VCU researchers participate in a multi-center study to determine the best strategy to improve survival from cardiac arrest

Researchers at Virginia Commonwealth University, along with several other locations throughout the United States, will be performing a research study to determine whiPhoto of a defibrillator on a wallch of two standard strategies of care after a cardiac arrest produces better outcomes.

The study, called the ACCESS Clinical Trial, will include adults who are having a cardiac arrest and have been successfully treated with a defibrillator shock. Cardiac arrest is a medical condition in which the heart stops beating blood to the brain and other organs of the body. It results in death, unless able to be reversed.

Cardiac arrest, commonly known as a heart attack, is often caused by a blockage in one or more of the arteries supplying blood to the heart. Blockages causing heart attacks must be treated urgently with a heart catheterization to prevent significant heart damage. Typically, heart attacks are diagnosed by certain findings on an electrocardiogram, or ECG, performed when the patient arrives in an Emergency Department. After a cardiac arrest, however, heart attacks cannot be reliably identified by the ECG and therefore can go undetected and untreated. Most patients whose heart has been restarted after a cardiac arrest are unconscious and in a coma, so they are unable to provide medical information. Most patients who come out of the coma after several days will then undergo the heart catheterization to look for blockages, but by this time the damage may have already been done to the heart muscle.

The purpose of the ACCESS Clinical Trial is to determine if more of the patients do better if they are taken to receive heart catheterization at the time of admission. Both strategies, early and late heart catheterization, are currently used clinically and both are considered the standard of care, therefore all patients will receive the standard of care treatment.

Since patients are often in a coma after cardiac arrest due to brain injury from when the heart had stopped, they may not be able to give consent. Attempts will be made to contact the patients’ legally authorized representative to obtain consent for the research study. Since the early heart catheterization must be performed within 90 minutes from the time of admission to result in the most benefit, if the legally authorized representative cannot be contacted to provide consent that would allow the procedure to be done within this time frame, the patient will be enrolled into the study under the Department of Health and Human Services regulations allowing an exception to informed consent under emergency research circumstances. 

Interested persons wishing more information, having questions or concerns, or who do not wish to participate in the trial should they experience a cardiac arrest and would like to request an opt-out bracelet, are encouraged to visit https:/z.umn.edu/accesstrial, email access@vcuhealth.org, or call (804) 828 – 6047.

Clinician-scientist finds a balance between career and family

By Anne Dreyfuss
VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research

As a clinician-scientist, Sinem Esra Sahingur, D.D.S., Ph.D., teaches at the Virginia Commonwealth University School of Dentistry, conducts research in the laboratory she manages in the school’s Department of Periodontics and the Philips Institute for Oral Health Research, and sees patients at VCU dental clinics.

“Balancing is so important,” the 47-year-old dentist said.

Sahingur has balanced a career in academia with raising two sons and accommodating her husband’s professional advancements along with her own. She was 40 weeks pregnant when she defended her doctoral dissertation at the State University of New York at Buffalo. Six days later, she delivered her second child. For more than three years prior, Sahingur worked on her thesis and completed a clinical residency program in periodontics in New York while raising her older son as her husband, Emre, worked in Richmond. After graduating, she interviewed for a faculty position at VCU, but with an infant and young child, she and Emre decided it would be better for the family if she took time off from work.

Sinem Esra Sahingur, D.D.S., Ph.D.

“We don’t have any family here, so I needed to stay at home,” she said.

In 2007, before her younger son’s third birthday, VCU contacted Sahingur asking if she was ready to join the dental school faculty. “I said yes,” she said. “They were very understanding. They asked, ‘Do you want to start part time?’ And I said, ‘No, I think we are good now.’”

Sahingur was hired to contribute to the school’s research enterprise, with additional responsibilities as a faculty member and clinician also competing for her time. Like many women who take time off from work to care for their family, she felt pressured to excel when she returned to the workforce.

Now a full-time, tenured professor with more than $5 million in funding to her name, Sahingur’s academic and professional achievements distinguish her as an exceptional faculty member. With the help of institutional, federal and philanthropic funding, she has obtained National Institutes of Health awards, contributed to academic journal publications and presented at conferences around the world.

She hopes to inspire other women to pursue their career goals in the same way. “If you need some time off to take care of your family, do it,” she said. “You can always start where you left off. It may not be as easy as if you had started earlier, but if you are determined and focused, you can catch up.”

Predestined for academia

A native of Istanbul, Sahingur’s earliest childhood memories are of her father, a physician-scientist at Istanbul University, coming home with stories about his students, patients and fellow researchers.

“I grew up surrounded by academicians,” she said. “It was part of my life.”

Sahingur’s father died when she was 11, leaving her with a desire to continue his legacy. “I always knew I would pursue a career in research and medicine,” she said.

At VCU, she has focused on clarifying the links between gum disease and systemic health issues. She is especially interested in preventing and curing periodontitis, a disease that results from interactions between pathogens in the gums and the body’s immune response.

