the 1999 summer research program for medical...

RESEARCH PROGRAM FOR MEDICAL STUDENTS

Dr. Maria José CrespoCoordinator

Research Programs for Medical Students

[email protected] of Medicine

mailto:[email protected]

PROGRAM OBJECTIVES

To foster biomedical research interests in medical students.To increase the number of medical students participating in research.To provide a structured research program for medical students.To provide continuity to the medical students research efforts.To create an environment for the development of a medical researcher.

Research Alternatives for Medical Students

Enrollment in one or two Research Courses

Completion of the “Research Track”

MD-PhD Program of the UPR-School of Medicine

Combined MD-PhD Program

UPR-School of Medicine - Mayo Clinic

UPR-School of Medicine – MD Anderson

MD-MS Program of the UPR-School of Medicine (Planned)

REQUIREMENTS FOR THE SUMMER PROGRAM

The summer program is best suited for 1st

year medical students.

Good academic standing

Commitment to work 8 weeks in the

summer.

Interview with coordinators.

The Structured Research Program for medical students is provided by enrollment in 3 sequential courses:

• MCBI 7001- Introduction to Research in Basic or Clinical Sciences

• MCBI 7002- Research in Basic or Clinical Sciences

• MCBI 7003- Advanced Research in Basic or Clinical Sciences

Students who complete all 3 courses will receive a “Research Track Certificate” at the Graduation Ceremony

APPLICATION PROCEDURE FOR RESEARCH COURSES

Orientation activity toFirst year medical students

Identification of area of interest

Interview with selectedResearcher (Mentor)

Enrollment in MCBI courses

Program introduction during the orientation week for

Medical students

STRUCTURE OF THE SCHOOL OF MEDICINE “RESEACH TRACK”

“RESEARCH TRACK” CERTIFICATE DURING THE GRADUATION CEREMONY

MCBI 7001 (160 Hour-Credit)Introduction to Research in Clinical or Basic Sciences

MCBI 7002 (160 Hour-Credit)Research in Clinical or Basic Sciences

MCBI 7003 (160 Hour-Credit)Advanced Research in Clinical or Basic Sciences

NIH Research Experience or Equivalent Research Experience

RESEARCHSUMMER PROGRAM

Medical Students Receiving the “Research track” certificate during the 2009 Graduation Ceremony

Medical Students Receiving the “Ramón Ruiz-Arnau” Research Award during the 2009 Graduation Ceremony

MEDICAL STUDENTS ENROLLED IN MCBIRESEARCH COURSES (1999-2009)

Year Number of Student

MCBI 7001 MCBI 7002 MCBI 7003 TOTAL

2000-2001 50 12 5 672001-2002 88 10 11 1092002-2003 76 17 3 962003-2004 44 11 6 612004-2005 64 29 8 1012005-2006 66 21 14 1012006-2007 67 21 7 952007-2008 62 23 9 942008-2009 80 18 9 1072009-2010 69 25 17 111

MCBI 7001: Includes Summer and Academic Year

PRODUCTIVITY OF STUDENTS ENROLLED IN MCBI COURSES

Articles published in:International J of Clinical and Experimental Pharmacology

Journal of Perinatology

Puerto Rico Health Sciences Journal

Journal of Pediatric Orthopaedics

Human Biology

FASEB Journal

J Thrombosis and Haemostasis

Journal of Trauma

Journal of the Association of Research in Otolaryngology

Pediatric Research

Archives of Otolaryngology- Head and Neck Surgery

PRODUCTIVITY OF STUDENTS ENROLLED IN MCBI COURSES

Meetings attended:Annual Convention of the American Academy of Pediatrics

World Biomaterials Congress

National Hispanic Medical Association Annual Meeting

Emergency Medicine Annual Meeting

AMSA Annual Convention

Society for Neuroscience Annual Meeting

Annual Pharmacogenetics in Psychiatry Meeting

UPR-Research and Education Forum

Foro Rafael Fernandez- Filiberti

ALEH Congress

Congreso Chileno de Gastroenterología

Pavía Hospital Convention

UPR-Research & Education Forum

NIH Poster Day

First medical student graduated from UPR-Mayo Clinic MD-PhD Progam

Joaquin Zalacain (MS III)- Oral Presentation at the Experimental Biology Meeting, San Diego

