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Sheba's Dr. Jacob Kuint and colleagues find that postpartum depression negatively affects infant development

Thu, 20 Aug 2009 12:07:28 PDT

Postpartum depression has long been known to compromise a mother's capacity to optimally care for her newborn. But just how maternal depression can negatively affect infant development and physiological regulation is the subject of a study to be published in the August 2009 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).

Feldman and colleagues at the Bar-Ilan University and Sheba Medical Center in Tel-Hashomer, Israel studied three infant outcomes - social engagement, fear regulation, and physiological stress reactivity, in a cohort of 100 mother-infant dyads at nine months postpartum. These three infant outcomes are considered foundations of social-emotional growth and are associated with the infant's ability to manage physiological stress and regulate negative emotions.

The researchers collected a large community cohort of 971 mothers who reported symptoms of depression and anxiety at 2 days postpartum and again at 6 months. Of these, a cohort of 100 mothers and infants were observed at 9 months and included three groups: Mothers who were depressed across the first nine months and were diagnosed as suffering a Major Depression Disorder at 9 months, mothers who reported high levels of anxiety across the first 9 months and were diagnosed with an Anxiety Disorder at 9 months, and control mothers who reported low anxiety and depressive symptoms across the first 9 months after childbirth. To remove the influence of other known risk factors such as teenage pregnancy or premature birth, which could independently contribute to maternal depression, the researchers only recruited women who were in stable relationships, were physically healthy, educated, and those who delivered a healthy full-term infant.

In the article titled, "Maternal Depression and Anxiety across the Postpartum Year and Infant Social Engagement, Fear Regulation, and Stress Reactivity," the authors reported that infants of depressed mothers scored the poorest on all outcome measures at 9 months: they showed the lowest levels of social engagement during interactions with their mothers, were unable to self-regulate during situations that introduced novelty, fussed and cried more often, and their physiological stress response showed both higher baseline levels and a more pronounced stress reactivity. Children of anxious mothers showed lower social engagement than children of control mothers but higher than children of depressed mothers. However, their physiological stress response was similar to children of depressed mothers.

The mother's sensitive behavior played an important role in shaping infant outcomes. Sensitive mothering was related to the infant's social engagement and protected against the effects of maternal depression on the development of the child's social skills. Maternal sensitivity also had a positive impact on the infant's physiological stress response and reduced the degree of physiological reactivity as measured by cortisol reactivity to stress.

Sensitive mothering is important in an infant's ability to develop social competence and further study of the effects of maternal depression on child development within the first year of life is warranted.

Feldman and colleagues stated, "By recruiting a large community sample, separating maternal depression from typically-occurring conditions, comparing cases of major depressive disorder to those of post-partum anxiety disorders, and assessing the chronicity of the mother's mood from birth, the findings may illuminate specific pathways leading from maternal depression to child outcomes across the first year of life. Furthermore, the unique associations found between maternal depression and each outcome underscore the need to consider maternal depression in the context of the child's global rearing environment and in relation to the attainment of specific developmental goals."

Source article:

"Maternal Depression and Anxiety across the Postpartum Year and Infant Social Engagement, Fear Regulation, and Stress Reactivity. " Feldman R, Granat A, Pariente C, Kanety H, Kuint J, Gilboa-Schechtman E.

The Journal of the American Academy of Child and Adolescent Psychiatry. 2009; 48:919-927.

[Dr. Jacob Kuint is a senior physician in Sheba's Buchman Women's and Maternity Hospital.]

The study findings by Drs. Feldman and colleagues were supported by the Israel Science Foundation (#1318/08), the US-Israel Bi-National Science Foundation (#2005-273), and the NARSAD Foundation (Independent Investigator Award, RF).

Article URL: http://www.medicalnewstoday.com/articles/161320.php

Sheba's Dr. Shai Izraeli discovers novel alternative to chemotherapy for children with leukemia

Wed, 29 Jul 2009 10:13:43 PDT

Each year, approximately 4,500 children in America are diagnosed with leukemia, according to the Leukemia and Lymphoma Society. A potentially deadly cancer of the blood, it is the most common cancer in children.

"Modern medicine can cure eight out of 10 cases of childhood leukemia, so parents can still be hopeful when they hear a diagnosis," says Dr. Shai Izraeli of Tel Aviv University's Sackler School of Medicine and the Sheba Medical Center at Tel Hashomer. "Our research gives hope and life to the 20% who might not make it as well as those who may experience a relapse."

The first researchers to discover a mutation of the JAK2 protein in patients with Down syndrome, the Tel Aviv University team suspected that this protein might also be linked to other disorders and diseases ― and they were right. Based on the successful results of this research a drug that is already in clinical trials for a blood disease common in adults may be relevant for acute childhood leukemia. If initial trials go well, the drug could fast-track through approvals and could be available for treating children with leukemia in only a few years.

The recent findings are based on Dr. Izraeli's original discovery of the JAK2 in Down syndrome, published recently in the prestigious medical journal The Lancet.

Finding a model in children with Down syndrome

According to Dr. Izraeli, a similar mutation of the JAK2 in Down syndrome and leukemia causes Polycythemia Vera, a disease common in adults that leads to the overproduction of blood. This discovery of a similar mutation in a subset of pediatric leukemia cases may provide a path to new life-saving medication options.

Dr. Izraeli first discovered JAK2 mutations in children who initially suffered from Down syndrome and subsequently developed leukemia (a child with Down syndrome is 20 to 30 times more likely to develop leukemia during childhood than a child without it). Dr. Izraeli was then inspired to screen for gene mutations that could result in increased proliferation of cells. In collaboration with the iBFM Study Group, a European childhood leukemia consortium, 90 cases of Down syndrome leukemia from all over Europe were studied. A JAK2 mutation was found in 20% of these cases.

The discovery represents a unique biological phenomenon. "This is perhaps the first example of two very similar ― but different ― mutations that apparently do the same thing in a cellular protein. But they're associated with two completely different disorders, one that causes polycythemia in adults and the other that causes leukemia in children," says Dr. Izraeli.

"Those children at the highest risk for leukemia may be treated with inhibitors of JAK2," he says. "And because of the existence of polycythemia in adults, there are already drugs to fight polycythemia entering into trials as we speak. We will know in just a few years what these drugs are capable of."

An alternative to chemotherapy

Dr. Izraeli says the discovery offers "potential hope" to children who suffer from leukemia. "JAK2 inhibitors are not based on chemotherapy. The first experiences with these treatments show very few side effects. All that researchers need to do is to expand these clinical trials to children and adults with high-risk leukemia ― and that can happen relatively quickly," says Dr. Izraeli.

Dr. Izraeli explains that typical chemotherapies for leukemia also have a high "toxicity cost." Children with leukemia are treated with 10 to 12 different chemotherapies over a period of two to three years. Some of them have long-term and irreversible damage, such as neurological, heart, bone problems and sterility. Researchers looking for viable alternatives may turn to Dr. Izraeli's research as a promising avenue for success.

Sarah Ferber of Sheba in Israel shows that potentially, patients with diabetes can be donors of their own therapeutic tissue

Mon, 13 Jul 2009 10:18:40 PDT

A ONE-OFF treatment for diabetes is a step closer thanks to a better understanding of how human liver cells can be transformed into something like the beta cells that produce insulin in a healthy pancreas.

The new insights have allowed Sarah Ferber of the Sheba Medical Center in Tel Hashomer, Israel, and colleagues to implant these cells into diabetic monkeys. The ultimate plan is to take liver cells from people with diabetes, reprogram the cells and reinject them. Because they are the patient's own, the cells should escape rejection by the immune system, sparing the individual a lifetime of daily insulin injections. "Potentially, patients can be donors of their own therapeutic tissue," says Ferber.

In 2000, her team discovered that the Pdx-1 gene is crucial for the creation of the pancreas in the embryo. They went on to infect adult human liver cells with a harmless virus engineered to carry Pdx-1. The virus didn't insert the gene into the cells' DNA, but the liver cells produced Pdx-1 protein, enabling diabetic mice to manufacture insulin after injections of the altered cells.

Now the team has found out more about how Pdx-1 operates, which should eventually help them design a human treatment. By repeating the experiment and analysing the changes in gene expression as liver cells are transformed, the team showed that the gene deactivates a range of genes relevant to the cell's function in the liver, as well as activating unexpressed genes vital for beta cell function. A knowledge of this dual ability, which probably arises from the role Pdx-1 plays in the embryo, where pancreas and liver tissue develop from the same family of cells, will be important in predicting how the cells might act if they are implanted into people. Ferber is presenting the work on 9 July at an International Society for Stem Cell Research (ISSCR) meeting in Barcelona, Spain.

She also reports that the technique works best in liver cells that are in the process of multiplying. During cell division, chromosomes are exposed, which might make it easier for the Pdx-1 protein to alter their gene expression. Ferber has identified liver regions where dividing cells are more common, which should make reprogramming liver cells more efficient. The transformed cells do not seem to provoke the immune system.

Ferber's team is also looking for the best place for a transplant. Leading candidates, she says, are the liver and the omentum, the sac lining the abdomen.

Jonathan Slack of the University of Minnesota, Minneapolis, who has previously used Pdx-1 to turn frog liver tissue into beta cells, doubts whether Ferber's liver cells are completely changed into beta cells. "Rather, it may be the induction of some beta cell genes in liver cells," he suggests. But he points out that this could still have therapeutic value.

Last year, Doug Melton of Harvard University and colleagues reported that they had transformed a different type of specialist pancreatic cell into beta cells. Ferber says liver cells may be more practical because they are more abundant, easier to replace and more accessible.

Meanwhile, Harry Heimberg of the Vrije University of Brussels in Belgium reports at the ISSCR meeting that he is close to identifying elusive pancreatic stem cells in adult mice. If the same cells exist in humans, they might be activated to regenerate beta cells.

http://www.newscientist.com/article/mg20327164.300-liver-cells-could-be-reprogrammed-as-insulin-factories.html

In pursuit of a happiness gene

Tue, 23 Jun 2009 09:25:45 PDT

Physorg.com Magazine, June 23, 2009

The pursuit of happiness characterizes the human condition. But for those suffering from stress, money trouble or chronic illness, a positive outlook on life can be difficult to find. Now, Tel Aviv University and Sheba Medical Center researchers say we should look to our genes.

Prof. Yoram Barak of Tel Aviv University's Sackler School of Medicine is engaged in the "attempt to find the happiness gene, the genetic component of happiness," which may be 50% responsible for an optimistic outlook. The research is a collaboration between Tel Aviv University and its affiliated research hospital, the Chaim Sheba Medical Centre at Tel Hashomer, which is the largest hospital in Israel.

Initial research findings have made Prof. Barak optimistic about their ability to succeed. "If something is genetic, it should have a large concordance among twins," he says. "And the twin studies we are looking at show that 50% of happiness is genetically determined." Prof. Barak is now working with Prof. Anat Achiron of the Sheba Medical Center to identify the specific genes that are associated with happiness.

Dr. Barak's current findings in the hunt for the happiness gene were presented at The World Congress on Treatment and Research in Multiple Sclerosis in Montreal, Canada in 2008, and most recently detailed in the journal Expert Review of Neurotherapeutics, April 2009.

Positive psychology

We may be a long way off from being able to genetically engineer happiness, Prof. Barak says, but we can start by thinking positively. Much of his work is based on positive psychology, which is the "fastest and largest growing area of psychology in the United States ― and in the world," he says.

For the 50% of happiness that is not genetic, Prof. Barak is working on a program of positive psychology workshops, with exercises he recently tested in a one-day workshop for 120 participants at the Multiple Sclerosis Society of Israel. Early results indicate that the workshops improved the happiness level of participants by as much as 30%.

This work is dedicated to finding "practical and intervention oriented research and the application of psychology into medicine," says Prof. Barak. His research into the physical affects of mental state on patients with neurological diseases is an attempt to bridge the gap between psychology and clinical medicine.

Feeling good in mind and body

Prof. Barak says that the psychological benefits of the program were accompanied by physical benefits as well. "We were able to raise levels of happiness in these patients so they were just about equal to those of healthy subjects," he says. "If we can apply positive psychology, we can better their adherence to their treatment regime. And we have been able to show that there is a stabilization of the neurological disability as well."

For healthy individuals, Prof. Barak says that his happiness exercises can enrich their lives, too. Meanwhile, his search for the happiness gene goes on.

Read this and other stories about Sheba at www.sheba.co.il

http://www.physorg.com/news164976767.html

Babies given transfusions in the womb do well

Thu, 30 Apr 2009 14:18:11 PDT

NEW YORK (Reuters Health) - Babies with severe anemia who are given blood transfusions while still in the womb do not show signs of short-term or long-term developmental abnormalities, new research indicates.

Dr. B. Weisz, from The Chaim Sheba Medical Center, Tel Hashomer, Israel, and colleagues looked at outcomes of 54 anemic fetuses that received between one and seven blood transfusions before they were born.

According to the report in the Archives of Disease in Childhood: Fetal and Neonatal Edition, 33 fetuses had severe anemia and 21 had mild to moderate anemia, based on standard criteria.

The outcomes of the two groups during the newborn period were comparable. Likewise, at follow-up later in childhood, no differences were noted between the groups in motor development score, the percentage of abnormal mental development, and the percentage of children needing supportive therapy.

"It is reasonable to conclude that, although some studies have found cerebral lesions and poor outcome in extremely anemic fetuses, fetuses with severe ... anemia receiving optimal treatment are not at increased risk of neurodevelopmental abnormalities," the authors conclude.

SOURCE: Archives of Disease in Childhood: Fetal and Neonatal Edition, May 2009.

http://www.reuters.com/article/healthNews/idUSTRE53T76920090430

Sheba Doctor Publishes Inflammatory Breast Cancer Drug Advance

Thu, 30 Apr 2009 09:28:15 PDT

Lapatinib Shows Activity Against Inflammatory Breast Cancer

NEW YORK (Reuters Health) - New research suggests that lapatinib, an inhibitor of epidermal growth factor receptor tyrosine kinases, may be an effective treatment for HER2-overexpressing relapsed or refractory inflammatory breast cancer.

Although none of the patients experienced a complete response to the drug, 39% had a partial response, defined as a 50% drop in the extent of skin disease. Side effects, however, were fairly common, including a few fatal complications that may have been drug related.

Inflammatory breast cancer is known to be a highly aggressive malignancy and for patients with resistance to first-line chemotherapy, treatment options are limited, according to the report in the April 27th online issue of The Lancet Oncology.

In an earlier study of 30 patients, treatment with lapatinib produced a 50% response rate, lead author Dr. Bella Kaufman, from The Chaim Sheba Medical Center in Tel Hashomer, Israel, and colleagues note. To better gauge the effectiveness of the drug, the cohort was expanded to 126 patients.

Subjects in the phase II, open-label study were treated with lapatinib 1500 mg once daily. The skin disease response was assessed every 4 weeks and the response in sites of locally advanced or metastatic disease was evaluated every 8 weeks using the response evaluation in solid tumors (RECIST) criteria.

The median progression-free survival and duration of response were 14.6 and 20.9 weeks, respectively. Prior treatment with trastuzumab did not affect the likelihood of a lapatinib response.

Ninety-two percent of patients had at least one adverse event during treatment. Nearly one third of patients had a serious event, most often dyspnea and pleural effusion. Five patients died from adverse events that may have been drug related.

"Lapatinib monotherapy," the authors conclude, "is potentially clinically effective in heavily pretreated patients with inflammatory breast cancer with HER2+ tumors. The objective response rate noted in these treatment-refractory patients coupled with the median duration of response and median overall survival supports a role for lapatinib in these patients."

