Alzheimer’s institute to open this year amid flurry of support
A comprehensive care center for Alzheimer’s disease and other neurological disorders will open at the Health Science Center in 2016, fueled by millions in donations gathered in less than two years.
Over $41 million has been secured in cash and endowment support to launch South Texas’ first Institute for Alzheimer and Neurodegenerative Diseases, located in the Medical Arts & Research Center.
Of that, $735,000 was collected at the 2015 President’s Gala, themed “An Evening of Service.” Proceeds from the Sept. 26 event established the Bartell and Mollie Zachry Endowment for Alzheimer Research and Patient Care, in recognition of the gala’s honorees, Bartell and Mollie Zachry.
“They have made and continue to make exemplary contributions to San Antonio, to education and to the welfare of our entire community,” said Health Science Center President William L. Henrich, M.D., MACP. “They are our city’s finest examples of integrity and kindness and they embody, in all respects, service.”
The Health Science Center must play an active role in tackling Alzheimer’s and other neurodegenerative diseases, Dr. Henrich told the more than 1,000 gala attendees. That mission is something the community has rallied behind, offering unprecedented support for the project in record time, he added.
“As one of America’s leading academic health centers, we must serve our community’s health-related needs,” he said. “The time is now to focus on new discoveries, treatments and auxiliary services to help those suffering from the ravages of Alzheimer’s disease and related disorders.”
The institute is designed to be a comprehensive care center and will feature expert diagnostics; physician specialists in Alzheimer’s, Parkinson’s and other diseases; support programs for caregivers; and access to clinical trials of new therapies.
By 2025, the number of Americans age 65 and older with Alzheimer’s disease is expected to reach 7.1 million, a 40 percent increase from today. In Texas, the number of residents with the disease is projected to increase 48.5 percent. Texas ranks third in the nation in the estimated number of Alzheimer’s cases and second in the number of deaths attributable to the disease, behind California and Florida.
“There are many reasons to be concerned about this illness,” Dr. Henrich said, citing “its unrelenting cruelty in robbing a person of memory and faculty, the toll it takes on families and caregivers, its devastating effects on the economy and our collective sense of futility in trying to arrest its insidious lethal aggression.”
There are also personal reasons. A little more than a year before his death, Glenn Biggs, the university’s founding Development Board chairman, approached Dr. Henrich and Long School of Medicine Dean Francisco González-Scarano, M.D., about his diagnosis of Alzheimer’s.
“He came to us seeking guidance on where to go and what to do for his advancing condition,” Dr. Henrich said. “So you can understand our frustration in not being able to provide him answers that pointed him to a comprehensive care center or, even better, being able to assure him that prevention was available that could make a difference. After he left that day, Francisco and I pledged ourselves to this singular purpose.
“Glenn Biggs was the inspiration for our vision to establish the Institute for Alzheimer and Neurodegenerative Diseases, and we are committed to the promise we made to him and so many other families to see this vision achieved.”
Dr. Henrich said he will ask the UT Board of Regents for approval to name the center in his honor.
Biggs’ wife, Ann, was the gala’s honorary chair. In a video tribute to her husband, who died in May, she spoke of the hope he carried with him that someday a cure would be found.
“He wanted to help others,” she said. “This was his dream, and he would be so pleased. He took great pride in doing what he could to help the Health Science Center in all the years he had. It’s my pleasure to do what I can to carry on his wishes.
“Don’t give up hope. Something good is going to come.”
Gifts and pledges of $1 million or more
- Anonymous
- Baptist Health Foundation
- The Greehey Family Foundation
- J.M.R. Barker Foundation
- Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation
- Klesse Foundation
- Kronkosky Charitable Foundation
- Keith and Pat Vigeon Orme
- Valero Energy Foundation
- Anonymous
Gifts boost pediatric transplant program
Transplant surgeon Francisco G. Cigarroa, M.D., believes children who need life-saving organ transplants deserve care that is both high quality and accessible. Three recent gifts to the pediatric transplant program at San Antonio’s University Transplant Center will help create a National Center for Excellence in pediatric liver transplantation, grow an already renowned pediatric kidney transplant program and improve access to services for patients along the Texas-Mexico border.
Particularly transformative, Dr. Cigarroa said, is a $2 million gift from Carlos and Malú Alvarez to create the Carlos and Malú Alvarez Distinguished University Chair in Pediatric Transplant Surgery. Dr. Cigarroa, the inaugural recipient of the chair, specializes in adult and pediatric kidney and liver transplant surgery and is surgical director of the pediatric transplant program at the University Transplant Center. The center is a partnership between University Health System and the Health Science Center.
The Alvarez Distinguished University Chair will advance both the clinical and research missions of the program, he said.
