HHC Research News (March 2012) - Hartford Hospital!

HHC Research News (March 2012)
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IN THIS ISSUE...
Medical Staff Patient Safety and Quality
Research Grant Competition
- - - - - - - - - - - - - - - - - -
Justin Lundbye, MD awarded new
research funding from Gilead Sciences
- - - - - - - - - - - - - - - - - -
New study clarifies benefits, risks of
laparoscopy vs. laparotomy for
endometrial cancer
- - - - - - - - - - - - - - - - - -
Dr. Paul Thompson on statin side
effects: Benefits outweigh risks of
severe side effects, high levels of
exercise are linked to statin-induced
muscle aches
- - - - - - - - - - - - - - - - - -
Dr. John Goethe invited to present at
the Nevada Psychiatric Association
Meeting
- - - - - - - - - - - - - - - - - -
National Community Cancer Center
Program 2012 whitepaper monograph
now available online
- - - - - - - - - - - - - - - - - -
Internal Funding Update
- - - - - - - - - - - - - - - - - -
Hartford Hospital Medical Staff funded
projects
MARCH 2012
Medical Staff Patient Safety and Quality Research Grant Competition
The Medical Staff Executive Committee is once again committing a total of $75,000 to the Medical
Staff Patient Safety and Quality Research Grant Competition, a program designed to encourage
investigators to develop research projects aimed at improving patient safety and enhancing the
quality of health care service delivery at Hartford Hospital. This RFP will be administered by the HHC
Research Institute and will be evaluated by the HHC Research Committee. We are interested in
funding multiple projects with the potential to impact patient care. Therefore, project budgets
should be approximately $15,000. Interested investigators must complete a 2 page Letter of Intent
due 4/16/12. The complete RFP was recently released in a special edition of Research News. Please
contact Dr. Ilene Staff Istaff@harthosp.org with any questions.
Justin Lundbye, MD awarded new research funding from Gilead Sciences
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The Research Program is pleased to announce that Gilead Sciences has recently approved a donation
of study drug and $173,000 in support of a clinical research trial to be conducted by Drs. Justin
Lundbye, Gary Heller, and Hanna Slim. The study, Impact of Ranolazine on Endothelial Dysfunction in
Patients with Diabetes will evaluate the use of Ranexa therapy to improve myocardial blood flow as
determined by a repeat PET scan. Ranolazine (Ranexa) is an oral antianginal agent which has an antiischemic
effect and may be beneficial to patients with endothelial dysfunction. Endothelial
dysfunction is a well-known condition which affects patients with diabetes, hypertension and heart
failure and is associated with a poor vasodilatory response. The study will use cardiac PET imaging to
assess the impact of Ranolazine (versus placebo) on myocardial blood flow response in patients with
diabetes who present to Hartford Hospital for a clinically indicated cardiac PET scan. The study is
being coordinated by Alan Ahlberg, MA, Deb Katten, RN, and Giselle Cyr, RN, Clinical Research Center
coordinators.
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New study clarifies benefits, risks of laparoscopy vs. laparotomy for
endometrial cancer
Endometrial cancer is the most common malignancy of the female genital tract. Total laparoscopic
hysterectomy, while not yet widely performed, has been proposed as one possible means of treating
this condition. If laparoscopy is to be widely accepted, its safety, effectiveness and benefit relative to
laparotomy must be established. In a new study, led by Dr. Hui Zhang of Qilu Hospital, Shandong
University, Jinan, China, a recent participant in Hartford Hospital's Scholar-Exchange Program, the
safety and efficacy of laparoscopy and laparotomy on clinical outcomes were compared among
patients with endometrial cancer. Meta-analysis was used to analyze data from eight randomized
controlled trials (RCTs) conducted between 1966 and June 2010 representing 3599 patients in total.
No significant differences were observed between laparoscopy and laparotomy in overall, disease-free
or cancer-related survival. While laparoscopy was significantly associated with more intraoperative
complications and longer operative time, significant differences also included fewer postoperative
complications, lower blood loss and short hospital stay favoring laparoscopy. No significant
differences were noted in pelvic or para-aortic lymph node yield. Laparoscopy thus appears to offer
short-term advantages and seemingly equivalent long-term outcomes and might represent a feasible
alternative to laparotomy in the treatment of endometrial cancer. The new study represents the
successful collaboration between researchers from Shandong University, Jinan, China and Research
Program Staff (Dadong Li, PhD). The Research Program offers statistical capabilities including metaanalysis,
propensity score matching and other advanced techniques. Investigators wishing to utilize
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HHC Research News (March 2012)
these techniques in their research may contact Dadong Li PhD (Dli@harthosp.org) for more
information.
Reference:
Zhang H, Cui J, Jia L, Hong S, Kong B and Li D. Comparison of laparoscopy and laparotomy for
endometrial cancer. International Journal of Gynecology and Obstetrics 116 (2012) 185-191.
