Unique graduate program marries
medicine, engineering

A new graduate program in collaboration with the Department of Orthopaedic Surgery and the UT Department of Biomedical Engineering aims to prepare engineers to design the total joint implants of tomorrow.

The two-year master’s degree program in orthopaedic technology – unique in the country - will combine the fields of orthopaedic surgery and bioengineering to produce bioengineers with medical and anatomical knowledge.

“In the United States, more than 350,000 total knee replacements and around 300,000 total hip replacements are done each year,” said Dr. Alexander Rosenstein, professor of orthopaedic surgery and co-director of the program. “The need for new joint replacement designs is increasing, especially as this Baby Boomer balloon approaches – the general population is getting older and people want to stay active longer.”

This collaborative curriculum will prepare engineers for the task of joint design at a rapid pace, with specialized offerings of operating room observation, an anatomy course, research, and a three-month internship. While the work will be done at the Medical School, the degree will be granted by The University of Texas.

Rosenstein has been working five years to create this program. The curriculum, which was developed with Dr. Catherine Ambrose, an associate professor of orthopaedic surgery, engineer, and the program’s co-director.

One student will be funded for the program this fall by DJO Surgical, a company that designs and manufactures implants.

“It is very valuable for an implant company to have a potential employee with this type of training,” Rosenstein said. “A highly educated workforce is very important in this field.”

Rosenstein said he expects the program to grow into other types of implants and to be offered to more students. For application information, contact Alexander.D.Rosenstein@uth.tmc.edu

-D. Brown

 

Healthy growth reported at MSRDP meeting

Positive margins, collections, and charges for the UT Medical School practice plan were the highlights of the July 24 meeting of the Medical Service, Research and Development Board’s (MSRDP) board of directors. The meeting also marked the last appearance of Dr. James Willerson as MSRDP chairman president.

The Medical School practice plan includes MSRDP and UT Physicians. MSRDP is the “trust fund” for the university’s clinical services, and its board members are the Medical School’s department chairmen and at-large members, who are elected by the faculty. UT Physicians is the business arm of the practice plan.

Dean Giuseppe Colasurdo, MSRDP vice chair, announced that the practice plan is posting a $3.5 million positive margin as of the end of June. Gross charges are $37 million higher than in FY07, and gross collections are $11 million higher than FY07, he said.

“We are experiencing healthy growth, and our goal is 200,000 patient visits next year,” he said.

More revenue is being collected per dollar of faculty salary/benefit, according to Angela Hintzel, executive director of Medical School finance.

"The practice plan must continue its growth," Dean Colasurdo said. "Our physicians have enormous opportunities for growth in the Texas Medical Center, at LBJ Hospital and in our new UT Physicians space at Loop 610 and Bellaire Boulevard."

Andrew Casas, vice president and chief operating officer of UT Physicians, gave an update on UT Physicians, reporting an increase in patient visits of 8 percent during the year’s first three quarters, compared to last year.

“Results of our patient focus groups told us we need to do a better job of preparing patients to experience our academic practice and work on our phone issues,” he said, adding that UT Physicians is registering numerous trademarks associated with the organization.

Dr. Brent King, executive vice dean for clinical affairs, confirmed that it is important to take seriously the recommendations of the focus group.

“We are looking into creating a patient service center, which patients told us they needed. They would be able to do blood draws there and make specialist appointments with someone in person,” he said.

He also brought up financial incentives for areas of compliance.

Writing hospital discharge orders by 10 a.m. the day of patient discharge is a request from Memorial Hermann – Texas Medical Center that can have a financial impact on the Medical School, King said.

“Memorial Hermann will forgive part of the loan we owe them for the transfer of the clinics to our operation, if we comply with this request,” he explained.

In addition, he said, Medicare will increase its reimbursements by 2 percent for those who e-prescribe. “For those who do not, there will be a negative financial result,” he said.

