0n June 10th, Israeli Friends and Friendsfrom abroad converged on Haifa for thefirst international Rambam Summit:

“Where Medicine, Technology and HumanityIntertwine.“

The event was the brainchild of Mr. AdamEmmerich, President of American Friends ofRambam Medical Center (AFORAM). The ideawas warmly received by Director General Prof.Rafi Beyar, whose signature concerns werewritten all over the final product: puttingpatients first, and promoting creativepartnerships across disciplines.

The morning session was devoted to lecturesand panels by physician-scientists, healthcarepolicymakers, life sciences entrepreneurs, andmedical ethicists. Participants explored the roleof drug and medical device R&D in theadvancement of medicine, and thesocioeconomic and ethical implications ofmedical progress.

2004 Nobel Laureate in Chemistry Prof. AaronCiechanover, Chair of Rambam’s ScientificAdvisory Board, established the framework fordiscussion by identifying three modernrevolutions in drug development: the era ofincidental discoveries such as antibiotics(1930s-1960s), the era of brute-force screeningof large libraries of chemical compounds suchas statins (1970s-2000), and the current eraof personalized medicine using such targetedmolecules as Herceptin.

Ms. Jami Rubin, Senior Healthcare andPharmaceutical Analyst at Goldman Sachs,conceded that the pharmaceutical industry isstruggling to move from the second era intothe third, and predicted that by 2014, seven ofthe top ten drugs in the market will be biotechdevices. New York-based entrepreneur Dr.Yuval Binur forecast that medical devices willbridge the healthcare gap with cheaper andless invasive treatments. Israeli healthpolicymaker Dr. Ran Balicer asked the audienceto imagine a future in which medicine will havemoved from bedside care to e-medicine andtelemedicine provided via virtual consultationsand mentored by health coaches.

“Personalized medicine is the biggestrevolution in healthcare since vaccines,“declared entrepreneur Mr. Uzia Galil, “but it

can be applied to the patient only if we puttogether the information technology andsoftware and make them accessible to thegeneral practitioner.“ Prof. Beyar commentedthat for this to happen, funding mechanismsare needed. Mr. Gavriel Meron, Founder andCEO Emeritus of Given Imaging Ltd, spoke ofdeveloped countries’ thirst for innovative andeffective healthcare solutions, which, he said,can be supplied by Israel and therebystrengthen the national economy.

GALA EVENING

Fourteen-year-old Eyal stood on a stagebuilt on the spacious back lawn of theDan Carmel Hotel, the Haifa Symphony

Orchestra directly behind him, and a sea ofgrownups in evening attire facing him.

The audience had just watched a clipfeaturing a younger version of Eyal, but thatlittle boy with soulful eyes and a face madepuffy from cancer treatment looked unlikethe poised teenage speaker to whose face anatural slimness had been restored: “Iovercame cancer,“ he said, thanking Prof.Myriam Ben Arush, Head of the PediatricHematology and Oncology Department.“Today I can live my life like every normalchild of my age.“

The boy’s listeners included Rambam Awardrecipients for 2010. They are philanthropistsMrs. Ruth Rappaport and Mr. Sammy Ofer,trauma specialist and immediate pastDirector General of Rambam Prof. MosheRevach, and Israel Prize recipient RabbiAvraham Elimelech Firer. Rabbi Firer is

Pictured above right (l to r), Prof. Rafi Beyar, RHCC DirectorGeneral, Prof. Karl Skorecki, RHCC Director of Medical andResearch Development, Prof. Yehuda Hayuth, Chairman ofIsraeli Friends of Rambam Medical Center, and MK Prof.Daniel Hershkowitz, Minister of Science and Technology,congratulate Rambam 2010 Awardees:

Mrs. Ruth Rappaport

Prof. Moshe Revach

Rabbi Avraham Elimelech Firer

Mr. Sammy Ofer

2InterviewProf. Derek LeRoith

3Tachlis

4PrizewinningSynergy

6InternationalOutreach

7Friends Help BuildA Hospital!

8Nurses’ Station

RambamISSUE No.6 NOVEMBER 2010

on CallHealth CareC a m p u s

RAMBAMAWARD

2010Recipients

Ruth Rappaport arrived fromGeneva, Switzerland withfriends M. et Mme. Didier andMarie-erese Escaut. AnitaAlexander-Passe came fromLondon. e Canadiancontingent includedTorontonians Moti Fishmanand Suzanne Kaye, andManitobans Kerry Auriat,Sandra Penny, and MikeWaddell. A large contingentarrived from the States, amongthem Adam Emmerich, HarveyKrueger with grandson AlexCohen and friend Jerry Gotkin,Relly Dibner, Yair andShoshana Kagan, Staci Light,Etti and Zeev Pilpel, andFlorence Tatistcheff-Amzallag. cont. p2

RAMBAMSCALES SUMMIT1

1

2

3

4

2

3 4 Mr. Adam Emmerich

legendary for having acquired his medical expertiseautodidactically, and for putting his diagnosticbrilliance at the service of thousands of needyindividuals seeking his second opinion.

Hundreds of guests gathered in their honor, amongthem Minister of Science and Technology Prof.Daniel Hershkowitz, MK; Lieutenant-General (res.)Shaul Mofaz, MK; senior physicians and nurses,and Friends of Rambam.

Mr. Emmerich took the podium to thank Rambamon behalf of “those of us who are not in Israel andnot in the healing profession“ for doing“tremendous work truly without borders thatbenefits the whole world in the great tradition ofMaimonides.“

What originally attractedyou to endocrinology?The personality of my mentor in Cape Town made itvery attractive. Endocrinology is a cognitive specialty.There are no procedures – it’s using the kup [points tohis full head of silver hair and uses the Yiddish wordfor brains]. There are millions of symptoms. Weinterpret blood tests, tissue tests, x-rays.

