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  • June 10, 2019

    In honor of National Aphasia Awareness Month, MedStar St. Mary’s Hospital will offer free information sessions from noon to 1 p.m. on Tuesday, June 25 and Thursday, June 27 to help educate individuals about the communication disorder.

    Aphasia is an acquired condition that impairs a person’s ability to process language, but does not affect intelligence. The most common cause of aphasia is stroke, though it can also result from head injury, a brain tumor, or other neurological causes.

    Individuals with aphasia often have difficulty reading, writing, speaking, and/or understanding language. Approximately 2 million Americans are affected by the disorder.

    “Many people do not understand that aphasia is a loss of language, not a loss of intelligence,” said Anna Decker, MS, CCC-SLP, speech language pathologist at MedStar St. Mary’s. “There are strategies available to help those impacted improve their communication, and we hope to help families by sharing these resources.”

    Interested individuals may stop by The Blue Heron Café at MedStar St. Mary’s between noon and 1 p.m. June 25 and June 27. A speech language pathologist will discuss how to help those affected by aphasia. To learn more about the disorder and strategies for improvement, visit MedStarStMarys.org/Aphasia or call 301-475-6062.

    About MedStar St. Mary’s Hospital

    MedStar St. Mary's Hospital (MSMH) is a full-service community hospital, delivering state-of-the-art emergency, acute inpatient and outpatient care in Leonardtown, Maryland. Nestled in a waterside community, MedStar St. Mary's provides advanced technology with a dedication to excellence in all services provided. The not-for-profit hospital has been named among the nation’s Top 100 Hospitals™ and is an eight time recipient of the prestigious Delmarva Medicare Excellence Award. In addition, MSMH received the Maryland Performance Excellence award at the Platinum level in 2014 – the highest in the state. Our staff is committed to providing quality and compassionate medical care for all patients by coupling innovation with our outstanding team of Medical Staff members, associates and volunteers. Visit MedStarStMarys.org to learn more.

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  • June 10, 2019

    In honor of National Aphasia Awareness Month, MedStar St. Mary’s Hospital will offer free information sessions from noon to 1 p.m. on Tuesday, June 25 and Thursday, June 27 to help educate individuals about the communication disorder.

    Aphasia is an acquired condition that impairs a person’s ability to process language, but does not affect intelligence. The most common cause of aphasia is stroke, though it can also result from head injury, a brain tumor, or other neurological causes.

    Individuals with aphasia often have difficulty reading, writing, speaking, and/or understanding language. Approximately 2 million Americans are affected by the disorder.

    “Many people do not understand that aphasia is a loss of language, not a loss of intelligence,” said Anna Decker, MS, CCC-SLP, speech language pathologist at MedStar St. Mary’s. “There are strategies available to help those impacted improve their communication, and we hope to help families by sharing these resources.”

    Interested individuals may stop by The Blue Heron Café at MedStar St. Mary’s between noon and 1 p.m. June 25 and June 27. A speech language pathologist will discuss how to help those affected by aphasia. To learn more about the disorder and strategies for improvement, visit MedStarStMarys.org/Aphasia or call 301-475-6062.

    About MedStar St. Mary’s Hospital

    MedStar St. Mary's Hospital (MSMH) is a full-service community hospital, delivering state-of-the-art emergency, acute inpatient and outpatient care in Leonardtown, Maryland. Nestled in a waterside community, MedStar St. Mary's provides advanced technology with a dedication to excellence in all services provided. The not-for-profit hospital has been named among the nation’s Top 100 Hospitals™ and is an eight time recipient of the prestigious Delmarva Medicare Excellence Award. In addition, MSMH received the Maryland Performance Excellence award at the Platinum level in 2014 – the highest in the state. Our staff is committed to providing quality and compassionate medical care for all patients by coupling innovation with our outstanding team of Medical Staff members, associates and volunteers. Visit MedStarStMarys.org to learn more.

  • March 13, 2019

    WASHINGTON  — Laboratory analysis from the first arm of a phase II clinical trial testing the use of nilotinib in patients with Parkinson’s disease demonstrates precisely how the agent increases levels of dopamine in the brains of study participants, says a research team at Georgetown University Medical Center. Symptoms of Parkinson’s, such as motor dysfunction, are a result of a dopamine loss.

