The California Cure Quantum Leaps
by Gwen Moran
The California Cure
Future of Medicine
New medical treatments don’t just appear through osmosis. They take blood, sweat, tears and, mostly, time. Throughout Southern California, daring research is tackling a slew of conditions, from cancer and heart disease to diabetes and HIV. Some remarkable new directions in treatment are closer than you think. Herewith, a sampling of some of the field's greatest hits—and what it means for you.
The Issue: Stroke
Study Name: Field Administration of Stroke Therapy—Magnesium (FAST-MAG) Trial
The Big Idea: Los Angeles County and 48 area hospitals are participating in this trial to determine if administering magnesium sulfate in the ambulance within two hours of symptom onset improves long-term outcomes for acute stroke patients.
What It Means: Magnesium sulfate is a neuroprotector and, in one previous study, its administration within three hours of symptom onset resulted in a nondisabled outcome in 45.9 percent of patients, versus 33.3 percent in placebo patients.
Estimated Completion Date: June 2011
Sponsor: National Institutes of Health; National Institute of Neurological Disorders and Stroke (NINDS); University of California, Los Angeles
The Issue: Heart Disease/Women
Study Name: Heart Disease of the Small Arteries in Women
The Big Idea: Women suffer disproportionately more often than men from coronary heart disease in the small vessels (arterioles). Because it is hard to diagnose—current testing is invasive and not performed routinely—delays in diagnosis may contribute to increased death rate. Using noninvasive imaging testing such as tonometry can detect abnormalities associated with the disease.
What It Means: More accurate, less invasive testing could lead to faster diagnoses and outcomes for the more than 9 million women who have coronary heart disease.
Estimated Completion Date: December 2012
Sponsor: Cedars-Sinai Medical Center
The Issue: Heart Disease/Stress Reduction
Study Name: The Effects of Traditional Acupuncture on Mechanisms of Coronary Heart Disease
The Big Idea: Researchers point to a large body of evidence that indicates stress can reduce blood flow to the heart and trigger heart attacks. Several studies suggest that acupuncture improves chest pain and tightness, improves blood pressure and contributes to better quality of life.
What It Means: Sudden and unexpected cardiac death kills more than 100,000 people each year. This study examines whether acupuncture, by relieving stress and regulating blood pressure, can be a factor in minimizing deaths from coronary heart disease.
Estimated Completion Date: August 2010
Sponsor: Cedars-Sinai Medical Center; National Center for Complementary and Alternative Medicine (NCCAM)
The Issue: Depression
Study Name: Omega-3 Fatty Acids for Treating Adults with Major Depression The Big Idea: Recently, research has indicated that an increase in polyunsaturated fats (PUFAs), such as omega-3 fatty acids, could help treat depression. This study compares the effects of two common types of omega-3 fatty acids, which are available in low dosages in some dietary supplements.
What It Means: While numerous therapies for depression exist, they may not be appropriate for various people. The study’s outcome may open the door to an inexpensive and safe alternative for the many people who suffer from the disease.
Expected Completion Date: July 2011
Sponsor: Cedars-Sinai Medical Center; National Institute of Mental Health
The Issue: Multiple Sclerosis
Study Name: A Combination Trial of Copaxone Plus Estriol in Relapsing Remitting Multiple Sclerosis (RRMS) (Estriol in MS)
The Big Idea: Multiple sclerosis (MS) symptoms decrease sharply in pregnant women. Several years ago, a team at UCLA discovered the cause: the female sex hormone, estriol, which is produced during pregnancy. In a pilot of this study, 10 nonpregnant women with MS were given estriol, yielding what the team called “pretty remarkable” results, including an 80 percent drop in inflammatory brain lesions, which are among the hallmarks of the disease.
What It Means: Delivering a two-pronged attack against MS, the drug potentially reduces the ability of immune cells to attack the brain while making the brain more resistant to damage if any of the immune cells do reach it.
Estimated Completion Date: July 2012
Sponsor: University of California, Los Angeles; National Institutes of Health
The Issue: Cancer/Diet
Study Name: Dietary Intervention in Women Who Have Been Treated for Stage I, Stage II or Stage III Breast Cancer: Women’s Healthy Eating and Living (WHEL)
The Big Idea: Dietary fats, fruits, vegetables and fiber may affect the risk of breast-cancer recurrence. This randomized clinical trial will determine the effectiveness of a diet low in fat and rich in vegetables, fruit and fiber in women who have been treated for Stage I, Stage II or Stage III breast cancer.
What It Means: It’s no mystery that eating fruits and vegetables is good for you—but now scientists will know if they can save cancer patients’ lives.
