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Archive - 02 - 2010
February 26, 2010 (Newswise) - On March 1, the first eye patients will enter an innovative new $132 million facility that expands the University of Michigan Health Systems capacity for eye care, research and education, and unites diabetes researchers as they work to accelerate the search for a cure and prevention of diabetes.The Brehm Tower at the W.K. Kellogg Eye Center Complex includes 230,000 square feet spanning eight stories and makes a striking addition to the skyline of the medical campus. It is adjacent to the existing Kellogg Eye Center research tower on Wall Street in Ann Arbor built in 1985.The new building houses seven eye care clinics with new suites for refractive surgery and cosmetic surgery. On the upper floors, the Brehm Center for Diabetes Research, and laboratories for vision scientists, will foster discoveries in both ophthalmology and diabetes.Eye disease and diabetes both pose growing challenges to our nations health, and Kellogg and Brehm scientists will help us continue to lead the way in both fields, says Ora Hirsch Pescovitz, M.D., executive vice president for medical affairs and chief executive officer of UMHS.The architect, TSA of Massachusetts, created a building that is modern in design but incorporates features to create a warm and welcoming environment. Large windows and a full wall of glass panels on the buildings facade allow natural light to fill the clinics and common space, of particular benefit to patients whose vision is impaired.Construction of the new building, just across the river from the main medical campus, is an important part of our master plan and expansion of our system, says Douglas L. Strong, director and chief executive officer of the U-M Hospitals and Health Centers.
Clinics have space for patient education and comfortable waiting areas designed to aid patient flow. Research areas feature open laboratories to encourage collaboration and provide flexibility as research projects grow.Creating this clinical care and research facility shows confidence in the ground-breaking work undertaken by our scientists and the impact they will have on future treatment options, says James O. Woolliscroft, M.D., dean of the U-M Medical School.Notes Paul R. Lichter, M.D., chair of Ophthalmology & Visual Sciences and director of the Kellogg Eye Center, This project has significantly expanded the Eye Center, allowing us to serve a rapidly growing and aging patient population and expand the critical mass of scientists needed to advance research aimed at preserving vision."We often say that we can help patients one at a time in the clinic, but we can help the world in our labs. Thats what we will do in this new building, Lichter adds.Made possible by part of a gift given to the U-M Medical School by Delores and William Brehm in 2004, the building also serves as the main laboratory component of the U-M Comprehensive Diabetes Center. The gift was motivated by the couples desire to find a cure for type 1 diabetes, the disease that Mrs. Brehm has been coping for 60 years.We started with the goal of accelerating diabetes research but our approach was to go beyond creating bricks and mortar and to foster a new paradigm in how medical research is conducted, says Bill Brehm. The building is designed to enhance collaboration among researchers as they translate discoveries in the laboratory into practical treatment options.The Brehm Center spaces feature an open laboratory layout to encourage collaboration, shared procedure and equipment areas, a central connecting staircase and centrally located lab services. It also houses cutting-edge facilities for communication and data-sharing among diabetes researchers throughout U-M and beyond.Like in any vibrant and growing medical center, research space is terribly precious and scarce, says Peter Arvan, M.D., Ph.D., the Brehm Professor of Type 1 Diabetes Research, chief of the Division of Metabolism, Endocrinology & Diabetes and director of the Comprehensive Diabetes Center. Bill Brehm has jump-started the process of making Michigan the leading national center for diabetes research.The proximity is expected to help U-M vision researchers and diabetes researchers collaborate on studies of eye-related complications of diabetes, notably diabetic retinopathy.People with either form of diabetes type 1, sometimes called juvenile diabetes, and type 2, which is linked to obesity are especially prone to eye disease. Many of them will, over time, lose some or all of their eyesight due to diabetic retinopathy. People with diabetes are also far more prone to other eye diseases, including glaucoma and cataracts.In addition to a national reputation in studies of diabetic retinopathy, the U-M is a leader in other areas of vision care and research, including cataracts, glaucoma, age-related macular degeneration (AMD), and other conditions of the aging eye. U-M offers such advanced clinical options as bladeless laser surgery first developed at U-M and cutting edge metabolic imaging of the retina for early detection of disease.
