SPRING 2021
COVER STORY
The gift of a lifetime PAGE 8
Kristen Batkiewicz needed a new liver. Her brother became her living donor.
ALSO IN THIS ISSUE PAGE 3
Zoom meetings, masks and voice strain PAGE 4
Answers to your vaccine questions PAGE 6
How to tell if your child has IBS or IBD
Health, Science & Wellness
Insights from the President Tom Jackiewicz
Building trust in the safety of COVID-19 vaccines As we head into the new year, we have reason to be optimistic that 2021 will be better. Distribution of the COVID-19 vaccines is picking up momentum, and we at the University of Chicago Medicine are dedicating significant time and resources to ensure that we can distribute the vaccine quickly and safely to as many people as possible. While there is light at the end of the tunnel, Brian Sinotte, President of UChicago Medicine’s Community Health and Hospitals Division and President of Ingalls Memorial Hospital, recently reminded me that the tunnel may be long. One of the challenges we are addressing is building trust in the safety of the COVID-19 vaccines. Over the last several years, we have seen a growing distrust of the scientific community, nurtured by political leaders with agendas that have not prioritized public health. We also know that communities of color have their own personal and painful memories of the medical community failing them.
These recent and historical events cannot be erased with a few words of reassurance and encouragement to get vaccinated. To simply share a message that you should trust our organization, vaccine manufacturers and the federal agencies overseeing safety measures trivializes the deep concerns you may have, and ignores the responsibility the medical community must take for these past mistakes and tragedies. Anthony Williams, PhD, a postdoctoral researcher at UChicago Medicine, is Black and grew up on the South Side of Chicago. He has spoken candidly about the skepticism his friends and family had about his participation in the Moderna vaccine trial. He acknowledged that their concerns didn’t make sense from a scientific perspective, but culturally they did. Williams emphasized the need to break the cycle of distrust that prevents solving the health disparities affecting Black people and other minority groups. While he believes the healthcare community needs to make amends to communities of color, he has yet
to see bold and ambitious initiatives beyond the immediacy of the current push for the COVID-19 vaccinations. He is encouraging us to attack the problem instead of just managing the symptoms. To Williams and everyone within the communities served by UChicago Medicine, we are prepared to earn your trust and partner with you on your health and wellness, including COVID-19 vaccinations. We know that it is up to us as medical care providers to think bigger than this moment. We are connecting with community organizations and other stakeholders on ways to better reach the people we serve and address their concerns, as we continue to follow the city’s guidance on a broader vaccination plan.* If you have ideas to share with us, please let us know. The best solutions are reached when we arrive at them collectively. In the meantime, may you and your family have a healthy start to 2021. We are here to support you.
* Vaccination information may have changed since this magazine went to press in late January.
We know that it is up to us as medical care providers to think bigger than this moment. We are connecting with community organizations and other stakeholders on ways to better reach the people we serve and address their concerns. If you have ideas to share with us, please let us know.” NELSON MANDELA
Senior Vice President, Chief Communications and Marketing Officer: William “Skip” Hidlay
The Forefront magazine features stories about life-changing care and breakthroughs in medical research at the University of Chicago Medicine and Biological Sciences. Kenneth S. Polonsky, MD Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine and Executive Vice President for Biology and Medicine Thomas E. Jackiewicz President of the University of Chicago Medical Center
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suggestions. If you have medical problems or concerns, contact
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a physician, who will determine your treatment. Do not delay seeking medical advice because of something you read here. For urgent needs, call 911 right away.
The Forefront
SPRING 2021 IN THIS ISSUE
ON THE COVER
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LIFELONG CARE When a schoolteacher’s liver started to fail, her younger brother stepped up to donate part of his.
Cover photo by Nancy Wong
Minimally invasive techniques for living donor organ donation, including a nearly scarless procedure for kidney donors.
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Center for Adults with Congenital Heart Disease bridges gap between pediatric and adult heart care.
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Kitzia Ayala-Avila
HEALTH RESTORED
New medication helps Kitzia Ayala-Avila manage a rare neurological disease.
READ ONLINE COVID-19 UPDATES Get the latest advice on how to stay safe. Learn about vaccine trials, treatments and research.
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READY TO RECOVER Behavioral health program offers holistic approach to sobriety.
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SHEDDING LIGHT ON HAIR LOSS
Causes and solutions for women with thinning hair. Our ophthalmologist weighs in on the trend.
Proud to be a national leader in patient safety We thank our physicians, nurses and caregivers for helping the University of Chicago Medicine achieve its 18th consecutive A grade in patient safety from prestigious industry watchdog the Leapfrog Group. We are one of only 29 organizations in the country with this record.
UChicagoMedicine.org
OUR ‘TOP DOCS’ Olatoyosi Odenike, MD, is one of 36 University of Chicago Medicine cancer specialists on the “Top Doctors” list in the January 2021 issue of Chicago magazine. A total of 111 UChicago Medicine physicians in primary care and a variety of medical specialties — including dermatology, digestive diseases, pulmonology, endocrinology and neurology — are on the list.
MAKING MEDICAL SCRIBES COST EFFECTIVE
Patients and doctors alike benefit when their visits include a medical scribe helping with the paperwork. Employing scribes frees up time for two or three additional patients daily, which can cover the cost of a scribe program, according to a University of Chicago Medicine study. Researchers concluded that scribes are a cost-effective solution to the increasing requirements for electronic health records, a burden contributing to physician burnout. “Patients gain increased access, and doctors can focus on thinking, talking and listening, and not on typing and clicking and ordering,” said internist Neda Laiteerapong, MD, who led the study published in Annals of Internal Medicine.
IMPROVING PATIENTS’ ACCESS TO VIRTUAL VISITS
Doctor visits via phone or video may have seemed futuristic not long ago, but these virtual visits got a big boost from COVID-19 lockdowns and are likely here to stay. From midMarch to the end of May, 60% of visits to the University of Chicago Medicine were virtual. Of those 50,000 visits, 60% were by video and 40% were by phone. When examining use of virtual visits by demographics, the research team found that phone visits (as compared to video visits) were more likely to be used by older patients, Black patients and patients with Medicare and Medicaid (as opposed to commercial) insurance. As a result of these findings, the team offered a number of policy recommendations, including equal reimbursements for video and telephone visits, and universal broadband to address the digital divide. “Our research suggests that if insurance doesn’t cover telephone visits going forward, many patients will not have the same access to healthcare,” said Sachin Shah, MD, Associate Chief Medical Information Officer and senior author of the study published in the journal JMIR Medical Informatics.
