UCLA Urology - UCLA Health
UCLA UrologyUPDATEAbove left: UCLA Urology’s Dr. Bernard Churchill (center), who held the Judith and Robert Winston Chair in Pediatric Urology until his retirement and is currently chairman of theboard for MicrobeDx, with the company’s CEO, Richard Janeczko (left) and lab manager Colin Halford, who co-founded the company along with Dr. Churchill and UCLA Urology’s Dr.David Haake. Above right: The company is developing a rapid test to confirm urinary tract infection and determine appropriate antibiotics.UCLA Urologists DevelopRapid UTI Diagnostic TestWinter 2019Sir Alexander Fleming, a Scottish bacteriologist, changed the course of medicine with his1928 discovery of penicillin, which paved the way for the use of antibiotics to treat patientswith bacterial infections. But nearly a century later, antibiotic resistance has become one ofthe world’s biggest public heath crises. Through the evolutionary process, bacteria learn to adaptto antibiotics over time, necessitating the development of new drugs. And because antibiotics areoverused — according to the U.S. Centers for Disease Control and Prevention, each year at least 47million antibiotic prescriptions are unnecessary — the pace of antibiotic resistance is accelerating.One of the primary reasons for the overuse of antibioticsis that for some infections it can take up to 72 hoursto determine what, if any, drug is appropriate — theprocess known as antibiotic susceptibility testing. Suchis the case for urinary tract infections (UTIs), which areamong the most common infections worldwide. Morethan 150 million UTIs occur each year, primarily inwomen. And as anyone who has ever experienced aUTI can attest, the discomfort can be so severe thatwaiting up to three days to confirm the infectionand determine what antibiotic will be effectiveisn’t feasible. So in most cases, physicians use theirbest judgment in prescribing an antibiotic before thebacterial culprit has been identified and the antibioticcontinued on page 2VOL. 30 NO. 1Holiday Givingp3Alumni Profilep4Donor Spotlightp4Letter from the Chairp5Kudosp6Healthy at Every Agep7Improving Cancer Carep7The Men’s Clinic at UCLAp8
Rapid UTIDiagnostic Test“redefining antibiotic informatics.”“Molecular diagnostic microbiology, as pioneered bythe Ruby-Winston-UCLA-MicrobeDx group, is muchfaster than microscopic testing [used by competitors],which in turn is much faster than current culture-basedtechniques,” Dr. Churchill explains. “In addition, rRNAis the optimal molecular target because of its large copynumbers, species-specific sequences, and very rapidmetabolic rate.” While the company’s initial focus has beenon UTI, the test has also shown promise when used withblood cultures, and thus could have other applications.continued from coverDr. Churchill notes thatmolecular diagnosticmicrobiology, as pioneeredby the Ruby-Winston-UCLAMicrobeDx group, is much fasterthan microscopic testing (usedby competitors), which in turnis much faster than currentculture-based techniques.Above right: Predicted toll ofantimicrobial resistance (AMR).Above: MicrobeDx lab managerand co-founder Colin Halford(right) with lab assistantScott Churchman.susceptibility profile is known.As an internationally renowned pediatric urologist —originally in Toronto, and then as chief of pediatric urologyat UCLA from 1995 to 2015, where he held the Judithand Robert Winston Chair — Dr. Bernard M. Churchillbegan to observe that children with spina bifida wereexperiencing an alarming increase in antibiotic-resistantUTIs. “The parents were getting concerned,” Dr. Churchillrecalls. “One of them said, ‘What are we going to do whenwe run out of antibiotics?’ ”Dr. Haake notes that rapid diagnostics have been shownto improve health care outcomes and reduce costs in anumber of other conditions. Rapid flu and strep tests arewidely employed in emergency rooms. Tests now usedThat concern set Dr. Churchill and others on a journeyfor patients with positive blood cultures have reducedto harness the power of molecular biology to develop athe time for diagnosis and identification of the bacteriarapid test that would bring the time required to confirma UTI infection and determinefrom approximately two daysthe appropriate antibiotics fromto less than an hour. “It’s timethree days to three hours or less.that such a test become availableIn 2001, with 500,000 in initial“The technology is therefor patients with less severesupport from the Wendy andto bring UTI into theinfections, like UTIs,” Dr. HaakeKen Ruby Fund for Excellence insays. “We’re still living in the eramolecular age.”Pediatric Urology Research, Dr.of Louis Pasteur, where we waitChurchill and a multidisciplinary-Dr. David Haakefor the bacteria to grow, but theteam that included Dr. Davidtechnology is there to bring UTI,Haake, a member of thewhich is an underappreciatedUCLA Urology faculty and anqualityoflifeproblemthatdisproportionately affectsinfectious disease specialist at the Greater Los Angeleswomen, into the molecular age.”VA Healthcare System, began conducting preliminaryexperiments toward their goal of revolutionizing UTItreatment through rapid testing and personalizedantibiotic therapy. “The science was getting smaller andfaster, but bacteriology was stuck on big and slow,” Dr.Churchill says.2“The idea is that if a rapid diagnostic test for urinarytract infection could be used at the point of care to makethe diagnosis and determine the best antibiotic for thepatient, it would avoid overtreatment in patients witha susceptible bacteria, avoid unnecessary treatment inpatients who don’t actually have an infection, and avoidundertreatment in patients who have resistant bacteria,”explains Dr. Haake.By 2015, the research team, backed by 10 million ingrants from the National Institutes of Health to go alongwith continued philanthropic support, had provided aproof of principle — a rapid molecular testing platformthat identifies the bacteria in 30-45 minutes, and concludesantibiotic susceptibility testing in less than three hours,with greater than 96 percent accuracy. Approximatelya month after he retired from clinical practice in 2015,Dr. Churchill, along with Dr. Haake and Colin Halford,helped to found MicrobeDx, a company with the mottoDr. Churchill now devotes all of his time to moving thetechnology from the research stage to clinical practicethrough his work for MicrobeDx, where he serves aschairman of the board. The company is headed by RichardJaneczko, CEO, who has extensive experience in the invitro diagnostic industry. MicrobeDx and the Regentsof the University of California recently concluded anexclusive license for the intellectual property that hasbeen developed, bringing to nine the number ofMicrobeDx intellectual properties in various stages ofmaturity. “There are still significant technical and businesschallenges that have to be overcome before extensiveclinical acceptance and financial success are achieved,”Dr. Churchill says. “But we have come a long way.”
HOLIDAY GIVINGPhilanthropists Help UCLA Urology Fulfill its MissionsPhilanthropic supporters of UCLAUrology make a huge impact on thedepartment’s research and teachingprograms and in doing so, touch the livesof countless patients and their families.Following are examples taken from a long listof generous gifts and pledges made for the2018 season.important investment to something she isdeeply passionate about: education to supportprostate cancer research under the directionof Dr. Mark S. Litwin. For the last several years,she has funded the Jerry Janger Fellowshipin prostate cancer research for a UCLAUrology resident.patient care and outcomes. They decided tofocus their impact on the research of Dr. KarimChamie in the development of new treatmentapproaches for urothelial cancers. Their gift willalso support UCLA Urology resident education.Thanks to the generosity of philanthropicsupport from G. Louis Graziadio III, Dr.Leonard S. Marks, UCLA Urology professor,is able to take his research to new levels ashe advances the diagnosis and treatmentof prostate cancer. Dr. Marks and hismultidisciplinary UCLA team are providingmany new options for men with prostate cancer.Private philanthropy fuels the innovative ideasand brings them to fruition.Celebration of the 100th transplant of the UCLA KidneyExchange Program.At the direction ofHelen Spiegel, theThomas SpiegelFamily Foundationhas contributed tothe UCLA KidneyTransplant Program tosupport postoperativeon-campus housingfor qualified UCLAkidney transplant patients. Under the leadershipof Dr. Albin