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The Beverly Hills Comprehensive Medical Group Announces Name Change










Dr. Jacobsen stresses that the practice will continue to provide primary and urgent care to patients. "If you are sick now, we are here to see you immediately," said Dr. Jacobsen. "We know our patients are busy and they deserve immediate access to the care that they need. That's why we never want to make patients wait to see a doctor." BHCMG welcomes patient walk-ins between 7 a.m. - 3 p.m., Monday through Friday. Patients will be seen by a board-certified physician in 30 minutes or less.

Dr. Tannaz Zahirpour D.O., has recently joined The Beverly Hills Comprehensive Medical Group, "I am board certified in family practice...I really enjoy treating the whole family. I love when I get to see Moms, Dads, and their children." Dr. Zahirpour's clinical  interests include preventative medicine, adolescent medicine, women's
health, and dermatology. To facilitate treatment and prevention, patients are examined for more than just their immediate condition. "I have a holistic approach to medicine and try to treat the whole body and not just the ailment," said Dr. Zahirpour. "I take pride in being thorough with the care of my patients."

"We are thrilled to welcome Dr. Zahirpour to our practice, she is a tremendous asset," said Dr. Jacobsen. "From her extensive medical training to her compassionate approach to patient care, she brings many talents. Additionally, her unique method makes a big difference for each patient's health."

The office projects a positive energy and creates a personal camaraderie with patients. "I truly love when I get to know my patients on a first name basis, and make them part of our family at BHCMG," said Dr. Zahirpour. "It is important for me to teach my patients, and also learn from them every chance I get."

Prospective patients who wish to learn more about the services at The Beverly Hills Comprehensive Medical Group may contact the clinic by phone or visit the website.

CONTACT: The Beverly Hills Comprehensive Medical Group, 1-888-667-5235
To better reflect the practice's diverse array of medical services, The Beverly Hills Comprehensive Medical Group (BHCMG) will no longer be known as Executive ER. "Our new name is meant to reflect the diversity of services that we currently offer to the community," said chiropractor and founder Dr. Daniel Jacobsen. "We are proud to be a premier provider of both urgent medical care as well as complementary wellness services
such as weight loss and chiropractic care. Our new name reflects this integrated approach to medicine." The doctors at BHCMG collaborate with each other to promote overall wellness.

Study Links Autistic Behaviors to Enzyme




obsessive-compulsive and repetitive behaviors, and other behaviors on the autistic spectrum, as well as cognitive deficits.

The researchers found that an enzyme, MMP-9, plays a critical role.  MMP-9 is produced by brain cells.  Too much MMP-9 activity causes synapses in the brain to become unstable, leading to functional deficits.  So, working on mice, the researchers targeted MMP-9 as a potential therapeutic target in FXS and showed that genetically deleting MMP-9 favorably impacts key aspects of FXS-associated behaviors.

The study appears in the Journal of Neuroscience.

For more information, please visit: http://ucrtoday.ucr.edu/2394
Biomedical scientists at the University of California, Riverside have published a study today that sheds light on the cause of autistic behaviors in Fragile X syndrome (FXS), the genetic disorder that causes
Ruthigen Treats First Human Subjects In Clinical Trial For RUT58-60






In June 2014, Ruthigen's Investigational New Drug (IND) application became effective following review by the U.S. Food and Drug Administration (FDA).  Ruthigen is developing RUT58-60 as a safe and fast acting, broad spectrum and potent anti-infective drug candidate intended to be used as an adjunct therapy to systemic antibiotics for the prevention and treatment of infection associated with abdominal surgery.

"We are excited to begin a new chapter for Ruthigen with the initiation of human clinical testing of RUT58-60," said Hoji Alimi, Chairman, CEO and CSO of Ruthigen.  "Treatment of our first subject with RUT58-60 is an important milestone and marks a transition for Ruthigen into a clinical-stage company."  Mr. Alimi continued, "Patients undergoing abdominal surgery should not have to worry about the risk of infections associated with their procedures.  At Ruthigen we believe the key to optimizing patient care is to focus on the prevention of infections in the hospital and outpatient surgical settings."

Following an independent data monitoring committee review, the Company plans to begin enrollment in a 150 patient, 28-day Phase 1/2 clinical trial using RUT58-60 within the abdominal cavity.  The Phase 1/2 trial will be a controlled, double blind, randomized, and multi-centered study to evaluate the safety, tolerability, and potential efficacy of RUT58-60.

About Ruthigen, Inc. Ruthigen is a biopharmaceutical company focused on the discovery, development, and commercialization of novel therapeutics designed to prevent and treat infection in invasive applications.  The Company's lead drug candidate, RUT58-60, is a broad-spectrum anti-infective that Ruthigen is developing for the prevention and treatment of infection in surgical and trauma procedures.  The Company plans to complete its Phase I/II clinical trial in Q1 2015 and pending the successful completion of that trial, Ruthigen plans to conduct pivotal clinical trials.  For more information, visit www.ruthigen.com.

About RUT58-60: RUT58-60 is a new chemical formulation containing hypochlorous acid, HOCl, with no hypochlorite, and utilizes other small molecule stabilizers.  RUT58-60 is a broad-spectrum anti-infective drug candidate designed for prophylactic use during invasive surgical procedures. The drug has been shown in laboratory tests to eradicate both gram-positive and gram-negative bacteria, including antibiotic resistant bacteria within the first 30 seconds of contact.  RUT58-60 was designed to improve patient lives, redefine infection control in surgical procedures and deliver cost savings to hospitals.  RUT58-60 uses a mechanism of action designed to prevent emergence of bacterial resistance and improves patient safety by neither targeting specific bacterial cell membrane receptors nor exposing patient's vital organs to unnecessary systemic drugs.  The Company's clinical program targets an initial $700M potential market in the prevention of infections associated with abdominal surgery.  The Company believes the market for prevention of infection in the U.S. surgical market is estimated at $3B. 
Ruthigen, Inc., (Nasdaq:RTGN) today announced that it has treated the first human subjects with its leading drug candidate RUT58-60 in a 30 patient, 21-day skin irritation trial, which is expected to be completed in August 2014.
UCLA faculty contribute to international study on the biology behind schizophrenia
Research identifies genes, pathways that could suggest new approaches to treatment




The study, the largest genomic study published on any psychiatric disorder to date, provides important new insights about the biological causes of schizophrenia, and it could lead to new approaches to treatment. The report was published in the July 22 online edition of the journal Nature.

"As recently as five years ago, we still lacked proof that mental disorders had a genetic basis," said Dr. Nelson Freimer, a UCLA professor of psychiatry and director of the UCLA Center for Neurobehavioral Genetics, who was part of the study. "This work now demonstrates unequivocally that at least 100 distinct genes contribute to schizophrenia. By providing the strongest evidence to date for the biological underpinnings of mental illness, this study is of historic importance."

Schizophrenia, a debilitating psychiatric disorder that affects approximately 1 percent of the world's population, is characterized by hallucinations, paranoia and a breakdown of thought processes, and it often emerges in the teens and early 20s. Its lifetime impact on individuals and society is high, both in terms of years of healthy life lost to disability and in terms of financial cost, with studies estimating that schizophrenia costs over $60 billion annually in the U.S. alone.

Despite the pressing need for treatment, there have been few innovations in drugs to treat schizophrenia for more than 60 years — in part because the disease's underlying biological mechanisms have not been understood. Current medications treat only the psychosis that is one of its symptoms but do not address its debilitating cognitive symptoms.

Since the dawn of genomic medicine in the early 2000s, schizophrenia research has focused on the disorder's genetic underpinnings, because it is so frequently hereditary. Previous studies have suggested that it is caused by the combined effects of many genes, and roughly two dozen locations of the chromosome have been found to be associated with the disorder.

The new study confirms those earlier findings and sheds new light on schizophrenia's genetic basis and underlying biology.

"These results firmly show a biological basis of schizophrenia, which should remove some of the remaining stigma that still surrounds the disease," said Roel Ophoff, a professor of human genetics and psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior who also contributed to the study. "It is remarkable to observe that the genetic architecture of schizophrenia is very similar to that of other heritable human diseases and traits. Our ability to detect genetic risk factors on this massive scale, which is providing a wealth of information, should give us hope to develop new treatments for schizophrenia."

The authors analyzed more than 80,000 genetic samples from people with and without schizophrenia. They identified 108 specific locations in the human genome associated with risk for schizophrenia, 83 of which had not previously been linked to the disorder.

The study implicates genes expressed in brain tissue, particularly those related to neuron and synapse function. Among them are genes active in the pathways that control the ability for neuronal synapses to change — a function essential to learning and memory.

Additionally, the researchers found a small number of genes associated with schizophrenia that are active in the immune system, a discovery that offers some support for a previously hypothesized link between schizophrenia and immunological processes. The study also found an association between the disorder and the region of the genome that holds a gene called DRD2, which produces the dopamine receptor targeted by all approved medications for schizophrenia. That finding suggests that other locations uncovered in the study may be targets for new therapies.

