Clinicians

Innovations in Geriatric Cardiology: Greater New York Geriatric Cardiology Consortium Kick-off Event

by Columbia Surgery on July 25, 2011

Attention: Health care providers who treat older adults with cardiovascular disease

Greater New York Geriatric Cardiology Consortium

Greater New York Geriatric Cardiology Consortium

You are invited to attend the Greater New York Geriatric Cardiology Consortium’s kick-off event Friday, September 9, 2011 at the Vivian and Seymour Milstein Heart Center, NewYork-Presbyterian/Columbia, New York.

As described in a recent Journal of the American College of Cardiology white paper, it is time for a new paradigm in cardiac care of older adults. According to Mathew Maurer, MD, “There are significant disparities between the needs of older adults and the current status of cardiac care today.” To address this challenge, noted experts throughout the New York area have formed the Greater New York Geriatric Cardiology Consortium (GNYGCC).

Newly established in 2011 with NIH funding, GNYGCC includes members from Columbia University Medical Center, Albert Einstein College of Medicine/Montefiore Medical Center, Mount Sinai Medical Center, New York University, Rockefeller University, Weill Cornell Medical Center, and Yale School of Medicine. Their goal is to improve the care of older adults with cardiovascular disease by organizing professional medical education activities and performing innovative, multi-center and multi-disciplinary investigator-initiated clinical research.

After Innovations in Geriatric Cardiology in September, the consortium will set out to identify the current state of affairs among aging patients with cardiovascular disease through its ongoing seminar series, beginning in October, 2011. Thirteen topics will be covered in this series, which is modeled after the Essentials of Cardiac Care in Older Adults (ECCOA) curriculum.

The kick-off event on September 9 will include plenary sessions by nationally noted experts. Sessions will be followed by members’ presentations of current research, cocktails, and hors d’oeuvres.

Participants who attend the seminar series during the following year will receive a Certificate of Attendance from Columbia University.

Innovations in Geriatric Cardiology is free and open to all health care practitioners, but space is limited. To register for this event, please contact info@gnygcc.org.

For more information about the seminar series, please visit Innovations in Geriatric Cardiology: Greater New York Geriatric Cardiology Consortium Kick-off Event or call Stephen Helmke at 212-932-4537

Tagged as: cardiac, CME

{ 0 comments }

superDimension ENB: New technology helps diagnose lung nodules

by Columbia Surgery on July 20, 2011

Every year, a half million bronchoscopies are performed in the U.S. in order to investigate lesions within patients’ lungs. Because conventional bronchoscopy cannot reach the distant regions of the lungs, more invasive surgical procedures are often needed to diagnose lung nodules that may be malignant.

The General Thoracic Surgery Division at NewYork-Presbyterian/Columbia has begun using a new technology, superDimension Electromagnetic Navigation Bronchoscopy™ (ENB). ENB creates a computer-generated reconstruction of the lungs from a CT scan of the tracheobronchial tree, explains Lyall A. Gorenstein, MD, FRCS (C), FACS, Director, Minimally Invasive Thoracic Surgery. Using these reconstructed images, the system creates a visual pathway so that surgeons can guide steerable catheters to where lung nodules are located, facilitating examination and biopsy.

“This enables us to diagnose lung nodules which may not be easily diagnosed without surgical procedures,” Dr. Gorenstein says. “It also allows better staging of lung cancers in patients with a known lung cancer who may have other nodules in the lung.” By enabling surgeons to determine whether nodules in a patient’s other lung may be malignant, ENB improves their ability to accurately determine what stage a cancer has progressed to (staging) and provide better treatment.

