A new study led by Cedars-Sinai Health Sciences University investigators found that prostate-specific antigen (PSA) levels in the blood, which are used to track the effectiveness of prostate cancer treatment, need to be 10 times lower than most physicians generally target for the best patient outcomes.

The study, published in Cancer, could help doctors better manage treatment of prostate cancer patients, maximizing patients’ chances of survival.

“PSA levels drop dramatically when patients receive hormone therapy,” said Stephen Freedland, MD, professor of Urology and director of the Center for Integrated Research in Lifestyle and Cancer at Cedars-Sinai, and first author of the study. “Our study found that the optimal PSA level was less than 0.2 nanograms per milliliter of blood. However, fewer than half of patients given hormone therapy alone reached that optimal level for overall survival.”

Investigators reviewed Veterans Health Administration data on 4,090 prostate cancer patients. They found that even if PSA dropped 90%, if it did not get below 0.2 nanograms per milliliter of blood, outcomes were not good.

Importantly, the study found that if doctors added drugs called androgen receptor pathway inhibitors to their hormone therapy, patients were much more likely to reach PSA levels below 0.2 nanograms per milliliter of blood.

“Many physicians don’t offer patients additional treatment because hormone therapy alone lowers their PSA levels below 2 nanograms per milliliter, which we previously showed was many physicians’ target level,” Freedland said. “We hope these data will change that practice.”

Additional authors include Wei Gao, PhD; Maëlys Touya, PharmD, MSc; Hongbo Yang, PhD; David Russell, MD, FACS; Jingyi Chen, MS; Grace Chen, MS; and Jasmina I. Ivanova, MA.

Funding: Sponsored by Pfizer Inc. and Astellas Pharma Inc.

Disclosures: Stephen J. Freedland reports consulting or advisory roles with Astellas Pharma Inc., AstraZeneca, Bayer, Candel, Eli Lilly, Johnson & Johnson Innovative Medicine (formerly Janssen), Merck, Novartis, Pfizer Inc., Sanofi, Sumitomo Pharma America, Inc. (formerly Myovant Sciences), and Tolmar.

New Tool Measures Thyroid Cancer Patients’ Anxiety

A new tool created by Cedars-Sinai Health Sciences University investigators is the first to measure anxiety in patients with thyroid cancer. Described in Thyroid, the Thyroid Cancer Modified Anxiety Scale (TC-MAX) could help doctors clarify patients’ expectations, better match their treatment to their needs, and improve patient outcomes.

“A patient’s distress greatly influences which thyroid cancer treatment the patient prefers and what their doctor recommends,” said Allen Ho, MD, professor of Surgery, co-director of the Thyroid Cancer Program at Cedars-Sinai Cancer and senior author of the study. “We found that our tool effectively assesses patient concerns to help doctors better determine the best course of treatment. This is especially important when the treatment options have similar likely outcomes but patient preferences vary widely.”

The tool includes 18 questions that measure a patient’s general cancer-related anxiety, their anxiety around ultrasound testing, which is used to monitor thyroid cancer progression, and their fear about whether their cancer will progress or come back. Investigators created TC-MAX in collaboration with Thyroid Cancer Survivors’ Association, the world’s largest thyroid cancer patient consortium. They relied on medical literature, physician expertise and the perspectives of more than 1,000 thyroid cancer patients.

The study showed that the extent of each patient’s anxiety mirrored the extent of surgery they chose, Ho said. When active surveillance, partial thyroid removal and total thyroid removal were all options, patients with the highest TC-MAX anxiety scores chose to have their entire thyroid removed, while those with lower average TC-MAX scores generally selected partial thyroid removal. Patients with the lowest scores chose active surveillance.

Ho said that the tool is now ready for use in clinical trials and patient care.

Additional Cedars-Sinai authors include Amanda J. Bastien MD, Sungjin Kim MS, Cynthia Zalt, Iris Cong PhD, Jewel Ng, Caroline Marshall, Christopher V. Almario MD MSHPM, Omer Liran MD, Brennan M.R. Spiegel MD, MSHS, Jon Mallen-St. Clair MD, PhD, Evan Walgama MD, Kevin S. Scher MD, Julie K. Jang MD, Yufei Chen MD, Samuel Zhang MD, Linnea Peterson MD, Wendy L. Sacks MD, and Zachary S. Zumsteg MD.

Other authors include Gary Bloom and Michelle M. Chen MD.

Funding: AAOHNS CORE Grant; Cedars-Sinai Jim and Eleanor Randall Department of Surgery Research Award.

Reducing Unnecessary Fluid Testing Could Lower Cancer Care Costs

Doctors might be able to safely reduce healthcare costs by skipping unnecessary laboratory tests for patients with advanced gynecologic cancers, according to a Cedars-Sinai Health Sciences University study. The paper, published in JAMA Network Open, examined testing on fluid drained from the abdomen or around the lungs.

Patients with advanced gynecologic cancer often experience fluid buildup in these areas. Draining the fluid helps relieve pain, pressure and other symptoms, but the investigators found that laboratory testing of the fluid is frequently unnecessary.

Cedars-Sinai gynecologic oncology fellow Yingao Zhang, MD, and obstetrics and gynecology resident Olivia Foy, MD, are co-first authors of the study.

“We undertook this study to determine how often unnecessary tests may be safely skipped, and to estimate how much this would help reduce healthcare costs,” Zhang said.

Investigators reviewed 976 fluid-draining procedures performed on gynecologic cancer patients at one hospital over 10 years. Laboratory testing was ordered in 40% of cases, a common practice done to rule out infection, check for the presence of cancer cells, and determine the cause of fluid buildup.

Nearly 80% of those orders included at least one test the researchers determined was likely unnecessary—either because a cancer diagnosis had already been confirmed or a patient had no symptoms that would prompt further fluid testing. The estimated cost of these tests was roughly $1million over 10 years.

The investigators found that unnecessary tests were more likely to be ordered in the emergency department or for hospitalized patients than in outpatient clinics. They also found that non-oncology care providers were more likely to order unneeded fluid tests than oncologists.

“Avoiding automatic lab testing on fluid from patients with known cancer diagnoses represents a low-risk opportunity to reduce healthcare costs,” Foy said.

The investigators identified clinician education as a way to reduce unnecessary testing and related costs, and suggested that similar analyses in other cancer types and other institutions could uncover additional cost-reducing opportunities.

Additional Cedars-Sinai authors include Grace Pipes, MD; and Margaret I. Liang, MD, MSHPM.

Funding: The Cedars-Sinai Honest Enterprise Research Broker (HERB) Committee, which assisted with cohort building, is supported by the NIH National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number UL1TR001881.

Disclosures: Dr. Liang reported grants from Merck, grants from Foundation for Women’s Cancer, and personal fees from Association of Cancer Care Centers outside the submitted work.

How Your Brain Stays Focused on a Goal

Cedars-Sinai Health Sciences University investigators have discovered how the brain maintains focus when a person is working toward a goal. The study, published in Nature Human Behaviour, sheds light on how a person’s brain actively maintains task goals in working memory while that person responds to changes in their environment.

“Our findings show that the brain maintains memories of task goals by keeping certain neurons persistently active over minutes,” said Ueli Rutishauser, PhD, professor of Neurosurgery, at Cedars-Sinai and senior author of the study. “The two different brain regions we studied maintained such memories in two different formats, thereby giving people the flexibility to adapt while continuing to pursue the same goal.”

The study concentrated on two brain regions: the medial frontal cortex, which supports planning, decision-making and long-term goal achievement, and the hippocampus, which plays an important role in learning and memory.

Investigators recorded the activity of individual brain cells while study participants completed tasks designed to test how the brain remembers goals over many minutes without reminders.

By analyzing activity patterns in different brain regions, investigators found that task goals are stably and persistently represented by brain cells in the medial frontal cortex many minutes after instructions were given to the participants. In contrast, the hippocampus continuously updated task goal information as circumstances changed on the timescale of seconds. This allows a person to adapt quickly to change without losing sight of a desired long-term outcome.

Additional Cedars-Sinai authors include Hristos Courellis, Michael Kyzar, Juri Minxha and Adam Mamelak.

Other authors include Araceli R. Cardenas, Taufik Valiante and Ralph Adolphs.

Funding: This work was supported by the BRAIN Initiative through the NIH Office of the Director (U01NS117839 to U.R.), the Simons Foundation Collaboration on the Global Brain (to U.R. and R.A.), and by a merit scholarship from the Josephine De Karman Fellowship Trust (to H.S.C.).

Small Bowel Microbiome Offers Clues to Women’s Health        

A new study by investigators at Cedars-Sinai Health Sciences University has identified differences in the makeup and organization of the small bowel microbiome between women and men. The findings, published in iScience, could offer new insights into why some conditions are more prevalent in women.

The small bowel microbiome comprises a community of microorganisms that coexist in this part of the digestive tract and play vital roles in immune function, metabolism and hormonal regulation.

“One intriguing finding was a bacterial community containing Granulicatella, which we found only in women,” said Ruchi Mathur, MD, director of Clinical Research and Clinical Operations for the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai and corresponding author of the study. “Bacteria in this community appear at increased levels in women with polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome.”

Investigators also found sex differences related to how small bowel microbes produce fructans, complex carbohydrates known for triggering digestive symptoms in irritable bowel syndrome (IBS), a condition far more common in women than men.

“Our findings show that biological sex is a critical variable in the small bowel microbiome,” said Mathur, also a professor of Medicine. “We must consider it as we move toward more personalized approaches to understanding and treating disease.”

Other Cedars-Sinai authors include Mohamad Rashid, Gabriela Leite, Gillian M. Barlow, Ava Hosseini, Daniel Brimberry, Dilara Flor, Gonzalo Parodi, Maritza Sanchez, Ignacio Rivera, Angel Trujillo, Maria Jesus Villanueva-Millan, Walter Morales, Stacy Weitsman and Mark Pimentel.

Funding: This study was supported by the Monica Lester Charitable Trust and the Elias, Genevieve and Georgianna Atol Charitable Trust in support of Ruchi Mathur’s research, and the National Philanthropic Trust in support of Mark Pimentel’s research.

Boosting the Accuracy of Disease Risk Prediction From Genetic Data

Investigators at Cedars-Sinai Health Sciences University have developed a new computational framework for improving how genetic data is used to estimate the inherited risk that an individual will develop conditions like Alzheimer's disease, Type 2 diabetes, high blood pressure and breast cancer.

The framework, called Adaptive Boosting of Pre-trained Polygenic Risk Scores (AB-PRS) and described in Nature Communications, builds on existing polygenic risk scores, tools that estimate disease risk based on many genetic variants across the genome, and identifies additional genetic signals that may not be fully captured by current scoring methods.

"As more people undergo genetic testing, it's becoming increasingly important to make the best use of that information," said Ruowang Li, PhD, co-corresponding author of the study and assistant professor of Computational Biomedicine at Cedars-Sinai. "Our findings aim to improve the accuracy of genetic risk prediction, allowing us to better predict disease risk and guide more personalized care."

Polygenic risk scores are increasingly used in research and clinical settings to estimate genetic susceptibility to common diseases, but their accuracy varies across diseases, datasets and populations. Investigators trained AB-PRS to identify genetic signals that existing risk scores may miss. They tested the approach using genetic data from the UK Biobank and validated the findings in three independent biobanks. The method consistently matched or outperformed existing polygenic risk scores across multiple diseases. The researchers say additional validation, particularly in more diverse populations, will be needed before the approach can be widely used in clinical care.

Additional Cedars-Sinai authors include Raelynn Chen, Olivia Wu, Okan Bilge Ozdemir, Zaldy Tan.

Other authors include Jie Hu, Maxwell Salvatore, Yiwen Lu, Shawn Murphy, Elizabeth Karlson, Atlas Khan, Krzysztof Kiryluk, Iftikhar Kullo, Johanna Smith, Eimear Kenny, Yuan Luo, William G. La Cava, Marylyn D. Ritchie and Yong Chen.

Funding: J.H. and Y.C.’s efforts were supported in part by National Institutes of Health

(U01TR003709, RF1AG077820, R01AG073435, R01DK128237). R.L. is supported

by the National Institutes of Health grants R01 AG094962, P30 AG094848 and U01 AG066833 and in part by Cedars-Sinai Department of Neurology/Jona Goldrich Center for Alzheimer’s & Memory Disorders. R.C. and O.B.O. are supported by the Department of Computational Biomedicine, Cedars-Sinai.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Soliz initially shrugged it off as a pulled muscle. But the pain grew progressively worse. Soon, he was experiencing sharp pain throughout the day, using walls for support as he walked and struggling to find a comfortable position to sleep.

Soliz underwent an MRI, revealing a large tumor in his spine. Recognizing the critical diagnosis of this bone tumor, an orthopedic surgeon in Ventura County near Soliz’s home referred him to Cedars-Sinai.

An image-guided biopsy performed by interventional neuroradiologist Marcel Maya, MD, co-chair of the Department of Imaging at Cedars-Sinai, made the diagnosis of an aneurysmal bone cyst, a rare, blood-filled tumor that can grow rapidly and, as in Soliz’s case, destabilize the spinal column and compress the spinal cord.

Although the tumor was benign, its location made it dangerous, said his surgeon, Tiffany Perry, MD, associate professor of Neurosurgery and co-director of Spine Oncology.

“Spinal fluid normally surrounds the cord, providing space for the cord and the nerve roots as they exit the spinal column,” Perry said. “But in Ryan’s case, the tumor was taking up about 80% of the spinal canal and was blocking the flow of fluid and compressing the cord, causing weakness in his legs.”

For Soliz, the diagnosis quickly became about more than treating a rare tumor—it was about saving his ability to walk. Three days after his outpatient appointment in the neurosurgery clinic, Soliz began losing feeling in his legs, prompting doctors to act emergently. By the time he was admitted to the ICU, he had lost the ability to walk.

“It was a roller coaster of emotions. I was terrified thinking I might never be able to walk again,” Soliz said.

A Rare Tumor and Emergency Surgery

Aneurysmal bone cysts are uncommon, and involvement of the spine with significant spinal cord compression is particularly unusual, Maya said.  

“Although these tumors are benign, they can be locally very aggressive—destroying bone, bleeding significantly and, when they occur in the spine, compressing the spinal cord,” Maya said.

After Soliz was seen in the outpatient clinic, his case was reviewed by a spine tumor board, a group of specialists at Cedars-Sinai from different disciplines that discusses complex spinal tumors. The board ensures patients like Soliz receive coordinated care, formulating a comprehensive, individualized treatment plan for each patient. Maya said the multidisciplinary tumor board allows specialists in neurosurgery, imaging, interventional neuroradiology, pathology and other disciplines to develop a coordinated treatment strategy from the outset. Given the rapid decline of Soliz’s condition, his care team implemented the developed plan in an expedited manner.

Before removal of the tumor, Michael Alexander, MD, vice chair of Neurosurgery, performed a preoperative embolization of the tumor. This minimally invasive procedure blocked blood flow to the tumor, reducing the risk of major blood loss during surgery.

Following the embolization, Perry resected the tumor during a five-hour surgery, ultimately relieving the pressure on Soliz’s spinal cord and preserving his ability to walk.

In addition to Perry, Maya and Alexander, many Cedars-Sinai specialists contributed to Soliz’s care, including the pathologists who confirmed his diagnosis. The specialists and staff in the Neuroscience Critical Care Unit were also instrumental in his recovery, providing attentive care before and after surgery that helped him begin walking again.

“Ryan’s case reflects the importance of every team bringing its expertise together toward one shared goal—taking care of every patient and ensuring the best outcomes possible within our abilities,” Perry said.

A Recurrence, and Off to College

After surgery, Soliz spent time in rehabilitation recovering his strength. But in April, the tumor returned.

Alexander performed another embolization, blocking the blood vessels supplying the tumor. The approach allowed Soliz to avoid another operation to remove it and instead take medication to suppress the tumor’s growth.

Today, Soliz is in good health, golfing and hiking, and preparing to start his freshman year at the University of Hawaii, where he will be followed by a specialist throughout the school year. During breaks, he will continue his medical care at Cedars-Sinai.

Despite everything he has been through, Soliz is looking ahead to college and to a possible career in healthcare.

“I’ve always had huge respect for healthcare workers, but being a patient made me realize I want to work in healthcare and help others as a nurse,” he said.

For Perry, Soliz’s story feels personal.

“I have a daughter one year older than Ryan who just went through the college application process and moved away,” Perry said. “I could only imagine what Mrs. Soliz was feeling. I knew we had to work together for Ryan. He has amazing things he will do—and I cannot wait to see how he changes the world.”

Read more from Cedars-Sinai Stories and Insights: Seeking a Second Opinion for a Spine Condition

, a national recognition awarded to programs that bring together specialists across disciplines to advance care for patients with complex skull base tumors through clinical expertise, research, education and innovation. These programs offer advanced surgical approaches to treating skull base tumors, including some cases considered inoperable elsewhere.

The designation recognizes Cedars-Sinai’s collaborative approach to treating tumors that develop at the base of the skull—an anatomically complex area where tumors grow near nerves and blood vessels that control vision, hearing, facial movement and swallowing.

“There is very precious real estate, and treatment often requires expertise from multiple specialties,” said Vladimir Ljubimov, MD, assistant professor of Neurosurgery at Cedars-Sinai, where he and other neurosurgeons at Cedars-Sinai Medical Center and Torrance Memorial Medical Center collaborate with a range of specialists to remove some of the most complex tumors.

The Cedars-Sinai Newsroom spoke with Ljubimov about what skull base surgery involves, why a multidisciplinary team is essential, and how advances in surgical techniques are expanding treatment options for patients.

What is skull base surgery?

Skull base surgery involves treating tumors that develop in one of the body's most anatomically complex regions. But the goal isn't simply to remove the tumor—it's to do so while preserving the nerves and blood vessels that control critical functions. Even a small injury to one of these structures can have life-altering consequences, including stroke, vision loss or facial paralysis. That's why skull base surgery requires advanced techniques, meticulous planning and close collaboration among specialists.

Treatment is tailored to each patient. Depending on the tumor's location, we may perform a traditional craniotomy, in which surgeons temporarily remove a small section of the skull to reach the tumor. We also use minimally invasive endoscopic techniques through the nose, orbit, or mouth, or combine multiple surgical approaches. These techniques allow us to safely treat tumors that were once considered extremely difficult or even impossible to reach.

What does a multidisciplinary skull base team involve?

Skull base surgery is truly a team effort. Neurosurgeons and otolaryngologists often work together during surgery, especially for minimally invasive endoscopic procedures performed through the nose or ear. Depending on where the tumor is located, other specialists may join the team. For example, ophthalmologists and oculoplastic surgeons help us safely treat tumors near the eye while preserving vision and appearance. Plastic surgeons may assist with reconstruction when needed. We also collaborate with endocrinologists, neuro-oncologists, neurologists and radiation oncologists, depending on the patient's diagnosis.

Every case is reviewed by our multidisciplinary team before surgery. Together, we evaluate imaging, discuss treatment options and determine the safest, most effective approach. Just as important as removing the tumor is reconstructing the skull base afterward. Our specialists work together to rebuild these structures, helping prevent complications such as cerebrospinal fluid leaks or infection while allowing patients to recover safely. After surgery, we continue coordinating care, which may include hormone management, radiation therapy, chemotherapy or rehabilitation.

What are the symptoms of a skull base tumor?

Not all skull base tumors are cancerous. Many are benign, but because of where they're located, they can still cause serious problems by pressing on the brain, nerves or blood vessels.

Skull base tumors include tumors such as pituitary tumors, tumors that arise from the lining of the brain (meningiomas), rare tumors that develop near the pituitary gland (craniopharyngiomas), tumors of the bone and cartilage (chordoma, chondrosarcoma), as well as cancers that have spread to the skull base from other parts of the body.

Symptoms vary depending on where the tumor is located and may include vision changes or vision loss, double vision, dizziness, balance problems, headaches, nausea or hormonal changes.

What are the latest advances in skull base surgery?

One of the biggest advances is the development of sophisticated endoscopic techniques that allow us to reach tumors through the natural openings of the nose, avoiding large incisions in many cases. These approaches give us access to areas that were once considered too risky to operate on, including tumors deep within the skull base and around the cavernous sinus.

As technology continues to advance, we're able to treat increasingly complex tumors with greater precision while reducing complications and improving quality of life for our patients.

How should patients look for the right skull base surgeon for them?

Patients should look for a program that offers multidisciplinary care. Complex skull base conditions often require expertise from multiple specialists, and having those experts work together from the beginning leads to more comprehensive treatment planning.

At Cedars-Sinai, we evaluate each case as a team and offer the full spectrum of surgical and nonsurgical treatment options. If a patient has been told their tumor is too difficult to remove or has limited treatment options, seeking a second opinion at a high-volume skull base center can help determine whether additional approaches may be available.

Read more from Cedars-Sinai Stories and Insights: From Vacation Vertigo to an Acoustic Neuroma Diagnosis

El modelo aborda un desafío histórico de la atención hospitalaria. La glucosa baja, también conocida como hipoglucemia, es una complicación frecuente y potencialmente mortal entre los pacientes hospitalizados, incluidos los que reciben tratamiento para la diabetes, quienes permanecen en ayuno antes de un procedimiento o quienes se encuentran en cuidados críticos. Sin embargo, actualmente no existen herramientas de uso generalizado para predecir qué pacientes hospitalizados desarrollarán hipoglucemia.

“Hoy en día, la mayor parte de la atención hospitalaria para la hipoglucemia es reactiva, y respondemos después de que el nivel de azúcar en sangre de un paciente baja”, afirmó Roma Gianchandani, MD, autora principal del estudio, vicepresidenta de Calidad e Innovación del Departamento de Medicina y directora del programa de Diabetes.

