School of Medicine

Wayne State University School of Medicine
AHEC offers webinar on behavioral health issues of returning armed forces members
In Headlines on July 9, 2013

The Western Regional Center of the Michigan Area Health Education Center, National AHEC Organization and Postgraduate Institute for Medicine are sponsoring a continuing education webinar designed to provide an educational resource for health care professionals to address the behavioral health issues of returning service members and their families more effectively.

“Rules of Engagement: Understanding Behavioral Needs of Service Members and Their Families,” is scheduled for Aug. 1, from 5 to 6 p.m. Health professionals should visit http://miahec.wayne.edu/events/rules-of-engagement-final.pdf to register. The registration fee is $20. Individuals will receive a link for the webinar once they register.

The webinar is part of the AHEC Veterans Mental Health Project. Now in its second year, the national initiative seeks to support civilian health care professionals in providing high-quality, culturally competent care to veterans, service members and their families. In the first year of the program, AHECs trained more than 2,700 health professionals.

“Many veterans battle with mental health issues. As more of our troops return home, it is critical that primary care professionals are equipped to address issues, particularly behavioral and mental health concerns, they may have,” said Linda Tarjeft, associate program director of the Michigan Area Health Education Center at the Wayne State University School of Medicine.

The program is open to physicians, physician assistants, nurse practitioners, registered nurses, certified medical assistants, social workers and other behavioral/mental health providers, as well as health providers involved in the care of patients who have served in the military and their families. Continuing education credit will be available for physicians, registered nurses, social workers, and marriage and family therapists.

Speakers will address topics related to understanding military culture, increasing awareness of behavioral health issues, and providing appropriate care and counsel for patients and their families. Presenters include Richard Long, Ph.D., associate dean of the College of Health and Human Services at Western Michigan University; Capt. Anthony Strong, professor of Military Science at Western Michigan University; and Shirley Thomas, Ph.D., clinical assistant professor in the School of Social Work at Wayne State University.

For more information, visit http://miahec.wayne.edu or contact Lori Stegmier, executive director of the Western Regional AHEC, at 616-771-9494 or lori.stegmier@wmich.edu.

Dr. Li to lead program introducing nursing students to research earlier
In Headlines on July 9, 2013
Xiaoming Li, Ph.D.

Xiaoming Li, Ph.D.

A Wayne State University School of Medicine professor will lead a program that provides eight WSU undergraduate nursing students with unique insight about the research field thanks to a $40,000 grant awarded to the university’s College of Nursing and School of Medicine from the National Institute of Nursing Research of the National Institutes of Health.

The “Socio-behavior Training and Research (STaR) Program,” led by Xiaoming Li, Ph.D., professor of pediatrics and director of the Pediatric Prevention Research Center in the School of Medicine, and Nancy Artinian, Ph.D., associate dean for Research and director of the Office for Health Research in the College of Nursing, will provide participants with skills and experiences not offered at the undergraduate level. In doing so, Dr. Artinian said, the students will have a more successful transition to research work environments or graduate studies sooner.

“Now is the time to get them excited about research and expose them to the many possibilities available in the field of nursing,” she said. “We don’t want them to get to a doctorate level and find out that it is too late for a research career.”

An important goal of the program is to attract nursing students to doctoral education at an earlier age. Research has found that the median age of graduates receiving doctorate degrees is 47.3 years. Earlier engagement would result in increased years for productive teaching and research.

StaR students Lisa Bensmiller of Brighton, Kurt Omadlao of Royal Oak, Roberta Ukavwe of Detroit, Amber Buchholz of Dearborn Heights, Brittany Nelson of Brownstown, Anita D’Souza and Emily Glick of Troy and Cristina Miclea of Rochester Hills are paired with faculty of the College of Nursing and the School of Medicine’s Pediatric Prevention Research Center.

Throughout the eight-week program, trainees spend 20 hours a week between laboratory and field work while attending seminars and topical workshops relative to socio-behavioral health research and career development.

The experience introduces participants to every facet of research, from determining focus groups to recruiting participants and collecting and analyzing data. The students receive a $3,000 stipend for their participation in the program, to which they were accepted through a competitive application process.

