Women's Health and the Brain

Lisa Dixon, M.D., Professor, Department of Psychiatry, School of Medicine.  Dr. Dixon's clinical experience and research have focused on persons with severe mental illnesses such as schizophrenia who have co-morbid medical and substance abuse disorders, homelessness and other vulnerabilities as well as on services to family members.  The overall goal of her work ahs been to develop, test and disseminate strategies to improve the quality of care for persons with these disorders.  Other studies include a project on diabetes outcomes in schizophrenia as well as health disparities in mental health.

Joel D. Greenspan, Ph.D., Associate Professor, Department of Oral & Craniofacial Biological Sciences, Dental School. Dr. Greenspan's laboratory focuses on the neural mechanisms of somesthesis, and physiological factors that influence our perception of touch, temperature, and pain. He has several active areas of investigation, which allows him to gain different perspectives of this complex field:

The role of cerebral cortical processing in the various aspects of somesthesis. A. Brain activation studies (both PET and fMRI) have identified multiple regions in the parietal and insular lobes that respond to somesthetic stimulation. He combines psychophysical and fMRI brain imaging techniques to determine what functional roles these various brain regions play in different aspects of somesthetic perception. Both the initial processing regions of the cortex (S1 and S2), and the subsequent processing regions (posterior parietal, insular, and cingulate cortices) are of interest, particularly in terms of their relationship to sensory-discriminative vs. affective aspects of somesthesis. B. Dr. Greenspan has used a combination of high-resolution MRI and psychophysical evaluations to associate specific sensory abnormalities with sites of cerebral pathology in individuals with localized cerebral lesions. He is now combining such "lesion analysis" with functional brain imaging, in order to better understand the functional changes that occur within the somatosensory system. Of particular interest is the phenomenon of "central pain"--a debilitating and poorly treated pain condition that results from certain brain lesions, principally strokes involving the somatosensory pathways. C. Dr. Greenspan is evaluating the neural changes that occur following acupuncture and placebo analgesia using fMRI. He seeks to identify the specific cerebral structures that are engaged as a result of using these analgesic manipulations, as well as identifying those pain-related cerebral structures that are suppressed.

The bases for gender differences in pain. It has become increasingly evident that there is some degree of gender difference in pain sensitivity, both in laboratory animals and in humans. Dr. Greenspan is examining this issue in human subjects by evaluating which CNS mechanisms of nociceptive processing show sex differences. He is also examining the question of whether those aspects of nociceptive processing that show sex differences may play a role in those pathological pain conditions that are more prevalent in females, particularly, temporomandibular joint (TMJ) pain.

Gloria E. Hoffman, Ph.D., Professor, Department of Anatomy & Neurobiology, School of Medicine. The research in Dr. Hoffman's laboratory has for many years focused on issues of the CNS control of reproductive function. Currently, this research has evolved to a study of the processing of excitatory stimuli to the neurons that contain luteinizing hormone releasing hormone (LHRH or gonadotropin releasing hormone, GnRH) and trigger ovulation. At the system’s levels, studies are examining the neural circuits that transduce steroid signals to the LHRH neurons. The LHRH neurons are an essential component of reproductive function and marked increases in their activity accompany the preovulatory LH surge. The study of LHRH neurons has been particularly challenging since they are diffusely organized within the forebrain, small in size, and few in number, making conventional approaches for studying their activity impractical. Dr. Hoffman's laboratory has determined that the immediate early genes, c-fos, and c-jun are expressed in LHRH neurons during an LH surge. The appearance of immediate early gene proteins accurately reflects LHRH stimulated activity. Using this approach, this laboratory has examined the dynamics of LHRH activation, participation of steroid hormones in this process, and the role of selected afferents containing catecholamines, neuropeptides and excitatory amino acids in regulating LHRH activity. Recently, attention has shifted from where immediate early gene proteins are expressed to what changes in gene expression within neuroendocrine neurons are triggered by immediate early gene expression. In those studies, the expression of a second transmitter in the LHRH neurons, galanin, is the target of investigation. In addition, the laboratory has addressed the neuronal changes in the prolactin regulatory neurons during lactation. New quantitative non-radioactive in situ hybridization methods have been devised and studies are now underway to examine the neural mechanisms underlying suckling-induced synthesis suppression of the tyrosine hydroxylase, the rate-limiting enzyme for production of the prolactin inhibiting factor, dopamine. A separate but related path of inquiry in Dr. Hoffman’s laboratory focuses on the consequences of ovarian function on the injured brain. These studies examine the role that ovarian hormones play in seizure-induced brain damage, and neuronal damage induced by CNS inflammatory disease experimental allergic encephalitis.

