Spring is in the air, Pesach arrives once more. It is the holiday of freedom, but peace and quiet still eludes us:
The tragic event in Toulouse, France, have shown us that anti-semitism is alive in the world. We have seen that only those with no shred of humanity can commit such horrific murder of innocent children.
The Iranian threat continues to plague us, and the subject dominates the national discourse as well as the international stage. There are numerous warnings of terrorist attacks at the hand of Iran, both in Israel and abroad. Some of them have succeeded: Tal Koren Yehoshua, an envoy of the Ministry of Defense stationed in the Israeli embassy of India, was seriously injured in a car bomb attack in New Delhi. Tali miraculously survived the attack after an incendiary device attached to her car exploded while she was driving to pick up her kids. Tali was flown to Israel to the TASMC where she was treated. She is currently undergoing therapy and rehab in our own renewed Rehabilitation Department recently opened.
Recently, the TASMC has run several emergency drills in order to ensure we are ready for any disasters, natural or otherwise, that may arise. Now more than ever, we must be vigilant and prepared for what might be ahead. (see article below).
The worldwide recession is, however, making itself felt here as well. We are feeling it in our revenues as well as in our donations; some of our donors are cutting back. So it is with even greater appreciation and gratitude that we extend our thanks to those who, despite what is going on in the world, continue to stand by our side. To those who understand the importance of our work and of helping the hospital achieve its goals, and who continue to give generously- we thank from the bottom of our and ours and our patients' hearts.
Our principal efforts these days are focused on improving hospitalization conditions; in supporting and expanding our ‘Adopt-A-Researcher’ program; in the establishment of the Neuroscience Institute; in renewing and upgrading the Dana Dwek Children’s Hospital; as well as in obtaining the necessary medical equipment, such as new Linear Accelerators, for our Radiotherapy Institute.
I want to wish you and your families a happy, healthy and peaceful Passover holiday.
Sincerely yours,
Ronit Blum
Director Association of Friends of the TASMC
Tel Aviv and the TASMC Are Ready For An Emergency
Here is the link to an article that appeared in the Washington Post on March 1, 2012. The article described the preparations involved in preparing this metropolis for any emergency situation. Tel Aviv and the TASMC’s readiness is very much predicated upon the Sammy Ofer Underground Emergency Hospital at the TASMC. The Sammy Ofer Underground Emergency Hospital is featured here. Read More.
And here’s a link from CNN the 24th of February about the TASMC’s preparednes. Watch Video.
We hope you will find these articles interesting- and we hope that we will never be called upon to use our preparedness!
Donations
The Dwek Families Continue to Help Us Develop and Expand the Dana Dwek Children’s Hospital
Recently, the Dwek brothers Maurice and Solo approved another generous donation earmarked for the development and upgrade of the Dana Dwek Children’s Hospital. The funds will go towards the renovation and upgrade of the two pediatric inpatient wards as well as the Pediatric Intensive Care Unit. We are so grateful for this donation and we thank the Dwek brothers and their families with all of our hearts!
Direct Donating Over The Internet
A year has passed since we opened a new website for the TASMC and its fundraising arm, Friends of the TASMC. The website offers donors the possibility of donating directly to the hospital with a credit card. We have already managed to raise NIS100,000 (about $30,000), mainly through our website. These donations are generally from new donors who are only now discovering the TASMC and its important work. The important heart touching donations are adding up, in particular from those that have made standing monthly orders, as well as overseas donors- Jewish and Christian alike. We are hopeful that this website will be a tool to strengthen our circle of friends and supporters.
Silicon Valley Raises Funds For the TASMC’s Neuroscience Institute
On the West Coast, Dr. Karin Weiner Lachmi is continuing her efforts, with perseverance and dedication, to obtain resources for the establishment of the Neuroscience Institute.
The Neuroscience Institute at the Tel Aviv Sourasky Medical Center held its second series of events and programs in Northern California. The program kicked off on December 3rd with a dinner and presentation for over seventy local Israeli and Jewish community leaders. Addressing the group were two speakers, Professor Gabi Barbash MD, Director General of the Tel Aviv Sourasky Medical Center and Professor Talma Hendler.
