text: WEILL CORNELL MEDICAL COLLEGE NEW YORK-PRESBYTERIAN HOSPITAL DEPARTMENT OF MEDICINE DIVISION OF INFECTIOUS DISEASES DIVISIONAL PROGRAMS & FACULTY AND FELLOW PROFILES 2010-2011 Weill Medical College of Cornell University 1300 York Avenue, Box 125 New York, NY 10065 Telephone: 212-746-6320 Fax: 212-746-8675 Email: firstname.lastname@example.com TABLE OF CONTENTS Page INTRODUCTION 1 FACULTY ROSTER AND CLINICAL/RESEARCH INTERESTS 2-3 INFECTIOUS DISEASES FELLOWSHIP TRAINING PROGRAM 4-11 Mission, Clinical Rotations, Research …...………………………………….……………………………………... 4-6 Supplemental Training Programs ...…………………………………………………………………..................... 6-8 Current and Former Infectious Diseases Fellows …...............…...…………………………..…………………. 9-11 CURRENT RESEARCH AND TRAINING GRANTS, 2010-2011 12-14 CORE FACULTY PROFILES 15-23 Barry Brause, MD .………………………………………………………………………………………………….... 15 David Calfee, MD Macarthur Charles, MD, PhD Daniel W. Fitzgerald, MD ............................................................................................................................... 16 Marshall J. Glesby, MD, PhD Linnie M. Golightly, MD Roy (Trip) M. Gulick, MD, MPH ...……………………………………………………………………..................... 17 Barry Hartman, MD David C. Helfgott, MD Warren D. Johnson, Jr., MD .......................................................................................................................... 18 Laura A. Kirkman, MD Albert I. Ko, MD Kristen M. Marks, MD, MS ............................................................................................................................. 19 Andrew Miller, MD Henry W. Murray, MD Jean W. Pape, MD …..………………………………………………………………………………………………. 20 Robert N. Peck, MD Kyu Y. Rhee, MD, PhD Richard B. Roberts, MD ………………………………………………………………………………..................... 21 Mirella Salvatore, MD Rosemary Soave, MD Mary A. Vogler, MD ....................................................................................................................................... 22 Scott Weisenberg, MD Timothy J. Wilkin, MD, MPH Stephen J. Wilson, MD ………………………………………………………………………………………………. 23 Research Training Faculty in Other Departments & Institutions …..……………………………………………. 24 RESEARCH PROGRAMS 25-38 Antibiotic Development .................................................................................................................................. 25 Bioterrorism …………..................................................................................................................................... 25-26 Food- and Water-Borne Pathogens ............................................................................................................... 26 Hepatitis ………….......................................................................................................................................... 26-27 HIV/AIDS ……………..................................................................................................................................... 27-29 Hospital Epidemiology and Infection Control ………….................................................................................. 29-30 Human Papillomavirus (HPV) ........................................................................................................................ 30 Leishmania …………..................................................................................................................................... 30-31 Malaria …………............................................................................................................................................ 31-32 Transplantation …………............................................................................................................................... 32 International Programs 33-38 Brazil …………............................................................................................................................................... 33-35 Haiti …………................................................................................................................................................. 35-37 India …………................................................................................................................................................ 37-38 Tanzania ……….……..................................................................................................................................... 38 DIVISION OF INFECTIOUS DISEASES -- INTRODUCTION The mission of the Division of Infectious Diseases at the Weill Medical College of Cornell University and New York-Presbyterian Hospital is to conduct laboratory, translational, clinical, and epidemiologic research; to provide clinical care in both outpatient and inpatient settings; and to provide education and training in infectious diseases. The Division has over 50 full-time, affiliated, voluntary and adjunct faculty members and includes basic, translational, clinical, and epidemiologic research programs; the Infectious Diseases clinical services at New York-Presbyterian Hospital-Weill Cornell Medical Center; the Center for Global Health; and the Infectious Diseases Fellowship Training Program. The Division of Infectious Diseases facilities include over 12,000 square feet of research and administrative space. There are 10 research laboratories (7,500 sq. ft.) equipped for basic and translational molecular, microbiological and immunologic studies, an administrative center, and investigator offices. Major laboratory research projects are ongoing in antibiotic development, bacterial pathogenesis, bioterrorism agents, food- and water-borne pathogens, leishmaniasis, malaria, and tuberculosis. Major clinical research projects are ongoing in bacterial drug resistance, hepatitis, HIV/AIDS, hospital epidemiology/infection control, human papillomavirus, and transplantation. Current funding for sponsored research and training in the Division of Infectious Diseases in 2010-2011 exceeds $10 million. Infectious Diseases outpatient clinical facilities include ID Associates, located across the street from the medical school at 450 East 69th Street. ID Associates includes the Infectious Diseases Faculty Practice, the Infectious Diseases Fellows Clinic, and the Travel Medicine service that is staffed by the faculty and provides travel advice and immunizations for ~3,000 persons annually. The HIV/AIDS Program provides care to over 2,000 HIV-infected persons in New York City, in addition to conducting basic and clinical research. The Center for Special Studies (the HIV primary care clinic, a New York State-designated AIDS Center) and the Cornell HIV/AIDS Clinical Trials Unit (CCTU) outpatient facilities occupy two floors of New York-Presbyterian Hospital as well as an off-site location on the first floor of the Gay Men's Health Crisis (GMHC) building in the Chelsea neighborhood of Manhattan (West 24th Street and Sixth Avenue). The Center for Global Health coordinates the Division's international network of research and training programs, including our activities in Brazil, Haiti, and Tanzania, with full-time faculty at each site. These sites offer clinical and research opportunities for Weill-Cornell medical students, residents, fellows and faculty. Research interests include HIV/AIDS, HTLV-1, malaria, leishmaniasis, leptospirosis, schistosomiasis, and tuberculosis. The Fellowship Training Program in Infectious Diseases provides intensive clinical and research training for developing physician-scientists. Graduates of the program are highly qualified for the practice of infectious diseases; for conducting bench, translational, clinical, and/or epidemiologic research; and to assume leadership roles in medicine. Our fellows typically go on to academic faculty appointments and/or positions in state, federal, or international public health organizations. The ID fellowship training program emphasizes both inpatient and ambulatory clinical training during the first year. The second and subsequent years of fellowship emphasize basic, translational, clinical, or epidemiologic research at Weill- Cornell, Rockefeller University (including the Aaron Diamond AIDS Research Center, ADARC) or the Memorial Sloan-Kettering Cancer Institute. Fellow research training is supported by an NIH-sponsored T- 32 Training Grant. Additional training for fellows is available through separate Masters degree programs in clinical investigation or clinical epidemiology/health services research and other specialized training programs in clinical microbiology, preventive medicine, and public health. 1 DIVISION OF INFECTIOUS DISEASES FACULTY Roy M. Gulick, MD, MPH Professor of Medicine and Chief, Division of Infectious Diseases Susan Ball, MD, MPH Clinical HIV Warren D. Johnson, MD Parasitic Diseases; Associate Professor of Clinical Medicine Professor of Medicine HIV Barry Brause, MD Bone and Joint Sian Jones, MD Clinical HIV Professor of Clinical Medicine Infections Assistant Professor of Medicine David Calfee, MD, MS Hospital Laura A. Kirkman, MD Malaria Associate Professor of Medicine Epidemiology/ Instructor in Medicine Pathogenesis (appointment pending) Infection Control Macarthur Charles, MD, PhD HIV Drug Albert I. Ko, MD [Brazil] Leptospirosis; [Haiti] Resistance Associate Professor of Medicine Meningitis Instructor in Medicine Salvatore Cilmi, MD Hospital Medicine Kristen M. Marks, MD, MS HIV / HCV Co- Assistant Professor of Medicine Assistant Professor of Medicine infection Associate ID Fellowship Director Lewis M. Drusin, MD Nosocomial Samuel T. Merrick, MD Clinical HIV Professor of Clinical Medicine Infections; STDs Associate Professor of Clinical Medicine Laura L. Fisher, MD Lyme Disease Shari R. Midoneck, MD Clinical Infectious Clinical Assistant Professor of Medicine Associate Professor of Clinical Diseases; Women's Medicine Health Daniel W. Fitzgerald, MD HIV; Bioethics Andrew Miller, MD Bone/Joint Associate Professor of Medicine Assistant Professor of Clinical Medicine Infections; Rheumatologic Disease-Associated Infections Marshall Glesby, MD, PhD HIV Clinical Henry W. Murray, MD HIV; Leishmaniasis Associate Professor of Medicine Trials; Professor of Medicine Associate Chief, Division of Infectious Hepatitis C Diseases Linnie Golightly, MD Malaria; Bioterror Thomas W. Nash, MD Clinical Infectious Associate Professor of Clinical Medicine Agents Clinical Assistant Professor of Medicine Diseases ID Fellowship Director Catherine C. Hart, MD Clinical Infectious Oksana Ocheretina, PhD Tuberculosis Clinical Assistant Professor of Medicine Diseases Instructor of Biochemistry in Medicine Barry J. Hartman, MD Antibiotic Anthony Ogedegbe, MD Hospital Medicine Clinical Professor of Medicine Therapy Assistant Professor of Medicine David C. Helfgott, MD Immunocompro- Jean W. Pape, MD [Haiti] Tuberculosis; HIV Clinical Assistant Professor of Medicine mised Hosts Professor of Medicine Jonathan L. Jacobs, MD Clinical HIV Robert Peck, M.D. [Tanzania] Medicine/ Professor of Clinical Medicine Instructor in Medicine Pediatrics Education Stephen Jenkins, PhD Clinical Kyu Y. Rhee, MD, PhD Antibiotic Professor of Pathology and Laboratory Microbiology Assistant Professor of Medicine Development; Drug Medicine Resistance Professor of Pathology in Medicine 2 Richard B. Roberts, MD Antimicrobial Charles A. Steinberg, MD Clinical Infectious Professor Emeritus of Medicine Resistance Professor of Clinical Medicine Diseases Howard E. Rosenberg, MD Clinical Infectious Bruce W. Stewart, MD Clinical HIV Clinical Assistant Professor of Medicine Diseases Assistant Professor of Clinical Medicine Michael A. Rosenbluth, MD Tropical Mark Y. Stoeckle, MD Viral Diseases; Clinical Assistant Professor of Medicine Diseases Clinical Associate Professor of Antibiotics Medicine Mirella Salvatore, MD Immunology Carlos Vaamonde, MD, MSPH Clinical HIV; Assistant Professor of Medicine Assistant Professor of Clinical Medicine Antibiotic Control Audrey Schuetz, MD Clinical Mary A. Vogler, MD Clinical HIV; HIV Assistant Professor of Pathology and Microbiology Assistant Professor of Medicine Clinical Trials; Laboratory Medicine pregnancy Assistant Professor of Medicine Lawrence Siegel, MD Clinical HIV; Scott Weisenberg, MD Antibiotic Instructor in Medicine STDs Instructor in Medicine Resistance; Tuberculosis Harjot K. Singh, MD Clinical HIV Timothy J. Wilkin, MD, MPH HIV Clinical Trials; Instructor in Medicine Assistant Professor of Medicine HPV Duane M. Smith, MD Clinical HIV Stephen Wilson, MD, MPH Hospital Assistant Professor of Clinical Medicine Associate Clinical Professor of Epidemiology/ Medicine (appointment pending) Infection Control Paul T. Smith, MD Clinical Infectious Cecilia Yoon, MD Clinical HIV; Clinical Assistant Professor of Medicine Diseases Assistant Professor of Medicine Medical Education Rosemary Soave, MD Transplantation Clinical Associate Professor of Medicine ADJUNCT FACULTY Edgar M. Carvalho, MD, PhD Immunology; Susan C. Nicholson, MD Skin and Soft [Brazil] Leishmaniasis Assistant Professor of Medicine Tissue Infections Adjunct Professor of Medicine (courtesy) R. Gordon Douglas, Jr., MD Vaccines Mina Pistagia, MD Staphylococcus Adjunct Professor of Medicine [Rockefeller U.] aureus Adjunct Assistant Professor of Medicine Thomas C. Jones, MD Clinical Trials Steven G. Reed, PhD Antigen Discovery Adjunct Professor of Medicine Adjunct Professor of Microbiology in Medicine Jose R. Lapa e Silva, MD, PhD TB Pathogenesis Lee W. Riley, MD Molecular [Brazil] [U. California, Berkeley] Epidemiology Adjunct Professor of Immunology in Adjunct Professor of Medicine Medicine Martin H. Markowitz, MD HIV [Rockefeller U.] Adjunct Assistant Professor of Medicine 3 INFECTIOUS DISEASES FELLOWSHIP TRAINING PROGRAM Mission The major goal of our program is the training of academic physician-scientists. We provide a wide variety of clinical training experiences in different venues including: the inpatient consult services of New York- Presbyterian (NYPH)/Weill Cornell, the Hospital for Special Surgery (orthopedics, rheumatology), and Memorial Sloan Kettering Cancer Center; weekly outpatient clinic experiences encompassing general ID, HIV/AIDS, and