TAG: "Women’s health"

UCSF receives $100M gift to advance health sciences mission


Landmark gift cements Chuck Feeney’s role as UC system’s top philanthropist.

Chuck Feeney

By Jennifer O’Brien, UC San Francisco

UC San Francisco has received a $100 million gift from visionary philanthropist Charles F. “Chuck” Feeney to support its new Mission Bay hospitals, world-class faculty and students, and research programs focused on the neurosciences and aging.

This donation brings the longtime supporter’s total UCSF giving to more than $394 million, making Feeney the single largest contributor to the University of California system.

“I get my gratification from knowing that my investments in medical research, education, and the delivery of health care at UCSF will provide lifelong benefits to millions of people not only in the Bay Area but also around the world,” said Feeney, who, despite his global presence as a successful entrepreneur and discerning philanthropist, prefers remaining out of the limelight. “I can’t imagine a more effective way to distribute my undeserved wealth.”

Reflecting on Feeney’s contributions, UCSF Chancellor Sam Hawgood, M.B.B.S., said, “As we celebrate UCSF’s 150th anniversary this year, it is only fitting that we acknowledge the unique role Chuck has played in our history. While his impact has been felt most profoundly during this past decade, his generosity will carry on forever at our university, in the San Francisco community, throughout the Bay Area and globally, as our faculty and students advance knowledge and provide the finest clinical care. We are honored that he has decided to invest again in UCSF.”

Feeney’s gifts to UCSF are most visible at the university’s Mission Bay campus, where he has provided indispensable support to create advanced facilities and foster the environment for the biomedical research and patient care that goes on within them.

Before the latest funding, Feeney’s most recent gift to the campus was to UCSF Global Health Sciences, enabling the October 2014 opening of Mission Hall, which houses global health researchers, scientists and students under the same roof for the first time. Feeney, who coined the term “giving while living,” also generously supported the building of the Smith Cardiovascular Research Building and the Helen Diller Family Cancer Research Building.

“Chuck Feeney has been our partner at Mission Bay for more than 10 years,” added Hawgood. “He immediately embraced the Mission Bay concept, and he has enthusiastically helped us shape a larger vision for the campus and finance its development because he knew that our research and clinical programs could not flourish without state-of-the-art buildings.”

Gift to support four primary areas

The Campaign for the UCSF Medical Center at Mission Bay
Funds will support the $600 million philanthropy goal of the $1.5 billion hospitals project. The latest donation builds upon the transformative $125 million matching gift Feeney made to support the hospitals complex and its programs in 2009, the largest gift received toward the campaign.

The opening of the 289-bed hospital complex – which includes UCSF Benioff Children’s Hospital San Francisco, UCSF Betty Irene Moore Women’s Hospital, UCSF Bakar Cancer Hospital, and the UCSF Ron Conway Family Gateway Medical Building – was the culmination of more than 10 years of planning and construction. Strategically located adjacent to UCSF’s renowned Mission Bay biomedical research campus, the new medical center places UCSF physicians in close proximity to UCSF researchers and nearby bioscience companies who are working to understand and treat a range of diseases, from cancer to neurological disorders.

“It’s been thrilling to see the reactions of our patients and their families as they encounter the amazing care offered at our new UCSF Mission Bay hospitals,” said Mark Laret, CEO of UCSF Medical Center and UCSF Benioff Children’s Hospitals. “This world-class experience would never have been possible without the support of Chuck Feeney who, as the largest contributor to the project, helped us create the hospitals of our dreams. Every patient cured, every breakthrough discovered at Mission Bay, will be thanks in part to Chuck. His legacy is unparalleled.”

Neuroscience and aging
The gift also supports UCSF’s pre-eminent neuroscience enterprise, including its Sandler Neurosciences Center and neurology programs at Mission Bay.

The center, a five-story, 237,000-square-foot building that opened in 2012, brings under one roof several of the world’s leading clinical and basic research programs in a collaborative environment. UCSF’s neurology and aging efforts are focused on finding new diagnostics, treatments, and cures for a number of intractable disorders, including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, stroke, migraine, epilepsy and autism. The programs also seek to integrate neuroscience and clinical disciplines with public health initiatives in order to disseminate and implement novel findings from research centers of excellence, as well as conduct community outreach to raise awareness about the diseases of aging.

“Chuck Feeney has taken a keen interest in the challenges of aging,” said Hawgood. “In turn, he has recognized UCSF’s extraordinary talent in the neurosciences, among both basic researchers and those who translate research into clinical care and public policy. This gift will build on UCSF’s strengths while encouraging strong partnerships at other research institutions around the world where Chuck also has made important investments.”

Student scholarships and housing
Even with its extraordinary academic firepower, UCSF has extremely limited funds to support scholarships for professional students in its schools of dentistry, medicine, nursing and pharmacy. Part of the gift will provide scholarship support, bolstering UCSF’s ability to recruit the best and brightest students, regardless of their financial circumstances.

Recent decreases in state funding led to tuition increases and higher demand for scholarships. This, in turn, increased student debt. Combined with Bay Area housing prices that are among the highest in the nation – from 2011 to 2013, the median rent increased by 24 percent – the prospect of overwhelming debt can deter economically vulnerable students as well as those from middle-class backgrounds from attending UCSF. By minimizing debt upon graduation, the scholarships will help ensure that a UCSF education remains in reach for students from underserved populations, as well as for those students who choose to become health care leaders in underserved communities.

