Explore Education

Clinical Research

Updated Nov. 2013



Behavioral Medicine

Faculty name: Beth Cohen, MD MAS

Contact information: Phone: 221-4810, extension 4851
                                   Beth.Cohen@ucsf.edu

Subspecialty/research focus: Posttraumatic stress disorder, cardiovascular disease

Title of research project: The Mind Your Heart Study

Description of research projects:

• The Mind Your Heart Study is a prospective cohort of 746 veterans who were recruited between 2008 and 2010 to study the long-term health consequences of posttraumatic stress disorder, particularly increased cardiovascular disease risk. Baseline examinations included interviews to assess mental health, medical history, cognitive function, and health behaviors; treadmill tests; echocardiograms; and blood draws for measurement of traditional cardiac risk factors and novel biomarkers. Annual follow-up interviews are conducted to assess ongoing mental health status, cardiovascular events, and hospitalization for any cause. Participants are also being invited back to complete an in-person examination at study year 5 that will include repeat assessments of many baseline measures. 
• I’m happy to mentor residents on projects related to the effects of mental health conditions on the cardiovascular system or to explore other research ideas using this dataset.




Faculty name: Judith Moskowitz, PhD, MPH

Subspecialty/ research focus: Coping with HIV and other chronic illnesses

Title of research project: The role of positive affect in adjustment to HIV

Brief description of project: A growing body of literature indicates that positive affect may have a unique adaptive role in the process of adjustment to chronic stress, independent of the effects of negative effects like depression. This study will document the occurrence, predictors, and consequences of positive affect during the 18 months postnotification of HIV+ serostatus. This is a longitudinal cohort study in which 250 participants recruited from 4 San Francisco Bay area sited will be interviewed 7 times over the course of 18 months after notification of HIV+serostatus. Data will consist of quantitative questionnaires, qualitative interviews (audiotaped), and CD4 and viral load measure. The specific aims of the study are: 1) Document the positive and negative affect in response to notification of HIV+ serostatus. 2) explore the potential adaptational significance of positive affect by examining its associations with adherence, HIV risk behaviors, healthcare utilization, health behaviors, role functioning, quality of life, and symptoms of clinical depression. 3) Identify coping processes and coping resources . 4) To explore the association of positive affect with cost of HIV treatment based on healthcare utilization and medication costs.




Faculty name: Anna M. Nápoles, PhD

Contact information: UCSF Box 0856
                                    phone: (415) 476-6290
                                    anapoles@ucsf.edu

Subspecialty/research focus: behavioral epidemiology

Title/description of research projects: Nuevo Amanecer (A New Dawn): Enhancing the psychosocial health of Latinas with breast cancer

This RCT is testing a peer-delivered community-based cognitive-behavioral stress reduction program called Nuevo Amanecer in newly diagnosed Spanish-speaking Latinas. Nuevo Amanecer is, a manualized 8-week cognitive-behavioral stress management intervention for Latina women just diagnosed with breast cancer. It was based on an evidence-based cancer coping program that improved QoL among White breast cancer survivors and on formative research. Adaptations included translation into low-literacy Spanish (6th grade level) and for delivery by trained Latina breast cancer survivors (peers) rather than professionals. Nuevo Amanecer is being tested in a 6-month RCT. We have trained a core of 12 recruiters and six interventionists from our CBO partners who serve as the field staff on the project. To date, 120 women have been randomized. As designed, we are successfully enrolling low-SES Latinas, e.g., 63% have less than a high school education, 83% have public or no health insurance, and 66% reported financial hardship in the last year. Age ranges from 30-76 years (mean 51). Enrollment will close September 2013, and baseline analyses and a manuscript are in process. Compared to norms for the FACT breast-cancer-specific quality of life (QoL) measures, women in the Nuevo Amanecer study demonstrated worse QoL at baseline on total scores and all subscale scores. Baseline survey data is available for analysis and includes the following self-reported measures: sociodemographics, QoL, anxiety, depression, financial hardship, neighborhood cohesiveness, breast cancer diagnosis and treatment, etc.




Faculty name: Mary Whooley, MD
                         Professor of Medicine, Epidemiology and Biostatistics
                         University of California, San Francisco
                         Section of General Internal Medicine (111A1)
                         Department of Veterans Affairs Medical Center
                         4150 Clement Street
                         San Francisco, CA 94121
                         Phone: 415-750-2093
                         Fax: 415-379-5573
                         mary.whooley@ucsf.edu
                         Web site: http://www.heartandsoulstudy.net

Subspecialty/ research focus: Cardiovascular Disease, Quality of Life, Mental Health

Title of research project: The Heart and Soul Study

Brief description of project: The Heart and Soul Study is a prospective cohort study of 1024 patients with coronary heart disease. Between 9/00 and 12/02, all subjects completed exercise treadmill testing with stress echocardiography, an extensive questionnaire, and several blood and urine measurements of cardiovascular disease risk factors. Participants are being followed for 10 years to assess cardiovascular outcomes (MI, CHF, stroke). As of 2008, UCSF residents and fellows have published over 50 papers from this dataset. Dr. Whooley has many ideas for future research projects, and would be happy to help residents write and publish papers on these projects or others.




Cardiology

Faculty name: Nitish Badhwar, MD

Contact information: badhwar@medicine.ucsf.edu

Subspecialty/research focus: Cardiac Electrophysiology
                                                  Research focus
                                                  Catheter ablation of SVT and VT
                                                  Cardiac resynchronization therapy (CRT)
                                                  Percutaneous left atrial appendage (LAA) ligation

Title/description of research projects:

ECG analysis in patients with heart failure receiving CRT
Utility of ERNA imaging in pts undergoing CRT
ECG analysis in pts undergoing LAA ligation
Symptom and quality of life evaluation for pts with arrhythmias




Faculty name: Beth Cohen, MD MAS

Contact information:  Phone: 221-4810, extension 4851
                                     Beth.Cohen@ucsf.edu

Subspecialty/research focus: Posttraumatic stress disorder, cardiovascular disease

Title of research project: The Mind Your Heart Study

Description of research projects:

• The Mind Your Heart Study is a prospective cohort of 746 veterans who were recruited between 2008 and 2010 to study the long-term health consequences of posttraumatic stress disorder, particularly increased cardiovascular disease risk. Baseline examinations included interviews to assess mental health, medical history, cognitive function, and health behaviors; treadmill tests; echocardiograms; and blood draws for measurement of traditional cardiac risk factors and novel biomarkers. Annual follow-up interviews are conducted to assess ongoing mental health status, cardiovascular events, and hospitalization for any cause. Participants are also being invited back to complete an in-person examination at study year 5 that will include repeat assessments of many baseline measures. 
• I’m happy to mentor residents on projects related to the effects of mental health conditions on the cardiovascular system or to explore other research ideas using this dataset.




Faculty name: Elyse Foster, MD

Subspecialty/research focus: Cardiology/Echocardiology

Title of research project:

Various projects are available that could be tailored to the interest of the resident. Examples include:

Echocariographic determinants of cardiac dyssynchrony and their relationship to benefit from cardiac resynchronization therapy in heart failure.

Three-dimensional echocardiographic evalulation of mitral valve motion in patients with mitral regurgitation. Prognostic valve of echocardiographic variable of diastolic function.

Description of projects: Both retrospective and prospective projects can be tailored to the interest of the resident.




Faculty name: Ian S. Harris, MD

Contact information: Phone: (415) 353-9156
                                   505 Parnassus Ave, M314
                                   San Francisco, CA 94143-0214

Subspecialty/research focus: Cardiology Adult Congenital Heart
                                                  Disease Women's health-management of maternal cardiac disease during pregnancy

Title/description of research project: The Heart and Soul Study

Description of project: Medical and surgical advances in recent decades have resulted in an enormous improvement in life expectancy and quality of life among patients with congenital heart defects and adults with congenital heart disease now outnumber children. Many of these patients are now reaching child-bearing age. A critical and very under-studied component of the care of young women with congenital heart disease is the assessment of maternal and fetal risk during pregnancy, management of pregnancy and labor, and genetic counseling. Several prospective and retrospective projects dealing broadly with these topics are available and can be tailored to the interest of the resident.




Faculty name: Alka Kanaya, MD

Contact information:  alka.kanaya@ucsf.edu; 353-7919

Subspecialty/research focus: General Internal Medicine, Endocrinology, Cardiology

Title/description of research projects:

We have created a population-based cohort of 906 South Asians called the MASALA study (Mediators of Atherosclerosis among South Asians Living in America) modeled on the Multi-Ethnic Study of Atherosclerosis. This cohort is well-phenotyped and has many measures of glucose tolerance, adiposity, cardiovascular risk factors, behavioral factors, and subclinical atherosclerosis outcomes.  A resident who is skilled in analytic methods can propose a novel analysis from the MASALA database, or can work with our writing group to help on an ongoing analysis. 

Other smaller datasets which have been used by other residents to do independent analyses include the MASALA pilot study (n=150). This smaller dataset has many more novel biomarkers measured than the new larger cohort.




Faculty name: Grace Lin, MD

Contact information: glin@medicine.ucsf.edu

Subspecialty/research focus: Appropriate utilization of health care services; shared decision making; decision quality

Title/description of research projects:

My research focuses on determining the appropriateness use of tests and procedures, particularly cardiac procedures, using both qualitative and quantitative methods.  Current projects include:

  • Measurement of decision quality – Development of an instrument to measure the quality of decision making in cardiology, from the patient point of view. 
  • Determining appropriate use of tests and procedures using administrative and clinical databases - we are working on creating more accurate metrics for determining the appropriateness of a test or procedure for use with administrative data or clinical registry data. 
  • Assessment of current medical decision making in the field of cardiology, using both qualitative and survey data.
  • Implementation of shared decision making/decision aids into clinical care.

There are opportunities for both primary data collection and secondary data analysis, depending on interest.




Faculty name: Gregory Marcus, MD, MAS, FACC

Contact information: Division of Cardiology, Electrophysiology Section
                                    500 Parnassus, MUE 434
                                    Phone: 415-476-3450
                                    marcusg@medicine.ucsf.edu

Subspecialty/research focus: Cardiac Arrhythmias

Title/description of research project: Understanding Mechanisms of Arrhythmias through Clinical Research

Brief description of project: We have a cohort of several hundred EP patients with atrial fibrillation, atrial flutter, and SVT. These patients have serum and DNA collected as well as detailed historical information. We have published several papers from this cohort and continue to collect data.

We also have several projects involving review of our clinical EP database and patient interviews regarding a variety of EP related conditions.

We have performed nationwide electronic survey studies of general internal medicine physicians regarding beliefs, attitudes and knowledge about the treatment of atrial fibrillation. We plan to perform similar survey studies in the future.

I am happy to discuss ideas and to craft projects specific to the needs and interests of individual residents, always with the goals of abstract presentation and manuscript publication.




Faculty name: Barry Massie, MD

Contact information: Phone: 415-750-2112
                                   Fax: 415-379-5573
                                   barry.massie@va.gov

Subspecialty/research focus: cardiology, clinical trials and outcomes

Title/description of research project: The Heart and Soul Study

Brief description of project: ICD outcomes research: We have a VA funded 5-year grant to determine the predictors of benefit or lack of benefit of ICDs in the VA system, as well as the cost-effectiveness of these devices. All ICDs implanted in the VA system are followed at the San Francisco VAMC by the VA National ICD Surveillance Center (Ed Keung Director), with the device implant and follow-up data being captured through each manufacturer's web-based system. These implants are occurring at a rate of 400-600/month. All patients are enrolled as patients at the San Francisco VAMC, so that clinical data can be abstracted from the VA electronic record and outcomes tracked via VA databases. A team of 4 research associates is building this database. In addition to the primary goals of this project, a number of shorter term and less extensive projects are feasible. Fellow involvement would involve some work on the database itself. I am the PI, with Paul Varosy leading much of the project. Other participants are Paul Heidenreich (Palo Alto VA, heading the economic aspects).

Secondary manuscripts from clinical trials:

I am the PI and have access to data from the Warfarin and Antiplatelet Trial in Chronic Heart Failure (WATCH) trial, which hopefully will be published in JAMA shortly. This is a 1500 patient trial in which patients with heart failure in sinus rhythm were randomized to warfarin, aspirin, or clopidogrel. We will begin analyses on secondary manuscripts shortly.

I am also the PI of the I-Preserve trial. This is a 4,100 patient trial of irbesartan in patients with heart failure and EF >/= 45% (the largest such trial). The trial should reach its stopping point (1,440 events) in early 2008. We are preparing several manuscripts using baseline data, including 1 year outcomes in the entire population since relatively little is known of the natural history of this condition. Ultimately, many secondary manuscripts are planned but I don't anticipate that the final database will be available until late in 2008.

I am also co-PI of the PROTECT trial. This is a 2,000 patient trial of patients admitted to for decompensated heart failure who have underlying renal dysfunction (eGFR <60-80) randomized to an adenosine antagonist or placebo. This agent appears to improve or prevent worsening of renal function and facilitate diuresis. Enrollment has been active and this will ultimately be a unique dataset for looking at cardiorenal interactions.




Faculty name: Rajni K Rao, MD

Contact information: rao@medicine.ucsf.edu

Subspecialty/research focus: Cardiology, echocardiography, medical student and resident education

Title/description of research project: The Heart and Soul Study

Description of project: Echo Predictors of elevated LV filling pressures in heart transplant patients.  Cardiology curriculum and education assessment: For example, how well does the UCSF internal medicine residency program and UCSF SOM prepare trainees to recognize emergent or basic cardiac diagnoses?

Use of echocardiography in rural or international urban underserved populations.

Other projects as well.




Faculty name: Rita F. Redberg, MD

Contact information: Redberg@medicine.ucsf.edu

Subspecialty/research focus: Cardiology/ Technology Assessment particularly medical device approvals – what is the evidence base required for FDA approvals? Does it assure safety and effectiveness?  My work is focused on strategies to eliminate the $1 billion of waste in our system, as estimated by the recent IOM report on Better Care at Lower Cost. 

I was an RWJ Health Policy Fellow and am very interested in Health policy and

Medicare payment policy

Title/description of research projects:

Post approval studies for FDA approved high risk devices

Post market surveillance of medical devices -

The relationship of evidence reviews and Medicare coverage decisions

How to operationalize appropriate use criteria




Faculty name: Melvin Scheinman, MD

Contact information: scheinman@medicine.ucsf.edu

Subspecialty/research focus: Focus Cardiac Arrhythmias ,Cardiac Electrophysiology

Title/description of research project: Genetics of Sudden Cardiac Death
                                                              Electrocardiography of Ventricular tachycardia
                                                              Nuclear imaging for pts. With RV dysplasia




Faculty name: Nelson Schiller, MD

Contact information: Phone: 353-1709 
                                   schiller@medicine.ucsf.edu

Subspecialty/research focus: Echocardiography (quantification of cardiac function, supine bicycle exercise, pulmonary hemodynamics, intraoperative TEE and outcome research through the Heart and Soul Study.Mary Whooley, MD PI)

Title/description of research projects: Have projects dealing with:

Pulmonary pressure by noninvasive means.particularly pulmonary vascular resistance.
Phonocardiography integrated with echocardiography.particularly first heart sound Adenosine augmented stress testing -- particularly supine bicycle exercise Quantification of left heart size and function -- particularly outcome of CAD in Heart & Soul study.




Faculty name: Kendrick A. Shunk, MD, PhD, FACC
                         Assistant Professor of Medicine, UCSF
                         Director, Cardiac Cath Lab, SFVAMC
                         415-750-2076
                         FAX 415-750-6950

Subspecialty/research focus: MR-guided cardiovascular interventions.

Description of project: Novel treatment methods for HOCM by MR-guided direct Intramyocardial EtOH injection. Brief Description of Project: In a large animal model we wish to test the hypothesis that, compared to ablation of HOCM by injection of EtOH into the first septal perforator branch (control group), that direct myocardial injections result in a more prescribed infarct pattern and avoid complications such as Complete heart block. The interested resident would obtain experience with a large animal research, catheter-based interventions, and MRI as a guidance and would be expected to take a leading role in the project from the beginning (obtaining appropriate approvals, etc.) through actual experiments to analysis and publication.




Faculty name: John R. Teerlink, MD, FAAC, FAHA, FESC
                         Associate Professor of Medicine, UCSF
                         Director, Heart Failure, SFVAMC

Contact information: 4150 Clement Street
                                   San Francisco, CA 94121-1545
                                   Phone: 415-221-4810, x4160
                                   john.teerlink@ucsf.edu

Subspecialty/research focus: Cardiology, Heart Failure (Acute and Chronic)
                                                  Clinical studies, clinical trials
                                                  Regulatory
                                                  Echocardiography
                                                  New diagnostic devices for heart failure and ventricular function

Title/description of project: The projects change rapidly, so please feel free to inquire, if interested in subject areas.




