Thomas Jefferson University Hospital - August 2005

Jeff Among Six Selected for Grant to Battle Infection Rates
(Published 8-26-05 to 9-1-05, Philadelphia Business Journal) Thomas Jefferson University Hospital was one of six Pennsylvania medical centers picked to receive a grant to help quantify the costs, and reduce the number, of hospital-acquired infections.

The demonstration project grants were funded through a partnership of the Pennsylvania Health Care Cost Containment Council (PHC4) amd tje Pittsburg-based Jewish Healthcare Foundation.

Jefferson's demonstration project targets infections tied to ventriculostomies, a procedure often performed on stroke patients to release excess pressure on the brain caused by a buildup of fluid.

The Center City hospital performs 90 to 100 ventriculostomies each quarter.

Dr. Jonathan Gottlieb, Jefferson's senior vice president for clinical affairs, said in the procedure a plastic catheter is inserted through the skull and into the brain to relieve the pressure. The surgery, Gottlieb said, carries a high risk for infections.

"We thought this grant program would be a great opportunity to try and reduce that rate to zero, or as close to zero as we can get," he said.

Jefferson will analyze every step of the procedure to search for opportunities to eliminate the chance for infection.

Media Coverage:
Philadelphia Business Journal

Botox for Migraines?
(Published 8-29-05, 7ABC News New York) Millions of Americans live in constant pain from daily headaches. For some sufferers, these headaches erupt into full-blown migraines. Now, Botox is giving some people the relief they've been waiting for.

More than 4.5 million Americans suffer from chronic daily headaches.

Dr. Stephen Silberstein, Thomas Jefferson University Hospital, Philadelphia: "Can you imagine what it's like to have a headache every day of your life?. To never wake up pain-free?"

Martha Fritz has headaches on most days of the month, every month. Those daily headaches often turn into migraines.

Martha Fritz, Headache Sufferer: "I can honestly tell you that it would be a 10 out of 10 on the pain scale. I was to the point I was desperate. I tried everything and anything."

Daily pain kept Fritz from work and from spending time with her mother. Needing relief, Fritz enrolled in a clinical trial on Botox, a poison that's commonly used to reduce wrinkles in the face. Some patients got Botox injections while others were injected with a saline solution.

Dr. Silberstein: "We found that in all the patients, headache frequency went down, but in the patients who got botulinum toxin type A, many more of them responded compared to simply getting the saline injections."
Department of Neurology
Jefferson Headache Center

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7ABC News New York

Easy Street is harder than you think Real-life scenarios help rehabilitations patients adapt to daily activities
(Published 8-23-05, News Journal) A Pontiac Grand Am with no engine, an ATM with no cash and a grocery store stocked with fruit you can't eat.

It can safely be said that Easy Street -- located on the sixth floor of Wilmington Hospital -- is not your typical city block. But it does come close, and therein lies the beauty of this collection of real-life scenarios situated in the middle of the hospital's rehabilitation center.

Stroke, spinal cord injury, amputation or a neurological disorder can complicate even the most basic of life activities. At most rehabilitation centers, physical therapy would involve work using balance beams, treadmills and parallel bars to help patients regain strength, flexibility and coordination and adjust to their new physical limitations. Occupational therapy would try to simulate some life activities through exercises that mimic them.

But since Easy Street's bank, beach, post office and grocery store were added in 1992, therapists and patients at Wilmington Hospital have had the luxury of real-life interaction without real-life restrictions.

Re-creating the combination of physical and cognitive challenges inherent in an activity like shopping is especially helpful for patients, said Melissa Towne, an occupational therapist with the department of rehabilitation at Thomas Jefferson University Hospital. Along with the physical tasks of standing, reaching and grabbing come intellectual demands like calculating prices and handling money.

Practicing clutching and lifting with a pegboard may be sufficient for patients who only need to improve their motor skills, Towne said. But a patient who has sustained a brain injury may not translate that simulation into actual behavior.

"It would be working on the movement pattern," she said. "But if I then moved them over to a kitchen, they're not going to be able to carry over that barebone activity into a functional activity."
Department of Rehabilitation Medicine

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News Journal

In future, ordinary lights may communicate, boost health
(Published 8-23-05, Associated Press) Scientists have been taking a closer look at the lighting in our homes, offices and vehicles, and they are seeing potential for a way to improve health and a new means of electronic communication.

Architects and lighting engineers might someday take body clocks into account when they design lighting schemes. They may be encouraged to take steps like providing plenty of natural light through windows and skylights, and installing bright blue LEDs near computer screens to give a dose of clock-adjusting light.

