Featured | Mount Sinai Today

Educating Providers on the Impact of Climate Change

Mar 5, 2019 | Featured, Research

From left: Robert O. Wright, MD, MPH; Emily Senay, MD, MPH; Allan Just, PhD, Assistant Professor of Environmental Medicine and Public Health; Perry E. Sheffield, MD, MPH, Assistant Professor of Environmental Medicine and Public Health; and Roberto Lucchini, MD.

Climate change is taking a toll not just on the environment, but also in the clinic, with a rise in asthma, cardiovascular disease, insect-borne viruses, and heat-related death. That was the urgent message of the inaugural Clinical Climate Change conference, hosted by Mount Sinai’s Institute for Exposomic Research. Panelists at the event, held on Saturday, January 12, at the New York Academy of Medicine, included environmental advocates and leaders in the study of environmental medicine and public health.

The conference aimed to provide public health professionals, policymakers, physicians, nurses, medical students, and allied health professionals with a base of up-to-date evidence to inform patient treatment and care as the global average temperature continues its steady rise. “Air pollution is a major driver of the health consequences of climate change,” said Robert O. Wright, MD, MPH, Professor and Ethel H. Wise Chair of the Department of Environmental Medicine and Public Health, and Director of the Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai. “In addition to conditions you would expect to increase, such as asthma and other lung diseases, our research shows that there are many downstream effects.” For example, Dr. Wright and several other panelists focused on fine particulate matter (PM2.5) from air pollution, which causes inflammation in the body that is associated with neurotoxicity, neurodevelopmental disorders, and increased insulin resistance.

Heat-related conditions are of particular concern for outdoor workers. Thousands become sick every year, and many die, due to these preventable illnesses, said Roberto Lucchini, MD, Professor of Environmental Medicine and Public Health, Icahn School of Medicine. “Studies show that recurrent heat exposure, with physical exertion, inadequate hydration, and exposure to chemicals, can lead to chronic kidney disease,” he said. “There is an epidemic of this disease among worker populations in Central America. We have to prepare health care workers in northern areas to be aware of the condition.”

In addition to these critical warnings, speakers presented actionable tools for clinicians both to better inform patients and to modify their practice. “Physicians can explain the importance of paying attention to heat and poor air-quality days,” said Emily Senay, MD, MPH, Assistant Professor of Environmental Medicine and Public Health, Icahn School of Medicine. “This is especially important for vulnerable patients who are elderly or chronically ill.” During a heat wave, clinicians might consider adjusting some medications, like diuretics, which reduce the ability to lose heat by sweating. And they should advise patients to close windows and use air conditioning to limit exposure to air pollution but also to be conscious of indoor pollutants like mold and fumes from cleaning products.

Physicians were encouraged to prepare for an influx of diseases previously unseen in their population, particularly those carried by insects. A warming climate will make habitats more hospitable to disease-carrying insects, such as mosquitoes and ticks, exposing a larger swath of the population to diseases such as Lyme disease, Zika virus, and dengue fever.

Another concern is that weather events, such as hurricanes and floods, are becoming more extreme as a result of climate change. Superstorms of recent years, like Hurricane Sandy, are leading to a shift from an “emergency response” model to a more forward-looking “risk mitigation” approach, said George Loo, DrPH, MPH, Assistant Professor of Emergency Medicine, and Population Health Science and Policy, Icahn School of Medicine. That includes moving critical infrastructure out of flood prone areas and developing extensive logistics for managing transportation, power, security, and staffing. In addition, Dr. Loo said, “Health care workers need to first have a plan to take care of themselves and their families. Knowing that your family is safe and that you have a way to contact them will reduce stress and help you focus on your patients.”

Physicians play an important role in helping patients understand how climate affects the health of individuals and how, at a population level, humans affect the environment, Dr. Senay said. With a nuanced approach, she added, providers can improve environmental literacy and open the door to discussions about how walking more, eating a plant-based diet, and advocating for renewable energy can make both the planet and patients healthier.

Department of Neuroscience at the Icahn School of Medicine at Mount Sinai Ranked No. 1 in Nation in NIH Funding

Updated on Jun 30, 2022 | Featured, Research

The Nash Family Department of Neuroscience at the Icahn School of Medicine at Mount Sinai received the most biomedical research funding from the National Institutes of Health (NIH) of any medical school neuroscience department in the nation in 2018, according to data compiled and released by the Blue Ridge Institute for Medical Research.

Paul J. Kenny, PhD

Seven other academic and clinical departments at the Icahn School of Medicine ranked among the top 10 nationally. They were Microbiology (No. 3), Emergency Medicine (No. 4), Pharmacology (No. 4), Genetics (No. 5), Anatomy/Cell Biology (No. 6), Psychiatry (No. 6), and Neurology (No. 10). Altogether, these seven disciplines and Neuroscience at Mount Sinai were awarded $184 million from the NIH in 2018.