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PROMISING TREATMENT SLOWS KIDNEY DISEASE
A new medication can slow chronic kidney disease (CKD) in patients with type 2 diabetes while reducing cardiovascular risk. “This promising therapy means patients could delay dialysis and the possible need for kidney transplants,” said George Bakris, MD, Director of the American Heart Association Comprehensive Hypertension Center at the University of Chicago Medicine. Bakris led the largest-ever CKD progression research effort into diabetic kidney disease, a disease that affects millions of people in the U.S. and is the leading cause of kidney failure. The study of the medication finerenone, which is not yet approved by the FDA, involved 5,700 patients at 1,000 sites in 48 countries. Findings were published in the New England Journal of Medicine and presented at the American Society of Nephrology’s Kidney Week 2020 conference.
Is too much you hoarse?
Zooming making
Life during the COVID-19 pandemic may be contributing to an unexpected health issue: voice problems. Specialists at the University of Chicago Medicine’s Voice Center are seeing more patients with functional voice problems, which may be related to changes in the way they use their voices while talking on Zoom, wearing masks and social distancing. Those affected may include teachers and others whose jobs require them to talk all day and healthcare professionals who must wear thicker N95 masks. In patients with existing voice problems, added vocal tension (also referred to as muscle tension dysphonia) in the larynx can cause a hoarse voice and occasionally even throat pain or other issues.
necessary for people to hear them, especially when they’re standing farther away than normal due to social distancing. While these COVID-19 safety measures are essential, they might require patients with pre-existing voice problems to take extra precautions.
“It’s not just one thing that causes a voice problem,” said UChicago Medicine speech-language pathologist Sweta Soni, MA, CCC-SLP. “It’s usually a mixture of things, and masks and video calls are likely contributing factors.”
“Stress can impact voice, too. So, all of the stress surrounding the pandemic may cause people to tighten the muscles of their throat when they speak, which may further enhance problems related to their voice,” Soni said.
UChicago Medicine laryngeal surgeon Brandon Baird, MD, Director of the Voice Center, noted that some of the increased tension may be related to increasing vocal effort because of inconsistent quality of teleconferencing microphones and speakers. This can cause people to overcompensate with their voice and speak louder than normal.
Treatments plus a full line of voice services are available at UChicago Medicine’s Voice Center. The center is staffed by specialists in such areas as laryngology, neurological voice disorders, muscle tension vocal problems, chronic coughing and swallowing disorders. The Voice Center’s comprehensive approach to care allows the patient to meet with both the physician and speech therapist during the same visit, reducing the total number of visits.
“We are seeing more patients who have a lot of Zoom commitments, especially those with known underlying muscle strain, come in with an exacerbation of their existing issues, or issues that they didn’t have before,” Baird said. “Additionally, we are seeing more people who have to push extra hard to be heard because the mask is muffling them.” Masks eliminate the visual cues people typically get from mouth movement. People might raise their voices thinking it’s
“It streamlines the process,” Soni said. “We work as a team to evaluate the various factors that can be contributing to the voice problem, discuss the findings with the patient and determine a personalized treatment plan.”
LEARN MORE
UChicagoMedicine.org/voice
Voice-saving tips from the voice experts at the University of Chicago Medicine: »S tay hydrated to reduce throat irritation. » Take short breaks between meetings. »P ay attention to how you are using your voice, and try to speak at a comfortable volume. »S ee a physician if your voice is persistently scratchy, strained or hoarse, or if you are feeling lasting discomfort and pain.
| A B O V E | Laryngeal surgeon and voice
specialist Brandon Baird, MD, sees patients at UChicago Medicine’s River East and Hyde Park locations.
MAKE AN APPOINTMENT
1-888-824-0200
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What you need to know about COVID-19 vaccines Each year, vaccines protect us from at least 20 diseases and save up to 3 million lives. When we get vaccinated, we aren’t just protecting ourselves, but also those around us. Some people are unable to receive certain vaccines. They depend on the rest of us to get vaccinated to help protect them and reduce the spread of disease.
of people before expanding to include much larger numbers — tens of thousands — making sure to include a wide range of people from across the country and around the world.
Thanks to emergency use authorization from the U.S. Food and Drug Administration, we now have vaccines to protect us from COVID-19. Here is what you need to know about the first two COVID-19 vaccines, developed by PfizerBioNTech and Moderna.
An interim independent analysis reported the Pfizer-BioNTech vaccine to be 95% effective after two doses. The Moderna vaccine was reported to be 94.1% effective after two doses.
HOW WAS THE COVID-19 VACCINE DEVELOPED SO QUICKLY?
Typically, it takes years to develop vaccines, assure their safety and effectiveness (known as efficacy), and then manufacture them on a mass scale. However, to quickly address the COVID-19 pandemic, the timeline was accelerated through national and international programs supporting the work of scientists around the globe, including teams at the University of Chicago Medicine. The accelerated research and development process allowed scientists to perform many steps simultaneously rather than sequentially. The federal effort also provided funding to support the work of pharmaceutical companies to begin manufacturing vaccines before they are approved — allowing for quick distribution if a vaccine earns FDA authorization. WHO WAS INCLUDED IN THE VACCINE TRIALS?
Scientists tested the vaccines during clinical trials to make sure each immunization met or exceeded established safety and efficacy thresholds. Trials began with small groups
HOW EFFECTIVE IS THE COVID-19 VACCINE?
HOW SAFE IS THE COVID-19 VACCINE?
Only vaccines that meet standards for safety and efficacy are approved for emergency use by the FDA. Any approved COVID-19 vaccine is tested in a trial of at least 30,000 volunteers and reviewed to make sure it is safe. Like any medical therapy, vaccination is accompanied by some degree of risk. However, the reported potential risks and side effects of a COVID-19 vaccine are substantially lower than the risks and side effects associated with contracting COVID-19. WHAT ARE THE POTENTIAL VACCINE SIDE EFFECTS?