Two-thousand children are among the more than 120,000 people in the U.S. waiting for an organ transplant. In Texas, nearly 200 of the 11,500 people waiting to receive an organ transplant are children.
Providing much-needed support to parents as they deal with their child’s illness also contributes to better outcomes for pediatric transplant patients, Dr. Cigarroa said.
Dr. Cigarroa created the first civilian pediatric liver transplant program in San Antonio after joining the Health Science Center in 1995. He continued performing transplants as president of the Health Science Center from 2000 to 2009. The pediatric liver transplant program was eventually put on hold while Dr. Cigarroa served as chancellor of The University of Texas System from 2009 to 2014.
“I’ve always felt very strongly that San Antonio needs to provide a center of excellence for transplanting these very sick children who otherwise would die, and at the same time being very sensitive to preserving the family unit, making sure there is adequate support to not only take care of their child, but to take care of their family and themselves,” he said. “This gift from Carlos and Malú Alvarez will save lives for children, and especially children in South Texas and along the Texas-Mexico border.”
A $125,000 gift from Robert Oliver established the Robert Oliver Pediatric Transplant Program Endowment to support outreach and education in San Antonio and surrounding communities and to help build a life-saving pediatric transplant program of excellence.
“We serve the South Texas community, and we want every family to know about this program,” Dr. Cigarroa said. “Robert Oliver’s gift is critical in helping us do this important outreach.”
A gift of $100,000 from Col. Robert E. Kelso and Betty Kelso will help establish outreach clinics in South Texas communities so that patients and their families will face fewer challenges in accessing care, he added.
“[The gift will] help us revitalize this critically important program for children who need a transplant to survive,” Dr. Cigarroa said.
“It’s wonderful when you have very passionate people like Carlos and Malú Alvarez, Robert and Betty Kelso, and Robert Oliver, who want to support excellence and want to be a part of something that actually impacts quality of life. What is more powerful than saving a baby’s life through the miracle of transplantation?”
All of the gifts will enable the program to recruit and retain faculty for the transplant team and sustain the program for years to come.
“When we transplant a child, we have to think that this is for a lifetime,” Dr. Cigarroa said. “Once you start taking care of a child, you are committed for life. You have basically inherited another family member, and that is a joy.”
Liver cancer research receives multi-year funding
The Clayton Foundation for Research is supporting, for up to five years, the development of a biorepository and new strategies for treating hepatocellular carcinoma (HCC), which is the most common liver cancer in adults. The gift provides $300,000 in research support each year.
The research team is interested in learning why the morbidity and mortality of HCC is higher in Hispanics in South Texas than in Hispanics from elsewhere in Texas and the U.S., as well as in other ethnic groups, said Francisco G. Cigarroa, M.D., professor of surgery at the Health Science Center. Dr. Cigarroa directs the research project with LuZhe Sun, Ph.D., professor in the Department of Cellular and Structural Biology.
“The mortality of this tumor is extremely high,” Dr. Cigarroa said, adding that researchers are already interpreting project data from DNA and RNA sequencing.
The Houston-based foundation also is supporting the ongoing heart attack and stroke prevention research of Marc D. Feldman, M.D., professor of medicine and engineering. The foundation’s original five-year gift totaling $1.5 million in 2011 was renewed and increased in 2015, with an option to continue year to year after 2016.
The Clayton Foundation seeks to invest in scientists who are key leaders in medicine and have a vision to advance biomedical discovery that has far-reaching benefits to humanity.
Bequest funds the search for answers in mystery illness
They were symptoms that couldn’t be explained. Chronic headaches, nausea, respiratory problems, weakness, irritability, problems with memory and concentration, and depression—all with seemingly no cause.
Sometimes, this mysterious cluster of symptoms was called “sick building syndrome.” For those who served overseas, it became known as “Gulf War illness.”
Then in the early 1990s, the phenomena reported by physicians worldwide was given a new term: Toxicant-induced Loss of Tolerance, or TILT.
TILT is a sensitivity to low-level chemical exposure, and the term was coined by Claudia Miller, M.D., M.S., professor emeritus at the Health Science Center. A research-validated tool to assess TILT, called the Quick Environmental Exposure and Sensitivity Inventory, was then created and is now the most-used screening instrument for chemical intolerance worldwide.
TILT occurs in one of five primary care patients, but is rarely diagnosed by practitioners.
“It’s not a rare event. You have many people who are suffering from these symptoms, but they are labeled as fibromyalgia or other problems,” said Carlos R. Jaén, M.D., Ph.D., chair of the Department of Family and Community Medicine. “So even if you present with these symptoms, it’s not a formally recognized condition and we don’t have formal training on it. We need to develop more ways of approaching these patients more systematically and as a team.”
