Health Sciences Report (2003-2004)

HEALTH SCIENCES REPORT UNIVERSITY OF UTAH Vol. 27, No. 3 Published by the Office of Public Affairs, University of Utah Health Sciences Center, 50 North Medical Drive, Salt Lake City, Utah 84132. Telephone 801- 581- 7387. Articles may be reprinted with permission. University of Utah Health Sciences School of Medicine College of Pharmacy College of Nursing College of Health University Hospitals & Clinics University of Utah Medical Group Eccles Institute of Human Genetics Huntsman Cancer Institute John A. Moran Eye Center Spencer S. Eccles Health Sciences Library Editor: Susan Sample Editorial Consultant: Anne Brillinger Contributing Writers: Cindy Fazzi, Phil Sahm Photographers: Sean Graff; Tim Kelly; Steve Leitch, Medical Graphics and Photography Visit the University of Utah Health Sciences Center Web site at: uuhsc. utah. edu. UNIVERSITY OF UTAH HEALTH SCIENCES R E P O R T FEATURES Diving Deep 10 College of Pharmacy researchers plumb the world's oceans to discover anticancer drugs in sponges, ascidians, and mollusks. Orthopedics on the Move 14 The U of U is the only institution in the Intermountain West offering orthopedic care in all eight subspecialty areas- and a new center to open in 2004. Coleman Laid the Groundwork 18 The integrity and compassion of Sherman S. Coleman, M. D., form the foundation of the U Department of Orthopedics. Welcome to the South Main Clinic 24 See for yourself in this photo essay: the patients are grateful and the staff is happy to serve them at this unique collaboration between the U School of Medicine and Salt Lake Valley Health Department. DEPARTMENTS Headlines 2 Research Update 5 People 8 Research in Brief 28 Gift of Health 30 Contributions expedite Moran Eye Center construction; University Hospital acquires a 3T scanner; and the College of Nursing offers new scholarships. Opinion 33 Will medical savings accounts save you money? Two College of Nursing researchers share their findings. HEADLINES m A. Lorris Betz, M. D., Ph. D. David J. Bjorkman, M. D., M. S. P. H. Betz Named Interim U President, Bjorkman to Lead Medical School A. Lorris Betz, M. D., Ph. D., was named interim president of the University of Utah, and David J. Bjorkman, M. D., M. S. P. H., interim dean of the School of Medicine, effective Jan. 1,2004.UNIVERSITY OF UTAH HEALTH SCIENCES REPORT three snowfalls, leaves still cling to the branches of the Japanese maple outside my window. Not unlike my surprise at the comment of a young acquaintance recently. I'm sure she didn't mean to sound callous. After she'd blurted, "I don't want to write about aging," there was silence and a few raised eyebrows. Not in judgment, really. Everyone in the room could remember having made a statement, sometime in our lives, that now makes us cringe. We were puzzled, though. I asked her, why. What I've really wanted to say ever since is: if only you could meet Sherm Coleman. " Eighty years is not a bad span," the orthopedic surgeon told me last August. A broken right arm, the result of " an honest- to- goodness fall, not a hot spot on a scan," had slowed him down, much more so than the prostate cancer he's battled for nearly eight years. It's metastasized to his bones. " Cancer," he admitted, " makes you test your philosophy." And the conclusion he's reached? " I wouldn't change any of the decisions I've made." He said it thoughtfully, with the earnestness that's gained him the respect of every orthopedic surgeon I spoke w i th at the University. The physician who founded the Division of Orthopedic Surgery is revered not only for his keen intelligence, exemplary teaching, superb surgical skills, and seminal articles and books, but also for his compassion. " Tumor patients used to have a hard time receiving appropriate care for horrible conditions," said Lor Randall, the surgeon who heads up the orthopedic department's Sarcoma Service. " Dr. Coleman embraced those patients and what was considered an incurable disease. He said, ' There is always hope. There's always something we can do to improve their lives.' " The rest of us," said Randall, " stand on the shoulders of people like that to see the horizon." Compassion, like wisdom, doesn't necessarily accompany aging. But when it does, and we have the privilege of meeting someone who embodies both w i th gratitude and grace, the windows we look through seem larger and our view of the winter sunset, spectacular, E SUSAN SAMPLE The appointments were announced at the Dec. 8 meeting of the University Board of Trustees. Bernie Machen is stepping down as U president in January to become president of the University of Florida in Gainesville. A national search is under way for his replacement. Betz has served as senior health sciences vice president and dean of the medical school since joining the U in 1999. He continues as CEO of the University of Utah Health System and is responsible for University Hospitals & Clinics, the Huntsman Cancer Institute, and the colleges of Pharmacy, Nursing and Health. Prior to joining the U, Betz was interim dean of the University of Michigan medical school. He also served there as associate dean for faculty affairs, senior associate dean for academic affairs, and executive associate dean, and was a full professor of pediatrics and neurology. He earned his bachelors, doctoral, and medical degrees from the University of Wisconsin. Since 2000, Bjorkman has served as senior associate dean