Medipost - Autumn 2012

As we reflect upon the year that is coming to a close, we recognize the great strides that the Tel Aviv Sourasky Medical Center has made in patient care and research, outreach and education, across a large cross-section of medical disciplines. Clinical outcomes continue to reflect the world-respected caliber of the clinicians who have committed their careers to the Medical Center. Among our recent milestones, thanks to generous donors from throughout the world, was the transition of the Neurology Department to its new home in the Sammy Ofer Heart Building.

Tel Aviv Sourasky Medical Center researchers have achieved medical breakthroughs in neurosurgery, neurology, transplantation, dermatology, ophthalmology, pediatrics, endocrinology, and many other fields—for the benefit of patients in Israel and throughout the world.

Looking to the year ahead and the long term, we still have so much to achieve. The horrific terrorist attack on Israelis in Burgas, Bulgaria was a shocking reminder that Israelis are vulnerable both on home soil and abroad. The Middle East remains turbulent as the Egyptian border heats up and chaos rules as Syrian unrest risks Israeli security. Iran has ticked up its threats to destroy Israel, and a sense of insecurity pervades the atmosphere as Rosh Hashanah approaches. Preparedness for catastrophic attacks is mandatory for the Medical Center, as the nerve center for medicine in the heart of Tel Aviv. The Sammy Ofer Emergency Underground Hospital, the 750-bed facility that converts from a parking lot, needs continuous support to keep it at-the-ready.

As for the economic picture, the Medical Center has had a major setback treating the serious health problems of illegal migrants who have arrived from Africa in the tens of thousands over the past several years. Our unwavering humanitarian ethics commit us to care for all patients; however, we have received little to no funding from the Israeli government for this uninsured population, which suffers in high disproportionality from severe medical conditions, such as tuberculosis, AIDS, and measles, as well as pregnancy complications. Their care has become a serious economic burden and their conditions pose medical risks to the entire population (many are not inoculated and are carriers of dangerous diseases). In 2011 alone, this self-funded care amounted to over $7.5 million – funding that could have gone to patient care, research, program development, and construction initiatives. Prof. Barbash’s published his opinion on this grave problem recently in the Jerusalem Post.

We are facing serious issues, and now, together with the support and commitment of our friends and donors, we will continue to properly serve the people of Israel.

In the coming year, thanks to the generous donations and support we have received, we will continue our efforts to upgrade the Dana-Dwek Children’s Hospital—to make care more comfortable for kids and their families. The Dermatology Department and its clinics will soon be populating a new floor in the Sammy Ofer Heart Building

If we are successful in raising new funds, we will be able to upgrade the Rehabilitation Division of the TASMC (including general rehab for adults, youth, and soldiers, a physiotherapy unit and a therapeutic pool). The current facility is bursting at the seams and demand for treatment continues to grow. With a committed funding partner, we can pursue our groundbreaking efforts on the Neuroscience Institute, to give a home to the far-reaching initiatives of our physicians and scientists.
 
We wish you, our dear friends, a happy New Year, and hope that this will be a year of prosperity and medical milestones, peace and health!

Best wishes,

Ronit Blum
Director of the Friends of the TASMC

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All seven Bulgarian terrorist attack victims treated at the Medical Center have been discharged

While the emotional trauma will remain with them for time to come, all seven victims treated at the Tel Aviv Sourasky Medical Center following the terrorist attack in Bulgaria have recovered and returned home. Recall that in July of this year, a suicide bomber attacked Israeli tourists vacationing in the resort town of Burgas, Bulgaria, killing seven and injuring over 40.

Prof. Gabi Barbash led the emergency medical trauma team that was dispatched by the Israeli Ministry of Foreign Affairs to Bulgaria to treat the attack victims and bring them home to Israel. Prof. Barbash was joined by Prof. Pinchas Halpern, Director of the Department of Emergency Medicine; Dr. Dror Soffer, Director of the Trauma Unit; Dr. Alexander Zegerman, a senior physician in the Department of Anesthesiology and General ICU; and Dr. Assaf Nini from the Surgical ICU Unit. All are veteran trauma specialists. The mission provided essential first-response medical care, situational analysis, and medical flight of victims back to hospitals throughout Israel.

Vered Kuza, one of the victims who was lightly injured in the attack, was hospitalized at the Medical Center along with her daughter Amit, who was seriously wounded.

Read about Prof. Barbash’s experience as head of the trauma team in the Jerusalem Post.

Program updates

Adopt-a-Researcher program kicks off its third year
Entering its third year, the Adopt-a-Researcher program has enjoyed tremendous success, with donor adopters expressing tremendous satisfaction in both helping advance important research and learning about cutting-edge medicine, while establishing bonds with pioneering researchers. 

