2018 Commencement for New York Eye and Ear Infirmary of Mount Sinai

James C. Tsai, MD, MBA, President of the New York Eye and Ear Infirmary of Mount Sinai (middle row, center) with the graduating residents and fellows.

Faculty, family, and friends celebrated the accomplishments of 22 residents and fellows in Ophthalmology, Otolaryngology, and Plastic and Reconstructive Surgery recently at the 2018 Commencement of the New York Eye and Ear Infirmary of Mount Sinai (NYEE).

James C. Tsai, MD, MBA, President, New York Eye and Ear Infirmary of Mount Sinai, and Chair of Ophthalmology, Mount Sinai Health System, welcomed graduates and guests to the event, held on Thursday, June 21, at the Friends Meeting House near campus.

“For 198 years, NYEE has proudly served the patients of our community, educated physicians, and led global ophthalmology and otolaryngology advances. You have inspired us to become better teachers and re-energized our dedication to educate tomorrow’s leaders in specialty surgical care,” Dr. Tsai said.  “Use your knowledge to aspire and inspire, innovate and reinvent as you realize your full potential.”

Four of the graduates were residents specializing in otolaryngology, and seven were residents in ophthalmology.  The eye residents will now take fellowships at top-tier institutions, including NYEE, the University of Southern California Roski Eye Institute in Los Angeles, and Kaiser Permanente, as well as private practices in New York, New Jersey, Colorado, and Texas.

Eleven fellows completed training in surgical specialties, including cornea and refractive surgery, glaucoma, ocular immunology, vitreoretinal surgery, and aesthetic plastic surgery.

A Focus on Wellness at the 2018 Aspen Ideas Festival

Kenneth L. Davis, MD, led a luncheon roundtable discussion on rising drug prices.

New models of care that keep people healthy—rather than intervening only when they are sick—were the focus of experts from the Mount Sinai Health System, which participated for the sixth time in the annual Aspen Ideas Festival. Presented by the Aspen Institute and The Atlantic magazine, the festival in Aspen, Colorado, which ran from Thursday, June 21, through Saturday, June 30, is a gathering place where thought leaders across many disciplines engage in an exchange of ideas.

“How do we keep people well? How do we keep people out of the emergency room? We think about this all the time,” Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System, said in “Health Systems of the Future,” a key panel discussion. “By moving away from the traditional fee-for-service model to population health care, we are better able to align incentives with clinical delivery. This result is keeping people healthy and out of the hospital.”

Next generation health care was discussed by, from left, Eric Schadt, PhD; Alan B. Copperman, MD; and Judy H. Cho, MD, in the panel “Saving Lives Through Genomics.”

Jesleen Ahluwalia, MD, Assistant Clinical Professor of Dermatology, screened festival participant Sam Abdelhamid.

Mount Sinai demonstrated its dedication to wellness and prevention by providing more than 1,300 attendees with complimentary screenings—the most ever at the festival. Dermatologists from the Kimberly and Eric J. Waldman Department of Dermatology performed 754 skin cancer screenings and identified 28 possible basal cell carcinomas, 15 possible squamous cell carcinomas, and 2 potential melanomas. Nurses from Mount Sinai Heart performed 635 blood pressure and cholesterol screenings.

The Health System also spread its message through social media, with its biggest audience ever. On Facebook, interviews with Mount Sinai experts at Aspen received more than 1 million views, compared with 92,000 in 2017, an increase that partly resulted from more precise targeting of viewers. And on Twitter, Mount Sinai was the festival’s third biggest “influencer,” with its content displayed more than 40 million times.

In a panel discussion led by Dr. Davis, experts from Mount Sinai elaborated on the promise and practice of precision medicine and genomics, especially in treating cancer. “We are able to conduct comprehensive molecular profiling of tumors to help guide treatment options,” said Eric Schadt, PhD, Dean for Precision Medicine, Icahn School of Medicine at Mount Sinai, and founder and Chief Executive Officer of Sema4, a patient-centered predictive health company spun out from Mount Sinai. “There is also the heritable side of your DNA—what you are born with and the risk that predisposes you for certain cancers. For example, the BRCA genes for breast cancer and ovarian cancer are increasingly seen as being important for men as they could impact the treatment for prostate cancer.”