Improved collections of 31 percent over last year has been a major accomplishment at LBJ General Hospital, reported Dr. Steve Brown, associate dean for Harris County Programs. “We are grateful for Andrew Casas’ team, which has put us in a position of becoming a bigger portion of the entire practice,” he said.

He also added that the county’s financial support of graduate medical education has tripled while the financial support of the faculty has quadrupled since 1991.

President Willerson closed the meeting, saying he was very proud of the Medical School at the UT Health Science Center. “If any of you needs my help, please let me know – I’m just down the street and expect to have a faculty appointment here,” he said, with a smile.

-D. Brown

Researchers: Pre-eclampsia may be autoimmune disease

Biochemists at the Medical School say they are the first to provide pre-clinical evidence that pregnancy-induced high blood pressure or pre-eclampsia may be an autoimmune disease. Their research could provide novel diagnostic and therapeutic possibilities for this intractable disease. Their findings appeared online in Nature Medicine July 27.

Scientists in the laboratory of Dr. Yang Xia, an assistant professor of biochemistry and molecular biology, provided evidence of the connection by inducing symptoms similar to pre-eclampsia in pregnant mice that had been administered autoantibodies isolated from women with the condition. This proof-of-principle experiment is called adoptive transfer.

Pre-eclampsia typically occurs in the last trimester of pregnancy and is characterized by a sudden increase in blood pressure, excess protein in the urine, and swelling of the hands, feet, and face. It affects about one in 20 pregnancies and the only cure is delivery of the baby. Pre-eclampsia contributes to 15 percent of premature babies and is associated with a high incidence of mother and infant morbidity and mortality in the United States.

“There is no effective treatment for pre-eclampsia other than delivery, in part because of the lack of complete understanding of the disease,” said Dr. Susan Ramin, study co-author, the Emma Sue Hightower Professor, and chair of the Department of Obstetrics, Gynecology and Reproductive Sciences, and a member of the medical staff of Memorial Hermann - Texas Medical Center. “This collaborative research is important because of its potential to lead to a possible cure of pre-eclampsia in pregnant women. Using the animal model we were able to prevent pre-eclampsia in pregnant mice. I don’t want to overstate the implications, but this is clearly a very exciting time for all of us involved in the research. We plan to focus our efforts in expanding this research to pregnant women.”

Unlike antibodies which attack foreign substances and clear diseases from the body, autoantibodies attack their own cells and cause conditions like lupus in which a person's immune system attacks the body's own organs and tissues, said Xia, the senior author. In the case of pre-eclampsia, autoantibodies are believed to bind and activate an angiotensin receptor that results in artery constriction.

Pre-eclampsia-like symptoms were prevented when the pregnant mice were given agents designed to block the activation of the angiotensin receptor.

“The antibody injection model of pre-eclampsia described here provides strong experimental support for our working hypothesis that pre-eclampsia is an autoimmune disease in which angiotensin receptor–activating autoantibodies contribute to many features of the disease,” Xia and her colleagues wrote in the paper.

If the research is confirmed in human trials, Xia believes this information could be used for both the earlier diagnosis and treatment of pre-eclampsia. By measuring autoantibody levels, clinicians could detect the disease weeks before symptoms appear. In addition, new drugs could be developed to inhibit the activation of the angiotensin receptor.

In the meantime, Xia said further research is needed to determine what triggers the production of the autoantibodies.

“Pre-eclampsia is one of the leading causes of prematurity and Small For Gestational Age (SGA) infants. Many of these babies are born with underdeveloped lungs or poor lung clearance of fluid, necessitating neonatal intensive care admission and various respiratory therapies to support their breathing. We continue to struggle to find a proven prevention or treatment solution for these problems," said Dr. Nehal Parikh, assistant professor of neonatal-perinatal medicine and a member of the medical staff of Children's Memorial Hermann Hospital.

“If targeting the angiotensin receptor autoantibody is a useful strategy to treat pre-eclampsia, then it will also be a useful way to prevent and treat SGA associated with pre-eclampsia,” Xia said.