Sheba's Prof. Mordechai Shani to be Awarded Israel's Top Award: "The Israel Prize" for Lifetime Achievement

Tue, 07 Apr 2009 09:26:05 PDT

"Shani: The guiding light and father figure of Israel's health system"

The Sheba Medical Center is delighted to congratulate Prof. Mordechai Shani on the State of Israel's decision to award him with the prestigious Israel Prize for "Lifetime Achievement." The decision was announced this week by the Minister of Education, and will be awarded by the President of the State of Israel on Israel Independence Day (Yom Haatzmaut), April 29, 2009.

The Israel Prize is the highest, most distinguished award given by the state, granted annually in a range of fields from music to science. "Lifetime Achievement Awards" are rare and especially coveted.

The Israel Prize committee for 2009 said that it was awarding Prof. Shani "for a lifetime of exemplary public service, and for being the guiding light and father figure for medicine and the health system of Israel."

"Prof. Shani was central to the establishment and development of the Sheba Medical Center; the reorganization of Israel's psychiatric services; the founding of the school for health policy at Tel Aviv University; the drafting and passage of Israel's national health insurance policy and legislation; and the founding of many medical research institutes and scientific foundations (that have produced hundreds of scientific studies); and the mentoring of generations of doctors at Sheba."

"In all these capacities, and through his tenures as director general of the Israel Ministry of Health, Prof. Shani had an enormous impact on the health and welfare sectors in Israel, and specifically on the care for Israel's weakest strata and most vulnerable populations, in Israel's peripheral areas and all across the country. He is an enormously impressive and accomplished man by any international standard; the natural and undisputed leader of Israel's health system. Nobody has had a greater influence than him," concluded the prize committee in its formal award citation.

Professor Mordechai Shani, was director general of the Sheba Medical Center at Tel Hashomer for 33 years; served two terms as director general of the Ministry of Health; was the architect of the 1994 reform of Israel’s health system; was a key player in the creation of the landmark Patient's Bill of Rights; was co-founder of the Alut Israel Association for Autism; founded Israel's "National Institutes of Health", known as the Gertner Institute for Health Policy and Epidemiology, at Sheba; was chairman of the all-powerful Pharmaceuticals Approval Council in the Ministry of Health; and founded the Ziering National Center for Newborn Screening. Today, he heads the Sheba/Tel Hashomer Research Foundation and the TAU School for Health Policy, among many other activities. The Israel Prize committee's formal review of Prof. Shani's career accomplishments (in Hebrew) runs five pages long!

Commenting on the award, Sheba CEO Prof. Zeev Rotstein (who succeeded Prof. Shani as director of the hospital), said that "nobody is more deserving of this exalted award than Prof. Shani. Everybody at Sheba is extraordinarily happy for Prof. Shani, and proud to be associated with him. It is a great honor for Sheba too, which continues to be the leading, most comprehensive, and most advanced medical center in Israel."

Prof. Shani will be attending the Friends of Sheba Medical Center Opera Benefit & Reception on Sunday, April 26 at the Dorothy Chandler Pavilion.

The Last Soldier Goes Home

Tue, 31 Mar 2009 09:20:07 PDT

Dror Kendelshein, severely injured in the summer 2006 war with Hezbollah in Lebanon, was released today from the Sheba Medical Center at Tel Hashomer

Dror Kendelshein, severely injured in the Bint Jbel battle with Hezbollah during the Second Lebanon War, was released today from the Sheba Medical Center at Tel Hashomer after 32 months of treatment. His friends, family and doctors celebrated the occasion together in the Sheba Rehabilitation Hospital lobby, with many tears of joy.

Dror was the last IDF soldier still hospitalized with injuries stemming from the 2006 war. He was unconscious for seven months, had severe memory loss for another six months, and underwent a series of difficult and very painful operations; followed by lengthy rehabilitation in Sheba's new head and brain trauma rehabilitation department, headed by Dr. Evgenia Agranov.

"This was the most difficult period of my life. I had to focus on survival. I thank my parents so much for standing by me; I adore them," said Dror at the small party organized on his behalf. "I can't thank Dr. Agranov and her staff at Sheba enough," said Dror's father, Itzik. "They are most devoted and professional people I have ever met."

"Beyond a sense of accomplishment that we all feel in seeing you rehabilitated, I want to say that we simply love you Dror, very much. You can see here today how we all feel for you," concluded Dr. Agranov.

For the Hebrew original of this article see http://www.ynet.co.il/articles/0,7340,L-3694578,00.html

Israel's first center for child abuse victims opens at Sheba Medical Center

Mon, 16 Mar 2009 10:28:13 PDT

Israel's first all-encompassing center for child and teen victims of sexual and physical abuse will open Tuesday as a separate department at Sheba Medical Center at Tel Hashomer.

Based on the successful US model, where currently 600 such centers are in operation, Beit Lynn will provide abuse victims between the ages of three and 18 with a wide range of services and therapy, including social welfare and legal services.

Its creation is based on a law passed last year, which calls for six more such centers to be set up.

"This is the first center of its kind to be established in Israel, and bringing together medical staff with other responders will provide the capacity to give treatment quickly and effectively in the most traumatic of cases," said Prof. Ze'ev Rotstein, Sheba Medical Center's director-general.

Funded by the Charles and Lynn Schusterman Family Foundation, together with the Ministry of Welfare and Social Services, Sheba Medical Center, NGO Ashalim, the Israel Police Force and contributions from the ministries of health, justice and education, the new center aims to streamline the initial process rape victims must undergo, whether their attacker is a family member or a stranger.

In the past, victims were forced to visit each office independently, usually being carted around by their parents from the hospital to the police station and on to social workers and lawyers.

The new center will bring all these elements together under one roof, with all first responders sharing information and easing the trauma for the victim.

A pilot center run along similar lines has been operating in Jerusalem for the past several years and was also established by the Schusterman Foundation. It is not based in a hospital, however.

According to the latest information from the Ministry of Welfare and Social Services, there are some 40,000 cases of child abuse reported each year, with child welfare officers following up on roughly one-fourth of those reports.

Last year, child welfare officers investigated 8,716 cases of child abuse, a rise of 12 percent over the previous year.

"This is a very welcomed and essential initiative," Minister of Welfare and Social Services Isaac Herzog said in a statement. "It will provide Israel with a breakthrough in the treatment of children and youth who have been abused physically, sexually or emotionally."

"The new center will allow thousands of children who have gone through a terrible trauma to receive the necessary treatment in an appropriate and holistic manner, all under one roof," he added.

Beit Lynn is expected to treat more than 700 children and teens a year from the area surrounding the hospital.

This article can also be read at http://www.jpost.com/servlet/Satellite?cid=1237114843849&pagename=JPArticle%2FShowFull

Innovative cardiac valve prosthesis developed at Sheba

Thu, 19 Feb 2009 10:29:38 PST

Prof. Ehud Schwammental, the inventor behind Ventor Technology's innovative cardiac valve prosthesis that has attracted the attention of medical instruments giant Medtronics, will have to pay the Sheba Medical Center 30% of the profit he stands to make on the sale of the startup, as may his brother Daniel, who is also a shareholder in the company. With Medtronics' bid for the four-year-old company standing at $325 million, the hospital could come into some $20 million. Sheba's claim to part of the profit is based on the fact that Schwammental, who heads the cardiac rehabilitation institute at the hospital, developed the valve while in the state hospital's employ. The agreement was reached following negotiations with Finance Ministry Accountant General Shuki Oren and the hospital's director, Prof. Zeev Rotstein.

Gaza War Update II from Sheba Medical Center

Tue, 20 Jan 2009 15:20:04 PST

IDF Chief-of-Staff Lt. Gen. Gabi Ashkenazi at Sheba: "I Thank Sheba for its Remarkable and Irreplaceable Work on Behalf of the Nation and its Soldiers!"

Sunday, January 18, 2009….

As Israel's unilaterally-declared ceasefire came into effect today, Israel's top soldier, Lieutenant General Gabi Ashkenazi, left his battle command post for the first time in three weeks, and hurried to the Sheba Medical Center at Tel Hashomer to visit soldiers wounded in the fighting.

IDF Chief-of-Staff Lt. Gen. Gabi Ashkenazi The Israel Defense Forces (IDF) Chief-of-Staff visited today with 25 soldiers and their families who are hospitalized at Sheba, accompanied by hospital CEO Prof. Zeev Rotstein. Rotstein has practically slept in the hospital throughout the 23-day war, and is personally known by each family that has a wounded soldier in treatment.

"On behalf of the IDF, I want to thank you, the doctors and nurses of the Sheba Medical Center, for your remarkable and irreplaceable work for the nation and its wounded soldiers," said Ashkenazi as he addressed a group of senior medical personnel in the trauma unit. "You have treated all of us with overwhelming compassion and professionalism – wounded civilians, regular army conscripts, and reservists," he said.

Sheba is currently treating 25 wounded IDF combat soldiers, including one soldier in critical condition, two in serious condition (who are still undergoing a series of complicated operations), and others with lifelong injuries including paralysis. Two elite Golani and Paratrooper commando battalion commanders were treated and released today.

Among the wounded at Sheba are Dr. Rotem Kuint, a medical officer whose father, Prof. Yaacov Kuint, heads neonatology at Sheba. Rotem Qunit was injured in battle during the 2006 Lebanon war and again now in the Gaza war; and he conducted heroic battlefield surgery several days ago, saving the life of Second Lieutenant Aharon Karov, who entered battle mere hours after his wedding. A Druze soldier, Val Jenam of the Golani brigade (who was wounded after an IDF tank accidentally fired on infantry troops), took shrapnel in his brain and was stabilized in a complicated 12-hour operation at Sheba, but has not regained consciousness since the injury.

"Sheba at war is a unified, mobilized institution that seeks to wrap our brave fighters returning from the battlefield in a powerful, professional, healing and loving embrace," said hospital CEO Prof. Zeev Rotstein. "All our most advanced medical resources are brought to bear, seeking to repair Israel's heroic warriors and return them healthy to their families. We know that this conflict may not yet be over; so we remain alert and ready for any eventuality."

Rotstein noted that, at the same time, Sheba is caring for wounded from the civilian towns of southern Israel hit by Hamas missiles; for Palestinians injured by Hamas' own missile fire and by IDF operations; for Palestinian children ill with cancer and heart ailments, including many children from Gaza; and for the full complement of sick and elderly who regularly avail themselves of Sheba Medical Center care. This includes Dr. Izzeldin Abuelaish, a Palestinian doctor from Gaza who works part-time at Sheba, who tragically lost three of his daughters to IDF fire on Friday. "Despite the delicate nature of our mission, especially during wartime, we treat all our patients with compassion and a complete heart," Rotstein said. 'This is what our Jewish and Israeli conscience dictates."

Medical Update on the Gaza War

Wed, 14 Jan 2009 15:18:24 PST

As the Gaza War continues, Sheba Medical Center is helping to treat the casualties.

January 14, 2009

Here is an update:

* In the first two days of conflict, seven military helicopters had already brought 15 IDF soldiers by airlift for treatment at Sheba. This includes the Golani battalion commander who was moderately injured in last week's unfortunate friendly-fire incident, and several others from the same battle. We have one soldier who is in very, very, serious and critical condition.

* Foreign Minister Tzipi Livni visited the wounded here last week.

* The Rehabilitation Hospital is gearing up in the expectation that we will begin to receive many soldiers for long-term healing from all the other hospitals in the country.

* IDF troops also evacuated a seven-year-old Palestinian child who was hit by the Palestinians' own kassam missile fire, and he is in the Safra Children's Hospital at Sheba for treatment. (This is highly unusual, because the Hamas is refusing to allow any Palestinian casualties out to Israeli hospitals. In this specific case, the child was brought out by IDF forces in the field.)

* Here is an interesting twist: For some time, we have had six senior Fatah officials and officers in rehabilitation. These men were senior Palestinian Authority figures in the Gaza Strip before the Hamas coup 18 months ago. They had their legs broken and limbs chopped off by the Hamas as part of the internal bloodletting that went on there. So, IDF soldiers battling the Hamas, and Fatah victims of the Hamas, will be doing rehab side by side at Sheba.

Uncomfortable, unique, and quintessentially Sheba.

Hoping for calmer times.

Israeli general: Never knew I was evacuating my wounded soldier son from Gaza

Haaretz 13:40 06/01/2009 - http://www.haaretz.com/hasen/spages/1053157.html

By Yuval Goren, Noa Kosharek and Yanir Yagna Brig. Gen. (res.)

Zvi Fogel commanded the artillery strike that provided cover for the evacuation of six IDF soldiers wounded in the Gaza Strip on Monday.

It was only after the six troops were successfully transferred to Tel Hashomer hospital in central Israel that he discovered he had helped to rescue his son.

"They told me it was his battalion, but it never crossed my mind that my son was among the wounded," he said. "A little before eight my other son phoned me and said 'Dad, we're going to Tel Hashomer.'"

After a brief hour-long visit with his wounded son, Fogel returned to Southern Command headquarters in Be'er Sheva.

The family and friends of the wounded flocked to the hospital.

"They phoned me a little before eight to tell me that my husband was lightly wounded and was being transferred to Tel Hashomer. I caught a glimpse of him before he was taken into the operating room? His face was a little burnt and I could see the shrapnel wounds," said the wife of one of the wounded soldiers.

An officer who was lightly wounded in the incident returned to his soldiers in the field right after he was treated.

The father of a wounded soldier, tears in his eyes, stood in the hallway and comforted his daughter. "Thank God he's only lightly wounded," he said. "He's covered in shrapnel. We spoke to him; he can communicate. But he hasn't told us what happened over there."

Collected stories from around the world...

Mon, 13 Oct 2008 20:16:35 PDT

The Associated Press

10/10/2008
By ARON HELLER, Associated Press Writer

Read Full Article

Israel grants rare entry to cancer-stricken Iranian boy
Haaretz and the Associated Press

A 12-year-old cancer-stricken Iranian boy arrived at an Israeli hospital on Friday for emergency treatment on his brain tumor.

The boy - who was identified only as Roy, to protect his privacy - was wheeled on a stretcher into the Sheba Medical Center near Tel Aviv, after treatments in Iran and Turkey failed. His face was puffy, apparently due to the drugs administered to ease his pain. Israel granted the child a special permit to enter the country and he arrived at Ben Gurion Airport on Friday. The rare arrangement was mediated by an Israeli businessman of Iranian origin. The boy was accompanied to the hospital by his father and veiled mother, who were also granted special entry permits into Israel.

Iran and Israel are bitter enemies and have no formal relations. Iran's president has denied the Holocaust and repeatedly called for Israel to be wiped off the map. Sheba CEO Zeev Rotstein said it wasn't the first time Israeli doctors have treated children from adversarial states. "We hope that with the love and affection we give these kids we are paving the way for at least some understanding between people," he said. "We can't change the politics. We are not politicians. We do this because we feel it is our job."

Israel is home to world-class hospitals and state-of-the-art medical technology. Dr. Amos Toren, head of Sheba's Pediatric Hemato-Oncology Department, said his initial diagnosis was that the boy's year- old growth was the most aggressive tumor that exists among brain tumors. "He is conscious and he can smile but it is hard," he said. "We will give him the most modern treatment possible and maybe we will be able to help him."

Rotstein said the child had been operated on before and may need another procedure in Israel. "There are very limited things you can do," he said. "But if this kid has any chance, it is here." He said the hospital kept the identities of patients from countries hostile to Israel secret, so that they would not face danger upon their return home. Iran and several other Middle East countries oppose any type of normalization with Israel.

