Patches of fabric honor the youngest AIDS victims
Pediatric AIDS quilt unveiled to promote
community awareness of young patients
Jennifer Baker was born HIV positive.
She inherited the disease from her parents, who were both infected, and spent 11 years of life battling the numerous illnesses that accompany the AIDS virus, her days stolen by visits to the hospital and clinics.
Baker, who survived both her parents, died in 1996 at age 11.
A regular patient at the Division of Community Pediatrics' South Texas AIDS Center for Children and Their Families, Baker's memory has been captured there in the thread and swatches of colorful fabric that hang on the institution's pediatric AIDS memorial quilt.
Baker's blue-and-white quilt panel includes a piece of the Charlotte Hornets basketball T-shirt she loved and her Hornets hat. It is bordered by the green, red and yellow handprints of other children like her who are now infected with the AIDS virus. There are four panels on the memorial quilt so far; each represents a San Antonio child who has died from the AIDS virus. Unfortunately, there will be more.
The quilt was born from an idea voiced by both Dr. Terrence Doran, director of the Health Science Center's Division of Community Pediatrics, and clinical nurse Sue Alderete, who wanted to honor the children and raise community awareness regarding the severity of the epidemic in infants and children. An estimated 7,000 infants are born each year to HIV-positive mothers. More than 4,800 children under age 15 have died of AIDS, while 10,000 other children are living with the disease.
Alderete began the project in 1997 with no funding, relying on volunteers and donations for materials and quilting expertise. Support came from Roxane Pharmaceutical Laboratories. Alderete spent off hours working on the quilt along with more than a dozen others who would stitch and add swatches here and there. The first four-panel section of the quilt was completed recently and unveiled during a small, private ceremony for the families of the children the center serves.
The quilt's panels contain favorite pictures, colors or other items from each of the children represented, along with the child's birth year and the year the child died. Sewn across the middle of the quilt is a red ribbon, a symbol for the fight against AIDS, and the words "Gentle Warriors," which is what Alderete calls the little ones who "fight" the disease."They are fighting a battle they do not understand," Alderete said. "They are warriors yet they are still gentle."
Alderete said she plans to have the quilt taken out into the community as an opportunity for people, who may not have direct contact with the AIDS virus, to see the personal aspects of the disease instead of just the cold, hard numbers. Along with the quilt, Alderete compiled several thick photo albums which have pictures of the children who passed away, in various stages of the disease along with their poems, drawings and memorabilia. She hopes that taking these things into the San Antonio communities will influence young people and the choices they make.
"It sends a message. It makes some people think," Alderete said. "We try to push preventative measures. It is worth a try at least and we have ignored it for too long. I want our children to be heard and maybe if it just influences one person, then we have made progress."
The quilt has been displayed during several health fairs and related events in San Antonio and was transported to Washington, D.C., for a national AIDS conference. The ultimate goal is to grow the memorial quilt from a local undertaking into a national project with the mission of providing education about preventing HIV transmission from mother to child and ultimately eradicating the disease from the lives of these children.
"One little child on that panel is one too many," Alderete said. "One day we will put up the last panel, and it won't be that of a child. The last panel will simply say, 'There is a cure.'"
Eight more memorial panels, remembering additional children from the center and other facilities, will be added when funding is available. Both materials and manpower are needed to complete these segments. Anyone wishing to contribute to the pediatric AIDS quilt should contact Alderete at ext. 7400.
The South Texas AIDS Center for Children and Their Families is part of the Health Science Center's Division of Community Pediatrics and provides comprehensive care for HIV-positive children, women and adolescents by offering a number of services, including medical care, counseling, access to clinical research, education and training.
Patients 18 or older and who developed stuttering in childhood will be considered for eligibility. These are the first studies of their type anywhere, said Dr. Peter Fox, the center's director.
One study, funded by the National Institutes of Health, will explore the basis of prolonged speech, a strategy that teaches stutterers to prolong syllables slightly. Two California researchers scheduled to visit the RIC will assess individuals' response to prolonged speech training. "We will screen for people who are selectively responsive to this treatment," said Fox. "Once we see a strong response in an individual, we will image the person to see how his or her brain is using prolonged speech."
