The Division of Cardiovascular Medicine successfully deployed the first transcatheter aortic valve implantation [TAVI].
University Hospitals Case Medical Center is one of only forty sites in the U.S. and the only one in Northeast Ohio – to participate in this clinical trial.
TAVI is a state of the art, minimally invasive technique that benefits high-risk elderly patients who develop aortic stenosis.
Cleveland is already well-known for its high quality medical care. But its reputation is growing elsewhere.
Some of the nation’s best and brightest are flocking to University Circle to be on the cutting edge of the biotech innovation. Channel 3′s Maureen Kyle continues our “Brain Gain” series with a look at how this could be the catalyst to change Cleveland forever.
“We are seen as a center for health care innovation among the leading clinicians that are here,” says BioEnterprise CEO Baiju Shah.
In between doctors and patient care is the medical innovation needed to save lives. And located between the Cleveland Clinic and University Hospitals sits BioEnterprise, an incubator for biotech startups.
“For every 10 ventures that is launched in the biomedical space, one of them will grow up to be the next ‘STERIS.’ Two of them will be successfully acquired by a larger company and then those entrepreneurs will start their next ventures.”
Shah started BioEnterprise in 2002 with 250 companies the incubator now has more than 600 and drawing in more.
“Went to the east coast, the west coast, someone convinced us to come to Cleveland, ” says Jake Orville, a New York native.
Orville could have taken his company anywhere and decided Cleveland was the best location.
“Having been here now for two years, I think that’s what’s unique with Cleveland. You have the combination of the technology and you have the combination of the physician care and the patient care and its the two of them that really helps breed companies like mine, Cleveland HeartLab.”
Cleveland HeartLab started with eight employees, now has 26 and is looking to add 10 more.
“Opportunity! Opportunity knocked,” says George Farr, vice president of biochemistry and biophysics at Cleveland startup Aeromics.
Farr was raised in Garfield Heights and moved to Connecticut to be a professor at Yale. He and a others moved back to work on protein advancement that will help stroke and brain trauma victims.
With their grant money they got a 16 hundred square foot lab in University Circle. “For that same amount of money back in New Haven, we would get basically just half of one of these benches. That’s it. No office space, no nothing.”
It’s these companies changing Cleveland’s reputation worldwide and will change the way we view successful local businesses. “They’re not the TRW’s. these are companies who have 10 to 50 employees that are working on very cool inventions that all of us are going to need.”
The Plain Dealer | November 14
The $298 million Ahuja Medical Center opens its doors to the community today for a peek at the first Cuyahoga County hospital built from the ground up in 30 years.
Workers continued to paint, wire and move furniture into the building last week. The finished product will incorporate concepts that promote patient healing and shorten the time they need to stay in the hospital.
The 144-bed facility opens to patients early next year after it receives certification.
When visitors enter, they immediately see a wall of windows that bathes the soaring two-story lobby in natural light. Warm and inviting neutral colors and wide hallways put them at ease. A comforting, gas-burning hearth is carefully positioned at the end of the lobby.
The seven-story hospital features all single-patient rooms, a wireless Internet campus, a comprehensive imaging center, inpatient and outpatient surgical suites with cutting-edge technology, catheterization labs, a medical office building, and adult and pediatric emergency services.
Saturday night more than 1,000 invited guests toured the center during a gala honoring Monte Ahuja, his wife, Usha, and their family. The public open house is from 1:30 to 5 p.m. today.
Ahuja, who donated $30 million to University Hospitals , said last week the medical center is his family’s legacy to the community.
“The final product is beyond our expectations,” said Ahuja, chairman of the UH board of directors. “Our grandchildren and great-grandchildren will know that we were here, leaving a great value to the community and promoting great thinking in medicine.”
The Ahuja center is part of University Hospitals’ $1.2 billion Vision 2010 expansion, which includes construction of numerous medical facilities throughout Northeast Ohio.
University Hospitals CEO Tom Zenty said the 53-acre Beachwood campus near Interstate 271 and Harvard Road is positioned to serve 540,000 people in an area stretching from the eastern suburbs to parts of Medina, Lake and Summit counties.
