2009 DOM Annual Report - Department of Medicine - University of ...

Better medicine through education and research.

Department of MedicineCOMMENTS FROM THE CHAIRThe Department of Medicine (DOM) has had another highly successful year as we continue to build our clinicalvolume while providing improved access and first-rate, empathetic clinical care. Our teaching programs continueto improve by all benchmarks, and despite challenges with obtaining the decreased pool of National Institutesof Health (NIH) funding, the Department increased its funding, and investigators made important basic andtranslational research breakthroughs. We attribute the success of the DOM to the leadership within eachDivision, the expertise of our hardworking faculty and trainees, the superb efforts of our adept administrators,and the contributions of our dedicated staff.PATIENT CAREPatient care grew 20%, namely in inpatient admissions, consultation, and outpatient activities. Our Divisions provided support and referralsto the greater University of Pittsburgh Medical Center (UPMC) medical community, across all disciplines focusing on areas of need for thesystem. Faculty productivity is monitored regularly and rewarded individually, and it is discernible that we have one of the most productivefaculties nationally. We also continue to focus on providing the highest possible quality of care, as shown by the quality improvementprograms highlighted by each Division. Providing access to care remains a high priority as we strive to reach the benchmark establishedby UPMC of 72 hours for urgent patient complaints. All Divisions have restructured their workflow and processes to reach and exceedthis target. The DOM’s increased admissions and the downstream revenue generated by our work has been recognized by UPMC throughgenerous support that allows us to provide outstanding patient care as well as fuel our education and research missions, which ultimatelywill result in improved healthcare for citizens in Western Pennsylvania and beyond.RESEARCHWhile national growth has slowed, we continue to enjoy progress in our research enterprise, with $65.6 million of research expendituresduring the last year. We have many junior faculty with K awards, and we have implemented additional career development mechanisms toassure their success. RO1 awards remain the main source of support, with several program projects. Our Pulmonary Division is a majorpart of two SCCOR grants recently awarded, and Veteran’s Administration (VA) funding also remains strong. Our goal for the future isto develop multidisciplinary research teams charged with understanding the different disease mechanisms and to develop new therapeuticstrategies for major diseases.“ We are ver y optimistic thatcurrent revolutions in genomics,imaging, computer sciencesand other areas will pay off inthe near future, fundamentallytransforming our ability toimprove outcomes for ourpatients. We are committedto being a major par t of theseadvances.”TEACHINGThe DOM continues to make progress in its mission to train the next generationof academic medicine physicians and physician-scientists. With respect to medicalstudents, our pre-clinical presence and clinical experience have been thoroughlyappreciated by the students. Despite national trends showing decreased interest, wehave gone from a nadir of 15 medical students entering medicine three years ago tomore than 30 for the past two years. Our resident training continues to improve, aswe stress education while providing meaningful service. We have an excellent class ofinterns, and we look forward to next year’s match. The University has been awardeda Clinical Translation Scholar’s Award, which includes a large educational componentheaded by Wishwa Kapoor; the Department has also been awarded an “EducationInnovation Proposal” to develop a program to train the next generation of internists.Each subspecialty has also made strides to recruit high caliber fellows, many of whomwill become successful physicians and researchers.We have also made changes in our leadership, as Wishwa Kapoor remained Vice Chair of Education, Raquel Baranosky was namedResidency Program Director, and Frank Kroboth was appointed Assistant Dean in charge of Fellowship programs. This remarkably talentedteam, in addition to the many faculty members dedicated to teaching, will allow us to continue to be nationally regarded as one of the finestand most dedicated teaching institutions.Currently, the DOM is an outstanding academic unit which prospers in all of its core missions. Despite an uncertain medical environment,our future is bright. In part this is due to our strong base of 20 UPMC hospitals including one in Italy and plans to continue ourinternational presence. Moreover, we are the only medical center that is all three of the following: U.S. News and World Report “BestHospitals”, top 10 NIH funded health care institution (#4 in total NIH grants 2006), and top 10 rated insurance company (rated by qualityin U.S. News and World Report). What these numbers indicate is that we not only have a strong reputation for providing outstanding clinicalcare, but that we have a broad infrastructure that makes us relatively independent from external forces as we develop models to determinehow to best deliver health care for the future. With respect to research, these statistics demonstrate not only that we are among the leadingBetter medicine through research and education.

2007institutions, but we are the only new member of the top10 funded institutions in decades. Our momentum andenergy is palpable and exciting. We are very optimisticthat current revolutions in genomics, imaging,computer sciences and other areas will pay off in thenear future, essentially transforming our ability toimprove our patient’s outcomes and we are resolved toplay a major part in these advances.As a relatively new chair in this highly successfulDepartment, I am committed to our Department beinga leader in quality patient care. We are excited aboutour potential to develop new models of education forinternists, and we are developing plans accordingly. Weare committed to continually staying on the cuttingedgeof medical technology and to playing a major partin advancing and fundamentally improving patient care.Steven D. Shapiro, MDJack D. Myers Professor and ChairDepartment of MedicineTABLE OF CONTENTSCOMMENTS FROM THE CHAIR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2ORGANIZATIONDepartment of Medicine Divisions . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Department of Medicine Centers and Institutes by Division . . . 6DIVISION REPORTSCardiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Clinical Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Endocrinology & Metabolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Gastroenterology, Hepatology & Nutrition . . . . . . . . . . . . . . . . . . . . 22General Internal Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Geriatric Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Hematology/Oncology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36Infectious Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40Pulmonary, Allergy & Critical Care Medicine . . . . . . . . . . . . . . . . . . 46Renal-Electrolyte . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52Rheumatology & Clinical Immunology . . . . . . . . . . . . . . . . . . . . . . . 56QUALITY IMPROVEMENT & PATIENT SAFETY REPORT . . . . . . 60MEDICAL EDUCATION IN THE DEPARTMENTOF MEDICINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64U.S. NEWS & WORLD REPORT RANKINGS . . . . . . . . . . . . . . . . . . . . 72TEACHING ACTIVITIESMedicine Housestaff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74Current Fellows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75Departing Fellows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77KEY STATISTICSOut-Patient Visits by Division . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79wRVUs by Division . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80Out-Patient Access Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82Faculty FTE’S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83ALOS by Division . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84Funding by Sponsor Type & Dollars Awarded . . . . . . . . . . . . . . . . . 85Final Report of Revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86Funding by Sponsor Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87PROFILESUniversity of Pittsburgh Medical Center . . . . . . . . . . . . . . . . . . . . . . . 88Selected Department of Medicine Clinical Sites. . . . . . . . . . . . . . . . 89The University of Pittsburgh School of Medicine . . . . . . . . . . . . . . 90City of Pittsburgh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Department of MedicineDEPARTMENT ORGANIZATIONUNIVERSITY OF PITTSBURGHUNIVERSITY OF PITTSBURGH MEDICAL CENTERVice ChairsSteven D. Shapiro, MDInterim Vice Chair, ClinicalWishwa Kapoor, MD, MPHChief, Division of General Internal MedicineVice Chair, EducationDavid Roodman, MD, PhDVice Chair, ResearchAdele Towers, MD, MPHVice Chair, Quality Improvement and Patient SafetyDepartment of MedicineOffice of the ChairSteven D. Shapiro, MDJack D. Myers Professor and ChairValerie C. Trott, CPA, MBA, CIA, CHFPExecutive AdministratorAll DivisionsCardiovascular InstituteClinical PharmacologyEndocrinologyGastroenterologyGeneral Internal MedicineGeriatric MedicineHematology/OncologyInfectious DiseasesPulmonaryRenal-ElectrolyteRheumatologyOffice of Education(General Internal Medicine)Lisa HolleranTheresa CullensCharlene GergelyKerry SosoDeborah Winn-Horvitz, MSAdministratorWilliam Row, CPAControllerMargaret L. Ealy, CPA, MAAssistant AdministratorFaculty and Staff AffairsJanet BrunnerManagerMary ButchLoni LutzAudrey McCarthyJeannett RossiSandra SebulakLoretta TarquinioInformation TechnologyShawn ThompsonGary FleckEd KucharDave PietrzykCindy StonebrakerBrian FullerOffice of the ChairJimette GilmartinPaula NaveResearch AdministrationKathy PoellnitzManagerCorporate AdministrationBarb KrausCaitlyn WilkinsMedical CodingBonnie BrownManagerKimberly GreenArlene MostMelanie MoytaRuth RidoshSherry StokesJa'net ThompsonTracy Bailey Rick Fabean Christina Klarnet Jason RosolMarsha Boyden Karen Gerenyi Todd Langer Nancy StropeKaren Chervenick Anastasia Hegedus Kris Limetti Kevin TuckerMarcie Conrad Jim Jarvis John Mahn Jen UrsidaTom Evansky Mike Javor Cathy Palmisano Jennifer WollardBetter medicine through research and education.

2007DIVISION ORGANIZATIONCardiovascular InstituteBarry London, MD, PhDDivision ChiefMichael GraceDivision AdministratorDepartment of MedicineOffice of the ChairSteven D. Shapiro, MDJack D. Myers Professor and ChairValerie C. Trott, CPA, MBA, CIA, CHFPExecutive AdministratorDeborah Winn-Horvitz, MSAdministratorRheumatologyLawrence W. Moreland, MDDivision ChiefKim MudrinichDivision AdministratorLupus Center of ExcellenceJoseph M. Ahearn, MDCo-DirectorSusan Manzi, MD, MPHCo-DirectorRosemary J. SabolAdministratorArthritis & Internal Medicine (AIM)Terence W. Starz, MDPractice AdministratorNancy DentelPractice ManagerClinical PharmacologyRobert Branch, MDDivision ChiefDenise SmalleyDivision AdministratorMargaret L. Ealy, CPA, MAAssistant AdministratorRenal-ElectrolyteThomas Kleyman, MDDivision ChiefRenee HillDivision AdministratorMargolis Rheumatology AssociationThaddeus A. Osial Jr., MDPractice AdministratorNancy DentelPractice ManagerEndocrinologyAndrew F. Stewart, MDDivision ChiefNancy PenneyDivision AdministratorPulmonaryAugustine Choi, MDDivision ChiefDorothy VoithDivision AdministratorMedical Thoracic Associates (MTA)Joel Weinberg, MDDirectorInfectious DiseasesGastroenterologyDavid C. Whitcomb, MD, PhDDivision ChiefChad ScottDivision AdministratorJohn W. Mellors, MDDivision ChiefMichelle AkersDivision AdministratorHematology/OncologyGeriatric MedicineRonald B. Herberman, MDDivision ChiefNeil M. Resnick, MDDivision ChiefMaureen HatchDivision AdministratorNicole RadulovichDivision AdministratorGeneral Internal MedicineWishwa N. Kapoor MDDivision ChiefOffice of EducationJoanne RileyDivision AdministratorCenter for Research on Health CareClinical Research Education InstituteConsortium Ethics ProgramWishwa N. Kapoor MDDirectorWishwa N. Kapoor MDDirectorRosa Lynn PinkusDirectorLynn RagoAdministratorMark Roberts, MDCo-DirectorAndrew Thurman, JD, MPHInterim Associate DirectorMarjory PitzAdministratorJody StockdillAdministrator

Department of MedicineDEPARTMENT OF MEDICINECenters and Institutes by DivisionCardiovascular InstituteCardiovascular InstituteBarry London, MD, PhDDirectorClinical PharmacologyCenter for Clinical PharmacologyRobert A. Branch, MDDirectorEndocrinologyDiabetes InstituteLinda Siminerio, PhDExecutive DirectorObesity/Nutrition Research CenterBret H. Goodpaster, PhDCo-DirectorJohn Jakicic, PhD(Department of Health and Physical Activity,School of Education)Co-DirectorOsteoporosis Prevention and Treatment CenterSusan L Greenspan, MDDirectorGastroenterologyCenter for Liver DiseasesObaid Shakil Shaikh, MBBSDirectorDigestive Disorders CenterBarry Kisloff, MDDirectorGastrointestinal Cancer Prevention andTreatment CenterRobert E. Schoen, MD, MPHDirectorInflammatory Bowel Disease CenterMiguel D. Regueiro, MDCo-DirectorRichard H. Duerr, MDCo-DirectorNeurogastroenterology and Motility CenterKlaus Bielefeldt, MD, PhDDirectorPancreas and Billary CenterDavid C. Whitcomb, MD, PhDDirectorGeneral Internal MedicineCenter for Health Equity Research andPromotionMichael J. Fine, MD, MScDirectorCenter for Research on Health CareWishwa N. Kapoor, MD, MPHDirectorData CenterDoris M. Rubio, PhDDirectorInstitute for Clinical Research EducationWishwa N. Kapoor, MD, MPHDirectorInstitute for Doctor-Patient CommunicationRobert M. Arnold, MDDirectorInstitute to Enhance Palliative CareDavid Barnard, PhDDirectorGeriatric MedicineUniversity of Pittsburgh Institute on AgingNeil M. Resnick, MDDirectorInfectious DiseasesGeneral Infectious Diseases Clinical ProgramKarin E. Byers, MDDirectorHIV/AIDS Clinical Research ProgramDeborah D. McMahon, MDDirectorPulmonaryAsthma, Allergy, and Airway Research CenterSally Wenzel, MDDirectorComprehensive Lung CenterChristopher N. Faber, MDDirectorSimmons Center for Interstitial Lung DiseaseNaftali Kaminski, MDDirectorRheumatologyArthritis InstituteThomas A. Medsger Jr, MDDirectorLupus Center of ExcellenceJoseph M. Ahearn, MDCo-DirectorSusan Manzi, MD, MPHCo-DirectorBetter medicine through research and education.

Department of MedicineCARDIOLOGYBarry London MD, PhDDivision Chief/ ProfessorDirector, Cardiovascular InstituteFACULTYLawrence N. Adler MDFerhaan Ahmad MDSaleem Ahmed MDAryan N. Aiyer MDRene J. Alvarez MDBarry L. Alpert MDMorteza Amidi MDWilliam D. Anderson MDWilliam W. Barrington MDRaveen R. Bazaz MDSusan E. Brode MDLawrence A. Bucklew MDLinda Cadaret MDJocelyn F. Camara MDXucai Chen PhDSimon H. Chough MDHoward A. Cohen MDJeffrey S. Cohen MDPeter J. Counihan MDFred W. Crock MDImad Domat MDDaniel Edmundowicz MDWilliam P. Follansbee MDAbraham W. Friedman MDJeffrey S. Garrett MDMark J. Geller MDJohn M. George MDJohn Gorcsan MDVijay K. Gulati MDMajid A. Hashmi MDRichard L. Heppner MDKaikobad J. Irani MDJerome M. Itzkoff MDSandeep K. Jain MDWilliam E. Katz MDSeymoure Krause MDVenkataraman Krishnaswami MDDean E. Kross MDJohn D. Kyriacopoulos MDWilliam J. Lauer MDAshley Lee MDJenifer E. Lee MDJoon S. Lee MDRodney C. Lipman MDBarry London MD, PhDAngel Lopez-Candales MDOscar C. Marroquin MDMichael Mathier MDSubhendra N. Mattagajasingh PhDKenneth R. McGaffin MDDennis M. McNamara MDCharles F. McTiernan PhDHaider Mehdi PhDMark A. Milchak MDRicci A. Minella MDLeRoy C. Moore MDSuresh R. Mulukutla MDJan Nemec MDOgundu C. Ngwu MDJames D. O’Toole MDJohn J. Pacella MDFrederick L. Porkolab MDJohn A. Power MDRavi N. Ramani MDMakum L. Ramesh MDP. Sudhakar Reddy MDSteven E. Reis MDRobert J. Ruffner MDSamir Saba MDJohn T. Schindler MDMark Schmidhofer MDDavid S. Schwartzman MDAlaaeldin A. Shalaby MDBrahma N. Sharma MDJames A. Shaver MDVladimir Shusterman MDSaul J. Silver MDMark A. Simon MDAnson J. Smith MDThomas C. Smitherman MDPrem Soman MDAli F. Sonel MDZeynep O. Soran MDNattapong Sricharoen MDVenkatraman Srinivasan MDMichael L. Steinfeld MDKathleen L. Sward PhDEdward T. Szabo MDStuart G. Tauberg MDJeffrey J. Teuteberg MDMark E. Thompson MDAndres R. Ticzon MDJalit Tuchinda MDFlordeliza S. Villanueva MDMaliha Zahid MDXiaodong Zhu PhDBetter medicine through research and education.

Department of Medicineelective time is provided to allow fellows to pursue individual interests.In addition to our continued development of the fellowship program,the CVI participates in the development of our future physiciansthrough the education of medical students and residents.HIGH IMPACT PUBLICATIONSLeading our molecular imaging effort, Dr. Villanueva had a series ofarticles published in Circulation. For example (Circulation, 115:345-352, 2007), her group showed that microbubbles designed to adhereto endothelial selectins identified newly ischemic myocardiumoffering a new approach to more timely and precisely diagnose acutecoronary syndromes. Genetics is another area of strength in theInstitute, and along this theme Dr. London and colleagues used therare Brugada syndrome as a method to understand the genetic andpathogenetic basis of ventricular fibrillation. They found that a GPD1-L is a novel gene that may affect trafficking of the cardiac Na+ channelto the cell surface.QUALITYIn addition to our premium research and clinical work, quality remainsa top priority, and several quality initiatives were undertaken. TheCVI was selected to participate in the Highmark Pilot Program for theNational Council of Quality Assurance (NCQA) Physician Recognition inHeart Stroke. By achieving NCQA recognition, the CVI physicians andfaculty demonstrated to their professional peers, group purchasersof health care, and the general public that they provide the highestquality care.The CVI continued to focus on the improvements in the door-toballoontime. The door-to-balloon quality improvement initiativewas a tremendous success, with a decreased door-to-balloon timefor percutaneous coronary intervention (average time 110 minutes infiscal year 2006 to 75 minutes in fiscal year 2007) and an increase inpercent of subjects under 90 minutes (29.1% to 74.2%). In addition,the CVI continued the Acute MI initiative and Congestive Heart Failure(CHF) initiatives to focus on the CORE measures that are now beingtracked and reported for all hospitals by CMS (e.g. , aspirin (ASA) within24 hours of admission, beta blocker use, smoking cessation, time tointervention for acute myocardial infarction (MI), ejection fraction (EF)assessment, cardiac medication (ACE/ARB) use for CHF).10 Better medicine through research and education.

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Department of MedicineSELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsGrant Reviewers for NIH and AHABarry London, Permanent Member, NIH ESTA Study Section Chairman, NIH Panel, Role of Omega-3 Fatty Acids in Sudden Cardiac Death,American Heart Association Pennsylvania-Delaware AffiliateMichael Mathier, Study Section Chairman, American Heart Association Mid-Atlantic ConsortiumFlordeliza Villanueva, Grant Reviewer, American Heart Association Mid-Atlantic Affiliate Member, Research Committee, American HeartAssociation Great Rivers AffiliateEditorial boardsJohn Gorcsan, Journal of the American College of Cardiology, Journal of the American Society of EchocardiographyKaikobad Irani, Antioxidants and Redox SignalingBarry London, Journal of Cardiovascular, Electrophysiology and Circulation ResearchSteven Reis, Journal of Women’s Health and Gender Based Medicine, Current Controlled Trials in Cardiovascular Medicine Electrophysiology andCirculation ResearchDavid Schwartzman, Journal of Cardiovascular Electrophysiology, Journal of the American College of Cardiology, Heart RhythmPATIENT DAYS BY DIVISIONFiscal Years 2005 - 2007Division Patient Days FY 05 Patient Days FY 06 Patient Days FY 07 % ChangeCardiology 23,597 24,838 24,278 -2.3%12 Better medicine through research and education.

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Department of MedicineCLINICAL PHARMACOLOGYRobert A. Branch MD, FRCPDivision Chief/ ProfessorDirector, Center for Clinical PharmacologyProgram Director, Montefiore-Clinical TranslationalResearch CenterFACULTYRobert A. Branch MDShama C. Buch PhDAlfred A. CecchettiRaghvendra K. Dubey PhDJohn R. Misage MDMatthew F. Muldoon MDTomoko Nukui PhDPetr Pancoska PhDMarjorie Romkes PhDNicolas A. Stewart PhDStevan P. Tofovic MDLefteris C. Zacharia PhDNathalie K. Zgheib MD14 Better medicine through research and education.