"By studying the genome, we are getting a better handle on the genetic variations that are making people vulnerable to psychiatric disease," said Dr. Tom Insel, director of the National Institute of Mental Health, which helped fund the study. "Through the wonders of genomic technology, we are in a period in which, for the first time, we are beginning to understand many of the players at the molecular and cellular level."

The study was conducted over several years by the Schizophrenia Working Group of the Psychiatric Genomics Consortium; it included 55 datasets from more than 40 different contributors, including Ophoff and Freimer, who genotyped their samples at UCLA. Ophoff was one of the founding principal investigators of the international collaboration, which was founded in 2007 to conduct broad-scale analyses of genetic data for psychiatric disease.

The PGC is currently genotyping new samples to further study schizophrenia, autism, bipolar disorder and other psychiatric diseases. 

Core funding for the Consortium comes from the National Institute of Mental Health, along with numerous grants from governmental and charitable organizations, as well as philanthropic donations. Rita Cantor, a UCLA professor of human genetics, was also an author on the paper.
UCLA researchers were part of a multinational effort that has identified more than 100 locations in the human genome associated with the risk of developing schizophrenia.
Watchdog Group Files FDA Petition to Better Protect Drug Trial Participants
Unreliable Drug Testing Practices Put Clinical Trial Participants and Consumers At Risk, Contends the Center for Responsible Science





petition with the Food and Drug Administration (FDA) to update its informed consent regulations so that clinical trial participants will no longer be kept in the dark about the hazards they may unwittingly assume when they agree to participate. 

Currently, drug manufacturers do not disclose to clinical trial participants that preclinical testing, which relies heavily on FDA-mandated animal testing, rarely predicts human drug response accurately. Failure to disclose this level of risk to human safety renders the FDA’s informed consent process faulty. Drug trial participants must receive meaningful warnings so they can decide for themselves if the uncertainties and risks of trial participation are warranted.

Many drugs that have appeared safe in animal studies have caused severe adverse reactions and death when given to humans. Because of a lack of published reports, it is unclear how many people suffer these consequences as a result of taking drugs administered in U.S. clinical trials. This uncertainty makes it even more important that the FDA update its regulations and issue proper warnings to trial participants.

“The FDA admits that 92 percent of drugs fail in humans even after the drugs tested well in preclinical studies,” said Mark Mazzarella, CRS’ lead counsel. “In light of the convincing evidence that human subjects are currently participating in clinical trials without a full understanding of the attendant risks, there is no public policy justification for a refusal by the FDA to act.”

Said CRS co-petitioner John Tessmer, a former clinical trial participant: “I do not believe that I should be asked to risk my health until I have been given the disclosure that this petition requests--that is, information that a reasonable person would need to make an informed decision with regard to the real risks posed by the clinical trial. I don’t believe anyone else should either.”

About the Center for Responsible Science: The Center for Responsible Science (CRS) is a California 501(c)(3) nonprofit organization. Its mission is to save lives by tackling the root causes of inefficient, outdated drug development. CRS works to expose and address issues threatening the health, public interest or well being of Americans.  This informed- consent citizen petition is the first of several petitions CRS plans to file in an effort to update Food and Drug Administration policy. For more information, go to www.crs501.org.
The Center for Responsible Science (CRS), a nonpartisan, nonprofit watchdog group advocating for more modern and accurately predictive test methods for new-drug development, is warning the public that conventional drug testing may put the health of clinical trial participants and consumers at risk.  CRS has filed a citizen
Prenatal Alcohol Exposure Alters Development of Brain Function
Researchers from The Saban Research Institute suggest neural basis for symptoms of fetal alcohol spectrum disorders











“Functional magnetic resonance imaging (fMRI) has been used to observe brain activity during mental tasks in children with FASD, but we are the first to utilize these techniques to look at brain activation over time,” says Gautam. “We wanted to see if the differences in brain activation between children with FASD and their healthy peers were static, or if they changed as children got older.”

FASD encompasses the broad spectrum of symptoms that are linked to in utero alcohol exposure, including cognitive impairment, deficits in intelligence and attention and central nervous system abnormalities.  These symptoms can lead to attention problems and higher societal and economic burdens common in individuals with FASD. 

During the period of childhood and adolescence, brain function, working memory and attention performance all rapidly improve, suggesting that this is a crucial time for developing brain networks. To study how prenatal alcohol exposure may alter this development, researchers observed a group of unaffected children and a group of children with FASD over two years. They used fMRI to observe brain activation through mental tasks such as visuo-spatial attention—how we visually perceive the spatial relationships among objects in our environment —and working memory. 

“We found that there were significant differences in development brain activation over time between the two groups, even though they did not differ in task performance,” notes Elizabeth Sowell, PhD, director of the Developmental Cognitive Neuroimaging Laboratory at The Saban Research Institute and senior author on the manuscript. “While the healthy control group showed an increase in signal intensity over time, the children with FASD showed a decrease in brain activation during visuo-spatial attention, especially in the frontal, temporal and parietal brain regions.” 

These results demonstrate that prenatal alcohol exposure can change how brain signaling develops during childhood and adolescence, long after the damaging effects of alcohol exposure in utero. The atypical development of brain activation observed in children with FASD could explain the persistent problems in cognitive and behavioral function seen in this population as they mature.  

About Children’s Hospital Los Angeles: Children's Hospital Los Angeles has been named the best children’s hospital in California and among the top five in the nation for clinical excellence with its selection to the prestigious US News & World Report Honor Roll.  Children’s Hospital is home to The Saban Research Institute, one of the largest and most productive pediatric research facilities in the United States, is one of America's premier teaching hospitals and has been affiliated with the Keck School of Medicine of the University of Southern California since 1932.

For more information, visit www.CHLA.org. Follow us on Twitter, Facebook, YouTube and LinkedIn, or visit our blog: ResearCHLAblog.org
In the first study of its kind, Prapti Gautam, PhD, and colleagues from The Saban Research Institute of Children’s Hospital Los Angeles found that children with fetal alcohol spectrum disorders (FASD) showed weaker brain activation during specific cognitive tasks than their unaffected counterparts.  These novel findings suggest a possible neural mechanism for the persistent attention problems seen in individuals with FASD. The results of this study will be published in Cerebral Cortex on August 4.
Earlier Intervention for Most Common Form of Heart Attacks Linked to Improved Survival Rates





But the study also suggests that there is room for improvement in how current treatment guidelines are applied among specific patient groups.

The researchers reviewed records for 6.5 million people who were treated for heart attacks between 2002 and 2011. The analysis was among the first and largest national studies to assess the impact of the trend toward more aggressive care for patients who experience the type of heart attack known as non-ST elevation myocardial infarction, or NSTEMI.

Their findings are reported in the current online edition of the peer-reviewed Journal of the American Heart Association.

“The substantial reductions in in-hospital mortality observed for NSTEMI patients nationwide over the last decade reflect greater adherence to evidence-based, guideline-directed therapies,” said Dr. Gregg C. Fonarow, the study’s senior author and UCLA’s Eliot Corday Professor of Cardiovascular Medicine and Science.

“Nevertheless, there may be further opportunities to improve care and outcomes for patients with NSTEMI, who represent the greater proportion of patients presenting with myocardial infarction,” said Fonarow, who also is director of the Ahmanson–UCLA Cardiomyopathy Center at the David Geffen School of Medicine at UCLA.

Heart attacks are broadly classified into two types. The more severe form, ST-elevation myocardial infarction (STEMI), involves complete blockage of an artery supplying blood to the heart muscle. The less severe type, NSTEMI, involves partial or temporary blockage of the artery. Studies in the U.S. and Europe have found that although the incidence of STEMI heart attacks is declining, the number of NSTEMI heart attacks increased in the past decade.

Guidelines issued in 2012 by the American College of Cardiology and American Heart Association recommended initiating cardiac catheterization in high-risk NSTEMI patients within 12 to 24 hours after  the patient arrives at the hospital. This strategy had been evolving since 2009 following publication of the Timing of Intervention in Acute Coronary Syndromes trial. Previously, the recommendation was to begin catheterization in high-risk NSTEMI patients within 48 hours.

Fonarow and his colleagues examined trends in the use of cardiac catheterization for people who had been hospitalized after suffering an NSTEMI, within 24 hours and within 48 hours of presentation, seeking to determine whether changes in their care may have resulted in better outcomes.

The researchers analyzed publicly available records from the Nationwide Inpatient Sample, the largest U.S. database of hospitalized individuals. Of the 6.5 million patients whose records they examined, 3.98 million were admitted to hospitals with NSTEMI diagnoses.

The study tracked the proportion of those patients who underwent cardiac catheterization each year, and their outcomes — how many died in the hospital, the average length of their hospital stays, and the cost of hospitalization. They found that as the trend toward earlier intervention in NSTEMI patients took hold — with doctors beginning treatment within 24 hours after patients arrived at the hospital, rather than within 48 hours — the rate of in-hospital death declined from 5.5 percent in 2002 to 3.9 percent in 2011. Improvements were found for men and women, older and younger patients, and across all races and ethnic groups.