“Traditionally, we do not try to biopsy small lesions because such biopsies are not reliable,” Dr. Gorenstein continues. “Instead, we usually follow the patient with CT scans over time. For patients with lesions as small as 7 or 8 mm, this technology will alleviate the need for surveillance CT and its radiation exposure”

Tagged as: cancer, Gorenstein, lung

{ 2 comments }

Dr. Feldman Comments in General Surgery News Article on Study of Breast Cancer Treatment Patterns

by Columbia Surgery on July 8, 2011

Sheldon Feldman, MD, Chief of the Breast Surgery Section at NewYork-Presbyterian/Columbia, provided commentary in a General Surgery News article about a novel study evaluating breast cancer treatment methods. The review of more than 2,000 breast cancer operations showed that patients who were treated by surgical oncologists were significantly more likely to survive and to undergo breast conserving procedures than those patients treated by general surgeons. The results were presented at the 2011 annual Cancer Symposium of the Society of Surgical Oncology and reviewed in the article “Practice Patterns Account for Breast Cancer Survival.“*

Conducted by the University of Oklahoma, the study attributes the disparity in clinical outcomes to patterns of care rather than particular surgical techniques. Most importantly, it emphasizes the greater tendency of surgical oncologists to enroll their patients in clinical trials, as well as to offer their patients advanced multidisciplinary care.

In the General Surgery News article, Dr. Feldman stresses the importance of this research, and discusses ways that general surgeons could adjust their practices in order to replicate the superior clinical outcomes achieved by the surgical oncologists. He suggests that if general surgeons had the same access to multidisciplinary support, and were sufficiently motivated and institutionally capable of offering clinical trials, then outcomes for breast cancer patients could perhaps be improved.


* Readers will need to provide free registration information to access this article.

Tagged as: breast, cancer, Feldman

{ 4 comments }

9th Annual Vascular Surgery & Wound Healing CME Symposium

by Columbia Surgery on June 30, 2011

Center: James F. McKinsey, MD, FACS

From l to r: Darren B. Schneider, MD; James F. McKinsey, MD, FACS; John H. Rundback, MD

On May 12th and 13th, NewYork-Presbyterian Hospital hosted its 9th Annual Vascular Surgery & Wound Healing CME Symposium at the Marriott Marquis in New York City. Approximately 350 people attended the popular event, including clinicians from all over the country, as well as from Australia, Korea, and the UK.

The two-day educational event focused on the most up-to-date techniques for the treatment of peripheral vascular disease. Forty nationally renowned speakers gave 75 presentations over the course of the two-day symposium, addressing issues in current clinical practice, complications and pitfalls of newer technologies, the evolution of the field, and all major areas of vascular disease. The informative presentations were supplemented by interactive lunch sessions that included a hands-on negative pressure wound therapy lunch session. The Wound Healing aspect of the symposium is only in its second year, but has had a very positive response and is likely to remain a part of the program in the years to come.

Rajeev Dayal, MD, FACS

Rajeev Dayal, MD, FACS

The 14.5 CME Accredited Program was intended for a diverse audience of surgeons, cardiologists, therapists, nurses, and specialists of other kinds. Thirty-seven supporting companies were also in attendance, contributing to the already impressive wealth of information and resources regarding vascular disease that had been assembled for the occasion.

To to be notified about next year’s event or other continuing medical education seminars please provide us with your contact information on our clinician mailing list.

Tagged as: CME, vascular, wound

{ 0 comments }

Study Begins to Explain Why Surgery Cures Type 2 Diabetes

by Columbia Surgery on June 9, 2011

Science Translational Medicine

Science Translational Medicine

The April 27, 2011 issue of Science Translational Medicine included a study titled “Differential Metabolic Impact of Gastric Bypass Surgery Versus Dietary Intervention in Obese Diabetic Subjects Despite Identical Weight Loss.”

Melissa Bagloo, MD, Assistant Professor of Clinical Surgery at the Center for Metabolic and Weight Loss Surgery, NYP/Columbia, explains the context and importance of this study.

Q: What did this study find?

Dr. Bagloo: For years, surgeons have observed that gastric bypass surgery cures diabetes in over 80% of patients with diabetes. This improvement in blood sugar levels happens almost immediately after surgery, and far before any significant weight loss occurs. What’s more, studies have found that when patients lose the same amount of weight through diet as other patients lose after surgery, those who had surgery experience significantly better improvement in their diabetes than those who lost weight non-surgically. So we know surgery dramatically improves or resolves diabetes, but we do not know why this happens.

This recent study in Science Translational Medicine found an important clue as to why this effect may occur. The researchers found that after gastric bypass surgery, the levels of a certain type of amino acids (branched-chain amino acids) circulating in the blood were significantly reduced. This reduction in amino acids improved patients’ sensitivity to insulin, having the effect of normalizing their blood sugar levels.

