Brazil Platform

UMMS Dean Woolliscroft (center) receiving a token of friendship

UMMS Dean Woolliscroft (center) receiving a token of friendship from the University of São Paulo brought to him by Dr. Edmund Baracat (left) and Dr. Ana Claudia Latrônico (right)

Faculty members in the University of Michigan Medical School (UMMS) have been collaborating with partners in Brazil for more than a decade. Based in large part on the partnerships existing between the Medical School and several educational institutions in Brazil, President Mary Sue Coleman traveled to Brazil in 2012 with a delegation of researchers and scholars, including several from UMMS, in an effort to formalize these institutional relationships. During her visit, she signed a collaboration agreement with the State of São Paulo Research Foundation (FAPESP), one of the main funding agencies in Brazil, to stimulate collaboration between researchers across the University of Michigan campus and researchers throughout higher education and research institutions in the São Paulo state.  

One of the resulting initiatives was a joint research grant program. Ten grants have been awarded in the first two rounds of proposals, three of which went to UMMS faculty and their Brazilian collaborators. Another UM major partner in Brazil is Rio de Janeiro’s FIOCRUZ, a leading center for health promotion and social development. Multidisciplinary research involving FIOCRUZ and UM faculty (including UMMS researchers) has been funded and stimulated both by Global REACH and the Brazil Initiative at the UM Latin America and Caribbean Studies Center (LACS).

Within UMMS, Memoranda of Understanding exist with both the University of São Paulo Medical School (FMUSP), the Institute of Biomedical Sciences at the University of São Paulo (ICB-USP, as well as growing collaborations with USP's Ribeirão Preto Medical and Nursing Schools. FMUSP is widely considered to be the best medical school in Latin America, with a large research capacity and a network of hospital and ambulatory centers serving hundreds of thousands of patients. Recently, an MOU was also signed with the Medical School of Federal University of Bahia (UFBA), an important university from the Northeast region of Brazil. 

As the Brazil Platform has expanded, so has the increased interest of faculty and student from the University of Michigan and the Brazil partner institutions. Currently, more than 40 Global REACH Faculty Associates and Affiliates from 15+ UMMS departments and other UM Schools and Colleges, are engaged in the Brazil Platform. 

UMMS Dean Woolliscroft (center) receiving a token of friendship

Collaborators from Brazil enjoy one of the first snowfalls of winter during the November 2014 UM-Brazil Platform Symposium

Some of their collaborative research programs are highlighted on this page as are many of the educational and research initiatives that have taken place over the past few years. Events such as the August 2013 FIOCRUZ Symposium (held in Brazil),and the March 2014 Brazil Meet and Greet and the November 2014 UM-Brazil Platform Symposium (see below), which were held in Ann Arbor, have provided additional opportunities for multi-partner engagement and to showcase many of the institutional collaborations. 

 If you have any inquires or suggestions about Brazil Platform, please contact Elisa DuarteTeixeira at elisadut@umich.edu.

View list of Global REACH Faculty Associates collaborating in Brazil here.

 

Research Programs and Collaboration

Adrenal and Other Endocrinological Cancers and Disorders

  • Brazil has one of the highest concentrations of adrenal cancer in the world with 15 percent more prevalence than anywhere else.

  • FMUSP is the South American hub of activity in regard to adrenal cancer work, and UM’s Endocrine Oncology Program is an lnternational Destination Program Center of Excellence for the treatment of adrenal cancer.

  • UMMS and FMUSP programs have collaborated on research studies over the years, and are now working to create combined data registries. Other joint projects include developing mass spectrometry methods to comprehensively examine steroid production and to detect partial blocks in specific steps in cortisol synthesis.

  • A recent publication by researchers from the two institutions shows that the two common mutations in adrenal cancer are critical for the induction of the disease in humans and in mouse models.  It is a powerful example of how international collaboration (which is critical to make progress in the disease) and genomic platforms, together with animal modeling, can shed light on the pathogenesis of rare diseases like adrenal cancer.  The work was funded in part by NIH and in part by the Schembechler Adrenal Cancer Research fund.

