LifeNotes | Spring 2021
New Incisionless Brain Surgery Gives Patients Immediate Relief from Disabling Tremors
Neurosurgeons at the Norman Prince Neurosciences Institute (NPNI) will soon be offering an exciting new treatment option for patients suffering from Essential Tremor and some forms of Parkinson’s Disease.
The NPNI team will utilize the novel technology known as high-intensity focused ultrasound (HIFU) to treat patients suffering from disabling tremors. This procedure uses MRI-guided focused ultrasound energy to treat the brain circuit responsible for the tremors. This incisionless procedure is performed while the patient is awake in order to immediately confirm optimal treatment effect: immediate cessation of tremor with minimal side effects. Patients who are candidates for the procedure can experience significant and long-lasting reduction in hand tremors.
The focused ultrasound procedure combines two advanced technologies: magnetic resonance imaging (MRI) with fiber-tracking allowing visualization of the exact location in the brain responsible for the tremor, and an array of more than 1,000 beams of ultrasound energy precisely focused using sophisticated, patient-specific mathematical models to target that exact location without damaging surrounding brain tissue.
Movement disorders affect more than 40 million people in the United States. Our team employs a multidisciplinary approach to the treatment of conditions like Parkinson’s disease, essential tremor, and restless legs syndrome.
Because this outpatient procedure does not require an incision, it boasts several advantages including reduced risk of infection and quicker recovery time, along with the immediate and considerable reduction in hand tremors.
“Although Essential Tremor is relatively common and often fairly mild, there are a significant number of patients for whom the condition is more severe and debilitating, impairing a wide variety of routine daily activities such as eating, writing, and getting dressed,” noted Wael Asaad, MD, PhD, the neurosurgeon who will be conducting the procedure. “For those individuals who cannot find relief through medications, this procedure offers an effective, cutting-edge option without the cutting.”
Coastal Medical Joins Lifespan Team
In April 2021 Coastal Medical officially became a part of the Lifespan health system.
The two organizations have a long history of successful collaboration in caring for patients. Coastal is a national model for coordinated primary care, while Lifespan offers complementary strengths in specialty services, research, and education. Combining Lifespan’s vast specialty care capabilities with Coastal’s primary care expertise will benefit patients across the state, offering enhanced value through a continuum of coordinated, high-quality patient care.
“Coastal shares Lifespan’s commitment to Rhode Island, fostering innovation and ensuring value, to deliver excellence in care,” said Alan Kurose, MD, Coastal president and CEO.
“Bringing together these two organizations will be transformative for health care in our state,” said Timothy J. Babineau, MD, Lifespan president and CEO. “With Coastal, Lifespan can accelerate its journey to provide more value-based care, which will advance quality, increase access and ensure patients receive care in the most appropriate setting.”
All Coastal practices are recognized by the National Committee for Quality Assurance (NCQA) as patient-centered medical homes and have earned a NCQA distinction for Integrated Behavioral Health, while simultaneously lowering the overall cost of care delivery.
New Mini-PCNL Procedure Now Offered at the Minimally Invasive Urology Institute
The Minimally Invasive Urology Institute (MIUI) at The Miriam Hospital is now offering a new procedure, the minimally invasive percutaneous nephrolithotomy, also known as the Mini-PCNL.
The procedure removes large kidney stones through a small tube placed into the kidney via a key-hole incision in the patient’s back. Similar to the existing PCNL procedure, the mini-PCNL requires an even smaller incision, effectively further reducing the risk of complications.
The new technique is available to all patients struggling with kidney stones. For patients who currently have or are trying to manage their kidney stones, telehealth services are also available at the MIUI.
Two Lifespan-Affiliated Surgeons First in RI to Perform Groundbreaking Treatments for Gastroparesis, Achalasia
Two new treatments are now an option for southern New Englanders suffering from two different, debilitating gastrointestinal issues. Both procedures are incision-free, resulting in a shorter hospital stay and quicker recovery.
The POP, or per-oral pyloromyotomy, treats gastroparesis – a chronic condition that affects the stomach muscles and prevents proper stomach emptying. The POEM, or per-oral endoscopic myotomy, treats achalasia – a rare disorder that makes it difficult for food and liquid to pass into the stomach.
Surgeons Marcoandrea Giorgi, MD, and Andrew Luhrs, MD, along with gastroenterologist Zilla Hussain, MD, from Lifespan Physician Group, recently performed both procedures for the first time in Rhode Island and southeastern Massachusetts.
