Download THE SECRETS INSIDE US How Advances in Genetics Testing are

FALL 2014
A PUBLICATION OF MAGEE-WOMENS RESEARCH INSTITUTE & FOUNDATION
9 MONTHS
TO 90 YEARS
THIS GROUND-BREAKING STUDY
IS DR. YOEL SADOVSKY’S
PASSION AND IT COULD CHANGE
HEALTH CARE FOR EVERYONE.
PREGNANZZZZZ’S
Can Better Sleep Make for a
Healthier Mom and Baby
THE SECRETS INSIDE US
How Advances in Genetics Testing
are Personalizing Medicine and
Saving Lives
A WOMB WITH A VIEW
How NICView Cameras Help
Parents Keep Their Eyes on Magee’s
Littlest Patients
www.mwrif.org
MAGEE :: PAGE 1
VOLUME 9 | FALL 2014
MAGEE is published two times a year for supporters of
Magee-Womens Research Institute & Foundation.
If you have comments regarding the publication or would
like additional copies, please email [email protected].
EDITOR
Christine Caruso
4
10
4
18
24
9 MONTHS TO 90 YEARS
This Ground-Breaking Study Could Change Health Care for Everyone
CONTRIBUTING EDITORS
W. Allen Hogge, MD, professor and chairman,
Department of Obstetrics, Gynecology &
Reproductive Sciences, University of Pittsburgh
Yoel Sadovsky, MD, director, Magee-Womens Research Institute
10
THE SECRETS INSIDE US
How Advances in Genetics Testing Are Personalizing Medicine and Saving Lives
ADVISORY COUNCIL
David Kaplan, chairman
Board of Directors, Magee-Womens Research Institute
Arthur M. Scully III, vice president, Development
and Communications, Magee-Womens Research Institute
18
PREGNANZZZZZ’S
Can Better Sleep Make for a Healthier Mom and Baby
DESIGN & PRODUCTION
Garrison Hughes
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9
Internship Program Sparks Interest with Future Women’s Health Researchers
15
Charting the Course: How Magee’s Navigator Program Helps Patients on the Path through Treatment
16
A Womb With a View– How NICView Cameras Help Parents Keep Their Eyes on Magee’s Littlest Patients
22
Endometrial Cancer Prevention and Obesity: Magee Epidemiologist Looks for Cancer Clues in Healthy People
24
Cancer Care Bags Offer Comfort to Patients
27
Lacing Up for Cancer Research
28
Thirty-five Years of Gratitude for Exceptional NICU Care
30
Mile After Mile, Joe Scarpaci Rides to Help Breast Cancer Patients
32
Noteworthy
34
Happenings
35
Morsels
35
Clinical Trials
9 MONTHS
TO 90 YEARS
THIS GROUND-BREAKING STUDY
IS DR. YOEL SADOVSKY’S PASSION
AND IT COULD CHANGE HEALTH
CARE FOR EVERYONE.
We spend nine months in pregnancy. How does that time impact
our lifelong health — the next 90 or so years of our lives? That’s the
question Yoel Sadovsky, MD, director, Magee-Womens Research
Institute, and his colleagues want to answer. And that’s how the
project 9-90 was born.
“We’re trying to understand the impact of development and
exposures to the environment, nutrition, education, infection, and
other influences that occur during pregnancy. How do they impact
lifelong health and wellness?”
Although the question is not unique, Dr. Sadovsky is leading a
most robust investigation, right here at Magee.
“We have a large group of investigators who are focusing on the very
beginning of life, even prior to formation of the fetus. We center on
the germ cells in the ovaries and testes and how they form the
embryo. We assess exposures and things that may happen normally
and abnormally throughout pregnancy, and how they can potentially
imprint in the fetus and result in a disease risk.”
With 9-90, Sadovsky has high hopes for helping women, children, and
men by promoting wellness and preventing diseases such as Type 2
diabetes, obesity, and heart disease.
PICTURING A HEALTHIER FUTURE
Over the last 20 years, research has linked the origin of some
diseases and conditions to developmental stages. “This work was
initiated by a British epidemiologist named David Barker,” says
Dr. Sadovsky. “He was really one of the first ones to make this
association between exposures in the uterus in pregnancy and
adult diseases.”
under-grown, perhaps weighing only 5 pounds because of nutritional
deficiencies or because the mother has high blood pressure and has
not been delivering enough blood to the uterus, that may predispose
the baby to this set of diseases in adulthood. That’s an association
that David Barker has made.”
Dr. Sadovsky is using 9-90 to build on this research, taking a robust
approach to a problem that could affect humankind.
“We take pride not only in advancing knowledge, but also in how
successfully and pragmatically we take our discoveries from the
bench to the bedside. When we are looking through our microscopes,
we keep in mind the middle-aged woman with high cholesterol, or the
fetus who has inherited a trait that puts him at risk for a disease later
in life,” Sadovsky said. “We are dedicated to finding ways to predicting
these conditions earlier in life — when fetuses are in the womb — to
result in healthier lives, throughout their lives.
See the Secrets Inside Us article on page 10 for more examples of
how our research impacts patients directly.
THE STUMBLING BLOCKS
Of course, research of this scope doesn’t come without challenges.
First, there’s the difficulty of monitoring a pregnancy in real-time,
from the beginning through birth. Then, as Dr. Sadovsky points out,
“We don’t have direct access to the fetus. So everything that we study
on the fetus is through the mother or through maternal exposures
to the environment and so forth.” He explains that, typically, when
you’re trying to define the health of an individual, you perform studies
on that person directly, such as blood tests and other analyses, in an
attempt to understand their biology.
“With the fetus,” he adds, “we need to do everything in a manner that
“We’re trying to decrease the incidence and severity of Type 2 Diabetes, either goes through the mom or uses innovative ways to try to
obesity, high blood pressure, heart disease, and the consequences of interrogate the impact of those exposures and the health of the
these conditions, like kidney failure, and stroke,” says Dr. Sadovsky.
(continued)
He believes that by better understanding intra-uterine exposures and
intra-uterine development milestones, we can potentially mitigate
those diseases — and not just in adults. “Here’s an example of a fetal
condition that can be associated with these conditions. If a baby is
MAGEE :: PAGE 4
MAGEE :: PAGE 5
“One of the reasons why we’re
able to pursue this kind of research
mother. Don’t forget that the mother is also the environment for the
fetus. So through interrogation of the mother and the environment, we’re
trying to obtain fetal material, fetal tissue, imaging of the fetus and the
like, and trying to understand the process of imprinting in the fetus.”
Another big challenge? “We may have to wait 90 years to understand
the outcome of the impact of nine months of pregnancy.” Obviously,
such a long-term study could exceed the lifetime of its researchers.
“Therefore we have to use other systems that may mimic or capture
the outcomes we’re after, or use surrogates for the outcomes we’re
interested in. For example, if we have an indicator for the risk of
heart disease that may develop at the age of 50, but that manifests at
the age of three, we can potentially study a three-year-old child in
research of a disease that wouldn’t be seen until decades later.”
Knowledge in the field of pregnancy is another barrier. According to
Dr. Sadovsky, “Understanding the developmental milestones that
characterize normal pregnancy and how the body responds to
exposures is a major challenge because our knowledge in the field
of women’s health has been lagging over the years, compared to our
knowledge of other areas or systems.”
Dr. Sadovsky and his team are working to bridge that gap by studying
normal development, normal physiology and pharmacology, as well
as other techniques and disciplines that allow them to fully
interrogate the development of the human embryo and fetus until
it reaches maturity and is ready for delivery. A complete understanding
of this normal development is an important step in understanding
abnormalities. “That’s a big challenge, even if we had access to the
fetus,” adds Dr. Sadovsky.
But the fetus isn’t the only place to look for answers. One place that
may offer a wealth of information is the placenta. He explains that the
placenta, or afterbirth, functions for the fetus like the lungs, guts,
liver, kidney, hormone producing system, and the immune system
function as adults. “Many of these processes occur through the
placenta. It really is the conduit of the fetus, and the communication tool
of the fetus to the outside world, which includes the mother. So by
further studying the placenta, we can gain insight into many of the
challenges mentioned. Unfortunately, our understanding of placental
function is very limited. Over the years, this organ has not received
enough priority by investigators, the community, and funding agencies.
We’re trying to change that.”
MAGEE :: PAGE 6
at Magee is because we have
assembled a critical mass of highly
trained investigators and clinicians
who come from diverse points of
view, but can focus their interests
on the placenta from those
different angles. That’s a very
powerful approach.”
– Dr. Yoel Sadovsky
A third component is working with researchers who understand
outcomes. “These are scientists who’ve done long-term
analyses using databases and bio banks — people who can make a
link between exposures in the present time and future outcomes that
are critical for adults’ health.” Dr. Sadovsky is reaching
out to University of Pittsburgh researchers, as well as Carnegie
Mellon University researchers to make sure that the core group is
as robust as possible.
“To be able to pursue this kind of research, it takes a combination of
skills in the biology of genes and pregnancy, skills in the placenta,
skills in the exposures, skills in the outcomes,” says Dr. Sadovsky.