Judy H. Cho, MD, Professor of Genetics and Genomic Sciences, and Medicine (Gastroenterology), Icahn School of Medicine, and Director of the Charles Bronfman Institute for Personalized Medicine at Mount Sinai, noted, “If you know your genome and you carry one of the high-risk mutations for colon cancer, the goal is to screen early and more effectively for colon cancer.” Inflammatory bowel disease and fatty liver disease also have a genetic component. “We think this understanding will allow us to diagnose patients earlier and treat more effectively, as well as identify drugs that will be most effective in patients,” Dr. Cho said.

Alan B. Copperman, MD, a leader in the treatment of infertility and Chief Medical Officer of Sema4, discussed breakthroughs in screening for couples using in vitro fertilization. Genomic sequencing is advancing so fast that over the next year or two, “We should be able to routinely test for all known diseases and even tiny rearrangements and deletions of DNA. This will move us forward in a way we could never have dreamed of in figuring out which embryo has the best chance of being a healthy baby,” Dr. Copperman said.

The microbiome—trillions of bacteria and fungi that live in the gut—was the subject of a popular talk by Ari Grinspan, MD, Assistant Professor of Medicine (Gastroenterology), Icahn School of Medicine, and Director of Gastrointestinal Microbial Therapeutics, Mount Sinai Health System. Dr. Grinspan said that for patients with persistent Clostridium difficile infections, fecal transplants are “incredibly effective,” curing 90 percent of cases. And he answered questions from a very engaged audience: Is taking probiotics good for you? It doesn’t hurt, and might help. How do you maintain a robust microbiome? “Eat fiber, fiber, fiber,” Dr. Grinspan said. “And exercise.”

Innovative models of care were outlined by, from left, Niyum Gandhi; Linda V. DeCherrie, MD; and Prabhjot Singh, MD, PhD, in the panel “Do or Die: It’s Time to Think Beyond the Hospital.”

In a second panel led by Dr. Davis, Mount Sinai experts discussed models that allow care to be delivered to its 3.8 million patients a year in more effective ways. “We must reimagine the financial model so that we can be rewarded for keeping people healthy,” said Niyum Gandhi, Executive Vice President and Chief Population Health Officer, Mount Sinai Health System.

Another innovation is Mount Sinai at Home, which encompasses programs that deliver home-based primary care, rehabilitation, hospital care, and palliative care. One of those programs, Hospitalization at Home, has resulted in shorter hospital stays and fewer readmissions and emergency department visits. “Though the model is successful, we still cannot do this widely because few insurance companies have been able to develop a payment model for services,” said Linda V. DeCherrie, MD, Professor of Geriatrics and Palliative Medicine, Icahn School of Medicine, and Clinical Director of Mount Sinai at Home.

“Addressing the social determinants of health is critical to reducing the cost of health care and improving the lives of our patients,” said Prabhjot Singh, MD, PhD, Director of the Arnhold Institute for Global Health, and Chair of Health System Design and Global Health, Icahn School of Medicine. “We need to find smart ways to recognize the food insecurity, housing, and transportation issues that our patients face, and then incorporate the right support as a seamless part of their care.”

All of these measures help Mount Sinai to control health costs, which are rising fast across the nation. “And they allow us to maintain our core values—to take care of everybody who comes to our door and still be an Honor Roll hospital and a leader in education and in research innovation,” Dr. Davis said.

Festival participants on the grounds of the Aspen Institute. Credit: CZ Photography

Could Dogs Serve as Hosts for the Next Flu Pandemic?

Study investigators Adolfo García-Sastre, PhD, left, and Guojun Wang, PhD, Postdoctoral Fellow

Dogs are becoming increasingly friendly hosts for a surprising array of influenza viruses, a situation that could pose a potential threat to humans. That is the finding of a new study from the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine at Mount Sinai, published June 5, 2018, in mBio.

The results were based on scientific evidence that dogs in southern China had the capacity to serve as “mixing vessels” for influenza viruses they receive from swine and birds—two animals considered to be the most common reservoirs of influenza viral genetic diversity.

“The more diversity we see in influenza viruses, the greater the chance they could jump from one host to another,” says the study’s lead author, Adolfo García-Sastre, PhD, Professor of Microbiology at the Icahn School of Medicine, and Director of the Global Health and Emerging Pathogens Institute. He is also Director of the Center for Research on Influenza Pathogenesis, one of five National Institutes of Health (NIH) Centers of Excellence for Influenza Research and Surveillance. The research took place in the Guangxi region of southern China, an area where diverse animal species are raised in proximity to one another and intermingle in live-animal markets.