    In the journal Pharmacology Research & Perspectives, investigators report that a single low dose of the leukemia drug, nilotinib (Tasigna® by Novartis), reduces levels of a toxic protein that prevents the brain from utilizing dopamine that is stored in tiny vesicles, or pockets, in brain areas that may control movement.

    The researchers say nilotinib appears to rev up the ability of immune cells within the brain to reduce the constant flow of the misshapen alpha-synuclein protein produced by damaged neurons, allowing normal alpha-synuclein to facilitate release of stored dopamine. 

    “We detect the drug in the brain producing multiple effects, including improving dopamine metabolism reducing both inflammation and toxic alpha-synuclein. This is unprecedented for any drug now used to treat Parkinson’s disease,” says the study’s senior author, Charbel Moussa, MBBS, PhD, director of the Laboratory for Dementia and Parkinsonism, and scientific and clinical research director of the Translational Neurotherapeutics Program at Georgetown University Medical Center.

    The research team examined cerebral spinal fluid (CSF) and plasma collected from patients participating in the clinical trial to examine Parkinson’s disease biomarkers. The CSF was collected after a single dose of nilotinib or placebo was administered.

    Researchers examined levels of dopamine breakdown products, 3,4-Dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in the CSF that bathes the brain and spinal cord of patients, after nilotinib or placebo. They also looked at levels of TREM-2, which reflects the immune response to inflammation.

    Without nilotinib treatment, DOPAC and HVA were at low levels in the CSF of all patients. These molecules are produced when dopamine is broken down, or metabolized. A low level suggests a low level of dopamine is being used in the brain.

    Investigators divided participants into five groups to test different drug levels (150, 200, 300 or 400 mg.) or a placebo. After a single dose of nilotinib, they found DOPAC and HVA were elevated in patients who received nilotinib compared to placebo, suggesting the brain was utilizing substantially more dopamine. The optimal dose of nilotinib for elevating DOPAC and HVA, they found, was 200 mg.

    “When the drug is used, levels of these breakdown molecules quickly rise. This is what we also found in our preclinical studies and proof of concept clinical trial,” says Moussa. “This is exciting because this kind of potential treatment for Parkinson’s could increase use of a patient’s own dopamine instead of using or periodically increasing drugs that mimic dopamine.”

    They also found 150 mgs dose of nilotinib treatment led to a significant reduction of alpha-synuclein in the blood, outside of the CSF. Alpha-synuclein is typically very high, and may be toxic, in the blood of Parkinson’s disease patients.

    In addition, the single dose of nilotinib (200 mg.) significantly increased the CSF level of TREM-2 in patients. “This suggests an elevated beneficial immune activity that targets misfolded alpha-synuclein for destruction.

    “The TREM-2 findings fit neatly with DOPAC and HVA findings,” Moussa says.

    He explains that under normal circumstances, the brain stores as much dopamine neurotransmitter as it can and uses it regularly to transmit messages across neurons. Research suggests that normal alpha-synuclein helps maintain the vesicles that dopamine is stored in and helps release the neurotransmitter when needed. But in Parkinson’s disease, dopamine-secreting neurons produce alpha-synuclein that is folded up (misfolded), and so cannot mediate dopamine re-cycling and breakdown. Eventually, more and more dopamine-secreting neurons emit the tangled protein and die.

    In preclinical studies, Moussa says nilotinib appears to trigger brain cells (including immune cells and neurons) to attack the misfolded protein that is being produced, allowing normal alpha-synuclein to access and release dopamine from storage vesicles. Hence the increase in TREM-2 and dopamine breakdown chemicals in the central spinal fluid, Moussa says. Dopamine produced in the brain is then recycled, stored in vesicles and available for future use. The cycle repeats itself over and over.

    Dr. Fernando Pagan
    Dr. Fernando Pagan

    Fernando Pagan, MD, principal investigator of the clinical trial and first author of the paper says the scientific evaluation of nilotinib’s effect suggest it can reduce toxic alpha-synuclein and brain inflammation, while protecting dopamine and dopamine-secreting neurons. Pagan is medical director of Georgetown’s Translational Neurotherapeutics Program and director of the Movement Disorders Clinic at MedStar Georgetown University Hospital.