You have been recruited to Rambam foryour impressive record of research centerleadership and group building. How wouldyou define leadership?The components of leadership are a mentoringpersonality, interpersonal communication skills, andno hidden agendas – for example,[no] using [of] others to further one’sown career. A mentoring personalityis inherent [in certain individuals], butit can be built upon. If you have this idea that the nextgeneration is important, already by mid career youbegin mentoring.

Which aspects of diabetes and metabolismdo you intend to research?One – the brain, which controls fat, liver, and musclemetabolism; we will be investigating appetite, satiety,and what goes wrong in obese type 2 patients. Andthe pancreas, which is responsible for insulin secretionand is important for type 1 diabetes. Two – howinsulin works and doesn’t work in obese and type 2individuals. For example, if you take one hundredobese individuals, only 20% of them will becomediabetic. Three – the genetics of beta-cell becausediabetes is a dual-defect disease; every obese personhas a defect in insulin action in the three major tissues– fat, liver, and muscle – but only those who have thebeta-cell defect, which is genetic, become diabetic.

Four – the complications of diabetes. Five – vascularproblems such as atherosclerosis.

Please describe your vision for theDiabetes and Metabolism ClinicalResearch Center of Excellence.The Center of Excellence will be a core facility withthe capacity for phenotyping mice (this meansdescribing their physical and chemical abnormalities)and for performing metabolomics and lipidomics, inwhich you look at substances that you find in thetissues and blood and describe their metabolicqualities. One to two Principal Investigators willcompose the core, and the others will be attracted bytheir presence, the funding, the facilities and thepeople. We require a group of colleagues that cantalk to each other.

What is the medical-research urgencyregarding type 2 diabetes?In the last 20-25 years, there has been an epidemic ofobesity and, with that, an epidemic of type 2diabetes. We are speaking of the Western world withthe U.S. as an example, but [the phenomenon] isapplicable to Israel and even to developing countries– the Chinese, the Indians, the Southeast Asians andthe Africans, [people in] the developing countries

with more economically advancedlifestyles. [Factors include] processedfood – high-fructose corn syrup is abig industry – and [pauses, leans

forward, and in his native South African accent,slowly pronounces the word with a degree of obviousrelish] – slóth-ful-ness.

You don’t have to be large framed. Asians are slim,for example, but are developing visceral adiposity, andthat leads to type 2 diabetes. It’s a crisis for middle-aged men and postmenopausal women. Between theages of 35-55 in the U.S., the percentage of diabeticsis 8-10% [in the general population], but by old age,the percentage has doubled. And the number ofdiabetics is increasing all the time. Type 2s can go foryears without being diagnosed. They have nosymptoms until they develop such complications as aheart attack, high blood pressure, or lipidabnormalities. A doctor has to think: maybe diabetesis being incubated.

P�

on CallRambam

Published by the Department of InternationalRelations & Resource Development

Head, International Relations Talia Zaks& Resource Development

Administrative Assistant, Abigail ZoharInternational Relations& Resource Development

Spokesman David RatnerAssistant to the Spokesman Dganit KenigDirector, Public Relations Nurit Naeh

Writer & Editor Dvora KredaDesign CastronawyPhotography Pioter Fliter; KoKo (Rambam Scales

Summit, p.1); Danielle Manson(Shofar, So Good, p.7); Shirley NigriFarber (Boston Been, p.7);Lisa Woliner (Well-Appointed, p.7)and others.

Architectural rendering Arieh Sharon, Eldar Sharon, Architects& Town Planners Ltd. (West Side Story, p.3)

GREETINGS FROMPROF. RAFI BEYAR

INTERVIEW

Dear Friends of Rambam,

As with every large endeavor to improvesociety, a core group of idealistic andethical individuals gifted with creative ideasand executive skills is required at the helm.For the past several years, on behalf ofrealizing Rambam’s master developmentplan for the 21st century, Trustee Boardsfor the American and Canadian FriendsAssociations have been recruited andassigned responsibility for managing theinternational activities of AFORAM andCFRAM respectively. With the kindpatronage of Chief Rabbi Lord JonathanSacks, we hope to achieve the same in theUnited Kingdom (p7).

Meanwhile, we have so many firsts toshare with you in these pages! Ribbonshave been cut for the State of Israel’s firstViral In Vitro Fertilization Unit (p3) and forthe laboratories of the LHCRIR Diabetesand Metabolism Clinical Research Centerof Excellence. Rambam researchers haveplayed leading roles in the decoding of theJewish genome (p5), and the RambamMaimonides Medical Journal (RMMJ) hasbeen launched (p8). The first drum ofconcrete has been poured for the newWest Campus building complex (p3).And of course, the first annual RambamSummit took place in Haifa, and many ofyou were present.

Please accept our thanks, for not one ofthese achievements would be possiblewithout your generous partnership.