George Brainard, Ph.D., Professor of Neurology and director of the Light Research Program at Thomas Jefferson University, comments: Over the next two decades it will inspire engineers to look at "the redesign of virtually all human environments for lighting."
Department of Neurology

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Scleroderma attacks all but the brain
(Published 8-23-05, Wilmington News Journal)
Jane Turner, 48, was diagnosed with scleroderma, a chronic autoimmune disease, 17 years ago. The constant pain has caused her to change her lifestyle and spend most of her day indoors. Few people have heard of the disease, and those who have often think of it only as a skin problem, even though scleroderma can cause serious, life-threatening damage to internal organs.

Sergio Jimenez, M.D., director of the Scleroderma Center at Thomas Jefferson University Hospital, where about 1,500 patients from across the globe seek treatment, says the disease is very heterogeneous; it is not uniform. "No two patients are exactly the same."
Department of Medicine
Division of Rheumatology

Media Coverage:
Wilmington News Journal

Blood Enzyme May be Tip to Heart Failure
(Published 08-22-05, United Press International) Cardiac researchers at Jefferson Medical College have found an enzyme in the blood that could be a potential advance warning for heart failure.

A team of scientists led by Walter Koch, Ph.D., director of the Center for Translational Medicine in the Department of Medicine at Jefferson Medical College of Thomas Jefferson University, previously showed that an enzyme called GRK2 is critically important in heart function. It is increased in failing human hearts and contributes to the loss of the heart's contractile strength during heart failure.

Now, the researchers have shown, using samples from heart failure patients, that they could track heart levels of GRK2 in the blood.

"We can track levels of this kinase with a simple blood test," he says. "It appears consistent with the numerous animal studies we have done. When GRK2 is elevated in the blood, patients have more severe heart failure."
Department of Medicine

Media Coverage:
United Press International

Health: Ovarian Cancer Warning
(Published 8-22-05, CBS 3 Philadelphia)
A new study indicates that women with early warning signs of ovarian cancer are not being quickly diagnosed. Dr. Carmen Sultana, a gynecologist at Thomas Jefferson University Hospital, says that the symptoms of ovarian cancer are often mistaken for gastro-intestinal problems. Those symptoms include abdominal swelling, pelvic pain, indigestion or gas, feeling full and weight changes. "What you are trying to do is find out where they are having the pain. Is it the large bowel or is it the ovaries?" Dr. Sultana explains.
Department of Obstetrics and Gynecology
Division of Gynecologic Oncology

Media Coverage:
CBS 3 Philadelphia

Genetic Material Offers Potential SARS Treatment
(Published 8-21-05, Associated Press) Small fragments of genetic material that can silence specific genes are showing promise in battling the deadly severe acute respiratory syndrome. Researchers reported in the journal Nature Medicine that such fragments called interfering RNA, or siRNA, can reduce an existing infection in monkeys and help protect them from new ones.

Postdoctoral fellow Rajnish S. Dave, Ph.D. of the Institute for Human Virology and Biodefense at Jefferson said the study is significant for all siRNA-based treatment of viruses. It's also a step closer to translating these technologies to regular use. He said, however, that the use of siRNA-based technologies is limited in fighting respiratory viruses.
Institute for Human Virology and Biodefense

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Associated Press
USA Today
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Battling the Politics of Cancer
(Published 8-19-05, The Baltimore Sun) Even before the death of ABC anchorman Peter Jennings, advocates and scientists were organizing to combat lung cancer's image as a smoker's comeuppance and increase government funding to match other, equally deadly forms of cancer.

But they were perfectly willing to capitalize on the flurry of attention from Jennings' death from lung cancer Aug. 7 and the news a day later that Dana Reeve, widow of the late Superman star Christopher Reeve, also has the disease. There's general recognition in Washington that funding for medical research is not driven by science alone.

Researchers and advocates blame public attitudes for the fact that lung cancer research doesn't get as much federal funding as studies involving breast and prostate cancer, even though lung cancer kills far more Americans.

"We just haven't had the same level of patient, doctor and family advocacy," said Walter J. Curran Jr., clinical director of the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia and co-chair of a new association of scientists established to coordinate research and lobby for more money.
Radiation Oncology
Kimmel Cancer Center

Media Coverage:
The Baltimore Sun

National Public Radio -- A Talk with Hilary Koprowski
(Published 8-16-05, National Public Radio) In an interview with Dr. Moira Gunn of National Public Radio's BioTech Nation, Hilary Koprowski, M.D., professor of microbiology and immunology at Jefferson Medical College of Thomas Jefferson University, discussed how half a century ago he created the live polio vaccine. Dr. Koprowski talked about both his research then and today, his passion for music, and the creative mind.
Kimmel Cancer Center

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National Public Radio

Increasing U.S. supply of doctors proves tricky
(Published 8-12-05, Philadelphia Inquirer) Whitney Jackson thinks she's just a new medical student at Jefferson Medical College.