The evening was followed up with a series of meetings with business and community leaders including the President and CEO of Stanford Hospital and Clinics, Dan Amir Rubin, and the Consulate General of Israel in San Francisco, Akiva Tor. Prof. Barbash was also honored as a special guest at the annual AIPAC event at the Fairmont Hotel in San Jose. He was also interviewed by the J Weekly Journal for a recently published article.
During his visit, Professor Barbash discussed the state of health care systems in Israel and the U.S. today, and how recent protests by Israeli doctors has impact innovation in medicine.
Professor Hendler demonstrated how an extraordinary combination of basic research and clinical neuroscience have advanced methods of brain mapping. She shared how brain mechanisms regulate emotions and how these processes are modulated by our life-experiences and culture.
Dr. Karin Weiner Lachmi, PhD, Director of Development at the Tel Aviv Sourasky Medical Center, organized the week-long program and is responsible for fundraising and business relationships for the Institute.
The Neuroscience Institute of the Tel Aviv Sourasky Medical Center is dedicated to building the world’s most innovative institute for clinical care, research and education on the human brain. The Institute addresses a wide range of neurological disorders including cerebrovascular and neuro-muscular diseases, Parkinson’s, Alzheimer's, brain tumors, epilepsy, depression, multiple sclerosis, the effect of aging on the brain and neurologic function. Our vision is to acquire an entirely new understanding about brain abnormalities and dramatically accelerate the pace of improvements in the diagnosis and treatment of neurological and psychiatric disorders.
For more information, contact: friends@tlvmc.gov.il / tel: 972-3-6974275 or Dr. Karin Weiner Lachmi: karinwe@tasmc.health.gov.il / tel: 650-283-0391
Thanks to all who volunteered in support of this successful program, including Yael Wilnai, Dana Huber and Chami Lerner. We also thank Hillary and Ilan Frank for their warm hospitality.
What’s New in the Medical Center
The Interventional Cardiology Unit, directed by Prof. Shmuel Banai, and the Cardiac Catheterization Unit, directed by Dr. Ariel Finkelstein, have moved to their new home on the second floor of the Sammy Ofer Heart Building.
New Services
For the first time ever anywhere in the world, the TASMC has implanted a pediatric valve in an elderly woman!
A prosthetic valve originally designed for pulmonary artery implantation in children by cardiac catheterization, was recently implanted in an elderly, 80-year old female patient at the Tel Aviv Sourasky Medical Center. The implantation was carried out using a minimally invasive surgical approach via the apex of the heart, by a team of specialists headed by Dr. Yanai Ben-Gal – Director of the Minimally Invasive Cardiac Surgery Service, together with Dr. Ariel Finkelstein – Director of the Catheterization Service, Dr. Amir Kramer, and Dr. Elhanan Bruckheimer, Director of Catheterization at the Schneider Children's Hospital.
This unique implantation was carried out due to the complicated medical condition of the patient, who in the past underwent cardiac surgery for replacement of the aortic valve and coronary artery bypass. The patient recently suffered a severe deterioration in her condition due to the destruction of the previously implanted valve. Because of her general status, the extremely high surgical risk and the size of the previous valve, it was not possible to perform conventional cardiac surgery.
Dr. Ben-Gal pointed out: "The implanted valve is used, as mentioned above, for implantation in children via catheterization and for treatment of problems of the pulmonary artery. This was the only valve suitable for implantation within the valve that already existed in the patient's heart. The difficulty was searching for technical solutions in order to enable us to implant the valve in a minimally invasive approach, as opposed to its natural purpose.”
Dr. Ben-Gal, who formerly practiced cardiac surgery at the New York Columbia Presbyterian Hospital, stressed that "immediately after the implantation, the patient's valve and cardiac function improved dramatically, and, after being ventilated for a month in critical condition, she is now breathing independently, walking in the ward, and will be discharged for a short rehabilitation period. Despite the risk involved in this special operation, we had no other alternative, since, without action, the patient's condition would have continued to deteriorate. This operation presents a precedent for treating these complex patients, until a specialized valve designed for this purpose will be developed".
To date, there are no official publications describing implantation of this pediatric valve in such a small prosthetic aortic valve. This operation characterizes the emphasis placed at the Tel Aviv Medical Center on intensifying advances in the field of minimally invasive cardiac surgery.