An Interview withProf. Derek LeRoith, MD, PhD, FACPDirectorDiabetes and Metabolism Clinical Research Center of ExcellenceLegacy Heritage Clinical Research Institute at Rambam (LHCRIR)Emeritus Chief, Division of Endocrinology, Diabetes and Bone DiseaseEmeritus Director, Metabolism InstituteMount Sinai School of Medicine, New York

RAMBAM SCALES SUMMIT

(l-r) Mr. Peter Kash and Ms. Jami Rubin

• 16,000 sq m of obsolete hospitalbungalows and old, above-groundparking facilities were demolished tofree up campus land for excavationand construction

• 250,000 cubic meters of earthand dolomite bedrock were drilled,pulverized, excavated, and cleared

• Eighty-one 8-meter-deep wells weredug, and 81 underground pumps and16 surface-level pumps were kept

busy 24/7 siphoning off groundwaterand seawater at a flow rate of 12,000cubic meters per hour (cmh) per well;the water was piped 200 metersnorth into the sea

• 100,000 cubic meters of concretewill be poured to construct a three-level parking garage convertiblewithin 72 hours into the 2,000-bedUnderground Emergency Hospital

“This honor comes to me in partnership with Baruch. So manyaspects of the Rambam were in him: vision, a multidisciplinaryapproach, love of the future, charisma. He would not start aproject if he didn’t see a chance to complete it.“

On June 10th at the first Rambam Summit, with these words,Rambam Award recipient Ruth Rappaport paid dignified andaffectionate tribute to her late husband.

On June 13th, the planned Ruth Hospital, a gift from thecouple to the children of Haifa, Northern Israel, andneighboring countries, was brought one step closer torealization. On this day, the first of 20,000 concrete mixers –recruited for a vast construction project expected to lastapproximately 18 months – turned north from the Haifathoroughfare bordering Rambam, rumbled heavily down a dirtaccess ramp into the 14 m deep, 20,000 sq m wide pit at thesite of Rambam’s future West Campus, and poured out thefirst drum of concrete for the Sammy Ofer Northern RegionalUnderground Emergency Hospital.

The underground hospital’s reinforced ceiling will provide thefoundation for the above-ground Ruth Hospital and its threecompanion buildings – the Joseph Fishman Oncology Hospital,a Cardiovascular Hospital, and a Biomedical Discovery Tower.

The Haifa Municipality has defined the project as central to itsurban development plans and authorized night construction inorder to advance the completion date.

P�

Rambam on CallTACHLIS

Stats:

WEST SIDE STORY

Of the Ruth Hospital’s $45M total cost, $25M has been raised, the majority ofwhich has been donated by the Rappaport Family. The new hospital is slatedto open in 2012. The project requires an additional $20M for its completion.

Israel offers the world a model for the detection,treatment, and follow-up of humanimmunodeficiency virus (HIV) carriers and acquiredimmunodeficiency syndrome (AIDS) patients,states Prof. Shimon Pollack, Director of theAllergy, Immunology & AIDS Institute. In Israeluntil recently, however, if HIV carriers or otherswith chronic viral diseases wished to start familieswith the help of in vitro fertilization (IVF), they hadeither to seek treatment abroad or to abandonthe idea.

This changed on April 13, 2010, when Israel’s firstViral IVF Unit was dedicated at Rambam. The NIS2m facility was planned and established in jointpartnership with the Ministry of Health and isintended to serve HIV-infected childless couplesfrom throughout the country.

“When AIDS was a lethal disease, we faced thebig question of whether we should help HIV-infected couples have children if those childrenwould eventually be orphaned,“ recalls Prof.Pollack, “but now we can manage the disease[with the HAART drug cocktail], and carriers havea very long life expectancy.“

Rambam and other large Israeli hospitals took thefirst step in this direction by helping HIV-infectedwomen who had become pregnant by naturalmeans give birth to uninfected babies. “In thesecond half of pregnancy,“ Prof. Pollack explains,“we administer drugs in order to lower the viralload to an undetectable minimum. Then, duringlabor, mother and child are treated intravenously,and the baby is treated for four to six weeks afterbirth. Four hundred HIV-free babies have beenborn to HIV-infected mothers in Israel, 230 ofthem at Rambam.“

The State of Israel has now taken the second step.The new Viral IVF Unit builds on the expertise ofRambam’s pioneering IVF Unit, under the directionof Prof. Joseph Itskovitz-Eldor, Chief, Division ofObstetrics & Gynecology, and also cooperateswith the Allergy, Immunology & AIDS Institute,Institute for Liver Diseases, and Viral Laboratory.

In the late 80s and early 90s in Israeland all over the world, AIDS wasthought to be an epidemic ofhomosexuals and heroin addicts;supposedly, heterosexuals were notinvolved. It was also a fatal disease, sothe patient was affiliated withextraordinary groups and was stuckwith the label of a lethal disease.Today, when AIDS is a heterosexualdisease, and is chronic andmanageable, not even a minor reasonfor stigmatizing it exists!

Prof. Shimon Pollack

DirectorAllergy, Immunology & AIDS Institute

Although statistics don’t begin to tell the story, they do suggesthow complicated an urban engineering feat has already beenaccomplished here, and something of what lies ahead:

(l-r) Prof. Itskovitz-Eldor and Prof. Rafi Beyar host Dr. Hezi Levy,Head of Medical Administration, Ministry of Health, and

Mr. Yonatan Karni, CEO, Israel AIDS Task Force.

“We're Expecting!”

Prof. Skorecki’s team, composed of researchersfrom Israel, Canada, England, and Ethiopia, hadalso focused on the MYH9 gene. But they werepuzzled; they could find no mutations on thatgene with a likely functional effect that mightaccount for nondiabetic ESKD.

In March 2010, with the release into the publicdomain of the 1000 Genomes Project Dataset,they and other teams received a windfall. 1000Genomes is an evolving dataset that currentlyaims to compile population-based wholesequence information on 2,500 individuals. Thepilot data contained the complete genomes of180 individuals.

Of these, Prof. Skorecki’s team analyzed 119whole genome sequences, 60 of Europeanorigin and 59 of West African origin. The

sleuths conjectured that in the case ofsusceptibility to ESKD, the MYH9 gene wasacting not causatively, but solely as a physicalproximity signpost. Applying computerized datamining methods, they looked again at the DNAinterval that includes MYH9 and neighboringgenes, but this time, they looked beyond thecircumstantial evidence pointing to MYH9. Theywere looking for a protein-changing mutationor mutations with explicit disease-causingbiological mechanisms.