Q: Why is this finding important?

Dr. Bagloo: The molecular mechanisms that cause diabetes are still unknown to us. Elevated amino acids have been identified previously in diabetic patients, but this is the first study to compare surgical with non-surgical weight loss. In that context, observing reduced amino acids after surgery clearly adds to our body of knowledge about the role they may play in the mechanisms underlying diabetes.

Q: Do you perform weight loss surgery specifically to treat diabetes?

Dr. Bagloo: The use of weight loss surgery to treat diabetes is called metabolic surgery, and as our knowledge has increased, metabolic surgery has become a very important therapeutic option for patients with morbid obesity and diabetes. The Center for Metabolic and Weight Loss Surgery at NYP/Columbia has been at the forefront of advancing and studying metabolic surgery for about a decade, and the use of metabolic surgery has been well established in diabetic patients with a body mass index (BMI) of 35 or greater. At this time, we are now studying the effect of weight loss surgery among patients with diabetes and BMI between 30-35. Select patients with BMI between 30-35 may be eligible for participation in the Diabetes Surgery Study, which is currently underway.

Visit the NYP/Columbia Center for Metabolic and Weight Loss Surgery or call 212.305.4000 for more information about metabolic surgery or the Diabetes Surgery Study. Read more about the Science Translational Medicine study in NPR’s health blog post, “New Clues To Why Gastric Bypass Surgery Cures Type 2 Diabetes”.

Tagged as: Bagloo, diabetes, weightloss

{ 1 comment }

M. Wasif Saif, MD, MBBS, Authors Study in Anticancer Research, March 2011

by Columbia Surgery on June 9, 2011

Anticancer Research

Study finds pancreatic cancer drug helps to overcome resistance to chemotherapy.

Erlotinib (Tarceva) is an oral medication approved by the FDA as a first-line therapy for stage 4 pancreatic cancer. In an article published in Anticancer Research, in March 2011 M. Wasif Saif, MD, MBBS, describes previously undocumented findings about additional benefits of this drug.

The article, “Does erlotinib restore chemosensitivity to chemotherapy in pancreatic cancer? A case series”, explains that not only does erlotinib work as a first-line treatment, but it works in second and third lines, even after a patient may fail chemotherapy. “If a person becomes resistant to chemotherapy,” Dr. Saif explains, “adding erlotinib to chemotherapy such as gemcitabine helps the patient respond to chemotherapy again.” The ability of erlotinib to restore sensitivity to gemcitabine was a significant discovery in itself, but the study also found it restored sensitivity to different kinds of therapy as well. “That is beautiful,” says Dr. Saif. “We did not know the drug worked like that.”

Dr. Saif is a clinical trialist and translational researcher, meaning that he collaborates directly with researchers in the laboratory and helps to translate their work into clinical therapies for faster study and use in patients. Dr. Saif joined the faculty at NewYork-Presbyterian/Columbia in 2010 and is currently working on several new drugs for pancreatic cancer.

For more information about clinical trials of pancreatic cancer therapies, see Pancreas Center Clinical Trials.

Tagged as: cancer, clinicaltrials, pancreas

{ 0 comments }

Advances in Liver Transplantation: Abstracts presented at the American Transplant Congress in May, 2011

by Columbia Surgery on June 2, 2011

American Transplant Congress

American Transplant Congress

Each year, the nation’s leading transplant surgeons convene at the American Transplant Congress, a joint meeting of the American Society of Transplant Surgeons (ASTS) and the American Society of Transplantation (AST). Surgeons from NewYork-Presbyterian Hospital/Columbia University Medical Center presented the results of their latest research, including the following.

Presentation 1: Excellent Outcomes of Machine Preservation of “Orphan” Extended Criteria Liver Allografts: Interim Results of a Phase 2 Trial;.

James V. Guarrera, Benjamin Samstein, Scot D. Henry, Claudia Musat, Charlotte Fisher, Theresa Lukose, Tomoaki Kato, Jean C. Emond. Division of Abdominal Organ Transplantation.

