1. < Cardiology/Epi

On Tuesday, May 30th, the department of medicine (DoM) hosted the 38th Annual Solomon Scholars Research Day. Established in 1981, Solomon Scholars Research Day  offers the opportunity for resident physicians from our affiliated internal medicine programs to show case their research and scholarship, while providing an opportunity to  network with colleagues and investigators across our programs. In welcoming remarks, Senior Executive Academic Vice Chair Gregory Brent, MD noted that success in medicine depends on the tools acquired as part of the research process. We are all life-long investigators seeking answers whether it be for a clinical diagnosis, treatment, or advancing research.

We were thrilled to highlight 182 abstract submissions at Solomon Scholars Research Day that included original research (29), clinical vignette’s (124), quality improvement (14), and medical education innovation (15). I must give a special mention to the internal medicine residency program at Kern Medical Center who had a notable year of participation with 101 abstracts submitted. The afternoon of presentations was inspiring for all attendees, reminding us of our commitment to ensure that UCLA remains a premiere research destination where trainees can benefit from research oversight, program support, funding, and mentorship. As we continue to develop the research priorities for our department's strategic plan, I appreciate the leadership of Judith Currier, MD, MSc, our newly appointed executive vice chair for research, who joined the event to share with attendees how her research career began during the early stages of the HIV epidemic. She highlighted that it is exciting to spend a career in the field of discovery where the things we learn have an impact on the things that we do every day. Here a few of the ways that our affiliated internal medicine residents are leading new discoveries in the field.

Bhupinder (Rose) Kaur, MD from the Cedars Sinai Internal Medicine Residency Program presented “COVID-19 Pandemic Impact on Diagnosis of Hepatocellular Carcinoma in the United States.” In Dr. Kaur’s presentation, she discussed the changes in the frequency of diagnosis and characteristics of hepatocellular carcinoma (HCC) in the United States during the COVID-19 pandemic. Using a retrospective study from the US National Cancer Database, Kaur and researchers assessed the number of reported cases between 2010 to 2020 to determine the rate of diagnosis among the total population. Researchers also assessed cancer stage and treatment modality. Using a trend analysis, they estimated the number of HCC cases for the first year of the pandemic 2020, based on the trends identified in the years 2010-2019. Researchers found a 14.8% reduction in cases of HCC reported in 2020. However, tumor stage and the proportion of patients receiving treatment in 2020 remained stable.

Matthew Bell, MD from the Internal Medicine Residency Program at Harbor-UCLA followed with a presentation about “Integrated Molecular Pathology as a Predictor of Malignant Transformation of Pancreatic Cysts with up to 11-Year Follow-Up.” According to American College of Gastroenterology (ACG) guidelines, cysts with high-risk features must undergo surgical evaluation. In Dr. Bell’s presentation, he discussed the long-term diagnostic utility of integrated molecular pathology (IMP), which uses molecular and biochemical analysis with cytology, to determine the malignancy of pancreatic cysts. His findings showed that the absence of high-risk features identified by ACG guidelines and IMP is a negative predictor of malignant transformation of pancreatic cysts. Features identified as high-risk by ACG guidelines or IMP all found malignancies.

Next, Vishal Narang, MD from the Kern Medical Internal Medicine Residency Program presented, “Takotsubo Syndrome: A case series of 12 patients.” Takotsubo syndrome clinically presents like acute coronary syndrome. Dr. Narang’s research presented twelve cases of Takotsubo Syndrome aimed at gaining a better understanding of the causes and risk factors of this syndrome. The research found that the etiology of the disease had several factors as patients had comorbidities and triggers. Ultimately, pathogenesis was difficult to predict.