2007The Center for Clinical Pharmacology (CCP) is made up of a smallgroup of faculty, and the purpose of the group is pre-clinical andclinical translational research in the areas of drug developmentand the evaluation of pharmacotherapy and clinical pharmacologyeducation for both undergraduate and medical students. Futureopportunities for the Division of Clinical Pharmacology includeexpansion of the application of cutting-edge core laboratories inpharmacogenetics and metabolomics and expansion of informationtechnology and support of clinical research through the ClinicalInvestigation Core (CIC) to clinical translational researchers in theDepartment of Medicine (DOM).CLINICAL AND CLINICAL RESEARCHThe newly-renovated UPMC Montefiore (MUH) Clinical TranslationalResearch Center (CTRC) remains fully funded ($2.2 million/year) aspart of a larger Clinical Translational Sciences Institute(CTSI) networkof facilities ($16 million/year) by the National Center for ResearchResources (NCRR). It serves approximately 1,000 inpatient days and6,000 outpatient days of clinical translational science research peryear, mostly requiring extended, intensive research care. Areas ofexcellence include diabetes, bone metabolism, clinical pharmacology,oncology, rheumatology and pulmonary disease.TEACHINGClinical Pharmacology teaching is extensive. It includes theElective in Clinical Pharmacology (intensive one month coursefor fourth year medical students), which focuses on the principlesof clinical pharmacology, rational drug prescribing, evidencebasedpharmacotherapy for multiple topics in medicine, extensiveinvolvement in the Clinical Research Training Program (CRTP)and experimental clinical research training at all levels. Otherteaching activities include lectures to second and first year medicalstudents, post graduate training for MDs, PhDs and PharmDs andthe introduction of 24 10th grade high school students to conceptsinvolved in clinical trials.Pharmacovigilence (Pv) Program and Information Technology/Biostatistics Core continues to be successful. The goal is to use andintegrate resources to improve the overall efficiency of drug use inhealthcare institutions so as to enhance efficacy, safety and cost, witha focus on drugs made newly available in the healthcare market. Thisclinical area provides clinical, outcome-based information technologyfor decision analysis of clinical drug use and provides IT support to labbased,clinical research collaborative projects and grants.“Areas of excellence include diabetes, bonemetabolism, clinical pharmacology, oncology,rheumatology and pulmonary disease.”PRE-CLINICAL AND CLINICAL TRANSLATIONALRESEARCHThis research area includes molecular and cellular pre-clinicalpharmacology, organ/tissue pre-clinical pharmacology, and wholeanimal pre-clinical pharmacology. Clinical Translational ResearchCenters related to the Pharmacogenomics program serve investigatorsin Specialized Programs of Research Excellence (SPORE) grants, inlung cancer, as well as in head and neck cancer, where it providesstrong research on pathways of DNA repair, drug transporters, andmediators of inflammation. Clinical Pharmacology conducts studieson the regulation of drug metabolizing enzymes in discrete projectsthat include drug interactions in young subjects, the influence of age(>70 yr), morbid obesity, chronic liver disease, hepatocellular cancer,bladder cancer and as part of a national network that studies theeffect of pregnancy on drug disposition.QUALITYClinical Pharmacology makes a major contribution to the quality ofdrug prescribing through the Pv technology described in Clinical andClinical Research Activities. This extends from UPMC PresbyterianShadyside to all UPMC-related facilities via the activities of the SystemwidePharmacy and Theraputics (P&T) Hospital Committee.15

Department of MedicineHIGH IMPACT PUBLICATIONSDr. Tofovic and colleagues (Vascular Pharmacology. 45(6):358-67, 2006) have opened up the potential for previously unrecognizedpathophysiological mechanisms involved in pulmonary hypertension consequent to monocrotaline induction in preclinical models in the rat.This model is considered to be relevant to primary pulmonary hypertension in man. The role of estrogen metabolites that are biologically activethrough non-estrogen receptor mediated mechanisms offers a novel therapeutic option for translation from preclinical to clinical study in thefuture.SELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsGrant Reviewers for NIHRobert A. Branch, Member, NIH NCRR Special Emphasis Panel, Research Infrastructure, Member, Association of GCRC Program DirectorsEdwin K. Jackson, NIH Study Section, Permanent member (Hypertension and Microcirculation), 2005-2009Marjorie Romkes, Member, Subcommittee E (Cancer Epidemiology, Prevention and Control) of the National Cancer Institute Initial ReviewGroupEditorial boardsRobert A. Branch, , Hepatology, Clinical Pharmacology and Therapeutics, Therapeutic Drug MonitoringEdwin K. Jackson, Hypertension, Journal of Pharmacology & Experimental Therapeutics, Clinical and Experimental Hypertension, American Journal ofPhysiology, Renal Physiology, Comparative Physiology, American Journal of Physiology, Heart and Circulatory PhysiologyMatthew Muldoon, Psychosomatic Medicine, Annals of Behavioral MedicineMarjorie Romkes, Open Drug MetabolismPetr Pancoska, Current Drug Discovery TechnologiesOtherRaghvendra K Dubey, Invited Speaker and Moderator for the workshop on Sex Hormones, Gender and Hypertension- Molecular Mechanismsand Clinical Implications held by American Heart Association Council for High Blood Pressure Research (San Antonio, Texas, 4th Oct 2006)Matthew Muldoon, Secretary-Treasurer, American Psychosomatic Society16 Better medicine through research and education.

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2007With 33 faculty members and a 50-year tradition of excellence inbasic and clinical research, education and patient care, the Divisionof Endocrinology and Metabolism is, without question, one ofthe largest, strongest and most stable in the U.S. and is a leader inacademic, didactic and clinical endocrinology. Interdisciplinaryresearch programs have been emphasized and links forged to thepediatrics research program and the diabetes and osteoporosisprograms at the Graduate School of Public Health.CLINICALThe Endocrinology Division now provides endocrinologyconsultations and care at UPMC Presbyterian Shadyside and Magee-Womens Hospital as well as the Pittsburgh Veterans Affairs Hospital(VA). Visits to the endocrine clinics averaged 1,200 visits per monthat our Falk Endocrinology Clinic alone, despite undergoing extensiverenovations. Additionally, our Mt. Lebanon and Monroeville sitesaveraged 118 visits and 74 visits per month, respectively. We havedeveloped and validated a database of 107,000 patients with diabeteswho were cared for in the 19 UPMC hospitals and their associatedoutpatient facilities and clinics in Western Pennsylvania. Remarkably,this is the largest diabetes registry of unselected patients in the U.S.We have also developed one of the largest ADA-certified diabeteseducator networks in the U.S.RESEARCHFaculty within the Division received over $5 million in researchsupport. Areas of clinical research excellence include clinicaldiabetes, obesity, calcium metabolism and osteoporosis, and thyroidcancer. Areas of excellence in basic research include diabetes, insulinresistance, pancreatic beta cell function, survival and regeneration,osteoblast and osteoclast biology, and arterial smooth muscle inhealth and disease. Research is supported by an National Institutes ofHealth (NIH) Training Grant, now in its 39th year, which was recentlyrenewed, by the NIH-funded Clinical Translational Research Centerand by the NIH-funded Obesity and Nutrition Research Center.Outstanding facilities for microarray gene profiling, DNA and proteinsynthesis and sequencing, animal care, proteomics, cellular imaging,and bioinformatics and biostatistics are available.“...the Division of Endocrinology and Metabolism is,without question, one of the largest, strongest andmost stable in the U.S. and is a leader in academic,didactic and clinical endocrinology. “and occur at our University, Magee-Womens Hospital, UPMCShadyside, Children’s Hospital of Pittsburgh, and the PittsburghVA. Training excellence is documented by a 100% passage rate onthe Endocrinology Board exams for the past 29 years, by the largeproportion of training graduates who enter academic careers, and bythe excellent scoring of our NIH Training Grant.QUALITYThe Division of Endocrinology has been actively involved in improvingthe safe management of hospitalized patients with diabetes or newlyrecognizedhyperglycemia. Members of the Division of Endocrinology,together with the Department of Anesthesia and the UPMC DiabetesPatient Safety Committee, have developed and implemented aprotocol entitled Pre-operative Instructions for Patients with Diabetes.TEACHINGThe Endocrine Fellowship Program has received approval to increasethe program by an additional two slots beginning July 1, 2008.Recent and current fellows have trained at Columbia, Brown, Pitt,Penn, Jefferson, Cornell, Harvard, Northwestern and other excellentinstitutions. Training in clinical endocrinology is intense, rich,high-volume, and exceptionally diverse. Teaching and supervisionare equally outstanding. Research and clinical care are exemplary19

Department of MedicineHIGH-IMPACT PUBLICATIONSDrs. Greenspan and Stewart, as well as Drs. Roodman and Sperling who closely work within the Division, all had one or more manuscripts relatedto endocrine disease published in the New England Journal of Medicine the past year. Pancreatic islet stem cell biology is another theme of theDivision. In an attempt to induce beta-cell replication, Vasavada, Stewart and colleagues reported (Diabetes, 2007) that conditional knockout ofthe retinoblastoma protein had limited ability to induce proliferation. They are currently working to identify additional proteins and pathwaysthat will achieve this goal and enhance beta-cell mass.SELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsMajor HonorsAndrew F. Stewart, Gerald D. Aurbach Award of the Endocrine Society for outstanding scientific contributions to research, 2007Grant Reviewers for NIHBret Goodpaster, Study Section Member, NIH/NIDDK 2006 Subcommittee B (Training Grants)Susan Greenspan, Directors Pioneer Award Reviewer, 2007Robert O’Doherty, Study Section, Integrated Physiology of Diabetes (IPOD) NIH/NIDDKAndrew F. Stewart, Chair, NIDDK Islet Cell Resource Center User Working GroupEditorial boardsFrederick R. DeRubertis, Metabolism, Associate EditorSusan Greenspan, Journal Clinical Densitometry, Review Group Member, NIH, 2007Bret Goodpaster, Associate Editor, Medicine and Science in Sports and Exercise, Editorial Boards, Diabetes, J Gerontology Medical Sciences, DiabetesForecast20 Better medicine through research and education.

2007Mara Horwitz, Journal of Clinical Endocrinology and Metabolism, 2006-2011Robert O’Doherty, Biochemical JournalDonald Scott, Experimental Biology & Medicine, Analytical BiochemistryLinda Siminerio, Editor-in-Chief, Diabetes Forecast, International Diabetes MonitorAndrew F. Stewart, Associate Editor, Journal of Bone and Mineral Research, Bone, Endocrine ReviewsOtherJanet Amico, America’s Top Doctors , Best Doctors in AmericaAdolfo Garcia-Ocana, Invited Speaker, 1st International Meeting of the Spanish Society of Endocrinology and Metabolism, Seville, SpainSusan Greenspan, America’s Top Doctors, Best Doctors in America, “Top Doctors” for 2007, Pittsburgh magazine, Program Chair, 2006 AnnualMeeting ASBMR Mid-Atlantic, Osteoporosis Board Member Guidelines Panel, American Association Clinical Endocrinology Guidelines forOsteoporosis, 2006-2007Mary Korytkowski, America’s Top Doctors, Best Doctors in America, “Top Doctors” for 2007, Pittsburgh magazineHaruko Kuffner, Invited Keynote Speaker, Japan-North American Medical Exchange Foundation Annual Seminar, Tokyo, JapanR. Harsha Rao, America’s Top Doctors, Best Doctors in America, “Top Doctors” for 2007, Pittsburgh magazine, Fulbright Senior Specialist PanelMichelle Roberts, America’s Top Doctors, Best Doctors in America, “Top Doctors” for 2007, Pittsburgh magazineRose Ann Jeannette Salata, America’s Top Doctors, Best Doctors in America, “Top Doctors” for 2007, Pittsburgh magazineLinda Siminerio, Member, National Standards for Diabetes Self-Management Education Committee, Chair, American Diabetes AssociationEducation Recognition Review Criteria Committee, Chair, American Diabetes Association Safe at School Task Force, Member, Legal AdvocacyCommittee, American Diabetes Association, Member, National Diabetes Education Outcome System Committee, American Association ofDiabetes EducatorsAndrew F. Stewart, Secretary-Treasurer, Endocrine Society21

Department of MedicineGASTROENTEROLOGY, HEPATOLOGY & NUTRITIONDavid C. Whitcomb MD, PhDDivision Chief/ ProfessorFACULTYSteven R. Abo MDJawad Ahmad MDKathryn M. Albers PhDShirish A. Amin MDRagunath Appasamy MDGeorge L. Arnold MDM. Samir Ayasso MDLeonard K. Baidoo MDAnthony J. Bauer PhDJaideep Behari MDKlaus Bielefeldt MDRajagopal Chadalavada MDKapil B. Chopra MDBrian M. Davis PhDHoward M. Dubner MDRichard H. Duerr MDMichael A. Dunn MDPatricia K. Eagon PhDMary S. ElmMichael F. Ennis MDFadi F. Francis MDMichael S. Gold PhDToby Graham MDJulia B. Greer MDChristine L. Gulati MDRefaat M. Hegazi MDLee M. Hershenson MDFarhad Ismail-Beigi MDNiraj D. Jani MDHossam E. Kandil MDRobert J. Kania MDThomas J. Kelly MDAsif Khalid MDAmy Kilbourne PhDBarry Kisloff MDChristianna M. Kreiss MDJanet H. Kuzmishin MDJanette Lamb PhDSteven S. Lasky MDH. David Lipsitz MDShao-Gang Lu MDJames B. McGee MDKevin M. McGrath MDDerek C. Molliver PhDPeter J. Molloy MDMorry Moskovitz MDTina Musahl MDMichael R. O’Connell PhDStephen OKeefe MDGeorgios I. Papachristou MDMichael A. Pezzone MDEdward Post MDJoseph P. Pusateri MDMordechai Rabinovitz MDRichard E. Raizman MDDarrell K. Reed MDMiguel D. Regueiro MDVictor M. Rudkin MDMichael K. Sanders MDRobert E. Schoen MDObaid Shakil Shaikh MDGail Sekas MDAdam Slivka MD, PhDDan R. Trellis MDElena E. Ustinova-Gutkin PhDMahesh K. Varindani MDLee M. Weinberg MDDavid C. Whitcomb MDJohn M. Wood MDDhiraj Yadav MDFang Zhong MD22 Better medicine through research and education.

2007The University of Pittsburgh Division of Gastroenterology, Hepatologyand Nutrition enjoyed an outstanding year in fiscal year 2007.Strategic goals were defined and implemented to provide for thecontinued growth and success of the Division.CLINICALThe Division has the 3rd highest pancreatic cancer inpatient servicein the U.S. Twenty-two thousand patients received services fromseveral Division of Gastroenterology, Hepatology and Nutritionfacilities. The Digestive Disorders Center (DDC) is the hub ofoutpatient gastroenterology care. The DDC provides a setting forthe Division’s gastroenterologists to deliver quality care to adult andgeriatric patients with disorders of the gastrointestinal, hepatobiliaryand pancreatic systems. The Center for Liver Diseases servespatients with liver diseases and partners to deliver care with theStarzl Transplantation Institute and the Liver Pancreas Institute. TheWomen’s Center for Digestive Health at Magee-Womens Hospitalincludes full outpatient evaluations, inpatient consultations andclinical research protocols. Additionally, the Division now cares forpatients at a UPMC Shadyside office, with specializations in generalgastroenterology and hepatology as well as GI cancer prevention andscreening.QUALITYThe safety and quality of patient care is an utmost priority for theDivision. Perhaps the most comprehensive quality improvementshave related to the GI Lab and the DDC. The new DDC opened in earlyJune 2007 and provides an enhanced environment in which to visitwith and manage patients. Gastroenterology fellows will soon enjoyenhanced work space on the third floor of UPMC Presbyterian. Thesecapital improvements enhance work flow significantly. The Divisionis also participating, on a limited basis, in the Center for MedicaidServices (CMS) Physician Quality Reporting Initiative (PQRI) programdesigned to enhance the appropriateness of care in light of nationalperformance parameters.HIGH-IMPACT PUBLICATIONSTwo notable research advancements were discovered, including:1) identification of IL23R gene mutations as a risk for Crohn’s diseasepublished in Science (Richard H. Duerr, MD) and 2) the identificationof an abnormal palladin gene as a risk for familial pancreatic cancerpublished in Public Library of Science Medicine (David C. Whitcomb, MDPhD).“The safety and quality of patient care is anutmost priority for the Division. Perhaps themost comprehensive quality improvementshave related to the GI Lab and the DDC.”RESEARCHThe Division provided leadership for the development of the Centerfor Pain Research with its concentration on visceral pain. The Division’sresearch faculty focus on the integration of epidemiology, genetics,immunology and neuroscience into patient care. Key Divisionresearch initiatives include pancreaticobiliary disease research,inflammatory bowel disease research and neurogastroenterology/motility research, especially related to visceral pain.TEACHINGThe teaching program highlight is the reorganization of and successof the Gastroenterology Fellowship Program, which currently trains14 fellows and continues its rank as one of the top programs in thecountry. The Accrediation Counsel for Graduate Medical Education(ACGME) reviewers awarded two commodations, recognizing theprogram’s outstanding faculty and fellow research productivity andthe program’s excellent organization and regulation compliance.The Second Year Medical School GI/Hepatology course continuesto operate with an online adjunct component. The Division’s GIRounds Online program continues to experience outstanding success.Six inflammatory bowel disease, two pancreas and one GI motilityphysician education cases are currently available online. Futureplans include an online publication partnership with the AmericanGastroenterological Association (AGA).SELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards,and other honorsGrant Reviewers for NIH and GI SocietiesKathryn Albers, Member, NIH Study Section, Somatosensory andChemosensory Systems (SCS)Richard Duerr, Chairman, NIDDK IBD Genetics ConsortiumGenotyping CommitteeMichael Gold, Member NIH Study Section NST- 2Stephen O’Keefe, Chair, Nutrition & Obesity Section, AmericanGastroenterology AssociationMichael Pezzone, Section Chair, Basic Research in Interstitial Cystitis:Second Investigators Meeting Bladder Pain & NeurophysiologyObaid S. Shaikh, Member, DSMB, A2ALL: adult to adult living donorliver transplantation cohort (NIDDK 5UO1 A1052748-02)23

Department of MedicineEditorial boardsKathryn Albers, Drug Discovery Today: Disease ModelsKlaus Bielefeldt, Journal of PainKapil Chopra, Associate Editor, (Liver): Digestive Diseases and SciencesMichael Gold, Associate Editor: Journal Pain, Journal of Neuropathic Pain and Symptom Palliation, Brain ResearchKevin McGrath, World Journal of GastroenterologySatdarshan (Paul) Monga, World Journal of GastroenterologyMichael Pezzone, World Journal of GastroenterologyMiguel Regueiro, Associate Editor, Inflammatory Bowel Disease JournalRobert Schoen, American Journal of Gastroenterology and Clinical Gastroenterology and HepatologyObaid S. Shaikh, Liver TransplantationAdam Slivka, Gastroenterology, Gastrointestinal Endoscopy, Section Editor, Up to DateDavid C. Whitcomb, Associate Editor, Pancreas, Pancreatology and Digestive Disease and Science, Pancreas, Pancreatology and American JournalPhysiology: Gastrointestinal & Liver Physiology, Section Editor, Current Treatment Options in GastroenterologyOtherMichael Gold, Director at Large for the American Pain SocietyMichael Pezzone, Audrey Love Charitable Foundation Award for Research in IBSRobert Schoen, National Colorectal Cancer Roundtable, Quality Assurance Task GroupAdam Slivka, Chairman, American Society for Gastrointestinal Endoscopy Post Graduate Education CommitteeDavid C. Whitcomb, Inaugural Hans From MD Memorial Lecture, Dartmouth University, NH24 Better medicine through research and education.

200725

Department of MedicineGENERAL INTERNAL MEDICINEWishwa N. Kapoor MD, MPHDivision Chief/ ProfessorDirector, Institute for Clinical Research EducationDirector, Center for Research on Health CareCo-Director, RAND-University of Pittsburgh HealthInstituteCo-Director, Clinical and Translational ScienceInstituteFACULTYMeena S. Agarwala MDFadeke B. Akanbi MDSyed T. Ali MDChris M. Allen MDWendy G. Anderson MDEric J. Anish MDThomas J. Antos MDRobert M. Arnold MDCarol H. Azar MDEileen Baade MDDavid Barnard PhDAmber E. Barnato MDHerbert C. Bazron, Jr. MDSergei N. Belenky MDEllen S. Berne MDRobert W. Bernstein MDLori M. Bigi MDJudith S. Black MDDavid L. Blinn MDRachel A. Bonnema MDMadeline Borhani MDSonya A. Borrero MDJames E. Bost PhDRobert C. Brooks MD, PhDJohn D. Brungo MDCindy L. Bryce PhDDiemthuy D. Bui MDPeter D. Bulova MDJames H. Bumbaugh DOGregory M. Bump MDRaquel A. Buranosky MDTimothy R. Burke MDBonnie K. Case MDIbrahim I. Ghobrial MDEugene H. Ginchereau MDJames A. Gleason MDGeorge H. Gleeson MDAlda M. Gonzaga MDChester B. Good MDAdam J. Gordon MDAnuradha Gowda MDRosanne Granieri MDRichard L. Green MDMeghan E. Grove MDBernard A. Grumet MDAudrey S. Hall MDDavid A. Harinstein MDBernadette G. Harris MDPeggy B. Hasley MDRandy S. Hebert MDBea Herbeck-Belnap PhDBruce Hough MDKristin Humphreys MDSaid A. Ibrahim MDDany H. Issa MDAlan L. Itskowitz MDJames R. Jarvis MDHarish Jasti MDRichard B. Johnson MDAndrew H. Joseph MDFranziska F. Jovin MDRichard L. Kalla MDKeith T. Kanel MDWishwa N. Kapoor MDCarissa L. Katz MDLinda A. King MDChung-Chou Ho H. Chang PhD John G. Kokales MDPhilip J. Cichon MDRussell C. Kolarik MDJohn T. Cinicola MDKevin L. Kraemer MDWarren A. Coax MDRobert E. Kraftowitz MDMargaret B. Conroy MD Emanuel Krifcher MDAngelo Constantino MD Frank J. Kroboth MDAmanda L. Cooper MD Keith R. Lagnese MDJames S. Costlow MDWilliam Lamb DOMegan S. Cunnane MD Vincenzo Lamonaca MDFrank R. Cymerman MD Bruce Y. Lee MDQianyu Dang PhDLouis E. Leff MDAdele D’Antoni MDGary L. Lemoncelli MDMarilyn S. Daroski MD Kenneth H. Lentz MDJoan M. Devine MDMacy I. Levine MDPeter A. Dickinson MD David S. Lilienthal MDJoan E. Diegel MDYang Lin PhDEllen M. Dillinger MDBruce S. Ling MDEdward J. Donnelly, III MD Ramon G. Lozano MDMark A. Duca MDCheryl P. Lynch MDRobert G. Edwards MD Ahmad Maarouf MDCarolyn D. Ellis MDDavid S. Macpherson MDDavid M. Elnicki MDSharon L. MaddoxMichael J. Farrell MDVicki March MDJoan S. Farris MDChristopher R. Marsh MDMichelina Fato MDMegan C. Matoka PhDDonald E. Fetterolf MD Michele R. Matthews DOMichael W. Finikiotis MD David J. McAdams MDMarsha J. Fino MDJames P. McDowell DOAnthony B. Fiorillo, Jr MD Melissa Ann McNeil MDGary S. Fischer MDKathleen M. McTigue MDDouglas D. Fletcher MD Ateev Mehrotra MDNicole R. FowlerSharon F. L. Miller DOJanine M. Frank MDEvgueni M. Minev MDMatthew S. Freiberg MD Natalia E. Morone MDMichael A. Gaglia MDVisala S. Muluk MDSwaytha Ganesh MDJayanta T. Mukherjee MDLawrence D. Gerber MD Larissa Myaskovsky PhDCarol S. Myron MDDaniel J. Nalin MDKhaled Nashar MDAmit Nautiyal MDSmita Nayak MDMichelle S. Nazareth MDLee M. Neiman MDAnthony Nicassio MDRonald J. Nigborowicz MDMarc H. Oster MDRobert W. Otte MDThomas D. Painter MDGiovanna Panarello MDHitendra R. Patel MDKim M. Pierce MDRosa L. Pinkus PhDRuth M. Preisner MDBrian A. Primack MDPhilip F. Rabinowitz MDJennifer G. Reeder MDMark S. Roberts MDKeri L. Rodriguez PhDMariola Roguszka-Jozwiak MDBruce L. Rollman MDDoris M. Rubio PhDRussell J. Sacco MDJames R. Sahovey MDMaryBeth P. Salama MDPaola Salis MDAimee K. Santucci PhDEleanor B. Schwarz MDTracy R. Seewald MDGeorge B. Sestric MDDeborah L. SeltzerMary Ann Sevick PhDAshok K. Shetty MDHubert Y. Shick MDSankaran Shrikanthan MDKenneth J. Smith MDAdam E. Sohnen MDCarla L. Spagnoletti MDAbby L. Spencer MDAnthony Spinola MDAlan J. Steckel MDDennis F. Stull MDGalen E. Switzer PhDGary H. Tabas MDPeter P. Tanzer MDGaetana I. Tarantino MDWinifred G. Teuteberg MDHilary A. Tindle MDTheodore L. Tsai MDAsher Tulsky MDPeri Unligil MDRekhi P. Varghese MDAndrew G. Vayonis MDKaren L. Velazquez MDLevi Walker MDThomas P. Wein MDMieczyslaw Weinfeld MDElizabeth Weinstein MDT. Michael White MDLewis V. Whitman MDJohn T. Wisneski MDAnthony P. Yates MDAli R. Yazdanyar DOG. Alan Yeasted MDDianne M. Zalenski MDSusan L. Zickmund PhDNeal Zweig MD26 Better medicine through research and education.

