It is unusual for one academic institution to have more than a single article published simultaneously in a high-impact research journal, so even the authors were surprised to learn that UPMC researchers wrote three of the articles published in the most recent edition of The International Journal of Radiation Oncology, Biology and Physics, the most prestigious publication in the radiation oncology field.
“I don’t think we realized it until after they all went online,” said Beant S. Gill, M.D., lead author of one of the articles and a radiation oncology resident at UPMC CancerCenter and the University of Pittsburgh Cancer Institute (UPCI).
Dr. Gill is one of three UPMC residents to contribute to the March issue under the mentorship of Sushil Beriwal, M.D., medical director of radiation services at Magee-Womens Hospital of UPMC, and Dwight Heron, M.D., director of radiation services for UPMC CancerCenter. His article, “MRI-Guided High-Dose-Rate Intracavitary Brachytherapy for Treatment of Cervical Cancer: The University of Pittsburgh Experience,” is the largest study conducted in North America to show that the use of MRI-guided brachytherapy (a radiation therapy that inserts radioactive implants directly into the cavity through an applicator) leads to higher cure rates and fewer side effects for patients with advanced cervical cancer.
“Image-based brachytherapy is one of the most cutting-edge capabilities we have to treat cervical cancer,” said Dr. Gill. “Patients in our study had advanced cancer and received chemotherapy as well as external beam radiation therapy in conjunction with their brachytherapy treatment. Cervical cancer is an aggressive disease, but image-based brachytherapy provides us with an effective way to cure patients while limiting their risk of side effects.”
For an article discussing a prospective clinical trial exploring the effectiveness of stereotactic body radiation therapy in addition to targeted chemotherapy for patients with recurrent head and neck cancers, John A. Vargo, M.D., found that this approach, which has been pioneered at UPMC, was a feasible re-treatment strategy for a challenging group of patients.
Beyond treating a wide-variety of cancers, radiation therapy is also regularly used as a pain control measure for certain cancers. Malolan S. Rajagopalan, M.D., a resident at UPCI and UPMC CancerCenter, evaluated the cost-effectiveness of two different approaches to palliative radiation therapy. The results identified patients in whom utilization of specialized techniques would be cost effective.
“We live in an era where identifying treatment strategies that improve patient outcomes at a reasonable cost is more important than ever,” said Dr. Rajagopalan. “Understanding which patients will benefit from certain treatments is important for the patient and her health care team.”
In addition to this publication, Dr. Rajagopalan was also the lead author of a study published in the March edition of Practical Radiation Oncology.
Dr. Rajagopalan worked with Dr. Heron and Dr. Beriwal, as well as John C. Flickinger, M.D., to find out if the use of shorter courses of post-surgical radiation for breast cancer patients, a treatment approach that has produced excellent patient outcomes, could be increased if recommended through a clinical pathways program.
“This study is practice-changing,” said Dr. Beriwal. “Despite significant research proving that these shorter courses of external beam radiation treatment produce equivalent patient outcomes, radiation oncologists have been slow to change their treatment recommendations. Once the treatment option became the standard in the pathway program, practice patterns altered.”
According to both Drs. Heron and Rajagopalan, clinical pathways could be a potentially powerful tool in standardizing patient care and changing practice patterns.
“It’s enormously exciting to watch the work our residents are accomplishing,” said Dr. Beriwal. “The Radiation Oncology Department at UPCI, in conjunction with the large network of patients UPMC CancerCenter treats, allows them to tackle research that directly impacts best practices and patient care.”
There was a celebration within a celebration at Pitt’s School of Medicine’s Match Day. The entire class of 148 students found out where they are heading for residency training, the next step in their medical careers. They also got another surprise: Dr. Chenits Pettigrew, beloved dean of students affairs, who suffered a heart attack a few weeks ago, made it back to hand students their Match letters and to give – and get – warm hugs.
The 2015 class will head to residencies in all reaches of the country – 24 states as well as Washington DC. A record number of 15 students train in Massachusetts for Harvard programs, 12 will train in New York, 8 in Ohio and 7 each in Tennessee, Illinois, Florida and DC.
And of special note, “We will have the great pleasure of the continued company of 34 of you who matched in our Pitt Programs,” said an excited Dr. Joan Harvey, associate dean for student affairs. “They will remain closely knit and support each other in Pittsburgh next year.”
