November 2012

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Published monthly for CC employees by the Office of Communications and Media Relations. News, article ideas, calendar events, letters, and photographs are welcome. Submissions may be edited.

Clinical Center News
National Institutes of Health
Building 10, 10 Center Drive
Room 12C440,
Bethesda, MD 20892-1504
Tel: 301-496-6787
Fax: 301-402-1982

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RM ResearchMatch

NIH Clinical Cener on ResearchMatch

Stop searching on your own for clinical studies.
Let opportunities to join a study find you.

The NIH Clinical Center has joined ResearchMatch, an online, national clinical research registry that "matches" people who want to participate in clinical studies with researchers who are seeking volunteers. To learn more, visit researchmatch.org/?rm=Volunteer3

 

Mechanical space serves as model for future projects

Jim Wilson and Fred Manuel working on an exhaust pipe
Jim Wilson (left) and Fred Manuel visit the Hatfield Building's
dedicated mechanical space on the second floor to check on an exhaust pipe that manages airflow in the laboratory below.

To the untrained eye, the mechanical space on the even floors of the Clinical Center's Hatfield Building is a maze of wires, tracks and pipes. Architects and engineers, however, understand the area dedicated to keep out of sight the tweaks necessary to run the hospital.

A recent visit from professionals planning an animal holding facility between NIH Buildings 7 and 9 gave the CC's Office of Space and Facilities Management (OSFM) a chance to show off the space they reserve for easy adjustments and corrections to plumbing, wiring and air ventilation.

"The mechanical space is paramount for quality care and quality assurance," said Sara O'Neil-Manion, principal at O'Neil & Manion Architects, the firm planning the new facility. "If you don't have adequate space and your mechanical systems don't get maintained, you get real issues with the system performance."

The Hatfield Building, which opened in April 2005, features patient care and laboratory areas on the odd floors, while the even arms of the building off the center atrium house the facility infrastructure. There lies information technology cabling for electric and Internet access, chilled water systems to keep rooms at a suitable temperature for advanced research equipment, airflow controls to easily make a specific room negative or positive pressure, and transportation tracks to bring supplies from storage to the units and labs.

The separation of these service materials into an unseen but accessible area allows for important patient care and research activities to continue uninterrupted and also speeds the alteration process for maintenance and repairs.

"The NIH is known for rapid response to public health issues, and this design allows us to be flexible at a relatively quick pace," Debra Byram, chief of the OSFM, said. "I always think of the guy on the ladder with the ceiling tile pushed away, fiddling with wires and pipes. We don't have that anymore. You can still conduct business in a space rather than having to shut it down to fix or change something."

"When we designed the Hatfield Building, there were only a couple facilities in the country with this set-up," said CC Director Dr. John I. Gallin. "We selected Bob Frasca of ZGF as the architect in part because of his design of the Fred Hutchinson Cancer Center in Seattle, which had this design feature."

"This design is truly a testament to the Clinical Center's commitment to research and patient care, and I am glad other institutions can learn from our experience and implement the same in their architecture.," Gallin said.

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Pharmacogenomics program personalizes drug prescribing

The Clinical Center initiated a formal pharmacogenomics testing program Sept. 19.

Pharmacogenomics, which may also be called pharmacogenetics, is the use of information about a person's genes to choose drugs and drug dosages that are likely to work best for that individual.

"Driven by the deciphering of the human genome, the discipline of pharmacogenomics has become an important vehicle to increase patient safety over the past decade," said Dr. David Henderson, deputy director for clinical care. "Testing for known genetic predispositions to adverse drug reactions moves us closer toward the concept of individualized medicine."

The CC's program is focused initially on three medications – abacavir, allopurinol, and carbamazepine – in an effort to improve safety. The Department of Transfusion Medicine is able to test for human leukocyte antigen, or HLA, gene variations that may predict severe reactions to these medications, such as fever, hypotension, skin rash, and more severe conditions like Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. HLA sequence testing is required prior to starting abacavir in a patient and strongly recommended for patients initiating allopurinol or carbamazepine treatment.

"These are fortunately rare reactions," explained Dr. Juan Lertora, director of clinical pharmacology. "But if they occur, they can be life-threatening."

A clinical decision support (CDS) tool within the Clinical Research Information System provides researchers with a mechanism to check for relevant HLA variants at the time of drug ordering. Logic built into the CDS program also provides guidance to the prescriber as to the recommended course of action.

"We're trying to look at your genetics to make sure you don't have a significant complication to the drug," said Dr. William Figg, chief of the Molecular and Clinical Pharmacology Section of the National Cancer Institute. "If you're able to metabolize the drug, it will give us insight in order to guide our therapy and make it safer for you."

