(Houston, Texas) – The Harris County Office of Homeland Security & Emergency Management (HCOHSEM) hosted a county-wide exercise at NRG Center on Tuesday, July 25, to test and train on Point of Distribution (POD) operations.
This full-scale exercise focused on the recovery phase following the landfall of a category 4 hurricane. The exercise helped assess coordination and communication between local partners, operational areas and the Harris County Emergency Operations Center.
“The exercise was developed for staff and partners to learn about the POD plan in place following a disaster,” said Harris County Judge Ed Emmett. “Drills and exercises help work out any kinks, so that during an actual event operations run more smoothly.”
PODs are established post-incident for distributing life-sustaining commodities. The need for a POD is based on lack of infrastructure to support normal distribution of food, water, ice and other supplies.
After a disaster, HCOHSEM in coordination with local cities determine the need for a POD, the location, and the commodities to be distributed there. When recovery has reached a point where the local community can sustain itself, the POD closes.
“This POD exercise provides an excellent opportunity for participants to become familiar with their roles and responsibilities,” added Emmett. “Lessons learned from the exercise will help improve our plans to better serve the residents of Harris County.”
Training and exercises are integral parts of community readiness and preparedness. Last year, HCOHSEM hosted 69 training opportunities and participated in more than 25 partner exercises throughout the region.
Volunteers practice distributing food and water during POD exercise at NRG Center.
‘This is just the beginning, not the end. So we would invite their participation to help us improve this bill.’
WASHINGTON – Today at a press conference, U.S. Senator John Cornyn (R-TX) discussed the open amendment process where Senators on both sides of the aisle can offer amendments on the health care legislation following today’s vote. Excerpts of Sen. Cornyn’s remarks are below, and video of his remarks can be found here.
“We were all glad to see our old friend John McCain… I thought he delivered a very important message and at a very timely basis because this legislation is open for amendment, not just by Republicans but by Democrats as well.”
“This is just the beginning, not the end. So we would invite their participation to help us improve this bill.”
Senator John Cornyn, a Republican from Texas, is a member of the Senate Finance, Intelligence, and Judiciary Committees.
WASHINGTON, D.C. – According to a new report conducted by the Department of Health and Human Services, the Consumer Freedom amendment proposed by U.S. Sen. Ted Cruz (R-Texas) to the Senate’s Better Care Reconciliation Act expands coverage by more than two million individuals, and reduces health insurance premiums by more than $7,000 per year.
Following lunch at the White House, Sen. Cruz discussed his efforts to reduce health insurance premiums with Fox News. The full interview may be viewed here.
“It was a good and productive meeting,” Sen. Cruz said. “I think we’re close. There’s a lot of common ground. There were discussions about areas that there are still differences, and I think we’re making progress. We came from that meeting with a renewed commitment to keep working, to keep negotiating and to get to yes. In my view, failure is not an option. For seven years Republicans have campaigned promising the voters we would repeal the disaster that is Obamacare. We’ve got to deliver on that promise, and I think we can. I think we’re making real progress.”
Sen. Cruz continued, “Just a few days ago, HHS released a study analyzing the effect of the Consumer Freedom amendment. It is a study that shows that the Consumer Freedom amendment would increase coverage, increase insurance coverage by over 2 million people, and it would decrease premiums substantially by over $7,000 a year. For people who are hurting that’s real money and that shows exactly what we’ve been saying for a long time which is the way you lower premiums is through competition, through market forces, through giving consumers the freedom to choose their own health care for them and their families.”
The Washington Examiner recently covered the report, citing “those who are considered high risk, would pay on average $380 per month in 2024, down from $845 per month projected under current law,” and “consumers who purchase plans outside of the Obamacare mandates would save even more money by 2024 and would pay $240 per month on average.”
Sen. Ted Cruz plans to unveil to Senators at a White House meeting on Wednesday an analysis from the Department of Health and Human Services showing his healthcare Consumer Freedom amendment would lower costs and raise individual enrollment, including those considered “high risk.”
The report comes as President Trump attempts to revive talks on a healthcare bill that has failed to garner the support of 50 GOP senators, in part because they fear any change in Obamacare will reduce coverage and raise premiums.
“One way or another, this amendment is going to lower premiums and make people better off,” a source close to Cruz told the Washington Examiner.
The Congressional Budget Office, which said a previous version of the Senate healthcare bill would leave 22 million fewer Americans with insurance, has yet to release an analysis of the Cruz amendment, and Republicans had said they may rely on an analysis from Trump’s HHS instead.
