Latest news with #UChicagoMedicine
Yahoo
5 days ago
- Health
- Yahoo
UChicago Medicine to discontinue all gender-affirming pediatric care
CHICAGO — Bowing to federal pressure under the Trump administration, UChicago Medicine has become the latest Illinois hospital to end gender-affirming pediatric care. The decision, announced Friday, leaves no room for ongoing transitional care, and an unknown number of patients in limbo. 'UChicago Medicine has reached the difficult decision that, in response to continued federal actions, it will discontinue all gender-affirming pediatric care effective immediately,' the hospital said in a statement. 'We understand that this news will have a significant impact on our patients.' The announcement by UChicago Medicine, the esteemed century-old academic medical health system based at the University of Chicago, follows a similar decision by Rush University System for Health, which 'paused' hormonal care to new patients under the age of 18 beginning July 1. Rush is continuing to offer mental and behavioral support, but referring gender care patients that need additional treatment to other providers. UChicago Medicine will no longer be on that shrinking list of hospitals providing gender-affirming pediatric care, which can include counseling, medications to delay puberty and surgery. In January, President Donald Trump issued an executive order ostensibly protecting children under 19 from 'chemical and surgical mutilation' that threatened to withhold federal research grants as well as Medicaid and Medicare reimbursement for institutions that provide such pediatric gender care services. 'We reached this conclusion in light of emerging federal actions, which would place at risk our ability to care for all Medicare or Medicaid patients,' UChicago Medicine said in its statement. 'These patients make up the majority of those we serve. As the largest Medicaid provider in Illinois, this step is necessary to ensure UChicago Medicine can continue serving our broader community and delivering on our mission.' Federal pressure to end gender-affirming pediatric care has caused several Chicago-area hospitals to curtail such services. In February, Lurie Children's Hospital paused gender-affirming surgeries for patients younger than 19, a policy which remains in place, the hospital said earlier this week. Meanwhile, UI Health allegedly canceled an Illinois teenager's gender-affirming chest surgery, according to a February federal court filing. Reached earlier this week, UI Health would not say if it was still providing gender-affirming care to minors. As for UChicago Medicine, all gender-affirming pediatric care ends Friday. 'Our focus right now is working with affected patients to discuss options going forward,' the hospital said in its statement. _____ Solve the daily Crossword
Chicago Tribune
5 days ago
- Health
- Chicago Tribune
UChicago Medicine to discontinue all gender-affirming pediatric care
Bowing to federal pressure under the Trump administration, UChicago Medicine has become the latest Illinois hospital to end gender-affirming pediatric care. The decision, announced Friday, leaves no room for ongoing transitional care, and an unknown number of patients in limbo. 'UChicago Medicine has reached the difficult decision that, in response to continued federal actions, it will discontinue all gender-affirming pediatric care effective immediately,' the hospital said in a statement. 'We understand that this news will have a significant impact on our patients.' The announcement by UChicago Medicine, the esteemed century-old academic medical health system based at the University of Chicago, follows a similar decision by Rush University System for Health, which 'paused' hormonal care to new patients under the age of 18 beginning July 1. Rush is continuing to offer mental and behavioral support, but referring gender care patients that need additional treatment to other providers. UChicago Medicine will no longer be on that shrinking list of hospitals providing gender-affirming pediatric care, which can include counseling, medications to delay puberty and surgery. In January, President Donald Trump issued an executive order ostensibly protecting children under 19 from 'chemical and surgical mutilation' that threatened to withhold federal research grants as well as Medicaid and Medicare reimbursement for institutions that provide such pediatric gender care services. 'We reached this conclusion in light of emerging federal actions, which would place at risk our ability to care for all Medicare or Medicaid patients,' UChicago Medicine said in its statement. 'These patients make up the majority of those we serve. As the largest Medicaid provider in Illinois, this step is necessary to ensure UChicago Medicine can continue serving our broader community and delivering on our mission.' Federal pressure to end gender-affirming pediatric care has caused several Chicago-area hospitals to curtail such services. In February, Lurie Children's Hospital paused gender-affirming surgeries for patients younger than 19, a policy which remains in place, the hospital said earlier this week. Meanwhile, UI Health allegedly canceled an Illinois teenager's gender-affirming chest surgery, according to a February federal court filing. Reached earlier this week, UI Health would not say if it was still providing gender-affirming care to minors. As for UChicago Medicine, all gender-affirming pediatric care ends Friday. 'Our focus right now is working with affected patients to discuss options going forward,' the hospital said in its statement. rchannick@
