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October 25, 2001


Grants awarded to researchers

The National Institute of General Medical Sciences has granted $252,499 to Karen Arndt of biological sciences for a project, "Transcription Factor Mutants of Yeast." The project's long-term objectives are to identify important factors in transcription by RNA polymerase II in vivo and to determine the mechanisms by which these factors govern the process.

David N. Finegold of pediatrics has been awarded $351,572 by the National Institute of Child Health and Human Development for genetic studies of lymphedema, a chronic disabling condition that results in swelling of the extremities. Patients with the incurable condition suffer from recurrent local infections, physical impairment and social stigmatization, and may be at increased risk of developing certain cancers such as lymphangiosarcoma.

The Heinz Endowments have granted $250,000 to Christina Groark of the University Center for Social and Urban Research for an interdisciplinary fellowship program in human service program evaluation and policy, with a focus on services for children and families.

The National Institute of Nursing Research has awarded the nursing school's Mary Kerr $372,935 to examine the apolipoprotein E genotype and its relationship to the cerebrovascular, metabolic and neurotransmitter responses and functional outcomes following traumatic brain injury.

Sergio Onate of cell biology and physiology has been granted $734,000 by the American Cancer Society to study the role of steroid receptor co-activators in prostate growth and development.

The National Heart, Lung and Blood Institute has granted Tim Oury of pathology $284,872 to investigate the role of the antioxidant enzyme extracellular superoxide dismutase (EC-SOD) in pulmonary fibrosis, a chronic, potentially lethal response to lung injury.


Epidurals safe for women of all sizes

There is no relationship between the size of a patient and the occurrence of epidural fever, according to a study presented Oct. 15 by Pitt researchers at the annual meeting of the American Society of Anesthesiologists.

Researchers also found that there was no relationship between occurrence of epidural fever and the length of epidural anesthesia. Maternal temperatures may increase in healthy women who have received lumbar epidural anesthesia — a condition called epidural fever.

"Epidural anesthesia is safe for both the mother and the baby and can make the birthing experience much more positive," said Helene Finegold, Pitt assistant professor of anesthesiology and critical care medicine. "By finding that the size of the patient has no relation to the chance of epidural fever, we can reassure our patients that they are not putting themselves or their babies at an increased risk by being larger or smaller than average."


Pregnant women should take extra precautions while driving, riding in cars

Motor vehicle crashes involving pregnant women are the leading cause of traumatic fetal death, researchers from Pitt's Center for Injury Research and Control (CIRCL) reported in the Oct. 16 Journal of the American Medical Association. While they found the detected number of deaths to be disturbing, researchers also suggest their data substantially underestimates the problem.

Based on their findings, the authors urge automotive industry and highway transportation safety officials to search for ways to reduce crash risks and improve the safety of pregnant women and their fetuses while driving or riding in motor vehicles.

"There is an urgent need to better understand how to protect pregnant women by reducing crash risk, and if they are in a crash, how to better protect women and fetuses," said Harold B. Weiss, associate director of CIRCL, assistant professor of neurological surgery and lead author of this study. "Furthermore, without better case identification, the magnitude and trends of the problem, who is at risk and what circumstances carry the highest risk, remain difficult to decipher."

Researchers looked at 16 states' fetal death certificates from 1995 to 1997, representing 55 percent of the U.S. live births during the study, and approximately 15,000 fetal death registrations per year. Any fetal death of at least 20 weeks' gestation as a result of an in utero traumatic injury either to the fetus or mother was considered a case of traumatic fetal death. Out of the 240 traumatic fetal deaths identified from these records, motor vehicle crashes were the leading cause of maternal injury related to the fetal death, representing 82 percent of the cases with listed causes.

This is the first population-based study that looks at all causes of traumatic fetal death. It supports the claim that the annual number of fetal motor vehicle-related deaths, conservatively estimated in this article at more than 369 (after partial adjustment for missed cases), far exceeds the number of infant motor vehicle-related deaths in the U.S., which averages about 180 deaths per year.

To put these numbers into context: The ATX and Wilderness AT Firestone tires recalled last year have been associated with 123 deaths of all ages over a several year period. The Centers for Disease Control and Prevention reported that in 1998, 376 infants died from unintentional suffocation causes, 63 from unintentional drowning, 43 from fires and burns, 9 from poisonings and 5 from firearms.

Because state fetal death registries usually don't code or computerize the circumstances of maternal injury, to assemble a picture of the patterns of injury related fetal death it was necessary for researchers to review narrative statements on the fetal death certificates. Like standard death certificates, fetal death certificates contain sections that include demographic information and descriptive information supplied by coroners, medical examiners and doctors on contributory causes of death. Upon close examination of these narratives, most of the targeted fetal death certificates were found to contain good information on the circumstances of the mother's injury enabling the researchers to discern relative contributions of different causes.

Other important results of the study showed that the youngest mothers, ages 15 to 19 years old, were at highest risk. Also, placental injury was often involved and all gestational ages examined shared a substantial part of the risk.

Other authors of the study are Thomas J. Songer, assistant professor of epidemiology at Pitt's Graduate School of Public Health, and Anthony Fabio, visiting assistant professor at CIRCL and the department of neurological surgery.

This study was supported in part by National Highway Traffic Safety Administration through a grant to the University of Pittsburgh Graduate School of Public Health's department of biostatistics.


Supplements cut risk of vision loss from age-related macular degeneration

A dietary supplement of high levels of antioxidants and zinc significantly reduces the risk of advanced age-related macular degeneration (AMD) and its associated vision loss. These findings, from the nationwide Age-Related Eye Disease Study (AREDS) clinical trial, are reported in the October 2001 issue of Archives of Ophthalmology.

Researchers from 11 centers nationwide, including ophthalmologists from Pitt's School of Medicine, found that people at high risk of developing advanced stages of AMD lowered their risk by about 25 percent when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene (antioxidants), and zinc. In the same high-risk group, the supplements reduced the risk of vision loss caused by AMD by about 19 percent.

For study participants who had either no AMD or early AMD, the supplements did not provide an apparent benefit.

"AMD is the leading cause of vision impairment and blindness in Americans over the age of 50, and up until this point we have been limited in our treatment options," said Pitt ophthalmology professor Thomas R. Friberg, principal investigator of the trial here and chief of retina services, UPMC Health System. "By showing the positive benefits of these dietary supplements, we have established the first effective treatment proven to slow the progression of AMD."

"While numerous claims are made for various over-the-counter drugs for the treatment of AMD, in reality, the effectiveness of such supplements for the treatment of AMD remain largely unproven. The AREDS study was so large and comprehensive that there is no doubt that a major breakthrough has taken place. No other formulations and supplements for the prevention of AMD have been so convincingly proven to be effective," said Friberg.

The AREDS study was sponsored by the National Eye Institute (NEI), one of the National Institutes of Health.

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