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This file is provided for reference purposes only. It was current when it was produced, but it is no longer maintained and may now be out of date. Persons with disabilities having difficulty accessing information may contact us for assistance. For reliable, current information on this and other health topics, we recommend consulting the NIH Clinical Center at http://www.cc.nih.gov/.
Clinical Center News

Published monthly for CC employees by Office of Communications, Patient Recruitment, and Public Liaison.

past issues

December 2005


Royal couple visits NIH

President Bush at NIH to reveal national flu response

Carol Romano named PHS chief nurse

A healing heartbeat

Clinical Center hosts program to prepare students for careers in research

Respected author discusses mental illness with patients

Understanding NCI: A toll-free teleconference series

News briefs

Upcoming events

Celebrity composer Marvin Hamlisch performs holiday concert at Family Lodge

Photos from royal visit


   Duchess speaks on osteoporosis during the royal couple's visit to NIH's Clinical Center

As a part of their eight-day tour of the United States last month, Prince Charles and his wife Camilla, Duchess of Cornwall, visited the Clinical Center on Nov. 3. The duchess, who is involved with promoting awareness of osteoporosis in the U.S. and Great Britain, came here to meet with NIH staff and bone health advocacy group members to discuss the disease.

The Duchess of Cornwall, followed by the Prince of Wales, is welcomed to the Clinical Center by Surgeon General Richard H. Carmona (left) and CC Director John I. Gallin (right).
The Duchess of Cornwall, followed by the Prince of Wales, is welcomed to the Clinical Center by Surgeon General Richard H. Carmona (left) and CC Director John I. Gallin (right).
CC Director John I. Gallin greeted the royal couple as they entered the Clinical Center with escort Surgeon General Richard H. Carmona. Meanwhile, hundreds of employees, patients and visitors who had gathered in the lobby, many of whom had waited more than an hour to catch a glimpse of the distinguished visitors, loudly applauded as the two smiled and waved.

To the delight of many, the prince and the duchess took a few moments to shake outstretched hands and talk with individuals before going to the medical board room to attend a briefing on osteoporosis research.

Surrounded by representatives of the National Osteoporosis Foundation, U.S. officials and others, Camilla gave a statement about the disease that had afflicted her mother and grandmother, urging people to continue working together toward a cure. At the conclusion of her presentation, Carmona gave the duchess a copy of his “Bone Health and Osteoporosis: A Report of the Surgeon General,” which was released last year.

To see more of the photos from the royal visit, click here.

 

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   President George Bush at NIH to reveal national flu response

President George W. Bush came to NIH to announce the government’s response plans for a possible influenza pandemic. The Nov. 1 event marked the president’s fourth visit to the NIH campus in three years and he took a moment to recognize the work being done here. “For more than a century, NIH has been at the forefront of this country’s efforts to prevent, detect and treat disease... . This is an important facility, an important complex, and the people who work here are really important to the security of this nation.”
President George Bush at NIH to reveal national flu response
President George Bush at NIH to reveal national flu response.


Bush outlined a $7.1 billion plan to address the threat of avian flu, speaking to an audience that included several cabinet secretaries, senators, congressmen, HHS officials and international representatives from the World Health Organization and the United Nations.

“A flu pandemic would have global consequences, so no nation can afford to ignore this threat, and every nation has responsibilities to detect and stop its spread,” he said.

He went on to detail the steps being taken to prepare for a possible outbreak, which include detecting outbreaks before they spread across the world, stockpiling vaccines and antiviral drugs and accelerating the development of new vaccines.

Dr. David Henderson, deputy director for clinical care at the Clinical Center, recently presented “Avian Influenza: Preparing for the Pandemic” at the annual Medicine for the Public lecture series.
Henderson discussed what avian flu is, how it spreads and where to look for possible treatment and prevention. To read more about his lecture, visit http://www.cc.nih.gov/about/news/mfp.shtml. An archived videocast of the lecture is also available online.