Steven Kittner, M.D., M.P.H., Professor, Department of Neurology, School of Medicine.  Dr. Kittner's current activities include epidemiology and outcome studies of recovery after stroke, maitaining a 46-hospital research consortium in the Baltimore-Washington area for the study of ethnic differences in stroke risk and risk factors for stroke in young adults, including genetic risk factors, participation in a national study of siblings with ischemic stroke to support linkage studies for the identification of new genes related to stroke, a randomized clinical trial of medical managment versus catheter closure for treatment of patent foramen ovale-associated stroke in young adults.

Margaret M. McCarthy, Ph.D., Professor, Department of Physiology, School of Medicine. The developing brain remains a source of fascination and awe to neuroscientists and lay men alike. Less known to many is the bipotentiality of the developing brain, capable of taking on a masculine or feminine phenotype in equal measure. Body gender is determined by genes on the Y chromosome while the gender of the brain is dictated by the hormones produced by the gonad during a perinatal sensitive period. Events occurring as part of normal brain development are profoundly and permanently altered by the neonatal hormonal milieu, making this a useful model system of brain development. In particular, hormones modulate the fundamental yet still poorly understood processes of neurite outgrowth, synaptogenesis and naturally occurring cell death or apoptosis. Elucidating the cellular and molecular mechanisms mediating steroid-induced brain differentiation is the principle goal of Dr. McCarthy's research program.

The amino acid transmitter, GABA, mediates most synaptic inhibition in the mature brain but is actually the principal source of excitation in developing neurons and activates voltage gated calcium channels, causing a precipitous rise in intracellular calcium (Ca2+). Changes in free cytosolic Ca2+ activate multiple signal transduction pathways to alter cell function. Dr. McCarthy found that the hormonal profile of neonatal males results in GABA being more depolarizing, thereby doubling the magnitude of Ca2+ influx, and also extends the developmental period during which GABA exerts an excitatory action (Perrot-Sinal et al., Endocrinology 2001). She further demonstrated that the transduction sequelae of GABA are opposite in developing male and female brains. The transcription factor CREB is activated (phosphorylated) by GABA in males but is inhibited (dephosphorylated) by GABA in females. The activation of kinases versus phosphatases by the same transmitter, GABA, represents a major divergence point in the pathway to a male versus female brain. Dr. McCarthy's current research investigates the consequences of this gender-specific difference for cellular differentiation and adult brain function.

Istvan Merchenthaler, M.D., Ph.D., Sc.D., Professor, Departments of Epidemiology & Preventive Medicine and Anatomy and Neurobiology, School of Medicine. Dr. Merchenthaler's research focuses on the following: 1) the pathomechanism of hot flashes including the role of ovarian steroids, neurotransmitters and neuropeptides; 2) neuroprotection with estrogen including the role of estrogen receptor-a (ER-a and (ER-; 3) the development of CNS-selective estrogens for hormone replacement therapy; and 4) central regulation of reproduction including the role of stress, ER-a, enkephalin and galanin in pulsatile luteinizing hormone-releasing hormone (LHRH) secretion and ovulation.

Teodor Postolache, M.D., Associate Professor, Department of Psychiatry, School of Medicine.  Dr. Postolache's research centers on associations of inflammation including allergic reactions, with depression and suicide, especially in women.  He is also testing the role of inflammation as a trigger for exacerbation of mood disorders in women with postpartum depression.  His research bridges basic science, clinical and translational approaches.  Dr. Postalache also heads the Mood and Anxiety Program.

