Introduction

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a treatment process for restoring normal hematopoietic and immune functions. In this method, patients undergo high-dose radiotherapy and chemotherapy, and immunosuppressive pre-treatment is done to eliminate abnormal hematopoietic and immune systems. The patient is then transfused with allogeneic hematopoietic stem cells. This strategy is an effective cure for blood diseases, bone marrow failure syndrome, and immune deficiency.1,2 However, neutrophil deficiency, impaired mucosal barrier, and weakened immune function typically occur after transplantation, which increases the risk of infection after HSCT.3

Bloodstream infections (BSI) are a severe type of systemic infectious disease caused by the invasion of the circulatory system by pathogenic microorganisms. Notably, BSI is a common complication in the early stages of allo-HSCT and has an incidence rate of 13.6%38.9%.47 According to literature, the occurrence of bloodstream infections is a huge risk factor to early deaths after HSCT.810 The occurrence of BSI after HSCT is exacerbated by the widespread use of antibiotics and the resultant antibacterial resistance, especially multi-drug-resistant bacteria (MDR) that seriously affects the survival of transplant patients.1113 Thus, evaluation of the distribution and prevalence of drug-resistant pathogens of the bloodstream in allo-HSCT patients and the study of the BSI risk factors could guide the course of clinical treatment for BSI prevention and control. This study retrospectively analyzed the BSI risk factors in patients with allo-HSCT in the First Affiliated Hospital of Zhengzhou University from 2013 to 2017. The detection rate, distribution, and drug sensitivity of pathogenic bacteria after allo-HSCT was also evaluated.

From January 2013 to December 2017, 397 patients who received allogeneic HSCT for the treatment of hematological diseases in the First Affiliated Hospital of Zhengzhou University were selected. The patients included 242 males and 155 females, with a median age of 21 (162) years. Of these, 115 cases had acute myeloid leukemia (AML), 110 with severe aplastic anemia (SAA), 102 with acute lymphocytic leukemia (ALL), and 70 patients with other conditions.

According to the difference in the histocompatible typing and relationship, allo-HSCT is divided into matched sibling transplantation, partially matched related transplantation and matched unrelated transplantation. Among the 397 cases of allo-HSCT, 177 were matched sibling transplantation, 165 were partially matched related transplantation, and 55 were matched unrelated transplantation. According to the stem cell source, there were 333 cases of peripheral hematopoietic origin, 55 from peripheral blood combined with bone marrow transplantation, and nine involved cord blood transplantation.

Central vein catheterization was performed for all patients before transplantation conditioning. Modified busulfan/cyclophosphamide (Bu/Cy) and total body irradiation/cyclophosphamide (TBI/Cy) conditioning regimens were used for patients with acute leukemia, myelodysplastic syndrome, and lymphoma. Meanwhile, cyclophosphamide + anti-thymocyte globulin (Cy-ATG) and FluCy-ATG pre-treatment regimens were used for severe aplastic anemia. The GVHD prevention program used cyclosporine combined with mycophenolate mofetil and methotrexate, of which 272 cases were also treated with ATG to prevent GVHD.

All HSCT patients were admitted to the laminar flow purification ward after a medicated bath, and were given a sterile diet, and received oral, eye, nose, and perianal care. Take a 1:2000 chlorhexidine liquid medicinal bath for 20 minutes; routinely gargle with saline and cermetium chloride before and after three meals a day, add metronidazole solution if necessary; use 1% chloramphenicol, 0.5% Rifampicin eye drops alternate eye drops, 4 times/d; alternate nose drops with houttuynia cordata and streptomycin nasal drops, 4 times/d; rinse the perineum with warm water after each bowel movement, 3% boric acid solution for a bath for 20 Minutes, mupirocin is applied to the perianal area. Itraconazole, berberine, and compound sulfamethoxazole were administered orally for intestinal disinfection two weeks before transplantation. If the body temperature of patients got to 38.00C during transplantation or shivering occurred, 10 mL of blood from the peripheral vein was collected using standard. The blood was drawn twice in a row for separate cultivation of aerobic and anaerobic bacteria. For positive cases, broad-spectrum antibiotics were administered intravenously, and the treatment efficacy was evaluated 48 hours after the initial treatment. Treatment efficacy was empirically assessed based on blood culture results, WBC, C-reactive protein, and procalcitonin levels, after which ineffective treatment strategies were adjusted.

Agranulocytosis refers to the absolute value of neutrophils <0.5 109/L,14 while granulocyte reconstitution refers to neutrophils 0.5 109/L for three consecutive days after transplantation.

Fever is a single measurement of oral temperature 38.3C (axillary temperature 38.0C) or 38.0C (axillary temperature 37.7C) for more than 1 hour.

The pathogenic diagnosis of BSI was made after the isolation of pathogenic microorganisms from blood culture. If the same patient isolates the same bacteria, if the drug sensitivity is the same, it is 1 BSI. BSI-related mortality was defined as death occurring within 30 days after the diagnosis of BSI. Pre-engraftment BSI is defined as the infection that arises from the onset of the pre-treatment regimen to the time before granulocyte implantation.

