Featured | Mount Sinai Today

Student-Run Community Clinic Celebrates 15 Years

Updated on Jun 30, 2022 | Community, Featured

Students celebrated the 15th anniversary of EHHOP. From left: Rebecca Choi, Saloni Agrawal, Rachel Levantovsky, Derek Kao, Michelle Tran, Mimi Chung, and Anna Stacy.

For 15 years, students at the Icahn School of Medicine at Mount Sinai have been providing free, confidential medical services to uninsured residents of East Harlem at a campus-based clinic at 102nd Street. Supported entirely by donors and volunteers, and supervised by physicians, the East Harlem Health Outreach Partnership, or EHHOP, serves more than 300 patients annually in more than 1,000 clinic visits.

On Wednesday, April 10, 150 Mount Sinai students, faculty, staff, alumni, donors, and friends gathered to celebrate EHHOP’s long-standing success and commitment to providing health services to the East Harlem community at a fundraising gala held at the Museum of the City of New York. The event helped move EHHOP closer to its goal of raising $100,000, which will enable it to continue supporting underserved patients.

Over the years, EHHOP has expanded beyond its primary care clinic and now operates ancillary clinics that provide care in mental health, women’s health, and ophthalmology, as well as in-house podiatry and cardiology care. EHHOP’s eye clinic distributes free prescription glasses to patients, and all prescription medications are free. The clinic recently began offering free legal services to its patients, as well.

“Beyond its dual mission of service and education, EHHOP brings together a community of students, staff, and faculty who believe that health is a human right,” said medical student and EHHOP gala co-chair James Blum.

Mitchell Katz, MD, President and Chief Executive Officer of NYC Health + Hospitals, the largest municipal health system in the United States, was the event’s keynote speaker. Dr. Katz commended EHHOP on its emphasis on primary care and mission to deliver high-quality care to all New Yorkers. EHHOP Program Director Yasmin S. Meah, MD, Associate Professor, Medicine (General Internal Medicine), Medical Education, and Geriatrics and Palliative Medicine, said the show of support at the event was “energizing and moving.” Dr. Meah oversees the clinic with Medical Director David C. Thomas, MD, Professor, Medicine (General Internal Medicine), Medical Education, and Rehabilitation Medicine.

Medical student and gala co-chair Denisse Rojas-Marquez told the crowd, “What may not have been so obvious is the outpouring of support for EHHOP from Mount Sinai alumni who live in different parts of the country.” For example, she added, “An alumnus from the class of ’73 who lives in California donated the wine at tonight’s event. Everything was given with so much love to contribute to our successful event.”

Ari Bar-Mashiah, a medical student who serves as EHHOP co-chair with fellow student Pepe Muniz Rodriguez, said, “It is an honor to be able to serve patients in our own backyard, and know that we can truly make a difference in the health care landscape of our local community and New York City at large.”

Mount Sinai Researchers Show That Early Intervention in Preschool Is a Unique Opportunity for Promoting a Healthy Lifestyle

Updated on Jun 30, 2022 | Community, Featured, Research

Natalia Leal and her son Gabriel are participants in FAMILIA, which instructs preschoolers and their families on cardiovascular health.

Children may have a better chance of avoiding unhealthy habits linked to obesity and cardiovascular disease later in life if they are taught properly about healthy behaviors in preschool, Mount Sinai researchers have shown in a first-of-its-kind study.

The researchers focused on children living in a socioeconomically disadvantaged community, a situation that is commonly linked to higher rates of obesity, heart disease, and other health issues. Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital, created and led the trial, called the FAMILIA Project at Mount Sinai Heart. The results were published in the April 22 online issue of Journal of the American College of Cardiology.

Read the press release

Road to Resilience Episode 11: The Long Arm of Childhood Trauma

Updated on Jun 30, 2022 | Featured, Insights

Recording the Road to Resilience podcast are actor Darrell Hammond, in hat, and, clockwise, filmmaker Michelle Esrick, Mount Sinai podcast producer Jonathan Earle, and Jacob Ham, PhD.

A regular cast member for 14 seasons on Saturday Night Live, Darrell Hammond entertained millions with his spot-on impersonations of Bill Clinton, Donald Trump, Sean Connery, and others.

But behind the scenes, he endured debilitating flashbacks, substance abuse, and self-harm. Misdiagnosed and medicated for decades, it wasn’t until Mr. Hammond was in his 50s that he finally received the correct diagnosis: childhood trauma.

