Mount Sinai Queens Celebrates Anniversary and Staff

Sep 23, 2019 | Community, Featured

Norma Calame, Director, Human Resources, center, and Carol Moutaftsis, Administrative Manager, Human Resources, far right, celebrated with honorees that included, from left: Nelson Barayuga, MT, Assistant Director, Laboratory (Team of the Year); Daniella Stephen, MPH, MSN, RN, CPHQ, Clinical Program Manager, Nursing Quality (Service Excellence); Hakima Aouchiche, MD, Critical Care Medicine (Physician of the Year); Roseller Tagupa, MT, Director, Laboratory (Team of the Year); and Anthony Auditore, MNST, RN, NE-BC, Nurse Manager, Hemodialysis and 3 East (Manager of the Year).

Mount Sinai Queens recently marked 20 years of delivering high-quality health care to Queens residents, hosting jubilant hospital-wide celebrations that spotlighted its transformation from a small community hospital into a world-class institution since it joined The Mount Sinai Hospital in 1999. As part of the festivities, Mount Sinai leadership honored outstanding hospital staff and FDNY-EMS partners for providing skilled and compassionate patient care and service, every day.

Today, its six-story, 140,000-square-foot, $180 million Pavilion is home to Mount Sinai Doctors, new operating rooms and an interventional radiology suite, the Stavros Niarchos Foundation Emergency Department, and more, serving as a beacon of health care excellence in the borough.

Mount Sinai Queens Executive Director Caryn A. Schwab with Employee of the Year Rashid Larry, RT, Lead CT Technician, Radiology.

Most recently, Mount Sinai Queens opened a first-of-its-kind Cerebrovascular Stroke Center—introducing technology never before used in the United States—to provide the fastest and most efficient treatment for people experiencing the most devastating forms of stroke.

“Everyone on our staff, from doctors and nurses to technicians and housekeepers, are key to our accomplishments and future success,” said Caryn A. Schwab, Executive Director of Mount Sinai Queens. “We recognize and celebrate their contributions because they are extraordinary, and we are fortunate to have a great group of people working toward our shared mission.”

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Road to Resilience Episode 16: Unknown Exposure

Sep 11, 2019 | Featured, Insights

Nobody knows what was in the dust cloud that blanketed Lower Manhattan on September 11, 2001. But we’re increasingly sure about the health consequences—including asthma, PTSD, and cancer. On this episode, Michael Crane, MD, MPH, Medical Director of the World Trade Center Health Program Clinical Center of Excellence at Mount Sinai, and volunteer responder Bianca Bob Miller, talk about what it was like to work at Ground Zero, what we know about 9/11-related illnesses, and what their experiences taught them about resilience.  

Road to Resilience brings you stories and insights to help you thrive in a challenging world. From fighting burnout and trauma to building resilient families and communities, the podcast explores what’s possible when science meets the human spirit. 

Listen to this episode on the Road to Resilience website

Michael A. Crane, MD, MPH

Mount Sinai Receives U.S. Military Contract to Identify Exposure to Weaponized Infectious Agents

Sep 9, 2019 | Featured

One of the greatest challenges facing the U.S. military is being able to determine, definitively, whether troops serving in combat zones have been exposed to weaponized infectious agents, chemicals, or radiation, or if someone has been working with materials used in making weapons of mass destruction. This knowledge would enable the U.S. military to respond immediately.

The Icahn School of Medicine at Mount Sinai is now taking an active role in such a national security initiative, which was launched recently by the Defense Advanced Research Projects Agency (DARPA)—an arm of the U.S. Department of Defense. Under the four-year, $27.8 million contract, Mount Sinai researchers and colleagues from industry and other academic institutions will work together to explore new methods of finding molecular signatures in blood that can identify exposures and the time of exposure. They will also develop field-deployable instruments that can perform these sensitive forensic and diagnostic analyses.

“The human body logs exposures in a rich biographical record that we carry around with us in our epigenomes,” says Stuart Sealfon, MD, Professor of Neurology at the Icahn School of

Principal Investigator Stuart Sealfon, MD, right, with research team members from the Department of Neurology: Elena Zaslavsky, PhD, Assistant Professor, and Venugopalan Nair, PhD, Associate Professor.

Medicine at Mount Sinai, and Principal Investigator on the contract, which is part of DARPA’s new Epigenetic Characterization and Observation (ECHO) program. “The ECHO technology we’re developing will enable us to quickly read someone’s epigenome from a small amount of blood and measure any changes in the cells to accurately predict exposure to hazardous agents or materials.”

Current forensic and diagnostic screening methods require large instruments and are unable to detect previous exposure, according to Dr. Sealfon. The researchers will focus on creating advanced microfluidic instrumentation with a reduced footprint that can be easily deployed and moved around battlefields for the sequencing and analysis of human cells. “This level of portability could enhance the military’s ability to conduct timely surveillance of emerging threats around the world where U.S. troops or our allies are actively engaged,” he says. It could also make a difference by ensuring that medical countermeasures are undertaken when soldiers encounter hazardous nerve agents, such as sarin and VX, or other toxic agents, such as phosgene and chlorine.

