School of Medicine

Wayne State University School of Medicine
Dr. Chaturvedi on executive committee of study funded by NIH
In Headlines on June 27, 2013
Seemant Chaturvedi, M.D.

Seemant Chaturvedi, M.D.

Seemant Chaturvedi, M.D., F.A.H.A., F.A.A.N., professor of Neurology for the Wayne State University School of Medicine, is serving on the executive committee of a clinical trial recently funded by National Institutes of Health.

The Carotid Revascularization Endarterectomy Stent Trial 2, or CREST 2, aims to compare optimal medical therapy alone versus optimal medical therapy plus carotid revascularization for patients with asymptomatic narrowing of the internal carotid artery.

“This is an important study since modern medical therapy has never been evaluated relative to carotid surgery in a clinical trial,” said Dr. Chaturvedi, who also serves as director of the Wayne State University/Detroit Medical Center Stroke Program.

The study’s principal investigator is Thomas Brott, M.D., professor of neurology and director for research at the Mayo Clinic in Jacksonville, Fla.
WSU-affiliated geriatrics practice earns URAC national accreditation
In Headlines on June 27, 2013

The Wayne State University Physician Group-affiliated Rosa Parks-Wellness Institute for Senior Health has met the requirements for a national achievement from URAC, a Washington, D.C.-based independent non-profit organization promoting health care quality through accreditation and certification programs.

The practice was designated a Patient-Centered Health Care Home this month after a comprehensive review and three-day site visit held in May, and is part of an Accountable Care Organization.

The RP-WISH, a multidisciplinary geriatrics practice located within the Detroit Medical Center’s Detroit Receiving Hospital, opened in 2004. Primary care is provided by the Wayne State University Physician Group.

URAC accreditation requires applicants to submit policies, procedures and other organizational information to URAC before an onsite review.

“Only six sites so far in Michigan have met this achievement, but it is the future of primary care,” said practice manager Marybeth Lepczyk, C.N.P.

According to URAC, a Patient-Centered Health Care Home provides a quality-driven, interdisciplinary clinician-led team approach to delivering and coordinating care that puts patients, family members and personal caregivers at the center of all decisions concerning the patient’s health and wellness. A PCHCH provides comprehensive and individualized access to physical health, behavioral health and supportive community and social services, ensuring patients receive the right care in the right setting at the right time.

“The Rosa Parks-Wellness Institute for Senior Health should be commended for meeting strict quality standards,” said URAC Chief Operating Officer William Vandervennet in a news release. “It is critically important for health care organizations to make a commitment to quality and accountability. URAC accreditation is a demonstration of that commitment.”

URAC, formerly known as Utilization Review Accreditation Commission, is the largest accrediting body for health care, and is recognized by the health care industry and federal and state government agencies as a measure of an organization’s quality.

URAC's standards keep pace with health care system changes, providing a mark of distinction for health care organizations to demonstrate commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures all stakeholders are represented in setting meaningful standards for the health care industry. For more information, visit www.urac.org.

Race apparently a factor in sleep apnea, researcher finds
In Headlines on June 25, 2013
James Rowley, M.D.

James Rowley, M.D.

A Wayne State University School of Medicine researcher has found that sleep apnea severity is higher among African-American men in certain age ranges, even after controlling for body mass index.

A study by James Rowley, M.D., professor of internal medicine, showed that being an African-American man younger than 40 increased the apnea-hypopnea index, or AHI, by 3.21 breathing pauses per hour of sleep compared to a white man in the same age range with the same BMI.

Obstructive sleep apnea affects at least 4 percent of men and 2 percent of women. It involves repetitive episodes of complete or partial upper airway obstruction occurring during sleep despite an ongoing effort to breathe.

Among participants in Dr. Rowley’s study ages 50 to 59, being an African-American man increased AHI by 2.79 breathing events per hour of sleep. No differences in AHI were found between African-American women and white women.

“The results show that in certain age groups, after correcting for other demographic factors, the severity of sleep apnea as measured by the apnea-hypopnea index is higher in African-American males than Caucasian males,” he said.

The study, “The Influence of Race on the Severity of Sleep Disordered Breathing,” was published in the April 15 issue of the Journal of Clinical Sleep Medicine.

Researchers studied 512 patients over three years, comprising 340 African-Americans and 172 Caucasians. The inclusion criteria required that participants were at least 18, have an AHI of more than five events per night of sleep and be willing to submit to a full-night sleep study.

Researchers examined the association between race and AHI while controlling for the effect of confounders such as gender, age, BMI and comorbidities.

Dr. Rowley said the mechanism for a racial difference in sleep apnea severity is unclear, but that possibilities include anatomical differences that affect the upper airway mechanics and collapsibility, as well as differences in the neurochemical control of breathing.
Wayne State awards $1.8 million to enhance multidisciplinary research
In Headlines on June 20, 2013
James Granneman, Ph.D.

James Granneman, Ph.D.