Many vaccines have mild side effects, which usually range from soreness at the site of injection to a slight fever, body aches and a headache; some people have no reaction at all. After receiving the Pfizer-BioNTech vaccine, trial participants commonly felt injection site pain. That was followed by fatigue and a mild to moderate headache. Other reported side effects included fever, chills, muscle pain, joint pain and swollen lymph nodes. Side effects were more commonly seen in people under the age of 65. Side effects also were slightly more
likely to occur after the second dose. They typically peaked within two days and were completely over within seven days. Early data from Moderna’s clinical trial also showed typical mild to moderate side effects, such as headaches, fatigue, muscle aches, chills and injection site pain. Severe side effects included fatigue in 9.7% of participants, muscle pain in 8.9%, joint pain in 5.2% and headache in 4.5%. Reactions typically occurred within one to two days of receiving the vaccine and were all resolved within seven days. CAN YOU GET COVID-19 FROM THE VACCINE? CAN IT CAUSE A FALSEPOSITIVE TEST RESULT?
No, it is not possible to get COVID-19 from this vaccine, and it won’t produce a positive COVID-19 test result. You may feel unwell after getting vaccinated, but this is a sign of your immune system starting to activate to protect you.
Information in this story was up to date as of January 2021. For recent updates to frequently asked questions about the COVID-19 vaccines, visit UChicagoMedicine.org/vaccineFAQ. 4 » THE UNIVERSITY OF CHICAGO MEDICINE
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Demystifying vaccines UChicago Medicine science writer Alison Caldwell, PhD, explains how vaccines work, different types of vaccines, and how vaccines are made and approved: UChicagoMedicine.org/vaccine-videos
a matter of days, the mRNA from the vaccine is destroyed by our cells, leaving no permanent mark in our bodies. Other potential vaccines are currently in development, such as those being tested by Janssen Pharmaceuticals of Johnson & Johnson and AstraZeneca. These candidates use a viral vector instead of mRNA to present a genetic blueprint of the virus’s spike protein to your immune system to generate an immune response. As of January 15, 2021, no non-mRNA vaccine candidates had yet been approved by the FDA. CAN I STILL GET COVID-19 AFTER BEING VACCINATED?
WILL THE COVID-19 VACCINE ALTER MY DNA? WHAT IS AN MRNA VACCINE?
No, the COVID-19 vaccine will not alter your DNA. It also does not enter the nucleus of your cells. The COVID-19 vaccine is an mRNA vaccine. While this is the first mRNA vaccine, it uses a technology that scientists have been perfecting for decades. In our bodies, our naturally created mRNA — or messenger RNA — delivers recipes to our cells on how to make specific proteins. An mRNA vaccine capitalizes on that process using laboratory-developed mRNA with information on how to defeat a virus. In this case, the COVID-19 vaccine delivers a blueprint to your cells on how to make the spike protein, an essential piece of the COVID-19 virus. The spike protein serves as a wanted poster, telling your body to be on the lookout for the virus and to develop an immune response to defeat it. Then, your natural cell processes take over. After receiving both doses of the vaccine, your body will be prepared to identify and attack the SARS-CoV-2 virus, if it ever enters your system. And, within
Yes, it’s still possible for you to contract COVID-19, even after receiving the vaccine. No vaccine is 100% effective. However, your chances are much lower, and researchers believe you may be less likely to get as sick as you would if you were unvaccinated. HOW LONG WILL IT TAKE FOR THE VACCINE TO START PROTECTING ME?
The vaccine immediately begins teaching your immune system what to look for to protect you against COVID-19. However, the amount of time it takes to gain full immunity to the virus will depend on what vaccine you receive. Generally, you should be protected about 14 days after you receive your second dose of the vaccine. HOW MANY DOSES OF THE COVID-19 VACCINE WILL BE NEEDED?
The Pfizer-BioNTech vaccine requires two doses, which are given three weeks apart. The Moderna vaccine also requires two doses, which are given four weeks apart. Not taking the second injection could leave you unprotected.
HOW LONG WILL I BE PROTECTED BY THE VACCINE? WILL I NEED TO GET VACCINATED MULTIPLE TIMES OVER MY LIFETIME?
We don’t know how long immunity to COVID-19 will last. Some vaccines produce a lifetime of immunity, but others — like the annual flu shot — require regular immunizations to provide continued protection. WILL I NEED TO WEAR A MASK AND FOLLOW OTHER RESTRICTIONS AFTER I GET VACCINATED?
Yes, you will still need to wear a mask after you’re vaccinated. It will take months for the majority of people to be vaccinated. It is also possible for people who have been vaccinated to still act as carriers for the virus. People will need to wear masks, practice social distancing, wash their hands and take other precautions until we’ve reached herd immunity. That occurs when a large portion of the population is vaccinated, making it difficult for infectious diseases to spread because there are not many people who can be infected. Herd immunity works only if most people are vaccinated.
How do vaccines work? Vaccines reduce the risk of getting a disease by working with your body’s natural defenses to build protection. When you get a vaccine, your immune system typically responds by: »R ecognizing the invading germ, such as a virus or bacteria. »P roducing antibodies. Antibodies are proteins produced naturally by the immune system to fight disease. »R emembering the disease and how to fight it. If you are exposed to the germ in the future, your immune system can destroy it before you become unwell.
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ASK T HE E XPE R TS
Does my child have IBS or IBD? Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) both affect the intestines. But while their names sound similar, the conditions are distinctly different. Pediatric gastroenterologist Marc Elias, MD, answers questions about IBS and IBD in kids, and stresses the importance of getting an accurate diagnosis to ensure appropriate care and treatment.
HOW IS IBD DIAGNOSED?
Evidence of inflammation caused by IBD can be seen through an endoscopy, which is a nonsurgical procedure that examines and evaluates the digestive tract. Other exams used to screen for pediatric IBD include blood tests, imaging (X-ray and MRI), and stool studies. HOW ARE IBS AND IBD TREATED IN CHILDREN?
WHAT’S THE DIFFERENCE BETWEEN IBS AND IBD?
IBS is a common problem that happens when digested food does not move smoothly (either too fast or too slow) through the large intestine. This can “irritate” the intestines and cause discomfort or even severe pain.
Treatment options for children with IBS include dietary changes and avoiding
IBD is a chronic condition that causes swelling, redness and bleeding in parts of the intestine (bowel). This inflammation can permanently damage the gastrointestinal tract. There are two kinds of IBD: ulcerative colitis and Crohn’s disease. We don’t know the exact cause of IBD, but scientists believe it involves an interaction between genes, the immune system and environmental factors. WHAT CAUSES IBS?
IBS can occur when the bowel is sensitive to specific foods or other triggers like stress. Symptoms include stomach pain, cramping, gas, bloating, trouble sleeping, fatigue, and constipation and/or diarrhea. IBS does not cause inflammation or any visible changes in the digestive tract.