VersaTREK automatic blood culture instrument (Thermo Fisher, USA), VITEK MS IVD 3.0 mass spectrometer identification instrument and VITEK2 Compact automatic microbial identification, and drug sensitivity analysis system for bacterial culture, identification, and drug sensitivity detection, spread through paper (K-B) method and E-Test were used in in vitro susceptibility tests and review of abnormal susceptibility results. The results were interpreted according to the standards issued by the United States Committee for Clinical and Laboratory Standardization (CLSI).15

The SPSS21.0 software was used for statistical analysis, and descriptive statistics were used to summarize clinical features. The univariate analysis used a chi-square test, while logistic regression was applied for multivariate analysis. A P-value of 0.05 was used as the level of significance; thus, P<0.05 indicated statistically significant differences.

Among the 397 HSCT patients, 294 had agranulocytosis fever, out of which 52 were microbiologically confirmed as BSIs. Therefore, the incidence of BSI was 17.7% (52/294), accounting for 13.1% (52/397) of all transplant patients. The implantation time of neutrophils is 13 days (11,15), and the time from agranulocytosis to BSI is 12 days (7,30). For 294 patients, we did 607 blood cultures, among which 60 were positive (9.9% positive blood culture rate). Out of the 294 patients, six had two or more pathogenic bacteria.

Sixty pathogens were detected in 52 patients, including 43 Gram-negative bacteria (71.67%), 10 Gram-positive bacteria (16.67%), and 7 fungi (11.67%). We found that Gram-negative bacteria accounted for most BSIs, followed by Gram-positive bacteria, and fungal infections were the least. The numbers and proportions of different strains of pathogenic bacteria are shown in Figure 1. In terms of drug resistance, the extended-spectrum -lactamase (ESBL) detection rates of E. coli and K. pneumoniae were 46.7% (7/15) and 30% (3/10), respectively. Carbapenem-resistant Enterobacteriaceae (CRE) accounted for 17.9% (5/28). The recorded patterns for Gram-negative bacteria drug susceptibility are shown in Table 1. The two staphylococci detected in Gram-positive bacteria were all methicillin-resistant, and all the three enterococci were sensitive to vancomycin, teicoplanin, and linezolid. The detected fungi belong to the genus Candida, and the resistance rates to itraconazole and voriconazole were 57.1% and 28.6%, respectively.

Table 1 Resistance Rate of Major Gram-Negative Bacteria to Common Antibacterial Drugs

Figure 1 Distribution of 60 isolated pathogenic bacteria pathogen.

Out of the 52 BSI patients, 33 improved after treatment, while 19 died after treatment failed (36.5%). Among the 19, 13 had Gram-negative bacteria infection, three were Candida infections, while another three were mixed Gram-negative and Gram-positive bacterial infection. Six of the seven patients who were resistant to carbapenems died.

We divided the 294 patients with agranular fever into two groups: BSI-free (242) and BSI (52). Univariate and multivariate analyses were applied for the study of BSI risk factors, including patients age, gender, disease type, stem cell source, pre-treatment application of ATG, combined diarrhea, oral ulcers, and presence of granules. Univariate analysis results demonstrated that the occurrence of BSI was correlated to the transplantation method, pre-treatment application of ATG, agranulocytosis time (21 days), and stem cell source (Table 2). Meanwhile, multivariate analysis showed that pre-treatment application of ATG, agranulocytosis time (21 days), and stem cell source were risk factors for BSI (Table 3).

Table 2 Univariate Analysis of Risk Factors for BSI

Table 3 Multivariate Analysis of Risk Factors for BSI

Allo-HSCT patients undergo prolonged agranulocytosis and develop an impaired mucosal barrier. Besides, the long-term use of immunosuppressive agents increases the incidence of bloodstream infections.47 In the present study, the incidence of bloodstream infections was 13.1% in all patients, and 17.7% in patients with febrile neutropenia. A previous study conducted in China reported that the incidence of bloodstream infections in patients with febrile neutropenia was 17.0%.16 Thus, our findings are consistent with earlier results of other studies. The mortality rate of allo-HSCT bloodstream infections in our center was 36.5%, which is higher than the 26.9% reported by Mikulska et al17 and the 31.1% reported by Stoma et al.18 In addition, studies by Stoma et al also found that the application of fluoroquinolones can reduce the incidence of bloodstream infections by affecting the colonization of intestinal bacteria, while insufficient empirical antibacterial treatment is associated with increased mortality.18,19 This disparity suggests that we should pay attention to the prevention and treatment of bloodstream infections in transplant patients and formulate anti-infection strategies based on the distribution of pathogens and drug resistance patterns to improve transplantation and survival rates.

This study detected 60 pathogens in BSIs, of which gram-negative bacteria (71.67%) were the main ones, followed by gram-positive bacteria (16.67%), and fungi were the least (11.67%) (Figure 1). Gram-negative bacteria were mainly of the Enterobacteriaceae family, particularly E. coli and K. pneumoniae. The non-fermenting bacteria P. aeruginosa was also detected. A 25-year study in Spain showed that BSIs after HSCT were mainly caused by gram-positive bacteria, with a downward trend in positive bacteria and an increasing trend in gram-negative bacteria.20 Blennow et al also reported similar conclusions.21 However, many transplant centers in China have reported that BSIs after HSCT are mainly caused by gram-negative bacteria, followed by gram-positive bacteria, while fungi make up the least proportion. Thus, the epidemiology of BSIs in our center conforms to the distribution pattern reported in other centers in China.22,23