In the future, drugs will be added to the program where knowledge of gene variants can be used to maximize therapeutic efficacy or reduce the potential for drug-related toxicity.

Added deputy chief of the Pharmacy Department Dr. Barry Goldspiel, "To me, pharmacogenomics and pharmacogenetics are just another piece of the puzzle to make sure the patient gets the right drug and the right dose of that drug."

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Volunteer celebrates 300th platelet donation

Hal Wilkins and Elmer Sappington
Hal Wilkins (left), NIH Blood Bank recruitment specialist, presented long-time platelet donator Elmer Sappington with a Fenwal™
Hall of Fame award from the maker of the
platelet separation machine.

Elmer Sappington certainly doesn't consider himself a hero. Yet it is the quiet dedication of this Altoona, Pa. grandfather that has earned him a place of honor in the NIH Blood Bank for giving more than 300 platelet donations during the past 40 years.

Platelets are small blood cell fragments that help the blood to clot, which prevents excessive bleeding. Each year, more than 30,000 units of platelets are transfused at the Clinical Center to treat patients here undergoing cancer therapy or stem cell transplants, or with other diseases that disrupt platelet production in the bone marrow.

Healthy people can donate platelets through a process called plateletpheresis. Blood flows through a needle in one arm into a machine that separates, concentrates and collects the platelets. Red blood cells and other parts of the blood are returned to the volunteer through a needle in the opposite arm. The NIH CC Blood Bank – forerunner to the Department of Transfusion Medicine – pioneered the use of platelets as a transfusion product almost 50 years ago and helped develop the process of plateletpheresis.

Sappington started donating at the NIH in 1972 when his sister was being treated at the CC for leukemia. Back then, he said, the donation process was much different.

"It was a four-hour ordeal and it was a four-foot, by four-foot, by four-foot machine," said Sappington. "There weren't any radios or videos to watch or listen to. You were dedicated to what you were doing completely."

Decades later, the donation process has changed dramatically, and now Sappington said he can donate in a little more than an hour – about the time it takes to watch a video and finish his hot chocolate. He makes the seven-hour roundtrip once a month, much to the appreciation of the staff.

"He has come in every month for years and years and years, and he's just a great, happy person," said Monica Riordan, a CC apheresis specialist.

His dedication earned Sappington a nomination from the NIH Blood Bank staff for the Fenwal™ Hall of Fame award from the makers of the plateletpheresis machine. He was chosen as one of 12 recipients this year and will be featured in the company's 2013 calendar.

Sappington also donated bone marrow in the past to an unrelated recipient. He plans to keep visiting the platelet center well past his 400th donation, which he hopes to reach within the next eight years.

"People need all the help they can get. If you became disabled for whatever reason, you would want someone to help you," Sappington said. "It's the right thing for everybody."

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Chinese researcher visits NIH, expands research horizons

Chunping Ni, Li Yang and Mike Krumlauf
Visiting nurse researcher Chunping Ni (center) discusses research data with fellow nurse researchers Li Yang and Mike Krumlauf.

Chinese nurse researcher Chunping Ni is spending six months with Clinical Center Nursing and Patient Care Services, focusing primarily on nursing education, mental health and epidemiological studies exploring post-traumatic stress disorder.

"During my time here I hope I can learn so many things: innovative research ideas, advanced research methods and the working spirit of NIH," said Ni, who is an associate professor and director of the military medical university's Fundamental Nursing Department.

Ni said that she is looking forward to working with many individuals and expanding some of her research interests by learning more about genetics and genomics.

"Here I can feel the spirit of collaboration and innovation," she added.

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Resident Career Day introduces options in clinical research

Nkiruka Emeagwali, Sean Kim, and Tara Berman
Medical residents (left to right) Drs. Nkiruka Emeagwali, Sean Kim, and Tara Berman visited the NIH to learn
more about their clinical research fellowship options.

The Clinical Center's second annual Resident Research Career Day on Oct. 9 welcomed future clinician-scientists from across the United States and afforded an opportunity to share information about academic careers with a focus on scientific research.

The Office of Clinical Research Training and Medical Education organized the event in conjunction with the National Graduate Student Research Conference and the annual NIH Research Festival.

"We hope residents will take advantage of this unique opportunity to explore advances in biomedical science, network with established investigators and clinical colleagues, and learn more about training and career development resources available through the NIH Intramural Research Program," said Dr. Robert M. Lembo, the CC executive director of graduate medical education.

Dr. Steven Holland, chief of the Laboratory of Clinical Infectious Diseases at the National Institute of Allergy and Infectious Diseases, gave the keynote address: "The Unexpected Intersection of Mycobacteria, Lymphatics, and Leukemia."

