Asthma disease management study opens to Austin residents

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San Antonio (June 29, 2004) – A four-year asthma disease management study at The University of Texas Health Science Center at San Antonio is being expanded to include Travis and surrounding counties, the study director, Autumn Dawn Galbreath, M.D., M.B.A., assistant professor of medicine at The University of Texas Health Science Center at San Antonio, said today.

“We will be partnering with the Community Care Services Department of the city of Austin,” Dr. Galbreath said. “The department has multiple clinics throughout Austin and we will be using space in those clinics to see our patients.” Nearly 50,000 people in Travis County have asthma, including 10,600 children and 37,900 adults, she said.

Through the support and leadership of U.S. Rep. Henry Bonilla, the asthma study received $2.5 million earlier this year from the U.S. Department of Health and Human Services and $2.8 million in 2003. The study, which randomly places participants into three groups receiving different levels of intervention to help them monitor their asthma, is expected to benefit the daily lives of 1,053 individuals from San Antonio and now Austin. It will help the federal government, which administers Medicare, Medicaid and military dependent programs, to make decisions about disease management services for chronic diseases such as asthma.

“This is the largest disease management study in the country and one of the only ones being done at an academic medical center,” Dr. Galbreath said. “The point of this study is to test the concept of disease management of asthma in an objective fashion so that tax dollars can be spent in an educated way.”

The study intentionally targets the underserved, minority population – Medicare and Medicaid recipients and military dependents – and this is a population that has not been part of previous disease management research, Dr. Galbreath said.
The purpose is twofold: to improve the health of patients by preventing adverse events related to their asthma and to reduce the health care costs associated with emergency room visits and hospitalizations.

The co-principal investigators from the Health Science Center are Gregory Freeman, M.D., professor of medicine; Jay Peters, M.D., professor of medicine; and Stephen Inscore, M.D., associate professor of pediatrics. Associate investigators are David Shelledy, Ph.D., professor and chair of respiratory care; Pamela Wood, M.D., professor of pediatrics; Terry LeGrand, Ph.D., associate professor of respiratory care; and several physicians in the military.

The three subcontractors are National Jewish Medical and Research Center, Denver, Colo., which provides telephone and mail patient support; Pulmonary Therapies, San Antonio, which sends licensed respiratory therapists to do home visits; and the Altarum Institute, San Antonio office, which provides data analysis support.

Individuals and families in Austin and surrounding counties may call the toll-free number, 1-888-699-4877, for more study information.

UT Health Science Center Fertility Center listed among best in U.S.

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The cover of the July issue of Town & Country magazine.

San Antonio (June 29, 2004) – The South Texas Fertility Center at The University of Texas Health Science Center at San Antonio is recognized as one of “America’s Top Infertility Clinics” in the July issue of Town & Country magazine. The article lists Robert S. Schenken, M.D., professor and chairman of the department of obstetrics and gynecology at the Health Science Center, as a noted physician who sees patients at the San Antonio center. The Health Science Center is the only center in the Southwest and among only 12 centers to make the list.

The other centers include those at Johns Hopkins, the Cleveland Clinic and Stanford.

“It is a significant honor to be included with these centers that are recognized around the country and around the world as the best centers for reproductive endocrinology and infertility (REI),” said Craig A. Witz, M.D., associate professor of obstetrics and gynecology and director of the REI division. “All of the personnel in our center, from nurses to physicians to laboratory personnel to secretaries, take this work very seriously. The people who come to us feel they have received personalized care from an entire health care team that cares for them.”

What should patients look for in choosing a top-notch center? “Programs should offer a broad range of services and not specialize in just one type of treatment,” said Robert Brzyski, M.D., Ph.D., associate professor of obstetrics and gynecology at Health Science Center and director of the in vitro fertilization (IVF) program at the South Texas Fertility Center. “Patients also should look for their physicians to participate in professional organizations such as the Society for Assisted Reproduction Technology and to be certified by the American Board of Obstetrics and Gynecology with subspecialty certification in reproductive endocrinology and infertility. That reflects extensive training and experience. Ongoing certification on an annual basis ensures continuing quality.”

All of the Health Science Center faculty physicians in the South Texas Fertility Center – Drs. Schenken, Witz and Brzyski – have the REI subspecialty certification.

The fertility center averages 340 patient visits a month, said Jana Lee Normandin, clinic manager. The center offers comprehensive diagnostic and therapeutic options for couples. Treatment includes endoscopic surgery, microsurgery, ovulation induction and various methods of IVF, including with sperm donation and/or egg donation. The fertility procedures are performed on site.

