Scientists unlocking genetics of AIDS progression
Studies published Oct. 12 in the Proceedings of the National Academy of Sciences reveal significantly more details about why some individuals infected with the AIDS virus grow sick within months, while others go years without noticeable symptoms.
The studies, conducted at the Health Science Center in collaboration with other institutions, spotlight gene variations in molecules that influence
an individual's susceptibility to AIDS progression. The molecules in which these genetic variations were found play a critical role in the entry of the AIDS virus into cellular portals called "co-receptors."
"One of the most startling aspects of the studies is that they have provided further evidence that the spectrum of gene variants associated with disease acceleration or retardation differs between African-Americans and Caucasians," said study leader Dr. Sunil K. Ahuja, associate professor of medicine.
The study looked for co-receptor gene variants in 2,300 people--half with HIV infection and half without. The scientists found combinations that retarded HIV-1 disease in African-Americans and others that retarded it in Caucasians.
"Such combinations of alleles (gene variants) may have offered selective advantages to ancestral Caucasian and African populations who were exposed to different spectrums of disease-causing agents," Dr. Ahuja said.
Dr. Ahuja likened these combinations to genetic "ZIP codes" that in the future could be used to assess a person's AIDS susceptibility. Treatments could also result.
Of the 1,151 HIV-positive patients evaluated, 54 percent were Caucasian, 37 percent were African-American, 6 percent were Hispanic and 3 percent were of other origin. The 1,199 uninfected individuals represented ethnic groups living in Africa, Asia and Europe. Ninety-four percent of the subjects were male.
During the study, 38 percent of HIV-infected individuals progressed to AIDS and 34 percent died. The researchers compared these outcomes with the genetic analysis.
AIDS incidence in this country is changing. The disease once pre-dominantly affected homosexual Caucasian men but now largely strikes minority groups.
"Non-Hispanic blacks and Hispanics accounted for 47 percent and 20 percent, respectively, of persons diagnosed with AIDS in 1997, the highest proportions thus far in the epidemic," according to a report summary from the U.S. Centers for Disease Control and Prevention.
This trend makes the study of population-specific genetic determinants "compelling," the authors wrote.
The study was conducted in close collaboration with Lt. Col. Matthew Dolan of the Infectious Diseases Service at Wilford Hall Medical Center. Wilford Hall is the referral hospital for all Air Force personnel who develop HIV infection.
Other study collaborators are with the South Texas Veterans Health Care System, Brooke Army Medical Center in San Antonio, the University of Utah, Wake Forest University School of Medicine, the Public Health Research Institute in New York and the Henry M. Jackson Foundation.
The R. J. Kleberg Jr. and H. C. Kleberg Foundation, the U.S. Department of Veterans Affairs, the National Institutes of Health and the National Science Foundation provided grant funding.
The paper was edited by Dr. Anthony S. Fauci, director of the
National Institute of Allergy and Infectious Diseases.
Institutional Strategic Planning Committee
Every two to four years, the Health Science Center engages in a campuswide planning effort to identify in broad terms the direction in which to take the institution to achieve our various missions.
The Institutional Strategic Planning Committee, chaired by Dr. David Shelledy, respiratory care, will be reviewing the currency of the goals and objectives included in the existing comprehensive plan. The 15-member committee also will be looking at internal and external factors affecting the Health Science Center.
The committee is charged with providing a report and recommendations to Dr. John P. Howe, III, president, by Feb. 1. Between September and mid-November, the committee will update an environmental assessment; review and possibly revise objectives for each of the five current goals.
The committee also will discuss strategies and activities; internal performance measures and external benchmark measures to evaluate full or partial achievement of objectives; and the factors responsible for accomplishing stated objectives and for reporting measures at the Annual Campus Review and to external agencies.
Progress on the plan will be provided in future News articles and through broadcast e-mail messages. The committee will solicit input from members of the Health Science Center community and its external constituencies, as well as feedback from these groups when a draft report is available. During the month of October, members of the committee will visit faculty councils and assemblies as well as directors' meetings to provide information about the committee's activities. Copies of a draft report, targeted for December, will be disseminated for comments to the campus community.
In addition to Dr. Shelledy, the committee includes Dr. Martin Adamo, biochemistry; Dr. Theresa Chiang, student services; Dr. James Freeman, surgery; Dr. Birgit Glass, dental dean's office; Dr. Gary Harris, medicine; Dr. Keith Krolick, microbiology; Dr. Mary MacDougall, pediatric dentistry; Dr. Toni Miles, family practice; Jack Park, legal affairs and technology licensing; Wayne Reed, purchasing; Dr. Chuck Rodriguez, university relations; Dr. Kathleen Stevens; family nursing care; Dr. Janet Williams, pediatrics; and A. Jerome York, vice president and chief information officer.