The Neovasc Stent – A New Innovation by TASMC's Director of Interventional Cardiology
Prof. Shmual Banai, Director of the Interventional Cardiology Unit at the TASMC, headed a team of researchers that recently developed a unique stent that is implanted in the vein of the heart through a simple catheterization procedure. The procedure improves the blood's circulation to the heart. The stent has just recently won approval to be marketed from European Union regulators.
The Neovasc Reducer is a novel implantable product designed to treat heart disease patients who suffer from refractory angina. Refractory angina is a painful and debilitating condition that occurs when the coronary arteries deliver an inadequate supply of blood to the heart muscle. It currently affects over two million patients worldwide, who typically lead severely restricted lives. The incidence of refractory angina is growing, and current treatment options are limited.
The Neovasc Reducer is a unique device that is implanted in the coronary sinus (vein of the heart) using minimally invasive techniques. It is intended to provide relief of refractory angina symptoms by modulating blood flow in the coronary sinus and thereby increasing perfusion of oxygenated blood to areas of the heart muscle, where it is needed most. Placement of the Reducer is performed using a minimally invasive percutaneous procedure that is similar to implanting a coronary stent, and takes approximately 20 minutes.
The new device originated in Israel and has been developed by a group of researchers led by Prof Shmuel Banai, the medical director of the project and the Director of the Interventional Cardiology Unit at the Tel Aviv Sourasky Medical Center.
Up until today, about 80 patients have been treated worldwide with the Reducer. Five patients were treated in Israel at the TASMC.
Patients with severely disabling symptoms of angina pectoris report dramatic improvement in their ability to perform physical activity as well as dramatic relief of their angina within 1-2 months following implantation of the Reducer.
Recently the Neovasc Reducer was recognized by the European Health Authorities (CE mark) for the treatment of patients with refractory angina pectoris. Also the Israeli Ministry of Health approved the use of the Reducer in Israel.
A New Non-Invasive Respiratory Procedure for Premature Infants is performed by Professor Dror Mendel
A new method of respiratoy support to premature infants has been performed at the TASMC. The procedure obviates the need for mechanical ventilation (including oral insertion of endotracheal tube)and is termed: NIPPV – Non-Invasive Positive Pressure Ventilation. The procedure was recently introduced and implemented by the Neonatal Intensive Care Unit of the Lis Maternity Hospital, headed by Prof. Dror Mandel. This system helps to preventchronic lung disease of prematurity (termed Bronchopulmonary dysplasia = BPD), an ailment characterized by inter-cell edema between the cells and alveoli cells prone to chronic inflammation and fibrosis. As stated, infants suffering from BPD present a higher rate of lung motbidities , and this is expressed in the need for longer respiratory support, need for and medications, and requiring repeated and more prolonged hospitalization. While numerous reasons for BPD exist, intubation and tubal administration of respiration under positive pressure constitute the highest forerunners for developing the disease.
Changes in pulmonary tissue cannot be controlled, but changes in respiratory techniques can help to reduce the damage to the developing lungs. One of these techniques is the introduction of fine tubes into the nostrils, enabling the premature infant to breathe spontaneously through them under positive pressure. This thechnique, the NIPPV, was developed in order to reduce the adverse effects associated with ventilation via an endotracheal tube.
According to Prof. Dror Mandel, director of the Neonatal IntensiveCare Unit at the Lis Maternity Hospital, "the mechanical ventilation of premature infants, albeit a life-saving procedure, is not without its dangers and complications. In addition to the medical risks entailed, the cost of ventilating premature infants is high. Since the premature infant's developing lung is a highly delicate element, we need to take into consideration its exposure to respiratory damage caused by a need for high pressure and by the length of time required for administering such aspiration."
"This method requires a lengthy follow-up by a medical and nursing-care team, but most important of all: clinical studies show that this method reduces damage to the developing lungs of these infants, decreasing the frequency of chronic lung disease of p[rematurity, and improving the pulmonary and overall prognosis of the infant," Prof. Mandel explains.
