniak has developed a new test for measuring RNase H that is faster and simpler than the older assay, and as such may facilitate the discovery and development of drugs that would render the protein ineffective in helping the virus to replicate.

Research instructor Kelly Stefano Cole has received $72,000 to identify methods for evaluating potential AIDS vaccines. In previous research, Cole has developed two tests to help clarify the specific regions of the simian immunodeficiency virus (SIV) surface proteins that elicit antibody responses. Her current project will expand these studies to evaluate antibody responses to specific segments of the surface proteins of HIV.

The grants received by Parniak and Cole are two of 33 awarded by amfAR to scientists nationwide for new projects aimed at developing AIDS vaccines, microbicides, anti-HIV drugs and methods of restoring immune function in HIV-infected individuals.


CIRCL awards two grants to young investigators

Pitt's Center for Injury Research and Control (CIRCL) has awarded grants to study deaths during interaction between suspects and police as well as gender differences after brain injury as part of a program to encourage young investigators to initiate research in injury prevention.

Injuries are the leading cause of death and disability in children and young adults. In fact, injuries constitute one of the most expensive health problems in the United States, costing $75 billion to $100 billion a year directly and indirectly. Conversely, research on injury receives less than 2 cents out of every federal dollar for investigation on health problems. To help combat these alarming statistics, CIRCL established its small grants program.

The first grants funded through the program have been awarded to Amy Wagner , instructor in Pitt's Department of Physical Medicine and Rehabilitation, and to Steve Koehler , a forensic epidemiologist in the Allegheny County Coroner's Office.

Wagner's study, "Gender Based Associations With Outcome After Severe Traumatic Brain Injury," will examine whether gender difference is an independent risk factor for poor outcome after traumatic brain injury. Wagner will evaluate specific gender differences in neuropsychological function, physical disability and outcome after hospitalization with severe brain injury. Her study also hopes to further delineate other contributing epidemiological and event-related variables influencing the role of gender and brain trauma.

Traumatic brain injury is considered an epidemic in the United States, with an overall incidence of 200 per 100,000 total brain injuries per year. Survivors of brain injury often suffer devastating consequences, costing themselves, their families and society millions of dollars in lost opportunities.

Earlier studies conducted by Wagner showed that women with traumatic brain injury were over 2.5 times more likely to be disabled than males one year after injury. Other studies on traumatic brain injury demonstrated women also were more likely to report sleep disturbances, headaches, fatigue, anxiety, depression, missed work and relationship difficulties.

Koehler's study, "Deaths During the Interaction Between a Suspect and Law Enforcement Officers: A Coroner's Based Study," involves a retrospective assessment of the risks of fatal injury to suspects and prisoners during the four phases of legal custody: apprehension, arrest, transport and incarceration. This will be the first study of the hazards of fatal injury by phase of legal intervention.

Deaths while in the custody of law enforcement officials have received increased attention due to several high-profile cases. However, few studies have examined the risk of injury and death while in police custody.

Koehler's study will determine the risk of death during each of the four phases by sex, age and race. His study also will clarify the manner and mechanism of death within each phase, and examine if the actions of the deceased or the actions of police contributed to events leading to death. Koehler will analyze data from the Allegheny County Coroner's Office collected between 1995 and 1999 and examine the death certificates of all non-natural deaths within Pennsylvania during the same time- frame.


1st study of weight loss in type 2 diabetes launched

Pitt is participating in the first long-term study to look at the effects of weight loss in people with type 2 diabetes.

Funded by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIH), it is the largest study on the effects of weight loss interventions ever funded by the NIH.

Called Look AHEAD (Action for Health in Diabetes), the 16-center, randomized clinical trial will examine the effects of a lifestyle intervention program designed to promote weight loss through reduced caloric intake and regular exercise in approximately 5,000 volunteers.

The study will examine how lifestyle interventions affect heart attack, stroke and cardiovascular-related death in people with type 2 diabetes, the disease most affected by excess weight and obesity.

People who are 45-75 years of age, have type 2 diabetes and are overweight or obese are eligible to participate.

Participants will be assigned at random to either the project's lifestyle program or its diabetes support and education program. The lifestyle program is an intensive diet and exercise program designed to help participants lose at least 7-10 percent of their initial weight in the first year of the study. Participants will be expected to adopt a program of regular exercise, primarily walking, with a goal of 25 minutes per day. A comparison group enrolled in the diabetes support and education program will attend sessions on nutrition and physical activity and may attend support groups with other people who have diabetes.

Researchers will track cardiovascular risk factors, diabetes control and development of complications, general health and quality of life. "We have an enormous opportunity to learn more about the role that long-term weight loss can play in improving the health of overweight people with type 2 diabetes," said David Kelley, professor in the Division of Endocrinology and Metabolism at the School of Medicine and principal investigator for the Pittsburgh site.

Type 2 diabetes has reached epidemic proportions in the United States, largely due to the number of overweight Americans. According to the American Diabetes Association, the incidence of diabetes among people 40-74 years old increased 38 percent between 1976 and 1994.


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