A PUBLICATION OF THE MOUNT SINAI HEALTH SYSTEM May 2 - 22, 2016

Mount Sinai Vascular Surgeons Among First in Nation To Treat Complex Aortic Aneurysm With New Device

Physicians at The Mount Sinai Hospital were among the first in the nation to implant an investigational device, a fabric and metal mesh tube known as a stent graft, as part of a clinical trial to treat aneurysms located in the thoracic/abdominal area of the aorta. Mount Sinai is one of only six institutions in the nation granted approval by the U.S. Food and Drug Administration to test the safety and initial feasibility of the device in patients.

The stent graft is used to strengthen the inner lining of the aorta—the main artery that carries blood from the heart to organs—in patients where the aortic walls have weakened and caused a balloon-type bulge known as an aneurysm to grow. Once implanted, the device serves to direct blood From left: Rami O. Tadros, MD, FACS; James F. McKinsey, MD, FACS; and Michael L. Marin, flow away from the aneurysm, causing MD, FACS, are using a new-generation implantable device to treat complex thoracoabdominal it to shrink in size. If not repaired, the aortic aneurysms.

continued on page 2 › Mammograms May Reveal Early Signs of Heart Disease

Routine mammograms used for the 70 percent of mammograms with breast early detection of breast cancer may also arterial calcification (BAC) correlated with provide women with an early warning the presence of coronary artery calcium of cardiovascular disease, according to (CAC). Calcium deposits in the coronary a recent study led by Laurie Margolies, arteries can narrow arteries and increase MD, Associate Professor of at the risk of heart attack. Heart disease is the Icahn School of Medicine at Mount the leading cause of death in women. Sinai, and Chief of Breast Imaging at the Dubin Breast Center at The Mount The study, which examined BAC in 292 Sinai Hospital. women between the ages of 39 and 92, appeared in the March 2016 issue of Dr. Margolies’ research, funded by the the Journal of the American College of nonprofit Flight Attendant Medical Cardiology Imaging (JACC: Cardiovascular Research Institute, showed that nearly Imaging). Laurie Margolies, MD continued on page 3 ›

› Mount Sinai Vascular Surgeons Among First in Nation (continued from page 1) aneurysm can rupture and result in life-threatening internal bleeding. Before Aneurysm Repair After Aneurysm Repair

“This is an important advance. We are the first in the region to implant this device and we were instrumental in its development,” says Michael L. Marin, MD, FACS, The Jacobson Professor of Surgery, and Chairman, Department of Surgery, Icahn School of Medicine at Mount Sinai, and Surgeon-in-Chief, Mount Sinai Health System. The minimally invasive procedure is being performed in several dozen select patients around the nation who have life-threatening aneurysms.

Vascular surgeons have had a formidable challenge treating these particular kinds of aneurysms. They typically are large and encroach upon or involve many of the major blood Preoperative 3D reconstruction Postoperative 3D scan of minimally vessels of the abdomen, including from a CT scan of the 6.5-cm wide invasive thoracoabdominal stent graft those arteries that extend to the liver, thoracoabdominal aneurysm (see with complete repair of the aneurysm spleen, intestines, and both kidneys, arrow) encroaching upon the renal, as well as those leading into the leg (see arrow), completely isolating the and pelvis. The investigational device, bowel, and other arteries leading into complex thoracoabdominal aneurysm. known as a Thoracoabdominal Branch the pelvic area. Endoprosthesis, gives surgeons the capacity, for the first time, to repair these aneurysms using minimally anatomy, but all phases went as planned.” Because of invasive techniques. the minimally invasive technique employed by this procedure—small incisions in both groins and the This first procedure was performed on left clavicle without the need for chest or abdominal a 78-year-old male patient on Thursday, incisions—the hospital stay was dramatically reduced March 17, by a team that included Dr. and his recovery was shortened from many months to Marin; James F. McKinsey, MD, FACS, two weeks. Vice Chair of the Department of Surgery at and Chief of the “As many as 8,000 to 12,000 patients across the United Mount Sinai Health System’s Complex States may benefit from this procedure if approved for Aortic Interventions Program; and Rami wider use, far more than the 3,000 we are only able to O. Tadros, MD, FACS, Associate Program treat now,” says Dr. Marin. Director, Vascular Surgery Residency, and Associate Professor of Surgery, and Dr. McKinsey will help lead the team of vascular Radiology, Icahn School of Medicine at surgeons who will advance the use of this new Mount Sinai. Dr. Tadros is the principal generation of stent grafts to repair the most investigator of the Phase 1 investigational complicated forms of aortic aneurysms. Considered a trial at Mount Sinai. A TAMBE thoracoabdominal pioneer in this specialty, Dr. McKinsey has performed stent graft with side branches more than 200 complex thoracoabdominal aortic “The patient had severe heart and lung for repair of complex aneurysms. procedures using minimally invasive techniques. disease caused by atherosclerosis and “Mount Sinai performs more of these types of emphysema from smoking, all risk factors for aortic aneurysms,” procedures than any other institution in the region while having says Dr. Tadros. “He had a large, 6.5-cm wide aneurysm that put some of the best outcomes, measured by long-term survival rates, him at significant risk of rupturing and death. The procedure was and fewer procedure-related complications and deaths,” says complicated and challenging because of the patient’s complex aortic Dr. McKinsey.

