Kim joined Penn Medicine following nearly four years in the healthcare practice of a leading public relations agency in Chicago, where she specialized in a range of therapeutic areas, including oncology, hematology, neurology, infectious diseases and pediatric obesity. She has broad experience in media, social media and advocacy relations and led medical communications surrounding numerous data publications, medical meeting presentations and regulatory announcements. Kim is a graduate of Northwestern University where she received a Bachelor of Science in Radio/Television/ Film and Communication Studies.
Visits with doctors, nurse practitioners and physician's assistants are changing, thanks to emerging technology advances. When tagging along for a house call recently with one of our geriatricians, I was really impressed by all the types of tests and care that they can deliver from the comfort of a patient's living room.
Penn Geriatric's overarching House Calls program keeps watch over 220 home-bound elderly patients at a given time, and partners with Penn Home Care nurses to provide all levels of care, from a routine check in appointment after a hospitalization, to managing serious and complex acute illnesses all at home.
Thanks to innovations that have miniaturized medical devices, care providers on the go - from home care visits to busy outpatient practices - can get more and more real-time feedback at the patient's bedside.
When you have a handful of serious medical conditions to deal with, the number of specialists to see can become complicated and exhausting. A new program – to treat people dealing with unrelenting wounds – aims to simplify the process by bringing a cadre of specialists together, centering around patient needs.
The new Penn Center for Wound Healing and Reconstruction has started seeing patients in a coordinated clinic format, designed to flex and meet the variety of patient conditions the team sees.
"A typical patient is in their 50s, has diabetes and high blood pressure, peripheral vascular disease, and is dealing with a wound that just won't heal," said Center director Stephen Kovach, MD,
Assistant Professor of Surgery in Plastic Surgery. "Chronic wounds can be very challenging for patients, as well as caregivers, given that the wounds are so persistent and require unique treatment approaches."
At the same visit, a patient can see a plastic surgeon, foot and ankle surgeon and/or vascular surgeon about any surgical needs to repairs the wound, while also meeting with a specialists from departments such as Cardiology, Endocrinology, Hyperbaric Medicine and Infectious Diseases, to treat both the acute issue and the underlying condition(s) in parallel.
An estimated 3.8 - 5.7 million people are affected by chronic wounds in the United States, where most injuries start as minor issues - an insect bite, a scratch or a scrape. Because of underlying diseases like diabetes or neuropathy, the wounds or ulcers don't heal normally, and can become infected or persist despite treatment efforts.
"We're treating the whole patient, with medical and reconstructive experts, in one place," notes Kovach. "And we're looking at the patho-physiology of the wound itself, to figure out why the wound may not be healing normally and how we can fix it."
Teaching hospitals are filled with room after room of patients, all hoping to be healed. And countless doctors, nurses, pharmacists, social workers, food services, and students, may visit the patient and their loved ones while they are in the hospital, working towards that goal. So how can a patient's values, humanity and personality be integrated with the pace and procedures of a hospital?
Last week, at a talk hosted by the Hospital of the University of Pennsylvania's Ethics Committee, I observed as the co-chair of HUP's Patient and Family Advisory Council opened the eyes of clinicians to a whole new way of looking at interactions with patients. Anita McGinn-Natali recounted her experience as a caregiver during the battle she described as "our cancer journey" during her husband Clark's successful battle with oral cancer.
For a mysterious and complex disease that wasn't discovered until 2005 or formally defined until 2007, Anti-NMDAR Encephalitis has made the rounds, being featured on TV shows like Mystery Diagnosis and CBS3 Philadelphia (video below), Medical Mysteries in the New York Times and a best selling memoir in which a journalist chronicled her own decent due to the condition. Now, the Penn team that discovered a series of related conditions involving autoimmune responses impairing neurological function, is taking the program one step further by opening the Penn Center for Autoimmune Neurology.
The new center, developed through Penn’s department of Neurology, will be run by leaders in the field including center director Josep Dalmau, MD, PhD, adjunct professor of Neurology and Eric Lancaster, MD, PhD, assistant professor of Neurology. The clinic will focus on consultations and long-term care of patients with antibody mediated neurological diseases such as anti-NMDA receptor encephalitis. Physicians from outside hospitals can refer patients to the center, and patients with a positive antibody diagnosis can make appointments for follow-up care. Additionally, Penn neurologists will handle in-patient consults of those hospitalized at the Hospital of the University of Pennsylvania with autoantibody disorders.
A water color by Hilgos, an accomplished artist who continued to paint through the last years of her life despite the severity of her illness. Her artistic production is well documented in the film ‘I Remember Better When I Paint.’” Credit: Hilgos Foundation, used with permission.
Imagine Alzheimer's disease as a type of brain failure, where the brain's functions - memory, decision-making, processing information - are diminished as the organ declines. What if some components remain functional beneath the primary failures?
Neurologists say that ability to appreciate and produce art is one area of the brain that is relatively preserved in Alzheimer's disease, and that with proper support, people can continue to create and appreciate art well into the course of their disease.
Not only does art draw upon neural capacities in a flexible manner, but art allows people with Alzheimer's to express feelings they may not be able to verbally communicate. Alzheimer's patients may even have a slight advantage to achieving the state of "flow" where they are intensely engaged and unself-conscious, experts suggest, as decreased blood flow to the front part of the brain allows for analytical areas to be suppressed.
Donald Silberberg, MD, professor emeritus and former chair of Neurology in the Perelman School of Medicine at the University of Pennsylvania, is continuing his efforts to improve neurological assessment and care across the globe. He's been praised for his work in Ecuador and Iraq, and now the Government of India is bringing one of his pilot projects to life - screening every child in India for neurodevelopmental disorders.
Prince Albert II of Monaco and Philadelphia Mayor Nutter Attend Ceremonial Signing Event at Penn Medicine
Penn Medicine hosted His Serene Highness Albert II, Prince of Monaco – whose mother, the late Princess Grace of Monaco was one of Philadelphia’s most beloved citizens – during an event on Saturday, October 26, to celebrate a new partnership between Penn Medicine and the Princess Grace Hospital in the Principality of Monaco. The new venture, which focuses on cardiovascular medicine and oncology, will allow patients in Monaco and Philadelphia to have access to some of the most innovative new treatments in these areas of medicine, and for students, faculty and staff from both institutions to learn from one another.
