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Wilmington, DE – Nemours Children’s Health System, providing pediatric care at more than 80 sites in five states, is proud to once again be recognized among the nation’s best. U.S. News & World Report has ranked Nemours/Alfred I. duPont Hospital for Children in Wilmington, DE, in five pediatric specialties in the new 2020-21 Best Children’s Hospitals rankings published online today. Orthopedics ranked in the top 20 in the nation. In addition, Nemours’ pediatric partner, Wolfson Children’s Hospital in Jacksonville, FL, achieved rankings in three specialty areas that are staffed solely by Nemours pediatric specialists. “Congratulations to our outstanding faculty and staff on this acknowledgement of our commitment to exceptional patient care,” said Nemours President and CEO R. Lawrence Moss, MD. “The information provided by U.S. News and World Report helps families make important health care decisions. Patients come to Nemours from across the country and around the world for our expertise and innovative approaches to care. We are proud to be ranked among the nation’s best and to offer skilled, compassionate and equitable care every day.” The duPont Hospital for Children’s ranked specialties include: Cancer Cardiology & Heart Surgery Gastroenterology & GI Surgery Neurology & Neurosurgery Orthopedics Nemours/Alfred I. duPont Hospital for Children has been ranked among the nation’s best children’s hospitals in each year it has participated in the survey. “To achieve these important rankings in our hospital’s 80th anniversary year is a testament to the high standard of care that families have come to expect from us,” said Jay Greenspan, MD, MBA, Nemours CEO, Delaware Valley Operations. Ranked specialties provided by Nemours physicians at Wolfson Children’s Hospital include: Diabetes & Endocrine Disorders Orthopedics Urology “Through the partnership with Wolfson Children’s Hospital, Nemours is proud to support excellence in patient care services, research, and educational endeavors to provide a superior experience for children and their families,” said Gary Josephson, MD, chief medical officer for Nemours Children’s Specialty Care, Jacksonville. The U.S. News Best Children’s Hospitals rankings rely on clinical data and on an annual survey of pediatric specialists. The rankings methodology factors in patient outcomes, such as mortality and infection rates, as well as available clinical resources and compliance with best practices. U.S. News introduced the Best Children’s Hospitals rankings in 2007 to help families of children with rare or life-threatening illnesses find the best medical care available. The rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals.

Clinical researchers are getting trials to patients with COVID-19 faster than ever. Here are the latest Jefferson trials testing potential COVID-19 therapies. PHILADELPHIA — There’s a lot we don’t yet know about the coronavirus that causes COVID-19, although researchers are working on it. We know that some people develop life-threatening disease, while others don’t, and clinical researchers are currently racing to find therapies to help patients survive the disease. Clinical trials are the best way to find out which medicines might work for this disease, and which are not actually effective. “We all desperately want to find treatments for patients to recover from the disease,” says David Whellan, MD, senior associate provost of clinical research at Jefferson and founder of the Jefferson Clinical Research Institute. “Clinical trials give us a way to find real improvement, not just hope.” “Our clinical research teams worked incredibly hard to get these trials to patients in record time,” says Dr. Whellan. Many of the drugs focus on reducing the inflammatory reaction to this virus, which seems to be at the heart of the worst patient outcomes. Others try to limit viral replication and spread within the body, giving the immune system a chance to keep up with the virus. Many of the therapies have been used for other diseases and conditions, but could also be effective for COVID-19 patients because they target overlapping biological processes. Read on to learn about the latest clinical trials at Jefferson for COVID-19. Convalescent Plasma Treatment Jefferson is collecting plasma – the clear component of blood that lacks blood cells, but is rich in antibodies – from patients who have recovered from COVID-19. Researchers think that the antibodies from recovered patients might help treat COVID-19 infected-patients. Antibodies work by both tagging the virus so it can be swept up by immune cells more easily, and also by blocking the virus’s ability to enter cells and spread to other organs in the body. Jefferson is uniquely positioned to support this trial with its own blood collection unit, under the direction of Julie Karp, MD, and Alexis Peedin, MD. These doctors along with Kristin Rising, MD, and Anna Marie Chang, MD, developed and implemented the Jefferson donor protocol to collect convalescent plasma.  The plasma is than used in a clinical trial for treatment, led by Mike Baram, MD, and clinical research coordinator Nicole Renzi.  