News Briefs

Revisions recommended for PTSD

The U.S. Department of Veterans Affairs (VA) should revise how it evaluates and compensates former military personnel for service-related post-traumatic stress disorder (PTSD), according to an Institute of Medicine and National Research Council report issued in May. The report committee was chaired by Nancy Andreasen, ('70 MD), PhD, UI Carver College of Medicine psychiatry professor.

PTSD cases within the VA system jumped almost 80 percent between fiscal years 1999 and 2004, increasing from 120,265 cases to 215,871. PTSD payments increased almost 150 percent over the same period, rising from $1.72 billion to $4.28 billion.

The large increase in PTSD disability claims revealed inconsistencies in compensation awarded nationwide, raising questions about the VA's current ways of assessing and rating PTSD and reimbursing veterans for treatment, the report stated.

'As the increasing number of claims to the VA shows, PTSD has become a very significant public health problem, particularly for veterans of current and past conflicts,' said Andreasen, the Andrew H. Woods Chair of Psychiatry and director of the Psychiatric Neuroimaging Research Center. 'Our review of the current methods for evaluating PTSD disability claims and determining compensation indicates that a comprehensive revision is needed.'

Report addresses the Iowa physician workforce

Iowa's supply of doctors has increased by more than 50 percent over the past 25 years, while the state's population has remained stable, and this growth is expected to continue. On the other hand, relocation, rather than retirement, is the main cause of physician attrition in Iowa.

These are among the findings included in a report issued by leaders of the UI Carver College of Medicine and UI Hospitals and Clinics. The report is the product of a task force established to examine issues related to Iowa's physician workforce.

Members of the UI-initiated task force, led by Peter Densen, MD, executive dean of the College and task force chair, included health care leaders, hospital executives and medical educators from across the state, and was formed in part to address growing discussions at the national level regarding physician shortages in some U.S. regions and specialty areas.

'The task force did not analyze data for every specialty in Iowa, but rather those specialties that members selected as being key priorities in their areas of the state,' Densen noted. 'This report is a first step in gaining a better understanding of the physician supply and demand in Iowa, one that requires collaboration among all the entities that have a stake in this issue.'

The physician supply, demand and trend data came from the Iowa Physician Information System, a one-of-a-kind database that has tracked the state's physician population for more than 30 years. Developed and maintained by the Carver College of Medicine's Office of Statewide Clinical Education Programs, the database is extremely useful in that it contains actual, not estimated, physician-supply figures and available practice opportunities.

Densen emphasized that the quality of medical care Iowans receive is outstanding and among the best in the United States. 'In terms of quality of care provided to its Medicare patients, for example, studies have ranked Iowa sixth among states in quality. This exemplary outcome is even more extraordinary given that Iowa's Medicare reimbursement rates from the federal government are among the lowest in the nation,' Densen noted. 'What that means is that to date, any physician workforce challenges that might exist have not affected the quality of care Iowans receive.'

Iowa and other rural states face challenges related to the uneven geographic distribution of physicians within the state, the mix of specialty-trained physicians, and less favorable reimbursement for physician services. While the state's physician supply is strong, the College, in recognition of anticipated work force challenges, has increased its class size by six students. This fall, the class size will be 148 students.

The complete report is available online at the Carver College of Medicine Administration Web site.

Rodnitzky— head of neurology

Robert Rodnitzky, MD, ('70 R), has been named head of the Department of Neurology in the UI Carver College of Medicine and University of Iowa Hospitals and Clinics.

Rodnitzky, who has been a UI faculty member for more than three decades, has served as interim department head since July 2005. He is a professor of neurology and director of the Movement Disorders Division.

He is an expert on movement disorders, including Parkinson's disease and Huntington's disease, and has been a leading figure in developing experimental therapies for patients with these conditions. He earned a medical degree from the University of Chicago in 1966.

Bringing real-world scenarios

The Clinical Beginnings program, a week-long orientation for new third-year students beginning clinical rotations in the UI Carver College of Medicine, has implemented a bold new strategy to introduce teamwork into the curriculum. The program involves not just medical students, but also nursing, pharmacy, physician assistant, physical therapy and social work students. Until now, medical students received no formal preparation for working in teams.