Cruz, R-Texas, authored an amendment that would allow insurers to sell plans that do not comply with Obamacare mandates if they offer plans that do.
The goal was to lower health insurance premiums and raise participation, but the plan has scared off moderate Republicans, who fear it will leave those with pre-existing conditions without affordable coverage. Critics, including within the insurance industry, have argued that it would disrupt the market by creating two different regulatory regimes, and driving up the cost of insurance for sicker Americans, putting coverage out of reach.
But according to the analysis, obtained by the Washington Examiner, the opposite is true.
According to HHS, those likely to sign up for Obamacare-compliant Silver plans, presumably those who are considered high risk, would pay on average $380 per month in 2024, down from $845 per month projected under current law.
Consumers who purchase plans outside of the Obamacare mandates would save even more money by 2024 and would pay $240 per month on average.
However, the HHS analysis is based on the assumption that non-Obamacare compliant plans would carry a $12,000 annual deductible.
Enrollment in the individual market would climb, according to HHS.
The HHS report says enrollment in health insurance under the individual market is expected to reach 13.9 million in 2024. Under the Consumer Freedom plan included in the Senate healthcare bill, 16.1 million would be enrolled by 2024. These numbers do not take into account Medicaid, which Obamacare expanded and the Senate healthcare bill would scale back.
Cruz last week agreed to alter the language in the amendment so that all consumers would be included in one risk pool.
Cruz originally backed a plan he authored with Sen. Mike Lee, R-Utah, that would have created two insurance pools — one for high-risk consumers and another for everyone else. But in an effort to keep moderates on board, Republican leaders insisted on keeping Obamacare’s single risk pool requirement, which lost Lee’s vote.
Cruz’s office asked HHS to analyze both the single risk pool plan and the plan with dual risk pools. Cruz believed GOP leaders would more likely use the single risk pool plan but wanted to “give conservatives the opportunity to continue to fight for an even stronger version of Consumer Freedom.” a Cruz source said.
Now Cruz wants to convince lawmakers on both ends of the party’s political spectrum that the plan saves money and helps enrollment.
“His goal is to make the case for why we need to continue to debate Consumer Freedom,” a source close to Cruz told the Washington Examiner. “Both versions. The point is, which ever version you pick is going to be a win-win.”
Texas Gulf Coast smoke alarm installation events part of nationwide effort to install 100,000 free smoke alarms in 100 cities in just three weeks
The American Red Cross is calling for 35,000 volunteers to Sound the Alarm this fall to install 100,000 free smoke alarms in more than 100 major cities across the country, helping to save lives and lessen the number of tragedies attributed to home fires.
Sound the Alarm is part of a nationwide series of home fire safety and smoke alarm installation events to be held between September 23 and October 15, culminating in the Red Cross’ installation of the one-millionth free smoke alarm since its Home Fire Campaign launched in 2014. Volunteers and partners canvass high-risk neighborhoods to install free smoke alarms, replace batteries in existing alarms and help families create escape plans.
“Every day home fires are responsible for as many as seven deaths and 36 injuries in this country. We want that number reduced and so far our Home Fire Campaign is responsible for saving 258 lives across the U.S.,” said David Brady, Regional Chief Executive Officer, American Red Cross of the Texas Gulf Coast. “We are grateful to have made such an impact but there is more to be done.”
To that end, the Red Cross of Greater Houston will be participating in Sound the Alarm and seeks volunteers to help install smoke alarms on September 30 and October 14 in Southwest Houston and North Houston, respectively.
Since 2014, Red Cross volunteers and members of more than 4,200 partner organizations have installed 886,823 smoke alarms in 10,664 cities and towns in all 50 states, serving more than 998,500 people. In the past 12 months alone, the American Red Cross of the Texas Gulf Coast has responded to 1,266 home fires and installed more than 6,000 free home smoke alarms.
“No one should have to experience the tragedy of a home fire,” said Brady. “We hope community members will join us to Sound the Alarm throughout the Texas Gulf Coast and help save lives.”
Volunteer to help Sound the Alarm. Save a Life.
Visit org to find events in your local community and join neighbors in going door-to-door to install free smoke alarms, replace batteries in existing alarms and help families create escape plans.
Make this life-saving campaign a group activity. Invite friends and family to register.
Donate to help Sound the Alarm. Save a Life.
Visit org to help families prepare for, respond to and recover from home fires.
