Cigarette Smoke Makes Superbugs More Aggressive

In lab and mouse experiments, cigarette smoke helps drug-resistant bacteria fight off the immune system —

Methicillin-resistant Staphylococcus aureus (MRSA), an antibiotic-resistant superbug, can cause life-threatening skin, bloodstream and surgical site infections or pneumonia. Researchers at the University of California, San Diego School of Medicine now report that cigarette smoke may make matters worse. The study, published March 30 by Infection and Immunity, shows that MRSA bacteria exposed to cigarette smoke become even more resistant to killing by the immune system. …Read the full story from the UC San Diego Newsroom

Laura E. Crotty Alexander, MDPulmonologist Laura E. Crotty Alexander, MD, is senior author of the study report. She is a Health Sciences assistant clinical professor in the Department of Medicine at UC San Diego and a staff physician at the Veterans Affairs San Diego Healthcare System.

Read the study abstract with link to PDF in Infection and Immunity (UCSD only)

Dr. Joseph M. Vinetz Presents CPC on Chronic GI Bleeding in Ethiopian Man at November 12 Medicine Grand Rounds

Dr. Joseph VinetzChronic gastrointestinal bleeding in a 50-year-old man from Ethiopia is the topic of a clinicopathological conference to be presented by Dr. Joseph M. Vinetz at Medicine Grand Rounds on November 12.

Joseph M. Vinetz, MD, is professor of medicine in the Division of Infectious Diseases, Department of Medicine at the UCSD School of Medicine. He is associate editor of the American Journal of Tropical Medicine and Hygiene and deputy editor of PLoS Neglected Tropical Diseases.

Stuck on Flu

How a sugar-rich mucus barrier traps the virus – and it gets free to infect

Researchers at the University of California, San Diego School of Medicine have shown for the first time how influenza A viruses snip through a protective mucus net to both infect respiratory cells and later cut their way out to infect other cells. … Read the full story from the UC San Diego News Center

Dr. Robert T. "Chip" Schooley

Dr. Robert T. Schooley

Project co-investigators from the Division of Infectious Diseases in the Department of Medicine are Robert T. “Chip” Schooley, MD, professor of medicine and chief of the division; associate project scientist Xing-Quan Zhang; and Hui-Wen Chen, now at the School of Veterinary Medicine at National Taiwan University.

Dr. Schooley is academic affairs vice chair for the Department of Medicine.

Citation for the study report in Virology Journal:

Miriam Cohen, Xing-Quan Zhang, Hooman P Senaati, Hui-Wen Chen, Nissi M Varki, Robert T Schooley, Pascal Gagneux. Influenza A penetrates host mucus by cleaving sialic acids with neuraminidase. Virology Journal 2013, 10:321 (22 November 2013) doi:10.1186/1743-422X-10-321.  |  Full text (Open access)

More news from the Division of Infectious Diseases:


Twenty-One Department of Medicine Physicians on National “Top Doctors” List for 2011-2012

Top Doctors Gallery
See a photo gallery
of the Department of Medicine
Read the UC San Diego Health System press release

See the list of UC San Diego Health System physicians honored

Twenty-one Department of Medicine physicians are among the 83 UC San Diego Health System doctors designated Top Doctors by U.S.News & World Report for 2011-2012.

U.S. News teamed with Castle Connolly Medical Ltd., publisher of America’s Top Doctors and other consumer health guides, to create its Top Doctors™ list.

Of the 21 Top Doctors from the Department of Medicine, 16 are among Castle Connolly’s top 1% in the nation and 5 are considered in the top 10%.

In the following list, an asterisk indicates the physician is in Castle Connolly’s Top 1%.

Auger, William R.*

    – Pulmonary and Critical Care Medicine

Ball, Edward D.*

    – Bone Marrow Transplantation

Blanchard, Daniel G. *

    – Cardiology

Catanzaro, Antonino*

    – Pulmonary

Choe, Charles H.

    – Endocrinology and Metabolism

Edelman, Steven V.*

    – Endocrinology and Metabolism

Feld, Gregory K.*

    – Cardiology

Gamble, Paul N.

    – General Internal Medicine

Gish, Robert*

    – Gastroenterology

Kipps, Thomas J.*

    – Hematology-Oncology

Mahmud, Ehtisham*

    – Cardiology

Mittal, Ravinder

    – Gastroenterology

Parker, Barbara A.*

    – Hematology-Oncology

Read, William L.

