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Feed for "Health + Behavior" newsClaude Bruni has 98 marathon races under his belt, including every Los Angeles Marathon since 1986. Nothing can keep Bruni, who’s 80, from running. Not even major surgery, as it turns out. Allergy sufferers can expect a bumper crop of weeds and pollen

California experienced record rainfall this year and may have even made headway against the state’s historic drought. Now that lush landscapes abound and spring is upon us, what does this mean for allergy sufferers? 

The wet weather can be a harbinger of intense allergy-related symptoms such as nasal drainage, sinus congestion, headaches and shortness of breath, according to Dr. Maria Garcia-Lloret, an allergist with UCLA Health. It’s not the rain that causes the symptoms, according to Garcia-Lloret, but the rain’s effect on trees, grass and weed pollen.

For one thing, the increased plant growth following years of lackluster rains will cause the spore count in many areas to soar. For another, raindrops can cause pollen grains to burst into smaller particles, which are then released into the air at a much higher concentration.

UCLA Dr. Maria Garcia-Lloret

“Because of the smaller size, the pollen can enter the small airways and noses of susceptible people and cause them to have an allergic reaction,” says Garcia-Lloret. 

Additionally, mold spores can increase after heavy rains, causing even more suffering for people allergic to mold. Following a thunderstorm, mold is the main cause of allergic asthma exacerbations.

The U.S. Geological Survey also has daily maps that show how early spring has arrived in states across America, and that can portend a more vigorous pollen season, according to a Vox article.

The common sneezing, drippy noses and itchy eyes experienced by both adult and child  seasonal allergy sufferers can be unpleasant enough, but those with asthma or other serious respiratory symptoms need to be especially prepared with proper allergy medication.

There are non-medical steps you can take to lessen the effect of rain allergies, says Garcia-Lloret, citing tips from the National Institutes of Health

  • Limit your pollen exposure: Roll up the windows in your car or home.
  • Run a HEPA filter or fan at home to circulate air through your house.
  • Keep a tissue box, antihistamines and nasal sprays on hand.
  • When you are outdoors, pollen is falling on you. Take a shower every night and wash your hair and skin, so you are not sleeping in the very substances that aggravate your symptoms.
  • Minimize time outdoors when there are high pollen counts, such as early in the morning. If you’re gardening, get inside and take a quick shower to get the pollen off your hair and body. Wear glasses to protect your eyes and a hat to protect your face; the nose and mouth are entrances for pollen so a facemask might be helpful.

Many allergy symptoms will abate with help from over-the-counter medications, including antihistamines and nasal steroids but the relief is often transient and incomplete. People with more severe symptoms — the kind that significantly disrupt daily routines — should see a doctor and get tested to identify their specific triggers. Many patients benefit from regular allergy shots that remedy symptoms, or oral immunotherapy tablets that can be placed under the tongue to combat the causal allergy.

For those hoping to ride out the allergy season, be patient. Pollen levels tend not to drop until after three 100-degree days in a row, a weather event that generally does not occur until after Memorial Day.

In the meantime, there’s no reason allergy sufferers can’t enjoy the enhanced greenery and flowers of a beautiful California spring if they follow a few common-sense precautions. You can take the following seasonal allergy quiz and allergy quiz to learn more about the signs, symptoms and a few simple steps to keep allergies at bay for a good start to a healthier spring.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Ambrosia_artemisiifolia_9364-65.jpgCommon ragweedThe wet weather, while beneficial to plants, like ragweed, can be a harbinger of intense allergy-related symptoms such as nasal drainage, sinus congestion, headaches and shortness of breath.

The wet weather, while beneficial to plants, like ragweed, can be a harbinger of intense allergy-related symptoms such as nasal drainage, sinus congestion, headaches and shortness of breath.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Ambrosia_artemisiifolia_9364-65.jpgCommon ragweed

The wet weather, while beneficial to plants, like ragweed, can be a harbinger of intense allergy-related symptoms such as nasal drainage, sinus congestion, headaches and shortness of breath.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/MGarcia-Lloret_17885_03.jpgDr. Maria Garcia-Lloret

Dr. Maria Garcia-Lloret is an allergist with UCLA Health.

RoxanneMoster310-267-7022rmoster@mednet.ucla.eduCalifornia experienced record rainfall this year, and may have even made headway against the state’s historic drought. Now that lush landscapes abound and spring is upon us, what does this mean for allergy sufferers?  Roxanne Mosterhttp://newsroom.ucla.edu/stories/heavy-winter-rains-are-nothing-to-sneeze-atFri, 24 Mar 2017 00:03:00 GMTUCLA public health experts say poorer neighborhoods lack access, outdoor amenities

What are the societal factors that influence health?

When Dr. Richard Jackson asks this question, the response often includes some combination of economics, education and culture. Rarely does he hear the one he is looking for: the physical environment of one’s neighborhood.

“If it’s not easy to walk to places, you’re surrounded by unhealthy food choices, and you spend hours each day driving to and from your job, that’s a powerful determinant of your health,” says Jackson, a pediatrician and professor in the Department of Environmental Health Sciences in UCLA’s Fielding School of Public Health.

A well-known author, lecturer and consultant on how to align urban environments  with public health goals, Jackson has called the built environment “social policy in concrete,” given the impact of urban planning and architectural design on health and well-being. Unfortunately, Jackson notes, “communities that don’t have a strong voice are more disenfranchised when these decisions are made.”

At the Fielding school, faculty and students are working with community partners and policymakers in Los Angeles and beyond to ensure that decisions about everything from buildings and green spaces to public transit, bike lanes and streetscapes are made with an eye on their public health implications.

Of particular interest is the notion of transportation equity — matching the infrastructure of communities with the needs of their populations.

Michael Jerrett, professor and chair of the Department of Environmental Health Sciences, points out that in Los Angeles and many other cities, inequities persist not just in the ability to get around, but in access to parks and open spaces that are conducive to outdoor activity. In addition to their value to our quality of life, these facilities are critical at a time when sedentary lifestyles are associated with high rates of obesity and related chronic conditions such as diabetes, cardiovascular disease and certain cancers.

In a series of studies, Jerrett has found wide-ranging disparities between low-income communities and more affluent areas in both the quantity and quality of park spaces. “People living in low-income communities aren’t getting sufficient access to this health-promoting resource, and when they do have access, the area tends to be more polluted, the park facilities are not as well-maintained, and there is less park programming and less energy going into the programs offered,” Jerrett says.

Most recently, Jerrett’s group found that for pedestrians and bicyclists in Los Angeles, traveling to and from parks is dangerous — with as much as a 50 percent greater risk of traffic accidents in the area within a quarter-mile of the destination.

The study found that the risk is amplified in low-income and predominantly minority communities, in part because of an insufficient safety infrastructure. Jerrett notes that children and young adults are disproportionately at risk for traffic-related injuries and fatalities around parks. “There has been a movement toward instituting safe routes to school and safe routes to transit,” he says. “Given the unequivocal evidence of the benefits of physical activity, we need to also focus on ensuring safe routes to play.” Jerrett is currently consulting with the Southern California Association of Governments to integrate his group’s research into ongoing transportation planning.

Efforts to encourage more walking and bicycling face significant obstacles, and not just around parks. Jerrett notes that in Los Angeles, surveys consistently show personal safety concerns as a major barrier to bicycling.

“Unless you have an integrated system in which people can have options that allow them to bike away from dangerous roads and intersections, safety is going to be a deterrent,” he says. Advocates for more pedestrian-friendly boulevards must also overcome major challenges. “Unlike many European cities that evolved at a time when walking was the predominant mode of transportation, much of Los Angeles was developed around a car-dominated culture,” Jerrett says.

Nonetheless, there is growing momentum behind initiatives to reclaim the built environment for walkers and bikers — as illustrated by the success of CicLAvia, a Los Angeles nonprofit organization that temporarily closes a section of streets to vehicular traffic for Sunday events that promote walking, biking, local commerce and community engagement. CicLAvia reports that it has created more than 110 miles of open streets during its events throughout Los Angeles and has drawn more than 1 million people to these streets since it began in 2010. The next event is set for Sunday, March 26, when streets in Culver City, Mar Vista and Venice will be closed to vehicles.

In 2014, a Fielding school group embarked on a series of studies assessing CicLAvia’s impact. The researchers started with basic questions around who was attending the events and what impact CicLAvia had on businesses along the routes, but they quickly realized that something special was occurring — a dramatic shift in the physical and social environment that, though technically only for a day, could have long-term ramifications.

Among the benefits: improved air quality. A 2015 study led by Yifang Zhu, associate professor of environmental health sciences, measured air pollutants during a CicLAvia event held in and around downtown Los Angeles and found substantial declines in the presence of ultrafine particles and particulate matter measuring 2.5 micrometers or smaller — both of which are associated with increased risk for respiratory and cardiovascular disease.

Courtesy of CicLAvia UCLA public health researchers have found that CicLAvia events, even if they only last a day, have the potential of delivering longer-lasting health benefits.

“Not only does CicLAvia reduce the concentrations of traffic-emitted air pollutants, but we were also struck that the reduction of particulate pollution extends beyond the CicLAvia route,” Zhu says. Other studies by Fielding school researchers found more good news: significant reduction in crime around CicLAvia sites on the event days.

The researchers found that more than half of the participants surveyed would have been home or sedentary if not at the event. And fewer than half of CicLAvia’s participants arrive by car — opting for transit, biking and walking instead. Initial evidence also suggests that the more events the participant attended, the less likely that person arrived by car. “This could be pointing to alternative transportation behaviors being promoted or reinforced by CicLAvia attendance, though further study is needed,” says Christina Batteate, a Fielding school Ph.D. student who helped spearhead the CicLAvia research effort.

The team also found that when CicLAvia’s temporary public space is located in park-poor, low-income communities, a substantial number of the participants are first-time attendees from the local area. “At each event, thousands of new people are being exposed to this new paradigm of what our city can look like and how fun mobility and social connections can be,” Batteate says. “CicLAvia and other open-streets programs tangibly flip the narrative by saying that pedestrians and bicyclists matter. Even if for a day, this allows the community to envision that it can be something different.”

