Posts filed under ‘Features’
Changing the concussion culture in the NFL
Robert Harbaugh, M.D., ’78 has a unique vantage point as a member of an NFL subcommittee studying the long-term effects of concussions on professional football players. First, Harbaugh is a well published and highly regarded neurosurgeon who serves as director of the Penn State Institute of the Neurosciences and chair of the Department of Neurosurgery. That’s the professional part.
Second, he’s lived the experience of watching his own son play football, and has a 12-year-old transitioning from flag to tackle football. That’s the parent perspective. Third, Harbaugh himself played football in high school and college, and suffered three concussions along the way. That’s the personal piece.
All three reasons have enticed him to serve—unpaid, with no perks, no Super Bowl tickets, and no chance to mingle with football legends—as chair of this NFL subcommittee, which is part of a larger committee established by NFL Commissioner Roger Goodell to study head and spine injuries in football players. Harbaugh’s group is charged with developing a comprehensive database that will gather and analyze information over time to help determine what factors lead to acute and delayed neurological injuries in NFL players. (more…)
Interview study designed to investigate association between mode of first delivery and subsequent fertility
Kristen Kjerulff, Ph.D.
Ongoing research at the Penn State Hershey Medical Center explores the effect of caesarian section on subsequent fertility. In previous studies conducted in countries throughout the world it was discovered that mothers who deliver by caesarian section are less likely to have subsequent children for reasons that are not clear. “This is a mystery that we need to understand,” said principal investigator Kristen H. Kjerulff, Ph.D. Most researchers in this subject area survey women retrospectively—after the birth has taken place—or review very large data sets that do not indicate the reasons why the caesarian section option was chosen and why the women did not have more children. Kjerulff’s First Baby Study is novel in that it interviews pregnant women before they have their first baby and then at multiple points over the course of a three-year period, to see how mode of first delivery (cesarean, instrumental, or vaginal) affects subsequent childbearing and, if so, why.
This study has enrolled more than 3,000 women from all parts of the Commonwealth of Pennsylvania. Kjerulff and her colleagues sought a diverse population across socioeconomic strata, racial and ethnic groups, and insured/uninsured populations. They recruited participants from hospital ob-gyn clinics; Nurse-Family Partnership programs; child birth education classes; low-income patient clinics; private ob-gyn practices; hospital tour groups; Women, Infants, and Children (WIC) program offices; and Medicaid programs. Researchers from the various hospitals around the state helped enroll and consent women interested in participating in the study, reviewed data, and provided advice on various aspects of the study.
The Department of Humanities: Once a ‘curiosity,’ now an ‘awakening’
When medical students from Penn State College of Medicine make their Friday call at the Downtown Daily Bread soup kitchen in Harrisburg, it’s more than an exercise in providing counsel and comfort to the homeless. The brainchild of professor Cheryl Dellasega, Ph.D., this outreach illustrates one way the institution reaches “far beyond our boundaries,” according to Daniel Shapiro, Ph.D., chair and professor of the Department of Humanities at the College of Medicine.
The students’ service is part of a larger goal of the Department of Humanities and the College of Medicine to produce compassionate healers, or, as Shapiro says, “clinicians and scholars who are not only technologically sophisticated but also sophisticated about matters of the human body, mind, and spirit.”
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The Department of Humanities at Penn State Hershey has been a model for other medical schools. Founded in 1967, the College of Medicine is young by medical school standards. But it’s also a pioneer as the first U.S. medical school with a Department of Humanities, a fixture since its inception. “This department has really been a springboard for founding other kinds of programs and centers and departments in many medical schools across the country,” says Philip Wilson, Ph.D., historian of medicine and science and professor of humanities.“What was first a curiosity became an awakening.” The founder of the Department of Humanities is considered a pioneer in humanistic medicine—E. A.Vastyan, who died in 2010 in Harrisburg. Vastyan was an Episcopal priest and chaplain at the University of Texas Medical Branch in Galveston when founding Dean, George Harrell, recruited him to Hershey. “The fact that this institution was founded with a humanities department is one piece of data to support that that mission has been incorporated into the heart of the place from the start,” says Shapiro. (more…)
Learning together increases open communication and mutual respect
Before medicine became so specialized or new technology so freely available, the team delivering care to a patient was small and able to communicate easily. Today, multiple professionals, including everyone from emergency physicians, surgeons, and nurses to social workers, pharmacists, and rehab personnel, must work together to do what is best for the patient. “Medicine has come to the point where it has so many moving parts,” says Paul Haidet, M.D., M.P.H., ’91, ’94R, director of medical education research, Penn State College of Medicine. “What needs to happen is people seeing how their role fits in the big picture and coordinating with others in that picture to benefit the patient.”