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Dr. Paul Thompson on statin side effects: Benefits outweigh risks of severe side
effects, high levels of exercise are linked to statin-induced muscle aches
In response to recent news that the US Food and Drug Administration is now requiring that the makers
of cholesterol-lowering statins add new side effect warnings to their labels, Dr. Paul Thompson,
Director of Cardiology at Hartford Hospital and one of the first researchers to study adverse effects in
statins, says that the risks of dementia, muscle damage and diabetes are real but rare and that most
patients currently on statins are better off continuing with the medication (1). Muscle aches (known
as statin myalgia) are far more common than the more severe side-effects, occurring in about 1 in 10
users, according to Thompson. "It seems to be more common in people who do a lot of exercise" he
said (2). In one study Dr. Thompson noted that marathon runners taking statins developed a greater
increase in the liver enzyme creatine kinase right after their race compared with runners who weren't
on statins. "We also see more muscle aches in older people and women since they have less muscle
mass," he said (2). Lowering the statin dose or switching to a different statin doesn't always help,
Thompson said. "In our studies, those who develop statin myalgia tend to get it again and again"
indicating that the body may get sensitized to statins (2). Genetics may also play a role as statinrelated
muscle aches occur more often in patients whose parents also had them. According to
Thompson, about 1 in every 1,000 statin users will develop severely elevated liver enzymes that
indicate muscle death, and only 1 in 10 million die from developing an extremely severe case known
as rhabdomyolysis (2). About 5 people in 1,000 will develop diabetes as a result of statin use (1). The
relationship between memory problems and statin use is less clear. One of Dr. Thompson's current
studies aims to measure cognitive effects in statin users compared to those on placebo which will
shed more light on the exact incidence of these effects when it is published later this year (2). While
the FDA now requires added warnings for statin labeling, it has cautioned that, due to the clear
benefits of statins, the new warnings should not stop people from taking these drugs (1).
References:
1. Weir W. Statins: Doctors say added warnings on statins shouldn't cloud the drugs' clear benefits.
The Hartford Courant, 3/2/12. Available at http://www.courant.com/health/connecticut/hc-ctstatins-0303-20120302,0,7407781.story
2. Kotz, D. Statin side effects: How common are memory loss, diabetes and muscle aches? Boston.
com, 3/9/12. Available at http://www.boston.com/Boston/dailydose/2012/03/statin-side-effectshow-common-are-memory-loss-diabetes-and-muscle-aches/jjSsnfRshNt7TWQHbSsxJP/index.html
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Dr. John Goethe invited to present at the Nevada Psychiatric Association
Meeting
John W. Goethe, M.D., Director of the Burlingame Center for Psychiatric Education and Research at
the Institute of Living, was an invited presenter at the 17th Annual Psychopharmacology Conference
of the Nevada Psychiatric Association, held from February 15-19, 2012 in Las Vegas, Nevada. Dr.
Goethe's presentation, "Current Prescribing Practices: Antipsychotic Use in Child and Adolescent
Inpatients" was coauthored by BL Szarek, MC Stevens, AL Price.
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National Community Cancer Center Program 2012 whitepaper monograph now
available online
Authors from Hartford Hospital's Helen & Harry Gray Cancer Center, a pilot site in the National
Community Cancer Center program (NCCCP), have contributed to four of thirteen articles included in
the recently released 2012 white paper monograph from the National Community Cancer Center
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HHC Research News (March 2012)
Program (NCCCP). Published by the Association of Community Cancer Centers (ACCC), the monograph
contains all of the articles published in the 2011 Oncology Issues series featuring white papers from
the NCCCP pilot sites. The monograph is available as a digital publication through NxtBook Media.
Access to the 2012 NCCCP Monograph is accessible by clicking on this link: http://www.nxtbook.com/
nxtbooks/accc/ncccp_monograph/.
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Internal Funding Update
Requests for support through the Hartford Hospital Small Grants program (for research projects
requesting $10,000 or less) may be submitted at any time through the Research Program's online form
system. The goal of the Small Grant program is to provide seed money for pilot projects with the
potential to generate external research support. Medical Staff funding is also available to support
data analysis and database development through the Research Program. Contact Ilene Staff, PhD (545-
0178) for more information.
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The following investigators were supported through the generosity of the
Hartford Hospital Medical Staff for on-going projects and/or protocol/proposal
development:
Hema Brazell MD (Urogynecology): Do patients with pelvic organ prolapse have an increased frequency
of microscopic hematuria?
Orlando Kirton, MD (Surgery): Trends in methods of monitoring and vasopressure use in surgical ICU FY
2004-FY2009; Development and evaluation of an objective and simulation-based core curriculum for
surgery residents
Kent Kilborn PA (Neurology): Clinical characteristics of stress induced cardiomyopathy and cerebral
vasospasm
Louise McCullough MD (Neurology): Necessity of percutaneous endoscopic gastrostomy tube placement
in acute ischemic stroke in the right versus left middle cerebral artery territory: Is there a difference?
Andrew Salner MD (Oncology): Clinical and quality of life outcomes following diagnosis of prostate
adenocarcinoma
Adam Steinberg MD ((Urogynecology): Comparing Repliform ® tissue regeneration matrix with natural
graft in pelvic floor reconstruction outcomes (The "REPLIFORM" study)
Paul Tulikangas MD (Urogynecology): Changes in the microscopic vaginal environment caused by
pessary use in urogynecology patients
Steven Zweibel, MD (Electrophysiology): Insulation failure in St. Jude Riata leads: Screening and
predicting impending lead failure
In addition, Christine LaSala, MD (Urogynecology), Donna Chelle MD (Cardiology) and Robert McComb
PhD (Clinical Chemistry) received senior scientist consultation for manuscript development and study
design.
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We thank Lauren Cadiz, MA for her assistance with this month's Research News.
____________________________________________________________________________
Hartford HealthCare Research News is a monthly newsletter published by Research Administration at
Hartford Hospital. If you would like to contribute to this publication, please contact Joe
(jtortor@harthosp.org) or Tara (tmclaug@harthosp.org) for more info.
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