    – Hematology-Oncology

Reid, Tony R.*

    – Hematology-Oncology

Richman, Douglas D.*

    – Infectious Diseases

Rubin, Lewis J.*

    – Gastroenterology

Sandborn, William J.*

    – Gastroenterology

Savides, Thomas

    – Gastroenterology

Schooley, Robert T.*

    – Infectious Diseases

Wasserman, Stephen I.*

    – Rheumatology, Allergy & Immunology

U.S. News and Castle Connolly use a combination of peer nomination and physician-directed analysis to create their Top Doctors™ database. | More about the methodology: Castle Connolly | U.S. News

Dr. Philip Lederer Receives the 2011 Lee Rickman Humanism in Medicine Award

Dr. Philip LedererPhilip Lederer, MD, senior resident in the UC San Diego Internal Medicine Residency Program, received the 2011 Lee Rickman Humanism in Medicine award at Medicine Grand Rounds on June 8.

The award is given each year to the resident who most embodies the energy and devotion of Lee Rickman, MD, a UC San Diego residency program graduate and Department of Medicine faculty member who practiced infectious disease medicine with singular passion until his death in 2003.

“Phil has that same passion,” said Elaine Muchmore, MD, residency program director, in presenting the award. “It’s with pride and enthusiasm that I introduce him as this year’s Rickman award winner.”

When Dr. Lederer graduates from the program later this month, he will join the faculty as Health Sciences Assistant Professor in the Division of Infectious Diseases and Clinical Director of the UC San Diego Department of Medicine’s Maputo Central Hospital Educational Collaboration.

Living in Maputo, Mozambique, he will be the on-site UC San Diego faculty attending for residents on global medicine elective rotation.

He will play a major role in the Medical Education Partnership Initiative (MEPI), which unites UC San Diego and the Universidade Eduardo Mondlane (UEM) in an effort to build sustainable, local capacity for educating doctors in Mozambique and southeast Africa.

In accepting the Rickman award, Dr. Lederer reflected on the 30th anniversary of the HIV/AIDS epidemic. Thirty-five million people have died of AIDS, he said, and 75 million have been infected since the epidemic began, primarily in sub-Saharan Africa.

Africa carries 24% of the world’s disease burden but has only 3% of the world’s trained medical professionals, he said.

As clinical director in Mozambique, he will direct both UC San Diego and UEM residents in their training. He will also play myriad roles in the process of strengthening the UEM training program and developing research collaborations on topics of greatest concern to Mozambique.

He concluded his remarks by introducing Drs. Clotilde Nhatave Paiva and Ermenia Miguel Muthambe, internal medicine residents from the UEM training program in Maputo who are currently on rotation here at UC San Diego.

“They are the future,” Dr. Lederer said.

About Dr. Lederer

Dr. Lederer received his MD degree from the University of Pennsylvania School of Medicine. He has sought out opportunities for service in health and social justice since 2003, when he served as a full-time diabetes educator in a community health center after he graduated from Brown University.

In 2005, he co-founded the Guatemala Health Initiative to bring together University of Pennsylvania students and Guatemalan communities in efforts to improve public health, focusing on the Tz’utujil Maya town of Santiago Atitlán.

During his residency, Dr. Lederer has completed both the global medicine rotation in Mozambique and the Global Health in Local Populations rotation in San Diego.

He is currently conducting research studies in HPV and conjunctival cancer, rapid diagnostics for tuberculosis, and bacteremia in Mozambique.
About Dr. Rickman

Leland Rickman, MD, was a UC San Diego infectious disease specialist who graduated from the Internal Medicine Residency Program here in 1983. He completed his fellowship training in infectious diseases at the Naval Medical Center San Diego and served in naval hospitals until he returned to UC San Diego to join the Department of Medicine faculty in 1990.

Dr. Muchmore met Dr. Rickman at that time.

“I was struck by his passion for teaching and for clinical care and his meticulous attention to details,” she said. “He was a font of knowledge.”

Dr. Rickman was appointed Hospital Epidemiologist and Medical Director of the Epidemiology Unit in 1993.

“He dedicated himself to being the infection control physician for the hospital,” Dr. Muchmore said. “He bird-dogged things in a way that was truly awe inspiring.”