2007The Division of General Internal Medicine (GIM) had a successfulyear in all activities, including those related to clinical care, research,teaching, and administration. Overall, outpatient and inpatient clinicalactivities have increased, and inpatient hospitalist activities have beenboth expanded and reorganized. The success of the Clinical ResearchTraining Program and the Clinician Educator Training Program led tothe development of the Institute for Clinical Research Education (ICRE),which now serves as a resource for fellows, junior faculty, medicalstudents and residents throughout the Schools of the Health Sciencesat the University of Pittsburgh.CLINICALThis year’s two new clinical initiatives have been to develop anincreased community profile concerning the management of eatingdisorders, which is rapidly becoming a dominant part of the women’shealth program, and the opening of an intrauterine device clinic.The Division’s inpatient service continues to grow. Our new hospitalistprogram, designed last year, has five teaching teams, a geriatrics team,and five A-Service non-teaching hospitalist teams.We also saw growth in consultations, the Palliative Care Program,and our primary care practices. The Palliative Care Program inpatientclinical service is receiving national recognition as a model clinicalprogram in an academic medical center and expanded to outpatientservices with the opening of the Pain, Rehabilitation, and SupportiveCare Clinic at Hillman Cancer Institute in 2006. Our primary carepractices grew in all ambulatory care sites. A major part of theDivision’s ambulatory practice remains at UPMC Montefiore.RESEARCHThe Division has 38 research faculty (23 MDs and 15 PhDs) who aredevoting 75% or more of their efforts to research. This past year, 32grant proposals were submitted, and direct and indirect researchexpenditures totaled more than $11 million in comparison with $10million in the previous year. The Division’s major research foci includestudies of effectiveness and quality guidelines, women’s health,prevention, health care disparities, mental health services, costeffectivenessand substance abuse. Research education is also a majorpart of the Division’s activities and is done through the ICRE. Thesecenters provide a mechanism for interdisciplinary collaboration andresearch with faculty throughout the University and with members ofthe RAND–University of Pittsburgh Health Institute.“Overall, outpatient and inpatient clinical activitieshave increased, and inpatient hospitalist activitieshave been both expanded and reorganized.”TEACHINGThe Internal Medicine Residency Training Program continues to dowell in recruitment and curricular innovations. Key reasons for thissuccess included our acceptance into the Educational InnovationProject (EIP) (described below), our addition of a Global Health Trackthis year and our emphasis on individualization of training within thevarious tracks that we offer, including the Geriatrics, Global Health, andWomen’s Health Tracks, the Clinical Scientist Training Program (CSTP),and the Ambulatory and Hospitalist Pathways. Division memberscontinue to play a vital role in teaching medical students.The EIP was created with the goal of redesigning internal medicineresidency education. In October, we were selected as one of only 12university internal medicine programs across the country to take partin this project. Subcommittees in the project focus on individualizingcareer paths, finding technology solutions, developing innovativeteaching methods, promoting continuous healing relationships,developing effective communication, using evidence-based practice,enhancing patient safety, improving chronic disease and preventivecare, and developing evaluation methods and competencies.Our five community clinics under the Program for Health Care toUnderserved Populations continue to see an increase in visits. Thisfiscal year, patient visits totaled 2,902, a 12% increase over lastfiscal year. All sites train residents and medical students. Medicalstudents, residents, and faculty donated a record high of 2,016 hoursof service for these clinics. The General Internal Medicine–OaklandOutpatient Clinic continues to expand technology in its practice.UPMC HealthTrak has grown and now serves over 4,700 patients,allowing them to view test results, upcoming appointments, andhealth reminders, communicate with physicians and staff, scheduleappointments and request prescription refills online. Through tabletcomputers connected to a wireless network, patients report pain,functional status, smoking habits, alcohol use and nutritional data.The General Internal Medicine Fellowship Program remained strong,supporting 8 fellows, and continues to grow. Fellows participated inan integrated program of inpatient and outpatient clinical service,in supervised teaching activities, in mentored research projects, andin formal coursework leading to the Master of Science in MedicalEducation or the Master of Science in Clinical Research.The ICRE, which was established under the direction of WishwaKapoor, MD, brings all of the clinical research education effortstogether to create efficiencies of operation and improvement inorganization. It allows for better communication among students andtrainees and better use of resources. There are several programs thatfall under the ICRE, including the Clinical Research Training Program,which awards the Master of Science in Clinical Research, the Clinician27

Department of MedicineEducator Training Program (CETP) that offers a Master of Science anda Certificate in Medical Education, and the Clinical Scientist TrainingProgram (CSTP) that was developed to provide clinical researchtraining for medical students. Other programs include the K12 ClinicalResearch Scholars Program (CRSP) and new programs offering a PhD inClinical and Translational Sciences, a program offering a Certificate inClinical and Translational Research, the Minority Career DevelopmentProgram, and Web-based teaching and mentoring programs.For inpatient care, our Division, in cooperation with the Departmentsof Pharmacy, Nursing, and Respiratory Therapy, completed a patientsafety and quality initiative that was funded by the Agency forHealthcare Research and Quality (AHRQ) and focused on EnhancedPatient Safety Interventions to Optimize Medication Education(EPITOME). Many other initiatives are in process, including two largescaleprojects. One initiative is designed to improve communicationwith patients and among providers through Electronic Medical Recordmessaging functions, and the second initiative is designed to decreasethe time taken to respond to patients’ phone call requests regardingrefills, forms and care for illnesses.HIGH IMPACT PUBLICATIONSAfrican-Americans currently bear the greatest burden of morbidity andmortality due to smoking, and they are exposed to a greater amountQUALITYThe Division’s QI efforts were recognized this year by two awardsreceived at UPMC Quality Fairs. GIM at UPMC Shadyside received anaward for Outstanding Achievement in Quality Improvement. GIMat UPMC Montefiore won second place for Outstanding SustainedAchievement in Management of Diabetes in Primary Care. TheDivision completed an outpatient clinic QI initiative that was fundedby a UPMC Clinical Quality and Safety Initiative (CLIQS) grantentitled “Effect of Decision Support and Computerized Ordering onHypertension Management”. The initiative demonstrated that EMRdecision support tools resulted in a three-fold increase in the numberof ordered interventions. Additional QI interventions will continuethrough 2008 to improve population outcome measures for bloodpressure.of pro-tobacco media messages. Dr. Brian Primack and colleaguesconducted a systematic review and meta-analysis comparing protobaccoadvertising in African-American and Caucasian markets.This analysis was published in the September 2007 issue of PublicHealth Reports, the official journal of the U.S. Public Health Service.In that analysis, the authors found that there were 2.6 times as manytobacco advertisements in African-American markets compared withCaucasian markets. The authors concluded that it is urgent to studythe reasons for this differential marketing, as well as racial marketingdifferences in newer new types of media/promotions used by thetobacco industry. The article was covered by many important newsoutlets, including National Public Radio, the New York Times, thePhiladelphia Inquirer, and the Pittsburgh Post-Gazette.28 Better medicine through research and education.

2007SELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsGrant Review for NIHMichael Fine, Member, National Advisory Council on Minority Health and Health Disparities, Department of Health and Human Services,National Institutes of Health, Member, Field-Based Science Advisory Committee, Health Services Research and Development (HSR&D) EquityPortfolioKevin Kraemer, Study Section Reviewer, AA-2 Health Services, Prevention, and Epidemiology Research, National Institutes of Health andNational Institute on Alcohol Abuse and AlcoholismDavid Macpherson, Member, Grant Review Section, Service Directed Projects, Health Services Research and Development, Veterans HealthAdministrationBrian Primack, Member, NIH Study Section, National Cancer Institute, “International Tobacco and Health Research and Capacity BuildingProgram”Bruce Rollman, Member, Study Section, Clinical and Treatment Subcommittee, National Institute on Alcohol Abuse and AlcoholismMary Ann Sevick, Special Emphasis Panel, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Galen Switzer, Member, Study Section on Health Services Organization and Delivery, National Institutes of Health, Member, VA Scientific Reviewand Evaluation Board, VA Health Services Research and DevelopmentEditorial boardsRobert Arnold, Editor, Journal of Palliative Medicine Encyclopedia of Medical Ethics, 3rd editionDavid Barnard, Journal of Palliative Care, Journal of Palliative MedicineJames Bost, American Journal of Managed CareMichael Fine, American Journal of Medicine, Pulmonary Infections ForumWishwa Kapoor, American Journal of Medicine, Journal of General Internal MedicineKevin Kraemer, Associate Editor, Alcohol and Health: Current EvidenceBruce Lee, Editor, Society of Medical Decision Making Newsletter, Editor, Alcohol and Health: Current EvidenceMelissa McNeil, Editor, Forum Newsletter, Society of General Internal MedicineMark Roberts, Associate Editor, Medical Decision MakingBruce Rollman, Psychosomatic MedicineDoris Rubio, Consulting Editor, Social Work ResearchKenneth Smith, Hospital PhysicianGalen Switzer, Marrow MessengerOtherEric Anish, Member, Abstract Review Board, National Abstract Competition, American College of Physicians and Member, Clinical VignetteSubcommittee, and Medical Education Workshop Subcommittee, Society of General Internal MedicineRobert Arnold, Board of Directors, American Academy of Hospice and Palliative Medicine, Past President, American Academy of Hospice andPalliative MedicineDavid Barnard, Award: 2006 Thomas M. Cooley II Legal Writing Award, Award: 2006 Center for Computer-Assisted Legal Instruction (CALI)Excellence for the Future Award, for Excellent Achievement in the Study of Race, Racism, and American LawAmber Barnato, Award: 2006 Best Geriatrics Abstract, Society of General Internal MedicineCindy Bryce, Co-Chair, 2007 Annual Meeting of the Society for Medical Decision MakingD. Michael Elnicki, Board of Directors, Alliance for Academic Internal Medicine, Past President, Clerkship Directors in Internal MedicineMichael Fine, Member, National Guideline Panel for the Management of Community-Acquired Pneumonia, Infectious Diseases Society ofAmerica29

Department of MedicineC. Bernie Good, 2006 Mark Wolcott Award for Excellence in Clinical Care Leadership, presented by the Veterans Administration NationalLeadership Board, Chair, Medical Advisory Panel, Pharmacy Benefits Management Strategic Healthcare Group, Veterans Health Administration,Chair, Adoption, Development, and Revision Workgroup for Clinical Guidelines Task Force, Department of Veterans Affairs, Vice Chair, NationalAdvisory Council for Clinical Practice Guidelines, Department of Veterans Affairs, Vice Chair, Clinical Practice Guidelines Task Force, Department ofVeterans Affairs and Department of Defense, Member, Drug Oversight Board, Food and DrugAdam Gordon, President, Pennsylvania Society of Addiction Medicine, President-Elect, Allegheny County Medical SocietyRachel Hess, 2006 Hamolsky Finalist, Best Abstract by a Junior Faculty Member, Society of General Internal Medicine, Co-Chair, Women’s Caucus,Society of General Internal MedicineSaid Ibrahim, Treasurer, International Society for Equity in HealthHarish Jasti, Chair, Clinical Vignette Selection Committee, Mid-Atlantic Meeting, Society of General Internal Medicine (SGIM)Wishwa Kapoor, “Top Doctors” for 2007, Pittsburgh magazineDavid Macpherson, Chair, Primary Care Committee, Veterans Integrated Service Network 4 (VISN 4), Veterans Health Administration Member,National Technical Advisory Group for Tobacco Cessation, Veterans Health AdministrationAteev Mehrotra, Best Abstract Award, for “The Relationship between Quality and Efficiency among Individual Physicians,” at the AnnualResearch Conference of the Academy for Health Services Research and Health Policy, Orlando, Florida, June 2007Brian Primack, 2006 New Investigator Award of the Society for Adolescent Medicine, 2006 Bronze Telly Award (National Video ProductionAward)Mark Roberts, Chair, Health Care Technology and Decision Sciences Study Section, Agency for Health Care Research and Quality, Co-Chair,Education Committee, International Society for Pharmacoeconomics and Outcomes Research, Member, Scientific Advisory Committee of theScientific Registry of Transplant Recipients, Division of Transplantation, Health Resources Services Administration (HRSA)Bruce Rollman, Elected to Academy of Behavioral Medicine Research, Member, National Council, American Psychosomatic Society Member,Scientific Advisory Board, Anxiety Disorder Association of AmericaEleanor Bimla Schwarz, 2006 Hamolsky Research Award Finalist, Society of General Internal Medicine, Member, Advisory Board, Standards ofCare Project, National Health Law ProgramKenneth Smith, Member, National Associates Competition Review Board, American College of PhysiciansGalen Switzer, Member, Donor Advocacy Advisory Council, National Marrow Donor Program, Advisory Board, Collateral Uses of the NationalMarrow Donor Registry, sponsored by the National Marrow Donor ProgramGary Tabas, Board of Advisers, Medcalc 3000 System, Committee Chair, Interactive Resources in Internal Medicine Section for the 2008 AnnualMeeting of the Society of General Internal Medicine30 Better medicine through research and education.

200731

Department of MedicineGERIATRIC MEDICINENeil Resnick MDDivision Chief/ ProfessorDirector, Institute on AgingDirector, Hartford Center of Excellencein GeriatricsFACULTYNamita S. Ahuja MDPatricia G. Coyle MDAnthony B. Csoka PhDHollis D. Day MDMario J. Fatigati MDAlfred L. Fisher MDAmelia Gennari Bartels MDSteven M. Handler MDJoseph T. Hanlon PharmDSusan E. Hardy MDSusanne C. Hartmann MDShuja Hassan MDEmily J. Jaffe MDLaurie L. Lavery MDJorge Lindenbaum MDCynthia E. Luck DODavid A. Nace MDElizabeth A. OKeefe MDMark H. Overton MDDavid A. Pasquale MDKPG Subashan Perera PhDLouis A. Piccoli MDSangeeta Rana MDNeil M. Resnick MDEric G. Rodriguez MDMichelle I. Rossi MDWerner Schafer DIStephanie A. Studenski MDAdele E. Towers MDDebra K. Weiner MDMelissa M. Wotring MDRollin M. Wright MD32 Better medicine through research and education.

2007The Division of Geriatric Medicine focuses on prevention andmanagement of the complex medical and psychosocial problems thatafflict older adults. Excluding the VA, Division faculty are now annuallyresponsible for 14,000 ambulatory visits, 300 visits to homeboundpatients, nearly 1000 hospital admissions and the care of 600 nursinghome and 150 Program for All-Inclusive Care of the Elderly (PACE)patients.CLINICALThe Division’s clinical volume increased by 19% in long-termcare visits, 7% in outpatient visits, and 3% in inpatient visits. TheDivision’s vertically-integrated care is enhanced by its geriatricsubspecialty clinics, which are led by fellowship-trained geriatricianswith additional subspecialty expertise in pain, sarcopenia, gait andmobility, falls, osteoporosis, sleep disorders, voiding dysfunction andincontinence, rheumatology, depression, dementia and palliative care.Additionally, a geriatric pharmacist reviews medications, provideseducation, and counsels patients. Our Division staffs a hospitalistservice for patients over age 65 at each of the three hospitals that weserve. Other initiatives included a group visit program, a deliriumprevention initiative which cut rates by half, and a long-term careintravenous/oral switch program.which includes a curriculum, clinical experiences and a scholarlyproject. Our fellowship program is a one to three year program andtrains two to four physicians per year to become academic leaders.After their required year, fellows may elect to pursue either research oreducational training during the second and third year.QUALITYThe Division continues to focus on quality care in their ambulatory,inpatient and long-term care settings. Some highlights include thecontinuous use of efficient processes which kept wait times at a day orRESEARCHOur goals are to conduct cutting edge research that will improve thehealth and health care of older adults and to train the next generationof investigators to do the same. Areas of inquiry include mobilityand falls, chronic pain, adverse medication effects, frailty, biology of“The Division continues to focus on quality carein their ambulatory, inpatient and long-term caresettings .”longevity, successful aging, urinary incontinence and long term care.Despite substantial NIH budget cuts, the Division’s support increasedby 10% in fiscal year 2007. Some new awards include an R01 to studyosteoporosis treatment in nursing homes and an NIH grant to developnational conferences that focus on emerging research issues in aging.Ongoing research includes the NIH-funded Cancer and Aging Center;the Claude Pepper Older Americans Independence Center, whichthe National Insitute of Aging considers its most prestigious award inclinical research; a National Center of Excellence Center, renewed thisyear by the John A. Hartford Foundation; and many other federallyfundedR01s and training grants (e.g., T32 and T35).TEACHINGWe teach trainees at all levels, from high school students to practicingphysicians, nursing, pharmacy, psychology, chaplaincy, physicaland occupational therapies and social work. Our Geriatrics Area ofConcentration includes activities in all four years of medical school,such as an MS 1 program that matches students to elders for monthlyinteractions and MS 4 electives that combine research and clinicalactivity. We have developed a novel Geriatrics Track for residents,less for new appointments and the ability to improve blood pressurein hypertensives and diabetics to 64%. Additionally, we developed anautomated electronic process to schedule bone densitometry (DXA)for all appropriate patients without a prescribed bisphosphonate ora DXA in three years. Osteoporosis or osteopenia was detected in82% of such patients and was treated appropriately. For inpatientcare, average length of stay (ALOS) was kept to

Department of Medicineof this work was published this year in NeuroImage and earned awards at both national and international meetings. One reviewer wrote that,“It is rare to read a paper which describes a novel method to discover a finding that may have such far reaching consequences for biologicalunderstanding in its immediate field as well as for more far reaching areas.”SELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsMajor HonorsJoseph Hanlon, Edward Henderson Award, American Geriatrics Society, 2007Neil Resnick, Best Research Prize (Derek Griffiths), International Continence Society, 2006Stephanie Studenski, Chair, NIH Review Group: Aging Systems and Geriatrics, 2003-2006Grant Reviewers for NIHJoseph Hanlon, General Health Services Research Scientific Merit Review Board Member, Department of Veteran Affairs, 2006Michelle Rossi, Chair, VA Rehabilitation and R&D Merit Review BoardStephanie Studenski, Chair, NIH Review Group: Aging Systems and Geriatrics, 2003-2006, Review Group Member, NIA Review Group for ClaudeD. Pepper Older Americans Independence Centers, 2006Editorial boardsJoseph Hanlon, Co-Editor, American Journal of Geriatric PharmacotherapyDavid Nace, Senior Editor, Long Term Care Grand Rounds, Journal of the American Medical Directors AssociationAnne Newman, Associate Editor, Journal of Gerontology34 Better medicine through research and education.

2007Neil Resnick, Neurology and UrodynamicStephanie Studenski, American Journal of Geriatric Pharmacotherapy, Journal of Gerontology, Journal of the American Geriatric Society, AssociateEditor, Journal of Gerontology, Associate Editor, Principals of Geriatric Medicine and GerontologyDebra Weiner, American Journal of Geriatric Pharmacotherapy, Pain Medicine, Section Chief, Pain & Aging (Pain Medicine)OtherHollis Day, President Mid-Atlantic Region, Society for General Internal Medicine, 2007, Chair, Geriatrics Interest Group, Society of GeneralInternal MedicineJoseph Hanlon, Chair, Council of Experts, Special Populations/Clinical Pharmacology Expert Committee, United States Pharmacopia Council ofExpertsSteven Handler, Co-Chair, Centralized Database Working Group, American Medical Directors Association, Steering Committee Member,American Medical Directors Association, Chair, Leadership Council, Leadership Council on End of Life Care in Long-Term CareSusan Hardy, Member, Research Methods Sub-Committee, American Geriatrics Society, 2003-current, Steering Committee Member, AGS JuniorResearch Faculty Development SIGShuja Hassan, President, PA Geriatric Society Western DivisionDavid Nace, PA Delegate, AMDA House of Delegates, Infection Control Advisory Committee Member, Pittsburgh Regional Healthcare Initiative,2003-present, Chair, Policy and Advocacy Committee, American Medical Directors AssociationAnne Newman, Academic Advisory Board Member, Hartford Geriatrics Outcomes Research Scholars, 2005-present, Advisory Board Member,Award Program, NIH/NIA Baltimore Longitudinal Study of Aging, 2005-presentElizabeth O’Keefe, Best Doctor at UPMC Shadyside, Pittsburgh Tribune-Review, 2007Neil Resnick, Abstract Review Committee, American Geriatrics Society, Board of Directors, PA/WV American Geriatrics Society Chapter, 2000-present, Council of State Affiliates Rep., American Geriatrics Society, America’s Top Doctors, Best Doctors in America, “Top Doctors” for 2007,Pittsburgh magazine, Castle Connolly, Guide to America’s Top Physicians, 2007, Best Paper on Geriatric Syndromes (with Stasa Tadic), AmericanGeriatrics Society Annual Meeting, 2007Eric Rodriguez, Top Doctors in America, Castle Connolly, Guide to America’s Top Physicians, 2006Fred Rubin, UPMC Shadyside Quality Fairground Prize plus Award for Sustained Achievement, 2007, “Top Doctors” for 2007, Pittsburgh magazineWerner Schaefer, ICS Award, Best Basic Science Presentation (Griffiths, Tadic, & Resnick), International Continence Society, 2006, Elected Chair,Education Committee, International Continence Society, 2007-2010Stephanie Studenski, Committee Chair, Hartford Center of Excellence National Advisory Committee, 2005-present, Chair, Research Committee,American Geriatrics Society, 2003-2006, Annual Meeting Chair, Claude D Pepper OAIC Annual Meeting, 2007Adele Towers, Best Doctors in America, Best Doctors, Inc., 200735

Department of MedicineHEMATOLOGY/ONCOLOGY“The Division has continued to grow both clinicallyand academically, as well as in levels of researchfunding and accomplishments .”Ronald B. Herberman MDDivision Chief/ ProfessorDirector, University of Pittsburgh Cancer InstituteDirector, UPMC Cancer CentersFACULTYMounzer E. Agha MDLeonard J. Appleman MDAthanassios Argiris MDPiching S. Bandaranayake MDChandra P. Belani MDSandra A Blakowski MDElana J. Bloom MDFranklin A. Bontempo MDMichael Boyiadzis MDAlan N. Bress MDAnthony G. Brickner PhDAdam M. Brufsky MD, PhDLisa H. Butterfield PhDTimothy M. Carlos MDGurkamal S. Chatta MDPreet M. Chaudhary MDBrenda S. Cole PhDAlbert D. Donnenberg PhDMerrill Egorin MDPeter G. Ellis MDCarol Evans MDTerry L. Evans MDRen-Tian Feng MDKenneth A. Foon MDJulien J. Fourcade PharmDDavid M. Friedland MDDeborah L. Galson PhDVeronica Garcia Palacios PhDMark S. Georgiadis MDMichael K. Gibson MDAnthony R. Haradin MDChang Sook Hong PhDBo Hu PhDSamuel A. Jacobs MDBratislav M. Janjic PhDDaniel E. Johnson PhDUddhav P. Kelavkar PhDJohn M. Kirkwood MDJoseph E. Kiss MDPavol Kudela PhDNoriyoshi Kurihara PhDByeong-Chel Lee PhDBarry C. Lembersky MDSuzanne Lentzsch MDFaina Linkov PhDAnna E. Lokshin PhDGanwei Lu MDYi Lu PhDEdward L. Malloy MDMarkus Y. Mapara MDStanley M. Marks MDHittu Matta PhDKenneth S. McCarty Jr MDDennis J. Meisner MDMilton M. Michaels MDMichelle Miranda PhDRuth A. Modzelewski PhDFrederick L. Moolten MDKeith H. Morgenlander PhDStergios Moschos MDElizabeth A. Mundy PhDTeresa A. Nolan MDRekha Pal PhDEva Pizzoferrato PhDMargaret V. Ragni MDMohammad P. Rahman MDSuresh S. Ramalingam MDPriya Rastogi MDRobert L. Redner MDJohn F. Robinson MDGarson David Roodman MDEric L. Safyan MDJeffrey E. Shogan MDSheryl R. Simon MDRoy E. Smith MDCharles H. Srodes MDRichard A. Steinman MD, PhDRonald G. Stoller MDMatthew G. Sulecki MDAhmad A. Tarhini MDDarcy L. ThullJ. Franklin Viverette MDVictor G. Vogel MDRobert L. Volkin MDQingde Wang MDWenjun Wang MDGuozhi Xiao MDHassane Zarour MDJian Zhang MDZella R. Zeigler MD36 Better medicine through research and education.

