Afleveringen
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On this episode of Advances in Care, host Erin Welsh talks to Dr. Andrew Goldstone and Dr. David Kalfa, pediatric cardiac surgeons at NewYork-Presbyterian and Columbia, about their groundbreaking heart transplant that saved the lives of three separate children. It was the first time doctors at NewYork-Presbyterian Morgan Stanley Children’s Hospital performed a split-root domino partial heart transplant. In this procedure, one child was transplanted with a new heart and their original heart was used to donate living pulmonary and aortic valves to two separate recipients in need.
Dr. Goldstone, Dr. Kalfa and the rest of the team at NewYork-Presbyterian and Columbia had previous experience with a handful of domino partial heart transplants where one patient is transplanted with a new heart and another receives a valve from the explanted heart. Those experiences helped prepare for the split-root domino, which took nearly 24 hours of extremely coordinated care. In addition to their efforts to increase the number of domino heart transplants being done, physician-researchers at the institution are leading new studies that are also helping improve living valve procurement and storage, allowing more children to receive heart valves that will grow with them and require less surgeries.
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Dr. Andrew Goldstone is the Surgical Director of Heart Transplant and Mechanical Circulatory Support and Director of the Valve Transplant Program at Columbia and NewYork-Presbyterian. He has been recognized nationally and internationally for his clinical and basic science research. In the lab, he focuses on mechanisms underlying collateral artery formation and cardiac regeneration. His long-term goal is to continue adding high-level evidence to better inform the surgical treatment of pediatric and adult cardiovascular disease.
Dr. David Kalfa is a Board-certified cardiothoracic surgeon with a subspecialization in pediatric cardiac surgery. He is also a researcher focusing in the field of growing heart valves and growth accommodating heart valves.
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On this episode of Advances in Care, host Erin Welsh and Dr. Moeun Son, OB/GYN and Maternal-Fetal Medicine Specialist at NewYork-Presbyterian and Weill Cornell Medicine, discuss Dr. Son’s perspective on treating patients who face a high-risk pregnancy and might need a caesarian delivery.
Dr. Son explains that even though c-sections are a highly common and safe delivery option for many women, they’re not often not the top option in a woman’s birth plan, and don’t carry the same benefits as natural labor. She outlines the standard methods for labor induction to prevent the necessity of a c-section, which includes the administration of a synthetic form of the hormone oxytocin.
Beyond her work with patients, Dr. Son is also passionate about researching alternative methods for labor induction and preventing unnecessary c-sections. She and her colleagues designed a study to promote natural oxytocin release through nipple stimulation – mimicking breastfeeding through the use of a hospital grade breast pump. The success of that treatment eventually led to the The Stimulation To Induce Mothers Study – or STIM Study. Today, it’s an ongoing trial that aims to compare the effectiveness of natural oxytocin versus synthetic oxytocin in helping women give birth vaginally.
Dr. Son hopes that this research will broaden birthing options for women experiencing a high-risk pregnancy, and add more safe and effective treatment methods to the field of women’s health.
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Dr. Moeun Son is board-certified in Obstetrics and Gynecology and Maternal-Fetal Medicine. In her practice, she focuses on women with high-risk pregnancies, from pre-existing maternal conditions to babies with health anomalies. She is the principal investigator on many clinical research projects, including various randomized clinical trials. Dr. Son also serves as the Program Director of the MFM Fellowship Program at Weill Cornell
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Zijn er afleveringen die ontbreken?
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On this episode of Advances in Care, host Erin Welsh and Dr. Karan Dua, an orthopedic surgeon at NewYork-Presbyterian and Columbia, discuss novel approaches to shoulder surgery, including transferring donor tendons to the upper extremity with arthroscopic tools. Dr. Dua shares his passion developing personalized treatments that get to the root cause of a wide range of shoulder issues.
Dr. Dua explains the importance of the scapula and what happens when its range of motion is abnormal, or out of alignment. He talks about his process for balancing the scapula to relieve pain in his patients, who are often young and suffering from pain due to injuries from work or sports.
He also discusses the difference between shoulder replacement – a common treatment for patients with arthritis – and shoulder reanimation. Dr. Dua is skilled in shoulder reanimation, and describes how he performs tendon transfers to preserve a patient’s joints and allow them to restore movement of their shoulder. Using arthroscopic instruments, Dr. Dua collects a donor tendon either from another part of the patient’s body or from a cadaver, and replaces the injured tendon with a healthy one.
