Regions Hospital

EAST LANSING, Mich., July 24, 2023 /PRNewswire/ -- Ramon W. Johnson, M.D., M.B.A., is the new President of the American Board of Emergency Medicine (ABEM). Dr. Johnson has been an oral examiner for more than 30 years and has been a member of the Board of Directors since July 2015. Dr. Johnson received his medical degree from the University of Connecticut School of Medicine, completed residency training in both Emergency Medicine and Pediatrics at the University of California, Los Angeles, and received an Executive Health M.B.A. degree from the École des Hautes Études en Santé Publique in Rennes, France. He has been a community physician and full-time partner in Mission Viejo Emergency Medicine Associates at Mission Hospital Regional Medical Center in Mission Viejo, California, for the past 27 years and until recently, served as the Medical Director of the Doctor's Ambulance Company, Santa Ana, California. "It is an incredible honor to represent ABEM as a community physician. Continuing to set the highest standards for knowledge assessment and professionalism for all emergency physicians will benefit our patients and the specialty." Others elected to the Executive Committee are: Diane L. Gorgas, M.D., President-Elect. Dr. Gorgas is a Professor and Vice Chair of Academic Affairs in the Department of Emergency Medicine and Executive Director of the Office of Global Health at The Ohio State University in Columbus, Ohio. She practices clinically at the Ohio State Wexford Medical Center. Samuel M. Keim M.D., M.S., Immediate-Past-President. Dr. Keim is Professor and Chair of the Department of Emergency Medicine at the University of Arizona College of Medicine, and a professor in the Division of Epidemiology and Biostatistics at the Mel and Enid Zuckerman College of Public Health. He practices clinically at Banner University Medical Center in Tucson. James D. Thomas, M.D., Secretary-Treasurer. Dr. Thomas is a community physician and practices Emergency Medicine at St. Anne's Hospital in Fall River, Massachusetts. Felix K. Ankel, M.D., Member-at-Large. Dr. Ankel is Professor of Emergency Medicine at the University of Minnesota and Medical Director, Health Professions Education, at HealthPartners in Bloomington, Minnesota. He practices clinically at Regions Hospital in St. Paul, Minnesota. John L. Kendall, M.D., Member-at-Large. Dr. Kendall is Professor of Emergency Medicine and Vice Chair of Education at the University of Colorado School of Medicine. He practices clinically at Denver Health. All ABEM physician directors are clinically active emergency physicians. SOURCE American Board of Emergency Medicine

WEDNESDAY, July 19, 2023 (American Heart Association News) -- Hmong American adults who have a stroke tend to be much younger than their white counterparts and may be more likely to have a less common type that causes bleeding in the brain, a new study suggests. The research, published Wednesday in the Journal of the American Heart Association, also found that Hmong stroke patients had higher blood sugar levels and worse cholesterol than their white peers. The Hmong people are an ethnic group of clans primarily from mountainous areas in Laos, China, Vietnam and Thailand. Many fought alongside the United States during the Vietnam War. Persecution from that alliance forced thousands of Hmong to flee Southeast Asia in the mid- to late 1970s, with many coming to the U.S. as refugees. The U.S. Hmong population now hovers at an estimated 368,609, according to 2021 census data. Previous research shows refugees, including Hmong refugees, may have a higher prevalence of cardiovascular disease and risk factors. But little is known specifically about stroke among the Hmong. Researchers used an American Heart Association database of medical records to identify 128 Hmong stroke patients and 3,084 white stroke patients treated at Regions Hospital in St. Paul, Minnesota, between 2010 and 2019. Most of them had an ischemic stroke, the type caused by a clot that blocks blood flow to the brain. But intracerebral hemorrhage , an often deadly type of stroke that causes bleeding in the brain, was twice as common in Hmong stroke patients: 31% compared to 15% among white patients. The Hmong's high rate of intracerebral hemorrhage is similar to that of other Asian ethnic groups, the researchers said. Hmong Americans also were much younger at the time of their strokes. They had clot-caused strokes 11 years sooner on average, at age 60 versus 71 for white people. For intracerebral hemorrhage, the age gap was even wider: 56 versus 70. The study included another type of bleeding stroke called subarachnoid hemorrhage, but the researchers said there weren't enough cases to make comparisons. Researchers also found that after symptoms started, Hmong people having an ischemic stroke arrived at the emergency room almost four hours later than white people – and were less likely to get there by ambulance. They had higher blood sugar, especially those with diabetes, and worse cholesterol and triglyceride levels. While the severity of ischemic strokes was similar among both groups, Hmong patients were less frequently discharged to rehabilitation facilities. The findings show health care professionals must intensify their outreach in a population that comes from "a completely different culture and lifestyle," said Dr. Haitham Hussein, the study's lead author and an associate professor of neurology at the University of Minnesota in Minneapolis. "There's different food, and the physical activity is not the same, and, particularly for the first generations of Hmong refugees, the cultural and the language gaps remain wide." For the Hmong, their language does not have a word for "stroke," Hussein said. "This was a surprise to us because for many years, our stroke education efforts assumed a common understanding that was not there, which raises questions about the effectiveness of such efforts." For that reason, Hussein's team helped to develop stroke educational material – including videos that feature survivors speaking Hmong or that are specifically adapted to the Hmong culture. Lan Ðoàn, an assistant professor in the department of population health at New York University Grossman School of Medicine, said the study provides valuable observations into stroke in the Hmong population that can help better address health disparities. "What we typically see in a lot of data is the clustering of Asian populations together under these labels of Asian American, Asian and Pacific Islander," said Ðoàn, who was not part of the study. "This generalization and use of this large Asian American label really has inhibited our ability as researchers, as health professionals to understand the true prevalence of health conditions across the diversity of Asian ethnicities." Ðoàn said the findings could apply to other small and emerging communities experiencing health disparities and help to start conversations about preventive care. Despite the study's retrospective design, small number of Hmong patients treated at a single hospital and lack of follow-up data, researchers said their observations were valuable. The findings can help address health care inequities through outreach work, Hussein said. "We must start soon and include the young generations," he said. "Without that foundation of knowledge early in life, we are intervening late. When people are in their 60s or in their 50s and already coming in with a brain hemorrhage, it's too late." American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. By Lourdes Medrano, American Heart Association News Posted July 2023