This story is in the UCLA Fielding School of Public Health Magazine.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Family+Heart+of+LA+2016.jpgFamily at Heart of LA 2016 CicLAvia rideBy opening up more than 110 miles of open streets in urban neighborhoods during its popular events, the L.A. nonprofit CicLAvia has shown people that walking, biking and interacting socially outdoors are possible in the city and can be fun. The next event is Sunday, March 26, when streets in Culver City, Mar Vista and Venice will be open to people minus their cars.

CicLAvia has created more than 110 miles of open streets during its events throughout Los Angeles and has drawn more than 1 million people to these streets since it began in 2010.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Family+Heart+of+LA+2016.jpgFamily at Heart of LA 2016 CicLAvia ride

CicLAvia has created more than 110 miles of open streets during its events throughout Los Angeles and has drawn more than 1 million people to these streets since it began in 2010.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/bike+scene+Heart+of+LA+2016.jpgBike scene during a CicLAvia event in L.A. in 2016

Participants in CicLAvia's Heart of L.A. event in 2016.  

CarlaDenly310-825-6738cdenly@support.ucla.eduIn L.A. and other cities, inequities persist not just in the ability to get around, but in access to parks and open spaces that are conducive to outdoor activity. Dan Gordonhttp://newsroom.ucla.edu/stories/public-health-experts-find-poor-neighborhoods-lack-access-to-parks-open-spaceWed, 22 Mar 2017 18:46:00 GMTUCLA research could help improve understanding of Parkinson’s, Huntington’s and Tourette’s

In his famous experiment, Russian scientist Ivan Pavlov rang a bell each time he fed his dogs. Soon, the dogs began drooling in anticipation when they heard the bell, even before food appeared.

Now, a UCLA study has traced the Pavlovian response to a small cluster of brain cells — the same neurons that go awry during Huntington’s disease, Parkinson’s disease and Tourette’s syndrome. Published March 22 in the journal Neuron, the research could eventually help scientists identify new approaches to diagnosing and treating these neurological disorders.

“Species survive because they’ve learned how to link sensory cues like specific sounds, smells and sights to rewards like food and water,” said Sotiris Masmanidis, the study’s senior author and an assistant professor of neurobiology at the David Geffen School of Medicine at UCLA. “We wanted to uncover the brain circuitry that encodes reward-based learning and behavior.”

The UCLA team focused on cellular activity in the striatum, a part of the brain associated with reward, movement and decision-making.

In a modern version of Pavlov’s experiment, Masmanidis and colleagues repeatedly exposed mice to the unfamiliar scent of banana or lemon, followed by a drop of condensed milk. Eventually, the mice learned that the fragrances predicted the arrival of a sweet reward and began fervently licking the air in anticipation.

“The mice learned to associate the new scent with food, just like Pavlov’s dogs,” said Masmanidis, who is also a member of UCLA’s California NanoSystems Institute and Brain Research Institute. “Our next step was to uncover what happens to the Pavlovian response when we silence different groups of cells in the striatum.”

Based on clues from earlier studies, the team zeroed in on a tiny group of cells that support the principal neurons in the striatum. Although these supporting players comprise fewer than 2 percent of the cells in the region, the scientists were surprised to discover that they play a disproportionately important role. Using a combination of specialized electrodes and optogenetics — the use of light to control cells — they were able to “turn off” those support cells.

“When we switched off the support cells, the mice licked the air in anticipation of the milk only half as often as normal,” Masmanidis said. “We suspect that the support cells enhance the brain circuits that encode Pavlovian response.”

The support cells’ influence appeared strongest when the mice were first learning to pair the unfamiliar scents with a reward. The change was less dramatic in mice who had already mastered the connection.

“These cells were most essential to inexperienced mice who hadn’t yet mastered the Pavlovian response,” Masmanidis said.

The findings suggest that neurological disorders could be caused in part by malfunctioning support cells, and that restoring the cells’ function may eventually help people with these diseases.

More than a century after Pavlov’s classic study, there is still much to learn about Pavlovian responses. “Our findings open up exciting opportunities for further studying the roles of different types of neurons in health and disease,” said Kwang Lee, a UCLA postdoctoral researcher in neurobiology and a co-first author of the study.

The paper’s other co-authors are co-first author Sandra Holley, Justin Shobe, Natalie Chong, Carlos Cepeda and Michael Levine, all of UCLA.

The study was funded by the McKnight Endowment Fund for Neuroscience, the National Institute on Drug Abuse, the National Institute of Neurological Diseases and Stroke, and the National Science Foundation.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Striatum.jpgStriatumThe new study focused on cellular activity in the striatum, a part of the brain associated with reward, movement and decision-making.

Rendering of the human brain, highlighting the striatum, which is associated with reward, movement and decision-making.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Striatum.jpgStriatum

Rendering of the human brain, highlighting the striatum, which is associated with reward, movement and decision-making.

ElaineSchmidt310-267-8323 (o) | 310-597-5767 (c)eschmidt@mednet.ucla.eduA UCLA study has traced the phenomenon to the same neurons that go awry during Huntington’s disease, Parkinson’s disease and Tourette’s syndrome. Elaine Schmidthttp://newsroom.ucla.edu/releases/study-identifies-brain-cells-involved-in-pavlovian-responseWed, 22 Mar 2017 16:28:00 GMTDoctors discovered a benign mass was causing the 9-year-old’s giggling fits

​Justin Cho is an engaging 9-year-old. Although he’s somewhat shy, he is quick to smile and has an infectious laugh.

“Justin has always been a happy child — very energetic and bubbly,” said his father, Robert Cho. “We assumed that giggling was just part of his personality.”

What Robert and his wife, So, didn’t know was that the laughing fits he often had before bedtime were actually seizures and signs of a serious medical problem. One morning as Justin was waking up, the couple saw him go into a full seizure.

“We were terrified,” Robert Cho said. “Had we not witnessed it ourselves, who knows how long these would have gone on?”

The Chos brought Justin to UCLA Mattel Children’s Hospital, where he was treated by Dr. Aria Fallah, a pediatric neurosurgeon.

“Justin had what’s known as gelastic epilepsy, which was caused by a benign mass called a hypothalamic hamartoma, deep inside his brain,” Fallah said.

Hypothalamic hamartomas are extremely rare, but left untreated they can affect a child’s IQ and ability to learn, and can cause premature puberty and death.

The condition rarely responds to medication, which makes surgery the only treatment option. But the surgery most often used to correct the problem is particularly difficult because the masses are located deep inside the hypothalamus, the part of the brain that regulates hunger, thirst, body temperature and hormones.

“You couldn’t find a more challenging spot to treat in the human body,” Fallah said. “The hypothalamus is difficult to access and surrounded by critical nerves, arteries, veins and neurological tissue that are vital to everyday functions.”

Removing a hypothalamic hamartoma typically requires open-brain surgery: Surgeons remove a large section of the skull and slice open the brain to reach the lesion. The surgery leaves a large scar on the patient’s head and, because the procedure is so invasive, patients generally remain in intensive care for up to a week and require months to fully recover. Side effects can include memory loss, hormonal imbalance and vision problems. Up to 10 percent of patients do not survive the surgery — a high figure compared with more common procedures.

So Fallah and his colleagues used a cutting-edge technique designed to minimize the risks and dramatically speed up Justin’s recovery. The approach uses heat from an optical laser to destroy the mass.

Surgeons made a 2 millimeter incision in Justin’s skull and, using GPS-like technology, mapped his brain and pinpointed the location and size of the hamartoma. Then, they fed a thin optical laser deep into the brain and penetrated the lesion.

“Essentially, we cook the mass from the inside out,” Fallah said. “Once it’s destroyed, the epilepsy is gone.”

Although preparing for the surgery and mapping the patient’s brain can take several hours, the minimally invasive procedure itself takes only a few seconds. And the results last a lifetime.

“The last seizure patients ever have is the one they experience right before surgery,” Fallah said. “They wake up and the seizures are completely gone. And the child can go home the next day and resume normal activity almost immediately.”

In Justin’s case, that meant getting back to playing soccer with his friends and sharing laughs with his family.

“It’s a miracle,” Robert Cho said. “We’re so grateful we learned in time that Justin had this issue and that we found doctors who were able to treat it the way they did.”

Now, whenever the Chos hear their son giggling, they’ll know it’s simply because he’s happy.

Journalists: Please email or call the UCLA Health Sciences media contact for B-roll, sound bites, web elements and high-resolution still photos.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20171/Cho+family.jpgCho familyRobert and Justin Cho enjoying a board game at home. UCLA doctors used an optical laser to destroy a benign mass in Justin’s brain.

Robert and Justin Cho

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20171/Cho+family.jpgCho family

Robert and Justin Cho

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20171/Fallah.jpgFallah

Dr. Aria Fallah

ElaineSchmidt310-267-8323 (o) | 310-597-5767 (c)eschmidt@mednet.ucla.eduJustin Cho was experiencing a rare form of epileptic seizures caused by a lesion in his brain; UCLA Mattel Children’s Hospital used a new minimally invasive approach to stop them.Elaine Schmidthttp://newsroom.ucla.edu/releases/ucla-surgeons-minimally-invasive-procedure-cure-boy-rare-form-of-seizuresWed, 22 Mar 2017 09:00:00 GMTUCLA RESEARCH ALERTFINDINGS

For non-depressed, pregnant women with histories of major depressive disorder, preventive treatment with antidepressants may not necessarily protect against postpartum depression, according to new UCLA-led research. In addition, asking questions about daily activities — especially work — appears to be an effective screening tool for helping doctors identify women at risk of depression after they have their babies.

BACKGROUND

Twenty percent of adult women will experience an episode of major depressive disorder at some point in their lives. Women with a history of depression are particularly vulnerable to depression after they give birth. The researchers recognized that there is a lack of data on predictors of postpartum depression in women with previous histories of depression but who don’t suffer from it during pregnancy.

METHOD

From April 2003 to March 2009, researchers recruited 343 pregnant women who were not suffering from depression at the time of conception but who had been diagnosed with major depressive disorder at some time prior to pregnancy. Women with bipolar disorder, schizophrenia or a substance abuse disorder were not included.

Scientists enrolled participants in the study between 12 and 36 weeks gestation. A study psychiatrist assessed each woman’s mood and psychotropic medication at least twice, once within 60 days before their babies’ due dates and again within 60 days after delivery. The researchers used structured, clinical interviews including questions about work activities and difficulties, insomnia and suicidal thoughts.

