NYU Langone Health Begins New Chapter in Cardiac Care

Good News on Lung Cancer pg. 5 | Brooklyn’s New Epilepsy Unit pg. 6 | Eat Your Veggies! pg. 4 A Hypertension Tsunami pg. 9 | Elder Care in the ED pg. 8 | Medicine’s Tech Revolution pg. 12

The Newsletter of NYU Langone Health NEWS&VIEWS WINTER 2018

MILESTONES RESEARCH Lupus Hits NYU Langone Health Begins Some Harder New Chapter in Cardiac Care Than Others Expanding its lifesaving repertoire, the Transplant Institute offers hope to patients in need of a new heart. NYU Langone Health researchers are leading A decade ago, when Sofya could barely manage a couple ing Levit Medical, to assess and potential donor in Massachu- efforts to help identify and Tokarev, 62, received treat- of steps. “I had broached the manage heart-failure patients setts, and transplant surgeon treat those who are most ment for an advanced form of topic of a heart transplant within their communities. As Kazuhiro Hisamoto, MD, was susceptible to this debilitating cancer, she never imagined before,” says heart failure long as immunosuppressants sent to procure the organ. By autoimmune disease. the cure would come at a cost specialist Alex Reyentovich, succeed in preventing organ 9:00 pm that evening, Nader so high. By the time she found MD, “but now Sofya let go of rejection, Dr. Reyentovich Moazami, MD, NYU Langone’s FOR YEARS, SABINA Batista her way to NYU Langone Levit her reluctance.” had explained to Tokarev, a new surgical director of heart had symptoms doctors could Medical in Brooklyn, in 2016, Dr. Reyentovich is the transplant could extend life for transplantation and mechanical not explain: periodic swelling she had developed advanced medical director of NYU Lan- 13 years or longer, and provide circulatory support—assisted in her left leg, lower back heart failure, a potential com- gone’s new Heart Transplant a high quality of life, too, with by fellow transplant sur- pain, and a strange tingling plication of some aggressive Program, which closely collab- no physical limitations. geon Deane Smith, MD—had sensation in her fingers and chemotherapies. Last De- orates with six NYU Langone On Friday January 5, toes. The 28-year-old social

PHOTO: TONY LUONG TONY PHOTO: cember, she was so weak she ambulatory practices, includ- Tokarev was matched with a Continued on page 2 services case manager from Yonkers, New York, recalls that physicians routinely dismissed or misdiagnosed One month after transplant her health complaints until surgery, Dr. Alex Reyentovich (left) and Dr. Nader Moazami 2016, when she was finally visit their patient, Sofya diagnosed with lupus. The Tokarev, during a followup. incurable and potentially life-threatening autoimmune disease triggers bouts of inflammation and attacks the body’s tissues and organs. In Batista’s case, it had begun to assail her kidneys. Rheumatologists at NYU Langone Health have found that lupus is not only more prevalent among women of color, but also much more aggressive.

For mysterious reasons, lupus hits some people harder than others. Of the estimated 1.5 million Americans afflicted by the disease, most are women of childbearing age. Studies have shown that black women are about three times more likely to suffer from lupus than

Continued on page 3 A New Level of Cardiac Care (Continued from page 1) given Sofya Tokarev a new Department of Cardiothoracic we’ve created for them is a The demand for heart transplants has heart, and a new lease on life. Surgery. “We no longer need very caring one.” never been higher. An estimated 6.5 million The operation, the first to do that.” The demand for heart of three heart transplants NYU Langone’s heart trans- transplants has never been Americans live with heart failure. By 2030, NYU Langone performed in plant program—a collabora- higher. More people are sur- that number is projected to rise by some 50%. January, came less than one tion between its Transplant viving heart attacks, placing month after New York State’s Institute, Department of them at higher risk for heart For NYU Langone, a its priorities is research to Department of Health granted Cardiothoracic Surgery, and failure. An estimated 6.5 mil- successful transplantation pro- rehabilitate the hundreds of approval for heart transplan- Leon H. Charney Division of lion Americans live with heart gram must not only deliver the potential donor hearts rejected tation, and the 50th anniver- Cardiology—is the first such failure. Such patients at NYU highest quality of care, but also annually in the US due to sary of the first human heart program approved in New York Langone who are candidates squarely address the critical diseases such as hepatitis C. transplant. (In January, NYU City in more than 15 years. To for a heart transplant or a shortage of donor organs, a cri- “You can always find a reason Langone also received approv- spearhead it, NYU Langone ventricular assist device (an sis that is particularly acute in to reject a marginal heart,” says al to perform lung transplants, recruited Dr. Moazami from implanted mechanical circula- New York State. Only 28% of the Dr. Moazami. “But the key is appointing Zachary Kon, MD, the Cleveland Clinic, where he tory support pump) are evalu- state’s residents are registered to accept as many hearts as formerly director of heart and led its heart transplant pro- ated by a team of cardiologists organ donors—the lowest rate possible because this is a truly lung transplantation at the gram, earning international and other specialists led by Dr. in the country. While 161 heart lifesaving procedure. You win University of Maryland Medi- recognition as a clinician and Reyentovich. “As an institution transplants were performed the confidence of patients by cal Center, as surgical director researcher (see page 11). “What with a premier Transplant in 2016 at the five existing demonstrating that you’re the of its new Lung Transplant makes this program special is Institute and several hospitals transplant centers throughout best. We have everything in Program.) that it’s very comprehensive in the New York area, we can the state, some 1,000 people place to ensure that we are.” ■ “Transferring a patient and multidisciplinary, yet very now provide the full spectrum died waiting for a donor heart to another institution for a patient centered,” explains of state-of-the-art care for a to become available. transplant disrupts the con- Dr. Moazami, who has large population of patients To earn state approval, FOR MORE INFORMATION tinuity of care,” says Aubrey performed more than 300 with advanced heart disease,” NYU Langone developed a about NYU Langone’s Heart Galloway, MD, the Seymour heart transplants. “This is a says Robert Montgomery, MD, comprehensive strategy for Transplant Program, call 833- Cohn Professor of Cardiotho- life-changing proposition for DPhil, director of the Trans- increasing donation and 344-3278 or visit nyulangone. racic Surgery and chair of the patients, and the environment plant Institute. transplantation rates. Among org/transplantinstitute.

GETTING FIT FOR A HEART TRANSPLANT

At Rusk Rehabilitation, “prehab” plays an integral role in preparing heart-transplant patients for the stress of surgery.

