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Advances in Care: Daily Summaries Delivered
by NewYork-Presbyterian
On Advances in Care, epidemiologist and science communicator Erin Welsh sits down with physicians from NewYork-Presbyterian hospital to discuss the details behind cutting-edge research and innovative treatments that are changing the course of medicine. From breakthroughs in genome sequencing to the backstories on life-saving cardiac procedures, the work of these doctors from Columbia & Weill Cornell Medicine is united by a collective mission to shape the future of health care and transform the lives of their patients. Erin Welsh, who also hosts This Podcast Will Kill You, gets to the heart of her guests’ most challenging and inventive medical discoveries. Advances in Care is a show for health careprofessionals and listeners who want to stay at the forefront of the latest medical innovations and research. Tune in to learn more about some of medicine’s greatest leaps forward. For more information visit nyp.org/Advances
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- 1 weeks ago18 min
Cerebral Organoids Provide New Strategy to Personalize Glioblastoma Treatment
On this episode of Advances in Care, Erin Welsh is joined by Dr. Howard Fine, a neuro-oncologist at NewYork-Presbyterian and director of the Brain Tumor Center at Weill Cornell Medicine, to explore his pioneering research on glioblastoma, the most common and aggressive form of brain cancer. Glioblastoma has long resisted meaningful therapeutic progress. When Dr. Fine began working in this field, the median survival after diagnosis was just 12-13 months. Forty years later, there’s been little progress made to meaningfully extend life for glioblastoma patients, despite concerted research efforts. Unlike many other cancers, glioblastoma cells diffusely infiltrate the brain, making complete surgical removal and targeted chemotherapy extremely difficult, thus limiting the effectiveness of traditional cancer treatment approaches. Dr. Fine’s work aims to fundamentally change how glioblastoma is studied and treated. His lab is bioengineering human embryonic stem cells to form cerebral organoids - also called mini brains - which exhibit similar characteristics to a human brain. Through a platform they’ve created called GLICO, his team can develop genetically matched, patient-specific models that incorporate a patient’s own immune cells and glioma stem cells, allowing researchers to screen various drug therapies and map how an individual patient’s glioma might progress. By combining these personalized glioblastoma models with artificial intelligence and machine learning, Dr. Fine’s goal is to build a future care model where clinicians can identify patient-specific therapies and test treatments before they reach the bedside, ultimately transforming glioblastoma into a more manageable disease. Chapters: [00:00 - 07:13] Past Research and Treatment for Glioblastoma Dr. Fine and Erin discuss his history in researching and treating glioblastoma. [07:13-10:54] Reframing Glioblastoma Dr. Fine explains how glioblastoma differs from other types of cancers and why traditional approaches haven’t improved outcomes. [10:54-14:46] GLICO and Glioblastoma Cerebral Organoids Dr. Fine describes the GLICO platform he’s pioneering, and how advancements in cerebral organoids open new pathways for treatment strategies. [14:46-18:34] Shifting the Paradigm Dr. Fine shares his research goals to accommodate this new biological understanding of glioblastoma and how it could transform the condition into a manageable disease and improve survivorship. [18:35-18:59] Credits *** Howard A. Fine, M.D., is the founding Director of the Brain Tumor Center at NewYork-Presbyterian/Weill Cornell Medicine and Associate Director for Translational Research at the Sandra and Edward Meyer Cancer Center. Over his career, he has built multidisciplinary brain tumor programs at leading institutions including the National Institutes of Health and Dana-Farber Cancer Institute/Harvard Medical School. He has cared for nearly 20,000 patients with brain and spinal cord tumors, led more than 100 clinical trials, and authored over 250 publications. His laboratory has operated continuously for more than two decades, focusing on the genetic and molecular drivers of brain tumors. Today, his research centers on developing patient-specific tumor models, creating genetically precise replicas of individual brain tumors to better predict disease behavior and enable real-time drug screening tailored to each patient. At WCM, he leads a multidisciplinary team dedicated to delivering highly personalized neuro-oncology treatment plans. For more information visit nyp.org/Advances
- 3 weeks ago17 min
Navigating High-Risk Pregnancy with Multidisciplinary Cardio-Obstetrics Care