In addition, the average length of patients’ hospital stays decreased during the decade-long study, from 5.7 days to 4.8 days. NSTEMI patients who underwent cardiac catheterization within the first 24 hours had the shortest average stays.

Although more NSTEMI patients in all demographic groups received early cardiac catheterization as the study progressed, there were still significant differences across age, gender, and racial and ethnic groups in how frequently early intervention was used. Men, for example, were more likely to receive earlier catheterization than women.

“Despite the improvement, there are significant differences in the age-, gender-, and ethnicity-specific trends in the use of invasive management of NSTEMI, and these findings may help guide further improvements in care and outcomes for male and female patients of all ages, races and ethnicities,” said New York Medical College’s Dr. Sahil Khera, the study’s first author. “Further efforts are needed to enhance the quality of care for patients with NSTEMI and to develop strategies to ensure more equitable care for patients with this type of heart attack.”

No outside funding was used in the study.

Additional study authors were Dr. Dhaval Kolte, Dr. Wilbert Aronow, Dr. Chandrasekar Palaniswamy, Dr. Kathir Selvan Subramanian, Dr. Marjan Mujib, Dr. Diwakar Jain, Dr. Rajiv Paudel, Dr. William Frishman and Dr. Julio Panza from the New York Medical College; Dr. Taimoor Hashim and Dr. Ali Ahmed from the University of Alabama at Birmingham; and Dr. Deepak Bhatt from Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School.
Changes in the treatment of the most common form of heart attack over the past decade have been associated with higher survival rates for men and women regardless of age, race and ethnicity, according to a UCLA-led analysis.
Keck Medicine of USC welcomes addition of father-son team of vein specialists to USC Department of Surgery



treatment were recruited to the faculty of the Department of Surgery, Keck School of Medicine of USC, effective May 1, 2014.

The father-son team of Dario Perez, M.D., F.A.C.S., assistant professor of surgery and Jose M. Perez, M.D., F.A.C.S., clinical assistant professor of surgery, are now offering their skills to patients at the USC Surgery – Glendale clinic, 1510 S. Central Ave. Suite 200, Glendale, Calif. Together, the faculty physicians bring more than 25 years of experience in venous disease and therapy, including minimally invasive procedures for varicose and spider veins, as well as vein ulcers.

Dario Perez is skilled in a range of minimally invasive procedures for the treatment and removal of varicose and spider veins. He earned his medical degree from the University of Guadalajara School of Medicine and completed his general surgery residency at the University of Connecticut – Saint Francis Hospital & Medical Center.

Jose Perez is focused on all aspects of venous disease and its complications. He offers comprehensive venous treatments such as The VNUS® procedure, EVLA (Endovenous Laser Ablation), foam sclerotherapy, contact sclerotherapy, microphlebectomies and treatments for venous ulcers. He earned his medical degree from the University of Guadalajara School of Medicine and completed his residency in general surgery at Stamford Hospital-Columbia University College of Physicians & Surgeons. He is board-certified by the American Board of Surgery and the American Board of Venous and Lymphatic Medicine.

In 1984 Dario Perez established a general surgery practice in Glendale that his son and fellow surgeon eventually joined. Both faculty physicians are board certified in general surgery and are fellows of the distinguished American College of Surgeons.

ABOUT KECK MEDICINE OF USC: Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-based medical systems in the Los Angeles area. Encompassing academic, research and clinical excellence, the medical system attracts internationally renowned experts who teach and practice at the Keck School of Medicine of USC, the region’s first medical school; includes the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; has a medical faculty practice, the USC Care Medical Group; operates the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and owns USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties. For more information, go to www.keckmedicine.org/beyond
Adding to the surgical expertise at Keck Medicine of the University of Southern California (USC), two faculty physicians specializing in vein disease and
To Eat or Not to Eat: New Disposable Biosensor May Help Physicians Determine which Patients can Safely be Fed Following Surgery
                                             Invention Monitors an Important New Vital Sign                                                                                                                                                      



invention that may improve outcomes, decrease healthcare costs and shorten hospital stays, according to a UCLA study.

Some patients who undergo surgery develop a condition called post-operative ileus (POI), a malfunction of the intestines. The condition causes patients to become ill if they eat too soon, which can lengthen an affected patient’s hospital stay by two to three days. Until now, there was no way to monitor for POI other than listening to the belly for short periods with a stethoscope, said study first author Dr. Brennan Spiegel, a professor of medicine at the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health. 

If proven successful, the device, a non-invasive acoustic gastrointestinal surveillance biosensor called AbStats, could also be used to help diagnose irritable bowel syndrome and inflammatory bowel disease, in addition to helping obese people learn by the sounds from their gut when they should or shouldn’t eat to help them lose weight.

Spiegel and his team worked with researchers at the UCLA Wireless Health Institute at the Henry Samueli School of Engineering and Applied Science to develop the sensor, which resembles a small plastic cap and has a tiny microphone inside to monitor digestion.

“We think what we’ve invented is a way to monitor a new vital sign, one to go along with heart rate, blood pressure and respiration. This new vital sign, intestinal rate, could prove to be important in diagnosing and treating patients,” Spiegel said. “The role of wearable sensors in healthcare has reached mainstream consciousness and has the capacity to transform how we monitor and deliver care. Yet, there are very few biosensors that are supported by any peer-reviewed evidence. This study represents peer-reviewed evidence supporting use of a biosensor, a device born and bred out of UCLA multidisciplinary research.”

The study appears in the early online edition of the peer-reviewed Journal of Gastrointestinal Surgery.

In this study, the biosensor was used to listen to sounds emanating from the intestines and was connected to a computer that measured the rate of acoustic events – movement of the intestines - as they occurred. The research team compared intestinal rates of healthy subjects using the device for 60 minutes after a standardized meal to rates recorded in two post-operative groups, patients who were tolerating food and those that had POI.

Using the biosensor, Spiegel and his team could distinguish patients with POI from patients who did not suffer from the condition by the sounds made by their intestines. In the future, doctors may use the biosensor to determine which patients can be fed, making an evidence-based decision instead of just guessing based on less specific information, Spiegel said.

Going forward, Spiegel hopes to be able to determine if the biosensor can be used to identify patients at risk for POI to help doctors make post-operative feeding decisions.

“After surgery, the bowels shut down under stress as the body is focused on keeping the brain, heart and lungs alive,” Spiegel said. “We also give patients narcotic medications for pain that can also cause the bowels to freeze up. The way doctors currently monitor for POI is putting a stethoscope on the patient’s belly for 15 seconds, briefly listening for sounds of intestinal awakening, and asking about flatulence. It’s all very rudimentary and inaccurate. With this new vital sign, the team can now monitor the intestines empirically and make more informed decisions.”

When the bowels shut down, they become very quiet, moving only a few times per minute versus the digestion of a healthy person, who generates 10 or more intestinal movements per minute. The movements make a “clicking” noise, and it is that noise the biosensor picks up and sends to a computer for analysis.

William J. Kaiser, a professor of electrical engineering and co-director of the UCLA Wireless Health Institute, said development of the biosensor system has been a primary focus of the institute.

“It has been rewarding and exciting for our entire team. The institute develops wearable biomedical sensor systems to support our physician colleagues and fulfill our mission of advancing healthcare delivery,” Kaiser said. “The biosensor system is an important example of this rapid development that has resulted in a low-cost instrument that serves an unmet need for continuous, non-invasive monitoring of the human digestive processes. The potential for this biosensor has been thrilling, since it will serve many applications from monitoring of POI to a wide range of digestive process diagnostic applications. The biosensor can operate in the clinic, at home and at any location on the globe.”

Gastrointestinal disorders are highly prevalent in both inpatient and outpatient settings. A recent study commissioned by the National Institutes of Health found that there are more than 70 million ambulatory care visits every year in the U.S. with a gastrointestinal disorder listed as the first diagnosis. That number swelled to more than 100 million visits when gastrointestinal disorders were mentioned anywhere in the diagnosis, the equivalent of nearly 36,000 outpatient visits per 100,000 Americans.

Gastrointestinal disorders also have enormous direct and indirect societal costs, Spiegel said. The total direct cost of care for gastrointestinal disorders is estimated at $100 billion annually. Indirect costs increase that figure to more than $140 billion.

“With the aging of the American population and the rising incidence of obesity, it is certain that the economic impact of gastrointestinal disorders will get increasingly worse over the next decade and beyond,” Spiegel said.
A disposal, plastic listening device that attaches to the abdomen may help doctors definitively determine which post-operative patients should be fed and which should not, an
Stroke Survivor Seeks to Help Veterans and Others get Physical Therapy when Insurance Runs Out
Sean Entin Receives Therapy at Providence Tarzana’s Outpatient Center





         More difficult than getting to the next level in his recovery, however, is watching fellow survivors leave the program before they are ready. They are unable to continue therapy because their insurance covers a set number of visits with these invaluable specialists, regardless of their progress.

         Sean was a month shy of his 40th birthday when he suffered a ruptured carotid artery, likely during a martial arts workout. The husband and father of two young girls was hard at work, trying to get in the best shape of his life.

