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New law helps grads of accelerated medical programs

UC co-sponsored bill signed by governor will allow more physicians to practice in California.

A new law sponsored by the University of California will allow graduates of accelerated and fully accredited medical education programs to become licensed physicians in California by as early as January 2015.

AB 1838, co-sponsored by UC and the Medical Board of California and introduced by Assembly Member Susan Bonilla, will allow more physicians to practice in California and help doctors incur less student debt. Gov. Jerry Brown signed the bill into law last week.

The law previously required California physicians to complete a medical curriculum over at least four academic years with a minimum of 4,000 hours of coursework. Those provisions created a barrier for well-qualified graduates of accelerated programs who were interested in practicing in the state.

There is already a shortage of medical doctors in California and it is estimated that the state will need an additional 8,000 primary care physicians by 2030. Debt is another problem facing students pursuing medical degrees; the median debt for graduate students is $175,000. AB 1838 addressed both problems by allowing students to finish their training sooner. It also allows California medical facilities to recruit physicians who have attended accelerated programs in other states.

The UC Davis School of Medicine is the first UC campus to offer an accelerated program. The Accelerated Competency-based Education in Primary Care (ACE-PC) program provides approximately three years of medical school training after which students move directly into a primary care residency program operated by UC Davis or Kaiser Permanente of Northern California.

“We want to thank Assembly Member Susan A. Bonilla and the Medical Board of California for their leadership on this important and timely legislation,” said Dr. Cathryn Nation, UC associate vice president for health sciences. “UC is proud that its School of Medicine at Davis, in partnership with Kaiser Permanente, developed the first accelerated medical education program in California, enrolling its first class of six students in June 2014. Now future graduates from this primary-care focused program and other accelerated programs will have a clear path to medical practice in California.”

The accelerated programs enable students to complete a more concentrated, modified year-round education schedule that often eliminates summer breaks and involves reduced time for electives.

The University of California operates six of California’s nine M.D.-granting medical schools and provides specialty training for nearly half of the state’s medical residents.

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Regents confirm San Hawgood as UCSF chancellor

He is 10th chancellor of the health sciences campus.

UC President Janet Napolitano shakes the hand of the newly confirmed UCSF Chancellor Sam Hawgood at a press briefing after the Board of Regents approved his appointment on July 17. (Photo by Cindy Chew)

The University of California Board of Regents today (July 17) approved Sam Hawgood as the 10th chancellor of UC San Francisco, where he has served as dean of the UCSF School of Medicine and interim chancellor.

Hawgood, 61, was selected by President Janet Napolitano as the next chancellor after he rose to the top of a strong field of candidates. A search committee composed of regents, faculty, alumni, staff and students reviewed more than 375 candidates and interviewed seven finalists for the position.

“Dr. Hawgood’s list of accomplishments in the lab, in the clinic and in the administrative suite is long and illustrious,” said Regents Chairman Bruce D. Varner.

“Throughout a truly exhaustive selection process, Dr. Hawgood demonstrated the intellectual inquisitiveness, leadership acumen and powerful vision we seek in our chancellors,” Napolitano said. “When an exhaustive search lands on a candidate from within the institution, it is a sign that the enterprise is fundamentally robust. We have been fortunate to have Sam as a member of the UC family for more than 30 years.”

Hawgood had served as interim chancellor since Susan Desmond-Hellmann stepped down April 1, 2014, to become chief executive officer of the Bill & Melinda Gates Foundation.

UCSF, with an annual budget of $4.2 billion, includes nationally top-ranked graduate schools of medicine, dentistry, nursing and pharmacy, as well as affiliated hospitals, a pre-eminent biomedical research enterprise and a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences.

“I understand and deeply respect the core values of UCSF – and both the principle and practice of shared governance with the faculty,” Hawgood told the regents after they approved his appointment.

“But I know that, while we should remain connected to our past and preserve our values,” he said, “our times call for a rigorous look at the reality of the world today and a willingness to move forward in new directions. I embrace the opportunity to work closely with the faculty as we embark, together, on this journey.”