In the latest episode of the Road to Resilience podcast from the Icahn School of Medicine at Mount Sinai, Mr. Hammond and filmmaker Michelle Esrick sit down with Jacob Ham, PhD, a clinical psychologist and Director of the Center for Child Trauma and Resilience at the Icahn School of Medicine at Mount Sinai, to discuss childhood trauma, complex post-traumatic stress disorder (PTSD), and healing. They talk about the long-term health effects of childhood trauma, how to deal with triggers in daily life, and the ways loved ones can support survivors in their recovery.

Jacob Ham, PhD

Mr. Hammond’s experience with trauma, addiction, and recovery is explored in a new documentary film, Cracked Up, directed and produced by Ms. Esrick.

Cracked Up explores the lifelong effects of childhood trauma, addiction and recovery through Mr. Hammond’s inspiring story. It features extensive interviews with Mr. Hammond, as well as leading trauma experts such as Bessel van der Kolk, MD, psychiatrist and author of The New York Times bestseller The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.

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. To listen, visit Apple Podcasts, Spotify, Stitcher, Google Play, or the Road to Resilience website.

Listen to Road to Resilience Episode 10: Resilience Stories (Live!)

Icahn School of Medicine at Mount Sinai Launches Enhanced Scholarship Initiative

Updated on Jun 30, 2022 | Featured

From left: Dennis S. Charney, MD; Phyllis Schnepf, Senior Associate Dean for Education and Research Administration; David Muller, MD, Dean for Medical Education; Valerie Parkas, MD, Senior Associate Dean for Recruitment and Admissions; and Donald J. Gogel, Chair of the Mount Sinai Boards of Trustees Medical Education Committee.

The Icahn School of Medicine at Mount Sinai unveiled its Enhanced Scholarship Initiative (ESI), a new program offering substantial debt relief for students with demonstrated financial need. The program will launch in the upcoming academic year and will enable qualifying medical students entering in 2019 and thereafter to graduate with a maximum total debt of $75,000.

Read the press release

Watch the video

A Novel Approach to Making Organ Transplants Successful

Updated on Jun 30, 2022 | Featured, Research, Your Health

Study co-authors, from left: Zahi Fayad, PhD, Director of the Translational and Molecular Imaging Institute; and Willem J.M. Mulder, PhD, Professor of Radiology, and Oncological Sciences.

The nearly 35,000 individuals who receive organ transplants each year in the United States face a harsh reality: the immunosuppressive drugs they must take to maintain organ survival also weaken the immune system, breaking down the body’s critical defenses against cancer, infection, and more. Researchers at the Icahn School of Medicine at Mount Sinai recently developed an innovative type of immunotherapy based on nanotechnology that they hope will address this conundrum. Their findings, published in the November 6, 2018, issue of Immunity, have demonstrated the technology’s feasibility of long-term organ acceptance in mice.

“This is a whole new approach to programming the immune system, not just another small molecule drug that’s going to help with organ transplantation,” says Zahi Fayad, PhD, Director of the Icahn School of Medicine at Mount Sinai’s Translational and Molecular Imaging Institute, which conducted the work. Dr. Fayad is also Professor of Diagnostic, Molecular, and Interventional Radiology, and Medicine (Cardiology). “Because of the many problems this approach addresses—the risk of rejection, the shortage of organs for transplant, the cost of these procedures—we believe it can be transformative for the organ transplant field.”

Jordi Ochando, PhD

The immunotherapy works by regulating innate immune memory, or trained immunity, which the investigators found to play a central role in organ rejection. In trained immunity, immune cells known as myeloid cells initiate the body’s immune system response by activating T cells, which then attack the transplanted organ.

“By inhibiting trained immunity, we prevent activation of the myeloid cells and their subsequent activation of T cells,” says Jordi Ochando, PhD, the study’s co-senior author, who is Assistant Professor of Medicine (Nephrology), Oncological Sciences, and Pathology at the Icahn School of Medicine. “This novel technology preserves the normal function of the T cells, which is to protect the body against cancer and infections.”

Identifying trained immunity as a target enabled the Mount Sinai scientists to focus on a signaling pathway known as mammalian target of rapamycin (mTOR), which regulates immune cell metabolism. The team developed an injectable nanoimmunotherapy based on high-density lipoprotein (HDL) nanomaterials and the existing mTOR inhibitor rapamycin.

“These nanomaterials essentially deliver the rapamycin to the myeloid cells, and that changes the metabolic state of the cells and prevents their activation,” says co-senior author Willem J.M. Mulder, PhD, Professor of Radiology, and Oncological Sciences at Icahn School of Medicine, and Director of the Nanomedicine Program. The absence of myeloid cell and T cell activation, Dr. Mulder points out, could drastically reduce the need for transplant patients to take lifelong immunosuppressive medicines to prevent graft rejection.

