UPMC Physician Resources

Inflammation-Cancer Feedback Loop Discovery is a Step Toward Better Cancer Drugs

PHILADELPHIA, April 20, 2015 – New findings hidden within the complex machinery behind the vicious cycle of chronic inflammation and cancer are presented today by researchers from the University of Pittsburgh Cancer Institute, partner with UPMC Cancer Center, at the American Association for Cancer Research (AACR) Annual Meeting in Philadelphia.

The research is funded by the National Institutes of Health (NIH) and Fondazione RiMED, of Palermo, Italy.

Inflammation is an important immune system tool that helps the body rid itself of foreign invaders, such as bacteria. However, chronic inflammation can fuel tumor growth by facilitating formation of cancer blood vessels, supplying nutrients and setting cancerous cells free to colonize other parts of the body.

The basic research into the specific mechanisms promoting cancer inflammation is a critical step in the development of drugs that could interrupt this process.

“In the last 20 years we’ve recognized that chronic inflammation and cancer are connected – long-term inflammation leads to the development of dysplasia and tumor progression,” said lead author Sandra Cascio, Ph.D., a research associate in Pitt’s Department of Immunology. “Recently, scientists have provided detailed insights into molecules and cellular pathways linking inflammation and cancer. In our study, we found a new mechanism that had previously escaped us.”

The mechanism is driven by a complex of MUC1, a molecule long studied in the laboratory of senior author and Pitt immunologist Olivera Finn, Ph.D., and p65, a molecule belonging to a protein complex family known to be activated in inflammation.

Dr. Cascio, in collaboration with Dr. Finn, looked for MUC1/p65-mediated epigenetic modifications affecting inflammatory genes. Epigenetics refers to outside factors that modify the activity of a gene, but do not cause a more obvious genetic mutation. Sure enough, the researchers discovered that this complex, which they found specifically in cancer cells, was causing DNA to be transcribed differently than expected.

“Normally MUC1 is covered in sugar molecules, like leaves cover a tree in spring,” said Dr. Cascio. “When it is made by a tumor, it lacks sugar and is more like a tree in fall. Our research shows that this form of MUC1 associates with p65 and regulates transcription of pro-inflammatory cytokine genes in tumor cells. This leads to the recruitment of inflammatory cells into the tumor site. Inflammatory cells, including macrophages, produce additional cytokines that enhance the activity of MUC1 and p65, establishing a continuous positive feedback loop, or a vicious circle, resulting in tumor progression.”

In order to pinpoint this altered pro-inflammatory mechanism in cancer cells, Dr. Cascio and her team combed through more than 20 types of epigenetic modifications and 300 factors that allow for the remodeling of chromatin, which are macromolecules in cells that control gene expression and DNA replication.

Specifically, the researchers found that MUC1 and p65 involve an enzyme called the Enhancer of Zeste homolog 2, or EzH2, known to induce epigenetic modifications, in order to prompt chromatin remodeling on cytokine gene promoters.

“Developing drugs that could keep these genes from being improperly turned on and off could interrupt this cancer-inflammation process and stop the tumor growth and spread,” said Dr. Cascio. “It’s a promising avenue for future exploration.”

Joshua Sciurba, B.S., of Pitt at the time of this research, also participated in this work.

This research was funded by Fondazione RiMED and NIH National Cancer Institute grant CA56103.

New Study Will Test if Anti-Amyloid Antibody Can Prevent Development of Alzheimer’s Disease

PITTSBURGH, April 20, 2014 – Researchers at the University of Pittsburgh School of Medicine will be part of a multicenter trial that will test for the first time whether a drug that treats brain plaques can prevent later development of memory loss in Alzheimer’s Disease.

Studies have shown that brain changes in Alzheimer’s begin many years before disease onset, and that all patients have deposits of beta amyloid in their brains, said Oscar Lopez, M.D., professor of neurology, Pitt School of Medicine, and co-director of the Alzheimer’s Disease Research Center (ADRC). He is the principal investigator of the Pittsburgh arm of the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s (A4) study.

“This is the first study to assess whether an experimental antibody that counteracts amyloid will have long-term impact that can prevent Alzheimer’s,” said Dr. Lopez, who noted that many people have beta amyloid deposits in the brain but never develop dementia. “We suspect that these plaques have a role in disease development, but it’s not been proven that they affect memory and cognition. The A4 study could shed light on that.”

