Spring is here … and so are seasonal triggers for asthma

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San Antonio (March 26, 2004) – San Antonio this month made the list of the 100 Worst U.S. Asthma Cities, coming in at No. 81. Although cedar fever season is nearly over, a bunch of spring pollens are circulating in full force in the Alamo City, causing breathing problems for many.

“Mountain cedar is bad in San Antonio because it is in such high concentrations, but it can be any pollen that triggers an allergic reaction in the asthmatic individual,” said Autumn Dawn Galbreath, M.D., assistant professor of medicine at The University of Texas Health Science Center at San Antonio and program director of the Health Science Center’s South Texas Asthma Management Program (STAMP). “Molds are another common trigger because so many people are exposed to them. With all the wet weather in the spring, leaks can develop in the home and molds can grow, and that can cause airway flare-ups.”

The STAMP seeks to assist asthma patients, families and their physicians with education, outpatient resources and access to health care personnel. The study is comparing various degrees of intervention to determine whether more aggressive monitoring of asthma, including home visits from health care providers, will prevent attacks and visits to the emergency room. The goal is to provide objective data about asthma disease management to the federal government for effective decision making concerning programs to help Medicare and other beneficiaries.

Dust mites are another strong asthma trigger found in every home, school or office. “They are ubiquitous,” Dr. Galbreath said. “The more dust mite exposure a sensitive patient has, the more difficult it is for him to control his asthma.” As the pollen level increases outside, people move inside to protect themselves, so they spend more time around the dust mites, particularly at home, she said. Eighty percent of patients with asthma test positive for dust mite allergy, according to the American Lung Association.

Cockroaches are a huge asthma trigger, shedding or emitting proteins that can cause allergic reactions. “It’s kind of like cat dander,” Dr. Galbreath said. “The cockroach can spread a microscopic allergen that tears up some people.” In one study in Louisiana, 61 percent of homes had levels of cockroach allergens high enough to trigger asthma.

As pleasant as the South Texas spring is, it is full of potential triggers. These include humidity, rain and temperature changes; increased exercise outdoors; mowing the lawn and other yard work; and walking or playing with the dog. And as we move into ozone action days, the issue of air pollution again moves to the forefront.

“The terrible thing about asthma from the sufferers’ point of view is that there are triggers year-round,” Dr. Galbreath said. “That’s why it’s important to manage your disease 365 days a year. We are confident our study will underscore that importance.”

The STAMP study is looking for Hispanic, African American and Caucasian patients from San Antonio and surrounding counties. To enroll or for more information, please call (210) 567-9700 or toll-free 1-888-699-4877.

“There are very high-quality and effective medications available for asthma and allergies,” Dr. Galbreath stressed. “Multiple studies have demonstrated that they reduce or even eliminate asthma symptoms. The problem for some parts of our population is getting access to them. Therefore some researchers are turning their attention to studies to improve access to care for people with asthma. One group of those researchers is conducting the STAMP study at the Health Science Center.”

Escalante appointed to NIH rehabilitation research committee

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San Antonio (March 30, 2004) – Agustín Escalante, M.D., professor of medicine at The University of Texas Health Science Center at San Antonio, has been appointed to a three-year term on the National Institutes of Health (NIH) Function, Integration and Rehabilitation Sciences Subcommittee. The subcommittee is responsible for reviewing and assigning priority scores to proposals for individual research grants, program projects, career development awards and conference grants submitted to the National Center of Medical Rehabilitation Research.

The center is part of the National Institute of Child Health and Human Development at the NIH. The committee meets every four months in Bethesda, Md. The center uses the committee’s priority scores as the primary criterion in making funding decisions regarding grant proposals.

“Being named to this NIH study section is an honor,” Dr. Escalante said. “In essence, the NIH is asking for our opinion about the merits of grant proposals submitted by investigators throughout the United States and other countries,” he added. “As a member of the committee I will gain enormous insight into the inner workings of NIH funding.”

Dr. Escalante earned his medical degree from the Universidad Nacional Autónoma de México in Mexico City in 1983. He joined the Health Science Center in 1992. Dr. Escalante is a board-certified rheumatologist who diagnoses and treats arthritis, rheumatism, lupus, back pain and related ailments. His research interests include rheumatoid arthritis-related disabilities and outcomes. He also studies ethnic and racial disparities in patients with musculoskeletal diseases.

Miller named to San Antonio Women’s Hall of Fame

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San Antonio (March 30, 2004) – Claudia S. Miller, M.D., M.S., associate professor of family and community medicine at The University of Texas Health Science Center at San Antonio, was inducted into the San Antonio Women’s Celebration and Hall of Fame March 24. Dr. Miller was selected for her outstanding contributions in the category of health professions.