The students worked in groups of seven to eight to address hypothetical cases designed to bring each member's professional knowledge and perspectives into play. 'What that represents is the real-world interaction between these different professionals,' said Joel Gordon, MD, professor of internal medicine and director of curriculum for the M3 and M4 years. 'When a student gets on a team that involves a pharmacist or a physician assistant, he or she will know what their roles are.'

Also for the first time, Clinical Beginnings incorporated programming to acquaint medical students with the core competencies they will need to master as resident physicians. The competencies, as enumerated by accreditation and medical specialty boards, address patient care, medical knowledge, communication skills and other areas.

AGA honors Summers

The American Gastroenterology Association (AGA) presented Robert Summers ('65 MD, '68 R, '70 F), professor of internal medicine at the UI Carver College of Medicine, with an AGA Mentors Research Scholar Award from the AGA Foundation for Digestive Health and Nutrition for his exemplary contributions to gastroenterology through mentoring.

An endowed Research Scholar Award will be established in his and this year's co-honorees' names and presented once every three years in perpetuity to an outstanding young digestive disease researcher.

Summers is the James A. Clifton Professor of Medicine in Internal Medicine and director of clinical programs for the UI Division of Gastroenterology/Hepatology.

Mason new UI president

The Board of Regents, State of Iowa, named former Purdue University Provost Sally Mason, University of Iowa's 20th president in June. Her appointment began August 1.

Mason succeeds David Skorton, who left the UI to become president of Cornell University in New York. Gary Fethke, retired dean of the UI Henry B. Tippie College of Business, has served as interim UI president since Skorton's departure.

'I am the first person in my family to receive a university degree,' she said. 'And now I am the president of one of the world's great universities. Standing here before you today, I can't help but wonder what my parents would think if they could see me now. I think they would be very proud. Very amazed. But also very proud.' Mason said her first priority as president is to meet with students, faculty, staff and administrators to learn more about the university she'll be leading. She also plans to meet with alumni, friends of the University, Iowans and community leaders.

A native of New York City, Mason received her bachelor's degree in zoology from the University of Kentucky in 1972, a master's degree from Purdue University in 1974, and a PhD in cellular, molecular, and developmental biology from the University of Arizona in 1978. After two years at Indiana University in Bloomington doing postdoctoral research, she joined the University of Kansas in 1981. During the span of her 21 years at KU, she served as a professor in the Department of Molecular Biosciences, acting chair of the Department of Physiology and Cell Biology, associate dean in the College of Liberal Arts and Sciences, and finally, dean of the College of Liberal Arts & Sciences.

In 2001, Mason returned to Purdue, where she was professor of biology and provost.

UI receives blood pressure grant

The Center on Functional Genomics of Hypertension in the Cardiovascular Research Center, a multidisciplinary UI Carver College of Medicine research program, has received a five-year, $10 million grant from the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH) to study the regulation of blood pressure in essential hypertension and the mechanisms causing hypertension associated with obesity.

With this latest funding, the program, previously known as a Specialized Center of Research on the Genetics of Hypertension, has received more than $42 million to date in NIH support.

Curt Sigmund, PhD, professor of internal medicine and molecular physiology and biophysics, and director of the Center on Functional Genomics of Hypertension, is principal investigator of the grant.

Hypertension remains a serious health problem worldwide, particularly in Western societies where the incidence of hypertension and obesity-associated hypertension continues to rise. The new research program aims to make fundamental discoveries in hypertension and obesity-associated hypertension that will improve human health. The researchers will explore how two important signaling hormones, angiotensin and leptin, act in the brain to control blood pressure and body weight regulation, and how abnormal signaling may promote hypertension and obesity-associated hypertension.

The research program is comprised of three projects complemented by two scientific cores providing expertise in neuroanatomy and genetics. Sigmund, Allyn Mark ('57 BA, '61 MD, '67 R, '69 F), the Roy J. Carver Professor of Medicine, and Kamal Rahmouni, PhD, assistant professor of internal medicine, are lead investigators. Program co-investigators include Alan Kim Johnson, PhD, the F. Wendell Miller Distinguished Professor of Psychology and Pharmacology; Val Sheffield, MD, PhD, professor of pediatrics and a Howard Hughes Medical Institute investigator; Baoli Yang, MD, PhD, assistant professor of obstetrics and gynecology; and Martin Cassell, PhD, professor of anatomy and cell biology.

Conference fosters creative work

The University of Iowa is world renowned for its creative writing programs and its medical teaching, research and patient care. Now members of the two communities are coming together to explore their common territory and shared purpose.

