Advances in Care

On this episode of Advances in Care, host Erin Welsh revisits her conversation with Dr. Joel Gabre, a gastroenterologist at NewYork-Presbyterian and Columbia who specializes in cancer care. They discuss the ongoing rise in colorectal cancer rates among younger individuals. Dr. Gabre lays out trends observed by the medical community in colorectal cancer rates, including the increasing likelihood by birth cohort for patients to develop this disease. He also talks about the main differences in colorectal cancer for patients from these different cohorts, most notably the location where cancers are likely to develop in the colon. 

Dr. Gabre also shares some of the leading hypotheses for why colon cancer rates are rising in younger people, and that clinicians and researchers are focused on searching for answers to improve prevention and treatment options. He gets into the importance of the western diet in developing these forms of cancer and shares details about his team’s recent findings regarding changes at the cellular level that could be contributing to the accelerated growth of these cancers. 

Finally, Dr. Gabre speaks to his personal experiences as a gastroenterologist who has seen first-hand the rise in colon cancer rates among his patients. He shares a story of what motivated him to begin researching the cellular mechanisms driving colorectal cancer in young people, with the hope of finding a solution. 

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Dr. Joel Gabre is a gastroenterologist and GI cancer genetics specialist interested in studying diseases of the upper GI tract with particular focus on the esophagus. He completed his undergraduate degree at Johns Hopkins University in biophysics, medical degree at the University of Maryland, internal medicine residency at the University of Cincinnati, and gastroenterology fellowship and post-doctoral research fellowship at the University of Pennsylvania, where he was chief GI fellow. He currently serves as Assistant Professor of Medicine at Columbia University Irving Medical Center in the Division of Digestive and Liver Diseases and as a member of the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian and Columbia. 

For more information visit nyp.org/Advances 

CHAPTERS   

[00:00 – 5:26] Rising Rates of Colon Cancer  

Dr. Joel Gabre introduces the emerging trends in patient demographics for colorectal cancer, and the differences in where the cancer tends to be located between early vs late onset.  

[5:26 – 11:31] Using Single-Cell RNA Sequencing to Profile Tumors 

Dr. Gabre shares the story of a young patient who presented with metastatic colorectal cancer, and how that experience inspired him to focus on studying colorectal cancer. Dr. Gabre discusses his research in profiling early-onset and late-onset tumors using single-cell RNA sequencing.  

[11:31 – 14:14] Inferring the Data 

Dr. Gabre talks about the findings from the study, which showed an increase in inflammatory markers in the early-onset samples and led to a new hypothesis.  

[14:14 – 16:28] Developing Biomarkers 

Dr. Gabre discusses how identifying a biomarker could help identify which patients may need to be screened for colorectal cancer earlier in life.  

[16:28 – 17:14] Credits 

On this episode of Advances in Care, host Erin Welsh revisits a recent conversation about psychedelic drug therapies for psychiatric disorders. First Erin 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.

For more information visit nyp.org/Advances

CHAPTERS

[00:00 – 5:43] The Challenges of Conventional Treatments for Major Depression

Dr. Richard Friedman shares the shortcomings of relying on SSRIs and SNRIs for major depression. 

[5:43 – 9:15] Psychedelics and the Default Mode Network

Dr. Friedman outlines how psychedelics like psilocybin can stimulate a specific serotonin receptor and quiet the Default Mode Network, redirecting the brain’s focus away from rumination and distressing thought cycles. 

[9:15 – 15:02] Challenge of Clinical Testing 

Dr. Friedman outlines a key challenge in clinically testing psychedelics, such as finding a successful placebo. Dr. David Hellerstein shares how he and his team designed a study around synthetic psilocybin, and how they approached the placebo challenge with microdoses. 

[15:02 – 19:49] Potential Applications for Different Psychedelics 

Dr. Hellerstein discusses applications for different types of psychedelics, which includes looking to MDMA for treating Post Traumatic Stress Disorder or using DMT to treat patients with Long Covid. 

[19:49 – 20:37] Credits

On this episode of Advances in Care, host Erin Welsh revisits the story behind the GUARDIAN study, which screens thousands of newborn babies 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, former 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. 

Since recording this episode, Dr. Orange has taken on the role of pediatrician-in-chief of the Children’s Hospital of Philadelphia. Under his leadership, the department of pediatrics received consistent funding for research projects, reaching its highest level in 2024. This podcast conversation is a direct reflection of his team’s commitment to advancing children’s health at NewYork-Presbyterian and Columbia. 