IMPACT

The findings suggest that structured interviews about difficulties at work could alert doctors to women at risk of postpartum depression who might benefit from being referred to a psychiatrist for monitoring after they give birth.

In contrast to previous studies, the researchers found that among women with prior histories of major depressive disorder but who were not depressed when they become pregnant, only 11 percent developed postpartum depression. That figure is significantly lower than the 25 to 40 percent depression occurrence found in other studies.

AUTHORS

Dr. Rita Suri, Dr. Vivien Burt, Ana Aquino-Elias and the late Dr. Lori Altshuler, all of the David Geffen School of Medicine at UCLA; Dr. Zachary Stowe and Bettina Knight of the University of Arkansas; Dr. Lee Cohen of Harvard Medical School; Dr. Jeffrey Newport of the University of Miami; and Jim Mintz of the University of Texas Health Science Center, San Antonio.

JOURNAL

The study was published in the Journal of Clinical Psychiatry.

FUNDING

Funding for the research was provided by the National Institute of Mental Health.

LeighHopper310-267-7149 LHopper@mednet.ucla.eduUCLA-led study showed also that preventive antidepressants didn’t affect risk of postpartum depression in pregnant women with previous history of major depressive disorder.Leigh Hopperhttp://newsroom.ucla.edu/releases/clinical-interviews-effective-in-predicting-post-partum-depression-among-expectant-womenTue, 21 Mar 2017 22:45:00 GMTUCLA RESEARCH ALERT Ting Zhang and Ming Guo/UCLA In IBMPFD-diseased fruit flies, muscles are damaged and mitochondria severely disrupted. (Red circles highlight representative damaged mitochondria.) Treatment of VCP inhibitors in these diseased flies reverts muscle pathology and rescues mitochondrial damage. (Green circles highlight representative rescued mitochondria.)   FINDINGS

UCLA researchers have discovered the molecular basis of, and identified potential treatment for, an incurable disease known as inclusion body myopathy, Paget disease with frontotemporal dementia, or IBMPFD. Using both genetically engineered fruit flies that have the fly equivalent of the disease gene as well as cells from people with IBMPFD, the researchers discovered how mutations carried by those with IBMPFD cause cellular damage. They also identified two compounds that are able to reverse the effects of IBMPFD-associated mutations in flies and human IBMPFD cells. The findings suggest potential strategies to combat IBMPFD and other degenerative diseases, including amyotrophic lateral sclerosis, commonly known as ALS.

BACKGROUND

IBMPFD is an inherited disorder that affects the muscles, the brain and bones. Most people with the disorder show progressive muscle weakness, or myopathy, leading to mobility loss or even respiratory failure. Others develop dementia that predominantly affects language and behavior. No treatment is available to halt progression of the disease. Prior studies showed that mutations in a gene that encodes Valosin-Containing Protein, known as VCP, cause IBMPFD and some forms of ALS. Moreover, in people with IBMPFD, mitochondria, the energy-generating powerhouse of the cell, do not produce energy properly. However, it was not clear how VCP mutations disrupt mitochondria and how this disruption leads to disease.

METHOD

The team created fruit flies that are given the disease in their muscles, which results in multiple defects, including muscle cell death, similar to that seen in patients. In addition, abnormally small, fragmented mitochondria appeared, a sign of mitochondrial distress. This led the team to examine a protein called Mitofusin which controls mitochondria fusion, maintaining mitochondrial energy-production capacity in healthy cells. The team showed that VCP normally degrades Mitofusin, but mutant VCP is abnormally overactive, and promotes excessive degradation of Mitofusin. This discovery explains how cellular damage occurs. Most importantly, flies fed VCP-inhibiting compounds showed reversal of muscle wasting and mitochondrial fragmentation. Patient cells treated with the same compounds showed similar positive responses.

IMPACT

Biomedical researchers are increasingly aware that defects in mitochondrial fusion are a hallmark of conditions ranging from Parkinson’s disease, heart disease to diabetes. This paper reveals how mutant VCP can cause cellular destruction seen in IBMPFD by interfering with proteins responsible for controlling mitochondrial fusion. Importantly, VCP inhibitors can reverse the pathology of IBMPFD in flies and in patient cells. VCP inhibitors are currently being studied in clinical trials for cancer. This raises the possibility of using VCP inhibitors for treatments of IBMPFD and other diseases caused by VCP mutations, such as ALS, peripheral neuropathy and hereditary spastic paraplegia.

AUTHORS

The senior author of the study is Dr. Ming Guo, and the first author is Dr. Ting Zhang, both of the department of neurology in the David Geffen School of Medicine at UCLA. Additional co-authors include Dr. Prashant Mishra, Bruce Hay and Dr. David Chan, all working at California Institute of Technology.

JOURNAL

The research is published in the journal eLife. 

FUNDING

This work was supported by the National Institutes of Health (NIA R01, NINDS Eureka award), the Natalie R. and Eugene S. Jones Fund in Aging and Neurodegenerative Disease Research, the Kenneth Glenn Family Foundation, the McKnight Neuroscience Foundation and the Ellison Medical Foundation.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Mitochondria.jpgMitochondriaIn IBMPFD-diseased fruit flies, muscles are damaged and mitochondria severely disrupted. (Red circles highlight representative damaged mitochondria.) Treatment of VCP inhibitors in these diseased flies reverts muscle pathology and rescues mitochondrial damage. (Green circles highlight representative rescued mitochondria.)

In fruit flies modeled with IBMPFD disease, muscles are damaged and mitochondria (red circles) are severely disrupted. Treatment of VCP inhibitors in these diseased flies revert muscle pathology and mitochondrial damage (green circles). 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Mitochondria.jpgMitochondria

In fruit flies modeled with IBMPFD disease, muscles are damaged and mitochondria (red circles) are severely disrupted. Treatment of VCP inhibitors in these diseased flies revert muscle pathology and mitochondrial damage (green circles). 

TamiDennis310-267-7007tdennis@mednet.ucla.eduFindings in a UCLA study suggest potential strategies to combat other diseases, including amyotrophic lateral sclerosis, commonly known as ALS.Elise Lamarhttp://newsroom.ucla.edu/releases/ucla-research-potential-treatment-for-muscle-and-brain-degenerative-diseaseTue, 21 Mar 2017 12:01:00 GMTResearchers say states that participated under Affordable Care Act also saw longer wait times for low-income residents

States that participated in Medicaid expansion under the Affordable Care Act, or ACA, saw increased numbers of insured, better access to care and less worry about paying medical bills, but also longer wait times among low-income residents, according to new research.

In a study published this month in the New England Journal of Medicine, Laura Wherry, assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, and Sarah Miller, assistant professor of business economics and public policy at the University of Michigan, analyzed survey data from states that participated in the Medicaid expansion and states that declined.

Under the Affordable Care Act, Medicaid eligibility was expanded to individuals earning up to 138 percent of the federal poverty level. Though the expansion was initially intended to apply to all states, a U.S. Supreme Court ruling left the decision as to whether to expand up to the states. As of January 1, 2017, 31 states and the District of Columbia have adopted the Medicaid expansion, according to the Kaiser Family Foundation.

The researchers found that the numbers of uninsured dropped in the expansion states in year two after implementation by 8.2 percentage points and Medicaid coverage increased 15.6 percentage points among low-income residents when compared with non-expansion states.

Though expansion wasn’t associated with significant changes in health status, expansion states saw an increase in the ability of low-income residents to afford follow-up care — 3.4 percentage points compared with non-expansion states — and fewer reports of concerns about paying medical bills — a decrease of 7.9 percentage points compared with non-expansion states.

“Medicaid expansion appears to help low-income adults afford the medical care they need,” Wherry said.

The study comes as Congress debates a proposed replacement of the Affordable Care Act.

“These results suggest that any proposed cuts to the ACA Medicaid expansions would substantially reduce access to health care for low-income individuals,” Miller said.

Wherry and Miller also found that expansion states reported increases in medical care delays caused by wait times for appointments for low-income residents — a 2.6-percentage-point increase over non-expansion states.

The researchers compared changes in outcomes two years after the Medicaid expansion — 2014 and 2015 — relative to the four years before it. They used data from the National Health Interview Survey and compared results from expansion and non-expansion states. The survey sample was 60,766 U.S. citizens from 19 to 64 years of age who had incomes below 138 percent of the federal poverty level.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Laura+Wherry.jpgLaura WherryLaura Wherry

Laura Wherry

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Laura+Wherry.jpgLaura Wherry

Laura Wherry

EnriqueRivero310-267-7120erivero@mednet.ucla.eduStates that participated in Medicaid expansion under the Affordable Care Act saw increased numbers of insured, better access to care and less worry about paying medical bills, but also longer wait times among low-income residents, according to new research.UCLA Health Sciences Media Relationshttp://newsroom.ucla.edu/releases/medicaid-expansion-boosts-access-reduces-costs-for-poorMon, 20 Mar 2017 16:33:00 GMTFindings could eventually help identify mechanisms linking cholesterol to coronary artery disease

Researchers from UCLA and the University of Western Australia have developed a new way of visualizing the distribution of cholesterol in cells and tissues. Their research provides insights into the movement of cholesterol into and out of cells and could eventually identify mechanisms linking cholesterol to coronary artery disease. 

Using a new high-resolution imaging mass spectrometry approach called NanoSIMS imaging, the team was able to visualize and quantify a pool of cholesterol called “accessible cholesterol” on the surface of cells.

Cholesterol is an essential lipid and is critical for maintaining the integrity of the plasma membrane in every cell in the body. But elevated levels of cholesterol in the blood represent a risk factor for coronary artery disease.

The accessible pool of cholesterol on the plasma membrane is thought to play a role in regulating production of cholesterol by cells and likely plays a role in the ability of cells to unload surplus cholesterol. “Accessible cholesterol” on the surface of cells can be detected with a cholesterol-binding protein from bacteria. 

By taking advantage of the bacterial protein, along with NanoSIMS imaging, researchers showed that the accessible pool of cholesterol is not evenly distributed on a cell’s plasma membrane but instead is highly enriched on specialized projections from the plasma membrane called microvilli.

“In the past, other scientists had speculated that microvilli play a role in moving cholesterol into and out of cells,” said the study’s co-author, Dr. Stephen Young, a distinguished professor of medicine and human genetics at the David Geffen School of Medicine at UCLA. “The discovery that ‘accessible cholesterol’ is highly enriched in microvilli lends support to that idea.”

