Groups

Member not yet following any Groups.

Posts (18)

Mon, Apr 13 2:52pm · UCLA Health Pursues Creative Solutions to Conserve Personal Protective Equipment

Coronavirus cases in California are projected to peak in April or May. At UCLA Health, a troubleshooting team of physicians, nurses, scientists and staff organized in January to begin planning for the anticipated rise in COVID-19 patients.

A chief concern was how to ramp up enough personal protective equipment, or PPE — the masks, gowns and goggles that hospital workers wear every day — to shield patients and themselves from infection. A hospital the size of Ronald Reagan UCLA Medical Center, for example, uses thousands of masks daily. A national PPE shortage only complicates the challenge.

The health system has doggedly pursued a myriad of creative solutions to stretch its PPE supplies and keep its patients and staff safe for the duration of the pandemic.

Respirator mask decontamination

UCLA Health has installed two new ultraviolet-light machines in Ronald Reagan UCLA Medical Center and UCLA Medical Center, Santa Monica. The machines emit UV radiation to sterilize used N95 respirator masks several times, ensuring a renewable supply to the emergency rooms, intensive care and other units. An earlier model of the machine, previously used to decontaminate wheelchairs, has been adapted for mask-sterilization duty.

“Ultraviolet germicidal irradiation is a validated process to kill viruses,” said Dr. Daniel Uslan, co-chief infection prevention officer for UCLA Health. “So far, we have disinfected more than 800 masks for reuse. UCLA is one of the first health systems in the nation to use UV light for mask sterilization.” 

Help from Hollywood

The International Alliance of Theatrical Stage Employees has mobilized an army of costume and wardrobe workers to fashion face masks from medical-grade fabric. The IATSE local 44 has also donated N95 respirator masks from the sets of furloughed film and television shows and offered to produce face shields in bulk, if needed.

“IATSE has been functioning as a true partner to UCLA Health during our crisis response efforts,” Becky Mancuso-Winding, executive director of strategic community and business relations at UCLA Health, commented in a recent Los Angeles Times article. “They are producing face masks from recycled fabric normally used to wrap surgical instruments for sterilization. The two-ply material is ideal as it allows air and heat to penetrate but keeps water and microbes out.”

Laser-cut face shields

Nearly 100 volunteers, including students and alumni from the David Geffen School of Medicine at UCLA, have invested long hours over four shifts to assemble single-use face shields from plastic parts that faculty and staff cut by lasers at the Henry Samueli School of Engineering and Lux Labs at the UCLA Library. So far, 6,750 of the shields have been delivered for distribution to staff at Ronald Reagan UCLA Medical Center. The group hopes to transition to a reusable model of the face shield in the future.

“Our medical students have been phenomenal,” praised Dr. Robert Cherry, chief medical and quality officer for UCLA Health. “They’ve assembled thousands of masks. This has helped us flatten the curve for our use of supplies to manage the expected surge in patients.”

Mon, Mar 30 9:07am · Lost Your Sense of Smell? Five Things You Should Know

As if the fever, dry cough and shortness of breath associated with COVID-19 weren’t enough, some patients are grappling with the loss of their senses of smell and taste as well.  UCLA Health consulted with Dr. Nina Shapiro to explain what causes these unusual symptoms. Dr. Shapiro is a professor of head and neck surgery at the David Geffen School of Medicine at UCLA.

Q. How common is it for someone to lose their sense of smell?

A. The general rate of anosmia, or smell blindness, in the healthy population is quite rare. As we age, loss of smell grows more common, affecting up to 20 percent of seniors. This tends to be a gradual process and may be accompanied by the slow blunting or alteration of one’s sense of taste, called dysgeusia.

Q. How many cases of sensory loss tied to COVID-19 have been reported?

A.
In Korea and Germany, the rate is quite high. About 30-to-60 percent of COVID-19
patients have reported abrupt symptoms related to the loss of smell.

Q. What causes sensory loss in patients with COVID-19?

A.
The sensory loss likely resembles changes we see in other respiratory viruses.
Inflammation of the nose’s mucus membranes can lead to obstruction of hair-like
cells in the airway that carry odors to the olfactory nerve, which controls
smell. Rarely, viruses like influenza affect the olfactory nerve. This may hold
true for COVID-19, though it’s too early to tell.

Q. Should I alert my doctor if I experience sensory loss?

A.
With so many overseas patients experiencing sensory loss as an early sign of
COVID-19, it is critical that you report these symptoms to your primary care doctor.
It may prompt your physician to pursue earlier testing or other measures.

Q. If I lose my sense of smell, do I need to isolate myself?

First of all, don’t panic. We’re at the tail end of cold/flu season and about to enter spring allergy season. If you have other COVID-19 symptoms in addition to a sudden loss of smell or taste, contact your doctor or public health department and self-quarantine until otherwise notified. To protect yourself and others from exposure, please do not go to your doctor’s office, urgent care or emergency room without a referral from your physician or public health department.

