UCLA Annual Scientific Evening

Annual Scientific Evening 2019

Our department once again hosted a stellar Annual Scientific Evening on March 5, where residents and fellows had the opportunity to present a spectrum of outstanding research to a panel of judges headed by eminent Visiting Professor Roderic Eckenhoff, MD, of the University of Pennsylvania Health System.

Congratulations to the winners!

Sara Navab (pictured right), MD, a CA-1 resident, took “best in show”, winning the Leonard F. Walts, MD, Research Excellence Award for best overall presentation. Under the mentorship of Soban Umar, MD, PhD, her project examined the role of the LDL receptor and oxidized LDL in the pathogenesis of pulmonary hypertension (PH). The team’s method consisted of using explanted lung tissue and plasma samples from patients with PH compared with a control group to analyze gene expression and lipoprotein oxidation. They found an increase in pro-inflammatory and pro-proliferative oxidized lipids, along with an increase in lung macrophage infiltration, in the lungs and plasma of patients with PH. They concluded that future studies are warranted to understand the precise role of the LDL receptor and oxidized lipids in the pathogenesis of PH.
Vikram Fielding-Singh, MD, JD, won the 1st Place Fellow award for his population-based “big data” analysis of intraoperative cardiac arrest incidence and survival in the U.S. Dr. Fielding-Singh is new to UCLA, joining our department this year for an adult cardiothoracic fellowship after completing law school at Yale, medical school at Stanford, and anesthesiology residency at UCSF.
Jeffrey Kim, MD, also a fellow in cardiothoracic anesthesiology, won the 2nd Place Fellow award for his study of the frequency and outcomes of elevated perioperative lactate levels in adult patients with congenital heart disease undergoing cardiac surgery.
Monica Miller, MD, a CA-3 resident, earned the 1st Place Resident honor for her analysis of the perioperative outcomes of patients with pulmonary hypertension who undergo noncardiac surgery with general anesthesia compared with monitored anesthesia care, or MAC. Her presentation raised a host of audience questions regarding the type of sedation used, the variety of surgical procedures, and the severity of the underlying pulmonary hypertension, suggesting many avenues for further research on this clinically important topic.
Christian Makar, a UCLA undergraduate, received the 2nd Place Researcher award for his hypothesis-based research involving the role of transcription factor SNAI1, known as “Snail”, as a key mediator of endothelial-to-mesenchymal transition in right ventricular remodeling in pulmonary hypertension. Makar’s work also received top undergraduate honors at the UCLA Cardiovascular Theme Symposium last fall.

All the research posters were on display for the evening for general view by faculty, residents, and fellows, as the judging team – Tristan Grogan, MS, Andrew Hudson, MD, PhD, Rajesh Kumar, PhD, and Soban Umar, MD, PhD (pictured right) – made rounds and questioned each presenter. Oral presentation of selected projects followed, with discussion moderated by Vice Chair for Perioperative Medicine Maxime Cannesson, MD, PhD.

After time for the judges to confer, Dr. Cannesson presented the awards to the winners, and the entire group enjoyed a social hour with appetizers and dessert.

The next morning, Dr. Eckenhoff presented his Grand Rounds lecture titled “Why has Grandma never been the same after her surgery?” He tackled the complex subject of perioperative neurocognitive disorder and what may – or may not – be the role of anesthesia in its development.

“The drugs we use don’t seem to make too much difference,” Dr. Eckenhoff declared. “Whatever you do, do it well.” He noted that there is no conclusive evidence that proves there is less delirium with EEG-guided care, and that there is no proven correlation of delirium with intraoperative hypotension.

At most, “anesthetics are a minor contributor,” Dr. Eckenhoff said. He discussed a recent study in which volunteers age 60 to 80 were given two hours of sevoflurane anesthesia without any surgery, and none had any change in cognition afterward or any sign of inflammatory biomarkers indicating injury. “Surgery leads to a whole host of things,” he concluded.

In response to an audience question about the type of informed consent discussion that should occur with patients and families concerning cognitive decline after surgery, Dr. Eckenhoff said the best advice for patients is to tell them that they may have some brain fog or some memory issues, but this will clear in most cases after a period of some weeks or months. This informed consent discussion should be a shared process with the surgeon, he advised.