Faculty name: Mary Whooley, MD

Contact information: Associate Professor of Medicine, Epidemiology and Biostatistics
                                   University of California, San Francisco
                                   Section of General Internal Medicine (111A1)
                                   Department of Veterans Affairs Medical Center
                                   4150 Clement Street
                                   San Francisco, CA 94121
                                   Phone: 415-750-2093
                                   Fax: 415-379-5573
                                   mary.whooley@ucsf.edu
                                   Web site: http://www.heartandsoulstudy.net

Subspecialty/research focus: Cardiovascular Disease, Quality of Life, Metal Health

Title/description of research project: The Heart and Soul Study

Description of project: The Heart and Soul Study is a prospective cohort study of 1024 patients with coronary heart disease. Between 9/00 and 12/02, all subjects completed exercise treadmill testing with stress echocardiography, an extensive questionnaire, and several blood and urine measurements of cardiovascular disease risk factors. Participants are being followed for 8 yearrs to assess cardiovascular outcomes (MI, CHF, stroke). As of January 2006, UCSF residents and fellows have published over 20 papers from this dataset. Dr. Whooley has many idease for future research projects, and would be happy to help residents write and publish papers on these projects or others.




Faculty name: Yerem Yeghiazarians, MD

Contact information: yeghiaza@medicine.ucsf.edu
                                    office phone 415-353-3817

Subspecialty/research focus: Cardiology; Interventional Cardiology; Peripheral Vascular Disease; Vascular Biology; Cardiac Stem Cell Research

Title/description of research projects: After a myocardial infarction, loss of contracting heart muscle cells occurs resulting in scar formation and subsequently heart failure. Current therapies designed to treat heart attack patients in the acute setting include medical therapies and catheter-based technologies that aim to open the blocked coronary arteries with the hope of salvaging as much of the jeopardized heart muscle cells as possible. Unfortunately, despite these advances over the past 2 decades, it is rarely possible to rescue the at-risk heart muscle cells from some degree of irreversible injury and death. In addition, the delay in the time that most patients present to receive their care has been recognized as a major factor in the failure of current techniques in preventing significant cardiomyocyte injury.

Attention has thus turned to new methods of treating heart attack and heart failure patients in both the acute and chronic settings after their event. Heart transplantation remains the ultimate approach to treating end-stage heart failure patients but this therapy is invasive, costly, some patients are not candidates for transplantation given their other co-morbidities, and most importantly, there are not enough organs for transplanting the increasing number of patients who need this therapy. As such, newer therapies are needed to treat the millions of patients with debilitating heart conditions. Recently, it has been discovered that stem cells, which are early progenitor cells with the ability to direct the production of all different types of human cells, may hold the therapeutic potential for these patients. Experimental studies in both animals and humans have revealed encouraging results when stem cells are injected into the heart in the areas of myocardial infarction. These therapies appear to result in improvement in the contractile function of the heart.

Despite these promising early trials, many questions remain unanswered concerning the use of stem cells as therapy for patients with heart attack and heart failure. To answer these questions and to ultimately offer this therapy routinely to patients, the UCSF Cardiology Division has launched a Cardiac Stem Cell Translational Development Program to address these issues. We have numerous on-going projects in the small and large animal heart attack models; in-vitro experiments studying both adult and embryonic stem cell are underway; numerous observational human clinical trials are also currently being performed.




Emergency Medicine

Faculty name: John Stein, MD
                         jstein@medicine.ucsf.edu

Subspecialty/research focus: Emergency Medicine/Use of Ultrasound in Emergency Setting

Title of research project: Outcome research in the use of emergency ultrasound.

Description of research project: A variety of issues in emergency ultrasound are currently being evaluated, and there is opportunity for new projects to start. 




Faculty name: Christopher Fee, MD

Contact information: Christopher.Fee@ucsfmedctr.org

Subspecialty/research focus: Emergency Medicine
                                                  Care of patients with pneumonia in the ED
                                                  Identification and management of sepsis
                                                  JCAHO pneumonia measures

Description of research project: Effect of emergency department crowding on time to antibiotics for patients admitted with pneumonia

Rate of inappropriate ED antibiotic administration to patients admitted for CHF in response to JCAHO pneumonia care measures

Effect of ED boarding on care provided to patients admitted with pneumonia

Identification of causative bacteria in septic patients using a 16s micro array




Faculty name: Martha L. Neighbor, MD

Contact information: mneighbor@sfghed.ucsf.edu
                                   206-5748

Subspecialty/research focus (areas):

Pain Management in the ED
Racial and Ethnic Disparities in Pain Management
Pain Management in Substance Users
Anxiety and Pain

Title/description of research projects: 
"Characteristics of Pain in Chemically Dependent Patients in the Emergency Department"

"Modification of Pain using Benzodiazepines in Anxious Patients"




Faculty name: Robert M. Rodriguez, MD
                         Research Director Department of Emergency Services
                         SFGH

Contact information: rrodriguez@sfghed.ucsf.edu 
                                   Phone: 206-5875

Subspecialty/research focus: My research interests are eclectic; I enjoy working with young investigators to develop their own ideas as they pertain to emergency medicine and critical care medicine. My particular areas of interest are 1) ICU/Emergency Department interface.interventions to improve outcomes in critically ill ED patients, 2) Acute Sepsis management, 3) Decision rules

Title/description of research projects:

Derivation of a Clinical Decision Rule for Selective Chest Radiography in Blunt Trauma Patients

The ICU Family Members Knowledge Study

Fever in IV Drug Abusers Study

Meta-analysis of Sgarbossa Criteria for AMI Prediction in the Presence of LBBB

Acute ED Interventions for the Prevention of Post-traumatic Stress Disorder

A Prospective Study of Stress Hyperglycemia in the Critically Ill Patient




End of Life Care

Faculty name: Michael Rabow, MD

Subspecialty/research focus: Palliative Care, End-of-life care, Medical Education, Professional Development, Humanity in Medicine

Title of research project: Learning in the Valley of Death

A cohort study of UCSF medical students from the Class of 2005 investigating the hidden curriculum in end-of-life care training. This project includes survey research from the entire class yearly since the second year and qualitative analysis from repeated interviews from a subset of students.

Symptom Management and Palliative Care at the UCSF/Mount Zion Comprehensive Cancer Center

This project is to perform a detail needs assessment among both patients and clinicians, and then to develop, implement, and evaluate a symptom management and palliative care consultation services.




Endocrinology

Faculty name: Alka Kanaya, MD

Contact information: alka.kanaya@ucsf.edu;
                                   Phone: 353-7919

Subspecialty/research focus: General Internal Medicine, Endocrinology, Cardiology

Title/description of research projects:

We have created a population-based cohort of 906 South Asians called the MASALA study (Mediators of Atherosclerosis among South Asians Living in America) modeled on the Multi-Ethnic Study of Atherosclerosis. This cohort is well-phenotyped and has many measures of glucose tolerance, adiposity, cardiovascular risk factors, behavioral factors, and subclinical atherosclerosis outcomes.  A resident who is skilled in analytic methods can propose a novel analysis from the MASALA database, or can work with our writing group to help on an ongoing analysis. 

Other smaller datasets which have been used by other residents to do independent analyses include the MASALA pilot study (n=150). This smaller dataset has many more novel biomarkers measured than the new larger cohort.




Gastroenterology

Faculty name: Daniel C. Adelman, MD

Contact information: Phone:650.596.2427
                                    dadelman@alvinepharma.com
                                    dadelman57@gmail.com

Subspecialty/research focus: Pharmaceutical drug development, especially interventional immunotherapeutics

Title/description of research projects: Development of orally active gluten-specific proteases for the treatment of celiac disease.




Faculty name: Danielle Brandman, MD, MAS

Contact information: Danielle.Brandman@ucsf.edu
                                    415-514-1094

Subspecialty/research focus: Nonalcoholic fatty liver disease (NAFLD), post-transplant metabolic syndrome, liver transplant outcomes

Title/description of research projects:

• UNOS-based studies evaluating post-transplant outcomes in patients with NAFLD and selection of patients with NAFLD for transplant
• UCSF-specific studies evaluating short- and long-term outcomes of patients transplanted for NASH or cryptogenic cirrhosis, particularly with regards to hospital stay, survival, recurrence of NAFLD post-transplant, and metabolic syndrome (prevalence, severity, consequences)




Faculty name: Mandana Khalili, MD

Contact information: University of California San Francisco, San Francisco General
                                    Hospital, 1001 Potrero Ave, NH-3D, San Francisco, CA, 94110
                                    Office number: 415 206 4766
                                    Mandana.khalili@ucsf.edu

Subspecialty/research focus: Hepatology/Gastroenterology

Title/description of research projects:

Dr. Khalili’s research focuses on natural history of chronic viral hepatitis (hepatitis B and hepatitis C), novel treatments for viral hepatitis, health services/health disparity in viral hepatitis, and evaluation of metabolic abnormalities and pathophysiology of diabetes within the context of hepatitis C and B. Her group previously evaluated mechanisms of insulin resistance and secretion in a large cohort of hepatitis C infected patients, and is now examining how HCV affects insulin action among the high risk Latino population. She is also studying the mechanisms of immune response to hepatitis C therapy through the Bay Area Hepatitis C Cooperative Study. Moreover, through community and participatory research, she is assessing hepatitis B management and liver cancer screening practices in hepatitis B-infected underserved populations including the impact of liver cancer screening on mortality. Her focus on health services research involves evaluation of the impact of educational interventions on patient and provider knowledge, attitudes, and barriers to hepatitis C and hepatitis B care as well as primary care-specialist care coordination and access to care for viral hepatitis. In addition, as one of the clinical research centers for the NIH-funded Hepatitis B Research Network, she is currently working on better understanding the natural history of chronic hepatitis B and the optimal long-term treatment for this disease. Dr. Khalili’s research program involves a significant mentoring component and she is actively involved in mentoring trainees and faculty in clinical research related to liver disease.




Faculty name: Marion Peters, MD

Contact information: Phone: 415-502-0318
                                    Marion.Peters@ucsf.edu

Subspecialty/research focus: Hepatology

Title/description of research projects:

Clinical:

Clinical studies in Co-infection of HIV patients with Hepatitis B and C; the role of liver disease in HIV infection; and the effects menopause on progression of liver disease. These studies evaluate the role of cofactors such as alcohol, HIV, drug use in outcome of disease and response to therapy.

Studies on pathophysiology and management of end stage liver disease including autoimmune liver diseases, primary biliary cirrhosis and recurrent disease post liver transplantation.

Studies on accurate evaluation and management of end stage liver diseases

Translational

  1. Identify the associations between candidate inflammatory gene markers and the progression of liver disease in HCV/HIV coinfected women, using data from a genome wide association study of over 3000 women.
  2. Study the role of non invasive markers of fibrosis including serum markers and transient elastography to accurately evaluate progression of liver disease.   



Faculty name: Justin Sewell, MD, MPH, FACP

Contact information: justin.sewell@ucsf.edu

Subspecialty/research focus: gastroenterology, inflammatory bowel disease, primary-specialty care communication, large databases

Description of research projects:

  1. Primary-specialty communication, including preconsultation exchange: Preconsultation exchange is a form of specialty care that involves communication between the PCP and specialist prior to a patient being scheduled for an ambulatory specialty visit.  It is intended to improve access to, and timeliness and efficiency of, specialty care.  We perform a great deal of preconsultation exchange at SFGH using eReferral.  I have current projects that seek to assess patient attitudes toward preconsultation exchange, the safety of preconsultation exchange, and impact of preconsultation exchange on PCPs and specialists.  Additionally, I am interested in pursuing other projects assessing communication between primary and specialty care providers, including communication at the resident and fellow level.
  2. Inflammatory bowel disease: I have done a number of IBD-related projects over the past several years.  Although I am not actively pursuing IBD-related research, I am available to discuss potential projects with those interested in IBD-related research.
  3. Large national databases: I have complete databases for the National Hospital Discharge Survey, the National Ambulatory Medical Care Survey, and the National Hospital Ambulatory Medical Care Survey, and experience in managing and analyzing these databases.  I can advise residents and fellows regarding the use of these databases and am available as a mentor (for appropriate projects).

See my UCSF Profiles site for more details: http://profiles.ucsf.edu/justin.sewell




Faculty Name: Aparajita Singh, MD, MPH

Contact information: Aparajita.singh@ucsf.edu
                                   Parnassus and Mt Zion

Sub-Specialty/research focus: I am interested in following research topics but I will be glad to discuss and help residents with any other research ideas:

Quality Improvement in Gastroenterology
Medical Education
Hereditary colon cancer syndromes
Microbiome in patients with pouchitis




Faculty name: Ma Somsouk, MD, MAS

Contact information: 1001 Potrero Ave., 3D2, Box 0862
                                    San Francisco, CA 94110
                                    (415) 206-6480 (Office)
                                    (415) 641-0745 (Fax)
                                    somsoukma@medsfgh.ucsf.edu

Subspecialty/research focus: Gastroenterology/HIV

Title/description of research projects:

1. Gastrointestinal tract as a site of HIV pathogenesis. We examine the relationship between HIV, persistent inflammation, and microbial translocation and how they contribute to excess morbidities and mortality observed in HIV-infected individuals. We believe that this process may be mediated by depletion of T cell subsets, impaired epithelial barrier function, and microbial dysbiosis in the gastrointestinal tract. Moreover, mucosal inflammation could accelerate colorectal carcinogenesis in our aging HIV population.

2. Prevention of colorectal cancer. The SFGH population often presents with late-stage cancer, particularly among Asians and blacks, with low rates of colorectal cancer screening and late utilization of health care services. We identify barriers to access healthcare / colorectal cancer screening in the safety-net population. In addition to cohort studies, we use mathematical simulation models to identify challenges and best practices for colorectal cancer screening / surveillance.

3. CT radiation and the development of cancer – Widespread adoption of CT scans including CT colonography may pose adverse health risks. We have assembled a national VA database to quantify the risk of cancer associated with CT radiation exposure.

Techniques Used

  • Epidemiological methods using databases - UNOS, SEER, Medicare, VA, etc.
  • Histopathological and molecular characterization of mucosal specimens
  • Translational research methods – serum biomarkers, flow cytometry
  • Decision analytic modeling & meta-analysis



Faculty name: Norah Terrault, MD 

Contact information: Director, Viral Hepatitis Center
                                    University of California, San Francisco
                                    S357, 513 Parnassus Ave.,
                                    San Francisco, CA 94143-0538
                                    Norah.Terrault@ucsf.edu
                                    415-476-2227 phone
                                    415-476-0659 FAX

Focus: Hepatology, Transplant Medicine

Title/description of research projects:

Active projects

  1. Epidemiology and natural history studies in patients with chronic HBV in the U.S. (NIDDK-HBV Clinical Research Network) and fatty liver (NIDDK NASH CRN)
  2. Clinical trials of the safety and efficacy of new antiviral therapy of HCV-infected persons with cirrhosis and liver transplant recipients, including those with HIV coinfection
  3. Prediction models for recurrent disease and graft loss among transplant recipients with specific disease etiologies (HBV, HCV, fatty liver)

Techniques Used

  • Epidemiological studies using large databases - UNOS, HCV-TARGET, HBVRN
  • Clinical trial methodologies
  • Histopathologic and virologic characterization of archived specimen collection



Faculty name: Phyllis C. Tien, MD

Contact information: Infectious Disease Section, 111W
                                    4150 Clement St
                                    San Francisco, CA 94121
                                    ptien@ucsf.edu
                                    415-221-4810 ext 2577

Subspecialty/research focus:

Metabolic complications (fat distribution changes, lipid and glucose abnormalities, and hepatic steatosis) of HIV and HCV coinfection

Sex differences in metabolic complications of HIV

Occult viral hepatitis infection




General Internal Medicine

Faculty name: Wendy G. Anderson, MD, MS

Contact information: Wendy.Anderson@ucsf.edu

Subspecialty/research focus: Palliative care, Critical Care, Hospital Medicine, Communication, Pain Management

Title/description of research projects:

IMPACT ICU: Integrating palliative care into the ICU. This is a 5-site quality improvement project being conducted at the 5 University of California medical Centers. Its goal is to establish systems for providing primary palliative care in the ICU, and involving specialty consults when appropriate. 

Improving hospital pain management: A quality improvement project being conducted at Moffitt-Long hospital with the goal of improving the safety and efficacy of pain management for patients admitted to the medical service.

Hospitalist rapport study: Observational study of hospitalist-patient communication in admission encounters with goal of identifying communication skills associated with improved patient satisfaction and decrease anxiety.




Faculty name: Doug Bauer, MD

Contact information: dbauer@psg.ucsf.edu 

Subspecialty/research focus: Clinical epidemiology projects related to diseases of older men and women: osteoporosis, thyroid disease, breast and prostate cancer, and functional decline. Particular emphasis on biomarkers.

Title/description of research projects:

Multiple opportunities for secondary data analysis; can join existing project related to area of interest or review available datasets to formulate a new research question.




Faculty name: Mary S. Beattie, MD

Contact information: mary.beattie@ucsfmedctr.org
                                    pager 719-8889

Subspecialty/research focus: General Internal Medicine and Women.s Health
                                                  Hereditary cancer, particularly BRCA1/2; hormones and breast cancer risk

Title/description of research projects:

Endogenous sex hormones and breast cancer risk

Hereditary Breast can Ovarian Cancer Predisposition: cohort study of over 1000 high risk participants with stored blood.

