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Annual Report, 1998-99

 

The VHL Family Alliance was founded in early 1993 with the following purposes stated in its Articles of Organization:

  • To disseminate timely and accurate information about von Hippel-Lindau (VHL) to patients, family members, physicians, and others
  • To provide means for patients and relatives to share experiences, support one another, and improve their medical care
  • To encourage, advise, and establish standards for clinics specializing in the diagnosis and treatment of von Hippel-Lindau
  • To aid and encourage formation of Chapters and to provide assistance and guidance to enhance their effectiveness
  • To promote research on von Hippel-Lindau.

We are pleased to submit this seventh Annual Report and look forward to continued growth of what is now a strong worldwide organization.

 

Distributing Information

Collection and distribution of information about VHL remains our most important activity. We gather information about VHL from families, from physicians, and from researchers.

 

We have published twenty-six issues of our quarterly newsletter, the VHL Family Forum, which has become a well respected forum for sharing ideas among families and physicians.

 

During the past twelve months over 2000 information packets have been distributed to patients and physicians throughout the world Requests for information are coming in through the 800 line and the internet.

 

Our World Wide Web service, inaugurated in April 1995, continues to be hosted as a charitable service of Kivex, Inc., of Bethesda, Maryland, an Allegiance Telecom Company. This site has won several additional qualitative awards this year, including NORD’s "Site of Excellence," and approval as a site conforming to the "HonCode" principles of the Health on Net Foundation, certifying that the information on our site is medically reviewed and accurate. Our web site contains basic information about VHL, posts articles from the newsletter in online form, and connects people with local chapters and clinical care centers around the world.

 

This service has continues to be our leading connection with the world. Requests come from people both with and without diagnoses of VHL, from countries throughout the world.

 

Services and articles are available in English, Spanish, French, German, Italian, Dutch, Flemish, and Japanese. Our site is cross-referenced by numerous health sites worldwide.

 

We are easily found through various search engines on the Web, through keywords including the various aspects of VHL, so that people looking for pheochromocytoma, for example, will find their way to us. Our 800 number and internet support staff frequently receive calls seeking information about related conditions, and are able to refer them to other support groups or medical professionals to assist them. A number of patients and physicians have in this way discovered VHL as a possible diagnosis, and later confirmed that their condition was in fact VHL. We are pleased to have helped contribute to an early diagnosis for these people.

 

Sharing and Family Support

There are two primary ways that people can make a personal contact and ask their own questions: telephone and e-mail. We are grateful to the volunteer members of the 800 and Online Committees who are our first contacts with the world.

 

In addition this year we added interactive services in cooperation with Dr. Koop’s website. On this password-protected site we sponsored discussion groups, monitored by Gale Lugo, where people can ask questions and converse through written messages. Beginning June 1999 we have added monthly chats, a designated hour where people with VHL can meet and type messages to one another interactively. After several months of experimentation there we moved the interactive services to www.egroups.com/list/vhlfa, where we have greater control and visibility, and there are fewer technical hassles for members. We see these early experiments as the beginning of increasingly interactive services on the internet.

 

Our toll-free family support hotline continues to be one of our premier services. 1-800-767-4VHL always reaches a VHL family, one of five members of the 800 Committee, chaired by Peggy M.: Lois Erickson, Altheada Johnson, Eva Logan, Barbara Redding.

 

Altheada Johnson and Bob Lydon staff our Internet account, info@vhl.org.

 

Don and Peggy M. prepared and continue to maintain an excellent Resource Guide for these two Committees, to ensure that they have the best current information at hand when people call. These materials are also used as a base for chapter chairpersons, and for local affiliate groups in other countries.

 

People call with a broad range of questions and concerns. For most people, their call is the first time they have spoken with another person with VHL outside their own families.

 

Conferences

The Sixth Annual Patient/Provider Conference was held in June 1999 in Atlanta, Georgia, chaired by Dr. Louis Elsas, Chief of Genetics at Emory University, and Eva Logan, who also chairs the Georgia chapter of VHLFA. 150 people attended, our largest attendance to date. The very excellent agenda, put together by Peggy and Don M., was enthusiastically received. Emory University awarded 14.5 Continuing Medical Education (CME) credits to specially registered physicians. Nurses in attendance also received certification from the Georgia Nursing Board. A report from this meeting is posted on the website.