Their search was rewarded. The team discernedmutations in the shape and function of theapolipoprotein L-1 coded to the APOL1 gene,which they have predicted will be found to causeheightened vulnerability to renal injury.

On June 21, 2010, at Sunnybrook HealthSciences Centre in Toronto, Canada, Prof.Skorecki announced the discovery (which was

subsequently published with his co-authors inthe July issue of the journal Human Genetics)simultaneously with the independent report ofsimilar findings by another research groupbased at Harvard.

Based on data by the United StatesRenal Data System (USRDS), 32 millionAmericans have chronic kidney disease(CKD). Of these, 550,000 patients haveprogressed to end-stage kidney disease(ESKD) and are on life-sustainingdialysis. Five thousand Israelis haveESKD and are receiving dialysistreatments; based on this figure, andextrapolating from USRDS statistics, itis estimated that 300,000 Israelis havechronic kidney disease.

Chronic, progressive kidney disease (CKD), whichis the prelude to end-stage kidney disease (ESKD),afflicts over 30 million individuals in NorthAmerica. In about half of the individuals withCKD, the underlying cause is diabetic injury to thekidneys. In most of the remaining patients, agroup of other causes prevail.

Persons of West African heritage are at four-foldhigher risk for developing nondiabetic end-stage

kidney disease (ESKD) compared with Caucasiansof European origin. Persons of Hispanic heritage(because that population is admixed with a WestAfrican heritage population) are at two-foldhigher risk.

Population geneticists, suspecting that thesehealth disparities cannot be attributed solely tosocioeconomic, cultural, dietary or environmentalfactors, have hypothesized African ancestry as acontributing factor.

In order to test this theory, a number of researchgroups around the world, including Prof.Skorecki‘s laboratory, have looked at resultsobtained from the DNA analysis of blood samplestaken from African Americans and HispanicAmericans, as well as from individuals frompopulations currently residing in Africa.

Using genome-wide analysis methods, thescientists searched for disease risk markers (thescientific term is single nucleotide polymorphisms[SNPs]). They identified a genomic interval on

chromosome 22, comprising more than 30 genes,and then set out to look for point mutations inthe region that would be predicted to modifycellular function.

Prof. Skorecki explains, “SNPs are telltalesignposts that are predictive, but not necessarilycausative, of disease.“ Since September 2008,researchers looking for a genetic reason forsusceptibility to ESKD had focused on the MYH9gene because it features a rare mutation that cancause kidney failure.

Prof. Skorecki states bluntly: “The scientificcommunity jumped to the wrong conclusion, andfocused exclusively on the wrong gene for almosttwo years.“

In order to “see” the genes, scientists will tag these segments with a probe, a chemical structurethat emits a color specific to each gene. The explanation is delivered by nephrologist and moleculargeneticist Prof. Karl Skorecki, Director of Medical and Research Development at Rambam, whoseMolecular Medicine Laboratory at the Technion‘s Rappaport Institute investigates variouspopulations‘ genetic susceptibility to such common scourges as cancer and kidney disease.

So elegant is DNA‘s structure that scientists, looking at it in the lab, have sought beautiful languagewith which to describe it – a double helix, a coiled ladder – and artists have rendered its sidemembers (the sugar-phosphate backbone) and 3 billion rungs (chemical-base pairs) in silver andgold studded with gleaming gems (histone proteins).

As for the secrets of DNA applicable to clinical medicine? Rambam is on the case.

A significant clue that led Prof. Skorecki’s teamto focus on the APOL1 gene is the absence ofthe alleged culprit mutation in the 306Ethiopian individuals whose DNA analysis hadbeen included in the scientific community’sprevious investigations of MYH9. Prof.Skorecki’s team had noticed that Ethiopians arerelatively protected from kidney disease. Theysuspected a causative link.

Furthermore, the APOL1 gene was alreadyknown to be involved in resistance to Africansleeping sickness. This disease is caused by aninfectious pathogen that attacks the brain andresults in coma and death. It does not occur inNorth America, but is still prevalent in certainregions of Africa and is thought to have been amajor cause of death in the past. This detail hasled Prof. Skorecki’s team to suspect thatincreased vulnerability to kidney failure amongpersons of West African heritage in North

America may be related to their forebearshaving acquired protection from Africansleeping sickness in the ancestral past.”The challenge is now to prove the biological andepidemiological relationship between mutationson the APOL1 gene and the risk for kidneydisease, and to develop preventive andtherapeutic interventions,” Prof. Skorecki says. Heand his team plan to pursue their hypothesis incollaboration with nephrologist Dr. Sheldon Tobeof Sunnybrook and other colleagues worldwide.

P�

PRIZEWINNING SYNERGY

e Mystery of the Missing Mutations

On the Culprit's Trail

Following the Clues

ESKD is a multi-gene disease, but it'slikely as close to a single-gene diseaseas any multi-gene disease will get.

Prof. Karl Skorecki

Director, Medical and Research Development

ELEMENTARY, DEAR WATSON

Dr. Doron Behar of Rambam’s Molecular MedicineLaboratory, directed by Prof. Karl Skorecki, and Prof. RichardVillems, Director of the Estonian Biocentre in Tartu, are thelead authors of a report in the June 9, 2010 issue of Naturethat has announced the most comprehensive mapping ofthe Jewish genome.

The researchers’ comparative genetic analysis ofindividuals whose ancestry traces to 14 Diasporacommunities and 69 worldwide non-Jewish populationshas yielded findings consistent with the traditionalhistorical narrative of Jewish origins in the Levantfollowed by migrations and varying degrees ofassimilation and admixture with local non-Jewishpopulations.