"Now more than ever, people want to avoid a long hospital stay if possible. Both cutting-edge procedures not only provide relief but also drastically reduce the amount of time patients will need to stay in the hospital following the procedure," said Dr. Luhrs.
Like traditional myotomy, the pyloric muscle is cut during a POP myotomy. However, this procedure doesn't require incisions. Instead, it is performed endoscopically through the mouth, with a camera.
The procedure is an option for any patient diagnosed with gastroparesis via a gastric emptying study who hasn't undergone a traditional myotomy. Even those who have undergone traditional myotomy may be candidates. The POP myotomy does not preclude further potential operations, so it can be offered as a safe, early option.
POEM – or per-oral endoscopic myotomy – is similar to a heller myotomy for the esophagus but is done endoscopically, eliminating the need for incisions.
"With POEM, we are now able to perform the same effective myotomy using cameras through the mouth like a routine endoscopic procedure without the need for incisions in the abdomen," explained Dr. Giorgi.
Newport Hospital Once Again Receives Leapfrog Honors
Newport Hospital has earned its eighth consecutive 'A' grade for safety from Leapfrog, while also being named one of Leapfrog's 2020 Top Hospitals in the country. It is the only hospital in Rhode Island to make the list.
The ‘A’ grade honor recognizes the hospital's achievements in providing safer health care. The hospital has received the top grade in each of the last eight twice-yearly ratings that Leapfrog issues. The Top Hospital award is given to less than five percent of all eligible hospitals in the country.
"Safety is our number one priority and something we focus on unrelentingly, from our daily manager ‘safety huddles’ to address timely safety concerns to the conscientious care our medical professionals deliver to patients every single day," said Newport Hospital president Crista F. Durand. "Being named a Top Hospital in the country, in addition to achieving a eighth straight A-grade from Leapfrog, is a reflection of our unwavering pursuit of excellence and the hard work and commitment of our entire staff, even as we navigate the daunting challenges of the coronavirus pandemic."
Lifespan Cancer Institute Launches Supportive Care Services to Improve Patient Quality of Life
The Lifespan Cancer Institute, under the guidance of Dana Guyer, MD, launches Supportive Care services for patients and their families to live well in the face of serious illnesses and chronic diseases like cancer.
Supportive Care services are provided by a team of specially trained health care professionals who work with the patient's oncologist to provide an extra layer of support. The partnership focuses on treating the whole person and provides measurable benefits. By working with patients, their families, and caregivers the team strives to make life easier for everyone affected by the illness. The mission is to improve quality of life by reducing stress, managing pain, and lessening symptoms.
Supportive Care is appropriate for people of all ages, suitable for patients with all stages of cancer, and helpful for patients receiving curative therapies. Patients who receive Supportive Care can live longer, with less depression, and better adherence and response to treatments such as chemotherapy. It is also an important resource for people who are no longer receiving cancer treatments.
If you have a patient who could benefit from the extra support provided by these services, or if you have additional questions about Supportive Care please call 844-222-2881 or learn more on our website.
New Health Coaching Program Supports Lifestyle Changes That Last a Lifetime
The Lifespan Lifestyle Medicine Center has launched a pilot program for the primary care patients of the Women’s Medicine Collaborative. The center’s dynamic Health Coaching program is designed to help patients develop and maintain new skills to reach their health goals.
Using various behavior change approaches, the program intends to help patients identify goals, build momentum, and overcome barriers to make lasting health changes. Patients are referred by their primary care provider and overseen by the center’s two certified health coaches and the nurse care manager.
“Our nationally certified health coaches work closely with patients to uncover their personal vision for optimal health and wellbeing, said Greg Salgueiro, program manager of the Lifestyle Medicine Center. “By identifying what’s truly important to each patient, coaching supports lifestyle changes that last a lifetime.”
Together, health coaches seek to understand each patient’s specific needs and current Stage of Change, using Prochaska’s Transtheoretical Model. Lifestyle Medicine focuses on six key areas to improve health: physical activity, healthy eating, avoiding risky substances, stress management, sleep, and relationships.
The Health Coaching program is delivered through in-person interaction, via the MyLifespan patient portal, Zoom, or telephone.
Following the pilot, the Lifestyle Medicine Center looks forward to expanding the Health Coaching program to welcome men and women from the larger Lifespan and Rhode Island Community.
For additional information on how to enroll a patient, contact the Lifestyle Medicine Center at 401-793-7837.
Lifespan Launches Latinx Mental Health Clinic
Lifespan’s Psychiatry and Behavioral Health Services launches, Servicios Siquiatricos Lifespan (SSOL), a new clinic to address the specific needs for Latinx patients.