Philadelphia Mayor Michael Nutter was on hand for an event – featuring a ceremonial signing of the agreement and a plaque presentation – to formalize the partnership and commemorate His Serene Highness Albert II’s visit to Penn.
Prince Albert II of Monaco (top right) and Philadelphia Mayor Michael Nutter look on as Patrick Bini, Director of Princess Grace Hospital in Monaco (seated left), and J. Larry Jameson, MD, PhD, Dean of the Perelman School of Medicine and Executive Vice President of the University of Pennsylvania for the Health System, formally sign the agreement between Penn Medicine and the Princess Grace Hospital.
Monaco's Prince Albert II and Princess Charlene are greeted and presented with flowers upon their arrival at Penn Medicine's Perelman Center for Advanced Medicine.
Prince Albert II and Princess Charlene of Monaco talk with Stephen Hahn, MD, Chair of the Department of Radiation Oncology, to learn about the Roberts Proton Therapy Center's state-of-the-art cancer treatment facility.
How important is our appearance to our
success, or to our happiness? Our appearance may be more important than we
More and more people are seeking out
medical procedures to improve their appearance - over 12 million facial
cosmetic procedures are performed each year in the United States alone - but
how does it impact their self confidence, or their quality of life?
A new study by researchers with Penn's
Center for Human Appearance found scarce evidence to show whether facial
cosmetic procedures actually improve psychological outcomes such as quality of
life. "With the limited amount of well-performed studies, it is certainly
premature to conclusively state that facial cosmetic procedures will not only
make patients 'look better' but also 'feel better'," said senior study
author Joseph F. Sobanko, MD, assistant professor of Dermatology.
While experts suggest that attractive
people are more successful, ethical challenges of altered identity, or even
transferred identity, are increasing. How can we cope with our personal self
image when it changes, either for better or for worse? Or when beauty becomes
more important to our success?
As they prepare for an upcoming conference
on the confluence of appearance and identity, Penn Medicine's Jesse Taylor, MD,
and Annenberg's Sharrona Pearl, PhD, sat down and provided a snapshot of the conference:
For more information on the Appearance ∞ Identity
Conference on November 1-3 at Penn, please visit the Center for Human
The research round tables will discuss issues of self and identity, the impact
of appearance on individual and corporate success, medical advances in facial
aesthetics, as well as ethical and psychological considerations regarding
It was a perfect fall morning - sunny and
62 - for the second annual Penn 5K for the IOA and Memory Mile Walk on
September 22, 2013. Nearly 300 walkers and runners, ranging from 3 years old to
90 years old, turned out some fast times on the new race course through Penn
Park, with skyline views of Center City.
Ever wonder what it's like to work in a
media relations office at a busy academic medical center? Much like other
aspects of medicine, it’s fast-paced – and there’s something new and often
unexpected to work on every day. To give you a glimpse of the velocity and
variety of topics we cover in a given year, we're pulling out some interesting
stats from our 2013 fiscal year end media wrap-up report to share with you.
We're constantly working to share important
advances and news with the public and with reporters, from all parts of the
Perelman School of Medicine and University of Pennsylvania Health System. Penn
Medicine is a busy place - with nearly 22,000 employees including 1,975 faculty
- and there's no shortage of information to talk about.
Last Monday, following a briefing on the
current state of neuroscience research across the United States, held in
Philadelphia's University City Science Center and hosted by Congressman Chaka
Fattah, we had the opportunity to take the morning's featured speaker, Dr.
Philip Rubin, Principal Assistant Director for Science at The White House
Office of Science and Technology Policy (OSTP), on a whirlwind tour of
brain-related research here at Penn Medicine.
When added together, brain diseases and
mental health conditions like Parkinson's and depression affect a total of 50
million Americans annually, costing an estimated $500 billion dollars a year in
medical and long term care costs. While national and international initiatives
are emerging to address the widespread impact of diseases such as Alzheimer's
and stroke, Penn's collaborative efforts are already pushing research forward
into helping patients today.
Throughout the tour, we visited innovators
and pioneering thinkers from a range of departments - Neurology, Neurosurgery,
Radiology, Psychiatry, Medical Ethics, Engineering, Psychology and Psychiatry -
who showed and discussed the latest applications and advances in their areas.
As pictured below, we trekked from end to end of the medical campus to give Dr.
Rubin a sampling that he said "thoroughly impressed [me] with everything
that I saw."
Neurological diseases are a bit intimidating to talk about – the last time most of us thought about axons and neurotransmitters, we were in high school biology – so in an effort to make the science a little easier to digest, we're going to make an effort to start trying to deconstruct some of the key studies and overarching findings.
So let's start by deconstructing Alzheimer's disease. There has been a rapid rise in research pertaining to Alzheimer's, which means there's more to understand. Before we dive into any specific studies or what you can do, it's important to clarify a few things.
Penn’s Institute on Aging recently
co-hosted its annual Sylvan M. Cohen lecture and poster session. This year, in
partnership with the Abramson Cancer
Biology Program, the event focused on “protecting the genome in the
longevity revolution: cancer and aging.” Brian
Duke, Pennsylvania Secretary for Aging, set the stage for the day,
encouraging Penn Medicine’s national experts in aging, Alzheimer’s and cancer
in attendance to look to improve quality of life for the aging . “May today
lead to breakthroughs,” Duke said.
The “wonder of
discoveries to be presented today,” as co-host Chi
Van Dang, MD, PhD, director of the Abramson Cancer Center, described,
started with an intriguing Sylvan M. Cohen lecture by this year’s Visiting
Sharpless, MD, from the Lineberger Comprehensive Cancer Center at the
University of North Carolina.
"Imagine the sound of this gong is
like a rocket ship that can send messages up to your loved one," said drummer Josh Robinson, "take 10 seconds to think of your message,
and when I ring the gong, it'll reach your loved one."