For more information visit nyp.org/Advances 

CHAPTERS:  

[00:00 – 7:024 Establishing the GUARDIAN Program 

Dr. Jordan Orange introduces the GUARDIAN Program, a newborn screening panel that can detect over 450 rare and treatable genetic conditions.  

[7:24 – 13:48] Early Detection of Severe Combined Immune Deficiency (SCID) 

Dr. Orange emphasizes the importance of genetic diversity in the testing population for the GUARDIAN study. Dr. Joshua Milner, co-author of the study, talks about how the GUARDIAN screening detected a patient with severe combined immune deficiency and allowed for early intervention.  

[13:48– 17:45] Identifying Wilson’s Disease with GUARDIAN 

Dr. Steven Lobritto shares how identifying Wilson’s disease before complications manifest later in life allows for a simple treatment that can enable patients to avoid organ damage and transplant.  

[17:45 – 21:41] Long QT Syndrome and Results of GUARDIAN  

Dr. Eric Silver discusses how early detection of Long QT Syndrome found the same gene in a child and their father and led to both starting medication to prevent abnormal heart rhythms. Dr. Orange also discusses the implications and future goals of this study.  

[23:01 – 23:45] Credits 

On this episode of Advances in Care, Erin Welsh speaks with Dr. Lawrence Lustig, otolaryngologist-in-chief at NewYork-Presbyterian and Columbia. Dr. Lustig has spent decades working to advance various interventions to treat genetic deafness and after years of research, his team was the first to show that gene therapies could be effective at reversing hearing loss in mouse models.

Dr. Lustig focused his initial study on otoferlin, a gene that is missing in people with a rare form of genetic deafness, and how to safely deliver it back to patients. Starting with mouse models and solving for the uniquely large size of the gene, they discovered that packaging otoferlin with an adeno-associated virus and injecting it into the ear completely reversed deafness. From there, they began the process of trialing this approach in humans at NewYork-Presbyterian and Columbia. The trials were successful, leading to natural hearing restoration in most patients, and in April 2026 the work culminated with an FDA approval of the first ever gene therapy for genetic deafness based on the research pushed forward by Dr. Lustig and his team.

Dr. Lustig’s team has trialed the therapy in patients across a range of ages, from six years old to thirty-one, and have seen hearing restoration take place to varying degrees. This means that unlike cochlear implant surgery, which has to be performed at a young age, this research could have important implications for treating patients into adulthood. It is also laying critical groundwork for continued gene therapy trials for other forms of genetic deafness.

Chapters: 

[00:00 – 08:15] Identifying the Right Gene Therapy for Hearing Loss

Dr. Lawrence Lustig tells the story of how he and his team targeted the otoferlin gene, a rare cause of genetic deafness when missing, to successfully reverse hearing loss in mouse models. 

[08:15 – 9:51] From Mouse Model to Clinical Trial and FDA Approval

Dr. Lustig shares the process his team undertook to move this groundbreaking discovery from mouse models into human subjects, eventually leading to FDA approval for the first ever gene therapy for genetic deafness.

[9:51– 16:10] Patient Responses to Restored Natural Hearing

Dr. Lustig describes the impact that restoration of natural hearing has on his patients and their families. He explains why the setting of a large academic medical center at NewYork-Presbyterian and Columbia was critical in recruiting patients and the success of these trials. 

[16:10– 17:46] Results and the Future of Treatment for Genetic Hearing Loss

Dr. Lustig shares the results from the otoferlin clinical trials and describes how this groundbreaking research could impact treatments for more common forms of genetic deafness in the future.

[17:46 – 18:25] Credits

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Dr. Lawrence Lustig is Chair of Otolaryngology–Head & Neck Surgery at NYP/Columbia and a nationally recognized otologist, neurotologist, and researcher specializing in hearing loss and gene therapy. Over the course of his career, Dr. Lustig has helped pioneer some of the foundational research that led to the development of gene therapies for inherited deafness. His laboratory was among the first to demonstrate complete restoration of hearing in animal models using gene therapy, and he played a leading role in the development and clinical testing of the recently FDA-approved otoferlin gene therapy, the first gene therapy approved to restore hearing in children with a rare genetic form of deafness. His work focuses on translating cutting-edge discoveries in molecular medicine into transformative treatments for patients with hearing loss.

For more information visit nyp.org/Advances

On this episode of Advances in Care, Erin Welsh is joined by Dr. Barbara Ma, a medical oncologist at NewYork-Presbyterian who leads Cellular Therapy for Solid Tumors at Weill-Cornell Medicine. Dr. Ma and her team are at the forefront of advancing cell-based treatments which include tumor-infiltrating lymphocyte therapy—or TIL—a groundbreaking cell therapy for metastatic melanoma that received FDA approval in 2024. Their program is one of only a handful in the United States with the expertise and infrastructure to offer TIL therapy to patients with advanced melanoma based on the complexity of this treatment approach.