FOR MANY OF the estimated 3,000 patients who undergo a heart transplant every year, rehabilitation begins even before surgery. In many cases, by the time someone needs a new heart, years of cardiovascular disease have left the patient increasingly weak and debilitated, compromising their ability to tolerate the demands of transplant surgery and endure the rigors of recovery. As part of their evaluation, transplant candidates at NYU Langone physical and occupational therapists treat patients Health are referred to Rusk Rehabilitation’s Joan daily to keep them mobile and promote their inde- Dr. Jonathan Whiteson (above), the center’s medical director, also oversees rehabilitation for patients with and Joel Smilow Cardiopulmonary Rehabilitation pendence. The outpatient program is designed to cardiac or pulmonary issues who do not need a transplant. and Prevention Center. The center’s evaluation increase endurance, reduce symptoms of shortness program tests the patient’s physical, metabolic, and of breath and fatigue, improve cholesterol and blood emotional fitness and guides them through a course sugar levels, facilitate weight loss, provide stress man- “Many candidates for a heart transplant have of “prehab” exercise and lifestyle modifications to agement, and instill a lifelong heart-healthy lifestyle. become relatively inactive,” Dr. Whiteson explains. bolster their strength and stamina. “The healthier Since its inception in 1991, Rusk’s center, the “They need to improve their strength, endurance, the patient is going into surgery, the better they’ll largest and most comprehensive program of its kind balance, and mobility. It’s hard, hard work, and we fare during the operation, throughout the hospital in the tri-state region, has been at the forefront of set high goals to ensure that they thrive. Typical- stay, and over the course of their recovery,” says Jon- managing cardiopulmonary disease. In addition to ly, they are so grateful for a new lease on life that athan Whiteson, MD, the center’s medical director. caring for NYU Langone’s patients who have under- they’re highly motivated. For our part, we have a After surgery, patients generally receive two to gone heart transplants and other cardiopulmonary lifelong commitment to these patients. They may three weeks of inpatient rehabilitation, followed by procedures, the program serves patients referred by mature past their need for us, but we never get three months of outpatient therapy. In the hospital, other local medical centers. over them.” ■ PHOTO: KARSTEN MORAN KARSTEN PHOTO:

02 NYU LANGONE HEALTH At NYU Langone’s Lupus Clinic in Manhattan, Dr. Jill Buyon examines her patient Sabina Batista during a follow-up visit.

Tracking Lupus (Continued from page 1)

white women. Now, research published recently by rheumatologists at NYU Langone Health suggests that lupus also takes a heavy toll on Asian and Hispanic women. “They’re two of the fastest-growing populations, but data regarding their risk for lupus has been limited,” says rheumatologist Peter Izmirly, MD, the study’s lead author. The epidemiological sleuthing by Dr. Izmirly’s research group, called the Manhattan Lupus Surveil- lance Program, and a related effort called the Califor- nia Lupus Surveillance Project, documented similar racial and ethnic disparities among men, although at much lower rates. The reasons for these differences are unknown, though data suggest that both genetic and environmental factors play a role. After her diagnosis, Batista, who is of Dominican heritage, tried to learn all she could about the disease. Her desire for a second opinion led her to NYU Lan- gone, where specialists have long treated a racially and ethnically diverse mix of patients from the New York metropolitan area. That experience is critical, given that Dr. Izmirly’s latest findings suggest the disease is not only more prevalent among women of color, but also much more aggressive. “About half the patients Under NYU Langone’s care, Sabina with lupus who are black, Asian, or Hispanic are, based Batista found that her disease on our data, likely to develop lupus kidney disease, was far more manageable with the compared to only about a quarter of those in the white Lupus and the population,” says Dr. Izmirly. right interventions. Lupus is devilishly difficult to diagnose. Symptoms Hidden Burden of can be vague, and there’s no definitive diagnostic test. and Sir Deryck Maughan Professor of Rheumatology, Kidney Disease The disease is often associated with a butterfly-shaped also encouraged Batista to adopt a healthier diet and rash that covers the bridge of the nose and both lifestyle to help manage her symptoms. “I feel a lot bet- In one of the most extensive surveillance cheeks, but not all patients develop this telltale sign. ter,” Batista says. “I haven’t had a flare-up in months.” studies of lupus among minority Batista, for example, didn’t develop the rash until after At the scientific level, Dr. Buyon, Dr. Izmirly, and populations in the US, NYU Langone multiple tests and referrals finally led to a diagnosis. their research collaborators are exploring potential researchers found that lupus-associated Dr. Izmirly says healthcare providers should be on the genetic and environmental links to explain why some kidney disease was roughly twice as common in nonwhite patients as in their lookout when assessing a range of signs and symp- groups are more likely to develop lupus and fare worse white counterparts. toms—including rashes, joint pain, and signs of kidney than others. “The outcome over time is probably some disease, such as abnormal urinalysis results, swelling combination of socioeconomic and behavioral, in addi- in the legs, and unexplained high blood pressure. “By tion to racial and ethnic, factors,” says Dr. Izmirly. Asian the time we see some of these patients, they’ve already More answers may come from NYU Langone’s 53% had irreversible damage,” he says. “So the earlier the Translational Center of Molecular Profiling in Preclin- diagnosis, the more likely we are to get on top of it and ical and Established Lupus, or COMPEL. A new five- hopefully improve outcomes.” year, $6.7 million grant from the National Institutes 51% Black Under NYU Langone’s care, Batista found that of Health will aid the researchers’ efforts to better her disease was far more manageable with the right characterize lupus in a racially and ethnically diverse interventions. An initial daily dose of nine medications group of patients. “It’s about looking at women who are had left her depressed, in pain, and unable to sleep. at high risk and understanding why they do or don’t 49% Hispanic Her new rheumatologists, Dr. Izmirly and Jill Buyon, develop the disease,” Dr. Buyon says, “and then looking MD, codirectors of the Lupus Center at NYU Langone, at people with established lupus and understanding cut that drug regimen by more than half. Along with what makes the disease flare.” ■ medication to suppress her lupus-associated kidney 25% White disease, Batista now takes an antimalarial drug to suppress flare-ups and an anticoagulant to prevent blood TO FIND A DOCTOR who treats lupus, call 646-501-7400

PHOTO: SASHA NIALLA SASHA PHOTO: clots, a risk for some patients. Dr. Buyon, the Lady Va or visit nyulangone.org/lupuscenter

NEWS&VIEWS WINTER 2018 03 Clinical trials led by Dr. Arjun Balar (left), a medical oncologist who specializes in bladder cancer, have paved the way for the first effective therapies approved in 30 years.

urologic oncology surgeon William Huang, MD, who was not involved in the trials. Dr. Balar, in collabo- ration with Dr. Huang, is now leading a trial to see if surgery can be avoided by using immunotherapy in combination with chemoradiation. “If immunotherapy can reduce the number of people who may need to have their entire bladder removed,” says Dr. Huang, “that would be a huge step forward.” Dr. Balar first recognized the potential of immunotherapy during the clinical trial with atezolizumab. He recalls one participant, an 80-year-old woman with a very aggressive cancer that had widely metastasized, who looked and felt better within weeks of her first dose. Dr. Balar reports that three years later, the woman remains cancer free. Nearly a dozen clinical trials are currently under way at NYU Langone to test novel therapies for bladder cancer, including new immunotherapies, targeted therapies, and combinations. “Patients used to choose between chemotherapy and hospice care,” says Dr. Balar. NEW THERAPIES “It’s a privilege to provide them with hope instead.” ■

A Death Sentence Reversed TO FIND A DOCTOR who treats bladder cancer, call 646-929-7950 or visit nyulangone.org/cancer Clinical trials at NYU Langone pave the way for the first effective therapies for bladder cancer approved in 30 years, giving hope to older patients too frail for conventional treatments.