The students will assist with research on a host of health topics including juvenile diabetes, asthma, HIV, immunization rates and cancer. The students are developing their own abstract studies for submission to research conferences and events such as the college’s Research Day or the annual WSU Undergraduate Research Conference. Several are pursuing the publication of their work in research journals.

With the growing complexity of today’s health issues, a significant component of the program is educating participants about the importance of working in multidisciplinary teams.

The NIH grant number for this project, “Socio-Behavioral Training and Research (STaR) Program for Nursing College Students,” is NR013160.
Distinguished Professor Jeanne Lusher retires, leaves lasting legacy of medical research
In Headlines on July 5, 2013
Jeanne Lusher, M.D.

Jeanne Lusher, M.D.

A distinguished professor who has served the Wayne State University School of Medicine for 44 years has retired.

Jeanne Lusher, M.D., now professor emeritus of pediatrics, retired June 28.

“It has been great working at the School of Medicine,” Dr. Lusher said. “I had the opportunity to interact with a lot of great faculty people in other departments over the years. Chief among these was Marion Barnhart, Ph.D., in the Physiology Department, who I began working with in 1970. I learned a lot from her. We did a lot of translational research together over the next 15 years, which was fun and exciting!”

Dr. Lusher, who also served as co-director of the Division of Hematology/Oncology and as medical director of the Special Coagulation Laboratory of Children’s Hospital of Michigan, said she plans to participate in the Hemostasis/Thrombosis group meetings and the meetings of two hospital boards. She also will participate in WSU's Academy of Scholars meetings and activities.

In addition, she will continue as chair of a steering and oversight committee for a National Institutes of Health-funded multi-center study for at least another year. She intends to remain active on committees of the American Thrombosis/Hemostasis Network and the National Hemophilia Foundation, as well as continuing as a member of the editorial board for the journals Haemophilia and the International Monitor on Hemophilia.

“I will really miss my wonderful colleagues – faculty and support staff – patients and their families, and great trainees,” she said. “Seeing my junior colleagues and hematology/oncology fellows blossom into extremely knowledgeable, dedicated and enthusiastic physicians has been particularly rewarding.”

Dr. Lusher’s accomplishments have been recognized with numerous awards, including the Distinguished Career Award from the American Society of Pediatric Hematology/Oncology, the Marion I. Barnhart Endowed Chair in Hemostasis Research, the Lawrence Weiner Award, the Gershenson Distinguished Faculty Fellow, the Kenneth Brinkhous Award for Outstanding Research in Hemophilia from the National Hemophilia Foundation, the Career Achievement Award and the Visionary Award for Women’s Bleeding Disorders from the National Hemophilia Foundation and the Lifetime Achievement Award from the Hemostasis Thrombosis Research Society. She was elected to lifetime membership in Wayne State University’s Academy of Scholars, and in 2003, received the Distinguished Service Award from the School of Medicine.

She has written more than 300 publications, including 220 original peer-reviewed articles, 70 book chapters and 17 review articles. She also wrote or edited nine books.

“Above all, what stands out most from our perspective as colleagues and trainees is that she is a gentle, caring person, never known to have a negative thought, who teaches by the example of her own dedication and commitment,” said Yaddanapudi Ravindranath, M.D., M.B.B.S., professor of Pediatrics, who has worked with Dr. Lusher since 1969.

Dr. Ravindranath, the Georgie Ginopolis Chair for Pediatric Cancer and Hematology at the School of Medicine and co-director of the Division of Hematology/Oncology for Children's Hospital of Michigan and the Barbara Ann Karmanos Cancer Institute, added, “Dr. Jeanne Lusher is a world leader in the treatment of hemophilia and other bleeding disorders. It is an honor to have worked with her over these many years.”

Ashok Sarnaik, M.D., interim chair of the WSU Department of Pediatrics, said the following story describes Dr. Lusher’s commitment: In 1979, at an international meeting, she saw a poster about the use of the drug DDAVP, or desmopressin acetate, in treating patients with mild to moderate hemophilia A. On returning to Detroit, she found that DDAVP was not licensed or available in the United States. She obtained an investigational new drug application from the Food and Drug Administration, which allowed her to obtain the drug from its European manufacturer. During the next two years, Dr. Lusher was the only person in the U.S. with access to the drug. She treated not only children with mild-moderate hemophilia A at Children’s Hospital of Michigan, but also had patients from other states who came to Detroit to receive it. Before administering the drug to children, Dr. Lusher and her colleagues infused it into each other, collecting serial blood samples to document its effects over time and ensuring the drug was safe.