That is exactly what the College of Medicine and School of Nursing had in mind when they collaborated on a new project to improve health care delivery. Initially funded through a Josiah Macy, Jr. Foundation grant, the project brings together fourth-year nursing students and first-year medical students in a series of workshops that focus on safety and quality issues. The need for this type of interprofessional education came out of recent studies related to quality improvement, according to Mary Beth Clark, R.N., Ed.D., assistant professor of nursing, School of Nursing—Penn State Hershey Campus Coordinator. “More and more attention is being paid to patient safety and quality improvement. When there is a medication error, it is not really just one person’s issue. Many times it is a system-wide error that leads to the mistake,” explains Clark, who is responsible, together with Haidet, for the coordination of the interprofessional quality and safety curriculum in health sciences education. “You have to look at the system and how it is designed to help people interact and communicate with each other.The idea grew that this should start in the education process.” (more…)
Trailblazer C. Bart Rountree, M.D., provides hope for liver cancer patients
According to the World Health Organization, hepatocellular carcinoma (HCC), commonly referred to as liver cancer, ranks third behind lung and stomach cancers in numbers of cancer deaths worldwide. Liver cancer is also one of the few cancers that are on the rise in the United States. Although the liver has the ability to completely regenerate itself during short-term injury, once cancer appears, prognosis for recovery in adults is not good. Researchers led by C. Bart Rountree, M.D., at the College of Medicine, seek to extend the lives of adults who suffer from liver cancer by providing personalized, targeted therapies based on manipulation of liver proteins CD-133 and c-Met. These proteins are found on the surface of stem cells and cancer stem cells in the liver.
“The five-year survival rate of HCC patients is only 5 percent when diagnosed after metastasis. Sorafenib, the only approved medication for advanced HCC, benefits patients with an extra two months survival,” said Rountree. “We aim to use our research findings to design smarter therapies for the patients with advanced disease and provide hope for better care.”
Rountree is an assistant professor of pediatrics at the College of Medicine with a joint appointment in the Department of Pharmacology. His areas of expertise are hepatology, nutrition, and pediatric gastroenterology. Rountree’s educational background includes a medical degree from the University of Texas at San Antonio and a residency and fellowship at the Children’s Hospital of Los Angeles. His current research interest is not where he started. His research focus began to change in 2003, when Rountree was given the opportunity to conduct embryonic stem cell research while serving as a pediatric gastroenterology fellow in Los Angeles. His initial objective was to cure liver disease in children by using stem cells. After about two years of work, he discovered that there may be a link between liver stem cells and cancer during chronic liver injury. He decided that—using the proposed stem cell-based therapies—he would be unable to surpass the more than 90 percent success rate of liver transplants in children, so he chose to pursue further his stem cell research to find alternative HCC therapies. (more…)
Penn State researchers make strides toward early diagnosis of Parkinson’s disease
The casual observer barely notices how a person’s arms swing when walking, but to Penn State Hershey Medical Center neurologist Xuemei Huang, M.D., that natural movement can speak volumes about a person’s neurological health.
Specifically, Huang and her team of clinicians, engineers, kinesiologists, and computer scientists at Penn State have made the study of gait the focus of their research into identifying early signs of Parkinson’s disease. About 1 million Americans suffer from the tremors and movement abnormalities that Parkinson’s cause, and that number is rising as the population ages. “Over the past years, we have been focused on understanding what happens in the brain of Parkinson’s patients. If we don’t understand a disease then we don’t know how to treat, cure, or prevent it,” Huang says. “One of our projects was to try to detect Parkinson’s disease very early because we know the disease does not appear overnight; it develops over a long period of time. We have shown how we may use arm swing during walking as a potential early gauge of disease.”
Parkinson’s disease involves the death of dopamine nerve cells in the brain. Dopamine regulates dexterity, spontaneity, smoothness, and stability when a person moves. Today, the typical Parkinson’s patient does not get a diagnosis until their tremor or motor dysfunction is so obvious that the brain has already lost 60 to 80 percent of its dopamine. “One of the inspirations for our research was to be able to diagnose Parkinson’s before that 60-plus percent of dopamine is lost,” Huang says.
Huang’s breakthrough research into the role of gait in Parkinson’s disease began while she was at the University of North Carolina. She coauthored a scientific paper that reported that symmetry in arm swing differed significantly between people with early Parkinson’s and people who did not have the disease. She came to Penn State Hershey in 2008 to further her research.