CREdIT: Cancer Risk Educational Intervention Tool: Study of a computer-based educational tool to educate patients at risk of hereditary cancer, particularly underserved populations

Variants of Undetermined Significance in BCRA1/2: Collaboration with basic scientists to determine whether variants in BRCA1/2 are of low or high clinical significance

Breast MRI for BRCA carriers: meta-analysis and cost effectiveness analysis

Clinical trial of targeted chemotherapy for BRCA carriers with metastatic breast or ovarian cancer using a PARP inhibitor (phase II international trial)




Faculty name: Mary S. Beattie, MD, MAS

Contact information: mary.beattie@ucsfmedctr.org

Subspecialty/ research focus: Genetics
                                                   General Internal Medicine
                                                   Oncology

Title of research project: The UCSF Cancer Risk Program: BRCA Testing in over 1000 Women The 2008 UCSF Cancer Risk Program Survey achieved a response rate of over 80%, and has multiple potential avenues for secondary clinical research analysis. Areas open for resident research projects include:

Screening and prevention in women at high risk of Hereditary Breast and Ovarian Cancer

MRI screening in women at high risk of breast cancer

Genetic testing and its impact on health behavior and opinions

Risk prediction models for breast cancer

BRCA testing in underserved women at San Francisco General Hospital




Faculty name: Stephen Bent, MD

Contact information: Stephen.Brent@ucsf.edu

Subspecialty/research focus: Complementary and Alternative Medicine
                                                  Clinical Trials
                                                  Systematic Review

Title of research project: My primary research focus is the evaluation of the safety and efficacy of complementary and alternative therapies. Because there are few databases with complete information about herb and supplement use, most of the work in this area involves the development and execution of randomized controlled trials. Current studies include: Randomized controlled trial of valerian for the treatment of primary insomnia Omega-3 fatty acids for the treatment of autistic spectrum disorder. Analysis of herb and supplement use among veterans attending anticoagulation clinics, and determining if there is an association between herb/supplement use and poor control of anticoagulation.

Analysis of adverse event reports to poison control centers regarding herbs and supplements.

I also have an interest in clinical trial methodology, and would be happy to assist in the development of resident/fellow projects in this area. In addition, I have conducted over a dozen meta-analyses, many of them with residents, and this can be a great first step towards developing expertise in a both a defined topic area and the skills of systematic review.




Faculty name: Calvin Chou, MD, PhD

Contact information: calvin.chou@ucsf.edu
                                    Voice mail: 415-221-4810 x2740
                                    Campus mail: VAMC 111

Subspecialty/ research focus: Medical Education

Title of research project: I have five areas of inquiry where residents would be welcome and could contribute significantly.

Delineating the relationship between communication and professionalism: In collaborative work with Anna Chang and Karen Hauer on developing a curriculum in remediation, it has become increasingly clear that students identified as having deficits in communication skills may also (or instead) have professionalism issues. There is ample literature that connects communication and professionalism, but there is no paper that explicitly and formally links the two. The student/resident would conduct a literature review, gaining important fundamental skills in systematic and critical analysis of the literature, with the goal of preparing a manuscript for publication.

Literature review of effective teaching behaviors and curricula for physical examination skills: Som Mookherjee (Dept of Hospital Medicine, Parnassus) and I are embarking on a narrative literature review of physical examination curricula to examine the features that will effectively move early medical students from the comprehensive approach of gathering information to a more targeted, reasoning-based approach. The student/resident would conduct a literature review, gaining important fundamental skills in systematic and critical analysis of the literature, with the goal of preparing a manuscript for publication.

Completing a survey study of medical student comfort levels and partnering practices in co-ed settings: Kali Stanger (UCSF class of 2009) and I are working on analyzing data from one medical school class about their relative comfort with practicing on co-ed peers. The data has been collected; the resident would complete the data analysis, and critically analyze how this study adds to the literature (most recent lit review done in 2008). The project is very near completion; the goal is to edit and complete a manuscript for publication.

Analyzing how the impact of student feedback to faculty can be enhanced: Marieke Kruidering (Dept of Pharmacology) and I have recently published a manuscript showing that feedback from students to faculty improves soon after the institution of a curriculum in feedback but slowly devolves in specificity over time. The decrease in specificity is wholly attributable to the loss over time of positive specific feedback. There are two sub-projects, both potentially publishable, that grow from this initial study (students/residents may choose one or both to work on):

We are currently undertaking a follow-up study in which we electronically remind first-year students to remain specific in their positive feedback. The student/resident would gain experience in qualitative analysis by helping with the analysis of the impact of these electronic reminders on specific feedback in MS1s' evaluations of faculty lectures, using a previously-established rubric we developed.

How do faculty actually use evaluations that students write of their teaching? There is surprisingly no literature addressing this question. Students/residents would work with us to develop a list of open-ended and closed-ended questions for faculty, help us select the types of faculty to interview, conduct focus groups or individual interviews, and analyze quantitative and qualitative data.

Determining the impact of the VALOR Program: VALOR is a six-month longitudinal clerkship based at the VA in which cohorts of students rotate through surgery, medicine, neurology, and psychiatry. VALOR is currently the highest-rated such program at UCSF, and there are a number of projects related to individual components of VALOR that can be studied. VALOR students have written narratives on what patients have taught them during the program, and these are ripe for qualitative analysis. VALOR students undergo a mini-curriculum in professional development and career choice using a structured inquiry model that has not yet been described. Finally, as VALOR students graduate, tracking where they have matched for residency and determining the effect of their training at the VA will be of great interest, both to the School of Medicine as well as to the VA. Please contact me for further details about the directions in which these projects may develop.

Career Counseling for Medical Students: To describe a novel method of helping medical students choose their eventual careers. The trainee(s) would interview MS4's who have undergone the counseling to determine their satisfaction with the method, the limitations, and follow the eventual outcomes.




Faculty name: Kenneth Covinsky, MD, MPH

Contact information: Ken.covinsky@ucsf.edu 

Subspecialty/research focus: Outcomes research/Epidemiology/Health Services Research

Title/description of research projects:

We focus on understanding the determinants of major health outcomes in the elderly. We are particularly interested in the determinants of functional status outcomes and the use of functional status as a prognostic determinant of mortality and other health outcomes. We have a number of ongoing projects. Some are focused on understanding how a diverse range of risk factors predict outcomes in the elderly. Others are focused on developing and validating risk indices to accurately differentiate between elders at differential risk of adverse outcomes.

Minority Aging Research. The Center for Aging in Diverse Communities (CADC). provides infrastructure support for developing human capacity among minority investigators to conduct aging research. CADC funds 4 to 8 pilot studies per year and these have already led to publications. In collaboration we have also addressed the importance of race/ethnicity in research, recruitment of minority patients with cancer, and attitudes in interval cancer screening. We are currently conducting an evaluation of a video medical interpretation technology for limited English-proficient patients in three clinical settings and a church-based program to promote use of adult immunizations.




Faculty name: Madhavi Dandu, MD, MPH

Contact information: dandum@medicine.ucsf.edu

Subspecialty/research focus: Global Health and Medical Education

Title/description of research projects: I have several projects available for trainees interested in global health education in curriculum development for health professional as well as in development of evaluation tools.




Faculty name: Mitchell D. Feldman, MD, MPhil

Contact information: Professor of Medicine
                                   UCSF Director of Faculty Mentoring
                                   University of California, San Francisco
                                   400 Parnassus Ave.
                                   San Francisco, CA 94143-0320

Subspecialty/ research focus:

General internal medicine, Behavioral medicine, Mentoring and Faculty development, Depression, Doctor-patient communication, HIV/AIDS in Japan, Medical technology assessment

Title of research project: Depression in Primary Care/Quality Improvement

I have devoted much of career to attempting to impact the processes and outcomes of care for patients with behavioral and psychiatric disorders, particularly depression, in the general medicine setting. As principal investigator of the UCSF site of the Robert Wood Johnson national demonstration project "Depression in Primary Care", we addressed the structural and financial barriers dictated by the mental health carve-out arrangement through an innovative economic and clinical partnership. We modified existing economic arrangements so that primary care providers could receive reimbursement for depression care and have access to mental health consultation and care management for their depressed patients. We have published two manuscripts describing our unique collaborative model, and are currently analyzing a variety of outcomes data.

My research interests extend to the level of the doctor-patient interaction. I have been especially interested in better understanding and ultimately designing an intervention that examines the influence of patient prompts on physician behavior. I was co-investigator (and UCSF site PI) of an NIMH funded multicenter randomized trial of 150 primary care physicians that studied the impact of direct-to-consumer advertising and patient requests on physician's evaluation and treatment of patients with depressive symptoms. We are currently extending this work with additional support from NIMH to develop targeted educational messages designed to reduce stigma and promote effective participation in care among adults at risk for depression.

Mentoring/Faculty Development

As Director of Faculty Mentoring at UCSF, I am charged with leading a faculty mentoring program for all UCSF faculty across all schools. An essential component of this responsibility is the evaluation and dissemination of our program. I designed a baseline survey that was sent to over 800 junior faculty mentees to assess factors that predict successful mentorship and to examine the relationship between mentoring and self-efficacy. I am currently leading a number of projects examining the process and outcomes of mentoring in the health sciences.




Faculty name: Stanton Glantz, PhD

Contact information: glantz@medicine.ucsf.edu 
                                    476-3893
                                    Room 366 Library

Subspecialty/research focus: Public health policy, population health, cardiovascular disease, smoking

Title/description of research projects:  PUBLIC HEALTH AND INDIVIDUAL EFFECTS OF SMOKING, SECONDHAND SMOKE AND TOBACCO CONTROL INTERVENTIONS

Effects of tobacco control policies on heart and other diseases:  Population level statistical analysis of disease patterns related to implementation of tobacco control policies complemented with studies of the biology of the effects of tobacco smoke exposure.

Risk assessment of e-cigarettes:  This will be a modeling study based on what is known about the chemicals and ultrafine particles in e-cigarettes.

Smoking cessation interventions for light and intermittent smokers.

Effects of exposure to smoking in movies on relapse among people trying to quit smoking.

Policy analysis of the process of and obstacles to implementing tobacco control policies.

Global tobacco control.

Analysis of tobacco industry documents on a wide range of topics.




Faculty name: Ralph Gonzales, MD

Contact information: phone: 514-0569
                                   ralphg@medicine.ucsf.edu

Subspecialty/research focus: Quality improvement
                                                  Practice guideline development and implementation
                                                  Management of acute respiratory tract infections in outpatient/acute care settings
                                                  Appropriate antibiotic use activities
                                                  Computerized applications to facilitate acute care and primary care services

Title/description of research projects:

Minimizing Antibiotic Resistance in Colorado: Impact of office-based and mass media campaign on public knowledge/attitudes/behavior, antibiotic use and antibiotic resistance.

Improving Antibiotic Use in Acute Care Settings (IMPAACT) Trial. 16-site randomized trial of provider/patient educational intervention to improve antibiotic use. And validation of a rapid, c-reactive protein test-based algorithm to improve diagnosis and treatment of acute cough illness.

Implementation of a self-service computer kiosk for the management of uncomplicated UTIs in women.




Faculty name: Judy Hahn, MD

Contact information: 415-206-4435
                                    jhahn@epi-center.ucsf.edu

Subspecialty/research focus: HIV/HCV/substance use/alcohol use

Title of research project: Utilization of HIV care and alcohol use in Mbarara, Uganda
                                          Measurement of alcohol use in HIV positives in Uganda
                                          Dynamic models of HCV in injecting drug users




Faculty name: Alison Huang, MD

Contact information: 1635 Divisadero Street, Suite 600
                                    San Francisco, CA 94115-1793
                                    Phone: (415) 353-9752
                                    FAX: (415) 353-9790
                                    Pager: (415) 443-1110
                                    ahuang@medicine.ucsf.edu

Subspecialty/research focus:

My research program is directed at advancing scientific understanding and improving clinical management of menopause- and aging-related health conditions in women.  I have a particular interest in examining risk factors, improving diagnostic strategies, and identifying new treatments for 1) genitourinary health conditions and 2) menopausal symptoms in women. 

Title/description of research projects:

I welcome resident involvement in data analysis projects drawing upon: 1) a cohort study of ~2000 ethnically-diverse middle-aged and older women who completed questionnaires about urinary and vaginal symptoms and sexual health (the RRISK cohort), 2) a randomized trial of two types of behavioral relaxation therapies for treatment of menopausal symptoms in ~120 women (the MaTURE trial), or 3) other publically available clinical datasets involving older women, such as the Study of Osteoporotic Fractures.  Recent past mentee projects:

 

Mentee

Products

Kelli Copeland

1)    Oral presentation at national SGIM meeting (presented by Kelli). 

2)    Published paper with Kelli as first author: Diabetes Mellitus and Sexual Function in Middle-Aged and Older Women.  Obstetrics & Gynecology. 2012; 120 (2):331-340.

Ayesha Appa

1)    Plenary presentation at national AUA meeting  (presented by Ayesha), poster presentation at national SGIM meeting in 2013 (presented by Ayesha)

2)    Published paper with Ayesha as first author: Clinical Predictors and Significance of Postvoid Residual Volume in Women with Diabetes.  Diabetes Research and Clinical Practice. (in press)

Julia Fehniger

1)    Published paper with Julia as first author:  Childbirth and Female Sexual Function Later in Life.  Obstetrics and Gynecology. 2013 (in press).

Laurel Imhoff

1)    Poster presentation at national ASCRS meeting (presented by Laurel).

  1. Published paper with Laurel as first author: Fecal incontinence decreases sexual quality of life, but does not prevent sexual activity in women.  Diseases of the Colon and Rectum. 2012; 55(10):1059-1065.

Anna Frick

1)    Poster presentation at national AUGS meeting (presented by Anna)

2)    Published paper with Anna as first author:  Mixed urinary incontinence: greater impact on quality of life.  The Journal of Urology. 2009 (182): 596-600.




 

Faculty name: Mallory O. Johnson, PhD

Contact information: UCSF Center for AIDS Prevention Studies 
                                    50 Beale Street, Suite #1300 
                                    San Francisco, CA 94105 
                                    P: 415-597-9374 
                                    F: 415-597-9213 
                                    Mallory.Johnson@ucsf.edu

Subspecialty/research focus: Behavioral Medicine, HIV interventions

Title/description of research projects:

2005-Present

Principal Investigator, A mindfulness approach to HIV treatment side effects.
NIH/NCCAM R21. Co-Investigators: R. Hecht, T. Neilands, and J. Moskowitz.

2004-Present

Principal Investigator, Measuring and understanding HIV treatment expectancies.
UARP Grant. Co-PI: T. Neilands.

2004-Present

Principal Investigator, NIMH R01 RCT of an HIV treatment side effects coping intervention.
4/1/2004-2/28/2009. Co- Investigators: S. Folkman, J. Moskowitz, T. Neilands.

2003-Present

Co-Investigator, NIMH R01 Positive Affect in Adjustment to HIV. 12/1/2003- 1/30/2008. PI: Judith Moskowitz.




Faculty name: Alka Kanaya, MD

Contact information: alka.kanaya@ucsf.edu
                                   353-7919

Subspecialty/research focus: General Internal Medicine, Endocrinology, Cardiology

Title/description of research projects:

We have created a population-based cohort of 906 South Asians called the MASALA study (Mediators of Atherosclerosis among South Asians Living in America) modeled on the Multi-Ethnic Study of Atherosclerosis. This cohort is well-phenotyped and has many measures of glucose tolerance, adiposity, cardiovascular risk factors, behavioral factors, and subclinical atherosclerosis outcomes.  A resident who is skilled in analytic methods can propose a novel analysis from the MASALA database, or can work with our writing group to help on an ongoing analysis. 

Other smaller datasets which have been used by other residents to do independent analyses include the MASALA pilot study (n=150). This smaller dataset has many more novel biomarkers measured than the new larger cohort.




Faculty name: Beth Kaplan, MD

Contact information: 206-5757
                                    bkaplan@sfghed.ucsf.edu

Subspecialty/research focus: intimate partner violence, sexual assault, rapid HIV testing, diagnosis of ectopic pregnancy




Faculty name: Karla Kerlikowske, MD


Subspecialty/research focus: Breast cancer screening. Risk factors for breast cancer.
 
Title of research project: San Francisco Mammography Registry

Description of research project:
www.mammorgraphy.ucsf.edu/sfmr/research.html/



Faculty name: Grace Lin, MD

Contact information: glin@medicine.ucsf.edu

Subspecialty/research focus: Appropriate utilization of health care services; shared decision making; decision quality

Title/description of research projects:

My research focuses on determining the appropriateness use of tests and procedures, particularly cardiac procedures, using both qualitative and quantitative methods. Current projects include:

  • Measurement of decision quality – Development of an instrument to measure the quality of decision making in cardiology, from the patient point of view. 
  • Determining appropriate use of tests and procedures using administrative and clinical databases - we are working on creating more accurate metrics for determining the appropriateness of a test or procedure for use with administrative data or clinical registry data. 
  • Assessment of current medical decision making in the field of cardiology, using both qualitative and survey data.
  • Implementation of shared decision making/decision aids into clinical care.

