The Scoop: A Publication of the University of Texas Medical School at Houston

Produced by the Office of Communications // January 19, 2012

ADHD, Bipolar Disorder focus of Feb. 11 Psychiatry Update

Third Annual UT Psychiatry Update

The Third Annual UT Psychiatry Update, “Untangling ADHD and Bipolar Disorder Across the Age Spectrum,” will take place on Saturday, Feb. 11, at the Memorial Hermann Conference Center.

The conference’s educational objectives are:

  1. To identify and describe current research and treatments for clinical practice advances in psychiatry, psychology, and other mental health fields.
  2. To summarize social dynamics and/or ethical issues related to mental health science research activities and patient care.
  3. To discuss basic and updated information concerning the treatment of major mental illnesses.

Program and guest faculty include the following faculty from the Department of Psychiatry and Behavioral Sciences: Drs. Oscar Bukstein, Prashant Gajwani, Andrew Harper, Teresa Pigott, Kirti Saxena, Dawnelle Schatte, Jair Soares, and Alan Swann.

Register online at www.utcme.net.

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Surgeons raise concerns over new class of blood thinners

Many people at risk of stroke associated with irregular heart rates and other factors take blood thinners. While these drugs can reduce the chance of stroke, they may complicate the treatment of traumatic injuries by worsening bleeding in some instances.

Trauma researchers at the UTHealth Center for Translational Injury Research (CeTIR) have expressed concerns about a new class of blood thinners. Researchers report that the effects cannot be rapidly reversed and are difficult to detect in patients with serious injuries. They address these concerns in a correspondence in the Nov. 24 issue of The New England Journal of Medicine.

The first Food and Drug Administration-approved drug in this class of blood thinners is dabigatran etexilate. It is designed to lessen the likelihood of stroke in people with atrial fibrillation unrelated to a heart valve problem. Atrial fibrillation is a common type of arrhythmia, a problem with the rhythm of the heartbeat. According to researchers, unlike with other blood thinners, patients on dabigatran do not require frequent testing to determine blood levels and do not have dietary restrictions.

When people on blood thinners are injured, they may bleed quicker and longer than others. Consequently when someone on a blood thinner arrives at an emergency center with a critical injury, one of the highest priorities is the immediate reversal of the anticoagulatory effects of the medication.

While there are multiple ways to reverse the effects of a traditional blood thinner for stroke (warfarin) and a way to measure the amount in the system, the same cannot be said for dabigatran, the researchers report. Patients must wait for the drug to clear their system, which can take approximately 18 hours, or be hooked up to an emergency dialysis machine so the drug can be filtered from their blood. In addition, the researchers are concerned that tests used to detect the drug’s impact are not readily available at many medical centers.

Dr. Bryan Cotton, the lead author of the correspondence and associate professor of surgery, said he is aware of several patients on dabigatran who were injured and who had poor outcomes.

Cotton said he feels helpless when people taking dabigatran show up in an emergency center with injuries suffered in a traffic accident or other traumatic event. “The problem is that I can’t reverse the medication if something happens. I also can’t test the levels of the drug in the patient with readily available lab tests,” Cotton said.

What does this mean for patients taking the medication? “Patients are put on blood thinners for a reason, so none of them should suddenly discontinue the drug. However, they should stop and schedule an appointment with whoever is prescribing this drug (dabigatran) and have an honest and open dialogue regarding the risks of this drug. The risks of dabigatran must be weighed with the benefits of its convenience,” Cotton said.

Trauma is the fourth-leading cause of death in the United States, and the elderly are the fastest growing population of trauma patients.

Cotton said additional research is needed to develop the tools healthcare teams need to manage the bleeding of injured patients on dabigatran. Cotton’s two co-authors from the Medical School are Dr. John Holcomb and Dr. James McCarthy.

The authors of the correspondence wrote, “As such, we strongly urge that hemorrhagic complications and death resulting from trauma be included as part of the routine surveillance of all newly approved oral anticoagulants.”

When evaluating anticoagulants, greater attention should be paid to the “real-world” impact of these drugs on patients at risk for trauma, Cotton said.