It's Monday afternoon after another warm, sunny
weekend here in Philadelphia, and that familiar reddish tint of sunburn is on
faces all around me. As we emerge from a particularly gloomy and cold
winter, people have been embracing every opportunity to spend time
outside, but we're apparently out of practice when it comes to remembering to
Spring is the perfect time to replenish
your sunscreen supply, and take a few minutes to get your skin checked. If you
notice any suspicious spots, or haven't had a full-body skin screening in a
year or two, now is the time.
Just in time for the summer, Penn
Dermatology and the Abramson Cancer Center's annual and free skin cancer
screening will be held on May 18. If you haven't signed up already, or
know someone who may need to get their skin cancer checked, call 215-662-2737
to schedule an appointment, as space is limited. A large team Penn
dermatologists will be screening 300 patients in 4 hours; it only takes a pro
about 7 minutes to assess your skin.
early April, Penn Medicine hosted a fast-paced lightning round of presentations
highlighting new and emerging technology being used inside and outside the
Health System that may help patients and medical professionals alike. “Connected health” is
about continuous sensing and monitoring to enable early detection, diagnosis
and intervention, and improving outcomes at lower cost. Alternating between internal and external projects, the
presenters brought their best ideas and applications to share, explaining how
these new devices fit within the existing health care system and, in some
cases, how they stretch the boundaries and may change the way healthcare is
David Asch and Bill Hanson interact with the latest health innovations at Penn Medicine's Connected Health Symposium.
wanted a chance to bring some of the best innovations from industry and from
within Penn Medicine together, to share ideas, connect like-minded groups, and explore
new ways we can use technology now and in the futureto improve
patient care and convenience and lower costs," saidBill Hanson, MD, Chief Medical Information Officer for the University of
Pennsylvania Health System and professor of Anesthesiology in the Perelman
School of Medicine at the University of Pennsyvania. The event was organized by
the Penn Medicine Center for Innovation and moderated by David
Asch, MD, MBA, Professor of Health Care Management and
Executive Director of Penn Medicine's Center for Innovation, as well as Roy Rosin, MBA,
Chief Innovation Officer at Penn Medicine's Center for Innovation and former
Vice President for Innovation at the software company Intuit.
Last week, a fleet of community health
workers fanned out to help patients in need of some extra support, as part of
an ambitious new Penn Medicine program that brings relatable neighbors and
peers on board to help vulnerable Penn Medicine patients navigate the medical
system and address underlying causes of illness.
hard to anticipate your next step if you've never done something before, or
even seen someone go through it. The prospect of graduating - high school,
college, medical school - can be daunting if you're going through it alone or
unassisted, if you’re the first generation to pursue a degree, or if you’re
trying to counteract the growing
educational gaps between high- and low-income students. A series of Penn
Medicine programs are all aimed at confronting the steep learning curve and
helping smooth the way at every step - applications, financial aid,
matriculation and beyond - and collectively demonstrate one professor's ongoing
efforts to break down barriers along the way.
assistant professor of Neurology and director of Pipeline Initiatives for the
Perelman School of Medicine's Council for Diversity and Inclusion, has
cultivated a handful of education and outreach programs that extend from high
school through medical school and residency. Through exposure, mentorship, and
education, his efforts are helping to prepare students before they get to the
next step, so they can anticipate and succeed along the way.
Dr. Roy Hamilton (3rd from left) receives 2013 University of Pennsylvania Dr. Martin Luther King, Jr. Commemorative Award for Community Service.
students of any level with disadvantaged backgrounds don't know the game when they
start playing it," said Dr. Hamilton. "We're collectively trying to
help students and trainees overcome the barriers that separate them from
success when they transition from one step of career to the next."
the Penn Medicine Educational Pipeline program, students at Sayre High School
in West Philadelphia go through a multi-tiered mentorship program. In
partnership with Penn's Netter Center for Community Partnerships, Penn
undergraduates spend the fall semester tutoring students on health and science
at Sayre High School. In the spring, approximately 20 high schoolers most
interested in health-related issues and medical science are invited to come to
the Penn campus for an after school program in medical school lab and
classrooms in an immersive experience mimicking what it's like to be at the
Perelman School of Medicine. For some, it's the first time they've set foot on
campus, even though they’ve grown up just blocks away. The spring semester
gives an opportunity for medical students to teach the high schoolers about
specific topics and systems-related material in medicine (such as the brain or
gastrointestinal system), while exposing teens to what could be future steps in
the summer, a mentorship program run by the Penn Provost's office draws high
school students from across the Philadelphia School District. This program was
modeled in part after the Penn Medicine Educational Pipeline program and was
initially started with three professional school partners from across the
University, including Medicine. Now, more of Penn's professional schools each
have their own programs. In this program, 12-15 students are selected to come
to the Perelman School of Medicine all day throughout the summer for an
immersive medical school experience. A strong shadowing portion pairs students
with physicians in their particular area of interest.
medical students in the Perelman School of Medicine, Dr. Hamilton and
colleagues host an academic career seminar series that shows students the steps
along various different career paths. This shows the variations in experiences,
even for people on a similar path, that help the students prepare for
residencies, specialties and careers in research, education and or clinical
"This series allows us to share what we wish we'd known
when starting our medical careers, and what we would do differently during
medical school to develop accordingly," explains Dr. Hamilton. "Even
in the same medical specialty, a basic scientist leads a very different life
than an academic clinician. We bring in faculty from variety of career paths,
and show the medical students what the currency of success is for that person
celebrate February as American Heart Month, the News Blog is highlighting some
of the latest heart-centric news and stories from all areas of Penn Medicine.
Imagine going through life with an
extremely elevated blood pressure that cannot be controlled by medication,
walking around for months and years with dangerously high risks of blindness,
stroke, heart attack or even heart failure.
More than 75 million American adults are
living with hypertension; nearly 1 in 3 adults, according to the CDC.
Of that, up to 10 percent, or around 7 million people, have treatment-resistant
hypertension, where their blood pressure remains high (over 140/90 mmHg)
despite treatment with at least three or more different types of blood pressure
medications (including a diuretic).
