Department of Medicine

Case Western Reserve University School of Medicine & UH Case Medical Center

First multi-PI combined training program between CWRU and Cleveland Clinic headed by Fabio Cominelli

June 9th, 2010 Posted in Case Western Reserve University School of Medicine, cleveland, department of medicine
Jun, 09 2010
No Comments »
Beginning in July, the first multiple-principal investigator combined training program between Case Western Reserve University and Cleveland Clinic will be initiated by Fabio Cominelli MD, PhD, the Hermann Menges, Jr. Chair in Internal Medicine at the School of Medicine, and Claudio Fiocchi MD¸ Clifford and Jane Anthony Chair for Digestive Disease Research and Education, Lerner Research Institute at Cleveland Clinic.
The National Institute of Diabetes, Digestive and Kidney Diseases provided the new joint effort with a five-year grant worth nearly $1M. The funding supports post-doctoral fellows in obtaining digestive disease science training for a period of three years; for physicians this will be in conjunction with their clinical training in gastroenterology.
This training program is unique in that it follows the city-based program model of the Clinical and Translational Science Collaborative (CTSC). Trainees will come to Cleveland with the option to train either at the Lerner Research Institute or the School of Medicine, and they will have the ability to choose among 20 mentors whose laboratories are supported by more than $20 million per year in National Institutes of Health funding.
, , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Read More

Good Morning America visits new heart imaging device in Cleveland

May 27th, 2010 Posted in cleveland, department of medicine, medical news, physician
May, 27 2010
No Comments »

Dr. Marco Costa found a second blocked artery in Mack Bailey’s heart — and demonstrated to a Good Morning America audience the first vascular-imaging technology based on optical coherence tomography (OCT) — at the same time Thursday.

Costa is an interventional cardiologist and director of the cardiovascular research institute at University Hospitals Case Medical Center in Cleveland, Ohio. Bailey is a 60-year-old Clevelander with had a heart attack and is being treated by Costa.

Both agreed to be filmed and interviewed by the NBC morning news show because University Hospitals is the first — and so far only — hospital to use the C7-XR Imaging System and accompanying C7 Dragonfly Imaging Catheter made by LightLab Imaging Inc. during patient heart procedures.

While using the technology to place a stent in one of Bailey’s heart arteries, Costa found a second blocked artery that had not shown up on images of Bailey’s heart. Costa ended up placing two stents, that day.

“If he had gone home this weekend without having this procedure today, he would have gone home with a very nice, well-placed stent in the vessel that did not cause the heart attack,” Costa said during the Good Morning America segment.

The LightLab system uses near-infrared light to produce high-resolution, real-time images that are better and faster than images produced by competing ultrasound technology. The system recently was approved for sale by the Food and Drug Administration. UH Case Medical Center was the core laboratory on the FDA approval study and analyzed the study’s results, according to the Case Western Reserve University School of Medicine blog.

, , , , , , , , , , , , , , , , , ,
Read More

Impotence plus heart disease ups death risk – Dr. Sahil Parikh discusses the study

May 27th, 2010 Posted in department of medicine, medical news, physician
May, 27 2010
No Comments »

Reuters Report ::

Men with heart disease who also have erectile dysfunction die sooner than men who do not seek treatment for impotence, researchers reported on Monday.

They found that men who had both conditions were twice as likely to die from any cause and twice as likely to have a heart attack than men with heart disease alone.

The researchers expressed concern that using drugs such as Pfizer’s Viagra or Eli Lilly’s Cialis to treat erectile dysfunction could mask the symptoms that point to widespread heart and artery disease and said men complaining of impotence should be checked by a cardiologist.

“Erectile dysfunction is something that regularly should be addressed in the medical history of patients; it might be a symptom of early atherosclerosis,” Dr. Michael Bohm of the University of Saarland in Germany, who led the study, said in a statement.

His team studied 1,519 men in 13 countries taking part in some larger studies of various heart disease treatments. As part of the study the men were also asked about erectile dysfunction.

More than half of them, 55 percent, did, Bohm’s team said in a report published in the journal Circulation and also presented at a meeting of the American College of Cardiology.

During the two years of the study, 11.3 percent of the patients who reported erectile dysfunction died, compared to 5.6 percent of those with mild or no impotence problems.

“It has long been known that erectile dysfunction is a marker for cardiovascular disease,” said Dr. Sahil Parikh at University Hospitals Case Medical Center in Cleveland, Ohio, who was not involved in the study.

The first impotence drug, Pfizer’s Viagra, known generically as sildenafil, was at first developed to lower blood pressure, he said.

