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DEPARTMENT OF INTERNAL MEDICINE NEWSLETTER

internalmed.slu.edu

January 2008

SPOTLIGHT ON Vaccine Center Renewed for 7 Years The National Institutes of Health has renewed the Saint Louis University Vaccine and Treatment Evaluation Unit (VTEU) contract for another 7 years. This is a feather in the cap for the Department of Internal Medicine and the University said Dr. Robert Belshe, Principal Investigator of the Vaccine and Treatment Evaluation Unit at Saint Louis University. Funding for 7 years will allow us to conduct long-term projects and do substantial planning for contributing to improve vaccines and healthcare for the United States. SLU has been a VTEU site for 18 years and more than 100 million in federal research dollars have come to SLU to conduct vaccine research at the Vaccine Center. Dr. Belshe and his group are the longest continuously funded VTEU, 25 years at two institutions Marshall University and SLU. SLU recruited the Vaccine Center in 1989 to enhance its research mission. At that time Bordley Tower had just opened as a research facility and faculty were added in 1989-90 to expand the research mission of the Department. Dr. Di Bisceglie noted that he expects SLU to move to another level in research funding with the opening of the Doisy research facility, and the addition of additional research faculty. The Vaccine Center renewal comes at an opportune time with the development of the new Doisy Research Building. The Vaccine Center currently occupies laboratories on the 8th floor and the clinic on the 1st floor for clinical trials. Recent clinical projects include evaluation of novel vaccines for influenza, including the live attenuated influenza vaccine available for children and adults age 2-49. Ongoing projects include clinical studies with

avian influenza vaccine (H5, the bird flu), and a series of vaccine trials designed to develop better strategies for protection against tuberculosis (including mucosal delivery of TB vaccines and studies of novel recombinant TB vaccines). Additional ongoing studies include the Herpevac Trial for Women. Saint Louis University is coordinating 50 other academic centers to evaluate a sub-unit vaccine for HSV2 in women age 18-30. More than 8,300 women are participating in the efficacy field trial. Past successes include evaluating haemophilus conjugate vaccines in infants, pneumococcal vaccines in infants and adults, demonstrating that smallpox vaccine dilutions could extend the national vaccine reserve by tenfold, evaluation of efficacy of acellular pertussis vaccines in college students, and development of Flumist as an improved vaccine for influenza. Collaborations between the Vaccine Center and the Liver Center are important to the department and to the research community. This collaboration led to the first in human studies of a prophylactic vaccine for hepatitis C. These studies are ongoing and may lead to therapeutic vaccine trials, said Dr. Di Bisceglie. The Division of Infectious Diseasees and VTEU have significant collaborations beyond the University, including the Midwest Research Center for Excellence for Biodefense Studies. Dr. Sharon Frey has chaired several key studies of new second and third generation smallpox vaccines for the NIH, and she has become nationally known in this area. The new Immunobiology Division chaired by Dr. Dan Hoft is another important collaboration for the study of immune responses to vaccines, and has been highly successful in obtaining additional funding from the NIH and the Gates Foundation. Dr. Hoft commented that this

DEPARTMENT OF INTERNAL MEDICINE NEWSLETTER

internalmed.slu.edu

January 2008

VTEU renewal ensures that our strengths in vaccine development will continue to be strong and expand over the next 7 years with our potential for increased collaborations in the new Doisy Research Building. How Can Physicians Job Satisfaction Be Improved? (St. Louis Post-Dispatch 11/28/07) Thomas J. Olsen, M.D., Acting Director, Division of General Internal Medicine, was quoted in the Post-Dispatch as saying that Salary, hours, paperwork, and malpractice often dominate discussions about physician satisfaction. From my perspective as an internist and medical educator, addressing two other issues could increase the satisfaction of all who interact with that system. Medical student debt is at a worrisome level. At graduation, more than half of all medical students owe more than $120,000 if they attended a public institution and $150,000 if they attended a private institution. This debt influences students career choices. Students with large debt are less likely to enter primary care because of its lower salaries compared to other specialties. They are less likely to start a new practice in an area where there is need because of the cost of opening a practice. Announcements Laura J. Kroupa, M.D., will assume her new duties as Associate Chief of Staff (ACOS) for Education January, 2008. As ACOS, she is responsible for overall cognizance, coordination and evaluation of the St. Louis VAs educational activities and is an active liaison to the medical