Then during a Thanksgiving visit with friends and family he passed out. When he awakened 10 days later in a Santa Barbara hospital, he was bedridden, unable to speak clearly or to walk and was lucky to be alive.

         Today he marvels at his progress – and counts his blessings. He is among the fortunate with the means to continue his physical therapy with therapist Sylvia Pena of Providence Tarzana, where his father, a retired surgeon, once served as chief of staff.

         Now to help those less fortunate, Sean has established the Move 2improve Foundation, a nonprofit organization, to raise money for continued physical therapy for survivors of traumatic brain injuries. He and a small group of friends have identified 47 other survivors in need of therapy. They especially want to help wounded veterans who have fallen between the cracks and need continued rehab to rebuild their lives.

          “These are people who have had very serious injuries and they can’t afford to go back to therapy,” he said. “And if you don’t have therapy you can’t get back to work.  I am the proof of what’s possible with continued care.
Just two years after a stroke that should have killed me I’m back to work and running a foundation.”

         Sean created his organization to “engage patients in cutting-edge therapies and finance rehabilitation for the underinsured. Our goal is to help them regain mobility and cognitive skills, provide support for their families and friends and make them MOVERS once again,” according to the Move 2improve website, http://move2improvefoundation.com/#.

         Continued improvement gives these patients hope. Sean remembers when he had trouble walking and his senses were slow. Now he walks, climbs stairs, drives, works on computers and more. He gets tired but he rests and starts again. And he never forgets his blessings.

          “I have hope, and they need hope,” he said. “It’s an accomplishment when you can walk 10 feet, but you need so much more. There’s so much ahead of you and 10 feet is not enough. We have to advocate for people.”

About Providence Health & Services: Providence Health & Services, Southern California, is a Catholic not-for-profit, mission-driven healthcare system. Providence Southern California operates five award-winning hospitals and a comprehensive, fully-integrated network of primary care clinics, urgent care centers, home care, TrinityCare and TrinityKids Care hospice as well as Providence High School. Providence is anchored locally by Providence Holy Cross Medical Center in Mission Hills, Providence Saint Joseph Medical Center in Burbank, Providence Tarzana Medical Center and Providence Little Company of Mary Medical Centers in Torrance and San Pedro. With more than 3,400 physicians, Providence provides coordinated primary and specialty care through an array of physician groups and individual providers including Providence Medical Institute and physician groups in the South Bay, the West Valley and Santa Clarita. Providence affiliate, Facey Medical Group, provides primary and specialized care in the San Fernando, Santa Clarita and San Gabriel valleys. For more information, visit California.providence.org.

About Move 2improve: The Move2Improve Foundation, a registered 501(c)(3) non-profit organization, was established to help those who have suffered Traumatic Brain Injuries. We are here to engage patients in cutting edge therapies and finance rehabilitation for the underinsured. Our goal is to help them regain mobility and cognitive skills, provide support for their family and friends, and make them MOVERS once again.
For two years, stroke survivor Sean Entin has been rebuilding his strength in a challenging physical therapy program at Providence Tarzana Medical Center’s outpatient rehabilitation center.
Donors Help Update Appearance Center at Providence Saint Joseph’s Roy and Patricia Disney Family Cancer Center






         The newly remodeled Warner Bros. Appearance Center is a place where you find pretty scarves, hats and wigs to cover the hair loss from chemotherapy, or prosthetic bras to retain that curvy shape after a mastectomy. And now, following a redesign, it’s an open, welcoming place filled with gifts and other treasures.

         “We are bringing a touch of glamour into the lives of people who have been touched by cancer, said Ed Romano, Warner Bros.’ executive vice president and chief financial officer, who attended last week’s grand opening with his wife Murphy Romano. “But beyond glamour, what we hope to provide here is a sanctuary where patients can find comfort when they are in need of reassurance and confidence, and a little tender care from specialists who understand what these patients are experiencing.

         “We are honored to be involved and very happy that the time has come to open.”

         The redesign, providing a more open and uplifting atmosphere, was the vision of Sheri Disney, who helped fund the project. She and her husband Roy P. Disney have contributed to the cancer center since it opened in 2010, continuing decades of support from the Disney family.

         “Roy and I are very proud to be a part of the inspirational work that takes place here,” she said. “We felt passionately about this project many years ago when we first learned of this opportunity, and we remain as deeply committed to this day.”

         Disney recruited designer Michelle Laskey-Nielson of Dwell Floor Five in Studio City, who donated her time and discounted furnishings and fixtures to help the cause. A tree branch Laskey-Nielson spotted while hiking is suspended from the Appearance Center ceiling, a dramatic hanger for items for sale.

         Aside from clothing, the shop offers gifts such as candles, journals, plush robes and blankets and jewelry.

         Also attending the opening were DFCC medical director Raul Mena, M.D., and his wife Barbara, and Teresa McGilvray and Laura Pistotnik, co-chairwomen of Friends of the Disney Family Cancer Center, which raises money to help patients undergoing cancer treatment.

         The cancer center provides a full spectrum of outpatient care for cancer patients, utilizing the latest in diagnostics and treatment. The center offers integrative therapies such as yoga, acupuncture and massage, psychological counseling, genetics counseling and spiritual care.

About Providence Health & Services: Providence Health & Services, Southern California, is a Catholic not-for-profit, mission-driven healthcare system. Providence Southern California operates six award-winning hospitals and a comprehensive, fully-integrated network of primary care clinics, urgent care centers, home care, TrinityCare and TrinityKids Care hospice as well as Providence High School. Providence is anchored locally by Providence Holy Cross Medical Center in Mission Hills, Providence Saint Joseph Medical Center in Burbank, Providence Saint John’s Health Center in Santa Monica, Providence Tarzana Medical Center and Providence Little Company of Mary Medical Centers in Torrance and San Pedro. With more than 3,400 physicians, Providence provides coordinated primary and specialty care through an array of physician groups and individual providers including Providence Medical Institute and physician groups in the South Bay, the West Valley and Santa Clarita. Providence affiliate, Facey Medical Group, provides primary and specialized care in the San Fernando, Santa Clarita and San Gabriel valleys. For more information, visit California.providence.org.
Hollywood studios, with their long history of supporting Providence Saint Joseph Medical Center, have stepped up again – this time to bring a little glamour to the boutique at the hospital’s Roy and Patricia Disney Family Cancer Center.
USC Eye Institute study finds African-Americans at higher risk for diabetic vision loss
Study points to need for improved screening and access to treatments for diabetic macular edema, a leading cause of vision loss




The research, published online today in the Journal of the American Medical Association (JAMA) Ophthalmology, indicates a higher burden of diabetes-related vision loss among certain ethnic populations because of problems with access to care, said corresponding author Rohit Varma, M.D., M.P.H., director of the USC Eye Institute and professor and chair of ophthalmology at the Keck School of Medicine of USC.

“We were surprised that our research showed that African-Americans have the highest rates of DME, when Hispanics tend to have the highest prevalence of diabetes,” said Varma, who is recognized as one of the leading researchers of eye disease in underserved populations. “There is not enough vision screening for DME among diabetics, yet there are much better therapies available that are covered by insurance. We hope that our research will help those in the position to influence policy to get a better handle on costs and where the need for treatment is the greatest.”

Diabetic eye disease is one of the leading causes of vision loss in people ages 20-70 years. Approximately 347 million people throughout the world have diabetes mellitus, and the Centers for Disease Control estimates that 25.8 million Americans had diabetes in 2010.

Diabetic macular edema results when fluid and protein accumulates on the macula of the eye, which is part of the retina, causing it to thicken and swell. The victim’s central vision is affected and, left untreated, the condition can range from slight blurring to blindness.

Varma’s team conducted the study by using the National Health and Nutrition Examination Study (NHANES) database, a national dataset measuring the health and nutritional status of American adults and children. The assessment has been surveying about 5,000 Americans every year since the early 1960s and is used by researchers nationwide to determine the prevalence of major diseases and risk factors for disease.

As part of NHANES, subjects undergo a physical exam that includes photos of their retinas, which Varma’s team reviewed to determine the prevalence of DME.

Clinicians should assess diabetes patients, especially those who are African-American or Hispanic, more closely for vision loss, Varma advised. He also stated that patients should do everything they can to control their glucose and monitor their own vision. Varma pointed out that August is when we commemorate National Eye Exam Month –  a perfect time for ophthalmologists and patients to concentrate on eye health.

Varma’s next target for research in this area is examining barriers to access to eye care among African-Americans.

The study, “Prevalence of and risk factors for diabetic macular edema in the United States,” was funded by Genentech, a pharmaceutical company. Varma is a consultant for Genentech.

The research team includes scientists from the Wilmer Eye Institute at Johns Hopkins University School of Medicine; Outcomes Insights, Inc.; The Ohio State University Division of Public Health; and Genentech, Inc.

The USC Eye Institute is one of the leaders in National Eye Institute funding and ranked No. 9 in the United States for ophthalmology care by U.S. News & World Report.