THE FIRST STEPS
Not surprisingly, Dr. Sadovsky’s first year goal was solidifying a team
with the required skills. “We’ve done this already,” says Dr. Sadovsky.
“We have great talent here but we need to bolster our skills with even
more investigators.”
THE KEYS TO SUCCESS
To understand fetal development and impacts on the embryo, job
one is creating a team with great abilities to tackle the fetus and
placenta from many perspectives. Between Magee-Womens
Research Institute and the University of Pittsburgh, Dr. Sadovsky has
attracted world-class investigators who focus on different aspects of
pre-pregnancy, pregnancy, and post-pregnancy health. And Magee’s
reputation as a leader in women’s health and research has made
that part of his job easier.
“One of the reasons why we’re able to pursue this kind of research at
Magee is because we have assembled a critical mass of highly trained
investigators and clinicians who come from diverse points of view, but
can focus their interests on the placenta from those different angles.
That’s a very powerful approach.”
But he knows it takes more. “We’re also interacting and collaborating
with other investigators who may not target the fetus and the embryo,
but have a great understanding of how the environment can affect the
biology of an individual. Our collaborators have knowledge in drug
exposure, nutrition, infections, and other potential environmental
influences that can affect the developing pregnancy.”
“The effort will hopefully carry such a momentum that makes MWRI
a magnet for others to join us either here or through collaboration,
developing a real synergy for a very potent investigation. Then we can
really harness the power of biology and epidemiology and study longterm diseases over a number of generations to be able to understand
how these systems work.”
A GREAT PLACE TO GROW
An ambitious endeavor such as 9-90 comes with extraordinary
demands. And Dr. Sadovsky believes MWRI is in the right place to
achieve these goals. In addition to the breadth and quality of the
Research Institute’s researchers, the Institute’s affiliation with
Magee-Womens Hospital of UPMC bolsters its research capabilities.
A third component is Magee-Womens Hospital of UPMC. “This is one
of the largest women’s hospitals in the country,” says Sadovsky. “We
have nearly 11,000 deliveries here. Our access to these histories and
women who may want to participate in our studies is key to our
success. The ability to follow up with these women is important as
well.” Also key is the ability to create databases and bio banks from
tissues such as placentas, blood, and blood materials.
“The academic environment here in Pittsburgh is really second to
none,” states Dr. Sadovsky. “Our success will largely depend on our
ability to interact and collaborate with researchers who will bring
new skills — not just in the field of pregnancy — but in other areas
in biology and medicine, to help us achieve our goals.”
Dr. Sadovsky is happy to point out that another great strength of
performing research here each year is the community. “We have
great supporters in our community. People have been reaching out
to us to understand what we do and asking us how they can help.
They really care about our outcomes. Many of our funders have, and
I hope will continue to, come from our community.”
He adds, “Don’t forget that Pittsburgh is one of those areas that had
years of exposure to many adverse influences that occur in our
environment. There have been generations of people here who have
delivered at Magee years ago, and now their children and grandchildren are coming to deliver at Magee, and they have been exposed
to all kinds of environmental components that used to be prevalent in
Pittsburgh. Luckily, many of these environmental factors are gone now,
but that material might have impacted the progeny of many people
who live here. So having this research conducted in Pittsburgh, where
we have access to multiple generations of families who have received
care at our facilities is a tremendous asset.” (continued)
One percent of women are pregnant at any one
point in our life. But during pregnancy, women
carry 100 percent of our future. And if we can
impact better wellness through pregnancy
and reduce the risk of disease later on, we can
positively impact 100 percent of our future
society. This is not just a women’s health
issue; this is a humankind issue.”
– Dr. Yoel Sadovsky
MAGEE :: PAGE 7
A BIG INVESTMENT WITH BIG REWARDS
Naturally, to perform research of this scope in a robust, impactful
way requires significant investment. Community leaders,
philanthropic support from both individuals and corporate donors,
fundraising, and foundation support are all absolutely critical to
Magee’s mission.
But these are investments that Dr. Sadovsky believes will pay off in
a radically healthier future. “If we are successful, we may be able
to define health and wellness in unprecedented ways. For example,
links between exposures during pregnancy and increased risk of
disease in later life have already been made, but if we can
understand how these associations work, and translate that
research to understand a mechanism or understand how to better
diagnose those diseases or even prevent an exposure, then we may
potentially be able to mitigate adult diseases.”
disease later on, we can positively impact 100 percent of our future
society. This is not just a women’s health issue; this is a humankind issue.”
Such ground-breaking and ambitious goals need a special place
where they can be pursued. From the researchers in the labs and the
doctors at the bedsides, to those providing financial support, Magee
is at a special place point in time where such a renowned research
institution is on the precipice of discovery that will impact all those
who we care about.
To add your support to research that promotes lifelong health for all,
visit www.mwrif.org/donate.
Dr. Sadovsky also wants to make sure everyone knows what is at
stake, and who the research can ultimately help. “Many people tend
to think that pregnancy is a women’s issue. People tend to forget that
men and women are born to women. So if you think about it seriously,
through improvement of health and promotion of wellness during
pregnancy through better mitigation of potential adverse effects, we
can potentially affect every person, women and men. One percent of
women are pregnant at any one point in our life. But during
pregnancy, women carry 100 percent of our future. And if we can
impact better wellness through pregnancy and reduce the risk of
MOTHER
CHOLESTEROL
PETERS
EPIGENOME
GROWTH, LIPIDS
BARAK
YANOWITZ
NUTRITION
CATOV
SIMHAN
LONG TERM
OUTCOME
IMPRINTS, RETROELEMENTS
PHENYLALANINE, BRAIN, EPIGENOME
FOLATE, TELOMERES
ADIPOCYTES
Schematic representation of the 9-90 program’s investigators
and areas of research focus.
MAGEE :: PAGE 8
Unlike many interns, the students in this program are able to take charge of important work. Alyssa
Warth, a recent high school graduate, expected to serve in an assistant capacity. Instead, she was
surprised to find that she was granted a high level of independence in developing a pilot program
to teach mothers and daughters the importance of nutrition, physical activity, oral hygiene, and sleep.
She appreciated the responsibility, which has helped prepare her for college at the University of
California-Los Angeles (UCLA). Likewise, Kaetlyn Conner, a student at Vincentian Academy, was
surprised and delighted that she was able to head her own experiment in the laboratory of Dr. Robert
Edwards, director of Gynecologic Oncology at Magee. Her project focused on T-Cell Infiltration, which
Dr. Edwards called “a very active area of research.” By giving these young people such responsibility, our
investigators
our
investigators
allow
allow
them
them
to contribute
to contribute
tremendously
tremendously
to our
to our
research
research
goals.
goals.
Individual donors make this program possible through their philanthropic support and have provided an
important steppingstone
stepping stonefor
forthe
theyouth
youthwho
whoparticipate
participatein
inthe
theprogram.
program.By
Bygiving
givingthese
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the
chance to take responsibility for impactful projects, they help instill a passion for women’s health in the
next generation of scientists.
TRANSGERNERATIONAL EFFECT (WORMS)
KRISHNAMURTI
You might not know the answers to these questions, but the youth in the Magee-Womens Research
Institute Summer Internship Program do! Once again, high school and college students were
welcomed into the labs to work side-by-side with our researchers, tackling a wide variety of areas
and issues from genetics to diet in pregnancy. They presented their research at the 2014 College
Student Presentation Day on June 20 and the 2014 High School Student Presentation Day on
July 22 at the Research Institute.
It’s not surprising that such an exceptional program draws students back for a second year. Margaret
Gegick, a student at the University of Notre Dame, completed her second internship this summer.
Working in the lab of Dr. Yoel Sadovsky, director of the Research Institute, she is continuing the work she
started last year with the research goal of finding a system to study microRNA in mouse placenta. Like
Puja, Margaret was drawn to the internship program by the prestige of Magee’s robust research program.
Once here, she admired the passion her mentors had for women’s health, which she says, “…
“…affects
affectsall
all
humans and has the opportunity to help a lot of people.” She found their passion contagious, and
welcomed the opportunity to return for a second year and become more deeply involved in this
ground-breaking work.
INFORMATION/COMMUNICATION
LARKIN
DOBROWOLSKI/RAJKOVIC
FETUS
MOLECULAR COMMUNICATION
SADOVSKY
HIMES/BODNAR
PLACENTA
Can you define consanguineous? How about emesis or spermatogenesis? Do you know what a
knockout mouse is? Is that the same thing as an overexpressor mouse? And, what’s important
about cisplatin-resistant cell lines? Do they even exist?
The students also gain significant real world and laboratory experience in the program. While Alyssa
had the opportunity to develop grant-writing skills in support of her pilot program, another student, Puja
Tripuraneni, was introduced to work in a lab environment for the first time and had the opportunity to try
a variety of tasks during her internship. Having researched numerous programs before applying to ours,
she knew how unique such an opportunity is for a high school student. Combining hands-on experience
with the chance to work with an impressive staff of investigators, the Magee-Womens Research Institute
Summer Internship Program was the right fit for this ambitious young woman, who traveled from Fulton
County, Georgia to participate. She looks forward to putting the skills she learned into action in her AP
Biology course next year, and plans to apply for the college internship program in the future.