“They realized it had this other effect, which patients quite enjoyed,” Parikh said in a telephone interview.

HAPPY SIDE-EFFECT

Viagra and rival drugs such as Eli Lilly’s Cialis and Bayer AG’s BAYG.DE Levitra all work by increasing blood flow.

“In order to have proper erectile function, you have to have adequate blood flow to the genitals. If you have atherosclerosis, whether in the arteries on the neck, which can cause stroke, or the arteries of the heart, which can cause heart attack … it is the same disease.”

But while the erectile dysfunction drugs help blood flow all over the body, they do not treat the underlying hardening and narrowing in the arteries that is causing the problem.

“If patients have erectile dysfunction, we have to be very aggressive about screening and treating them for heart disease,” Parikh said.

When Viagra came onto the market, many health experts welcomed it as a way to get men who might otherwise neglect their health to go to a doctor. But Bohm and Parikh both agreed that patients — and their doctors — need to look hard at the hearts of men with erectile dysfunction.

“Men with ED going to a general practitioner or a urologist need to be referred for a cardiology workup to determine existing cardiovascular disease and proper treatment,” Bohm said.

“The medication works and the patient doesn’t show up any more,” he added. “These men are being treated for the ED, but not the underlying cardiovascular disease.”

The drugs are wildly popular. Viagra alone had sales of nearly $2 billion in 2009.

, , , , , , , , , , , , , , , , , ,
Read More

Ohio Third Frontier approves biomedical project, investing grants

May 27th, 2010 Posted in cleveland, department of medicine, medical news
May, 27 2010
No Comments »

The Ohio Third Frontier Commission on Wednesday approved $20 million in Wright Project grants, including nearly $9 million for three biomedical projects.

During their first meeting since voters approved an extension and expansion of the Ohio Third Frontier through fiscal 2015, commissioners also approved $11 million in entrepreneurial support and pre-seed investment fund grants, as well as a fiscal 2011 budget between $125 million and $143 million.

Third Frontier is the 10-year, $1.35 billion program to re-energize Ohio’s economy by investing in projects in five industry clusters, including biomedical. Early this month, voters added $700 million in bond proceeds and four years to the program.

The five commissioners who attended Wednesday’s meeting voted unanimously to fund seven Wright Project grant proposals, including:
Cleveland Clinic: $3 million for its Clinically Applied Rehabilitation Engineering project, which aims at developing, testing, manufacturing and commercializing advanced, rehabilitative medical products for patients suffering from cardiovascular, neurodegenerative, metabolic and musculoskeletal diseases. Collaborators: Parker Hannifin Corp., Bertec Corp., Case Western Reserve University and the Louis Stokes Cleveland VA Medical Center.

Case Western Reserve University School of Medicine, Cleveland: $2.1 million for its Development of a Quantitative Analysis System for Stem Cells project, which focuses on research commercialization of non-embryonic stem cells from umbilical cord blood as part of a Food and Drug Administration-licensed therapy to help some transplant patients and for testing. Collaborators: Center for Stem Cell and Regenerative Medicine, Cleveland Clinic, Cincinnati Children’s Hospital Medical Center, Cleveland Cord Blood Center, BioInVision, Athersys (NASDAQ: ATHX), PerkinElmer, Thermogenesis (NASDAQ: KOOL), GE Healthcare (NYSE: GE), Hospira and Lakeland Community College.

University of Cincinnati: $3 million for its project, The Ohio Center for Microfluidic Innovation — New Products and Competitive Manufacturing of Emerging Biomedical Applications. The project wants to study, make and commercialize microfluidics technology, which could generate more valuable test results from a much smaller fluid sample than current technology. National Academies reviewers suggested the project be scaled back to just its biomedical applications. Collaborators: Siloam Biosciences, Gamma Dynamics, Sun Chemical and EnMonT.

Third Frontier advisers and commissioners spent a lot of time Wednesday debating “continuity” issues among entrepreneurial support and pre-seed investment funds that already have received grants. Facing state budget challenges, the program limited awards to only organizations that have received past money:

Cleveland Clinic was awarded $2 million for its Ohio BioValidation Fund III, which will invest in promising early stage biomedical companies.

JumpStart Inc., the venture development organization in Cleveland that has invested in several biomedical and healthcare companies, will receive $4 million for operations and investments. JumpStart gets an additional $1.8 million for its bioscience and entrepreneurial network, which will provide entrepreneurial services to bioscience start-ups in the Northeast Ohio region. Collaborators: BioEnterprise, Great Lakes Innovation and Development Enterprise and the Akron Global Business Accelerator.