Richard Traub, Ph.D., Associate Professor, Department of Biomedical Sciences, Dental School.  The overall goal of Dr. Traub’s lab is to study how the spinal cord processes information about pain from the visceral organs in healthy individuals and following injury or disease using animal models of visceral pain syndromes. There are two major projects underway. First, he is interested in the role of gonadal hormones in pain arising from the viscera. It is well known that women are more prone to irritable bowel syndrome than men and it has been reported that symptoms fluctuate with the menstrual cycle. His laboratory is examining the role of specific gonadal hormones, estrogen and progesterone, on visceral sensitivity. Specifically, he is investigating how these hormones modulate synaptic function in the spinal cord, looking specifically at excitatory amino acids and their receptors. In addition, women and men respond differently to opioid analgesics and he is examining the biological basis for this difference in opioid sensitivity. In the second project, he is examining how injury to the newborn can influence pain processing from the viscera in the adult. As part of this project, his lab is investigating the role of different regions of the spinal cord in pain processing from the lower gut and how the normal circuitry is affected by neonatal injury.

The Aging Woman

Susan Fried, Ph.D., Professor, Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, School of Medicine.  Dr. Fried is a professor in the Division of Gerontology, Department of Medicine, University of Maryland School of Medicine and a Research Scientist in the Geriatric Research Education Clinical Core at the Baltimore Veteran's Administration Medical Center. She earned an A.B. in biology at Barnard College and a Ph.D. in nutritional biochemistry at Columbia University. She was a post-doctoral fellow in endocrinology and metabolism at Emory University and in lipid biochemistry at the Medical College of Pennsylvania. Dr. Fried was an assistant professor in the Laboratory of Human Metabolism and Behavior at Rockefeller University from 1986 to 1990. She then joined the Department of Nutritional Sciences at Rutgers University, and became a full professor in 1997. She was the Director of the Graduate Program in Nutritional Sciences at Rutgers from1996 to 2002. Dr. Fried's research concerns the regulation of adipose tissue metabolism, with a focus on the cellular and molecular mechanisms underlying depot differences in human adipocyte metabolism and hormone production. Dr. Fried currently serves on the editorial boards of the Journal Obesity Research, and she is Associate Editor of the International Journal of Obesity. She has served on a number of national scientific advisory panels, including the Nutrition Study Section of the National Institutes of Health and the Dietary Reference Intake Panel on Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids of the Food and Nutrition Board, Institute of Medicine, National Academy of Sciences. Dr. Fried is a member of the American Society for Clinical Nutrition, the American Physiological Society, and the North American Association of the Study of Obesity (NAASO). She served on the Council of NAASO for 8 years, as Representative to International Association for the Study of Obesity General Council.

Andrew Goldberg, M.D., Professor, Division of Gerontology, Department of Medicine, School of Medicine.  Dr. Goldberg leads research programs in the Baltimore VA GRECC and UMB Claude D. Pepper Older American Independence Center that investigate the hypothesis that some of the functional declines and medical diseases associated with aging in Western society are not the result of aging per se, but are contributed to significantly by physical deconditioning and the development of obesity, i.e. lifestyle habits, as well as genetic and ethnic factors. Aging and obesity have many medically- related similarities, and there is progressive relationship between obesity, physical deconditioning, aging, and risk for diabetes, hypertension, hyperlipidemia, and their arteriosclerotic-thrombotic complications.

The Goldberg laboratory focuses on the elucidation of the mechanisms by which exercise and weight loss effect obesity and its glucose and lipid metabolic complications. Our previous studies showed that weight loss was more effective in improving glucose and lipid metabolism and blood pressure profiles in obese older men, and that the combined effects of exercise and weight loss are synergistic in reducing central obesity and raising VO2 max to reduce risk factors associated with the metabolic syndrome. These and other studies confirm that exercise and weight loss increase insulin sensitivity and reduce lipid profiles, hyperinsulinemia and glucose intolerance more than either will independently in obese men with central obesity. This suggests that mechanisms in both fat and muscle contribute to the metabolic complications associated with central obesity, and may be modifiable by exercise and weight loss. Current research assesses the mechanisms by which weight loss and exercise improve the metabolic dysfunction associated with obesity. The addition of a moderate intensity exercise program to a weight loss program seems to promote the loss of visceral adiposity. The influence of gene polymorphisms (LPL, PPAR) on metabolic and body fat responses to weight loss and exercise training are being studied; women with certain gene variants may respond better or worse to weight loss programs that combine moderate exercise training.