The process for administering TIL is multi-step beginning with the surgical removal of a patient’s tumor, from which the potent TIL cells are isolated, and grown in large quantities in a lab. These enhanced immune cells are then infused back into the patient’s body, to attack the malignant tumor directly. This process requires close supervision of the patient due to the side effects of a drug called IL-2 that helps prepare their body to receive the infusion and stimulate the immune cells. Despite the intricacy of the treatment, patients have experienced significant tumor shrinkage, sometimes within weeks, of receiving TIL therapy providing a new option with lasting effects.

Dr. Ma and her team are now investigating ways to optimize TIL therapy by shortening the manufacturing process, which can take several weeks, and reducing the toxicity associated with IL-2 to improve the patient experience. NewYork-Presbyterian and Weill Cornell Medicine is one of the few medical centers to both administer and continue to research this groundbreaking therapeutic avenue, which will likely have future applications in other types of solid tumor cancers. 

Chapters: 

[00:00 - 6:40] A New Treatment for Melanoma 

Dr. Barbara Ma talks about a new treatment option for melanoma – tumor-infiltrating lymphocyte therapy or TIL. 

[6:40 – 9:02] The Challenges of Immunotherapy and Solid Tumor Cancers

Dr. Ma discusses the toxicity associated with some immunotherapies, and how TIL therapy is administered. 

[9:02 - 12:55] Response Rates for TIL Therapy 

Dr. Ma describes the timeline of response following TIL therapy. 

[12:55 - 16:26] Future Applications of TIL 

Dr. Ma shares how patients can benefit from TIL as a second-line therapy, and how her team is working to shorten the manufacturing time and reduce IL-2 associated toxicity. 

[16:26 – 18:07] Cell Therapy as the Next Frontier

Dr. Ma talks about her outlook for cell therapy as the next frontier in cancer treatment. 

[18:07 – 18:48] Credits

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Dr. Barbara Ma is an Assistant Professor of Medicine at Weill Cornell Medicine and a medical oncologist specializing in cellular therapy and immunotherapy for solid tumors. She serves as Head of the Phase I Unit and leads Cellular Therapy for Solid Tumors at WCM, where her work focuses on advancing Tumor-Infiltrating Lymphocyte (TIL) therapy and next-generation cell therapies for cancers including melanoma, lung cancer, head and neck cancer, gastrointestinal cancers, and cervical cancer. Her clinical and research efforts center on translating emerging cellular therapies from early-stage clinical trials into real-world patient care, while improving treatment safety, reducing toxicity, and expanding access for patients with advanced cancers.

For more information visit nyp.org/Advances

On this episode of Advances in Care, Erin Welsh is joined by Dr. Leonardo Lopez, a psychiatrist at NewYork-Presbyterian and vice chair for inpatient services in the Department of Psychiatry at Weill Cornell Medicine. Dr. Lopez and his team are at the forefront of electroconvulsive therapy (ECT), and have built one of the largest programs of its kind in the country dedicated to treating severe psychiatric illness through this revolutionary method. Though it is one of the most effective therapies available for certain psychiatric conditions like treatment resistant depression and schizophrenia, ECT isn’t widely adopted or accessible. However, Dr. Lopez hopes to change that. In the episode, he describes the history of this treatment, how it has evolved since its inception to become one of the safest procedures done under general anesthesia, and the dramatic response rates. 

ECT works by restructuring neurotransmitter release and promoting neuronal growth. Patients with conditions like psychotic depression and catatonia can sometimes see upwards of 90-95% response rates. To illustrate the power of ECT, Dr. Lopez shares the story of a pediatric patient who was referred to his team after being diagnosed with catatonia caused by another condition. Although the other condition was treated, the catatonia persisted until she was entirely dependent and non-verbal. Following a 6-week ECT treatment plan, the catatonia resolved completely and the patient was able to return to a normal life. 

The treatment is less than 5 minutes and administered while patients are under general anesthesia and muscle relaxants, resulting in some of the fastest-acting psychiatric treatment for certain conditions, with minimal side effects. Dr. Lopez hopes that as ECT becomes increasingly destigmatized and sees continued treatment success, there will be more access across the country to this transformative and life-saving therapy. 

Chapters:

[00:00 – 5:12] Efficacy of Electroconvulsive Therapy 

Dr. Leonardo Lopez describes a potentially fatal syndrome called catatonia and the remarkable results of electroconvulsive therapy (ECT) in catatonia and other psychiatric conditions. 

