MedNotes

E-Newsletter for the Medical Community

LifeNotes | Spring 2024

A note from the President and CEO

Dear Colleague: 

john-fernandez

I’m pleased to share this spring edition of LifeNotes, our biannual newsletter spotlighting the talented physicians, researchers, educators and innovators who support our mission of delivering exceptional patient care.

As we look to the future, our vision is to braid together diverse strands of our mission—patient care, research, education—into a tighter weave. We have been working hard to enhance and deepen our academic affiliation agreements with Brown University, our academic medical partner, to support a closer alignment in advancing research, innovation, and medical education. The closer affiliation with Brown will help us attract and retain the nation’s best medical faculty, students, and residents, who in turn provide the world-class medical care our community deserves. You’ll be hearing more about this in the months to come.

Meanwhile, the range of services highlighted here, from new tools to diagnose heart attacks in women, to non-judgmental walk-in addiction care, demonstrates our commitment to building a healthier community for all Rhode Islanders, at all levels of acuity and need.

I hope you’ll take a moment to read about the cutting-edge technology now available to treat prostate cancer, using ablation therapy to destroy targeted cancerous cells. You can also learn about the use of a new intraoperative CT scanner and robotic navigational bronchoscopy system to better diagnose lung nodules.

You’ll find information on the newest tools offered at Vanderbilt Rehabilitation Center, from a wearable robotic exoskeleton to an indoor model car. For patients working to reclaim their mobility and independence after stroke, brain injury or other traumatic events, Vanderbilt’s teamwork and technology are a lifeline.

Some lifelines don’t require technology at all—the Aubin Child Protection Center offers assessment and treatment of potentially abused children, and is the site of the only academic fellowship in child abuse pediatrics in New England. And you can learn about the work Bradley Hospital is doing to better connect young people experiencing a mental health crisis to intensive treatment, thanks to a new collaboration with a telehealth platform.

As always, I’m proud to share this snapshot of the impressive work happening every day across the Brown University Health system. Thank you for your continued partnership in creating a healthier Rhode Island. 

LifeNotes updates

New Treatment Options and Program Developments in Advanced Heart Failure and Cardiomyopathy Care

The Brown University Health Cardiovascular Institute (LCVI) offers heart failure sub-specialty management services for conditions that are difficult to diagnose and manage and for which new and emerging treatment options are available. These disease states include cardiac amyloidosis, hypertrophic cardiomyopathy, and cardiac sarcoidosis. 

“Our heart failure sub-specialty management programs take a multidisciplinary approach to the diagnosis and treatment for patients struggling with conditions that are difficult to diagnose, complicated to treat, and have the potential to cause death and disability if left untreated,” said Jessica L. Guidi, MD, a heart failure trained and board-certified specialist, now practicing at the LCVI.

Cardiac amyloidosis

Amyloidosis is a systemic illness. It causes abnormal deposits of amyloid proteins in the heart tissue leading to symptoms including arrhythmias, valve dysfunction and heart failure. 

When it affects the heart, cardiac amyloidosis is increasingly recognized as the most typical type of restrictive cardiomyopathy. Amyloid can have a genetic basis (familial amyloidosis), a spontaneous appearance typically in older patients (wild type amyloidosis) or come from a hematologic problem that leads to the production of abnormal proteins in the blood called light chains (AL amyloid).

Diagnosis of cardiac amyloidosis can be difficult but typically involves a clinical suspicion followed by a confirmatory assessment. This could include lab analysis, genetic assessment, imaging studies, (such as echocardiography, cardiac MRI, or nuclear imaging), and confirmation through biopsy of affected tissue (often from the heart or other organs). 

Early diagnosis, including distinguishing the type of amyloid and appropriate management, are crucial for optimal patient outcome. In addition to managing heart failure in this setting, exciting new treatment options for cardiac amyloidosis have emerged over the past few years and are available in our program. These include protein stabilizers to slow disease progression, mRNA silencers to stop abnormal protein production, and in rare cases, organ transplantation has been offered.

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a genetic heart condition that involves hypertrophy of the heart muscle, particularly the left ventricle. This results in symptoms that include chest pain, shortness of breath, palpitations, dizziness, and fainting spells. 

HCM is typically diagnosed through a combination of clinical evaluation, electrocardiography, echocardiography, and in some cases, genetic testing. The goal of HCM treatment is to manage symptoms, prevent complications, and reduce the risk of sudden cardiac death. Treatment may include medications such as beta-blockers or calcium channel blockers to relieve symptoms, lifestyle modifications, and for some patients, surgical procedures, or an implanted device to prevent arrhythmias. 