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   Rear Adm. Carol Romano appointed chief nurse in the U.S. Public Health Service

Rear Adm. Carol Romano was appointed chief nurse officer in the U.S. Public Health Service (PHS), effective Nov. 1. In her new position, she is responsible for providing leadership and coordination of PHS nursing programs and professional affairs for the Office of the Surgeon General and HHS. She also maintains her role as deputy chief of the Clinical Center’s Department of Clinical Research Informatics where she manages the administrative planning and clinical operations for CRIS. Romano was promoted to rear admiral in a formal ceremony on Dec. 2. 
Carol Romano (right) with Surgeon General Richard H. Carmona at her formal promotion ceremony on Dec. 2.
Carol Romano (right) with Surgeon General Richard H. Carmona at her formal promotion ceremony on Dec. 2.


“I am excited about the opportunity to contribute to nursing in this new capacity and I am humbled by the responsibility,” Romano says. “Some of the issues that will frame my direction in the next four years include nurse readiness and preparedness for emergency responses, evidence-based practice and inquiry, recruitment and progressive career development for nurses, and communications and partnerships with stakeholders in health and education.”

The corps considers the factors of performance, education, training, career progression, contribution to the Public Health Service, emergency preparedness and length of time in service and/or grade when promoting officers.

Romano’s educational background includes an undergraduate degree in nursing, a graduate degree in administration/nursing, and a PhD with a focus on operations analysis/ informatics from University of Maryland. She is certified in nursing informatics and nursing administration, advanced. She also attended the Interagency Institute for Federal Executives and the Harvard University Senior Managers in Government program.

Over her 33 years of service at NIH, Romano has worked in a variety of positions including associate investigator, clinical research nurse, nurse educator, nursing information systems specialist, director of marketing and recruitment and director of clinical informatics and quality assessment. In addition, she has served as a temporary advisor to the World Health Organization, a consultant to the HHS Secretary’s Commission on Nursing, consultant to the NINR Priority Expert Panel, executive secretary to the Surgeon General’s Workgroup on Physical Activity and Health, chair of the NIH Advisory Committee for Women, member of the NIH Diversity Congress, and co-developer of the NIH Nurse Scientist Training Program.

As a result of her dedicated work and service, Romano’s accomplishments have been recognized with NIH and Clinical Center Directors’ awards, the PHS meritorious, outstanding service, commendation, and achievement medals and several citations. She has also received the HHS Secretary’s Quality of Life Award and is a fellow in the American Academy of Nursing.

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   A healing heartbeat
Using a new form of biofeedback to identify stressors

The human body is constantly sending messages letting us know when we are stressed, sick or tired. At times, those messages may seem subtle, but they eventually manifest themselves as headaches or other obvious symptoms. Scientists have developed methods that allow us to identify, and in some cases literally watch, how the body is reacting to a situation or treatment, thus allowing a better chance of controlling the symptoms before they control us.

One type of treatment, known as biofeedback, trains people to improve their health by using signals from their own bodies. For decades, scientists have used skin response tests, or electromyography, to measure those reactions. Recently, however, a newer form of biofeedback called heart-rate variability (HRV) has been put to use at the Clinical Center. This new service is now available to CC patients thanks in part to the efforts of Dr. George Patrick, chief of the recreation therapy section, Rehabilitation Medicine Department, who oversees the use of this technology for those patients referred to his section.

Heart-rate variability gives a detailed and extremely accurate view of what is going on inside the body of a patient by measuring the beat-to-beat fluctuations in the rhythm of the heart, explains Patrick. “The sympathetic side of the human body reflects a state of excitement or ‘fight or flight’ response, while the parasympathetic is the meditative side. Both sympathetic and parasympathetic activities have distinct oscillations,” he says.

When the two sides are working in harmony, or homeostasis, a heartbeat will show up on a screen as a distinct wave pattern. When measuring heart-rate variability, researchers look for changes in the amplitude of oscillations or an irregular rhythm to indicate a case of anxiety or stress in a patient.

Heartbeat sensors are placed on a patient’s body. Age, gender and other personal data are inputted into a software program. The computer then records the heartbeat while giving a real-time analysis of the patient’s stress levels, based on what is normal for that individual, allowing the patient and researcher to watch the stress markers go up or down on a graphic display throughout the session. Using the imagery as a guide, patients can make internal adjustments to alter the direction of the marker, thus controlling their stress levels.

By allowing patients to observe what is truly going on inside their bodies, the technology provides them with an unbiased and clear picture of what behaviors need to change in order to maintain good health.

