Telemental Health Appointments at Lifespan Psychiatry and Behavioral Health
To refer a patient for a telehealth appointment with any adult outpatient psychiatry or behavioral health program call the Lifespan Psychiatry and Behavioral Health Access Center at 401-606-0606. To refer a pediatric patient for a telehealth appointment call PediPRN at 401-432-1KID or 401-432-1543.
As the COVID-19 pandemic evolves, and experts continue to learn more about the disease, concerns over the virus may be weighing on the minds of our patients. Telemental health, also known as telepsychiatry, is a resource that Lifespan is offering to patients during this time of social distancing.
Telehealth and telepsychiatry offer a number of capabilities, including speaking over the phone or by video conference, although other services may be available depending on the patient’s specific needs. By utilizing telehealth technologies, patients are able to continue working with their clinician, from the safety of their own home. This technology supports long-distance clinical health care and eliminates the physical obstacles that may prohibit a patient from continuing or seeking professional help.
By utilizing telehealth platforms patients are able to initiate and maintain behavioral health care with a clinician during this uncertain time. Lifespan’s adult outpatient psychiatry and behavioral health programs are committed to continuing to provide high-quality, evidence-based care, even when face-to-face delivery of services may not be possible.
Herbert Aronow, MD, MPH of Lifespan Cardiovascular Institute, Examines Interventional Cardiac Procedures and Precautions during COVID-19
COVID-19 has placed an enormous strain on health care systems where the illness has widely spread. Additionally, there are specific implications of the disease on best practices in catheterization laboratories. These implications include how modifications should be made for the safety of standard cardiac patients, those who are suspected COVID-19 patients, and those patients with COVID-19 who have either unrelated cardiac conditions or cardiac signs of the disease.
The article, accepted for rapid publication in the Journal of the American College of Cardiology and written by representatives from both the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions, examines:
How preexisting cardiovascular disease affects severity of COVID-19 infection
Cardiovascular complications that can arise from infection
Cardiovascular side effects of therapies under investigation
How the rapid triage of non-COVID cardiovascular patients may be affected by the response to COVID-19
How the provision of cardiovascular care may make health care workers vulnerable to infection
Additionally, Dr. Aronow examines the essential protocols for a variety of cardiac-related topics and concerns including elective patients, STEMI patients, NSTEMI patients, patients requiring intubation, suctioning or CPR, resource allocation for health care workers, and protection of health care workers and personal protective equipment (PPE).
As the medical community gains more experience dealing with the various issues raised by the COVID-19 pandemic, it will be important to have the ability to exchange experiences and best practices. Already, social media has provided a venue for some excellent discussions and insight from practitioners at institutions experiencing the effects of the pandemic. As the pandemic progresses, avenues will need to be created for the reporting and collation of data, as well as methods for rapidly dispersing information in order to better care for patients and to protect health care workers.
Newport Hospital Awarded 5 Stars for Overall Quality of Care
Newport Hospital has once again earned five stars for overall quality from the Centers for Medicare and Medicaid Services (CMS) in the most recent “Hospital Compare” ratings.
According to the CMS website, overall quality ratings summarize a range of measures reflecting common conditions that hospitals treat, such as heart attacks and pneumonia. The overall rating shows how well each hospital performed, on average, compared to other hospitals in the United States. Newport Hospital was among 407 hospitals across the country to be awarded the top rating.
Lifespan hospitals, including Newport Hospital, review information from several quality and safety benchmarks, including from the CMS, to inform our continuous quality improvement efforts. The CMS star ratings reflect an emphasis on patient experience.
New Woven EndoBridge (WEB) Technology Enables Streamlined Treatment for Brain Aneurysms
Exciting things continue to happen in the field of interventional neuroradiology at the Norman Prince Neuroscience Institute at Rhode Island Hospital. In 2019, we began using the WEB device, short for Woven EndoBridge, a new technology that enables physicians to better treat challenging brain aneurysms.