El modelo de IA desarrollado por investigadores de Cedars-Sinai analiza patrones en medicamentos, resultados de laboratorio, alimentación y otros datos de los expedientes clínicos electrónicos de los pacientes. Recopila la información en intervalos de cuatro horas durante un periodo de cinco días y la utiliza para predecir si un paciente desarrollará hipoglucemia en las siguientes 24 horas.

Los investigadores desarrollaron y validaron el modelo utilizando datos de más de 143,000 hospitalizaciones de adultos en tres hospitales del Cedars-Sinai Health System entre 2014 y 2025. Posteriormente, evaluaron la herramienta con datos prospectivos para confirmar sus hallazgos iniciales.

"El modelo de IA está diseñado para alertar a los equipos de atención al paciente antes de que este experimente un nivel bajo de azúcar en sangre e identificar los factores clave que impulsan ese riesgo", señaló Amanda Momenzadeh, PharmD, autora principal del estudio y científica de proyectos en el Meyer Research Lab de Cedars-Sinai. "Al ofrecer información procesable a los equipos de atención, también busca apoyar los programas de gestión de la diabetes en los hospitales".

Los investigadores estiman que la herramienta podría prevenir entre tres y cuatro episodios de hipoglucemia por día en un hospital de gran tamaño. Extrapolado a todas las camas hospitalarias del mundo, el impacto podría ser considerable.

“Lo emocionante es que no se trata solo de un modelo teórico, sino que está construido y validado para funcionar de manera prospectiva y en tiempo real utilizando datos que los hospitales ya recopilan”, afirmó el autor principal del estudio, Jesse Meyer, PhD, profesor asistente en el Departamento de Biomedicina Computacional de Cedars-Sinai. “Al identificar antes a los pacientes en riesgo, tenemos la oportunidad de reducir las complicaciones prevenibles y mejorar la seguridad del paciente”.

Si se adopta ampliamente, este modelo podría impulsar una atención más proactiva y basada en datos para pacientes hospitalizados con diabetes y otras afecciones que afectan los niveles de glucosa.

Autores adicionales de Cedars-Sinai: Caleb Cranney, Dennis Chen y Elizabeth Nguyen.

Financiamiento: NIGMS R35GM142502, NIH National Center for Advancing Translational Science (NCATS) y UCLA CTSI Grant Number UL1TR001881.

Declaración: Jesse Meyer, Amanda Momenzadeh y Caleb Cranney figuran como inventores en una solicitud de patente relacionada con esta herramienta de IA.

La Universidad de Ciencias de la Salud de Cedars-Sinai está impulsando investigaciones innovadoras y formando a los futuros líderes en medicina, ciencias biomédicas y ciencias de la salud afines. Más información sobre la universidad.

“Spinal CSF leaks can be incredibly debilitating, and in many cases we haven’t understood why they happen,” said Wouter Schievink, MD, co-senior author of the study and professor of Neurosurgery at Cedars-Sinai.

The brain and spinal cord are bathed in protective cerebrospinal fluid. A tear or hole in the membrane that surrounds the spinal cord can allow this fluid to leak out, leading to nausea, neck stiffness and severe headaches that worsen when standing. Current treatments for spinal CSF leaks focus on sealing the leak after it occurs. Patients are often treated with epidural blood patches, which can provide temporary relief, or may require specialized surgery to repair the tear when symptoms persist.

Spinal CSF leaks are associated with genetic connective tissue diseases that affect tissues supporting the body’s structure, but for many patients without a diagnosis of connective tissue disorder, the cause of the ruptured membrane is unknown.

“Because some patients with unexplained spinal CSF leak show subtle signs of connective tissue disease, even though they do not have a defined diagnosis, we sought to find a genetic cause,” Schievink said.

Investigators, including lead author of the study Cassie Parks, MD, PhD, and co-senior author Hal Dietz, MD, analyzed whole-exome sequencing from 42 patients with unexplained spinal CSF leak and compared the results with more than 3,800 individuals without the condition. They tested how the genetic variants they detected behave in human cells and laboratory mice.

The study found that about 1 in 5 patients with this type of spinal CSF leak had changes in the FBN2 gene, and that these changes appeared significantly more often in patients with CSF leak than in those without the condition.

Additional experiments showed that these genetic changes disrupt the way cells attach to the supportive tissue surrounding the spinal cord, potentially weakening this protective layer. In laboratory mice carrying the same mutations, the spinal lining was more prone to tearing and leaking.

Together, these findings suggest that defects in connective tissue caused by FBN2 variants may increase a person’s risk of developing spinal cerebrospinal fluid leaks.

“By identifying a genetic contributor, we now have the first understanding of cellular events that may be targetable for prevention or treatment of spontaneous CSF leaks,” said Dietz, professor of Genetic Medicine at the Johns Hopkins University School of Medicine.

“Potential future treatments can include medications that strengthen connective tissue or target the biological pathways affected by the FBN2 gene,” Schievink added.

Additional authors include Mukti Singh, Elizabeth Wohler, Renan Martin, Silke Peeters, Emily Juzwiak, Xinyi Sun, Bart Loeys, Nara Sobreira and Claire Baldock.

Funding: This work was supported by the Howard Hughes Medical Institute, the Marfan Foundation, the Pease/Scheeler Fund and the Biotechnology and Biological Sciences Research Council.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Investigators and clinicians from Cedars-Sinai will present research and discuss advances in care for older adults at the third annual California Academic Geriatric Institutions Conference May 29 at Stanford University.

Cedars-Sinai is a founding organizer and co-sponsor of the conference.

“We are proud to bring together leaders committed to improving the lives of older adults,” said Sonja Rosen, MD, chief of Geriatric Medicine at Cedars-Sinai and chair of the conference. “This conference reflects our shared dedication to advancing research, education and clinical care and to improving the healthspan of our patients.”

Rosen will deliver opening and closing remarks and participate in a panel on careers in geriatrics.

Cedars-Sinai Experts Available for Media Interviews

Sara Espinoza, MD, director of the Center for Translational Geroscience and co-director of the Los Angeles Claude D. Pepper Older Americans Independence Center, will participate in a panel focused on longevity and can discuss strategies to improve healthy aging.

Zaldy Tan, MD, MPH, medical director of the Jona Goldrich Center for Alzheimer’s and Memory Disorders and director of the Memory and Healthy Aging Program, will present research on modifiable risk factors—such as healthy eating and exercise—for Alzheimer’s disease in middle-aged individuals.

Allison Moser Mays, MD, geriatrician and assistant professor of Medicine, will present research on improving medication management for older adults. She will also present findings from the Framingham Heart Study on loneliness trends over four decades.

Nabeel Qureshi, PhD, a research scientist, will present studies focused on dementia care, including the implementation of a comprehensive dementia screening tool. He will also present research on cultural considerations in dementia care in Asian American communities.

Kathleen Breda, NP, associate director of Orthopaedic Clinical Programs and an acute care nurse practitioner, will present research on a nurse-led program that improves recovery and reduces risk of death among older patients with hip fractures. She will also discuss post-traumatic stress among older adults who have sustained a fracture and the impact on their recovery, mental health and quality of life.

Moizza Shabbir, MD, emergency medicine physician, will present a case study involving a patient who experienced internal bleeding after a traumatic injury. She will also discuss a new blood test that may help doctors quickly rule out serious brain injuries in patients with mild head trauma.

Hiroshi Gotanda, MD, PhD, geriatrician and associate professor of Medicine, will present research examining how geriatric training for physicians affects time spent at home among people with dementia.

Media Contact

To schedule an interview, contact Kelsie Sandoval at kelsie.sandoval@cshs.org or 562-631-1169.

The new clinic, located at 76 New Cavendish St. in London’s Harley Street Health District, will serve as a regional hub for patients in the U.K. and for global travelers, including those from the U.S. It will provide high-quality primary care, executive health and concierge medicine, while establishing an important international bridge to better coordinate care between healthcare systems in the U.K. and Cedars-Sinai in Los Angeles.

“Cedars-Sinai’s newest location is designed to meet the needs of patients seeking a seamless healthcare experience from one of the top-rated academic health systems in the world,” said Sandeep Kapur, MD, medical director of Cedars-Sinai Clinic London.

Spanning four floors, the new clinic features four private exam rooms designed for in-depth, personalized consultations. Patients can also access on-site diagnostic services, including DEXA, ultrasound and ECHO machines, with access to advanced imaging and testing.

Patients who visit the clinic can access second opinions, specialty consultations and referrals to Cedars-Sinai physicians in Los Angeles. Likewise, Cedars-Sinai patients traveling to or residing in the U.K. can receive care through the clinic in London.

Cedars-Sinai created 11 new high-skilled clinical and operational roles, which will double when the clinic is at full operational mode. The clinic is designed with healing in mind. A reception area features a modern welcoming and soothing atmosphere in addition to an exclusive lounge for patients and their caregivers to relax.

Cedars-Sinai entered the U.K. in March 2025 through a strategic collaboration with Guy’s and St Thomas’ NHS Foundation Trust. The collaboration expanded access to specialty care by establishing Cedars-Sinai’s first clinical presence in London. The clinic, located at 79 Wimpole St. in the Royal Brompton & Harefield Specialist Care building, features two exam rooms.

Leaders of the new, larger clinic said its comprehensive approach will make a big difference for those who receive services.

“Cedars-Sinai Clinic London reflects our commitment to extend the high standard of care we provide to our Los Angeles and U.S. communities to patients in London and the U.K., allowing them to benefit from our personalized and innovative care,” said Peter L. Slavin, MD, president and CEO of Cedars-Sinai Medical Center and Cedars-Sinai Health System.

Heitham Hassoun, MD, senior vice president and chief executive of Cedars-Sinai International, said the opening of Cedars-Sinai’s clinic in the U.K. “marks an important achievement in Cedars-Sinai’s strategic expansion to serve patients of the global healthcare community.”

Cedars-Sinai selected London as the location for the organization’s first flagship international clinic due to its role as a leading global healthcare hub, with a growing private healthcare sector and a diverse population of internationally mobile patients.  The Harley Street Medical Area alone is home to thousands of clinicians and specialist services, making it the most concentrated center of private medical care in the U.K. The clinic will help meet the growing demand for private healthcare services in the U.K. and internationally.

“Whether patients begin their journey in London, Los Angeles or another place around the world, Cedars-Sinai Clinic London will allow us to foster stronger relationships with individuals who rely on our care,” said Lawrence Piro, MD, president and CEO of The Angeles Clinic and Research Institute, a Cedars-Sinai affiliate, and medical director of Cedars-Sinai International’s Global Care program. “The launch of our clinic in London shows our strong commitment to managing the care of our patients wherever they are in the world.”

Mark Kildea, CEO of the Howard de Walden Estate, landlord and long-term steward of Harley Street Health District, said the opening of the new Cedars-Sinai clinic reflects the growing demand from leading international healthcare organizations to establish a presence in the area.

“We are pleased to have Cedars-Sinai joining Harley Street Health District,” Kildea said. “This is helping to advance our shared vision for an integrated globally connected center for innovation, collaboration and whole health in the center of London."

Cedars-Sinai International’s global footprint also includes patient referral offices in Mexico, China, Singapore, Qatar and Ecuador.

Read more from Cedars-Sinai Global Perspectives: Redefining Healthcare Delivery in Europe

Cedars-Sinai experts will present research on age-friendly health systems, dementia and patient-centered outcomes—such as time spent at home. They will also lead sessions on age-friendly healthcare and advances in dementia diagnosis and treatment.

“As our population ages, it is increasingly important that we deliver care that is evidence based and aligned with what matters most to older adults,” said Sonja Rosen, MD, chief of Geriatric Medicine at Cedars-Sinai. “Meetings like AGS provide an important opportunity to share knowledge and accelerate progress in this field.”

Rosen recently earned her credential as a certified professional in age-friendly health care, affirming her commitment to safer, more responsive care for older adults.

Cedars-Sinai experts attending the meeting and available for interviews include:

Sara Espinoza, MD, director of the Center for Translational Geroscience, can discuss building a career in aging research and navigating professional challenges and opportunities in the field.

Zaldy Tan, MD, MPH, medical director of the Jona Goldrich Center for Alzheimer’s and Memory Disorders, and director of the Memory and Healthy Aging Program, can discuss dementia diagnostics and treatment, including key updates about caring for patients with cognitive impairment.

Hiroshi Gotanda, MD, PhD, geriatrician and associate professor of Medicine, can discuss patient outcomes associated with age-friendly health systems. These include time spent at home for patients with dementia, and recovery following hip fracture surgery. He can also discuss the impact of physician geriatric specialty training on outcomes for patients with dementia.

Allison Mays, MD, MAS, geriatrician and assistant professor of Medicine, and Rosen will discuss strategies to improve follow-up care after fall risk screening during Medicare Annual Wellness Visits in primary care at the presidential poster session.

To schedule an interview, contact Kelsie Sandoval at kelsie.sandoval@cshs.org or 562-631-1169.

Elam, de 91 años, lleva 23 años jubilada de su trabajo en United Food and Commercial Workers Local 770. Y está prosperando, afirma su médica, Sonja Rosen, MD, jefa de Medicina Geriátrica en Cedars-Sinai, porque está viviendo su jubilación de la manera correcta.

“Carrie está haciendo muchas de las cosas que recomendamos a nuestros pacientes a medida que envejecen: mantenerse físicamente saludable y tener una vida social activa”, dijo Rosen.

Estadísticas de la Oficina de Estadísticas Laborales de EE. UU. muestran que casi el 20% de la fuerza laboral actual tiene 65 años o más, en comparación con el 10% a mediados de la década de 1980. Y muchos adultos mayores continúan trabajando por razones de salud, no financieras. Un análisis sugiere que jubilarse antes se asocia con una mayor mortalidad, con una reducción del 11% en el riesgo de muerte por cada año adicional de trabajo.

Entonces, ¿cómo pueden los adultos mayores de hoy reducir su ritmo laboral o dejar sus carreras sin afectar su salud?

“La jubilación del trabajo no es la jubilación de la vida”, dijo Zaldy Tan, MD, MPH, director médico del Jona Goldrich Center for Alzheimer’s and Memory Disorders en Cedars-Sinai. “No existe una edad universal en la que nuestro cuerpo se apague o el cerebro deje de funcionar. Esa no es una realidad fisiológica. La idea de la jubilación es una construcción humana”.

El factor clave, dijo Tan, no es la jubilación en sí, sino lo que las personas hacen después de dejar de trabajar. Quienes permanecen social y cognitivamente activos suelen experimentar mejor salud física, un envejecimiento biológico más lento y mayor bienestar mental.

Elam es un ejemplo perfecto. Sus días tienen estructura y propósito: es voluntaria en el comité de recaudación de fondos de su iglesia, camina en Fox Hills Park, asiste a la ópera y comparte cenas familiares los domingos.

“Me gusta arreglarme, contribuir a mi comunidad y asegurarme de tener un día lleno”, dijo Elam.

Rosen explicó que ese sentido de rutina y propósito puede marcar una gran diferencia en la experiencia de la jubilación.

Cómo Prepararse Para una Jubilación Saludable

Para muchas personas, el trabajo ofrece más que ingresos: proporciona rutina, propósito e interacción social diaria. Cuando desaparece, la transición puede ser difícil, especialmente para quienes dependen del entorno laboral para sus relaciones y actividades.

“A veces se ve el trabajo como algo negativo”, dijo Tan. “Pero no deberíamos pensar que el trabajo es malo y las vacaciones o la jubilación son buenas. Todo depende de lo que uno haga con cada situación”.

La jubilación incluso puede mejorar la salud de algunas personas, especialmente de quienes dejan trabajos físicamente exigentes o muy estresantes. Rosen señaló que algunos pacientes jubilados encuentran más tiempo para hacer ejercicio, cocinar de manera saludable, disfrutar del aire libre o explorar nuevos intereses.

Pero Tan enfatiza que la transición funciona mejor cuando se planifica.

“Las personas pasan años preparándose para ingresar al mundo laboral, pero la jubilación también requiere disciplina”, dijo. “Si tus amistades y rutinas giran en torno al trabajo, necesitas comenzar a construir actividades, conexiones sociales e intereses fuera del trabajo antes de jubilarte, para evitar el aislamiento”.

Rosen recomienda que quienes estén considerando jubilarse reflexionen sobre dónde encuentran significado en sus vidas—ya sea en el trabajo o en actividades, pasatiempos y relaciones fuera de él.

“Lo más importante son los objetivos y preferencias individuales del paciente”, dijo Rosen. “Todo depende de la persona y de lo que le resulte más significativo”.

Para quienes sí se jubilan, mantener una estructura y hábitos saludables es esencial. Rosen recomienda al menos 150 minutos de ejercicio cardiovascular por semana y entrenamiento de fuerza dos veces por semana. También aconseja incluir actividades sociales en la rutina, como voluntariado o reuniones regulares con amigos.

La estimulación mental es otro componente clave. El trabajo suele proporcionar desafíos intelectuales diarios, y los jubilados se benefician al reemplazarlos con actividades como educación continua, mentoría o ejercicios de memoria.

Elam, por ejemplo, lee todos los días y mantiene su mente activa con pequeños ejercicios mentales. Si no recuerda una palabra, repasa el abecedario hasta que una letra le ayude a recordarla.

Cuando la Jubilación no es la Mejor Opción

Para Christine Maclin, la jubilación simplemente no fue adecuada.

Maclin, ahora de 79 años, se jubiló inicialmente a los 69 de su trabajo como cocinera, con la intención de descansar y disfrutar su tiempo libre. Pero después de seis meses, se dio cuenta de que extrañaba el aprendizaje y el sentido de propósito que le daba el trabajo.

“¿Cuántas películas puedes ver? ¿A cuántas cafeterías puedes ir?”, dijo Maclin. “Me encanta pasar tiempo con mis amigos, pero al final sentí que la jubilación era tiempo desperdiciado”.

Regresó al mundo laboral a través de una agencia de empleo, trabajando como cocinera en el Magic Castle y en la University of Southern California, y más tarde como asociada de ventas en Nordstrom. En enero de 2025, decidió probar algo nuevo y tomó un curso de 10 semanas en cuidado profesional.

“Lo que ha hecho Christine—seguir trabajando y aprendiendo—demuestra que algunos pacientes se benefician al continuar activos laboralmente”, dijo Tan, su médico.

Actualmente, Maclin trabaja dos veces por semana como cuidadora personal, cocina para su cliente, socializa y ayuda con mandados, mientras sigue aprendiendo algo nuevo cada día.

“Me gusta tener un lugar a donde ir y algo que hacer”, dijo.

Mantener una Mentalidad Positiva, Con o Sin Jubilación

Tanto Elam como Maclin atribuyen su buena salud a una mentalidad resiliente y positiva.

Maclin dice que olvidar cosas ocasionalmente es parte normal de la vida y no vale la pena frustrarse. En lugar de enojarse, se enfoca en resolver el problema, como hizo recientemente cuando no recordaba si había tomado su medicamento.

“En vez de molestarte porque olvidaste algo, resuelve el problema”, dijo. “Decidí que después de tomar mi medicamento, volteo el envase boca abajo para saber que ya lo hice”.

Elam, por su parte, intenta enfrentar el envejecimiento con estilo y gracia, evitando preocuparse antes de tiempo.

Esté jubilada o no, cree que la clave para mantenerse saludable es simple:
“Encuentra actividades que disfrutes y sé siempre agradecido”, dijo.

Lea más en Historias y Perspectivas de Cedars-Sinai: Por Qué el Ejercicio es Importante a Medida que Envejeces

El estudio demuestra que las mismas neuronas del cerebro se activan cuando imaginamos algo y cuando lo percibimos. La investigación, liderada por Cedars-Sinai, es la primera en ofrecer una comprensión detallada del mecanismo compartido que subyace a la percepción visual y a la creación de imágenes mentales en el cerebro humano. Los resultados se publicaron en la revista Science.

“Generamos una imagen mental de un objeto que hemos visto antes reactivando las células cerebrales que utilizamos para verlo en primer lugar”, dijo Ueli Rutishauser, PhD, director del Center for Neural Science and Medicine y profesor de Neurocirugía, Neurología y Ciencias Biomédicas en Cedars-Sinai Health Sciences University, y coautor principal del estudio. “Nuestro estudio reveló el código que utilizamos para recrear las imágenes”.

Los hallazgos proporcionan una base biológica para la imaginación visual, un proceso que también es fundamental para las artes creativas.

“Comprender mejor este proceso neuronal tiene el potencial de abrir nuevas vías para desarrollar terapias para el trastorno de estrés postraumático, el trastorno obsesivo-compulsivo y otras afecciones mentales que implican imágenes vívidas e incontroladas”, dijo Adam Mamelak, MD, director del Programa de Neurocirugía Funcional y profesor de Neurocirugía en Cedars-Sinai, y coautor del estudio.

Para llevar a cabo el estudio, los investigadores pidieron a 16 adultos con epilepsia —quienes tenían electrodos implantados temporalmente en el cerebro para diagnosticar sus convulsiones— que observaran una serie de imágenes de rostros y objetos. Después de verlas, a un grupo de participantes se les pidió que imaginaran esas mismas imágenes a partir de la memoria. Mientras tanto, los investigadores registraron la actividad eléctrica de cientos de neuronas individuales en el cerebro de cada participante.

Cuando los pacientes observaron las imágenes, se activaron neuronas en el giro fusiforme, un área del cerebro esencial para el procesamiento visual de alto nivel, especialmente de los rostros. En el 80% de las neuronas sensibles a estímulos visuales registradas en el estudio, los investigadores identificaron los aspectos específicos de las imágenes a los que reaccionaban, revelando así su código neuronal. Cuando los pacientes posteriormente imaginaron las imágenes, aproximadamente el 40% de estas neuronas se reactivaron utilizando el mismo código, recreando el patrón de actividad que ocurrió durante la observación inicial.

