Health Science Center notches top U.S. award for libraries, museums

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San Antonio (Oct. 19, 2004) – The Regional Academic Health Center (RAHC) Medical Library, a branch of the Dolph Briscoe Jr. Library at The University of Texas Health Science Center at San Antonio, has been selected to receive the nation’s highest honor for public service provided by museums and libraries. The award, presented by the Institute of Museum and Library Services, includes $10,000 and recognition at a national award ceremony in Washington, D.C.

“I welcome the news of this prestigious award for our talented and capable team of library professionals,” said Francisco G. Cigarroa, M.D., president of the Health Science Center. “The extension of state-of-the-art library services to health professionals, students and lay health promotion workers in the Lower Rio Grande Valley, where the RAHC Medical Library is located, is a testament to individual ingenuity and the support of many partners, including the state legislators who saw library services as a crucial area of need.”

Located in Harlingen, the RAHC Medical Library is the first health sciences library – indeed the first library at an institution of higher education – to win the National Award for Museum and Library Service. Mary J. Moore, Ph.D., director of libraries at the Health Science Center, said the honor actually caps decades of visionary work by the library staff in San Antonio to reach out to Valley health professionals and their patients.

The rapidly growing population of the Valley is more than 80 percent Hispanic. One-third of the area’s 1 million residents live below the poverty level. Many residents experience transportation, language and cultural barriers that substantially limit access to health care.

“The establishment of the RAHC Medical Library in 2001 provided the first medical library in the Lower Rio Grande Valley,” Dr. Moore said. “Open to the public, this library serves not only the faculty, staff and students of the Regional Academic Health Center, but records more than 2,000 visits a month from students and faculty of health programs at other regional institutions.”

The Health Science Center is authorized by the Texas Legislature to operate the Medical Education and Medical Research Divisions of the RAHC. Each year, 24 third-year and 24 fourth-year medical students from the Health Science Center are educated and trained at the RAHC Medical Education Division in Harlingen and at the RAHC’s many clinical partners, which include the Valley Baptist Health System and Su Clinica Familiar. The RAHC Medical Education Division also provides medical residency programs.

Debra Warner, director of the RAHC Medical Library, will travel to Washington with Dr. Moore on a date to be determined for the national award ceremony. Warner completed a needs assessment of the Lower Rio Grande Valley in 2001, meeting with public librarians, agency directors and outreach workers throughout the area. “Partnerships have been established with high schools and health action groups, and we have provided training in the use of quality health information for parish nurses, school nurses and ‘promotoras’ (lay outreach workers),” Warner said.

Last year, more than 2,000 students and teachers from the Valley were trained in the use of quality health information on the National Library of Medicine’s MEDLINEplus, Warner said. Many of the young people were from the South Texas High School for the Health Professions, a regional magnet school known as “Med High.” Others were from high school chapters of the Health Occupations Students of America. “A survey at Med High showed that, on average, each Med High student has demonstrated the Internet-based health information sources to three other people in the community,” Warner said.

The RAHC Medical Library also is training Health Science Center medical students and internal medicine residents about the problems of health literacy among patients and about the use of consumer health resources in Spanish and English to accommodate largely Hispanic patient populations.

The Briscoe Library’s founding director, David Kronick, Ph.D., had the original vision in 1965 to hire an outreach librarian to serve South Texas. That was just six years after the 1959 legislative charter that gave the Health Science Center the responsibility to serve all of South Texas, including Cameron, Hidalgo, Willacy and Starr counties, the four counties that make up the Lower Rio Grande Valley. Dr. Kronick’s idea later took shape as a “circuit librarian” program throughout South Texas. “Mary Jo Dwyer and Graciela Reyna were our pioneering circuit librarians,” Dr. Moore said.

The Briscoe Library’s second director, Virginia Bowden, Ph.D., successfully obtained funding from the National Library of Medicine (NLM) for the RAHC Medical Library’s programs. She made a personal visit to the NLM in Washington and wrote the original creative proposals with Debra Warner. “Today, 33 staff members of the Briscoe Library work on a day-to-day basis to support the RAHC Medical Library,” Dr. Moore said. When Dr. Bowden retired in 2003, the Health Science Center conducted a national search and recruited Dr. Moore from her position as head of reference and customer services at the NLM.