Medscape
30-06-2025
- Health
- Medscape
ACS Guidance Makes Hospitalists' Cardiac Decisions Easier
Hospitalist Arti Tewari, MD, no longer has to second-guess some of her decisions about the best treatment for managing patients with acute coronary syndrome (ACS). New ACS clinical practice guidelines she refers to as 'groundbreaking' help her more confidently care for her cardiac patients at UChicago Medicine to improve their health and safety, she said. 'There have been times previously where I have weighed the risks and benefits of dual antiplatelet therapy, specifically not knowing if a patient would need open heart surgery or bypass surgery and not wanting to delay that surgery by giving them antiplatelet agents,' said Tewari, assistant professor of medicine at the University of Chicago in Chicago. Since hospitalists are among the first clinicians to care for patients with ACS when they are admitted into the hospital, Medscape Medical News sought to learn how the specialty physicians apply the new guidelines in their practice. The directive to use more antiplatelet therapy was one of the biggest changes Tewari noted in the new guidelines released earlier this year by the American College of Cardiology and the American Heart Association. It was the first update in the guidelines in more than a decade. ACS continues to be a leading cause of morbidity and mortality worldwide, with an estimated 1.2 million individuals in the US hospitalized with the group of acute cardiovascular conditions defined by sudden reduced blood flow to the heart muscles, according to the AHA's 2024 data. Arti Tewari, MD Symptoms include chest pain, shortness of breath, and dizziness. Associated conditions include unstable angina and myocardial infarction, or a heart attack. Tewari said patients with ACS typically come to the hospital complaining of chest pain. Hospitalists often are the first to manage their care, deciding if they are experiencing a cardiac, muscular, or another issue such as gastrointestinal reflex. If hospitalists suspect a cardiac condition, they may consider whether the patient needs intervention such as a stent for a potential lesion in one of their coronary arteries. In that case, the hospitalist would administer antiplatelet agents as recommended in the guidelines while the patient is being stabilized for that procedure. Another change Tewari noticed in the guidance was more careful optimization of lipid-lowering agents. 'We used to use statins and to really kind of go based off of a cumulative risk score for our patients, but with these new guidelines there's really a push for non-statin lipid-lowering agents, and that is definitely a change in my practice that I think is going to benefit the patients greatly.' Focus Areas for Hospitalists The committee that drafted the new guidelines kept hospitalists in mind along with other clinicians who might provide care for patients with ACS during their treatment path, said Michelle O'Donoghue, MD, MPH, vice chair of the ACS guideline writing committee. Hospitalists tend to see such patients after they are stabilized following coronary revascularization or readmitted after a recent ACS event, said O'Donoghue, a cardiologist at Brigham and Women's Hospital and an associate professor at Harvard Medical School, Boston. Like other clinicians following the new guidelines, hospitalists should become aware of the new recommendations for using lipid-lowering therapy and the selection and duration of dual antiplatelet therapy (DAPT), O'Donoghue told Medscape Medical News, for which she frequently posts cardiology commentaries. She also serves on Medscape's cardiology advisory board. O'Donoghue summed up some of the key points of the new guidelines for hospitalists and other clinicians, especially early after an ACS event. 'The new ACS guidelines want to target an LDL [low-density lipoprotein] cholesterol that is < 55 mg/dL, so, by and large, all patients should be on a high-potency statin, barring any contraindication, and if they're already on a high-potency statin, then the hospitalist should be initiating a non-statin lipid-lowering therapy.' She cited several non-statin lipid-lowering therapies that can be considered, including proprotein convertase subtilisin/kexin type 9 inhibitors, ezetimibe, and bempedoic acid, that can help patients achieve their LDL cholesterol goal. 'But if they're not at goal and they're already on a high-potency statin, then really the hospitalist should be initiating non-statin therapies before hospital discharge and then also making sure that that patient is scheduled to have their lipid panel rechecked in another 4-8 weeks to make sure as an outpatient that they are, in fact, achieving that goal.' Hospitalists should also focus on management of antiplatelet therapy, O'Donoghue said. 'By and large all patients who undergo placement of a stent will be on dual antiplatelet therapy including aspirin and a P2Y12 inhibitor for some period of time after that stent is placed, but the duration is somewhat variable,' she explained. 