SEVERAL YEARS AGO, when Arjun Balar, MD, would first ever approved for this typically frail population— FOOD FOR THOUGHT deliver a diagnosis of advanced bladder cancer to a typi- give older patients a nearly 25% chance of survival. cal patient—a man over the age of 70—the conversation Atezolizumab (Tecentriq), approved in April 2017, was a grim one for doctor and patient alike. Dr. Balar, and pembrolizumab (Keytruda), green-lighted one a medical oncologist at NYU Langone Health’s Laura month later, belong to a class of cancer drugs known and Isaac Perlmutter Cancer Center, had to explain as immune checkpoint inhibitors, which are designed that if the cancer had traveled beyond the lining of the to release a break on immune cells, allowing them to bladder, that organ and others nearby would need to attack tumor cells. Trial results showed that the immu- be removed; that for cancer that had spread beyond the notherapy treatments shrank tumors by at least 30% bladder, most older patients found the standard che- in one-quarter of the nearly 500 study participants The number5.4 of additional cups of motherapy regimen intolerable; and that the less potent combined in both studies. Of those, 5% got the best fruits and vegetables purchased alternative would extend life by only 10 months or so. news imaginable: their tumors had totally disap- by food shoppers from “The patient would be devastated,” recalls Dr. Balar. peared. “While this percentage may seem small,” Dr. Bronx mobile produce vendors But earlier this year, despair gave way to hope. Balar notes, “remember that on average, these patients who used wireless bank Two ongoing international clinical trials led by Dr. would otherwise have died within 10 months.” Balar, director of the Genitourinary Medical Oncology Each year, about 79,000 Americans are diagnosed transfers for food stamps. Program at the Perlmutter Cancer Center, and funded with bladder cancer. The disease claims some 17,000 by pharmaceutical manufacturers, have paved the way lives annually, and less than 15% of those with a late- for the approval of two novel treatments for patients stage tumor survive more than five years. Bladder can- NYU Langone researcher Brian Elbel, PhD, with advanced bladder cancer who are ineligible for cer strikes four times as many men as women, making surveyed shoppers to explore ways of improving the standard chemotherapy. The medications—the it the fourth most common cancer among men. About access to nutritious foods in low-income 80% of those diagnosed are current or former smokers. communities. He hopes the findings might lead The malignancy is usually confined to the inner lining policy makers to consider whether more vendors Trial results showed that the of the bladder, requiring most patients to undergo should be equipped for electronic payment. ■ immunotherapy treatments shrank surgery to remove the tumor. If the cancer has invaded tumors by at least 30% in one- deeper, from the inner lining into the muscle, however, quarter of the nearly 500 study the bladder must be removed, along with the prostate participants combined in both in men or the uterus and ovaries in women. “Removal of the entire bladder and reconstruction studies. Of those, 5% got the news of a new urinary tract is a complex surgical procedure

that their tumors had disappeared. associated with a high rate of complications,” explains MORAN KARSTEN PHOTO: ABOVE STOCKA BILLIONPHOTOS.COM/ADOBE PHOTO:

04 NYU LANGONE HEALTH THE EXPLAINER 5 ThingsYou Should Know about Lung Cancer Experts from NYU Langone Health’s new Lung Cancer Center share promising news about one of the deadliest forms of cancer.

In the war on cancer, some foes are mightier than others, target specific genetic changes individuals. But intervention- and so-called epigenetic drugs and lung cancer tops the list. To advance the quest for within the tumor or boost al pulmonologists now use that target the proteins that better treatments and help patients benefit from the latest the immune system’s ability advanced technology to less turn genes on or off. “With to detect and destroy tumor invasively perform biopsies some forms of leukemia and discoveries, NYU Langone Health recently launched the cells can lead to longer and that once would have required prostate cancer, patients now Lung Cancer Center at the Laura and Isaac Perlmutter better life. Researchers are still piercing the chest wall. “These live for decades with few symp- Cancer Center. Led by Robert Cerfolio, MD, director trying to identify which kinds techniques are far less trau- toms,” says Dr. Kwok-Kin Wong. of clinical thoracic surgery, the new center brings of patients are most likely to matic,” says Gaetane Michaud, “It’s going to take time, but together a growing roster of internationally recognized benefit. MD, chief of interventional we’re on our way to transform- Meanwhile, many clinical pulmonology. “Patients can ing lung cancer into a chronic researchers and clinicians, who are working to unlock trials are devoted to even usually go home the same but controllable disease.” lung cancer’s secrets and translate those findings into newer therapies—and new day.” When surgery is required cutting-edge care. Here, they share some insights. combinations—that may to remove a tumor, the most extend the benefit of immu- common approach is video-as- notherapy, in particular, to sisted thoracic surgery, per- “By investing in top talent and more patients. “By enrolling formed through tiny incisions dramatically expanding our in clinical trials for investiga- and guided by a miniature research capacities, NYU Lan- tional therapies, patients have camera. Dr. Cerfolio takes it to gone is taking a stand against access to treatments beyond another level, relying instead this major killer.” those in our existing arsenal,” on robotic surgery, which en- explains Leena Gandhi, MD, hances the surgeon’s dexterity PhD, director of thoracic med- and precision. To date, he has Teamwork ical oncology, who’s currently performed over 1,750 robotic counts. leading more than 20 trials and procedures, more than any Lung cancer patients No cancer is collaborating on many others. other thoracic surgeon in the often require several deadlier, but “For some, that can make a world. “We can do complex 5specialists, and at NYU Lan- the tide may big difference in quality and procedures with less pain, gone’s Lung Cancer Center, be turning. quantity of life.” Dr. Gandhi is faster recovery, and less risk of the entire team is housed on 1Although the numbers are also leading efforts with Kwok- complications,” he says. a single floor, eliminating the falling as smoking becomes Kin Wong, MD, PhD, director stress of traveling to different less popular, lung cancer still of the Division of Hematology locations. “If a patient needs a claims the lives of 158,000 and Medical Oncology, to build pulmonary drainage proce- Americans annually—more Clinical trials a comprehensive database of dure, we can perform it on- than breast, colon, and pros- can change patient characteristics and site,” says Daniel Sterman, MD, tate cancers combined. More- the odds. specimens to study potential the Thomas and Suzanne Mur- over, the five-year survival rate What makes lung biomarkers of response to phy Professor of Pulmonary is less than 20%. Yet new types 2cancer so lethal is that it different therapies. and Critical Care Medicine of treatments are extending seldom causes symptoms in and director of the Division life significantly for some its earliest stages and tends of Pulmonary, Critical Care, patients, and researchers are to spread quickly—primarily Better and Sleep Medicine. A team of making strides in understand- to the brain, bones, or liver. therapies multidisciplinary experts also ing the genetic and molecular Only 16% of cases are diag- are quickly convenes at a weekly “tumor mechanisms behind the dis- nosed at stage 1, when they emerging. board,” where physicians, sur- ease. “We’ve reached the end can often be treated surgically. 4The pace of cancer research is geons, researchers, and nurses of the beginning,” says Benja- For advanced lung cancers, now advancing at a rapid clip, discuss challenging cases and min Neel, MD, PhD, director of chemotherapy can be helpful, in part thanks to a remarkable the latest science. “We take the Perlmutter Cancer Center. but newer medications that new gene-editing technology a coordinated approach to that allows scientists to recreate each patient’s care,” explains and manipulate cancer genes Abraham Chachoua, MD, the New high-tech with unprecedented speed and Jay and Isabel Fine Professor Gaetane Michaud, MD, a leading Meet the Experts interventional pulmonologist, uses endo- procedures precision. In the lab, scientists of Oncology and associate scopic tools and techniques to help patients are gentler, are untangling the factors that director of cancer services. The new Lung Cancer Center team: breathe easier. with fewer accelerate or halt tumor growth “Every person we treat has a Robert Cerfolio, MD, has per- Kwok-Kin Wong, MD, PhD, is a 3complications. and learning to identify molec- think tank on his side.” ■ formed over 1,600 robotic procedures, world-renowned investigator of the genetic About 70% of lung cancers are ular signals that reveal which more than any other thoracic surgeon. and environmental causes of lung cancer. diagnosed among people 65 tumors might respond best to Leena Gandhi, MD, PhD, designs Daniel Sterman, MD, is internationally or older. Invasive procedures, which treatments. In the clinic, TO FIND A DOCTOR who treats studies to determine how treatments for recognized for his research on cancer such as open-chest surger- they’re testing new experimen- lung cancer, call 212-731-5662 lung cancer can be personalized. immunotherapy. ies or needle biopsies, can tal therapies, including vaccines or visit nyulangone.org/ be especially hard on older that stimulate immune cells lungcancercenter.