If you have any questions or would like to provide input into
the committee's activities, please contact Dr. Shelledy at
<Shelledy@uthscsa.edu>or Dr. Greene at
Physical therapy month targets falling dangers
Every year one-third to one-half of Americans age 65 and over experience falls. Of those, one-third who fracture a hip and are hospitalized die within a year. The Texas Physical Therapy Association (TPTA) wants to change those statistics.
Physical therapists from the Health Science Center, the University Health System and the community are celebrating National Physical Therapy Month by screening the elderly for risk of falling and by teaching them how to avoid falls. Even if a fall does not result in hospitalization, the fear of falling can keep a person from being active. This can lead to weakness and loss of range of movement, and, ironically, an increase in the risk of falls.
Dr. Barbara Boucher, physical therapy, says the free screenings are being provided to educate not only the public, but health providers as well. "It's not enough to tell people to go out and get more exercise," she said. "People who are at risk for falling need an appropriate exercise treatment."
In order to get that treatment, however, individuals must have a prescription from their physicians. "Physical therapists are like a controlled substance, a medication," Dr. Boucher said. "If there were a pill to prevent falling, everyone would want that. Physical therapy is the medical equivalent of that pill."
Falls are caused by a combination of internal and external factors. Internal factors include visual decline, hearing loss, foot pain, reduced sensation (especially in cases of diabetes), use of four or more medications, and a decline in balance and speed of gait, which are related to activity level and blood pressure problems. External factors include poor lighting in the home, throw rugs, slippery floors and clutter.
One goal of the TPTA is to make balance screenings part of routine medical exams. When physicians determine a patient is at risk, the patient could then be referred to a PT for the correct treatment.
At the first screening session, held at McCreless Mall during a health fair sponsored by the University Health System, the therapists assessed 33 individuals, several of whom were referred back to their physicians, Dr. Boucher said.
The next two sessions will be held from 10 a.m. to 2 p.m. on Oct. 16, at Baptist HealthLink at Bitters and West Avenue and from 9 a.m. to 2 p.m on Nov. 4, at Silver Sage Senior Activity Center in Bandera.
Proposition 17 on the ballot in November
Proposition 17, on the Nov. 2, 1999, constitutional election ballot, directly affects the Health Science Center and other designated public universities. If the proposed constitutional amendment concerning the Permanent University Fund (PUF) passes, the Health Science Center, which shares in the PUF, could receive a major increase in funding from the PUF.
Proposition 17, if adopted, would allow the Fund's investment managers to take advantage of broader investment strategies and to increase the proceeds available for programs and facilities at PUF institutions within both The Texas A&M University System and The University of Texas System. The proposition does not change the institutions participating in the PUF. Most important, the proposition, if adopted, would not increase taxes.
The funding made possible by the proposed changes would be used to finance much needed capital improvements or to acquire capital equipment and library books or materials. Improved facilities, equipment and library materials from this source will reduce the potential financial burden on students who might otherwise have to pay for these items.
The need for legislation that led to placement of Proposition
17 on the November ballot was also supported by a report from
the Office of the State Auditor, which suggested the proposed
changes would allow better financial returns for the PUF. The
proposal was passed unanimously by the Legislature.
Expo '99 introduces students
Introducing young people to career possibilities in bioscience is the objective of Health Science Center sponsors at the annual science and health careers exposition Oct. 28.
to the world of careers in science
Bill Rogers, rehab medicine, (second from left)
demonstrates a wound imaging device at the Science
'98 expo. The device measures wounds to ensure they
Science '99 "Explore the Connections" will include exhibits from occupational therapy, clinical laboratory sciences, respiratory care and the South Texas Poison Center, among others.
Participating students can get a variety of information on careers and schools, including how to apply to professional schools and matching student personality to a health career field. Presentations at the expo will include a look at the brain and the heart, information on emergency medicine and a visit to the Health Science Center Briscoe Library.
The event will provide high school students with an opportunity
to explore health professions and the relationship science has with everyday life.
The Health Science Center is just one of the many components of Science '99. Throughout the week of Oct. 25 through Oct. 30, students will have a chance to visit the Academy of Health Sciences at Fort Sam Houston, the H-E-B Science Treehouse at the Witte Museum and the Scobee Planetarium at San Antonio College.