MARC ELIAS, MD
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known triggers when possible. Stress management to ease flare-ups and medicine are also treatment options for pediatric IBS that should be discussed with a healthcare provider. For children with IBD, we first recommend changes in their diet and prescribe medicine to reduce inflammation and prevent infection. In some cases, surgery may be necessary. Removal of the large intestine can cure ulcerative colitis. Crohn’s disease cannot be cured, but surgery to remove parts of the intestine may help lessen symptoms.
IBS IBSvs vs. . IBD IBD • • • •
IBS S IBS S Symptoms Symptoms
Gas • Gas Bloating • Bloating Trouble sleeping • Trouble sleeping Constipation • Constipation
MaiM naDiniffDeirfe fenrcee n:ce: • No visible changes • No visible changes seen in examination seen in examination
• • • •
Symptoms Symptoms Both BothShare Share
pain •Abdominal Abdominal pain •Diarrhea Diarrhea •Cramping Cramping Fatigue • Fatigue
IBD IBD Symptoms Symptoms
• Fever • Fever • Blood in the stool • Blood in the stool • Anemia • Anemia •• Weight Weightloss loss
Main MainDDififffeerreenncceess:: •• Visible Visibleinflammation inflammation ininexamination examination •• Can Canget getprogressively progressively worse worse •• Risk Riskof ofsurgery surgery and andhospitalization hospitalization
PEDIATRIC GASTROENTEROLOGY LOCATIONS
ComerChildrens.org ComerChildrens.org Flossmoor Hyde Park
For appointments, call 1-773-702-6169. For appointments, Merrillville, Indiana South Loop call 1-773-702-6169. Little Village
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Naperville
ComerChildrens.org For appointments, call 1-773-702-6169.
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Saving his sister In April 2019, Kristen Batkiewicz’s husband, parents and siblings gathered in a conference room at the University of Chicago Medicine for an update on her health. Her liver was failing, but because she was otherwise healthy, the 37-year-old sixth-grade teacher was not high on the waiting list for a new organ. Liver disease specialist Helen Te, MD, and transplant surgeon Diego di Sabato, MD, explained that if Kristen’s health declined during a long wait for a donor, the odds of a successful transplant would be lower. A living donation from a relative or friend could save her life. Kristen resisted the idea of a family member or friend donating part of a liver. “It’s not like you are asking for a simple favor or to borrow something,” she said. “You are asking someone to undergo major surgery and recovery for you.” Several relatives and friends volunteered to be tested as potential donors. GIVING A ‘SECOND CHANCE TO LIVE’
More than 13,000 people are on the waiting list for a new liver in this country. Because the need for donor organs far exceeds the number of livers available for transplant, about 1,500 Americans die each year while waiting. A living donation is another transplant option for patients with severe liver disease. Due to the liver’s unique ability to grow back, a living donor can safely give a part of his or her healthy liver to a family member, friend or even a stranger. “To be a living organ donor, you need to be a brave person with a big heart,” di Sabato said. “You can give someone who is suffering, or close to death, a second chance to live.” DECIDING TO DONATE
Kristen’s younger brother, Jason Korkosz, met the preliminary criteria — matching blood type, between the ages of 18 and 55, and healthy — to be her donor. Jason had watched his sister’s health worsen over several years as a result of primary sclerosing cholangitis. This progressive disease causes inflammation and scarring of the bile ducts, which carry digestive fluids from the liver to the gallbladder. Over time, bile builds up and damages the liver, eventually causing it to fail. “Kristen was in and out of the hospital every two to three months,”
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Jason Korkosz and Kristen Batkiewicz
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Jason said. “Her quality of life was not good.” He underwent imaging tests to assess the quality of his liver. He also met with members of the liver transplant team to rule out any potential barriers — medical, surgical, psychological or social — that would preclude him from being a living donor. The high school physical education teacher and football coach was deemed a perfect candidate. Jason, who considers himself a careful person, weighed the potential complications of the surgery, which are similar to the risks associated with any major surgery. “Then I thought about my sister and her young daughter,” he said. “I made my decision and that was it.” SEPARATE BUT TOGETHER
Just before their surgeries, Kristen told Jason that she wasn’t afraid, just excited to start a better life. “I have never witnessed someone so brave,” he said. Kristen gave her brother one of their grandfather’s Army ribbons, which he had given to her as she struggled with being so sick. “He deserves to have it back, because he is the hero,” she said. On the morning of October 29, 2019, the siblings from the Southwest suburbs hugged before Jason was taken into the operating room. Liver transplant surgeon Talia Baker, MD, and di Sabato performed the surgery to remove the right lobe of his liver — about two-thirds of the organ. The two-step “hybrid” procedure combined a minimally invasive laparoscopic technique with open surgery to reduce postoperative pain, risk of complications and recovery time. In an operating room down the hall,
| A B O V E | Kristen and Jason
just before their surgeries at UChicago Medicine.
| R I G H T | Kristen gives her
baby brother a hug.
transplant surgeons John Fung, MD, PhD, and Dympna Kelly, MD, removed Kristen’s diseased liver and replaced it with Jason’s healthy lobe. The two patients recovered from surgery on the same floor of the hospital, but at opposite ends. “The transplant team did this intentionally so we had to walk to see each other,” Kristen said. “Jason came to my room often to check on me and encourage me. We watched lots of football and Netflix shows together.” Both reported feeling much better by the end of 2019. Jason went back to work in January. By that time, his liver had grown back to 90% of its original size. Kristen,
who had taken a medical leave for the school year, is now teaching again, remotely due to COVID-19. Kristen didn’t realize how sick she had been until after the transplant. “Chronic pain and fatigue had become my norm,” she said. “With a new liver, I felt healthy and energized for the first time in a long time. “To say UChicago Medicine is at the forefront of medicine is an understatement. I’ve had many serious issues with this disease, and each time my medical team was available and ready with an answer — in this case with the living donor liver transplant that saved my life. I will be forever grateful.”
In 1989, UChicago Medicine performed the first living donor liver transplant in the U.S., the first successful transplant of its kind in the world. DIEGO DI SABATO, MD
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ASK T HE E XPE R T
What to know about living organ donation Where to find us for transplant consultations
Each year, far more patients need a new liver or kidney than there are organ donors. One way to increase the number of possible transplants is through living donation. Rolf Barth, MD, transplant surgeon and Associate Director of the Transplant Institute at the University of Chicago Medicine, answers questions about living donation and how advanced technology has made the surgery safer for the donor.
