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News Article | February 1, 2017
Site: www.techtimes.com

Beth Israel Deaconess Medical Center (BIDMC) and Lahey Health have announced they will try, for the fourth time, to combine their forces and create one single entity, as an attempt to better compete with Partners HealthCare. The system would be led by Dr. Kevin Tabb, who is the current CEO of Beth Israel Deaconess Medical Center. It is the fourth time in the past six years that these two major systems are trying to merge. Should this attempt be successful, the system will be the largest hospital merger in Massachusetts since the mid-1990s. "We are engaged in ongoing discussions, exploring the opportunity to combine our two systems and create the region's premier integrated health care delivery system, one that would offer patients exceptional care and unparalleled value, while keeping care in the community whenever possible," noted Tabb in a statement. According to the administrators of the two systems, the networks have complementary advantages and should work well together. While Lahey has one of the biggest behavioral health divisions in the United States and a hospice program, BIDMC is more focused on research and teaching. As SVP and general counsel for BIDMC, Jamie Katz believes that once the two networks are united, it will be able to offer a full range of services in complementary geographic areas. What these both systems have in common is their positioning statement on the market. Their official declaration is that they deliver qualitative services that can compete with Partners HealthCare, the largest system in the state, but at lower prices. However, not everybody is as optimistic about this possible union as the administrators of the two health care providers, especially since there is no guarantee that the overall decrease in the administrative costs will stop the leaders of the union from charging more for their services. "Every merger means fewer competitors and more leverage for the parties that merge to squeeze higher prices and premiums out of everybody who lives or works or does business in Massachusetts," noted Alan Sager, a professor of health law, policy and management at the Boston University School of Public Health. When the affiliation of Partners HealthCare was created, Beth Israel was invited to be part of it. However, the company refused and partnered with Deaconess-Hospital, hoping that it will create the necessary leverage for a close competition on the market. As sources report, this initial merge wasn't a very successful one from the start, partly because of the major differences in the vision of the two hospitals. The first time the information was made public concerning a possible union between Beth Israel and Lahey was in 2011 when a deal fell through. Both the systems were interested in building their own network to compete against the Partners, and a union would have made sense. In 2014, a merger of the two systems with Atrius Health was made public. Although geographically speaking it made sense, due to the different areas the companies covered, the merger never happened. Then, in October 2015, another attempt failed yet again. Despite the efforts, the two entities were not able to unite the first three times. Should they go through with the merger this time, the health care system would undergo a significant change. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.


New owner invests in continued effort to build a unique marketplace that will feature a broad range of green products used in health care settings; online catalog set to launch later this year RESTON, VA--(Marketwired - October 24, 2016) - Greenhealth Exchange (GX) -- a purchasing cooperative that makes it easy to source products and services used in health care settings that are good for people, the planet and the bottom line -- announced today that The University of Vermont (UVM) Health Network has become the newest owner to join the organization. The UVM Health Network has been acknowledged over the years with awards from leading national organizations for its sustained efforts to reduce energy consumption, waste stream and carbon footprint, and to increase the use of healthy, locally produced foods. "At The University of Vermont Health Network, we believe practicing green health care is the right thing to do for our patients, the environment and the communities we serve. We're proud to become the latest owner of Greenhealth Exchange," said Charles Miceli, Vice President, Network Chief Supply Chain Officer. "This investment is an exciting next step in our continued efforts to be one of the greenest health care organizations in the nation and provide leadership that helps drive change across the sector as a whole." "We welcome The University of Vermont Health Network to Greenhealth Exchange, adding its strong history of prioritizing products that support healthy people, a healthy environment, and healthy communities. We're thrilled to have their support," said John Strong, President of GX. "This new partnership further strengthens our efforts to ensure hospitals have greater access to high-quality green products at competitive prices and a way to finally know what's in a product and the attributes that make it green." Health care organizations in the U.S. purchase more than $300 billion of goods and services each year, accounting for 17 percent of the marketplace. Strong shared that this buying clout puts hospitals and health systems in a strong position to accelerate the adoption of products that are safer and healthier and spark innovation in the supply chain. The UVM Health Network joins the nation's top leaders in health care sustainability who launched GX earlier this year. Founders include four health systems -- Dartmouth-Hitchcock, Dignity Health, Gundersen Health System, and Partners HealthCare -- along with longtime sustainability advocates Health Care Without Harm and Practice Greenhealth. Since the launch, GX has continued its focus on developing a network of suppliers. With the addition of The UVM Health Network, the purchasing cooperative is now backed by a combined total of 60 hospitals that together represent $25B in annual revenues and almost $5B in purchasing power. "With the support of our owners and our product manufacturers and suppliers, GX is on track to launch its online catalog by the end of the year," said Strong. Through detailed product specifications and supplier performance requirements, the unique marketplace will offer members access to the following: Strong shared that additional major health systems are expected to join GX as owners before the catalog goes live. Learn more about GX and follow the latest updates by visiting the website: www.GreenhealthExchange.com About Greenhealth Exchange Greenhealth Exchange (GX) is a Public Benefits Corporation structured as a purchasing cooperative created by Practice Greenhealth, Health Care Without Harm, and leading health systems deeply committed to environmental sustainability in health care. GX makes it easy to source products and services used in health care settings that are good for people, the planet and the bottom line. We work with our members to spark innovation in the supply chain: getting to next generation products, smarter and faster. www.GreenhealthExchange.com About The University of Vermont Health Network The University of Vermont Health Network is a five-hospital system serving the residents of Vermont and northern New York with a shared mission: working together, we improve people's lives. The partners are: Our 4,000 health care professionals are driven to provide high-quality, cost-efficient care as close to home as possible. Strengthened by our academic connection to the University of Vermont, each of our hospitals remains committed to its local community by providing compassionate, personal care shaped by the latest medical advances and delivered by highly skilled experts.


