Complex Health Issues of Aging Patients Not Solved in a Senior Moment

Program teaches medical professionals how to address obstacles to care, such as isolation and homelessness —

Reams of medical books and guidelines exist on how to manage a patient’s diabetes, but much of that goes out the window when your patient is a 70-year-old homeless man eating out of a trashcan.

“There’s no point in simply giving this patient insulin and telling him to get on a restricted diet,” said Dr. Diane Chau, associate professor of medicine at UC San Diego School of Medicine and a physician at Veteran Affairs San Diego Healthcare System. “We need to intervene in a broader, more comprehensive way.” … Read the full story from the UC San Diego Newsroom


Enzyme Restores Function with Diabetic Kidney Disease

Mouse findings reverse prevailing theory; point to potential treatment options

Researchers at the University of California, San Diego School of Medicine say that, while a prevailing theory suggests elevated cellular levels of glucose ultimately result in diabetic kidney disease, the truth may, in fact, be quite the opposite. The findings could fundamentally change understanding of how diabetes-related diseases develop – and how they might be better treated. … Read the full story from the UC San Diego News Center


Kumar Sharma, MD, FAHA Kumar Sharma, MD, FAHA, senior author of the study report, is professor of medicine and director of the Center for Renal Translational Medicine in the Division of Nephrology-Hypertension.

Dr. Laura DuganFirst author Laura L. Dugan, MD, at right, is professor of neurosciences and professor and chief of the Division of Geriatrics in the Department of Medicine. She holds the Larry L. Hillblom Chair in Geriatric Medicine.

Second author Young-Hyun You is an associate project scientist in the Division of Nephrology-Hypertension,

Other DOM faculty coauthors are Sameh S. Ali, assistant professor of medicine in the Division of Geriatrics, and Robert K. Naviaux, MD, PhD, professor of medicine in the Division of Medical Genetics.

Citation for the study report:

Laura L. Dugan, Young-Hyun You, Sameh S. Ali, Maggie Diamond-Stanic, Satoshi Miyamoto, Anne-Emilie DeCleves, Aleksander Andreyev, Tammy Quach, San Ly, Grigory Shekhtman, William Nguyen, Andre Chepetan, Thuy P. Le, Lin Wang, Ming Xu, Kacie P. Paik, Agnes Fogo, Benoit Viollet, Anne Murphy, Frank Brosius, Robert K. Naviaux and Kumar Sharma. AMPK dysregulation promotes diabetes-related reduction of superoxide and mitochondrial function. J Clin Invest. 2013;123(11):4888–4899. doi:10.1172/JCI66218.  |  Full text (UCSD only)

Related UC San Diego news stories:

High Rankings for Internal Medicine Specialties in 2013-2014 “America’s Best Hospitals” Report

Internal medicine subspecialties received high rankings and played a large part in UC San Diego Health System’s excellent showing in the U.S. News & World Report “America’s Best Hospitals 2013-2014” guide released July 16.

Clinical efforts of Department of Medicine divisions are either partly or completely responsible for 7 of the 10 UC San Diego Health System adult specialties that ranked in the nation’s top 50 this year and 1 of the 4 ranked as high performing:

In addition, Rheumatology is ranked as high performing once again (Division of Rheumatology, Allergy & Immunology).

Last year, three Department of Medicine specialties ranked in the nation’s top 50 and five were rated high performing.

Wolfgang H. Dillmann, MD“We can be very proud of achieving such a significant rise in our specialty rankings in one year,” said Wolfgang H. Dillmann, MD, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine.

In an announcement to the Department of Medicine faculty, he said, “Thank you for your hard work and your dedication in your patient care activities.

“Your efforts play a major part in distinguishing UC San Diego Health System as one of the finest hospitals in the country, and the top hospital in the San Diego metropolitan area.”

Details of the rankings for UC San Diego Health System are published online here. |  More about the methodology

Drug Treatment Corrects Autism Symptoms in Mouse Model

An old drug gives hope for new treatment in autism

Autism results from abnormal cell communication. Testing a new theory, researchers at the University of California, San Diego School of Medicine have used a newly discovered function of an old drug to restore cell communications in a mouse model of autism, reversing symptoms of the devastating disorder.

The findings are published in the March 13, 2013 issue of the journal PLOS ONE. … Read the full story from the UCSD Newsroom


First author of the study report is Robert K. Naviaux, MD, PhD, professor of medicine in the Division of Medical Genetics and professor in the departments of pediatrics and pathology.

Naviaux leads a medical genetics research laboratory whose two major areas of study are the mitochondrial mechanisms of disease and development and evolutionary systems biology and marine metagenomics. He is founder and co-director of the UC San Diego Mitochondrial and Metabolic Disease Center.

Naviaux earned his MD and PhD degrees at the Indiana University School of Medicine and received his advanced training in virology and molecular biology at the Salk Institute for Biological Studies. There, in the laboratory of Dr. Inder Verma, he conducted investigations in gene therapy and retrovirus biology.