     “Whether or not, or how much, the drug demonstrates improved clinical outcomes will be determined when the phase II clinical trial results are in,” he says.

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    Additional study authors included Michaeline L, Hebron, MS, Barbara Wilmarth, CRNP, Yasar Torres-Yaghi, MD, Abigail Lawler, MD, Elizabeth E Mundel, MD, Nadia Yusuf, MD, Nathan J Starr, DO, Joy Arellano, RN, Helen H. Howard, RN, Margo Peyton, Sara Matar, BS, Xiaoguang Liu, MD, PhD, Alan J. Fowler, Sorell L. Schwartz, PhD, and Jaeil Ahn, PhD.

    Georgetown holds an issued US patent for the use of nilotinib for the treatment of certain neurodegenerative diseases and has other pending patent applications in US and foreign jurisdictions. Moussa is also the named inventor on this related intellectual property.

    This study was supported by the Lasky-Barajas Family Fund and other donors. Novartis, the maker of nilotinib, provided nilotinib and matching placebo free of cost to Georgetown University for all participants while on the study.

  • February 05, 2019

    An international group of experts, led by MedStar Georgetown University Hospital’s Karen Anderson, MD, recently published new clinical guidelines focusing on the treatment of behavioral symptoms seen in patients with Huntington’s disease.

    Huntington’s disease is a fatal genetic disorder that impairs physical and mental abilities as movement-controlling cells die in the brain. It’s estimated that 70% of American patients with the disease do not receive specialist care; instead seeking treatment from general practitioners, general neurologists, and psychiatrists.

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    “These guidelines convey the important message that we have treatments available now for many neuropsychiatric symptoms of HD. This should encourage patients to seek care. They also help non-specialist clinicians understand that HD is a not a hopeless condition,” explains Dr. Anderson, director of the Huntington’s Disease Care, Education, and Research Center (HDCERC), a joint program between MedStar Georgetown University Hospital and Georgetown University Medical Center.

    The guidelines, published in the Journal of Huntington’s Disease, provide primary caregivers with a stronger set of tools and specialist-led strategies to treat five behavioral symptoms of the disease: agitation, anxiety, apathy, psychosis, and sleep disorders.

    Before publication, Dr. Anderson and the panel of nine others submitted ideas to Huntington’s disease experts around the world to reach consensus. Clinical Practice Guidelines (CPG) like these can be relied on in the absence of randomized clinical trial evidence, which is harder to obtain when studying rarer diseases.

    “We encourage patients and families to use these guidelines to partner with their clinicians when seeking care since these symptoms often have a huge impact on patients’ wellbeing and their relationships with individuals close to them,” advised Dr. Anderson.

    Currently, there is no treatment available to slow, stop, or reverse the course of Huntington’s disease, according to the Centers for Disease Control.

    For more on the newly published guidelines, visit: https://www.iospress.nl/ios_news/expert-based-clinical-guidelines-focus-on-behavioral-symptoms-in-huntingtons-disease/

     

     

     

     

  • October 12, 2018

    (Washington, D.C.,) - Epilepsy patients looking for a minimally invasive alternative for brain surgery have a new option thanks to a novel tool that lets surgeons perform brain surgery with the help of a robot.

    MedStar Georgetown is the first and only center in the Washington, D.C., area to offer this new option for adults with epilepsy.

    ROSA Brain™ is a surgical navigation and positioning system using robotic technology that allows surgeons, through a tiny three millimeter opening in the skull, to place electrodes, which detect seizures in the brain.  Traditional methods require a more invasive craniotomy and shaving a patient’s head.

    “About 30 percent of patients with epilepsy don’t respond to medication,” says Christopher Kalhorn, M.D., FACS, neurosurgeon and surgical director of the Movement Disorders Program and the Epilepsy Program at MedStar Georgetown University Hospital.

    “For this group of people who don’t respond to medicine and for whom debilitating seizures are a daily threat, surgery can be a good option for eliminating their seizures.”

