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Our neurologists and neurosurgeons are leaders in the treatment of complex
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BREAKTHROUGHS AND BREAKING NEWS


HELP FOR COMPLEX SCOLIOSIS PATIENT

Sixteen-year-old Rishee Ray is making history at Cedars-Sinai as the first
pediatric patient to undergo halo-gravity traction ahead of spinal surgery.
Rishee has spent most of his life in a wheelchair due to a condition known as
spinal muscular atrophy, a group of inherited diseases that affect the muscles
responsible for voluntary movement in the body.  The condition caused Rishee to
develop severe scoliosis, with a 135-degree curve in his spine that was
compressing vital organs and impairing his ability to sit upright. Additionally,
he developed severe kyphosis, another dramatic curve from the side of his spine.
“When we looked at the right side of the chest, we could see his ribs literally
stacked on top of each other, causing severe restrictive lung disease,” said
Kenneth Illingworth, MD, pediatric spine surgeon at Cedars-Sinai Guerin
Children’s. “Not only that, but there was also severe shoulder imbalance and
coronal imbalance when he was sitting down.” Illingworth said that to correct
the extreme curvature in Rishee’s spine, spinal fusion surgery was the best
option. However, because the curvature was so severe, surgery would have to wait
while Rishee underwent a different treatment.   “When you have curves that are
that large, it makes it extremely challenging to operate on,” said Illingworth.
“It also makes it extremely dangerous to the spinal cord.” As a prelude to
surgery, Illingworth recommended halo-gravity traction, a method that gently
stretches and straightens the spine using a lightweight metal ring or halo that
is attached to the skull with small pins. Once the halo is in place around the
head, it is attached to a pulley system, and weights are gradually added to
slowly straighten the curved or compressed spine. Most halo-gravity traction
procedures on children last between three and eight weeks. For Rishee, it was a
five-week process. “At first it was difficult; it was this new thing on my head,
but I got used to it,” said Rishee. Pooja Ray, Rishee's mother, provided
constant support, staying by Rishee’s side day and night, sleeping alongside him
at Cedars-Sinai Guerin Children’s. “We’ve been in the hospital for 40 days, but
we have a purpose, so I don’t give my comfort that much of a thought, my goal
was more important,” Pooja said. The process ultimately yielded remarkable
results. Halo-gravity traction reduced Rishee’s curvature by half, decreasing it
from 135 to approximately 70 degrees. And the straightening gave Rishee an
additional three inches in height. “I know it looks barbaric, but trust me, it’s
one of the best procedures when you have to do corrective scoliosis treatment,”
said Pooja. After the halo traction device proved successful, Illingworth
proceeded with the spinal fusion surgery, providing Rishee with relief from the
severe lung compression he had been enduring and improving his daily comfort in
his wheelchair—a critical element of his everyday life. With the successful
surgery behind him, Rishee can now sit upright, igniting a newfound sense of
hope and optimism for his future. “I feel more confident,” said Rishee. “I am
able to control my neck and body better and can hold my head up and sit up
straight without any external support.” Rishee, who divides his time between
India and Los Angeles, is back to his hobbies of swimming and painting and is
pursuing higher education. He feels tremendous gratitude to his care team at
Cedars-Sinai and to his mother. “My mom was a great support, both emotionally
and physically,” said Rishee. “Without her, this couldn’t have been possible.”
Read more on the Cedars-Sinai Blog: Seeking a Second Opinion for a Spine
Condition



KEEPING RHYTHM: HOW CONGENITAL HEART PATIENTS CAN MOVE FROM PEDIATRIC TO ADULT
CARE

The transition from pediatric to adult care is a crucial one for people with
congenital heart defects. Smidt Heart Institute experts share tips for a
seamless transition.