The research team also included scientists and scholarsfrom Italy, Portugal, Russia, Spain, the United Kingdomand the United States. The names of these countriescould not be more evocative for they recall major stationsin the 2,000-year Jewish Diaspora.

Think of it as a video game with clear-cut bad guys, good guys, and a teamof championship gamers alert for the surprises and shifting rules generatedby the game itself – and for the recalcitrant mysteries at the game’s core.

In this case, the bad guys are cancer cells. The good guys, a daring duo, areantigen-presenting cells (APCs) and T cells – white blood cells that worktogether and are essential to the body's immune response. APCs present (pointout) foreign bodies to the T cells, which attack and destroy the interlopers. But

cancer is an aggressive and resourceful disease. Cancer cells damage thebiological process by which APCs present intruders to T cells for destruction.The gamers are clinical researchers. For the past five years, a multicenterteam from Rambam Health Care Campus and Beth Israel DeaconessMedical Center/Harvard Medical School has worked to develop a vaccineable to prevent cancer recurrence in patients with chemotherapy-inducedremission.

On April 27, 2010, team members met at Rambam for a conferenceentitled ”Cancer Vaccine and Immunotherapy Program.”They discussed theoutcomes to date of a joint Rambam-Harvard Phase I-II interventionalprevention trial involving 42 patients with multiple myeloma (MM), ahematological malignancy of the white blood cells in the bone marrow. Acombined Phase I-II trial is intended to test the efficacy and toxicity of anexperimental drug or vaccine.

Team member Dr. Irit Avivi, Senior Attending Hematologist in theDepartment of Hematology and Bone Marrow Transplantation, under thedirection of Prof. Jacob Rowe, explains that in the lab, the researchersmechanically fused MM patients’ APCs and myeloma cells. The fusion cellswere produced at disease presentation, then frozen and stored.Meanwhile, trial participants underwent chemotherapy until their diseaselevel became minimal. At this point, they received the fusion cell vaccine inan attempt to rouse the immune system against residual MM cells.

”In most evaluable cases, we found that the patient’s immune system workedagainst the tumor, and in many patients, we saw durable remission,” Dr. Avivireports, adding that the researchers will next test fusion cell vaccines on patientswith leukemia and kidney cancer.

P�

Rambam on CallPRIZEWINNING SYNERGY

RAMBAM-HARVARD TEAM’S

ON A QUESTIn Israel, all holidays begin on the preceding eve. On December 31, 2009,Rambam ushered in secular New Year 2010 with the 3rd Annual ResearchSeminar. Prof. Scott L. Friedman delivered the Rafael Research AlumniHonorary Lectureship; LHCRIR Charter Members gastroenterologist Prof.Yehuda Chowers and molecular pathologist Dr. Edmond Sabo describedtheir progress in studies generously supported by the Legacy HeritageFund; and Class of 2010 Etai Sharon Memorial Fellows presented theirresearch results to date.

Rambam's Prof. Jacob Rowe (far right) hosts Beth Israel Deaconess Medical Center/Harvard MedicalSchool colleagues (l-r) Prof. Mark Zeidel, Chairman, Department of Medicine; Dr. Jacalyn Rosenblatt,Division of Hematology/Oncology; Prof. Lowell Schnipper, Chief, Division of Hematology/Oncology;and Prof. David Avigan, Director, Hematologic Malignancies/Bone Marrow Transplantation Program.

One-Two Punch

e FamilyTREE

Physicians are always primed to ask the correct questions;they need protected time to pursue the answers.

Scott L. Friedman, MD

President, American Association for the Study of Liver DiseasesFishberg Professor of Medicine and Chief of the Division of Liver DiseasesMount Sinai School of Medicine in New York

Keynote Speaker, 3rd Annual Research Day, Rambam Health Care Campus

I see a great future! In another five to ten years, we will havehere in Bat Galim a major center of biomedical activities thatwill include one hundred research groups led by PrincipalInvestigators – approximately 60 Technion Members and 40Technion Faculty of Medicine affiliated Legacy Heritage ClinicalResearch Institute at Rambam Members plus 500 graduatestudents and research assistants. It's for the good of Haifa, theGalilee and the State of Israel.

Prof. Ido Perlman

Dean, Rappaport Faculty of MedicineTechnion-Israel Institute of Technology

3rd Annual Research Day, Rambam Health Care Campus

InMasaka, 25physicians, nurses,teachers, andcommunityworkers attend a2-week course inwhich Dr. MargalitLorber conveys the latest medical knowledgeconcerning HIV.

Gynecologicaloncologist Dr.Amnon Amitspends 3 weeksin Xinghuateachinglaparoscopy toyoung physicians,and also performs laparoscopic surgeries to remove ovarianand uterine tumors from 18 patients.

In late May 2010, a confrontation between Israel Navy commandos and foreignactivists aboard the Turkish-flagged ferry Mavi Marmara ended tragically. NineTurkish nationals were killed, and seven commandos and dozens of activistswere wounded. Israel Air Force helicopters evacuated the most severely injuredto Rambam.

“Doctors do not busy themselves with politics,” Director General Prof. RafiBeyar soberly stated in answer to a reporter‘s question as he strode into ER.There, the wounded adversaries had been placed side by side in Shock TraumaRoom beds and then wheeled into parallel surgical suites for lifesavingoperations.

”We treat all of our patients with the same professionalism,” Prof. Beyaradded, ”and the most advanced medical expertise is provided to everyone.”