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    The surgeon uses ROSA Brain and its planning software to create a 3D map of the patient’s brain and plan out the pathways needed to carry out the procedure. ROSA Brain is aligned to the trajectories outlined by the surgical plan, and the surgeon carries out the surgery using the robot as a guide. ROSA Brain provides robotic alignment of the planned pathway which allows the surgeon to access deep brain targets for the placement of electrodes, all without a craniotomy.

    “Conventional brain surgery for epilepsy requires a craniotomy, which is the surgical removal of part of the bone from the skull to expose the brain,” says Dr. Kalhorn.

    This common surgery is invasive and can lead to long recovery times.

    “Using Rosa Brain through a tiny opening in the skull, I can offer a much less invasive option for my patients who recover quicker and with less pain than before.”

    ROSA RobotAccording to the U.S. Centers for Disease Control and Prevention 3.4 million Americans either take medication to try to control seizures, or have had at least one seizure in the past year.

    Minimally invasive surgery using ROSA Brain may allow surgeons to lower operating time and eliminate the need of traditional craniotomies.

    “The beauty of this technology is while it’s mainly used for epilepsy surgery, it can also be used for other brain surgeries like biopsies, endoscopic brain surgeries as well as Deep Brain Stimulation (DBS) for Parkinson’s disease and other movement disorders,” says Dr. Kalhorn.

  • August 14, 2018

    New Facility Unlocks New Model of Care and Patient Experience

     

    Washington, D.C., June 14, 2016 – The first dedicated heart and vascular hospital in the nation’s capital is opening on the campus of MedStar Washington Hospital Center. The Nancy and Harold Zirkin Heart & Vascular Hospital is a 164-bed state-of-the-art facility, which will be the cornerstone of the MedStar Heart & Vascular Institute and will advance cardiovascular care for patients throughout the Washington and mid-Atlantic regions.

    “This is an extraordinary milestone for our patients,” said Stuart F. Seides, MD, physician executive director, MedStar Heart & Vascular Institute. “The new heart and vascular hospital, its construction, its design, its philosophy, was designed with patients’ needs in mind, coupled with our long-standing commitment to providing the most advanced heart and vascular care.”

    MWHC_Patient-Unit-4---press-releaseAs one of the highest-volume and nationally recognized heart and vascular surgery programs in the nation, MedStar Washington Hospital Center is the founding member of MedStar Heart & Vascular Institute, which has cared for patients with highly complex cardiovascular disorders for nearly 60 years. It has been at the forefront of innovative new treatments and prevention of heart and vascular disease.

    The four-story, 160,000-square-foot facility centralized all cardiovascular services in the Hospital Center’s North Addition. The new space ushers in a new model of care and patient experience. Patients with similar medical conditions are cared for on designated specialty-care units that have dedicated teams of cardiologists, cardiac and vascular surgeons, nurse practitioners and nurses, to collaboratively deliver the highest quality cardiovascular care and achieve the best patient outcomes.

    “We want to make the overall experience for the patients and their families as good as it can be,” added Dr. Seides. “Every team member who works at the heart and vascular hospital takes great pride in their work. As a team, we are all focused on patients getting the best clinical care possible. And the only way to safely provide that kind of highly advanced care is through highly coordinated teamwork.”

    Increased critical care capacity was an important linchpin in the new design of the heart and vascular hospital. The 44-bed cardiac intensive care unit on the second floor was built to meet the increasingly complex needs of patients from all over the region. The ICU rooms are much larger, with wider doorways facilitating access for team members and advanced equipment to the bedside. Each ICU room is equipped with ceiling-mounted booms carrying medical gases, and electric and data outlets, offering greater flexibility and providing clinicians unrestricted access to the patient from all four sides of the bed.

    “The booms give us 360-degree access to patients. Beds pushed up against walls limit our ability to perform certain procedures in patient rooms. Opening the space in this way allows us to position patients, ourselves, and needed equipment for optimal care,” concluded Dr. Seides.