Julie Hoehl, a recreation therapist and certified biofeedback specialist, works with the CC pain and palliative care clinic. “Sometimes we have patients who are unable to realize what their body is doing,” she says. “There could be triggers that elicit pain and the patient is unable to interrupt that cycle. If we can help that person see what is actually occurring, what the body is physiologically doing, we can interrupt that pain cycle and treatment with narcotics can become more effective or perhaps even be reduced.”

Michael Duquette, a recreation therapist and certified biofeedback specialist, works with alcoholic patients at the Clinical Center. “Alcoholic patients express a lot of anxiety, and that anxiety can result in the impulse to drink. By teaching them to control their breathing, they are able to control the anxiety and  the impulse,” he explains.

According to the Mind/Body Medical Institute at Harvard University, between 60 and 90 percent of all medical office visits in the United States are for stress-related disorders. Stress and anxiety can be attributed to increased body pain, lengthier recovery times from surgery, and difficulty in fighting diseases like alcoholism. By showing patients what their bodies are experiencing and how stress is affecting them, some researchers hope to empower those individuals to take control.

“This technology is really about education,” says Carmen Russoniello, a guest researcher at NIH and professor of psychophysiology and biofeedback at East Carolina University.  “We give the people the tools to train themselves.”
The uses for this type of biofeedback are becoming increasingly varied as researchers, both in the medical and non-medical fields, discover more and more applications. For example, marketing professionals can see precisely how an individual mentally responds to an image or slogan; and counselors can help a client control the physiological responses evoked by an individual’s innermost concerns, all by watching the data displayed on a screen. And the possibilities continue to expand.

—Kathryn Boswell

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   Clinical Center hosts program to prepare students for careers in research

Director John I. Gallin joins, from left, Albert Einstein College of Medicine students Kristen Thorstenson, Ashley Holder and Daniel Schreeder. With them is Dr. Frederick P. Ognibene, director of the CC Office of Clinical Research Training and Medical Education, at the annual Clinical Investigator Student Trainee (CIST) Forum. More than 250 medical and dental students attended this year’s three-day event.
Director John I. Gallin joins, from left, Albert Einstein College of Medicine students Kristen Thorstenson, Ashley Holder and Daniel Schreeder. With them is Dr. Frederick P. Ognibene, director of the CC Office of Clinical Research Training and Medical Education, at the annual Clinical Investigator Student Trainee (CIST) Forum. More than 250 medical and dental students attended this year’s three-day event.

More than 250 medical and dental students attended the third annual Clinical Investigator Student Trainee (CIST) Forum held at the Clinical Center, Nov. 2–4. This event was co-sponsored by the NIH, Howard Hughes Medical Institute, Doris Duke Charitable Foundation, Sarnoff Endowment for Cardiovascular Science, and the Ellison Medical Foundation.

Students were invited to participate in the CIST lectures, panels and workshops based on their participation in year-long clinical and translational research fellowships and their expressed interest in becoming clinical investigators later in their careers. During the CIST Forum, investigators from NIH and other academic medical centers presented their ideas and experiences, discussed controversies in medicine and bioethics, and gave advice about how to succeed as a physician-scientist.

“These students have already committed to a year of research in addition to their formal medical education,” explains Dr. Frederick P. Ognibene, director of the CC Office of Clinical Research Training and Medical Education. “Our goal is to demonstrate that a career in research can be both scientifically and personally rewarding.”

For more information on clinical research training opportunities here, contact the CC Office of Clinical Research Training and Medical Education at (301) 496-9425.

 

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   Respected author discusses mental illness with patients as part of Patient Library lecture series

 Renowned author and authority on mood disorders, Dr. Kay Redfield Jamison took time to speak with patients at the Clinical Center on Nov. 3, as a part of a new series of author-patient dialogues presented by the NIH Patient Library. She candidly shared stories from her personal battle with depression and answered questions from the audience.

Dr. Kay Redfield Jamison shares her personal experience battling depression.
Dr. Kay Redfield Jamison shares her personal experience battling depression.

Well-known among mental health professionals and considered a leading authority on manic-depressive illness for decades, in 1995 Jamison authored her memoir, “An Unquiet Mind,” in which she revealed she suffered from the illness herself. At the discussion event, Jamison displayed the same open honesty that readers have appreciated about her book, sharing details of past psychotic episodes and manic behavior.

“She was dynamic and unafraid,” said Patty Potts, a nurse in the adult behavioral health unit who attended the event. “She had the courage to bring light to the darkness that surrounds the whole notion of mental illness and she was able to offer hope.  I was so glad to have the chance to listen to her.”