The study aims to test whether the plasma from recovered COVID-19 patients can improve a current COVID-19 patient’s chances of successful recovery by reducing the amount of virus particles in the body. (Listen to ER doctor and researcher Anna Marie Chang’s story of recovery from COVID-19. She talks about how her experience made her want to donate plasma and help to get this clinical trial up and running for other patients.) To learn more about this trial, go to Clinicaltrials.gov, identifier #NCT04389710 Migraine Therapy for Preventing Inflammation in COVID-19 Patients (Vazegepant) A Phase 2/3 study, sponsored by Biohaven Pharmaceuticals, will evaluate the safety and efficacy of vazegepant in patients hospitalized at Jefferson with COVID-19 who require supplemental oxygen. Vazegepant is an intranasal spray being investigated for treating acute migraine. However, researchers have reason to believe it may improve outcomes from patients with COVID-19. The drug targets and blocks an enzyme that’s thought to cause inflammation in the brain. The trial will test whether vazegepant can also reduce inflammation in the lungs of COVID-19 patients. The clinical trial is being led by Mike Baram, MD and lead clinical research coordinator, Diana Clarkson. To learn more about this trial, go to Clinicaltrials.gov, identifier # NCT04346615 Putting the Brakes on Inflammation (Tocilizumab) Inflammation is a hallmark of most infections, and is usually part of a normal and healthy immune response. In COVID-19 disease, however, some research suggests that the inflammatory reaction is too strong and contributes to damage to the lungs and other organ systems. A phase 3 clinical trial sponsored by Genentech at Jefferson will test whether a medicine that blocks inflammation, can potentially treat patients with COVID-19 pneumonia. The drug tocilizumab, is an antibody against a major inflammatory cytokine called IL-6. Researchers think the drug could help reduce the body’s inflammatory reaction to prevent the runaway immune response. The trial is being led at Jefferson by Gautam George, MD, with lead clinical research coordinator, Merrybeth Lynch. To learn more about this trial, Clinicaltrials.gov identifier # NCT04320615 A Multiple Myeloma Drug in Testing for Blocking Coronavirus Growth and Inflammation (selinexor) A phase 2 clinical trial sponsored by Karyopharm Therapeutics and carried out at Jefferson and other sites will evaluate whether a drug approved for the treatment of the blood cancer multiple myeloma might work in patients with COVID-19. The drug, called selinexor targets exportin 1 (XPO1), a protein involved in moving cargo out of the cell’s nucleus into the cytoplasm. This nuclear export process is both important for driving inflammation and also for the virus’s ability to replicated thousands of copies of itself within the cell. In preliminary laboratory experiments, selinexor reduced both inflammation and the virus’s ability to replicate within the cell. The clinical trial, led by Ross Summer, MD, and clinical research coordinator, Merrybeth Lynch at Jefferson, will test whether the observations in the lab translate to improvement in patients with COVID-19. To learn more about this trial, go to Clinicaltrials.gov, identifier: NCT04349098 A Drug for Stem Cell Transplantations Tested for COVID-19 (CD24Fc) In some cases of viral infection, our own immune system does more damage to our own cells, in an attempt to get rid of the virus, than the virus itself. Taking learning from a similar situation, researchers are testing a drug used to treat bone marrow transplant patients. Bone marrow transplantation patients are treated with immune-suppressing drugs to keep the new bone marrow cells, which make up the immune system, from attacking the patient’s body. The phase 3 clinical trial sponsored by OncoImmune, Inc., will test whether the drug CD24Fc can help reduce inflammation and prevent organ failure in COVID-19 patients. The drug may do this in part by dampening the immune overreaction, and also rescuing T cells from exhaustion and elimination. T-cell exhaustion is something clinicians have observed in worst-case patients with COVID-19. The study is being led by Mike Baram, MD, and clinical research coordinator Elizabeth Duddy. To learn more about this trial, go to Clinicaltrials.gov, identifier: NCT04317040 Vitamin C infusion While later stages of COVID-19 disease are caused by an overactive immune response, there is a need for the immune system to fight the disease in earlier stages.  Vitamin C infusion have shown to increase the activity and activation of some immune cells, which are a crucial component of the body’s defense against viral disease progression. Dagan Coppock, MD, will lead a phase 1 clinical trial testing whether vitamin C, or ascorbic acid, infused via intravenous is safe and effective in patients suspected of COVID-19. The study will enroll patients who require supplemental oxygen, but are unlikely to require a ventilator within 48 hours of being admitted to the hospital for COVID-19. The lead clinical research coordinator for the trial is Bret Mullin. To learn more about this trial, go to Clinicaltrials.gov, identifier: NCT04363216 Defining Characteristics of Severe Disease Dysregulation of immune responses and alterations of peripheral lymphocyte subsets are hallmarks of severe COVID-19 infection. Non-survivors are more likely to have low lymphocyte counts and high pro-inflammatory cytokine signatures. However, how these changes develop overtime and drive progression in early stages of disease is largely unknown. In order to understand the changes in the immune system of severe COVID-19 disease, Neda Nikbakht, MD, PhD, will collect serial blood samples from COVID-19 patients treated at Jefferson for analysis. Testing a Drug with Antibiotic, Antifungal, and Anti-inflammatory Properties  (Sirolimus) The drug sirolimus, also called rapamycin, is known for its anti-inflammatory properties and used as a medicine to prevent organ rejection after transplants, and used to coat stents. The drug also has antibiotic and antifungal properties. These unique characteristics make it a candidate therapy for COVID-19. The phase 1 clinical trial will test whether the drug is safe and effective in patients, and is being led by Walter Kraft. To learn more about this trial, go to Clinicaltrials.gov, identifier: NCT04371640 ###