Your donation will: help educate families on fire safety; help fund the installation of free smoke alarms in high-risk neighborhoods nationwide; and provide food, comfort and aid to those who have been affected by a home fire.
This work is made possible thanks to generous financial donations from national partners Almost Family and Delta Air Lines. In addition, the Red Cross has received funding from FEMA through the Assistance to Firefighters Grant Program. We are also grateful for the generous donations of Texas Gulf Coast partners Sysco Corporation and Palais Royal, part of the Stage Family.
About the American Red Cross:
The American Red Cross, a United Way agency, shelters, feeds and provides emotional support to victims of disasters; supplies about 40 percent of the nation’s blood; teaches skills that save lives; provides international humanitarian aid; and supports military members and their families. The Red Cross is a not-for-profit organization that depends on volunteers and the generosity of the American public to perform its mission. For more information, please visit redcross.org or cruzrojaamericana.org, or visit us on Twitter at @RedCross.
Laser Prostate Centers of America (LPCA) is a team of expert urologists and interventional radiologists moving prostate cancer detection and treatment into the twenty-first century with the introduction of the latest in diagnostics and image-guidance technology.
It is a fact that most Americans aren’t aware of, but need to know – other than skin cancer, prostate cancer is the most common cancer among men and represents 10.7% of all new cancer cases in the United States. With these kind of statistics, it is surprising that the technology for detection and treatment of prostate cancer has not been similar to that of other organ cancers like breast cancer. With recent breakthroughs in technology, prostate cancer can now be better detected with high resolution multi-parametric MRI (mpMRI), and treated with image-guided focal laser ablation (FLA). These new approaches allow patients to better understand prostate cancer diagnosis and treatment options to make more educated and informed decisions regarding their care, and to help them maintain quality of life.
Focal therapies like FLA for low grade or early stage prostate cancer has advantages over traditional treatment. With this cutting-edge procedure, cancers can be detected and treated without sacrificing the whole prostate gland, which leads to significantly lower risk of side effects like incontinence and impotence.
Xavier Garcia-Rojas, M.D., Ph.D., M.B.A., a partner in the multi-specialty team at LPCA who offers MRI-guided biopsies and focal therapies including focal laser ablation (FLA), noted that, “the use of advanced image-guidance and focal therapies has opened the door for superior diagnosis and treatment of prostate cancer. LPCA wants to educate the public about these new breakthroughs that can help detect and treat men with prostate cancer while retaining their quality of life.”
Founded earlier this year, LPCA’s goal is to help educate, diagnose, and treat men suffering from prostate cancer. Low grade (early stage) prostate cancer treatment has long included active surveillance and more aggressive treatments such as radical prostatectomy (whole gland removal) and radiation. The newer FLA technology is not only a quick, minimally-invasive procedure with a quicker recovery time, it offers several benefits that traditional whole gland therapies do not, such as: real-time MR imaging, real-time visualization of ablation, immediate confirmation of treatment success, it is repeatable and does not hamper other treatments in the future like surgery and radiation, and it preserves urinary and erectile function.
The older transrectal ultrasound (TRUS) method of detection, which dates back to the 1980s is commonly accepted by healthcare professionals, but misses 50% of cancers, detects non-significant cancers in the prostate and can lead to under grading the cancer, overaggressive treatment, or missing the clinically significant tumor. The TRUS method has been referred to as a “blind biopsy” due to the way in which the samples are collected.
Focal treatments have also become widely accepted for many other types of cancer treatment. For breast cancer patients routinely subjected to a mastectomy (surgical removal of the entire breast), focal therapy allowed for a lumpectomy (removal of the tumor only), which was less invasive and equally as effective for most patients. The same FLA technology used for prostate was first used by neurologists to successfully remove brain tumors and help children with epileptic seizures.
The bottom line is prostate cancer management can now be elevated to the level seen in other cancer treatments through detection with high resolution imaging and focal treatment. The team at LPCA, with offices in Houston, is available to help men from across the country and the globe with minimally-invasive alternatives for prostate cancer that have fewer side effects and hope to educate the public about these advances in that technology.
