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Archives for Gastroenterology

Higher Risk of GI, Major Bleeding in Atrial Fibrillation Patients Taking Blood Thinner Dabigatran

PITTSBURGH, Nov. 3, 2014 – Patients with atrial fibrillation who take the blood thinner dabigatran are at greater risk for major bleeding and gastrointestinal bleeding than those who take warfarin, according to a new study by researchers at the University of Pittsburgh Graduate School of Public Health.

The findings, based on Medicare claims data and published today in JAMA Internal Medicine, indicate greater caution is needed when prescribing dabigatran to certain high-risk patients.

Atrial fibrillation, an arrhythmia in which the heart’s upper chambers irregularly contract, can send tiny clots from the heart to the blood vessels in the brain, explained the study’s senior author Yuting Zhang, Ph.D., associate professor and director of the Pharmaceutical Economics Research Group in Pitt Public Health’s Department of Health Policy and Management. For that reason, these patients often are prescribed a blood thinner to limit clot formation with the aim of preventing strokes.

“Dabigatran was introduced in 2010 and, at the time of approval, it was the only available alternative to warfarin,” Dr. Zhang said. “Warfarin dosing can be tricky and regular monitoring with blood tests is required, so doctors and patients were glad to have a drug that was easier to manage. But some recent studies suggest that dabigatran is associated with a higher risk of bleeding.”

To investigate that possibility, the study’s first author, Inmaculada Hernandez, Pharm.D., Pitt Public Health, and the team looked back at pharmacy and medical claims data, which employ a unique identifier code rather than patient names, from 2010 and 2011 of a random national sample of Medicare beneficiaries. They tracked 1,302 dabigatran users and 8,102 warfarin users to see whether they experienced bleeding episodes, classifying the events as major, such as intracranial bleeding or gastrointestinal bleeding requiring a hospital or emergency room stay, or minor, such as gastrointestinal bleeding that was treated on an outpatient basis, or nose bleeds.

They also looked more closely at bleeding episodes in four high-risk subgroups: those who were 75 and older; African-Americans; those with chronic kidney disease; and those with seven or more co-existing medical problems.

Medicare data showed that the incidence of major bleeding was 9 percent and of any bleeding was 32.7 percent in the dabigatran group and 5.9 percent and 26.6 percent, respectively, in the warfarin group. In other words, dabigatran users were 58 percent more likely to have a major bleed and 30 percent more likely to have any kind of bleed than those taking warfarin. African-Americans and patients with chronic kidney disease using dabigatran were about twice as likely to have a major bleed as those taking warfarin. In addition, dabigatran users were more likely than warfarin users to experience gastrointestinal or vaginal bleeding, or blood in the urine, joints or sputum. However, the dabigatran group had a lower risk for bleeding in the brain.

“These findings indicate that physicians should be cautious when prescribing dabigatran, particularly to African-Americans and patients with kidney impairments,” Dr. Hernandez said. “Also, the incidence of gastrointestinal bleeding was high in all the subgroups, so we recommend doctors explain to patients how to detect it so that it can be treated promptly.”

“We plan to examine 2012 data to monitor the risk of stroke for patients on dabigatran, which is the primary indication for taking the blood thinner,” Dr. Zhang said. “It’s possible that for some patients a greater reduction in the risk of stroke will outweigh the higher risk of bleeding with dabigatran compared to warfarin.”

Other co-authors are Seo Hyon Baik, Ph.D., of Pitt Public Health; and Antonio Piñera, M.D., of La Paz University Hospital, Madrid, Spain.

The project was funded by the Commonwealth Foundation for Public Policy Alternatives and the Agency for Healthcare Research and Quality.

