BRIGHAM AND WOMEN’S HOSPITAL

In a first of its kind study, researchers from Brigham and Women’s Hospital (BWH) and the Harvard School of Public Health, examine new methods for compensating doctors and hospitals that encourage accountability for not only the cost of care but also for the quality of care they provide to their patients. Overall, researchers conclude that in order to be successful, health reform initiatives will need a multipronged approach and that both care providers and insurance companies are equally focused on delivering high quality care while simultaneously reducing costs. The researchers found that changes to both the payment systems and care delivery models need to happen in tandem in order to be effective. New models of care, such as Shared Savings Arrangements, accomplish this goal by allowing physicians and hospitals to share in any monetary savings that may be achieved from improvements to care processes. This strategy is a cornerstone of health care reform under President Obama’s administration and it is also being rapidly adopted by private insurance companies. Shared savings arrangements are used in a variety of new models of care delivery such as medical homes, alternative quality contracts, and accountable care organizations (ACOs). However, the authors found that important details of such payment models can vary widely. Learn more at http://bit.ly/P0UGYT.

NEWYORK-PRESBYTERIAN

Researchers have successfully developed and tested a new prostate cancer screening method that uses the combined power of a novel drug therapy and changes in PSA levels over time to identify men with a high PSA who are more likely to have aggressive prostate cancer despite negative biopsies. The new study by researchers at NewYork-Presbyterian Hospital/Weill Cornell Medical Center  shows that PSA can be a much more effective marker for prostate cancer when an additional drug therapy is used than it can as a stand-alone test, which is how it is currently used by physicians. “At a time when the value of PSA is being increasingly debated, we have shown that when used in a specific way, it can be of great value in identifying men with previously undetected prostate cancer,” says the study’s lead investigator, Dr. Steven A. Kaplan, the E. Darracott Vaughan Jr., Professor of Urology at Weill Cornell Medical College and director of the Iris Cantor Men’s Health Center at NewYork-Presbyterian/Weill Cornell. Learn more at http://bit.ly/OiSwC8.

MASSACHUSETTS GENERAL HOSPITAL

A phase I clinical trial has confirmed that use of a generic vaccine to raise levels of an immune system modulator can cause the death of autoimmune cells targeting the insulin-secreting cells of the pancreas and temporarily restore insulin secretion in human patients with type 1 diabetes. Results of the study – led by Denise Faustman, MD, PhD, director of the Massachusetts General Hospital (MGH) Immunobiology Laboratory – are being published and a larger Phase II trial is currently underway. Faustman’s team first reported in 2001 that inducing expression of tumor necrosis factor (TNF), previously shown to destroy insulin-autoreactive T cells, cured type 1 diabetes in mice by permitting pancreatic islets to regenerate. Since high doses of TNF are toxic to humans, the clinical trials use the bacillus Calmette-Guérin (BCG) vaccine, which safely elevates TNF levels. The Iacocca Family Foundation has been the primary supporter of this work. Learn more at http://bit.ly/OS60Gx.

CHRISTIANA CARE HEALTH SYSTEM

A research team at the Helen F. Graham Cancer Center at Christiana Care Health System and the Center for Translational Cancer Research performs a key role in a prestigious National Institutes of Health research project grant of $2.5 million to continue groundbreaking work into the creation of artificial salivary glands. “The purpose of our project is to relieve the debilitating lack of saliva in a patient who has undergone radiation treatments for throat cancer,” says Robert Witt, M.D., chief of the Multidisciplinary Head and Neck Oncology Clinic at the Helen F. Graham Cancer Center and the clinician/scientist principal investigator (PI) in the four-year initiative. “These patients have lost the ability to swallow properly and enjoy food and liquids. They suffer from a lack of taste and are prone to many dental problems.” Already, the team has discovered a laboratory technique to isolate salivary acinar cells in culture. Acinar cells are the basic building blocks of salivary glands and are responsible for water and enzyme production. Learn more at http://bit.ly/QCby4u.

BRIGHAM AND WOMEN’S HOSPITAL

Researchers from Brigham and Women’s Hospital are the first to discover that changes in monocytes (a type of white blood cell) are a biomarker for amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease. This finding also brings the medical community a step closer toward a new treatment for the debilitating neurological disease that affects approximately 30,000 Americans. In pre-clinical studies involving mice with an ALS gene mutation, the researchers saw that two months prior to ALS onset, monocytes in the spleen began exhibiting proinflammatory qualities. As disease onset loomed, there was an increase in cell-signaling molecules that directed monocytes to flood the spinal cord. Influx of these inflamed white blood cells was associated with nerve cell death in the spinal cord. When the researchers treated the mice with antibodies to modulate the inflammatory monocytes, they found that it led to fewer monocytes entering the spinal cord, diminished nerve cell loss and extended survival. After having observed these activities in mice, the BWH researchers, working with the Massachusetts General Hospital ALS Clinic and research team, found that there were similar monocytes in humans with ALS that also exhibited a disease-specific inflammatory signature. Learn more at http://bit.ly/QGzdH8.