Sixth annual CIST Forum engages, inspires medical and dental students

The CIST Forum let fellows from across the country share their research and medical school experiences.

Mention of a changing political landscape drew cheers from the 321 medical and dental students representing 78 schools gathered at NIH for the Sixth Annual Clinical Investigator Student Trainees (CIST) Forum in November. 

Dr. Michael M. Gottesman, NIH deputy director for intramural research, acknowledged the enormity of the upcoming transition—a new US president, HHS secretary, and NIH director. “Despite all of the changes, NIH and the federal government are very strongly dedicated to the idea of training research scientists who can really pick up on the thread of improving public health in this country,” Gottesman said in welcoming the attendees.

Dr. John I. Gallin, Clinical Center director, echoed the sentiment. “To see all the young people in the room representing the future of research science, I feel very excited and hopeful of change.”

The students, who represent the next generation of clinician-scientists, met November 6 and 7 for information panels comprised of leading researchers speaking on recent changes in medical research methods and technologies, a tour of the Clinical Center’s newest labs and research units, and networking opportunities with peers and potential mentors. 

Student participants included Howard Hughes Medical Institute (HHMI)-NIH research scholars and HHMI medical fellows; Doris Duke Charitable Foundation clinical research fellows; students sponsored by National Center for Research Resources/Clinical and Translational Science Awards (NCRR/CTSA) programs; NIH Clinical Research Training Program fellows; Sarnoff Cardiovascular Research Foundation fellows; Applied Epidemiology Fellowship participants at the Centers for Disease Control and Prevention; Fogarty International Clinical Research Scholars; and the NIH MD/PhD Partnership Training Program fellows.

A highlight was a presentation illustrating the importance of mentoring in students' training in clinical research, “Mentoring Teams in Clinical Research: Project in Tugela Ferry, Africa, on Multi-Drug Resistance in Tuberculosis.” Dr. Gerald H. Friedland, professor of medicine, epidemiology, and public health at Yale University School of Medicine, is the study’s lead investigator. Joining him on the panel were three of his protégées at various stages in their training.

"The work done by members of the Friedland team is an excellent example of how senior clinicians nurture and enrich their students' educational experiences," noted Dr. Frederick P. Ognibene, director of the Office of Clinical Research Training and Medical Education at the Clinical Center.

Other panel discussions included “Translation from the Bench to the Bedside: Innovations in Imaging Sciences,” moderated by Gallin and “The Importance of Mentoring in the Development of Careers in Clinical and Translational Research,” led by Ognibene.

Speakers for the imaging discussion were Dr.  N. Reed Dunnick, Fred Jenner Hodges Professor and chair, Department of Radiology, University of Michigan, “Better Living Through Imaging;”  Dr. Ronald M. Summers, chief of the Clinical Image Processing Service, CC Radiology and Imaging Sciences, “Virtual Bronchoscopy and Virtual Colonoscopy;” and Dr. David A. Bluemke, director, CC Radiology and Imaging Sciences, “Insights Using MRI and CT in Evaluating Cardiovascular Disease.”

Participating in the panel discussion on mentoring were Dr. Peggy C. Nopoulos, professor of psychiatry, pediatrics, and neuroscience and director of the Iowa Doris Duke Clinical Research Fellowship Program and of the Psychiatric Iowa Neuroimaging Consortium, University of Iowa Carver College of Medicine; Dr. Lars F. Berglund, professor of medicine, associate dean of clinical and translational research, and program director, Clinical and Translational Science Center, University of California Davis School of Medicine; and Dr. Timothy G. Buchman, Edison Professor of Surgery, professor of anesthesiology and of medicine, Washington University School of Medicine. In the presentation, Buchman noted, “There are only two things you own: your integrity and your passion. Guard them and grow them.”

Attendees were able to tap into advice from successful clinician-scientists during networking sessions, with the students branching out to networking lunches grouped by research interests. The session on pulmonary critical care attracted 30 students. “You really need to pick something you love—that will make you happy,” urged Dr. Stewart Levine, chief of NHLBI’s Asthma and Lung Inflammation Section and acting chief, Pulmonary and Vascular Medicine Branch.