“The WEB device is a gamechanger for our patients,” said Dr. Ryan McTaggart, director of interventional neuroradiology at the Norman Prince Neuroscience Institute at Rhode Island Hospital. “The WEB device offers many advantages for the patient, including a shorter recovery time, less or no dependence on anti-platelet drugs, and fewer challenges during a procedure that runs an hour or less.”
The WEB is a self-expanding, mesh ball made of nickel and titanium that is implanted within aneurysms that arise from arterial branch points in the brain. The WEB’s “microbraid” technology disrupts blood flow into the aneurysm and diverts that blood flow away from the neck (or entrance) of the aneurysm.
The aneurysms for which the WEB is designed are, historically, a challenge to treat and require neurointerventional surgeons to create complex configurations of embolization coils and “assist devices” such as stents. In contrast, the WEB system is a unique, single-device treatment solution for these challenging aneurysms - also known as wide neck bifurcation aneurysms, which account for approximately 35 percent of all aneurysms.
Another benefit of WEB device repairs is that patients are spared the need for medications, sometimes indefinitely, after their aneurysm repair. “When patients have brain aneurysms repaired with other devices, we sometimes need to keep them on medications for six months or so, and then on aspirin forever,” explains Dr. McTaggart. “With the WEB, patients may take these medications, but only for a short period of time.”
For more information about WEB technology or to refer a patient to Dr. McTaggart, call 401-606-2645.
Center For Bariatric Surgery
Our specialists can help people who struggle with obesity and related medical conditions such as high blood pressure, sleep apnea or diabetes.
Duodenal Switch Now Offered to Patients with High Body Mass Index (BMI) or with Significant Obesity-Related Comorbidities
The Center for Bariatric Surgery at The Miriam Hospital is now offering a new weight loss option for patients with a body mass index of greater than 50 or BMI greater than 35 with significant obesity-related comorbidities. The biliopancreatic diversion with duodenal switch (BPD/DS), most often known as a duodenal switch, is a weight-loss surgery that reduces a patient’s ability to absorb calories, vitamins, and minerals. Duodenal switch patients can lose more weight than with other surgical methods like gastric bypass or sleeve gastrectomy, as much as 70 to 98 percent of their excess weight. Additionally, unlike other weight loss options, nearly 100 percent of duodenal switch patients have resolution of their type 2 diabetes.
Weight loss surgeons not only recommend duodenal switch for patients who are severely overweight or suffer from type 2 diabetes, but also those who suffer from other serious obesity-related comorbidities such as:
Obstructive sleep apnea
High blood pressure
Nonalcoholic fatty liver disease
During a duodenal switch procedure, the surgeon removes a large portion of the stomach by tubularizing the stomach or creating a “sleeve.” This limits food intake and alters hormones related to hunger. The small intestine is then “switched” by creating a connection between the ileum and first portion of the duodenum. This alters the digestion process and limits calorie absorption.
This weight loss option has shown greater results than gastric bypass or sleeve gastrectomy, more favorable changes in gut hormone to reduce appetite, and is most effective against diabetes. Like with any surgical procedure, there are risks. The duodenal switch is the longest bariatric surgery and may carry a higher risk of post-operative complications, although these rates are still very low (less than one percent). Additionally, due to the reduced ability to absorb certain vitamins and minerals, there is an increased risk of developing nutritional deficiencies after surgery.
Dr. Nikhil Panda Is First Physician in State to Implant Micra AV Leadless Pacemaker
Nikhil Panda, MD, a clinical cardiac electrophysiologist with the Lifespan Cardiovascular Institute, has successfully implanted the first leadless pacemaker in Rhode Island. In January, the device was cleared by the U.S. Food and Drug Administration (FDA).
Unlike conventional pacemakers, which are placed in the patient’s chest with leads running to the heart, the Micra pacemaker is implanted directly inside the heart, eliminating the need for leads or wires. The procedure, which takes 15 to 20 minutes, uses the femoral vein in the patient’s leg to pass the device up into the heart, making it a less invasive process, with no surgical incisions, reduced recovery time, and limited post-operative complications. Early results show a 63 percent reduction in complications compared to traditional pacemakers.