Erin Welsh is joined by Dr. Jennifer Haythe, director of the Adult Pulmonary Hypertension Center and Cardio-Obstetrics programs at NewYork-Presbyterian and Columbia, to discuss the prevalence of high-risk pregnancies due to heart disease and the multi-disciplinary efforts required for optimal patient care. Many women in the US are having children at a later age than in the past, and with that comes an increased occurrence of certain conditions that create risk for heart disease during, or after, pregnancy. In fact, cardiovascular disease is the leading cause of maternal mortality in the US, with pulmonary hypertension and peripartum cardiomyopathy posing significantly high risks. Dr. Haythe discusses how coordinated, multi-disciplinary care is crucial in treating these vulnerable patients, and how the cardio-obstetrics program at Columbia is approaching care to allow women, many of whom have been told they could never give birth, achieve safe and successful pregnancies. Dr. Haythe also talks about the latest cutting edge research for cardiac conditions in pregnancy and her program’s involvement in the ReBIRTH study, a national, multi-center, randomized placebo controlled trial examining the use of bromocriptine as a course of treatment for pregnant patients with peripartum cardiomyopathy - a study that could potentially introduce a new paradigm in high-risk pregnancy care. Chapters: [00:00 - 5:49] Columbia’s Multidisciplinary Cardio-Obstetrics Program Dr. Haythe and Erin discuss how the multidisciplinary cardio-obstetrics program at Columbia and the growing population of pregnant patients with heart disease. [05:49 - 10:28 ] Navigating Cardiovascular Complications Dr. Haythe and Erin talk about the risks of pulmonary hypertension and other cardiovascular complications in pregnant patients, including during the post-partum period, and also highlights new research that may help change the course of treatment. [10:28 - 14:08] A Rewarding Patient Story Dr. Haythe tells a story of a pregnant patient with pulmonary hypertension who delivered successfully, demonstrating how the program effectively managed her care. [14:08 - 17:12 ] Vision For the Future Dr. Haythe shares her experience as part of the New York City Maternal Mortality Review Board, a committee formed to review maternal deaths and determine how to minimize the risk of recurrence going forward. [17:12 - 18:04] Credits *** Jennifer Haythe, MD, is the Director of the Adult Pulmonary Hypertension Center, and the Cardio-Obstetrics program at Columbia. She is currently the Irene and Sidney B. Silverman Associate Professor of Cardiology, Center for Advanced Cardiac Care at Columbia, and Co-Director of The Columbia Women’s Heart Center. Dr. Haythe specializes in pulmonary hypertension, cardio-obstetrics, heart failure, HFPEF, and cardiovascular disease in women. For more information visit nyp.org/Advances
- Apr 30, 202619 min
Redefining Treatment for Chiari Malformation with a Transitional Care Model
On this episode of Advances in Care, Erin Welsh and Dr. Jeffrey Greenfield, pediatric neurosurgeon at NewYork-Presbyterian and director of the Chiari CARE program at Weill Cornell Medicine, discuss a rare condition called Chiari malformation. Typically diagnosed by MRI, Chiari malformation is classified when part of the cerebellum descends into the upper spinal canal. Though some of the most severe types of Chiari malformation can be diagnosed during pregnancy, the most common type may present asymptomatically until adolescence or adulthood, with symptoms that are often misdiagnosed as other disorders. To address the unmet need for proper diagnosis and management of this condition, Dr. Greenfield created the Chiari CARE program–a multidisciplinary approach involving neurology, pain management, neuropsychology, radiology, and more–to help provide full-spectrum care to patients. A key factor of the Chiari CARE program is its emphasis on transitional care, which includes both treating patients who come in as pediatrics throughout their adulthood as well as those who are diagnosed later in life. But Dr. Greenfield’s vision extends to the future. Having just treated the program’s thousandth surgical patient, his team is amassing and analyzing outcomes data and using machine learning to refine predictions for which future patients would be good candidates for surgery or require other treatment methods that will enhance overall quality of life. Chapters: [00:00 - 4:12] Chiari CARE Dr. Greenfield and Erin discuss a rare congenital brain condition called Chiari malformation, and highlight Dr. Greenfield’s Chiari CARE program at NewYork-Presbyterian and Weill Cornell Medicine. [4:12 - 8:35] The Importance of Transitional Care Dr. Greenfield expands on the importance of transitional care for patients with congenital neurological conditions like Chiari malformation. [8:35 - 11:51] Determining the Right Approach Dr. Greenfield explains how he and his team determine whether their patients need surgery or not, and the challenges of diagnosing and treating Chiari malformation in adults. [11:51 - 14:31] Harnessing Data to Advance Research Dr. Greenfield describes how his team is utilizing the MRI scans from over a thousand patients to develop models that could predict who may be a good candidate for surgery or other treatment avenues. [14:31 - 18:35] Advancing Diagnostics Dr. Greenfield shares his vision for an improved coordinated care model for patients newly diagnosed with Chiari malformation. [18:35 - 19:20] Credits *** Jeffrey Greenfield, MD, PhD is a board-certified neurosurgeon who specializes in pediatric neurosurgery. In addition he sees certain adult patients with congenital neurosurgical conditions. Compassionate clinical care, research, and education are all central to his philosophy as a neurosurgeon and physician. His clinical expertise includes Chiari malformation, all forms of tethered spinal cord, pediatric brain tumors and congenital neurosurgery into adulthood. As creator and director of the Chiari CARE program, Dr. Greenfield has developed an international reputation caring for children and adults with Chiari malformation, tethered cord, syringomyelia, and other associated conditions such as craniocervical instability, CSF leaks, and hydrocephalus as part of a large multidisciplinary team. For more information visit nyp.org/Advances
