Mar 10, 2020 | Community, Featured
U.S. Surgeon General Jerome M. Adams, MD, MPH, center, with David L. Reich, MD, President and Chief Operating Officer, The Mount Sinai Hospital, right, and Jonathan S. Gal, MD, Assistant Professor, Anesthesiology, Perioperative and Pain Medicine.
The Mount Sinai Hospital in February hosted a lecture by U.S. Surgeon General Jerome M. Adams, MD, MPH, who called upon the hospital’s medical community to embrace their role as “health advocates” while helping to guide the public in critical areas such as smoking cessation and the treatment and prevention of opioid abuse.
During a question-and-answer session in Hatch Auditorium that was led by Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System, Dr. Adams said, “We need more of you to use your voices.”
There is a lot of misinformation on the internet, said Dr. Adams, a board certified anesthesiologist. “It’s going to take a hands-on approach for us to communicate to people what it will take for them to be healthy.”
Dr. Adams discussed his priorities as Surgeon General. He said he was pleased that the United States has the lowest rate of cigarette smoking among adults and youth in history, but was also dismayed by a rise in e-cigarette smoking among high school and middle school students.
For the first time in 20 years, he said, national opioid-related deaths were decreasing, yet every 11 minutes someone still dies from opioid abuse. He also said the trend toward legalizing the use of marijuana in many states did not take into account the negative effects of its active ingredient, THC, on the developing brains of youngsters or on pregnant women.
Medical professionals in every specialty should help people understand the health consequences of their actions, he said, and be as well trained in handling drug abuse as they are in managing relatively commonplace complications, such as hypertension.
Updated on Jun 30, 2022 | COVID-19, Featured, Your Health
A newly identified coronavirus now known as COVID-19 was first recognized in Wuhan, China, in early December 2019 and is rapidly spreading throughout the world.
Bernard Camins, MD, MSc, Medical Director for Infection Prevention for the Mount Sinai Health System, offers some basic guidelines for understanding this latest health concern. You can also get up-to-date information from the Centers for Disease Control and Prevention (CDC).
Who is most at risk?
According to the CDC, those at the most risk include: people in places where ongoing community spread has been reported and people who have had close contact with those who have COVID-19. In addition, people who recently traveled to an area where cases of COVID-19 are occurring are most at risk, and they should consult their doctor or the CDC for the latest information. The CDC maintains a list of countries with significant COVID-19 cases.
What are the symptoms?
Symptoms have included mild to severe respiratory illness with fever, cough, and difficulty breathing. The symptoms usually begin within two to three days of exposure but could take as long as 14 days to develop. These symptoms are also typical of the flu and other seasonal viral illnesses, and if you have symptoms like these and you have not traveled to an area with COVID-19 cases or been in close contact with someone who has, you probably have a seasonal illness and not the novel coronavirus.
What if I recently traveled to an area with COVID-19 cases and now have symptoms of a respiratory illness and/or fever?
If you feel sick with fever, cough, or difficulty breathing within 14 days after you return to the United States, you should seek urgent medical care. However, before going to your doctor’s office, an urgent care center, or an emergency room, call ahead and alert the staff about your recent travel and symptoms.
Avoid contact with others. Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing. Frequently wash your hands with soap and water for at least 20 seconds to avoid spreading the virus to others. Use an alcohol-based hand sanitizer if soap and water are not available. As soon as you arrive at the medical facility, let a staff member know about your symptoms and travel history. You should be provided with a mask and moved to an area away from other patients.
How is coronavirus spread?
There are many types of human coronaviruses, including those that cause the common cold. They typically spread from an infected person through the air in tiny droplets produced when coughing or sneezing. These droplets, when they come into contact with another person’s mucous membranes (e.g., mouth, nose, or eyes), can lead to infection. The virus can also be transmitted if you touch a person, an object, or a surface on which the virus has settled and then touch your mouth, nose, or eyes before washing your hands.
How can I protect myself?
As with other respiratory viruses, you can protect yourself from infection through frequent, proper hand hygiene, either with an alcohol-based hand sanitizer or with soap and water. Also, practice proper respiratory hygiene by covering your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
How is Mount Sinai prepared to treat infectious diseases?
