LifeNotes | Fall 2023

A note from the President and CEO

Dear Colleague:

I’m delighted to share this fall edition of LifeNotes, our biannual newsletter spotlighting the talented physicians and high-level services so fundamental to our mission of delivering outstanding patient care.

As the president and CEO of this dynamic, innovative health system, I’m particularly proud of the impressive work highlighted here, from being the first and only medical center in the region to offer cardiac patients a new imaging technique to assess coronary artery disease, to the launch of a rehabilitation clinic entirely focused on patients newly diagnosed with Parkinson’s disease.

Expanding our research enterprise continues to be a top priority of mine. I hope you’ll take a minute to read about pioneering new drug trials for lung cancer, offered through the Lifespan Cancer Institute, or the important role our physicians are playing in the development of emerging treatments for the aggressive brain tumor, glioblastoma.

We’ve also highlighted useful information on new services and technologies that address a broad span of health needs, such as a new shockwave technology that can safely clear calcium deposits from arteries; a new specialized trauma track in our adult partial hospitalization program; and a pilot program focused on mind-gut wellness in pediatric GI patients.

Some of our most impactful work is realized when we can share our unique expertise and resources with partners in the community. You can read about how the Lifespan Pharmacy is now partnering with the Rhode Island Free Clinic to help patients in need obtain necessary medications at no cost, or about the Lifespan Orthopedics Institute new summer leadership program for high school students interested in orthopedic research.

I hope you’ll find these stories—and the many more below—as interesting and inspiring as I do.

Thank you for your commitment to patients and families across our state, and for your partnership in creating a healthier Rhode Island.

Lifespan Cardiovascular Institute First in New England with Shockwave Technology to Open Calcified Arteries

The Lifespan Cardiovascular Institute was the first site in New England to offer Shockwave technology for treating peripheral and coronary artery disease. Shockwave uses intravascular lithotripsy (IVL) to crack calcium from the arteries, rendering the arteries softer and more malleable, allowing full vessel expansion at low pressures.

Calcium is problematic and has long been associated with worst clinical outcomes in patients. “As the global population ages, the incidence of cardiovascular calcium is on the rise. We know that calcium increases the complexity of cases and decreases the effectiveness of treatment,” said Peter A. Soukas, MD, director of vascular medicine and the Interventional Peripheral Vascular Lab.

Soukas notes that patients are at increased risk of adverse events due to calcium buildup, such as dissection (disruption of the inner lining of the artery) and even perforation. Existing treatments such as high pressure and modified balloons can’t reliably dilate the vessels that contain severe calcium. In addition, the current technologies do not address the issue of “deep wall calcium” in the arteries.

IVL changes that. The technology was developed based on the principles of urologic lithotripsy for kidney stone treatment and uses sonic pressure waves to impact hard tissue. Shockwave uses miniaturized and arrayed lithotripsy emitters to create a localized field effect at the site of the calcium, disrupting the calcium while leaving normal tissue undisturbed.

“With the new IVL technology, physicians now have a great tool for modifying calcium and reducing its negative impact on the health of our patients,” Dr. Soukas noted.

To refer patients, please contact the Lifespan Cardiovascular Institute, 1-855-332-8474. 

FDA approves Lecanemab, First Drug to Slow Progression of Alzheimer’s Disease

In July, the Food and Drug Administration (FDA) approved Lecanemab – the first drug ever to treat Alzheimer’s disease, and not just its symptoms. The Alzheimer’s Disease and Memory Disorders Center (ADMDC) at Rhode Island Hospital was a local site for this groundbreaking study.

“This is 20 years of work," says Chuang-Kuo Wu, MD, PhD, director of the ADMDC. “This is the first drug of its kind to actually slow progression of Alzheimer’s.” It was studied in nearly 1,800 individuals over an 18-month period, and results indicate the drug slowed progression of the disease by 27 percent.

Wu explains, “Lecanemab is a monoclonal antibody that is administered intravenously every two weeks. It is designed for use in patients with mild stage of Alzheimer’s or mild cognitive impairment due to Alzheimer’s disease.”

“We know this drug targets the amyloid plaques in the brain associated with Alzheimer’s disease. While it doesn’t improve memory, it does slow down memory loss,” notes Wu. Wu cautions about one serious side effect from the newly approved medication. He notes that 13 percent of study participants experienced brain swelling when taking Lecanemab. Wu says, “Knowing this, it’s important that all patients on Lecanemab should be closely monitored. However, despite this side effect, the potential benefits of the drug outweigh the risks.” He stresses that it is important for patients to have an open discussion with their doctor, so they are aware of the risks and benefits of taking this drug.

The research community is awaiting more studies on other drugs, and the ADMDC will continue to participate in these important clinical trials. “We are committed to fighting this disease, and we look forward to the day when we finally have the cure for Alzheimer’s,” says Wu. For more information on this and other research studies, please call the center at 1-844-563-6679 (1-844-5-MEMORY) or 401-444-0085 or visit the Alzheimer's and Memory Disorder Research website.

Lifespan Cancer Institute Takes Center Stage in Emerging Treatments for Deadly Brain Tumors

Glioblastoma is the most common and aggressive form of brain cancer. Although it recurs, the tumor can be treated and contained with a variety of modern-day technologies and drugs.

“It’s hard to treat because the tumor invades the brain and nerve cells. So that means we must use a combination of surgery, radiation, and drug therapy to treat this kind of tumor,” says Eric Wong, MD, director of medical neuro-oncology at the Lifespan Cancer Institute (LCI).

Wong says in the past 20 years, the FDA has approved three treatments for glioblastoma. These treatments are much more tolerable now and they have made an impact on life expectancy and the well-being of patients. But more is needed. In fact, Lifespan is at the forefront of glioblastoma research and treatment.