    Construction of the Nancy and Harold Zirkin Heart & Vascular Hospital took three years to complete and was divided into four phases. In January 2015, a 60-bed inpatient unit opened to patients on the fourth floor of the hospital, followed by the third floor inpatient unit. The first floor, with a separate entrance and lobby, opened in December and is solely dedicated to outpatient care. The second floor cardiac ICU, the final phase of construction, is scheduled to open in July.

    The Nancy and Harold Zirkin Heart & Vascular Hospital was named to recognize long-time Washingtonians Nancy and Harold Zirkin for their generosity and extraordinary philanthropic support to the heart and vascular hospital. Their $10 million leadership gift is the largest single contribution in the history of MedStar Washington Hospital Center and MedStar Health.

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    *A dedication ceremony for the Nancy and Harold Zirkin Heart & Vascular Hospital will be held on Thursday, June 16, starting at 6 p.m.  View the Media Advisory here.

    B-roll footage and photos of the facility are available to download. Click here to access.

     

     

    MedStar Heart & Vascular Institute, founded at MedStar Washington Hospital Center in Washington, D.C., is a national leader in the research, diagnosis and treatment of cardiovascular disease, and has been consistently recognized by U.S. News & World Report and The Society of Thoracic Surgeons as one of the top cardiovascular programs in the nation. In January 2013, MedStar Heart formed a first-of-its-kind clinical and research alliance with world-renowned Cleveland Clinic Sydell and Arnold Miller Family Heart & Vascular Institute, the #1 heart program in the country. Together, MedStar Heart and Cleveland Clinic have forged a relationship of shared expertise that is transforming cardiovascular care, enhancing quality, improving safety and increasing access to advanced heart and vascular services. MedStar Heart & Vascular Institute comprises more than 140 cardiovascular physician specialists throughout the mid-Atlantic region, as well as the nationally recognized heart care of all nine MedStar Health acute care hospitals and MedStar National Rehabilitation Network. For more information, visit MedStarHeartInstitute.org.

    Washington, D.C., August 14, 2018 – MedStar Washington Hospital Center is the first hospital in Washington, D.C., to use the Brainlab Airo® Mobile Intraoperative CT, an advanced imaging scanner that gives surgeons a real-time look at the brain or spine during surgery in order to make immediate decisions when it counts the most.

    Thirty patients have been treated so far at the Hospital Center using the system’s synchronized imaging capabilities. The portable scanner produces high-quality CT images of the patient’s brain or spine in the operating room, allowing surgeons to clearly see their exact position and make the most precise next steps. This eliminates the need to rely on images taken before surgery that might not be as accurate or wait to get images afterwards that could result in a second surgery.

    “Our goal is to provide our patients with safe and precise treatments,” said Edward F. Aulisi, MD, chairman of Neurosurgery at MedStar Washington Hospital Center. “With Airo, we have the ability to perform intraoperative CT imaging of a patient’s anatomy while still in the OR, allowing us to make decisions rapidly and to change course if it’s appropriate. This helps to both save time and, when combined with our image-guided surgery system, enable greater surgical accuracy.”

    Brittani R., a vibrant 32-year-old diagnosed with a benign pituitary tumor recently underwent image-guided transsphenoidal surgery performed through the nose and sinus, and will be able to get back to her busy everyday routine in a few weeks.

    “I was trying to cope with extreme fatigue and constant thirst, but the idea of surgery, including incisions and possible scars, was very scary. The fact that Dr. Aulisi was able to use this new non-invasive technique gave me greater confidence and alleviated some of my fears. I am thrilled that my surgery was successful and I am starting to feel like myself again. I am building up my energy, happy to be working from home, and exercising with some light walking.”

    “Having the ability to confirm the surgical progress during procedure is critical,” added Dr. Aulisi. “Verifying one’s work intraoperatively may reduce re-operation rates and lead to improved patient outcomes. Intraoperative imaging can also offer patients the benefit of a less-invasive surgical procedure, reduced trauma and potentially faster recovery times.”

    Brainlab Airo can be used in a wide range of surgical procedures, including cranial, spinal, ear/nose/throat (ENT), head and neck trauma, orthopedic and general surgery.


