On this episode of Advances in Care, host Erin Welsh and Dr. Markus Mapara, Director of the Blood and Marrow Transplantation and Cell Therapy Program at NewYork-Presbyterian and Columbia, discuss the current challenges in treating sickle cell disease and how newly FDA approved gene editing treatments are leading to new treatment pathways. Dr. Mapara covers two new gene editing approaches, explaining that both involve editing stem cells and reintroducing them to patients’ bodies to curb the sickling of red blood cells. He also helps listeners to understand the difference between the two: one gene therapy uses CRISPR technology to help the body create fetal hemoglobin which mitigates cell sickling while the other uses a lentiviral vector to edit stem cells to produce anti-sickling hemoglobin that’s similar to fetal hemoglobin once reintroduced to the body. 

Dr. Mapara also goes into the innovative work that the Blood and Marrow Transplantation and Cell Therapy Program is doing with CAR-T cell therapies. And he shares how these advancements in treating sickle cell disease will have a significant impact on how physicians approach treating patients.

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Dr. Mapara is a Professor of Medicine at Columbia University Medical Center and the Director of the Blood and Marrow Transplantation (BMT)/Cell Therapy Program at New York Presbyterian Hospital/Columbia University Medical Center. He specializes in the care of patients with sickle cell disease and certain blood cancers (Multiple Myeloma, Amyloidosis) undergoing bone marrow transplantation and gene therapy.  His research is focused on developing novel approaches to make bone marrow transplantation and cell therapy safer for patients.. 

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On this episode of Advances in Care, host Erin Welsh and Dr. Craig Smith, Chair of the Department of Surgery and Surgeon-in-Chief at NewYork-Presbyterian and Columbia discuss the highlights of Dr. Smith’s 40+ year career as a cardiac surgeon and how the culture of Columbia has been a catalyst for innovation in cardiac care. Dr. Smith describes the excitement of helping to pioneer the institution’s heart transplant program in the 1980s, when it was just one of only three hospitals in the country practicing heart transplantation.

Dr. Smith also explains how a unique collaboration with Columbia’s cardiology team led to the first of several groundbreaking trials, called PARTNER (Placement of AoRTic TraNscatheteR Valve), which paved the way for a monumental treatment for aortic stenosis — the most common heart valve disease that is lethal if left untreated. During the trial, Dr. Smith worked closely with Dr. Martin B. Leon, Professor of Medicine at Columbia University Irving Medical Center and Chief Innovation Officer and the Director of the Cardiovascular Data Science Center for the Division of Cardiology. Their findings elevated TAVR, or transcatheter aortic valve replacement, to eventually become the gold-standard for aortic stenosis patients at all levels of illness severity and surgical risk. Today, an experienced team of specialists at Columbia treat TAVR patients with a combination of advancements including advanced replacement valve materials, three-dimensional and ECG imaging, and a personalized approach to cardiac care.

Finally, Dr. Smith shares his thoughts on new frontiers of cardiac surgery, like the challenge of repairing the mitral and tricuspid valves, and the promising application of robotic surgery for complex, high-risk operations. He reflects on life after he retires from operating, and shares his observations of how NewYork-Presbyterian and Columbia have evolved in the decades since he began his residency.

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Join host Erin Welsh as she talks with NewYork-Presbyterian physicians from Columbia & Weill Cornell Medicine about how they are solving some of the most challenging and complex cases in medicine. Together, they discuss groundbreaking discoveries, novel treatments, and the dedication to providing compassionate patient care. This is a show for medical professionals interested in how cutting-edge research and innovations are transforming the future of health care.

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On this episode of Health Matters, Faith Salie talks with Dr. Benjamin Lebwohl, a gastroenterologist at NewYork-Presbyterian and Columbia. He’s also the Director of Clinical Research at Columbia’s Celiac Disease Center, and an expert on the connections between gastrointestinal health and the other systems in our body that rely on good digestion for their function. He describes how GI diseases like Celiac have implications for mental health, and what anyone can do to support their digestive health.