He received more UC San Diego teaching awards than anyone in the Department of Medicine, Dr. Muchmore said. The San Diego County Medical Society’s Physician Citizen of the Year award in 2003 was one of many acknowledgments of his service to the community.

Dr. Rickman died in June 2003 while traveling in Lesotho, Africa, to train local medical personnel in AIDS treatment and prevention. In that effort, he was working with Dr. Wm. Christopher Mathews, UC San Diego Professor of Clinical Medicine and Director of the Owen Clinic.

“His loss was not only to those of us at UCSD but to the world,” said Dr. Kenneth Kaushansky, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine at the time.

Dr. Kaushansky and the residency program faculty established the Rickman award in his honor in 2003.

Hospitalist Program, Dr. Timothy Morris, and Dr. Davey Smith Honored as 2008 Health Care Champion Finalists

Three Department of Medicine individuals and teams are among UCSD Medical Center’s honorees in the 2008 “Health Care Champions” awards from the San Diego Business Journal.

Pulmonary specialist Dr. Timothy Morris, infectious disease physician-scientist Dr. Davey M. Smith, and the Division of Hospital Medicine were honored August 21 as “Health Care Champion” finalists.In all, 5 individuals and teams from UCSD Medical Center received a Champion award and 20 were selected as finalists.

Dr. Greg MaynardThe Division of Hospital Medicine, headed by Dr. Gregory Maynard (left), has achieved national recognition for its contributions in health care quality improvement.

These include a venous thromboembolism (VTE) prevention program that has made the UCSD hospitals a national leader in protecting inpatients from the risk of developing blood clots.

Read the full story
from UC San Diego
Health Sciences Communications

The program was developed as a joint venture between Dr. Maynard and the Hospitalist Program and Dr. Timothy Morris. A clinical and research specialist in VTE, Dr. Morris helped create the VTE prevention protocols and oversees the follow-up on individual cases.

Dr. Timothy Morris

Dr. Morris, left, is Professor of Medicine and Clinical Service Chief in the Division of Pulmonary and Critical Care Medicine. He is medical director for both the Respiratory Care program and the Pulmonary Function Laboratory.

In July, the California Thoracic Society honored Dr. Morris with the Outstanding Clinician Award for 2008.

The Pulmonary and Critical Care Medicine division was recognized by U.S. News & World Report in 2008 for the 14th consecutive year as one of the top ten centers in the nation, and #1 in California, for the treatment of respiratory diseases.

Davey M. Smith, M.D., M.A.S., Assistant Adjunct Professor of Medicine, is a physician-scientist in the Division of Infectious Diseases. Dr. Smith is medical director of the Early Intervention Program at the Antiviral Research Center.  A translational research virologist, he specializes in the study of HIV transmission.

Dr. Davey M. SmithEarlier this year, Dr. Smith (left) received an R01 grant award from the National Institute of Mental Health for a 5-year, multi-national study of HIV and the brain.

Dr. Smith directs the Center for AIDS Research Viral Pathogenesis Core on the UCSD campus.

More Information:

Dr. Joseph Vinetz and Colleagues Discover a New Species of Leptospirosis Bacteria

Infectious disease specialist Dr. Joseph Vinetz and colleagues have discovered a new species of bacteria that may be a major cause of a potentially fatal tropical disease.

The disease, leptospirosis, is transmitted from animals to humans. Severe forms of leptospirosis have high fatality rates.

Joseph Vinetz, M.D., is Professor of Medicine in the Division of Infectious Diseases. In the study, he collaborated with researchers at other North American centers and the Universidad Peruana Cayetano Heredia in Lima, Peru.

The study was published in the April 1 issue of Neglected Tropical Diseases:

Matthias MA, Ricaldi JN, Cespedes M, … and Vinetz, JM. Human Leptospirosis Caused by a New, Antigenically Unique Leptospira Associated with a Rattus Species Reservoir in the Peruvian Amazon. PLoS Negl Trop Dis. 2008 April; 2(4): e213. Published online 2008 April 2. doi: 10.1371/journal.pntd.0000213. Read the report

Read the full story from UC San Diego Health Sciences Communications

More Information:

New 5-Year Grant Is a Boon for Major UCSD Study on HIV and the Brain

Why does HIV infection cause dementia in some patients and not in others?

With help from a new 5-year, $3.7 million federal grant, UC San Diego clinician-researcher Dr. Davey M. Smith is looking for the answer.