Micra is 93 percent smaller than other pacemakers. It is intended for the treatment of patients with AV block-- a condition in which the electrical signals between chambers of the heart (the atria and the ventricle) are impaired. When the process is achieved, patients are healthier, have a decreased chance of pacemaker syndrome, increased blood flow, and generally improved quality of life.
“The new leadless pacemaker is a significant advancement in leadless pacemaker technology,” Dr. Panda said. “It allows select patients who require AV synchrony and a pacemaker to have the benefits of leadless pacing technology, including faster procedure time, no risk of lead complications, and a significantly decreased risk of infection.”
The Micra AV is bullet sized, weighing only 2 grams, making it possible for it to be fully contained within the heart.
“The Micra AV leadless pacemaker is ideal for patients who are unable to have a traditional transvenous surgical pacemaker for anatomical reasons,” said Dr. Panda. “These patients, who would have otherwise required open heart surgery, now have the Micra AV leadless pacemaker as the preferred option.”
Surgeons at The Miriam Hospital Perform the First Robot-Assisted Inferior Vena Cava (IVC) Thrombectomy with New Da Vinci Xi Robot
Lifespan has expanded and enhanced its minimally invasive surgical programs by acquiring two new da Vinci Xi robots, one for The Miriam and one for Rhode Island Hospital.
The robotic surgical systems can perform procedures through tiny incisions, contributing to better outcomes for patients, including reduced pain and blood loss, quicker recovery, minimal scarring, and fewer complications. The Xi offers additional capabilities that allow for robot-assisted surgeries for some of the most complicated cases.
The addition of the robots allows the hospital, and surgeons, to substantially increase the volume of robot-assisted cases for urologic procedures, along with colorectal cases, and general surgery. The units include dual surgeon consoles that allow residents and fellows to gain the necessary experience in robot-assisted surgery under the supervision of attending surgeons.
Surgeons at The Miriam Hospital’s Minimally Invasive Urology Institute, Drs. Sammy Elsamra and Dragan Golijnain, with assistance from Dr. Robert Patterson, recently began performing robot-assisted procedures that are not currently offered anywhere else in the region. The team made history by completing the first robot-assisted inferior vena cava (IVC) thrombectomy with robot-assisted radical nephrectomy and intraoperative ultrasound in southeastern New England.
The multidisciplinary team enlisted colleagues from urologic, vascular, anesthesia, and nursing specialties to reach this milestone.
The procedure is typically performed using open surgery for patients with a large renal mass with tumor thrombus extending into the IVC. The high-risk, intricate surgery completed in a robot-assisted fashion allows for a shorter hospital stay, significantly smaller incision, decreased risk of bleeding and faster recovery for patients.
For more information or to refer a patient, please call 401-793-5400.
Hasbro Children’s Hospital Once Again Earns National Recognition for Patient-Centered Care
The Medicine Pediatrics Primary Care Center and Pediatric Primary Care at Hasbro Children’s Hospital have once again earned Patient-Centered Medical Home (PCMH) recognition from The National Committee for Quality Assurance (NCQA). The designation recognizes evidence-based, patient-centered processes, highly coordinated care, and long-term patient-clinician relationships.
Medical homes foster ongoing partnerships between patients and clinicians, and help ensure patient care is overseen by clinician-led care teams that coordinate treatment across the health care system. Research shows that medical homes can lead to higher quality care and lower costs.
NCQA standards align with the joint principles of the Patient-Centered Medical Home, established with the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Osteopathic Association.
Health care services at the Pediatric Primary Care Clinic (located in the lower level of the hospital) include comprehensive primary care for children and adolescents. The Medicine Pediatrics Primary Care Center at 245 Chapman Street in Providence offers well child, adolescent and adult annual exams, sports physicals, immunizations and vaccines, and management of chronic conditions such as asthma, diabetes, hypertension, and urgent care. Specialized clinic services range from basic office procedures such as suture removal, skin biopsy, skin tag removal, and wart treatment to puberty, sexual health, contraception services, and behavioral health services.