“Perhaps the most important contribution Jeanne has had is the thousands of patients she has treated and hundreds of trainees, including me, she has taught,” Dr. Sarnaik said. “We are all grateful that she has had such profound influence on so many lives.”
WSU stroke experts say landmark study emphasizes early recognition of symptoms and possible superiority of combination therapy
In Headlines on July 1, 2013
Ramesh Madhavan, M.D., D.M.

Ramesh Madhavan, M.D., D.M.

Pratik Bhattacharya, M.D., M.P.H.

Pratik Bhattacharya, M.D., M.P.H.

Kumar Rajamani, M.D., D.M.

Kumar Rajamani, M.D., D.M.

A landmark study published in the June 26 issue of the New England Journal of Medicine concluded that among patients with high-risk transient ischemic attack or minor ischemic stroke seen within 24 hours of symptom onset, treatment with clopidogrel (Plavix®) plus aspirin for 21 days, followed by clopidogrel alone for a total of 90 days, is superior to aspirin alone in reducing the risk of subsequent stroke.

The Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events, or CHANCE study, tested the hypothesis that three months of treatment with a combination of clopidogrel and aspirin would reduce the risk of recurrent stroke, compared with aspirin alone.

“The CHANCE study is a well-designed remarkable study that demonstrates the superiority of combining the two most commonly used antiplatelet therapies for reducing the risk of future strokes,” said Ramesh Madhavan, M.D., D.M., Wayne State University School of Medicine associate professor of neurology and director of Telemedicine and the Michigan Stroke Network. “Although, a definitive study is still needed, this is a major step forward that may change how we practice.”

Dr. Madhavan is the investigator of a similarly designed ongoing study in the United States called the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke, or POINT, study.

In the large-scale CHANCE trial involving patients with high-risk TIA or minor ischemic stroke, the addition of clopidogrel to aspirin within 24 hours after symptom onset reduced the risk of subsequent stroke by 32 percent, as compared with aspirin alone. Combination therapy with clopidogrel and aspirin, as compared with aspirin alone, was not associated with an increased incidence of hemorrhage.

“This is an important study because it provides the potential to have a significantly improved outcome in patients who experience mild stroke. The combination of aspirin and clopidogrel was better than aspirin alone,” said Pratik Bhattacharya, M.D., M.P.H., assistant professor of WSU Neurology, who also serves as the Stroke Quality officer for the Detroit Medical Center and chief of Neurology at Sinai-Grace Hospital. “The study was conducted in China and cytochrome expression in the trial population could have influenced response to aspirin. However, an important message from the study is early recognition and treatment of stroke symptoms.”

Providing with some “chilling facts” about stroke in the United States, Kumar Rajamani, M.D., D.M., WSU associate professor and chief of Neurology at Detroit Receiving Hospital, provided some “chilling facts” about stroke in the U.S.:

* Stroke is the fourth leading cause of death, killing more than 133,000 people each year, and a leading cause of serious, long-term adult disability.

* There are an estimated 7 million stroke survivors in the U.S. over the age of 20.

* Approximately 800,000 strokes occur every year, one every 40 seconds, and taking a life approximately every four minutes.

* Stroke can happen to anyone at any time, regardless of race, sex or age.

* Approximately 55,000 more women than men have a stroke each year.

* African-Americans have almost twice the risk of first-ever stroke compared with Caucasians.

“There is absolutely no question that the sooner stroke is recognized and treated, the better the outcome,” Dr. Madhavan said. “In an increasingly aging U.S. population, early recognition of stroke is a critical message of the study, even though the investigators demonstrated that dual therapy is better than aspirin alone in the early hours following acute stroke.”
Psychiatry event celebrates the legacy of Helene Lycaki, Ph.D.
In Headlines on June 28, 2013
The Dr. Helene Lycaki Conference Room includes this plaque honoring the former WSU faculty member.

