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| Dr. Alicia Au |
Congratulations to Dr Alicia Au, a current fellow in the Department of Critical Care Medicine for publication of a paper titled “Cerebrospinal Fluid Levels of High-Mobility Group Box 1 and Cytochrome C Predict Outcome after Pediatric Traumatic Brain Injury” in the Journal of Neurotrauma. In her study, Dr. Au demonstrated that a unique biomarker pattern of neuronal death was seen in infants with severe traumatic brain injury (TBI) who were victims of child abuse. Her findings lend additional support to the hypothesis that is being put forth by Safar Center investigators that abusive head trauma represents a unique form of TBI that may require unique therapies—possibly separate from other forms of TBI such as injuries resulting from motor vehicle accidents. Dr. Au is supported by a T-32 fellowship training grant from the National Institute of Child Health and Human Development. Her work was mentored by Dr. Robert Clark, Chief of Critical Care Medicine at Children’s Hospital of Pittsburgh. |
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| Dr. Patrick Kochanek |
Dr. Patrick Kochanek led an international team of clinicians and clinical investigators in the field of traumatic brain injury (TBI) to write and publish the second edition of the Guidelines for the Acute Medical Management of Severe TBI in Infants, Children, and Adolescents in the journal Pediatric Critical Care Medicine. A discussion on this Guidelines document is featured in a newly released Podcast by the Society of Critical Care Medicine. The Podcast is available at http://www.sccm.org/Podcasts/SCCMPod176.mp3 |
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| Dr. Mish Shoykhet |
Congratulations to recent fellow graduate Dr. Mish Shoykhet for publication of his paper titled: “Thalamocortical Dysfunction and Thalamic Injury after Asphyxial Cardiac Arrest in Developing Rats” in the Journal of Neuroscience. This work which will appear in the April 2012 issue was carried out under the mentorship of Safar Center Associate Director Dr. Robert Clark and Dr. Daniel Simons in the department of Neurosurgery at the University of Pittsburgh. Dr. Shoykhet has just joined the faculty of the department of pediatrics at Washington University St. Louis School of Medicine.
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| Dr. Rachel Berger |
Safar Center Associate Director, Dr. Rachel Berger, has been appointed by Senator Scarnati to serve on the 11-member Child Abuse Task Force which was ordered by the governor in response to the Penn State scandal. Congratulations to Dr. Berger for being honored with this appointment. Please see the press release on the governors page at the following link: PA Governor's Office News Releases 01-10-2012,
Governor Corbett, Legislative Leaders Name Members to Task Force on Child Protection.
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| Dr. Patrick Kochanek |
Safar Center Director Dr. Patrick M. Kochanek has been selected to receive the honor of Master in Critical Care Medicine (MCCM) at the 2012 annual meeting of the SCCM in Houston. The Master in CCM designation was just created to honor senior distinguished CCM professionals who are already Fellows in the College of Critical Care Medicine (FCCM) and whose body of work exemplifies the ideals and goals of the Society for Critical Care Medicine. This distinction is meant to be the highest honor the College of Critical Care Medicine can bestow on its members. The inaugural class of inductees to receive the MCCM is numbered at only 20 from around world. Also of note, CPR and Critical Care Medicine Pioneer Dr. Peter Safar will also receive this award posthumously.
Selection as a MCCM is based on status as a Fellow of the American College of Critical Care Medicine (FCCM) for the past five years and having distinguished oneself by achieving national and international professional prominence due to personal character, leadership, eminence in clinical practice, outstanding contributions to research and education in critical care, and years of exemplary service to SCCM, ACCM, and the field of critical care in its broadest sense. |
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 Safar Center graduate student researcher Jing Ji successfully defended his doctoral thesis titled "Neuronal survival after traumatic brain injury: cardiolipin-a critical target" on December 5, 2012. Dr. Ji has worked at both Safar Center for Resuscitation Research and Center for Free Radical and Antioxidant Health for completion of his thesis and he has been well liked by all the people he has interacted with at both centers. Jing is very bright, hardworking and extremely highly motivated.