Internal medicine resident Dr. Tara Berman from St. Luke's-Roosevelt Hospital Center in New York City said, "I thought that by coming here, I would be exposed to this fantastic institution and meet people and hear about how I could incorporate research into my career with the different programs and opportunities that are available to us as residents."

Dr. Sean Kim, an internal medicine resident at Hahnemann University Hospital-Drexel University College of Medicine in Philadelphia, added that he was excited to come to the NIH and see what was "behind the gates."

Medical residents (right to left) Drs. Nkiruka Emeagwali, Sean Kim, and Tara Berman visited the NIH to learn more about their clinical research fellowship options.

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Know where to find help before an emergency

AED SignDo you know where help is if you need it? New signage announcing automated external defibrillators (AED) in the Clinical Center should call attention to the life-saving machines.

AEDs introduce an electrical current to the heart to reestablish a proper rhythm in the case of a cardiac incident.

"It is important to know where the AEDs are before there is an emergency so you can act fast," said Connie Koefka, CC nurse and member of the Code Blue team. "If you find someone in the hospital who is not responding, you could use it and potentially save their life."

The CC boasts 95 AEDs primarily in the elevator lobbies of the Hatfield Building and sporadically around the Magnuson Building. If someone is having a cardiac incident, call the Code Blue team at 111 and follow instructions that accompany the AED.

Cardiopulmonary resuscitation and AED training is available through the Office of Research Services Division of Occupational Health and Safety. Call 301-496-2960 for more information.

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Informatics chief honored by award named for his mentor

Dr. James Cimino
Dr. James Cimino

Dr. James Cimino, the chief of the Laboratory for Informatics Development at the Clinical Center, has been named the recipient of the 2012 American Medical Informatics Association (AMIA) Donald A.B. Lindberg Award for Innovation in Informatics. This award recognizes Cimino's dedication and contribution to the field of biomedical informatics.

The award was named after the director of the National Library of Medicine (NLM) and first AMIA president Lindberg, who pioneered the application of computer technology to health care and dramatically altered the extent of informatics' practice and research.

Cimino commented on what this award meant to him. "It is a tremendous honor for me to be given this award by an organization that has been my professional home since it began more than 20 years ago," he said. "I am doubly pleased that the award honors Dr. Lindberg, who has been an important mentor, role model and supporter of my career since my NLM-sponsored postdoctoral fellowship, through many years of involvement with exciting NLM projects while at Columbia University, and now with my appointment at the NIH."

The informatics chief joined the CC in January 2008. In his tenure he developed and launched the Biomedical Translational Research Information System (BTRIS), an NIH-wide repository of data collected over the past four decades. BTRIS provides clinical investigators with access to identifiable data for the subjects on their own active protocols, while providing all NIH investigators with access to de-identified data across all protocols. The system allows users to create data sets to support ongoing studies and stimulate ideas for new research with advanced search, filtering, and aggregation methods.

Cimino will be honored at the AMIA Leadership Dinner in November.

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Hyundai grant supports pediatric cancer research

Pediatric patients and National Cancer Institute (NCI) staff gathered in the Clinical Center on Sept. 19 to celebrate Hyundai Hope on Wheels and its grant to NCI's Pediatric Oncology Branch associate scientist Dr. Rimas Orentas. Jared Hart (at right) joined in the fun, leaving his mark on an art project.

The nonprofit organization is the united effort of Hyundai Motor America and its more than 800 dealers to raise awareness about childhood cancer and to celebrate the lives of the children battling the disease.

Jared Hart

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Foreign visits evidence Clinical Center as
international role model

Chinese dignitaries and Dr. Gallin
Chinese dignitaries met with CC Director Dr. John I. Gallin (middle)
and other staff during an October visit.
Dr. Frederick P. Ognibene and Denise Ford talking with sixteen Norwegian hospital presidents
Deputy Director for Educational Affairs and Strategic Partnerships
Dr. Frederick P. Ognibene (left) and Hospitality Services Chief
Denise Ford (second from left) led a tour of the CC for
Norwegian hospital presidents in September.

Two foreign groups visited the Clinical Center recently to learn about clinical research in the United States and build connections to professional communities across oceans.

In the last few years, the Clinical Center has made strides in international relations – bringing the "Introduction to the Principles and Practice of Clinical Research" course to China, Russia, Nigeria and India and sending clinical research nursing education staff to China to communicate about their specialty practice.

Sixteen Norwegian hospital presidents on Sept. 27 heard an overview of the hospital and its latest programs and advances before touring the facility.