Mon, Mar 23 6:28pm · UCLA Patients Need Blood Donations

To prevent the spread of COVID-19, Los Angeles County just issued a “Safer at Home” order.

But UCLA Health hospitals in Westwood and Santa Monica are facing a critical shortage of donated blood, which many patients depend on to survive. Can people still leave their homes to donate blood?

The answer is a resounding yes, according to Dr. Dawn Ward, medical director for the UCLA Blood & Platelet Center.

“Blood donation is considered an essential service that is exempt from the Safer at Home directive,” explained Ward. “Cancer patients, trauma patients, mothers delivering babies, babies born in critical condition, and patients undergoing surgeries still frequently require blood transfusions.

“When blood is not available, the risk to our patients can make the difference between life and death,” she added.

What about donors? Is it safe for them to come to the donation center?

“Absolutely,” assured Ward. “We are following every precaution recommended by the American Association of Blood Banks to keep our staff and donors safe.” In fact, the U.S. Surgeon General Jerome Adams posted a tweet emphasizing the continuous need for blood and urging healthy people to donate. First, schedule your donation online. This will enable the blood center to stagger appointments and ensure six feet of space between all donors and staff in the lobby and collection room.

“We are prescreening all donors for fever, encouraging everyone to follow strict hand hygiene, and increasing cleaning within our facilities — including cleaning the donor bed and other surfaces between every donation,” said Ward. Additional eligibility and safety measures can be found on the UCLA Blood & Platelet Center’s website.

“While these are uncertain times, our doctors and nurses will always need blood to treat our patients,” emphasized Ward. “Please join us in saving lives.”

Fri, Mar 20 3:46pm · Can Ibuprofen Worsen COVID-19? An Expert Offers the Truth.

French health authorities recently rocked the world by announcing that anti-inflammatory drugs like ibuprofen could exacerbate COVID-19, the infection caused by coronavirus. The proclamation made headlines in prominent news outlets and social media alike. Even the World Health Organization first supported the claim and then flip-flopped 24 hours later.

Which is true?

Dr. Otto Yang, a world-renowned infectious disease expert at UCLA Health, helps us sort fact from fiction.

Q. Can ibuprofen aggravate symptoms for COVID-19 or any infectious illness?

A. There is no scientific evidence that ibuprofen causes worsening of COVID-19.

Q. So why have French health authorities claimed that anti-inflammatory drugs increase the risk of complications during fever or infection?

A. This is mostly theoretical. The thinking is that inflammation, which contributes to symptoms like fever and muscle aches, is part of the body’s immune response against infection — and if you reduce inflammation, you might reduce your immune response, too. Whether this is a significant effect or not in patients is debated.

Doctors’ observations in small numbers of patients suggest that ibuprofen could slow recovery from bacterial pneumonia — or increase the severity of some viral infections like chickenpox — but these aren’t careful prospective scientific studies.

Consider this counterargument: Patients experiencing worse symptoms are more likely to take ibuprofen; so their worse conditions have nothing to do with the ibuprofen itself. Other studies have argued that ibuprofen can actually help combat lung infections by reducing inflammation, which may damage the lung.

Q. How does this theory apply to COVID-19?

A. Some laboratory experiments in cells show that ibuprofen may increase the amount of a receptor used by the coronavirus to infect cells, and this could make the virus spread faster. Again, this has not been supported by clinical evidence in patients.

Whether this type of experimental finding translates to impact in the clinic is usually unclear. For example, it may be true that ibuprofen increases cells’ receptor level, but that may prove meaningless in people if the increase is small, or there is already so much receptor that adding more doesn’t matter.

Q. If someone is diagnosed with COVID-19, what should they know about choosing a pain medicine?

It depends on the individual. A person can certainly take acetaminophen, but the case against ibuprofen is entirely theoretical and not backed by evidence. So if someone has chronic liver disease or another reason to avoid acetaminophen, it is still reasonable to take ibuprofen or a similar medication. Check with your doctor if you have questions.

Jul 25, 2018 · Maine basketball coach with rare hearing disorder crosses country for specialized surgery at UCLA

Out of the blue, Richard Barron, 49, woke up deaf in one ear.

The University of Maine women’s basketball coach was ultra-sensitive to noise–the sound of someone loading the dishwasher was excruciating.

Even stranger, Richard began hearing his bones creak and his eyelids move. Far worse was the noise-related brain fog that descended on him inside the raucous basketball gym. He’d call a timeout during a game—only to hear the ref blow a whistle or the band strike up a tune–and forget why he called the timeout.

Forced to take a medical leave from work, Richard retreated to bed, and his wife and three children took turns tip-toeing upstairs to share their day in whispers.