Physicians at the Pediatric Primary Care Clinic are faculty at The Warren Alpert Medical School at Brown University and are board-certified or training for certification in pediatrics; physicians at the Medicine Pediatrics Primary Care Center hold faculty appointments at the Alpert Medical School and are dually board-certified, or training for dual certification, in both internal medicine and pediatrics, enabling them to treat patients of all ages.
Dr. Marcoandrea Giorgi Brings New Techniques to Abdominal Wall Reconstruction
One of the biggest challenges that minimally invasive and general surgeons face are ventral hernias. Historically, many techniques have been described to address ventral hernias, primary repair of the fascial defect being one of them, which resulted in more than 50 percent recurrence rates. Tension-free repair using mesh quickly became the standard of care.
Unfortunately, regardless of the use of mesh, high recurrence rates -- up to 30 percent -- are still reported.
Marcoandrea Giorgi, MD, a general surgeon specializing in robot-assisted surgeries has begun to utilize the da Vinci robot in an innovative way to improve short- and long-term outcomes for abdominal wall reconstruction.
Hernia defect size has been one of the greatest independent risk factors for outcomes and recurrence. Multiple models have shown the extent of myofascial medialization that can be achieved following different techniques, such as laparotomy, retro-rectus muscle dissection, and transversus abdominis muscle division.
With increasing advances in technologies and improved surgical techniques, we expect to see a significant improvement in, recurrence rates, reduction of morbidity, and decreased costs. With the introduction and wide adoption of robotic surgery, primarily using the da Vinci system, surgeons now have another tool to use to perform ventral hernia procedures.
Surgeries that were once “open” can now be performed with very small incisions.
Improved wrist articulation and dexterity.
Small surgical incisions provide numerous benefits including: less pain, faster recovery, shorter hospital stay, faster return to work, and a reduced risk of wound complications.
Affiliated with Rhode Island and The Miriam hospitals, Dr. Giorgi is a general surgeon at Brown Surgical Associates. Although primarily a bariatric surgeon, his clinical interests also include treating patients requiring traditional surgeries with minimally invasive and endoscopic techniques.
The spine surgeons, who are part of University Orthopedics, attained this achievement by utilizing Spineart individually packaged, sterile, single-use implants during lumbar and cervical implant surgeries performed at Rhode Island and The Miriam hospitals. Because of the true, single-use nature of the implants, certain variables are completely eliminated as risk-factors.
One potential cause of postoperative infection is the practice of reprocessing implants: devices are stored in trays and after each surgery, and the un-used implants are washed and sterilized for countless cycles, posing risks of corrosion and inadequate cleaning. With single-use implants, that possibility is avoided completely.
Infection rates following traditional spine surgery can be as high as 15 percent. By eliminating infections in these cases, increased costs and poor clinical outcomes were also avoided.
“Utilizing single-use, sterilely packaged spinal implants is just one way we are making spine surgery safer for our patients,” said Dr. Daniels, chief of orthopedic spine surgery. “We will continue to use the latest technologies to improve not only procedure outcomes, but also the lives of our patients.”
New Medication Packaging Technology Improves Prescription Adherence
In June, Lifespan Pharmacy will introduce new medication packaging technology, which will empower patients to be in control of their own health and medication adherence. This packaging technology will simplify a patient’s ability to keep track of their medication by utilizing easy-to-open pouches that are organized by day and time of dose.
By utilizing strip packaging, Lifespan Pharmacy will be able to deliver a more streamlined experience for its patients, differentiating themselves from the competition, and reducing overall health care costs. When a patient opts-in for blister packs, all their prescriptions are packed by dose and time of administration. This system will help eliminate any guesswork that patients may experience when it comes to their medications.
Blister packs will offer both single- and multi-dose pouches with complete customization, ensuring that patients have the medicines they need without having to count, sort, or worry. This technology will also streamline changes in patients’ medication, because sorting and packaging is done in the pharmacy for the patient, eliminating the risk of confusing medications, dosages, and timing.