Seventy-one students, or approximately 48 percent, matched in primary care fields, substantially higher than last year in which 54 students, or 38 percent, chose primary care specialties. The biggest change was in internal medicine, with 48 students this year, compared with 36, an increase from 24 to 32 percent. Nationally, 48 percent of students received their first choice residency program, 16 percent their second and 10 their third.
This new partnership will allow Family Hospice and Palliative Care, Pennsylvania’s largest nonprofit hospice and palliative care organization, to grow substantially in both volume and geographic coverage. Family Hospice will become part of UPMC’s Community Provider Services, which includes the Home Nursing Agency (HNA) hospice, serving Blair County and the surrounding area. HNA Hospice is among the top providers in the state and was the first home health agency in Pennsylvania to become a Medicare-certified hospice. Family Hospice will continue to operate under its name, and serve patients and families with end-of-life health care services, locations, staff, and educational outreach programs. The combined program will be managed by HNA.
“UPMC has a long history of support for palliative care as a fundamental part of our commitment to our patients and their families to actively communicate and respect their individual goals and wishes about their care,” says Deborah Brodine, president, Community Provider Services. “Family Hospice has been a wonderful partner, with a complementary mission and vision, and we are pleased to fully embrace the organization as part of our larger health system. We welcome the opportunity to continue to partner with Presbyterian SeniorCare and other like-minded organizations in this important work.”
The combined assets, experience, and depth of resources under UPMC’s Community Provider Services will enable Family Hospice to offer ongoing, better-coordinated, comprehensive care for patients dealing with progressive and life-limiting illness, and maintain the highest quality of end-of-life care.
“Family Hospice and Palliative Care has a long history of providing fabulous care in the community and we are thrilled to work more closely, allowing us to ensure that every patient gets the right care at the right time in the right location,” says Robert Arnold, MD, medical director, UPMC Palliative and Supportive Institute.
A staggering number — more than 41,000 children and adults in the greater Pittsburgh area had poisoning exposures in 2014 and sought assistance from the Pittsburgh Poison Center. Nearly half of those poison exposures occurred in children 5 and younger with nearly 6,000 of those were 1- and 2-year-olds. To combat these dangerous occurrences, Pittsburgh Mayor Bill Peduto and Allegheny County Executive Rich Fitzgerald have proclaimed March “Poison Prevention Month” under the theme, “Children Act Fast – So Do Poisons.”
Throughout March, the Allegheny County Pharmacists Association (ACPA), in conjunction with Safe Kids Allegheny County, will distribute Poison Prevention Home Checklists, which educate the public about preventing unintentional poisonings, and proper use and storage of medicines, cleaners and chemicals. The checklists, as well as Mr. Yuk stickers, will be available in almost every pharmacy in Allegheny County as well as city, county and Indian Head Start programs.
In addition, State Representative Adam Ravenstahl presented the Pittsburgh Poison Center with a House Resolution, HR126, in which the state of Pennsylvania designated the week of March 15 through March 21, 2015, as “Poison Prevention Week.” He visited the Pittsburgh Poison Center to present the HR and discuss bipartisan support of Pennsylvania Poison Centers.
State Representative, Adam Ravenstahl (left) and Dr. Michael Lynch (right), Medical Director of the Pittsburgh Poison Center, with the “Poison Prevention Month” Proclamation
Every day, Pennsylvania has at least one crash involving an ambulance, according to the Emergency Medical Services Institute (EMSI). UPMC has partnered with EMSI to bring a sophisticated ambulance simulator training system to EMS providers in the region.
The fully loaded console – consisting of lights, sirens, seatbelts and mirrors – allows the operator to experience the feeling of driving an actual ambulance while facing extreme conditions in a simulated environment.
“We can throw scenarios at students that they might not see on a city street or country road, like fires or airplane crashes. We can change time of day. We can add rain, snow or fog,” said Brian S. Shaw, deputy director, EMSI.
EMSI partnered with UPMC and regional EMS providers to purchase the simulator and will make EMS Virtual Drive training available to 135 EMS services throughout the 10-county region.
“UPMC has a long-standing relationship with EMS providers in the region, providing medical direction, support and training,” said Myron Rickens, director of the UPMC Prehospital Care Program. “Through simulation, we can challenge them with events they don’t see every day.
The EMS Virtual Drive is the first training simulator to exclusively serve EMS providers in Western Pennsylvania.