Twenty-six weeks pregnant, Scarlet and her husband, Jen, rushed across the island to Bermuda Hospital Emergency Department. “I had an early membrane rupture and I needed to be transferred out of Bermuda to receive specialized care. Mateo, my son, was in danger and under a lot of stress,” said Scarlet. After an evaluation and testing, Scarlet and Jen’s insurance company referred them to a hospital in Canada but, because of an issue with their Venezuelan passports, they could not travel there. “We couldn’t get new passports and couldn’t go to Canada. That is when the insurance reached Philadelphia International Medicine (PHL Medicine), and they contacted the US government to help us with the process of getting the Visa to travel to Philadelphia,” said Jen. With the paperwork ready and their bags full of hope, the three of them flew to the US to fight for an opportunity for Baby Mateo. “I was admitted to Thomas Jefferson Hospital, and the attention there was exceptional. They did all the tests they needed and verified the diagnosis given by our physician in Bermuda. They confirmed that we had a high-risk pregnancy and assigned a nurse that was almost wholly dedicated to me and Mateo, her name is Mallory. She, all the nurses, and the rest of the clinical staff are very loving and caring,” Scarlet remembers while smiling. The nurses and the doctors monitored Scarlet and Mateo continually, asking her to let them know how she felt, and if something did not feel right, to tell them right away. “Not long after being admitted to the hospital, I told them that I had a certain kind of pain that I hadn’t had before. A lot of physicians and nurses appeared to review my case and determined that I needed an emergency C-section because our baby was suffering stress, and that wasn’t good,” mentioned Scarlet. “What I can tell you is that the nurses and physicians are real experts, they know what to do. I felt very safe with them.” Baby Mateo was born and immediately admitted to the Neonatal ICU (NICU) to support his development while his mother recuperated from the surgery. “All the nurses were very involved in a level that I didn’t expect in the care of Scarlet and Mateo. They kept us informed all the time of every step in Mateo’s treatment,” said Jen. “Regarding PHL Medicine, I’m pleased with all that they did for us. They helped us to find a place to stay that was very close to the hospital; we could walk to go there. Everything was close to the NICU, where Mateo stayed. Stephanie, the patient coordinator at PHL Medicine, was very accommodating; she was checking upon us all the time. We don’t have any family in Philadelphia, but they were there for us,” Jen recounts while sighing with relief. “I remember that everybody at PHL Medicine and Thomas Jefferson Hospital would tell us: Mateo and your health are our priorities, we’ll solve everything related to paperwork or insurance. I always counted on their support. They made the whole situation easier for us,” concludes Scarlet. The dedicated teams from both Philadelphia International Medicine and Jefferson Health took care of every detail during Mateo, Scarlet and Jen’s stay in Philadelphia. The teams shared that “Witnessing how their health improved everyday was very motivating.” After months of treatment in Philadelphia, the new family of three was cleared to fly back to Bermuda. Mateo, Scarlet and Jen flew home filled with hope, happiness and confidence that no matter where they were in the world, they could always count on their new ‘family’ in Philadelphia.

PHILADELPHIA (April 27, 2020) – The Pennsylvania Medical Society (PAMED) released its list of this year’s Top Physicians Under 40. Two Fox Chase Cancer Center doctors were honored: Sanjay S. Reddy, MD, FACS, associate professor in the Department of Surgical Oncology, and Namrata “Neena” Vijayvergia, MD, assistant chief of gastrointestinal medical oncology in the Department of Hematology/Oncology. Winners were nominated by colleagues and selected by a committee of PAMED members. To appear on the list, physicians must practice in Pennsylvania and be under the age of 40 on Dec. 31, 2020. The 45 physicians on the 2020 list represent 19 different medical specialties. This select group has demonstrated a significant amount of success early in their medical careers, said Lawrence John, MD, president of PAMED. “The future of Pennsylvania medicine is very promising,” said John. “We are excited to recognize these outstanding individuals and look forward to seeing the difference they will make in their communities for years to come.” Below are the listings for Reddy and Vijayvergia as they appear on the PAMED website: Sanjay S. Reddy, MD, FACS Philadelphia A surgical oncologist with Fox Chase Cancer Center, Dr. Reddy serves as the associate program director for his organization’s Complex General Surgical Oncology Fellowship Program. He is also  the co-director of the  Marvin and Concetta Greenberg Pancreatic Cancer Institute. Dr. Reddy is passionate about improving care and outcomes for pancreatic cancer patients. He is involved in numerous clinical trials and participates in community outreach efforts concerning treatment and care of pancreatic cancer. Namrata Vijayvergia, MD Philadelphia A gastrointestinal medical oncologist with Fox Chase Cancer Center, Dr. Vijayvergia specializes in treating neuroendocrine cancers. She is the principal investigator on multiple national and local clinical trials related to neuroendocrine and rectal cancer. Dr. Vijayvergia is also actively involved with training residents and fellows. She participates in community outreach, lecturing locally on prevention, education, and treatment of GI malignancies. Read more here