“We bring the latest clinical trials to Rhode Islanders so that they can get their treatments closer to home .” Wong said. “Even when a patient does not fit into one of our trials, then we can design a personalized treatment plan for him or her based on the unique medical profile of the patient and our knowledge of the latest scientific principles.”

For example, Wong and his colleagues provided data to the FDA that was instrumental in the approval of a new treatment for glioblastoma known as the Tumor Treating Field. “Tumor Treating Field is an electrical delivery device designed to be worn on the skull of patients with glioblastoma,” explains Wong. “It provides continuous treatment and has been shown to keep the tumor at bay and prolong patient survival in a prior clinical trial.”

“We are dedicated to bringing the latest technology, life-saving drugs, and expertise to Rhode Islanders to treat their glioblastoma and other cancers,” Wong adds.

Glioblastoma vaccine shows promise

“On average, patients survive one to three years following a glioblastoma diagnosis, so we focus on keeping our patients well enough to enjoy some quality of life,” says Heinrich Elinzano, MD, a neurologist with subspecialty training in neuro-oncology and spinal cord injury medicine, at the Lifespan Cancer Institute.

Elinzano notes, “With glioblastoma, one challenge we face is the brain’s natural defense mechanism, which makes it difficult to use chemotherapy or medications that actually target and reach the tumor.”

Earlier this year, the LCI joined other sites around the world to announce a breakthrough in a new vaccine for glioblastoma, which was shown to improve survival time. “There was a significant difference – six to seven months of extended survival with this approach. The bottom line is that this is a new way of attacking the tumor and enhancing the standard of care for these tumors,” says Elinzano.

More research underway

Doctors have struggled for years to improve the survival rate of patients with glioblastoma. Now, research underway at the Lifespan Cancer Institute and Brown University’s Legorreta Cancer Center offers reason for hope.

Researcher Sean Lawler has been studying glioblastoma for 20 years and admits that research has been relatively slow. “There is an element of frustration, but for scientists we see it as a challenge, and we work harder to address it,” says Lawler.

There are basic and clinical studies underway to identify new treatments to stop tumor progression and others that target the brain’s ability to block treatments from entering the tumor. Lawler says they have been able to show that it is possible to get drugs into the tumor using new approaches.

One thing the experts agree on – there is reason for optimism in the growing number of physicians and researchers around the world who are committed to finding successful treatments and potential cures for this deadly cancer.

Watch interviews with Elinzano and Wong on WPRI-TV 12. For more information on research currently underway at the LCI, visit the Lifespan research portal.

Lifespan Cardiovascular Institute Opens Advanced Cardiac Care Center, Expands EP Lab Capacity

The Lifespan Cardiovascular Institute (LCVI) opened its new Advanced Cardiac Care Center (ACCC) earlier this year. The new clinic, located on the first floor of the George Building at Rhode Island Hospital, is home to clinical operations for outpatient management of LCVI’s Medical Heart Failure and Cardiac Arrhythmia (Electrophysiology) programs. The ACCC gives patients greater access to a broader array of advanced treatments at one central location.

“Prior to the opening of our new Advanced Cardiac Care Center, patients in our heart failure and cardiac arrhythmia programs were cared for at various LCVI locations. Recognizing that these patients require highly specialized care teams and specific treatment protocols, we brought these programs together under one roof,” said Chris Borgstrom, director of operations and strategic growth, LCVI.

“With the support of Rhode Island Hospital, these programs now function in a centralized location allowing physicians, advanced practice providers, nurses, technicians, and support staff to work more closely together, while offering improved operational capabilities and the latest in clinical practice and technology for our patients.”

Also, the recent opening of an additional EP lab at Rhode Island Hospital has created increased capacity for performing ablations and implanting devices. You can read more about the additional EP lab. 

“This year we will be doing over 700 ablations, about 300 more than last year. Our increased capacity means offering exceptional heart rhythm care close to home for even more individuals,” said Renee Bernard, MSN, APRN, director of cardiovascular services. To refer a patient, or to learn more about the Advanced Cardiac Care Center and LCVI’s Medical Heart Failure and Cardiac Arrhythmia programs, please call the Lifespan Cardiovascular Institute at 401-606-1004.

To learn more about the ACCC and our programs, please visit the following websites:

• Lifespan Advanced Cardiac Care Center
• Medical Heart Failure Program
• Cardiac Arrhythmia Services

Rhode Island Hospital Aortic Valve Surgery Program Recognized by US News and World Report

The Aortic Valve Surgery program at Rhode Island Hospital received a “High Performing” rating from US News and World Report. Hospitals that earn this rating are considered significantly better than the national average.

“Our outcomes in aortic valve surgery are impressive and we are honored to be recognized among the best programs in the country,” said Frank Sellke, MD, chief of cardiothoracic surgery. “Our data indicates mortality is better than the national benchmark for six consecutive years. And our 30-day readmission rate is zero for this current fiscal year, compared to a national average of six percent.”

For the rankings, US News evaluated over 6,000 hospitals in numerous data categories, such as patient survival, length of stay, volume, and more. Of those, 154 were deemed “high performing” while 506 were “average” and 133 were “below average”. The remaining hospitals either did not offer the service or performed too few procedures to be rated.

“We strive to deliver the very best surgical care for our patients, and our high performing ranking from US News is evidence that we are doing just that,” Sellke added. For more information on the aortic valve surgery program’s rankings, visit US News and World Report's website.

Lung Cancer Program Gains Recognition while Expanding Services

Rhode Island Hospital Lung Cancer Surgery Program Receives US News and World Report Recognition

For patients undergoing surgery for lung cancer, they can take some comfort in Rhode Island Hospital’s recognition from US News and World Report as a “High Performing” hospital in its report on the best cancer hospitals in the country. “Rhode Island Hospital’s lung cancer surgery team is one that deserves to be recognized among the best in the country. We are honored to have received this distinction,” says Abbas El-Sayed Abbas, MD, Lifespan chief of thoracic surgery and Lifespan Cancer Institute chief of thoracic oncology.

