School of Medicine

Wayne State University School of Medicine
WSU alumnus, professor secures $1.4 million VA career development grant to study spinal cord injury
In Headlines on June 6, 2013
Abdul Ghani Sankri-Tarbichi, M.D., Ph.D., will use a new $1.4 million grant to study sleep and breathing disorders in spinal cord injury patients.

Abdul Ghani Sankri-Tarbichi, M.D., Ph.D., will use a new $1.4 million grant to study sleep and breathing disorders in spinal cord injury patients.

The United States Department of Veteran Affairs’ Veterans Health Administration has granted the Wayne State University School of Medicine’s Abdul Ghani Sankri-Tarbichi, M.D, Ph.D., a new five-year, $1.4 million career development award to study sleep and breathing disorders in spinal cord injury patients at the John D. Dingell Veteran Affairs Medical Center in Detroit.

The results will have a direct impact on the quality of life of veterans living with spinal cord injury, he said.

Dr. Sankri-Tarbichi is assistant professor of medicine in the Department of Internal Medicine’s Division of Pulmonary and Critical Care and Sleep Medicine.

“This study may become a seed for a comprehensive program for spinal cord injury research and cutting-edge treatments,” he said. “This study will be one of few studies to focus on veterans’ long-term health related to traumatic injury to the spine.”

A severe spinal cord injury often causes loss of feeling and paralysis, as well as loss of reflex function below the point of injury, according to the National Institutes of Health’s U.S. National Library of Medicine. The injury interrupts bodily functions such as breathing, bowel control and bladder control.

The Career Development Award I01BX007080 is from the Biomedical Laboratory clinical service program of the VHA Office of Research and Development.

Dr. Sankri-Tarbichi started the project, “Pathogenesis of Sleep Disordered Breathing in Spinal Cord Injury Patients,” in April. It’s the first of its kind seeking to determine the mechanism of sleep apnea (a sleep disorder characterized by intermittent paused or very low breathing) in injury survivors. The project sets the stage for the development of innovative therapies for this prevalent disorder, he added.

The research team includes Professor of Medicine and Division Chief Safwan Badr, M.D.; Professor of Anatomy and Cell Biology Harry Goshgarian, Ph.D.; and doctoral student Amy Bascom. The team will first determine the mechanisms of sleep apnea in spinal cord injury patients, then test the effect of breathing air with low oxygen on breathing patterns in sleeping patients.

From there, they will study the effect of the medications buspirone (for anxiety) and trazodone (for depression) on breathing during sleep, including using an animal model to pinpoint the level responsible for unstable breathing while asleep.

Study subjects will include veterans and civilians with spinal cord injury in the thoracic and cervical levels.

Dr. Sankri-Tarbichi earned his medical degree in 2000 from Aleppo University in Syria, and his doctoral degree in physiology from the School of Medicine’s graduate program in 2009. He completed a pulmonary and critical care fellowship at WSU in 2008. He is a physician at the John D. Dingell VA Medical Center and the Wayne State University Physician Group Sleep Disorders Center at Detroit Receiving Hospital.
SEMCME announces Research Forum winners
In Headlines on June 6, 2013
Jocelyn Leon Peters, M.D., right, accepts the first place award in the oral competition.

Jocelyn Leon Peters, M.D., right, accepts the first place award in the oral competition.

The Southeast Michigan Center for Medical Education, in collaboration with the Wayne State University School of Medicine and Oakland University, presented the 36th annual Meadow Brook Lecture and the 35th annual SEMCME Research Forum at Meadow Brook Hall in Rochester, Mich.

The May 22 Meadow Brook Lecture featured Julie Gerderding, M.D., M.P.H., former director of the U.S. Centers for Disease Control and Prevention, who presented “Emerging Infections: New Treachery and New Tools.”

The Research Forum involved 28 residents from the SEMCME member hospitals presenting research projects in the form of oral or poster presentations. More than $4,000 in cash prizes and awards were handed out, including the coveted Donald Dawson Medallion, named in honor of the gifted medical researcher and educator.