  • Collaborators are working on a center grant to continue their pilot work (funded by the National Cancer Institute) on The Cancer Genome Project, a comprehensive, concentrated effort to accelerate the understanding of the molecular basis of cancer through the application of genome analysis technologies. More about this collaboration can be found in presentations from the 2014 Brazil Symposium by investigators Hammer (view here) and Fragoso (view here).

  • View a video interview with Dr. Gary Hammer about the importance of the adrenal cancer collaboration with the University of Sao Paulo.

UMMS Contact
Gary Hammer, MD, PhD
Millie Schembechler Professor of Adrenal Cancer, Professor of Internal Medicine, Professor of Molecular and Integrative Physiology, Director of Center for Organogenesis and Professor of Cell and Developmental Biology, Medical School


Health Equity and Chronic Disease Management

  • FMUSP has a mandate to run all primary care centers (Basic Health Units - UBSs) in Sao Paulo’s low-income neighborhoods of Western Region (Região Oeste).

  • These centers are organized into healthcare teams consisting of 1 doctor, 2 nurses, 2 medical assistants, and 6 community health workers from the served communities.

  •  UM faculty members are working with FMUSP colleagues to develop and test innovative approaches to improve community health worker-led self-management training for patients with chronic disease in Região Oeste.

  • The Região Oeste project itself is interdisciplinary, bringing together faculty and students from numerous USP departments and schools — including engineering, urban planning, environmental sciences, sociology, economics, and psychology, among others — to conduct interdisciplinary projects to study and improve conditions in the poor urban communities in the Região Oeste.

  • For the second consecutive year, 5 UMMS medical students will be spending 8 weeks in Brazil during Summer 2015 to work on a project involving Região Oeste. More information about this collaboration was captured in the recent Global REACH Activities Report (view here) and in a presentation made by investigators at the 2014 Brazil Symposium (view here). 

UMMS Contact
Michele Heisler, MD, MPA
Associate Professor of Internal Medicine, Medical School and Associate Professor of Health Behavior and Health Education, School of Public Health; Co-Director, Robert Wood Johnson Foundation Clinical Scholars®, Research Scientist, Center for Clinical Management Research, Ann Arbor VA HSR&D


Spinal Cord Injury

SCI co-investigator, Dr. Julia Greve (USP), visiting the U-M SCI outpatient clinic to observe patient walking with robotic assistive device
  • The incidence and prevalence of spinal cord injury (SCI) in the US and Brazil are among the highest in the world. The cost of caring for someone with SCI continues to exceed that of most disease conditions.

  • UMMS and MFUSP researchers are working together to develop a common database to collect information to be used in research to aid clinical care. The collaboration emphasizes the importance of standard datasets to guide clinical treatment and research in SCI. They have translated and completed psychometric studies of the SCI Bowel Function Basic dataset and are currently in the process of completing others for joint use in future clinical validation studies. Testing these datasets adds to the current studies being conducted at the U-M SCIMS which focus on examining the influence of bowel and bladder management on complications and quality of life after SCI. 
  • Comparing data cross culturally is another added benefit of this international collaboration. The Presidents of the International Spinal Cord Society (ISCoS) and the American Spinal Injury Association (ASIA) have approved the project and the most recent updates were presented at the September 2012 meetings of the International Spinal Cord Society (ISCoS) in London.
  • Kidney failure is the number one cause of SCI related mortality. This group is interested in studying the best methods for neurogenic bladder and bowel care in this population.
  • The collaborating team is developing a short-term training program on SCI care and research for USP residents and an exchange program for UMMS PM&R residents giving them the opportunity to work with SCI inpatients and outpatients who are clinically and characteristically very different from SCI patients seen in Michigan. ·More information about this collaboration can be viewed from the Global REACH Activities Report here and a presentation at the 2014 Brazil Symposium here.