Over 6,000 hospitals were evaluated, based on data in a variety of categories, including patient survival, prevention of prolonged hospitalizations, cancer center designation, volume, and more. Of those hospitals evaluated, only 254 were awarded the high performing category, and are considered significantly better than the national average. In addition, 507 hospitals were ranked “average” while 276 were in the “below average” category. The remaining hospitals either did not offer the service or performed too few procedures to be rated.

To refer a patient to Dr. Abbas, call 401-553-8320. For referrals to thoracic surgeon Hayley Leesley, MD, call 401-228-0612. For more on Rhode Island Hospital’s scorecard, visit the US News website.

New Lung Screening and Nodule Program Open at The Miriam Hospital

The Lifespan Cancer Institute opened its lung cancer screening and nodule program at The Miriam Hospital earlier this year.

“The focus of our lung screening program is really to help high-risk patients over the age of 50 with a smoking history get screened for lung cancer," says oncologist Hina Khan, MD. “We know that low-dose CT is the recommended modality to screen for lung cancer.”

Khan says in the United States only about six percent of those individuals who should be screened for lung cancer get a scan; in Rhode Island it is slightly higher, at 13 percent. But Khan stresses that screening saves lives.

"In large, international studies there has been a significant decrease in risk of death from lung cancer in patients who got screened -- at least 20 percent drop in deaths from lung cancer by finding and treating these cancers early," said Khan.

Anyone aged 50 to 80 years who smokes or has quit within the past 15 years, and who smoked more than 20 pack years in their lifetime (one pack per day for 20 years, two packs per day for 10 years, etc.), is eligible for screening. In most cases the screening is covered by insurance.

The clinic is located on the 2nd floor of the Fain Building. Patients may be referred through a LifeChart order (“Ambulatory Referral to Lung Cancer Screening Clinic,” select TMH site). For paper referrals, send via fax to Kristin Andrews, navigator, at 401-793-2452, or call 844-222-2881 for more information. Learn more about the clinic and its multidisciplinary care team, or call the clinic at 844-401-LUNG.

Hasbro Children’s Hospital Launches Pilot of Mind-Gut Wellness Program

Hasbro Children’s Hospital has launched a new pilot program for children with functional gastrointestinal disorders, or disorders of gut-brain interaction. These disorders frequently present with gastrointestinal symptoms such as abdominal pain, nausea or vomiting, constipation, or diarrhea with no organic etiologies. Patients frequently experience comorbid health conditions, such as depression and anxiety, which negatively impact quality of life.

The new Mind-Gut Wellness Program will address the physical, psychological, and nutritional needs of children with functional gastrointestinal disorders. The program will consist of a multidisciplinary team: a pediatric gastroenterologist, pediatric GI psychologist and a nutritionist. The team will complete a one-hour comprehensive evaluation and develop an individualized treatment plan for each child to improve their quality of life, increase confidence, and help with their symptoms.

“Our new Mind-Gut Wellness Program is an integrated program we created to diagnose and treat children with functional GI disorders in a comprehensive, multidisciplinary approach,” said Irina Gorbounova, MD, a pediatric gastroenterologist who is leading the program. “Each child will undergo an extensive evaluation with a team of experts. This well-rounded approach will address their symptoms, psychological well-being, and nutrition; to provide them with an optimal treatment plan targeting multiple facets of their disease.”

To refer a patient, contact the center at 401-444-8306. For more information on the program, visit the website.

Minimally Invasive Urology Institute Launches New Therapy for BPH

In the spring of 2023, the Minimally Invasive Urology Institute at The Miriam Hospital introduced the latest treatment option for benign prostatic hyperplasia (BPH): the iTind procedure. The iTind is a proven therapy to relieve lower urinary tract BPH symptoms by remodeling the prostate using a temporary stent rather than a permanent implant.

“This procedure is performed through the urethra and preserves sexual functioning with a very low risk of bleeding,” says urologist Samuel Eaton, MD. “The iTind is one of the newest options available for the treatment of BPH and we are thrilled to offer this option to patients at the Minimally Invasive Urology institute.”

Eaton explains that iTind’s temporary stent expands and applies gradual and slow pressure on the prostate, creating a wider opening for urine to flow freely. There is no burning or cutting of tissue. It is performed as an outpatient procedure and is ideal for prostates small to average in size. The temporary stent is removed in the surgeon’s office five to seven days later.

Learn more about MIUI and its treatment options for BPH, including iTind. More information on iTind technology is available. 

The Miriam Hospital Ranked Top Hospital by US News & World Report

The Miriam Hospital was again recognized by US News & World Report as the Top Hospital in Rhode Island in its 2023-2024 Best Hospitals list, marking 12 straight years the hospital has achieved the prestigious ranking.

“I am so proud that The Miriam Hospital has earned the distinction of being the top hospital in Rhode Island for our care and treatment of patients for the 12th year in a row,” said Maria Ducharme, DNP, RN, NEA-BC, president of The Miriam Hospital. “It is a tribute to our talented team who are committed to patient-centered care and truly living our mission of delivering health with care every day. I consider myself fortunate to work among such amazing individuals.”

The Miriam Hospital was also named the top hospital in the Providence metro area, which includes Providence, Pawtucket, Fall River, and New Bedford. US News also awarded the hospital’s specialized adult orthopedics services a "high performing" rank for care and treatment. Additionally, US News & World Report awarded The Miriam a "high performing" rating for 10 common adult procedures and conditions:

• Hip replacements
• Knee replacements
• Colon cancer surgery
• Heart failure
• Heart attack
• Stroke
• Kidney failure
• Diabetes
• Leukemia Lymphoma & Myeloma
• Prostate Cancer Surgery

For the 2023-2024 rankings and ratings, US News evaluated more than 4,500 hospitals across 15 specialties and 21 procedures and conditions; only 12 percent of evaluated hospitals earned a Best Hospitals ranking. You can find more information on Best Hospitals. 