When asked if her memoir had effected her relationships with other psychiatrists when it was published, essentially outing her secret, Jamison responded in the affirmative, but went on to say, “But I don’t believe psychiatrists have a monopoly on compassion,” which brought laughter from the audience.

She discussed medications, bipolar disorder, behavioral problems and psychotic episodes—balancing the science of her profession with the impact of her personal stories—as she spoke with the more than 30 patients, their family members and even their doctors who were in attendance.

“There was no pretense in the room at all,” said Marie Kaplan, head librarian of the Patient Library and the event organizer. “She brought a stark honesty, humility and compassion to the dialogue with patients, not to mention some self-deprecating humor and hope. It was very moving.”

NIH Patient Library plans to continue the author-patient discussion events as part of an ongoing series.

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   Understanding NCI: A toll-free teleconference series

According to former Clinical Center patient, cancer survivor and advocate Susan Butler, the CC “is a magical place where science and compassion come together to save our lives.” 

Learn more about the CC’s cancer patients and survivors as they participate in clinical research to find new treatments for cancer. 

An educational toll-free teleconference will be held on Friday, Dec. 16, at 1 p.m. It will give cancer survivors and their family members an opportunity to learn more about the Clinical Center and the important role of cancer patients and survivors at NCI.

Join Dr. John I. Gallin, CC director; Dottie Cirelli, CC patient recruitment coordinator; and Susan Butler, who is a member of the Consumer Advocates in Research and Related Activities (CARRA), as they discuss NCI clinical trials. 

A question and answer session for participants will follow the panelists’ presentations. The call is toll-free and no registration is required. 

Call (800) 857-6584 and punch in the password 4683# to join the call. There will also be a toll-free playback available at (800) 216-4418 until Jan. 16, at 11:30 p.m.

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   News briefs

NIH-Duke training program in clinical research
Applications are being accepted for the 2006-2007 NIH-Duke Training Program in Clinical Research. The program is designed primarily for physicians and dentists who desire formal training in the quantitative and methodological principles of clinical research. Courses are offered at the NIH Clinical Center via video-conference and academic credit may be applied toward a Master of Health Sciences in Clinical Research from Duke University School of Medicine. The program, designed for part-time study, requires 24 credits of graded course work, plus a research project for which 12 units of credit are given. Additional information regarding coursework and tuition costs is available at http://tpcr.mc.duke.edu or by e-mail at tpcr@mc.duke.edu. The application deadline is March 1 and space is limited.

Annual gingerbread house decorating contest
Nursing and Patient Care Services’ recruitment and retention committee announces the 2nd Annual Gingerbread House Decorating Contest. Last year’s contest was such a hit that this year organizers opened the contest to all areas and departments in the Clinical Center. Participants can decorate a house in any theme or style they choose and the finished houses will be displayed in the Clinical Center atrium beginning Tuesday, Dec. 13, until Thursday, Dec. 15. The entries will be judged by staff, patients and visitors and prizes will be awarded for the top three houses. On the afternoon of Dec. 15, the houses will be donated to the Children’s Inn and the Safra Family Lodge.

Holiday concert series
Come to the Clinical Center’s atrium on the following dates for some great holiday entertainment:

RMD Carol Sing-along
Tuesday, Dec. 13, noon

Mini-Nutcracker by Young Ballet Troup
Thursday, Dec. 15, 4 p.m. 

NIH Singers
Tuesday, Dec. 20, 7 p.m.    

Volunteers needed for clinical studies
Jet lag study
NIH researchers are looking for travelers going east 6-8 time zones to study the effects of replacing hormones disrupted by jet travel. Participants will take a study medication (hydrocortisone, melatonin or placebo), fill out questionnaires and obtain salivary samples. Travel stay of 4-10 days at destination required. Time involved will include one screening visit and blood work and one follow-up visit. Healthy adults, ages 18-65 call 1-800-411-1222 (TTY 1-866-411-1010). Compensation will be provided for a completed study. Refer to study 05-CH-0037.

Healthy volunteers needed
NICHD is seeking healthy volunteers, ages 18-30, to participate in an investigational anthrax vaccine study. Medical tests will determine eligibility. Compensation provided. Please call 1-800-411-1222 (TTY 1-866-411-1010). Refer to study 04-CH-0283.