UMMS Contact
Denise Tate, PhD, ABBP, FACRM
Professor of Physical Medicine & Rehabilitation, Medical School; Associate Chair for Research and Director, Model Spinal Cord Injury (SCI); Director, Advanced Rehabilitation Research Program


Endocrine Genetics Collaboration

  • Collaborations have existed for a number of years with shared publications and presentations, and UMMS faculty have taught short-duration courses at USP attended by students and faculty.
  • Dr. Carlos Carvalho, one of the major mouse users at USP, was a postdoc in Dr. Sally Camper’s lab at UMMS. Camper and Carvalho have a collaboration aimed at identifying stem cell markers in pituitary gland using mouse models. Another USP researcher using zebrafish is studying the effect of environmental toxins on fertility. 
  • Camper also collaborates with Carvalho’s colleagues Dr. Mendonca and Dr. Arnhold. Mendonca is internationally known for her work in disorders of sexual development, while Arnhold is an expert in short stature.
  • Sao Paulo used to be the only site in Brazil that could treat patients with growth hormones, so they have a large cohort they are following from childhood through adulthood. Carvalho, Arnhold, and colleagues identify mutations in patients with short stature and growth hormone deficiency, Camper’s lab advises and assists with developing the functional tests when needed.
  • Plans are in the works to do SNP typing and exome sequencing on patients who have growth hormone deficiency, but have no mutations in known genes. More updates about this collaboration can be viewed from a presentation at the the 2014 Brazil Symposium here.

UMMS Contact

Sally Camper, PhD
James V. Neel Collegiate Professor of Human Genetics; Chair, Department of Human Genetics; Professor of Human Genetics and Professor of Internal Medicine, Medical School


Brains from mice infected with an encephalitic virus (bottom row) show disruption of the blood-brain barrier (green dye permeability) that is not seen in control uninfected mice (top).

Neuropathogenesis of Oropouche Virus

  • Oropouche virus (OROV) is second only to dengue in causing febrile illnesses in Brazil. Infection can be quite debilitating, although the virus does not cause death. OROV is currently rated as a BSL-3 (Biosafety Level 3) virus, 4 being the most dangerous. UMMS does have a BSL-3 facility, but one of the aims of this collaboration is to petition to reduce OROV's rating to BSL-2 to faciliate additional research.

  • The arthropod vector of OROV is primarily biting midges (Culicoides paraensis). Deforestation and global climate change impact the potential for expansion of the range of the vector and increase of the disease in South and North America.

  • Two forms of the OROV disease exist, a classic febrile form and one that progresses to aseptic meningitis in approximately 5% of patients seeking medical care. Nearly 60% of patients have a recurrence of clinical signs 1-2 weeks after their initial disappearance. There is a gap in knowledge about the cells or organs in which OROV replicates and in how it causes relapses and meningitis. Currently, there are no treatments or vaccines.

  • The long-term goal of this project is to improve therapy for people with arboviral disease by understanding how viral gene products interact with the host to cause disease. Toward that goal, this team seeks to determine how OROV infects the central nervous system (CNS) using and further developing mouse models in which there is severe CNS involvement. Read more about this project from a page in the Global Reach Activities Report (view here). 

    Dr. Eurico Arruda (left) and Dr. Kathy Spindler in Dr. Arruda's laboratory, University of São Paulo Medical School at Ribeirão Preto, FMRP
  • Dr. Spindler and her Brazilian collaborator, Dr. Eurico de Arruda Neto from the Cell Biology and Virology Research Center at the University of São Paulo Medical School at Ribeirão Preto (FMRP), have known each other through scientific meetings since 2008. In 2012, Dr. Arruda was on the PhD committee of Luiza Antunes de Castro Jorge, who is now a post-doc in Dr. Spindler’s lab with a “Science Without Borders” scholarship.  View a presentation by Dr. de Castro Jorge here.

UMMS Contact
Katherine Spindler, PhD
Professor of Microbiology and Immunology, Medical School


Immunological/Pulmonary Diseases

  • Collaborations between UMMS and USP date back more than 10 years. Many high-level publications have resulted from these collaborations.