Magee’s Ground-Breaking 9-90 Project
Magee-Womens
Research Institute
Investigators
Internship Program Sparks Interest with
Future Women’s Health Researchers
PATIENTS &
FAMILIES
You can help support this program – and the next generation of women’s health researchers –
by donating today
Established
in 1995,
at www.mwrif.org.
the high school program has benefited 203 students. The application process
begins in January and typically ends by April of each year. The college program began in 2002, and
154 undergraduate students have participated. It is currently accepting applicants for next summer,
and the application process will run through Feb. 1, 2015. For more information or to apply,
visit www.mwrif.org. To help support this program – and the next generation of women’s health
researchers – make a donation at www.mwrif.org/donate.
THE SECRETS
INSIDE US
How Advances in Genetics Testing Are Personalizing
Medicine and Saving Lives
What if an expectant father could pass along his love of baseball and not a genetic
susceptibility? We all want to pass on the best of ourselves to our children. But
genetics goes far beyond determining eye color and the shape of a nose. Our genes
may carry diseases or abnormalities that can affect our lives and the lives of our
children. And thankfully, researchers at Magee-Womens Research Institute are
uncovering better ways to find those genes, provide appropriate counseling and
intervene to improve outcomes.
Dr. Aleksandar Rajkovic
“With the advent of whole genome sequencing, our ability to diagnose a lot of
intrauterine disorders will increase tremendously,” says Dr. Aleksandar Rajkovic,
director of the Division of Reproductive Genetics at Magee. “With it, we’ll be able to
much better prepare parents in terms of what problems the babies will have at the
time of delivery, and hopefully it will also help with timely neonatal intervention.”
IT’S CALLED PERINATAL PRECISION MEDICINE.
And it’s improving our ability to make very early diagnoses – both in the womb and
right after delivery. “Whole genome sequencing will allow us to quickly diagnose
physically undecipherable medical conditions in many cases and allow us to perform
interventions that will save babies’ lives,” says Dr. Rajkovic. (continued)
MAGEE :: PAGE 10
MAGEE :: PAGE 11
Even before a couple conceives, there are genetic screenings that can determine the risk for passing
on a particular disease. “For example, in Ashkenazi Jewish families, we offer screenings for 19 or more
genes that are known to affect one in five Ashkenazi Jews, and we can see whether they’re at risk for
having a baby that will be affected. So even before they become pregnant, you can basically give them
a risk percentage of passing the gene on. If they are found to be carriers of the same disease, then you
can do prenatal diagnosis to figure out whether the baby is affected of not.”
With perinatal precision medicine and whole genome sequencing, doctors will be able to make much
more accurate diagnoses, which will enable them to offer more tailored counseling and appropriate
treatment for the baby and the couple.
“We actually have genetic tests that help us make diagnoses in utero,” says Dr. Rajkovic. “When we need
to perform an intervention, such as draining fluid out of the lungs or the heart, it is important for us to
know whether the baby has a particular genetic condition. Genetic testing provides this information and
allows us to tailor the fetal intervention for this individual.”
The ability to diagnose conditions in utero will help doctors learn what particular interventions are
effective on babies that have particular genetic variations.
“Right now, we use ultrasound to diagnose certain things, but a lot of times ultrasound just tells us
that there is a certain abnormality with the baby – it doesn’t tell us why. Genetic testing will allow us
to complement the ultrasound by showing the doctor what other systems in the baby are affected.
That will then help us see what the best interventions are for this particular baby. That’s the only way
we can improve prenatal interventions, by really knowing the molecular causes of the fetal diseases,”
says Dr. Rajkovic.
THE GOOD NEWS ABOUT NON-INVASIVE TECHNIQUES.
“We used to do a lot of fetal diagnosis – including screening for spina bifida and Downs Syndrome using invasive technology such as amniocentesis,” says Dr. Rajkovic. “But this has now changed to the
point where we can do a lot of the diagnosis non-invasively, based on drawing blood from the mother.”
To advance non-invasive prenatal diagnosis, Dr. Rajkovic collaborates with Dr. David Peters, a senior
investigator at Magee-Womens Research Institute and an associate professor in the Department of
Obstetrics, Gynecology, and Reproductive Sciences at the University of Pittsburgh. Dr. Peters and his
colleague, Dr Tianjiao Chu, developed a unique screening test for detecting whether babies have a
chromosome abnormality such as Downs Syndrome in early pregnancy by taking a sample of the mother’s
MAGEE :: PAGE 12
Magee offers two unique centers – the
Center for Advanced Fetal Diagnostics,
which offers cutting-edge testing and
result interpretation and the Center for
Advanced Fetal Intervention, which
provides state-of-the-art in utero
procedures, from ultrasound-guided
fetal interventions to open fetal surgery.
“Magee has just opened a new molecular genomic laboratory that
has already begun testing for cystic fibrosis,” says Dr. Rajkovic. “In
blood, extracting DNA from the plasma, and sequencing it. “It’s a
the very near future, this lab plans to start offering whole genome
method that’s very good at detecting anomalies,” says Dr. Peters. “The sequencing that will be available for diagnosing prenatal and
previous screening test was far less accurate. One in 20 of all the
post-natal conditions. We are dedicated to being able to provide
mothers doing the old test would be tracked as having a possible
precision medicine in the perinatal period to our families and their
abnormality in the baby. They would then be referred for consultation future children.”
and offered an invasive procedure like amniocentesis. The new test
that we developed here at Magee is more accurate, so far fewer
At Magee, we are also cultivating people who can carry on this
women are referred for those invasive tests.”
research into the future. “We have a training program in medical
genetics and a medical genetic residency,” says Dr. Rajkovic. “We
And the significance of that is tremendous. “You can lose your baby
also have combined programs where individuals from obstetrics
during an invasive test,” remarks Dr. Peters. “Of course, even if you and maternal fetal medicine or neonatology are trained in genetics.”
don’t lose your baby, you’re counseled that you might, which can
be worrisome to parents and create anxiety. This is why Magee is
In addition, Dr. Rajkovic and his team are working to train
at the forefront in the field of genetics. The work we are doing here
individuals who put this knowledge into daily practice. “It’s not a
is some of the most advanced genetics research being done in the
small task,“ he says. “Sequencing a genome is actually fairly easy,
world and the impacts of our work will be far-reaching.”
but interpreting what that means is a complicated task. We are
fortunate to have a number of good bioinformaticians and
While the development of the blood test will have huge ramifications
researchers who have done quite a bit of whole genome sequencing,
for pregnant women, the team at Magee is hoping to develop even
and who are more than willing to teach a new generation of molecular
more precise screening tests.
geneticists and post-docs, and physicians who are interested in this
area of precision medicine.” This training and the genetics team at
According to Dr. Rajkovic, “One thing that we are working on is the
Magee are establishing a new standard of care for patients.
ability to isolate fetal cells from the maternal circulation that will allow
us to practice better precision medicine. At this time, we have to use
Dr. Peters talks about another rare aspect of the environment at
maternal plasma, which is good for diagnosing larger genetic
Magee. “Here researchers like me have the opportunity to take
abnormalities such as an extra or missing chromosome, but it’s not
discovery that’s born in a laboratory environment and take it all the
as good as looking at the fetus at the nucleotide level.” He adds, “Dave
way through to the clinical setting. The speed at which we are able
Peters really has been one of the pioneers in this area of non-invasive
to conduct this bench-to-bedside method of research is very
prenatal diagnosis. And it’s great to see his work and the work of his
unusual. I’ve never come across that before. In my 24 years of
colleagues finding clinical application here at Magee.”
experience in genetics, the clinical and research worlds were quite
separate. At Magee, we are literally delivering this test that we’ve
THE PLACE TO BE
conceived and developed and optimized through the clinicians. The
Magee offers two unique centers – the Center for Advanced Fetal
patients in western Pennsylvania—and beyond—will use that test,
Diagnostics, which offers cutting-edge testing and result
and that’s something that’s very satisfying.”
interpretation, and the Center for Advanced Fetal Intervention,
which provides state-of-the-art in utero procedures, from
Collaborations like these at Magee are pushing the genetics frontier
to new levels. “This is like no other time in genetics,” says Dr. Peters.
ultrasound-guided fetal interventions to open fetal surgery.
“It’s an absolute revolution. It reminds me of computer science in the
1990’s – what a discovery phase that was and how it changed our lives.
At Magee, we’re in that phase with genetics now. It’s a very interesting
environment to be in, in this whirlwind of development.”
MAGEE :: PAGE 13
Charting the Course: How Magee’s Navigator Program
Helps Patients on the Path through Treatment
WHO NEEDS GENETIC TESTING
Dr. Rajkovic believes that all couples can benefit. While in the past, a lot of genetic testing focused
on certain ethnic groups, such as those of African ancestry for sickle cell anemia, Dr. Rajkovic
recommends pre-conceptual genetic counseling for all couples. “These days, everybody is fairly
mixed, and a lot of people don’t know their heritage. Offering much broader testing — that
surpasses what we used to do as testing based on ethnicity — is where genetic testing is going. We
basically want to offer every couple the ability to test their genome to see what they are carriers of
and what they are at risk of passing on to their babies, and what is the chance that they will have a
baby that is affected with a particular condition. This is something that should be offered to every
couple that is considering having a child.”