But the 24-year-old from Moorestown is part of the school's efforts to stem a national physician shortage expected to hit in two decades. The Philadelphia college increased enrollment from 228 a year to 255, one of the largest private medical school classes in the country, school officials said.

Thirty-one percent of medical schools said they planned to increase enrollment in the next few years, according to a 2004 association survey.

So far, Jefferson is the only school expanding in the region.

Thomas Nasca, dean of Jefferson's medical school, said it receives about 8,000 applicants for its incoming class, so officials are not worried about lowering the bar to add more students.

"The main thing we were concerned about was making sure students would have adequate clinical opportunities," such as working in the hospital or in ambulatory care, Nasca said. The school also built a new auditorium that can hold 300 people, he said.
Jefferson Medical College

Media Coverage:
Philadelphia Inquirer

Obesity Today, Alzheimer's Disease Tomorrow?
(Published 8-9-05, Fox News) People with diabetes are at particularly high risk of Alzheimer's disease.

High insulin levels are known to cause blood vessels to become inflamed. Inflamed tissues send off chemical warning signals. These warning signals set off an avalanche of tissue-damaging effects.

One dangerous effect of this insulin-caused brain inflammation is increased brain levels of beta-amyloid. Beta-amyloid is the twisted protein that's the main ingredient in the sticky plaques that clog the brains of people with Alzheimer's disease.

Because they are overweight and inactive - and because they may have genetic risk factors - many people have high insulin levels. It's not good for their hearts. And it's not good for their brains, says Samuel Gandy, M.D., Ph.D., director of the Farber Institute for Neurosciences at Thomas Jefferson University.

"I think this reinforces the idea that it's wise to maintain your brain," Dr. Gandy tells WebMD. "Controlling blood sugar and body weight - all those things we know are good for your heart health are also really good at preventing Alzheimer's disease. So there are more and more reasons not to be slouchy about getting these things under control."
Farber Institute for Neurosciences

Media Coverage:
Fox News

Health: Lung Cancer
(Published 8-9-05, KWY-TV) Dana Reeve, widow of actor Christopher Reeve, announced that she has been diagnosed with lung cancer. To many, the report came as a surprise because Ms. Reeve was apparently not a current cigarette smoker.

Medical oncologist Rita Axelrod, M.D., at Thomas Jefferson University Hospital says treatment for lung cancer has improved. "It not only prolongs life, it preserves quality of life and comfort."

Smoking is not the only cause of lung cancer, Dr. Axelrod says, although it is a primary cause. "Some chemical exposures, exposure to products of combustion, the combined effect of asbestos or radon, or certain chemicals will also increase the risk of lung cancer."
Department of Medicine
Division of Medical Oncology

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KYW-TV

Health: Lung Cancer
(Published 8-8-05, KYW-TV) The death of ABC News Anchor Peter Jennings Sunday at the age of 67 is focusing new attention on the disease that took his life.

Lung cancer is the number one cancer killer in America. Nearly 60 percent of people with lung cancer will die within one year of their diagnosis. Jennings was a heavy smoker and quit 20 years ago, but started again during the 9-11 attack on America.

"The single biggest risk factor is smoking and we need to work very hard to decrease the rate of smoking in this country," said Dr. Rita Axelrod.

Dr. Axelrod, a medical oncologist at Thomas Jefferson University Hospital, says even after years of heavy smoking, quitting will still have benefits. If you stop smoking by the age of 40 you can reverse your risk substantially almost to the same as the normal population," she said.
Department of Medicine
Division of Medical Oncology

Media Coverage:
KYW-TV

Health: Breast Cancer
(Published 8-8-05, KYW-TV) A sweeping new study says survival rates for breast cancer are improving.

Breast cancer tumors are often small when they are discovered and researchers say that is why more women are surviving.

Medical oncologist, Rita Axelrod, M.D., at Thomas Jefferson University Hospital says early detection and treatment is the key to surviving breast cancer. "Most women who have lumps discovered when they're small can be treated with breast conserving surgery," she says.

Early detection usually comes with regular mammograms after age 40 and now, 70 percent are getting yearly mammograms, Dr. Axelrod added.
Department of Medicine
Division of Medical Oncology

Media Coverage:
KYW-TV

Some health systems explore laborists idea
(Published 8-8-05, USA Today) By hiring what have been called "laborists" and paying their malpractice insurance costs, the hospital could take the pressure off community doctors and possibly help with two related problems. Nationwide, fewer doctors, including obstetricians, want to serve "on call" for hospital emergency rooms. And rising malpractice insurance costs are causing some obstetricians to retire or cut back on OB services.

One proponent, Louis Weinstein, M.D., chairman of the department of obstetrics and gynecology at Jefferson Medical College, says laborists may eventually become commonplace, with women having one doctor for prenatal care and a different one to deliver her baby.

