Virtual event: COVID-19 Translational Research at Lankenau Institute for Medical Research (LIMR)

Join us for the LIMR Round Robin, “COVID-19: Translational Research at LIMR,” 12-1 pm, Wed., Dec. 2.

 

Learn about LIMR’s discoveries this year regarding coronavirus antibodies, natural products that may help patients, T-antigens, and drug-drug synergy. Also learn about COVID-19 clinical trials available for your patients. Speakers will be LIMR investigators who have pivoted their teams to COVID research. LIMR President and CEO George Prendergast will moderate. CMEs are available for physicians.

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Clinical Trials of the Week: Studies of patients diagnosed with heart failure

By Donna Loyle, communications manager, LIMR

Main Line Health is participating in several clinical trials for patients who have been diagnosed with heart failure. Trials are testing new devices and treatment options.

  • LOFT-HF seeks to determine if non-invasive administration of oxygen during sleep can help patients with both heart failure and sleep apnea.

 

  • Transform-HF is comparing long-term outcomes among heart failure patients treated with torsemide or furosemide.

 

  • Alt Flow is an early feasibility study of the Edwards transcatheter atrial shunt system for patients with left heart failure.

 

  • Guide-HF is testing the CardioMEMS HF system, a battery-less pressure sensor implanted in the pulmonary artery.
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Medtronic’s Latin Webinar – Healthcare insight in Colorectal Surgery: 11.21.2020 8-11am

Dr. Marks will be a featured presenter and the only colorectal surgeon representing the United States in Medtronic’s Latin American Webinar entitled “Healthcare Insight in Colorectal Surgery:

Better outcomes in Colorectal Surgery – How I do?” where he will be showing how he performs his colorectal surgical expertise through video and discussion.

This is taking place tomorrow, November 21 from 8-11am. Click here to access ZOOM webinar.

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COVID-19 Town Hall Medical Staff

The next Town Hall for Medical Staff will be held on Wednesday, November 25 at 5:00pm. An invitation will be sent the day of event.

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Clinical Trial of the Week: Treatment trial for patients with ALK-positive NSCLC

By Donna Loyle, communications manager, LIMR

 

November is Lung Cancer Awareness Month, which makes this a great time to highlight a phase II clinical trial for patients who were previously treated for stage 4 non-squamous non-small cell lung cancer (NSCLC) caused by a genetic mutation of the ALK gene. Eligible participants are those who were treated with a second-generation ALK inhibitor but their disease has progressed.

 

Researchers seek to determine how well a combination of medications work in these patients. Overall, the study is testing several FDA-approved cancer treatment options and one experimental medication.

 

Study #NRG-LU003 is approved for all MLH acute care hospitals. The principal investigators are Albert DeNittis, MD, and Paul Gilman, MD. For more, email cancertrials@mlhs.org or visit https://www.mainlinehealth.org/research/clinical-trials/nrg-lu003

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New LIMR study finds coronavirus’s M protein may resemble structure of sugar transporters

While the coronavirus’s spike protein has been the primary focus of researchers searching for COVID-19 treatments and vaccines, it may be the less-studied membrane glycoprotein that could be markedly aiding in the pathogen’s rapid proliferation, replication and immune evasion, according to a newly published study from the Lankenau Institute for Medical Research (LIMR).

 

Sunil Thomas, PhD, research assistant professor at LIMR, performed in silico analyses of SARS-CoV-2 and its four structural proteins: spike, envelope, nucleocapsid and membrane glycoprotein (M). He found that the M protein is homologous to the sugar transport protein SemiSWEET.

 

“Sugar transporters are essential for the maintenance of blood glucose levels in animals and in bacterial nutrition,” said Dr. Thomas. “Our finding may shed light on the clinical observation that COVID-19 patients with diabetes have a three-fold higher mortality rate than patients without diabetes, and that patients without diabetes may get the disorder after being infected. Diabetes may create a physiological environment that favors proliferation of this virus whose most abundant structural protein, the M protein, resembles a sugar transporter.”

 

The sugar transporters on the viral envelope, he added, may be aiding in rapid proliferation of the virus.

 

Dr. Thomas also noted that, to his knowledge, this is the first report of the presence of a sugar transporter-like structure in a virus membrane. It’s unknown if the M protein fuses to a healthy cell membrane, but if it does, the protein may aid in increased sugar uptake into cells, thereby influencing the cell’s energy metabolism. “The presence of a SemiSWEET glucose transporter in the virus’s M protein could be serving as an efficient mechanism to induce rapid viral proliferation and immune evasion,” said Dr. Thomas.

 

His peer-reviewed manuscript, “The structure of the membrane protein of SARS-CoV-2 resembles the sugar transporter SemiSWEET,” was published in the journal Pathogens and Immunity. This research was funded by the Women’s Board of Lankenau Medical Center.

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Clinical trial results of IVL for peripheral artery calcium

William A. Gray, MD, System Chief, Division of Cardiovascular Diseases at Main Line Health, and Co-director, Lankenau Heart Institute, reported on the results of the DISRUPT PAD III randomized clinical trial during the virtual conference “DISRUPT PAD III: A New Wave of Calcium Data is Coming” on November 7.

 

Dr. Gray is the national principal investigator (PI) for this multi-site clinical trial, and Sarang Mangalmurti, MD, is the MLH PI. Researchers are testing the Shockwave Medical Peripheral Lithoplasty System in combination with drug-coated balloon vs. standard balloon angioplasty in over 300 enrolled patients worldwide to treat moderate and severely calcified femoropopliteal arteries.

