A national panel appointed by Congress has sounded a clarion call for stepping up the war against diabetes mellitus, which affects 16 million people in the United States and thousands in the South Texas/Border Region. One of the key voices on the committee was the Health Science Center's Dr. Michael Stern, professor of medicine and chief of the Division of Clinical Epidemiology.
National Institutes of Health (NIH) funding for diabetes research programs would be doubled by 2000 and quadrupled by 2004 if Congress adopted levels contained in the "Summary of the Report and Recommendations" of the Congressionally Established Diabetes Research Working Group, of which Dr. Stern is a member.
"Diabetes research has been dramatically under-funded," Dr. Stern said. "Comparing diabetes funding with research support for other major public health problems, such as hypertension, cardiovascular disease, cancer and AIDS, the difference is startling."
For example, more than a thousand dollars of NIH funds are spent per each reported case of AIDS in the United States. Several hundred dollars are spent on each case of breast cancer and cardiovascular disease. Only $20 to $30 is spent per case of diabetes.
NIH grants for disease research are wisely invested, no matter what the disease, Dr. Stern said. Thanks in part to research discoveries, incidence of conditions such as heart disease, hypertension and stroke actually are declining.
"Where we have made the investment, there has been a satisfactory return on investment--we have made a major dent in incidence of a disease," Dr. Stern said. "Where we have not made the investment, in areas such as diabetes, there has been a marked rise in incidence rather than a fall. It seems diabetes has not been seen as a public health problem the way heart disease and hypertension and other problems have been."
Incidence of diabetes has tripled in South Texas in the last 10 to 15 years. One in four persons living in the barrios of San Antonio reports having the disease, according to figures from the South Texas Health Research Center.
The Health Science Center's new South Texas Centers for Biology in Medicine, under construction in the Texas Research Park, will include a research focus on diabetes in South Texas. The University Health System's Texas Diabetes Institute, headed by Dr. Ralph DeFronzo, professor of medicine and chief of the Division of Diabetes, also provides leading research and patient care for the region.
Dr. Stern's research interests are the epidemiology and genetics of type 2 (later-onset) diabetes and cardiovascular disease in Mexican Americans and non-Hispanic whites. He and his colleagues are carrying out an eight-year follow-up study of more than 5,000 individuals (60 percent Mexican American) and are examining risk factors for diabetes and cardiovascular disease in the two ethnic groups.
Discoveries in genetics and molecular biology are making this a "very exciting time in diabetes, full of possibilities for new treatments and understandings for the future," he said.
Taking advantage of this momentum, the Diabetes Working Group would increase the grand total of NIH spending on diabetes research from $442.8 million in 1999 to $827.3 million in 2000. By 2004 under the proposal, federal diabetes research would reach $1.6 billion, a fourfold increase in five years.
That would counter a trend that, according to the Working Group's summary, has seen funding for diabetes research plummet by more than 30 percent since 1981. During the same period, the death rate due to diabetes has increased by 30 percent.
Dr. Stern served on the Working Group's Subcommittee on Clinical Trials, which recommended ways of documenting benefits of existing diabetes therapies with the goal of improving therapy outcomes in diabetes patients.
The findings were formally presented to Congress in Washington on Feb. 25.
The public, faculty, staff and students are invited to explore "The Beginning and End of Life" at the university's 1999 "Mini-Medical School," set for March 30, April 6 and April 13 on campus. Slots are still open. To register or for a copy of the registration form, call ext. 1925 or send e-mail to <email@example.com>.
"School is open" every Tuesday at 7 p.m. for three weeks. Professors including Nobel Laureate Dr. Louis Ignarro will take the class through the wonders and complexities of human development (the start of the life cycle) and the equally amazing facets of the aging process (the end of the cycle). The three weekly sessions will last from 7 to 9 p.m. Tuesdays in lecture hall 3.102B.
The lecture series is a free-of-charge gift to the South Texas community for its generous support of the Health Science Center. Employees also are encouraged to come and learn more about health and science. A science background is not required and persons of all ages are welcome. Registration is required since seating is limited. Enrollment is on a first-come basis.
The program provides informative and interesting presentations from various Health Science Center points of view: basic research, medicine, nursing, dentistry and the allied health professions.
The March 30 session will explore "The Beginning of Life and Its Challenges," including presentations on human embryology, birth defects and surgical repair of congenital hand defects. On April 6, speakers will cover "How the Body Changes at the End of Life." Topics will include cell death, rheumatoid arthritis and disease prevention in the elderly. Dr. Ignarro will discuss his Nobel Prize in Medicine or Physiology during the closing April 13 session.
APRIL 6--HOW THE BODY CHANGES AT THE END OF LIFE
APRIL 13--THE BRACKENRIDGE LECTURE:
AN EVENING WITH A NOBEL LAUREATE
Olga Rodriguez, pathology, hangs her March of Dimes HealthWalk cardboard sneaker indicating she made a donation to this year's HealthWalk. The department raised about $100 for the March of Dimes through its shoe sales. Other departments, including photographic services and laboratory animal resources, proudly displayed their sneakers as well. At the 16th annual HealthWalk on campus Thursday, April 8, employees will seek to surpass last year's $18,200 raised for research programs supported by the March of Dimes. The HealthWalk is a triumphant two laps around the Health Science Center track, culminating a monthlong fund-raising campaign.
