School of Medicine

Wayne State University School of Medicine
WSU alumnus inducted into Space Technology Hall of Fame
In Headlines on April 18, 2013
Scott Dulchavsky, M.D., Ph.D.

Scott Dulchavsky, M.D., Ph.D.

Dr. Dulchavsky introduces first-year students to the capabilities of ultrasound.

Dr. Dulchavsky introduces first-year students to the capabilities of ultrasound.

A Wayne State University School of Medicine alumnus has been inducted into the Space Technology Hall of Fame for his work with ultrasound technologies developed for use in manned space flights  that are now adapted for practice on earth

Scott Dulchavsky, M.D., Ph.D., Class of 1983, was inducted into the Space Foundation’s Space Technology Hall of Fame on April 11. The hall, established in 1988, was designed to increase public awareness of the benefits that result from space exploration programs and encourage further innovation. Induction, according to the foundation, “honors world class technology and those who transform technology originally developed for space exploration into products that help improve the quality of life here on Earth.”

“It’s a great honor to receive this award on behalf of my entire team. This enabling technology development began with a space program need, was modified and improved by many astronaut and ground personnel, and finally matured into a product that benefits not only NASA, but more importantly, medical care on the planet. My introduction to the space program began with an astronaut classmate at Wayne State University, so I feel that this university shares in this award as well,” said Dr. Dulchavsky, chair of the Department of Surgery at Henry Ford Hospital and professor of Surgery, Molecular Biology, and Genetics at the WSU School of Medicine.

He was honored as the principal investigator for the Advanced Diagnostic Ultrasound in Microgravity experiment, a collaboration of Henry Ford Hospital, Johnson Space Center and Wyle Laboratories Inc. He led a team that used small, portable ultrasound devices to train astronauts aboard the International Space Station from 2003 to 2005 so they could obtain diagnostic-quality medical images transmitted by satellite to earth, where radiologists can read them. The experiment showed the effectiveness of ultrasound as a remote diagnostic tool and serves in place of bulky X-ray equipment difficult to accommodate on the space station.

Dr. Dulchavsky leads the ultrasound technology efforts for NASA’s space program. He is responsible for ultrasounds and ultrasound technology involving all United States astronauts, Russian cosmonauts and taikonauts of China.

He has since worked with the Detroit Red Wings to test the technology. A portable ultrasound device was placed in the team’s locker room and connected to an ultrasound workstation at Henry Ford Hospital, where a radiologist guided team trainers to perform ultrasounds and send images for diagnosis.

His research with space explorers was modified for use on Earth, and his team now supports the onsite care of professional sports teams and United States Olympic Committee athletes as well as the Olympic Games. His team works with worldwide organizations, including the United Nations, to enhance point-of-care ultrasound in underserved areas through remote ultrasound guidance and to support maternal care. NASA also funds his work to establish micro-invasive surgical techniques in zero gravity through the National Space Biomedical Research Institute, Smart Medical Systems Team.

Thanks to Dr. Dulchavsky’s work with NASA and General Electric, the manufacturer donated 30 of its portable ultrasound devices to the Wayne State University School of Medicine. Each device costs about $70,000. First-year students, starting with the Class of 2006,  now have hands-on ultrasound training in how to use the devices, which look like slightly beefed-up versions of laptop computers. The School of Medicine was the first medical college in the nation to secure the technology produced by GE Healthcare and incorporate it into the first-year curriculum for 300 students.

“Because of this equipment, our students, when they get to the stage of seeing standardized patients in their third and fourth years, and residency, they are ahead of other students,” said medical student Michelle Campbell, who has completed the ultrasound training and has assisted first-year students in their training. “They have an edge because at most medical schools students don’t begin this type of experience until their third or fourth year.”

Dr. Dulchavsky shares his passion for ultrasound technology because the medical students will eventually face the decision of purchasing such equipment for their own practices, or will serve in decision-making positions for hospitals and surgical centers investigating ultrasound equipment.

In a recent session, the medical students also explored the future of ultrasound science. Dr. Dulchavsky brought with him an even smaller portable version – about the size of an iPod without the wand – that the students also tested.