For A4, the researchers will perform a baseline PET scan on otherwise healthy volunteers, ages 65 to 85, to determine if brain plaques are present. If so, participants will be randomly assigned to receive monthly intravenous infusions of the experimental anti-amyloid antibody or a placebo. All participants will have regular assessments and blood tests for three years.

“Because of the nature of the disease, a friend or family member also must be willing to answer questions annually about how the participant is doing at home,” Dr. Lopez explained. “This study could help us find ways of predicting who might be at greater risk for progressing to Alzheimer’s.”

People who are interested in participating should call study coordinator Katy Orchowski Zorich at 412-624-2730 or email her at orchowskik3@upmc.edu.

Pitt, Children’s Research Papers Receive Top 10 Awards from Clinical Research Forum

PITTSBURGH, April 20, 2015 – Three scientific papers published in 2014 by research teams from the University of Pittsburgh School of Medicine and Children’s Hospital of Pittsburgh of UPMC have each been selected to receive a Clinical Research Forum Annual Top 10 Clinical Research Achievement Award.

The awards were announced last night at the Forum’s annual meeting in Washington, D.C. The winning papers from Pitt and UPMC were chosen based on their degree of innovation from a pool of more than 50 nominations from 30 research and academic health centers nationwide. The Forum and its supporters believe these and other top ten papers represent the best and brightest work in the field, and will lead to advancements in medicine that will change lives and patient outcomes worldwide.

“It is extraordinary to have three University of Pittsburgh projects in a variety of disciplines recognized by the Forum for their clinical impact and rigorous science,” said Arthur S. Levine, M.D., Pitt’s senior vice chancellor for the health sciences and the John and Gertrude Petersen Dean of Medicine. “This impressive showing reflects the commitment and caliber of the researchers on our campus, and is a tribute to the University’s Clinical and Translational Science Institute, which facilitates and supports these endeavors.”

The three winners are:

  • “Upper-Airway Stimulation for Obstructive Sleep Apnea,” published Jan. 9, 2014, in the New England Journal of Medicine, showed implanting a device called Inspire® Upper Airway Stimulation led to a 70 percent reduction of severe obstructive sleep apnea symptoms. Project investigators included lead author Patrick Strollo, M.D., professor of medicine and clinical and translational science, Pitt School of Medicine, and medical director of the UPMC Sleep Medicine Center, and Ryan Soose, MD.
  • A Randomized Trial of Protocol-Based Care for Early Septic Shock,” published May 1, 2014, in the New England Journal of Medicine, showed that a structured, standardized approach to diagnose and treat sepsis in its early stages did not change patient survival rates. Project investigators included Derek Angus, M.D., M.P.H., distinguished professor and Mitchell P. Fink Chair, Department of Critical Care Medicine, Pitt School of Medicine, and Donald M. Yealy, M.D., professor and chair of Pitt’s Department of Emergency Medicine.
  • Antimicrobial Prophylaxis for Children with Vesicoureteral Reflux,” published June 19, 2014, in the New England Journal of Medicine, showed that children with abnormal flow of urine from the bladder to the upper urinary tract, called vesicoureteral reflux (VUR), can avoid recurrent urinary tract infections by taking daily low-dose antibiotics. Project investigators included senior author Alejandro Hoberman, M.D., chief, Division of General Academic Pediatrics at Children’s Hospital, and professor of pediatrics, Pitt School of Medicine.

“I applaud the researchers recognized for their groundbreaking clinical research that will advance new treatments to reduce suffering and bring hope to millions of people,” said National Institutes of Health director, Francis S. Collins, M.D., Ph.D. “And I’m especially proud that NIH funding makes these advances possible.”

Other awardees include scientists from Harvard Medical School, Yale University, the University of Pennsylvania, UCLA and other leading institutions.

The Clinical Research Forum was formed in 1996 to discuss the unique and complex challenges to clinical research in academic health centers. The mission of the Forum is to provide leadership to the national clinical and translational research enterprise and promote understanding and support for clinical research and its impact on health and health care.

Magee, UPCI Researchers Seek New Targets for Ovarian Cancer Treatment

PHILADEPHIA, April 19, 2015 – Identifying molecular changes that occur in tissue after chemotherapy could be crucial in advancing treatments for ovarian cancer, according to research from Magee-Womens Research Institute and Foundation (MWRIF) and the University of Pittsburgh Cancer Institute (UPCI), partner with UPMC CancerCenter, presented today at the American Association for Cancer Research (AACR) Annual Meeting 2015.

