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Dr. Robert T. Sataloff has been working with transgender and other LGBTQ patients since 1975 when he was an intern at the University of Michigan. When Dr. Sataloff returned to Philadelphia in 1980, he established the world's first comprehensive, multidisciplinary voice center that included not only laryngologists, but also speech-language pathologists and singing voice specialists. The voice center has grown to include three speech-language pathologists and singing voice specialists, acting voice specialists, nurse clinicians, voice scientists, psychological professionals, and collaborating Arts Medicine personnel in other medical disciplines including endocrinology, pulmonology, neurology, gastroenterology, various surgical specialties and other fields. Closely collaborating, multidisciplinary team structure is essential to provide optimal voice care for the LGBTQ population, as well as for other voice patients. Read Dr. Sataloff's publication in Professional Voice, The Science and Art of Clinical Care on Management of Gender Reassignment Patients Robert T. Sataloff, MD, DMA, FACS is Professor and Chairman, Department of Otolaryngology-Head and Neck Surgery and Senior Associate Dean for Clinical Academic Specialties, Drexel University College of Medicine. He also holds Adjunct Professorships in the Departments of Otolaryngology – Head and Neck Surgery at Thomas Jefferson University, Temple University and the Philadelphia College of Osteopathic Medicine; and he is on the faculty of the Academy of Vocal Arts. He serves as Conductor of the Thomas Jefferson University Choir. Dr. Sataloff is also a professional singer and singing teacher. He holds an undergraduate degree from Haverford College in Music Theory and Composition; graduated from Jefferson Medical College, Thomas Jefferson University; received a Doctor of Musical Arts in Voice Performance from Combs College of Music; and he completed Residency in Otolaryngology - Head and Neck Surgery and a Fellowship in Otology, Neurotology and Skull Base Surgery at the University of Michigan. Dr. Sataloff is Chairman of the Boards of Directors of the Voice Foundation and of the American Institute for Voice and Ear Research. He also has served as Chairman of the Board of Governors of Graduate Hospital; President of the American Laryngological Association, the International Association of Phonosurgery, the Pennsylvania Academy of Otolaryngology – Head and Neck Surgery, and The American Society of Geriatric Otolaryngology, and in numerous other leadership positions. Dr. Sataloff is Editor-in-Chief of the Journal of Voice; Editor Emeritus of Ear, Nose and Throat Journal; Associate Editor of the Journal of Singing; on the Editorial Board of Medical Problems of Performing Artists, and is an editorial reviewer for numerous otolaryngology journals. He has written over 1,000 publications including 70 books, and he has been awarded more than $5 million in research funding. His H-index is 43 (as of July 2021). He has invented more than 75 laryngeal microsurgical instruments distributed currently by Integra Medical, ossicular replacement prostheses produced by Grace Medical, and a novel laryngeal prosthesis (patent pending). He holds a patent on a unique thyroplasty implant. His medical practice is limited to care of the professional voice and to otology/neurotology/skull base surgery. Dr. Sataloff has developed numerous novel surgical procedures including total temporal bone resection for formerly untreatable skull base malignancy, laryngeal microflap and mini-microflap procedures, vocal fold lipoinjection, vocal fold lipoimplantation, and others. Dr. Sataloff is recognized as one of the founders of the field of voice, having written the first modern comprehensive article on care of singers, and the first chapter and book on care of the professional voice, as well as having influenced the evolution of the field through his own efforts and through the Voice Foundation for over 4 decades. Dr. Sataloff has been recognized by Best Doctors in America (Woodward White Athens) every year since 1992, Philadelphia Magazine since 1997, and Castle Connolly’s “America’s Top Doctors” since 2002.