Like computers, ultrasound technology is getting better, smaller and less expensive. Dr. Dulchavsky is experimenting with an ultrasound device that can hook up to his cell phone. He believes the use of the technology in space will one day allow physicians to diagnose and provide treatment to patients in remote locations around the planet.
Spring concert set for April 24 in Margherio Conference Center
In Headlines on April 17, 2013
The sounds of spring will ring out on the School of Medicine campus next week when the UltraSounds and Music in Medicine perform as part of the “Arts in the Atrium” program.

The performance, titled “A Cappella Through the Ages,” will take place April 24 from noon to 1 p.m. in the Margherio Family Conference Center.

The Ultra Sounds is an a capella group of medical students who perform in school functions, hospitals and nursing homes. Members of the student organization Music in Medicine volunteer at hospitals, playing instruments or singing to provide music in lobbies. Volunteers perform solo or as part of an ensemble.

The Shiffman Medical library and the School of Medicine sponsor the “Arts in the Atrium” program for the enjoyment of students, staff, faculty and the community. The series of programs is designed to highlight the artistic talents of students, staff and faculty of both the library and the School of Medicine with seasonal performances scheduled at lunch time in the atrium of the Mazurek Medical Education Commons.
Dr. Omar Khan appointed chair of Department of Neurology
In Headlines on April 17, 2013
Omar Khan, M.D.

Omar Khan, M.D.

Omar Khan, M.D., Wayne State University School of Medicine professor of Neurology, has been appointed chair of the Department of Neurology.

Valerie M. Parisi, M.D., M.P.H., M.B.A., announced the appointment April 17. Dr. Khan’s appointment is effective April 22.

“His devotion to education and the clinical treatment of patients, combined with his passion for collaborative research, make Dr. Khan the ideal person to lead the department into its next chapter,” Dean Parisi said. “A widely published and internationally respected neurologist and clinical researcher, Dr. Khan is the ideal leader to maintain the high quality research and sought-after patient care for which the department has become known.”

Dr. Khan, a resident of West Bloomfield, Mich., has served as interim chair of the department for the last year while the school conducted an extensive national search and interviewed candidates.

“I am honored and humbled by the opportunity to lead a prestigious department nationally known for its excellence in teaching, clinical care and research,” said Dr. Khan, the director of the Wayne State University Multiple Sclerosis Center and the Sastry Foundation Advanced Imaging Laboratory. “I am looking forward to working with my colleagues and leading the department.”

Dr. Khan, who joined the Department of Neurology in 1998, also serves as neurologist-in-chief for the Detroit Medical Center and associate chief medical officer for the Wayne State University Physician Group.

He received his medical degree in 1987 from the Allama Iqbal Medical College, University of the Punjab in Lahore, Pakistan. Following initial residency training in Pakistan, he performed an internship in Internal Medicine at the Jewish Hospital of Cincinnati from 1990 to 1991. He then completed a Neurology residency at the Medical College of Virginia and dual fellowships in Neuroimmunology and Neuroimaging at the University of Maryland and the Veterans Affairs Medical Center in Baltimore, Md. He served on the University of Maryland Department of Neurology faculty from 1996 to 1998, before joining Wayne State University in 1998.

Since joining WSU, Dr. Khan has secured more than $10 million in research funding. He has served as principal investigator in more than 60 studies and is the principal investigator in more than 15 clinical trials, investigator-initiated and National Institute of Neurological Disorders and Stroke-funded studies. He directs the Wayne State University Multiple Sclerosis Center, one of the top five MS centers in the country, with a patient population exceeding 4,500. He is internationally recognized in the field of therapeutic development, genotype-phenotype MR mapping in multiple sclerosis. Dr. Khan has established the largest African-American Multiple Sclerosis Clinic in the United States and is the founding member of the African-American Initiative in Multiple Sclerosis, a Detroit community-based endeavor. His MRI Analysis Laboratory, supported by a generous gift from the Sastry Foundation, focuses on developing biomarkers and investigations into mechanisms of tissue injury and repair in neurodegenerative disorders, including Parkinson’s disease, amyotrophic lateral sclerosis, Alzheimer’s disease and multiple sclerosis.