More information on The Miriam’s many awards can be found on our website. 

Vanderbilt Rehabilitation Center Earns CARF Re-Accreditation

The Vanderbilt Rehabilitation Center at Newport Hospital has once again earned accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) for its adult inpatient rehabilitation program as well as its Stroke Specialty Program.

CARF accreditation reflects a facility’s commitment to continually improving services, encouraging feedback, and serving the community. Founded in 1966, CARF is an independent, nonprofit accreditor of health and human services.

“Vanderbilt Rehabilitation is known throughout the region for its unique programs, excellent outcomes, and outstanding patient-focused care we have provided for decades,” said Missy Fournier, director of inpatient rehabilitation services. “This certification is further evidence of our commitment to delivering the best care and services to improve the quality of life for our patients.”

The Vanderbilt Rehabilitation Center boasts a history of extremely high patient satisfaction scores. It is also accredited by The Joint Commission and is a four-time Guardian of Excellence award winner. It is one of only two inpatient rehabilitation facilities in Rhode Island to earn CARF accreditation, and one of nine throughout New England. In 1979, Vanderbilt Rehabilitation became the first CARF-accredited inpatient rehabilitation program in Rhode Island. In 2011, VRC achieved its first CARF Stroke Specialty accreditation as well.

To refer a patient for inpatient rehab, call Vanderbilt at 401-606-4432. Learn more about CARF accreditation. 

Newport Hospital Acquires ROSA Robot for Knee Replacement

Lifespan’s first robotic technology for total knee replacement is now available at Newport Hospital. The new Zimmer Biomet’s ROSA® Knee System brings together robotic technology with industry-leading knee implants to help surgeons personalize surgical procedures for patients seeking joint replacement.

ROSA Knee is a robotically assisted surgical system designed to help perform total knee replacement surgery. The system uses vision guidance to assess balance and alignment, combined with a robotic arm that allows more precise placement of the surgical cuts. It provides detailed data on range of motion and kinematic alignment, ligamentous balance, and bone anatomy to help surgeons with complex decision-making and ultimately a personalized approach to every patient. The goal is to optimize surgeon accuracy and allow for greater flexibility during procedures to control and move surgical instruments thanks to the computer and advanced software processing.

“We are excited to incorporate this new but proven technology,” said Valentin Antoci, MD, PhD, medical director, Newport Hospital Total Joint Replacement Program. “The ROSA Knee offers key benefits and advantages for surgeons that will only improve our ability to provide our patients with outstanding and personalized care, efficient and minimally invasive surgery, with potentially superior outcomes.”

Along with Dr. Antoci, surgeons Mouhanad El Othmani, MD, and Michael Staebler, MD, will be using the new ROSA Knee to continue improving care at Newport Hospital, University Orthopedics, and Lifespan.

To learn more about the joint replacement program at Newport Hospital, visit our website. You can also learn more about the ROSA Knee. 

New Ziehm Navigation System for Spine Surgery Now Available at Newport Hospital

The Norman Prince Spine Institute (NPSI) at Newport Hospital recently acquired the Ziehm RFD 3D C-Arm, an advanced navigation system for use in spine surgeries. The new technology allows for greater accuracy with real-time imaging during the surgery.

The Ziehm expands the scope of the spine surgery practice at Newport Hospital. “Our new equipment at the NPSI increases the quality of patient care, minimizes inaccuracies, and reduces the need for future hardware revisions,” said Joaquín Cámara, MD, director of minimally invasive spine surgery at NPSI who is now seeing patients in Newport and in Providence. “Offering this technology in Newport allows our patients in the Aquidneck Island area to get great care close to home.”

The Ziehm expands access to minimally invasive spine surgery for patients on Aquidneck Island. “Our goal is always to be as conservative as possible, and surgery is always the last option. However, when a patient does require surgery, we know a minimally invasive approach is best,” Cámara added. “Using robotics and navigation tools like the Ziehm in the OR make things more precise, allows for smaller incision surgery, makes care safer for patients, and we can get them back to their routines and daily activities as soon as possible.”

To refer a patient, call 401-845-1190. For more information about the Norman Prince Spine Institute, visit the website.

Anne C. Pappas Center for Breast Imaging Expands with New Screening Location

The Anne C. Pappas Center for Breast Imaging has opened a new screening location at 146 West River Street. The new site provides patients with mammography interpretation from the same expert radiologists using state-of-the-art equipment and experienced technologists in a convenient space for patients.

“For more than 25 years, our team of experts has provided the best, most advanced breast imaging in the region,” said Martha Mainiero, MD, radiologist, and medical director of the Pappas Center. “Our new location will increase our ability to screen even more women and save more lives.”

A ribbon cutting ceremony was held in September to officially open the center. Mainiero was joined by Sandy Stamoulis, sister of the center’s namesake and former vice president of cancer services at Lifespan, and Maria Pappas Machado, Pappas’s daughter.

Patients can call 401-444-7770 or email [email protected] to schedule an appointment. 

New Rehabilitation Clinic for Parkinson’s Disease

Lifespan Rehabilitation Services has launched a new rehabilitation clinic for patients newly diagnosed with Parkinson’s disease (PD). The Multidisciplinary Parkinson’s Disease Rehabilitation Clinic provides physical therapy, occupational therapy, and speech-language pathology services on an outpatient basis for those newly diagnosed with the disease.

As PD causes early onset of disability, exercise and rehabilitation can help slow the progression of symptoms. It can also help the care team to establish a rehabilitation profile that can help track disease progression and assist with symptom management. This way, individuals can be better equipped with tools to improve independent self-management of their condition.

