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October 18, 2013

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Message from Paul Ramsey

Paul G. Ramsey

UW researchers to test novel therapy for idiopathic pulmonary fibrosis

Dear Colleagues:

I am very pleased to report that UW researchers have received a grant from the National Institutes of Health (NIH) to test a promising, novel surgical therapy for treating idiopathic pulmonary fibrosis (IPF). IPF is a chronic, progressive lung disease of unknown cause and increasing prevalence in the United States. An estimated 100,000 Americans die from IPF each year, typically within three to five years of diagnosis.

The disease is characterized by development of excess fibrous tissue in the lungs. Aside from lung transplantation, which only one percent of affected patients receive, there is no FDA-approved therapy. The grant brings new hope for slowing progression of a fatal disease through safe, minimally invasive surgery.

Ganesh Raghu, professor of medicine in the Division of Pulmonary and Critical Care Medicine and a principal investigator on the study, is one of the world’s leading experts on IPF. In 1998, his pulmonary fibrosis program made the original observation that 90 percent of patients with IPF demonstrated abnormal and asymptomatic acid gastroesophageal reflux (GER).

Since then, Dr. Raghu and Carlos Pellegrini, professor and Henry Harkins Chair in the Department of Surgery, have investigated the role and treatment of GER in patients with IPF. Their observation that laparoscopic anti-reflux surgery (LARS)—Nissen fundoplication—is a promising treatment led them to the current successful proposal for a Phase 2 clinical trial.

The trial will test the hypothesis that reduction in abnormal GER with laparoscopic fundoplication slows the progression of IPF, and will also investigate the impact of abnormal GER on the phenotype of lung epithelial cells. Preliminary retrospective observations in a cohort of patients with IPF who had demonstrated decline in pulmonary function tests showed significant improvement following the LARS and also demonstrated the relative safety of the operation for patients with IPF when performed in a center of excellence by an experienced team. This prospective phase II clinical trial will provide the scientific opportunity for the first time to further test the hypothesis.

Ganesh Raghu
Ganesh Raghu

Starting in January 2014, 60 patients will be recruited across five clinical sites throughout the United States. UW Medicine and University of California at San Francisco are primary study sites; the University of Michigan at Ann Arbor, University of Chicago in Chicago and University of Wisconsin at Madison are the other three sites. Dr. Pellegrini is co- investigator and lead surgeon who will direct and coordinate the surgical aspects of the study. Harold Collard at UCSF is co-principal investigator with Dr. Raghu. The overall research grant will be primarily administered through UCSF and the data gathered will be analyzed by the data coordinating center at Duke University.

Ganesh Raghu has devoted his professional life to the field of IPF and related interstitial lung diseases in an effort to increase understanding of the pathogenesis and management of IPF. In addition to serving as director of the UW Pulmonary Fibrosis Program, he started the first long-running support group for patients with IPF in 1988—the first of its kind in the world.

He is the founding director of the UW Medicine Center for Interstitial Lung Disease that began in March this year. The next issue of Online News will feature an article about this new center that is jointly overseen by Carlos Pellegrini and Bill Bremner, professor and chair in the Department of Medicine.

The new grant is a very exciting opportunity to make dramatic progress in what has been an intractable and fatal disease. I would like to offer my thanks to Dr. Raghu for his outstanding, sustained leadership in and commitment to finding ways to treat and prevent progression of IPF and other lung diseases.


PGRamsey Signature2


Paul G. Ramsey, M.D.
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington




Major funding awarded for research on drugs taken during pregnancy


Faculty members from the UW School of Pharmacy and the UW School of Medicine have secured a $4.7 million National Institutes of Health (NIH) grant to study drug disposition during pregnancy. Disposition refers to how drugs are absorbed, distributed, metabolized, and excreted.

The principal investigator on this multi-part, five-year grant from the NIH National Institute on Drug Abuse is Jashvant Unadkat, professor of pharmaceutics.