“Scholarships give our students the gift of freedom: to make career choices based on purpose and passion, rather than the price of education; to use time to study, explore science, and volunteer to help others, rather than working to make ends meet; and to succeed because someone who never met them saw enough potential to invest in their dreams,” said Catherine Lucey, M.D., vice dean for education at UCSF’s School of Medicine. “These scholarships catalyze our schools’ ability to find, recruit, educate and nurture the workforce our country needs: talented professionals whose life experiences enable them to provide compassionate care to today’s diverse communities and advance science to improve the health of future communities.”

Faculty recruitment
The donation also will help UCSF recruit the next generation of promising faculty in an increasingly competitive marketplace.

New funding will attract junior faculty – who frequently find it more challenging to secure research funding – and provide initial startup funds as they launch their research careers and clinical practices. With decreasing federal support for young investigators, this gift will underwrite a new generation of brilliant upcoming faculty.

“While Chuck’s unprecedented generosity has been focused primarily on Mission Bay, he understands the power of the entire UCSF enterprise, from our cutting-edge stem cell research at Parnassus to our innovative cancer programs at Mount Zion,” Hawgood said. “We’re thrilled that Chuck has inspired other philanthropists to join him in creating one of the most vibrant life science communities in the world, where progress will ripple far beyond Mission Bay and the campus for generations to come.”

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UCSF Medical Center at Mission Bay opens


Large-scale transport completed with support of city of San Francisco agencies.

More than 130 patients were carefully transported from Parnassus and Mount Zion campuses to the new UCSF Medical Center at Mission Bay on Feb. 1. (Photo by Noah Berger)

>>Related: UCSF Medical Center at Parnassus and Mount Zion to expand care

>>Related: President Bill Clinton tours new UCSF hospitals

By Karin Rush-Monroe, UC San Francisco

With 40 ambulances, approximately 300 UCSF staff and faculty, as well as 100 emergency medical services personnel, UCSF Medical Center on Sunday, Feb. 1,  safely transported 131 patients to the new UCSF Medical Center at Mission Bay from its Parnassus and Mount Zion campuses.

The move day started at 7 a.m. on the UCSF Parnassus campus; later in the day patients also were transported from the UCSF Mount Zion campus. The last patient to be moved arrived at UCSF Medical Center at Mission Bay at 3:33 p.m. The new medical center also greeted the first baby born at the new hospitals, a healthy boy who entered the world at a little more than seven pounds.

The opening of the new hospitals was the culmination of more than 10 years of planning and construction of the complex, which includes UCSF Benioff Children’s Hospital San Francisco, UCSF Betty Irene Moore Women’s Hospital, UCSF Bakar Cancer Hospital and the UCSF Ron Conway Family Gateway Medical Building.

The move day, itself, reflected significant planning. “Patient safety was our top priority during the patient move, along with minimizing disruption to our neighbors. We achieved both goals, thanks to the superb work of our medical center faculty and staff as well as our partners in the City of San Francisco,” said Mark R. Laret, CEO of UCSF Medical Center and UCSF Benioff Children’s Hospitals. “We have been looking forward to this day for some time, and the opportunity to start providing care in our new location at UCSF Mission Bay.”

The majority of patients who made the trip on Sunday were children, as UCSF Benioff Children’s Hospital San Francisco moved from Parnassus to its new home at UCSF Mission Bay.

Strategically located on UCSF’s world renowned UCSF Mission Bay biomedical research campus, the new medical center puts UCSF physicians in close proximity to UCSF researchers and nearby biotechnology and pharmaceutical companies in Mission Bay and beyond who are working to understand and treat diseases ranging from cancer to cardiovascular disease to neurological conditions.

“Placing the hospitals on our Mission Bay campus underscores our commitment to driving discoveries toward patient care, ensuring that our world-class researchers are working in close proximity to our leading clinical researchers and physicians in the hospitals,“ said Sam Hawgood, M.B.B.S., chancellor of UC San Francisco.  “They also will provide invaluable training for our medical students, the next generation of clinicians who will take care of patients at health care facilities across California and nationally.

“Significantly, the move also frees up space on our Parnassus and Mount Zion campuses, which will allow us to enrich our medical programs for adult patients there. With the opening of the hospitals at Mission Bay, we now have integrated clinical care and research programs on all of our campuses, the critical factor that has contributed to UCSF’s local, regional and global impact.”

The UCSF Parnassus campus will be restructured to provide more specialized clinical services, such as transplants, and the UCSF Mount Zion campus will become a world-class hub for outpatient care.

“UCSF Medical Center’s new $1.5 billion, state-of-the-art campus in our city’s Mission Bay neighborhood will help improve the health of children, women and cancer patients,” said San Francisco Mayor Ed Lee. “This is not just a milestone for UCSF; this is a milestone for our city and our city’s health care industry, which is at the heart of our economy providing good jobs for our residents.

“Right before our eyes, we have seen the transformation of this underutilized railyard in Mission Bay into an epicenter where new discoveries and innovation in medicine are saving lives around the world. By working together with our great partner UCSF, and the many generous philanthropists that helped build these new hospitals, we will continue to ensure our residents get the highest quality of health care.”

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Obesity poses serious health risks for moms and their babies


‘Eating for two’ no longer holds weight.

By Shari Roan, U Magazine

Veronica Romero was 21 years old and worried. Pregnant with her first child, she was putting on a lot of weight. Her obstetrician leveled with her: “You’re gaining too much.” But as she approached 50 pounds of weight gain near the end of her pregnancy, Romero felt helpless.

“I tried to watch what I was eating, but it was so hard. Pregnant women get cravings, and my cravings were sugary,” she recalled.

“I tried to eat carrots and small appetizers, but it didn’t work. I was disappointed. I didn’t want to get bigger.” The pregnancy set into motion a health crisis on two fronts: for Romero, now 38, and her son, Anthony, now 17. Romero eventually grew to nearly 300 pounds, and Anthony became a big baby, then a chubby toddler and now an obese adolescent.

