Kristi: The health care business is vast.

From patient care and clinical outcomes to innovation and research.

Clinicians here often hel to advance medicine and enhance their expertise, all whil continuing to provide patients access to the latest treatments and high quality care.

Well, let's head out to ProMedica Toledo Hospital and ProMedica Children's Hospital to hear from some of the innovative clinicians and some of the latest research studies that you may not know are occurring in our region.

We'll talk with doctor Zaidi and Doctor Richard Burgess, stroke neurologist and neuro interventionists on the ProMedica Stroke Team.

We'll also hear from Docto Imad Hariri, an advanced heart failure cardiologist, and doctor Jamie Target, a pediatric hematologist oncologist.

Let's head out.

I'm here at ProMedica Toledo Hospital talking with Doctor Hariri, who is an advanced heart failure cardiologist, and we're talking about research today.

So, Doctor Hariri, great to be with you today.

Dr. Harriri: Thank you, Kristi, for having me.

Appreciate you guys coming on here.

Kristi: Glad to be her to hear more about your study.

So I know that you'r really involved in this research that's going to improve people's lives specifically those who have had heart failure and perhaps can't get relief from medication.

But I want you to tell u more.

Dr. Harriri: Yeah, sure.

You know, often patients think of, studies for things like cancer treatments and chemotherapy.

But we've really gotte to a point in our heart failure care locally where we're thinking outside the box for our patients, trying to make sur that they get the opportunities afforded elsewhere right here at home.

Especially in access to studies that are conducted at many of the elite centers around the country.

And, allowing them and affording them the opportunity to be enrolled in these studies here to get the first dibs at treatments available for heart failure.

Our study that we have now, that we've enrolled our first patient and, is a study for patients who have heart failure and are not getting the relie they should get with medications and kind of thinking outside the box on new and emerging treatments, and creating something called a shunt inside the heart that helps relieve the symptom of congestion and fluid overload that often a lot of, patient with heart failure, suffer from.

And seeing how they do over time and reducing the symptoms burden and also looking at their rates of hospitalizations and improvement and things like their six minute walk, the same distance that they're able to achieve with that and their functional capacity overall.

Kristi: So when you're talking about those who can get involved in your study, they would have those kind of symptoms.

Dr. Harriri: Yeah.

So those are patient who are on classical treatments for heart failure, basically water pills or other medications for blood pressure and, symptoms contro that are still getting symptoms of shortness of breath o hospitalized with heart failure, that, are, essentially looking for a symptoms relief outside of what's available for them.

Kristi: And through your study obviously you are really pushing emerging technologies and impact for the future.

Tell us more about that and how the outcomes will be impacte positively for those patients.

Dr. Harriri: I think the innovation across the cardiac world has really propelled these therapies forward for patients because, every day with the use of technologies that we have ou there is helping our patients.

You know, get out of just using medications to treat their condition and getting fixed, whether it's for valvular heart disease, holes in the heart, going away from things like open heart surgery to minimally invasive surgeries or even surgeries or procedures that happen through going through their arteries and veins, essentially.

Kristi: And I would imagin that this study is truly drawing people from across the region, but also across the country.

Dr. Harriri: Yeah.

So this is actually the study we're part of as an international study involves, a lot of centers around the world and in the country, led by, people over at Tufts University in Boston and Duke University in North Carolina.

Kristi We thank you for your time today and for all of the research to do this.

Dr. Harriri: Absolutely.

Thank you.

Thanks for coming.

Kristi: Thanks, doctor.

Very.

We are here at ProMedica Children's Hospital with Doctor Jamie Target.

She is a hematologist oncologist in pediatrics.

Thanks for being with us.

Thank you.

So let's hear a little bit more.

I know you've really been, participating in an importan clinical trial that is helping some of the pediatric hematology oncology patients to heal, to thrive, to have better treatment protocols.

So tell us more about the study.

Dr. Dargart: So the study is a part of a larger group called the Children's Oncology Group or Cog.

This is over 200 pediatric cancer centers in North America, Australia and New Zealand.

And it's smaller centers like ours working with larger centers, all with the goal o studying newer therapies, better therapies to improve outcomes in our children with cancer.

Kristi: What is B-cell acute lymphoblastic leukemia?

And tell us how the study is really working into that.

Dr. Dargart: So B-cell acute lymphoblastic leukemia or B-cell alall.

This is the most common type of cancer that we see in children and adolescents.