Zenty said the center will be a key component of UH’s integrated health-care network, with suburban ambulatory facilities throughout Northeast Ohio and tertiary care at Case Medical Center in University Circle.
The new hospital could ultimately serve as an economic catalyst for businesses, said James Benedict, the Ahuja Medical Center president. “We anticipate we will be in a position to showcase Cleveland.”
The hospital has hired 400 people for nonphysician jobs, and an additional 100 should be onboard once the center is up and running next year, said Benedict.
The hospital’s planners used designs scientifically proven to reduce the length of a hospital stay, noise, secondary infections and medical errors.
A key component in creating the uplifting healing environment is artwork, Benedict said.
More than 250 original pieces can be found throughout the center, created by local, national and international artists, said UH art curator Trudy Wiesenberger.
One of the greatest challenges, she said, was filling the space above the cafeteria, which can be seen from the lobby.
For that, Wiesenberger commissioned a 36- by 10-foot installation by Dale Chihuly — the largest public display in the region by the internationally known glass artist.
The “Ahuja Azure, Citron and Amber Persian Wall” installation has more than 100 hand-blown pieces of glass.
The center’s landscaping and its gardens are also designed for patient and visitor enjoyment and comfort. There are parklike walkways, night lighting, a boardwalk and four ponds. To protect the environment, landscaped areas have bioswales to reduce water runoff and increase on-site filtration.
The medical center was constructed using green-building specifications and is anticipating a Leadership in Energy and Environmental Design silver rating, Benedict said.
The grounds include parking lots with a total of 400 spaces, a helicopter pad and a central energy plant. The emergency generator has the capacity to power the hospital for 72 hours.
Although the center has a separate pediatric emergency department, the hospital itself will not have inpatient pediatrics or obstetrics services. Those specialties could be considered for future expansion at the campus, which has a capacity for two more towers and 456 more beds.
Other features of the 435,000-square-foot center include:
•Specialty treatment in radiology, orthopedics, surgery, heart and vascular, neurology, gastroenterology and urology.
•Patient rooms with large windows, flat-screen TVs, and beautiful views. Each room has a space for the patient, private bathroom, convertible daybeds for visitors to stay over and sink area for caregivers.
Benedict said suites are available on each patient floor so family members can stay overnight in an adjoining room. These will cost extra, with pricing based on what area hotels charge, he said.
UH exceeded its goal of keeping construction as local as possible, said Margaret Hewitt, vice president of construction. So far, 91 percent of its Vision 2010 project spending has remained in the region, she said, with 20 percent of the construction jobs held by Cleveland residents, 22 percent of the work done by minority businesses and 7.3 percent by female-owned businesses.
The Plain Dealer | November 4
The debilitating pain of sickle cell disease can come on suddenly. The pain is so severe, and so unexpected, that many who suffer from this disease — some 1,000 in the Greater Cleveland area — can’t work full time.
“Most people just don’t get it,” says Stanley Little, 49, of Cleveland.
Little changed physicians — and hospitals — so he could be around people who knew how to treat sickle cell.
“People say, ‘You look fine. There can’t [be anything] wrong with you,’ ” he says.
About a year ago, University Hospitals started its Sickle Cell Fast-Track Clinic, adopting the model from places such as the Georgia Comprehensive Sickle Cell Center at Grady Memorial Hospital in Atlanta, a pioneer in the treatment of sickle cell disease.
At the first signs of a crisis, a patient can call the clinic with a heads-up that he or she needs treatment. By the time the patient gets there (bypassing the emergency room), pain medication and intravenous fluids are waiting. Also waiting are medical professionals well-versed in treating sickle cell patients, instead of physicians who see it infrequently.
If needed, patients can be admitted to UH for further observation. The clinic’s goal, however, is to avoid as many ER visits and hospital admissions as possible by treating a crisis before it becomes full-blown.