News Article | November 16, 2016
Site: www.eurekalert.org

To treat an aneurysm, gastrointestinal bleeding or other forms of uncontrolled hemorrhaging, clinicians often use tiny metallic coils, which can be permanently inserted into a blood vessel to prevent further bleeding. But such coils come with limitations. Patients on blood thinning medications or who cannot form blood clots for other reasons can experience dangerous break-through bleeding, with rebleeding occurring in as many as 47 percent of patients. To find a better solution, bioengineers from Brigham and Women's Hospital, led by Ali Khademhosseini, PhD, collaborated with Rahmi Oklu MD, PhD, FSIR, a clinician who is an interventional radiologist (previously at Massachusetts General Hospital, now at Mayo Clinic). Khademhosseini and Oklu's team develop a rapidly deployable hydrogel that can hold its shape within a blood vessel to prevent bleeding, even in those who cannot form blood clots. The newly developed agent is described in a paper published in Science Translational Medicine Nov. 16. "This work is an example of how bioengineering can help address the challenges that clinicians and patients face," said Khademhosseini. "Our work thus far has been in the lab, but we are on a translational path to bring this new biomaterial for embolization to the clinic to improve patient care." The new agent, known as a shear-thinning biomaterial (STB), has a consistency similar to toothpaste and is made up of both gelatin - which gives it gel like properties - and nanoparticles. Using a catheter, the material can be flowed into a blood vessel but is able to maintain its shape once inside the vessel, obstructing the vessel or aneurysm without relying on the formation of a blood clot. Mechanical testing in the lab was initially performed and monitored the STB's changes over time to optimize the material's properties in animal models. The team then tested the STB in both rodent and porcine models, the latter of which have blood vessels of similar dimensions to human blood vessels. Some of the beneficial properties of the STB include its ability to withstand pressure within the blood vessel, remain at the site of injection and naturally degrade over time. In addition, the team found that the material attracted cells to migrate and deposit themselves at the site of the STB, helping to block the vessel. The individual component materials that make up the STB have been previously used in humans making their subsequent regulatory process and clinical use easier. As a next step, the team hopes to begin clinical trials to test the safety and efficacy of the STB for use in humans. This work was supported by the National Institutes of Health, U.S. Army Research Office, National Science Foundation, Sloan Foundation and Mayo Clinic. Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits and nearly 46,000 inpatient stays, is the largest birthing center in Massachusetts and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 3,000 researchers, including physician-investigators and renowned biomedical scientists and faculty supported by nearly $666 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.


