Dr. Pescovitz Comes to Michigan

Ora Hirsch Pescovitz, M.D. — the new U-M executive vice president for medical affairs and CEO of the U-M Health System — admits she was a bit intimidated on May 11 when she moved into the office formerly occupied by her long-time friend and professional colleague, Robert Kelch, M.D.

“I knew I had big shoes to fill,” Pescovitz says. “It’s remarkable what Dr. Kelch accomplished here in such a short period of time. A significant part of what attracted me to U-M was the extraordinary alignment he created between U-M Hospitals and Health Centers, the Medical School and the School of Nursing. This alignment is unique among academic medical centers and a tremendous source of strength for the institution.”

A nationally recognized pediatric endocrinologist, researcher and university administrator, Pescovitz came to the U-M from the Indiana University School of Medicine where she treated children with endocrine disorders and served as executive associate dean of research affairs. In 2004, she also became the first president and CEO for the Riley Hospital for Children in Indianapolis where she actively spearheaded both the development and planning efforts that led to a $470-million addition to the hospital. In her most recent position as IU’s interim vice president for research administration, Pescovitz was responsible for the research infrastructure at all eight IU campuses.

Although still in the listening and learning phases of her new job, Pescovitz says she already has identified major areas of strength at the U-M — including an institutional culture of “partner or perish,” which encourages research collaboration, an outstanding faculty group practice and a genuinely warm and collegial working atmosphere.

“U-M is a top-tier research powerhouse with a down-to-earth perspective and Midwestern values,” she says. “These are exceptional qualities that bode well for the future.”

One of four children, Pescovitz grew up in Bethesda, Maryland, with her three younger brothers. In high school, she was torn between becoming a doctor or a concert pianist. Fortunately for the University of Michigan Health System and countless patients, she chose medicine.

Pescovitz received her M.D. degree in 1979 from Northwestern University’s Feinberg School of Medicine. She began a residency in pediatrics at the University of Minnesota Medical Center and completed it at Children’s National Medical Center in Washington, D.C. Her husband, Mark Pescovitz, M.D., is a transplant surgeon and professor at the Indiana University School of Medicine. The couple has three grown children in college or graduate school.

Optimistic and excited about the move to Ann Arbor, Pescovitz has applied for a license to practice medicine in Michigan and says she is learning the words to “The Victors” in preparation for the September 5 kick-off of the U-M football season
—SALLY POBOJEWSKI

A Warning Sign for Diabetics

People with diabetes, and physicians who treat them, should pay close attention to the results of a common blood test for fats called triglycerides, according to a new study by scientists at the U-M Medical School and Wayne State University.

The researchers found that diabetics with elevated triglyceride levels were more likely to develop a serious complication called neuropathy. Nerve damage from neuropathy can cause disabling numbness, tingling and pain — most often in the hands, arms, legs and feet.

About 60 percent of the 23 million people in the United States with diabetes develop diabetic neuropathy and the U-M study identifies those at greatest risk. Most often, the condition is diagnosed after irreversible nerve damage has already occurred.

A predictive test for neuropathy could help doctors and patients take proactive steps when interventions can do some good, says Eva Feldman, M.D., Ph.D., the Russell N. DeJong Professor of Neurology, who also serves as director of the U-M’s A. Alfred Taubman Medical Research Institute.

Feldman and her collaborators analyzed data collected over a 12-month period from 427 diabetes patients with mild-to-moderate neuropathy. The researchers found that study participants with elevated triglycerides were more likely to report during the study that their neuropathy symptoms were getting worse. Biopsies of peripheral nerves from study participants showed that diabetes patients with high triglycerides lost five times more nerve fibers over 12 months than patients with normal triglyceride levels.

The link between elevated triglycerides and lost nerve fibers was more statistically significant than for any other variable in the study — including the patient’s age, disease duration, cholesterol levels and blood glucose levels.

“Results from our study suggest that clinicians should address lowering lipid counts with their diabetes patients as vigilantly as they pursue glucose control,” says Feldman. She adds that people can reduce blood triglyceride levels by avoiding fats and exercising regularly.
—SP

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Patient information on diabetic neuropathy

Mapping Survival

U-M researchers have developed a way to analyze magnetic resonance imaging, or MRI, data to predict — as early as one week after the start of treatment — how long patients with brain tumors will survive. The method creates what the researchers call parametric response maps that make it possible to monitor changes over time in the amount of blood in the tumor within individual MRI data points.