About Laser Prostate Centers of America (LPCA)
Laser Prostate Centers of America is a group of expert physicians that offer cutting-edge technologies to determine detection and treatment options for prostate cancer. The team of highly-skilled physicians and staff bring many years of knowledge in urology and interventional radiology to their patients in helping determine the best strategy and treatment plans using the new technologies that were not available to men in the past. In using these approaches for minimally-invasive treatment and detection, men have a quicker recovery time and can better maintain their quality of life with fewer side effects such as incontinence and impotence. With offices located in Houston, Texas, LPCA works with patients from across the country and the globe to help determine their best path for prostate cancer treatment. www.laserprostate.com
Katy Visual and Performing Arts Center offered a new class this past summer, one that they will continue to offer, and indeed, expand upon once the regular school starts. Called Theatre For Life, it is a full series of classes for tweens on the Autism spectrum being taught by Ann Marie Morris, a Theatre Performance graduate from SUNY Fredonia and formerly a teacher at The Arbor, a private school for Special Needs children. “This class really fulfills a dream for me – to combine the professional loves of my life, theatre and special needs kids! It’s a challenge to be sure, for both myself and the students, but so rewarding.” With each class, the students are encouraged to see how what they are learning can be applied to their daily challenges of life, how the world and the people in it are a theatre and an audience.
The goal is to show the students how theatre techniques can help them cope with and have more confidence in their daily lives. Classes started with the basics, such as Relaxation and Calming, Learning the Stage Space, Sharing the Stage With Other Actors, Using the Voice and Body, Focus and Memory, Working With a Script, Blocking and Staging, The Five W’s (Who, What, When, Where and especially Why), Making Contact, and The Joy and Pain of Criticism!
As the last weeks of the class approach, the students are starting preparations for their performance on the last day. With the help of their teacher, each student is writing a monologue about their future. They will be asked to use all the different techniques that they have been learning to present the monologues for an audience, sharing the stage and working together as a theatre company. Their enthusiasm is obvious. They are very much looking forward to, as one youngster put it, “putting on their show!” And when asked if they would like to continue the class during the coming school year, the response from the kids was a resounding “Yes!”
The goal for KVPAC and the coming school year is to build on the experiences of the summer and expand the class offerings to three classes. All called Theatre For Life, one class will be for Young Children (ages 6-10), the second for Tweens (ages 11-14), and a third for the Teens (ages 15-18). All will offer everything from the very basics of theatre techniques to harder work, such as Preparing an Audition Piece and Learning About Directing, Management and Crewing shows. All classes will be a continuing series and conclude with a performance by the students. For more information, please visit the KVPAC website at www.kvpac.org or call 281.829.2787. KVPAC is a 501c3 non-profit arts education organization serving the Katy community since 2001. We are located at 2501 S Mason Rd, # 290, Katy, TX 77450 in the Great Southwest Equestrian Center Complex. ###
New And Expanded Risk Factors For Cognitive Decline And Alzheimer’s Disease
– Verbal and sensory skills, hospitalization may predict future cognitive function –
LONDON, July 17, 2017 – Detection of dementia at the earliest stages has become a worldwide scientific priority because drug treatments, prevention strategies and other interventions will likely be more effective very early in the disease process, before extensive brain damage has occurred. Research results reported at the Alzheimer’s Association International Conference (AAIC) 2017 provide clues about associations between cognitive status in older people and several behavior and lifestyle factors, including verbal skill, hearing, and hospitalization.
“It is essential that we learn more about factors that indicate or impact risk for Alzheimer’s disease and other dementias, especially lifestyle factors that we can change or treat,” said Maria C. Carrillo, PhD, Alzheimer’s Association Chief Science Officer. “The Alzheimer’s Association is committed to advancing scientific research to identify simple and accessible ways to spot the signs of cognitive decline.”
Having trouble with memory does not mean you have Alzheimer’s. That said, the Alzheimer’s Association says early detection allows people with dementia and their families:
A better chance of benefiting from treatment.
More time to plan for the future.
Increased chances of participating in clinical drug trials, helping advance research.
An opportunity to participate in decisions about care, living options, financial and legal matters.
Hearing loss is associated with poor cognition and progression to mild cognitive impairment
Taylor Fields, a doctoral student in the Neuroscience Training Program within the University of Wisconsin School of Medicine and Public Health, and colleagues examined the prevalence of hearing loss in late middle-aged adults with a family history of Alzheimer’s, and the association between hearing loss and cognitive status and decline. The researchers found evidence for a link between hearing loss and mild cognitive impairment, a condition that can be a precursor to Alzheimer’s disease.