This mother-child pair is not unique. The obesity tsunami that has washed across the United States over the past four decades has swept up pregnant women and their offspring too. In fact, pregnant women today are considered by some medical authorities to be at the nexus of the obesity crisis. Abundant research has revealed that pregnancy is a key period of increased risk for developing obesity in women and that obesity in pregnancy may genetically “program” offspring to become overweight or obese later in life.

The concept, commonly known as fetal programming, is rapidly altering the fields of obstetrics and pediatrics, said Dr. Sherin Devaskar, Mattel Executive Endowed Chair of the Department of Pediatrics, physician-in-chief of Mattel Children’s Hospital UCLA and assistant vice chancellor of children’s health. “There have been many studies to prove beyond a doubt that fetal programming is real. If a mother is obese, her babies are at very high risk for obesity and chronic disease.”

In the United States, more than half of all pregnant women are overweight or obese, according to the American College of Obstetricians and Gynecologists. An estimated 9 percent of babies are born macrosomic — weighing too much for their gestational age. Fetal macrosomia is typically defined as a birth weight of more than 9 pounds, 15 ounces, regardless of gestational age.

However, obesity in pregnancy can also result in babies who are born prematurely or underweight. These infants also seem to be predisposed to obesity and related diseases, such as diabetes and heart disease, later in life, Devaskar explained.

More than three decades ago, Dr. David Barker, a British physician and epidemiologist, linked birth weight, either excessively high or low, to a heightened risk of heart disease, type 2 diabetes and obesity in offspring. He posited that these diseases had their roots, at least in part, in under- or over-nutrition during pregnancy. If a pregnant woman is under-nourished, her infant is prone to low birth weight with a rapid “catch-up” gain in body fat later when exposed to plentiful food. If a pregnant woman is over-nourished, her infant is prone to high birth weight and a booming growth trajectory that increases the risk of obesity later in life.

The amount of nutrients provided to a developing fetus, as well as the type of nutrients, appears to chemically modify genes that predispose a child to obesity and obesity-related diseases, said  Devaskar, whose own research on the subject resulted in her election to the prestigious Institute of Medicine in 2012. Her current research focuses on whether or not it’s possible to further modify those genes to reverse the propensity to gain weight. “In the fetus, the organs are still developing,” she explained. “It’s a critical window of development, and it’s very plastic at that time. Any insult — whether it’s from diet, drugs or toxins — creates a permanent mark that lasts for one’s lifetime. The hypothalamus — the part of the brain governing metabolism and hunger — is already programmed. The infant is used to seeing so much nutrition coming from the mother. These children are ever-hungry; they are born hypersensitive to high-calorie foods. Their insulin sensitivity is low, so they are at high risk for developing diabetes, obesity and heart disease.”

In 2009, the Institute of Medicine issued revolutionary new guidelines to begin to address obesity in pregnancy. The group put tighter limits on weight gain in pregnancy, warning doctors to help their patients stay within a healthy range and even strictly limit weight gain in obese pregnant women to 11 to 20 pounds.

“It’s a major change,” said Dr. Aisling Murphy, assistant professor in the Division of Maternal-Fetal Medicine. “More recent data have suggested that obese women really don’t need to be gaining as much weight as women who enter pregnancy at a normal weight.”

Moreover, doctors are encouraging pregnant women to exercise — something many women had been fearful of doing. “Sometimes, women are under the impression that they shouldn’t be walking or going to the gym when they are pregnant. That is not the case,” Murphy said. “They really should be active.”

In addition to the risk of fetal programming, obesity during pregnancy is linked to several other potential complications. The chances of developing both hypertension and gestational diabetes are higher in pregnant women who are obese. About 7 percent of pregnant women in the United States develop gestational diabetes. Studies show that these women have an increased likelihood of developing type 2 diabetes later in life. In essence, gestational diabetes often isn’t a “temporary” condition that goes away after childbirth.

Obesity during pregnancy also raises the risk of some types of birth defects and other complications, such as an increased risk of Cesarean section or complications during childbirth, Murphy noted.

While two decades ago, few pregnant women were given extra resources and support they needed to manage weight gain, overweight or obese women who are planning to have children are now encouraged to seek pre-conception counseling, where they are given advice and resources to help them lose weight before becoming pregnant. And pregnant women who are obese are typically referred to a registered dietician for assistance with a healthy diet. Breastfeeding for at least six months is highly recommended to help the mother lose weight.

“If we can take care of young women before pregnancy and during pregnancy, we will end up with a healthier society, and it will bring down health care costs dramatically,” Dr. Devaskar said.

Read the complete story in the latest issue of U Magazine.

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California breast density law slow to have an impact


UC Davis research demonstrates need for more physician education.

Jonathan Hargreaves, UC Davis

By Dorsey Griffith, UC Davis

Ten months after California legislators enacted a controversial law mandating that radiologists notify women if they have dense breast tissue, UC Davis researchers have found that half of primary care physicians are still unfamiliar with the law and many don’t feel comfortable answering breast density-related questions from patients. The findings, to be published in the March print edition of Journal of the American College of Radiology, suggest that if the law is going to have any significant impact on patient care, primary care providers need more education about breast density and secondary imaging options.

“Overall, the impact of the breast density legislation probably is not significant if  primary care physicians are not educated or aware of it,” said lead author Kathleen Khong, a UC Davis radiologist and staff physician. “We should put some emphasis on educating the primary care physicians so that when they get questions from patients, they can be comfortable in addressing the issues.”