Research malaria vaccine study
Doctors are conducting a study to test the safety of a research malaria vaccine and its ability to generate immunity. Healthy males or non-pregnant females, between the ages of 18 and 50, who have never been exposed to malaria may consider participating. All study-related tests and medicines are provided at no cost, and you will be compensated. The research vaccine will not infect you with malaria. Call 1-800-411-1222 (TTY 1-866-411-1010). Refer to study 05-I-0133.

Ovarian function
Participate in a clinical study to learn more about ovarian function. Information obtained from this study will be used to develop a test that will enable physicians to uncover various kinds of ovarian dysfunction early in a woman’s life. Women 18 to 25 years of age call 1-800-411-1222, or TTY 1-866-411-1010, for information. Study-related tests or treatment are provided at no cost. Participants will be compensated. Refer to study 00-CH-0189.

West Nile vaccine
Help build better vaccines for a healthier world. Healthy adults 18-50 years old are needed to participate in the study of an investigational West Nile virus vaccine. Financial compensation is provided. These studies are being conducted by the Vaccine Research Center. To volunteer, or for more information, please call 1-866-833-LIFE or TTY 1-866-411-1010. Refer to study 05-I-0126.

Abnormal platelets study
Platelets are blood cells that help to stop bleeding, and people with abnormal or missing platelet sacs tend to bleed longer than others. NIH doctors are conducting a study to examine how platelet sacs are formed and what happens to cause bleeding disorders. Study results may contribute to the medical care, treatment and prevention of problems associated with this disorder. If you have been diagnosed with abnormal platelets, call 1-800-411-1222 (TTY: 1-866-411-1010). Refer to study 04-HG-0226.

Leading thinker in molecular imaging speaks at annual Doppman lecture
Dr. Sanjiv “Sam” Gambhir, a leader in molecular imaging, gives the keynote address at the Doppman lecture.
Dr. Sanjiv “Sam” Gambhir, a leader in molecular imaging, gives the keynote address at the Doppman lecture.
Dr. Elias A. Zerhouni, NIH director, and Dr. John I. Gallin, CC director, joined a standing-room-only audience for the fifth annual Doppman lecture on Oct. 5 to hear Dr. Sanjiv “Sam” Gambhir, a leader in molecular imaging, give the keynote address.

During his lecture “Of Mice and Men: Molecular Imaging in Living Subjects,” Gambhir described the research his team is conducting at Stanford University School of Medicine where they are working to create new ways to see inside the body, with a particular focus on cancer biology and gene therapy.

The annual John Doppman Memorial Lecture for Imaging Sciences honors the memory of a devoted physician, researcher and teacher who spent more than 30 years at NIH and was chief of the Clinical Center’s Diagnostic Radiology Department.

Emergency closure and dismissal procedures for NIH employees
If a weather-related or other emergency arises before the workday begins, the Office of Personnel Management (OPM) will provide an announcement regarding the operating status of the federal government to the media as early as possible. The status will also be posted online at http://www.opm.gov and a recorded message will be available at (202) 606-1900.

For more information, read OPM’s complete guide to the Washington, D.C., area dismissal or closure procedures at http://www.opm.gov/ oca/compmemo/dismissal.htm.

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   Upcoming Events

December 12 (Monday)
12:30 p.m. Masur Auditorium
Manchester String Quartet at NIH
Made possible by the Merck Company Foundation

December 13-15 (Tuesday-Thursday)
Hatfield Center Atrium
Gingerbread House Decorating Contest
The houses will be displayed in the atrium and there will be a ballot box next to each one for patients, visitors and staff to cast their votes for the favorites.