2007The primary mission of the Division of Hematology/Oncology is tocontribute to the School of Medicine’s goal of excellence in research,teaching and provision of clinical care. The Division has continuedto grow both clinically and academically, as well as in levels ofresearch funding and accomplishments. Our Division’s diversitycovers many different disease subspecialties and faculty memberswho are heterogeneous in terms of research activities. With anextensive network of community-based clinical oncologists in UPMCCancer Centers, there has been an ongoing emphasis on integratingthe research and clinical activities of the full-time faculty and todeveloping close and effective interactions with community-basedcolleagues, as well as multidisciplinary interactions with faculty inother divisions and departments.CLINICALSince the opening of the Hillman Cancer Center in the summer of2002, clinical activities of the Division have grown progressively. Inaddition, the outreach and networking efforts of the UPMC CancerCenters in establishing regional cancer centers has led to an increasein volume in referrals for subspecialty care. The clinical capacity of theDivision has expanded and will be able to meet increased demand forservices with the current clinical structure.Currently, faculty members in the Division conduct outpatientclinics at the Hillman Cancer Center and Magee-Womens Hospital,seeing 20,875 patients in fiscal year 2007. All disease sites are wellrepresented, including melanoma, lung, head and neck, GI, breast,myeloma, leukemia and lymphoma. The Division has placed a highpriority on providing an optimal level of patient access and hasbeen able to ensure appointments for all new patients within fivedays of calls for appointment. Additionally, within the Division, fourphysicians are attending physicians on the inpatient and outpatientconsult services at the VA Pittsburgh Healthcare System UniversityDrive Division.RESEARCHResearch continues to be a major component of the Division’s mission.During this fiscal year, the Division’s level of direct funding fromvarious funding agencies totaled $10,562,374, despite the continuedpressures on the NIH budget. There were 215 clinical trials open infiscal year 2007. Our faculty members are working in conjunction withUPMC Cancer Centers’ physicians to implement specific and detailedclinical pathways of treatment for various major disease sites. On eachclinical pathway that is developed, the first line of treatment is to be aclinical protocol. This will further enhance our patient care, accrual totrials and our collaboration with the community physicians. Specificresearch interests of our faculty include myeloma, lung cancer andprostate cancer, among others.TEACHINGSeveral components of the fellowship have been revised and we haveintroduced a number of innovative educational programs, such asour writing group, our intensive “mini-course” approach to didactics,and our structured research-mentorship program, which have beenwell received by the fellows. In addition to the Neoplasia course forfourth year medical students and multiple lectures for residents, theexpanding appeal and prestige of the fellowship program has beenreflected in the progressive growth in both quality and quantity of thefellowship applicant pool, as exemplified by the receipt of over threehundred applicants for the seven available slots. The introductionto research for the fellows has been formalized. Most importantly,the commitment to scholarships among the fellows recruited in thepast two to three years has clearly increased. Fellows are regularlyaccepted into the ASCO-AACR Clinical Research Training Workshop.One fellow received a prestigious Amgen Fellowship Award, and asecond the Eastern Cooperative Oncology Group (ECOG) FellowshipAward.QUALITYQuality initiatives continually underway at the Hillman CancerCenter outpatient clinic include targeted patient satisfaction surveys,aggressive interventions to improve the patient flow process,compliance with administration of moderate or deep sedationfor procedures, prevention/management of extravasations inchemotherapeutic agents, quarterly chart review, infection controland monitoring of events related to chemotherapy administration.Aligned with a major focus for this year, patient access has improvedgreatly and patient wait time has improved in all areas: registration,clinic visits, lab work, treatment and radiology. There has also beena major recent initiative to carefully evaluate the nutritional needsof cancer patients in both the inpatient and outpatient settings andto ensure that nutritional needs of patients, especially those withadvanced cancer, are consistently monitored.HIGH IMPACT PUBLICATIONSAmong the many publications of the Division of Hematology/Oncology during the last year, several point to the high potentialof translational and clinical research studies to make an importantimpact on the treatment of patients with cancer. For example, Dr. Liand colleagues in Targeting Antiapoptotic Bcl-2 Family Members withCell-Permeable BH3 Peptides Induces Apoptosis Signaling and Deathin Head and Neck Squamous Cell Carcinoma Cells (Neoplasia, 2007)studied a series of cell-permeable peptides for their ability to inhibitDivisionHematology /OncologyUPMC - DEPARTMENT OF MEDICINEPATIENT DAYS BY DIVISION - Fiscal Years 2005 - 2007AdmissionsFY 05AdmissionsFY 06AdmissionsFY 07%Change986 899 1,057 17.6%37

Department of Medicinecellular survival proteins that are overexpressed in human head and neck cancers. They determined that targeting these survival proteins led torapid death of head and neck cancer cells that are highly resistant to chemotherapy, suggesting a novel strategy for treatment of patients withthis malignancy, as well as other forms of cancer that are chemotherapy resistant.Dr. Ramalingam and colleagues performed a Phase I trial with a histone deacetylase inhibitor, vorinostat, in combination with chemotherapy andobserved a clinical response rate that was substantially greater than that expected with the chemotherapy drugs alone. Based on these results,NCI-sponsored Phase II studies of this combination will be performed by the Division in patients with melanoma, lung or ovarian carcinomas.Additional preclinical and clinical studies of other histone deacetylase inhibitors in combination are also in progress as epigenetic aspects ofmalignancy are becoming a new focus within the Division (Clin Cancer Res. 2007 Jun 15;13(12):3605-10).Dr. Brufsky and colleagues addressed osteoporosis associated with treatment with an aromatase inhibitor, which is a major problem associatedwith such therapy in postmenopausal women with breast cancer, and demonstrated that zolendronic acid substantially inhibited bone loss.These results indicate that zolendronic acid should serve as an important adjunct to breast cancer treatment by an aromatase inhibitor (J ClinOncol 25(7): 829-836, 2007).SELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsMajor HonorsG. David Roodman, Elected Chairman for the Paget Foundation in 2006 and received Louis V. Avioli Founders Award for Basic Research in Bone,2007Grant Reviewers for NIHAthanassios Argiris, External reviewer for CTEP (Cancer Therapy Evaluation Program) at the NCI (National Cancer Institute) for Phase III Studies,2005-PresentPreet M. Chaudhary, Charter member, Developmental Therapeutics Study section, 2006-presentDaniel E. Johnson, Standing member for NIH/NCI Study Section (“Drug Discovery and Molecular Pharmacology”)John M. Kirkwood, HJ Lloyd Trust Research Review Section, 2003-presentJoseph E. Kiss, Co-chair NHLBI Transfusion Medicine & Hemostasis TTP subcommitteeKenneth Scott McCarty, Department of Defense Breast Cancer Research Program TRN-6 panelMargaret V. Ragni, Am. Soc. Hematology (ASH) Study Section, Clinical Research Training Institute (CRTI), 2005-2007; Member, NHLBI Hemostasisand Thrombosis (HT) Study Section, NIH, 2007-2011, Steering Committee, Hemophilia Subcommittee, Transfusion Med Clinical Trials Network(NHLBI)38 Better medicine through research and education.

2007Robert L. Redner, Leukemia, Immunology and Blood Disease (LIB) Study Section, American Cancer SocietyG. David Roodman, SRA, Skeletal Biology Structure & Regeneration Study Section, 2005-presentEditorial boardsAthanassios Argiris, Journal of Clinical Oncology, International Journal of Cancer ResearchLisa H. Butterfield, Associate Editor, Cancer Research, and Associate Editor, The Journal of ImmunologyPreet M. Chaudhary, Cancer Biology and Therapy, International Archive of Bioscience, Experimental Biology and MedicineAlbert Donnenberg, Clinical and Applied Immunology Reviews (CAIR), Editor, CRC Handbook of Clinical Immunology, 2nd Edition, CRC Press, BocaRaton, FLMerrill J. Egorin, Editor-in-Chief, Cancer Chemotherapy and Pharmacology; Clinical Cancer Research, Clinical Pharmacology and Therapeutics;Cancer Therapeutics; Journal of National Cancer Institute; Current Clinical Pharmacology, Journal of Experimental Biology and Medicine, Field Editor,Fundamental and Clinical Pharmacology; International Journal of Clinical OncologyKenneth A. Foon, Clinical Cancer Research, Associate Editor; Journal of Experimental Biology and Medicine, Editor, Translational Research SectionExpert Opinion on Biological Therapy, Co-Editor, Future PerspectivesDaniel E. Johnson, Section Editor, LeukemiaMarkus Mapara, Associate Editor Journal of ImmunologyMonica C. Panelli, Associate Editor Journal of Translational MedicineMargaret V. Ragni, ASH Daily News: Writer for American Society Hematology (ASH) Annual Meeting, 2006; Editor, ASH Daily News: Edit theAmerican Society Hematology (ASH) Annual Meeting publication, 2007.G. David Roodman, Experimental Hematology, Bone , Journal of Clinical Investigation, and Endocrinology, Associate Editor, Journal of Bone andMineral Research, Experimental Biology and MedicineAhmad Tarhini, Cancer Chemotherapy and PharmacologyVictor G. Vogel, Breast Diseases (Mosby), Oncology, Cancer Updates, Research, and Education (CURE), The Breast Journal, Associate Editor, Journalof Clinical OncologyOtherAthanassios Argiris, Advisory Committee Membership: Eastern Cooperative Oncology Group (ECOG) Head and Neck Core Committee Member,2001-present; Eastern Cooperative Oncology Group (ECOG) Thoracic Core Committee Member, 2002-present; Head and Neck Intergroupmeeting participant, ECOG Developmental Therapeutic CommitteeAnthony G. Brickner, 2004 ASH Celgene Scholar, The American Society of Hematology Clinical/Translational Research Junior Faculty ScholarAward (recipient of one of six Junior Faculty Scholar Awards awarded), 2004,2005,2006Adam Brufsky, America’s Top Doctors, Castle Connolly Corporation, 2005, 2006, 2007; America’s Top Doctors for Cancer, Castle ConnollyCorporation 2005, 2006Frank S. Lieberman, Subcommittee for Board Examination Development, Neurooncology Subspecialty Board, American Academy of NeurologyMargaret V. Ragni, Executive Board, Hemophilia Research Society North America, Nomination, Chair, National Hemophilia Foundation (NHF)Medical & Scientific & Advisory Committee (MASAC), 2006Priya Rastogi, NSABP, Associate Director for Medical Affairs, NSABP, Vice Chair for Medical AffairsRobert L. Redner, Advisory Committee Membership: American Society of Hematology TMDC Committee (to develop an in-service examinationfor Hematology Fellowships)G. David Roodman, Medical Advisory Committee – The Leukemia & Lymphoma Society,Victor G. Vogel, Advisory Committee Membership: Board of Directors, National Surgical Adjuvant Breast and Bowel Project; PreventionCommittee, American Society of Clinical Oncology (ASCO); Education Committee, American Society of Clinical Oncology (ASCO)39

Department of MedicineINFECTIOUS DISEASESJohn W. Mellors MDDivision Chief/ ProfessorFACULTYUme L. Abbas MDAdeel A. Butt MDKarin E. Byers MDKelly S. Cole PhDNancy C. Connolly MDElodie Ghedin PhDAurelio D. Gomes MDElias K. Halvas PhDLee H. Harrison MDShahid Husain MDEun J. Kwak MDNathaniel S. Landerman MDJane W. Marsh PhDJohn E. McKinnon MDDeborah D. McMahon MDJohn W. Mellors MDRobert R. Muder MDCarlene Muto MDDavid L. Paterson MDRaymond E. Pontzer MDNalini Rao MDSharon A. Riddler MDTed M. Ross PhDKathleen A. ShuttFernanda P. Silveira MDNina Singh MDNicolas P. Sluis-Cremer PhDPeter J. Veldkamp MDEmanuel N. Vergis MDDavid R. Weber MDDavid L. Weinbaum MD40 Better medicine through research and education.

2007The goals of the Division of Infectious Diseases (ID) are to providestate-of-the-art care to patients with infectious diseases that is easilyaccessible to patients and responsive to the needs of our physiciancolleagues; to mentor fellows in our training program to become thenext generation of academic ID specialists; to rigorously train medicalstudents and residents in the discipline of ID; to perform “cuttingedge”laboratory and clinical research and translate progress thatarises into clinical practice; and to develop and implement policies toprotect the public health from natural and man-made epidemics.Research awards for fiscal year 2007 totaled $6,187,695 in total costsfrom the NIH, Centers for Disease Control and Prevention (CDC),Health Resources and Services Administration (HRSA), the Departmentof Veterans Administration and Industry. The HIV/AIDS Programsuccessfully competed again for Ryan White HRSA funding for a periodof five years. In fiscal year 2008, five to six new research faculty, withexpertise in transplant ID, mycology, and HIV-1 pathogenesis, willrelocate to the ID Division. This will strengthen the research portfolioof the Division and support the patient care needs in ID at UPMC.CLINICALThe inpatient ID Consult Services continued to be a major clinical focusof the Division. In addition to the regular rounding teams, two newID Consult Services were established in the past few years to meet thegrowing needs of UPMC Health System. The Surgical ID Service, whichconsults on patients with neurosurgical, cardiothoracic, orthopaedic orear, nose and throat infections was added to the Clostridium difficile(C.difficile) Management Service, which initially played a significantrole in educating physicians about this particular disease, and now hasan “on demand” order set so that the appropriate treatment can begiven to patients in order to avoid negative outcomes.The number of inpatient consults increased by 26% between fiscalyear 2006 and fiscal year 2007, and there was a 22% increase infollow-up visits within the same time period. This increase is a resultof several factors: 1) expansion of the Surgical ID Service; 2) increasedactivity on the Transplant ID Service related to the rising number ofsolid organ transplants; and 3) increased coverage at Magee-WomensHospital. Similarly, total outpatient visits had an increase of 9%over the prior year. Outpatients requiring ID consults and followupvisits were evaluated in the General ID Clinic, which has grownfrom one morning clinic per week to four half day clinics every week.Additionally, the UPMC HIV/AIDS program provided primary care toapproximately 1,200 HIV infected persons from the tri-state area, and148 new patients entered into care.TEACHINGThe Division continues to be active in education by teaching medicalstudents, pre-doctoral students at the Graduate School of PublicHealth, and residents. Our activity in the medical school includes afirst year course that introduces the basic science of infectious disease,second year courses about the organ systems, an opportunity in thethird year to experience the HIV/AIDS Ambulatory Clinic, and, finally,the chance to rotate on the inpatient infectious disease consultservice in the third or fourth year, during which time the medicalstudents are assigned patients. The bulk of residency and housestaffteaching occurred on the General ID Consult Services and at theHIV/AIDS outpatient clinic. This ward teaching was complementedby weekly Resident and Medical Student Core Curriculum lectures, aweekly clinical conference, a weekly journal club, a weekly HIV clinicalconference and a biweekly joint research seminar with the MolecularVirology and Microbiology Program.The Infectious Diseases Fellowship Training program providesexcellent clinical training and provides opportunities for fellows toconduct research with nationally-known investigators. Advanced“Research awards for Fiscal Year 2007 totaled$6,187,695 in total costs from the NIH, Centersfor Disease Control and Prevention (CDC), HealthResources and Services Administration (HRSA),the Department of Veterans Administration, andindustry. ”RESEARCHA major activity of the ID Division is laboratory and clinical research.These activities are grouped into specific Research Units led bya senior investigator. Research Units within the Division includeEpidemiology, Infection Control, Antibiotic Management, SpecialPathogens, Geriatric Infectious Diseases, HIV/AIDS, Viral Diseases, SolidOrgan Transplant Infectious Diseases and Surgical Infectious Diseases/Biosecurity.training in infectious diseases research is available through ourNIH-funded NRSA Training Grant. Recent and current fellows havetrained at the University of Pittsburgh, Boston University, AlbertEinstein College of Medicine and other excellent institutions. Ourfellows’ accomplishments are promoted by faculty mentors and mostrecently one fellow was awarded the highly-competitive IDSA/NFIDPfizer Global Fellowship in Infectious Diseases for his research onantimicrobial resistance among gram-negative bacteria. Trainingin infectious diseases is intense and high-volume and provides the41

Department of Medicinefellows with multiple opportunities to learn from a diverse patientpopulation. Clinical sites for teaching include the University,Magee-Womens Hospital and the Pittsburgh VA Health Care System.Additionally, fellows receive superb teaching and supervision onthe various inpatient consultation services which include generalinfectious diseases, surgical infectious diseases, transplant infectiousdiseases and in the ambulatory HIV/AIDS clinic.In the future, the Division plans to further its educational activitiesby reviewing the medical curriculum for the second to fourth yearstudents and fully integrating clinical infectious diseases into thesecourses wherever feasible. Additionally, the ID Division will assistthe fellows in developing a series of didactic lectures dedicated tothe housestaff and third and fourth year medical students taking anelective rotation in ID and HIV/AIDS clinic. Lastly, efforts will be madeto further strengthen the combined ambulatory medicine clerkship aswell as to develop additional elective courses and rotations.QUALITYThe ID Division has a comprehensive, sustainable quality management(QM) structure in place. The structure includes Division leadership;implementation of an annual QM Plan; development of qualitypriorities and measurable indicators for clinical care, supportiveservices and administrative program components; a calendar ofQM activities; and a QM Committee, which meets monthly. The HIVprogram has been well represented in the hospital’s annual QualityFair. This year the HIV Program was presented the President’s Awardfor Innovation for the project entitled, “Formulary Revisions SavingsCQI Initiative” and the third place award in sustained improvementcategory for a project entitled, “Connecting to Care CQI Initiative:Two Year Follow-up”. Other ongoing quality initiatives includepatient retention in care, infection control, C.difficile and antibioticmanagement.HIGH IMPACT PUBLICATIONSThe ID Division published high impact research on HIV/AIDS includingstudies on the central importance of viremia in disease pathogenesis(Mellors et al, JAMA, 297(21):2349-50, 2007), on persistence of lowlevelviremia despite currently recommended antiretroviral therapy(Maldarelli, et al PLos Pathogens, 4:e46 online, 2007), indicating thatnew strategic approaches are needed to cure HIV infection; and onsimplification of antiretroviral therapy to once daily dosing of anHIV protease inhibitor (Swindells, et al JAMA, 296:806-814, 2006).These studies are an important contribution to the field of HIV/AIDSpathogenesis and therapy.42 Better medicine through research and education.

200743

Department of MedicineSELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsMajor HonorsJohn Mellors, Recipient, Gertrude Elion Distinguished Lecturer Award, presented at the HIV DART 2006 “Frontiers in Drug Development forAntiretroviral Therapies” Annual Meeting, December 2006Grant ReviewLee Harrison, Member, Clinical Research and Field Studies Study Section, National Institutes of HealthDonald Henderson, March of Dimes, Technical Advisory Committee, 1998-presentEditorial boardsLuciana Borio, Associate Editor, Biosecurity and Bioterrorism: Biodefense Strategy, Science and PracticeGigi Kwik Gronvall, Associate Editor, Biosecurity and Bioterrorism: Biodefense Strategy, Science and PracticePenny Hitchcock, Associate Editor, Biosecurity and Bioterrorism: Biodefense Strategy, Science and PracticeThomas Inglesby, Co-Editor in Chief, Biosecurity and Bioterrorism: Biodefense Strategy, Science and Practice, Special Section Editor, ClinicalInfectious DiseasesJohn Mellors, Editor, HIV Database, Los Alamos National LaboratoryRobert Muder, Editor, Hospital Epidemiology Section, Infection Disease AlertsCarlene Muto, Editor, Web Review, Current Infectious Diseases Report, Infection Control and Hospital Epidemiology; Clinical Infectious DiseasesTara O’Toole, Co-Editor in Chief, Biosecurity and Bioterrorism: Biodefense Strategy, Science and PracticeDavid Paterson, Infection Control and Hospital Epidemiology; International Journal of Antimicrobial AgentsMonica Schoch-Spana, Associate Editor, Biosecurity and Bioterrorism: Biodefense Strategy, Practice and ScienceNina Singh, Transplantation, J Invasive fungal Infections, Current Opinion in Fungal Infections, Associate Editor, Liver Transplantation, Section Editor,Current Opinion in Organ Transplantation,Nicolas Sluis-Cremer, Special Guest Editor, Current Pharmaceutical DesignBrad Smith, Associate Editor, Biosecurity and Bioterrorism: Biodefense Strategy, Science and Practice44 Better medicine through research and education.