The Board of Regents approved a state-funded base salary of $500,000, plus $250,000 to be funded through an endowed chair, The Arthur Rock and Toni Rembe Distinguished Professorship, created specifically for the chancellor position by the UCSF Foundation, using no state funds.  His total cash compensation ranks 34th among chancellors and presidents of the 62 public research universities that are part of the Association of American Universities.

Consistent with past practice, Hawgood will receive an annual auto allowance of $8,916, and the university will provide him with the existing UCSF Chancellor’s home, which is suitable for duties such as fundraising. The residence is maintained with non-state funds.

With 22,800 faculty and staff, UCSF is the second-largest employer in San Francisco, and generates more than 17,000 additional jobs locally through its construction, its expenditures and purchases by employees, students and visitors.

Hawgood has served as dean of the UCSF School of Medicine and as vice chancellor for medical affairs since September 2009, after assuming the role of interim dean in December 2007. He previously had chaired the Department of Pediatrics, having first served in an interim role. He also served as associate director of the Cardiovascular Research Institute.

The School of Medicine has an operating budget of more than $1.9 billion, 7,400 faculty and staff, and about 3,655 medical and graduate students, residents, fellows and postdoctoral scholars. The school’s clinical faculty is known widely for world-class medical care through its practice in the top-ranked UCSF Medical Center, UCSF Benioff Children’s Hospital, San Francisco (newly affiliated with Children’s Hospital Oakland, now known as UCSF Benioff Children’s Hospital, Oakland), Langley Porter Psychiatric Institute, San Francisco General Hospital & Trauma Center, and the San Francisco Veterans’ Administration Medical Center.

Under Hawgood’s leadership, the school became the top medical school in the nation in research funding from the National Institutes of Health ($439.6 million in 2013), with many of its departments also leading the nation in their fields. It also became the only medical school in the nation to rank in the top five in both research and primary-care education, in the U.S. News & World Report’s annual assessment of graduate schools.

Numerous organizations and publications have recognized Hawgood’s scientific contributions. He is past president of the Society for Pediatric Research and a member of the American Association of Physicians, and in 2010 was elected to the Institute of Medicine (IOM), which provides authoritative advice to Congress, other decision makers and the public as part of the National Academy of Sciences. Membership in the IOM is one of the highest honors for individuals at the top of their fields.

“Curiosity-driven basic science is and will remain the jewel in the UCSF crown,” Hawgood said, “but two realities must be faced. The first is funding.  Federal funding in basic research and development is flat with declining purchasing power. I am committed to doing everything possible to strengthen basic research at UCSF.

“The second is the merging of technologic and biologic sciences in ways unimagined only a few years ago. Both these trends in the research sector suggest innovative public-public and public-private partnerships are needed as well as new routes to commercialization.”

UCSF research has led to revolutions in health and therapeutics, from the birth of the field of biotechnology and first therapies for HIV/AIDS to clinical innovations such as fetal surgery and stem cell therapies offering the promise of transforming lives worldwide. The faculty includes five Nobel laureates, who have made seminal contributions to advance the understanding of cancer, neurogenerative diseases, aging and stem cell research.

Hawgood has been active for decades in clinical medicine. He served as division chief of the Division of Neonatology, then as chair of Pediatrics and physician-in-chief of the UCSF Benioff Children’s Hospital before becoming dean. He has been serving as president of the UCSF Medical Group, the faculty association that represents more than 1,800 UCSF physicians.

He joined UCSF as a research fellow in 1982, working with distinguished scientists John A. Clements, M.D., and William H. Tooley, M.D., both pioneers in the discovery and therapeutic uses of pulmonary surfactant, the key lipoprotein that lines healthy lungs and enables them to expand with each breath. He has maintained his own laboratory since 1984. His research has gained him an international reputation in neonatology research.

A native of Australia, Hawgood entered medical school at the age of 17, and was graduated with First Class Honors from the University of Queensland in Brisbane with a degree in medicine and surgery (M.B.B.S.).

Hawgood and his wife, Jane, a social worker who recently retired after focusing on palliative care for adults, met at the University of Queensland. They have two grown sons.