Other Department of Medicine authors of the report are Laura L. Dugan, MD, who is chief of the Division of Geriatrics and Larry L. Hillblom Chair in Geriatric Medicine; research associates Lin Wang and Qingbo Tang; and Mihael Rogac.

Citation for the report:  Naviaux RK, Zolkipli Z, Wang L, Nakayama T, Naviaux JC, et al. (2013) Antipurinergic Therapy Corrects the Autism-Like Features in the Poly(IC) Mouse Model. PLoS ONE 8(3): e57380. doi:10.1371/journal.pone.0057380  |  Read the report

$5.9 Million Grant to UC San Diego for Paradigm-Shifting Diabetes Research

Kumar Sharma, MD, FAHA, professor of medicine at the University of California, San Diego School of Medicine and director of the Center for Renal Translational Medicine, has received a $5.9 million grant from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health, to study kidney complications related to type 1 and type 2 diabetes…. Read the full story from the UCSD Newsroom


Kumar Sharma, MD, FAHADr. Sharma’s project, “Novel Paradigms in Diabetic Complications,” is a five-year Type 1 Diabetes Targeted Research Award.

Read the project abstract

Other Department of Medicine investigators in the project:

Appreciation and a Fond Farewell to Dr. Ken Kaushansky

Kenneth Kaushansky, MD, MACPOn July 19, Dr. Ken Kaushansky officially begins his work as Senior Vice President for Health Sciences and Dean of the School of Medicine at Stony Brook University in New York.

When he announced his departure to the faculty and staff of the UCSD Department of Medicine on June 7, he described his new position as an opportunity to implement, on a larger scale, the successful programs that the Department of Medicine has instituted under his leadership here.

He called his years at UCSD a time of “incredible transition in our faculty, our leaders, our teaching programs, and our clinical impact.”

During Dr. Kaushansky’s tenure as Helen M. Ranney Distinguished Professor and Chair, the Department of Medicine expanded from 253 to over 420 faculty members, added four divisions, and recruited 11 division chiefs. Its annual budget grew from $86 million to nearly $150 million.

Dr. Robert Schooley“Dr. Kaushansky has been an outstanding Chair for this department,” said Dr. Robert “Chip” Schooley, Professor and Chief of the Division of Infectious Diseases and Vice Chair for Academic Affairs in the Department of Medicine.“

During his eight years as Chair, the medical house staff program became one of the most highly regarded programs in the country. New divisions in Hospital Medicine, Biomedical Informatics, Geriatrics, and Global Public Health were developed and research programs thrived throughout the Department,” Dr. Schooley said.

“In response to increasing interest in international medicine among the medical house staff, Dr. Kaushansky launched the Department’s Global Medicine Residency Program in 2009,” he said.“Dr. Kaushansky worked with his counterpart at the Universidade Eduardo Mondlane to establish a model program in international cooperation that has revitalized postgraduate medical training in the Republic of Mozambique.”


Dr. Kaushansky with Drs. Marisa Magaña, Emilia Noormahomed, and Robert Schooley in Mozambique Dr. Kaushansky on a global medicine planning trip to China.Dr. Kaushansky with Drs. Marisa Magaña, Emilia Noormahomed, and Robert Schooley in Mozambique (left); on global medicine program planning trip to China (right).

Since 2002, the Department’s NIH research funding has grown from $60 million to $113.6 million. It has more than twice as many complex multi-investigator program-project grants and career development awards granted to the junior faculty and fellows.

The Department has also boosted its showing in the “America’s Best Hospitals” rankings from U.S.News & World Report. In 2002, two subspecialty clinical programs ranked in the nation’s top 50: respiratory at 9th and cancer at 41st. In the most recent rankings, five subspecialties ranked in the top 50, including one (HIV/AIDS) in the top 10.

Dr. Greg Maynard“Ken was directly responsible for building up the strength of clinical care at UCSD,” said Dr. Greg Maynard (right), Health Sciences Professor of Medicine and Chief of the Division of Hospital Medicine.

“He recruited me here about 7-1/2 years ago, and in that time, the Hospital Medicine program has grown from 4 hospitalists to nearly 30, as just one example of that.”

“Dr Kaushansky nurtured my career here at UCSD,” said Dr. Pradipta Ghosh (below left), physician-scientist and Assistant Professor of Medicine in the Division of Gastroenterology.

Dr. Pradipta Ghosh“As a product of the Physician-Scientist Training Program,” she said, “I am one of those few who enjoyed special access to this busy department chair. His doors were always open. I recall having multiple consultations with him at various stages of my career as it grew here at UCSD.

“When the time came for me to choose where to spend the first decade of my young career as an independent investigator, it was his support and a match in our visions which tilted my decision in favor of UCSD,” she said.