Dental students, who organize the race annually, will announce further plans at a later date. Miles for Smiles could possibly be held in the fall.
"We regret having to postpone our popular Miles for Smiles Run/Walk," according to a statement issued by the Dental Dean's Office. "It was simply a mix-up in the scheduling of the facilities. UTSA had previously scheduled a large cheerleading event, and the realization became clear that logistics difficulties might be compounded with the presence of both events.
"We felt it best to help out UTSA and postpone our event for the time being. The Miles for Smiles Committee apologizes to anyone inconvenienced by the decision."
HHMI awards, funded by a multiyear grant to the Health Science Center, support recruitment and development of new faculty, innovative high-quality research projects in early phases, and enrichment activities such as conference programs, visiting scientist programs, mini-sabbaticals and supplements for minority trainees.
The most recent awards included faculty start-up awards to Drs. Jared Clever, microbiology; Renee Yew, molecular medicine; and Aurelio Galli, pharmacology. Pilot research awards went to Drs. Eduardo Montalvo, pediatrics, and Mark Steinhelper, physicology, and enrichment grants went to Drs. Steven Mifflin, pharmacology, and Martin Adamo, biochemistry.
HHMI grants are awarded every several months. The next deadline for submitting proposals is April 1. For more information, call Rosie Marti, ext. 4978.
The "Interdisciplinary Collaboration Teaching Grants Program" will foster cooperation that provides integrated foundations for teaching and learning. The grants must involve interdisciplinary collaboration among two or more departments or schools of the Health Science Center.
Awards may be used to introduce an innovative instructional program for which resources are not currently available, or they may serve as seed money for teaching innovations that receive future funding from government or private programs.
It is hoped the grants will help health care educators to continually improve educational skills, to develop new teaching methods and to stay informed of technological advances that improve student-teacher communication.
The program will be available to faculty and graduate students who have clinical, laboratory or didactic teaching responsibilities. For more information, call Dr. John Littlefield at ext. 2280. He is director of instructional development in the Division of Educational Research & Development.
Sessions will be presented on a variety of topics, including copyright in the electronic environment, access to full-text journals, reference management software and drug information on the Internet. Exhibitors will include Apple Computers, EndNote/Niles Software, and the UTHSCSA Center for Distance Learning and Telehealth.
The EXPO is free and open to the general public and to Health Science Center students, faculty and staff. For more information, check the library's Web site.
Rosalinda Castro, network specialist in the Department of Telecommunications & Networking, reviews materials at the Continental Airlines display during the 1999 Travel Fair held recently. She was one of hundreds of employees who visited the fair to learn more about travel opportunities for business and for pleasure.
Each summer the Health Science Center and the South Texas Veterans Health System's Audie Murphy Hospital offer 25 medical students a chance to work with faculty mentors who are actively and prominently involved in aging research. With choices of working in clinical, health service and basic aging research settings, these students can pursue their own research interests and receive an attractive stipend while they learn.
The program was especially fruitful for Peña and Bunker--their summer investment led to national recognition. Each will present posters of their summer's research at the Experimental Biology 1999 national meeting to be held in Washington, D.C., April 17-21.
Bunker will present "ET-B receptor control of vascular tone in human hypertension," a poster describing findings he made under the guidance of Dr. Dean Kellogg, assistant professor in the Departments of Medicine and Physiology and at Audie Murphy's Geriatric Research, Education & Clinical Center (GRECC).
Peña's poster, "Increased oxidative damage is correlated to altered mitochondrial enzyme activities in skeletal muscle," represents the results of his summer experiments while working in the laboratories of Drs. Arlan Richardson, professor, and Holly VanRemmen, assistant professor, both of the Department of Physiology and the GRECC.
Dr. Walter Ward, associate professor of physiology and the program's director, describes the program as an opportunity for medical students to work in both basic research and clinical practice with faculty mentors who are well established in their areas of aging research.
Students also participate in seminar and discussion group meetings where they learn about the most up-to-date technology and treatments used in geriatrics and gerontology.
For more information on the program, call Dr. Ward's office at ext. 4330 or Madge Cluck at ext. 4331.
(Submitted by Corinne Price, Aging Research & Education Center)
The department, located in room 1148/1150, provides administrative assistance to researchers using the University Health System. All Institutional Review Board-approved protocols, including those classified as "exempt" or "expedited," that make use of the University Health System must have approval from the office before start-up.
For more information, call 358-4815. Office hours are 8 a.m. to 4:30 p.m. Monday through Friday.
The Health Science Center President's Council on March 5 awarded more than $160,000 to projects in the medical, dental, nursing, graduate and allied health schools, and to projects for interdisciplinary teaching and bioscience career outreach.