PHILADELPHIA (March 19, 2020) – In new findings published in the prestigious journal Cell, researchers at the Fox Chase Cancer Center have clarified a fundamental host defense mechanism that detects the presence of influenza virus and rapidly destroys infected cells. The findings are a “major milestone” that has exciting implications for a variety of fields, including cancer immunotherapy, said Siddharth Balachandran, PhD, lead author of the study and professor in the Blood Cell Development and Function program at Fox Chase. In previous research, Balachandran and other researchers had identified a protein called ZBP1 that is essential for sensing the presence of influenza virus in lung cells. But they did not know how ZBP1 was being activated. “In other words, what was ZBP1 ‘seeing’ that told it the cell was infected? Now, we know the answer,” Balachandran said. It turns out that ZBP1 sees Z-RNA, a new form of RNA produced by influenza virus. “Z-RNA is made by the flu virus as it replicates in lung cells. ZBP1 senses these foreign Z-RNAs and interprets them as a sign that the cell is infected. It then pushes an autodestruct button that not only kills the infected cell, but also alerts the immune system to the presence of the virus,” Balachandran said. “Folks have been looking for Z-RNA for decades. This particular structure of RNA is what is called a pathogen-associated molecular pattern, and discovering a new such pattern is a major milestone. It also has significant implications for cancer immunotherapies,” he added. “Although immunotherapy is clearly the most promising new cancer treatment approach in decades, a major problem with current immunotherapeutic drugs is that over half of all patients either are refractory to treatment or will develop resistance to the therapy. Making such resistant cancers sensitive to treatment is therefore a huge unmet need,” Balachandran said. “Mimicking a virus infection in resistant tumors has the potential to fill this need, because it can rekindle the immune response to the tumor. The tumor cells now light up as ‘infected,’ and in doing so, become visible to current immunotherapeutic modalities such as the checkpoint inhibitor nivolumab.” Balachandran expects that synthetic Z-RNAs and other ZBPI agonists, by mimicking an influenza infection and activating ZBP1 in resistant tumors, will alert the immune system to the malignancy and promote positive immunotherapeutic outcomes in otherwise refractory disease. The research was a collaboration between the Balachandran laboratory and laboratories at the University of Texas, St. Jude Children’s Hospital, the University of Pennsylvania, and the University of Miyazaki in Japan. The paper, “Influenza virus Z-RNAs induce ZBP1-mediated necroptosis,” was published in Cell.

PHILADELPHIA – During a time of COVID-19 precautions and isolation, pregnancy, especially high-risk pregnancies, which usually require more frequent in-office monitoring, presents a particular challenge for mom and healthcare provider. To allay fears and provide clear guidance, the division of Maternal Fetal Medicine at Jefferson Health published recommendations today in one of the leading journals in the field, The American Journal of Obstetrics & Gynecology MFM. “Pregnant women might be at increased risks from complications from COVID-19. In particular, if they get pneumonia, they are at increased risks of miscarriage, preterm birth, preeclampsia, and their babies of stillbirth and neonatal death, as well as admission to intensive care unit” says senior author Vincenzo Berghella, MD, director of the division of Maternal Fetal Medicine at Jefferson Health. “Pregnant women should try to remain at home as much as possible, as should those in the same home; therefore we are decreasing as much as possible in-person prenatal visits, and using instead telehealth, keeping in touch closely with them via web.” The majority of the recommendations involve reducing the number of visits that pregnant women should make, asking moms to monitor their blood pressure if possible, and report those numbers to physicians via telehealth visits. “There’s a lot we can still do via telehealth. Many patients are surprised, but with a few basic tools, like the blood pressure cuff if a patient can get one, ability to access their medical records online, and of using telehealth, we can get a good picture of the mom and baby’s health in a normal pregnancy,” says Dr. Berghella. Other visits, such as those to measure a baby’s growth and check for abnormalities, should be combined whenever possible with in-person visits and laboratory tests to limit a new mom’s potential exposure. Some of the specific guidelines outlined in the report: Each patient should be called to decide on need for next in-person visit and/or test. No support person to accompany patient to outpatient visits or possibly delivery unless they are an integral part of patient care; use video to involve significant others. Pregnant women with any flu-like symptoms should get a COVID-19 test, especially if there are additional risk factors. Create separate areas for patients who may have COVID-19, and disinfect all areas and surfaces regularly. Modify frequency of non-stress tests for high-risk pregnancies where possible. Patients with gestational diabetes or preeclampsia should plan weekly visits with daily blood-pressure checks at home, with all labwork done at the time of in-person visit. For some patients, such as those with higher maternal age or BMI greater than 40 but no other risk factors, consider kick counts instead of formal non-stress test. “We know that these recommendations won’t cover every situation,” says Dr. Berghella. “In areas with a higher COVID-19 incidence more restrictive measures will be likely be appropriate. This guidance is changing daily, in fact hourly. Stay tuned” Article Reference: Rupsa C. Boelig, MD, MS, Gabriele Saccone, MD, Federica Bellussi, MD, Vincenzo Berghella, MD, “MFM Guidance for COVID-19,” American Journal of Obstetrics & Gynecology MFM, DOI: 10.1016/j.ajogmf.2020.100106, 2020.