Chicago | Kidney and Liver Duchossois Center for Advanced Medicine (DCAM) 5758 S. Maryland Ave., 2F ROLF BARTH, MD
Chicago | Liver
WHY ARE LIVING KIDNEY AND LIVER
ARE THERE RISKS TO LIVING
River East
DONATIONS DESIRABLE?
DONATION SURGERY?
355 E. Grand Ave.
Unlike a heart or lung, a liver segment or kidney can be donated by a healthy, living donor. This essentially eliminates any time on the waiting list. (For kidney transplantation, wait times for donor organs can exceed six years.) When an organ or segment of an organ is removed from a living donor, it is given to the recipient within hours, resulting in immediate function, fewer complications and significantly shorter hospital stays. These organs, especially kidneys, appear to last two to three times longer than organs from deceased donors. So, no waiting, better surgical results and a longer-lasting transplanted organ.
As with any major surgery, organ donation surgery has minor risks of complications such as bleeding, infection or issues with the incision. A team of surgeons, physicians and independent donor advocates focuses only on donor safety, without bias or influence from the recipient’s transplant team.
Hinsdale | Liver
WHAT IS INVOLVED IN THE LIVING DONOR EVALUATION PROCESS?
A potential living donor goes through a detailed evaluation, including blood tests, imaging studies such as CT scans and X-rays, and meetings with the transplant team. These tests and consultations help us determine if the individual can safely become a living donor and rule out any barriers that would prevent them from donating. Safety is always the primary concern.
Hinsdale | Kidney 12 Salt Creek Lane Salt Creek Suite 106
Flossmoor | Kidney and Liver 19550 Governors Hwy.
HOW DOES UCHICAGO MEDICINE MAKE SURGERY SAFER FOR LIVING
For more information, contact
ORGAN DONORS?
our living donor intake coordinator
Our transplant surgeons use the most advanced techniques to procure the organ from the donor. When removing a portion of a healthy liver, we use a hybrid approach: the first step in the operation is done laparoscopically with smaller incisions, followed by an open surgery. We offer two types of kidney donation (nephrectomy) procedures: laparoscopic or robotic with three small incisions and a larger incision for organ removal, and a nearly scarless approach with only one small incision hidden in the belly button. These minimally invasive techniques reduce pain and shorten the hospital stay and overall recovery time.
Transplant surgeon Rolf Barth, MD, pioneered the nearly scarless donor nephrectomy (kidney removal) and has performed this minimally invasive surgery more than 500 times. 10 Âť THE UNIVERSITY OF CHICAGO MEDICINE
911 N. Elm St., Suite 128
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at 773-702-0620 or living.donor@ uchospitals.edu.
Fill out a living donor questionnaire:
UChicagoMedicine.org/donorquestionnaire
Expert care for adults born with heart defects More than 1 million adults are living with congenital heart disease (CHD) in the U.S. While most patients do well, many remain at risk for late complications and need lifelong follow-up and care. The goal is to identify and treat problems early, before they become serious and life-threatening. Michael G. Earing, MD, is Chief of Pediatric Cardiology at the University of Chicago Medicine Comer Children’s Hospital and Medical Director of the Center for Adults with Congenital Heart Disease. He’s treated more than 3,000 adult CHD patients during his nearly two decades working in the field. WHAT IS CONGENITAL HEART DISEASE?
It’s the most common birth defect in the country, affecting one out of every 100 children. Most commonly, it’s characterized by the abnormal formation of the chambers of the heart, valves, or the blood vessels entering or leaving the heart.
WHY GO TO AN ADULT CONGENITAL HEART DISEASE SPECIALIST, RATHER THAN JUST A CARDIOLOGIST?
Adult cardiologists receive less than one month of training in caring for patients with CHD. Similarly, pediatric cardiologists, while well-versed in CHD, lack training in common adult issues, such as pregnancy, hypertension, coronary artery disease and obstructive sleep apnea. The field of adult congenital heart disease bridges this knowledge gap between pediatric cardiology and adult cardiovascular medicine. WHAT COMPLICATIONS CAN ADULTS WITH CONGENITAL HEART DISEASE HAVE?
Late complications include abnormal heart rhythms, both fast and slow; heart failure; leaky valves; tight valves; and blood vessel issues. Some patients will need repeat surgical or catheter-based interventions, and a few may even need a heart transplant. Women with CHD can be at increased risk
WHY IS TREATING ADULTS WITH CONGENITAL HEART DISEASE AN EMERGING AREA OF MEDICINE?
Forty years ago, only 10% of children with CHD survived to adulthood. Now, thanks to advances in medicine, 90% will survive. Unfortunately, the number of specialists trained to take care of this growing group of patients is few.
for complications during pregnancy and need close monitoring to make sure the mom and baby are healthy. Patients with CHD may also have issues with their kidneys, liver and lungs; varicose veins; or neurocognitive issues. Adult congenital heart disease programs are designed to address all of these needs. Most children with CHD get regular follow-up care, but when they transition to adulthood, there is increased risk that they stop seeking regular cardiac care. We have developed a transition program that prepares young adults to manage their CHD on their own. While still under the supervision of their parents, the program teaches them about their condition, the importance of follow-up care, the risk for late complications and other issues. WHAT IS ON THE HORIZON FOR CONGENITAL HEART DISEASE?
We’re doing a lot of research, with multiple clinical trials being launched. We work closely with our heart transplant and heart failure colleagues, and we’re one of the key sites for the Alliance for Adult Research in Congenital Cardiology, the largest multicenter research group dedicated to research on adults with CHD. We’re also exploring some new minimally invasive techniques to avoid future surgeries and have better outcomes.
MICHAEL G. EARING, MD
Some of the country’s top congenital
treatment from infancy through
Chicago-area collaboration that
heart disease experts and researchers
adulthood. The goal is to provide
merges resources and expertise
have teamed up to form the University
better outcomes, make care more
from UChicago Medicine, Advocate
of Chicago Medicine’s new Center for
cost effective, and advance the field
Children’s Hospital and NorthShore
Adults with Congenital Heart Disease.
through research, education and
University HealthSystem.
The center is an important bridge
treatments.