Penn Medicine is the first in the region to
begin testing a new
procedure to help people whose high blood pressure can't be controlled
using currently available medications.
"Many of our patients have tried
diligently to get their blood pressure under control, through medication and
lifestyle changes, to no avail," said Debbie Cohen,
MD, co-investigator of the study
at Penn and associate professor of Medicine in the division of Renal,
Electrolyte and Hypertension. "So we're trying an approach that makes
physiologic sense in hopes that it will denervate the renal sympathetic
nerves and reduce blood pressure."
This procedure, called renal denervation,
is being tested by an interdisciplinary team of hypertension and interventional
cardiology experts at Penn. It involves inserting a catheter through an artery
in the groin, which is threaded up to the renal artery, where a specific
catheter using radio frequency energy is used to deactive the renal
nerves. It doesn't involve a permanent implant and can be performed under
clinical trial, we are studying whether the procedure effectively get
the patients back to their target blood pressure," said Robert
L. Wilensky, MD, co-investigator of the study and professor of Medicine in
Interventional Cardiology. "We've done a number of procedures at this
point and are ahead of our recruitment goal, which indicates the real unmet
need for people with complex hypertension."
The approach works to control the activity
of nerves going in and out of the kidneys responsible for regulating the
sympathetic nervous system, which plugs into the body's system to regulate
blood pressure. If the nerves are overactive, hypertension can ensue.
The procedure is still being tested in a clinical
trial, and is only being used in controlled research studies. Penn is
actively recruiting at least 15 patients for the study and is on track to reach enrollment goals
around June; results should be available a few months later. The procedure is
already approved and available in Europe, Australia and New Zealand.
If the results of the current study prove
positive, researchers anticipate that renal denervation may become an important
approach to treatment for patients with difficult to control high blood
Just when I think
I've got a handle on where things stand in neuroscience, the next step in the
process takes a turn that surprises me. In December and early January, years of
research unfolded in a few weeks time as papers published the work of Penn researchers
and were able to deepen our understanding of a variety of conditions, both rare
and common, hopefully getting closer to refining or finding effective
treatments as a result.
you indulged on Turkey Day, are watching your calories, or trying to
avoid an annual weight gain during the holidays, Thanksgiving can be an
important time to stay in control of your health. And the day after
Thanksgiving can be a great opportunity to reinvest your energy and set
the stage for a happy - and healthy - holiday season.
In early November, I went to an eye-opening town hall meeting, led by Penn's
Institute for Diabetes, Obesity and Metabolism (IDOM) and Rodebaugh
Diabetes Center, where obesity and diabetes experts candidly answered
questions about weight, diabetes, and metabolic syndrome. The team
provided useful insight into the reasons behind our individual and
societal challenges with weight.
One of the joys of working in
Communications at Penn Medicine is that I get to meet all these amazing people.
Staff, physicians, and, when I'm especially lucky, amazing patients.
Every patient is amazing, to me, as they
all have such unique stories, lives, and personalities. But Candace Gantt's
story is one of the stories I talk about the most.
On July 19th, 2005, Candace suffered a
serious brain injury after being struck by a car while riding her bike.
Following an extensive hospitalization and surgeries at the Hospital of the
University of Pennsylvania, she was back on her bike just 6 months after her
If you haven't heard her story before, you'll
feel like you know her after watching this video:
On October 20th, 2012, Candace will
participate in an Ironman Triathlon in Wilmington, North Carolina called
Beach to Battleship to raise funds for brain injury research in Penn’s Center
for Brain Injury and Repair (CBIR). This event includes a 2.4 mile open water
swim, a 112 mile bike ride, and a marathon (26.2) mile run for a total of 140.6
miles of competition. This is a grueling task that requires physical and
To help her strong mentally for the 13
hours she'll be racing, people can send quotes, jokes or a antidotes that she
will carry on her bike and run and read one every mile. Her daughter, Carter,
is collecting inspirational messages at [email protected] (just put IRON WOMAN in
the subject line).
Back to school, back to work, back to...close-toed shoes.
Sayonara, sandals. Seasonal shoe changes can have a bigger impact on our feet
and body mechanics than we might think.
Al D'Angelantonio, III, DPM, looks at feet as the foundation
for the rest of the body. Like the structure of a house, if support isn’t
there, the structure will start to fail. As such, everything from precariously
high heels to unsupported flip-flops can have short- and long-term consequences
on your joints, bones and quality of life.
Take high heels, for example: if the heel height is greater
than 3 inches, you are putting major stress on the ball of your foot.
If you wear heels regularly, your Achilles
tendon contracts and can become difficult to stretch out.
If you have early signs or are at high risk for
bunions (when your big toe points toward your second toe and a bump appears),
they will get worse with continued pressure and weight on the front toe joint.
The mechanics of walking in heels requires
muscles in front of your leg to work overtime, trying to pull the foot up and
clear the ground, which will exacerbate existing hammer toes (when your second,
third or fourth toe becomes permanently bent, looking like a hammer).
To prevent pain and progressive injury, Dr. D'Angelantonio
recommends keeping the height under 3 inches. Or, if you want to wear
very high heels, wear them in moderation. Dr. D’Angelantonio is the very
first foot and ankle surgeon to pioneer a dedicated lower extremity fellowship
within Plastic Surgery at the Hospital of the University of Pennsylvania. His
fellowship training focuses on providing patients with both functional and
aesthetic outcomes for all conditions of the foot, ankle, and lower leg.
As for flats, flip-flops and sandals, support is key. On
average, we take about 10,000 steps per day (not including exercise), so
imagine the impact that your body - from your feet, ankles, knees, and even
your back - has to take when there’s no cushioning to absorb the impact. Like a
car, you need support to keep the mechanics aligned and balanced to prevent
wear and tear on your joints. If you wear the same shoes regularly, their
support function will likely only last for 3 to 6 months - another excuse to go
And, when switching shoes for a new season, remember that
your feet expand and contract - from flattening arches caused by unsupported
flip-flops, to temperature changes, water retention, and even hormones - so
expect that your foot will have to adjust to different shoes.