Physicians and Researchers Present at 2014 American College of Gastroenterology Annual Meeting

PITTSBURGH, Oct. 31, 2014 – The University of Pittsburgh Division of Gastroenterology, Hepatology, and Nutrition was well-represented in Philadelphia at the recent American College of Gastroenterology (ACG) Annual Meeting. Faculty research was featured in both oral and poster presentations throughout the conference, including:

  • Pancreatic Cancer: The Genes You Need to Know
    Presented by Randall Brand, MD
  • Perceived Effectiveness of Endoscopic and Surgical Treatments Among North American Women With Complications of Chronic Pancreatitis (2014 ACG Presidential Poster Award winner)
    UPMC co-authors: Jyothsna Talluri, MD; Dhiraj Yadav, MD; David Whitcomb, MD, PhD
  • Antibiotic-Associated Microbiome Changes in Health Volunteers and Corrective Impact of the Probiotic Saccharomyces Boulardii (2014 ACG Presidential Poster Award winner)
    UPMC co-author: Toufic Kabbani, MD
  • Stratification of Crohn’s Disease Patients Using the Lemann Index to Quantify Gut Damage: A 5-Year Prospective Study (2014 ACG Presidential Poster Award winner and 2014 ACG Governor’s Award for Excellence in Clinical Research)
    UPMC co-authors: Claudia Rivers-Ramos, MD; Miguel Regueiro, MD; Jason Swoger, MD; Marc Schwartz, MD; Leonard Baidoo, MD; Jana Al Hashash, MD; Arthur Barrie III, MD; Michael Dunn, MD; David Binion, MD
  • Association of Mean Vitamin D Level With Clinical Status in Inflammatory Bowel Disease: A 5-Year Prospective Study
    UPMC co-presenters: Toufic Kabbani, MD; Claudia Rivers-Ramos, MD; Jason Swoger, MD; Miguel Regueiro, MD; Arthur Barrie III, MD; Marc Schwartz, MD; Jana Al Hashash, MD; Leonard Baidoo, MD; Michael Dunn, MD; David Binion, MD

For more information on ACG’s Annual Meeting, please visit the conference page.

UPMC Investigation into GI Scope-Related Infections Changes National Guidelines

PITTSBURGH, Oct. 9, 2014 – National guidelines for the cleaning of certain gastrointestinal (GI) scopes are likely to be updated due to findings from UPMC’s infection prevention team.

The research and updated disinfection technique will be shared Saturday in Philadelphia at ID Week 2014, an annual meeting of health professionals in infectious disease fields.

“Patient safety is our top priority,” said senior author Carlene Muto, M.D., M.S., director of infection prevention at UPMC Presbyterian Hospital. “We are confident that the change from disinfection to sterilization of GI scopes is necessary in preventing serious infections and we are glad to share our findings with hospitals nationwide.”

After tracking and monitoring  an uptick in antibiotic-resistant infections in 2012 in patients who had undergone an Endoscopic Retrograde Cholangiopancreatography (ERCP) procedure with flexible endoscopy scopes, UPMC began investigating the devices, which are equipped with an “elevator channel” used to deflect accessories passed through the biopsy channel and assist clinicians in examining a patient’s gastrointestinal tract. The elevator channel is most commonly found on ERCP and endoscopic ultrasound scopes.

UPMC took the scopes out of service, notified the manufacturer and began an investigation into the disinfecting process that takes place between each use. When it was ultimately determined that the normal process failed to eliminate all bacteria, UPMC switched to gas sterilization using ethylene oxide to ensure proper disinfection of the scopes.

“Throughout UPMC, no additional health care-associated infections have been linked to scopes since switching to sterilization,” said Dr. Muto.

The move from high-level disinfection of endoscopes to sterilization of them was foreshadowed earlier this year at the Association for Professionals in Infection Control and Epidemiology annual conference in Anaheim, Calif., by Bill Rutala, Ph.D., M.P.H., author of the Centers for Disease Control and Prevention Guideline for Disinfection and Sterilization in Healthcare Facilities. He said he believed the transition would take place in the next five years.

Approximately 11 million gastrointestinal endoscopies are performed annually in the U.S. and contaminated scopes have been linked to more hospital-acquired infections than any other type of medical device.

Pitt Drug Discovery Researchers Receive $5.8 Million Federal Grant to Build 3D Liver Model

PITTSBURGH, Sept. 23, 2014 – With a new $5.8 million, three-year award from the National Institutes of Health (NIH), researchers at the University of Pittsburgh School of Medicine will further develop a state-of-the-art, microfluidic 3D model system that mimics structure and function of the liver to better predict organ physiology, assess drug toxicity and build disease models.