of the medical school. He joined the U faculty as a gastroenterologist in 1985 and is professor of internal medicine. He also is executive director of the University of Utah Medical Group, the organization of University physicians. In 1996, he completed the Administration for Physicians Program at the U's David Eccles School of Business; he just concluded a one- year fellowship sponsored by the Association of American Medical College's Council of Deans. Bjorkman received his bachelor's, master's, and medical degrees from the U. New Cardiology Chief Named at Medical School Ivor J. Benjamin, M. D., joined the U Ivor J. Benjamin, M. D. School of Medicine last July as professor and chief of the Division of Cardiology, replacing Roger A. Freeman, M. D., who had served as interim chief. Benjamin, who oversees the 30- member U division, previously was on the faculty of the University of Texas Southwestern Medical Center and on the staff of Parkland Memorial and Zale Lipshy University hospitals. He serves as a reviewer for more than a dozen profes-sional publications, including Science and the New England Journal of Medicine. His own research interests include myocardial ischemia and pathways for cardio-protection; molecular and genetic analysis of transcriptional networks in murine develop-ment; and molecular mechanisms of alpha B crystallin familial cardiomyopathy. A graduate of The Johns Hopkins Univer-sity School of Medicine, Benjamin completed an internship and residency at Yale University School of Medicine. He held a clinical fellow-ship in cardiology at University of Chicago ( Michael Reese Hospital) and in molecular cardiology at Duke University Medical Center. University Hospitals & Clinics Is Repeat Winner For the fifth consecutive year, University Hospitals & Clinics received the Consumer Choice Award for the Salt Lake City metropolitan area. For the 10th year, the hospital's range and quality of care landed it on the U. S. News & World Report list of America's Best Hospitals. University Hospitals & Clinics was the only one in Utah to win the 2003 Consumer Choice Award, with top honors in four major categories: best doctors, best nurses, best overall quality, and best image and reputation. University Hospital also was judged the best in orthopedics, neurology, oncology, mental health sen/ ices, physical therapy, technology and equipment, widest range of services, community health programs, and most- used Web site. National Research Corporation polled households in the Salt Lake metro area and people in Salt Lake, Davis, and Weber counties to determine consumers' top choice. In the U. S. News & World Report list, which ranked specialties at 203 hospitals nationwide, University Hospital ranked in the top 20 percent in its care in obstetrics and gynecology, and cancer. Obstetrics and gynecology departments were rated on care in fertility problems and reproductive cancers. The University was rated 40th in the country in this area. Cancer rankings looked at a medical center's research into drugs and the genetic underpinnings of the disease. University Hospital, which works closely with Huntsman Cancer Institute in this area, was ranked 43rd nationwide. r~ « c onsumer Choice 1 University of Utnit Hospitals & Clinics Salt Lake City's Most Preferred Hospital Overall Quality & Image NATIONAL RESEARCH CORPORATION 2 Health Sciences Report Winter 2003- 04 1 Jadie Barrie, R. N., M. S. N. Barrie Heads U Hospitals' Inpatient Services, Nursing Jadie Barrie, R. N., M. S. N., was named associate administrator of Inpatient Services/ Chief Nursing Officer for University Hospitals & Clinics in October. Barrie, who served as interim associate administrator since May 2002, " has made great improvements in the development of the Nursing Services organization. She's partnered with the University's College of Nursing, as well as other nursing programs around the state, and continues to infuse our organization with new and innovative programs and ideas," said Richard A. Fullmer, University Hospital executive director. Barrie joined the U in 1999 and served as service director for emergency and trauma services. Prior to that, she was chief nursing officer and vice president of clinical services, and interim CEO at Pioneer Valley Hospital in West Valley City, Utah. She also held administrative and management positions at medical centers in St. Petersburg, Fla., and Shreveport, La., and at University of Alabama Hospitals and Clinics in Birmingham, and at the University of South Alabama in Mobile. U Hospital Ranks 7th in Nation for Organ Donation Consent University of Utah Hospital ranked seventh highest in the nation for its organ donation consent rate, according to the Association of Organ Procurement Organizations. Among 200 hospitals, it was one of seven to receive an " A" rating. The rankings are based on the percent-age of families who consent to organ donation compared with the total number of patients who were medically eligible to donate. To receive an " A," hospitals must have at least 75 percent of potential donors agree to give organs. University Hospital enlisted a total of 55 combined organ, tissue, and eye donors between August 2001 and July 2002, accord- " The award is very special to me," noted Kopecek, who spent the first 25 years of his scientific career in the Institute of Macromolecular Chemistry of the Czechoslovak Academy of Sciences. He joined the U faculty in 1988 and