Author: yec14002

Making the Connection

By Stacey Mancarella

Illustrations by Yesenia Carrero

illustration of photos of unconnected symptoms

A rare but debilitating condition, hereditary amyloidosis (hATTR) presents as seemingly unrelated illnesses that mask the root cause. But increased awareness and new treatment options bring hope for sufferers of this devastating genetic condition.


We hear of it too often in health care. Even with the most diligent doctors and patients, sometimes figuring out the correct diagnosis of a rare medical condition can be a challenge.

Unexplained weight loss and diarrhea. Shortness of breath during exercise. Carpal tunnel syndrome. Weakness and difficulty balancing that gets progressively worse. Tingling or numbness in the hands and feet. Symptoms like these point to different culprits, bringing patients to a variety of specialists and glimmers of hope as they find potential answers. But treating one symptom doesn’t help the others, and everything gets worse.

This particular collection of ailments, among other symptoms, points to hereditary amyloidosis (hATTR), a devastating genetic disease that, up until recently, was considered untreatable. Dr. Fernanda Wajnsztajn is all too familiar with the plight of her patients who have searched in vain for a diagnosis. A neurologist at the UConn Health neuropathy clinic, Wajnsztajn specializes in peripheral neuropathy, damage or disease of the peripheral nervous system.

“Because some of the symptoms of hereditary amyloidosis are also seen in a variety of diseases, some of my patients went to several doctors for years until hATTR was suspected,” she says. “With a detailed history, we are also able to trace the heritage of patients, and, often, patients realize during the interview that some their relatives also have similar symptoms.”

Now these families have options. New drug treatments have been approved to treat neuropathy, the nerve pain, tingling, or numbness that’s a symptom of this little-known disease, and doctors at UConn Health have assembled a team to tackle hATTR head on.

Interpreting the Evidence

Wajnsztajn has been aware of hATTR since her days at Columbia University, where she was involved in research and clinical trials for hATTR therapies. Only about 50,000 people worldwide are affected by hATTR, “but we suspect that many cases go undiagnosed or misdiagnosed,” Wajnzsztajn says. “Our goal is to reach those people.”

Hereditary amyloidosis is caused by a hereditary mutation of the TTR gene. If one parent carries the gene mutation, offspring have a 50 percent chance of inheriting the disease. Hereditary amyloidosis wreaks havoc on the body by depositing amyloid proteins into organs, most commonly the heart, nerves, and digestive tract. These deposits cause the organs to function improperly, which eventually leads to a myriad of debilitating symptoms.

Even though the gene mutation is present at birth, most patients don’t experience symptoms until well into adulthood. And even once symptoms start, it can take years for a proper diagnosis.

“Hereditary amyloidosis is not a well-known disease. The patient can present with a history of heart problems and receive a diagnosis of polyneuropathy, but if the doctor isn’t familiar with it, they won’t put it together. It’s easy to miss,” Wajnsztajn says.

For example, two of the most common symptoms of hereditary amyloidosis are carpal tunnel and cardiomyopathy, or heart muscle disease. Because these two diseases are seemingly unrelated and treated by different kinds of doctors, hereditary amyloidosis can go undetected. The average delay in diagnosis is four years, and in that time, amyloid is continuously deposited into the affected organs, causing symptoms to worsen.

Even with the new treatments, a timely diagnosis is important as the medications cannot reverse the symptoms but only prevent further protein deposits that cause the condition to worsen. The earlier a patient can be identified and a course of treatment initiated, the slower the disease will progress.

Dr. Fernanda Wajnzsztajn (left) and Dr. Sarah Tabtabai discuss a patient case.

Dr. Fernanda Wajnsztajn (left) and Dr. Sarah Tabtabai discuss a patient case.

Case Closed

UConn Health’s multidisciplinary approach can shorten this delay, giving patients relief sooner and stopping hATTR in its tracks. Cardiologists at the Pat and Jim Calhoun Cardiology Center work hand in hand with neurologists from the peripheral nerve disease clinic to examine a patient’s symptoms, get that crucial neuropathy or polyneuropathy diagnosis, and schedule them for genetic testing to confirm a hATTR diagnosis. Once the diagnosis is confirmed, treatment can begin very quickly, and the deposition of amyloid into the organs is halted within weeks — sometimes within days — thanks to neurologists, cardiologists, neuropathy testing, and an infusion center to administer treatment being all in one place.