Unadkat’s grant includes researchers from the UW departments of Pharmaceutics, Pharmacy, and Obstetrics and Gynecology. It will involve three subprojects, each examining different drug types and their disposition in pregnant women and their fetuses: the drug abuse treatment methadone, amphetamines and other illicit drugs, and the antidepressant bupropion.

Researchers will work with the British company Simcyp to synthesize the data from all three projects. Simcyp uses a population-based simulator to conduct physiological pharmacokinetic modeling—a mathematical modeling technique for predicting the disposition of synthetic or natural chemical substances in virtual human populations. The analysis may help predict how pregnant women and their fetuses handle illicit drugs, medications for drug abuse, and antidepressants.

Unadkat will collaborate with project leaders Nina Isoherranen, Qingcheng Mao, Jashvant Unadkat and Joanne Wang; and co-investigators are Gail Anderson, Rodney Ho and Ed Kelly, all from the School of Pharmacy. Co-investigators from the School of Medicine are Justine Chang, Michael Grayett and Alyssa Stephenson-Famy.

Read more in UW Today.

UW study shows cognitive rehabilitation improves brain function in cancer survivors

Study participants take several tests before entering cognitive  rehabilitation sessions.
Cancer Cognitive Rehab

Cancer survivors who experience memory and thinking problems may benefit from cognitive rehabilitation, according to a new study led by Monique Cherrier, UW associate professor of psychiatry and behavioral sciences.

The study, published Sept. 16 in Life Sciences, found that participants experienced improved cognitive function and a decrease in perceived cognitive impairments, and also reported a higher quality of life. The study is one of few to examine the effects of cognitive rehabilitation on cancer survivors.

Study participants take several tests before entering rehabilitation sessions. One of these, the Stroop test, measures executive brain functions like multitasking and working memory.

Cherrier and her research team held cognitive rehabilitation sessions for 28 people during a seven-week period. The sessions were held in a group setting.

“There’s a sense of connectedness that patients get with other patients who are struggling with a similar problem,” Cherrier said. “They also get a chance to practice the skills we teach them while they’re in the group each week.”

Cognitive rehabilitation is a therapy involving memory aids and skill-based tasks to improve memory and attention similar to techniques used to treat patients with traumatic brain injury.

Chemotherapy and some anti-cancer medications such as tamoxifen, which prevents the growth of breast cancer cells have been associated with memory and attention problems, informally referred to as “chemo brain.”

Cognitive impairment is the second-most reported problem among cancer survivors, yet little research has been conducted to find effective treatments. Past studies have explored using medication to treat cognitive impairment in cancer survivors, but most have not demonstrated that drugs can treat these issues effectively.

The results of the recent study reflect emerging understanding of brain plasticity, the brain’s ability to recover from damage, Cherrier said.

Read more in UW Today.



Clinical Care 

My HeartMap Seattle Challenge enlists the public to locate city’s life-saving device


Seattleites can join in a life-saving scavenger hunt. Players will compete to identify and report the locations of Seattle’s automatic external defibrillators, or AEDs, for a cash reward. Prizes range from $50 to $10,000. The contest began Oct. 15 and continues through Nov. 15.

Can you spot the automatic external defibrillator (AED)? The MyHeartMap Seattle Challenge will help locate and create a database of the city’s AEDs.

AEDs are electronic briefcase-size devices designed to allow bystanders on scene at a medical emergency to help someone who has collapsed with loss of mechanical activity of the heart, or cardiac arrest.

“Our list of AED locations may be incomplete. We are seeking the public’s help to learn where more of these devices are,” said Graham Nichol, professor of medicine in the Center for Pre-Hospital Emergency Care at UW Medicine’s Harborview Medical Center.

AEDs are cost-effective lifesavers that are often placed where cardiac arrests are most likely, such as airports, sports clubs and shopping malls, according to Nichol, who explained why it is important for a bystander to be able to locate an AED immediately.

“Cardiac arrests are a leading cause of death in the United States but can be treated if recognized and responded to quickly with an AED.”