PARTICIPATING FACULTYFaculty from Basic Sciences Departments:

PhysiologyAnatomyPharmacologyBiochemistryMicrobiology

Faculty from ClinicalDepartments:

Internal Medicine PediatricsSurgeryEmergency MedicinePathologyNeurologyObstetrics -GynecologyPsychiatry

Faculty from Other Academic Institutions:

NIHMD AndersonMayo ClinicJohns Hopkins UniversityUniversidad de SalamancaLouisville-KentuckyYale UniversityMassachusetts General HospitalUCSF Children’s HospitalHospital Montefiore (New York)Injury Research Center (Ohio SUCollege of Medicine) HSHPS/CDCBoston Children’s Hospital

PARTICIPATING FACULTY

Medical Student Training in Aging Research (MSTAR) Program of the AFAR (American Federation Aging Research)

Jonhs Hopkins

David Geffen School of Medicine at UCLA

University of Pittsburgh

Michigan School of Medicine

Eleine Pages (Graduated in June 2008) received the Banco Santander-UniversiaResearch Award in October 2007

American Federation for Aging Research (AFAR) Summer Experience

Coordinated at UPR-SOM by:

Prof. Delia Herrera (Ext. 2219) [email protected]. Ivonne Jimenez (Ext. 1828) [email protected]

Duration: 8 WeeksDeadline for Application: January 31, 2011Funding: Funded by American Federation for Aging Research (AFAR) and

National Institute on Aging (NIA) Stipend: approximately $1,748 per monthDocuments Required: www.afar.org/medstu.html

- Application form by internet- Good Standing letter from the Dean of Studen Affairs (Dr. Gladys González Navarrete)- Internet letter from local research mentor: Dr. Ivonne Jiménez- Curriculum Office registration documents

Questions to: [email protected], 212-703-9977***Research courses (MCBI) should be registered with Dr. Maria J. Crespo***

http://www.afar.org/medstu.html


Summer Research Program in Geriatrics at Johns Hopkins (2007)

Neda Isabel Sedora Román Bernadette Nazario Omar Santana Hernández

Mayo Clinic Summer Research Program

Coordinator: Dr. Clemente Diaz ([email protected])

Duration: 8 Weeks

Funding: Funded by Mayo Clinic [ Aproximatelly $1,731 monthly stipend]

Requirements: CV (Undergraduate GPA, MCAT), Letter of Intention and Recommendation letter (1).

Deadline for Application: All the documents should be send by email to [email protected] and clemente.diaz@upr,edu by January 30, 2011.

***Research courses (MCBI) should be registered with Dr. Maria J. Crespo***




RCM-SOM Students in Mayo ClinicSummer 2010

Silén Rivera, PamelaVelázquez Mañana, Ana I.Viruet Guzmán, Lynette Báez Gutiérrez, Pedro J.Santiago De Jesús, FranciscoRivera Rosado, EmanuelMolini Griggs, Christopher Bravo Hixson, Dalibel

MD Anderson Summer Research Program

Director: Dr. Ilka Ríos ([email protected])Prof. Blanca Amorós (Contact Person)787-758-2525 Ext. 5209 y 5210

([email protected])

5 positions available for Summer 2011!!!!!Duration: 8 Weeks

Funding: Expenses are covered from MHI-MCI Project # NIH-NCI U54 CA 096297 / “UPR MDAPartnership for Cancer Research”




Expenses Covered

Air flight TicketHousingMeals at M.D. Anderson (Boucher)Stipend for the Summer approximately $2,500

Application RequirementsSummit application by December 10, 2010College TranscriptsReport for First Semester Grades 2010-2011

Requested to Dr. Gladys González Navarr2009-2ete, Assistant Dean for Student Affairs

A one page statement specifying your interests, experiences and goals in Cancer Research2 letters of recommendation from Science /Biomedical Sciences Health Sciences and Medical Professors

Mentorship/GuidanceMonthly SeminarsCollaboration Sponsorship

MD Anderson-Summer 2010

Summer Research Program at Utah University

http://www.path.utah.edu/medresearch/abstracts/index.htm

Coordinator: Dr. Maria J. Crespo([email protected])

Duration: 8 WeeksPositions: 3 StudentsFunding: Funded by Utah School of Medicine [Travel expenses plus

$5,100 stipend]Requirements: CV (Undergraduate GPA, MCAT), Letter of Intention and

One Recommendation letter.