After finishing Medical College of Nanjing University, Nanjing, China, Jing worked as a neurosurgeon at Nanjing Drum Town Hospital Affiliated with Nanjing University. His decision to pursue further training in basic science in the United States testifies for dedication to science and its application to clinical disease process. Dr. Ji obtained his masters in Cell and Molecular Biology at Northeast Ohio Medical University (NEOMED) and then joined Safar Center for his PhD training in 2008. Dr. Ji has worked with both in vitro and in vivo models of traumatic brain injury and cerebral ischemia to decipher the specific role of mitochondrial reactive oxygen species in signaling neuronal death. He has been instrumental in the development of the in vitro traumatic brain injury model at Safar Center. His paper titled “Mitochondrial Injury after Mechanical Stretch of Cortical Neurons in Vitro: Biomarkers of Apoptosis and Selective Peroxidation of Anionic Phospholipids” in press in Journal of Neurotrauma. Dr. Ji received awards from Neurotrauma Society and Critical Care Research Society for his work. |
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| Dr. Patrick Kochanek |
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| Dr. Mike Bell |
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| Dr. C. Edward Dixon |
Dr. Patrick Kochanek served as one of the five editors of the 6th edition of “The Textbook of Critical Care” published by Elsevier. Formerly known as the “Shoemaker Textbook of Critical Care” and recognized as one of the leading texts in the field, the 6th edition features a number of important contributions from faculty at the Safar Center. This includes Drs.: Hülya Bayır, Robert S.B. Clark, Ericka L. Fink, Patrick M. Kochanek, and Samuel A. Tisherman.
 Drs. Michael Bell and Patrick Kochanek contributed the chapter on “Neurologic Emergencies and Stabilization” in the 19th edition of the Nelson’s Textbook of Pediatrics. Of note, this is the first time that a chapter on this topic has been written, identifying the importance of the emerging field of pediatric neurocritical care that has been the focus of Dr. Bell’s work. The pediatric neurocritical care service at Children’s Hospital of Pittsburgh which he leads is considered a leader in this emerging field and we are honored to be able to contribute to this high impact textbook.
 Drs. C. Edward Dixon and Patrick Kochanek contributed the chapter on experimental models of traumatic brain injury in the 6th edition of Youman’s Textbook of Neurological Surgery. Safar Center Associate Director Dr. Dixon is a pioneer in the development of traumatic brain injury models, including the controlled cortical impact model which is used world-wide. This is the premier textbook in the field of neurosurgery and the section on traumatic brain injury was edited by traumatic brain injury expert Dr. Ross Bullock in the Department of Neurosurgery at the University of Miami. |
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| Students pictured from Left to Right: Kate Paul, Christina Monaco, Kaitlin Folweiler, Michelle Carter, Sara Tisherman, Rashed Harun. Missing from picture: Ify Efwuatu. |
The Safar Center serves as a resource for research training for interested individuals at all levels, including residents in medical and surgical training, graduate students, and undergraduates. We actively participate in the medical school and undergraduate summer student programs, and also in the minority research programs supported by the University of Pittsburgh. This photo was taken on the occasion of our annual summer student research day which occurs each August at the Safar Center. Seven of the students gave enthusiastic and impressive presentations of their work. Their mentors are listed in parenthesis.
