BIDMC Research Brief Digest: July 2018
Beth Israel Deaconess Medical Center's (BIDMC) Research Brief Digest is a monthly roundup of research briefs showcasing recent scientific advances led by BIDMC faculty.
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The Origins of Parkinsonism in the Brain
Parkinsonism – slowed movement, muscle rigidity and tremor – is a classic set of neurological symptoms most often seen in patients with Parkinson’s disease. Because neuron loss in the substantia nigra – a region of the brain associated with motor planning – is the hallmark characteristic of Parkinson’s disease, parkinsonism has long been thought to originate there. However, parkinsonism can occur in patients who have other conditions that leave the substantia nigra intact, making the true source of the suite of symptoms a mystery. Now, a team of investigators led by Michael Fox, MD, PhD, Associate Director of the Deep Brain Stimulation Program at BIDMC, has identified the claustrum – a little understood sheet of neurons thought to play a role in sensory integration – as the likely origin of parkinsonism across different conditions. Featured as an Editor’s Choice, the study was made available free to the public on July 26 in the journal BRAIN.
Speaking Up for Patient Safety
In a new study, a team led by Sigall K. Bell, MD, the Director of Patient Safety and Discovery at OpenNotes, BIDMC and an Associate Professor of Medicine at Harvard Medical School surveyed family members and patients with recent ICU experiences about their willingness to speak up about care concerns to medical providers. The findings, published in BMJ Quality and Safety on July 12, revealed that 50 to 70 percent of family member respondents with a loved one in the ICU at the time of the survey expressed hesitancy about speaking up about common care situations with safety implications. (July 2018)
Researchers Prevent, Reverse Renal Injury by Inhibiting Immune-Regulating Molecule
Special cells called podocytes aid the kidneys as they clean the blood and balance the body’s fluid levels. Podocytes filter blood as it passes through the cells’ foot-like projections they are named for, interwoven like the fingers of clasped hands. Podocyte damage – indicated by proteinuria or abnormal proteins in the urine – is a common symptom of diseases including the autoimmune disorder lupus and non-immune diseases and can result in kidney failure requiring dialysis or organ transplant. In a research article published in the Journal of Clinical Investigation on July 9, a team of scientists led by George C. Tsokos, MD, Chief of the Division of Rheumatology at BIDMC, describes how overexpression of an immune regulating molecule called CaMK4 can destroy podocytes’ structure and function. (July 2018)
Preventative HIV Vaccine Candidate Triggers Desired Immune Responses in Humans, and Protects from Infection in Pre-Clinical Trials
More than three decades after the identification of the human immunodeficiency virus (HIV), scientists are still working to develop a preventative vaccine that could finally put an end to the epidemic for which there are nearly two million new infections each year. In a new study, published July 6 in The Lancet, a team of researchers led by Dan H. Barouch, MD, PhD, Director of the Center for Virology and Vaccine Research at BIDMC in collaboration with Janssen Vaccines & Prevention and other partners, evaluated a series of preventative HIV vaccine regimens in uninfected human volunteers in five countries. In a similarly designed study, Barouch and colleagues tested the same vaccine for its ability to protect rhesus monkeys challenged with an HIV-like virus from infection. The findings showed the vaccines induced robust and comparable immune responses in humans and monkeys and protected monkeys against acquisition of infection. (July 2018)
Embracing Respect and Dignity as The Next Frontier in Preventing Patient Harm
A group of national leaders in quality and safety led by Lauge Sokol-Hessner, MD, Associate Director of Inpatient Quality at BIDMC and Patricia Folcarelli, RN, MA, PhD, Vice President of Health Care Quality at BIDMC, has developed a consensus statement – a document developed by an independent panel of experts about a particular issue – intended to embrace an expanded definition of patient harm that includes non-physical harm, with the goal of improving the practice of respect across the continuum of care. The set of six recommendations, published online by the Joint Commission Journal on Quality and Patient Safety, provides a roadmap for health care organizations and professionals interested in the practice of respect. (June 2018)
Hospitals May Take Too Much of the Blame for Unplanned Readmissions
A major goal of hospitals is to prevent unplanned readmissions of patients after they are discharged. A new study published in the Annals of Internal Medicine and led by Kelly Graham, MD, MPH, Director of Ambulatory Residency Training at BIDMC and an Instructor in Medicine at Harvard Medical School, reveals that the preventability of readmissions changes over time: readmissions within the first week after discharge are often preventable by the hospital, whereas readmissions later are often related to patients’ difficultly accessing outpatient clinics. (June 2018)
BIDMC Researchers Develop Decision-Making Tool to Benefit Patients with HCV
An estimated 3.5 million people in the United States have chronic hepatitis C (HCV), according to the Centers for Disease Control and Prevention. It is the most common cause for cirrhosis and liver cancer in the U.S. and the leading indication for liver transplantation. While recently developed direct anti-viral agents (DAAs) have proven to be a highly effective treatment option for many patients with HCV, those with decompensated HCV cirrhosis or liver failure may experience little to no improvement in liver function following eradication of HCV. Published in the June 2018 issue of Gastroenterology, a team of BIDMC researchers led by Michael P. Curry, MD, Section Chief of Hepatology at BIDMC and Z. Gordon Jiang, MD, a translational investigator at BIDMC’s Liver Center, led a retrospective analysis of four randomized clinical trials focused on the effects of DAA therapies in patients with HCV-associated liver failure, and developed a new means of predicting improvement in liver function in response to DAA treatment. (June 2018)
Research Points to Potential Shortcoming of Antibiotic Lab Tests
To determine which antibiotics reliably treat which bacterial infections, diagnostic laboratories that focus on clinical microbiology test pathogens isolated from patients. As multidrug-resistant organisms continue to emerge, these tests – called antibiotic susceptibility assays – are increasingly critical. Clinicians depend on reliable results when choosing the right drug to treat patients. A recent study published in the journal Antimicrobial Agents and Chemotherapy and led by James Kirby, MD, Director of the Clinical Microbiology Laboratory at BIDMC, revealed that one aspect of these tests may fall short and not be stringent enough. (May 2018)
Savory Foods May Promote Healthy Eating Through Effects on the Brain
A team of researchers led by Miguel Alonso-Alonso, MD, PhD, Assistant Professor at the Center for the Study of Nutrition Medicine in BIDMC’s Department of Surgery, have found that consuming a broth rich in umami—or savory taste—can cause subtle changes in the brain that promote healthy eating behaviors and food choices, especially in women at risk of obesity. Umami is a Japanese word to express a delicious, savory meal, and it represents one of the five basic tastes, together with sweet, salty, bitter, and sour. A key component of umami taste is glutamate, a naturally occurring non-essential amino acid that can be found in nearly all foods, and especially in foods high in protein such as dairy products, fish, and meat. (March 2018)
Barbara B. Kahn, MD Receives 2019 FASEB Excellence in Science Award
Barbara B. Kahn, MD, will receive the 2019 FASEB Excellence in Science Award. Kahn is Vice Chair for Research Strategy in the Department of Medicine at BIDMC and the George R. Minot Professor of Medicine at Harvard Medical School. One of few physician-scientists to receive this award, Kahn leads a highly successful research laboratory that has made seminal contributions to understanding the pathogenesis of obesity and type 2 diabetes. Awarded by The Federation of American Societies for Experimental Biology (FASEB), the Excellence in Science Award recognizes women whose outstanding career achievements in biological science have contributed significantly to the understanding of a particular discipline through scientific achievements, training of students and postdoctoral fellows, and contributions to the broader scientific community. (July 2018)