“It’s a pretty innovative approach,” says Lawrence, adding that sickle cell patients have the second-highest readmission rate within a 30-day period. “Readmission is a very large concern.”
So far in 2010, the Fast-Track Clinic has had roughly 250 patient visits, says UH oncologist Dr. Joseph Bokar, who leads a team of oncologists and oncology nurses in providing care for patients with sickle cell disease.
“We think our patients are becoming more comfortable using this approach,” he says.
Since late 2008, University Hospitals Ireland Cancer Center has been expanding resources to deal with the often misunderstood symptoms and side effects associated with the disease. Because the fields of hematology (blood disorders) and oncology (cancer) often overlap, sickle cell patients are treated at Ireland.
Social worker Christine Lawrence, who facilitates a new support group there, joined UH nearly two years ago. Her full-time focus is sickle cell patients.
“Working with this patient population, I realized there are a lot of unmet needs,” she says.
UH also has begun a transitioning program for children with sickle cell, so they can become well-versed in making their own appointments and following treatment plans.
Starting at age 13, younger patients at Rainbow Babies & Children’s Hospital meet regularly with the physicians and nurses who treat adult patients so there is some familiarity long before a patient leaves Rainbow.
All of these resources are applauded by patients living with a disease that is often met with ignorance and skepticism from the general public.
Often, sickle cell patients don’t get the same degree of attention as people with other genetic diseases, Bokar says.
“There are a lot of inherited serious lifelong diseases,” he says. “[Diseases such as cystic fibrosis and muscular dystrophy] get a lot of press and support from the public. Sickle cell anemia is more common than those but gets very little publicity.
“This disease affects every organ system in the body,” he says.
Diagnosed at age 3 months with sickle cell anemia, Jamele Green says he has had more health challenges in recent years than at any other time in his life.
The Fast-Track Clinic, however, has made his hospital stays — once as often as every few weeks — much less frequent.
“I’ve been through Fast-Track several times,” Green, 32, says. “It is a lot better. You’re not waiting in the ER for hours.”
UH’s support group has been met with the same enthusiasm.
Tasha Taylor is in an associate degree program in medical assistance and hopes to eventually become a registered nurse.
“It was good to meet different people, different ages,” says Taylor, 30. The attendees at the inaugural group meeting ranged in age from 19 to 68.
For Taylor, diagnosed with sickle cell anemia at birth, cold weather triggers extreme joint pain and headaches that can send her to the hospital for up to two weeks at a time.
Two things struck Stanley Little as he walked into the support group meeting last month.
There was nowhere for him to sit — and most of the 27 other sickle cell patients there were strangers.
“I was like, ‘Wow!’ ” says Little, of Cleveland, who thought he had met all of his fellow “sicklers” in town. Diagnosed at age 10 with sickle cell beta thalassemia, Little says he doesn’t have as many severe attacks, or sickle cell crises, as other patients with the disease. He did have a total hip replacement surgery a few years ago, the result of avascular necrosis, in which one’s bones are deprived of oxygen and a blood supply. (Sickle cell patients have a higher risk of developing the condition.)
Meeting new people with sickle cell, he says, has been eye-opening.
“I’m learning how many different ways it affects people,” he says.
Sickle cell disease facts ::
* A substance in red blood cells called hemoglobin carries oxygen inside the cell. Normal red blood cells are round and move easily in the body to deliver oxygen. A sickle red blood cell looks like a sickle, the C-shaped farm tool used to cut wheat, thus the name. Cells shaped like this are hard and pointed and clog the blood flow to nearby tissue.
* More than 75,000 Americans have sickle cell disease, one of the most common genetic diseases in the country (and the most common inherited blood disorder in the United States, according to government statistics). About 1 in 10 African-Americans and 1 in 100 Hispanic-Americans carry the sickle cell trait. Carriers don’t have the disease, but the trait raises their chances of passing it on to children. Sickle cell also can be present in people of Mediterranean, Middle Eastern, Indian, Caribbean, and Central and South American descent, although less frequently.
