Archive for June, 2010

CWRU School of Medicine :: Medical Firsts

June 25, 2010

* 1905 Development of the modern technique for human blood transfusion using a cannula to connect blood vessels by surgeon George Crile
* 1912 Pioneering the process of chlorinating drinking water by Professor Roger Perkins
* 1915 First simulated milk formula for infants, by alumnus and pediatrics professor Henry Gerstenberger
* 1927 Discovery of the cause of ptomaine food poisoning and development of an antiserum by immunologist Enrique Ecker and colleagues

* 1935 First surgical treatment of coronary artery disease by Professor Claude Beck

* 1950s Development of the first heart-lung machine for use in open heart surgeries by Professor Frederick Cross
* 1961 First successful genetic alteration of human cells in a test tube by Professor Austin Weisburger
* 1969 William Insull, M.D., describes the role of cholesterol in blood vessel disease
* 1975 Discovery that human rennin, an enzyme produced by the kidney, is involved in hypertension
* 1990 Discovery of the gene for osteoarthritis by a national team led by rheumatologist Roland Moskowitz
* 1991 First triple organ transplant in Ohio-a kidney, liver and pancreas-by James A. Schulak, M.D., and colleagues
* 1997 Creation of the world’s first artificial human chromosome by a team led by Professor Huntington Willard

Additional medical firsts include:

* First large-scale medical research project on humans in a study linking iodine with goiter prevention
* Discovery of early treatment of strep throat infections to prevent rheumatic fever
* Discovery of the Hageman factor in blood clotting, a major discovery in blood coagulation research
* First description of how staphylococcus infections were transmitted, leading to required hand-washing between patients in infant nurseries
* First description of what was later named Reye’s syndrome
* Research leading to FDA approval of clozapine, the most advanced treatment for schizophrenia at the time

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CWRU School of Medicine :: Historical Highlights

June 25, 2010

* In 1843, five faculty members and sixty-seven students began the first medical lectures at the Medical Department of Western Reserve College (also known as the Cleveland Medical College).
* In 1852, the medical school became the second allopathic medical school to graduate a woman, Nancy Talbot Clarke.
* Six of the first seven women in the United States to receive medical degrees from recognized allopathic medical schools graduated from Western Reserve University (as it was called then) between 1850 and 1856.
* The School of Medicine was one of the first in the country to employ instructors devoted to full-time teaching and research.
* In 1896, the first affiliation agreement was approved between Western Reserve University and University Hospitals of Cleveland (Lakeside Hospital).
* The Western Reserve University School of Medicine revolutionized medical education in 1952 with the most progressive curriculum in the country which integrated the basic and clinical sciences.
* In 2002, the School of Medicine became only the third medical school in history to receive the best review possible from the Liaison Committee on National Education, the national body responsible for accrediting the medical schools.
* In 2006, the School of Medicine’s University Program instituted a new integrated curriculum of medicine and public health awareness, which emphasizes the both the biology of disease and social and behavioral context of illness.

CWRU School of Medicine FACTS & FIGURES

June 25, 2010

Student Body

* More than 5,700 applications were received by the School of Medicine for the 2008-2009 year.
* For the 2007-2008 year, the School of Medicine had 1,475 full-time and part-time students with 698 in M.D. degree programs and 777 in M.S./Ph.D. programs.
* Of approximately 140 graduates each year, 96 percent pass Step 1 and 97 percent pass Step 2 of the United States Medical Licensing Examination.

Faculty and Research

* The School of Medicine has more than 3,800 faculty members.
* There are 620 full-time faculty members working on National Institute of Health research grants and 595 NIH-funded studies.
* The total NIH annual research funds granted to the School of Medicine in 2008 was $243,512,609.

Programs and Departments

* The School of Medicine offers 25 graduate degree options, including M.D., dual M.D./Ph.D. degrees and combined M.S./Ph.D. programs.
* The School of Medicine has 54 academic departments and 28 research centers and institutes.

Rankings

* The School of Medicine is ranked as one of the nation’s top 20 medical schools by U.S. News & World Report’s Guide to Graduate Education. Additionally, the Departments of Family Medicine and Pediatrics are ranked 13th in the country.
* The largest medical research institution in Ohio, the School of Medicine at Case Western Reserve University was ranked 15th highest in research funding by the National Institutes of Health in 2007.
* During 2007, the economic impact of the School of Medicine and its affiliates on the State of Ohio equaled $5.82 billion and accounted for more than 65,000 Ohio jobs.

The Prophetic Protein :: Who is at risk for heart attack?

June 25, 2010

Tense hours in the emergency room while tests confirm a heart attack may be rolled back to mere minutes, thanks to a telltale protein marker identified by Case Western Reserve University School of Medicine researchers. Better yet, a routine blood test for the nefarious protein could serve as an early warning to people at high risk :: Take steps now, and you may dodge the dangerous attack altogether.

When the proverbial elephant takes a seat on one’s chest, it is a decided hint: That person might be having a heart attack, or myocardial infarction (MI). Every 25 seconds, someone in the United States has one, according to the American Heart Association, but the oft-reported sensation of chest tightening or pain is just that-a clue. Even in the hospital, it can take eight to 12 hours for current tests to conclusively rule a heart attack in or out. Common alternative culprits in chest pain are intense heartburn or a gallstone attack.