“We see responses that can’t be detected at all with existing technology and we see them as soon as one week into treatment, which is amazing for brain tumors,” says Craig Galbán, Ph.D., assistant professor of radiology. Working with Brian Ross, Ph.D., professor of radiology, Galbán tested the technique in a clinical study of 44 people with high-grade glioma, a type of brain tumor.

“Parametric response mapping has the potential to become a generalized analytical approach to quantify treatment intervention in patients,” says Ross, who adds that the method also might be useful with other imaging techniques like PET and CT scans. The U-M has filed a patent application on the technology.
—SP

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Child-Friendly Alternatives

Complementary and alternative therapies — like yoga, acupuncture and herbal remedies — aren’t just for grown-ups anymore. They are becoming popular with children and adolescents, as well. If used under a doctor’s supervision, many of these treatments can be a safe, effective way for children and adolescents to get and stay healthy, says Dolores Mendelow, M.D., a clinical assistant professor of pediatrics and communicable diseases.

Mendelow recommends alternative therapies for many of her young patients. She suggests yoga as a beneficial therapy for patients with asthma and to reduce stress in teenagers. Tai chi also helps reduce stress, depression and anxiety. Taking probiotics, either as supplements or in foods like yogurt, can help children with antibiotic-associated diarrhea return to school or day care faster.

However, Mendelow warns that some alternative therapies can be harmful to children. These include a popular Chinese medicine called Ma Haung, a muscle-building supplement called creatine and chiropractic spinal manipulation.

What’s safe for one child may not be safe for another, so Mendelow emphasizes that parents should check with their child’s pediatrician before starting any new treatment.
—SP

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Want Strong Bones? Keep It Moving!

Staying active is just as important for healthy bones as it is for a healthy cardiovascular system, says Ronald Zernicke, Ph.D., director of the U-M Bone and Joint Injury Prevention and Rehabilitation Center. Weight-bearing activities like running, walking, playing basketball and dancing are best for strengthening bone.

While exercise can increase bone mass density in all age groups, the benefits are greatest during childhood and adolescence, when new bone is added to the skeleton faster than old bone is removed. This means that adolescents have a window of opportunity to enhance bone mass and strength that will benefit them for the rest of their lives.

“Physical activity is absolutely beneficial for overall bone health,” says Zernicke, a U-M professor of biomedical engineering, of kinesiology, and of orthopaedic surgery. “It is a modifiable factor under our control that develops and maintains healthy bone mass.”
—SP

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Caregivers from Michigan Visiting Nurses celebrated the organization’s 100th anniversary during National Nurses Week on May 11 by releasing 100 balloons into the sky. MVN, which has served the Ann Arbor community in various capacities during the last century, today provides home care services for patients being discharged from U-M hospitals.

Michigan Visiting Nurses

Health Briefs

A simple blood test could help diagnose an often-lethal tear, called an aortic dissection, in the body’s largest blood vessel, according to a study led by Cardiovascular Center specialists. They found dramatically elevated levels of a substance called D-Dimer in the blood of patients experiencing an aortic dissection. Symptoms of aortic dissection are similar to those of an acute heart attack, but treatments for the two conditions are different, so a rapid and accurate diagnostic test could save lives.

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Doctors are reporting an increase in cases of children with kidney stones, a condition usually seen in middle-aged men. Common symptoms are back and abdominal pain that are often mistaken for appendicitis or gastritis. Gary Faerber, M.D., professor of urology, blames diet and lifestyle. He says sugary drinks, a fast-food diet, obesity, dehydration and lack of exercise add up to increased risk of kidney stones for children as well as adults. Faerber’s prescription: Fewer sodas, more water.

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A national survey of pediatricians and family medicine physicians found that one out of seven did not recognize the symptoms of whooping cough in a standardized adolescent case patient. U-M researchers say the survey indicates a need for more physician education.

—SP

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Patient information on whooping cough