Israel’s ALYN Hospital Pediatric & Adolescent Rehabilitation Center and Philadelphia International Medicine Join Forces to Advance Medical Innovation, Education And Care -- The ALYN-PIM Health Gateway Initiative is a collaborative program aimed at delivering medical education, joint research, and patient care -- Jerusalem, Israel, and Philadelphia, November 7, 2021. ALYN Hospital Pediatric & Adolescent Rehabilitation Center, a leading healthcare provider in Israel, and Philadelphia International Medicine (PIM), a provider of specialized clinical services and education from world-renowned Philadelphia area hospitals, have established the ALYN-PIM Health Gateway Initiative to advance education, research, innovation, and patient care including second opinion activities. “Medical education, research, and innovation are ongoing activities at ALYN, bringing considerable benefits not only to our staff but primarily to our patients,” said Dr. Maurit Beeri, Director General of ALYN Hospital. “By partnering with PIM, we can build a valuable health gateway, connecting our medical teams and professionals. We are looking forward to identifying and developing collaborative initiatives, such as physician exchanges, research projects, and more.” “We are very excited to be working with ALYN and for the many opportunities that lie ahead,” said Edgar Vesga, CEO and President of PIM. “It is important to us that we can continue to make quality medical care available to international patients, and we see cooperation between centers of excellence in Philadelphia and Jerusalem as an ideal way to achieve this goal. Connecting Israel with Philadelphia opens many doors for both PIM and ALYN to collaborate in future endeavors to improve the future of medicine.” The ALYN-PIM Health Gateway initiative will focus on sharing medical knowledge and technology, while improving accessibility to highly skilled care. By building relationships and jointly exploring opportunities, ALYN and PIM seek to improve the overall medical status of their communities. ALYN and PIM will continuously grow this initiative to identify and develop additional opportunities, including physician exchanges, lectures and programs in hospital administration, consulting projects, training in best practices, and more. About ALYN ALYN Jerusalem is one of the leading healthcare providers in Israel, dedicated to providing the best quality of medical and rehabilitation treatment for children facing physical challenges, both congenital and acquired. ALYN enables them to function to the best of their ability and integrate into their family life within the framework of a supportive community. ALYN is affiliated with the Hebrew University Faculty of Medicine and offers advanced care from birth to adulthood. With more than 90 years of experience, it is now one of the world leaders in Pediatric Rehabilitation. https://www.alyn.org/ About PIM PIM provides international patients and physicians with access to an unmatched network of world-renowned doctors, surgeons and hospitals that deliver personalized medical, surgical and rehabilitative care ranked among the best in the world. PIM is owned and operated by Thomas Jefferson University Hospital, Temple University Hospital, and Fox Chase Cancer Center and affiliated with Wills Eye Hospital, Rothman Institute, Main Line Health, Nemours Children’s Health, Magee Rehabilitation Hospital, the Vincera Institute, and the Renfrew Center. https://www.philadelphiamedicine.com/ Contact Shirel Daniel Senior Manager of Global Outreach sdaniel@philadelphiamedcine.com

Join us for a webinar on November 8th at 8:00PM. Featured speakers Bonnie Grant, Dr. Maria Cecilia Aponte and Dr. Ignazio Marino will discuss the future of this exciting industry! Philadelphia International Medicine is proud to be hosting this event with Temple University School of Sport, Tourism and Hospitality Management. REGISTER HERE!! Speakers Bonnie Grant, Executive Director, PHL Life Sciences As Executive Director, Bonnie is responsible for marketing Greater Philadelphia, ranked the second largest life sciences sector in the country, as “America’s Life Sciences Meetings Destination.” She manages more than 60 regional life sciences leaders from Pennsylvania, New Jersey and Delaware, leveraging common resources to enhance awareness of the region as a vibrant destination for life sciences meetings and conventions. Representing public, private and academic entities, members of the Congress assist with sales, on-site services and sponsorship efforts, as well as promoting the region’s premier attractions in history, science, arts, culture and entertainment, all making for a unique and memorable Philadelphia convention experience. For more than two decades, Bonnie has promoted Philadelphia to residents and visitors in positions with government, corporate and educational institutions. For nine years, she served as Deputy City Representative for the City of Philadelphia under the administrations of Mayors Edward G. Rendell and John F. Street. She has also served as director of communications and spokesperson for Greater Philadelphia Urban Affairs Coalition; the Philadelphia Eagles; and Chestnut Hill College. Dr. Maria Cecilia Aponte, International Accounts Manager, The Panama Clinic Dr. Maria Cecilia Aponte is physician, specialized in Health Services, Marketing, and Management with 15 years of experience. Dr. Aponte has had leadership, management and advisory roles in the pharmaceutical industry, health insurance and service delivery. Dr. Aponte currently leads the international department of The Panama Clinic and positioning of Panama in the international scope with the city’s Chamber of Commerce. Her international experience includes USA, Mexico, Panama, Salvador, Guatemala, Costa Rica, Honduras, Venezuela, Ecuador, Chile, Peru, Aruba, Curazao, St Maarten, and Germany, Panama. Dr. Ignazio Marino Professor of Surgery, Sidney Kimmel Medical College EVP, International Innovative Strategic Ventures Executive Director, Jefferson Italy Center Ignazio R. Marino, MD, ScD is executive vice president of Jefferson International Innovative Strategic Ventures. He is a trailblazer in transplant medicine who has also held high public office as a senator of the Republic of Italy and mayor of Rome. Dr. Marino has performed more than 650 transplants and was a member of the surgical team that performed the only baboon-to-human liver xenotransplants in medical history, and he performed the first transplant in Italy on an HIV-positive patient. He has authored more than 700 scientific publications and four scientific books, and has served on the editorial boards of “Transplantation,” “Liver Transplantation,” “Digestive Diseases and Sciences,” and 15 other international scientific journals. He has also published on the religious, bioethical, and humanitarian aspects of medicine, including a monograph on the future of the Italian national healthcare system. In 2006, he was elected senator of the Republic of Italy and appointed chair of the Standing Health Committee of the Italian Senate and later, chair within the senate of the Investigative Committee on the National Healthcare System. Dr. Marino was elected mayor of Rome in 2013 and served until 2015. REGISTER HERE!!