The Health Science Center expo will begin at 8:30 a.m. with registration and a welcome session. Exhibits for Session I will be open from 9 a.m. to 11:30 a.m. Session II will begin at 12:30 p.m. and run until 3:30 p.m.
The Office of Special Programs is looking for faculty and staff to help at the registration tables and escort students to breakout sessions. Additional exhibitors also are welcome. For more information, to register or to reserve a table, contact the Office of Special Programs at ext. 2654.
Voting places will be set up in major malls (except for North Star Mall) and at locations throughout the city. Hours are 8 a.m. to 6 p.m. Monday through Friday, 10 a.m. to 6 p.m. Saturday and noon to 6 p.m. on Sunday.
For more information, call Bexar County Voter Registration at 335-6625.
Lawler honored for award-winning article
Dr. W. Ross Lawler, family practice, was awarded the Walter H. Kemp Award for the best article published by a family physician author in the American Family Physicians (AFP) journal in 1998.
The article, "An Office Approach to the Diagnosis of Chronic Cough," was selected from more than 130 articles published last year in AFP. Dr. Lawler is the 13th recipient of the Kemp Award, which carries a $1,000 honorarium. The award was named for Walter H. Kemp, managing publisher of AFP for 15 years.
Dr. Lawler is a 25-year veteran of the Health Science Center's Department of Family Practice and the recipient of several educational development awards and nominations for the Presidential Excellence in Teaching Award. He has received the Golden Heart Award and the Distinguished Service Award from the Texas affiliate of the American Heart Association (AHA) and the Meritorious Service Award and Gratitude Award from the San Antonio Division of the AHA.
Dr. Lawler's article reviewing the diagnosis and management of chronic cough, originally appeared in the December 1998 edition of AFP. It was selected by the publication's editorial staff based on presentation, scientific substance, originality of thought and relevance to family practice. The American Academy of Family Physicians' Commission on Continuing Medical Education nominates top articles considered for the accolade.
"It is very flattering to receive this award," said Dr. Lawler. "I owe much to the help of colleagues in this institution who reviewed and made suggestions for the article."
Dr. Lawler received his medical degree from The University of Texas Medical Branch in Galveston and went on to a rotating residency internship at Hennepin County General Hospital in Minneapolis. After serving two years as a flight surgeon in the Army, he completed his residency training in family medicine at the University of Rochester Highland Hospital in New York.
The link between periodontal disease and the body
When Melvin Skinner had a heart attack three years ago, he never thought his gum disease might have contributed to his heart condition. It's a connection he and many health care providers have not made before, but studies are now confirming the link.
"We know already that there is a link between systemic
disorders and periodontal disease. If you had leukemia or
diabetes, you tended to have more oral problems such as
abscesses in diabetic people for example. Now we have learned
that the reverse is going on--the mouth is affecting the rest of the body," said Dr. David Cochran, professor and chairman of the Health Science Center's Department of Periodontics.
The connection is particularly evident in cardiovascular
"Gum disease is the inflammation of the tissues surrounding the teeth. The approximately 400 types of bacteria in your mouth cause the trouble that can lead to gum and bone loss. That same group of bacteria gets in your bloodstream and damages the linings of blood vessels. If your coronary arteries are already damaged, the bacteria exacerbate the situation even more," said Dr. Cochran.
About 36 million Americans have gum disease. The disease often goes untreated because there are few symptoms. Because it rarely causes pain, the disease is allowed to quietly eat away the teeth and gums. Some individuals experience bleeding and an inability to chew, which eventually requires medical attention.
"By the time patients do come in to find out what is the matter with their gums, the disease has advanced considerably," said Dr. Cochran.
Periodontal disease also is being linked to other disorders. Poor oral health in pregnant women has been implicated in the incidence of low birth weight, preterm babies. It seems the inflammatory response in the gums and teeth causes a hyperimmune response in the body, which affects the fetus. In addition, researchers have found that if diabetics are treated for periodontal disease, their glucose levels will be easier to maintain.
"Since the blood vessels of diabetics are already compromised, the disease becomes even more pronounced and the ability to heal suffers," said Dr. Cochran. "It's crucial for diabetics to keep their gums healthy, not only because of their diabetes but because of the threat of heart disease as well."
Beyond researching the mouth-body connection, periodontists are developing techniques and materials to aid in regeneration of bone and tissue following periodontal surgery. One such material, bone morphogenetic protein (BMP) is already in phase 2 and 3 clinical trials in the Dental School. "We have about six human trials going right now," said Dr. Cochran. Another promising new material is emdogain, which is currently being tested under a three-year grant.
