Annual Report 2003 - 2004
Foundation Highlights
Research
2003
Dr. Jack S. Remington, chair of the PAMF Research Institute's Department of Immunology and Infectious Diseases, accepted the role of interim vice president for research and director of the Research Institute until a new director has been appointed. Dr. Remington is also professor of infectious diseases at Stanford University Medical Center. He marked his 40th anniversary with the Research Institute in 2002.
The Department of Immunology and Infectious Diseases' Toxoplasma Serology Laboratory is developing a new commercial test kit that, when used together with existing tests, may improve diagnosis rates for toxoplasmosis infection in newborns. The kit uses a method called Western Blot, which can show if antibodies in the blood have been actively produced by the baby - signaling infection - or inherited passively from the mother. Dr. Remington and his colleagues first reported that Western Blot can be used for this purpose in 1985, but because the method is time-consuming, it has only recently become feasible for routine use with a test kit produced by a European company.
Dr. Andrew Nevins, a post-doctoral fellow in infectious diseases at the PAMF Research Institute and Stanford, joined Dr. José Montoya, co-director of the Research Institute's Toxoplasma Serology Laboratory, to study cytokines, or molecules that facilitate communication between cells in the immune system. If manipulated correctly, cytokines might be used to influence the immune response and treat disease.
The Asthma and Allergy Foundation of America began nationwide dissemination of the Department of Health Services Research's Wee Wheezers and Wee Wheezers at Home programs, which help parents and young children learn to manage childhood asthma. In 2001, the national Centers for Disease Control and Prevention (CDC) identified these as effective asthma education
programs for children under 7 and their families, and supported their packaging for widespread dissemination.
2004
Dr. Iris Colon, a high-risk fetal medicine fellow
in obstetrics/gynecology at Stanford, is working with Drs. Montoya and Remington on a new method to recognize the source of infections by detecting genetically engineered antigens of the infecting organisms. This information will help prevent an infection from occurring.
Dr. Jennifer Schneider, a resident in internal medicine at Stanford, is working with
Dr. Montoya to study the epidemiology of infections in South America and different approaches to prevent the infections.
Dr. Montoya and his colleagues at the Research Institute, in collaboration with the CDC, are spearheading a study to more clearly define the reasons women become infected with certain infectious organisms that can pass from the infected mother to her offspring. Such information will be used to educate mothers on how to prevent themselves from becoming infected.
The Sutter Health Prostate Cancer Service Line Committee, including Dr. Gordon Ray, head of the Palo Alto Clinic's Radiation Oncology Department, Dr. Sandra Wilson, chair of the PAMF Research Institute's Department of Health Services Research, and Dr. Nancy Brown, senior research associate, was awarded a pilot grant by the Sutter Health Institute for Research and Education (SHIRE) to develop a program to help prostate cancer patients with treatment decision-making.
Some studies have suggested that women who use hormonal contraceptive methods are less likely than other women to use condoms in situations where they are at risk for a sexually transmitted infection (STI). However, among women who recently experienced such an infection, Dr.Wilson, Dr. Brown and colleagues have found that this is not the case. Previous studies may have failed to control for other differences between hormonal contraception users and non-users, or used inappropriate measures of condom use, they reported. This recently published work was done in conjunction with an experimental trial of the Practicing Safer Sex Today (PSST!) program and supported by a grant from the National Institute of Child Health and Human Development.
With funding from the California University-wide AIDS Research Program, Dr. Nancy Brown and Veronica Luna completed an evaluation of a prevention intervention, the Women's Options for Risk Reduction through Knowledge of Self (WORKS) program. Offered by Santa Clara County HIV service providers, WORKS involved a series of HIV-prevention workshops and STI and HIV counseling and testing for female injection drug users (IDUs) or partners of IDUs. Results suggest that WORKS was successful in increasing condom use and the number of women who carried condoms, felt confident they could use them properly, and used needle exchange services.
The PAMF Research Institute's Department of Clinical Research is conducting several clinical trials. One compares two drugs, Tamoxifen and Raloxifene, and their effectiveness in reducing the occurrence of breast cancer. A second study, in association with the Palo Alto Division's Department of General Surgery, is underway to assess postoperative pain in patients who have had hernia-repair surgery. Two studies are being conducted with the Palo Alto Division's Department of Neurology. One focuses on the use of the medication Avonex for patients with multiple sclerosis, and a second is assessing patients after cervical-disc surgery. Two additional studies with rheumatoid arthritis patients are evaluating various medications used to treat the disease.
Two Clinical Research studies are examining new medical devices. One device is used to test blood-sugar levels in diabetic patients, and is being tested at the Camino Division. The second focuses on a new machine to measure prothrombin time in patients who need to take medication to prevent clotting of the blood. The Palo Alto Division is conducting this study.
PAMF was the first health care organization in the area to participate in a new national study comparing two techniques for managing breast cancer patients whose cancer has spread to the lymph nodes. The Palo Alto Division's clinical trial will evaluate the long-term outcomes and side effects of axillary lymph node dissection (ALND), in which all lymph nodes under the arm are removed, and sentinel lymph node dissection (SLND), which removes only those lymph nodes to which the cancer is likely to spread first.
Dr. Neil B. Ingels, senior staff scientist and head of the PAMF Research Institute's Laboratory of Cardiovascular Physiology and Biophysics, presented four invited lectures. Dr. Ingels' research, in collaboration with Dr. D. Craig Miller, professor of cardiovascular surgery at Stanford, focuses on the biomechanics of the heart - the size, shape and motion of the heart and valves. Postdoctoral fellows supervised by Drs. Ingels and Miller won four major awards.
Dr. Andreas Stahl of the PAMF Research Institute's Department of Cardiovascular Biology was awarded two five-year grants. One is a Career Development Award and grant by the American Diabetes Association to study the link between obesity-associated type 2 diabetes and the uptake of fatty acids by a transport protein (FATP) specific to skeletal muscles. If there are too many fatty acids in the bloodstream, muscles can become resistant to insulin. Dr. Stahl and a team of scientists are now exploring if muscles without the FATP are protected from obesity-associated diabetes. The other grant, from the National Institutes of Health, focuses on the relationship between a different transporter, the liver-specific FATP, and its role in liver diseases and type 2 diabetes.
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