If you’re having a baby — or thinking about having a baby — during the pandemic, there’s a ton of information to sift through and make sense of. You might be wondering how COVID-19 affects pregnancy or if your unborn baby could be impacted by the coronavirus if you get sick. Another common concern is whether or not it’s safe to get vaccinated when pregnant, and if the vaccine could somehow impact fertility. It’s certainly understandable if you’re concerned about how COVID-19 could interfere with your pregnancy, but with the right protocols in place and a strong medical support team, you and your baby will be able to have a healthy pregnancy and smooth delivery. “Main Line Health moves with current thought and data,” says Antonette Dulay, MD, a maternal-fetal medicine specialist with Main Line Health. Because restrictions frequently change, you should always be in touch with your OB/GYN about who can be in the delivery room during labor and what the protocols are for the baby. Here’s what to know about how coronavirus affects pregnancy and fertility. What to know about pregnancy and COVID-19 The first thing to understand is that pregnant people are at a higher risk for experiencing severe outcomes with COVID-19. When you are pregnant, the body undergoes changes in the lungs and cardiac system. These are normal physiological changes, but they can make the mother-to-be more sensitive to infections that cause inflammation, such as the flu and COVID-19. When it comes to coronavirus and pregnancy, know that the vast majority of pregnant people who test positive for COVID-19 won’t develop serious symptoms or complications. However, about five percent will experience severe and critical outcomes, including being admitted to the intensive care unit, requiring oxygen support, or needing mechanical ventilation. “If you’re pregnant and you get COVID, you’re still at a significantly increased risk of developing severe and worse disease,” says Dr. Dulay. According to Dr. Dulay, pregnant people who contract the coronavirus and develop severe or critical disease have a higher risk of pre-term birth and Cesarean section. Recent data from the Centers for Disease Control and Prevention (CDC) shows pregnant people diagnosed with COVID-19 have no greater risk of miscarriage or stillbirth, notes Dr. Dulay. It’s also widely believed that in utero transmission from mother to fetus is rare. How do the coronavirus vaccines affect pregnancy and fertility? Pregnant people were not included in vaccine clinical trials, so there is limited data on the safety and efficacy of the vaccines in pregnant people. That said, Dr. Dulay thinks the benefits of getting vaccinated far outweigh the risks of contracting COVID-19. And the CDC, American College of Obstetrics and Gynecology, and Society for Maternal-Fetal Medicine have all recommended that the vaccine be made available to pregnant and lactating patients. Despite not having pregnant or lactating patients as part of the initial trials, the available vaccines have been effective in preventing death or hospitalization for severe disease. Your chances of developing severe illness are much lower if you’ve been vaccinated. Will I experience side effects from the vaccine? Reactions to the vaccine are similar in pregnant and non-pregnant people and generally include pain at the injection site, body aches, fatigue, headache and fever. The kind of short-term fever that may come on after vaccination should not be an issue for pregnant people, says Dr. Dulay. “It’s really more sustained fever that is a problem,” she said. Monitor your temperature and take Tylenol if need be, she advises. Dr. Dulay recommends alerting your doctor if you do develop a fever, even if it’s low grade. Some have felt concern that the vaccine may inject genetic material into the body that can impact fertility, but Dr. Dulay says this is not the case. The vaccine ingredients are quickly broken down by the body and discarded. There is currently no evidence the vaccine could impact future fertility or cause genetic mutations. Those who want to start trying to have a baby should consider getting the vaccine as soon as they qualify. “Now’s the time to get it so you don’t even have to worry about what it does to your developing baby,” Dr. Dulay said. Getting the shot will provide protection now and in the future. Can pregnant people get the vaccine at Main Line Health? Yes, but currently only to pregnant patients who are 20 to 32 weeks pregnant. This decision was made based on vaccine supply, as well as to avoid any scheduling conflicts with other vaccines required during pregnancy. According to Dr. Dulay, pregnant people should not get the COVID-19 vaccine within two weeks of receiving another vaccine, such as the TDAP shot. In addition, the CDC states that the second dose can be given within 48 days of the first dose, so if you experience a slight delay in getting the second shot, there is no need to panic. After getting vaccinated, sign up for the CDC’s V-safe program where you can log any symptoms and reactions. You will get a link to register at your vaccine appointment. Not only will this help you keep track of reactions, it can also help collect data and information to help other pregnant patients. “It's the best way we have now to track pregnancy outcomes,” Dr. Dulay said. Main Line Health has been proactively reaching out to pregnant people who are eligible for the vaccine to help them book an appointment. Check in with your doctor on a regular basis in case supply increases and more vaccination appointments become available. If you have any questions or concerns about the vaccine, bring them up with your doctor who can review your risks, benefits, and what to expect. Staying safe and giving birth during the pandemic Because pregnant people have a greater chance of experiencing severe disease and pregnancy complications, Dulay says it’s critically important to continue following the safety protocols that can help prevent COVID-19: Wash your hands, wear a tight-fitting face mask, and maintain social distance from others. Finally, stay in touch with your OB/GYN. Restrictions and guidance about who can be in the room during delivery and the protocols for the newborn change often as researchers learn more about how the coronavirus affects pregnancy. Currently, Main Line Health is allowing two partners in the delivery room, including a doula, if the parent chooses to use one. They must produce a negative coronavirus test before labor and delivery begins. Unless there is an emergency, babies aren’t necessarily being separated from their parents. With the right protocols in place, new mothers who test positive for the coronavirus will be able to breastfeed their newborns safely and comfortably after delivery.