The forum included tours of the Clinical Center. I don’t think many of us had seen such a large hospital devoted to clinical research,” said Parham Khalili, a NCRR/CTSA-sponsored student at the University of Chicago Pritzker School of Medicine.

Emily Williams, a HHMI fellow at the University of Pennsylvania School of Medicine, noted peer connections as her biggest takeaway from the meeting. “It’s so intriguing to hear about their research and what the different medical schools are like,” she said.
 

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Duke chancellor delivers CIST Forum keynote

Dr. Ralph Snyderman gave a longitudinal perspective on clinical research training.

Delivering the keynote address was Dr. Ralph Snyderman, chancellor emeritus of Duke University and James B. Duke Professor of Medicine at the Duke University School of Medicine. He spoke on the historical impact of science on medical research and the transition seen today toward personalized medicine. “When you’re in the forest, it’s hard to look at it from the outside in, but I hope you see how dynamic your profession is and how it is teetering on a really big change. You can be a part of that.” he said.

Snyderman named the tools trainees should employ to succeed: persistence, curiosity, passion, and creativity. He warned the students, though, not to give too much weight to predetermined milestones such as grants or awards. “What it’s really all about is the value of your self-worth,” Snyderman said. “The real thing is having that insatiable curiosity of yours satisfied by your own mind.”

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Fellows recount African research experiences at CIST Forum

Palav Babaria (left) and Michelle Scott tell of their time spent addressing multi-drug resistant tuberculosis in South Africa.

For a student engrossed in research, the lab can begin to feel like a home away from home. For Doris Duke Charitable Foundation Clinical Research Fellows Michelle Scott and Palav Babaria, stationed in South Africa in 2007 and 2008, it was more than a feeling.

The two spent the year in Tugela Ferry in the province of KwaZulu-Natal working on two studies aimed at fighting the drug-resistant tuberculosis (TB) epidemic in the area. The leading infectious disease cause of death in the world, TB accounts for 30-40 percent of the annual morbidity in HIV patients.

The students and their mentors—Dr. Neel R. Gandhi and Dr. Gerald H. Friedland—presented a panel discussion describing their experiences during the CIST forum. Gandhi is assistant professor in the Departments of Medicine and Epidemiology & Population Health at Albert Einstein College of Medicine. Friedland is professor and director of the AIDS Care Program at Yale School of Medicine.

While drug-sensitive TB is very responsive to treatment, South Africans and their neighbors suffer from stronger strains of the disease. Multidrug-resistant TB (MDR TB) is not cured by two of the most popular TB drugs, isoniazid and rifampicin. The second-line drugs used on MDR TB are less effective and exponentially more expensive, require longer therapy, and create risk for more adverse reactions, Gandhi said. Extensively drug resistant TB (XDR TB) sufferers have limited options, as isoniazid, rifampicin, and the second-line drugs do not treat the disease.

Fellows Scott, attending Harvard Medical School, and Babaria, attending Yale School of Medicine, worked to characterize and bring treatment to patients in KwaZulu-Natal, home to a large HIV-infected population. The MODS (microscopic-observation drug-susceptibility) study implemented a recent faster, cheaper way first developed in Peru to diagnose and characterize TB. Previously tested only in low-HIV prevalent settings, MODS was tested in South Africa for its sensitivity and specificity on dual HIV-TB patients.

The other study, the Community-Based MDR TB Study, tested the effectiveness of bringing care into patients’ homes. Tugela Ferry, an area roughly the size of Manhattan, had one hospital and one paved road. “We believe that an alternative treatment—one that would bring the treatment to the patients instead of the patient to the treatment—would work,” Gandhi said. A nurse visited the home on weekdays to administer a treatment vaccine, supplemented by monthly visits to a clinic to repeat sputum and drug-susceptibility tests.

More than the physical and technical obstacles of administering medical care in a developing country, the mental and social challenges wore on the fellows. “I don’t think there was a single day in Tugela Ferry that I didn’t see someone die,” Babaria said. While tragic, such casualties steeled her commitment even more to the research she and her team worked on. Babaria noted that it helped to e-mail her mentor or voice her concerns during their weekly scheduled phone calls. “That was really great to have someone invested in the research, but invested in us as people, too,” said Scott.