February 20, 2020 A research article published in the Journal of Oncology Practice (JOP) last year featured Fox Chase Cancer Center as one of eight cancer centers of excellence in the United States. This paper was recently awarded the 2019 JOP Editor’s Pick Award for being one of the top five most-read articles published in the journal in 2019. Evelyn González, senior director of the Office of Community Outreach at Fox Chase, was one of the study co-authors. The paper was conceived by Jeanne M. Regnante, chair of the Diverse Communities Working Group, National Minority Quality Forum, to identify cancer centers that successfully recruit racial and ethnic minorities into clinical trials, and to recognize what strategies they employ. One of the key strategies the research revealed was community engagement. “As a research institution, we want to make sure that the communities we serve have access to quality care, which for us also includes access to potential life-saving research opportunities,” said González. Regnante said the work is important because racial and ethnic minorities make up less than nine percent of participants in cancer clinical trials in the United States. “That is very daunting, especially when we know in 2040, we will be a minority majority country. The promise of what is known as precision medicine depends on having representative populations in clinical trials,” she said. The study identified cancer centers, of which Fox Chase was one, that recruit racial and ethnic minority participants into clinical trials and exhibit several other related criteria. Fox Chase reported the accrual of 20 percent racial and ethnic minorities in their clinical trials. Then, by interviewing leaders at each of the eight identified centers, Regnante and the other researchers determined what strategies and best practices the centers put in place that enabled them to hit these recruitment numbers. González’s team is responsible for establishing partnerships with the community, especially neighborhoods and populations that experience a higher cancer burden, in order to impart bilingual cancer education addressing prevention, risk, screening guidelines, and treatment options, including participation in medical research. This approach allows audiences to share their feedback and concerns and creates an opportunity for open dialogue. She described it as a “bidirectional approach.” One way González’s team puts this approach into practice is through community forums. At these public events, González interviews a researcher who is involved in conducting a clinical trial and also a community member who has been through a clinical trial. The forums are designed to encourage audience participation via questions to the panel that enables them to clarify any misconceptions and to update everyone on patient protection measures. The ultimate goal is to help underrepresented minority (URM) audiences to understand the negative impact of not benefitting from new treatment as other populations do. “As a Latina, I am very passionate about this issue. If URMs are not represented in studies, we will never learn why we are disproportionately affected by cancer or which treatments work best for our populations. This study enables us to share our experience while learning of other strategies we need to consider implementing,” González said. This is what the JOP article was intended to do—to share strategies like community engagement, plus investigator training and mentoring, patient engagement, and leadership commitment with cancer centers in the United States and globally to help them improve their standards of care. “They don’t do things to patients, they don’t do things for patients—they do things with patients,” Regnante said of Fox Chase and the other cancer centers of excellence. “It’s a long-standing commitment. Places like Fox Chase have been doing this for 15, 20 years. I think other centers can learn from the good work that they do.” She added that a top success factor for all centers is engaging patient providers in the process and decision making. The paper, “US Cancer Centers of Excellence Strategies for Increased Inclusion of Racial and Ethnic Minorities in Clinical Trials,” was published in the Journal of Oncology Practice. A second paper that came out of the same study focused on how cancer centers of excellence collect racial and ethnic minority data and how they measure recruitment success. This paper, “Operational Strategies in US Cancer Centers of Excellence That Support the Successful Accrual of Racial and Ethnic Minorities in Clinical Trials,” was just published in Contemporary Clinical Trials Communications.