Two treatment options currently exist, one that’s infused intravenously every three weeks, the other given by weekly subcutaneous injection. These new treatments work by inhibiting the body’s ability to create the amyloid protein. They reduce the amount of the protein the liver can make by 84 percent, improving the patient’s quality of life. Clinical trials are ongoing, with the hope that such medications can treat other types of amyloidosis as well.

“Before medicines like this came along, there was really no therapy for this particular heart disease. It’s progressive and very debilitating, and the hereditary type, in particular, occurs in younger people,” says Dr. Sarah Tabtabai, cardiologist at the Pat and Jim Calhoun Cardiology Center at UConn Health.

Previously attempted treatments for hATTR symptoms were drastic, sometimes including heart transplants or heart and liver transplants, Tabtabai says. But with the new medications, “patients have had good outcomes with both their neurologic disease and their heart disease, and it sort of keeps things at bay.”

Close collaboration between the departments makes everything go smoothly for patients who have already waited so long for answers, says Wajnsztajn.

“We work very closely with cardiology to obtain the appropriate exams for diagnosis as quickly as possible. Despite being a challenging or daunting diagnosis, our patients feel fortunate that they finally have answers, and we are able to provide the most advanced treatments along with the support necessary,” she says.

Because of the high rate of misdiagnosis, the companies that produce the new medications are currently offering free screenings for patients with suspected hereditary amyloidosis. A patient simply has to schedule the genetic test at UConn Health, and the billing is handled directly through the hospital, creating a streamlined process for the patient.

Early diagnosis of hATTR can also bring awareness to family members who might be afflicted.

“Once a patient is diagnosed with hereditary amyloidosis, we can test blood relatives as well to identify any members of their family who may also have this disease,” Tabtabai says. “The hope is that, down the line, we can offer medications like this sooner, before patients become symptomatic or right at the onset of symptoms so that they fare even better as time goes on.”

Taking Control

By Delker Vardilos

Photos by Tina Encarnacion

UConn Health is the first hospital in New England to use a new robotic technology to diagnose lung cancer sooner, getting patients the treatment they need and saving lives.

Product images courtesy of Auris Health

Lung cancer kills about 150,000 Americans each year. But when it is detected early, survival rates improve exponentially. UConn Health is the first hospital in New England to use a new robotic technology to diagnose cancer sooner, getting patients the treatment they need and saving lives.


Supporters of U.S. Supreme Court Justice Ruth Bader Ginsburg breathed a collective sigh of relief this winter after two cancerous nodules were successfully removed from her left lung through a lobectomy. Ginsburg’s cancer was found during the routine testing done after the fit 85-year-old fractured several ribs in a fall, and for a moment the diagnosis cracked the seemingly invincible façade of the octogenarian icon.

Although Ginsburg’s cancer was found by chance, her story is a great example of how early detection and swift action can improve the likelihood of survival for lung cancer, the deadliest cancer for both men and women in the U.S. by a wide margin. More people die of lung cancer each year than of colon, breast, and prostate cancers combined, and more than half of people with lung cancer die within a year of being diagnosed, according to the American Lung Association.

“The accuracy of this is going to pan out to be second to none. I think this is the tip of the iceberg in diagnosis.”

But when the cancer is detected early, before it spreads beyond the lungs, the five-year survival rate jumps from 5 percent to 56 percent. The problem is, just 16 percent of lung cancer diagnoses come at an early stage, American Lung Association statistics show. Since lung cancer is the second most common cancer in both men and women, proper screening for those at risk could save tens of thousands of lives.

A revolutionary precision technology now at UConn Health is making early diagnosis easier than ever.

UConn Health is the first hospital in New England and among the first in the nation to offer robotic bronchoscopy on the Monarch platform from Auris Health, allowing physicians to quickly diagnose lesions detected through low-dose CT scans, including those that are small or in hard-to-reach parts of the lung.

“Before this technology, the targets would’ve had to be bigger. I wouldn’t be able to make certain angles without the robotic arm to navigate,” says Dr. Omar Ibrahim, UConn Health director of thoracic oncology and interventional pulmonology. “I have a higher degree of confidence and accuracy with this than with prior equipment.