A Rare Bladder Condition, and in Need of a Kidney Transplant: Little Lexi’s Extraordinary Medical Journey

Updated on Jun 30, 2022 | Featured, Patient Stories, Your Health

Lexi Isler got a kiss from her father, Luther, before the kidney transplant surgery in January.

In 2009, when a prenatal ultrasound showed an abnormal kidney, Luther and Ashley Isler knew that their daughter, Lexi, would be born with a urinary problem. What they did not expect, however, was that Lexi would also be born without a bladder, a condition known as bladder agenesis that has only 20 known survivors worldwide.

Today, 8-year-old Lexi is among those remarkable survivors as she continues an extraordinary medical journey supported by her loving family and an interdisciplinary team of Mount Sinai physicians that has included pediatric urologists and nephrologists, and transplant surgeons, along with nurses and countless other caring staff over the years.

When Lexi was 2 years old, doctors at Mount Sinai Kravis Children’s Hospital confirmed by magnetic resonance imaging that urine had been backing up into her kidney—because she did not have a bladder. While she was in diapers, not having a bladder was not immediately obvious, but as she grew older, Lexi would need a way to both hold and pass urine. Meanwhile, her kidneys—damaged by her urinary outflow anatomy—had been steadily deteriorating and doctors realized that she would eventually need a kidney transplant.

Lexi’s urology and pediatric doctors formed a close team to strategize about her case from the earliest stages. “Long before a transplant, our team first had to think about how to make a bladder and how to get it to work,” says Jeffrey M. Saland, MD, Chief of Pediatric Nephrology and Hypertension at Mount Sinai Kravis Children’s Hospital and Medical Director of the Pediatric Kidney Transplant Service.

When Lexi was 5 years old, Jeffrey A. Stock, MD, Associate Professor of Urology, and Pediatrics, Icahn School of Medicine at Mount Sinai, and Chief of the Division of Pediatric Urology at Mount Sinai Kravis Children’s Hospital, performed the complex, six-hour surgery to create an artificial bladder.

“We removed part of her colon and connected the ends to create a bowel pouch that functioned as a bladder,” says Dr. Stock. “Then, we used her appendix to create a urethra to drain urine from the neobladder.” The neobladder can store, but not empty, urine so Lexi has learned to use a catheter in the bathroom to empty her new bladder. The neobladder procedure is rare. Dr. Stock, who specializes in the surgical reconstruction of genitourinary birth defects, has done only four such procedures in his 25 years of practice.

By January 2018, Lexi’s kidney function was so compromised that at one point, she was unresponsive for days. The situation remained critical all year with very little improvement, and in December 2018, the need for a kidney transplant could not be deferred. Fortunately for Lexi, when she was 3, her father had been identified as a match for her. “It was an easy decision,” says Mr. Isler. “I felt blessed that I was a match.”

Victoria Caselnova, RN, BSN, left, and Stacey Brooks, RN, BSN, with a smiling Lexi Isler on the day she was discharged from the hospital.

In January 2019, as Lexi was about to go into kidney failure, surgeons from the Recanati/Miller Transplantation Institute at Mount Sinai performed the transplant using her dad’s kidney. “We had all of our firepower available,” says Ron Shapiro, MD, Professor of Surgery, and Surgical Director of the Kidney and Pancreas Transplant Program, referring to the expert team of surgeons involved with the transplant and the bladder creation. A smiling Lexi was discharged after spending nine days in the hospital for the transplant surgery.

Still, says Dr. Saland, “This is a work in progress. Lexi remains at higher risk for urinary tract infections and we’ll need to make ongoing adjustments for drainage as well as in her anti-rejection medications. But at Mount Sinai, we believe we have all the expertise and resources we need to treat all aspects of Lexi’s condition.”

“I have the utmost respect for the doctors and nurses at Mount Sinai,” says Ms. Isler. “They all treated Lexi with so much respect and love. The nurses even came to her bedside when their shifts were over to paint with her.”

Despite periodic hospital stays, Lexi is happy and back at school, facing her health challenges with grace and an amazingly positive attitude for a girl her age, says Ms. Isler. Lexi recently found the courage to stand before her classmates and tell them about the condition she was born with and how it was treated. “Her classmates have been very supportive, and they don’t treat her like she’s different,” says Ms. Isler.

At home, the child who had been taking dance classes since the age of 2 has newfound energy and dances around the house with a lack of inhibition, Mr. Isler says. “With a lot of support, our goal is to enable Lexi to live a long, happy, and healthy life,” says Dr. Stock.

To learn more about organ donation, visit www.LiveOnNY.org.

Learn more about organ donation at LiveOnNY.org

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