The scanning method is positron emission tomography (PET), which uses radiation tracers to tag brain chemicals. PET images show brain activity, such as speech, while it is occurring.
A second study, funded by the Charles A. Dana Foundation, will focus on the brain's response to a technique called transcranial magnetic brain stimulation (TMS). "In stutterers, we're trying to down-regulate an abnormal area," Dr. Fox said. "In earlier studies, we've identified a number of areas that are overactive in stuttering and a smaller number that are underactive. In this study, we will direct TMS therapy at a motor planning center near the top of the head."
Only 20 participants are needed, 10 in each study. Patients' travel will be reimbursed. This research is not available in Dallas, Houston or Austin. "The Research Imaging Center is the only place in the world approved to do this trial of TMS in stut-tering," Dr. Fox said. "Other sites conduct studies of prolonged speech, but none is investigating its physiology in this way."
Individuals or family members may inquire about eligibility by calling ext. 8220.
Nursing preceptors often act as mentors, building student self-confidence, providing informative evaluations for developing skills and teaching students in a clinical environment. In an effort to provide these preceptors with teaching strategies, four area nursing schools, including the School of Nursing at the Health Science Center, joined together to put on a citywide Invitational Preceptor Conference.
Preceptors from all over the city spent the day learning about their role and responsibilities, identifying strategies for clinical teaching, and analyzing principles of adult learning that could benefit them in the role of teacher.
"This was to thank them and also to help them continue to enhance their own personal development in being the kinds of preceptors, role models and mentors that they would like to be," said Dr. Suellen Reed, director of academic projects and grants in the School of Nursing. "What was significant about this program was that four schools of nursing in the city participated, including Incarnate Word, San Antonio College, Baptist Health System and ours."
All four of the area schools planned the event.
National speaker, Dr. Bette Case, discussed the myths and realities of the preceptor role. Dr. Nancy Hudepohl spoke about diagnosing learning needs, adult teaching principles and evaluation techniques.
"I think the research done here will benefit not just Texas but the world," Briscoe said. "Remember, whatever you do in the future, your ultimate goal must be the improvement of human health."
Briscoe, governor of Texas from 1973 to 1979, said during the graduation ceremony that receiving a degree from the Health Science Center would be a "point of pride" for graduates because he believes it to be "the best health science center to be found anywhere in these United States." Briscoe has been a staunch supporter of the Health Science Center in many ways, including initially working in the Texas Legislature to help establish the South Texas Medical School, which was later expanded into the Health Science Center. The institution's library is named for Briscoe.
Briscoe, a Uvalde rancher and World War II veteran, praised the importance of scientific research done by graduates, students and staff members like those at the Health Science Center. Briscoe said he has seen the benefits of research in many facets of his own life, including the recent treatment his wife of 58 years, Janey, received while hospitalized at University Hospital.
Janey Briscoe, a University of Texas graduate and a former regent of the U. T. System, spent two months at University Hospital undergoing treatment in the
cardiac intensive care unit and is home recovering. Briscoe commended the staff, saying the "state-of-the-art" treatment "saved her life."
"It highlights what you can do for others because of the training you have received," Briscoe said. "The ability of the clinical staff to test and treat her was directly dependent on the science developed by your colleagues of an earlier period."
The Graduate School's 1999 graduating class was the largest in the school's 27-year history. Twenty-one Graduate School students were candidates for the Doctor of Philosophy degree (Ph.D.), certifying them as scholars in their areas of study, which include biochemistry, cellular and structural biology, microbiology, molecular medicine, nursing, pharmacology, physiology and radiological sciences. An additional 28 students were candidates for the Doctor of Pharmacy degree (Pharm.D.) and 25 students received a Master of Science in seven fields, including biochemistry, dental diagnostic science, microbiology, periodontics and prosthodontics.
The Graduate School has conferred nearly 350 Ph.D. degrees since its founding in 1972.