  • This partnership has resulted in many visiting scholars from Brazil, including three PhD postdocs and four PhD students. Two of the postdocs now hold faculty appointments and remain collaborators; one is at Sao Paulo State University, one at the Federal University of Rio De Janeiro.

  • Dr. Peters-Golden is a formal collaborator on grants held in Brazil by Professor Jancar and former trainee Professor Medeiros (Araraquarra).

  • During a visit in the fall of 2011, Peters-Golden visited with Dr. Carlos Carvalho, Professor of Internal Medicine and Director of Pneumonology, and his department. Based on their discussion, there is mutual interest to further explore possible opportunities for research collaboration and exchange of trainees at the fellowship level (i.e., individuals who have completed MD and internal medicine residency, and are in subspecialty training in Pulmonary and Critical Care Medicine).

UMMS Contact
Marc Peters-Golden, MD
Professor of Internal Medicine, Medical School, Pulmonary & Critical Care Medicine


Reproductive Endocrinology and Technology

  • UMMS researchers and USP researchers have been collaborating on projects since 2004.

  • UMMS Professor of Obstetrics & Gynecology Dr. Gary Smith serves as the Off-Site Scientific Director of the Huntington Centers for Reproductive Medicine of Brazil (HCRMB), which is now the largest in-vitro fertilization (IVF) clinic in the Americas performing over 3,000 cycles per year.

  • The collaborative team has completed phase I and II clinical trials, implemented state-of-the-art infertility treatment and fertility preservation technologies, and improved fertility healthcare. There have been 10 collaborative peer-reviewed publications since 2006, 23 national/international meeting presentations and abstracts, and 11 physician, fellow and/or student exchanges since 2004.

  • Current aims are to continue reciprocal training, research, and improvement of healthcare in reproductive endocrinology, gamete/embryo biology, and treating infertility.

  • The team is working to implement a Fertility Preservation Program at USP. This will provide on-site and off-site (across the entire country of Brazil) service of male and female gamete cryopreservation for individuals at risk of losing fertility due to gonadotoxic treatments for cancers, immune diseases, and transplant therapies.

UMMS Contact
Gary D. Smith, PhD, HCLD
Professor of Obstetrics & Gynecology, Professor of Physiology, Professor of Urology, Co-Director, Taubman Consortium for Stem Cell Therapies; Co-Director, Reproductive Sciences Program; Visiting Professor, University of Sao Paulo; Off-Site Scientific Director of Huntington Centers for Reproductive Medicine of Brazil (HCRMB)


UMich-FIOCRUZ Collaboration

The UMich-FIOCRUZ Collaboration is a joint project involving researchers of the University of Michigan and Rio de Janeiro’s Oswaldo Cruz Foundation, FIOCRUZ.  The program is part of the University of Michigan's Presidential Initiative on Brazil, which was launched in 2012 and is managed by Bebete Martins, Brazil Initiative Program Manager at the Latin American and Caribbean Studies Center (LACS).

The collaboration brings together researchers from both institutions working in the areas of health status, determinants, outcomes, interventions, and histories to engage in substantive and medium-range projects. The research methods are interdisciplinary, including quantitative and qualitative approaches (implementation studies, survey data collection, ethnography, archival research, and more).

On the Michigan side, the interdisciplinary faculty group includes researchers based in the SPH, UMMS, SNRE, LS&A, and ISR. This three-year research collaboration was consolidated at a research symposium held August 7-9, 2013, at the FIOCRUZ campus, in Rio de Janeiro, Brazil. A summary report of the symposium can be downloaded here (PDF). Click these links to learn more about their joint projects from presentations at the 2014 Brazil Symposium: History of Cardiology (view here); Milk Banks (view here and here); Brazilian Longitudinal Study of Adult Health - ELSA-Brazil (view here and here).