Rotstein said he hoped treatments, like those of Roy, would help break down some of those barriers. "As far as we are concerned, we are not involved in politics," he said. "He is from a country that doesn't really like our existence here, but I think part of our job is to prove to countries like Iran that we are here to help the regular people."

Reuters and The Washington Post

Iranian boy gets cancer treatment in Israel
Friday, October 10, 2008

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TEL HASHOMER, Israel: A 13-year-old cancer victim from Iran came to Israel for treatment on Friday, the hospital which received him said, attracting media interest in a country used to decades of hostility with Tehran.

The boy, who has an advanced brain tumour, had travelled from Turkey with his parents after undergoing surgery as well as chemotherapy and radiotherapy in Iran that failed to cure him, Chaim Sheba Medical Centre director Zeev Rotstein said. Turkish doctors who examined the boy advised his family to seek help at Sheba, which has an international reputation and experience in treating patients from countries that have no diplomatic ties with Israel, Rotstein told Reuters.

"He has been suffering from the tumour for more than a year," Rotstein said. "We are doing our best, in the knowledge that his chances are not very good." Sheba declined to give the boy's name, citing concern that his family could face legal problems when they return to Iran. The boy and his parents received permission to enter the Jewish state from the Israeli embassy in Ankara. Iran is locked in difficult talks with Western powers over its nuclear programme and has stirred war fears with fiercely anti-Israel rhetoric. Israel, assumed to have the region's only atomic arsenal, has hinted it could attack its foe preemptively.

Los Angeles Times

World Briefing
Iranian boy seeks cancer treatment

A 13-year-old cancer patient from Iran has come to Israel for treatment, attracting widespread interest in a country used to decades of hostility with Tehran.

The boy, who has an advanced brain tumor, traveled from Turkey with his parents after undergoing unsuccessful surgery, chemotherapy and radiation therapy in Iran, said Zeev Rotstein, director of the Chaim Sheba Medical Center. Turkish doctors who examined the boy suggested he seek help at Sheba, Rotstein said.

"We are doing our best, in the knowledge that his chances are not very good," he said. Sheba declined to give the boy's name, citing concern that his family could face legal problems when they return to Iran.

The Telegraph

Iranian boy is treated for brain tumour at Israeli hospital An Iranian teenager suffering from a serious brain tumour has been brought to an Israeli hospital for treatment, in a rare case which goes against the grain of regional politics.
By Carolynne Wheeler in Jerusalem, Telegraph.co.uk Oct. 11, 2008

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The 13-year-old, who has been identified only as Roy to prevent him and his family facing persecution on their eventual return to Iran, arrived in Chaim Sheba hospital in Tel Hashomer, near Tel Aviv, on Friday, after a journey assisted by an Israeli businessman of Iranian origin.

When surgery, chemotherapy and radiation at medical facilities in Iran failed to help their son, the boy's parents took him to Turkey, where doctors advised them to seek treatment at Sheba. The hospital has a highly regarded cancer treatment programme. The Israeli embassy in Ankara issued permits for them to enter the country. "As far as we are concerned, we are not involved in politics," the chief executive officer of Sheba hospital, Zeev Rotstein, said.

"He is from a country that doesn't really like our existence here, but I think part of our job is to prove to countries like Iran that we are here to help the regular people." Various charities have brought children from other countries, including those without diplomatic relations with Israel, here for treatment before; at least 35 Iraqi children have received heart surgery in Israel through a programme based in Amman, Jordan. But the treatment of the Iranian boy is believed to be a first. Israel and Iran are sworn enemies; the Iranian president, Mahmoud Ahmadinejad, has threatened to wipe the Jewish state off the map while Israel is widely believed to be preparing a pre-emptive military strike to prevent Iran's nuclear programme from achieving an atomic weapon.

The outlook for the boy is not good, however. His tumour is aggressive and while he is still conscious and able to smile, doctors are uncertain how much more they can do to treat him. "He has been suffering from the tumour for more than a year," Prof. Rotstein said. "We are doing our best, in the knowledge that his chances are not very good."

YnetNews

Iranian cancer patient arrives in Israel

Sixteen-year-old Iranian boy suffering from highly aggressive brain cancer given special permission to enter Israel along with parents; doctors in Sheba Medical Center optimistic about giving him chance

by Meital Yasur-Beit Or, Ynet 10.10.08

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A 16-year old Iranian boy suffering from a cancerous growth in his brain was transported to Israel on Friday in a move coordinated in part by the Shin Bet, landing in Ben Gurion International Airport along with his parents. He was immediately transferred to Sheba Medical Center in Tel Hashomer to begin treatment.

The youth has developed a highly aggressive growth termed GBM, and was treated in both Tehran and Turkey, to no avail. He arrived on a flight from Turkey after his doctors there recommended Israel as a last resort. Dr. Amos Toren, head of Sheba's Pediatric Hemato-Oncology Department, said his initial diagnosis was that the boy's year- old growth was "The most aggressive tumor that exists among brain tumors."

"He is conscious and he can smile but it is hard," he said. "We will give him the most modern treatment possible and maybe we will be able to help him." Sheba Medical Center is reputedly one of the most advanced hospitals in the Middle East, within this particular field of medical technology. This reputation is what eventually brought the boy to Israel.

Sheba CEO Zeev Rotstein was therefore optimistic. "We have the most advanced resources to give this boy a chance," he said. "It's still early to be pessimistic." He added that Sheba had acquired a certain history in treating children from various foreign countries. "We hope that with the love and affection we give these kids we are paving the way for at least some understanding between people," he said. "We can't change the politics. We are not politicians. We do this because we feel it is our job.

"As far as we are concerned, we are not involved in politics. He is from a country that doesn't really like our existence here, but I think part of our job is to prove to countries like Iran that we are here to help the regular people."

YnetNews

Iranian patient's father thanks Jews

(Video) Tehran boy flown to Israel for emergency surgery said to be in serious condition, as doctors' fight for his life. Father grateful for hospitality, says 'It's important that you know the majority of Iranians don't hate Israel'

by Noam Barkan, Ynet 12.10.08

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Watch the video at http://www.ynetnews.com/articles/0,7340,L-3607798,00.html

VIDEO - "I can't thank the Jewish people enough for all the love and support we've been getting," said the father of the Iranian boy flown to Israel for emergency brain surgery over the weekend.

The 13-year-old arrived in Israel from Turkey on Friday, after Interior Minister Meir Sheetrit and the Shin Bet gave an ex-gratia authorization to the move, due to his grave medical condition. A special authorization was required as Iranian citizens, who are essentially residents of an enemy state, are forbidden from entering Israel.

The boy's father and grandmother stayed by his side at the Safra Children's Hospital, a facility adjacent to the Chaim Sheba Medical Center at Tel Hashomer, throughout the weekend. "I ask you, all of you, to pray for my son. A father's love for his son goes beyond borderlines and religion... It is important to me that you know that the majority of Iranians don't hate Israel. We are all people and we all have the same feelings.

"All I want now is to hear my son's laughter again. I'm sure any parent in my condition would do anything they can to save their child. My wife and my baby daughter are waiting for us back in Tehran. We are all praying for the best," he added. The boy underwent an extensive battery of tests since arriving at the Safra Hospital. "The tests have shown that the disease has spread throughout his brain, the central nervous system and the spinal cord," Prof. Amos Toren, head of Hemato-Pediatric Oncology Unit, told Yedioth Ahronoth.

"His condition is too grave for us to operate on him, so we're trying aggressive chemotherapy, in hopes that it would help." Prof. Zeev Rothstein, chief administrator of the Sheba Medical Center, added that "the boy's chances are rather slim, but there are always surprises. It's too early to be pessimistic. We're not going to give up so easily."

Paralysed man walks again thanks to Robocop-style exoskeleton

Tue, 07 Oct 2008 11:07:55 PDT

A man who has been paralysed for the past 20 years is able to walk again thanks to a revolutionary electronic exoskeleton.

Radi Kaiof, 41, now walks down the street with a dim mechanical hum as the system moves his legs and propels him forwards. Radi Kaiof walks using an electronic exoskeleton. It is due to go on sale in 2010.

'I never dreamed I would walk again. After I was wounded, I forgot what it's like,' said Kaiof, who was injured while serving in the Israeli military in 1988. 'Only when standing up can I feel how tall I really am and speak to people eye to eye, not from below.'

The device will allow many wheel-chair bound people to stand. The device, called ReWalk, is the brainchild of engineer Amit Goffer, founder of Argo Medical Technologies, a small Israeli high-tech company.

Engineer Amit Goffer developed the Robocop-style exoskeleton. Something of a mix between the exoskeleton of a crustacean and the suit worn by Robocop, ReWalk helps paraplegics - people paralysed below the waist - to stand, walk and climb stairs.

Goffer himself was paralysed in an accident in 1997 but he cannot use his own invention because he does not have full function of his arms. The system, which requires crutches to help with balance, consists of motorized leg supports, body sensors and a back pack containing a computerized control box and rechargeable batteries. The user picks a setting with a remote control wrist band - stand, sit, walk, descend or climb - and then leans forward, activating the body sensors and setting the robotic legs in motion.

'It raises people out of their wheelchair and lets them stand up straight,' Goffer said. 'It's not just about health, it's also about dignity.' Kate Parkin, director of physical and occupational therapy at NYU Medical Centre, said it has the potential to improve a user's health in two ways. 'Physically, the body works differently when upright. You can challenge different muscles and allow full expansion of the lungs,' Parkin said. 'Psychologically, it lets people live at the upright level and make eye contact.' The ReWalk is now in clinical trials in Tel Aviv's Sheba Medical Centre. It is due to go on sale to the public in 2010 and will cost around £10,000.

Dogs may help lower children's blood pressure

Wed, 16 Apr 2008 16:26:44 PDT

Dogs, long known as man's best friend, may be more than just loyal companions: they may also have a positive impact on your children's health, according to new Israeli research.

The study shows that having a dog at home can help lower a child's blood pressure and mitigate some health problems.

Nearly 230 children from first through third grades at two elementary schools in Shoham were examined in the study carried out by researchers from Gertner Institute for Epidemiology, the children's ward at the Sheba Medical Center, Tel Hashomer, and the Hebrew University of Jerusalem, 85 of which own dogs.

"Our results were very significant," Dr. Michel Bailash, who led the study, told ISRAEL21c. "A normal blood pressure is around 120/80 millimeters of mercury. In our study, children without a dog had a blood pressure that was higher by nearly 4.5 mercury-millimeters. While not dangerous, this difference is very telling of the impact that dogs can have on children's blood pressure.

"Children are much less stressed when they have a dog to play or spend time with," continues Bailash, an epidemiologist at the veterinary services of the Israeli Agricultural Ministry. A dog may not be the most intellectually or socially stimulating companion, he adds, "but they also won't steal your toys like a brother or sister, or yell at you for not doing your homework like your mother or father."

Bailash also suggests that dogs help increase children's physical activity, which in turn helps regulate their blood pressure. "Children are more likely to exert themselves physically when they are with dogs: whether it's taking the dog to the park, or playing a game-instead of wasting away the day in front of a television, children are more physically active when there is a dog at home."

The importance of Bailash's research cannot be underestimated. High blood pressure is considered one of the leading causes of death and illness in the Western world, and can lead to serious heart disease and, in extreme cases, to fatal strokes. While few children between ages six and nine suffer from high blood pressure, past research shows that one third of the children who suffer from high blood pressure will continue to suffer from this problem as they mature, sometimes with serious ramifications. "My research offers an important and simple way to preemptively combat high blood pressure," Bailash admits.

The study itself was broken into two stages. In the first stage, the children's parents were asked (via a distributed questionnaire) whether the child has a dog at home, and if so, to describe the type of relationship the child has with the animal. (For example, questions included "how often does the child play with the dog" and "does the child help feed the dog?") Parents were also asked to detail their child's medical history and disclose any hereditary diseases in the family. Later, the children themselves underwent weight and height tests.

In the second stage, children's blood pressure was measured under a variety of conditions. First, children's blood pressure was tested in a control setting - "each child sat relaxing for five minutes and refrained from any kind of activity." Afterwards, children were tested in an atmosphere that would induce stress or pressure-in one case, children were asked to remember and read aloud a number during a blood pressure test.

Under all circumstances, Bailash and his fellow researchers concluded: "Children who take care of a dog, who help feed it and play with it-have lower blood pressure than those children who do not have a dog."

"There are thousands of dogs in Israel, and millions in the world," says Bailash. "They are one of the most popular pets in the world, a man's best friend, and any health benefits we can find will only help the medical community and dog owners all over the world."

War Between The Sexes Begins Before Twins' Birth, Sheba Researcher Says

Tue, 08 Apr 2008 10:49:16 PDT

ScienceDaily (Apr. 8, 2008) - The battle of the sexes may begin in the womb, researchers from Tel Aviv University and the Sheba Medical Center believe. And it may have troubling consequences - a male twin can compromise the health of his twin sister before she is born.

In a new study recently published in the journal Pediatrics, the researchers analyzed the incidence of complications, such as respiratory distress syndrome, found in pre-term twins. When born premature, girls who share the womb with a boy twin lost the respiratory health advantage normally seen in premature girl infants, they discovered.

"The male disadvantage, the study suggests, seems to be transferred from the boy to the girl in utero," says Prof. Brian Reichman, a lecturer in pediatrics at Tel Aviv University's Sackler School of Medicine and a pediatrician at the Sheba Medical Center.

Girl Twins Lose Their Advantage

Compared to premature twin boys, premature twin girls had a 60 percent advantage. The premature twin girls tended not to develop respiratory distress syndrome and chronic lung diseases sometimes found in premature infants. This advantage was lost in infant girls with a male twin.

This new study is expected to help pediatricians better understand the health risks and outcome of premature babies.

Prof. Reichman helped analyze the data collected by the Israel Neonatal Network comprising 8,858 very low birth weight infants (1 to 3 pounds) born prematurely at 24 to 34 weeks' gestation. The study data covered infants born between 1995 and 2003 and included singletons, same-sex and mixed-sex pre-term twins.

Beginning in the Womb

The TAU study is somewhat unusual. Twin studies tend to focus on what happens after birth, when complicated environmental and learned behavioral factors come into play. "The effects are occurring already in the uterus," says Prof. Reichman, citing studies showing that females with male twins may be more masculinized later in life.

A Pediatrics commentary on the research, "Beware of the Weaker Sex: Don't Get Too Close to Your Twin Brother," by Dr. David K. Stevenson, Department of Pediatrics, Stanford University; and Dr. Jon E. Tyson, Department of Pediatrics, University of Texas Medical School, sums up the findings. "For the time being, there remains some biological truth to the old nursery rhyme that boys are made of ‘snakes, snails and puppy dogs' tails,' and ‘girls are made of sugar and spice and everything nice.'

"Perhaps nature knows something we do not," Drs. Stevenson and Tyson write.

Researchers conducting this study derived their data from the Israel Neonatal Network, a network of all 28 neonatal departments in Israel. Study co-authors include Professors Eric Shinwell and Isaac Blickstein, both from the Kaplan Medical Center in Rehovot and Hebrew University.

Prof. Reichman also works at the Sheba Medical Center, Safra Children's Hospital, Tel Hashomer and the Gertner Institute for Epidemiology.

SCIENTIFIC AMERICAN features Sheba's Prof. Yoni Leor: Repairing Hearts with Seaweed

Mon, 07 Apr 2008 13:31:37 PDT

Can Seaweed Mend a Broken Heart?

New research [at Sheba and BGU] indicates that an alginate-based biomaterial injected into heart attack victims may stave off further damage

By Cynthia Graber

http://www.sciam.com/article.cfm?id=can-seaweed-mend-a-broken-heart

TEL AVIV, ISRAEL—Physicians for decades have grappled with ways to block further tissue damage in patients who suffer heart attacks. They have tried everything from drugs to cell therapy—all with little luck. But promising new research indicates that a biogel made from seaweed may have the healing powers that have thus far eluded them.