Gritsch, surgical director of theKidney Transplant Program, the foundation’sgenerous gift will benefit patients who travellong distances by providing the necessarymeans for UCLA to facilitate recovery andprovide optimal postoperative care.UCLA Urology hasreceived a substantialcommitment fromthe PHASE ONEFoundation (www.phaseonefoundation.org). The foundation’sgrant will supportDr. Karim Chamie,associate professor,in his research on upper urinary tracturothelial carcinoma (UTUC). Urothelialcarcinoma is a common malignancyaffecting more than 400,000 people eachyear. PHASE ONE’s support will furtherDr. Chamie’s studies toward developingnew minimally invasive therapies forinvasive UTUC.Rebecca and Sandor (Sandy) Shapery havegenerously donated to UCLA Urology. TheShaperys wanted to support cancer researchand the training of young doctors to improveUCLA Urology 2018 fourth-year research residents.Aurelio De Laurentiis has continued to bestowhis support on the Department of Urologyand Dr. Mark S. Litwin, professor and chair,with a focus on the department’s academicprograms and research by contributing toUCLA Urology’s resident research year. Thiscritical support will foster the next generationof physician-scientists in the UCLA Urologyresidency program as they pursue a deeperunderstanding of urologic science.Once again, Sheldon and Carol Appel havemade a charitable contribution to support theleadership of Dr. Litwin and his team. Their giftis bolstering the research and clinical experiencefor UCLA Urology patients with kidneystones. The Appels are longtime supporters ofthe kidney stone program at UCLA Urology,dating back to the 1980s when the departmentacquired one of the first lithotripters in the U.S.UCLA alumna LindaJanger is activelyi nvolve d i n t h eL os Angeles ar tscommunity, includingas a member of theboard of directorsat the HammerMuseum, as well asbeing a generoussupporter of many areas of the university.She enjoys giving back to the community andhas made a thoughtful philanthropic gift andHoward B. Klein has made a major contributionto support Dr. Robert Reiter, professor ofurology and Bing Endowed Chair in UrologicResearch, and Dr. William Aronson, professorand chief of urology at Olive View-UCLAMedical Center. Dr. Reiter is the principalinvestigator of the UCLA Specialized Programof Research Excellence (SPORE) in ProstateCancer, which supports multidisciplinaryinvestigations that aim to translate basiclaboratory research into therapies that prevent,manage, and cure all forms and stages ofprostate cancer. Dr. Aronson and his team ofresearchers are continuing to make importantadvances in the lab related to the favorableimpacts of fish oil on the immune system andcancer control.The Saul BrandmanFoundation continuesits philanthropic investment in support of Dr.Leonard Marks, UCLAurology professor,and his expert team,in groundbreakingresearch to bringexciting prostatecancer treatment approaches to fruition.Together, the foundation and Dr. Marks’ teamare making exciting new advances in prostatecancer technology possible through the supportof some of the brightest minds in their field.3
ALUMNI PROFILEDONOR SPOTLIGHTDavid C. Miller, MD, MPHIn his new role as chiefclinical officer for theUniversity Hospital andCardiovascular Center at theUniversity of Michigan, Dr.David C. Miller is part of amultidisciplinary leadershipteam charged with identifyingand implementing initiatives toimprove the quality and safety ofcare across the university healthsystem. It’s a broader applicationof an interest Dr. Miller has pursued throughout his career, beginningwith his UCLA Urology fellowship training.A urologic oncologist with clinical interests in kidney cancer, prostatecancer and robotic surgery, Dr. Miller completed his residency at theUniversity of Michigan Health System in 2005 and then began a twoyear urologic oncology fellowship at UCLA. The first year was spentconducting health services research under the mentorship of UCLAUrology faculty, including Drs. Mark S. Litwin and Christopher Saigal,currently the chair and vice chair of the department, respectively; thesecond year was devoted to patient care. As Dr. Miller focused on usingdata to identify quality-of-care gaps in urology, it became increasinglyclear to him that identifying the gaps was one thing, but actually solvingthem was the bigger challenge.