- Apr 16, 202617 min
Single Port Robotic Surgery Transforms Outcomes for Lung Tumor Removal
Erin Welsh is joined by Dr. Jeffrey Port, a thoracic surgeon at NewYork-Presbyterian and Weill Cornell Medicine, and a leader in thoracic surgical oncology, to discuss advances in minimally invasive robotic surgery and the unique collaborative care model that his program employs to operate on complex chest tumors. When Dr. Port first started his career, the surgical techniques used to operate on lung cancer patients were akin to open heart surgery. But in recent years, his team has pioneered new techniques in thoracic surgery, specifically a minimally invasive single port robotic approach, which utilizes a multi-finger robotic hand to operate through one incision. Weill Cornell Medicine is currently one of only 10 centers nationwide using this technology for thoracic surgery, and the highest-volume center in the country that is performing these advanced procedures. Dr. Port also discusses the unique collaborative model his team utilizes to perform complex chest tumor surgeries which oftentimes require cardiopulmonary bypass. This combination of cutting edge surgical techniques, high case volume, and a multidisciplinary approach, is meaningfully expanding treatment options for patients who cannot be treated elsewhere. Chapters: [00:00 - 04:39] Introduction to Thoracic Surgery Dr. Port and Erin discuss the standard of care for thoracic surgery as it stood a few years ago and his pioneering use of robotics in single port thoracic surgery today. [04:39 - 09:06] Recovery Benefits of Single-Port Robotic Surgery Dr. Port expands on how the technology differs from standard robotics and the recovery benefits of single-port robotic thoracic surgery. [09:06 - 13:20] NewYork-Presbyterian/Weill Cornell Medicine as Early Adopter of Innovative Technology Dr. Port details his department’s efforts as a training facility, teaching surgeons and health care professionals from across the world the techniques and workflows that contribute to their success. [13:20 - 16:16] Multidisciplinary Approach as a Key to Cardiopulmonary Care Dr. Port outlines how multi-specialty care allows his team to undertake very complex cases with success. [16:16 - 17:01] Credits *** Dr. Jeffrey L. Port is a Professor of Thoracic Surgery at Weill Cornell Medicine and a leader in thoracic surgical oncology. For more than two decades, he has helped shape Weill Cornell’s robotic thoracic surgery program and played a central role in advancing both minimally invasive and complex, high-risk chest surgery. His clinical focus spans lung cancer and other thoracic malignancies, with particular expertise in robotic approaches and coordinated cardiac–thoracic procedures for patients with advanced disease. For more information visit nyp.org/Advances
- Apr 2, 202620 min
Improving Preterm Birth Outcomes with Virtual Cervix Technology
On this episode of Advances in Care, host Erin Welsh is joined by Dr. Mirella Mourad, maternal-fetal medicine specialist at NewYork-Presbyterian and co-director of the Preterm Birth Prevention Center at Columbia, to explore a groundbreaking new technology aimed at improving the diagnosis and treatment of preterm birth. Preterm birth impacts approximately 1 in 10 pregnancies in the United States, making it a leading cause of neonatal complications and long-term health challenges. But despite its prevalence and associated risks, innovative solutions to address the condition have lagged behind. To address this gap, Dr. Mourad and her collaborator, Dr. Kristin Meyers, a professor of mechanical engineering at Columbia’s School of Engineering, are developing a new tool: a patient-specific “digital twin” of the cervix. This advanced technology has the potential to revolutionize obstetric care for patients, by allowing clinicians to test new treatment methods, collect data to better understand why certain people are at risk for preterm birth, and overall, catalyze innovation in the historically under-researched field of maternal-fetal medicine, ultimately helping to drive better outcomes and successful pregnancies. Dr. Mourad also discusses how this digital twin can potentially assist with identifying women with placenta accreta spectrum disorder, and inform more precise and proactive treatment plans for patients with this high-risk condition. *** Mirella Mourad, MD is the Co-Director of the Preterm Birth Prevention Center and a Maternal-Fetal Medicine specialist at Columbia University Irving Medical Center. She is particularly interested in the medical diseases that affect pregnancy, focusing on maternal cardiac conditions, autoimmune diseases, and surgical complications involving abnormal placentation. Dr. Mourad is a fellow of the American College of Obstetricians and Gynecologists and a member of the Society of Maternal-Fetal Medicine. For more information visit nyp.org/Advances