LEARN MORE
between pediatric and adult care,
The center is part of the Chicagoland
allowing patients to receive expert
Children’s Health Alliance, a unique
UChicagoMedicine.org/CHDadults
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Kitzia Ayala-Avila
Clinical trial gives young woman ‘my normal life back’ New drug treats rare autoimmune disorder that affects the eyes and spinal cord Kitzia Ayala-Avila was a freshman in high school when she started to experience weakness, hot and cold sensations in her hands and feet, and numbness and sensitivity in other parts of her body. The troubling symptoms seemed to come on overnight. “They got worse and affected my concentration in school and my ability to sleep,” said Ayala-Avila, 28, of South Elgin. “My whole life changed.” She was diagnosed with a central nervous system disorder called neuromyelitis optica (NMO). This rare disease occurs when the body’s own immune system attacks the spinal cord and the optic nerves of the eyes, in most cases. Some of the symptoms can be reversible, but most flare-ups are severe, often leading to significant visual impairments and weakness of the limbs or even blindness and paralysis. Only a handful of neurologists in this country have experience and expertise in treating patients with NMO. More than 90% of NMO patients are women, and the
12 » THE UNIVERSITY OF CHICAGO MEDICINE
autoimmune disorder disproportionately affects Black, Asians and Latinx populations.
participate in a clinical trial testing a new therapy for NMO.”
Ayala-Avila’s diligent and determined mother’s research eventually led her to University of Chicago Medicine neurologist Adil Javed, MD, PhD, an expert in autoimmune diseases of the brain and spine, including NMO and multiple sclerosis (MS).
Ayala-Avila agreed and began receiving a monthly injection of a then-experimental drug, a monoclonal antibody called Enspryng (satralizumab), in 2015.
“The inflammation in NMO is intense, much more so than in other autoimmune inflammatory diseases, such as MS,” Javed said. “We don’t know the exact cause of NMO. There is an interplay between genetically programmed autoreactive immune cells and some environmental trigger — the exact nature of the latter remains elusive at this time.” Once the disease is triggered, it usually progresses fairly quickly. A patient can go from having blurred vision to blindness in a few days, or sometimes in as little as a few hours. Ayala-Avila’s symptoms progressed more slowly, which can happen occasionally. “When she first came to me, she was not responding to the currently available treatments,” Javed said. “So I suggested she
The Forefront | S P R I N G 2 0 2 1
“The medication works by blocking the inflammatory cascade and quiescing the immune system,” Javed explained. “So, there’s mitigation of ongoing inflammation, and the potential for future inflammatory attacks is decreased.” Results of the trial showed as much as a 78% reduction in NMO flare-ups. Enspryng was approved by the U.S. Food and Drug Administration in August 2020. “I have not relapsed since 2015,” said Ayala-Avila, who works as a patient navigator at a clinic. “It’s given me my normal life back and I am able to live day to day without worrying about getting sick.” Javed praises Ayala-Avila and the other patients in the trial for their role in the successful development of the new drug. “We owe them a lot of gratitude for participating and making treatment better for future generations,” he said.
Research offers hope for patients with multiple sclerosis and other neurological disorders Multiple sclerosis (MS) is a chronic autoimmune disease of the brain and spinal cord. MS causes a person’s immune system to damage the protective covering of nerves. This leads to interruptions of the nerve impulses that travel to and from the brain and spinal cord. Symptoms can be unpredictable and erratic and range from mild to severe. University of Chicago Medicine neurologist Adil Javed, MD, PhD, an expert in the diagnosis and treatment of MS, explains the importance of clinical trials in bringing about the life-transforming therapies that have slowed progression of the disease and reduced the severity of symptoms. He is a principal investigator in many MS and neuromyelitis optica (NMO) clinical trials. His translational research interests include analyzing brain pathology using new and advanced magnetic resonance imaging techniques. WHEN DID UCHICAGO MEDICINE START CONDUCTING MULTIPLE SCLEROSIS
WHAT ARE THE BENEFITS OF CLINICAL TRIALS?
When a medication has worked in a phase 3 trial, you can tell patients with confidence that it has been proven to be effective and what the magnitude of effectiveness is. In addition, clinical trials are important for determining side effects. If there are concerns, we know how to follow the laboratory abnormalities and other clinical signs and symptoms of adverse effects. HOW SAFE IS A CLINICAL TRIAL?
A placebo-controlled trial has built in protections. For one thing, the randomization is not 50-50. There is usually a two-fold greater chance that someone is getting the drug. If the patient has active disease during the trial, then the blinding is broken and the patient is switched from the placebo to the active arm. We watch trial patients very closely and they can see us very rapidly.
component of MS. In fact, two drugs — Kesimpta and Zeposia — were approved this year and others are in the pipeline. Repairing the nerves is the next frontier in MS care. We are part of this effort.
LIVE AT T H E F O R E F R O N T
Watch multiple sclerosis experts Anthony Reder, MD, and Adil Javed, MD, PhD, talk about treatments and research. UChicagoMedicine.org/MS-Live
WHAT ARE SOME OF THE LATEST ADVANCES MADE IN TREATING
CLINICAL TRIALS?
MULTIPLE SCLEROSIS?
We have been doing trials for MS and related autoimmune diseases of the central nervous system since the late 1980s. In fact, UChicago Medicine has been a site for testing most of the approved drugs for MS.
There have been a lot of strides in getting better and safer drugs for the inflammatory
Where to find MS care Hyde Park Duchossois Center for Advanced Medicine (DCAM) 5758 S. Maryland Ave. Orland Park 14290 S. La Grange Road Call 1-888-824-0200 to make an appointment.
ADIL JAVED, MD, PHD
Learn more about MS clinical trials at UChicago Medicine UChicagoMedicine.org/MS-clinical-trials
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Alcoholism Prescription:
re Mind, body, social ca to reach sobriety
Drinking alcohol is socially acceptable behavior, easily accessible and somewhat affordable. When alcohol is abused, however, it may result in serious mental and physical health consequences. UChicago Medicine Ingalls Memorial’s Behavioral Health Department offers help for those who struggle with their alcohol use. Addiction specialist Joseph Beck, MD, discusses alcohol use disorder and recovery.
Addiction recovery at Ingalls Memorial features a holistic approach, meaning mental, physical and environmental factors are considered in every treatment plan. This includes psychiatric and medical detox assistance, therapeutic counseling, nursing, peer support and coping skills to control one’s behavior and improve quality of life.