The TASMC opens a new center for Women's Health
We are happy to announce the upcoming opening of the Center for Women's Health at the Lis Maternity Hospital. The new Center will house multidisciplinary clinics in Gynecology, Obstetrics and Infertility and will be directed by Dr. Ishai Levin, a senior specialist in Obstetrics and Gynecology.
We wanted to establish a center for women's health issues that will be able to answer women's needs throughout the different cycles of life, from the beginning of adulthood through the reproductive age and later years.
Nineteen clinics in different fields of Obstetrics Gynecology and Infertility will be housed together under the same roof of this new center for women's health.
Upon establishing this new center, we had in mind three main objectives:
We will strive to see and treat patients in a holistic, all inclusive "one-stop-shop" manner, so as to limit the burden of successive visits.
All patients will be treated by attending physicians (specialists in Ob/Gyn) in their respective fields of specialization.
We will help improve the patient experience both before and after hospitalization, by helping them find their 'way' between the different departments and emergency units of our hospital.
Clinical Trials
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Professor Yitzchak Fried’s study on memory enhancement through deep brain stimulation was published in the prestigious New England Journal of Medicine on February 9th, 2012. Read More.
- Professor Eli Sprecher has uncovered the gene that causes the tendency to Pemphigus vulgaris, a debilitating skin disease that is highly common amongst Jews.
Deeper than skin: A gene conferring risk for a devastating skin disease in Jewish populations
Pemphigus vulgaris is among the most severe diseases of the skin. It usually manifests with widespread blistering of the skin and mucosal tissues, and is often fatal if left untreated. The disease results from the inappropriate production of antibodies directed against skin elements responsible for maintaining cell-cell cohesion.
Despite the fact that pemphigus most often affects adults, it seems that it is to a large extent genetically determined. Indeed, the disease sometimes runs in families. Also, the deleterious antibodies can be found in healthy relatives of patients. And finally, the disease’s prevalence is highly population-dependent. For example, it is up to 40 times more common in Jewish vs. non-Jewish populations.
An international multicenter study, coordinated by Prof. Eli Sprecher, chair of the Department of Dermatology at the Tel Aviv Medical center, and Prof. Ibrahim Saleh, from the University of Luebeck, led to the identification of genetic variations in a gene called ST18, which significantly determines the propensity of patients of Jewish and Egyptian origin to develop the disease. The TASMC’s Dr. Ofer Sarig, who led the study group, comments: "Although rare globally, pemphigus vulgaris is relatively common among Jewish populations, which enabled us to assemble the largest cohort of pemphigus patients to date. This in turn, combined with the fact that Jewish people share a lot of their genetic material together, allowed us to identify quite easily genetic variations which confer a more than 6-fold increased risk to develop the disease".
These genetic variations are associated within the skin with an increase in the expression of ST18. Since ST18 is known to promote programmed cell death, increased expression of this protein is expected to render the skin tissues more susceptible to the deleterious effects of the pathogenic antibodies. Thus, by shedding new light on the genetic foundations of pemphigus vulgaris, this new data may pave the way for novel targeted therapies for this dreadful disease.
The research was published at Journal of Investigative Dermatology advance online publication on 2 March 2012.
- Dr. Nicola J. Mabjeesh- advances in prostate cancer treatment Less Oxygen, Fuel for Cancer : Deplete the Fuel
Prostate cancer is the most common non-skin cancer in men in the United States and the Western world, and is second only to lung cancer as a cause of cancer deaths in men. Over 80% of patients with advanced prostate cancer are affected by bone metastasis, an incurable progression of the disease that accounts for a vast majority of disease-related mortality and is associated with significant morbidity.
Initial treatment of metastatic disease relies on the use of hormonal agents. Because these systemic therapies offer only a palliative, temporary benefit and are frequently associated with toxicities that can impair quality of life, more effective and less toxic systemic therapies are clearly needed.
Dr. Nicola J. Mabjeesh, the Deputy Chairman of the Urology Department and the Director of the Prostate Cancer Research Laboratory at the TASMC and his team study prostate cancer characteristics under low oxygen levels (hypoxia). There are very sophisticated mechanisms that allow the normal (noncancerous) cells to survive conditions of hypoxia. The regulation of this survival mechanism is mainly mediated by two factors, the hypoxia-inducible factor 1 and 2 (HIFs). Cancer cells use these factors in order to promote growth and progression, even under normal oxygen levels. Therefore, Dr. Mabjeesh’s team believes targeting of HIFs to exact a therapeutic response for the treatment of cancer could be beneficial.
