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Distinguished Researcher Named Director of Aging Institute and Beckwith Professor of Translational Medicine at UPMC and Pitt

UPMC and the University of Pittsburgh today announced the appointment of Toren Finkel, MD, PhD, a world-renowned aging researcher, as director of the Aging Institute of UPMC and Pitt and the inaugural holder of the G. Nicholas Beckwith III and Dorothy B. Beckwith Chair in Translational Medicine.

The endowed chair, made possible through a $2.5 million gift by UPMC Chairman G. Nicholas Beckwith III and his wife, Dorothy, will fund a distinguished faculty member focusing on translational medicine and is being made in recognition of UPMC’s commitment to teaching, research, clinical care and community service.

“We are fortunate to have a physician-scientist of Dr. Finkel’s stature join UPMC and Pitt. His discoveries going forward will have a meaningful and favorable impact on the community, and Dotty and I are pleased to support his efforts in translational medicine through this gift,” said Beckwith.

Finkel most recently served as chief of the Center for Molecular Medicine at the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) and will succeed Charles F. Reynolds III, MD, at the helm of the Aging Institute.

A collaboration between the University of Pittsburgh and UPMC, the Aging Institute brings together the expertise of clinical researchers, scholars and clinicians to identify and implement innovative care models for older adults and to support western Pennsylvania’s population with resources for seniors and their caregivers.

“We are delighted that Dr. Finkel, an exceptional clinician and researcher, has chosen to join our pursuits of advancing discovery and treatment,” said Steve Shapiro, MD, chief medical and scientific officer at UPMC. “His expertise will move us forward in transforming discoveries in the field of aging from the lab to patients.”

“Under Dr. Finkel’s innovative leadership, we will focus on fundamental research and therapies that target the aging process, with the ultimate goal of extending healthspan — essentially a long life free of disease,” said Arthur S. Levine, MD, Pitt’s senior vice chancellor for the health sciences and John and Gertrude Petersen Dean of Medicine.

Among his other research accomplishments, Finkel and colleagues provided the first demonstration that molecules called reactive oxygen species (ROS) –– originally thought to be damaging byproducts of chemical reactions in cells –– can act as molecular signals that control how cells and tissues function. An entirely new field of research known as redox signaling emerged from this discovery, which focused on the role of ROS signals in normal disease and aging.

His laboratory added major contributions to the understanding of aging over the past decade, including identifying how a specific class of enzymes known as sirtuins are key regulators of aging and how cellular energy pathways are involved in the maintenance of stem cells in the body. In the future, he plans to explore how the immune system and inflammation are connected to aging. His research over the years has involved both animal models and human participants, bridging clinical medicine and basic science.

“I am incredibly excited to lead the Aging Institute that was so ably directed by my predecessor, Chip Reynolds, and honored to be the inaugural holder of the Beckwith Chair in Translational Medicine. I firmly believe that understanding aging biology will alter how we approach a myriad of diseases and fundamentally change how we treat the vast majority of our patients,” said Finkel.

Finkel has published nearly 200 studies in high-impact journals, including Science, Nature, and The New England Journal of Medicine. According to Google Scholar, his work has been cited more than 48,000 times; he currently ranks as the 12th most highly cited author in aging and the 11th most highly cited author in cardiovascular disease. He is a member of the American Society for Clinical Investigation and the Association of American Physicians and is a fellow of the American Association for the Advancement of Science. Finkel has served on numerous editorial boards, including 10 years as an associate editor for Circulation Research and currently as a member of the board of reviewing editors for Science.

After receiving his undergraduate degree in physics from the University of Maryland and his MD and PhD degrees from Harvard Medical School in 1986, Finkel completed a residency in internal medicine at the Massachusetts General Hospital and a fellowship in cardiology at Johns Hopkins Hospital. In 1992, he joined the NIH as an investigator within the NHLBI intramural research program. He later served as chief of the Cardiology Branch and chief of the Translational Medicine Branch. In 2010, he assumed the position of chief of the Center for Molecular Medicine at NHLBI, which he held before joining Pitt and UPMC.