Young Adult Outpatient Psychiatry Expands to East Greenwich, Helps Youth Face Mental Health Issues
Young adults with psychiatric issues may face challenges when seeking treatment. By streamlining programs and delivery systems, the Young Adult Outpatient Psychiatry (YAOP) program removes barriers that can discourage patients. Designed with younger patients in mind, the program efficiently evaluates and treats those in crisis, helping them combat their mental health illnesses and live more productive lives by providing comprehensive, age-appropriate care.
In addition to its Providence location, YAOP now sees patients in East Greenwich. YAOP provides comprehensive evaluations, psychopharmacologic treatment, and referral and partnership with interpersonal, supportive, dialectical, and cognitive behavioral therapists. Working with patients and their family members as appropriate, treatment programs are tailored to each person’s individual needs. Clinicians coordinate directly with inpatient and partial hospital programs to provide each young adult with a continuum of care that is customized to their specific needs.
All the staff have expertise in treating young adults in a variety of areas including:
The New PACE Clinic Opens at Hasbro Children’s Hospital
The new PACE (Psychiatry Access, Continuity, and Evaluation) Clinic, an outpatient clinic for children and teens with behavioral health needs, is now open at Hasbro Children’s Hospital. The PACE Clinic ensures that patients have access to experienced medical professionals who can treat them safely and quickly when they need it most.
The clinicians at PACE are equipped to handle children experiencing depression, anxiety, suicidal thinking, those who may be lashing out at family and friends, or hurting themselves or others. By appointment, the clinic provides short-term, outpatient care until a child or teen is able to find an appropriate, ongoing treatment program.
Children with urgent psychiatric needs take different paths to the PACE Clinic. They may:
Have been diverted from making an emergency department visit after a call to Kids’ Link RI, a caregiver’s behavioral health triage service and referral network for children in emotional crisis.
Have been evaluated by Lifespan’s Pediatric Behavioral Health Emergency Services providers in the Hasbro Children’s ED or in Bradley Hospital’s Access Center. A provider has found that the child urgently requires a medication evaluation or they would benefit from visits to the PACE Clinic team while awaiting the start of their care plan (which may include home-based services, outpatient care, or a partial hospital program).
Be on a waiting list for another outpatient program.
Have been discharged from inpatient or partial hospital program levels of care and are awaiting the start of their long-term care plan.
A member of the clinic team guides parents and/or guardians and their children to the most appropriate type of care and setting in which to receive treatment.
The PACE Clinic is located near the elevator bank in the lower lobby of the pediatric emergency room. The clinic is open Monday through Friday from 8 a.m. to 5 p.m.
For more information about the PACE Clinic and its services, please call Kids' Link RI at 1-855-543-5465.
Lifespan Specialty Pharmacy Moves
Lifespan Specialty Pharmacy has moved to its new home at 117 Chapman Street. The same convenient services that patients know are now readily available day and night by phone.
The Lifespan Specialty Pharmacy program provides access to hard-to-find specialty medication, one-on-one drug counseling with a specially trained pharmacist, a close working relationship between doctors and health care teams, and an available pharmacist 24 hours a day, 365 days a year. The program also ensures free home delivery of specialty medication.
The new address is 117 Chapman Street, Suite 200, Providence, RI 02905. Hours are Monday through Friday, 7 a.m. to 7 p.m.; and Saturdays, Sundays, and holidays, 8 a.m. to 4:30 p.m. For more information, call 401-444-9909.
Dr. Athena Poppas Named President of the American College of Cardiology
Dr. Poppas has been a long-standing leader of the college throughout her more than 20 years of membership. She previously served as President of the Rhode Island chapter, holding a seat on the ACC Board of Governors. As a member of the Governance Committee, she helped spearhead the restructuring of the ACC’s governance structure and process to ensure the ability of the College to be nimble, strategic, accountable and inclusive of the diverse needs of the global cardiovascular community. She’s also held positions on the Cardiometabolic Strategic Work Group, Clinical Quality Committee and Women in Cardiology Council.
Dr. Poppas has been a member of the ACC Board of Trustees since 2010, most recently serving as vice president.