Neuroscience Institute event series held in Silicon Valley
The Tel Aviv Sourasky Medical Center Neuroscience Institute held its third event series in Silicon Valley, California, on May 20 and 21, 2012. The program kicked off with a lunch for local Israeli and Jewish community leaders at the home of Intel executive Dadi Perlmutter and his wife Haya.
The event continued with the Silicon Valley Jewish Film Festival, at which Professor Gabi Barbash, Director General of the Medical Center, presented a unique perspective on treating trauma incurred in Israeli urban settings, as well as trauma from war and terror. 
The first day concluded with a dinner program and wine tasting sponsored by local Jewish wineries. Addressing the group of over 80 local Israeli and Jewish community leaders were two honored speakers: Professor Barbash and Professor Shlomi Constantini, Director of the Department of Pediatric Neurosurgery. Several attendees shared their own personal stories of the outstanding support and care received at the Medical Center. The event series culminated with a lunch meeting with prominent business and community leaders, as well as Akiva Tor, the Consulate General of Israel in San Francisco.

Karin Weiner Lachmi, PhD, Director of Development for the US Western Region at the Tel Aviv Sourasky Medical Center, organized the event series. Dr. Weiner Lachmi raises funds and establishes business relationships to further the mission of the Neuroscience Institute. Weiner helps community leaders and donors from over 7000 miles away support the institute’s vision to elevate the quality of healthcare and research to an entirely new level—enabling an even stronger Israel, in yet another worldwide technology leadership position.
Dr. Weiner Lachmi expressed her deep gratitude to all who volunteered in support of this enlightening program and compelling mission, including: Yael Wilnai, Dana Huber, Eric Weiss, Chami Lerner, Longboard Vineyards, Cannonball Wine Company, and Neiman Cellars, and to Haya and Dadi Perlmutter and Yasmin and Oren Lukatz for their warm and generous hospitality. Dr. Weiner Lachmi can be reached at karinw@tlvmc.gov.il | +1-650-283-0391

Donation news

Mr. David Goldfarb, his wife Deborah and brother donate to the new cardiology unit in memory of their parents
The Goldfarb family chose to honor the memory of their parents, Yehuda and Paulina Goldfarb, Z”L, with a generous donation to help build the new Cardiac Hospitalization Unit in the Sammy Ofer Heart Building in memory of their parents who suffered from heart problems. The facility includes the inpatient unit, directed by Dr. Sammy Viskin, and the Cardiothoracic Surgery Department, directed by Professor Gideon Uretzky.

In a modest ceremony attended by family and friends, Goldfarb remarked that he and his wife decided many years earlier to make a donation in honor of his parents. Their acquaintance with Prof. Sammy Viskin (Goldfarb was his patient), Prof. Gabi Barbash and the Friends of TASMC was what ultimately brought them to make the donation to the institution. Says Goldfarb, “We made a ‘selfish’ decision to donate to a place that gives to others (health, of course!). Our donation will enable TASMC to offer others excellent medical care with improved hospitalization conditions, and we are grateful to have had the honor to be a part of that.”


Prof. Barbash thanked the Goldfarb family, expressing how moved he was by their true generosity of spirit.

The perfect birthday gift: a donation to benefit Dana-Dwek’s children!
Our beloved Maurice Dwek celebrated his birthday recently by asking that instead of material birthday gifts, his friends give donations to the children of the Dana-Dwek Children’s Hospital. Maurice’s friends were happy to oblige and donated generously in his honor to the pediatric hospital.
Brothers Maurice and Solo Dwek, cousins of Dana Renee Z”L, in memory of whom the Dana-Dwek Children’s Hospital is named, have been wonderfully generous donors who have helped us enormously in upgrading the pediatric hospital of the TASMC that bears their family name and which they have, in effect, adopted.

The brothers have recently offered to help renovate two hospitalization departments as well as the Pediatric Intensive Care Unit.
Unquestionably, thanks to the generosity of these two brothers, we have been able to revolutionize the care that children receive.

What’s new

New Pediatric Rheumatology Clinic Opens at TASMC
At the end of July, we were fortunate to have inaugurated a new Rheumatology Clinic for children and youth. The clinic, under the direction of Dr. Gil Amarilyo, treats a wide variety of rheumatological diseases in children, among them juvenile rheumatoid arthritis, persistent limping that is not attributable to orthopedic issues, juvenile fibromyalgia and autoimmune diseases, such as juvenile dermatomyositis (JDM) and more.
Rheumatism and arthritis do not only afflict adults. Rather, children and teens can also suffer from these diseases. Unfortunately though, many children are not diagnosed properly or are misdiagnosed. The last decade has seen a revolution in drug treatment for rheumatological diseases in children. Fortunately, the variety of treatments available today is wider in comparison to just a few years ago, and there are many new drugs in the pipeline that are awaiting regulatory approval. Today’s drug treatments are primarily based upon biologics that specifically target elements in the immune system responsible for disease outbreaks.
Although the clinic has only recently been opened, its director is not a new face at the Dana-Dwek Children’s Hospital; Dr. Gil Amarilyo rose through the hospital ranks, and in the summer of 2011, returned after a specialization stint at a UCLA-affiliated hospital in Los Angeles, California.