UPMC Senior Services Honors Resnick as 2016 Grand Champion

UPMC Senior Services will honor Neil Resnick, MD, Thomas Detre Professor and chief of the Division of Geriatric Medicine and Gerontology as its 2016 Grand Champion for demonstrating exceptional leadership in improving the lives of seniors in western Pennsylvania and nationally. It is the highest honor awarded by UPMC Senior Services.

“Dr. Resnick’s research has fundamentally changed the clinical care of older patients around the world. Through innovation and collaboration, he’s created specialized centers to evaluate the most difficult problems, trained others to do the same, and has investigated geriatric conditions that had fallen through the cracks,” said Deborah Brodine, president of UPMC Community Provider Services. “UPMC Senior Services is exceptionally proud to recognize him for such exemplary work on behalf of the seniors in western Pennsylvania.”

The awards will be presented October 26 at the annual UPMC Senior Services “Celebrating Senior Champions” Dinner and Auction at the Omni William Penn hotel.

Dr. Resnick founded the Aging Institute of UPMC Senior Services at the University of Pittsburgh, which is now one of the country’s top-funded aging research programs. His research led to a discovery of a new cause of incontinence, a syndrome that leads to significant disability, and helped develop new approaches to its diagnosis and treatment. These approaches also led to federal guidelines that have since been adopted by many other countries.

Additionally, Dr. Resnick has made major research contributions to other geriatric conditions, including osteoporosis, falls and delirium. Lessons from his research also enabled him to develop geriatric modules for primary care providers and help national urological and gynecological organizations develop training programs in geriatrics.

“This award is such a wonderful testament to the importance of geriatric care, as well as to the research we need to offer still better care tomorrow,” said Dr. Resnick. “It’s been an incredible privilege to have been able to do both and it is a real honor to receive this award.”

The UPMC Senior Services also will honor Operation Safety Net as its 2016 Community Champion. James S. Withers, MD, founder and CEO of Pittsburgh Mercy’s Operation Safety Net, will accept the award on behalf of the organization. Operation Safety Net supports the homeless of Pittsburgh, a growing segment of which are seniors, by delivering health care, case management, housing follow up, and other vital health and human services.

Elaine H. Berkowitz, DMD, will receive the 2016 Caregiver Champion award. Dr. Berkowitz practices geriatric and special needs dentistry in private homes, nursing homes, personal care homes, rehabilitation hospitals and general hospitals, bringing essential oral care to the home-bound, including residents at UPMC Canterbury Place.

Burning More Calories Associated with Greater Gray Matter Volume in Brain, Reduced Alzheimer’s Risk

Whether they jog, swim, garden or dance, physically active older persons  have larger gray matter volume in key brain areas responsible for memory and cognition, according to a new study by researchers at the University of Pittsburgh School of Medicine and UCLA.

The findings, published today in the Journal of Alzheimer’s Disease, showed also that people who had Alzheimer’s disease or mild cognitive impairment experienced less gray matter volume reduction over time if their exercise-associated calorie burn was high.

A growing number of studies indicate physical activity can help protect the brain from cognitive decline, said investigator James T. Becker, PhD, professor of psychiatry, Pitt School of Medicine. But typically people are more sedentary as they get older, which also is when the risk for developing Alzheimer’s disease and other dementias increases.

“Our current treatments for dementia are limited in their effectiveness, so developing approaches to prevent or slow these disorders is crucial,” Dr. Becker said. “Our study is one of the largest to examine the relationship between physical activity and cognitive decline, and the results strongly support the notion that staying active maintains brain health.”

Led by Cyrus Raji, MD, PhD, formerly a student at Pitt School of Medicine and now a senior radiology resident at UCLA, the team examined data obtained over five years from nearly 876 people 65 or older participating in the multicenter Cardiovascular Health Study. All participants had brain scans and periodic cognitive assessments. They also were surveyed about how frequently they engaged in physical activities, such as walking, tennis, dancing and golfing, to assess their calorie expenditure or energy output per week.