“We will be undertaking several initiatives exploring new partnerships as well strengthening existing ones,” Dr. Khan said of his immediate plans. “On the clinical side, our hospital partners provide several opportunities to collaborate and create services that benefit teaching, clinical care and even research. Research is critical to the success of teaching and clinical missions of the department, the school and the university. While federal funding of research remains challenging, amidst these challenges also lay opportunities. Collaborative and translational studies in neurosciences will continue to be favorably viewed as evident from President Obama’s recent neurosciences-related initiative. In this context, we will soon start active discussions to undertake such collaborative projects.”

He said he also looks forward to recruiting “top-notch faculty with a view to carry our mission in the years to come.” He also wants to expand residency and fellowship programs. “Last, but certainly not least, will be our renewed effort on philanthropy, which will be critical to the research undertakings in the department, both in clinical and basic sciences,” he said.

Dr. Khan serves on the Translational Research Committee of the National Multiple Sclerosis Society and is a member of the society’s National Medical Advisory Board. He is one of the few neurologists in the United States serving on the prestigious European Charcot Foundation for Multiple Sclerosis Research. He also has served on study sections of the National Institutes of Health, the Department of Defense, the Canadian Institute of Health Research and the Multiple Sclerosis Society of Canada. He has served on the U.S. Food and Drug Administration CNS & PNS Advisory Committee. He is a member of the American Academy of Neurology, International Society of Magnetic Resonance in Medicine, the International Genetic Consortium in Multiple Sclerosis, and is a fellow of the American Neurological Association.
WSU study examines relationship between 1991 Gulf War exposure, birth outcomes
In Headlines on April 16, 2013
Bengt Arnetz, M.D., Ph.D.

Bengt Arnetz, M.D., Ph.D.

Hikmet Jamil, M.D. Ph.D.

Hikmet Jamil, M.D. Ph.D.

Robert Sokol, M.D.

Robert Sokol, M.D.

Data collected and analyzed at the Wayne State University School of Medicine in Detroit has resulted in what could be the first published work to examine the relationship between wartime environmental exposures and birth outcomes for children of men and women living in Iraq before and after the 1991 Gulf War.

“The key finding is that exposures to that war seem to be associated with an increase in adverse pregnancy outcomes,” said reproductive health expert Robert Sokol, M.D., the WSU distinguished professor of Obstetrics and Gynecology and the John M. Malone Jr., M.D., Endowed chair and director of the C.S. Mott Center for Human Growth and Development in Detroit.

The study also revealed a dose-response relationship between war-related environmental exposures and total number of adverse birth outcomes, especially for certain chemical exposures, and suggests primary care doctors in particular consider reproductive risks in pregnant mothers with a history of exposure to war.

“There’s very little data like this in the whole world. Most of the work involves veterans, not civilian populations,” Dr. Sokol added.

Adverse birth outcomes were defined as congenital anomalies, stillbirth, low birth weight and preterm delivery.

The study stresses the need to design better studies of reproductive health risks from war and conflicts, including those that consider the interaction between chemical and psychosocial stressors.

“You’ll collect, hopefully, better data the next time,” Dr. Sokol said. “It will be very helpful to know these kinds of things.”

Using data from interviews with 307 Iraqi families who immigrated to the United States, the WSU team compared mothers giving birth in Iraq before and after being exposed to the Gulf War, to those giving birth in the U.S. before or after the first Gulf War.

“1991 Gulf War Exposures and Adverse Birth Outcomes” is published in the April-June issue of the United States Army Medical Department Journal. While previous studies about the 1991 Gulf War implied potential exposure to psychological trauma and environmental stressors such as smoke from oil-burning fires, diesel or gas fumes and skin contact, burning trash, burning feces, nerve gas, mustard gas, contaminated water, depleted uranium and pesticides on clothing or bedding, little was known about how the war might affect an unborn child.

“There is generally a lack of good studies of the reproductive hazards of war in which there are both data on exposures as well as outcomes,” said Bengt Arnetz, M.D., Ph.D., WSU professor of Family Medicine and Public Health Sciences and the study’s principal investigator.

After adjusting for other risk factors, psychosocial stress/trauma did not relate significantly to adverse birth outcomes, Dr. Arnetz said.

Co-author Hikmet Jamil, M.D., Ph.D., WSU professor of Occupational and Environmental Health, lived in Iraq from 1991 to 1997, and in 1998 began voluntarily collecting the self-reported data from Iraqi immigrants living in Michigan. The Detroit area’s Iraqi population is estimated at more than 46,000, per the U.S. Census, making it the largest concentration in the country.