Leading oncology experts, physicians, and researchers are continuously working to identify innovative approaches to limiting a person’s unique cancer risk, controlling the spread of the disease in the body, and eliminating certain types of cancer altogether. While new breast cancer treatments continue to be developed, the key to effective cancer prevention and control might come from cancer patients themselves – or at least from their immune systems. Immunotherapy is an innovative treatment that combines these efforts by utilizing the power of the body’s natural immune system to maximize an individual’s potential for cancer resistance and to optimize their success while undergoing treatment. From preventive vaccines to cutting-edge interventional techniques, immunotherapy has already led to significant breakthroughs in the treatment of breast cancer and a variety of other cancers. What is immunotherapy? Our immune systems are comprised of organs, cells, and other organic materials in the body that serve as our first line of defense against infection, illness, and disease. Cancer immunotherapy, sometimes referred to as immuno-oncology, is a form of treatment that utilizes the immune system in order to enhance the ability to inhibit and attack cancerous cells in the body. When implemented successfully, immunotherapy has the potential to: Train the immune system to identify and attack specific cancer cells Strengthen existing immune cells to boost their cancer elimination response Supplement the body’s overall immune response Immunotherapy treatments come in different forms. Many include targeted antibodies and other cancer-specific vaccines while others involve more progressive approaches like adaptive cell transfers or tumor-infecting viral agents. Other immunotherapy treatments may be referred to as gene therapies, as they use genetic engineering to enhance the cancer-fighting capabilities of immune cells. Immunotherapy for breast cancer With over 270,000 new cases of breast cancer diagnosed each year, the need for potent and lasting treatments is urgent. While current treatment methods typically involve surgery or a variety of radiation therapies, recent clinical studies have shown that immunotherapy also has the potential to improve outcomes for breast cancer patients. In breast cancer care, immunotherapies are almost always used in conjunction with radiation therapy, chemo, or surgery in order to optimize the prevention, management, and elimination of cancerous cells in the body. The physicians, surgeons, and immunologists in Main Line Health’s Breast Cancer Program are passionate about delivering the best possible outcomes for our patients. Because every cancer diagnosis is different, we utilize individualized and highly-informed treatment plans that cater to each patients’ unique genetic makeup, family history, and current health status. Main Line Health is at the forefront of breast cancer research, immunotherapy clinical trials, and new frontiers in cancer treatment. We prioritize patient comfort and safety above all else, which is why we only incorporate innovative therapies, medications, and surgical interventions once they have been thoroughly researched and trialed. When immunotherapy is an appropriate option to explore, any and all treatment decisions rely on the informed consent of the patient, their cancer care team, and the expert guidance of an immuno-oncologist. If you believe immunotherapy could be added into your cancer care, talk to your doctor to determine your eligibility and discuss your personalized treatment options.

Yoshihiro Yonekawa, MD, reports on the findings of an investigation looking at the prevalence of endophthalmitis following minimally invasive glaucoma surgery. Originally Published on Ophthalmology Times, Lynda Charters Yoshihiro Yonekawa, MD, from Wills Eye Hospital, Mid-Atlantic Retina, Thomas Jefferson University, Philadelphia, reported that the prevalence of endophthalmitis following minimally invasive glaucoma surgery (MIGS) is similar to the prevalence rates of endophthalmitis after other incisional glaucoma surgeries but warned of the potential risk of endophthalmitis with the use of implantable MIGS devices. While endophthalmitis is a rare event after glaucoma surgery, ranging from 0.20% to 6.3%, little is known about the characteristics of endophthalmitis after various MIGS procedures, he emphasized. To shed more light on this complication after MIGS, Yonekawa and associates retrospectively reviewed bacterial endophthalmitis cases after MIGS that were diagnosed and treated at the Wills Eye Hospital from October 1, 2015, to July 1, 2020. In this study,1 a MIGS procedure involved both implantable devices, i.e., the iStent (Glaukos Corp.), Hydrus device (Ivantis, Inc), Xen Gel stent (Allergan Plc), CyPass Microstent (Alcon), and MIGS procedures not involving an implantable device. Factors Associated with Endophthalmitis Over the study course of almost 5 years, 979 cases of endophthalmitis were treated, of which 13 (1.3%) were diagnosed after a MIGS procedure and 4 of those were from Wills Eye Hospital or affiliated practices. A total of 3,055 MIGS procedures had been performed at Wills, which resulted in a prevalence rate of 0.13% (4/3,055; 95% Poisson confidence interval [CI], 0.04%-0.30%), or 1 in 769 patients, Yonekawa reported. Nine of the 13 cases were associated with the iStent (7 from external practices and 2 of 2,101 internal; 0.095%; 95% CI, 0.036%-0.29%), 3 cases with the Xen Gel stent (2 external and 1 of 406 internal; 0.25%; 95% CI, 0.014%-1.1%), and 1 case with the CyPass Microstent (0 external and 1 of 111 internal; 0.90%; 95% CI, 0.051%-3.97%). Endophthalmitis was not associated with the 437 MIGS procedures that did not involve an implantable device, i.e., goniotomy, trabeculectomy, gonioscopy-assisted transluminal trabeculotomy, trabectome, Kahook Dual Blade (New World Medical), or OMNI surgical system (Sight Sciences, Inc.). Three cases of endophthalmitis had delayed presentation, and 2 of these were related to Xen Gel exposure. Of 7 eyes with positive cultures, 2 eyes showed Staphylococcus epidermidis, 1 eye S. aureus, and 4 eyes various Staphylococcus species, findings that differed slightly from findings after cataract surgery, which is associated mostly with coagulase-negative staphylococcal species. The investigators concluded, “The calculated prevalence of endophthalmitis in this study is similar to the reported incidences of endophthalmitis after other incisional glaucoma surgeries. Surgeons need to be cognizant of the potential risk of endophthalmitis with the use of implantable MIGS devices and the differences between endophthalmitis after MIGS procedures and endophthalmitis after standard cataract surgery. Not all MIGS devices are similar in their approach to lowering intraocular pressure (IOP), and thus each device and case of endophthalmitis may require unique management decisions.” --- Reference 1. Starr MR, Huang D, Israilevich RN, et al. Endophthalmitis after minimally invasive glaucoma surgery. Ophthalmology 2021;Jun 5 [Online ahead of print] DOI: 10.1016/j.ophtha.2021.06.004.

