Epidemiology

New research from the University of Pittsburgh School of Medicine and the UPMC Hillman Cancer Center sheds light on how tumors use the body’s regulators of immunity for their own benefit. Published in Nature Immunology, the findings could be used to develop the next generation of immune therapies to fight various cancers.  McGowan Institute for Regenerative Medicine affiliated faculty member James Luketich, MD—Henry T. Bahnson Professor of Cardiothoracic Surgery, the Chairman, Department of Cardiothoracic Surgery, the Chief, Division of Thoracic and Foregut Surgery, the Director, Thoracic Surgical Oncology, the Co-Director, Lung Cancer Center, the Associate Director of Surgical Affairs, University of Pittsburgh Cancer Institute, and the Director, Mark Ravitch/Leon C. Hirsh Center for Minimally Invasive Surgery—is a co-author on the paper.

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Total pancreatectomy with islet autotransplantation (TPIAT) is a surgical procedure used to treat severe complications of chronic pancreatitis (CP) or very high risk of pancreatic cancer while reducing the risk of severe diabetes mellitus.

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Pancreatic cancer is a grim diagnosis, with a five-year survival rate of less than 9 percent. To improve those odds, researchers at UPMC and the University of Pittsburgh School of Medicine sought genetic signatures in the largest study of its kind that could be used to better match drugs to patients and for early detection.

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If you follow transplant news, you probably know the grim facts: Worldwide, there is an enormous and widening gap between the number of people who need transplant organs and the number of donor organs available. According to the United Network for Organ Sharing (UNOS), 20 people die every day waiting for a transplant. While UNOS and other organizations work to increase awareness and recruit more donors, researchers and doctors are working hard to find medical solutions that can help close that gap.

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Pioneered at UPMC at the Center for Innovative Fetal Intervention at UPMC Magee-Womens Hospital which is directed by McGowan Institute for Regenerative Medicine affiliated faculty member Stephen Emery, MD, a new technique using microcoil embolization shows early promise in treating inoperable placental tumors.

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Nine patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving heart transplants from deceased donors who were infected with the disease, according to a study published in the American Journal of Transplantation. The results highlight the potential for expanding the use of HCV-infected organs, including hearts, to broaden the donor pool for the more than 100,000 Americans currently on a transplant waitlist.  McGowan Institute for Regenerative Medicine affiliated faculty member Christian Bermudez, MD, Director of Thoracic Transplantation at the University of Pennsylvania and Associate Professor of Surgery at the University of Pennsylvania School of Medicine, was a team member on the study.

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The Peripartum Cardiomyopathy Network (PCN) is a network of physicians and nurses at clinical sites across the United States and Canada dedicated to both clinical care and investigation of peripartum cardiomyopathy. McGowan Institute for Regenerative Medicine affiliated faculty member Dennis McNamara, MD, Professor of Medicine, University of Pittsburgh and the Director of the Heart Failure/Transplantation Program at the University of Pittsburgh Medical Center, is a co-director of PCN.

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McGowan Institute for Regenerative Medicine affiliated faculty member Abhinav Humar, MD, Clinical Director of the Thomas E. Starzl Transplantation Institute, Chief, Division of Transplantation in the Department of Surgery at the University of Pittsburgh Medical Center, Professor in the Department of Surgery at the University of Pittsburgh School of Medicine, and a Staff Physician at the Pittsburgh VA Medical Healthcare System, is the principal investigator of the clinical trial entitled, “Safety and Preliminary Efficacy of Donor-derived Regulatory Dendritic Cell (DCreg) Infusion and Immunosuppression Withdrawal in Living Donor Liver Transplantation” (ClinicalTrials.gov Identifier: NCT03164265).

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The Department of Defense Office of the Congressionally Directed Medical Research Programs (CDMRP) announced that the FY18 Peer Reviewed Medical Research Program Discovery Award application submission from the laboratory of McGowan Institute for Regenerative Medicine affiliated faculty member Prashant Kumta, PhD, Edward R. Weidlein Chair and Professor at the University of Pittsburgh Swanson School of Engineering and School of Dental Medicine, was recommended for funding.