For years now, intraperitoneal chemotherapy, a treatment which involves filling the abdominal cavity with chemotherapy drugs after surgery, has been considered the standard of care for ovarian cancer. According to Shannon Grabosch, M.D., a gynecologic oncology fellow at Magee-Womens Hospital of UPMC and the study’s lead investigator, treatment advances for this disease haven’t moved forward as quickly as they have for other cancers.

“The addition of intraperitoneal chemotherapy for women with ovarian cancer was one of the biggest achievements in improving survival outcomes, but unfortunately, we still don’t understand the biological mechanisms by which this works,” said Dr. Grabosch. “We wanted to understand what changes occurred to the local tumor environment after chemotherapy was administered, with the idea that these changes could eventually be targets for new, personalized ovarian cancer treatments.”

Dr. Grabosch and her team examined peritoneal cavity fluid and peripheral blood samples of 13 patients. The samples were obtained prior to intraperitoneal treatment and after the first and second rounds of chemotherapy. Using multiple sequencing techniques, Dr. Grabosch and her team identified chemotherapy-induced molecular changes.

“We were able to identify changes in both miRNA and genes which appear to be related to chemotherapy. Furthermore, we identified different, significant changes between the peritoneal cavity and blood samples, proving that the local tumor environment is an underutilized wealth of information,” said Dr. Grabosch. “Now we need larger studies to determine whether the changes that occur in the tumor microenvironment after chemotherapy could be potential targets for new, more personalized drugs and to further understand the mechanisms of intraperitoneal chemotherapy.”

Additional authors on this research, which was funded by the Magee-Womens Research Institute and Foundation and the Gynecologic Oncology Group, are Anda M. Vlad, M.D., Ph.D., Tianzhou Ma, M.S., Jyothi Mony, Ph.D., Mary Strange, M.S., Joan Brozick, M.H.A., Julia Thaller, M.B.A., George Tseng, Ph.D., Xin Huan, Ph.D., Katie Moore, M.D., Kunle Odunsi, M.D., Ph.D., and Robert P. Edwards, M.D., all with MWRIF and UPCI.

Broccoli Sprout Extract Promising for Head and Neck Cancer Prevention

PHILADELPHIA, April 19, 2015 – Broccoli sprout extract protects against oral cancer in mice and proved tolerable in a small group of healthy human volunteers, the University of Pittsburgh Cancer Institute (UPCI), partner with UPMC CancerCenter, announced today at the American Association for Cancer Research (AACR) Annual Meeting in Philadelphia.

The promising results will be further explored in a human clinical trial, which will recruit participants at high risk for head and neck cancer recurrence later this year. This research is funded through Pitt’s Specialized Program of Research Excellence grant in head and neck cancer from the National Cancer Institute.

“People who are cured of head and neck cancer are still at very high risk for a second cancer in their mouth or throat, and, unfortunately, these second cancers are commonly fatal,” said lead author Julie Bauman, M.D., M.P.H., co-director of the UPMC Head and Neck Cancer Center of Excellence. “So we’re developing a safe, natural molecule found in cruciferous vegetables to protect the oral lining where these cancers form.”

Previous studies, including large-scale trials in China, have shown that cruciferous vegetables that have a high concentration of sulforaphane – such as broccoli, cabbage and garden cress – help mitigate the effects of environmental carcinogens.

Dr. Bauman collaborated with Daniel E. Johnson, Ph.D., professor of medicine at Pitt and a senior scientist in the UPCI Head and Neck Cancer Program, to test sulforaphane in the laboratory. For several months, Dr. Johnson and his team gave sulforaphane to mice predisposed to oral cancer and found that it significantly reduced the incidence and number of tumors.

“The clear benefit of sulforaphane in preventing oral cancer in mice raises hope that this well-tolerated compound also may act to prevent oral cancer in humans who face chronic exposure to environmental pollutants and carcinogens,” said Dr. Johnson.

Dr. Bauman treated 10 healthy volunteers with fruit juice mixed with sulforaphane-rich broccoli sprout extract. The volunteers had no ill-effects from the extract and protective changes were detectable in the lining of their mouths, meaning it was absorbed and directed to at-risk tissue.

These findings were enough to prompt a clinical trial that will recruit 40 volunteers who have been curatively treated for head and neck cancer. The participants will regularly take capsules containing broccoli seed powder to determine if they can tolerate the regimen and whether it has enough of an impact on their oral lining to prevent cancer. From there, larger clinical trials could be warranted.