Dr. Dua hopes to develop a robust scapula program at NewYork-Presbyterian and Columbia that offers targeted treatment for patients suffering from a range of upper extremity issues.
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Dr. Karan Dua is an orthopedic surgeon specializing in the treatment of structures affecting the form and function of the entire arm. He is dual trained in hand, upper extremity, and microvascular surgery, and in shoulder and elbow surgery. He has an avid interest in open and arthroscopic tendon transfers of the shoulder, complex reconstructions after failed surgery, arthroscopic and minimally invasive techniques for nerve decompression including the brachial plexus and around the shoulder blade, and tendon transfers for scapular winging.
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On this episode of Advances in Care, host Erin Welsh first hears from Dr. Richard Friedman, a clinical psychiatrist at NewYork-Presbyterian and Director of the Psychopharmacology Clinic at Weill Cornell Medicine. Using his background in psychopharmacology, Dr. Friedman distinguishes between psychedelics and standard antidepressants like SSRIs and SNRIs, explaining the various mechanisms in the brain that respond uniquely to psychedelic compounds. While both methods of treatment involve serotonin stimulation, psychedelics are the only known drug to shut off the brain’s Default Mode Network, which is the group of brain regions that are active when a person is not thinking about external stimuli. Dr. Friedman also identifies that the challenge of proving efficacy of psychedelic therapy lies in the question of how to design a clinical trial that gives patients a convincing placebo.
To learn more about the challenges of trial design, Erin also speaks to Dr. David Hellerstein, a research psychiatrist at NewYork-Presbyterian and Columbia. Dr. Hellerstein contributed to a 2022 trial of synthetic psilocybin in patients with treatment resistant depression. He and his colleagues took a unique approach to dosing patients so that they could better understand the response rates of patients who use psychedelic therapy. The results of that trial underscore an emerging pattern in the field of psychiatry – that while psychedelic therapy has its risks, it’s also a promising alternative treatment for countless psychiatric disorders. Dr. Hellerstein also shares more about the future of clinical research on psychedelic therapies to potentially treat a range of mental health disorders.
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Dr. Richard Friedman is a professor of clinical psychiatry and is actively involved in clinical research of mood disorders. In particular, he is involved in several ongoing randomized clinical trials of both approved and investigational drugs for the treatment of major depression, chronic depression, and dysthymia.
Dr. David J. Hellerstein directs the Depression Evaluation Service at Columbia University Department of Psychiatry, which conducts studies on the medication and psychotherapy treatment of conditions including major depression, chronic depression, and bipolar disorder.
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On this episode of Advances in Care, host Erin Welsh and Dr. Serge Przedborski, Chief of the Division of Movement Disorders at NewYork-Presbyterian and Columbia, discuss what happens in the brains of patients with Parkinson’s disease. Dr. Przedborski came to Columbia thirty two years ago and has spent that time researching why some neurons in the brain die while others live in people who suffer from the condition – and he’s learned a lot. With the help of the New York Brain Bank at Columbia, his lab has been able to map out what the neuronal patterns of death look like with the goal of using these brain maps to develop novel treatments that seek to address the progression of Parkinson’s rather than just treating the symptoms, which is how all current treatments work.
Dr. Przedborksi also shares updates on new gene therapies that are being investigated across the institution to replace Deep Brain Stimulation – a common treatment for Parkinson’s where a wire is placed in the brain. While these gene therapy treatments are still invasive, the technology behind them is constantly improving and will likely lead to significant benefits to patients
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Dr. Przedborski’s ongoing research aims at understanding the contributions of cell-autonomous and non cell-autonomous mechanisms to neurodegeneration using both toxic and genetic experimental models of Parkinson’s Disease and ALS. In keeping with this goal, how alterations in mitochondrial biology, especially of mitochondrial dynamics and mitophagy, provoke degeneration of specific subpopulations of neurons is one of the main areas of research in the Przedborski laboratory. To what extent and by which mechanisms do non-neuronal cells, like microglia and astrocytes, participate in the demise of neurons in neurodegenerative disorders, such as Parkinson’s and ALS, represent a second main line of research in this laboratory. These research efforts are supported by federal grants from both NIH and the DoD as well as by several private agencies such as the Parkinson's Disease Foundation and the Thomas Hartman Foundation.