If you have foot or ankle pain, have it checked out by a
doctor. The earlier you get treated, the better. If you wait until symptoms are
really bad, it usually takes a longer time to recover and can require more complex
"If you bite the bullet to deal with pain, you are going to create more problems down the
line," said D'Angelantonio.
While feet are "designed to take a beating," they
serve a crucial function in getting us from point A to point B and need to be
supported and protected to prevent debilitating issues.
The National Football League (NFL) season
doesn't officially kick off until September 5, but a familiar tale is starting
to repeat itself. So far, 11 players have been listed on injured reserve
because of concussions suffered during pre-season games and practices.
The fear that athletes who suffer repeated
blows to the head may end up with a preventable cause of dementia called
chronic traumatic encephalopathy (CTE) is leading neurodegeneration researchers
at Penn to join in a collaborative study of retired NFL players, to see if
there are any clinical symptoms (such as depression, disinhibition, cognitive
or motor impairment) and biomarkers present that can be measured and tracked
over time. The ultimate goal is to use the clinical symptoms and biomarkers to
be able to diagnose CTE during lifetime, as the only way to diagnose CTE
currently is through an examination of brain tissue after death.
The study, done in collaboration with
researchers at Boston University’s Center for
the Study of Traumatic Encephalopathy, will evaluate 100 retired NFL
players, ages 40-69, who played certain high risk positions for a particular
number of years. They will be compared to male non-contact sport athletes of a
similar age without any history of brain injury.
The study will not determine the risk for
professional football players of developing a disease, or try to estimate the
incidence or prevalence of CTE. Instead, researchers hope to develop biomarker
tests for CTE and to explore the clinical presentation of this disease likely
to affect athletes at all levels of play, as well as other members of our
society, such as combat military personnel.The study is funded by the National Institutes of Health's National Institute of Neurological Disorders and Stroke
(NINDS), National Institute on Aging (NIA), and Eunice Kennedy Shriver National
Institute of Child Health & Human Development (NICHD) (1R01NS078337-01A1).
Penn researchers will transfer their
knowledge of neurodegenerative biomarker test development from
their major roles in Alzheimer's
disease and Parkinson's
disease cognitive biomarker efforts. In 2009, the Penn team announced that
a biomarker test was capable of confirming or ruling out Alzheimer’s disease;
the test is now being used in research studies and similar tests are being
evaluated in other conditions.
While there are only 1,800 active NFL
players and 2,700 former players, studies like this can help researchers better
understand how CTE manifests, and hopefully find biomarker tests to detect
disease and targets for possible neurodegeneration treatments. Future studies
may try to track people at high risk over time to map out characteristics and
risk factors of CTE.
The NFL has issued new rules aimed at
preventing injuries on the field, but the more tests available for on sidelines
and at hospitals, the better.
Now that Penn Medicine's new fiscal year, for 2013, is underway, we took a look back at our last year’s worth of media activities to see how our efforts to promote the research and clinical care work by our amazing faculty and staff made an impact from July 2011 through June 2012.
One of our key jobs is to share the latest news from Penn Medicine and its experts far and wide – that means letting the world know when our faculty publish important studies or are presenting newsworthy research at medical meetings, when Penn launches new interesting new programs, and when Penn faculty are experts on a topic that’s in the news. In the past year, here’s the data on how that work shaped up: Our now 7-person media team facilitated nearly 1,300 interviews and issued 318 press releases, blog posts, media alerts and announcements. That’s all in approximately 255 business days!
In FY12, Penn Medicine news appeared in media that reached a total of 10.8 billion viewers and readers, resulting from nearly 18,000 news stories mentioning Penn Medicine (including syndicated stories via wire services such as the Associated Press). On average, approximately 30 million people could see – via TV, print newspapers and magazines and online news sources – stories about Penn Medicine in the news each day.
Alzheimer's disease (AD) impacts the whole family, in a way very few medical conditions do, and coping with a progressively fatal disease takes a toll on everyone involved.
Hope is precious, and in the case of AD, research can hardly move fast enough to get us to a place where the disease doesn't conquer all it touches.
Knowing that it's mid-July, my optimism starts to rise. In an annual summit, AD experts will flock from across the globe to the Alzheimer’s Association International Conference (AAIC) in Vancouver this week. I'm waiting with anticipation for the next big Alzheimer's discovery to be unveiled.
I was pleasantly surprised that AD news started pouring out the week before the big meeting. Last Wednesday, two separate studies were released and add pertinent information to the greater understanding of AD.
The first, in the New England Journal of Medicine, found that gene carriers of the rare familial form of Alzheimer's disease start showing changes in diagnostic tests up to 25 years before symptoms would occur. This study, which may or may not correlate with what happens in the more common sporadic form of AD, establishes how early interventions may need to be made to stop the disease before it spreads through and damages the brain.
Penn Memory Center director Steven Arnold, MD, professor of Neurology and Psychiatry in the Perelman School of Medicine at the University of Pennsylvania, told ABC News "We can learn so much from these people that would be applicable to Alzheimer's disease at large. If you can identify biomarkers early and see that there are AD changes, that is really the time where you can intervene with medicines...or perhaps lifestyle interventions," to reduce risk.
In the second study, published in Nature, researchers found a genetic mutation that actually protected people from producing a protein that contributes to AD. While it won't lead to a new genetic test to see if people carry this protective gene mutation, it does show that the production of amyloid protein, one of the pathological contributors to Alzheimer's disease, is detrimental in Alzheimer's disease progression, and pushes research forward targeting amyloid.
“We all have extrapolated what we learned from early onset and applied it to late onset,” said Dr. Schellenberg. “This study gives us more confidence that all the stuff we use in our models and our experiments is going to apply to late−onset AD. That's something I find probably more interesting than just the fact that there is another APP mutation.”
And, at AAIC in Vancouver, we're expecting to hear updates on recent drug trials to slow the progression of the disease, and any promising new targets or approaches to combat this complex disease.