He and his coworkers will study HIV in a total of 1000 HIV-infected patients in Brazil, China, India, Romania, and the U.S.

In these five countries, three major subtypes of the HIV virus are found.

Dr. Davey Smith

His latest study, funded by the National Institute of Mental Health, will look for the causes of AIDS dementia in HIV subtypes from five countries (in red on the map above).

Dr. Smith hopes to find out which HIV subtypes, or clades, are more likely to cause neurological damage, and why the affected individuals are susceptible.

Dr. Smith is an Assistant Professor of Medicine in the Division of Infectious Diseases. He joined the faculty in 2003 as a clinician and translational researcher.

He learned in January that the National Institute of Mental Health had decided to fund his study. The title is “A Multi-site Investigation into the Effect of HIV Clade on Neurocognitive Impairment.”

It’s the first study of its kind.

“There’s a need to compare the HIV subtypes in their genetic makeup and their effect on the brain,” Dr. Smith says. “Most of it is still an open question.”

The HIV found in the rest of the world
is very different from that
in the U.S. and Europe.

“Everything we know about the way HIV affects the brain is based on the HIV virus that’s found in the United States and Europe,” he says. “The HIV found in the rest of the world is very different.”

HIV mutates rapidly as it enters new environments, both in the world and in the human body. Not only is HIV in China different from HIV in Romania; HIV in an individual’s brain is different from the HIV in his or her blood.

“HIV is one of the most diverse organisms, if not the most diverse organism we have,” Dr. Smith says. “It’s a hundred times more diverse than influenza.”

Researchers are just beginning to understand the genetic variations of HIV and how they affect the way the virus is transmitted.

Dr. Smith has developed a way to inspect the HIV virus for its genetic signature, a pattern of mutations in the HIV gene.

In the new project, he and his team will use that technique to compare the genetic makeup of HIV in blood versus brain, in individuals with and without neurological damage, in the five countries.

Researchers will look at
the “genetic signature” of HIV
across the world.

The study is an example of translational research, which is a high priority at UC San Diego and in the Department of Medicine.

“UCSD is a great place for doing translational research, applying basic science to clinical problems,” Dr. Smith says. “There’s very strong support for it here.”

“The HIV research team,” he adds, “is a really great group of people.”

Dr. Smith joined the faculty in 2003 after training at UC San Diego in both internal medicine and basic and clinical research. After his internal medicine residency training and a term as Chief Resident, he completed a fellowship in Infectious Diseases and a Masters of Advanced Studies (M.A.S.) in Clinical Research here.

He is Medical Director of the San Diego County Early Intervention Program at the Antiviral Research Center (AVRC).

He directs two co-infection clinics at the Veterans Administration San Diego Healthcare System (VASDHS), one for HIV/Hepatitis C and one for HIV/HPV infection.

He conducts his clinical research at the AVRC and his basic science studies in his UC San Diego campus laboratory.

“UCSD is a great place
for doing translational research.”

His advisor and mentor is Dr. Douglas D. Richman, Professor of Pathology and Medicine and the Florence Seeley Riford Chair in AIDS Research.

Dr. Richman is Director of the UC San Diego Center for AIDS Research (CFAR).

Another HIV researcher whom Dr. Smith considers a mentor is Dr. Joseph K. Wong, now Associate Professor in the Division of Infectious Diseases at UC San Francisco and a staff physician at the San Francisco Veterans Affairs Medical Center.

As both a clinician and a translational research virologist, Dr. Smith divides his time between the laboratory and the patient clinic.

“It means a lot to me,” he says, “to be able to do both patient care and research.”

His goal, both in the laboratory and in his clinics, is to provide better care for individuals who are infected with HIV.

“It’s good to see people getting better
and going on in their lives.”

On a recent trip to Ethiopia, Dr. Smith saw HIV-infected patients who had not had access to the antiretroviral treatments we have here in the U.S. and Europe.

“Seeing them reminded me of where we were in the early 90’s here,” he said. “It was heartbreaking; HIV is so destructive. We have got to do better in getting our antiretroviral therapy out there.

“But we’re getting there,” he says. “It’s good to see people getting better and going on in their lives. It’s good to see things change.

“That perspective, I think, makes me a better researcher,” he says. “I get to see the why. Why this research is so important.”

More Information:

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