 “Mentoring is the soul of our profession,” said Friedland. “The traditions and the skills and the culture of what we do are passed down.” He emphasized the responsibility of mentorship: “A mentor must convey the excitement.”

Palav Babaria (left) and Michelle Scott said they were grateful for scheduled calls and support from their mentors, Dr. Gerald H. Friedland (right) and Dr. Neel R. Gandhi, while doing research in South Africa.

Another hurdle Scott and Babaria faced was the skepticism of the locals they were there to serve. The South Africans were wary of them as foreigners, wondering what they wanted from them, they said. In time, though, the research team earned the trust of the people they wanted to care for. Before their fellowship ended, Scott and Babaria became mentors of a sort to the caregivers in Tugela Ferry. “We didn’t want things to fall apart when we left,” Scott said.

Far from falling apart, the work the fellows began is thriving. “I can proudly tell you that both projects are enrolling patients and we are seeing promising results,” Gandhi told the CIST Forum crowd.

Babaria has returned to KwaZulu-Natal since her fellowship ended and is impressed with the growth in the project and technology. Scott plans to carve out some time soon to return also.

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Study Links Media Consumption to Unhealthy Behaviors in Children

Children and adolescents fill 45 hours a week—more than time spent in school and with family—using media: television, music, movies, video games, and the Internet. A new study led by the Dr. Ezekiel J. Emanuel, chair of the Clinical Center’s Department of Bioethics, has revealed such exposure relates to a rise in negative health behaviors.

A systematic review of 173 cross-sectional and longitudinal quantitative studies showed a positive relationship between the quantity of media consumption and, most notably, obesity and tobacco use. An increase in exposure to such electronic resources correlated with an increase in drug use, alcohol use, and low academic achievement, too.

“That 80 percent of the studies we would find have this negative association, that is pretty surprising,” Emanuel said.

He joined forces with researchers from Yale University to produce the report, commissioned by Commonsense Media, a non-partisan nonprofit formed to shape families’ media experience, to better inform policy and identify existing knowledge gaps. The process reviewed studies published between 1980 and 2006.

Overall, 80 percent of the studies concluded the general association between media and undesirable health behaviors. Of the 73 studies that addressed the link between media and overweight or obesity, 86 percent showed a statistically significant relationship. Smoking was found to be increased by media consumption in 88 percent of relevant studies. Links to drug use, alcohol use, low academic achievement and sexual behavior were weaker, though still alarming. A correlation between amount of media use and attention deficit disorder with hyperactivity was the least significant.

The report showed a lack of research into the effects of more recent technologies—the Internet, cell phones, social-networking Web sites, and video games. As media continues to increasingly infiltrate the lives of American children, Emanuel and his collaborators recommended that less toxic, more family-friendly media options must be introduced.

Emanuel stressed that regardless of content, media intake alone can lead to behavioral effects and is incorrectly assumed to be unavoidable. “We probably have sent somewhat the wrong message—that if you don’t expose your kids to computers they’ll be ignoramuses and they won’t be ready for the 21st century jobs,” he said. “What you really want are kids who are creative, and there’s no evidence that being exposed to the various media enhances creativity.”

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Treatment of a Champion

David Perrin (center), former CC patient, visited Dr. Richard Chang (right) and Dr. McDonald K. Horne III in September. The physicians cured Perrin of a debilitating deep vein thrombosis in 2002, after which Perrin went on to become an international bowls champion for his home country of England.

It is England, and the year is 2003. An electric but hushed tension rolls through the crowd as David Perrin steps up to the green to roll the final ball that will decide the National Indoor Over-60 Bowls Championship. Bowls—similar to bocce, which more Americans may recognize—is enjoyed in Europe and Asia.

Perrin, now 68, of Falmouth Cornwall, United Kingdom, won the 2003 title, as well as the 2004 National Outdoor Over-55 Championship and the 2007 British Isles Championship Fours—playing with three teammates for England against Ireland, Scotland, and Wales—feats “impossible,” in Perrin’s words, without the NIH Clinical Center.

A year before his first major win, Perrin barely could walk more than 20 yards. This September, the champion returned to the CC to visit Dr. Richard Chang, chief of the interventional radiology section in the Clinical Center’s Radiology and Imaging Sciences, and the nurses who cured him of a debilitating deep vein thrombosis (DVT). He credits the NIH with giving him “a new lease on life” after fearing he might never recover.