NEWS&VIEWS WINTER 2018 05 SPOTLIGHT ON EPILEPSY

BEST OF BROOKLYN Calming the Brain’s Electrical Storms A dedicated epilepsy unit opens at NYU Langone Hospital–Brooklyn, bringing NYU Langone Health’s international expertise to a community in need.

EACH YEAR, NEARLY 600 people are brought to pital–Brooklyn’s emergency department is now able Vazquez, MD, director of epilepsy clinical trials in NYU the Emergency Department at NYU Langone Hospi- to tap the expertise of three such experts, who are on Langone Health’s Department of Neurology and head tal–Brooklyn in the throes or aftermath of a seizure. call 24/7 to help diagnose and treat the most myste- of the epilepsy program at NYU Langone Hospital– But only two-thirds of these patients are eventually rious or complex cases. They belong to the hospital’s Brooklyn. But in more than 60% of cases, the cause is diagnosed with epilepsy, a complex brain disorder first dedicated epilepsy unit, an eight-bed facility that never determined. characterized by sudden, often unpredictable sei- opened last August. The new epilepsy unit is designed to get answers zures. “Knowing whether a person is actually having Epilepsy is a spectrum of disorders that have in quickly. It’s equipped with state-of-the-art audio-video a seizure and diagnosing the type of seizure can be common a kind of electrical storm within the brain. technology and electroencephalograms (EEGs), which difficult,” notes Nicholas Gavin, MD, chief of service The fourth most common neurological disease, it record the electrical activity in the brain. By evalu- for the Emergency Department. “There are many afflicts more than 3 million Americans, and its most ating the patient’s behavior and EEG results at the disorders that can cause changes in behavior and be severe forms claim the lives of thousands each year. same time, clinicians can determine whether epilepsy mistaken for epilepsy. In the Emergency Department, Any person can develop seizures at any age, though should be ruled in or out. our biggest challenge is when we learn that the patient the onset is highest among children and the elderly. A “There’s an urgency to make the right diagnosis lost consciousness and exhibited abnormal move- seizure typically involves uncontrolled shaking, which and prescribe the right medication,” says Dr. Vazquez. ments, but has never been diagnosed with epilepsy.” can last for a few seconds or several minutes, but in “Electrical activity creates a highway for more of the When the pieces don’t quite fit together, Dr. Gavin many cases, there are no overt signs. same, resulting in additional seizures. The more explains, it’s time to call in an epileptologist, a neurol- “Many things can trigger seizures, including fever, seizures patients experience, the more likely they will

ogist who specializes in epilepsy. NYU Langone Hos- alcohol withdrawal, or sleep deprivation,” says Blanca become treatment resistant.” NIALLA SASHA PHOTO:

06 NYU LANGONE HEALTH SPOTLIGHT ON EPILEPSY

In the new Epilepsy Unit of NYU Langone Hospital–Brooklyn, Dr. Blanca Vazquez monitors one of her patients for signs of seizures.