The RAHC Medical Library also would not be a reality without the leadership of the Valley legislative delegation, especially that of state Sen. Eddie Lucio Jr., author of the bill that established the RAHC, and state Sen. Juan “Chuy” Hinojosa, at the time a state representative, who sponsored the bill in the House. “This award acknowledges that outreach is a longstanding mission or heritage of the Health Science Center libraries,” Dr. Moore said. “We also acknowledge our dedicated legislators and community partners who have helped make the RAHC Medical Library and its programs a success.”

This fall, the RAHC Medical Library and the Biblioteca Las Américas Library, located at Med High, received the Blue Ribbon Consumer Health Information Award from the National Commission on Libraries and Information Science for the MEDLINEplus peer tutor project.

Acupuncture Clinic gets to the point

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A National Institutes of Health Consensus in 1997 suggested that acupuncture could be used as an adjunct treatment for fibromyalgia, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, asthma, and infertility.

What has more pins than a porcupine?

The new Acupuncture Clinic, located at the University Physicians Group Diagnostic Pavilion at 4647 Medical Drive.

Acupuncture is an ancient Chinese system of healing believed to date back as far as 5,000 years. Fine needles are inserted just under the skin at specific points along meridians to stimulate, disperse and balance the flow of energy, known as chi or qi (pronounced chee), to relieve pain and treat a variety of conditions. The modern scientific explanation is that needling acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord and brain. These chemicals change the experience of pain and influence the body’s own internal regulating system.

Medical acupuncture is a term used to describe acupuncture performed by a physician. Unlike Traditional Chinese Acupuncture, points are selected on the basis of their neuroanatomical location and effect. Physicians also use medical techniques such as trigger point needling and deactivation and electrical stimulation to change the quality of pain.

“Acupuncture can be a great adjunct in the treatment of conditions that are difficult to treat with conventional treatments. Conditions such as fibromyalgia, chronic pain, low back pain, headaches can be frustrating for patients and physicians alike,” said Harpreet Lotay, M.D., clinical assistant professor in the department of family and community medicine.

Acupuncture is involved in ongoing trials on its efficacy in treating diverse medical conditions. A National Institutes of Health Consensus in 1997 suggested that acupuncture could be used as an adjunct treatment for fibromyalgia, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, asthma, and infertility. The World Health Organization provides an extensive list of diagnoses for which acupuncture may be considered.

Dr. Lotay became interested in acupuncture after working with many of her patients in Oregon who used acupuncture to manage pain when conventional treatments had failed. Dr. Lotay received training in medical acupuncture at The David Geffen Medical School at The University of California at Los Angeles.

“Once all medical investigations have ruled out an organic pathology, acupuncture is a good adjunct for the treatment of various functional problems such as pelvic or abdominal pain of unknown origin,” Dr. Lotay said.

The Acupuncture Clinic has been offering services since Aug. 18. Patients may be referred by any provider or they may self refer if their insurance allows. Patients may make an appointment by calling (210) 592-0150 and ask for an initial acupuncture appointment. Acupuncture is not covered by many insurance plans.

More information on acupuncture is available at www.medicalacupuncture.org.

SACI supports book of Latinas’ breast cancer experiences

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Francisco G. Cigarroa, M.D., president, visits with Sylvia Fernandez, Ph.D., vignette author (center), and Amelie Ramirez, Dr.P.H., associate director of community research for the San Antonio Cancer Institute. Dr. Fernandez holds the gift she and the other Nuestras Historias authors received.

San Antonio (Oct. 19, 2004) – Among Latina women, breast cancer is the most commonly diagnosed cancer and the number one cancer killer. In a new book, 26 South Texas women who have fought this deadly disease describe the Latina breast cancer experience in their own words.

The book, Nuestras Historias: Mujeres Hispanas Sobreviviendo el Cáncer del Seno (Our Stories: Hispanic Women Surviving Breast Cancer), is a 114-page, full-color publication presented in both English and Spanish. Through the stories of the women, the book relates the influence of the Hispanic/Latino culture on the breast cancer experience and on the coping skills used by many of the Latina women in battling the disease.