- Mar 19, 202619 min
How ECMO Leadership is Driving Improved Survival and Post-ICU Recovery
On this episode of Advances in Care, Erin Welsh is joined by Dr. Cara Agerstrand, director of the Medical ECMO Program at NewYork-Presbyterian and Columbia, and Dr. Matthew Baldwin, critical care specialist at NewYork-Presbyterian and research lead of Columbia’s Baldwin Lab which focuses on the study of critical illness survivorship. Thousands of people suffer from cardiopulmonary conditions such as cardiac arrest and severe respiratory illnesses in the United States every year, with many requiring mechanical ventilation and critical care in the ICU. To better serve these patients, NewYork-Presbyterian and Columbia has built a renowned program to manage these patients on rescue therapies like extra-corporeal membrane oxygenation (ECMO), the most advanced form of cardiopulmonary life support. Since 2009, the team at NewYork-Presbyterian and Columbia has established an expertise to care for the sickest respiratory and cardiac failure patients with this technology, and has been at the forefront of utilization which has rapidly evolved from early pediatric use to post H1N1 and COVID surges. The standards of care for ECMO treatment and patient outcomes set by New York Presbyterian and Columbia over the past decade has earned them recognition as an ELSO Platinum Level Center of Excellence, one of only a few centers worldwide to have consistently achieved this status since it was first awarded. The team takes this expertise further through advanced research in The Baldwin Lab, which focuses on a variety of projects to better understand the biological factors of why some patients fully recover from ICU stays and others do not, as well as physical, mental, and emotional wellbeing for patients. *** Dr. Cara Agerstrand is an Associate Professor of Medicine and Director of the Medical ECMO Program at Columbia University Irving Medical Center / NewYork-Presbyterian Hospital. Dr. Agerstrand completed her Internal Medicine residency and Pulmonary & Critical Care fellowship at Columbia University Irving Medical Center. She is an elected member of the Steering Committee of the Extracorporeal Life Support Organization, a member of the ECMO and Mechanical Circulatory Support Domain Task Force of the American College of Chest Physicians and is extensively involved in clinical care, research, and educational efforts involving extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCO2R). She has special interests in the use of ECMO for severe forms of the acute respiratory distress syndrome (ARDS), pulmonary hypertension and in pregnant and postpartum patients. Dr. Agerstrand is widely published and is an internationally invited speaker. Dr. Matthew Baldwin, MD, MS, is a board-certified pulmonary and critical care physician and clinical investigator with a Masters in Biostatistics. Dr. Baldwin’s laboratory aims to improve critical illness survivorship. His research into survivors of acute respiratory failure works to elucidate the mechanisms of post-ICU frailty as therapeutic targets for improving physical recovery. He has identified frailty subtypes in acute respiratory failure survivors, and discovered that aging-related plasma biomarkers of inflammation, neuro-endocrinopathy, and muscle mitochondrial myopathy are potential therapeutic targets for post-ICU interventions. His research related to palliative care aims to improve ICU survivorship, and he has developed novel palliative care interventions for mechanical ventilation patients, such as chaplain-led communication-board-guided spiritual care. For more information visit nyp.org/Advances
- Mar 5, 202615 min
Phase 3 Trial Reduces Risk of Progression in Metastatic Prostate Cancer
On this episode of Advances in Care, host Erin Welsh is joined by Dr. Scott Tagawa, medical oncologist at NewYork-Presbyterian and director of the Genitourinary Oncology Program at Weill Cornell Medicine, to talk about the latest developments in prostate cancer care. Prostate cancer is the most common cancer in men after skin cancer, with 5-10% of patients presenting with metastasis at the time of diagnosis. Advancing treatment options for men with metastatic disease remains a critical priority in oncology. To address this challenge, Dr. Tagawa recently led a promising Phase III randomized trial– called PSMAddition– to assess radioligand therapy, a subset of targeted radionuclide therapy, or TRT. This new therapeutic agent, lutetium PSMA-617, is being tested in men with hormone-sensitive metastatic prostate cancer. Radioligand therapy works by seeking prostate-specific membrane antigens (PSMAs) to deliver radiation to prostate cells throughout the body while minimizing surrounding damage that other therapies can