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On this episode of Advances in Care, host Erin Welsh explores the story behind the GUARDIAN study, where thousands of newborn babies have been screened against rare disease by sequencing their genes, and looking for more conditions than any of the current standard screening panels. First, she hears from Dr. Jordan Orange, Physician-in-Chief at Morgan Stanley Children’s Hospital at NewYork-Presbyterian and Columbia, about why genetic testing is a promising way of not only catching treatable rare diseases in infants, but also expanding health equity and medical resources to marginalized populations.
Erin also hears from Dr. Josh Milner, a pediatric immunologist who treated a patient with a rare form of SCID, or severe combined immune deficiency, also known as bubble boy disease that was detected in the GUARDIAN screening panel. SCID is a disease that typically occurs in 1 of 50,000 babies. But GUARDIAN caught two cases within the first 10,000 babies involved in the program, indicating that the rate of the disease might be higher than expected, and that the most accurate way to detect is through genetic screening.
Dr. Steven Lobritto, a pediatric gastroenterologist, also weighs in on how genetic screening can help identify Wilson’s disease, a copper storage disorder that causes liver damage when left unchecked. And Dr. Eric Silver, a pediatric electrophysiologist, discusses how the program detected a heart rhythm disorder called Long QT Syndrome for both a newborn baby and their father.
Finally, Erin gets the big-picture takeaways from Dr. Orange, who reflects on what the results of GUARDIAN could mean for the future of newborn screening and health policy, and how he hopes to see genetic testing expand research and treatment of rare diseases.
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On this episode of Advances in Care, host Erin Welsh and Dr. Markus Mapara, Director of the Blood and Marrow Transplantation and Cell Therapy Program at NewYork-Presbyterian and Columbia, discuss the current challenges in treating sickle cell disease and how newly FDA approved gene editing treatments are leading to new treatment pathways. Dr. Mapara covers two new gene editing approaches, explaining that both involve editing stem cells and reintroducing them to patients’ bodies to curb the sickling of red blood cells. He also helps listeners to understand the difference between the two: one gene therapy uses CRISPR technology to help the body create fetal hemoglobin which mitigates cell sickling while the other uses a lentiviral vector to edit stem cells to produce anti-sickling hemoglobin that’s similar to fetal hemoglobin once reintroduced to the body.
Dr. Mapara also goes into the innovative work that the Blood and Marrow Transplantation and Cell Therapy Program is doing with CAR-T cell therapies. And he shares how these advancements in treating sickle cell disease will have a significant impact on how physicians approach treating patients.
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Dr. Mapara is a Professor of Medicine at Columbia University Medical Center and the Director of the Blood and Marrow Transplantation (BMT)/Cell Therapy Program at New York Presbyterian Hospital/Columbia University Medical Center. He specializes in the care of patients with sickle cell disease and certain blood cancers (Multiple Myeloma, Amyloidosis) undergoing bone marrow transplantation and gene therapy. His research is focused on developing novel approaches to make bone marrow transplantation and cell therapy safer for patients..
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On this episode of Advances in Care, host Erin Welsh and Dr. Craig Smith, Chair of the Department of Surgery and Surgeon-in-Chief at NewYork-Presbyterian and Columbia discuss the highlights of Dr. Smith’s 40+ year career as a cardiac surgeon and how the culture of Columbia has been a catalyst for innovation in cardiac care. Dr. Smith describes the excitement of helping to pioneer the institution’s heart transplant program in the 1980s, when it was just one of only three hospitals in the country practicing heart transplantation.
Dr. Smith also explains how a unique collaboration with Columbia’s cardiology team led to the first of several groundbreaking trials, called PARTNER (Placement of AoRTic TraNscatheteR Valve), which paved the way for a monumental treatment for aortic stenosis — the most common heart valve disease that is lethal if left untreated. During the trial, Dr. Smith worked closely with Dr. Martin B. Leon, Professor of Medicine at Columbia University Irving Medical Center and Chief Innovation Officer and the Director of the Cardiovascular Data Science Center for the Division of Cardiology. Their findings elevated TAVR, or transcatheter aortic valve replacement, to eventually become the gold-standard for aortic stenosis patients at all levels of illness severity and surgical risk. Today, an experienced team of specialists at Columbia treat TAVR patients with a combination of advancements including advanced replacement valve materials, three-dimensional and ECG imaging, and a personalized approach to cardiac care.