Led by top physician-researcher Daniel I. Simon, MD, investigators at the School of Medicine, however, have discovered a marker of heart attack that promises to cuthours off the time for definitive MI diagnosis-to the tune of confirmation within 10 to 15 minutes of arriving at the emergency room. What’s more, a simple blood test for the novel myeloid-related protein-8/14 (MRP-8/14) marker could give long-used cholesterol screening a run for its money as a signal of MI in the making, years ahead of the cardiac attack.

“Though we gain great insight into patients’ potential risk for cardiovascular disease using conventional biomarkers, we are limited in identifying some people at risk,” says Douglas Vaughan, MD, professor of cardiology at Northwestern University’s Feinberg School of Medicine and chair of its Department of Medicine. “An additional marker measured in people’s blood could valuably refine our ability to take care of patients with coronary artery disease.”

To hone in on the up-and-coming predictive protein MRP- 8/14, researchers applied an unprecedented scientific approach that scoured entire human genomes for cardiac warning signs. “We were on the hunt. We wanted to know what genes turn on or off in heart attack patients,” explains Dr. Simon, the Herman K. Hellerstein Professor of Cardiovascular Research at the School of Medicine and director of University Hospitals Harrington-McLaughlin Heart & Vascular Institute. Dr. Simon and his team of researchers identified MRP-8/14 as their best-bet marker for heart attack for use in emergency settings and as a potential companion to routine cholesterol screening in the doctor’s office.

Dr. Simon’s account is a tale of finding a little molecule with big potential-a project born in a lab in New England that has grown on a campus in Cleveland.

Read the full story at Medicus.

Much-needed complement to cholesterol testing

June 25, 2010

For patients outside the highest and lowest traditional risk factor categories, based on factors like high cholesterol, smoking, diabetes, hypertension and family history of heart disease, MRP-8/14 could become a prominent diagnostic tool. “We are attempting to determine whether the use of MRP-8/14 should sway us toward more aggressive preventive therapies,” says Carl Orringer, MD, the HarringtonMcLaughlin Chair in Preventive Cardiovascular Medicine at the School of Medicine.

Currently, a “high-sensitivity C-reactive protein” (hs-CRP) assay is sometimes used in conjunction with cholesterol tests to assess heart disease risk. Like hs-CRP, MRP-8/14 represents a different biological process than cholesterol and is likely to serve as a complement to, not a substitute for, cholesterol screening. Of cholesterol testing’s shortcomings, Dr. Orringer says, “Relying on cholesterol alone is ignoring the inflammation that lights the fuse that sets off the explosion that is the heart ttack.”

Dr. Orringer, who developed an innovative heart attack risk assessment program that uses CT scans to see whether a person has hardening of the arteries, believes that MRP-8/14 may come to be incorporated to aid in risk estimation.

“A person’s heart attack risk is related to how much calcium is in the arteries—the more calcium, the greater the risk,” Dr. Orringer explains. “Those with calcium in their arteries indicating atherosclerosis might be really good candidates for MRP-8/14 evaluation to see who is at the highest risk.”

Director of Institute for Transformative Molecular Medicine, Inaugural Robert S. and Sylvia K. Reitman Family Foundation Distinguished Chair in Cardiovascular Innovation

June 25, 2010

Pamela B. Davis, M.D., Ph.D., dean of the Case Western Reserve University School of Medicine, announced the appointment of Jonathan S. Stamler, M.D., as the director of the Institute for Transformative Molecular Medicine and the first to hold the Robert S. and Sylvia K. Reitman Family Foundation Distinguished Chair in Cardiovascular Innovation at the Case Western Reserve University Cardiovascular Center and University Hospitals Harrington-McLaughlin Heart & Vascular Institute.

The newly established chair was made possible by a $1.5 million gift from the Reitman Family Foundation and was slated to be held by a preeminent physician scientist dedicated to advancing cardiovascular medicine through compassionate patient care, clinical research, and training of fellows and residents.

As director of the Institute for Transformative Molecular Medicine, primarily based in the Department of Medicine, Stamler will be charged with developing the Institute, with purview across Case Western Reserve University and University Hospitals. His efforts will catalyze scientific discoveries in molecular medicine, formulate new therapies that benefit humankind, and inspire the next generation of physician scientists.

His research specifically has led to elucidating the fundamental role of nitric oxide in control of complex physiological responses through S-nitrosylation, a protein modification that he discovered. His work has helped to transform the simple notion of cellular redox state into the concept of a dynamic and precisely regulated mechanism for control of protein function, analogous to phosphorylation, but operating through covalent modifications at cysteine thiols. The ramifications of his work extend to all major classes of proteins and accumulating evidence suggests that protein S-nitrosylation is aberrant in many diseases.