New outpatient radiosurgery unit inaugurated
Dr. Andrew Kanner, Director of the Stereotactic Radiosurgery Service, launched the Stereotactic Radiosurgery Outpatient Unit to complement the comprehensive radiosurgery approach, including a comfortable atmosphere and privacy that best serves the needs of patients and their families. The unit assembles the multi-disciplinary team of neurosurgeons, radiation oncologists, medical physicists and technicians who can focus on treating the diverse needs of a variety of patients.

Stereotactic radiosurgery, a non-invasive treatment technique for tumors (benign and malignant) that occur in the brain or spinal column, focuses radiation beams to target a defined tumor with surgical precision. The Tel Aviv Sourasky Medical Center is the leading center in Israel for stereotactic radiation treatments, serving as a national center for stereotactic radiosurgery and pioneering the treatment of spinal lesions in Israel.

TASMC among the four centers to set up a national human tissue bank
For the first time in Israel, the Ministry of Health has established a national bank for human tissue, to preserve tissue donated for research and development. TASMC is one of four hospitals in Israel selected by a government tender to take part in this national initiative.

In the first stage, the bank will preserve samples of cancerous growths donated by patients. The ultimate goal is match each patient with the ideal treatment, based on his or her individual profile, using, among other sources, their genetic profile. In order to accomplish this, individual genes and genetic mutations that are expressed in certain diseases must be identified. To this end, as many tissue samples as possible should be collected to enable comparison. The tissue bank will promote disease research progress and the development of more advanced and effective treatments.
According to Dr. Miki Roll, Director of Research & Development at TASMC: “We are pleased and proud to be a part of this national tissue bank initiative, to advance the efforts of our research team and to work in partnership with researchers at other academic institutions. We already maintain different cancer-growth databases approved under the Helsinki Accords, but expanding the infrastructure will facilitate wider interdisciplinary group research studies.”

New Operating Room Endovascular Hybrid Suite 

With the help of a generous donation from the Wolfson Family Charitable Trust and other donors, TASMC has opened an operating room endovascular hybrid suite. Professor Yehuda Wolf, Director of the Vascular Surgery Department highlights:
"The endovascular hybrid suite has opened up an array of new possibilities for novel and improved procedures, with an emphasis on minimizing invasiveness and improving control. Equipped with a state-of-the-art angiography imaging system and the latest in operating room gear, this hybrid suite provides the ideal environment for procedures requiring simultaneous use of open surgery and catheter-based vascular and cardiac interventions.

“Thus far, this facility has enabled the performance of abdominal and thoracic aortic stent grafts, treating several cases of aortic aneurysms involving major branches which would otherwise have required extensive open surgical procedures. In the new suite, we were able to perform these endovascular reconstructions with custom-made fenestrated aortic grafts and chimney procedures.

“In summary, the addition of the new endovascular hybrid suite has improved our ability to provide the most advanced minimally invasive procedures to vascular, cardiac and other patients with complex pathology involving the cardiovascular system."

Medical breakthroughs

Successful kidney transplant with ABO incompatibility
The Medical Center has celebrated another first: a kidney transplant between a donor and recipient with different blood types. The recipient had type O blood, while his wife, the donor, had type B blood. The patient was discharged from the hospital two weeks after the procedure with normal kidney function. Kidney transplantation with ABO incompatibility requires an extensive preparation process and post-transplant care to ensure that the recipient’s body does not reject the transplanted organ.

This groundbreaking method has the potential to significantly increase the number of transplants performed in Israel. According to estimations, about 30% of patients are unable to receive donations from family members due to incompatible blood types.

A first in Israel: A brain implant to reduce epileptic attacks
TASMC was the first in Israel to perform deep brain stimulation (DBS) implantation to combat epilepsy that does not respond to drugs. The procedure was performed by Prof. Itzchak Fried, director of the Functional Neurosurgery Unit. The treatment involves a two-step process: inserting a detector to pinpoint the source of the problem and placing a permanent implant, which regulates brain activity to prevent epileptic attacks. 