Deadline for Application: All the documents should be send by email to [email protected] by January 30, 2011.




Marcia Alayon,Veronica SantiagoAndres MorgadoUtah-Summer 2010

HOWAR HUGHES MEDICAL INSTITUTE(HHMI)

www.hhmi.org/medfellowships/pos.

Duration: 1 year. Annual stipend of $28,000. Allowance of $5,500 for health and dental insurance. Allowance of $5,500 for travel to regional events.

Funding: HHMIDeadline for Application: January 11, 2011.

• Mentors:– Dr. Alfredo Quinones-

Hinojosa– Dr. Hongjun Song

HOWARD HUGHES MEDICAL INSTITUTE (HHMI)

Neda I. Sedora‐Roman MS‐IVUPR‐School of Medicine

(2009‐2010)

PDGF Enhances the Proliferative and Invasive Behavior of Human GBM‐

Derived Brain Tumor Stem Cells through PDGF Receptor‐alpha

Neda I. Sedora‐RomanHoward Hughes Medical Fellow

May 26th, 2010

Brain Tumor Stem Cell LaboratoryDr. Alfredo Quinones‐Hinojosa, P.I.

Department of NeurosurgeryJohns Hopkins School of Medicine

*Elias Sobrino and Faculty from the Pediatric Oncology Section, Hospital Universitario Virgen de la Arrixaca, Murcia Murcia-Spain, Summer 2010

*

Elias Sobrino- Summer 2010Mount Sinai International Exchange Program

MOUNT SINAI MEDICAL SCHOOLhttp://www.mssm.edu/cpm/education/iep_minority/

Summer Research Program at UPR-SOM

http://www.path.utah.edu/medresearch/abstracts/index.htm

Coordinator: Dr. Maria J. Crespo ([email protected])

Duration: 8 Weeks

Positions: Open

Funding: Funded by SOM

Requirements: Good Academic Standing (must not have failed any Medicine I course or have pending repositions)

Deadline for Application: April 15, 2011.



Typical Activities for the Summer Research Program at the UPR-School of Medicine

First year medical students during Journal Club weekly activities at RCM-SOM Summer 2010

Fernando Roca (MS-IV) in Dr. Simon’s laboratory in Salamanca (Spain)

Summer Research in Spain (Summer 2008)

Summer 2005 (Medicine 2008)

Dyalin Soto, Rafael Vicéns, Wilmarie Bruckman

Summer Research Program in Geriatrics at Johns Hopkins

UPR School of Medicine Participants

Plasma Microparticles and Correlation with Platelet Activation and Thrombin

Generation Markers

Akram Mesleh Shayeb, 1 Jayesh Jani, 2 Tai Hong Ph.D., 2 Thomas S. Kickler M.D. 2

1University of Puerto Rico, Medical Science Camus, School of Medicine, San Juan, PR; 2Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.

Akram Mesleh Shayeb (UPR-School of Med) and Pathology Lab Staff at JHMI

Summer 2009

Johns Hopkins University School of Medicine,

Baltimore, MD.

Anaerobic Power and Local Muscular Strength in Pre-Adolescents with HIV and Controls: A Pilot Study.

INTRODUCTIONHIV has become a chronic disease. What was considered in thepast, as a fatal disease has become a chronic entity with multiplerehabilitation issues. Those of us in the rehabilitation field will bemore exposed to this population. This was a condition presentmostly in adults, but in the past 5 to 10 yrs there has been anincrease in the pediatric population. Pharmacologic treatmenthas the most therapeutic options. Physical training has beenused in the adult population. Very few studies have addressedphysical fitness status in the HIV pediatric population. In onestudy (Keyser et al 2000), a low VO2 in adolescents seropositivefor HIV was found when compared with controls. In a latterstudy, the same group, (Cade et al.) also found reduced aerobiccapacity in late adolescents infected with HIV compared withcontrols.