will step down as department chair in June to devote his time to teaching and research. At a meeting of the American Association of Pharmaceu-tical Scientists ( AAPS) in Salt Lake City last October, Kopecek and three other U of U scientists received the AAPS PharmSci and AAPS PharmSciTech Outstanding Use of Technology Award. It recognizes " the best and most innovative use of technology in the presentation of a peer- reviewed manuscript published in the official AAPS journals." Co- authors were: Keith D. Jensen, Ph. D., a 2002 U College of Pharmacy alumnus who works in the pharmaceutical industry; Pavla Kopeckova, Ph. D., research professor of pharmaceutics and pharmaceutical chemistry; and John H. B. Bridge, Ph. D., research professor of cardiology at the University's Nora Eccles Harrison Cardiovascular Research and Training Institute. ing to the Utah Donor Registry, part of the Salt Lake City- based Intermountain Donor Services ( IDS). A federally designated non-profit organization, IDS is dedicated to the recovery of organs and tissue for transplanta-tion. The U accounted for the highest number of organ and tissue donors in the IDS Utah recovery area, which includes 2.7 million people and 79 hospitals in Utah, southeastern Idaho, western Wyoming, and Elko, Nevada. Staff training about donation is a primary reason for the hospital's high donor rate, noted Kim Phillips, R. N., M. S. N., nursing manager for solid organ transplants at U Hospital. He also cited the high rate of Utahns who favor organ donation- 97 percent in recent surveys. It's a Ph. D. " Live" Online at College of Nursing Students in the new Ph. D. Distance Education Program not only see and hear the professor online, but also their classmates-in nine states and four time zones- in a live format through the College of Nursing's unique virtual classroom. The program, which began last January, was designed to meet the nation's critical need for nurses with advanced education, according to director Kathi Mooney, R. N., Ph. D., U professor of nursing. The U is well positioned to help nurses with both bache-lor's and master's degrees overcome barriers, such as time and location, which prevent many from pursuing doctorates. The U is the only university in the state that offers a doctoral program in nursing, has a nursing faculty active in research, and has a unique interdisciplinary resource available through the Huntsman Cancer Institute. It also has access to the Utah Telehealth Network's videoconferencing bridging system. The U program, which focuses on cancer research, is partially funded by a $ 1.5 million grant from the National Cancer Institute. However, it shares the same goal as the college's traditional nursing Ph. D. program on campus: to equip students with skills in conducting scientific research to help improve patient care, according to Mooney, holder of the Louis S. Peery, M. D., and Janet B. Peery Presidential Endowed Chair in Nursing. The curriculum spans nine contiguous semesters. Students spend the first week of every school year on the Salt Lake City campus, then do everything else online. Jindrich " Henry" Kopecek, Ph. D., D. Sc. Kopecek Awarded Czech Medal, U. S. Prize for Polymer Research Jindrich " Henry" Kopecek, Ph. D., D. Sc., was honored on two continents last summer and fall, receiving awards in the Czech Republic and the United States. Kopecek, distinguished professor and chair of the Department of Pharmaceutics and Pharmaceutical Chemistry at the U College of Pharmacy, was presented with the J. Heyrovsky Honorary Medal for Merit in the Chemical Sciences by the Academy of Sciences of the Czech Republic last July. The medal is named for the Czech chemist who won the Nobel Prize in 1959. Health Sciences Report Winter 2003- 04 3 Drug- Free Is Way To Be, Says College of Health Group West Jordan is the newest addition to the Neighborhood Action Coalition ( NAC), an outreach project of the College of Health that helps communities create local solutions to health- related problems they've identified, such as drugs and gangs. Lynne Durrant, Ph. D., associate professor and lecturer in the Department of Health Promotion and Education, recently received a five- year, $ 500,000 Drug- free Community Support grant from the U. S. Department of Justice that will enable NAC to mobilize citizens of West Jordan. Durrant and colleagues from the College of Health formed NAC in 1990 with funding from the federal Center for Substance Abuse Prevention. The coalition has been awarded more than $ 6 million to work with communities in Salt Lake County, including Midvale, Murray, West Valley City, Taylorsville, and the Glendale- Fairpark- Poplar Grove area. In Midvale, a task force created an after-school program in which retired teachers and coaches volunteered twice a week to work with elementary students. In West Valley City, NAC worked with the Granger Schools/ Community Coalition No Language Barriers Here University Hospitals & Clinics opened its first clinic with a complete native Spanish-speaking staff last August at the Redwood Health Center. " I'm very excited to care for patients in a situation where they will have no cultural or language barriers," said Enrique Baires, M. D., a U family practice physician. The El Salvador native earned his undergraduate and medical degrees from the U of U. University Hospital has 10 Spanish-speaking doctors serving in community clinics, along with bilingual