Using mathematical modeling, the researchers found that the individuals who burned the most calories had larger gray matter volumes in the frontal, temporal and parietal lobes of the brain, areas that are associated with memory, learning and performing complex cognitive tasks. In a subset of more than 300 participants at the Pitt site, those with the highest energy expenditure had larger gray matter volumes in key areas on initial brain scans and were half as likely to have developed Alzheimer’s disease five years later.

“Gray matter houses all of the neurons in your brain, so its volume can reflect neuronal health,” Dr. Raji explained. “We also noted that these volumes increased if people became more active over five years leading up to their brain MRI.”

He added that advancements in technology might soon make it feasible to conduct baseline neuroimaging studies of people who already have mild cognitive impairment or who are at risk for a dementia disorder, with the aim of prescribing lifestyle approaches such as physical activity to prevent further memory deterioration.

“Rather than wait for memory loss, we might consider putting the patient on an exercise program and then rescan later to see if there are any changes in the brain,” Dr. Raji said.

In a journal press release, George Perry, PhD, Dean of Sciences at the University of Texas at San Antonio and Editor in Chief of the Journal of Alzheimer’s Disease, called the research “a landmark study that links exercise to increases in gray matter and opens the field of lifestyle intervention to objective biological measurement.”

Other members of the research team include Kirk I. Erickson, PhD, Oscar L. Lopez, MD, H. Michael Gachi, PhD, and Lewis Kuller, MD, DrPH, all of the University of Pittsburgh; David A. Merrill, MD, PhD., Harris Eyre, MD, Sravya Mallam, BS, Nare Torosyan, BS, and Paul M. Thompson, PhD, all of UCLA; Owen T. Carmichael, PhD, of University of California, Davis; and W.T. Longstreth, Jr., MD, of the University of Washington.

The research was supported in part by funds from contract numbers N01-HC-80007, N01-HC-85079 through N01-540 HC-85086, N01-HC-35129, N01-HC-15103, N01-541 HC-55222, N01-HC-75150, N01-HC-45133 and grant HL080295 from the National Heart, Lung, and Blood Institute, with additional contribution from the National Institute of Neurological Disorders and Stroke.

Pitt Leads Trial to Reduce Antibiotic Overuse at Post-Acute and Long-Term Care Facilities

PITTSBURGH, June 30, 2015 – The University of Pittsburgh School of Medicine will be leading a $1.5 million national trial to examine methods to reduce unnecessary use of antibiotics in post-acute and long-term care (PA/LTC)facilities.

The three-year study, funded by the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ), will investigate guidelines and tools to help PA/LTC facilities better manage urinary tract infections (UTIs), which are commonly misdiagnosed and incorrectly treated.

“Antimicrobial resistance is a hot button issue in health care nationally and internationally – and improper overutilization of antibiotics is the single largest culprit,” said David A. Nace, M.D., M.P.H., director of long-term care and flu programs in Pitt’s Division of Geriatric Medicine, and primary investigator on the AHRQ grant. “It is critically important that we find ways to cut unnecessary use of antibiotics.”

The World Health Organization and the White House, among others, recently made announcements declaring efforts to address antimicrobial resistance top priorities. JAMA Internal Medicine published an article today finding that antibiotic use is highly variable across nursing homes, exposing residents to an increased risk of antibiotic-related harms and indicating a need to improve antibiotic stewardship in PA/LTC facilities.

The leading reason for antibiotic use at PA/LTC facilities is to treat a suspected UTI. Antibiotics often are started before a correct diagnosis is made. However, as many as two-thirds of those suspected cases turn out not to be UTIs, and the patients don’t benefit from – and could be harmed by – the antibiotics.