“Patients must be informed about the pros and cons in taking these new medications,” McCarthy said. “The advantages over the traditional warfarin are always discussed with little attention to the potential downside.”

Holcomb is professor, CeTIR director, vice chair of the Department of Surgery and chief of the Division of Acute Care Surgery. McCarthy is an assistant professor of emergency medicine and medical director of the emergency center at Memorial Hermann-Texas Medical Center.

The mission of CeTIR is to lead in the research and development of next-generation medical technologies related to hemostasis, resuscitation, and computerized decision support for trauma patients.

— Robert Cahill, Office of Advancement, Media Relations

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Collaborative program improves care for children with autism, neurodevelopmental disabilities

Children’s Learning Institute logo

Having recently completed graduate school, Faiza Sheikh knew she wanted to work with children with autism, but realized that she, like many other up-and-coming health care professionals, did not have the necessary experience to do so.

“There is a critical shortage of professionals who are adequately trained to treat children with both autistic spectrum disorders and neurodevelopmental disabilities (ASD/ND),” Sheikh said. “I was more than ready for the opportunity to learn how to improve care and facilitate access to service for these children.”

Thanks to a new collaborative program developed at the Children’s Learning Institute at The University of Texas Health Science Center at Houston (UTHealth), Sheikh now has the chance to make an impact on the lives of the growing number of children with ASD/ND.

The LoneStar LEND (Leadership Education in Neurodevelopmental and Related Disabilities) program, funded through a $2.9 million grant from the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA), is the first program of its kind in Texas and one of 43 LEND programs located at universities or major children’s hospitals across the United States. Its mission is to prepare future leaders in the diagnosis and treatment of ASD/ND, increase the rate of accurate diagnosis of ASD/NDs in Texas, empower families to be an active participant in their child’s treatment plan, and improve ASD/ND service delivery and systems.

Dr. Pauline Filipek, director of The Autism Center at the Children’s Learning Institute, serves as program director of LoneStar LEND, which is comprised of five member institutions: UTHealth, Baylor College of Medicine, Texas Woman’s University, the University of Houston, and the University of Houston-Clear Lake.

It is estimated that more than 62,000 children across Texas have an ASD. According to the Texas Council on Autism and Pervasive Developmental Disorders, no one agency is responsible for coordinating services, collecting uniform data, or assessing the needs of these children.

“The LEND team hopes to change the face of autism in Texas,” Filipek said. “As a state, we lack individuals adequately trained to not only educate individuals with ASD but also other professionals on how to provide these services as well.”

Dr. Deborah Pearson, professor of psychiatry, said the program is very exciting because it involves a cross-section of specialists who are uniting to deliver a multidisciplinary education to future professionals. “As a professional who has worked in this field for more than 20 years, and as a family member of an individual with a developmental disorder, I am honored to be a part of this very important program,” Pearson said.

The LoneStar LEND program uses an interdisciplinary training model to provide educational options for students, health care professionals, parents, teachers, and the general public. Those options open to anyone include seminars led by both LEND faculty and families of children with ASD/ND and coordinated visits to autism support and advocacy groups. Medical residents and graduate students in the program also receive clinical practice. In addition, LoneStar LEND plans to produce web-based training for Texas residents to reach the largest number of interested professionals and families.

The LEND training model focuses on 14 core disciplines, including audiology, speech-language pathology, occupational and physical therapy, psychology, medicine, health care administration, nursing, nutrition, special education, pediatric dentistry, social work, and genetic and family counseling.

Sheikh, who was encouraged by her graduate school adviser at the University of Houston to join the program, is one of seven people in the initial class of trainees. In addition to attending seminars and working directly with families and their children, she is working with faculty member Dr. G. Thomas Schanding, Jr., from the University of Houston on a research project using observational learning from video modeling as a way to increase sharing behaviors, eye contact, joint attention, and pretend play in preschoolers with autism.

Not only do students and faculty collaborate on various research projects, but faculty also work together to share best practices for the benefit of the trainees.