The funding supports the next phase of the NIH’s Tissue Chip for Drug Screening program, which aims to improve ways of predicting drug safety and effectiveness. Researchers from 11 institutions will collaborate over three years to refine existing 3-D human tissue chips and combine them into an integrated system that can mimic the complex functions of the human body.

“We are very enthusiastic about the potential of these microphysiology systems to serve as powerful platforms for studying human diseases and identifying human toxic liabilities,” said the Pitt project’s principal investigator D. Lansing Taylor, Ph.D., Allegheny Foundation Professor of Computational and Systems Biology, Pitt School of Medicine, and director, University of Pittsburgh Drug Discovery Institute.

“The development of tissue chips is a remarkable marriage of biology and engineering, and has the potential to transform preclinical testing of candidate treatments, providing valuable tools for biomedical research,” said NIH Director Francis S. Collins, M.D., Ph.D.

The Pitt research team, along with additional collaborators, is creating models of the functional unit of the liver, called the acinus, using human liver cells and eventually liver cells derived from precursor cells known as induced pluripotent stem cells, as well as three additional cell types. The liver platform includes microfluidic devices, human cells, engineered matrix materials, fluorescence-based biosensors for real-time physiological read-outs, and biochemical and mass spectrometry measurements to determine acute and chronic toxicity effects. They also will build a “microphysiology database” to manage, analyze and model the data collected from the liver constructs.

With such a platform, biomedical scientists will be able to test treatment efficacy in conditions such as non-alcoholic fatty liver disease, liver cancer and breast cancer that has spread to the liver, as well as liver damage including immune-mediated toxicology and fibrosis.  Also, a team of institutions and investigators has been assembled to integrate the liver, kidney and gut models to recapitulate the organ system that is central to drug absorption and metabolism.

The integrated platform will involve the creation of a universal medium, the development of the proper “scaling” of the interacting organ constructs, physiologically relevant flow, incorporation of a micro-formulator to add factors from missing organs and micro-analyzers for monitoring parameters such as pH and oxygen.

Fifteen NIH Institutes and Centers are involved in the coordination of the tissue chip program. Current funding is being provided by the National Center for Advancing Translational Sciences, the National Institute for Biomedical Imaging and Bioengineering, the National Cancer Institute, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Environmental Health Sciences, NIH Common Fund and NIH Office of Research on Women’s Health.

Collaborators include Martin Yarmush, M.D., Ph.D., of Massachusetts General Hospital; John Wikswo, Ph.D., of Vanderbilt University; Jonathan Himmelfarb, M.D., of the University of Washington; Mark Donowitz, M.D., of Johns Hopkins University; and Mary Estes, Ph.D., of Baylor University.

Screening and Drug Therapy Predicted to Make Hepatitis C a Rare Disease

PITTSBURGH, Aug. 4, 2014 – Newly implemented screening guidelines and improved, highly effective drug therapies could make hepatitis C a rare disease in the United States by 2036, according to the results of a predictive model developed at the University of Pittsburgh Graduate School of Public Health.

The results of the analysis, funded by the National Institutes of Health (NIH) and performed with the University of Texas MD Anderson Cancer Center, are published in the Aug. 5 issue of the Annals of Internal Medicine.

A “rare” disease is one that affects at most one in every 1,500 people. Approximately one in every 100 people in the U.S. currently has chronic hepatitis C, a viral infection that compromises liver function.

“Making hepatitis C a rare disease would be a tremendous, life-saving accomplishment,” said lead author Mina Kabiri, M.S., a doctoral student in Pitt Public Health’s Department of Health Policy and Management. “However, to do this, we will need improved access to care and increased treatment capacity, primarily in the form of primary care physicians who can manage the care of infected people identified through increased screening.”

In the U.S., hepatitis C is the leading cause of chronic liver disease and the leading reason for liver transplantation. At 15,100 deaths annually, hepatitis C surpassed the annual number of deaths from HIV in 2007. The economic burden associated with chronic infection is estimated at $6.5 billion a year.

“This is, indeed, a very interesting time for hepatitis C patients and providers,” said senior author Jagpreet Chhatwal, Ph.D., now of the University of Texas MD Anderson Cancer Center, who performed most of the research while at Pitt Public Health. “Several changes have happened in the last two years, including screening policy updates and availability of highly effective therapies.”

