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UCLA Clinical Updates strokes in people who have a high amount of blockage of their carotid artery but no stroke symptoms related to that blockage. Triage Protocol for Metastatic Brain Tumors Learn about the Latest Advances from UCLA At UCLA, an internal triage staff immediately evaluates brain-tumor patients’ needs and offers same-day or next-day appointments with a neurosurgeon, radiation oncologist or both. UCLA Breast Center in Santa Monica The UCLA Breast Center in Santa Monica offers a streamlined approach that allows newly diagnosed breast-cancer patients to see the entire team of specialists in one day, with a patient navigator to serve as a single point of contact to facilitate and coordinate care. Behavioral-Health Services in Woodland Hills UCLA psychiatrists are providing medical oversight and services for the Samuel Goldwyn, Jr. Center for Behavioral Health — a 12-bed inpatient unit for adults over 55 years of age with acute mental-health needs. Device to Treat Mitral Valve Disease A breakthrough percutaneous mitral regurgitation (MR) therapy significantly improves symptoms, disease progression and quality of life for people who are at prohibitive risk for an invasive procedure. Care for Women with Uterine Fibroids UCLA’s multidisciplinary fibroid treatment program was the first in the country to offer minimally invasive, noninvasive and robotic surgical treatments for uterine fibroids and adenomyosis. Improving Number and Quality of Donor Livers Pioneering research at UCLA aims to extend the availability of donor livers by treating suboptimal organs prior to transplantation and by preventing cellular damage to donor organs. Managing Inborn Errors of Metabolism Infants with these disorders can appear healthy, but if not properly treated, an IEM can lead to intellectual disability, organ damage, immunodeficiency, coma and death, sometimes within hours of birth. Rapid-Deployment Aortic-Valve System Safe and Effective Weight Loss UCLA has combined its multiple obesity services into one center in order to simplify referrals and optimize patient care, including state-of-the-art programs for both surgical and nonsurgical weight loss. Clinical Trial for Asymptomatic Carotid Artery Stenosis Patients UCLA is one of 35 sites evaluating the safety and effectiveness of the INTUITY Elite valve, which is held in place by a circular, balloon-expandable frame rather than complex suturing. Managing Breast-Cancer Risk Breast density is an important factor in determining a woman’s risk of breast cancer. Studies suggest women with dense breasts have a four- to six-fold increased risk of developing breast cancer. To download these and other clinical advances at UCLA Health, go to: CREST-2 is a multicenter randomized clinical study to determine the best way to prevent UCLA introduces triage protocol for patients with metastatic brain tumors uclahealth.org/clinicalupdates Clinic offers a comprehensive approach to immune-mediated digestive diseases Laser ablation targets cancer cells in brain with focused heat therapy Treating a wide range of disorders Neurosurgeons and radiation oncologists in the UCLA Brain Tumor Program routinely collaborate to provide the latest in high-tech care for patients with metastatic brain tumors, including minimally invasive surgery, whole-brain radiation, fractionated stereotactic radiation, stereotactic radiosurgery and laser-ablation therapy. Now, these experts have created a single point of contact for all patients with metastatic brain tumors to provide easy and rapid access to optimal treatment solutions. In this enhanced, dedicated service, an internal triage staff immediately evaluates the patient’s needs and offers a same-day or next-day appointment (or another time convenient for the patient) with a neurosurgeon, radiation oncologist or both. The triage protocol is one example of the team’s innovative approach to metastatic brain tumors, the most common brain tumor in adults. As cancer patients live longer because of more effective treatments, metastatic tumors — especially tumors that spread to the brain and spinal cord from other organs — are on the rise. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) UCLAHEALTH.ORG “Laser ablation technology gives us the ability to access and treat some very deep-seated tumors that can be hard to reach with open-brain surgery,” says Nader Pouratian, MD, associate professor of neurosurgery. “We’re pleased to offer patients this advanced option.” Major advance in treatment of mitral valve regurgitation “Our team designed this clinic to treat a wide range of allergic and immune-mediated gastrointestinal diseases,” says Laura Wozniak, MD, MS, co-director of the UCLA Pediatric Celiac Disease & Eosinophilic Esophagitis Clinic and assistant clinical professor of pediatric gastroenterology. “These conditions can be quite variable in terms of symptoms and management, which makes it important to involve an experienced, multidisciplinary team. UCLA is one of only a few centers across the country with a dedicated team to do just that.” Laser ablation surgery is the newest high-tech tool in the UCLA Brain Tumor Program’s arsenal for treating metastatic brain tumors. This minimally invasive treatment — used for decades to treat other conditions — employs laser energy to heat and destroy cancerous cells from the inside out while sparing healthy tissue. Guided by real-time magnetic resonance imaging (MRI), the neurosurgeon makes a tiny incision (about 4 millimeters) and a hole in the skull about the diameter of a chopstick. A thin, fiber-optic laser probe follows that pathway to the