For all the families dealing with AD on a daily basis, or those who have helped by participating with a loved one in a clinical trial, let our collective hope continue. With so many passionate people working on this, solutions are hopefully closer than ever.
I love sports. Football, hockey, wrestling, gymnastics, soccer. You name a sport, chances are, I love it. I'm counting down until the London Olympics (35 days!). As a die-hard sports fan, it's tough for me to imagine significant changes in the way sports are played, to prevent brain injuries. Can football or hockey be played without the crushing blows? As awareness over concussions has grown, society is now facing a tough question:
How can individuals and society on the whole balance the love of sports with the growing concerns over long term issues resulting from traumatic brain injuries?
Photo credit: Dan Burke Photography
In early June, Penn Medicine and Penn Athletics co-hosted an event to debate this virtues and peril of sports. Following an advance screening of the documentary Head Games - a revealing documentary about the concussion crisis in sports - a panel of experts talked about controversies in concussion diagnosis, treatment and policy.
As the film demonstrates, there's a struggle between what we know - that concussions are serious - and how that impacts our decisions to play the sports we love. There are no easy answers, even for people who have already been severely impacted by traumatic brain injuries.
There is so much to learn, in terms of what is happening to the brain after a blow to the head, if or when someone can return safely to play, and what the long term implications may be for someone who experiences significant head injuries. If the packed house at Penn Medicine’s event was any indication, there are a lot of willing collaborators to drive the conversation forward, with a push for more research, more awareness and more discourse on the topic.
Neuro-oncologist researchers at Penn are investigating ways to help patients diagnosed with the most aggressive type of brain tumor, Glioblastoma Multiforme. Building on the Abramson Cancer Center's previous success with research designed to attempt to treat cancers using novel immunotherapies, and Penn's neuro-oncology expertise, researchers will be studying two different personalized approaches to stimulate an immune response against brain tumor cells.
In one study, the investigational immunotherapy will target peptides that are overrepresented in cancer stem cells, and will potentially train the immune system to recognize the glioblastoma tumor cells and hopefully inactivate them.
A slightly different approach will be used in the second study, where the investigational vaccine aims to incite an immune response by activating the cells that signal for help. The vaccine binds to a type of cell called antigen presenting cells, which attract attention from the immune system to recognize the malignant cells.
Once the cells are obtained during surgery and post-surgically apheresis procedure, they will be re-engineered, tested and placed back into the patient. The patient's own cells are intended to recognize the tough-to-treat tumor cells and hopefully inactivate them.
If you have been recently diagnosed with glioblastoma multiforme and have not yet had surgery, please contact Neurosurgery Clinical Research trial coordinator Lisa Pritchett at 215-615-4597 or [email protected]to find out if you may be eligible for either of these glioblastoma research studies.
While researchers are busy identifying new biomarkers to detect disease and tailor treatments to individual needs, legal battles have been waged all the way up to the Supreme Court, trying to sort out whether a private company can own the rights to a particular biomarker.
In the months since a US Supreme Court ruling unanimously “rendered invalid two patents covering a method for determining proper drug dosage," as Nature reports, discussions have swirled about how to pay for personalized medicine. The NEJM co-authors report that "a patentable process now needs to involve an inventive and novel application of a law of nature beyond well-understood, routine, conventional activity, previously engaged in by those in the field."
Without patents protecting such medical discoveries, some have argued that there is no way to recoup the costs of biomarker innovation. To that end, Supreme Court Justice Breyer suggested whether special market-exclusivity protection was warranted.
Instead, the authors suggest that enhanced public funding, public-private partnerships, and open-source consortia may improve biomarker discovery and development, more than a private model. According to the NEJM piece, "the Supreme Court's move to free the fundamental processes of medical diagnosis from private ownership…could ultimately enhance the public health."
As biomarkers become more and more prevalent -- helping diagnose diseases, and pairing with treatments targeted to individual needs -- there will need to be solutions to balance the needs of ensuring access to this useful information and paying for personalized medicine.
People can have a brain full of Alzheimer's disease, but not have the dementia that typically goes along with it. By the numbers, this subset of people can have many plaques and tangles in the brain, enough to qualify them for a diagnosis of Alzheimer's disease, but in reality, they don't have the memory loss or other clinical symptoms of Alzheimer's.
In most cases, people have more and more symptoms of dementia as the plaque and tangle Alzheimer's disease lesions accumulate in the brain. And , most people who have normal memory and thinking are found to have very few plaques or tangles.
Yet, there's this outlier group, who should, by most definitions, have dementia due to Alzheimer's disease, but they are resistant.
In a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania with colleagues from Rush University, published online in Neurobiology of Aging, the team investigated why these people are resilient to Alzheimer's and found several biological factors that help distinguish the resilient group from those with dementia. They discovered that synapses are preserved in resilient cases and found an increase in the number of brain cells called astrocytes, that may provide a protective response to the "toxic" effects of plaques and tangles.
The team also identified new biochemical targets that may be associated with resilient cognitive brain aging in the subset of people who have Alzheimer's pathology, which they'll investigate further, thanks to a new grant from the National Institute on Aging.
In a disease with no known treatments or cures, this will be one more angle researchers will pursue, to thwart the diseases' advances. While research continues to progress in understanding how plaques and tangles develop and cause damage in the brain, it is also important to understand how the brain can fight this damage and preserve cognition.
Arnold SE, Louneva N, Cao K, Wang LS, Han LY, Wolk DA, Negash S, Leurgans SE, Schneider JA, Buchman AS, Wilson RS, & Bennett DA (2012). Cellular, synaptic, and biochemical features of resilient cognition in Alzheimer's disease. Neurobiology of Aging PMID: 22554416
Every moment counts for brain diseases. The saying among medical experts is that “time is brain.” The earlier you receive treatment, the better. This week, a diverse team of researchers from the Perelman School of Medicine at the University of Pennsylvania is in New Orleans at the American Academy of Neurology’s 64th Annual Meeting, sharing the latest data aimed at enhancing the speed of diagnosis and treatment, and ultimately helping people with neurologic conditions.