In a recently published study, a researcher at Fox Chase Cancer Center outlined new methods for handling heterogeneous data types from large-scale studies. These studies generate genomic profiles with the goal of identifying subgroups of patients who may have a better prognosis or benefit from a particular treatment. Genomic profiling is a process used to understand the way genes interact with each other and the environment of a specific individual. It can be used to develop new methods of monitoring, diagnosing, and preventing diseases—including cancer—by identifying specific genomic features that are unique to a subgroup of individuals with the disease. The number of such genomic markers of interest typically far outnumbers the subjects that can be followed up clinically. “Our approach provides a unified framework for handling various types of genomic feature measurements,” said Karthik Devarajan, PhD, the study’s lead author and associate professor of population science in the Biostatistics and Bioinformatics Facility at Fox Chase. “We developed a generalized algorithm that facilitates the delineation of tumor samples into homogeneous subgroups with similar genomic profiles which can, in turn, be linked to clinical outcomes. For instance, it can ultimately aid in determining which patients are likely to respond favorably to a new therapy.” In order to fully comprehend the genomic profile of a tumor sample, it is often necessary in practice to measure and quantify diverse aspects of it. This is made possible by an array of genomic technologies that are currently available for profiling tumor samples. Methods such as the ones developed by Devarajan are critical in predicting cancer outcomes, particularly because there are several challenges researchers face when using standard statistical methods in analyzing and interpreting the effect of genomic profiles on patient survival, disease progression or recurrence, and response to a particular treatment. In addition, they are useful for discovering a completely unknown cancer subtype or distinguishing lesser-known subtypes. “Our methods are designed to handle the large volume and disparate nature of genomic data, incorporate relevant clinical information, and account for confounding clinical factors,” said Devarajan. He added that by accurately identifying specific genomic markers associated with clinical outcomes in subgroups of patients, their work could aid in the design of clinical studies that could ultimately lead to improved and personalized cancer treatments. The study, “A Statistical Framework for Non-Negative Matrix Factorization Using Generalized Dual Divergence,” was published in Neural Networks.

On September 14th, Dr. Raúl Germán Rodríguez, President and CEO of CASMU - IAMPP and Dr. Horacio Rodríguez Dulcini, Human Management and Training Manager of CASMU - IAMPP, met with Mr. Edgar Antístenes Vesga-Arias President and CEO of Philadelphia International Medicine (PIM) and members of the health systems of Temple Health, Nemours Childrens´ Health and Main Line Health to sign an agreement of mutual understanding and joint collaboration that includes: clinical and administrative training, medical exchanges, telemedicine , interactive real-time knowledge exchanges, clinical care, long-term research, and patient referral for second medical opinions. This agreement supports the development of opportunities in different medical specialties including oncology and robotics among other specialties. "We are proud to work with one of the centers of excellence in healthcare in South America with opportunities to create legacies in the healthcare sector that benefit communities in both countries" comments Philadelphia International Medicine President, Edgar Vesga. The memorandum of understanding is a first step in establishing a long-term formal relationship between the two organizations. It is intended that both parties continue to develop this relationship and, over time, identify and develop additional opportunities. About CASMU IAMPP CASMU IAMPP is one of the largest Private Medical Assistance Institutions in Uruguay. It has 36 Medical Centers all over the country, 2 hospitals, and almost 200,000 team members. The Institution stands out for its great infrastructure, state-of-the-art technology, as well as having the most qualified medical staff in Uruguay. ​​ 20 years after its creation, Casmu has become a Medical Care Institution with the highest number of affiliates. But its importance transcends above just the numbers and statistics, because its creation marks a historical achievement in terms of the level and quality of care benefits it offers for all of collective medicine. About PIM For over 20 years, Philadelphia International Medicine (PIM) has welcomed patients and partners from around the globe to Philadelphia. PIM is dedicated to excellence in international patients services, global partnerships and continuing medical education for healthcare providers. PIM brings together the services of ten world-renowned Philadelphia-area medical centers to the international community. PIM network partners are internationally recognized experts who are committed to providing the highest quality of care – with a great deal of compassion. The Philadelphia International Medicine network of ten (10) health systems includes Fox Chase Cancer Center, Temple University Hospital, and Thomas Jefferson University Hospitals, Wills Eye Hospital, Rothman Orthopaedics Institute, Main Line Health, Nemours Childrens´ Health, the Vincera Institute, Magee Rehabilitation Hospital and the Renfrew Center