The Nuestras Historias project was supported by grants from the San Antonio Cancer Institute (SACI), the San Antonio Affiliate of the Susan G. Komen Breast Cancer Foundation and the Lance Armstrong Foundation. The SACI is a National Cancer Institute (NCI)-designated Cancer Center and represents the combined cancer research programs of The University of Texas Health Science Center at San Antonio and the Cancer Therapy and Research Center. Francisco G. Cigarroa, M.D., president of the Health Science Center, and David Boldt, M.D., interim director of the SACI, praised the strength and courage of the women who shared their stories.

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The San Antonio Cancer Institute’s support of Nuestras Historias, a book to promote awareness of breast cancer in the Latina community, fits right in line with the SACI’s cancer prevention program.

The book was produced by Redes En Acción: The National Hispanic/Latino Cancer Network, a Special Populations Networks initiative supported by the NCI. Headquartered in San Antonio, Redes En Acción is coordinated by Baylor College of Medicine.
“One of the threads that you see running throughout these stories is the amazing resiliency of these Latinas as they cope with a disease that is having a devastating impact not only on their own lives but on the lives of their families and loved ones,” notes Amelie G. Ramirez, Dr.P.H., Redes En Acción principal investigator, associate director of community research for the SACI and professor of medicine at Baylor College of Medicine.

The women’s stories reflect this resilience and resolve not only in fighting the disease, but also in confronting the numerous accompanying issues – fear, depression, financial worries, and the possibility of leaving loved ones behind. Coping skills employed in this day-to-day battle included prayer and faith, as well as reliance on tools such as humor, music, books, dance and even family pets.

“My message now is to cultivate an attitude of gratitude,” said Sylvia Fernandez, Ph.D., one of the vignette authors and a familiar face to Health Science Center faculty and staff from her years in student services. She is enjoying her retirement and savoring time with family and friends. “Life is a precious gift – enjoy each moment,” she said.

The Nuestras Historias stories include practical advice, such as the importance of regular screening, the value of perseverance and education, and the assistance available through local organizations that provide support and help guide patients through the health care system.

Nuestras Historias serves a dual purpose – inspirational and educational – and will be provided free to Latina women diagnosed with breast cancer through organizations such as the Komen Foundation, Alamo Breast Cancer Foundation, American Cancer Society, and Women Involved in Nurturing, Giving and Sharing (WINGS). Copies of the book can be obtained by calling the Komen Foundation at (210) 222-9009.

Controlled release of drugs is topic of 2004 Presidential Lecture

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Dr. Robert Langer, the Kenneth J. Germeshausen Professor of Chemical and Biomedical Engineering at MIT, envisions plastics that can be programmed to assume specific shapes at body temperature, potentially answering a host of medical needs.

San Antonio (Oct. 19, 2004) – An MIT scientist known as the father of biomedical engineering in America made a stop at The University of Texas Health Science Center at San Antonio on Oct. 13 to present the university’s Third Annual Presidential Distinguished Lecture.

Over the past three decades, research by Robert Langer, Sc.D., of the Massachusetts Institute of Technology and his graduate students has led to controlled release of drugs and paved the way for innovations such as the Norplant® five-year contraceptive for women, the nitroglycerin patch for patients with angina, controlled release of insulin for diabetics, depot medicines for schizophrenia patients, and a chemotherapy wafer to extend survival of patients with an aggressive type of brain cancer.

Francisco G. Cigarroa, M.D., Health Science Center president, said Dr. Langer “does not simply follow the crowd” but thinks of new ways to do the impossible. Dr. Cigarroa said students at the Health Science Center represent the promising future of the biosciences in America with potential to be the next Robert Langers.

Dr. Langer noted that controlled-release drug-delivery systems are a vast improvement over traditional medicines that, when they enter the body, start at a low level, reach a peak and go back down. These peaks and valleys of concentration in the body cause problems, he said. He described plastics that have pores to allow controlled release in the body for specific periods.

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Dr. Francisco G. Cigarroa, president (from left), Dr. Julio Palmaz, professor of radiology and inventor of the Palmaz Stent, and Dr. Robert Langer, professor at the Massachusetts Institute of Technology, enjoy conversation after Dr. Langer delivered the 2004 Presidential Distinguished Lecture.