For a long time, Mount Sinai has been developing procedures to make sure that people arriving for care at our facilities are quickly screened for infectious diseases. This includes questioning people about whether they have traveled abroad in the last three weeks or come into contact with people who are traveling abroad. Our procedures enable us to quickly isolate any possible cases of infectious disease.
Feb 25, 2020 | Featured, Global Health
Keynote speaker Karenna Gore with conference host Robert Wright, MD, MPH.
Global warming is having an increasingly profound effect upon human health, making it harder to breathe, giving rise to more infectious diseases, and even lowering nutritional levels in our food supply.
These were among the many consequences cited on Friday, January 24, when the Institute for Exposomic Research at the Icahn School of Medicine at Mount Sinai hosted its second annual Clinical Climate Change Conference at the New York Academy of Medicine. The event drew more than 150 clinicians and other members of the U.S. medical community.
“Health care professionals are on the front lines of this planetary health problem,” which is having a disproportionate effect on “the poor, the marginalized, the elderly and infirm, and nonhuman life,” said Karenna Gore, the Conference’s keynote speaker, and the founder and Director of the Center for Earth Ethics at Union Theological Seminary.
She told the audience, “This is no ordinary time and we are together in not knowing how it will turn out. We need you to warn, and we need you to heal.” Ms. Gore is the daughter of former U.S. Vice President Al Gore, who received the 2007 Nobel Peace Prize for his work on climate change.
Robert Wright, MD, MPH, the Ethel H. Wise Chair of the Department of Environmental Medicine and Public Health, Director of the Institute for Exposomic Research, and Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai, said exposomics—a new field of science that uses technology to measure an individual’s total environmental exposures over their lifetime—could help physicians understand the effects of global warming.
Satellites, for example, are used to help measure a person’s external exposure to air pollution, whereas mass spectrometry is used to measure an individual’s internal chemical exposures. As the field matures, Dr. Wright said, exposomic data will be used more widely to determine cause and effect and monitor the success of interventions.
Dr. Wright shared information from the U.S. Centers for Disease Control and Prevention (CDC), which highlighted the negative impact of extreme heat and air pollution on cardiovascular health and asthma and showed that warmer weather would lead to an increase in tick-and-mosquito-borne illnesses such as Lyme disease and the Zika virus, since insects could live and breed in more places.
Conference attendees gathered at the New York Academy of Medicine in New York City.
As a point of reference, Dr. Wright cited the European heat wave of 2003, which led to tens of thousands of deaths. France, he said, had the highest temperatures and the most deaths. Another example, he said, was chronic kidney disease of unknown origin, a progressive loss of kidney function that has killed more than 20,000 people in Central America over the past 10 years, most of whom were agricultural workers.
“The leading theory of the cause,” he said, “is a combination of dehydration and pesticide exposure. With climate change and higher temperatures, workers may be dehydrated for longer periods of time.”
Lewis Ziska, PhD, Associate Professor of Environmental Health Sciences at the Columbia University Mailman School of Public Health, and a former plant physiologist at the U.S. Agricultural Service, said increasing levels of carbon dioxide in the atmosphere were creating an imbalance in many plant species that people consume. Rice, wheat, potatoes, and barley, he said, were all showing a decline in protein, nitrogen, sulfur, zinc, and iron. Extreme weather-related events that take place in one part of the continent also affect the health of people living thousands of miles away.
Allan C. Just, PhD, Assistant Professor of Environmental Medicine and Public Health at the Icahn School of Medicine, discussed the unprecedented Canadian wildfires of 2015, which followed a hot, dry spring. The forest fires burned millions of acres and displaced thousands of people, mainly in Saskatchewan. Airborne particles from the fires spread to the Eastern United States, he said, and led to unsafe levels of air pollution in cities as far away as Baltimore.
In her closing remarks, Ms. Gore reminded the audience of the earth’s interconnectedness. “The climate crisis is a force that will ultimately spare no one,” she said. “Solving it should be a unifying cause.”
Updated on Feb 26, 2020 | Cardiology, Community, Featured
Health fairs were held throughout the Mount Sinai Health System to raise awareness of women’s risk for disease. Above, the fair at The Mount Sinai Hospital.