North Coast Angel Fund II in Mayfield Heights is getting $2 million to invest in high-potential, early stage technology companies.

Ohio TechAngel Fund III in Columbus was awarded $825,000 to invest in early stage Ohio-based technology companies, with a strong emphasis on healthcare innovations and information technology.

TechColumbus is getting $500,000 to continue investing in early-to-late-stage technologystart-ups in Central Ohio. Focus areas of the fund are bioscience, information technology and advanced materials.

Third Frontier commissioners put off votes on three more entrepreneurial support and pre-seed fund grant proposals, asking for more information with plans to vote on those proposals in June.

As for next year’s fiscal budget, the commissioners plan to award $20 million to entrepreneurial support and pre-seed funds, as well as $7 million to both biomedical and medical imaging grant-seekers. The commissioners also budgeted $8 million for a new Wright Center Success Fund, which will invest operating dollars in existing centers of innovation.

, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Read More

Donald Hricik discusses new hypertension study published in the Journal of American Medical Association

May 27th, 2010 Posted in cleveland, department of medicine, Nephrology & Hypertension, physician
May, 27 2010
No Comments »

Half of Americans are in control of their blood pressure. But the number of new cases has gone up according to a new study out published in the Journal of American Medical Association which finds that one out of every three people had their hypertension under control 20 years ago compared to 50% of patients now. However, the number of people diagnosed with the condition has continued to go up.

Dr. Donald Hricik of CWRUmedicine Division of Nephrology and Hypertension at University Hospitals Case Medical Center is interviewed for the story. Watch the video.

, , , , , , , , , ,
Read More

Read about "A Segregation Analysis of Barrett's Esophagus and Associated Adenocarcinomas"

March 30th, 2010 Posted in medical news
Mar, 30 2010
4 Comments »

Familial aggregation of esophageal adenocarcinomas, esophagogastric junction adenocarcinomas, and their precursor Barrett’s esophagus (BE) has been termed familial BE (FBE). Numerous studies documenting increased familial risk for these diseases raise the hypothesis that there may be an inherited susceptibility to the development of BE and its associated cancers. I

n this study, using segregation analysis for a binary trait as implemented in S.A.G.E. 6.0.1, we analyzed data on 881 singly ascertained pedigrees to determine whether FBE is caused by a common environmental or genetic agent and, if genetic, to identify the mode of inheritance of FBE. The inheritance models were compared by likelihood ratio tests and Akaike’s A Information Criterion. Results indicated that random environmental and/or multifactorial components were insufficient to fully explain the familial nature of FBE, but rather, there is segregation of a major type transmitted from one generation to the next (P < 10(-10)). An incompletely dominant inheritance model together with a polygenic component fits the data best.

For this dominant model, the estimated penetrance of the dominant allele is 0.1005 [95% confidence interval (95% CI), 0.0587-0.1667] and the sporadic rate is 0.0012 (95% CI, 0.0004-0.0042), corresponding to a relative risk of 82.53 (95% CI, 28.70-237.35) or odds ratio of 91.63 (95% CI, 32.01-262.29). This segregation analysis provides epidemiologic evidence in support of one or more rare autosomally inherited dominant susceptibility allele(s) in FBE families and, hence, motivates linkage analyses.

Read the full article on CWRUmedicine.org

, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Read More

Dr James Fang discusses the VAD Approach

March 24th, 2010 Posted in medical news
Mar, 24 2010
No Comments »

An alternative one-on-one, patient-oriented approach to  heart disease and heart failure

According to James C. Fang, MD, Medical Director, Advanced Heart Failure & Transplant Center and Professor, Case Western Reserve University Department of Medicine, “The mission of the Advanced Heart Failure & Transplant Center is to provide the latest and most effective therapies to patients in Northeast Ohio and surrounding regions in a personalized one-on-one, patient-centered approach.”

With a high level of expertise in treating heart failure, performing heart transplants, and implanting VADs (also known as heart pumps), the Center offers another sophisticated site in Ohio for patients to consider for their heart and vascular health. One of the most important services provided by the physicians at the Center is their ability to review a patient’s current medical and device therapies and then to provide other treatment options to improve their prognosis and quality of life. “At University Hospitals Case Medical Center, we offer many options and a very personalized approach. We are proud of the fact that we offer very individualized care,” says Dr. Fang. “Many patients don’t recognize that they are suffering needlessly.”