On Oct. 16, 30 Chinese translational researchers heard from CC department and section chiefs to learn more about the core infrastructure required to support a clinical research enterprise. They visited the National Center for Advancing Translational Science that afternoon.

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Symposia welcome the blood community

Dr. Harvey G. Klein presenting an award to Dr. Kenneth C. Anderson
Department of Transfusion Medicine chief Dr. Harvey G. Klein (left) presented the Richard J. Davey Lectureship Award to the 2012 recipient, Dr. Kenneth C. Anderson of the Dana-Farber
Cancer Institute.

The Clinical Center's Masur Auditorium hosted two symposia addressing the latest in the field of transfusion medicine in September.

The well-attended 31st Annual Immunohematology and Blood Transfusion Symposium was held on Sept. 13. Dr. Kenneth C. Anderson, director of the Jerome Lipper Multiple Myeloma Center and LeBow Institute for Myeloma Therapeutics at the Dana-Farber Cancer Institute, and Kraft Family Professor of Medicine at the Harvard Medical School, was presented the Richard J. Davey Lectureship Award. The annual honor recognizes the recipient's significant contribution toward the field of transfusion medicine.

Red Cell Genotyping 2012: Clinical Applications on Sept. 14 was a joint effort by the CC Department of Transfusion Medicine and the BloodCenter of Wisconsin. The symposium, now an annual event at the NIH, began with a keynote speech on "Science and the Media" from The New York Times best-selling author, John M. Barry. Dr. John I. Gallin, CC director, announced a new grant option to foster collaborations between intramural and extramural researchers using CC resources. Several former and the acting presidents of the AABB, previously known as the American Association of Blood Banks, shared their views on the rapidly expanding technology of red cell genotyping and its clinical applications within the field of transfusion medicine.

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NICHD conducts study on reproductive disorders

The Eunice Kennedy Shriver National Institute of Child Health and Human Development is conducting a research study at the Clinical Center on reproductive disorders in patients with either early (precocious) puberty or who are age 14 and older with delayed or absent pubertal development and/or low levels of testosterone or estrogen. This study seeks to learn how gonadotropin-releasing hormone (GnRH) controls puberty and fertility by studying the range of abnormalities in GnRH-secretion disorders and how they are inherited. Call 1-866-444-2214 (TTY-1-866—411-1010) and refer to studies 12-CH-0049 and 12-CH-0050.

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Upcoming Events

Astute Clinician Lecture
November 7, 2012
3:00 pm – 4:00 pm
Masur Auditorium

Dr. Huda Y. Zoghbi will deliver the annual Astute Clinician Lecture, on "The Value of Clinical Clues in Solving Neurogenetic Riddles." Zoghbi is professor of pediatrics, neurology, neuroscience, and molecular and human genetics at Baylor College of Medicine, and serves as an investigator with the Howard Hughes Medical Institute. She is also the director of the Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital.

The Astute Clinician Lecture was established through a gift from Haruko and Dr. Robert W. Miller and is part of the NIH Director's Wednesday Afternoon Lecture series. For information and reasonable accommodation, contact Jacqueline Roberts at 301-594-6747.

Family Caregiver Day Information Fair & Expo
November 13, 2012
10:00 am – 2:00 pm
Hatfield Building seventh floor bridge

In recognition of National Family Caregiver Month, Clinical Center departments and outside exhibitors will offer resources for family caregivers. This event does not require registration. For program details, visit www.cc.nih.gov/wecare/.

Combined Federal Campaign Awareness Event: Games of Thrones
November 29, 2012
12 pm – 1:30 pm

The Clinical Center will hold an event to increase awareness of the Combined Federal Campaign, which promotes and supports philanthropy that provides all federal employees the opportunity to improve the quality of life for all. Games of Thrones will be a team competition consisting of popular TV game shows.

NCCAM Stephen E. Straus Distinguished Lecture
December 5, 2012
9:00 am – 10:00 am
Lipsett Amphitheater

This year's annual lecture hosts Dr. David G. I. Kingston, distinguished professor and director of the Virginia Tech Center for Drug Discovery at the Virginia Polytechnic Institute and State University. Kingston's talk "Natural Products: Drugs and Medicines for All Reasons and All Seasons" will review some of the past successes of the natural products approach, with an emphasis on anticancer activity and the success of natural products as drugs and herbal medicines. The event is open to the public.

The Stephen E. Straus Distinguished Lecture was established to honor the founding director of NCCAM. This series brings leading figures in science and medicine to the NIH to speak about their perspective on the field of complementary health therapies. The lectures shed light on the evolution of complementary health practice and research, and the current use of complementary therapies by the public.

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