    About MedStar Washington Hospital Center:
    MedStar Washington Hospital Center is a 912-bed, major teaching and research hospital. It is the largest private, not-for-profit hospital in the nation’s capital, among the 100 largest hospitals in the nation and a major referral center for treating the most complex cases. Its cardiology program is highly acclaimed and its cardiac surgery program has consistently earned the highest national rating–three stars–from the Society of Thoracic Surgeons. It also is a respected top facility in the areas of cancer, diabetes & endocrinology, Ear, Nose & Throat, gastroenterology & GI surgery, geriatrics, gynecology, nephrology, pulmonology and urology. It operates MedSTAR, a nationally-verified level I trauma center with a state-of-the-art fleet of helicopters and ambulances, and also operates the region’s only adult Burn Center.

  • August 08, 2018

    WASHINGTON --  Can nicotine slow or stop memory loss in people experiencing mild memory problems, or mild cognitive impairment (MCI)? A new study being conducted at Georgetown University Medical Center aims to find out.

    Recent studies have suggested that one of the causes of memory disorders may be a reduction in a particular chemical substance in the brain. This chemical substance, known as acetylcholine, is thought to act on certain brain cells in a specific way, helping us to remember and use memories as well as affect our mood.

    In people with MCI (and Alzheimer’s disease), the level of acetylcholine may be changed, and this may impair brain functioning. Preliminary studies have suggested that shorter-term administration of nicotine appears to improve memory in patients with mild memory loss and early Alzheimer’s disease (AD). It has been known for years that nicotine imitates many of the actions of acetylcholine.

    To expand on this finding, a clinical trial led by Georgetown’s principal investigator, R. Scott Turner, MD, PhD, will explore whether nicotine may act to improve memory loss symptoms over the longer term and whether it may help to delay the progression of memory loss symptoms.

    “We are increasingly able to detect those at risk for future Alzheimer's disease in order to perhaps slow or stop their progression to dementia,” says Turner. “About 10-15% of those diagnosed with mild cognitive impairment (MCI) will advance to dementia each year most commonly due to Alzheimer's disease – with a total risk of greater than 50% after 5 years. This new study is seeking volunteers with MCI to test whether treatment with a daily Nicotine skin patch can slow or stop further cognitive decline.”

    This phase 2 randomized clinical trial is being conducted at approximately 30 to 40 clinical trial sites across the United States and will enroll 300 participants. Participants will wear a skin patch, containing either nicotine or placebo, for approximately 16 hours per day for two years.

    Half of the participants will receive transdermal nicotine (nicotine by skin patch) called a “nicotine patch” with a dose of 7 mg per day increasing to 21 mg per day. The other half (the control group) will receive an identical patch, which does not contain an active dose of nicotine, called a “placebo patch.” The placebo patch contains a small amount of nicotine that cannot pass into the skin or be absorbed by the body.

    Given that this is a randomized trial, neither the investigator nor the participant will know which group they are in.

    During the first visit, participants will undergo standard physical and cognitive testing with the addition of an electrocardiogram (ECG). They will also be given a memory and thinking skills test that will be written as well as administered on an electronic device.

    Some side effects could include sleepiness, diarrhea, stomach ache, muscle pain or joint pain  (reported by 3-9 percent of patients using the nicotine patch) and reddening or irritation of the skin where the patch is applied (reported by 17 percent of patients using the patch).

    “Since we don't know all the possible risks and benefits as yet of Nicotine patch treatment in individuals with MCI, we advise against taking the drug for this purpose outside of the study,” says Turner.

    Study participants must be between the ages of 55-90 and have a study partner who can accompany them to all appointments.

    Full study criteria are available at ClinicalTrials.gov.

    To learn more about this or other clinical trials, please contact Carolyn Ward, program coordinator of the Memory Disorders Program at (202) 784-6671, cw2@georgetown.edu.

    The study is sponsored by the National Institute on Aging and is being conducted by the

    Alzheimer’s Therapeutic Research Institute (ATRI) with Vanderbilt University through a grant from the National Institute on Aging (NIA).  Turner conducts additional clinical research supported by funding to Georgetown University from Lilly, Biogen, Merck, Acadia, and Toyama as well as the National Institutes of Health and Department of Defense.