In the spring of 2011, Penn celebrated the opening of the Smilow Center for Translational Research – a new home for Penn Medicine's emphasis on translating breakthroughs in the lab to clinical therapies for patients. The story profiled here is just one example of such research at Penn.
My colleague Karen Kreeger has written press releasesabout what the drug is and does, but I'm fascinated by how it came to be. It's not every day that academic researchers go so far beyond identifying a specific target by seeing an agent well into the drug development stages and discovering new uses after its initial clinical testing.
Kurt Brunden, PhD, who spearheads the drug discovery efforts at Penn's Center for Neurodegenerative Disease Research, came to Penn from the pharmaceutical industry, with hopes of progressing the basic research being conducted here and speeding it toward clinical trials. Here, he explains how the process works at Penn, and how teamwork from across the Penn campus has helped make it possible for this academic drug discovery program to be a success.
As Dr. Brunden notes, academia can play a complementary role – alongside the typical research and development might of the pharmaceutical industry -- in helping bring much-needed therapeutics into clinical trials as quickly as possible.
When I heard that Jesse Taylor, MD, assistant professor in Plastic Surgery, was using 3D computer-aided design (CAD) to plan out a surgery to restructure someone's face, I had to find out more. My father is a pattern maker by trade, and develops prototype parts and molds. After growing up talking about some of the same 3D design tools, it’s fascinating to see how the latest technical innovations are now helping patients with facial malformations.
Dr. Taylor walked me through a recent surgery, one of the most complicated cases he's done, of a patient whose facial structure was significantly impacted by a rare genetic condition called Saethre-Chotzen syndrome (SCS).
It may sound like an alphabet soup of diseases, but these intertwined diseases are changing the way we look at, and hope to treat, progressive neurodegenerative diseases attacking the brain.
For diseases historically considered in the domain of distinct neurological sub-specialties - movement disorders, neuromuscular conditions, and dementia - the steady increase in our understanding of their overlapping causes and symptoms, as well as their co-existence in the same individual, has led to a shift in how care is delivered. Physicians, nurse practitioners, therapists, and other care-team members are cross-training and collaborating more than ever.
Rachel Gross, MD, now an assistant professor of Neurology in the Perelman School of Medicine at the University of Pennsylvania, noticed the overlap as she completed advanced training in Neurology. She decided to get dual-trained in both Cognitive Neurology and Movement Disorders while completing her fellowship at Penn. "I realized that patients who suffer from diseases characterized by a movement disorder and dementia would appreciate seeing one physician who can address both their motor and cognitive issues.”
At last weekend's FTLD Caregiver Conference, hosted by the Penn FTLD Center, we saw how neurological sub-specialties are blending, overlapping, and informing each other. For instance, researchers are now considering FTLD and ALS to be on the same spectrum of disease. Some people may start with the physical stiffness seen in Lou Gehrig's disease, while someone else - with the same underlying protein markers - starts with FTLD-symptoms like behavioral outbursts or language mix-ups.
Some of the less common neurodegenerative diseases are also informing the more common diseases. Last year, we reported genetic clues on risk factors and biological causes of a rare neurodegenerative disease called progressive supranuclear palsy (PSP). Biologically, PSP is primarily caused by an abnormal accumulation of tau protein, which is well-known for its secondary role in Alzheimer's disease.
Pieces of research - genetics, biomarker tests, imaging, pathology, and clinical symptoms - are starting to come together to give us a better picture of neurodegenerative disease. The team of researchers and clinicians, at Penn and beyond, are in a race to find a cure. The more experts battling neurodegenerative diseases, the better!
If you're getting not-so-tech-savvy loved ones of any age new gadgets for holiday gifts this year, take a page or two from the Penn Memory Center's Cognitive Fitness program lessons. They've been working one-on-one with a pilot group of participants, helping them use tech tools and other coping skills to counter memory issues. While sitting in on a recent Cognitive Fitness class, I watched as the instructors spent considerable time going over the various items the participants were learning to use, cell phones to iPads. WHYY Radio attended a recent class – get a peek inside their story.
The devices have definite perks that make them appealing gifts for seniors: e-readers are light and portable for people who do not want to carry lots of things around and make it easy to access books if transportation is problematic; iPhones and smart phones are fairly intuitive to use and great for directions or setting medication reminders; internet access allows you to find new (healthy) recipes or webchat via Skype to stay connected with loved ones far away; and email can bring photos of grandkids galore.
For gift-givers who have grown up surrounded by new technology, it's tough to understand how challenging it can be for tech newbies to learn to use their new devices. So, I asked the instructors for some advice. Here's what they recommended for anyone teaching a loved one to use a new gadget -- memory issues or not.
1. Teach one tech tool at a time. Instead of teaching them how to use all the functions on their gadget at once, break it out into sessions. If adding contacts to a cell phone is a priority, start with that. Or, if adding a calendar appointment is a helpful tool, offer a separate lesson to walk through that process.
2. Be patient. Plan on spending a few sessions helping them learn, and space it out so they have some time to practice on their own between new sessions.
3. Write detailed instructions out. One Cognitive Fitness program participant photocopied his new remote control and annotated it, so he could have a reference guide to refer to if he couldn't recall the right button to press. Printouts of screen shots, showing people what icons to look for to check email, or what the calendar button looks like, are also helpful.
a. If passwords are required, a handy password guide might be helpful (if stored in a secure, yet easy to find place). b. Some people learn more if they write the instructions out themselves, in their own words and in a format that may be more intuitive for them. If they're a visual learner, drawing diagrams may work well for them. c. Once instructions are written, the user should work through them step-by-step to make sure all steps are accounted for and identify any places at which they may get "stuck" in the process.
4. Practice makes perfect. Work with them to see if they can use the device on their own. For example, call and leave a voicemail, to see if they're able to retrieve it, send an email to make sure they can email you back, or call them via Skype to see if they can respond. It may take a couple of practice runs for more complicated instructions.
5. Build confidence. Technology can be overwhelming, so working one-on-one with a loved one can help them feel more capable and confident that they won't mess up or hit the wrong button. If they get overwhelmed, take a break and try again later, focusing on basic skills first to help them build their confidence.