2007OtherLuciana Borio, Senior Health Advisor, Office of Public Health Emergency Preparedness, DHHS National Academy of Sciences, Committee onMethodological Improvements to the Department of Homeland Security’s Biological Agent Risk Analysis, U.S. Department of Health and HumanServices, Technical Evaluation Panel of Medical Countermeasure, The National Academy of Sciences. Methodological Improvements to theDepartment of Homeland Security’s Biological Agent Risk Analysis Committee , Interagency Working Group, Revision of the U.S. Government’sSmallpox Vaccines Utilization PoliciesAdeel Butt, Yale-Johnson and Johnson Scholarship/Award in International Health, National Talent Pool, awarded by Government of Pakistan toexpatriates of exceptional talentLee Harrison, CDC Emerging Infectious Diseases Network Steering Committee, CDC Active Bacterial Core Surveillance Steering CommitteeDonald Henderson, Principal Science Advisor for Public Health Preparedness, Office of the Secretary, DHHS, Department of Defense, DefenseThreat Reduction Agency Advisory Committee, Member, American Council for Science and Health, Board of Directors, 2006-presentPenny Hitchcock, Member, Working Group, National Influenza Vaccine SummitThomas Inglesby, Member, Bio-Chem 20/20, U.S. Department of Defense, Defense Intelligence Agency Member, National Academy of Sciences,Biodefense Analysis and Countermeasures Committee, Member, Department of Homeland Security, Biodefense Net Assessment ExecutiveReview Panel, Member, Biological Emergency Advisory TeamJohn Mellors, Vice-Chair, Annual Conference on Human Retroviruses and Opportunistic Infections, Co-Chairman, International Workshopon HIV Drug Resistance and Combination Therapies, Member, US Public Health Service Panel on Clinical Practices for the Treatment of HIVInfection, Member, International AIDS Society-USA Panel on HIV drug resistance, International Association of Physicians in AIDS Care: LifetimeHonorary Membership Award, Member, NIH-sponsored AIDS Clinical Trials Group (ACTG) Scientific Advisory Committee, Executive Committee,Translational Research and Drug Development Research Committee and Lab Steering Committee, Member, NIH-sponsored Microbicide TrialsNetwork (MTN) Executive Committee and Central Laboratory Committee, and MTN Director of VirologyCarlene Muto, Member, Subcommittee to prevent transmission of antimicrobial resistant organisms, Society for Healthcare Epidemiology ofAmericaTara O’Toole, Chair, Board of Directors, Federation of American Scientists, National Academy of Sciences, Biological Weapons Working Group,National Academy of Sciences, Committee on Technical and Privacy Dimensions of Information for Terrorism Prevention and Other NationalGoals, National Biodefense Analysis and Countermeasures Centers, Science and Technology Advisory Committee, Biological Sciences ExpertsGroup, Consultant to the National Intelligence CouncilMonica Schoch-Spana, Steering Committee Member, Disaster Roundtable, National Research CouncilNina Singh, Best Doctors in America 2005-06, Commendation Award, VA Central Office, Transplant Program, 200645

Department of MedicinePULMONARY, ALLERGY & CRITICAL CARE MEDICINEAugustine M. K. Choi MDDivision Chief/ ProfessorMichael Donahoe MDInterim Division Chief/ ProfessorAssociate Division Chief, Pulmonary, Allergy andCritical Care MedicineDirector, MICU, UPMC PresbyterianFACULTYShakeel M. Amanullah MDMeenakshi Arora PhDCharles W. Atwood Jr. MDSilvana Balzar MDRoberto P. Benzo MDAnna Blumental-Perry PhDCarol A. Bostwick PhDMehboob K. Chaudhry MDAugustine Choi MDMelissa Clark MDStephen Clute MDTimothy E. Corcoran PhDMaria M. Crespo MDTamas Dolinay MDMichael P. Donahoe MDSteven R. Duncan MDChristopher N. Faber MDMyron Friedlander MDKevin F. Gibson MDRachel J. Givelber MDEmily E. Grum MDSamuel I. Hammerman MDDixie L. Harris MDAlexander Hoetzel MDRobert M. Hoffman MDAshley McGarry Houghton MDPaula M. Jernigan MDYang Jin MDBruce A. Johnson MDNaftali Kaminski MDDong H. Kim MDHong P. Kim PhDJoann B. Kim MDCharles M. Koliner MDJohn W. Kreit MDDavid Laman MDPhilip E. Lamberty MDJames K. Lanz MDJanet S. Lee MDAdriana S. Leme PhDBryan J. McVerry MDAlison Morris Gimbel MDE. Danielle D. Morse MDMajd Mouded MDChristopher P. ODonnell PhDVictor K. Okwiya MDTimothy B. Oriss PhDMitchell J. Patti MDAndrej A. Petrov MDJoseph M. Pilewski MDHarry S. Rafkin MDA. Ananth Raman MDPrabir Ray PhDAnuradha Ray PhDRabindranath Ray PhDThomas J. Richards PhDRobert M. Rogers MDIvan Rosas MDXimena D. Ruiz MDStefan W. Ryter PhDMurray Sachs MDMark H. Sanders MDFrank C. Sciurba MDJigme M. Sethi MDTodd J. Sheppard MDRonald A. Stiller MDPatrick J. Strollo MDSean M. Studer MDCraig G. Viti MDMichael E. Wald MDJoel H. Weinberg MDSally E. Wenzel MDDavid O. Wilson MDWei Wu PhDHui Xu PhDEmily L. Yee MDGuoying Yu PhDYingze Zhang PhDJinming Zhao PhDXiuxia Zhou PhD“Our strengths lie in the strong clinical,academic and research reputation of ourfaculty, as well as our ability to effectivelycollaborate locally, nationally, andinternationally. ”46 Better medicine through research and education.

2007The Division of Pulmonary, Allergy and Critical Care Medicine (PACCM)has experienced sustained years of growth in clinical and researchactivity, while maintaining a strong local and national reputation inteaching excellence. Our core programs in clinical care and researchinclude Acute Lung Injury/ARDS, Adult Cystic Fibrosis and HostDefense, Asthma and Allergy Inflammation, Emphysema Biologyand Lung Imaging, Interstitial Lung Disease, Lung Transplantationand Advanced Lung Disease, Sleep Disordered Breathing and theGenomics in Lung Disease. These comprehensive programs continueto bring local and national recognition to the Department of Medicineand UPMC. The academic faculty has grown to 62 members. Ourstrengths lie in the strong clinical, academic and research reputationof our faculty, as well as our ability to effectively collaborate locally,nationally and internationally.CLINICALOver the past five years, the PACCM Division has experienced aremarkable 70% growth in outpatient visit volume, a 60% increase ininpatient visit volume and a 38% increase in laboratory visit volume.The Comprehensive Lung Center (CLC) is a multidisciplinary diagnosticcenter incorporating expertise in general pulmonary medicine,pathology, radiology and thoracic surgery. The CLC is developedaround seven key clinical programs including Adult Cystic Fibrosisand Bronchiectasis, Asthma and Airway Inflammation, DiagnosticPulmonary Medicine, Emphysema and COPD, Interstitial LungDisease, Lung Transplantation and Advanced Lung Disease and SleepDisordered Breathing. The CLC is home to the Simmons Center forInterstitial Lung Disease and the UPMC Sleep Medicine Center.The inpatient efforts of the Division are focused around four services,including the Medical Intensive Care Unit (MICU) and respiratory stepdownunit, the lung transplant and advanced lung disease service, thepulmonary consultation service, and the long-term acute care hospitalservice. In July 2006, a consult service was started at Magee-WomensHospital. With this, and with an increase in MICU volume, the Divisionexperienced a 14.8% growth in total inpatient clinical activity for fiscalyear 2007. Over 120 lung transplants have been performed in each ofthe last two years.The Division supports three clinical laboratories for the evaluationof patients with lung disease including a comprehensive pulmonaryphysiology laboratory (including exercise and inhalation challenge),two bronchoscopy suites with fluoroscopy and the sleep and controlof breathing laboratory.RESEARCHThe Division is currently focused around the development of eightcore programs of research excellence. The Acute Lung Injury/AdultRespiratory Distress Syndrome Research Program is focused on theinvestigation of fundamental mechanisms in lung injury and repairand extensive collaborative interactions exist with the Departmentsof Surgery, Anesthesiology, Pathology and Environmental Health.The Adult Cystic Fibrosis and Host Defense clinical and researchefforts focus on the disease model of cystic fibrosis. The core AdultCystic Fibrosis Center and the Cystic Fibrosis Research Center provideprocedures for identifying functional outcomes, monitored in termsof lung function, ion transport or gene expressions for investigatorsacross the University.Other research interest areas include the Asthma and AllergicInflammation Program, the Emphysema Biology and Lung ImagingResearch Program, the Lung Genomics and Proteomics Center, acomprehensive service and data storage center that serves pulmonaryclinicians, toxicologists and basic scientists and the Dorothy P.and Richard P. Simmons Center for Interstitial Lung Disease, whichestablishes the University as a premier center for the investigation andclinical care of patients with idiopathic pulmonary fibrosis. Two otherPrograms include the Sleep Disordered Breathing and RegulationProgram, which is a multidisciplinary program incorporatingrespiratory medicine, psychiatry, otolaryngology and bariatricsurgery specialists, and the Transplantation Immunology Programthat is dedicated to a greater understanding of the basic biology oftransplantation of the lung allograft.TEACHINGThe PACCM Division conducts a comprehensive educational programin lung diseases and critical care medicine for trainees, physiciansand patients throughout the region. In addition to a second yearmedical student course with an integrated curriculum, including thepathophysiology of pulmonary disease, the Division also supportsfour fellowship positions. Other teaching activities include weekly,quarterly and annual conferences, including Pulmonary Grand Rounds,the PACCM Collaborative Research Seminar, weekly conferences forfellows (Journal Club and Case Conferences), Sleep Medicine Lectures,Radiology Conferences, the Pittsburgh International Lung Conference,47

Department of Medicinean annual update in Pulmonary Medicine and the Robert M. RogersLectureship.QUALITYThe Division of Pulmonary, Allergy and Critical Care Medicine supportsa continuous quality improvement process in both the inpatient andoutpatient care enviroments. The Medical ICU process, termed theRules of Evidence program, establishes a comprehensive ventilatorcare bundle based upon Level I critical care clinical trials. The Divisionconsistently exceeds the care standard for rapid patient access (within72 hours) for all the specialty clinics within the Comprehensive LungCenter. Effective use of information technology in both the inpatientand outpatient environment provides important clinical alerts andguidelines to further support quality patient care.system. This study has shown that statins activate dendritic cellsto promote production of a protein called Ym1 that belongs to thechitinase family of proteins, recently shown to be associated withasthma. Lung dendritic cells isolated from statin-treated mice alsodisplayed increased Ym1 expression. The Ym1-expressing dendriticcells induced CD4+ T cells to differentiate along the Th2 lineage thatorchestrates asthma in both humans and experimental models. Thisstudy raises a cautionary note in the use of statins in patients withallergic diseases such as asthma (Arora, et al, Proc. Natl. Acad. Sci. USA,2006; 103:7777-7782)..In cystic fibrosis, mucus clearance from the lung is impaired due todehydration of the airway surface liquid (ASL). Absorption of the ASLis driven by an osmotic gradient established by the sodium absorptionthough epithelial sodium channels. The results of this workHIGH IMPACT PUBLICATIONSEach of the eight individual programs is composed of investigatorsin the areas of basic laboratory, translational, and clinical research.The following publications from the past year highlight importantadvances in our understanding of human lung disease from three ofthese programs.Statins are best known as cholesterol-lowering drugs. However,increasingly, additional effects of statins on biological processes,including effects on the immune system are being recognized. Theauthors have identified a novel effect of statins on the immunedemonstrate that a balance between channel activating proteases andanti-proteases regulates sodium absorption in the airway, and thatthis balance is disrupted in cystic fibrosis leading to excessive sodiumand ASL absorption. Therefore, impaired mucus clearance in thecystic fibrosis airway appears to be in part due to excessive proteaseactivity and suggests that inhalation of protease inhibitors may have abeneficial effect on mucus clearance (Myerburg et al, J Biol Chem, 2006;281:27942-9).48 Better medicine through research and education.

2007SELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsMajor HonorsJames Dauber, Distinguished Achievement Award, American Thoracic Society, 2006Michael Donahoe, American Thoracic Society Outstanding Clinician Award, 2006Steven D. Shapiro, National Heart Lung and Blood Advisory CommitteeSteven D. Shapiro, Encylopedia of Respiratory Medicine, Award for Best Multi-volume Reference Work in Science and Teaching, Academy ofAcademic PublishersSally Wenzel, Member, Board of Scientific Council, NHLBIGrant ReviewAugustine MK Choi, AHA National Research Committee/Lung, Resuscitation, and RespirationNIH Study Section, Lung Biology Pathology A/NHLBI Carol Feghali-Bostwick, American Heart Association National Research CommitteeKevin Gibson, National Institute of Health: National Heart Lung and Blood Institute – Research Training Review Committee, 1993-present,National Institutes of Health, Small Business Innovative Research Scientific Review Panel 2004-presentA. McGarry Houghton, American Lung Association Research Fellowship Study SectionJoseph Pilewski, American Heart Association Mid-Atlantic Peer Review Consortium Steering Committee 2004-2006 Frank Sciurba, NIH StudySection SSS-8 SBIR, April 2002-presentSteven D. Shapiro, Cystic Fibrosis Foundation, Clinical Grant review committee, State of CA Tobacco Tax Grants in Lung Disease Grant Review,ChairSally Wenzel, Chair, VA Merit Grant Review Board49

Department of MedicineEditorial BoardsAugustine MK Choi, Associate Editor, American Journal of Respiratory Cell Molecular Biology, American Journal of Physiology: Lung Cellular andMolecular Biology Free Radical Biology and Medicine, Journal of Respiratory, Cell and Molecular BiologyTimothy Corcoran, Journal of Aerosol Medicine, Atomization and SpraysChristopher O’Donnell, Associate Editor for Journal of Applied PhysiologyAnuradha Ray, American J. Physiology: Lung Cellular and Molecular Physiology, AmericanPrabir Ray, American Journal of Respiratory Cell and Molecular BiologyMark Sanders, Editor-in-Chief (Section on Sleep Medicine), UpToDATE® in Pulmonary and Critical Care Medicine, CD-ROM and On-Line basedContinuing Education Resource, 2004-present Associate Editor, Sleep Medicine, Chest, American Journal of Respiratory and Critical Care Medicine,Frank Sciurba, RespirationSteven D. Shapiro, Editor-in-Chief: American Journal of Respiratory Cell and Molecular Biology, Journal of Clinical Investigation, Journal ofExperimental MedicineSally Wenzel, Deputy Editor: American Journal Respiratory and Critical Care Medicine, Annals of Asthma, and Allergy and Immunology,, Journal ofAllergy and Clinical Immunology, and Clinical and Experimental AllergyOtherMichael Donahoe, Best Doctors in America 2007Carol Feghali-Bostwick, Chair, Scleroderma Foundation Fundraising Committee, 2007, Member, Board of Directors, National SclerodermaFoundation, 2007Naftali Kaminski, Advisory Board, Pulmonary Fibrosis FoundationRobert Rogers, American College of Chest Physicians: Ad-Hoc Committee on E-StrategyMark Sanders, Chair, Section on Sleep-Disordered Breathing, American Academy of Sleep Medicine, Chair, National Sleep Foundation Gala,March 2007, Thomas Ball Award, Chesapeake Bay Sleep Society, 2006, Murray Kornfield Memorial Founder’s Lecture, American College of ChestPhysicians, Chest, 2007Frank Sciurba, National Institutes of Health steering committee for Lung Volume Reduction Clinical Trial., Chair, Exercise Testing Subcommittee,1996-present, Executive Committee (elected by peers), 1998-present, National Emphysema Treatment Trial (NETT) Publications and PresentationsCommitteeSteven D. Shapiro, Transatlantic Airway Conference, Scientific CommitteePatrick Strollo, Committee Chairman, National Sleep Medicine Courses, Best Doctors in America (Pulmonary & Critical Care Medicine), 2001-present, Board of Directors, American Academy of Sleep Medicine, 2005-2008, American Board of Internal Medicine Subspecialty Board onPulmonary DiseasesSally Wenzel, Global Initiative for Asthma (GINA) Scientific Counsel50 Better medicine through research and education.

200751

Department of MedicineRENAL-ELECTROLYTEThomas R. Kleyman MDDivision Chief/ ProfessorFACULTYGerard L. Apodaca PhDFilitsa H. Bender MDJose F. Bernardo MDLori A. Birder PhDFrank J. Bruns MDMarcelo D. Carattino PhDGeetha Chalasani MDMary E. Choi MDStephen H. Cooksey MDRobert S. Edinger PhDLinda F. Fried MDAlejandro R. Gonzales MDKenneth R. Hallows MDKevin Ho MDRebecca P. Hughey PhDJohn P. Johnson MDJames R. Johnston MDOssama B. Kashlan PhDSung Il Kim PhDThomas R. Kleyman MDJoon H. Kwak PhDJonathan J. Lebowitz MDJi-Yang Lee MDDavid J. Levenson MDHui Li MDJoseph H. Liput MDJerry McCauley MDGunhild M. Mueller PhDPaul M. Palevsky MDNuria Maria Pastor Soler MDBeth M. Piraino MDMohan Ramkumar MDRaymond M. Rault MDHashim Raza MDAdriana M. Selvaggio MDNirav A. Shah MDShaohu Sheng MDMark L. Unruh MDLin Wang MDSteven D. Weisbord MDOra A. Weisz PhDKelly M. Weixel PhDChristine M. Wu MD52 Better medicine through research and education.

2007The Renal-Electrolyte Division of the University of Pittsburgh has afundamental commitment to excellence in patient care, teaching andresearch. The faculty and clinicians continue to provide outstandingcare for our patients, and researchers continue to bring in significantawards and advance their research in a diverse array of topics,including, among many others, protein folding and malnutrition andcontrast nephropathy.CLINICALOur clinicians provide state-of-the-art care for patients withrenal and/or electrolyte disorders at facilities on the Oakland andShadyside campuses of UPMC and on the Oakland campus of the VAMedical Center. The Division has continued to enhance its clinicalservices. Inpatient dialysis treatments grew from 10,977 in fiscal year2006 to 11,104 in fiscal year 2007. The Division continued servicesat Dialysis Centers, Inc. (DCI) Oakland, Squirrel Hill and Banksville. Inaddition to these services, inpatients with renal and/or electrolytedisorders are cared for by our rounding teams, consisting of aphysician, fellow, physician extender, residents and medical students.The Division has other exciting activities including the dialysis center,on the 11th floor of UPMC Presbyterian which performs more than11,000 dialysis treatments per year. A large number of continuous“The Division has continued to enhance its clinicalservices. Inpatient dialysis treatments grew from 10,977in fiscal year 2006 to 11,104 in fiscal year 2007. ”renal replacement therapies are administered in the various intensivecare units under the supervision of nephrology attendings andfellows. The Division’s General Renal Clinic sees patients with a widevariety of renal and hypertensive disorders, where nephrologistsand staff coordinate all aspects of patient testing and care. A newChronic Kidney Disease clinic focusing on the care of patients withmore advanced stages of chronic kidney disease has recently beenestablished at the DCI Oakland dialysis unit. Other clinical sitesinclude the Renal Transplant Clinic, Lupus Clinic and the OutpatientDialysis Clinic. The Division is also active in the VA PittsburghHealthcare System, with in-center hemodialysis and home peritonealdialysis, as well as inpatient dialysis and a VA Renal Clinic foroutpatient management.RESEARCHResearch activities are supported by grants from the NIH, VA, privatefoundations and corporations. Total direct cost expendituresin fiscal year 2007 were over $4 million. Approximately 74% ofextramural grant support was derived from federally-sponsoredprojects. Faculty members within the Renal-Electrolyte Divisionand within other divisions and departments have developed adynamic research program over the past decade directed at studyingkidney/epithelial cell structure and function in health or diseasestates. Faculty members also have active research programs that arefocused on renal epidemiology and clinical studies. An NIH-fundedT32 grant provides support for the training of graduate studentsand postdoctoral fellows in renal-related research. An NIH-fundedT35 grant provides support for the training of medical students inrenal research. Two faculty members are chairing large, multicenterclinical trials funded through the Department of Veterans AffairsCooperative Studies Program. Basic research interests include a widevariety of subjects, for example, structure, function and regulationof epithelial sodium, potassium and chloride channels, response ofepithelia to biomechanical forces, regulation of protein folding andmaturation, mechanisms of bladder epithelial injury, neural-epithelialinteractions in the urinary bladder, biology of T cell memory, geneticsof complex diseases, including hypertension and diabetes andgenetics of autosomal dominant nephrotic syndrome. Additionally,clinical research interests include topics like sleep disorders in thesetting of CKD and ESRD, pharmacokinetics of drugs in CKD, peritonealdialysis and hemodialysis, continuous renal replacement therapy, ICUnephrology, acute kidney injury, outcomes and cost of dialysis andrenal transplantation, among others.TEACHINGTeaching medical students, graduate students, medical residentsand renal fellows continues to be a strength of the Division. Ourfaculty are consistently recognized as some the best educators in theSchool of Medicine, as evidenced by their consistently high scoreson evaluations by students and by the teaching awards that theyreceive. Our faculty have had such distinctions as serving as directorsof courses and blocks and as coordinator of the second year medicalstudent curriculum. Other faculty have served as the AssociateDean of Admissions of the School of Medicine and have received theprestigious William S. McEllroy Award from the University of PittsburghSchool of Medicine (UPSOM) Medical Alumni Association.HIGH IMPACT PUBLICATIONSDrs. Balestreire and Apodaca published a manuscript in Mol Biol Cell(18:1312-23, 2007) demonstrating a novel physiological role for theEGF receptor in coupling upstream mechanical stimuli to downstreamreorganization of the apical membrane of the bladder in response tobladder filling.Dr. Cresawn and colleagues published a manuscript in EMBO J(26:3737-48, 2007) demonstrating that apical and basolateral proteinstraverse distinct endocytic intermediates en route to the cell surface,and that multiple routes exist for delivery of newly synthesizedproteins to the apical membrane.53

Department of MedicineDr. Bruns, Kleyman and colleagues published a manuscript in J Biol Chem (282:6153-60, 2007) demonstrating that multiple proteases need tocleave the gamma subunit of the epithelial sodium channel (ENaC) to fully activate the channel. Channel activation is due to the release of aninhibitory domain. They proposed that multiple proteolytic cleavage events, including cleavage of the alpha and gamma subunits, lead to astepwise activation of ENaC, reflected in a graded increase in channel open probability.Dr. Weixel, Kleyman and colleagues have a manuscript in press in J Biol Chem that demonstrates regulation of cell surface ENaC expression by anapically localized isoform of phosphatidylinositol 5-kinase (PI5K). Their data suggest that a PI5K-mediated increase in PIP2 levels downregulatesENaC activity via an increase in epsin-dependent endocytosis of the channel.SELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsMajor HonorsGerard Apodaca, MERIT Award, National Institutes of HealthLori A. Birder, MERIT Award, National Institutes of HealthThomas R. Kleyman, Recipient of MERIT Award from the NIHGrant ReviewGerard Apodaca, American Heart Association Cell Biology Study Section, ACS Cell Structure and Metastasis Study SectionMary Choi, American Heart Association, National Center, Cardiorenal Study Section, American Society of Nephrology Grant Review54 Better medicine through research and education.