Dr. Rajkovic adds, “We are fortunate at Magee that we have some of the best counselors who have
expertise in discussing various options for testing. They can analyze the data and answer virtually any
question related to genetic testing, which helps alleviate the patient’s fears. My advice for the couple is to
come to Magee and become educated about genetic testing. That really is the best way to dispel a lot of
the myths, fears and concerns. They would be in great hands at Magee because of the caliber of genetic
counselors that we have.”
MAKING MEDICINE MORE PERSONAL THROUGH GENETIC TESTING
Genetics is helping to personalize medicine. Each day discoveries in this field are shaping the
care of tomorrow.
Genomic sequencing can predict an individual’s ability to respond to various medications. The area is
called pharmacogenetics. “This may be very useful in prescribing medications to individuals, leading
to fewer allergies, adverse reactions, and more effective therapeutic dosing,” says Dr. Rajkovic.
“We are just at the cusp of this personalized medicine revolution,” he states. “And, I think that the
possibilities are tremendous. When individuals know what they’re at risk for or what their genome
contains, it will give them great empowerment of knowing who they are, what they are, and what
they should be doing to optimize their life span and their productive years. I think this will make
for a healthier nation and hopefully reduce the number of terminal disease cases that could have
been prevented.
“Basically, personalized medicine is already here. It’s just at its beginning. We’ll see its effects
in the next few decades, and it’s very important that Magee is part of that.”
To make a donation to one of the most advanced genetic research
institutes in the world, visit www.mwrif.org/donate.
Receiving a cancer diagnosis is often a very difficult time for
patients. They must make choices about treatments and
medications, weigh side effects and privacy concerns, and
become familiar with specialists and medical terminology. The
last thing a cancer patient needs to do is worry about things like
insurance, transportation, and finances. That’s where the Oncology
Patient Navigation Service team at Magee-Womens Hospital of
UPMC comes in.
From the initial diagnosis through treatment and follow-up,
Magee’s patient navigators are available to patients every step
of the way. Navigators can help by connecting patients with
community resources for psychological and social support,
finding financial assistance programs to help them begin or
continue treatment, and providing a link between the patient
and their medical providers to get questions answered and
information clarified.
The program began in 2008 at Magee for breast cancer patients
through a grant from the Susan G. Komen Foundation to support
one navigator and a social worker. “The goal of the patient
navigator program, from the very beginning, has been to help
patients navigate through the cancer treatment process,” says
Judy Herstine, program administrator, Women’s Cancer Services.
“The navigators initially do an assessment with each patient to
determine what barriers to care they are facing — things like work
schedules, transportation, child care — and to help them find
ways to overcome those challenges through community support
and resources.”
That guidance and support has been invaluable to patients like
Bonnie, a single mother who was diagnosed in 2012 with cervical
cancer. Bonnie connected right away with Rhonda Martini, an
oncology patient navigator, to help address challenges she was
facing as she started on her course of treatment. Bonnie was
getting by with a part-time job, but it offered no health insurance,
so Rhonda pointed her toward an insurance program for women
with cervical cancer. Without a car, Bonnie also needed help
coordinating transportation for her appointments. Rhonda provided
multiple community transportation resources that successfully got
Bonnie to and from every medical appointment for free. More than
1,300 patients each year, like Bonnie, benefit from the Oncology
Patient Navigation Service.
Patients get access to navigators in many different ways — through
caregiver referrals, word-of-mouth, or automatically as part of a
patient population facing unique challenges, including
pre-menopausal breast cancer patients, patients who are going
through breast-reconstruction surgery, radiation oncology
patients, and patients who are undergoing chemotherapy prior
to surgery. Navigators may meet with patients right away in their
physicians’ offices or cancer center, or they will give the patient
a phone call to assess their needs and arrange a meeting face to
face. “Sometimes they see a patient every time they’re in. In other
cases, they’ll just talk once to provide specific information for a
patient who doesn’t need anything more,” Ms. Herstine explains.
“But often the navigators work with these patients over the course
of years. The relationship is really dependent on the patient’s need.
It’s very flexible.”
The Oncology Patient Navigator Service team works closely
with several organizations and community resources for cancer
care, including the American Cancer Society, Susan G. Komen
of Pittsburgh, Our Club House, Cancer Caring Center, National
Ovarian Cancer Coalition, and the Ovarian Cancer Research
Foundation. Donations through Magee-Womens Research Institute
& Foundation provide financial support for the Breast Cancer
Patient Care Fund and the Gynecologic Cancer Patient Care Fund,
which help patients who need financial assistance for transportation,
overnight housing, and medications.
Community support for the navigation program has been
crucial. We have received support from: The American Cancer
Society, Susan G. Komen Foundation, Eden Hall Foundation, Magee
Volunteer Service Board, The Glimmer of Hope Foundation, and The
Young Women’s Breast Cancer Awareness Foundation. “We couldn’t
have done it without the support from their funding,” Ms. Herstine
says. “It allowed us to branch out from just breast cancer patient
navigation to the point where all women’s cancer patients at Magee
have access to a patient navigator in their course of treatment. The
navigator program is integral to our services, and it is a great
complement to the exceptional, individualized, and compassionate
care provided by our specialty physicians and staff.”
To support the Oncology Patient Navigator Service,
visit www.mwrif.org/donate or call 412-641-8977.
MAGEE :: PAGE 14
MAGEE :: PAGE 15
How NICView
Cameras Help
Their
Parents Keep
e’s
Eyes on Mage
ts
n
Littlest Patie
A Womb
With a View
When newborn babies gets a bumpy start in life, there is no better place for them to be than in the
neonatal intensive care unit (NICU) at Magee-Womens Hospital of UPMC. The level of care from
doctors, nurses, and care workers in the NICU is unparalleled. But for the new parents and families
of these babies, the experience can be extremely difficult. When a baby is placed in an isolette, it can
leave mothers and fathers feeling quite isolated, too. With the launch of the NICView camera system
(which was introduced in the Summer 2013 issue of MAGEE) at Magee as well as in the Children’s
Hospital of Pittsburgh of UPMC, parents can rest a little easier knowing that they can quickly and
easily check on their little ones from anywhere, even when they’re not yet in the nursery at home.
Magee and Children’s are two of only three hospitals in Pennsylvania with this innovative,
password-protected webcam system installed in their NICUs, which gives parents and families a
virtual connection to their newborns 24 hours a day, seven days a week. And there are plenty of
people connecting. In the first six months since the NICView system was launched at Magee in March
2014, there have been 42,215 logins. Some views have come from as far away as Canada, the United
Kingdom, Spain, Belgium, and Tunisia. The system averages 7,000 logins each month.
“The camera is at the bedside of the babies, and we keep it on 24 hours a day, except when we’re
doing hands-on care or during an emergency,” explains Suzy Guess, director, Neonatal Patient Care
Services. “I’ve heard parents say that it’s the last thing they look at before they go to bed and the first
thing they look at when they wake up in the morning, so it provides that comfort of seeing your baby
when you can’t be there or they can’t yet be with you.”
“After the shock of having our son eight
weeks early and being in the NICU, we
were pleasantly surprised to find that his
room was equipped with a webcam that
allowed us to securely log in and check up
on him at any time. Even though we don’t
live far from Magee, we couldn’t be there
all the time, so it gave us a lot of peace of
mind to be able to see him on the camera.
Both sets of grandparents live in Australia,
and we shared the login details with them
so that they could see their new grandson.
It really helped our parents who were so far
away feel connected to us, and of course it
made them feel connected to our son.”
– Andrew Stephen, father of a Magee NICU graduate
It also helps parents save precious bonding time until babies are discharged from the hospital. “It
provides that comfort if moms need to go back to work, that they can save their maternity leave time
while the babies are still being cared for in the NICU,” Ms. Guess says.
Of the 77 beds in Magee’s NICU, 62 currently have the cameras installed, but the last sets of eyes
are on their way thanks to the fundraising efforts at the 2014 Savor Pittsburgh event in August. Funds
to support the initial installation of the NICView camera system at Magee were raised through the
Volunteer Services Board of Magee-Womens Hospital and the 2013 Savor Pittsburgh
fundraising event.
To support Magee’s NICU or neonatology research at Magee-Womens Research Institute,
visit www.mwrif.org/donate or call 412-641-8977.
MAGEE :: PAGE 16
MAGEE :: PAGE 17
Pregnanzzzzz’s
Can better sleep make for a healthier mom and baby?
Ah, the benefits of a good night’s sleep. You wake up feeling refreshed, restored and ready to tackle
the day. But what happens when you have a bad night’s sleep? We all know that if we don’t sleep
well, we don’t feel well. But are there more serious consequences to poor sleep – particularly for
pregnant women and their babies? That’s the question that keeps Francesca Facco, MD, up at night.
For the last six years, Dr. Facco, a researcher at Magee-Womens Research Institute and an
assistant professor, Obstetrics and Gynecology, and Maternal Fetal Specialist at the University of
Pittsburgh, has been studying sleep and its impact on pregnant women and their babies. And the
results may be eye-opening.