Over the past five years, Southern California has experienced an increase in cases of murine typhus, a flea-borne disease causing acute febrile illness, which has reached an endemic level. Paola Ortiz, MD from the St. Mary’s Internal Medicine Residency Program presented an overview of recent murine typhus patients treated at St. Mary’s Hospital, an urban community hospital. She described the variety of complaints from patients admitted into the emergency room which include septic shock with elevated liver enzymes, severe sepsis due to either urinary tract infection, pneumonia, acute hepatitis, or an unclear etiology. Other patients developed rashes or required tracheal intubation, mechanical ventilation, or developed ARDS. Dr. Ortiz points out that to mitigate murine typhus, there needs to be widespread knowledge about the disease and how to prevent it. Additional studies should be conducted to examine whether seasons impact incidence of cases, whether underlying disease would lead to worse health outcomes, and the role of housing insecurity.

Representing the UCLA Internal Medicine Residency Program, Xuchen Hu, MD, PhD presented “Single center trends in chest pain presentation through the emergency room – impact of COVID-19 pandemic on sex and race differences.” In this retrospective study that included 98,258 patients from the Ronald Reagan UCLA Medical Center emergency room, Dr. Hu and researchers evaluated whether the pandemic contributed to existing sex disparities in the management and outcomes of patients who went to the ER for chest pain. Researchers examined diagnostic evaluations, treatment decisions, and health outcomes among males and females and found that emergency room visits for chest pain notably decreased among women during the COVID-19 pandemic. Women received less work-up and acute myocardial 0infarction diagnosis.

Alcohol use disorder (AUD) is the third leading cause of preventable death in the United States. Although there are outstanding treatment options, only 0.9% of patients with AUD received  indicated medication in 2021. Parinaz Abiri, MD, PhD from the UCLA Olive-View Internal Medicine Residency Program presented “An Inpatient Workflow for Medication-Assisted Treatment of Patients with Severe Alcohol Use Disorder,” described how to improve the prescription rate of medication assisted treatment (MAT) of AUD with the goal of decreasing patient morbidity and hospital readmission rates. Through a collaboration with inpatient pharmacy, substance use bridge clinic and inpatient social work at Olive View-UCLA Medical Center, patients identified with AUD, were recommended AUD medications prior to their discharge, and received follow-up from social workers who connected them to the substance use clinic once discharged. This workflow resulted in a 195% improvement in discharge prescriptions which used a pharmacy-guided discharge planning protocol. As Dr. Abriri looks to next steps, the team will seek to expand the workflow across major Department of Health Services hospitals.

In the spirit of Solomon Scholars Research Day, I would like to take the opportunity to highlight our robust partnership with Olive View-UCLA Medical Center. OVMC has been academically connected to UCLA for decades and is one of our largest internal medicine residency training sites where our trainees are working alongside OVMC and UCLA Health faculty learning to become exceptional physicians emerging investigators. Over the past six months, OVMC trainees and faculty have published nearly 30 peer reviewed publications in topics ranging from digestive diseases, health services research, dermatology, and hematology oncology. I encourage you to explore these publications by clicking HERE.

2023 STAR PROGRAM COMMENCEMENT CEREMONY

On May 26, I had the opportunity to celebrate with graduates of our Specialty Training and Advanced Research Program (STAR) and the STAR Physician Scientist Training Program (PSTP). These early career investigators underwent rigorous scientific training during either their clinical fellowship (STAR) or residency training (PSTP), leading to a graduate degree in addition to their MD for our STAR graduates. In brief opening remarks to our graduates, I emphasized that although they are graduating, this is really the beginning, and our department  will strengthen its commitment to providing continued mentorship across their entire career continuum. I also underscored the important role that they will play in strengthening the contribution of physician scientists to our collective futures in academic medicine and the importance of innovation, research and discovery to advancing human health.

We had the privilege of hearing keynote remarks from Karol Watson, MD, PhD, director of the UCLA Women’s Cardiovascular Health Center, and director of the UCLA Cardiovascular Fellowship Program, who highlighted the importance of keeping in contact with the mentors who are invested in the development of the physician scientist’s career as well as the trainees' key life moments. She reminded that out of the box thinking can be transformative, to question things that may not make sense as these may lead to new discovery. Additionally, Dr. Watson shared that success requires strong collaboration with others and giving back to the budding physician scientists that are following in our footsteps. Most importantly, she reminded us that we are all here because we love science, the process, and the exhilarating feeling of discovery and the potential it has to do something good for the world.