tumor location. Real-time MRI allows the neurosurgeon to track the area being heated. The extremely precise technique works well on tumors that are small, inoperable or have failed other therapies. With this minimally invasive approach, patients typically recover faster than with open surgery and are discharged from the hospital the next day. Device treats patients with mitral valve disease who are not candidates for open-heart surgery Through collaboration among Pediatric Gastroenterology, Allergy & Immunology, and Nutrition, the new Pediatric Celiac Disease & Eosinophilic Esophagitis Clinic at Mattel Children’s Hospital UCLA offers comprehensive patient-centered care for children across a wide range of immune-mediated digestive diseases. It is the only multidisciplinary clinic of its kind in Southern California. Immune-mediated digestive diseases Celiac disease (CD) and eosinophilic esophagitis (EoE) are two of the more common allergic and immune-mediated digestive diseases among a diverse group of conditions that affect the gastrointestinal (GI) tract. These disorders, which often develop in early childhood and require a lifetime of vigilant management, have been on the rise over the past decade although the underlying pathogenesis remains poorly understood. Symptoms can be nonspecific, and a lack of targeted testing and clinical biomarkers cause the disorders to often go unrecognized or misdiagnosed. CD, affecting approximately one in 100 children, can appear at any age after gluten — the protein found in wheat, rye and barley — is introduced into the diet. Classic symptoms include poor weight gain, diarrhea and anemia, but some children may have constipation, bloating or no symptoms at all. Although it is a lifelong condition, CD is manageable with a gluten-free diet. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) 1-844-4UCLADR (1-844-482-5237) The Pediatric Celiac Disease & Eosinophilic Esophagitis Clinic at Mattel Children’s Hospital UCLA sees patients with a wide range of disorders including: • Celiac disease and gluten sensitivity • Eosinophilic esophagitis and gastroenteritis • Food allergy and food sensitivity • Food protein-induced enterocolitis syndrome (FPIES) • Food protein intolerance (e.g., cow’s milk protein intolerance) • Gastrointestinal complications associated with primary or secondary immunodeficiency A breakthrough percutaneous mitral regurgitation (MR) therapy now available at UCLA — known as the MitraClip transcatheter mitral valve repair procedure — significantly improves symptoms, disease progression and quality of life for people who are at prohibitive risk for an invasive procedure. Until recently, the only way to repair mitral valves was through open-heart surgery, but the presence of co-morbidities, frailty or advanced age left many patients with MR — the backflow of blood into the heart due to a faulty mitral-valve — without effective treatment options. Approved by the Food and Drug Administration (FDA) in 2013, the MitraClip remains the only effective treatment for patients with mitral-valve disease who are not good candidates for traditional surgery. One in 10 people 75 and over affected by mitral regurgitation Healthy valves function as one-way gates that keep blood moving forward through the heart. Mitral regurgitation — the most common type of heart-valve insufficiency — occurs when the leaflets of the mitral valve do not close completely, allowing blood to UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) “Patients treated with the MitraClip device can have dramatic improvements when their mitral regurgitation is reduced and their heart can pump blood more efficiently,” says Richard J. Shemin, MD, chief of cardiac surgery and co-director of the UCLA Cardiovascular Center. “Many of these patients have suffered with MR without an effective treatment option because they are prohibitive-risk surgical candidates. Now with the MitraClip, we are seeing results that are remarkable, especially when one considers that most of these patients are elderly and with significant morbidities.” “An ongoing environment of innovation, where the latest therapies are offered and cutting- edge techniques and devices are developed and tested, is integral to cardiac care at UCLA,” says Ravi Dave, MD, clinical professor of cardiology and director of UCLA Interventional Cardiology. “We’re excited to be one of only a handful of centers in the U.S. with the resources and expertise to offer the MitraClip. After spending just two or three nights in the hospital, a patient can return to a more full and active life.” News from UCLA Health Key to Effective Personalized Medicine UCLA surgeons and bioengineers have taken a major step to advance personalized medicine with a revolutionary technology platform called phenotypic personalized medicine, or PPM, which can accurately identify a person’s optimal drug and dose combinations throughout an entire course of treatment. uclahealth.org/ personalizedmedicine Exome Sequencing Improves Diagnosis of Neurogenetic Disorders UCLA researchers have found that a state-of-the-art molecular genetic test greatly improves the speed and accuracy with which they can diagnose neurogenetic disorders in children and adults. The test, called exome sequencing, involves determining the order of all of the genes in a person’s genome. uclahealth.org/exomesequencing Glial Scar Tissue May Assist Spinal-Cord Regeneration Rather than impede damaged nerve cells from regrowing after a brain or spinal-cord injury, UCLA researchers have found that the glial scar tissue that forms might actually favor nerve-cell regeneration. uclahealth.org/spinalregeneration