In 2012, the Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommended that anyone born between 1945 and 1965 — encompassing about 81 percent of chronically infected people — receive a one-time screening for hepatitis C. Hepatitis C often is asymptomatic, meaning that infected people do not know they have it until it is detected through a blood screening.

In early 2014, hepatitis C drug regimens that could be taken orally were introduced to the market, allowing primary care physicians and infectious disease specialists to take on the role of treating hepatitis C patients. The drugs have been shown to be highly effective in making the virus almost undetectable in the blood of patients previously found positive for hepatitis C.

The research team created a highly detailed computer model of the natural history and progression of hepatitis C, both with and without treatment. The model predicts the number of hepatitis C infections in the U.S. at any given time from 2001 to 2050, under multiple potential scenarios describing future treatment, while taking into consideration infection status awareness, stage of disease, treatment history and continued drug development, based on data from the National Health and Nutrition Examination Survey (NHANES) and published clinical studies.

To validate the prediction, the researchers ran the model for the years 2003 to 2010 and predicted 2.7 million cases of hepatitis C, which equaled the actual number of cases reported by NHANES.

The research team then considered what would happen if the guidelines were increased to include a one-time universal screening for hepatitis C among all U.S. citizens, not just baby boomers.

“In that scenario, nearly 1 million cases of hepatitis C would be identified in the next 10 years,” said Ms. Kabiri. “And that translates into making hepatitis C a rare disease by 2026, a decade earlier than we’d predicted with the current screening guidelines.”

The researchers note that such a measure would bring increased costs. The oral therapy regimen costs as much as $1,000 per day.

The model estimated that universal screening coupled with the new drug therapies would reduce liver-related deaths by 161,500 and liver transplants by 13,900 from 2014 to 2050.

“Though impactful, the new screening guidelines do not identity the large number of hepatitis C patients who would progress to advanced disease stages without treatment and could die,” said Dr. Chhatwal. “More aggressive screening recommendations are essential in further reducing the burden, preventing liver-related deaths and eventually eradicating hepatitis C.”

Future research will be needed to determine how the reduction in deaths and transplants offsets the increased costs of screening and drug therapy.

Additional researchers on this study are Alison B. Jazwinski, M.D.; Mark S. Roberts, M.D.; and Andrew J. Schaefer, Ph.D., all of Pitt.

This study was supported by the National Center for Advancing Translational Sciences of the NIH under award number KL2TR000146.

Surgical, Other Advances Made at UPMC Improve Graft Survival of Intestinal, Multi-Visceral Transplant Patients

SAN FRANCISCO, July 30, 2014 – Innovations in surgical techniques, drugs and immunosuppression have improved survival after intestinal and multi-visceral transplants, according to a retrospective analysis of more than 500 surgeries done at UPMC over nearly 25 years.

The study was led by Goutham Kumar, M.D., a transplant surgery fellow at UPMC’s Thomas E. Starzl Transplantation Institute. Dr. Kumar was recognized for his work with the Young Investigator Award by the 2014 World Transplant Congress and presented his findings at the group’s July 26 to 31 meeting in San Francisco.

“UPMC has led the way in the development of new surgical techniques and important research involving transplantation, and our analysis shows that our innovations have made a real difference to patients,” Dr. Kumar said.

The researchers examined 541 intestinal and multi-visceral transplants done at UPMC from 1990 to 2013. The total consisted of 228 pediatric transplants and 313 adult transplants; 252 were intestine-only transplants, 157 were liver-intestine, 89 were full multi-visceral, and 43 were modified multi-visceral. A majority of the pediatric patients suffered from gastroschisis, followed by volvulus and necrotizing entercolitis. The adult patients needed transplants because of thrombosis, Crohn’s disease or some kind of obstruction.

Researchers analyzed several outcomes and found that pre-conditioning with certain immunosuppressants, the time the graft is outside of the body, certain blood types and a disparity in the gender of donor and recipient were among the factors predicting graft survival.