Cultural factors can influence perceptions and behaviors, including in medicine and psychiatry. SSOL is sensitive to the unique cultural needs of each patient, and is staffed with clinicians familiar with, and part of, the cultures of the Latinx community.
Services are provided by licensed mental health clinicians who specialize in the evaluation, diagnosis, and treatment of mental disorders, including:
- Bipolar disorder
- Family and interpersonal difficulties
- Obsessive-compulsive disorders
- Personality disorders
- Post-traumatic stress disorder
- Psychotic disorders, such as schizophrenia
The clinic is currently offering individual therapy and medication management when appropriate. Each staff member is fluent in at least two languages, and all services are provided in English and Spanish.
New Clinic Helps Cancer Survivors Create a Living Care Plan
Under the leadership of Christine Duffy, MD, MPH, the Lifespan Cancer Institute has launched a new program for cancer survivors. The OWLS – Oncology, Wellness Lifestyle, and Survivorship – Clinic is a consultative survivorship clinic for cancer patients. The clinic comprises a multidisciplinary team that focuses on addressing a myriad of health concerns, including but not limited to:
- Brain fog
- Anxiety or depression
- Fatigue and deconditioning
- Heart, lung, genitourinary, gastrointestinal tract, neurologic, and dermatologic issues
- Nutrition and weight loss
- Sleep issues
Once referred, each patient will have the opportunity to meet with an OWLS team member who will guide them through the intake and evaluation process. After that, clinicians will review the patient’s needs with the multidisciplinary team and create a living care plan. Specialties included in the process are:
- Internal medicine
- Physical therapy
- Sexual health
Center for Weight and Wellness Launches Your Choice, Your Weigh Program
The Center for Weight and Wellness at The Miriam Hospital launches a weight loss program designed for individuals who want to improve their health and lose 10 to 20 pounds. The 10-week, Your Choice, Your Weigh program addresses the importance of healthy eating habits, explores eating behaviors, helps patients develop an active lifestyle, and includes behavioral therapy to help manage stress.
The program is offered in person or via telehealth and provides the comprehensive treatment plans and tools needed to help patients achieve a healthy weight and overall greater well-being.
New Service Locations
Radiation Therapy Program Expands to West Bay
The Lifespan Cancer Institute now offers radiation therapy at its second location in the West Bay. Located at 1454 S. County Trail, in East Greenwich, the new clinic is just minutes off several major highways and offers free and convenient parking. Radiation treatments are also offered at Rhode Island Hospital.
“Since the East Greenwich location already offers infusion services for chemotherapy as well as physician visits, the addition of radiation treatment further reduces the need for patients to travel to multiple sites for appointments,” said David Wazer, MD, director of the institute and a leading radiation oncologist.
The Lifespan Cancer Institute in East Greenwich is open Monday through Friday, 8:30 a.m. to 4:30 p.m. For more information about their radiation therapy services, call 844-222-2881 or visit the Radiation Oncology Services website.
Lifespan Cancer Institute Opens Clinic in Bristol
The Lifespan Cancer Institute has expanded its services in the East Bay, adding a new location at the Bristol County Medical Center, 1180 Hope Street in Bristol, led by hematologist/oncologist Peter Barth, MD.
Dr. Barth diagnoses and treats all types of cancers and specializes in the treatment of benign and malignant blood disorders.
"Lifespan Cancer Institute has undergone tremendous growth in recent years. We have been actively recruiting some of the nation's foremost clinicians and researchers and greatly expanding the number and diversity of clinical trials we can offer our patients, including promising and newly emerging immunotherapies," said David Wazer, MD.
"We are excited to bring the Lifespan Cancer Institute's top-notch care for cancer to Bristol, making high-quality oncology care even more accessible to individuals in Rhode Island and southeastern Massachusetts."
Third Lifespan Urgent Care Opens its Doors in Providence
The third Lifespan Urgent Care center, a Lifespan Physician Group program, has opened its doors at 66 Branch Avenue in Providence. The center provides walk-in treatment for common medical issues to adults and children 18 months and older. The new location joins Lifespan Urgent Care centers in Warwick and Middletown.
Among the injuries and illnesses treated are colds and flu, earaches, sinus infections, fractures and sprains, cuts, burns, and upset stomachs. It also offers sports physicals and flu and tetanus vaccines. Both rapid and PCR testing for COVID-19 is available at all three urgent care locations. In addition, Lifespan Urgent Care is now offering the COVID vaccine to those who are 18 years and older.
