Featured | Mount Sinai Today

For 24th Year, Mount Sinai Receives Top Safety Rating for Cardiac Catheterization

Updated on Apr 14, 2023 | Cardiology, Featured

Annapoorna S. Kini, MD, left, and Samin K. Sharma, MD.

For the 24th consecutive year, The Mount Sinai Hospital’s Cardiac Catheterization Laboratory or its interventionalists have received the highest two-star safety rating from the New York State Department of Health (NYSDOH) for percutaneous coronary interventions (PCI), also known as angioplasty. PCI—one of the most common procedures for patients with coronary artery disease—opens blocked arteries and restores normal blood flow to the heart.

In a highlight of the report, Annapoorna S. Kini, MD, Director of the Cardiac Catheterization Laboratory at The Mount Sinai Hospital, received the two-star rating for significantly lower 30-day risk adjusted mortality for PCI in all cases and in non-emergency cases. She was the only interventionalist in the state to receive this rating in both categories, while performing 2,844 procedures in the latest period reported, December 1, 2016, to November 30, 2019.

“This NYSDOH report is again a testament to the top quality work being done in The Mount Sinai Hospital Cardiac Catheterization Laboratory by the dedicated interventionalists, making it No. 1 in the nation in volume and quality,” says Samin K. Sharma, MD, Director of the Mount Sinai Cardiovascular Clinical Institute, and Senior Vice President of Operations and Quality for Mount Sinai Heart.

Mount Sinai’s exceptional ratings appeared in the latest NYSDOH report, released in April 2023, on the risk factors associated with PCI at 65 hospitals across New York State. The NYSDOH began publishing PCI safety ratings in 1995, in reports designed to help patients make better decisions about their care based upon a statistical review of each hospital’s data.

“Despite taking on some of the most challenging referrals, our Cath Lab has received the double-star rating again. I believe that our efforts as educators and investigators—in our conferences, live cases, publications, educational applications, and clinical trials—bring us to the forefront of the field,” says Dr. Kini, the Zena and Michael A. Wiener Professor of Medicine. “We are looking forward, toward the horizon, and are always seeking the best practices and proven methods to provide our patients with the best outcomes.”

During the three-year period, The Mount Sinai Hospital had a risk-adjusted PCI mortality rate of 0.85 percent for all of its cases—emergency and nonemergency—significantly lower than the statewide average of 1.22 percent, while performing the largest number of procedures (10,347). For nonemergency cases, Mount Sinai’s PCI mortality rate was 0.50 percent, compared with the statewide average of 0.79 percent

Mount Sinai Neuroradiologist Collaborates on New Opera About a Long-Ago Pandemic

Updated on Apr 13, 2023 | Featured

Jarrett Porter and Joyce El-Khoury in the Odyssey Opera performance of Awakenings. Photo by Kathy Wittman

The COVID-19 pandemic is the most significant public health crisis of our time. However, from 1916 to 1927, there was another pandemic that shaped and ended lives—encephalitis lethargica, or sleeping sickness, which afflicted more than one million people worldwide, causing 500,000 deaths. Of those who recovered, many were left in a catatonic state, speechless and motionless. Most of these patients were warehoused in mental health or hospital facilities, with no ability or means to treat them successfully.

The story of three of these patients in the Bronx, and their physician, Oliver Sacks, MD, is the subject of an opera by a Mount Sinai neuroradiologist, Aryeh Lev Stollman, MD, and his composer husband, Tobias Picker. Awakenings made its debut in June 2022 at the Opera Theatre of St. Louis and its East Coast premiere in Boston in February 2023 with Odyssey Opera in a limited run at the Huntington Theatre. The opera was recently featured in The New Yorker and The New York Times.

Oliver Sacks, a neurologist, was struck by the similarities between encephalitis lethargica and Parkinson’s disease. He advocated to hospital management that L-dopa, an experimental drug used to treat Parkinson’s, might be an effective way to treat these patients. He was given permission to treat one patient as a test. The patient, Leonard, made a spectacular recovery, and Dr. Sacks gained authorization to treat many more patients. Unfortunately, the effects did not last, and most patients relapsed into their former trance-like state.