Originally posted on PHL INNO Philadelphia’s startup ecosystem ranks among the best in the world, reaching No. 28 globally, according to the latest report from research firm Startup Genome. Startup Genome’s Global Startup Ecosystem Report ranked more than 275 regional ecosystems based on factors like startup growth and activity, innovation and research, capital availability, talent and support for companies. Silicon Valley, London and New York topped the 2021 rankings. Philadelphia climbed 15 spots in the last year, from No. 43 to No. 28, marking one of the largest jumps on the list. In North America, Philadelphia ranks at No. 13 overall, behind Atlanta and Denver-Boulder — ranked at No. 11 and No. 12, respectively. Startup Genome uses sources like Crunchbase, Pitchbook, Glassdoor, survey data from 10,000 startup executives, information from local startup accelerators and investors, as well as interviews with more than 100 experts to make its determinations. The region was highlighted for a high concentration of talent, research, experienced investors and local market reach. The life sciences industry was also touted as an area of significant growth in Greater Philadelphia, as were startups specializing in artificial intelligence and data management. Philadelphia’s ecosystem saw $994 million in early stage funding over the last two-and-a-half years, according to Startup Genome. The new ranking comes just a year after Philadelphia was named the top emerging startup ecosystem in the U.S., and a few months after the region smashed its annual venture capital funding record. “We're finally doing a little better job of letting the world know what we do and what we've done for a long time,” said Scott Nissenbaum, CEO of Ben Franklin Technology Partners of Southeastern Pennsylvania, a state-backed seed fund. Philadelphia has long been regarded as an “understated overachiever” when it comes to startups and innovation, Nissenbaum said. Now the region has major strength in technology and cell and gene therapy startups. Spark Therapeutics, for example, was acquired by Roche for $4.3 billion in 2019. Fast-growing startups and entities like Ben Franklin, the University City Science Center and local universities, are driving recognition and attention to Greater Philadelphia. The region ranked high in Startup Genome’s connectedness category, which takes into account the number of accelerators and incubators, research grants and research and development centers available to startups. “We’ve always been rowing the boat in the same direction, we just haven’t been rowing the boat in the same boat together,” Nissenbaum said.

Main Line Health researchers find that changes in treatment increased anxiety for breast cancer patients amid pandemic, and Main Line Health physicians respond to this patient need The COVID-19 pandemic forced medical centers nationwide to delay or change course on treatment for many breast cancer patients. A new study by Main Line Health researchers has taken an in-depth look at the issue, finding the pandemic caused wide-ranging effects. About 44% of patients saw changes to their breast cancer treatment plan due to the pandemic, according to the study led by the Center for Population Health Research at the Lankenau Institute for Medical Research (LIMR), part of Main Line Health. Regardless of whether their plan was altered, nearly 1 in 3 experienced elevated levels of anxiety and depression. The study involved patients who needed medical evaluation or had a scheduled surgery date at Lankenau Medical Center or Bryn Mawr Hospital, two acute-care hospitals under Main Line Health, a community-based health system providing multidisciplinary breast cancer care throughout the Philadelphia region. “This data is relevant to cancer care across the U.S. especially as we are now seeing an increase in COVID cases,” said lead author Kaitlyn Kennard, a postdoctoral fellow for LIMR and Lankenau Medical Center surgical resident. “More than 75% of surgical care for breast cancer nationally is delivered in community hospitals. That means Main Line Health’s experience with the impact of COVID-19 reflects the majority of breast cancer care.” Data was collected during the initial COVID-19 surge from March to June 2020. Surgery at the time was limited to essential cases. Established patients were seen via telemedicine. The study found 32 of the 73 enrolled patients (44%) had changes to their care. Changes included delay in therapy (15%) and use of hormonal therapy (29%) to compensate for delays in surgery. The median time to surgery for patients whose cases could not wait was 24 days. Additionally, a survey showed nearly one-third of patients reported higher anxiety and depression. Those levels were similar regardless of whether the patient had a change in care or not. However, more than 55% of those with changes in care said they believed COVID-19 affected their treatment outlook. “This study reinforces that we should have plans in place to meet the needs of patients with all types of cancer in the case of an emergent situation,” said Sharon Larson, executive director of the Center for Population Health Research and a study coauthor. “Since the initial COVID-19 surge, we have been diligently working to address the pandemic’s impact on Main Line Health cancer patients,” said Michael Walker, MD, medical director, Main Line Health Cancer Care. “We have developed programs and services to help our patients through this challenging time.” Walker cited creating online support groups and webinars, ensuring easy access to telemedicine, and providing early access to vaccines as examples of how the health system strived to serve patients and ease their anxiety. “Main Line Health breast cancer nurse navigators have always been by a patient’s side throughout testing, diagnosis and treatment, and they came up with innovative ways to continue this support, which was needed more than ever,” Walker said. The study, “COVID-19 Pandemic: Changes in Care for a Community Academic Breast Center and Patient Perception of Those Changes,” is in the September issue of Annals of Surgical Oncology.