The findings were recently published in the journal Proceedings of the National Academy of Sciences USA.

Dr. Haibo Jiang, a study co-author, noted that NanoSIMS imaging provides unique insights into cholesterol distribution on the plasma membrane and future studies will make it possible to assess mechanisms by which cells dispose of excess cholesterol.

“We would like to gain a better understanding of the mechanisms of cholesterol movement in cells and tissues,” said Jiang, a lecturer from the University of Western Australia’s Centre for Microscopy, Characterisation and Analysis. “We believe that NanoSIMS imaging could yield new strategies for lowering cholesterol levels in the blood or at least new strategies for optimizing the effects of existing cholesterol-lowering drugs.”

Added Young: “The plan now is to use NanoSIMS, along with novel biochemical approaches, to investigate cholesterol distribution and movement in multiple cell types.”

Additional UCLA authors included: Cuiewen He, Xuchen Hu, Rachel Jung, Thomas Weston, Norma Sandoval, Peter Tontonoz and Loren Fong. Jiang and Matthew Killburn are from the University of Western Australia.

The research was supported by the National Heart, Lung, and Blood Institute.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Cholesterol.jpgCholesterolNanoSIMS imaging of “accessible cholesterol” on cultured cells, demonstrating increased amounts of accessible cholesterol on the microvilli projections from cells.

NanoSIMS imaging of “accessible cholesterol” on cultured cells, demonstrating increased amounts of accessible cholesterol on the microvilli projections from cells.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Cholesterol.jpgCholesterol

NanoSIMS imaging of “accessible cholesterol” on cultured cells, demonstrating increased amounts of accessible cholesterol on the microvilli projections from cells.

AmyAlbin310-267-7095aalbin@mednet.ucla.eduFindings by scientists from UCLA and the University of Western Australia could eventually identify mechanisms linking cholesterol to coronary artery disease.Amy Albinhttp://newsroom.ucla.edu/releases/researchers-find-new-way-to-study-cholesterol-distribution-and-movementMon, 20 Mar 2017 16:29:00 GMTJubilation follows anxiety as they find out which hospitals have selected them as new residents

There was a reason why many UCLA medical students and their families wore emerald green this St. Patrick’s Day. Superstition aside, a little leprechaun luck could only help their circumstances. 

This year, the holiday coincided with Match Day, the day when 40,000 aspiring doctors nationwide find out simultaneously which hospitals have accepted them for 30,000 residency slots across the United States.

Elaine Schmidt/UCLA Medical students Jasmin-Ann Reyes, Razmik Ghukasyan and Pooja Upadhyaya react to their matches.

The annual Match Day ceremony, held for the first time in the newly opened Geffen Hall — part of the David Geffen School of Medicine at UCLA — peaked in a mad scramble as 170 future doctors rushed to tear open blue and gold envelopes, with excited families and friends looking on, waiting to hear the news.  

Depending on the students’ chosen specialty, their residency match for advanced training determines where they will live and work for the next three to seven years, starting in July.  

This year, almost 70 percent of the class chose to remain in California. “I think the winter weather back east took its toll on the recruitment process,” teased Dr. Lee Miller, associate dean for student affairs, as he welcomed the capacity crowd of students, their families and friends.

Among other Match Day statistics:

  • 62 percent of the class will pursue training in primary care;
  • 33 students, or 20 percent of the class, will train to be surgeons;
  • 33 percent of the class will remain with University of California hospitals;
  • 20 percent of the class will head to the Northeast;
  • 12 students will train in psychiatry.

Here are some of the UCLA medical students who met their match today:

Jasmin-Ann Reyes, 34, who grew up seeing some of her friends become pregnant as early as the 8th grade, is pursuing a career in obstetrics-gynecology. After graduating this June with a dual M.D./M.A. degree in public policy, she wants to work in health care administration and increase low-income women’s access to reproductive health resources. She matched at the University of Hawaii.

Razmik Ghukasyan, 26, grew up in war-torn, post-Soviet Armenia, where essential resources like natural gas, electricity, running water and food were scarce. When he was 14, his family won the green-card lottery and emigrated to the U.S. He quickly progressed in high school from ESL (English as a second language) classes to advanced placement, and graduated with honors from UCLA. In medical school, he was named a Leader of Tomorrow and was awarded a four-year scholarship. He will graduate in June with a joint M.D./M.B.A. degree. Inspired by his uncle, who died at age 48 of pancreatic cancer, he plans to pursue a career in surgical oncology at UCLA.

Pooja Upadhyaya, 28, launched a global health nonprofit called Mobilizing Health in college. She and her team helped 5,000 rural patients in India communicate with their local doctors via text messages. Midway through medical school, she also earned a master’s degree in public administration. She will pursue a residency in general surgery at Brigham and Women’s Hospital and aims to increase patients’ access to care by working to improve the health care system.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Green+trio.jpgRebecca Citron, Vinh Lam and Marisa YanezWearing green for good luck, UCLA medical students Rebecca Citron, Vinh Lam and Marisa Yanez hold up letters informing them which hospitals have selected them as new residents.

UCLA medical students Rebecca Citron, Vinh Lam and Marisa Yanez hold up their letters announcing which hospitals have selected them as new residents.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Green+trio.jpgRebecca Citron, Vinh Lam and Marisa Yanez

UCLA medical students Rebecca Citron, Vinh Lam and Marisa Yanez hold up their letters announcing which hospitals have selected them as new residents.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Grab+for+letter2.jpgUCLA medical students

Medical students at UCLA look for their letter informing of their residency destination.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Trio+elated.Elaine.JPGJasmin-Ann Reyes, Razmik Ghukasyan and Pooja Upadhyaya

Jasmin-Ann Reyes, Razmik Ghukasyan and Pooja Upadhyaya show their elation.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/class.jpgClass of 2017

UCLA David Geffen School of Medicine's Class of 2017.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/cake.jpgSteffanie Wright with the cake

UCLA medical student Stephanie Wright holds a cake given to her by her husband.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/IMG_2546.JPGErica Tukiainen and her fiancé

UCLA medical student Erica Takiainen gets a congratulatory kiss from her fiancé at Match Day.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/IMG_2567.JPGUCLA medical student Mostafa Al-Alusi and his family

Mostafa Al-Alusi was one of the many UCLA medical students embraced by their families on Match Day.

ElaineSchmidt310-267-8323 (o) | 310-597-5767 (c)eschmidt@mednet.ucla.eduThis year, St. Patrick's Day coincided with Match Day, the day when 40,000 aspiring doctors nationwide find out simultaneously which hospitals have accepted them for 30,000 residency slots across the United States.Elaine Schmidthttp://newsroom.ucla.edu/stories/ucla-medical-students-luck-out-on-match-day-and-that-s-no-blarneyFri, 17 Mar 2017 22:43:00 GMTUCLA Jonsson Comprehensive Cancer Center’s Dr. Zev Wainberg sheds light on a handful of common misconceptions Milo Mitchell/UCLA Jonsson Comprehensive Cancer Center  

Dr. Zev Wainberg, a member of the UCLA Jonsson Comprehensive Cancer Center, debunks some common myths about colorectal cancer — starting with the misconception that the disease only affects people over the age of 50 — and shares a few prevention tips. March is Colorectal Cancer Awareness Month.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Zev+Wainberg+UCLA.jpgZev Wainberg UCLAhttp://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Zev+Wainberg+UCLA.jpgZev Wainberg UCLAhttp://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Healthy+diet.jpgHealthy diet

A healthy diet can reduce the risk for colorectal cancer

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Tubing.jpgTubing

Model for colon

ReggieKumar310-206-2805reggiekumar@mednet.ucla.eduDr. Zev Wainberg, a member of the UCLA Jonsson Comprehensive Cancer Center, sheds light on a handful of common misconceptions about the disease, which kills 50,000 Americans each year.UCLA Jonsson Comprehensive Cancer Centerhttp://newsroom.ucla.edu/stories/debunking-myths-about-colorectal-cancerFri, 17 Mar 2017 20:43:00 GMTTeam discovers marker that may help to identify youths at risk of poor outcomes and prevent cognitive decline UCLA Health  

A new biological marker may help doctors identify children at risk of poor outcomes after a traumatic brain injury, UCLA scientists report in a preliminary study.

The discovery, published in the online issue of the medical journal Neurology, will allow researchers to zero in on ways to prevent progressive cognitive decline seen in roughly half of children with moderate to severe traumatic brain injuries.

“It’s really very hopeful. It means there’s something we can do about this,” said Robert Asarnow, the study’s senior author and the Della Martin Professor of Psychiatry in the UCLA Department of Psychiatry and Biobehavioral Sciences. “If we understand which kids are showing this neurodegeneration and why, then it’s possible to start using existing treatments to forestall this process or identify new ones to forestall this process.”

The study involved 21 children with moderate to severe traumatic brain injuries who were treated in hospital intensive care units in Los Angeles County. Causes of injuries included auto-pedestrian accidents, motor vehicle accidents, and falls from bikes, scooters and skateboards. The children, ages eight to 18, were assessed twice — two to five months after injury, and again at 13 to 19 months post-injury. The results were compared with children of the same age who had not had a brain injury.

Traumatic brain injury is the leading cause of disability and death in children and adolescents in the United States, according to the Centers for Disease Control and Prevention. Researchers at UCLA and elsewhere have observed that after children sustain a moderate to severe traumatic brain injury, they typically follow one of two trajectories — either steady gains toward normal, pre-injury functioning, or progressive, widespread cognitive decline.

UCLA In these images of children’s brains, red correlates with slower brain signaling speeds, while green and blue indicate normal brain signaling.

Researchers, however, have been unable to predict, early on, the outcomes. The likelihood of poor outcomes is not immediately apparent; in fact, studies have shown that brain damage visible on a CT scan does not accurately predict a patient’s potential for full recovery. It’s only later, often after the child returns to school, that parents start noticing the child is falling behind or has problems with attention, learning or depression.

“While the severity of the injury certainly plays a role in this, there’s still a lot of uncertainty — you frequently have two patients with similar injuries who have different recoveries,” said Emily Dennis of the University of Southern California and first author of the study.