Richard Macko, M.D., Associate Professor, Department of Neurology, School of Medicine.  Dr. Macko leads the Pepper Center investigators in studies of exercise rehabilitation and the epidemiology of stroke rehabilitation, fibrinolysis and thrombosis, and neuroplasticity. Trainees participate in all aspects of these research projects to learn approaches to the study of the epidemiology of stroke, CVD, and genetics. His research investigates the neuromuscular and cardiovascular-metabolic mechanisms of aging with the disability of stroke, and their modification by novel models of exercise training. This research considers that disuse along with age-associated declines in fitness and muscle mass compound neurological deficits and the cardiovascular-metabolic risk factor profile. Novel task-oriented training regimens merging principles of motor learning and brain plasticity with gerontologic models of aggressive risk factor intervention including exercise are investigated to improve function and cardiovascular fitness after stroke. Mechanistic studies of adaptive plasticity using transcranial magnetic stimulation and fMRI are combined with a multi-faceted approach to muscle biology including morphometrics, biochemical and molecular-genetic analyses from biopsies, and quantitative motor performance testing to differentiate central and peripheral neuromuscular adaptations in task-specific training models. Trainees are involved in the implementation and research measures obtained, and given opportunities to develop new hypothesis and outcome measures to study the effects of these programs. An emerging research area is inflammatory-prothrombotic mechanisms common to sarcopenia of aging and insulin resistance, that we now believe are accelerated in hemiparetic leg muscle. Delineating their molecular-genetic regulation and potential for attenuation by exercise training is an active area of research in which trainees can be mentored by Drs. Hafer-Macko, DeDeyne and McLenithan. Translational research is now underway to determine the impact of these mechanisms on systemic elements of the insulin resistance syndrome in Drs. Goldberg's, Ryan's, DeDeyne's, and Macko's Research labs. Trainees are encouraged to participate in this research learn the methodologies, assist on current and develop their own research questions. The rehabilitation research conducted in the GRECC and the UMB Pepper Center provides opportunities for trainees to learn from physical therapists techniques of gait and biomechanics testing, the physiology of motor control and the mechanisms by which task-oriented training improves muscle metabolism, central (neural) and musculoskeletal function after stroke.

Jay S. Magaziner, Ph.D., M.S.Hyg., Professor, Department of Epidemiology & Preventive Medicine, School of Medicine. Dr. Magaziner’s interdisciplinary training in gerontology, enhanced by his training in epidemiology, provides a unique perspective and special skills which he brings to his teaching and research. His research is focused on the consequences of hip fracture, health and long-term care, and methods for studying older populations to identify ways of enhancing functioning and improving the quality of life of older persons. His work on hip fracture has earned Dr. Magaziner a MERIT award from the NIA to evaluate a wide range of medical and psychosocial consequences of hip fracture. Recently this work has expanded to examine interventions for improving post-fracture bone, muscle and functional status and to chart the sequelae of hip fracture. Dr. Magaziner teaches a graduate course in epidemiology of aging, and is PI/director of a T32 pre- and post-doctoral training program in the Epidemiology of Aging supported by the NIA and of a T32 post-doctoral training program in primary care research from HRSA. He co-directs the newly established doctoral program in gerontology, which draws on faculty and resources from two UM campuses.

Braxton Mitchell, M.P.H., Ph.D.  Professor, Department of Epidemiology and Preventive Medicine, School of Medicine.  Dr. Mitchell's research involves the use of genetic epidemiologic methods to dissect the genetic and environmental determinants of type 2 diabetes, cardiovascular disease and obesity, with the hope of detecting and identifying common gene variants that may have pleiotropc effects on this constellation of traits.  In addition, he is interested in the genetic epidemiology of osteoporosis, and is currently involved in several family-based studies to understand the genetic and lifestyle factors which lead to variation in bone density. One aim of these studies is to identify specific gene variants that are associated with low (or high) bone density and to understand how lifestyle factors might influence the expression of these variants.