Co-authors on the study are George Mazariegos, M.D., Guillerme Costa, M.D., Gaurav Gupta, M.D., Dolly Martin, Geoff Bond, M.D., Kyle Soltys, M.D., Rakesh Sindhi, M.D., Abhinav Humar, M.D., and Hiroshi Sogawa, M.D., all of either the Thomas E. Starzl Transplantation Institute, Children’s Hospital of Pittsburgh of UPMC or UPMC.

In addition to Dr. Kumar, six other UPMC and University of Pittsburgh Schools of the Health Sciences researchers were recognized this year with Young Investigator Awards by the World Transplant Congress. They and their presentations are:

Aravind Cherukuri, M.D., Ph.D.
“Transitional B Cell (TrB) T1/T2 Ratio is a Marker for Graft Dysfunction in Human Kidney Transplant Recipients (KTRs)”

Vinayak Rohan, M.D.
“Outcomes of Liver Transplantation for Unresectable Liver Malignancy in Children”

Qing Ding, Ph.D.
“TIM-1 Signaling is Required for Maintenance and Induction of Regulatory B Cells Through Apoptotic Cell Binding or TIM-1 Ligation”

Kanishka Mohib, Ph.D.
“TIM-4 Expression by C Cells Identifies an Inflammatory B Effector 1 Subset that Promotes Allograft Rejection and Inhibits Tumor Metastases”

Dalia Raich-Regue, Ph.D.
“Myeloid Dendritic Cell-Specific mTORC2 Deficiency Enhances Alloreactive Th1 and Th17 Cell Responses and Skin Graft Rejection”

Tripti Singh, M.D.
“B Cell Depletion of Naïve Recipients Enhances Graft Reactive T Cell Responses”

Pitt-led Study Suggests Cystic Fibrosis is Two Diseases, One Doesn’t Affect Lungs

PITTSBURGH, July 17, 2014 – Cystic fibrosis (CF) could be considered two diseases, one that affects multiple organs including the lungs, and one that doesn’t affect the lungs at all, according to a multicenter team led by researchers at the University of Pittsburgh School of Medicine. The research, published online today in PLOS Genetics, showed that nine variants in the gene associated with cystic fibrosis can lead to pancreatitis, sinusitis and male infertility, but leave the lungs unharmed.

People with CF inherit from each parent a severely mutated copy of a gene called CFTR, which makes a protein that forms a channel for the movement of chloride molecules in and out of cells that produce sweat, mucus, tears, semen and digestive enzymes, said co-senior investigator David Whitcomb, M.D., Ph.D., chief of gastroenterology, hepatology and nutrition, Pitt School of Medicine. Without functional CFTR channels, secretions become thick and sticky, causing problems such as the chronic lung congestion associated with CF.

“There are other kinds of mutations of CFTR, but these were deemed to be harmless because they didn’t cause lung problems,” Dr. Whitcomb said. “We examined whether these variants could be related to disorders of the pancreas and other organs that use CFTR channels.”

Co-senior author Min Goo Lee, M.D., Ph.D., of Yonsei University College of Medicine in Seoul, Korea, conducted careful tests of CFTR in pancreatic cell models and determined that a molecular switch inside the cell called WINK1 made CFTR channels secrete bicarbonate rather than chloride molecules.

“Pancreas cells use CFTR to secrete bicarbonate to neutralize gastric acids,” Dr. Whitcomb said. “When that doesn’t happen, the acids cause the inflammation, cyst formation and scarring of severe pancreatitis.”

The research team found nine CFTR gene variants associated with pancreatitis after testing nearly 1,000 patients with the disease and a comparable number of healthy volunteers. They also learned that each variant could impair the WINK1 switch to prevent CFTR from becoming a bicarbonate-secreting channel.

Co-senior author Ivet Bahar, Ph.D., Distinguished Professor and John K. Vries Chair of Computational Biology, Pitt School of Medicine, built a computer model of the CFTR protein’s structure and determined that all the nine variants alter the area that forms the bicarbonate transport channel, thus impairing secretion of the molecule.

“It turns out that CFTR-mediated bicarbonate transport is critical to thin mucus in the sinuses and for proper sperm function,” Dr. Whitcomb said. “When we surveyed pancreatitis patients, there was a subset who said they had problems with chronic sinusitis. Of men over 30 who said they had tried to have children and were infertile, nearly all had one of these nine CFTR mutations.”

