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January 8, 2010

Table of contents


Message from Paul Ramsey

Northwest Hospital & Medical Center now formally part of UW Medicine

Dear Colleagues: 

The University of Washington and Northwest Hospital & Medical Center signed an agreement in 1997 to collaborate on selected patient care, clinical research, and education activities. This led to a satisfying and productive long-term relationship focused on meeting the needs of the community. Over the past year, plans were developed to expand on this relationship. I am very pleased that effective Jan. 1, Northwest Hospital & Medical Center formally joined UW Medicine.

Northwest Hospital, a 281-bed full service acute care hospital located in north Seattle, becomes the seventh entity of UW Medicine. Northwest Hospital joins Airlift Northwest, Harborview Medical Center, UW Medical Center, the UW School of Medicine, UW Physicians practice plan, and the UW Medicine Neighborhood Clinics. The UW Medicine health system now has 1,144 licensed hospital beds, about 51,000 inpatient admissions, and 1.4 million outpatient and emergency room visits per year.

Early in 2010, Northwest will begin participating in the ongoing UW Medicine strategic planning process, with an initial focus on three areas of particular strength at Northwest — cancer, heart disease, and obstetrics and perinatal care. This strategic planning will center on enhancing patient care services and supporting the mission of Northwest Hospital and UW Medicine.

The addition of Northwest Hospital to the UW Medicine family is a wonderful beginning for 2010 and the start of a new decade. Northwest is an outstanding institution with strong leadership, focused on its mission and excellent service to the community. Please join me in welcoming Northwest Hospital & Medical Center to UW Medicine.

Sincerely,

Signature of Paul G. Ramsey

 

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

Paul Ramsey to address the UW Medicine community, 4:30 p.m., Jan. 14

Paul Ramsey, CEO of UW Medicine, executive vice president for medical affairs and dean of the School of Medicine, University of Washington, will address the UW Medicine community at 4:30 p.m., Thursday, Jan. 14, in Hogness Auditorium, A-420 UW Health Sciences Center. Ramsey will describe UW Medicine’s progress in the past year and review challenges and opportunities for educational, research and patient care programs in 2010. A reception will follow in the Health Sciences Lobby. For more information, call 206.543.7718.
 


Research

Risk of complications and death after abdominal surgery may increase with age

The risk of complications and early death after commonly performed abdominal surgical procedures appears to be higher among older adults, according to a report in the December issue of Archives of Surgery, one of the JAMA/Archives journals.

It is estimated that one in six Americans will be age 65 or older by 2020 and that 15 percent of this population will be older than age 85, according to background information in the article.

“Approximately 2 million older Americans undergo abdominal surgical operations each year,” the authors note. “For clinicians, patients and families considering abdominal surgical procedures, informed decision making is challenging because of limited data regarding the risks of adverse perioperative events associated with advancing age.”

Nader N. Massarweh, second-year surgical resident, and colleagues at the UW School of Medicine examined complication and death rates in 101,318 adults age 65 or older who underwent common abdominal procedures such as cholecystectomy (gall bladder removal), hysterectomy and colectomy from 1987 to 2004. Complications were recorded within 90 days of discharge and deaths were recorded within 90 days of hospital admission.

The 90-day complication rate was 17.3 percent and the 90-day death rate was 5.4 percent. Advancing age was associated with increasing frequency of complications and mortality the authors note.

“After adjusting for demographic, patient and surgical characteristics as well as hospital volume, the odds of early postoperative death increased considerably with each advance in age category,” the researchers report. These associations were found among patients with both cancer and noncancer diagnoses and for both elective and nonelective admissions.

“Older adults may be less able to adapt to the stress of surgery or to the added stress of any postoperative complication, greatly increasing their risk of early mortality,” the authors conclude. “These effects appear to be additive, highlighting the need for interventions to both prevent decline among older patients and avoid postsurgical complications.”

Toxicants in Asian monkey hair may warn of environmental threats to humans

Photo of Monkey in TrashcanTesting hair from Asian monkeys living close to people may provide early warnings of toxic threats to humans and wildlife, according to a study published last week in the American Journal of Physical Anthropology.

In parts of South and Southeast Asia, macaques and people share the same ecological niche. They drink from identical water sources, breathe the same air, share food sources, and play on the same ground.

“Macaques are similar to humans anatomically, physiologically and behaviorally,” says the senior author on the study, Lisa Jones-Engel, a senior research scientist at the National Primate Research Center at the UW.

“They are also similar in their response to toxic exposures,” notes lead author Gregory Engel, research scientist at the UW National Primate Research Center and a physician at Swedish Cherry Hill Family Medicine in Seattle.