“Las herramientas avanzadas de inteligencia artificial fueron fundamentales para nuestra investigación en todas sus etapas”, dijo Varun Wadia, PhD, investigador postdoctoral en el laboratorio de Rutishauser y primer autor del estudio. “Utilizamos redes neuronales visuales profundas para crear descripciones numéricas de los objetos y así comprender el código de las neuronas. Luego verificamos ese código utilizando inteligencia artificial generativa para crear imágenes nunca antes vistas y predecir correctamente las respuestas del cerebro a esas imágenes”.

La investigación se basa en el trabajo de Doris Y. Tsao, PhD, de la University of California, Berkeley, coautora principal del estudio, quien identificó el código neuronal para el reconocimiento de objetos en primates no humanos. El estudio actual revela que el mismo código neuronal está presente en los humanos y explica la imaginación visual.

“Estos hallazgos respaldan la idea de que imaginar y ver comparten un código neuronal común y pueden tener implicaciones importantes para comprender trastornos psiquiátricos caracterizados por alteraciones en las imágenes mentales y en la capacidad de distinguir la realidad”, dijo Hermon Gebrehiwet, DrPH, funcionario de programa en los National Institutes of Health.

Aún queda por determinar qué desencadena la reactivación neuronal observada por los investigadores y cómo los recuerdos conducen a la reactivación del subconjunto preciso de neuronas necesarias.

Otros autores de Cedars-Sinai incluyen: C. M. Reed, J. M. Chung y L. M. Bateman.

Financiamiento: El estudio fue respaldado por la iniciativa Brain Research Through Advancing Innovative Neurotechnologies® (BRAIN Initiative®) de los National Institutes of Health, el Howard Hughes Medical Institute, la Simons Foundation Collaboration on the Global Brain y el Chen Center for Systems Neuroscience en Caltech.

La Universidad de Ciencias de la Salud de Cedars-Sinai está impulsando investigaciones innovadoras y formando a los futuros líderes en medicina, ciencias biomédicas y ciencias de la salud afines. Más información sobre la universidad.

“The AAN Annual Meeting is an important opportunity for neurologists to share scientific and clinical advances shaping the care of patients with neurological disorders,” said Nancy Sicotte, MD, chair of the Department of Neurology at Cedars-Sinai. “Our physician-scientists are sharing information about the most important challenges in neurology—from improving treatments for chronic neurological diseases to strengthening communication and support for patients and families.”

Cedars-Sinai Experts Presenting Research at the Meeting

Alexis Simpkins, MD, PhD, director of Stroke Research and the Stroke RNA, Imaging, and Protein Predictors for Patient Tailored Treatment Program at Cedars-Sinai, will receive the DEI Changemaker Award, and she will chair the research hub at the meeting. She will also share information on women’s leadership in neurology and the history of neurology.

Andrew Blumenfeld, MD, a Cedars-Sinai neurologist specializing in headache disorders, will present research on the use of botulinum toxin, popularly known as Botox, for chronic migraine management, and he can discuss advances in migraine treatment.

Richard Lewis, MD, professor of Neurology, will present research on new therapies for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), a rare disorder in which the immune system damages the nerves, leading to weakness and numbness. He will also share results from late-stage clinical trials evaluating potential new CIDP treatments.

Paula Barreras, MD, assistant professor of Neurology and director of the Center of Excellence in Rare Neuroimmune Disorders at Cedars-Sinai, will discuss vascular causes of myelopathy, a frequent source of misdiagnosis in spinal cord disorders.

Jessica Besbris, MD, director of Neuropalliative Care and the Neurology Supportive Care Medicine Program, will discuss neuropalliative care, including ways neurologists can effectively and compassionately communicate about serious illnesses to their patients.

Yvette Bordelon, MD, PhD, director of the Cedars-Sinai Huntington’s Disease Society of America Partner Center of Excellence, will discuss gene therapy for Huntington’s disease, including new therapeutic developments, clinical applications of research and innovative technical advances.

Maranatha O. Ayodele, MD, assistant professor of Neurology, will moderate a session on cerebrovascular diseases and can discuss intracerebral hemorrhage and traumatic brain injuries.

Additional Cedars-Sinai Experts

Lisa Bateman, MD, director of the Surgical Epilepsy Program and professor of Neurology, can discuss epilepsy research and treatment advances.

Ilana E. Lasner, DO, assistant professor of Neurology, can discuss Alzheimer’s disease, Parkinson’s disease and migraines.

Marwa Kaisey, MD, associate professor of Neurology, will discuss disease-modifying therapies for multiple sclerosis.

Konrad Schlick, MD, Neurology Residency Program director, can discuss ischemic stroke management and neurology resident training.

Jodi Nelson, DO, assistant professor of Neurology, can discuss treating dementia and multiple sclerosis.

Contact

To arrange interviews with Cedars-Sinai experts, contact Kelsie Sandoval at Kelsie.sandoval@cshs.org or 562-631-1169.

“El accidente cerebrovascular es una de las emergencias más sensibles al tiempo en la medicina”, dijo Dr. Nestor González. “Cuanto más rápido restablezcamos el flujo sanguíneo al cerebro, más función cerebral podemos preservar”.

El consejo de González coincide con la nueva Guía 2026 de la American Heart Association y la American Stroke Association para el manejo temprano del accidente cerebrovascular isquémico agudo. En la primera actualización desde 2019, las guías recomiendan una mayor dependencia de estudios de imagen, procedimientos basados en catéter y la intervención de los servicios médicos de emergencia. Además, introducen por primera vez orientación nacional para el tratamiento del accidente cerebrovascular en niños.

González, co-vicepresidente del grupo de la American Stroke Association que desarrolló la guía, conversó con el Newsroom de Cedars-Sinai sobre las actualizaciones y la investigación de vanguardia en este campo.

¿Cuáles son los cambios más importantes en la guía actualizada para el accidente cerebrovascular isquémico agudo?

El tratamiento de accidente cerebrovascular ha avanzado significativamente en las últimas décadas, especialmente con el desarrollo de medicamentos que disuelven coágulos y procedimientos endovasculares que pueden eliminar obstrucciones en el cerebro. Desde la publicación de las guías anteriores en 2019, nuevos ensayos clínicos han ampliado la comprensión sobre qué pacientes pueden beneficiarse de estos tratamientos.

Las guías anteriores recomendaban procedimientos endovasculares dentro de las seis horas desde el inicio del accidente cerebrovascular, con solo un grupo limitado elegible hasta 24 horas después. La guía actualizada amplía esos criterios, permitiendo que más pacientes sean considerados dentro de esa ventana de 24 horas.

También se amplían las opciones para pacientes con accidente cerebrovascular de gran extensión, cuando una parte significativa del cerebro está afectada. En el pasado, existía cautela debido a la incertidumbre sobre los beneficios, pero estudios recientes muestran que la intervención puede reducir la discapacidad en ciertos casos.

Además, las guías amplían la elegibilidad para procedimientos de extracción de coágulos a pacientes con discapacidades preexistentes, ya que la evidencia sugiere que pueden recuperar su nivel funcional previo.

Usted es parte de Cedars-Sinai Guerin Children’s, y las recomendaciones actualizadas incluyen la primera orientación específica para tratar el accidente cerebrovascular en niños. ¿Por qué es importante?

El accidente cerebrovascular puede ocurrir a cualquier edad, incluidos los niños. Sin embargo, debido a su baja frecuencia, no siempre se considera de inmediato ante síntomas neurológicos repentinos.

Las nuevas guías brindan orientación práctica para reconocer y tratar el accidente cerebrovascular en población pediátrica, incluyendo el uso de estudios de imagen y tratamientos como la trombólisis intravenosa o la trombectomía endovascular.

En los últimos años, centros especializados han comenzado a aplicar en niños algunos tratamientos desarrollados para adultos, con resultados prometedores.

¿Cómo cambiarán estas guías la atención en los hospitales?

Las guías destacan la necesidad de mejorar todo el sistema de atención del accidente cerebrovascular para garantizar una evaluación y tratamiento rápidos. Esto incluye el reconocimiento temprano por servicios de emergencia, diagnóstico ágil y acceso a tratamientos especializados.

También enfatizan la importancia de sistemas coordinados que integren diagnóstico por imagen, telemedicina para hospitales más pequeños y traslado eficiente a centros especializados como Cedars-Sinai Medical Center.

Mientras que muchos de estos sistemas ya existen para adultos, el impacto en la atención pediátrica podría ser aún mayor, ya que muchos hospitales aún están desarrollando estos procesos.

¿Qué áreas de investigación le resultan más prometedoras?

Gran parte del progreso reciente se ha centrado en la fase aguda del accidente cerebrovascular, pero también es clave abordar a pacientes con flujo sanguíneo cerebral crónicamente reducido, lo que aumenta el riesgo de eventos recurrentes.

Dos condiciones relevantes son la enfermedad de Moyamoya, que afecta a niños y adultos jóvenes, y la aterosclerosis intracraneal, más común en adultos mayores.

En la enfermedad de Moyamoya, las arterias cerebrales se estrechan o bloquean, y se pueden realizar cirugías de bypass para restaurar el flujo sanguíneo. La investigación del Dr. González se ha enfocado en mejorar estas técnicas.

En adultos con aterosclerosis intracraneal, los medicamentos ayudan en muchos casos, pero no siempre son suficientes. En colaboración con los National Institutes of Health, se está estudiando una técnica llamada revascularización indirecta (EDAS), originalmente desarrollada para niños, que ahora se adapta para adultos con enfermedad vascular grave. Estudios iniciales muestran resultados prometedores.

La Universidad de Ciencias de la Salud de Cedars-Sinai está impulsando investigaciones innovadoras y formando a los futuros líderes en medicina, ciencias biomédicas y ciencias de la salud afines. Más información sobre la universidad.

The study shows that the same brain neurons are activated when we imagine something and when we perceive something. The research, led by Cedars-Sinai, is the first to provide a detailed understanding of the shared mechanism that underlies visual perception and creation of mental images in the human brain. It was published in the journal Science.

“We generate a mental image of an object that we have seen before by reactivating the brain cells we used to see it in the first place,” said Ueli Rutishauser, PhD, director of the Center for Neural Science and Medicine and professor of Neurosurgery, Neurology and Biomedical Sciences at Cedars-Sinai Health Sciences University, and the study’s joint senior author. “Our study revealed the code that we use to re-create the images.”

The findings provide a biological basis for visual imagination, a process that is also critical for creative arts.

“Further insight into this neural process has the potential to open pathways toward developing new therapies for post-traumatic stress disorder, obsessive-compulsive disorder, and other mental conditions that involve uncontrolled vivid imagery,” said Adam Mamelak, MD, director of the Functional Neurosurgery Program and professor of Neurosurgery at Cedars-Sinai, and co-author of the study.

To conduct the study, investigators asked 16 adults with epilepsy, who had electrodes temporarily implanted in their brains for diagnosing their seizures, to view a series of images of faces and objects. After viewing them, a subset of the participants were asked to imagine those same images from memory. Meanwhile, researchers recorded the electrical activity of hundreds of individual neurons in each participant’s brain.

When the patients viewed the images, neurons were activated in their fusiform gyrus, an area of the brain essential for high-level visual processing, particularly for faces. For 80% of the visually responsive neurons recorded in the study, the researchers uncovered the aspects of the images they reacted to, thereby revealing their neural code. When the patients later imagined the images, about 40% of these neurons reactivated using the same code, thereby recreating the pattern of activity that occurred during the initial viewing of the images.

“Advanced artificial intelligence tools were critical to our investigation at all stages,” said Varun Wadia, PhD, a postdoctoral scientist in Rutishauser’s laboratory and first author of the study. “We used deep visual neural networks to create numerical descriptions of objects so that we could understand the neurons’ code. We then verified the code by using generative AI to create never-before-seen images and correctly predict the brain’s responses to these images.”

The research builds on the work of Doris Y. Tsao, PhD, of the University of California, Berkeley, who is co-senior author on the study. She identified the neural code for object recognition in nonhuman primates. The current study reveals that the same neural code is present in humans and that it explains visual imagination.

“These findings support the idea that imagining and seeing share a common neural code and may have important implications for understanding psychiatric disorders marked by disruptions in mental imagery and reality discrimination,” said Hermon Gebrehiwet, DrPH, program officer at the National Institutes of Health.

Still to be determined are what triggers the neural reactivation the investigators found, and how memories lead to reactivation of just the right subset of neurons needed, the investigators said.

Other Cedars-Sinai authors include: C. M. Reed, J. M. Chung, and L. M. Bateman

Funding: The work was supported by the National Institutes of Health’s Brain Research Through Advancing Innovative Neurotechnologies® Initiative, or The BRAIN Initiative® (U01NS117839 to UR), the Howard Hughes Medical Institute (DYT), the Simons Foundation Collaboration on the Global Brain (UR and DYT) and the Chen Center for Systems Neuroscience at Caltech (DYT).

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Elam, 91, has been retired for 23 years from her job at United Food and Commercial Workers Local 770. And she is thriving, says Elam’s physician, Sonja Rosen, MD, chief of Geriatric Medicine at Cedars-Sinai, because Elam is doing retirement the right way.

“Carrie’s doing many of the things we encourage our patients to do as they age— keeping herself physically healthy and having a full social calendar,” Rosen said.

Statistics from the U.S. Bureau of Labor Statistics show nearly 20% of today’s workforce are 65 or older, up from 10% in the mid-1980s. And many older adults stay in the workforce for health—not financial—reasons. One analysis suggests that retiring earlier is associated with higher mortality, finding an 11% reduction in risk of death for each additional year of work.

So how can today’s older adults slow down or leave their careers without losing their health?

“Retirement from work is not retirement from life,” said Zaldy Tan, MD, MPH, medical director of the Jona Goldrich Center for Alzheimer’s and Memory Disorders at Cedars-Sinai. “It’s not like there is a universal, specific age at which our bodies shut down or our brains slow down to a halt. That is not physiological. This idea of retirement is man-made.”

The key factor, Tan said, is not retirement itself—but what people do after they stop working. Retirees who remain socially and cognitively engaged often experience better physical health, slower biological aging and improved mental wellbeing than those who do not, Tan said.

Elam is a perfect example. Her days still have structure and purpose: volunteering on her church’s fundraising committee, walking in Fox Hills Park, attending the opera and sharing Sunday dinners with family.

“I like to get dressed, give back to my community and make sure I have a full day,” Elam said.

Rosen said that sense of routine and purpose can make a big difference in how people experience retirement.

How to Prepare for a Healthy Retirement  

For many, a job gives more than income—it provides routine, purpose and daily social interaction. When the job disappears, the transition can be challenging, particularly for people whose relationships and activities revolve around the workplace.

“Work is sometimes seen as negative,” Tan said. “But we shouldn’t look at work as evil and vacation or retirement as good. It’s really what you make of both situations.”

Retirement can even improve the health of some—especially those leaving physically demanding or high-stress careers. Rosen said that some of her retired patients find they have more time to focus on exercise, cook healthier meals, spend time outdoors or explore new interests.

But Tan said the transition works best when people prepare for it.

“People spend years preparing to enter the workforce, but retirement requires discipline, too,” he said. “If your friendships and routines are centered on work, you need to start building activities, social connections and interests outside the workplace before you retire so you don’t end up isolated.”

Rosen recommends that people who are considering retiring take stock of where they find meaning in their lives—whether that purpose comes primarily from work or from activities, hobbies and relationships outside the workplace.

“What matters most are a patient’s individual goals and preferences,” Rosen said. “It really depends on the individual and what they find most meaningful in their life.”

For those who do retire, Rosen said maintaining structure and healthy habits is essential. She recommends aiming for at least 150 minutes of cardio each week and strength training twice a week. She also advises retirees to build social activities into their routines, such as volunteering or scheduling regular get-togethers with friends, to stay socially connected.

Mental stimulation is another important piece. Work often provides daily intellectual challenges, and Rosen said retirees benefit from replacing that engagement with activities such as continuing education, mentoring or doing memory exercises.

Elam, for example, reads every day and keeps her mind active with small mental exercises. If she can’t remember the name of something, she runs through the alphabet until a letter triggers her memory.

When Retirement Isn’t the Right Fit

For Christine Maclin, retirement simply wasn’t a good match.

Maclin, now 79, originally retired from her job as a cook at age 69, planning to rest and enjoy her free time. But after six months, she realized she missed the learning and sense of purpose that work provided.

“I mean, how many movies can you go to? How many coffee shops can you go to?” Maclin said. “I love hanging out with my friends, but ultimately I felt like retirement was time wasted.”

She returned to the workforce through a staffing company, first working as a cook for the Magic Castle and the University of Southern California—and later as an associate on the sales floor at Nordstrom. In January 2025, she decided to try something new and took a 10-week course in professional caregiving.

“What Christine has done—finding work and continuing to learn—shows that some patients fare better when they work,” Tan, Maclin’s physician, said.

Now Maclin works twice a week as a personal caregiver—cooking for her client, socializing and helping with errands—while continuing to learn something new every day.

“I like having somewhere to go and having something to do,” Maclin said.

Keeping a Positive Mindset, Retired or Working

Elam and Maclin each attribute their good health to a resilient, positive mindset.

Maclin says occasionally forgetting things is a normal part of life and not something worth getting upset about. Instead of becoming frustrated, she focuses on solving the problem, as she recently did one morning when she couldn’t recall if she had taken her medication.

“Instead of getting angry because you forgot something, solve the problem,” Maclin said. “I decided that after I take my medication, I just turn the container upside down, so I know.”

Elam says she tries to approach the aging process with as much style and grace as possible and avoids worrying prematurely.

Retired or not, she believes the key to staying healthy is simple: “Find activities you enjoy, and always be grateful,” Elam said.

Read more from Stories and Insights: Why Exercise Is Important as You Age

A New Algorithm Could Improve Location of Lifesaving Devices

Cedars-Sinai Health Sciences University investigators and colleagues created an algorithm designed to use data on sudden cardiac arrests to determine the best public locations for lifesaving devices called automated external defibrillators. Their findings were published in IJC Heart & Vasculature.

Known as AEDs, the portable devices deliver an electrical shock, with an aim to restart the heart when it stops beating due to sudden cardiac arrest. Sudden cardiac arrest is common and usually fatal when it happens somewhere other than a hospital.

“Research shows that the sooner a bystander can locate and use an AED, the higher the likelihood that the person experiencing sudden cardiac arrest survives,” said Sumeet Chugh, MD, vice dean and chief AI Health Research Officer at Cedars-Sinai, and senior author of the paper.

The investigators reviewed data on incidents of sudden cardiac arrest in Ventura County, California, and Multnomah County, Oregon, that took place between 2012 and 2023. The algorithm they created identified clusters of three or more incidents that occurred within a 100-meter radius of each other, and proposed AED locations within 200 meters of where these clusters occurred. 

Future studies will be needed to determine whether the algorithm is an improvement over current AED location strategies, the investigators said.

“These community-based studies are a huge team effort that involves ongoing collaborations with colleagues in emergency medical services and the fire department,” said Chugh, who is also director of the Center for Cardiac Arrest Prevention in the Smidt Heart Institute. “We hope researchers use this algorithm to study how the placement of AEDs reduces deaths from sudden cardiac arrest.”

Cedars-Sinai investigator Elizabeth Heckard, MS, is first author of the paper. Additional Cedars-Sinai authors include Harpriya Chugh, BE, MSHS, and Kyndaron Reinier, PhD, MPH.

Other authors include Katy Hadduck, Bryan McNally, Ali Sovari, Jonathan Jui, and Angelo Salvucci.

Cedars-Sinai Studies Pharmacist-Led Transitions-of-Care in Older Adults

Older hospitalized patients who struggled with taking their medications correctly were 10% less likely to need to return to the hospital if they had a pharmacist’s help at discharge, according to a new multisite clinical trial based at Cedars-Sinai. But the findings, published in JAMA Network Open, found the extra help didn’t significantly reduce unplanned hospital visits for the rest of those 55 and older.

The trial included more than 6,000 hospitalized older adults on high-risk or multiple medications, randomly assigning some to receive special pharmacist-led review of their medications and follow-up based on any issues identified. Investigators tracked patients’ hospital readmissions and emergency department visits for 30 days after discharge.

“The study suggests that pharmacist-led care could be beneficial for certain patients,” said Joshua Pevnick, MD, MSHS, co-director of the Cedars-Sinai Division of Clinical Informatics, associate professor of Medicine and corresponding author of the study. “With this new data, we encourage hospital care teams to ensure they support patients with low medication adherence and understanding, as they likely would benefit most from the efforts of our strong pharmacy transitions-of-care team.”

Other Cedars-Sinai authors include An T. Nguyen, OTD, OTR/L, BCG; Kallie Amer, PharmD, BCPS; Carl T. Berdahl, MD, MS; Galen Cook Wiens, MS; Hiroshi Gotanda, MD, PhD; James Guan, PharmD, BCPS; Andrew J. Henreid, MS, MPH; Donna W. Leang, PharmD, MSHS, BCPS; Yervant Malkhasian, PharmD; Teryl K. Nuckols, MD, MSHS; Audrienne S. Ortiz, PharmD, BCPS; Emily Phung, PharmD, BCPS; Nabeel Qureshi, PhD, MPH; Rita Shane, PharmD; and Shirley Wu, PharmD, BCPS.