Organizations building a health gateway to expand and enhance education and the continuum of care February 18, 2020 PHILADELPHIA, PA., USA: Philadelphia International Medicine, the World Trade Center Sydney, and the World Trade Center Greater Philadelphia have signed a Memorandum of Understanding (MOU) to build a health gateway linking the organizations in collaborative efforts. PIM, WTC Sydney, and WTC Greater Philadelphia agreed to a collaborative relationship that will allow for the sharing of knowledge in the areas of continuing medical education, training in hospital administration, innovative uses of medical technology, exchange of physicians, and coordinated comprehensive patient care and other opportunities for all partners including infrastructure development. Under the terms of this agreement, all parties will work together to facilitate learning and relationship building between the WTC Sydney’s health network and members to provide a better understanding of each party’s culture, communities, and norms. PIM agreed to lay the foundation by identifying specific opportunities and initiatives involving cooperative programs in research, education, training, clinical referrals, marketing, and administration. “We look forward to establishing an informative gateway and continuous relationship with WTC Sydney. This professional relationship allows WTC Sydney, WTC Greater Philadelphia, and PIM experts to share innovations and best practices, enhance both organizations regarding the continuation of care, and collective medical education for both communities,” said Edgar Vesga, President and CEO of Philadelphia International Medicine. “This collaboration supports the WTCGP’s mission to bring growth and prosperity to communities, neighborhoods in Greater Philadelphia and worldwide through global trade and investment. Partnering with our fellow WTC in Sydney leverages the power of our worldwide network with our member company Philadelphia International Medicine to advance our region’s leading healthcare sector,” says Linda Conlin, President, World Trade Center of Greater Philadelphia. “Collaboration with the world’s leading Medical Institutions in Philadelphia will help WTC Sydney offer world-class Health Care and Education in the Smart City that is being developed near the Western Sydney International Airport,” said Jomon Varghese, Managing Director & CEO, World Trade Center Sydney. Integration of the PIM, WTC Greater Philadelphia, and WTC Sydney relationship began last year during the 50th annual meeting of the World Trade Center Association in Queretaro, Mexico where for the first time, the WTC Association featured a healthcare innovator as one of their components. Ignazio R. Marino, MD, ScD, Professor of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Senior Vice President for Strategic Aairs, Thomas Jefferson University and Jefferson Health, and Executive Director, Jeerson Italy Center was featured as the keynote speaker in the area of healthcare, which opened the opportunity for the relationship. About World Trade Center Greater Philadelphia The World Trade Center of Greater Philadelphia (WTCGP) is one of over 320 World Trade Centers in 89 countries around the globe. A non-profit and membership-based organization, the WTCGP accelerates global business growth for companies in Southeastern Pennsylvania and Southern New Jersey by providing customized, one-on-one trade counseling, market research, educational programs, trade mission support, business networking events, and powerful connections to customers and partners worldwide. Since 2002, the WTCGP has served as a catalyst for regional economic growth and job creation, helping area companies generate over $2B in incremental export sales, supporting over 26,000 jobs. www.wtcphila.org About World Trade Center Sydney World Trade Center Sydney (WTC SYDNEY) is an ‘Ecosystem for International Trade of all types of Goods & Services’, connecting businesses in Sydney with 320 other Cities across nearly 100 Countries. WTC Sydney is being developed near Western Sydney International Airport with Four WTC Towers, International Convention & Exhibition Centre, Hospital, University, Innovation & Incubation Centre, Retail and Residential Components. As per the Economic Impact Analysis by PwC, WTC SYDNEY will create 54,500 Direct Jobs; 46,000 Indirect Jobs; 66,500 Induced Jobs and contribute AUD 12.6 Bn Tax Revenue per year. For more information on WTC Sydney visit www.wtcsydney.com.au

January 23, 2020 Like pieces of tape that crumple, stick together, and can be turned into a ball, proteins that begin to lose their shape become sticky and tend to clump together. When this happens, rather than being transported to recycling sites within cells, old or dysfunctional proteins instead become trapped within cellular compartments. Eventually, they accumulate to the point that they gum up cellular machinery, causing major problems. Fortunately, cells are equipped with molecular machinery that detects defective proteins, sorts them out, and then either removes or stabilizes them, preventing them from accumulating and causing harm. In recent years, scientists have developed small drug molecules, known as pharmacological chaperones, that can help in this process. Now, scientists at the Lewis Katz School of Medicine at Temple University show that pharmacological chaperones could fill a critical role in Alzheimer’s disease therapy. In a new study published online January 21 in the journal Molecular Neurodegeneration, they describe a novel pharmacological chaperone capable of preventing Alzheimer’s disease in animals prone to developing the condition. The study is the first to show that a pharmacological chaperone drug can effectively disrupt the abnormal processes that damage neurons in the brain, fuel memory loss, and ultimately give rise to Alzheimer’s disease. “Our chaperone drug specifically restored levels of a sorting molecule known as VPS35, which helps move proteins out of endosomes, compartments inside cells where proteins are sorted for degradation,” explained Domenico Praticò, MD, the Scott Richards North Star Charitable Foundation Chair for Alzheimer’s Research, Professor in the Departments of Pharmacology and Microbiology, and Director of the Alzheimer’s Center at Temple in the Lewis Katz School of Medicine, Dr. Praticò was a senior investigator on the new study. The trafficking of proteins from endosomes to the cell membrane or to another cellular compartment known as the Golgi apparatus is fundamental for normal cell function. VPS35 is of particular importance to this trafficking system, since it separates out dysfunctional and old proteins and sends them off for recycling. In previous work, Dr.Praticò and colleagues found that VPS35 actively clears the brain of potentially harmful proteins such as amyloid-beta and tau. However, in Alzheimer’s disease, VPS35 levels are reduced. This reduction is associated with the formation of tau tangles inside neurons, as well as the accumulation of amyloid-beta outside neurons. Eventually, these deposits of abnormal proteins interrupt neuron activity and contribute to neurodegenerative disorders, including Alzheimer’s disease. In the new study, the researchers investigated the effects of a pharmacological chaperone on protein sorting in mice engineered to develop Alzheimer’s disease at they age. Mice were treated from a young age before they began to show signs of disease. As the animals grew older, they were tested for effects on memory and learning. Dr.Praticò team found that, compared to untreated mice destined for Alzheimer’s disease, the treated animals had much better memory and behaved just like normal, or wild-type, mice. When the researchers examined neurons from treated mice, they observed significant decreases in tau tangles, as well as decreases in amyloid-beta plaques – another type of protein aggregate that contributes to Alzheimer’s disease. The researchers further noticed that VPS35 levels were restored and the junctions where neurons come together to exchange information, known as synapses, were fully functional following the pharmacological chaperone therapy. “Relative to other therapies under development for Alzheimer’s disease, pharmacological chaperones are inexpensive, and some of these drugs have already been approved for the treatment of other diseases,” Dr. Praticò said.” Additionally, these drugs do not block an enzyme or a receptor but target a cellular mechanism, which means that there is much lower potential for side effects. All these factors add to the appeal of pursuing pharmacological chaperone drugs as novel Alzheimer’s treatments.” Before moving to trials in human patients, however, Dr.Praticò plans to next investigate the effects of pharmacological chaperone therapy in older mice. “Because our most recent investigation was a preventative study, we want to know now whether this therapy could also work as a treatment for patients already diagnosed with Alzheimer’s disease,” he added. Other researchers contributing to the study include Jian-Guo Li and Jin Chiu at the Alzheimer’s Center at Temple, Lewis Katz School of Medicine; and Mercy Ramanjulu and Benjamin E. Blass at the Moulder Center for Drug Discovery Research, School of Pharmacy, Temple University. The research was funded in part by National Institutes of Health grants AG055707 and AG056689.