January 13, 2002, Perrin was dining out with his wife and friends, when his left leg fell numb then painful. He was admitted to the Royal Cornwall Hospital with a DVT that began in his left common iliac vein and extended almost completely down his leg. When anticoagulation treatment failed to relieve symptoms, he received catheter-based thrombolytic therapy and stent placement in England. But when the stents reclotted and his condition had not improved, David Perrin turned to a promising protocol by Dr. Chang and Dr. McDonald K. Horne III, now-retired senior investigator in the hematology section of the CC’s Department of Laboratory Medicine (DLM).

The trial provided for direct injection of tissue plasminogen activator (tPA) throughout the clot once a day to convert plasminogen into its active form, plasmin, which dissolves blood clots. “We try to treat the entire clot, not piecemeal,” Chang explained. “If the clot extends below the knee, we chase it all the way down to the ankle if necessary.” The goal is to restore patency and flow in the leg veins.

Chang and Horne’s protocol, which ran from 1998 to 2004, explored the dosage of tPA necessary to treat DVT, beginning with up to 50mg a day. Data from this initial study allowed reduction of the dose to 10mg per day—a dosage Dr. Chang is testing in a present protocol in collaboration with Dr. Jay Lozier, attending physician in DLM.

In addition to refining dosage, Perrin’s participation in the study suggested that there may be hope for DVT sufferers more than two weeks out. The protocol was limited to patients afflicted for less than 14 days, but because of the severity of the thrombosis, Chang and Horne allowed Perrin’s participation under a special exemption. His recovery proved that some patients can still benefit despite a delay in starting treatment.

Perrin flew to Dulles Airport on February 24, more than six weeks after the onset of DVT. He recalled Chang’s dedication and stamina throughout the eight-day treatment, “That first day, he worked on another patient until 10:30 am then on me from 11 am to 8 pm with only one break for a sandwich, which he shared with me!” This fall Perrin returned to the States to visit those whose care he remembers as compassionate and professional.

For more information on Chang and Horne’s thrombolitic therapy protocol, see the March 2008 issue of CC News.

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CC course offered in China

The Clinical Center’s “Introduction to the Principles and Practice of Clinical Research” was offered live outside the NIH for the first time Nov. 10-15 when clinician-scientists (including CC Director Dr. John I. Gallin, left above) brought the course to Beijing. “We are honored our colleagues in China offered this opportunity to broaden education and training in the conduct of clinical and translational research,” Gallin said. With Gallin are Dr. Jerry A. Menikoff (center), one of the course lecturers, director, Office for Human Research Protections, Office of Public Health and Science, Office of the HHS Secretary; and Dr. Tim Shi, executive director of GlobalMD.

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Astute Clinician Lecture addresses Marfan syndrome

"Marfan syndrome and related disorders: from molecules to medicine” is the Astute Clinician Lecture slated for Wednesday, Jan. 14, at 3 p.m. in Masur Auditorium.

The speaker will be Dr. Harry C. Dietz, III, professor of pediatrics, medicine, and molecular biology and genetics in the Institute of Genetic Medicine at the Johns Hopkins University School of Medicine. He is also an investigator in the Howard Hughes Medical Institute.

Dr. Harry C. Dietz, III, of the Johns Hopkins University School of Medicine will deliver the Astute Clinician Lecture January 14.

Dietz heads a multidisciplinary clinic for the diagnosis and management of individuals with heritable forms of cardiovascular disease, with a special emphasis on Marfan syndrome and related connective tissue disorders. He directs the William S. Smilow Center for Marfan Syndrome Research, a group of dedicated molecular biologists focused on improvement of the lives of individuals with Marfan syndrome through the development of novel diagnostic and treatment strategies. Other research interests include the molecular basis of vessel wall homeostasis and cardiovascular aging and the mechanism and physiologic significance of mRNA quality control mechanisms in health and disease.

His awards include the Richard D. Rowe and Young Investigator Awards from the Society for Pediatric Research. He is a member of the American Society for Clinical Investigation and the American Association for the Advancement of Science. He was the 2006 recipient of the Curt Stern Award from the American Society of Human Genetics, the Antoine Marfan Award, and the 2008 Hero with a Heart Award from the National Marfan Foundation.