The first clinical trial in humans recently began of an alginate-based biomaterial that, when injected into animals, helped their hearts repair themselves. The therapy is set to be tested over the next year in 30 patients in Germany, Belgium and Israel who have suffered severe heart attacks; if successful, the trial will be expanded to include a few hundred U.S. heart patients, and the experimental biogel could be on the market by 2011.

"This could revolutionize the treatment of patients recovering from a massive heart attack," says Jonathan Leor, director of the Neufeld Cardiac Research Institute at Tel Aviv University's Sheba Medical Center, who helped develop the potentially heart-saving therapy.

A heart attack, or myocardial infarction, occurs when blood flow to the heart is cut off, killing part of the muscle due to lack of oxygen. The severity of the damage depends on the amount of time that elapses before blood flow is restored. Once damaged, heart tissue never regenerates; if a patient survives, necrotic (dead) tissue is replaced by scar tissue.

The scar wall is thinner than that of surrounding healthy tissue. Damage to the region worsens and spreads when inflammatory cells (that rush to the scene as part of the body's immune response) secrete enzymes that erode the exposed extracellular matrix, the natural scaffolding that supports heart cells. As the scar gets larger, the wall gets thinner.

To compensate, the remaining healthy muscle works harder to pump blood, swelling as it does so. For about 10 to 20 percent of heart attack survivors, this overexertion may lead to arrhythmia (irregular heartbeat), future heart attacks, heart failure and even death, according to Leor.

Leor has spent the past fifteen years researching potential ways to prevent this deterioration. He initially tested therapies incorporating stem cells, which he thought might spawn new heart cells or prompt hobbled hearts to regenerate their own. The results were disappointing: most of the stem cells died, and those that survived failed to spur new tissue growth.

He says he then discovered that the damage was related to the extracellular matrix. That is, the progressive thinning of the scaffolding put a strain on the healthy areas of the heart. Rebuilding this support would not only give a boost to remaining muscle mass, he reasoned, but would also provide more real estate on which cells could live and replicate.

"I thought maybe we could prevent that [deterioration]" by using a biomaterial as a substitute for the lost natural tissue, Leor says.

At the same time, Smadar Cohen, head of the Department of Biotechnology Engineering at Ben-Gurion University of the Negev in Israel, was exploring the potential of a biomaterial to fix damaged hearts after having successfully used it to repair liver tissue.

Cohen wanted to design an implant on which cells replicated by surrounding healthy tissue could set up shop; she believed that once there, the cells would excrete extracellular material that would thicken scar tissue as well as prevent its expansion. She initially considered using polymers (large molecules comprising repeating units) made of natural human proteins such as collagen or synthetic ones made from degradable polyester. But neither material was up to the task, which prompted her to consider alginate, a seaweed-derived polymer, which has a similar molecular structure to natural extracellular material and has been used by the food, drug and medical-device industries.

Cohen froze the alginate solution to form water crystals, which she then flash-dried. The result was a porous substance on which cells could grow and link to one another. Cohen formed the material into a Band-Aid–like patch, which she applied directly to the hearts of rats (and later pigs) after inducing heart attacks.

Blood vessels grew into the patch, and heart cells from neighboring areas settled and reproduced on it, secreting their own extracellular material that beefed up the scar tissue. After six weeks, the alginate disintegrated and the remains were excreted in urine—leaving behind tissue in the rats and pigs that was significantly healthier than that in those that did not receive the implants. The problem was that the patch could only be inserted via risky open-heart surgery, limiting the likelihood of volunteers for human trials, Leor says.

In an effort to lower the risk, Cohen stitched the alginate polymers into an injectable solution that would turn into a sticky gel when it came into contact with calcium ions (the electrically charged form of calcium atoms that circulate in the bloodstream) that congregate at the site of heart muscle damage.

The gel proved so promising in rats that in 2005, BioLineRx, Ltd., an Israeli start-up created to bring promising early-stage therapies to clinical trials, selected Cohen's process from among hundreds of potential treatments. It continued to test the biogel, which it dubbed BL-1040, in pigs (which are anatomically similar to humans)—with the same success as Cohen had with the patch.

Leor says that no negative side effects were observed. But he notes the results may have been skewed, because the animals were young and healthy (until researchers induced their heart woes), whereas most heart attack victims are elderly and have other diseases and complications. "The challenge,'' he says, "is to show that our approach will be effective in real patients."

Timothy Gardner, president-elect of the American Heart Association and medical director of the Center for Heart & Vascular Health at Delaware's Christiana Care Health System, is cautiously optimistic. "This addresses a real problem, and if [the human trials] are successful," he says, "it will be an important additional therapeutic option."

Burnt "Miracle Girl" Undergoes Unique Skin Growth Treatment at Sheba

Thu, 03 Apr 2008 10:43:32 PDT

A few seconds of carelessness can turn everything upside down and lead to a life of misery and pain. The Sulam family of Bnei Brak learned this lesson 10 months ago when a mistake by the father, Pini, caused burns over 95 percent of the body of his two-year-old daughter Ravid, 20% of his wife Ayelet's body and 70% of his own.

Ravid, now three, has undergone hundreds of excruciating bandage changes in the surgical theater and numerous operations at Sheba Medical Center at Tel Hashomer since Pini - unable to get a fire going for a family barbecue in Netanya - added paint thinner to it after kerosene and oil didn't work.

The 39-year-old father put the empty thinner container alongside the barbecue, causing a terrible explosion that set both him and Ravid on fire.

"She didn't scream or cry; she just called me to see what had happened to her father," Ayelet recalled in an interview Wednesday with The Jerusalem Post. The mother ran to take Ravid inside and suffered serious burns herself.

Pini, a professional cook in the Israel Defense Forces, was discharged from the hospital only two months ago after his legs were saved from amputation, and he is currently undergoing rehabilitation and unable to work. Ravid has been hospitalized at Sheba since the accident, while Ayelet - an engineering technician at the RAD company until the accident - runs between the hospital and home to take care of Ravid as well as her other two children, aged eight and 12.

Dr. Josef Haik, director of Sheba's burns unit, says that Ravid will need operations for the rest of her life, as only on the lower part of one foot does she have skin untouched by the fire. She also lost one ear in the fire. As a child, she will continually grow, and as there is not enough skin for culturing to cover her body as it grows, she needs to undergo a special process in which all the layers of the skin are successfully multiplied and used for grafts to cover her body.

The only place in the world that has been successful in clinical trials for this procedure is Shriners Hospital in Cincinnati, Ohio, where Prof. Richard Kagan, head of the hospital's burns unit and president of the American Burns Association, works. He has promised to treat Ravid at no cost over the three years she will need for the treatment to be completed. It is not known how much money the family's health fund, Kupat Holim Leumit, will pay for their stay (along with that of Ayelet's mother, who is needed to help out).

Rabbi Avraham Elimelech Firer, head of the Ezra Lemarpeh Association, will help by raising money for some expenses. The Sulam family is trying to raise money to cover the huge costs that remain (Bank Mizrahi-Tefahot, branch #431, account #66656).

Haik says Ravid is a "charming girl" who tries to smile, but "when she sees me, she is anxious, because I have to remove the bandages and dead skin, and it hurts. She associates me with pain." But, said the Sheba burns expert, "she has not given up on life."

Haik said that although burns experts here have much experience treating victims of Palestinian suicide bomb attacks, they have not been able to grow skin with all the protective layers needed for grafting to deal with such a severe case.

"A small sample of skin is taken, and it is grown on a synthetic substrate. Few places in the world have tried and succeeded, but Shriners has the most experience and best results. The technique was sold to a private company, but it has not yet been put on the market," Haik said.

He explained that a continual supply of Ravid's skin would be needed as she grows, since scars can even limit her growth. Skin taken from cadavers can be used only temporarily, he said, and do not replace the victim's own skin.

"In Shriners, they will try to maximize what she has," he said.

Her doctor is optimistic that Ravid can improve with the experimental treatment. It is a miracle, he and the family say, that she is alive at all.

Police commander who lost leg visits wounded Sderot boy

Wed, 12 Mar 2008 10:13:48 PDT

Losing a leg is a trauma that Southern District Police chief Cmdr. Uri Bar-Lev knows well: When he was 20, he lost his in combat in Lebanon.

Hence Bar-Lev's promise on Tuesday to eight-year-old Osher Twito, who lost his left leg to a Kassam rocket in Sderot on February 9. "You will walk again, and when you get out of the hospital, we'll play soccer together," Bar-Lev told the boy during his second visit to the children's intensive care unit at the Sheba Medical Center in Tel Hashomer.

Two days ago, Twito finally learned that he had lost the limb, and he has since been struggling to come to terms with the permanent consequences of his injury, the Southern District Police spokeswoman told The Jerusalem Post.

"Having lost a leg, I know what he's going through," Bar-Lev said after concluding his visit, stressing that the ordeal was far more difficult for a child.

"I am in touch with the family, and we are going to continue to provide continuous, round-the-clock support. We know Osher loves the Liverpool soccer club, and we are planning on flying him to England so that he can watch a match," Bar-Lev said.

Twito is undergoing intensive care to stabilize his remaining leg, which doctors have managed to save. He was transferred to [Sheba Medical Center at] Tel Hashomer from Barzilai Hospital in Ashkelon.

Bar-Lev made a point of showing the boy his own artificial leg, to prove "that he will get back on his feet," said community police officer Batsheva Zitun, who accompanied Bar-Lev on the visit.

"When Bar-Lev promised him that they would play soccer, Osher looked up at him with such a meaningful look in his eyes," Zitun said. "The message to Osher is that he can do anything."

The boy's worn-out parents remained at his bedside, while at he same time keeping tabs on the progress of their 19-year-old son, Rami, who was also wounded by the Gazan rocket, though less severely.

Immediately after the attack, Osher lost consciousness and needed help breathing. However, he has been making steady progress since then.

"The fact that Bar-Lev went through this is a big encouragement for Osher," the boys' mother, Iris, told the Post. "This is a boost for us."

Sheba study links protracted cellphone use with tumors

Sun, 17 Feb 2008 11:47:34 PST

Tumors of the parotid (salivary) glands are significantly more common in people who use cellular phones over a relatively long period, according to a retrospective study of nearly 500 Israelis who contracted such benign or malignant growths compared to more than twice as many healthy controls. This is reportedly the first study of the possible effects of cellphone use by Israelis, who are known to utilize them for many minutes per day and start at young ages.

The study, led by Sheba Medical Center physician and Tel Aviv University epidemiologist Dr. Siegal Sadetzki, was announced late last week on the Web site Science Daily (www.sciencedaily.com) and published recently in the American Journal of Epidemiology.

Sadetzki, who has appeared several times at Knesset committees about the possible risk of cellular phone usage, said that while the results needed to be confirmed by additional and longer studies, in the meantime precautions should be taken. These include limiting the use of cellphones by children and both kids and adults using earphones and other means to distance the cellphone from the head whenever possible.

She conducted her study as part of the international Interphone Study, which aimed to discover if cellphone use and several kinds of brain and salivary gland tumors were linked.

Those who used a cellphone very frequently on the side of the head where the tumor developed were found to have an increased risk of about 50 percent for developing a tumor of the main salivary gland, compared to those who did not use cellphones, the study revealed. The parotid gland is located under the external ear about four to 10 millimeters under the skin.

Sadetzki, who owns and uses a cellphone, but sparingly, said that the fact that the study was done on an Israeli population is significant. Only a small minority of Israelis do not use cellphones, and those who do are likely to use them many more minutes than in other countries.

In Israel, where the cost is relatively inexpensive, there is a greater tendency to keep in touch due to familial closeness and security problems and nearly every part of the country has cellular antenna coverage.

Sadetzki explained: "Unlike people in other countries, Israelis were quick to adopt cellphone technology and have continued to be exceptionally heavy users. Therefore, the amount of exposure to radio-frequency radiation found in this study has been higher than in previous cellphone studies.

"This unique population has given us an indication that cellphone use is associated with cancer," added Sadetzki, whose team surveyed (by regular telephones) salivary tumor patients in hospitals around the country. The study's subjects were asked to detail their cellphone use patterns according to how frequently they used one, the average length of calls, and the side of the head the phone was next to. Their responses were then compared to a randomized sample of about 1,300 healthy control subjects.

The study also found an increased risk of cancer for heavy users who lived in rural areas, as cellphones in rural areas emit more radiation to communicate effectively because of longer distances between them and antennas.

Sadetzki predicted that, over time, the greatest effects would be found in heavy users and children. The lead researcher said that while the world was not willing to give up their cellular phones, precautions must be taken to reduce exposure and lower the risk for health hazards.

She recommended that people use hands-free devices at all times and when talking, hold the phone away from one's body. Less frequent calls, shorter in duration, should also have some protective effect. In addition, parents need to consider at what age their children start using them and insist that they use speakers or other hands-free devices.

"Some technology that we use today carries a risk. The question is not if we use it, but how we use it," she concluded.

Dr. Siegal Sadetzki of Sheba: Heavy Cell Phone Use Linked To Cancer

Fri, 15 Feb 2008 08:20:45 PST

An Israeli scientist, Dr. Siegal Sadetzki, has found a link between cell phone usage and the development of tumors.

Dr. Sadetzki, a physician, epidemiologist and lecturer at Tel Aviv University, published the results of a study recently in the American Journal of Epidemiology, in which she and her colleagues found that heavy cell phone users were subject to a higher risk of benign and malignant tumors of the salivary gland.

Sadetzki's main research on this new study was carried out at the Gertner Institute for Epidemiology and Health Policy Research at the Sheba Medical Center. Her research is part of the international Interphone Study, which attempts to determine an association between cell phones and several types of brain and parotid gland tumors.

Those who used a cell phone heavily on the side of the head where the tumor developed were found to have an increased risk of about 50% for developing a tumor of the main salivary gland (parotid), compared to those who did not use cell phones.

The fact that the study was done on an Israeli population is significant. Says Sadetzki, "Unlike people in other countries, Israelis were quick to adopt cell phone technology and have continued to be exceptionally heavy users. Therefore, the amount of exposure to radiofrequency radiation found in this study has been higher than in previous cell phone studies.

"This unique population has given us an indication that cell phone use is associated with cancer," adds Sadetzki, whose study investigated nearly 500 people who had been diagnosed with benign and malignant tumors of the salivary gland.

Controlled Study Reveals Link

The study's subjects were asked to detail their cell phone use patterns in terms of how frequently they used one, and the average length of calls. They were compared to a sample of about 1,300 healthy control subjects.

The study also found an increased risk of cancer for heavy users who lived in rural areas. Due to fewer antennas, cell phones in rural areas need to emit more radiation to communicate effectively.

Sadetzki predicts that, over time, the greatest effects will be found in heavy users and children.

While anecdotal evidence has been substantial, the consistency of the results of this study support an association between cell phone use and these tumors. The risks have been hard to prove, mainly due to the long latency period involved in cancer development, explains Sadetzki.

Keep Calling but Call Smarter

Today it is estimated that more than 90% percent of the Western world uses cell phones. As the technology becomes cheaper and more accessible, its usage by a greater number of people, including children, is bound to increase.

"While I think this technology is here to stay," Sadetzki says, "I believe precautions should be taken in order to diminish the exposure and lower the risk for health hazards." She recommends that people use hands-free devices at all times, and when talking, hold the phone away from one's body. Less frequent calls, shorter in duration, should also have some preventative effect.