To detect which individuals might be at risk for ongoing cognitive decline, a team of researchers from different medical specialties used special MRIs and electroencephalograms, or EEGs, to measure the speed of brain signals passing from one hemisphere of the brain to another, a measure of brain function. Previous studies have shown that both children and adults have slow signal transfer times right after a traumatic brain injury.

In the first assessment, the children wore headphones and watched a movie while the MRI scanner assessed the integrity of the brain’s white matter, which connects different brain regions to support cognitive functions. The children also took tests of attention and memory skills.

After the first assessment, UCLA researchers found half of the children had brain signaling speeds within normal range, an indication of healthy white matter. The other half had significantly slower signaling, compared with healthy children, an indication of white matter disorganization or disruption.

At 13 to 19 months after their injuries, the children who had normal signaling at the first assessment still compared favorably with healthy peers. In contrast, the children with slower signaling showed progressive decline in white matter organization and loss of white matter volume.

Researchers suspect a prolonged, inflammatory process may be the culprit, causing ongoing damage to the still-maturing brain. Anti-inflammatory agents might alter this course, Asarnow said. But these agents may have some adverse effects.

“You don’t want to give these drugs unless you have a pretty good assurance that they would work,” Asarnow said. “We don’t have enough evidence right now to make that leap.”

The study was small and the results need to be confirmed in larger studies, the researchers noted.

The study’s other authors are Talin Babikian, Monica Ellis, Dr. Christopher Giza and Alexander Olsen, all of UCLA; Yan Jin, Dr. Jeffrey Johnson, Faisal Rashid, Paul Thompson and Julio Villalon-Reina, all of USC; Dr. Christopher Babbitt of Miller Children’s Hospital; Dr. Richard Mink of Harbor-UCLA Medical Center; and Roza Vlasova of Children’s Hospital Los Angeles.

The study was supported by the National Institutes of Health, the UCLA Brain Injury Research Center, the UCLA Steve Tisch BrainSPORT Program, the Easton Foundation and the UCLA Staglin IMHRO Center for Cognitive Neuroscience.

To learn more about traumatic brain injury, visit www.aan.com/patients.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/brain+injury+1.jpgTraumatic brain injury study scansIn these images of children’s brains, red correlates with slower brain signaling speeds, while green and blue indicate normal brain signaling.

Traumatic brain injury study scans

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/brain+injury+1.jpgTraumatic brain injury study scans

Traumatic brain injury study scans

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/brain+injury+scan+2.jpgTraumatic brain injury study scans

Traumatic brain injury study scans

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/robert+asarnow.jpgRobert Asarnow

Robert Asarnow, Della Martin Professor of Psychiatry in the UCLA Department of Psychiatry and Biobehavioral Sciences.

LeighHopper310-267-7149 LHopper@mednet.ucla.eduThe team discovers a biological marker that may help to identify youths at risk of poor outcomes and prevent cognitive decline.Leigh Hopperhttp://newsroom.ucla.edu/releases/ucla-researchers-finding-holds-promise-for-treating-children-after-brain-injuriesWed, 15 Mar 2017 20:21:00 GMTUCLA’s Dr. Sara Hurvitz sheds light on the benefits of caps, how they work and if men could use them

Hair loss — one of the most-feared side effects of cancer treatment — may have met its match. Scientists have known since the 80s that cooling a person’s scalp can prevent significant hair loss during chemotherapy. A cooling device called DigniCap was cleared for women with breast cancer by the U.S. Food and Drug Administration in 2015. This cap was tested in a clinical trial at UCLA led by Dr. Sara Hurvitz, director of hematology and oncology breast cancer program at UCLA’s Jonsson Comprehensive Cancer Center.

Two studies published this month in the Journal of the American Medical Association found that the cap was effective; results showed that women lost less than 50 percent of their hair. The trial Hurvitz participated in paved the way for physicians to help people with cancer overcome one of the most visible signs of treatment.

How did scientists come up with the idea of cooling the scalp to help save the hair of a woman who has cancer, and how long did the development process take?

The idea to cool the scalp during chemotherapy infusion to reduce hair loss is not a new one. It has been in place for over three decades and evaluated by several other companies. There are other devices in use clinically. This is the first one to be FDA cleared.

How did your research play a role in the FDA clearance of this cooling cap?

We participated in the clinical trial that led to the FDA clearance of this device. We enrolled and treated multiple patients on this study who were undergoing standard chemotherapy for early stage breast cancer.

How does the cooling cap actually work?

Cooling the scalp slows down blood flow to the hair follicles during the infusion of chemotherapy, which in turn limits the delivery of chemotherapy to the scalp. This lessens the toxic effects of chemotherapy on the hair follicle, thus limiting hair loss. Several devices utilize ice caps that are cumbersome to store and to manage. The device we evaluated is a tight-fitting cap, much like a bathing cap, that is attached to a cooling machine and worn during chemotherapy and for an hour or two after chemotherapy. This machine avoids the need to use a freezer or change caps during treatment.

Why do you think this cooling cap is beneficial for women going through treatment?

Hair loss from chemotherapy causes a major impact on quality of life for many women with early stage breast cancer. The hope is that reduction in or prevention of hair loss will reduce the emotional stress associated with a cancer diagnosis.

Why is it that some women still lose their hair after using the cooling cap?

Hair loss is not completely prevented in the majority of patients with scalp cooling, but half of patients are able to keep more than 50 percent of their hair with cooling (whereas nearly all patients who take curative chemotherapy without cooling cap use will lose over 50 percent of their hair). This allows a woman to look more like herself during chemotherapy. Hair also tends to fill in and look normal more quickly after chemotherapy has completed, compared to women who did not use scalp cooling.

What is the future of the cooling cap and could it prevent hair loss in people with other cancer types as well as men who have cancer?

Different devices are being evaluated in clinical trials in a variety of cancer types. This could certainly be utilized by male cancer patients as well.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Sara+Hurvitz.jpgSara HurvitzDr. Sara Hurvitz

Dr. Sara Hurvitz, director of hematology and oncology breast cancer program at UCLA’s Jonsson Comprehensive Cancer Center

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Sara+Hurvitz.jpgSara Hurvitz

Dr. Sara Hurvitz, director of hematology and oncology breast cancer program at UCLA’s Jonsson Comprehensive Cancer Center

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Dignicap.jpgDignicap

The Dignicap scalp cooling device

ReggieKumar310-206-2805reggiekumar@mednet.ucla.eduIn this Q&A, UCLA’s Dr. Sara Hurvitz sheds light on the benefits of caps, how they work and if men could use them Reggie Kumarhttp://newsroom.ucla.edu/stories/are-cooling-caps-the-solution-to-prevent-hair-loss-during-chemotherapyTue, 14 Mar 2017 20:00:00 GMTThe thoracic transplant program also ranks among the country’s best in terms of patient survival rates, according to the Scientific Registry of Transplant Recipients.UCLA RESEARCH ALERTFINDINGS

New UCLA research could lead to the development of a drug that combats several mosquito-borne viruses, including Zika virus. The research reveals that an enzyme produced naturally by the immune system protects animals against Zika virus infection and the neurological damage linked to the virus. The enzyme, called 25-hydroxycholestrol or 25HC, can be manufactured to create a compound that works against a broad range of viruses. The research was led by senior author Genhong Cheng, professor of microbiology, immunology and molecular genetics and a member of the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA.

BACKGROUND

Zika virus was not commonly seen in humans before 2007. However, the virus became widely recognized due to large outbreaks in the Caribbean and South America in 2015 that were associated with unusually high incidences of severe birth defects in children born to Zika-infected mothers. Zika virus can be sexually transmitted, but it is primarily spread by a type of tropical mosquito and is closely related to the mosquito-borne dengue and yellow fever viruses.

Most people infected with the Zika virus either don’t get sick or experience mild symptoms; a very small number of people develop temporary muscle weakness or even paralysis. Zika virus has become a public health threat due to its rapid spread throughout the world and link to severe birth defects including microcephaly, in which babies are born with abnormally small heads resulting from underlying brain damage. There are no approved antiviral drugs or vaccines to combat Zika virus and no treatments for the associated microcephaly in babies.

Previous preclinical research published by Cheng and his collaborators in 2013 showed that the body produces 25HC naturally to aid the immune system as it fights viruses. While the natural production of 25HC is typically not strong enough to combat many aggressive viruses, the 2013 research showed that administration of a synthetically produced version of 25HC protects cells from infection by a range of viruses such as hepatitis C, Ebola and human immunodeficiency virus, or HIV. However, 25HC’s effect on the Zika virus had never been tested.

METHOD

The team found that 25HC reduces the amount of Zika, dengue and yellow fever viruses in infected cells in a petri dish. The research team then tested 25HC’s effect on Zika virus by administering synthetically produced 25HC to animals with the Zika virus. They found that 25HC significantly suppressed Zika virus infection in the animals and reduced brain damage in fetal mice. 25HC was also tested in mini brain “organoids” which are simplified, three-dimensional versions of the human brain produced in petri dishes using human stem cells. These organoids mimic human-specific characteristics of brain growth that cannot be tested in animals. Results revealed that 25HC also blocks Zika virus infection and preserves human brain cell formation.

IMPACT

The new research highlights the potential use of 25HC to combat Zika virus infection and prevent its devastating outcomes, such as microcephaly. The research team will further study whether 25HC can be modified to be even more effective against Zika and other mosquito-borne viruses.

AUTHORS

In addition to Cheng, the co-first authors are Chunfeng Li, Yong-Qiang Deng, Shuo Wang, Feng Ma, Saba Roghiyh Aliyari and Xing-Yao Huang. Co-corresponding authors include Bennett Novitch, Zhiheng Xu, and Cheng-Feng Qin. Additional co-authors and author institutional affiliations can be found in the manuscript.

JOURNAL

The study was published in the journal Immunity.

