The faculty members of the Department of Medicine have contributed many important research advances during the past year. In addition to original research, many of the faculty members participate in consensus conf erences, prepare clinical guidelines, participate in the peer-review process for grants and manuscripts, and write authoritative chapters and reviews. Because it is not possible to highlight all research activity in this space, you are invited to visit the individual division pages to see where Northwestern clearly excels and where our momentum is likely to accelerate in the near future. Publications in the department range from high-impact general interest journals such as the New England Journal of Medicine, The Lancet, the Journal of Clinical Investigation, the Journal of the American Medical Association, Nature Genetics, Nature, and Science, to high quality specialty journals in each of our many disciplines. Department of Medicine faculty publishes over 400 peer-reviewed articles each year. Research in our department can be predicted to grow in several complementary directions. With active recruitment and retention of visionary faculty members who are leaders in their chosen fields and the opening of the Robert H. Lurie Medical Research Center in 2005, we have significantly increased laboratory-based research. There is an increased critical mass of investigators interested in preventive medicine, clinical trials, and health services research. In each of these areas, considerable training and specialization are required for the greatest chance of success. Our faculty members are therefore becoming increasingly differentiated in the types of research they perform and are establishing premiere multidisciplinary research collaborations and consortia. While such differentiation is important for success in the current era, it creates special challenges for communicating across disciplines. To maximize our ability to take advantage of institutional resources and the experts that we have on site, we are working hard to keep up with the many advances occurring within our institution. Research funding has also grown tremendously in the last several years. In 1998, the Northwestern University Department of Medicine was ranked 48th among all departments of medicine in schools throughout the United States, with $9.4 million in NIH funding. By 2003, we had increased NIH funding to $38.2 million, and had risen to 31st in NIH rank. We anticipate research funding to continue to increase in the coming years. Ultimately, the Department of Medicine's research program should set the standard for excellence and value in coming decades. The Allergy and Immunology Division has a long history of excellence in the three major areas of pursuit in academic medicine: patient care, teaching and research. Areas of clinical expertise include asthma, allergic bronchopulmonary aspergillosis, hypersensitivity pneumonitis, idiopathic anaphylaxis, drug allergy, occupational immunologic lung disease, and allergen immunotherapy. As our appreciation of the impact of the immune system on disease continues to expand, the field of allergy-immunology will expand in relevance to the practice of medicine and the understanding of disease. We continue efforts to recruit new faculty members to further expand a research program that emphasizes excellence in research in allergy-immunology. New areas of interest include, but are not limited to, Toll-like receptor expression and signaling, expression and function of innate immune effectors, microbial defense, mechanisms of lymphocyte co-stimulation and antigen presentation, dendritic cell biology, mast cell biology, mouse models of asthma and mechanisms of inflammation. The faculty members are striving to apply new information in these research areas toward better understanding and treatment of diseases of interest including asthma, chronic rhinosinusitis, allergic bronchopulmonary aspergillosis and occupational immunologic lung disease. The research vision of the Division of Cardiology is to be a national leader in three major areas in cardiovascular medicine during the next decade. These areas are cardiovascular magnetic resonance imaging, stem cell biology for cardiac and vascular regeneration (including translational research), and basic and clinical investigation in ventricular arrhythmias and sudden death. These research agendas provide opportunities for interdisciplinary collaboration and leverage our current strengths in cardiac electrophysiology and cardiovascular imaging. “The thing that drives us is a burning curiosity to figure out why and how things work the way they do.” The vision of the Division of Endocrinology, Metabolism, and Molecular Medicine is to expand our clinical and research programs to address the twin epi demics of diabetes and obesity and to investigate the interface of these disorders with reproductive health and disease. The research initiatives will investigate novel areas, such as the impact of the intrauterine environment on adult health and the neural control of metabolism, and will identify new molecular targets through genetic analyses in animal models and in human populations. This vision will be accomplished through the development of interdisciplinary research programs and clinical centers. Within the Division of Gastroenterology, active areas of research are both basic and clinical. On the basic side, Dr. Terrence Barrett pursues studies of intestinal immunology with a slant toward inflammatory bowel disease. On the clinical side, Drs. Kahrilas, Pandolfino, Jones, and Hirano pursue studies of intestinal physiology with a slant toward motor disorders and reflux disease. Additionally, Dr. Ferreira is heavily involved in outcomes research mentored by Dr. Charles Bennett. The vision for the future is to build upon these programs as opportunities arise. On the basic science side this would involve the additional recruitment of an individual with complementary interests to those of Dr. Barrett. On the clinical side, we plan to continue developing a center of excellence for managing GI motor and functional disorders and add investigators. The research purpose of the Division of General Internal Medicine is to conduct research to improve the quality of care for all Americans. Four research concentration areas are the focus: 1) health communication, 2) improving quality of care and safety, 3) clinical epidemiology, and 4) reducing disparities for vulnerable populations. Several division faculty members head distinct research programs. For isntance, Dr. Kevin Weiss directs the