 

The Fourth Biennial Symposium on VHL, combined with the Annual Meeting, will be held in Rochester, Minnesota, in June 2000, co-sponsored by the Mayo Clinic and chaired by Dr. Virginia Michels and Kelly Heselton of VHLFA. We look forward also to meeting in Padua, Italy, in 2002.

 

Research

The Tissue Bank continues to be a strong and growing resource for families and researchers. We are grateful to the University of Maryland for its inclusion of VHL in its Tissue Bank for Developmental Disorders. The Tissue Bank is available 24 hours a day to receive contributions from people having surgery, or in case of death. Having a bank of available tissue serves as an encouragement to additional research teams to undertake projects on VHL.

 

Our Research Advisory Committee approved three grants for funding this year. Through the generosity of the membership, and especially because of cooperative funding from the Murray Foundation, all three grants were fully funded. The Murray Foundation awarded $30,000 to Dr. Burk. The VHL Family Alliance provided $10,000 supplementary funding to Dr. Burk, $40,000 to Dr. Maria Czyzyk-Kzreska of the University of Cincinnati, and $30,000 to Dr. Eamonn Maher of Birmingham, England. All three are working to understand in greater detail the role that the VHL protein plays in the body, and how alternative drugs might be used to emulate or replace that function to keep tumors from forming or to inhibit or reverse their growth.

  • Dr. Robert D. Burk, Albert Einstein School of Medicine, "Studies on the VHLp18(MEA) protein."
  • Dr. Eamonn R. Maher, University of Birmingham, will study "Molecular Pathology of VHL disease"
  • Dr. Maria Czyzyk-Krzeska, University of Cincinnati, will be studying "VHL Function in Pheochromocytoma."

All three have already done impressive work on the VHL gene, and these projects build upon the strong foundations they have laid down.

 

Membership

When we started out in January 1993 we were in touch with six families, and redistributed 200 newsletters through physicians, for a total reach of only 218 affected people. By July 1994 we were reaching 2950 people in 20 countries. In September 1998 we were reaching 7555 people in 46 countries, an increase of 12.1% over the previous year. In September 1999 we are reaching more than 8700 affected people and 2227 medical professionals in 57 countries, up 15% over last year.

 

Figure 1: Population served.
Left bar = Professionals, Right bar = people with VHL

 

We are always looking for new ways to find more affected families, or people whose set of symptoms might be VHL. VHL affects every ethnic group in every country worldwide.

 

The French group grew significantly this year. The introduction of the Japanese website had generated increased interest in Japan. Dr. Opocher’s practice in Padua, Italy, has significantly improved clinical care in Italy.

 

Through the Internet, we are able to reach and serve a number of people scattered in various countries. This year saw a significant increase in Spanish-language requests from Spain, Mexico, and Central and South America. Our web statistics have been climbing steadily. In June alone we were contacted nearly 1000 times a day, 6500 requests a week from 650 people, approximately twice the "hit rate" in the previous year.

 

Chapters

The Chapters Committee continues to grow with strength to 27 local chapters available in the United States.

 

We also have official affiliate groups in England, Australia, Canada, Denmark, France, Ireland, Italy, Poland, Holland, and New Zealand, and contact people in Chile, Germany, Belgium, Israel, Switzerland, Hungary, Norway, Nepal, Malaysia and Japan. Non-U.S. groups are self-supporting financially. They add enormously to our knowledge about VHL and its management.

 

This network of local people is a critical component in providing people with the friendly contact they need in times of worry. It’s not just a local phone call, it’s also some guidance on services in the local area, perhaps in local language. The local public relations and outreach work of the chapter locates additional physicians and affected families in that area, and increases the likelihood of an early diagnosis.

 

Our thanks to Peggy and Don M. who head the Chapters Committee in the U.S., and to the heads of each of our international affiliates who make local services available in those countries.

 

Particular thanks this year go to Tania Durand, Chairman of the Canadian affiliate, VHL Family Alliance Canada, for her work in securing charity status for the Canadian group, and her collaboration in the creation of a bilingual Canadian newsletter and a bilingual Canadian website, maintained in the U.S. Thanks to Elaine Follansbee and Paul Bonneau for assistance with translation.

 

Clinical Care Centers

The Clinical Care Centers program is working to improve the strength of the "chain of information" represented by this program.

 

Joyce Graff now chairs this program. We currently have 25 participating centers in nine countries. These institutions have agreed to help patients obtain complete screening across all the necessary medical specialties, and to ensure communication and coordination of their care among members of the medical team. While some centers have greater expertise than others in VHL, no single center has seen every aspect of VHL. All centers need the ability to easily find physicians who have seen a particular problem before and can offer some perspective and advice on the issue.