The scientists used data collected from 783 people enrolled in the Wisconsin Registry for Alzheimer’s Prevention (WRAP), a longitudinal study group of people with a parental history of Alzheimer’s. Participants undergo periodic tests to evaluate their ability to remember, process, and learn information. Study volunteers self-reported whether they had been diagnosed with hearing loss. At the beginning of the study, all volunteers had normal test results for clinical tests of cognitive function, and all were assessed for progression to mild cognitive impairment.
Over the course of four years, 72 (9.2 percent) study participants reported being diagnosed with hearing loss. Relative to those who reported normal hearing, people in the study with hearing loss were:
More likely to score significantly poorer on cognitive tests such as how quickly new information is processed, flexibility in thinking, and how the brain, eye, and hand coordinate during information processing.
Roughly three times as likely to be characterized as having mild cognitive impairment.
“This study suggests that hearing loss could be an early indicator of worsening cognitive performance in older adults,” Fields said. “Identifying and treating hearing loss could have value for interventions aimed at reducing the burden of Alzheimer’s disease.”
Verbal fluency predicts cognitive health
In another analysis of participants in WRAP, Kimberly Mueller, PhD, of the Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, and colleagues investigated whether people with very early memory declines also show changes in their everyday speech. The researchers found that subtle changes in everyday speech, such as the use of short sentences, more pronouns, and pauses like “um” and “ah,” correlated with early Mild Cognitive Impairment (eMCI), which can be a precursor to Alzheimer’s disease.
In the study reported at AAIC 2017, the scientists analyzed two speech samples, taken two years apart, from 264 participants in WRAP. Of these participants, 64 were identified as having eMCI based on cognitive testing over 8-10 years. The speech samples, averaging one minute long, were collected by asking the participants to describe a simple picture.
Study participants with eMCI declined faster on two measures of speech: content and fluency. The content of their speech was less specific, with a higher proportion of pronouns to nouns (e.g., “she,” “it,” “them”). Their fluency was more disrupted (more hesitations, word repetitions, and filled pauses (“um,” “uh”)). Also, those with eMCI used less complex syntax and shorter sentences, and took more time to express the same amount of content as the cognitively healthy group.
“Our study is the largest prospective, longitudinal study of spontaneous speech samples in a study group of this kind,” Mueller said. “We don’t know whether the eMCI group will go on to develop Alzheimer’s, so we will continue to follow them, and our next step is to repeat these analyses with participants who have other biomarker evidence, such as amyloid plaques and neurofibrillary tangles as seen on PET scans. Speech analysis may be a valuable cognitive marker to add to clinical assessments of cognitive function in the future.”
Emergency and urgent hospitalizations, but not elective admissions, are related to accelerated cognitive decline in older people
Research shows that older adults are at high risk for memory and other cognitive problems after being hospitalized, not only transient delirium but also long-term changes in cognition. However, it is unknown whether elective hospitalizations, such as for scheduled surgery, put older individuals at the same risk for faster cognitive decline as emergency or urgent admissions (nonelective hospitalizations).
In research reported at AAIC 2017, Bryan James, Ph.D., of the Rush Alzheimer’s Disease Center at Rush University Medical Center in Chicago, Illinois, USA, and colleagues found that nonelective hospitalizations were associated with acceleration in cognitive decline from prehospital rates, but elective hospitalizations were not associated with a change in the rate of cognitive decline. Data came from 930 older adults (75% female, mean age of 81 years old) enrolled in the Rush Memory and Aging Project (MAP) in Chicago. The study involved annual cognitive assessments, as well as clinical evaluations. Information on hospitalizations was acquired by linking 1999-2010 Medicare claims records for these participants to their MAP data. All hospital admissions were designated as elective, emergency, or urgent (the latter two combined as nonelective for analysis).
Of the 930 participants, 613 were hospitalized at least once over an average of almost five years of observation. Of those who were hospitalized, 260 (28%) had at least one elective hospital admission, and 553 (60%) had at least one nonelective hospital admission; 200 participants (22%) had both types of hospitalizations. In a model adjusted for age, sex, education, self-reported chronic medical conditions, length of stay, surgeries, intensive care unit stays, and comorbidities, nonelective hospitalizations were associated with acceleration in the rate of cognitive decline from before hospitalization, while elective hospitalizations were not. Nonelective hospitalizations were associated with an approximately 60% acceleration in the rate of decline.
“We saw a clear distinction: nonelective admissions drive the association between hospitalization and long-term changes in cognitive function in later life, while elective admissions do not necessarily carry the same risk of negative cognitive outcomes,” James said. “These findings have important implications for the medical decision making and care of older adults. While recognizing that all medical procedures carry some degree of risk, this study implies that planned hospital encounters may not be as dangerous to the cognitive health of older persons as emergency or urgent situations.”