Institute for Healthcare Studies, which houses a nationally recognized asthma care research program and includes a computerized telephone interview team. Dr. Weiss is also the director of the Veteran's Affairs HSR&D Midwest Center for Health Services Policy and Research, based at the Hines and Lakeside VA Hospitals. Dr. Linda Emanuel is the Director of the Buehler Center on Aging, Health & Society, which includes a growing group of geriatrics health services researchers in addition to her pioneering Robert Wood Johnson Foundation (RWJ) funded Educating Physicians in End of Life Care (EPEC) team. Greg Makoul, PhD.directs the Program in Communication and Medicine. This program has a national and international reputation for its work in studying doctor-patient communication and how we can teach communication skills to students and residents. As a division in a clinical department of the Feinberg School, a research-intensive medical school, with an affiliation to the Robert H. Lurie Comprehensive Cancer Center of NU, our mission is translational research in cancer and blood diseases. This means to define and measure an important pre-clinical target, apply that target to a patient population, then measure that target or surrogate as endpoints in an intervention designed to treat disease, understand etiology, or impact on prevention. “I regularly see patients dying from advanced cancer. This is a horrible thing to witness. We do not understand the disease, and our therapy is largely ineffective. I do research because I want to change that.” The Division of Hepatology strives for excellence in the area of basic and clinical research on the pathogenesis and treatment of liver diseases. Research initiatives focus on non-alcoholic steatohepatitis (NASH), cholestatic liver disease, viral hepatitis, and liver failure and transplantation. Active basic research investigations include murine models of NASH, regulation of liver-specific transport proteins, cerebral edema induced by hepatic failure and hepatic encephalopathy. Active clinical protocols are examining treatment regimens for viral hepatitis B and C (including patients co-infected with HIV), NASH, MARS (albumin-dialysis) for hepatic failure, and treatment protocols as members of the National Acute Liver Failure Group. The Division of Hepatology will accomplish these goals through the development of multidisciplinary research programs, both within the Department of Medicine and with other Basic Science and Clinical Departments at Northwestern University. The mission of the Division of Infectious Diseases at the Feinberg School of Medicine is to provide consultations for clinical care, undertake cutting-edge clinical and laboratory research, and offer opportunities for research training in infectious diseases. The Division has 9 full-time faculty members, seven of whom receive external funding for clinical and/or basic scientific research. Fellowship training is certified by the ACGME. The Division offers a range of outpatient and inpatient services for the care of patients with infectious disease problems. Consultations are provided for the diagnosis and treatment of patients with general infectious disease problems, HIV infection, organ transplantation and other immunodeficiencies, sexually transmitted diseases, and tropical diseases. Services provided by The Travel Medicine and Immunization Clinic include pre- and post-travel consultation and CDC/WHO recommended immunizations. Research in the Division of Infectious Diseases focuses on the pathogenesis and treatment of viral and bacterial infections. These studies include: the molecular evolution of HIV; the state of viral gene expression in persistent reservoirs of HIV infection; the role of the immune system in controlling infection with HIV; the dynamics of HCV infection; the natural history of HIV disease; clinical trials of candidate drugs against HIV and HCV; international collaborative studies in Kenya and Nigeria on HIV; healthcare-associated infections and clinical outcomes; and bacterial and viral infections related to transplantation. Research funding is provided by the National Institutes of Health, the Centers for Disease Control and Prevention, the Department of Defense, and various foundations and industry. “In theoretical research, the moment of clarity and resolution is breathtakingly exciting.” Our mission is to provide excellent nephrological and dialysis related patient care and outstanding teaching to our fellows, house staff and medical students while aiming at becoming a top-ten research division as well. In the context of a very busy clinical program, the division will be able to engage and compete for research funding by having a group of research-focused faculty with at least 75% protected time for research. In conjunction with this research and clinical effort our faculty is involved in scholarly activities and publications, all of which are necessary to enhance the visibility of the division and for their professional development. Our division is expanding rapidly with the recruitment of more faculty including additional transplant nephrologists to accommodate the growing transplant activity at Northwestern Memorial Hospital. Areas of research focus include diabetic nephropathy, nocturnal hypertension, electrolytes and acid-base disorders, and the molecular mechanisms of proteinuria. The Division of Pulmonary and Critical Care Medicine has three research goals: 1) to be a leading center in lung injury research that focuses on basic and clinical studies involving mechanisms underlying pulmonary edema clearance, lung injury due to hypoxia / hyperoxia, cell death / apoptosis, mechanical stretch, the fibroproliferative phase of ARDS, and exposure to particulates (airborne particulate matter and asbestos); 2) have strong research programs in asthma, pneumonia/sepsis, sleep disordered breathing and clinical research related to critically ill patients in the ICU; and 3) utilize our recently awarded NIH Pulmonary Training Grant to instruct students and fellows in various aspects of basic and clinical research. The goal of the Division of Rheumatology is to be a well-rounded, diversified and dynamic leader in Rheumatology research, patient care, and education. Our local, national, and international leadership role promotes investigator initiated clinical and basic research that advances our knowledge and understanding of the pathogenesis of the disease, translates novel ideas into innovative therapies, and fosters professional and patient education opportunities.
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