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Inborn errors of metabolism, or inherited disorders caused by a single gene, affect two or three out of every 1,000 babies. Most of these disorders are extremely complex, but they are medically and nutritionally manageable with early diagnosis and highly tailored treatment. Because they are complex and require specialized approaches, inborn errors of metabolism comprise a broad class of diseases with hundreds of variants; treatment protocols are myriad.

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McGowan Institute for Regenerative Medicine affiliated faculty member Steven Belle, PhD, MScHyg, Professor in the Department of Epidemiology, Graduate School of Public Health at the University of Pittsburgh and a Co-Director in the Epidemiology Data Center in the Graduate School of Public Health, was part of a team of researchers analyzing data from more than 2,400 obese patients who underwent bariatric weight-loss surgery. The researchers identified at least four different patient subgroups that diverge significantly in eating behaviors and rate of diabetes, as well as weight loss in three years after surgery.

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Mary Kekatos Health Reporter for the Dailymail.com and the Dailymail.com Reporter, recently detailed in her article that statins could prevent the spread of breast cancer, per a new study.  Researchers say the drugs, which combat high cholesterol, do not prevent the cancer from occurring but stop it from spreading to other organs.  Experiments performed in human cells and laboratory mice found that the pills prevent tumors from migrating to the lungs and liver.

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For millions of Americans struggling with obesity and considering surgical procedures to achieve weight loss and alleviate obesity-related health complications, a new study adds weight to the health benefits attributed to bariatric surgery.

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For a few years now, trendy IV (intravenous) spas have been popping up in non-medical facilities promising their clients hydration, more energy, and recovery from hangovers, jet lag, and symptoms of the flu.  But are IV treatments for these reasons safe?

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Genetic testing is a powerful diagnostic tool that is increasingly being used for the diagnosis of dilated cardiomyopathy, a disease in which the heart becomes enlarged, making it difficult to pump blood. Cardiomyopathy affects more than 3.5 million people in the United States. African Americans are at especially high risk but have been underrepresented in genetic studies, often due to socioeconomic barriers and other health disparities.

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More than one in 10 children hospitalized with sepsis die, but when a series of clinical treatments and tests is completed within an hour of its detection, the chances of survival increase considerably, according to a new analysis led by the University of Pittsburgh School of Medicine and co-authored by McGowan Institute for Regenerative Medicine affiliated faculty member Derek Angus, MD, MPH. Dr. Angus is Chair of the Department of Critical Care Medicine of both the University of Pittsburgh School of Medicine and the UPMC Healthcare System.

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Stress hormones can save lives or take them. Released during an emergency or in pressure situations, stress hormones can gang up with white blood cells to fight infections or lead to heart attacks.

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In his opinion piece for STAT, McGowan Institute for Regenerative Medicine affiliated faculty member Derek Angus, MD, MPH, Chair of the Department of Critical Care Medicine of both the University of Pittsburgh School of Medicine and the UPMC Healthcare System, states:

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When it comes to diagnosing suspected endometrial cancer and several other endometrial pathologies in post-menopausal women, physicians in the U.S. have two choices: Pipelle biopsy, a minimally invasive procedure that has a 60 to 80 percent chance of success, or a more expensive, riskier procedure that works nearly every time called dilation and curettage (D&C).

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McGowan Institute for Regenerative Medicine affiliated faculty member Steven Belle, PhD, MScHyg, co-director of the Epidemiology Data Center at the University of Pittsburgh Graduate School of Public Health, has been named a Fellow of the Society for Clinical Trials, a prestigious honor that only a few scientists achieve each year.

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More than half of patients hospitalized for a concussion receive no follow-up care within three months of their discharge, according to a national multi-center study published recently.  McGowan Institute for Regenerative Medicine affiliated faculty member David Okonkwo, MD, PhD, is a co-author on the study.  Dr. Okonkwo is Professor and Executive Vice Chair of Neurological Surgery, University of Pittsburgh, with a secondary appointment as Professor of Sports Medicine and Nutrition. He serves as Director of Neurotrauma and of the Scoliosis and Spinal Deformity Program at UPMC. In addition, he is the Clinical Director of the Brain Trauma Research Center. Dr. Okonkwo is also a member of the Medical Staff for the Pittsburgh Steelers.