Dr. Sacks wrote a book, Awakenings, in 1973, detailing the cases of 20 patients. Dr. Stollman and his husband became friends with Dr. Sacks after being introduced at a dinner party in Manhattan in 1993. Mr. Picker had Tourette syndrome as a child, and over the course of his friendship with Dr. Sacks, was helped by him, both in accepting his condition and learning to live with it. Dr. Sacks noticed that Mr. Picker, who wrote the music, was relieved of his symptoms while playing piano, which Dr. Sacks wrote about in his book describing the therapeutic effects of music, Musicophilia.

Dr. Stollman, who is also an award-winning novelist, wrote the libretto for Awakenings. “We based the story on Dr. Sacks’ book, but because he wrote about 20 separate patients, we chose three main patients and created their interaction with each other and Dr. Sacks,” Dr. Stollman says. “Dr. Sacks realized that his book wasn’t just a collection of case histories, but rose to the level of allegory or myth. It’s symbolic of our own lives and what we go through. Even if we’re not afflicted like these patients, we have our own awakenings and then have to return to everyday life. So we framed this story in the myth of Sleeping Beauty, and Dr. Sacks is the prince who awakens our characters. However, Sleeping Beauty doesn’t have to go back to sleep, but these patients do.”

In the opera, as Leonard responds to his treatment and awakens, he sings:

It’s a lovely feeling!

A lovely feeling.
To walk. To talk.

I have watched you every night and every day for years.
How many years have I been imprisoned in that chair?
I could only live in books,
And live through other people’s lives.
It’s a lovely feeling.
A lovely feeling!
I am reborn.

“The opera was ready to premiere in June 2020 when the pandemic struck,” Dr. Stollman says. “Every opera company closed, and Awakenings had to be delayed. Perhaps audiences can now understand a little better and can relate through their own experience, coming out of this pandemic.”

Tobias Picker, left, and Aryeh Stollman, MD, at their wedding at the U.S. Supreme Court in Washington, D.C. Photo by Jon Fleming

In the opera, Dr. Sacks has an awakening of his own, coming to an awareness of his own identity as a gay man. But he feels he is not ready to fully embrace that fact, singing, “I am no longer the man I was / But I have not truly awakened yet.” “When Dr. Sacks came out, it took him a long time, but he wanted to do that before he died,” Dr. Stollman says. “In the end, he was a proud gay man. And we were fortunate to be his friend.”

While Dr. Sacks’ book was also the basis for a film starring Robin Williams and Robert De Niro, the opera written by Dr. Stollman and Mr. Picker is a fresh and original take on the story, enriched by their personal friendship.

As a neuroradiologist, Dr. Stollman reads CT scans and MRIs for neurological diseases and disorders of the spine. “My background in medicine certainly helped in writing the story, but I think writing and medicine are both life-affirming pursuits. As a doctor, you have an intense engagement with life. You can learn more about a patient in a few minutes than perhaps their closest friends know about them. And writing reflects the more intense and emotional aspects of our lives. They’re not that different, in some ways.”

Dr. Stollman has written several novels, including The Far Euphrates, which won the Lambda Literary Award and has been translated into German, Dutch, Italian, Portuguese, and Hebrew. His second novel, The Illuminated Soul, won the Harold U. Ribalow Prize for Jewish literature from Hadassah Magazine.

Shaping the Future of LGBTQ+ Medicine

Updated on Jun 1, 2023 | Diversity and Inclusion, Featured

Fellows of the LGBTQ+ Medicine Fellowship from left to right, Jean Carlo Rodriguez-Agramonte, MD; Alexander Boulos, MD; Roy Zucker, MD.

Throughout the day, the flow of patients at Mount Sinai Health System’s Institute for Advanced Medicine clinics is nonstop, says Jean Carlo Rodriguez-Agramonte, MD. “But I couldn’t be happier, seeing these patients and knowing I’m helping them,” he adds.

Caring for LGBTQ+ people forms the bulk of Dr. Rodriguez-Agramonte’s training as part of the LGBTQ+ Medicine Fellowship at the Icahn School of Medicine at Mount Sinai. The third fellow since the program’s inception, he rotates through various specialties—internal medicine, adolescent medicine, and endocrinology, to name a few—through a year of training to learn skills needed to provide competent care for LGBTQ+ populations.