 

Among the trial’s key results that Dr. Gray presented during the virtual conference:

 

  • Intravascular lithotripsy (IVL) is superior to standard balloon angioplasty in treating severely calcified peripheral lesions, as demonstrated by the greater ability to achieve a residual stenosis <30% (the threshold for the definition of success) but with much less severe vascular dissections.

 

  • IVL achieved superior vessel preparation with lower pressure, fewer stents, and less need for post-dilatation than standard balloon angioplasty, with no safety outcome issues such as perforation and distal embolization.

 

  • The data confirm the consistent safety and effectiveness of IVL from previous studies that were done in multiple vessel beds.

 

A video featuring Dr. Gray, his slides and a summary of the study’s results are available from https://bit.ly/3loRTM8

For more on the DISRUPT PAD III trial ongoing at MLH, visit: https://www.mainlinehealth.org/research/clinical-trials/disrupt-pad-iii

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Events Message – Delay Until 2021

As our region and our local communities continue to adhere to social distancing measures to prevent the spread of COVID-19, Main Line Health has canceled all in person events of more than 10 people until at least July 1, 2021. This date is subject to change, pending a vaccine or change in the course of COVID within our community.

We will continue to use virtual solutions and platforms to engage our patients and community during this time. If your department is looking to host a virtual event, please fill out this event request form to ensure you have the appropriate IT support. Meanwhile, please encourage patients and our community to stay connected with us on social media and through our Well Ahead newsletter for the latest MLH news, happenings and virtual events to come.

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21st Century Cures Act: Weekly Update and Tip Sheets

Sent on behalf of Don Klingen, MD & John Potts, DO

 

Colleagues,

 

As of Monday morning, November 9th Main Line Health patients will now have access to provider notes, imaging and lab results via MyChart as part of the 21st Century Cures Act legislation. As you know, we have been preparing for this for several weeks and have made several resources available to assist with this change.

 

Included in today’s email are three additional resources:

 

  • Tip Sheet: Process to request/amend patient medical records
  • Tip Sheet: How to Withhold a Note or Result from MyChart
  • WATCH: An Epic provider workflow video demonstration: https://bit.ly/3mBQMZt

 

Additionally, the Medical Staff Town Hall that took place on Wednesday, October 28 included a presentation and Q&A session for the 21st Century Cures Act and its impact on providers. You can watch this portion of the Town Hall here: https://bit.ly/3mGYWzX.

 

You may have heard that, nationally, the mandated implementation date for this legislation has been delayed until April 2021. However, as much is still unknown about the future of COVID in our community and our hospitals, we are committed to moving forward with our implementation at Main Line Health. Sharing this information with our patients is an extension of our commitment to doing the right thing and giving patients the tools they need to manage their health.

 

We understand that you—and our patients—will continue to have questions about this moving forward. Over the next several weeks, we will continue with regular emails to our providers and provide updates in our biweekly Medical Staff Town Hall meetings. The 21st Century Cures Act Wellspring page remains up and available to you as a resource, as well.

 

Thank you for your partnership and cooperation as we adapt to this change across MLH, and please continue to reach out to your chairs or VPMA with any questions or concerns.

 

Sincerely,

 

Don Klingen, MD

Senior Vice President & Chief Medical Information Officer

 

John Potts, DO

Assistant Chief Medical Information Officer

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October LIMR Clinical Research Report

By Donna Loyle, communications manager, LIMR

 

Research studies with direct clinical implications for melanoma, COVID-19 and the cardiac condition Brugada syndrome were published in peer-reviewed journals by investigators at the Lankenau Institute for Medical Research (LIMR) in October.

 

Patient age is a factor in melanoma treatment

Researchers previously discerned that both angiogenesis and metastasis increase in older patients diagnosed with melanoma. Recent data analysis of a clinical trial showed older patients respond poorly to Avastin® (bevacizumab), while younger patients show improvement. In a related preclinical study to determine the mechanism for this, researchers determined that frizzled-related protein 2 is increased in the aged tumor microenvironment, therefore the patient’s age should be considered when determining appropriate treatment. LIMR investigator: Marie Webster, PhD, assistant professor. The manuscript: “sFRP2 Supersedes VEGF as an Age-related Driver of Angiogenesis in Melanoma, Affecting Response to Anti-VEGF Therapy in Older Patients” in Clinical Cancer Research.

 

Coronavirus’s M protein could be more dangerous than the spike protein

A LIMR researcher hypothesizes that the sugar transporter-like structure of the coronavirus’s membrane glycoprotein (M protein) may be involved in multiple functions that aid in the rapid proliferation, replication and immune evasion of the SARS-CoV-2 virus. In silico analyses show that the M protein is homologous to the sugar transport protein SemiSWEET. These findings may shed light on the clinical observation that COVID-19 patients with diabetes have a three-fold higher mortality rate than patients without diabetes, and that patients without diabetes may get the disorder after being infected. Diabetes may create a physiological environment that favors proliferation of the virus whose most abundant structural protein, the M protein, resembles a sugar transporter. LIMR investigator, Sunil Thomas, PhD, research assistant professor. The manuscript: “The Structure of the Membrane Protein of SARS-CoV-2 Resembles the Sugar Transporter SemiSWEET” in the journal Pathogens and Immunity

 

Cautious use of anti-migraine drugs in certain cardiac patients

Migraine co‐morbidity is common in patients with the cardiac disorders Brugada syndrome/drug-induced type 1 Brugada pattern, researchers found. They identified clinical variables necessitating cautious use of certain anti‐migraine drugs in these patients. LIMR investigator: Charles Antzelevitch, PhD, distinguished professor emeritus. The manuscript: “Recognition and Clinical Implications of High Prevalence of Migraine in Patients with Brugada Syndrome and Drug‐Induced Type 1 Brugada Pattern” in Journal of Cardiovascular Electrophysiology.

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