Sylvie Naar-King, Ph.D.

Sylvie Naar-King, Ph.D.

Bengt Arnetz, Ph.D.

Bengt Arnetz, Ph.D.

Melissa Runge-Morris, M.D.

Melissa Runge-Morris, M.D.

Wayne State University’s Office of the Vice President for Research announced two research awards totaling $1.8 million in the Multidisciplinary Research Group Incubator Program, an internal funding program at the university.

The seed-funding program seeks to foster the development of multidisciplinary research groups with significant growth potential for external funding through centers of excellence grant programs, program project grants or similar multidisciplinary grants.

The first three-year grant, with an anticipated total of $900,000, was awarded to James Granneman, Ph.D., professor of psychiatry and behavioral neurosciences and director of the Center for Integrative Metabolic and Endocrine Research in Wayne State’s School of Medicine, and Sylvie Naar-King, Ph.D., professor of pediatrics and director of the Interdisciplinary Program in Obesity Research and Education in Wayne State’s School of Medicine. The grant, “WSU Diabetes Obesity Team Science,” will focus on addressing the challenges of obesity-related diseases, including diabetes, cardiovascular disease and cancer.

Drs. Granneman and Naar-King’s grant aims to expand existing collaborations and identify new synergies that will lead to additional grant applications across the spectrum of basic and translational research in the biomedical and behavioral sciences, with the goal of reducing obesity and metabolic disease. In addition, the team will work to advance the science of team science, education, training and the institutional reputation of Wayne State in this field of research.

“Drs. Granneman and Naar-King will pair up to focus on research in the critical area of obesity-related diseases, all of which are growing epidemics that affect the urban community Wayne State serves,” said Gloria Heppner, Ph.D., associate vice president for Research at Wayne State.  “Their work will make an impact on the community of Detroit by not only increasing our understanding of the etiology of obesity, but also the individual differences in the health burden of obesity.”

The second three-year grant, with an anticipated total of $900,000, was awarded to Melissa Runge-Morris, M.D., director of WSU’s Institute of Environmental Health Sciences, and Bengt Arnetz, Ph.D., deputy director of family medicine for the School of Medicine. The grant, “Center for Urban Responses to Environmental Stressors,” will work to address the need to develop environmental health leadership and capacity, as well as equip the next generation of environmental health scientists with the necessary skills to identity, evaluate and mitigate environmental health challenges.

“Drs. Runge-Morris and Arnetz will lead this cutting-edge environmental health research project, which will make a significant impact not only in Detroit, but in urban areas around the United States,” Dr. Heppner said. “This project will have an important community engagement component led by Dr. Peter Lichtenberg, director of Wayne’s Institute of Gerontology and Merrill Palmer Skillman Institute. This team of experts has the potential to improve the health and economic vitality of Detroit, and serve as a model for other cities experiencing environmental stress.”
Internal Medicine's Teferi Mitiku, M.D., pushes for local awareness of sudden cardiac arrest
In Headlines on June 19, 2013
Teferi Mitiku, M.D., presented his Arrest the Risk lecture last month to fellow physicians at Scott Hall.

Teferi Mitiku, M.D., presented his Arrest the Risk lecture last month to fellow physicians at Scott Hall.

Wayne State University School of Medicine faculty member Teferi Mitiku, M.D., continues to serve as the Detroit spokesman for the Heart Rhythm Society’s “Arrest the Risk” campaign, creating awareness for the cardiac event that claims a life every 90 seconds.

(Watch a video on sudden cardiac arrest here).

Dr. Mitiku, assistant professor of medicine in the Department of Internal Medicine’s Division of Cardiology, appeared on WJBK-TV (Fox 2) and WWJ-AM (950) earlier this month to discuss the lack of awareness in the African-American community of sudden cardiac arrest, one of the leading causes of death in the United States each year. He also presented a grand rounds lecture on the topic at the School of Medicine’s Scott Hall on May 28. Dr. Mitiku is an attending physician and cardiologist with the Wayne State University Physician Group’s internal medicine services at the Detroit Medical Center’s University Health Center in Detroit.

The average survival rate outside a hospital for sudden cardiac arrest in Detroit is 0.2 percent. The chance of survival doubles if hands-only cardiopulmonary resuscitation is performed within three minutes of the patient collapsing, he said.

“The goal of this campaign is to get people screened before they get ‘arrested,’” Dr. Mitiku said.

Nearly 383,000 out-of-hospital sudden cardiac arrests occur annually, according to the American Heart Association, with 88 percent happening at home. Ninety-five percent of people who experience SCA die as a result, often because immediate treatment is not accessible, according to the Heart Rhythm Society.

“People need to get help immediately, and people shouldn’t be afraid of (performing) CPR,” said Brian O’Neil, M.D., chair of the School of Medicine’s Department of Emergency Medicine, in a recent interview with WWJ-AM regarding National CPR Awareness Week and sudden cardiac arrest.