“We call this ‘green chemoprevention,’ where simple seed preparations or plant extracts are used to prevent disease,” said Dr. Bauman, also an associate professor in Pitt’s School of Medicine. “Green chemoprevention requires less money and fewer resources than a traditional pharmaceutical study, and could be more easily disseminated in developing countries where head and neck cancer is a significant problem.”

Additional authors on this research are Yan Zhang, Ph.D., Malabika Sen, Ph.D., Daniel P. Normolle, Ph.D., Thomas W. Kensler, Ph.D., Sumita Trivedi, M.B.B.S., and Siddharth H. Sheth, D.O., M.P.H., all of Pitt; Jennifer R. Grandis, M.D., F.A.C.S., of Pitt at the time the research was conducted; and Patricia A. Egner, M.S., of Johns Hopkins University.

Trial Co-Led by Pitt Researcher Shows Greater Function after Stroke When Blood Clots Removed from Brain Blood Vessels

PITTSBURGH, April 17, 2015 – A technique that removes blood clots from large brain blood vessels reduced disability after stroke in a trial conducted in Catalonia, Spain, and co-led by an expert from the University of Pittsburgh School of Medicine. The findings will be announced today at the annual meeting of the European Stroke Organisation in Glasgow, Scotland, and published online in the New England Journal of Medicine.

The results of the trial, known as REVASCAT, echo findings from other recent large studies that were stopped early when  the technique, called endovascular therapy or stent retriever thrombectomy, appeared to be highly effective, said co-principal investigator Tudor Jovin, M.D., associate professor of neurology and neurological surgery, and director of the UPMC Stroke Institute. Originally, the REVASCAT trial expected to enroll nearly 700 participants.

“This is a giant step forward that will change the way we approach triage and treatment of stroke patients,” Dr. Jovin said. “After an interim analysis once 25 percent of the original participant sample size were enrolled, the data safety monitoring board of the study recommended stopping the trial as it became clear that it was no longer ethically justified to randomly assign patients to receive only conventional therapy. “And, as other studies found, removing blood clots from the brain did indeed lead to better outcomes for patients.”

Endovascular therapy is performed by inserting a thin tube into a groin artery to thread it through the aorta and into the brain vessels using X-ray-guided imaging. A retrievable stent opens the blocked vessel to restore blood flow and then is withdrawn, pulling the clot out with it. Dr. Jovin discusses and demonstrates the treatment in this video: http://youtu.be/s7wY9RgAFTk.

For the study, conducted at four large designated stroke centers in Catalonia, Spain, between November 2012 and December 2014, the researchers treated and monitored 206 patients whose stroke symptoms began not more than eight hours earlier and who had evidence of vessel blockage in imaging studies. For the 70 percent of patients who received an intravenous dose of the clot-busting drug tPA, or alteplase, imaging studies conducted 30 minutes after tPA administration had to confirm the vessel was still blocked. Half the patients were randomly assigned to receive medical therapy alone and the other half to medical therapy plus stent retriever thrombectomy.

The researchers found a 1.7 fold reduction in disability and a 15.5 percent increase in the rate of return to functional independence in the endovascular therapy group compared to the medical intervention-alone group.

Because the Catalan Department of Health keeps a registry of all  stroke patients treated with clot busting therapies (intravenous or intra-arterial) , the researchers were able to determine that nearly all eligible patients who were treated at participating centers and in Catalonia over the duration of the trial were actually enrolled in REVASCAT. This unique feature distinguished the trial from other similar recently published randomized studies, removing any lingering concerns that endovascular therapy for stroke is only beneficial for a minority of eligible patients, Dr. Jovin noted.

“We now have five global studies that provide an overwhelming body of clinical evidence in support of stent retriever thrombectomy. Based on these findings, it is time for the stroke community to come together to re-evaluate stroke treatment guidelines and to look for systems to facilitate the access of treatable patients to specialized centers,” said co-principal investigator Antoni Dávalos, M.D., Ph.D., of Hospital Universitari Germans Trias i Pujol, and professor of neurology at the Universitat Autònoma de Barcelona in Spain.

The researchers say that more work needs to be done to determine whether the technique is effective when performed more than eight hours after stroke onset, in vessels that are smaller and in different locations in the brain than those treated in REVASCAT, and in the very elderly.