News Article | February 21, 2017
Site: www.eurekalert.org

Boston, MA-- Hearing loss affects 360 million people worldwide according to the World Health Organization. Inner ear sensory cells, called hair cells, are responsible for detecting sound and helping to signal it to the brain. Loud sounds and toxic drugs can lead to death of the hair cells, which do not regenerate, and is the root cause for widespread hearing loss. Until now, it was not possible to promote the generation of sufficient quantities of new hair cells. In a new paper in Cell Reports, scientists from Brigham and Women's Hospital, Massachusetts Institute of Technology, and Massachusetts Eye & Ear describe a technique to grow large quantities of inner ear progenitor cells that convert into hair cells. The same techniques show the ability to regenerate hair cells in the cochlea. Humans are born with only 15,000 sensory hair cells in each cochlea, which are susceptible to damage from exposure to loud noises and medications, which can lead to cell death and hearing loss over time. "Amazingly, birds and amphibians are capable of regenerating hair cells throughout their life, suggesting that the biology exists and should be possible for humans. Intrigued, we decided to explore whether these hair cells could be regenerated," says Jeff Karp, PhD, co-corresponding author and biomedical engineer at BWH. In order to find out, "we took cochlear supporting cells expressing Lgr5, a marker recently found in stem cells of several organs, and treated them with a drug cocktail that stimulated critical pathways," says Xiaolei Yin, co-lead author on the paper and instructor of medicine at BWH. The team achieved a >2000-fold increase in Lgr5 progenitor cells and found that these progenitors could generate new hair cells in high yield. The team also demonstrated that this approach could work with cells from mouse, non-human primate, and human tissue. Importantly, the drug cocktail "generates new sensory hair cells in intact cochlear tissue, which shows promise for a therapy to treat patients with hearing loss," says Karp. This expansion of large populations of Lgr5-expressing cells and their differentiation to hair cells provides a powerful tool for investigating the regenerative biology of hearing, and these drugs should be relevant for clinical application. To advance this work to patients, Frequency Therapeutics, is developing a novel small molecule approach to treat chronic hearing loss and expects to be in the clinic within the next 18 months. Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits and nearly 46,000 inpatient stays, is the largest birthing center in Massachusetts and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 3,000 researchers, including physician-investigators and renowned biomedical scientists and faculty supported by nearly $666 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.


News Article | December 1, 2016
Site: www.eurekalert.org

Boston, MA-- Although the hallmark symptoms of Parkinson's disease (PD) - such as involuntary shaking, slowness of movement and muscle rigidity - are related to movement, recent evidence has suggested that memory impairment plays an outsized role in diminished quality of life and the burden placed on caregivers. A new study led by investigators in the Ann Romney Center for Neurological Diseases at Brigham and Women's Hospital finds that mutations in the gene for glucocerebrosidase (GBA), known to be a risk factor for PD, also have a powerful influence on the development of cognitive decline. The study is available online and published in the November edition of Annals of Neurology, the journal of the American Neurological Association. "I believe this is the dawn of personalized medicine for Parkinson's disease," said corresponding author Clemens Scherzer, MD, associate professor of Neurology, who leads the Neurogenomics Lab and Parkinson Personalized Medicine Initiative of Brigham and Women's Hospital and Harvard Medical School. "This is one of the largest longitudinal assessments of patients with Parkinson's disease, and we believe that its insights will help to fix what is currently broken with clinical trials for patients. We see more precise clinical trials that will help match the right therapist with the right patient as the next logical step." Two defective copies of the GBA gene are known to cause Gaucher's disease, a childhood disorder that causes death by age two or severe neurologic complications. One defective copy of the gene was once thought to be of little consequence, but has recently emerged as a common risk factor for Parkinson's disease. The new report examined 2,304 patients from the US, Canada and Europe, finding that 10 percent carried one (or more) defects in copies of the GBA gene. Patients carrying one defective GBA gene copy had an increased risk of memory troubles. This effect was most troublesome for patients carrying a GBA copy with the most severe type of defect -- known as a neuropathic GBA mutation -- whose risk of developing cognitive decline over time was increased by 217 percent. Approximately half of the carriers of a neuropathic GBA mutation developed global cognitive impairment within ten years of being diagnosed with Parkinson's. Among the PD patients without a mutation, only about 20 percent developed this decline in cognitive function. Therapies for Gaucher disease have been available since 1994. Scherzer and colleagues hope that their findings will open the door for a completely new type of clinical trials in Parkinson's -- GBA-directed trials designed to proactively prevent memory troubles in patients with movement-related symptoms. They estimate that such innovative, nimble trials would need 25-fold fewer patients then conventional trials, with reduced costs and a better chance of success. More than 15 previous clinical trials for medications designed to slow or halt Parkinson's have been inconclusive or failed, perhaps in part, Scherzer notes, due to cumbersome and inefficient trial designs. Scherzer and his colleagues hope that their findings will breathe new life into better trial design and interest from pharmaceutical companies to tackle Parkinson's. "We have now launched a Consortium with The Michael J. Fox Foundation and industry to put together a tool kit for GBA-directed, molecularly targeted trials in PD," said Scherzer. "This tool kit will be an open resource for all scientists and pharma, and will comprise gene tests, biomarkers, and clinical parameters needed for successful proof-of-concept trials in PD. Smaller, more efficient trials remove a big entry barrier for pharma companies. This is good news for drug development and patients." The new work represents seven international, longitudinal studies, and a collaboration among Scherzer and colleagues from the International Genetics of Parkinson Disease Progression (IGPP) Consortium. This study was supported by The Michael J. Fox Foundation; the National Institutes of Health; Harvard NeuroDiscovery Center; U.S. Department of Defense; M.E.M.O. Hoffman Foundation; Parkinson's Disease Foundation; Wellcome Trust; MRC; Parkinson's UK; Cure-PD; Patrick Berthoud Trust; Van Geest Foundation; NIHR; Assistance Publique Hôpitaux de Paris; French clinical research hospital program-PHRC; "Investissements d'Avenir"; Prinses Beatrix Fonds; Stichting Alkemade-Keuls; and Stichting ParkinsonFonds. Paper cited: Liu G et al. "Neuropathic Gaucher's mutations accelerate cognitive decline in Parkinson's" Annals of Neurology DOI: 10.1002/ana.2478 Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits and nearly 46,000 inpatient stays, is the largest birthing center in Massachusetts and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 3,000 researchers, including physician-investigators and renowned biomedical scientists and faculty supported by nearly $666 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.