Periodontal diseases are chronic inflammatory conditions that affect the structures around the teeth. They generally are categorized as either gingivitis or periodontitis. Gingivitis, the mildest form, presents as inflammation of the gums without bone or tissue loss. It can be prevented by adequate home care and regular dental exams. Periodontitis is the progression of the inflammation into the deeper tooth-supporting tissue. If left untreated, it results in destruction of bone and soft tissue, eventually leading to tooth loss.

“I look at how inflammation progresses through the body and try to identify therapeutic targets to reduce the inflammation,” Sahingur said. Specifically, her research team is attempting to characterize the key regulators of inflammation with the ultimate goal of discovering better therapeutics to treat periodontitis.

Nearly half of all adults in the United States suffer from periodontal disease and almost 10 percent of that group exhibits severe forms of the disease. Chronic oral inflammation can raise the risk for several life-threatening conditions such as cardiovascular diseases, diabetes, pregnancy complications, arthritis and cancer. Sahingur aims to discover a treatment that could improve the lives of millions.

“As a clinician, I get to experience the benefits of research firsthand, and I would like for my work to have a broad impact on improving overall health,” Sahingur said. “As a clinician-scientist, I am able to focus my research toward projects that will translate to better clinical care.”

Hard work and a little help

In 2013, Sahingur was an inaugural awardee of the VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research’s endowment fund. The Wright Center and the VCU Office of the Vice President for Health Sciences created the fund to support meritorious pilot and feasibility research.

That same year, Sahingur was awarded a KL2 scholarship through the Wright Center. Two years later, she was awarded a $1.9 million NIH grant for five years to continue her research, making her the first VCU KL2 scholarship recipient to receive a Research Project Grant.

Sinem Esra Sahingur flanked by VCU School of Dentistry postgraduate students.
Sinem Esra Sahingur, middle, flanked by VCU School of Dentistry postgraduate students. (Photo courtesy of Sinem Esra Sahingur)

“The KL2 scholarship and endowment fund were tremendously helpful because they gave me the time and money I needed to be involved more with research,” she said. “In addition, being part of the Wright Center enabled me to build lasting relationships with colleagues from different disciplines.”

Paying it forward

Sahingur intends for her research in oral health to improve the lives of patients beyond the dental clinic.

“Research shows that poor oral health does not only lead to tooth loss, but also has a negative impact on different parts of the body and ultimately quality of life,” she said. “As we move to a new era of precision medicine which aims to personalize treatments, it will be important to integrate oral health as part of overall health to generate more effective preventive and treatment options and better serve our patients.”

While developing her research program, Sahingur pursued interdisciplinary collaborations with colleagues whose research related to the systemic health effects of oral health. The collaborations led to peer-reviewed publications that reported on topics ranging from the effects of newly emerged smoking products to the effects of periodontitis on conditions such as cirrhosis, oral cancer and preterm birth.

“Future research success and translation to the clinics will only be possible through interdisciplinary projects,” Sahingur said. “My goal is to build on the studies we have already started and look for more opportunities to bridge the gap between dental and medical professions.”

Sahingur is on track to achieve her goal. In June, she received a second NIH grant of nearly $2 million to further her research.

“Dr. Sahingur is a vital member of the School of Dentistry’s research enterprise,” said the school’s dean, David C. Sarrett, D.M.D. “During her time at VCU, she has developed a national and international reputation as a dental researcher and clinician-scientist. We are proud to have her as a member of our faculty.”

Sarrett recognized Sahingur’s achievements in September with the Dean’s Faculty Excellence Award for Research. The award came on the heels of a string of laurels last year, including the VCU Office of Research and Innovation’s Outstanding Faculty Mentor Award in April and the university’s Women in Science, Medicine and Dentistry Professional Achievement Award in May.

Sahingur with David Sarrett, dean of the School of Dentistry.
Sahingur with David Sarrett, dean of the School of Dentistry. (Photo courtesy of University Relations)

While her focus has remained on research, Sahingur has devoted much of her time to supporting the next generation of clinicians and scientists by teaching, directing courses and serving as a mentor for faculty and students. For the past three years, she also has been involved in developing the school’s recently launched Ph.D. program in oral health research.

“Although Dr. Sahingur has an abundance of responsibilities as a researcher, professor and periodontist, she never forgets about her mentees,” said Nitika Gupta, a senior biology student who worked in Sahingur’s lab and nominated her for the Outstanding Faculty Mentor Award last year.

Gupta plans to attend the University of Pennsylvania School Of Dental Medicine in the fall to pursue a doctorate in dental medicine.

“Dr. Sahingur invested her time in enhancing my education,” Gupta said. “My passion for molecular and cellular biology and biochemistry grew exponentially while working in her lab. I hope to inspire others the way she inspired me.”

A delicate balance

Not long after Sahingur started at VCU, Emre was offered a job in Washington and the family was again separated. For nearly a decade, she lived in Richmond with her two sons while Emre lived in Washington. “He was there during the weekdays and I was here taking care of the children while I worked,” she said. Two years ago, her older son started college and Sahingurmoved with her younger son, who is now 14, to Washington. She commutes two hours each way to work in Richmond.