WHAT IS AN ALCOHOL USE
As a psychiatrist and addictions specialist, I join my colleagues in offering this whole body, mind and environment treatment approach. We address biologic-psychosocial elements of alcohol use during treatment. We are here to facilitate change in behavior and reduce harm to a person’s physical and mental health and lifestyle.
DISORDER?
A person with an alcohol use disorder uses alcohol in a repetitive compulsive pattern, regardless of consequences. The consequences can include disruption of work, relationships and even loss of life. Over the last year, clinicians across the country have reported an increase in new mental health and alcohol use disorder cases related to the pandemic. The many stressors of 2020 — in addition to normal work and family struggles — have intensified the stress that problem drinkers already experience.
THE RECOVERY JOURNEY
Our experts are committed to providing clinical care, education and research in the field of addiction prevention, treatment and recovery, and to design effective rehabilitative care that is personalized to meet the needs of each patient and co-treated with any existing mental health issues.
People with alcohol use disorders are typically unable to stop drinking by themselves, and even functional alcoholics — those who hold a job, raise a family and participate in a seemingly normal lifestyle while abusing alcohol — at some point experience relationship issues, legal or law enforcement problems, and financial and health consequences. JOSEPH BECK, MD
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The Forefront | S P R I N G 2 0 2 1
Treatment options include medically monitored intensive and partial inpatient care, medically managed inpatient detox, day treatment, and extended outpatient rehabilitation to help patients achieve and maintain sobriety. Even during the pandemic, most of Ingalls Memorial’s behavioral health programs have been considered essential to recovery and have remained open with both staff and patients strictly following COVID-19 safety guidelines like social distancing, masking and hand hygiene. Virtual visits and counseling offer another avenue for patients to receive the care they need. Despite the success of telehealth, patients recovering from addiction appreciate the ability to share coping techniques through socially distant in-person, small group sessions on how to manage stress, identify high-risk behaviors and lower the risk of relapse. Ingalls Memorial has a trained mental health professional available 24 hours a day, seven days a week to offer a no-cost, confidential assessment and referral for behavioral health care. Call 708-915-6411 or visit UChicagoMedicine.org/ mental-health. Joseph Beck, MD, is a UChicago Medicine Medical Group physician. UChicago Medicine Medical Group physicians are not employees or agents of the University of Chicago Medical Center, UChicago Medicine, UChicago Medicine Ingalls Memorial or the University of Chicago.
Thinning hair? Experts on women’s hair loss discuss causes and treatments While some hair shedding is normal, it’s important for women who are losing an excessive amount of hair to understand why it is happening, how to prevent further hair loss and how to treat it.
increase in the number of people with telogen effluvium who suddenly started losing clumps of hair. Stress shedding starts two to four months after a stressful event and can last anywhere from two months to two years. Eventually the shedding improves on its own, but it is often distressing.
Dermatologist and hair loss expert Victoria Barbosa, MD, MPH, leads the hair loss program at the University of Chicago Medicine’s Center for Women’s Integrated Health. Her expertise includes managing hair issues specifically affecting Black women. Obstetrician-gynecologist Monica Christmas, MD, is an expert on menopause and hormonal changes that can contribute to hair loss.
LOSS?
WHAT CAUSES HAIR LOSS?
Hair loss, or alopecia, is often caused by a combination of factors. The most common causes of sudden rapid hair loss, or telogen effluvium, are stress and fluctuating hormones, especially after pregnancy. Hair might also fall out after a major illness or injury. The shedding usually doesn’t happen until a few months later, regardless of the trigger. Female pattern hair loss, which typically begins with thinning of hair at the part, is hereditary. It’s more prevalent after menopause because hormones play a role. Some hairstyling techniques and products can lead to hair loss. So can certain medications, other scalp diseases or a poor diet with nutritional deficiencies. Hair loss is sometimes tied to underlying health conditions, such as thyroid disorders, anemia and autoimmune disease. CAN STRESS MAKE IT WORSE?
Yes. Physical or emotional stress can contribute to hair loss. In 2020, we all had a lot of emotional stress, and we saw a huge
VICTORIA BARBOSA, MD, MPH
DO CHEMICALS AND CERTAIN HAIRSTYLES CONTRIBUTE TO HAIR MONICA CHRISTMAS, MD
Yes. Relaxers, dyes and other chemicals can strain and damage the hair shaft. Styling techniques, such as tight braids, can cause hair loss from the root, a condition called traction alopecia. Often these practices can cause permanent damage to the follicles over time. It helps to have a dermatologist who understands differences in hair types and can give advice about healthy styling practices.
Specialized care for women’s hair loss The University of Chicago Medicine Center for Women’s Integrated Health’s hair loss program offers education, treatments and support for
WHAT CAN WOMEN TO DO PREVENT
patients suffering from many
HAIR LOSS?
different kinds of hair loss. After
Have a well-balanced diet and get enough iron, zinc, and vitamins D and B. Avoid hairstyles that cause pulling. Minimize the use of direct heat on the hair, and keep hair well conditioned. Natural oils like argan oil, Jamaican black castor oil or olive oil may help. Over-the-counter products, such as minoxidil, or laser caps or helmets, may provide some benefit. It takes up to four months for any of these treatments to work. If there is no improvement, then it’s time to make an appointment with a doctor.
a thorough work-up to identify the type of hair loss, each patient receives a personalized care plan. The program also offers quarterly Zoom support group meetings and a series of educational webinars. LEARN MORE
UChicagoMedicine.org/ female-hair-loss
WHAT TREATMENTS ARE AVAILABLE?
Depending on the type of alopecia you are experiencing, treatment options include prescription oral and topical medications, hair growth supplements, and over-thecounter drugs. The doctor also may recommend steroid injections, low-level laser therapy, platelet-rich plasma therapy, hair transplantation or even a diet tweak. U C M C O N N E C T 1 - 8 8 8 - 8 2 4 - 0 2 0 0 | UCHICAGOMEDICINE.ORG » 15
NEWS NEW PHYSICIANS
HONORS
Anesthesiology
Pediatrics
DAVID CASSAGNOL, MD
MILAN MULYE, MD
ARCANGELO IUSCO, MD
Pediatric Critical Care NANCY GHANAYEM, MD
ASHLEY JOSEPH, MD
REBECCA PROPPER, MD
NAVEED MAMEGHANI, MD VIKAS SHARMA, MD
Pediatric Emergency Medicine
ZACHARY WRIGHT, MD
MORA PUERTOLAS, MD ELLEN RODMAN, DO
Emergency Medicine NATHAN WOLTMAN, MD
Orthopaedic Surgery
ANITA CHONG, PHD, Professor
in the Department of Surgery, was named a fellow of the American Association for the Advancement of Science for “distinguished and pioneering contributions to the immunology related to organ transplantation, tolerance and immuno-suppressive drug action.”