Estimated Completion Date: Ongoing
Sponsor: University of California, San Diego; National Cancer Institute
The Issue: Colorectal Cancer
Study Name: Ischemic Conditioning (Delay Phenomenon) in Colorectal Surgery
The Big Idea: A major complication after colorectal cancer surgery is improper healing of the anastomosis—the reconnection of the cancer-free intestine. Recently, however, a breakthrough in esophageal surgery has drastically decreased similar complications. Called Ischemic conditioning, the technique involves dividing the blood supply to the stomach and returning two to four days later to finish the resection.
What It Means: In esophageal surgery, this procedure has led to improved stricture rates and leak rates, as well as fewer deaths as a result of surgical complications.
Estimated Completion Date: December 2009
Sponsor: University of California, Irvine
The Issue: Cholesterol
Study Name: Cholesterol and Pharmacogenetic Study (CAP) Phase IV
The Big Idea: The overall objective of this study is to determine genetic influences on a certain type of statin treatment in reducing LDL cholesterol and to identify other markers of cardiovascular disease risk.
What It Means: Statin therapy for elevated cholesterol works well in some people and less so in others. This study allows doctors to make more effective and timely decisions about prescriptions, benefitting about 17 percent of the population that has high cholesterol.
Completion Date: October 2004
Sponsor: Children’s Hospital and Research Center, Oakland; University of California, Los Angeles; Cedars-Sinai Medical Center
Health Issue: HIV
Study Name: CCR5 Inhibitor Treatment Intensification on CD4+ T-Cell Recovery
The Big Idea: This study’s purpose is to prove that the drug Maraviroc may help HIV-infected people in two ways: First, by blocking HIV entry into CD4+ T-cells, preventing the disease from replicating in its usual fashion and, second, by possibly preventing T-cell self-destruction.
What It Means: By both blocking the disease from replicating and offering a measure of protection to hard-fighting T-cells, this treatment may offer greater stability of T-cell counts and, as a result, enhance the body’s ability to fight HIV.
Estimated Completion Date: March 2011
Sponsor: California Collaborative Treatment Group; University of California, Los Angeles; University of Southern California; Pfizer; California HIV/AIDS Research Program
Health Issue: Breast Health
Study Name: Measurements of Breast Tissue Optical Properties (LBS)
The Big Idea: The Beckman Laser Institute at the University of California, Irvine, has developed a simple hand-held diagnostic device that uses a technique called frequency-domain photon migration (FDPM), which provides information to help differentiate healthy breast tissue from diseased tissue.
What It Means: A noninvasive device can help provide doctors with additional information about changes in breast tissue, which can help in the quest for early breast-cancer detection.
Estimated Completion Date: July 2015
Sponsor: University of California, Irvine; Beckman Laser Institute, UCI; UCLA; UCSF
The Issue: Oral Health
Study Name: Optical Sensor for Photodynamic Detection of Oral Pathology
The Big Idea: The Beckman Institute has developed a diagnostic device that produces high-resolution, cross-sectional images and may eliminate the need for biopsy and histopathology in diagnosing oral cancers and other diseases of the mouth.
What It Means: This is another example of the quest to develop noninvasive technologies that benefit people by giving the medical community new tools for detecting, monitoring and screening oral pathologies earlier.
Estimated Completion Date: July 2012
Sponsor: UC, Irvine; Beckman Laser Institute, UC, Irvine; Otolaryngology Medical Clinic, UC, Irvine; General Clinical Research Center, UC, Irvine
The Issue: Sleep Apnea
Study Name: Brain Oxygenation and Hemodynamics During Sleep in Obstructive Sleep Apnea Sufferers (NIRS-OSAS)
The Big Idea: The OxiplexTS is an absolute near-infrared instrument that measures brain oxygenation in sleep medicine and is also used in the broader field of cardiovascular/cerebrovascular diagnostics. The device provides reliable oxygen-saturation readings in real time, allowing doctors to better identify patients at risk for cardiovascular disease, as well as those who have serious sleep disorders.
What It Means: Monitoring oxygen-saturation drops during sleep studies helps doctors determine if a patient has obstructive sleep apnea, which can increase risk for other issues such as high blood pressure, heart attack and stroke. By getting reliable oxygen-saturation readings, doctors can better judge the severity of a condition and prescribe proper treatment protocols.
Estimated Completion Date: June 2010
Sponsor: ISS, Inc.; University of California, Irvine
The Issue: Colon Health/Aortic Aneurysm (AAA) Repair
Study Name: Prevention of Colon Ischemia During Aortic Aneurysm (AAA) Repair
The Big Idea: A device developed by Spectros, called a T-Stat, has been approved by the FDA and is reported to work in AAA aneurysm surgery and stenting, allowing the surgeon take action quickly, while the condition is still treatable.
What It Means: Patients undergoing surgery on their aortas can have a complication called ischemia, a lack of blood flow, to their intestines and colon. Two out of three patients who have this problem die before leaving the hospital. If this study proves that the device can help surgeons act more quickly, this potentially deadly complication can be mitigated.
Estimated Completion Date: September 2009
Sponsor: Stanford University; University of California; Spectros Corp