Finally, Dr. Smith shares his thoughts on new frontiers of cardiac surgery, like the challenge of repairing the mitral and tricuspid valves, and the promising application of robotic surgery for complex, high-risk operations. He reflects on life after he retires from operating, and shares his observations of how NewYork-Presbyterian and Columbia have evolved in the decades since he began his residency.
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Join host Erin Welsh as she talks with NewYork-Presbyterian physicians from Columbia & Weill Cornell Medicine about how they are solving some of the most challenging and complex cases in medicine. Together, they discuss groundbreaking discoveries, novel treatments, and the dedication to providing compassionate patient care. This is a show for medical professionals interested in how cutting-edge research and innovations are transforming the future of health care.
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On this episode of Health Matters, Faith Salie talks with Dr. Benjamin Lebwohl, a gastroenterologist at NewYork-Presbyterian and Columbia. He’s also the Director of Clinical Research at Columbia’s Celiac Disease Center, and an expert on the connections between gastrointestinal health and the other systems in our body that rely on good digestion for their function. He describes how GI diseases like Celiac have implications for mental health, and what anyone can do to support their digestive health.
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Dr. Melissa Frey, a gynecologic oncologist at NewYork-Presbyterian and Weill Cornell Medicine, has a genuine passion for the power of genetic testing because she knows that it can completely change the direction of her patient’s lives for the better. As a leader in the field, she helped launch a unique screening program with multi-disciplinary expertise and counseling, the Genetics and Personalized Cancer Prevention Center at Weill Cornell Medicine. The center not only helps patients gain access to genetic testing to assess their risk of cancers but it also uses cascade testing to contact their relatives and help them get genetic testing too. In doing so, the center is working to identify more people whose lives haven't yet been affected by cancer and help them take preventive action based on their risk. In many cases this can mean avoiding a life threatening illness.
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The field of lung transplantation is relatively new with widespread lung transplants beginning in the early 1980s. Throughout the last forty years, it is a field that has rapidly evolved with drastic changes in lung allocation, or deciding who will receive the next available lungs for transplantation. Dr. Selim Arcasoy has led the NewYork-Presbyterian and Columbia Lung Transplant Program through these changes since 2001. Thanks to his dedication to improving lung allocation and foundational research, the program has been a catalyst in changing how lung allocation works in New York and beyond. These policies, in conjunction with Dr. Arcasoy's talented team, clinical research and state of the art tools, have led to greater numbers of patients receiving life-saving transplants.
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In 2012, Dr. Lisa Roth had just landed her dream job as a research scientist and attending physician at NewYork-Presbyterian and Weill Cornell Medicine. But her world came to a screeching halt when she discovered a swollen lymph node on her neck, and was soon diagnosed with the exact type of cancer that she had dedicated her career to studying and treating: Hodgkin Lymphoma. After that experience, Dr. Roth was more determined than ever to uncover the biology of this notoriously difficult to study cancer. Dr. Roth, now Director of Pediatric Oncology and Associate Professor in the Departments of Pediatrics, Medicine and Pathology and Laboratory Medicine at NewYork-Presbyterian and Weill Cornell Medicine, tells the story of how she and her team became the first researchers to sequence the entire Hodgkin Lymphoma genome, opening doors for precision and preventative treatment options.
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Monitoring patients with aneurysmal rupture for delayed cerebral ischemia was historically a numbers game. It was difficult for doctors to predict outcomes in the weeks that followed their rupture, so at-risk patients could find themselves under observation in the ICU anywhere from 7 to 21 days. Dr. Soojin Park, Medical Director of Critical Care Data Science and AI at NewYork-Presbyterian/Columbia, knew there had to be a better way to monitor patients and predict outcomes. So, relying on her background in machine learning and leveraging vast amounts of data, Dr. Park developed the potentially game-changing Continuous Monitoring Tool for Delayed Cerebral Ischemia (or COSMIC) score. The score uses machine learning, and basic patient data that can be collected with equipment available at any hospital, to detect signals that more accurately assess risk, allowing doctors to treat each neurocritical patient with targeted care - ultimately improving outcomes and patient experience.