Dr. Francesca Facco
“I think what surprises people is that sleep is not a biologically inactive state,” says Dr. Facco. “People
used to think that the only purpose of sleep was for your brain to restore itself and be able to function
the next day. More and more data shows that sleep is not just something you need to do for your brain,
but you need to do it for your whole body – your immune system, cardiovascular system, and metabolic
system. It’s interesting from an evolutionary perspective, too. If sleep weren’t important in maintaining
health, it doesn’t make a lot of evolutionary sense that you spend eight hours a night as an animal
being defenseless, sleeping. Obviously there’s a strong evolutionary drive to maintain sleep, because
it probably is protective from a health perspective on many different levels. I realized there was a lot of
data about how sleep is important to your overall health, but that it hadn’t been looked at in pregnancy
– in terms of how poor sleep or sleep disorders could affect a woman’s pregnancy.”
Dr. Facco became fascinated with studying sleep and pregnancy when she served her residency and
was a fellow at Northwestern University in Chicago. But growing up outside of Pittsburgh, she wanted
to return to the area while still remaining in academic medicine. Fortunately, Magee provided the
ideal setting to continue her research. (continued)
MAGEE :: PAGE 18
MAGEE :: PAGE 19
can’t get more than six hours of sleep at night? And should we be
intervening?” Those are questions Dr. Facco hopes to answer with
her research, helping to inform women and their physicians.
Don’t Ignore the Snore – Or Any Other Sleep Problems
Sleep problems range from short sleep duration and long sleep
our study group active Continuous Positive Airway Pressure (CPAP)
duration to frequent snoring, sleep apnea, and conditions like
treatment, or placebo CPAP treatment for their sleep apnea.” She
restless leg syndrome. The possible impact of these problems
is looking to see whether pregnancy outcomes are impacted by
on mothers and their babies ranges from gestational diabetes,
aggressively screening and treating for sleep apnea.
high blood pressure in pregnancy, and preeclampsia to low
infant birth weight, premature birth, and maternal
A Good Night’s Sleep
complications at delivery like blood loss and infection. Stating
that sleep is a whole complex biological phenomenon, Dr. Facco “There’s not any great data about how much sleep a pregnant
woman should get,” says Dr. Facco. “That’s what I’m trying to
believes, “If sleep leads to pregnancy complications, it could
understand. Outside of pregnancy there is pretty strong evidence
certainly impact the fetus on different levels, too.” Since her
that less than six hours a night and very long sleep durations of
fellowship, Dr. Facco has done several projects studying sleep
greater than nine hours a night can have a negative impact on your
and pregnancy from different perspectives. Not surprisingly,
metabolic health as well as your cardiovascular health.”
she’s found that sleep disorders and poor sleep quality are
common in pregnant women. Even more troublesome is the
Old wives tales abound, warning moms-to-be about what to expect
link between poor sleep and poor health outcomes. “I’ve done
work with survey data that shows that women who self-reported in terms of sleep – or lack thereof. “There’s a lot of anecdotal advice
and evidence that goes around for women about what to expect
short sleep and frequent snoring had an increased risk of
with sleep and pregnancy,” says Dr. Facco. “People say you’re not
diabetes in pregnancy. I decided it was time to look objectively
going to sleep well because your body is getting ready to be up with
at sleep, measuring sleep and how it can impact pregnancy.”
the baby. There’s not a lot of science behind that. Even as doctors,
we don’t know what to tell women to aim for. What should be your
New Sleep Studies
overall sleep goal? What problems should you look out for? Should
Dr. Facco embarked on several projects, one of which used a
you tell us if you have frequent snoring? Or should you tell us if you
watch that measures sleep by keeping track of the mother’s
motion at night. “We did a study of more than 800 women who
wore this watch, and we’re examining how the time they spend
sleeping at night may impact their pregnancy health.”
In another study, she used a different device that measures
sleep apnea, the breathing pauses that cause oxygen
desaturation at night. The study involved 3,000 pregnant women.
“We are looking at that data to see how sleep apnea may impact
pregnancy and health. We’re looking forward to having that data
soon to report our findings.”
Here at Magee, Dr. Facco is performing a study to see if
screening for and treating sleep apnea in pregnancy results in
a change in the health profile of obese pregnant women. “We’re
going to identify, screen, diagnose, and then randomly give
One thing is for certain, though: sleep is important. “We as a society
have to recognize the health benefits of sleep and what sleep can
impact. Right now we are a 24/7 society with constant access to
media and devices,” says Facco. “We have to put forth the effort to
protect sleep and make time for it just like we do for other things
that are good for us like exercise.”
To support our efforts to learn more about how sleep
impacts pregnant women and their babies, visit
www.mwrif.org/donate.
Tips for a top-notch sleep
• Keep work materials, computers, TVs, and smartphones out of the bedroom.
• Keep regular sleep habits and times, even on weekends.
• Avoid daytime napping.
• Create a bedtime routine that’s relaxing, like reading a book, or listening to
soothing music.
• Make sure your room is dark, quiet, comfortable, and cool.
• Evaluate your mattress for comfort and support. If it’s older than 7 years,
it may be time for a new one.
• Make sure if you exercise, you’re done at least two hours before bedtime.
• Avoid nicotine and caffeine close to bedtime.
• Finish eating two to three hours before you head for bed.
MAGEE :: PAGE 20
HEALTHIER PREGNANCIES? THERE WILL BE AN APP FOR THAT, SOON
Magee-Womens Research Institute is currently involved in yet another important and ground-breaking
collaboration aimed at healthier pregnancies. Pulling together researchers from Carnegie Mellon
University, community leaders from Hazelwood, and physicians from Magee, work is under way to
develop a mobile app to help women have healthier pregnancies and healthier babies. And it’s all
possible because of funding from The Pittsburgh Foundation. Look for more updates on this exciting
initiative with our community partners in future issues of MAGEE.
MAGEE :: PAGE 21
Endometrial Cancer Prevention and Obesity:
Magee Epidemiologist Looks for Cancer Clues
in Healthy People
Dr. Faina Linkov, PhD
In a country like the United States with a full-blown obesity epidemic, it should come as no surprise
that the rate of a cancer that is strongly tied to obesity is growing right along with our waistlines. Over
the past decade, researchers have noted an alarming increase in the incidence of endometrial cancer
(or uterine cancer), the most common gynecologic cancer in the U.S. Although endometrial cancer is
potentially preventable through lifestyle modifications such as weight loss, there is limited evidence
that such measures in high-risk patients are beneficial. But at Magee-Womens Research Institute, Dr.
Faina Linkov, PhD, MPH, associate professor, Obstetrics, Gynecology, and Reproductive Sciences and
Epidemiology, along with her clinical collaborators like Robert Edwards, MD, director, Gynecologic
Oncology, Magee-Womens Hospital of UPMC, aim to fill that gap in evidence. “Many women do not
know that endometrial cancer is caused by obesity or that they are at increased risk of getting other
obesity-related health problems,” Dr. Linkov says. “So as health care providers and scientists, we’re
trying to determine the best time to share that message with high-risk patients.” She is researching the
obesity/gynecologic cancer link by focusing on whether massive weight loss achieved through bariatric
surgery can potentially prevent endometrial cancer and its precursors.
To study the link between obesity and endometrial cancer, Dr. Linkov looks for clues known as
“biomarkers” in adipose tissue (fat), endometrial tissue, and the blood of patients with endometrial
cancer, as well as in high-risk, morbidly obese women who do not yet have the disease. Dr. Linkov and
her collaborators have also organized patient forums and research collaborations to determine the
best education and prevention methods for healthy, at-risk women as well as endometrial cancer
survivors. These patient forums revealed one simple reality: weight loss is difficult. “This is especially
true for those patients who are morbidly obese, as they may have much greater difficulty achieving
weight loss through exercise due to increased orthopedic risk and comorbid conditions,” Dr. Linkov
explains. Bariatric surgery is often a good alternative for such patients, so Dr. Linkov is currently
working with the bariatric surgery clinic at Magee-Womens Hospital to evaluate whether weight loss
associated with bariatric surgery may provide an effective way for the prevention of endometrial cancer
and other obesity-associated endometrial pathologies.
Dr. Linkov’s ground-breaking research suggests that morbidly obese women – those with a body mass
index (BMI) over 35 – who undergo intentional weight loss through lifestyle modifications and/or
bariatric surgery, experience changes in blood and tissue biomarkers associated with cancer
development. These findings – based on Dr. Linkov’s collaboration with Dr. Lora Burke (University
of Pittsburgh School of Nursing). Dr. Dana Bovbjerg (Biobehavioral Oncology Program, University of
Pittsburgh Cancer Institute), Peter Argenta (University of Minnesota), and a team of local researchers –
were recently published in a special issue of Gynecologic Oncology specifically dedicated to obesity.
One of the most rewarding research projects of Dr. Linkov’s career has been evaluating the endometrium
(uterine lining) of morbidly obese, bariatric surgery candidates. “Frighteningly, 20 percent of
the women we studied had some kind of pathology in the endometrium, including precancerous lesions,
that they didn’t know anything about,” Dr. Linkov explains. “I think it’s a very important discovery because,
at this point, we do not screen for endometrial cancer. However, screening may prove important for morbidly obese women if more in-depth investigations confirm our preliminary data. I think that our research,
conducted with the help of gynecologic oncologists and pathologists, may support that need.”