2 Volunteers Recognized at Annual Breakfast

More than 1,200 volunteers who provide Today, the “Music for Healing” assistance to The Mount Sinai Hospital program offers music in the and the Icahn School of Medicine at Mount Guggenheim Pavilion Atrium and at Sinai were recognized at a breakfast on the bedside. In addition, hundreds Wednesday, April 13, during National of students volunteer in research- Volunteer Week. related activities.

“Today we celebrate Mount Sinai’s volunteers “You make an extraordinary and the energy and compassion they bring to difference at Mount Sinai,” Kenneth patient care, office support, and research,” L. Davis, MD, President and Chief said Peter W. May, Chairman, Boards of Executive Officer, Mount Sinai Trustees, Mount Sinai Health System. Health System, told the volunteers. “I receive letters every day about the The tradition of service to Mount Sinai quality of care at Mount Sinai. Lots began in the 1880s, when volunteers taught of them are very positive and often hospitalized children. Today, requests the positive letters make note of From left: Kenneth L. Davis, MD; Jennifer Price, President, for volunteers to support inpatient and the volunteers.” The Mount Sinai Auxiliary Board; Claudia Colgan; Cynthia outpatient units, the Emergency Department, Levy; and Peter W. May. and research are rising and programs are Claudia Colgan, Vice President for growing and evolving in response. Care Coordination, Mount Sinai Care, said, to celebrate Mount Sinai’s outstanding “The Volunteer Program is a huge success, volunteers—who are found in more than 200 Care and Respect for the Elderly (CARE) has a direct result of the skill and dedication of placement areas—and their supervisors,” expanded from the Emergency Department Cynthia Levy, Kaye Derman, and their team, said Ms. Levy. “We are also fortunate to have to inpatient units through “CARE II: Up and who select the best volunteer applicants the opportunity to acknowledge The Mount About!” The Pet-Assisted Therapy program and carefully match them to assignments.” Sinai Auxiliary Board, who, 100 years ago, continues to be popular, and available sites Ms. Levy is Director, and Ms. Derman is set the standard for commitment and caring now include the Dubin Breast Center of Assistant Director, of the Department of and laid the groundwork for the Department The Tisch Cancer Institute at Mount Sinai. Volunteer Services. “It is a great pleasure of Volunteer Services.”