Between the time a liver is retrieved from a donor and transplanted into the recipient, it must be very carefully preserved in order to maintain optimal function. An approach known as cold storage (CS), essentially keeping the organ on ice during transport, has been the standard practice in liver transplant for 20 years. Now there is new evidence that a technique called hypothermic machine perfusion (HMP) outperforms standard preservation, according to the first-ever study comparing the impact of the two techniques on transplant outcomes. The phase I study was carried out by Dr. James Guarrera and his colleagues at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Unlike cold storage, which Dr. Guarrera describes as a static technique, HMP dynamically simulates “aliveness” by providing a continuous flow of oxygen and key nutrients to the liver while diluting and removing toxins and waste products. In his presentation to the American Transplant Congress in May 2011, Dr. Guarrera reported that HMP reduced injury to donor organs effectively enough that organs declined elsewhere for transplantation could be preserved well enough to function successfully after transplantation. Of 15 ‘extended criteria’ livers preserved using HMP in this study, all had good function after transplantation. Fourteen patients were alive and well at the time of presentation, and one patient had died due to multidrug resistant Klebsiella sepsis.

Watch for ATS Presentations 2 and 3 later this month at columbiasurgery.net.

Tagged as: Emond, Guarrera, Kato, liver, Samstein, transplant

{ 0 comments }

CATCH-UP 2011: Heart Failure, Devices, and Interventions

by Columbia Surgery on May 31, 2011

CATCH-UP 2011: Heart Failure, Devices, and Interventions

CATCH-UP 2011: Heart Failure, Devices, and Interventions

On May 5, 2011, NewYork-Presbyterian Hospital/Columbia University Medical Center presented CATCH-UP 2011: Heart Failure, Devices, and Interventions in New York. This CME course was intended for cardiologists, interventional cardiologists, cardiothoracic surgeons, internists, and other medical professionals involved in the care of patients with heart failure. Sessions covered the latest clinical trials in heart failure, device therapy for cardiogenic shock, destination therapy for LVADs, updates on current investigational therapies, and more.

Over 240 participants attended the conference. They were particularly delighted at the opportunity to hear Robert Jarvik, MD, inventor of the artificial heart, speak on the evolution of cardiac devices. Other presenters included directors and faculty at the Division of Cardiology, Division of Cardiothoracic Surgery, the Center for Advanced Cardiac Care, Endovascular Services, the Cardiac Transplant Program, and others at NewYork-Presbyterian/Columbia.

For information on CATCH-UP 2011 or other CME events at NewYork-Presbyterian/Columbia, please visit: www.ColumbiaSurgeryCME.org

Tagged as: CME, LVAD

{ 0 comments }

Pancreatic Cancer Vaccine Trial Opens at NYP/Columbia’s Pancreas Center

by Columbia Surgery on May 26, 2011

M. Wasif Saif, MD, MBBS

M. Wasif Saif, MD, MBBS

Unlike some other forms of cancer, pancreatic cancer is often detected only in advanced stages, making it one of the most deadly forms of cancer overall. Surgical removal of tumors is possible in only 10% to 20% of patients, chemotherapy is not nearly as beneficial as patients and physicians would hope, and the risk of recurrence after treatment is high. Given these conditions, researchers are working hard to develop alternative therapies that extend patients’ lives past the average survival time, 20 months after diagnosis.

One of the most promising areas of research entails development of vaccines to harness the immune system to fight the cancer from within. An important study at NewYork-Presbyterian/Columbia’s Pancreas Center is now moving this concept one step closer to reality. The trial is studying whether a new vaccine, developed specifically to target pancreatic cancer cells, will help to prevent recurrences among patients who have had pancreatic tumors surgically removed.

The trial includes two arms: 350 patients will receive chemotherapy alone or with radiation therapy, and 350 will receive chemotherapy alone or with radiation, plus the new pancreatic cancer vaccine. Those receiving the vaccine will receive a series of injections, administered one month apart, beginning 8 to 10 weeks after surgery. Patients will be monitored every three months for the first 36 months, every 6 months for 2 years, and then annually to determine whether the vaccine helps to reduce the rate of recurrence.