FUNDING

The study was funded by grants from the Chinese Academy of Medical Sciences Initiative for Innovative Medicine (2016-I2M-1-005), the National Science and Technology Major Project for Significant New Drugs Innovation and Development (2015ZX09102023), the National Natural Science Foundation of China (91542201, 81590765, 81522025, 81661130162, 31430037, 31500145 and 31670883), the National Institutes of Health (R01 R01AI069120, AI056154, NS089817 and AI078389), the Peking Union Medical College Youth Fund (3332016125), the Ministry of Science and Technology of the People’s Republic of China (2016YFD0500304, 2014CB942801 and 2012YQ03026006), the State Key Laboratory of Pathogen and Biosecurity (SKLPBS1601), the Innovative Research Group (81621005), the Newton Advanced Fellowship from the United Kingdom Academy of Medical Sciences, the Shanghai brain-intelligence project from the Shanghai Science and Technology Committee (16JC1420500), the Beijing brain project (Z161100002616004), the California Institute for Regenerative Medicine (DISC1-08819), and both a research award and a training fellowship from the UCLA Broad Stem Cell Research Center.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Cell+with+Zika.jpgCell with ZikaAt left the Zika virus depicted in green infects and destroys the formation of neurons (pink) in human stem cell-derived brain organoids. At right, picture showing how 25HC blocks Zika infection and preserves neuron formation.

Left pair of images: Zika virus (green) infects and destroys the formation of neurons (pink) in human stem cell-derived brain organoids. Administration of 25HC blocks Zika infection and preserves neuron formation in the organoids.

Right pair of images: Reduced brain size and structure in a Zika-infected mouse brain. Administration of 25HC preserves mouse brain size and structure.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Cell+with+Zika.jpgCell with Zika

Left pair of images: Zika virus (green) infects and destroys the formation of neurons (pink) in human stem cell-derived brain organoids. Administration of 25HC blocks Zika infection and preserves neuron formation in the organoids.

Right pair of images: Reduced brain size and structure in a Zika-infected mouse brain. Administration of 25HC preserves mouse brain size and structure.

MirabaiVogt-James310-983-1163mvogt@mednet.ucla.eduUCLA researchers’ findings could work against a broad range of viruses and protect against Zika and its associated neurological defects in mice and human brain models.Mirabai Vogt-Jameshttp://newsroom.ucla.edu/releases/natural-compound-protects-against-zika-virus-infection-and-microcephalyTue, 14 Mar 2017 16:45:00 GMTGenerous gift to fund expanded child-centric services and best-in-class facilities

Mattel, Inc. announced today a $50 million gift to UCLA Health that will fund an expansion of the UCLA Mattel Children’s Hospital and help establish a world-class pediatric care center and research hub focused on improving children’s health. A committed partner for more than 20 years, Mattel has provided more than $80 million to UCLA in support of the university and health care system.

This donation from Mattel — the largest ever made to UCLA Mattel Children’s Hospital — enables the hospital to build a “kids-only” system of care, ensuring the child’s experience remains the No. 1 focus through facilities designed with patients and families in mind. In addition, the gift will help the hospital continually improve care and outcomes; ensure that all staff is specialized in treating children; and better integrate play and health during treatment to comfort children when they need it most.

“By combining the resources and expertise of two of Los Angeles’ leaders in children’s health and wellness, we are ensuring world-class care to the neediest in our community,” said UCLA Chancellor Gene Block. “This partnership extends our impact far beyond what either of us could achieve on our own, and together, UCLA and Mattel will build on our commitment to establish the best children’s hospital in the world.” 

With the gift comes a revision of the hospital’s name and logo to better reflect the synergy and commitment between the two organizations.

“Mattel has always been committed to serving our communities in meaningful and impactful ways,” said Richard Dickson, president and chief operating officer of Mattel. “Today’s gift is an extension of that legacy, and more importantly, it will help ensure that even more children and families will benefit from exceptional healthcare at UCLA Mattel Children’s Hospital.”

As one of the nation’s top children’s hospitals, UCLA Mattel Children’s Hospital attracts top doctors and nurses to provide care that is consistently ranked among the best in the country by U.S. News and World Report. With the expansion of the hospital, UCLA’s superior care can reach more children and families, thanks to the strengthened partnership.

“The best practices and insights from research available at UCLA Mattel Children’s Hospital are a model for pediatric care worldwide,” said Dr. John Mazziotta, vice chancellor of UCLA Health Sciences and CEO of UCLA Health. “With Mattel, we look forward to an enhanced ability to expand that care.”

Mattel’s commitment will also support global children’s health through programs in China, Indonesia, India and South Africa, including doctor exchanges and research partnerships.

The gift is part of the $4.2 billion UCLA Centennial Campaign, which is scheduled to conclude in December 2019 during UCLA’s 100th anniversary year.

UCLA Health includes four hospitals on two campuses — Ronald Reagan UCLA Medical Center; UCLA Medical Center, Santa Monica; UCLA Mattel Children’s Hospital; and Resnick Neuropsychiatric Hospital at UCLA — and more than 160 primary care and specialty clinics throughout Southern California. UCLA Health ranks No. 1 in Los Angeles, No. 1 in California and No. 5 in the nation in U.S. News and World Report’s 2016–17 Best Hospitals survey.

Mattel is a creations company that inspires the wonder of childhood. Our mission is to be the recognized leader in play, learning and development worldwide. Mattel’s portfolio of global consumer brands includes American Girl®, Barbie®, Fisher-Price™, Hot Wheels®, Monster High® and Thomas & Friends®, among many others. Mattel also creates a wealth of lines and products made in collaboration with leading entertainment and technology companies. With a global workforce of approximately 31,000 people, Mattel operates in 40 countries and territories and sells products in more than 150 nations.

Journalists: B-roll and sound bites are available for free and unrestricted use by the news media by clicking here. High-resolution photos can be downloaded here.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Pediatrics+room.jpgPediatrics roomThe gift from Mattel, Inc. will help the hospital continually improve care and outcomes for children.

Pediatrics room at UCLA Mattel Children’s Hospital.

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Pediatrics room at UCLA Mattel Children’s Hospital.

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Dr. John Mazziotta, vice chancellor of UCLA Health Sciences and CEO of UCLA Health, and Richard Dickson, president and chief operating officer of Mattel, at the ceremony announcing a new $50 million gift from the company to the UCLA Mattel Children’s Hospital.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Mattel+gift+group.jpgMattel gift group

Dr. Kelsey Martin, dean of the David Geffen School of Medicine at UCLA; Dr. Sherin Devaskar, physician-in-chief, UCLA Mattel Children’s Hospital; Richard Dickson, president and chief operating officer of Mattel; UCLA Chancellor Gene Block; Margo Georgiadis, Mattel chief executive officer; Dr. John Mazziotta, Dr. John Mazziotta, vice chancellor of UCLA Health Sciences and CEO of UCLA Health; Johnese Spisso, president of UCLA Health, CEO of UCLA Hospital System, and associate vice chancellor of UCLA Health Sciences; Robert Goodwin, executive director, Mattel Children’s Foundation.

TamiDennis310-267-7007tdennis@mednet.ucla.eduA committed partner for more than 20 years, the company now has provided more than $80 million to UCLA in support of the university and health care system.Tami Dennishttp://newsroom.ucla.edu/releases/mattel-commits-50-million-to-uclaMon, 13 Mar 2017 18:00:00 GMTThe study could pave the way for understanding and treating neurological disorders, and for developing computers that “think” more like humans.Discovery by UCLA researchers could be applied to other solid tumors such as breast and colon cancer

Targeting cancer stem cells may be a more effective way to overcome cancer resistance and prevent the spread of squamous cell carcinoma — the most common head and neck cancer and the second-most common skin cancer, according to a new study by cancer researchers at the UCLA School of Dentistry.

Head and neck squamous cell carcinoma is a highly invasive form of cancer and frequently spreads to the cervical lymph nodes. Currently, cisplatin is the standard therapeutic drug used for people with HNSCC. Yet, more than 50 percent of people who take cisplatin demonstrate resistance to the drug, and they experience a recurrence of the cancer. The five-year survival rates remain sorely low and researchers still don’t understand the underlying mechanisms behind head and neck squamous carcinoma. Therefore, said UCLA cancer biologist Dr. Cun-Yu Wang, who led the study, there’s an urgent need to understand why people with this type of cancer are resistant to therapy and to develop new approaches for treating it.

Wang’s research is published online today in the peer-reviewed journal Cell Stem Cell.

Cancer stem cells are known to be responsible for tumor formation and development; they also self-renew and tend to be unresponsive to cancer therapy. These cells have been found in head and neck squamous cell carcinoma. Given the unique challenges that cancer stem cells pose for oncologists, it remains unclear what the optimal therapeutic strategy is for treating HNSCC.

To address this, Wang, who holds the Dr. No-Hee Park Endowed Chair in Dentistry at UCLA and holds a joint appointment in the UCLA Department of Bioengineering, and his research team first developed a mouse model of head and neck squamous cell carcinoma that allowed them to identity the rare cancer stem cells present in HNSCC using in vivo lineage tracing, a method to identify all progeny of a single cell in tissues.

The researchers found that the cancer stem cells expressed the stem cell protein Bmi1 and had increased activator protein-1, known as AP-1, a transcription factor that controls the expression of multiple cancer-associated genes. Based on these new findings, the UCLA team developed and compared different therapeutic strategies for treating head and neck squamous cell carcinoma. They found that a combination of targeting cancer stem cells and killing the tumor mass, consisting of high proliferating cells, with chemotherapy drugs resulted in better outcomes.

The team further discovered that cancer stem cells were not only responsible for squamous cell carcinoma development, but that they also cause cervical lymph node metastasis.

“This study shows that for the first time, targeting the proliferating tumor mass and dormant cancer stem cells with combination therapy effectively inhibited tumor growth and prevented metastasis compared to monotherapy in mice,” said Wang, who is a member of the UCLA Jonsson Comprehensive Cancer Center and of the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA. “Our discovery could be applied to other solid tumors such as breast and colon cancer, which also frequently metastasizes to lymph nodes or distant organs.”

“With this new and exciting study, Dr. Wang and his team have provided the building blocks for understanding the cellular and genetic mechanisms behind squamous cell carcinoma,” said Dr. Paul Krebsbach, dean of the UCLA School of Dentistry. “The work has important translational values. Small molecule inhibitors for cancer stem cells in this study are available or being utilized in clinical trials for other diseases. It will be interesting to conduct a clinical trial to test these inhibitors for head and neck squamous cell carcinoma.”

Additional authors of the study include Demeng Cheng, first author and postdoctoral scholar in Wang’s lab; Mansi Wu, Yang Li, Dr. Insoon Chang, Yuan Quan, Mari Salvo, Peng Deng, Dr. Bo Yu, Yongxin Yu, Jiaqiang Dong, John M. Szymanski, Sivakumar Ramadoss and Jiong Li who are all from the laboratory of molecular signaling in the division of oral biology and medicine at the UCLA School of Dentistry.