› Mammograms May Reveal Early Signs of Heart Disease (continued from page 1)

“The finding that additional information radiologists is not to mention breast arterial JACC: Cardiovascular Imaging, Khurram concerning the risk for coronary artery calcification in mammogram reports. But Nasir, MD, MPH, Director, Center for disease—a common disease in women—can women should have the right to know so they Healthcare Advancement and Outcomes, be derived from a study that is routinely have the opportunity to make healthy lifestyle Baptist Health South Florida, wrote that performed in women for the early detection changes based on this information.” “Although cardiovascular disease remains of breast cancer, is a welcome and unexpected the leading cause of mortality, morbidity, benefit of screening mammography,” says The study showed that the presence of and cost in women, there is no consensus Burton Drayer, MD, Chair of the Department calcification in women’s breasts and coronary on national screening for early signs of of Radiology, Mount Sinai Health System, arteries increased with age. The frequency actual disease, such as CAC testing.” Among and Chief Executive Officer of the Mount of BAC in women under the age of 60 was the steps he suggested to remedy the Sinai Doctors Faculty Practice. “There are 27 percent, increasing to 47 percent in those situation were supporting the widespread important public health implications.” between ages 60 to 69, and then rising to 69 documentation of BAC in mammography percent in women who were between 70 and reports and improving the education of Indeed, Dr. Margolies says such screening 92 years of age. The corresponding frequency primary care and radiology providers enables women to take early steps to improve of CAC in women went from 28 percent, to 55 regarding the link between BAC and their health. “If you’re a 50-year-old patient, percent, to 79 percent. atherosclerotic cardiovascular disease. you’re glad to know that your mammogram is normal. But if your breast exam shows Dr. Margolies says that larger studies are Additional authors of the study included arterial calcification, you may want to take needed. But in the meantime, she says, “If we Mount Sinai Health System physicians, steps to improve your cardiovascular health, can find out information that’s indicative of Jagat Narula, MD, PhD; Mary Salvatore, such as stopping smoking or losing weight,” heart disease, we can save even more lives.” MD; Harvey S. Hecht, MD; Sean Kotkin, MD; she says. “Further evaluation with a dedicated Usman Baber, MD; Vivian Bishay, MD; David coronary artery CAT scan may provide In a supportive editorial comment on the Yankelevitz, MD; and Claudia Henschke, MD, more information. The standard among study that appeared in the same issue of PhD; and Rowena Yip, MPH.

3 Around the Health System

Tenth Annual Dean’s Cup Strongest Person Competition

Icahn School of Medicine at Mount Sinai students and staff showed off their biceps along with Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System, during the Tenth Annual Dean’s Cup Strongest Person Competition on Monday, April 11, in the Aron Hall Gym. This contest included deadlift, bench press, squat, pull-ups, and push-ups. The Dean’s Cup is a week of fun and competition with games for all medical students, including a 3v3 basketball tournament, 5K run, table tennis, pool, soccer, and Ultimate Frisbee. Winners received Icahn School of Medicine sweatshirts, sweatpants, and other prizes.

Morningside Clinic Moves to a Newly Renovated Location

The Institute for Advanced medicine, and behavioral health Medicine has relocated the care. The attendees at a recent Spencer Cox Morningside Clinic ribbon-cutting ceremony (see to renovated space at 440 West photo) included, from left: Vani 114th Street and renamed it the P. Gandhi, MD, Interim Medical Morningside Clinic. The new site Director, Morningside Clinic, provides patients with a more and Assistant Clinical Professor, convenient and comfortable Medicine (Infectious Diseases), setting that includes a spacious Mount Sinai St. Luke’s; Michael P. waiting room with a television, Mullen, MD, Director, and Matt and a pediatric waiting area. The Baney, Senior Director, Institute Morningside Clinic continues to for Advanced Medicine; and Judith provide patients with HIV/AIDS A. Aberg, MD, Dr. George Baehr treatment and other services, Professor of Clinical Medicine, and including dental, integrative Division Chief, Infectious Diseases.