Alice Ryan, Ph.D., Associate Professor, Division of Gerontology, Department of Medicine, School of Medicine.  The prevalence of obesity continues to rise in the United States.  Total and abdominal obesity increase the risk for coronary heart disease and mortality among women. Moreover, there is an accumulation of fat in the abdominal region during the aging process with an increase in the infiltration of fat around and within skeletal muscle which adversely affects glucose and lipoprotein metabolism.  A main focus of Dr. Ryan’s research is the study of obesity, body fat distribution, intramuscular fat and their role in insulin resistance with emphasis on the effects of weight loss and exercise training on muscle and glucose metabolism in sedentary, overweight individuals. The basic research includes the study of mechanisms by which diet and exercise interventions (aerobic and resistive training) affect skeletal muscle and adipose tissue metabolism, insulin signaling and gene expression in muscle, and in vivo insulin action in sedentary older individuals.  In addition, Dr. Ryan’s research involves the study of residual hemiparesis following stroke which leads to physical deconditioning and possibly muscle atrophy and abnormal metabolism due to disuse or aberrant neural innervation.  She has described skeletal muscle atrophy and greater fat deposition within the muscle of the hemiparetic limb in chronic hemiparetic stroke patients which may contribute to functional disability and increased cardiovascular disease risk in chronic hemiparetic stroke patients.  Her research is currently examining the muscle molecular phenotype and its relationship to gait deficit severity and interventions designed to prevent muscle atrophy and reduce insulin resistance which are needed to minimize the loss of functional independence and cardiovascular disease risk in older chronically disabled stroke patients.

Alan Shuldiner, M.D., Professor, Division of Endocrinology, Diabetes & Nutrition, Department of Medicine, School of Medicine.  Alan R. Shuldiner, M.D. studies the genetics of complex disorders including type 2 diabetes, insulin resistance and obesity. Identification of susceptibility genes for these disorders will provide novel avenues for therapy and prevention. Utilizing candidate gene and positional cloning approaches, he searches for susceptibility genes for diabetes and obesity, as well as gene variants that may predict responsivity to medications used to treat diabetes (pharmacogenomics). These studies have led to the identification of genetic variants in the beta-3-adrenergic receptor and peroxisome proliferator activated receptor-gamma (PPAR-gamma), which are susceptibility genes for obesity and/or type 2 diabetes. Collaborations with investigators throughout the world provide access to thousands of DNA samples from diverse populations for these studies including Pima Indians, Mexican Americans and African Americans. In addition, in his Amish Research Clinic in Strasburg, PA, Dr. Shuldiner has recruited and studied over 2,500 Old Order Amish subjects for a genome-wide scan and positional cloning of susceptibility genes for complex diseases including type 2 diabetes, obesity, osteoporosis, hypertension and longevity, as well as to dissect gene-environment interactions in shaping the risk of cardiovascular disease.

Linda Simoni-Wastila, B.S.Pharm., Ph.D., Associate Professor, Department of Pharmaceutical Health Services Research, School of Pharmacy. Dr. Simoni-Wastila has been involved in research focusing on prescription drugs for over 15 years. As a health services researcher, she has examined issues including access to prescription drugs, outcomes related to reduced prescription drug access, cost and financing of prescription drug benefits and programs, appropriateness of drug prescribing, outcomes associated with inappropriate prescribing, and prescription drug misuse and abuse. She is particularly interested in the impacts of limited prescription drug use and inappropriate drug use in vulnerable populations, including elders, racial and ethnic minorities, and those at risk due to impaired physical and mental health. Her current research portfolio includes Quality of Pharmacologic Treatment of Mental Illness in Long-term Care Recipients, Prescription Drug Issues Under the New Medicare Prescription Drug Benefit and the Prescription Drug Use, Abuse, and Outcomes.  She has received grants and contracts from the National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, the Agency for Healthcare Research and Quality (formerly the Agency for Health Care Policy and Research), the Centers for Medicare and Medicaid Services, and various states, foundations and proprietary firms. Dr. Simoni-Wastila received her undergraduate pharmacy degree from the University of North Carolina, where she also completed a Master’s in Public Health policy. In 1993, she received her doctorate in Health Policy from Brandeis University. Most recently, she was a Senior Scientist at the Schneider Institute for Health Policy at Brandeis University where, in addition to her research, she was Co-Director of a doctoral training program sponsored by NIAAA.

Barbara Smith, Ph.D., R.N., Professor, Department of Family and Community Health, and Associate Dean for Research, School of Nursing. Dr. Barbara Smith is funded by NINR to study effects of a physical activity and nutrition intervention on fat mass, insulin, glucose and C-peptide levels in HIV-infected individuals.