physicians, nurses, and a translation team at the hospital. to train 30 teachers in substance abuse and violence prevention. They have become trainers for PTA members, school staffs, and business partners. A truancy- tracking program was established in Redwood, Academy Park, and Pioneer elementary schools. High school students also were trained as mentors for the younger children. In Taylorsville, the NAC community board funded training and materials for before- and after- school programs in literacy, social skills, and " bully- proofing" at nine elementary schools. Miller Selected to Lead Ambulatory Services Thomas L. Miller, M. D., was named medical director of Ambulatory Services for University Hospitals & Clinics last fall. Miller, assistant professor of internal medicine at the School of Medicine, will work with Rob Lloyd, executive director for ambulatory services and community clinics. Miller will continue as medical director of the University's Wasatch Internal Medicine Clinic at the Madsen Health Center, a position he has held since 1995. A medical graduate of George Washington University, Miller completed an internship and residency in internal medicine at the U. " Click ' N Clone" on Award- winning Genetic Learning Center Web Site An Internet Web site operated by the University's Genetic Science Learning Center ( GSLC) was honored by Scientific American as one of the top 50 science and technology Web sites, and one of the top five in biology. ScientificAmerican. com announced its Sci- Tech Web Awards 2003 last May. The magazine's online edition described the GSLC site as offering " everything you ever wanted to know about chromosomes, mutations and biowarfare, and even a few things you didn't... . The site's crowning jewel?' Click and Clone,' wherein you, via the wonder of anima-tion, actually replicate your own mouse." Jennifer Logan, Ph. D., and Louisa Stark, Ph. D., co- direct the GSLC, whose Web site received more than 40,000 visits per week during the 2002- 03 academic year with visitors from more than 100 nations. The Web site- http:// gslc. genetics. utah. edu- is open to free public access. It's funded by grants from the National Institutes of Health, National Institute on Drug Abuse, and the Howard Hughes Medical Institute, with start- up support from the R. Harold Burton Foundation in Utah. DO YOU SEE WHAT I SEE? The University's John A. Moran Eye Center and Department of Ophthalmology and Visual Sciences partnered with the Utah Museum of Natural History to present " Animal Eyes." The on- campus exhibit, with six interactive areas that explore what we know about human and animal vision, ends Jan. 4, 2004. The national portion of the exhibit was developed by the Foundation of the American Academy of Ophthalmology's Museum of Vision. The Moran Eye Center and U museum created an accompanying exhibit that provides an in- depth look at human vision and ongoing research at the U. 4 Health Sciences Report Winter 2003- 04 RESEARCH UPDATE Anemia in Hispanic Babies Focus of Student Research A high incidence of anemia among babies born in the United States to mothers of Mexican or South American origin is being investigated by a U medical student in research funded by the National Medical Fellowships. Miguel Knochel, a third- year student, was chosen as a 2003 Bristol- Myers Squibb Academic Medicine Fellow. He is one of 35 minority students granted the fellowship last May. Knochel's research proposal was inspired by working at the South Main Clinic in Salt Lake City, which provides prenatal, family planning, and pediatric care to under-served women and children ( see pg. 24). He observed that 25 percent of all infants who visit the clinic- six times the national average- showed symptoms of anemia. Typical causes of anemia in children include an iron- deficient diet, lead ingestion, or introduction of cow's milk before the baby's first birthday. Knochel is investigating other factors, including lead- containing herbal remedies that mothers may take or a general lack of nutrition in the mother's diet. He is getting information from pregnant mothers, then will study whether their infants develop anemia. This prospective approach is impor-tant, he feels. Even if anemic infants get iron supplements, they are likely to suffer long- term damage to their cognitive and motor skills. Knochel's co- investigator is Karen F. Buchi, M. D., associate professor of pediatrics. The study is being conducted under the guidance of Carrie L. Byington, M. D., associate professor in the Division of Pediatric Infectious Diseases and Geographic Medicine. Endocrinologist Studies Obesity, Heart's Resistance to Insulin E. Dale Abel, M. D., Ph. D., received a $ 1.9 million grant from the National Institutes of Health and the National Heart Lung and Blood Institute to investigate how obesity makes the heart resistant to insulin. Sheldon E. Litwin, M. D., a cardiologist and associate professor of internal medicine, is co- investigator on the five- year grant. Insulin, a hormone made by the pancreas, regulates the heart's ability to metabolize fatty acids, glucose, proteins, and other substances. As the heart becomes less responsive to insulin, the pattern of metabolism changes in heart muscle cells, leading to a buildup of potentially toxic substances, explained Abel, assistant professor of internal medicine and an investigator with the U Program in Human Molecular Biology and Genetics. This