In the study, researchers swabbed the noses of some 800 dogs that had all been brought to veterinarians or clinics in the region after showing respiratory symptoms consistent with canine influenza. The scientists sequenced the complete genomes of 16 influenza A viruses obtained from the dogs. All of these strains represented introductions of H1N1 swine influenza viruses circulating in pigs in Asia and Europe into these dogs.

They also found a set of three new viruses (H1N1r, H1N2r, and H3N2r) in which these swine-origin canine influenza viruses exchanged genes with previously identified avian-origin H3N2 canine influenza viruses.

Flu viruses have eight mini chromosomes and when two different strains infect the same cell they can exchange genetic segments, a process known as reassortment. All pandemic flu viruses that have been tracked have involved reassortment. The 2009 H1N1 swine-origin human influenza pandemic, for example, was a derivative of two different strains of swine influenza, one that had been circulating in Asia and Europe and the other in the Americas, particularly North America. That pandemic virus traced to a very small region in central Mexico, and was responsible for more than 17,000 deaths worldwide when it jumped from pigs into humans.

There is no known case of a human contracting a canine flu. Nor is it certain that the new strains of dog flu virus discovered in China would have that transmission capability. Still, as Dr. García-Sastre points out, the potential exists, especially in light of the frequent contact between pets and their owners. Moreover, the health risk increases for humans who have not previously been exposed to these viral strains and have not built an immunity to them.

Dr. García-Sastre does not predict a new pandemic, but he says there is a need for additional research and heightened vigilance by public health authorities around the world.

“We must start thinking about dogs as potential reservoirs for influenza viruses,” he says. “The more awareness we create, the more likely that countermeasures can be developed by countries to diminish the circulation of influenza virus in domestic animals.”

Melinda Lantz, MD, Assumes Leadership Role

Melinda Lantz, MD

Members of the American Association of Geriatric Psychiatry (AAGP) have elected Mount Sinai Beth Israel physician Melinda Lantz, MD, to become the organization’s President. Dr. Lantz, Vice Chair, Chief of Geriatric Psychiatry, and Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, assumes her new role at a pivotal time.

Founded in 1978 to promote the well-being of older people through education, advocacy, and career development of psychiatrists, AAGP has embraced change. Its growing ranks now include nurses, physician assistants, and mental health professionals coping with a growing geriatric population.

Every day, an estimated 10,000 people reach age 65. Behavioral health problems affect 15 percent of older adults and up to 5 percent have serious mental illnesses, according to the federal Substance Abuse and Mental Health Services Administration. In 2013, more than 7,000 people age 65 or older died by suicide. Additionally, experts say direct health care costs associated with dementia in the elderly often equal or exceed the costs for heart disease and cancer.

In her role as President of AAGP, Dr. Lantz—a specialist in dementia care and geriatric mental illness—plans to address the need for additional recruitment and training by increasing interest in and availability of subspecialty fellowships in geriatric psychiatry. Boosting physician compensation for providing care to older adults with complex needs would also revitalize career opportunities.

Dr. Lantz would like to see an emphasis placed on empathy during training, a critical element for older patients who often cannot advocate for themselves. Elderly patients as a whole, she says, tend to like and respect doctors and welcome human contact.

Encouraging empathy in the treatment of patients “inspired me to be in the organization,” she says.

Too often, physicians lose empathy when they are stressed and have heavy workloads. “Everybody does better when they perceive empathy from physicians. One of the things that fellowships can do is help them get it back.”

After robust lobbying by the AAGP, the Centers for Medicare and Medicaid Services recently agreed to assign an insurance code to monitor the impact of geriatric psychiatry. “Getting that code suffix added was a major win,” says Dr. Lantz, who anticipates a favorable outcome once all of the factors are weighed. Tracking patients will show how geriatric psychiatry affects medical costs and resources.

Having spent billions of dollars researching dementia drugs with little success, many drugmakers have pulled back, according to Dr. Lantz. Today, she adds, “There are limited drug options for dementia in the pipeline. We need to focus on care and quality of life for those with dementia.”

An area that does show promise for helping in the treatment of geriatric psychiatry is technology. For elderly patients who are less mobile, telemedicine via videoconferencing can ease loneliness and increase access to care.  Dr. Lantz says technology will also expand the scope of support to other health care providers who are located in communities where there are no specialists in geriatric psychiatry.