travel medicine; clinical elective rotations; clinical microbiology laboratory and hospital epidemiology rotations; and a sexually transmitted disease rotation at the NYC Department of Health. All fellows develop a research project in collaboration with one or more faculty mentors from Weill-Cornell, Rockefeller University, or Memorial Sloan-Kettering Cancer Center. Fellows' research projects span basic, translational, clinical, and epidemiologic research in diverse areas of investigation. The majority of our fellowship graduates seek careers either in academia, government or with private foundations. Clinical Rotations The clinical rotations are concentrated in the first year of the training program. The New York- Presbyterian Hospital-Weill Cornell Medical Center is the primary institution of our fellowship training program. The medical center is located in a large clinical and research complex on the Upper East Side of Manhattan. New York-Presbyterian Hospital is the current name of what were formerly two distinct institutions: the Cornell-New York Hospital and the Columbia-Presbyterian Medical Center. Currently, New York-Presbyterian Hospital is the largest health care facility in the New York Metropolitan area and one of the largest in the world. The Greenberg Pavilion of the New York-Presbyterian Hospital (Cornell campus) is a one million square foot facility with 840 patient beds. Weill-Cornell Medical College and Columbia College of Physicians and Surgeons remain independent institutions with separate infectious diseases fellowship programs. First-year fellows spend ~10 months on clinical rotations and second-year fellows spend ~2 months. Our active consultation service serves a broad range of complex medical and surgical patients. On average, the consult service manages 80-90 inpatient consults per month from both New York-Presbyterian Hospital as well as Hospital for Special Surgery (affiliated 192-bed hospital renowned for treatment of orthopedic and rheumatologic conditions). A PharmD specializing in ID participates actively on the consult service. Fellows spend a minimum of one month in the Clinical Microbiology Laboratory and in the Hospital Epidemiology/Infection Control Department. Memorial Sloan-Kettering Cancer Center (MSKCC), located across the street, is a private hospital specializing in oncologic evaluation and treatment. Fellows spend one month on the MSKCC inpatient consultation service during their first year. Fellows rotate through selected clinical electives including cardiovascular and neurologic infections, HIV/AIDS, neutropenic and non-HIV immunocompromised hosts, orthopedic and rheumatologic infections, pediatric infectious diseases, and bone marrow/solid organ transplantation (including kidney, liver, and pancreas). First- and second-year fellows participate in a weekly continuity outpatient clinic that alternates between care for patients with general infectious diseases and for patients with HIV/AIDS. Through the ambulatory care system, fellows build a panel of patients who they will follow over the course of the fellowship, with guidance from a faculty preceptor. Fellows also participate actively in the care of patients seeking consultation prior to international travel. 4 Sample schedule of the first two fellowship years: Month First Year Second Year Vacation July NYPH Consult Service Research Vacation August Microbiology Rotation/Travel NYPH Consult Service Medicine September NYPH Consult Service Research NYPH Consult Service October Research Research Memorial Sloan Kettering Cancer November Research Center Consult Service Epidemiology Rotation/Travel Research December Medicine Vacation Clinical Elective #1 January NYPH Consult Service NYPH Consult Service Clinical Elective #2 STD Clinic Rotation February Clinical Elective #3 Research Vacation March Research Research April NYPH Consult Service Research Clinical Elective #4 May Research NYPH Consult Service NYPH Consult Service June Research Clinical Elective #5 During the epidemiology and microbiology rotations, the fellows see patients in Travel Medicine one evening per week. Clinical Electives: • Bone marrow and solid organ transplantation – Rosemary Soave, MD • Cardiovascular/Neurosurgical Infections – Barry Hartman, MD • HIV Outpatient Interdisciplinary Care Team – Harjot Singh, MD • Neutropenic Hosts (leukemia service) – David Helfgott, MD • Orthopedic/Rheumatologic Infections – Barry Brause, MD • Pediatric infectious diseases – Christine Salvatore, MD Basic, Translational, Clinical, and Epidemiologic Research Research training occupies the majority of the second and third years of fellowship. Fellows select from a broad range of research opportunities in basic, translational, clinical or epidemiologic research. Fellows conduct their research in the Weill-Cornell Division of Infectious Diseases, other divisions within the Department of Medicine (e.g. Gastroenterology/Hepatology), other departments within the Medical College (e.g. Department of Microbiology and Immunology, Department of Public Health), Rockefeller 5 University, or the Memorial-Sloan Kettering Cancer Center. Faculty mentorship from these diverse institutions allows a wide diversity of research opportunities. The Division has an NIH-sponsored T32 training grant to support research training of developing physician-scientists that supports fellows during their research years. The objective is to train physician- scientists in biomedical research, with an emphasis on the pathogenesis of infectious diseases. Weill Cornell has an NIH-funded Clinical and Translational Science Center (CTSC) with state-of-the-art facilities for conducting translational and clinical research. Division fellowship graduates have generally received independent research awards following their fellowship, primarily from the NIH, including K08 (Mentored Clinical Scientist Development Award) and K23 (Mentored Patient-Oriented Research Career Development Award) awards. Research topics for these awards have included bioterrorism, HIV pathogenesis, HIV/TB coinfection, HIV vaccine development, HTLV-1, human papillomavirus, KSHV/HHV8, leishmania pathogenesis, leptospirosis, malaria, tuberculosis, and viral hepatitis. Supplemental Training Programs Other training programs within the medical college are available to supplement fellowship training, depending on the fellow's specific interests. Clinical Research Training: Certificate and Masters Degree Programs http://www.med.cornell.edu/clinicalresearch/ –The Graduate Program in Clinical and Translational Investigation at Weill Cornell Medical College trains patient-oriented researchers to conceive, design, and conduct independent clinical research in a well-structured cross-disciplinary team environment. The National Institutes of Health funds this program through their Clinical & Translational Science Award. The curriculum offers two tracks that are designed for rigorous training in clinical investigation. Track I is a core curriculum providing the basic skills of clinical investigation, leading to a Certificate of Clinical Investigation. It includes training in the development of research hypotheses and methods of hypothesis testing; grant writing and manuscript preparation; data collection, construction of databases and data management systems; computer programs for data analysis; statistical analysis and the appropriate use of various statistical techniques in clinical research; basic epidemiologic principles in clinical research; design and conduct of meta-analyses and clinical trials; ethics and human subjects protection in the conduct of patient-oriented research; regulatory requirements of clinical research; preparing protocols for the Institutional Review Board and other agencies; grants management and intellectual property; and general and specific state-of-the-art research tools and techniques. Track II, leading to a Masters Degree in Clinical Investigation, includes the core curriculum (Track I); additional electives in the trainee's area of interest; and a clinical research project mentored in its design and implementation by a clinical investigator. Members of the Infectious Disease Division (Drs. Glesby, Gulick, Wilkin) serve as faculty for this training program. Several of our fellows and junior faculty members have used this program to supplement their training as clinical researchers. Tuition is free. Preventive Medicine Training http://www.med.cornell.edu/public.health/res_gen.html – Weill Cornell's Department of Public Health offers a General Preventive Medicine Training Program, for which ID fellows are eligible after their initial year of clinical ID training. As part of the General Preventive Medicine Program, fellows are eligible to apply for an MPH program from the Columbia University School of Public Health and also are eligible for certification by both the American Board of Internal Medicine / Infectious Diseases and the American Board of Preventive Medicine. The program emphasizes epidemiology, biostatistics, clinical and preventive medicine, medical care organization, medical sociology, and health economics and education. Fellows take classes at Columbia and participate in Cornell's Public Health seminars and teaching program for undergraduate and medical students. Fellows also undertake an original research project. 6 Each fellow will have an individual program designed to meet his/her specific professional goals. Fellows have used this program to supplement their training in hospital epidemiology and public health. Fellowship in Public Health Research http://www.med.cornell.edu/publichealth/education_and_training/residencies_and_fellowships.html In the second fellowship year, it is possible to facilitate a 1-2 year public health research experience in the Department of Public Health. Activities include mentored research and coursework in the Weill Cornell Masters Degree Program in Clinical Investigation. Supervised research including mentors from the Division of Infectious Diseases and faculty from the Department of Public Health is a key part of the training program. The fellowship also uses the conference and review procedures for post-graduate training in the Department of Public Health and leads to a certificate recognizing advanced public health research. Medical Microbiology Fellowship Program The Clinical Microbiology Laboratory offers a one-year ACGME-accredited fellowship in Medical Microbiology designed to train pathologists and infectious disease specialists for academic careers in Medical Microbiology, focusing on a combination of clinical research training and direction of laboratory services. Medical Microbiology fellows will primarily rotate through the Clinical Microbiology Laboratory of New York-Presbyterian Hospital-Weill Cornell Medical Center. In addition, fellows will spend time in the infectious disease-related serology section of the Central Laboratory and in the microbiology-related section of the Molecular Pathology Laboratory. A one-month rotation on the patient care units with members of the Infectious Disease service, followed by weekly rounds with the Infectious Disease team, is also a component of the scheduled curriculum. The program provides individualized training through faculty guidance, mentored research, and didactic lectures. Trainees will gain hands-on experience in all aspects of clinical microbiology including bacteriology, mycobacteriology, mycology, parasitology, virology, antimicrobial susceptibility testing, infectious disease molecular testing, and serology through structured bench rotations. The fellows will participate in test development and evaluation as well as applied clinical research. The Medical Microbiology fellow not only will provide interfaces between Clinical Microbiology, Pathology, and Infectious Diseases, but will also aid in further education to clinicians and nursing staff on the importance of laboratory medicine in patient care, as well as the most appropriate methods for collection and transport of clinical specimens for diagnosis of infectious diseases. This fellowship will help prepare participants for a career in directing a clinical microbiology laboratory. Graduate Program in Clinical Epidemiology & Health Services http://www.cornellmedicine.com/clinical_practices_and_divisions/general_internal_medicine/education The Graduate Program in Clinical Epidemiology & Health Services offers an 8-week intensive summer program or a 2-4 year Master of Science (MS) degree in Clinical Epidemiology & Health Services Research. The program is designed for fellows who wish to plan, implement and analyze quantitative and qualitative research studies, using appropriate research designs. The core of the curriculum includes research methodology, biostatistical techniques, data management, decision analysis, health economics and program evaluation. Graduates of the Masters program will be prepared to pursue academic careers in a variety of settings where data is required to answer complex questions. The emphasis is on training clinician researchers to teach research methods, conduct methodologically rigorous and scientifically sound studies, evaluate programs and perform cost-effectiveness and cost- benefit studies in a variety of populations. Research and Training Programs for International Biomedical Researchers http://weill.cornell.edu/globalhealth/education/graduate_students_and_post_doctoral_fellows_1/ We offer an international research and training program in global infectious diseases/HIV-AIDS designed to increase the capability of scientists in foreign countries, and especially in developing countries, conduct their own research. Cornell clinical and research fellows may collaborate with the international fellows on these research projects. The program focuses on training Brazilian and Haitian health 7 professionals. The training program includes work that will lead to a M.S. or Ph.D. degree, training for 3-6 months in laboratory procedures and research techniques, and practical and applied short-term training courses. Long-standing research and training programs between the Division of Infectious Diseases