Mount Sinai will draw on its considerable experience in the fields of genomics, proteomics, and epigenomics over the course of the research project. In order to detect epigenetic markers in small amounts of blood, the researchers will also leverage their strengths in the rapidly unfolding science of single cell biology. “My laboratory is an integrated computational and experimental group with cell biologists, molecular biologists, computer scientists bioinformaticists, physicists, mathematic modelers, and database developers,” Dr. Sealfon says. “We are also fortunate to have outstanding collaborators within Mount Sinai—including Robert Sebra, PhD, Associate Professor, Department of Genetics and Genomic Sciences, and his lab—and from outside laboratories, since that gives us a broader range of expertise.”

Defense security is only one aspect of the project funded by DARPA. Just as important, according to Dr. Sealfon, is the potential application of ECHO technology in general medicine. “It could be valuable in the field of infectious disease, for example, to quickly and reliably predict if someone has a bacterial or viral infection during the influenza season, giving patients a point-of-care benefit,” he says. Another possible outgrowth of the DARPA work is the development of basic research instruments that could generate epigenetic data on single cells within minutes. “It’s likely that medical applications from this research program will be realized in a shorter time frame than those on the military side, which are more demanding,” Dr. Sealfon says. “This may result, for example, in the next-generation sequencing technology making many of the genomic analyses we now do much faster, easier, and more accessible.”

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Study Links Dust at Ground Zero to Prostate Cancer

Sep 9, 2019 | Featured, Prostate Cancer

Eighteen years after the September 11 attacks, Mount Sinai Health System researchers have found a higher incidence of prostate cancer among the World Trade Center (WTC) first responders than other populations, suggesting that chronic inflammation can facilitate the development of prostate cancer.

Emanuela Taioli, MD, PhD; and William Oh, MD

The most recent findings, published in June in Molecular Cancer Research, were led by Emanuela Taioli, MD, PhD, Director of the Institute for Translational Epidemiology and Associate Director for Population Science at The Tisch Cancer Institute; and William Oh, MD, Chief of the Division of Hematology and Medical Oncology at the Icahn School of Medicine at Mount Sinai, and Deputy Director of The Tisch Cancer Institute.

“Our research supports the first line of evidence that acute World Trade Center dust exposure through inhalation can profoundly disturb gene expression and immune cell infiltration in the prostate,” says Dr. Taioli.

While working at Ground Zero, the first responders did not wear protective gear and were exposed to dust particles composed of volatile organic compounds from jet fuel, as well as asbestos, benzene, silica, glass fibers, polychlorinated biphenyls, polychlorinated dibenzofurans, and dioxins from the collapsed buildings. Given the fine particulate nature of the WTC dust, the researchers hypothesize that the toxins entered the blood through the lungs and eventually reached the prostate and other distal organs.

“The results of this study support our hypothesis that exposure to the dust at the World Trade Center caused chronic changes in the body,” says Dr. Oh. “The long-lasting inflammatory effect in the prostate revealed in our study calls for further investigation as to the effect of this exposure in other organs, such as the kidney or thyroid, or the central nervous system.”

In 2018, Dr. Taioli led a study published in the European Journal of Cancer Prevention, which reported that responders who spent more time working at Ground Zero and had a higher exposure to the dust cloud that formed after the WTC buildings collapsed, had more advanced stages of prostate cancer—stages III and IV—representing tumor invasion. Interestingly, the 2018 study found that at the beginning of their service at the WTC, the responders were mostly nonsmokers of diverse ethnic backgrounds who were considerably healthier than the general population and at lower risk for cancer.

According to the recent 2019 report, approximately 20 percent of human cancers are thought to be caused by chronic infection or inflammatory states, and chronically unresolved inflammation is related to increased risk of malignant disease. When tested in the laboratory, the toxic dust was shown to induce the secretion of cytokines— small proteins involved in modulating responses to inflammation infection, cancer, and trauma.

Mount Sinai runs the largest World Trade Center Health Program Clinical Center of Excellence in the New York metropolitan region, with 25,000 patients who have consented to participate in research. A biobank of more than 600 cancer samples from first responders has helped lay the groundwork for Mount Sinai’s WTC research findings.

Dr. Taioli says the latest research raises additional questions about whether air pollution, in general, causes an inflammatory response in people. “This work has larger implications for the population exposed to environmental particulates, such as emissions from motor vehicles, industrial processes, power generation, and the household combustion of solid fuel,” she says. “Inflammation could be the common pathway driving an increase in cancer occurrence.”