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Four UC health systems named among nation’s most wired

List includes Davis, Irvine, UCLA, San Diego.

UC Davis, UC Irvine, UCLA and UC San Diego health systems have been designated among the nation’s information technology leaders, according to the 2014 Health Care’s Most Wired Survey that appears in the July issue of Hospitals & Health Networks magazine.

UC San Diego earned the Most Wired designation for the ninth consecutive year, UC Davis for the fourth consecutive year, UCLA for the second straight time and UC Irvine for the first time. They are among only 17 institutions in California designated Most Wired in this year’s assessment. UC San Diego Health System was the only California facility named to the Most Wired Advanced list.

Health Care’s Most Wired Survey, now in its 16th year, asked hospitals and health systems nationwide to answer questions regarding their IT initiatives. Respondents completed 680 surveys, representing 1,900 hospitals. A full list of award winners can be found online at www.hhnmostwired.com.

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UC Health appoints interim supply chain executive

UC Davis’ Vincent Johnson to lead systemwide supply chain efforts.

Vincent Johnson

The University of California has appointed Vincent Johnson, chief operating officer of UC Davis Medical Center, as interim UC Health systemwide supply chain executive.

In fiscal year 2015, Johnson will be responsible for the leadership and success of the joint UC medical centers’ systemwide procurement strategies and programs, as part of the “Leveraging Scale for Value” project to reduce costs at UC hospitals.

Advancing health care reform will require UC’s medical centers to operate more efficiently. UC medical centers recognize this challenge and have embarked upon an aggressive program to apply the integrated scale of UC to adapt to increasing resource and financial challenges.

UC’s Leveraging Scale for Value project, announced in March, initially will focus on three areas: supply chain, revenue cycle and clinical laboratories. This effort is governed by the UC Health Shared Services Management Council, which consists of the five UC medical center CEOs, three medical school deans, two chancellors, one regent, three external experts and is chaired by UC Health Senior Vice President John Stobo.

Increasing systemwide leverage in supply chain is among the first efforts launched by the council to rapidly reduce operating expenses through aggressive procurement savings. Focusing initially on non-medical supplies, purchased services and capital procurement, UC plans to find savings through increasingly coordinated procurement. Medical supply savings also will be sought out with appropriate clinical support.

Johnson will lead this effort and report directly to the council. He will be supported by UC San Francisco Medical Center Chief Operating Officer and Supply Chain Vice Chair Ken Jones and the UC medical centers’ supply chain leadership team. Their savings target for fiscal year 2015 will be in excess of $50 million.

To accomplish these savings, Johnson and his teams will focus on working directly with UC’s supply and service vendors to reduce expenses through systemwide procurement leverage, infrastructure development and operating efficiencies.

Future supply chain improvement efforts will advance UC’s competitiveness through transformative programs built upon these initial systemwide savings efforts.

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UCLA to develop ‘brain prothesis’

UCLA awarded $15M to create implantable device that could restore memory to millions.

Illustration of memory-restoring device to be developed by UCLA researchers.

UCLA has been tapped by the Defense Advanced Research Projects Agency to spearhead an innovative project aimed at developing a wireless, implantable brain device that could help restore lost memory function in individuals who have suffered debilitating brain injuries and other disorders.

The four-year effort, to be led by UCLA’s Program in Memory Restoration and funded by up to $15 million from DARPA, will involve a team of experts in neurosurgery, engineering, neurobiology, psychology and physics who will collaborate to create, surgically implant and test the new “neuroprosthesis” in patients.

Memory is the process by which neurons in certain brain regions encode information, store it and retrieve it. Various illnesses and injuries can disrupt this process, causing memory loss. Tramautic brain injury, which has affected more than 270,000 military members since 2000, as well as millions of civilians, is often associated with such memory deficits. Currently, no effective therapies exist to address the long-term affects of these injuries on memory.

“Losing our ability to remember past events and form new memories is one of the most dreaded afflictions of the human condition,” said UCLA’s lead investigator, Dr. Itzhak Fried, a professor of neurosurgery at the David Geffen School of Medicine at UCLA and a professor of psychiatry and biobehavioral sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA.

