Updated on Jun 30, 2022 | Featured, Research
Joshua B. Bederson, MD, with a 3D model and an interactive simulation of the skull of a patient with a large epidermoid tumor—tools he used in planning the patient’s surgery.
The Mount Sinai Health System recently launched the Medical Modeling Core, a collaboration led by the Department of Neurosurgery, where Mount Sinai clinicians can order 3D and virtual models that can be used to explain procedures to patients, plan surgeries, and even conduct trial runs.
“Our simulation, prototyping, and 3D printing resources developed here at Mount Sinai are rare for a medical institution,” says Joshua B. Bederson, MD, Professor and Chair of Neurosurgery for the Mount Sinai Health System, and Clinical Director of the Neurosurgery Simulation Core at the Icahn School of Medicine at Mount Sinai. “In conjunction with simulation, they also play an important role in the patient-consultation process.”
The team is led by Anthony B. Costa, PhD, Assistant Professor in the Department of Neurosurgery, Scientific Director of the Neurosurgery Simulation Core, and Director of the Medical Modeling Core. Dr. Costa has developed digital tools to expedite the process of turning radiological data into 3D models and interactive, virtual modeling. The work is done rapidly—“in days, as opposed to weeks,” Dr. Costa says—and at a significantly lower cost than outside vendors. Recent models include brain tumors with surrounding vasculature and cranial nerves, spine modeling for the correction of severe scoliosis, and pelvic models for the planning of total hip replacement.
“When patients come in and are told they require a surgical procedure, it is often difficult for them to have a clear picture of what is going on in their own body,” Dr. Costa says. And 3D printing enables patients to pick up a model of the area affected, as the physician explains their condition and how the surgical procedure will work. “This offers patients confidence about what is about to happen to them,” Dr. Costa says. “We have found this to be a very successful approach.”
Mount Sinai clinicians and researchers who are interested in Medical Modeling Core services may visit icahn.mssm.edu/medicalmodeling or contact holly.oemke@mountsinai.org.
Updated on Jun 30, 2022 | Featured
From left: Peter McCann, MD; Leesa M. Galatz, MD; and Steven F. Harwin, MD
Mount Sinai West and Mount Sinai Beth Israel have earned The Joint Commission’s Advanced Certification for Total Hip and Total Knee Replacement, joining an elite group of institutions nationwide that have earned this highest recognition for quality and safety.
The Joint Commission established Advanced Certification for Total Hip and Total Knee Replacement in 2016 in response to growing demand, due to an aging population and expanding clinical indications for the procedure, along with an increased focus by physicians on helping patients manage pain, improve their quality of life, and return to everyday activities. The Advanced Certification is for two years.
Each year, nearly 700,000 total hip and knee replacements are performed in the United States. The surgery is among the most common performed, and the number of procedures is expected to quadruple by 2030, according to The Joint Commission.
Evan L. Flatow, MD
“This achievement points out our quality and exceptional orthopedic care,” says Leesa M. Galatz, MD, Mount Sinai Professor of Orthopaedics at the Icahn School of Medicine at Mount Sinai and Chair of the Leni and Peter W. May Department of Orthopaedic Surgery. “We are dedicated to giving patients top-level orthopedic care throughout the Mount Sinai Health System.”
The Joint Commission conducted site visits at Mount Sinai West and Mount Sinai Beth Israel that focused on all aspects of the total hip and knee replacement process, including pre-admission testing, operating room holding, the operating room, post-anesthesia care, services in the inpatient rehabilitation unit, and home care arrangements.
To prepare for the visits, the hospitals implemented a vast collaborative effort involving physicians, nursing, physician assistants, social workers, and staff from rehabilitation medicine, the quality improvement subcommittee, food and nutrition, and environmental services.
Michael J. Bronson, MD
“Mount Sinai West staff demonstrated exemplary teamwork to showcase our commitment to providing the highest level of care,” says Evan L. Flatow, MD, President, Mount Sinai West, and Bernard J. Lasker Professor of Orthopaedic Surgery. “We congratulate all involved in this remarkable achievement and look forward to continuously improving patient safety and quality of care.”
Michael J. Bronson, MD, Chair, Orthopaedic Surgery at Mount Sinai West and Mount Sinai St. Luke’s, says the certification “shows that Mount Sinai West provides an exceedingly high level of care in every parameter of joint replacement when it comes to positive outcomes, low complication rates, and high patient satisfaction.”