Medical Students Host First Annual Ethics Conference

The Icahn School of Medicine at Mount Sinai’s as Future Physicians.” Keynote Speakers Bioethics Program hosted its First Annual Vanessa Northington Gamble, MD, PhD, CaptionMedical Student Ethics Conference, a forum University Professor of Medical Humanities, Captiondesigned to provide medical students across George Washington University, and Robert the country with an opportunity to discuss Klitzman, MD, Professor of Clinical and resolve the ethical challenges they Psychiatry and Director of the Masters of may encounter during physician training. Bioethics Program, Columbia University A call for abstracts was issued to medical Medical Center, discussed, respectively, schools in the region and to several academic personal and historical reflections on medicine and medical ethics organizations. racism, medicine, and bioethics; and the Eight students from six medical schools gave role reversal experienced when physicians From left: Nada Gligorov, PhD, Associate Professor, Bioethics Program; Vanessa poster presentations that examined such become patients. The conference, funded by Northington Gamble, MD, PhD; and Paul J. topics as “Anatomy and Cadavers as First The Arnold P. Gold Foundation, took place on Cummins, PhD, Education Program Manager, Patients,” and “Anticipating Obligations Saturday, March 19, and drew 65 participants. Medical Education, Bioethics Program.

4 Enhancing Employee Health at Mount Sinai

Valerie Ruffin, an Executive Mount Sinai Fit includes a “Lunch Assistant in the Department of and Learn” group discussion Information Technology, thought series that features cooking that drinking homemade fruit demonstrations and health and juices was a good way to improve wellness discussions. By the end of her health and lose weight—until the year, a cooking demonstration she had a physical exam in 2015. featuring hospital leadership “I was in shock when I was told will be held at each Mount Sinai I had diabetes,” she recalls. “My Health System campus. blood work showed extremely high sugar levels, the result of all the The program also offers fruit juice I was drinking daily.” employees weekly yoga and meditation classes, running Colleague Angela Mazzone, and walking groups, nutrition Project Manager III, Department classes, and access to face- of Information Technology, was to-face and mobile wellness similarly surprised when her Dietitian Maria Elena Rodriguez, RD, CDE, center, helped Mount programs through OffTheScale. physical exam uncovered glucose Sinai employees Angela Mazzone, left, and Valerie Ruffin achieve a Personal nutrition, diabetes self- levels consistent with pre-diabetes. healthier lifestyle. management education, and the She always thought of herself as a healthy eater, and athletic, but the diagnosis forced her to re-examine that perception. She was now a working mom and, in reality, she “We are offering our was devoting less time to exercising and preparing nutritious meals. hard-working faculty Both quickly vowed to make lifestyle changes to improve their overall well- and staff the tools to being. They turned to the Mount Sinai Health System’s Employee Health and make healthy lifestyle Wellness Program, Mount Sinai Fit, an initiative that is part of the Employee changes to improve their Benefits program within the Department Valerie Ruffin learned how to eat healthier meals at Mount Sinai’s “Lunch and Learn” program. of Human Resources. Mount Sinai Fit overall well-being. coordinated access to wellness visits Livongo for Diabetes Program are available provided through Mount Sinai Doctors by participating in the Diabetes Alliance. Primary Care Associates, lifestyle coaches – Jane Maksoud, RN, MPA As participants in the Diabetes Alliance, who focus on diabetes prevention, a employees receive free consultations with walking group, and registered dietitians Ms. Rodriguez or Jennifer Kartashevsky, who are certified diabetes educators (CDEs). RD, CDE. As a participant, each received healthy, satisfying, and easy-to-follow meal plans, “We are inspired by the initial results and access to an exercise program. blood sugar levels over a three-month time Mount Sinai employees have achieved by frame—is now 7 percent. It had been more working with us,” says Ms. Rodriguez. By making healthy meals at home, than 10 percent. A normal A1C is equal to increasing their time spent walking, or below 5.7 percent. Adds Jane Maksoud, RN, MPA, Chief meeting with Mount Sinai wellness Human Resources Officer, Mount Sinai clinicians, and working with their Ms. Mazzone participated in the Mount Health System: “We are offering our hard- respective Mount Sinai primary care Sinai Selikoff Centers for Occupational working faculty and staff the tools to make physicians over the past year, Ms. Ruffin Health Diabetes Prevention Program and healthy lifestyle changes to improve their and Ms. Mazzone have lost weight and seen has nutritional wellness visits with Maria overall well-being. Our goal is to continue to a significant decrease in blood sugar levels, Elena Rodriguez, RD, CDE. Ms. Mazzone roll out new initiatives that will transform cholesterol, and triglycerides. says, “Not only am I looking and feeling our employees, in mind, body, and spirit.” better, my husband has started to lose Ms. Ruffin lost 20 pounds, and her A1C weight, and my kids are enjoying healthier To learn more about how to join these programs, results—a blood test that measures average meals at home.” email [email protected].