In this study, the common Enterobacteriaceae (E. coli and K. pneumoniae) had ESBL detection rates of 46.7% and 30%, respectively, and carbapenem resistance rates of the two bacteria were 6.7% and 30%, respectively (Table 1). Thus, we found that E. coli is highly sensitive to carbapenem drugs, suggesting that these drugs can be used for empiric antibacterial treatment. The ESBL positivity rate and carbapenem resistance rate of K. pneumoniae were both 30% (Table 1), indicating that its clinical treatment can be a combination of tigecycline, polymyxin, and other drugs. Notably, research shows that combination therapy with antibacterial medications such as cyclin and polymyxin can reduce the mortality of patients.24,25 In the present study, the resistance rate of P. aeruginosa to carbapenems was 28.6%, while its resistance rate to both aminoglycosides and quinolones was 14.3% (Table 1). Thus, a combination of carbapenems, aminoglycosides, and quinolones can be used for clinical treatment. Multi-center research in China reported carbapenem resistance rates of 3.6% and 18.9% for E. coli and K. pneumoniae, respectively.26 Similarly, this study revealed high resistance of E. coli and K. pneumoniae to carbapenem. The high rate of mycene resistance could be attributed to the repeated use of broad-spectrum antibiotics in transplant patients and the continuous increase in multi-drug-resistant bacteria in recent years.27 In response to the rise in multi-drug-resistant bacteria, our center uses perianal swabs to regularly screen intestine colonizing bacteria in transplant patients. As such, pathogenic bacteria are identified early, and treatment strategies are adjusted based on drug sensitivity results. The sensitivity of Gram-positive bacteria to the glycopeptides vancomycin, linezolid, and teicoplanin was 100.0%, suggesting that Gram-positive bacteria BSIs can be completely treated in clinical practice. Thus, glycopeptide or azole drugs can be the first choice for the treatment of Gram-positive bacteria BSIs.

All the seven fungi in this study were Candida, and Candida tropicalis was the predominant species. The resistance rates to itraconazole and voriconazole were 57.1% and 28.6%, respectively. The mortality rate of candidiasis was high, which significantly threatened the survival of transplant patients. According to previous studies, caspofungin should form the first choice fungal treatment after allo-HSCT in clinical practice, combined with antifungal treatment if necessary.28,29

The single-factor and multi-factor analysis results showed that pre-treatment application of ATG, agranulocytosis time (21 days), and stem cell source were risk factors for BSI. The removal of T-lymphocytes from the body of ATG-pretreated patients significantly delays immune reconstitution,30 and the continued lack of granulocytes causes immunodeficiency in transplant patients, thus increasing the risk to BSIs. Peripheral blood combined with bone marrow transplantation, hematopoietic implantation is relatively fast, which may be the reason for the lower incidence of BSIs in this group of patients, relative to peripheral blood and cord blood transplantation.3133

The results of this study show that BSI is a common complication of allo-HSCT patients with agranulocytosis. Gram-negative bacteria were the most prevalent pathogen in BSIs, and drug resistance to carbapenem drugs was relatively high. The use of ATG in pre-treatment, agranulocytosis time (21 days), and stem cell source are risk factors for BSI. The high mortality rate of BSI substantially affects the prognosis of transplant patients, and attention should be paid on the distribution of pathogenic bacteria and drug resistance in the bloodstream of transplant patients. Besides, the treatment plan should be adjusted based on the specific bacteria and drug resistance patterns.

The patient consent was waived, since the research involves no more than minimal risk to the subjects because the review of subjects medical records is for limited information. The information is not sensitive in nature, and the data are derived from clinically indicated procedures. The precautions taken to limit the record review to specified data and the coding of the data further minimize the primary risk, which is a breach of confidentiality. This study has been approved by the ethics review committee of the research project of the First Affiliated Hospital of Zhengzhou University, and has obtained relevant certificates.

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. This study complies with the Declaration of Helsinki.

This project was supported by the Key Scientific Research Project Plan of Higher Education Institutions in Henan Province (18A320040).

The authors report no conflicts of interest in this work.

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[Full text] Clinical Analysis of Bloodstream Infections During Agranulocytosis Aft | IDR - Dove Medical Press

Dr. Shavelle, a Millikan High School (Long Beach, Calif.) graduate, is returning to Long Beach with more than 20 years of cardiology practice, research leadership, and teaching experience. He joins Long Beach Medical Center from Keck Medical Center at the University of Southern California, where he served as the Director of Interventional Cardiology while leading a multitude of clinical research trials, including several focused on implanted devices for heart failure. He plans on increasing the availability of clinical research trials for cardiology patients at Long Beach Medical Center.

"The MemorialCare Heart & Vascular Institute has a rich history of research and pioneering new treatment techniques," says Ike Mmeje, chief operating officer, Long Beach Medical Center.

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MemorialCare Heart & Vascular Institute facilities are among the most comprehensive centers for diagnosis, treatment and rehabilitation of cardiac disease, providing groundbreaking care for complex heart conditions, including myocardial infarction, heart failure, arrhythmias and peripheral vascular disease. In addition to his hopes to expand research opportunities, Dr. Shavelle plans on expanding the programs for heart failure and structural heart disease.