“The ability to diagnose the cancers at an earlier stage will allow us to surgically manage the disease,” he says. “This is the only chance for a cure.”

probe snaking through lung

The Monarch platform’s advanced, precision endoscope allows physicians to access hard-to-reach parts of the lungs and their bronchi and to diagnose lesions earlier than ever before.

With its user-friendly, video-game-style controller, the Monarch platform allows the physician to move the endoscope up and down, left and right, forward and backward through a lung and its bronchi. Buttons on the controller make the scope of view bigger or smaller, while others control suction or irrigation. Procedures are done in the operating room under general anesthesia. Within about an hour, the doctor will biopsy the suspicious nodule and a lymph node for analysis by a pathologist. The patient can go home the same day.

If cancer is confirmed in the lung, it will then be staged to see how far it has advanced. A team of cancer specialists then develop an individualized treatment plan that is ideal for the patient and their specific type and stage of cancer. A patient’s treatment plan might include surgery to remove a small portion of the lung or the entire lung, radiation therapy, chemotherapy, medications,
and immunotherapy.

Not only does earlier diagnosis improve patients’ chances for survival, but it also helps reduce unnecessary stress, says Wendy Thibodeau, the lung cancer nurse navigator at UConn Health’s Carole and Ray Neag Comprehensive Cancer Center.

“We have had patients where initial and subsequent biopsies are inconclusive. A decision then has to be made: remove the nodule surgically, or watch it for growth,” Thibodeau says.

“This can be stressful on a patient. They either have to go through a significant procedure they may not have needed or wait to see if the nodule gets worse. This technology will give us better accuracy for appropriate tissue sampling, making the decision more clear.”

A revolutionary precision technology is making early diagnosis easier than ever.

Routine screenings of high-risk patients — those with histories of smoking, especially — using low-dose CT scans and minimally invasive techniques help detect lesions and diagnose more people all the time.
The Monarch platform is the next step in improving outcomes for lung cancer patients, and Ibrahim sees even more groundbreaking advances on the horizon.

“Within the next year or two, this technology should allow us to treat lesions with radiofrequency ablation [a minimally invasive procedure that uses heat to destroy cancer cells],” Ibrahim says. “Diagnosis and treatment could be done all at the same time.”

In his time at UConn Health, Ibrahim has worked to improve the experience of UConn Health’s lung cancer patients, particularly through a multidisciplinary team that allows patients to come to one clinic to see a variety of doctors.

“Since we’ve enhanced and personalized the way we care for lung cancer, the number of lung cancer patients at UConn Health has quickly increased,” says Ibrahim. “Time to diagnosis and treatment is tremendously shorter, and patients are happier with the quality of their care.”

He believes the robotic bronchoscopy technology will allow the team to deliver even better results.

“The accuracy of this is going to pan out to be second to none,” says Ibrahim. “I think this is the tip of the iceberg in diagnosis, and the therapeutic aspect of it, which will evolve over time, is really exciting. Being at the forefront of that is amazing.”

Dr. Omar Ibrahim, UConn Health director of thoracic oncology and interventional pulmonology, demonstrates the Monarch technology.

Dr. Omar Ibrahim, UConn Health director of thoracic oncology and interventional pulmonology, demonstrates the Monarch technology.

Lab Notes – Spring 2019

Deciphering Herpes Hybridization

Herpesviruses reproduce in an unusual way. Normally, DNA viruses replicate their genes by copying each strand of the double-stranded DNA. But researchers have suspected that herpesvirus uses recombination — exchanging one version of a gene with another related version — to replicate. Now, UConn Health researchers from Sandra Weller’s lab have found another clue: a specific viral protein that seems essential to the new DNA’s ability to assimilate into the strand. This protein may provide a target for new herpes drugs. Blocking the protein responsible for the insertion event prevents the virus from copying its own DNA. If it can’t copy its DNA, it can’t reproduce, and so the herpesvirus can’t be infectious or reactivate after going dormant.

herpes virus

Electron micrograph of HHV-6, human herpesvirus-6


‘Stealth Condition’ Riskier Than Previously Thought

The Western world’s most common genetic disorder is a “stealth condition” that causes far more death and disability than previously thought. Hemochromatosis, which causes people to absorb too much iron from their food, quadruples the risk of liver disease, doubles the risk of arthritis and frailty in old age, and causes a higher risk of diabetes and chronic pain, report researchers at UConn Health and the University of Exeter. It’s thought that the extra iron absorption was advantageous for northern European women eating poor diets, but is harmful in today’s iron-rich food supply. Although more than 1 million Americans have hereditary hemochromatosis, few doctors are taught to look for the condition in the early stages of joint pain and tiredness, when it can be easily treated.