A limited number of Health Science Center employees work at the hospital, have the proper permits and are authorized to park at the facility. In the past, Health Science Center employees were, at times, accommodated in the visitors' paid parking area; however the hospital can no longer support this accommodation.
University Hospital has provided parking for physicians from other facilities during "grand rounds" of the various departments, but the space available to support this parking is no longer available. Parking for medical students is not available anywhere on hospital property.
Should you have any questions, please contact the Department of Protective Services at University Hospital, 358-2465.
The study involves the use of an intrathecal delivery system designed to alleviate some of the chronic pain suffered by ALS patients and improve their quality of life.
Both the principal investigator for the study, Dr. Carlayne Jackson, and the co-investigator, Dr. Anthony Amato, are members of the Health Science Center Department of Medicine. The study coordinator is Department of Medicine research nurse Erin Iturriaga. Dr. Alexander West, surgery, is a neurosurgeon involved in the implantation of the pumps, which deliver medication to the spinal cord region.
"This is the first study to use an intrathecal delivery system in the treat-ment of patients who suffer from ALS," Dr.West said. "We are trying to provide hope, through the study, to improve the quality of life to patients in which the life expectancy is three to five years."
ALS is a fatal neurological disorder, characterized by the progressive degeneration of motor cells in the spinal cord and the brain. ALS affects the motor neuron cell, preventing the neuron from sending impulses to the muscles, and causing an increase in muscle weakness in the body, especially in the arms and legs. It also affects speech, swallowing, and breathing. The muscles, which no longer receive the messages required to function properly, eventually begin to atrophy. The disease does not affect intellectual functioning nor does it inter-fere with the ability to see, taste, smell or recognize touch. Both the cause of the disease and a possible cure are unknown.
It is believed the internal pump used in the study could provide physicians with a more effective way of delivering medications to the spinal regions of ALS patients, which has been difficult because the spinal cord is protected by the spine and surrounding tissues.
The pump, which was developed by Med-Tronics Inc., is placed under the skin in the abdomen region and a catheter is surgically implanted from the pump to the spine to supply medication directly into the spinal cord. A growth factor is used to maintain the neuron from cell-defined death and prolong the patients life expectancy. The pump is normally used to treat patient's with chronic pain, including Parkinson's disease or cerebral palsy patients.
Six study sites in the United States, two in Canada and eight in Europe, are enrolling patients. Once sufficient data has been collected, researchers from the above sites are expected to gather and review the outcome. For more information regarding the study, call Iturriaga at ext. 1979.
The South Texas Veterans Health Care System provided the information/photo for this
article.
Computer users are invited back to the same room at 1 p.m. June 2 for another Tex-MUG workshop on "FileMaker Pro on the Web."
In the first workshop, Sal Espinosa of Apple Computer Inc. will discuss principles of good and bad World Wide Web page design. He will describe the
process of creating individual components of a Web page, and will discuss tools used to put the pieces together, including Graphic Converter, Web Painter, QuickTime, Myrmidon, Media Cleaner Pro and Microsoft Office 98.
From 1 to 2:30 p.m., Dr. Leo Maxwell, Department of Physiology, will demonstrate the use of FileMaker Pro in conjunction with Web sites. FileMaker Pro is a versatile database program which runs on both Macintosh and Windows/Intel platforms. One of its features is that it can be readily incorporated into a Web page for a variety of purposes, such as online surveys, application and other forms, and questionnaires.
The user needs a Web browser to access FileMaker Pro-generated materials, and the Webmaster/owner has ready access to results from the online users, including tallies and statistics compiled by the FileMaker Pro database. Dr. Maxwell will demonstrate several working examples of FileMaker Pro on Health Science Center Web sites.
Tex-MUG meetings are open to all interested individuals.
Some of the major attractions included a products show featuring ergonomic equipment available through the Boise Cascade Ergonomic Products catalog, and an ergonomic forum featuring presentations by occupational therapy and physical therapy at the Health Science Center.