A graduate of University of Wisconsin Medical School, Dr. Poppas completed her residencies in internal medicine at University of Wisconsin Hospital and Clinics and in cardiovascular medicine at University of Chicago Hospitals. Additionally, she is a professor of medicine and chair of the cardiology department at The Warren Alpert Medical School of Brown University.
Dr. Poppas specializes in valvular heart disease, heart disease in women, and echocardiography and heart disease in pregnancy She has focused much of her research on echocardiography and also the various facets of heart disease in women, with a special interest in peripartum cardiomyopathy.
Dr. Thomas DeNucci Named Medical Director of Endoscopy at Rhode Island Hospital
In addition to overseeing the endoscopy department, Dr. DeNucci will also maintain his teaching responsibilities at The Warren Alpert Medical School of Brown University. After earning his medical degree from the Alpert Medical School in 1980, he completed his residency in internal medicine at Roger Williams Medical Center in Providence, followed by a fellowship in gastroenterology at Rhode Island Hospital.
As medical director, Dr. DeNucci is responsible for reviewing advances in gastrointestinal endoscopy and overseeing the physicians at Rhode Island Hospital and Wayland Square endoscopy suites. Additionally, he will serve as co-chair of the Endoscopy Steering Committee and continue his role on the Gastroenterology Fellowship Selection Committee.
Janine Lairmore Joins Lifespan as Vice President of Cardiovascular Services
Janine Lairmore has joined the Lifespan executive team in the newly created position of vice president for cardiovascular services. In this role, she reports to Nick Dominick, Lifespan's senior vice president for clinical service lines and facilities development, and will work closely with Athena Poppas, MD, chief of cardiology and director of the Lifespan Cardiovascular Institute, and Frank Selke, MD, chief of cardiovascular surgery for Lifespan.
Lairmore has more than two decades of high-level experience in health service and clinical operations. Prior to joining Lifespan, she held positions at Care New England Medical Group, most recently directing the Brigham and Women’s cardiology service line.
A lifelong Rhode Islander, Lairmore holds a master’s degree in healthcare administration from Salve Regina University and is a licensed radiologic and nuclear medicine technologist.
Dr. Laura Levine Named Medical Director of the Lifespan Recovery Center
Laura B. Levine, MD has been appointed director of the Lifespan Recovery Center. Dr. Levine is board-certified in psychiatry and addiction medicine and has more than 15 years of experience providing evidence-based treatment for substance use disorders, including opioid use disorder, and co-occurring mental health conditions.
Dr. Levine is committed to training the next generation of physicians in the provision of evidence-based treatment of substance use disorders, including opioid disorders and co-occurring mental health conditions.
A graduate of Tufts University School of Medicine, she completed her residency at The Warren Alpert Medical School of Brown University where she is a clinical associate professor of psychiatry and human behavior. She also directs the David C. Lewis Fellowship in Addiction Medicine at Rhode Island Hospital.
Named a “Top Doc” in Rhode Island for addiction medicine, Dr. Levine aims to build the capabilities at the Lifespan Recovery Center to emphasize evidence-based, patient-centered care for this high-risk population.
Dr. Heather Hall Elected President of Newport Hospital Medical Staff
In February, Dr. Hall, a 12-year veteran at the hospital, oversaw her first full medical staff meeting, officially becoming the first woman to lead the Medical Executive Committee in recent memory. In addition to overseeing and representing the medical staff, she will play an integral role in offering input into hospital operations and credentialing of medical providers for hospital privileges.
Dr. Hall is a graduate of the State University of New York Downstate College of Medicine. She completed her residency at New York University Medical Center.
Gabriella J. Avellino, MD, MA
A surgical urologist specializing in male reproductive medicine, Gabriella Avellino, MD, recently joined the division of urology at Rhode Island and The Miriam hospitals.
Her areas of expertise include male and female urinary tract and male reproductive organs, with an emphasis on male fertility and sexual medicine - along with other genitourinary and urological disorders.
Dr. Avellino earned her medical degree and completed her general surgery internship and her residency in urology at Boston University School of Medicine. She completed her fellowship in male reproductive medicine and surgery primarily at Rhode Island Hospital, but also spent time training at The Miriam Hospital and the Providence VA Medical Center.