For years, Marilyn Brachman Hoffman felt misunderstood by her health care providers, who found her cluster of symptoms puzzling. She knew there was something beyond what her doctors were seeing.
“She went all around the world looking for help and nobody could pinpoint what was going on,” Dr. Jaén said. “Then she worked with Dr. Miller and found somebody was actually making sense of what she was experiencing. In her will, there was an explicit request to fund studies related to this problem.”
After her death, The Marilyn Brachman Hoffman Foundation gave more than $2.7 million to create the Hoffman TILT Program. Over three years, the money will fund interventions in homes of sensitive people, and will be used to develop a coordinated approach to outreach, education and research for patients and health care professionals.
“We are really the world’s headquarters for this issue,” Dr. Jaén said. “No one is working in this same area the way we are. This grant brings together the advancing of additional knowledge by doing studies in homes of those affected, but it also is a very heavy component of education. People need to be aware that this is an important issue.”
The goal of the TILT program is to build a pipeline of health professionals who can recognize, understand and address TILT and the challenges faced by patients. It also aims to improve health outcomes of patients through home visits to identify triggers and appropriate interventions.
“This leverages the new knowledge that has been developed at the Health Science Center,” Dr. Jaén said. “It gives us ways to transform the way we educate this generation and future generations of health care professionals and identify and alleviate this level of suffering.”
Fare thee well
Course has good taste in health
Second-year medical student Tiya Clark enjoyed cooking long before she ever tied on an apron and donned a chef’s toque for the first meeting of her Introduction to Clinical Nutrition class. But the future pediatrician believes learning how to create healthy, affordable meals will make a huge impact on the lives of her young patients someday.
“Nutrition is important while children are growing,” Clark said while preparing roasted asparagus to accompany shrimp fra diavolo during a class in November. “It’s walk the walk. You can say, ‘I’ve substituted lentils for ground beef. It tastes good.’”
Piloted last summer, the elective course is the fruit of a partnership between the Health Science Center and H-E-B. The course follows a culinary nutrition curriculum of the Tulane University School of Medicine, and is part of a national trend emphasizing culinary nutrition fluency among physicians, said Tisha Lunsford, M.D., clinical associate professor of medicine and director of the Gastroenterology Fellowship Program. Dr. Lunsford directs the course along with Michelle Savu, M.D., FACS, clinical associate professor of surgery.
“Food is universal,” Dr. Lunsford said. “Everyone eats, and everyone has a culture of food. The doctor can take a few moments to connect to the patient: ‘Tell me what you like to eat.’”
H-E-B purchased the curriculum from Tulane and also provides all supplies, expert chefs and the use of its teaching kitchen. H-E-B culinary nutritionist and corporate chef Charlotte Samuel teaches the culinary portion of the class. Samuel also is an adjunct instructor in the Health Science Center’s Department of Epidemiology and Biostatistics.
The recipes featured in the program are based on a Mediterranean diet and cost no more than $2.50 per serving, Samuel said.
“I want them to have a really good understanding [of food preparation] so that when they do talk to their patients, they are confident and authentic in what they are teaching,” Samuel said.
Each class session lasts four hours. During a recent class, students tasted eight unlabeled food items in a special presentation on the physiology of taste.
“You blew my mind right there!” second-year medical student Max Cadena called out when a guest chef noted that iodized salt is double the volume of kosher salt because of its smaller grains.
During class, students cook in groups of four, share meals, review how to apply what they’ve learned, and engage in simulated clinical exercises led by Dr. Lunsford. The idea, she said, is to train proactive physicians who encourage patients to make doable dietary modifications, rather than simply treating symptoms of disease.
Another course goal is to cultivate student mentors. Second-year medical student Justin Low took the class last summer and was back this fall, checking in with students as they made collard greens and honey mustard pork tenderloin, and pesto pasta with roasted tomatoes, broccoli and white beans.
“I’ve never taught anything before,” Low said. “It’s helping me learn how to be an effective teacher to others.”
Dr. Lunsford hopes to be able to expand the course to accommodate more than the current maximum enrollment of 16 and to make it available to other students in health professions courses at the Health Science Center.
“The ‘do as I say’ approach has failed,” Dr. Lunsford said. “We have a patient population growing in girth despite all of our best efforts. We have to meet patients where they are.”
Military Medicine City, USA
Two gifts support military health programs
The San Antonio area has one of the largest concentrations of active-duty military personnel and veterans in the nation, with an estimated 159,000 veterans living in Bexar County, according to the Bexar County Veterans Service Office. And that number is expected to grow.
To support them, USAA has given $1.5 million to establish the USAA “Patty and Joe Robles, Jr.” Distinguished Chair for Military Health and the USAA “Patty and Joe Robles, Jr.” Endowment in Military Health. The funds will be used to support the director of the Military Health Institute and for military health programs and institute infrastructure. Another $500,000 was given for faculty recruitment and start-up costs for the institute.