It arises in the bone marrow which is actually a liquidy part inside the bone where the body makes the blood cells and childre that can present with bone pain.

They might have enlarged liver, spleen, s they might have abdominal pain if they become anemic, or their red blood cell count is low, they can be more tired, pale, or dizzy if their platelet count is low.

These are the cells that help the blood clot.

They can have nosebleeds or can lead to more easily bruising.

They can have fevers.

There's a lot of different ways, children can present with this.

Kristi: In the world of childhood leukemia, there has been success.

I have read in terms of immunotherapy and using immunotherap earlier in treatments to perhaps impact outcomes.

Tell us more about that an how that ties into your study.

Dr. Dargart So actually childhood leukemia is one of the success stories in cancer therapy.

Back in the 60s or 70s, children diagnosed with cancer, almost universally died.

And it was actually one of the first types of cancer in children or adults, where we looked at using different types of chemotherapy to kill those cancer cells, so that if the, cancer cells develop resistance to one type of chemotherapy, we're using multipl other kinds that kill the cells in different ways to overcome that resistance.

And over the last 50, 60 years, pediatric leukemia survival went from less than 20% to 80, 90 even higher, rates of survival.

So it's truly an amazing success story.

And we have built this on decades of research, of building on that, looking at how we can both improve outcome in terms of decreasing the risk of relapse, improving survival, but also decreasing the short term and long term side effects of treatment.

So we are so grateful to our patients and families who participate in this research, because they know and they understand that we ma or may not benefit their child, but it's definitely going to, benefit children, coming in the future.

Kristi: And what is involved if a patient is coming into the study, what would that patient partake in?

Dr. Dargart: Traditionally, chemotherapy is medications that kill cells that are dividing.

And that's why we have so many side effects that I think so many people are familiar with hair loss, lower blood counts requiring transfusions.

It suppresses the immune systems, a higher risk of infections or serious infections, nausea, vomiting.

So we have pretty much, maxed out on how much we can d with conventional chemotherapy.

And there are some newer classes of medications like blended to my mouth, which was the focu of this clinical trial that use the body's immune system to kill the cancer cells.

So the study is looking at using it in the beginning, early on in treatment in children newly diagnosed with B-cell allowe to see if it improved outcomes.

The medication is challenging to give.

It does have to go into an IV and most of our patients have a special IV, that can stay in for months or years.

The medication, rather than just coming to clinic, getting a dose of the medication and going home, these children actually needed to receive the medication as a continuous infusion for, 28 days at a time.

Kristi: Tell us then about patient outcomes.

Dr. Dargart: Within our community.

It's a small community but the outcomes of this study actually caused a lot of excitement because it really changed the standard of care for these patients that it improved their, overall, the risk of relapse decreased by about 8%, and overall, that's about a 60% decrease in the rate of relapse in these children.

Kristi: Dr. Dargart, thank you so much for all you're doing.

We appreciate you being with u today.

Dr. Dargart: Thank you.

Kristi I'm here with Doctor Syed Zaidi.

He is on the America Stroke team and as a stroke neurologist and doctor said it's great to be with you.

Dr. Syed Zaidi: Thank you so much.

Kristi: You've done so much here.

ProMedica and the stroke tea is really involved in research.

So tell us more about one of the studies that you've been truly involved in.

Dr. Syed Zaidi: One of the main procedures that I do as a stroke neurologist, neuro interventional, is when someone comes to us for their stroke is to try to retrieve a clot out from the brain.

These strokes happen when the blood supply to the brain is interrupted.

So if a if a blood clot is plugging up a main artery in the brain, what we do is we either go to the wrist or to the groin, to the main arteries, into the brain.

Using our catheters and devices.

And our goal is to try to extrac Quite often w are very successful, thankfully, and it has shown that this procedure saves lives and saves disability.

It's very remarkable, very rewarding on our end.

Unfortunately, there are time when, as we take the blood clot out of the brain, some small fragments of it are release or they're not caught properly and the they go downstream in the brain, the plug up like really, really small, tiny branches of the brain.

And as you can imagine, all the blood vessels in our brain, regardless o their size, they are important.

So.

So what to do?

What to do with these tin fragments of clot which are now lodged deep in the brain?

Right.

So one of the things that we have to our at our disposal, which has been studied in cardiac world a lot, it's a medicine.

It's called connected plays.

It's a clot busting medicine.

So the, the thought that we had was in the, in the scenario where we are dealing with these residual small fragments of clots deep in the brain, which we can go up and chase out and extract anymore.