Stamler completed his undergraduate studies at Brandeis University, earned his medical degree from Mount Sinai School of Medicine, and completed his medical residency and fellowship training in both cardiology and pulmonary medicine at Harvard Medical School and the Brigham and Women’s Hospital. He joined the faculty of Harvard Medical School as Assistant Professor of Medicine in October 1993. In December of 1993, Stamler joined the faculty of Duke University, where he is currently the George Barth Geller Professor of Research in Cardiovascular Disease and Professor of Medicine and Biochemistry.

Renowned researcher to lead transformative institute

June 25, 2010

A new initiative in translational research at Case Western Reserve University Department of Medicine and University Hospitals promises to catalyze scientific discoveries, formulate new therapies and inspire the next generation of physician-scientists.

Leading the effort will be one of the school’s newest additions: Jonathan S. Stamler, MD, who will serve as founding director of the Institute for Transformative Molecular Medicine. Dr. Stamler is also the first to hold the Robert S. and Sylvia K. Reitman Family Foundation Distinguished Chair in Cardiovascular Innovation at the Case Cardiovascular Center and University Hospitals Harrington-McLaughlin Heart & Vascular Institute.

“This newly established chair in cardiovascular investigation and its relationship to the Institute for Transformative Molecular Medicine will accelerate our scientific research to its full potential and provide new cures and therapies for the patients we serve,” says Richard A. Walsh, MD, physician-in-chief at University Hospitals and the John H. Hord Professor and chair of the Department of Medicine at Case Western Reserve University.

Cardiologists discover cancer risks in group of blood pressure medications

June 24, 2010

University Hospitals Case Medical Center cardiologists have uncovered new research showing an increased risk of cancer with a group of blood pressure medications known as angiotensin-receptor blockers (ARBs).

This class of drugs is used by millions of patients not only for high blood pressure but also for heart failure, cardiovascular risk reduction and diabetic kidney disease.

University Hospitals Harrington-McLaughlin Heart & Vascular Institute’s Drs. Ilke Sipahi, Daniel I. Simon and James C. Fang recently completed a meta-analysis of over 60,000 patients randomly assigned to take either an ARB or a control medication. Their findings are published online today at The Lancet Oncology.

The researchers found that patients randomized to ARBs has “significantly increased risk of new cancer” compared to control patients.

“We have found the risk of new cancers was increased with these medications by 8-11 percent,” said Dr. Ilke Sipahi, associate director of heart failure and transplantation and assistant professor at Case Western Reserve University School of Medicine. “Most importantly, risk of lung cancer was increased by 25 percent.”

However, the research did not establish any link between ARBs and other types of cancer such breast cancer.

“This is the first time an association between ARBs and cancer development is suggested,” Dr. Sipahi continued. “While our findings are robust, they need to be replicated in other studies before they can be considered as definitive.”

Before this study, there were no major safety concerns with ARBs except for their use in pregnancy and in patients with chronic kidney or blockages of kidney arteries. Interestingly, previous animal studies with ARBs have been negative for cancer development.

“In medicine, physicians must balance the benefits and risks of all drug and device therapies,” said Dr. Daniel Simon, director of the Harrington-McLaughlin Heart & Vascular Institute at University Hospitals Case Medical Center and professor at Case Western Reserve University School of Medicine. “We recommend that patients discuss the findings of this study with their physicians since ARBs are effective agents in the treatment of high blood pressure and heart failure. Meta-analyses are a powerful tool to look at low frequency safety signals, but require confirmation with other approaches, such as large national health and managed care registries.”

UH received Top Health System Award

June 24, 2010

University Hospitals named one of the Top 10 Health Systems in U.S.

For the second consecutive year, University Hospitals (UH) has been named one of the top 10 health systems in the United States based on clinical performance by Thomson Reuters, a leading business and professional information organization.

UH and the other top 10 systems outperformed their peers by a wide margin. They provided better care, followed standards of care more closely, saved more lives, had fewer patient complications, and made fewer patient safety errors.

The list was compiled in a study conducted by researchers from the Thomson Reuters 100 Top Hospitals®. They analyzed the quality and efficiency of 255 health systems based on eight metrics that gauge clinical quality and efficiency: mortality, medical complications, patient safety, average length of stay, 30-day mortality rate, 30-day readmission rate, adherence to clinical standards of care (evidence-based core measures published by the Centers for Medicare and Medicaid Services), and HCAHPS patient survey score (part of a national initiative sponsored by the U.S. Department of Health and Human Services to measure the quality of care in hospitals).

Thomson Reuters rankings are available at www.thomsonreuters.com.

Prostate Cancer at CWRUmedicine

June 20, 2010

Worldwide, prostate cancer is one of the most common types of cancer found in men. Learning more about prostate cancer and treatment options can help you and your loved ones take an active part in making choices about care.

* Click here to read about new research conducted by the Division of Hematology Oncology at Case Western Reserve University.

The prostate is a chestnut-sized gland below the bladder, which contributes most of the fluid that combines with a man’s sperm to make semen.

Prostate cancer is the most common cancer other than skin cancer in American men and is the second leading cause of cancer death in men.

The American Cancer Society estimates that more than 234,000 men will be diagnosed with prostate cancer in 2006. Incidence rates for the disease are higher for African-American men than for white men.

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