Studies aim to improve outcomes for trauma critical care patients
Can a hormone decrease the brain damage caused by a blow to the head? Is there a better way to treat people with life-threatening seizures? Answers to these questions could provide hope to millions of Americans who suffer these medical emergencies every year.
The Medical Center’s Department of Emergency Medicine is one of many centers nationwide participating in two encouraging clinical trials investigating these questions. “RAMPART and ProTECT are two examples of hypothesis-designed trials that will change medical practice if benefit is shown,” says Thomas Terndrup, M.D., ’81, chair, Department of Emergency Medicine.
Because animal studies have shown that the hormone progesterone reduces swelling and recovery time in brain injury, researchers now hope to harness this therapy for victims of head injuries. “Right now we don’t have an intervention or medication that improves the outcome for traumatic brain injury,” Terndrup says. “And this is a very serious problem in the world, especially for younger individuals, because it affects their entire life if they don’t successfully recover, and a lot of them do not.” (more…)
When the doctor becomes the patient
There are, of course, easier ways to bond with one’s patients. When asked what was a normal-appearing post-open heart surgery scar, many doctors would show the patient a photograph or do a simple visual assessment of the scar. But Peter Alagona, Jr., M.D., associate professor of medicine and radiology, Penn State Hershey Heart and Vascular Institute, on the other hand, lifted up his own shirt so they could compare their scars side-by-side. Like the patient, Alagona had earned his scar in 2009 during surgery to repair an acute aortic dissection, a sudden event for which he had no risk factors or warning. The fact that Alagona was even at Penn State Hershey Medical Center to have that surgery is a story in itself. (more…)
An Interview with E. Eugene Marsh, M.D.
Eugene Marsh, M.D.
In January 2011, E. Eugene Marsh, M.D., became the first senior associate dean of the Penn State College of Medicine Regional Medical Campus in University Park, where he will drive the College of Medicine’s vision for a regional academic and clinical campus in collaboration with the University and Mount Nittany Medical Center. He is also associate director of the Penn State Hershey Medical Group in State College, which has grown from one to five clinical sites in the State College area in the past year. He came to University Park from the University of Alabama, where he served as dean of the College of Community Health Sciences, the regional medical campus in Tuscaloosa as the culmination of a career ranging from private practice, medical education, and health care administration. In his new role, his priority list is long: to oversee the growth of medical group practices; to develop academic programs for College of Medicine students who will pursue their clinical training in State College; to craft a curriculum that emphasizes primary care and rural health; to develop dual-degree programs in areas such as business and law; and to establish a Family Medicine residency training program with Mount Nittany Medical Center. Dr. Marsh recently talked about the vision for the Regional Medical Campus and how it can help prepare physicians for the future demands of medicine. (more…)
Penn State CTSI aims to push research findings to the people
As a physician on the front line of the obesity and diabetes epidemics gripping the United States, Urs Leuenberger, M.D., professor of medicine in the Division of Cardiology at the Penn State Hershey Heart and Vascular Institute, has seen the disconnect between medical knowledge and reality. “We know an immense amount about many of the major health problems today, say obesity or diabetes, and we know a lot more than we did ten years ago or thirty or fifty years ago,” Leuenberger says. “So why is it that when we know so much more, the epidemic is getting worse?”
That is precisely the kind of question that the Penn State Clinical and Translational Science Institute (CTSI) will tackle over the next five years, thanks to a $27.3 million award from the National Institutes of Health (NIH). Penn State CTSI, a collaborative effort of the University, Penn State Milton S. Hershey Medical Center, and Penn State College of Medicine, joins a prestigious consortium of institutions that include Harvard, Johns Hopkins, Mayo Clinic, Yale, and the University of Chicago. In Pennsylvania, only the University of Pittsburgh and the University of Pennsylvania are also members.
“The CTSAs (Clinical and Translational Science Awards) support the innovation and partnerships necessary to bridge the traditional divides between basic research and medical practice,” NIH Director Francis S. Collins, M.D., Ph.D., said in announcing the latest awards. “The combination of resources and collaboration made possible by these awards is essential for developing and delivering new treatments and prevention strategies.”
Resources and collaboration are two of Penn State’s strengths in winning the CTSI grant. “Already, our Penn State Clinical and Translational Science Institute is bringing together researchers from across the University’s colleges, campuses, programs, and departments and fostering collaborative research,” says Harold L. Paz, M.D., CEO of Penn State Hershey Medical Center. “This CTSA funding award will add to this momentum and substantially increase our infrastructure for supporting translational research, expanding our ability to take scientific progress from the laboratory bench to the patient’s bedside.” (more…)