The Dr. Helene Lycaki Conference Room includes this plaque honoring the former WSU faculty member.

David Rosenberg, M.D., remembers Dr. Lycaki at the dedication June 27.

David Rosenberg, M.D., remembers Dr. Lycaki at the dedication June 27.

James Haveman, director of the Michigan Department of Community Health, delivers a heartfelt tribute to Dr. Lycaki.

James Haveman, director of the Michigan Department of Community Health, delivers a heartfelt tribute to Dr. Lycaki.

Vice Dean Bonita Stanton, M.D., speaks at the event.

Vice Dean Bonita Stanton, M.D., speaks at the event.

From left, Diana Censoni and Michael and Athina Lycaki admire the Dr. Helen Lycaki Conference Room plaque honoring their family member and friend.

From left, Diana Censoni and Michael and Athina Lycaki admire the Dr. Helen Lycaki Conference Room plaque honoring their family member and friend.

Friends, colleagues and family of the late Helene Lycaki, Ph.D., gathered June 27 to remember her and celebrate the dedication of the Dr. Helene Lycaki Conference Room on the fifth floor of the Wayne State University School of Medicine Tolan Park Medical Office Building in Detroit.

Dr. Lycaki’s brother, Michael Lycaki, and sister-in-law, Athina Lycaki, traveled to Detroit from Athens, Greece, to attend the event that honored the 30-year faculty member for her dedication to both WSU and the Michigan mental health community.

“It was a surprise for us that there was going to be such recognition,” Michael Lycaki said. “Nobody has forgotten her.”

Dr. Lycaki died in 2008 in an auto accident while attending a conference in Croatia.

The Tolan Park building became the new home of the Department of Psychiatry and Behavioral Neurosciences in March. Guests also toured the building, hearing from faculty, staff and students about the department’s groundbreaking research and its commitment to continue meeting the mental and physical health care needs of the Detroit community – a commitment many noted Dr. Lycaki would be happy to see.

“There was no greater champion and stronger advocate for ensuring equal access to mental health care and treatment for our poorest citizens. She also advocated vigorously for equal opportunities for women in medicine, science, academia and beyond,” said David Rosenberg, M.D., who was hired at WSU by Dr. Lycaki nearly two decades ago and is now chair of the department.

“She was an invaluable advisor to the university’s faculty, chairs, deans, presidents and Board of Governors. She was well known, liked and respected by the legislative community in Lansing,” he said.

Dr. Rosenberg also announced the establishment of the Lycaki-Young Fund in his remarks to the crowd, receiving audible gasps of approval. Formerly known as the Joseph Young Fund, the fund, in partnership with the state of Michigan, has helped provide vital psychiatric services to hundreds of thousands of patients in southeast Michigan during the last two decades.

“(Dr. Lycaki) was a giant in her field, a wonder to behold and a joy to be around,” said James Haveman, director of the Michigan Department of Community Health.

After earning her master’s degree from the University of Athens, Dr. Lycaki left Greece for Detroit, where she earned a doctorate degree in clinical psychology from WSU. And while a university in Texas attempted to lure her away after graduation, she stayed in Detroit “because she knew the path she would take,” Haveman said.

Dr. Lycaki served as a respected member of the School of Medicine faculty for three decades, and was named the school’s assistant dean for Health Affairs in 2001. She also played a vital role as the school’s liaison for government relations in Lansing, identifying networking opportunities linking outside resources to clinical, research and educational programs within the School the Medicine.

“She touched so many people on so many levels, from faculty to students to patients, that her legacy remains a living and breathing entity, even here in this building,” said Bonita Stanton, M.D., the School of Medicine’s vice dean of Research and a colleague and friend of Dr. Lycaki.

Dr. Lycaki, working alongside the university’s chief lobbyists, was the first woman to represent the School of Medicine to local, state and national governments. She met Haveman in that realm, and they quickly became friends. He spoke of her vibrant personality, tenacious spirit, keen intellect and ability to maneuver the political waters boldly but appropriately.

“She was one of those individuals who used the force of her personality as a change agent,” Haveman said. “She did it well and she always did it respectively.”