There are opportunities for both primary data collection and secondary data analysis, depending on interest.




Faculty name: Lindsay Mazotti, MD

Contact information: Lindsay.mazotti@ucsf.edu

Subspecialty/research focus: Medical education; hospital transitions of care

Title/description of research project: I have a few projects ongoing. Multiple curricular and assessment/evaluation projects for longitudinal third year clerkship PISCES; working on project to improve patient communication at hospital discharge; piloting a clinic project at Mt. Zion. Happy to assist resident in initiating own project as well- either in med education or involving transitions in care. Many options exist in the PISCES clerkship for projects as well.




Faculty name: Sunita Mutha, MD

Subspecialty/research focus: Cultural competence, organizational strategies for addressing health care disparities, using QI methods to reduce health care disparities, curriculum development, organizational change, and leadership skills.

Title of research project:

Qualitative analysis of interviews with organizational leaders

Identifying effective organizational strategies for addressing cultural and language barriers to care

Revising a nationally distributed educational toolkit for teaching cultural competence

Assessing the feasibility of integrating cultural competence measures into Pay-for-Performance




Faculty name: Eliseo J. Pérez-Stable, MD

Contact information: eliseops@medicine.ucsf.edu
                                    415-476-5369,
                                    Box# 0320

Subspecialty/research focus: Tobacco use and cessation
                                                  Disparities by race/ethnicity
                                                  Cancer control, screening and care
                                                  Latino health care
                                                  Language Access

Title/description of research projects:

1 P30 AG15272 (Pérez-Stable, PI) 09/30/1997- 06/30/2007 
NIH/National Institute of Aging

Center for Aging in Diverse Communities. The major goal of this study is to foster the development of investigators who will conduct research with older minority persons, develop and implement strategies to diversify the investigator workforce conducting research on the health of older minority persons, and develop and implement strategies for recruiting and retaining minority group members in research dealing with the health of minority elderly.

P01 HS10856 (Washington, PI) 09/01/2000-08/31/2006 
AHRQ (project #2/Pérez-Stable)

Promoting Effective Communication and Decision-Making for Diverse Populations
In this Program Project we will a) identify elements of effective communication in diverse populations; b) determine factors that enhance effective, patient-preference based, clinical decision-making; c) evaluate methods for communicating risks (probability and outcomes) in diverse populations; d) lay foundation for developing decision-assisting tools; and e) develop greater capacity for health services research.

R01 TW05935 (Pérez-Stable, PI) 07/01/2002-6/30/2007
NIH/Fogarty International Center
Tobacco Use Among Argentinian Youth: A Cohort Study
The overall purpose is to assess factors associated with smoking initiation among Argentinian adolescents recruited at schools in the province of Jujuy. The grant also has a training component of Argentinian researchers.

U01-CA 86117-04 (Ramirez, PI) 04/01/2000-03/31/2010
NIH/National Cancer Institute
Redes En Accion: A Cancer Awareness, Research and Training Network
The overall goal of the Redes En Acción will be to establish a national network of investigators and organizations focused on cancer in Latinos in order to increase awareness about cancer prevention and treatment, expand training opportunities for future investigators, and support new research ideas targeting Latinos.

The California Endowment #20023080 ((Pérez-Stable, PI) 02/01/2003-01/31/2006 
VideoConferencing Medical Interpretation Program

The overall goal is to evaluate the implantation of a videoconferencing medical interpretation program at Alameda County Medical Center. Evaluations and process description will take place in the hospitalized patient, in a subspecialty clinic and in primary care setting.

My research theme is focused on health and health care disparities by race and ethnicity with a special emphasis on cancer prevention among Latino populations. Since 1993, I have been a leader of the Medical Effectiveness Research Center for Diverse Populations (MERC) in collaboration with A. Eugene Washington, MD. We lead a team of multidisciplinary investigators focused on health disparities by race/ethnicity with a special emphasis on cancer prevention, reproductive health, patient-doctor communication, and cardiovascular disease.

Cigarette Smoking Cessation and Prevention. Since 1985 I have led projects that involve tobacco cessation and prevention. We completed a survey of California pediatricians and family physicians and compared their reported behavior in counseling adolescents about smoking cessation. For most evidence-based practices to promote smoking cessation, family physicians were significantly more likely to report these behaviors than pediatricians. A national survey of primary care physicians (stratified by Latino and White ethnicity) is completed and shows poor adherence to recommended cessation practices. I collaborate with Ricardo Muñoz, PhD on an innovative adaptation of a self-help smoking cessation intervention (developed by our group) combined with mood management components for a web-based intervention to be evaluated in a randomized trial. Recently funded for a third cycle to further develop an Internet based research program. Preliminary findings from the web-based intervention indicate cessation rates similar to those obtained with quit lines. A study of African American adolescents and a parent identified differential attitudes by tobacco exposure at home. In collaboration with the laboratory of Neal Benowitz, MD, we completed analyses of nicotine metabolism in 160 White, Latino, African American and Chinese American smokers. Comparison of Latinos to Whites showed no significant differences in nicotine metabolism or consumption, but Chinese smokers had lower clearance compared to Whites. Intake of nicotine per cigarette among Chinese smokers was significantly lower compared to Whites and Latinos (0.73 mg vs. 1.10 mg vs. 1,05 mg) and this may explain in part lower lung cancer rates in Chinese (ref #89). In 2002 we were funded by the Fogarty International Center of the NIH for a collaborative tobacco program with a university in Jujuy, Argentina. We completed data collection on 3500 10 to 12 year old children enrolled in schools to ascertain factors that predict smoking initiation. This is the first study of its type in Latin America. We are also analyzing the tobacco documents to evaluate legislation, court cases and policy issues in Argentina and have two papers published on this topic.

Cancer Screening and Prevention. We are analyzing results of 970 interviews with women with an abnormal screening mammography examination stratified by four ethnic groups. The study is comparing psychological reactions, communication with the clinician, health related quality of life measures, and evaluation of index abnormality by four ethnic groups with adjustments for socioeconomic factors. Three initial manuscripts are submitted and under second review. The NCI funded Redes En Accion Network to address cancer prevention in Latino populations. We completed a survey of Latino leaders to identify priorities in cancer for Latinos, a national survey of Latino primary care physicians, evaluations of types of prostate cancer treatment by ethnicity and the role of support groups in Latinas with breast cancer. We are collecting data on 1600 women stratified by language and ethnicity to identify perception of risk in considering chemo prevention of breast cancer, screening of colon cancer and stopping cervical cancer screening after age 65.




Faculty name: Edgar Pierluissi, MD

Contact information: epierluissi@medsfgh.ucsf.edu

Subspecialty/research focus: Quality Improvement
                                                  Geriatrics

Title of research project: My area of research interest is in improving care for hospitalized older adults. We have started an Acute Care for Elders Unit that is a unique clinical site for implementing and testing interventions. We are currently designing interventions to increase the level of exercise in this population both during and after hospitalization. In addition, we have created a database of patients treated on the unit to compare outcomes with patients treated on other units.




Faculty name: Karron LeGarie Power, MD, MPH

Subspecialty/research focus: Occupational and Environmental Medicine

Title of research project: Effects of Ozone and Nitrogen Dioxide Exposure on Cardiovascular Responses in Healthy and Susceptible Humans.

Description of project: To determine the effects of controlled exposure to Ozone and Nitrogen Dioxide on Heart Rate Variability, airway and systemic inflammation, components of the renninangiotensin system, and coagulability in healthy and asthmatic humans.




Faculty name: Michael W. Rabow, MD

Contact information: mrabow@medicine.ucsf.edu
                                    Pager: 719-4206

Subspecialty/research focus: General Internal Medicine and Palliative Care Research focus: palliative care, including outpatient palliative
care, Medical student and physician professional development.

Title/description of research projects: Developing and evaluating palliative care in the Comprehensive Cancer Center. Includes clinical, interdisciplinary consultation, patient discussion groups, RN continuing educ. Research includes evaluation of staff/MD satisfaction, as well as a planned RCT of patient depression, anxiety, and QOL in the setting of palliative care consultation vs usual care

Physician-Family Caregiver Project - A collaboration between Osher and the Dept of Neurosurgery. Producing a documentary film about family caregiving and developing a web-based training module for neurosurgery residents on supporting family caregivers. Research includes effectiveness evaluation of resident training sessions, documentation of dissemination

The Healer.s Art Evaluation - National evaluation of the impact of the Healer.s Art elective, now offered at UCSF and 44 other medical schools nationwide. Current project is qualitative analysis of student mission statements. Planned: evaluation of faculty experience nationally.




Faculty name: David Rempel, MD,MPH (Professor in Residence)

Contact information: drempel@itsa.ucsf.edu

Subspecialty/research focus: Occupational Medicine/Hand and arm disorders related to work.

Title of research project: Biomarkers for Carpal Tunnel Syndrome and Epicondylitis.

Description of project: Evaluate the relationship between serum and urinary cytokines and severity (symptom and function) of carpal tunnel syndrome and epicondylitis. The goal is to identify biomarkers that are predictive of onset or worsening severity of these disorders in order to evaluate treatments and improve case management. Study takes place at the UCSF Hand Clinic and Occupational Medicine clinics in the Bay Area.




Faculty name: Elise Riley, PhD, MPH
                         Associate Professor, Department of Medicine, Division of HIV/AIDS

Contact information: 1001 Potrero Ave.,
                                    Bldg. 100, Rm. 339,
                                    San Francisco, CA 94143-0874
                                    (415) 206-4983
                                    eriley@epi-center.ucsf.edu
                                    UCSF Profile: http://profiles.ucsf.edu/elise.riley

Subspecialty/research focus

I work with a multidisciplinary team of clinicians, epidemiologists, statisticians and social scientists. Our research with homeless and unstably housed adults living in San Francisco focuses on health risks and barriers to receiving care that are disproportionately common in extremely low-income populations. Unexpected findings emerge in the context of poverty; our goal is to use both clinical and behavioral factors to better understand health through studying the confluence of co-morbidity, patterns of health care use and social factors, such as addiction and violence. Our work is intended to inform and connect health care delivery, social services and health policy. 

Title/description of research projects:

■ Shelter, Health and Drug Outcomes among Women (SHADOW).  This study focuses on bidirectional influences of psychiatric (mental health and addiction) co-morbidity, violence, physical health status and the use of health services, including primary care, emergency services, mental health care and drug treatment.

■ HPV Epidemiology and Response to Testing Study (HEARTS).  This study focuses on how factors that are disproportionately common in impoverished populations, such as co-occurring sexually transmitted infections and the use of crack cocaine, influence the uptake of STI screening as well as the prevalence of HPV, trichomoniasis, HSV-2, HBV and HIV.   




Faculty name: Urmimala Sarkar, MD

Contact information: Phone: (415) 939-1907
                                    usarkar@medsfgh.ucsf.edu
                                    San Francisco General Hospital
                                    1001 Potrero Ave
                                    Bldg. 10, FL 3, Ward 13
                                    San Francisco, CA 94610

Subspecialty/research focus: General Internal Medicine / ambulatory patient safety, patient-facing health information technology for vulnerable populations, social media and health behavior

Title/description of research projects:

 Prevalence and spread of health behaviors and perceptions via online social media

  • Health beliefs and behaviors are often shared on public online social networks; it is unclear how such behavior or beliefs spread online
  • Qualitative and quantitative analytic methods can be used to describe public perceptions of health conditions online across a wide range of conditions
  • Measuring and improving ambulatory patient safety with an electronic dashboard
  • Ambulatory safety electronic dashboard (visual summary of safety measures) for use in primary care settings
  • Identify incipient safety problems (such as abnormal results not acted upon, recommended monitoring for high risk medications not performed) prior to patient harm
  • Population-based rather than visit-based identification of safety problems

California Safety Net Institute Innovation and Dissemination Network

  • Developing a network to spread evidence-based innovative practices in safety-net settings
  • Understanding and characterizing the barriers to widespread implementation of evidence-based, innovative practices in safety-net health systems using implementation science methods

Advancing the Universal Medication Schedule (UMS)

  • UMS is a set of validated medication instructions which are more comprehensible to patients than standard medication instructions
  • Currently developing/ testing literacy-friendly medication instructions for liquid, inhaled, tapered-dose, and as-needed medications among SFGH patients



Faculty name: Melvin Scheinman, MD

Contact information: scheinman@medicine.ucsf.edu

Title/description of research projects:

We have a number of projects that may be of interest to our residents.

  1. correlation of exercise-induced polymorphic Vt with a gene panel reflective of calcium handling
  2. ECG studies of patients with the Long QT syndrome in response to exercise as well as upright posture
  3. Correlation of clinical findings with induced pleuropotential myocyte function obtained with skin biopsy
  4. Response of patients with CPVT to beta blockers vs Flecainide in iPcs cells from these patients.



Faculty name: Dean Schillinger, M.D.
                         Associate Professor of Clinical Medicine
                         Director, UCSF Center for Vulnerable Populations
                         Contact Information: San Francisco General Hospital
                         1001 Potrero Avenue
                         Building 10, Ward 13
                         San Francisco, CA 94110
                         Tel: 415-206-8940
                         DSchillinger@medsfgh.ucsf.edu

Subspecialty/research focus: Health communication, literacy, disparities, chronic disease, diabetes, language barriers, vulnerable populations.

Title of research project: Multiple projects.

Description of research projects:

"Improving Diabetes Efforts Across Language and Literacy: Contextual Factors"

"Development a Diabetes Self-Management Toolkit"

"Patient Safety in Primary Care through Use of Interactive Technology Surveillance"

"Health Literacy, Health Communication, and Chronic Disease Care"

"Interactive Voice Response System to Transform Diabetes Care Among Vulnerable Populations"

"The Role of Government in a National Health System, a Study of Chile"

"Health Literacy & Self-Management in Heart Failure"

"Harnessing Health IT for Self-Management Support and Medication Activation in a Medicaid Health Plan"

"Disparities in Utilization and Outcomes in Rheumatoid Arthritis"




Faculty name: Steven A. Schroeder, MD

Contact information: Home Address: 10 Paseo Mirasol, Tiburon, CA 94920
                                    Home Phone: (415) 435-3872
                                    Work Phone: (415) 502-1881
                                    schroeder@medicine.ucsf.edu

Subspecialty/research focus: Smoking Cessation

Title/description of research projects: Opportunity to synthesize results of national smoking cessation interventions.




Faculty name: Karen H. Seal, MD
                         Associate Professor
                         Departments of Medicine and Psychiatry
                         University of California, San Francisco
                         Director, Integrated Care Clinic
                         San Francisco VA Medical Center

Contact information: karen.seal@ucsf.edu or karen.seal@va.gov

Subspecialty/research focus:

As a primary care internist and health services/implementation researcher, over the past several years I have dedicated my career to developing and testing new interventions to address mental health and substance abuse problems among returning Iraq and Afghanistan veterans. The development and evaluation of our integrated primary care-mental health clinic for Iraq and Afghanistan veterans at the SFVAMC is just one example of this. In addition, our established and highly and productive research team has excelled in both qualitative and quantitative research methodology as demonstrated by several recent high-profile publications. For example, we recently published a high-impact paper exposing the problem of high-risk prescription opioid use and associated adverse clinical outcomes in Iraq and Afghanistan veterans nationwide.  We also completed a randomized controlled trial of telephone motivational interviewing that successfully increased mental health treatment engagement and decreased marijuana use in returning combat veterans.

In addition to qualitative, clinical trials, and secondary data analysis research, our group is engaged in developing new lines of research in online education to build competency among primary care providers in the detection and initial management of posttraumatic stress disorder (PTSD) and in developing novel therapeutics to treat and prevent PTSD.  We have a number of exciting ongoing research projects and would welcome resident involvement at any stage of the research process, from designing new projects to data collection, to helping write manuscripts from the data we’ve already collected.  I hold a joint appointment in medicine and the department of psychiatry at UCSF and am happy to talk to residents about hybrid career paths in academia.

For more information about our group, please see: www.vetsreturnhome.com

Title/description of research projects: VA HSR&D Merit Award

“Neuropyschological Screening of Iraq and Afghanistan Veterans in VA Primary Care”

The main aim of this study is to investigate the extent to which the VA TBI screen fails to correctly identify the source of cognitive dysfunction and other postconcussive symptoms, limiting VA clinicians’ ability to triage and provide targeted services for Iraq and Afghanistan veterans.  We will test a novel system of identifying veterans with cognitive impairment in primary care.

Department of Defense

“Enhancing Cognitive Function and Reintegration in Iraq and Afghanistan Veterans with PTSD Using Computer-Based Cognitive Training”

The primary aim is to assess change in cognitive function in Iraq and Afghanistan veterans with PTSD who participate in a pilot randomized controlled trial of computer-based cognitive remediation games vs an attention control.  In addition, we will assess change in functioning, quality of life, and reintegration.

