Mar 20, 2017 | Featured, Patient Stories
Patient Louis Burns told Douglas T. Dieterich, MD: “You are always full of joy and compassion.”
The Institute for Liver Medicine held a special party on Tuesday, March 7, on The Mount Sinai Hospital campus, for an extraordinary group of patients: men and women who have been cured of Hepatitis C.
“It’s rare in medicine that we get to bring people back to celebrate a cure,” Barbara Murphy, MD, Murray M. Rosenberg Professor of Medicine and Chair of the Department of Medicine for the Mount Sinai Health System, told the 85 jubilant patients, who clapped and cheered.
Watch the video
Hepatitis C is a liver disease caused by a virus, but most individuals do not have any symptoms until 10 years or more after infection. Without medical treatment, chronic Hepatitis C can eventually cause liver cancer or liver failure. Frequently, patients need liver transplants to survive.
The patients who came together were celebrating their health—and the nine new direct-acting antiviral medications that have transformed treatment and significantly increased cure rates in the last three years. A patient is considered cured if a blood test reveals no presence of virus in the blood 12 weeks after treatment is completed.
“The advances in Hepatitis C treatment have been revolutionary—it is now possible to cure up to 99 percent of patients with virtually no side effects,” says Douglas T. Dieterich, MD, Director, Institute for Liver Medicine, and Professor of Medicine (Liver Diseases), who hosted the celebration. The new medications, given in daily pill form for 8 to 24 weeks, replaced former treatments that had severe side effects, little tolerability, and cure rates of only 20 percent to 30 percent.
“This is astounding scientific progress,” says Dr. Dieterich, who notes that Mount Sinai clinical researchers helped develop the new medications. “Through medication and liver transplants, we have now cured more than 2,000 patients at The Mount Sinai Hospital and a total of 5,000 in the Health System since the beginning of 2014. Still, there remain huge numbers of people who have Hepatitis C who do not even know they have it. Our task now is to identify, test, and treat them.”
Dr. Dieterich, other physicians, and staff, including Alyson Harty, RN, and Maria Rivera, Medical Assistant, were among those singled out by a dozen patients who gave spontaneous testimonials. “I want to give kudos to you, Dr. Dieterich. You are always full of joy and compassion,” said patient Louis Burns. “I am just so grateful for the treatments. You have definitely transformed my life. You have helped us.” Patient Harry Bangel sought Ritu Agarwal, MD, Assistant Professor of Medicine (Liver Diseases) in the crowd, posed for a photograph, and said, “This is the woman who cured me.” Patient Arlene Gray recalled a long-ago memory of being “so afraid” when she was diagnosed. At the party, she spoke of the compassion she felt from the staff. “This is a family of love,” she said. Patient David Jordon smiled and posed with Danielle Carter, MD, fellow, Liver Diseases, and said: “I’m cured. I can’t think of anything better.”
Mar 19, 2017 | Featured, Research
From left: Rosalind J. Wright, MD, MPH; Manish Arora, PhD, MPH; the two moderators, Shevon Skinner, RN, MSN, MPH, Director of Patient Services, LSA Family Health Service in East Harlem, and Maida Galvez, MD, MPH, Associate Professor, Environmental Medicine and Public Health; David Bellinger, PhD; and Avi Reichenberg, PhD.
“The Decade of the Developing Brain,” a symposium held in honor of the tenth anniversary of the Department of Environmental Medicine and Public Health’s Children’s Environmental Health Center, could arguably be summed up by these three points: “Our environment is complex and constantly changing. Prenatal and early postnatal life are critical periods that can affect lifelong health,” said Manish Arora, PhD, MPH, Vice Chair of the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai. And finally, “Save your teeth.”
At the half-day symposium, held at the New York Academy of Medicine on Friday, February 24, a keynote speech by David Bellinger, PhD, Harvard T.H. Chan School of Public Health, Boston Children’s Hospital, outlined the population-level effects of environmental chemicals on neurodevelopment. Avi Reichenberg, PhD, Professor of Psychiatry, and Environmental Medicine and Public Health, addressing the complexity of autism risk, said multiple published studies have concluded that “there is no association between vaccination and the risk for autism. Yet unfortunately this comes up again and again.”
Rosalind J. Wright, MD, MPH, Horace W. Goldsmith Professor in Children’s Health Research and Dean of Translational Biomedical Sciences at the Icahn School of Medicine, discussed the relationship between a mother’s physical response to stress and fetal development. “When you are living with chronic financial strain, violence, and discrimination, it can have effects on the developing baby, starting in pregnancy with particular implications on the developing brain,” she said. On the positive side, she also showed evidence indicating that good nutrition and “sensitive, responsive, supportive care” can buffer young children from the effects of stress.
Dr. Arora called the study of the developing brain a “relay race” in which bench scientists like him supply packets of information that clinicians and researchers in the field can act upon. One of his major contributions is developing new techniques to study human teeth, which have growth rings that each day capture information about chemical exposure and nutrition—a hard drive of biologic information. Dr. Arora advised attendees not to throw away the teeth they shed, saying, “They are more valuable than you think.”
For video, photos, and more information about the Symposium, please go to: https://decadeofdevelopingbrain.wordpress.com/.
Mar 19, 2017 | Featured, Patient Stories
From left: Robert Friedman; Aaron E. Miller, MD, Professor of Neurology, and Medical Director, Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai; Blair Underwood; and Fred D. Lublin, MD.