One of the applications of controlled-release drug delivery involves the balloon-expandable stent, which was developed two decades ago by Julio C. Palmaz, M.D., professor of radiology at the Health Science Center. Dr. Palmaz was in the audience. Localized delivery through a drug coating on newer versions of stents is cutting the rate of restenosis, the problem of arteries closing again after the first stent implant. Restenosis occurs in about one-third of patients.

Dr. Langer also discussed tissue engineering, which involves seeding micro-scaffolds with cells to grow new tissue. This could include replacement cartilage for blown-out knees, new skin for burn victims and potential help for spinal cord-injured patients. He showed before and after photos of a burned child who was helped with new skin.

The Presidential Distinguished Lecture has become one of the highlights of the academic year at the Health Science Center. Three of America’s top scientists – Judah Folkman, M.D., of Harvard Medical School, Tom Starzl, M.D., Ph.D., of the University of Pittsburgh Medical Center, and now Dr. Langer – have accepted President Cigarroa’s invitation to visit the Health Science Center and discuss their work.

Dr. Langer, who filed his first patent at age 27, has more than 500 issued or pending patents worldwide. He holds a doctorate in chemical engineering from MIT and completed his postdoctoral fellowship at Boston’s Children’s Hospital, where he worked with Dr. Folkman.

At the close of his address, the Ambassador Scholars from the Health Science Center’s five schools presented Dr. Langer with the Presidential Distinguished Lecture Commemorative Medal, which is inscribed with the Health Science Center seal and honors the lecturer for lifetime contributions to the field of science. “Dr. Langer has given us a lifetime example of academic excellence,” said Lawrence Carter II, the 2004 Ambassador Scholar from the Graduate School of Biomedical Sciences.

Each year, the honored lecturer is invited to leave a personal message in the Presidential Distinguished Lecture Series Commemorative Album. Dr. Langer’s message can be viewed in the Health Science Center’s Dolph Briscoe Jr. Library, where the album is on permanent display.

Swift drop in PSA after radiation therapy called portent of better survival

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San Antonio (Oct. 12, 2004) – New research presented in Atlanta last week suggests the embattled PSA test may yet be a useful tool in the early detection of prostate cancer. Researchers from the San Antonio Cancer Institute (SACI) – a National Cancer Institute-designated Cancer Center that is a partnership of The University of Texas Health Science Center at San Antonio and the Cancer Therapy & Research Center – report that men who had a rapid drop in PSA after receiving radiation therapy were roughly five times less likely to die of the disease within 10 years than men whose PSA levels did not drop so quickly.

“Our claim is that as early as three months after radiation therapy, we can use PSA to separate men into two groups – men who are likely to die of their disease and men who are not so likely,” said Sean X. Cavanaugh, M.D., a SACI member and Ph.D. candidate from the Health Science Center’s department of radiation oncology. He presented the findings Oct. 4 in Atlanta at the 46th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO). In addition to SACI, co-authors of the study are from the Cleveland Clinic and the M.D. Anderson Cancer Center Orlando.

Dr. Cavanaugh and five co-authors examined data from 918 men who received external-beam radiation therapy at the Cleveland Clinic and whose outcomes were already known. The researchers charted disease-specific survival (deaths related to prostate cancer only) and overall survival (deaths from all causes). Men whose PSA levels were lower than 3.0 ng/ml (nanograms per milliliter) three months after therapy had a 96.1 percent disease-specific survival rate, compared to an 81.7 rate for men who had readings above 3.0. The overall survival rate also was higher.

“Those patients who reach lower thresholds faster on the PSA scale have better disease-specific survival and overall survival,” Dr. Cavanaugh summarized. “Our argument is, look, the early PSA matters, and all patients should not be managed the same way.”

Traditionally, two tests have been used to detect prostate cancer – digital rectal examination and prostate-specific antigen (PSA). The PSA test measures a protein that is made generally only by the prostate and that is increased in men with prostate cancer. If either the DRE or PSA is suspicious for prostate cancer, the physician may recommend a prostate biopsy. If prostate cancer is present, treatment options include radiation therapy, hormone therapy and surgical removal of the prostate.

The PSA test has taken its share of hits. This past May, a study revealed that 15 percent of men with supposedly “normal” PSA readings later developed cancer, including some men whose cancers were considered high grade. The lead author of that national study was Ian M. Thompson Jr., professor and deputy chair of surgery at the Health Science Center and director of the SACI Cancer Prevention and Population Science Program. He has said that while PSA still has value, a more-effective way of ascertaining a man’s risk of prostate cancer is needed.