“The kind of care we’re trying to impart is one that is focused on addressing the patient’s identity,” says Erick Eiting, MD, Medical Director for Quality of the Center for Transgender Medicine and Surgery, and program director of the LGBTQ+ Medicine Fellowship. The fellowship is now gearing up to recruit its fourth fellow in the upcoming academic year.

Learn more about applying for the LGBTQ+ Medicine Fellowship

When Mount Sinai created the fellowship in 2020, it was one of the first two such programs in the country—the other was at the University of California, Los Angeles. “There’s a dire need for fellowships such as ours,” Dr. Eiting says. “That there were none prior was shocking given the legacy of health crises with the LGBTQ+ population in this country.”

Erick Eiting, MD

Only about a third of medical students have had any sort of LGBTQ+ training, and even that might be in the form of lectures that span one day, notes Dr. Eiting. “We need to step up and shape the future of LGBTQ+ medicine,” he says.

At the core of that effort is addressing disparity. Studies have shown that rates of depression, suicidal ideation, substance use, and HIV are significantly higher in LGTBQ+ populations, and yet access to health services to address those issues continue to be difficult for these communities, says Alexander Boulos, MD, MPH, who was the second program fellow. “Having a physician who’s well-trained to be sensitive to the patient’s gender identity and sexual orientation can help ensure proper testing, or asking the right questions,” he says.

The LGTBQ+ Medicine Fellowship has evolved over each iteration, and continues to challenge itself to grow. “Just as we train each fellow, we try to have each fellow help us expand the offerings we have,” Dr. Eiting says.

With a goal of diversity, the program is aiming for greater representation in gender, racial, and socioeconomic background from future fellows.

“Having people with rich and diverse backgrounds will bring about the ‘rising tide phenomenon,’ where a rising tide lifts all boats,” says Dr. Eiting. Just as a fellow receives instruction from the institution, so too does the fellow teach and be able to share experiences with staff who work alongside them, he adds.

Additionally, the fellowship seeks to ensure relevance amid rapidly changing technology in the health field. For example, Mount Sinai recently launched a telehealth program for pre-exposure prophylaxis (PrEP) for HIV, and Dr. Eiting hopes future fellows might be able to think creatively about technological innovations. “Telemedicine has great potential for LGBTQ+ medicine. How can we take it further?” Dr. Eiting asks. “That’s a goal: to always be thinking about how we can increase access more.”

Jean Carlo Rodriguez-Agramonte

Alexander Boulos

Roy Zucker

Jean Carlo Rodriguez-Agramonte, MD; 2022-2023 LGBTQ+ Medicine Fellow

What drew you to the fellowship?
When I was applying, there were only two such programs of its kind: one at Mount Sinai and one at UCLA. But what was a particular draw for Mount Sinai was that there was a large Latino population, especially Puerto Rican, in New York. There’s a saying that Puerto Rico almost feels like a borough of New York City. But coming from there, I was interested in continuing to treat and understand that population.

What were some of your takeaways from the fellowship?
The amount of patients I’ve seen here and the availability of resources is incredible and humbling. As a physician, you don’t get sidetracked from your goal of treating patients simply because of the lack of resources.

For example, when a patient comes in here, they get to have their labs done immediately, instead of having to wait weeks. Then, I get the results first, and I’m able to explain the results to them. It feels more personal and leads to better communication. Sometimes, when patients get their results first without any guidance, it leaves them with a lot of questions and causes unnecessary stress.

Being surrounded by so many experts here at Mount Sinai, it doesn’t feel like you’re constantly running into walls. Patients sometimes expect you to know everything, but we don’t know everything. At least here, I know where to tell my patients to go to, even if I don’t have all the answers.

What were some challenges or highlights faced during the program?
I got dropped into a population I wasn’t used to seeing a lot of, such as the transgender population. I had a lot of learning to do on how to properly care for them. Not just medically, but also on things such as using the proper pronouns, and centering their identity as part of the care.

A highlight for me was being able to treat Latino patients at a deeper level. In general, it’s very difficult to provide preventive care without understanding the person’s underlying culture, since so many nuances are unsaid. But I’ve had so many Spanish speakers say to me, “I’m so glad I can speak to you on my own terms. Because you get it.” That connection feels special to me each time I hear it.