2007Kenneth Hallows, The Wellcome Trust, Programme Grant Reviewer (three times)Thomas R. Kleyman, Regular Member, Cellular and Molecular Biology of the Kidney Study Section, NIH, NIDDK, T35 Training Grants, NIDDK, CFCenters, Research Committee, American Heart Association, National CenterOra A. Weisz, American Heart Association Study Section (Mid-Atlantic affiliate)Editorial BoardsGerard Apodaca, Associate Editor, American Journal of Physiology, Renal Physiology, American Journal of Physiology, Cellular Physiology, TrafficLori A. Birder, American Journal of Physiology, Neurourology and Urodynamics, and PharmacologyOnLine.itLinda F. Fried, Journal American Society of NephrologyKenneth Hallows, American Journal of Physiology: Renal PhysiologyRebecca P. Hughey, American Journal of Physiology: Renal PhysiologyJohn P. Johnson, American Journal of Physiology: Renal PhysiologyThomas R. Kleyman, Editor-in-Chief, American Journal of Physiology: Renal Physiology 2007; Journal of Biological Chemistry, the Journal of ClinicalInvestigation, and the Scientific World JournalPaul M. Palevsky, Associate Editor, NephSAP, Associate Editor (Acute Renal Failure), Clinical Journal of the American Society of Nephrology, Journalof Intensive Care Medicine, ACCP-SEEK (Critical Care Medicine), UpToDate (Section Editor: Renal Failure)Beth M. Piraino, Peritoneal Dialysis International, Seminars in Dialysis, The kidney.org, Editor of the Peritoneal Dialysis Section, CJASN, 2005-present, American J Kidney Disease,Ora A. Weisz, American Journal of Physiology, Renal, American Journal of Physiology, Cell Physiology,OtherLori A. Birder, Secretary/Treasurer, ASPET Division Systems/Integrative Pharmacology, Chair, Neural Control Committee, 4th World HealthOrganization International Consultation on Incontinence, ParisMary Choi, American Journal of Physiology-Renal PhysiologyKenneth Hallows, American Society of Nephrology, Abstract Review Category Chairperson, Nephrology Faculty, Faculty of 1000 MedicineJames R. Johnston, Best Docs in Pittsburgh, Pittsburgh magazine, May 2007, Recognized by Castle Connolly as one of America’s Top Doctors,May 2007 Member, Executive Council for Training Program Directors of the American Society of Nephrology (elected), Chairman, Subcommitteefor Future Recommendations to the Residency Review Committee for the Training program directors of the ASNThomas R. Kleyman, Research Representative, American Heart Association, Council on the Kidney in Cardiovascular Disease LeadershipCommitteePaul M. Palevsky, Member ASN Acute Kidney Injury Advisory Group, ESRD Network 4 Member, Network Coordinating Council, 1989-present,Forum of ESRD Networks, Member, Board of Directors, Co-Chairman, Anemia Workgroup, 2007Beth M. Piraino, Co-chair of the Spring Meetings Planning Committee, NKF, Chair Guidelines Committee of the ISPD, Secretary and now VicePresident of the NKF of the Alleghenies, Best Doctors in America, 2006 and 2007, Pittsburgh magazine as Best Doctor in Renal, 2007Ora A. Weisz, Symposium Organizer, The Physiological Society Main Meeting, London, England, Abstract Review Chair, Cell and TransportPhysiology: Protein Sorting/Epithelial Polarity section, American Society of Nephrology Annual Meeting55

Department of MedicineRHEUMATOLOGY & CLINICAL IMMUNOLOGYLarry Moreland MDDivision Chief/ ProfessorFACULTYAntonio A. Achkar MDJoseph M. Ahearn MDGhassan Alayli MDChristiane L. Arsever MDDana P. Ascherman MDNoah S. Bass MDThomas G. Benedek MDAlan M. Berg MDLeo P. Bidula MDRobert B. Buckingham MDPaul S. Caplan MDHerbert S. Diamond MDRobyn T. Domsic MDJennifer R. Elliott MDKenneth N. Gold MDElliot B. Goldberg MDAmy H. Kao MDEswar Krishnan MDC. Kent Kwoh MDPaul J. Killian MDPhillip D. Klahr MDDouglas W. Lienesch MDChau-Ching Liu MD, PhDSusan M. Manzi MDKathleen M. McKinnon D.O.Thomas A. Medsger MDAlexander M. Minno MDNiveditha Mohan MDLawrence M. Mulhern MDJeannine S. NavratilChester V. Oddis MDThaddeus A. Osial, Jr MDBurton H. Pollock MDWilliam Ridgway MDDawn M. Santora MDTerence W. Starz MDBertrand L. Stolzer MDMolly T. Vogt PhDMary Chester Morgan Wasko MDElizabeth A. Young MD“The Division continues to have a reputation as oneof the best in the country. Two faculty members areincluded among the peer-selected Best Doctors inAmerica.”56 Better medicine through research and education.

2007The Division of Rheumatology and Clinical Immunology strives to rankamong the top Rheumatology Divisions in the country and to providestate-of-the-art care to patients with rheumatic and musculoskeletaldiseases that is appreciated by patients and responsive to the needsof referring physicians. Our goals also include providing outstandingtraining for fellows so that they can become the next generationof academic and practicing rheumatologists and for residents andmedical students so as to increase their awareness of the frequency,impact and modern approach to diagnosis and treatment ofrheumatic diseases. Lastly, we strive to develop “cutting edge” clinicaland laboratory research programs capable of training academicrheumatologists of the future and translating investigative discoveriesto clinical practice.CLINICALTen Division faculty members are actively involved in seeingoutpatients at the University Arthritis and Autoimmunity Center, theOakland Veterans Affairs Medical Center Arthritis Clinic, the LupusCenter and our Greensburg site. The total number of patient visits tothese four facilities was over 10,000, an increase of 14.5% comparedwith fiscal year 2006. Thetotal number of patientvisits to our Arthritis InternalMedicine (AIM) and Margolispractice sites during fiscalyear 2007 were 13,615and 14,892, respectively.Division faculty serve botha consultative, tertiary carerole, seeing complicatedautoimmune diseasepatients referred by otherrheumatologists andinternists, and an ongoingcare role to patients with alltypes of rheumatic diseases.There are three designatedspecialty clinics which serve as regional and national referral centers:Scleroderma Clinic, Polymyositis Clinic and Lupus Clinic. The ArthritisNetwork of 26 rheumatologists recorded over 41,500 outpatient visitsat six practice sites this year, and our faculty completed over 600 newinpatient consultations at UPMC-affiliated institutions and the VAMC.RESEARCHThe Division’s research program continues to be nationally recognizedfor its high quality and productivity. Extramural funding has remainedsteady during the past year. We had five years of funding for theRheumatic Diseases Core Center (RDCC) grant sponsored by NationalInstitute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)/NIH. This grant supported three core facilities (Molecular Biology,Analytical Cytochemistry and Biostatistics) and two pilot and feasibilitystudies of basic/translational research related to rheumatic diseases.Major faculty areas of investigative interest include basic mechanismsof tissue injury and pathogenesis as well as clinical features,natural history and therapy of systemic sclerosis, systemic lupuserythematosus, polymyositis-dermatomyositis, rheumatoid arthritis,vasculitis and osteoarthritis. We have recently been awarded a fiveyear NIAMS/NIH Multidisciplinary Clinical Research Center grant, whichincludes three clinical research projects that address important clinicalproblems, an Administrative Core, and a Methodology Core. Otherresearch activities include the Arthritis Institute, established in 1998,which is an interdepartmental structure designed to foster integratedclinical and research activities related to arthritis, autoimmune andmusculoskeletal diseases.TEACHINGFaculty members of the Division have extensive teachingresponsibilities, both in the Department of Medicine and in theSchool of Medicine. Division faculty are involved in all levels ofmedical school classes, from directing first year courses to having upto six students participate in the four-week Rheumatology elective.Interns and more senior Internal Medicine residents rotate on theRheumatology Service for two to four weeks. Faculty and fellowsteach residents in the Rheumatology Clinics during their AmbulatoryMedicine block. Faculty give lectures in the annual Internal MedicineProgram’s noon conference series. Our clinical training componentfor fellows includes a comprehensive didactic curriculum (weeklyGrand Rounds, Summer Didactic Lecture Series, Immunology LectureSeries, monthly Journal Club, and monthly Radiology Conference). Allof these activities have direct faculty supervision and, thus, intimatecontact between fellows in training and academic faculty. Wecurrently have six clinical fellows (three first year, three second year),and one research fellow (third year).In addition to the traditional training of medical students, residentsand fellows, rheumatology faculty members participate in mentoringmedical students throughout their medical school careers as partof the Faculty and Students Together (FaST) program. A uniquesummer research/clinical program provides the opportunity formedical students between their first and second years to participatein American College of Rheumatology-sponsored clinical and researchpreceptorships. The Lupus Center offersall day sessions for high school studentspotentially interested in medical researchcareers and has an intensive summerresearch program which, annually,attracts one or more medical students.QUALITYThe Division continues to have a reputation as one of the best inthe country. Two faculty members are included among the peerselectedBest Doctors in America. More specifically, our focus onquality is evidenced by our work with rheumatic disease patients onimmunosuppressive medications, particularly parenteral biologicmodifier therapies.57

Department of MedicineHIGH IMPACT PUBLICATIONSDr. Ridgway and colleagues (Diabetes 56:186-196, 2007) demonstrated that treatment of nonobese diabetic (NOD) mice, an animal model ofspontaneous Type one diabetes (T1D), with an agonist anti-CD137 antibody prevented diabetes. The mechanism of protection was specificallymediated by CD4+CD25+CD137+ T regulatory cells. This research is important because candidate genes in NOD diabetes have often been foundin human diabetes.Dr. Ascherman and colleagues (Journal of Autoimmunity 29:174-186, 2007) continue to study the role of Jo-1 directed B and T cell responsesin different genetic backgrounds of animal models (C57BL/6 and NOD congenic mice). This animal model of myositis provides a uniqueopportunity for elucidating the mechanisms of this immune-mediated muscle disease.Dr. Wasko and colleagues (JAMA 298:187-193, 2007) reported from a study evaluating patients with rheumatoid arthritis the role ofhydroxychloroquine in preventing or reducing the risk of diabetes. These finding provide the framework for defining additional mechanisms ofaction of this commonly used arthritis medication.A major research focus in the Lupus Center of Excellence is the dramatic 50-fold increased risk of myocardial infarction observed in youngwomen with lupus. Research progress in this field has been hampered by the lack of an informative animal model that can be used tounderstand the mechanisms of this process and to develop effective therapies. Investigators in the Lupus Center of Excellence, in collaborationwith the McGowan Institute for Regenerative Medicine, the Center for Vascular Remodeling and Regeneration, and the Department ofBioengineering have recently reported successful development of the first experimental model for ex vivo investigation of vascular stiffness andatherosclerosis in a mouse model. This multidisciplinary team, using a laser-based perfusion system, successfully measured the progressionof vascular stiffness, an early sign of atherosclerosis, in the aortas of mice deficient in apolipoprotein E. Additional studies, performed incollaboration with the Center for Biologic Imaging, simultaneously identified pathologic inflammatory and immune responses within the vesselwall during progression of the disease. These advances can now be extended to investigate atherosclerosis in mouse models of lupus and otherhuman vascular disorders and to identify potential targets for therapeutic intervention in humans.SELECTED SCHOLARLY ACTIVITIESStudy sections (excluding ad hoc review), editorial boards, and other honorsGrant ReviewJoseph M. Ahearn NIH NIAMS Special Emphasis Panel, Chair: ZAR MLB-L 01 (K awards), 2006, Dept. of Veterans Affairs - Merit Review Board forImmunology, Wellcome Trust Scientific Reviewer, Lupus Panel; Department of Defense; Scientific Peer Advisory and Review NHLBI Study Section,Member, 200758 Better medicine through research and education.

2007Eswar Krishnan, Member-Scientific Advisory Council, Study Section A. REF ( American College of Rheumatology)C. Kent Kwoh, National Institutes of Health, Neurology, Aging and Musculoskeletal Epidemiology (NAME) Study section, MemberSusan Manzi, NIH/CICS Study Section, 2005-present, NIAMS Clinical Trial “Prevention of Cardiovascular Complications in Pediatric SLE:Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE)Editorial boardsJoseph M. Ahearn, Executive Editor, Clinical and Translational Science, 2007 ( a new journal to be launched in 2007)C. Kent Kwoh, Associate Editor, Arthritis Care and ResearchSusan Manzi, Section Editor, Current Rheumatology Reports, SLEOtherJoseph M. Ahearn, Lupus Panel; American Institute of Biological Sciences (AIBS) and The United States Army Medical Research and MaterialCommand (USAMRMC) (Department of Defense); Scientific Peer Advisory and Review Services; Peer Reviewed Medical Research Program, 2006Faculty of 1000 Biology: Pharmacology & Drug Discovery; Immunopharmacology & Hematologic Pharmacology, 2006-present, Plenary SessionChair; First Lillehammer Biomarker Meeting, Lillehammer, Norway, 2007Dana P. Ascherman, American College of Rheumatology Abstract Review Committee – Myositis SectionC. Kent Kwoh, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Arthritis Data Workgroup, VARheumatology Consortium, Quality Indicators Committee, American College of Rheumatology (ACR), Board of Directors, Osteoarthritis ResearchSociety International (OARSI), Annual Meeting Planning Committee and Treatment Guidelines Committee,Chester V. Oddis, The Myositis Association, Research/Grant Review CommitteeSusan Manzi, Data Safety Monitoring Board, Duke University (Chairperson), 2001-present, NIAMS Intramural Program for SLE Clinical Trials(Chairperson), Data Safety Monitoring Board, 2002-present ,Abbott Scholar Award in Rheumatic Diseases Scientific Board 2002-present,Canadian Network for Improved Outcomes in Systemic Lupus Erythematosus (CANOIS)Thomas A. Medsger, Jr., Physician Achievement Award, Arthritis Foundation Western Pennsylvania Chapter, 2006, Scleroderma Foundation,Western PA Chapter, Board of Directors and Treasurer, Samuel & Emma Winters Foundation, Executive Committee, Grants Review Committee,Co-ChairChester V. Oddis, Western PA Chapter, Arthritis Foundation Governing Board, The Myositis Association Medical Advisory Board, Board ofDirectors, American College of Rheumatology Committee on Education, International Myositis Assessment and Clinical Studies (IMACS), Board ofDirectors, The Myositis Association, International Myositis Assessment and Clinical Studies (IMACS) Group and Classification Criteria Project59

Department of MedicineQUALITY IMPROVEMENT & PATIENT SAFETY REPORTAdele Towers MD, MPHVice Chair/ ProfessorQuality Improvement & Patient Safety President60 Better medicine through research and education.

2007DESCRIPTION OF ACTIVITIES AND MISSIONUnder the direction of Adele Towers, Vice Chair of QualityImprovement and Patient Safety, the Department of Medicine (DOM)continues to progress in its endeavor to provide safe and quality careto all patients. It coordinates quality efforts, enhances patient safety,encourages innovation and promotes education in QI and patientsafety for nurses and physicians.QUALITY IMPROVEMENTThe DOM provides leadership and expertise for many qualityimprovement initiatives at UPMC. UPMC leads the regional hospitalsfor the CMS Core Measures, and the DOM has a significant role inthe performance of the Pneumonia, CHF and Acute MI initiatives.Collaboration with UPMC Infection Control and the Department ofPharmacy has led to an improvement in nosocomial infection rates,especially Clostridium difficile infections and blood stream infectionsassociated with central line placements. Our performance continuesto be significantly lower than the national average. The AntibioticManagement Program provides surveillance and education forappropriate use of antibiotics. Hand hygiene initiatives are showingpositive impact on compliance with the standards. These initiativesare positively influencing the culture and training of house staff andnursing staff. New initiatives by the Anticoagulation Taskforce toensure proper implementation of heparin protocols for acute coronarysyndromes and venous thromboembolism are likely to reduceheparin administration related errors and prevent adverse events.These projects are ongoing and outcome results will be compiled insubsequent years.PATIENT SAFETYThe DOM continues to review all adverse events and incorporatesthe findings in future initiatives to improve the care and safety of ourpatients. Education, counseling and increased awareness regardingerrors and safety lessons occur via individual and group sessions fornursing, house staff and attendings. We often utilize the NursingQI Forum to help resolve issues with medication reconciliationon admission and transfer, discharge barriers, medication deliveryprocesses, implementation of national patient safety goals, transitionsof care, safe transport system and several other initiatives.Anticoagulation management continues to be our primary patientsafety goal for 2006-2007. Our efforts are focused on providing saferanticoagulation management through the Anticoagulation Taskforceinitiatives as described below:3. Review of all adverse events related to anticoagulation inpatientmanagement and follow up with the care team, providingeducation and counseling as required. Many nursing initiativesand modification of nursing documentation have resulted fromthese reviews.4. Review of specific processes: Heparin induced thrombocytopeniadocumentation, recognition and management;recommendations for heparin in TPN; laboratory aPTTturnaround times.5. Proposed and ongoing activities:• Evaluation of effectiveness of post-op and low doseheparin protocols (ongoing)• LMWH order sets; DVT prophylaxis order set expansionto specific recommendation for various subsets of at risk populations (in progress)• Pilot program of a nursing led inpatient anticoagulationservice (under development)• Monitoring high INRs and aPTT to assure patient safety(ongoing)Several other areas have been addressed for patient safety. Withthe help of Jewish Healthcare Foundation, the University ofPittsburgh Institute of Aging, and the University of Pittsburgh Schoolof Pharmacy, we have made care delivery safer by eliminatinginappropriate use of dangerous medications such as Meperidine,Promethazine, Diphenhydramine and Lorazepam. In addition, ourongoing Condition A & C reviews for medical patients has identifiedlorazepam intravenous administration as a contributing factor to crisisin several instances. Subsequent evaluation of utilization and adverseevents relate to lorazepam has led to development of intravenouslorazepam administration and monitoring policy for the nurses, andthe development of an acute anxiety management order set. Resultsof this evaluation are submitted for publication in the Journal ofPatient Safety.INNOVATIONSuccess of Departmental QI projects have been recognized at localand national levels. Medicine housestaff, students and nurses haveparticipated in QI and patient safety research activities and presentedtheir work at national meetings. Our team has helped develop toolswhich provide patient education as well as facilitates compliance withhospital accreditation and quality measures.Anticoagulation Taskforce Initiatives:1. Standardizing unfractionated heparin therapy: Order sets forDVT/PE treatment, acute coronary syndrome, postoperative andlow dose heparin are completed and implemented afterappropriate nursing and house staff education.2. DVT prophylaxis order set is being developed.QI Fair: Our Community Acquired Pneumonia and Anticoagulationprojects won prizes at the 2007 Presbyterian QI Fair.EDUCATIONAll our QI and Safety efforts are intimately tied with continuingeducation for Anticoagulation Taskforce activities, nursing and housestaff education.61

Department of MedicineHouse staff is also involved in QI and patient safety research and havepresented their work at national meetings. Thus QI and patient safetyin DOM had a successful year with improved quality and safe deliveryof care to our patients, education and training for the house staff andresearch activities.QUALITYExcellent performance on the quality care measures for CommunityAcquired Pneumonia (CAP), Chronic Heart Failure (CHF) and AcuteMyocardial Infarction (AMI) patients have been delivered by DOMclinicians during the year 2006-07. Ongoing house staff counseling,education and increasing awareness regarding patient safety hascontributed to improved care delivery. Other focused initiatives likeanticoagulation management, allergy documentation, reduction ofmedication errors and development of safe medication prescribinginitiatives has helped to prevent adverse events and improveappropriate care delivery. The development of several order sets hasfacilitated delivery of evidence based and safe care while providingeffective tool of education.RESEARCH AND OTHER SCHOLARLY ACTIVITIESEach of our QI and patient safety projects has been tied into researchactivities resulting in presentations at national meetings, publicationsand house staff research training. Many of these projects areimplemented in collaboration with Pharmacy, Institute of PerformanceImprovement, Institute of Aging and various DOM Divisions.The following lectures were organized for this series. Lecture andpanel format included: case presentation, discussion of safety andQI issues and take home messages regarding appropriate medicalmanagement and UPMC and national safety initiatives.1. Anticoagulation management2. Opioid management3. Malpractice and legal issues4. Informed consent5. Antibiotic management6. Hyperkalemia management7. Thromboembolic episodes (DVT and PE)8. End of life careNursing orientation, inservices, education material and self learningmodules are created with help and guidance of DOM Patient SafetyCommittee.Education Credit Units (ECU) dataHeena Sheth has facilitated small group sessions for the MSI and IIstudents and interviewed medical school applicants and served as amember on Admission Committee. This has accumulated a total of50+ ECUs for the department.Internal medicine house staff were mentored for a research projectthat was presented at the 2007 Society of General Internal Medicine(SGIM) national meeting in Toronto, Canada by Amit Raina, IshSingla, Adele Towers and Heena Sheth titled, “Anticoagulation withUnfractionated Heparin in Obese Patients”.In addition, Division faculty have contributed a significant amountof time and expertise to several hospital committees, such as PatientSafety Committee, Medicine Program Line, Infection Control, TotalQuality and Patient Safety Council, Safe Medication Practices and QICommittee (SMPQI), Allergy Taskforce and Adverse Drug Event (ADE)Committee and Anticoagulation Taskforce.The Delirium Prevention Program received funding of $75,000 fromJewish Healthcare Foundation in collaboration with the PittsburghInstitute of Aging.Physician champion award of $25,000 by Jewish HealthcareFoundation was received for the “Safe transfer of patients to skillednursing facilities” project which is ongoing.TEACHING ACTIVITIESExpert physicians from all specialty divisions have contributed todevelop guidelines and order sets to empower our trainees to deliverquality and safe care. Safety curriculum is being developed for themedicine house staff. Patient safety culture assessment survey wasimplemented last year and the safety topics of interest are includedin the lectures and seminars. Academic detailing for ADE reporting isalso occurring as part of the curriculum.62 Better medicine through research and education.

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Department of MedicineMEDICAL EDUCATION IN THE DEPARTMENT OF MEDICINEWishwa N. Kapoor MD, MPHDivision Chief/ ProfessorVice Chair, EducationRaquel A. Buranosky MD, MPHAssistant ProfessorProgram Director, Internal Medicine ResidencyProgram, Division of General Internal MedicineMedical Director, Pittsburgh’s Women’s CenterFrank J. Kroboth MDProfessor, Department of MedicineAssistant Dean for Graduate MedicalEducation, University of Pittsburgh64 Better medicine through research and education.