Moving the Motivation Meter

Two novel drugs kick-start motivation in rats suffering from apathy and a lack of oomph, UConn researchers led by behavioral neuroscientist John Salamone reported at the 2018 Society for Neuroscience conference in San Diego. Both of the experimental drugs cause a buildup of dopamine in the synapses between brain cells. Stimulants like amphetamines and cocaine do the same thing, but in a much more extreme way. The researchers are now testing other, chemically related drugs to see which are most effective and have the least potential for abuse. Lack of motivation is a common symptom of depression that’s harder to treat than other symptoms; the findings could point toward potential treatments.


Targeting Tricky Tuberculosis

school of fish

Tuberculosis is a sneaky disease. The bacteria that cause it allow themselves to be eaten by the immune cells sent to destroy them. But instead of dying, mycobacterium tuberculosis sets up housekeeping and multiplies before busting out to infect more cells. Antibiotics can’t get inside the immune cells, so the only time the mycobacterium are vulnerable are when they’ve just broken out and are cruising for a new cell to infect. But now, UConn chemist Alfredo Angeles-Boza and his colleagues have found certain antibiotic proteins from fish can get at the mycobacterium where they hide, and report their results in ACS Infectious Diseases.

Honor Roll – Spring 2019

Dr. Cato T. Laurencin received the 2019 American Association for the Advancement of Science Philip Hauge Abelson Prize for significant contributions to the advancement of science in the U.S. In addition, he was honored among the “100 Most Influential Blacks in Connecticut” for 2018 by the State Conference of NAACP Branches.


Rheumatologist Dr. Naomi Rothfield, a founding faculty member of the UConn School of Medicine who retired in 2016, was honored with a lifetime achievement award by the Arthritis Foundation. The award will be named in her honor going forward: The Naomi Rothfield Physician Exemplar Award.


Dr. Carla Rash received the G. Alan Marlett Mid-Career Award from The Association of Behavioral and Cognitive Therapies in recognition of her significant contributions to the field of addictions research.


Susan Reisine, professor emeritus of the School of Dental Medicine, was named a 2018 Fellow of the American Association for the Advancement of Science (AAAS).


Dr. Vijay Rathinam was named a 2018 Milstein Young Investigator Award winner. Awards are bestowed upon individuals who have made an impact on interferon and cytokine research early in their careers.


Dr. Nancy Day Adams, professor emeritus in the Department of Medicine, received the 2018 Robert G. Naris Award from the American Society of Nephrology. The award honors those who have made substantial and meritorious contributions in education and teaching.


UConn Health faculty researchers Dr. Emily Germain-Lee, Dr. Se-Jin Lee, Dr. Annabelle Rodriguez-Oquendo, and Riqiang Yan are among 24 newly elected members of the Connecticut Academy of Science and Engineering.

Treating Traumatized Immigrant Children

Q&A with Julian Ford, Ph.D., Director, Center for Trauma Recovery and Juvenile Justice

Q

How is trauma impacting these young people?

They are impacted by violence in their countries of origin and on the journey to the U.S., as well as by race-related and institutional trauma in this country. Many develop a sense of fear, distrust, and even hopelessness that interferes with relationships, school, adjustment to new communities, and their physical health. These problems can persist for many years.


Q

What behaviors do they exhibit as a result?

These youth are often distrustful as a result of trauma, and can be very withdrawn or impulsive in an attempt to protect themselves from further trauma. This is a form of “survival coping,” which results from chronically not feeling safe. Justice involvement can occur when these youths feel that they must take extreme steps to protect themselves, which can lead to breaking rules — such as at school — or confrontations with law enforcement.


Q

How can physicians provide the best care to these patients?