The event also included a workstation audit program, presented by Mark Simmons of Fellowes Manufacturing Co. Each attendee received the ergonomics and productivity workbook that complemented a slide presentation, an audit form, and a tool for determining your "Eye Dominant."
Door prizes, ranging from gift certificates to ergonomically correct wrist rests, were awarded to nine attendees including Helen Cavazos, Madge Cluck, Mario de la Pena, Jayson Felty, Rafaela Gomez, Debbie Hensley, Juan Portela, Neera Satsangi and Delfino Velasco.
Additional race sponsors include Coca-Cola, Signs by Tomorrow,
Magic 105 FM, VVP's Creative Designs and the Schertz Area Faculty for Emergency Services.
Runners and walkers can pick up registration forms at any Schlotzsky's Deli in San Antonio, New Braunfels, Schertz and Seguin and at the Run-A-Way runner's store, 3428 N. St Mary's St. The entry fee is $15 for adults prior to June 9 and $17 through race day. Entry fees for children are $10. For more information, call the Run-A-Way runner's store at 732-1332.
"We are excited about bringing this important study to South Texas," said principal investigator Dr. Anatolio Cruz, professor of surgery. "Women everywhere are at risk for breast cancer, and we are pleased that South Texas women will have the chance to participate in this important study."
Study goal
The Health Science Center is part of the National Surgical Adjuvant Breast and Bowel Project (NSABP), the network of research professionals that will conduct
STAR, which is supported by the National Cancer Institute (NCI). NSABP chairman, Dr. Norman Wolmark, noted that "studies of raloxifene suggest it has the potential to prevent breast cancer. The only way to prove that potential is to do a clinical trial in which the risks and benefits of raloxifene are directly compared with the risks and benefits of tamoxifen."
Tamoxifen and Raloxifene
However, the drug increased the women's chances of developing four potentially life-threatening health problems including endometrial cancer, deep vein thrombosis, pulmonary embolism and possibly stroke. The U.S. Food and Drug Administration (FDA) approved the use of tamoxifen to reduce the incidence of breast cancer in women at increased risk of the disease in October 1998.
Dr. Leslie Ford, associate director for clinical research in NCI's Division of
Cancer Prevention, noted that "tamoxifen is a medically proven intervention, but it is not perfect. Women who are at an increased risk of breast cancer need options for preventing this disease with a minimum of side effects, and STAR is a concerted effort to find one."
Raloxifene was approved in December 1997 by the FDA to prevent
osteoporosis and has been in clinical trials for about five years. Tamoxifen has been approved by the FDA to treat women with breast cancer for more than 20 years and has been in clinical trials for about 30 years.
Safety
Women who participate in STAR must be postmenopausal and at least age 35, and must have an increased risk of breast cancer as determined by their age, family history of breast cancer, events intheir personal medical history, age at first menstrual period, and age at first live birth. They will also learn about the potential benefits and risks of tamoxifen and raloxifene before deciding whether to participate in STAR.
Once a woman chooses to participate, she will be randomly assigned to receive either 20 mg tamoxifen or 60 mg raloxifene daily for five years and will have regular follow-up examinations, including mammograms and gynecologic exams.
The maker of tamoxifen, Zeneca Pharmaceuticals, Wilmington, Del., and the maker of raloxifene, Eli Lilly and Co., Indianapolis, are providing their drugs for the trial without charge. Eli Lilly and Co. has given NSABP a $36 million grant to defray recruitment costs at the participating centers and to help local investigators conduct the study.
For more information about STAR, call ext. 5751 or 4762, or visit
NSABP's
Web site or NCI's clinical trials Web site.
The conference is sponsored by South Texas AIDS Training (STAT), a group that works with mental health providers, social workers, primary care givers and others who come into contact with the HIV/AIDS population. The conference includes lectures, panel discussions, a question-and-answer session, and audiovisual presentations.
The conference is designed to enable participants to become more familiar with the newest medical advances, recognize the effects of anxiety and depression on HIV-infected persons, understand drug interactions, and identify psychological issues associated with the prospect of extended survival.