This work was supported in part by the National Institute of Dental and Craniofacial Research grants R37DE13848, R01DE15964 and R01DE043110.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Stem+Cell.jpgHead and neck squamous cell carcinomaAt left, head and neck squamous cell carcinoma invasive growth, and at right, cancer stem cells (shown in red) in head and neck squamous cell carcinoma.

At left, an image of head and neck squamous cell carcinoma invasive growth and at right an image of cancer stem cells (shown in red) in head and neck squamous cell carcinoma.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Stem+Cell.jpgHead and neck squamous cell carcinoma

At left, an image of head and neck squamous cell carcinoma invasive growth and at right an image of cancer stem cells (shown in red) in head and neck squamous cell carcinoma.

BriannaAldrich310-206-0835baldrich@dentistry.ucla.eduUCLA researchers found that a combination therapy going after stem cells and chemotherapy resulted in better outcomes. Brianna Aldrichhttp://newsroom.ucla.edu/releases/targeting-cancer-stem-cells-improves-treatment-effectiveness-and-prevents-metastasisThu, 09 Mar 2017 17:59:00 GMTUCLA physician is on research team that's studying a lower-cost alternative to surgery

For 130 years, surgery has been the standard treatment for appendicitis — inflammation of the appendix, a short tube extending from the colon.

After all, it’s best to remove an infected body part that is not essential to survival rather than risk a rupture that spews bacteria into the abdomen. Right? Maybe not.

UCLA Dr. David Talan

Dr. David Talan, professor in the department of emergency medicine at the David Geffen School of Medicine at UCLA, is helping to lead a $12-million clinical trial to determine whether treating appendicitis solely with antibiotics can be a safe, effective and less expensive alternative to surgery.  

Talan, who also holds an appointment in the department of medicine’s division of infectious diseases, recently addressed questions about this alternative approach to treating appendicitis.

Why are you looking into this subject?

About one in 10 people in the U.S. will be diagnosed with an appendicitis in their lifetime, so it’s very common. Over time, the medical community has become almost exclusively reliant on surgery to address appendicitis — an operation called an appendectomy. Today, surgeons perform something like 300,000 appendectomies in the U.S. each year, and it’s considered the most common emergency surgery.

Traditional medical approaches are constantly being re-evaluated to determine their value to society. Extensive data from a large-scale study will help patients and their physicians make more informed health care decisions.

You seem to be challenging more than a century of medical tradition. How do you respond to skeptics?

Routine appendectomy has served us well for a long time, so we should be skeptical of change. But skepticism also demands that we carefully study and compare the relative efficacy of different treatment approaches.

Surgery was available decades before antibiotics, and when antibiotics were introduced, they made surgeries safer. Only in the last few years have we begun to carefully research the possibility that antibiotics alone might be a reasonable first treatment instead of surgery.  Simultaneously, our understanding of the disease has changed, and it’s now clear that when caught early and treated with antibiotics, appendicitis is not always a ticking time bomb that must be removed for fear of rupture and death.

Is there evidence to suggest that antibiotics could be a good alternative to an appendectomy?

There have been seven studies outside the U.S. in which patients with the earliest stage of appendicitis either received antibiotics or underwent an urgent appendectomy. All patients were hospitalized for several days. Together, these studies found that an antibiotic approach appeared to be safe and was associated with quicker recovery compared to surgery.  But over a year's time, about 25 percent of patients had appendicitis that required surgery.

Our UCLA group was the first to receive National Institutes of Health funding and conducted the first U.S. trial last year. In that study done at Olive View-UCLA Medical Center, the innovation we found was that most patients treated with antibiotics could be successfully managed as outpatients, thus avoiding hospital admission and increasing the potential to substantially reduce costs.

The bottom line is that managing appendicitis with antibiotics shows promise as a safe, lower-cost alternative to surgery. However, we should not discount the safety of surgery established over decades and its effectiveness to cure the disease once and for all. Surgery also has advanced with endoscopic techniques. Far more data are needed to determine the risk and benefit tradeoffs in individual patients and how these might best be incorporated in a model of shared decision-making with patients.

How will you go about collecting additional data?

We will be comparing the outcomes of more than 1,500 patients diagnosed with appendicitis at UCLA-affiliated and other hospitals across the country. Participants will be randomly selected for treatment with either antibiotics or an appendectomy, and we will track a wide range of data over a year or more. Among those data points are recurrence of appendicitis, length of hospital stay, repeat health care visits and treatment costs. We also will track patient experiences using self-reported quality-of-life measurements like pain and discomfort, mobility and anxiety.

It is the largest randomized clinical trial on this subject. Dr. David Flum, a surgeon at the University of Washington, is the principal investigator, and I am the study director.

We’ve been working on this project for several years and anticipate completion in 2021.   

Recently, there has been extensive news coverage about the spread of so-called “superbugs” — bacteria that develop a resistance to medication in part due to the overuse of antibiotics. Are you concerned that using antibiotics to treat appendicitis will contribute to the problem?

No. The spread of medication-resistant bacteria is a serious challenge. But antibiotics, when properly prescribed, are an important tool in fighting illness. Use of antibiotics presents problems when they are inappropriately prescribed for conditions without a demonstrated need, such as for colds and simple bronchitis. It’s also problematic when antibiotics are dumped into our food supply; the single largest user of antibiotics is the livestock industry.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/appendicitis-treatment.jpgAppendicitis

Stock photo for Q&A on a study to determine whether treating appendicitis solely with antibiotics can be a safe, effective, and less expensive alternative to surgery. 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/appendicitis-treatment.jpgAppendicitis

Stock photo for Q&A on a study to determine whether treating appendicitis solely with antibiotics can be a safe, effective, and less expensive alternative to surgery. 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20171/David+Talan.jpgDr. David Talan

Dr. David Talan is a professor in the department of emergency medicine at the David Geffen School of Medicine at UCLA

PhilHampton310-267-7014phampton@mednet.ucla.eduDr. David Talan is on a research team that's studying whether treating appendicitis solely with antibiotics can be a safe, effective and less expensive alternative to surgery. Phil Hamptonhttp://newsroom.ucla.edu/stories/challenging-tradition-can-an-appendicitis-be-treated-solely-with-medicationThu, 09 Mar 2017 03:07:00 GMTDr. Ben Wu is part of consortium to receive NIH funding Dr. Ben Wu

Dr. Ben Wu, a professor of advanced prosthodontics and bioengineering at the UCLA School of Dentistry, has received second-phase funding that will help continue groundbreaking research on a project for the Center for Dental, Oral and Craniofacial Tissue and Organ Regeneration (C-DOCTOR). Wu is among nine principal investigators receiving funding from the National Institute of Dental and Craniofacial Research.

"The institutions in the C-DOCTOR consortiums are pioneers in stem cells and regenerative medicine, and many projects at various stages of research and development at UCLA and other institutions and companies nationwide will benefit from the amazing C-DOCTOR resources," said Wu.

Based in California, C-DOCTOR represents a partnership among UC San Francisco, Berkeley, Davis and UCLA; the University of Southern California; and Stanford University, all of whom joined forces in 2016. The center will be a national resource for the development, cultivation and clinical translation of innovative regenerative technologies to replace dental and craniofacial tissues and organs lost to congenital disorders, trauma and disease. The center's primary mission is to provide comprehensive clinical, scientific, technical, regulatory, financial and managerial resources to promote cost-effective and timely progression of tissue engineering/regenerative medicine products to human clinical trials.

“The NIDCR award will accelerate the development of advanced tissue engineering products to repair dental, oral and craniofacial defects,” said Wu who is also the director of the UCLA Weintraub Center for Reconstructive Biotechnology at the UCLA School of Dentistry.

Other principal investigators of C-DOCTOR include Dr. Yang Chai, Dr. Mark Urata and Yong Chen of USC; Kevin Healy of UC Berkeley; Dr. Ophir Klein and Jeffrey Lotz of UC San Francisco; Dr. Nancy Lane of UC Davis; and Dr. Michael Longaker of Stanford University.

For more information, see the C-DOCTOR project.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Ben+Wu_web.gifDr. Ben WuDr. Ben Wu

Dr. Ben Wu is a professor of advanced prosthodontics and bioengineering at the UCLA School of Dentistry.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Ben+Wu_web.gifDr. Ben Wu

Dr. Ben Wu is a professor of advanced prosthodontics and bioengineering at the UCLA School of Dentistry.

BriannaAldrich310-206-0835baldrich@dentistry.ucla.eduA professor of advanced prosthodontics and bioengineering at the UCLA School of Dentistry has received second-phase funding for his research on a project for the Center for Dental, Oral and Craniofacial Tissue and Organ Regeneration.Brianna Aldrichhttp://newsroom.ucla.edu/dept/faculty/new-funding-allows-ucla-dentistry-professor-s-work-on-tissue-regeneration-to-continueWed, 08 Mar 2017 21:00:00 GMTUCLA RESEARCH ALERTFINDINGS

Online weight management tools and weekly peer coaching resulted in greater weight loss for people with serious mental illness than when they visited health professionals in person in clinics, according to a new study led by Dr. Alexander Young, a professor of psychiatry at UCLA.

BACKGROUND

About 5 percent of the U.S. population has a serious mental illness such as schizophrenia or bipolar disorder. People with these disorders die 10 to 20 years prematurely, mostly as a result of cardiovascular disease or cancer, studies have shown.  A major risk factor contributing to these outcomes is obesity.

An estimated 40 to 60 percent of individuals with serious mental illness are obese, compared to about 30 percent of the general population. Research has found that even modest weight loss mitigates some of the harmful effects of obesity.

Despite widespread recognition of the importance of weight loss, people with schizophrenia or bipolar disorder rarely receive services to help with weight. It has been too expensive to have clinicians provide these services, and people with serious mental illness often do not want to travel each week to clinics to participate in weight groups, according to Young.

METHOD

Researchers recruited 276 overweight people who were  taking antipsychotic medication for serious mental illness and who were receiving care at a Veterans Health Administration medical center. Young serves on the executive committee of a national Veterans Administration program to improve mental health care. Participants were randomly assigned to receive in-person weight services, web-based weight services or to continue with their usual care.