LACS is now overseeing pilot fund to support research in the identified areas. If you are interested in learning more about this collaboration, please contact Bebete Martins at bmartins@umich.edu.

Educational Exchanges and Engagement

The exchange of medical students, residents, and fellows between the Brazil Platform partner institutions has been enhanced by the establishment of MOUs and increased cross-national visits of Platform faculty. Since 2012, UMMS has hosted Brazilian medical students who were competitively selected from partner universities in Brazil to participate in clinical observerships. Current students now attend a 6-week Seminar Series on Comparative Health Systems. 

For the second year in a row, 5 UM medical students will go to Brazil in Summer 2015 on a 2-month Faculty-led Trip, funded by Global REACH and led by a Global REACH Faculty Associate, to work on an ongoing joint project. A pilot course on Medical Portuguese for Spanish-Speaking Health Professionals was offered in the Winter 2014 and a Medical Portuguese and Conversation Practice Group will be meeting biweekly in the Winter 20015. In addition, the creation of an Online Medical Portuguese course in partnership with FMUSP is underway.

There’s also a shared interest among UMMS and FMUSP departments in sending and hosting residents from various medical areas for short-period, mentored observerships. Several Brazilian post-docs and fellows, most fully funded by Brazilian agencies, continue to come to work on several research laboratories within UMMS. 

Recent student exchanges include:

  • Summer 2014: Five M1 students participated in Dr. Michele Heisler’s Faculty-Led Trip to Brazil sponsored by Global REACH.  (Read about the project here).
  • May 2014: Dr. Luis Felipe Carissimi Schmidt, resident from UFRGS, arrived in Ann Arbor for a 2-month observership at UMMS Pathology and Oncology.
  • February 2014: M4 Adam Baruch participated in a 4-week medical observership in the FMUSP Divisions of Endocrinology and Gynecology.
  • January 2014: Pilot course “Portuguese for Spanish-Speaking Health Professionals” began for UMMS students and faculty interested in learning/improving their language proficiency. The course was taught over the Spring semester by Brazil Platform Program Manager, Dr. Elisa Teixeira.
  • January 2014: M3/M4 medical student, William (Trey) Shield III , began a six-month observership at FMUSP’s Hospital das Clínicas under the guidance of FMUSP surgeon, Dr. Luiz A. Carneiro D’Albuquerque,  and Dr. Wellington Andraus (Director of Student Exchanges for the Liver Transplant Unit at USP).
  • January-February 2013: Two FMUSP Brazilian medical students visit UMMS as part of the first formal exchange program.
  • July 2013: Dr. Bernardo Rodrigues , Brazilian Neurology fellow, began a 2-year fellowship in Dr. Hank Paulson’s Movement Disorders Lab.
  • July 2013: Brazilian post-Doc student Beatriz de Carvalho Borges  began a 1-year project in Dr. Carol Elias ’ laboratory at the Department of Molecular and Integrative Physiology. The research project, Role of PI3K Signaling Pathway in Endotoxin-induced Leptin Resistance, is partially funded by a Brazilian grant from FAPESP.
  • December 2012-January 2013: Four FMUSP Brazilian medical students visit UMMS as part of the first formal exchange program.  

 

​Other recent engagements include:

  • May 2014: Led by Dr. Akinlolu Ojo (UM Department of Internal Medicine), an MOU with Federal University of Bahia (UFBA) was finalized.

  • April 2014: Dr. Denise Tate led a team of five UM researchers to visit FMUSP Institute of Orthopedics and Traumatology and participate in a workshop on driving assessment for the elderly and persons with disabilities.

  • March 2014: The first annual Meet & Greet was held in Ann Arbor.  About 40 U-M investigators who collaborate with partners in Brazil were in attendance. Read more about the event here.
  • November 2013: Dr. Marcio A. Torsoni, (Faculty of Applied Sciences, UNICAMP), began a 1-year project, The role of AMPK activity in the modulation of reproductive-neuroendocrine axis, at Dr. Carol Elias ’ lab, fully funded by a Brazilian grant by FAPESP.