“His tireless efforts at instilling the physician-scientist culture here in the Department of Medicine, both from top-down and bottom-up, have paved the path for many young folks like me to craft a career for themselves as physician-scientists,” Dr. Ghosh said.

Dr. John Carethers“Ken was the reason why I eventually accepted the GI Chief job at UCSD,” said Dr. John M. Carethers (right), now John G. Searle Professor and Chair of the Department of Internal Medicine at the University of Michigan.

When Dr. Kaushansky joined the UCSD faculty, Dr. Carethers was an associate professor of medicine in the Division of Gastroenterology. Dr. Carethers became division chief in 2004

“Ken … gave me enough autonomy to help grow the GI Division, gain a GI Center grant, coordinate well with the Cancer Center and other divisions, and allowed me to grow personally,” Dr. Carethers said. “The GI Division flourished under that mantra.

“We went to a clinical service chief structure, developed a new hierarchy for our administrative staff, started a robust web site, grew our fellowship, and survived many challenges over that time because of his support,” he said.

“Ken provided invaluable advice on my career,” Dr. Carethers said. “He was a great sounding board, not pretentious; encouraging, but never overprotective. I think he understood the value of growth and opportunity, something that is hard to come by these days.”

Dr. Patricia FinnDr. Patricia Finn (left), Professor and Chief of the Division of Pulmonary and Critical Care Medicine, described Dr. Kaushansky as “a tireless advocate for his faculty.”

“He is accessible 24/7 to offer support and guidance, which is huge to a new faculty member just moving cross country,” she said.

“On a personal note, when I had barely arrived here he was already nominating me for positions and committees to help me advance my career.”

Dr. Kirk Knowlton“His integrity, fairness, and open-mindedness built an environment of trust that allowed the substantial growth of the Department of Medicine during his tenure as Chair,” said Dr. Kirk U. Knowlton (right), Professor of Medicine and Chief of the Division of Cardiology.

“I am struck by how he has been able to hold the respect of so many people with widely disparate interests,” Dr. Knowlton said.

“This included people who were fully engaged in basic science and those who were busy taking excellent care of their patients; medical students and residents and post-graduate research fellows; administrators and faculty; and others over whom he might have had influence or who crossed his path.

“The people he has worked with knew that they could count on him to represent their interests in the context of the institution’s goals in a considered and reasonable manner while at the same time maintaining his vision of the future of the Department of Medicine.”

“He is a rare breed,” Dr. Maynard said. “I guess I’d call him a quadruple threat. An outstanding scientist, a superb clinician, a great educator, and an incredible leader and administrator to boot.

“While he is not really replaceable,” he said, “he has left an enduring legacy that stresses clinical and operational excellence, as well as research contributions.”

Dr. Finn said, “In addition to [his] world-class scientific reputation, Dr. Kaushansky is most respected for his character and vision.”

“He makes his department and faculty a priority, while striving to always do the right thing for the patients,” she said. “He will be most remembered for his infectious enthusiasm, upbeat attitude, and steady, insightful guidance of students and faculty.”

“He leaves an 8-year legacy that advanced the Department of Medicine in many ways,” said Dr. Carethers, “including growing faculty, changing the way residents learn, obtaining key recruitments for division chiefs and faculty, enhancing VA relations, and being an all out cheerleader for the Department.”

On June 21, Dr. Kaushansky was honored at a farewell reception hosted by David Brenner, M.D., Dean of the UCSD School of Medicine and Vice Chancellor, Health Sciences. In his remarks there, Dr. Kaushansky expressed his appreciation for “eight and a half years of good friends, challenges, and teamwork.”

Observing that he had been involved in recruiting many of the faculty members in the room, he said, “Everything at UCSD works toward recruiting great people.”

“It’s easy, at UCSD, to build things and to make a difference,” he said. “Everybody makes everyone else stronger.”

Dr. Kaushansky praised UCSD’s “incredible richness” of people, science, teaching, and clinical programs. “I’ve never seen more devotion to the three missions,” he said.

And now he looks ahead.

“In academic medicine, you get to re-craft yourself every ten years,” he said. “I’m looking forward to my newly-found steep learning curve.”

Dr. Kaushansky was honored at a tribute from the senior leaders of the Department of Medicine on July 11. There will be a tribute from all departmental staff, faculty, and house staff on a date to be selected.

“Although one could cite metric after metric by which his unceasing efforts strengthened the Department,” said Dr. Schooley, “what many of us think distinguished his tenure most was the way in which his ‘bottom up’ style of leadership brought out the best in all of us.

“The Department will benefit for many years to come from things he set in motion – as will each of its members from what we learned from his multifaceted demonstration of scholarship, integrity, imagination and dedication to his Department.”


Drs. Ken Kaushansky and Wolfgang Dillmann   Drs. Ken Kaushansky and Wolfgang DillmannDr. Kaushansky with newly designated Interim Chair Wolfgang Dillmann, M.D.