ABOUT USC EYE INSTITUTE: The USC Eye Institute, part of Keck Medicine of USC, has consistently ranked as a Top 10 ophthalmology program by U.S. News & World Report and Ophthalmology Times and is No. 3 in research funding from the National Eye Institute. Led by Rohit Varma, M.D., M.P.H., the USC Eye Institute has 21 full-time faculty physicians covering all subspecialties of ophthalmology. The USC Eye Institute is headquartered near downtown Los Angeles and has satellite clinics in Pasadena, Beverly Hills and Arcadia. For more information, go to eye.keckmedicine.org.

ABOUT KECK MEDICINE OF USC: Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-based medical systems in the Los Angeles area. Encompassing academic, research and clinical excellence, the medical system attracts internationally renowned experts who teach and practice at the Keck School of Medicine of USC, the region’s first medical school; includes the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; has a medical faculty practice, the USC Care Medical Group; operates the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and owns USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties. For more information, go to www.keckmedicine.org/beyond
Research by Keck Medicine of USC ophthalmology scientists demonstrates that African-Americans bear heavier burden of diabetic macular edema (DME), one of the leading causes of blindness in diabetic patients in the United States.
Natural (Born) Killer Cells Battle Pediatric Leukemia




multiplied in the lab, creating an army of natural killer cells that can be used to destroy the cancer cells. Results of their in vitro study, published August 19 in the journal Leukemia, could one day provide a less toxic and more effective way to battle this cancer in children.

Acute lymphoblastic leukemia (ALL) is the most common cancer of childhood. This disease hinders the development of healthy blood cells while cancer cells proliferate.  Currently, children with ALL receive chemotherapy for two to three years, exposing them to significant side effects including changes in normal development and future fertility. 

As a way to avoid these adverse effects, investigators have been researching how to supercharge the body’s innate cancer-fighting ability – a technique called immunotherapy.  One branch of the immune system – and a possible component of immunotherapy – includes a class of cells called natural killer (NK) cells. These specialized white blood cells police the body and destroy abnormal cells before they turn cancerous.  

Using NK cells as immunotherapy presents challenges. If the cells come from a donor, the patient might reject the cells or worse, be at risk for graft-versus-host disease – where contaminating donor cells regard the patient’s body as foreign and attack it. To avoid these problems, the researchers wondered if they could enlist the help of the patients’ own, or autologous, NK cells. Using autologous cells would remove the risks associated with donor cells. 

But using autologous cells raised other issues. Would it be possible to multiply NK cells from patients with leukemia, even though they had very few to start with?  Also, could the patient’s own NK cells attack their leukemia… and win?

“In this study, we used NK cells and ALL cells from the same pediatric patients. We found that autologous natural killer cells will destroy the patient’s leukemia cells,” said Nora Heisterkamp, PhD, of The Saban Research Institute of Children’s Hospital Los Angeles and one of the co-lead investigators.

To help the NK cells identify their target as leukemia cells, the researchers also added a monoclonal antibody. Antibodies are normally made by cells of the immune system to identify and neutralize foreign material. Researchers can design and produce antibodies, called monoclonal antibodies (mAb), that specifically target a certain protein like the ones found on cancer cells. In a previous paper, Heisterkamp showed that a mAb targeted to a specific receptor (BAFF-R) on the leukemia cells stimulated the NK cells to attack and kill the cancer.  The BAFF-R mAb was also used in this study.

“These results are very promising — with potential as a part of first line therapy and also as a treatment for eliminating any remaining cancer cells, known as minimal residual disease, following standard chemotherapy,” said Hisham Abdel-Azim, MD, of Children’s Hospital Los Angeles and co-lead investigator on the study. “We anticipate additional pre-clinical testing and then, a clinical trial to evaluate the therapy in children with leukemia.”

Additional contributors include first author Fei Fei, Min Lim, Aswathi A. George, Jonathan Kirzner, Robert Seeger, and John Groffen of Children’s Hospital Los Angeles; and Dean Lee of MD Anderson Cancer Center, Houston TX. 

Funding for the study was provided in part by grants from Alex’s Lemonade Stand Foundation, the Leukemia & Lymphoma Society, the V-Foundation and Public Health Service grant CA090321.

About Children’s Hospital Los Angeles: Children's Hospital Los Angeles has been named the best children’s hospital on the West Coast and among the top five in the nation for clinical excellence with its selection to the prestigious U.S. News & World Report Honor Roll. Children’s Hospital is home to The Saban Research Institute, one of the largest and most productive pediatric research facilities in the United States. Children’s Hospital is also one of America's premier teaching hospitals through its affiliation since 1932 with the Keck School of Medicine of the University of Southern California.

For more information, visit CHLA.org and follow us on ResearCHLAblog.org. 
Researchers at Children’s Hospital Los Angeles have shown that a select team of immune-system cells from patients with leukemia can be
Providing Futile Treatment Prevents Other Patients from Receiving the Critical Care They Need, Study by UCLA and RAND Health Finds





The study is the first to show that when unbeneficial medical care is provided, others who might be able to benefit from treatment are harmed, said study lead author Dr. Thanh Huynh, an assistant professor of medicine in the division of pulmonary and critical care medicine at the David Geffen School of Medicine at UCLA.

The findings also have implications for the fairness of the American healthcare system, and points toward needed policy improvements to more efficiently use limited healthcare resources, said senior author Dr. Neil S. Wenger, a UCLA professor of medicine, a RAND Health scientist and director of the UCLA Health Ethics Center at the David Geffen School of Medicine at UCLA.

“Many people do not realize that there is a tension between what medicine is able to do and what medicine should do. Even fewer realize that medicine is commonly used to achieve goals that most people, and perhaps most of society, would not value – such as prolonging the dying process in the intensive care unit when a patient cannot improve,” Wenger said. “But almost no one recognizes that these actions affect other patients, who might receive delayed care or, worse, not receive needed care at all because futile medical treatment was provided to someone else.”

The study appears in the August issue of the peer-reviewed journal Critical Care Medicine.

For the study, the research team surveyed critical care physicians in five ICUs in one health system to identify patients that the clinicians identified as receiving treatment that would not help them get better. They then identified days when an ICU was full and contained at least one patient receiving futile treatment and looked at the number of patients waiting for ICU admission for more than four hours in the emergency department or more than one day for transfer from an outside hospital.

The study showed that on 16% of days when an ICU was full, it contained at least one patient receiving futile treatment. During those days, 33 patients were kept in the emergency department for more than four hours, nine patients waited more than one day to be transferred from an outside hospital and 15 patients canceled their transfer request after waiting more than one day. Two patients died at outside hospitals while waiting to be transferred into the academic medical center ICU.

“These findings should contribute to the public debate about the use of limited healthcare resources and whether limitations should be placed on using those resources for treatments that physicians feel will not benefit patients,” Wenger said. “To date, healthcare payers have been willing to pay for any life-sustaining treatment that has already been started and the public has been unwilling to discuss the trade-offs silently made between patients receiving futile treatment and patients not receiving the treatment they need. This study demonstrates that those trade-offs occur and can be measured.”

Huynh said that going forward, the research team hopes to develop interventions to decrease instances of hospitals providing critical care to patients for whom there will be no benefit.

“With advances in medicine and technology, the ICU is now able to save lives as well as prolong the dying process,” Huynh said. “Because resources are not unlimited, patients receiving futile treatment can mean delayed or even denied access to care for other patients in need. This needs to change.”

“It is unjust when a patient is unable to access intensive care because ICU beds are occupied by patients who cannot benefit from such care. Our findings are particularly relevant in the U.S., but are also instructive elsewhere given universal concerns regarding providing treatments that are non-beneficial,” the study states. “The ethic of ‘first come, first served’ is not only inefficient and wasteful, but it is contrary to medicine’s responsibility to apply healthcare resources to best serve society. In the context of healthcare reform, which aims to more justly distribute medical care to the nation, opportunity cost is one more reason that futile treatment should be minimized.”

The study was funded by the late philanthropist Mary Kay Farley in a donation to RAND Health.
Providing futile treatment in the intensive care unit sets off a chain reaction that causes other ill patients needing medical attention to wait for critical care beds, according to a study by researchers from UCLA and RAND Health.
Providence Saint John’s, Santa Monica Fire Department and Bowers Ambulance Offer Compression-Only CPR Training




        “Heart Sunday—Your Heart and Stayin’ Alive,” will be held from 1 to 3 p.m. on National Grandparent’s Day in the hospital’s Keck Center, 2121 Santa Monica Blvd. It will be presented by Providence Saint John’s and the Saint John’s Health Center Foundation in collaboration with the Santa Monica Fire Department and Bowers Ambulance.

         The program will be moderated by the event’s honorary chairman John M. Robertson, M.D., medical director of cardiothoracic surgery and chairman of the board of the Saint John’s Health Center Foundation. Providence Saint John’s cardiologists, Nicole Weinberg, M.D., and Shephal Doshi, M.D., medical director, electrophysiology and pacing will present brief lectures on heart health.