at Cornell and the Federal Universities of Bahia and Rio de Janeiro, Brazil and GHESKIO Centers in Haiti provide the infrastructure and framework for the coordination of this training program with ongoing overseas research efforts. A small number of U.S. physicians with an interest in global health who plan to conduct their thesis research abroad also are admitted to this program. Conferences A variety of conferences are available to support education and training of Infectious Diseases Fellows and include: • Advanced Topics in Infectious Diseases (weekly lectures from WMC and MSKCC faculty or outside speakers on diverse topics) • Clinical Case Conference (weekly discussion of cases led by the fellows) • Core Topics in Infectious Diseases (weekly basic lectures during the summer) • Department of Microbiology and Immunology Research-In-Progress talks (monthly) • Faculty Journal Club and Research Conference (alternating biweekly) • Fellow Journal Club (weekly) • HIV Conference (weekly alternating with journal club, lectures, and discussion of ongoing clinical trials) • ID Fellow Research-In-Progress talks • Intercity Infectious Disease Rounds (monthly rotating with other institutions in the New York area) • Medical Grand Rounds (weekly) • Microbiology Laboratory Plate Rounds (weekly review of interesting specimens, often from the clinical service, from the lab) 8 CURRENT INFECTIOUS DISEASES FELLOWS (2010 – 2011) Year of Internal Medicine Name Medical School Research Project Fellowship Residency Molecular epidemiology and mechanisms of drug Elizabeth Alexander, MD 4 Weill Cornell Mt. Sinai resistance in S. aureus; Certificate Program in Clinical Investigation Female urogenital schistosomiasis; Masters of Jennifer Downs, MD 4 Weill Cornell Columbia Science program in Clinical Epidemiology and Health Services Research Stavudine-related peripheral neuropathy in HIV Virginia Commonwealth infection; Masters of Science program in Clinical Meera Pahuja, MD 3 Weill Cornell University Epidemiology and Health Services Research ( application pending) Quality of HIV care; HIV risk behaviors in Rituparna Pati, MD, MPH 3 University of Connecticut Weill Cornell adolescents in NYC; Preventive Medicine Program Treatment of multi-drug resistant gram-negative Michael Satlin, MD 3 University of Virginia Weill Cornell infections; Masters Program in Clinical Investigation Kathryn Dupnik, MD 2 University of Virginia Columbia Leprosy Latent TB and HIV in pregnancy; Masters of Jyoti Mathad, MD 2 Albany Medical College Maryland Science program in Clinical Epidemiology and Health Services Research (application pending) Selin Somersan, MD 2 Harvard Weill Cornell Pathogenesis of M. tuberculosis Samantha Jacobs, MD University of Pennsylvania Mount Sinai Medical 1 TBA School of Medicine Center University of Daniel Shirley, MD University of Kansas 1 Colorado Health TBA School of Medicine Sciences Center Albert Einstein College of Matthew Simon, MD 1 Medicine/Yeshiva Weill Cornell TBA University 9 FORMER INFECTIOUS DISEASES FELLOWS (since 1999) Internal Medicine Period of Fellowship Training and Name Medical School Current Position Residency Research Topic University of University of 1999-2002 Kamran Khan, MD, MPH Assistant Professor, University of Toronto Toronto Minnesota Immigrant health 1999-2001 Cecilia Yoon, MD Mt. Sinai Mt. Sinai Assistant Professor, Weill Cornell HIV clinical trials 2000-2003 Associate Professor & Associate Hospital Gonzalo Bearman, MD, MPH SUNY Buffalo SUNY Buffalo Epidemiologist, Virginia Commonwealth Nosocomial infections University 2000-2002 Assistant Director, Office of Epidemiology Kiren Mitruka, MD UMDNJ Yale-New Haven Malaria gene expression and Disease Control, CDC/Miami-Dade County Dept of Health Escuela Colombiana de University of 2000-2002 Physician, I.D. Associates of Central Johanna Reina, MD Virginia, Lynchburg, VA Medicina, North Carolina Leishmaniasis therapy Colombia 2001-2004 Medical Director, Discovery Medicine, David Gardiner, MD Jefferson Jefferson Virology Research and Development, HIV vaccines Bristol-Myers Squibb 2001-2005 University of Kyu Rhee, MD, PhD Weill Cornell Tuberculosis Assistant Professor, Weill Cornell California, Irvine 2002- 2005 Kristen Marks, MS, MD Columbia Weill Cornell HIV/HCV hepatic steatosis Assistant Professor, Weill Cornell 10 Free University, University of 2002-2006 Assistant Professor, Hamburg Institute for Matthias Frank, MD, PhD Berlin, Germany Washington Malaria antigens Tropical Medicine, Germany Universidad 2003-2006 St. Luke's- Instructor in Clinical Investigation, Marina Caskey, MD Federal de Roosevelt HTLV-1 epidemiology Rockefeller University Sergipe, Brazil 2003-2007 Macarthur Charles, MD, PhD Albert Einstein Weill Cornell Instructor in Medicine, Weill Cornell HIV drug resistance 2004-2007 Instructor in Medicine, Weill Cornell, Sandra Kesh, MD Cornell Weill Cornell Antibiotic pharmacology Westchester Medical Group 2004-2008 Laura Kirkman, MD Albert Einstein Yale-New Haven Instructor in Medicine, Weill Cornell Malaria 2004-2008 Assistant Professor of Epidemiology and University of University of Daniel Morgan, MD Preventive Medicine, University of Rochester Rochester HTLV-1 & MRSA Maryland Beth Israel- 2005-2008 Lawrence Siegel, MD Brown Instructor in Medicine, Weill Cornell Deaconess HPV infection University of 2005-2008 Scott Weisenberg, MD Tufts California, San Instructor in Medicine, Weill Cornell Diego Tuberculosis Massachusetts 2006-2010 Clinical Research Fellow, Massachusetts Dahlene Fusco, MD Albert Einstein General Hospital Immune responses to influenza General Hospital 11 ID DIVISION CURRENT RESEARCH AND TRAINING GRANTS 2010 - 2011 Selected current research and training grants of the faculty and fellows in the Division of Infectious Diseases are listed below. There are opportunities for fellows to participate in these research projects, as well as with investigators at Rockefeller University or Memorial Sloan- Kettering Institute. 1. Pathogenesis of Leishmaniasis: Host, Parasite and Vector – Tropical Medicine Research Center (TMRC). E Carvalho, WD Johnson. NIH P50 AI30639. 1991-2012. 2. Tropical Infectious Disease Training Grant. E Carvalho, WD Johnson. NIH D43 TW007127, 2004-2010. 3. Monitoring Response to ARV Therapy and Development of HIV-1 Drug Resistance. M Charles. 5K23 AI073190. 2008-2013. 4. Amos Medical Faculty Development Award. M Charles. Robert Wood Johnson Foundation. 2008-2012. 5. Fogarty International Clinical Research Scholars - Haiti D Fitzgerald, WD Johnson, JW Pape. NIH 5R24 TW0007988. 2004-2011 6. Haitian Research-Training Program in AIDS Related Cervical Cancer. DW Fitzgerald. NIH D43TW000018-21S1. 2006-2010. 7. AIDS International Training and Research Program. DW Fitzgerald. Fogarty International Center. 3 D43 TW000018-22S1. 2009-2011. 8. Clinical Trials for HIV Infection and HIV-Related Diseases. MJ Glesby, RM Gulick, K Marks, M Vogler, TJ Wilkin. Multiple Sources. 1999-2013. 9. NY/NJ AIDS Education and Training Center (AETC). MJ Glesby, RM Gulick. Health Research Services Administration (HRSA), CU H4A HA00071. 2002-2010. 10. The Women's Interagency HIV Study (WIHS/subcontract). MJ Glesby. NIH UO1 AI35004. 2003-2012. 11. Growth Hormone and/or Rosiglitazone for Visceral Adiposity in HIV. MJ Glesby. NIH R01 DK065515. 2004-2010. 12. Fogarty International Clinical Research Scholars Program – The Salvador, Brazil Training Program for Tropical Disease Research. MJ Glesby, E Carvalho, A Ko, WD Johnson. NIH R24 TW007988. 2004-2011. 13. Complications of Chronic Viral Infections. Mid-Career Investigator Award in Patient- Oriented Research. MJ Glesby. NIH K24 AI07884. 2008-2013. 14. Multiplexed Detection of Food and Waterborne Pathogens. F Barany, LM Golightly, D Larone. NIH U01 AI075470. 2007-2012. 15. Antiretroviral Therapy. Mid-Career Investigator Award in Patient-Oriented Research. RM Gulick. NIH K24 AI51966. 2003-2013. 16. Cornell HIV Clinical Trials Unit (ACTU). RM Gulick, MJ Glesby, K Marks, M Vogler, TJ Wilkin. NIH U01 AI69419. 2007-2013. 17. H1N1 Influenza - Observational Studies in Inpatients and Outpatients. RM Gulick, MJ Glesby, M Salvatore, TJ Wilkin. NIH-funded INSIGHT Clinical Trials Network. 2009- 2011. 12 18. H1N1 Clinical Trials Site. RM Gulick, MJ Glesby, M Salvatore, TJ Wilkin. NIH Division of Clinical Research. 2009-2011. 19. AIDS International Training and Research Program. WD Johnson. NIH D43 TW00018. 1988-2013. 20. Pathogenesis of Infectious Diseases Training. WD Johnson, MJ Glesby. NIH T32 AI07613.1999-2014. 21. Caribbean HIV/AIDS Regional Training/CHART Initiative (I-TECH). WD Johnson. HRSA UW U69HA00047. 2004-2011. 22. Haiti Research Training: Models to Implementation (ICOHRTA). WD Johnson. NIH U2R TW06901. 2004-2014. 23. Framework Program for Global Health. WD Johnson. NIH R25 TW007736. 2006- 2010. 24. M. tuberculosis Proteins to Enhance the Sensitivity of TB Serodiagnostic Assay. WD Johnson. Foundation for Innovative New Diagnostics (Bill & Melinda Gates Foundation). 2007-2011. 25. Genetic Diversity in Virulence Genes of Plasmodium falciparum. L Kirkman. 1K08 AI076635. 2008-2013. 26. Emerging Infectious Diseases and Urbanization. AI Ko, WD Johnson. NIH D43 TW00919. 1997-2010. 27. Natural History of Leptospirosis. AI Ko. NIH RO1 AI052473. 2003-2014. 28. Transmission of Drug-Resistant Streptococcus Pneumoniae in Brazil. JN Reis, AI Ko. NIH R01 TW007303. 2005-2010. 29. Rapid Serodiagnostic Test for Leptospirosis. K Lyashchenko, AI Ko. NIH R43- AI072856. 2007-2012. 30. Thrombocytopenia and HIV/HCV: Risk Factors and Treatment. K Marks. NIH K23 AI065319. 2005-2010. 31. Immunochemotherapy in Visceral Leishmaniasis. H Murray. NIH R01 AI083219. 2010-2015. 32. Comprehensive International Program of Research on AIDS (CIPRA). JW Pape, WD Johnson, DW Fitzgerald. NIH UO1 AI010018. 2003-2011. 33. Haiti Research Training: Models to Implementation (ICOHRTA). JW Pape. NIH U2R TW06901. 2004-2014. 34. International Clinical Trials Unit (Haiti CTU). JW Pape, RM Gulick, DW Fitzgerald, WD Johnson. NIH U01 AI069421-01. 2006-2013. 35. Caribbean, Central South America Network: CCASAnet (IEDEA). JW Pape. NIH 5 U01 AI06992303. 2007-2010. 36. Epidemiology of HPV Related Cervical Diseases in Haiti. JW Pape. International Development Research Centre (IDRC) of Canada. C111-2, HIT-05. 2009-2012. 37. Enzymes of Intermediary Metabolism in Mycobacterium tuberculosis: Anti-Mycobacterial Targets of Nitric Oxide. KY Rhee. Burroughs Wellcome Career Award in the Biomedical Sciences. 2005-2010. 38. Applied Research in Antimicrobial Resistance: Studies of Susceptibility Testing on Gram-negative Multidrug Resistant Organisms. KY Rhee (Co-PI), L Saiman (PI). NIH/CDC. 2007-2010. 13 39. Metabolosomes: The Organizing Principle of Latency in Mycobacterium tuberculosis. KY Rhee. Bill and Melinda Gates Foundation Grand Challenges Exploration. 2009- 2010. 40. Metabolomics Approaches to TB Drug Development. KY Rhee. NIH/NIAID R21. 2009- 2010. 41. Metabolomics Approaches to Antibiotic Resistance. KY Rhee. NIH/CTSC Pilot Award. 2009-2010. 42. Nuclear Hormone Receptor-Dependent Regulation of Host Susceptibility to Mtb. KY Rhee. Stony Wold Herbert Fund. 2009-2010. 43. AIDS Malignancy Consortium (subcontract). TJ Wilkin. NIH U01 CA121947. 2008- 2011. 14 PROFILES OF CORE FACULTY Barry Brause, MD Professor of Clinical Medicine and Director of Infectious Diseases at Hospital for Special Surgery. Dr. Brause was trained in infectious diseases at Cornell and he has been a member of the Infectious Diseases division since 1973. His clinical research has focused on musculoskeletal infections and particularly on infections associated with indwelling foreign materials and prostheses. Dr. Brause has taken part in major national meetings and workshops as an invited participant including the National Institute of Arthritis and Musculoskeletal Disease, the American Dental Association, Council on Dental Therapeutics and the Infectious Diseases Society of America/ Interscience Conference on Antimicrobial Agents and Chemotherapy. He has authored chapters on bone and joint infections in the last five editions of Principles and Practice of Infectious Diseases and on "Osteomyelitis" in three recent editions of Cecil-Textbook of Medicine. firstname.lastname@example.com David Calfee, MD, MS Associate Professor of Medicine and Chief Hospital Epidemiologist (starting May 2010). Dr. Calfee trained in internal medicine and infectious diseases at the University of Virginia, and received his MS in health evaluation sciences (epidemiology) at the University of Virginia. His research and clinical interests focus on the epidemiology and prevention of healthcare-associated infections. Dr. Calfee previously served as the deputy editor of Infection Control and Hospital Epidemiology and was the chair of the Patient Safety and Quality Improvement committee of the Society for Healthcare Epidemiology of America (SHEA). Specific research interests include the clinical and molecular epidemiology of multidrug-resistant bacteria (such as K. pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae and methicillin-resistant S. aureus (MRSA)), surgical site infections in solid organ transplant recipients, and prevention of vascular access-associated bloodstream infections in New email pending hemodialysis patients. Macarthur Charles, MD, Ph.D. Instructor in Medicine. Dr. Charles received his MD and PhD degrees from the Albert Einstein College of Medicine. He received clinical training in internal medicine and infectious diseases at the New York Presbyterian-Weill Cornell Medical Center, where he was also the recipient of the Alpha Omega Alpha Medical Honor Society Teaching Award. Dr. Charles' research interests include response to antiretroviral therapy and the development of HIV drug resistance. Currently, he is based full-time at the GHESKIO Centers in Port-au-Prince, Haiti. He is the recipient of a NIH-sponsored Mentored Patient-Oriented Research Career Development Award (K23). email@example.com 15 Daniel W. Fitzgerald, MD Associate Professor of Medicine. Dr. Fitzgerald trained in internal medicine and infectious diseases at the Massachusetts General Hospital. His