News Article | December 14, 2016
Site: www.eurekalert.org

Women who used ibuprofen or acetaminophen for 6 years or more were at higher risk of hearing loss than those who used these medications for a year or less Boston, MA -- As many as two-thirds of women in the United States over the age of 60 have some degree of hearing loss. Using data from the Nurses' Health Study, a team led by researchers from Brigham and Women's Hospital has found evidence that the duration of use of over-the-counter medications for pain relief, including ibuprofen or acetaminophen, is associated with higher risk of hearing loss. The new study, published on Dec. 14 in the American Journal of Epidemiology adds to a growing body of evidence linking the use of non-steroidal anti-inflammatory drugs (NSAIDS) or acetaminophen with loss of hearing, although the exact mechanism at play remains unknown. "Hearing loss is extremely common in the United States and can have a profound impact on quality of life," said senior author Gary Curhan, MD, SCD, a physician in the Channing Division of Network Medicine at Brigham and Women's Hospital. "Finding modifiable risk factors could help us identify ways to lower risk before hearing loss begins and slow progression in those with hearing loss." The research team examined data from more than 54,000 women between the ages of 48 and 73 enrolled in the Nurses' Health Study. They analyzed information on usage of aspirin, ibuprofen and acetaminophen, as well as self-reported hearing loss. Longer duration of ibuprofen or acetaminophen use was associated with higher risk of hearing loss. The team did not find a significant association between hearing loss and duration of usual-dose aspirin use. (Hearing loss is an established side effect of high dosages of aspirin, but such dosages have become uncommon over the last two decades.) "Although the magnitude of higher risk of hearing loss with analgesic use was modest, given how commonly these medications are used, even a small increase in risk could have important health implications. Assuming causality, this would mean that approximately 5.5 percent of hearing loss occurring in these women could be due to ibuprofen or acetaminophen use," said Curhan. The study's authors note that the NHS data are limited to mostly older, white women and that further investigation in larger groups and among other populations will be important to understand the connection between hearing loss and pain reliever usage. The team has previously published findings that indicate that higher frequency use of NSAIDs and acetaminophen are associated with higher risk of hearing loss in men and younger women. This work was supported by grants U01 DC010811 and UM1 CA176726 from the National Institutes of Health. Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits and nearly 46,000 inpatient stays, is the largest birthing center in Massachusetts and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 3,000 researchers, including physician-investigators and renowned biomedical scientists and faculty supported by nearly $666 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.


