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Update on Adult and Pediatric ID Clinical D ivisions

Update on Adult and Pediatric ID Clinical D ivisions. Stony Brook Medicine: Schools. School of Dental Medicine School of Health Technology & Management School of Medicine School of Nursing School of Social Welfare . Cross Two D epartments. Adult ID Pediatric ID

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Update on Adult and Pediatric ID Clinical D ivisions

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  1. Update on Adult and Pediatric ID Clinical Divisions

  2. Stony Brook Medicine: Schools • School of Dental Medicine • School of Health Technology & Management • School of Medicine • School of Nursing • School of Social Welfare

  3. Cross Two Departments • Adult ID • Pediatric ID • Interact with basic science groups across campus

  4. Resources • Inpatient services for ID • Peds: 500 new consults per year • Adult: 120 per month • Outpatient ID services • Peds: 1000 visits per year • Adult: 300 per year • HIV services: • Adult HIV: 700 patients • Peds HIV: <100 patients • HIV OB: 20 deliveries per year

  5. Other resources • Inpatient EMR • Outpatient EMR • Linkage of orders to interested investigators • Full complement of clinical labs • Micro, flow cytometry, pathology etc. • http://www.stonybrook.edu/research/vpr/centers.shtml#clinical-tab

  6. Biomedical Sciences • Center for Biotechnology • Center for Cancer Genetics • Center for Developmental Genetics • Center for Functional Nanomaterials • Center for Infectious Diseases • Center for Medical Humanities, Compassionate Care, and Bioethics • Centers for Molecular Medicine • Center for Structural Biology • Communications, Signal Processing, Speech and Vision Laboratory • Institute of Chemical Biology and Drug Discovery • Institute for Molecular Cardiology • Laufer Center for Physical and Quantitative Biology

  7. Centers/Laboratories Providing Services to the Research Community • Bioinformatics Facility • Biostatistical Consulting Core • Cell Culture/Hybridoma Facility, Microbiology • Center for Advanced Technology in Diagnostic Tools and Sensor Systems (SensorCAT) • Center for Structural Biology • Central Microscopy Imaging Center • Division of Laboratory Animal Resources • DNA Microarray Facility • DNA Sequencing Facility • Flow Cytometry Laboratory • Genomics Core Facility • Imaging Center • Materials Characterization Laboratory • Micro Computed Tomography Facility • Office of Clinical Trials • Pollock-Krasner House and Study Center • Proteomics Center • Rapid Prototyping • Transgenic Mouse Facility • University Nuclear Magnetic Resonance Center • X-Ray Optics and Microscopy

  8. Clinical Centers • Alzheimer’s Disease Assistance Center of Long Island • Ambulatory Surgery Center • Burn Center • Cancer Center • Carol M. Baldwin Breast Care Center • Center for Minimally Invasive Surgery • Chronic Pain Management Center • Cystic Fibrosis Clinical Center • Dental Care Center • Diabetes and Metabolic Diseases Research Center • General Clinical Research Center • Heart Center • Laboratory for Imaging Research and Informatics (IRIS) • Long Island Occupational and Environmental Health Center • Long Island Geriatric Education Center • Lung Cancer Evaluation Center • Medical Image Processing Laboratory • National Pediatric MS Center • Osteoporosis Center • Plastic & Cosmetic Surgery Center • Stony Brook Cleft Palate-Craniofacial Center • Sleep Disorders Center • Vascular Center • Vein Center

  9. Office of Clinical Trials • https://bioinfo.osa.sunysb.edu/octs/mission.jsp • For Investigators • Functions & Services • Guidelines & Forms • Resources & Tools • Education & Training • Fully staffed with study coordinators, IRB experts and Clinical trials specialists • Master contracts with Pharma • Charge master for institution

  10. Research projects: Adult • Influenza: • R. Steigbigel, National PI: DAS181, a sialidase, for treatment of Influenza infection . Funded by BARDA. • Completed Phase II (JID : 2012:206 :1844-1851) • Results of Phase IIB under analysis. • HIV: • R. Steigbigel, National PI: Efficacy and safety of raltegravir combined with optimized background therapy in treatment experienced patients with unsuppressed multi-drug resistant HIV-1 infection. (NEJM : 2008:358: 339-354; ClinInf Dis: 2010:50:605-612; Lancet Infectious Diseases, in press).