The California law, which took effect in April 2013, requires that patients whose breast density is defined as “heterogeneously dense” or “extremely dense” (about 50 percent of women), receive the following notification:

“Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the results of your mammogram and may also be associated with an increased risk of breast cancer. This information about the results of your mammogram is given to you to raise your awareness and to inform your conversations with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your physician.”

The researchers point out that breast density has long been a required part of any radiological report following mammography, but unless a patient asks to see the report, the information is shared only with the patient’s providers. Led by patient advocates, the legislation is intended to increase awareness of dense breasts and encourage patients to discuss the clinical issues with their doctors. According to published research, 28 states have passed, rejected or considered dense-breast notification legislation since 2009.

But the UC Davis study demonstrated that while women and their doctors are receiving the notifications, many of those physicians are unclear about what to do with the information. As a consequence, the researchers said, it appears that relatively few patients with dense breasts are asking questions about their breast density and its implications.

The UC Davis study surveyed 77 physicians about the new law.  Roughly half (49 percent) reported no knowledge of the legislation and only 32 percent of respondents noted an increase in patient levels of concern about breast density compared to prior years. In addition, a majority of primary care physicians were only “somewhat comfortable” (55 percent) or “not comfortable” (12 percent) with breast-density questions from their patients.

Khong said their survey results were surprising, but acknowledged that many primary care physicians may not feel they have sufficient training to make a clinical recommendation for a particular type of secondary screening. In fact, the study also found that 75 percent of respondents would like more education about the breast-density law and its implications for primary care.

“They are eager to learn and want to help their patients and be part of something positive as a result of this,” Khong said.

Jonathan Hargreaves, assistant professor of clinical radiology and a study co-author, said, for example,  that if a patient has dense breasts she should have a risk assessment, which takes into account her family history of breast cancer, biopsy history and other factors to determine whether a supplemental screening is warranted. Once  complete, the physician should then discuss the potential benefits and risks of supplemental imaging in determining the most appropriate approach for the patient. The use of ancillary screening in addition to mammography is a complex subject and still the subject of considerable debate, explained Hargreaves.

Tomosynthesis, known as 3-D mammography, is one supplemental test that breast radiologists generally agree provides a slight benefit for women with dense breasts over a standard mammogram and can be scheduled for the next annual mammographic screening appointment after receiving a notification. Breast magnetic resonance imaging (MRI) is another secondary imaging option, Hargreaves said, but is generally only used for screening in women who have a very strong family history of breast cancer or have a known high-risk gene, such as BRCA.

“The law has raised a lot of awareness about breast density,” Hargreaves said. “That being said, mammography screening is the primary thing patients need to do, and beyond that, the real benefits of other screening techniques are still the subject of ongoing medical debate.”

Khong and Hargreaves hope to validate their findings by expanding their research to include primary care physicians from other major university health care systems in California.

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UCSF, CMC sign letter of intent to increase pediatric, women’s health services


Collaboration to expand services in Valley would build on foundation of existing relationship.

By Karin Rush-Monroe, UC San Francisco

UCSF Medical Center and Community Medical Centers (CMC) have signed a letter of intent (LOI) to expand women’s and children’s services to the Central Valley, which has an undersupply of specialists for a growing population. The collaboration also would broaden medical education services in the area.

CMC, a Fresno-based regional health system, owns and operates Community Regional Medical Center (CRMC) and other licensed general acute care hospitals and outpatient centers in Fresno and Clovis that serve Fresno County and the surrounding counties.

“The delivery of health care is changing. We’re going to rely on medical information technology and strong alliances with private and academic physicians to more efficiently manage the health of entire families. This project with UCSF will be a key part of that,” said Craig Wagoner, CEO at Community Regional Medical Center.

The shared vision of CMC and UCSF includes development of a clinically integrated health system to facilitate better sharing of information in order to manage patient health; improved access to high-quality pediatric services in Fresno and surrounding communities; higher acuity pediatric services at CRMC to reduce the need for patients’ families to travel outside of Fresno; and increased integration of the academic and training missions of UCSF and CRMC.

An immediate goal for 2015 is to increase the availability of specialists at CRMC by this summer.

UCSF School of Medicine, which consistently is ranked among the nation’s top medical schools, has for decades operated a graduate medical education program in collaboration with Community, the San Joaquin Valley’s largest hospital organization.

About 300 UCSF medical residents and fellows currently practice on the Community Regional Medical Center campus, which is the Valley’s Level 1 trauma center. Pediatrics is one of 22 specialties currently offered in the Fresno-based graduate medical education program.

The collaboration among UCSF Fresno, CRMC and Valley Children’s Healthcare has afforded UCSF residents the ability to receive high-quality residency training across the entire spectrum of pediatric needs within a diverse set of clinical settings. UCSF remains firmly committed to maintaining and strengthening this long-time, top-ranked pediatric residency program for the benefit of patients, the community and the entire San Joaquin Valley.

“This is the next logical step in our relationship with Community,” said Michael Peterson, M.D., interim associate dean for UCSF Fresno. “The medical school is committed to serving the Valley, and our leadership team in San Francisco is excited about the opportunity to partner with the Community Regional Medical Center and build a leading-edge women’s and children’s program.”

“We have a great relationship with Fresno and the Central Valley, and this partnership with Community Medical Centers will strengthen that relationship,” said Stephen Wilson, M.D., Ph.D., associate chief medical officer for UCSF Benioff Children’s Hospital San Francisco. “This is an opportunity to better integrate our women’s and children’s services in the region and support UCSF’s mission to provide care to patients in areas that are underserved.”