While she appreciates the ease of communication that cell phones allow between parents and their children, Sadetzki says that parents need to consider at what age their children start using them. Parents should be vigilant about their children's using speakers or hands-free devices, and about limiting the number of calls and amount of time their children spend on the phone.

"Some technology that we use today carries a risk. The question is not if we use it, but how we use it," concludes Sadetzki.

New York Times: 2 Boys, 2 Sides, 2 Beds in an Israeli Hospital Ward (Sheba)

Wed, 13 Feb 2008 09:31:51 PST

TEL HASHOMER, Israel — Two small boys lay sedated in a hospital ward in this Tel Aviv suburb on Tuesday, unaware of each other or of the growing commotion around them.

One was Osher Twito, 8, an Israeli boy from the town of Sderot, was seriously wounded Saturday by shrapnel from a rocket fired by Palestinian militants from Gaza. The other was Yakoub Natil, almost 7, a Palestinian who was brought here three weeks ago from Gaza City after he was badly hurt by shrapnel from an Israeli Air Force strike on Jan. 18.

Sderot is less than two miles from the Gaza border, making it a prime target for the crude and inaccurate rockets that have killed 13 Israelis over the past seven years. Now Osher and Yakoub lie in booths across from each other a few paces apart in the pediatric intensive care department of the Chaim Sheba Medical Center at Tel Hashomer.

Here, the conflict’s pain has been compressed into an improbable intimacy. There is pathos. “The Palestinian boy on one side, Osher on the other — it’s something that gets to your heart,” said Prof. Gideon Paret, the director of the department.

But there is anger and repudiation as well, and the proximity of the two boys has not brought reconciliation. Osher’s parents, Iris and Rafi Twito, are outraged at the thought of comparing the boys’ cases. They refuse to allow them to be photographed together.

“The Palestinians aim to hurt our sons and rejoice at their injuries,” they said in a statement issued Tuesday, “while neither we, nor our army, intended to hurt them.”

The statement, relayed through a hospital spokeswoman, continued: “The State of Israel took the decision to treat the boy,” meaning Yakoub. “That is its right. We protest the fact that he is lying here by our son and his brother.” Osher’s older brother Rami, 19, is being treated in another wing of the same hospital.

Many major hospitals in Israel regularly treat Palestinians and are no strangers to such mixed feelings or incongruous scenes. Here at Sheba, the anomalies are cast in sharper relief.

This was a military hospital from 1948, when Israel fought its war of independence, until 1953. It has since operated as a civilian hospital that works in special cooperation with the Army, treating many of its soldiers and charged with educating its medical corps.

“It’s like a theater of the absurd,” said Prof. Zeev Rotstein, the chief executive officer and director of the hospital. “You have army doctors in white gowns alongside Palestinian doctors who are being trained, at the same time treating Israeli casualties of terrorist attacks and Palestinians who may have been hurt in army actions.”

Yakoub was hurt when Israel bombed an empty, half-ruined Palestinian Interior Ministry building that had been used by Hamas. He was at a wedding party with his family next door. The army said that it had meant to hit the ministry building and that the raid was a response to days of increased rocket fire, mostly aimed at Sderot.

Osher and Rami were hit in the street. They had gone out to buy a birthday present for their father when the rocket crashed down.

Yakoub’s grandmother, Amira Natil, 52, was at the boy’s bedside on Tuesday. She and Yakoub came here with Israeli permission three days after the airstrike from the more basic hospital Al Shifa in Gaza City. “Thank Allah, the lord of the universe,” Mrs. Natil said, kissing her hand and placing it on her brow in a gesture of religious reverence.

Mrs. Natil had not met Osher’s parents and was speaking shortly before they issued their statement, unaware of its contents. About the Israeli boy, she said: “They are children. Haram,” using an Arabic word that denotes something shameful, forbidden or taboo.

The story of the Twito brothers has particularly moved Israelis, in large part because of their youth. Osher, described by his family as a keen soccer player, has had his left leg amputated from the knee down. The doctors are still battling to save his right leg. Rami suffered damage to his legs, too. Both boys were transferred to Sheba on Sunday from Barzilai hospital in Ashkelon, a city north of Gaza that has come under rocket fire.

Yakoub was wounded in both legs and his spine. He suffered renal failure but is said by the hospital staff to be getting better. “This is the best day he’s had,” his grandmother said.

It is not clear who will pay for Yakoub’s treatment. “To date we are treating him without any financial commitment from the Palestinian authorities or anyone else,” said Ulrike Haen, a spokeswoman for Sheba.

In similar cases, she said, money has come from the Israeli Ministry of Defense; or from the Peres Center for Peace, a nonprofit organization founded in 1996 by Shimon Peres, the current president of Israel; or from the Palestinian Authority, with supplements from the hospital.

Since Hamas took control of Gaza last June after a brief but bloody factional war, the issue of Gaza residents’ access to medical treatment in Israel has become increasingly charged. Israel refuses all dealings with Hamas, whose charter calls for the destruction of the Jewish state, and has recently blockaded the area in response to the intensified rocket fire.

In an article published in the Israeli newspaper Haaretz on Tuesday, Ahmed Youssef, an adviser to the Hamas government in Gaza, wrote that “30 people have died in the last month for lack of medical care brought on by the embargo.”

According to recent statistics from the Israeli Coordination and Liaison Administration, more than 7,000 permits were issued for Palestinian patients from Gaza in 2007, along with nearly 8,000 permits for their escorts, representing a 50 percent increase over 2006. Shadi Yassin, a spokesman for the Coordination and Liaison Administration, said Tuesday that medical patients were still leaving Gaza every day to receive treatment in Israel.

But Yakoub is the exception, not the rule. “We know of others who can’t get out and die there,” said Professor Rotstein of Sheba’s pediatric intensive care department. “It is so complicated now.”

Injured Sderot Boys Transferred to Sheba for Treatment

Mon, 11 Feb 2008 10:27:53 PST

'I screamed as loud as I could so they'd hear me'

Osher Twito, the eight-year-old Sderot boy who was seriously wounded in a Kassam rocket attack over the weekend, was transferred from Barzilai Medical Center in Ashkelon to Sheba Medical Center at Tel Hashomer on Sunday because Barzilai lacks rehabilitation facilities.

One of the boy's legs was amputated below the knee; the other one is in danger because of harm to an artery at ankle level.

Osher, who dreamed of becoming a soccer player, does not know yet that he has lost one of his legs.

Barzilai sources said Sunday that it was impossible to know immediately whether his whole-but-injured leg would have to be amputated or not, as there is always the threat of infection.

Osher also suffered a fracture in one hand. He remains under total sedation and attached to a respirator, even though he can breathe on his own, so he doesn't suffer from severe pain.

The amputation of the one leg took a long time and was difficult. If all goes well, the stump will be attached to a prosthetic leg.

"It's too early to know what will happen to the other leg," said the Barzilai spokeswoman, Lea Malul.

Osher and his brother Remi, 19, from Sderot, went for a short trip to the cash machine on Saturday night to withdraw some money for the present they planned to buy their father, Rafi, whose birthday was on Sunday.

When the brothers and Remi's girlfriend, Kinneret, arrived at the ATM, they realized they had forgotten Remi's credit card at home.

"Remi and Osher waited for me on the street to bring the credit card from the house," an exhausted Kinneret recalled Sunday as she waited for her boyfriend to get out of the operating room at Barzilai. "When I came back from the house, they started walking in my direction, and then the 'Color Red' alert was sounded for a second before it [the rocket] hit them. I was hiding, but when I lifted my head, I saw them both lying on the ground, crying for help and screaming in pain. I screamed as loud as I could so they would hear me, but what else could I do?"

Osher loved to play soccer, his relatives said.

"I don't know how my son will live without a leg," cried Osher's mother, Iris, shortly before seeing her two children for the first time since they had been rushed to the hospital.

"He doesn't understand a thing yet, and he will have to understand that. Why does it have to be like this?" Iris asked in tears.

Remi, moderately wounded in both legs, was awakened when transferred to Tel Hashomer. "I remember running in the street, and then the alarm went off. Next thing I knew, I was lying on the ground and my legs hurt. I called my mother and told her to come immediately because we were wounded," Remi said before he was put inside the Magen David Adom ambulance that took him to the hospital.

Still hazy from the operation, Remi added that he hated Prime Minister Ehud Olmert, "who let them [the Palestinians] ruin Sderot's residents' lives."

One of Remi's legs is undergoing treatment of the soft tissues, and the other leg is broken and in a cast.

The boys' parents and 15-year-old brother all suffered severe emotional trauma and are being treated.

Barzilai staffers themselves were traumatized by Osher's suffering, as he was conscious upon arrival at the trauma room and repeatedly screamed "Save me!" while describing his pain.

MDA enters Ramallah to save Palestinian baby

Fri, 25 Jan 2008 10:33:56 PST

For the first time since the intifada, an Israeli ambulance enters Palestinian territories in order to evacuate critically injured baby

A bullet-proof Israeli ambulance entered the West Bank city of Ramallah on Thursday in order to save a six-month old baby in critical condition after reportedly inhaling toxic substances.

This was the first time a Magen David Adom ambulance entered the Palestinian territories since the second intifada broke out in the year 2000.

Up until now, MDA ambulances would only go as far as the IDF checkpoints, where they would pick up Palestinian patients in need of medical care in Israel.

Immediately after receiving the Palestinians' call for help, the Civil Administration's West Bank division called MDA requesting paramedics from Jerusalem take on the mission. Two Arab-Israeli paramedics took the call.

The paramedics evacuated the unconscious baby, just a few hours after two other babies, who went to the same daycare center as the boy, died of similar symptoms.

MDA believes the babies were poisoned, but it is not clear with what or how.

Upon arriving in Ramallah, the ambulance was escorted by a convoy of Palestinian police, who accompanied it all the way to the hospital, and blocked roads to ensure it got through safely.

The MDA team reported that the baby was handed over to them in a professional manner, along with all the needed medical documents. The team was in constant contact with the Jerusalem dispatch.

The baby was taken to the Chaim Sheba Medical Center at Tel Hashomer, along with his parents, who received a special permit from the Civil Administration due to their son's serious condition.

A source from the Palestinian Ministry of Health told Ynet that all humanitarian matters, especially those concerning human lives, should be separated from political issues.

Ali Waked contributed to this report

http://www.ynetnews.com/articles/0,7340,L-3383023,00.html

Sheba Hematologist Prof. Uri Seligson awarded the Prestigious Robert P. Grant Medal from the International Society of Thrombosis and Hemostasis

Mon, 13 Aug 2007 15:32:04 PDT

Sheba Hematologist Prof. Uri Seligson has been awarded the Robert P. Grant Medal from the International Society of Thrombosis and Hemostasis. The prestigious global award is given once every two years in recognition of excellence in research, teaching and contribution to the profession. The medal was awarded to Prof. Seligson at the society's annual meeting in Geneva, which was attended by 7,700 hematologists from around the world. Prof. Uri Seligson is director of the Institute of Thrombosis and Hemostasis at the Sheba Medical Center, former chairman of the department of hematology, and former deputy director of Sheba. He is also director of the Amalia Biron Research Institute of Thrombosis and Hemostasis at Tel Aviv University, former vice dean of TAU's Sackler Faculty of Medicine, and former chairman of the Israel Association of Thrombosis and Hemostasis and the Israel Society of Hematology and Blood Transfusion.

In 1995, he was president of the Congress of the International Society on Thrombosis and Hemostasis when it was held in Jerusalem, and from 2000-2002 he was international chairman of the society. He is one of only two doctors to be a member of the Israel Academy of Sciences and Humanities. In 1991, he was awarded the esteemed Ham–Waserman Lectureship Award by the American Society of Hematology. Prof. Seligson is credited with many advances and research discoveries in his field, including the salient international work on three inherited bleeding disorders that are particularly common in Jewish ethnic groups, as well as other molecular genetic and clinical aspects of derangements of blood coagulation.

More information on Prof. Seligson is available at http://eng.sheba.co.il/main/siteNew/index.php?page=3&stId=217

Laughter Therapy at Sheba: Laughter is Contagious — Cancer Isn't

Thu, 09 Aug 2007 15:30:51 PDT

Once every two weeks, 20 people gather to laugh, even if they don't feel like it - especially if they don't feel like it. They are cancer patients at Sheba Medical Center, Tel Hashomer. Their laughter can be heard bursting out of the hospital's movie theater and rolls down the corridors to the specialists' offices. "Laughter is contagious," their facilitator, Ruthie Hai, explains, as she encourages the group to laugh louder, to force themselves. "Go with what you feel," she exhorts the patients, seated on the upholstered chairs with their eyes closed.

Suddenly, Hai bursts out with a great guffaw over nothing, and is greeted with a roar in response. But not by everyone. "Laugh, laugh," she urges a patient who is merely smiling. "Laugh, let it loose," she commands. He breaks out in a little giggle. "Good, you're moving along!"

Hai has been "treating" patients at Sheba's oncology department for a year now. She embraces them, dances with them, plays them music and makes them laugh even if they are troubled and their bodies ache from chemotherapy. This afternoon, she plays the song "Together" ("Yahad") by Gaya and asks people to dance.

Yehuda Hudra, 79, from Neveh Monoson, has come with his wife Ida. About two years ago, he was diagnosed with cancer in his right lung, which had to be amputated. He rises from his chair, dances a bit and then sits back down to rest. He tires quickly but never misses his laughter yoga session. "I come here for some air," he says. "It opens up the lung I have left. I learn to laugh and it really makes me feel good." Yehuda's wife Ida says that since he was taken ill, his mood has not been good. "At first he didn't want to come here, but I made him come so he would forget his troubles a little. When we're at home, I see him sitting in the living room in a bad mood. I apply the techniques I learn here. I come up to him and surprise him. I laugh out loud right in his face. He laughs back; the mood changes and he feels different," Ida says.

Gabriel Sa'id, 46, a married father of seven from Safed, has been undergoing chemotherapy and arrives at the session with an infusion in his arm. Ruthie greets him with a great big laugh. "She taught me to laugh like a broken ignition of a car," Sa'id says. "I learned here that sadness doesn't lead anywhere. I learned to leave sadness aside and to laugh more. Sometimes I dance with myself," he says.

Hannah Tzarfati comes from Rishon Letzion to the laughter yoga class every chance she gets. She says it has taught her to deal with her frustration and pain. "The workshop gets me out of the house. I learned that the house is depressing. The most important thing is to get out as much as possible, to get around. Not to be closed up inside," she adds.

The head of oncology at Sheba, Prof. Raphael Katan, says cancer can develop in both sad and happy people. And yet, on more than one occasion he has found himself referring patients to Ruthie Hai's workshop.

"It's a good influence on patients' moods and it's important to us that their quality of life be good, even if they are going through a difficult period," Katan continues. "Unfortunately, laughter doesn't improve their medical condition, but it certainly improves the atmosphere."

The Way the Wheel Turns

Wed, 18 Jul 2007 15:51:43 PDT

Ronen Argalazi was born in 1967 in Tel Aviv, the second child of immigrant parents from Aleppo, Syria. He could hardly wait till his 16th birthday to buy a motorbike. For months the blue-eyed, soccer-playing teenager got all grimy working in a Tel Aviv garage after school to finance this ambition. Impressed by his tenacity, his parents overcame their misgivings and pitched in too.

For an entire year Argalazi was on a high. He could whiz down to the beach, take exhilarating trips and show off his bike to the girls. When he turned 17, his next plan was to sell the bike and buy a car - but fate intervened. Just one moment of inattention caused the wheel of fortune to swerve sharply and cruelly in the wrong direction, and take him from the saddle of his motorbike to the seat of a wheelchair.