"I am excited to join the MemorialCare Heart & Vascular Institute at Long Beach Medical Center," says Dr. Shavelle. "My dad was a physician here, and many of my mentors and fellows are at Long Beach Medical Center. I'm looking forward to creating more collaboration among cardiologists, surgeons, residents and the entire team to expand the already comprehensive cardiology care available to the community."

After earning his medical degree from the University of California, Los Angeles (UCLA), Dr. Shavelle completed his internal medicine internship and residency at Harbor-UCLA Medical Center. He completed General Cardiology Fellowship at the University of Washington and Interventional Cardiology Fellowship at Harbor-UCLA Medical Center/Good Samaritan Hospital. Dr. Shavelle served as Associate Professor at both the David Geffen School of Medicine at UCLA and the Keck School of Medicine at the University of Southern California. He alsoserveson the editorial boards for the Journal of Cardiovascular Pharmacology and Therapeutics, Current Medical Research and Opinion and Cardiology Clinics.

The MemorialCare Heart & Vascular Institute delivering nearly 20,000 cardiovascular diagnostic tests and treatments last year continues to push the boundaries of discovery with many "firsts." These began 70 years ago when world-renowned cardiologist, researcher and educator, the late Mervyn Ellestad, M.D., co-invented at Long Beach Medical Center the modern-day maximum stress test to detect heart disease. Today, millions of exercise stress tests performed annually save hundreds of thousands of lives globally.

"It is amazing how the field of cardiology has grown and how many treatment options are available through minimally invasive techniques," says Dr. Shavelle. "Many of these new treatment options have come from research trials, and I'm looking forward to expanding the opportunities for patients in the Long Beach area. The studies we have in the pipeline include trials with stem cells and heart failure devices."

About MemorialCare Long Beach Medical Center:MemorialCare Long Beach Medical Center has been providing the community with compassionate, quality health care for more than 100 years. While leading in specialized care, research and education, Long Beach Medical Center uses the most advanced health care technologies it is the only hospital in L.A. County with the innovative ExactechGPS and ExcelsiusGPS surgical systems. Long Beach Medical Center is ranked no. 7 in the Los Angeles Metro Area by U.S. News & World Report and has earned Magnet recognition for nursing excellence. With leading centers for cancer, heart, rehabilitation, orthopedics, neurology and trauma, physicians and surrounding hospitals continually refer to its accredited programs. For more information, visit memorialcare.org/LongBeach.

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Newswise HACKENSACK, N.J.,AUGUST 17, 2020 U.S. News & World Report has recognized John Theurer Cancer Center at Hackensack University Medical Center as the best cancer center in New Jersey. The recognition reflects the extraordinary strength of its comprehensive patient care, research and education programs.

In 2019, John Theurer Cancer Center became a member of the National Cancer Institute-approved Georgetown Lombardi Comprehensive Cancer Center Consortium, making the Cancer Center a member of one of just 16 cancer consortia based at the nation's most prestigious institutions. The NCI endorses such consortia to bring together accomplished institutionswith independently proven records of excellence to join forces in pursuit of the NCI's original mission: improving cancer outcomes through scientific discovery, reducing the impact of cancer on individuals and communities and diminishing cancer disparities, and developing the next generation of cancer scientists, clinicians and educators.

John Theurer Cancer Center is organized into 16 specialized divisions, each led by a recognized expert in the field. With a strong focus on clinical science and innovation, John Theurer Cancer Center investigators were directly involved in the development of more than 40 new anticancer agents approved by the U.S. Food and Drug Administration over the last three yearsparticularly for blood cancers such as leukemia, lymphoma, and multiple myeloma, as well as solid tumors through Phase I first-in-human clinical trials.

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"Our exceptional team is proud to be recognized as the top cancer program in New Jersey. The scope and depth of expertise, together with our focus on clinical science and innovation, are what make our Cancer Center a destination program, explained Andre Goy, M.D., M.S., chair and chief physician of John Theurer Cancer Center, Lymphoma Division chief, physician-in-chief of the Hackensack Meridian Health Oncology Care Transformation Service, and a renowned lymphoma expert who led the Cancer Center's participation in the pioneering ZUMA-2 study. "Understandably, every person who receives a diagnosis of cancer seeks the center with the most experience and the best innovation. This is why patients come to John Theurer Cancer Center. We take care of each patient in a compassionate and friendly environment, and that's what makes our patients smile.

A number of metrics support that successful track record:

This recognition as the state's best cancer center reflects the strength of our research, the dedication of our multidisciplinary team, and the expertise of our physicians," said Ihor Sawczuk, MD, FACS, Hackensack Meridian Health regional president, Northern Market and chief research officer. We are grateful to our patients who have trusted us with their care and who continually inspire us to provide the best possible experience.