'The important area for the hospitalist to know is that if the patient requires the addition of an anticoagulant, then the aspirin should be discontinued 1-4 weeks after PCI [percutaneous coronary intervention] for a patient who does not require an anticoagulant while the P2Y12 inhibitor is continued.' The guidelines now offer more flexibility during follow-up for the possibility of discontinuing DAPT earlier, O'Donoghue said. 'Traditionally, shorter duration of DAPT has meant stopping the P2Y12 inhibitor. However, the guidelines now have a class 1 recommendation to endorse the discontinuation of aspirin after 1-3 months for patients discharged on aspirin and ticagrelor to reduce risk of bleeding.' She added that prasugrel and ticagrelor are both preferred over clopidogrel in the absence of a contraindication. 'But we recognize for the hospitalist, who might be caring for a patient early in the course of their ACS, that there may be barriers such as cost that prevent them from getting those more potent antiplatelet therapies,' O'Donoghue said. 'If there is a need to switch between therapies, the hospitalist should make sure that they are consulting the pharmacist to best understand how to do that.' Hospitalists should also refer the patient to cardiac rehab if they have been recently diagnosed with an ACS, she said. 'There's been a clear benefit that has been shown for patients who participate in those types of programs.' The guidelines even offer an alternative for a patient who can't attend in person — virtual cardiac rehab programs, she said. Patients with ACS also should have an annual flu shot because the flu puts considerable stress on a recent patient with the heart condition, O'Donoghue said. Practical Applications Community-based hospitalist Jeff S. Shapiro, MD, believes the new guidelines offer 'a more nuanced approach to treatment of ACS with a continued emphasis on DAPT and aggressive lipid-lowering treatment, including clearer recommendations on adding non-statin therapy to patients who have either reached maximal doses of statins or in which statins are contraindicated.' The guidelines on blood transfusion also 'feel more aggressive than what we are currently using,' said Shapiro, regional medical director of the Southern California Hospitalist Network, Orange, and chief of staff, elect, of Emanate Health Foothill Presbyterian Hospital in Glendora, California. Jeff S. Shapiro, MD 'Recommendations such as microaxial flow pumps are less helpful for community-based physicians, as it will take time for that type of technology to reach our hospitals, although I used to say the same thing regarding stroke neuro-intervention, which we now do regularly at one of our hospitals.' In general, Shapiro believes the new guidelines help community-based hospitalists discharge patients back to their primary care physicians on 'optimal medical therapy similar to what we are doing with goal-directed medical therapy' for congestive heart failure. Bleeding Risks For academic hospitalist Farzana Hoque, MD, the updates on DAPT, particularly the individualized step-down approach for high bleeding risk patients and lipid management, are especially valuable for patient care, she told Medscape Medical News . The guidelines recommend at least 1 year of DAPT for patients with ACS who are not at high risk for bleeding to reduce major adverse cardiovascular events (MACE), said Hoque, associate professor of medicine at Saint Louis University in St. Louis. Farzana Hoque, MD She noted the guidelines' preference for ticagrelor or prasugrel over clopidogrel in patients with ST-segment elevation myocardial infarction — a more serious type of heart attack — managed with the nonsurgical PCI to reduce stent thrombosis and MACE. 'The updated recommendation favors clopidogrel over ticagrelor or prasugrel to minimize bleeding risk in patients requiring oral anticoagulation,' said Hoque, who also teaches the new recommendations to her medical students and residents. She added that the old guidelines needed to be updated to reflect new evidence, evolving clinical practices, and advances in technology. Care for High-Risk Patients Hoque said she regularly consults such guidelines in her practice at the academic medical center, which cares for high-risk patients with diverse clinical and social needs from an underserved community. Many of Hoque's patients are elderly with an increased tendency to bleed. So they will benefit from the update for patients with ACS who require anticoagulation. When it comes to bleeding risk, Tewari said hospitalists also have to balance the risk for cardiac ischemia, reduced blood flow to the heart muscle because of blocked arteries. 'Every day we have patients who come in [the hospital] who make it successfully to a cardiac catheterization to unblock a heart vessel because of these guidelines,' she said. She's gained confidence giving DAPT up front because the new guidelines suggest administering a large dose of it and then holding one of the platelet agents for 24 hours prior to a surgery, rather than 5 days. While hospitalists are expected to stay informed of changing guidelines, Tewari admits there's a learning curve associated with them. 'Certainly, it's a pretty significant change than what I learned in my training,' she said, adding that her practice is teaching its staff and residents to provide the updated standard of care. 'The guidelines are definitely helpful for us to refer back to because we can't possibly know all of this off the top of our head.'