areas of interest include HIV/AIDS prevention and therapeutic clinical trials and targeted evaluations of HIV/AIDS and TB service programs in Haiti. He is an investigator in: HIV Vaccine Trials to determine the efficacy of an adenovirus 5 recombinant HIV vaccine; a randomized study to determine the optimal time to start antiretroviral therapy in resource- poor countries; studies of drug resistance in Haiti and effects of tropical diarrhea/malnutrition on antiretroviral therapy. Other interests include improving informed consent and empirical studies to inform ethical guidelines for the conduct of clinical research in resource-poor countries. He is on the faculty committee for the Weill-Bugando Program in Mwanza, Tanzania. He is Chair of the Cornell International Education Committee, which oversees international medical student electives and the Co-Director of the Center for Global Health within the email@example.com ID Division. Marshall J. Glesby, MD, PhD Associate Professor of Medicine and Public Health and Associate Chief, Division of Infectious Diseases. Dr. Glesby trained in internal medicine and in infectious diseases at Johns Hopkins and also received a Ph.D. in clinical investigation from the Johns Hopkins School of Hygiene and Public Health. His research interests include metabolic and cardiovascular complications of antiretroviral therapy and viral co-infections in HIV. Current projects include interventions for insulin resistance and increased visceral fat in HIV-infected patients with lipodystrophy, optimization of management of HCV/HIV co-infection, and epidemiology of HTLV-1 in Brazil. He is Vice Chair of the Hepatitis Committee of the AIDS Clinical Trials Group and a member of the group's Scientific Advisory Steering Committee. Dr. Glesby also directs the HIV/AIDS Clinical Trials Unit at Weill Cornell and serves on the Adult Translational Research and Multi-Institutional/ Disciplinary Advisory Committees of the Weill Cornell Clinical & email@example.com Translational Science Center. Linnie M. Golightly, MD Associate Professor of Clinical Medicine and Microbiology and ID Fellowship Director. Dr. Golightly trained in internal medicine at Harlem Hospital and in infectious diseases and molecular parasitology at Harvard University. Dr. Golightly's research interests include: (1) The development and validation of ligase detection reaction (LDR) techniques combined with PCR, capillary electrophoresis, and Universal Arrays to simultaneously differentiate multiple microbial pathogens in a single sample. Dr. Golightly's laboratory is employing high throughput screening platforms using microbial signature profiles to detect Dengue, West Nile and other emerging pathogens in blood as well as food and waterborne pathogens in stool samples. The later studies are being performed in collaboration with the Noguchi Memorial Institute for Medical Research (NMIMR) in Accra, Ghana and GHESKIO in Port-au-Prince, Haiti. (2) Elucidation of the pathogenesis of cerebral malaria. These studies are being performed in collaboration with investigators at the NMIMR in email@example.com Accra, Ghana. 16 Roy (Trip) M. Gulick, MD, MPH Professor of Medicine and Chief of Division of Infectious Diseases. Dr. Gulick trained in internal medicine at Columbia and in infectious diseases at Harvard, and received his MPH in clinical trial design from the Harvard School of Public Health. His research focuses on clinical trials of antiretroviral therapies for treatment and prevention of HIV infection. Dr. Gulick currently serves as Principal Investigator of the Cornell Clinical Trials Unit of the NIH-sponsored AIDS Clinical Trials Group (ACTG). He also serves as a member of the Panel for Clinical Practices for Treatment of HIV Infection, U.S. Department of Health and Human Services, and is a Board Member of the International AIDS Society-USA. Current projects include studies of new antiretroviral agents (e.g. the investigational HIV chemokine receptor inhibitor, vicriviroc) evaluating strategies for both antiretroviral therapy-naïve and -experienced HIV-infected patients, and exploring antiretroviral therapy as a prevention strategy (PREP, pre- firstname.lastname@example.com exposure prophylaxis). Barry J. Hartman, MD Clinical Professor of Medicine. Dr. Hartman completed his medicine and infectious disease fellowship training at Cornell. Dr. Hartman did his basic research in the Alexander Tomasz laboratory of the Rockefeller University in New York City studying the mechanism for methicillin-resistance in the Staphylococcus aureus. His current focus is clinical care and education and his interests include antibiotics and antibiotic resistance, surgical infections and endocarditis. He has received several teaching awards from students and house staff. He has been the Formulary & Therapeutics Committee Chairman and Co-Chairman at the New York- Presbyterian Hospital for the past 20 years. firstname.lastname@example.com David C. Helfgott, MD Assistant Clinical Professor of Medicine. Received his B.A. at the University of Pennsylvania and his M.D. at the Yale School of Medicine. Dr. Helfgott did his internship and residency at The New York Hospital and his Infectious Diseases fellowship at Cornell University Medical College. During his fellowship, Dr. Helfgott was involved in the study of inflammatory cytokines, in particular IL-6, in the laboratory of Dr. Igor Tamm, and he continued this research as an Assistant Professor of Medicine at Cornell University Medical College for several years after completing his fellowship. Dr. Helfgott is an author on several peer-reviewed publications which studied interleukin-6. Since 1994, Dr. Helfgott has been involved in direct patient care and teaching as an Assistant Attending Physician at The New York-Presbyterian Hospital and an Assistant Clinical Professor of Medicine at Weill Medical College. email@example.com 17 Warren D. Johnson, Jr., MD The Ben Kean Professor of Medicine and Director, Center for Global Health in the ID Division. He is the former Chief of the Division of International Medicine and Infectious Diseases. Dr. Johnson's career has been committed to research and training in infectious diseases, particularly in resource poor countries. His research interests have included clinical and epidemiological studies of AIDS, tuberculosis, and leishmaniasis. His research has received uninterrupted NIH and Foundation support in Brazil (1969-2012) and in Haiti (1979-2013), including a NIH Merit Award (1990). He has also established outstanding training programs in Brazil, Haiti, and Tanzania. He has chaired numerous NIH Research Committees and served on the NIAID National Advisory Council. He also served as a Director of the ABIM, Chair of the ABIM Infectious Diseases Subspecialty Board, and as a Councilor of the Infectious Diseases Society of America. Dr. Johnson recently received the honor of having the new clinical facility of the GHESKIO Institute for Infectious firstname.lastname@example.com Diseases and Reproductive Health in Haiti named for him. Laura A. Kirkman, MD Instructor in Medicine. Dr. Kirkman received her M.D. from Albert Einstein College of Medicine with distinction in research. She completed her clinical training in internal medicine at Yale-New Haven Hospital and her infectious disease training at the New York-Presbyterian-Weill Cornell Medical Center followed by a postdoctoral fellowship in the laboratory of Dr. Kirk Deitsch in the Department of Microbiology and Immunology. Dr. Kirkman's current research focuses on the DNA repair mechanisms in the human malaria parasite, Plasmodium falciparum, and how DNA damage and repair in the parasite relates to diseases pathogenesis. Specifically examining the generation of genetic diversity in genes that encode the key proteins implicated in antigenic variation and the generation of drug resistance. Dr. Kirkman is the recipient of an NIH K08 grant. email@example.com Albert I. Ko, MD Associate Professor of Medicine. Dr. Ko trained in internal medicine at the Brigham and Women's Hospital and in infectious diseases at the Massachusetts General Hospital. He is located full-time in the city of Salvador, Brazil where he coordinates an NIH-supported research and training program that the Division has established with the Oswaldo Cruz Foundation, Brazilian Ministry of Health. The program focuses on infectious disease problems that have emerged as a consequence of rapid urbanization and urban poverty in Brazil and other developing countries. Current research includes community-based cohort studies on the natural history of urban leptospirosis and pneumococcal disease; development of rapid diagnostic tests and recombinant sub-unit vaccines for leptospirosis; active population-based surveillance for emerging infectious diseases and the use of molecular epidemiology to study the transmission of bacterial meningitis and acute respiratory infections. email@example.com 18 Kristen Marks, MD, MS Assistant Professor of Medicine and Associate ID Fellowship Director. Dr. Marks received internal medicine and ID fellowship training at New York-Presbyterian Hospital, where she focused her clinical training and research on HIV and hepatitis virus infections, and she recently completed Weill Cornell's Masters Degree in Clinical Investigation. Her current research focuses on improving treatment outcomes in patients with HIV and hepatitis virus co-infections and includes studies of acute HCV as well as new treatment strategies for chronic HCV. She also serves as a co- investigator in the Cornell HIV/AIDS Clinical Trials Unit and Center for Study of Hepatitis C. She is the recipient of an NIH-sponsored Mentored Patient-Oriented Research Career Development Award (K23). email@example.com Andrew O. Miller, MD Assistant Professor of Clinical Medicine and Assistant Attending Physician at the Hospital for Special Surgery. Dr. Miller received his B.Sc. at Yale College and his M.D. at Harvard Medical School. He then trained in Internal Medicine at Columbia-Presbyterian and in Infectious Diseases at NYU. From 2007 to 2010 he was an ID consultant and HIV primary care doctor at Bronx- Lebanon Hospital. He is the author of several peer-reviewed publications. Dr. Miller provides consultative ID services to patients at both HSS and NYH. He is interested in developing clinical research programs to study infections in patients receiving new biologic agents for rheumatologic disease, and to study outcomes of patients with surgical bone/joint infections. email@example.com Henry W. Murray, MD The Arthur R. Ashe Professor of Medicine. Dr. Murray is an expert in macrophage activation, immunopathogenesis of infection caused by intracellular pathogens, in particular, Leishmania, and the chemo- and immunochemotherapy of leishmaniasis. Dr. Murray's long-term, NIH-supported research is currently focused on immunoregulation of the host response to antileishmanial chemotherapy in experimental visceral leishmaniasis (kala-azar). This work has in part formed the basis of experimental treatment trials in Indian patients at the internationally-recognized kala- azar clinical trials unit he co-directs in Bihar State, India. Dr. Murray received the Squibb Award (1989) from the Infectious Diseases Society of America for outstanding achievement in infectious diseases, and previously was Chief of the Division of Infectious Disease (1983-1995) and Associate Chairman of Medicine for Clinical Research (1995- 2007). Dr. Murray is currently Director of the Arthur Ashe Endowment firstname.lastname@example.com for the Defeat of AIDS, Editor of the travel medicine web site, Tropimed U.S., and chairs the Department of Medicine's Quality Assurance Committee. 19 Jean W. Pape, MD Professor of Medicine. Dr. Pape completed his medicine and ID training at Cornell, prior to returning to his native Haiti in 1980. In 1982, he founded the Haitian Study Group on Kaposi's sarcoma and opportunistic infections (GHESKIO). He currently directs NIH-supported HIV vaccine and therapy trials in Haiti. Dr. Pape is the recipient of numerous awards including a citation from Secretary of State Colin Powell for his commitment to AIDS education and training in 2001, the French Legion d'Honneur for his contribution to "the improvement of the health of the Haitian people and that of the people of the world" in 2002, the N'Galy-Mann Lecture Award which recognizes individuals who have contributed in major ways to AIDS clinical research and/or epidemiology in 2007, the Distinguished Service Award from the Global Health Education Consortium (GHEC) in recognition of his "outstanding and dedicated leadership in expanding and enhancing the education of physicians in the field of global health" in 2007, and the firstname.lastname@example.com "National Alive Treasure of Haiti" award by Foundation Francoise Canez Auguste in 2008. He was elected to the Institute of Medicine of the U.S. National Academies of Science in 2003. Robert N. Peck, MD Instructor in Medicine. Dr. Peck received his MD from Vanderbilt University, where he was Alpha Omega Alpha, as well as a Candy Robinson Scholar; he also received the Award of Excellence in Infectious Diseases. He completed a combined medicine/pediatrics residency program at Harvard/ Massachusetts General Hospital and the Children's Hospital in Boston. Dr. Peck currently supervises and teaches Weill Cornell medical students and NYPH residents and fellows rotating through Bugando University College of Health Sciences (BUCHS) and Bugando Medical Center (BMC). He also participates in the teaching and training of BUCHS medical students and interns, as well as the development of the BUCHS/BMC internal medicine and pediatrics residency programs. He is based full-time in Mwanza, Tanzania, at BUCHS and BMC. firstname.lastname@example.com Kyu Y. Rhee, MD, PhD Assistant Professor of Medicine and Microbiology and Immunology. He received his M.D. and Ph.D. from the University of California, Irvine through a medical scientist training program. He then received clinical training in internal medicine and infectious diseases at the New York Presbyterian-Weill Cornell Medical