         Dr. Weinberg will discuss sudden cardiac arrest and share ways to keep the heart healthy. Dr. Doshi will review the heart’s electrical system, risk of cardiac arrest and ways it can be prevented or treated with CPR and defibrillators. Survivors of cardiac arrest and family members will celebrate life with remarkable stories of their experiences.

         Free skills training in compression-only CPR will highlight the event. Paramedics from the Santa Monica Fire Department and Bowers Ambulance , as well as Providence Saint John’s nurses, physicians and community nurses will facilitate training. (No credit or certificates will be given for this training program.)

         A leading cause of death in the U.S., sudden cardiac arrest differs from heart attack, affects nearly 360,000 people each year in the U.S, including youths . Just 10 percent of these patients survive.  For some, cardiac arrest is the first sign that a heart problem exists.  When cardiac arrest patients are treated quickly with CPR and automated external defibrillators (AEDs) before emergency medical services arrive, average survival rates climb to nearly 40 percent.  With this intervention,  more than 100,000 lives could be saved.

         Supported by Saint John’s Health Center Foundation, this program is appropriately planned for National Grandparent’s Day and families are encouraged to attend.

         Reservations are required and can be made by calling 310 829-8453 or emailing SpecialEvents@stjohns.org. Complimentary valet parking will be available at the main entrance to the hospital on Santa Monica Boulevard.

About Providence Health & Services: Providence Health & Services, Southern California, is a Catholic not-for-profit, mission-driven healthcare system. Providence Southern California operates six award-winning hospitals and a comprehensive, fully-integrated network of primary care clinics, urgent care centers, home care, TrinityCare and TrinityKids Care hospice as well as Providence High School. Providence is anchored locally by Providence Holy Cross Medical Center in Mission Hills, Providence Saint Joseph Medical Center in Burbank, Providence Saint John’s Health Center in Santa Monica, Providence Tarzana Medical Center and Providence Little Company of Mary Medical Centers in Torrance and San Pedro. With more than 3,400 physicians, Providence provides coordinated primary and specialty care through an array of physician groups and individual providers including Providence Medical Institute and physician groups in the South Bay, the West Valley and Santa Clarita. Providence affiliate, Facey Medical Group, provides primary and specialized care in the San Fernando, Santa Clarita and San Gabriel valleys. For more information, visit California.providence.org.
Free compression-only CPR training will be provided Sept. 7 at Providence Saint John’s Health Center as a part of a healthy heart education program that also will celebrate life and survivorship.
Keck Medical Center of USC becomes only worldwide training center for Da Vinci Xi robotic-assisted thoracic surgery
USC thoracic oncological surgeons first to perform FDA-approved operation in Southern California for lung cancer patients




(FDA)-approved robotic-assisted procedure for a lung cancer patient using the latest, minimally invasive surgical system, the da Vinci Xi robot. In addition, USC chief of thoracic surgery, Jeffrey A. Hagen, M.D., and Keck Medicine of USC thoracic surgeon, Daniel S. Oh, M.D., will head the only worldwide training center located at Keck Medical Center of USC for other surgeons to learn how to use the Xi robotic system for thoracic procedures.

The new da Vinci Xi Surgical System robot created by Intuitive Surgical was approved by the Food and Drug Administration on April 1. The first FDA-approved thoracic surgical procedures were performed this summer, among them cases by Hagen and Oh. The new Xi robot is optimized for thoracic procedures. The robotic system gives surgeons greater dexterity, precision and ability to remove cancerous tissue in all quadrants of the abdomen and chest because of its smaller arms. In addition, surgeons have a larger operating field in which to work, leading to better maneuverability without having to reposition the robot as frequently throughout the procedure.

For patients, robotic surgery, when appropriate, provides a minimally invasive treatment choice that often leads to smaller incisions (less than one inch), less pain and less need for medication, minimal scarring and reduced bleeding. However, the biggest advantages for robotic surgery are the shorter hospital stay and faster recovery time for patients to return to normal daily routines – often cutting these times in half.

“Having our surgeons become the only training team worldwide for thoracic robotic surgeries using the Xi is another example of how Keck Medicine of USC is continuing our dominance in robotic surgeries in Southern California,” said Tom Jackiewicz, CEO of USC Health, which oversees Keck Medicine of USC. “Because we perform more robotic surgeries than any other hospital in the metro Los Angeles area, patients have more confidence in our expert surgeons and overall this leads to better patient safety and outcomes.”

The Keck Medical Center of USC, which consists of Keck Hospital of USC and USC Norris Cancer Hospital, has been pioneering robotic surgery for years and is the fastest-growing robotic surgery center in the country.

According to the American Lung Association, lung cancer is the leading cancer killer in both men and women in the United States. In 1987, it surpassed breast cancer to become the leading cause of cancer deaths in women.

“Having the most advanced robotic surgical system at USC gives us the opportunity to create a public education message to encourage patients to seek treatment from experts who understand specialized surgical options,” said Hagen, who is also an associate professor of clinical surgery at the Keck School of Medicine of USC. “We know there has been a stigma associated with lung cancer because of its connection to smoking. However, over the last 10 years, the incidence for this type of cancer has been rising among non-smokers, especially women, and our goal is to have patients seek out experts for treatment options that increase your chances for survival.”

As a university-based medical center, Keck Medicine of of USC’s reputation as a center of excellence for robotic surgery has led other surgeons and physicians worldwide to its doorstep to be trained on the latest advances in robotic procedures.

“Only three percent of lung cancer surgeries are done by dedicated thoracic surgical oncologists such as Dr. Hagen and myself,” said Oh, who is also an assistant professor of surgery at the Keck School of Medicine of USC. “Patients have better outcomes when they see a specialist in the area of medicine with which they need help. The more doctors we can teach how to use this new technology, the more opportunities we give patients for cure and recovery.”

ABOUT KECK MEDICINE OF USC: Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-based medical systems in the Los Angeles area. Encompassing academic, research and clinical excellence, the medical system attracts internationally renowned experts who teach and practice at the Keck School of Medicine of USC, the region’s first medical school; includes the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; has a medical faculty practice, the USC Care Medical Group; operates the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and owns USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties. U.S. News & World Report ranked Keck Medical Center of USC among the Top 10 in ophthalmology (No. 9), and among the Top 25 hospitals in the United States for urology (No. 20) and cancer care (No. 23). The medical center was also awarded an “A” grade from The Leapfrog Group in March, representing outstanding patient safety practices and overall patient outcomes.

For more information, go to www.keckmedicine.org/beyond
Surgeons at the Keck Medical Center of the University of Southern California (USC) this summer became the first in Southern California and among the first west of the Mississippi to perform the Food and Drug Administration
USC Eye Institute study shows Native American ancestry significant risk factor for diabetic eye disease in Latinos
Diabetic retinopathy is most common diabetic eye disease and leading cause of blindness in working-age U.S. adults




among Latinos with Type 2 diabetes. Diabetic retinopathy is the leading cause of blindness in working-age adults in the United States, affecting more than 4 million Americans age 40 and older.

The research was published online today in Investigative Ophthalmology & Visual Science, the peer-reviewed academic journal of The Association for Research in Vision and Ophthalmology, the largest and most respected eye and vision research organization in the world.

Diabetic retinopathy occurs when blood vessels in the eye’s retina are damaged. The retina is the light-sensitive tissue at the back of the eye that acts like a film inside a camera; like damaged film, a damaged retina will produce a bad picture. Symptoms may not be noticeable at first, but the disease can get worse over time and lead to vision loss.

“This is the first study, to our knowledge, that examines the contribution of genetic ancestry in vision-threatening diabetic eye disease in Latinos,” said USC Eye Institute Director Rohit Varma, M.D., M.P.H., professor and chair of the Department of Ophthalmology at the Keck School of Medicine of USC and the study’s principal investigator. “Previous research has shown that Latinos have a higher prevalence of diabetic retinopathy than non-Hispanic Whites and African-Americans. Our findings suggest that one contributor to this heavy burden may be due to their Native American ancestry.”

Latinos are a diverse group of people typically with a varying mixture of Native American, European and African ancestry. Varma’s research team examined data from 944 Latinos with Type 2 diabetes from the Los Angeles Latino Eye Study (LALES), the largest population-based study of eye disease in that ethnic group. The participants in the study were 40 years of age or older and hailed from the city of La Puente in Los Angeles County, California. Ninety-five percent of them were of Mexican origin. Of the 944 people with type II diabetes, 135 had vision-threatening diabetic retinopathy while 809 did not.

Using genetic assays and detailed ophthalmologic examinations, the team found that individuals with more than 50 percent Native American ancestry had an 87 percent higher chance of also having vision-threatening diabetic retinopathy compared to those who had less than 50 percent Native American ancestry, even after controlling for known risk factors for the disease.

“Our next steps will be to try to narrow down which genomic locations among those with a Native American origin might be contributing to boosting the risk for developing severe diabetic retinopathy,” said Xiaoyi Gao, the study’s first author who started his research at USC. Gao is now associate professor of ophthalmology in the University of Illinois, Chicago College of Medicine.