The ASTRO poster presentation is titled “Time and PSA Threshold Modeling Predicts Overall and Disease-Free Survival as Early as Three Months after External Beam Radiation Therapy for Prostate Cancer.” Authors are Dr. Cavanaugh, a medical resident at the Health Science Center who is working on a Ph.D. in human imaging; Patrick Kupelian, M.D., of the Cleveland Clinic and the M.D. Anderson Cancer Center Orlando; Patrick Bradshaw and Dave Fuller of the Health Science Center; Chandra Reddy from the Cleveland Clinic; and Martin Fuss, M.D., Ph.D., of the Health Science Center and the Cancer Therapy & Research Center.

Dr. Fuss is the chairman of Dr. Cavanaugh’s Ph.D. dissertation committee and his mentor in clinical training in radiation oncology. “For the last several years, he has taken a daily personal interest in training me as a scientist and as an oncologist,” Dr. Cavanaugh said.

Cancer institute atrium named for Tom and Nancy Loeffler

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(Left to right) Cyndi Taylor Krier, vice chair of The University of Texas System Board of Regents; Nancy Loeffler; Graciela Cigarroa; Barbie O’Connor; Toby O’Connor; Dr. Sharon Murphy, director of the Children’s Cancer Research Institute; Dr. Francisco G. Cigarroa, president of The University of Texas Health Science Center at San Antonio; and Tom Loeffler, former U.S. representative and former chair of the UT System Board of Regents, unveil a plaque commemorating the naming of the Loeffler Atrium at the Children’s Cancer Research Institute, which is part of the Health Science Center. The O’Connors head the Ambassadors Circle, a group of supporters who have raised $100,000 for the institute.

San Antonio (Oct. 12, 2004) – The University of Texas Health Science Center at San Antonio honored Tom Loeffler and his wife, Nancy, on Oct. 8 with the naming of the Loeffler Atrium at the Health Science Center’s new Children’s Cancer Research Institute. Tom Loeffler is a former member of the U.S. House of Representatives and former chair of The University of Texas System Board of Regents.

“Tom, few people have had the impact on Texas that you have had, not just as a Congressman, but as one of the top leaders in Congress, and not just as an adviser and friend to one president, but to many,” said Francisco G. Cigarroa, M.D., Health Science Center president. He called Loeffler “a great leader for education, and a great leader in the communitywide effort to bring this Children’s Cancer Research Institute to San Antonio.”

Loeffler, a cancer survivor, recalled the doctor’s pronouncement, “You have cancer,” as the “three most deafening words.” He and Mrs. Loeffler are among a group of community leaders who are supporting the new research institute. The naming of the atrium “is a great honor for Nancy and me,” he said.

Cyndi Taylor Krier, vice chair of the UT System Board of Regents, said she and Loeffler both worked for former U.S. Sen. John Tower in the 1970s. She recalled that Loeffler, a University of Texas football player for Darrell Royal and champion cutting horse rider, was about to make his first speech as a candidate for Congress at a home in San Antonio.

“There was a swimming pool in the back yard, and somebody got the idea to have Tom make his first speech on the diving board,” Krier said. “His legs were bending as he spoke. Jim McCrory of the San Antonio Express-News leaned over and said to me, ‘I can see the headline tomorrow: ‘Loeffler makes big splash.’”

That light-hearted remark proved to be prophetic. “He and Nancy have made many big splashes in the years since then,” Krier said.

Sharon Murphy, M.D., director of the Children’s Cancer Research Institute, underscored her commitment to make it a world-class research institute. She invited Ambassadors’ Circle members, who are headed by philanthropists Toby and Barbie O’Connor of San Antonio, to attend future events to hear about science conducted at the institute.

“Since February (2004), we have moved in four research groups (into the institute’s new building at 8403 Floyd Curl Drive),” Dr. Murphy said. “Recently, we have seen the acceptance of three more offers to researchers, one from Harvard, one from the Huntsman Cancer Institute at the University of Utah, and one from Research Triangle Park in North Carolina.” She said they are expected to arrive in January.