On February 9, 1984, he was at the shore with friends after school. Feeling thirsty, he got on his motorbike to go buy a drink. Though he rode at only 10 kilometers per hour on the grassy area by the Dolphinarium, he failed to notice a small mound of sand ahead until the bike suddenly veered sideways, skidding and toppling him forcefully onto his neck. Argalazi felt no pain at first, but when his friends ran over, he groaned repeatedly that he could not move or get off the ground. Once they realized he was not joking, they called an ambulance. The medics immediately perceived that the situation was critical and headed for Ichilov Hospital.

Argalazi came to in the hospital after two weeks of heavy sedation. Excruciating pain had set in and he suffered three episodes of cardiac arrest. In the next few weeks five operations were performed on his neck and spine. After his condition stabilized he was sent to Sheba Medical Center for 10 months of rehabilitation. As the haze around him cleared, he gradually became aware of the other disabled people and had to adjust to the harsh reality that he was one of them. He began spending more time each day in a wheelchair. After his discharge, his parents and four siblings moved to an elevator building to accommodate his special needs.

As time passed, Argalazi had a compelling need for a space of his own. Despite a warm, supportive family, he was overwhelmed by the constant flow of people at home. He opted for independence by moving to his own apartment in Tel Aviv at the age of 19. Now 40 years old, he still lives there, assisted by a round-the-clock caregiver.

When his friends all joined the Nahal brigade, Argalazi found himself at a loose end. Their youthful dream of founding a new settlement was no longer relevant for him. Needing meaningful activity and new goals, he turned to his social worker for guidance.

At her suggestion, he enrolled in a computerized graphics course run by the National Insurance Institute in Ra'anana. Using a special mouse and other keyboard aids, he became a graphic artist 18 months later. He had begun to make a life for himself.

One day, while visiting a friend Argalazi was so enthused by the sight of his oil and acrylic paintings that he decided then and there to take up painting. A frenetic shopping spree for bags of art supplies ensued. But once back at his apartment, they were at a loss how to proceed. His friend hung the canvas on the easel, and Argalazi instinctively grasped the paintbrush in his mouth to apply the color. His first efforts were clumsy and fumbling. It took eons of willpower and perseverance until he reached his present proficiency.

He was never disheartened by the struggle because, "As soon as I saw the first blots of paint on the canvas, when I discovered the colors and shapes, I realized the tremendous power and energy involved in creating works of art. My imagination soared along with the strokes of the brush, and made me happy. Suddenly I had a purpose in life and felt vital as never before."

To improve his artistic skills, Argalazi studied painting and drawing at Beit Berl College near Kfar Saba from 1996-98, and continued at the Ramat Hasharon Art Academy for two more years. He became a qualified art instructor, while continuing to develop his skills.

He has held private exhibitions in community centers, public buildings and galleries all over Israel. The vibrant, exotic colors Argalazi favors in his paintings usually radiate optimism. His early works have a charming naïvete though they are highly textured, while the later ones are more emotional in expression.

Joining the International Foot and Mouth Painters' Association was another milestone for him. This highly acclaimed organization operating out of Liechtenstein has 14 members in Israel and 500 worldwide. It funds painting materials for its member artists, gives them publicity and recognition, helps them participate in worldwide exhibitions and publishes a large variety of greeting cards and other artistic stationary that are mailed out to supporters.

Though art is his main passion, Argalazi leads workshops with impressive skill. Most outstanding are his educational endeavors and readiness to share the story of his accident and rehabilitation with others. He regularly volunteers to speak to the upper grades of schools, where even the most unruly students are captivated by his calm, self-assured presence and steady gaze, and listen attentively.

They hear, see and feel the important message Argalazi delivers - namely that loss of concentration for even a split second while driving can have a devastating and irreversible effect. They learn that a serious accident is as traumatic for their near and dear ones, and that they have a responsibility to others as well as to themselves.

Argalazi's complex educational message includes an aspect of empathy. After his presentation, each student takes a pen or pencil in their mouth and tries to draw without the use of their hands - a most difficult feat! This humbling assignment allows them a brief glimpse into the life of a disabled person. They also see a striking example of rehabilitation.

Argalazi also gives art workshops for school children of all ages, where the youngsters take turns explaining their drawings and sharing thoughts and feelings. "I feel that this particular interaction not only provides me with joy and satisfaction, but also exposes the kids to a new experience. Their reactions and participation give a new meaning to my life," he told Metro.

Argalazi has a steady job lecturing two days a week at Jerusalem's Ein Kerem and Mount Scopus Hadassah hospitals, as part of an ongoing road-safety program to shock school-age youth into awareness. He also lectures to groups of nursing and social-work students, to help them develop sensitivity towards injured people. Increased mobility has entered his life in the shape of a gray van that he enters and drives by himself. He has been featured on television programs, which can be viewed at www.argalazigallery.com.

Argalazi's story is not only about his tragic accident and its aftermath, but about his subsequent accomplishments and full and interesting life today. His achievements can be attributed partly to his strong support network, but mainly to his optimistic nature and willpower, and are a true victory of the spirit.

An Unsimulated Success

Sun, 15 Jul 2007 16:00:56 PDT

People are not born doctors, nurses, paramedics, social workers or fighter pilots. In professions where lives are at stake, it's best to use simulation to determine whether someone's suited for the profession, and even after they pass this hurdle, they should be trained and tested by simulation.

It was for innovation in the field of medical simulation - simulation which can be adapted to other professions - that Dr. Amitai Ziv, an Israel Air Force combat pilot who became a pediatrician and then a medical administrator, recently received the $100,000 Charles Bronfman Prize.

Some 30,000 people have passed through MSR ( www.msr.org.il) - a Hebrew acronym for the Israel Center for Medical Simulation - that he founded at Sheba Medical Center in Tel Hashomer six years ago as a non-profit organization, saving countless lives and improving professionals' clinical skills. Some of its 30 unconventional classrooms look like Hollywood sets of battlefields, surgical theaters or delivery rooms.

"There are no lectures, only hands-on learning," he declared in an interview with The Jerusalem Post. The 48-year-old MSR head and deputy director of Sheba in charge of risk management and patient safety was honored at the Israel Museum in Jerusalem two weeks ago, after receiving the prize in New York in May.

Instead of applicants to medical school being chosen solely according to their matriculation and psychometric scores, thus letting in people who aren't suited, actors playing patients are used to test communications skills and empathy. Unsuitable applicants are thereby filtered out. And after graduation, instead of "practicing" on patients before internship or after passing through various stages of specialization, doctors perform "invasive procedures" and interact with the actors and their "families" to see how they cope and learn from their mistakes.

THE 550 INTERNS who graduate each year from Israeli medical schools take a five-day course at MSR before they start working. Situations involving "drunk" patients, relatives whose loved one has just died and other high-pressure scenarios are simulated. All sessions are videotaped from several angles and followed by debriefings with a physician.

"Amitai Ziv was a fighter pilot who applied the lessons learned in flight simulation to that of his chosen profession of medicine. His pioneering effort in the education of young doctors is the kind of creative breakthrough that my children sought to identify and honor when they established the prize," said Charles Bronfman, the Canadian philanthropist for whom the prize was named and endowed by his son Stephen, daughter Ellen Bronfman Hauptman and Claudine Blondin Bronfman in honor of his 70th birthday. The previous two winners were Jay Feinberg, founder and director of the Gift of Life Bone Marrow Foundation in the US, and Dr. Alon Tal, an Israeli environmentalist and founder of the Arava Institute for Environmental Studies.

The prize celebrates the vision and talent of an individual or team under 50 whose humanitarian work has contributed to the betterment of the world. Ziv was chosen from among a large number of nominees by a panel of judges comprised of former justice minister Dan Meridor, former World Bank president James Wolfenson and Rosalie Silberman Abella, a Supreme Court justice from Canada.

"He embodies the very qualities that have guided our father throughout his lifetime," said Stephen Bronfman at the ceremony, "and represents the best of the young generation's values, commitment, creativity and energy. His insightful and innovative work responds to the imminent need for reshaping the way medical care is delivered."

Simulation has been used unsystematically since the early days of medical practice. In the 16th century, mannequins (called "phantoms") were developed to teach obstetrical skills and cut high maternal and infant mortality rates. Today, said Ziv, it's common for medical students to do their first injections on an orange, practice suturing on pieces of cloth, rehearse medical interviews while role playing, or practice physical exams on actors.

SUCH SIMULATION-BASED medical education (SBME) began many years ago in various parts of the world, acknowledges Ziv, who was born in Israel to parents who came from Canada. But abroad it was unstructured.

"MSR is unique in that it was the first to build a national simulation center that integrates all the medical, nursing, paramedic and other professions," he explained. Applicants for the Technion's Rappaport Medical Faculty and Tel Aviv University Medical Faculty are all sent for half a day through MSR to face actors at a variety of "stations" and see how they function. The Hebrew University Medical Faculty and Ben-Gurion University's Health Science Faculty do not yet use MSR to sift out unsuitable applicants, but do use the center for later stages in doctors' training.

Newly minted physicians, for example, work on hi-tech mannequins that cost as much as $200,000 and bleed, present symptoms, have vital signs such as a beating "heart" and blood pressure that rises or falls. They can go into "convulsions" or suddenly suffer a "heart attack." More veteran doctors learn to perform laparoscopy (keyhole surgery), angioplasty (insertion of tiny video cameras, catheters or supportive stents inside clogged and weakened coronary arteries), deliver babies and do a wide variety of other procedures without first trying them out on real people. Deputy directors of hospitals who are responsible for patient safety and risk management also come to learn. MSR also trains the trainers, and some 800 have passed through MSR, which is not budgeted by the government but receives institutional fees for services. Emergency room doctors and operating room and other advanced nurses practice procedures and teamwork at the center.

"Most medical errors," added Ziv, "come from a lack of teamwork. These can be prevented with simulation." Emergency room teams learn to work in a coordinated fashion, as do child abuse and domestic violence detection and treatment teams, Israel Defense Forces and Magen David Adom medics and others.

"At MSR, one is allowed to make mistakes. Medical professionals are busy with defensive medicine, to protect themselves from lawsuits. Simulation lets them make mistakes and learn from them," Ziv said. He noted that a study at the US National Institutes of Health found that about 100,000 Americans a year die due to medical errors. "That's as if a jumbo Boeing 747 crashed into the ocean every day," he said. The corresponding estimated figure of Israelis is 2,000 per year - four times the number of road accident victims.

During the Second War in Lebanon last summer, IDF medical teams on the battlefield had been trained at MSR, and said the training helped them save lives. Soldier mannequins come in blood-stained uniforms, and virtual-reality computers produce the noise of helicopters. Rockets and mortars sound as if they are falling nearby, making the scene seem real. MSR's 40 staff members consist of physicians, nurses, social workers, paramedics, psychologists, educational workers and technology and logistics; they work together with some 150 specially trained freelance actors.

SINCE ITS founding in 2001, MSR has become a model at medical institutions around the world, including the famed Mayo Clinic in Minnesota, Case Western Reserve in Cleveland and McGill University in Montreal. As an Israeli center cannot hope to serve as a model in Arab countries, Mayo Clinic staffers were trained by MSR and are now helping Saudi Arabia develop SBME. In addition, Amharic-speaking Israeli actors recently helped a visiting group of Ethiopian physicians take part in role-playing scenarios connected to the treatment of HIV/AIDS patients.

"Methods developed and implemented by MSR are revolutionizing the manner in which physicians and allied health personnel are trained," said Dr. William Dunn, medical director of the Mayo Multidisciplinary Simulation Center. Ziv's impact and accomplishments "are unsurpassed by any other physician dedicated to medical education. His tireless efforts have given birth to the pre-eminent center in medical education, utilizing the revolutionary and powerful means of experiential education. He has established a facility unlike any in the world. He's had an incalculable worldwide impact," Dunn continued.

Professionals from Britain's National Health Service, the World Health Organization, the International Committee of the Red Cross, the US Centers for Disease Control and Prevention and other institutions abroad have also come to see what MSR does.

"We don't do active marketing. They come to us," Ziv noted.

He was officially nominated for the Charles Bronfman Prize by Sheba director-general Dr. Zev Rothstein, who has supported his venture from the beginning. Prof. Shimon Glick, former dean of BGU's medical school and currently the Health Ministry's ombudsman who deals with claims of medical negligence, has known and admired Ziv for years, and was one of those who recommended him for the award.

"His doctoral thesis on peer evaluation of medical students was not only awarded a prize for excellence, but also exemplified the unusually high stature that [he] had among his classmates," said Glick. "Gradually he became one of the world's authorities on the use of simulators in medicine."

Ziv founded the first medical simulation center in Philadelphia, conducted major research and outcome studies with leading US medical schools, and then left behind many opportunities to return home in the hope that he could change the culture of medical training not just in Israel but around the world.

And he did. His skill, continued Glick, "is so vital in an era where super-specialists' views are often narrow and limited in scope... This ability combined with Amitai's unusual leadership ability enables him to organize and activate teams to produce major innovations." The first thing one learns in medical school is the Latin phrase Primum non nocere (First Do No Harm)," Ziv concluded at the reception in the Israel Museum's sculpture garden. "But you also need a human touch, transparency, honesty and modesty. You have to learn from your errors. That is the message of MSR."

World Leading Cancer Researcher Prof. Steven Rosenberg Visits the Sheba Cancer Center

Wed, 13 Jun 2007 13:11:56 PDT

Prof. Steven Rosenberg, chief of surgery at the U.S. National Cancer Institute – perhaps the world's most celebrated cancer researcher – visited the Sheba Medical Center yesterday (June 12). Dr. Jacob Schachter, head of Sheba's Elah Center for Melanoma Treatment and Research, is partnered with Dr. Rosenberg in offering a revolutionary "immunotherapy" treatment for melanoma. Rosenberg met a 58-year-old patient whose cancer is in complete remission thanks to this pioneering treatment.

By the "Rosenberg immunotherapy" protocol, Sheba doctors seek to re-engineer the patient's immune system so that it will act to destroy the cancers. Doctors remove white blood cells from the tumor, seeking cells that show strong and aggressive immune properties. These cells are re-grown and amplified in the lab, then re-introduced to the patient's body – after the patient's sick immune system is shut down by intensive chemotherapy. In the newest form of experimental treatment a gene called NCR, which has shown strong anti-cancer properties, is attached to the cells before their reinsertion to the patients' body.

"The conventional treatments for cancer – surgery, chemotherapy and radiation – fail in about fifty percent of patients," said Prof. Rosenberg yesterday. "Our approach, which employs individualized immunotherapy and genetic manipulations in cell therapy -- is the wave of the future," he said. Sheba is one of the few medical centers in the world, and the only center in Israel, capable of treating patients by Rosenberg's specialized protocol.

"My collaboration with Dr. Schachter here at Sheba is tremendously important and beneficial, and I am very impressed by the magnificent facility that Sheba has built for the Elah Center and for cancer treatment and research in general," Rosenberg said.

Nehemiah and Haya Lemelbaum, the philanthropists who established the Elah Center, participated in the Rosenberg visit, as well. Mr. Lemelbaum, a businessman who has devoted his life to advancing cancer research and treatment, actively follows the scientific progress of the Sheba Cancer Research Center. "In science as well as business, we try to make smart investments," Mr. Lemelbaum said, "and we will continue to invest in this facility and in Sheba's world-class research team."