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Personalized Digital Health Screenings at Lab 100

Sep 9, 2019 | Featured

Tucked away in an office on the campus of the Icahn School of Medicine at Mount Sinai is a futuristic medical clinic—Lab 100—that provides patients with a 90-minute comprehensive health checkup using the latest technology to measure their vital signs, their strength, cognition, balance, and dexterity. Designed as a complement to a primary care visit, Lab 100, which opened to the public in October 2018, provides patients with information that can help them lead a healthier lifestyle. It serves as a digital biometric health screening that alerts patients and practitioners to areas of their health they need to improve, such as poor sleep habits or a stronger core that can be achieved through yoga or a different exercise routine.

“Our goal is to empower patients by rapidly and transparently providing them with their own personalized health data,” says Marina Gazayeva, NP, Lab 100.

Lab 100 patients fill out an online questionnaire in advance of their appointments. When they arrive at the clinic, they visit eight health stations, including one that measures their body fat ratio and skeletal muscle mass. At the conclusion of the visit, their health results are posted on a large digital screen that serves as a point of discussion between the patient and a Lab 100 nurse practitioner. Within 24 hours after their visit, patients receive a health report card of their results, with recommendations for improving their health.

The cost of a visit, which is not covered by medical insurance but may be covered through a health spending account, is $199 for Mount Sinai Health System employees and $399 for nonemployees.

Learn more about Lab100

Specialty Pharmacy Adds Access to Complex Therapies

Sep 9, 2019 | Community, Featured

Donald Mashni, PharmD, right, with David L. Reich, MD, center, and José Almonte, Director, Specialty Pharmacy Call Center.

A new option is now available for Mount Sinai Health System patients and employees who have rare or chronic disorders that require complex medications such as immunotherapy or chemotherapy—the Mount Sinai Specialty Pharmacy. The facility, which opened in June at The Mount Sinai Hospital, helps patients seek insurance approval and financial assistance, and relieves the administrative burden of physicians, with the ultimate goal of improving patient outcomes.

“The Mount Sinai Specialty Pharmacy will offer patient-focused, convenient, and affordable services for all our patients,” says Donald Mashni, PharmD, Director, Specialty and Outpatient Pharmacy, Mount Sinai Health System. Specialty pharmacies dispense complex medications that require special storage and handling and ongoing clinical support and monitoring by specially trained pharmacists.

When patients and doctors present specialty prescriptions to the Mount Sinai Specialty Pharmacy, the pharmacy staff can assume the important tasks of securing insurance approval, financial assistance, and clinical counseling. Pharmacy staff also coordinate delivery to the patient’s home or to the physician’s office. “Our facility will tie everything together,” Mr. Mashni says. “The goal is to keep all patient care inhouse, from diagnosis through post-treatment follow-up. This approach provides thorough and immediate communication among pharmacists and specialists. It also improves the efficiency and accuracy of the medications.”

For example, one commonly prescribed specialty drug is adalimumab, or Humira, an advanced biologic medication for severe Crohn’s disease and rheumatoid arthritis. Patients inject a pre-filled syringe every other week. The drug must be refrigerated, and each syringe must be used in full and injected in the thigh or stomach, in a different spot each time. The patient should not skip a dose or stop taking the medication without consulting a physician or pharmacist. “Adherence to the treatment schedule is critically important,” Mr. Mashni says. “It maximizes the benefit patients get from the medication and improves outcomes.”

Specialty medications once were a niche market. But advances in drug research mean they are available for many more conditions. The U.S. Food and Drug Administration approved 39 new specialty medications in 2018, according to Specialty Pharmacy Times, and because they can be so costly, specialty drugs are expected to account for almost 50 percent of drug spending by 2020, although they represent only about 2 percent of the total prescriptions filled.

The Mount Sinai Specialty Pharmacy is launching services in therapeutic categories that include HIV, hepatitis C, inflammatory bowel disease, rheumatology, dermatology, and oncology. It shares space with the Mount Sinai employee pharmacy in the Annenberg Building and functions like a traditional specialty pharmacy but with the advantage of full integration with Mount Sinai’s hospitals and physicians. The Health System also operates two other specialty pharmacies, which are part of the Institute for Advanced Medicine and specialize in treating patients with HIV. They are the West Village Pharmacy, at the Center for Transgender Medicine and Surgery, and the St. Luke’s-Roosevelt Outpatient Pharmacy in the Samuels Clinic at Mount Sinai West.

A new Call Center, adjacent to the Mount Sinai Specialty Pharmacy at The Mount Sinai Hospital, is centralizing all of the Health System’s specialty pharmacy services and fulfillment, with Call Center staff coordinating prior authorization, financial assistance, and delivery of medications. These services are essential as the Mount Sinai Specialty Pharmacy is seeking accreditation from URAC, the gold-standard accrediting body for specialty pharmacies. URAC accreditation will allow the pharmacy to gain access to more limited-distribution drugs and get contracts with more insurance plans.

“The Specialty Pharmacy is enabling Mount Sinai to provide seamless service for patients with complex and chronic illnesses, from diagnosis through treatment and long-term aftercare,” says David L. Reich, MD, President and Chief Operating Officer of The Mount Sinai Hospital, and President of Mount Sinai Queens.

Learn more about Mount Sinai Specialty Pharmacy