While the U.S. Congress has recently provided additional funding for Alzheimer’s research at the National Institutes of Health, the commitment continues to fall far short of the need. In 2017, for every $100 the NIH spends on Alzheimer’s research, Medicare and Medicaid will spend $12,500 caring for those with the disease. Congress must continue its commitment to Alzheimer’s and other dementias by increasing funding for Alzheimer’s research by at least an additional $414 million in fiscal year 2018.
About Alzheimer’s Association International Conference (AAIC)
The Alzheimer’s Association International Conference (AAIC) is the world’s largest gathering of researchers from around the world focused on Alzheimer’s and other dementias. As a part of the Alzheimer’s Association’s research program, AAIC serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community.
The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Our mission is to eliminate Alzheimer’s disease through the advancement of research, to provide and enhance care and support for all affected and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer’s. Visit alz.org or call +1 800.272.3900.
# # #
Taylor Fields, et al. Self-Reported Hearing Loss, Cognitive Performance, and Risk of MCI: Findings from the Wisconsin Registry for Alzheimer’s Prevention. (Funder(s): University of Wisconsin at Madison Neuroscience Training Program)
Kimberly Mueller, Ph.D., et al. Signs of Early Cognitive Decline within Connected Speech: Evidence from the Wisconsin Registry for Alzheimer’s Prevention (WRAP). (Funder(s): U.S. National Institutes of Health)
Bryan James, Ph.D., et al. Cognitive Decline after Elective and Nonelective Hospitalization in Community-Dwelling Older Adults. (Funder(s): National Institute on Aging)
Alzheimer’s Association International Conf. Press Office, +44 (0) 20-7069-6000, firstname.lastname@example.org
Niles Frantz, Alzheimer’s Association, + 1 312-363-8782, email@example.com
Six Memorial Hermann Hospitals, including Memorial Hermann Heart & Vascular Institute-Texas Medical Center, Memorial Hermann Katy Hospital, Memorial Hermann Northeast Hospital, Memorial Hermann Southeast Hospital, Memorial Hermann Sugar Land Hospital and Memorial Hermann The Woodlands Hospital, were recently honored with Mission: Lifeline Awards by the American Heart Association (AHA) for the treatment of patients who suffer severe heart attacks.
“Memorial Hermann is dedicated to improving the quality of care for our patients who suffer a heart attack, and the American Heart Association’s Mission: Lifeline program is helping us accomplish that goal through nationally-respected clinical guidelines,” said Amy Harberg, vice president of Heart & Vascular Services at Memorial Hermann. “We are honored to be recognized for our dedication and achievements in cardiac care. Our team of expert physicians and staff are among the very best in the country and deserve this recognition.”
“We’d also be remiss if we didn’t thank our local EMS providers who recognize the signs of heart attack and begin care in in the field,” added Harberg.
Every year, more than 250,000 people experience an ST-elevation myocardial infarction (STEMI),the deadliest type of heart attack caused by a blockage of blood flow to the heart that requires timely treatment. To prevent death, it’s critical to restore blood flow as quickly as possible, either by mechanically opening the blocked vessel or by providing clot-busting medication.
The Mission: Lifeline program’s goal is to reduce system barriers to prompt treatment for heart attacks, beginning with the 9-1-1 call and continuing through hospital treatment. As part of the program, AHA recognizes hospital achievements with a series of awards at various levels. Memorial Hermann’s 2017 awards include:
Mission: Lifeline® Gold Receiving Quality Achievement Award
Memorial Hermann Heart & Vascular Institute-Texas Medical Center (HVI)
Mission: Lifeline STEMI Silver Receiving PlusQuality Achievement Award
Memorial Hermann Southeast Hospital
Mission: Lifeline STEMI Silver ReceivingQuality Achievement Award
Memorial Hermann Katy Hospital
Memorial Hermann Northeast Hospital
Memorial Hermann The Woodlands Hospital
Mission: Lifeline NSTEMI Bronze Quality Achievement Award
Memorial Hermann Heart & Vascular Institute-Texas Medical Center (HVI)
Memorial Hermann Sugar Land Hospital
“We commend Memorial Hermann for its achievement awards, which reflect a significant institutional commitment to the highest quality of care for their heart attack patients,” said James G. Jollis, MD, Chair of the Mission: Lifeline Advisory Working Group. “Achieving these awards means the hospitals have met specific reporting and achievement measures for the treatment of their patients who suffer heart attacks and we applaud them for their commitment to quality and timely care.”