The Neuroscience Department’s No. 1 ranking reflects $31.2 million in awards received during the NIH’s 2018 fiscal year and includes 41 awards for which department faculty members are Principal Investigators.

“We are thrilled by this outstanding achievement, which is a milestone for the neuroscience community at Mount Sinai. This is a testament to the outstanding quality of our faculty, postdoctoral fellows, graduate students, and staff, and reflects the cutting-edge research conducted in our laboratories,” says Paul J. Kenny, PhD, Chair of the Department. “These highly competitive funds enable Mount Sinai researchers to pursue initiatives that advance understanding of human health and disease and to swiftly develop treatments and technologies that will change the lives of patients worldwide.”

Eric J. Nestler, MD, PhD

Each year, Blue Ridge releases its analysis of NIH funding, ranking individual departments by total award dollars.

“Through a large, multidisciplinary effort that involves numerous basic science and clinical departments, we have made impressive strides in understanding how the nervous system functions under normal conditions and malfunctions in disease, making us uniquely poised to translate these advances into fundamentally new and improved treatments for some of the world’s most devastating disorders,” says Eric J. Nestler, MD, PhD, Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, and Dean for Academic and Scientific Affairs at the Icahn School of Medicine at Mount Sinai.

Dubin Gala Honors Champions of Breast Cancer Care and Awareness

Updated on Jun 30, 2022 | Featured, Patient Stories

At the benefit gala, from left: Elisa Port, MD, FACS; Eva Andersson-Dubin, MD; and Amy Tiersten, MD.

A leading physician-scientist and three “passionate champions” of breast cancer awareness were honored by the Dubin Breast Center of The Tisch Cancer Institute at the Mount Sinai Health System at its eighth annual benefit. The celebratory event, held on Monday, December 10, at the Ziegfeld Ballroom in Manhattan, attracted 520 guests and raised $2.6 million to support the Center’s breast health and treatment programs.

The three “champions” were Melissa Spohler, Meredith Shepherd, and their mother, Priscilla Alexander—all diagnosed with breast cancer in their 50s. “This is a family of women who have strength. They have integrity, they are kind, they give to others,” says Eva Andersson-Dubin, MD, founder of the Dubin Breast Center and Mount Sinai Health System Trustee, who presented awards to the honorees with Elisa Port, MD, FACS, the Center’s Director. “These are women we should all look up to as role models to see how they deal with breast cancer.”

Also honored at the gala was a “spectacular clinical investigator,” Amy Tiersten, MD, Clinical Director of Breast Medical Oncology, The Mount Sinai Hospital, and Professor of Medicine (Hematology and Medical Oncology), Icahn School of Medicine at Mount Sinai. “I have really poured a lot of lifeblood and energy into building a research program and clinical practice and collaborating with all the wonderful other physicians at the Dubin Breast Center,” says Dr. Tiersten, who specializes in metastatic breast cancer. “Through Dr. Tiersten’s research, we can provide our patients with the next generation of treatments—treatments that provide hope,” Dr. Port says.

The event included music by accomplished performers, including LaChanze, Ariana DeBose, and Storm Lever from Summer: The Donna Summer Musical on Broadway. And Ms. Alexander, 81, gave a moving speech about the Dubin Breast Center, saying that it did not yet exist when she was treated with cancer at age 53, but it now provides “great comfort” to her daughters and other patients.

From left: honorees Melissa Spohler, Priscilla Alexander, and Meredith Shepherd

“My daughters are part of a sisterhood at the Center,” Ms. Alexander says. “They have the good fortune of being watched over by the best professionals in their specialties, trained at the cutting edge of testing, diagnosis, treatment, emotional support, and ongoing research.” As a patient at another New York City hospital 28 years ago, Ms. Alexander had a double mastectomy and took an early test for a BRCA (breast cancer susceptibility) gene mutation. The test was negative. But because her mother and four of her six female cousins had all been treated for breast cancer, Ms. Alexander urged her four daughters to be vigilant. Ms. Shepherd says, “In hearing my family’s history, everyone’s first question is ‘Are you a BRCA family?’ I always say, ‘No, we’re a something family, it just hasn’t been found yet.’”

Ms. Spohler, 56, had at least one breast screening test every six months starting at age 40. In March 2016, a radiologist saw ambiguous “bright spots” on an MRI, and six months later an ultrasound identified breast cancer. “I was lucky because it was discovered when it was small,” Ms. Spohler says. “I had a double mastectomy because I didn’t want to live with the fear of it coming back.” Ms. Shepherd, 52, was diagnosed with breast cancer in August 2018. Her radiologist saw a small mass in her right breast, and a biopsy found that it was a benign growth called a papilloma. Ms. Shepherd says she went “right away” to Dr. Port, who had also treated her sister. As part of a preoperative check before removing the growth, Dr. Port ordered an MRI. That test discovered breast cancer unrelated to the papilloma, and Ms. Shepherd also had a double mastectomy.