Conditions Specific to Women

Angela M.H. Brodie, Ph.D., Professor, Department of Pharmacology & Experimental Therapeutics, School of Medicine. Dr. Brodie’s research interests focus on steroid biochemistry, reproductive endocrinology, and the endocrinology of prostate cancer as well as breast cancer and other estrogen-mediated diseases. Dr. Brodie developed the first selective aromatase inhibitors for the treatment of breast cancer. In particular, formestane (4-hydroxyandrostenedione) was the first selective aromatase inhibitor to be used clinically and at that time was the only new drug specifically designed for the treatment of breast cancer in 10 years. Formestane was released for worldwide use in 1994. Dr. Brodie’s current research interests include the development of a novel pre-clinical model for determining effective treatment strategies to aid in the design of clinical trials. The model is also being used to investigate changes in gene expression during aromatase and antiestrogen treatment. These studies could help understand the mechanisms involved in drug resistance and lead to new ways to improve treatment and prevention.

Charles Chaffin, Ph.D., Associate Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine.  Follicular growth, ovulation, and the formation of the corpus luteum are central, but poorly understood, aspects of fertility, as well as potential sites of contraceptive intervention.   Given the increasingly widespread use of assisted reproductive technologies, including methods aimed at superovulation, a better understanding of these basic ovarian processes is essential in order to develop safer, more effective protocols for ovarian stimulation, in vitro fertilization, assessment of infertility, and novel avenues of contraceptive intervention.  As part of this effort, Dr. Chaffin’s studies encompass two main topics.  The first is the control of granulosa cell proliferation and differentiation, with the hypothesis that controlled ovarian stimulation protocols augment proliferation to the point that the ability of follicular granulosa cells to differentiate into steroid producing cells of the corpus luteum is impaired.   Second, he is involved in research pertaining to the regulation of steroid synthesis and action during the critical transformation of the follicle into the corpus luteum, looking at lipoprotein usage, regulation of steroidogenic enzyme expression, and novel steroid synthetic pathways. 

Amy F. Fulton, Ph.D., Professor, Department of Pathology and Program in Oncology, School of Medicine. The Cyclooxygenase (COX) enzyme is commonly overexpressed in many solid tumors, including breast cancers. COX expression is emerging as a risk factor for more aggressive disease. Dr. Fulton has several projects that would be appropriate for an interdisciplinary research project. (1) How is high level expression of COX induced in tumors. Dr. Fulton has preliminary evidence that the expression of the COX gene is regulated by hypermethylation of the COX promoter. This project will extend these studies to establish a definitive mechanism of promoter regulation. (2) Dr. Fulton also has data indicating that selective pharmacologic inhibitors of COX inhibit growth and metastasis of malignant breast tumors. Using gene expression studies and examination of cell response pathways, she will determine the mechanism(s) by which these drugs exert therapeutic activity. (3) Cyclooxygenase metabolites have profound effects on immune function. She is studying how COX inhibitors modulate antitumor immune effector function.

Anne Hamburger, Ph.D., Professor, Department of Pathology, School of Medicine. Our laboratory has had a long standing interest in the modulation of the activity of the Epidermal Growth Factor Receptor (ErbB) family as a means of cancer treatment. Previous studies showed that interferons could down regulate ErbB2 receptor activity in breast and ovarian cancer. We also showed that inhibition of ErbB2 receptor synthesis in lung cancer inhibited tumorigenesis by altering interactions with other ErbB family members and their ligands. Our laboratory recently cloned a protein, Ebp1, that interacts with the ErbB3 receptor. Overexpression of this protein inhibits growth of breast and prostate cancer cells. Ebp1 interacts with the E2F transcriptional activator to inhibit transcription of cell cycle regulated genes. Ebp1 also specifically interacts with the androgen receptor in prostate cancer, leading to downregulation of androgen receptor and other AR activated genes. We are exploring the potential therapeutic use of this protein in breast and prostate cancer.