When used incorrectly, antibiotics can kill good bacteria and allow harmful, drug-resistant bacteria to flourish. Antibiotics also can cause allergic reactions or side-effects and are the leading cause of adverse drug reactions in long-term care facilities.

Dr. Nace, also chief medical officer for UPMC Senior Communities, and his co-investigators at AMDA – The Society for Post-Acute and Long-Term Care Medicine and the University of Wisconsin are looking at existing guidance and research on UTIs to develop comprehensive guidelines and tools geared toward easy implementation at PA/LTC facilities. University of Wisconsin co-investigator Christopher Crnich, M.D., Ph.D., associate professor of medicine, is an expert in antimicrobial stewardship in long-term care facilities. AMDA has long been respected for improving care in nursing homes, and their reputation will be critical to disseminating the results of this project and improving care across the U.S.

Next year, the team will enroll 40 PA/LTC facilities from Pennsylvania, Texas, North Carolina and Wisconsin in their trial. Half will receive the guidelines, as well as on-going mentoring and education, while the other half will operate as normal.

For a year, the team will collect data on the number of UTIs before and after the trial, the rate of appropriate and inappropriate treatment, and adverse outcomes. Once the trial concludes, all the facilities will be given the guidelines, tools, mentoring and education.

“There’s a lot of pressure across both agriculture and medicine to rein in use of antibiotics,” said Dr. Nace. “We are very quickly running out of antibiotics to do the job for us, and the problem is only going to grow worse. New antibiotics are not being created and licensed fast enough to keep pace with bacterium’s ability to develop drug-resistance. Efforts like ours to become better stewards of existing antibiotics are among the few solutions left at our disposal.”

Geriatric Incontinence Expert to Present at AUA 2015

PITTSBURGH, April 27, 2015 – Neil Resnick, MD, Thomas Detre Professor and Chief of the Division of Geriatric Medicine, is schedule to present on brain activity in overactive bladder at the upcoming American Urological Association (AUA) Annual Meeting.

Dr. Resnick’s research has helped to pioneer the field of geriatric voiding dysfunction and incontinence, improving the understanding of these conditions and leading to the development of novel diagnosis and treatment strategies. His work has been recognized nationally by the National Institutes of Health (NIH), the International Continence Society, the Society for General Internal Medicine, and the AUA.

Dr. Resnick’s presentation, entitled “Aging and Urologic Manifestations: Brain Activity in Overactive Bladder,” is scheduled to be presented during a basic science symposium on Friday, May 15.

For more information about the AUA Annual Meeting, please visit the conference page.

Geriatric Medicine Faculty to Present at AGS 2015

PITTSBURGH, April 27, 2015 – The Division of Geriatric Medicine and UPMC will be well-represented at the American Geriatrics Society 2015 Annual Scientific Meeting in National Harbor, MD. Faculty research will be presented in oral and poster presentations throughout the conference, including topics such as:

  • Cultural Differences and Approaches to Care: Cardiology
    Daniel Forman, MD
  • 2012 JCDA, Effect of Aging and Aortic Wall Behavior as Predictors of Aortic Aneurysm Growth
    Rabih Chaer, MD

Additionally, Daniel Forman, MD, will serve as a mentor in the One-on-One AGS Mentoring Program for students, residents, fellows, junior faculty, and other healthcare professional trainees.

For more information about the AGS Annual Scientific Meeting, please visit the conference page.

Pitt Experts Evaluate Efficacy and Safety of Osteoporosis Treatment in Frail Elderly Women

PITTSBURGH, April 14, 2015 – Experts from the Division of Geriatric Medicine at the University of Pittsburgh conducted a randomized clinical trial to test the efficacy and safety of single-dose zoledronic acid for osteoporosis in frail elderly women in long-term care facilities. The results recently were published online in JAMA Internal Medicine.

