Doing More With Less: A Radiologist Shares His Expertise in Nigeria

Steffen Sammet (fifth from left) with colleagues at the University College Hospital, Ibadan, Nigeria

Steffen Sammet (fifth from left) with colleagues at the University College Hospital, Ibadan, Nigeria

Practicing medicine is hard enough under the best circumstances, with state of the art facilities and the latest in equipment and technology. But imagine trying to treat patients at the largest hospital in the country when the electricity goes out on average 10 times a day, or without a reliable telephone or water system. That’s what faces doctors at the University of Ibadan, which has the largest hospital in Nigeria.

Physicians at the University College Hospital, Ibadan are among the most experienced and talented clinicians in the world, but they struggle to overcome these obstacles. A particular challenge is radiology and medical imaging. Radiology, by its nature, requires sophisticated and expensive equipment—CT scanners, MRI machines and computer systems that need reliable power, routine quality control and maintenance.

Thanks to an NIH grant (NIH/NINDS Grant #1R25NS080949 and NIH/FIC Grant #5R24TW008878), a group of physicians and researchers from the United States is working with doctors in Ibadan to help them improve their medical imaging systems. In turn, the team from Nigeria is teaching them about listening to their patients, and doing more with less.

Steffen Sammet, MD, PhD

Steffen Sammet, MD, PhD

Steffen Sammet, associate professor of radiology and medical physics at the University of Chicago Medicine, recently joined researchers from Northwestern University and Lurie Children’s Hospital of Chicago for a trip to Ibadan, part of an ongoing exchange program to help improve imaging capabilities for treating stroke and epilepsy in Nigeria. The trip followed a month-long visit to Chicago by the team from Ibadan that coincided with the Radiological Society of North America’s annual meeting in December.

Sammet said that the biggest challenge his partners from Ibadan face is finding high-functioning technical equipment for imaging that can work within the confines of the sometimes unreliable infrastructure. For instance, they can’t use an MRI machine with high-powered 1.5 or 3 Tesla magnets that are common in the US because the power often goes down. So on the most recent trip, he and his colleagues helped them set up a technique called diffusion imaging that can work even with lower-field magnets and still generate high-quality images of stroke in the brain. Continue Reading »

A Look Behind Low Vaccination Rates in Chicago-area Schools

Dr. Bartlett practicing what she preaches, with 2-year-old son Will while he gets a hepatitis A vaccination.

Dr. Bartlett practicing what she preaches, with 2-year-old son Will while he gets the hepatitis A vaccine.

Last week NBC 5 Chicago ran an investigative report on the surprisingly low vaccination rates of children in Chicago-area schools. After reviewing data from the Illinois State Board of Education, they found 369 schools across the Chicago area where more than 10 percent–and as many as 76 percent–of students are not vaccinated for one or more serious illnesses.

Despite decades of evidence that vaccines are safe and effective, some parents still refuse to vaccinate their children out of the mistaken belief that they are harmful or unnecessary. NBC investigative reporter Tammy Leitner spoke to Allison Bartlett, MD, Associate Medical Director of the Infection Control Program at the University of Chicago Medicine Comer Children’s Hospital, about why vaccines are necessary, and the danger posed by increasing numbers of unvaccinated children in schools. You can see Dr. Bartlett in the video version of the story. What follows is a lightly edited version of their complete conversation:

Allison Bartlett, MD, MS

Allison Bartlett, MD, MS

Why should children be vaccinated?

We have a lot of vaccines that are available that were developed over the years to combat the most common and most serious illnesses in childhood. We often don’t think about those illnesses today, because no one I know has ever seen a child with measles or polio, so we don’t think it’s a really big deal. But when we think back historically about how devastating these illnesses were, we’re so fortunate today to have these vaccines available to help keep our kids safe.

Are vaccines foolproof?

Unfortunately they’re not foolproof. When someone gets a vaccination, we know that maybe 95 percent of the time it works just as we want. But there is a chance that, for some reason, the vaccine isn’t being as effective in a certain person. We’ve learned that the hard way with the chicken pox vaccine. When it first came out we gave every child a dose of the chicken pox vaccine, and then we saw that after several years there were a certain number of kids that were still getting the chicken pox infection. It looked like maybe 10 or 20 percent of kids, even though they got the vaccine, were still getting chicken pox and it didn’t look like the vaccine worked. So what we do now is give everyone a second dose, and once we made that recommendation we’re seeing a lot less chicken pox. That’s much better for our kids.

How important is it for every child to be vaccinated?

It’s critical that every child who can be vaccinated, should be vaccinated. There are some important exceptions in kids who shouldn’t be vaccinated: children with cancer whose immune systems aren’t working, children who are born with immune system problems, and some young infants that just aren’t old enough to be vaccinated. So it’s our duty for everyone else to be vaccinated to protect the people who really truly cannot be vaccinated.

