NEWS OF THE TEXAS MEDICAL CENTER — VOL. 6 / NO. 4 — MAY 2019 A Leap Forward 3 for TMC p. 18 A NEW GOLD STANDARD, p. 14 HOW LONG DO TRANSPLANTED ORGANS LAST? p. 20 AS A PROUD PARTNER OF OUR TEXAS MEDICAL CENTER TRANSPLANT CENTERS, NORA'S HOME IS GRATEFUL TO CELEBRATE 1,000 FAMILIES SERVED. FOR MORE INFORMATION VISIT: norashome.org CAN YOU SPOT THE SIGNS OF A STROKE? WHERE TO FIND HELP Take our Think F.A.S.T. Quiz to test your stroke Comprehensive Stroke Center knowledge at CHIStLukesHealth.org/Stroke. Baylor St. Luke's Medical Center 6720 Bertner Avenue, Houston, TX 77030 At CHI St. Luke's Health, we oer comprehensive care for even the most complex stroke cases. Comprehensive Stroke Center Our Comprehensive Stroke Centers have the CHI St. Luke's Health–The Woodlands Hospital capability to quickly intervene to stop the 17200 St. Luke’s Way, The Woodlands, TX 77384 progression of stroke damage and prevent permanent impairment through the use of Primary Stroke Center thrombolytic medications and minimally CHI St. Luke's Health–Brazosport Hospital invasive techniques. 100 Medical Drive, Lake Jackson, TX 77566 President’s Perspective TMC | PULSE Vol. 6 No. 4 May 2019 President and Chief Executive Officer William F. McKeon Communications Director Ryan Holeywell Pulse Editor Maggie Galehouse [email protected] Assistant Editor Cindy George [email protected] Mark Mulligan/© Houston Chronicle. Used with permission. with Used Chronicle. Houston Mark Mulligan/© Staff Writers WILLIAM F. McKEON Alexandra Becker President and Chief Executive Officer Britni R. McAshan Texas Medical Center Shanley Pierce Photojournalist Cody Duty t’s hard to go even a single day without hearing about the promise of Iartificial intelligence (AI), which is increasingly deployed in a broad Contributing Photographer spectrum of products and services. To many, the term stimulates excite- Annie Mulligan ment and curiosity, while others worry about AI’s impact on humanity. NEWSROOM We are quickly realizing the benefits that AI can provide to humans. 713-791-8812 In cars, for example, cameras, sensors and software can identify [email protected] objects quickly approaching the vehicle and apply the brakes faster ADVERTISING and more efficiently than a human could—all while avoiding distraction. Felicia Zbranek-Zeitman Retailers have implemented AI to predict with astonishing accuracy 713-791-8829 what we will buy before we actually place an order to ensure speedy [email protected] delivery. Almost every commercial flight is landed by AI software that simultaneously interprets thousands of sensors in real time and makes DISTRIBUTION Wallace Middleton the necessary adjustments. [email protected] In medicine, artificial intelligence is making a difference in many ways. For example, when machines review MRI images to identify abnormalities READ US ONLINE like tumors, they can draw on a library of millions of other images to reach tmc.edu/news a conclusion. Often, machines can perform this task more quickly and with FOLLOW US more accuracy than a human ever could. But that’s just the start. @TXMedCenter At the Texas Medical Center, we conduct more research on our campus @texasmedcenter than any other place on Earth. The challenge we face—and that clinical @thetexasmedicalcenter researchers around the world face, too—is the arduous process of finding and matching patients for clinical trials. This process requires research- TMC Pulse is an award-winning ers to manually sift through patient records. As a result, it typically takes monthly publication of the Texas months to find just a few patients for each trial. Medical Center in Houston, Texas. Here at the TMC, we are beginning to implement an AI platform that Permission from the editor is will transform this sorting process from months and years to minutes and required to reprint any material. seconds. This could provide life-saving opportunities for our patients. It could help draw more industry to Texas. And eventually, it will establish the Texas Medical Center as not only the largest medical city in the world— but also the most efficient. 