News Article | November 10, 2016
Site: www.eurekalert.org

Boston, MA - Women have a two-fold higher risk of developing Alzheimer's disease than men, yet strikingly little is known about how changes in brain function promote this difference -- and how early in midlife those changes can be detected. Now, in a population-based study involving more than 200 healthy women and men ages 47 to 55, a team of researchers led by the Brigham and Women's Hospital reveals specific changes in memory function that correspond to sex and menopausal stage, rather than chronological age. The work implicates key areas of the brain that are vulnerable to age-related decline and highlights the importance of ovarian hormones in maintaining memory function. The new study appears in the Nov. 9 online issue of the journal Menopause. "For years, the dominant thinking in the field was that women were at higher risk of Alzheimer's disease simply because they tend to live longer," said senior author Jill Goldstein, PhD, Director of Research at the Connors Center for Women's Health and Gender Biology at BWH. "But that idea was perpetuated by research that looked late in life -- not at middle age, when key hormonal transitions take place and when changes in memory begin to surface." Age-related cognitive decline impacts both men and women, with people reporting forgetfulness and a lack of mental clarity (so-called "brain fog") as they age. While women in general tend to fare better than men on tests of verbal memory and men have a higher rate of mild cognitive impairment later in life, women are disproportionately affected by Alzheimer's disease. In the U.S. alone, there are roughly 5.4 million people living with Alzheimer's disease; nearly two-thirds are women. Goldstein and her colleagues seized an opportunity to examine how and why these sex differences unfold when one of their long-studied community cohorts, known as the New England Family Study, began entering their later-40s and 50s. That allowed the researchers to carefully examine what happens to memory function in healthy, middle-age women over time as menopause unfolds -- spanning the pre- , peri-, and post-menopausal periods -- and to compare those findings to healthy, age-matched men. Because the individuals studied showed no signs of dementia or obvious memory loss, standard tests of memory function were not challenging enough to detect changes. So the team turned to a series of neuropsychological tests, refined by Dorene Rentz, PsyD, a lead author on the paper, senior neuropsychologist in the Department of Neurology at BWH, and an expert on Alzheimer's disease. These tests rigorously evaluate different forms of learning and memory, offering a finer-grained view that could identify even early, age-related cognitive deficits. The researchers found that, when compared to age-matched men, the women scored significantly higher on all categories of memory function assessed by the tests, with one notable exception: Post-menopausal women performed at roughly the same level as their male counterparts (and worse than the other women) on tests of initial learning and retrieval of information. The finding suggested changes in frontal areas of the brain, known for their roles in short-term memory and so-called "executive functions" -- advanced cognitive abilities, like organizing, structuring and evaluating information. In addition, hormone measurements revealed that across all women studied, higher estradiol levels (the form of estrogen that has the greatest effects on the brain) correlated with better memory performance. When taken together with other recent work, both from Goldstein's group and others, the Menopause paper helps paint a picture of the memory circuits in the brain that begin to change with age -- in both males and females -- and underscores the importance of steroid hormones, especially estradiol for women, in maintaining memory function. "We need to develop the capability to identify early on who is at highest risk of developing Alzheimer's disease," said Goldstein. "This is critical because the treatments given after disease onset have been unsuccessful. We hope findings from our cohort will ultimately provide clues early in mid-life with regard to who is at highest risk for the disease in later mid-life, and how this may differ for men and women. " Goldstein and her colleagues are already working toward that goal. Together with collaborator Philip de Jager, MD, PhD, who directs the Program in Translational NeuroPsychiatric Genomics at the Ann Romney Center for Neurologic Diseases at BWH, the researchers are designing a clinical risk tool that can help pinpoint patients who are most vulnerable to Alzheimer's disease. This tool -- which is being developed for both men and women -- will incorporate genetic risk factors as well as a host of other clinical characteristics known to affect memory decline and the sex differences therein. "Alzheimer's disease is one of the greatest public health challenges of our time," said Goldstein. "Going forward, it is imperative that we understand how to retain memory function throughout life, and that we incorporate these sex differences into future research and therapeutic discovery strategies." This study was supported by the National Institute of Mental Health (R01MH090291 to J. Goldstein). Additional support was provided by ORWH-NICHD BIRCWH K12 HD051959 to author E. Jacobs. The Harvard Clinical and Translational Science Center (NIH UL1RR025758) also provided support for serologic acquisition and evaluations. Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits and nearly 46,000 inpatient stays, is the largest birthing center in Massachusetts and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 3,000 researchers, including physician-investigators and renowned biomedical scientists and faculty supported by nearly $666 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.