Developing models of the brain’s ‘memory works’

The ambitious, first-if-its-kind project at UCLA builds on Fried’s 2012 research — published in the New England Journal of Medicine with UCLA’s Nanthia Suthana and colleagues — demonstrating that human memory can be strengthened by stimulating the brain’s entorhinal cortex, a region involved in learning, memory and Alzheimer’s disease. Considered the entrance to the hippocampus, which helps form and store memories, the entorhinal cortex plays a crucial role in transforming daily experience into lasting memories.

“The entorhinal cortex is the ‘golden gate’ to the brain’s memory mainframe,” Fried said. “Every visual and sensory experience that we eventually commit to memory funnels through that doorway to the hippocampus. Our brain cells send signals through this hub in order to form memories that we can later consciously recall.”

In a key part of the project, the research team will stimulate and record the activity of single neurons and of small neuronal populations in patients who already have brain electrodes implanted as part of epilepsy treatment. UCLA’s Mayank Mehta, a professor of physics and neurobiology, and Harvard Medical School’s Gabriel Kreiman will then work with Fried’s group, using this information to develop computational models of the hippocampal–entorhinal system and determine how to intervene with electrical stimulation to help restore memory function.

Turning the models into a workable ‘neuroprosthesis’

The models will be transformed into therapeutics using technology developed by researchers from UCLA’s Henry Samueli School of Engineering and Applied Science. This group, led by associate professor of electrical engineering Dejan Markovic, will work with engineers from Lawrence Livermore National Laboratory and Stanford University to develop electronics for the implantable neuromodulation device. As part of the UCLA-led project, Lawrence Livermore will be awarded a separate $2.5 million grant from DARPA to build the device, which will have the ability to record and stimulate neurons to help restore memory.

Markovic said the goal is to create miniature wireless neural sensors that are far more sophisticated — much smaller and with much higher resolution — than those that exist today. The sensors will track and modulate neural activity with very precise spatial and temporal resolution, allowing the device to continuously update and modulate precise patterns of stimulation to optimize therapy and restore memory function.

“We are developing ultra–low-power electronics in order to measure activity of specific areas of the brain, perform neural signal analysis and wirelessly transmit that information to an outside device in close proximity to the implants,” Markovic said. “The implants and the outside device will talk to each other. The goals are to provide better therapy for people with neurological dysfunction and help those with epilepsy and brain injury to enhance and restore memory.”

“Currently, there is no effective treatment for memory loss caused by a condition such as traumatic brain injury,” said Lawrence Livermore project leader Satinderpall Pannu, director of the lab’s Center for Bioengineering, a facility dedicated to fabricating biocompatible neural interfaces. “This is a tremendous opportunity from DARPA to leverage Lawrence Livermore’s unique capabilities to develop cutting-edge medical devices that will change the health care landscape.”

Testing the new device in brain-injured patients

During the second phase of the program, Fried, using a minimally invasive procedure, will implant the neuromodulation device into the entorhinal area and hippocampus in patients with traumatic brain injury as part of a groundbreaking clinical trial.

The DARPA initiative aimed at developing these implantable brain devices, Restoring Active Memory (RAM), also involves the University of Pennsylvania. The program supports President Obama’s BRAIN initiative. Under the terms of a cooperative agreement with DARPA, UCLA is slated to receive up to $15 million for its work on the program, with full funding contingent on meeting a series of technical milestones.

The RAM program poses a formidable challenge reaching across multiple disciplines from basic brain research to medicine, computing and engineering,” Fried said. “But at the end of the day, it is the suffering individual, whether an injured member of the armed forces or a patient with Alzheimer’s disease, who is at the center of our thoughts and efforts.”

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Sen. Boxer highlights efforts to prevent medical errors

She visits UCSF Medical Center.

U.S. Sen. Barbara Boxer (second from right) tours UCSF Medical Center on July 2 to learn how it is working to reduce preventable deaths. Susan Barbour (left), R.N., talks about pressure ulcer prevention. (Photo by Cindy Chew)

Every year, between 210,000 and 440,000 Americans die as a result of preventable errors in hospitals, according to a special report released at UC San Francisco by Democratic Sen. Barbara Boxer.