A graduate of Duke University, Dietz earned his MD degree at SUNY Upstate School of Medicine in Syracuse. At Johns Hopkins hospital he completed an internship in pediatrics and residencies in pediatrics and anesthesia and critical care medicine. He also held a clinical fellowship in pediatric cardiology and a post-doctoral fellowship in medical genetics there.

The Astute Clinician Lecture was established through a gift from the late Dr. Robert W. Miller and his wife, Haruko. It honors a US scientist who has observed an unusual clinical occurrence, and by investigating it, has opened an important new avenue of research.

The Astute Clinician Lecture is an NIH Director's Wednesday Afternoon Lecture Series event. It is hosted by the Clinical Center. Sign language interpretation can be provided. For information or accommodations, contact OIR Communications Director Christopher Wanjek at 301-401-4274 or wajek@mail.nih.gov, or call the Federal Relay Service at 1-800-877-8339.
 

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Utilization of local resources fights infectious disease across continents

"A global hero and a legend,” according to NIAID Director Dr. Anthony Fauci, Dr. Paul Farmer presented his methods and his successes in “Community-Based Care for Infectious Disease and the Future of Antibiotic Resistance,” the November 12 Great Teachers Grand Rounds.

Farmer is the Maude and Lillian Presley Professor of Social Medicine in the Department of Global Health and Social Medicine at Harvard Medical School; associate chief of the Division of Global Health Equity at Brigham and Women’s Hospital, Boston; and co-founder of Partners In Health, an organization that provides direct health care and undertakes research and advocacy on behalf of the sick and the poor.

He is a pioneer in introducing and fostering an approach to fight infectious diseases such as multi-drug resistant tuberculosis and HIV/AIDS in developing countries that utilizes local health workers to increase outreach of and compliance to treatment. Farmer’s work has brought him to Haiti, Peru, Russia, Rwanda, Lesotho, and Malawi.

“He has devoted his life to creating health care systems in diverse regions of the world based on a vision that essential health services can be provided in resource-poor settings,” Fauci told the packed Masur Auditorium. “Paul has been a shining inspiration to me as he lives his dream and his vision with enormous self-sacrifice.”

Farmer presented his approach to strengthen primary health care in drug-resistant infectious disease-ridden areas: introduce essential drugs to the community; establish a laboratory; train community health workers; complement the Ministry of Health personnel with the local staff; aggressively find and treat tuberculosis and sexually transmitted infections; focus on women’s health; and build up the medical treatment facilities.

The impacts of such interventions are both physical and mental, uplifting the patients and those who serve them, Farmer said. He showed photos of the “Lazarus effect,” patients on the brink of death brought to robust health, but spoke also on the lift in staff morale. Admitting patients without the means to make them better frustrated the doctors and nurses working in highly affected areas. “Simply putting the tools of the trade in place had a very big impact on our staff,” Farmer said.
 
The US President’s Emergency Plan for AIDS Relief (PEPFAR) has been an invaluable resource in support of the fight against HIV infection, which affects 33 million people worldwide; tuberculosis; and malaria. Farmer commented on the promise of the next wave of action from PEPFAR and its reach beyond health care to other global issues, such as housing and food shortages.

“This is going to be the most massive poverty reduction in the history of international health. It can be like a Marshall Plan for Africa and elsewhere, if we do this right,” he said. “It’s linking these interventions to the broader effect to rupture this cycle of poverty and disease.”

With clear positive results, Farmer is bringing his methods home. “I think this is a model that could have real legs in our country, as well,” he told the Grand Rounds crowd. The reasons may be more social—addiction, language barriers—than in Haiti and Rwanda, but many Americans cannot adhere to treatment, Farmer said. A project based at Brigham & Women’s Hospital is applying the community-based care approach pioneered in Haiti and Peru to HIV patients who have fallen through the cracks of other healthcare delivery systems in Boston.

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CC says goodbye to one of its family

Medical Records' Franco Carpela passed away while visiting his home country of the Philippines.

The Medical Record Department (MRD) suffered a loss in November, when Franco V. Carpela passed away in his home city of Dumaguete City in the Philippines. Carpela, 56, was a medical record administrator in MRD’s medicolegal section.