“LEND brings all faculty together so we can consistently model how to provide the best care for children with ASD/NDs,” Schanding said. “Our trainees will then get to model that collaboration across the state and advocate for innovation in how we cooperate and coordinate services.”

Sheikh said she believes LoneStar LEND has the potential to make a difference not only in her professional career but also for those families who are underrepresented and underserved.

“Our program is comprised of passionate and exceptional individuals who all share a common goal and are working together toward it,” Sheikh said. “The impact I see this program having on the medical community is increased awareness and a greater focus on early intervention in an effort to effectively help children with ASD/ NDs.”

—Andrew Heger, Children’s Learning Institute

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Public library access comes to the TMC Library

Harris County Public Library logo

Have you ever had trouble finding the time to make it to the public library to pick up the latest bestseller, an audio book for your commute, or a picture book for bedtime sharing? Starting Jan. 3, Harris County Public Library (HCPL) materials are available for convenient pickup at the TMC Library location.

If you don’t currently have a HCPL library card, you can apply for one online or at the TMC Library. Library cards are free to residents of the state of Texas with proof of mailing address, and three-month visitor cards are available for non-Texas residents.

To check out eBooks and eAudios from the Digital Media Catalog for use on your iPad, iPod, Kindle, or Nook, you will first need to get your card from The TMC Library, and then enjoy convenient access, anytime, anywhere. Harris County Public Library has 26 library locations throughout the area and a collection of over 2 million items, including books, CDs, DVDs, databases, eBooks, and eAudios for all ages, so there is something to appeal to everyone.

Please contact the TMC Library Circulation department at 713.799.7146 for questions.

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Distinguished docs

Drs. James Grotta, from left, Johnnie Frazier, Richard Plum, and Michael Gordon, were recognized as Distinguished Physicians during a ceremony at the annual Medical Staff Meeting at Memorial Hermann Dec. 6.

Drs. James Grotta, from left, Johnnie Frazier, Richard Plum, and Michael Gordon, were recognized as Distinguished Physicians during a ceremony at the annual Medical Staff Meeting at Memorial Hermann Dec. 6.

— Dwight C. Andrews, Office of Communications, Medical School

 

 

 

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Events to know

January 20

12th Annual BioResearch Product Faire.
10 a.m.–2 p.m., Marriott Texas Medical Center Ballroom.
Read details.

January 21

The Neuroscience Research Center (NRC) 17th Annual Public Forum.
10:30 a.m.–noon, MSB 3.001.
Register here.

January 23

Department of Biochemistry & Molecular Biology Seminar Series: Dr. Mark Gladwin (University of Pittsburgh) presents, “Hemolysis-associated endothelial dysfunction and pulmonary hypertension: An emerging cause of death in the hemolytic anemias.”
Noon–1 p.m., MSB 2.135.

Department of Integrative Biology and Pharmacology Seminar Series: Dr. Gregg Roman (University of Houston) presents, “G(o) activation is required for presynaptic inhibition during memory formation in Drosophila.”
4–5 p.m., MSB 2.135.

January 24

Microbiology and Molecular Genetics Seminar Series: Faculty candidate Dr. Vasant Muralidharan (Washington University School of Medicine) presents, “Chaperoning the intraerythrocytic life cycle of Plasmodium falciparum.”
10:45 a.m., MSB 2.103.

Research Coordinator Forum: Jeanette Podbielski, Center for Translational Injury Research, presents, “CeTIR Clinical Research Studies.”
11:45 a.m.–1 p.m., MSB 2.135.
Lunch will be available for the first 50 attendees. Registration is not required.

January 25

Department of Psychiatry & Behavioral Sciences Grand Rounds: Dr. Alan Peterson (UT San Antonio) presents, “Treating Combat-Related PTSD in Returning War Veterans.”
Noon–1 p.m., HCPC Auditorium.

Family & Community Medicine Grand Rounds: Dr. Gulzar Punjwani presents, “PGY III Case Presentation.”
1–2 p.m., MSB 2.135.

Quarterly MSRDP Board of Directors meeting.
4–6 p.m., MSB B.100.