Center where he also completed a postdoctoral fellowship in the laboratory of Dr. Carl Nathan (Department of Microbiology and Immunology). Dr. Rhee's current research focuses on biochemical approaches to drug target discovery against M. tuberculosis, the causative agent of tuberculosis, using novel mass spectrometry-based tools. In more recent work, Dr. Rhee has extended his work to translational studies of multidrug resistant gram-positive and gram- negative pathogens. Dr. Rhee is the recipient of an NIH K08 award, a Burroughs Wellcome Career Award in the Biomedical Sciences, and the first William Randolph Hearst Foundation Clinical Scholar in Microbiology and Infectious Diseases. firstname.lastname@example.com 20 Richard B. Roberts, MD Professor of Medicine (Emeritus); Adjunct Professor, Rockefeller University. Dr. Roberts has served as Chief of the Division of Infectious Disease, Vice Chairman of the Department of Medicine, and Associate Dean at the Medical College. As of May 2009, Dr. Roberts is also Dean and Professor (Medicine) of Trinity School of Medicine, St. Vincent and the Grenadines, West Indies. His recent research interests include the molecular epidemiology of multidrug resistant gram-positive pathogens. email@example.com Mirella Salvatore, MD Assistant Professor of Public Health in the Division of Community and Public Health Programs, and Assistant Professor of Medicine in the Division of Infectious Diseases at Weill Cornell Medical College. Dr. Salvatore completed her undergraduate degree at the Scientific Lyceum in Italy, and her M.D. summa cum laude at the Catholic University Medical School in Rome, Italy. In the United States she completed Internal Medicine Residency training and a 3-year clinical and research fellowship in Infectious Diseases at Mount Sinai School of Medicine. Since her postdoctoral fellowship in the laboratories of Adolfo Garcia-Sastre at Mount Sinai School of Medicine, she has focused her research interest on host responses to influenza virus infection and influenza vaccines. She is currently Principal Investigator on a grant from the Stony Wold-Herbert Fund and of an NIAID R21 award. firstname.lastname@example.com Rosemary Soave, MD Clinical Associate Professor of Medicine and Public Health. Dr. Soave's interests are the immunopathogenesis, treatment and epidemiology of the coccidial infections, cryptosporidiosis and cyclosporiasis, and infections in solid organ and bone marrow transplant recipients. Dr. Soave studies the impact of viral infections on solid organ and bone marrow transplantation and the management of febrile neutropenia in bone marrow transplant recipients. firstname.lastname@example.com 21 Mary A. Vogler, MD Assistant Professor of Medicine. Dr. Vogler trained in internal medicine at the University of Connecticut School of Medicine and in infectious diseases at NYU (New York University School of Medicine) where she served on the faculty prior to coming to Weill Cornell. Dr. Vogler serves as an HIV/AIDS primary care provider in the Center for Special Studies both for HIV-infected adults and adolescents. She also participates actively as an investigator in the NIH-funded Cornell HIV/AIDS Clinical Trials Unit (CCTU) and in the Fogarty international research programs. Her area of expertise is in the area of HIV-infected women, including pregnancy and mother-to-child transmission. She recently received the AIDS Clinical Trials Group (ACTG) Women's Health Investigator award. email@example.com Scott Weisenberg, MD, D.T.M.&H. Instructor in Medicine. Dr. Weisenberg received his M.D. from Tufts University School of Medicine, and completed an Internal Medicine residency at the University of California at San Diego (UCSD). He was an Assistant Professor of Medicine at UCSD from 1998-2004 where he worked as a clinician- educator. He subsequently received training at the London School of Hygiene and Tropical Medicine, and completed an Infectious Disease fellowship at Weill Cornell Medical Center. He received a KL2 Clinical Scholars Award from the Clinical Translational Science Center in 2008, and he is completing the K30 Masters in Clinical Investigation program. Dr. Weisenberg's research interests include the local and global transfer of antimicrobial resistance genes in Gram-negative populations. He is the medical director of the Weill Cornell Travel Medicine Practice and sees patients at I.D. Associates. email@example.com Timothy J. Wilkin, MD, MPH. Assistant Professor of Medicine. Dr. Wilkin, who completed his internal medicine residency at the University of Chicago and a fellowship in Infectious Diseases and an MPH at Columbia University, joined the Cornell HIV/AIDS Clinical Trials Unit (CCTU) in 2002. He conducts research on human papilloma virus (HPV) infection and anal squamous intraepithelial lesions (ASIL) in HIV+ and HIV-men. He received a K23 award to prospectively determine and compare the prevalence of ASIL in both HIV+ and HIV- men; to examine the association of immunologic parameters on ASIL; and to compare the prevalence and persistence of anal HPV infection between HIV+ men (both with and without a history of receptive anal intercourse) and HIV- men. He also serves as Co-Director of the CCTU, as well as leading several protocol teams in the AIDS Clinical Trial Group. He is chairing AIDS Malignancy Consortium Protocol 052, a clinical trial of the safety and immunogenicity of a quadrivalent human papillomavirus vaccine in email@example.com HIV-infected men. 22 Stephen J. Wilson, MD, MPH Associate Clinical Professor of Medicine and Hospital Epidemiologist (starting June 2010). Dr. Wilson trained in internal medicine at Duke University Medical Center. He completed his clinical training in infectious diseases at University of California, San Francisco, and then did his research training in infectious diseases back at Duke. During his research fellowship he received his MPH in epidemiology from the University of North Carolina School of Public Health. His research interests range from the molecular epidemiology of multidrug-resistant organisms to comparative effectiveness research of infection control interventions. He has a particular interest in pursuing research that elucidates new and better ways to deliver high quality of care in the hospital setting that also minimizes unintended consequences. As one of two new hospital New email pending epidemiologists at New York-Presbyterian Weill Cornell Medical Center, he is looking forward to developing a robust research and training program in infection control and hospital epidemiology. 23 Research Training Faculty ID Fellows have the opportunity to work in laboratories or programs within the Division of Infectious Diseases, other divisions in the Department of Medicine (e.g. GI, Immunology), other Departments at WMC (Microbiology and Immunology, Pathology, Public Health), as well as Memorial Sloan-Kettering Cancer Institute, and the Rockefeller University, including the Aaron Diamond AIDS Research Center. RESEARCH TRAINING FACULTY IN OTHER DEPARTMENTS & INSTITUTIONS Francis Barany, PhD Weill Cornell Multiplex detection of microbial http://www.med.cornell.edu/research/fbarany/ Dept of Microbiology and pathogens by ligase chain reaction Immunology Ethel Cesarman, MD, PhD Molecular basis of viral oncogenesis in http://www.med.cornell.edu/research/ecesarman/ Weill Cornell AIDS-related non-Hodgkin's Dept of Pathology lymphomas due to KSHV (HHV-8) Andrew J. Dannenberg, MD Weill Cornell Cancer Center: Weill Cornell Translational studies of http://www.med.cornell.edu/research/andrewdannenberg/ Division of Gastroenterology cyclooxygenase-2 (COX-2) and & Hepatology chronic inflammation in cancer Kirk W. Deitsch, PhD Molecular basis of var gene-mediated Weill Cornell antigenic variation in Plasmodium http://www.med.cornell.edu/research/kdeitsch/ Dept of Microbiology and falciparum Immunology Sabine Ehrt, PhD Host-pathogen interactions of Weill Cornell Mycobacterium tuberculosis and the http://www.med.cornell.edu/research/sehrt/ Dept of Microbiology and macrophage: Mycobacterial survival Immunology strategies in the phagosome David D. Ho, MD Basic and Clinical Development of http://www.adarc.org/david_ho_424.html Rockefeller University Vaccines and Other Prevention Aaron Diamond AIDS Strategies against HIV-1 Research Center Carl F. Nathan, MD Molecular mechanisms of innate Weill Cornell http://www.med.cornell.edu/research/cnathan/ immunity against Mycobacterium Dept of Microbiology and tuberculosis Immunology Charles Rice, PhD Molecular virology and immunology of http://www.rockefeller.edu/labheads/rice/rice.php Rockefeller University Hepatitis C Dirk Schnappinger, PhD Molecular genetic studies of http://www.med.cornell.edu/research/dschnappinger/ Weill Cornell Mycobacterium tuberculosis virulence Dept of Microbiology and and persistence Immunology Dendritic cell-mediated regulation of lymphocyte function in tolerance and Ralph M. Steinman, MD resistance and the development of http://www.rockefeller.edu/research/abstract.php?id=15 Rockefeller University dendritic cell-based therapies and vaccines Andrew H. Talal, MD, MPH Identification of biomarkers of Weill Cornell histological progression and treatment http://www.weillcornell.org/ahtalal/ Division of Gastroenterology outcome in Hepatitis C & Hepatology Thomas J. Templeton, PhD Weill Cornell Host: parasite interactions of the http://www.med.cornell.edu/research/tjtempleton/ Dept of Microbiology and malaria parasite, Plasmodium Immunology Chemical structure, mode of assembly, and biological functions of Alexander Tomasz, PhD bacterial cell walls and associated cell http://www.rockefeller.edu/labheads/tomasz/contact.php Rockefeller University surface components in Gram positive bacteria 24 RESEARCH PROGRAMS ANTIBIOTIC DEVELOPMENT: Biochemical Approaches to Drug Target Identification. Rhee. The defining interest of our laboratory is the identification and validation of new antibiotic targets. Unlike the case for virtually every other field of medicine, infectious diseases is the only discipline to become progressively less and less effective over time. In large part, this is due to the fact that bacteria replicate far faster and more abundantly than the hosts they infect. As a result, resistance has become the inevitable fate of every antibiotic ever developed. This problem has been further compounded by the fact that no new mechanistic classes of antibiotics have emerged in the last 40 years. While the reasons for this are multifactorial, it is a commonly overlooked fact that virtually all antibiotics in clinical use were discovered with little foresight and often serendipitously. As a result, we lack sufficient knowledge of what defines a good drug target and how to develop new antibiotics from it. We aim to address this deficiency by applying novel mass spectrometry-based metabolomics approaches to gain insight into the underlying biology of the microbes we wish to target and their responses perturbation at the pharmacologically relevant level of metabolites. Current efforts focus chiefly on Mycobacterium tuberculosis, Staphylococcus aureus and Enterococcus faecium. Fusco D, Alexander EL, Weisenberg S, Mediavilla J, Kreiswirth B, Schuetz AN, Jenkins SG, Rhee KY. Clinical failure of vancomycin in a dialysis patient with hVISA MSSA. Diag Micro Inf Dis 2009;65:180-83. Weisenberg S, Butterfield T, Fischer SM, Rhee KY. (2009). Suitability of silica hydride stationary phase, aqueous normal phase chromatography for untargeted metabolomic profiling of Enterococcus faecium and Staphylococcus aureus. J Sep Sci 2009;32: 2262-65. Blumenthal A, Isovski F, Rhee KY. Tuberculosis and host metabolism: Ancient association, fresh insights. Translational Research 2009;154:7-14. Bryk R, Gold B, Venugopal A, Singh J, Samy R, Pupek K, Cao H, Popescu C, Gurney M, Hotha S, Cherian J, Rhee K, Ly L, Converse P, Ehrt S, Vandal O, Jiang X, Schneider J, Lin G, Nathan C. Selective killing of non-replicating Mycobacteria. Cell: Host and Microbe 2008;3:137-45. Rhee KY, Erdjument-Bromage H, Tempst P, Nathan C. S-nitroso-proteome of Mycobacterium tuberculosis: enzymes of intermediary metabolism and anti-oxidant defense are targets of reactive nitrogen intermediates. Proc Natl Acad Sci USA 2005;102:467-72. Rhee KY. Mycobacterial resistance to reactive oxygen and nitrogen intermediates: Recent views and progress in M. tuberculosis. In Mycobacterium: Molecular Microbiology. Parish, T. ed. 2005. Horizon Press. BIOTERRORISM: Multiplexed Detection of Bioterror Agents. Barany, Golightly, Larone. The current biothreat to our nation requires the ability to rapidly detect and distinguish bioweapon agents from normal pathogens. Existing detection systems have a limited ability to simultaneously screen in a single sample for multiple agents and their antibiotic resistance, toxin or virulence genes. We are developing ligase detection reaction (LDR) techniques combined with PCR, capillary 25 electrophoresis, and Universal Arays, which we have already validated in the detection of cancer gene mutations and the diagnosis of genetic diseases. The study will initially test bacterial, fungal and viral nucleic acids and isolates in the laboratories of Drs. Barany and Golightly. Blood culture isolates from patients admitted to the NYP hospital, obtained through Dr. Davise Larone, former Head of clinical microbiology at the NYP hospital, will be tested to validate the clinical usefulness of the technique. Samples to test for viral pathogens (Dengue, West Nile and viral hemorrhagic fever viruses) are obtained from the CDC, NYC Department of Health, and sites of endemic disease. Pingle MR, Granger K, Feinberg P, Shatsky R, Sterling B, Rundell M, Spitzer E, Larone D, Golightly L, Barany F. Multiplexed identification of blood-borne bacterial pathogens by use of a novel 16S rRNA gene PCR-ligase detection reaction-capillary electrophoresis assay. J Clin Microbiol 2007;45:1927-35. Das S, Pingle MR, Muñoz-Jordán J, Rundell MS, Rondini S, Granger K, Chang GJ, Kelly E, Spier EG, Larone D, Spitzer E, Barany F, Golightly LM. Detection and serotyping of dengue virus in serum samples by multiplex reverse transcriptase PCR-ligase detection reaction assay. J Clin Microbiol 2008;46:3276-84. Rondini S, Pingle MR, Das S, Tesh R, Rundell MS, Hom J, Stramer S, Turner K, Rossmann SN, Lanciotti R, Spier EG, Muñoz-Jordán J, Larone D, Spitzer E, Barany F, Golightly LM. Development of multiplex PCR-ligase detection reaction assay for detection of West Nile virus. J Clin Microbiol 2008;46:2269-79. Granger K, Rundell MS, Pingle M, Shatsky R, Larone DH, Golightly LM, Barany F and Spitzer E. Multiplex-PCR-LDR-CE assay for the simultaneous detection of drug resistance and toxin genes for Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium. J Clin Microbiol. 