An April conference, 'The Examined Life: Writing and the Art of Medicine,' brought physicians, authors, medical educators, publishers and others from across North America to the UI Carver College of Medicine. Participants attended workshops to learn about a broad spectrum of projects in medicine and writing, and could also attend readings and take part in writing workshops.

'The conference was an opportunity for dialogue' among participants, said Margaret LeMay-Lewis, coordinator of the College's Writing Program and herself a poet and graduate of the Iowa Writers' Workshop. The conference'the first of its kind in the Midwest'was an outgrowth of the Writing Program's work to foster the role of writing, arts and humanities in medical education, she noted.

Across the country, medical educators, clinicians and others are recognizing the benefits of narrative and reflective writing for physicians, medical students and patients.

Project 3000 offers hope

The UI John and Marcia Carver Nonprofit Genetic Testing Laboratory has joined the team effort of Chicago Cubs Charities, Cubs' first baseman Derrek Lee and his 1st Touch Foundation, and Boston Celtics CEO and co-owner, Wyc Grousbeck, to raise awareness of Leber's Congenital Amaurosis (LCA) and Project 3000, an effort to find every person in the U.S. with the blinding eye disease. LCA is an inherited disease that strikes during infancy or early childhood and has partially blinded Lee's daughter. Grousbeck also has a child with LCA.

Project 3000 refers to the number of people in the U.S. with LCA. Nearly 500 Americans with LCA already are known; 2,500 people in the nation remain to be identified.

In most cases, the disease affects children who are otherwise completely healthy. At least nine different genes are currently known to cause the disease and as a group these genes are responsible for about 65 percent of all cases. It is not currently possible to restore vision to affected people although this has been accomplished in animals affected with similar disorders. It is expected that treatments will soon be ready for testing in humans. For most of these clinical trials, knowledge of the disease-causing gene will be important.

Through Project 3000, every person identified in the U.S. affected by LCA will be offered state-of-the-art genetic testing through the Carver Nonprofit Genetic Testing Laboratory, directed by Edwin Stone, MD, PhD, ('89 R, '90 F, '92 F), professor of ophthalmology and visual sciences and Howard Hughes Medical Institute investigator. Through the testing service, UI experts will give people with LCA more accurate information about their disease. For affected families who lack health insurance, philanthropic donations will be used to reduce the cost of the testing.

The goals of Project 3000 are to provide hope and accurate information, find the disease's remaining genes and cures, and make a genetic test for LCA available to all who might benefit from one. For more information about the search for people with LCA, visit the John and Marcia Carver nonprofit Genetic Testing Laboratory.

PT Association honors Sluka

The American Physical Therapy Association (APTA) selected Kathleen Sluka, PhD, professor in the Graduate Program in Physical Therapy and Rehabilitation Science in the UI Carver College of Medicine, as the 2007 recipient of APTA's Marian Williams Award for Research in Physical Therapy. She received the award at the APTA annual conference in June.

The award was established to recognize individuals who have performed continuous and outstanding basic, clinical, and/or educational research pertaining to physical therapy. Sluka was chosen for her contributions to the scientific basis of physical therapy and muscle pain.

A UI faculty member since 1996, Sluka is the director of the UI Neurobiology of Pain Laboratory and a faculty member in the UI Pain Research Program. She and her colleagues study the peripheral and central nervous system to learn more about neuronal responses to muscle and joint pain. In 2006 she received a five-year, $1.7 million grant from the National Institutes of Health to study the role of acid-sensing ion channels in muscle using an animal model of fibromyalgia. The investigators hope to understand the mediators and molecules that initiate development of chronic muscle pain, which could lead to new treatment strategies aimed at treating musculoskeletal pain.

Mohler named Pew Scholar

Peter Mohler, PhD, assistant professor of internal medicine and molecular physiology and biophysics in the UI Carver College of Medicine, has been selected as a 2007 Pew Scholar in the Biomedical Sciences. He joined the UI faculty in 2006.

Mohler is one of just 20 scientists nationwide to receive the prestigious four-year, $240,000 award from the Pew Charitable Trusts and the University of California, San Francisco.

Mohler's laboratory is focused on understanding the molecular mechanisms underlying the function of excitable cells, including heart muscle cells. Specifically, he is investigating ankyrins a family of proteins crucial to the healthy function of excitable cells.