She presented the updated report detailing the most common and harmful errors at our nation’s hospitals and highlighted what UCSF Medical Center is doing to prevent them.

“We have the opportunity to save not just one life, but to save hundreds of thousands of lives,” Senator Boxer said during her visit to UCSF Medical Center on July 2. “Many people will be shocked to hear this, but medical errors are one of the leading causes of death in America today. These deaths are all the more heartbreaking for families because they are preventable.”

Boxer said she is grateful to UCSF for the steps it has taken to save patients’ lives.

“If we all work together – doctors, nurses, hospital administrators, patients, patient advocates, medical technology pioneers, public health experts and federal officials – we can prevent so much heartbreak for families and stop these tragedies before they occur,” said Boxer at a press conference following a tour of UCSF Medical Center.

Preventable errors in hospitals, such as hospital-acquired infections, adverse drug reactions, patient falls and bedsores, total $19.5 billion annually and that the economic costs of medical errors, including lost productivity, could be as much as $1 trillion a year, according to Boxer’s report.

“We’re one of the nation’s top hospitals,” said Mark R. Laret, CEO of UCSF Medical Center and UCSF Benioff Children’s Hospitals. “But that is meaningful only as it relates to every single patient who walks through our doors, and how we administer their care, follow up and safety. We’re proud of the great strides we’ve made as a leader in patient safety and to partner with Senator Boxer to help all hospitals become places where safe care is offered to every patient, every day.”

While touring UCSF Medical Center, Senator Boxer was shown the interdisciplinary approach UCSF takes to address major hospital issues such as sepsis, ulcer prevention, medication errors and hand hygiene.

As part of its interdisciplinary approach, UCSF creates teams comprised of nurses, pharmacists, doctors and medical center leaders, in addition to staff in medical records and environmental services. Those teams focus on understanding the underlying causes that may have allowed an error to occur and on collaborative problem solving. An open discussion ends with a clear action plan, which might involve implementing a new system, purchasing a piece of equipment, or training doctors and nurses in communication strategies.

UCSF processes and results for sepsis prevention

Sepsis is a potentially fatal, full-body inflammation caused by infection, and one of the main sources of sepsis is hospitals themselves.

“At UCSF we now treat sepsis as a true emergency with a focus on immediate interventions proven to help patients,” said Joshua Adler, M.D., chief medical officer at UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco. “This approach has involved innovations in our electronic health record systems, use of rapid response personnel, novel nursing protocols, and continuous evaluation of our performance.”

UCSF’s electronic sepsis surveillance system continuously searches for warning signs, alerts clinicians to the potential presence of sepsis, and provides a means to activate “Code Sepsis”. The Code Sepsis team – a rapid response team, critical care nurse practitioner, and pharmacist – has helped UCSF to treat sepsis as an emergent situation requiring immediate attention and action. “With this approach we have reduced the mortality rate for sepsis by nearly 25 percent since 2012,” Adler said.

Processes and results for ulcer prevention

Ulcers resulting from being bedridden, and thus immobile for a lengthy time, are an ongoing challenge for hospitals. In addition, to training all patient care providers in pressure ulcer prevention, UCSF conducts quarterly pressure-ulcer prevalence study days. On these days, every patient in the hospital is examined for evidence of a pressure ulcer. The total number of pressure ulcers counted is divided by the total number of patients examined to obtain a percentage of patients with pressure ulcers.

UCSF has reduced the rate of hospital acquired pressure ulcers among adult and pediatric patients by 79 percent, from 4.98 percent in fiscal year 2008 to 1.03 percent in fiscal year 2014.

Preventing inpatient medication errors

In 2011, UCSF launched what is believed to be the nation’s most comprehensive automated hospital robotic pharmacy that is designed to prepare and track medications, with the goal of improving patient safety. The pharmacy operation is now linked to the electronic health record system, creating an end-to-end electronic system in which a nurse at the bedside scans the barcode on the patient’s wristband, scans the medication and then scans the bar code on his/her own ID badge. Only after confirming all the information matches is the medication administered. UCSF administers over 10,000 doses of medication daily.