What about we use this drug sort of as like adrenal.

So we did the very first study of its kind in the United States.

We enrolled 20 consecutive patients who received this drug at a certain dose.

And the idea was to begin with just that safe.

And it's feasible and doable.

And we got very promising signal.

So proud to say that that wa the first study in nine states, actually in the world showing the safety of this medication, which was published earlier this year.

And we are now embarking on phase 2B3 larger clinical trial.

This is an area of very active investigations very clearly not in our field.

Kristi: Congratulations.

Thank you.

And that's a big deal.

And we talk about stroke patients all the time and the impact that neurologists can have on stroke patients.

What can patients do to perhaps prevent a stroke.

Or if they believe there are symptoms coming on, what should they be looking for?

Dr. Syed Zaidi: You know, thi is such an important question.

Stroke patients, you know, the time is of the essence.

Time is very critical.

The sooner they can come to us, the better.

Perhaps we can attend to the and try to reverse the symptoms of stroke.

As I said, time is important.

So knowing the stroke symptoms is very, very important.

So one of the acronyms we use is be fast which basically stands for balance and vision phase ARM speech.

If there is any trouble i any of those domains call 911.

You know, eight.

So if public at large is is educated about a stroke symptom, that becomes very important.

The other part of your question, what can be done to prevent a stroke?

I think that's very important.

Just taking care of yourself, right.

We know that regular exercise and heart healthy diet, those traditional risk factors and avoiding smoking, simple things like that and Kristi: That, that stress thing.

That's a big one.

Dr. Syed Zaidi: And that is a big we.

Kristi: You know, handle that one.

Dr. Syed Zaidi: Yeah.

Yeah I know up.

Such a good question there because stress certainly has impact.

You know we we know that it' just so hard to measure though.

And everyone deals with stress differently.

And in some cases it can it can have.

Yeah.

These these, morbid outcomes both heart attack and stroke.

Kristi We look forward to hearing more about the outcomes in your research studies.

And thanks for being with us today.

Dr. Syed Zaidi: Absolutely.

Kristi: Thank you.

We appreciate the impact you're having on your patients as well.

Dr. Syed Zaidi Thank you for this opportunity.

Kristi: I'm here on location with Doctor Richard Burgess, and we're talking about the ProMedica Stroke team and some of the incredible research that's going on.

So thanks so much for being with me.

Dr. Richard Burgess: It's great to be with you.

Great to give an opportunity to, talk about the amazing research that's going on at, at ProMedica and with the with the stroke team.

I always appreciate the, the opportunity to sort of tell folks that are out there about some of the great things that we're doing and that are really advancing care, for our patients, and, both in the region and around the world.

Kristi: Tell us more about some of the impactful research on doing for stroke patients.

Dr. Richard Burgess: We do research into stroke.

And and stroke is about, blood vessels in the brain.

Sometimes they are clogged and we have to unclog them, and sometimes they leak, and we have to plug them.

And we're doing research into different ways to take care of all of that.

Both medications, novel devices and so innovative ways to deal with that.

As an example, over the year of at least even in my career, we've been only able to open u blood vessels with medications in the first three hours, and it pushed out in a 4.5 hours and then out to a day, and went from medications to devices.

And, you know, right now with some of my colleagues, we're doing studies that look to try to open up those blood vessels beyon 24 hours with novel medications.

And on the, the, the leaking side, you know, people, come to us, unfortunately, with brain aneurysms that have ruptured, leaking into the brain.

And these are you know, critically ill folks, and over the last 20 years, during my career there've been amazing advances in the devices that we have to treat those.

But one o the great things about ProMedica is because we treat so many patients, and because we work with so many of our partners around the country and around the world, that we get access to devices that that other places don't.

Strok care has gotten so much better.

It's gone from the the third most significant, cause of death in United States to, to the fifth, just in, you know, during my career.

Kristi And when you talk about the goal for you with your stroke patients, what is that goal?

Dr. Richard Burgess: You know, typically it is to improve their outcomes.

It is to you know, get them back to life.

And there are so many patients now that would have been in a nursing home and their life would have been changed forever, that now walk out of the hospital.

And that's because of research that has been going on around the country.

But right here at ProMedica as well.

And that's been going on over the last 10 to 20 years, and we're only pushing forward even more.

Kristi Thank you for all you're doing.

And thanks for being in business life to 60.

Dr. Richard Burgess: Great t talk to you.

Kristi: Thank you.

Thank you.