Other co-authors include W. James Gauderman, Paul Marjoram and Mina Torres of USC, and Yii-Der I. Chen, Kent Taylor and Jerome Rotter of the Los Angeles Biomedical Research Institute at Harbor-UCLA. The study  was supported in part by the National Institutes of Health (grants U10EY011753, R01EY022651, P30EY001792), Research to Prevent Blindness, National Center for Advancing Translational Sciences, USC Clinical Translational Science Institute (grant UL1TR000124), and the National Institute of Diabetes and Digestive and Kidney Disease Diabetes Research Center (grant DK063491).

ABOUT USC EYE INSTITUTE: The USC Eye Institute, part of Keck Medicine of USC, is led by Rohit Varma, M.D., M.P.H. and has 21 full-time faculty physicians covering all subspecialties of ophthalmology. USC's ophthalmology program has been ranked in the Top 10 by U.S. News & World Report for 20 years and is No. 3 in research funding from the National Eye Institute. The USC Eye Institute is headquartered near downtown Los Angeles and has satellite clinics in Pasadena, Beverly Hills and Arcadia. For more information, go to eye.keckmedicine.org.

ABOUT KECK MEDICINE OF USC: Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-based medical systems in the Los Angeles area. Encompassing academic, research and clinical excellence, the medical system attracts internationally renowned experts who teach and practice at the Keck School of Medicine of USC, the region’s first medical school; includes the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; has a medical faculty practice, the USC Care Medical Group; operates the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and owns USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties. For more information, go to www.keckmedicine.org/beyond
New research led by the University of Southern California (USC) Eye Institute, part of Keck Medicine of USC, shows for the first time that Native American ancestry is a significant risk factor for vision-threatening diabetic retinopathy
Teen Cancer America Offers Campaign Donors The Chance to Battle IndyCar Drivers Josef Newgarden and Justin Wilson in Online Forza Motorsport 5 Challenge
Teen Cancer America and Honda Racing Team Up for “Race Against Cancer” to Benefit Teen and Young Adult Cancer Centers









livestream on Thursday, August 28. The livestream will take place at 4:00pm PT at Twitch.tv/Tiltify.

Eligible donations can be made through Saturday, August 23 at 11:59pm ET via Tiltify at tiltify.com/events/race-against-cancer. One grand prize winner will be selected to battle Newgarden and Wilson will also win a signed copy of Forza Motorsport 5 plus an Xbox One.

Donations made Sunday, August 24 through Thursday, August 28 will still be eligible to win a downloadable version of Forza Motorsport 5 and DLC codes for the Forza Motorsport 5 Car Pass.

An Ask Me Anything interview with Josef Newgarden and Justin Wilson will be held on Reddit Thursday, August 21 beginning at 1:30pm PT.
Teen Cancer America, in partnership with Honda Racing, announces the last week of the Race Against Cancer campaign, part of their push to $50,000 for the development of specialized teen and young adult cancer centers.

Race Against Cancer donors will be entered to win a chance to challenge IndyCar drivers Josef Newgarden and Justin Wilson in Forza Motorsport 5 online during a special
Knowledge is Power: UCLA Study Finds Men who are Uneducated About their Prostate Cancer Have Difficulty Making Good Treatment Choices





UCLA researchers found that men who aren’t well educated about their disease have a much more difficult time making treatment decisions, called decisional conflict, a challenge that could negatively impact the quality of their care and their long-term outcomes.

The study should serve as a wake-up call for physicians, who can use the findings to target men less likely to know a lot about their prostate cancer and educate them prior to their appointments so they’re more comfortable making treatment decisions, said study first author Dr. Alan Kaplan, a resident physician in the UCLA Department of Urology.

“For prostate cancer, there is no one right answer when it comes to treatment. It comes down to the right answer for each specific patient, and that is heavily dependent on their own personal preferences,” Kaplan said.  “Men in general, and specifically economically disadvantaged men, have a hard time deciding what their preferences are, how they feel about any possible complications and what the future after treatment might be like. If you don’t know anything about your disease, you’ll have a really tough time making a decision.”

The findings from the one-year study appears in the early online edition of the peer-reviewed journal Cancer.

The research team surveyed 70 men at a Veterans Administration clinic who were newly diagnosed with localized prostate cancer and had enrolled in a randomized trial testing a novel shared decision-making tool. They collected baseline demographic and clinical such as age, race, education, co-existing medical conditions, relationship status, urinary and sexual dysfunction and their prostate cancer knowledge. 

UCLA researchers talked one-on-one with the men after they had received their cancer diagnosis, but before they consulted with a physician. Median age of the men in the study was 63 years, 49% were African American and 70% reported an annual income of less than $30,000. 

Kaplan said the team found that a low level of prostate cancer knowledge was associated with increased decisional conflict and higher uncertainty about what treatment to choose. Low levels of prostate cancer knowledge also were associated with lower perceived effectiveness – meaning the less they knew about their cancer, the less confidence they had that the treatment would be effective.

“Knowledge about prostate cancer is an identifiable target. Interventions designed to increase a patient’s comprehension of prostate cancer and its treatments may greatly reduce decisional conflict,” Kaplan said, adding that further study is needed to better characterize this relationship and identify effective targeted interventions.

“If you get shot in the gut, there aren’t many options. You go into the operating room to get fixed up,” he said. “With prostate cancer, there are lots of options and not all are right for everybody.”

Men with prostate cancer might need to decide between surgery versus radiation or opting for active surveillance, in which patients are monitored closely for changes in the progression of their cancer and are tested at regular intervals. Prostate cancers can also be treated implantable radioactive seeds or tumors may be burned or frozen as treatment.

Another benefit to reducing decisional conflict is that patients who feel comfortable with their decision may regret their decisions less down the line, Kaplan said. They’re less likely to sue their doctors and generally experience better outcomes.

“In a way, it’s like buying a car. You prepare, you read reports, do your homework,” Kaplan said. “If something goes wrong with the car, you feel OK because you knew what you were getting into. When patients take ownership of the decision-making process, their outcomes are better.”

Kaplan said economically disadvantaged men may be having more difficulty because they may not have as much experience negotiating the healthcare system and are less confident when communicating with doctors.

“Doctors, we know intuitively, should spend more time with their patients, especially when they’re making an important decision,” he said. “But all of us are challenged with the numbers of patients we must see in a day. If you know beforehand that a patient has a poor knowledge about his cancer, that’s someone you need to spend more time with.”

Doctors may also want to provide these patients with educational information  before their consultation so they can begin to increase their prostate cancer knowledge, Kaplan said.

Prostate  cancer is the most frequently diagnosed cancer in men aside from skin cancer. An estimated 233,000 new cases of prostate cancer will occur in the United States in 2014. Of those, nearly 30,000 men will die. 

The study was funded by UCLA’s Jonsson Comprehensive Cancer Center and the National Institutes of Health (R01 CA134997, 5R25CA087949-14, 5R01CA134997-02).

For more than 50 years, the urology specialists at UCLA have continued to break new ground and set the standards of care for patients suffering from urological conditions. In collaboration with research scientists, UCLA’s internationally renowned physicians are pioneering new, less invasive methods of delivering care that are more effective and less costly. UCLA’s is one of only a handful of urology programs in the country that offer kidney and pancreas transplantation. In July of 2013, UCLA Urology was once again ranked fourth in the nation by U.S. News & World Report, a ranking it has held for the last 15 years. For more information, visit http://urology.ucla.edu/.
They say knowledge is power, and a new UCLA study has shown this is definitely the case when it comes to men making the best decisions about how to treat their prostate cancer.
USC Eye Institute ophthalmologists implant first FDA-approved Argus II retinal prosthesis in western United States



of Southern California (USC) Eye Institute.

Kulik is a 55-year-old Peoria, Ariz. resident who has retinitis pigmentosa, a degenerative disease that progressively robs its victims of sight. On June 2, she became the first person west of the Mississippi to receive the FDA-approved Argus II retinal prosthesis, innovative wireless technology co-invented by Humayun, who is the Cornelius Pings Professor of Biomedical Sciences and professor of ophthalmology, biomedical engineering, cell and neurobiology at Keck Medicine of USC and the USC Viterbi School of Engineering.

When Kulik wore the Argus II to the July 4 celebration with her husband and niece, she didn’t expect to see anything. But when the fireworks went off, so did flashes in her field of vision.

“My husband and niece were more excited than I was,” she said. “I was seeing thick and thin flashes, and I knew it was the fireworks. I’ve also seen the moon, and I can see the contrast between the grass and the sidewalk.

“I’m hoping I will be able to see silhouettes of people, like my grandchildren, and be able to get around by myself. Losing independence has been the hardest part [of being blind] for me. I’d like to be able to take a walk down the street.”

Kulik’s progress is encouraging to Humayun, who started developing the Argus II more than 20 years ago.

“She could see spots of light on the first day of activation, which is very exciting,” said Humayun, who is professor of ophthalmology and biomedical engineering at USC and co-director of the USC Eye Institute. The USC Eye Institute has ranked as a Top 10 ophthalmology program for 24 years and is No. 3 in research funding from the National Eye Insitute. “That put her ahead of our expectations. Most of our patients haven’t seen for decades and they have to relearn how to interpret visual signals, which takes quite a while. It’s like seeing a baby learn to crawl, then to walk, then to run.”