Originally posted on American Heart Association Scientific Statement Obstructive sleep apnea, a form of sleep-disordered breathing, is common in children and adolescents and may be associated with elevated blood pressure and changes in heart structure, according to a new scientific statement from the American Heart Association, published today in the Journal of the American Heart Association. A scientific statement is an expert analysis of current research and may inform future guidelines. “The likelihood of children having disordered breathing during sleep and, in particular, obstructive sleep apnea, may be due to enlargement of the tonsils, adenoids or a child’s facial structure, however, it is important for parents to recognize that obesity also puts kids at risk for obstructive sleep apnea,” said statement writing group chair Carissa M. Baker-Smith, M.D., M.P.H., M.S., director of pediatric preventive cardiology at the Nemours Children’s Hospital in Wilmington, Delaware, and associate professor of pediatric cardiology at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia. “Sleep disruptions due to sleep apnea have the potential to raise blood pressure and are linked with insulin resistance and abnormal lipids, all of which may adversely impact overall cardiovascular health later in life.” Sleep-disordered breathing is when someone experiences abnormal episodes of labored breathing, snoring and snoring sounds during sleep. It includes a spectrum of conditions from snoring to obstructive sleep apnea (OSA). OSA is associated with cardiovascular disease in adults, however, less is known about how the condition affects the immediate and long-term heart health of children and adolescents. The research reviewed for the statement reveals the following: Obstructive sleep apnea disrupts normal, restorative sleep, which can impact emotional health, as well as the immune, metabolic and cardiovascular systems in children and adolescents. An estimated 1-6% of all children and adolescents have obstructive sleep apnea. About 30-60% of adolescents who meet the criteria for obesity (BMI≥95th percentile) also have obstructive sleep apnea. Risk factors for obstructive sleep apnea in children may vary with age; in general, the primary factors are obesity, upper and lower airway disease, allergic rhinitis, low muscle tone, enlarged tonsils and adenoids, craniofacial malformations and neuromuscular disorders. Sickle cell disease has also been reported as an independent risk factor for OSA. Children who were born premature (before 37 weeks gestation) may have increased risk for sleep-disordered breathing, partly due to delayed development of respiratory control and the smaller size of the upper airway. However, this risk appears to decrease as children who are born premature age and grow. OSA may be present in children with the following symptoms: habitual snoring, more than 3 nights per week; gasps or snorting noises while sleeping; labored breathing during sleep; sleeping in a seated position or with neck hyperextended; daytime sleepiness; headache upon waking up; or signs of upper airway obstruction. The statement reiterates the recommendation of the American Academy of Otolaryngology and Head and Neck Surgery that a sleep study, called polysomnography, is the best test for diagnosing sleep-disordered breathing. They recommend a sleep study before a tonsillectomy in children with sleep-disordered breathing who have conditions that increase their risk for complications during surgery, such as obesity, Down syndrome, craniofacial abnormalities (e.g., cleft palate), neuromuscular disorders (e.g., muscular dystrophy) or sickle cell disease. Children with these conditions and OSA are considered at high risk for breathing complications during any surgery. Anesthesia medicine should be carefully considered, and breathing should be closely monitored after surgery. Children and adolescents with OSA may also have higher blood pressure. The statement details elevated sleeping blood pressure, which is normally more than 10% lower than a person’s blood pressure level when awake. Research shows that children and youth with OSA have a smaller dip in blood pressure while asleep, which may indicate abnormal blood pressure regulation. In studies of adults, “non-dipping” is associated with a higher risk of cardiovascular events. The statement suggests that children and adolescents with OSA have their blood pressure measured over a full 24-hour period to capture waking and sleeping measurements given the likelihood for higher nighttime blood pressure. Metabolic syndrome is another concern for children with even mild OSA (as few as 2 episodes of pauses in breathing per hour). This syndrome includes a cluster of factors such as high insulin and triglyceride levels, elevated blood pressure and low levels of high-density lipoprotein (HDL, the “good” cholesterol). Continuous positive airway pressure (CPAP), a treatment for OSA, can significantly lower triglyceride levels and improve HDL levels. Treating OSA may also improve the factors of metabolic syndrome, at least in the short term. However, obesity status may be the main reason for some metabolic factors, such as poor insulin control. “Obesity is a significant risk factor for sleep disturbances and obstructive sleep apnea, and the severity of sleep apnea may be improved by weight loss interventions, which then improves metabolic syndrome factors such as insulin sensitivity,” Baker-Smith said. “We need to increase awareness about how the rising prevalence of obesity may be impacting sleep quality in kids and recognize sleep-disordered breathing as something that could contribute to risks for hypertension and later cardiovascular disease.” The statement also outlines research that suggests a risk for pulmonary hypertension in children and adolescents that have long-term