Eat healthy, get plenty of exercise, manage stress, and know your numbers. This was some of the crucial advice dispensed at health fairs held throughout the Mount Sinai Health System in honor of Go Red for Women Day® on Friday, February 7. The fairs, which were spearheaded by the nurses of Mount Sinai Heart, also provided nutritious snacks and free health screenings. Go Red is an initiative of the American Heart Association with the goal of increasing the awareness that heart disease is the No. 1 cause of death for women. Says Beth Oliver, DNP, RN, Senior Vice President, Cardiac Services, Mount Sinai Health System: “We want all women to understand the importance of knowing their numbers—their cholesterol levels, weight, blood sugar, and blood pressure—and to understand the risks of stress, smoking, and a sedentary lifestyle.”
Updated on Mar 5, 2020 | Featured, Global Health
Pathology technicians at work in the new laboratory at John F. Kennedy Medical Center in Monrovia, Liberia.
The only pathology laboratory in Liberia recently opened, thanks to a collaboration led by Ann Marie Beddoe, MD, MPH, Director of Global Women’s Health and Associate Professor of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai. The laboratory, which became operational in October 2019, is a crucial step in rebuilding the health infrastructure in Liberia after years of civil war. “The impetus for founding this laboratory was our mission to improve women’s health,” Dr. Beddoe says. “But this is not just for women or for cancer. This is something that will benefit the entire country.”
In an event attended by President George Weah of Liberia, the 4,000-square-foot laboratory at the John F. Kennedy Medical Center in Monrovia, Liberia, was dedicated in July 2019, along with an imaging center donated by the National Institutes of Health and an infectious disease center donated by the United States Agency for International Development. The new facilities are part of an overarching mission to provide evidence-based care in Liberia, which was wracked by civil wars for more than a decade. Around 2006, Ellen Johnson Sirleaf, then president of Liberia, noted that only 50 physicians were left in the nation of more than 4 million people, and she sent out a call for volunteers to help restore health care. In 2008, Dr. Beddoe was part of a group from Mount Sinai who answered that call, led by Jeffrey S. Freed, MD, Clinical Professor of Surgery, Icahn School of Medicine at Mount Sinai; and Eileen Solomon, Senior Director, Special Events, Mount Sinai Health System. “Our early teams recognized the need for gynecologic oncology services, and Dr. Beddoe had the courage and fortitude to make it happen,” says Dr. Freed, who has made many trips to Liberia to care for patients there.
From the beginning, Dr. Beddoe was struck by the prevalence of cervical cancer in Liberia. “Women would walk to the clinic, or come in strapped to motorbikes, and when we examined them, we found they were dying of cervical cancer,” she says. “I couldn’t walk away from this.” Low-income nations bear most of the burden of cervical cancer because industrialized nations benefit from widespread prevention, screening, and early treatment. For example, among more than 500,000 new cases of cervical cancer each year, only 14,000 are in the United States, Dr. Beddoe says. In addition, cancer carries a stigma in Liberia. “We couldn’t really treat these patients,” she says. “Nobody even acknowledged that they had cancer.”
Over the years, she has returned to Liberia every few months to work with physicians there to improve the diagnosis and treatment of cancer. The first step in securing any health care funding from the Liberian government is building a registry to document the nation’s cancer burden, Dr. Beddoe says. The creation of the pathology laboratory, where diseases can be diagnosed through the analysis of body fluids and tissues, is integral to this effort.
Ann Marie Beddoe, MD, MPH, at the dedication of the laboratory with Jerry Brown, MD, Chief Executive Officer of the John F. Kennedy Medical Center.
The $250,000 facility was built in a suite of storage rooms at JFK Medical Center and funded partly by The Women Global Cancer Initiative, a nonprofit led by Dr. Beddoe. Sakura Finetek USA, a pathology supply company, donated equipment, including a tissue processor and slide stainer, and Mount Sinai donated computers and printers, and a year’s worth of “consumable” supplies, such as reagents, alcohol, blades, and gloves.
Staffing the laboratory presented a challenge. Licensed clinical laboratory technicians—known as histotechnicians—are crucial to a pathology laboratory, and there were none in Liberia. So in 2019, four Liberians were trained by the American Society of Clinical Pathology, a crucial partner in the project. JFK Medical Center hired two physicians specializing in pathology, and other physicians at the hospital are being trained in handling and labeling specimens and in the discipline of evidence-based medicine.
