1. < Cardiology/Epi

Over the past few weeks, department of medicine (DoM) faculty and trainees have been traveling across the country to attend major annual meetings and conferences where they have showcased their leadership in medicine, research, patient care, as they networked with other health care professionals. They recently traveled to San Diego, CA for the American College of Physician’s Internal Medicine Meeting 2023. From May 10 – 13, DoM faculty and trainees were spotted throughout Aurora, Colorado at the Society of General Internal Medicine’s (SGIM) Annual Meeting 2023. This year’s theme “Meeting the Promise of Tomorrow,” invited conference participants to reflect on how COVID-19 has impacted our field and our colleagues’ experiences providing care while continuing to mentor our trainees. Let me highlight a few of the presentations and posters presented by our faculty and trainees which demonstrate their high-impact research contributions to the field.

Society of General Internal Medicine Meeting 2023

Let me first spotlight our trainees and junior faculty who whose research earned award distinctions at SGIM 2023. They are:

Evan Shannon, MD, MPH who presented "Effect of Patient-Physician Racial Concordance on Outcomes of Patients Treated by Hospitalists," and Richard Leuchter, MD who presented “Identifying Unnecessary Hospitalizations Using the Covid-19 Pandemic as a Natural Experiment: An Instrumental Variable Analysis.”  They both received the Milton W. Hamolsky Junior Faculty Scientific Presentation Award. The Hamolsky Award is presented to the most outstanding scientific presentations by junior faculty during the 2023 SGIM annual meeting.

Carlos Irwin Oronce, MD, MPH who presented "Association Between Governmental Spending on Social Services and Health Care Use Among Low-Income Medicare Beneficiaries," was awarded the Mack Lipkin, Sr. Associate Member Scientific Presentation Award. The Lipkin Award is presented to the scientific presentations considered most outstanding by students, residents and fellows during the 2023 SGIM annual meeting.

Both the Hamolsky and Lipkin Awards are made based on participant evaluations of the presentations and are endowed by the Zlinkoff Fund for Medical Education. Congratulations to Evan, Richard, and Carlos who brought three of the six national physician scientist awards to UCLA!

Next, third year internal medicine resident and soon-to-be National Clinician Scholar at UCLA Jessica Zhang, MD presented four posters at SGIM 2023. It is not typical for a resident to present multiple posters at SGIM, but Dr. Zhang showcased her leadership and expertise in her presentations about the following:

• "Association Between Physicians’ Geriatric Training and Patterns of End-of-Life Care Delivered to Persons with Dementia: a Cross-Sectional Study" 
• "Association Between Physician Age and Patterns of End-of-Life Care Delivered to Persons With Dementia" 
• "Timing and Setting of Advance Care Planning Among Medicare Decedents in 2016-2019"
• "Changes in Site of Death Among Medicare Beneficiaries During the COVID-19 Pandemic"

The success of our junior faculty and trainees is largely influenced by the mentorship that they receive from our faculty who are highly committed to developing our trainees into the future leaders of medicine. I would like to note that Yusuke Tsugawa, MD, PhD, associate professor of medicine in the Division of General Internal Medicine and Health Services Research at UCLA and the David Geffen School of Medicine, was involved in seven presentations at SGIM 2023, with six being led by his mentees that include Drs. Shannon, Oronce, and Zhang. When Dr. Tsugawa was not cheering on his mentees, he presented "Days Spent at Home and Patient Well-Being Among Frail Older Adults." Thank you Dr. Tsugawa for dedicating so much effort to developing the next generation of clinician scientists.

Additional DoM faculty also took center stage at SGIM 2023. They included Utibe Essien, MD, MPH who presented “VA Facility-Level Variation in Racial Disparities in Anticoagulation for Atrial Fibrillation,” Reza Manesh, MD who led the plenary session, “Finding Joy in Medicine through Adversity, Creativity, and Community.” I am also pleased to share that Cristina Valdovinos, a fourth year Drew/UCLA medical student who will be joining our internship class in primary care in July 2023 presented a poster “The Los Angeles Health Technology Navigators: A novel workforce addressing the digital divide in the safety net.” Carol Mangione, MD, chief of the division of general internal medicine and health services research and chair of the United States Preventive Services Taskforce (USPSTF), updated attendees on the latest USPSTF guidelines. These are just a few of the highlights of SGIM 2023. You may view pictures captured throughout the meeting by clicking HERE. 