Lead toxicity, the authors wrote, remains a significant public health problem around the world. Intense exposure to lead can damage the nervous, circulatory, and reproductive systems, as well as the kidneys and liver. Exposure during childhood, according to other studies, may cause more subtle effects, such as decreased intelligence.

The researchers hypothesized that young macaques, in particular, would be good sentinels for human exposure to lead exposure.

Jones-Engel and a team of primatologists, physicians, epidemiologists, veterinarians and toxicologists decided to test urban macaques as a potential early indicator that their human neighbors, especially the children, are being exposed to lead and other toxic metals. They took hair samples from three groups of free-ranging macaques at the Swoyambu temple overlooking Kathmandu, Nepal. The temple is located in a densely populated urban area with poor infrastructure that leaves point sources like discarded lead batteries, flaking leaded paint, and lead contaminated soil, a by-product of decades of leaded fuel, in the environment.

Hair lead levels differed among the three groups of macaques, and were much higher in younger macaques. The researchers’ data suggested that, in this population of macaques, behavioral or physiological factors among young macaques might play a significant role in determining exposure to lead and subsequent tissue concentration.

The research team concludes, “Chemical analysis of hair is a promising, non-invasive technique for determining exposure to toxic elements in free-ranging, non-human primates, and further multidisciplinary research is needed to establish whether it can be used to predict lead levels in humans who live in the same areas.”

Air bags not a risk to pregnant women, study finds  

Photo of Melissa Schiff An estimated 32,800 pregnant women each year in the United States are involved in motor vehicle crashes. Studies have concluded that crashes are one of the leading causes of injury-related maternal and fetal deaths, and the most common cause of injury-related hospitalization among pregnant women. Now, a new ground-breaking study from UW researchers has found that air bags do not seem to elevate the risk of most potential adverse outcomes during pregnancy. Study results are published in the January 2010 issue of Obstetrics & Gynecology.

"No one has conducted any large scale data-driven studies looking at air bags and pregnant women," says Melissa Schiff, lead author and professor of epidemiology at the UW School of Public Health and researcher at the Harborview Injury Prevention and Research Center.

The findings may seem counter-intuitive, but researcher Schiff said she was satisfied with what the team found. Reports on early model airbags found an increased risk of death among special populations, namely children and small statured women.

"I was very pleased that there was not an increased risk for pregnant women among many of the outcomes we looked at," she says. "Air bags are such a ubiquitous part of motor vehicles and have complicated our behaviors, due in part to the documented risk of first generation airbags. Over the years, airbags have been redesigned and have greatly reduced this threat."

In the Washington state study, researchers looked at 3,348 police-reported non-rollover crashes among pregnant front seat occupants during the study time period of 2002 to 2005. The study found that pregnant occupants in vehicles with an air bag were not at increased risk of pregnancy complications such as Cesarean delivery, fetal distress, and a low birth weight baby, compared with occupants in vehicles without an air bag.

"One of the main messages beyond air bags is that pregnant women are best protected by wearing a seatbelt in motor vehicles," notes Schiff. "It's going to protect you and your baby. Prior studies in non-pregnant populations have shown that air bags do not add substantial additional protection if you are wearing a seat belt."


Clinical Care

UW Medicine regularly audits and closely monitors access to electronic medical records

As a health system, UW Medicine takes its commitment to protecting patient information seriously. This is a reminder to all faculty, staff, students and trainees of UW Medicine that it is only permissible to access a patient’s medical record when involved in the care (treatment, payment, and health-care operation) of that patient. Access for any other reason is expressly prohibited.

Misuse of medical records access privileges at UW Medicine has resulted in a range of disciplinary actions, including termination. With passage of the American Recovery and Reinvestment Act (ARRA) in 2009, individuals can now be fined or imprisoned for inappropriately accessing medical records. The new rules also require us to notify the patient and the Department of Health and Human Services about inappropriate accesses; and, if the patient asks who inappropriately accessed or disclosed their information, your name may be provided.

Privacy policies are located at http://depts.washington.edu/comply/privacy.shtml.  

Please contact UW Medicine Compliance at comply@uw.edu if you have any questions about your responsibilities for protecting patient privacy.


Feb. 27 UW Medicine Salute Harborview Gala benefits charity-care mission 

The Salute Harborview Gala, the signature fundraising event for Harborview Medical Center, will be held Saturday, Feb. 27, at the Sheraton Seattle Hotel. One hundred percent of the Gala’s net proceeds benefit Harborview’s Mission of Caring serving vulnerable populations.