“The barcoding system is a way to minimize the potential for an error at every step of the medication delivery process,” said Laret.

Hand hygiene training and surveillance

Hand hygiene is considered one of the most effective approaches for reducing hospital-related infections. In July 2010, UCSF implemented a hand hygiene education and surveillance program. Since then the rate of hand hygiene has improved from 75 percent to about 92 percent each month. The data are collected and monitored by cameras in some hospital areas, and a daily report is distributed. Some floors even feature real-time monitoring that displays hand hygiene compliance rates.

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DDT linked to slow metabolism, obesity and diabetes

Study shows developmental exposure to DDT can affect female offspring.

Exposure of pregnant mice to the pesticide DDT is linked to an increased risk of obesity, diabetes, high cholesterol and related conditions in female offspring later in life, according to a study led by the University of California, Davis.

The study, published online today (July 30) in the journal PLOS ONE, is the first to show that developmental exposure to DDT increases the risk of females later developing metabolic syndrome — a cluster of conditions that include increased body fat, blood glucose and cholesterol.

DDT was banned in the United States in the 1970s but continues to be used for malaria control in countries including India and South Africa.

Scientists gave mice doses of DDT comparable to exposures of people living in malaria-infested regions where it is regularly sprayed, as well as of pregnant mothers of U.S. adults who are now in their 50s.

“The women and men this study is most applicable to in the United States are currently at the age when they’re more likely to develop metabolic syndrome, because these are diseases of middle- to late adulthood,” said lead author Michele La Merrill, assistant professor of environmental toxicology at UC Davis.

The scientists found that exposure to DDT before birth slowed the metabolism of female mice and lowered their tolerance of cold temperature. This increased their likelihood of developing metabolic syndrome and its host of related conditions.

“As mammals, we have to regulate our body temperature in order to live,” La Merrill said. “We found that DDT reduced female mice’s ability to generate heat. If you’re not generating as much heat as the next guy, instead of burning calories, you’re storing them.”

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Gene behind rare birth abnormality provides a window on evolution

Fine-tuning genes shapes teeth as evolution did.

Ophir Klein, UC San Francisco

A UC San Francisco physician who treats birth defects affecting the face has teamed up with a European expert on animal evolution to create rodent teeth that harken back in evolutionary time.

By making a molar that mimics features found in an ancestral uber-rodent that roamed the earth 60 million years ago, the scientists successfully demonstrated a new way to explore how genetic changes affect mammalian development and how advantageous genetic mutations that spontaneously arise in new generations might take hold over time in an evolving population.

It’s not Jurassic Park, but the research team showed that real-time lab experiments are relevant to paleontologists, who typically are stuck working on mysteries of evolution equipped with little more than bits of fossilized bone or teeth. Especially for mammals, the fine features of teeth are used to determine how fossil species are related to each other and to modern animals.

A key gene manipulated by the researchers in their new study, published online today (July 30) in Nature, already had been a clinical research focus of study co-senior author Ophir Klein, M.D., Ph.D., Larry L. Hillblom Distinguished Professor in Craniofacial Anomalies at UCSF. The gene, Eda, encodes a developmental protein called ectodysplasin. It is defective in a rare human birth defect that results in a shortage or absence of sweat glands, misshapen and absent teeth, and loss of hair follicles – all appendages that develop from the same embryonic tissue. The syndrome was even described by Charles Darwin in “The Variation of Animals and Plants Under Domestication,” published in 1868.

Researchers in Switzerland had previously found that the syndrome in mice can be treated during the mother’s gestation by administering the missing ectodysplasin — the first demonstration that a structural birth defect could be prevented with a medical approach, Klein said.

Klein led the first phase I clinical trial to similarly treat the condition in humans, and this past November treated the first North American baby in an ongoing phase II study.

But Klein and collaborator Jukka Jernvall, Ph.D., Academy Professor of evolution and development at the University of Helsinki, Finland, had also been wondering if the same biochemical pathway also could be manipulated to study evolution.