He is most remembered for his great customer service and his constant smile. “Franco always made the job more enjoyable, and I will miss him,” coworker Nancy Holmfeld said. “I feel I am a better person for knowing him.”

Carpela joined the MRD in 1987 and spent time in Record Management, Documentation Analysis and Coding, and the Office of Credentialing Services. He was in the Philippines at the time of his death visiting family; travel was one of his passions.

MRD Chief Tricia Coffey noted her employee’s dedication to the team and the patients they serve. She recalled that Carpela was once one of only two employees who made it to work with two feet of snow on the ground. “He was incredibly dedicated to the NIH mission and just a great guy,” she said.

The department held a ceremony in their comrade’s memory on December 3.

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Emergency Preparedness Exercise Caption

NIH participated in the fourth-annual multi-agency Emergency Preparedness Exercise on Thursday, October 30—a simulation of how area medical facilities would handle a catastrophic event. The drill was conducted in real-time to maximize training and to evaluate the medical readiness of personnel responding to multi-casualty disaster with potential hazardous material exposure.

Most of the action took place at the National Naval Medical Center; drill participants acting as victims of the disaster were transported to Suburban Hospital. Mock stable inpatients from Suburban were moved to the Clinical Center to free resources to address the emergency. The arriving “patients,” wearing green, yellow, or red tags to communicate the severity of their condition, were met by a team of nurses.

The Bethesda Hospitals’ Emergency Preparedness Partnership, consisting of the National Naval Medical Center, Suburban Hospital Health Care System, the CC, the National Library of Medicine, and the NIH Fire Department and Hazardous Response Units, was formed in 2004 to stand ready to provide a rapid and sustained medical response to the community during a catastrophic event in the National Capital Region. Mary Price (left) and Ellen Eckers (right), Nursing and Patient Care Services, were among the staff who helped triage the incoming patients.

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Preceptors Recognized

The first Preceptor Recognition Day was celebrated by the Department of Nursing and Patient Care Services on October 23. The department’s Recognition and Retention Committee planned the afternoon event to recognize the significant contribution that preceptors make developing, mentoring, and retaining new staff on the patient care units and clinics.  Sixty-seven nurses were recognized for their commitment to excellence in their role as preceptors and mentors.

Dr. Clare Hastings, chief of Nursing and Patient Care Services, presented the opening remarks for the event. Dr. Cheryl Fisher, program manager, and Sandra Phelps, nurse consultant, both in the Research and Practice Development Service presented “Preceptorship: What’s New? Research and Education Perspectives.” “Research shows that the preceptor-preceptee relationship is critical to retention,” Fisher said. Following the celebration, preceptors were offered the opportunity to view the newly developed online self-study module “Preceptor Workshop.” The electronic course provides the current mentor instruction content, a useful tool for the long-standing preceptors. From left, the speakers at the reception were: Dr. Clare Hastings, Rosa Clark, Dr. Cheryl Fisher, and Sandra Phelps.

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New Vending Machine Offers Hot Food 24-7

In response to a recommendation by the Accreditation Council for Graduate Medical Education and the results of the 2007 Clinical Fellows Committee survey, a vending machine selling hot and cold food items, such as sandwiches, soup, and yogurt, was recently installed in room 3-5560 near the Intensive Care Unit.

Previously, there was a lack of available food items during nights and weekends when the cafeterias are closed. Reasonably priced hot foods, including vegetarian options, and access to a microwave are now offered 24 hours a day. The vending machine is available for use by all NIH staff and visitors.

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Marvin Hamlisch visits the Family Lodge

The Edmond J. Safra Family Lodge welcomed a pair of famous visitors on December 13: Marvin Hamlisch, Oscar, Grammy, Tony, Emmy, and Pulitzer Prize-winning composer; and Santa Clause. Since 2005, Hamlisch has performed at the Lodge during the holidays to bring cheer to the residents. He was joined this year by a vocalist, harpist, and violinist from the National Symphony Orchestra.

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CC Celebrates Pharmacy Month

The Clinical Center Pharmacy staff celebrated American Pharmacists Month in October with a series of ceremonies and awards.  During the week of October 20th, which was designated as National Hospital and Health-System Pharmacy Week, outpatient pharmacists handed patients car-litter bags with the “Know Your Medicine—Know Your Pharmacist" slogan.