What do you hope to achieve after the fellowship?
I hope to implement the things I’ve learned here in Puerto Rico, particularly regarding providing better transgender care. I also hope to be part of the conversation there for improving medical education on LGBTQ+ populations. Just as it is here, medical school systems there lack inclusive care instruction.

Part of why I wanted to go into family/internal medicine and pediatrics is that I like the “figuring out the puzzle” part of medicine. Unlike in surgery, where all the complicated part of diagnosis is done and you’re fixing the problem, in family medicine, you’re talking and listening to patients and figuring out what is wrong. Similarly, I want to figure out where the missing parts are in research and education, and find the answers.

Alexander Boulos, MD, MPH; 2021-2022 LGBTQ+ Medicine Fellow

What drew you to this fellowship?
Ever since medical school, I’ve been involved in increasing awareness of LGBTQ+ health issues, giving training and competency lectures to faculty, staff and residents about the LGBTQ+ patient, and even starting a PrEP clinic at the Veterans Affairs in the Bronx to help increase access to medication that can be used to prevent HIV for at-risk patients living in underserved communities.

I realized that I’ve been working in LGBTQ+ medicine all this time and not even knowing it. When I discovered the existence of this program while completing my preventive medicine residency program here at Mount Sinai, I knew it was the perfect opportunity to help set the tone for the rest of my career.

What were some of your takeaways from the fellowship?
I remember vividly, after my first day of this fellowship, calling my family and friends and saying, “I’ve never seen so many gay patients in my life!” And I was absolutely loving it. How was it that I was already a resident and hadn’t had much exposure to LGBTQ+ patients?

In the program, I was able to rotate and learn from experts in almost every field, including infectious disease, endocrinology, plastic surgery, urology, OB/GYN, psychiatry, adolescent medicine, and addiction medicine. The scope of experiences I had was nothing short of amazing. I got to scrub in for gender-affirming surgeries, including vaginoplasty, chest masculinization, and facial feminization. I’ve worked with experts in HIV/AIDS treatment, provided gender-affirming hormone therapy to transgender and gender-diverse patients, and even cared for intersex pediatric patients.

Why do you think LGBTQ+ fellowships are important?
Especially today, there are many places in the United States where health care access for LGBTQ+ communities continues to be a challenge. We’ve seen a recent wave of anti-transgender bills passed throughout the country that serve to block and/or limit access to gender-affirming care.

Programs such as this one are important for changing the future of medicine, as it serves as a bold statement about the need for more training and resources to serve a community that has all too often been left out on their own. We need more doctors to be advocates for LGBTQ+ patients and to be aware of their specific health needs, just as we are trained to do so for every other patient.

Unfortunately, that training isn’t quite the norm yet, and I’m here to help change that. I’ve found my purpose in this field and I want to help make a difference for my community.

How do you intend to make that difference, after your residency?
As I gear up for graduation and make my way out in the real world, I plan to continue serving the LGBTQ+ community clinically as a primary care physician, focusing on HIV/AIDS treatment, PrEP management, anal cancer screening, and gender-affirming care.

In addition, I hope to play a part in medical education reform where we can incorporate important LGBTQ+ competency trainings in medical school curriculums. Doctors and medical students need to be more comfortable treating LGBTQ+ patients, and they’ve shown that they are open to learning.

I also hope to increase my community outreach engagement to the LGBTQ+ population directly and find new and innovative ways to teach and inform the community about important health issues, such as ones they might find too uncomfortable bringing up to their provider. I’m excited to see what the world has in store for me, but one thing I do know is that it all started here.

Roy Zucker, MD; 2020-2021 LGBTQ+ Medicine Fellow

How did you get involved with the first fellowship?
I had been working in LGBTQ+ medicine in Tel Aviv for about seven years, and was in the infectious disease program at the Tel Aviv Sourasky Medical Center (Ichilov). Mount Sinai has a collaboration with my hospital, and Mount Sinai’s dean of education came to Ichilov to discuss setting up a one-month observership program at its Institute for Advanced Medicine.

I participated in that program and realized physicians seemed to only be looking at their own disciplines, and no one was looking at LGBT care holistically. For example, a transgender patient will get the best care with a transgender medicine practitioner, but if HIV is involved, another provider would need to be involved.