Other authors include Korey Kennelty, PharmD, MS, PhD, BCGP, John Fanikos, RPh, MBA; Julie Fiskio; Michelle S. Keller, PhD, MPH; Eunji M. Ko, PharmD; Lina Matta, PharmD, MPH, BCPS; Dylan Moriarty, PharmD, BCACP, BCGP; Logan Murry, PharmD, PhD; Annie Muske, PharmD; Onyeche Oche, RPh, PhD, MBA-HCA; and Jeffrey L. Schnipper, MD, MPH, MHM on behalf of the PHARM-DC Group.

Funding support for this study was provided by the National Institutes of Health, National Institute on Aging, grant number R01AG058911 (to Joshua Pevnick). Additional funding support was provided by the UCLA Clinical and Translational Science Institute under grant number UL1TR001881 and the American Society of Health-System Pharmacists Research and Education Foundation.

Scientists Target Key Protein Duo Driving Colon, Liver Cancer

Cedars-Sinai Health Sciences University investigators have identified a drug-like compound that prevents two proteins from working together to promote the growth of colorectal and liver cancer. Findings from the preclinical study were published in Cell Death & Disease.

Investigators focused on the proteins GIT1 and MAT2B, which are found at unusually high levels in these cancers. The proteins partner to form a “scaffolding” that drives cancer growth. The team discovered that a compound called C3 targets GIT1 and disrupts this structure. The disruption slows cancer cell growth and triggers cancer cell death, which helps prevent the cancer from spreading.

Colorectal cancer is among the most diagnosed cancers, and its spread to the liver is a common, serious and life-threatening complication.

“We were pleased to find a promising drug candidate that attacks colon and liver cancers simultaneously,” said Shelly Lu, MD, the Women’s Guild Chair in Gastroenterology, director of the Karsh Division of Gastroenterology and Hepatology at Cedars-Sinai, and the study’s corresponding author. “And because GIT1 is overactive in many cancers, this discovery could have broad and powerful applications in cancer treatment.”

The next step is to refine the compound to improve its effectiveness.

In related research, Lu, a member of Cedars-Sinai Cancer, and Cedars-Sinai investigators recently uncovered another way colorectal cancer spreads. They found that cancer cells release two forms of an enzyme called MATα2 that work together to weaken the liver’s natural defenses, which helps cancer spread to the liver and survive there. The findings suggest that blocking this process could offer another promising future treatment approach.

Additional Cedars-Sinai authors include Hui Peng, Jyoti Chhimwal, Wei Fan, Jiaohong Wang, Lucia Barbier-Torres, Sonal Sinha, Avradip Chatterjee, Yi Zhang, Maria Lauda Tomasi and Ramachandran Murali.

Additional authors include Jose M. Mato.

Funding: The work was supported by NIH grant P01CA233452 (SC Lu, ML Tomasi), Plan Nacional of I+D SAF2017-88041-R (JM Mato).

Disclosures: SCL and RM have filed a patent for small molecule inhibitors of GIT1 (Title: COMPOUNDS AND METHODS FOR TREATING CANCERS; Application No. 63/422,672; Filed: Nov. 4, 2022).  

Cedars-Sinai Creates First Working Model of Specialized Gut Cells

Cedars-Sinai Health Sciences University investigators have for the first time created human intestinal organoids that include functional Paneth cells, a specialized cell type that is found in the inner lining of the intestine. This achievement, published in Cellular and Molecular Gastroenterology and Hepatology, facilitates study of the cells’ role in health and disease and opens new opportunities for understanding gastrointestinal disorders.

Organoids are tiny groups of cells, grown in the lab, that mimic some of the structure and functions of actual organs. The organoids are generated from induced pluripotent stem cells, which can be turned into many different cell types.

“The model of Paneth cells that we developed can facilitate research into how genetic variations, microbes and the intestines’ immune system influence them,” said Robert Barrett, PhD, associate professor of Medicine and Biomedical Sciences and corresponding author of the study. “This knowledge is important because changes in Paneth cells are associated with chronic gastrointestinal disorders such as Crohn’s disease that involve abnormal reactions of the immune system.”

No team of investigators had previously been able to grow intestinal organoids that included functional Paneth cells. By changing the environment in which the organoids were grown, investigators this time were successful. In addition, because organoids derived from induced pluripotent stem cells carry the donor’s genetic material, the new model eventually could lead to personalized treatments for gut illnesses such as inflammatory bowel disease, according to the investigators.

Additional Cedars-Sinai authors include Shachi Patel, Monica Silveira Wagner, Olivia Bay, Christian E. Wong Valencia, Eliska Zgarbova, Cynthia I. Rodriguez, Daniel N. Leal, Michifumi Yamashita, Suzanne Devkota, Kathrin S. Michelsen and Stephan R. Targan.

Funding: Supported by the National Institutes of Health R01 DK123511 (SRT) and the F. Widjaja Inflammatory Bowel Disease Institute. MSW and CWV were supported by the California Institute for Regenerative Medicine (CIRM EDUC4-12751). The study sponsors played no role in the study design collection, analysis, or interpretation of data.

Disclosures: Shachi Patel, Monica Silveira Wagner, Stephan R. Targan and Robert J. Barrett are named as inventors on a U.S. Application No. 19/458,165, each titled “Methodologies to Generate Human Paneth Cells and Enterochromaffin Cells and Determine Their Responses.” The remaining authors disclose no conflicts.

Study Identifies Genetic Drivers of Resistant Hypertension

Cedars-Sinai investigators have identified distinct genetic variants associated with resistant hypertension, a type of high blood pressure that remains uncontrolled despite medication. Their findings, published in the journal Hypertension, suggest potential targets for diagnosing and treating this serious condition.

More than 10% of people with high blood pressure have resistant hypertension, which means they face higher risk of cardiovascular illness and death than people with nonresistant high blood pressure do.

Investigators reviewed genetic data on 92,740 people with consistently high blood pressure in Finland and the United Kingdom. The study identified variants in genes involved in hormonal regulation and blood vessel function that are highly associated with resistant hypertension. The findings highlight overproduction of the hormone aldosterone as a likely cause of difficult-to-control blood pressure.

“Understanding the genetic and bodily pathways that predispose individuals to resistant hypertension may help us identify these patients,” said co-corresponding author Joseph Ebinger, MD, associate professor of Cardiology and director of the Coronary Intensive Care Unit and Clinical Analytics in the Smidt Heart Institute at Cedars-Sinai. “This knowledge can help us develop strategies to lower their blood pressure and reduce their risk for heart attacks and other potentially fatal cardiovascular events.”

Additional Cedars-Sinai authors include Sandy Y. Joung, MSHS, MBA, and Susan Cheng, MD, MPH.

Other authors include Anni Kauko, PhD; Felix Vaura, MD; Paul Hage, BS; Johan Sundström, MD; FinnGen; and Teemu Niiranen, MD.

Funding: This work was funded by the Academy of Finland (321351), the Finnish Foundation for Cardiovascular Research, the Paavo Nurmi Foundation, the Sigrid Juselius Foundation, the Mary and Georg Ehrnrooth Foundation, the Hospital District of Southwest Finland, and the National Institutes of Health grants R01-HL134168, R01-HL131532, R01-HL143227, R01-HL142983, K23-HL153888, K23-HL136853, and R01-HL153382.

New Method Rapidly Analyzes Cell Proteins and Metabolites

Researchers at Cedars-Sinai have developed a fast, new technique for analyzing cells, described in the journal Angewandte Chemie. The approach, called single-injection multi-omics analysis by direct infusion (SMAD), can detect more than 1,300 proteins and more than 9,000 molecular features from a single sample in less than five minutes. The method could help researchers study health, disease and drug responses more quickly and at lower cost, while simplifying analyses that usually require more complex workflows.

To show how the method can be used, the researchers applied it in several case studies. These included tracking how immune cells shift into different inflammatory states and screening how human cells respond to drug treatments.

“By making molecular analysis faster, this approach could one day accelerate drug discovery, enable more powerful machine learning models, and help move rapid, large-scale biological testing closer to clinical use,” said Jesse Meyer, PhD, senior author of the study and an assistant professor of Computational Biomedicine at Cedars-Sinai.

Additional Cedars-Sinai authors include Yuming Jiang, Amanda Momenzadeh and Jesús Muñoz-Estrada.

Other authors include Ivan Salladay-Perez, Utkarsh Tripathi and Anthony J. Covarrubias.

Funding: NIH (R35GM142502, R35GM156893, and R21AG074234).

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Every minute counts when someone has a stroke, which occurs when blood flow to the brain is blocked. Without rapid treatment, brain cells begin dying within minutes, often leaving patients with permanent speech, movement or memory disabilities.

“Stroke is one of the most time-sensitive emergencies in medicine,” said Nestor Gonzalez, MD, director of the Neurovascular Laboratory in the Department of Neurosurgery at Cedars-Sinai. “The faster we restore blood flow to the brain, the more brain function we can preserve.”

Gonzalez’s advice is echoed in the American Heart Association and American Stroke Association’s new 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke. In the first update since 2019, the guidelines recommend more reliance on imaging, catheter-based procedures and emergency first responders. The guidelines also introduce the first national guidance for treating stroke in children.

Gonzalez, co-vice chair of the American Stroke Association group that developed the guideline, sat down with the Cedars-Sinai Newsroom to discuss the updates and leading-edge stroke research.

What are the most important changes in the updated guideline for acute ischemic stroke, in which a clot blocks blood flow to part of the brain?

Stroke treatment has advanced significantly over the past few decades, particularly with the development of clot-dissolving drugs and catheter-based procedures that can remove blockages in the brain. Since the previous stroke guidelines were published in 2019, new clinical trials have expanded our understanding of which patients can benefit from these treatments.

Previous guidelines recommended endovascular [minimally invasive] clot-removal procedures within six hours of stroke onset, with only a small group of selected patients eligible for treatment up to 24 hours after onset. The updated guideline broadens those criteria, allowing more patients to be considered for treatment in the 24-hour time frame.

The guidelines also expand treatment options for patients with large-core strokes—cases in which a significant area of the brain is affected. In the past, physicians were often hesitant to treat these patients because the potential benefit was uncertain. However, several recent studies have shown that intervention can still reduce disability in some cases.

The guidelines also expand eligibility for endovascular clot-removal procedures to include patients with preexisting disabilities, reflecting evidence that treatment may help them return to their baseline level of function.

You are a faculty member at Cedars-Sinai Guerin Children’s, and the updated recommendations include the first dedicated guidance for treating stroke in children. Why is that important?

Stroke can occur at any age, including in children. However, because it is rare, clinicians may not immediately consider stroke when a child presents with sudden neurological symptoms.

The updated guidelines provide clinicians with practical guidance for recognizing and managing stroke in children. Until now, there were no dedicated recommendations specifically addressing treatment in this population. The guidelines address early recognition of stroke symptoms, imaging strategies and circumstances in which treatments such as intravenous thrombolysis [clot-dissolving medication given through an IV] or endovascular thrombectomy [procedure removing clots from the brain] may be considered.

Over the past several years, specialized centers have begun applying some of the endovascular stroke treatments developed for adults to pediatric patients, and outcomes suggest that children can benefit from these interventions.

How will the updated guidelines change the treatment stroke patients receive in hospitals?

The guidelines emphasize improving the entire system of stroke care so patients can be evaluated and treated rapidly. That process begins with recognizing symptoms in emergency medical services, prompt evaluation and use of specialized treatment. They also synthesize a large body of research into recommendations that clinicians can apply in real-world practice.

The updated recommendations also highlight the importance of coordinated stroke systems that include rapid imaging, telemedicine support for smaller hospitals, and efficient patient transport to specialized stroke centers capable of performing advanced procedures, like Cedars-Sinai Medical Center.

For adult stroke patients, many of these systems are already in place. But for pediatric stroke, the impact may be even greater, as many hospitals are still developing formal systems for diagnosing and treating stroke in children.

What areas of stroke research are you most excited about right now?

Much of the recent progress in stroke care has focused on treating patients in the acute phase, when a clot suddenly blocks blood flow to the brain. But another challenge is helping patients whose brains receive chronically reduced blood flow, putting them at risk for repeated strokes. Two conditions that can cause this are Moyamoya disease, which often affects children and young adults, and intracranial atherosclerosis, which is more common in older adults.

In Moyamoya disease, the arteries at the base of the brain narrow or become blocked. To treat it, surgeons can perform bypass procedures that create new pathways to restore blood flow to the brain. My research has focused on improving these techniques and understanding how they benefit patients.

In adults with intracranial atherosclerosis, plaque buildup narrows, thickens or hardens the arteries in the brain. Medications help many patients, but in some cases, it is not enough. Working with the National Institutes of Health, we have been studying a surgical technique called indirect revascularization, or EDAS. Originally developed for children with Moyamoya disease, this approach is now being adapted for adults with severe vascular disease. Early clinical trials have shown encouraging results, and we are working to expand those studies to multiple centers to determine whether the technique can improve outcomes for patients who currently have limited treatment options.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Philip and Linda Simmons spent 35 years building their life together before facing their greatest challenge: back-to-back cancer diagnoses.

“Phil was diagnosed with pancreatic cancer. Then he was declared cancer-free on a Friday, and the following Monday, I was diagnosed with breast cancer,” Linda Simmons said.

The couple caught both cancers early thanks to routine medical testing—Philip's during screening for another condition and Linda's through her regular mammogram.

About 40% of cancer cases in the U.S. are preventable, according to an American Cancer Society study. To reduce the risk of developing the disease, experts recommend maintaining a healthy weight, staying physically active, avoiding tobacco and limiting alcohol use.

Osipov told Spectrum News 1 that if diagnosed early, cancers can be cured, but “if you diagnose cancers at a later stage, typically, let's say stage 4, where the cancer may have metastasized to a different organ, you're not really talking about cure, you're more talking about palliation or prolonging people's lives.”

Now healthy, Philip and Linda are back to living their lives, including doing puzzles, spending time with friends and visiting their mountain home in Lake Arrowhead. Philip recommends that people “make sure that nothing's growing that shouldn't be growing for early detection and early treatment,” he said.

Watch the complete segment from Spectrum News 1.

Regular physical activity supports brain health while preserving balance, coordination, and the muscle strength needed for independent daily living. To stay in shape, the World Health Organization recommends that adults should aim for at least 150 minutes of moderate physical activity per week, or 75 minutes of vigorous activity.

Mandelbaum said the value of keeping fit shifts with age—from aesthetics to longevity and autonomy.

“Staying active as you get older isn’t about chasing a certain look—it’s about protecting your independence and enjoying life fully,” he told Medical News Today.

He said maintaining an active lifestyle should include enjoyable activities—and often involves redefining what counts as exercise. Everyday examples include walking through the park, gardening and household chores.

Mandelbaum told Medical News Today that consistency is key to reaping long-term health benefits, and that staying present can help people remain motivated.

“It’s not about numbers on a scale—it’s about moving comfortably, staying steady on your feet, carrying what you need, and participating fully in the moments that matter,” he said.

Focus on small wins to build lasting habits. Mandelbaum said setting simple, realistic goals can make a big difference.

“Be patient with yourself and celebrate milestones—whether that’s walking a little farther, trying something new, or simply staying consistent,” he said.

Read the complete article from Medical News Today.

En pacientes de edad avanzada, una ITU común puede desencadenar delirio, una emergencia médica caracterizada por confusión repentina y alteración del estado de conciencia.

Esta condición no solo puede acelerar el deterioro cognitivo, sino que con frecuencia se confunde con una afección neurológica subyacente, lo que retrasa el diagnóstico y tratamiento adecuados.

En una revisión reciente publicada en la revista Alzheimer’s & Dementia, investigadores de Cedars-Sinai exploraron cómo el delirio inducido por ITU afecta la función cerebral, por qué las personas con demencia son especialmente vulnerables y la necesidad crítica de reconocimiento e intervención tempranos.

“Es un círculo vicioso: la demencia aumenta el riesgo de infección, y el delirio relacionado con infecciones acelera el deterioro cognitivo”, explicó Shouri Lahiri, MD, investigador principal del Laboratorio de Medicina Neurodegenerativa en Cuidados Críticos y director de la Unidad de Cuidados Críticos en Neurociencias e Investigación en Neurocuidados Críticos en Cedars-Sinai, y autor principal de la revisión.

Estudios previos en laboratorio realizados por Lahiri y sus colegas revelaron que la respuesta del sistema inmunológico al delirio inducido por ITU—específicamente la proteína inflamatoria interleucina-6—puede provocar cambios en el cerebro. Al bloquear esta vía, los síntomas similares al delirio se revirtieron en modelos con ratones.

Lahiri conversó con el Newsroom de Cedars-Sinai sobre las ITU como un factor potencialmente prevenible y tratable del deterioro cognitivo, y sobre la importancia del reconocimiento temprano y el tratamiento oportuno.

¿Qué es el delirio y en qué se diferencia de la pérdida de memoria?

El delirio es un cambio repentino en el pensamiento y el nivel de conciencia. Afecta la atención, el juicio y la memoria a corto plazo, y se desarrolla en cuestión de horas o días.

La pérdida de memoria asociada con afecciones como la enfermedad de Alzheimer progresa lentamente con el tiempo. En cambio, el delirio es agudo y generalmente es desencadenado por una enfermedad médica, como una infección urinaria, deshidratación u otra infección en el cuerpo.

¿Por qué las infecciones urinarias pueden causar confusión, especialmente en adultos mayores?

La investigación muestra que las ITU pueden causar disfunción cerebral aguda a través de la inflamación. Una infección en la vejiga libera señales inflamatorias al torrente sanguíneo que pueden afectar el cerebro y alterar su funcionamiento normal, provocando delirio.

Los adultos mayores son más vulnerables porque sus cerebros suelen ser menos resistentes al estrés fisiológico.

Las ITU no son las únicas infecciones que pueden desencadenar esta respuesta. Cualquier infección sistémica, incluida la neumonía, infecciones gastrointestinales o infecciones de la piel, puede provocar inflamación generalizada que afecte el cerebro y cause confusión aguda.

¿Por qué las personas con Alzheimer tienen mayor riesgo de ITU?

Las personas con Alzheimer pueden tener dificultades para mantener una higiene adecuada y experimentar cambios hormonales relacionados con la edad que aumentan el riesgo de ITU.

Además, el Alzheimer puede afectar la sensibilidad y la capacidad de comunicación, lo que dificulta reconocer o reportar síntomas clásicos de una ITU, como ardor al orinar o urgencia urinaria. Como resultado, las infecciones pueden no tratarse hasta que desencadenan delirio.

En personas sin demencia, el delirio aumenta aproximadamente tres veces el riesgo de desarrollar demencia. Episodios repetidos elevan aún más ese riesgo.

¿Por qué una ITU puede empeorar repentinamente los síntomas del Alzheimer?

Una ITU puede provocar un deterioro cognitivo rápido que parece un empeoramiento súbito del Alzheimer. La diferencia clave es el momento: el Alzheimer progresa gradualmente, mientras que el delirio causa un cambio abrupto respecto al estado habitual de la persona.

La inflamación relacionada con la infección añade estrés a un cerebro ya vulnerable, lo que puede agravar los síntomas de la demencia y, en algunos casos, causar daño duradero.

¿Es reversible el delirio causado por una ITU?

El tratamiento temprano ofrece la mejor oportunidad de recuperación. Cuando las ITU se identifican y tratan rápidamente, los síntomas de delirio pueden mejorar o resolverse. Sin embargo, en algunos casos, los efectos cognitivos pueden persistir o volverse permanentes.

Por eso el reconocimiento temprano es fundamental.

Debido a que las ITU no siempre provocan síntomas urinarios evidentes—especialmente en adultos mayores—es necesario mejorar la forma en que se diagnostican, combinando observaciones clínicas con análisis de orina y sangre que confirmen la infección.

¿Cómo pueden los cuidadores diferenciar entre la progresión del Alzheimer y una ITU?

El cambio repentino es la señal de alerta más importante. La demencia generalmente no causa deterioros abruptos. Si una persona con Alzheimer se vuelve súbitamente mucho más confusa, menos alerta o presenta cambios marcados en su comportamiento, podría tratarse de delirio.

Otros signos incluyen cambios en los patrones de micción, incontinencia, dolor o alteraciones en el color u olor de la orina.

¿Qué pueden hacer los cuidadores para prevenir ITU y delirio?

Los cuidadores deben asegurarse de que la persona mantenga buena higiene y una hidratación adecuada. También deben notificar al médico si las ITU son recurrentes, ya que existen tratamientos para reducir episodios repetidos.

Estar atentos a cambios repentinos en el estado mental y buscar atención médica de inmediato puede marcar una diferencia significativa.

¿Las ITU están relacionadas con el delirio en otras enfermedades neurológicas?

Sí. La enfermedad de Parkinson es un ejemplo importante. Muchas personas con Parkinson tienen dificultad para vaciar completamente la vejiga, lo que aumenta el riesgo de infección. Las ITU pueden empeorar los síntomas motores del Parkinson, así como afectan la cognición en el Alzheimer.

¿Qué investiga ahora su laboratorio?

El equipo está estudiando nuevos medicamentos dirigidos a las vías inflamatorias involucradas en la disfunción cerebral relacionada con ITU, con el objetivo de llevarlos a ensayos clínicos.

También están desarrollando nuevos enfoques diagnósticos para identificar mejor las ITU en pacientes que no presentan los síntomas urinarios clásicos.

Cedars-Sinai Health Sciences University impulsa investigaciones innovadoras y forma a futuros líderes en medicina, ciencias biomédicas y ciencias de la salud aliadas. Obtenga más información sobre la universidad.

Corpus told Medscape that he has noticed similarities between pulmonary rehabilitation exercises and how professional singers approach vocal training.

“You have to sustain notes when singing,” he said. “You’re changing the pressures in your airway and the musculature of the thoracic cage. You’re moving air through.”