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About Hackensack Meridian Health Hackensack University Medical Center

Hackensack Meridian Health Hackensack University Medical Center, a 781-bed nonprofit teaching and research hospital located in Bergen County, NJ, is the largest provider of inpatient and outpatient services in the state. Founded in 1888 as the countys first hospital, it is now part of the largest, most comprehensive and truly integrated health care network in New Jersey, offering a complete range of medical services, innovative research and life-enhancing care, which is comprised of 35,000 team members and more than 7,000 physicians. Hackensack University Medical Center is ranked #2 in New Jersey and #59 in the country in U.S. News & World Reports 2019-20 Best Hospital rankings and is ranked high-performing in the U.S. in colon cancer surgery,lung cancersurgery,COPD, heart failure, heart bypass surgery, aortic valve surgery,abdominal aortic aneurysm repair, knee replacement and hip replacement. Out of 4,500 hospitals evaluated, Hackensack is one of only 57 that received a top rating in all nine procedures and conditions. Hackensack University Medical Center is one of only five major academic medical centers in the nation to receive Healthgrades Americas 50 Best Hospitals Award for five or more years in a row. Beckers Hospital Review recognized Hackensack University Medical Center as one of the 100 Great Hospitals in America 2018. The medical center is one of the top 25 green hospitals in the country according to Practice Greenhealth, and received 28 Gold Seals of Approval by The Joint Commission more than any other hospital in the country. It was the first hospital in New Jersey and second in the nation to become a Magnet recognized hospital for nursing excellence; receiving its sixth consecutive designation in 2019. Hackensack University Medical Center has created an entire campus of award-winning care, including: John Theurer Cancer Center, a consortium member of the NCI-designated Georgetown Lombardi Comprehensive Cancer Center; the Heart & Vascular Hospital; and the Sarkis and Siran Gabrellian Womens and Childrens Pavilion, which houses the Joseph M. Sanzari Childrens Hospital and Donna A. Sanzari Womens Hospital, which was designed with The Deirdre Imus Environmental Health Center and listed on the Green Guides list of Top 10 Green Hospitals in the U.S. Hackensack University Medical Center is the Hometown Hospital of the New York Giants and the New York Red Bulls and is Official Medical Services Provider to THE NORTHERN TRUST PGA Golf Tournament. It remains committed to its community through fundraising and community events especially the Tackle Kids Cancer Campaign providing much needed research at the Childrens Cancer Institute housed at the Joseph M. Sanzari Childrens Hospital. To learn more, visit http://www.HackensackUMC.org.

About John Theurer Cancer Center atHackensack University Medical Center

John Theurer Cancer Center at Hackensack University Medical Center is New Jerseys largest and most comprehensive center dedicated to the diagnosis, treatment, management, research, screenings, and preventive care as well as survivorship of patients with all types of cancers. The 16 specialized divisions covering the complete spectrum of cancer care have developed a close-knit team of medical, research, nursing, and support staff with specialized expertise that translates into more advanced, focused care for all patients. Each year, more people in the New Jersey/New York metropolitan area turn to John Theurer Cancer Center for cancer care than to any other facility in New Jersey.John Theurer Cancer Center is amember of the Georgetown Lombardi Comprehensive Cancer Center Consortium,one of just 16 NCI-approved cancer research consortiabased at the nations most prestigious institutions. Housed within a 775-bed not-for-profit teaching, tertiary care, and research hospital, John Theurer Cancer Center provides state-of-the-art technological advances, compassionate care, research innovations, medical expertise, and a full range of aftercare services that distinguish John Theurer Cancer Center from other facilities.For additional information, please visitwww.jtcancercenter.org

ABOUTHACKENSACKMERIDIAN HEALTH

Hackensack Meridian Health is a leading not-for-profit health care organization that is the largest, most comprehensive and truly integrated health care network in New Jersey, offering a complete range of medical services, innovative research and life-enhancing care.

Hackensack Meridian Health comprises 17 hospitals from Bergen to Ocean counties, which includes three academic medical centers Hackensack University Medical Center in Hackensack, Jersey Shore University Medical Center in Neptune, JFK Medical Center in Edison; two childrens hospitals - Joseph M. Sanzari Childrens Hospital in Hackensack, K. Hovnanian Childrens Hospital in Neptune; nine community hospitals Bayshore Medical Center in Holmdel, Mountainside Medical Center in Montclair, Ocean Medical Center in Brick, Palisades Medical Center in North Bergen, Pascack Valley Medical Center in Westwood, Raritan Bay Medical Center in Old Bridge, Raritan Bay Medical Center in Perth Amboy, Riverview Medical Center in Red Bank, and Southern Ocean Medical Center in Manahawkin; a behavioral health hospital Carrier Clinic in Belle Mead; and two rehabilitation hospitals - JFK Johnson Rehabilitation Institute in Edison and Shore Rehabilitation Institute in Brick.

Additionally, the network has more than 500 patient care locations throughout the state which include ambulatory care centers, surgery centers, home health services, long-term care and assisted living communities, ambulance services, lifesaving air medical transportation, fitness and wellness centers, rehabilitation centers, urgent care centers and physician practice locations. Hackensack Meridian Health has more than 36,000 team members, and 7,000 physicians and is a distinguished leader in health care philanthropy, committed to the health and well-being of the communities it serves.

The networks notable distinctions include having four of its hospitals are among the top hospitals in New Jersey for 2020-21, according toU.S. News & World Report. Additionally, the health system has more top-ranked hospitals than any system in New Jersey. Childrens Health is again ranked a top provider of pediatric health care in the United States and earned top 50 rankings in the annual U.S. News 2020-21 Best Childrens Hospitals report. Other honors include consistently achieving Magnet recognition for nursing excellence from the American Nurses Credentialing Center and being named to Beckers Healthcares 150 Top Places to Work in Healthcare/2019 list.