"After tonight's awards are given, the President's Council's members should know that the total they have given to the schools of the Health Science Center is in excess of $600,000," said Dr. Spencer Rowland, outgoing co-chair of the President's Council.
The President's Council Dinner and Reception was held at the wonderfully refurbished Buckhorn Museum on East Houston Street. Invited dignitaries journeyed to
the event from as far away as the Rio Grande Valley. Health Science Center faculty and staff dined with the university donors and members in the museum's Toepperwein Room.
The invited guests were treated to an evening of discussion with faculty researchers, close-up looks at fascinating museum pieces, and expressions of thanksgiving for their generosity to the Health Science Center. They met patients who have benefited from expertise of Health Science Center faculty members.
Nine-year-old Eddie Benavides was on hand with his parents and older brother as J. Tullos Wells, President's Council co-chair, described the child's amazing road to recovery from leukemia. After Eddie's leukemia failed to respond to several chemotherapies, Dr. Naynesh Kamani, pediatrics, performed an experimental bone marrow treatment that had never been done in San Antonio.
"It is the first in this region, and, to the great relief of Mr. and Mrs. Benavides, this treatment was a remarkable success," Wells said. "This year, Eddie received his first bike and is enjoying all those things we want little boys to enjoy--thanks to the children's cancer research that is available right here through the Health Science Center."
Wells also introduced Setsuko Bass, a cancer survivor who underwent a
minimally invasive thermal ablation technique performed by Dr. Gerald Dodd,
III, radiology. Dr. Dodd was able to obliterate both of Mrs. Bass' liver tumors on an outpatient basis, Wells said.
Later in the evening, the President's Council awarded:
The evening ended with thanks to Dr. Rowland for his service as President's Council co-chair and announcement of the new co-chair, San Antonio civic leader Luis de la Garza.
To be eligible, a nominee must have taught as a full-time faculty member at the Health Science Center for a minimum of three consecutive years as of Sept. 1, 1998, and not have received the award in the past eight years.
Faculty members may be nominated by any of the following individuals: three students or house officers, two faculty members, or a department chair. Nomination forms may be obtained from class presidents, department chairs or the President's Office.
Completed nomination forms should be returned to Dr. Deborah Greene, vice president for institutional effectiveness and planning, ext. 2004.
The report was conducted by the San Antonio Evidence-Based Practice Center on behalf of the U.S. Agency for Health Care Policy and Research (AHCPR). It found that selective serotonin re-uptake inhibitors (SSRIs) are equally as effective in treating depression as older generation anti-depressants, such as tricyclics.
"SSRIs are therapies of choice for many practitioners, but there are a lot of options out there and no particular class of drugs is routinely more effective than others," said Dr. Cynthia Mulrow, the study's lead investigator and a professor of medicine and geriatrics at the Health Science Center.
The study found that both newer- and older-generation anti-depressants have side effects. Patients taking the newer anti-depressants were more likely to have higher rates of diarrhea, nausea, insomnia and headache.
The older drugs were likely to cause adverse effects on the heart and blood pressure, and result in dry mouth, constipation, dizziness, blurred vision and tremors. While anecdotal reports suggest high rates of difficulty in sexual functioning, this report found little data that directly addressed this problem.
"The good news for the many people suffering from depression is that this rigorous analysis of the scientific literature has endorsed the effectiveness of a wide array of medication options," said co-author Dr. John Williams Jr., associate professor of medicine at the Health Science Center. "However, the risks and benefits of these options must be carefully weighed. In the studies we analyzed, people dropped out of clinical trials of both older and newer anti-depressants at similar rates because of drug side effects."
The study did not compare drug costs for the nine categories of anti-depressants, the dosing schedules, nor the risk of various drug-to-drug interactions. The report was designed to provide a comprehensive evaluation of the efficacy of newer pharmacotherapies and herbal medications, such as St. John's wort, kava kava and valeriana, for depressive disorders.
A summary of the report is available on the Web.
(Submitted by Karen Stamm of the Evidence-Based Practice Center)
"Students at your school feel that you are a wonderful teacher, one who makes his students fall in love with medicine," wrote Dr. Brad Deal, AMSA national president, in a congratulatory letter to Dr. Pestana. "AMSA's selection committee was impressed with the variety and depth of your experience, as well as your contributions to medical education. As an instructor, you have made a significant impact on the educational value that medical students receive from their coursework."
The Golden Apple Award was pre-sented March 12 in Chicago at AMSA's 49th Annual National Convention. Dr. Pestana's award nominators included Kavita Patel, a Health Science Center medical student who served as AMSA national president in 1997-98.
Dr. Pestana joined the Medical School in 1968 and was associate dean for academic affairs for many years until stepping down from the post in January 1998. He is widely known for his open door to students, his visits to their courses and his adherence to high academic standards.
AMSA is the oldest and largest independent association of physicians-in-training in the country.
Index of issues