Dr. Rosenberg also announced plans to fundraise for the Helen Lycaki Endowed Chair in Mental Health, an endowment created to help support women pursuing careers in what he called an important, underrated and underrepresented area of medicine and psychology.

“This endowment will honor Dr. Lycaki, her rich and varied experience as an educator, clinical practitioner and scientist, and her proven leadership in medical education and administration,” he said.

WSU scientists identify neural origins of hot flashes in menopausal women
In Headlines on June 28, 2013
Robert Freedman, Ph.D.

Robert Freedman, Ph.D.

Vaibhav Diwadkar, Ph.D.

Vaibhav Diwadkar, Ph.D.

A new study from neuroscientists at the Wayne State University School of Medicine provides the first novel insights into the neural origins of hot flashes in menopausal women in years.  The study can inform and eventually lead to new treatments for those who experience the sudden but temporary episodes of body warmth, flushing and sweating.

The paper, "Temporal Sequencing of Brain Activations During Naturally Occurring Thermoregulatory Events," by the WSU Department of Psychiatry and Behavioral Neurosciences’ Professor Robert Freedman, Ph.D., founder of the Behavioral Medicine Laboratory and a member at the C.S. Mott Center for Human Growth and Development, and his collaborator, Associate Professor Vaibhav Diwadkar, Ph.D., appears in the June issue of Cerebral Cortex, an Oxford University Press journal.

“The idea of understanding brain responses during thermoregulatory events has spawned many studies where thermal stimuli were applied to the skin. But hot flashes are unique because they are internally generated and studying them presents unique challenges,” said Dr. Freedman, the study’s principal investigator. “Our women had to lie in the MRI scanner while being heated between two body-size heating pads for up to two hours while we waited for the onset of a hot flash.  They were heroic in this regard and the study could not have been conducted without their incredible level of cooperation.”

“Menopause and hot flashes that result during it are a significant women's health issue of widespread general interest,” Dr. Diwadkar added. “However, understanding of the neural origins of hot flashes has remained poor. The question has rarely been assessed with in vivo functional neuroimaging. In part, this paucity of studies reflects the technical limitations of objectively identifying hot flashes while symptomatic women are being scanned with MRI. Nothing like this has been published because this is a very difficult study to do.”

During the course of a single year, 20 healthy symptomatic postmenopausal women ages 47 to 58 who reported six or more hot flashes a day were scanned at the School of Medicine’s Vaitkevicius Imaging Center located in Harper University Hospital in Detroit.

The researchers collected skin conductance levels to identify the onset of flashes while the women were being scanned. Skin conductance is an electrical measure of sweating. The women were connected to a simple circuit passing a very small current across their chests, Dr. Diwadkar said. Changes in levels allowed researchers to identify a hot flash onset and analyze the concurrently acquired fMRI data to investigate the neural precedents and correlates of the event.

The researchers focused on regions like the brain stem because its sub regions, such as the medullary and dorsal raphe, are implicated in thermal regulation, while forebrain regions, such as the insula, have been implicated in the personal perception of how someone feels.  They showed that activity in some brain areas, such as the brain stem, begins to rise before the actual onset of the hot flash.

“Frankly, evidence of fMRI-measured rise in the activity of the brain stem even before women experience a hot flash is a stunning result. When this finding is considered along with the fact that activity in the insula only rises after the experience of the hot flash, we gain some insight on the complexity of brain mechanisms that mediate basic regulatory functions,” Dr. Diwadkar said.

These results point to the plausible origins of hot flashes in specific brain regions. The researchers believe it is the first such demonstration in academic literature.

They are now evaluating the network-based interactions between the brain regions by using more complex modeling of the fMRI data. “We think that our study highlights the value of using well-designed fMRI paradigms and analyses in understanding clinically relevant questions,” Dr. Diwadkar said.

The researchers also are exploring possibilities for integrating imaging with treatment to examine whether specific pharmacotherapies for menopause might alter regional brain responses.

The study was supported by the National Institutes of Health Merit award (R37-AG05233), with additional support by a National Institute of Mental Health award (MH68680) and the state’s Joseph A. Young Sr. Fund award to the Department of Psychiatry & Behavioral Neurosciences.

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