The web-based system differed from standard, online weight loss interventions or apps designed for the general public. The system provided specialized audio and text-based education tailored for cognitive deficits seen in this population. Other features of the program included educational videos, pedometer tracking, goal setting, homework, diet plans and knowledge quizzes. Participants also were contacted regularly by phone by trained peer coaches who had personal experience with mental illness.

At six months, participants in the web services group lost, on average, 6.2 pounds. People in the in-person services group had no change in weight; the treatment as usual group gained 2 pounds, on average.

IMPACT

Delivering weight-management services online would be far more convenient for people and could produce substantial improvements in health, at a relatively low cost, Young said. While this study’s approach is designed for a population with serious mental illness, it could be effective in other populations with cognitive disabilities, inconsistent literacy or socioeconomic challenges.

AUTHORS

The study’s authors are Young, Amy Cohen, Gerhard Hellemann, Noosha Niv, Dr. Nancy Nowlin-Finch and Fiona Whelan, all of the UCLA Department of Psychiatry and Biobehavioral Sciences; Richard Goldberg and Julie Kreyenbuhl of the University of Maryland School of Medicine; and Rebecca Oberman of the Veterans Affairs Greater Los Angeles Healthcare System.

JOURNAL

The study appears online today in the Journal of General Internal Medicine.

FUNDING

This study was supported by the Department of Veterans Affairs Health Services, the National Institute of Mental Health, the VA Desert Pacific Mental Illness Research Education Clinic (MIRECC), the VA Capitol Healthcare Network MIRECC, and the VA Health Services Research and Development Service Center for the Study of Healthcare Innovation, Implementation and Policy.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20170/Alex+Young+headshot.jpgAlex Young

Dr. Alexander Young, a professor of psychiatry at UCLA.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20170/Alex+Young+headshot.jpgAlex Young

Dr. Alexander Young, a professor of psychiatry at UCLA.

LeighHopper310-267-7149 LHopper@mednet.ucla.eduUCLA study shows that delivering weight-management services online offers a convenient way to produce substantial improvements in health, at a relatively low cost.Leigh Hopperhttp://newsroom.ucla.edu/releases/to-treat-obesity-among-seriously-mentally-ill-web-based-weight-management-works-better-than-in-person-servicesWed, 08 Mar 2017 17:29:00 GMTResearchers aim to harness immune system to control disease

T cells, the managers of our immune systems, spend their days shaking hands with another type of cell that presents small pieces of protein from pathogens or cancerous cells to the T cell. But each T cell is programmed to recognize just a few protein pieces, known as antigens, meaning years can go by without the T cell, or its descendants, recognizing an antigen.

When the T cell does recognize an antigen, it gives the cell presenting the antigen a “hug,” so to speak, instead of a handshake. This initial interaction causes the T cell to search nearby to find other cells that are presenting the same antigen to give them “hugs” as well.

In a study published today in Science Signaling, UCLA researchers have discovered that after the initial hug, T cells become more gregarious, giving something more like a bear hug to any cell presenting its antigen. These larger hugs help to activate the T cell, equipping it to go out into the body and coordinate multi-cellular attacks to fight infections or cancers. The UCLA team learned that how stiff or soft T cells are controls their response — the cells react slowly when they are stiff and trigger easily when they are soft. 

“T cells are like the shy person at the office holiday party who acts stiff until they loosen up a bit and then are all over the dance floor,” said Dr. Manish Butte, associate professor of pediatrics and microbiology, immunology and molecular genetics at the David Geffen School of Medicine at UCLA and the study’s senior author.

Butte and his colleagues pioneered an approach using an instrument called an atomic-force microscope to make real-time observations about what excites T cells at the nanoscale. Once they learned that T cells soften after activation, the UCLA team identified the biochemical pathway that controls the cell’s stiffness. They then identified drugs that can help the T cells either elicit or subdue a response. The finding provides scientists with a new capability to manipulate the immune system, Butte said.

Diseases arise in people and animals when T cells attack the body’s other cells, or when they fail to signal attacks against cancer cells or infectious pathogens.

“Until now, we had a limited understanding of what controls T cell activation,” said Butte, who is chief of pediatric allergy and immunology at Mattel Children’s Hospital UCLA and a member of the UCLA Children’s Discovery and Innovation Institute. “We wanted to identify how to both encourage and speed up T cell activation for fighting infections and cancers and to disrupt it in order to prevent immune disease. Now that we understand the precise steps taking place, our findings suggest that altering T cell stiffness with drugs could one day help us thwart diseases where T cells are too active or not active enough.”

Butte and colleagues are beginning to apply these findings — in a study funded by the National Institutes of Health — to diminish the role T cells play in triggering Type 1 diabetes.

“We can’t talk about precision medicine and still use a sledgehammer to treat disease,” Butte said. “By exploiting the mechanism we discovered to soften T cells, we could accelerate vaccine responses so a patient won’t need multiple boosters and months of waiting to get full immunity. Or we could stiffen up T cells to prevent the body from rejecting transplanted organs.”

Grants from the National Institute of Allergy and Infectious Diseases, the National Institute of General Medical Sciences, the Stanford Child Health Research Institute, the Morgridge Family Foundation and the National Science Foundation supported the research.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/T+cells.jpgT cell stiffness mapIn this atomic-force microscopy image of a T cell, dark purple indicates stiffer sections and lighter purple represents softer spots.

In this atomic-force microscopy image of a T cell, dark purple areas indicate stiffer sections and the lighter purple represents softer spots.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/T+cells.jpgT cell stiffness map

In this atomic-force microscopy image of a T cell, dark purple areas indicate stiffer sections and the lighter purple represents softer spots.

ElaineSchmidt310-267-8323 (o) | 310-597-5767 (c)eschmidt@mednet.ucla.eduManipulating the stiffness or softness of T cells could help doctors harness the immune system to control disease.Elaine Schmidthttp://newsroom.ucla.edu/releases/ucla-scientists-show-how-to-amplify-or-stifle-signals-for-immune-responsesTue, 07 Mar 2017 19:00:00 GMTThe researchers identified genes that they believe control hundreds of other genes linked to Alzheimer’s disease, Parkinson’s disease, depression and several other disorders. Volunteer companions spend time with elderly at UCLA Medical Center, Santa Monica

Hospitals can be lonely places for patients, especially elderly patients who may have few, if any, family members or friends living nearby to visit them.

“Hospitalization is never fun, but for patients who don’t have visitors, it can be very lonely,” said Valerie Yeo, unit director of the inpatient geriatrics unit at UCLA Medical Center, Santa Monica. Even patients with family members close by often discover  their relatives are unable to visit frequently due to work or other commitments.  

That’s why the UCLA Geriatrics Program launched its Companion Care Program at the hospital last year. Funded by a gift from the Samuel Steinberg Family Foundation, the program provides specially trained volunteers who offer individualized companionship to older adult patients while they are hospitalized.

The companions spend time reading to patients, playing games with them, assisting with feeding and accompanying them on walks under a nurse’s supervision.

Presently, there are more than 60 trained companions in place, with a goal of having 200 on board when the program becomes fully operational. Volunteers, ages18 or older, donate at least one four-hour shift per week. Companions are easily identifiable by the bright green polo shirts they wear while rounding on the unit.

Companion Julia Torrano believes she benefits as much from the program as do the patients she visits during her shift every Friday. “This is the most rewarding volunteer program I’ve ever participated in,” she said. “Most of the patients just crave talking to people. They love talking about their lives, sharing their knowledge and wisdom, and I love hearing about them.”

Torrano, a 24-year-old from Santa Monica who’s planning to attend medical school, recalled visiting with an older gentleman who had no family, and he began talking about his passion for music and ballroom dancing. “He said it had gotten him through a divorce and other bumpy patches in his life. He was so enthusiastic and animated that it made me want to learn ballroom dancing myself!”

Dr. David Reuben, chief of the UCLA Geriatrics Program in Santa Monica and Westwood, said companions also help interested patients tell their life story through the Living History Program, designed to improve the connection between caregivers and patients by encouraging patients to share life experiences.

“These volunteers provide individualized social interaction and attention — engaging patients in a more personal way than might otherwise be possible. Most of the patients on the unit are sick, and a significant number have dementia, so levels of ability to participate in activities will vary,” Reuben explained.

He added that volunteers must acquire CPR certification, receive specialized training in the needs and care of the geriatric population, and attend a two-hour orientation program.

However, lonely patients are not the only beneficiaries of companion care, according to Pedro Jimenez, program manager.

“Sometimes volunteers are assigned to patients who actually do have family members and friends, but those visitors may need a break — maybe just an hour to grab lunch or run home and take a shower,” Jimenez said. “They may be reluctant to leave their loved one even for that amount of time. A companion can step in and provide a bit of respite.”

The Companion Care Program is currently available only at UCLA’s Santa Monica campus. Anyone interested in volunteering may learn more by contacting Jimenez at 310-351-2527, emailing him at pdjimenez@mednet.ucla.edu or visiting this website. 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Geriatric+Companion+Program.+Julia+Torrano+v.jpgVolunteer companion Julia Torrano and a patient Julia Torrano visits with a patient at UCLA Medical Center, Santa Monica. She is a volunteer in the Companion Care Program, launched by the UCLA Geriatrics Program with a gift from the Samuel Steinberg Family Foundation.

Julia Torrano, 24, of Santa Monica is a volunteer in the Companion Care Program. She visits with a patient at UCLA Medical Center, Santa Monica.  

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Geriatric+Companion+Program.+Julia+Torrano+v.jpgVolunteer companion Julia Torrano and a patient

Julia Torrano, 24, of Santa Monica is a volunteer in the Companion Care Program. She visits with a patient at UCLA Medical Center, Santa Monica.  

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20172/Geriatric+Companion+Program-12.jpgJulia Torrano and a patientTedBraun310-319-4567tbraun@mednet.ucla.eduThe Companion Care Program provides specially trained volunteers who offer individualized companionship to older adult patients while they are hospitalized.Ted Braunhttp://newsroom.ucla.edu/stories/hospital-stays-less-lonely-for-older-adultsFri, 03 Mar 2017 16:59:00 GMTTwenty-three high school students are getting a unique opportunity to launch their future careers in the health care field, thanks to a new hands-on internship program.
Updated: 4 hours 59 min ago