“Both as a research fellow and as a clinical fellow, I learned the importanceof not just identifying problems or challenges in the delivery of urologicalcare, but also taking the next step — coming up with actionable solutionsand opportunities for change,” Dr. Miller says. “When I would show myfindings to UCLA Urology faculty members they would always say, ‘That’svery interesting. What’s next?’ That emphasis on impacting patients’ livesthrough a purposeful focus on ‘what’s next’ has stuck with me.”At the University of Michigan, Dr. Miller has continued to study howthe health care delivery system influences quality and access to care forpatients with urological cancers. He is director of the Michigan UrologicalSurgery Improvement Collaborative, a statewide consortium of morethan 40 urology practices, in collaboration with Blue Cross Blue Shield ofMichigan, that aims to improve the quality and cost-efficiency of prostatecancer, kidney cancer and kidney stone care in the state. The consortiumcollects data to inform and drive quality improvement initiatives.4“Fundamentally, it’s still my interactions with patients — helping themaddress the challenges that come with a new cancer diagnosis and beingable to provide expertise to help them navigate that diagnosis — thatare the moral compass for everything I do,” Dr. Miller says. “But it’salso been a great pleasure to collaborate with urology practices all overthe state of Michigan to create a resource and infrastructure that wasn’tpreviously possible, and I’m hoping to make similar progress in my newadministrative role.”Jamie CarrollWhen it comes to determining where to direct its support,the Jean Perkins Foundation likes to “bet on brains.”That’s how Jamie Carroll, the foundation’s president,describes the annual decision-making process of his organization’sboard of directors, which has invested substantially and consistentlyin the brainpower of UCLA Urology’s faculty and programs for morethan a decade.The Los Angeles-based foundation was established in 1991 by the lateJean Perkins Stuart, an heir to the Carnation Company. It continuesto be run by Mr. Carroll, who was Ms. Stuart’s friend and attorney.The beneficiaries of the foundation’s support are wide-ranging —undergraduate combat veterans, children of first responders, brightyoung people from underprivileged backgrounds, and children offallen Navy SEALs, to name a few.In medicine, much of the foundation’s focus has been on supportingtalented young researchers. “The idea is to provide seed money topromising labs for a few years so that they can make progress in theirarea of inquiry, then use their results to obtain additional grants fromthe National Institutes of Health,” Mr. Carroll explains.The Jean Perkins Foundation’s support for UCLA Urology is rootedin the friendship Mr. Carroll developed more than a decade ago withDr. Jean deKernion, who was then chair of the department. After Mr.Carroll was diagnosed with prostate cancer, he began asking friendswho were physicians where they would seek care if they were in hisshoes. “All roads led to Jean,” he recalls. “And in the process of getting toknow him, I learned that he was not just a world-renowned physician,but also a tremendous human being. We became very good friends,and he introduced me to a number of worthwhile projects.”The foundation has supported the work of Dr. Leonard S. Marks,UCLA Urology professor, a pioneer in developing the targeted prostatebiopsy, which has improved the accuracy of diagnosis and enabledmore men with non-aggressive tumors to choose active surveillanceover treatment. More recently, the foundation has supported the workof Dr. Marks and his colleagues in developing focal therapy, which aimsto target the cancer while sparing normal tissues. The foundation hasalso supported the research of Drs. Arnold Chin and Isla Garraway,both members of the UCLA Urology faculty, as well as the department’sresidency program.Mr. Carroll says his involvement with UCLA Urology has beenpersonally rewarding. “It feels good to know that we are supportingwork that will benefit humanity,” he says. “And for me, getting to knowso many smart, dedicated people in the process has been a great bonus.”