Video appointments are also available for some conditions. See our website for more details.
Lifespan Urgent Care is open 8 a.m. to 8 p.m. Monday through Friday, and 8 a.m. to 6 p.m. on Saturday, Sunday, and most holidays.
For added safety, patients with higher acuity needs may be better served at the nearest emergency department.
No appointment is needed, but patients can register and reserve a timeslot online.
Lifespan Pharmacy Now Open at Newport Hospital
Lifespan has recently opened its doors to another Lifespan Pharmacy on the first floor of Newport Hospital.
This new location is Lifespan's fifth and will offer a full range of services to customers. Patients can enjoy free home delivery, courtesy refills, appointment or walk-in vaccinations for adults, and access to Lifespan's team of expert pharmacists.
Lifespan Pharmacy is located on the Sheffield Building's first floor, 11 Friendship Street, Newport, RI 02840.
The pharmacy is open Monday through Friday, 8 a.m. to 4:30 p.m. While hospital visitation is limited, the pharmacy will not be open to walk-in customers. For more information, please call 401-845-1100 or visit the Lifespan Pharmacy website.
Newport Women's Health Unveils New Space
Newport Women's Health, a Lifespan Physician Group practice, recently consolidated its two Newport offices into one new space on the first floor of Newport Hospital, behind the Hill Courtyard. Providers began seeing patients in the clinic on November 19. The practice has 10 exam rooms, an ultrasound room, and a consult room, all in a spacious, modern environment.
"Newport Hospital and LPG work very closely together," said Emily DeGrace, director of physician practices, Lifespan Physician Group. "As part of our strategic plan for Newport Hospital, we're very invested in the women's health service line and felt it was time to bring those two separate suites together into one location."
"We know this beautiful, new, patient-centered space will make a significant difference to patients and providers," said Crista Durand, president of Newport Hospital. "The environment now matches the quality of the care our Women's Health team delivers."
The practice also continues to see patients at 77 Turnpike Avenue in Portsmouth.
Newport Women's Health has also added a new provider to their team. Sarah West Allen, MN, CNM, FNP, a board-certified nurse midwife. She joins Virginia Bass, MD; Gail E. Carreau, MD; Triste M. Coulombe, MD; and Karolyn Zambrotta, CNM.
Dr. Maria Ducharme Selected President of The Miriam Hospital
In January, Maria Ducharme, DNP, RN, NEA-BC, was promoted to president of The Miriam Hospital. She joined The Miriam in 1987 as a cardiovascular medical/surgical nurse and has held a variety of positions, including leadership roles in inpatient nursing, respiratory therapy, and rehabilitation services. In 2010, she was named senior vice president of patient care services and chief nursing officer. She is the first nurse in the hospital’s 96-year history to be promoted to the top leadership position from within the organization.
Dr. Ducharme is credited with leading some of The Miriam’s most ambitious and successful efforts to achieve excellence in the quality of patient care at the hospital. Most recently, she has helped lead the hospital’s response to COVID-19, directly overseeing the refinement and deployment of new safety protocols developed in response to the coronavirus pandemic. Under her leadership, The Miriam attained four-year Magnet recognition six consecutive times, which has been accomplished by only three other hospitals in the United States.
“I am thrilled to occupy a role that will be integral to shaping the future of The Miriam Hospital, contributing to the overall strategy of Lifespan, and furthering our mission of excellent patient-centered care,” she said.
Dr. Ducharme earned a doctor of nursing practice degree from Massachusetts General Hospital Institute of Health Professions, and a master of science degree in nursing from the University of Rhode Island.
Dr. Saul Weingart Named President of Rhode Island Hospital
Prior to joining Lifespan, Dr. Weingart served as the chief medical officer and senior vice president of medical affairs for Tufts Medical Center and Tufts Children’s Hospital in Boston. He was also a medicine, public health, and community medicine professor at Tufts University School of Medicine.
“Dr. Weingart’s experience and record of accomplishments at top-notch health care institutions is a tremendous asset to Lifespan as we look to further elevate Rhode Island Hospital’s national profile as a leading academic medical center,” said Lifespan President and CEO Timothy J. Babineau, MD.
Before Tufts, Dr. Weingart spent nine years at Dana-Farber Cancer Institute as the vice president for quality and patient safety, gaining experience as a patient safety executive and quality expert. He established himself as a national leader in patient safety, with his team winning millions of dollars in grant funding to support initiatives including novel quality metrics and research focused on medication safety.