* People affected with sickle cell disease have a wide range of symptoms and conditions. Some have no problems, while others have frequent bouts of joint or organ pain, vulnerability to infection, stroke, slow growth or internal organ damage.
TimesNews.net | November 4
In 1972, after a month of deliberation, Congress launched the nation’s most ambitious experiment in universal health care: a change to the Social Security Act that granted comprehensive coverage under Medicare to virtually anyone diagnosed with kidney failure, regardless of age or income.
It was a supremely hopeful moment. Although the technology to keep kidney patients alive through dialysis had arrived, it was still unattainable for all but a lucky few. At one hospital, a death panel — or “God committee” in the parlance of the time — was deciding who got it and who didn’t. The new program would help about 11,000 Americans, just for starters. For a modest initial price tag of $135 million, it would cover not only their dialysis and transplants, but all of their medical needs. Some consider it the closest that the United States has come to socialized medicine.
Now, almost four decades later, a program once envisioned as a model for a national health care system has evolved into a hulking monster. Taxpayers spend more than $20 billion a year to care for those on dialysis — about $77,000 per patient, more, by some accounts, than any other nation. Yet the United States continues to have one of the industrialized world’s highest mortality rates for dialysis care. Even taking into account differences in patient characteristics, studies suggest that if our system performed as well as Italy’s, or France’s, or Japan’s, thousands fewer patients would die each year.
In a country that regularly boasts about its superior medical system, such results might be cause for outrage. But although dialysis is a lifeline for almost 400,000 Americans, few outside this insular world have probed why a program with such compassionate aims produces such troubling outcomes. Even during a fervid national debate over health care, the state of dialysis garnered little public attention.
Over the course of more than a year, ProPublica reviewed thousands of inspection reports and interviewed more than 100 patients, advocates, doctors, policy makers, researchers and industry experts to get a grasp on American dialysis. The findings were bleak: At clinics from coast to coast, patients commonly receive treatment in settings that are unsanitary and prone to perilous lapses in care. Regulators have few tools and little will to enforce quality standards. Industry consolidation has left patients with fewer choices of provider. The government has withheld critical data about clinics’ performance from patients, the very people who need it most. Meanwhile, the two corporate chains that dominate the dialysis-care system are consistently profitable, together making about $2 billion in operating profits a year.
One reason the system’s problems have evolved out of the health care spotlight is that kidney failure disproportionately afflicts minorities and the dispossessed. But given a patient pool growing by 3 percent a year and the outsize 6 percent bite that the kidney program takes from the Medicare budget, we ignore dialysis at our own risk. “We’re offering our patients a therapy we wouldn’t accept for ourselves,” said Dr. Tom F. Parker III, a Dallas nephrologist and national advocate for better care. More and more leaders in the field, he said, “are starting to say this isn’t sufficient.”
As the United States moves to expand access to health care, dialysis offers potent lessons. Its story expresses the fears of both ends of the ideological spectrum about what can happen when the doors to care are thrown wide open: Neither government controls nor market forces have kept costs from ballooning or ensured the highest-quality care. Almost every key assumption about how the program would unfold has proved wrong.
The Sharp End of the Needle
Henry Baer went in for his third dialysis treatment on New Year’s Eve day in 2005. It turned out to be his last. He was only 39, but years of diabetes and high blood pressure had caused Baer’s kidneys to shut down. Built-up waste and fluid were causing his limbs to swell and making him short of breath. He was sent for what’s called in-center hemodialysis, the most common type of dialysis, at a beige-toned clinic near his home in Prescott Valley, Ariz.
His first two sessions were pretty normal. A patient-care technician hooked Baer to a machine the size of a filing cabinet, connecting it with plastic tubing to the catheter in his chest. He sat in a lounge chair, still as stone, for about four hours as the machine, whirring gently, moved his blood through a specialized filter, then returned it, cleansed of toxins. It was uncomfortable and boring. “Sis, this isn’t for me,” he told his older sister, Karen Gable, vowing to make himself a viable candidate for a kidney transplant.