During this week, each day had a different theme; one celebrated National Pharmacy Technician Day. Another day honored the CC Pharmacy’s Employee of the Year and Pharmacist of the Year. Awards were presented to the winners, nominated by another Pharmacy staff member and chosen by non-management committee members. Pictured (from left to right): Zakaria Ganiyu, Donna Scott-Harper, Frank Nice, Justine Harris, Bob DeChristoforo, Maksura Shahabuddin, and Hon Lam.

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News Briefs

BTRIS Sponsors Info Sessions
A Translational Research Informatics Seminar Series will begin at the Clinical Center in January 2009. This series will bring to campus leading figures in the current use of information systems for translational research. The team behind the Biomedical Translational Research Information System (BTRIS)—a research data repository and tool that will provide investigators with electronic access to, and analysis capabilities of, research data—will host the monthly sessions.

The seminars will be held in the Lipsett Amphitheater from 2—3pm on:
• Wednesday, January 21, 2009
• Tuesday, February 17, 2009
• Tuesday, March 17, 2009
• Tuesday, April 21, 2009
• Tuesday, May 19, 2009
• Tuesday, June 16, 2009

For more information on BTRIS, visit http://btris.nih.gov/.

Battery recycling helps NIH go green
Alkaline batteries make up approximately 20 percent of the waste in US landfills. The casings and metals in the batteries begin to slowly degrade releasing toxic chemicals into the air, soil, our food chain, and ultimately our bodies, and the incineration of batteries produces toxic air pollution and ash. The case metals can be separated and used to make more batteries. Manganese and zinc can be processed and sold to make other products.

Much of this toxicity can be avoided, however, by recycling the battery materials. To further the NIH Goes Greener program, the Clinical Center Safety Committee is adding alkaline battery recycling containers to the patient care areas. The white, plastic jars will be placed in the soiled utility rooms. Staff should call NIH Chemical Waste at 301-496-7710 for pickup when the jar is full. For more information or to request a container for another location, call the CC Safety Office at 301-496-5281 or the NIH Recycling Program at 301-402-0680.

Tool searches for infections in the CC
Infectious diseases have a new foe in the Clinical Center: Theradoc. An informatics tool to help CC staff with surveillance and control of hospital infections, Theradoc integrates data from several clinical departments and alerts infection control practitioners to the presence of infections and clusters of infections.

The system was implemented by the Hospital Epidemiology Servicein late October. Dr. David Henderson, CC deputy director for clinical care, said the tool “will elevate the standard of infection control for the Clinical Center.”  When transmission of infections is suspected, staff can quickly determine if patients had ever been housed in the same geographic location, if they were in isolation, and if they shared risk factors for acquiring infection. 


Drs. Cimino and McDonald talk PHRs
As more information has become available to the general public via the Internet, people have taken a more active role in their health management. "The increased demand by patients to play a role in their own health care decisions has expanded the use of personal health records," noted Dr. Jim Cimino, chief of the CC’s Laboratory for Informatics Development, at the November 5 Grand Rounds.

Cimino is also the project manager for the Biomedical Translational Research Information System, a tool for investigators to access research data, develop streamlined mechanisms for protocol reporting and data analysis, and reuse data for hypothesis generation and collaboration. In his previous post at Columbia University, Cimino led the development of a personal health record (PHR) system. He has watched as PHRs have evolved with the rise of the World Wide Web, making health information one of the most-searched subjects online. Cimino’s Grand Rounds presentation was the first in a two-part act with Dr. Clement McDonald, director of the Lister Hill National Center for Biomedical Communication with the National Library of Medicine (NLM), on the past, present, and future of PHRs.

This diffusion of health records necessitates a common language to standardize entry and interpretation of health data.  McDonald is developing an electronic PHR system utilizing the Logical Observation Identifiers Names and Codes (LOINC) to make entries for lab tests and clinical measurements more uniform and universal. LOINC is maintained by Regenstrief Institute, Inc., a grantee of NIH. McDonald’s PHR will offer features such as reminders about preventive care and links to NLM resources. He hopes to release the new PHR system for public trials in the coming year.