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Families of critically ill hospital patients report higher satisfaction with clinician communication and a better perception of patient-centered care when the care team uses a low-cost strategy involving intensive emotional support and frequent meetings, according to the results of a University of Pittsburgh School of Medicine randomized trial presented at the American Thoracic Society (ATS) 2018 International Conference in San Diego and scheduled for publication in the June 21 issue of the New England Journal of Medicine.

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Recent research published in the journal Circulation estimated the impact of lifestyle factors on premature mortality and life expectancy in the US population.  The researchers recommended the following 5 simple lifestyle changes:

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Ex vivo lung perfusion (EVLP) has developed as a novel organ preservation method in lung transplantation. EVLP allows physicians to evaluate lung graft function and condition prior to transplantation, leading to the possibility to utilize marginal lung grafts and/or high-risk donor lungs including donation after circulatory death (DCD), atelectasis lung, lung with slight edema and functional problem without other concerns, as well as the lung grafts met to normal criteria. Also, EVLP allows reconditioning of such lung grafts on ex vivo prior to transplantation using various options for treatment including high dose drug administration, stem cell transplantation, gene transfection, ex vivo surgery, and so on.

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The following is an excerpt from an article published in The Conversation and authored by McGowan Institute for Regenerative Medicine affiliated faculty member Abhinav Humar, MD, Clinical Director of the Thomas E. Starzl Transplantation Institute and the Chief, Division of Transplantation in the Department of Surgery at the University of Pittsburgh Medical Center. He is also a Professor in the Department of Surgery at the University of Pittsburgh School of Medicine and a Staff Physician at the Pittsburgh VA Medical Healthcare System.  Read the entire article here.

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In response to repeated calls for an integrated and coordinated emergency and trauma care system in the U.S., University of Pittsburgh School of Medicine scientists and UPMC physicians—including McGowan Institute for Regenerative Medicine affiliated faculty member Derek Angus, MD, MPH, who is a co-author on the study—rose to the challenge and divided the nation into hundreds of referral regions that describe how patients access advanced care, in a way that respects geopolitical borders. Dr. Angus is Chair of the Department of Critical Care Medicine of both the University of Pittsburgh School of Medicine and the UPMC Healthcare System. At the University, he holds the rank of Distinguished Professor and the Mitchell P. Fink Endowed Chair in Critical Care Medicine with secondary appointments in Medicine, Health Policy and Management, and Clinical and Translational Science and he directs the CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illnesses) Center. He also co-directs the UPMC ICU Service Center, responsible for the provision of ICU services across the 20-plus hospital system.

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Lisfranc injury, also known as Lisfranc fracture, is an injury of the foot in which one or more of the metatarsal bones (five long bones in the foot) are displaced from the tarsus (a cluster of seven articulating bones in each foot situated between the lower end of tibia and fibula of the lower leg and the metatarsus.  Lisfranc injuries are caused when excessive kinetic energy is applied either directly or indirectly to the midfoot.  This foot injury is treated by McGowan Institute for Regenerative Medicine affiliated faculty member MaCalus Hogan, MD, Assistant Professor in the Departments of Orthopaedic Surgery and Bioengineering and Vice Chair of Education and Residency Program Director in the Department of Orthopaedic Surgery at the University of Pittsburgh Medical Center.

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As reported by the Associated Press Chief Medical Writer Marilynn Marchione, new research from Vanderbilt University calls into question what’s in those IV bags that nearly every hospitalized patient gets. Using a different intravenous fluid instead of the usual saline greatly reduced the risk of death or kidney damage, two large studies found. The difference could mean 50,000 to 70,000 fewer deaths and 100,000 fewer cases of kidney failure each year in the U.S., researchers estimate. Some doctors are hoping the results will persuade more hospitals to switch.

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The University of Pittsburgh recently announced the launch of LifeX^TM, an initiative that will provide expertise, capital and working space to new companies addressing the most complex challenges facing modern medicine.  The 10-year goal of the project is to deliver new solutions to tackle prevalent and intractable global diseases. Led by McGowan Institute for Regenerative Medicine affiliated faculty member Dietrich Stephan, PhD, the renowned human geneticist and entrepreneur and professor and chairman of the Department of Human Genetics at the University of Pittsburgh, the initiative’s initial focus will be on cancer, Alzheimer’s, multidrug-resistant bacterial infections, obesity and diabetes, and rare genetic diseases.