Digestive Diseases Week 2023

A few days earlier, and 1,000 miles east of Aurora, faculty members from the division of digestive diseases met in Chicago, Illinois for Digestive Diseases Week 2023. Digestive Disease Week is the largest annual international conference for gastroenterology and hepatology. This year, the Vatche and Tamar Manoukian Division of Digestive Diseases, led by Eric Esrailian, MD, MPH, was strongly represented at the conference with over 90 poster presentations and lectures.

Many of our UCLA Health residents and fellows attended the conference to present their basic science, clinical, and health services research, including: Vivy T. Cusumano, MD, Lauren DeDecker, MD, Sadie De Silva, MD, Kush Fansiwala, MD, Jessica Haraga, MD, Shailavi Jain, MD, Oliva Jordan, MD, Wendi LeBrett, MD, Rahul Kamath, MD, Anna Lee, MD, Yvonne Lei, MD, Megan McLeod, MD, MSc, Shaya Noorian, MD, Devin Patel, MD, Andrew Roney, MD, Sagar “Arnie” Shah, MD, Ellen Spartz, MD, Camille Soroudi, MD and Jamie Yang, MD.

Some of the many featured awards and distinguished lectures are listed below:

• American Gastroenterological Association (AGA) Morton I. Grossman Distinguished Lecture
  Brain-Gut Interactions in IBS: Novel Applications for Clinical Practice
  Lin Chang, MD
• American Gastroenterological Association (AGA) Abstract Award for Health Disparities Research
  Colorectal Cancer Rates at FQHC in the US from 2020 to 2021: Incomplete Rebound & Worsening Disparities
  Matthew Y. Zhao, BS
  UCLA contributors: Yvonne Lei; Megan McLeod, MD, MSCR; Jayraan Badiee, MPH; Artin Galoosian, MD, MS; Folasade P. May, MD, PhD, MPhil
• American Gastroenterological Association (AGA) Abstract Award for Health Disparities Research
  Discrimination Exposure Impacts Unhealthy Processing of Food-Cues: Crosstalk Between the Brain & Gut
  Xiaobei Zhang, PhD
  UCLA contributors: Hao Wang; Lisa A. Kilpatrick, PhD; Tien S. Dong, MD, PhD; Gilbert Gee, PhD; Hiram Beltrán-Sánchez, PhD; May Wang, PhD; Allison Vaughn, MPH; Arpana Gupta, PhD
• State-of-the-Art Presentation
  ASGE Innovations to Improve Endoscopic Practice
  Raman Muthusamy, MD, MAS
• State-of-the-Art Presentation – Research Forum
  State-of-the-Art: Can We Move the Needle in CRC Screening in Under-Represented Minorities 
  Folasade (Fola) P. May, MD, PhD, MPhil

See the full list of abstracts, posters, and presentations.

UCLA Health Systems and Management Pathways

Finally, seven of our DoM residents visited our nation’s capital as part of their participation in the UCLA Health Systems and Management Pathways. As part of the program, this two-year longitudinal program is designed to improve training opportunities for a select group of residents interested in careers in healthcare management, health policy, and delivery innovation. One of the core pathway activities is a trip to Washington DC to meet with policy stakeholders. The program is led by Nika Harutunyan, MD and Sun Yoo, MD, MPH. Dr. Harutunyan reports that,

“this year Olumuyiwa Akinrimisi, MD, Shailavi Jain, MD, Alex Kokaly, MD, Hollyann Loui, MD, Sarah Takimoto, MD, Madeline Treasure, MD, Jessica Zhang, MD and I met with healthcare leaders such as the Chief Transformation Officer of the CMS Innovation Center, various white house physician fellows working on important healthcare policies, the Deputy Undersecretary of Health at the National VA, and attended a townhall about "Medicare for all" with Bernie Sanders among other activities.”

Dr. Harutunyan received the following feedback from an external stakeholder who shared,

"You have such an impressive group of graduating IM residents – you and the department have much of which to be proud."

I agree, but importantly I view accounts like this with hope, that we are preparing trainees who will have the tools and skills to transform health care delivery in America.