[5:12 – 10:17] Electroconvulsive Therapy to Treat Severe Catatonia 

Dr. Lopez recounts a recent case of a pediatric patient with catatonia whose syndrome resolved completely after receiving electroconvulsive therapy (ECT), and why ECT should not be considered a treatment of last resort. 

[10:17 - 13:05] Destigmatizing the Treatment

Dr. Lopez talks about how ECT has been stigmatized by media portrayals despite modern advancements in application. 

[13:05 - 15:26] Expanding Access to ECT

Dr. Lopez shares his role in developing NewYork-Presbyterian’s ECT program and his hopes for increased access in the future. 

[15:26 – 15:55] Credits

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Dr. Leonardo Lopez is a psychiatrist and clinical leader who serves as Vice Chair for Inpatient Services in the Department of Psychiatry at Weill Cornell Medicine. In this role, he partners closely with leadership at NewYork-Presbyterian to oversee the development, implementation, and ongoing management of inpatient psychiatry services, including electroconvulsive therapy (ECT), across multiple sites, including Weill Cornell Medical Center, Westchester Behavioral Health, and Brooklyn Methodist Hospital, while also collaborating with Gracie Square Hospital to integrate clinical services and advance system-wide behavioral health policies and practices. In these roles, he oversees large-scale inpatient services caring for New York’s most vulnerable populations, including specialized units for co-occurring disorders and patients in Department of Corrections custody, while also expanding access to advanced treatments like ECT and intravenous ketamine for treatment-resistant depression and other disorders.

For more information visit nyp.org/Advances

On this episode of Advances in Care, Dr. Steven Lobritto, pediatric medical director for liver transplant at NewYork-Presbyterian and Columbia, joins host Erin Welsh to tell the story of a high-risk pediatric liver transplant that he and his team performed to save the life of a two month old baby, after the center where the baby was originally treated deemed her inoperable. 

Dr. Lobritto describes how NewYork-Presbyterian and Columbia has been building their liver transplant center since 1998, allowing them to push forward innovative, and life-saving, surgical strategies, like living donor and partial liver transplants, in order to increase the odds of survival for pediatric patients on the organ waitlist.

Children under one year of age have the highest mortality rates while waiting for a transplantable organ. In the case of this infant, the optimal treatment required surgical expertise in partial liver transplant due to her uniquely small size. Dr. Lobritto explains how he and his team coordinated with the patient’s initial care team across the country to prepare the critically ill, 11-pound baby to fly to New York, and the intricacies of the surgical procedure.

Dr. Lobritto also explains his involvement with the STARZL Network, a consortium of hospitals that share protocols, best practices, and learnings to address knowledge and training gaps in pediatric organ transplantation. He advocates for partial liver transplantation to be universally taught as a requirement of surgical training, to increase access to organs and save the lives of more young patients.

Chapters:

[00:00 - 5:58] NewYork-Presbyterian and Columbia’s Liver Transplant Center 

Dr. Lobritto describes the strengths of the NewYork-Presbyterian and Columbia Liver Transplant Center, including the cutting edge techniques that allowed them to coordinate a partial liver transplant in a critically ill baby. 

[5:58 - 8:12] A Specialized Transport to New York

Dr. Lobritto outlines the challenges of transporting the baby, who needed a mobile ICU team for life-support to travel to New York City. 

[8:12 - 12:50] Multidisciplinary Collaboration 

Dr. Lobritto shares the considerations that went into preparing for the baby’s complex surgery and how they adapted care when a complication arose. 

[12:10 - 14:41] The STARZL Network

Dr. Lobritto discusses his work with the STARZL Network, which strives to increase access to pediatric organ transplant. 

[14:41 - 15: 31] Credits

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Dr. Steven Lobritto is a distinguished pediatric gastroenterologist and a professor of pediatrics and medicine at Columbia University Irving Medical Center (CUIMC). He has been instrumental in the development of the Pediatric Liver Transplantation Program at NewYork-Presbyterian/Columbia and is the Medical Director of the program. Dr. Lobritto has trained many leading physicians in transplant hepatology and has contributed significantly to pediatric liver transplantation through his research and clinical care. His expertise in pediatric gastroenterology and liver transplantation has made him a respected figure in the medical community.

For more information visit nyp.org/Advances

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.

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

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

***

Dr. Haythe specializes in pulmonary hypertension, cardio-obstetrics, heart failure, HFPEF, and cardiovascular disease in women.

For more information visit 

nyp.org/Advances

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