One of the reasons that we’ve been so successful at eradicating some of these diseases is that we have something called herd immunity. This basically means that even though not every vaccine is 100 percent effective, and we know that 100 percent of people can’t be vaccinated, as long as the overwhelming majority of people are vaccinated and respond to the vaccine, the community is kept safe. Continue Reading »

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The Molecular Future of Neurosurgery

Robert Martuza from Massachusetts General Hospital, along with UChicago's Issam Awad, Maciej Lesniak and Peter Warnke at the symposium on neurosurgery on March 26, 2014.

Robert Martuza from Massachusetts General Hospital, along with UChicago’s Issam Awad, Maciej Lesniak and Peter Warnke at the symposium on neurosurgery on March 26, 2014.

The word neurosurgery conjures images of drills, scalpels, saws and all manner of sharp, invasive instruments. But the tools of neurosurgeons in the future are unlikely to be based in stainless steel, at least according to neurosurgeons from the University of Chicago Medicine.

At a symposium held on March 26, David Frim, MD, Chief of the Section of Neurosurgery, Maciej Lesniak, MD, Director of Neurosurgical Oncology, Peter Warnke, MD, Director of Stereotactic and Functional neurosurgery, and Issam Awad, MD, the John Harper Seeley Professor of Surgery, with distinguished guest Robert Martuza, MD, Chief of the Neurosurgical Service at the Massachusetts General Hospital in Boston, discussed what they hope will be the basis for neurosurgical treatments into and beyond the 21st century: viruses, genes, proteins and molecules.

“The role of the academic neurosurgeon is to put himself out of business,” said Martuza, a pioneer of gene therapy approaches toward treating brain tumors and mentor to many prominent neurosurgeons around the world, including Frim and Lesniak. “The neurosurgery of the future is to exploit the internal anatomy of brain circuits and change what neurons do—strategies of altering the brain in ways that are not thought of traditionally neurosurgical.”

The average adult brain weighs around just three pounds, and is made of cells, fat, proteins and blood vessels. Remarkably, when these components are functioning correctly, they generate senses, memories and thought, and regulate functions critical to life such as movement, breathing and the heartbeat. Encased in the skull and protected by the blood-brain barrier, which keeps harmful toxins and other molecules in the blood from entering, the brain is normally well-defended from harm. However, because of these vital functions and natural defenses, when disease or injury does occur, it can be difficult to treat. Continue Reading »

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LabBook April 11, 2014

Brain scan images on display at the Crerar Library as part of the Body as Data exhibit, on display until June 20.

Brain scan images on display at the Crerar Library as part of the Body as Data exhibit, on display until June 20.

A protein named Tim, Your Inner Fish, schizophrenia and much more in this week’s LabBook, our weekly roundup of University of Chicago Medicine and Biological Sciences research news from our blogs, around campus and the internet.

Last two weeks on the blog:

From our partner blog, UChicago Cancer Conversations:

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University of Chicago Faculty Named Guggenheim Fellows

The John Simon Guggenheim Foundation awarded 177 Fellowships today to a diverse group of scholars, artists and scientists, including two members of the University of Chicago Medicine & Biological Sciences faculty.

Lainie Ross, MD, PhD

Lainie Ross, MD, PhD

Lainie Ross is the Carolyn and Matthew Bucksbaum Professor of Clinical Ethics and a professor of pediatrics, medicine and surgery. She’s also an associate director of the MacLean Center for Clinical Medical Ethics, and the codirector of the Institute of Translational Medicine.

“I am very honored to have been selected,” Ross said. “It is even more special because I am following in the footsteps of my two mentors, Paul Ramsey (Guggenheim Fellow 1977 humanities religion) and Jay Katz (Guggenheim Fellow 1980 medicine and health). It helps to stand on the shoulders of giants.”

She said she plans to spend her fellowship term writing a book tentatively titled “From Peapods to Whole Genomes: Incidental Findings and Unintended Consequences in a Post-Mendelian World.” The study has taken on a greater urgency as the cost and time required to perform whole genome sequencing has dropped from $3 billion dollars and fifteen years to less than $1,000 dollars and less than one week.

Science Life has spoken to Dr. Ross a number of times about ethical issues raised by genetic testing and shortages of available donor organs, including unintended consequences from an NCAA policy to screen football players for sickle cell anemia, how residents on the South Side of Chicago feel about contributing blood and tissue samples to biobanks and a proposal for a more efficient allocation of donor kidneys.

Joe Thornton, PhD

Joe Thornton, PhD

Joe Thornton is a professor in the Department of Human Genetics and Department of Ecology & Evolution, known for resurrecting ancestral genes and tracing the mechanisms by which proteins evolve new functions. He said he also plans to write a book during his fellowship.

“I will use it to write a book on the Functional Synthesis of Molecular Biology and Evolution — the recent, and exciting, union of these disciplines to uncover the mechanisms by which genes and proteins evolved new functions and to understand the historical causes of the structure and function of modern-day molecules,” he said.