Within the safety of the monitoring unit, doctors “There’s an urgency to make the right may try to provoke a seizure by lowering the dosage of the patient’s medication or withdrawing it. “Some diagnosis and prescribe the right people have been treated for seizures for many years, medication,” says Dr. Blanca Vazquez. but when we monitor them, we find that 25% don’t “Electrical activity creates a highway have epilepsy after all,” reports Dr. Vazquez. for more of the same, resulting in When a diagnosis of epilepsy is confirmed, identify- additional seizures.” ing the type of seizure is critical. Partial seizures begin with an abnormal electrical discharge restricted to one small region of the brain, while generalized seizures powerhouse program is a huge win for the Brooklyn begin with a widespread, excessive electrical discharge community.” involving both hemispheres. “The medicines used to For the great majority of patients who can be treat- treat partial seizures actually aggravate generalized ed at NYU Langone Hospital–Brooklyn, Dr. Vazquez ones,” Dr. Vazquez explains, “so you really have to notes that being able to access such specialized care CLINICAL TRIALS know which type you’re dealing with.” close to home is not only more convenient, but safer. In severe cases, when medications fail and a Some patients with epilepsy are not allowed to drive, A POTENT WEAPON surgical intervention may be required, patients can and public transportation can be risky for someone be transferred to NYU Langone’s Comprehensive who can suddenly have a seizure at any moment. AGAINST A DEADLY Epilepsy Center at Tisch Hospital in Manhattan (see “Having a resource like this where patients can be near “Chasing Storms at NYU Langone Health’s Com- their families and we can maintain continuity of care FORM OF EPILEPSY prehensive Epilepsy Center”), where a renowned is a huge asset,” she says. “Good access translates into team of clinicians and researchers treats patients better compliance to medication, and that translates ONE OF THE rarest forms of epilepsy, Dravet from around the world with complex conditions. into fewer ED visits.” ■ syndrome, is also one of the most dangerous. “We’re fully integrated with the Comprehensive Not only do its neural storms lead to develop- Epilepsy Center at the main campus,” notes Jennifer mental and cognitive delays, but 20% of those Frontera, MD, chief of neurology at NYU Langone TO FIND A DOCTOR who treats epilepsy, call afflicted have died by age 20. The frequent, Hospital–Brooklyn, “and being affiliated with such a 646-558-0800 or visit nyulangone.org/epilepsycenter. intense seizures triggered by the disease are seldom fully controllable, even with multiple medications. However, a recent study led by Orrin Devinsky, MD, director of NYU Langone Health’s Comprehensive Epilepsy Center, PIONEERS demonstrates that a standardized, pharmaceutical-grade derivative of the cannabis plant—a Chasing Storms at NYU Langone Health’s chemical compound called cannabidiol—can be a potent weapon against the disorder. Comprehensive Epilepsy Center Cannabidiol, which is not addictive and has no psychoactive properties, had shown WHEN PATIENTS WITH each patient. An evaluation undergo surgery are cured of promise in earlier studies, but this one, pub- epilepsy are told that nothing typically begins with an out- seizures. The center is equal- lished last May in the New England Journal more can be done to control patient evaluation, which is ly renowned for its research, of Medicine, was the first to subject the drug their seizures, many find their often followed by an inpatient including drug develop- to a double-blind, placebo-controlled trial— way to NYU Langone Health’s stay at the center’s 16-bed ado- ment for cannabidiol-based the most rigorous standard of evidence. Comprehensive Epilepsy lescent/adult or 8-bed pediat- therapies (see “A Potent Dr. Devinsky’s team gave cannabidiol or a Center. One of the largest ric monitoring units in Tisch Weapon against a Deadly placebo, along with standard medications, programs of its kind in the Hospital. Two additional beds Form of Epilepsy”), studies on to 120 children and young adults with Dravet US, the center was founded are reserved for newborns. sudden unexplained death in syndrome over 14 weeks. In the cannabidiol in 1989 to treat the most Like its newly established epilepsy, and treatments for group, the median frequency of convulsive challenging cases. “Seizures counterpart at NYU Langone neuroinflammation-induced seizures per month decreased from 12.4 to can impact every aspect of Hospital–Brooklyn, the unit is epilepsy. ■ 5.9, compared with a decrease from 14.9 to the patient’s life,” notes Orrin equipped with sophisticated 14.1 with placebo. Moreover, 43% of those Devinsky, MD, the center’s di- technology that enables clini- who took cannabidiol experienced at least a rector, “and bring significant cians to confirm the diagnosis 50% reduction in the frequency of convulsive stigma and isolation.” and map the part of the brain A surgical option for seizures, compared to 27% in the placebo The center’s philosophy, where seizures originate. localized seizures group—and 5% (versus none on placebo) Dr. Devinsky explains, is When localized seizures became seizure free. Most participants expe- to devise a balanced care resist treatment, the cen- rienced mild to moderate side effects, ranging plan that allows people with ter’s neurosurgeons can use from fatigue and diarrhea to elevated liver epilepsy to lead full, active surgical techniques they’ve 65% enzymes, but only eight had reactions severe lives. At weekly conferences, pioneered to neutralize of patients enough to discontinue treatment. Future who undergo a team of epileptologists, malfunctioning parts of the surgery studies will explore whether the effectiveness neuropsychologists, neuro- brain—without injuring are cured of of standardized cannabidiol can be main- surgeons, psychiatrists, and healthy brain tissue or im- seizures tained at lower doses, and whether its safety other specialists develops a pairing neurological function. and tolerability can be improved. ■ treatment strategy tailored to About 65% of patients who PHOTO: VIKINGUR/ADOBE STOCK PHOTO:

NEWS&VIEWS WINTER 2018 07 RESEARCH Finding the Best Path to Palliative Care A $12 million grant to the Ronald O. Perelman Department of Emergency Medicine aims to better meet the needs of elderly patients.

WHEN IT COMES to providing older patients with palliative care—managing their symptoms, pain, and stress to improve quality of life—perhaps the last place that comes to mind is a fast-paced emergency department (ED). But with palliative care designated the newest subspecialty in emergency medicine, EDs are playing an increasingly larger role in this effort. Studies point to numerous benefits for initiating palliative care in the ED, including better control of symptoms, improved outcomes, shorter hospital length of stay, less need for intensive care, reduced family depression, higher patient and family satisfaction, and overall cost savings. “The ED is an opportune place for establishing a Hospital–Brooklyn, and Bellevue Hospital Center. At Grudzen’s leadership, emergency medicine research at comprehensive, long-term care plan with older patients NYU Langone, the project will draw upon the exper- NYU Langone continues to tackle some of healthcare’s and their families,” explains Corita Grudzen, MD, vice tise of the Division of Geriatrics in the Department of biggest challenges,” says Robert Femia, MD, chair of the chair for research in NYU Langone Health’s Ronald O. Medicine, the Department of Population Health, and Department of Emergency Medicine. “This study ex- Perelman Department of Emergency Medicine. That’s NYU College of Nursing. Last year, NYU Langone was emplifies our commitment to finding novel approaches because some 75% of Americans 65 or older visit an ED accredited by the Joint Commission in recognition of that will improve patients’ lives.” in the last six months of life. At NYU Langone’s Ronald its overall excellence in palliative care. The new study is recruiting more than 1,300 volun- O. Perelman Center for Emergency Services, 25% of ED When older patients with serious illnesses are dis- teers, along with some of their personal caregivers. Pa- patients—about 18,000 annually—are 65 or older. charged from an ED, they may have access to a palliative tients are eligible for the study if they are 65 or older and In December, Dr. Grudzen, a nationally recognized care physician in an outpatient setting who facilitates living at home with advanced cancer or end-stage organ expert on palliative care in the ED, became the primary medical treatment and psychosocial support. However, failure. Upon discharge from the ED, a participating investigator of a multisite national study to research such specialists are in short supply nationwide. Even patient is randomly assigned to a palliative care special- how palliative care can be delivered most efficiently, when a palliative care physician is available, in-person ist—either a nurse who monitors the patient by phone and how it can best satisfy the goals and preferences patient visits are costly and difficult for frail patients to or a physician who sees the patient in an outpatient of patients and their families. The $12 million study, maintain. A more practical option has emerged: special- setting. Both kinds of practitioners evaluate the same funded by the Patient Centered Outcomes Research ly trained nurses who coordinate patient care by phone. patient- and caregiver-centered measures, such as the Institute, represents the largest grant in the history of This novel approach has never been rigorously studied, alleviation of symptoms, clinical resources that are uti- NYU Langone’s Department of Emergency Medicine. It but the grant will enable Dr. Grudzen’s research team lized, and quality of life. “We’ll find out not only which will gather data from nine diverse EDs over the next five to systematically compare it to the physician model model of care works better, but why,” says Dr. Grudzen, years, including those at NYU Langone, NYU Langone to determine which one is more effective. “Under Dr. “so that it can be replicated at other institutions.” ■