Just over two hours into his next session, Baer’s incoming bloodline “became disconnected,” a federal inspection report says. The attending technician panicked, “yelling and screaming hysterically.” Blood sprayed onto Baer’s shirt, pants, arms and hands. Then, “contrary to emergency standing orders,” the report continued, she reconnected the line to Baer’s catheter, infusing him with “potentially contaminated blood.” By the time Mike Wright, Baer’s boss at a local car dealership, picked Baer up after the treatment, he was complaining of nausea.
Over the next two days, Baer spiked a fever. His wife found him in bed, having a convulsion. He was taken to the hospital, where tests later showed that his catheter had become infected with antibiotic-resistant staph. The infection moved swiftly to his heart and brain. He died a few days later, on Jan. 7, 2006, leaving behind a 2-month-old daughter. (Fresenius Medical Care North America, the clinic’s operator, declined to comment on the incident, citing patient privacy rules. In 2008, without admitting wrongdoing, it agreed to settle a wrongful-death lawsuit brought by Baer’s survivors.)
What happened to Baer was a worst-case scenario. Yet in some ways it is symptomatic of how dialysis is delivered. Medical supervision is minimal. Clinics must have board-certified physicians as medical directors, but usually have no doctor on site, and some struggle to meet the federal requirement of at least one full-time registered nurse. Technicians, who can start with just a high-school diploma and an in-house course (though they are later required to pass a state or national certification test), have been the field’s workhorses for a generation. Medicare sets no staffing ratios for dialysis centers, and most states don’t either.
Although some clinics are orderly and expert — attentive not only to patients’ health, but also to their dignity — others are run like factories, turning over three shifts of patients a day, sometimes four. Safety experts say technicians shouldn’t monitor more than four patients at once, but some operators save money by stretching them further. The pace can be so intense, inspections show, that clinics have allowed patients to soil themselves rather than interrupt dialysis for a bathroom break. One technician said he quit his job at a large Colorado clinic because he often had to juggle six patients or more. “The last two years, I was just getting old,” he said.
Conditions within clinics are sometimes shockingly poor. ProPublica examined inspection records for more than 1,500 clinics in California, New York, North Carolina, Ohio, Pennsylvania and Texas from 2002 to 2009. Surveyors came across filthy or unsafe conditions in almost half the units they checked. At some, they found blood encrusted in the folds of patients’ treatment chairs or spattered on walls, floors or ceiling tiles. Ants were so common at a unit in Durham, N.C., that when a patient complained, a staffer just handed him a can of bug spray.
Hundreds of clinics were cited for infection-control breaches that exposed patients to hepatitis, staph, tuberculosis and HIV. A Manhattan center closed in 2008 after cross-contamination infected three patients with hepatitis C within six months. Prescription errors were common: 60 clinics had at least five citations for them. In dozens of instances, patients died or were hospitalized after suffering hemorrhages like Baer’s, when dialysis needles or tubing dislodged and staffers failed to adhere to safety guidelines.
Providers say they work hard to meet or exceed government standards, correcting deficiencies quickly when they surface and sometimes employing their own internal auditing programs. “You will find cases where things go wrong, but it’s a small percent when you consider all of the hundreds of thousands of treatments every day,” said Diane Wish, the CEO of a small Ohio dialysis chain and president of the National Renal Administrators Association, the group that represents dialysis facility managers. But patient advocates say conditions in some clinics have been problematic for so long that everyone in the system has come to accept it. “It’s become ingrained that dialysis is expensive and dangerous and has terrible outcomes,” said Bill Peckham, a patient known widely for his blog, Dialysis From the Sharp End of the Needle. “Once you’re there, God help you. What do you expect? You’re on dialysis.”
Rise of an Entitlement
Dialysis entered the American consciousness in the early 1960s as the country’s signature example of medical rationing. In those days, kidney disease killed about 100,000 people a year. Chronic dialysis was possible, thanks to two inventions: the artificial-kidney machine developed by the Dutch doctor Willem Kolff during World War II and a vascular-access device designed by Belding Scribner, a pioneering Seattle physician who opened the first outpatient dialysis center in the United States. But treatments were expensive, and most private insurers would not pay for them. At Scribner’s medical center, the Life or Death Committee parceled out the few slots, weighing not only the health of patients and their income, but also their perceived social worth.