“I am 99 percent sure that when I see a cervical cancer, it’s a cervical cancer, but that is not the way to introduce cancer care to a country that is trying to do things right,” Dr. Beddoe says. “Having pathology, and good diagnoses, will start generating more research, which is what you need to provide good medicine.”
Mount Sinai’s Division of Global Women’s Health focuses on the long term in its overall mission to improve research and clinical care. “We try to do a lot of capacity building—training people, and focusing on ongoing, sustainable projects,” Dr. Beddoe says. Her years of dedication were acknowledged at the ceremony in July, when the pathology laboratory was dedicated in her name.
Updated on Jun 30, 2022 | Asthma, Featured, Patient Stories
2019 Heisman Trophy winner Joe Burrow met with pediatric patients, including Ryan Diaz.
Patients and families at the Child Life Zone at Mount Sinai Kravis Children’s Hospital received a special visit on Sunday, December 15, from Joe Burrow, just a day after he was named the 2019 Heisman Trophy winner. The Louisiana State University quarterback hosted a special trivia-themed episode on KidZone TV, answered questions, opened up about his personal life and adversity, and provided inspiration to patients and their families in an appearance made possible through the Companions in Courage Foundation.
Mr. Burrow also signed football keepsakes for the patients, much to the delight of one 13-year-old patient, Ryan Diaz, an aspiring football player himself. Ryan already has helped his Harlem Jets youth football team win two championships—no easy feat for this offensive guard and center who happens to have severe asthma.
“He has had asthma since he was a baby, and he has been in and out of the hospital,” recalled his mother, Christina Ortiz. “He would miss up to 18 days a year of school.” Added Ryan: “It was really hard. I would miss so many things because I couldn’t control my asthma. I struggled so much from something I didn’t cause.”
“We have many, many patients like Ryan with severe asthma,” said Alfin G. Vicencio, MD, Vice Chair for Clinical Affairs and Strategy, and Division Chief for Pediatric Pulmonology at Kravis Children’s Hospital, who started treating Ryan in September 2018. “He has multiple triggers, and it’s hard to isolate one thing, so what is your recourse, stay inside a bubble?”
Ryan Diaz with Alfin G. Vicencio, MD
Dr. Vicencio is primarily treating Ryan with an injection of omalizumab, a monoclonal antibody, every two weeks. “This medication targets very specific molecules that are important in the asthma-inflammation cascade,” said Dr. Vicencio. The treatment acts to decrease the number of sudden episodes of wheezing, shortness of breath, and trouble breathing in individuals whose symptoms are not controlled with inhaled steroids.
“Mount Sinai has a very active program for the diagnosis and treatment of children with severe asthma,” said Dr. Vicencio. “This includes some important research initiatives that are starting to identify new subtypes of asthma, some of which may be driven by unsuspected infections.”
Other components of the research program, he added, are starting to identify new genes in the airway that may contribute to severity. This is part of a collaborative project with Supinda Bunyavanich, MD, MPH, MPhil, Professor of Pediatrics, and Genetics and Genomic Sciences, aimed at finding new therapeutic targets for patients with severe disease.
Following this protocol has allowed Ryan to keep active—except for when he was sidelined for two weeks in February with the flu and pneumonia. He is now able to resume his strenuous four-hour weekend football workouts and continue his participation in a dance and theater program.
Throughout it all, he has excelled in middle school, which has earned him an academic scholarship to Archbishop Stepinac High School in White Plains, New York, a football powerhouse.
“I just love football,” said Ryan, whose father, Juan Diaz, a registrar in Mount Sinai’s Institute for Advanced Medicine, played football for George Washington High School in New York City and has been a coach for the Harlem Jets since 2013. “It is a bond,” said Ryan.
Mr. Burrow is now certainly part of this bond, too. “It was really inspiring to speak with someone of that caliber,” said Ryan. “We talked about football, staying in school, and doing your best. One thing that made me proud—he signed my football jersey, and I gave him a signed Ryan Diaz #74 Harlem Jets hat, which he wore for the entire event.”
As for the football that Mr. Burrow signed, Ryan said he no longer has it. “We decided to give it to Dr. Vicencio because he has done so much for me. He let me lead a normal life. He really likes football, and I felt he really deserved that,” said Ryan. “I felt very, very touched,” said Dr. Vicencio. “I told Ryan that when he is in the National Football League, I will ask for one of these signed by him.”