$25M GIFT CREATES ALFRED E. MANN PRECISION MEDICINE INNOVATION CENTER

Alfred E. Mann possessed a rare superpower: He could seamlessly connect the dots
between science and philanthropy to improve the lives of people all over the
world. Today, seven years after his passing, Mann extends his legacy as a
scientific trailblazer by funding next generation medical research and
technology through his charitable organization. Alfred E. Mann Charities,
Incorporated, has just announced a $25 million gift to the Cedars-Sinai Board of
Governors, which marks the organization’s largest single pledge to an individual
institution. The gift will establish the Alfred E. Mann Single Cell Precision
Medicine Center at Cedars-Sinai, which will accelerate single cell biology
research being advanced at the Board of Governors Innovation Center. “This
generous gift will propel groundbreaking research at the innovation center,”
said Shlomo Melmed, MB, ChB, executive vice president of Academic Affairs and
dean of the Medical Faculty. “Single cell biology is a rapidly growing field in
medicine and Cedars-Sinai continues to position itself as an innovative leader
in this exciting field, driving clinical innovation for our patients.” The Mann
center will house laboratories where researchers will focus on the causes of
developmental, neurological, immunological, cardiovascular, pulmonary and
gastrointestinal diseases, as well as develop curative treatments for patients
diagnosed with these challenging illnesses. “What an incredible honor for
Cedars-Sinai to receive this unprecedented gift to the Board of Governors,” said
Arthur J. Ochoa, JD, senior vice president of Advancement and chief advancement
officer at Cedars-Sinai. “The name Alfred Mann characterizes what selfless
humanitarianism and scientific brilliance can accomplish.” This transformative
donation also enables the Board of Governors—a community of philanthropic
leaders supporting innovation in healthcare—to conclude and celebrate its
current $50 million fundraising campaign five years ahead of schedule. “We are
so grateful to Alfred E. Mann Charities for their generous support and for being
the catalyst to closing this crucial chapter of the Board of Governors
fundraising campaign,” said Jeffrey Golden, MD, vice dean of Research and
Graduate Education and director of the Burns and Allen Research Institute at
Cedars-Sinai. Alfred Mann was a prolific inventor who dedicated his life to
utilizing technology and innovation to improve health outcomes for millions of
people. Some of his most renowned accomplishments include pioneering the
development of pacemakers, insulin pumps, inhalable insulin powder, and cochlear
implants for the deaf. During his lifetime, he founded 17 companies, all focused
on bridging medicine and engineering. Today, his visionary influence carries on
through the work of Mann Charities and its officers and directors, Michael
Dreyer and Anoosheh Bostani, valued members of the Board of Governors who are
dedicated to facilitating pioneering medical discoveries that result in better
treatments and compassionate care of patients. This significant gift from the
charitable organization will help to fully realize the shared mission of Mann
Charities and Cedars-Sinai. “There’s no question that this contribution is what
Alfred Mann would have envisioned in his unwavering commitment to furthering
health care with new and innovative treatments and technologies,” Dreyer said.
Bostani added, “As invested Board of Governors members, we look forward to
supporting forward-thinking initiatives that will now come to fruition at this
new center." Read more on the Cedars-Sinai Blog: New Tools at the Innovation
Center



NEW USES FOR EXISTING TREATMENTS: THE PRACTICE OF DRUG REPURPOSING

The practice of studying existing drugs for novel uses is supported by the
emergence of artificial intelligence.



SUBSTANCE ABUSE IN PREGNANCY DOUBLES CARDIOVASCULAR RISK

Pregnant women with a history of substance abuse face a dramatically increased
risk of death from heart attack and stroke during childbirth when compared with
women without history of substance abuse, a new Smidt Heart Institute study
shows. These findings are published in the Journal of the American College of
Cardiology: Advances.   “This telling research shows that substance use during
pregnancy doubled cardiovascular events and maternal mortality during delivery,”
said Martha Gulati, MD, senior and corresponding author of the study and the
associate director of the Barbra Streisand Women’s Heart Center in the
Department of Cardiology in the Smidt Heart Institute. “Substance abuse also
doubled the risk of acute heart failure.” The substances studied in the research
included cocaine, opioids, alcohol, amphetamine/methamphetamine, and cannabis.
Each substance carried a different amount of risk on expectant mothers:
Amphetamine/methamphetamine had the greatest association with the development of
acute heart failure (nine times greater risk), acute heart attack (7 1/2 times
greater risk), cardiac arrest (seven times greater risk) and maternal mortality
(three times greater risk). These substances are known to increase heart rate
and blood pressure and cause structural and electrical changes of the heart.
Cocaine had the strongest association with stroke and was also found to be
associated with arrhythmias, which are abnormal heart rhythms. Opioid use had
the strongest association with infection of the heart valves—a disease known as
endocarditis—which was not surprising given that these drugs are often injected
into the bloodstream. Alcohol use was associated with the greatest risk for
arrhythmias. Cannabis—the most commonly used substance—was not associated with
maternal mortality. It was, however, associated with a higher risk (twofold
greater risk) of heart attack. “Despite the widespread legalization of cannabis
across the nation, many people are unfamiliar with the risks it can pose during
pregnancy,” said Gulati, also the director of Preventive Cardiology in the Smidt
Heart Institute and the Anita Dann Friedman Endowed Chair in Women’s
Cardiovascular Medicine and Research. “Cannabis causes heart cell death and can
also lead to severe cardiovascular events.” To decipher these results, study
investigators reviewed data on delivery hospitalizations between 2004 and 2018,
using the Nationwide Inpatient Sample database. A total of 60,014,368 delivery
hospitalizations occurred during the time frame, with substance use complicating
955,531 deliveries, or 1.6%. Of the 1.6% of substance-related deliveries, women
experienced conditions including heart attack, stroke, arrhythmia, endocarditis,
acute cardiomyopathy, heart failure and cardiac arrest. Investigators say these
findings underscore an important public health issue. “This study highlights the
need for additional medical care for pregnant women with substance use,” said
Christine M. Albert, MD, MPH, chair of the Department of Cardiology in the Smidt
Heart Institute and the Lee and Harold Kapelovitz Distinguished Chair in
Cardiology. Albert also suggests that prenatal care for women with a history of
substance use should include a multidisciplinary cardio-obstetrics approach with
high-risk pregnancy specialists and cardiologists to help identify and minimize
adverse outcomes. “For the wellbeing of pregnant women and their children,
substance abuse needs to be considered an independent risk factor for
cardiovascular events in pregnancy,” Albert said.   Read more from the
Cedars-Sinai Blog: Understanding Prenatal Genetic Testing and Diagnostics




BENCH TO BEDSIDE EXCELLENCE


RESEARCH

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knowledge of complex medical conditions and treatments.




ACADEMICS

Compassion and curiosity drive our commitment to educating the next generation
of medical professionals.




MEDICAL PROFESSIONALS

Collaborate with specialists across a wide range of clinical areas and benefit
from our commitment to innovation and education.





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