schools and other affiliated training programs. She will no longer be the ACOS for Primary Care, but will continue her current clinical and teaching duties. Grand Rounds Sign-In Sheet There will be a new evaluation/sign-in form for Grand Rounds attendance starting with the January 4, 2008 Grand Rounds. Faculty, residents, students and others will use the same form. In order to receive CME credit for attendance, please make sure your name is printed on this form. Awards Akwi Asombang, M.D., fourth-year internal medicine and pediatrics resident, has been honored by the Association of American Medical Colleges (AAMC) Organization of Resident Representatives (ORR) for her work with African refugees in St. Louis. Dr. Asombang received the 2007 ORR Resident Physician Community Service Recognition Award at the AAMCs Organization of Resident Representatives at the associations annual meeting in Washington, D.C., in November 2007. The ORR Award distinguishes those who have made substantive community contributions going well above and beyond the rigors of their residency training. In honoring Dr. Asombang, the association cited her work as a long-time volunteer and now president of African Refugees and Immigrant Services (ARIS), which was founded to help recent African refugees integrate into the St. Louis community. Research Grants Robert B. Belshe, M.D., Infectious Diseases, $23,699,925 from the NIAID for Vaccine and

Laura J. Kroupa

DEPARTMENT OF INTERNAL MEDICINE NEWSLETTER

internalmed.slu.edu

January 2008

Treatment Evaluation Units (VTEUs): Evaluation of Control Measures Against Diseases Other Than AIDS. H. J. Reimers, M.D., Hematology/Oncology, $39,000 from the CDC/The Childrens Mercy Hospital for Region VII Hemophilia Program. H. J. Reimers, M.D., Hematology/Oncology, $39,000 from HRSA/The Childrens Mercy Hospital for Great Plains Regional Hemophilia Diagnostic Treatment Centers Program. Michael Rauchman, M.D., Nephrology, $500,000 from the American Heart Association for Sall Genes, Transcriptional Repression, Chromatin Remodeling and Kidney Development. Mark Schnitzler, Ph.D., SLUCOR, $84,282 from NIDDK/Washington University for Washington University Center for Kidney Disease Research. Terry Moore, M.D., Arthritis/Rheumatology, $25,000 from the American College of Rheumatology for ACR REF/Amgen/Wyeth Rheumatology Fellowship Training Award. Adrian M. Di Bisceglie, M.D., Gastroenterology/Hepatology, $14,028 from NCI/Drexel University for Early Detection of Liver Cancer. Daniel Hoft, M.D., Ph.D., Immunobiology, $35,283 from NIAID/Case Western Reserve University for Tuberculosis Research Unit. Denise Janosik, M.D., Cardiology, $261,800 from NIH/Columbia University for Warfarin vs. Aspirin in Reduced Cardiac Ejection Fraction.

Charlene Prather, M.D., Gastroenterology/ Hepatology, $67,911 from NIDDK/Mayo Clinic for Antidepressant Therapy for Functional Dyspepsia. Clinical Ticker:
FY 07 LESS NUC MED AMB ENCs 8,783 632 2,485 49,405 137 93 62 15,246 7,274 10,753 6,083 100,953

PRACTICE LOCTION CANCER CENTER CARDINAL GLENNON DES PERES DOB MIDWEST ENDOSCOPY OP CATH LABS SLEEP DISORDERS CENTER SLUH SNF/NF/CC/HOSPICE UNIVERSITY CLUB TOWER OTHER Grand Total FY 07 Monthly Amb Enc Figure (less NUC MED) FY 08 Monthly Amb Encs / FY 07 Monthly Amb Encs

FY 08 YTD DEC 07 4,660 359 1,118 24,862 182 151 82 7,110 3,052 5,000 3,006 49,581 48,442 1002.4%

Website Access the Department of Internal Medicine website at http://internalmed.slu.edu. Information for Next Newsletter If you have any news, grants, notices, achievements that you would like to be included in the next newsletter or if you think something important was missed, please let Camille Goff know at goffcj@slu.edu .

Editor Adrian M. Di Bisceglie, M.D., FACP Professor of Internal Medicine Acting Chairman