AMBULATORY CARE NYU Langone Health Offers Urgent Care on Manhattan’s West Side

Where multispecialty ambulatory threatening emergencies through Epic, NYU care sites to offer urgent care but require prompt medical Langone’s electronic medical NYU Langone Urgent Care at services. This new model of attention. record system. Ambulatory Care West Side, urgent care will better serve 355 West 52nd Street. existing and prospective Benefits On-site diagnostic patients by building on services Call 646-754-2599 or visit our established expertise Prompt, convenient medical nyulangone.org/locations/nyu- and familiar presence in care provided by a board- X-rays and blood tests langone-ambulatory-care-west- neighborhoods throughout the certified physician trained in side/urgent-care-at-nyu-langone- New York City area. urgent care. ambulatory-care-west-side. Referrals to NYU Langone’s Hours Patient care vast network of primary care Monday–Friday: What’s new physicians and specialists for 9:00 a.m.–9:00 p.m.; Walk-in urgent care services follow-up care. Saturday: Ambulatory Care West Side is for adults with injuries and Access to an array of 9:00 a.m.–1:00 p.m.

the first of NYU Langone’s large illnesses that are not life- patient services available SHOUT ILLUSTRATION:

08 NYU LANGONE HEALTH PERSPECTIVES Hypertension: How Low Should We Go? Two of NYU Langone Health’s top experts on high blood pressure sort out new recommendations designed to stem a growing epidemic.

Under new guidelines recently issued by the American Heart Association convince patients of their are complex—education level, and the American College of Cardiology, the number of adult Ameri- risk without scaring them. poverty, social determinants, Otherwise, it’s going to be access to care. But actually, cans diagnosed with high blood pressure will rise from 72 million to 103 difficult for physicians to put everyone is at risk. We used million. The 192-page report, more than a decade in the making, con- all this into practice. Also, to say that 25% of the adult people who have treatment- population, regardless of race tains 106 recommendations. News & Views asked two of NYU Langone resistant hypertension or ethnicity, had hypertension. Health’s leading hypertension experts—Howard Weintraub, MD, clinical require additional resources Now, it will be about 40% of director of the Center for the Prevention of Cardiovascular Disease, and because we have to screen the adult population. them for concomitant Gbenga Ogedegbe, MD, director of the Center for Healthful Behavior diseases, such as sleep Are plant-based diets Change—about the highlights and their related concerns. disorders. Few practices have effective at keeping the wherewithal to do that. hypertension in check? Dr. Ogedegbe: Studies show Do you consider Do you have any diabetes, but no study has ever Dr. Weintraub: The vast that a diet rich in fruits the new guidelines concerns about the shown that these patients are majority of hypertension is and vegetables can reduce for hypertension new threshold? better off with lower blood treated not by cardiologists blood pressure. Plants have controversial? Dr. Ogedegbe: The moment pressure. To me, this is a bit but by those in primary care. a lot of potassium, which Dr. Ogedegbe: I was you label someone with a of a leap. However, patients These providers vary widely lowers blood pressure. But surprised by some of disease, you change their with diabetes have always in their knowledge base and it’s important to remember the recommendations, self-perception—and their been thought to be at higher comfort level, so many are that up to 75% of the sodium particularly the one to treat quality of life. This, in turn, has risk and hence deserving not likely to adopt aggressive, we consume comes from patients with hypertension at been shown to lead to negative more aggressive therapy. I’m nuanced guidelines. The processed foods. So going a lower threshold. We used consequences, such as missed also concerned that some ramifications of this are huge vegan won’t help much unless to think that hypertension days at work, because people physicians will aim to get their because the potential benefit you also control your salt occurs with blood pressure see themselves as sick. We patients’ blood pressure even is going to be diluted. intake. readings above 140/90 on two need to think about how to lower than the recommended or more office visits. The new deliver this new message. We level. That’s when things can Which populations Dr. Weintraub: I can torture guidelines are 130/80. We’re don’t want to add a stressor backfire. are most at risk under anybody with a diet that going to have a tsunami of new that will raise the patient’s these new guidelines? brings down their blood patients to treat. By lowering blood pressure, putting them What are the biggest Dr. Ogedegbe: About 48% of pressure, but is it sustainable? the threshold, we’ve made over at even greater risk. challenges of African Americans and 52% I tell patients to stay away one-third of our population implementing these of African American women from processed foods, lose hypertensive. Yellow is the Dr. Weintraub: The findings recommendations? will now be diagnosed with weight, and take medicine if new green. now extend to people with Dr. Ogedegbe: We’ve got to hypertension. The reasons it’s appropriate.

Dr. Weintraub: When my Beyond high blood colleagues and I reviewed pressure, which other Dr. Gbenga Ogedegbe treatment data two years ago, and Dr. Howard factors put people we felt that a systolic level Weintraub are two of at risk? between 120 and 130 would NYU Langone’s most Dr. Weintraub: The be the sweet spot—the level prominent hypertension new guidelines go after specialists. with the fewest side effects everything—blood pressure, and greatest benefits—and weight, lipids, blood sugar, this report harmonizes with smoking, and stress. This that thinking. There used to be is how we have approached a “lower is better” mentality. patients for years at the Risks do fall as blood pressure Center for the Prevention of falls, but if the levels fall Cardiovascular Disease. It’s too low, the risks rise again more work for healthcare because enough blood isn’t practitioners, but does what’s flowing to the brain or into best for the patient. ■ the heart. I applaud these guidelines for emphasizing nonpharmacologic therapy for TO FIND A DOCTOR who patients who are not at high specializes in hypertension, risk. There’s no medicine like call 212-263-5162 or visit

PHOTO OF DR. OGEDEGBE: MISTINA HANSCOM; PHOTO OF DR. HANSCOM;WEINTRAUB: JOHN ABBOTT PHOTO OF DR. OGEDEGBE: MISTINA PHOTO no medicine. nyulangone.org/cvdprevention