In June, Dr. Margalit Lorber, Head of the Autoimmune Diseases Unit, directlyexperienced the diplomatic fallout from the clash when she traveled to a pre-G8 Summit event in Ottawa, Canada to deliver a keynote address entitled ”TheFeminization of AIDS.” As she rose to speak, the Turkish delegation walked outin protest.

Prof. Beyar’s words ring true, however. In the contest within the human psychebetween belligerent and destructive urges and creative, healing andconstructive impulses, physicians strive to realize the humanitarian ideals oftheir profession.

For instance, also at the pre-G8 Summit, Dr. Lorber was cordially approachedby Afghani pediatrician Dr. Massouda Jalal, who raised the idea of cooperationbetween Israel and Afghanistan. Dr. Jalal, who received the UN Watch’s MorrisB. Abram Human Rights Award for 2010, has served her country as Women's

Affairs Minister from 2004-2006 and was a candidate for her country'spresidency in 2002.

Dr. Avraham Lorber, Director of the Pediatric Cardiology Institute and Adultswith Congenital Heart Disease Service, is Dr. Margalit Lorber’s husband and theother half of an Israeli couple that travels the globe sharing their medicalknow-how.

In June, he was at home in Israel and at Rambam to direct the third in a seriesof four intricate surgeries to repair the heart of Nikolay Bocharnikov (7), wholives with his family in an agricultural station of Krasnodar Federation in Russia.

Nikolay was born with a univentricular heart. ”Leave the child to die,” theregional-hospital specialist had advised. Through the grapevine established byfamilies in Russia whose children had successfully undergone lifesavingcardiological interventions in Israel, the distraught parents found their way toDr. Lorber. He assured them that with appropriate medical intervention, Nikolaystood a 95% chance of survival and of enjoying a reasonable quality of life.

How is it, Dr. Lorber is asked, that the small State of Israel has medical expertiseso keenly sought by nations around the world?

”Our excellent physicians have the gifts,” he answers, ”and there is qualitativesurgical activity at Rambam, but our skills have been learned abroad wherethere is a critical mass of interventions that provides us with invaluableexperience.”

Rambam has shared Israeli medical expertise with more than a dozen countriesin Africa, Asia and Europe and also as far afield as South America:

Twenty-fivePortuguesephysicians travelto Rambam for 10days of advancedMass Casualty Situations (MCS) preparedness training.

Four months after Chile is hit with an 8.8 earthquake followedby a tsunami, Dr. Moshe Michaelson, Director of the Trauma Unit, andGila Hyams, RN, Director of the Teaching Center for Trauma Emergencyand Mass Casualty Situations (MCS), lead an Israeli delegation to thatcountry, where they train 300 rescue unit personnel.

INTERNATIONAL OUTREACH

P�

BEYOND POLITICS

Senior PhysicianDr. Yoav Bergerand ChiefResident Dr.Sergiu Socea ofthe Departmentof Ophthalmology conduct 55 cataract and glaucoma operations onchildren and adults at the Centre Hospitalier d’Essos in Yaounde, andalso train local medical teams to perform the procedures.

Prof. Moshe Berant, Chair of the Clinical Studies Ethics(Helsinki) Committee, leads workshops at Addis Ababa MedicalSchool to assist that institution in obtaining World HealthOrganization (WHO) certification for conducting clinical research.

Thirtyhealthcareprofessionals fromBelarus, Georgia,Russia, Ukraine andUzbekistan cometo Rambam for advanced training in caring for HIV carriers.

InAugust 2010, Dr.Mo’men Kharraz ofRafidia Hospital inNablus completestwo years ofadvanced orthopedic surgical training at Rambamunder the auspices of the Peres Center for Peace.

Drs. Avraham and MargalitLorber travel to Da Nang Hospital, where he teaches local physiciansto perform lifesaving therapeutic catheterizations for children withcongenital heart disease, and she teaches prevention of mother-to-child HIV transmission.

For the past seventeen years, British Friendshas been directed by one extraordinarilydedicated volunteer, Anita Alexander-Passe.Her quiet and consistent efforts have broughta steady stream of tzedakah our way, whichwe have used to replace obsolete medicalequipment and modernize hospital facilities.We can’t think of higher praise for Anita andher values than that expressed by hergranddaughter, Anoushka Alexander-Rose (pictured). Anoushka has decidedto use some of the gifts that she received for her Bat Mitzvah to purchasenew equipment for our Children’s Hospital.

In 2007, Mr. Sammy Ofercontributed $25M for the Northern RegionalUnderground Emergency Hospital. The projectrequires additional tens of millions of dollars for itscompletion. In May 2010, in order to help raisefunds for the new facility, Canadian Friends turnedthe underground parking garage of GreenwinSquare in Toronto into the replica of a hospitalcomplete with doctors, patients, and equipment.Board member Marilyn Gotfrid introduced RHCCDirector General Rafi Beyar and Dr. MichaelHalberthal, Director, Pediatric Cardiac Critical CareUnit at Rambam, to the over 150 people in attendance. The event wassponsored by Greenco, the Danbury Group, Minden Gross LLP, and VerdirocDevelopment Corporation.

”I hear somethingabout a child or an elderly person inneed of medical attention and I wantto do something, but to be effective,you need to focus your energy – Sandytaught me this” says Joan (Mrs.Sanford) Weill, pictured with her

husband and flanked by(l-r) Mr. AdamEmmerich,President,American Friends ofRambam Medical Center(AFORAM); Prof. RafiBeyar, Director General,RHCC; and (far right) Mr.Yair Kagan, Executive VicePresident, AFORAM. On

March 3rd, the couple opened theirManhattan home to American Friends.Mrs. Weill appears holding a 1stcentury CE Roman unguentarium(cosmetic flask) of light amber glass,which was presented to the couple byRambam.