This year’s winners were:

“Neonatal Mortality According to Timing Of Elective Repeat Cesarean Delivery,” Jocelyn Leon Peters, M.D.; Gustavo Vilchez, M.D.; Anushka Chelliah, M.D.; and Roohi Jeelani, M.D., Department of Obstetrics and Gynecology, Huzel Women’s Hospital, first place, oral competition, $1,500 and the Donald Dawson Medallion.

“Effects of Amantadine on Functional Recovery in Acute Stroke Patients,” Neena Sharma, M.D., and Tatyana Geraschenko, M.D., Department of Internal Medicine, St. Joseph Mercy Oakland, second place, oral competition, $500.

“Systemic Proteomic Profiles Associated with Healing and Nonunion Of Mid-Shaft Femur Fractures,” Andrew Ringnes, M.D., and Melissa Zimel, M.D., Department of Orthopaedic Surgery, William Beaumont Hospital, first place, poster competition, $750 and engraved plaque.

“Molecular MiRNAs for Early Detection, Prevention and Treatment of Breast Cancer Metastasis to Brain,” Seema Sethi, M.D., Department of Pathology, Detroit Medical Center, second place, poster competition, $500.

Judges from the WSU School of Medicine faculty included Lisa MacLean, M.D., assistant dean of Student Affairs and Career Development; James Meza, M.D., assistant professor of Family Medicine & Public Health Sciences, and Bonita Stanton, M.D., the Schotanus professor of Pediatrics and vice dean of Research.
Ophthalmology organization recognizes WSU fellow Dr. Xiaoyu Jiang for corneal infection research
In Headlines on June 5, 2013
Xiaoyu Jiang, M.D., Ph.D., presented this poster on the role of autophagy on corneal infection.

Xiaoyu Jiang, M.D., Ph.D., presented this poster on the role of autophagy on corneal infection.

A 2012 alumnus of the Wayne State University School of Medicine graduate program was honored for his research last month at the Association for Research in Vision and Ophthalmology annual meeting.

Xiaoyu Jiang M.D., Ph.D., won the Cora Verhagen Prize for his poster presentation of “The Role of Autophagy in Pseudomonas Aeruginosa Keratitis” at the meeting, held May 5-9 in Seattle.

The award is presented annually to the best ocular immunology poster or paper presentation. His was part of an immunology and microbiology poster session on corneal infection and inflammation.

The Association for Research and Vision in Ophthalmology is the largest eye and vision research organization in the world, made up of more than 12,500 eye and vision researchers from 80 countries. The Maryland-based organization encourages and assists research, training, publication and knowledge-sharing in vision and ophthalmology.

Dr. Jiang is a postdoctoral fellow in the lab of Linda Hazlett, Ph.D., distinguished professor and chair of the School of Medicine’s Department of Anatomy and Cell Biology.

“I am happy to have received this award and it is a privilege to present my work to a group of renowned scientists in the areas of immunology and ophthalmology,” Dr. Jiang said. “I also appreciate all of the training from my advisor, Dr. Hazlett.”

The study provides evidence that autophagy – a pro-survival mechanism involving cell degradation of unnecessary cell components – plays an important role in bacterial infections of the cornea.

Dr. Jiang received $250, a bronze medallion and a plaque.

He began his doctoral studies at the School of Medicine in 2008, and joined Dr. Hazlett's lab in 2009. He completed his doctoral studies in 2012, and chose to remain in the lab as a postdoctoral fellow to further his research and grant-writing skills, he said. He received his medical degree from Hebei Medical University in northern China.
WSU cardiologist represents American College of Cardiology at speaking series in India
In Headlines on June 5, 2013
Luis Afonso, M.D., F.A.C.C., speaks at the American College of Cardiology’s 2013 Scientific Sessions Highlights Program in India last month.