Bariatric Surgery Information Session.
6 p.m., 6700 West Loop South.
RSVP: 713.892.5500 or website.

January 26

Department of Surgery Grand Rounds: Dr. Howard Monsour (The Methodist Hospital) presents, “Management of the Cirrhotic Surgical Patient.”
7 a.m., MSB 3.001.
CME credit is available.

Department of Neurosurgery Grand Rounds: Brent Peery, Chaplain Services, Memorial Hermann-TMC, presents, “Delivering Difficult News.”
8 a.m., MSB G.100.

Microbiology and Molecular Genetics Seminar Series: Faculty candidate Dr. Eduardo Torres (Koch Institute for Integrative Cancer Research, MIT) presents, “Identification of aneuploidy-tolerating mutations.”
10:45 a.m., MSB 2.135.

Staff Development Committee Brown Bag Session: Eric Fernette, vice president of Human Resources, presents, “Hot Topics.”
Noon–12:50 p.m., MSB B.645.
Email for details.

Neurobiology and Anatomy Seminar Series: Dr. Mark Wallace (Vanderbilt University) presents, “Development and Plasticity in Multisensory Representations.”
4 p.m., MSB 2.135.

January 27

Center for Membrane Biology Seminar Series: Dr. Hartmut Luecke (University of California) presents, “Crystal structure of the urea channel from the human gastric carcinogen Helicobacter pylori.”
10:30–11:30 a.m., MSB 2.103.

25th Annual William A. Spencer, MD, Memorial Lectureship: Dr. David Gater (Virginia Commonwealth University) presents, “Fat Gone Wild! Metabolic Dysfunction after Spinal Cord Injury.”
Noon–1 p.m., MSB 3.001.
Sponsored by the Physical Medicine & Rehabilitation Alliance.

January 30

Center for Membrane Biology Seminar Series: Dr. Erik Jorgensen (Howard Hughes Medical Institute) presents, “Synaptic Vesicle Endocytosis: Revisiting Heuser and Reese in the 21st Century.”
Noon–1 p.m., MSB 2.135.

Department of Integrative Biology and Pharmacology Seminar Series: Dr. Armen Akopian (The University of Texas Health Science Center in San Antonio) presents, “Interaction of TRPV1 and TRPA1 in control of inflammatory hyperalgesia/pain.”
4–5 p.m., MSB 2.135.

January 31

Microbiology and Molecular Genetics Seminar Series: Faculty candidate Dr. Frank Liu (Yale University) presents, “Systems-level analysis of host-pathogen interactions using mass spectrometry-based proteomics.”
10:45 a.m., MSB 2.135.

February 1

Microbiology and Molecular Genetics Seminar Series: Faculty candidate Dr. Alexander Paredez (University of California-Berkeley) presents, “The Giardia actin cytoskeleton: Lessons from a non-conformist.”
10:45 a.m., MSB 2.103.

Department of Psychiatry & Behavioral Sciences Grand Rounds: Dr. Christopher Thomas (UTMB) presents, “Legal and Ethical Issues in the Treatment of Substance Abuse.”
Noon–1 p.m., HCPC Auditorium.

February 2

Department of Surgery Grand Rounds: Dr. George Van Buren, II (University of Pittsburgh Medical Center) presents, “Neoadjuvant Therapy for Pancreatic Adenocarcinoma.”
7 a.m., MSB 3.001.
CME credit is available.

February 3

University Classified Staff Council food sale.
11 a.m.–2 p.m., MSB Leather Lounge.
UCSC will be selling nachos with chili and cheese for $2.50, nachos with cheese for $2, and pickles for $1. All proceeds benefit the UCSC Educational Awards Program, which provides educational awards to children of classified staff. Email for details.

UTMost

As part of its reaccreditation process, the Medical School will host members of the ad hoc survey team representing the Liaison Committee on Medical Education (LCME) Jan. 22–25. The LCME is the nationally recognized accrediting authority for medical education programs leading to the M.D. degree in U.S. and Canadian medical schools and is sponsored by the Association of American Medical Colleges and the American Medical Association.

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