Please welcome Michele Segelnick, who has been appointed Deputy ExecutiveDirector of American Friends of Rambam Medical Center (AFORAM). Ms.Segelnick most recently served as Director of Development, Hebrew Academy ofthe Five Towns & Rockaway, in Lawrence, New York. She brings to her newposition more than two decades of fundraising experience on behalf of localJewish schools and Israeli hospitals.

Well-Appointed

Israel’s achievements in the lifesciences, medical robotics, solarand water technology, and morewere on display in Boston fromApril 30-May 9, 2010 atCongregation Mishkan Tefila andthe Museum of Science duringIsraeli Innovation Week, whichattracted thousands of visitors.Director General Prof. Rafi Beyarwas among the keynote speakers.

The opening event took place atMishkan Tefila in the context ofthe third Alan J. Tichnor MemorialWeekend, whose theme wasHealing the World throughTechnology. The event was madepossible through the generosity ofSid and Nancy Lejfer.

Friend of Rambam Robin JR Blattarranged our participation in themuseum show. Visitors to theRambam exhibit interacted withcomputerized simulations thatinvited them to diagnose and”treat” atrial fibrillation andischemic heart disease, and togrow pulsating human heart cellsand heart tissue from stem cells.Lisa Woliner (pictured below, right)of AFORAM patiently instructedchildren in how to use thecomputer program.

Vieux Montréal(est. May 1642) is so lovely inspringtime that the heart expands!Prof. Rafi Beyar was there – also inMay – to expand his listeners’scientific understanding of theheart at an event entitled”Cardiovascular Innovations:Where Engineering MeetsMedicine.” P.M. Johnson, formerPremier of Québec, was amongthe guests. Henri Elbaz, FormerExecutive Director of the JewishGeneral Hospital, arranged Prof.Beyar’s visit, and Gérard Laganièreand Bernard Poulin (the latter is

President of the engineering firmSMi) co-hosted the event, whichincluded a cocktail reception andgourmet supper at handsome andhistoric Club 357c. Prof. Beyar alsolectured at theMontreal HeartInstitute and metwith the Deans ofthe Faculty ofMedicine atMcGill Universityand the Universitéde Montréal.

In 2009, the gift of anOncology Hospital for Rambam's new WestCampus was announced by the FishmanFamily in loving memory of Joseph Fishman.On August 11, 2010, Dr. Esty Golan, ChiefAdministrative Officer of RHCC, was guest ofhonor at an outdoor reception at the homeof Moti and Nati Fishman, son and daughter-in-law of the late Mr. Fishman, whosedaughter and son-in-law Ilanit and Noam Cohen were among those attending.The event was held to introduce 60 guests from the Israeli community in Torontoto Canadian Friends of Rambam (CFRAM), and was held in the presence of theConsul General of Israel in Toronto, Mr. Amir Gissin. Nati Fishman and Nahariyanative Orly Meyer organized the evening. Guest vocalist Paula Valstein entertained.Dr. Golan is pictured at far right with hostess Nati Fishman and guests Mr. andMrs. Moshe Rosen, dear friends of the late Joseph Fishman.

Chief Rabbi Lord JonathanSacks is pictured sounding a silver shofarpresented to him by Director General ofRambam Prof. Rafi Beyar. The occasionwas a reception hosted by the ChiefRabbi and his wife, Lady Elaine Sacks, attheir home on May 11th. The convivialevening brought together prominentLondon Jewish Community memberswith representatives of Rambam’sleadership echelon, among them Prof.Aaron Ciechanover and Mr. EitanWertheimer. The aim was to recruit aBoard of Directors to lead an expanded

and reinvigorated British Friendsassociation (BFRAM), of which the ChiefRabbi has graciously agreed to becomethe patron. Stanley Brodie QC has set anexample by becoming the first chartermember. Among the organizers whogave generously of their time wereMalka Leon, who attended with herhusband, Amnon, Leora Torn-Hibler,who attended with her husband,Shimshon, Mr. Amir Levy of GoldmanSachs UK, and Mr. Lior Hannes, whorepresented the IDB Group.

P�

Rambam on CallFRIENDS HELP BUILD A HOSPITAL!

A Friend in Deed

SALUTARY EVENTS

A Weill of a Good Time! Boston Been

SHOFAR, SO GOOD(l-r) Chief Rabbi Lord Sacks; Mr. Eitan Wertheimer, Friend of Rambam and CapitalCampaign Co-Chair; Prof. Jacob Rowe, Director of the Department of Hematologyand Bone Marrow Transplantation; Mr. Ron Prosor, Ambassador of the State ofIsrael to the Court of St James.

Friend of RambamHenri Elbaz

BRITISH FRIENDS

AMERICAN FRIENDS

CANADIAN FRIENDS

(l-r) Friends of Rambam Barry Green,Barry Alper, and Larry Zimmerman

Mazel Tov toEditor-in-ChiefShraga Blazer,Director,Department ofNeonatology,on the June10th launch ofthe RambamMaimonides

Medical Journal (RMMJ). The international, open-access, peer-reviewed journal is published onlineonly atwww.rmmj.org.il. Guests attending theRambam Summit received the handsomeinaugural issue in hard copy, and it will surely be acollector’s item for Israel buffs: the first-ever

medical center affiliated scientific journal to bepublished in this country.

On July 21st, Prof. Blazer, accompanied byAssociate Editor Prof. Rafael Beyar, DirectorGeneral of Rambam, and Deputy EditorsProfessors Michael Aviram, Ian M. Gralnek, andJacob M. Rowe, went up to Jerusalem to presentthe first fruits of their endeavors to the Knesset’sScience and Technology Committee. They werereceived with warm congratulations by Minister ofScience and Technology Prof. Daniel Hershkowitz,MK, Committee Chair Meir Sheetrit, MK, and theChief Scientists of the Ministry of Science andTechnology and the Ministry of Health.