Dr. Avellino is a member of the American Urological Association, American Society of Andrology, American Society of Reproductive Medicine, and Society for the Study of Male Reproduction.
Sammy Elsamra, MD
A urologist specializing in urologic oncology, Sammy Elsamra, MD, has joined the Minimally Invasive Urology Institute at The Miriam Hospital.
His areas of expertise include prostate cancer, kidney cancer, bladder cancer, and testicular cancer. Dr. Elsamra has a special interest in robotic urologic surgery, laparoscopic surgery, percutaneous renal surgery, and endourology. He is board certified in urology and committed to resident, fellow, and medical student education, clinical service line developments, and improvement of service line delivery.
Dr. Elsamra earned his medical degree at the University of Medicine and Dentistry of New Jersey (now Rutgers)—New Jersey Medical School. He completed his residency at The Warren Alpert Medical School of Brown University, and a two-year Endourology Society-accredited fellowship at the Smith Institute for Urology, part of the North Shore Long Island Jewish Health System, under the guidance of Arthur Smith, MD, an internationally recognized pioneer in endourology.
He previously served as clinical assistant professor and program director of the urology residency program at the Rutgers Robert Wood Johnson Medical School and as director of robotic surgery at Robert Wood Johnson University Hospital.
Richard Wein, MD
Otolaryngologist and head and neck surgeon, Richard Wein, MD, recently joined the Lifespan Cancer Institute.
Dr. Wein earned his medical degree from Tufts University School of Medicine in Boston. He completed his otolaryngology-head and neck surgery residency at the University of Rochester Medical Center and subsequently completed his fellowship in head and neck surgical oncology at the University of Pennsylvania Health System.
Dr. Wein specializes in surgical management and reconstruction for patients requiring care for tumors of the head and neck.
New Study Shows One in Three School-Age Children Do Not Get Enough Sleep
A new study by Hoi See Tsao, MD, has identified that one out of three school-age children are not sleeping enough, as defined by the American Academy of Pediatrics (AAP) sleep guidelines. The study also showed that children who aren’t getting enough sleep exhibit decreased “childhood flourishing” – which describes a child’s resilience, approach toward learning, and overall positive behavioral and social well-being.
Based on AAP guidelines, sufficient sleep is defined as sleeping more than or equal to nine hours on an average weeknight for 6- to 12-year-olds and sleeping more than or equal to eight hours on an average weeknight for 13- to 17-year-olds. Parents and caregivers were asked how well each of the following phrases or flourishing markers described their child: if their child showed an increased interest and curiosity in learning new things, cared about doing well in school, did all required homework, saw tasks through completion, and stayed calm and in control when faced with challenges.
The study revealed that insufficient sleep was reported in 36.4 percent of 6- to 12-year-old children and 31.9 percent of 13- to 17-year-old children—meaning nearly a third of school-age children in the nation are not getting adequate sleep. Additionally, children with insufficient sleep were less likely to demonstrate the five flourishing markers when compared to children getting sufficient sleep.
The study concluded that insufficient sleep is associated with decreased childhood flourishing, which may have critical repercussions on the physical and mental health, school performance, and overall well-being of children. The study shows that greater efforts need to be made to maximize sleep sufficiency, most especially addressing delayed school start times, digital media usage, and developing consistent bedtime routines.
New Brain Stimulation Study Launches at Bradley and Butler Hospitals
Under the direction of Brian Kavanaugh, PsyD, Bradley and Butler hospitals launched the Brain Stimulation for Working Memory in Teens study to help determine whether a certain type of brain stimulation, called repetitive transcranial magnetic stimulation (rTMS), can improve attention/concentration (i.e., “working memory”) in teens.
Experts that make up the team utilize a combination of neuroscientific and psychological tools to test if rTMS can enhance the brain activity responsible for working memory. “Oftentimes, working memory deficits accompany primary psychiatric disorders such as ADHD or depression, yet we don’t yet have enough treatment options for these deficits,” says Dr. Kavanaugh. “Our goal is to develop new treatments that can target precise brain regions or networks in order to improve neurocognitive deficits, such as working memory deficits. If we find in this study that rTMS can enhance working memory-related brain activity, we would next want to test if daily sessions of rTMS could improve the clinical symptoms of working memory.”