“As women, we make sacrifices to balance our commitments to our families with our professional aspirations,” she said.

So far, the sacrifices have paid off, Sahingur said.

“I am dedicated to my family and my work,” she said. “Life is full of surprises and often steers us in unexpected directions. The most important thing is not to give up on our ambitions and direct our positive energy to continue chasing the things that fulfill us.”

Three reasons to register for an ORCID identifier

By Anne Dreyfuss
VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research

The New Year inspires many of us to make positive changes in our lives. We may resolve to eat healthier, get more sleep, or save money. While those resolutions have the potential to improve our personal lives and overall health, less thought is often given to resolutions that could improve our professional lives.

As a researcher, you have likely heard about ORCID (Open Researcher and Contributor ID). The unique, persistent identifier distinguishes scientific and other academic authors from one another. Perhaps you have been asked to provide an ORCID ID in a grant application or in an academic journal article that you were submitting for review, but haven’t seen the value in taking the time to register.

If you are a researcher, registering for an ORCID ID could be the most impactful resolution you make this year. There are many reasons why more than 5.6 million ORCID IDs have been issued since the organization first launched its registry service in 2012. Some researchers register to make themselves more searchable, while others do so to make their research more accessible to the public. While the motivation for registering may vary and can be as unique as the 16-digit identifiers themselves, the bottom line remains the same – registering for an ORCID ID can help you advance your science and improve your career.

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Young researchers will further work in prenatal care, cancer immunotherapy and microRNA through career development program

From left to right: Mario Acunzo, M.D., Elizabeth Wolf, M.D., Guizhi (Julian) Zhu, Ph.D.

By Anne Dreyfuss
VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research

Virginia Commonwealth University this month welcomed three clinician researchers to a mentored career development program designed to prepare them for the health care challenges of the future.

Elizabeth Wolf, M.D., and Mario Acunzo, M.D., both from the VCU School of Medicine, and Guizhi (Julian) Zhu, Ph.D., from the VCU School of Pharmacy, have been named Clinical Research KL2 Scholars. The KL2 program provides early-career researchers with dedicated time to help their findings benefit human health more quickly, while becoming successful, independent translational scientists.

“There is a national need to increase the clinical and translational research workforce and prepare the future generation of research leaders to address imminent health care challenges,” said VCU President Michael Rao, Ph.D. “Through opportunities like the KL2 research program, VCU is leveraging its interdisciplinary strengths in clinical research and community engagement to make meaningful improvements in patient care.”

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Can liver disease be linked to heart failure? VCU study highlights liver-heart interaction

By Anne Dreyfuss
VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research

Virginia Commonwealth University researchers have collaborated on a clinical trial that identifies indicators for nonalcoholic fatty liver disease — a typically asymptomatic disease caused by fat buildup in the liver and the leading cause of liver disease in the United States.

Mohammad Siddiqui, M.D., an associate professor in the VCU School of Medicine, and researchers with expertise in cardiology, hepatology, and exercise physiology have been conducting research with a focus on the link between heart and liver damage. Their efforts have resulted in a study in which they draw a connection between patients with aggressive types of fatty liver disease and limitations in exercise capacity.

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Wright Center translational science classes inspire VCU cancer researcher

Headshot of Dr. Lathika Mohanraj
Lathika Mohanraj, Ph.D.

By Blake Belden
VCU Massey Cancer Center

Lathika Mohanraj, Ph.D., identifies genetic biomarkers that could aid in the early detection of patients at risk for complications from bone marrow transplantation, hematologic cancers and other malignancies.

Her mother, a breast cancer survivor, was diagnosed with the disease while Mohanraj was an undergrad student in India. Living through that experience solidified her passion to pursue a career in cancer research and treatment.

“Watching my mom go through it and going to the hospital and seeing the other cancer patients there — it was a lot for me to experience at an impressionable age,” Mohanraj said. “That triggered my interest, and from then on I knew that’s what I was going to do.” Read More

Interdisciplinary VCU research team provides clinical and diagnostic guidance for broken-heart syndrome

By Anne Dreyfuss
VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research

 

Infographic describing broken heart syndrome
Broken heart syndrome usually results from severe emotional or physical stress such as the death of a loved one. (Image courtesy of the Journal of the American College of Cardiology)

A team of cardiology and psychiatry specialists from Virginia Commonwealth University has authored a new comprehensive clinical review article in the Journal of the American College of Cardiology that summarizes the latest evidence-based diagnostic criteria and treatment strategies for Takotsubo cardiomyopathy, also known as broken-heart syndrome.

“Takotsubo cardiomyopathy is a recently recognized condition that is difficult to diagnose and treat,” said corresponding author Antonio Abbate, M.D., Ph.D. Abbate is a cardiology professor at VCU School of Medicine. He serves as associate director of the C. Kenneth and Dianne Wright Center for Clinical and Translational Research and as medical director of the Clinical Research Services unit. Read More