Science Life has also covered Thornton’s work over the past few years, including a 2012 study in which he used a form of “molecular time travel” to observe a crucial event in the evolutionary history of life on Earth, and again last year when he used a similar technique to find two genetic mutations that set the stage for how our reproductive systems work today.

Haun Saussy, a professor in the Department of Comparative Literature at the University of Chicago, was also awarded a Guggenheim Fellowship. The Foundation has posted a complete list of the 2014 fellows on their website.

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A Conversation with Neil Shubin About “Your Inner Fish,” Premiering Tonight on PBS

Lance Grande (left), distinguished service curator at the Field Museum, with UChicago Prof. Neil Shubin

Lance Grande (left), distinguished service curator at the Field Museum, with UChicago Prof. Neil Shubin

Your Inner Fish,” UChicago biologist Neil Shubin’s new TV series about the evolutionary links between humans and our oldest ancestors, debuts tonight on PBS at 8 pm CST. Last week at an advance screening of the first episode, Prof. Shubin sat down for a Q&A with Lance Grande, distinguished service curator at the Field Museum, and answered questions from the audience about the show. You can listen to the complete conversation in a special edition of our podcast:

If you can’t tell, we’re pretty excited about the show, and it’s generated a lot of buzz elsewhere in the run up to tonight’s premiere. The Washington Post and USA Today previewed the series, and the Chicago Tribune’s Steve Johnson spent the day with him as he taught his comparative biology class on human anatomy to UChicago undergrads. Earlier this week Claudia Dreifus from the New York Times spoke to Shubin about his work and why he wants to tell the story of evolution this way. In our favorite part of the interview, he talks about the show’s effect on his dad, a fiction writer who is somewhat averse to science:

A few weeks ago, I brought my parents a screener of “Your Inner Fish.” When my dad, who is 92, saw it, I think he really understood what I’ve been trying to do with my books and this series: bring complex ideas to a broad audience. All these years, I’ve been going off to the Arctic and he never quite understood why. It came together in a way that fit: the experiments, the trips, the fossils. He was blown away.

You can find out more about one of Prof. Shubin’s most recent discoveries about the hind limbs of our ancient fishy ancestors here on Science Life.

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Genetic Predisposition To Liking Amphetamine Reduces Risk Of Schizophrenia And ADHD

adderall

Scientists have had a long-standing hypothesis that dopamine, the neurotransmitter connected with the euphoric effects of amphetamine, is related to schizophrenia and ADHD. Now, in a new study published in the Proceedings of the National Academy of Sciences this week, researchers from the University of Chicago show that genetic variants associated with enjoying the effects of d-amphetamine — the active ingredient in Adderall — are also associated with a reduced risk for developing schizophrenia and attention deficit hyperactivity disorder (ADHD).

“Some of the variants that make you like amphetamine also appear to make you less likely to develop schizophrenia and ADHD,” said study leader Abraham Palmer, associate professor of human genetics at the University of Chicago. “Our study provides new insights into the biology of amphetamine and how it relates to the biology of risk for these psychiatric diseases.”

Palmer and his team previously conducted a genome-wide association study (GWAS) to identify genetic variants associated with experiencing the euphoric effects of amphetamine, which is thought to affect risk for drug abuse. Almost 400 volunteers were given d-amphetamine in a double-blind, placebo-controlled experiment. They were then asked to report how the drug made them feel using carefully designed questionnaires. The researchers measured genetic differences between these subjects at approximately a million sites throughout the genome to identify variations in the DNA code known as single nucleotide polymorphisms, or SNPs. They assessed the relationships between each of these SNPs and sensitivity to amphetamine.

Abraham Palmer, PhD

Abraham Palmer, PhD

Using data from other large-scale GWAS studies, the team examined these same SNPs for possible overlapping associations with psychiatric disorders. Through rigorous statistical testing they found that an unexpectedly large number of SNPs were associated with both sensitivity to amphetamine and risk of developing schizophrenia or ADHD. This suggested that these traits are influenced by a common set of genetic variants.

Moreover, a significant proportion of this observed overlap appeared to be caused by variants that increased enjoyment of the effects of amphetamine but decreased the risk for both psychiatric diseases.

The researchers performed similar analyses for traits that were not expected to be related to amphetamine sensitivity, such as height, irritable bowel disease and Parkinson’s disease. In all of these cases they observed no more overlapping SNPs than would have been expected by chance alone.

“While this approach would not be a useful diagnostic test, we expect that people who like the effects of amphetamine would be slightly less likely to develop schizophrenia and ADHD,” Palmer said. “And people who did not like amphetamine, we would predict, are slightly more likely to develop these diseases.”

“What is particularly striking is that by examining people’s responses for just a few hours after taking a drug, we can identify an underlying genetic propensity that can manifest as a psychiatric disease over the course of a lifetime,” he adds. Continue Reading »

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