NEWS&VIEWS WINTER 2018 09 HONORS Awards & Accolades

Society for Neuroscience ment to service. As director of the Repeat Recognition for Division of Health and Behavior Honors Moses Chao, PhD, and director of the Center for Patient-Centered Care Healthful Behavior Change, he has Its Former President dedicated himself to developing NYU LANGONE HEALTH was honored with two MOSES CHAO, PHD, a neurosci- strategies to eliminate racial dis- awards for delivering outstanding patient care from entist at NYU Langone’s Skir- parities in cardiovascular diseases Vizient, Inc.—formerly the University HealthSystem ball Institute of Biomolecular and improve the outcomes of chronic diseases in Consortium—the nation’s largest member-driven Medicine, was honored with minority populations. His novel strategies for manag- healthcare-performance-improvement company. The the Julius Axelrod Prize by the ing hypertension include translating evidence-based 2017 Bernard A. Birnbaum, MD, Quality Leadership Society for Neuroscience. The interventions into community-based settings to Award, named in memory of NYU Langone’s former $25,000 award, funded by the Eli ensure that those with poor access have their blood chief of hospital operations, recognizes superior Lilly and Company Foundation, recognizes exception- pressure tested. A native of Nigeria, Dr. Ogedegbe has quality and safety performance, and NYU Langone has al achievements in neuropharmacology or a related expanded his work to Sub-Saharan Africa, where his received this honor for the past five years. The Vizient field and exemplary efforts in mentoring young sci- efforts to improve hypertension control are funded by 2017 Ambulatory Care Quality and Accountability entists. Dr. Chao’s work has contributed significantly the National Institutes of Health. Award was given to our faculty group practice network to the body of knowledge on nerve growth factors and for excellence in patient-centered outpatient care. receptor signaling, and has yielded important discov- This marks the third consecutive year that the eries in how neurotrophins nourish neurons, guide For Adult Congenital network has ranked number one among more than axons to form their proper connections, and promote 200 participating academic medical centers and their survival. Heart Disease, NYU community hospitals nationwide. Langone Becomes State’s Pew Charitable Trusts First Accredited Program Funds Collaborative Work NYU LANGONE HEALTH is the first institution in New York State—and one of only 16 nationwide—to by Research Partners earn accreditation as an Adult Congenital Heart Neuroscientist ROBERT FROEMKE, PHD, and im- Disease Comprehensive Care Center from the Adult Nursing at NYU Langone munologist DAN LITTMAN, MD, PHD, were one of six Congenital Heart Association (ACHA). To better teams of basic scientists nationwide awarded a grant serve the 1.3 million Americans living with congen- Orthopedic Hospital through the Pew Charitable Trusts’ new Innovation ital heart disease—the most common birth defect, Lauded for Excellence Fund. The grant, bestowed on alumni of Pew’s bio- affecting about 1% of the population—ACHA estab- medical program, promotes interdisciplinary collab- lished standards and protocols to ensure optimal FOR THE SECOND time, NYU Langone Orthopedic oration to yield cutting-edge discoveries. Dr. Froemke patient-centered care. “Because these patients are Hospital has earned Magnet designation from the Amer- and Dr. Littman, the Helen L. and Martin S. Kimmel living longer, there is an unmet need to treat them ican Nurses Credentialing Center, an accrediting body Professor of Molecular Immu- with the latest medical advances,” says Dan Halpern, that recognizes healthcare institutions for their excel- nology and a Howard Hughes MD, director of NYU Langone’s Adult Congenital lence in nursing. Only 8% of the more than 5,400 accred- Medical Institute investigator, are Heart Disease Program. “This accreditation reflects ited hospitals in the US achieve Magnet status, consid- both members of NYU Langone our commitment to patients and enables us to pro- ered the gold standard for nursing, and only 5% receive Health’s Skirball Institute of vide them with the finest possible care as a unified, the distinction twice in a row. NYU Langone Orthopedic Biomolecular Medicine. The multidisciplinary team.” Hospital was cited for practices that help set the highest $200,000 award will help them standards for other hospitals. The Magnet Recognition explore how the neuronal sensing Program advances nursing practices worldwide, provid- of gut microbes and intestinal Two Hospitals, One ing numerous benefits—among them, lower mortality function can alter an animal’s rates, shorter lengths of stay, higher patient satisfaction, behavior. A better understanding Certification for Stroke and better rates of retention and recruitment. of this process may help scientists map how information is relayed TISCH HOSPITAL AND NYU Langone Hospital– from the gut to the nervous sys- Brooklyn have been recertified as a Comprehensive NYU Langone Garners tem to promote healing. Stroke Center by the Joint Commission, an independent accreditation organization responsible Highest Marks from CMS for certifying that some 17,000 US healthcare Gbenga Ogedegbe, MD, institutions are following the best practices for NYU LANGONE HEALTH has received a five-star rating quality, safety, and patient care. While each hospital for overall quality, safety, and patient experience from Elected to the National had previously received the designation separately, the Centers for Medicare and Medicaid Services, the this is the first time the two campuses were certified federal agency that oversees quality and care for Medi- Academy of Medicine together, as a single program. Stroke is the fifth care and Medicaid beneficiaries. Only 9% of the more GBENGA OGEDEGBE, MD, the Dr. Adolph and leading cause of death, claiming the lives of more than 4,000 hospitals evaluated nationwide earn this Margaret Berger Professor of Population Health and than 130,000 Americans annually, but it has dropped highest score, and NYU Langone is the only full-service Medicine, has been elected to the National Academy from third to fifth because of programs like those hospital in New York State to earn a five-star distinc- of Medicine, one of the highest honors in the fields implemented by NYU Langone Health that have tion. The star rating offers consumers a simple guide to of health and medicine. Dr. Ogedegbe joins more increased awareness of the risks and warning signs. healthcare institutions based on rigorous metrics. NYU than 2,000 physicians worldwide, including 50 Nobel NYU Langone’s Comprehensive Stroke Center treats Langone exceeded the national averages for safety, low laureates, elected by their peers to recognize their more than 1,400 patients every year. mortality rates, hospital readmissions, and efficient use outstanding professional achievement and commit- of medical imaging. ■

10 NYU LANGONE HEALTH NEW FACES CLINICAL TRIALS Appointments & Recruitments THE ENVIRONMENT

Transplant Institute and Perlmutter Cancer Center expand services with distinguished recruits. AND CHILD HEALTH