Professor Miri Neufeld, Director of Epilepsy Unit and the EEG Laboratory notes that “in Israel today there are 60,000 epilepsy patients, 30% of whom do not respond to existing drug therapies. This innovative therapy offers new hope and higher quality of life for epilepsy sufferers and their families.” Read more on this treatment in the Jerusalem Post.

Innovative therapy treats pediatric neuromuscular scoliosis
An innovative intervention for treating pediatric neuromuscular scoliosis, an irregular spinal curvature, has been introduced recently at the Dana-Dwek Children’s Hospital.

“The MAGEC system includes a one-time surgery to implant and fuse adjustable rods on either side of the spine,” says Dr. Dror Ovadia, director of the Department of Pediatric Orthopedics. For gradual correction while accommodating the natural physiological growth of the patient, the rods can be elongated using an external remote control. The device helps postpone or prevent further recurring invasive, risky surgical procedures.

Proven insights

Rare disease discovery illuminates the connection between skin and bones

Imagine you have been asked to build a large edifice, with hundreds of separate rooms dedicated to quite distinct activities. Clearly, the shape and arrangements of these rooms will differ, but the materials used to build most of them will be similar. Sharing materials is also at the core of the process through which most human tissues are generated and regenerated over the course of a lifetime. And, this is why the usage of any defective component in this process is likely to affect the composition of more than one single tissue, or, in other words, to lead to a disease manifesting various and apparently unrelated symptoms and signs. This is also why the study of such disorders is, of course, very likely to reveal intersecting biological pathways of importance for the normal function of a human body.
Prof. Eli Sprecher, Chair of the Department of Dermatology and Prof. Stavit Shalev, Director of the Institute of Human Genetics at Haemek Medical Center, applied this fact to help understand SOFT, a rare syndrome that features short stature, abnormal nails (onychodystrophy), peculiar facial traits and sparse hair (referred to as hypotrichosis). The results of their seven-year effort, with many other prominent contributors, were published in the prestigious “American Journal of Human Genetics” in July 2012. In brief, the findings indicate that the absence of the POC1A protein causes slow cell replication, and thus, arrested growth of bone, nails and hair.

Prof. Sprecher concludes: "We will now be able to provide affected families with proper genetic counseling, and we have now added a new and important piece to our understanding of the way skin and bone develop and interact during the formation of our body tissues." For a Jerusalem Post write-up on this fascinating discovery, link here.

International Research Team Discovers Gene Responsible for ALS
Prof. Vivian Drory of the TASMC’s Neurology Department took part in an international study that has uncovered an additional defective gene that causes amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease or motor neuron disease. Prof. Drory, along with a team of scientists from the University of Massachusetts in the U.S., discovered profilin 1, which causes ALS. The study results were published in the journal “Nature” and the story was featured in the Jerusalem Post.
The defective gene causes improper protein creation, which brings about intracellular skeletal damage, and then ultimately degeneration of the nerve tissue. These findings are important on three levels. First, for families that carry the gene, through genetic counseling, this discovery could prevent the gene and ultimately the disease from being carried over to the next generation. Second, ALS sufferers can already be tested for the presence of the gene (30% of ALS cases are hereditary) and obtain appropriate genetic counseling. Finally, over the long-term, this discovery should enable the creation of drug therapies that can more efficiently target the disease’s mechanisms.

Dermatology revisited: new disease entities revealed through genetic research

PRP, also known as pytiriasis rubra pilaris, is a severe skin disease, known to be occasionally hereditary, that is notoriously resistant to treatment. The potential genetic source triggered the interest of an international team of geneticists, led by Prof. Eli Sprecher of the Tel Aviv Sourasky Medical Center.

The molecular basis of the disease took 10 years to discover: CARD14, a gene that codes for a very important regulator of skin inflammation. As Prof. Sprecher points out, “This finding shifts the focus of inflammatory skin disease causes from the immune system to the skin. In addition, this is not the first time that genetics is redefining disease classification in dermatology, but this may be one of the first times that this is likely to have major therapeutic implications."

The results were published in the prestigious American Journal of Human Genetics in August 2012.

Finding improves whole body insulin sensitivity in diabetics
Sigal Fishman, MD, Senior Physician and Director of the Obesity Service in the Gastroenterology Department, in collaboration with Chen Varol, PhD, conducted medical research with a grant sponsored by the Israeli Science Foundation.

Research results strongly suggest that administration of GIP, a gastrointestinal hormone, improves insulin sensitivity in obesity through the regulation of immune cells in adipose (fat) tissue. This novel finding may pave the way for clinical use of another class of gastrointestinal hormone drugs, namely GIP-analogs, for obesity and type 2 diabetes. 

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Stay in touch!

Our email address has changed to: friends@tlvmc.gov.il

Friends of Tel Aviv Sourasky Medical Center: +972-3-697-4238