UCSF has been providing services in Fresno for decades. Established in 1975 and now celebrating its 40th anniversary, the UCSF Fresno Medical Education Program plays a substantial role in providing health care services to residents of California’s San Joaquin Valley and training medical professionals in the region. A clinical branch of UCSF, the Fresno medical education program has trained approximately one-third of Central San Joaquin Valley physicians.

Faculty and medical residents at UCSF Fresno engage in a broad spectrum of research addressing health issues pertinent to the Valley. Faculty and residents also care for the overwhelming majority of the region’s underserved populations at health care facilities like CRMC.

In addition, UCSF Fresno provides academic preparation programs for middle- and high school students interested in the health professions through the Junior Doctors Academy and the Doctors Academy. UCSF Fresno academically prepares students at Fresno State to become competitive applicants to health professional schools and ultimately aims to prepare them for careers in health and medicine. UCSF Fresno also is a key partner in the UC Merced San Joaquin Valley Program in Medical Education.

The collaboration is anticipated to be finalized in the fall of 2015.

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UCSF receives $40M gift for new Medical Center at Mission Bay


Outpatient medical building to be named in honor of the Ron Conway family.

CSF Medical Center's new outpatient building, located on 16th Street, will be named the UCSF Ron Conway Family Gateway Medical Building in honor of the family $40 million gift. Some outpatient clinics will begin opening on Jan. 26. (Photo by Cindy Chew)

By Karin Rush-Monroe, UC San Francisco

UC San Francisco has received a $40 million gift from angel investor and philanthropist Ron Conway, his wife Gayle, and sons Ronny, Topher and Danny, to help fund the outpatient medical building at the new UCSF Medical Center at Mission Bay, which opens on Feb. 1 on UCSF’s world-renowned biomedical research campus. The outpatient medical building, a 207,500-square-foot facility that anchors the hospital complex, will house outpatient services for women, children and cancer patients.

In honor of the Conways’ generosity, UCSF will name the outpatient building the UCSF Ron Conway Family Gateway Medical Building.

UCSF Medical Center at Mission Bay, a result of more than 10 years of planning and construction, comprises UCSF Benioff Children’s Hospital San Francisco, UCSF Betty Irene Moore Women’s Hospital and UCSF Bakar Cancer Hospital. The new facilities include a 289-bed hospital complex, with children’s emergency and outpatient services that will integrate research and medical advancements with patient-focused, compassionate care.​

Ron Conway is the founder of SV Angel and has worked with hundreds of startups including Google, Facebook, Zappos, Square, Airbnb, Dropbox, Pinterest  and Twitter. He also is a board member of the Salesforce.com Foundation and actively supports the tech civic organization sf.citi, College Track, Sandy Hook Promise, Americans for Responsible Solutions, Teach for America, THORN and Donors Choose.

“Ron and Gayle have been true partners with UCSF for more than a decade, and we are extremely grateful for their ongoing support. This building is significant for the connection it provides between the high-quality medical care patients will receive at our three specialty hospitals as inpatients, and the groundbreaking continuing care they will receive as outpatients,” said Sam Hawgood, M.B.B.S., chancellor of UCSF.

Ron Conway is a member of the UCSF Medical Center Campaign Cabinet and served on the UCSF Foundation Board for several years. He has been a generous fundraiser for and philanthropist to UCSF and in particular, UCSF Benioff Children’s Hospital San Francisco.

He also has been an active supporter of neurodegenerative disease research and treatment, through the UCSF Neuroscience Initiative, which brings together under one roof outstanding scientists and clinicians from multiple disciplines – and the core technologies that they need to be successful.

“Ron is known as an ‘angel’ investor, and that description certainly holds true for his passion to better the lives of patients at UCSF,” said Mark R. Laret, CEO of UCSF Medical Center and UCSF Benioff Children’s Hospitals. “As a public medical center, we depend on the generosity of people like Ron and Gayle to continue serving the patients of San Francisco as well as Northern California and beyond. The Conways have been generous not just through financial gifts but with their time, introducing UCSF to their colleagues throughout the technology sector and Silicon Valley in order to advance our mission of care, research and education.”

The UCSF Ron Conway Family Gateway Medical Building is expected to draw more than 1,500 outpatient visits daily, as well as serve as a teaching facility for students. It includes a cancer clinic and women’s health clinic, and pediatric clinic. Some outpatient clinics will begin opening on Jan. 26.

The new medical center, strategically located on UCSF’s 60.2-acre Mission Bay research campus, will enhance UCSF’s ecosystem of innovation by putting physicians in close proximity to researchers and near biotechnology and pharmaceutical companies in Mission Bay and beyond. The new cancer hospital, for example, will sit near the UCSF Helen Diller Family Cancer Research Building, where every day leading scientists are seeking causes and cures for cancer.

UCSF Medical Center at Mission Bay also will feature the only operating hospital helipad in San Francisco to transport critically ill babies, children and pregnant women to the medical center from outlying hospitals.

“Gayle and I are proud to partner with UCSF to improve the health of the Bay Area. We have watched UCSF Medical Center at Mission Bay grow from a concept to a magnificent hospital complex, and can think of no better investment than supporting patients who are accessing needed outpatient medical services,” Ron Conway said. “We encourage others to get involved with the new medical center philanthropically, as well as other programs at this leading institution.”

The total $1.5 billion cost of the Mission Bay Hospitals Project has been funded by UCSF Medical Center financing and private philanthropy. Of the $600 million fundraising goal, UCSF has raised $550 million.

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Birth control shot linked to moderately increased risk of HIV infection


UC Berkeley findings have potentially broad implications.