I thought, “Why not a training program where providers are taught to look at the broader picture of LGBTQ+ care—including the spectrum from transgender medicine to psychiatry to HIV care?” I wrote an email to David Reich, MD, President of The Mount Sinai Hospital, not expecting a response. In five minutes, I got an email back, and soon we started discussing starting up the program. A year and a half later, I became the first fellow.

What were some of your takeaways from the fellowship?
Unlike in Israel, the patients at Mount Sinai are much more diverse. The exposure to the patient diversity really challenged me as a physician in how I get to treat and address patients. There were initial cultural and language differences, but patients were patient with me. On the professional side, because I had already been treating patients and involved in LGBTQ+ medicine for many years, I felt I had a lot to offer to people working alongside me. While Mount Sinai was giving me expanded knowledge, I also felt people could learn from my experience in Israel too.

While the term “leadership” might be overused in America, I felt it was really on display at the Health System level, and also at the Icahn School of Medicine. Their commitment to health care delivery and excellence has led to great name recognition in Israel, where being affiliated with Mount Sinai is an impressive achievement.

What are you working on today?
Since August of 2021, I have been the Director for LGBTQ Health Services with Clalit, the biggest health service organization in Israel overseeing 5 million patients. We created LGBTQ+ clinics in Tel Aviv, Jerusalem, and Haifa.

I am also Director for LGBTQ Health Services with Ichilov in Tel Aviv, and in partnership with city hall, we’re about to open an LGBTQ community health center that integrates medicine and community initiatives. A focus of this center involved “clinical champions”—people within Ichilov who are specialized in a specific branch of LGBTQ medicine such as geriatrics or adolescent medicine, who will focus on research and education.

These are some current steps, but I am hoping to guide what the future of medicine might look like for LGBTQ+ people.

What might that future look like?
Even in 2023, LGBTQ+ patients are still hesitant to access health care services because they’re afraid of exposing themselves and are not comfortable discussing their sexuality with providers. Patients are going to hospitals when their conditions become an emergency, not before, when things can still be prevented. We need to provide accessibility on the patients’ terms—if they’re only comfortable in an LGBT-defined space, it should be there.

But in the long term, I hope that LGBTQ+ care goes beyond just about providing accessibility and addressing discrepancies, but more into “community-oriented” care. This means thinking about LGBTQ+ populations across all ages—how they’re exposed to LGBTQ+ topics, how they age and their mental health, etc. For example, if you’re talking about sexual health and gender identities at a younger age, having that acceptance early on affects mental health outcomes later in life. When you put it there from the beginning for young people, they don’t feel as on the fringe.

As someone who has an entrepreneurial soul, I found Mount Sinai embraced that spirit. I came to New York and people here at the program helped take an idea from my head and made it real. The biggest motivational word of mine is “no”—when someone says “no,” all the more I want to make it happen. Mount Sinai certainly helped with the obstacles to make my dream happen.

Yellow III Trial Finds That Lipid Lowering With a PCSK9 Inhibitor Could Benefit Heart Patients on Statin Therapy

Updated on Apr 7, 2023 | Cardiology, Featured, Research

Annapoorna S. Kini, MD, Director of the Cardiac Catheterization Laboratory at The Mount Sinai Hospital, was principal investigator of the late-breaking clinical trial.

Even after high-intensity statin therapy, a considerable residual risk exists for heart attack and stroke among adults with coronary artery disease (CAD). A clinical study led by Mount Sinai offers strong evidence that aggressive lipid lowering with a proprotein convertase subtilisin kexin type 9 inhibitor (PCSK9i), along with a statin, can significantly reduce that threat and potentially help doctors identify patients who would benefit most from intensification of treatment to change their coronary plaque morphology and composition.

The findings were presented by principal investigator Annapoorna S. Kini, MD, Director of the Cardiac Catheterization Laboratory at The Mount Sinai Hospital, as a late-breaking clinical trial at the American College of Cardiology/World Congress of Cardiology meeting in New Orleans in March.

The study, known as Yellow III, used advanced multimodality imaging to show favorable plaque characteristics after a 26-week regimen of evolocumab, including substantial reductions in total cholesterol, LDL cholesterol, and total/HDL cholesterol ratios. More specifically, the investigation showed a significant increase in the minimum fibrous cap thickness (FCT) through optical coherence tomography (OCT), reduction in lipid core burden index at the maximal 4-mm segment (maxLCBI4mm) through near-infrared spectroscopy, and reduction in atheroma volume through intravascular ultrasound in angiographically nonobstructive lesions.