In the past, biologists have studied fine features of teeth in mutant animals to try to help them reconstruct evolutionary history. However, the changes in the mutants are often too dramatic to be very informative. “We wanted to know if we could play with these biochemical pathways to recapitulate changes that are seen in the fossil record,” Klein said.

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Diverticulitis patients reveal symptoms long after acute attacks

UCLA findings could lead to better disease management.

UCLA researchers interviewed people with diverticulitis and confirmed that many suffer psychological and physical symptoms long after their acute illness has passed.

For the study, published this week in the peer-reviewed journal Quality of Life Research, a UCLA team led by Dr. Brennan Spiegel interviewed patients in great detail about the symptoms they experience weeks, months or even years after an acute diverticulitis attack. Their striking findings add to growing evidence that, for some patients, diverticulitis goes beyond isolated attacks and can lead to a chronic condition that mimics irritable bowel syndrome.

As they age, most people develop diverticulosis, a disorder characterized by the formation of pouches in the lining of the colon. More than 50 percent of people over 60 have the condition, but the pouches usually don’t cause any problems. Occasionally, however, the pouches become inflamed, leading to a related disorder called diverticulitis, which causes pain and infection in the abdomen. Doctors usually treat diverticulitis with antibiotics, or in more severe cases, surgery.

The condition has long been thought to be acute with periods of relative silence in between attacks, but according to researchers, that’s not true for everyone. Some patients experience ongoing symptoms.

In an earlier study, Spiegel and colleagues found that people suffering from diverticulitis have a four-fold higher risk of developing IBS after their illness, a condition called post-diverticulitis irritable bowel syndrome, and that patients had anxiety and depression long after the initial attack. However, that study was based on a database of more than 1,000 patients and did not draw from personal testimonials from people living with diverticulitis.

In the latest research, patients described feelings of fear, anxiety and depression, and said they had been stigmatized for having the condition. Interviewees also said they live in constant fear of having another attack, are scared to travel and feel socially isolated. In addition, many patients continue to experience bothersome physical symptoms such as bloating, watery stools, abdominal pain, incomplete evacuation and nausea.

“We dug deeper into identifying the chronic physical, emotional and behavioral symptoms that can profoundly change people’s lives after an attack of diverticulitis,” said Spiegel, a professor of medicine at the David Geffen School of Medicine at UCLA and the Fielding School of Public Health. “Our findings reveal that many people suffer silently with severe quality-of-life problems long after an acute diverticulitis attack.”

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Kids with autism, SPD show brain wiring differences

UCSF study builds on its research showing kids with SPD have measurable brain differences.

Pratik Mukherjee, UC San Francisco

Researchers at UC San Francisco have found that children with sensory processing disorders have decreased structural brain connections in specific sensory regions different than those in autism, further establishing SPD as a clinically important neurodevelopmental disorder.

The research, published in the journal PLOS ONE, is the first study to compare structural connectivity in the brains of children with an autism diagnosis versus those with an SPD diagnosis, and with a group of typically developing boys. This new research follows UCSF’s groundbreaking study published in 2013 that was the first to find that boys affected with SPD have quantifiable regional differences in brain structure when compared to typically developing boys. This work showed a biological basis for the disease but prompted the question of how these differences compared with other neurodevelopmental disorders.

“With more than 1 percent of children in the U.S. diagnosed with an autism spectrum disorder, and reports of 5 to 16 percent of children having sensory processing difficulties, it’s essential we define the neural underpinnings of these conditions, and identify the areas they overlap and where they are very distinct,” said senior author Pratik Mukherjee, M.D., Ph.D., a professor of radiology and biomedical imaging and bioengineering at UCSF.

SPD can be hard to pinpoint, as more than 90 percent of children with autism also are reported to have atypical sensory behaviors, and SPD has not been listed in the Diagnostic and Statistical Manual used by psychiatrists and psychologists.

Elysa Marco, UC San Francisco

“One of the most striking new findings is that the children with SPD show even greater brain disconnection than the kids with a full autism diagnosis in some sensory-based tracts,” said Elysa Marco, M.D., cognitive and behavioral child neurologist at UCSF Benioff Children’s Hospital San Francisco and the study’s corresponding author. “However, the children with autism, but not those with SPD, showed impairment in brain connections essential to the processing of facial emotion and memory.”

