Congratulations to our four, 2015 DIG winners!

After careful consideration, the DIG Application Review Committee, which is comprised of: Dr. Manuel Fontes, Dr. Ru-Rong Ji, Dr. Jerrold Levy, Dr. Joseph Mathew, Dr. Richard Moon, Dr. Mihai Podgoreanu, Dr. Mark Stafford-Smith, and Dr. David Warner, selected four research studies to receive the grant.  We would like to recognize and congratulate the following 2015 DIG recipients:

[headline_box text=”1. Dr. Terrence Allen, for his study, “The role of progestins and PGRMC1 in inflammation-induced fetal membrane weakening.””]
[headline_box text=”2. Dr. Atilio Barbeito, for his study, “Using Health Information Technology to Bridge the Quality Gap in Anesthesiology.””]
[headline_box text=”3. Dr. Boyi Liu, for his study, “Investigating Mechanisms Underlying Pathological Itch Conditions.””]
[headline_box text=”4. Dr. Jennifer Dominguez, who received the TJ Gan DIG Award, for her study, “Obstructive Sleep Apnea in Pregnancy: Development of a Pregnancy-Specific Screening Tool.””]

We are confident that their work will truly improve and advance the field of anesthesiology, and want to thank the review committee and all of our DREAM supporters who make the DIG possible.

Chris KeithCongratulations to our four, 2015 DIG winners!
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Duke wins first place for the fourth year in a row at the ASA Run for the Warriors

Congratulations to the Duke Anesthesiology Racing Team for finishing in first for fundraising out of 16 teams at this year’s ASA Run for the Warriors 5K Race in New Orleans! Under the leadership of Drs. Warwick Ames and Luke James, Duke surged into first by raising $11,655. The money raised will go towards supporting U.S. service members and their families who have been affected by injuries or death to defend our country.

A special thanks goes out to the following runners and donors who helped make Duke number one, including those who gave anonymously or were not on the team:

Warwick Ames, MBBS
Karsten Bartels, MD
Elliott Bennett-Guerrero, MD
Tera Cushman, MD
Adam Hartz
Juliann Hobbs, MD
Michael James, MD

Yinghui Low, MD
Keila Maher, MD
Jonathan Mark, MD
Joseph Mathew, MD
Brittany Merk, MD
Richard Moon, MD

Alina Nicoara, MD
Ron Olson, MD
Jamie Privratsky, MD
Uma and Karthik Raghunathan, MBBS
Alicia Shook, MD
Annemarie Thompson, MD

[headline_box text=”GO DUKE!“]
Chris KeithDuke wins first place for the fourth year in a row at the ASA Run for the Warriors
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Winter 2014 DIG Report: Michael Manning, MD, PhD

Cardiopulmonary Bypass-Induced Inflammatory Changes in the Atrial Wall: The Novel Role for Cardiac Chymase produced Angiotensin II in the Development of Atrial Fibrillation

Michael Manning, MD, PhD

Atrial fibrillation is a common complication following cardiac surgery because of the use of the heart-lung machine. Previously, it has been very difficult to make advances in treating this complication because of our inability to reproduce atrial fibrillation in animals, thereby hindering our ability to study what factors are the root causes of its development.

During the funding period of the DIG, we have now found a way to study the development of atrial fibrillation using a scaled down heart-lung machine in rats. We are able to simulate the physiological consequences of stopping the heart during the bypass, which approximates what we do to our human patients everyday. Using techniques we have developed as part of the DIG, we are then able to induce atrial fibrillation in these rats.

Using the results from these tests, we believe that the changes in the heart leading to increased susceptibility to atrial fibrillation are not a result of the anesthesia, but more a consequence of exposure to the heart-lung machine. Findings from our experiments have been submitted to present at the 36th Annual Meeting of the Society of Cardiovascular Anesthesiologists in the Spring of 2014.

We are now trying to understand the molecular changes that are occurring within the heart to ultimately arrive at a way to prevent this from occurring. We are very fortunate to have been awarded a $50,000 starter grant in the Spring of 2013 from the Society of Cardiovascular Anesthesiologists to continue this important work.

Chris KeithWinter 2014 DIG Report: Michael Manning, MD, PhD
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Winter 2014 DIG Report: Karthik Raghunathan, MD, MPH

Comparative effectiveness in Perioperative and Critical Care Medicine: Crystalloid Fluid Therapy

Karthik Raghunathan, MD, MPH

Different types of  Intravenous Fluids are widely used for the treatment of patients with serious infections who are admitted to the ICU. The conventional comparison has always been between fluids called, “crystalloids,” versus, “colloids.” Despite years of debate, these types of fluids have proved equivalent.

Currently, crystalloids are recommended for most patients because they are inexpensive and readily available. However, there may be important differences between  commonly available types of crystalloids. Therefore, we set out to answer the question, “does crystalloid choice matter during serious infectious illness?”

Contrasting crystalloid fluids in terms of their electrolyte content, we assembled two similar groups of patients in a large national database: those who received saline (high chloride) were compared with those who received balanced fluids. We found that treatment with balanced fluids reduced the risk of death among patients with serious infections. This is important as balanced fluids are widely available but infrequently used.

Earlier this year, we received the 2014 Anesthesia Patient Safety Foundation/American Society of Anesthesiology Endowed Research Award for $94,000 over two years to study the comparative effectiveness of intravenous fluids among patients undergoing surgery.

Also, we are excited for a pending $210,000 grant from Baxter, Inc. for a related study regarding different fluid types during cardiac surgery.

Chris KeithWinter 2014 DIG Report: Karthik Raghunathan, MD, MPH
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Winter 2014 DIG Report: Miklos Kertai, MD, PhD

Pharmacogenomics of β-blockers: Implication for Postoperative Atrial Fibrillation

Miklos Kertai, MD, PhD

The purpose of our study is to identify genetic variations in human genes that are responsible for modulating the efficacy of beta-blockers for the prevention of postoperative atrial fibrillation after heart surgery. For the purposes of the present study, we are using isolated DNA and human heart tissue from patients who underwent coronary artery bypass grafting (CABG) surgery at Duke University Medical Center.

Since our last progress report in July 2013, we received the data from the DNA sequencing and messenger RNA gene expression profiling. Our statisticians have been working hard to analyze the complex data that was derived from the DNA sequencing and RNA expression profiling. As a result of these analyses, we expect to identify genes that might be associated with an increased risk for postoperative atrial fibrillation and reduced efficacy of beta-blockers.

Our research and understanding of the role of these potential genetic variants in postoperative atrial fibrillation and reduced efficacy of beta-blockers has also led to a grant submission (Co-Principal Investigators: Drs. Mihai Podgoreanu and Deepak Voora; Co-Investigator: Dr. Miklos Kertai) to the National Institute of Health Sciences. Our submission has received an outstanding score, so we are eagerly waiting to find out if it gets funded.

Chris KeithWinter 2014 DIG Report: Miklos Kertai, MD, PhD
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Winter 2014 DIG Report: Steve Melton, MD

Neurointerventional Regional Anesthesia to Improve Hand Rehabilitation in Stroke

Steve Melton, MD

Collaboration between investigators from anesthesiology, physical therapy, neurology, and the Brain Imaging and Analysis Center continues as planned.  Having completed manuscripts related to our preliminary fMRI investigation in healthy, human subjects, our current focus is on translating data from this work to the current project in stroke-affected individuals.

Additionally, we have applied for extramural funding from the American Society of Regional Anesthesia and Pain Medicine through the Carl Koller Memorial Research Grant.

Chris KeithWinter 2014 DIG Report: Steve Melton, MD
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