DoM in the Community

Locally, our clinical practices have been busily engaging in community relations efforts by participating in various events which continue to increase awareness of our presence in the community and strengthen our ties to the communities we serve. Most recently, our community practices in the South Bay and Santa Clarita Valley participated in the largest Relay for Life events in this country. Relay for Life is one of American Cancer Society’s largest peer-to-peer fundraising events dedicated to saving lives from cancer. In the Santa Clarita Valley, Nimit Sudan, MD, a community physician and resident of the Santa Clarita Valley led the events for the day providing inspiring remarks at the top of the event and partaking in the walk.

In Torrance, Deborah J. Wong, MD, PHD kicked off the day’s activities with an inspirational keynote address which included the following:

“All of us come together today united in a common purpose – to find a cure for cancer.  It will take all of us together to accomplish this goal. To this end, I thank the American Cancer Society for affording UCLA Health this opportunity to continue in this partnership. For those of you who participate to honor the memory of a friend or loved one who has faced the cancer battle, as a cancer doctor, I thank you for being there and walking that journey with them. Together, we press forward to honor their memory. For you, cancer survivors who are going through treatment or have completed treatment who joined today, we stand with you, shoulder to shoulder with you in this fight. As the saying goes, ‘it takes a village…’ What you are here to do is such an integral part of the village to fight cancer.”

I am also pleased to share that our community footprint is expanding with the latest opening of the Pasadena community practice. Earlier this month, our newest practice joined the northeast San Gabriel Valley to provide primary care services and specialty services that include dermatology, cardiology, and pulmonology. The clinic is directed by Cristina Nguyen, MD and Fabrizio Zambrano, community practice manager. I celebrate all of our colleagues who worked diligently to expand our reach in communities by providing the highest quality of care.

UCLA Health Opens New Primary Care Clinic in Pasadena

UCLA Health announced the opening of a new primary care clinic in Pasadena. The clinic is located at 625 S. Fair Oaks Ave., North Tower, Suite 300, and is adjacent to Huntington Hospital. The clinic is open from 8 a.m. ... Read More

Melissa Lechner, MD, PhD, “Clonally-Expanded, Thyrotoxic Effector CD8+ T cells Driven by IL21 Contribute to Checkpoint Inhibitor Thyroiditis,” in Science Translational MedicineFinally, let me highlight a recent publication that represents an important advance in understanding endocrine complications of checkpoint inhibitor therapy that is increasingly used to treat various cancers. Assistant Professor of Medicine in the division of endocrinology, Melissa Lechner, MD, PhD published, “Clonally-Expanded, Thyrotoxic Effector CD8+ T cells Driven by IL21 Contribute to Checkpoint Inhibitor Thyroiditis,” in Science Translational Medicine. The study describes how activation of the cytokine interleukin 21 (IL-21) contributes to the development of autoimmune disorders in patients undergoing immune checkpoint inhibitor (ICI) therapy for cancer.

The study describes how activation of the cytokine interleukin 21 (IL-21) contributes to the development of autoimmune disorders in patients undergoing immune checkpoint inhibitor (ICI) therapy for cancer. In the United States, 50% of patients undergoing cancer treatment are eligible for ICI therapy, which has been identified as a promising cancer treatment. However, 2/3 of cancer patients will develop an autoimmune disorder because of the therapy, which may result in the interruption of treatment. Dr. Lechner teamed up with researchers in oncology and immunology on this translational study to conduct single cell RNA sequencing of immune cells isolated from thyroid biopsies from affected patients and compared these findings with another group of patients with a common condition known as Hashimoto’s thyroiditis and a third group of normal thyroid samples. These studies identified a population of immune T Cells that were uniquely increased in ICI treated patients but not in Hashimoto’s or unaffected patients and showed that this was due to increased release of IL-21 by other immune cells in the thyroid. Findings were validated in a unique mouse model developed in the Lechner lab. This discovery has catalyzed plans by Dr. Lechner and others to take these findings into clinical trials to determine if inhibiting these pathways could limit autoimmune toxicities while maintaining the cancer killing benefits of checkpoint inhibitor therapies.

“This was a team science effort that took an important clinical problem, applied rigorous endocrinology and immunology tools available at UCLA over the past 3 years, and identified a key mechanism driving immunopathogenesis that can be targeted for therapy to help patients,”

states Lechner.

Read the publication HERE.

Beautiful study, Melissa!

Dale

P.S.

Yesterday I received a $32.36 credit on my auto insurance. I initially thought that this was due to my “exceptional” driving record, then I read the fine print.

"We found that you are eligible for COVID credit on your auto insurance policy."

So, although masks are coming off, looks like the pandemic is still with us…

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