The conference covers strategies for enhancing patient adherence to treatment regimens and improving the ability to identify and respond to ethical issues that arise when working with HIV/AIDS patients.
For registration and conference information, call the Continuing Medical Education Office at the Health Science Center at ext. 4446.
Unraveling the mysteries of stuttering, through imaging
Research Imaging Center to offer two studies
for speech disorder sufferers
Teaching the teachers
Nursing preceptors attend Health Science Center conference
More than 200 area registered nurses were on campus May 1 for an all-day conference focusing on how to train and work with students as nursing preceptors.
Briscoe bids graduates farewell
Former governor stresses importance
of science and research
Former Gov. Dolph Briscoe Jr. addressed more than 70 students receiving advanced degrees from the Health Science Center during a May 21 graduation ceremony of the Graduate School of Biomedical Sciences. He said the work these science and health care graduates will undertake in the future will be important not only to San Antonio, but to the nation and the world.
Applause
Parking rules enforced at UH
In an effort to stop the rising number of unauthorized vehicles being parked at University Hospital, the Department of Protective Services at the hospital has
increased enforcement efforts in the parking areas. Vehicles illegally parked at the facility are subject to be cited, booted, and/or towed at the owner's risk and expense.
International Lou Gehrig's disease study draws
The Health Science Center and the South Texas Veterans Health Care
System are participating in an international study regarding the treatment of amyotrophic lateral sclerosis (ALS), also referred to as Lou Gehrig's disease.
Health Science Center researcher
Making the Rounds
Mac Users Group to hold two workshops
The campus Macintosh Users Group (called "Tex-MUG") will hold a Web page creation seminar from 9 to 11:30 a.m. Wednesday, June 2, in lecture hall 3.102B.
Ergonomics highlighted at HSC Expo
The Ergonomics Expo, sponsored jointly by Institutional Safety, General Stores in conjunction with Boise Cascade, and the Council for Administrative Personnel, attracted more than 200 employees of the Health Science Center from 61 departments and divisions.
Run for cancer scheduled June 12
The 4th Annual Bun Run 5K Race will kick off Saturday, June 12, at Retama Park. The "Run Your Buns Off to Cure Cancer" event is co-sponsored by Schlotzsky's Deli and Channel 4, KMOL-TV. Proceeds from the race will benefit cancer research. The charity event will include a USA Track and Field-sanctioned 5K run/walk for adults,
as well as a special race for children.
Health Science Center site for STAR cancer study
The Study of Tamoxifen and Raloxifene, or STAR, one of the largest breast cancer prevention studies ever, is now recruiting volunteers at more than 400 centers across the United States, Canada and Puerto Rico, including the Health Science Center.
The trial will include 22,000 postmenopausal women at increased risk of breast cancer to determine whether the osteoporosis prevention drug raloxifene (Evista) is as effective in reducing the chance of developing breast cancer as tamoxifen (Nolvadex) has proven to be.
Tamoxifen was shown to reduce the chance of developing breast cancer by about half in the Breast Cancer Prevention Trial (BCPT), a study of more than 13,000 premenopausal and postmenopausal women at high risk of breast cancer. Results of this trial were announced a year ago and published in the
Journal of the National Cancer Institute in September 1998. In the BCPT, half the women took tamoxifen and half took a placebo (an inactive pill that looked like tamoxifen). Participants taking tamoxifen also had fewer fractures of the hip, wrist and spine than women taking the placebo.
Women taking raloxifene in studies of osteoporosis have had an increased
chance of developing a deep vein thrombosis or pulmonary embolism similar to the risk seen with tamoxifen. In these studies, raloxifene did not increase the risk of endometrial cancer. An important part of STAR will be to compare the long-term safety of raloxifene and tamoxifen in women at increased risk for breast cancer.
HIV/AIDS conference offered for caregivers
Persons working with the HIV/AIDS population are being offered a one-day AIDS conference, "A Second Life Agenda: HIV/AIDS in the Era of Extended Survival," held Friday, June 4, at the San Antonio Airport Hilton.