“In the literature review, we don’t see, until now, such type of impact of the environment on health,” Dr. Jamil said.

“We were surprised to see the high levels of adverse birth outcomes following the Gulf War. However, there are independent and smaller local studies in Iraq, and a few from Kuwait, suggesting adverse effects on the fetus from the war,” Dr. Arnetz said.

The study does not lend support to the popular, but so far unproved notion, that psychosocial stress per se induces adverse birth outcomes, he added.

Study participants lived both in and away from the war zone, and were also asked about socioeconomics and lifestyle. “We found that the mean number of adverse birth outcome per women increased from a pre-Gulf War prevalence of 3.43 to 4.63 in those that had experienced the Gulf War. There were no differences before the Gulf War in adverse birth outcome whether the birth had occurred in Iraq or the United States. This supports the notion that something associated with the Gulf War contributed to the findings,” Dr. Arnetz said.

The mean stress exposure increased by 2,300 percent from before to after the Gulf War, on the study scale. The mean environmental exposure increased by 1,900 percent.

“It might be that there are residual effects from the Gulf War exposures that affect reproductive health many years later. A weakness in our study is that we do not know the timing of birth, only whether they gave birth before or after the 1991 Gulf War,” Dr. Arnetz said. “We also need to develop better exposure measures of civilians’ exposures during war and conflict and how it might affect reproductive health.”

Study co-authors include statistician Michael Kruger and School of Medicine graduate Alexis Drutchas, M.D., Class of 2012.

Drs. Arnetz and Jamil’s work was funded by R01MH085793 from the National Institute of Mental Health, National Institutes of Health. The study was also funded by an unrestricted grant from Pfizer Inc.

Resident contributes skills to medical mission trip to Dominican Republic
In Headlines on April 16, 2013
Pierre Rojas, D.O.

Pierre Rojas, D.O.

Drs. Claudia and Pierre Rojas are flanked by two other members of the recent medical mission trip.

Drs. Claudia and Pierre Rojas are flanked by two other members of the recent medical mission trip.

The Wayne State University School of Medicine and its Department of Physical Medicine and Rehabilitation - Oakwood are known for physicians who excel in bringing health and healing to patients. The residency program staff includes the example of one such generous physician, found in the gifts and skills of Pierre Rojas, D.O., a first-year resident who spent his winter break with his wife, Claudia Rojas, an Obstetrics and Gynecology resident, on a volunteer medical mission trip to San Pedro de Macoris, Dominican Republic.

Dr. Rojas joined a team of 15 health care provides based in of Toledo, Ohio, who packed medical supplies and pharmaceuticals, and then traveled to the Caribbean nation to provide vital medical care to those in need.

The physicians who volunteer their skills began conducting mission trips to Latin America in 1979. Based out of the Mercy Health Care system in Toledo, Ohio, the Midwest Regional Mission Team spends a week each winter in Santo Domingo providing the poor with surgical and medical treatments not readily available in the region. The team included a gynecologist, a general surgeon, an anesthesiologist, an obstetrics and gynecology resident, a nurse anesthetist, a student nurse anesthetist, a physician assistant, two scrub nurses, two recovery nurses, three circulators, a Spanish-expert volunteer and Dr. Rojas.

The Midwest Regional Mission Team traveled to the Dominican Republic the week of Feb. 15- 23, and performed 40 surgeries, mostly hysterectomies, cystectomies, cholecystectomies and hernia repairs. Patients were triaged for their medical procedures when the mission physician group arrived at the state hospital, Dr. Antonio Musa Regional Hospital, a 150-bed hospital with four operating rooms.

Members of the team who travel on medical missions enhance their clinical skills in ways they do not often get to experience in the United States. One of those is the art of communication in the doctor-patient relationship. Being a first-generation Colombian-American, Dr. Rojas’ first language was Spanish, so he was a valuable asset in communicating with patients during the trip.

Dr. Rojas said he learned significantly from his patients while in the Dominican Republic. “I had been there twice before, I knew the country pretty well and I identified a lot with the people,” he said. “My family had to go through a similar life before coming to the States.”

When asked why he used his vacation time on a volunteer medical mission trip, Dr. Rojas said, “I wanted to give back to a population and culture that means so much to me and that I love. It was like being home away from home.”