Department of Veterans Affairs –Polytrauma/Brain Injury QUERI            

“Educational Videos to Improve VA Traumatic Brain Injury Screening”

The main aim of this implementation study is to develop, implement, and test TBI educational videos for Iraq and Afghanistan veterans after they undergo TBI screening in VA primary care with the goal of mitigating misconceptions about TBI and promoting appropriate use of VA health services.  In a subsequent phase, we will be adapting the videos to a mobile app.

University of California, San Francisco, REAC Award                               

Motivational Interviewing to Improve Safety in Opioid Prescribing for Chronic Pain Patients in Primary Care: A Pilot Study”

The primary aim of this study is to develop and pilot test a motivational enhancement intervention that can be used to successfully communicate e-recommendations from a computer-based clinical decision support system to improve prescription opioid safety in VA primary care patients.

VA HSR&D Merit Award                                                                             

Motivational Coaching to Enhance Mental Health Treatment Engagement in Veterans Using Rural VA Community-Based Outpatient Clinics”

The main aim of this implementation project is to better understand barriers and facilitators to mental health treatment among rural Iraq and Afghanistan veterans and to use this information to hone a Motivational Peer Coaching intervention that uses e-health adjuncts to enhance mental health treatment engagement among rural veterans.




Faculty name: Hilary Seligman, MD, MAS

Contact information: Phone: 415-206-4448
                                    Fax: 415-206-5586
                                    hseligman@medsfgh.ucsf.edu
                                    Box 1364

Subspecialty/research focus: Food insecurity; health disparities; social determinants of health; self-management; obesity; diabetes; policy and advocacy

Title/description of research projects:

My research focuses on the intersection between food insecurity (going hungry or being at risk of going hungry) and health, particularly the prevention and management of obesity and diabetes. I use both primary data collection and secondary data analysis. My interests include obesity in vulnerable populations; self-management of obesity and diabetes; and the experiences of food insecurity in households with and without children.




Faculty name: Brad Sharpe, MD

Contact information: 415-514-2198 (office)
                                   415-443-0989 (pager)
                                   sharpeb@medicine.ucsf.edu

Subspecialty/research focus: Hospital Medicine
                                                  Community-acquired pneumonia
                                                  Healthcare-associated pneumonia
                                                  Oral Case Presentations
                                                  Medical Education
                                                  Faculty Development

Title of research project:

Oral Case Presentations
I am part of a multi-center group studying oral case presentations as there is minimal literature on how to do these well or how to teach them. We have done multiple surveys of faculty trying to determine "best practices" for oral case presentations for 3rd-year students. I am interested in figuring out what makes a "great presentation" and how to teach this skill more effectively.




Faculty name: Ida Sim, MD

Contact information: ida.sim@ucsf.edu

Subspecialty/research focus: Medical informatics
                                                  Mobile health
                                                  Clinical trials publication and data sharing

Title/description of research projects:

1. Mobile health for chronic disease management: Working with mobile health companies (e.g., FitBit, Jawbone), care providers (e.g., Kaiser, Stanford Preventive Cardiology), and research projects  (e.g., Health eHeart) to define and build mobile apps and data analytics for diabetes and cardiac care.

2. Clinical trial data modeling and sharing: Modeling biases and statistical methods in the Ontology of Clinical Research, applying natural language processing to clinical trial reports and protocols, and designing and building retrieval and visualization interfaces for the designs of clinical trials.




Faculty name: Maria A. Wamsley, MD

Contact information: maria.wamsley@ucsf.edu

Subspecialty/research focus: General Internal Medicine
                                                   Medical Education Research

Title of research project: Interprofessional Standardized Patient Exercise - I am working with faculty from the Schools of Nursing, Dentistry, PT and Pharmacy to develop and implement a standardized patient exercise for an interprofessional group of learners. The resident would work with us to develop the SP case and assist in data collection and analysis. This would be an opportunity to gain expertise in writing a standardized patient case and in analyzing curricular evaluation data. Potential for presentation at national meetings as well as for publication. Chronic Illness Curriculum – We implemented a chronic illness curriculum in 2007 at UCSF. We have collected outcomes data that is mostly quantitative. The resident's role would be to assist in the analysis of data and preparation of a manuscript for publication.




Faculty name: Sheri Weiser, MD

Contact information: sheri.weiser@ucsf.edu

Subspecialty/ research focus: HIV/AIDS, Primary care

Title of research project: General:Structural barriers to HIV prevention, treatment and care in underserved populations in resource-rich and resource-poor settings. Current specific focus: 1) Examining the impact of food insecurity on HIV transmission risk behaviors, access to care, antiretroviral adherence, and clinical outcomes among HIV-infected individuals in sub-Saharan Africa and the US. 2) Developing sustainable food security interventions domestically and in sub-Saharan Africa in order to improve HIV health outcomes, chronic disease outcomes, and gender empowerment. Other research interests/projects: HIV stigma, mental illness and HIV clinical outcomes, provider-initiating testing and counseling, gender disempowerment and its impacts on HIV prevention and health outcomes.




Faculty name: Mary Whooley, MD
                         Professor of Medicine
                         Epidemiology and Biostatistics
                         University of California, San Francisco
                         Section of General Internal Medicine (111A1)
                         Department of Veterans Affairs Medical Center
                         4150 Clement Street
                         San Francisco, CA 94121
                         Phone: 415-750-2093
                         Fax: 415-379-5573
                         mary.whooley@ucsf.edumary.whooley@ucsf.edu
                         Web site: http://www.heartandsoulstudy.net

Subspecialty/research focus: Cardiovascular Disease, Quality of Life, Mental Health

Title of research project: The Heart and Soul Study

Description of project: The Heart and Soul Study is a prospective cohort study of 1024 patients with coronary heart disease. Between 9/00 and 12/02, all subjects completed exercise treadmill testing with stress echocardiography, an extensive questionnaire, and several blood and urine measurements of cardiovascular disease risk factors. Participants are being followed for 10 years to assess cardiovascular outcomes (MI, CHF, stroke). As of 2008, UCSF residents and fellows have published over 50 papers from this dataset. Dr. Whooley has many ideas for future research projects, and would be happy to help residents write and publish papers on these projects or others.




Faculty name: Elad Ziv, MD

Contact information: Box 1732
                                   DGIM
                                   1701 Divisadero St., Suite 537
                                   San Francisco, CA 94115
                                   Office: 415-353-7981
                                   elad.ziv@ucsf.edu

Subspecialty: General Internal Medicine 

Research focus: Genetic Epidemiology
                             Identification of Common Genetic Variants Associated with Cancer Susceptibility
                             Genetic Studies in Admixed Populations
                             Genetics of Mammographic Density
                             Breast Cancer Epidemiology

Title/description of research projects:

Admixture and breast cancer risk among Latinas

Genetics of Mammographic Density, a Strong Risk Factor for Breast Cancer

Admixture mapping of inflammatory markers in African Americans

Genetic variants that modify the effect of Tamoxifen




Genetics

Faculty name: WJohn P. Kane, MD, PhD
                         415-476-1517

Subspecialty/research focus:

Disorders of lipid and carbohydrate metabolism at the gene level; genetic determinants associated with coronary disease and stroke, diabetes.

Title of research project: There is a wide scope of possible studies within the interests being pursued in our laboratory such as the relationship of the genotype of the Lp(a) lipoprotein to disease, investigation of the mechanisms of action of gene polymorphisms recently discovered in our collaborations that are associated with increased risk of MI, etc., the molecular speciation of HDL in relationship to disease phenotypes, effects of medications on the distribution and function of HDL molecular species,etc.,etc.




Faculty name: Melvin Scheinman, MD

Contact information: scheinman@medicine.ucsf.edu

Title/description of research projects: We have a number of projects that may be of interest to our residents.

  1. correlation of exercise-induced polymorphic Vt with a gene panel reflective of calcium handling
  2. ECG studies of patients with the Long QT syndrome in response to exercise as well as upright posture
  3. Correlation of clinical findings with induced pleuropotential myocyte function obtained with skin biopsy
  4. Response of patients with CPVT to beta blockers vs Flecainide in iPcs cells from these patients.




Geriatrics

Faculty name: Louise Aronson, MD, MFA

Contact information: 415-514-3154
                                   aronsonl@medicine.ucsf.edu

Subspecialty/research focus: Geriatrics/Medical Education, Reflective learning, Narrative Medicine

Title of research project/brief description of project: Promoting reflection in medical students: A randomized trial Can reflective ability be assessed independently from writing and storytelling ability? Teaching reflection: Impact of a faculty development program The biopsychosocial approach: Potential impact on compliance and care transitions Bolus v. drip: Teaching geriatrics to third year medical students Systematic review: UME geriatrics education Multiculturalism: A narrative medicine reader




Faculty name: Kenneth Covinsky, MD, MPH

Contact information: Ken.covinsky@ucsf.edu 

Subspecialty/research focus: Geriatrics
                                                  Outcomes research/Epidemiology/Health Services Research

Title/description of research projects: We focus on understanding the determinants of major health outcomes in the elderly. We are particularly interested in the determinants of functional status outcomes and the use of functional status as a prognostic determinant of mortality and other health outcomes. We have a number of ongoing projects. Some are focused on understanding how a diverse range of risk factors predict outcomes in the elderly. Others are focused on developing and validating risk indices to accurately differentiate between elders at differential risk of adverse outcomes.




Faculty name: Sei J. Lee, MD, MAS
                         415-221-4810 x4543
                         Sei.lee@ucsf.edu

Subspecialty/research focus: Geriatrics Clinical Research

Title of research project/description of project: Geriatrics Diabetes
                                                                               Risk Reduction in the Elderly (especially nontraditional risk factors)
                                                                               Quality Measurement in the Elderly




Faculty name: Edgar Pierluissi, MD

Contact information: epierluissi@medsfgh.ucsf.edu

Subspecialty/research focus: Quality Improvement
                                                  Geriatrics

Title of research project: My area of research interest is in improving care for hospitalized older adults. We have started an Acute Care for Elders Unit that is a unique clinical site for implementing and testing interventions. We are currently designing interventions to increase the level of exercise in this population both during and after hospitalization. In addition, we have created a database of patients treated on the unit to compare outcomes with patients treated on other units.




Faculty name: Michael Steinman, MD

Contact information: 415-221-4810 x3677
                                   FAX 415-750-6641
                                   mstein@itsa.ucsf.edu

Subspecialty/research focus: Geriatrics

Research interests include:

  • measurement of prescribing quality in elders
  • appropriator ate use of antibiotics in outpatient infections
  • pharmaceutical marketing.

Title of research project/description of project: I have several research projects related to my research interests, and would be happy to discuss them individually with interested residents.




Faculty name: Katie L. Stone, PhD

Contact information: Senior Scientist
                                   San Francisco Coordinating Center/ California Pacific Medical Center Research Institute
                                   185 Berry St, Lobby 5, Suite 5700
                                   San Francisco, CA 94107
                                   415-600-7422
                                   FAX 415-514-8150

Subspecialty/research focus: Insomnia/Sleep Disorders in Older Adults

Title of research project/description of project:

Outcomes of Sleep Disorders in Older Men (MrOS Sleep Study):
The Osteoporotic Fractures in Men (MrOS) Study is a large multi-center cohort study of risk factors for osteoporosis and osteoporotic fractures in older men. The MrOS Sleep Study, a substudy to the MrOS parent study, was funded by NHLBI and enrolled approximately 3000 older men between December, 2003 and April, 2005. The major objective of the MrOS Sleep Study is to determine the relationship of sleep characteristics (measured comprehensively and objectively using wrist actigraphy and in-home overnight PSG) and a broad set of outcomes, including incident centrally-adjudicated cardiovascular events, falls and fractures, total and cause-specific mortality, and neuropsychiatric and physical function. In brief, the examination was comprised of three components: 1) an in-clinic visit during which subjects completed a self-administered questionnaire and interview, and a variety of clinical measures such as height and weight, blood pressure, ECG, bone density testing, and performance-based tests of strength and physical function; 2) single night unattended in-home polysomnography; 3) wrist actigraphy (five consecutive 24-hour periods), beginning the day of the clinic visit. A recently funded renewal application will allow for follow-up measures of sleep and other characteristics in approximately 1000 MrOS Sleep Study participants, beginning in October 2009. Changes in Sleep and Cognition in Older Women (SOF Sleep Study): The SOF Sleep Study is an ancillary study to the Study of Osteoporotic Fractures SOF). SOF is a longitudinal epidemiologic study of 9,704 women aged 65 and older recruited from four study centers located in Portland, OR; Baltimore, MD; Minneapolis, MN; and the Monongahela Valley near Pittsburgh, PA. SOF was originally designed to investigate risk factors for osteoporosis and osteoporotic fractures. The baseline SOF exams were conducted from 1986-88. Since then follow-up exams have taken place approximately every two years. We successfully established banks of clinical data, sera, DNA, and urine. During the eighth SOF examination (2002-2003) new measures were added to address aims related to outcomes of sleep disturbances in older women. Outcomes of interest in the SOF Sleep Study included falls and fractures, total and cause-specific mortality, and cognitive and physical function. We obtained objective measures of sleep including wrist actigraphy (n=3,131) and in-home unattended polysomnography (single night) in a subset of 461 subjects at two centers. Follow-up measures of sleep and other clinical measures were completed during 2007-2009. In addition, during the follow-up examination an expanded cognitive testing battery was performed and subjects were adjudicated for incident mild cognitive impairment and dementia. These additional measures in this unique, well-characterized cohort of older women will allow for testing a variety of aims focused on the longitudinal relationships of sleep and cognitive function. Previously archived serum samples will also be utilized to explore potential mechansims for the relationships between poor sleep, cognition and mortality.




Faculty name: Victor Valcour, MD

Contact information: vvalcour@memory.ucsf.edu

Subspecialty/research focus: Geriatric Medicine, HIV

Title/description of research projects:

Dr. Valcour’s research addresses the cognitive consequences of HIV infection through local and international studies in Thailand and Africa. These are all clinical research protocols involving neuropsychological testing, neurological examinations, brain MRIs, and laboratory testing among HIV-infected and HIV-exposed child, adult, and elderly populations. Individuals who work on these projects may learn techniques associated with cognitive characterization of patients and imaging, and clinical care. Opportunities exist to participate in data analysis including imaging analyses and manuscript preparation. For more detailed descriptions of Dr. Valcour’s various research projects, please visit his lab website at :

http://valcourlab.ucsf.edu/mentoring--training.html




Hematology/Oncology

Faculty name: Donald I. Abrams, MD

Contact information: dabrams@hemonc.ucsf.edu

Subspecialty/research focus: Integrative oncology

Title/description of research projects: Biofeedback for Breathlessness in Patients with Lung Cancer Problem:Patients with pulmonary malignancies, primary or metastatic, often suffer from a frightening sensation of breathlessness as the disease progresses. This serves to further increase anxiety which could exacerbate the breathlessness. A Cochrane review just analyzed the literature on non-pharmacological interventions for breathlessness in this population, concluding that more evidence is needed. Biofeedback was not mentioned as a previously studied intervention in the review. Intervention: The OCIM biofeedback nurse will conduct eight weekly sessions of training with patients to instruct them in the tools of engaging their mind to modulate the symptom as well as the anxiety it creates. We will measure breathlessness using the Borg scale of dyspnea, a visual analog scale and a 6 minute walk test. Quality of life and anxiety/depression scores will also be obtained. Title: Mindfulness-Based Stress Reduction for Men with Prostate Cancer Undergoing Active Surveillance Problem: Men with a diagnosis of prostate cancer who are being followed with active surveillance experience significant stress, especially awaiting results of their serial PSA blood tests, drawn every 4 months. Dr. Carroll and the new Psycho-oncology team at the Cancer Center are eager to investigate potential interventions to allay some of the anxiety and stress experienced by these men. Intervention: OCIM has established a reputation for excellence in the MBSR programs offered. We will develop a dedicated 8 week program for men with prostate cancer undergoing active surveillance and comparing their outcome to a control group who receives weekly supportive telephone calls. We will measure quality of life, anxiety/depression and positive affect for 12 months after the intervention. Title: Tai Chi for Post-Menopausal Women with Breast Cancer and Musculoskeletal Symptoms Secondary to Aromatase Inhibitor Therapy Problem: The majority of post-menopausal women with breast cancer are now being prescribed a 5-year course of aromatase inhibitors following their initial therapy. This intervention has been demonstrated to prolong survival. Unfortunately, up to 40% of women experience some degree of bothersome joint or muscle complaints and 20% actually stop taking treatment because of the symptom. As yet, no pharmaceutical intervention has proven effective. Intervention: Dr. Acquah is a renowned Tai Chi instructor who agrees that the mindful movement of the practice may allow women to decrease their musculoskeletal symptoms via continued movement and activity. Fifteen to 20 women will participate in a 12-week series of sessions at the OCIM and will be asked to practice with a DVD at home. Pain, quality of life and a functional measure of activity will be monitored during and after the intervention period. N.B. Dr. Dhruva is proposing that an identical study be conducted using yoga as the mindful movement intervention. The team is still deliberating the feasibility and implications of one vs two modalities, randomization, control groups, etc. Title: Acupuncture for Peripheral Neuropathy and Cytopenias Resulting from Intraperitoneal Chemotherapy in Women with Ovarian Cancer Problem: Women with advanced ovarian malignancies have improved survival if treated with chemotherapy instilled directly into their abdominal cavity (intraperitoneal) in addition to intravenous treatment. The intraperitoneal therapy, however, is associated with an increased risk of toxicities including painful nerve damage in the hands and feet (peripheral neuropathy) and prolonged lowering of the blood counts. Both occur in the majority of patients so treated. The neuropathy can impact the ability to walk as well as impacting negatively on overall quality of life. The low blood counts can delay treatment dosing and puts the patient at risk for fatigue, infection and bleeding. There is some evidence that acupuncture may be of benefit in the prevention and/or treatment of these treatment-related side effects. Intervention: The OCIM acupuncturists will treat the women receiving intraperitoneal chemotherapy during each of their three day hospitalizations for chemotherapy infusion. Blood counts will be monitored. Patients will complete visual analog scales rating the extent of their painful peripheral neuropathy. We will treat a group of women at risk for neuropathy and low counts who do not yet have these side effects as well as a group of women with established neuropathy to see if there is differential benefit with regard to prevention vs treatment of the symptoms.