More than 1.2 million AEDs are now in public places in the United States, and about 180,000 more are installed each year. Sometimes bystanders cannot find the nearest AED during a medical emergency. That’s where the My HeartMap Seattle challenge comes in. Game players will assist UW clinicians by reporting the location of AEDs in community settings throughout Seattle.

Read about the rules of the game in UW Today or on the CPR Nation website.



Education and Training 

Interprofessional Education Initiative draws faculty and students into healthcare’s new world of teamwork

The UW schools of health sciences are at the forefront of a national sea-change in the way healthcare is taught and delivered. Interprofessional teams are the new “name of the game.” And the schools are jumping in with excitement and anticipation.

The UW Board of Health Sciences Deans, chaired by Thomas Baillie, dean of the School of Pharmacy, has launched the Interprofessional Education Initiative: Vision for a Collaborative Future that lays the foundation for progressive integration of collaborative learning across the UW’s six schools of health sciences—dentistry, medicine, nursing, pharmacy, public health and social work.

Third-year pharmacy student Nastaran Yazdi and first-year physician assistant student Matthew Smith
Yazdi and Smith

“This is the single most important multidisciplinary initiative of our time, in terms of impact and scope. The nature of healthcare is changing rapidly and significantly; much of it driven by cost and technology, and a changing workforce,” Baillie said.

“To meet these pressures, healthcare must take a more team-based approach. This will require healthcare professionals working together to bring the best solutions to health concerns facing individuals and communities. Today’s healthcare students need an awareness of issues, challenges and perspectives of colleagues outside their particular disciplines.”

Students from all six health sciences schools are participating in the new Foundations of Interprofessional Practice curriculum, a seven-session series in which students work together in consistent teams solving real health challenges.

The sheer number of students—more than 600—is a logistical challenge. Led by Karen McDonough, associate professor of medicine in the Division of General Internal Medicine, a core interprofessional group of faculty has met weekly and spent countless hours developing the curriculum over the last six months.

Joseph Falcone, second-year medical student
J Falcone

This series is one of several activities of the Interprofessional Education Initiative, which has set an ambitious path and is moving forward quickly. Sarah Shannon, associate professor of biobehavioral nursing and health systems, leads the subcommittee focused on curriculum and metrics for measuring outcomes from these efforts. The subcommittee reports to a larger committee, chaired by Dave Anderson, executive director of Health Sciences Administration. This Interprofessional Education Implementation Committee was charged by the six health sciences deans with addressing the need for increased focus on interprofessional education at a number of different levels, including curriculum.

Faculty, too, need preparation for the new world of interprofessional education. On Sept. 17, McDonough and Brenda Zierler, professor of behavioral nursing and health systems, led a faculty development workshop, Teaching Interprofessional Learners, attended by 77 individuals from across the six schools. Working in interprofessional teams, faculty first explored new methods for teaching specific interprofessional core competencies. Then, using video clips produced with funding from the Health Resources and Services Administration (HRSA) grant Technology Enhanced Interprofessional Education for Advanced Practice Students, faculty worked together to problem- solve how to help students navigate awkward or conflictual interactions as a team. Zierler is the principal investigator on the grant.

Faculty put their new skills to work a week later on Sept. 24, at the IPE Healthcare Team Kickoff. Nearly 600 students attended the event, held in six different locations across the UW campus, including the new Odegaard Undergraduate Library active learning spaces.

Karen McDonough, associate professor of medicine, sets the stage for the first Interprofessional Education Initiative session.
K McDonough

McDonough explained the process: “This year we’re laying the foundation of interprofessional practice by having students participate in seven sessions over the year. The sessions will include collaborative learning projects, role-playing, individual and group learning plans, and case studies that approximate situations, such as medical error disclosure, that may be faced on the job. There are many ways of maximizing collaborative learning through service learning, at clinical sites, and through shared classes.”

Students should get to know each other well across multiple sessions and develop a deeper understanding of the roles each health profession plays. A core goal of the initiative is to improve health—individual health and population health. The two are inextricably tied together—addressing health disparities, for example, is a pathway to improving individual health. When they graduate, students should be ready to take a collaborative, integrated, team-based approach to solving 21st century health issues.