In a fascinating medical-scientific brainstorming session, Prof. Rosenberg met jointly with a range of Sheba oncologists and scientists for a discussion of futuristic cancer research and treatment approaches. Among the participants in this 90 minute detailed scientific discussion were Dr. Itzhak Zaidise (acting director of Sheba), Dr. Jacob Schachter (deputy chief of oncology services and Rosenberg's scientific partner at Sheba), Prof. Gidi Rechavi (chairman and director of the Sheba Cancer Research Center), Prof. Arnon Nagler (chief of hematology and bone marrow transplantation), Dr. Moshe Papa (chief of surgical oncology), Dr. Avi Treves (executive director of the Sheba Cancer Research Center), and other scientists.

The BioLineRx Drug Development Company Seeks to Begin Clinical Trials of an Implant Developed at Sheba to Treat Damaged Heart Tissue

Wed, 06 Jun 2007 14:54:06 PDT

The Implant Was Developed by Prof. Jonathan Leor of Sheba together with Prof. Smadar Cohen of Ben Gurion University

BioLineRx Ltd. (TASE:BLRX), Israel's leading drug development company, announced today that it has submitted a request to a European regulatory agency to begin pilot (Phase 1/2) clinical trials of BL-1040, an absorbable implant to treat cardiac tissue damaged as the result of an acute myocardial infarction (heart attack or MI). The submission comes following BioLineRx's successful completion of pre-clinical studies of BL-1040.

The multi-center, open label study will be conducted at several sites in selected European countries and Israel. The results of the study will provide feasibility data that the Company will use to support the pivotal clinical trial that is intended to form the basis of the pre-market approval application for BL-1040 with the U.S. Food and Drug administration (FDA). BioLineRx's development strategy for BL-1040 is the result of extensive discussions with regulatory authorities including a pre-IDE meeting with the FDA in March, 2007.

The safety biocompatibility and efficacy of BL-1040 was demonstrated in pre-clinical trials performed in multiple species. BL-1040 was shown to be safe, improve survival and effective in preventing deterioration of the myocardium, by reducing left ventricle dilatation and eventual heart failure.

"BL-1040 is the first treatment that attempts to treat damaged cardiac tissue resulting from an acute MI and addresses a tremendous unmet medical need. More than one million patients suffer an acute MI each year in the U.S. alone," commented Morris C. Laster, MD, CEO of BioLineRx. "Our regulatory strategy is specifically designed to allow patients to benefit from the technology with an accelerated timeline."

"BL-1040 promises to revolutionize the treatment of patients recovering from massive heart attack," says Professor Jonathan Leor, Director of the Neufeld Cardiac Research Institute at Sheba Medical Center and Tel-Aviv University who together with Professor Smadar Cohen from Ben Gurion University invented and conducted the initial experiments with BL-1040. "I am optimistic that future clinical studies will continue to provide more evidence for the success of our new approach and will bring effective and safe treatment for those patients with injured hearts," added Professor Leor.

BL-1040 is an absorbable liquid polymer intended to provide mechanical support to damaged heart tissue post acute myocardial infarction in order improve cardiac function and survival. BL-1040 is administered via the coronary artery, as a liquid that is injected during catheterization into the blood stream and flows into the damaged heart muscle. The liquid polymerizes within the infarcted tissue and forms a protective scaffold that enhances the mechanical strength of the heart muscle during recovery and repair, thereby preventing pathological enlargement of the left ventricle after the MI. BL-1040 is absorbed naturally six weeks after injection leaving behind a stronger, more stable, healthier heart muscle.

Patients who have undergone an acute MI with severe heart damage are the most likely to benefit from BL-1040. Approximately 40% of acute MI patients develop left ventricle dilatation or heart failure, which carries a substantially greater mortality risk. This population includes approximately 380,000 patients in the US, with a total estimated U.S. market of over $1.5 billion.

BioLineRx, a clinical stage drug development company traded on the Tel Aviv Stock Exchange (TASE:BLRX), is dedicated to building a robust pipeline of promising therapeutics for unmet medical needs. The Company's leading programs are for schizophrenia and treatment of damaged heart tissue post-myocardial infarction. Additional products under development include compounds for the treatment of cancer and CNS, cardiovascular, metabolic, infectious and autoimmune diseases.

BioLineRx advances projects from early stage discovery and lead generation to advanced clinical trials, regulatory approval and marketing. Partnering with researchers, universities and biotech companies to further the commercialization of promising compounds, BioLineRx seeks to enrich the pipeline of large pharmaceutical companies seeking their next blockbuster drugs. The Company was founded in 2003 by leaders in the Israeli life science arena including Teva Pharmaceuticals Ltd, Giza, Pitango, Hadasit and the Jerusalem Development Authority. For more information, please visit www.biolinerx.com.

Sheba inaugurates lipid treatment center

Sun, 27 May 2007 14:57:01 PDT

A new home for the Center for Lipid and Atherosclerosis Treatment and Research was dedicated Friday at Sheba Medical Center at Tel Hashomer.

Named for the late Bert W. Strassburger of Germany, the curved glass and steel ultramodern building was donated by his son Robbie, an Israeli. More than 200 dignitaries and guests were on hand as Tel Aviv Chief Rabbi Israel Meir Lau affixed the mezuza at the main entrance to the building. Sheba Director-General Prof. Zeev Rotstein delivered the main address.

The center integrates a sophisticated patient care program with advanced scientific research into lipid metabolism disorders and cardiovascular diseases, integrating a lipid clinic, service laboratory and research laboratories.

Since its founding in 1993, the facility has gained nationwide recognition as the leading Israeli center in this field; and this year, the Health Ministry will formally designate it the Israel National Center for Lipids.

Atherosclerosis is the leading cause of death in the Western world. More than 10,000 Israelis die each year from the disease and its many complications. It is caused by the buildup of lipids - blood fats - in the coronary arteries.

Founded and directed by Prof. Dror Harats, the center conducts primary and secondary preventive programs for cardiovascular diseases; in the diagnosis and treatment of complicated cases of lipid disorders; and in sophisticated biochemical and genetic testing.

Harats diagnosed the first cases of congenital deficiency of lipoprotein lipase (a critical enzyme in lipid metabolism) - a diagnosis which has allowed for lifesaving treatment of ill newborns; the ApoCll and ApoB48 genetic mutations; and of severe pregnancy-related Hyperlipidemia (type V dyslipidemia) that causes recurrent miscarriages in women.

The labs are actively engaged in research of lipoprotein metabolism and cholesterol homeostasis, hypolipidemic drugs, targeting therapeutic genes to the vascular wall and the development and progression of the atherosclerotic lesion. They are accredited by the US Centers for Disease Control (CDC) in Atlanta and provide blood lipid profiling services to all Israeli hospitals.

Sheba Dedicates the New Bert W. Strassburger Lipid Center

Fri, 25 May 2007 15:29:25 PDT

TEL HASHOMER, ISRAEL The Sheba Medical Center at Tel Hashomer today dedicated a magnificent new building for its leading Center for Lipid and Atherosclerosis Treatment and Research. Named for the late Bert W. Strassburger of Germany, the curved glass-and-steel ultra-modern building was donated by Bert Strassburger's son Robbie, of Israel. More than 200 dignitaries and guests were on hand as Tel Aviv Chief Rabbi Israel Meir Lau affixed the mezuzah at the main entrance to the building. Sheba CEO Prof. Zeev Rotstein delivered the main dedication address.

The Bert W. Strassburger Lipid Center at Sheba integrates a sophisticated patient care program with advanced scientific research into lipid metabolism disorders and cardiovascular diseases. The Center integrates a lipid clinic, a service laboratory, and research laboratories. Since its founding in 1993, the center has gained nation-wide recognition as the leading Israeli center in this field; and this year, the Israel Ministry of Health is to formally designate the Sheba center as the Israel National Center for Lipids.

Atherosclerosis is the leading cause of death in the Western world. More than 10,000 Israelis die each year from the disease and its many complications.

Founded and directed by Prof. Dror Harats, the Sheba center is engaged both in primary and secondary preventive programs for cardiovascular diseases; in the diagnosis and treatment of complicated cases of lipid disorders; and in sophisticated biochemical and genetic testing. Prof. Harats diagnosed the first cases of Congenital Deficiency of Lipoprotein Lipase (a critical enzyme in lipid metabolism) – a diagnosis which has allowed for live-saving treatment of ill newborns; the ApoCll and ApoB48 genetic mutations; and of severe pregnancy-related Hyperlipidemia (type V dyslipidemia) that causes recurrent miscarriages in women.

Prof. Harats' laboratories are actively engaged in research of lipoproteins metabolism and cholesterol homeostasis, hypolipidemic drugs, targeting therapeutic genes to the vascular wall, and the development and progression of the atherosclerotic lesion. His labs are accredited by the American Center for Disease Control (CDC) in Atlanta, Georgia, and they provide blood lipid profiling services to all medical centers in Israel.

Prior to the dedication ceremony, the Israel Association for Prevention and Treatment of Atherosclerosis, of which Prof. Harats is chairman, held its annual conference at the Sheba Medical Center.

Sheba Doctor says: Type 2 Diabetes Takes Toll on Teens

Thu, 24 May 2007 15:02:11 PDT

With the incidence of type 2 diabetes and its complications among young people on the increase worldwide, aggressive measures are needed to treat and prevent the disease, two diabetes experts say.

Their article appears in the May 26 issue of The Lancet.

"The complications associated with adolescents' type 2 diabetes seems to behave differently than in children and adolescents with type 1 diabetes," said article co-author Dr. Orit Pinhas-Hamiel, of the Pediatric Endocrinology and Diabetes Department at Sheba Medical Center in Tel-Hashomer, Ramat-Gan, Israel.

These complications may be present at the time of diagnosis, and their rate of progression may be higher than in children and adolescents with type 1 diabetes, Pinhas-Hamiel said. "We need to develop improved approaches to awareness and early treatment of type 2 diabetes and associated abnormalities."

These complications, including high blood pressure, kidney disease, eye disease and problems with blood fat levels, may already be present when type 2 diabetes is diagnosed, while they rarely exist at the onset of type 1 diabetes, noted Pinhas-Hamiel and her colleague Dr. Philip Zietler, from the Department of Pediatrics at the University of Denver.

"In addition, studies to date suggest that early onset of type 2 diabetes is associated with a more rapid progression of these complications compared with adolescents with type 1 diabetes," Pinhas-Hamiel said.

Moreover, psychiatric problems are also associated with type 2 diabetes. In a study in Philadelphia, one in five such teens suffered from conditions such as depression, obsessive-compulsive disorder or other psychiatric conditions.

Another study found that the deaths of seven young black males, aged 13 to 21, with undiagnosed diabetes, met the criteria for high blood sugar and diabetic coma, the authors added.

Type 2 diabetes also puts unborn infants at risk. In a Canadian study of 51 pregnant adolescent girls with type 2 diabetes, only 35 had live births, and the pregnancy loss rate was 38 percent, the authors reported.

Pinhas-Hamiel thinks that adolescents with type 2 diabetes should be screened for signs of these complications when they are first diagnosed. "In addition, there is a need for well-established guidelines for the initiation of antihypertensive and anti-lipid treatments for adolescents with type 2 diabetes," she said. "Type 2 diabetes mellitus in children and adolescents is associated with significant morbidity and mortality."

One expert thinks this review confirms that type 2 diabetes in teens has become a serious public health problem.

"Recent studies have confirmed what most of us have long suspected, that the rate of what used to be called adult onset diabetes is rising rapidly in children and adolescents," said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine.

This study confirms another suspicion that even greater dangers are around the next corner should current trends persist, Katz said.

"In adults, type 2 diabetes is a potent risk factor for cardiovascular disease and other complications, from kidney failure to nerve damage," Katz said. "There is every reason to expect, and now findings to confirm, that these relationships hold in youth as well. When formerly adult onset diabetes develops in 7-year-olds, the threat of heart disease in 17-year-olds clearly looms," he said.

"Anyone who was waiting for an even more strident alarm before accepting that epidemic obesity and type 2 diabetes in our children is a public health crisis of the first order -- this is it," Katz said.

Another expert thinks that overweight adolescents who lead a sedentary life need to be tested for diabetes.

"Here we have a situation where we are not examining our youngsters for diabetes, and they already have complications present or developing," Dr. Stanley Mirsky, of Lenox Hill Hospital in New York City and a board member of the Juvenile Diabetes Foundation, said in a statement.

"We have to test these kids that spend all their time in front of the televisions or computers eating junk food instead of being outside exercising and eating right, especially when there already is a family history of diabetes," Mirsky said.

Founder of medical simulation center receives Humanitarian Award

Thu, 10 May 2007 15:13:21 PDT

The founder and director of the Medical Simulation Center at Sheba Medical Center, Dr. Amitai Ziv, was recognized last week for his efforts. He received the Charles Bronfman Humanitarian Award ($100,000), which is given to "an individual or team of people under the age of 50 whose Jewish values infuse their humanitarian accomplishments and provide inspiration for the next generation."

Leah and David, an ultra-Orthodox couple, brought their son to the hospital last Saturday night after he stopped breathing. They did not understand the meaning behind the questions the medical staff was asking, and antagonistically asked the attending social worker if she suspected they had done something to him.

When the doctors restored the boy's pulse, the parents asked them, "You're not Jewish, are you?" The Arab doctor and nurse responded that this was irrelevant.

This type of scenario occurs every day in Israeli hospitals, but last week the parents were actors, participants in an exercise conducted at the Medical Simulation Center (MSR in Hebrew) at Sheba Medical Center. The care providers were workers from Yoseftal Hospital in Eilat. The child was a sophisticated doll controlled remotely from an adjacent room.

After the exercise, the staff moved into a conference room for a detailed debriefing and performance analysis - how quickly the workers identified the medical problem and how they responded to the parents.

The MSR, which has 30 simulation rooms, is the largest of its kind in Israel and one of the largest in the world. The center is designed to minimize the number of mistakes that could cost patient lives.

Ziv says an estimated 2,000 patients die in Israel each year due to erroneous medical treatment. This figure is four times the number of traffic casualties.

Ziv likens the center to a flight simulator, an education method he knows from his military service as a fighter pilot.

"I crashed with the simulator dozens of times, but not even once with a real plane," he says.

Ziv's efforts in establishing the MSR were recognized last week when he received the Charles Bronfman Humanitarian Award ($100,000), Every day dozens of medical personnel - doctors, nurses and medics - come to the center to face situations that occur daily in hospitals. There are also training sessions for army personnel, who wear combat uniforms, complete with protective vests and helmets, and provide first aid to injured soldiers "on the battlefield."

The adult-size dolls wear blood-soaked uniforms. One doll has had its foot blown off. A machine emits thick smoke, and the sounds of gunfire and explosions echo in the air. A technician sitting in front of three computer monitors in the control room can give the wounded soldier complications with the push of a button, such as internal bleeding, a previously undetected head injury, falling blood pressure, low pulse and even death.

Ziv says Israel Defense Forces medical teams came to train at the MSR during the Second Lebanon War.

One of the videos in the MSR's library shows the head of a hospital oncology ward telling a man waiting in the hall that his wife has died in the operating room. The man starts crying bitterly and collapses against the wall.

"We introduce the teams that train here to the toughest moments in their profession, exposing them to nightmare situations," says Ziv. "One of our goals is to bring these people to their limits."

Some 30,000 personnel have trained at the MSR, and now medical schools are demanding candidates come here for testing. MSR staff cannot say how many unnecessary deaths the center has prevented, but are convinced that the exercises and the subsequent debriefing improve the quality of medicine at Israeli hospitals.

Bronfman Prize-winner Dr. Amitai Ziv from Sheba honored in New York

Fri, 04 May 2007 13:44:34 PDT

Teaching Medical Advances, And Humility

Tuesday Amitai Ziv, recipient this week of the $100,000 Charles Bronfman Prize, would like to see his work in medical simulation — a discipline that trains doctors and other health professionals to avert errors in times of crisis — expand to the entire Middle East, and well beyond the field of medicine.