News Article | November 10, 2016
Site: www.eurekalert.org

Meningiomas are the most common primary brain tumors, but the term encompasses over a dozen subtypes that range from benign to highly aggressive. Rhabdoid meningiomas are classified as highly aggressive due to their high rates of recurrence and mortality, but the experience and outcomes for patients with this rare form of brain tumor vary widely. Researchers from Brigham and Women's Hospital, in collaboration with colleagues at Massachusetts General Hospital, have identified genetic mutations in this form of brain cancer that can distinguish aggressive rhabdoid meningiomas from more benign forms using routine laboratory tests. The new findings could have immediate implications for clinical decision-making. The work is published Nov. 10 in the journal Neuro-Oncology. "Our work has practical implications for the care of patients with meningiomas," said Sandro Santagata, MD, PhD, a pathologist in the Neuropathology Division at BWH. "We hope that this work will have an impact not only on clinical management, but also for the enrollment of patients in clinical trials. Novel treatments for meningiomas are urgently needed, and determining which patients have more aggressive forms of the disease based on the tumor's genetics could help us design better trials and more precise treatment approaches." Ganesh Shankar, MD, PhD, a neurosurgeon at Massachusetts General Hospital, said, "Two meningiomas may appear similar under the microscope, but we know these two tumors may have very different clinical courses. The goal of this study was to identify an easy-to-measure feature that would help predict which tumors require closer surveillance and upfront therapies following surgical resection to delay progression. This is an effort that drew on the resources of multiple collaborating institutions working towards the same goal." Usually, rhabdoid meningiomas are classified based on physical appearance and characteristics, but these enigmatic tumors can be difficult for pathologists to accurately classify. To find a molecular fingerprint that could help identify rhabdoid meningioma, Santagata and his colleagues sequenced 560 cancer-related genes from 14 meningiomas. In one sample, the team detected a mutation in the BAP1 gene along with telltale physical features (such as the shape of the tumor cells) of rhabdoid meningioma. Previous studies had found that people with inherited mutations in the BAP1 gene that cause a loss of BAP1 protein are prone to a tumor predisposition syndrome - a condition that puts them at a very high risk of developing several kinds of tumors including tumors in the eye, lung, kidney and elsewhere. But primary brain tumors had not been associated with the syndrome before. The team went on to analyze samples from 47 patients with rhabdoid meningiomas as well as 265 additional meningiomas of diverse subtypes and grades. None of the non-rhabdoid meningiomas had a loss of BAP1. However, five of the 47 patients with rhabdoid meningiomas did have mutations or deletions affecting BAP1. These patients had poor clinical outcomes: two died of the disease and two had multiple cases of recurrence; clinical follow-up information was not available for the fifth. For those patients with intact BAP1, average time of disease progression was 116 months; for the patients with BAP1 mutations, it was only 26 months. The presence or absence of BAP1 can be monitored with a simple and inexpensive test known as immunohistochemistry - in which a tissue sample is collected and stained for a particular protein. This approach is currently in routine use for characterizing samples of an eye cancer known as uveal melanoma and a tumor that arises from the linings of the chest and abdomen known as mesothelioma - forms of cancer tied to the tumor predisposition syndrome. The number of cases of rhabdoid meningioma studied in this work was small; larger studies will be needed to determine the prevalence of BAP1 mutations in rhabdoid meningiomas and to assess the impact of their detection on clinical care. However, the new work strongly suggests that a careful assessment of family history is a critical for patients who develop rhabdoid meningiomas and that patients with BAP1 negative tumors may warrant more careful observation and focused care. "Testing for BAP1 in rhabdoid meningiomas could be performed routinely and at a low cost, with the potential to change the course of clinical care and avoid overtreatment or to identify those who may need more aggressive therapy," said Santagata. "We hope that this new work will offer insights for clinicians and patients alike as they seek more information on these tumors." The work was supported by the Brain Science Foundation, the Jared Branfman Sunflowers for Life Fund for Pediatric Brain and Spinal Cancer Research; King Abdulaziz City for Science and Technology Saudi Arabia; the Ludwig Center at Harvard; National Institutes of Health; Susan G. Komen for the Cure, Terri Brodeur Breast Cancer Foundation; Conquer Cancer Foundation; American Brain Tumor Association and the Humor to Fight the Tumor Committee. Paper cited: Shankar GM et al. "Germline and somatic BAP1 mutations in high-grade rhabdoid meningiomas." Neuro-Oncology DOI: 10.1093/neuonc/now235 Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits and nearly 46,000 inpatient stays, is the largest birthing center in Massachusetts and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 3,000 researchers, including physician-investigators and renowned biomedical scientists and faculty supported by nearly $666 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.