 

This program is providing us with centers to which we can refer people with VHL for primary care or second opinions. It is also serving to raise the visibility of VHL in the medical community and increase the likelihood of an early diagnosis.

Kathy B., chairing Professional Education, focuses on additional ways of making information about VHL available to physicians and other health care personnel, and to add information about VHL into existing curricula and online resources. She, Altheada Johnson, Eva Logan, and Lois Erickson each participated in one or more training events in medical schools and at the National Institutes of Health. Eva Logan and Alice Coday appeared before Congress in support of the NCI budget request.

 

Spanish Language Outreach

The Second Edition of the VHL Handbook was translated into Spanish by Dr. Myriam Gorospe, and is being published in Chile in cooperation with , for distribution in South America. We see an increasing number of accesses to our website from Central and South American countries, and we are now in contact with 18 people in Spain. We are increasing our Spanish language services, including interactive services through egroups.

 

Medical Advisory Board

The members of our Medical Advisory Board continue to play a key role in nearly everything we do. They ensure that we produce quality materials, provide advice and guidance for the Board, and for members as needed, and most important, provide a chain of quality information for physicians seeking help with patients with VHL throughout the world. All of us are grateful for their advice and participation.

 

Financial Report

This year’s operating expenses of $56,534 were down 8% over fiscal 1998.

 

We are all volunteers. We pay no staff; we do not rent office space. The money we raise goes directly into programming and research. We are able to do this because of the hard work of a large number of dedicated volunteers in twelve countries around the world. Volunteers provide telephone and internet inquiry service, maintain our web site at www.vhl.org, and provide outreach in local areas.

FY99, Ended June 30, 1999

INCOME:  
Contributions $89,172
Conference & sales income $18,207
Membership dues $ 4,503
Interest & dividends $2,145

TOTAL INCOME

$116,716
EXPENSES:  
Administration $10,792
Capital Expenses $941
Goods Sold $843
Conference Expenses $2,069
Fundraising $2,069
Fees $1,731
Hotline $1,731
Newsletter $9,864
Online $1,589
Publications $10,480
Education $10,928
Research $71,000

TOTAL EXPENSES

$123,666

Conferences are intended to be self-funding, but they generally do cost us a modest amount each year. Conferences serve to get people together, and raise real patient issues in an organized way with physicians and researchers, so that they are understood to be more than unique to a single patient. They also provide a forum for members of the medical community to share ideas and work toward consensus on medical management. They are not only beneficial to the people who attend, they expand our knowledge of VHL for everyone. Numerous researchers have told us they find our meetings very inspiring – after meeting real people with VHL, they return to their labs with greatly increased eagerness to succeed in their work.

 

Business Plan, Fiscal 2000

Our operating budget for the coming year is $60,000, and our goal for research funding is $100,000. We will be doing more electronic publishing, looking to convert some of the paper publishing to electronic in the course of the year.

 

Our existing programs will be continued into the coming year. We are proposing to extend our interactive services: online discussions and chats on specific topics.

 

Sigma Phi Gamma Service Sorority has adopted VHLFA as their primary charitable recipient for the first two years of the millennium. We are grateful for the work of Toni Brunk of Cincinnati, Ohio, in achieving this designation for us.

 

We need your help! We are already making a difference, bringing closer the day when there will be better medical management for VHL. Please help us continue this important work.

Budget, Fiscal 2000

Telephone $7,000
InfoBase $3,000
Supplies $3,000
Conferences $2,000
Hotline $4,000
Online $1,000
Newsletter $15,000
Postage $9,000
Education $10,000
Publications $13,000
Grants $100,000
Fees $1,000

TOTAL

$168,000

Special Projects in Need of Funding:

  • Interactive services (teleconferences and chats) at $500 to $1000 per event
  • Scholarships of $100 each and Sponsorships of $1000 or more will enable more VHL patients and family members to attend the conference and learn to manage their health
  • Sponsorships of foreign physicians to attend the Symposium, especially from Central and South America. $1000 or more each.
  • Research Grants of at least $20,000 each will spur research on VHL management

Other project proposals on request.

 

VHL Family Alliance

2001 Beacon St, Suite 208, Boston, MA 02135-7787 USA

+1 617 277-5667; Fax: +1 858-712-8712; Patient support: +1 800 767-4VHL

info@vhl.org or http://www.vhl.org

 

All persons listed are volunteers who receive no compensation for their services to the Alliance.