MAGEE :: PAGE 22
This focus on screening and preventive measures is driving the latest
direction of Dr. Linkov’s research into the search for a biomarker
panel that could point to an increased risk for endometrial cancer
development. Additionally, Dr. Linkov is pioneering the investigation
of stem cells in adipose (fat) tissue to serve as such biomarkers,
believing that adipose tissue might offer more clues for detection
than traditional blood- or tissue-based markers.
Trying to encourage prevention through weight loss and lifestyle
changes requires more than a strong body of clinical research, so
Dr. Linkov works in collaboration with the University of Pittsburgh
Cancer Institute, international cancer researchers, and patient
stakeholders to develop better patient-centered approaches.
“A lot of patients diagnosed with obesity related cancers don’t get
lifestyle advice when they’re diagnosed,” she reveals. “At the time
of cancer diagnosis, most women probably don’t want to hear that
they need to lose some weight. But patients said that there’s a point
in cancer care when they are done with surgery, chemotherapy, and
radiation, and are extremely motivated to become healthier. Therein
lies our ‘teachable moment’ for introduction of weight loss
interventions, because most endometrial cancer patients don’t die
from the disease, they die from obesity-related complications.”
By 2030 research indicates
that the U.S. could see a
sharp increase in the rate of
endometrial cancer incidence,
which could rise by 55 percent
even if the current rates of
obesity remain the same.
MAGEE :: PAGE 23
Cancer Care Bags Offer
Comfort to Patients
According to Mahatma Gandhi, “The best way to find yourself is to
lose yourself in the service of others.” At Magee, we understand
the value of those who are dedicated to service projects that benefit
our patients and the positive impact they make. A number of
volunteers have seen a particular need in the area of cancer
treatment, and have worked hard to help ease the discomfort of
chemotherapy. These service projects are a true labor of love, and
ultimately impact not only the patients, but also the donors.
“When my mother went through chemotherapy a few years ago,
I noticed that even the smallest things other people did for her
brought her happiness,” said Abbi Yachini. When it was time for
Abbi to select a project to complete in order to graduate with
honors from Brooke High School in West Virginia, she remembered
this, and she knew just what she wanted to do. Her mother,
Christie, received chemotherapy nearly three years ago. After
watching her endure the harsh side effects of the drugs, Abbi
wanted to do something that would have a positive impact on the
patients and allow her to give back to Magee-Womens Hospital of
UPMC after the excellent care they had provided and still continue
to provide, to her mother. She decided to make and donate Cancer
Care Bags to women who are undergoing chemotherapy at Magee.
These bags contain items intended to provide comfort and support
to patients, often including things like tissues, fuzzy socks, hats,
scarves, and crossword puzzle books.
,
.
-Abbi Yachini
“I thought by giving these bags to patients, I could put a smile on
their face. Chemo patients need to be showered in positivity, and
I believe just knowing someone wants to help will brighten their
spirits,” said Abbi.
She first set up a page on GoFundMe.com, and then linked it to
her Facebook page. Abbi received donations immediately, and as
her friends shared the link, they quickly spread the word. She also
hosted a Princess Party at her house, where girls could come for
crafts, nail art, and cupcake designing in exchange for a donation.
Altogether, Abbi raised more than $800 and was able to assemble
100 bags over the summer. She also hand decorated each bag to
add a personal touch, and now delivers about a dozen bags each
week. Although she has met her original goal, Abbi plans to
continue the project as long as possible. Anyone interested in
contributing can visit her at http://www.gofundme.com/9m0w3s.
“It’s amazing how so many people came together to help make cancer
patients smile. I am beyond thankful to everyone who donated to
my project, as I could not have gone nearly as far in assembling the
bags without the incredible support I have received,” she said.
Abbi isn’t the only student working hard to support patients at
Magee. The Girls’ Athletic Association (GAA) at the Western PA
School for the Deaf also created and delivered Cancer Care Bags
for their annual service project last year. The group has a long
history of service for raising awareness about breast cancer, and
to those who are fighting their own battles. In past years, they
sold T-shirts and other items to make donations toward Susan G.
Komen Foundation, and participated in Lee National Denim Days,
said Erin McNeil-Mascaro, GAA advisor and teacher at the Western
PA School for the Deaf. Other years they took up collections to do
something special for school staff members who had been affected
in some way by breast cancer.
“Every year, we try to do something to help breast cancer awareness,
but also to do something that lets the kids really see personally
where their work goes,” Erin said.
Last year, the girls chose to make Cancer Care Bags, and were able
to get the entire school involved. Not only did they collect enough
items to make almost 70 bags, they also worked with the home
economics teacher in their spare time to make scarves and caps for
the patients.
“I think it had a good impact on the girls,” Erin said. “One of the girls
had lost her mom a few years ago to breast cancer. I could see that
she was really motivated to help, and it seemed to be healing for
her. She was a big leader in getting the project moving.”
The girls assembled the bags, but the project didn’t end there.
(continued)
MAGEE :: PAGE 24
MAGEE :: PAGE 25
GENEROSITY IN ACTION
Lacing Up for Cancer Research
Erin interpreted for her students as they signed in American Sign
Language and presented each woman with a care bag. They said,
“Stay strong. You are beautiful.”
They may have hung up their skates, but members of the Penguins Alumni Foundation are still skating toward an important goal—to
cure breast cancer. For the past few years, the Pittsburgh Penguin Alumni Foundation has teamed up to generously support the efforts of
Magee-Womens Research Institute & Foundation. The group holds two charity events—the Penguins Alumni Charity Golf Classic and Skate
With The Greats—which directly benefit breast cancer research at Magee.
“The kindness and compassion of my students is always inspiring to
me, but it’s moments like this when I am truly proud and awed by
them,” Erin said.
This remarkable group of students received several thank you cards.
One card said, “It was so heartfelt, I wept. I want you all to know
how much that meant to me.”
.
-Erin McNeil-Mascaro
“I like to share those with the girls to show them how their service
to the community really does have an impact,” Erin said. “The girls
really feel like they are making a difference. I want this to spread
throughout their lives after they leave here, for them to continue
making a difference.”
The group, which includes about 10 girls from across Pennsylvania,
is planning to repeat the project again this year. “They came in
asking about it at the start of the school year, and they are already
excited about it,” Erin said. Anyone wanting to contribute toward
this year’s project can contact Erin through www.wpsd.org.
For more information about how you can make a difference in
the lives of those who are fighting cancer, please call the
Magee-Womens Research Institute & Foundation at 412-641-8977.
The goal to find a cure is near and dear to the alumni. “Throughout the years, a number of players’ wives and family members have been
affected by breast cancer,” said Heather Hillier, wife of former Penguins player and coach, Randy Hillier. Randy lost his mother and
grandmother to breast cancer, and Heather and her sister were both diagnosed with the disease within the same year. The alumni also lost
Nicole Meloche, wife of former Penguins player and coach Giles Meloche, to inflammatory breast cancer in 1993 at the age of 42.
The connection between the Alumni Foundation and Magee-Womens Research Institute stems from Heather’s personal battle with breast
cancer and the alumni’s willingness to support the cause. According to Heather, the Pittsburgh Penguin Foundation also has been an integral
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and they are there. They’ve been amazing!” The Charity Golf Classic has been held for 17 years, and has supported Magee for the last four
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fans the chance to skate with popular alumni, gathering autographs, photos, and memories. Over the years, the two events have generated
more than $67,000 for breast cancer research.
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Opportunities to Help are Limitless
If you are interested in hosting your own event to
support patients at Magee, call 412-641-8977.
Some examples of events include:
“Thealumni
Alumni
committed
supporting
cancer
research,”
Heather
said.
“We
know
that
breast
cancer
treatable,
survivable
disease,
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isis
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toto
supporting
cancer
research,”
Heather
said.
“We
know
that
breast
cancer
isis
aa
treatable,
survivable
disease,
and we hope to be a part of finding that cure.”
To make a gift to support women’s cancer research, visit www.mwrif.org/donate.
• Fashion shows
• Contests such as talent shows or cooking bake-offs
• Benefit concerts with school chorus and jazz bands
• Live or silent auctions
• Craft shows
FPO
• Super Bowl parties
• Monte Carlo nights
Visit the Penguins Alumni Foundation at
http://pittsburghpenguinsfoundation.org
for more information.
MAGEE :: PAGE 26
Plans are under way for next year’s Skate With The
Greats. Please plan to join Randy and Heather Hillier and
otherPlans
members
of theway
Penguins
alumni,
Billy
are under
for next
year’s including
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Donna
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andHeather
Jen Trottier,
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to join Randy
Hillier and
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Taglienetti
and Dr.
Vonda
Wright,alumni,
Mark Recchi,
members
of the
Penguins
including Billy
Jay Caufi
eld, Kim
Ken and Donna
Cindy Wregget,
Edand
andJen
Diane
Guerin,
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an evening
of Dr.
family
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in support
of Recchi,
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Taglienetti
and
Vonda
Mark
cancer
research
atKen
Magee.