“I am thrilled to join Lifespan, Rhode Island Hospital, and Hasbro Children’s, and am thoroughly enjoying working with our outstanding staff and clinicians,” said Dr. Weingart. “Rhode Island Hospital’s commitment to compassionate, world-class care is evident, perhaps never more so than in this past year. I feel privileged to join this extraordinary team.”
A general internist and former primary care physician, Dr. Weingart earned his medical degree from the University of Rochester and his MPP and PhD from Harvard University. He brings more than 25 years of experience to the hospitals.
Dr. Edward Akelman Presented Dean’s Excellence Award in Teaching
Edward Akelman, MD, chief of the department of orthopedics at Rhode Island Hospital and The Miriam Hospital, and the chair of the department of orthopaedics at The Warren Alpert Medical School of Brown University was awarded a Dean’s Excellence Award in Teaching, Advising, and Mentoring.
The award recognizes the dedicated campus-based faculty, hospital-based instructors, and office-based teachers who effectively teach and mentor students and residents. Dr. Akelman was presented the Dean’s Excellence in Teaching Award for his exemplary contributions as a physician, surgeon, and colleague and a well-respected member and distinguished leader of the orthopedic community.
Dr. Akelman is board-certified by the American Board of Orthopedic Surgery (ABOS) and holds the subspecialty certificate in orthopedic surgery of the hand. He devotes his practice to hand, wrist, and elbow conditions. He has expertise in caring for common hand problems such as Dupuytren’s disease, hand fractures, sports injuries, arthritis, and nerve problems of the hand, wrist, and elbow.
Laura Stroud Named Director of the Center for Behavioral and Preventive Medicine
Laura Stroud, PhD, was appointed the new director of the Center for Behavioral and Preventive Medicine. In addition to being the senior research scientist at the center, Dr. Stroud is also a professor of psychiatry and human behavior, and obstetrics and gynecology at The Warren Alpert Medical School of Brown University and a professor of social and behavioral sciences at The School of Public Health of Brown University and The Miriam Hospital.
Dr. Stroud oversees the maternal-infant studies laboratory and child and adolescent stress laboratory at the Center for Behavioral and Preventive Medicine. Her research focuses on the biobehavioral mechanisms of stress, mood and addictive disorders and includes a focus on vulnerable populations, pregnancy and women’s health, and the adolescent transition. Her work involves identifying early biobehavioral markers of risk and a focus on novel neurobehavioral and stress response paradigms.
The National Institutes of Health have continuously funded Dr. Stroud since 2001. She is the recipient of three NARSAD awards from the Brain and Behavior Research Foundation, and funding from the National Science Foundation, the Food and Drug Administration (FDA), and the Robert Wood Johnson Foundation. She was awarded the Bruce Selya Research Excellence Award from Lifespan hospitals and the Outstanding Early Career Investigator Award from the National Institute on Drug Abuse.
Dr. Stroud is also a dedicated mentor. She co-directs a postdoctoral fellowship training grant focused on stress, trauma, and resilience based at The Miriam and mentors numerous students, postdoctoral fellows and faculty. She also serves as co-director of the Initiative on Stress, Trauma, and Resilience (STAR) within the Brown Department of Psychiatry and Human Behavior.
Dr. Stroud received her PhD in psychology from Yale University. She completed her postdoctoral fellowship at the Alpert Medical School and subsequently joined the faculty in psychiatry and human behavior. Since 2013, Dr. Stroud has also held a secondary appointment in the behavioral and social sciences department in the School of Public Health.
Dr. Shadi Yaghi Named Director of Vascular Neurology
Shadi Yaghi, MD, is the new director of vascular neurology at Lifespan, as well as director of research at the Neurovascular Center at Rhode Island Hospital. He is also co-director of the Comprehensive Stroke Center at Rhode Island Hospital, along with Tracy Madsen, MD.
Dr. Yaghi returns to Lifespan from New York Langone Hospital in Brooklyn, where he was director of the stroke program. Previously, he was on staff at Rhode Island Hospital.
A board-certified vascular neurologist, Dr. Yaghi earned his medical degree at the American University of Beirut and completed an internal medicine internship and a research fellowship there. Dr. Yaghi continued his training with an internal medicine internship and neurology residency at the University of Arkansas Medical Center. He spent two years at New York-Presbyterian Hospital/Columbia University furthering his training in vascular neurology.
Dr. Yaghi is certified by the American Board of Psychiatry and Neurology and the American Board of Vascular Neurology. He is a fellow of the American Heart Association, active on its Stroke Council, and is a member of the American Academy of Neurology.