News reports about the committee’s work sparked one of the earliest national debates over the right to care and put pressure on the government to step in. A turning point came when Shep Glazer, vice president of the largest patient group, made an emotional appeal to the House Ways and Means Committee as he underwent dialysis on the hearing-room floor. “If your kidneys failed tomorrow, wouldn’t you want the opportunity to live?” asked the 43-year-old father of two. “Wouldn’t you want to see your children grow up?”
The measure establishing taxpayer funding for treatment of end-stage renal disease, signed into law by President Richard M. Nixon, was expansive, and its lopsided, bipartisan approval reflected the times. Many lawmakers — even conservatives — thought the United States would adopt a European-style national health care system. Also, the program that took effect in July 1973 was expected to have about 35,000 patients and cost about $1 billion in its 10th year.
Those estimates came to seem almost laughable. The number of dialysis patients surpassed 35,000 by 1977 and has gone up from there. The growth reflected not only lower-than-expected transplant rates and the spread of diabetes, but also positive trends, like better cardiac care. With Americans living long enough for their kidneys to fail and no disqualifying conditions for the program, even the oldest and sickest patients increasingly were prescribed dialysis. Upwards of 100,000 now start treatment each year. “It’s been a perfect example of that line, ‘Build it and they will come,’” said Dr. Jay Wish, Director of dialysis services for University Hospitals Case Medical Center in Cleveland.
Because the kidney program absorbed that unforeseen wave — and thus prolonged so many lives — some call it one of the great success stories of modern medicine. Still, the annual bill for the program quickly outpaced early projections, surging past $1 billion within six years. Per-patient expenditures were expected to drop as technology advanced. Instead they have risen steadily, as drug and hospitalization costs grew for the program’s increasingly frail clientele.
Medicare has struggled to enforce quality standards for dialysis while meeting its prime directive of providing universal access. As the medical community’s understanding of kidney disease grew, the government set biochemical targets for improving care. Clinics got better at hitting them, but overall rates of death and hospitalization have seen little change. And Medicare’s record of making sure that clinics meet health and safety standards has been spotty. Clinics are supposed to be inspected once every three years on average, but as of October, almost one in 10 hadn’t had a top-to-bottom check in at least five years, as shown by data from the Centers for Medicare and Medicaid Services. About 250 facilities hadn’t had a full recertification inspection in seven years or more. Nursing homes, by contrast, must be inspected once every 15 months, and in 2006, CMS reported that 99.9 percent had been.
Even when inspectors find that clinics are not meeting government standards, the consequences are seldom meaningful. CMS can demand that facilities submit correction plans, but it cannot fine violators as it can nursing homes. The agency almost never imposes its toughest sanction — termination from Medicare — because clinic closures could hinder access to care. From 2000 to 2008, the agency barred just 16 dialysis facilities; federal regulations set no limits on how many violations are too many. “It’s a judgment call,” said Jan Tarantino, deputy director of CMS’s survey-and-certification group.
When the Memphis University Dialysis Center was terminated from Medicare in June 2007, the step had been at least four years in the making. During that time, the clinic was flagged for dangerous conditions, inadequate care, higher-than-expected mortality rates and subpar clinical results. CMS threatened to yank the unit’s certification in March 2006 and again the following year. Both times, however, even though inspectors continued to find problems, the agency allowed the clinic to stay open.
In April 2007, nine days after CMS sent the center a letter confirming that it was back in compliance, 66-year-old James “Tug” McMurry came in for treatment. When he had slow blood flow after being given his regular dose of blood thinner, staffers administered doses of a clot-dissolving medicine, according to a CMS survey. Later, a nurse told inspectors that a doctor had given a verbal order to administer the drug, but the doctor denied it, writing “This order was not given by me” on a form.