2009 Oct 28. [Epub ahead of print]. FOOD AND WATER-BORNE PATHOGENS: Multiplexed Detection of Food and Waterborne Pathogens. Barany, Golightly, Larone. The ability to rapidly detect food and waterborne pathogens is of utmost importance in preventing outbreaks associated with contamination of our nation's food and water supply. Existing detection systems have a limited ability to simultaneously screen a single sample for multiple agents. To meet this need we will use the ligase detection reaction (LDR) combined with PCR, and Universal Array detection. We will transfer our assays for distinguishing blood-borne bacterial and viral pathogens onto the Cepheid GeneXpert system, as well as evaluate their performance in modular microfluidic devices. We will extend the family of microbial PCR/LDR assays to the detection of category B bacterial, viral, and protozoan food and water-borne pathogens in stool specimens. The assay will be validated using samples obtained from the NYPH/Cornell as well as collaborators in Haiti (GHESKIO) and Ghana (NMIMR). HEPATITIS: Clinical Studies of Viral Hepatitis. Marks, Glesby. Hepatitis C infection is the leading cause of end stage liver disease and need for liver transplantation in this country. Studies have shown that patients with HIV/HCV coinfection have an accelerated course of progression to cirrhosis and end stage liver disease compared to patients with HCV infection alone. Strategies for improving treatment outcomes are needed for this population. Current studies being conducted at Cornell focus on initial treatment of HCV infection as well as treatment of refractory disease. 26 CCTU investigators are conducting ACTG study utilizing nitazoxanide as part of initial HCV treatment (ACTG 5269) and leading another ACTG study examining the treatment of insulin resistance prior to HCV retreatment (ACTG 5239). We are also leading the development of a phase I clinical trial of a novel HCV entry inhibitor (ITX 5061) in HCV monoinfection through the ACTG In addition, CCTU is collaborating with investigators from UCSF to conduct a pilot study examining the safety and efficacy of treatment of acute HCV infection in HIV-infected patients. Completed studies include an epidemiologic investigation of risk factors for hepatic steatosis in HIV/HCV coinfection, as well as additional clinical trials conducted with the ACTG. The Center for the Study of Hepatitis C, a multidisciplinary center involving Rockefeller University, Weill Cornell Medical College, and New York Presbyterian Hospital, provides additional opportunities for translational research, access to a serum and tissue bank, and collaboration with experts in the field of virology and hepatitis treatment (e.g. Drs. Ira Jacobson, Charlie Rice, Andrew Talal). Brau N, Fox RK, Xiao P, Marks KM, Naqvi Z, Taylor LE et al. Presentation and outcome of hepatocellular carcinoma in HIV-infected patients: A U.S.-Canadian multicenter study. J Hepatol 2007;47:527-37. Bussel JB, Marks KM. How effective is eltrombopag for the treatment of thrombocytopenia in patients with HCV infection? Nat Clin Pract Gastroenterol Hepatol 2008;5:424-25. Marks KM, Petrovic LM, Talal AH, Murray MP, Gulick RM, Glesby MJ. Histologic findings and clinical characteristics associated with hepatic steatosis in HIV/HCV coinfected patients. J Infect Dis 2005;192:1943-49. Glesby MJ, Bassett R, Alston B, Fichtenbaum C, Jacobson EL, Owens S, Race E, Sherman K for the ACTG A5088 team. Pilot study of low dose interleukin-2, pegylated interferon-alfa2b, and ribavirin for the treatment of hepatitis C virus infection in patients with human immunodeficiency virus infection. J Infect Dis 2005;191:686-93. Wan D, Marks KM, Yantiss R, Talal A. Autoimmune hepatitis in the HIV-infected patient: a therapeutic dilemma. AIDS Patient Care and STDs 2009;23:407-13. HIV/AIDS: Observational Studies. Glesby, Gulick, Jacobs, Marks, Merrick, Vaamonde, Vogler, Wilkin. The Center for Special Studies (HIV clinic) at New York-Presbyterian-Weill Cornell Center uses an electronic medical records system that is an invaluable resource for clinical research. Over 10,000 records of HIV-infected patients dating back to 1991 are available. Completed projects include case-control studies of osteonecrosis and diabetes mellitus in HIV-infected patients, a retrospective review of the safety and efficacy of antiretroviral regimens containing three protease inhibitors, temporal trends in hospital admission diagnoses, and hepatic steatosis. Ongoing studies are addressing diabetes mellitus and erythrocytosis. Other projects utilize data from the Women's Interagency HIV Study (WIHS, a cohort study of women with or at high risk for HIV infection) through ongoing collaboration. Fellows have the opportunity to design, conduct, and analyze studies using the databases. Glesby MJ, Hoover DR, Tan T, et al. Herpes zoster in women with and at risk for human immunodeficiency virus infection: Data from the Women's Interagency HIV Study. JAIDS 2004;37:1604-09. Marks KM, Clarke RM, Bussel JB, Talal AH, Glesby MJ. Risk factors for thrombocytopenia in the era of potent antiretroviral therapy. JAIDS 2009;52:595-99. 27 Raiszadeh F, Hoover DR, Lee I, Shi Q, Anastos K, Gao W, Kaplan R, Glesby MJ. Plasma homocysteine is not associated with HIV serostatus or antiretroviral therapy in women. JAIDS 2009;51:175-78. Vaamonde CM, Hoover DR, Anastos K, Tan T, Shi Q, Gao W, Kovacs A, Cohen M, DeHovitz J, Glesby MJ. Factors associated with poor immunologic response to virologic suppression by highly active antiretroviral therapy in HIV-infected women. AIDS Res Hum Retroviruses 2006;22:222-31. Yoon C, Gulick RM, Hoover DR, Vaamonde CM, Glesby MJ. Case control study of diabetes mellitus in HIV-infected patients. J AIDS 2004;37:1464-69. Clinical Trials of HIV/AIDS Therapies. Glesby, Gulick, Marks, Vogler, Wilkin. The Cornell HIV/AIDS Clinical Trials Unit (CCTU) designs and conducts clinical trials in HIV-infected individuals. The CCTU participates actively in studies sponsored by the NIH-funded AIDS Clinical Trials Group (ACTG) and the pharmaceutical industry. Current clinical investigation centers on three broad areas: (1) antiretroviral agents; (2) immune-based therapies; and (3) treatment and prevention of HIV-related complications, including co-infections and complications of antiretroviral therapy. Additional areas of investigation are pharmacokinetics of HIV drugs and HIV-infected women's health. Current specific projects include studies of the initiation of antiretroviral therapy (ACTG study A5257); HIV therapy for treatment-experienced patients, including new antiretroviral drugs (vicriviroc, an investigational HIV entry inhibitor in ACTG study A5211); immune-based therapy (HIV DNA therapeutic vaccine ACTG study, A5197); and prevention of HIV-related complications (HPV vaccine in ACTG A5240; herpes zoster vaccine in ACTG A5247). Treatment issues in women, specifically, women previously treated with antiretroviral therapy only for prevention of maternal to child transmission (ACTG 5227) is an area of active investigation in studies initiated by CCTU investigators. In addition, management of visceral adiposity in HIV-infected patients is the focus of an investigator- initiated, NIH-funded project. There are opportunities for fellows to participate in all aspects of HIV/AIDS clinical trials. Fellows may spend their fellowship research year(s) conducting HIV/AIDS clinical research as part of the clinical trials unit under the mentorship of one of the HIV clinical trials investigators, and participate in the K30 program (Masters Degree Program in Clinical Investigation). Glesby MJ, Aberg JA, Kendall MA, et al for the Adult AIDS Clinical Trials Group A5159 Protocol Team. Pharmacokinetic interactions between indinavir plus ritonavir and calcium channel blockers. Clin Pharmacol Ther 2005;78:143-53. Gulick RM, Ribaudo HJ, Shikuma CM, et al. Three- vs. four-drug antiretroviral regimen for the initial treatment of HIV-1 infection: a randomized controlled trial. JAMA 2006:296:769-81. Gulick RM, Su Z, Flexner C, et al. Phase II study of the safety and efficacy of vicriviroc, a CCR5 inhibitor, in HIV-1-infected, treatment-experienced patients: ACTG 5211. J Infect Dis 2007;196:304-12. 28 Gulick RM, Lalezari J, Goodrich J, et al. Maraviroc for previously treated patients with R5 HIV-1 infection. N Engl J Med 2008;359:1429-41. Shikuma CM, Yang Y, Glesby MJ, et al. Metabolic effects of protease inhibitor-sparing antiretroviral regimens given as initial treatment of HIV-1 Infection (AIDS Clinical Trials Group Study A5095). JAIDS 2007;44:540-50. Vogler MA, Teppler H, Gelman R, et al. Daily low-dose subcutaneous interleukin-2 added to single- or dual-nucleoside therapy in HIV Infection does not protect against CD4+ T-cell decline or improve other indices of immune function: Results of a randomized controlled clinical trial (ACTG 248). JAIDS 2004;36:576-87. Wilkin TJ, Su Z, Kuritzkes DR, et al. HIV type 1 chemokine coreceptor use among antiretroviral-experienced patients screened for a clinical trial of a CCR5 inhibitor: AIDS Clinical Trial Group A5211. Clin Infect Dis 2007; 44:591-5. Wilkin TJ, McKinnon JE, Dirienzo AG, et al. Regimen simplification to atazanavir- ritonavir alone as maintenance antiretroviral therapy: final 48-week clinical and virologic outcomes. J Infect Dis 2009; 199:866-71. HOSPITAL EPIDEMIOLOGY AND INFECTION CONTROL Healthcare-Associated Infections. Calfee, Wilson. The Hospital Epidemiology Program at New York Presbyterian Hospital-Weill Cornell Medical Center has research activities ranging from traditional epidemiologic studies of infection control risk factors and outcomes to intervention trials of infection control policies and procedures. The primary goal of the research program is to improve patient safety by reducing the risk of healthcare-associated infections. Observational studies can be carried out utilizing infection control surveillance data, clinical microbiology data, and a robust hospital-based clinical database, which can be queried electronically. Previous and ongoing projects have studied patient-oriented and systems-based factors associated with transmission of multidrug-resistant organisms, device-related infections, and procedure-related infections. In addition, the program has the potential for performing individual and cluster randomized trials of infection control interventions at Weill Cornell and in collaboration with Columbia Presbyterian Medical Center. Fellows, residents, and students interested in epidemiologic research can choose from a wide variety of large or small projects depending on their needs. For fellows interested in a career in hospital epidemiology, there is opportunity to receive intensive training in this exciting field by participating in the Masters of Science Clinical Research Program, the Masters of Public Health Program, or the Graduate Program in Clinical Epidemiology and Health Services. Calfee DP, Jenkins SG. Use of active surveillance cultures to detect asymptomatic colonization with carbapenem-resistant Klebsiella pneumoniae among intensive care unit patients. Infect Control Hosp Epidemiol 2008; 29:966-68. Bontrager JA, Wilson SJ. Prevalence and attributable mortality of healthcare- associated infections in patients who die in the hospital. Fifth Decennial International Conference on Healthcare-Associated Infections. March 18-22, 2010, Atlanta, GA. Morgan DJ, Weisenberg SA, Augenbraun MH, Calfee DP, Currie BP, Furuya EY, Holzman R, Montecalvo MC, Phillips M, Polsky B, Sepkowitz KA. Multidrug-resistant Acinetobacter baumannii in New York City – 10 years into the epidemic. Infect Control Hosp Epidemiol 2009; 30:196-97. 29 Patel G, Huprikar S, Factor SH, Jenkins SG, Calfee DP. Outcomes of carbapenem- resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infect Control Hosp Epidemiol 2008; 29: 1099-1106. Kho A, Johnston K, Wilson J, Wilson SJ. Implementing an animated geographic information system to investigate factors associated with nosocomial infections: a novel approach. Am J Infect Control 2006; 34:578-82. Young EM, Commiskey ML, Wilson SJ. Translating evidence into practice to prevent central venous catheter-associated bloodstream infections: a systems-based intervention. Am J Infect Control 2006; 34:503-06. HUMAN PAPILLOMAVIRUS (HPV): Anal Dysplasia and HPV in HIV+ and HIV- Men. Wilkin. Anal carcinoma is increased among HIV+ and HIV- men who have sex with men. Similar to the cervix, premalignant lesions of the anus (squamous intraepithelial lesions or SIL) are readily detectable by screening cytology and have high-risk types of human papillomavirus as the most important cofactor. Previous studies have demonstrated a high rate of anal SIL in HIV+ and HIV- men, but were done prior to the routine use of highly active antiretroviral therapy and were done in a relatively homogenous, white population. Building on Dr. Wilkin's previous work at Columbia University, this study is a prospective cohort study, examining the factors associated with persistence of high-risk HPV in the anal canal. The cohort is comprised of a diverse population of HIV+ and HIV- men, HIV+ men on and off of antiretroviral therapy, and HIV+ men with and without a history of receptive anal intercourse. Wilkin TJ, Palmer S, Brudney KF, Chiasson MA, Wright TC. Anal intraepithelial neoplasia in heterosexual and homosexual HIV-positive men with access to antiretroviral therapy. J Infect Dis 2004;190:1685-91. LEISHMANIASIS: Visceral Leishmaniasis: Immunoregulation of Host Response to Antileishmanial Chemotherapy and Immunochemotherapy. Murray. Various host immunologic mechanisms, largely T [Th1] cell-dependent, regulate the in vivo capacity to respond to antileishmanial chemotherapy. Using pentavalent antimony and amphotericin B as two distinct pharmacologic probes in L. donovani-infected mice, this project is examining the host mechanisms that determine or can enhance initial in vivo host responsiveness to chemotherapy and/or regulate subsequent prevention of posttreatment relapse. The work is focused on the interaction of antileishmanial chemotherapy with amplified cytokine-induced macrophage activation, chemokine-induced granuloma assembly, CD4 and CD8 cell responses, activating and deactivating mechanisms (cytokines, receptors, intracellular signaling) and immunologic effects induced by chemotherapy itself. The goal of the project is to employ immunochemotherapy to improve treatment-induced outcome in visceral leishmaniasis, both the initial host response to chemotherapy and the long-term prevention of relapse in this intracellular protozoal infection. Murray HW. Accelerated control of visceral Leishmania donovani infection in IL-6-/- mice. Infect Immun 2008;76:4088. Murray HW, Xiang Z, Ma X. Responses to Leishmania donovani in mice deficient in both phagocyte oxidase and inducible nitric oxide synthase. Am J Trop Med Hyg 2006;74:1013. 