No studies have been done to assess muscle strength andmuscle power in HIV pediatric subjects. Muscle power oranaerobic energy production is important for the growing childbecause most of the activities during this age group use thismetabolic pathway.

Muscle strength is required for movements, and the level ofstrength determines, in part, the ease and effectiveness ofperformance in many day-to-day, recreational and sport activities.

Since HIV infection and treatment complications could impactmultiple body systems and most of these children have sedentarylifestyles, we hypothesized that preadolescents with HIV will havelower anaerobic power and muscle strength compared with anage and gendermatched control group.

Experimental ProtocolAnaerobic power was measured using the Wingate AnaerobicPower Test (Bar-Or, 1983). The test/retest reliability has beenfound to be between 0.95 and 0.97 (Bar-Or & Inbar, 1978). Thetest protocol involved cycle pedaling at maximal velocity for 30seconds on a MONARK cycle ergometer. The MONARK cycleergometer was setup with a computer interface (Power PackUltra TM, SMI, Inc., Minneapolis). The resistance was setaccording to the body weight (Bar-Or, 1987).

Muscle strength was tested using an isokinetic dynamometerwith a Cybex Model 6000. The knee extensors of the dominantknee were tested at 60 and 180 deg/sec. Each subjectperformed three maximal warm-up repetitions at each velocity.The dynamometer’s lever arm was attached to the tibia, and itsaxis of rotation was aligned with the anatomic axis of rotation ofthe joint. The subjects were seated with back support. Theywere restrained with straps at the level of the chest, pelvis, andthigh. The hip joint angle was between 90 and 100 degrees offlexion. The fully extended knee was considered equal to 0degrees of flexion. The subjects were verbally encouraged toexert maximal force.

Statistical analysis was performed using the Wilcoxon Signed-Rank Test. Statistical significance was accepted at an alphalevel <0.05.

RESULTS

General characteristics of the population under study can be seen inTable 1. No significant differences in the general characteristicswere found.

FIGURE 2 & 3: MUSCLE STRENGTH. Thevalues of isokinetic peak torques of the knee extensors60deg/sec are presented in Figure 2 and Figure 3 (corrected forweight). No significant differences between groups were noted.Also, no significant differences were noted intra sexes.

FIGURE 4: ANAEROBIC POWER. HIVsubjects present significant lower mean anaerobic power thanthat of the control subjects.

ABSTRACTObjective: To determine the anaerobic power and local muscularstrength in pre-adolescents with HIV disease.Design: Cross-sectional designSetting: Human performance laboratory at the University DistrictHospital at the Puerto Rico Medical CenterParticipants: Fifteen adolescents (8 females and 7 males) withHIV classification A & B attending an investigational treatmentprogram at the Pediatric University Hospital. Fifteenseronegative controls matched by age and gender.Main Outcome Measures: Power of lower extremities wasmeasured using the Wingate Anaerobic Power Test on aMONARK cycle ergometer (mean power in watts). Local musclestrength of the dominant knee extensors (peak torque/bodyweight X 100) was tested using an isokinetic dynamometer at 60degree/second.Statistical analysis was performed using the Wilcoxon Signed-Rank Test.Results: No significant differences between the control groupand study group were detected on muscle strength testing. Thestudy group presented a lower anaerobic power (mean power)compared with controls (p=0.04).Conclusions: This exploratory study suggests that HIV-infectedpre-adolescents present lower anaerobic power, compared touninfected controls. This finding is compatible with possibleenzymatic impairment in the glycolysis metabolic pathway of HIV-infected patients. The current study design cannot discriminatebetween HIV-infection and treatment for HIV infection as thepotential cause for these findings.However, lower anaerobic power may have a profound effect onactivities of daily living that involve bursts of energy expenditureamong these patients.