2 t m c » p u l s e | m ay 2019 Table of Contents 7 24 29 32 Undocumented Mexican The Face Must-Have Medicines Five Ways to Immigrants Plagued by Loss of Courage for Kids with Cancer Eliminate HIV and Distress in the Next Decade 4 Vitals: Textured breast implants linked to cancer 10 Spotlight: Jim McIngvale 13 Next Med: Welling up with real tears 17 Curated: Biophilia: A Dialogue with Art, Nature and Science on the cover: TMC3 will link the Texas Medical Center’s 34 Field Notes clinical and research campuses and serve as 36 Calendar an icon for Texas. (Rendering by Elkus Manfredi Architects) By Shanley Pierce Textured breast implants linked to cancer he U.S. Food and Drug Administration assistant professor in the Michael E. DeBakey T (FDA) recently held a two-day hearing Department of Surgery at Baylor College of on the long-term safety of a specific type of Medicine and member of the Dan L Duncan breast implant that is linked to a rare cancer Comprehensive Cancer Center at Baylor. that grows in the scar tissue around the “Infections or sterile seromas … are far breast, known as breast implant associated- more frequent than ALCL,” he said. anaplastic large cell lymphoma (BIA-ALCL). A woman with symptoms should talk to The FDA reported 457 confirmed cases her physician, who can perform a physical of BIA-ALCL in the United States, all linked exam and order tests—including magnetic to textured breast implants. For women in resonance imaging and ultrasounds—to the U.S. with textured implants, the current check for any suspicious lumps or swelling. lifetime risk of BIA-ALCL runs between 1 in In the presence of fluid or a mass, a physician 3,817 and 1 in 30,000. will then perform a needle biopsy to test for “It’s devastating,” said Alan Matarasso, BIA-ALCL. M.D., president of the American Society of No testing or screening is available to Textured breast implants offer a different feel and mobility compared to smooth implants. Plastic Surgeons (ASPS). “But we have to women who are asymptomatic. If caught recognize that this is a device, and as much as early, BIA-ALCL is completely curable by we study it and as much as we try to perfect removing the implant and the surrounding it, it adds a third factor into the equation of scar tissue. BREAST IMPLANTS surgery. It goes beyond just the patient and AND BIA-ALCL the surgeon; it [includes] the device. … We BIA-ALCL causes are still unclear have to look at this and study this to get our The direct cause of BIA-ALCL is still arms around it.” unknown, but doctors and scientists are The rough surface of textured implants focusing on implant texture, bacterial con- 550,000 total allows them to adhere to surrounding tissue, tamination and geographical location. breast implants which makes them less likely to become Patients with smooth implants who are placed per year repositioned in the implant pocket. Smooth develop capsules of scar tissue around the in the U.S., including implants, on the other hand, settle faster in the implants sometimes opt to replace them with 70,000 textured body and tend to create a more natural look. textured implants, which have been shown to breast implants The FDA and the ASPS maintain that reduce the risk of scar formation. BIA-ALCL breast implants are safe devices. Although has been found most frequently in patients France recently decided to ban textured undergoing implant revision operations for • implants, most of the 19 panelists at the persistent seroma—a fluid-filled pocket that 457 FDA hearing and many experts in the medi- often develops after surgery, according to confirmed cases cal community say a similar measure in the the FDA. of BIA-ALCL in the U.S. U.S. would be premature. In addition, some studies have shown that bacteria in the breast lymphoma trig- Symptoms can look like gers a long-term inflammatory response, • other illnesses Winocour said. 9 Common symptoms of BIA-ALCL include Researchers have also identified a possi- known deaths* pain, a swelling or hardening of the breast ble geographical and genetic variability in in the U.S., may be attributable due to fluid collecting around the implant BIA-ALCL cases. For example, Australia and to BIA-ALCL and a discrete mass or lump in the breast New Zealand reported a higher incidence of or armpit. BIA-ALCL than the U.S., with a 1 in 1,000 to These symptoms are similar to other, 1 in 10,000 risk with textured implants. more common, conditions and are more “All three of those factors are at this likely indicative of other issues or ill- point associations. They’re not causations,” Source: American Society of Plastic Surgeons * As of 4/12/19 based on FDA report. nesses, said Sebastian Winocour, M.D., Winocour emphasized. 4 t m c » p u l s e | m ay 2019 KEEP YOU MOVING without joint pain Live life without joint pain. At Houston Methodist Orthopedics & Sports Medicine, we know that joint pain affects every part of your life. 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