HOUSTON – Immune cells with a general knack for recognizing and killing many types of infected or abnormal cells also can be engineered to hunt down cells with specific targets on them to treat cancer, researchers at The University of Texas MD Anderson Cancer Center report in the journal Leukemia.
The team’s preclinical research shows that natural killer cells derived from donated umbilical cords can be modified to seek and destroy some types of leukemia and lymphoma. Genetic engineering also boosts their persistence and embeds a suicide gene that allows the modified cells to be shut down if they cause a severe inflammatory response.
A first-in-human phase I/II clinical trial of these cord-blood-derived, chimeric antigen receptor-equipped natural killer cells opened at MD Anderson in June for patients with relapsed or resistant chronic lymphocytic leukemia (CLL), acute lymphocytic leukemia (ALL), or non-Hodgkin lymphoma. All are cancers of the B cells, another white blood cell involved in immune response.
“Natural killer cells are the immune system’s most potent killers, but they are short-lived and cancers manage to evade a patient’s own NK cells to progress,” said Katy Rezvani, M.D., Ph.D., professor of Stem Cell Transplantation and Cellular Therapy.
“Our cord-blood derived NK cells, genetically equipped with a receptor that focuses them on B-cell malignancies and with interleukin-15 to help them persist longer — potentially for months instead of two or three weeks — are designed to address these challenges,” Rezvani said.
Moon Shots Program funds project
The clinical trial is funded by MD Anderson’s Moon Shots Program™, designed to more rapidly develop life-saving advances based on scientific discoveries.
The chimeric antigen receptor (CAR), so-called because it’s added to the cells, targets CD19, a surface protein found on B cells.
In cell lines and mouse models of lymphoma and CLL, CD19-targeted NK cells killed cancer cells and extended survival of animals compared to simply giving NK cells alone. Addition of IL-15 to the CD19 receptor was crucial for the longer persistence and enhanced activity of the NK cells against tumor cells.
NK cells are a different breed of killer from their more famous immune system cousins, the T cells. Both are white blood cells, but T cells are highly specialized hunters that look for invaders or abnormal cells that bear a specific antigen target, kill them and then remember the antigen target forever.
Natural killers have an array of inhibitory and activating receptors that work together to allow them to detect a wider variety of infected, stressed or abnormal cells.
Using a viral vector, the researchers transduce NK cells taken from cord blood with the CD19 CAR, the IL-15 gene, and an inducible caspase-9-based suicide gene.“By adding the CD19 CAR, we’re also turning them into guided missiles,” said Elizabeth Shpall, M.D., professor of Stem Cell Transplantation and Cell Therapy.
Cell line tests found the engineered NK cells to be more efficient killers of lymphoma and CLL cells, compared to unmodified NK cells, indicating the engineered cells’ killing was not related to non-specific natural killer cell cytotoxicity.
Another experiment showed the engineered cord blood NK cells killed CLL cells much more efficiently than NK cells taken from CLL patients and engineered, highlighting the need to transplant CAR-engineered NK cells from healthy cord blood rather than use a patient’s own cells.
Suicide gene to counter cytokine release syndrome
Mouse model lymphoma experiments using a single infusion of low dose NK cells resulted in prolongation of survival. At a higher, double dose, none of the mice treated with the CD19/IL-15 NK cells died of lymphoma, with half surviving for 100 days and beyond. All mice treated with other types of NK cells died by day 41.
A proportion of mice treated with the higher dose of engineered NK cells died of cytokine release syndrome, a severe inflammatory response that also occurs in people treated with CAR T cells.
To counteract this toxicity, the researchers incorporated a suicide gene (iC9) that can be activated to kill the NK cells by treatment with a small-molecule dimerizer. This combination worked to swiftly reduce the engineered NK cells in the mouse model.
Subsequent safety experiments were conducted in preparation for the clinical trial. Rezvani, the principal investigator of the clinical trial, says the protocol calls for vigilance for signs of cytokine release syndrome, treatment with steroids and tocilizumab for low-grade CRS with AP1903 added to activate the suicide gene for grade 3 or 4 CRS.
NK CARs available off the shelf
T cells modified with chimeric antigen receptors against CD19 have shown efficacy in clinical trials. In these therapies, a patient’s own T cells are modified, expanded, and given back to the patient, a process that takes weeks. Finding a matched donor for T cells would be a challenge, but would be necessary because unmatched T cells could attack the recipient’s normal tissue – graft vs. host disease.