Scientific evidence supporting the therapeutic effects of singing is modest. However, a recent study, which compared the benefits of participating in a group singing program with standard care for lung disease, found that the individuals who sang reported better quality of life compared with patients who did not.

Corpus told Medscape that although the study did not assess objective changes in patients’ lung function, perceived improvement is still a meaningful measure of success.

“Apparently, patients are saying they felt better, so from a quality perspective the singing was helpful per their perception,” he said.

Cohen agreed that singing can be a valuable tool for patients with lung disease.

“Finding ways to cope with the challenges and the discomfort that comes with it, to feel better, and be able to be more functional in daily activities is also important, even if it doesn’t specifically show an improvement in lung function itself,” Cohen told Medscape.

He said singing could be incorporated into existing rehabilitation programs as an additional therapy for patients who are interested in music.

Corpus said this approach could help asthma patients manage their condition.

“It’s a diagnosis that is scary, and the biggest question I always get is, ‘Will I grow out of it?’” Corpus said. “But rather than framing it as it possibly going away, maybe it should be more of how to deal with it at its current state and how to empower patients to do things because they are capable.”

Read the complete article from Medscape.

“Había probado muchas opciones de tratamiento, pero el dolor seguía interfiriendo con mi vida diaria”, dijo Makkar.

Makkar, de 73 años, se sometió a una cirugía convencional de reemplazo de rodilla derecha en 2023. Aunque el procedimiento finalmente alivió su dolor y le ayudó a recuperar la movilidad, la recuperación fue larga y difícil. Durante semanas dependió de un andador, necesitó medicamentos recetados para el dolor y evitó actividades sociales mientras retomaba poco a poco su rutina diaria.

Sin embargo, para su segundo reemplazo de rodilla—esta vez en la izquierda—se benefició de un nuevo enfoque diseñado para acelerar la recuperación y disminuir el dolor.

El nuevo enfoque funcionó. Esta vez, Makkar utilizó el andador solo durante dos días, se reunió con sus amigos en cuestión de días y dependió de Tylenol en lugar de analgésicos recetados.

“Esta recuperación se sintió mucho más fácil”, dijo Makkar.

Las personas viven más tiempo y, en muchos casos, sobreviven a la vida útil de sus articulaciones. Sin embargo, muchos pacientes evitan cirugías necesarias porque anticipan una recuperación difícil, explicó Sean Rajaee, MD, jefe de Artroplastía en Cedars-Sinai Orthopaedics y cirujano de Makkar en ambos procedimientos.

Para ayudar a los pacientes a recuperarse más rápido y caminar antes después de la cirugía—lo que puede reducir el riesgo de complicaciones como coágulos sanguíneos, neumonía e infecciones urinarias—Cedars-Sinai lanzó una iniciativa de recuperación mejorada para reemplazos articulares. Como resultado, casi el 80% de los pacientes con reemplazo total de articulación están caminando y regresando a casa dentro de las 24 horas, en comparación con el 68% en 2022.

“Ahora que los pacientes escuchan sobre técnicas mejoradas y recuperaciones más fluidas, hay una creciente demanda de atención más rápida—y Cedars-Sinai está comprometido a satisfacer esa necesidad”, dijo Rajaee.

Construyendo una Mejor Recuperación

Para acelerar el tiempo de recuperación de los pacientes con reemplazo total de articulación, los líderes de Cedars-Sinai desarrollaron pautas para identificar a los pacientes más adecuados para un régimen de recuperación mejorada. Los cirujanos consideran factores como la salud general y la edad. Las enfermeras evalúan el entorno del hogar del paciente y si cuenta con apoyo confiable después de la cirugía.

La colaboración entre cirujanos, anestesiólogos, enfermeras y fisioterapeutas es otro elemento clave del programa. Michael Kissen, MD, anestesiólogo, señaló que los equipos se reúnen regularmente para discutir los planes de tratamiento óptimos, incluido el uso de medicamentos, el momento del procedimiento y los apósitos para heridas, con el objetivo compartido de que los pacientes se levanten y comiencen a moverse pocas horas después de la cirugía.

“Cada parte de esta vía ha existido por separado durante algún tiempo, pero coordinar todos estos procesos y perfeccionar lo que hacemos a través de retroalimentación constante y reuniones regulares es el concepto novedoso detrás de esta vía”, dijo Kissen.

Rajaee agregó que la educación del paciente también ayuda. Durante las citas prequirúrgicas, establecer expectativas sobre el plan de recuperación y explicar los beneficios del enfoque prepara mentalmente a los pacientes.

El nuevo enfoque ha sido tan exitoso que ya existen planes para ampliarlo a otros procedimientos, comenzando con cirugías robóticas de próstata.

Avances Médicos Aceleran la Recuperación

Los avances en el manejo del dolor desempeñan un papel fundamental para ayudar a los pacientes a caminar poco después de la cirugía. En lugar de depender únicamente de la anestesia general, los anestesiólogos suelen utilizar anestesia espinal, una forma de anestesia neuroaxial que adormece la parte inferior del cuerpo y evita muchos efectos secundarios de la anestesia general. En comparación con esta, la anestesia espinal se asocia con menos complicaciones respiratorias, menos dolor y náuseas postoperatorias, menor necesidad de narcóticos y movilización más temprana.

“La anestesia espinal se ha utilizado de manera segura durante años”, dijo Kissen. “Lo que ha cambiado es nuestro uso de medicamentos de acción más corta que duran durante la cirugía, pero desaparecen rápidamente, lo que permite que los pacientes se muevan y comiencen la terapia mucho antes”.

Además, los anestesiólogos emplean técnicas de anestesia regional, como bloqueos nerviosos periféricos y catéteres nerviosos, para proporcionar un control del dolor más prolongado tras la cirugía, minimizando el uso de opioides. Un enfoque común en la cirugía de rodilla es el bloqueo del canal aductor, que actúa sobre los nervios sensoriales sin afectar la función motora. Esto permite aliviar el dolor alrededor de la rodilla sin limitar la capacidad de caminar inmediatamente después de la cirugía. En algunos casos, se coloca un catéter cerca del nervio para que una bomba administre anestésico local de forma continua durante dos o tres días.

Rajaee señaló que la cirugía asistida por robot también ayuda a los pacientes a caminar antes al reducir el trauma en los tejidos y preservar el músculo sano.

Segunda Cirugía Con Menos Dolor

Cuando Rajaee realizó el primer reemplazo de rodilla de Makkar, utilizó un torniquete, una técnica común que reduce el flujo sanguíneo a la rodilla para facilitar la colocación del implante.

Sin embargo, en el segundo procedimiento optó por un enfoque sin torniquete, un método más reciente que ha demostrado reducir el dolor después de la cirugía. También utilizó un abordaje midvastus que preserva el cuádriceps, evitando cortar el tendón principal unido al gran músculo en la parte frontal del muslo.

Durante la segunda cirugía, los anestesiólogos añadieron una dosis baja de ketamina para actuar sobre vías del dolor que no se alivian con narcóticos. Makkar experimentó una recuperación más fluida y quedó encantado con los resultados.

“A mi edad, estoy súper feliz de estar caminando”, dijo.

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This condition not only can accelerate cognitive decline but is often mistaken for an underlying neurological condition—delaying proper diagnosis and treatment.

In a recent review published in the journal Alzheimer’s & Dementia, Cedars-Sinai researchers explored how UTI-induced delirium affects brain function, why individuals with dementia are especially vulnerable, and the critical need for early recognition and intervention.

“It’s a vicious cycle where dementia increases the risk of infection, and infection-related delirium accelerates cognitive decline,” said Shouri Lahiri, MD, principal investigator of the Critical Care Neurodegenerative Medicine Lab, director of the Neurosciences Critical Care Unit and Neurocritical Care Research at Cedars-Sinai, and senior author of the review.

Previous laboratory studies by Lahiri and his colleagues revealed that the immune system’s response to UTI-induced delirium—specifically the inflammatory protein interleukin-6—can cause changes in the brain. Blocking this pathway reversed delirium-like symptoms in mice.

Lahiri sat down with the Cedars-Sinai Newsroom to discuss UTIs as a potentially preventable and treatable contributor to cognitive decline and the importance of early recognition and swift treatment.

What is delirium, and how is it different from memory loss?

Delirium is a sudden change in thinking and awareness. It affects attention, judgment and short-term memory, and develops over hours or days.

Memory loss from conditions such as Alzheimer’s disease progresses slowly over time. Delirium, by contrast, is acute and usually triggered by a medical illness, such as a urinary tract infection, dehydration or infection elsewhere in the body.

Why can urinary tract infections cause confusion, especially in older adults?

Our research shows UTIs can cause acute brain dysfunction through inflammation. An infection in the bladder releases inflammatory signals into the bloodstream, which can affect the brain and disrupt normal function, leading to delirium.

Older adults are more vulnerable because their brains are often less resilient to physiological stress.

UTIs aren’t the only infections that can trigger this response. Any systemic infection, including pneumonia, gastrointestinal infections or skin infections, can provoke widespread inflammation that affects the brain and causes acute confusion.

Why are people with Alzheimer’s disease at higher risk for UTIs?

People with Alzheimer’s may have challenges upkeeping with hygiene and age-related hormonal changes that increase UTI risk. Alzheimer’s can also impair sensation and communication, making it harder for patients to recognize or report well-known UTI symptoms such as burning or urgency to urinate. As a result, infections may go untreated until they trigger delirium.

For people without dementia, delirium increases the risk of developing dementia by about threefold. Repeated episodes further raise that risk.

Why can a UTI make Alzheimer’s symptoms suddenly worse?

A UTI can cause a rapid cognitive decline that looks like a sudden worsening of Alzheimer’s disease. The key difference is timing. Alzheimer’s progresses gradually, while delirium causes an abrupt change from a person’s baseline.

We believe inflammation related to infection places added stress on an already vulnerable brain, which can worsen dementia symptoms and, in some cases, cause lasting damage.

Is delirium from a UTI reversible?

Early treatment offers the best chance for recovery. When UTIs are identified and quickly treated, delirium symptoms can improve or resolve. However, in some cases, cognitive effects can persist or become permanent. That’s why early recognition is critical.

Because UTIs don’t always cause obvious urinary symptoms, especially in older adults, we need to change the way we diagnose UTIs, using a mix of clinical observations and urinary and blood tests that show infection, to recognize when a UTI is behind sudden confusion.

How can caregivers tell the difference between Alzheimer’s progression and a UTI?

Sudden change is the biggest warning sign. Dementia generally does not cause abrupt declines. If someone with Alzheimer’s suddenly becomes much more confused, less alert or behaves very differently, that may signal delirium.

Other changes to look out for include changes in urination patterns, incontinence, pain, or changes in urine color or odor.

What can caregivers do to help prevent UTIs and delirium?

Caregivers should make sure the person they’re taking care of maintains good hygiene and adequate hydration. Caregivers should also notify a physician if UTIs are recurrent, because treatments are available to reduce repeated episodes.

Also, being aware of sudden changes in mental status and seeking prompt medical care can make a significant difference.

Are UTIs linked to delirium in other neurological conditions?

Yes. Parkinson’s disease is a key example. Many people with Parkinson’s have difficulty fully emptying their bladder, which increases infection risk. UTIs can worsen Parkinson’s movement symptoms, just as they worsen cognition in Alzheimer’s disease.

What is your lab studying next?

We are studying new drugs that target inflammatory pathways involved in UTI-related brain dysfunction, with the goal of advancing them to clinical trials. We are also developing diagnostic approaches to better identify UTIs in patients who  don’t have the well-known urinary symptoms.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Un nuevo enfoque para la extirpación de quistes espinales evita la fusión espinal, mantiene la movilidad y acelera la recuperación

AJ Starsiak estaba haciendo estiramientos en el gimnasio, preparándose para hacer sentadillas, cuando sintió un chasquido alarmante en la espalda.

Este papá de 39 años, que juega al sóftbol, al hockey sobre hielo y pasa los fines de semana practicando todoterreno, no era ajeno a las lesiones leves. Pero los antiinflamatorios recetados por su médico de cabecera solo le proporcionaban un alivio temporal. Durante los meses siguientes, sus caderas se endurecieron y comenzó a perder sensibilidad y masa muscular en la pierna.

Luego, durante un viaje de negocios, el dolor llevó a Starsiak a un punto de inflexión.

“No podía caminar de una puerta a otra en el aeropuerto y terminé teniendo una crisis nerviosa, llorando porque sentía mucho dolor”, explicó Starsiak.

Tras múltiples visitas al médico, incluida una a urgencias, una resonancia magnética reveló la causa: un quiste de 2 centímetros alojado en la parte delantera de un nervio, escondido debajo de una articulación de la columna vertebral. Su ubicación lo hacía especialmente difícil de tratar.

Un médico cercano a su domicilio en el condado de Orange derivó a Starsiak al Dr. Corey Walker, profesor adjunto de Neurocirugía y Ortopedia en Cedars-Sinai, especializado en casos complejos y mínimamente invasivos de columna vertebral.

Starsiak, vendedor de dispositivos médicos especializado en productos ortopédicos, estaba familiarizado con las opciones quirúrgicas y confió en su instinto al elegir a Walker para supervisar su tratamiento.

“Cuando conocí al Dr. Walker, supe inmediatamente que era el cirujano adecuado, una persona íntegra que escuchaba con atención y sentía una profunda pasión por su trabajo”, afirmó Starsiak.

Extirpación de Quistes Sin Fusión Espinal

Walker realiza cirugía endoscópica de columna, una técnica mínimamente invasiva que utiliza un pequeño endoscopio, del grosor aproximado de un bolígrafo, para acceder a lugares difíciles de alcanzar dentro del cuerpo.

En comparación con la cirugía tradicional, el enfoque mínimamente invasivo suele requerir incisiones más pequeñas, causa menos daño al tejido y permite una recuperación más rápida.

En el caso de Starsiak, el quiste comprimía los nervios contra el canal espinal, lo que interfería en su capacidad para enviar señales entre el cerebro y la pierna. Esa presión puede provocar pérdida de fuerza, sensibilidad y coordinación.

La extirpación del quiste sería complicada. Para acceder al nervio y al quiste subyacente, un cirujano normalmente tendría que extirpar una articulación espinal y fusionar las vértebras con varillas y tornillos para estabilizarlas.

“Habría sido una operación que le habría cambiado la vida a alguien de su edad”, dijo Walker. «La fusión ejerce una presión adicional sobre las articulaciones cercanas y puede dar lugar a futuras cirugías”.

En su lugar, Walker adoptó un enfoque diferente.

Mediante un procedimiento endoscópico ultra mínimamente invasivo, Walker accedió al quiste a través de un endoscopio con una pequeña cámara acoplada. Tras localizar el nervio afectado, él y su equipo pudieron utilizar el endoscopio para guiarse en la extirpación del quiste, sin cortar el músculo, extirpar la articulación ni dañar el nervio.

“Nos enfrentábamos a lo que parecía una tarea imposible”, afirmó Walker. “Estoy orgulloso de que Cedars-Sinai pueda tratar a pacientes con casos complejos”.

Para Starsiak, evitar la fusión era fundamental.

“Me preocupaba que una fusión pudiera limitar significativamente, por no decir acabar, con mi capacidad para practicar deporte y levantar pesas”, afirmó.

Un Alivio que le Cambió la Vida

Cuando Starsiak despertó tras la intervención, inmediatamente sintió un gran alivio del dolor y la presión, como si le hubieran quitado un peso de encima.

Su recuperación duró unas ocho semanas, durante las cuales se centró en recuperar la movilidad y la fuerza en las caderas, las piernas y la espalda. Hoy en día, Starsiak ha vuelto a su rutina habitual: practicar deporte, conducir por caminos todoterreno y levantar pesas en el gimnasio.

La experiencia también cambió su forma de pensar.

Antes de la lesión, Starsiak dijo que medía el éxito principalmente por el avance profesional. Como padre de dos hijos, la pérdida de movilidad le obligó a reconsiderar sus prioridades.

“En el momento en que pierdes la salud, te das cuenta de que no hay nada más importante”, dijo. “No puedes disfrutar del éxito si no estás sano”.

Para Walker, ese impacto es lo que hace que su trabajo sea significativo.

“Como neurocirujano, es increíble perfeccionar tu técnica, trabajar con tus manos y ver cómo se soluciona un problema al final de la cirugía”, afirma. “Pero lo que es aún más gratificante es saber cómo ha cambiado la vida de alguien, eso es lo mejor”.

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According to the Centers for Disease Control and Prevention, roughly 40,000 babies in the U.S. are born with a congenital heart defect, making it one of the most common types of birth defects.

“The heart is a very complex organ and sometimes in utero it just doesn't form right—the valve may not form, a ventricle may not form, an artery or vein may be abnormal,” Sklanksy told CBS LA anchors Jamie Yuccas and Rachel Kim. He added that in some cases, babies are born with a hole in the heart.

Fortunately, advances in ultrasound technology over the past several decades have dramatically improved physicians’ ability to detect heart defects before birth, Sklansky told Yuccas and Kim. He noted that doctors can often identify structural abnormalities during an ultrasound performed around 20 weeks of pregnancy.

In a small number of cases, specialists may also be able to intervene before birth using a catheter “to change how the heart evolves so the child may be born with less severe form of heart disease,” Sklanksy said.

He told Yuccas and Kim that early detection is crucial to reducing long-term health issues. If doctors know about a heart defect, they can coordinate timely postnatal care to ensure that a baby receives prompt treatment.

“The vast majority of children with heart disease can have very long, productive, happy lives,” Sklansky said.

Watch the complete segment from CBS LA.

“I had tried many treatment options, but the pain was still interfering with my day-to-day life,” Makkar said.

Makkar, 73, underwent conventional knee replacement surgery for his right knee in 2023. While the procedure ultimately relieved his pain and helped him regain mobility, the recovery was long and difficult. For weeks, he relied on a walker, needed prescription pain medication and avoided social activities as he slowly worked his way back to daily life.  

However, for Makkar’s second knee replacement—this time for his left knee—he benefited from a new approach to the procedure intended to speed recovery and lessen pain.

The new approach worked. This time, Makkar used a walker for only two days, met up with his friends within days and relied on Tylenol instead of prescription painkillers.

“This recovery felt so much easier,” Makkar said.

People are living longer and outliving their joints. However, many patients avoid much-needed surgery because they expect a tough recovery, said Sean Rajaee, MD, chief of Arthroplasty at Cedars-Sinai Orthopaedics, and Makkar’s surgeon for both of his procedures.

To help patients recover faster and walk sooner after surgery—which can reduce the risk of complications, such as blood clots, pneumonia and urinary tract infections—Cedars-Sinai launched an enhanced joint replacement recovery effort. As a result, nearly 80% of total joint replacement patients are walking and going home within 24 hours, up from 68% in 2022.

“Now that patients are hearing about improved techniques and smoother recoveries, there is a growing demand for faster care—and Cedars-Sinai is committed to meeting that need,” Rajaee said.

Building a Better Recovery

To speed recovery time for total joint replacement patients, Cedars-Sinai leaders developed guidelines to identify patients best suited for an enhanced recovery regimen. Surgeons consider factors such as overall health and age. Nurses screen patients to assess their home environment and whether they have reliable support after surgery.

Collaboration among surgeons, anesthesiologists, nurses and physical therapists is another key element of the program. Anesthesiologist Michael Kissen, MD, said teams regularly meet to discuss optimal treatment plans, including medication use, procedure timing and wound dressings, with the shared goal of getting patients up and moving within hours after joint replacement surgery.

“Every part of this pathway has existed for a while on its own, but coordinating all these processes and fine-tuning what we do through constant feedback and regular meetings is the novel concept behind creating this pathway,” Kissen said.

Rajaee said educating patients also helps. During presurgical appointments, setting expectations about the recovery plan and explaining the benefits of the approach prepares patients mentally.

The new approach has worked so well that plans are underway to expand the approach to other procedures, beginning with robotic prostate surgeries.

Medical Advances Speed Healing

Advances in pain management play a major role in helping patients walk soon after surgery. Rather than relying solely on general anesthesia, anesthesiologists often use spinal anesthesia, a form of neuraxial anesthesia that numbs the lower body while avoiding many side effects of general anesthesia. Compared with general anesthesia, spinal anesthesia is linked with fewer respiratory complications, less postoperative pain and nausea, reduced need for narcotics, and earlier mobilization.

“Spinal anesthesia has been used safely for years,” Kissen said. “What’s changed is our shift to shorter-acting medications that last through surgery but wear off quickly, so patients can move and start therapy much sooner.”

In addition to spinal anesthesia, anesthesiologists use regional anesthesia techniques, such as peripheral nerve blocks and nerve catheters, to provide longer-lasting pain control after surgery while minimizing opioid use. One commonly used approach for knee surgery is the adductor canal nerve block, which targets sensory nerves while sparing motor function. This allows patients to experience pain relief around the knee without limiting their ability to walk immediately after surgery. In some cases, a catheter is placed near the nerve so a pump can deliver local anesthetic continuously for two to three days after surgery.

Rajaee said robotic-assisted surgery also helps patients walk sooner by reducing tissue trauma and preserving healthy muscle.

Second Surgery, With Less Pain

When Rajaee performed Makkar’s first knee replacement, he used a tourniquet, a common technique that reduces blood flow to the knee to allow surgeons to place an implant.

However, during the second procedure, Rajaee opted for a tourniquet-free approach, a newer method shown to reduce pain after surgery. He also used what’s called a quadriceps-sparing midvastus approach, which avoids cutting through the main tendon attached to the large muscle on the front of the thigh, preserving the tissue.