Immigrant youths and their families, especially recent newcomers, have come to the United States in a period of turmoil and controversy that has heightened the stress they face in coming to a new country and new community. Many may feel reluctant to seek health care for fear of facing prejudice or discrimination. Providing a clear message of welcome and acceptance, in addition to showing interest in learning and respect for their culture and traditions, is essential to forging a positive treatment relationship — and can reduce patients’ anxieties and contribute to better health outcomes.

Expect that it will take some time, often several visits, for these youths and their families to feel sufficiently trusting and safe to fully and actively engage in dialogue and the treatment process. Patience and consistency on the part of the health care professional are a crucial counterbalance to the often harsh and even traumatic encounters many have had with putative helpers and institutional officials during their journey and once in the United States.

Explaining the nature and limits of confidentiality can help reduce fears about being subject to immigration sanctions.


Q

Is there a plan in place to help youths who suffer from this type of trauma?

The National Child Traumatic Stress Network has established more than 15 programs nationally for these youths. [The Center for Treatment of Developmental Trauma Disorders and The Center for Trauma Recovery and Juvenile Justice, of which Ford is the director, are members of the network.] This network was established by the federal government in 2001, and its centers provide public education, counseling, advocacy, and behavioral health treatment services for children and families, as well as consultation to community leaders and policymakers.

Benign Breast Disease Specialist Provides Follow-Up and Reassurance

Dr. Dana Scott, OB/GYN


While it would be a huge relief for a patient to find out a growth in her breast is noncancerous, she might still require follow-up care. That’s where Dr. Dana Scott comes in.

Scott, who recently joined UConn Health’s obstetrics and gynecology team at the Charlotte Johnson Hollfelder Center for Women’s Health, specializes in breast health and cancer genetics. In addition to providing routine OB/GYN care, Scott is referred patients who have breast issues that aren’t cancer.

These might include breast pain, breast infections, noncancerous lumps, and fibroadenomas. Some patients with benign breast disease may need an excision while others simply need continuing check-ups. Additionally, she sees patients at high risk for breast and gynecologic malignancies due to their family history and/or a genetic mutation.

“Benign breast disease is a common issue that arises, but it’s not something that typically has received a lot of focus in medical care,” Scott says.

Being able to develop a benign breast disease program, which is unique in the area, drew Scott to UConn Health, she says. “The chair of my department [Dr. Molly Brewer] was very open-minded and eager to have someone with a different background and training. The surgical oncologist [Dr. Christina Stevenson] was very open to working with me and developing a mechanism for women with benign breast diseases to receive care.”

As part of an American College of Obstetrics and Gynecology committee, Scott is working to develop new screening guidelines for those at risk for early-onset breast cancer, with funding from the Centers for Disease Control and Prevention.

Scott stresses that it is important for OB/GYN and primary care doctors to get good family histories from patients. They should also lower their threshold for referring patients to a genetic counselor.

“Genetic testing for risks of breast, ovarian, and other cancers has become a lot more accessible and affordable,” she says.

In addition to her unique background, patients will find a listening ear in Scott.

“I try to really listen to my patients and spend the appropriate amount of time with them to hear their concerns,” she says. “Especially with the breast patients, a lot of them are really worried that they have breast cancer, and when they learn they don’t, having someone who can listen to them, thoroughly examine them, and provide follow-up and reassurance is really important.”

MRIs Now Offered on UConn Storrs Campus

MRI service manager Elisa Medeiros prepares a patient for functional MRI testing at the Brain Imaging Research Center in Storrs.

MRI service manager Elisa Medeiros prepares a patient for functional MRI testing at the Brain Imaging Research Center in Storrs.


UConn Health patients in eastern Connecticut will now be able to get MRI scans done in Storrs just as if they were at UConn Health in Farmington, thanks to a collaboration between doctors and researchers at the two campuses.

UConn’s Brain Imaging Research Center (BIRC) houses a powerful 3 Tesla Magnetic Resonance Imaging (MRI) scanner that was installed in 2015 and originally dedicated purely to research. The BIRC’s machine can take detailed pictures of fine structures in the brain, do functional MRI, and spot tiny flecks of blood that might signal a concussion or spine injuries. But the state had not previously licensed the BIRC’s machine to perform medical work.