McMurry called one of his sisters, Betty Tindall, on his way home that day. “He said, ‘They don’t know what they’re doing up there,’” Tindall recalled. A couple of hours later, McMurry’s neighbor heard him bang on the shared wall between their apartments. “Help! Help!” he yelled. Paramedics found him slumped in a chair, vomiting. Tests at the hospital showed McMurry had suffered a devastating brain hemorrhage. By the time family members made it to his bedside, he was in an irreversible coma.
In an inspection three weeks later, regulators cited Memphis University Dialysis for failing to provide “safe dialysis services” and violating rules on the proper administration of drugs. They found multiple errors involving blood thinners, including one that resulted in the hospitalization of another patient. This time, CMS revoked the dialysis unit’s Medicare certification, prompting it to close. “It took people dying before they did anything,” said Bobby Martin, an attorney for McMurry’s brother and sister-in-law, who reached a confidential settlement with DaVita Inc., the clinic’s owner, in August 2009. (A DaVita official declined to comment on the case, citing patient privacy.)
CMS officials disputed the idea that they had acted too slowly. “Please understand that this is not an easy decision,” said Jessica Jenkins, a spokeswoman for the regional office that handled the matter. “We’re not in the business of putting facilities out of business.”
Full article available on TimesNews.net
Tense hours in the emergency room while tests confirm a heart attack may be rolled back to mere minutes, thanks to a telltale protein marker identified by Case Western Reserve University School of Medicine researchers. Better yet, a routine blood test for the nefarious protein could serve as an early warning to people at high risk :: Take steps now, and you may dodge the dangerous attack altogether.
When the proverbial elephant takes a seat on one’s chest, it is a decided hint: That person might be having a heart attack, or myocardial infarction (MI). Every 25 seconds, someone in the United States has one, according to the American Heart Association, but the oft-reported sensation of chest tightening or pain is just that-a clue. Even in the hospital, it can take eight to 12 hours for current tests to conclusively rule a heart attack in or out. Common alternative culprits in chest pain are intense heartburn or a gallstone attack.
Led by top physician-researcher Daniel I. Simon, MD, investigators at the School of Medicine, however, have discovered a marker of heart attack that promises to cuthours off the time for definitive MI diagnosis-to the tune of confirmation within 10 to 15 minutes of arriving at the emergency room. What’s more, a simple blood test for the novel myeloid-related protein-8/14 (MRP-8/14) marker could give long-used cholesterol screening a run for its money as a signal of MI in the making, years ahead of the cardiac attack.
“Though we gain great insight into patients’ potential risk for cardiovascular disease using conventional biomarkers, we are limited in identifying some people at risk,” says Douglas Vaughan, MD, professor of cardiology at Northwestern University’s Feinberg School of Medicine and chair of its Department of Medicine. “An additional marker measured in people’s blood could valuably refine our ability to take care of patients with coronary artery disease.”
To hone in on the up-and-coming predictive protein MRP- 8/14, researchers applied an unprecedented scientific approach that scoured entire human genomes for cardiac warning signs. “We were on the hunt. We wanted to know what genes turn on or off in heart attack patients,” explains Dr. Simon, the Herman K. Hellerstein Professor of Cardiovascular Research at the School of Medicine and director of University Hospitals Harrington Heart & Vascular Institute. Dr. Simon and his team of researchers identified MRP-8/14 as their best-bet marker for heart attack for use in emergency settings and as a potential companion to routine cholesterol screening in the doctor’s office.
Dr. Simon’s account is a tale of finding a little molecule with big potential-a project born in a lab in New England that has grown on a campus in Cleveland.
Read the full story at Medicus.
A $33.5 million commitment by Philips Healthcare and a $5 million Third Frontier grant from the state of Ohio will provide researchers at Case Western Reserve University, University Hospitals Case Medical Center, and Philips an opportunity to create medical imaging systems that will detect disease far earlier and be safer for patients than current methods.