The study team included researchers from Barcelona, Spain; the University of Calgary in Canada; and the Dresden University of Technology in Germany. The project was funded by the Fundació Ictus Malaltia Vascular through an unrestricted grant from device manufacturer Covidien, and by a grant from the Spanish Ministry of Health co-financed by FEDER (Instituto de Salud Carlos III).

Published the same day in the NEJM and presented at the European Stroke Organisation Meeting, researchers announced further results of another large stroke trial of nearly 200 patients called SWIFT PRIME. That study showed endovascular treatment within six hours of stroke onset led to increased functional recovery and decreased 90-day disability. The Pitt arm of SWIFT PRIME, led by Dr. Jovin, was the second-leading enroller in the trial.

Pitt Cancer Virology Team Reveals New Pathway that Controls How Cells Make Proteins

PITTSBURGH, April, 13, 2015 – A serendipitous combination of technology and scientific discovery, coupled with a hunch, allowed University of Pittsburgh Cancer Institute (UPCI) researchers to reveal a previously invisible biological process that may be implicated in the rapid growth of some cancers.

The project, funded by the National Institutes of Health (NIH), is described in today’s issue of the Proceedings of the National Academy of Sciences (PNAS).

“I was so amazed by what I was seeing,” said lead author Masahiro Shuda, Ph.D., research assistant professor in Pitt’s Department of Microbiology & Molecular Genetics. “We repeated and repeated our work to prove that the standard scientific dogma wasn’t the complete story.”

Dr. Shuda and his colleagues showed that a well-known cancer protein called mTOR, previously thought to be solely responsible for controlling a form of protein production important in cancer cells, called cap-dependent translation, can actually hand its work off to a different protein, CDK1, when cells are dividing. They observed the process while examining a viral oncoprotein that allows a common and usually harmless virus to transform healthy cells into cancer cells.

Merkel cell polyomavirus (MCV) was discovered in 2008 by co-authors Yuan Chang, M.D., and Patrick S. Moore, M.D., M.P.H., in the Cancer Virology Program at UPCI, partner with UPMC CancerCenter. It causes a rare but deadly skin cancer called Merkel cell carcinoma. They later found a viral protein called “small tumor protein,” or sT. It may start a chain reaction that enables tumor growth resistant to cancer drugs that inhibit the protein mTOR.

In studies dating back to the 1960s, scientists had assumed that cap-dependent protein synthesis was turned off during cell division. The new study reveals that this is not necessarily so and that CDK1 can substitute for mTOR. Both mTOR and CDK1 work by inhibiting a gatekeeper protein, called 4E-BP1, that shuts off cap-dependent protein synthesis.

Less than 1 percent of cells are in the active division cycle called mitosis, even in very aggressive cancers, which makes studying cells in mitosis difficult. In addition, a drug traditionally used to arrest the cells during division inhibits protein production by CDK1. This is likely why previous research did not identify the important role that CDK1 appears to play.

Dr. Shuda used a technology called flow cytometry to identify cells undergoing division. With special fluorescent tags, he was able to see mitotic cells produce fully inactivated 4E-BP1 by CDK1. He also directly measured proteins being made during mitosis.

Sure enough, even when mTOR was knocked out, CDK1 was still present and able to allow protein synthesis needed for cell division to progress.

“Now, we still can’t say that this process involving CDK1 contributes to cancer – that’s something we’ll tackle with future research,” said Dr. Moore, senior author and professor of molecular genetics and biochemistry at Pitt. “But it does point toward a fundamental control mechanism in cell biology and leads to the interesting possibility that creating or combining cancer drugs, so that they inhibit both mTOR- and CDK1-related protein synthesis, could be a very useful therapy to pursue.”

Additional researchers on this work are Celestino Velásquez, B.S., Erdong Cheng, Ph.D., Daniel G. Cordek, Ph.D., and Hyun Jin Kwun, Ph.D., all of Pitt. Drs. Moore and Chang jointly run their laboratory at UPCI.

This research was supported by NIH National Cancer Institute grants R01CA136806, CA136363 and CA170354. The flow cytometry was performed using a facility supported in part by NIH grant P30CA47904.

Pitt Collaborates with Janssen to Study and Tailor New Treatments for Inflammatory Bowel Disease

PITTSBURGH, April 8, 2015 – Researchers at the University of Pittsburgh will collaborate with Janssen Research & Development, LLC (Janssen) on a project to study the effectiveness of potential new therapies for inflammatory bowel disease (IBD).