Dr. Rojas recommends that every resident have the opportunity during clinical training to join a medical mission trip. The mission allowed him to experience a broader world in the field of medicine, which he described as, “You step back and see how other people live, how health care is different in other countries. It makes you a better person, a better physician. It helps you not take things for granted.”

Dr. Rojas’ reflection upon his experience included a deeper appreciation for the medical resources available in the U.S. “As physicians and patients, we have all of this technology, labs, imaging and medicine,” he said. “Not everyone in the world has that luxury. You become better clinically. You think about the patient more because the care is simplified.”

Dr. Rojas described the difference in medical care as “more human” because of the limited medical resources available. This nurtures another level of human interaction with the patient. The communication between doctor and patient is more intimate.

“For the most part, patients in Latin America are incredibly grateful and appreciative of the care they are being provided,” he said. “They may view you as an extension of their family and may express their appreciation with hugs, homemade food or blessings, for example. And while they may not have much, the efforts are genuine.”

Dr. Rojas is considering another trip -- this time in the field of physiatry -- after he hones and perfects a new skill set as a Physical Medicine and Rehabilitation resident. He has his heart set on making a return to another country he knows well, Costa Rica, and offering services to a pediatric orphanage.
Discovery could improve life for congestive heart failure patients
In Headlines on April 12, 2013
Donal O'Leary, Ph.D.

Donal O'Leary, Ph.D.

New research from a study on chronic heart failure has the potential to dramatically improve quality of life for congestive heart failure patients fatigued by daily activities such as walking across a room.

Donal O’Leary, Ph.D., Wayne State University School of Medicine professor and director of Cardiovascular Research in the Department of Physiology, is the senior author of a paper that provides insight on how ventricular function could be improved during exercise by relieving vasoconstriction, the narrowing of blood vessels due to exaggerated sympathetic activity to the coronary arteries.

 “When we can relieve the vasoconstriction, we see a marked increase in the function of the heart. This could be used as a treatment for heart failure patients, especially if the blockage of nerves can be directed to the heart itself,” Dr. O’Leary said. “If we could get a significant improvement, going out and gardening could be possible. You could improve their heart function to where that doesn’t totally tire them out.”

“Muscle Metaboreflex-Induced Coronary Vasoconstriction Limits Ventricular Congratility During Dynamic Exercise in Heart Failure” is the featured article in the American Journal of Physiology: Heart and Circulatory Physiology’s April 1 edition. Associate Editor Fabio Recchia interviewed Dr. O’Leary for the journal’s accompanying podcast.

“I was really honored,” said Dr. O’Leary, a member of WSU’s Cardiovascular Research Institute. “There is usually only one article selected each month. This is the third we’ve had selected.”

Vasoconstriction occurs because of excessive activation of sympathetic nerves to the heart itself, he said, citing the spike in deaths during snow shoveling after a heavy snow fall as one example of the condition.

The latest publication from his group represents the culmination of more than 20 years of work, bringing together ventricular function and coronary blood flow control in one experiment. “It’s a great big project that we’re getting better and better at refining how we’re going to investigate these phenomena,” he said.

While previous studies showed that systemic therapies with nerve blockers could improve ventricular function during exercise, there are side effects, he said. “We need to find a way to directly target to the coronary vascular. With nanobiotechnology, we can absolutely see this within the clinical lives of our current students and residents,” he said.

He expects the answer is in a specialized delivery process.

The research and results, collected over two years served as the doctoral dissertation for WSU graduate Matt Coutsos, Ph.D., and is the second paper to be published from his work. The initial paper looked at the same phenomena in normal, healthy subjects, and another section of the study focuses on those with hypertension.

Dr. O’Leary is the principal investigator of the National Institutes of Health’s award R01HL055473-16, a $1.56 million four-year competing grant used to fund the ongoing study “Blood Pressure Control During Exercise in Heart Failure.”

“These experiments require a team. They’re highly complex. It has been through the great fortune I have had of having outstanding postdoctorates, students and technicians, that we’ve been able to do this work,” Dr. O’Leary said. “Each study builds on the next.”

The grant, in its 15th year, was renewed earlier this month by the National Heart, Lung and Blood Institute.

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