2011 - NIH Clinical Center - National Institutes of Health

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NEW UNIT PROVIDES UNIQUE SUPPORT FOR CLINICAL RESEARCHFauci said. Simonson applauded NIH staff for theability to “use their imagination, try to anticipateproblems, and create solutions before they happen.”Inpatient healthy volunteers and low-acuitypatients in clinical trials will typically spendextended periods of time on the unit.The facility,designed as a mini-apartment to make the timespent more comfortable, includes one singleroom (with an anteroom), three double inpatientrooms, a common area for dining, a kitchenette,an exercise area, and laundry space.(Above) Dr. H. Clifford Lane,NIAID clinical director, wasamong speakers at theunit’s opening.(Right) Doing the honors ata ribbon-cutting for the newSpecial Clinical Studies Unitwere (from left) Stewart Simonson,former HHS assistantsecretary for public healthemergency preparedness; Dr.(Col. US Army) Mark Kortepeter,deputy director of the InfectiousDiseases Clinical ResearchProgram at the UniformedServices University of theHealth Sciences; CC DirectorDr. John I. Gallin; and NIAIDDirector Dr. Anthony Fauci.A ribbon-cutting for NIAID’s new SpecialClinical Studies Unit at the Clinical Center washeld on April 14, 2010.The new seven-bedunit, which is in the 5NE-S corridor of theHatfield Building, affords state-of-the-artisolation capabilities.“This new unit is another example of theClinical Center’s ability to adapt to emergencysituations,” said CC Director Dr. John I. Gallinat the ceremony.During the event, NIAID Director Dr.AnthonyFauci presented a special award to Stewart Simonson,former HHS assistant secretary for publichealth emergency preparedness, who was instrumentalin the creation and development of theunit.“He promised it would happen, and here it is,”The entire unit is also capable of functioning as anisolation suite of rooms and can be used to housepatients with known or suspected infections withespecially virulent infectious agents. It will beavailable for use by investigators whose patients aresuspected of having a highly contagious condition.When patient isolation is needed, all four patientrooms and their connecting corridor will bekept under negative pressure at a high rate of airexchange and with HEPA-filtered exhaust.Whenisolation is mandated, access to the unit will berestricted to the unit staff with state-of-the-artinfection control procedures in place. Point-ofcarelaboratory testing and telemetry monitoringare additional capabilities of the unit.Staffing the access-protected Special ClinicalStudies Unit requires a new process, too, said AnnMarie Matlock, nurse manager.While new to theCC, all 10 nurses hired to staff the unit came withclinical experience and a professional interest ininfectious diseases. Specific training was developedand implemented to deal with infectious pathogensstaff could potentially encounter despite theexpected rarity of these types of occupationalexposures or exotic infections, Matlock said.26 • ANNUAL REPORT 2011
DC PARTNERSHIP FOR HIV/AIDS PROGRESS SEES ACCELERATEDACTION, OPENS FOURTH CLINICThe DC Partnership for HIV/AIDS Progress,announced in January 2010, has seen substantialacceleration in progress for the four original pillarsof the program, said Dr. Henry Masur, chief of theClinical Center Critical Care Medicine Department.In addition to directing the overall project in collaborationwith Dr. Carl Dieffenbach, director ofthe National Institute of Allergy and InfectiousDiseases (NIAID) Division of AIDS, Masur leadsone of the four pillars—enhanced care.Theothers—surveillance, prevention, and test andtreat—complete the base of the initiative.Theinitial investment in this long-term program, $26.4million over the first two years, supports clinicalresearch to help address the District’s HIV/AIDSepidemic, where roughly 3 percent of the populationis infected with HIV—among the highestHIV/AIDS rates in the nation.The project is acollaboration among several NIH institutes andcenters and the NIH Office of AIDS Research.One of the most exciting programs in the initiativeis the DC Cohort, which will link electronicrecords from the 12 largest HIV providers in DCto a database that can be used for research andfor quality improvement studies.These 12 clinicalpartner sites see 85 to 90 percent of the District’sHIV patients.The collected information will provideimportant data for epidemiologic and clinicalinvestigations.“We think we will have an unparalleledopportunity to look at an urban cohort,”said Masur.The four clinics where NIH specialists are embeddedto improve HIV subspecialty care for theunderinsured—directed by Dr. Dawn Fishbeinand within Masur’s pillar of enhanced care—haveseen approximately 200 patients with HIV andhepatitis C infections.Three initial clinics openedin June 2009 in connection with existing programsat Family & Medical Counseling Service, Inc., inSoutheast Washington; Unity Health Care’s WalkerJones Health Center in Northeast Washington; andWhitman-Walker Clinic in Northwest.The fourthclinic based at Unity’s D.C. General Health Centeropened in the fall of 2010.In each clinic, NIH staff work directly with patientsto provide care and treatment.As the clinics expand,NIH is adding more experts. Dr.Anu Osinusi,an HIV-hepatitis co-infection specialist from theUniversity of Maryland School of Medicine inBaltimore, joined the Clinical Center to workwith patients at the new Unity Health Care’s D.C.General site and at the Unity’s Walker Jones facility.Additionally, Dr. Suad Kapetanovic, a psychiatristwith extensive HIV clinical and research experienceat the University of Southern California, hasbeen recruited by the National Institute of MentalHealth to develop HIV-related mental healthresearch initiatives in connection with the DCPartnership.“This is a chance for NIH to do something goodfor the city and to expand our intramural researchagenda into more areas that will contribute toreducing the impact of HIV/AIDS in urbanAmerica,” said Masur.The clinics serve as study sites for a currently enrollingsafety and tolerability clinical research studyexamining an experimental, orally administereddrug in combination with injectable interferon andribavirin to treat hepatitis C in patients with HIV/AIDS.The oral drug has been proven safe and effectiveto treat parasitic infections, and is currentlybeing studied in research volunteers with hepatitisC mono-infection.The new study will involveas many as 35 research volunteers with HIV andhepatitis C who did not respond to prior standardtreatment regimens.New oral medicines potentially could replaceinjectable interferon-based regimens that areassociated with adverse effects. “The patients areexcited about the opportunities they will have tobe enrolled in clinical trials, especially for hepatitisC, which is so hard to treat,” added Osinusi.In addition to the new treatment study, the sitesare participating in a study that is retrospectivelyexamining progression of liver disease in African-American patients with HIV/AIDS and hepatitis Cto evaluate the theory that this population remainsin early stage liver disease longer than otherpopulations with the same co-infections.“We think wewill have anunparalleledopportunity tolook at anurban cohort.”ANNUAL REPORT 2011• 27
Page 1 and 2: PROFILE 2011There’s NoOther Hospi
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Page 6 and 7: OUR VISION As America’s research
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