Children with SPD struggle with how to process stimulation, which can cause a wide range of symptoms including hypersensitivity to sound, sight and touch, poor fine motor skills and easy distractibility. Some SPD children cannot tolerate the sound of a vacuum, while others can’t hold a pencil or struggle with emotional regulation. Furthermore, a sound that is an irritant one day can be tolerated the next. The disease can be baffling for parents and has been a source of much controversy for clinicians who debate whether it constitutes its own disorder, according to the researchers.

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Stem cell agency awards two grants to UC researchers

Projects will address Limbal Stem Cell Deficiency and Huntington’s disease.

Two University of California researchers received bridge funding from the state’s stem cell agency totaling $1.2 million.

The California Institute for Regenerative Medicine’s governing board Thursday awarded UCLA researcher Sophie Deng almost $700,000 for work in developing a synthetic scaffold to be used in advancing knowledge of Limbal Stem Cell Deficiency, a blinding eye disorder, generally caused by damage to the cornea on the surface of the eye.

UC Irvine researcher Leslie Thompson was awarded more than $500,000 to conduct laboratory tests of a potential therapy for Huntington’s disease, a devastating and always fatal brain disorder. Currently there are no effective treatments for Huntington’s.

Deng and Thompson each had previously received funding from CIRM for their efforts.

In other stem cell news, a new stem cell discovery might one day lead to a more streamlined process for obtaining stem cells, which in turn could be used in the development of replacement tissue for failing body parts, according to UC San Francisco scientists who reported the findings in the current edition of Cell.

Embryonic stem cells can develop into a multitude of cells types. Researchers would like to understand how to channel that development into the specific types of mature cells that make up the organs and other structures of living organisms. One key seems to be long chains of sugars that dangle from proteins on surfaces of cells. Kamil Godula’s group at UC San Diego has created synthetic molecules that can stand in for the natural sugars, but can be more easily manipulated to direct the process, they report in the Journal of the American Chemical Society.

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UCSF Medical Center, John Muir Health to collaborate

Affiliation would be cornerstone of regional network offering high-quality, affordable care.

UCSF Medical Center and John Muir Health have signed a letter of intent to develop a company that will serve as the cornerstone of a Bay Area health care network intended to provide patients with high-quality care and an exceptional experience at an affordable price. A final agreement is expected by the end of 2014.

Under the proposed agreement both organizations would remain independent, but a new company would be created that is equally owned and operated by both organizations. The new company would serve as a funding vehicle for future joint initiatives and a shared services organization to support programs and initiatives focused on better health care, at lower costs, for Bay Area patients.

The first of these joint initiatives is investment in a collaborative effort with other health care providers to form a regional health care network, or “accountable care organization” (ACO). Establishing a Bay Area-wide ACO will provide patients from throughout the Bay Area and Northern California with a competitively priced option to access, close to where they live or work, many of the Bay Area’s most trusted and respected hospitals, health systems and physician organizations.

Both John Muir Health and UCSF Medical Center have experience in successful ACOs that have demonstrated lower health care costs and improved health care quality. The goal of an ACO is to provide the right care at the right time and in the most appropriate setting, whether that is the primary care physician’s office, an outpatient center or a hospital, and savings achieved as part of an ACO can be passed along to consumers in the form of lower health care benefit premiums.

“By combining John Muir Health and UCSF’s strengths, we aim to offer patients the highest value system of care available,” said Mark R. Laret, CEO of UCSF Medical Center and UCSF Benioff Children’s Hospitals. “We look forward to working not just with each other, but with other health organizations throughout Northern California, in order to provide an exceptional health care experience for patients.”

“The jointly owned and operated company brings together two organizations that share a commitment to providing patients with high-quality care at an affordable price,” said Cal Knight, President and CEO of John Muir Health. “We looked at a number of affiliation options that would allow us to grow without compromising our mission, vision and independence. We found the right fit with UCSF and look forward to the development, along with other partners, of a regional ACO that will benefit patients and the communities we serve.”

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