Main Line Health physicians to enhance the international patient base of PIM’s program (November 19, 2019, Philadelphia, PA)-Philadelphia International Medicine (PIM) and Main Line Health signed an agreement this week to provide international patients and physicians access to Main Line Health’s hospitals. PIM connects patients from around the world with the Philadelphia region’s leading hospitals and health systems, helping international patients to navigate the American healthcare system by coordinating everything from scheduling appointments and transferring medical records, to arranging hotel accommodations and securing visas. “We are thrilled to be joining forces with Philadelphia International Medicine, and see this as a gateway for international patients and physicians to take advantage of the high-quality, internationally-renowned care provided at Lankenau Medical Center and across our Health System,” says Phillip D. Robinson, FACHE, President of Lankenau Medical Center, part of Main Line Health. “Our physicians’ skill and talent attract patients from across the globe-particularly in the areas of cardiovascular care and colorectal cancer-and this program will further enhance our abilities to care for our international patients.” Not only has Lankenau Medical Center been named one of the nation’s 50 Top Cardiovascular Hospitals by IBM Watson Health™, Lankenau has also been recognized by U.S. News & World Report as being among the top five hospitals in the Philadelphia region as well as one of the top 10 hospitals in Pennsylvania. Additional- ly, it has received service-specific recognition for colorectal cancer and cardiovascular treatment from nationally recognized quality organizations, including The Joint Commission, Truven Health Analytics, and the National Accreditation Program for Rectal Cancer (NAPRC). In addition to world-renowned clinical programs, Lankenau Medical Center also offers private inpatient suites with a personal concierge, deluxe amenities, chef-prepared gourmet meals, and private living and dining areas to accommodate patients and their families who are looking for added comfort in an elegant healing environment. Main Line Health will join Fox Chase Cancer Center, Temple University Hospital, Thomas Jefferson University Hospital, Wills Eye Hospital, The Rothman Institute, Magee Rehabilitation Hospital, The Renfrew Center and The Vincera Institute as part of PIM’s network for international medicine and educational services. “Main Line Health will complement our network of some of the greatest medical institutions in the Philadelphia area,” says Edgar Antfstenes Vesga-Arias, MPR, CMI, President and CEO, Philadelphia International Medicine. “We look forward to working with key, premier physicians at Main Line Health who have already begun great work in international medicine. In addition, Main Line Health’s location in the suburbs gives  our patients a different environment outside the city and access to relatives who may live there.” In attendance at the signing of Main Line Health and Philadelphia International Medicine’s partnership agreement were: (seated from left to right) John Marks, MD, System Chief, Colorectal Surgery, Main Line Health; Phillip D. Robinson, President, Lankenau Medical Center; and Edgar Antfstenes Vesga-Arias, MPR, CMI, President and CEO, Philadelphia International Medicine. (Standing from left to right) John T. Schwarz, Vice President of Administration, Lankenau Medical Center; Patricia Wong, MD, Director of Women’s Gastroenterology Center at Lankenau Medical Center; Roberto Rodriguez, M.D., Cardiac Surgery, Lankenau Heart Institute, Main Line Health; and William Gray, MD, System Chief, Division of Cardiovascular Diseases, Main Line Health.