A phase I clinical trial of PAC-1, a drug that spurs programmed cell death in cancer cells, found only minor side effects in patients with end-stage cancers. The drug stalled the growth of tumors in the five people in the trial with neuroendocrine cancers and reduced tumor size in two of those patients. It also showed some therapeutic activity against sarcomas, scientists and clinicians report. A phase I clinical trial of PAC-1, a drug that spurs programmed cell death in cancer cells, found only minor side effects in patients with end-stage cancers. The drug stalled the growth of tumors in the five people in the trial with neuroendocrine cancers and reduced tumor size in two of those patients. It also showed some therapeutic activity against sarcomas, scientists and clinicians report in the British Journal of Cancer. The drug was first identified and developed as an anti-cancer agent by scientists at the University of Illinois Urbana-Champaign. The findings from the clinical trial are noteworthy because the drug was tested in a small number of patients with advanced disease, said study clinical director Dr. Arkadiusz Dudek, an oncologist with the HealthPartners Cancer Center at Regions Hospital in St. Paul, Minnesota, and at Mayo Clinic in Rochester, Minnesota. Phase I clinical trials are designed to test whether a new drug compound has worrisome side effects or toxicities in human patients, Dudek said. But scientists also can look for early evidence of therapeutic benefits. The trial enrolled cancer patients with advanced disease who had run out of other treatment options. "We had patients with colon cancer, breast cancer, pancreatic cancer, adenocarcinoma, melanoma and others," he said. The clinical trial -- and another testing PAC-1 against brain cancer -- involves patients and clinicians at three institutions: Regions Hospital, the University of Illinois Chicago and Johns Hopkins University. Phase I clinical trials track side effects in patients who first are given very low doses of the compound being tested. If the drug is well tolerated and causes no discernible toxicities over the course of a month, the dose is incrementally increased. This process can take several months before a potentially therapeutic dose is given, said Dr. Oana Danciu, a medical oncologist and associate director for clinical research at the University of Illinois Cancer Center in Chicago, who led the clinical trial. Researchers at the U. of I. first identified PAC-1 as a potential anti-cancer compound in the early 2000s when they discovered that it could switch on a pathway that is suppressed in cancer cells. The first step of this pathway involves the conversion of procaspase-3, a protein found in most cells, into caspase-3, an enzyme that, when activated, initiates programmed cell death. Led by chemistry professor Paul Hergenrother, the U. of I. team also recognized that procaspase-3 occurs in greater abundance in many cancer cells relative to healthy tissues. That characteristic, along with its tendency to not be activated in cancer cells, made it a good target for anti-cancer therapies. In animal trials involving pet dogs with spontaneously occurring lymphomas, meningiomas and osteosarcomas, Hergenrother and Dr. Timothy Fan, a U. of I. professor of veterinary clinical medicine, found that an early formulation of PAC-1 had anti-cancer effects. Their work in cells and in animals set the stage for the human clinical trials, which were initiated several years ago with funding from an anonymous angel investor. Hergenrother founded biotechnology company Vanquish Oncology to lead the effort. The clinicians are currently seeking further funding to move the drug into phase II clinical trials, which would involve many more, much healthier patients with very similar cancer profiles to one another. "Our strategy is to figure out which tumor type will be the most sensitive and pursue that," Dudek said. "So we are very excited about the results in neuroendocrine tumors because there are not many drugs available for that disease." More results are expected soon from a phase I clinical trial of PAC-1 in patients with glioblastoma multiforme, an aggressive form of brain cancer that has only one drug available to treat it. In the new clinical trial, the team combined PAC-1 with this drug, temozolomide. In previous studies, the researchers discovered that PAC-1 crosses the blood-brain barrier, which is essential for any brain cancer treatment. They also saw promising results of PAC-1 in combination with the drug temozolomide and radiation in pet dogs with brain cancer. If clinical trials reveal that PAC-1 is therapeutic against one or more cancer type and the drug is approved for use in those populations, it will make it less costly to test it against other cancers, the researchers said. An approved drug also can be prescribed for "off-label use" by doctors who think their patients might benefit from adding it to their cancer-treatment protocols. It can take many years for the results of new clinical trials to be available, and longer still before a new drug like PAC-1 is approved for cancer treatment, the researchers said. Hergenrother and Fan are affiliates of the Carl R. Woese Institute for Genomic Biology at the U. of I. and members of the Cancer Center at Illinois. Vanquish Oncology, the University of Illinois Cancer Center, the National Institutes of Health and the Engdahl Family Foundation supported this research.