Dr. Yaghi’s research focuses on intracranial atherosclerosis, treatment and outcome of thrombolysis-related hemorrhage, and cardiac biomarkers in patients with cryptogenic stroke.
He was named the Rhode Island Top Vascular Neurologist in 2018-19.
Dr. Beth Ryder Named Director of the Center for Bariatric Surgery
On April 2, Beth Ryder, MD, FACS, was named the new director of the Center for Bariatric Surgery (CBS), a program of Rhode Island and the Miriam hospitals. Dr. Ryder is a board-certified bariatric and general surgeon who specializes in minimally invasive surgery. She is an associate professor of surgery and medical science at The Warren Alpert Medical School of Brown University.
Dr. Ryder has academic interests in surgical education as well as bariatric surgery. She has distinguished herself at the Alpert Medical School, having received numerous Dean’s Excellence in Teaching awards as well as a Faculty Award. She also is co-director of the core clerkship in surgery.
In the coming years, she anticipates continuing technological advances and broader applications for robotics in bariatric surgery.
“I’m very fortunate to be working with a really talented group of individuals, between my partners, the operating room staff, the nurses, and the dietitians,” she said. “Basically, everybody at The Miriam Hospital does a great job helping with their aspect of care for the bariatric patients.”
Dr. Ryder earned her medical degree at Tufts University School of Medicine in Boston and completed a residency in general surgery and a fellowship in minimally invasive surgery at Rhode Island Hospital. She began practicing at Rhode Island Hospital immediately after concluding her fellowship training in 2005 and moved to The Miriam in 2012. She has been named a Top Doc by Rhode Island Monthly.
Nikos Tapinos, MD, PhD, Earns Bruce M. Selya Award for Excellence in Research
Nikos Tapinos, MD, PhD, is the recipient of the 2020 Bruce M. Selya Award for Excellence in Research, which recognizes outstanding biomedical research at Lifespan hospitals.
Dr. Tapinos is director of molecular neuro-oncology research at Rhode Island Hospital and an associate professor in the department of neurosurgery at The Warren Alpert Medical School of Brown University.
Dr. Tapinos was nominated by Ziya L. Gokaslan, MD, Lifespan neurosurgeon-in-chief, clinical director of the Norman Prince Neurosciences Institute, and professor and chair of neurosurgery at Brown.
The nomination describes how innovative work in Dr. Tapinos' laboratory has led to a broad array of advances in the highly complex science of treating certain tumors. Intellectual property developed from his work includes drug delivery methods, techniques to lure migrating tumor cells towards targeted regions in the brain, development of novel antibodies for cancer therapy, development of RNA therapeutics against eRNA targets in glioblastoma, and the identification of drugs now in preparation for human clinical trials.
Dr. Tapinos’s notable research grant awards include a current $4 million, four-year grant from the Alpert Foundation for which he is co-primary investigator, supporting, “Investigation of the role of epigenetics in adult and pediatric malignant glioma.”
He is a member of prominent professional associations, including the Society for Neuroscience, the American Society for Neurochemistry, the Society of Neuro-Oncology and Sigma Xi Scientific Research Honor Society.
After completing his MD and PhD in molecular biology at the University of Athens, Greece, Dr. Tapinos completed his postdoctoral fellowship at the Laboratory of Bacterial Pathogenesis and Immunology at The Rockefeller University, New York, which is where he was introduced to the field of molecular neuroscience.
Neishay Ayub, MD
Fellowship-trained in neurophysiology and epilepsy, Neishay Ayub, MD, is an epileptologist who recently joined the Comprehensive Epilepsy Program at Rhode Island Hospital.
Susan V. Clemens, MD
Family Medicine Physician
Susan V. Clemens, MD, is a family medicine physician who recently joined Lifespan Urgent Care. She is board-certified in family medicine and medical acupuncture.
Monica Bhagwansingh Dhakar, MD, MS
Epileptologist, Monica Bhagwansingh Dhakar, MD, MS, has joined the Comprehensive Epilepsy Program at Rhode Island Hospital. She is board-certified in neurology and epilepsy.
Elias S. Hyams, MD
Elias Hyams, MD, is a board-certified urologist specializing in prostate, kidney, bladder, and testicular cancer who recently joined the Minimally Invasive Urology Institute at The Miriam Hospital.
Jia Yu (Nancy) Liu, OD
Optometrist, Nancy Liu, OD, recently joined Lifespan Physician Group Ophthalmology. Dr. Liu treats patients with a variety of serious eye conditions including ocular disease/cornea.