Letterfrom theChairThe holiday season is a time when many of us pause from our daily routines to reflect onwhat we are thankful for, both personally and professionally. Our UCLA Urology familyis immensely appreciative to be part of a community of healthcare providers, scientistsand trainees with the ability to make a profound impact on the lives of our patients, our communityand the world through state-of-the-art care, research, and our training of the future leaders ofour profession.It is also gratifying to have such wonderful supporters. For those who can afford it, one of the mostenduring forms of support is to establish an endowed chair, which creates a fund to be used inOur ability to carry outour academic missiondepends heavily on thegenerous support of privatephilanthropists.perpetuity. This year a small group of large donors funded the Shlomo Raz, MD, Chair in Urology,named after a pioneer in the field of pelvic medicine and reconstructive surgery. This philanthropyhighlighted the plight of the many women Dr. Raz has helped over the years, substantially improvingthe lives of those who have suffered from conditions such as pelvic pain and urinary incontinence.And we will soon be announcing another special new endowment, this one to support the UCLAUrology residency program. It is highly unusual for a department to have one endowed fund forits educational mission, but this new chair will be our second such endowment; it joins the PeterStarrett Chair in Medical Education, which supports faculty leadership in teaching.In this era of uncertain public funding, both at the state and federal levels, our ability to carry out ouracademic mission depends heavily on the generous support of private philanthropists. While somesupporters have the means to establish endowments, we are deeply appreciative of every donation— be it 25,000, 250, or 25. The smaller checks we receive are pooled into funds that providecritical support for our research and education programs, whether allowing a trainee to travel to animportant scientific meeting or enabling a junior faculty member to provide the proof of principlefor an important new research idea that could one day lead to a breakthrough.At this time of year, we at UCLA Urology are appreciative of all types of support — from the largestgifts to the heartfelt notes of thanks we receive from the patients whose lives we are dedicated toimproving. We are fortunate to be in this fulfilling position, and we remain ever grateful for thatgood fortune.v Mark S. Litwin, MD, MPHProfessor and Chair, UCLA Urology5
Arash Amighi, a fourth-year student at theDavid Geffen School of Medicine atUCLA, presented a poster titled “Ratesof Completion and Reasons for Dropoutfrom a Standard Eight-Injection Courseof Collagenase Clostridium HistolyticumT
David Haake. Above right: The company is developing a rapid test to confirm urinary tract infection and determine appropriate antibiotics. Winter 2019 VOL. 30 NO. 1. 2 Rapid UTI Diagnostic Test “redefining antibiotic informatics.” “Molecular diagnostic microbiology, as pioneered by
and leading UCLA Urology's Division of Female Urology, Reconstructive Surgery and Urodynamics, helped to define the field through numerous innovations that would become the standard of care worldwide. "On the urology side, female pelvic medicine really started here at UCLA," says Dr. Nitti, who was trained by Dr. Raz as a UCLA Urology fellow.
Urology training The Urology Department is also well-known for its educational activities, training a growing number of medical students and urology residents. The resident training programme was established by Ministry of Health and the Croatian Board of Urology. Currentl
General Urology Isuru Jayaratna, MD General Urology, Urologic Oncology Steven A. Kaplan, MD Men’s Health, Benign Prostate Disease Reza Mehrazin, MD Urologic Oncology, Robotic Surgery Jay A. Motola, MD Male and Female Urology Craig F. Nobert, MD Urologic Oncology, General Urology Sovrin M. Shah, MD, FPMRS
Robotic-Assisted Laparoscopic Surgery (RALS) in Pediatric Urology. Sherry S. Ross, MD. Associate Professor of Urology and Pediatrics. Department of Urology. Division of Pediatric Uro
5 Aims and Scope European Urology Oncology is the new sister journal to European Urology and European Urology Focus, and the first official publication of the EAU fully devoted to the study of genitourinary malignancies. The journal aims to deliver high quality res
Augusta Urology Surgicenter, we will transfer the credit balance to Augusta Urology Surgicenter, or vice versa. Procedure/Surgery If you have a procedure and/or surgery scheduled at Augusta Urology Surgicenter, LLC or at a hospital, a minimum of 72 hours (3 business
Urology, Oncology The Brady Urological Institute Department of Urology Johns Hopkins Medical Institutions Baltimore, Maryland Sam S. Chang, MD, MBA Patricia and Rodes Hart Professor of Urologic Surgery Vanderbilt University Medical Center Chief Surgical Officer Vanderbilt Ingra
Department of Urology Update fall 2009 Vol.20 No.1 Alumni Spotlight p. 3 Donor Spotlight p. 3 BPH UDA Study p. 4 Kudos p. 5 Clinical Trials p. 6 Comings & Goings p. 7 When he went to the UCLA Department of Urology to see Robert Reiter, MD, MBA, for a second opinion, Mr. Heflin learned of another option. "Dr. Reiter told me he thought I was too