Rezvani and Shpall have given patients cord-blood derived NK cells in a variety of clinical trials and found that they do not cause graft vs. host disease, therefore don’t have to be matched. NK cells can be an off-the-shelf product, prepared in advance with the necessary receptor and given promptly to patients.
“CAR NK cells are scalable in a way that CAR T cells are not,” Rezvani noted.
A strength of T cells is the development of memory cells that persist and repeatedly attack cells bearing the specific antigen that return. NK cells do not seem to have a memory function, but Rezvani says the experience of the longer-lived mice, which are now more than a year old, raises the possibility that a prolonged NK cell attack will suffice.
Shpall, Rezvani and colleagues are developing cord blood NK CARs for other targets in a variety of blood cancers and solid tumors.
MD Anderson and the researchers have intellectual property related to the engineered NK cells, which is being managed in accordance with the institution’s conflict-of-interest rules.
Shpall founded and directs MD Anderson’s Cord Blood Bank, originally established to provide umbilical cord blood stem cells for patients who need them but cannot get a precise donor match. Donated by mothers who deliver babies at seven Houston hospitals and two others from California and Michigan, the bank now has 26,000 cords stored. MD Anderson researchers pioneered the extraction and expansion of NK cells from umbilical cords.
Shpall is also co-leader of the Moon Shots Adoptive Cell Therapy Platform™, along with Cassian Yee, M.D., professor of Melanoma Medical Oncology, which develops cell-based cancer immunotherapies.
Co-authors with Rezvani and Shpall are first author Enli Liu, Yijiu Tong, Hila Shaim, Xinhai Wan, Pinaki Banerjee, Rong Cai, Mustafa H Bdaiwi, Rafet Basar, Muharrem Muftuoglu, Li Li, David Marin, Richard Champlin, all of Stem Cell Transplantation and Cellular Therapy; Xinyan Lu and Alexandra Reynolds of the Department of Hematopathology; Mihai Gagea of the Department of Veterinary Medicine and Surgery; William Wierda and Michael Keating of the Department of Leukemia: Gianpietro Dotti, Barbara Savoldo of the University of North Carolina; Malini Mukherjee and Jordan Orange of Baylor College of Medicine
Funding for this research was provided by MD Anderson’s Moon Shots Program, the National Cancer Institute of the National Institutes of Health Cancer Center Support Grant (CA016672) to MD Anderson and grants from the Leukemia and Lymphoma Society and the American Cancer Society.
Richmond, Tx– Do you sometimes feel that you are on a carnival ride with your world going round and round? Do you get dizzy when you jump out of bed or stand up or turn around too quickly? At OakBend Medical Center’s rehabilitation clinic, they frequently hear patients ask… “Do I have the Vertigo?” or the common complaint “Every time I move, my world is spinning and I can’t stand up!” Does this sound familiar to you or someone you know? In some cases, just a few positional maneuvers can help “reset” your world upright again.
Many people have seen Alfred Hitchcock’s movie Vertigo where Jimmy Stewart has difficulty running up the tower to save Kim Novak because his world is spinning out of control. Vertigo is an imbalance of a person’s Equilibrium, specifically the Vestibular System. The Vestibular System is a person’s internal compass, located in the inner ear that tells your head which way is up. Disturbances to the Vestibular System can linger for a few seconds or become chronic. Simple daily activities such as dressing, walking, or sitting up from bed can become terrifying due to the fear of having a vertigo spell. The fear of falling from dizziness can also become debilitating which may impact your quality of life or even rob you of your independence. Fortunately, in most cases this does not have to happen.
Many types of vertigo are treatable by Certified Vestibular Therapists. It may take several sessions or, in some cases, can be relieved in only one treatment. Receiving vestibular rehab therapy early has been shown to reduce the risk of recurrence, and significantly reduce the risk and fear of falling. OakBend Medical Center has two certified vestibular therapists, Mia Williams and Kristi Rice-Council. These therapists are trained to help patients discover how vertigo is affecting their lives and what can be done to treat the cause.
If you are having these types of experiences, don’t delay. Speak with your doctor and explain your symptoms; he or she can write you a prescription for therapy for Vertigo/Dizziness. You don’t have to live with certain types of dizziness and having treatment from Certified Vestibular Therapists can set your world upright again!