All of the honorees say the key to early detection is awareness. “I would say to any woman that if you have breasts, you are potentially at risk,” Ms. Spohler says. “You have to monitor yourself. You have to know your own history and know your family’s history, because that is what might save you.”

Consortium Sheds New Light on Brain Disorders

Updated on Jun 30, 2022 | Featured, Neuroscience, Psychiatry, Research

From left: Kristen Brennand, PhD, Associate Professor, Neuroscience, Genetics and Genomic Sciences, and Psychiatry; Prashanth Rajarajan, MD/PhD candidate; and Schahram Akbarian, MD, PhD, Professor, Psychiatry, and Neuroscience.

Reprinted with permission from AAAS.

More than two dozen researchers at the Icahn School of Medicine at Mount Sinai are advancing brain science by mapping the complex molecular underpinnings of autism spectrum disorder, schizophrenia, and bipolar disorder through their work in the National Institute of Mental Health’s (NIMH) PsychENCODE Consortium. Since this work began in 2015, their contributions—and that of their PsychENCODE colleagues from 14 other U.S. institutions—have helped identify several hundred new risk genes for mental disorders. The research has also revealed critical time windows during brain development when these genes can influence the disease process.

In December, the Consortium published its initial findings in 10 studies that appeared in Science, Science Translational Medicine, and Science Advances. The researchers analyzed more than 2,000 postmortem brain samples from people with no psychiatric conditions and those with schizophrenia, autism, and bipolar disorder. They created and then integrated data sets that included information on DNA variations and gene expression for about 32,000 cells from major regions of the brain. Then the investigators employed machine learning to create a predictive model of risk for the psychiatric disorders.

Their seminal findings received an enthusiastic response from the NIMH. “The PsychENCODE project came through,” said Thomas Lehner, PhD, MPH, Director of the Office of Genomic Research Coordination at the NIMH. “We’re at the beginning—I cannot overstate how early we are. But I can confidently say that for the first time we have a beginning of an understanding of the biology—the molecular pathophysiology of mental disorders—of schizophrenia, and bipolar and autism spectrum disorder.”

Unraveling the Complexity of the Human Brain

“Exploring how the human genome is folded and packaged into the nucleus of each of our billions of brain cells was both awe-inspiring and humbling at the same time,” says Prashanth Rajarajan, MD/PhD candidate at the Icahn School of Medicine at Mount Sinai, who was first author on seminal brain research that was published in the December 14, 2018, issue of Science.

The scientific team discovered that early development is associated with major changes in the spatial organization of DNA inside of brain cells. These changes in how the chromosomal material is packed seem to disproportionately affect DNA sequences linked to schizophrenia heritability risk and provide new insights into the genetic causes underlying this disease.

The study, which was conceived and executed at the Icahn School of Medicine, included senior authors Schahram Akbarian, MD, PhD, Professor, Psychiatry, and Neuroscience; and Kristen Brennand, PhD, Associate Professor, Neuroscience, Genetics and Genomic Sciences, and Psychiatry. Colleagues at the New York Genome Center and the University of Massachusetts also contributed to the study.

According to Mr. Rajarajan, “There is so much more to the genome than just the four-letter DNA code (A, T, C, G)—such as its folded architecture, which is a highly organized and regulated process. Eighteen years after fully sequencing the human genome, we still understand very little about how it actually comes to life. Our study, and the others that were published, are beginning to unravel more nuances than previously imagined, making it a really exciting time to be in the field of neuroscience and psychiatry research.”

NIMH Program Director Geetha Senthil, PhD, added that the massive scope of the project required a “concerted effort. Many investigators had to come together and do this collectively.” While the mental disorders in the studies are distinct, Dr. Senthil said, “There are some aspects where the biology is similar. The genes interact with each other in a way to influence the disease process. If we can find biological clues early on, we can intervene early on. While we are building and generating more data, analyzing this data to find basic mechanisms, there’s an opportunity also for drug discovery.”

The 10 papers published by the PsychENCODE Consortium were dedicated to the late Pamela Sklar, MD, PhD, former Chair of the Department of Genetics and Genomic Sciences at the Icahn School of Medicine, and a pioneer in genomic brain research, who was an early leader of the NIMH effort. The Icahn School of Medicine last year renamed the division she created the Pamela Sklar Division of Psychiatric Genomics.

Mount Sinai laboratories within The Friedman Brain Institute, The Seaver Autism Center for Research and Treatment, the Department of Psychiatry, The Mindich Child Health and Development Institute, the Department of Genetics and Genomic Sciences, the Department of Neuroscience, and the Icahn Institute for Data Science and Genomic Technology were involved in the PsychENCODE Consortium.