While technology can be very beneficial, change can be unsettling. With any new process, it will take some time for your loved one to get used to making the new technology work for them. Take the time to help your loved ones warm up to the new gadgets, and you'll both be happier.
520 days ago, in June 2010, a team of six astronauts embarked on a simulated Mars mission, conducted by the State Scientific Center of the Russian Federation – Institute for Biomedical Problems (IBMP) of the Russian Academy of Sciences.
On November 4, 2011, the hatch was opened in Russia and the crew members ended their mission. But the mission continues for the Penn-led U.S. scientific team charged with monitoring the six crew members’ rest-activity cycles, performance and psychological responses.
David Dinges, PhD, chief of the division of Chronobiology and professor of Psychology in Psychiatry with the Perelman School of Medicine, and team members collected over 75,000 hours of data during the 520-day mission's three stages: 250 days for the trip to Mars, 30 days on the surface, and 240 days for the return to Earth.
Using unobtrusive miniaturized wristwatch-like devices to measure crew members' sleep-wake patterns and specially programmed computers with brief assessment tests, the team hopes determine the extent to which sleep loss, fatigue, stress, mood changes and conflicts occurred during the mission.
Dr. Dinges and colleague Mathias Basner, MD, PhD, MSc, assistant professor of Sleep and Chronobiology in Psychiatry, captured 99 percent of their intended data. Results of the study will be reported after the data has been fully analyzed.
The Penn Medicine research program was funded by the National Space Biomedical Research Institute (NSBRI) and in part by the Institute for Experimental Psychiatry Research Foundation. Dr. Dinges and Dr. Basner will be available for interviews when they return from Russia.
For more information, please see the NSBRI press release or watch the Associated Press video, below.
As Breast Cancer Awareness Month winds down, we wanted to talk about one of the last steps some of our breast reconstruction patients face: nipple reconstruction and tattooing.
Once the breast reconstruction(s) are complete, nipple reconstruction can take place several months after breast surgery and following other treatments. Patients may elect to undergo nipple reconstruction on one or both breasts using local flaps, grafts, or a combination of the two. After the reconstructed nipple has healed, nipple tattooing can re-pigment the area, to make it look more realistic.
Nipple tattooing, as I've come to find out, is a true demonstration of art's impact on healing.
Mandy never imagined she'd find herself working as a tattoo artist in the most unlikely of places, a hospital. Her mother owns a body art shop outside Philadelphia, so Mandy grew up expecting to build a career working and teaching tattooing in her mother's shop. After spending nearly a decade as a full time tattoo artist, Mandy explored the burgeoning area of permanent cosmetics, and trained with an expert in micropigmentation, where permanent pigment is placed below the dermal layers of the skin. She earned her board certifications through the American Academy of Micropigmentation, is a member of the Society of Permanent Cosmetics and is now a busy permanent cosmetics/tattooing expert.
I asked Mandy for some tips and things to consider when investigating whether nipple tattooing is a good option. Here are some of her tips.
In honor of Breast Cancer Awareness Month, we'll be spotlighting breast cancer-related news from around Penn Medicine on our News blog every Wednesday in October.First up, we delve into Penn Medicine research providing personalized breast reconstruction options for women of all shapes and sizes.
Two new reports out recently provide further evidence of the hurdles facing families with a child on the autism spectrum disorders (ASD).
Using data from the largest population-based survey to date of individuals and families living with autism, the Pennsylvania Bureau of Autism Services’ statewide Autism Needs Assessment identified several themes and challenges facing Pennsylvanians affected by autism, as well as potential ways to improve quality of life.
The report raises broad and multi-dimensional issues, all highlighting a lack of available and appropriate resources and giving a stark look at the day-to-day challenges confronting families living with autism.
In the spring of 2011, Penn is celebrating the opening of the Smilow Center for Translational Research – a new home for Penn Medicine's emphasis on translating breakthroughs in the lab to clinical therapies for patients. The story profiled here is just one example of such research at Penn.
It takes a long time for a new drug to get approved for patients, usually about 10 years. Tucked away in two separate labs at the Department of Psychiatry at Penn Medicine, researchers have spent more than a decade researching and testing a new treatment for depression. The drug became the first new medicine to treat depression in more than a decade when it received FDA approval in January.
The drug, vilazodone, packs a one-two punch, preventing serotonin reuptake like traditional SSRIs, as well as activating an impaired receptor, targeting the underlying pathology of depression. The drug’s mechanism was initially studied in the basic science labs at Penn, which led to clinical trials for major depressive disorder (MDD), also conducted by Penn Medicine researchers. The result: a truly translational effort, from bench to bedside.
There is a great need for effective depression treatments. Standard medicines, called selective serotonin reuptake inhibitors (SSRI), are effective but limited treatments for MDD. Impairing side effects – including weight gain, sexual dysfunction and tiredness – are the most common reason for treatment discontinuation, especially in the first month of treatment. And the cost is tremendous: Suicide is the 10th leading cause of death in the United States, and claims the lives of more than 34 thousand people each year. There are nearly twice as many suicides in the U.S. as there are homicides. Serious mental illness costs society an excess of $300 billion per year, with $193.2 billion in lost earnings alone.
We’re in the midst of the Year of Water here at Penn, but I can’t help but think there is a water disconnect – the water that we’re trying to save and protect is the same thing we’re rejecting as a drink.
I, like many Americans, drink water only if I’ve exhausted other options – if there are no carbonated soft drinks, sparkling water, or coffee around. I’m careful to choose diet drinks and avoid caffeine and sodium for health reasons, but for some reason, I’ve rejected the best option out there: water. And I’m not the only one. We're drinking more of our calories than ever before, and it's taking a toll on our waistlines and our overall health.
This blog is written and produced by Penn Medicine's Department of Communications.
Views expressed are those of the author or other attributed individual and do not necessarily represent the official opinion of the related Department(s), University of Pennsylvania Health System (Penn Medicine), or the University of Pennsylvania, unless explicitly stated with the authority to do so.
Health information is provided for educational purposes and should not be used as a source of personal medical advice.