The vaccine in this phase III trial was developed on the basis of a hypothesis called hyperacute immunotherapy. According to M. Wasif Saif, MD, MBBS, immunotherapy works by causing “hyperacute rejection:” in the way that other vaccines cause the body to develop an immune response against measles, polio or another disease, the pancreatic cancer vaccine triggers an immune reaction that leads to immunity against specific pancreatic cancer cells. In this case, the pancreatic cancer vaccine is produced using alpha-GT epitopes from mouse cells, which are not found on human cells. These epitopes cause a reaction that leads human cells to attack pancreatic cancer cells from within (called cell mediated immunity).

Data from a multicenter phase II study (preceding the current phase) showed encouraging results for this therapy. At 12 and 24 months after surgery, survival rates were 91% and 54% respectively, which is a significant improvement upon the median survival rate of 16 months. Patients are still being followed up to determine long-term survival benefits.

The phase III trial opened at NewYork-Presbyterian/Columbia in late April 2011. Dr. Saif strongly encourages eligible patients to consider enrolling in this trial. As he explains, “This is an important study for every patient and family member with pancreatic cancer. It is very important to come to centers that offer this study, and to understand that we now have more therapies to offer to patients with pancreatic cancer.”

To read about hyperacute immunotherapy for pancreatic cancer, see Dr. Saif’s March, 2011 article in the Journal of the Pancreas, Adjuvant therapy of pancreatic cancer: beyond gemcitabine. Highlights from the “2011 ASCO Gastrointestinal Cancers Symposium”. San Francisco, CA, USA. January 20-22, 2011.

For information about pancreatic cancer, treatments at the Pancreas Center, and other clinical studies, please visit The Pancreas Center.

Tagged as: cancer, clinicaltrials, pancreas, Saif, vaccine

{ 14 comments }

Breast Cancer Trial: NYP/Columbia Tests Intraoperative Radiofrequency Ablation after Lumpectomy

by Columbia Surgery on May 12, 2011

The Breast Surgery Division at NewYork-Presbyterian/Columbia is now offering intraoperative radiofrequency ablation (RFA) to women undergoing breast conservation surgery as part of a protocol to study whether RFA will reduce the need for re-operation.

Women with early stage breast cancer are increasingly choosing breast conservation surgery (lumpectomy) because it is less invasive and results in a more natural cosmetic outcome than mastectomy. Yet the rates of re-operation after BCS can vary between 25-49%, due to the presence of tumor cells remaining in the surrounding tissue after the tumor is removed.

The current study, called the ABLATE Registry (Radiofrequency Ablation After Breast Lumpectomy (eRFA) Added To Extend Intraoperative Margins in the Treatment of Breast Cancer), aims to determine whether the use of RFA will decrease the rate of second operations to clear involved margins in women undergoing lumpectomy. Additional goals are to evaluate the effect of RFA on patients’ cosmetic outcomes and quality of life; to monitor side effects and complications associated with RFA; and to evaluate the effects of RFA on post-operative imaging.

Mammography showing Breast Cancer

Mammography Showing Breast Cancer

Women who choose to participate will have RFA applied to the lumpectomy cavity during the same procedure once their tumors are surgically removed. The RFA treatment helps to ensure that no tumor cells remain in that tissue by destroying any cells close to the surgical margin, and thereby eliminate the need for a second surgery to remove more breast tissue.

According to Sheldon Feldman, MD, Chief, Breast Surgery Section, “We are very excited to be able to offer intraoperative radiofrequency to women who are are undergoing breast conservation surgery. This technique will help reduce the number of patients requiring a second operation to remove additional cancerous breast tissue. It is also likely that some patients may be spared post-lumpectomy radiation treatments. This is a significant advance in patient care that may expand the role of breast conservation to areas of the world where radiation facilities are not readily available.”

At the time of publication, four patients have been treated under this protocol at the Breast Center. Leaders of the ABLATE Registry hope to expand it to additional centers, but at this time NYP/Columbia is the only center in the New York area to offer this therapy.

Patients over age 50 who are undergoing breast conservation surgery for stage 0, I or II breast cancer may be eligible to participate in the ABLATE Registry. For more information, see Herbert Irving Comprehensive Cancer Center Clinical Trials, Study ID:AAAF3783, or call 212.305.9676.

Tagged as: breast, cancer, clinicaltrials, Feldman

{ 3 comments }

← Previous Entries

Next Entries →