On this episode of Advances in Care, host Erin Welsh hears from Dr. Juan P. Rocca, a transplant surgeon at NewYork-Presbyterian and Weill Cornell Medicine, who recently led the first fully robotic liver transplant in New York.

Dr. Rocca details the recent developments in robotic surgery at Weill Cornell Medicine’s Division of Liver Transplantation and Hepatobiliary Surgery, including an ongoing push to advance from laparoscopic and open surgical methods, and now to robotics. He explains why the robotic approach is optimal for complex liver surgeries, and discusses how he and his team have been training to make robotic living donor hepatectomies a standard in their department.

Then, Dr. Rocca breaks down the process of the liver transplant operation that became the first fully robotic execution in New York. He describes the most critical steps of the procedure, how it felt to achieve this milestone, and the example that he hopes to set for other institutions beyond NewYork-Presbyterian and Weill Cornell Medicine.

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Dr. Juan Rocca is the Surgical Director of the Weill Cornell Liver Cancer Program and an attending surgeon in the Division of Liver Transplantation and Hepatobiliary Surgery at NewYork-Presbyterian and Weill Cornell Medicine. He was an early adopter of laparoscopic techniques for major hepatectomy and later transitioned to robotic surgery for complex liver procedures in patients with chronic liver disease. At Weill Cornell Medicine, he led the development of a comprehensive robotic liver surgery program, encompassing liver cancer resections, living liver donation, and the state's first fully robotic liver transplant

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On this episode of Advances in Care, host Erin Welsh and Dr. Joel Gabre, a gastroenterologist at NewYork-Presbyterian and Columbia who specializes in cancer care, 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.

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On this episode of Advances in Care, host Erin Welsh talks to Dr. David Majure, a cardiologist and heart failure specialist at NewYork-Presbyterian and Weill Cornell Medicine. Together they discuss the rapid rise in GLP-1 research over the past few years, indicating new applications for these therapies to help a wide variety of patients. They explore how GLP-1s work on a molecular level, and how using them to treat diabetes revealed other potential cardiovascular benefits.

Dr. Majure highlights several  recent studies that explore the effects of semaglutide and tirzepatide on patients with heart failure, particularly those with preserved ejection fraction. This new research demonstrates that GLP-1s can be an effective treatment beyond diabetes, helping with weight management and cardiovascular disease. Dr. Majure breaks down what effects doctors can expect to see in patients who are prescribed GLP-1s, including the difference in outcomes between semaglutide and tirzepatide. He also notes the potential risk factors, cautioning that while these medications are effective, the focus in addressing heart disease should always remain on prevention.

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Dr. David Majure is the Medical Director of the Heart Transplant Service at NewYork-Presbyterian and Weill Cornell Medicine. He specializes in the care of patients with heart failure, patients requiring or who have a heart transplant or ventricular assist device (LVAD), and patients with pulmonary hypertension. He has contributed extensively to research and has served as principal investigator in multiple clinical trials, exploring all aspects of advanced heart failure. Dr. Majure has been recognized as a Castle Connolly Top Doctor since 2020.

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On this episode of Advances in Care, host Erin Welsh and cardiologist Dr. Diala Steitieh discuss the current landscape of care for hypertrophic cardiomyopathy — or HCM — the most common genetic heart disorder. Dr. Steitieh outlines the advantages of genetic screenings for patients who have HCM, along with the symptoms and risks if the condition is left undiagnosed or unmanaged.

She expands on the importance of understanding obstructive vs. non-obstructive conditions and the importance of making a precise diagnosis to get a clear sense of each patient’s severity. Dr. Steitieh and her team recently implemented a new approach to their diagnostic imaging protocol called goal-directed Valsalva. With this emerging tool in the landscape of cardiology, they are able to get a better sense of an obstruction impacting blood flow, and ultimately offer a wider variety of treatment options.

Beyond diagnosis, Dr. Steitieh also shares her excitement about updates to the management of HCM, including recently approved drugs and new guidelines regarding sports & exercise. She and her team at Weill Cornell Medicine are in the process of becoming a designated Hypertrophic Cardiomyopathy Association Center of Excellence, a development that Dr. Steitieh hopes will improve access to care for patients in New York and beyond.

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Dr. Diala Steitieh is an Assistant Professor of Clinical Medicine, and the Director of the Hypertrophic Cardiomyopathy program in the Division of Cardiology at Weill Cornell Medical College and New York Presbyterian Hospital. She has a background in sports cardiology and also cares for patients with a wide array of cardiovascular diseases, including coronary disease and valvular heart disease. Dr. Steitieh also serves as an attending physician on the inpatient services at NewYork-Presbyterian Hospital, including the intensive care unit and cardiac units.

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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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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.

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.

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