By Sarah Yang, UC Berkeley

A large meta-analysis of 12 studies in sub-Saharan Africa found that women who used a type of injectable birth control had a moderately increased risk of becoming infected with HIV.

The contraceptive, depot medroxyprogesterone acetate, is sold under the brand name Depo-Provera, and it is administered as a shot every three months.

The findings, published today in The Lancet Infectious Diseases, included data from 39,500 women. The researchers selected the studies based upon methodological rigor, such as whether they accounted for the use of condoms.

In addition to Depo-Provera, the studies also examined other commonly prescribed forms of hormonal contraception, such as the injectable norethisterone oenanthate (sold as NET-EN), combined oral contraceptives and progestin-only pills. The other birth control methods did not appear to increase HIV infection risk for women in the general population.

“We embarked on this study because of the inconsistency in the scientific literature on this topic,” said study lead author Lauren Ralph, who did this research for her UC Berkeley Ph.D. dissertation in epidemiology. “The results have potentially broad implications because hormonal contraceptives remain popular for women worldwide.”

Approximately 144 million women worldwide use hormonal contraception, and of those about 41 million women use injectable forms of birth control instead of the pill.

The study found that women who used depot medroxyprogesterone acetate had a moderate, 40 percent increased risk of acquiring HIV compared with women using non-hormonal methods and those not practicing birth control. The increased risk was slightly lower, 31 percent, among the studies done in women in the general population.

It remains unclear why the increased risk was seen among those using Depo-Provera but not the other forms of hormonal contraception, the authors said. One possibility may be that birth control with higher levels of progestin, the synthetic form of the natural hormone progesterone, changed the vaginal lining or altered local immunity, increasing the risk for HIV infection, though the researchers emphasized that this study did not examine the physiological effects of the different contraceptive methods and more research on potential underlying biologic mechanisms is needed.

The researchers cautioned that the increased HIV infection risk needs to be considered in the context of the risks associated with not using birth control.

“We do not believe that the findings merit withdrawal of this method of birth control for most women,” said Ralph. “There are significant risks associated with pregnancy and childbirth as well. It can be tricky to ensure a reliable supply of contraceptives in sub-Saharan Africa. Removing Depo-Provera doesn’t mean the women will have immediate access to other methods of birth control that are as effective. Ultimately, decisions around which birth control method to use should be made between a woman and her healthcare provider.”

The researchers noted that the results highlight the need for more studies among high-risk populations.  Among the 12 studies analyzed, only two included sex workers or women with HIV-positive partners.

“The most important next steps for women all over the world are to examine ways to broaden women’s contraceptive options and increase uptake of other safe and effective contraceptive methods, and to step up research on new contraceptive methods, especially those that protect against both HIV and pregnancy,” said senior author Nancy Padian, a UC Berkeley adjunct professor of epidemiology.

Other co-authors of this study are Sandra McCoy, a UC Berkeley assistant adjunct professor of epidemiology, and Karen Shiu, who was a research analyst in Padian’s research group at the time of the study.

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Preeclampsia during mother’s pregnancy linked with greater autism risk


Likelihood of autism diagnosis even greater if mother experienced more severe disease.

By Phyllis Brown, UC Davis

Children with autism spectrum disorder (ASD) were more than twice as likely to have been exposed in utero to preeclampsia, and the likelihood of an autism diagnosis was even greater if the mother experienced more severe disease, a large study by researchers with the UC Davis MIND Institute has found.

Women with preeclampsia experience hypertension during the latter half of their pregnancies, and may have increased levels of protein in their urine and edema, or fluid retention. Preeclampsia can develop into eclampsia, a life-threatening condition in which seizures may occur.

The study was conducted in more than 1,000 children between the ages of 2 and 3 years enrolled in the Childhood Risks of Autism from Genetics and the Environment (CHARGE) study in Northern California. It is published online today in JAMA Pediatrics.

Cheryl Walker, UC Davis

“We found significant associations between preeclampsia and ASD that increased with severity. We also observed a significant association between severe preeclampsia and developmental delay,” said Cheryl Walker, study senior author, assistant professor, Department of Obstetrics and Gynecology Division of Maternal Fetal Medicine and a researcher affiliated with the UC Davis MIND Institute.

While preeclampsia has previously been examined as a risk factor for autism, the literature has been inconsistent. The current study provides a robust population-based, case-controlled examination of the association between autism and preeclampsia and whether risk was associated with preeclampsia severity.

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Major complication rate after abortion is extremely low, study shows


UCSF research is first to use complete data on post-abortion care.

By Laura Kurtzman, UC San Francisco

In the most comprehensive look yet at the safety of abortion, researchers at UC San Francisco have concluded that major complications are rare, occurring less than a quarter of a percent of the time, about the same frequency as colonoscopies.

The study, published today in Obstetrics & Gynecology, analyzed data from more than 50,000 women enrolled in the Medi-Cal fee-for-service program who obtained abortions from 2009 to 2010, and looked for complications that occurred within six weeks of the procedure.

The rate is similar to what has been found in previous studies, but this is the first study in which researchers have based their conclusions on complete data on all of the health care used by women who have received abortions. Since some women must often travel long distances to find abortion providers, they tend to receive follow-up care at facilities closer to where they live. For many women, this means their local emergency department. But, up until now, no study has systematically examined emergency department use for post-abortion care.

The researchers said they expect the study will contribute to the national debate over abortion safety. Many state legislatures have recently passed laws that have the effect of reducing access to abortion by requiring providers to have transfer agreements or admitting privileges with hospitals or to construct their clinics so that they meet the requirements of an ambulatory surgical center. But the researchers said that these restrictions were likely to make women travel further to get abortions or induce them on their own using unsafe methods, both of which may increase the risks for women.