“The quality of hip and knee replacement surgeries can vary greatly among hospitals, and our exceptional performance will help us differentiate our program,” says Steven F. Harwin, MD, who was Chief of Adult Reconstruction and Total Joint Replacement at Mount Sinai Beth Israel when The Joint Commission conducted the review. Dr. Harwin, Professor of Orthopaedic Surgery, recently joined the Department of Orthopaedic Surgery at Mount Sinai West.
For example, last year at Mount Sinai West and Mount Sinai Beth Israel, the infection rate for total hip replacement and total knee replacement—a key concern for patients—was below the national average.
“The Joint Commission recognizes the outstanding quality of care provided by our entire team of caregivers, from nurses in the operating room to physical therapists, internists, and orthopedic surgeons,” adds Peter McCann, MD, Chair of the Department of Orthopaedic Surgery at Mount Sinai Beth Israel and Professor of Orthopaedics.
Updated on Jun 30, 2022 | Featured
Denisse Rojas Marquez
Growing up as an undocumented immigrant in Fremont, California, had a profound impact on Denisse Rojas Marquez and shaped her belief that access to higher education and quality health care should be available to all. In 2012, she gained relief from deportation through President Barack Obama’s Deferred Action for Childhood Arrivals program and in 2015 gained acceptance to the Icahn School of Medicine at Mount Sinai. Her achievements earned her the prestigious Paul & Daisy Soros Fellowship for New Americans award.
Now, Ms. Marquez can add another accomplishment to her impressive resume. She was named to the Forbes 30 Under 30 list of young achievers, which appeared in the magazine’s January 24, 2017, issue. Her work in cofounding Pre-Health Dreamers (PHD), a growing network of more than 800 undocumented students from 42 states who are interested in pursuing careers in science and health care, was cited by Forbes in its inclusion of Ms. Marquez. PHD provides resources and advocates for progressive institutional and governmental policies. Ms. Marquez’s inspiration for PHD is based on her experiences as a student who had to navigate her own educational and career aspirations with limited resources.
“Denisse embodies all of the best values and highest aspirations of a true physician-advocate,” says David Muller, MD, Dean for Medical Education at the Icahn School of Medicine at Mount Sinai, and the Marietta and Charles C. Morchand Chair for Medical Education. “I have great respect for the work she has done and the lives she’s changed as a result of her accomplishments.”
Updated on Jun 30, 2022 | Featured, Research
A population of cells in early development may give rise to the ventricular chambers of the heart, but not the atria, according to a study led by researchers from the Mindich Child Health and Development Institute at the Icahn School of Medicine at Mount Sinai and published in Nature Communications.
Feb 6, 2017 | Community, Featured, Seaver Autism Center
As part of an outreach program created by the Seaver Autism Center for Research and Treatment, children with autism have an opportunity to visit the American Museum of Natural History.
One Saturday morning each month, the American Museum of Natural History in New York City opens its doors an hour early to welcome a special group of visitors: children with autism and their families. What they experience is more than a simple stroll through the museum’s labyrinthine exhibition halls. Specialists at the Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai have taught museum tour guides and volunteers how to engage and interact with children with autism spectrum disorder (ASD). The Seaver Autism Center has also developed social stories, visual cues, and prompt cards for these visits and has chosen to tour specific halls (Dinosaurs, North American Mammals, Planet Earth, and Ocean Life) based on their ability to meet the children’s sensory needs.
The three-year-old program has been “hugely successful,” says Michelle Gorenstein-Holtzman, PsyD, Assistant Professor of Psychiatry at the Mount Sinai Health System and Director of Community Outreach for the Seaver Autism Center for Research and Treatment. Specialized tours of the museum are continually booked, and exhibits are being added to keep up with the program’s popularity.
“I think you’re going to see more and more museums adopt specialized programs such as this, due to the growing demand,” says Dr. Gorenstein-Holtzman. She is helping the Long Island Children’s Museum—where she is an advisory board member—develop such a program.
The museum connection is a natural fit for the Seaver Center, which uses community outreach to share its knowledge and resources with patients and families across the tri-state area. Supported by a grant from the UJA Federation of New York, Dr. Gorenstein-Holtzman develops evidence-based social skills programming for children, adolescents, and young adults with ASD. The children’s lessons focus on play and conversational skills, while the newly developed young adult curriculum focuses on employment-based social skills.
