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UCLA Clinical Updates treatment options available or imminent for patients with kidney, bladder or prostate cancer. Robotic Technology Extends Minimally Invasive Colorectal Surgery Colorectal robotic-assisted surgery is the latest advance in minimally invasive procedures for colon and rectal diseases, including colorectal cancers, diverticulitis and inflammatory bowel disease (ulcerative colitis and Crohn’s disease). Learn about the Latest Advances from UCLA UCLA Adult Cystic Fibrosis Program UCLA has an adult cystic fibrosis clinic focused on patients 18 years and older that provides careful attention to the seamless transition of pediatric patients to adult care. Low-Testosterone Diagnosis and Treatment A significant decline in testosterone can produce symptoms ranging from low sex drive and memory problems to fatigue and depression. Undiagnosed Diseases Network As part of the nationwide Undiagnosed Diseases Network, UCLA’s Department of Human Genetics and other clinical departments are now treating select patients at no cost to them or their insurance in an attempt to diagnose rare and difficult conditions. Minimally Invasive Diagnoses and Treatment for Chest Diseases UCLA’s Interventional Pulmonology Program offers an expanding list of minimally invasive procedures, giving patients the most advanced and comprehensive clinical care while benefitting from shorter recovery times. Immunotherapy Checkpoint Blockers Immunotherapy checkpoint blockers are a new class of drugs that help release restraints on the immune system. Immunotherapy Approaches for Genitourinary Cancers 4 Radiation Therapy for Patients with Recurrent Glioblastoma This external beam radiation therapy, which can deliver a dose of radiation more precisely, is currently available only at UCLA as part of a Phase 1 clinical trial for patients with recurrent glioblastoma multiforme. Spinal Deformity Program The Spinal Deformity Program at UCLA offers comprehensive clinical care services for infants, children, adolescents and adults with scoliosis and other spinal deformity disorders. Pediatric Blood and Marrow Transplant Program UCLA has been a pioneer in many alternative transplant protocols, including the use of haploidentical bone-marrow transplantation, and continues to find new ways to improve survival rates and decrease complications. Surgery for Congenital Anomalies of the Kidney and Urinary Tract Congenital anomalies of the kidney and urinary tract are birth defects that are often discovered in a routine fetal ultrasound during pregnancy. While some resolve on their own after birth, others require close monitoring and corrective surgery, often within the first year of life. Breakthroughs in immunotherapy are revolutionizing the treatment of genitourinary cancer, with new UCLA pushes the boundaries of minimally invasive colorectal surgery with robotic technology While laparoscopic surgical techniques have provided an alternative to the large abdominal incision and long recovery period required by conventional open surgery, laparoscopy has presented technical challenges with limited, two-dimensional visualization and tight pelvic space in which to maneuver instruments. Robotic-assisted laparoscopic surgery — using the da Vinci Surgical System — offers a minimally invasive alternative to both open and standard laparoscopic colorectal- related interventions. The colon and rectal robotic surgical team at UCLA is one of the most experienced in Southern California and UCLA is among the top centers in CRS volume nationwide. How colorectal robotic-assisted surgery works State-of-the-art robotic arms — three tipped with specially designed laparoscopic surgical instruments and one with a light and fiber-optic camera — are inserted through tiny abdominal incisions. The robotic tools enable a three-dimensional, high-definition view of the entire surgical area and enhanced 360-degree wrist and finger micro-movements. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) UCLAHEALTH.ORG “The continued evolution of robotic technology will further facilitate the widespread application of robotic surgery to colorectal disease,” says Dr. Kazanjian. “We are seeing the tip of the iceberg. What we thought was impossible 10 years ago is now commonplace.” Program focuses on unique needs of adults with cystic fibrosis Patients benefit from expanded donor pool Overcoming the challenges and limitations of traditional open and laparoscopic surgery, colorectal robotic-assisted surgery using the da Vinci Surgical System is becoming the approach of choice for the surgical treatment of both benign and malignant colorectal diseases. Colorectal robotic-assisted surgery (CRS) is the latest advance in minimally invasive procedures for colon and rectal diseases including colorectal cancers, diverticulitis and inflammatory bowel disease (ulcerative colitis and Crohn’s disease). uclahealth.org/clinicalupdates Pediatric Blood and Marrow Transplant Program offers new therapies for cancer and blood disorders A major advance in colorectal surgery “The application of robotic surgery in treatment of complex conditions of the colon and rectum has revolutionized the field of colorectal surgery,” says Kevork Kazanjian, MD, associate professor of surgery and chief of the Section of Colon and Rectal Surgery. “With this innovative, minimally