To be eligible, participants are required to attend four hospital visits that consist of questionnaires/cognitive tasks, electroencephalogram (EEG) recording, computer games, and rTMS sessions, as well as complete two “real” stimulation sessions and one “fake” stimulation session. Visits will last approximately one to three hours, and participants will be financially compensated for study participation.
For more information about Brain Stimulation for Working Memory in Teenagers, contact Dr. Kavanaugh at 401-432-1359 or firstname.lastname@example.org.
New First In-Human Study to Test DF-1001
The first in-human Phase 1 study of a new anti-cancer immunotherapy has been developed by the biotech company Dragonfly, based in Waltham, Massachusetts. The initial clinical testing was performed at the M.D. Anderson Cancer Center in Houston and the Lifespan Cancer Institute.
The investigational drug DF-1001 is the first drug in a new class of molecules called Tri-specific, NK cell Engager Therapies (TrinKETS). DF-1001 is a molecule designed to boost the immune system to kill cancer cells. The study drug is designed to stick to a protein called HER2, found on the outer part of cancer cells. At the same time, the drug is also designed to stick to a protein called CD16, found on the outer part of NK cells and to a protein called NKG2D, found on the outer part of NK and T cells. NK and T cells are types of immune cells in the body.
The drug works by bringing the cancer cell, NK cells, and T cells all together. This then allows the NK cell to directly kill the cancer cell and allows other types of immune cells in the body to attack the cancer.
The first two trial patients were treated in Houston, and the third, fourth, and fifth patients were treated in Providence in February, March, and April respectively.
Fibromyalgia Study Aims to Utilize Shared Medical Appointments
Fibromyalgia is a condition characterized by chronic widespread pain and nonspecific symptoms, including muscle and nerve pain. Because of its multifactorial nature and broad symptom profile, fibromyalgia is difficult to treat; patients often experience a delay in diagnosis and are often stigmatized. An estimated 2 to 6.4 percent of the U.S. population have fibromyalgia, with women outnumbering men at least two-to-one.
While current treatment guidelines recommend combining pharmacologic and non-pharmacologic therapies, the magnitude and benefit of the non-pharmacologic (largely lifestyle) interventions often exceed those of the pharmacologic. However, given its complex nature and presentation, primary care providers often struggle with providing the optimal treatment strategy for fibromyalgia patients within the time constraints of the typical office visit.
Primary care providers are often the first to diagnose and treat fibromyalgia, yet are limited to the constraints of 15-minute follow-up appointments, making it impossible to adequately manage medications and counsel patients on the multiple lifestyle factors contributing to symptoms.
In this new fibromyalgia study, a shared medical appointment approach would allow for patients to be educated on management strategies, which are the cornerstone of success with fibromyalgia: lifestyle approaches such as physical activity/movement, nutrition (specifically an anti-inflammatory diet), and importance of mental health, sleep, and self-care for optimization of pain control. Patients learn gentle chair yoga, short mindfulness exercises, and breathing techniques to help them better cope with painful stimuli.
During week one of the session, patients complete questionnaires on sleep patterns, functional status, pain scales, and mood. Participating in this study may improve fibromyalgia symptom severity and may help subjects better manage their fibromyalgia through improved quality of life. The information gained will enhance our understanding of what may be a more effective approach for managing fibromyalgia. The questionnaire is repeated at week six.
All sessions take place at the Women’s Medicine Collaborative (146 West River St., Providence, RI 02904). The program is offered three to four times per year. The maximum number of participants per session is 10 patients, in order to maximize each participant's voice and experience.
Of note: Within a typical outpatient primary care practice that sees a patient for 30 minutes per visit once-a-month, it would take a minimum of two years to achieve 12 clinical hours. Therefore, if this program were implemented by primary care providers, it has the potential to accomplish in six months what would ordinarily take nearly two to four years to achieve.