Radiology DONALD CANTRELL, MD
Hospital Medicine NATHANIEL MEADOW, MD
ERIC TRITCH, Vice President for Supply Chain and Logistics, was recognized as an Unsung Hero by Illinois Governor J.B. Pritzker. The designation is a new initiative through the Illinois Health and Hospital Association that acknowledges valiant, sustained efforts of healthcare workers on the pandemic’s front lines for their dedication, hard work and sacrifice. Tritch was recognized for his work to ensure hospital staff had the necessary personal protective equipment and supplies needed to care for COVID-19 patients.
Reproductive Endocrinology and Infertility
DANA BRANCH, MD
DANA MCQUEEN, MD Transplant ROSARIO PEREZ GUTIERREZ, MD
RIMA MCLEOD, MD, Professor in the Departments of Ophthalmology and Visual Science and Pediatrics, was named a fellow of the American Association for the Advancement of Science for “distinguished contributions to understanding the medical consequences of Toxoplasma gondii infection, the molecular mechanisms contributing to these consequence and potential treatments.”
LEADERSHIP ADEKUNLE “KUNLE” ODUNSI, MD, PHD, an expert in immunotherapy and vaccine therapy for cancer, has been appointed Director of the University of Chicago Medicine Comprehensive Cancer Center. Odunsi is a nationally recognized physician-scientist with a deep knowledge of discovery and innovation in oncology. Before coming to UChicago Medicine, he served as deputy director at Roswell Park Comprehensive Cancer Center in Buffalo, New York.
has been appointed Chief of the Section of Hematology/Oncology. A lymphoma specialist, Smith is committed to expanding the section’s reputation as a national/international destination for cancer care, growth of the investigative programs, and recruitment of top faculty and fellowship candidates with an increased focus on diversity.
SONALI SMITH, MD,
has been named Interim Chair of the inaugural Department of Neurological Surgery at the University of Chicago Medicine. A neuro-oncologist, he is an expert in minimally invasive neurosurgery for children and adults.
BAKHTIAR YAMINI, MD,
JUSTIN KLINE, MD, is the new Director of the Lymphoma Program. He is a hematologist/oncologist and assistant program leader for the University of Chicago Medicine Comprehensive Cancer Center’s Immunology and Cancer Program. MARCUS PASCHALL has been promoted to Director, Ambulatory Operations for Cancer Services. Paschall will oversee outpatient oncology clinics at Hyde Park, including radiation oncology, infusion therapy services and the hematology/oncology clinics.
has been promoted to Director, Community Affairs and Volunteer Services, at Ingalls Memorial.
DONELLA BRADFORD, MBA, LISA WILLIAMSON BARKER has
been promoted to Director, Fundraising and Foundation Events, at UChicago Medicine Ingalls Memorial.
16 » THE UNIVERSITY OF CHICAGO MEDICINE
The Forefront | S P R I N G 2 0 2 1
ANSWERING THE TOUGH QUESTIONS Gift empowers experts in digestive diseases research and care After searching for a recognized leader in digestive diseases, Lee Matricaria found David T. Rubin, MD, Joseph B. Kirsner Professor of Medicine at the University of Chicago. “Dr. Rubin is one of the top doctors in the world for digestive diseases, and he’s right here in Chicago,” Matricaria said. “He’s very approachable and makes sure his whole team is plugged in, so I don’t have to retell my story every time I see the nutritionist or pharmacist.” Matricaria also appreciates Rubin’s access to the latest clinical trials. “He’s not just a clinician; he also has expertise on the research side, which allows me and other patients to access the newest treatments,” Matricaria said. Thanks to Lee’s positive patient experience, coupled with a family tradition of giving back, the Matricaria family donated $3.5 million to establish and endow the Matricaria Family Professorship in the Section of Gastroenterology, Hepatology and Nutrition at the University of Chicago Medicine. The professorship will recognize and support leading digestive disease experts and help to ensure that the University’s gastroenterology program continues to grow and thrive for years to come. Rubin is chief of the section, as well as Co-Director of the UChicago Medicine Digestive Diseases Center. “Through this gift, we hope to empower experts at UChicago Medicine to move the standard of care forward, advance treatments and ultimately bring relief to people who are suffering from digestive diseases,” Matricaria said.
The extraordinary gift from the Matricaria family recognizes the amazing teamwork that UChicago Medicine offers our patients with inflammatory bowel disease and the collaboration with our research scientists.” DAVID T. RU B IN , M D
Ron, left, and Lee Matricaria
Awarded to those who have attained rare distinction in their field, professorships not only honor scholars for their successful careers, but also fuel their exceptional work. Furthermore, they have a profound ripple effect — enabling the University to attract the most talented students, researchers and faculty; secure competitive research grants; and disseminate new findings to transform patient care. “The extraordinary gift from the Matricaria family recognizes the amazing teamwork that UChicago Medicine offers our patients with inflammatory bowel disease and the collaboration with our research scientists,” said Rubin. “Their support enables us to continue our efforts to identify better treatments for our patients, while also answering tough questions about the causes of digestive diseases so we can push the frontiers of science and medicine.” After meeting with Rubin and his team, the Matricarias were inspired to establish the professorship, with the goal of improving the lives of other patients and families impacted by digestive diseases. Lee’s father, Ron Matricaria, who has worked in the healthcare industry for more than 50 years, added, “The more our family was exposed to UChicago Medicine, the more its legacy of excellence was validated. We found a group that not only provides compassionate clinical care, but blends that with scientific rigor.” The Matricarias look forward to the gift’s potential to accelerate the development of new treatment and prevention strategies for digestive diseases, and even lead to research breakthroughs. “I think the work that Dr. Rubin and his colleagues are pursuing to change the paradigm and standard of care for inflammatory bowel disease and other digestive diseases is realistic — and with some outside support, it can be achievable,” Lee said.
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The University of Chicago Medicine Ingalls Memorial offers comprehensive primary care services in the Southland. Same-day appointments, virtual visits and walk-in care are available at most locations.
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