The Hackensack Meridian School of Medicine, the first private medical school in New Jersey in more than 50 years, welcomed its first class of students in 2018 to its On3 campus in Nutley and Clifton. The Hackensack Meridian Center for Discovery and Innovation (CDI), housed in a fully renovated state-of-the-art facility, seeks to translate current innovations in science to improve clinical outcomes for patients with cancer, infectious diseases and other life-threatening and disabling conditions.

Additionally, the network partnered with Memorial Sloan Kettering Cancer Center to find more cures for cancer faster while ensuring that patients have access to the highest quality, most individualized cancer care when and where they need it.

Hackensack Meridian Health is a member of AllSpire Health Partners, an interstate consortium of leading health systems, to focus on the sharing of best practices in clinical care and achieving efficiencies.

To learn more, visit http://www.hackensackmeridianhealth.org.

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Hackensack University Medical Center Has the Best Cancer Center in New Jersey John Theurer Cancer Center recognized by U.S. News & World Report -...

- Axol Softwave Therapy is a new treatment for erectile dysfunction (ED) and for men who want enhanced sexual performance

- The in-office treatment is non-invasive, safe, and effective with virtually no side effects

- Axol Therapy uses low-intensity sound waves

- Axol Therapy is an alternative to ED medications, surgical implants, penile pumps, and injections

DENVER, Feb. 24, 2020 /PRNewswire/ -- The men's sexual health specialists at Colorado Urology now offer an exciting new treatment option for men living with erectile dysfunction (ED) called Axol Softwave Therapy. This safe and non-invasive treatment option is helping many men with ED achieve spontaneous and natural erections without the help of medications. The therapy can also be used to enhance a man's sexual performance.

Colorado Urology (PRNewsfoto/Colorado Urology)

About 5 in 10 men experience erectile dysfunction (ED) at some point in their lives. First-line therapies often include oral medication to help men achieve an erection. Now, Axol Therapy is providing a safe and effective alternative.

This non-invasive procedure uses gentle full-spectrum, low-intensity sound waves that stimulate revascularization, a process in which new blood vessels form. Axol Therapy promotes improved blood flow to the penis, reduces inflammation, and stimulates the migration of the body's stem cells for long-term healing. The new treatment is helping men to achieve natural erections without ED medications, pumps, injections, or penile implants.

Learn about Axol Softwave Therapy at Colorado Urology: https://www.coloradouro.com/specialties/axol-softwave-therapy/.

Axol Therapy How it Works

Axol Therapy is a modern approach to healing the body by using four types of energy: Heat, Electrohydraulic, Acoustic, and Light (HEAL). Unfocused acoustic waves are delivered to the shaft of the penis using a treatment wand that features a patented unfocused electrohydraulic acoustic wave.

The pulsed acoustic waves are delivered through the skin into the tissue to open and repair aging blood vessels, stimulate new blood vessel growth, restore blood flow, and improve erectile quality. Axol Therapy typically takes only 20 minutes, once a week, for a total of six sessions in the physician's office.

How Well Does Axol Therapy Work?

For men who are the right candidates, Axol Therapy is a safe and effective option without the side effects often experienced with oral medications. Most patients can get the quality, rigid erections they once had with Axol Therapy's gentle acoustic pulse treatment within just six office visits. Incremental improvement in erectile function may be seen after just a few sessions.

Restoring Vitality and Quality of Life

There are a number of significant benefits to Axol Therapy. For men who are candidates for this treatment option, a future without erectile dysfunction is perhaps the biggest one. The restoration of a man's vitality and spontaneous active sex life are also major benefits of this exciting new treatment.

Learn more about Axol Softwave Therapy, the benefits, and how to schedule a consultation. Visit https://www.coloradouro.com/specialties/axol-softwave-therapy/or call 888-401-7149.

About Colorado Urology

Colorado Urology, an affiliate of United Urology Group, is Eastern Colorado's premier urology practice, which was formed when Advanced Urology, Alpine Urology, and Foothills Urology became one urology group in April 2019. The group provides a broad array of urologic services, and its integrated approach to urologic care provides patients with access to experienced specialists, a comprehensive support team of healthcare professionals, innovative diagnostic tools, and highly advanced treatments and therapies. Colorado Urology operates 12 medical offices throughout the Denver metro and Boulder area, has 18 urologists, 9 advanced practice providers, and more than 130 employees.

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About United Urology Group

United Urology Group is a national management services organization whose member groups of urology practices include: Arizona Urology Specialists with locations across the greater Phoenix area; Chesapeake Urology, with offices located throughout Maryland and Delaware; Tennessee Urology, based in Knoxville, TN; and Colorado Urology, located in the greater Denver, Boulder and Front Range areas. United Urology Group members' collective staff today number more than 1,400 employees, including 150 physicians. United Urology's vision is to support the creation of a national network of urology affiliates, which will enable urologists to better meet the needs of their patients and provide the highest level of urological care.

Media Contact:

Patricia Schnably, Senior Vice President, Marketing & Communications United Urology Group25 Crossroads Drive, Suite 306, Owings Mills, MD 21117443-738-8107 pschnably@uniteduro.com

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SOURCE Colorado Urology

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Breakthrough, Non-Invasive Treatment Called Axol Therapy For Erectile Dysfunction And Enhanced Sexual Performance Now Available At Colorado Urology -...

Howard University Hospital's Dr. Ermias Aytenfisu seeks to clear up misconceptions about marrow donation in the minority community.