- Ify Egwuatu (Rachel Berger, MD, MPH) A comparison of clinical and demographic characteristics between children with mild vs. moderate and severe abusive head trauma
- Kaitlin Folweiler (Anthony Kline, PhD) Reassessment of the potential benefits of environmental enrichment in female rats after experimental traumatic brain injury
- Christina Monaco (Anthony Kline, PhD) Evaluation of the AChE inhibitor, donepezil, after experimental TBI in female rats
- Rashed Harun (Amy Wagner, MD) c-Fos activation in the striatum following injury and chronic methylphenidate
- Michelle Carter (Amy Wagner, MD) Variants of SLC6A4 and BDNF in depression risk and onset following severe TBI
- Sara Tisherman (Clifton Callaway, MD, PhD) Chest wall compliance during CPR
- Kate Paul (C. Edward Dixon, PhD) Passive avoidance (TBA)
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| Dr. Robert Garman |
 Work on experimental blast traumatic brain injury by Safar Center investigators was published in the June 2011 issue of the Journal of Neurotrauma and featured on the cover of that issue. Neuropathologist and Safar Center Scientist Dr. Robert Garman was the first authors of an important paper demonstrating axonal injury primarily in the cerebellum and brainstem after blast injury in rats, in studies done in collaboration with Drs. Richard Bauman at Walter Reed Army Institute of Research and Steve Parks and Dr. Davit Ritzel, experts in blast physics. These findings mirror the recent work by Dr. David Brody at Washington University St. Louis who reported similar axonal injury assessed by diffusion tensor imaging of U.S. soldiers exposed to blast traumatic brain injury in Afghanistan. This work was supported by Defense Advanced Research Projects Agency of the U.S. Army as part of the PREVENT Blast program. We are very honored to be participating in this important program.
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Dr. Travis Jackson, a new Research Associate in Critical Care Medicine (CCM) working at the Safar Center was awarded grants from both the American Heart Association and Laerdal Foundation to study a novel pathway that may play an important role in mediating the selective vulnerability of neurons to ischemic and traumatic injury. Pleckstrin homology and leucine rich repeat protein phosphatase 1 (PHLPP1) is an endogenous inhibitor of the PKB cell survival pathway. Dr. Jackson has recently published that PHLPP1 is enriched in neurons and represents an exciting potential new target for therapies aimed at reducing neuronal death. His studies in the proposal focused on the role of PHLPP1 in mediating neuronal death after cardiac arrest. Congratulations to Travis for this extremely rapid success in his new position in CCM.
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 The 9th Annual Safar Symposium was a two day event this year held on June 22nd and 23rd, 2011, along with the 31st Peter & Eva Safar Annual Lectureship in Medical Sciences and Humanities, in the Starzl Biomedical Science Tower.
The first day of the Symposium was a Multi-Departmental Trainees’ Research Day comprised of over 60 students and fellows from the Departments of Anesthesiology, Critical Care Medicine, Emergency Medicine, and Physical Medicine and Rehabilitation giving either poster or oral presentations of their submitted abstracts. An esteemed panel of judges of the posters included speakers from the Symposium and local experts from each department.
Award winner for the best Overall Poster:
- Erica S. Schwartz, PhD (Anesthesiology)
Awards for the best Poster Presentation from each department went to:
- Dan Willenbring, PhD (Anesthesiology)
- Alicia K. Au, MD (Critical Care Medicine)
- Riana R. Pryor, MS, ATC (Emergency Medicine)
- Megan Miller, BS (Physical Medicine and Rehabilitation)
Oral Presentation Award winners:
- Qing Liu, MD PhD (Anesthesiology) 1st place
- Thomas I. Phelps, BS (Physical Medicine and Rehabilitation) 2nd place
The morning session of the symposium focused on “Breakthroughs in Resuscitation-New Developments in Traumatic Brain Injury,” and featured a number of leading experts in Traumatic Brain Injury including:
- Daniel P. Perl, MD, Professor of Pathology (Neuropathology), Director of the Military Brain Injury Studies from Uniformed Services University of Health Sciences, Bethesda, MD, presented “Traumatic Brain Injury in a Military Setting, What Do We (Really) Know.”
- David L. Brody, MD, PhD, Assistant Professor of Neurology, Washington University School of Medicine, St. Louis MO, discussed “Advanced MRI Detection of Blast-Related Traumatic Brain Injury in US Military Personnel: Early Prediction of Post-Traumatic Stress Disorder Severity.”