Over the past five years, the gala has raised more than $5 million in net proceeds to support Harborview’s charity-care mission. Although more than 35 percent of Harborview’s revenue comes from patients with private insurance, Harborview provides by far the most charity care in the state $155 million in fiscal year 2009.

The 18th Annual UW Medicine Salute Harborview Gala is chaired by community leaders Lynn and Michael Garvey, and presented by the Western Washington Toyota Dealers Association.

Sigvard T. Hansen, Jr., UW professor of orthopaedics and sports medicine, will be presented with the Mission of Caring Award, which recognizes people whose lives and work exemplify Harborview’s mission of caring.

Other honored guests will be patients Alec Corbett and Alessandro Gelmini, whose lives were put back together at Harborview after they were rescued from an ice cave at Snoqualmie Pass.

And, of course, there will be dinner, dancing, and a live auction. Entertainment will be provided by The Frustrations, covering hits from the ‘60s through today.

Tickets for the event are $3,500 per table (seats 10) or $350 per person.

If you would like to attend, please RSVP to 206.543.7873 by Monday, Feb. 15.

To learn more about the Gala, please visit the Gala web site, or follow the event on Facebook and Twitter.


Education and Training

Marshall Horwitz named new director of the Medical Scientist Training ProgramPhoto of Marshall Horwitz

Marshall Horwitz, UW professor of pathology, medicine, genome sciences, and biology, has been named director of the Medical Scientist Training Program (MSTP). He succeeds Mary-Claire King and Lawrence Loeb who served as co-directors of the program until last fall.

The Medical Science Training Program, established in 1971, and jointly funded by the National Institutes of Health and the School of Medicine, provides trainees with both a broad knowledge of medicine and the ability to investigate detailed mechanisms associated with human disease. The program prepares students for careers in academic medicine. The program emphasizes continuity between clinical and basic sciences curricula and leads to medical and doctoral (M.D./Ph.D.) degrees.

Horwitz was selected after a search led by Robert Waterston, professor and chair of genome sciences.

Horwitz is a University of California, San Diego alumnus, and a graduate of the UW MSTP. He received his doctoral degree in pathology in 1988 and his medical degree in 1990. He completed his residency in the Department of Medicine at the UW in 1992, followed by a fellowship at the Fred Hutchinson Cancer Research Center. He joined the faculty in 1995.

Horwitz's research interests are focused on cancers of the blood and bone marrow failure syndromes. His laboratory employs genetic linkage analysis and positional candidate cloning approaches to map and identify genes responsible for familial predisposition to leukemia, lymphoma, and bone marrow failure syndromes.

Horwitz's honors include the NIH Director’s Pioneer Award and Presidential Early Career Award for Scientists and Engineers; clinical research scholar awards from the Leukemia & Lymphoma Society, the Doris Duke Charitable Foundation, the Damon Runyon Cancer Research Foundation, and the Burroughs Wellcome Fund; and the UW Fialkow Scholar Award for outstanding research, teaching, clinical work and academic citizenship. 

Nobel Prize winner Edwin G. Krebs dies 

Photo of Edwin KrebsDr. Edwin G. Krebs, who shared the 1992 Nobel Prize in physiology or medicine for discovering a biological regulatory mechanism in cells, died Monday, Dec. 21, in Seattle. He was 91.

Krebs joined the UW School of Medicine faculty in 1948, two years after the school opened. He spent most of his career at the UW.

In the early 1950s, Krebs and his UW colleague, Edmond Fischer, were working on another scientific problem when they made an unexpected finding. They noticed that an enzyme that helps liberate energy in muscle cells (called glycogen phosphorylase) was activated by chemical reaction with phosphate, and de-activated by its removal. Adding and removing the phosphate was like turning on and off the switch that controlled the enzyme's activity.

Their findings were published without acclaim in the mid-1950s. Many years elapsed before scientists realized from the subsequent work of Krebs and Fischer and many others that this reversible process of adding phosphate (called phosphorylation) affects countless numbers of cellular proteins, and is a key regulator of many cellular activities. Problems with this key regulatory process are behind many disorders like cancer, diabetes, nerve diseases and heart conditions.

Krebs graduated from medical school in 1943 at Washington University in St. Louis and did his residency training in internal medicine at Barnes Hospital until 1945, when he was sent on active duty as a medical officer in the U.S. Navy.

After World War II ended, he returned to Washington University and did postdoctoral research in biological chemistry with Dr. Carl Cori, who received the Nobel Prize in 1947 for elucidating carbohydrate metabolism. When his fellowship was over, Krebs was offered a position as an assistant professor at the then-new medical school in Seattle.