December 13 (Tuesday)
3 p.m. Masur Auditorium
NIH Director's Lecture Beyond the Double Helix: Reading and Writing the 'Histone Code'
C. David Allis, PhD, The Joy and Jack Fishman Professor and Head, Laboratory of Chromatin Biology, The Rockefeller University, New York

December 13 (Tuesday)
Noon Hatfield Center Atrium
Holiday Concert Series: RMD Carol Sing-Along

December 14 (Wednesday)
3 p.m. Masur Auditorium
NIH Director's Lecture Neurodegeneration: Too Much of a Good Thing Kills You
John Hardy, PhD, Chief, Laboratory of Neurogenetics, NIA

December 14 (Wednesday)
Noon-1 p.m. Lipsett Amphitheater
Grand Rounds: Friendly Fire in the War Against Cancer: Why Screening Is a Double-Edge Sword
H. Gilbert Welch, MD, MPH, Professor of Medicine, Professor of Community and Family Medicine, Dartmouth Medical School; Co-Director VA Outcomes Group

December 15 (Thursday)
4 p.m. Hatfield Center Atrium
Holiday Concert Series: Mini-Nutcracker by Young Ballet Troup

December 20 (Tuesday)
7 p.m. Hatfield Center Atrium
Holiday Concert Series: NIH Singers

December 21 (Wednesday)
Noon-1 p.m. Lipsett Amphitheater
Grand Rounds: New Therapies for Crohn's Disease
Peter Mannon, MD, Head, Clinical Inflammatory Bowel Diseases Research Unit, NIAID
Monocional Antibody Therapy of Eosinophilic Gastroenteritis: Insights into Disease Pathogenesis
Calman Prussin, MD, Head, Clinical Allergy and Immunology Unit, NIAID

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   Celebrity composer Marvin Hamlisch treats Safra Family Lodge guests to a holiday concert

Marvin Hamlisch is joined by Alonzo Medley (front in antlers), son of Lodge staff member Dilcia Stephens-Medley. From right to left are: Jan Weymouth, executive director, Safra Family Lodge; Amy McGuire, executive director, Foundation for NIH; and Dr. John I. Gallin, CC director.
Marvin Hamlisch is joined by Alonzo Medley (front in antlers), son of Lodge staff member Dilcia Stephens-Medley. From right to left are: Jan Weymouth, executive director, Safra Family Lodge; Amy McGuire, executive director, Foundation for NIH; and Dr. John I. Gallin, CC director.

Legendary composer Marvin Hamlisch gave a special holiday performance Dec. 10, at the Edmond J. Safra Family Lodge. Lodge guests and their loved ones-who are adult patients at the Clinical Center-joined an intimate crowd of about 60 people to hear Hamlisch perform holiday tunes and some of his award-winning music, including selections from the movies “The Way We Were” and “The Sting.”

“It was beautiful. I enjoyed it very much,” said Hugh Hall, a patient from the Bahamas. Henry and Suzanne Schiller of Massachusetts were also part of the audience. Suzanne described being moved by Hamlisch's performance as well as the concert location. “All of us at the Lodge are like family. I feel better here than I do at home,” she said.

“The Safras have been friends of mine and my wife Terre for over ten years,” Hamlisch said. “Opening this Lodge is one of the best ideas and most beneficial projects I could imagine.”

 

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   Images from the royal couple's visit to the Clinical Center

Prince Charles takes a moment to chat with a young patient and her family as he and his wife Camilla, Duchess of Cornwall, prepare to leave the Clinical Center on Nov. 3, following a briefing on osteoporosis research.
Prince Charles takes a moment to chat with a young patient and her family as he and his wife Camilla, Duchess of Cornwall, prepare to leave the Clinical Center on Nov. 3, following a briefing on osteoporosis research.




The Duchess of Cornwall autographs a copy of the Clinical Center News for one of her many smiling admirers.
The Duchess of Cornwall autographs a copy of the Clinical Center News for one of her many smiling admirers.




Camilla speaks to a group of osteoporosis researchers and leaders in the Clinical Center medical board room as Prince Charles, seated beside her, listens. Camilla’s interest in the medical condition, which afflicted her mother and grandmother, prompted the royal couple’s visit to NIH as a part of their eight-day US tour.
Camilla speaks to a group of osteoporosis researchers and leaders in the Clinical Center medical board room as Prince Charles, seated beside her, listens. Camilla’s interest in the medical condition, which afflicted her mother and grandmother, prompted the royal couple’s visit to NIH as a part of their eight-day US tour.

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Editor: Jenny Haliski

Clinical Center News, National Institutes of Health, Building 10, 10 Center Drive, Room 12C440, Bethesda, MD 20892-1504. Tel: 301-496-6787. Fax: 301-402-2984. Published monthly for CC employees by the Office of Communications, Patient Recruitment, and Public Liaison. News, article ideas, calendar events, letters, and photographs are welcome.

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This page last reviewed on 06/9/11



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