30 Murray HW, Tsai CW, Liu J, Ma X. Responses to Leishmania donovani in mice deficient in IL-12, IL-12/IL-23 or IL-18. Infect Immun 2006;74:4370. Murray HW, Tsai CW, Liu J, Ma X. Visceral Leishmania donovani infection in IL13-/- mice. Infect Immun 2006;74:2487. Murray HW. Prevention of relapse after chemotherapy in a chronic intracellular infection: mechanisms in experimental visceral leishmaniasis. J Immunol 2005;174:4916. MALARIA: Endothelial Progenitor Cells and Malaria Pathogenesis. Golightly. Despite its virulence, the pathophysiologic basis of P. falciparum disease and cerebral malaria are poorly understood. Sequestration of infected red blood cells (iRBCs) in the microvasculature is a major pathologic finding in P. falciparum infections. The repair of microvasculature damaged by infection may occur either by the proliferation or migration of local endothelial cells, or the recruitment of bone marrow-derived circulating endothelial progenitor cells (EPCs). We hypothesize that P. falciparum infection results in an imbalance between microvascular damage and repair. Cerebral malaria occurs when circulating EPCs are diminished and damaged endothelial cells cannot be replaced. To test this hypothesis, EPC levels and markers of bone marrow activation in P. falciparum-infected patients with different degrees of disease severity are being compared with normal uninfected controls. These studies are being performed in collaboration with the Noguchi Memorial institute for Medical Research in Accra, Ghana. Studies to further validate this hypothesis are being performed using a mouse model system of cerebral malaria in collaboration with investigators at the Albert Einstein College of Medicine. Gyan B, Quarm Goka B, Adjei GO, Tetteh JKA, Kusi KA, Aikins A, Dodoo D, Lesser ML, Sison CP, Das S, Howard ME, Milbank E, Fischer K, Rafii S, Jin D, Golightly LM. Cerebral malaria is associated with low levels of circulating endothelial progenitor cells in African children. Am J Trop Med Hyg 2009;80:541-46. Desruisseaux MS, Machado FS, Weiss LM, Tanowitz HB, Golightly LM. Cerebral malaria, a vasculopathy. Am J Pathol 2010 [epub Jan 21]. Genetic variation in the human malaria parasite, Plasmodium falciparum. Kirkman. Malaria, a vector borne disease, causes great morbidity and mortality in tropical and subtropical regions of the world. Infection with the parasite leads to one to two million deaths and 300 to 500 million clinical cases per year. Crucial to the continuing burden of disease is the parasite's ability to evade clearance in the host; both the ability to evade the host immune system by changing surface proteins inserted into the host red blood cell, a process termed antigenic variation, and the ability to develop drug resistance. Underlying both is the ability of this eukaryotic pathogen with a haploid genome for most of its lifecycle to generate and incorporate DNA mutations. We aim to study malaria DNA recombination and repair in the context of disease pathogenesis focusing on antigenic variation and the development of drug resistance. Antigenic Variation: After invading a red blood cell the malaria parasite modifies its host cell in different ways including inserting parasite derived proteins into the surface of the parasitized red blood cell. These parasite proteins bind to receptors on host endothelial cells, a process termed cytoadherence and is one of the key pathogenic and virulence factors of P. falciparum infections. A surface protein termed Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) was identified as the protein responsible for cytoadherence. This protein is encoded 31 by the large multi-copy gene family termed var. There is great diversity within this gene family and the mechanisms creating this diversity are a focus of our work. To better understand the generation of genetic diversity within this multi-copy gene family we are manipulating the parasite genome to determine how the parasite repairs damaged DNA. Drug Resistance: We are studying the mechanisms by which a parasite becomes resistant to antimalarials by focusing on the ways in which the parasites acquire mutations in DNA. Using genetically modified parasites we are studying the ability of the parasite to generate point mutations and gene duplications that have been previously associated with drug resistance in the field. We are able to manipulate both copy number and specific sequence in order to further study the interplay of different aspects of pathways implicated in parasite drug resistance. Djimdé AA, Kirkman L, Kassambara L, Diallo M, Plowe CV, Wellems TE and Doumbo KO. Culture in vitro de souches locales de Plasmodium falciparum au Mali. Le Bulletin de la Société de pathologie exotique 2007;100:3-5. Frank M, Kirkman L, Constantini D, Sanyal S, Lavazec C, Templeton T and Deitsch K. Frequent recombination events generate diversity within the multi-copy variant antigen gene families of Plasmodium falciparum. International Journal of Parasitology 2008;38: 1099-1109. Kirkman L, Weiss L.M. and Kim, K. Cyclic nucleotide signaling in Toxoplasma gondii bradyzoite differentiation. Infection and Immunity 2001; 69: 148-53. TRANSPLANTATION: Transplant Infectious Diseases. Soave. We work with both the solid organ transplant (renal and pancreas transplants) and the bone marrow transplantation teams to provide infectious diseases consultations and to track infection patterns. We also carry out studies aimed at identifying the emergence of new infections, optimizing diagnostic capabilities, and maximizing preemptive and prophylactic regimens to prevent infections. The impact of CMV and other herpes viruses, as well as BKV, on the outcome of both solid organ and bone marrow transplant recipients is being studied. This project is aimed at identifying risk factors for viral activation such that the infections can be predicted and thus pre-empted. Although much progress has been made in successful prevention of CMV infection, very little is known about the risk factors for and the prevention of HHV-6, 7 and 8 and EBV in solid organ and bone marrow transplant recipients. The lack of simple diagnostic methods for the detection of these viruses has contributed to our inability to differentiate viral carriage from actual disease. We are also establishing a consortium of infectious diseases physicians who have expertise in transplantation. The purpose of this consortium is to facilitate the exchange of information and new findings, and to provide a framework for pooling data and collaborating in clinical investigations. 32 INTERNATIONAL PROGRAMS BRAZIL: The collaboration between Cornell University and the Federal University of Bahia started in 1964 and is still growing after four decades, with new partners in Natal, Fortaleza, Rio and the Oswaldo Cruz Foundation, the Cornell-Bahia program may be the longest collaboration of its type in the world today. To date, over 20 Cornell faculty members and ~120 students and fellows have participated in the program, and over 250 peer reviewed journal publications have emerged from the research. The program has been funded by the Commonwealth Fund and the Rockefeller Foundation, and since 1979, by the NIH. The current NIH funding supports our Tropical Medicine Research Center and a research and training program in infectious disease in urban slum health problems in Salvador, Brazil. Leishmaniasis and HTLV-I. Carvalho, Johnson, Glesby, Ko. This is a multi-disciplinary research program with investigators from Brazil and the United States. We seek to define the pathogenesis of these diseases and to develop intervention measures. Research is conducted at field study sites in the state of Bahia, Brazil, the University of Bahia, and the Division of International Medicine and Infectious Diseases at Cornell. We are working to identify host and parasite factors that determine the outcome of leishmania infection. Based on the immunological studies previously performed, clinical trials have been performed using immunomodulatory agents combined with antimony therapy in cutaneous and mucosal leishmaniasis. Ongoing studies are also investigating the spectrum of subclinical and clinical disease in HTLV-I infection in relation to cytokine profiles. Caskey MF, Morgan DJ, Porto AF, Giozza SP, Muniz AL, Orge GO, Travassos MJ, Barrón Y, Carvalho EM , Glesby MJ. Clinical manifestations associated with HTV-1 infection: a cross-sectional study. AIDS Res Hum Retroviruses 2006;23:365-71. Castellucci L, Menezes E, Oliveira J, Magalhaes A, Guimaraes LH, Lessa M, Ribeiro S, Reale J, Noronha EF, Wilson ME, Duggal P, Geaty TH, Jeronimo S, Jamieson SE, Bales A, Blackwell JM, de Jesus AR, Carvalho EM. IL-6 174 G/C promoter polymorphism influences susceptibility to mucosal but not localized cutaneous leishmaniasis in Brazil. J Infect Dis 2006;194:519-27. Machado PRL, Lessa H, Lessa M, Guimaraes LH, Bang H, Ho JL, Carvalho EM. Oral pentoxifylline combined with pentavalent antimony: A randomized trial for mucosal leishmaniasis. Clin Infect Dis 2007;44:788-93. Morgan DJ, Guimaraes LH, Machado PRL, D'Oliveira Jr A, Almeida RP, Lago EL, Faria DR, Tafuri WL, Dutra WO, Carvalho EM. Cutaneous leishmaniasis during pregnancy: Exuberant lesions and potential fetal complications. Clin Infect Dis 2007;45:478-82. Morgan DJ, Oliveira-Filho, J, Abbeheusen C, Caskey MF, Porto MAF, Muniz AL, Glesby MJ, Carvalho EM. Magnetic resonance imaging does not discriminate between HTLV-I carrier state and HAM/TSP. AIDS Res Hum Retroviruses 2007;23:1499-1504. Emerging Infectious Diseases and Urban Poverty: The Division established a research and training program with the Oswaldo Cruz Foundation (Fiocruz), Brazilian Ministry of Health in 33 1996 to address infectious disease problems that have emerged due to rapid urbanization and urban poverty. At present, one billion of the world's population resides in slum settlements. In Brazil, rapid urbanization and migration of the rural poor to the cities has led to a more than 350% growth in the slum (favelas) population in the last 40 years and has created a new pattern of infectious diseases. The Cornell-Fiocruz program is conducting research on urban health problems which include rat-borne epidemic leptospirosis, dengue, bacterial meningitis and acute respiratory infections. Epidemiology of Bacterial Meningitis and Pneumococcal Disease. Ko, Riley. Acute respiratory infections and bacterial meningitis have become the major infectious disease cause of mortality in increasingly urbanized developing countries such as Brazil. The Division established population-based surveillance for meningitis in the city of Salvador in 1996 and demonstrated penicillin resistance in 15% of the isolates from pneumococcal meningitis cases. Molecular typing analyses found that the emergence of penicillin-resistant pneumococcal meningitis was due to the introduction of a single serotype 14 clone. On-going studies focus on evaluating the current interventions, such as the Hib conjugate vaccine, and identifying new approaches for prevention against penicillin-resistant pneumococcal disease. A longitudinal study is measuring the disease burden of acute respiratory infections in a cohort of children from a poor urban slum and identifying factors associated with the acquisition of pneumococcal disease. The overall aim will be to evaluate the use of a conjugate vaccine and control of inappropriate antibiotic use as interventions in preventing invasive disease due to penicillin-resistant S. pneumoniae. Cordeiro SM, Neves AB, Ribeiro CT, Petersen ML, Gouveia EL, Ribeiro GS, LôboTS, Reis JN, Salgado KM, Reis MG, Ko Al. Hospital-based surveillance of meningococcal meningitis in Salvador, Brazil. Trans R Soc Trop Med Hyg 2007;101:1147-53. Reis JN, Palma T, Ribeiro GS, Pinheiro RM, Ribeiro CT, Cordeiro SM, da Silva Filho HP, Moschioni M, Thompson TA, Spratt B, Riley LW, Barocchi MA, Reis MG, Ko Al. Transmission of Streptococcus pneumoniae in an urban slum community. J Infect 2008;57:204-13. Ribeiro GS, Lima JBT, Reis JN, Gouveia EL, Cordeiro SM, LôboTS, Pinheiro RM, Ribeiro CT, Neves AB, Salgado K, Silva HR, Reis MG, Ko Al. Haemophilus influenzae meningitis five years after introduction of the Haemophilus influenzae type B conjugate vaccine in Brazil. Vaccine 2007;25:4420-28. Ribeiro GS, Reis JN, Cordeiro SM, Lima JBT, Gouveia ELG, Petersen M, Salgado K, Silva HR, Zanella RC, Almeida SCG, Brandileone MC, Reis MG, Ko AI. Prevention of Haemophilus influenzae type B meningitis and emergence of serotype replacement with type A strains following introduction of Hib immunization in Brazil. J Infect Dis 2003;187:109-16. Santos MS, de Sousa Ribeiro G, Oliveira TQ, Santos RC, Gouveia E, Salgado K, Takahashi D, Fontes