Over five months, Richard visited three prestigious medical centers and saw 15 doctors. No one could provide a diagnosis.

Finally, a CT scan of his skull revealed a tiny opening in his ear bone and an audiologist diagnosed him with superior semicircular canal dehiscence (SSCD).

Researching online, Richard found a webinar by a UCLA Health neurosurgeon, Dr. Isaac Yang, who offered to review his records electronically and confirmed the SSCD diagnosis.

Drawn to the minimally invasive approach that Yang pioneered with UCLA ear surgeon Dr. Quinton Gopen, Richard flew across the country for surgery at Ronald Reagan UCLA Medical Center.

In the operating room, Yang made a small incision in Richard’s skull behind his ear and gently pushed his brain out of the way, allowing Gopen to plug the miniscule hole in the ear bone.

When Richard awoke, he was ecstatic to realize that the bizarre noises in his head had vanished and his hearing had returned. That night, his wife and he celebrated over dinner in a Los Angeles restaurant.

Gopen and Yang say Richard’s frustrating journey toward diagnosis isn’t unusual. Superior canal dehiscence wasn’t identified until 1998 – a recent enough discovery only now being added to medical school textbooks. As a result, most physicians are unfamiliar with the rare syndrome, which affects an estimated 1% of the population.

Learn more about Semicircular Canal Dehiscence at UCLA Neurosurgery.

 

Jul 5, 2018 · UCLA doctor diagnoses teen's complex disorder, restoring her vision, ability to enjoy life

Rhianna Wilson spent her senior year of high school in and out of four San Diego hospitals, seeking relief for her vision loss, pain and debilitating headaches.

At age 18, she was diagnosed with Ehler-Danlos Syndrome (EDS), a rare genetic disorder marked by overly stretchy connective tissue. In Wilson’s case, the disorder revealed itself in double-jointedness that led to four dislocations of her shoulders.

An MRI also showed a small slippage of the brain, an abnormality called a Chiari malformation, Her doctors considered it too minor to be the source of her worsening vision loss, pain and headaches.

“I couldn’t see and couldn’t drive,” said Wilson, 20. “I lost the use of my legs. But because doctors couldn’t see my pain, to them it didn’t exist.”

Her physicians in San Diego where she was being treated encouraged Wilson’s parents to consider a seeing-eye dog and to enroll her in a school for the blind.

Refusing to give up, her mother scoured the internet for a possible link between EDS and Chiari. Her research led the family to pediatric neurosurgeon Dr. Aria Fallah at UCLA Mattel Children’s Hospital.

“Rhianna was absolutely debilitated by these problems,” said Fallah. “She had gone from doctor to doctor and hospital to hospital with essentially normal-looking MRIs. So they’d been quite dismissive of her symptoms.”

Fallah referred Wilson for an unconventional stand-up MRI: the scan revealed a diagnosis that previous doctors had missed. A large Chiari malformation—not visible on a traditional reclining scan– was compressing Rhianna’s brainstem and spinal cord, causing her excruciating pain and lost function.

Fallah removed Wilson’s top vertebra and the back bone of her skull, creating more space for her brain and relieving her symptoms.

When Wilson opened her eyes after surgery, she could see again.

In less than three weeks, she was living like a typical teenager: driving, working, hiking and enjoying the active social life she’d missed during her senior year.

“UCLA has experts in these rare conditions, which gives us a unique advantage in treating the most complex of disorders and really making a difference,” said Fallah.

Now 20, Wilson is reclaiming her life and making up for lost time. For more details, read The New York Times Magazine “Diagnosis” column on her case.

Jun 5, 2018 · Early detection of rare eye cancer is important

Ocular melanoma is a rare form of eye cancer. Each year, only 2,500 people –or five in 1 million– are diagnosed. So why, as the news media reports, are a baffling number of newly diagnosed ocular melanoma cases cropping up in the southern United States?

To shed light on the issue, we consulted Dr. Tara McCannel, director of the ophthalmic oncology center at UCLA’s Stein Eye Institute and Doheny Eye Institute, and one of the nation’s leading experts in ocular melanoma.

Q. What is ocular melanoma?

A. McCannel: Ocular melanoma is a tumor that arises in the pigmented cells under the retina of the eye. We don’t know exactly what causes it. When detected early, the cancer is treatable and a person’s prognosis for vision and survival remains good. When the tumor is large or detected at an advanced stage, patients face a higher risk of metastasis and losing their eye. If the cancer spreads to the liver or lungs, the five-year survival rate drops to 15 percent.

Q. What could explain the rise of new cases in Alabama and North Carolina?

A. McCannel:  Many of the newly diagnosed patients have lived at some point in the same geographic regions.  Also, most of these patients are far younger than 55–the average age of diagnosis for ocular melanoma. These factors suggest that the patients may be remotely related and have inherited a genetic mutation that predisposes them to the disease.