Anesthesiologists added a low dose of ketamine to target pain pathways not relieved by narcotics during the second surgery. Makkar experienced a smoother recovery and was thrilled with his results.

“At my age, I am super happy I’m walking,” he said. 

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When the body consumes fewer calories than it burns, it compensates by releasing more hunger-stimulating hormone and reducing production of the hormone that signals fullness. Metabolism also slows to help the body burn fewer calories. Set-point theory suggests that these physiological changes push the body back to a predetermined baseline weight, known as the set point.

"Even if one were to make all of the healthiest lifestyle changes they could, the set point will continue to try to persist," Velazquez told Everyday Health.

The theory could help explain why many people struggle to maintain weight loss over time.

“Patients feel like it’s something they are doing that is leading them to have the weight [come back], when that is not the case,” Velazquez said.

Several factors, including aging, menopause and environment, can affect the body’s set point. Experiencing trauma or being born to a mother who smoked or was overweight also can result in a higher set-point weight.

Velazquez said that while weight gain over time might elevate the body’s set point, the timeline for this shift remains unclear.

“We don’t fully know from the science how long a person needs to be at that higher weight for it to recalibrate that to be the set point,” she said.

Despite the body’s natural tendency to maintain a baseline weight, experts say individuals might be able to lose about 5% of their body weight by increasing muscle mass, managing stress and keeping a consistent sleep schedule.

If those strategies don’t work, or if an individual needs to lose more than 5% of their body weight, Velazquez recommends speaking with a doctor about other approaches, including GLP-1 medications, bariatric surgery or an endoscopic sleeve procedure.

“These are tools in the toolbox that are very much appropriate for patients to pursue to help them lose the weight and keep it off effectively,” she said.

 Read the complete article from Everyday Health.

Preclinical Study Targets ‘Zombie’ Cells

Senolytics—a class of drugs that reduce chronic inflammation and tissue damage in aging cells—are shown to eliminate 30% to 70% of “zombie” cells in the body. These zombie cells, known as senescent cells, stop dividing and don’t die, ultimately contributing to a host of diseases of aging, including cancer.

A preclinical study from Cedars-Sinai, published in Aging Cell, had three key findings:

• Senolytic drugs purge the most harmful cells, leaving less-harmful senescent cells behind.
• These remaining “senolytic-resistant” senescent cells can be activated into tissue-damaging senescent cells by infections and other factors in the environment of senescent cells.
• A new class of drugs, “senosensitizers,” can enable senolytics to eliminate these lurking senolytic-resistant “ticking time bomb” cells.

Investigators found that in laboratory mice treated with senolytic drugs, the remaining senescent cells were less inflammatory and damaging than the cells removed by the treatment. Researchers also found that these remaining senescent cells, when activated into tissue-damaging cells by an inflammatory environment, become more vulnerable to senolytics than those in a stable environment.

Based on their findings that infections can make senescent cells become susceptible to senolytics, study authors theorize that targeting senescent cells with newly developed senosensitizers—and then senolytics—might allow more senescent cells to be removed than when using senolytics alone. This could remove senolytic-resistant senescent cells and reduce the impact of infections in previously apparently healthy older people.

“This drug combination, which is still in the preclinical phase, has the potential to target senescent cancer cells that persist after radiation and chemotherapy and may later reemerge as more aggressive disease,” said James Kirkland, MD, PhD, director of the Center for Advanced Gerotherapeutics and senior author of the study.

Additional Cedars-Sinai authors include Masayoshi Suda, Tamar Tchkonia, Selim Chaib, Larissa Langhi Prata, Tamar Pirtskhalava and Nino Giorgadze.

Additional authors include Utkarsh Tripathi, Vagisha Kulshreshtha, Bryan T. Piatkowski, Allyson K. Palmer, Christina Inman, Nathan Gasek, Ming Xu, Kurt O. Johnson, Yi Zhu, Renuka Kandhaya-Pillai, Stefan G. Tullius, Saranya P. Wyles, Rambabu Majji, Hari Krishna Yalamanchili and David B. Allison.

Funding: This work was supported by NIH grants R37AG013925 (J.L.K., T.T.), R33AG061456 (J.L.K., T.T.), R01AG066679 (M.X.), R01AG076642 (M.X.), R01AG064165 (S.G.T.), R01AG087387 (Y.Z.), the Connor Fund (J.L.K., T.T.), Robert J. and Theresa W. Ryan (J.L.K., T.T.), HF-GRO-­23-­ 1199148-­ 3 (J.L.K.), HF-­ GRO-­ 23-­ 1199262-­ 27 (Y.Z., M.S.), the JSPS Grants-­ in-­ Aid for Scientific Research Fund for the Promotion of Joint International Research (Fostering Joint International Research) 23KK0295 (M.S.), the Yamada Science Foundation (M.S.), and USDA/ARS grant CRIS 3092-­ 51000-­ 065-­ 003S (H.K.Y.) and the Noaber Foundation (J.L.K.). U.T. was supported by an American Heart Association predoctoral fellowship (917775).

Cedars-Sinai Study Links GLP-1RA Drugs to Risk of Chronic Cough

Patients who take the widely used Type 2 diabetes and obesity medications known as glucagon-like peptide-1 receptor agonists (GLP-1RAs) appear to be at increased risk of developing chronic cough, according to a new multicenter study led by Cedars-Sinai and published in JAMA Otolaryngology – Head & Neck Surgery.

GLP-1RA medications, marketed under many brand names, work by stimulating insulin release from the pancreas, lowering blood sugar and slowing digestion. As a result, these drugs may help people with Type 2 diabetes manage their blood sugar and help people with obesity lose weight.

Investigators reviewed 10 years of electronic medical records with data on more than 2 million Type 2 diabetes patients at 70 healthcare organizations. They compared records of individuals prescribed a GLP-1RA drug with those who were prescribed a non-GLP-1RA drug to treat diabetes, and found that GLP-1RA use was associated with a significantly increased risk of new chronic cough.

“Further research is needed to confirm the existence, strength and mechanisms of the association between GLP-1RA drugs and chronic cough,” said Anca Barbu, MD, associate professor in the Jim and Eleanor Randall Department of Surgery and the study’s corresponding author. “However, our findings highlight the importance of physicians and care providers asking patients with new-onset chronic cough about possible GLP-1RA use, and for healthcare providers prescribing these medications to discuss chronic cough as a possible side effect.”

The other Cedars-Sinai author is Neelaysh Vukkadala, MD.

Additional authors include Tyler J. Gallagher, MD, MPH; Diego E. Razura, MD; Albert Li, BA; and Ian Kim, PhD. 

Bodily Fluid Changes Linked to Poor Heart Surgery Outcomes

Patients who lose or gain a significant amount of fluid after certain elective heart surgeries are more likely to be readmitted to the ICU, stay longer in the hospital or die than patients whose fluid levels remain stable, according to a new study from Cedars-Sinai. The findings, published in Anesthesia & Analgesia, could help improve patient care.

Investigators reviewed data on 2,557 patients who underwent nonemergency coronary artery bypass grafts, valve surgeries or a combination of the two. They calculated each patient’s total fluid intake (including oral and intravenous fluids and blood products) and output (including urine, stool and surgical drains), based on measurements taken in the operating room and in the ICU after surgery.

“It remains unclear whether changes in cumulative fluid balances above 1.5 liters on the day of ICU discharge actually cause adverse outcomes or are just associated with them,” said senior author Joseph Ebinger, MD, MS, associate professor of Cardiology and director of the Coronary Intensive Care Unit and Clinical Analytics in the Smidt Heart Institute at Cedars-Sinai. “Further study is called for. In the meantime, our findings suggest that greater attention to such variations may help improve outcomes for cardiac surgery patients.”

Other Cedars-Sinai authors are Abirami Kumaresan, George Gill, Jesse Navarrette, Tao Shen, Milad Sharifpour, Dominic Emerson, Joanna Chikwe and Susan Cheng.

Funding: This study was supported in part by a grant from the International Anesthesia Research Society and NIH grant: K23-HL153888. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Different Immune Cell Types Correlate with Breast Cancer Survival

The quantities of specific types of immune cells that appear in and around a breast cancer tumor are correlated with the prognosis for the patient, according to a new study led by Cedars-Sinai. The findings have implications for use of immunotherapy in this disease, the second leading cause of cancer deaths among women in the U.S.

The study was published in the peer-reviewed journal iScience.

Investigators analyzed images from 12,285 female breast cancers, including estrogen-positive breast cancer, the most common type, in which cancer cells have a protein that binds to the hormone estrogen; estrogen-negative breast cancer, in which the cells lack this protein, was also studied.

Using artificial intelligence (AI), investigators calculated the percentages of different types of immune cells within the tumors, in nearby connective tissue (known as stroma) and in total for both areas. They examined the relationship between these percentages and the likelihood that the patient would die from breast cancer over a certain period of time after diagnosis. Two types of immune cells, CD8+ and CD20+, were found to be associated with a better prognosis in estrogen-positive breast cancer patients, whereas another cell type, CD163+, was associated with a poorer prognosis. CD8+ and FOXP3+ immune cells were associated with a better prognosis in estrogen-negative breast cancer.

“Our findings suggest that the immune system is an important predictor of outcome in hormone-positive breast cancer,” said Paul Pharoah, MD, PhD, professor of cancer epidemiology in the Department of Computational Biomedicine at Cedars-Sinai and the study’s senior and corresponding author. “They support including this subset of patients in clinical trials of immune modulators, which could lead to improved treatments for women with this common cancer.”

Other authors include: Aaron J. Bernstein PhD, Renske Keeman MSc, Amber Hurson PhD, Fiona M. Blows PhD, Manjeet K. Bolla MSc, Jodi L. Miller PhD, Roger L. Milne PhD, Hugo Horlings MD, PhD, Alexandra J. van den Broek PhD, Clara Bodelon PhD, James M. Hodge JD, MPH, Alpa V. Patel PhD, Lauren R. Teras PhD, Federico Canzian PhD, Rudolf Kaaks PhD, Hermann Brenner MD, Ben Schöttker PhD, Sabine Behrens PhD, Jenny Chang-Claude PhD, Tabea Maurer DiplPsych, Nadia Obi PhD, Fergus J. Couch PhD1, H. Raza Ali PhD, Carlos Caldas MD, Irene Andrulis PhD, Gord Glendon MSc, Anna Marie Mulligan MD, Wilma Mesker PhD, Agnes Jager MD, PhD, Annette Heemskerk-Gerritsen PhD, Peter Devilee PhD, Scott M. Lawrence PhD, Jolanta Lissowska PhD, Karun Mutreja PhD, Thomas Ahearn PhD, Stephen Chanock MD, Maire A. Duggan MD, Diana Eccles PhD, J. Louise Jones MB ChB, PhD, Will Tapper PhD, Antoinette Hollestelle PhD, Maartje Hooning PhD, John Martens PhD, Carolien H.M. van Deurzen MD, PhD, Angela Cox PhD3, Simon S. Cross MB BS, Mikael Hartman MD, PhD, Jingmei Li PhD, Thomas C. Putti MD, Ute Hamann PhD, Muhammad Rashid MB BS, PhD, Ania Jakubowska PhD, Nicki Camp PhD, Melissa H. Cessna MD, Amy Berrington de Gonzalez DPhil, Katarzyna Bialkowska PhD, Jacek Gronwald PhD, Jan Lubiński MD, PhD, Siddhartha Yadav MD, Pietro Lio PhD, Doug F. Easton PhD, Mustapha Abubakar MD, PhD, Montse Garcia-Closas MD, DrPH,  and Marjanka K. Schmidt, PhD.

Acknowledgements: The authors thank the Histology and Genomics Cores at the Cancer Research UK Cambridge Institute for technical support, and all patients, researchers, clinicians, and administrative personnel who contributed to the studies taking part in BCAST.  The CPSII study investigators acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention's National Program of Cancer Registries and cancer registries supported by the National Cancer Institute's Surveillance Epidemiology and End Results Program.

BCAC was supported by Cancer Research UK grant: PPRPGMNov20\100002 and by core funding from the NIHR Cambridge Biomedical Research Centre (NIHR203312). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.  The BCAST project was supported by the Horizon 2020 Research and Innovation Programs of the European Union B (grant number: 633784) and the NIHR Cambridge Biomedical Research Centre. AJB was supported by the NIH Oxford-Cambridge Scholars and Gates Cambridge Scholars programs. (The funding of the contributing studies is listed in a supplementary table in the article.)

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

The 39-year-old father, who plays softball and ice hockey and spends weekends off-roading, was no stranger to minor injuries. But the anti-inflammatory drugs prescribed by his primary care physician only gave Starsiak temporary relief. Over the next few months, his hips stiffened, and he began to lose sensation and muscle mass in his leg.

Then, during a business trip, the pain caused Starsiak to reach a breaking point.

“I could not walk from one gate to the next at the airport and ended up having a breakdown, crying because I was in so much pain,” Starsiak said.

After multiple doctor visits, including a trip to the emergency room, an MRI revealed the cause: a 2-centimeter cyst lodged on the front side of a nerve, tucked beneath a joint in his spine. Its location made it particularly difficult to treat.

A physician near his home in Orange County referred Starsiak to Corey Walker, MD, an assistant professor of Neurosurgery and Orthopaedics at Cedars-Sinai, who specializes in minimally invasive and complex spine cases.

Starsiak, a medical device salesman with a focus on orthopedic products, was familiar with surgical options and trusted his instincts in choosing Walker to oversee his care.

“When I met Dr. Walker, I immediately knew he was the right surgeon—someone of integrity who listened carefully and was deeply passionate about his craft,” Starsiak said.

Cyst Removal Without Spinal Fusion

Walker performs endoscopic spine surgery, a minimally invasive technique that uses a small endoscope—about the width of a pen—to navigate hard-to-reach places inside the body. Compared with traditional surgery, the minimally invasive approach typically results in smaller incisions, less tissue damage and faster recovery.

In Starsiak’s case, the cyst was compressing nerves against his spinal canal, interfering with their ability to send signals between his brain and leg. That pressure can lead to loss of strength, sensation and coordination.

Removing the cyst would be challenging. In order to access the nerve and underlying cyst, a surgeon typically would need to remove a spinal joint and fuse the vertebrae with rods and screws to stabilize them.

“That would have been a life-altering operation for someone his age,” Walker said. “Fusion puts added stress on surrounding joints and can lead to future surgeries.”

Instead, Walker took a different approach.

Using an ultra-minimally invasive endoscopic procedure, Walker accessed the cyst through an endoscope with a small camera attached. After locating the affected nerve, he and his team were able to use the endoscope to guide them in removing the cyst—without cutting muscle, removing the joint or injuring the nerve.

“We had what felt like an impossible task,” Walker said. “I’m proud that Cedars-Sinai is able to treat patients who have complex cases.”

For Starsiak, avoiding fusion was critical.

“I was worried a fusion would significantly hamper—if not end—my ability to play sports and lift weights,” he said.

Life-Changing Relief

When Starsiak woke up from the procedure, he immediately felt relieved of the pain and pressure, as if a rock had been removed from his back.

His recovery took about eight weeks, and he focused on restoring mobility and strength in his hips, legs and back. Today, Starsiak is back to his normal routine—playing sports, off-roading and lifting weights at the squat rack.

The experience also changed his mindset.

Before the injury, Starsiak said, he measured success largely by career advancement. As a father of two, losing his mobility forced him to reconsider his priorities.

“The second you lose your health, you realize none of the other things really matter,” he said. “You can’t enjoy success if you’re not healthy.”

For Walker, that impact is what makes the work meaningful.

“As a neurosurgeon, it’s incredible to hone your craft—to work with your hands and see a problem fixed by the end of surgery,” he said. “But what’s even more rewarding is hearing later how it’s changed someone’s life—that’s the best part.”

Read more from the Cedars-Sinai Newsroom: Defying the Odds – Father's Love Leads to Life-Changing Surgery

Members of Cedars-Sinai International attend the conference annually, deepening the organization’s commitment to sharing medical expertise and cultivating relationships with partners in the Middle East and beyond.

“I look forward to representing Cedars-Sinai, presenting our latest research and advances in the multidisciplinary treatment of esophageal cancer, leveraging cutting-edge, minimally invasive robotic surgery combined with the latest advancements in medical oncology in the treatment of esophageal cancer,” said Harmik J. Soukiasian, MD, chief of the Division of Thoracic Surgery at Cedars-Sinai Cancer. He will discuss advances in surgical techniques during his keynote on “Medical Management of Esophageal Cancer,” as part of the General Surgery Conference.

Cedars-Sinai will have a booth at the exhibition—Booth S17.E70—where attendees can learn about Cedars-Sinai’s clinical excellence, patient care services, collaboration models and growing global footprint, including the recently opened clinic in London and offices in Mexico, Singapore and Ecuador.

The World Health Expo—formerly called Arab Health—showcases 850 exhibitors, attracting more than 35,000 professionals from 180 countries.

Cedars-Sinai Orthopaedics is also internationally recognized through its long-standing designation as a FIFA Medical Centre of Excellence.

“As one of just 49 FIFA Medical Centres of Excellence worldwide—and one of only three in the United States, a designation we have held since 2007—Cedars-Sinai Orthopaedics has long been at the forefront of research and innovation advancing musculoskeletal care in the global football community,” said Bert Mandelbaum, MD, vice chair of the Department of Orthopaedic Surgery at Cedars-Sinai.

In a keynote, “The Future of Musculoskeletal Longevity Through Stem Cells, PRP and Precision Movement Medicine,” Mandelbaum will discuss how emerging approaches in stem cells, platelet-rich plasma (PRP) and precision movement medicine are shaping the future of musculoskeletal longevity.

Mandelbaum will discuss how emerging approaches in stem cells, platelet-rich plasma (PRP) and precision movement medicine are shaping the future of musculoskeletal longevity during the keynote “The Future of Musculoskeletal Longevity Through Stem Cells, PRP and Precision Movement Medicine.”

James Kirkland, MD, PhD, director of the Center for Advanced Gerotherapeutics, will speak during the keynote address “Translating Senolytics and Gerotherapeutics Into a Global Longevity Ecosystem.” His presentation will highlight the impact of senolytic drugs, a class of medications designed to target the biological processes underlying aging and treat age-related diseases.

Cedars-Sinai has been named to the Honor Roll for the 10th consecutive year in U.S. News & World Report’s "Best Hospitals 2025-26" rankings. The medical center also tied for No.1 in California and Los Angeles. In addition, Cedars-Sinai had 11 specialties in the U.S. News & World Report hospital rankings.

To arrange interviews with Cedars-Sinai experts, contact Kelsie Sandoval 562-631-1169 kelsie.sandoval@cshs.org.

A major update to be highlighted at the meeting: “The American Stroke Association’s 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke.”

Nestor Gonzalez, MD, director of the Neurovascular Laboratory in the Department of Neurosurgery at Cedars-Sinai, is co-vice chair of the American Stroke Association group that developed the new guidelines. Gonzalez played a key role in shaping the recommendations for endovascular treatment and led the effort to incorporate the first pediatric acute ischemic stroke recommendations in the guideline’s history.

Across three sessions, Gonzalez will discuss the guidelines in depth, including advances in endovascular thrombectomy, other interventional treatments, and the physical changes caused by stroke.

Additional Cedars-Sinai experts presenting at the conference include:
 

• Shlee Song, MD, director of the Comprehensive Stroke Center and Telestroke Program at Cedars-Sinai, will present updates on the extended window for administering the clot-busting medication tPA and can discuss acute stroke therapies and neuroimaging.  
   
• Maranatha O. Ayodele, MD, assistant professor of Neurology at Cedars-Sinai and director of the Neurocritical Care Fellowship Program, will discuss intracerebral hemorrhage management during the “Stroke in Practice Discussion.”
   
• Alexis Simpkins, MD, PhD, MSCR, director of Stroke Research and the Stroke RNA, Imaging, and Protein Predictors for Patient Tailored Treatment Program at Cedars-Sinai, will speak on the importance of implementation strategies for guidelines recommendations for effective stroke prevention and management during the World Hypertension/AHA Hypertension session. She can discuss her role as a peer reviewer and member of the AHA/ASA Scientific Statement Oversight Committee for the 2026 acute ischemic stroke guidelines and the section editor of the co-published acute ischemic stroke Guidelines in Action Teaching Cases series. 

Contact

To arrange interviews with Cedars-Sinai experts, contact Kelsie Sandoval at Kelsie.sandoval@cshs.org or 562-631-1169.

Cycle syncing, part of a growing movement encouraging women to track the four phases of the monthly cycle that starts with their period, has gained popularity on social media. As the body moves through these phases—follicular, ovulation, luteal and menstrual—hormones fluctuate, often influencing energy levels.

Some fitness clubs are jumping on the tracking trend, offering classes with varying intensity levels to align with a woman’s hormonal phase. However, Hamilton told the Los Angeles Times that there is no scientific evidence to support the practice.

“There’s never been any literature that said, hey, women who follow cycle thinking have better strength outcomes or have more energy,” she said.

Hamilton also expressed concern about planning workouts around the menstrual cycle, adding another layer of complexity to maintaining a healthy lifestyle.

“Lifestyle changes and healthy lifestyle choices are difficult for all of us,” she said, noting that resting for extended periods based on the cycle could lead women to miss important resistance training that supports bone health and longevity.

Instead of exercising based on hormonal fluctuations, Hamilton recommends eating a balanced diet of fruits, vegetables, grains and beans, and maintaining a consistent exercise routine, including both cardiovascular activity and strength training to support reproductive health and overall wellness.

Read the complete article from the Los Angeles Times.

The study shows for the first time that Chlamydia pneumoniae can reach the retina—the tissue lining the back of the eye—where it triggers immune responses linked to inflammation, nerve cell death and cognitive decline.