Read more about the new Interprofessional Education here or in UW Today.

American College of Surgeons installs Carlos Pellegrini as president

Carlos Pellegrini

Carlos Pellegrini, the Henry N. Harkins Professor and Chair of Surgery at the UW, has been installed as the 94th president of the American College of Surgeons (ACS). The installation took place Oct. 6 in Washington, D.C., during the associations’ 2013 Clinical Congress. Pellegrini is a pioneer in minimally invasive surgery on the digestive tract. He has chaired the UW Department of Surgery since 1993. Under his leadership, the UW opened the Center for Videoendoscopic Surgery, the Center for Esophageal and Gastric Surgery, and the Institute for Simulation and Interprofessional Studies.

A fellow of the American College of Surgeons (FACS) since 1982, Pellegrini began serving on the ACS Board of Regents in 2001. He served as vice-chair of the Board from 2009-2010, and as chair from 2010- 2011. Pellegrini has also served on a number of ACS committees, often assuming a leadership role.

In addition to the ACS Presidency, Pellegrini’s ACS involvement includes serving on the Steering Committee on Simulation-Based Surgical Education, the Task Force on the Resident 80-Hour Work Week, and the Health Policy and Advocacy Group.

The American College of Surgeons is a scientific and educational association founded in 1913 to improve the quality of surgical care by setting high standards for surgical training and practice.

Read more about Pellegrini’s installation on the American College of Surgeons website.

Glenna Martin receives 2013 Piscano Leadership Scholarship

Glenna Martin

Glenna Martin, a fourth-year medical student at the UW School of Medicine, is one of six recipients of the 2013 Piscano Leadership Scholarship.

The scholarships, valued at up to $28,000 each, are awarded to students attending U.S. medical schools who demonstrate a strong commitment to the specialty of family medicine. In addition, each applicant must show demonstrable leadership skills, superior academic achievement, strong communication skills, identifiable character and integrity, and a noteworthy level of community service. The scholarship program provides educational programs, leadership training and funding for outstanding fourth-year medical students who have been identified as the future leaders in the field of Family Medicine.

Martin is participating in UW’s Underserved Pathway, Hispanic Health Pathway. She has received numerous awards as a medical student, including the American Academy of Family Physician’s Tomorrow’s Leader Award, and election to Alpha Omega Alpha and to the Gold Humanism Honor Society. Martin received the UW School of Medicine Service Award in 2011, 2012, and 2013.

She is a member of the Health Equity Circle, a student group that addresses health disparities, the UW Curriculum Renewal Committee on Health Equity, and she co-chairs the Washington State Medical Association Health Equity Task Force. Martin also has a master’s degree in public health from the UW.

The Pisacano Leadership Foundation, Inc. was created in 1990 by the American Board of Family Medicine in tribute to the founder and first Executive Director of the ABFM, Nicholas J. Pisacano, M.D. (1924-1990).

Read more about Martin on the UW Family Medicine website or about the Piscano Leadership Foundation scholars online.



WWAMI Regional News  

Wyoming WWAMI news update

Wyoming WWAMI first-year class

After undergoing a leadership and faculty change, the Wyoming WWAMI program is moving forward. Matthew McEchron, who served as assistant dean and first-year site director for the University of Wyoming WWAMI program, accepted a position at the University of Arizona School of Medicine in Phoenix. Tim Robinson, professor of statistics at the University of Wyoming, is interim director while a search is conducted for a new director.

Robinson teaches the medical information and decision making to Wyoming WWAMI first-year students. The first-year students have completed almost eight weeks of class after an introduction to the “flipped classroom,” which is a reversed teaching model that delivers instruction at home and moves active discussion of homework into the classroom. Students have the opportunity to ask questions and work through problems with the guidance of their professors and support of their peers which creates a collaborative learning environment.
Robinson says he is pleased with the effort and the ambition of the students. Several students have stepped into leadership roles for the class. Elise Sylar is the Medical Student Association representative; Sarah Gregory is the Wyoming Medical Society and the Service Learning Committee representative; Kelly Baxter coordinates student wellness activities; Roberta Enes is the Global Health Group representative; Millie Boyd and Hannah Phillips coordinate student participation at the Downtown Clinic, a nonprofit healthcare facility serving low-income people in Laramie, and Kimberly May, coordinates the outside speaker series.