Beauty and meaning were enhanced at Rambamon February 4th, International Cancer PreventionDay, with the opening of an exhibit of drawings bychildren hospitalized in pediatric oncology units inthe Middle East and the United States. The eventwas held in the context of "The Day I Will NeverForget" project, which was initiated in 2007 by theMiddle East Cancer Consortium (MECC). Childrenfrom Cyprus, Egypt, Israel, Jordan, the PalestinianAuthority, Turkey, and the USA participated.Pictured representing Rambam is young artist LenaIbrahem, who appears with her mom, Miriam; theyare flanked by (far l and r) Social Worker SiwarMakhoul-Khoury and Art Therapist AnaLia MagenSchlyfestone of the Pediatric Hematology &Oncology Department.

In 2010, fifty 9thgraders from IroniAleph Junior High

School in Haifa came to Rambam for a pilotcourse intended to provide them with insightsinto the medical profession. The pupils touredhospital departments, attended lectures by seniorphysicians and nurses, and participated inpractical workshops devoted to basicresuscitation, emergency and trauma care, theheart and vasculature, and organ donation andtransplantation. The pupils also took part in twolarge-scale Home Front Command exercisestesting hospital preparedness for mass casualtysituations (MCS) and chemical warfare attacks.

SoulSearching

”Why is there consciousness? Why do we have a soul? You canhave a whole course in biophysiology and never hear the wordsoul,” said psychoanalyst Prof. Yoram Yovell of the University ofHaifa, setting the day’s tone. The occasion was the Department ofNursing’s Second Annual Conference, which took place on March17th in Spencer Auditorium and was dedicated to the subject ofholistic mind-body healing. Guest and in-house speakersaddressed the meliorating powers of medical tai chi, musictherapy, relaxation guided imagery (RGI), and related techniques.Dr. Simon Vulfsons (pictured, far left), Deputy Director of the PainRelief Unit, didn’t keep it theoretical; he asked his listeners toclose their eyes, and led the audience in meditation.

P�

American Friends ofRambamMedical Center

Yair KaganExecutive Vice President521 Fifth Avenue, Suite 1731New York, NY 10175USA

Tel: 212.292 4499info@aforam.orgwww.aforam.org

Canadian Friends ofRambamMedical Center

Suzanne KayeExecutive Director64 Merton Street, 1st FloorToronto Ontario M4S 1A1Canada

Tel: 416.481 5552s.kaye@cframbam.comwww.cframbam.com

British Friends ofRambamMedical Center

Anita Alexander-PasseDirectorOpal Court 1120 Regents Park RoadLondon N3 3HYUnited Kingdom

Tel: 020.8371 1500Fax: 020.8371 1501alexanderpasse@tiscali.co.uk

Israeli Friends ofRambamMedical Center

Judith AsninCoordinatorRambam Health Care CampusPOB 9616Haifa 31096Israel

Tel: 972.4.852 0670Fax: 972.4.851 5527y_aguda@rambam.health.gov.il

Israel Main Office &All Other Countries

Talia ZaksHead, International Relations& Resource DevelopmentRambam Health Care CampusPOB 9602Haifa 31096, Israel

Tel: 972.4.854 2042Fax: 972.4.854 2104t_zaks@rambam.health.gov.il

SURF

RAM

BAM

www.rambam.org.il

For monthly updates, subscribe toour complimentary e-newsletter at

NURSES’ STATION

Young ArtistsGen Rx

Neonate

Visit the RAMBAMYouTube Channel

Research and technology have dynamicallytransformed medicine, but human needs and feelingsdon’t change. If we don’t relate to the patient’s soul,we will have added to the patient’s suffering.

Hanna Admi, RN, PhD

Director of Nursing

With thanks for assistance in compiling this bibliography to Margie Serling Cohn, Head Librarian, Alfred Goldschmidt Medical Sciences Library, Technion – Israel Institute of Technology.

Save the date

Kudos to recentlypublished Rambam authorsand editors Dr. AhmadAssalia, Deputy Director,Department of Surgery B;Dr. Doron Behar, SeniorPhysician, Department ofCritical Care Medicine, andRHCC-based coauthorsProf. Karl Skorecki,Director, Medical andResearch Development,

and GuennadyYudkovsky of theRappaport Facultyof Medicine and ResearchInstitute; Prof. ShragaBlazer, Director,Department ofNeonatology; and Prof.Diana Gaitini, Director,Ultrasound Unit,Department of MedicalImaging.

Schein’s Common SenseEmergency Abdominal Surgery:An Unconventional Book forTrainees and Thinking Surgeons/ Editors Moshe Schein, Paul N.Rogers, Ahmad Assalia; EditorialAdviser/ Robert Lane. Springer-Verlag New York, 2010.

RambamMaimonidesMedical Journal /Editor-in-ChiefShraga Blazer.Rambam HealthCare Campus, 2010.

Doron Behar and Richard Villemset al. The Genome-WideStructure of the Jewish People.Reprinted by permission fromMacmillan Publishers Ltd:Nature 466, 9 June 2010: 238-242, copyright 2010.

KUDOS!

RAMBAM SUMMIT >> May 30-31, 2011

MusculoskeletalUltrasound withMRI Correlations /Vikram S. Dogra,Diana Gaitini.Thieme MedicalPublishers, 2010.

Mrs. Ilana Siman Tov Dodeles, RN, Hospital NurseResuscitation Coordinator, teaches pupils toperform cardiopulmonary resuscitation.

Prin

ted

on10

0%re

cycle

dpa

per