A $298,877 grant awarded to Prashant Krishnamurthy supports curriculum development for a wireless information systems track in the master of science in telecommunications program. The first of its kind, the new track emphasizes a systems perspective in the development, design and deployment of wireless information networks.

NIH awards grant for oral health study

Walter A. Bretz, an assistant professor of restorative dentistry and epidemiology, has received a $1.08 million National Institutes of Health (NIH) grant for a mother-child oral health study in the United States and Brazil.
Investigators at the Universidade de Sao Paulo at Bauru and Pitt's School of Dental Medicine and Graduate School of Public Health will study the use of combination therapies (fluoride and chlorhexidine varnishes, xylitol chewing gum, and oral hygiene instructions) in mothers, to reduce the numbers of bacteria in the mouth that cause dental caries prior to the emergence of their babies' teeth.

The NIH's National Institute of Dental and Craniofacial Research awarded the grant.

Frequency of chlamydia screening in sexually active teens found to be inadequate

Two-thirds of doctors do not perform recommended chlamydia screenings on sexually active young women, according to a study by Pitt's Center for Research on Health Care, published in the March issue of the Journal of Adolescent Health.

Failure to detect chlamydia can lead to pelvic inflammatory disease, infertility, ectopic pregnancy and chronic pelvic pain.

"Our results show that adherence to recommended screening procedures is alarmingly low. Physicians may need to be educated about the disease and the need for chlamydia screenings in all sexually active young women. If measures aren't taken, many young women's reproductive health could be jeopardized," said Robert L. Cook, a Pitt assistant professor of medicine.

Chlamydia is the most common bacterial sexually transmitted disease in the United States; almost every major medical association recommends that sexually active young women get tested yearly for the disease.

Depending on the setting, anywhere between 1 percent and 20 percent of sexually active young women have chlamydia, with an average of about 3 percent; 80 percent show no symptoms. Even if the prevalence is low, screening has been shown to be clinically useful and cost-effective.

Cook and his colleagues surveyed over 800 primary care physicians in Pennsylvania. Participants were given a case study asking what tests they would conduct during a routine gynecological exam of a sexually active 19-year-old woman, who indicated no symptoms.

Only one-third of the physicians indicated they would test for chlamydia, according to the study. Female physicians, physicians in public clinics and academic settings, physicians in metropolitan areas and physicians with a large proportion of minority patients were more likely to screen for chlamydia.

The study also found that physicians were less likely to screen their patients for chlamydia if they believed that the majority of their 18-year-old patients were not sexually active or if they believed the prevalence of chlamydia is too low to make screening useful.

"It's a startling misconception among some doctors that their young patients aren't sexually active or wouldn't be exposed to the disease. Sixty-five percent of 18-year-old women have had intercourse and chlamydia is frequently detected across all populations," Cook said.

According to the study, screening for chlamydia prevents pelvic inflammatory disease, lowers the prevalence of chlamydia in a population over time and may reduce the risk of acquiring HIV infection. Current U.S. health care costs attributed to chlamydial infections exceed $2 billion; screening could significantly reduce this amount.

Prof receives 2-year grant The Lupus Foundation of Pennsylvania has awarded a $60,000, two-year grant to M. Ilyas Kamboh, a Pitt professor of human genetics and psychiatry, for the study, "Prothrombin Gene Variation and Risk of SLE and Thrombosis."

Autoantibodies called anti-phospholipid antibodies (APA) in lupus patients are associated with thrombosis, atherosclerosis, fetal loss and low counts of blood platelets. The genetic bases of both lupus and APA are not clear.

Kamboh's study will investigate the role of a gene called prothrombin in the production of APA and the occurrence of lupus. Successful completion of the study is expected to improve understanding of the genetic bases of lupus and APA.

Genetic testing can predict beta blocker effectiveness The effectiveness of beta blockers in improving the survival of congestive heart failure patients can be predicted by genetic testing of the angiotensin converting enzyme (ACE) gene, according to a Pitt study published in the March 27 issue of Circulation, a publication of the American Heart Association.

Beta blockers are drugs used to treat congestive heart failure, a progressive disease in which the heart's muscle is weakened after injury from a heart attack or high blood pressure and gradually loses its ability to pump blood. Previous studies have shown that beta blockers are more effective in some patients than in others.

Many important genes occur in the general population in multiple variations (or alleles), some of which may alter how the gene functions. A common variation of the ACE gene, the "ACE-D" or deletion allele, is missing a small section of DNA. This results in patients having higher levels of the hormone angiotensin II, which raises blood pressure. In patients with heart failure, higher levels of angiotensin II lead to a worsening of symptoms by causing blood vessels to constrict, putting an increased strain on the heart muscle.

"Despite this association between the D allele and higher angiotensin II levels, its role as a cardiac risk factor for heart failure progression remains controversial," said principal investigator Dennis McNamara, a Pitt assistant professor of medicine and director of the heart failure section at the UPMC Health System Cardiovascular Institute.

The study, called Genetic Risk Assessment of Cardiac Events (GRACE), looked at the effects of genetic variation on survival of patients with heart failure, particularly the impact of genetics on the effectiveness of drug therapy. The study followed 328 patients with heart failure due to a weakened heart muscle for an average of 21 months.

Survey finds clinical trials industry

performing 'reasonably well' A new survey has found that the clinical trials industry is performing "reasonably well" but not exceeding the expectations of the public, regulators or sponsors of clinical trials on a range of important measures.

The survey was commissioned by Pittsburgh Clinical Research Network (PCRN), an independently managed unit of UPMC Health System. PCRN provides professional clinical trials management services to industry sponsors of clinical trials such as pharmaceutical, biotechnology and medical device companies.

PCRN commissioned the survey, the first in a new series of "monitors" to track industry opinion on technical, regulatory and consumer issues relevant to the conduct of clinical trials, "in order to help contribute to the increasingly informed debate on complex trials-related issues," said Ronald B. Herberman, chairperson of the PCRN board of directors, Pitt associate vice chancellor for Health Sciences, and director of the University of Pittsburgh Cancer Institute.

The survey was conducted by an independent New York City-based opinion research firm and included over 100 detailed telephone interviews conducted with 55 sponsors of clinical trials, 21 academic medical centers, 13 independent trials management organizations known as contract research organizations, as well as 13 regulatory authorities directly involved in the oversight of trials conducted in the United States.

In the survey, respondents were asked to assess 16 aspects of the clinical trials process -- more particularly, whether the process in question had exceeded, met or fallen short of expectations.

The survey found that few respondents think the clinical trials community has exceeded expectations on any of the dimensions explored. The highest response for "exceeded" was 20 percent -- for protecting participants who enroll in clinical trials.

Moreover, the professionals surveyed thought the clinical trials community would do well to bolster the more consumer-intensive aspects of the clinical trials process. Specifically, 77 percent thought the industry had fallen short in terms of educating the public about the clinical trials process in general, while 83 percent thought the industry had fallen short in familiarizing the public with basic aspects of the trials process such as how to enroll in trials. In addition, 63 percent of the respondents felt the industry had fallen short in terms of enrolling an adequate number of patients in trials.

Respondents were more favorably disposed with respect to professional trials-management issues, such as the industry's efforts to monitor trial sites effectively: 74 percent thought the industry had met expectations in this regard while 67 percent thought the industry had met expectations in regard to protecting human subjects.

Herberman said that PCRN intended to revisit on an annual basis the clinical trials performance measures it explored in this survey.

Copies of the PCRN Monitor may be obtained by calling 420-3800 or sending an e-mail to panicj@msx.upmc.edu.