- David S. Warner, MD, Professor of Anesthesiology, Neurobiology and Surgery, Duke University, Durham, NC, spoke about “Why After 30 Years of Failure, I’m More Optimistic Than Ever Before for a Breakthrough in Neuroresuscitation”
- Grace Griesbach, PhD, Adjunct Assistant Professor, Department of Neurosurgery, David Geffen School of Medicine at UCLA, talked about “Exercise after Mild Traumatic Brain Injury: Implications for Sports and Rehabilitation.”
- Kees Polderman, MD, PhD, Professor, Critical Care Medicine, Medical Director, Neurocritical Care Services, University of Pittsburgh Medical Center discussed “Therapeutic Cooling for Traumatic Brain Injury: Still a Place?”
- Brian Blasiole, MD, PhD, PGY-4, Department of Anesthesiology, Research Fellow, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine presented “Effect of Hyperoxia on Resuscitation of Experimental Combined Traumatic Brain Injury and Hemorrhagic Shock.”
 Alicia K. Au, MD, a current University of Pittsburgh T-32 Fellow in the Department of Critical Medicine was the recipient of the 9th Nancy Caroline Fellowship Award. The Caroline Fellowship Award winner is determined by the Associate Directors of the Safar Center and is open to all trainees currently doing research at the Safar Center.
 This year’s Peter & Eva Safar Lecturer was Dr. Hugo Van Aken, Professor and Chairman of the Department of Anesthesiology and Intensive-Care Medicine at the University Hospital, Munster, Germany. Dr. Van Aken’s lecture was titled “Update on Thoracic Epidural Anesthesia and the Stress Response--Are the Benefits Worth the Trouble and Risks?” The lecture was a powerful, enlightening overview of his more than 30 years work and research in the field of Anesthesia.
The afternoon session of the symposium was held at the Winter Institute for Simulation, Education and Research (WISER) at 230 McKee Place. This session focused on “The Spectrum of Simulation—A Quest to Improving Healthcare Education” and was moderated by Drs. William McIvor and John O’Donnell. The afternoon speakers were as follows:
- Dr. Rosalyn P. Scott, Director, Simulation Center Veterans Affairs Medical Center, Dayton, Ohio presented “Beyond Mannequins.”
- Neal Bendict, PharmD, Assistant Professor, Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, discussed “Building Branched-Outcome Virtual Patients into Your Curriculum.”
- Haru Okuda, MD, SimLEARN National Medical Director, Veterans Health Administration spoke on “Simulation Dating: Matching the Appropriate Technology with your goals.”
- Gayle Gliva-McConvey, Director, Theresa Thomas Professional Skills Teaching and Assessment Center, Eastern Virginia Medical School, discussed “The Spectrum of Simulation—Using Standardized Patients.”
- Dr. William R. McIvor, Associate Professor of Anesthesiology, Associate Director, WISER for Medical Student Simulation Education, and Director, MOCA Simulation, University of Pittsburgh presented “Simulation and Medical Student Proficiency.”
A special thanks to all of the trainees, speakers, and Departments for another successful Symposium. We also are very grateful to the Laerdal Foundation, Medivance, and the United States Army for their support of our program. |
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Drs. Berger, Bell, and Kochanek were interviewed for an article based on the development of a blood biomarker that will accurately--and in real time--diagnose abusive head trauma (AHT) in infants, the leading, but often hard to diagnose, cause of infant death from injury.