"There are not enough hours in the day," he
said, "It's really exciting. This is probably the most
sought-after periodontal graduate program in the country, and
we get a really great selection of students."
Days of Caring begins Oct. 19
The United Way's October Days of Caring are beginning Tuesday, Oct. 19, with the construction of a 23-acre park in an underserved Northeast neighborhood. The project will run daily from 9 a.m. to 4 p.m. until Saturday, Oct. 23.
The project is designed to provide the neighborhood with a safe place for recreation. During the week, volunteers will be constructing softball fields, creating a nature trail and constructing a parking lot.
Volunteers should dress appropriately for outdoor labor in work
boots, gloves and if possible, long sleeved shirts. Bill
Miller Bar-B-Q will provide lunch at a cost of $5 in advance,
or volunteers may bring their own lunches. For more
information, contact Mary Yanes at ext. 2205, e-mail
<email@example.com>, or Joe Ocampo at ext. 2980.
Burroughs Wellcome Foundation lecture Oct. 27
The Health Science Center welcomes Dr. Howard K. Schachman, professor of the Graduate School Department of Molecular and Cell Biology at the University of California at Berkeley, for the Burroughs Wellcome Foundation Lecture on Oct. 27.
Dr. Schachman, who was awarded a visiting professorship from the Burroughs Wellcome Foundation, will discuss "Science Policy and Its Impact on Research," an outgrowth of his role as special advisor to the director of the National Institutes of Health and NIH ombudsman in basic sciences.
The lecture will begin at 3:30 p.m., in lecture hall 3.104A, with a wine and cheese reception to follow at 5 p.m. The Burroughs Foundation, Beckman Coulter Inc., and the Health Science Center Department of Biochemistry will sponsor the event, which is open to the public.
The Burroughs Wellcome Foundation is a private, independent foundation established to further the medical sciences by supporting research and educational activities.
Herbs and health seminar explores use and safety
The Nursing Advisory Council at the Health Science Center is holding a seminar on herbs and health Nov. 15 from 7:45 to 9 a.m. at the San Antonio Country Club.
Dr. Beverly Hall will discuss scientific research that supports the use and safety of herbs in health care. Sponsors for the event include the Biomedical Development Corporation, Mission Pharmacal, the San Antonio Express-News, Barbara Wulfe, Sun Harvest, San Antonio Credit Union, and S&C Advertising and Public Relations.
The cost is $20 per person. For more information or to reserve a space, call ext. 5901.
Friends of the P. I. Nixon Medical Historical Library
Dr. George R. Kerr, professor of Biological Sciences and International and Family Health at The University of Texas School of Public Health at Houston, will be the guest speaker at the Friends' annual dinner and lecture, Monday, Nov. 15, at 6:30 p.m. at the DoubleTree Hotel.
annual dinner set for Nov. 15
Dr. Kerr will discuss "Historic Advocates for the Public Health of Children." An amateur historian who teaches courses in the history of public health, Dr. Kerr has conducted extensive studies of children in both developed and underdeveloped countries to identify the preventable causes of fetal, infant and childhood death in Texas.
Reservations for the event must be made by Nov. 8 through Special Collections Library Assistant Pat Brown at ext. 2400.