Eight Wyoming WWAMI graduates have returned to the state to start their practice careers in 2013. The community of Sheridan will have four graduates beginning practice this year.

Three internal medicine physicians have returned to Wyoming to practice medicine. Hannah Hall has joined Bighorn Internal Medicine in Sheridan; Jason Ackerman is practicing at the Sheridan Memorial Hospital in Sheridan; and Clint McMahill is now with Lander Regional Hospital in Lander.

Emergency medicine physicians, Luke Goddard and David Nickerson joined the Sheridan Memorial Hospital.

Thor Hallingbye is an anesthesiologist with the Pain Consultants of the Rockies in Cheyenne, and Gregory Wallace joined the Anesthesia Associates in Laramie.

Samuel Linford joined Star Valley Medical Center in Orthopedics in Afton.

Clinical medical education in Wyoming is also growing. Larry Kirven, Wyoming WWAMI clinical assistant dean, and Tom Benedetti, UW professor of obstetrics and gynecology, visited the communities of Sheridan and Gillette to meet with physicians to discuss establishing third-year student clerkship sites in obstetrics and gynecology in 2014. In addition, a fourth-year chronic care clerkship will accept students in 2014 in Cheyenne . Rob Monger will be the site coordinator.

Kirven and Eileen Dinneen of the Wyoming Health Resource Network (WHRN) are working to establish WHRN as a trusted information source about practice opportunities in the state of Wyoming. The goal is to develop an information exchange resource for WWAMI graduates who seek to return to the state to practice and healthcare organizations interested in identifying physicians who are contemplating returning to the state. The WHRN office is now located in the Wyoming Medical Society building, which also houses the Wyoming WWAMI office. Both programs have the strong support of the Wyoming Medical Society.

Future endeavors for Wyoming may include joining the TRUST program, increasing opportunities for faculty development for the preceptors in the state, and working with educators to support graduate medical education opportunities in the state.



Upcoming Events

The following events may be of interest to the UW Medicine community:    


UW Medicine Sports Medicine Center Open House, Oct. 19

The new Sports Medicine Center flagship location at Husky Stadium will host a community open house from 1 to 3 p.m., Saturday, Oct. 19, at 3752 Montlake Blvd., NE, the south entrance of Husky Stadium. The open house will give the public an opportunity to meet sports medicine providers, tour the state-of-the art 30,000-square-foot clinic; and join the Passport to Health event that will feature interactive demonstrations of the latest sports medicine treatments. Free parking will be available in E-12 lot and the underground parking garage. Visit the Sports Medicine Center’s website for more information.

Science in Medicine, New Investigator Lectures, Oct. 23 & 30

An Accident Waiting to Happen: How Replication-Transcription Conflicts Impact the Genome and Evolution of Bacteria, 1 to 2 p.m., Wednesday, Oct. 23, Health Sciences Bldg., Turner Auditorium, D-209. Houra Merrikh, UW assistant professor of microbiology, will discuss how impediments such as DNA binding proteins and transcription can stall DNA replication, resulting in genomic instability, mutagenesis and reduced fitness.

Epilepsy Genetics: A New Era of Gene Discovery, 1 to 2 p.m., Wednesday, Oct. 30, Health Sciences Bldg., Turner Auditorium, D-209. Heather Mefford, UW assistant professor of pediatrics in the Division of Genetic Medicine, uses state-of-the-art technology to discover new copy number changes in genes that underlie a variety of pediatric conditions, including neurocognitive disorders, intellectual disability and congenital abnormalities.

For more information, visit the Science in Medicine website or contact Heather Hawley at hhawley@uw.edu or 206.221.5807.