“Our study had very complete follow-up data on all of the women in it, and we still found a very low complication rate,” said Ushma Upadhyay, Ph.D., M.P.H., an assistant professor at Advancing New Standards in Reproductive Health (ANSIRH), a program of the Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF. “Abortion is very safe as currently performed, which calls into question the need for additional regulations that purportedly aim to improve safety.”

California is one of 17 states that cover abortion and follow-up care for women enrolled in Medicaid, the state-federal health insurance program for the poor. Billing data from the Medi-Cal fee-for-service program gave researchers a complete picture of all the health care that women received in the six weeks following their abortion procedures.

California has more than 500 abortion providers, most of them practicing in an outpatient setting, and 97 percent of the abortions studied were performed in an outpatient clinic or a doctor’s office. Only 3 percent were performed in hospitals.

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Developing a noninvasive test for endometriosis


UCSF researchers ID patterns of genetic activity that could help in early detection of disorder.

Researchers at UC San Francisco have identified patterns of genetic activity that can be used to diagnose endometriosis and its severity, a finding that may offer millions of women an alternative to surgery through a simple noninvasive procedure.

The study is online in the journal Endocrinology.

“This promising molecular diagnostic approach would not have been possible without advances in genomics and bioinformatics,” said senior author Linda Giudice, M.D., Ph.D., distinguished professor and chair of obstetrics, gynecology and reproductive sciences at UCSF.

“Importantly, there are relatively few genes in each ‘classifier’ of disease or of no disease and endometriosis stage that have the potential for non-surgical diagnostic development,” Giudice continued. “The approach also could be used to detect disease recurrence without requiring surgery, and the newly identified gene profiles and pathways resulting from this approach have opened doors for innovative targeted therapy development for endometriosis-related pain and infertility.”

Endometriosis is an often painful condition that occurs when tissue normally lining the inside of the uterus grows outside the uterus.

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Building the future of health care


More than 1,000 donors give $131M in support of UC San Diego Jacobs Medical Center.

By Judy Piercey and Jade Griffin, UC San Diego

Committed to fostering the future of health care in San Diego, more than 1,000 donors have contributed $131 million to UC San Diego’s Jacobs Medical Center. Included in the total are gifts that matched a donation of $25 million, meeting the Challenge goal of the initiative.

Today (Nov. 20), the campus announced that the Challenge donation, originally anonymous, was made by Joan and Irwin Jacobs. They provided a $75 million lead gift for the new facility in 2010; with the Challenge gift, that brings their contributions to the Jacobs Medical Center to a total of $100 million. Continued private support will help fund the completion of the new medical center, which is the largest hospital project currently underway in Southern California.

Under construction and projected to open in 2016, Jacobs Medical Center is a $839 million, 10-story facility on the university’s La Jolla campus, which will include three new clinical care units in one location: The A. Vassiliadis Family Hospital for Advanced Surgery, The Pauline and Stanley Foster Hospital for Cancer Care and the Hospital for Women and Infants.

“We are deeply grateful to Joan and Irwin Jacobs for their generosity, including the recent $25 million match challenge,” said UC San Diego Chancellor Pradeep K. Khosla. “We also thank Carol Vassiliadis and Pauline Foster, who made leadership gifts, as well as all of the other donors who participated in meeting this challenge. These visionaries support UC San Diego’s commitment and vision to create a healthier world through new science, new medicine and new cures.”

“Jacobs Medical Center is part of a multibillion dollar university investment in the future of health care for the region,” said Dr. David A. Brenner, vice chancellor for Health Sciences and dean of the UC San Diego School of Medicine. “I want to thank all of the donors who have helped make this extraordinary medical center a reality.”

Irwin and Joan Jacobs

“When we came here in 1966, the medical school was just starting,” said Irwin Jacobs, co-founder, former chairman and CEO of Qualcomm Inc. and UC San Diego founding faculty member, who served as a professor in electrical and computer engineering from 1966 to 1972. “There was no hospital, just a school. So it’s very exciting to make Jacobs Medical Center possible. More and more, we’re learning how to bring results from basic research in biology and engineering to medicine, and to the clinic. I think this medical center is going to show how effective that can be. The innovations will spread out from San Diego, and go all around the world.”

The 509,500-square-foot facility will house 245 patient beds and be connected on multiple floors with the existing John M. and Sally B. Thornton Hospital on UC San Diego’s La Jolla campus, in the heart of the area’s nexus of biomedical research centers. Jacobs Medical Center has been designed with the patient in mind. From spacious private rooms to soothing color schemes and artwork, to next-generation medical equipment, the vision and needs of patients, doctors and nurses, all aspects of the Jacobs Medical Center have been fully integrated. Each floor will combine all the necessary healing elements while achieving optimal safety and efficient delivery of care.

“Soon we will have the largest, most technologically advanced hospital in the region, dedicated to offering specialized care for every kind of patient, in every phase of life,” said Paul Viviano, CEO of UC San Diego Health System.

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UCSF Mission Bay hospital complex to open Feb. 1


Three new hospitals for women, children and cancer patients.

UCSF Medical Center at Mission Bay will open Feb. 1, 2015. (Photo by Mark Citret)

After more than 10 years of planning and construction, UCSF Medical Center at Mission Bay will open Feb. 1, 2015 on UC San Francisco’s world-renowned biomedical research campus. UCSF Medical Center at Mission Bay comprises UCSF Benioff Children’s Hospital San Francisco, UCSF Betty Irene Moore Women’s Hospital and UCSF Bakar Cancer Hospital. The new facilities include a 289-bed hospital complex, with children’s emergency and outpatient services that will integrate research and medical advancements with patient-focused, compassionate care.​

UCSF Medical Center at Mission Bay will welcome its first patients the morning of Feb. 1, when teams of health care professionals and ambulances begin moving some inpatients from the UCSF Parnassus campus and Mount Zion campus into the new facilities.