THE NYU CHILDREN’S NADER MOAZAMI, MD, has been DIANE SIMEONE, MD, has been RAOUL TIBES, MD, PHD, has been Environmental Health appointed surgical director of heart named director of the new Pancre- appointed director of the Clinical Study—part of an $8.9 transplantation and mechanical atic Cancer Center and associate Leukemia Program at NYU Langone million grant awarded to circulatory support. He is spear- director for translational research Health’s Laura and Isaac Perlmut- epidemiologist Leonardo heading NYU Langone Health’s new at NYU Langone Health’s Laura and ter Cancer Center. A nationally Trasande, MD, by the heart transplant program, recently Isaac Perlmutter Cancer Center. renowned physician and researcher, National Institutes of launched by its Transplant Insti- A surgeon and international- he joins NYU Langone from the Health—has recruited more than 1,000 preg- tute, Department of Cardiothoracic ly renowned researcher with a Mayo Clinic’s Arizona facilities in nant women at Tisch Hospital, NYU Langone Surgery, and the Leon H. Charney long-standing focus on pancre- Scottsdale and Phoenix, where he Hospital–Brooklyn, and Bellevue Hospital Cen- Division of Cardiology. In Janu- atic cancer and pancreatic cystic served as a consultant for their ter to study how exposure to environmental ary, Dr. Moazami performed NYU tumors, she has performed more leukemia program. Dr. Tibes’ re- factors influences children’s health outcomes Langone’s first heart transplant, one than 1,000 pancreatic operations search focuses on developing more around the time of birth and later in childhood of more than 300 such lifesaving and has developed clinical trials for effective therapies for acute myeloid or adolescence. Dr. Trasande’s team is follow- procedures he has performed in innovative therapeutics. Dr. Sime- leukemia (AML), myelodysplastic ing participants throughout their pregnancies his career. Dr. Moazami previously one, the Laura and Isaac Perlmutter syndromes (MDS), and myelo- and into the first few years of their babies’ lives led the cardiac transplant program Professor of Surgery, leads a large proliferative neoplasm (MPNs), to examine how air pollution, environmental at the Cleveland Clinic, where he clinical research program that is employing funcional genomics, as chemicals, stress, sleep, diet, and other factors achieved an international reputation working to develop a blood test for well as identifying mechanisms of may predispose them to asthma, obesity, dia- for excellence. NYU Langone’s new early detection of pancreatic cancer. resistance to current therapies. His betes, autism, and attention deficit disorder. program offers a variety of surgical She is the principal investigator of laboratory work led to the develop- Without invasive procedures, the researchers options for patients waiting for a Precision Promise, a new national ment of several first-of-their-kind will collect specimens from women during heart transplant, including lifesaving consortium devoted to next-gener- clinical trials for AML, MDS, and pregnancy and at the time of their newborns’ mechanical devices that improve a ation clinical trials. Previously, Dr. MPNs. In addition, he spearheads delivery, then test these specimens, as well patient’s quality of life or serve as a Simeone served as director of the the development of DNA damage as others collected after birth. The timing of bridge to transplantation. gastrointestinal oncology program and cell cycle checkpoint inhibitory environmental exposures is considered an After earning his MD at at the University of Michigan Com- drugs in AML. important element, since research has shown Columbia University College of prehensive Cancer Center. After earning his MD and PhD that exposures during crucial developmental Physicians and Surgeons, Dr. By 2020, pancreatic cancer is from Ludwig Maximilian University windows can have lifelong effects on health. Moazami completed his residency expected to become the second- Medical School in Munich, Dr. Tibes at Columbia-Presbyterian Medical highest cause of cancer death in completed his residency at NYU Center, where, as chief resident, he the US. Dr. Simeone chairs the School of Medicine and a fellowship TREATING CORONARY participated in the thoracic organ Scientific and Medical Advisory in medical oncology and hematolo- procurement team. He completed a Board of the Pancreatic Cancer gy at MD Anderson Cancer Center ARTERY DISEASE fellowship in cardiothoracic surgery Action Network, a leading advocacy in Houston. He has published more at the Cleveland Clinic. A prolif- organization. After earning her MD than 70 articles in scientific journals IN 2011, NYU Langone ic researcher, Dr. Moazami has from Duke University, she complet- and was recently named a Scholar Health received $84 published more than 100 articles in ed a residency in general surgery at in Clinical Research by the Leuke- million in funding from leading scientific journals and has the University of Michigan Medical mia and Lymphoma Society. ■ the National Institutes of been the principal investigator on Center. Dr. Simeone is a member Health—its largest grant more than two dozen clinical trials of the Institute of Medicine of the ever—to lead an interna- to study mechanical assist devices National Academy of Sciences and tional study comparing and other therapies for end-stage the National Cancer Institute’s the effectiveness of two initial treatment heart failure. Pancreatic Cancer Task Force. strategies, one conservative and the other more aggressive, for people with moderate to severe ischemia, or impaired blood flow. Last December, the trial—conducted at more than 350 sites in 33 countries, including 115 medical centers in the US—hit its target recruitment goal of more than 5,000 patients. The study enrolled more than 8,000 patients and randomly assigned more than 5,000 who were fully eligible. Ischemia is the leading cause of death and disability worldwide, afflicting more than 17 million Americans and claiming some 450,000 lives annually. “This is a major step toward successfully achieving the aims of the trial,” says the study’s principal investigator, Judith Hochman, MD, the Harold Snyder Family Professor of Cardiology and director of NYU Langone’s Cardiovascular Clinical Research Center. ■

NEWS&VIEWS WINTER 2018 11 ALL RESERVED. RIGHTS COPYRIGHT HEALTH. ©2018NYU LANGONE publications. are available atnyulangone.org/ nyulangone.org. Digital editions Medical Center, visitusonlineat For more information aboutthe • Direction Art POINT FIVE Production Coordinator LARISA MANOUILOVITCH EditorSenior THOMAS RANIERI A. Director ofPublications DYERNICOLE News&Views • Communications andMarketing ViceSenior President, KATHY LEWIS Saul J. Farber DeanandCEO ROBERT I.GROSSMAN, MD Chairman, Board ofTrustees LANGONE G. KENNETH nyumc.org. requests topublications@ ideas,andsubscription story Submit your comments, We want tohearfrom you. Tell Us!

New York, NY10016 550 First Avenue animating something that was previously static.” away layers to seehow the heart actually functions, Gregory Dorsainville, “but allows the userto peel beating heart,” explains senior multimedia developer tive modelnot onlyshows the usera3-Dmodelof and augmented, or“mixed,” reality. “Thisinterac- resident, combines two emerging technologies: apps iPad (left),provided to each medical student and gies to transform teaching andlearning. Thelearner are happening. IIMEispioneering tools andstrate- for Innovations inMedical Education (IIME),both change things. At NYUSchoolofMedicine’s Institute SOME THINGS AREgame changers. Somegames FOR MD’S INTRAINING ONE-TOUCH TEACHING EDUCATION makes students excited andcurious. tivating acontinuously innovative environment that School ofMedicine a“distinguished school”for cul- easier, but more fun.Apple recently designated NYU integral andindispensable part ofthe medical field.” away,” says Dr. Triola, “but it’s going to becomean medicine andhealthcare. “It may be5or10years Marc Triola, MD, but itpromises to revolutionize ment andgaming fields, explains IIME’s director, Augmented reality emerged from the entertain These new technologies make learning not just ■

PHOTO: SASHA NIALLA