Jay
Caufield,
and Cindy Wregget, and Ed and Diane
Johnston for an evening of family fun in support of breast
cancer research at Magee.
Visit the Penguins Alumni Foundation at
http://pittsburghpenguinsfoundation.org for
more information.
MAGEE :: PAGE 27
GENEROSITY IN ACTION
Thirty-five Years of Gratitude for
Exceptional NICU Care
Thirty-five years after the birth of his son, Dick Diamondstone
still remembers the pain he felt when the doctor came out of the
delivery room at a Greensburg hospital and said, “Your wife is fine
but there is no chance of survival for your baby.” After dropping the
devastating news, the physician walked away before Dick could ask
any questions. Dick’s wife, Karen, had been admitted two days
earlier after her water broke three months prematurely.
Grieving, Dick followed the incubator as the nurse rolled his tiny son
down the hall to the nursery. Measuring 12 ½ inches and weighing
only 1 pound, 15 ounces, Jordan was wrapped in aluminum foil
and placed under a lamp to keep him warm but no other measures
were taken to save his life.
Dick recalls watching his newborn son kicking and squirming in
his bassinet and thinking to himself, “He is strong and he’s going to
make it!” Returning to his wife’s bedside, Dick tried to reassure her
that Jordan would live. A few hours later, a pediatrician advised the
couple to transfer Jordan to Magee-Womens Hospital immediately,
where he would receive the advanced care he needed to survive.
For the first day and a half, Jordan breathed on his own before
complications set in. His immature lungs made it extremely difficult
for him to breathe and his heart stopped many times over his
stay in the Neonatal Intensive Care Unit (NICU). Over the next few
weeks, the couple prayed hard as Jordan fought for his life. Each
day, under the expert care at Magee, Jordan grew stronger and the
Diamondstones grew hopeful that their precious child would beat
the odds and soon be coming home.
During Jordan’s three-month stay in the Magee NICU, Dick and
Karen visited every day to feed him and hold him. Dick recalls
that the nurses and doctors caring for Jordan loved him, bonded with him, and bought him many presents. Once when the
Diamondstones arrived, they were surprised to find Jordan dressed
in a doll-sized Pittsburgh Steelers’ outfit in celebration of the
Steelers making it into the playoffs.
Eight long weeks after Jordan’s birth, the Diamondstones received
exciting news — Jordan could go home as soon as he could make
it 10 days without any breathing problems. The couple began
counting down the days until they could take their baby home. Every
day they would think just a few more days, only to be disappointed
when an episode of breathing difficulties would set Jordan back and
the countdown would begin again. But each time he made it a little
further and after three months and one day — just one day past
MAGEE :: PAGE 28
his original due date — it was time to take Jordan home. “The staff told us that Jordan was the youngest baby [at that time] they had ever
cared for at Magee who survived with excellent health. Everyone at Magee was wonderful to Jordan,” Karen and Dick recall. “The care he
received was outstanding. It set him on a path to a wonderful life.”
In appreciation for the excellent and compassionate care Jordan received, the Diamondstones made a financial gift to the Magee NICU
and at Jordan’s first birthday, Dick crafted a special memento for each member of Jordan’s care team — based on the iconic pop art LOVE
emblem — which he cut from a one-inch steel plate and then had it chromed and engraved with Jordan’s name and birthday. The gifts were
accompanied by a letter, penned from Jordan’s perspective, detailing his remarkable one-year journey to health. Years later, Jordan and
his parents stopped by the office of the pediatrician who managed Jordan’s care at Magee. On his desk was the LOVE emblem given to him
to commemorate Jordan’s birth.
Dick still carries a copy of the letter as a daily reminder of the remarkable care Jordan received at Magee. He and Karen also make an
annual gift to Magee’s NICU in honor of Jordan’s birthday to support the innovative work being done there to save babies like Jordan.
Today Jordan is a healthy, happy 35-year-old with many friends and a good career. “Jordan is the happiest, most optimistic person I have
ever known,” says Dick. “Karen and I, and his brother Mike, will always be eternally grateful to Magee for giving us an
opportunity to watch this beautiful young man grow.”
To make a gift to support Magee’s NICU, visit www.mwrif.org/donate.
MAGEE :: PAGE 29
GENEROSITY IN ACTION
Mile After Mile, Joe Scarpaci Rides to Help Breast Cancer Patients
To many people, biking 613 miles over mountain trails from Blacksburg, VA to Pittsburgh, PA would seem
to be a journey too difficult to complete, but Joe Scarpaci, Jr. knows the journey a woman diagnosed with
breast cancer must take is a much more difficult one. Joe’s own beloved mother, Josie Cicero Scarpaci,
battled breast cancer for seven years before succumbing to the disease in the summer of 1998 at the age
of 64. His mother’s battle is what inspired the 59-year-old executive director of the Center for the Study of
Cuban Culture and the Economy to bike to Pittsburgh every summer for the past five years to raise breast
cancer awareness and much-needed funds to help breast cancer patients at Magee-Womens Hospital of
UPMC in the fight for their lives.
“I hung my hopes on the magical five-year mark — which she
reached — as well as the powers of Tamoxifen,” Joe says. “We
know now that breast cancer is way more complex and the
treatment strategies adjust every year as researchers’ knowledge
about the disease increases.”
Joe’s sister, Darlene Violetta, remembers her mother’s
determination to beat the disease. “She never complained; she was
always optimistic. But she worried about us kids and our father.
She was a wonderful mother and wife and a mentor to many young
women in Pittsburgh. We lost her way, way too soon.”
“Josie was an amazing woman, full of energy,” Joe’s wife Gilda
recalls. “She never gave up. Just three weeks before her death,
Josie attended a ceremony at Mt. Lebanon High School to accept
the Distinguished Alumni Award on Joe’s behalf while he was out
of the country.”
Each year, more than 1,300 women and men are treated at Magee for breast cancer. To help ease the
cancer journey for these patients, Joe, his father Joseph, and his siblings — Darlene, Josette, and Sam —
created the Josie Scarpaci Breast Health Access Fund at Magee. “We felt it would be a wonderful way to
memorialize our mother and honor the clinicians and nurses who cared for her at Magee,” says Darlene.
Through Joe’s bike rides, memorial contributions and proceeds from the sale of original artwork
notecards, Joe and his extended family have raised more than $57,600 for the Scarpaci Fund.
As Joe peddles along trails and through towns, he talks to the people he encounters about his mother’s
battle with cancer, the wonderful care she received from her medical team at Magee, and what he and
his family are doing to help women like her. In honor of Josie, the Scarpaci family also donated “My Satin
Doll,” a series of four acrylics that hang in the cancer center to help bring comfort to patients.
Joe is grateful for the support of friends, colleagues, and even
strangers he has met along his way. Once, while stopping at a
garage sale in Mint Spring, VA to rest, Joe struck up a
conversation with the homeowner. “When I told her I was riding for
Magee,” Joe recalls, “She immediately handed me all of the change
she had taken in that morning, explaining that she was a nurse who
had worked at Magee years before in the early 1960s. At that time,
Magee was one of the few hospitals in the country hiring AfricanAmerican nurses and she was touched by that.”
Another time Joe chatted with a couple who was dining in the
restaurant where he had stopped to have dinner. Learning the
purpose for his ride, the woman thanked him and made a gift,
sharing that she was a breast cancer survivor.
Through the meaningful gifts of donors who support Joe’s ride, and
those of other compassionate individuals, Magee is changing lives
in Pittsburgh and around the world. From advanced care to
ground-breaking research, Magee offers hope and healing for
women and men facing breast cancer.
To make a gift to support the Josie Scarpaci Health Access Fund,
visit www.mwrif.org/donate.
Through their efforts, Magee has developed comprehensive resource binders containing educational
materials and resources for newly diagnosed breast cancer patients. The binders include information
about treatment options, procedures, and medical terms and provide space for the patient to take notes
about her treatment and keep track of important details to improve her outcome and provide the support
each patient needs to regain their health. In honor of Josie, the Scarpaci family also donated “My Satin
Doll,” a series of four acrylics that hang in the cancer center to help bring comfort to patients
This year, Joe arrived in Pittsburgh after an eight-day ride, just minutes before a severe thunderstorm
rolled through the city. As he stretched the kinks out of his back, he shared what goes through his mind
as the miles loom ahead. “As I ride along the trail, “Joe says, “I think about all of the women facing
breast cancer and it keeps me going. I hope someday that all women will survive this terrible disease
and that their lives will not be diminished from having it.”
MAGEE :: PAGE 30
MAGEE :: PAGE 31
NOTEWORTHY
Magee Hosts Russian Physicians to Study Women’s Health
In August, Magee-Womens Hospital of UPMC, in collaboration with four local insurance companies
and the Allegheny County Office of Behavioral Health, launched a comprehensive Pregnancy Recovery
Center to provide concurrent treatment for opiate dependence and prenatal care and delivery. The
program, which is one of the first in the country, aims to offer comprehensive care for women suffering
from opiate addiction by providing medical support to prevent withdrawal during pregnancy, minimizing
fetal exposure to illicit substances, and engaging the mother as a leader in her recovery.