David W. Sobel, MD
David Watson Sobel, MD, recently joined the Minimally Invasive Urology Institute and Kidney Stone Center at The Miriam Hospital. Dr. Sobel is a board-certified urologist with interests in surgical management of complex kidney stone disease.
Physicians Uncover Link Between Genetic Markers and Central Nervous System Relapse of Diffuse Large B-Cell Lymphoma
Physicians at the Lifespan Cancer Institute (LCI) and the department of pathology are working to uncover risk factors for central nervous system (CNS) recurrence of diffuse large b-cell lymphoma (DLBCL).
While CNS recurrence is rare when it does happen, the outcomes can be devastating. Clinical models, such as the CNS international prognostic index, help predict the highest risk of recurrence. However, approximately 50 percent of relapses are categorized as low or intermediate risk.
Through his research, Thomas Ollila, MD, hematologist/oncologist at Lifespan Cancer Institute identified 26 patients through the LCI registry who had relapsed DLBCL. Half of the identified patients relapsed in the CNS, while the other half in various spots in the body.
Dr. Ollila and his team hypothesized that there might be specific genetic signatures associated with this type of relapse. Through a collaboration with Caris Life Sciences, samples were sent for Next Generation Sequencing. All the results were put into the recently published LymphGen classifier, which categories DLBCL into genetic subgroups. They also created a new classifier based on their findings, term the simplified hierarchical classifier (HC).
The HC has three groups:
- hc-MCD, which is genetically similar to primary CNS lymphoma or primary testicular lymphoma.
- hc-P53, which has frequent TP53 mutations seen in many cancers.
- hc-GCB, which resembles DLBCL not known to inhabit extranodal sites and more closely resembles a follicular lymphoma.
The hc-MCD subtype was found in nearly half of the CNS recurrences but only a quarter of the systemic recurrence. More than half of the cases with CNS recurrence had not been considered high risk and would not have received preventative chemotherapy.
While other groups have shown genetic subtypes to be associated with recurrence risk, this study was the first to show that a commercially available Next Generation panel might be able to better predict CNS recurrence risk. Future work will involve employing novel therapies to bring personalized medicine to lymphoma by targeting these mutations.
MIUI Awarded Pilot Project Funding for Evaluation of Nonopioid Recovery After PCNL
The Minimally Invasive Urology Institute and David Watson Sobel, MD, have been awarded a Pilot Project Award for $40,000, titled, “Evaluation of a Nonopioid Recovery Pathway after Percutaneous Nephrolithotomy.” This project aims to determine the safety and feasibility of a protocol to avoid the usage of opioid pain medications after a percutaneous nephrolithotomy (PCNL), a minimally invasive surgery for large kidney stones.
While the standard of care historically has been to give patient opioid pain medications for postoperative pain, overuse and over-prescription has contributed to the opioid epidemic. Besides the potential for chronic tolerance and dependence, opioid medications can slow the postoperative recovery process.
The pilot project, which is funded by the National Institutes of General Medical Sciences of the NIH through the Center of Biomedical Research Excellence (COBRE) on Opioids and Overdose, will apply the knowledge and experience gained through development of the outpatient opioid reduction protocol to percutaneous nephrolithotomy
“We previously were able to reduce opioid prescriptions after ureteroscopy (an outpatient procedure to treat kidney stones) by 90% through a standardized nonopioid recovery pathway which emphasizes good patient counseling and multimodal pain control. We aim to apply this protocol to PCNL, an inpatient procedure for larger kidney stones,” says Dr. Sobel.
Findings of these prior investigations have been presented nationally and the protocol is available at The Consortium for Ureteral Stent Pain website for urologists and patients alike.
The Center of Biomedical Research Excellence (COBRE) on Opioids and Overdose, based at Rhode Island Hospital, aims to address the opioid epidemic. The COBRE is an interdisciplinary center that supports research essential to understanding the mechanisms underlying opioid use disorder and developing innovative solutions.
The Miriam Hospital Announces New Outpatient COVID-19 Treatment Trial
The Miriam Hospital has been named a clinical trial site for ACTIV-2. It is one of 140 locations in the United States. Part of the National Institutes of Health (NIH) ACTIV network, the ACTIV-2 study aims to develop and test new breakthrough treatments for COVID-19 outpatients.
ACTIV-2 is a unique adaptive design that allows multiple study medications to be used in the same trial platform. The treatments are targeted at patients early in the disease and designed to test if new drugs can prevent people infected with COVID-19 from becoming ill or hospitalized.