STAR GRADUATES

• Mary Catie Cambou, MD, PhD, clinical instructor, Division of Infectious Diseases at UCLA
• Katherine Chen, MD, MSPH, PHD, assistant professor, Division of General Internal Medicine and Health Services Research at UCLA
• Iheanacho Obi Emeruwa, MD, MBA, PhD, assistant professor, Division of Pulmonary, Critical Care & Sleep Medicine at UCLA
• Daria Gaut, MD, MSCR, medical director, Myeloid Malignancies at Genetech
• Danielle Graham, MD, MBA, PhD, general surgery resident physician, Department of Surgery at UCLA
• Joseph Hadaya, MD, PhD, general surgery resident physician, Department of Surgery at UCLA
• Alexander Nguyen, MD, PhD, assistant professor, Division of Digestive Diseases at UCLA
• Carlos Oronce, MD, MPH, PhD, assistant professor, Division of General Internal Medicine and Health Services Research at UCLA
• Amir Razmjou, MD, PhD, clinical instructor, Division of Rheumatology at UCLA
• Adam Singer, MD, PhD, clinical instructor, Division of Hematology/Oncology at UCLA
• Richard Watson, MD, PhD, clinical instructor, Division of Pulmonary, Critical Care, and Sleep Medicine at UCLA
• Gloria Yiu, MD, PhD, assistant professor, Division of Rheumatology at UCLA

STAR PSTP GRADUATES

• Sohn Kim, MD, PhD, Fellow, Division of Gastroenterology at UCLA
• Rui Li, MD, PhD, Fellow, Division of Hematology/Oncology at UCLA
• Michael Raddatz, MD, PhD, Fellow, Division of Cardiology at UCLA
• Giulianna Repetti, MD, Fellow, Division of Cardiology at UCLA
• Eileen Shiuan, MD, PhD, Fellow, Division of Hematology/Oncology at UCLA

Over the next few weeks, I look forward to celebrating with you our graduating trainees who are completing residency of fellowship programs and are about to start their careers. I also look forward to introducing you to the trainees who will be joining us in July. As they begin their journey towards becoming leaders in medicine, they will be counting on us to provide mentorship as they navigate the innovative training programs that we lead.

• Kidney Transplant Program: Anum Hamiduzzaman, MD
• Melvin and Bren Simon GI Quality Improvement Program: Brandon Smith, MD
• Pulmonary Hypertension Program: Michael Troy, MD

We look forward to welcoming trainees in Transplant Infectious Disease, East West Medicine and Lung Transplant in future years.

Lastly, our department has been making great progress in our strategic planning process. Most recently, the strategic planning committee met for a day-long retreat to discuss the data collected and findings from phase 1 of the strategic planning process. As we move forward, I invite you to take part in the process, have your voice heard by joining me at an upcoming strategic planning townhall. We are offering in person and virtual events over the next two weeks in which I will share what we have learned so far and what will occur in the next phase of planning. Please note that participation is optional, space is limited, and RSVPs are required. Please RSVP for one of the townhall events listed below by TODAY Monday, June 5th. Additional dates and locations in the south bay and northwest regions will be announced soon.

• TUESDAY, JUNE 6 at Geffen Hall, Iris Cantor Auditorium
  11:15 am - 12 pm: Lunch available at Geffen Hall Revive Patio
  12 - 1 pm: Townhall with Dr. Abel
  
• WEDNESDAY, JUNE 7 at Luskin Conference Center, Centennial Ballroom
  5 - 6 pm: Social hour and refreshments
  6 - 7 pm: Townhall with Dr. Abel
  
• MONDAY, JUNE 12 - Virtual, via Zoom
  12 - 1 pm: Townhall with Dr. Abel

Dale

P.S.

I will use my PS this week for a public service announcement. I recently met with the curator for life sciences of the California Science Center.

I learned about their plans to completely reimagine their World of Life Gallery. She would love to put together a team of advisors with medical and science backgrounds. I believe that there are many such experts in our department. If you have an interest in contributing to this project, please email me at DOMChair_DaleAbel@mednet.ucla.edu.

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