He added that identification of the mechanisms that cause the conditions make it possible to develop treatments, as well as to launch trials to determine if medications that are used by CF patients might have some benefit for those who do not have lung disease, but who carry the other mutations.

The team includes researchers from the University of Pittsburgh, the Mayo Clinic, Brigham and Women’s Hospital, and many other institutions that are part of the North American Pancreatitis Study Group.

The study was supported by National Institutes of Health grants DK061451, DK062420, GM086238, DK063922, CA047904 and RR024153; the Ministry for Health & Welfare, Republic of Korea; and Brain Korea 21 Project for Medical Sciences, Seoul.

Jeffrey I. Gordon, M.D., Will Receive Pitt’s Dickson Prize at Science 2014—Sustain It!

PITTSBURGH, July 17, 2014 – A scientist who has explored how the tens of trillions of microbes that live in the gastrointestinal tract and their genes influence human physiology, metabolism and nutritional status will receive the University of Pittsburgh’s 2014 Dickson Prize in Medicine.

Jeffrey I. Gordon, M.D., will accept the University of Pittsburgh School of Medicine’s most prestigious honor during Science 2014—Sustain It!, a showcase of the region’s latest research in science, engineering, medicine and computation that will be held from Oct. 1 to 3 at Alumni Hall in Oakland. Dr. Gordon is the Dr. Robert J. Glaser Distinguished University Professor and director of the Center for Genome Sciences and Systems Biology at Washington University School of Medicine in St. Louis.

“Dr. Gordon’s work describes our species as a rich and meaningful ecosystem of interactions between human and microbial components,” said Arthur S. Levine, M.D., Pitt’s senior vice chancellor for the health sciences and John and Gertrude Petersen Dean of Medicine. “His fascinating work has broadened our understanding of obesity in the western world and malnutrition in developing countries and has the potential to stimulate new therapies directed at the microbiome.”

In the body, microbes, primarily bacteria, but also fungi and archaeons, and the viruses that infect them, outnumber an individual’s human cells by a factor of 10. The number of genes in the body’s indigenous microbial communities far exceeds the number of genes in the human genome. Most of these microorganisms reside in the gut. Through innovative experimental and computational methods, including studies of twins of different ages, geographic locales and cultural traditions, and the use of germ-free animal models colonized with gut microbial communities (microbiota) harvested from healthy and unhealthy humans, Dr. Gordon and his students have provided new insights about how the gut microbiota contribute to obesity and metabolic abnormalities, as well as to childhood undernutrition.

Their interdisciplinary studies have helped create a new field of research, altering ways to define the health benefits of foods being produced or that could be produced in response to the global challenges of population growth and sustainable agriculture. Also, Dr. Gordon’s lab is providing a microbial view of human development, including how functional maturation of the gut microbiota is related to healthy growth of infants and children, and helping to usher in a new era of microbiota-directed therapeutics.

At 11 a.m., Thursday, Oct. 2, Dr. Gordon will deliver the Dickson Prize in Medicine Lecture. His talk is titled “A Microbial View of Human Development: The Gut Microbiota and Childhood Undernutrition.”

Dr. Gordon earned his bachelor’s degree in biology at Oberlin College in 1969 and his medical degree at the University of Chicago Pritzker School of Medicine in 1973. He completed a residency in medicine at Barnes Hospital in St. Louis, a postdoctoral fellowship in biochemistry and molecular biology at the National Institutes of Health, and a fellowship in gastroenterology at Washington University in St. Louis. He is the recipient of the Danone International Prize for Nutrition, the Selman A. Waksman Award in Microbiology from the National Academy of Sciences, the Robert Koch Award, and many other honors. He is a member of the National Academy of Sciences, the Institute of Medicine of the National Academies, the American Academy of Arts and Sciences and the American Philosophical Society.

In addition to Dr. Gordon, other renowned researchers also will deliver plenary lectures at Science 2014. The Mellon Lecture will be given by Stuart Orkin, M.D., of Harvard Medical School; the Hofmann Lecture will be given by Jeannie T. Lee, M.D., Ph.D., also of Harvard Medical School; and the Provost Lecture will be given by Jonathan Rothberg, Ph.D., founder of Ion Torrent Systems, Inc., and a pioneer in the field of next-generation DNA sequencing.