The risk factors for pre-eclampsia include: having a history of pre-eclampsia; being obese; having twins, triplets or other multiples, and developing gestational diabetes.

Xia’s collaborators from the Department of Biochemistry & Molecular Biology include: Dr. Cissy Chenyi Zhou, instructor; Dr. Yujin Zhang, research associate; Roxanna Irani, graduate student; Tiejuan Mi; and Dr. Rodney Kellems, professor and chair of the Department of Biochemistry and Molecular Biology. Other collaborators included: Ramin; Dr. Hong Zhang, of the Baylor College of Medicine; and Dr. Edwina Popek, and Dr. M. John Hicks, of Texas Children’s Hospital.

The study is titled “Angiotensin receptor agonistic autoantibodies induce pre-eclampsia in pregnant mice.” Research was supported by the National Institutes of Health, the March of Dimes, the Texas Higher Education Coordinating Board, and Merck.

-R. Cahill

New location for UT Physicians clinics

As of tomorrow, Aug. 1, the UT Physicians building at Loop 610 and Bellaire Boulevard will be outfitted with three UT Physicians clinics along with the diagnostic imaging services offered by UT Imaging. UT Health Center and UT Specialty Surgery Center are joining UT Imaging and the UT Spine and Scoliosis Center, which are currently located in the UT Physicians building.

The UT Health Center provides primary and specialty care while UT Specialty Surgery Center offers general surgery and bariatric surgery. The UT Spine and Scoliosis Center focuses on adult and pediatric conditions of the spine including deformities, tumors, scoliosis, adult degenerative conditions of the cervical and lumbar spine, and spine trauma. General orthopaedic care, such as joint replacement and treatment of sports injuries, is also available there. UT Imaging provides the latest in diagnostic imaging, including MRI, CT, DEXA, digital mammography, ultrasound, and X-ray.

To contact the clinics for appointments and information:
UT Physicians Health Center: 713.572.8122
UT Specialty Surgery Center/Minimally Invasive Surgeons of Texas: 713.892.5500
UT Spine and Scoliosis Center: 713.838.8300
UT Imaging: 713.662.XRAY (9729)
For more information, see www.UTphysicians.com and www.UTimaging.com

 

UT-Houston Medicine here

The latest issue of The UT-Houston Medicine magazine is out and available for pickup. Please come to the Office of Communications, in B.340 in the basement of the Medical School building – across from the green elevator, to pick up your copies for recruitment and other needs. The online version is available at: http://med.uth.tmc.edu/comm/alumniMag/2008-Spring

 

Drug industry releases code to restrict marketing to doctors

The Pharmaceutical Research and Manufacturers of America (PhRMA) recently released a "Code on Interactions with Healthcare Professionals," that significantly limits drug marketing practices and gifts to healthcare providers.

The voluntary code, which will take effect in January, prohibits distribution of pens, mugs, and all other non-educational items to health care providers and their staff. It also prohibits sales representatives from providing restaurant meals to healthcare professionals, but permits "occasional" in-office meals in conjunction with informational presentations.

The code bans industry from providing "recreational events" at continuing medical education (CME) meetings and stresses that industry funding for CME must be given to the sponsor "without strings." The code also addresses the use of non-patient identified prescriber data, and calls for disclosure by faculty serving on formulary committees of all their industry supported speaking and consulting arrangements.

Last month the Association of American Medical Colleges (AAMC) adopted a set of recommendations urging medical schools and teaching hospitals to prohibit drug industry gifts, meals, and services to physicians, faculty, residents, students, and staff. Although many of the provisions in the new PhRMA code are concordant with the AAMC recommendations, the latter go much further in restricting financial interactions between academic medicine and industry.

Information: Go to http://www.phrma.org/news_room/press_releases/
phrma_code_reinforces_commitment_to_responsible_interactions_with_healthcare_professionals/

-AAMC

 

 

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