“Seeing Chlamydia pneumoniae consistently across human tissues, cell cultures and animal models allowed us to identify a previously unrecognized link between bacterial infection, inflammation and neurodegeneration,” said Maya Koronyo-Hamaoui, PhD, professor of Neurosurgery, Neurology, and Biomedical Sciences at Cedars-Sinai Health Sciences University and the leading, senior author of the study. “The eye is a surrogate for the brain, and this study shows that retinal bacterial infection and chronic inflammation can reflect brain pathology and predict disease status, supporting retinal imaging as a noninvasive way to identify people at risk for Alzheimer’s.”

To conduct the study, researchers used advanced imaging, genetic testing and protein analysis to examine retinal tissue from 104 individuals, some with normal cognition, some with mild cognitive impairment and some with Alzheimer’s disease.

They found significantly higher levels of Chlamydia pneumoniae in the retinas and brains of people with Alzheimer’s disease than they found in people with normal cognition. The higher the bacterial levels detected, the more severe the brain changes and cognitive decline investigators found.

Higher levels of the bacterium were more common in people who carried the APOE4 gene variant, a known risk factor for Alzheimer’s disease.

Investigators also studied human neurons in the lab and in laboratory mice with Alzheimer’s disease. In both, infection with Chlamydia pneumoniae increased inflammation, nerve cell death and cognitive decline, showing the bacterium can accelerate disease processes. The infection also triggered production of amyloid-beta, the protein that accumulates in the brains of people with Alzheimer’s.

The findings were driven by co-first authors Bhakta Gaire, PhD, and Yosef Koronyo, MSc.

“This discovery raises the possibility of targeting the infection-inflammation axis to treat Alzheimer’s,” said Timothy Crother, PhD, co-corresponding author of the study and research professor at Cedars-Sinai Guerin Children's and the Department of Biomedical Sciences at Cedars‑Sinai.

The findings suggest that targeting chronic bacterial infection—and the inflammation it triggers—could represent a new treatment strategy. The research also supports potential use of the retina as a noninvasive way to help diagnose and monitor the disease.

Additional Cedars-Sinai authors include Bhakta Gaire, Yosef Koronyo, Jean-Philippe Vit, Alexandre Hutton, Lalita Subedi, Dieu-Trang Fuchs, Natalie Swerdlow, Altan Rentsendorj, Saba Shahin, Daisy Martinon, Edward Robinson, Alexander V. Ljubimov, Keith L. Black, Jesse Meyer, and Moshe Arditi.

Other authors include Julie A. Schneider, Lon S. Schneider, Debra Hawes, Stuart L. Graham, Vivek K. Gupta, and Mehdi Mirzaei.

Funding: This work has been supported by the NIH/NIA grants R01AG056478, R01AG055865, and AG056478-04S1 (M.K.H.), R01AG075998 (M.K.H. and T.R.C.), and Alzheimer’s Association grant AARG-NTF-21-846586 (T.R.C.). MKH is also supported by The Goldrich and Snyder Foundations. ER has been supported by The Ray Charles Foundation.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Kwiatkowski said Cedars-Sinai’s efforts to grow and provide the most up-to-date resources to its information technology professionals helped earn the high ranking.

“We provide modern tools and continuous learning opportunities that help our teams grow their careers and stay ahead of emerging technologies,” he told Becker’s Health IT.

Kwiatkowski added that Cedars-Sinai’s flexible work arrangements widen the pool of job candidates, promoting an inclusive culture.

“Our hybrid and remote options attract diverse talent, and we are intentional about fostering a culture where everyone feels they belong,” he said.

Kwiatkowski told Becker’s Health IT that listening to frontline staff across Cedars-Sinai—both inside and outside his team—has yielded valuable insights that shape information technology strategies and innovation.

“That constant feedback loop is what helps keep Cedars-Sinai at the forefront of innovation while simultaneously strengthening our culture,” he said.

Computerworld also named Cedars-Sinai No. 1 in “workplace modernization” and “workplace culture,” and No. 9 in “retention and engagement.”

Cedars-Sinai’s information technology teams also recently earned top honors from two other organizations. The CHIME “Digital Health Most Wired” survey awarded a Level 9 rating for the effective use and implementation of technology, and Newsweek ranked Cedars-Sinai No. 17 on its “World’s Best Smart Hospitals” list, which recognizes tech‑forward healthcare organizations.

Read the complete article from Becker’s Health IT.

Nearly 40% of long-term colorectal cancer survivors experience ongoing moderate to severe fatigue.

“Fatigue is one of the most common and debilitating symptoms our patients experience, often long after treatment ends,” said Liu, the study’s lead author.

Physical activity is widely recommended for cancer survivors, but its optimal timing and impact remain unclear.

“We still don’t fully understand when during recovery activity is most beneficial, what types of activity are best for different patients, or how these effects play out in real-world longitudinal settings, especially in colorectal cancer survivors,” she said.

Using data from 1,718 colorectal cancer patients, researchers tracked physical activity at the time of diagnosis and continuing for two years. They also measured fatigue and quality of life.

The study, presented at ASCO Gastrointestinal Cancers Symposium 2026, found that among patients with nonmetastatic disease, those who regularly walked in the six to 12 months after diagnosis reported the most improvement in fatigue over time.

The study also found that maintaining higher activity levels through the first year after diagnosis was linked with better outcomes, suggesting short-term increases had little impact.

“When it comes to managing cancer-related fatigue, the key is to build steady, lasting habits that patients can stick with throughout their recovery,” Liu said.

Read the complete article from Medscape.

A Cedars-Sinai study found that within 90 days of the fires, the Cedars-Sinai Emergency Department saw a 46% increase in visits for heart attacks, a 24% increase in visits for respiratory illnesses, and a 118% increase in visits for general illness.

Joseph Ebinger, MD, MS, associate professor in the Department of Cardiology and first author of the study, published in JACC, told the Los Angeles Times that the fires were unusual because man-made materials, such as cars and batteries, burned alongside vegetation.

“The Eaton fire and the Palisades fire were unique, both in their size, their scale and the sheer volume of material that burned,” he said.

Susan Cheng, MD, MPH, vice chair of Research Affairs in the Department of Cardiology in the Smidt Heart Institute and senior author of the study, said smoke exposure “led to some kind of biochemical metabolic stress in the body that likely affected not just one but many organ systems,” resulting in a wide range of symptoms.

To help address those health concerns, Huntington Health, a Cedars-Sinai affiliate, has expanded pulmonary care for patients affected by smoke from the Eaton fire, which burned just miles away from the Pasadena hospital.

Raj Dasgupta, MD, associate professor of Clinical Medicine at Huntington Health, told Spectrum News 1 that people with respiratory symptoms should seek an evaluation. He also recommended taking precautions to limit ongoing exposure to contaminants.

“Getting the right filter, not for your whole house, but maybe the room you spend the most time in is going to be very important," Dasgupta said.

Read the complete article from the Los Angeles Times and watch the complete video from Spectrum News 1.

The New Cavendish Street location will serve as the central hub for primary care, executive health and concierge services. The location will also offer MRI and CT imaging, cardiac testing and ultrasounds. It will also provide echocardiography—imaging used to diagnose heart disease—and dual-energy X-ray absorptiometry (DEXA) scan, commonly used to analyze bone density and body composition. A key aim is to provide personalized, coordinated care.

“What’s often missing for patients here is a coordinator of their care—a team who truly understands the patient, navigates their medical journey, and ensures that treatments fit seamlessly into their lives,” said Sandeep Kapur, MD, medical director of Cedars-Sinai Clinic in London.

Vikas Mehta, MD, head of Executive Health and Concierge Medicine at Cedars-Sinai Clinic in London, told Harley Street Health District the clinic’s goal is to keep patients at the center of every decision.

“We want to ensure that our team is committed to putting patient care and experience at the heart of all we do,” Mehta said.

Cedars-Sinai has a strategic collaboration with Guy’s and St Thomas’ NHS Foundation Trust, a leading academic medical institution in London. Announced in March 2025, the collaboration expanded access to specialty care in the U.K., establishing Cedars-Sinai’s first clinic in London, located at 79 Wimpole St. in the Royal Brompton & Harefield Specialist Care building.

“Our network continues to grow, but our focus never changes—the patient is always at the centre,” said Heitham Hassoun, MD, chief executive of Cedars-Sinai International.

Read the complete article from Harley Street Health District.

Lopez was preparing to have a 22-pound ovarian tumor removed when a routine presurgical test revealed something unexpected: She was pregnant.

“I wasn't even believing it at first, because I have ovarian problems, so I was thinking it was a false positive,” Lopez told Good Morning America.

Three days later, Lopez experienced cramping while attending a Dodgers game and went to Cedars-Sinai, where diagnostic imaging revealed the baby was full term.

“It turned out the mass wasn’t growing; it was the baby growing in her abdomen behind the mass, pushing everything out,” John Ozimek, DO, medical director of Labor and Delivery, told Telemundo. “That’s why she didn’t know she was pregnant.”

It is extremely rare for a baby to survive an ectopic pregnancy because the placenta— the organ that delivers oxygen and nutrients to an unborn baby—cannot safely grow outside the uterus.

“In my entire career, I've never even heard of one making it this far into the pregnancy,”  Michael Manuel, MD, of Providence Cedars-Sinai Tarzana Medical Center, told the Daily Mail.

Lopez’s complex surgery required a team of 30 medical professionals to remove the tumor and deliver the baby. Although Lopez began hemorrhaging during the operation, she recovered quickly and was able to care for Ryu, who was born weighing 8 pounds with a full head of hair.

Lopez and her family have since recovered and credit their faith for welcoming a baby who defied all odds.

Watch the entire segment from Good Morning America and Telemundo, and read the complete article from the Daily Mail.

Es momento de hacer un cambio, dijo Sara Espinoza, MD, directora médica de la Clínica Healthspan de Cedars-Sinai, que se enfoca en mantener una buena calidad de vida a medida que las personas envejecen.

“Si las personas se sienten culpables por haberse excedido, mi consejo es que no se queden atrapadas en ese sentimiento”, dijo Espinoza. “Cada día es un nuevo comienzo, y nunca es demasiado tarde para cambiar de rumbo, especialmente al iniciar un nuevo año”.

Aunque muchas personas hacen propósitos saludables con buenas intenciones, una encuesta de Forbes Health/OnePoll de 2023 mostró que el propósito promedio dura menos de cuatro meses. Espinoza hablo con Noticias de Cedars-Sinai para explicar cómo adoptar hábitos saludables hoy —como el ejercicio regular y una alimentación balanceada— puede influir en la salud a largo plazo.

Para gente que no se sienten en su mejor momento después de las fiestas, ¿cuáles son algunos propósitos saludables que pueden ayudarles a empezar a sentirse mejor?

Cuando las personas se sienten sin energía después de las vacaciones y fiestas, generalmente empiezo por recomendarles que descansen. La higiene del sueño es fundamental para recuperar la energía, y uno de los pasos más sencillos es acostarse a la misma hora todas las noches.

Después del sueño, la actividad física constante es una de las formas más efectivas de mejorar los niveles de energía. Si alguien continúa sintiéndose fatigado a pesar de mejorar sus hábitos de sueño y ejercicio, eso puede ser una señal de depresión, y recomiendo que se realice una evaluación.

¿Qué propósitos de Año Nuevo considera que tienen el mayor impacto en la longevidad?

Casi siempre señalo la actividad física como el factor con mayor impacto en la salud a largo plazo.

Animo a las personas a proponerse al menos 150 minutos de ejercicio cardiovascular por semana, junto con entrenamiento de resistencia dos días a la semana. Este entrenamiento no tiene que ser complicado y puede incluir ejercicios con el peso corporal.

Si esa cantidad de ejercicio parece difícil de alcanzar, no quiero que las personas se desanimen. Incluso comenzar con el propósito de caminar más todos los días es beneficioso, especialmente porque hay evidencia que demuestra que caminar de forma regular reduce el riesgo de enfermedades cardíacas y accidentes cerebrovasculares.

Mi mensaje principal es que cualquier cantidad de ejercicio es mejor que ninguna.

¿Cómo apoyan los hábitos diarios saludables un envejecimiento saludable y ayudan a prevenir enfermedades relacionadas con la edad?

Hablo con frecuencia con mis pacientes sobre la importancia de mantener un peso corporal saludable debido a su fuerte relación con la salud a largo plazo. Incluso una pérdida de peso modesta —alrededor del 5% al 10% del peso corporal— puede reducir significativamente el riesgo de desarrollar diabetes, en algunos casos hasta en un 60%.

Las investigaciones también muestran que reducir la ingesta calórica durante varios años puede mejorar la salud cardiovascular, los niveles de colesterol y la sensibilidad a la insulina en adultos jóvenes y de mediana edad con sobrepeso u obesidad.

Al hablar de alimentación, a menudo hago referencia al Plato para Comer Saludable de Harvard. Aproximadamente la mitad del plato debe estar compuesta por frutas y verduras, una cuarta parte por granos integrales como arroz integral o pan integral, y el cuarto restante por fuentes saludables de proteína como pescado, pollo, frijoles o nueces.

Dicho esto, los cambios en la dieta no tienen que ser extremos para ser efectivos. Si la guía parece demasiado estricta, sugiero ajustes pequeños y realistas, como compartir una orden de papas fritas o elegir una ensalada en su lugar.

Las personas no necesitan cambiar por completo su alimentación de la noche a la mañana. Incluso incluir una comida al día centrada en verduras como propósito es un paso en la dirección correcta. La moderación es clave.

¿Por qué es tan difícil cumplir los propósitos de Año Nuevo y qué estrategias basadas en evidencia ayudan a lograrlo?

Una de las principales razones por las que las personas tienen dificultades para cumplir los propósitos de Año Nuevo es la falta de responsabilidad o acompañamiento. A menudo recomiendo hacer ejercicio con un amigo, inscribirse en una clase o contar con alguien que dé seguimiento regularmente.

La investigación sobre los rastreadores de actividad física y dispositivos portátiles es mixta, pero para muchas personas, dar seguimiento a su progreso resulta motivador. Simplemente monitorear los pasos diarios en un teléfono o podómetro puede ayudar a mantener la constancia o reforzar hábitos saludables.

También recomiendo establecer metas SMART, es decir, objetivos específicos, medibles, alcanzables, relevantes y con un tiempo definido. Comenzar con pasos pequeños y graduales es mucho más sostenible que fijar propósitos poco realistas.

¿Cuáles son algunos hábitos subestimados o que a menudo se pasan por alto y que pueden mejorar la salud y el envejecimiento a largo plazo?

Un hábito que a menudo se pasa por alto es la salud bucal. Una mala salud dental se ha relacionado con enfermedades cardiovasculares y demencia.

Para apoyar la salud bucal, recomiendo cepillarse los dientes al menos dos veces al día, usar hilo dental a diario y limitar el consumo de alimentos y bebidas azucaradas. Nuevamente, si eso resulta demasiado estricto, incluso cepillarse los dientes dos veces al día es un excelente propósito.

¿Existen otros propósitos adicionales que promuevan un envejecimiento saludable?

Si bien las recomendaciones generales son un buen punto de partida, mis sugerencias médicas para apoyar propósitos de envejecimiento saludable con el mayor impacto se adaptan al estado de salud de cada persona.

En los adultos mayores, por ejemplo, la pérdida de peso requiere una consideración cuidadosa, ya que puede provocar la pérdida tanto de grasa como de masa muscular. En esos casos, la pérdida de peso combinada con entrenamiento de resistencia puede ayudar a preservar la masa muscular y mantener la fuerza.

Para pacientes con enfermedades cardiovasculares, a menudo recomiendo no fumar, limitar el consumo de alcohol, tomar los medicamentos recetados para la presión arterial y seguir una dieta baja en sodio.

Para programar una cita con la Clínica Healthspan, llame al 310-423-3870, seleccione la opción 1 y solicite una cita con la doctora Espinoza.

Lea más de Historias y Perspectivas de Cedars-Sinai: Cómo Pensar Sobre su Edad Biológica

Following a joyful holiday season spent with loved ones, many people start the new year feeling sluggish—often from indulging in rich food and drinks or falling out of their workout routines.

Time for a change, said Sara Espinoza, MD, medical director of the Cedars-Sinai Healthspan Clinic, which emphasizes maintaining a good quality of life while aging. 

“If people are feeling guilty because they overindulged, my advice is, don’t wallow in it,” Espinoza said. “Every day is a new day, and it’s never too late to turn over a new leaf—especially in the new year.”

Although many earnestly make healthy resolutions, a 2023 Forbes Health/OnePoll showed that the average resolution lasts less than four months. Espinoza sat down with the Cedars-Sinai Newsroom to explain how resolving to practice healthy habits today—such as regular exercise and healthy eating—can affect long-term health.   

For people who are not feeling their best after the holidays, what are some healthy resolutions they can make to start feeling better?

When people feel sluggish after the holidays, I usually start with recommending sleep. Sleep hygiene is critical for restoring energy, and one of the simplest steps is going to bed at the same time every night.

After sleep, consistent physical activity is one of the most effective ways to improve energy levels. If someone continues to feel fatigued despite improving sleep and exercise habits, that can be a signal of depression, and I recommend being screened.

What New Year's resolutions would you say have the biggest impact on longevity?

I almost always point to physical activity as having the greatest impact on long-term health.

I encourage people to aim for at least 150 minutes of cardiovascular exercise per week, along with resistance training two days a week. That resistance training does not have to be complicated and can include body-weight exercises.

If that amount of exercise feels out of reach, I don’t want people to get discouraged. Even starting with a resolution to walk more each day is beneficial, especially because there is evidence showing regular walking reduces the risk of heart disease and stroke.

My main message is any time working out is better than no time.

How do healthy daily habits support healthy aging and help prevent age-related diseases?

I talk frequently with patients about maintaining a healthy body weight because of its strong link to long-term health. Even modest weight loss—about 5% to 10% of body weight—can significantly reduce the risk of developing diabetes, sometimes by as much as 60%.

Research also shows that reducing calorie intake over several years can improve cardiovascular health, cholesterol levels and insulin sensitivity in young to middle-aged adults who are overweight or obese.

When discussing diet, I often reference Harvard’s Healthy Eating Plate. About half the plate should be fruits and vegetables, a quarter should be whole grains such as brown rice or whole-wheat bread, and the remaining quarter should be healthy protein sources like fish, poultry, beans or nuts.

That said, dietary changes do not need to be extreme to be effective. If the guideline feels too strict, I suggest small, realistic adjustments, such as sharing a side of fries or choosing a salad instead.

People do not need to overhaul their entire diet overnight. Even one vegetable-focused meal a day as a resolution is a step in the right direction. Moderation is key.

Why is it so hard to stick to New Year’s resolutions, and what evidence-based strategies help people follow through?

One of the biggest reasons people struggle to stick with New Year’s resolutions is a lack of accountability. I often recommend working out with a friend, joining a class or having someone regularly check in.

Research on fitness trackers and wearables is mixed, but for many people, tracking progress is motivating. Simply monitoring daily steps on a phone or pedometer can help maintain consistency or reinforce habits.

I also encourage SMART goal setting, meaning goals that are specific, measurable, achievable, relevant and time bound. Starting with small, incremental steps is far more sustainable than setting unrealistic resolutions.

What are some underrated or often overlooked habits that can improve long-term health and aging?

One habit that often is overlooked is oral health. Poor dental health has been linked to cardiovascular disease and dementia.

To support oral health, I recommend brushing at least twice a day, flossing daily and limiting sugary foods and drinks. Again, if that is too rigid, even brushing teeth twice a day is a great resolution.

Are there any extra resolutions that promote healthy aging?

Although general guidelines are a helpful starting point, my medical recommendations to support healthy aging resolutions for the greatest impact are tailored to an individual’s health status.

For older adults, for example, weight loss requires careful consideration because it can lead to loss of both fat and muscle. In those cases, weight loss combined with resistance training can help preserve muscle mass and maintain strength.

For patients with cardiovascular disease, I often recommend not smoking, limiting alcohol, taking prescribed blood pressure medications and following a low-sodium diet.

To make an appointment with the Healthspan Clinic, call 310-423-3870 and select option 1 and ask to schedule an appointment with Espinoza.

Read more from Cedars-Sinai Stories and Insights: How to Think About Your Biological Age

Health Risks of Prostate Cancer Therapy Are Similar Across Races

Prostate cancer patients of all racial groups face roughly the same excess risk of developing heart and bone problems when they are treated with androgen deprivation therapy, according to a study led by Cedars-Sinai. The findings, published in JAMA Network Open, support a uniform approach to counseling and monitoring these patients.

Roughly 1 in 8 men will be diagnosed with prostate cancer during their lifetime, according to the American Cancer Society. Androgen deprivation therapy, which blocks the production or action of male hormones that drive prostate cancer, is widely used to treat cancers that have spread outside the prostate.

“While androgen deprivation is an important tool for fighting prostate cancer, numerous studies have found that it also raises the risk of developing bone fractures, osteoporosis, heart attacks, strokes, coronary heart disease, congestive heart failure and peripheral vascular disease,” said Nadine A. Friedrich, MD, a postdoctoral scientist in the Department of Urology at Cedars-Sinai and corresponding author of the study. “We wanted to learn whether these excess risks from androgen deprivation vary by race.”

Investigators reviewed the electronic health records of more than 790,000 patients in the nationwide Veterans Affairs Health Care System who were diagnosed with prostate cancer from 2001 to 2021. The data showed that androgen deprivation therapy was associated with increased cardiovascular and bone risks across all racial groups. There were differences in certain risks between Black and white patients, but they were small.