The team provides a multidisciplinary evaluation and treatment for people with PD, as well as early education, a guided exercise program and strategies to help patients maximize their independence, reduce progression of symptoms, and improve their quality of life. Patients will also receive regular six-month to one-year follow-ups.

“The new Lifespan Multidisciplinary Parkinson’s Disease Rehabilitation Clinic is a welcome addition to our robust neuro rehab program,” said Kenneth Vinacco, PT, DPT, who helped start the program. “Our team is excited to launch this new clinic to offer individuals with PD valuable tools, strategies, and resources to manage their symptoms and improve their overall quality of life.”

To refer a patient to the new Multidisciplinary Parkinson’s Disease Rehabilitation Clinic, please make referrals for physical and occupational therapy at 765 Allens Avenue, Providence, RI, and speech therapy at 115 Georgia Ave, Providence, RI with the designation “Newly Diagnosed PD Clinic.”

Afterwards, please secure chat Kenneth Vinacco on EPIC, “Newly Diagnosed pt with PD” so that the patient can be scheduled appropriately. For more information, please contact 401-444-5418 or email Ken directly at [email protected].

Cardiac Positron Emission Tomography Myocardial Perfusion Imaging

Cardiac positron emission tomography (PET) myocardial perfusion imaging (MPI) is an emerging technology to assess coronary artery disease (CAD) and other cardiovascular conditions. Rhode Island Hospital is the first and only medical center in Southern New England to offer this advanced cardiac imaging procedure.

“Like other stress testing performed with nuclear cardiology imaging, Cardiac PET can be used to evaluate symptoms such as chest pain or shortness of breath in patients with known or suspected CAD,” says Brian Abbott, MD, associate chief of cardiology, clinical excellence and operations, Lifespan Cardiovascular Institute. “Cardiac PET, however, has several advantages over traditional cardiac stress testing, including enhanced diagnostic accuracy, lower radiation exposure, and shorter protocol duration. The new Cardiac PET perfusion testing also provides for the simultaneous assessment of myocardial perfusion, function, and blood flow reserve.”

The program, a partnership of the Lifespan Cardiovascular Institute and the Department of Diagnostic Imaging, launched in the summer of 2023. Abbott oversees the program along with Edward Hulten, MD, MPH, director of cardiovascular imaging and Nishant Shah, MD, MPH, MSc, director of nuclear cardiology.

Rhode Island Hospital has already been performing PET imaging of the heart to evaluate other cardiac conditions such as inflammation (e.g., sarcoidosis), assess myocardial viability, and guide decisions for cardiac surgery and angioplasty procedures. Abbott explains, “Now, Cardiac PET MPI provides the referring provider with a complete and accurate assessment of blood flow to the heart. This information can be used for cardiac risk stratification and to guide further management decisions for both CAD and coronary microvascular disease with respect to medical therapy, catheter-based coronary interventions, and surgical revascularization.”

Patients most likely to benefit from Cardiac PET MPI are those with new signs or symptoms of ischemic disease, unexplained changes in the ECG, or with high residual risk assessed by calcium scoring, exercise ECG, or global coronary risk factor scoring. “With its quantitative nature, capacity to measure quantitative flow, high-quality images, and ultra-low-dose radiation exposure, Cardiac PET MPI is the preferred test to evaluate patients with known CAD, who have had prior coronary angiography and revascularization to assess therapeutic response and residual ischemic risk,” says Abbott.

Ideal patients for Cardiac PET MPI include:

• Individuals with advanced obesity (body mass index greater than or equal to 35).
• Women with large breasts or dense breast tissue.
• Younger patients, particularly women over 45 and men over 40.
• Patients with prior equivocal or abnormal stress test results.
• Individuals with familial hypercholesterolemia.
• Patients with coronary artery calcifications (CAC score) of greater than or equal to 400.
• Individuals with CAD and prior revascularization.
• Those who require evaluation for cardiomyopathy and/or heart failure.
• Patients being considered for solid organ transplantation, who have cancer and left ventricle dysfunction during or after chemotherapy or radiation therapy.
• Assessment of myocardial inflammation with 18F-FDG PET at baseline and during reevaluation for response to therapy or recurrent inflammation.

To refer a patient to the Rhode Island Hospital Cardiac PET Program, order in LifeChart “PET CT Myocardial Perfusion Stress” or call the nuclear cardiology PET Center at 401-444-7777.

Total Joint Center earns Fourth Joint Commission Recertification for Advanced Hip and Knee Replacement Program

The Total Joint Center at The Miriam Hospital has earned The Joint Commission’s Gold Seal of Approval® for Advanced Total Hip and Knee Replacement for the fourth time. The seal reflects an organization’s rigorous performance standards and commitment to providing safe, high quality patient care. The Total Joint Center at The Miriam Hospital was established 12 years ago in 2011.

“This recertification recognizes the Total Joint Center team’s expertise and ongoing commitment to the highest standards of care and outcomes for our patients,” said John Froehlich, MD, MBA, program director at the Total Joint Center at The Miriam Hospital. “Patient-centered care is at the heart of everything we do. We strive to provide a safe, welcoming environment for every patient who comes under our care.”

The recertification, offered in collaboration with the American Academy of Orthopedic Surgeons, focuses on comprehensive care including pre-surgical orthopedic consultations, rehabilitation activities following hospitalization or ambulatory surgical center admission, and follow-up visits with the orthopedic surgeon. “This achievement is yet another milestone in the Total Joint Center’s continued dedication to patient centered care and excellence,” said Maria Ducharme, DNP, RN, NEA-BC, president, The Miriam Hospital. “I am proud to work alongside such a talented, dedicated group of surgeons, nurses, and clinical staff. It is that dedication to excellence that makes the TJC the preferred choice for Rhode Islanders seeking joint replacement.”