“By using all three modalities for the first time in a study of this type we were able to demonstrate a measurable improvement in fibrous cap thickness, as well as in plaque volume,” says Dr. Kini, Zena and Michael A. Wiener Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai. “In addition, blood samples were drawn to enable us to conduct a gene expression analysis of peripheral blood mononuclear cells. This will help us uncover through ongoing research the molecular mechanisms responsible for beneficial changes in atherosclerotic lesions of patients treated with evolocumab.”

The investigation showed a significant increase in the minimum fibrous cap thickness through optical coherence tomography (OCT) imaging. Thicker fibrous caps are associated with more stable plaques that are less prone to rupture and subsequent adverse cardiac events.

Prior studies have established the ability of PCSK9 inhibitors—injectables that block PCSK9 proteins from breaking down LDL receptors—to reduce residual cardiovascular risk in statin-treated patients. As a result, the 2018 American College of Cardiology/American Heart Association cholesterol guidelines recommended the use of PCSK9 inhibitors in patients with stable CAD if sufficient LDL-lowering was not achieved on maximally tolerated doses of statins. In the Yellow III trial, 137 patients scheduled for elective coronary angiography were prescribed maximum-dosage statin therapy for at least four weeks before undergoing multimodality intracoronary imaging. They were then given evolocumab (140 mg) every two weeks for 26 weeks and reimaged to assess changes in plaque morphology and composition.

The gene expression analysis of peripheral blood mononuclear cells was a particularly important part of the Yellow III study because it could potentially lead to the development of biomarkers able to predict which patients would benefit the most from different approaches to lipid lowering. Researchers found that fibrous cap thickness did not improve in 20 percent of patients. The hope is that a genotypic characterization of patient response will ultimately reveal which patients should remain on statins, which should be put on a PCSK9 inhibitor, and which might benefit from combination therapy.

“We believe studies like ours can help physicians personalize therapies for their patients with coronary artery disease,” says Dr. Kini, a renowned interventionalist. “The first step could well be a recommendation for lifestyle modification, like exercise and diet. But it is important for cardiologists to know who could also benefit from the addition of a high-intensity PCSK9 inhibitor, particularly in the case of statin-treated patients with multiple risk factors.”

Mount Sinai Morningside Launches Incidental Lung Nodule Program to Promote Early Diagnosis of Lung Cancer

Mar 31, 2023 | Featured, Mount Sinai Morningside, Your Health

A photo showing Javier Zulueta, MD, Rahul Agarwal, MD, and Fernando Carnavali, MD.

Javier Zulueta, MD, right, is joined by, from left, Rahul Agarwal, MD, and Fernando Carnavali, MD.

Lung cancer is by far the leading cause of cancer deaths in the United States accounting for about one in five cancer deaths. It is difficult to detect because there are often no symptoms in its earliest stages—only 16 percent of lung cancers in the United States are detected at a localized stage.

Lung cancer screening for smokers and former smokers, like the Early Action Lung Cancer Action Program (I-ELCAP), has been found effective in detecting lung cancer at earlier stages. However, as more lung cancers are being detected in non-smokers and many are ineligible for screening under the I-ELCAP guidelines, additional tools are needed to detect lung cancers early and save lives.

The newly launched Incidental Lung Nodule Program (ILNP) at Mount Sinai Morningside opens a new path for early detection guided by methodically identifying the patients with lung nodules at most risk for lung cancer and ensuring they receive timely interventions.

How the Incidental Lung Nodule Program Works

CT scans ordered for other illnesses and injuries are methodically scanned by computerized search—a more equitable and inclusive tool for detecting lung cancer early. All of those scans with a reported and documented incidental lung nodule are reviewed by a team led by a pulmonologist with special expertise in lung nodules.

Research has shown that about 25 percent of individuals who have a CT scan of the chest will have an incidental lung nodule detected, most of which need follow-up. Approximately five percent of the individuals with lung nodules may have lung cancer. With an early diagnosis, lung cancer can be successfully treated in the majority of patients.