CBS News
26-06-2025
- Health
- CBS News
Chicago woman lives and thrives a year after complex heart and liver transplant
Climbing the stairs to the top of the former John Hancock Center is a feat unto itself, but Laura Valentine did it just months after undergoing a very complicated double organ transplant. Earlier this month, Valentine marked the one-year anniversary of her surgery — a major milestone. "You feel looser," said Valentine. "You feel freer when you get to that year mark." Valentine's medical problems started at birth. "There's a lot of technical terms, but the best way to describe it is that I had half a heart when I was born," Valentine said. Valentine was born with only one ventricle, or lower chamber in her heart. This made it harder for her heart to pump oxygenated blood throughout her body, and because of this, she turned blue shortly after she was born, according to UChicago Medicine. Valentine had her first open-heart surgery when she was under 2 years old. She was able to experience a relatively normal childhood as a result — swimming, riding horses, attending college and graduate school as an education professional, and becoming a mom, UChicago Medicine noted. But the congenital heart condition was not the only condition with which Valentine was born. She also had a rare genetic condition that caused her organs' positions to be reversed—her heart and her liver are "I'm a mirror image of you. So if we were to hug, our hearts would essentially be touching," said Valentine. "So my heart's on [my right] side, and then my liver's on [my left] side." In July 2023, Valentine noticed some troubling new symptoms. First, doctors found she had been suffering from silent atrial fibrillation — an irregular heartbeat with no symptoms that had caused blood clots in multiple organs, UChicago Medicine said. Medications and procedures eliminated any immediate danger, but the problems with her heart had also caused her liver to fail. "The biopsy came back cirrhosis, and my heart was failing. It was bad news," Valentine said. "So by December '23, I knew I needed new organs." While awaiting the new organs, Valentine walked four miles every day through the halls of the hospital for "prehabilitation." And then in June of last year, she got the new organs transplanted. "She was born with a heart that only one ventricle as opposed to two, and was pointed in the wrong direction in the wrong place," said Dr. Valluvan Jeevanandam, director of the Heart and Vascular Center at UChicago Medicine. "Other than that, it was perfectly fine." Dr. Jeevanandam did Valentine's heart transplant. Jeevanandam — along with Dr. Michael Earing, chief of the Section of Pediatric Cardiology at UChicago Medicine, pediatric cardiologist Dr. Stephen Pophal, and director of liver, kidney, and pancreas transplantation Dr. Rolf Barth — used a 3D model to design new connections for Valentine's organs and figure out where to put her new heart and liver. "So we basically made it so we could fit a heart… by moving all these vessels from the left side to the right side," he said. The surgery took about 20 hours. It was complicated, but went as planned. Now a year later, Valentine's outlook has changed. "Once you pass out a year, and if you've not had any major complications — your kidneys are working, everything else is working — then at that point, we're now looking for decades of life, not just years of life," said Jeevanandam. "She is really, really special. I mean, she has willed herself for so long, despite how sick she was. She willed her through the surgery, and now she's willing herself to a fantastic life." At a holiday party less than six months after the surgery, Jeevanandam urged Valentine to join the annual Hustle Chicago, in which participants climb 1,632 stairs up the former John Hancock Center to raise funds for lung disease. Valentine made the climb two months later with her fiancé, with Celine Dion in her earbuds to inspire her. Meanwhile, Valentine is also now passionate about organ donation, and wants to encourage more people to participate.
Yahoo
25-06-2025
- Health
- Yahoo
UChicago Medicine to enhance patient care with Agentforce
UChicago Medicine in the US is set to implement Agentforce for Health, a digital labour platform by Salesforce, aimed at improving the patient experience. This platform will be integrated into the health system's non-clinical, operational workflows for round-the-clock access to personalised, self-service information and support for patients. UChicago Medicine chief marketing officer Andrew Chang said: 'As part of our broader efforts to enhance the patient experience and streamline access to information, we're implementing new digital tools to support our teams and patients. 'These tools are expected to help automate routine inquiries so that staff can focus on more complex needs that benefit from personalised attention.' The academic health system pinpointed the need to optimise the non-clinical support efficiency for patients, especially for regular inquiries outside of standard business timings. This use of AI-driven, agentic tools is expected to relieve staff from high-volume, non-urgent tasks while offering answers to common questions in time. Through the combined capabilities of Agentforce and Health Cloud, digital agents will assist patients in finding specialised care, as well as providing information on parking and directions. Additionally, UChicago Medicine is exploring the potential of this technology to guide patients through their care journey via phone and web chat interfaces. The system will allow patients to manage prescriptions, appointments, and insurance verification with ease. Real-time logistical support, encompassing alternative parking suggestions when garages are full, is also part of the planned service enhancements. Salesforce AI executive vice-president and general manager Adam Evans said: 'UChicago Medicine is setting a new standard for how healthcare providers can strategically leverage agentic AI to deliver tailored and effective care to its patients. 'By leveraging Agentforce for Health on the deeply unified Salesforce Platform, UChicago Medicine is not just boosting operational efficiency, it is empowering its staff to dedicate more time to meaningful patient interactions and elevate health outcomes.' "UChicago Medicine to enhance patient care with Agentforce" was originally created and published by Hospital Management, a GlobalData owned brand. The information on this site has been included in good faith for general informational purposes only. It is not intended to amount to advice on which you should rely, and we give no representation, warranty or guarantee, whether express or implied as to its accuracy or completeness. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content on our site. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