Here’s why: scientists have identified a gene mutation on chromosome 3 of the ocular melanoma cell.  Normally, this gene suppresses tumor growth. In rare cases, some patients may inherit this mutated gene and be predisposed to ocular melanoma and other cancers. Doctors must inform their patients that genetic testing is available and alert patients and their families to their cancer risk.

Q.  How is ocular melanoma treated?

A. McCannel: Radiation is the best way to treat eye cancer. At UCLA, we stitch a gold plaque to the outside of the eye, and remove the plaque seven days later. The plaque contains tiny radioactive seeds that kill the cancer cells. During this time, patients must keep family members at a distance and avoid crowds. Once the plaque is removed, the patient is considered radiation-free and may return to normal activities.

The downside to radiation is that it can injure the optic nerve and retina, potentially leading to future blindness. My lab has pioneered a method to shield the eye during radiation and protect patients’ vision.

Q.  How does your research influence how you treat your patients?

A. McCannel: At UCLA, we treat ocular melanoma in an entirely novel way, by including vision-saving strategies in our approach to destroying the cancer. In 2012, we discovered that placing silicone oil in the eye during treatment reduces the amount of radiation that reaches the retina. Our research found that patients treated this way enjoy better vision, healthier eye tissue and fewer side effects after radiation therapy compared to patients we treated without silicone oil.

Q. What should patients know about their options for treatment?

A. McCannel: Seek care from a leading academic medical center. Surgeons who treat melanoma at these centers must undergo special training to treat ocular melanoma and use the most advanced technology and clinical approaches.

Equally important, choose a physician whose practice is primarily devoted to ocular melanoma– both treating the primary tumor and addressing the potential vision loss. A university teaching hospital is best equipped to bring together a team of cancer experts and to participate in clinical trials that translate the latest findings into new therapies.

Dec 20, 2017 · A cup of hot tea a day could keep glaucoma away

Sipping a mug of piping hot tea on a cold day doesn’t just warm you up—it may also protect your vision.

That’s the good news from a new UCLA study, which found a daily cup of hot tea may reduce your risk by up to 74 percent of developing glaucoma, one of the leading causes of blindness worldwide.

Darjeeling not your cup of tea? Too bad. Drinking decaffeinated tea, regular or decaf coffee, iced tea and sodas appeared to make no difference to glaucoma risk. The British Journal of Ophthalmology published the findings.

Glaucoma develops when fluid build-up increases pressure inside the eye. Without treatment, the rise in pressure damages the optic nerve and eventually leads to permanent blindness. Already affecting 57.5 million people worldwide, the number of people with the disease is predicted to reach 65.5 million by 2020.

“Earlier research suggests that caffeine can influence pressure inside the eye. Our study, however, is the first to look at the impact of decaffeinated and caffeinated drinks on glaucoma risk,” said lead author Dr. Anne Coleman, the Fran and Ray Stark Professor of Ophthalmology at UCLA’s Stein Eye Institute and David Geffen School of Medicine.

Coleman and colleagues examined 2005-2006 survey data collected by the U.S. Centers for Disease Control and Prevention. Tests detected glaucoma in 5 percent of the 1,678 people who underwent eye exams as part of the survey.

Survey participants answered questions about how often they drank caffeinated and decaffeinated beverages and in what amounts over the past 12 months.

People who enjoyed a daily cuppa hot tea were less likely to have glaucoma than those who were tea-teetotalers, the data found, even after controlling for variables like smoking, diabetes, age, body mass index, ethnicity and gender.

Latte lovers were out of luck. No similar risk reduction was found in people who regularly consumed regular or decaf coffee, decaffeinated tea, iced tea or sodas.

Flickr/Luxbao

A few caveats before you throw a tea party:

  • The study observed a correlation only; researchers did not draw firm conclusions about cause and effect.
  • A limited number of participants had glaucoma, and the timing of their diagnosis was unknown.
  • The survey did not record details like cup size, tea type or brewing time, all of which may have influenced the findings.
  • Drinking hot caffeinated tea may be associated with other lifestyle factors that underlie the reduced risk.

“We know that tea contains antioxidants and chemicals that help fight inflammation while protecting the brain,” said Coleman, who is also a professor of epidemiology at the UCLA Fielding School of Public Health. “Previous studies suggest oxidation and neurodegeneration may pave the way for glaucoma to develop.”

Antioxidants and inflammation-fighting chemicals are also associated with a lower risk for serious health conditions like heart disease, cancer and diabetes.

“Our next step will be to determine whether drinking hot tea could play a role in preventing glaucoma and uncover the mechanisms that protect the eyes from increased pressure,” Coleman said.

For persons with a family history of glaucoma, however, there’s no harm in playing it safe. Treat yourself to a plate of crumpets, follow Captain Picard’s example and order “Tea, Earl Grey, hot.”