Luis Afonso, M.D., F.A.C.C., speaks at the American College of Cardiology’s 2013 Scientific Sessions Highlights Program in India last month.

Dr. Afonso is associate professor of internal medicine in the Division of Cardiology.

Dr. Afonso is associate professor of internal medicine in the Division of Cardiology.

A Wayne State University School of Medicine faculty member was one of three cardiologists from the United States invited to represent the American College of Cardiology at a weeklong series of presentations in India.

Luis Afonso, M.D., F.A.C.C., associate professor of internal medicine in the Division of Cardiology and director of the WSU Cardiology Fellowship Program and the Echocardiography Laboratory at Harper University Hospital in Detroit, traveled to the cities of Lucknow, Kolkata and Delhi to present highlights and clinical updates from the ACC’s 2013 Scientific Sessions, held last March in San Francisco.

The speaking trio included medical faculty from Temple University School of Medicine in Pittsburgh and Tulane University School of Medicine in New Orleans.

Dr. Afonso was asked to attend by WSU Professor and Division of Cardiology Chair Kim Williams Sr., M.D., vice president of the ACC, and the ACC Presidential Committee, in recognition of his role as a leader in the field of lipids, a group of naturally occurring molecules.

In “Lipids: Management in 2013 and Beyond,” Dr. Afonso presented the status of managing patients with statin medications (used to lower cholesterol levels), including side effects and intolerance, and highlighted newer developments and treatments to elevate high-density lipoprotein (good) cholesterol, believed to reduce the likelihood of a heart attack or recurrent heart attack, through medications such as niacin and newer agents such as dalcetrapib and Anacetrapib, he said.

He also discussed a new class of medications called PCSK9 inhibitors. These injectable medications “are administered every two weeks and have been found to dramatically reduce low-density lipoprotein (bad) cholesterol,” he said, adding they will be available soon.

“These agents would serve as excellent alternatives for patients who do not respond to standard treatment with statin medications,” he said.

The series was organized by the ACC’s International Affairs Department and Alkem Laboratories, one of India’s largest pharmaceutical companies, Dr. Afonso said.

“There were between 150 to 400 attendees for these talks, with lively (question-and-answer) sessions that often exceeded the 30-minute allotted time, with moderator panels comprised of well-informed cardiologists from leading institutions in India,” he added.

The ACC is an international organization that represents more than 30,000 cardiovascular physician practitioners and several thousand allied health and cardiac care associates. The college promotes high quality cardiovascular care with registries for intervention and device therapies, disease treatment and procedure guidelines, position statements, and appropriate use criteria for diagnostic studies and cardiac interventions.
Speech pathologist helps patients regain speech after larynx removal
In Headlines on June 5, 2013
Mark Simpson, Ph.D., speech and swallowing pathologist, talks with his patient, Nancy Miko.

Mark Simpson, Ph.D., speech and swallowing pathologist, talks with his patient, Nancy Miko.

Mark Simpson, Ph.D., speech and swallowing pathologist for the Wayne State University School of Medicine’s Department of Otolaryngology and the Barbara Ann Karmanos Cancer Center, is one of the few experts in metropolitan Detroit who helps people regain the power of speech after the removal of their larynx because of cancer.

The larynx, which lies between the trachea and esophagus, prevents the passage of food into the airway as a person swallows. It also regulates the flow of air into the lungs and functions in producing speech. In some circumstances, a person with laryngeal cancer must have the entire larynx removed. In that situation, surgeons must bring the trachea forward and place it on the person’s neck to completely separate breathing and swallowing functions.

Dr. Simpson’s role comes in after the patient has had surgery. He has been involved with speech and swallowing rehabilitation for almost 40 years, having retired from the John D. Dingell Veterans Administration Hospital in Detroit and then joined Karmanos three years ago. While at the VA in the 1970s, Dr. Simpson worked closely with Eric Blom, Ph.D., who created the Blom-Singer Voice Prosthesis with Marc Singer, M.D., F.A.C.S. Dr. Blom now works with various health centers and universities in the Indianapolis area.