WASHINGTON, D.C. (August 21, 2017) Elsa Nega is an Ethiopian-Canadian mother of two young children. She loves her children and wants to watch them grow. However, Nega has a rare form of blood cancer, leukemia, and needs a bone marrow transplant to survive.

Black patients like Nega are the least likely to find their suitable blood marrow match, according to Be The Match which is hosting a Stem Cell/Bone Marrow registry event at the Howard University College of Medicine on Wednesday, Aug. 30 between 11 a.m. and 3 p.m. The exact location for the registry drive is the lobby outside of room 1008 in the Numa P. Adams building.

Negas story began in February when she walked into her local ER and was rushed to intensive care. By the next morning Nega was diagnosed with Acute Lymphoblastic Leukemia (ALL) and started on chemo immediately. Unlike 90 percent of patients who go into remission after the first round of chemo, she did not.

Now, after three rounds of chemo, a bone marrow transplant is her only hope of recovery. Negas siblings were not a match and she is reaching out to the Washington region because of its large population of people of Ethiopian descent.

There are a lot of myths associated with marrow donation, said Amanda Holk, community engagement representative with the Be The Match in Washington, D.C. There is so much fear surrounding the process but most donors are back to work the next day.

ErmiasM. Aytenfisu, M.D., stroke medical director at Howard University Hospital said the most common way to donate bone marrow is through a procedure called peripheral stem cell donation. No surgery is involved. Donors receive medication to increase peripheral stem cells before the donation. On the day of donation, blood is removed through a needle on one arm and passed through a machine that separates out the blood-forming cells. Uncommonly marrow donation involves surgical techniques that use a special needle to take out blood forming cells. During the procedure, the patient is anesthetized and feels no pain.

Joining the bone marrow registry at the Howard University College of Medicine event involves a simple as a cheek swab and an application. A persons chance of being a match at that point is only 1 in 500. But, for a patient like Elsa, you could be the only one. Elsa does not have a single match on the registry although there are 30 million people signed up.

For more information, contact Amanda Holk via email AHolk@nmdp.org or 202-875-9987

For the Howard University registry drive, please note that you must be between the ages of 18 and 44 to join the registry since research has shown that the younger the cells, the better the patient outcomes. And the following conditions prevent you from joining:

Hepatitis B or C

HIV

Organ, marrow or stem cell transplant recipient

Stroke or TIA (transient ischemic attack)

Other upcoming local events to support Elsa Nega:

*Empower the community (The Helen Show)

Date: 08/26/2017 (Sat.)

Location: Washington Convention Center

*Ethiopian Day Festival

Date: 09/03/2017 (Sun.)

Location: Downtown Silver Spring

About Howard University Hospital

Over the course of its roughly 155-year history of providing the finest primary, secondary and tertiary health care services, Howard University Hospital (HUH) remains one of the most comprehensive health care facilities in the Washington, D.C. metropolitan area and designated a DC Level 1 Trauma Center. The hospital is the nation's only teaching hospital located on the campus of a historically Black university. For more information, visit huhealthcare.com

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Howard University Hosts 'Be The Match' Marrow Registry Drive - Howard Newsroom (press release)

Los Angeles, CA (PRWEB) July 22, 2014

MetroMD, one of the leading names in regenerative medicines in all of California and one of the greatest proponents of holistic health services, now brings a reason to rejoice for individuals long suffering from debilitating arthritis. As per a report published on March 6 2013, by The Journal of Bone and Joint Surgery on The US National Library of Medicine National Institutes of Health (Ref: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748969/), on an average, around 500,000 revision of knee replacement surgeries were recorded in the US - with the prime reason being osteoarthritis in majority of these cases. And If Mr. Devin Stone, MetroMDs Operations Director is to be believed, the cumulative cost of the treatment is estimated to be around $50 billion every year.

The cost covers hospitals bills, doctors visits, medicine, etc and makes arthritic treatment, which often requires a repeat procedure, a hugely burdensome endeavor. But the fact is, even after spending so much of money, one is not sure about getting fully relieved from the agony that arthritis brings to ones life. Arthritis appears in many forms and the expresses itself as joint pain, stiffness and limited body movement in a patient, says Dr Alex Martin, MD, MetroMDs Director of Medicines. MetroMD, ensures that patients can put aside all these concerns and enjoy complete healing that only an advanced Stem cell therapy for arthritis can promise, says Dr. Martin highlighting the fact regarding how pocket-friendly the treatment is. One can regain a healthy knee, while retaining the health of his/her money bag now with MetroMDs stem cell therapy.

How does MetroMDs Stem cell therapy Work?

MetroMDs stem cell treatment process includes extraction of healthy bone marrow out of the patients body by experts and placing it in a centrifuge. After segregating various elements of blood, the stem cell is isolated and placed with cellular growth promoters (found in platelets). All of these are then inserted into the part of the body, ensuring a quicker tissue-based healing.

Mr. Devin Stone exuded confidence in mentioning that MetroMDs stem cell therapies come as a great alternative to invasive surgeries - making way for easier and quicker knee replacements and arthritic treatment.

Is the stem cell therapy safe?

Dr. Alex Martin says, If you are suffering from chronic joint paint due to arthritis, surgery is not anymore the only answer. Stem Cell Therapy can provide an amazing alternative, where your own cells are used to promote healing inside your body. Medicine has advanced significantly in the last 15 years and persistence with the techniques that were pioneered over two decades ago is illogical- and newer and less invasive procedures are the future of medicine.