severe OSA. The writing committee also identifies the need for additional studies of cardiovascular disease risk associated with OSA in childhood that incorporate 24-hour blood pressure monitoring and measures of metabolic syndrome factors. This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association’s Atherosclerosis, Hypertension and Obesity in the Young subcommittee of the Council on Cardiovascular Disease in the Young. Co-authors are Justin Zachariah, M.D., vice-chair; Amal Isaiah, M.D.; Maria Cecilia Melendres, M.D.; Joseph Mahgerefteh, M.D.; Anayansi Lasso-Pirot, M.D.; Shawyntee Mayo, M.D., M.P.H.; and Holly Gooding, M.D., M.Sc. Author disclosures are in the manuscript. Additional Resources: Available multimedia is on right column of release link - https://newsroom.heart.org/news/obstructive-sleep-apnea-is-common-in-kids-and-may-impact-blood-pressure-heart-health?preview=32e566c3832b3e1c138a024aa7117b01 After Aug. 18, view the manuscript online. What you need to know about how sleep apnea affects the heart Sleep Well infographic Follow AHA/ASA news on Twitter @HeartNews The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here. About the American Heart Association The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

“Well Beyond Medicine” reflects focus on whole child health philosophy Nemours Children's Health has officially launched the new brand reflecting its bold strategy to redefine children’s health. In addition to a new name and logo, Nemours Children’s also introduced “Well Beyond Medicine” as an expression of this new strategy that is going beyond medicine to improve the health of the world in which every child lives. As Nemours Children’s new tagline, “Well Beyond Medicine” is also a featured section on Nemours Children's newly redesigned website to showcase initiatives reflecting leadership and national collaboration focused on whole-child health. Also this week, a new advertising campaign called “Journey” commences to highlight how Nemours impacts the lives of children in achieving its vision to create the healthiest generations of children. This campaign is designed to reframe how consumers think about achieving health and highlights the ways Nemours Children's aims to keep children well, beyond medicine. The campaign underscores how the high-quality care at Nemours Children's goes beyond the walls of its hospitals to emphasize health at home, school, and the neighborhoods in which children live, learn, and play. "Given that up to 80 percent of the impacts on children’s health take place outside medical settings, Nemours Children's Health is looking beyond traditional medical care to help lead transformation across all the systems and support services that will work together to create the healthiest generations of children," said R. Lawrence Moss, MD, FACS, FAAP, president and CEO of Nemours Children's Health. "Our new strategy and brand are intentionally intertwined to express our continuing focus on providing the best medical care while also pivoting to look broadly at the people, places, and institutions that must be influenced and reformed to give children healthier lives." Nemours facilities will now be named Nemours Children's Health, providing a unified and simplified experience for families. Nemours Children's Health operates hospitals in Wilmington, Delaware and Orlando, Florida; a network of nearly 75 primary and specialty care practices; a National Office on Policy & Prevention in Washington, D.C.; a robust international program; and its corporate headquarters in Jacksonville, Florida. "We are excited to share our approach, which extends beyond the traditional ideas of children's healthcare," said Sarah Sanders, senior vice president and chief marketing officer of Nemours Children's Health. "This new brand serves as the communications platform to tell this amazing story and to create a voice of influence to be able to achieve this change.” "Our ‘Well Beyond Medicine’ positioning and new ‘Journey’ campaign exemplify how Nemours Children's Health is going above and beyond the standards of medicine to create a world where all children can achieve health,” Sanders added. “Our intention is to educate consumers and communities about the importance of whole-child health and inspire partnership with the multitude of stakeholders, including our families, that are critical to achieving these goals." The new brand mark, coined “The Loop of Care,” represents both the enduring relationship between a child and caregiver, as well as Nemours Children's constant forward-looking advocacy for children's health. The Loop of Care subtly includes the letter 'N' in an infinity loop that signifies the Nemours name. The new "Forever Green" brand color represents the more than 85-year legacy of caring and science, on which Nemours is grounded. “Journey” begins this week across Nemours' geographic footprint with TV, CTV, OTT, radio, streaming radio, out-of-home, programmatic video and display, social, and print placements over the next 14 weeks. ### About Nemours Children’s Health Nemours Children’s Health is one of the nation’s largest multistate pediatric health systems, including two free-standing children's hospitals and a network of nearly 75 primary and specialty care practices. Nemours Children's seeks to transform the health of children by adopting a holistic health model that utilizes innovative, safe, and high-quality care, while also caring for the health of the whole child beyond medicine. Nemours Children's also powers the world’s most-visited website for information on the health of children and teens, KidsHealth.org. The Nemours Foundation, established through the legacy and philanthropy of Alfred I. duPont, provides pediatric clinical care, research, education, advocacy, and prevention programs to the children, families and communities it serves