News Article | November 16, 2016
Site: www.eurekalert.org

BWH investigators and collaborators have created a swallowable capsule that can stay in the stomach and deliver medicine for up to two weeks or more Boston, MA -- Imagine swallowing a pill today that continues releasing the daily dose of a medicine you need for the next week, month or even longer. Investigators from Brigham and Women's Hospital and their collaborators from the Massachusetts Institute of Technology have developed a long-acting drug delivery capsule that may help to do just that in the future. To test the capsule's real-world applications, the team used both mathematical modeling and animal models to investigate the effects of delivering a sustained therapeutic dose of a drug called ivermectin, which is used to treat parasitic infections such as river blindness. Ivermectin has an added bonus of helping keep malaria-carrying mosquito populations at bay. The team found that in large animal models, the capsule safely stayed in the stomach, slowly releasing the drug for up to 14 days, and potentially providing a new way to combat malaria and other infectious diseases. The results of this work are published Nov. 16 in Science Translational Medicine. "We want to make it as easy as possible for people to take their medications over a sustained period of time. When patients have to remember to take a drug everyday or multiple times a day, we start to see less and less adherence to the regimen. Being able to swallow a capsule once a week or once a month could change the way we think about delivering medications," said co-corresponding author C. Giovanni Traverso, MB, BChir, PhD, a gastroenterologist and biomedical engineer in the Division of Gastroenterology at BWH and an instructor of medicine at Harvard Medical School. Medication non-adherence is a massive problem in the U.S. and globally. In the U.S. alone, non-adherence is estimated to lead to more than $100 billion in expenses annually. Medication non-adherence is also a persistent problem in low-resource settings, where there may not be reliable access to health care and the full course of a medication. To help develop a new solution, the multi-disciplinary research team included members with expertise in biomechanical engineering, pharmaceutical sciences, infectious disease modeling, polymer chemistry and health care innovation. "In addition to improving adherence, our ultra long-acting drug delivery system may reduce side effects and improve drug efficacy by smoothing out the high variability of serum concentration that often comes with taking a daily pill," said co-first Andrew Bellinger, MD, PhD, a cardiologist at BWH and co-founder and chief scientific officer at Lyndra, the healthcare company that licensed the technology from MIT and BWH and is developing it for commercial use in the U.S. and worldwide. The company is focusing on drug delivery for neuropsychiatric disorders. (Other diseases that could benefit from ultra long-lasting drug delivery include tuberculosis, HIV, diabetes, and epilepsy.) The research team developed a capsule that is about the size of a fish oil capsule when swallowed. Once inside the stomach, the capsule unfolds into a star-shaped structure too large to pass through the pylorus and exit the stomach, but designed to allow food to continue passing through the digestive system. "The gastrointestinal tract is a strong, durable passage way through the body. We designed the capsule to pause its transit in the stomach to allow for more controlled drug delivery and absorption, before passing through the GI tract without any harm," said Traverso. "Some of the challenges we face in getting the capsule in place are the 'ship in the bottle problem' - in this case, the neck of the bottle is the esophagus - and preventing the capsule from passing through the rest of the tube. The pylorus is about 2 centimeters in diameter so we designed our system to be 4 centimeters when it opens." The capsule contains polymers and other materials mixed with ivermectin to allow the drug to slowly diffuse out of the material over time. The team reports evidence of diffusion for up to two weeks, and is interested in continuing to develop the system so that it can provide the drug for one month or longer. Ivermectin is currently used to combat several kinds of parasites, including the parasitic worms that causes river blindness and lymphatic filariasis. (The researchers who discovered ivermectin were awarded the Nobel prize in 2015.) Ivermectin has also been shown to reduce malaria transmission as the drug is toxic to the mosquito species that spread malaria (Anopheles). The concentrations of ivermectin in the blood of humans taking the drug are high enough to kill mosquitoes that bite them. In collaboration with research teams at Imperial College London and the Institute of Disease Modeling in Seattle, the team applied mathematical modeling of malaria transmission and found that long-lasting ivermectin levels could amplify the efficacy towards malaria elimination of mass drug administration campaigns. In addition, they envision potential applications beyond infectious disease, including chronic diseases such as psychiatric disease, heart disease, renal disease and more. They plan to investigate the system's applications for these conditions as well. This work was funded, in part, by the Bill and Melinda Gates Foundation, the National Institutes of Health, the Alexander von Humboldt-Stiftung Foundation and a National Sciences and Engineering Research Council of Canada postdoctoral fellowship. Paper cited: Bellinger AM et al. "Oral, ultra-long-lasting drug delivery: Application toward malaria elimination goals." Science Translational Medicine DOI: 10.1126/scitranslmed.aag2374 Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits and nearly 46,000 inpatient stays, is the largest birthing center in Massachusetts and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 3,000 researchers, including physician-investigators and renowned biomedical scientists and faculty supported by nearly $666 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.