 

Board of Directors

  • Kathleen Braden, Professional Education Committee. Functional Outcomes Coordinator, St. Francis Hospital, Indianapolis, Indiana
  • Dr. Myriam Gorospe, Research Committee, National Institute on Aging, Baltimore, Maryland
  • Joyce Wilcox Graff, Co-Chair, and Editor, VHL Family Forum, Research Director, Intranets & Electronic Workplace, Gartner Group, Brookline, Massachusetts
  • Kelly Heselton, systems auditor, NorWest Bank, Faribault, Minnesota
  • Altheada Johnson, Membership Committee, Chairman of the Board, retired dietitian, Brooklyn, New York
  • Ellen Lydon, R.N., Vice Chair, Clinical Care Committee, nurse, Chicago, Illinois
  • Peggy Marshall, Chapters, child care business, Corinth, Mississippi
  • Sheldon C. Marshall, Jr., Publications, computer instructor, Corinth, Mississippi
  • Susan McGuire, Public Relations Committee. Office Administrator, Raleigh, North Carolina
  • Melissa Minster, Secretary of the Board, designer and jeweler, Newark, Delaware
  • Terrence R. Redding, President/CEO, Online Training, Inc., Palm Beach, Florida
  • Renée Rosado, Fund-Raising Committee, customer support, Peoplesoft Corporation, Morage, California
  • Paula Sicard, Esq., Legal and Insurance Committee, Attorney, Tampa, Florida
  • Pastor David Torres, Dialysis & Transplant Support, minister, Hanapepe Missionary Baptist Church, Kauai, Hawaii

Medical Advisory Board

  • Lloyd M. Aiello, M.D., Chief, Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts
  • Debra L. Collins, M.S., Division of Genetics, University of Kansas Med Center, Kansas City, Kansas
  • Col. James M. Lamiell, M.D., Chief, Clinical Investigation Regulatory Office, U.S. Army Medical Center and School, Fort Sam Houston, Texas
  • John A. Libertino, M.D., Chair, Institute of Urology, Lahey-Hitchcock Clinic, Burlington, Massachusetts
  • Eamonn R. Maher, M.D., Genetics, Birmingham Women's Hospital, England
  • Virginia V. Michels, M.D., Chair, Department of Medical Genetics, Mayo Clinic, Rochester, Minnesota
  • Haring J. W. Nauta, M.D., Ph.D., Chief of Neurosurgery, University of Texas Medical Branch, Galveston, Texas
  • Hartmut P. H. Neumann, M.D., Department of Nephrology, Albert-Ludwigs University, Freiburg, Germany
  • Edward H. Oldfield, M.D., Chief, Surgical Neurology Branch, National Institute of Neurological Disorders & Stroke, Bethesda, Maryland
  • Allan E. Rubenstein, M.D., Director, Neurofibromatosis Research & Treatment Center, Mount Sinai Hospital, New York
  • R. Neil Schimke, M.D., Dir. of Endocrinology, Metabolism & Genetics, University of Kansas Med Center, Kansas City, Kansas
  • Robert B. Welch, M.D., Chairman Emeritus, Department of Ophthalmology, Greater Baltimore Med Center, Baltimore, Maryland

International Affiliates

Contact people are available in additional countries; call for a referral
see current listing

AUSTRALIA:

Jennifer Kingston

 

BELGIUM:

Ms. Chris Hendrickx

 

CANADA:

Paul Bonneau and Ms. Tania Durand

 

DENMARK:

Richard & Vibeke Harbud

 

ENGLAND, U.K.:

Mark & Michelle East

 

FRANCE:

Mme Mireille Proux, Presidente VHL France

 

GERMANY:

Gerhard Alsmeier

 

ITALY:

M. Luisa Guerra
Loc. Malvicina, 19
Gavi (AL), 15066 Italy

 

JAPAN:

Dr. Taro Shuin, Urology
Kochi Medical School
Kohasu Okoh-cho
Nan-koku Kochi, 783-8505 Japan

 

THE NETHERLANDS:

Jeannette Bos-Mol
Oostenhoutstraat 64
9401 NH Assen
The Netherlands

 

NEW ZEALAND:

Jon & Valerie Johnson
3B Luana Way
Howick, Auckland New Zealand

 

POLAND:

Dr. Karol Krzystolik, Dept Genetics
Pomeranian Academy of Medicine
ul. Powstancow Wlkp. 72
Szczecin 70-111 POLAND