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Despite improvement in the rates of people dying of sepsis in the hospital, the condition is still a leading cause of hospital readmissions and costs, as well as long-term disabilities and impairments, prompting University of Pittsburgh and University of Michigan (U-M) medical scientists to develop thorough recommendations for post-hospital recovery care and future clinical trials.

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Heat, moisture, and force, in addition to other factors, can lead to pressure injuries — or bed sores — which are common among immobile patients and individuals who use wheelchairs. Many technologies and guidelines exist to help prevent and treat pressure injuries, but there is little evidence to prove which technologies are most effective for patients with different risk factors.

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While the proportion of adults with severe obesity using prescription opioids initially declines in the months after bariatric surgery, it increases within a matter of years, eventually surpassing pre-surgery rates of patients using the potentially addictive pain medications, according to new research from a National Institutes of Health (NIH)-funded multicenter study led by the University of Pittsburgh Graduate School of Public Health. McGowan Institute for Regenerative Medicine affiliated faculty member Steven Belle, PhD, MScHyg, Professor in the Department of Epidemiology, Graduate School of Public Health at the University of Pittsburgh, and a Co-Director in the Epidemiology Data Center in the Graduate School of Public Health, is a co-author on the study.

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The World Health Assembly and the World Health Organization (WHO) adopted a resolution to improve, prevent, diagnose, and manage sepsis – “a quantum leap in the global fight against sepsis.”

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In a feat of medical and scientific coordination, doctors across 138 hospitals in seven countries shared treatment protocols and harmonized data collection of three clinical trials resulting in the most comprehensive analysis to date on care for sepsis, the leading killer of hospital patients worldwide. The international evaluation was overseen by physicians at the University of Pittsburgh School of Medicine, who expect the work to serve as a model for future research of this scale. McGowan Institute for Regenerative Medicine affiliated faculty members Derek Angus, MD, MPH, Distinguished Professor and Mitchell P. Fink Chair, Department of Critical Care Medicine at Pitt, and John Kellum, MD, Professor in the Departments of Critical Care Medicine, Medicine, Bioengineering, and Clinical and Translational Science at Pitt, are co-authors on the study.

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Cardiovascular disease is the leading cause of death worldwide.  Per the American Heart Association, practicing meditation and mindfulness may reduce death, heart attack, and stroke in heart patients.  Meditation is a practice — often using deep breathing, quiet contemplation, or sustained focus on something benign, such as a color, phrase, or sound — that helps you let go of stress and feel peaceful and maintain a relaxed state of mind.  Mindfulness is a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique.

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Physical activity is good for our overall well-being. Yet, science has never determined exactly why that is. The University of Pittsburgh has been chosen by the National Institutes of Health (NIH) for a large-scale collaboration to investigate why being active is beneficial for our health.

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A team of University of Pittsburgh researchers—including McGowan Institute for Regenerative Medicine affiliated faculty members Louis Falo, MD, PhD, and Valerian Kagan, PhD, DSc—has demonstrated that a newly developed topical therapy applied before or after radiation exposure prevents skin damage in both animal and human models.

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The University of Pittsburgh Schools of the Health Sciences has been awarded a U.S. Department of Defense (DOD) contract that could lead to $90 million in research over the next decade to improve trauma care for both civilians and military personnel.

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Concussions, often viewed by the public as dire and perplexing, can be effectively treated despite their complexity, according to experts from around the U.S. in a Statement of Agreement available online and to be published in the December issue of the journal Neurosurgery.

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Fifty years after the release of the iconic sci-fi movie “Fantastic Voyage,” researchers are beginning to launch fleets of tiny swimming robots with biomedical applications. These super-small submarines have the potential to navigate the human body less invasively and with more maneuverability than some current surgical and medical procedures. However, since the physicians and surgeons won’t actually be on board the vessels like in the movie, the ability to accurately control the movement of these robots has become the focus of many studies.

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