Kulik received the implant during a four-hour surgery at Keck Medicine of USC, performed by Lisa Olmos de Koo, assistant professor of ophthalmology at the Keck School, with Humayun assisting. Kulik is now undergoing several months of follow-up testing while she trains her brain to see in a new way. Some Argus II patients can see contrast well enough to sort light and dark clothing, and to see the outlines of doors, bushes, people and other objects.

The Argus II system uses a camera mounted on special glasses that sends a signal to an electronic receiver with 60 electrodes implanted inside the eye. The receiver sends signals to the retina that travel through the optic nerve to the brain, where they can be interpreted as a visual picture. Future applications of the device are aimed at age-related macular degeneration, a similar but more common disease than RP. The prosthesis is manufactured and sold by Second Sight Medical Products in Sylmar, California.

Clinical trials for the Argus II at USC began in 2007, with more than 30 patients implanted with the device as part of the trial. Eligible patients must be over the age of 25, have little or no light perception in both eyes and have had previous sight.

The Argus II is not just a professional goal for Humayun. As a medical school student, he was inspired to study blindness when complications from diabetes stole his grandmother’s sight, and nothing could be done to help her.

“As her vision deteriorated, it was sad to see her losing the enjoyment she got through reading and being in her garden,” he said. “That experience made me reconsider my path in medicine, and I obtained a Ph.D. in engineering so I could help restore sight to blind people.”

Kulik began losing her sight in her late 20s, and by her early 30s, all she could see were shadows in extremely bright conditions. She had to give up her driver’s license and quit her job at a veterinary clinic, working with the animals she loved. And she missed seeing her two sons, now 31 and 24, become men.

Her journey toward sight began in 2012, when her husband Ed saw an article on the Internet about the Argus II.  Kulik said Ed’s discovery confirmed her continuous optimism that a solution to her blindness would be found.

“When I was diagnosed, I didn’t let it stop me,” she said. “I knew someone would come up with something.”

Innovation is one of the hallmarks of the USC Eye Institute, a leader in National Eye Institute funding and ranked No. 9 in the United States for ophthalmology care by U.S. News & World Report. The Argus II is one of many examples of how the interdisciplinary environment at USC enables the creation of potential miracle solutions to health problems.

"One of USC's strengths is that we have an extraordinarily collaborative environment with world-class expertise in many different areas that can impact our health — including medicine, engineering, pharmacy, interactive media and public policy," said Rohit Varma, M.D., M.P.H., director of the USC Eye Institute and chair, Department of Ophthalmology, Keck School of Medicine of USC. "The Argus II is one of the prime examples of such a collaboration, resulting from a strong relationship with the Keck School of Medicine of USC and the USC Viterbi School of Engineering.

“Losing sight is devastating to most people, making them depressed, more dependent on others and reducing their social interactions and productivity, among other things,” Varma added. “Now with the Argus II we have the potential to reverse all that and help people begin new, more independent, productive and fuller lives. By bringing sight back to the blind, the Argus II is truly a miracle."

Retinitis pigmentosa (RP) is a genetic disease affecting nearly 100,000 people in the U.S. Those with the disease experience progressive loss of photoreceptors (rods and cones) or the retinal pigment epithelium, a pigmented cell layer that nourishes retinal cells. As the disease progresses, patients experience night blindness, tunnel vision, blurring, and difficulty adjusting from dark to light environments. Eventually their vision is reduced to shadows and most victims are declared legally blind.

Kulik is also participating in a study to determine whether partial restoration of vision has an impact on how the brain processes information. She returns to USC periodically for magnetic imaging resonation (MRI) tests, as well as testing with the Argus II.

ABOUT USC EYE INSTITUTE: The USC Eye Institute has consistently ranked as a Top 10 ophthalmology program by U.S. News & World Report and Ophthalmology Times and is No. 3 in research funding from the National Eye Institute. Led by Rohit Varma, M.D., M.P.H., the USC Eye Institute has 21 full-time faculty physicians covering all subspecialties of ophthalmology. The USC Eye Institute is headquartered near downtown Los Angeles and has satellite clinics in Pasadena, Beverly Hills and Arcadia. For more information, go to eye.keckmedicine.org.

ABOUT KECK MEDICINE OF USC: Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-based medical systems in the Los Angeles area. Encompassing academic, research and clinical excellence, the medical system attracts internationally renowned experts who teach and practice at the Keck School of Medicine of USC, the region’s first medical school; includes the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; has a medical faculty practice, the USC Care Medical Group; operates the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and owns USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties. For more information, go to www.keckmedicine.org/beyond
Lisa Kulik saw fireworks for the first time in nearly 30 years this July 4 holiday, thanks to a groundbreaking retinal implant co-invented by Mark Humayun, M.D., Ph.D., an internationally renowned clinician-researcher at the University
Protein in ‘Good Cholesterol’ may be a Key to Treating Pulmonary Hypertension




they may also contribute to pulmonary hypertension, a serious lung disease that narrows the small blood vessels in the lungs.

Using a rodent model, the researchers showed that a peptide mimicking part of the main protein in high-density lipoprotein (HDL), the so-called “good” cholesterol, may help reduce the production of oxidized lipids in pulmonary hypertension. They also found that reducing the amount of oxidized lipids improved the rodents’ heart and lung function.

The study appears in the current online edition of the peer-reviewed journal Circulation.

A rare progressive condition, pulmonary hypertension can affect people of all ages. The disease makes it harder for the heart to pump blood through these vital organs, which can lead to heart failure.

“Our research helps unravel the mechanisms involved in the development of pulmonary hypertension,” said Dr. Mansoureh Eghbali, the study’s senior author and an associate professor of anesthesiology at the David Geffen School of Medicine at UCLA. “A key peptide related to HDL cholesterol that can help reduce these oxidized lipids may provide a new target for treatment development.”

Lipids such as fatty acids become oxidized when they are exposed to free radicals — tiny particles that are produced when the body converts food into energy -- or when they are exposed to pollution, and in numerous other ways.

Although researchers have known that oxidized lipids played a role in the development of atherosclerosis and other vascular diseases, the UCLA team discovered higher-than-normal levels of oxidized proteins in rodents with pulmonary hypertension.

The UCLA researchers also knew that apoA-1, a protein that is a key component of HDL cholesterol, can reduce oxidized lipids, so they used a small peptide called 4F that mimics the action of apoA-1 and found that the 4F not only decreased the levels of oxidized lipids in the rodents, but also improved their heart and lung function. Specifically, the peptide restored the altered expression of a key molecule called micro ribonucleic acid (microRNA-193), which targets the action of essential enzymes involved in the production of oxidized lipids. 

“The increased amounts of these oxidized lipids due to pulmonary hypertension keeps the expression of this molecule under check, which aggravates symptoms of the disease,” said first author Dr. Salil Sharma, a UCLA postdoctoral researcher in anesthesiology.

By restoring the expression of microRNA-193 to its full potential, the researchers reduced the amount of oxidized lipids in the animals with pulmonary hypertension.

One of the hallmarks of pulmonary hypertension is a proliferation of smooth muscle cells in the lungs, which is harmful because it narrows the lungs’ small blood vessels.

Additionally, Eghbali’s team found reduced levels of microRNA-193 in the blood and lung tissue of human patients with the disease and discovered that they could slow the proliferation of the smooth muscle cells by increasing levels of microRNA-193 in the cells that had been isolated from these patients’ lungs.

Further research will be required to test the potential of the HDL-related peptide and microRNA-193 in human disease, and to better understand how the levels of oxidized lipids in the blood may correlate to disease severity in people with pulmonary arterial hypertension.

The study was funded in part by the American Heart Association, the National Institute of Health, the UCLA Clinical and Translational Science Institute  and the Iris Cantor–UCLA Women’s Health Center executive advisory board.

The study’s other authors were Dr. Soban Umar, Andrea Iorga, Gabriel Wong, Denise Mai and Dr. Kaveh Navab of the division of molecular medicine at UCLA’s department of anesthesiology; David Meriwether, Dr. Mohamad Navab, Dr. Alan Fogelman and Dr. Srinivasa Reddy of the division of cardiology at UCLA’s department of medicine; Dr. David Ross of the division of pulmonary critical care medicine at the David Geffen School of Medicine at UCLA’s department of medicine; and Francois Potus, Sandra Breuils-Bonnet, Dr. Steve Provencher and  Dr. Sébastien Bonnet of Laval University in Québec, Canada.

All of the intellectual property for the HDL-related peptide is owned by the University of California Regents and managed by the UCLA Office of Intellectual Property and Industry Sponsored Research. The technology is currently licensed exclusively to Bruin Pharma Inc. Fogelman, Navab and Reddy are principals in Bruin Pharma, and Fogelman is an officer in the company. Other disclosures are listed in the manuscript.
Oxidized lipids are known to play a key role in inflaming blood vessels and hardening arteries, which causes diseases like atherosclerosis. A new study at UCLA demonstrates that