DISCUSSION

Our hypothesis was partially proven. We didn’t find differences inmuscle strength, but we found differences in anaerobic power.Possible explanations for the latter finding may be due to possibleenzymatic impairment in the glycolysis metabolic pathway of HIV-infected patients that can interfere with the anaerobic pathway.Other possible explanations include the primary disease of HIV orthe secondary effects of treatment on contractile properties ofskeletal muscle fibers affecting the shortening velocity of themuscle fiber. As a result, the power production at the musclelevel becomes affected.

Lower anaerobic power may have a profound effect on activitiesof daily living that involve bursts of energy expenditure amongthese patients. The role of physical training in this area shouldrequire further investigation.

Finally, the current study design cannot discriminate betweenHIV-infection and treatment for HIV infection as the potentialcause for these findings.

REFERENCES

1. Cade WT, Peralta L & Keyser RE “Aerobic capacity in lateadolescents infected with HIV and control” Pediatric Rehab2002: 5 #3 161-169

2. Keyser RE, Peralta L, Cade WT, Miller S, Anixt J “FunctionalAerobic Impairment in Adolescents Seropositive for HIV: AQuasiexperimental Analysis” Arch Phys Med Rehabil 2000;81: 1479-84

3. Moss RL, Diffee GM, Greaser ML “Contractile Properties ofSkeletal Muscle Fibers in Relation to Myofibrillar ProteinIsoforms” Rev Physiol Biochem Pharmacol Vol 126 1995

ACKNOWLEDGEMENTS

This study was supported in part by:

1. Hispanic Center of Excellence; US Dept of Health & HumanServices HRSA Grant #2 D 34 MB 02054

2. COPENIC

3. MBRS-RISE

4. This project was supported by Research Center in MinorityInstitutions grants G12RR03051 and P20RR11126 (RCRII)from the National Center for Research Resources, NIH.

0.355

Variables Control Group Patients P Value

Age (mean) 10.6 10.6

Gender 8F; 7M 8F; 7M

Body Weight (kg)

41.4 ± 15 37.0 ± 10

Body Height (cms.)

144 ± 13 139.1 ± 10 0.257

Body Mass Index(weight/height²)

20 ± 1.5 19.2 ± 1.9 0.641

Tanner-Breast

1.80 1.15 0.727

Tanner Genitalia

1.93 1.87 0.874

*Values are mean ± SD.

0

50

100

150

200

kg%

All Males Females

ControlsPatients

p = 0.923 p = 0.915 p = 0.823

Suzanne Gutiérrez Teissonniere,¹ José G. Conde Santiago,¹ Walter R. Frontera,² and Edwardo Ramos Cortés.¹ ¹ Department of Physical Medicine and Rehabilitation, School of Medicine, University of Puerto Rico Medical Sciences Campus and ²Department of Physical Medicine and Rehabilitation, Harvard Medical School Spaulding Rehabilitation Hospital.

METHODSSubjectsFifteen pediatric patients (8 females and 7 males) seropositive forHIV-1 confirmed by Western blot classification A and B attendingan investigational treatment protocol program at the PediatricUniversity Hospital (mild presentation) volunteered for the study.The patients were selected based on the attendance to the clinic(last 15 patients at the clinic). Fifteen seronegative age-gendermatched controls were also selected from relatives of the HIV-1seropositive patients within the same social economicalenvironment.

FIGURE 1. Isokinetic Strength of Dominant Knee Extensor(60 /sec) corrected for body weight – control vs. subjects andintragender comparison.

Figure 4. Mean Peak Power in N/s (Watts)

0

100

200

300

HIV serostatus

Positive PatientsNegative Controls

p = 0.041; Wilcoxon Signed-Ranks test n = 15 for each groupgroups matched by age and gender

Watts

0

50

100

150

Figure 2. Peak Torque Extensors of the Knee at 60 Degrees per Second

HIV serostatus



Newton-meters

Figure 3. Peak Torque Extensors of the Knee at 60 Degrees per Second Corrected for Weight

0

100

200

300

HIV serostatus



Newton-meters

Poster of Suzanne Gutierrez Teissoniere

For a Great Summer Research Experience in 2011:

Identify your research area of interestContact the Program Director as soon as possibleDo not delay the application process Maintain communication with SOM Research Coordinator (Dr. Maria J. Crespo) Remember to register for the MCBI courses