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As methods for early cancer detection improve and the number of cancer survivors rises, the innovative field of cardio-oncology has emerged to ensure that patients with chemotherapy or cancer-related cardiac dysfunction can be safely, and swiftly, treated for their cancer. Dr. Stephanie Feldman, a clinical cardiologist with focus on cardio-oncology at NewYork-Presbyterian/Weill Cornell Medicine, is one of a growing number of physicians advancing research and pushing care in this field forward with a multi-disciplinary, comprehensive approach to care. Dr. Feldman joins us to discuss the rare risks of immune checkpoint inhibitors, how genetic mutations could put patients at risk for arterial thromboembolism, and how the cardio-oncology field can optimize the course of cancer care for patients at risk for cardiovascular complications.
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With perspectives spanning hepatobiliary, gynecologic, and cardiac surgeries, NewYork-Presbyterian’s Dr. Jason Hawksworth (Columbia), Dr. Tamatha Fenster (Weill Cornell Medicine), and Dr. Arnar Geirsson (Columbia) describe how they each came to incorporate robotics into their practices. One of the biggest takeaways: robotic surgeries allow for more accuracy in minimally-invasive approaches; so patients experience shorter hospital stays and quicker recoveries, even after major procedures. But there are some limitations to robotic surgeries that the doctors are still navigating. Dr. Fenster discusses how there are haptics limitations in robotic surgery. As a result, she shares more about her innovative smartHER 3D MRI program that is addressing this issue and details how her and her team are developing a way of holographically projecting 3D MRIs over patients to help guide surgeons while they operate.
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Dr. Christian and Dr. Van de Velde’s backgrounds are a complementary combination. At their clinic, they see, diagnose, and determine treatment for their patients together. Dr. Christian takes on minimally invasive procedures, utilizing arthroscopy to address extra bone growth that can limit range of motion and can lead to labral tears. Dr. Van de Velde specializes in a more invasive type of surgery: periacetabular Ganz osteotomy. In complex cases, the two surgeons combine for a full-day surgery, where they each use their specialized surgical approach. Through their unique collaboration, the duo is able to provide optimal treatment for their patients, and help to preserve their hip function for as long as possible.
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Dr. Mario Gaudino is a cardiac surgeon at NewYork-Presbyterian/Weill Cornell Medicine and the Director of the Joint Clinical Trials Office at Weill Cornell Medicine. There he oversees ongoing improvement and enhancements to existing clinical infrastructure and is currently leading research on the effects of coronary artery bypass surgery on women and people of color. His work not only focuses on groups that have been historically underrepresented in research, it also takes a patient centric approach to outcomes focusing on how a patient feels in addition to clinical metrics. His research contributions have potential to change how doctors approach treating huge swaths of their patient population and how they analyze that data.
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It has been widely reported over the past ten to fifteen years that maternal mortality and morbidity in the US is on the rise. Dr. Dena Goffman has made it her personal goal to improve those numbers across the entire NewYork-Presbyterian health system. But how can one begin to tackle such a large and challenging issue? Dr. Goffman focuses on systematic shifts. She worked to set obstetrics goals across the entire hospital system, created new guidelines and utilized simulations to train and improve the skills of healthcare workers to be prepared for any situation. And she wasn’t afraid to use every tool in her toolbox, even new ones like an ingenious anti-hemorrhage device that she helped gain FDA approval. In this episode, Dr. Goffman shares what real systemic change for maternal fetal care looks like and how she is hoping these standards can help reverse the trends in maternal mortality across the country.
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As a doctor trained in both minimally invasive and open approach surgery, Dr. Chan is very familiar with comprehensive spinal care. But there are aspects of minimally invasive surgery that, when possible, position it as preferable for postoperative recovery, namely when it comes to pain. Open surgeries can have patients taking opioids for weeks or even months after their procedure. With minimally invasive spinal surgery, patients may only need opioid pain management for two days postoperatively–or none at all. Motivated by postoperative quality of life, Dr. Chan has fine-tuned several innovative surgical approaches, proving that a surgeon doesn’t necessarily have to perform large muscle dissections in order to correct spinal deformities like scoliosis. His techniques provide surgical opportunities for patients who otherwise would not be spinal surgery candidates due to age or illness. In this episode, Dr. Chan details how he customizes care for his various patients depending on their needs, and shares his hopes for the future of spinal surgery.
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