See a full list of awards for the Total Joint Center. For more information on the certification, visit The Joint Commission website. 

Lifespan Pharmacy Partners with RI Free Clinic to Provide Free Prescriptions

Lifespan Pharmacy is now helping patients of the Rhode Island Free Clinic get free prescriptions. Thanks to a partnership between Lifespan Pharmacy and the RI Free Clinic, patients in need can obtain necessary medications at no cost.

“The Rhode Island Free Clinic provides health services to many vulnerable patients in our community who do not have medical insurance and cannot afford treatment,” says Vincent Salerno, PharmD, director of retail pharmacy services at Lifespan Pharmacy. “At Lifespan, we believe everyone should have access to equitable healthcare. When we heard the Rhode Island Free Clinic needed a pharmacy partner, we jumped in to fill that void.”

Because the RI Free Clinic provides primary care, Salerno said most of the prescriptions are to manage chronic conditions such as high blood pressure, cholesterol, and diabetes, though acute care medications such as antibiotics have also been dispensed. The program, which began at the end of June, has provided more than 500 prescriptions to more than 250 unique patients.

“We felt it was the right thing to do for our community, and that’s why Lifespan Pharmacy is donating its time and resources to this important program. It’s our hope to expand the program to be able to serve even more patients throughout the Providence area,” Salerno added. “It’s very rewarding to be able to participate in giving back to area residents who have difficulty accessing critical resources, and to partner with a community organization who also believes in this.”

For more information, patients can be referred to the Rhode Island Free Clinic by calling 401-274-6347. You can also see an interview with Salerno on WPRI-TV Ch. 12 news at this link here. 

Abrar Qureshi, MD, Finds Gratitude Through Volunteerism

Whether a natural disaster or the horrors of war, when tragedies happen volunteers from all walks of life selflessly spring into action to help the less fortunate. Abrar Qureshi, MD, chief of dermatology at Rhode Island and The Miriam hospitals, is one of those amazing individuals.

Dr. Qureshi is a volunteer with the Syrian American Medical Society. Since joining in 2015, he has completed five missions to help individuals who find themselves in refugee camps in Jordan and Turkey. His latest trip was in March to assist the many who were affected by a devastating earthquake in the Gazientap region of Turkey.

Caring for people comes naturally to Qureshi. He grew up in Karachi, Pakistan, the son of two physicians. He recalls taking messages for his parents, who would commonly make house calls to their patients and believed it was important to know their patients personally, beyond their medical history.

“My dad knew his patients without having to look at a medical record. He would know the patient as a person – their family life, the stress in their lives, their children,” Qureshi says. “I like to know personal things about my patients as well, beyond their medical history.”

That personal touch was helpful in working with refugees. Dr. Qureshi points out that typically, an individual seeks care from a doctor because they recognize they have an issue and need help. For displaced persons, it is not a voluntary situation.

“Refugees are often caught in an unpredictable cycle of events, be it war or natural disaster. When we go to take care of a displaced population, they are there because they don’t have a choice,” says Qureshi.

When asked about his experience, Qureshi explains some of the challenges. “It was very cold, and we were working out of metal containers. We saw so many patients. We gave out so many topical medications we ran out,” he recalls. “We’d get back to our hotel rooms and be physically and mentally exhausted.”

Despite the physical demands and emotional toll of his volunteerism, Qureshi says his experiences have affected him deeply. “My time as a volunteer has made me very grateful. It has shown me what an incredible blessing it is to just go into the kitchen and get some water or fruit.”

Thank you to Dr. Qureshi and all the caretakers who volunteer their time around the world on medical missions to help those in need.

Psychiatry and Behavioral Health Expands Services to Address Changing Community Needs

Adult Gender and Sexuality Behavioral Health Program Expands

Lifespan’s Psychiatry and Behavioral Health is expanding its services to address the increasing and changing needs of individuals in the community.

First is the expansion of its Adult Gender and Sexuality Behavioral Health program. This unique program focuses on the behavioral health needs of gender-diverse individuals ages 18 and older. With the arrival of two new physicians in August, the program is now able to provide comprehensive, patient-centric therapy including psychosocial support, behavioral health, and integrated medication management services.

“Our program is based on anti-oppression, sex positivity, and social justice,” says Kira Keenan, licensed clinical social worker, sexuality educator, and program manager. “The team is unified in its goal of providing the highest quality care to individuals who want to explore gender and/or sexuality in a safe, affirming, and respectful environment.”

The program is accepting new patients. Learn more about the program on our website or call 401-606-0606.

New Partial Hospitalization Program Trauma Track

Another enhancement to Psychiatry and Behavioral Health services is a new Trauma Track within the Adult Partial Hospital Program (PHP) at Rhode Island Hospital. The PHP provides intensive, short-term treatment for individuals with acute psychiatric concerns. Patients participate in multiple groups per day and speak with a therapist and a psychiatrist for individual sessions every day.

The new trauma track offers specialized, evidence-based care to individuals who are impacted by post-traumatic stress disorder (PTSD) and other trauma-related concerns.

“Our new Trauma Track is specifically for those individuals who require mental health treatment for addressing trauma and PTSD,” says Sarah Schmidhofer, MD, a psychiatrist, and co-director of the PHP. “PTSD involves avoiding painful emotions associated with past trauma, which can lead to greater suffering and self-harm, as well as withdrawal from important activities and other unhelpful behaviors.”

Patients in the PHP Trauma Track receive daily individual and group psychotherapy, medication management with a psychiatrist, and an optional mindfulness meditation group. The approach uses evidence-based principles of Dialectical Behavior Therapy Prolonged Exposure (DBT-PE), Acceptance and Commitment Therapy (ACT), and Cognitive Behavioral Therapy (CBT).