More than 225 donors, patients, faculty, and friends attended the 15th Annual Gala for the Corinne Goldsmith Dickinson (CGD) Center for Multiple Sclerosis at Mount Sinai, which was held Thursday, March 2, at The Plaza. The event was chaired by Meruka Hazari, MD, a patient at the Center; her sister, Kernika Gupta, MPH; and their mother, Renu Gupta, MD.
A highlight of the evening was the presentation of a special award to Blair Underwood, actor, director, and philanthropist, by Robert Friedman, Mount Sinai Health System Trustee and a member of the CGD Center Advisory Board. The award recognized Mr. Underwood’s exemplary contribution to the advocacy community. He shared with the audience that his television show, GIVE, which profiles philanthropic efforts, was created to honor his philosophy that “to whom much is given, much is required.” He went on to say, “I’ve been given a great deal in my 50-something years on this planet. Though I believe ‘giving back’ and ‘being of service’ is a requirement, it also feels good, and it is a joy.”
The evening also featured a panel presentation moderated by Kate Milliken, founder of the website mycounterpane.com. Ms. Milliken interviewed CGD Center patients and caregivers, each with an inspirational personal journey that exemplified the program’s theme, “The Power Within.”
The Clifford H. Goldsmith Award for Outstanding Service was presented to Joan Noto, President of the Corinne Goldsmith Dickinson Center Advisory Board. “Through the efforts of generous, committed individuals, such as Joan, we have been able to provide comprehensive, compassionate care and become a worldwide leader in clinical research aimed at ending this disease,” said Fred D. Lublin, MD, Saunders Family Professor of Neurology at the Icahn School of Medicine at Mount Sinai and the Center’s Director.
Mar 15, 2017 | Featured, Insights
If the current Republicans’ health care bill becomes law, it could have a “fairly devastating effect” on the nation’s hospitals, Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System, said in a recent interview on CNBC.
“You’re going to see a lot of the hospitals that take care of indigent populations, large Medicaid populations, have to close. You’re going to see diminished services. You’re going to see hospitals like ours, which are academic medical centers, find ways to cut other parts of our programs substantially,” he said in an interview with “Closing Bell.” According to the Congressional Budget Office, 14 million more people would become uninsured next year if the American Health Care Act is signed into law.
Watch the video
Mar 13, 2017 | Featured, Research
Diane Meier, MD, director of the Center to Advance Palliative Care at The Mount Sinai Hospital, talks with STAT News about her pioneering work in palliative medicine, which seeks to optimize patients’ quality of life by preventing or reducing their suffering. “The people we’re trying to serve have serious illnesses, and they’re trying to live as well as they can for as long as they can. This notion that somehow you’re braver or smarter or wiser if you confront your death and accept it and plan for it-this is not what most patients and families are seeking. It’s not what most people care about. And it actually can get in the way of people having a good life,” she said.
Read the article
Mar 6, 2017 | Featured, Research
Julio Aguirre-Ghiso, PhD
New research from the Icahn School of Medicine at Mount Sinai has found that cancer cells can spread without the benefit of a primary tumor and remain dormant for months or even years before triggering aggressive, deadly breast cancer metastases. This surprising new model of early cell dissemination and metastasis appeared in the December 14, 2016, issue of Nature. It upsets the long-held scientific belief that tumors only spread from a pathologically defined and highly mutated invasive tumor. In fact, the findings revealed that a primary tumor may never develop.
“As a biologist who has been measuring tumors since I was 20 years old, this was, indeed, a very surprising finding,” says lead author Julio Aguirre-Ghiso, PhD, Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine at Mount Sinai. “It provides an alternative scenario for how metastases develop, and that could have a profound effect on our work going forward.”
Dr. Aguirre-Ghiso’s preclinical research, which focused on very early-stage breast cancer in animal models, was published with a companion paper authored by a team led by Christoph A. Klein, MD, at the University of Regensburg in Germany. The companion paper supported Mount Sinai’s findings with evidence of the same occurrence in human cancer cells and tumors.
This image captures early disseminating cancer cells in mouse models (cyan) moving toward blood vessels (red).
The studies’ new findings offer insights into several questions that have long puzzled scientists. First, why do as many as 10 percent of cancer patients worldwide have cancer metastases but no original tumor? Equally important, why is it so difficult to treat cancer that has spread? To that point, a key finding was that most early-spread cells remain dormant while most chemotherapeutic and targeted treatments are aimed at cells that are proliferative.
“Those cells that leave early can spend a long time without growing, or they can grow so slowly that any antiproliferative therapy will ignore them,” Dr. Aguirre-Ghiso says.
In women, the spread of early breast cancer cells is an extension of the normal process of creating a branching tree of breast milk ducts. Two major pathways are altered in the process: p38, a tumor suppressor, and HER2, an oncogene. As a mammary tree develops, p38 and HER2 are alternatively turned off and on, allowing cells to move through the mammary gland. In their experiments with mouse models, the researchers found that if HER2 is over-activated or switched on, and p38 is permanently turned off, cells are able to enter the bloodstream and travel to organs such as the lungs and bone marrow, where a growth switch can later activate the metastases.
With the help of a team of researchers from Albert Einstein College of Medicine, the Mount Sinai scientists were able to monitor the movement of oncogene cells that had been tagged with a fluorescent protein as they moved from the mammary tree to surrounding tissue and into the bloodstream. “It was quite amazing,” says Dr. Aguirre-Ghiso.
Developing full-scale biomarkers and mechanisms that can identify early-spread cells is a logical next step for Dr. Aguirre-Ghiso and his team. “If we had tests or imaging tools that could tell us in a minimally invasive way exactly where these cells are and if they’re evolving or growing, then we could take steps to eradicate them or keep them dormant,” he explains. “That kind of approach could truly be transformative.”