The VAD Option
Patients seen at the Center have refractory congestive heart failure and continue to be short of breath despite medications, device therapy (such as biventricular pacemakers) and heart surgery. These patients find that even doing simple activities like taking a shower or sitting in a chair are difficult. In addition, they cannot stay out of the hospital for very long – they are often regularly admitted for shortness of breath and fluid buildup in the legs. Such patients may be candidates for heart transplantation or a VAD.

VADs are sophisticated, miniaturized pumps that help the heart to provide sufficient blood flow throughout the patient’s body. “VADs are the newest form of a mechanical heart,” says Dr. Fang. A healthy heart can normally pump about 5 L of blood per minute around the body at rest. If, for example, a patient’s heart can pump only 1 L of blood per minute, the VAD will pump an additional 4 L, for a total of 5 L of blood per minute. “The heart pump helps,” notes Dr. Fang, “without entirely taking over the function of the heart.”

Typically, heart pumps are used temporarily while a patient awaits a heart transplant. Current first generation VADs, such as the Thoratec Heartmate XVE, are also used as a “destination” therapy – a permanent solution for heart failure. These devices can function for 12 to 18 months before they must be replaced. It is anticipated that a new, second generation of heart pumps, now undergoing investigational study, will increase the duration of ventricular assistance to two to four years. Nationwide about 2,500 heart transplant operations are performed annually and the Advanced Heart Failure & Transplant Center’s heart surgeons have collectively performed hundreds of heart transplants.

Learn more about VADs at CWRUmedicine.org

, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Read More

CWRUmedicine's Hepatitis C Research Update

March 23rd, 2010 Posted in medical news, Rheumatology
Mar, 23 2010
No Comments »

Acute Hepatitis C Virus  [HCV] infection commonly results in chronic persistence (50-90%), making HCV the most common cause of chronic viral hepatitis. There are nearly 4 million Americans chronically infected with HCV (roughly four times the number of HIV infected individuals).

The long-term risk of cirrhosis with chronic HCV infection is estimated at 20%, with subsequent increases in the risk for liver failure and hepatocellular carcinoma. Evidence suggests that HCV-specific T cell immunity contributes to the pathogenesis of HCV mediated disease, participating in favorable clinical outcome as well as in organ damage.

Our researchers at the CWRUmedicine Division of Rheumatic Diseases have observed a relative paucity of HCV specific effector T cells in freshly prepared PBMC from subjects with chronic HCV infection, contrasting with normal frequencies of effector T cells specific for other antigens in the same subjects. These data are consistent with the notion that circulating HCV specific T cells are deficient in effector function, number, or both, while HCV infection does not result in generalized dysfunction of T cells with other specificities. Though the mechanism for the antigen specific dysfunction in HCV infection is unclear, one possible mechanism is abnormal priming and stimulation of HCV specific T cell populations by dysfunctional HCV containing antigen presenting cell (APC) populations. We hypothesize that one consequence of HCV infection is altered DC function. In addition HCV infection may affect T-cell responsiveness to normal functioning DC. To address this hypothesis we will A)Determine the impact of HCV infection on DC phenotype and function; B) Determine the impact of HCV on T cells by characterizing T cell responsiveness in HCV infected and healthy control subjects; and C. Determine the effects of HCV proteins and virus as a direct inhibitor DC function.

Learn more about our researchers and the role of immature dendritic cells in host defense against HCV [Hepatitis C Virus] infection at CWRUmedicine.org

, , , , , , , , , , , , , , , , , , , , , , , , ,
Read More

19th Annual Cleveland Review of Rheumatic Diseases CME

March 15th, 2010 Posted in medical news, Rheumatology
Mar, 15 2010
2 Comments »

Friday and Saturday April 9 & 10, 2010
The Ritz-Carlton, Cleveland, OH

About the Symposium | This symposium updates the stateof-the-art on management of rheumatologic diseases and will be of interest not only to rheumatologists, but also to primary care physicians. Allied health professionals will also benefit from this symposium.

Learning Objectives | At the conclusion of this symposium, participants will be able to:

  • Develop strategies for managing patients with rheumatoid arthritis and related arthritis at every stage of the disease.
  • Identify selected treatment modalities for rheumatic diseases and enumerate how these new advances may impact the practice of rheumatology.
  • Identify patients who are at the stage of their disease where stem cell transplant may be beneficial.

Continuing Education | The Case Western Reserve University School of Medicine designates this educational activity for a maximum of 11 AMA PRA Category 1 CreditsTM.

Learn more at CWRUmedicine.org

, , , , , , , , , , , , , ,
Read More
Older Entries

Videos, Slideshows and Podcasts by Cincopa Wordpress Plugin