The San Antonio Women’s Celebration and Hall of Fame was established in 1984 to recognize and honor outstanding women who have helped shape San Antonio by contributing their talents and skills to our city’s growth and development.

Dr. Miller has made significant contributions to the field of environmental health, a growing medical specialty. She is particularly concerned with the health effects of low-level environmental exposures, such as wartime exposures and exposures to pesticides, solvents and even implants.

Dr. Miller’s current research interests include the use of special hospital-based facilities called environmental medical units (EMUs). “Just as the microscope was an important tool for understanding infectious diseases, the EMU is needed for understanding the role of environmental exposures in illness,” Dr. Miller said. “The United States needs one of these facilities.”

Dr. Miller is also the creator of the award-winning South Texas Environmental Education and Research (STEER) Center, the only border and environmental health course of its kind in our nation.

“It’s wonderful to be recognized by the community that you’re serving,” Dr. Miller said. “This recognition revitalizes my enthusiasm to continue to work toward solving the problems faced by South Texans.”

Ophthalmologist Orville E. Gordon leaves $150,000 for residents

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Terri Gordon (left), widow of Dr. Orville E. Gordon, and Chris Steussy, Mrs. Gordon’s daughter, are welcomed to the Health Science Center by Dr. W.A.J. van Heuven, professor and chairman of the department of ophthalmology.

San Antonio (March 30, 2004) – Ophthalmology residents at The University of Texas Health Science Center at San Antonio will perpetually benefit from an approximately $150,000 donation left by Orville E. Gordon, M.D., a distinguished clinical faculty member who died in June 2003.

The Orville E. Gordon Endowment for Ophthalmology will establish the Gordon Library in the department of ophthalmology at the Health Science Center. Gordon Prizes already are awarded to residents making the top three presentations at the annual meeting of the Alamo City Ophthalmology Residents Association.

W.A.J. van Heuven, M.D., professor and chairman of the department of ophthalmology, paid tribute to Dr. Gordon at the resident conference held in March. He recalled that Dr. Gordon was born in 1913 in Chicago to Jewish immigrant parents from Lithuania. He received his medical degree from the University of Illinois Medical School before the outbreak of World War II.

Dr. Gordon served under the illustrious Gen. George S. Patton Jr. on the Tunisian invasion, the Sicilian invasion, the Naples battle, the Rome-Arno battle, the Battle of Southern France, the Rhineland battle and several battles in Central Europe. He was with the unit that liberated the prisoners at the Auschwitz Concentration Camp, “which must have been quite an experience for a Jew,” Dr. van Heuven said. He received two Purple Hearts, a Silver battle star, two Bronze battle stars and a Bronze Service arrowhead.

He went on to practice ophthalmology in Chicago and was an attending physician at several hospitals. He also taught anatomy of the eye and orbit at the Northwestern Medical School and later continued this role of educator at the Health Science Center. He also taught at the American Academy of Ophthalmology meetings about the surgical considerations of the orbital facia, “at a time when people were just beginning to figure out the surgical anatomy of the orbit,” Dr. van Heuven said.

Dr. Gordon retired in 1978 to San Antonio and joined the Health Science Center’s clinical faculty. He attended Grand Rounds presentations on campus, taught residents and began attending at the Santa Rosa Low Vision clinic downtown. There he conceived the “macula scope,” a device to measure the vision of macular degeneration patients more accurately. He patented it in 1990. “This instrument has become the foundation for developing more accurate visual acuity measurements for macular degeneration patients, especially to monitor the effect of new drugs on this disease,” Dr. van Heuven said. Dr. Gordon also coined the phrase “fractured vision” to describe the vision of patients with macular degeneration.

Because he loved education and his relationship with Health Science Center faculty and residents, Dr. Gordon wanted to ensure that an endowment existed to support an educational library in the department of ophthalmology. The Gordon Endowment will fund construction of the library, ophthalmology books for faculty and staff to use on a loan basis, and the annual Gordon Prizes at the resident conference.

“This was a wonderful tribute to a man who generously contributed all that he could as a citizen, a husband, a father and a doctor,” said Dr. Gordon’s wife, Terri, who attended the commemorative presentation with her daughter, Chris Steussy.

Researchers collaborate to examine mystery illness that plagues women

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(L-R) Rachele Berria, M.D., research fellow in the department of medicine/diabetes, and Scott Lucidi, M.D., assistant instructor of ob-gyn at The University of Texas Health Science Center at San Antonio, talk to study participant Jessica Garza about what she can expect throughout the Polycystic Ovary Syndrome (PCOS) study. Garza travels from the Valley to participate in the study.