Dr. Simpson recalls a time when voice rehabilitation options for cancer patients were limited.

“When I would enter a patient’s room with an electropharynx (a device that creates an electronic-sounding voice), it’s not really what they wanted to see,” he said. “It was a long time before I could say that this is temporary and that something better is coming.”

The Blom-Singer Voice Prosthesis, along with Dr. Simpson’s customization talents and one-on-one guidance, allows patients to speak again.

Dr. Simpson works closely with head and neck surgeons and the patients affected by head and neck cancers, as well those diagnosed with brain cancer. He implants a tracheoesophageal voice prosthesis, which restores the ability to speak. The prosthesis comes with a small flapper located on the side of the patient’s esophagus that remains closed during swallowing but is pushed open for entrance of air into the upper esophagus for speech production.

Since he is so specialized in what he does, Dr. Simpson spends most of his days in the clinic. He typically spends about 10 one-hour sessions with his patients to help them regain speech. He sees about 15 to 20 new laryngectomy patients each year at Karmanos and has additional laryngectomy patients from other facilities around the state referred to him.

“It isn’t that we insert the prosthesis and off they go,” he said. “I encourage doctors to refer patients to me even before the total laryngectomy surgery because it is so traumatic to lose the power of speech. We take the time necessary to answer the many questions that they may have and arrange a meeting with an individual who has already undergone this procedure.”

Those affected by laryngeal cancer, including other head-and neck-related cancers, are usually those who have been smokers and/or drinkers, those exposed to certain chemicals or those with the human papilloma virus.
Dr. Simpson said that nearly every one of his patients outfitted with a voice prosthesis is successful in learning how to speak again.

“I refuse to accept defeat when it comes to voice rehabilitation,” he said. “I develop a close and intensely personal relationship with each and every one of my patients and in the end we become friends.”

Nancy Miko, a 64-year-old woman diagnosed with laryngeal cancer in 2001, was able to regain her speech with relative ease after being fitted with a prosthesis by Dr. Simpson. Miko, who lives in Dearborn, Mich., is a retired third grade teacher who taught in the Crestwood Schools district.

“You can’t tell a teacher to shut up,” she said with a grin. “It was devastating to lose the ability to speak and it was frustrating not to be able to converse in a quick way.”

Miko said she suspected something was amiss when after a week of classroom teaching it took the weekend to recover her ability to speak. After meeting with her doctor, she learned that she had cancer. She underwent radiation therapy, but the cancer continued to grow. She then decided on surgery to remove her larynx.

She was then referred to Dr. Simpson by Robert Mathog, M.D., chair of the WSU Department of Otolaryngology-Head and Neck Surgery following the tracheoesophageal puncture procedure he performed on Miko to create an opening in the trachea for the voice prosthesis. Today, Miko’s voice is lower in tone but she is easy to understand when she speaks. She credits Dr. Simpson, who she called a “wonderfully dedicated” doctor.

“It was like New Year’s Eve, regaining my ability to speak,” she said. “It wasn’t that bad, learning how to speak again. It depends on how much you’re willing to do.”

A former smoker, Miko and her husband George now keep themselves healthy with a vegan lifestyle and by growing their own food at home.

Miko also does her part to support other cancer patients by serving as president of the Anamilo Monthly Support Group at Karmanos. The Anamilo Club, one of the nation’s oldest support groups, is for laryngectomy patients and their families and friends. It is facilitated by Susan Fleming, Ph.D., adjunct assistant professor in the WSU Department of Otolaryngology. The group meets the second Sunday of each month from 2 to 4 p.m. in the Wertz Classroom at Karmanos’ main location, 4100 John R, Detroit. Call 1-800-KARMANOS (1-800-527-6266) to register or for more information.