Led by Susan Greenspan, MD, Professor of Medicine in the Division of Geriatrics and Endocrinology, the authors conducted a randomized, placebo-controlled, double-blinded study from December 2007 through March 2012 of 181 women 65 or older with osteoporosis — including those with cognitive impairment, immobility, and multimorbidity — who were living in nursing homes and assisted-living facilities.

According to the authors, eighty-five percent of institutionalized elderly people have osteoporosis and bone fracture rates are eight to nine times higher in this population than in community-dwelling elderly people. However, most of these people are left untreated and are excluded from osteoporosis trials.

“This study is important because trials of younger and healthier elderly suggest that the risk of a devastating hip fracture can be cut in half with such therapy so it’s important to know if that’s also true for seniors in nursing homes,” says Neil Resnick, MD, chief of the Division of Geriatric Medicine and a co-author of the study.

The authors found that, “in this group of frail elderly women with osteoporosis, 1 dose of zoledronic acid improved BMD over 2 years. The clinical importance of nonsignificant increases in fracture and mortality rates in the treatment group needs further study. Since it is not known whether such therapy reduces the risk of fracture in this cohort, any change in nursing home practice must await results of larger trials powered to assess fracture rates.”

“We expected to see a positive trend of fewer fractures, but we did not; if anything, there were more fractures in the treatment group,” says Dr. Greenspan. “We had postulated such a possible dissociation between bone metabolism and fracture reduction in a paper we published in JAMA in 1989, but this may be the first evidence for it. It will be important to prove whether or not that’s the case in follow-up studies.”

Additional authors included Subashan Perera, PhD, Mary Ann Ferchak, BSN, David Nace, MD, MPH, and Dr. Resnick, all of the Division of Geriatric Medicine.

 

To view the full abstract, please visit PubMed.gov.

Geriatric Psychiatry Experts Present at AAGP 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.

Charles F. Reynolds III, MD, Named Future Editor-in-Chief of the AJGP

PITTSBURGH, Jan. 12, 2015 – The American Association for Geriatric Psychiatry (AAGP) has named the next editor-in-chief of its flagship journal, the American Journal of Geriatric Psychiatry (AJGP). The AAGP Board of Directors selected Charles F. Reynolds III, MD, UPMC Endowed Professor in Geriatric Psychiatry, and professor of Behavioral and Community Health Sciences at the University of Pittsburgh Graduate School of Public Health.

Dr. Reynolds, who also serves as director of the Aging Institute of UPMC and the University of Pittsburgh, and director of the John A. Hartford Center of Excellence in Geriatric Psychiatry, has been an associate editor of the AJGP since 2001, and he has published more than 650 peer-reviewed papers. He also served as a past president of the AAGP.

Dr. Reynolds will succeed Dilip V. Jeste, MD, associate dean for Healthy Aging and Senior Care at the University of California, San Diego, who will complete his 15-year tenure as AJGP editor-in-chief on Dec. 31, 2015. Dr. Reynolds’ tenure will begin Jan. 1, 2016, following a transitional period set to start in January 2015.

For more information on the American Journal of Geriatric Psychiatry, please visit AJGPOnline.org.

Register for the 23rd Annual Clinical Update in Geriatric Medicine

PITTSBURGH, Dec. 19, 2014 – Registration is now open for the 23rd Annual Clinical Update in Geriatric Medicine, March 26–28, 2015.

This award-winning CME conference is designed to help clinicians provide exceptional care for their older patients. Its structure, speakers, and content have been specifically chosen to provide state-of-the-art yet pragmatic approaches to the most common and confounding conditions clinicians face. The conference attracts more than 500 attendees annually.

Who Should Attend
This course is designed for family practitioners, internists, geriatricians, and other health care professionals who provide care to older adults. Previous attendees also will be interested because of the conference’s continually changing topics, speakers, and approach.

Location
Marriott City Center
112 Washington Place
Pittsburgh, PA 15219

To register online, please visit the Upcoming Events page at the Center for Continuing Education in the Health Sciences and click the ‘23rd Annual Clinical Update in Geriatric Medicine′ link.

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