“Mount Sinai serves as one of the lead sites in this national consortium. The discoveries that are being made by our scientists and their colleagues at other major institutions are moving us closer to understanding and finding treatments for these devastating brain disorders,” says Eric J. Nestler, MD, PhD, Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, and Dean for Academic and Scientific Affairs, Icahn School of Medicine at Mount Sinai.

First He Donated His Bone Marrow, Then He Gave Her a Kidney: How Two Strangers Became ‘Family Forever’

Updated on Jun 30, 2022 | Featured, Transplant

When Jeramy Davies was a senior at Texas Tech University in 2010, he helped organize a charity drive for Be the Match®, the national program that matches potential donors to those needing a bone marrow transplant. Little did he know that five years later he would donate his own bone marrow to a stranger in New Jersey— Kelly Ribeiro, who was being treated for lymphoma. And in 2018, he would give Ms. Ribeiro one of his kidneys, effectively saving her life twice.

Since hospital protocol forbids the exchange of any information between donor and recipient for one year, and then only if both parties agree, Mr. Davies and Ms. Ribeiro remained unknown to each other immediately following her successful bone marrow transplant. In 2016, Mr. Davies reached out to her and they began exchanging emails and text messages and speaking frequently by phone.

But over time, they both faced significant challenges. Ms. Ribeiro was dealing with kidney failure due to her previous condition. During a bout with pneumonia she fell into a coma. When she emerged, she began dialysis three times a week. “I never felt so sick and depleted as I did with kidney failure,” she says. “Every day, I could feel the life draining out of me.”

At the same time, Mr. Davies was helping his wife batt le a brain tumor that would take her life in July 2017. “Kelly was great moral support for me,” Mr. Davies recalls. “She understood everything we were going through, and she was a huge source of strength.”

But Ms. Ribeiro did not want to burden him with her own struggle, and even as her kidney function dwindled to 19 percent, she did not ask for his help. Only after her mother told Mr. Davies how sick she was did he understand the full extent of Ms. Ribeiro’s situation. Immediately, he offered Ms. Ribeiro his kidney. Immediately, she turned him down.

“It didn’t feel right,” she says. But he persisted, and in late December 2018, she underwent a successful kidney transplant at The Mount Sinai Hospital. Since Ms. Ribeiro now had Mr. Davies’ immune cells and even his blood type from the earlier bone marrow transplant, they were a 100 percent match. This also meant she would require fewer antirejection medications.

“It’s the most satisfying thing I’ve ever done,” says Mr. Davies, 38. For her part, Ms. Ribeiro says, “I never met anyone so selfless. He really acted like it was no big deal. But he saved my life twice. He is my guardian angel, and he is now family forever.”

Ms. Ribeiro’s surgeon, Vikram Wadhera, MBBS, Assistant Professor, Surgery, says, “The surgery for both patients went extremely well but, for most of us involved, it was the human and emotional aspects of this case that touched us deeply.”

Says donor surgeon Edward Chin, MD, Professor of Surgery, and Director of the Living Kidney Donor Program at the Mount Sinai Health System: “This is such a compelling story. It was such an altruistic thing for Jeramy to do. It reminds us that there’s so much good in the world.”

This winter, Ms. Ribeiro has been regaining her strength and looking forward to jump-starting her life, which had been on hold for the past six years. She expects to complete her master’s degree in Library and Information Science from Rutgers University later this year. Mr. Davies, who now lives in Denver, says he is close to getting back to his routine. He is looking forward to snowboarding and training for a triathlon later this year.

Living donation is the shortest route to organ transplantation and often results in a closer match and better outcome for the recipient. The Zweig Family Center for Living Donation at Mount Sinai is one of the largest living donor programs in the United States.

For information about The Zweig Family Center for Living Donation, click here.

Carnegie Hall Fundraiser Supports Mount Sinai West Program

Updated on Jun 30, 2022 | Community, Featured

The Mount Sinai Health System, along with the UN Chamber Music Society at the United Nations and members of the New York Philharmonic Orchestra, partnered to host a benefit concert at Carnegie Hall on Tuesday, January 15, in support of the Helen Sawaya Fund at Mount Sinai West, a philanthropy program whose mission is to enhance the experience of cancer patients through art, music, reflexology, and more.

The fund was established in 2005 by Gabriel A. Sara, MD, Assistant Professor of Medicine (Hematology and Medical Oncology), Icahn School of Medicine at Mount Sinai, and his friend from high school, Fuad Sawaya, in memory of Mr. Sawaya’s wife, Helen, who had been a cancer patient at Mount Sinai West.

Says Dr. Sara, “Our program addresses the emotional component of the disease and helps alleviate the stress of treatment. It has had an unbelievable impact on patients’ lives and on staff experience. Art and music, especially, reach us where words cannot.”

« Older Entries

Next Entries »