“The new PHP trauma track helps people build and master skills to cope with strong emotions and PTSD symptoms so they can understand how trauma and PTSD have impacted their lives,” says Sarah Zimage, LMHC, a licensed mental health clinician and co-director of the PHP. “Through treatment, patients are able to face feared memories and go on to lead a productive life, free from the trauma they experienced in the past.”

Learn more about the program. To refer a patient please call 401-444-3748.

Hasbro Children’s Hospital’s Pediatric EEG and Sleep Disorder Center

Hasbro Children’s Hospital has combined two of its pediatric services into one center. The Pediatric Electroencephalogram (EEG) Laboratory and Sleep Disorders Center now allows for the dual-purpose use of equipment for both sleep studies and EEGs in one location. It is located on the 10th floor of the APC Building.

Pediatric EEG

EEGs measure the electrical activity in the patient’s brain. The test is recommended for children who have experienced seizures, development delays, or other symptoms such as loss of consciousness, abnormal movements, or behavioral concerns.

“Our pediatric EEG lab is a state-of-the-art facility where our young patients receive individualized attention and the highest quality care from our team of experts,” said pediatric neurologist John Gaitanis, MD, division director, Pediatric Neurology.

Several types of EEGs are performed at the lab. Those include:

• Routine and diagnostic EEG measure brain wave activity to evaluate different areas of the brain, and take between 20 to 190 minutes.
• Long-term monitoring from 2 to 12 hours or 12 to 26 hours, to detect intermittent seizure activity; televideo EEG is also available.
• Sleep-deprived exams, including full, partial, and pediatric studies.

Also, for patients who require EEG but are unable to come to the lab or those who require a prolonged study at home, the center also has portable EEG units available, if appropriate.

To refer a patient for EEG, call 401-431-5420. You can learn more about the lab on our website. 

Pediatric Sleep Disorders

“For children with sleep disorders, Hasbro Children’s Hospital is the only children’s hospital in southern New England with a dedicated sleep center. Our dual-purpose Sleep/EEG lab allows us to employ the latest diagnostic methods to provide our patients with the expert care they deserve,” said Richard Millman, MD, medical director, Hasbro Pediatric Sleep Disorders Center.

Several types of sleep studies are performed in the Pediatric Sleep Disorders Center. Those include:

• Overnight Baseline Sleep Studies
• Overnight PAP Titration Sleep Studies
• Multiple Sleep Latency Tests - MSLTs

Our team of experts includes a board-certified sleep medicine specialist, a pediatric psychologist specializing in behavioral sleep medicine, and residents and fellows in pediatrics, pulmonology, neurology, psychology, and psychiatry. The team works closely with pediatric pulmonary, otolaryngology, and neurology specialists.

To refer a patient for pediatric sleep studies, please call 401-606-8040. Learn more about the lab on our website. 

Cecilia Fix, MD, Appointed Division Director of Addiction Medicine

Cecilia Fix, MD, is the new director of Lifespan’s Division of Addiction Medicine. In her new role, she will oversee substance use disorder treatment services across Lifespan to address an ever-increasing demand.

“Addiction medicine includes the services and supports necessary to help those struggling with substance use. Dr. Fix brings a wealth of experience to this important role to help Rhode Islanders,” said Jody Underwood, MD, psychiatrist-in-chief.

Lifespan’s approach to addiction medicine includes several treatment programs, including:

• The Lifespan Recovery Center
• Addiction medicine inpatient consult services at Rhode Island Hospital and the Miriam Hospital
• The Buprenorphine Hotline
• Rhode Island Hospital Bridge Clinic—opening in early 2024.

"Addiction is a more dangerous illness today than it has ever been before. Overdose death rates are at an all-time high and fentanyl, specifically, is the leading cause of death for adults between the ages of 18 and 49,” said Fix. “Substance use disorders can be treated. I am excited to collaborate with our team of experts to ensure that anyone struggling with substance use can get cutting edge care in a warm and welcoming environment here at Lifespan.”

Prior to joining Lifespan, Dr. Fix was the medical director of the Overdose Prevention Program at Stanley Street Treatment and Resources (SSTAR) in Fall River, MA. She was also an HIV and primary care provider at the Early Intervention Program at Cooper University Healthcare, and assistant professor at Cooper Medical School of Rowan University in Camden, NJ.

Dr. Fix completed medical school at Columbia University College of Physicians and Surgeons and completed her residency in internal medicine at Columbia University, New York Presbyterian Hospital. She also completed the David C. Lewis MD Fellowship in Addiction Medicine at The Warren Alpert Medical School of Brown University.

Patrick McGann, MD, PhD, Named New Obama Foundation United States Leader

Congratulations to Patrick McGann, MD, PhD, director of the Lifespan Comprehensive Sickle Cell Center, who is among the inaugural cohort of 100 emerging changemakers selected to participate in the Obama Foundation’s Leaders USA program.

The Obama Leaders program is a six-month virtual program that supports and connects emerging leaders who are united by their passion for building a stronger, more sustainable, and more inclusive world. It offers a values-based leadership framework inspired by the ideals and legacy of President and Mrs. Obama.

McGann was selected to join the program for his commitment to improving the lives of individuals with sickle cell disease through a focus on anti-racism and health equity both locally and internationally.

“I am honored to be chosen to work with this amazing group of changemakers and I look forward to seeing the results of our efforts,” said McGann. “This is an exciting and unique opportunity to engage with thought leaders around the world to address some of the most pressing issues of our time.”

McGann added, “I look forward to building my leadership skills to inspire change in our healthcare system locally, nationally, and internationally with the specific goal of improving the care and lives of individuals living with sickle cell disease in Rhode Island, across the United States, and throughout the world.”