To be eligible, participants must be 18 years or older and have been diagnosed with COVID-19 within the past 10 days or less and have symptoms of COVID-19 but have not been hospitalized. The study lasts between 6 and 18 months, depending on which study medications and phase of the study a person is enrolled in.
Some of the medications tested include monoclonal antibodies, some given intravenously and some as injections. There are inhaled and oral medications in the trial as well. To learn more about ACTIV-2, visit the website or contact Dr. Natasha Rybak at 401-793-2463 or study coordinator, Helen Patterson at 401-793-4771. You can also email IDresearch@lifespan.org for additional information.
MyReport Study Now Enrolling Participants
A new research study at the Center for Behavioral and Preventive Medicine, MyReport (My Real Experiences and Personal Observations Recorded Today) investigates the link between the use of e-cigs/vapes, regular cigarettes, alcohol, and/or marijuana and stress in daily life among young adults.
Study participants must be between 18 and 25 years old and regularly use e-cigarettes, regular cigarettes, alcohol, and/or marijuana to be eligible.
Once enrolled, participants will visit the lab once to complete questionnaires and computer tasks, fill out surveys daily for 35 days, and provide saliva samples. Participants will be compensated for their time. For more information about MyReport, please call 401-649-1458 or email firstname.lastname@example.org.
Broken Heart II Investigation Now Underway
Researchers at The Miriam and Rhode Island hospitals are currently recruiting for a new research study to understand how stress affects people who have been diagnosed with takotsubo syndrome, also known as Broken Heart Syndrome. The study explores whether a greater response to stress puts patients at risk of having a subsequent episode.
To be eligible participants must have recently been diagnosed with takotsubo syndrome, speak and understand English, and attend three visits at the Rhode Island Hospital cardiac research office.
PEPPER Study Explores Effective Blood Thinners for Hip and Knee Replacement
The Total Joint Center at The Miriam Hospital is now offering a new study to patients called “Comparative Effectiveness of Pulmonary Embolism Prevention After Hip and Knee Replacement Prevention” (PEPPER) trial. The study aims to explore, compare, and identify which blood thinner currently on the market is the best at preventing blood clots following hip and knee arthroplasties.
The PEPPER trial will span five years and will include approximately 25,000 patients. The goal is to assess the safety and effectiveness of the three most prescribed blood thinners. The three anticoagulants are aspirin, warfarin (also known as Coumadin), and rivaroxaban (also known as Xarelto).
The study is a multicenter, PCORI (Patient-Centered Outcomes Research Institute) funded, randomized trial in which willing patients consent to be randomly assigned to one of the three study arms (Aspirin, Coumadin, or Xarelto). Participants are notified of the drug they are randomized to and will take only that blood thinner for 30 days following surgery, just as they would if they were not participating in the trial. Following the 30 days, participants will be asked to complete three follow-up surveys: one at one-month post-op, one at three months, and one at six months.
Rhode Island Hospital Launches Study on Postoperative Brain Recovery
A team at Rhode Island Hospital led by Lori Daiello, PharmD, senior research scientist at the hospital’s Alzheimer’s Disease and Memory Disorders Center, launched a groundbreaking investigation into brain health after surgery. The 5-year study, Cognitive Recovery After Elective Surgery (CREATES), is funded by a $3.8 million R01 grant from the National Institutes of Health.
Dr. Daiello will lead a team of hospital and university colleagues on the study, which will use a new MRI technique to examine the blood-brain barrier of patients age 65+ before and after surgery to measure their postoperative brain recovery.
“As we age, more time may be needed to recover completely after surgery,” Dr. Daiello said. “Researchers are increasingly interested in the body’s usual healing and recovery process after surgery and how it impacts postoperative brain health.”
The CREATES study will investigate whether blood-brain barrier (BBB) health is related to the rate of postoperative brain recovery. A healthy BBB is the most important natural line of defense for the brain, because it protects it from damaging infections, inflammation, and other threats.
CREATES co-investigator Brian Ott, MD, added, “Unchecked, we think that BBB dysfunction could increase the risk of certain illnesses, such as Alzheimer’s Disease; therefore, it is important for us to understand the risk factors that could negatively impact brain recovery.”
The study will enroll more than 200 adults, age 65+, who are scheduled for upcoming major elective non-cardiac surgeries at Rhode Island Hospital. Participants will undergo pre- and post operative brain MRIs, donate blood for genetic and biomarker analysis, and take periodic memory and thinking tests for 18 months following surgery to monitor brain health and cognitive recovery.