The company and state announced the creation of the Global Advanced Imaging Innovation Center, to be housed at the University Hospitals Case Medical Center campus, at the same press conference where Gov. Ted Strickland designated Cleveland’s Health-Tech Corridor a state Hub of Innovation and Opportunity yesterday.
The corridor, created by the non-profit BioEnterprise and the economic-development corporation MidTown Cleveland, runs from downtown to University Circle. It includes Case Western Reserve, University Hospitals Case Medical Center (UHCMC), the Cleveland Clinic, Cleveland State University, Louis Stokes Cleveland VA Medical Center, and St. Vincent Charity Medical Center along with 75 biomedical companies, 45 technology companies and seven business incubators.
“We are pleased that the State of Ohio has awarded Ohio Third Frontier funding to our project,” said Jay Mazelsky, Senior Vice President and General Manager for Computed Tomography and Nuclear Medicine at Philips Healthcare. The company, which employs 1,100 in Highland Heights, has committed more than $6 million annually for five years, to the project.
“The goals of this center will be to provide strategic research, development and clinical validation for advanced imaging technologies, further developing our presence in northeast Ohio and building on our existing partnerships with Case Western Reserve University and University Hospitals.”
Using Phillip’s latest imagers, physicians and researchers from CWRU will help develop a variety of medical imaging technologies expected to enable doctors to see into the body’s molecules and atoms, revealing anatomical and functional information currently unattainable. They will test and improve imagers to provide for earlier diagnostics and better tracking of disease progression while increasing safety and comfort to patients.
Case Western Reserve is the lead agency for the state’s $5 million grant supporting the effort.
“This award is emblematic of the way that members of this corridor work together to achieve more than any organization could alone,” Case Western Reserve President Barbara R. Snyder said of the Third Frontier grant.
Snyder recounted the success CWRU has had in generating business and collaborating with hospitals and industry. As a result of professors’ research, the university has launched 24 companies since 2001; reaped $16.3 million in licensing revenue last year alone; and won an average of $385 million in state, federal and other grants during the last five years. In 2007, Case Western Reserve became lead agency, partnering with University Hospitals and Cleveland Clinic, on a $64 million Clinical and Translational Science Award – the largest single grant the National Institutes of Health has made in Northeast Ohio.
The announcements were made at the BioEnterprise building, in a room packed with Health-Tech Corridor boosters and members, including Cleveland Mayor Frank Jackson, Cuyahoga County Commissioner Tim Hagan, Cleveland Foundation President Ronn Richard and officials from UHCMC, Cleveland State University, the Cleveland Clinic and media.
The hub overlays the corridor. The new state designation comes with a $250,000 grant and gives research and development within the hub priority for future state grants.
Baiju Shah, president of BioEnterprise, said the Dutch-owned Philips could have chosen any location worldwide, but, “Their decision to locate their Center within the Cleveland Health-Tech Corridor is an example of what can happen when public entities led by the State of Ohio, private institutions, philanthropy and nonprofits collaborate.”
Congratulations to everyone who participated in the Department of Medicine 2010 Research Day. The event had a tremendous turnout of faculty and young investigators. We are very proud of the research you are producing.
Check out the pictures from this CWRUmedicine event …
Marco Costa, MD, PhD, Medical Director, Cath Lab, Director, Center for Research & Innovation, will be featured in an exclusive segment tomorrow on ABC’s Good Morning America between 7:30 and 8 am.
Dr. Costa was filmed in the Stereotaxis Lab in Lerner Tower conducting the United States’ first ever Optical Coherence Tomography (OCT) procedure using the newly FDA approved C7-XR Imaging System made by LightLab. A pair of Dr. Costa’s patients will be featured in the story highlighting the speed, accuracy and new imaging technology that provides doctors faster operating times and improved accuracy.
This breakthrough intravascular imaging technology allows the clinician to readily see and measure important vessel characteristics otherwise invisible or difficult to observe with older intracoronary imaging modalities. UH Case Medical Center served as the core lab in the study prior to its FDA approval and was responsible for analyzing the study results. To date, UH Case Medical Center is the only hospital in the country where this procedure is available for patients.