News Article | November 29, 2016
Site: www.marketwired.com

WASHINGTON, DC--(Marketwired - November 29, 2016) - Healthcare organizations will be challenged to prove that the changing healthcare landscape has created an environment in which consolidation actually improves value to consumers. That is the conclusion of Health Care 2020: Consolidation, a new report published by the Healthcare Financial Management Association. "Consolidation is a trend that's here to stay," says HFMA President and CEO Joseph J. Fifer, FHFMA, CPA. "But controversy about the impact is ongoing. In many cases, consolidated entities have not demonstrated value to the communities served. Across the industry, the challenge going forward is to achieve and demonstrate higher value from consolidation by lowering the total cost of care and improving quality." This is the third in a series of four reports that comprise an environmental assessment designed to guide healthcare organizations in their strategic planning efforts over the next several years. Key takeaways in the 18-page report include the following: In addition to providing background and context for these key messages, the report also identifies several organizations to watch for their strategic approach to alliances with other organizations, including Catholic Health Initiatives and Dignity Health; the Monterey Bay Independent Physician Practice Association; Aetna; Partners HealthCare; and Geisinger Health System. Eleven healthcare policy experts were interviewed in the development of this report, including David Balto, Attorney, Law Offices of David A. Balto; Leemore Dafny, PhD, MBA Class of 1960 Professor of Business Administration, Harvard Business School; David Johnson, CEO, 4sight Health; Sonal Kathuria, Managing Director, Life Sciences & Health Care, Deloitte Consulting; Bob Leibenluft, Attorney, Hogan Lovells LLP; Eb LeMaster, Managing Partner, Ponder & Co.; Paul T. Liistro, Managing Partner, Arbors of Hop Brook Limited Partnership and Vernon Manor Health Care Center, and Administrator, Manchester Manor Health Care Center; Terry Rappuhn, Leader, HFMA's Patient Friendly Billing Project; Chris Stanley, MD, Vice President-Population Health, Catholic Health Initiatives; Adria Warren, Partner, Foley & Lardner LLP; and David Young, COO, Privia Medical Group. Two other reports in the Health Care 2020 series, focusing on consumerism and the transition to value, are available now. Another report, on innovation, will be released in December. All will be accessible at hfma.org/healthcare2020 With more than 40,000 members, the Healthcare Financial Management Association (HFMA) is the nation's premier membership organization for healthcare finance leaders. HFMA builds and supports coalitions with other healthcare associations and industry groups to achieve consensus on solutions for the challenges the U.S. healthcare system faces today. Working with a broad cross-section of stakeholders, HFMA identifies gaps throughout the healthcare delivery system and bridges them through the establishment and sharing of knowledge and best practices. It helps healthcare stakeholders achieve optimal results by creating and providing education, analysis, and practical tools and solutions. The association's mission is to lead the financial management of health care.

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