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Lectures and Events 

December 2, 2008
Medicine for the Public
7 pm
Lipsett Amphitheater
New Insights, New Directions for Treating Major Depression and Bipolar Disorder
Carlos A. Zarate, MD
Chief, Experimental Therapeutics, Mood and Anxiety Disorders Program
Division of Intramural Research Programs, NIMH

December 3, 2008
CC Grand Rounds
12 pm
Lipsett Amphitheater
Ethics Rounds
How to Present a Dire Prognosis
Gregory Makoul, PhD, Chief Academic Officer and Vice President for Academic Affairs, Saint Francis Hospital and Medical Center, Hartford, Conn.
Lecture will be videocast, http://videocast.nih.gov

December 9, 2008
Medicine for the Public
7 pm
Lipsett Amphitheater
The Next Breath We Take: Trailblazing New Treatments for Asthma
Stewart J. Levine, MD
Chief, Asthma and Lung Inflammation Section
Acting Chief, Pulmonary and Vascular Medicine Branch, NHLBI

December 10, 2008
CC Grand Rounds
12 pm
Lipsett Amphitheater
Contemporary Clinical Medicine: Great Teachers
The Art and Science of Hypertension Treatment
Domenic A. Sica, MD
Professor of Internal Medicine, Division of Nephrology, and Professor of Pharmacology and Toxicology
Virginia Commonwealth University Medical Center
Lecture will be videocast, http://videocast.nih.gov

December 16, 2008
Medicine for the Public
7 pm
Lipsett Amphitheater
New Frontiers in Traumatic Brain Injury: Evaluation and Treatment
Leighton Chan, MD
Chief, Department of Rehabilitation Medicine, CC

December 17, 2008
CC Grand Rounds
12 pm
Lipsett Amphitheater
From the Delayed Allergy Reaction to the Immunologic Constant of Rejection
Francesco M. Marincola, MD
Chief, Infectious Disease and Immunogenetics Section
Department of Transfusion Medicine, CC
MicroRNA Expression in Lung Cancer
Maria Teresa Landi, MD, PhD
Senior Investigator, Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI

January 7, 2009
CC Grand Rounds
12 pm
Lipsett Amphitheater
Psychogenic Movement Disorders: A Model for Conversion Disorder
Mark Hallett, MD
Chief, Human Motor Control Section, NINDS
Valerie Voon, MD
Clinical Fellow, Human Motor Control Section, NINDS

January 14, 2009
CC Grand Rounds
12 pm
Lipsett Amphitheater
Contemporary Clinical Medicine: Great Teachers
Evidence-Based Medicine: A Story of Science, Policy, and Politics
David F. Ransohoff, MD
Professor of Medicine and Clinical Professor of Epidemiology
Director, Clinical Research Curriculum
University of North Carolina School of Medicine
Lecture will be videocast, http://videocast.nih.gov

January 14, 2009
Astute Clinician Lecture
3 pm
Masur Auditorium
Marfan Syndrome and Related Disorders: From Molecules to Medicine
Harry C. Dietz, MD
Professor of Pediatrics, Medicine, and Molecular Biology, and Genetics, Institute of Genetic Medicine, Johns Hopkins University School of Medicine
Investigator, Howard Hughes Medical Institute

January 21, 2009
CC Grand Rounds
12 pm
Lipsett Amphitheater
Designing the Historical Atlas of the 1918-1919 Influenza Pandemic in the United States
Howard Markel, MD, PhD
The George E. Wantz Distinguished Professor and Director, Center for the History of Medicine, and Professor of Pediatrics and Communicable Diseases
The University of Michigan Medical School, Ann Arbor
Smallpox Vaccination at the NIH: Unexpected Findings
Jeffrey Cohen, MD
Chief, Medical Virology Section and Senior Investigator, Laboratory of Clinical Infectious Diseases, NIAIDD

January 28, 2009
CC Grand Rounds
12 pm
Lipsett Amphitheater
The Emerging Paradigm of Clinical Genomics: Technologic Developments
Eric Green, MD, PhD
Scientific Director, NHGRI
The Emerging Paradigm of Clinical Genomics: Clinical Implementation
Leslie G. Biesecker, MD
Chief, Genetic Disease Research Branch, NHGRI
 

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