In recent years, Dr. Mabjeesh and his team have been able to identify a factor (septin 9) that positively regulates HIF-1. Artificial disruption the interaction between the two proteins (HIF-1 and septin 9), inhibits tumor growth in several animal models. Dr. Mabjeesh’s team plans to identify small molecule drugs that would be able to disrupt this interaction and be utilized as cancer therapeutics.
- Visceral Fat- Cancer Cellular Interactions- Dr. Guy Lahat, Surgical Oncology Research Laboratory, TASMC
Approximately two thirds of the adult population in developed countries are categorized as overweight or obese. Obesity, a complex metabolic disorder is commonly associated with cardiovascular diseases and as recently shown, with cancer. Several epidemiologic studies demonstrate that high body mass index (BMI) and a high visceral (intra abdominal) fat content are associated with increased risk of cancer development and worse outcomes. These clinical observations are supported by recent in vitro studies showing that various molecules known to be secreted by adipocytes enhance various tumor cells proliferation, migration, and invasion. Despite the ongoing flow of new evidence, our knowledge concerning the molecular mechanisms of fat-induced carcinogenesis is very limited. Soft tissue sarcoma (STS) is a rare and diverse cancer, mostly located in the extremities and retroperitoneum (within the abdomen).
Dr. Guy Lahat recently demonstrated that increased visceral fat is strongly associated with a higher rate of retroperitoneal sarcoma (RPS), local recurrence and not-distant metastatsis. This observation could not be repeated in a cohort of extremity STS patients, implying that co-localization of tumor and fat cells (within the abdomen in a close vicinity) may play a role in STS development, recurrence, and outcome. Encouraged by our clinical data, we are conducting a multi-step in-vitro research focusing on the possible cross-talk between cancer and fat cells. So far, we have achieved our first goal in demonstrating that various adipokines (molecules secreted by adipocyes) directly affect STS cellular proliferation, migration, invasion, and resistance to chemotherapy. We have recently expanded our experiments showing that the effects of fat cells on pancreatic cancer cells are identical. Next, we plan to evaluate molecular deregulations in fat cells growing in a cancerous environment and vise versa. These future findings will hopefully be followed by further molecular research aiming to increase our knowledge concerning the association between cancer and obesity. Moreover, we hope to identify new potential biological targets for anti-cancer therapy.
Of Note
- Professor Eli Sprecher, Chairman of the TASMC’s Department of Dermatology, was awarded the ‘Teva Israel’ prize for his contribution to research in the field of genetic skin diseases.
- Under the directorship of Professor Nir Giladi, the Neurology Department leads the TASMC departments in grant awards in 2011, with nearly $2 million in competitive grants and awards for its remarkable work.
- The Gastroeneterology Unit, under the directorship of Dr. Iris Dotan, is in 2nd place with $1.5 million in awards and grants.
- Our own Sammy Ofer Heart Building has been chosen by Israel’s leading architecture and interior design magazine ‘Binyan Vediur’ as one of the 10 most beautiful buildings in Israel!
This is the first time that a hospital building has been chosen for such a prestigious list, alongside other acclaimed and magnificent structures in Israel such as museums, the Supreme Court complex, and luxury residential towers. In explaining their choice, the magazine noted that “within the simple ‘white architecture’- which in the past has been characteristic of hospital design- advanced technologies have been incorporated in order to create a transparent structure, which is at the same time both ecologically sound and adapted to the local climate.”
Nominations
- Professor Francis Mimouni was nominated to be director of the Dana Dwek Children’s Hospital. Professor Mimouni was previously the head of the Neonatology and Newborn unit at the TASMC. After that he was director of the Pediatric Wing of Shaare Zedek Hospital in Jerusalem, before returning to us now.
- Dr. Hannah Sprecher was recently nominated to the Head of Division of Laboratories at the TASMC.
- Dr. Yaniv Sharar was nominated to the Deputy Director General’s office at the TASMC.