5 2016 Wall Street Run Ways to Wellness Week And Heart Walk Mount Sinai Doctors (MSD) will host free community events Join Mount Sinai Heart and colleagues in this during its Ways to Wellness Week from Tuesday, May 17 - annual event to raise awareness and funds for Friday, May 20. Staff and the public are welcome to participate. cardiovascular disease. For more information email [email protected]. › MSD Urgent Care Upper West Side Thursday, May 19 Urgent Care vs. ER: Rachel Printy, PA, Senior Physician Assistant, Urgent Care, discusses the types of injuries and conditions that 5 – 8 pm can be treated at an Urgent Care center versus those conditions Brookfield Place that require Emergency Room care. RSVP is required: Email 230 Vesey Street [email protected]. Tuesday, May 17 Grand Rounds / Medicine 2:30 pm Gurpreet Dhaliwal, MD, Professor, Medicine, University of Jefferson Towers, Community Room California, San Francisco, presents “The Arthur W. Ludwig, 700 Columbus Avenue MD, Lectureship in Humanism in Medicine: Clinical Reasoning: Good to Great.” › MSD Brooklyn Heights Tuesday, May 3 Baby Skin Care: Stephen Turner, MD, MSD Brooklyn Heights 8:30 – 9:30 am Medical Director and pediatrician, visits Mama Bears' Picnic, a The Mount Sinai Hospital Campus supportive group for moms at AreaYogaBrooklyn, to advise on Hatch Auditorium diaper rash, cradle cap, infant acne, insect stings, and more. RSVP is required: Email [email protected]. Moms are welcome to bring their little ones. This event charges a fee. Grand Rounds / Anesthesiology Wednesday, May 18 Herb Niemirow, Senior Publisher, STM Journals, presents 3 pm “Journal Publishing 101 for New Researchers.” AreaYogaBrooklyn 144 Montague Street, Brooklyn Wednesday, May 11 6:30 – 8:10 am › The Mount Sinai Hospital Campus MSD East 85th Street Annenberg 13-01 Get Active: Learn more about this newest MSD location, and jump on a stationary “smoothie bike” for a unique form of exercise using pedal power to blend a healthy afternoon drink. Grand Rounds / Dermatology Thursday, May 19 Noon - 4 pm Dermatology Residents present “Residents’ Research No. 1,” a synopsis of clinical and/or lab research performed 234 East 85th Street by residents. › MSD Urgent Care Inwood Thursday, May 12 Letters to Heroes: In honor of Memorial Day, join staff to write 8 – 9 am The Mount Sinai Hospital Campus letters of appreciation to local veterans. Letters and artwork will Hess Center, Seminar Room A be donated to the James J. Peters VA Medical Center. RSVP is required: Email [email protected]. Friday, May 20 RAIN Senior Center Grand Rounds / Population Health Science 3 - 5 pm 84 Vermilyea Avenue and Policy Lynne D. Richardson, MD, FACEP, Professor, Vice Chair, Emergency Medicine, and Professor, Population Health INSIDE MOUNT SINAI VISIT INSIDE ON THE WEB Science and Policy, presents “The Role of the Emergency Marketing & Communications www.mountsinai.org/inside Department in the Era of Population Health.” Carrie Gottlieb, Editor Marilyn Balamaci, Editor To find out what’s happening Tuesday, May 17 Donald Maxton, Editor right now, follow Mount Sinai 1 – 2 pm Leslie Kirschenbaum, Design on Twitter @MountSinaiNYC The Mount Sinai Hospital Campus Goldwurm Auditorium SUBMISSIONS Visit us on Facebook Box 1475 facebook.com/mountsinainyc [email protected]

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