In the traditional practice of obstetrics, obstetrician/gynecologists juggle a variety of roles - delivering babies, performing hysterectomies, doing office visits and providing prenatal care - efforts that sometimes keep doctors busy around-the-clock.

"It just doesn't work anymore," says Dr. Weinstein. "Young people don't like to work these hours, and it's not good for patient safety."

Dr. Weinstein estimates there are about 10 hospitals nationwide using laborists, whom he says can save hospitals money by helping them avoid malpractice lawsuits. One of the biggest causes of malpractice cases in obstetrics, Dr. Weinstein says, is when labor goes awry and an OB isn't immediately available.
Department of Obstetrics and Gynecology

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USA Today

Rapid Scan Helps Diagnose Dangerous Childhood Cancer
(Published 8-04-05, HealthDay) A customized gene chip that scans DNA regions in tumor samples to detect genetic changes in the children's cancer neuroblastoma has been developed by researchers at Thomas Jefferson University and The Children's Hospital of Philadelphia.
Instead of scanning the entire genome, this gene chip zeroes in on suspect regions of chromosomes for evidence of deleted genetic material known to play a role in neuroblastoma. This technique can be adapted for other forms of cancer. The study appears in August in the journal Genome Research.

"We have customized this tool for neuroblastoma, but the approach might also be adapted to other types of cancer in which DNA changes are important," says study co-author Paolo Fortina, M.D., Ph.D., professor of medicine at Jefferson Medical College of Thomas Jefferson University.
Department of Medicine

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Smalley survives cancer, so what's a marathon?
(Published 8-3-05, Courier-Post) For Suzanne Smalley, going out for a run nowadays is more than just working up a sweat and getting her heart rate going. Instead, when Smalley returns from working out, she thinks about how great it is to still be alive and back to living her normal life.

And considering what Smalley has been through in the past couple of years, that's the greatest feeling in the world.

In July of 2003, the 25-year-old Smalley, who lives in Philadelphia now, but grew up in Washington Township, was diagnosed with Hodgkin's Lymphoma. And just like that, Smalley's world was thrown off.

For treatment, Smalley went to Thomas Jefferson Hospital, where she was under the care of Dr. Neal Flomenberg. She went through chemotherapy from August of 2003 to February of 2004, and after about 12 treatments, all the cancer cells were dead.

"Yeah, I knew I would beat it," Smalley said. "I had to be confident. Even on the worst days, I knew I was fighting for something that was worth it."

But with perseverance, the strong-willed Smalley got through the disease, and by November 2004, her cancer was in remission. Now, Smalley is back to living the life she did prior to her diagnosis.

And one of her favorite activities is going out for a run.
CancerCare at Jefferson
Philadelphia Distance Run

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Courier-Post

Patients Heal Thyself?
(Published 8-1-05, The Jewish Exponent) In the United States, a potentially problematic medical trend has a growing number of people medicating themselves, as they turn the old phrase, "Physician heal thyself," to "Patient, heal thyself."

"While a lot of people can perform self-diagnosis successfully, and it's a good idea for minor things - such as a sore throat or cold from a virus, which could include upper-respiratory congestion - those who do have to be very careful, and should definitely see their doctor if either symptoms persist for a couple of weeks or become worse in that time," says David Axelrod, M.D., an internal medicine associate at Thomas Jefferson University Hospital and instructor of medicine at Jefferson Medical College.

"Also, they have to be aware that what they're treating themselves [for] actually could be a sign of a much more serious condition. Either a persistent fever or prolonged weight loss could [indicate] something more serious, just as heartburn and chest pain might really be a symptom of a cardiac problem and not simply indigestion," says Dr. Axelrod.
Department of Medicine
Division of Internal Medicine

Media Coverage:
The Jewish Exponent

Heart Drug Helping African Americans
(Published 7-29-05, CBS 3) A new drug is making its appearance in the Philadelphia market which holds great promise for improving quality of life for African Americans with serious heart problems.

Bidil is the first drug tested for a specific ethnic group.

Dr. Paul Mather, M.D., medical director, Advanced Heart Failure and Cardiac Transplant Center at Thomas Jefferson University Hospital, says the clinical trial showed Bidil significantly improved survival rates among African American patients.

"It showed a 43 percent improvement in multiple parameters in the study," said Dr. Mather. "Those of us in this profession will be thrilled with a 15-percent improvement."

Bidil, a product of Nitromed, is not a new chemical compound. It combines two drugs known to control blood pressure and ease the contraction of the heart muscle into one pill. It is a medication that is added on to standard heart failure therapy, not replacing it.

"But whether this is the next step in its therapy or is it opening of a door into a whole new avenue of tailored therapy, where we target the individual genetics of every patient," said Dr. Mather.
Department of Medicine
Division of Cardiology

Media Coverage:
CBS 3