“Members of the support group are a wealth of information,” Miko said. “Family and support are the best therapy you can get. The culmination of the two helps to ensure a more successful recovery.”
WSU Family Medicine's Jinping Xu, M.D., gets $1.76 million to investigate care management decisions in prostate cancer
In Headlines on June 3, 2013
Jinping Xu, M.D., M.S.

Jinping Xu, M.D., M.S.

The American Cancer Society has awarded Wayne State University School of Medicine researcher and clinician Jinping Xu, M.D., M.S., a five-year, $1.76 million Research Scholar Grant (RSG-13-164-01-CPPB) to analyze how men with low-risk localized prostate cancer choose to manage their disease.

Dr. Xu, a School of Medicine associate professor of family medicine and public health sciences, and a physician with the Wayne State University Physician Group’s Family Medicine practice in Rochester, Mich., will lead the team on the project “Why Don’t More Men with Low-Risk Prostate Cancer Choose Active Surveillance?”

“We are all very excited about the opportunity to carry out this longitudinal, population-based cohort study of men with newly-diagnosed prostate cancer, which we believe has the potential for impact on both public health policies and clinical practices of taking care of men with prostate cancer,” Dr. Xu said.

The United States Preventative Services Task Force issued new recommendations last year against Prostate-Specific Antigen screening of healthy asymptomatic men, asserting that it caused more harm than benefit, primarily because of overtreatment. The new guideline sparked intense media coverage and a national debate on medical decision-making and the benefits of active surveillance as an appropriate management strategy for low-risk localized prostate cancer to decrease the harms of overtreatment, Dr. Xu said.

The study will identify determinants of treatment choice in men with low-risk localized prostate cancer, including the factors that affect the offer, acceptance and adherence of active surveillance as an initial management strategy. Localized cancer means there is no sign it has spread outside the prostate. Four out of five prostate cancers are found at this stage, according to the National Cancer Institute.

Active surveillance involves delaying treatment until test results show the cancer is growing or changing. The cancer is checked regularly, such as every three to six months at first.

Prostate cancer is the most commonly diagnosed non-skin cancer in men in the United States. One in six men will received the diagnosis in their lifetime, according to the most recent data available from the National Institutes of Health. The 10-year relative survival rate is 98 percent, according to the American Cancer Society.

“Active surveillance offers the opportunity to delay or avoid curative treatment and associated side effects unless the cancer progresses. Current practice guidelines identify active surveillance as an appropriate initial management strategy for low-risk localized prostate cancer. However, active surveillance is rarely chosen, and little research has addressed the reasons why men with low-risk prostate cancer receive aggressive treatment rather than active surveillance,” Dr. Xu said. “In addition, while black men historically have received less aggressive prostate cancer treatment than whites, they also report having more decision-making difficulty, decision regret and poorer quality of life.”

African-American men are twice as likely as Caucasian men to die from prostate cancer, according to the NCI.

The team also will survey urologists to understand how and why treatment decisions are made, with a focus on the urologist’s offer, and the patient’s acceptance and adherence of active surveillance. She expects the findings will provide a foundation for targeted efforts to optimize men’s treatment decisions and improve quality of life, while reducing racial disparity in prostate cancer treatment and outcomes.

The study will use a culturally-sensitive patient survey culled from a previous five-year pilot study on racial disparities in prostate cancer treatment decision-making, also funded by the American Cancer Society.

Co-investigators include the Department of Family Medicine and Public Health Sciences’ Professor Kendra Schwartz, M.D.; Assistant Professor and  Biostatistician James Janisse, Ph.D.; Professor and Biostatistician Joe Ager, Ph.D.; WSU Associate Professor Susan Eggly, Ph.D., of the Barbara Ann Karmanos Cancer Institute; WSU Assistant Professor of urology Jeffrey Triest, M.D.; and Michael Goodman, M.D., M.P.H, associate professor of epidemiology at Emory University, Atlanta, and medical director of Emory’s Georgia Center for Cancer Statistics.

Researchers will recruit about 2,000 men in Michigan and Georgia, identified from cancer registries sponsored by the NCI.

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