Chief resident Mario Tapia, M.D., and Dr. Joseph Leslie Pean, a Regional Academic Health Center faculty member, visit at the Kleberg Medical Scholars dinner.
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Contact: Will Sansom, (210) 567-2579

HARLINGEN, Texas (May 7, 2008) — The Kleberg Medical Scholars, a group of internal medicine residents conducting research at the UT Health Science Center San Antonio Regional Academic Health Center, presented their 2007 research results May 1 in Harlingen at a dinner honoring The Robert J. Kleberg Jr. and Helen C. Kleberg Foundation.

The projects, conducted at Valley Baptist Medical Center, Su Clinica Familiar and with other clinical partners, are of strong relevance to the Lower Rio Grande Valley population in areas such as diabetes and congestive heart failure.

The Kleberg Medical Scholars are resident physicians at the center who conduct clinical research projects supported by stipends from The Robert J. Kleberg Jr. and Helen C. Kleberg Foundation. This Texas foundation has funded resident research at the center for five years in the amount of $1.5 million.

The Kleberg scholars stand with a number of UT Health Science Center faculty members.

Results are in from the 2007 Kleberg-supported projects, while the 2008 projects are under way. James F. Hanley III, M.D., is the center’s Internal Medicine Residency Program director.

Here are brief synopses of selected Kleberg Medical Scholar projects:

• Hector Amaya, M.D., found that hypokalemia (low potassium level in the blood) is a significant problem in patients admitted to the hospital with congestive heart failure. This is important because low potassium has been associated with life-threatening arrhythmias and increased deaths. Hospitals might consider adopting a different threshold for replacement of potassium in these patients.
  
  
• Irina Minina, M.D., is finding a relatively high frequency of orthostatic hypotension (a drop in blood pressure upon standing) in older patients who take blood pressure or other medications. Orthostatic hypotension is associated with an increased risk of falls and passing out (called syncope) when they stand. So far she has studied 37 patients. It may be that the change in blood pressure upon standing in older individuals is being overlooked and should receive more attention from physicians.
  
  
• Luciana Oliveira, M.D., found drug-resistant infections called extended-spectrum beta-lactamases or more simply, ESBLs, in only 2 percent to 3 percent of patients she studied. This was fewer than predicted and may reflect the high quality of infection control at Valley Baptist Medical Center. However, these infections were associated with increased cost and number of procedures in the hospital.
  
  
• Mario Tapia, M.D., Kleberg Medical Scholar and chief internal medicine resident at the Regional Academic Health Center, studied random blood sugars drawn at Su Clinica Familiar at the time of patients’ visits. The blood samples were compared with hemoglobin A1C measurements. Dr. Tapia found the random blood sugar measurements did not correlate with the hemoglobin A1C measurements. The hemoglobin A1C is the standard by which a physician decides whether to treat a patient’s diabetes more intensively.
  
  A hemoglobin A1C reading is like having a movie of blood sugar instead of a picture. It is an average of sugars over three months versus a reading at only one point in time.
  
  Dr. Tapia was very surprised by a cost analysis. Su Clinica spent a significant sum of money on random glucose tests, which appear to have no value when routinely obtained, versus only $2.76 every three to six months for a hemoglobin A1C test, which can impact the therapy of the patient.
  
  Dr. Tapia calls random glucose testing “the appendix” of the management of diabetes. These tests take nurses’ time, use glucometer finger strips and require sticks.
  
  His study begs the question: Why do the random tests if they don’t drive decision making in diabetes and aren’t cost-effective?
  
  In terms of diabetes management with hemoglobin A1C, Dr. Tapia said Su Clinica is very good compared to the national average in that 80 percent of its diabetic population has an acceptable blood glucose control by AQA standards. (AQA is a national alliance working to improve physician practice.)

“I want to stress how grateful we are to the Kleberg Foundation for five years of generous support that has made these projects possible,” Dr. Hanley said. “The result is better health for Valley patients and a new class of physicians who are trained in conducting clinical research. It is hoped many of these resident scholars will stay in the Valley.”

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The University of Texas Health Science Center at San Antonio is the leading research institution in South Texas and one of the major health sciences universities in the world. With an operating budget of $576 million, the Health Science Center is the chief catalyst for the $15.3 billion biosciences and health care sector in San Antonio’s economy. The Health Science Center has had an estimated $35 billion impact on the region since inception and has expanded to six campuses in San Antonio, Laredo, Harlingen and Edinburg. More than 23,000 graduates (physicians, dentists, nurses, scientists and allied health professionals) serve in their fields, including many in Texas. Health Science Center faculty are international leaders in cancer, cardiovascular disease, diabetes, aging, stroke prevention, kidney disease, orthopaedics, research imaging, transplant surgery, psychiatry and clinical neurosciences, pain management, genetics, nursing, allied health, dentistry and many other fields. For more information, visit www.uthscsa.edu.