“Our Health Science Center affiliation affords us greater opportunities for collaboration in reproductive research,” Dr. Brzyski added. “One specific area is research in polycystic ovary syndrome, a condition that is associated with multiple health risks, including infertility.”

Hensler named to international Serotonin Club Council

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San Antonio (June 29, 2004) – Julie Hensler, Ph.D., associate professor in the department of pharmacology at The University of Texas Health Science Center at San Antonio, recently was elected as a U.S. councilor to the Serotonin Club, an international organization that promotes research into serotonin.

The biology of serotonin, a neurotransmitter that enables communication among brain cells, is a crucial topic in neuroscience. Medications such as fluoxetine (Prozac®, registered trademark of Eli Lilly & Co.) treat depression and other conditions by altering serotonin activity in the brain. Dr. Hensler is among 11 of the world’s foremost scientists who were invited to serve on the Serotonin Club Council, including five from Europe, four from the United States and two from other parts of the world.

Dr. Hensler received her Ph.D. from Northwestern University. “Because the treatment of many psychiatric disorders involves long-term pharmacological intervention, I am interested in the molecular mechanisms by which neurotransmitter receptor systems compensate (or regulate) following drug treatment,” she said. “My research group has focused primarily on the regulation of serotonin receptor function. The serotonergic system in the brain has been implicated in substance abuse and addiction, as well as many psychiatric disorders. This is really quite an honor to serve on the Serotonin Club Council with such esteemed colleagues.”

Dr. Hensler’s laboratory has received continuous research funding from the National Institute of Mental Health. Her work also has been supported by awards from the National Alliance for Research on Schizophrenia and Depression, the Pharmaceutical Research and Manufacturers of America Foundation, the San Antonio Area Foundation and the South Texas Health Research Center. Her term on the Serotonin Club Council is for four years.

Agricultural rescue class to prepare volunteer firefighters, emergency responders

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San Antonio (June 22, 2004) – Emergencies involving people trapped in farm equipment require specialized knowledge and skills. The department of emergency medical technology (EMT) instructors and students from The University of Texas Health Science Center at San Antonio, in conjunction with the East Central Citizens Forum, are sponsoring an agricultural rescue class to train volunteer firefighters and emergency responders how to extricate victims caught in farm equipment. The class is from 8 a.m. to 5 p.m. Saturday, June 26, at the East Central High School agricultural barn, 7173 FM 1628.

Extrication specialists from the San Antonio Fire Department’s Station 11 rescue team, who are experts with farm equipment operation, are volunteering to teach the participants how to safely work around farm equipment, how to shut the equipment down and, if necessary, lift, move or rip it open to get to a victim. Tractors, hay bailers, posthole diggers and other equipment for the program have been donated by Bill’s Tractor Supply and Southeast Bexar County citizens.

“Working in and around farm equipment is a highly specialized skill and is not taught on a regular basis,” said Geoffrey Smith, EMT instructor at the Health Science Center and program organizer, who has been in emergency medical services for 14 years. “The volunteer agencies do not get the training opportunities that the big municipalities do and I want to increase public awareness about agricultural safety.”

Courses in how to get an ambulance to a rural location more effectively, snake bite treatment and basic first aid using household products will also be included in the class.

Clinical laboratory sciences graduate enjoys toxicology work

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San Antonio (June 15, 2004) – She’s quick to point out that her job isn’t quite as glamorous as the forensic detective work depicted on CBS-TV’s “CSI.” But Tiffany Flowers, a 2003 graduate of the clinical laboratory sciences graduate degree program in toxicology at The University of Texas Health Science Center at San Antonio, is making her own mark in the Bexar County Toxicology Laboratory and Medical Examiner’s Office.

Among other duties, Flowers is identifying suspect chemicals and drugs, carbon monoxide poisoning and signs of drug abuse in autopsy specimens at the Bexar County Forensic Science Center. She recently was profiled in the Texas Association for Clinical Laboratory Science newsletter.

Flowers is one of six toxicology chemists in the Toxicology Lab and ME’s Office. According to the newsletter article, the Forensic Science Center “is one of the busiest forensic centers in the state and performed 300 autopsies in the first six weeks of the year.”