Nominations for the 2015 Dickson Prize in Medicine are now being accepted.

UPMC Named to U.S. News & World Report Honor Roll of ‘Best Hospitals’ for 15th Time

UPMC Ranks #1 in Pennsylvania, #1 in Pittsburgh for Clinical Excellence

PITTSBURGH, July 15, 2014 UPMC has once again received national recognition for its clinical expertise, earning 12th position on the annual U.S. News & World Report Honor Roll of America’s “Best Hospitals.” UPMC is the highest-ranked medical center in both Pennsylvania and in Pittsburgh.

“While we’re very proud that UPMC was recognized for the 15th year, it is our patients who are the ultimate winners. Our exceptionally skilled and devoted health care professionals do what they do best every day — provide the finest health care in the state and in the region,” said Leslie C. Davis, president, UPMC Hospital and Community Services Division.

“We are honored to receive this national distinction, which recognizes UPMC’s unique combination of high-quality medical care, a top health insurance plan, and close affiliation with the University of Pittsburgh, one of the best medical schools in the country,” added Steven Shapiro, M.D., executive vice president and chief medical and scientific officer at UPMC. “Furthermore, it emphasizes UPMC’s commitment to our patients and showcases how we are leading the way in the development of new technologies and methods of care.”

Nationally, UPMC is ranked for excellence in 15 of 16 specialty areas, and is among the top 10 hospitals in six specialties: ear, nose and throat; gastroenterology; gynecology; psychiatry; pulmonology; and rheumatology.

U.S. News analyzed 4,743 medical centers in the nation, but only those that achieved high scores in six or more specialties were included in the distinguished Honor Roll group. Scores were based on a variety of factors including hospital volume, patient safety, outcomes and reputation for delivering high-quality care.

Last month, U.S. News named its 2014 Honor Roll of America’s Best Children’s Hospitals, recognizing Children’s Hospital of Pittsburgh of UPMC as 9th in the country.

UPMC Expands Reach in Italy with Outpatient Diagnostic Center

PITTSBURGH, June 6, 2014 – Adding to its successful transplant and cancer treatment facilities in Italy, UPMC announced today that it is expanding its Italian operations to include outpatient diagnostic services for liver and digestive disorders in the Region of Tuscany.

UPMC is managing and operating the new center, the UPMC Institute for Health, at the Terme di Chianciano Spa in Chianciano Terme. Located near Siena, between Florence and Rome, the facility will build on the traditional attraction of the spa’s thermal water therapies and is expected to attract patients from throughout Italy and beyond when it opens on June 9, 2014.

The new center will offer diagnostic screenings, imaging and procedures for liver and digestive disorders, cardiovascular diseases, diabetes and other illnesses. Patients also will be educated about personal risk factors, healthy lifestyle and diet. Those who need more advanced care may be referred to local hospitals or to other UPMC facilities in Italy, namely the ISMETT transplant hospital in Palermo and the UPMC San Pietro Cancer Center in Rome.

“Building on our long reputation for clinical excellence in Italy, we are proud to expand our high-quality services into a new region of the country,” said Charles Bogosta, president of UPMC’s International and Commercial Services Division. “This popular destination for patients will now have the only facility in the area that can offer a complete digestive check-up in a place that already draws thousands of people every year to its healing waters.”

UPMC is partnering with Terme di Chianciano, a company that operates and manages historical thermal premises in the region, as well as with the municipality and the local health care authority. UPMC is leasing and renovating the spa’s existing medical center.

“With UPMC’s clinical, scientific and management know-how and the well-established treatments of Chianciano Spa, this partnership will deliver a higher level of services to patients in one convenient location,” said Bruno Gridelli, M.D., medical and scientific director of UPMC’s International and Commercial Services Division and chief executive officer of ISMETT.

UPMC’s international footprint already includes operations or services in Italy, Ireland, India, Canada, China, Singapore, Japan and Kazakhstan. Through its international growth and commercialization efforts with industry partners, UPMC is diversifying its revenue base, fueling economic development in its communities, and strengthening its ability to recruit and retain the best and brightest clinicians who are working together to improve health care outcomes globally.

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