Calendar for Oct. 18 - 24
Monday, October 18
Orthopaedic Grand Rounds "Integrative Medicine for Musculoskeletal Problems/Overview," Dr. Charles Kennedy (MED: 309L)
Neurosurgery Grand Rounds "Drug Regulation & Modulation of GABA-A & NMDA Receptors," Dr. Maharaj Ticku (MED: 444B)
Medical Housestaff Specialty Conf. "Residents & Interns: M&M" (MED: 409L)
Rehab Medicine Lecture Series "Environmental Control: A Review of the Literature," Drs. Gary Campbell & Maria Lomba (UH: Reeves Rehab Center 3rd-floor classroom)
Tuesday, October 19
Medical Housestaff Specialty Conf. "Derm Manifestations of Systemic Diseases," Dr. Kraus (MED: 409L)
Otolaryngology-Head & Neck Surgery Grand Rounds "Congenital Temporal Bone Abnormalities," Dr. Daniel Fleming (MED: 444B)
Rehab Medicine Lecture Series "Reciprocating Gait Orthosis: Patient Presentation," Drs. David LeMay, Thomas Darm & Gordon Bosker (UH: Reeves Rehab Center 3rd-floor classroom)
Training Office "More Library Skills" (Library room 2Acall ext. 2320 to register)
TNT "Hematology: Red Blood Cell Morphology," Dr. Randy Sosolik, Southern Ohio Medical Center, Portsmouth, Ohio (call ext. 2700 for information)
Medicine Research Conf. "Chemoprevention of Prostate Cancer," Dr. Ian Thompson (MED: 209L)
Training Office "Basic Travel Procedures" (call ext. 2320 to register)
Psychiatry Grand Rounds "Delirium: Acute Confusional States," Dr. Michael Wise, Uniformed Services University of the Health Sciences (MED: 409L)
TNT "Contemporary Topics on Infectious Diseases: Controlling Infectious Aerosols in Health Care Facilities: A Team Effort in Design, Construction, Operation and Maintenance," Dr. Eugene Cole, DynCorp Health Research Services, Durham, N.C. (call ext. 2700 for information)
Molecular Medicine Seminar Series "Role of the Proteasome in Protein Degradation & Immune Surveillance," Dr. Alfred Goldberg, Harvard Medical School (IBT: 3.002)
Wednesday, October 20
Podiatry Grand Rounds (MED: 309L)
Vascular Surgery Grand Rounds, Dr. Mellick Sykes (MED: 209L)
Medical Grand Rounds "Bartter Lecture: What Randomized Trials Have Taught Us About Prevention of Fractures," Dr. Steven Cummings, University of California (MED: 409L)
Surgery Trauma M&M Conf., Dr. Ronald Stewart (MED: 309L)
TNT "Respiratory Care: Neonatal Update," Arthur
Jones (call ext. 2700 for
TNT "Social Work: Anger Management for Fun & Profit," Robert Sheets, Scottsdale, Ariz. (call ext. 2700)
Pharmocology Seminar Series "Regulatory Mechanisms & Functional Roles of Phosphoinositide-Dependent Protein Kinase in Insuline Signaling," Dr. Feng Liu (MED: 444B)
TNT "Nutrition Updates: Latest Research on Sterols & Sterolins," Lorna Vanderhaege, British Columbia, Canada (call ext. 2700 for information)
Thursday, October 21
Thoracic Surgery Resident Teaching Conf. (VA: 4th-floor CT Library A404 )
Obstetrics & Gynecology Grand Rounds "Fetal Cardiac Dysrhythmias," Dr. Melinda McFarland (MED: 309L)
Neurology Grand Rounds "Migraine in Women," Dr. Gretchen Tietjen, Medical College of Ohio (MED: 444B)
TNT "Health Care Education & Training: Enliven Your Lesson Plan," Verolyn Bolander, U. T. Medical Branch, Galveston (call ext. 2700 for information)
Pulmonary, Thoracic & Oncology Conf. (MED: 309L)
TNT "Comprehensive Care & Management of Diabetes: The Latest in Oral Antidiabetic Agent Therapy," Dr. Janet Blodgett (call ext. 2700 for information)
Surgery Tumor Conference, Dr. Anatolio Cruz (MED: 209L)
Anesthesiology Grand Rounds "The Development Neurobiology of Pain in Neonates," Dr. Lynda Wells (UH: 212)
Citywide Thoracic Grand Rounds Conf. "Case Presentations," Dr. Claudio Guareschi (MED: 309L)
Friday, October 22
Saturday, October 23
Pediatric Grand Rounds "Update on Developmental Screening," Dr. Glen Aylward, Southern Illinois University School of Medicine (MED: 409L)
Rehab Medicine Lecture Series "Intramedullary Sarcoidosis Presenting as Spastic Paraparesis: Case Report: A Review of Research," Drs. Loida Ayala & Douglas Barber (UH: Reeves Rehab Center 3rd-floor classroom)
Cardiovascular Research Conf. "Effect of Carbon Dioxide on Autonomic Cardiovascular Responses to Systemic Hypoxia in Conscious Rats," Dr. Haruhisa Hirakawa (MED: 3.078V)
Continuing Dental Education "Bruised, Broken & Bedeviled Teeth: Managing Traumatic Injuries," Dr. Anthony Diangelis (call ext. 3177 for information)
Continuing Dental Education "OSHA-Required Annual Training: A Form-By-Form Program for the Entire Dental Team," Dr. Robert Cooley (call ext. 3177 for information)
Surgical Physiology Conf., Dr. Kenneth Sirinek (MED: 209L)
Continuing Dental Education "Preoperative & Postoperative Management of the Outpatient Oral Surgery," Dr. Gregory Spackman (call ext. 3177 for information)
General Surgery Grand Rounds, Dr. Wayne Schwesinger