In 2003, Mohler and colleagues found that ankyrin-B is critical for proper cardiac function and that one form of inherited arrhythmia is caused by dysfunction in ankyrin-B in heart muscle cells. Mohler will use his new funding from the Pew Trusts to expand his research program to focus on other excitable cells including pancreatic cells that secrete insulin and neurons.

Ponseti receives national award

Children's Miracle Network honored Ignacio Ponseti, MD, ('44 R), professor emeritus of orthopaedics and rehabilitation in the UI Carver College of Medicine and affiliated with University of Iowa Children's Hospital, during its national meeting.

Ponseti, 93, is world-renowned for pioneering and developing a non-surgical treatment for clubfoot more than 50 years ago that involves gentle, manual manipulation of the child's foot and application of toe-to-groin plaster casts. The casts are changed weekly after a clinician manipulates softened foot ligaments to gradually achieve near-normal muscle and bone alignment. Ponseti describes his method as 'just gently bringing the foot, without hurting the child, back to normal.' Following the casting process, a brace is used to keep the feet in the proper alignment.

Despite the success of the 'Ponseti method,' surgery remained the preferred treatment among orthopaedic specialists for decades. However, research showed that people who underwent surgical correction of clubfoot as children often experienced stiff, painful feet as young adults, severely limiting their mobility and adversely affecting their quality of life.

Physician, student receive award

Michael B. Cohen, MD, professor and head of the UI Carver College of Medicine Department of Pathology, and fourth-year medical student, Sally Leitch ('07 MD) were selected to receive the 2007 Leonard Tow Humanism in Medicine Award from the Arnold P. Gold Foundation. Since 1998, the College has been one of a number of medical schools nationwide that participates in this program.

The Leonard Tow Humanism in Medicine Award recognizes and honors faculty members and students who demonstrate the highest standards of compassion and sensitivity in their interactions with patients, their colleagues and public.

Cohen, who is the Richard G. Lynch Chair in Experimental Pathology, is an internationally renowned diagnostic cytopathologist, urologic pathologist and prostate cancer researcher. He has garnered respect from UI medical students for his personal approach to mentoring and his demonstrated excellence in humanism and leadership.

Cohen joined the UI faculty in 1990 and became head of pathology in 1999.

Leitch was honored for her compassion, her ability to connect with patients and their families, and her professionalism. She frequently volunteers for the Mobile Clinic, an interdisciplinary project started by the College and other UI health sciences students to serve underserved populations in Iowa City and surrounding communities. She also helps the medically underserved by volunteering in Guatemala, where she worked with local health care professionals. Leitch returned to Guatemala in February with the 'Miles of Smiles' team that repaired cleft lips and palates.

Mutation linked to autism

University of Iowa researchers have learned more about a genetic mutation that contributes to autism. The investigators now know more about how the mutation causes problems with a specific gene and are testing for additional mutations of the same gene in other people with autism. The mutation occurred in sperm cells of a father, who does not have autism, but passed the condition on to two of his children.

Earlier this year, UI Carver College of Medicine researchers and collaborators were part of an international team that identified, among other findings, deletions in a gene called neurexin 1, which caused the two cases of autism in one family. The UI researchers and collaborators were Thomas Wassink, MD, ('97 R, '98 F, '99 F), associate professor of psychiatry; Val Sheffield, MD, PhD, UI professor of pediatrics and a Howard Hughes Medical Institute investigator; Kacie Meyer, a UI graduate student in Wassink's laboratory; and former UI investigator Joseph Piven, MD, now professor of psychiatry at the University of North Carolina (UNC) and director of the UNC Neurodevelopmental Disorders Research Center.

'Genes with the most compelling evidence of causing autism appear to be components of a specific kind of neuronal connection, or synapse, called the glutamate synapse. The gene neurexin 1 was the fourth of these genes to be identified, and it is a scientifically interesting mutation because it wasn't found in either of the parents, who do not have autism,' Wassink said.

Instead, the mutation is a germline mosaic--meaning the deletion occurred only in the father's sperm cells when he himself was in gestation. As result, the father did not have autism, but his two children, both daughters, inherited from him a chromosome that was missing a small piece of DNA that contained neurexin 1 and have autism.

Because of this missing DNA, certain proteins cannot form that normally contribute to glutamate synapses and, by extension, normal development.