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El Paso ideal place for medical school centers to study cancer, diabetes & obesity, infectious disease, neurosciences
July 29, 2009

The Paul L. Foster School of Medicine hopes to one day develop into a force in international research with its investigation of conditions important to El Pasoans

Written by Erica Molina Johnson, The El Paso Times

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Dr. Alan Tyroch, chairman of surgery for the Texas Tech Health Sciences Center Paul L. Foster School of Medicine and trauma medical director at University Medical Center of ElPaso sits in the CT scan in the hospital's trauma center. Neurosciences researchers from the medical school will draw from trauma patients seen at the hospital, Tyroch said. (Mark Lambie / El Paso Times)

EL PASO -- The Paul L. Foster School of Medicine hopes to one day develop into a force in international research with its investigation of conditions important to El Pasoans.

The county's 81 percent Hispanic population and proximity to Mexico are set to help the medical school's growing research team explore parts of the population that long have been neglected.

"I can't emphasize enough the importance of the population which is here," said Dr. Rajkumar Lakshmanaswamy, an assistant professor in the department of biomedical sciences.

"You could be in New York or somewhere else and not get this population. When you're looking at federal agencies like the National Institutes of Health or the Department of Defense, all of them are emphasizing to study minority populations, and this is a place where the majority are minorities."

Dr. Jose Manuel de la Rosa, founding dean of Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, said that as the school determined its research priorities, its leaders stepped back to evaluate the region's strengths. They also looked at illnesses prevalent in the population.

The result was the establishment of four centers of excellence focusing on cancer, infectious disease, neurosciences, and diabetes and obesity.

Dr. Charles Miller, associate dean for research and professor and chairman of biomedical sciences, said the school also will be important in adding a Hispanic component to national biomaterials banks being developed to allow broader studies of genomes and their relation to one another.

He said most of those registered in the system are Anglo, making it difficult to do such studies. Larger population-based studies also are difficult because few minority groups are represented.

"Because El Paso is a heavily Hispanic area, this would be an ideal place for us to do this kind of database development, and it would really serve as a national treasure," Miller said.

As the medical school grows, its research focus is likely to change. Now, the focus is on recruiting directors and researchers to the new centers of excellence. The school has already set up laboratories with equipment not found in many others.

"Our goal is to build programs of national prominence that will become internationally known but that are focused on areas that are important to the El Paso region," Miller said.

Infectious disease

The Center of Excellence for Infectious Disease is the only one so far to have directors.

Dr. Premlata Shankar and Dr. Manjunath Swamy were recruited from Harvard Medical School as co-directors of the center. They brought with them more than $4 million in NIH funding for their ongoing research.

The two are focusing much of their work on West Nile virus and HIV, and they have received attention nationally for their work.

De la Rosa said it was important to establish a research focus in infectious disease because of illnesses that enter the area from Mexico, illnesses found in soldiers returning from the Middle East and the prevalence of other illnesses in El Paso, such as drug-resistant tuberculosis.

Miller said the area has a great need for more research.

"You don't have to look very far to see why this is important in a border community where you have two international populations right next to each other," he said. "El Paso really is a migratory pathway not just for people, but for birds and commerce and foods and all kinds of things that may or may not carry infectious illnesses or risks."

Dr. Armando Meza, chief of infectious diseases at the medical school, said the proximity to Mexico allows the El Paso area to see illnesses not often found in other areas, such as certain intestinal infections. He said he hoped the center would allow for greater collaboration with Mexico in studies of some illnesses.

Cancer

De la Rosa said developing a Center of Excellence for Cancer became an apparent need as differences began to be noticed in the breast cancers being diagnosed in this area as compared with the rest of the nation.

Lakshmanaswamy joined the school about five years ago and focuses much of his work on breast cancer research.

He said that nationally that Hispanic women have lower incidence of breast cancer than Anglo women, but that the survival rate is lower for Hispanic women.

Preliminary data for El Paso women show a breast cancer incidence that's 12 percent higher for Hispanic women than the national average for Hispanic women.

"Why is it? That's what we want to find out," Lakshmanaswamy said.

Researchers also want to learn why Hispanic women generally are diagnosed with breast cancer at an advanced stage earlier in life.

Lakshmanaswamy said research in the center of excellence will focus on endocrine-related cancers such as breast, cervical, endometrial and prostate.

An area where he hopes to further research is genomics and proteomics, or the study of genes and proteins. He wants to identify genes and proteins relevant to certain cancers that can be used to help determine a person's risk for the disease, diagnose the disease and determine a prognosis.

Neurosciences

To study neurosciences and traumatic brain injuries, medical school researchers will draw from trauma patients seen at University Medical Center of El Paso, as well as a relationship with Fort Bliss, said Dr. Alan Tyroch, chairman of surgery at the medical school and trauma medical director at the hospital.

The hospital is the only Level 1 trauma center for nearly 300 miles and receives all trauma patients from this part of Texas and Southern New Mexico. The patients have injuries from car wrecks, falls, stabbings and gunshots.

Tyroch focuses on the clinical aspects of head injuries, but he said he sees the need for research in the area.

He said school officials want to focus some research efforts on traumatic brain injury, incorporating data from military patients as well as from patients seen at University Medical Center.

"There are lots of soldiers who are coming back from Iraq who have been injured. As body armor gets better, the injuries that are survivable become more devastating," Miller said. "We're seeing lots of kids who survive their initial injuries, but then you have lingering neurological problems."

There also is an interest at the school in studying strokes, as well as neurological illnesses that affect older people, such as Alzheimer's disease and Parkinson's disease.

He said there are plans with the ophthalmology department to conduct research into optic nerve injuries and other eye disorders.

Diabetes and obesity

Studying diabetes and obesity was a no-brainer, de la Rosa said, considering the high incidence of both conditions in El Paso.

The El Paso Diabetes Association estimates that 85,000 people have been diagnosed with diabetes in El Paso and an additional 25,000 have the disease but are not aware of it. An additional 100,000 people are at risk of developing the disease.

"We have a diabetes epidemic going on," said Dr. Tamis Bright, chief of endocrinology for the medical school. "If the obesity gets worse, the nation's diabetes gets worse."

She dsof diabetes is one of the few diseases that will be much more prevalent in El Paso than in other areas.

Bright said research in this area was especially important because much of the research that has been done was in white patients.

"The Mexican-American population is our largest ethnic group in the nation," she said, "and if you have a disease that's affecting one of the largest groups of Americans that is very costly, you'd really like to target that disease and prevent it and control it."

Research at the center will focus primarily on Type 2 diabetes, which is typically diagnosed later in life, and the disease's complications. These include cardiac, renal and eye disease.

The school has five trials involving diabetes.

"We know where we want to go. We just have to find somebody whose vision of what he wants to do will kind of match where we really want to be five or 10 years down the road," Bright said.

Miller said the school has hired a recruiting firm to help find a director for the center.

De la Rosa said finding the director for this center was deliberately left until last because he or she will be the person the school is competing for the hardest because diabetes centers are being established at several locations throughout the nation.

Although many of the researchers who will work at the medical school have not yet been recruited, those who are here are excited about the future and about helping deal with El Paso's medical problems.

"It's tough, but we will work hard to make an impression and we will see to it that the rest of the country will turn around and take a look at us and say, 'You know what, there is something really good happening in El Paso,' and we will get that done," Lakshmanaswamy said. "That's what we'll do, whatever it takes."

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