Among recent Kellogg research efforts is a study to understand how photoreceptors light-sensing cells essential for vision can be preserved or even replaced to restore vision.The eye center is also developing a major research and treatment program for Graves eye disease and other autoimmune conditions, and plans to begin testing several promising therapies for these diseases.On April 23, UMHS will formally dedicate the building with a Dedicated to Discovery ceremony featuring tours of the building, musical celebrations, conferences for ophthalmologists and diabetes researchers, and a dedication event with remarks by Francis S. Collins, M.D., Ph.D., director of the National Institutes of Health, and Paul A. Sieving, M.D., Ph.D., director of the National Eye Institute.The advanced eye clinics will have much more space in the new building at a time when it is very much needed. Eye disease is costly and the aging population drives the need for new treatments and cures for disease. By 2030, people age 65 and older are expected to account for 20 percent of the population. The estimated cost of eye disease and vision loss in the U.S. is $68 billion annually.
February 26, 2010 (EurekAlert) - Two to three times more pregnant women may soon be diagnosed and treated for gestational diabetes, based on new measurements for determining risky blood sugar levels for the mother and her unborn baby, according to a study that was coordinated by investigators at Northwestern University Feinberg School of Medicine.
"As result of this study, more than 16 percent of the entire population of pregnant women qualified as having gestational diabetes," said lead author Boyd Metzger, M.D., the Tom D. Spies Professor of Metabolism and Nutrition at Feinberg and a physician at Northwestern Memorial Hospital. "Before, between 5 to 8 percent of pregnant women were diagnosed with this."
Blood sugar levels that were once considered in the normal range are now seen as causing a sharp increase in the occurrence of overweight babies with high insulin levels, early deliveries, cesarean section deliveries and potentially life-threatening preeclampsia, a condition in which the mother has high blood pressure that affects her and the baby.
Large babies, the result of fat accumulation, are defined as weighing in the upper 10 percent of babies in a particular ethnic group. Because large babies increase the risk of injury during vaginal delivery, many of the women in the study were more likely to have a cesarean section.
Previous guidelines to diagnose gestational diabetes were based on blood sugar levels that identified women at high risk for developing diabetes in the future. The guidelines weren't related to risks to the baby or other risks to the mother.
The study will be published in the March issue of Diabetes Care, a journal of the American Diabetes Association.
The good news, Metzger noted, is recent studies show women with mild gestational diabetes, who were treated with lifestyle and diet changes as well as blood sugar monitoring, greatly reduced their risk of complications. As a result of treatment, the women had smaller babies, fewer cesarean deliveries and less preeclampsia, Metzger said.
Based on a study of more than 23,000 women in nine countries, Metzger and an international group of 50 experts concluded a fasting blood sugar level of 92 or higher, a one-hour level of 180 or higher on a glucose tolerance test or a two-hour level of 153 or higher on a glucose tolerance test constitute serious risks to the mother and baby. Previously, these levels had been considered in the safe, normal range, and two elevated levels were required for a diagnosis of gestational diabetes.
"At these levels, the frequency of having an overweight baby is almost double, the frequency of having preeclampsia is almost double, and the frequency of early delivery is 40 percent greater," Metzger said. "These are really substantial differences."
The group of international experts in gestational diabetes spent almost two years determining how to apply findings from a 2008 study, also led by Metzger, that found a much lower level of a pregnant woman's blood sugar than previously believed increased the risk of serious complications.
The researchers set their new diagnosis and treatment criteria by determining the blood sugar level that nearly doubled the risks to the baby and mother.
"This study says these risks to pregnancy are like many things we deal with in medicine," Metzger said. "The risk of having a stroke doesn't begin when your blood pressure is 140 over 80. That's when we say you have hypertension, but that's not where the risk begins to affect your health. That starts sooner. A similar situation is how your cholesterol level relates to the risk of having heart disease. It doesn't begin at 200. That's where it reaches the threshold where common treatments can reduce the risks."
"Our research represents an examination of risks and a consensus about how high a level the risk needs to reach before a diagnosis should be made and treatment should be considered," Metzger said.
For the past decade, the rate of gestational diabetes as previously measured has soared as much as 50 percent. "We shouldn't be surprised," Metzger said. "The fact that we have a lot of gestational diabetes to deal with is consistent with the major impact that diabetes and obesity are having in our population at large. How could we expect pregnancy to escape that?"
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