Understanding and treating the root cause of heart attacks (myocardial infarctions) could change how we care for patients with heart disease. Myocardial infarctions occur when lesions (plaques) in blood vessels rupture, which attracts factors that clog the arteries. While the specific reasons that cause the lesions to form and break apart was thought to be understood, new research shows that the culprits may start on the OUTSIDE of the blood vessel rather than inside as previously thought. Dr. Andra Blomkalns of the Emergency Department and her colleagues propose that fat tissue on the OUTSIDE of blood vessel (called perivascular adipose tissue) may be linked to the rupturing process, opening up a whole new direction for research into understanding heart attacks

Congratulations to Dr. Stewart Wright on being awarded a $300,000 grant from the Agency for Healthcare Research and Quality (AHRQ), the federal agency charged with improving quality, safety, efficiency and effectiveness of healthcare. This award recognizes Stewart's role as a national leader in evidence based medicine. As the co-PI, he and his colleagues at the New York Academy of Medicine will be instrumental in building the practice of EBM, based on the Cincinnati model: CPQE - Know it, Use it, Love it. The grant will fund a series of conferences and educational activities on knowledge translation over the coming three years.

Emergency Medicine’s Dr. Sarah Ronan-Bentle is the Emergency Medicine investigator for PROMMTT (the Prospective Observational Multi-center Mass Transfusion Study), which began at University Hospital in August. This study is running at nine other leading trauma centers nationwide and aims to improve survival rates for major trauma patients who require blood transfusions. This collaboration between Emergency Medicine and the Division of Trauma is led by Dr. Peter Muskat, who is the Principal Investigator for the University of Cincinnati on this Department of Defense funded study. For more information, go to the PROMMTT website.

Welcome this year’s CSA Fellows Naushad Khakoo, Rupen Baxi and Cameron Collier to the Department. Cameron and Naushad come to us having just completed the MS in Physiology at the University of Cincinnati. Rupen earned an MD from Medical University of America and worked as a surgical resident at The Jewish Hospital. During the 10 month fellowship, all three fellows will be immersed in the clinical environment, screening patients for research studies and attending weekly grand rounds. They will participate in a research education program, and will each design and complete, along with a mentor, a formal research project. This unique fellowship is geared toward students interested in health care or clinical research and helps prepare them for doctoral studies.

Congratulations to Dr. Collins and his team on their publication outlining why it is important to establish a network to support clinical trials in acute heart failure. Importantly, the paper clearly discusses the need for early enrollment in acute heart failure studies, and how this can be achieved by a strong collaboration between Emergency Medicine and Cardiology. Great work Sean! Collins SP, Levy PD, Lindsell CJ, Pang PS, Storrow AB, et al. The Rationale for an Acute Heart Failure Syndromes Clinical Trials Network. J Cardiac Fail 2009;15(6):467-474.

First-year resident Dr. Jeremy Boyd’s first author paper entitled “Emergency Medicine Career Choice: A Profile of Factors and Influences from the Association of American Medical Colleges (AAMC) Graduation Questionnaires.” was just published in Academic Emergency Medicine in June 2009. The study was conducted while Dr. Boyd was a medical student at Brown University. Congratulations, Dr. Boyd. Acad Emerg Med • June 2009, Vol. 16, No. 6 544-549.

Dr. Shaw has successfully enrolled the first patient in the cellulitis imaging protocol, a study designed to investigate novel methods of quantifying infection. Good work, Dr. Shaw.

Congratulations to Dr. Brent Gottesman, whose manuscript entitled “Radiation Exposure in Emergency Physicians Working in an Urban Emergency Department: A Prospective Cohort Study” will be published in an upcoming issue of The American Journal of Emergency Medicine. This very thorough study tracked radiation exposure in physicians working in an urban, academic, emergency department, to discover whether or not the levels of radiation exposure were at or below the guidelines recommended for safety. Dr. Gottesman, a recent graduate of the Emergency Medicine Residency, received funding through the Emergency Medicine Resident Research Grant. Amy Gutman, M.D., Christopher Lindsell, PhD, and Hollynn Larrabee, M.D., co-authored the manuscript.

Breaking news: the NETT team has enrolled their first patient in the RAMPART study. This randomized controlled trial is comparing IM midazolam to IV lorazepam in the pre-hospital treatment of status epilepticus. The participant stopped seizing after being treated in the field, and was transported to hospital. This is a major accomplishment, and is the culmination of a huge amount of work from a host of people. It has taken well over a year of planning, community consultation, and working with EMS and hospitals across the whole region. Congratulations to everyone involved!