invasive technique, surgeons gain more vision, precision and control while making smaller, less invasive incisions.” To download these and other clinical advances at UCLA Health, go to: Blood and marrow transplantation (BMT), also called stem-cell transplantation, can be a lifesaving treatment option for children with cancers and blood disorders, including leukemia, lymphomas, neuroblastomas and sickle cell disease, as well as disorders of metabolism and the immune system. BMT replaces stem cells — blood-cell precursors found in hematopoietic (blood- cell-forming) bone marrow — injured or destroyed by disease, chemotherapy or radiation treatment. After entering the bloodstream via IV catheter, the stem cells make their way to the bone marrow. In a process called engraftment, they begin to produce new blood cells, restoring the patient’s hematopoietic and immune system. UCLA was one of the first centers worldwide to successfully perform a pediatric stem-cell transplant. The UCLA Pediatric Blood and Marrow Transplant Program was formally established in 1973. To date, nearly 1,000 children from around the globe — many with the most complex, rare or severe types of cancers and blood disorders — have had stem-cell transplants performed at UCLA. Success rates and donor-match rates meet or exceed the national averages despite the increased complexity of cases. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) 1-844-4UCLADR (1-844-482-5237) Convenient care for adult CF patients on the Westside “Children without traditional marrow donors can increasingly find transplant donors today thanks to alternative donor transplants,” says Theodore B. Moore, MD, director of the Pediatric Blood and Marrow Transplant Program and division chief of Pediatric Hematology/ Oncology. “Advances in drug therapy that prevent the patient from rejecting donated marrow have made possible haploidentical bone-marrow transplants — using half-matched cells from a first-degree relative. And because an infant’s immune system is immature, umbilical-cord blood transplantation requires less precise recipient tissue matching. The adult cystic fibrosis program at UCLA offers convenient and coordinated care to better serve patients on the Westside of Los Angeles, says Patricia H. Eshaghian, MD, adult director, Cystic Fibrosis Program, and assistant professor of medicine in Pulmonary and Critical Care Medicine. “The outcomes associated with these alternative donors for the treatment of hematologic malignancies and non-malignant hematologic disorders have reached the point where they are nearly the same as transplants from closely matched sibling donors,” says Dr. Moore. “Today, we rarely have to turn away someone who needs a transplant for lack of a donor. Most importantly, we offer the chance for a cure to many children who previously did not have one.” “Because there are so many guidelines on how you manage cystic fibrosis, it’s important that patients receive care at a specialized center,” she says. “We have access to all the specialists a patient might need.” About half of all cystic fibrosis patients in the United States today are adults, according to the Cystic Fibrosis Patient Registry. This remarkable statistic represents significant progress in the care of patients with the autosomal recessive disorder. More effective therapies in childhood and the emergence of detailed treatment guidelines have extended the median predicted survival age to 40 years. The growing number of adults with cystic fibrosis has created a need for specialized services unique to this population. UCLA has an adult CF clinic focused on patients 18 years and older. The clinic is part of UCLA’s Cystic Fibrosis Program, which is accredited by the Cystic Fibrosis Foundation. New oral medications Progress in the care of cystic fibrosis patients is attributed to following best practices as well as the introduction of new oral medications that target the underlying cause of the disease and slow the decline of lung function. In 2012, the Food and Drug Administration approved Kalydeco® (ivacaftor), a cystic-fibrosis transmembrane conductance regulator potentiator. The drug works by increasing the transfer of chloride into cells and is approved for patients ages 6 years and older with the UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) Careful attention is devoted to the seamless transition of pediatric CF patients to adult care. “What used to be a pediatric disease has become a disease of adulthood,” she says. “As these patients enter adulthood, they have to take more responsibility in caring for themselves. Education about the disease becomes very important. It can be hard to adhere to treatments. Patients need a medical team that understands and helps them with compliance.” UCLA Eye Care Locations UCLA Stein Eye Institute Westwood 100 Stein Plaza UCLA Los Angeles, CA 90095 (310) 825-5000 UCLA Stein Eye Center Santa Monica 1807 Wilshire Blvd., Suite 203 Santa Monica, CA 90403 (310) 829-0160 Doheny Eye Center UCLA Pasadena 625 S. Fair Oaks Avenue Suites 280, 285, 240, 227 Pasadena, CA 91105 (626) 817-4747 Doheny Eye Center UCLA Arcadia 622 W. Duarte Road, Suite 101 Arcadia, CA 91007 (626) 254-9010 Doheny Eye Center UCLA Orange County 18111 Brookhurst Street, Suite 6400 Fountain Valley, CA 92708 (714) 963-1444 For more information, go to: uclahealth.org/eye