In 1969 he accepted the position of chair of the Department of Biological Chemistry at the University of California Davis medical school. In 1977, the UW offered Krebs the chairmanship of the Department of Pharmacology.

At the UW, Krebs was appointed an investigator in the Howard Hughes Medical Institute and furthered his work on protein phosphorylation, carbohydrate metabolism, and cell signaling. Late in his career he contributed to discovery of an entirely new phosphorylation pathway, called the MAP kinase pathway, which is important in many aspects of cell regulation.

Krebs received many major scientific awards for his work, including the Passano Foundation Award, the Horwitz Prize, the Lasker Research Award, the 3M Life Sciences Award, and the Welch Award in Chemistry. In 1992, at the age of 74, Krebs and Fischer were honored with the Nobel Prize in physiology or medicine for the discovery made almost 40 years before.

Krebs is survived by his wife Virginia "Deedy" Krebs; children Sally Herman, Robert Krebs and Martha Abrego; four grandchildren; and six great-grandchildren.

Remembrances may be made through gifts to the Edwin G. Krebs-Hilma Speights Professorship in Cell Signaling and Cancer Biology, UW Medicine Advancement, 815 Mercer Street C-5, Box 358045, Seattle, WA 98109.

 Service Excellence Award winners announced

The Dean’s office of the School of Medicine is proud to recognize people who represent the values of excellent service and commitment to the School of Medicine’s mission. The following recipients of the Service Excellence Award have demonstrated their dedication to the mission through effective mentoring, inspiring leadership and exemplary service to others. The Service Excellence Award winners for spring 2009 (April - June) were:

Michael Lagunoff, associate professor of microbiology: In addition to maintaining a full-time teaching load and active research enterprise, Lagunoff was described as a mentor to graduate students and someone who exceeds normal expectations.

Kelly Fryer-Edwards, associate professor of bioethics and humanities: Fryer-Edwards was recognized for her commitment and service toward the advancement of professionalism within the School of Medicine.

Kristine K. Vosk, manager, Institute for Stem Cell and Regenerative Medicine Department of Pharmacology: Vosk was recognized for her tireless work in organizing a campus-wide stem cell meeting, developing a graduate level stem cell course, and planning and organizing the institute’s move to South Lake Union.

Maureen K. Holstad, program manager, Department of Pathology, Medical Science Training Program: Holstad was lauded for her exemplary work on admissions, organization of seminars and grant proposal preparation. Her department described her work on admissions, organization of seminars and grant proposal preparation as exemplary.

To nominate someone for a Service Excellence Award visit the Service Excellence Committee’s web site.



 Upcoming Events

The following is a listing of some upcoming events in the UW Medicine community. For the full UW Medicine events calendar, click here

Life Sciences Discovery Fund Competition Grant Information Sessions in January

The Life Sciences Discovery Fund (LSDF) has four grant competitions in 2010. The fund will host three grant competition information sessions at the UW in January. Session 1: 1 to 3 p.m., Monday, Jan. 11, Orin Smith Auditorium, South Lake Union. Session 2: 2 to 4 p.m., Friday, Jan. 15, Turner Auditorium (D-209), Health Sciences Bldg. Also simulcast in room 113, Research and Training Building, Harborview Medical Center. Session 3: 4 to 5:30 p.m., room 316-Right, South Campus Center, UW. Sessions are open to all faculty, staff and students. No registration required. For more information, contact somevent@uw.edu, or visit www.lsdfa.org.  

Science in Medicine Lecture, Jan. 13

Molecular Imaging of Breast Cancer: Insights into In Vivo Cancer Biology by David Mankoff, professor of radiology and bioengineering, noon to 1 p.m., Wednesday, Jan. 13, Hogness Auditorium, A-420 UW Health Sciences Center. Lecture will also be telecast at several locations. For locations and more information, visit the Science in Medicine web site  or e-mail somevent@uw.edu.  

Memorial Service for Walter E. Stamm set for 2 p.m., Jan. 14

A memorial service for Walter E. Stamm will be held at 2 p.m., Thursday, Jan. 14, in Meany Hall, UW-Seattle campus. Stamm, who was a professor of medicine and former head of the Division of Allergy and Infectious Diseases, died in Seattle Dec. 14 at the age of 64. Remembrances in lieu of flowers may be sent to: UW Medicine Advancement, 815 Mercer Street C-5, Box 358045, Seattle, WA 98109. Checks may be made payable to “UW Foundation” with indication that they are in memory of Dr. Walter Stamm and directed to The Walter E. Stamm, M.D., Memorial Fund.