African-Americans are nearly twice as likely as Caucasians to experience sudden cardiac arrest at home, work or in another public location, with lower survival rates, the American Heart Association said in a 2011 fact sheet.

SCA is not a heart attack, and occurs abruptly and without warning when the heart suddenly and unexpectedly stops beating. The heart’s electrical system is affected, preventing blood from being pumped to the rest of the body. The heart’s electricity must be restored to survive, usually through electrical shock via a defibrillator.

A national survey released last October by the Heart Rhythm Society indicated “a significant lack of awareness by consumers and providers. Most providers didn’t rank this as being a major risk to patients, especially African-Americans,” Dr. O’Neil said. “It isn’t apparent to patients that they are at risk.”

Ninety percent of African-Americans surveyed said their doctor had never talked to them about sudden cardiac arrest. The Heart Rhythm Society, an international medical professional organization, working with the Association of Black Cardiologists, launched the Arrest the Risk campaign in October 2012 to reduce disparities in the treatment and prevention of sudden cardiac arrest among African-Americans by increasing the dialogue between patients and physicians.

The groups are working with health care providers and community leaders in Detroit and nine other cities with at-risk populations, including Atlanta; Chicago; Dallas; Baltimore; Washington, D.C.; Jackson, Miss.; Nashville, Tenn.; New Orleans and Oakland, Calif., to spotlight the campaign at the local level. Local cardiologists like Dr. Mitiku give talks at churches, community centers and health fairs, delivering awareness and prevention tips, answering personal heart health questions and providing actionable follow-up materials to nearly 1,500 at-risk individuals so far.

Risk factors for sudden cardiac arrest include a previous heart attack; a family history of sudden death, heart failure or massive attack; an abnormal heart rate or rhythm of unknown case, even while resting; an unusually rapid heart rate that comes and goes; unexplainable episodes of fainting; and a low ejection fraction (a measure to determine how well a heart pumps blood).

For more information on sudden cardiac arrest and the Arrest the Risk campaign, visit www.ArrestTheRisk.org.

WSU breakthrough research of essential molecule reveals important targets in diabetes and obesity
In Headlines on June 18, 2013
Assia Shisheva, Ph.D.

Assia Shisheva, Ph.D.

Insulin is the most potent physiological anabolic agent for tissue-building and energy storage, promoting the storage and synthesis of lipids, protein and carbohydrates, and inhibiting their breakdown and release into the circulatory system. It also plays a major role in stimulating glucose entry into muscle tissue, where the glucose is metabolized and removed from the blood following meals. But gaps exist in understanding the precise molecular mechanisms by which insulin regulates glucose uptake in fat and muscle cells.

A research team led by Assia Shisheva, Ph.D., professor of physiology in Wayne State University’s School of Medicine, has made breakthrough advancements on a molecule that may provide more answers to this mystery.

The conserved phospholipid enzyme PIKfyve was discovered in Shisheva’s lab in 1999. Based on studies in cultured cells, the lab has implicated PIKfyve in the insulin-regulated glucose transport activation, which led to the development of a unique mouse model with PIKfyve removal in muscle, or MPlfKO, the tissue responsible for the majority of postprandial glucose disposal.

In Dr. Shisheva’s recent paper, “Muscle-specific PIKfyve gene distribution causes glucose intolerance, insulin resistance, adiposity and hyperinsulinemia but not muscle fiber-type switching,” published online in the American Journal of Physiology - Endocrinology and Metabolism, she and her research team characterize whether this new model exhibits metabolic defects.

“Our team found a striking metabolic phenotype in the MPIfKO mice consisting of glucose intolerance and insulin resistance at an early age and on a normal diet,” Dr.  Shisheva said. “We also revealed that PIKfyve is essential for normal insulin signaling to GLUT4/glucose transport in muscle and provided the first in vivo evidence for the central role of PIKfyve in the mechanisms regulating healthy blood glucose levels, or glucose homeostasis.”

In addition, the research team found that these metabolic disturbances were followed by increased animal fat (adiposity) and elevated levels of insulin (hyperinsulinemia), but not abnormal amounts of lipids or cholesterol in the blood (dyslipidemia).

“The combined phenotype manifested by the MPlfKO mouse closely recapitulates the cluster of typical features in human pre-diabetes, including systemic glucose intolerance and insulin resistance, hyperinsulinemia and increased visceral obesity without dyslipidemia,” she said. “Therefore, our mouse model, in addition to providing novel mechanisms of insulin resistance, represents a valuable tool for exploring new preclinical strategies to improve treatments in individuals with pre-diabetes.”

Funding for this research was provided by the National Institute of Diabetes, Digestive and Kidney Disease of the National Institutes of Health (R01 DK058058), Wayne State University’s Office of the Vice President for Research and the School of Medicine, and the American Diabetes Association. In-house instrumentation available at the Institutional Center for Integrative Metabolic and Endocrine Research ensured a more complete mouse metabolic phenotyping.

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