University Times

Drug reduces fractures in those with osteoporosis, study shows

Postmenopausal women with low bone mass (osteoporosis) who have pre-existing fractures can decrease their risk of subsequent fractures with the drug Fosamax, according to research findings published Dec. 7 in The Lancet by the Fracture Intervention Trial Research Group.

Pitt is one of 11 clinical centers in the group, which is coordinated by the University of California-San Francisco.

Fosamax was shown to reduce the risk of disabling hip fractures by 51 percent, the risk of new spinal fractures by 46 percent and the risk of wrist fractures by 48 percent. Further, the drug reduced hospitalizations by 20 percent in women who took Fosamax compared with women who received a placebo.

In a previous study, Fosamax was shown to increase bone mineral density (BMD) at the spine, hip and total body and to reduce the risk of vertebral fractures in women with low BMD.

Osteoporosis is a degenerative bone disorder causing approximately 1.5 million fractures in women each year in the United States. BMD decreases after the onset of menopause, leading to an increased susceptibility to fractures. Hip fractures, the most severe fractures, can be life-threatening and usually require hospitalization.

The Fracture Intervention Trial is the first large-scale, randomized trial that shows Fosamax can prevent debilitating hip fractures, said Jane Cauley, investigator at the Pitt site for the trial and associate professor of epidemiology at the Graduate School of Public Health.

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Prof gets grant for research on aortic disorder

David Vorp, research assistant professor of surgery and mechanical engineering and a member of the core faculty in the bioengineering program, was recently awarded a three-year, $210,000 grant from the Whitaker Foundation for research on bioengineering studies of abdominal aortic aneurysm (AAA).

A disease characterized by a balloon-like expansion of the aorta, AAA occurs over several years and, if left untreated, will expand until it ruptures, an occurrence that kills approximately 15,000 Americans annually. More than 400,000 new cases of AAA are diagnosed each year.

Vorp will examine the development of a potential non-invasive method of estimating biomechanical stresses in AAA by combining state-of-the-art diagnostic imaging techniques with mathematical analyses.

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UPMC, Quest Diagnostics plan partnership

The University of Pittsburgh Medical Center (UPMC) and Quest Diagnostics Inc. (currently Corning Clinical Laboratories) have signed a letter of intent to explore joint ventures in lab testing, medical informatics and molecular diagnostics research. If the proposed partnership comes to fruition, it would be one of the country's largest joint ventures combining the resources of a for-profit clinical testing laboratory with those of an academic medical center.

Under discussion are various scenarios that would use the resources and medical expertise of both organizations in laboratory processing and quality oversight. The purpose of this collaboration is to provide high quality service at low cost.

UPMC has developed a medical information system called MARS. Under discussion with Quest is a plan to test this system in their high volume laboratory. Joint research projects in genetic testing through molecular diagnostics also are under discussion.

Quest Diagnostics is one of the country's largest clinical testing laboratories, with revenues of $1.6 billion last year. It is being spun off as an independent company by Corning, Inc.

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UPMC participates in lung surgery multi-center study

The University of Pittsburgh Medical Center has been chosen by the National Heart, Lung and Blood Institute as one of 18 centers nationwide to participate in the first multi-center clinical trial of lung volume reduction surgery (LVRS) for emphysema.

Emphysema is the destruction and enlargement of the lungs' peripheral air sacs. It affects an estimated 2 million Americans. In LRVS, surgeons remove 20 to 30 percent of the diseased portions of lungs in people with severe emphysema. The surgery has been shown to offer significant short-term relief from breathing difficulties in the majority of patients. The procedure is not a cure and does not stop the disease, but offers patients an alternative to lung transplantation.

Uncertainties concerning optimal patient selection and duration of benefits warrant the clinical trial before making LRVS widely available, said Frank Sciurba, assistant professor of pulmonary and critical care medicine and co-principal investigator of the study at UPMC.

Since June 1994, more than 200 patients have undergone lung volume reduction surgery at UPMC. Because of its broad range of experience, Pitt's medical center was selected as one of the few centers that will randomize patients into three groups. Two-thirds of the patients will undergo one of two surgical approaches; the remaining third will be randomized to rehabilitation only.

For more information, call 647-8762 or 1-800-533-8762.

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Pitt researchers to study impact of insurance changes

A Pitt research team has received a $400,000, two-year grant from the Robert Wood Johnson Foundation to study how changes in health insurance offerings impact employees.

James M. Klingensmith, assistant professor of health services administration at Pitt's Graduate School of Public Health (GSPH), and John H. Evans III, professor of business at Pitt's Joseph M. Katz Graduate School of Business, will interview health insurance decision makers in about 50 major western Pennsylvania firms. Pitt researchers also will conduct phone interviews of 3,000 employees in eight firms that have significantly changed their health insurance options.

"Results from this study will increase our understanding of the impact of market developments on decisions related to employer-offered health insurance," said study leader Judith Lave, GSPH professor of health economics.

"The effects of a rapidly changing health care environment need to be examined from the vantage point of both consumer satisfaction and corporate management strategies."