San Antonio (March 23, 2004) – Acne, excessive hair growth, weight gain and infertility – these are some of the devastating side effects of a common female disorder called Polycystic Ovary Syndrome (PCOS). PCOS affects between 3 and 5 percent of women of reproductive age. Although doctors identified the disease in the 1930s, the exact cause remains elusive. Recently doctors have noticed a frightening new trend among PCOS patients. Most have high insulin levels, making them more prone to developing type II diabetes and diabetes-related health problems. The disease could also lead to other serious side effects, including high blood pressure, high cholesterol levels, heart disease and endometrial cancer.

Researchers in the departments of medicine/diabetes, obstetrics and gynecology (ob-gyn), plastic and reconstructive surgery and the Research Imaging Center at The University of Texas Health Science Center at San Antonio are conducting a study to find the cause of PCOS and treatment for its symptoms.

“This is the first time that PCOS has been looked at with such a wide perspective,” said Rachele Berria, M.D., research fellow in the department of medicine/diabetes. Dr. Berria, along with Ralph DeFronzo, M.D., professor and chief of the division of medicine/diabetes, are the principal investigators. They are collaborating with Robert Brzyski, M.D., Ph.D., associate professor of ob-gyn; Scott Lucidi, M.D., assistant instructor of ob-gyn; and Douglas Cromack, M.D., chief of the division of plastic and reconstructive surgery at the Health Science Center. Researchers in the department of molecular medicine at Northwestern University in Chicago are also involved in the project.

“Doctors wonder whether the drug pioglitazone, used to treat patients with type II diabetes, could help alleviate some of the symptoms of PCOS,” Dr. Berria said. “However, more information is needed to determine what exactly causes PCOS, what the mechanisms are through which pioglitazone works, and whether other treatment methods can be used to supplement the positive effects of pioglitazone,” she said.

For women who suffer from PCOS, a cure could mean relief from unwanted hair growth and acne. More importantly, it could mean protection from diabetes, heart disease and endometrial cancer. For women who are infertile, a cure for PCOS could mean the ability to become pregnant in the future.

Health Science Center researchers welcome study participants. Women who have PCOS are encouraged to sign up for the study. Women between the ages of 18 and 40, with a Body Mass Index of 35 or less, who are not on hormone therapy, including birth control, are eligible. Participants will be asked to undergo a series of diabetes tests, sonograms, MRIs, and tissue biopsies, and will be given pioglitazone for a period of four months. Participants will earn $600 after the study is completed.

For more information or to sign up for the study, call Irma Guerra, research coordinator, at (210) 567-4773.

Only 2 months left to enroll in STAR breast cancer prevention study

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San Antonio (March 23, 2004) – Most of us know someone, perhaps even a close loved one, who has had breast cancer. Nearly 200,000 American women a year are diagnosed with the disease and 40,000 deaths are linked to it. Breast cancer is the most common cancer in women.

Women who want to decrease their chances of developing the disease are invited to inquire about eligibility for the STAR breast cancer prevention trial (STAR is short for the Study of Tamoxifen and Raloxifen). More than 18,000 women are participating in the study at 500 sites across the United States through the National Surgical Adjuvant Breast and Bowel Program, a network of researchers supported by the National Cancer Institute. The University of Texas Health Science Center at San Antonio, a participating center since 1999, is offering a final opportunity for patients to enroll in the study through May 20, when enrollment will end.

“We seek to enroll postmenopausal women age 35 or older who are at increased risk for breast cancer because of factors such as present age, number of first-degree female relatives with breast cancer and history of previous breast biopsies,” said Morton S. Kahlenberg, M.D., principal investigator of the trial and associate professor of surgery at the Health Science Center. “Women will benefit by obtaining preventive medications at no cost while taking part in a study that will, No. 1, determine which medication is better in the long run at preventing breast cancer and, No. 2, compare the long-term safety of the two therapies.” An added benefit will be close medical observation throughout the study, resulting in earlier detection of disease should it develop.

Women will be randomized to one of the two treatment arms. STAR participants take the daily dose of either tamoxifen or raloxifen for five years and are followed for two more years after discontinuation of the study medication. After an initial visit to the Health Science Center, all tests and evaluations can be performed by the woman’s own physician.

At least 100 women are needed locally to participate. For more information, call Betty Razvillas, research nurse, at (210) 567-5755 or Mireya Vasquez, data manager, at 567-5759.