Faculty name: Hope S. Rugo, MD

Contact information: hrugo@medicine.ucsf.edu

Subspecialty/research focus: Breast Oncology with a focus on novel agents, predictive factors, and translational research

Title/description of research projects:

We have numerous ongoing and planned trials, as well as accumulated data for retrospective or subset reviews.  Our trials include several areas, and we are very interested in discussing additional study designs that are feasible within the timeframe available for interested residents.  An incomplete list is:

1. Impact of novel agents in combination with chemotherapy

2. Biomarker analysis

3. Patient communication

4. Quality of life

5. Trial design

6. Patient education

7. Survivorship

8. Brain metastases

9. Fertility

10. Numerous chart review projects, and completing projects where data has been collected, but not yet analyzed or written up for publication

We also have ongoing projects writing review papers which have been very nice collaborations in the past when time is relatively limited for intensive work on a clinical project.




Faculty name: Charles J. Ryan MD

Contact information: ryanc@medicine.ucsf.edu

Subspecialty/research focus: Oncology, Prostate Cancer
                                                  Hormonal therapies for prostate cancer
                                                  Developmental Therapeutics

Title of research: My research deals with the mechanisms of resistance to standard hormone therapy for prostate cancer patients. As a clinical/translational researcher, I conduct clinical trials of new drugs at the phase I and II level. My major clinical trials target the synthesis of androgens by the adrenal gland. Further, I study the interaction of androgen stimulation and signaling by the Insulin like growth factor (IGF) receptor in prostate cancer models. We do preclinical work in the lab that corresponds to our ongoing clinical trials.




HIV/AIDS

Faculty name: Laurence Huang, MD 

Contact information: Positive Health Program, Ward 84
                                   San Francisco General Hospital
                                   995 Potrero Avenue
                                   San Francisco, CA 94110
                                   Telephone: (415) 476-4082 extension 406
                                   Fax: (415) 476-6953
                                   Lhuang@php.ucsf.edu

Subspecialty/research focus: Pulmonary

Title of research project: Molecular Epidemiology Studies of Pneumocystis Pneumonia 
Description of Research Project: Dr. Huang's main clinical and clinical research interests are in HIV-associated pulmonary disease and especially Pneumocystis pneumonia (PCP). He has several collaborations with researchers at the Centers for Disease Control and Prevention, the National Institutes of Health, the University of Cincinnati, the University of Alabama- Birmingham and the University of Southern California as well as independent studies on PCP and ICU outcomes among HIV-infected patients. Current research studies include:

A multicenter molecular-epidemiology study investigating the association between Pneumocystis prophylaxis, Pneumocystis cannot be cultured, this study seeks to address the question of whether human Pneumocystis develops evidence of resistance to PCP treatment and prophylaxis regimens.

Development and validation of several new molecular applications to PCP, including the use of a quantitative PCR assay and a novel RT-PCR molecular viability assay on oropharyngeal wash specimens to diagnose PCP, development of Pneaumocystis antibody assays, and development of a .cytokine flow cytometry. assay to detect Pneumocystisspecific CD4+ and CD8+ T cell immune responses.

Comprehensive molecular-epidemiology study to address the question of whether PCP in humans results from person-to-person transmission (as has been convincingly demonstrated from animal-to-animal laboratory studies) and whether disease results from reactivation of latent infection or from recent exposure and infection.

Prospective cohort study of the incidences, persistence, and consequences of Pneumocystis colonization both for the individual under study as well as for the potential as a reservoir for the organism.

Prospective cohort study of the incidence and persistence of Pneumosystis colonization among health care workers (HCW).

Creation of an international Pneumocystis network to enable researchers to pool resources and share data to answer questions of mutual interest and to estimate the contribution of PCP to morbidity and mortality in HIV-infected persons worldwide.




Faculty name: Mark Jacobson, MD 
                        Professor of Medicine in Residence

Contact information: Positive Health Program
                                   University of California, San Francisco
                                   Ward 84, 995 Potrero
                                   San Francisco General Hospital
                                   San Francisco, CA 94110
                                   415-476-4082 ext 407
                                   FAX 415-476-6953

Subspecialty/research focus: Dr. Mark Jacobson is a Professor of Medicine in Residence at University of California, San Francisco (UCSF). He has previously been Director of the UCSF Adult AIDS Clinical Trials Unit and of the UCSF Center for AIDS Research Clinical Core and is now associate director of the General Clinical Research Center at SFGH. Dr. Jacobson did an Infectious Diseases fellowship at the University of California, Los Angeles, before joining the UCSF faculty in 1986. His major research interests are in the immunopathogenesis, natural history and treatment of AIDS-related opportunistic infections and in immune reconstitution of HIV-infected patients who have received highly active antiretroviral therapy. Residents can work with Dr. Jacobson on observational studies (involving medical record review).




Faculty name: Jay A. Levy, MD
                         Professor of Medicine

Contact information: Department of Medicine Division of Hematology/Oncology University of
                                   California, San Francisco 513 Parnassus, Room S1280 San Francisco, CA
                                   94143-1270
                                   Tel. (415) 476-4071 Fax. (415) 476-8365
                                   jay.levy@ucsf.edu

Subspecialty/research focus: Infectious Diseases
                                                  Immunology
                                                  HIV/AIDS

Description of project: Research interests of our laboratory are directed at understanding the mechanisms of HIV pathogenesis with the hope of designing novel antiviral therapies and an effective AIDS vaccine.

Virus Studies: Biologic, serologic, and molecular characterization of HIV-1 and HIV-2 strains are revealing their extensive heterogeneity and have demonstrated that viruses may evolve differently in the same individual (the immune system, bowel, and the brain). Molecular studies with intraviral recombinants of HIV-1 have shown that very few envelope gene changes can affect tissue tropism, cytopathicity and serum antibody sensitivity. Current anti-HIV experiments are evaluating RNA approaches.

Immune Studies: Recent emphasis in the laboratory has been on anti-HIV innate immune responses. We are evaluating the role of plasmacytoid dendritic cells (PDC), major producers of type 1 interferons. Studies are directed at understanding how HIV-infected cells induce interferon production from PDC and what cell surface molecules, including toll-like receptors, are involved in this process. Another innate response we have defined is the ability of CD8+ lymphocytes to suppress HIV replication without killing the cells. This CD8+ cell noncytotoxic antiviral response (CNAR) is mediated by a novel unidentified CD8+ cell antiviral factor (CAF). CNAR and CAF block HIV transcription. Certain cytokines such as IL-2, IL-15 and IFN-a as well as co-stimulation with CD3 and CD28 antibodies and co-culture with mature dendritic cells can enhance this antiviral response.

The identity of CAF is being determined by protein purification procedures involving mass spectrometry, and molecular analyses, using microarray techniques. Other studies focus on why the CD8+ cell anti-HIV response decreases with time in HIV-infected individuals. In acute HIV infection, we have found that antiviral drugs that reduce HIV plasma loads, decrease the CD8+ cell antiviral response. New treatment directions being evaluated are IL-2 therapy, immunization, and structured treatment interruptions in attempts to restore the host anti-HIV immune response.

Vaccine Studies: Experiments towards deriving an AIDS vaccine involve an HIV-2 DNA vaccine with genetic adjuvants (GM-CSF, B7.2). Immunized baboons are monitored for anti-HIV-2 neutralizing antibodies as well as cell-mediated anti-HIV immune responses. These studies will hopefully pave the way for the development of an effective HIV vaccine for humans.




Faculty name: Victor Valcour, MD

Contact information: vvalcour@memory.ucsf.edu

Subspecialty/research focus: Geriatric Medicine, HIV

Title/description of research projects:

Dr. Valcour’s research addresses the cognitive consequences of HIV infection through local and international studies in Thailand and Africa. These are all clinical research protocols involving neuropsychological testing, neurological examinations, brain MRIs, and laboratory testing among HIV-infected and HIV-exposed child, adult, and elderly populations. Individuals who work on these projects may learn techniques associated with cognitive characterization of patients and imaging, and clinical care. Opportunities exist to participate in data analysis including imaging analyses and manuscript preparation. For more detailed descriptions of Dr. Valcour’s various research projects, please visit his lab website at :

http://valcourlab.ucsf.edu/mentoring--training.html




Faculty name: Sheri Weiser, MD

Contact information: sheri.weiser@ucsf.edu

Subspecialty/research focus: HIV/AIDS, Primary care

Title of research project: General:Structural barriers to HIV prevention, treatment and care in underserved populations in resource-rich and resource-poor settings. Current specific focus: 1) Examining the impact of food insecurity on HIV transmission risk behaviors, access to care, antiretroviral adherence, and clinical outcomes among HIV-infected individuals in sub-Saharan Africa and the US. 2) Developing sustainable food security interventions domestically and in sub-Saharan Africa in order to improve HIV health outcomes, chronic disease outcomes, and gender empowerment. Other research interests/projects: HIV stigma, mental illness and HIV clinical outcomes, provider-initiating testing and counseling, gender disempowerment and its impacts on HIV prevention and health outcomes.




Hospital Medicine

Faculty name: Andrew D. Auerbach, MD, MPH

Subspecialty/research focus: Perioperative medicine, risk prediciotn, translating research into practice, biomarkers.

Title of research projects:

Novel Biomarkers of Perioperative Risk

Novel Biomarkers of Perioperative Risk: This prospective trail of patients undergoing major noncardiac surgery at UCSF seeks to understand whether preoperatively measured levels of a variety of biomarkers (e.g. IL-6, CRP, TNF-alpha) predict risk for postoperative complications (MI, Pneumonia, delirium, surgical site infection) mortality, after adjusting for traditional clinical risk factors (e.g.age, co morbidities).

Understanding and improving perioperative quality of care at UCSF.

Understanding and improving perioperative quality of care at UCSF: Using a data collection strategy similar to that for project 1, this large prospective trial seeks to understand the current gaps in delivering appropriate care for patients undergoing major noncardiac surgery, in particular 1) Use of perioperative beta blockers, 2) DVT prophylaxis, 3) Diabetes management, and 4) Prevention of surgical site infections.




Faculty name: Margaret Fang, MD, MPH

Contact information: fang@medicine.ucsf.edu

Subspecialty/research focus: Hospital Medicine, Anticoagulation, Atrial Fibrillation, Cardiovascular Epidemiology

Title of research project: Use and Outcomes of Anticoagulation among Frail Elders with Atrial Fibrillation

Description of Project:

I am a hospitalist-researcher at UCSF who focuses on studying the use and outcomes associated with anticoagulation, in both the inpatient and outpatient setting. There are several potential areas in which residents can work with me. As medical director of the UCSF Anticoagulation Clinic, I can help residents conduct research projects within the clinic. These may include measuring patient knowledge or developing educational interventions, studying the quality of anticoagulation control, and investigating adverse outcomes associated with warfarin. I have used national databases to conduct epidemiologic research, such as tracking trends in the use of catheter ablation for atrial fibrillation in the United States over time, and can assist residents in the use of these databases. Finally, I also am interested in studying anticoagulation related topics in the hospital setting, such as the use of perioperative anticoagulation and IVC filters.




Faculty name: Lawrence Haber, MD

Contact information: Lawrence.haber@ucsf.edu

Subspecialty/research focus: Hospital medicine, resident supervision practices, underserved populations

Title/description of research projects: Failure to Thrive in Adult Inpatients

Though the syndrome has been most often described in outpatient geriatric literature, failure to thrive is a frequent inpatient diagnosis. Failure to thrive is associated with underlying medical conditions, rather than being an etiologic diagnosis and may lead to an anchoring bias. We aim to compare characteristics of adult inpatients admitted to a general medicine service with or without a diagnosis of failure to thrive. Retrospective chart review. CHR pending.




Faculty name: Liz Goldman, MD

Contact information: legoldman@medsfgh.ucsf.edu

Subspecialty/research focus:

Dr. Goldman is interested in evaluating and improving quality of care for vulnerable populations and in safety-net settings. She is particularly interested in communication and coordination between providers during patient care transitions and across care settings. She has expertise analyzing large administrative datasets as well as qualitative method expertise using interviews and focus groups of providers and health care leadership.

Title/Description of Research Projects:

1. Evaluating and improving quality in safety-net hospitals, clinics, and mammography facilities
2. Improving transitions of care and cross setting communication in the safety net
3. Building value conscious care among providers




Faculty name: Niraj L. Sehgal, MD, MPH

Contact information: nirajs@medicine.ucsf.edu
                                    (415)476-0723

Subspecialty/research focus: Hospital Medicine. Patient Safety and Quality Improvement, Interprofessional communication and teamwork

Title/description of research projects: The TOPS (Triad for Optimal Patient Safety) Project is a pilot study targeting 14-Long that involves a large quality improvement project directed at providers and a research component directed at patients. The QI portion of the project involves a series of patient safety interventions with an overall goal to improve safety culture. The interventions include formal teamwork and communication training, monthly unit-based activities to reinforce the training, and interventions targeting patients by engaging them in patient safety education. The research component of the project involves recruitment of patients on 14-Long with a series of interviews during hospitalization and after discharge to assess their hospital experience and specifically address components of safety, teamwork, and communication. In addition, chart abstractions are being performed to capture addition demographic and clinical data. The TOPS project is a joint endeavor with the School of Nursing and Pharmacy at UCSF and we are directing identical efforts at two collaborating sites: Kaiser-SF and El Camino Community Hospital in Mountain View.

QI projects around discharge planning and communication between different healthcare professionals 




Infectious Diseases

Faculty name: Chip Chambers, MD

Contact information: hchambers@medsfgh.ucsf.edu
                                   phone 415 206 5437

Subspecialty/research focus: infectious diseases, staphylococcal infections, microbial pathogenesis, hospital epidemiology, antimicrobial drug resistance

Title/description of research projects:

I study the pathogenesis and treatment of infections caused by Staphylococcus aureus, in particular the nexus of antimicrobial resistance and virulence, both hallmark traits of this human pathogen. By far the most important resistance is methicillin resistance, i.e., beta-lactam antibiotic class resistance; beta-lactams are the most effective and least toxic of all antibiotics used to treat Staphylococcus aureus infections. A low-affinity penicillin binding protein, PBP 2a, mediates methicillin resistance. (PBPs are integral bacterial membrane proteins that catalyze final steps of cell wall synthesis and they the targets of beta-lactams.) We were the first to report that PBP 2a is inducible by beta-lactams and we described a novel signal transduction pathway that regulates expression of beta-lactamase, and, as it turns out, PBP 2a. Our work demonstrating that antibiotics differ in affinity for PBP 2a and as a result their antibacterial activity provided a foundation for drug discovery efforts in the pharmaceutical industry to identify compounds with high affinity for PBP 2a. Several such compounds have been developed and two cephalosporins are in late stage clinical development. We are interested in understanding mechanisms of resistance to high binding affinity beta-lactams and have identified mutations in PBP 2a and, unexpectedly, in other genes that confer high-level resistance to the compounds. We continue to pursue this area of research.

A little over a decade ago we and others recognized a change in the epidemiology of methicillin resistant S. aureus (MRSA) strains. MRSA, almost exclusively a hospital organism, was being isolated from patients who had no contact with the healthcare system. Through our work and the work of others it became apparent that these community strains of MRSA were distinct from those circulating in hospitals. By 2004 one particular clone known as USA300, originally identified by Dr. Perdreau-Remington at San Francisco General Hospital, accounted for the vast majority of community MRSA isolates in the United States. We have contributed to defining the clinical and molecular epidemiology of what is now an epidemic of community MRSA. In addition to their epidemicity USA300 strains are quite virulent and capable of causing rapidly lethal infections. We have characterized a novel mobile genetic element, ACME, which is unique to USA300 and appears to encoded one or more virulence determinants. We have also developed a rabbit pneumonia model that has allowed us to elucidate mechanisms by which Panton-Valentine leukocidin (PVL), a staphylococcal leukotoxin strongly associated with USA300 and other community MRSA strains, produces such extensive tissue damage. Our research to better understand the basis of this convergence of resistance and virulence is on going. Emergence of community MRSA has profound implication for therapy, as beta-lactams can no longer be relied upon for empirical therapy. We are involved in preclinical and clinical evaluation of several investigational agents for treatment of MRSA infections. In addition my research group is overseeing a multicenter clinical trial of the efficacy of oral, generic antibiotics for treatment of skin and soft tissue infections caused by MRSA.