sometimes cause. The results from the PSMAddition trial were significant. The addition of TRT in addition to standard hormone treatment slowed cancer progression by 28%, yielded notable declines in PSA levels, and proved benefits across patient subgroups. The PSMAddition trial is the first to analyze the use of this treatment regimen earlier in care and could potentially redefine the standard of care for patients with metastatic prostate cancer. While metastatic prostate cancer remains incurable, combination strategies incorporating PSMA-targeted therapy represent a promising pathway for expanding the quality and quantity of life for patients, and may prove beneficial as a first-line treatment. This breakthrough trial builds on 25 years of innovation in prostate cancer research at NewYork-Presbyterian and Weill Cornell Medicine, where foundational discoveries helped advance the development of PSA and PSMA-targeting agents that are now transforming cancer care. *** Scott T. Tagawa, MD, MS, FACP, FASCO, is a Professor of Medicine and Urology at Weill Cornell Medicine, and an Attending Physician at NewYork-Presbyterian – Weill Cornell Medical Center. His research covers clinical and translational investigations in genitourinary tumors and thrombosis (blood clotting) in people with cancer. As the Medical Director of the Genitourinary Oncology Research Program, Dr. Tagawa leads clinical trials in the areas of prostate, kidney, and bladder cancer as well as the prevention and treatment of thrombosis with cancer. He specializes in drug development and theranostics in prostate cancer. Dr. Tagawa also serves as leader of the GU Disease Management Team and co-leader of the Experimental Therapeutics Program of the Meyer Cancer Center. He is the WCM principal investigator for the Alliance for Clinical Trials in Oncology (formerly CALGB), serving on the Board of Directors and as a funded member of the Genitourinary Committee. For more information visit nyp.org/Advances
- Feb 19, 202617 min
Breakthrough Technology Improves Concussion Assessment and Player Safety
On this episode of Advances in Care, host Erin Welsh sits down with Dr. Thomas Bottiglieri, chief of the primary care sports medicine division at NewYork-Presbyterian and Columbia, to discuss the evolving landscape of concussion care– from prevalence to emerging diagnostic breakthroughs. With over 2 million estimated concussions occurring annually in the United States, and many of them affecting young athletes, Dr. Bottiglieri and his colleagues have sought to develop a more accurate and accessible way to objectively diagnose concussion. While a single injury may not cause long term issues, research shows that repeated head trauma– and lack of proper care– can lead to premature neurodegeneration. During their research to improve diagnostic measures, Dr. Bottiglieri and his team discovered a biomarker associated with severe concussions: a subtle tremor of the head and neck that becomes amplified when a concussed patient tries to visually focus on a target. This discovery led to the development of ProScope, an innovative eyetracking software tool that measures head and neck stability and can detect the diagnostic biomarker with over 80% sensitivity. With the advent of these tools, clinicians can now, for the first time, objectively measure concussion. A former competitive athlete himself, Dr. Bottiglieri hopes that the ProScope tool can become commercially available to improve access to cost-effective diagnosis, ensuring that athletes– or anyone with a head injury– can recover safely and return to the activities they love. ***Thomas S. Bottiglieri, D.O. is a sports medicine physician specializing in the management of orthopedic injuries and disorders impacting athletes at all skill levels from adolescents to seniors. In addition to treating the full spectrum of muscle, bone, tendon, and joint injuries, Dr. Bottiglieri is a nationally recognized expert in the field of concussion care. His practice stresses shared decision-making with patients and their families and uses the latest medical technology, evidence-based sports medicine, and a compassionate, patient-centered approach.For more information visit nyp.org/Advances
About Advances in Care
On Advances in Care, epidemiologist and science communicator Erin Welsh sits down with physicians from NewYork-Presbyterian hospital to discuss the details behind cutting-edge research and innovative treatments that are changing the course of medicine. From breakthroughs in genome sequencing to the backstories on life-saving cardiac procedures, the work of these doctors from Columbia & Weill Cornell Medicine is united by a collective mission to shape the future of health care and transform the lives of their patients. Erin Welsh, who also hosts This Podcast Will Kill You, gets to the heart of her guests’ most challenging and inventive medical discoveries. Advances in Care is a show for health careprofessionals and listeners who want to stay at the forefront of the latest medical innovations and research. Tune in to learn more about some of medicine’s greatest leaps forward. For more information visit nyp.org/Advances
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