  11. HIV Outpatient Study Site, Site PI J. Fuhrer • HOPS is a CDC directed clinical database of 10 HIV practices and clinics around the country. The data is analyzed retrospectively and occasionally prospectively for clinical outcomes, adverse events, etc. • Hepatitis B • Hepatitis C

  12. Lyme • Hot topic on Long Island with many outstanding issues in both adults and children • Open study: Profiling The Humoral Response To B Burgdorferi Infection And Development Of A Serodiagnostic Test • have sequenced the genomes of 22 strains of Borreliaburgdorferi • we have cloned, expressed and purified over 500 recombinant proteins that have certain characteristics indicative of their antigenicity. • need to identify antigens that may be useful in the development of a highly sensitive and specific test • Bioengineering multiprotein polypeptides utilizing sequences from 30 important proteins in order to make such a test feasible.

  13. Epigenetic Link Between PTSD & Respiratory Disease • Objective is to explicate the genetic mechanisms linking PTSD and lower respiratory symptoms • NIOSH/CDC: U01 OH010416-01 • Started September 2012 • PI: Benjamin J. Luft, MD • Co-I: Evelyn Bromet, PhD, Adam Gonzalez, PhD, Roman Kotov, PhD • Collaborators: S. Galea, K. Koenen, G. Guffanti, S. Southwick, W.R. McCombie

  14. Background & Rationale • PTSD and respiratory disease are comorbid in WTC responders (Luft et al., 2012) • Our prospective work indicates PTSD at V1 predicts onset and remission of respiratory sxs at V2 • Epigenetics is a promising technique to examine mechanisms • Uddin et al. 2010: Community residents with a hx of PTSD had a distinct biosignature reflecting immune activation and markers indicating a compromised immune system compared to trauma-exposed residents without PTSD • Results replicated by Smith et al. 2011

  15. Specific Aims • To determine and compare the methylation pattern of the peripheral blood DNA of patients with WTC-PTSD, patients who never developed PTSD, and a non-traumatized healthy control group.  • To determine whether the methylation patterns observed in the WTC cohort are similar for patients with chronic WTC-PTSD and those with PTSD in remission.  • To examine differences in methylation patterns among WTC responders with • comorbid WTC-PTSD and respiratory illness, • only respiratory illness, • only WTC-PTSD, and • neither respiratory illness nor WTC-PTSD.

  16. Progress • Ongoing clinical interviews and blood sample collection at Stony Brook University WTC Health Program • Database creation • Quality assurance checks for phenotypic data • Data analysis of 239 cases

  17. Pediatrics • HIV: • IMPAACT network • Site plus leadership • Subunit for Johannesburg unit • Recent HIV specific studies, S. Nachman as study chair: • 1066 • 1055 • TB: prevention (vaccine), treatment (new therapies), diagnostics, S. Nachman as study chair • 1108 • 1100, 1113 • IGRA, C. Beneri as study chair • DACS 658: Assessment of NIH clinical case definitions for TB diagnostics research evaluation using the IMPAACT P1041 study data, C. Beneri as study chair

  18. Influenza • 1086, 1088, 1089 • Appendicitis • Appropriate antibiotic and length of treatment • EBV • Basic science w/micro group • Leishmaniasis • With engineering (nanoparticles) • Antibiotic stewardship program

  19. Other areas of interest: • Tick study: Epidemiology of tick vectors in Suffolk County and clinical implications • The aim of this study was to report the number and type of ticks collected in our area • Osteomyelitis protocol: Management of acute uncomplicated osteomyelitis • To develop a standardized protocol for management of acute osteomyelitis in children • Latent tuberculosis infection related study

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