Patricia Langenberg, Ph.D., Professor, Department of Epidemiology and Preventive Medicine, School of Medicine.  Dr. Patricia Langenberg is currently involved either as Co-investigator or Statistician in a number of funded grants both in the Department of Epidemiology and Preventive Medicine and through other departments. One of the major research areas is Women's Health. She chairs the Women's Health Research Group, an inter-disciplinary body housed in Epidemiology but with membership across the UMAB campus. She is Principal Investigator of an NIH-funded grant 'Building interdisciplinary research careers in Women's Health (BIRCWH)' that funds four faculty members at the beginning of their careers working in areas of women's health research. She is biostatistician for a clinical trial examining endometrial ablation as an alternative to hysterectomy for Dysfunctional Uterine Bleeding. She was Co-investigator of a grant funded by NIH on risk factors for uterine fibroid growth, and biostatistician for an AHCPR-funded grant on effectiveness and outcomes of hysterectomy. She was also Co-Investigator for a clinical trial studying the effect of hormone replacement therapy on uterine fibroids funded by NIH. A second area of interest involves nutritional interventions; she is a co-investigator for a grant funded by NCI to promote reduction in fat and increases in fiber and fruits and vegetables in the diet. She was also statistician for a study of the 5-a-day program in Maryland WIC centers. As part of her research interest in clinical trials, Dr. Langenberg was statistician for the NEI-funded clinical trial of Ischemic Optic Neuropathy Decompression (IONDT). Another area of interest is in meta-analysis, and she has published several papers in this area, both application and methods papers. One meta-analysis application involved collaboration with members of the Department of Obstetrics and Gynecology in a study comparing two regimens of hormone replacement therapy.

Deborah McGuire, Ph.D., R.N., F.A.A.N., Professor, Department of Organizational Systems & Adult Health, School of Nursing.  Dr. McGuire is a Professor at the University of Maryland Baltimore, School of Nursing, where she directs the master’s program in oncology nursing and teaches and advises doctoral students who are studying cancer or palliative care topics.  Her program of interdisciplinary clinical research focuses on supportive and palliative care, specifically cancer-related symptoms, oral complications of cancer therapy, and quality of life.   Her current funded studies include a multi-site study evaluating a pain assessment tool for use in non-communicative palliative care patients (NINR/NIH) and a project examining trajectories of oral mucositis and pain in patients who received high dose chemotherapy (NCI/NIH).  She is the President of the International Society of Oral Oncology, a multidisciplinary group of health care professionals devoted to oral oncology supportive care issues.  She serves on the American Cancer Society’s Extramural Research Grants Council and the National Cancer Institute’s Subcommittee H:  Clinical Trials.  

Renee Royak-Schaler, Ph.D., M.Ed., Associate Professor, Department of Epidemiology & Preventive Medicine, School of Medicine. Dr. Royak-Schaler is a health psychologist whose research focuses on disparities in cancer screening and early detection. Before coming to the University of Maryland, she was the Director of the Division of Behavioral Sciences and Leader of the Population Based Cancer Control Program at the American Health Foundation Cancer Center (AHFCC) in New York. Under her direction, the AHFCC developed interdisciplinary studies designed to investigate the behaviors and biological markers associated with breast cancer outcomes in minority populations. Her ongoing studies investigate the psychosocial and behavioral factors that influence the risk perceptions, screening practices, and cancer outcomes of minority women. She was Principal Investigator of the PARTNERS in Breast Cancer Education Program (NCI-RO1-CA-68336, 1996-2000), a church-based initiative for African American women designed to promote accurate risk perceptions, prompt symptom care, and effective communication about breast cancer with primary care providers. Prior to leaving the AHFCC, she was Principal Investigator of the CUNY-AHFCC Partnership, Training Minorities in Bio-behavioral Cancer Research (NCI-P20-CA91401, 4/01/01- 3/31/04). This project was funded by the NCI to train minority faculty and graduate students at the City University of New York in cancer prevention and control research. She continues on this training partnership as Co-Principal Investigator of a funded pilot study, Targeting Breast and Colorectal Cancer Risk Communication for African American and Hispanic Populations in East Harlem (NCI-P20-CA91401, 6/01/01-5/31/02). Dr. Royak-Schaler is collaborating with the Crozer-Keystone Health System in Philadelphia, PA to develop evidence-based methods for providers to assess, communicate, and reduce cancer risk factors with their minority patients in primary care practices.