2007MISSION AND OVERVIEW OF ACTIVITIESEducation is one of the major missions of the Department of Medicine(DOM). The DOM aspires to teach Internal Medicine and its related scienceto learners of all levels from a variety of sources. The major areasof activity include:• Medical Student Teaching• Resident Teaching• Fellow Teaching• Advanced Degree Education• Continuing Medical EducationEach area will be described in detail. Some are covered elsewhere inthis Report, as well.MEDICAL STUDENT TEACHINGThe DOM is a provider of extensive hours of medical student teaching,both in the pre-clinical and clinical years. All subspecialty divisions aremajor contributors to the Problem Based Learning curriculum that comprisesthe first two years. Specific review of the design of the first twoyears curriculum reveals the following regarding members of the DOM:3/5 Major Blocks have directors from the DOM19/31 Courses have directors from the DOM19/55 Total faculty come from the DOMIn the clinical years, all Divisions are active. The Division of General InternalMedicine directs the Adult Inpatient Medicine Clerkship (AIMC).This eight-week inpatient rotation is the longest inpatient experienceof the clinical curriculum. This course is considered the cornerstoneof University of Pittsburgh School of Medicine (SOM) students’ clinicaleducation. In addition, the DOM directs and provides a majority of thefaculty for the Combined Ambulatory Medicine Clerkship (CAMC). Thistwelve-week block, which includes four weeks of Pediatrics, is the longestof the clinical years, reflecting the importance placed on ambulatoryexperiences. Between AIMC and the Internal Medicine componentof CAMC, students spend one-third of the basic clerkship year in InternalMedicine. A majority of students take advantage of the DOM’s ActingInternships in General Internal Medicine, the Medical Intensive CareUnit and the Coronary Care Unit in their fourth year. In addition, everysubspecialty offers elective experiences. These electives include varyingamounts of inpatient, consultative and ambulatory experiences.With regard to research education, the DOM offers the Clinical ScientistTraining Program. It currently enrolls nine students per year, with a targetenrollment of 36 students. In addition, DOM faculty are actively involvedas mentors for the required Medical Student Research Projects.Faculty also participate in relevant MD-PhD education projects. Departmentmembers are also very active in administrative jobs in the SOM.Many of the originators and earliest members of the Academy of MasterEducators were from the DOM. Chairs and major advisors to the StudentPromotions Committee, SHARP, Honor Council, Humanism HonorSociety, and Alpha Omega Alpha Honor Society are from the DOM.Members of the DOM direct the majority of the Areas of ConcentrationPrograms-Women’s Health, Underserved Medicine, and Humanities.RESIDENT TEACHINGThe DOM invests a great effort in the education of resident level trainees.The centerpiece is the Internal Medicine Residency Training Program.The largest tracks are in Oakland and rotate through both theUPMC Presbyterian and the Oakland VA Hospital. Integrated tracksare also taught at UPMC Shadyside. In addition, there are three singleyear programs and rotators from other specialties learning internalmedicine, such as Emergency Medicine, Anesthesiology, Obstetrics andGynecology and Orthopedics. Lastly, there are rotating residents fromUPMC community hospitals such as UPMC McKeesport.The year began with an internal site review by our Graduation MedicalEducation Office. The program was well received with commendations.Comments were that the Internal Review Team was very impressedwith the overall operation of the Internal Medicine Program, withstrong evidence of genuine commitment to the goals and objectivesof the program.The Program had an extremely successful recruitment year wherethose accepted came from the top 122 choices on the match list.Twenty-one of our twenty-eight categorical residents were listed inour top 100 rank applicants. Two key reasons for this success includedthe addition of a Global Health Track this year as well as our nationallyacknowledgedacceptance into the Educational Innovations Project.This will be described further below. In addition, we emphasizedour program as one that highlights individualization of training withthe different tracks that we offer including Geriatrics, Global Health,Women’s Health, Medicine-Pediatrics, Clinical Scientist TrainingProgram (CSTP), International Scholars Program and the Ambulatoryand Hospitalist Pathways.The work done by our subcommittees this year has blossomed. This isdue to our participation in the Educational Innovations Project (EIP) aswell as the continuation of efforts of the subcommittees from last year.The EIP was created by the Residency Review Committee with the goalof redesigning internal medicine residency education. In October2006, we were selected as one of only twelve university internalmedicine programs across the country to take part in this program.Subcommittees comprising this project include the following: 1)Individualizing Career Paths, 2) Information Technology Solutions, 3)Innovative Teaching Methods, 4) Promotion of Continuous HealingRelationships, 5) Development of Effective Communication, 6)Instillation of Evidence-Based Practice, 7) Patient Safety, 8) ChronicDisease and Preventive Care, and 9) Evaluations and Competencies.Nationally, we have taken a lead in the EIP organizational process. Ourprogram director, Raquel Buranosky, along with the program directorsof Duke and Baystate/ Tufts have organized the East Coast Regional EIPCommittee, which is working in conjunction with the American Boardof Internal Medicine to further the national EIP agenda.In the past year, the Subspecialty Education Coordinators Committeewas funded, created and made rapidly operative. The group wascreated to improve intern and resident education, especially in thesubspecialties of Internal Medicine. These faculty members act as65

Department of Medicinea liaison between the leaders of the residency program and thesubspecialty divisions. Innovations have included creation of new,two-week mini electives, of additional four-week electives, of an“on-call” system to participate in morning report, and of an evidencebasedmedicine faculty development seminar series. The faculty alsohave assisted in organizing speakers and topics for Grand Rounds andNoon Conferences.Residents continue to excel in research with the assistance of oursubspecialty and General Internal Medicine mentors through theResident Career Development Program. Many residents havepresented at national meetings, as well as contributed to publications.In addition, this research has led to very successful fellowshipplacements over this past year. We found that this program enhancestheir productivity as a resident, as well as their competitiveness forFellowship positions. Programs in place that have helped to supportthis include the newly-developed Clinical Scientist Training Program(CSTP).going for advanced specialty fellowships. Nearly 40% of fellowshipgraduates stayed at UPMC.In addition to the ten ACGME accredited fellowships, the DOMsponsors six well established non-accredited programs: GeneralInternal Medicine, Transplant Pulmonary, Transplant Nephrology,Transplant Hepatology, Palliative Care, and Congestive Heart Failure. Aseventh, Cardiac Imaging, was added this past year. These programsoffer post subspecialty level expertise available only in a selectnumber of major departments of medicines. There are also a numberof fellows engaged in research years before or after their formaltraining years.The faculty of the DOM are active in faculty development exercises,both institutionally and departmentally. The Program Directors areformally organized into a Common Fellowship Curriculum Committee,meeting bi-monthly to share and propagate best educational practicesfor the fellowships. Examples of the year’s academic products ofour fellowships, shared with the Committee, include an electronicFELLOW TEACHINGThe DOM offers fellowship training in all major Divisions. BetweenACGME accredited and non-accredited programs, an astonishing150 fellows train each year. As a whole, the fellowship programsare highly competitive and enroll outstanding fellows. For the sixfellowships that participated in a match this past year, the match ratiowas 2.6, compared with 3.8 over all programs at UPMC. Forty-fourpercent came from the designated Top Talent programs. A few of theDivisions, such as Cardiology, offer some of the largest programs in thecountry as well.Besides excellent clinical care, the fellows are highly productive inresearch. Last year, fellows produced more than 22 abstracts, 56publications, 36 scientific presentations, as well as a K12-sponsoredResearch Scholars Award and two grants in Nephrology. Half of theMedical Center’s T32 sponsored fellows are in the DOM. Over onethirdof graduates went on to faculty appointments as well as 18%portfolio system, an electronic subspecialty library, and two Divisions’versions of next generation procedural competency assessment tools.This Committee serves as a model for other departments’ fellowshipfaculty development. A matching Fellowship Program CoordinatorsCommittee was formed this year to ensure optimal synchrony ofdirectors’ and coordinators’ efforts.Our faculty also teach in other departments’ fellowship courses, suchas the Pediatrics Core Fellowship Curriculum, in which individualDOM faculty teach, and during which, Pediatrics fellows join thePulmonary Division’s basic research course. Fellows from otherdepartments also participate in large numbers in the other graduatedegree programs described below. Lastly, these efforts at measuringfellowship program outcomes and organizing fellowships withinthe DOM are shared center-wide through the role of the AssistantDean for Graduate Medicine Education, who is from the DOM. Thenewest target for improvement, non-ACGME accredited fellowship66 Better medicine through research and education.

2007programs, was established this past year. The Assistant Dean createda collaborative Fellowship Committee for these programs in Medicineand all departments collectively, using the model of the DOMCommittee.ADVANCED DEGREE TEACHINGThe DOM offers a great variety of training and education beyond thebasic clinical fellowships of the Medical Center Medical EducationPrograms. Already mentioned are a number of fellows doing extrayear(s) of research before or after their formal programs.There are also extensive formal programs in advanced researchor education areas, many of which offer a separate degree orcertification. They are organized as follows:Institute for Clinical Research Education (ICRE)At the heart of the clinical research training enterprise is the ICRE,an institute devoted to the development of high-quality clinicalresearchers through the Schools of the Health Sciences (SHS).The mission of the ICRE is to offer the highest-caliber training andeducation in clinical research to all levels of trainees in the SHS and toenhance collaboration among trainees and researchers from multipledisciplines. Established in 2005 under the direction of Dr. Kapoorof General Internal Medicine, the ICRE brings all of the University’spremier clinical research training programs under one organizationand into one physical space. Some of these programs, such as the K30CRTP, are described below. The establishment of the ICRE representsthe University’s clear commitment to high-quality training of clinicalscientists. The Institute includes core faculty and mentors from allof the six SHS. The ICRE has dedicated 12,000 square feet of spacewith smart classrooms, conference rooms (with smart Boards), astate-of-the-art computer laboratory, faculty offices, staff space, and30 cubicles for trainees. This facility allows for effective coordinationof programs and mentoring through the close proximity of programstaff and faculty. The organizational structure promotes cohesionand opportunities for multidisciplinary collaboration. The Director ofthe ICRE reports to the Senior Vice Chancellor for the Health Sciences.With funding of Clinical and Translational Science Institute (CTSI),ICRE became the organization supporting the education and careerdevelopment arm of the CTSI.CTSI was funded in September 2006 bringing together translationalresearch, training and institutional research resources under the CTSIfor advancing clinical and translational research. CTSI funding andstructure will be used to develop and enhance the following programsnow existing within the ICRE:Clinical Research Training Program (CRTP)This program, which is supported by NIH, provides students at alllevels the skills necessary to design and conduct high-quality clinicalresearch involving human subjects. The CRTP begins with a tightlyintegrated core curriculum that is taught over an intensive eightweeksummer session. This is followed by a nine-month integratedmethodology seminar that builds on the skills introduced during thesummer. Upon successful completion of the core curriculum and theseminar series, trainees may continue their studies in a more specificfield of interest. Completion of all the base programs leads to a Masterof Science in Clinical Research. Under CTSI, a PhD program in Clinicaland Translational Science is being developed as well as a Certificatein Clinical and Translational Research. New courses in translationalresearch will be added to the program. The CRTP is in its sixth yearand was successfully refunded for another five years starting in June2005. The number of enrolled trainees has increased substantiallyevery year, as has the number of course offerings. In 2007, there were46 enrollees in the summer intensive program, and 38 courses (alldeveloped over the past five years) were offered. There have been atotal of 150 trainees so far, and nearly all go on to careers in research.Clinician Educator Training Program (CETP)In its fourth year, the CETP is focusing on faculty development skillsand introducing innovative teaching strategies. A total of 18 newlycreatededucation courses are now available in the CETP, and eightDivision of General Medicine members serve as directors of thesecourses. Since its inception, the program has enrolled fifteen trainees,representing clinician educators in general medicine, geriatrics,pediatrics, critical care and nephrology. Four received a Master ofScience in Medical Education and two received a Certificate in MedicalEducation.Clinical Scientist Training Program (CSTP)This program was initially developed to provide clinical researchtraining for medical students. Students take one additional year fortraining as well as longitudinal seminars throughout the entire fiveyears. The didactic training is similar to that of the CRTP describedabove. A CSTP was also developed for residents in medicine. Thisprogram provides a Certificate in Clinical Research and hands-onclinical and translational research experiences for residents over threeyears of their training. Expansion of these programs occurred underCTSI, which will include a larger number of medical students andopening the program to residents from other specialties.K12 Clinical Research Scholars Program (CRSP)This program, initially funded by the NIH Roadmap initiative throughthe K12 mechanism, became part of the CTSI. The CRSP preparesjunior faculty from a broad range of disciplines, specialties, andsubspecialties for independent careers in clinical research. The CRSPbrings together the collaborative efforts of the Schools of the HealthSciences (Schools of Dental Medicine, Health and RehabilitationSciences, Medicine, Nursing, Pharmacy and Public Health), the manymultidisciplinary research centers at the University of Pittsburgh,and the extensive clinical entities that comprise the University ofPittsburgh Medical Center. The program awards salary and researchsupport for early junior faculty for up to five years and provides themwith training in clinical and translational research methods. We have28 scholars in the program.New Educational Programs under CTSIMultiple new programs and enhancement of existing programs isoccurring under the CTSI. New programs include: PhD in Clinical67

Department of Medicineand Translational Sciences; Certificate in Clinical and TranslationalResearch, Minority Career Development Program, Web-BasedTeaching and Mentoring Programs. Enhancements include newpositions for short-term and long-term training for existing doctoralstudents, new courses through the CTSP and supporting careerdevelopment awardees.CONTINUING MEDICAL EDUCATION ACTIVITIES OFTHE DEPARTMENT OF MEDICINEContinuing Medical Education (CME) is the final major area in whichthe DOM teaches. Indeed, the Department offers a comprehensivemenu of updates in most major specialties, as well as three annualresearch conferences. In addition, a large, multi-day Update inInternal Medicine is conducted each autumn, sponsored through theDivision of General Internal Medicine and taught by faculty from manydivisions.Many of the weekly didactic sessions of our Divisions are open tofaculty for CME, as well as to local practicing physicians. MedicalGrand Rounds is held on Fridays and is Department wide. As seenabove, there are a total of 26 conference series that are CME accreditedwithin the DOM. Individual faculty members also participate andteach in truly countless other CME venues, such as presentations atregional and national meetings. Lastly, Divisions such as Nephrologyare exploring web-based CME for practicing physicians.IN SUMMARYEducation is a major mission of the Department of Medicine and itoccurs on five levels. It includes didactics, innovation, and optimaladministration of educational efforts. The effects of the missionare felt throughout the Medical Center and the region, and aredisseminated nationally.CARDIOLOGYDIVISIONSENDOCRINOLOGYGERIATRICSINFECTIOUS DISEASEHEMATOLOGY/ONCOLOGYNEPHROLOGY(RENAL-ELECTROLYTE)PULMONARYGASTROENTEROLOGYGENERAL INTERNAL MEDICINEPALLIATIVE CARERHEUMATOLOGYCME ACCREDITEDANNUAL REGIONAL CONFERENCESCONFERENCE SERIESANNUAL HEART FAILURE MEETING,3ANNUAL CARDIAC CATHETERIZATIONCONFERENCEANNUAL UPDATE 3ANNUAL UPDATE 1ANNUAL UPDATE 2PITTSBURGH CANCER CONFERENCE(ANNUAL)ANNUAL UPDATE 3ANNUAL UPDATE IN PULMONARY1MEDICINE, PITTSBURGH LUNGCONFERENCE (ANNUAL)2 ANNUAL CONFERENCES 2ANNUAL UPDATE 5ANNUAL UPDATE 1ANNUAL UPDATE 23Total Department of Medicine 10 2668 Better medicine through research and education.

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Department of MedicineDepartment of MedicineUNIVERSITY OF PITTSBURGH DEPARTMENT OF MEDICINERESIDENTS AND CLINICAL FELLOWS BY DIVISIONFiscal Years 2003-2007 - ResidentsDepartment FY 2003 FY 2004 FY 2005 FY 2006 FY 2007Residents - UPMC Presbyterian 132 130 131 132 130Residents - UPMC Shadyside 70 68 63 57 55Total 202 198 194 189 185FellowsFellowships by Division FY 2003 FY 2004 FY 2005 FY 2006 FY 2007Cardiology 33 35 40 44 43Endocrinology 6 8 9 11 8Gastroenterology 12 14 14 14 14General Medicine 6 5 9 9 9Hematology/Oncology 19 19 21 21 21Infectious Diseases 7 7 6 7 9Pulmonary 14 15 20 20 17Renal-Electrolyte 14 13 12 13 13Rheumatology 6 6 6 6 6Transplantation Medicine 1 3 1 1 1Total 123 127 142 151 14570Better medicine through research and education.

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Department of Medicine2007 U.S. NEWS & WORLD REPORT RANKINGSU.S. NEWS HONOR ROLL OF AMERICA’S BEST HOSPITALS - NATIONALLY RANKED MEDICAL SPECIALTIESDEPARTMENT OF MEDICINERanking Specialty Division 2006 Rank 2007 RankCancer Hematology/Oncology 12th 12thDigestive DisordersGastroenterology, Hepatology,13th27th& NutritionRheumatologyRheumatology & Clinical13th10thImmunologyKidney Disease Renal-Electrolyte 16th 14thRespiratory Disorders Pulmonary, Allergy & Critical Care Medicine 16th 16thEndocrinology Endocrinology & Metabolism 17th 27thHeart and Heart Surgery Cardiovascular Institute 50th *Geriatrics Geriatrics * 8th* Not included in U.S. News & World Report survey72 Better medicine through research and education.

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Department of MedicineMEDICINE HOUSESTAFFChief Medical ResidentsDavid BroklScott HerrleAimee SandersStacey ShafferPGY 1 - CategoricalDaniel BrownJoy ChenNeha ChoksiJustin DumouchelJudit DunaiWalid El AyassHeather FerrisChristian FidlerMeghan FitzpatrickDaniel GeynismanGaurav GuptaPhillip HartleGavin HickeyAnnie ImArslan KahloonDustin KlinerPeter KometianiJosephine LontokSaurabh MalhotraBrian McLaughlinJohn NasrAugust NatalieBethany NordmanChristine OakleyBryan O’ConnellBrittany PalmerMatthew RockacyPaulraj SamuelGwendolyn SchwabJason ShackelfordAn TranSelahattin TurenJennifer VaccaPGY – 1 PreliminaryTofik AliPeter BrennenRushir ChoksiChristopher CummingsJayson EdwardsMariam El-BaghdadiStephanie FloresBrian HorvathArthur HuenRobert KaliappanClark SmithOana SpataruCrystal TungChristina VladutiuChristina WahlgrenSusan YuditskayaPGY – 1 TransitionalJonathan BlevinsPeter BusselbergGillianne DeFoeAndrew KwakAnkitkumar PatelPGY – 2 CategoricalSunil AbrahamNina AhujaMoustafa BannaKathryn BerlacherMyra CarreonSu Min ChoSelina ChowAmy CoxSergio CrespoMarisa DesimoneMati FriehlingAdam GiermaszSusan GlodLaura GoldbergDavid HarrisFeiyu HongSabina HoqueAngela HuangJessica JamesAaron KabbSusan KohliKeith LeungAriel LopezSiamak MalekAli MasudAndreea NegroiuFrederick PascuaChitra RaoNastaran SafdarianJennifer TottenJerry TranLiza VillaruzJohn WilsonCatherine WittmanPGY – 3 CategoricalRohit AggarwalLakya AmaranathaElie AounKaren AuKathleen BickelJason BierenbaumHelen DorraRobert EvansKevin FritzVishal GujralAkshay GuptaKen HoLily HongRussell JonesMinisha KocharLanna KwonHugo LinAlyssa MajeskoMamoo NakamuraIrem NasirJason NgRaza OrakzaiSarwar OrakzaiMalik RahimJamal RanaRobert SchilloPaul SchmeltzerJay ShahJulie SilversteinIsh SinglaJuliette SlomkaEmily StewartJo-Anne SuffolettoSuneel UdaniNizar Younas74 Better medicine through research and education.