Paying Tribute to a Giant in Medicine

Dr. Holland’s children, from left: David Holland; Diane Holland; Sally Holland; Peter Holland; Mary Holland; and Steven Holland, MD.

Family, friends, and colleagues of the late James F. Holland, MD, Distinguished Professor of Neoplastic Diseases at The Tisch Cancer Institute, gathered in May at the Mount Sinai Health System to celebrate his work as a renowned physician-scientist who helped cure acute lymphoblastic leukemia in children.

Dr. Holland’s work helped establish oncology as a medical discipline. In the 1950s, when chemotherapy was a relatively new treatment, he and his colleagues began treating seemingly incurable patients with drug combinations rather than administering each one sequentially. Nine out of 10 patients successfully responded to the therapy. Combination chemotherapy remains the standard of care today.  Dr. Holland encouraged physicians to share data and create common protocols. In 1972, he received the prestigious Albert Lasker Clinical Medical Research Award.

James F. Holland, MD

Speakers at Mount Sinai’s Celebration of Life event included many esteemed physicians from around the country whom Dr. Holland influenced and once mentored, as well as Mount Sinai leaders in academic affairs and cancer research. Dr. Holland’s six adult children attended the event, with several sharing their thoughts and memories.

In his opening remarks, William K. Oh, MD, Deputy Director of The Tisch Cancer Institute and Chief of Hematology and Medical Oncology, said Dr. Holland “was absolutely committed to changing the poor outcomes of patients with leukemia, breast cancer, and other devastating cancers by investing in translational research and clinical trials, principles that drive our work at The Tisch Cancer Institute today.”

Fourth Episode of Mount Sinai Future You

The fourth episode of Mount Sinai Future You features former supermodel Mahogany Phillips, who went through surgery to transition from male to female through Mount Sinai’s Transgender Fellowship program that is training the next generation of doctors to perform transgender surgeries. Mahogany received treatment from Jess Ting, MD, Associate Professor, Plastic and Reconstructive surgery.

Mount Sinai Future You, which highlights innovation at Mount Sinai, is being broadcast on CUNY TV, the non-commercial educational-access cable channel run by The City University of New York.

Mount Sinai Future You takes viewers behind the scenes as doctors at Mount Sinai Health System leverage innovative science to change patients’ lives every day. The series  highlights preventative care and treatment models that will lead to better health and longer lives.

Mount Sinai Future You, Episode Four, also features:

  • Denise Ely shares her story after receiving an “advanced age” liver transplant 20 years ago. Ely meets her donor’s family for the first time and discovers surprising similarities between her life and the life of her donor. Sander Florman, MD, Director of the Recanati/Miller Transplantation Institute, and Nancy Bach, MD, Associate Clinical Professor of Liver Disease, discuss the future of liver transplant and how utilizing “at risk” organs allows more people to have this life-saving surgery.
  • Matilda, who was diagnosed with a severe form of Neonatal Hermochromatosis, became the youngest liver transplant recipient at Mount Sinai.
  • Manuel Rivera, a patient who went through medical treatment in the comfort of his own home. The Mobile Acute Care Team (MACT) has partnered with Contessa Health to create an efficient payment and operating model that decreases the cost of treatment for patients.
  • Ettore Vulcano, MD, Foot and Ankle Orthopedic Surgeon, uses new technology to perform minimally invasive foot surgeries that significantly decrease a patient’s recovery time and allows them to return to their normal lives much faster than expected.
  • Joanne Loewy, Director of the Louis Armstrong Center for Music and Medicine, shares research about how music therapy is helping decrease stress and anxiety levels among cancer patients, as well as those recovering from spine surgery.

New episodes of Mount Sinai Future You will run monthly, in the first week of each month, on Wednesdays at 9:30 pm, Thursdays at 6:30 am and 5 pm, and Saturdays at 11 am. They will cover newsworthy topics in medicine, as well as highlight new treatments, innovations, and preventive care for patients. The series is produced by Mount Sinai.

Here is where you can find this series:

Cable System CUNY TV Channel
Spectrum 75
Cablevision 75
Optimum Brooklyn 75
RCN Cable 77
Verizon FiOS 30

 *Some RCN digital cable and MMDS systems carry CUNY TV and/or NYC TV on different channel numbers. For example, some RCN systems in Manhattan and Queens carry CUNY TV on channel 24, 106 or 108. Please consult your cable provider directly to be sure.

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