Faculty name: Judy Hahn, MD

Contact information: 415-206-4435
                                   jhahn@epi-center.ucsf.edu

Subspecialty/research focus: HIV/HCV/substance use/alcohol use

Title of research project: Utilization of HIV care and alcohol use in Mbarara, Uganda

                                          Measurement of alcohol use in HIV positives in Uganda

                                          Dynamic models of HCV in injecting drug users




Faculty name: Laurence Huang, MD
                         Professor of Medicine
                         Chief, AIDS Chest Clinic
                         San Francisco General Hospital
                         Mailing Address:
                         HIV/AIDS Division, Ward 84
                         San Francisco General Hospital
                         995 Potrero Avenue
                         San Francisco, CA 94110
                         Telephone: (415) 476-4082, Extension 406
                         Text Message: 4154432536@archwireless.net
                         Fax: (415) 476-6953
                         Lhuang@php.ucsf.edu

Subspecialty/research focus: HIV- Associated Pulmonary Disease, Pneumocystis Pneumonia (PCP)

Title of research project: Molecular Epidemiology Studies of Pneumocystis Pneumonia


Description of research project: Dr. Huang's main clinical and clinical research interests are in HIV-associated pulmonary disease and especially Pneumocystis pneumonia (PCP). He has collaborations with researchers at the National Institutes of Health, the University of Cincinnati, Makerere University (in Kampala, Uganda), the University of Pittsburgh, and Yale University as well as independent studies on PCP and ICU outcomes among HIV-infected patients. Current research studies include:  

Development and validation of several new molecular applications to PCP, including the use of a quantitative PCR assay on oropharyngeal wash specimens to diagnose PCP and development of Pneumocystis antibody assays to study Pneumocystis epidemiology and transmission.

Comprehensive molecular-epidemiology study to address the question of whether PCP in humans results from person-to-person transmission (as has been convincingly demonstrated from animal-to-animal laboratory studies) and whether disease results from reactivation of latent infection or from recent exposure and infection.

Prospective cohort study of the incidences, persistence, and consequences of Pneumocystis colonization both for the individual under study as well as for the potential as a reservoir for the organism.

Prospective cohort study of the incidence and persistence of Pneumocystis colonization among health care workers (HCW).

Creation of an international clinical research network to study HIV-associated pulmonary diseases worldwide.




Faculty name: Dr. Mark Jacobson, MD

Contact information: Mark A. Jacobson, MD
                                    Professor of Medicine in Residence
                                    Positive Health Program
                                    University of California, San Francisco
                                    Ward 84, 995 Potrero
                                    San Francisco General Hospital
                                    San Francisco, CA 94110
                                    415-476-4082 ext 407
                                    FAX 415-476-6953

Subspecialty/research focus: Dr. Mark Jacobson is a Professor of Medicine in Residence at University of California, San Francisco (UCSF). He has previously been Director of the UCSF Adult AIDS Clinical Trials Unit and of the UCSF Center for AIDS Research Clinical Core and is now associate director of the General Clinical Research Center at SFGH. Dr. Jacobson did an Infectious Diseases fellowship at the University of California, Los Angeles, before joining the UCSF faculty in 1986. His major research interests are in the immunopathogenesis, natural history and treatment of AIDS-related opportunistic infections and in immune reconstitution of HIV-infected patients who have received highly active antiretroviral therapy. Residents can work with Dr. Jacobson on observational studies (involving medical record review).




Faculty name: Mallory O. Johnson, PhD

Contact information: UCSF Center for AIDS Prevention Studies 
                                    50 Beale Street, Suite #1300 
                                    San Francisco, CA 94105 
                                    P: 415-597-9374 
                                    F: 415-597-9213 
                                    Mallory.Johnson@ucsf.edu 

Subspecialty/research focus: Behavioral Medicine, HIV interventions

Title/description of research projects:

2005-Present

Principal Investigator, A mindfulness approach to HIV treatment side effects.
NIH/NCCAM R21. Co-Investigators: R. Hecht, T. Neilands, and J. Moskowitz.

2004-Present

Principal Investigator, Measuring and understanding HIV treatment expectancies.
UARP Grant. Co-PI: T. Neilands.

2004-Present

Principal Investigator, NIMH R01 RCT of an HIV treatment side effects coping intervention.
4/1/2004-2/28/2009. Co- Investigators: S. Folkman, J. Moskowitz, T. Neilands.

2003-Present

Co-Investigator, NIMH R01 Positive Affect in Adjustment to HIV. 12/1/2003- 1/30/2008. PI: Judith Moskowitz.




Faculty name: Rupa Marya, MD

Contact information: rupa.marya@ucsf.edu
                                    Mobile: 415-810-2903

Subspecialty/research focus: Health Care Disparities
                                                  Indigenous Health
                                                  Immigrant Health
                                                  Society and Health
                                                  Food and Medicine

Epidemiologic research relating microbe resistance to agricultural practices worldwide. Currently developing team of soil microbiologists, epidemiologists, human microbiome specialists to investigate a possible causal link between agricultural practices and increased incidence of human bacterial GI pathogens.




Faculty name: Philip Rosenthal, MD

Contact information: Phone: 415-206-8845
                                    prosenthal@medsfgh.ucsf.edu

Subspecialty/research focus: ID/Malaria

Title of research project: Clinical and molecular epidemiology of antimalarial drug research.

Brief description of project: We have multiple projects, which can be broadly descried as:

Clinical trials of antimalarial therapies in Uganda

Studies of clinical and molecular epidemiology of malaria and antimarlarial drug resistance.

Basic science studies pf the biology and biochemistry of malaria parasites, and

Antimalarial drug discovery.




Faculty name: Kimberly Page Shafer, MD

Contact information: kshafer@psg.ucsf.edu
                                    597-4954

Subspecialty/research focus: Epidemiology and prevention of HIV and HCV infections; vulnerable populations (youth, IDU, MSM, CSW); international settings

Title of research project: Acute HCV infection in young injectors: UFO Study

                                          Studying youth in Northern California (SYNC)

                                          Chemoprophylaxis for HIV Prevention: preparation for HIV prevention trials (Thailand)

                                          Young Women's Health Study – Phnom Penh Cambodia (HIV epidemiology and prevention).

                                          HCV in incarcerated and recently incarcerated populations.




Faculty name: Phyllis C. Tien, MD

Contact information: Infectious Disease Section, 111W
                                   4150 Clement St
                                   San Francisco, CA 94121
                                   ptien@ucsf.edu
                                   415-221-4810 ext 2577

Subspecialty/research focus: Metabolic complications (fat distribution changes, lipid and glucose abnormalities, and hepatic steatosis) of HIV and HCV coinfection
                                                  Sex differences in metabolic complications of HIV
                                                  Occult viral hepatitis infection
                                                  Information Technology




Faculty name: Lisa Winston, MD
                         Assistant Clinical Professor
                         UCSF Department of Medicine
                         Infectious Diseases Division
                         415-206-8703

Subspecialty/research focus: Infectious Diseases. Research focus: hospital epidemiology, antibiotic resistant bacteria.

Title of research project:

Clinical failures of MRSA treated .adequately. with vancomycin.

Oral versus parenteral antibiotics for osteomyelitis.

Description of project:

Chart and electronic record review to determine failure rate and risk factors in patients who were appropriately treated for MRSA. Other questions also possible, including proportion of patients who do/do not receive recommended therapy.

Meta-analysis versus structured literature review to evaluate whether parenteral antibiotics are superior for osteomyelitis and if so, under what circumstances. Other projects gladly discussed.




Informatics

Faculty name: Russ Cucina, MD, MS

Subspecialty/research focus: Medical informatics and Applied Clinical Information Technology

Title of research project/description: My interests are in the study of clinical information systems as tools to improve the quality, safety, and efficiency of medical care. The electronic medical record (EMR) at UCSF Medical Center, known as UCare, has transformed the process of care at the hospital. The medical record is more accessible, more complete, more timely, and easier to read; it may also reflect a qualitatively different type of documentation than was created with a paper system. I am interested in mentoring projects that look at the creation, access, use and retrieval of information from UCare, and real-world design features that can aid clinician work with the system.




Faculty name: Raman Khanna, MD

Contact information: rkhanna@medicine.ucsf.edu

Subspecialty/research focus: Health IT, especially communication technologies and robotics.

Title/description of research projects:

I am currently working on two primary projects.

The first is CareWeb Messenger, a pager/facebook/twitter hybrid for ending silo-ed communication. As this platform rolls out at UCSF there are and will be many opportunities to study communication patterns through it, since it stores all electronic communication every sent/received/read by any provider. There are research projects ongoing around this tool, one of which is entirely driven by one of the medicine residents.

The second is a project to improve hypertension care through computerized decision-making, transitioning some aspects of patient care into the hands of a hybrid human/computer physician extender, with the computer’s role growing as its algorithms become more sophisticated. This project is in the planning stage as we build the first working prototype.




Faculty name: Ida Sim, MD

Contact information: ida.sim@ucsf.edu

Subspecialty/research focus: Medical informatics
                                                  Mobile health
                                                  Clinical trials publication and data sharing

Title/description of research projects:

1. Mobile health for chronic disease management: Working with mobile health companies (e.g., FitBit, Jawbone), care providers (e.g., Kaiser, Stanford Preventive Cardiology), and research projects (e.g., Health eHeart) to define and build mobile apps and data analytics for diabetes and cardiac care.

2. Clinical trial data modeling and sharing: Modeling biases and statistical methods in the Ontology of Clinical Research, applying natural language processing to clinical trial reports and protocols, and designing and building retrieval and visualization interfaces for the designs of clinical trials.




Medical Ethics

Faculty name: Bernard Lo, MD
                         Professor of Medicine
                         Director, Program in Medical Ethics
                         415-476-5370
               

Research focus: Medical ethics, particularly decisions at the end of life, ethical issues in clinical research, doctor-patient relationship.

Research projects:

Ethical issues in clinical trials involving stem cells

Is an analysis of issues such as informed consent from donors of reproductive materials, anonymizing specimens for which consent has not been obtained, and scientific and ethical review of stem cell transplantation protocols.

Providing medical care as part of clinical trials in developing countries.

Is a questionnaire study to determine how investigators in countries where antiretroviral therapy for HIV is not widely available provide care to patients who seroconvert during their study.

Housestaff experience with medical errors.

Would analyze data already collected from a questionnaire to UCSF medical residents.




Nephrology

Faculty name: Chi-yuan Hsu, MD, MSc

Contact information: hsuchi@medicine.ucsf.edu 

Subspecialty/research focus: Nephrology, clinical research, epidemiology

Title/description of research projects: We will tailor research projects that will be achievable within a resident’s research time frame which also fit within our broad interest in chronic kidney disease epidemiology and outcomes.

For examples of recent publications, please see:

http://nephrology.ucsf.edu/faculty/?key=26b1c2f96f9e0b80ef946ab4b0b6f84e&name=HSU%2CCHI-YUAN




Faculty name: Kathleen Liu, MD

Contact information: Kathleen.liu@ucsf.edu

Subspecialty/research focus: Nephrology/critical care

Title/description of research projects:
My major area of interest is acute kidney injury in critically ill patients. I have several types of data available for analysis by residents, focusing on both processes of care and biomarker measurements.




Name: Delphine Tuot

Contact info: delphine.tuot@ucsf.edu

Research focus: disparities and chronic kidney disease, patient awareness and engagement in kidney health, PCP-nephrologist interface. http://profiles.ucsf.edu/delphine.tuot

Research projects: Our team has data from a clinical registry of patients with CKD in the San Francisco safety net and a small RCT of SFGH patients with CKD that could be used to examine process of care, changes in CKD health over time and patient engagement/understanding of health. 




Occupational Health

Faculty name: Suzaynn Schick, PhD

Contact information: sschick@medsfgh.ucsf.edu
                                   Office phone: 415-206-5904
                                   Box 0854

Title/description of research projects: Acute Effects of Secondhand Smoke Exposure in the Upper and Lower Respiratory Tract
Funded by the Flight Attendants Medical Research Institute Research Focus: Health effects of secondhand smoke on human subjects. I work in the Human Exposure Laboratory at San Francisco General Hospital campus. My group studies the health effects of air pollutants on human subjects. I focus on secondhand cigarette smoke (SHS). We recruit volunteers and expose them to SHS at real world concentrations in our exposure chamber. I'm focusing on endpoints in the upper and lower respiratory tract and I have collaborations with members of the Cardiology division to assess cardiovascular endpoints. Other researchers in my group are studying ozone and woodsmoke.




Oncology

Faculty name: Donald Abrams, MD

Subspecialty/research focus: Oncology

Title of research project: Cancer in the Homeless

Description of project: Chart review of cancer cases as SFGH in homeless patients; type;treatment;outcome.




Faculty Name: Michelle Melisko, MD

Subspecialty/research focus: Breast Cancer - Brain metastases, Clinical trials for metastatic disease, Immune Dysfunction in Breast Cancer

Title of research project:

Several projects are possible including: Retrospective chart review investigating weight gain during neoadjuvant chemotherapy and its effect on treatment outcomes. Retrospective chart review of outcomes for patients with leptomeningeal disease in breast cancer. Review of anemia and transfusion requirements in breast cancer patients receiving dose dense chemotherapy Review of anemia and transfusion requirements in breast cancer patients receiving dose dense chemotherapy.




Orthopedics

Faculty name: David Rempel, MD, MPH (Professor in Residence)
                         drempel@itsa.ucsf.edu

Subspecialty/research focus: Occupational Medicine/Hand and arm disorders related to work.

Title of research project: Biomarkers for Carpal Tunnel Syndrome and Epicondylitis.

Description of project: Evaluate the relationship between serum and urinary cytokines and severity (symptom and function) of carpal tunnel syndrome and epicondylitis. The goal is to identify biomarkers that are predictive of onset or worsening severity of these disorders in order to evaluate treatments and improve case management. Study takes place at the UCSF Hand Clinic and Occupational Medicine clinics in the Bay Area.




Palliative Care

Faculty name: Wendy G. Anderson, MD, MS

Contact information: Wendy.Anderson@ucsf.edu

Subspecialty/research focus: Palliative care, Critical Care, Hospital Medicine, Communication, Pain Management

Title/description of research projects:

IMPACT ICU: Integrating palliative care into the ICU. This is a 5-site quality improvement project being conducted at the 5 University of California medical Centers. Its goal is to establish systems for providing primary palliative care in the ICU, and involving specialty consults when appropriate. 

Improving hospital pain management: A quality improvement project being conducted at Moffitt-Long hospital with the goal of improving the safety and efficacy of pain management for patients admitted to the medical service.

Hospitalist rapport study: Observational study of hospitalist-patient communication in admission encounters with goal of identifying communication skills associated with improved patient satisfaction and decrease anxiety.




Faculty name: Suzaynn Schick, PhD

Contact information: sschick@medsfgh.ucsf.edu
                                    Office phone: 415-206-5904
                                    Box 0854

Title/description of research projects: Acute Effects of Secondhand Smoke Exposure in the Upper and Lower Respiratory Tract

                                                                Funded by the Flight Attendants Medical Research Institute

Research focus: Health effects of secondhand smoke on human subjects. I work in the Human Exposure Laboratory at San Francisco General Hospital campus. My group studies the health effects of air pollutants on human subjects. I focus on secondhand cigarette smoke (SHS). We recruit volunteers and expose them to SHS at real world concentrations in our exposure chamber. I'm focusing on endpoints in the upper and lower respiratory tract and I have collaborations with members of the Cardiology division to assess cardiovascular endpoints. Other researchers in my group are studying ozone and woodsmoke.




Pulmonary

Faculty name: James K. Brown, MD

Contact information: james.brown@ucsf.edu
                                   Phone: 415 221-4810, x6464

Subspecialty/research focus: Pulmonary, Critical Care, and Sleep Medicine Section, Medical Service, VAMC-SF

Title/description of research projects:

Our VA is about to begin use of low dose chest CT scanning to screen for lung cancer among a cohort of high-risk patients. This approach was shown to reduce lung cancer mortality by 20% among high-risk patients in the recently completed National Lung Screening Trial (NEJM 2011; 365:395-409). Nationally, the VA is beginning an 8-site demonstration project to test the feasibility and advisability of screening all high-risk veterans using this approach. Our VA is one of the 8 sites, and Dr. Brett Elicker of Chest Radiology and I are co-directors of the program at SFVAMC. The plan is to enroll about 1000 “high risk” patients from our site over the next year, starting in about October 2013.

The goal of the demonstration project is not to re-test within the VA the hypothesis that was addressed in the NSLT. However, the demonstration project offers the opportunity for research that may help address a number of unanswered questions about use of low-dose chest CT scans for lung cancer screening. Dr. Elicker and I would welcome residents who might have an interest in helping with such research projects. Examples of potential projects include:

- lung cancer screening and smoking cessation: among active smokers entering the screening program, what are the effects of entering the program, or of positive findings on CT scans, on subsequent motivation to quit?