Citywide outreach also takes the form of a Community Lecture Series held at schools and local meeting halls and a Distinguished Lecturer Series that shares the latest autism research in areas such as epidemiology, genetics, and early detection that are relevant to caregivers and professionals. “What’s unique about the Seaver Center is that we don’t confine our research to the lab,” says Dr. Gorenstein-Holtzman. “We’re continually disseminating our findings to the community so that they have greater meaning.”
In addition, the Seaver Center is translating its materials into Spanish and offering its services to Spanish-speaking families. Pilar Trelles, MD, a child psychiatrist and Seaver Clinical Fellow, is the principal investigator on a research project that partners Latino families of children who are newly diagnosed with autism with “peer advocates” in their community. The peer advocates are actively engaged parents with special-needs children themselves, who have received training from the state. They help newcomers navigate the system, which can often seem complex and overwhelming.
“One of the things that’s important to us is reaching out to minority families who have little idea what we do or how to access the programs we provide,” says Dr. Trelles. “Peer advocates understand what these families are going through and can relate to them in ways that others can’t. They’re able to give them hope that things are going to get better and that their children are going to get the help they need.”
Updated on Jun 30, 2022 | Featured, Research
Manish Arora, PhD, MPH, is known for his work on biomarkers—using human teeth to reconstruct the timing of exposure to harmful chemicals and essential nutrients.
Manish Arora, PhD, MPH, Vice Chair of the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai, has been named a recipient of the Presidential Early Career Award for Scientists and Engineers, the highest honor bestowed by the U.S. government on science and engineering professionals in the first 10 years of their independent research careers.
“Dr. Arora’s research is one of those rare paradigm shifts in science,” says Robert O. Wright, MD, MPH, Ethel H. Wise Professor of Community Medicine and Chair, Department of Environmental Medicine and Public Health, and Director, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory at the Icahn School of Medicine. “I first met him 10 years ago when he was a trainee with a big idea. When he explained the concept of using teeth to measure exposure to lead in pregnancy—to assign a date to an event that happened years ago—it felt like science fiction, but he was able to make it happen, which is a testament to both his intellect and perseverance.”
Dr. Arora, an environmental epidemiologist and exposure biologist with a clinical background in dentistry, has long been passionate about the environment and inventing. He earned a PhD analytical chemistry, and nuclear beam methods from the University of Sydney in Australia. He had a joint appointment at that university and at Harvard University’s School of Public Health before being recruited by Dr. Wright to Mount Sinai in 2013. But he credits a source close to home for his current success: his late mother. “She was a big proponent of generating new knowledge,” Dr. Arora says, but as a young girl in India, her education ended in middle school. “So she always valued education, much more than most people do, because it was not easily attainable to many of her generation.”
Dr. Arora focuses his research, which is funded by the National Institute of Environmental Health Sciences, on the effects of prenatal and early childhood chemical exposures on lifelong health. In the same way that trees have growth rings, he says, “we have growth rings in teeth, and because those start forming before you are born, we can actually go back in time and figure out, for example, what you were exposed to in the second or third trimester.”
A baby tooth being prepared for analysis by a laser.
Dr. Arora and his team collect teeth donated by families and dentists all over the world. To study the teeth, they invented novel techniques and equipment, including a robot that cuts, or “micro-dissects,” samples the width of a human hair. The samples are then analyzed for thousands of chemicals the donors may have been exposed to at different times of their development.
“There are two big findings: One is that it’s not just how much you are exposed to, it’s also when you get exposed to it,” Dr. Arora says. “That is what we are finding for diseases like Lou Gehrig’s disease (ALS), in which you become symptomatic at age 50, 60, 70. But the initial exposure—what altered your trajectory—may have occurred early in life. We are also discovering this is true for autism and schizophrenia.” Dr. Arora says the second finding is that a single chemical is not always the key. “What happens when you get exposed to a mixture of chemicals is not the same as when you get any single component. Previously, the technology to study these mixtures of chemicals didn’t exist, but the methods we are developing allow measurement with novel precision. We now have an NIH laboratory hub for this new technology.”
For this work, Dr. Arora received a New Innovator Award in 2014, which included $2.2 million from the NIH. Dr. Arora is now seeing results in the search for metal and organic risk factors. “The next phase will be finding approaches to mitigate the risk, both at a clinical level, with the goal of personalized environmental medicine, and also at a population level, to support public health and policy development,” Dr. Arora says. “The idea is that as clinicians we can treat people one-on-one, but taking broader action like getting rid of lead in gasoline helps all of us.”