2007CURRENT FELLOWSFellow Medical School ResidencyDIVISION OF CARDIOLOGYGenevieve Brumberg Thomas Jefferson Thomas JeffersonRobert D. Grande Medical University of Ohio University of MichiganWhitney E. Juselius University of Colorado Tuft’s NEMCHan-Na Kim Eastern VA Medical School University of VirginiaJeff D. Krackow Drexel University Temple UniversityAvinash Linganna Drexel University Hospital of the University of PAAbena A. Osei-Wusu University of Maryland University of MarylandMarwan Refaat American University of Beirut Mass GeneralHemal Shah UMDNJ – NJ Medical School University of PittsburghBrion M. Winston SUNY Downstate NYUNeeraj Bajaj Penn State/Thomas Jefferson Emory UniversitySanjoy Bhattacharya Dartmouth College University of Texas SWSameer J. Khandhar Northeastern Ohio University Hosp. of the Univ. of PAGeorge S. Mendenhall NYU School of Medicine Beth Israel DeaconessUre L. Mezu Ross University Cleveland ClinicPradeep Nair Drexel University UPMC-PresbyterianMatthew S. Suffoletto University of Pittsburgh UPMC-PresbyterianWilliam M. Wolf Georgetown University Georgetown UniversityTimothy C. Wong NYU School of Medicine NYUSamuel R. Coleman George Washington University UPMC-PresbyterianAnna T. Czajka-Giermasz Medical University of Warsaw UPMC-PresbyterianJames D. D’Antonio Oregon Health & Science University Massachusetts GeneralEdmund T. Karam Georgetown University Georgetown UniversitySarang S. Mangalmurti NYU School of Medicine NYU School of MedicineAref M. Rahman Drexel University Beth Israel DeaconessEathar A. Razak Iraqi College of Medicine UPMC-PresbyterianRaghu R. Tadikamalla Washington University Barnes Hospital, St. LouisSanjay Vasudevan Chennai Medical College UPMC-ShadysideGeorge O. Angheloiu Univ of Med & Pharm, Romania Cleveland ClinicInterventional FellowsJohn P. Girod Philadelphia COM Cleveland ClinicAnisha Shah SUNY Stony Brook University of PittsburghEdward Tadajweski University of Pittsburgh UPMC PresbyterianEP FellowsRaed H. Abdelhadi University of Jordan Cleveland ClinicSara R. Grimley University of Virginia VanderbiltJohn W. Moore Indiana University Indiana UniversityJeffrey L. Williams Drexel University University of CincinnatiCHF FellowDavid Ishizawar University of Pittsburgh University of PittsburghGautam Ramani Jefferson Medical College University of PittsburghResearch FellowMichael J. Frangiskakis University of Michigan UPMC-PresbyterianDIVISION OF ENDOCRINOLOGY AND METABOLISMTodd Bigatel St. George’s University, Grenada Dartmouth-HitchcockSonali Ganguly West Virginia University Thomas Jefferson UniversityParmatma Greeley University of Pittsburgh Thomas Jefferson UniversityMarjorie Pennant Pennsylvania State University George WashingtonKara Hawkins Virginia Commonwealth University University of PittsburghSheela Joshi University of Pittsburgh Columbia UniversityJodie Reider University of Pittsburgh University of PittsburghJolene Brown University of Florida College of Medicine University of Maryland Medical SystemDIVISION OF GASTROENTEROLOGY, HEPATOLOGY AND NUTRITIONAllen T. Banegura University of Maryland University of Michigan HospitalsArthur “Tripp” Barrie Univ Cincinnati Duke UniversityYasser Bhat Kasturba Medical College Cleveland ClinicKaren Collinson UMDNJ Boston UniversityScott Cooper University of Pennsylvania University of PennsylvaniaKenneth E. Fasanela University of Virginia Duke University Medical CenterRachelle L. Johns University of Pittsburgh University of Pittsburgh Medical CenterMark Lazarev University of Pittsburgh Medical Center Beth Israel DeaconessJohn Lyons University of Southern CA Duke UniversityCarmen Meier University of Cincinnati University of Pittsburgh Medical Center75

Department of MedicineFellow Medical School ResidencyDaniel K. Mullady University of Connecticut Boston Medical CenterBrian Ng SUNY Syracuse Univ Pittsburgh Medical CenterJames Park New York University SUNYBenjamin Siemanowski Thomas Jefferson University University of Utah Affiliated HospitalsDIVISION OF GENERAL INTERNAL MEDICINEWendy Anderson UC San Diego, Duke, University of PittsburghRachel Bonnema University of South Dakota University of PittsburghSonya Borrero Case Western University University of PittsburghMichael Gaglia University of Pittsburgh University of MichiganCheryl Lynch Boston University Virginia Commonwealth UniversityMary Beth Pope Salama University of Pittsburgh Shadyside HospitalAbby Spencer University of Pittsburgh NY-Presbyterian Cornell Medical CenterReed Van Deusen Univ. of Cincinnati, College of Medicine University of CincinnatiElizabeth Weinstein University of Pittsburgh University of PittsburghAli Yazdanyar Des Moines University Reading Hospital and Medical CenterDIVISION OF GERIATRIC MEDICINENamita Ahuja Seth G. S. Medical College & King Edward Hospital, Methodist Healthcare University HospitalThe University of BombayLakshmi Anisingaraju Siddhartha Medical College, India UPMC McKeesportMatthew Levy Temple University Thomas Jefferson University HospitalLidia P. Rodriguez Universidad Autonoma de Guadalajara, Mexico Pinnacle Health SystemStasa Tadic University of Nis, Yugoslavia UPMC ShadysideShanjian Zhu Shanghai Medical University Cleveland Clinic Health SystemDIVISION OF HEMATOLOGY/ONCOLOGYSheikh Asim Ali Aga Khan University Medical School University of Pittsburgh Internal MedicineJason Brown Hahnemann University University of Pittsburgh Medical CenterBrian GellerNova Southeastern Univ. College of Osteopathic Med. University of Connecticut Internal MedicineAvina Kapoor Grant Medical College University of Pittsburgh Internal MedicineJohn Morcos Duke University Johns Hopkins Internal MedicineAna Oton Universidad Central of Venezuela University of Miami Internal MedicineGijsberga J. Van Londen University Medical Center of Utrecht, Netherlands University of Pittsburgh Medical CenterFlavia Esteve Escola Baiana De Medicina E Saude Publica Allegheny General HospitalLanie Kasdan Francis University of Pittsburgh School of Medicine George Washington University Internal MedicineHongmei Liang Shandong Medical University Greater Baltimore Medical Center Internal MedicineMichael McNamara Case Western Reserve University University of Pittsburgh Internal MedicineEnrico Novelli Universita Degu Studi De Milano University of Pittsburgh Internal MedicineTaofeek Owonikoko Obafemi Awolowo University Graduate Hospital Internal MedicineHussein Tawbi American University of Beirut University of Pittsburgh Internal MedicineTrevor Feinstein University of Illinois University of Pittsburgh Medical CenterRachel Jankowitz Temple University University of Pittsburgh Medical CenterPatricia Kropf Georgetown University University of Pittsburgh Medical CenterWassim McHayleh St Joseph University, Beirut Lebanon George Washington UniversityRajesh Sehgal Med College Amritsar, India Michigan State UniversityHashem Younes American University of Beirut University of Pittsburgh Medical CenterDIVISION OF INFECTIOUS DISEASESSunil Bhat Medical College of Ohio University of Pittsburgh School of MedicineScott Curry Medical University of South Carolina University of Pittsburgh School of MedicineJoseph Jones Royal Free Hospital School of Medicine, UK Pennsylvania HospitalOmolade Sarumi Royal Free Hospital School of Medicine, UK St. Agnes HospitalAdarsh Bhimraj Gandhi Medical College, India Drexel UniversityJo-Anne Maria Rivera Salangsang Burge University of the Philippines Univ. of the Philippines-Philippine General HospitalYohei Doi Nagoya University School of Medicine, Japan St. Luke’s Roosevelt Hospital CenterBernard Jonas Calingasan Macantangay University of the Philippines Roger Williams Medical CenterTRANSPLANT INFECTIOUS DISEASESKashif Raza Nishtar Medical College, Pakistan Marshall University School of MedicineDIVISION OF PULMONARY, ALLERGY AND CRITICAL CARE MEDICINESuzette Chin, MD University of Maryland UPMCAneal Gadgil, MD Kasturba Medical College University of PennsylvaniaMichael Myerburg, MD University of Pittsburgh UPMCJessica M. Bon, MD Thomas Jefferson Medical College Thomas Jefferson UniversityYvonne Chan, MD Harvard University Mt. Auburn HospitalMarjorie Patty George, MD Johns Hopkins University Johns Hopkins UniversityPeter Kochupura, MD New York Medical College State University of NYEileen Hsu, MD Georgetown University UPMCNilam Mangalmurti, MD Temple University New York University Medical Center76 Better medicine through research and education.

2007Fellow Medical School ResidencyJennifer McComb, MD Albany Medical College University of RochesterJahan Naghshin, MD Isfahan University Medical School Temple UniversityMatt Woodske, MD Pennsylvania State University UPMCJudie Howrylak, MD University of Michigan UPMCKeith Beaulieu, MD Thomas Jefferson Medical College UPMCAmy H. Lee, MD Medical School of WVU Mayo ClinicJohn E. Lee, MD University of New Jersey UPMCChristina E. Rigas, MD Indiana University Indiana UniversityJohn R. Tedrow, MD University of North Carolina Virginia Commonwealth UniversityNeeraj Gupta, MD(Sleep Fellow) All India Institute of Medical Sciences SUNY at Buffalo NYMichael Passero, MD(Sleep Fellow) Brown School of Medicine Boston Medical CenterDIVISION OF RENAL-ELECTROLYTEKhaled Abdel-KaderUniv. of Med. & Dentistry of New Jersey/Robert Wood Johnson Med. SchoolBrown Medical SchoolChristos Agyropoulos Medical School of Patras, Greece University Hospital of CincinnatiBabak BarmarRheinisch-Westfaelische Technische Hochschule,Aachen, GermanyUPMC - ShadysidePatricia Khalil St. Joseph’s University, Beirut, Lebanon State University of New York, Buffalo, NYAhmad Maarouf (second year)University of Damascus, SyriaWestern Reserve Care System – Forum Health – Northeastern Ohio University College of MedicinePreethi Murthy Universidad Iberoamericana, Santo Domingo, Dominican Rep. Greenville Memorial Hospital,Greenville, SCMatthew Novak Drexel University Guthrie/Robert Packer HospitalChristopher Passero Brown Medical School University of Pittsburgh Medical CenterReena Ranpuria SUNY Upstate Medical University University of Pittsburgh Medical CenterAndrew Reznick University of Rochester University of Pittsburgh Medical CenterHelbert Rondon-Berrios Universidad Nacional Mayor de San Marcos, Lima University of Texas, Medical BranchKevin SperlingUniversity of Pittsburgh, McGraw Medical CenterCairo University Faculty of Medicine, Cairo, EgyptUPMC - ShadysideDIVISION OF RHEUMATOLOGY AND CLINICAL IMMUNOLOGYAaron Eggebeen Michigan State University Michigan State UniversityNkechinyere Emejuaiwe Universita Karlova Medical School, Czech Republic Union Memorial HospitalJoseph Enama Penn State University-College of Medicine Penn State- Hershey Medical CenterSuzanne Gharib West Virginia University School of Medicine University of KentuckySara Kaprove SUNY at Buffalo Beth Israel Deaconess Medical CenterJoAnne Sickeri(placed on medical disability2/1/07) MCP Hahnemann School of Medicine UPMCDEPARTING MEDICAL RESIDENTSRohit AggarwalLakya AmaranathaElie AounKaren AuKathleen BickelJason BierenbaumHelen DorraRob EvansKevin FritzVishal GujralAkshay GuptaKen HoLily HongRuss JonesMinisha KocharLanna KwonHugo LinAlyssa MajeskoEmily MartinMamoo NakamuraJason NgRaza OrakzaiSarwar OrakzaiMalik RahimRobert SchilloPaul SchmeltzerJay ShahJulie SilversteinIsh SinglaJuliette SlomkaJo-Anne SuffolettoSunil UdaniNizar YounasRush University, Rheumatology FellowshipCardiology Research, UPMCUniversity of Pittsburgh, Gastroenterology FellowshipUCLA, Rheumatology FellowshipHospitalist, University of Pittsburgh Medical CenterClinical Instructor of Medicine, University of Pittsburgh Medical CenterPrimary Care, VAMC, Pittsburgh, PAPennsylvania State University, Gastroenterology FellowshipPrivate Practice, Pittsburgh, PATemple University, Cardiology FellowshipUniversity of Michigan, Gastroenterology FellowshipUniversity of Pittsburgh, Infectious Disease FellowshipUniversity of Pittsburgh, Hematology/Oncology FellowshipUniversity of Pittsburgh Medical Center, Chief Medical ResidentTemple University, Cardiology FellowshipClinical Instructor of Medicine, University of Pittsburgh Medical CenterUniversity of Pittsburgh, Endocrinology FellowshipUniversity of Pittsburgh, General Internal Medicine FellowshipChief Medical Resident, University of Pittsburgh Medical CenterBaylor College of Medicine, Cardiology FellowshipUniversity of Pittsburgh, Endocrinology FellowshipCedars-Sinai Medical Center (Los Angeles), Cardiology FellowshipBaylor College of Medicine, Cardiac Imaging FellowshipUniversity of Texas at Houston, Cardiology FellowshipUniversity of Pittsburgh, Hematology/Oncology FellowshipUniversity of Cincinnati, Gastroenterology FellowshipUniversity of Pittsburgh, Biomedical Informatics FellowshipWashington University in St. Louis, Endocrinology FellowshipUniversity of Alabama at Birmingham, Heart Failure and Pulmonary Hypertension FellowshipVAMC, Pittsburgh, Primary CareUniversity of Pittsburgh Medical Center, Chief Medical ResidentCook County Hospital, Chief Medical ResidentUniversity of Pittsburgh, Nephrology Fellowship77

Department of Medicine78 Better medicine through research and education.

2007UPMC - DEPARTMENT OF MEDICINEOUTPATIENT VISITS BY DIVISION - Fiscal Years 2005-2007Outpatient Visits (in thousands)79

Department of MedicineUNIVERSITY OF PITTSBURGH PHYSICIANSDEPARTMENT OF MEDICINEwRVUs BY DIVISION - Fiscal Years 2004-2007wRVUs ( in thousands)80 Better medicine through research and education.

(in thousands)2007UNIVERSITY OF PITTSBURGH PHYSICIANSDEPARTMENT OF MEDICINEwRVUs BY DIVISION - Fiscal Years 2004-2007wRVUs ( in thousands)81

Department of MedicineUNIVERSITY OF PITTSBURGH PHYSICIANSDEPARTMENT OF MEDICINEOUTPATIENT VISIT ACCESS TREND - Fiscal Years 2005 - 2007DaysUPMC is committed to delivering timely care to patients and closely monitors how quickly outpatients are seen as comparedto a 72 hour or 3 day standard. The majority of the Department of Medicine specialties are able to treat patients within 1 to 3days.82 Better medicine through research and education.

2007DEPARTMENT OF MEDICINEFACULTY FTEs - Fiscal Year 20071283

Department of MedicineKEY STATISTICSUPMC - DEPARTMENT OF MEDICINEPATIENT DAYS OF STAY (ALOS) BY DIVISIONFiscal Years 2005 - 2007UPMC - DEPARTMENT OF MEDICINEADMISSIONS BY DIVISIONFiscal Years 2005 - 2007DIVISIONPATIENT DAYSFY 05PATIENT DAYSFY 05PATIENT DAYSFY 05CHANGE%DIVISIONADMISSIONSFY 05ADMISSIONSFY 05ADMISSIONSFY 05CHANGE %CARDIOLOGY 23,597 24,838 24,278 -2,3%CARDIOLOGY 4,451 4,465 4,087 -8.50%ENDOCRINOLOGY 166 240 441 83.8%ENDOCRINOLOGY 116 165 174 5.50%GASTROENTEROLOGY 9,959 4,049 2,823 -30.3%GASTROENTEROLOGY 1,448 404 407 0.70%GENERAL MEDICINE 21,543 28,420 41,146 44.8%GENERAL MEDICINE 4,069 4,999 7,071 41.40%GERIATRIC MEDICINE 3,673 5,291 4,658 -12.0%GERIATRIC MEDICINE 787 1,100 989 -10.10%HEMATOLOGY / ONCOLOGY 5,999 6,160 7,505 21.8%HEMATOLOGY / ONCOLOGY 986 899 1,057 17.60%INFECTIOUS DISEASE 154 145 132 -9.0%INFECTIOUS DISEASE 28 27 28 3.70%PULMONARY MEDICINE 13,469 19,234 22,496 17.0%PULMONARY MEDICINE 1,387 1,629 1,837 12.80%RENAL-ELECTROLYTE 254 234 63 -73.1%RENAL-ELECTROLYTE 39 36 12 -66.70%RHEUMATOLOGY 1,057 1,216 1,053 -13.4%RHEUMATOLOGY 171 201 177 -11.90%DEPARTMENT OF MEDICINETOTAL - PATIENT DAYS79,871 89,827 104,595 16.4%DEPARTMENT OF MEDICINETOTAL - ADMISSIONS13,482 13,925 15,839 13.70%UPMC - DEPARTMENT OF MEDICINEAVERAGE LENGTH OF STAY (ALOS) BY DIVISIONFiscal Years 2005 - 2007DIVISIONALOS FY 05 ALOS FY 05 ALOS FY 05 CHANGE%CARDIOLOGY 5.3 5.6 5.9 6.8%ENDOCRINOLOGY 1.4 1.5 2.5 74GASTROENTEROLOGY 6.9 10.0 6.9 -30.8%GENERAL MEDICINE 5.3 5.7 5.8 2.4%GERIATRIC MEDICINE 4.7 4.8 4.7 -2.1%HEMATOLOGY / ONCOLOGY 6.1 6.9 7.1 3.6%INFECTIOUS DISEASE 5.5 5.4 4.7 -12.2%PULMONARY MEDICINE 9.7 11.8 12.2 3.7%RENAL-ELECTROLYTE 6.5 6.5 5.3 -19.2%RHEUMATOLOGY 6.2 6.0 5.9 -1.7%DEPARTMENT OF MEDICINETOTAL - ALOS5.9 6.5 6.6 2.4%84 Better medicine through research and education.

2007DEPARTMENT OF MEDICINEFUNDING BY SPONSOR TYPE AND DOLLARS AWARDED(excludes GCRC and Medical Informatics)Fiscal Years 2005 - 200785

Department of MedicineSCHOOL OF MEDICINE &UNIVERSITY OF PITTSBURGH PHYSICIANSDEPARTMENT OF MEDICINEFINAL REPORT OF REVENUE TOTAL DEPARTMENT - Fiscal Year 2007$39,955,835$33,817,684$14,335,251$14,250,741$49,170,836Hospital Contracted RevenueOther IncomeGifts, Endowments, InvestmentNet Patient Service RevenueSchool of Medicine ECU AllocationGrant DirectsGrant Indirect Cost Recovery86 Better medicine through research and education.

2007SCHOOL OF MEDICINE &UNIVERSITY OF PITTSBURGH PHYSICIANSDEPARTMENT OF MEDICINEFUNDING BY SPONSOR TYPE DIRECT COSTS - Fiscal Year 200787

Department of MedicineUNIVERSITY OF PITTSBURGHPITTSBURGH, PENNSYLVANIAMEDICAL CENTERBold and visionary, over the past two decades UPMC has woven together a complex tapestry of exceptional components into oneof the nation’s leading integrated health systems. With 19 hospitals and a myriad of community-based facilities and outpatientprograms, UPMC has over 3,300 beds, cared for more than 167,000 inpatients in fiscal year 2006, and has more than 4,500 affiliatedphysicians–of which 2,300 are employed by UPMC. The combination of these resources with its workforce of 43,000 employeesyields a dynamic, flexible delivery system that helps UPMC to meet the full spectrum of its patients’ health care needs.At the same time, UPMC has expanded the boundaries of community citizenship through a variety of initiatives. In fiscal year2006 UPMC contributed $228 million in uncompensated care and $60 million in services–including more than 3,000 separate“community benefit” initiatives that addressed health disparities and met community needs. Additionally, UPMC continues topursue leading-edge organizational transparency and governance and is a driving force in the region’s economy. According tothe Hospital Association of Pennsylvania, UPMC has a direct and indirect annual impact of $11 billion that supports more than80,000 incremental jobs. This broadly defined community citizenship agenda is central to UPMC’s philosophy and mission.Building on its unique success as an integrated healthsystem, UPMC is now using its domain expertise to forgea health enterprise. UPMC’s organizational infrastructurealong with its intellectual capital, technological innovation,distinctive management models, and academic and businesspartnerships, forms the platform for this enterprise and thebasis for creating and commercializing products nationallyand internationally. These efforts are a foundation for futuregrowth of the organization and for job creation and economicrevitalization in western Pennsylvania.88Better medicine through research and education.

2007SELECTED DEPARTMENT OF MEDICINECLINICAL SITESUPMC ShadysideUPMC Falk ClinicUPMC MontefioreUPMC NorthwestUPMC South SideUPMC St. MargretsUPMC South HillsUPMC MonroevilleMagee-WomensHillman Cancer CenterUPMC PresbyterianUPMCLiliane S. KaufmannBuildingUPMC Palermo, Italy, theMediterranean Institute for Transplantationand Advanced SpecializedTherapies (ISMETT)89

Department of MedicineTHE UNIVERSITY OF PITTSBURGHSCHOOL OF MEDICINEThe School of Medicine is one of the six health sciences schools at the University of Pittsburgh, which today stands among thenation’s leading academic centers for biomedical research. One of the few objective benchmarks by which an academic medicalcenter can evaluate its success is NIH support for research. Unlike reputational rankings, the NIH process is the only nationallycompetitive, peer-reviewed metric available. By this criterion, Pitt has thrived, breaking into the top 10 list of funded institutionsin 1997—a shift in rank that occurs only rarely—subsequently maintaining that enviable position. Since 1998, the University as awhole and the School of Medicine have both more than doubled their level of NIH support.Although UPMC and the University are legally separate and distinct entities, they share formal contractual bonds that definetheir relationship. Accompanying this structured association, both sides have an appreciation for mutual interdependence thatenables Pitt to provide opportunities for clinical training, educational experiences, and research in virtually any medical specialtyand that, likewise, enables the medical center to stand at the forefront of translating new scientific findings into innovative clinicalcare and to support the development of new medical technology.Further, in recognizing the SOM’s excellence in research and the importance of the never-ending quest for excellence in theeducation of would-be physicians, the School of Medicine has woven a scholarly project into their curriculum and made itan integral component of every medical student’s experience. Some students select traditional laboratory-based or clinicalresearch experiences, while others opt for less obvious choices. The goal in every case, however, is to enhance their ability tothink independently and critically and, thereby, becomebetter equipped to practice medicine in the 21st century.The scholarly projects represents a novel (and perhapseven prototypical) way to increase the number of medicalstudents who pursue research-based careers or clinical careersgrounded in evidence-based medicine–and those are thekinds of doctors we want.90 Better medicine through research and education.

2007PITTSBURGH, PENNSYLVANIAWhere the Allegheny and Monongahela Rivers meet to form the Ohio, one can find Pittsburgh – Pennsylvania’s second largest city.Pittsburgh manages to offer all of the opportunities of a large metropolitan area while retaining a small-town friendliness. It’s ablend so great that the City has been identified as one of the most livable in the country.Besides being the home to three leading universities and various colleges, Pittsburgh is also the corporate headquarters for suchcompanies as UPMC, US Steel, Alcoa, H.J. Heinz Company, and PPG. Outside of working hours, Pittsburgh offers world class sports,theater, and arts. As the home to the Steelers, Penguins, and Pirates, there is always a game to catch no matter what the season.If sports are not of your interest, then there’s Heinz Hall, the Benedum Center for the Performing Arts, the O’Reilly Theater andthe Post-Gazette Pavilion where one can see the best in symphony, opera, ballet, theater, or their favorite touring group. On thequieter side, the Carnegie Museums allow for four distinctive experiences with their Museums of Art, Natural History or Scienceand the Andy Warhol Museum.To get away from the hustle and bustle of the City, Pittsburghers do not have to go far. A trip up the Duquesne or MonongahelaInclines will put you atop Mount Washington, with one of the most refreshing views of the City. Additionally, parks and trailswithin and outside of the city provide ample opportunity to hike, kayak, bike, or climb.All in all, Pittsburgh offers the best in arts, theater, sports, fine dining, parks, education, and healthcare. This makes it a true city ofexcellence. Some of the prestigious rankings Pittsburgh has received in 2007 are #1 Most Liviable City in the U.S.A., (Places RatedAlmanac) and the Best Arts Destination in the country by American Style magazine. We invite you to experience all the excitementPittsburgh has to offer!http://www.coolpgh.pitt.edu/91

Department of MedicineIn preparation of report, special thanks to: Dr. Steven D. Shapiro, Valerie C. Trott, Margaret L. Ealy, Jimette M. Gilmartin and Jane Rollman,as well as the facutly, staff and patients of the DOM.Photography & Design by: Christopher P. Edwards92 Better medicine through research and education.