A research team led by Ian McGowan, M.D., Ph.D., professor of medicine, Pitt School of Medicine, will use tissue samples from patients with Crohn’s disease and ulcerative colitis, two types of IBD, as well as from healthy volunteers, to evaluate experimental medicines developed by Janssen.

“This is a wonderful opportunity to advance future therapeutic approaches that may one day benefit patients living with IBD,” Dr. McGowan said. “We hope that this process will guide us to more effective treatments for these complex immune-mediated diseases.”

More than 6,000 IBD patients are seen each year by physicians in the Division of Gastroenterology, Hepatology, and Nutrition at Pitt and UPMC, which is led by David Whitcomb, M.D., Ph.D., Giant Eagle Foundation Professor of Cancer Genetics and professor of medicine, Pitt School of Medicine.

“The integration of an outstanding clinical IBD program with cutting-edge basic science research teams to introduce the best new therapies to patients who desperately need them can only happen in a few places in the world,” Dr. Whitcomb said. “Everyone here is committed to the success of this program at every level, by every measure.”

The project was coordinated by the university’s Pharmaceutical Collaborations Committee, which is chaired by D. Lansing Taylor, Ph.D., director of Pitt’s Drug Discovery Institute.

UPMC Inpatient Child and Adolescent Bipolar Services (In-CABS) Program Receives National Honor for Technological Initiatives

PITTSBURGH, April 6, 2015 – The Inpatient Child and Adolescent Bipolar Services (In-CABS) program at Western Psychiatric Institute and Clinic of UPMC has received a first prize National Council for Community Behavioral Healthcare 2015 Impact Award of Excellence in Health Information Technology. The award, which will be announced on April 21 at the Excellence Awards Dinner in conjunction with the National Council Conference in Orlando, recognizes In-CABS’ use of health IT interventions, comprehensive diagnostic assessments, state-of-the-art pharmacological treatment, and psychosocial interventions. The program also trains students and professionals from a broad range of disciplines in health IT.

Each year, the National Council’s Awards of Excellence honor individuals and organizations that are making large strides in fighting mental illness and addiction. Specifically, the awards celebrate the achievements of individuals who dedicate themselves to improving the lives of those with serious mental illnesses, and the accomplishments and efforts of those living with schizophrenia or bipolar disorder in improving their own lives and the lives of their peers.

“This award is important for In-CABS because it acknowledges our high-tech, innovative initiatives in our daily morning report and triage,” says Rasim Somer Diler, MD, assistant professor of psychiatry at the University of Pittsburgh School of Medicine and medical director of Inpatient Child and Adolescent Bipolar Services. “We’ve also implemented the Philips® Actiwatch to objectively measure sleep and arousal using neurocognitive measures, and we set up daily electronic mood and energy monitoring with an interactive projector through the Beckwith Institute’s Clinical Transformation Program.”

To learn more about In-CABS, please download the program brochure.

Geriatric Psychiatry Experts Present at AAGP’s 2015 Annual Meeting

PITTSBURGH, April 2, 2015 – UPMC and the University of Pittsburgh were well-represented at the recent American Association for Geriatric Psychiatry 2015 Annual Meeting in New Orleans. UPMC and the Department of Psychiatry hosted an alumni and friends cocktail reception during the meeting.

Faculty research also was featured in oral and poster presentations throughout the conference, including topics such as:

  • Non-Pharmacological Management of Behavioral Disturbance in Dementia
    Chair: Lalith Solai, MD
  • Research Update: Healthy Aging and Prevention of Late-Life Mood and Cognitive Disorders
    Faculty: Charles Reynolds III, MD
  • Update on Geriatric Sleep Disorders
    Faculty: Charles Reynolds III, MD
  • Neurocircuitry Dysfunction in Late-Life Depression: The Role of Negative Valence Systems and Cognitive Control Networks
    Faculty: Howard Aizenstein, MD, PhD
  • IPTci vs. PATH as Psychosocial Approaches to Cognitive Impairment: Clinical Perspectives, Advantages, and Limitations for Managing MCI to Moderate Dementia With Co-Morbid Depression
    Faculty: Mark Miller, MD
  • Recent Advances in Late Life Schizophrenia Research
    Session Chair: John Kasckow, MD, PhD
  • Opioids for Agitation in Advanced Alzheimer’s Disease
    Discussant: Crystal White, MD

For more information about the AAGP annual meeting, please visit the conference page.

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