“This formalizes our Military Health Institute and allows it to be sustained,” said retired Maj. Gen. Byron C. Hepburn, M.D., the institute’s inaugural director. “It shows a commitment to us from a major national organization.”
The Military Health Institute was established in 2014 to improve the health of military service members, veterans and their families through education, research, clinical care and community engagement.
“San Antonio really has a unique aggregation of incredible assets and national resources when you talk about military health,” Dr. Hepburn said. “They say San Antonio is Military City, USA. It’s really Military Medicine City, USA.”
Livestock Expo steers scholarships to HSC
Students from the schools of medicine, nursing and health professions have received $270,000 in scholarships from the San Antonio Livestock Exposition, Inc.
This is the 11th consecutive year that the organization has supported the university, for a combined total of $3.07 million.
“The shared goal of our partnership is to attract the best and brightest students to our campus, and provide them with a first-class education,” said Francisco González-Scarano, M.D., dean of the School of Medicine. “Then we work to retain these professionals to practice within South Texas, where there is a great shortage of health care in rural and medically underserved communities.”
Seeds for the brain
From studies of mental disorders to brain-degenerating diseases, five research projects from the Health Science Center were each awarded $100,000 seed grants as part of the UT System initiative to jump-start multidisciplinary research on the human brain.
A total of $4.5 million was awarded through the UT System Neuroscience and Neurotechnology Research Institute, created by the Board of Regents in 2014 to facilitate team approaches to brain research. The Health Science Center was the only UT component in South Texas to receive the seed grants.
The projects receiving funding are:
- “Translatability of Rodent Dopaminergic Neuron Studies to the Primate Brain,” Michael Beckstead, Ph.D.
- “Transformative MRI Neurotechology for Micro-scale Human Cortical Imaging,” multiple researchers
- “Brain Circuit Function and Locus Coeruleus,” Martin Paukert, Ph.D.
- “Multimodal MRI-based Diagnosis and Treatment of Mild Cognitive Impairment,” multiple researchers
- “Responsive Neurostimulation in the Epileptic Baboon: A Pilot Study,” Charles Szabo, M.D.
Baby? Not yet.
Teens from Bexar County and throughout Texas will benefit from two grants totaling $13.75 million, awarded to the university’s UT Teen Health initiative that promotes healthy choices for adolescents.
Since 2010, the program has worked to decrease teen birth rates on San Antonio’s South Side. In three years, the program contributed to the decrease in teen births by 19 percent.
The grants will allow the program to expand its services, which have already impacted more than 12,000 teens, said Kristen Plastino, M.D., associate professor of obstetrics and gynecology and leader of the program.
“What makes UT Teen Health different is that we work with each of our stakeholders to understand their needs and to customize a plan to fit their goals,” she said. “With the new grants, we will continue to work with current partners and reach out to new stakeholders throughout the state that serve vulnerable youth.”
Those groups will include health care facilities, school districts, churches and organizations that work with the juvenile justice system and foster care youth, she said.
Fighting childhood obesity
Overweight and obese Hispanic children participating in increased behavioral counseling and education were more likely to adopt healthier lifestyles, resulting in healthier weights, according to a pilot study of children ages 5 to 14.
The study paved the way for a $2.9 million grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, part of the National Institutes of Health. It will extend the study through 2019.
“The pilot study was the ‘proof of concept’ we needed to be able to get full funding,” said Deborah Parra-Medina, Ph.D., M.P.H., study author and associate director for education and training programs at the Institute for Health Promotion Research.
A disproportionate number of Hispanic children in the U.S. are obese. Researchers believe if they are given additional counseling and education beyond the typical standard of care, weight gain can be controlled.
“Comprehensive behavioral programs have been shown to help these children improve their weight status, however, more efficient interventions that can be done in primary care clinics must be developed for Hispanic children,” Dr. Parra-Medina said.
The pilot study trained pediatric health care providers and clinical staff to offer behavioral counseling during routine clinic visits, and to schedule three follow-up visits over four months, following the American Academy of Pediatrics guidelines.
Beyond that, half of the participants received additional behavioral interventions, including a face-to-face counseling session with a health educator in which a family action plan was created, monthly telephone counseling and newsletters for a four-month period. All participants had to adopt two healthy dietary behaviors, and play outside for an hour or limit TV time to less than two hours a day.
“In these studies, we do not promote weight loss with children. We promote a healthier rate of weight gain,” Dr. Parra-Medina said. “Children have the advantage of growing. We hope to slow down their weight gain so they can grow into their weight. We hope they will adopt these healthy lifestyle changes so they will not leave childhood overweight or obese and continue that trajectory into adulthood.”