“The clinical relevance of these slight variations is unclear,” said Stephen J. Freedland, MD, professor of Urology at Cedars-Sinai, staff physician at the Durham VA Medical Center, and study senior author. “Overall, these findings underscore the importance of monitoring all prostate cancer patients undergoing androgen deprivation therapy, regardless of race.”

Additional Cedars-Sinai authors include Kiranbir Josan, MD; and Nicholas P. Tatonetti, PhD

Other authors include Jessica L. Janes, MA; Joshua Parrish, BS; and Amanda M. De Hoedt, MS.

Funding: This research received funding from Sumitomo Pharma America, Inc, and Pfizer, Inc. Dr. Friedrich was funded by National Institutes of Health grant T32 HL11627.

Disclosures: Dr. Freedland reported receiving personal fees from Astellas, Bayer, Pfizer, Sanofi, Merck, AstraZeneca, Eli Lilly, Novartis, Janssen, and Tolmar outside the submitted work.

Cedars-Sinai Neuroscience Study Earns ‘Buzziest Paper’ Honor

Neuroscience news outlet The Transmitter has named a study published in Nature and led by Ueli Rutishauser, PhD, professor and Board of Governors Chair in Neurosciences at Cedars-Sinai, as among “The Buzziest Neuroscience Papers of 2023, 2024.”

The paper, titled “Abstract Representations Emerge in Human Hippocampal Neurons During Inference," illuminated the processes of abstraction and inference. Abstraction is the learning of new knowledge from experience, while inference is the use of this knowledge to make decisions in situations we have never been in. The study found that when people successfully use inference to adapt to new situations, groups of neurons in the hippocampus represent information in an abstract format, a type of coordinated firing of neurons that becomes visible with new tools that make such neural geometries visible.

The Transmitter list, published as part of the publication’s year-end special report on the state of neuroscience, highlights innovative and impactful neuroscience research. The paper’s inclusion underscores its significance in advancing scientific understanding of how the human brain works.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Skaggs told Becker's Healthcare Podcast host Carly Behm that one of the most significant advancements in spine care is CT imaging developed from an MRI scan with the help of AI. Called a synthetic CT, this innovation generates accurate, 3D images while sparing children the radiation of a traditional CT scan.

“For pediatrics, this saves children from unnecessary radiation, but if we think bigger picture in adult spine, what it could also do is save people from getting two studies,” Skaggs said.

Skaggs told Behm that surgeons also use synthetic CT imaging for real-time navigation and during procedures.

Skaggs thinks AI also could improve patient safety. He said it could be used to detect early changes in a surgical patient’s neuromonitoring signals, alerting the care team to a potential risk of paralysis up to 20 minutes before a human technician typically would.

“AI really is going to offer us solutions that are better, faster and less expensive than existing technology,” Skaggs told Behm.

Another increasingly important aspect of spine care, Skaggs said, is designing more inclusive surgical tools. Skaggs recounted for Behm how a female surgeon he was training last year couldn’t use spinal instruments he had designed because they didn’t fit in her hands. Through that experience, he learned that one-size-fits-all surgical tools will not be useful as his field becomes more diverse.

“This is going to become increasingly important as we have more women in spine surgery,” Skaggs said.

Listen to the entire interview from Becker's Healthcare Podcast.

Constipation—which is characterized by infrequent bowel movements, stomach cramps or dry, lumpy stool—is a common digestive issue that affects people with and without Crohn’s disease, Rabizadeh told WebMD.

“Patients with Crohn’s disease can have constipation at the same rate as the general population,” he said.

Common causes include limited physical activity, high stress levels, use of strong pain medications, and low-fiber diets. Symptoms can include bloating, nausea and a feeling of incomplete bowel movements.

For those living with Crohn’s disease, experts identify additional potential causes of constipation, such as pelvic floor dysfunction and small intestinal bacterial overgrowth. Rabizadeh also highlighted the impact of distal colonic inflammation affecting the last part of the large intestine, which helps send signals to trigger a bowel movement.

“Inflammation here can lead to dysfunction, including constipation,” Rabizadeh told WebMD.

To support digestive health and promote regular bowel movements, experts recommend a diet rich in high-fiber foods like peas, oats and apples. Drinking coffee or tea can also help. Rabizadeh advised limiting rice and dairy products, which can make constipation worse.

If constipation is accompanied by abdominal pain or vomiting, it’s important to seek medical attention, as these symptoms could be signs of a bowel obstruction.

“Lack of bowel movements related to bowel obstruction needs to be evaluated by the doctor, and most times, patients need admission to the hospital for fluids, treatment, and potential surgery,” Rabizadeh said.

Read the complete article from WebMD.  

AI Framework Speeds Up Brain Neuron Modeling

Cedars-Sinai investigators worked with a multi-institutional team to develop a new artificial intelligence framework that can accurately, quickly and efficiently create virtual models of brain neurons. The achievement could accelerate discoveries in brain function research and ultimately lead to better treatments for brain disorders.

The study’s findings were presented at the 39th Conference on Neural Information Processing Systems in San Diego.

“Computational modeling of brain neurons has become an important tool for studying their activity and interactions,” said co-author Costas Anastassiou, PhD, associate professor of Neurology, Neurosurgery and Biomedical Sciences at Cedars-Sinai. “But traditional models are hindered by limitations including the cost of computer resources, data availability and cumbersome handling. Our new framework tackles this problem by operating at speeds thousands of times faster than existing methods while remaining so biologically accurate that it can capture the variability of actual brain neurons, unlike current approaches. The framework can also generate an unlimited number of virtual neurons, better reflecting the diversity and variability of actual biological neurons.”

Anastassiou added that the framework opens a pathway toward modeling larger-scale brain circuits that could improve understanding of the relationships between gene expression, electrical activity and networking in neurons. The investigators named their invention NOBLE, for Neural Operator with Biologically-informed Latent Embeddings.

“I am very happy to see this interdisciplinary and inter-institutional collaboration,” said Anima Anandkumar, PhD, Bren Professor of Computing and Mathematical Sciences at Caltech and a co-author of the study. “Neural operators are designed to capture the complex dynamics seen in biological neurons, and this is the first large-scale AI framework validated with experimental human cortex data.”

The additional Cedars-Sinai author is Philip H. Wong.

Other authors include Luca Ghafourpour, Valentin Duruisseaux, and Bahareh Tolooshams.

Funding: A.A. is supported by the Bren Endowed Chair, ONR (MURI grant N00014-23-1-2654), and the AI2050 Senior Fellow program at Schmidt Sciences. C.A.A. is supported by the National Institutes of Health R01 - NS120300 and R01 - NS130126. P.H.W. is supported by the National Institutes of Health R01 - NS130126.

Liver Cancer Prevention, Treatment Efforts Are Working

Prevention and treatment advances are reducing the number of new liver cancer patients and narrowing survival gaps among racial groups, a Cedars-Sinai Cancer study published in the journal Clinical Gastroenterology and Hepatology reports.

“We found that liver cancer rates in the U.S. have begun to decline after many years of increase, and deaths from liver cancer have stabilized,” said Ju Dong Yang, MD, medical director of the Liver Cancer Program at Cedars-Sinai and senior author of the study. “Younger patients and those with advanced disease are living longer, partly due to new therapies. And differences in survival rates between Black and white patients have nearly disappeared, suggesting that fairer access to care and treatment advances are helping reduce longstanding racial disparities.”

Investigators looked at data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results cancer registry on newly diagnosed liver cancer cases, tumor stage at diagnosis, treatment trends, and survival rates in the U.S. over the past two decades. Despite declining liver cancer rates and improved overall survival, they found that early detection and curative treatment decreased during the COVID-19 pandemic. Investigators suggest this highlights the importance of strengthening screening and care access during healthcare disruptions.

Additional Cedars-Sinai authors include Yi-Te Lee, Hyun-seok Kim, Alexander Kuo, Walid S. Ayoub, Hirsh D. Trivedi, Yun Wang, Aarshi Vipani, Paul Martin, and Cristina R. Ferrone.

Other authors include Jasmine J. Wang, Pojsakorn Danpanichkul, and Amit G. Singal.

Funding: Dr. Singal’s research is funded by National Institutes of Health R01CA256977 and R01 MD012565. Dr. Yang’s research is supported by National Institutes of Health K08CA259534; R21CA280444.

Disclosures: Dr. Yang provides a consulting service for AstraZeneca, Eisai, Exact Sciences, Exelixis, Fujifilm Medical Sciences, Merck, and Gilead Sciences.

New AI Tool Improves Heart Test Evaluation

A new AI tool can rapidly evaluate data from echocardiography, an imaging test commonly used to diagnose heart disease, according to new research led by Cedars-Sinai. The study, published in JACC, found the tool could speed up the testing process and yield more uniform results.

The AI system automatically takes 18 different measurements during echocardiography, which uses high-frequency sound waves to create moving pictures of the heart and evaluate blood flow. The procedure is used to assess signs and symptoms of heart failure, atherosclerosis, cardiomyopathy and other conditions.

“Our AI tool demonstrated accuracy and precision comparable to that of expert sonographers from two medical institutions,” said David Ouyang, MD, assistant professor in the Department of Cardiology in the Smidt Heart Institute at Cedars-Sinai and corresponding author of the study. “One of the primary benefits of automation is that it reduces examination time and produces more consistent readings.”

Ouyang added that more testing is needed before the tool is used for patients.

Additional Cedars-Sinai authors include Yuki Sahashi, Victoria Yuan, Matthew Christensen, Milos Vukadinovic and Christina Binder-Rodriguez.

Additional authors include Hirotaka Ieki, Justin Rhee, James Y. Zou, Bryan He and Paul Cheng.

Funding: This work was funded by National Institutes of Health, National Heart, Lung, and Blood Institute grants R00HL157421, R01HL173526, and R01HL173487.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

The study, published in Applied Sciences, surveyed 425 runners about their sleep habits and injury history. Researchers found that those who got the least sleep were more likely to be injured compared with those who slept seven to nine hours a night.

Scott, who was not involved in the study, explained to SELF that during sleep, the body releases growth hormones that help repair muscle fibers after a workout. These hormones also aid blood flow, delivering key nutrients to muscle tissue.

“When you sleep less, your body’s ability to recover from a workout is diminished,” Scott said, adding that fatigue can cause a runner to make physical and mental errors that increase the risk of injury.

In addition to getting the recommended seven to nine hours of sleep, Scott suggested several strategies to improve sleep quality, including a consistent bedtime routine.

“You want to do the same things every evening, along with avoiding electronics and screen time before laying down to go to sleep at night,” Scott said.

He also advised avoiding caffeine, alcohol and large meals right before bed, and keeping your bedroom cool and quiet.

“If you do those things, you’re not only going to get to sleep for longer, but you’ll get better-quality sleep,” he said.

Other experts said that if sleep issues persist after trying these strategies, people should see a clinician for an evaluation. 

Read the complete article from SELF.

The Centers for Disease Control and Prevention estimates that epilepsy affects about 450,000 children under 18 and almost 3 million adults in the U.S.

“Everybody should educate themselves about epilepsy—the signs and symptoms and when they need to seek out treatment,” Holder told CBS LA.

She explained that epilepsy stems from various causes—brain injuries, infections, a congenital brain malformation and genetic factors. “About 50% of people who have epilepsy will have an underlying genetic cause,” she said.

Holder told CBS LA that signs of epilepsy can include repeated seizures, which can manifest as recurrent abnormal smells, tastes, behaviors or staring spells. If parents suspect their child may be experiencing seizures, she recommends consulting a doctor for an electroencephalogram, a noninvasive test that monitors brain waves and helps neurologists confirm an epilepsy diagnosis.

As the field has evolved, neurologists have identified hundreds of genes linked to epilepsy and improved genetic testing. She recommends that people with epilepsy receive a simple cheek swab to determine whether their condition is caused by genes.

Holder told CBS LA that Cedars-Sinai Guerin Children’s is conducting a clinical trial testing a gene therapy for children ages 2 to 18 with epilepsy.

“We now can actually fix the epilepsy at the root of the cause at the genetic level,” Holder said.

Watch the complete segment from CBS LA.

The investigators want to study how the weakened gravitational pull in space affects the growth of organoids—small collections of cells that emulate the form and function of human organs. Scientists use organoids to model diseases and test drugs, and the hope is that they will grow more quickly in space than on Earth.

Putting Research Into Practice

“Our ultimate goal is to accelerate the progress of biological research and discovery,” said Arun Sharma, PhD, director of the Center for Space Medicine Research and research scientist in the Board of Governors Regenerative Medicine Institute at Cedars-Sinai. “Our partnership with Exobiosphere furthers Cedars-Sinai’s mission to be at the forefront of space biomedicine while deepening our understanding of how organoids develop in microgravity.”

Sharma and his colleagues hope to speed the discovery of therapies that treat medical issues astronauts experience, including bone and muscle loss and heart and immune system degradation. These discoveries could also be applied to terrestrial patients experiencing similar conditions, such as sarcopenia (muscle loss), osteoporosis (bone weakening) and cardiomyopathy (enlargement, stiffening or weakening of the heart muscle).

“Drugs that are used to treat astronauts can also benefit people on Earth, making a potential broader impact for millions of patients,” Sharma said.

Partnering to Solve Challenges of Research in Space

Microgravity offers tremendous opportunities for scientific discovery but also creates challenges that investigators don’t face on Earth. For example, when astronauts open petri dishes in space, the fluid and cells inside drift out.

However, a Cedars-Sinai study co-authored by Sharma and led by Maedeh Mozneb, PhD, from the Sharma Lab, found that in 96-well plates—rows of tiny wells much smaller than petri dishes—surface tension is strong enough to hold the contents in place.

“It was the first time that anybody has ever showed that you can take this piece of affordable hardware that’s commonly used in labs on ground and bring it to space to do cell biology research,” said Sharma, a research professor in the Department of Biomedical Sciences and the Smidt Heart Institute. “In a way, it's democratizing life sciences.”

Building on this discovery, Exobiosphere developed a research platform that automates organoid experimentation in microgravity. The hardware integrates precision liquid handling, environmental control, robotic manipulation and live imaging—capabilities that previously required intensive astronaut intervention.

"This system is designed to remove barriers for scientists," said Kyle Acierno, CEO of Exobiosphere. "By streamlining the complexity of space-based research, we’re enabling our partners to focus on the science itself—delivering data faster, with greater consistency, and at a scale that’s never been possible in orbit."

The unit, about the size of a carry-on suitcase, accommodates six 96-well plates and includes a built-in incubator, microfluidic‑based liquid dispenser, plate reader and robotic arm. While optimized for microgravity, the platform can also enhance lab productivity on Earth.

Exobiosphere’s innovative work earned it a spot in the Cedars-Sinai Accelerator+ program, which invests in startups focused on improving healthcare to help bring their products to market. Cedars-Sinai Technology Ventures also recently made a $1.4 million investment in the company and will provide mentorship from researchers.  

"As an academic medical center committed to innovation, we are thrilled to invest in a company conducting important biosciences research in space while collaborating with our colleagues at the Center for Space Medicine Research," said Nirdesh K. Gupta, PhD, managing partner of Cedars-Sinai Intellectual Property Company. "Our work together exemplifies our dedication to advancing breakthrough technologies that transform healthcare in space and on Earth."

Read more from Discoveries: Space Doctors and Stem Cell Production in Microgravity

According to research published in the Journal of General Internal Medicine, regular primary care visits are linked to better health outcomes and reduced risk of hospitalizations. For most healthy adults, doctors recommend a visit every one to three years.

Chen told U.S. News & World Report that annual physicals are useful occasions to discuss changes in health and address potential concerns before they arise.

"Even if you feel healthy, annual physicals for most adults – and Annual Wellness Visits for Medicare beneficiaries – are valuable opportunities to identify risks early and maintain long-term wellness," Chen said.

Chen added that exceptions to this yearly schedule include children, who need vaccines and growth monitoring, as well as adults with chronic conditions.

"Those with chronic conditions benefit from more regular monitoring to prevent complications and ensure treatment is working," Chen told U.S. News. He explained that if someone’s chronic condition is stable, they should see a doctor every three to six months, and more frequently if it’s uncontrolled.

Experts said other exceptions include seeing a specialist for screening if you have a family history of cancer, such as breast or colon cancer, of if you experience a significant life change, like switching jobs or starting menopause.

To better streamline doctor appointments, Chen recommends scheduling the next visit while still at the doctor’s office.

Read the complete article from U.S. News & World Report.  

Obesity increases the accumulation of senescent cells, aged cells that have stopped dividing but have not died, in several organs and tissues.

“Senescent cells differ depending on the originating cell types, diseases and other factors. Some senescent cells help with wound healing, but others cause harm and are known contributors to age-related diseases,” said Masayoshi Suda, MD, PhD, assistant professor of Medicine at Cedars-Sinai and lead author of the study. “Our goal is to identify and target these harmful types of senescent cells while sparing helpful cells.”

Previous research by the investigators showed that eliminating senescent cells with drugs called senolytics improved metabolic function, the body’s method for turning food and drink into energy.

In the current study, investigators focused on senescent blood vessel cells. They selectively removed these cells from obese laboratory mice and found that the animals’ inflammation and fat mass were reduced—and blood sugar levels improved.

When the investigators transplanted senescent blood vessel cells into lean laboratory mice, those mice developed inflammation in fat tissue and metabolic dysfunction.

Suda said this occurred because senescent blood vessel cells release high levels of inflammatory molecules.

The investigators next treated both groups of mice with fisetin, a naturally occurring senolytic compound, and found that the mice had fewer senescent blood vessel cells and improved diabetic symptoms. Investigators saw a similar decline in senescent blood vessel cells when they treated tissue samples from obese human patients with fisetin.

“Preliminary findings like these are crucial to translating aging research into clinical care,” said James Kirkland, MD, PhD, director of the Center for Advanced Gerotherapeutics and senior author of the study. “While more research is needed, we aim to eventually treat multiple age-related diseases simultaneously by using fisetin and related senolytics for aging and metabolic health.”

Suda said his team will next work to test this approach in clinical trials.

“If we can target senescent cells safely in humans, it could help address not just diabetes but a range of age-related conditions,” he said.

Additional Cedars-Sinai authors include Selim Chaib, Larissa Langhi Prata, Tamar Pirtskhalava, Nino Giorgadze, Sara Espinoza, Nicolas Musi, and Tamar Tchkonia.

Additional authors include Yi Zhu, Utkarsh Tripathi, Karl Paul, Allyson Palmer, Vagisha Kulshreshtha, Christina Inman, Kurt Johnson, Runqing Huang, Carolyn Roos, Luisa Leon-Sanchez, Jordan Miller, Thomas White, Linshan Laux, Laura Niedernhofer, Paul Robbins, Sundeep Khosla and Stefan G. Tullius.

Disclosures: Tamar Tchkonia, Allyson Palmer, Yi Zhu and James L. Kirkland have a financial interest related to this research, including patents and pending patents covering senolytic drugs and their uses held by Mayo Clinic.

Funding: This work was supported by the US National Institutes of Health (NIH) grants R37AG013925, R33AG061456, P01AG062413 (J.L.K., S.K., L.J.N., P.D.R.), U54 AG079754 (P.D.R., S.K., L.J.N), P01AG43376 (P.D.R., L.J.N.), R01AG086085 (S.K.), R01AG087387 (Y.Z.), and R01 AG063543 (L.J.N.). 

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Ishimori told HuffPost that cold weather affects the liquid that lubricates our joints.

“When the weather gets cooler, the synovial fluid that acts like motor oil in our joints becomes more like sludge,” she said.

Changes in barometric pressure—the measure of the weight of air—can cause muscles and tendons to expand, putting additional stress on already crowded joints. As they expand, joint tissue may become swollen or more uncomfortable, Ishimori said.

According to the Arthritis Foundation, patients may be less active on cold days, causing stiffness in the joints. The cold weather’s effect on outdoor activities that usually offer a healthy distraction may cause people to fixate on their pain.

Ishimori recommended several tactics to manage joint pain during cold weather, including avoiding wet, slippery surfaces.

“Our bodies aren’t used to navigating slick surfaces... And if your joints are damaged from arthritis, your sense of balance and proprioception may be affected,” she said, adding that arthritis increases the risk of falling.

Ishimori told HuffPost that people should also prioritize stretching before exercise.

To ease the effects of cold weather, experts also recommend staying warm and active, eating a nutritious diet, and managing stress effectively. They advise discussing arthritis symptoms with a physician, especially if the symptoms are new or haven’t been evaluated.

Read the complete article from HuffPost.  

Vrahas has dedicated his decades-long career to building orthopedics programs focused on educational excellence, exceptional clinical care and leading-edge research.

With the field of orthopedics now facing financial pressures and workforce shortages, Vrahas told Becker’s Spine Review he is focusing on retaining top talent and “creating a supportive, enjoyable environment where people want to stay.”

Part of that retention strategy is devoted to improving clinical care.

To ensure Cedars-Sinai is providing the highest-quality care to its orthopedic patients, the department tracks performance metrics at every stage of a patient’s journey—from the first appointment to follow-up care. Through these efforts, Vrahas said, they found that about 16% of orthopedic patients experience depression.

“To address that, we brought a social worker into our orthopedic clinics,” Vrahas told Becker’s Spine Review. “Orthopedic surgeons aren’t trained or equipped to manage anxiety and depression, so the social worker helps connect patients with the resources and programs they need.”

To address the mental health aspect of orthopedic care, the department launched a new study that uses virtual therapy to help manage anxiety and depression.

“We hope that will decrease catastrophization, improve outcomes and decrease opioid use,” Vrahas told Becker’s Spine Review. “That was all informed by collecting the measures and noting that a lot of our patients had unrecognized depression.”

Read the complete article from Becker’s Spine Review.