Ziv, 48, was honored here on Tuesday for his work as founder and director of the Israel Center for Medical Simulation (MSR) and as deputy director of the Sheba Medical Center , the largest medical center in Israel.

The prize, in honor of philanthropist Charles Bronfman and created by his children, has been given each of the last three years to an individual or team of people under the age of 50 "whose Jewish values infuse their humanitarian accomplishments and provide inspiration to the next generation." The founders said that Ziv "represents the best of the young generation's values, commitment, creativity and energy" through his work in "reshaping the way medical care is delivered throughout the world."

A ruggedly handsome and friendly man, Ziv told The Jewish Week the honor came as a total surprise to him and that he hopes the recognition will give added credibility to a form of medical education that can be applied in many creative ways on a global scale.

A former combat pilot in the Israeli Air Force, Ziv applied flight simulation training to the field of medicine by putting doctors and others through situations of great stress. Using actors in some cases and mannequins in others, the MSR program offers up scenarios as varied as bombings and warfare, patients and families who need to be told of a devastating prognosis or dealing with a difficult and constantly complaining patient.

Such simulation has been used in medical facilities before, but MSR was the first program to employ it in a systematic way and on a national level, according to Ziv. "We were the first to apply it as a must-have program, not just a nice-to-have program," he said.

During last summer's war with Hezbollah, Israeli medical teams that went into the battlefield were first trained by MSR and said the preparation helped them save lives.

MSR has worked with medical professionals from around the world, including several Jordanian health officials and more than 30 Palestinians who came as individuals, just before Hamas took power last year, and were trained in dealing with medical trauma. "We put politics aside and talked medicine," Ziv said, "and they were extremely enthusiastic."

His goal is to set up a regional center that he hopes would serve as "a bridge to peace." But the political front on the Palestinian side "is a barrier," he said. "I wish we could do more."

MSR is partnering with the Mayo Clinic in Rochester, Minn., which could be used as a "back window" for states hostile to Israel to benefit from the medical training.

In light of the current headlines about the political meltdown in Israel, could simulation techniques be taught to government officials who deal with matters of life and death?

Definitely, according to Ziv, who pointed out that it is human nature for one to simulate a scenario to help prepare oneself for a situation, whether it is imagining the questions in advance of a job interview or thinking through a crisis in piloting a plane.

"It's mostly applicable to high-stakes professions where there are grave consequences for error," he said.

Simulation teaches a person not only to be a more efficient professional but a more humble person, said Ziv. "It creates situations where you have to push yourself to your limit and make errors. The hidden agenda is to see how you respond, to give you a sense of humility, caution and safety."

Ziv noted that Judaism has much to say about learning from one's mistakes, and he applies his work to his participation in Kolot, a pluralistic beit midrash, or study group, in Israel. In addition to offering study sessions on the notion of error, Kolot has a program, funded in part by UJA-Federation of New York, for medical professionals, who go through scenarios designed to highlight "the broken moments" between doctors and patients dealing with mistaken diagnoses and other errors, according to Ziv. They then "discuss it and link it" to Jewish texts.

"We are building a new language of simulation, medicine and Jewishness," he said, applying the notion of learning from mistakes, appreciating Jewish values and "preparing ourselves for difficult moments."

http://www.thejewishweek.com/news/newscontent.php3?artid=14010

Israeli founder of simulation center changing the nature of medical training

Thu, 26 Apr 2007 15:52:49 PDT

Dr. Amitai Ziv of Sheba to be awarded the Charles Bronfman 2007 Humanitarian Award this week

He learned how to eject from an airplane, land without an engine, and pilot calmly as smoke and flames threatened to engulf the cockpit. After hundreds of simulated and real flights under every possible condition, Amitai Ziv got his wings. But the combat pilot emerged from his Israel Air Force training with something else too: an idea that would eventually change the way medicine is studied - and practiced - first in Israel, and later, beyond.

"When a pilot has to eject for the first time, he has a feeling of déjà vu because he has done it so many times on a simulator. But young doctors are faced with many 'nightmare' scenarios that they have only read about," says Ziv, who went into pediatrics following his military service.

"In aviation, your first take-off is on a simulator. But in medicine, your first 'take-off' is on an actual patient. It seemed to me that the medical world had a lot to learn from aviation."

Ziv set out to adapt flight simulation training to the field of medical training.

The result is the Israel Center for Medical Simulation (MSR), a world leader in the field and already a model for similar centers in the US, Canada and South America.

This week, Ziv, the 48-year-old founder and director of MSR will be awarded the Charles Bronfman 2007 Humanitarian Award, in recognition of his accomplishments. The $100,000 prize celebrates the vision and talent of an individual or team of people aged 50 and under, whose humanitarian works have contributed significantly to the world's betterment.

Upon entering the Israel Center for Medical Simulation - located at Sheba Medical Center, outside Tel Aviv - you may encounter a smoke-filled room with sirens blaring and gunfire staccato. Lifelike mannequins strewn on the floor, a frothing at the mouth distressed person may run past pleading for help.

In the next room there might be a staggering drunk with bottle in tow while down the hall or a doctor attempting to extricate a baby mannequin stuck in a synthetic "mother" mannequin womb with monitors beeping loudly.

"We can simulate virtually every medical setting: from an emergency room to a delivery room, from a pharmacy to a battlefield," says the trim, boyish-looking Ziv whose eyes light up when he talks about the center.

At the center, health professionals also undergo training in communication: Pharmacists face clients with prescriptions for drugs that interact adversely, physicians encounter victims of domestic violence and surgeons practice relaying bad news.

The simulations are a combination of what Ziv terms "low-tech" - some 30 trained actors - and "high tech" - state-of-the art mannequins that exhibit vital signs like heart rate, blood pressure and oxygen saturation. Computerized mannequins, some specially designed for the center, can bleed, convulse or go into anaphylactic shock. All encounters are videotaped to enable health professionals to improve medical procedures and communication skills through debriefing sessions that follow.

"During the last Lebanon War, there was not a single doctor who went to the front without first refreshing his skills at MSR," Ziv told ISRAEL21c.

"It is not easy for a pediatrician who is used to dealing with ear infections to suddenly find himself with 80 injured soldiers. Many doctors told us that the training they underwent here was invaluable in preparing them for Lebanon," says Ziv, who continued to serve as a reserve combat pilot in the IDF until 1996, and is today deputy director of the Sheba Center, the largest hospital in Israel and, with 2000 beds, one of the largest in the Middle East.

While MSR helps prepare doctors for emergency situations - including chemical and biological warfare attacks - its main purpose is to train physicians in dealing with a myriad of other less chilling but equally challenging routine medical situations, some of which claim many more lives than terror attacks.

In fact, as many as 98,000 Americans die every year as a result of medical errors, according to the ground-breaking 2000 report, To Err is Human, by the Washington-based Institute of Medicine. One of the report's recommendations was the adoption of medical simulation instruction as a means of improving training and reducing errors.

"That is really an astonishing figure," notes Ziv. "It's the equivalent of a Boeing 747 crashing into the ocean every day. We would never tolerate such a thing in aviation, so why do we tolerate it in medicine?"

While still a student at Hadassah Medical School in Jerusalem Ziv began to explore ways to apply aviation to medicine. By the early nineties, he was using simulation to test the clinical skills of doctors in Spain, the Ukraine, Russia, Italy, and Brazil in a project for the US-based Educational Commission for Foreign Medical Graduates (ECFMG). Later, while doing his fellowship in adolescent medicine in Philadelphia, he and mentor, the late Dr. Miriam Friedman, were part of a team asked to develop and implement simulation-based licensing tests for foreign doctors wishing to practice in the US. Since their exam was adopted in 1998 no foreign doctor can practice medicine in the U.S. without demonstrating clinical skills through simulation.

While in Philadelphia a few of Ziv's air force buddies recruited him to join a start-up that was moving from aviation to medical simulators.

"They were ahead of their time," laments Ziv of the venture that failed to raise sufficient capital. The venture fizzled but Ziv's vision lived on.

"I wanted to change the whole concept of patient safety and the way we do medical education. My dream was to set up a national simulation center in Israel that would be a model for the world."

That opportunity came during a visit home. While lecturing at Sheba, then hospital director-general Prof. Mordechai Shani and current director Prof. Zeev Rotstein made Ziv an offer he couldn't refuse: the chance to build and head just such a center. Three years later the MSR - a Hebrew acronym for Medical Simulation Center - became the first multi-disciplinary multi-modal center in the world with Ziv at its helm.

MSR now serves as a model for other simulation centers at leading hospitals in North America including the Mayo Clinic, the Cleveland Clinic/Case Western Reserve, and McGill University in Montreal. Ziv is also a consultant for hospitals in Brazil, Italy and other cities in Canada that are considering establishing such a center. He has testified before the US Congress on MSR's medical emergency preparedness programs and briefed the US office of Homeland Security.

Meanwhile, hundreds of American doctors have trained at MSR through the American Physicians Fellowship program and nurses from the U.S., Italy and Guinea have trained at the center as well. Recently Ethiopian doctors learned to enhance AIDS related skills through an MSR program that incorporates Amheric-speaking actors from Israel.

"The impact and accomplishments of Ziv are unsurpassed by any other physician dedicated to medical education," says Dr. William Dunn, Director of the Mayo Clinic's simulation center. "He has established a facility unlike any in the world. He's had an incalculable worldwide impact."

In Israel, the center has spurred a quiet revolution in medical training and practice. Three out of five Israeli medical schools requires candidates to undergo simulation-based personality testing at MSR.

"This is a major shift," explains Ziv. "Instead of choosing candidates with high marks alone we can select students who demonstrate compassion and other outstanding interpersonal skills in real-life situations - not just in an interview."

Before beginning an internship, all graduates of medical school in Israel are now required to complete an intensive 5-day training course at MSR, which exposes them to what Ziv calls "nightmare scenarios.'

"They are alone in a room with a patient who has a heart attack; or they are in an elevator and realize they forgot to bring the patient's oxygen tank. The students say this is the most effective five days of their entire education. It's a place where they are encouraged to make errors, and learn the risks of the profession. They emerge humbled."

Since 2003, all anesthesiologists in Israel must pass a clinical skills exam, administered by MSR, that tests their competency in resuscitation, trauma management, crisis management in the operating room and other simulated scenarios. Similarly, no paramedic in Israel can get a license today without demonstrating his or her clinical skills in an MSR-administered test.

These factors make Israel a rigorous leader in terms of world licensing standards in several branches of medicine and some 30,000 medical professionals in Israel including doctors, nurses, social workers, pharmacists and physiotherapists have undergone training in a variety of hands-on experiential courses at the simulation center.

Ziv, an affable man with an easy-going manner, is the son of Canadian-born parents who immigrated to Israel in 1949. He grew up in Jerusalem, studied pediatric medicine at Hadassah Medical School, and adolescent medicine at the Children's Hospital in Philadelphia, and spent a year traveling through India following his service in the air force. He and his wife, Margalit, an educator, have three children; the oldest one, daughter Inbar, 21, is herself an Israeli army simulation instructor.

When Ziv started out in medicine, he flirted with the idea of becoming a neurosurgeon - something he now dismisses as "a macho trip." He was really drawn to what he calls "the softer side of medicine - educating and communicating" - and chose pediatrics. "Even as a combat pilot," he recalls, "I was involved in education. I would instruct other instructors and used simulation to do so; I role-played the dumb cadet," he laughs, "and they had to teach me to fly a loop."

As head of the MSR, and deputy director of Sheba - with responsibility for risk management and quality assurance Ziv no longer works as a pediatrician. "I miss that to a degree, but my passion is medical education and safety. That's where I feel I can have more influence and in an indirect way save lives by reducing medical errors."

Ziv's other passion is the in-depth study of Jewish texts - something he has pursued for several years in the framework of Kolot, a pluralistic beit midrash (Jewish study center).

Recently, Ziv helped launch a new program for health professionals run jointly by MSR and Kolot. Called Ailing and Healing, the program gives participants a chance to explore their roles as caregivers through Jewish text study and simulated real life scenarios.

When Ziv returned from the US in August 2000, he had another dream: "My hope was that MSR would be a resource for the entire Middle East. One month later, the intifada began."

Despite the rupture in Israeli-Palestinian relations, Ziv notes that MSR has been able to train a number of Palestinian doctors in trauma management. "You try to give your two cents to make this disturbed region a little more sane," he says. "And I still hope that some day medical education can be a bridge for peace."

Sheba: A Model for Arab-Israeli Peace

Thu, 17 Nov 2005 15:59:11 PST

This column is being written literally from the bottom of my heart. That is where I had a cardiac episode that culminated in open-heart surgery -- triple bypass.

The operation was performed by Dr. Ehud Ranani, head of the cardiac surgery department at the incomparable Chaim Sheba Medical Center, a government hospital where competence and efficiency are legendary.

Dr. Ranani perfected his technique during a two-year clinical fellowship at Toronto General Hospital under the tutelage of Dr. Tirone David.

The superb medical treatment I received gave me an inside look at what really makes Israel tick.

It introduced me to the ethnic and religious mosaic of which its staff is composed: Jews and Arabs, native-born 'Sabras' and recent arrivals from the former Soviet Union, colleagues from neighbouring countries, such as Greece and Cyprus and former Ethiopians who emigrated en masse in Operations Moses and Solomon.

They have some amazing characteristics. No matter how complicated and mind-boggling the paraphernalia of modern medicine may be, they master it and incorporate it into their constantly-upgraded systems.

For example, every procedure is computerized and every treatment, prescription and diagnosis recorded instantly by doctors and nurses to make sure there is precise continuity in their methodology.

One unique feature of Tel Hashomer, as this former British military hospital is popularly called, is its cardiac intensive care unit. Conceived and directed by Dr. Hanoch Hod, it prepares patients for the sophisticated procedures in store for them from the installation of pacemakers to delicate repairs of the heart.

There are only two setups like it in the world, one in California and one in Western Europe.

Towards the end of my stay, Dr. Hod took time out to conduct an international conference which began in Israel and continued in Spain during which he elaborated on his original concept and suggested ways it could be emulated abroad.

But the outstanding impression made on me by his tireless team of nurses was the extent to which its Arab and Jewish personnel were integrated. In many instances it was impossible to pinpoint their ethnic origin, not by their looks, Arabic accent (they have none) or gestures.

One of them told of his frequent trips to neighbouring Egypt, once a favourite destination for Israeli Arabs, a country where their language and religious background are dominant. As far as the Egyptians are concerned, he said, we are Israelis. They refuse to differentiate between us and our Jewish friends.

Another male nurse, also an Israeli Arab, said he loves to read the legal reports published in the ultra-liberal daily Haaretz because the Hebrew language is outstanding in its ability to express the fine points of cases brought to court, he said.

It goes without saying that patients have no way of knowing whether the skilled medical hands which may have saved their lives belonged to Israeli Jews or Israeli Arabs. That is the way it is at Tel Hashomer and that is the way it is at Jerusalem's Hadassah, Haifa's Rambam or any of the other hospitals in this country.

In reality, these medical institutions can and should be held up as models of genuine Jewish-Arab coexistence (and of Israeli-Palestinian coexistence prior to the senseless terrorism that tore the latter two communities apart).

When the bi-national relationship is based on mutual respect and professional esteem, when members of these nationalities work side by side for a common goal -- especially a humanitarian one -- life-saving miracles are accomplished.

It is a much more promising and hopeful basis for true peace than the creation of a separate and potentially revanchist Palestinian state as advocated in the much-touted two-state solution, which is not a solution at all.