“Soon after I started as chair, it became clear we had a long history of our UConn Husky athletes having scans done on the outside. But then their docs would bring the scans to us for a second read because they trusted us,” says Dr. Leo Wolansky, head of radiology at UConn Health. “It’s our moral obligation to take care of our own people,” but it was a lot of unpaid work too, he observes.

When we read the scans, it’s no different than if patients were down the hall.

Wolansky worked with the team at BIRC, along with regulatory and business development staff at UConn Health, to get permission from the state to use the center’s machine for medical imaging. The machine was set up to run clinical scans, and hardware was installed to transmit medical data securely from the BIRC, which is located in the Phillips Communication Sciences Building in Storrs, to UConn Health in Farmington.

UConn Health doctors can now schedule MRIs for their patients at the BIRC in Storrs for Monday and Wednesday afternoons as easily as if they were going to the imaging center in Farmington. Urgent scans can be squeezed in at other times on a case-by-case basis. The BIRC capacity will free up some space at UConn Health, bringing new patients into the system, and is not expected to impact research done at the center at all.

“The biggest benefit is the integration between campuses. It’s a huge success for us to do this,” says Fumiko Hoeft, the director of BIRC, noting that revenue from the scans will enhance the financial stability of the center.

Wolansky, who is based in Farmington, agrees.

“Even though [patients] may be 40 minutes away by car, when we read the scans [at the imaging center in Farmington], it’s no different than if the patients were down the hall.”

New Program Promises Speedy Evaluation for Cranial Nerve and Brainstem Disorders

UConn Health Center Outpatient Pavillion


UConn Health this winter established New England’s first Cranial Nerve and Brainstem Disorder Program, bringing together a multidisciplinary team of experts to streamline care for patients with such conditions.

Led by esteemed neurosurgeon Dr. Ketan R. Bulsara and ear, nose, and throat specialist Dr. Daniel Roberts, the team collaborates with specialists from nearly a dozen departments and will encompass clinical care, research, and teaching.

“One of the core principles of patient care at UConn Health is a multidisciplinary approach to providing personalized care to optimize patient outcomes,” Bulsara says. “The Cranial Nerve and Brainstem Disorder Program extends that core principle by bringing together world-renowned experts in their fields. We are fortunate at UConn Health to have such an accomplished team across so many different specialties that is willing to work together to provide the best care for our patients.”

The program guarantees rapid evaluation of patients, regardless of whether they were diagnosed recently or long ago. Patients or practitioners can submit a request through the center referral portal, which is staffed by Bulsara and Roberts. For neurosurgical or ear, nose, and throat issues, the patient will be offered an initial evaluation appointment that is within a week of their request.

If the cranial nerve or brainstem issue is not related to the ear, nose, and throat or a neurosurgical issue, the physicians will connect the patient with the appropriate service.

“To have patients be able to access care in a very timely and expedited fashion is key,” Roberts says. “A patient can call us and we’ll say, ‘We’ll see you within a week’ to get the ball rolling and help direct them through this complicated process.”

Areas of care include acoustic neuromas; blood vessel problems including aneurysms, arteriovenous malformation, and cavernomas; brain tumors; hemifacial spasm; meningioma; neurofibromatosis; skull base tumors; trigeminal neuralgia; and taste and smell disorders.

“Brainstem and cranial nerve disorders are quite rare, and often require experts from different areas for complicated issues,” Roberts says. “We’re excited about the future of this.”

Care is offered at UConn Health’s Outpatient Pavilion in Farmington and at its community clinics in Southington and West Hartford.

Visit the Cranial Nerve and Brainstem Disorders Program website for more information.

UConn Med Students First to Learn With New Handheld Ultrasound

handheld ultrasound tool

Photo courtesy of Butterfly Network Inc


Students at the UConn School of Medicine are the first in the nation to use Butterfly iQ, a new handheld, full-body ultrasound system that plugs into an iPhone and is powered by a microchip, as part of their curriculum.

Guilford, Connecticut-based Butterfly Network Inc. created the first-of-its kind device, which at $2,000 is much more affordable than cart-based portable ultrasound machines that can cost tens of thousands of dollars.

Dr. Meghan Herbst, School of Medicine associate professor and ultrasound director in UConn’s Department of Emergency Medicine, is spearheading use of the device in medical education at UConn. She envisions the Butterfly iQ becoming as essential as a physician’s stethoscope.