Russell Ross Lecture, Oct. 23

A Genome-wide View of Macrophage Activation, 4:30 p.m., Wednesday, Oct. 23, Health Sciences Bldg., Room T-739. Christopher Glass, professor of medicine and cellular and molecular medicine, at the University of California San Diego, will give the lecture. Glass studies the molecular mechanisms by which sequence specific transcription factors, co-activators and co-repressors regulate the development and function of macrophages, including in such diseases as atherosclerosis. This special seminar is dedicated to the legacy of Russell Ross, professor and chair of the UW Department of Pathology from 1982 to 1994. For more information, contact Juliana Hinch at hinchj2@uw.edu or 206.616.9343.

Puget Sound Heart and Stroke Walk, Oct. 26

Join the UW Medicine team at the 2013 Puget Sound Heart and Stroke Walk, Saturday, Oct. 26, at Seattle Center. Festivities begin at 7:30 a.m. A three-mile walk through downtown Seattle and a one-mile Survivor Walk will begin at 9 a.m. In support of UW Medicine’s mission to improve the health of the public, the American Heart Association will fund nearly $4 million in research at UW Medicine and Seattle Children’s Hospital this year. The UW Medicine goal is to have at least 400 walkers and raise $50,000 in contributions at the event. Visit the UW Medicine Heart and Stroke Walk website to join a team or to become a team captain.

GME Grand Rounds for Residents and Fellows, Oct. 30

Teamwork: How to Prevent 98,000 Deaths a Year, noon to 1 p.m., Wednesday, Oct. 30, UW Health Sciences Building, T-733. Daniel Low, pediatric anesthesiologist at Seattle Children’s and an award-winning educator, will demonstrate how teamwork and checklists can create a near zero-error patient experience. The session will be broadcast to the Harborview Medical Center Board Room. Registration required. For more information, contact Shawn Banta at sbanta@uw.edu or 206.616.8286.

Leonard A. Cobb Symposium, Nov. 6

State of the Art in Resuscitative Medicine, 1 to 3 p.m., Wednesday, Nov. 6, UW Medicine South Lake Union, Orin Smith Auditorium. The symposium honors the life and work of Leonard A. Cobb, UW professor emeritus of medicine in the Division of Cardiololgy and one of the founders of the Medic One Foundation. Myron Weisfelt, director of the Department of Medicine at Johns Hopkins Medical Institutions, will speak about The National Impact of Cobb and his Legacy. Other speakers include William Bremner, UW professor and chair of the Department of Medicine; Paul Ramsey, CEO of UW Medicine and dean of the School of Medicine;and Michael K. Copass, UW professor of medicine and neurology. Reception will follow. RSVP at uwcard@cardiology.washington.edu or 206.543.8584 by Oct. 25.

Medical team volunteers needed for Seattle Marathon, Dec. 1

UW Medicine is looking for medical and administrative volunteers for the Seattle Marathon, Sunday, Dec. 1. Led by Mark Harrast, Seattle Marathon medical director, medical teams will manage seven stations along the course and two at the finish line. More than 10,000 runners are expected to participate in the Marathon and Half-Marathon races during the Thanksgiving Holiday weekend. For more information, contact Mia Coleman at miac@uw.edu.

Colin Powell to give keynote address at Prostate Cancer Survivors Celebration Breakfast, Dec. 5 

Former U.S. Secretary of State and retired four-star U.S. Army Gen. Colin Powell will be the keynote speaker for the 2013 Prostate Cancer Survivors Celebration Breakfast, which supports the Institute for Prostate Cancer Research, a collaboration between UW Medicine and Fred Hutchinson Cancer Research Center. The 2013 Prostate Cancer Survivors Celebration Breakfast will take place at the Seattle Sheraton Hotel, from 7:30 to 9 a.m., Thursday,  Dec. 5. For more information, visit the Prostate Cancer Survivors Breakfast site.

Continuing Medical Education 

Visit Continuing Medical Education for information on upcoming classes.


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