“For more than a decade, Magee has offered drug recovery assistance for pregnant women,” says
Dr. Dennis English, vice president of Medical Affairs at Magee. “The key difference between this
program and our more traditional methadone program is the Pregnancy Recovery Center operates
from the outset of pregnancy on an outpatient basis. The Pregnancy Recovery Center also will provide
consistent, collaborative care throughout the patient’s pregnancy.” For more information about the
program, call 412-641-1211.
Magee Saddened by the Loss of Two Physicians
The Magee community was saddened by the sudden loss of Dr. Morris Turner, who passed away on June
30. During his career, Dr. Turner served as medical director of the Magee-Womens outreach sites at
Wilkinsburg and Monroeville; medical director for Adagio Health; and chief of service for Obstetrics and
Gynecology at McKeesport Hospital. Dr. Turner, who graduated from Magee’s residency program in 1976,
will be remembered as a remarkable physician who devoted his career to eliminating health disparities.
Magee also mourns the loss of Dr. Leroy Indorato, who passed away on Oct. 26 following a brief illness.
An active member of the Pediatrics Department at Magee-Womens Hospital since 1971, Dr. Indorato left
an indelible imprint on pediatric care at Magee. He will be remembered for his clinical prowess, diligence,
his warmth, and his compassion.
A delegation of five Russian obstetrics gynecologists visited Magee in May for a comprehensive program
exploring advanced care practices and scientific research in an array of women’s health issues. Members
of the delegation shadowed physicians and nurses in Magee’s neonatal intensive care unit (NICU), birth
center, and breast imaging center and spent time in the Research Institute’s laboratories observing
research projects and technology in women’s cancer, fertility, reproductive biology, and uterine prolapse.
The delegation was hosted by Magee Womancare International, a non-profit organization that serves as
the international humanitarian outreach arm of Magee.
Magee in the National Spotlight
While Magee is characteristically in the national spotlight because of its high quality care and cutting-edge research, this summer Magee
enjoyed national media attention for our very own singing doctor – Dr. Carey Andrew-Jaja. Dr. Andrew-Jaja, who has delivered thousands
and thousands of babies throughout his career, was recognized for welcoming each baby he delivers into the world with a beautiful song.
From “Happy Birthday,” to “It’s a Wonderful World,” Dr. Andrew-Jaja inherited the tradition from his mentor and says he delights in the
special bond he creates with each and every one of the babies he delivers. You can watch Dr. Andrew-Jaja’s video online at
http://www.youtube.com/watch?v=NBrhF77Hqag.
2014 Philanthropy Report Now Available
Magee-Womens Research Institute & Foundation is grateful to our donors who fuel our research and
enhance patient care and education. Your investment enables research that directly affects patient care
today and contributes to a growing body of knowledge that will create healthier tomorrows in Pittsburgh
and beyond. Millions of women, infants, and men will benefit from your partnership with us. To read our
2014 Philanthropy Report, visit www.mwrif.org.
HAPPENINGS
MWRI MORSELS
April 11
June 7
Magee-Womens LiveWell
Cancer Survivorship “Health
and Wellness Workshop”
Where: Doubletree by Hilton –
Greentree
When: 9 a.m. to 2 p.m.
www.mwrif.org
Annual NICU Reunion
Where: Pittsburgh Zoo & PPG
Aquarium, Pittsburgh, PA
When: 11:30 a.m.
Proceeds benefit the neonatal
intensive care unit at Magee
May 16
June 22
and 23
Aiden J. Strack Golf Classic
Where: Indian Springs Golf
Course, Indiana, PA
Proceeds benefit families of
premature infants
www.aidengolf.com
7th Annual Noah Angelici
Memorial Golf Outing
Where: Mystic Rock at
Nemacolin Woodlands Resort,
Farmington, PA
Proceeds benefit the Fetal
Diagnosis and Treatment Center
at Magee
www.noahshouseofhope.com
On Aug. 21 more than
1500 people gathered to
support Magee’s fight to
end premature births at
Savor Pittsburgh at Stage
AE on the North Shore.
Susan Farabaugh, PhD, received a three-year, $300,000 grant from the U.S. Department of Defense’s Congressionally
Directed Medical Research Program in Breast Cancer. The grant, “Oncogene Induced Changes in Mammary Cell Fate
and EMT in Breast Tumorigensis,” will investigate the role of insulin-like growth factor receptors in altering mammary
lineage cell fate during breast tumorigensis.
Ian McGowan, MD, PhD, and colleagues from Magee-Womens Research Institute, and the University of Pittsburgh and Johns Hopkins
are collaborating on a five-year, $1.9 million U19 grant entitled, “Delivery of Rectal Enema as Microbicide (DREAM).”
More than 30 dishes
were prepared by 21
restaurants to compete
for the title “Dish of
the Year.”
Mothers of graduates
of Magee’s Neonatal
Intensive Care Unit (NICU)
show off a NICU diaper,
illustrating how tiny many
of the babies cared for in
the NICU are at birth.
Lisa Rohan, PhD, Ian McGowan, MD, PhD, and colleagues, received a five-year, $3.5 million grant from NIAID, as part
of U19 grant from NIAID with a group of researchers from the University of Louisville. The project is called “Griffithsinbased rectal microbicides for prevention of viral entry (PREVENT).
Rebecca Watters, PhD, received a three-year, $300,000 grant from the U.S. Department of Defense’s Congressionally
Directed Medical Research Program in Breast Cancer. The grant, “The Role of SRC-1 in Selectively Promoting Bone
Metastases,” will study the role of the estrogen receptor co-activators in the development of bone metastases from
breast cancer.
Judy Yanowitz, PhD, received an undergraduate diversity supplement for one year of training to support a minority trainee.
Interested in Participating in a Clinical Trial?
Clinical trials would not be possible without individuals who generously volunteer their time to participate or without individuals who give generously
to make these life-changing studies possible. We welcome your involvement in this important work through participation in a clinical trial. Following
are a few of the studies actively recruiting participants. For a complete list of clinical trials, visit http://www.clinicalresearch.pitt.edu/SPP/Studies.
Jason and Madeline Strack, and their son
Jason, presented staff of Magee’s Neonatal
Intensive Care Unit (NICU) with $4,000 on
behalf of the Strack Foundation. Each year,
the Strack Foundation hosts the Aiden J.
Strack Golf Classic in memory of Jason and
Madeline’s son, Aiden. Proceeds from the
event support families of premature infants
by funding expenses not covered by
insurance, including travel and lodging.
Participants at
Magee-Womens Research
Institute’s 3rd annual Fly
Fishing Classic proudly
display their fly fishing
awards. Held at
HomeWaters Club every
September, the Fly Fishing
Classic raises funds to
support women’s cancers
through Magee’s Women’s
Cancer Research Center.
To date, more than
$200,000 has been raised.
For more information, visit www.mwrif.org or call 412-641-8977. For sponsorship opportunities, call Denise Wickline at 412-641-8911.
Validity: Recruiting for women who have been diagnosed with a cancer other than basal cell carcinoma, squamous cell carcinoma, or cervical
intraepithelial neoplasia after the age of 18 and who speak fluent English to participate in a study to understand how women with cancer stand up
for themselves. Participants will be asked to complete a survey about their beliefs and behaviors as a cancer survivor. The survey will take 30 to 45
minutes to complete either online or in the mail and participants will receive a $10 Amazon gift card for their time. To learn more, call 412-624-4101.
Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence (ESTEEM): Recruiting women over the age of 21 who leak
urine with coughing, sneezing, or exercise for a study looking at better ways to treat urinary leakage and are interested in having surgery to correct
urinary leakage, although other exclusions may apply. All participants will undergo a mid-urethral sling surgery, and may also be assigned to attend
pelvic floor physical therapy before and after surgery. Participation lasts one year from the time of surgery, and involves in-person visits at the
Women’s Center for Bladder and Pelvic Health at Magee-Womens Hospital of UPMC. Women who enroll in the study will be compensated up to
$350 for their time. To learn more, call 412-641-2634.
Longitudinal Eating Assessment in Pregnancy (LEAP): Recruiting pregnant women over the age of 13, who are currently pregnant with one baby
and are planning to deliver at Magee-Womens Hospital of UPMC to participate in research to study the relationship between weight gain during
pregnancy and psychological factors. This research study conducted by the Department of Psychiatry at UPMC and involves questionnaires and
interviews that will take place at your doctor’s office or our office at UPMC and by telephone. Participants will receive up to $310 for completing all
of the study requirements over a period of about one year. To learn more, call 412-647-5370.
MAGEE :: PAGE 35
3339 Ward Street
Pittsburgh, PA 15213
www.MWRIF.org
412.641.8977
Address Service Requested
Making a planned gift is simple and doesn’t
have to cost you anything today.
1
Remember Magee through your will.
2
Name Magee as a beneficiary
on a retirement account.
3
Create an income stream for your life while
also making a gift to Magee.
There are many gift options to choose from including bequests,
gifts of real estate, and gifts of stock.
For more information about making a meaningful gift to Magee,
please contact Aruthur Scully at [email protected] or 412.641.8973.
NONPROFIT ORG
U.S. POSTAGE
PAID
PITTSBURGH, PA
PERMIT NO. 1212