C, Campos LC, Reis MG, Ko Al, Reis JN. Burden of group A streptococcal meningitis in Salvador, Brazil: report of 11 years of population-based surveillance. Int J Infect Dis 2008;13:456-61. Urban Epidemic Leptospirosis. Ko, Johnson. Leptospirosis, a spirochetal disease transmitted by rats, has emerged to cause large epidemics in cities throughout Latin America as a consequence of rapid urbanization and worsening social inequality. Outbreaks occur each year in poor urban slum communities associated with case fatality rates greater than 15%, due to severe clinical forms such as Weil's disease and pulmonary hemorrhage syndrome. In collaboration with the Brazilian Ministry of Health, the Division established active population- based surveillance in the city of Salvador and identified more than 2,500 hospitalized cases during annual rainfall-associated epidemics since 1996. These investigations have lead to 34 national initiatives to sequence the genome of Leptospira interrogans and apply high-throughput strategies towards developing vaccines. Current research focuses on: 1) understanding the natural history of leptospirosis and identifying community-based intervention strategies in a longitudinal study of 16,000 residents from a poor urban slum community; 2) developing rapid diagnostic tests for point-of-care use; 3) identifying candidates for a sub-unit vaccine for leptospirosis, and 4) characterizing determinants of leptospiral pathogenesis. Gouveia EL, Metcalfe J, de Carvalho AL, Aires TS, Villasboas-Bisneto JC, Queirroz A, Santos AC, Salgado K, Reis MG, Ko Al. Leptospirosis-associated severe pulmonary hemorrhagic syndrome, Salvador, Brazil. Emerg Infect Dis 2008;14:505-8. McBride AJ, Santos BL, Queiroz A, Santos AC, Hartskeerl RA, Reis MG, Ko Al. Evaluation of four whole-cell Lepstopira-based serological tests for diagnosis of urban leptospirosis. Clin Vaccine Immunol 2007;14:1245-8. Reis RB, Ribeiro GS, Felzemburgh RD, Santana FS, Mohr S, Melendez AX, Queiroz A, Santos AC, Ravines RR, Tassinary WS, Carvalho MS, Reis MG, Ko Al. Impact of environment and social gradient on leptospira infection in urban slums. PloS Negl Trop Dis 2008;2:e228. Silva EF, Medeiros MA, McBride AJ, Matsunaga J, Esteves GS, Ramos JG, Santos CS, Croda J, Homma A, Dellagostin OA, Haake DA, Reis MG, Ko Al. The terminal portion of leptospiral immunoglobulin-like protein LigA confers protective immunity against lethal infection in the hamster model of leptospirosis. Vaccine 2007;25:6277-86. Silva EF, Santos Cs, Athanazio DA, Seyffert N, Seixas FK, Cerqueira GM, Fagundes MQ, Brod CS, Reis MG, Dellagostin OA, Ko Al. Characterization of virulence of Leptospira isolates in a hamster model. Vaccine 2008;26:3892-6. Spichler A, Ko Al, Silva EF, De Brito T, Silva AM, Athanazio D, Silva C, Seguro A. Reversal of renal tubule transporter down regulation during severe leptospirosis with antimicrobial therapy. Am J Trop Med Hyg 2007;77:1111-9. HAITI: The Cornell program in Haiti began in 1980 with the establishment of a unit for the study and treatment of infantile diarrhea at the State University Hospital and Medical School. The Cornell team began its AIDS research in 1982 and was instrumental in the formation of Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO). Since 1983, Cornell and GHESKIO have had uninterrupted NIH support resulting in over 65 publications, including the first detailed description of AIDS in a developing country (NEJM, 1983). In addition to the established AIDS program, Cornell-GHESKIO provides STD and tuberculosis screening and treatment, as well as family planning, health education, and counseling programs to ~ 28,000 persons annually. Cornell-GHESKIO also conducts NIH-sponsored HIV vaccine and ART clinical trials. Research at GHESKIO: HIV/AIDS, STDs, and Tuberculosis Through clinical and operational research, GHESKIO seeks to define treatment and prevention models for HIV/AIDS and related diseases that are appropriate and effective for Haiti. The main 35 focus of the research is HIV, sexually transmitted infections, and tuberculosis. The GHESKIO research program has evolved from early observational studies to large clinical trials and its designation as an international research center of excellence. In 1983, GHESKIO received its initial funding from the National Institutes of Health to define the epidemiology, natural history, risk factors, and associated co-infections of HIV/AIDS. Since then, GHESKIO's consistent research productivity has been recognized by uninterrupted support from the National Institutes of Health, a MERIT award in 1990, and twenty new or competitive renewal grants. GHESKIO also conducts research with support from the World Health Organization and the French Government's National Agency for AIDS Research. HIV/AIDS Ongoing research projects include a randomized controlled clinical trial of early vs. late antiretroviral therapy for AIDS patients (NIH-sponsored CIPRA study; 2003 – 2009). The research is focused on finding the optimal time to start antiretroviral therapy in patients with CD4 counts between 200 and 350 cells/ml. GHESKIO is a member of an international collaboration of scientists and educators searching for an effective and safe HIV vaccine (NIH-sponsored HIV Vaccine Trials Network; 2001 – 2013). GHESKIO Director Dr. Jean Pape is the Principal Investigator of the HIV Vaccine Trials Network in Haiti and GHESKIO investigators conduct clinical trials of promising new HIV vaccine candidates. GHESKIO also is a member of an international group of scientists dedicated to developing treatment strategies for HIV and related disorders (NIH-sponsored AIDS Clinical Trials Group; 2002 – 2013. GHESKIO conducts clinical trials to evaluate the efficacy of antiretroviral treatment for HIV infected individuals in resource- limited countries. GHESKIO investigators conducted the largest study of treatment outcomes for AIDS patients in a developing country, following 1,000 AIDS patients receiving antiretroviral therapy. Research continues to evaluate the efficacy and feasibility of other AIDS prevention and treatment programs. GHESKIO investigators are evaluating the cost-effectiveness of HIV prevention and care services to maximize efficiency and demonstrate the feasibility of treatment programs in developing countries. Buchbinder SP, Mehrotra DV, Duerr A, Fitzgerald DW, Mogg R, Li D, Gilbert PB, Lama JR, Marmor M, Del Rio C, McElrath MJ, Casimiro DR, Gottesdiener KM, Chodakewitz JA, Corey L, Robertson MN; Step Study Protocol Team. Efficacy assessment of a cell- mediated immunity HIV-1 vaccine (the Step Study): a double-blind, randomised, placebo-controlled, test-of-concept trial. Lancet 2008;372:1881-93. Charles M, Noel F, Leger P, Severe P, Riviere C, Beauharnais CA, Miller E, Rutledge J, Bang H, Shealey W, D'Aquila RT, Gulick RM, Johnson WD Jr, Wright PF, Pape JW, Fitzgerald DW. Survival, plasma HIV-1 RNA concentrations and drug resistance in HIV- 1-infected Haitian adolescents and young adults on antiretrovirals. Bull World Health Organ 2008;86:970-7. Cleghorn F, Pape JW, Schechter M, et al; 026 Protocol Team and the NIAID HIV Vaccine Trials Network. Lessons from a multisite international trial in the Caribbean and South America of an HIV-1 Canarypox vaccine (ALVAC-HIV vCP1452) with or without boosting with MN rgp120. JAIDS 2007;46:222-30. George E, Beauharnais CA, Brignoli E, Noel F, Bois G, De Matteis Rouzier P, Altenor M, Lauture D, Hosty M, Mehta S, Wright PF, Pape JW. Potential of a simplified p24 assay for early diagnosis of infant human immunodeficiency virus type 1 infection in Haiti. J Clin Microbiol 2007;45:3416-8. 36 Joseph P, Severe P, Ferdinand S, Goh KS, Sola C, Haas DW, Johnson WD, Rastogi N, Pape JW, Fitzgerald DW. Multidrug-resistant tuberculosis at an HIV testing center in Haiti. AIDS 2006;20:415-8. Noel F, Mehta S, Zhu Y, Rouzier Pde M, Marcelin A, Shi JR, Nolte C, Severe L, Deschamps MM, Fitzgerald DW, Johnson WD, Wright PF, Pape JW. Improving outcomes in infants of HIV-infected women in a developing country setting. PLoS ONE 2008;3:e3723. Severe P, Leger P, Charles M, Noel F, Bonhomme G, Bois G, George E, Kenel-Pierre S, Wright P, Gulick R, Johnson WD, Pape JW, Fitzgerald DW. Antiretroviral therapy in a 1000 patients with AIDS in Haiti. N Engl J Med 2005;353:2325-34. SEXUALLY TRANSMITTED DISEASES Evaluation of Rapid Syphilis Diagnostics for the Elimination of Congenital Syphilis in Haiti (2002 – 2010); the goal of this project is to improve syphilis screening throughout the country to reduce deaths due to congenital syphilis. Support is from the United Nations Development Program, the World Bank, and the World Health Organization's Special Program for Research and Training in Tropical Disease. Fitzgerald DW, Behets F, Preval J, Schulwolf L, Bommi V, Chaillet P. Decreased congenital syphilis incidence in Haiti's rural Artibonite region following decentralized prenatal screening. Am J Public Health 2003;93:444-6. Herring AJ, Ballard RC, Pope V, Adegbola RA, Changalucha J, Fitzgerald DW, Hook EW 3rd, Kubanova A, Mananwatte S, Pape JW, Sturm AW, West B, Yin YP, Peeling RW. A multi-centre evaluation of nine rapid, point-of-care syphilis tests using archived sera. Sex Transm Infect 2006;82 Suppl 5:v7-12. Schackman BR, Neukermans CP, Fontain SN, Nolte C, Joseph P, Pape JW, Fitzgerald DW. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. PLoS Med 2007;4:e183. INDIA: Visceral Leishmaniasis in India: The Indo-Cornell Kala-Azar Medical Research and Treatment Center. Murray. In 1994, we established with Professor Syham Sundar (Banaras Hindu University) the Kala-Azar Medical Research Center (KAMRC) in rural India (in Bihar State, the epicenter of India's visceral leishmaniasis epidemic), to test new treatments and develop new diagnostic and therapeutic approaches. Some of these new clinical approaches were the direct result of experimental work carried out in parallel in Leishmania-infected animals in our Weill-Cornell laboratory in New York City. Visceral leishmaniasis (kala-azar) is a worldwide parasitic infection that involves the liver, spleen and bone marrow in children and adults. One-half of the world's 500,000 new cases occur in India. The treatment trials work at KAMRC has been remarkably successful, and we are the world's leading treatment unit for this infection. Nearly 40 separate clinical trials have now been carried out in over 54,000 children and adults. For injectible treatments, we have defined the usefulness of combination immunochemotherapy, short-course cost-effective therapy and recently, single-dose therapy using liposomal amphotericin B (heretofore, 21-28 days had been the usual prior treatment duration). Even more important, we identified and tested miltefosine, the first effective oral therapy for this disease, representing a major breakthrough in treatment in kala-azar. Most recently, we have also begun testing short-course combination chemotherapy, using a single 37 dose of a parenteral agent (liposomal amphotericin B) followed by 7 days of oral therapy (miltefosine). Separate results from a series of other trials have also demonstrated the sensitivity, specificity and clinical usefulness of rapid non-invasive diagnosis of kala-azar using fingerstick blood and the immunochromatographic K39 antibody strip test. This reliable diagnostic method spares patients with kala-azar splenic or bone marrow aspiration. Murray HW. Kala-azar -- progress against a neglected disease (editorial). N Engl J Med 2002;347:1793. Sundar S, Chakravarty J, Rai VK, Agrawal N, Singh SP, Chauhan V, Murray HW. Amphotericin B treatment in Indian visceral leishmaniasis: response to 15 daily vs. alternate-day infusions. Clin Infect Dis 2007;45:556. Sundar S, Chakravarty J, Agarwal D, Rai M, Murray HW. Single-dose liposomal amphotericin B for visceral leishmaniasis in India. N Engl J Med 2010;362:504-12. Sundar S, Maurya R, Sinugh RK, Brharti K, Chakravarty J, Parekh A, Rai M, Kumar K, Murray HW. Rapid, noninvasive diagnosis of visceral leishmaniasis in India: comparison of two imunochromatographic strip tests for detection of anti-K39 antibody. J Clin Microbiol 2006;44:251. Sundar S, Rai M, Chakravarty J, Agrawal D, Agrawal N, Vaillant M, Olloaro P, Murray HW. New treatment approach in Indian visceral leishmaniasis: single-dose liposomal amphotericin B followed by with short-course miltefosine. Clin Infect Dis 2008;47:1000. TANZANIA: In 2006, a formal affiliation was established between WCMC and the Bugando University College of Health Sciences (BUCHS) and Bugando Medical Center in (BMC) in Mwanza, Tanzania. BMC is an 850-bed tertiary care center serving a population of ~12 million Tanzanians. BUCHS was founded in 2003 and is currently in the process of scaling up to a capacity of 60 medical students per class/year. Since 2005, the philanthropic TOUCH foundation has supported the BUCHS and the BMC. The TOUCH foundation has provided Weill Cornell with a matching grant for a pilot program addressing the educational needs of BUCHS/BMC. The common goal of the TOUCH foundation and WCMC is to make BUCHS/BMC the best medical school and teaching hospital in East Africa. The goal of the Weill Cornell collaboration is to aid in the development of the BUCHS/BMC infrastructure and training programs by the exchange of faculty, fellows, residents and students. Long-term goals are to create a platform for self-sustaining research programs and clinical knowledge transfer as in our Haiti and Brazil programs. During the first year of the program, WCMC will rotate 50 senior teaching residents and fellows in medicine, pediatrics, and obstetrics and gynecology to Tanzania. Two WCMC faculty members have been recruited and are based in Mwanza to serve as mentors, for both the Tanzanian and WCMC medical students and physicians at BUCHS/BMC. Plans for the involvement of WCMC pre-clinical faculty and graduate student tutors at BUCHS are being implemented. Downs JA, Kalluvya SE, Kataraihya JB, Jackson K, Jaka H, Kabangila R, Peck RN. Cranial and epidural abscesses presenting as scalp swellings in a 16-year-old boy: a case report. Tanzanian Medical Journal 2009; 24:34-5. 38