UPMC physicians are collaborating with scientists at Banyan Biomarkers LLC to develop that “easy test” with its real-time diagnosis at the point of care. Dr. Berger has carried out several important studies with some “off-the-shelf” kits to measure for brain substance proteins not normally found in blood. Their presence says that the proteins have broken through the blood-brain barrier, signaling that something is wrong. The collaboration with Banyan is just being launched in an attempt to develop new brain injury markers for this important use. |
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In an article titled: “Child abuse in Pennsylvania is worse than you think.” Dr. Berger discussed important limitations in the current definition of abusive head trauma in the state of Pennsylvania and how this situation is leading to an underestimate of the actual number of cases. |
Drs. Dixon and Kochanek were interviewed for an article in PITTMED titled “What Hit Her?” appearing in the spring edition of 2011. The article discusses the field of traumatic brain injury (TBI) addressing important issues such as blast injury in combat casualty care and sports concussion. The Safar Center and the NIH supported University of Pittsburgh Brain Trauma Research Center serve as key facilities for TBI research by a number of investigators on the Pitt campus, and the fact that within the Safar Center many important models of TBI and federally funded research to develop new therapies is ongoing. The article also highlighted the fact that we are in a golden age of TBI research in great part to the strong support from the United States Army for research in their quest to develop new therapies for soldiers after blast TBI. Finally, the article also highlighted the work of collaborator Dr. Milos Ikonomovic, in the department of neurology, who is studying the link between TBI and Alzheimers disease.
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 Renowned brain injury expert Dr. Claudia Robertson, Medical Director of Center for Neurosurgical Intensive Care at Ben Taub General Hospital in Houston, TX, was a visiting professor at the Safar Center on February 16-17, 2011. Her lecture on February 16th was titled “Erythropoietin Neuroprotection after Traumatic Brain Injury” and drew a large crowd of interested faculty and trainees. On February 17th, in a reverse site visit fashion, she provided a critique to 17 fellows and trainees from our center who presented their current research to Dr. Robertson. We thank her for her valuable insight and taking the time out of her busy schedule to visit our Center.
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 A newly renovated 313 sq ft laboratory was just completed in the Safar Center which will house the experimental rehabilitation research work of Dr. Amy Wagner in the department of PM&R. this laboratory represents continued growth in the outstanding collaboration that has developed between Safar Center investigators and the department of PM&R, which is lead by Dr. Michael Boninger. Dr. Wagner is carrying out a number of studies examining bench-to-bedside applications in rehabilitation most notably related to the dopamanergic neurotransmitter system in experimental traumatic brain injury. Plans are in the works to link her research to other programs in the Safar Center such as experimental cardiac arrest and CNS injury in the developing organism.
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Linda Glah, an undergraduate student working with Dr. Amy Wagner, has been accepted to Drexel University for medical school and has been selected for a scholarship. Among her many accomplishments Linda carried out research with the drug amantadine and its effects on striatal neurotransmission using voltamatry. She will be finishing her project and writing her undergraduate neuroscience thesis on this topic. Congratulations to Linda!
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 PGY-4 Anesthesiology resident Brian Blasiole, MD, PhD received a seed grant, titled “Effect of Polynitroxylated Pegylated Hemoglobin (PNPH) and Hyperoxia on Inflammation and Oxidative Stress after TBI plus Hemorrhagic Shock”. Brian has been working with Dr. Kochanek studying the effect of both hyperoxia and the novel resuscitation agent PNPH in a clinically realistic model of combined traumatic brain injury plus hemorrhagic shock in mice. He has generated some exciting data in both of these areas and presented his work at the 2011 Congress of the SCCM. Congratulations to Brian.
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Dr. William Armstead, professor of anesthesiology at the University of Pennsylvania School of Medicine and Children’s Hospital of Philadelphia, visited the Safar Center and gave a lecture on February 22, 2011 titled “Role of ET-1 in Age and Sex Dependent Mechanisms in Pediatric Traumatic Brain Injury: Implications for Therapy”. Dr. Armstead’s visit coincided with the annual KO8 advisory committee meeting for Dr. Mioara Manole who is working in the area of cerebral blood flood and metabolism after experimental asphyxial cardiopulmonary arrest in the developing rat. Dr. Armstead is an expert in the area of cerebral blood flow autoregulation in the developing brain. We thank him for his helpful comments in evaluating of Dr. Manole’s progress.
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Resources |
 Dr.
Safar's Memoirs "From Vienna to Pittsburgh for Anesthesiology
and Acute Medicine. Careers in Anesthesiology (Volume V) " published
by the ASA's Wood Library Museum available here.
Peter Safar (1924 - 2003) Father
of CPR,
Distinguished Service Professor
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