  • October 2013: Dr. Kate Stanley (Obstetrics & Gynecology) gave a talk at the 70th Anniversary of Brazilian Milk Banks Project in Belo Horizonte, Minas Gerais. The Milk Bank Project was captured by the University of Michigan News Service (read the article here) and the Global REACH Activities Report (view the page here).

  • August 2013: UM joint symposium with Rio de Janeiro’s Oswaldo Cruz Foundation (FIOCRUZ) was held in Brazil. This collaboration brought together a multidisciplinary delegation of 14 UM faculty members and several FIOCRUZ researchers and students working in the areas of health status, determinants, outcomes, interventions, and histories to engage in substantive and medium-range projects. 

  • July 2013: Brazilian post-Doc student Beatriz de Carvalho Borges  began a 1-year project in Dr. Carol Elias ’ laboratory at the Department of Molecular and Integrative Physiology. The research project, Role of PI3K Signaling Pathway in Endotoxin-induced Leptin Resistance, is partially funded by a Brazilian grant from FAPESP.

  • July 2013: Dr. Bernardo Rodrigues, Brazilian Neurology fellow, began a 2-year fellowship in Dr. Hank Paulson’s Movement Disorders Lab.

 

Shown above are participants in the Winter 2014 Portuguese for Spanish-Speaking Health Professionals pilot course. From left to right: Dr. Bernando Rodrigues, MD, PhD (Brazilian fellow at Movement Disorders), Stephanie Chalifour*, Pooja Agrawal*, Elizabeth Kaselitz, LLMSW (Clinical Research Project Manager at the U-M Division of General Medicine), Marlon Bohorquez*, Thaisa Barbosa**, Leonardo Lima**, Simanjit Mand*, and Miguel Rovira*
*Faculty-Led Trip to Brazil scholarship recipients; **Visiting Brazilian Medical Students

 

Brazil Platform Symposium: November 12 and 13, 2014

The 2014 UM-Brazil Platform Symposium, Collaborating to Study and Improve Health, was held on November 12-13 in Ann Arbor. The aim of this symposium was to bring together Brazilian collaborators and their University of Michigan Medical School partners to discuss their recent achievements and share results of joint research, as well as to foster the creation of new partnerships with Brazilian faculty working at the institutions that are our preferred partners.

The event aimed to advance the establishment of formal programs for the exchange of medical students, residents and scholars in basic and clinical sciences, and to plan joint educational activities, such as bi-institutional courses and webinars.

Co-sponsors: Global REACH and the Brazil Initiative at the Center for Latin American and Caribbean Studies


View program here (PDF).


Speaker presentations

Note: The material presented in these PDF files has been made available to the public for personal viewing purposes only.  Any alternative use of the material requires permission from the author.  Should you wish to request permission for a particular file, please submit the title of the presentation along with the purpose of your request and your contact information to globalreach@umich.edu.

Presentations are listed according to order in the program.

Wednesday, November 12, 2014

Thursday, November 13, 2014


Created with flickr slideshow.

 

News and Resources

  • December 2014: University of Michigan News Services features Milk Bank project.  Read more here.

  • October 2013: Dr. Kate Stanley, UM neonatologist, goes to Belo Horizonte to participate in a Milk Bank International Meeting , as part of the UMich-FIOCRUZ Collaboration (more information, In Portuguese, here: http://www.youblisher.com/p/749759-rBLH-Comunica-N-171-Boletim-da-Rede-de-Bancos-de-Leite-Humano/)

  • September 2012:  President Mary Sue Coleman traveled to Brazil with a delegation of U-M faculty and staff. A pre-trip interview with Dr. Heisler and Dr. Sueann Caufield (another member of the delegation) can be seen hereAn article that appeared in the Detroit Free Press on January 14, 2013 can be found here.

  • March 2012: An Estate Gift supporting Community Health Training Programs in Brazil was captured in the 2012-13 Global Activities Report.  View here.