The new medical center, strategically located on UCSF’s 60.2-acre Mission Bay research campus, will enhance UCSF’s ecosystem of innovation by putting physicians in close proximity to researchers and near biotechnology and pharmaceutical companies in Mission Bay and beyond. The new cancer hospital, for example, will sit near the UCSF Helen Diller Family Cancer Research Building, where every day leading scientists are seeking causes and cures for cancer.

UCSF Medical Center at Mission Bay also will feature the only operating hospital helipad in San Francisco to transport critically ill babies, children and pregnant women to the medical center from outlying hospitals.

“UCSF Medical Center at Mission Bay profoundly advances our ability to fulfill our mission as a public hospital, providing high-quality health care that meets the future needs of the entire Bay Area,” said Mark R. Laret, CEO, UCSF Medical Center and UCSF Benioff Children’s Hospitals. “By embedding clinical care within our research enterprise at Mission Bay, UCSF physicians and scientists in the forefront of cancer medicine, and women’s and children’s health will be able to more readily translate discoveries into next-generation therapies and cures.”

Each of the new hospitals’ designs reflects significant input from patients and families, as well as clinicians.

“UCSF Medical Center at Mission Bay sets a national benchmark for patient- and family-centered health care by offering an unparalleled healing environment that supports and connects patients and their families during hospital stays,” said Cindy Lima, executive director, UCSF Mission Bay Hospitals Project. “These new hospitals expand our capacity to provide the most advanced treatments in buildings that reflect input from the people who will use them.”

The hospitals feature state-of-the art technology, including the world’s largest hospital fleet of autonomous robotic couriers which will deliver linens, meals and medications. Interactive media walls in each private room will enable patients to communicate with their families and clinicians, and an imaging suite specially designed to eliminate anxiety during an MRI offers children the chance to virtually experience a San Francisco trolley ride, or to play with a cast of animated critters as they boat around the San Francisco Bay.

Distinctive features of UCSF Medical Center at Mission Bay include 4.3 acres of green space and 1.2 acres of rooftop gardens, soothing art- and light-filled interiors and a public plaza created in partnership with the City of San Francisco. In addition, UCSF Medical Center at Mission Bay is on target to be one of the first LEED Gold-certified hospital in California.

The Integrated Center for Design and Construction brought together more than 200 architects, engineers and contractors working side by side in a command center on the construction site. Construction of the hospitals began in December 2010.

“The healing power of UCSF Medical Center at Mission Bay extends beyond the hospitals’ walls, as clinicians and researchers work side by side to accelerate medical breakthroughs and transform the delivery of health care in this country,” said Sam Hawgood, M.B.B.S., chancellor of UC San Francisco. “It’s important to note that the hospital complex was built only through the generous philanthropic support of the Bay Area community, who share our vision of advancing health care across the world. We are greatly appreciative of their unwavering commitment to our mission over the past decade. ”

UCSF Benioff Children’s Hospital San Francisco

UCSF Benioff Children’s Hospital San Francisco, one of the nation’s leading children’s hospitals, provides treatment for virtually all pediatric conditions, as well as for critically ill newborns. The Neonatal Intensive Care Nursery at UCSF Benioff Children’s Hospital San Francisco was one of the first of its kind in the world. The hospital is the only California state-designated children’s medical center in San Francisco and is affiliated with UCSF Benioff Children’s Hospital Oakland.

The new 183-bed facility at Mission Bay creates an environment where children and their families find quality care at the forefront of scientific discovery. Private rooms in the intensive care nursery support the youngest patients, while the fully accredited classroom and teachers enable school-age patients to continue their education while focusing on their health. The hospital offers accommodations for families of pediatric patients and nearby lodging for those requiring longer stays.

UCSF Bakar Cancer Hospital

UCSF ranks consistently among the top cancer care centers in the nation, according to the “America’s Best Hospitals” survey from U.S. News & World Report. UCSF Bakar Cancer Hospital sets the standard in personalized care, delivering advanced cancer therapies tailored to individual patient needs. The hospital increases UCSF’s inpatient and outpatient capacity to meet growing demand, in a state-of-the-art facility. The new hospital will absorb many of the cancer surgery beds currently located at UCSF Medical Center at Mount Zion, offering cancer surgeries in specialties ranging from urology and orthopedics, to head and neck and gynecologic oncology. Specialists also serve the individual needs of cancer patients from the children’s and women’s hospitals. In the future, Mission Bay could house as many as 250 or more surgery beds, with a full complement of outpatient cancer care services.

UCSF Betty Irene Moore Women’s Hospital

As the region’s first dedicated women’s hospital, UCSF Betty Irene Moore Women’s Hospital will embody the philosophy of the UCSF National Center of Excellence in Women’s Health. The new hospital will deliver care that addresses health needs across a woman’s lifetime, including cancer treatment, specialty surgery, a 36-bed birth center, nine deluxe labor and delivery rooms, and select outpatient services. Customizing care to each patient, the hospital will provide the best available diagnostic tests and treatments in a caring, women- and family-focused environment that incorporates the latest technology. Spacious rooms allow loved ones to spend the day or night comfortably.

Each labor and delivery room is designed to be respectful to patients and families during the life-altering event of childbirth. Combining sophisticated technical capabilities with carefully considered design choices, each room emits a sense of calm for the birthing experience. At the same time, it is a highly functional space for clinicians to provide quality care.

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