- lung cancer screening and incidental findings on CT scans: how common are incidental findings (in lung, mediastinum, thyroid, liver, kidneys)? Are there positive effects of these findings on patient care? What incremental costs might they incur?

- use of low-dose chest CT scans in high risk veterans: are nodules or lung cancers detected more commonly among veterans than in the general population in the US? Might veteran-specific risk factors such as Agent Orange exposure have effects?

- screening with low-dose chest CT scans and use of biomarkers: would concurrent use of an established blood biomarker add diagnostic value beyond clinical and radiographic findings?




Faculty name: Harold (Hal) Collard, Associate Professor of Medicine, Director Interstitial Lung Disease Program

Contact information: 505 Parnassus Avenue, M1093
                                   San Francisco, CA 94143-0111
                                   415-353-1043 (phone);
                                   hal.collard@ucsf.edu

Subspecialty/research focus: Pulmonary and Critical Care/Interstitial lung disease

Title of research project: Clinical research in interstitial lung disease

My research program has focused on clinical projects involving subjects with interstitial lung disease, particularly idiopathic pulmonary fibrosis (IPF). I have worked to better understand the natural history of IPF, risk prediction, the response of patients with IPF to traditional therapies, and novel ways of sub-classifying patients with this disease using population-based epidemiological methods. I also design and perform clinical trials (both interventional and cohort studies) on an individual investigator level as well as with multi-center government and industry supported networks. Many of my most successful projects have come from working with students and housestaff, and I am always happy to discuss research interests!




Faculty name: J. Lucian (Luke) Davis MD, MAS

                         Adithya Cattamamchi, MD

Contact information: lucian.davis@ucsf.edu
                                   acattamanchi@medsfgh.ucsf.edu

Subspecialty/research focus: Epidemiology and diagnosis of tuberculosis in low-income countries

Title/description of research projects: We are members of the MU-UCSF Research Collaboration, and are carrying out several different projects focused opn care and evaluations of patients with acute and sub-acute respiratory illnesses in Uganda.

The Mulago Hospital Noninvasive Diagnosis of Pneumonia Study - Cohort study of etiologies and outcomes of acute respiratory illnesses among mostly HIV-infected patients presenting to a large public hospital in Uganda.

The Uganda TB Surveillance Project - Multi-site cross-sectional study of evaluation and treatment practices in rural health clinics in Uganda, with a view to using novel technologies to improve diagnosis and treatment on a population scale.
More information is available at http://www.muucsf.org/current_projects.asp




Faculty name: Laurence Huang, MD
                         Associate Professor of Medicine
                         Chief, AIDS Chest Clinic
                         San Francisco General Hospital
                         Positive Health Program, Ward 84
                         San Francisco General Hospital
                         995 Potrero Avenue
                         San Francisco, CA 94110
                         Telephone: (415) 476-4082 extension 406
                         Fax: (415) 476-6953
                         Lhuang@php.ucsf.edu

Subspecialty/research focus: HIV- Associated Pulmonary Disease, Pneumocystis Pneumonia (PCP)

Title of research project: Molecular Epidemiology Studies of Pneumocystis Pneumonia

Description of research project: Dr. Huang's main clinical and clinical research interests are in HIV-associated pulmonary disease and especially Pneumocystis pneumonia (PCP). He has several collaborations with researchers at the Centers for Disease Control and Prevention, the National Institutes of Health, the University of Cincinnati, the University of Alabama- Birmingham and the University of Southern California as well as independent studies on PCP and ICU outcomes among HIV-infected patients. Current research studies include:

A multicenter molecular-epidemiology study investigating the association between Pneumocystis prophylaxis, Pneumocystis cannot be cultured, this study seeks to address the question of whether human Pneumocystis develops evidence of resistance to PCP treatment and prophylaxis regimens.

Development and validation of several new molecular applications to PCP, including the use of a quantitative PCR assay and a novel RT-PCR molecular viability assay on oropharyngeal wash specimens to diagnose PCP, development of Pneaumocystis antibody assays, and development of a .cytokine flow cytometry. assay to detect Pneumocystisspecific CD4+ and CD8+ T cell immune responses.

Comprehensive molecular-epidemiology study to address the question of whether PCP in humans results from person-to-person transmission (as has been convincingly demonstrated from animal-to-animal laboratory studies) and whether disease results from reactivation of latent infection or from recent exposure and infection.

Prospective cohort study of the incidences, persistence, and consequences of Pneumocystis colonization both for the individual under study as well as for the potential as a reservoir for the organism.

Prospective cohort study of the incidence and persistence of Pneumosystis colonization among health care workers (HCW).

Creation of an international Pneumocystis network to enable researchers to pool resources and share data to answer questions of mutual interest and to estimate the contribution of PCP to morbidity and mortality in HIV-infected persons worldwide.




Faculty name: Suzaynn Schick, PhD

Contact information: sschick@medsfgh.ucsf.edu
                                    Office phone: 415-206-5904
                                    Box 0854

Title/description of research projects:

Acute Effects of Secondhand Smoke Exposure in the Upper and Lower Respiratory Tract
Funded by the Flight Attendants Medical Research Institute Research Focus: Health effects of secondhand smoke on human subjects. I work in the Human Exposure Laboratory at San Francisco General Hospital campus. My group studies the health effects of air pollutants on human subjects. I focus on secondhand cigarette smoke (SHS). We recruit volunteers and expose them to SHS at real world concentrations in our exposure chamber. I'm focusing on endpoints in the upper and lower respiratory tract and I have collaborations with members of the Cardiology division to assess cardiovascular endpoints. Other researchers in my group are studying ozone and woodsmoke.




Faculty name: Katie L. Stone, PhD 

Contact information: Senior Scientist
                                    San Francisco Coordinating Center/ California Pacific Medical Center Research Institute
                                    185 Berry St, Lobby 5, Suite 5700
                                    San Francisco, CA 94107
                                    415-600-7422
                                    FAX 415-514-8150

Subspecialty/research focus: Insomnia/Sleep Disorders in Older Adults

Title of research project/description of project:

Outcomes of Sleep Disorders in Older Men (MrOS Sleep Study):

The Osteoporotic Fractures in Men (MrOS) Study is a large multi-center cohort study of risk factors for osteoporosis and osteoporotic fractures in older men. The MrOS Sleep Study, a substudy to the MrOS parent study, was funded by NHLBI and enrolled approximately 3000 older men between December, 2003 and April, 2005. The major objective of the MrOS Sleep Study is to determine the relationship of sleep characteristics (measured comprehensively and objectively using wrist actigraphy and in-home overnight PSG) and a broad set of outcomes, including incident centrally-adjudicated cardiovascular events, falls and fractures, total and cause-specific mortality, and neuropsychiatric and physical function. In brief, the examination was comprised of three components: 1) an in-clinic visit during which subjects completed a self-administered questionnaire and interview, and a variety of clinical measures such as height and weight, blood pressure, ECG, bone density testing, and performance-based tests of strength and physical function; 2) single night unattended in-home polysomnography; 3) wrist actigraphy (five consecutive 24-hour periods), beginning the day of the clinic visit. A recently funded renewal application will allow for follow-up measures of sleep and other characteristics in approximately 1000 MrOS Sleep Study participants, beginning in October 2009.

Changes in Sleep and Cognition in Older Women (SOF Sleep Study): The SOF Sleep Study is an ancillary study to the Study of Osteoporotic Fractures SOF). SOF is a longitudinal epidemiologic study of 9,704 women aged 65 and older recruited from four study centers located in Portland, OR; Baltimore, MD; Minneapolis, MN; and the Monongahela Valley near Pittsburgh, PA. SOF was originally designed to investigate risk factors for osteoporosis and osteoporotic fractures. The baseline SOF exams were conducted from 1986-88. Since then follow-up exams have taken place approximately every two years. We successfully established banks of clinical data, sera, DNA, and urine. During the eighth SOF examination (2002-2003) new measures were added to address aims related to outcomes of sleep disturbances in older women. Outcomes of interest in the SOF Sleep Study included falls and fractures, total and cause-specific mortality, and cognitive and physical function. We obtained objective measures of sleep including wrist actigraphy (n=3,131) and in-home unattended polysomnography (single night) in a subset of 461 subjects at two centers. Follow-up measures of sleep and other clinical measures were completed during 2007-2009. In addition, during the follow-up examination an expanded cognitive testing battery was performed and subjects were adjudicated for incident mild cognitive impairment and dementia. These additional measures in this unique, well-characterized cohort of older women will allow for testing a variety of aims focused on the longitudinal relationships of sleep and cognitive function. Previously archived serum samples will also be utilized to explore potential mechansims for the relationships between poor sleep, cognition and mortality.




Faculty name: Prescott G. Woodruff, MD, MPH

Contact information: Prescott G. Woodruff, MD, MPH
                                    Assistant Professor of Medicine
                                    Phone: 415-514-2061
                                    Fax: 415-476-0752
                                    Prescott.woodruff@ucsf.edu
                                    Webpage: http://woodrufflab.ucsf.edu/

Subspecialty/research focus:

Pulmonary Medicine - Our research comprises a program of NIH-funded clinical and translational research into a range of lung diseases including asthma, chronic obstructive pulmonary disease (COPD), and granulomatous lung diseases (e.g. sarcoidosis and hypersensitivity pneumonitis). These studies fall into three specific categories: 1) the identification of distinct molecular sub-phenotypes of these diseases, 2) the elucidation of disease-relevant mechanisms of airway inflammation and remodeling in the lung and 3) clinical trials of novel therapeutic approaches

Title of research project/escription of project: The identification of molecular sub-phenotypes of asthma and COPD:

These studies are funded by:

An R01 from the NIH/NHLBI, entitled "Molecular Phenotyping of Asthma" (R01 HL-095372) which has applied genomic analyses to airway samples from patients with asthma to distinguish Th2-driven and non-Th2-driven sub-phenotypes of asthma that have distinct clinical, pathological and treatment-related characteristics.

A seven-year NIH contract to apply similar methods to study COPD as part of the NHLBI Spiromics Project (N01 HR-08-08). The goal of the Spiromics project is to identify molecular phenotypes of COPD and to develop intermediate outcome measures for clinical trials.

Mechanisms of airway inflammation and remodeling in lung diseases.These studies apply innovative methods for quantitative morphometry and gene expression analyses to human tissue samples obtained at fiberoptic bronchoscopy. In work to date, we have applied these methods to study mechanisms of disease in asthma, COPD and sarcoidosis. Ongoing work in this area is supported by the NIH (R01 HL-095372). Our approaches combine the application of gene expression profiling methods (microarrays, qPCR, laser capture microdissection) and design-based stereology (for quantitative measurement of tissue remodeling in human samples).

Sample analysis and support for Clinical Trials.

Finally, the Woodruff Laboratory supports sample analyses for clinical trials in asthma and COPD in both NIH and industry-supported studies. These sample analyses include measurement of changes in airway remodeling in response to specific therapeutic interventions, assessment of inflammation and the application of biomarkers to enhance the interpretation of clinical trials.




Faculty name: Prescott G. Woodruff, MD, MPH

Contact information: Phone (415) 514-2061
                                    UCSF Address: Box 0111, Moffitt Hospital Rm M1098
                                    prescott.woodruff@ucsf.edu
                                    Webpage: http://pulmonary.ucsf.edu/faculty/woodruff.html

Subspecialty/research focus: Pulmonary Medicine
                                                  Asthma
                                                  COPD

Title/description of research projects: My research activity encompasses both clinical and bench research into the mechanisms of diseases of the airways and, consequently, much of it falls under the rubric of "translational research". In these studies, I am interested in understanding the mechanisms of inflammation, airway remodeling, and airway hyper-responsiveness in asthma and chronic obstructive pulmonary disease. These studies are performed in the Airway Clinical Research Center here at UCSF and in the General Clinical Research Unit at the UCSF Parnassus campus where I am an investigator. A major focus of my recent work has been gene expression profiling in tissues obtained at fiberoptic bronchoscopy. Recent applications have included studies of airway smooth muscle structure and phenotype in airway diseases and studies of alveolar macrophage activation in smoking related lung disease. From the purely clinical research perspective, I am a Co-investigator in the NIH/NHLBI COPD Clinical Research Network which is currently designing protocols for multicenter-clinical trials in the therapy of COPD.




Rheumatology

Faculty name: Sharon A. Chung, MD MAS

Contact information: Sharon.chung@ucsf.edu
                                    Office 415-514-1673

Subspecialty/research focus: Translational and genomic studies of vasculitis and systemic lupus erythematosus

Title/description of research projects:

Our goal is to discover genetic, epigenetic, and transcriptional factors that influence autoimmune disease susceptibility and its manifestations. Current projects focused on systemic lupus erythematosus (SLE) include whole genome sequencing and genome-wide association studies, detailed investigations of the major histocompatilibity complex, and DNA methylation studies of specific disease manifestations. My clinical interest is systemic vasculitis, and I direct the UCSF Vasculitis Clinic. Our research activities in vasculitis include exome sequencing, DNA methylation, and RNA-sequencing studies of ANCA-associated vasculitis. The UCSF Vasculitis Clinic is a member of the Vasculitis Clinical Research Consortium (VCRC), and the clinic participates in ongoing VCRC clinical and translational studies.




Faculty name: Lindsey A. Criswell, MD, MPH, DSc
                        Professor of Medicine and Orofacial Sciences
                        Jean S. Engleman Distinguished Professor in Rheumatology
                        Chief, Rheumatology Division, UCSF Medical Center

Contact information: Lindsey.criswell@ucsf.edu
                                    Tel: (415) 476-9026
                                    Fax: (415) 476-9370

Subspecialty/research focus: Genetics and epidemiology of autoimmune rheumatic disease

Title/description of research projects:

“Genetics, ancestry and SLE outcomes” (SLE = systemic lupus erythematosus)

“Refining the complex HLA association with SLE across ethnic and phenotype subgroups”

“DNA methylation profiling in rheumatoid arthritis”

“Epigenetic profiling of multiple cell and tissue types in Sjögren’s Syndrome”

“Exome-plus sequence analysis for scleroderma pathogenesis”




Faculty name: Jonathan Graf, MD

Contact information: Division of Rheumatology, SFGH
                                    1001 Potrero Avenue, Building 30/Room 3300
                                    San Francisco, CA 94110
                                    Tel: 415-206-8189
                                    Fax: 415-648-8425
                                    jonathan.graf@ucsf.edu
                                    Website: http://rheumatology.ucsf.edu/research/

Subspecialty/research focus: Autoimmune Diseases, Rheumatoid Arthritis, vasculitis, cardiovascular disease risk

Title/description of research projects: The primary focus of our research centers on translational studies related to rheumatoid arthritis, particularly those that take advantage of the UCSF Rheumatoid Arthritis Observational Cohort. Created in 2006, this longitudinal cohort captures real time clinical information from more than 750 patients at each of their clinical encounters across multiple UCSF campuses. The cohort uses a real-time database to record detailed clinical information that is coupled with a biological/serum sample bank linked to each patient. This cohort facilitates clinical and translational studies both within and outside of the UCSF division of rheumatology, including (but not limited to) collaborations that study cardiovascular risk and dyslipidemia, genetics and epigenetics, immunology and osteoclast function, MRI quantification of disease activity, and socio-economic determinants of disparity and depression. We also conduct investigator initiated and industry collaborative early-phase clinical trials of novel therapeutics for rheumatoid arthritis.




Faculty name: Lianne Gensler, MD

Contact information: lianne.gensler@ucsf.edu

Subspecialty/research focus: Rheumatology (Ankylosing Spondylitis)

Title/description of research projects:

1) We are part of a large multicenter prospective cohort study of Ankylosing Spondylitis patients seen every 6 months at 4 sites in the U.S. Genetic data is collected to identify susceptibility loci in addition to genetic predictors of severity and progression. Demographic, clinical, metrology, laboratory, and patient reported outcomes are collected at every visit. Radiographic data is collected every 2 years. This cohort has over 1200 patients and 4000 visits collected. We have a biostatistics core at UT Houston where the data is housed. We are open to interesting questions being proposed and would be happy to mentor residents.

2) We have a local cohort of UCSF clinic patients that have the broader definition of Axial Spondyloarthritis. In this cohort, we have collected bone densitometry as osteoporosis is more common. We bank serum and collect multiple measures every year. We have collaborated with the NIH to look at bone biomarkers. This has the potential for both clinical questions and translational questions.




Faculty name: Mary Margaretten, MD

Contact information: mary.margaretten@ucsf.edu

Subspecialty/research focus: Rheumatoid Arthritis
                                                  Depression
                                                  Systemic Inflammation
                                                  Rheumatology

Title/description of research projects:

Inflammation and Depressive Symptoms in Patients with Rheumatoid Arthritis
My primary research focus has been examining the predictors of depression among patients with rheumatoid arthritis, particularly evaluating disparities and the role of systemic inflammation in depression among patients with arthritis.

 

 

 

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