Her master’s degree thesis was a study of gamma-hydroxybutyric acid (GHB), which has been called a “date rape drug” because it may be used for drug-facilitated sexual assault, said her project mentor, George B. Kudolo, PhD, associate professor and coordinator of the graduate toxicology program in the Health Science Center’s department of clinical laboratory sciences.

“Sometimes these incidents end in death and an important issue is the interpretation of the postmortem results if GHB is present,” Dr. Kudolo said. “This is because there is a strong possibility of a postmortem production of GHB in the body, even in the absence of prior consumption before death. So, if postmortem GHB is found, it is important to know the contribution of the body’s own production of GHB.”

Flowers assessed three methods of measuring GHB in blood and urine samples. Each yields different analytical results. “Identifying the most reliable methods will obviously be very important for forensic toxicologists, who must interpret these results and help medical examiners determine the cause of death in a ‘drug-facilitated’ sexual assault case,” Dr. Kudolo said.

“My data fell in line with other studies that have been done,” Flowers said. “A method called liquid-liquid TMS proved to be superior to the other methods. In the forensic toxicology community, this should be very helpful.”

GHB is considered a schedule one controlled substance, which means possession is a crime. Therefore, the outcome of these forensic tests could make the difference between incarceration and freedom for living suspects.

“Tiffany’s findings are important contributions to understanding this date rape drug’s effects and its detection,” said Shirlyn McKenzie, Ph.D., professor and chair of the department of clinical laboratory sciences. The department is part of the School of Allied Health Sciences at the Health Science Center.

Flowers is helping to develop the quality assurance plan for the Toxicology Lab. Her first contact with the lab came when she completed an internship there during her master’s degree program. The Bexar County Forensic Science Center is located on the Health Science Center’s Central Campus in the South Texas Medical Center.

Online course in pain management reaches Latin America

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San Antonio (June 8, 2004) – An online pain management course written in Spanish and created in the department of anesthesiology at The University of Texas Health Science Center at San Antonio was rolled out this spring to a potential audience of 25,000 general practitioners, internists, rheumatologists, psychiatrists, neurologists, orthopedists and other physicians from Mexico to Argentina.

“Pain is the fifth vital sign,” said Marcos A. Zuazu, M.D., the course’s director and associate professor of anesthesiology at the Health Science Center. (Temperature, respiration, pulse and blood pressure are the others.) “This course provides criteria to establish a diagnosis of pain. Exams after its three modules test the physicians’ knowledge of the management of pain, and the tests are real doozies. We have made this relatively hard.”

Pain management fellows Bert Blackwell, M.D., and Greg Skiba, M.D., an anesthesiologist, wrote modules along with Dr. Zuazu. Prous Science, an international medicine and life sciences information provider headquartered in Barcelona, Spain, developed the online course from the core content. Prous Science, which has a subsidiary in Buenos Aires, Argentina, is coordinating with representatives of Merck & Co. Inc. to provide course access codes to physicians in Latin America. The course is free to physicians and is linked to the Merck Web site.

“The Health Science Center is breaking ice, because there is nothing specially designed for the Latin American physician in terms of a continuing education program with a certificate to provide educational material on this topic,” Dr. Zuazu said.

The course certificate is granted through the department of anesthesiology, and Dr. Zuazu credits Joseph J. Naples, M.D., professor and chair of anesthesiology and the R. Brian Smith, M.D., Professor at the Health Science Center, with supporting this endeavor. Martha A. Medrano, M.D., M.P.H., assistant dean for continuing medical education and director of the Health Science Center’s Medical Hispanic Center of Excellence, also lent her support. Becky Holloway, Web specialist in the office of multimedia and Web services, developed the course Web site for exam taking and crediting of scores to physicians.

“This is very well done,” Dr. Naples said. “It is very practical and challenging, timed and graded. It is a high-tech online course in Spanish. This will be useful for the physicians’ treatment of pain. Dr. Zuazu is the initiator of this and is well known in Spain and Central and South America.”

Percy Zambrana, M.D., a visiting anesthesiologist from the University of Chiclayo in Northern Peru, said he is trying to develop a pain clinic at a hospital in Chiclayo. “The course is a great development,” he said. “We need this course. We have only a small group of doctors in the area of pain.” Dr. Zambrana has returned to Chiclayo to continue his work.

“Our Hispanic Center of Excellence and Health Science Center are reaching beyond South Texas to provide high-quality, much-needed opportunities for our neighbors in South and Central America,” Dr. Medrano said.

The course is called the “Curso de Manejo del Dolor” (Course for Management of Pain).