“I will have an ultrasound unit on me, kind of like my stethoscope but a different tool — I think a better tool — to really look inside patients’ bodies,” she says. “Not only can you do everything that the cart-based machine can do, but the cart-based machine has a different probe for each frequency of sound.”

Butterfly iQ eliminates the need for multiple probes, with the silicon chip system able to create linear, curved, or phased ultrasound beams.

Students who tested out the device were impressed by the ease of use and image quality.

“It’s totally intuitive,” says third-year medical student Sam Southgate.“It’s like a modern tech device rather than a piece of medical equipment.”

Third-year medical student Zach Bovin agrees: “The first thing I noticed was that the [image] quality was as if I had the big ultrasound machine next to me.”

First- and second-year medical students are using the devices in their anatomy lessons, Herbst says, and fourth-year students recently used them during a four-hour ultrasound session as part of their preparation to transition to residency.

Butterfly Network aims to democratize health care, marketing director Guru Sundar says, whether that means providing devices to physicians in underserved areas or to students who might not have previously had the opportunity for such hands-on ultrasound experience.

“I hope to incorporate ultrasound into the first- and second-year Delivery of Clinical Care course, where they can ‘see’ the heart after learning how to listen to it, or ‘see’ the liver and thyroid after learning how to examine these organs,” Herbst says. “I also hope to have some of the fourth-year students independently scan while on certain clerkships, such as emergency medicine and critical care.”

The units are also being used in the Emergency Medicine Residency Program.

Those at UConn and in the health care industry at large believe the technology could revolutionize health care. According to Forbes, the company has raised $250 million in investments, including from the Bill and Melinda Gates Foundation.

“For us at UConn to be right at that cutting-edge, right at the future, is very exciting,” Southgate says.

Old Drug, New Hope for Pediatric Brain Cancer

Dr. Ching C. Lau sees a patient.

Dr. Ching C. Lau sees a patient.


Some drugs for heart disease might also work against brain cancer, according to an analysis by researchers from The Jackson Laboratory (JAX), Connecticut Children’s Medical Center, and UConn Health. The researchers used a new approach to identify five heart medicines that might also be effective at fighting the most common type of childhood brain cancer, they report in Science Translational Medicine.

Medulloblastoma is the most common malignant brain tumor in children, accounting for 20 to 25 percent of pediatric brain tumors. Current treatments have significantly increased the survival rate, but many children face difficult side effects that impact their brains, hormones, and fertility for the rest of their lives. There are also a handful of patients who either don’t respond to available treatment options or suffer and die from relapses.

To quicken the long route to developing cancer drugs, the research team used a process called drug repositioning, reanalyzing drugs previously approved by the FDA and looking for crossover among the diseases that a drug is likely to treat. Using computational modeling methods, they compared approved drugs’ effects on gene expression profiles — that is, what genes they work with or against — to the genes active in patients with various diseases.

But medulloblastoma tumors are complex and often very different from patient to patient, and even internally in a single patient. Dr. Ching C. Lau thought drug repositioning could work to find better drugs for medulloblastoma, but suspected the technique could be improved. Lau, who is jointly appointed as a professor at JAX, UConn Health, and Connecticut Children’s Medical Center, heads the division of pediatric hematology-oncology at UConn Health and is the medical director of hematology-oncology at Connecticut Children’s.

Lau worked with a team of researchers from those institutions, as well as from Houston Methodist Research Institute and Texas Children’s Hospital, to devise a new integrated drug repositioning method that could work against something as complicated as medulloblastoma.

Their new method has identified eight drugs as possible medulloblastoma-fighting agents, including three already used as chemotherapy against other cancers and five previously used to treat heart failure.

The researchers also showed that one of the heart drugs, digoxin, helped mice with medulloblastomas live longer. The mice survived even longer when digoxin was combined with radiation.

“This is exciting because not only can we potentially improve overall survival of medulloblastoma patients with digoxin, but the results also suggest that we could potentially reduce the dose of radiation necessary when combined with digoxin, and thereby minimize long-term side effects of radiation among the survivors,” says Lau. “Because digoxin has been used for so many years to treat heart failure, its potential side effects are well known, and could potentially help speed up the subsequent clinical trial.”