McGann was appointed director of the Lifespan Comprehensive Sickle Cell Center in September 2021. His efforts are focused on three areas:

• Developing an innovative approach to sickle cell care that aims to provide seamless, high quality, and equitable care throughout a patient’s life, directly addressing the well-known challenges patients face when transitioning from pediatric to adult care.
• Recognizing and addressing the negative impact of structural and interpersonal racism on the lives of individuals with sickle cell disease.
• Improving the diagnosis and treatment of children with sickle cell disease around the world to reduce the tremendous early mortality associated with sickle cell disease in Angola and other parts of Africa where he has worked.

As part of the six-month program, McGann will meet virtually each week with the US Obama Leaders cohort for interactive sessions to help them drive change by honing their leadership skills, building deep relationships with their peers, and engaging with thought leaders and members of the Obama Foundation community.

McGann will also have an opportunity to engage with President Obama, participate in a variety of virtual experiences and special events, and work with experienced mentors in the Foundation's global network. To learn more about this program and the individuals who make up the inaugural cohort, visit the website. 

Lifespan Cancer Institute Offers Pioneering Treatments for Patients with Lung Cancer

When it comes to lung cancer, the experts at the Lifespan Cancer Institute use state-of-the-art gene and protein tests to make the correct diagnosis and open doors to pioneering new treatments. These molecular tests provide the team with the best diagnostic information to tailor each patient’s treatment plan to provide the best outcome. For some, surgery or radiation alone may be enough. For others, clinical trials of new drugs may be combined with surgery or radiation or used instead of those options when treating patients with stage 4 cancer.

“These molecular tests are leading to dramatically improved rates of cure, including never-before seen long-term survival rates, even for patients with stage 4 lung cancer,” said Christopher G. Azzoli, MD, director of thoracic oncology at the Lifespan Cancer Institute. “It helps us match the right gene-targeted or immune drug to the right patient.”

Currently there are several pioneering new drug trials for lung cancer that may be right for certain patients.

One trial (BRUOG 397) offers a novel immune treatment to be given prior to lung surgery. When immune therapies are given prior to surgery, it can lead to a complete response prior to surgery. That is, after the immune treatment, when the surgeon removes the area of the lung where the cancer used to be, there is no cancer remaining. Patients with complete responses to pre-operative immune therapies are the most likely to be cured by surgery. “Doctors at the Lifespan Cancer Institute are developing new immune therapies which combine the best new drugs with immune-stimulating radiation to, hopefully, increase rates of immune response in patients prior to surgery. This allows patients to avoid traditional pre-operative or post-operative chemotherapy,” said Azzoli. Learn more about the trial here.

A study is also underway to develop a new drug, JDQ443, as a first line treatment for patients with lung cancer and the KRAS G12C mutation. “The most common gene mutation driving lung cancer is KRAS G12C, which can occur in up to 20 percent of patients. The growth signal in this type of lung cancer can now be blocked with pills, like JDQ443, designed to shut down this mutant protein,” said Azzoli. Such pills are commercially available as a back-up treatment, after traditional immune therapy or chemotherapy has stopped working. Azzoli explained, “Doctors at the Lifespan Cancer Institute are now offering a study that allows patients to take JDQ443 as the very first therapy. It is our hope that JDQ443 will work better than traditional immune therapy or chemotherapy in patients with specific gene mutations, or immune scores,” Azzoli said. Learn more about the trial here. 

Another trial currently underway at the Lifespan Cancer Institute is for AZD9592, a novel, bi-specific antibody drug conjugate with broad applicability in lung cancer treatment. Azzoli explains that there are many drugs which target the genes EGFR and MET. Lung cancers can sometimes be driven by MET, EGFR, or both. An increase in MET signal can cause EGFR-driven cancers to become resistant to EGFR inhibitors. Antibodies which bind to both EGFR and MET at the same time are in commercial use. “Doctors at the Lifespan Cancer Institute are offering a study using a new drug (AZD95952) which is an antibody that binds to both EGFR and MET at the same time and brings a powerful cancer killing ‘payload’ directly into the tumor,” said Azzoli. “The doctors at the Lifespan Cancer Institute were the first in the world to give this drug to patients and remain leaders in the multi-national clinical trial.” It is hoped that this drug may be used to treat many kinds of lung cancer given the importance of EGFR and MET in lung cancer biology. Learn more about the trial here.

To refer a patient to the Lifespan Cancer Institute, call the new patient access line, 401-444-4853, or the nurses’ line 844-222-2881, or visit our website for more information on clinical trials.

Lifespan Orthopedics Institute and Brown University to Launch New Summer Academy Leadership Program for High Schoolers

The Lifespan Orthopedics Institute will launch its new Department of Orthopaedic Research Summer Academy Leadership (DORSAL) Program, thanks to a $50,000 grant from the Rhode Island Foundation.

DORSAL is the department’s flagship community involvement/diversity, equity, and inclusion (DEI) initiative. The program is designed to give high school students foundational skills in orthopedic research while offering tools and strategies for establishing a successful career in the field. It introduces students to various disciplines from engineering to basic biology with the goal of establishing a diverse pipeline of students to the orthopedic research field.

“As a product of the Rhode Island Public School system, we are excited to bring this unique program to local students,” said Dioscaris R. Garcia, PhD, co-director of the Diane N. Weiss Center for Orthopaedic Trauma Research at Rhode Island Hospital and principal investigator (PI) for the DORSAL program. “We believe DORSAL is a great vehicle for exposure to the field of orthopedics, and an opportunity for students to develop an interest in orthopedic research as a career opportunity and ensure a diverse group of researchers to take us into the future.”

Students from local high schools will be matched with a program PI from the department of orthopedic research to serve as a mentor for 10 weeks. Each week will focus on a different area within orthopedic research, including laboratory safety, networking, organizing research, an introduction to clinical practice, scientific writing, and presentation skills. Participants will gain hands-on experience from mentors through seminars, lab time, and training modules.

You can find more information on the DORSAL program.