Dr. Melissa Frey, a gynecologic oncologist at NewYork-Presbyterian and Weill Cornell Medicine, has a genuine passion for the power of genetic testing because she knows that it can completely change the direction of her patient’s lives for the better. As a leader in the field, she helped launch a unique screening program with multi-disciplinary expertise and counseling, the Genetics and Personalized Cancer Prevention Center at Weill Cornell Medicine. The center not only helps patients gain access to genetic testing to assess their risk of cancers but it also uses cascade testing to contact their relatives and help them get genetic testing too. In doing so, the center is working to identify more people whose lives haven't yet been affected by cancer and help them take preventive action based on their risk. In many cases this can mean avoiding a life threatening illness. 

For more information visit nyp.org/Advances

For more information visit nyp.org/Advances

The field of lung transplantation is relatively new with widespread lung transplants beginning in the early 1980s. Throughout the last forty years, it is a field that has rapidly evolved with drastic changes in lung allocation, or deciding who will receive the next available lungs for transplantation. Dr. Selim Arcasoy has led the NewYork-Presbyterian and Columbia Lung Transplant Program through these changes since 2001. Thanks to his dedication to improving lung allocation and foundational research, the program has been a catalyst in changing how lung allocation works in New York and beyond. These policies, in conjunction with Dr. Arcasoy's talented team, clinical research and state of the art tools, have led to greater numbers of patients receiving life-saving transplants.

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In 2012, Dr. Lisa Roth had just landed her dream job as a research scientist and attending physician at NewYork-Presbyterian and Weill Cornell Medicine. But her world came to a screeching halt when she discovered a swollen lymph node on her neck, and was soon diagnosed with the exact type of cancer that she had dedicated her career to studying and treating: Hodgkin Lymphoma. After that experience, Dr. Roth was more determined than ever to uncover the biology of this notoriously difficult to study cancer. Dr. Roth, now Director of Pediatric Oncology and Associate Professor in the Departments of Pediatrics, Medicine and Pathology and Laboratory Medicine at NewYork-Presbyterian and Weill Cornell Medicine, tells the story of how she and her team became the first researchers to sequence the entire Hodgkin Lymphoma genome, opening doors for precision and preventative treatment options.

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Monitoring patients with aneurysmal rupture for delayed cerebral ischemia was historically a numbers game. It was difficult for doctors to predict outcomes in the weeks that followed their rupture, so at-risk patients could find themselves under observation in the ICU anywhere from 7 to 21 days. Dr. Soojin Park, Medical Director of Critical Care Data Science and AI at NewYork-Presbyterian/Columbia, knew there had to be a better way to monitor patients and predict outcomes. So, relying on her background in machine learning and leveraging vast amounts of data, Dr. Park developed the potentially game-changing Continuous Monitoring Tool for Delayed Cerebral Ischemia (or COSMIC) score. The score uses machine learning, and basic patient data that can be collected with equipment available at any hospital, to detect signals that more accurately assess risk, allowing doctors to treat each neurocritical patient with targeted care - ultimately improving outcomes and patient experience.

As methods for early cancer detection improve and the number of cancer survivors rises, the innovative field of cardio-oncology has emerged to ensure that patients with chemotherapy or cancer-related cardiac dysfunction can be safely, and swiftly, treated for their cancer. Dr. Stephanie Feldman, a clinical cardiologist with focus on cardio-oncology at NewYork-Presbyterian/Weill Cornell Medicine, is one of a growing number of physicians advancing research and pushing care in this field forward with a multi-disciplinary, comprehensive approach to care. Dr. Feldman joins us to discuss the rare risks of immune checkpoint inhibitors, how genetic mutations could put patients at risk for arterial thromboembolism, and how the cardio-oncology field can optimize the course of cancer care for patients at risk for cardiovascular complications. 

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With perspectives spanning hepatobiliary, gynecologic, and cardiac surgeries, NewYork-Presbyterian’s Dr. Jason Hawksworth (Columbia), Dr. Tamatha Fenster (Weill Cornell Medicine), and Dr. Arnar Geirsson (Columbia) describe how they each came to incorporate robotics into their practices. One of the biggest takeaways: robotic surgeries allow for more accuracy in minimally-invasive approaches; so patients experience shorter hospital stays and quicker recoveries, even after major procedures. But there are some limitations to robotic surgeries that the doctors are still navigating. Dr. Fenster discusses how there are haptics limitations in robotic surgery. As a result, she shares more about her innovative smartHER 3D MRI program that is addressing this issue and details how her and her team are developing a way of holographically projecting 3D MRIs over patients to help guide surgeons while they operate. 

For more information visit nyp.org/Advances