UCLA Clinical Updates Learn about the Latest Advances from UCLA Polycystic Kidney Disease The fragmentation of patient services for polycystic kidney disease has been a longstanding challenge for both PKD patients and healthcare providers. At UCLA, a multidisciplinary team offers comprehensive care. Pulmonary Arterial Hypertension Increased research efforts into pulmonary arterial hypertension have yielded significant advances in the field of pulmonary vascular disease, and new therapies offer hope of better outcomes. nonpharmacologic treatments, including the ketogenic diet, can sometimes be more beneficial than further trials of seizure medications. Pediatric Growth Disorders UCLA is a major center for the evaluation and treatment of pediatric growth disorders and is among the leaders in advancing treatment of these conditions, having made significant contributions to hormone-dose monitoring practices. Pediatric ACL Injury Repair With both pediatric and sports-medicine orthopaedic surgeons working in collaboration, UCLA offers a full range of reconstructive options, including advanced techniques that preserve the integrity of the physis in younger patients, who have more growth remaining, and established reconstruction techniques suitable for teen and collegiate athletes who are closer to skeletal maturity. Immunodeficiency Diseases in Children Brain PET can often provide a level of diagnostic certainty that is not possible with other imaging technologies. UCLA Nuclear Medicine is now offering a NeuroPET clinic in Westlake Village. In recent years, advances in immunology have contributed to an enhanced understanding of primary immunodeficiency disease (PID) and a greatly expanded number of disease-related genes. Dozens of major and minor immunodeficiency illnesses are now identifiable in children. MRI-guided Radiotherapy Enables Physicians to Target Tumors in Real Time To download these and other clinical advances at UCLA Health, go to: UCLA Brain PET in Westlake Village UCLA is one of the first three locations in the world for the ViewRay MRI-guided radiotherapy system, and the first in the Western United States with the technology, which enables physicians to see and accurately target cancerous tumors and make immediate adjustments in treatment delivery as needed in real time. Ketogenic Diet Effective in Treating Pediatric Epilepsy While many individuals with epilepsy respond to pharmacologic treatment, 20 to 30 percent develop medically refractory epilepsy. Alternative uclahealth.org/clinicalupdates The largest study to date using immunotherapy to treat lung cancer has found pembrolizumab (Keytruda) to be safe and effective in arresting tumor growth in people with advanced non-small cell lung cancer. uclahealth.org/ immunotheraphylungcancer Clot removal device improves outcomes in acute ischemic stroke A study led by a UCLA investigator finds that a new device to remove obstructing blood clots can significantly improve outcomes for people who suffer an acute ischemic stroke. The stent retriever device significantly reduced post-stroke disability and increased the percentage of patients who were independent in daily function after three months. Pediatric growth disorders are often treated effectively with hormones Translational research improves patient outcomes Responsive to parents’ concerns “Questions regarding a child’s growth can arise at any stage of development,” says Yung-Ping Chin, MD, an associate physician diplomate in UCLA’s Division of Pediatric Endocrinology. UCLA specialists work with pediatricians and parents to provide consultation and examination, offering prompt appointment scheduling. Polycystic kidney disease is the focus of significant research, and patients are now benefitting from a more sophisticated understanding of the molecular underpinnings of kidney injury and cyst formation. This research has identified new potential therapeutic targets in effector molecules, says Dr. Anjay Rastogi, MD, PhD, associate professor and PKD program director. The Polycystic Kidney Disease (PKD) Program at UCLA is dedicated to leading the fight against PKD by providing the highest-quality patient care, performing cutting- edge research and educating patients and healthcare professionals about the disease. Polycystic kidney disease is a systemic disease characterized by the accumulation of numerous fluid-filled cysts in the renal parenchyma and other organs, including the liver. It’s the third most common cause of kidney failure and the most common inherited form of kidney disease, often affecting multiple members and generations of the same family, including newborns, children and adults. The fragmentation of patient services has been a longstanding challenge for both PKD patients and healthcare providers. At UCLA, a multidisciplinary team offers comprehensive care for both autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD). “There is a lot of excitement in the field regarding effector molecules,” he explains. “Researchers are increasingly interested in how those molecules can be modulated to slow down the progression of kidney disease.” Patients in the Polycystic Kidney Disease Program can access clinical trials that represent the leading edge of translational research, including studies on new therapies that could significantly delay the need for dialysis. An equally important part of care is providing patient education, Dr. Rastogi adds. Early diagnosis is critical to preserving good health. Like most other kidney diseases, PKD tends to progress without clear symptoms, meaning the diagnosis can be easily missed. PKD is diagnosed using kidney ultrasound, and UCLA nephrologists with the Polycystic Kidney Disease Program are available to consult with primary-care physicians to assess cases of suspected PKD. 1-800-UCLA-MD1 Childhood growth rates are based on a number of factors including heredity, gender and environmental influences such as nutrition. However, an estimated one-in-3,500 U.S. children has a growth disorder, which can be diagnosed at any time during childhood or adolescence. UCLA is a major center for the evaluation and treatment of pediatric growth disorders and is among the leaders in advancing treatment of these disorders, having made significant contributions to hormone-dose monitoring practices. Dr. Chin adds, “Pediatric growth disorders can be successfully treated, allowing the child to build a healthy self-image. UCLA specialists have extensive experience in evaluating and treating these patients.” Short stature is the most commonly treated growth disorder and is typically defined as height below the third percentile with growth rates of less that five centimeters per year. Pediatric endocrinologists at UCLA offer comprehensive care for short stature and other growth conditions related to endocrine disorders and other systemic conditions. “UCLA is at the forefront of new applications for growth-hormone therapy,” she says. “We have the experience and resources to perform a thorough evaluation, and we are dedicated to developing a treatment plan that will meet the needs of each patient. Beginning this type of treatment can be daunting for families, so from beginning to end, we’re here to guide them through the process and help put their minds at ease.” These include: Endocrine-related growth disorders A focus on patient education UCLAHEALTH.ORG “Primary care physicians usually refer to us if they notice an unusual or worrisome growth pattern,” Dr. Chin explains. “If parents have specific growth concerns or would like to have a conversation with us about growth, we are available for consultation as well.” (1-800-825-2631) • Growth-hormone deficiency • Hypothyroidism • Cushing’s disease UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) Fifth Fetal Echocardiography Symposium at UCLA When: October 24, 2015 Where: Tamkin Auditorium, Ronald Reagan UCLA Medical Center What: This program will review key aspects of how to optimize image quality, how to scan and evaluate the normal fetal heart, and how to evaluate abnormalities of the four-chamber view, outflow tracts and the three-vessel view. Cost: $275 – Physicians / $150 – Sonographers/Nurses / $100 – Trainees Register: Go to cme.ucla.edu/courses and select “Fifth Fetal Echocardiography Symposium” 1-844-4UCLADR (1-844-482-5237) Immunotherapy drug to treat advanced lung cancer uclahealth.org/clotremoval Comprehensive services offer unified care for polycystic kidney disease patients Continuing Medical Education: Save the Date UCLAHEALTH.ORG News from UCLA Health Method helps to validate stem cells created in a lab Two UCLA stem cell researchers have received a patent for their method of verifying that stem cells created in a lab using adult donor cells have potentially reached a pluripotent state, which means they are capable of turning into any other cell in the body. Validating the pluripotent state of stem cells has become a critical step in ensuring that stem cell research studies are accurate. uclahealth.org/labstemcells