Backed by the fact that stem cell treatment is a minimally invasive procedure requiring little or no hospitalization, Dr Martins and MetroMDs stance towards propagating stem cell therapy looks only logical. The procedure is legal and the therapy rendered by MetroMD is in compliance with CFR 21 part 1271 standards. Being a non surgical process, evidently, its the safest and totally side-effect free process.

Dr. Martin welcomes the residents of LA suffering from debilitating arthritic condition to consult an expert at its branches spread across in several parts of Los Angeles - and enjoy an improved quality of life.

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Arthritis Alleviated: MetroMD Introduces Latest in Stem Cell Therapy in LA; Promises to be Especially Helpful for ...

WASHINGTON (AP) -- No batteries required: Scientists are creating a biological pacemaker by injecting a gene into the hearts of sick pigs that changed ordinary cardiac cells into a special kind that induces a steady heartbeat.

The study, published Wednesday, is one step toward developing an alternative to electronic pacemakers that are implanted into 300,000 Americans a year.

"There are people who desperately need a pacemaker but can't get one safely," said Dr. Eduardo Marban, director of the Cedars-Sinai Heart Institute in Los Angeles, who led the work. "This development heralds a new era of gene therapy" that one day might offer them an option.

Your heartbeat depends on a natural pacemaker, a small cluster of cells it's about the size of a peppercorn, Marban says that generates electrical activity. Called the sinoatrial node, it acts like a metronome to keep the heart pulsing at 60 to 100 beats a minute or so, more when you're active. If that node quits working correctly, hooking the heart to an electronic pacemaker works very well for most people.

But about 2 percent of recipients develop an infection that requires the pacemaker to be removed for weeks until antibiotics wipe out the germs, Marban said. And some fetuses are at risk of stillbirth when their heartbeat falters, a condition called congenital heart block.

For over a decade, teams of researchers have worked to create a biological alternative that might help those kinds of patients, trying such approaches as using stem cells to spur the growth of a new sinoatrial node.

Marban's newest attempt uses gene therapy to reprogram a small number of existing heart muscle cells so that they start looking and acting like natural pacemaker cells instead.

Because pigs' hearts are so similar to human hearts, Marban's team studied the approach in 12 laboratory pigs with a defective heart rhythm.

They used a gene named TBX18 that plays a role in the embryonic development of the sinoatrial node. Working through a vein, they injected the gene into some of the pigs' hearts in a spot that doesn't normally initiate heartbeats and tracked them for two weeks.

Two days later, treated pigs had faster heartbeats than control pigs who didn't receive the gene, the researchers reported in the journal Science Translational Medicine. That heart rate automatically fluctuated, faster during the day. The treated animals also became more active, without signs of side effects.

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Scientists Try To Create Biological Pacemaker

Ben Moody of Evanescence talks HGH Stem Cell Therapy MetroMD Los Angeles

By: CARLY SMITHSON

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Ben Moody of Evanescence talks HGH Stem Cell Therapy MetroMD Los Angeles - Video

05-02-2012 11:27 MetroMD.net Dr. Martin explains why bone marrow is a better source than fat tissue for viable stem cells in your own body. Questions? Please call the MetroMD Institute of Regenerative Medicine at (323) 285-5300 or email us at info@MetroMD.net. Los Angeles

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What Is The Best Source for Stem Cells- Bone Marrow or Fat Tissue? | MetroMD Los Angeles - Video

05-02-2012 05:11 Dr. Martin of MetroMD performs a bone marrow extraction procedure to harvest stem cells. The extracted bone marrow will be centrifuged to separate targeted stem cells and re-injected into the patient's injured joints. Questions? Please call the MetroMD Institute of Regenerative Medicine at (323) 285-5300 or email us at info@MetroMD.net. MetroMD.net

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Bone Marrow Extraction Procedure to Harvest Stem Cells | MetroMD Los Angeles - Video

02-09-2011 03:47 metromd.net Stem Cells to Treat Acne Scarring | An overview by Alex Martin, MD of how he combines stem cell therapy and the CO2 fractional laser to effectively treat facial scars caused by acne. Offices near Hollywood, Beverly Hills, Los Angeles and Orange County. Questions? Please call the MetroMD Institute of Regenerative Medicine at (323) 285-5300 or email us at info@MetroMD.net.

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Stem Cells to Treat Acne Scarring | Los Angeles | Hollywood | Beverly Hills - Video

metromd.net Where Do The Stem Cells Come From? A discussion of the different sources of stem cells for therapy and autologous treatment by Alex Martin, MD

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Where Do The Stem Cells Come From? Hollywood | Los Angeles - Video

metromd.net Stem Cell Therapy for Repairing Joint Injuries | Stem Cell Therapy is effective in many orthopedic applications. Restore function and relieve pain from torn ligaments, tendons and damaged cartilage.

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Repair Your Joint Injuries With Stem Cell Therapy | Los Angeles | Beverly Hills | Hollywood

MetroMD.net Stem cell face treatments are an exciting new application for stem cells. Although studies are still being compiled, people who have been treated claim that the stem cell facial provided them with smooth, translucent and far more youthful looking skin

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Stem Cell Face Treatment - What People Are Saying | Beverly Hills | Los Angeles