PHILADELPHIA (September 27, 2019) – Researchers at Fox Chase Cancer Center have discovered a correlation between higher patient volume at cancer facilities and improved survival in two studies of patients with advanced cancer. These results underscore the ability of a higher-volume facility to provide patients with more experience, expertise, and access to resources. “Centers of excellence see a lot of a certain kind of cancer and tend to have better outcomes,” said Daniel M. Geynisman, MD, an assistant professor in the Department of Hematology/Oncology at Fox Chase. “If a doctor sees 100 cases of a disease versus two, you have better expertise, access to new therapies, more clinical trials, and multidisciplinary teams dedicated to treating the disease.” Previous studies of more localized, potentially curable, cancer types that were not metastatic have shown a similar trend of increased survival at higher-volume centers. “We looked at whether this holds true for patients with more advanced disease,” said Elizabeth Handorf, PhD, assistant professor in the Biostatistics and Bioinformatics Facility. Handorf, Geynisman, and their colleagues gleaned past data from the National Cancer Database from between 2004 and 2013 and assessed the association between survival and treatment volume in patients with two different advanced cancer types. In a study of patients with metastatic renal cell carcinoma (mRCC), the researchers gathered data on 41,836 patients treated at 1,222 facilities. Patients were divided into cohorts based on whether they had active treatment, systemic therapy, systemic therapy at the reporting institution, or systemic therapy at the reporting institution with known liver and lung metastatic status. The researchers calculated patient survival based on treatment facility volumes, controlling for important patient characteristics. The researchers found that survival increased as patient volume increased. In the second study, the researchers collected data for 64,815 men with Stage T4, Ni-, or M+ advanced prostate cancer (aPC). They divided patients into groups based all patients with aPC, only Stage MO aPC, or only Stage M1 aPC, and based on treatment volume. The investigators also quantified nonlinear relationships between volume and overall survival. Patient survival improved as hospital volume increased. The association between patient volume and improved survival remained alter categorizing the patients according to disease and treatment characteristics. Geynisman stressed that lower volume facilities provide good care for most patients, but that “complex care may be better provided at high-volume centers.” The first study, “Treatment Facility Volume and Survival in Patients With Metastatic Renal Cell Carcinoma: A Registry-based Analysis,” was published in European Urology. The second study, “Treatment Facility Volume and Survival in Patients With Advanced Prostate Cancer,” was published in European Urology Oncology.

(Philadelphia, PA) – Temple University Hospital’s Pulmonary Hypertension, Right Heart Failure and Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Program within the Temple Heart and Vascular Institute recently achieved a clinical milestone by performing its 200th pulmonary thromboendar­terectomy (PTE) – a complex procedure offered at only a handful of hospitals in the U.S. “We are extremely proud of this accomplishment,” said Paul Forfia, MO. Co-Director of the Pulmonary Hypertension, Right Heart Failure & CTEPH Program and Professor of Medicine at the Lewis KatzSchool of Medicine at Temple University. “Our program has only been in existence since 2013 but has quickly grown to become the most active PTE program on the East Coast as evidenced by our 200th case.” CTEPH is a rare and often fatal form of elevated blood pressure in the lungs resulting from a blood vessel that has been blocked by a clot for a long period of time. The clots block blood flow through the lungs and can cause a variety of serious problems, including debilitating shortness of breath and right-sided heart failure. PTE is a highly specialized surgery in which a surgeon removes the clots. During PTE surgery, the patient’s chest is opened-up to allow access to the heart and lungs, and then the patient is placed on a heart-lung machine to keep blood circulating. Once this is done, the patient’s blood is cooled to 65 degrees Fahrenheit, which slows down the metabolism and allows the surgeons to periodically turn off the heart-lung machine. “This permits the surgical team to open the affected arteries and completely clear the vessels by removing the blood clots and any scar tissue that has built up around them,” said Yoshiya Toyoda, MD, PhD, Professor of Surgery and the William Maul Measey Chair of Surgery & Chief of Cardiovascular Surgery.”Once the clots are removed and the patients blood has been warmed back up to a normal temperature, their heart and lungs are returned to normal function. This surgery is often curative for patients.” In addition to having the most active PTE program on the East Coast, Temple published PTE data in a September 2017 issue of the Journal of Cardiovascular Surgery that showed its patients had a 96% survival rate, 70% decrease in pulmonary vascular resistance post-PTE and great improvements in heart function and quality of life. “Careful preoperative assessment is critical to assure the best outcomes for our patients,” offers Daniel Edmundowicz, MD, FACC, Medical Director of the Temple Heart and Vascular Institute and Section Chief of Cardiology. “ln addition to PTEsurgery, this collaborative effort also includes the expertise of our inter­ventional cardiology team for balloon pulmonary angioplasty in those CETPH patients who are inoperable. ” The success of Temple’s program has always relied on our highly specialized CT EPH team, including the surgical expertise of Dr. Toyoda and medical specialists Ors. William Auger and Riyaz Bashir” said Anjali Vaidya, MD, FACC, FASE, FACP, Co-Director of the Pulmonary Hypertension, Right Heart Failure & CTEPH Program, Associate Program Director of the Cardiology Fellowship and Associate Professor of Medicine. ” For our patients, the improvements they experience after surgery are life-changing. We are pleased to be able to offer them the expertise of our dedicated team for optimal preoperative assessment, surgical care and postoperative patient management.”