All scans with findings are entered into a database for tracking and follow-up. The ILNP team notifies the ordering physician and the patient’s primary care provider, if available, via Epic, phone call, or letter, with a specific follow-up recommendation. If the ordering physician was in the Emergency Department and there is no primary care provider available, the ILNP team will reach out to the patient directly.

Click here to see a flowchart showing the communication pathway.

How Do Patients Seek Evaluation and Treatment

Javier Zulueta, MD, a lung nodule expert and pulmonologist at Mount Sinai Morningside, leads a multidisciplinary clinic that accepts referrals from physicians and is available directly to patients. Patients who need evaluation by the nodule clinic will be offered an appointment within one week of notification. They will be evaluated by a pulmonary specialist, and a plan will be established according to guidelines, including a wide variety of diagnostic and treatment options depending on the characteristics of the nodule:

Blood test for cancer biomarkers
PET scan
Pulmonary function tests
Biopsy by robotic bronchoscopy or CT guidance
Evaluation by Thoracic Surgery

Smoking cessation will be offered to anyone who is a current smoker. All patients will be given a plan for CT scan follow-up within a predetermined period of time—anywhere between three and 12 months.

Patients may require exam and follow-up or diagnostic interventions like image-guided bronchoscopy or percutaneous biopsy. If cancer is diagnosed, the patient will be presented at Mount Sinai Morningside’s weekly multidisciplinary lung cancer and nodule conference. After review of all diagnostic and staging tests, a decision regarding treatment will be made. This can vary depending on the stage but includes thoracic surgery for early stages and oncologic assessment for all.

Patient Follow-Up

Patient not requiring immediate care will be prompted to repeat their CT scan on a recommended schedule and will continue to receive evaluation through the ILNP. The ILNP program navigators will contact the primary care physician, other provider, or the patient directly if patient is not getting the recommended diagnostics.

For more information or to refer a patient to the Lung Nodule Clinic, please call 212-523-3589.

New Wireless Monitoring Technology Now Offers Patients a Better Birthing Experience at Mount Sinai West

Mar 31, 2023 | Featured, Your Health

The maternal and fetal wireless technology is a single patch system placed on the birth parent’s abdomen.

Wireless technology has transformed virtually all aspects of our life, and now it is ready to transform the birthing and labor experience.

Mount Sinai West recently launched advanced wireless monitoring technology that allows patients the freedom to safely move around during the labor process.

The maternal and fetal wireless technology is a single patch system placed on the birth parent’s abdomen, allowing providers and nurses to monitor fetal heart rate, contractions, and uterine activity while offering patients more freedom of movement during the birth experience.

This technology is a cord-free, belt-free solution that increases the comfort of laboring patients. Without cords connecting the patient to a fetal monitor, laboring patients are free to get up, move around their room or the hospital, and change positions as needed. It can even be worn in the shower or tub. The Mount Sinai Hospital will soon offer this service to patients.

“Wireless technology has become a standard for all things modern. By utilizing wireless monitoring, we can significantly increase our patients’ comfort and mobility,” says Desmond Sutton, MD, Medical Director, Labor and Delivery in the Department of Obstetrics and Gynecology at Mount Sinai West and Assistant Professor of Obstetrics and Gynecology at the Icahn School of Medicine at Mount Sinai. “This really transforms the birth and labor experience, and we are pleased to have it available to all patients.”

The small device, about the size of computer mouse, uses a peel-and-stick patch to stay on the abdomen and Bluetooth technology, which sends data directly to monitors so the care team can effectively track contractions, and maternal and fetal heart rates.

In addition, the monitor allows patients to choose how they want to labor, improving patient satisfaction and comfort, which Mount Sinai West prioritizes for all their patients.

“We continue to focus on providing technology that supports a greater patient experience, so this technology tremendously assists us in our support of patients owning their birth plans and birth experience,” Dr. Sutton says.

Specialists at the Mount Sinai West Obstetric Service support patient needs, choices, and preferences with skilled, compassionate care. Obstetricians, midwives, maternal-fetal medicine experts, and nurses partner with you to ensure you receive comprehensive services personalized to your goals.

Learn more about pregnancy and birth experience at Mount Sinai West

« Older Entries

Next Entries »