Treatment of HCM has also progressed rapidly over the last few years and exciting new medical therapy is now available through our subspecialty clinic. Medical therapy, in appropriate patients, now offers an effective alternative to invasive therapies, which have included invasive catheter-based procedures and even open-heart surgery.

Cardiac sarcoidosis

Cardiac sarcoidosis involves the development of granulomas in the heart tissue. It causes a variety of symptoms, including heart failure, arrhythmias, conduction abnormalities, and sudden cardiac death. 

Diagnosis of cardiac sarcoidosis can be challenging and often involves a combination of clinical evaluation, imaging studies such as cardiac MRI or PET scan, electrocardiography, and sometimes endomyocardial biopsy to confirm the presence of granulomas. 

The goal of cardiac sarcoidosis treatment is to reduce inflammation, manage symptoms, and prevent complications. Treatment may include immunosuppressives such as corticosteroids or other immunomodulators, antiarrhythmic drugs, or implanted devices for managing arrhythmia.

“Cardiac amyloidosis, sarcoidosis, and hypertrophic cardiomyopathy may lead to significant cardiac symptoms and complications, but it must be recognized that they are distinct diseases with unique underlying mechanisms, requiring tailored management,” explained Guidi. “Patients with rare cardiomyopathies benefit from a healthcare team experienced in managing these specific cardiac conditions to optimize their quality of life." 

“What makes these programs unique is not only the local access to the latest therapeutic advances in these emerging fields, but the multidisciplinary team approach aimed at optimal patient care,” said Daniel Levine, MD, director of the Advanced Heart Failure Program at Brown University Health.

Hearts at home

Heart Failure and Cardiac Transplant Services

The Medical Heart Failure and Cardiac Transplant Program is located on the first floor of Rhode Island Hospital. To contact us, please call 401-444-5803.

 

Brown University Health Thoracic Surgery Acquires New Intraoperative CT Scanner to Enhance the Robotic Navigational Bronchoscopy System, Adds Surgeon to Team

Abbas Abbas

Under the direction of Chief Abbas E. Abbas, MD, Brown University Health Thoracic Surgery is a world-class program that combines stellar clinical expertise with the latest technology. Recently, the program acquired the CIOS Spin, which, along with the new robotic bronchoscopy system, provides unmatched accuracy in diagnosis and localization of lung nodules, in addition to providing the platform for future therapeutic options. 

The CIOS Spin is a compact and mobile cone-beam CT (CBCT) capable of two- and three-dimensional X-ray imaging of the lungs and other organs. Its 360-degree rotation provides the most precise image of a nodule or tumor and guides catheter placement for the cleanest possible biopsy and resection. 

“The CIOS Spin is an additional tool to help us diagnose lung cancer earlier and more accurately. It is less invasive than traditional methods, and it also integrates with our Ion and DaVinci systems,” said Abbas, an internationally recognized expert.

 “The Brown University Health Thoracic Surgery Center at Rhode Island Hospital is the only hospital in the region with this complete suite of intraoperative game-changing technology that combines CT scanner, robotic bronchoscopy, and robotic surgery all at the same time. We offer our patients access to the most advanced technology for minimally invasive, single anesthetic, robotic bronchoscopy, and removal of lung cancer, with unprecedented accuracy,” added Abbas.

New surgeon joins team

Haley Leesley, MD

In addition to new technology, Abbas is focused on increasing capacity with additional surgeons. The program recently welcomed Haley Leesley, MD. Leesley is a thoracic surgeon specializing in lung and esophageal cancer, as well as benign disease of the chest wall, foregut, and thoracic cavity. Her arrival has doubled the program’s capacity to offer the most advanced approaches to thoracic surgery. 

“I am thrilled to be part of this outstanding thoracic surgery program. I look forward to working with Dr. Abbas and the team to provide our patients with unmatched expertise and the most advanced technology,” said Leesley. 

Leesley completed a general surgery residency at The Warren Alpert Medical School of Brown University and a cardiovascular and thoracic surgery fellowship at The University of Texas Medical Branch in Galveston, Texas. She earned a master’s degree in physiology and biophysics from Georgetown University in Washington, DC, and a medical degree from Tulane University School of Medicine in New Orleans. 

“Our goal is to continue to expand our technology and recruit the finest physicians so we can provide unmatched care and minimally invasive surgical procedures for patients with cancer and other thoracic conditions. We are honored to welcome Dr. Leesley to our program, and we also look forward to another surgeon joining us later this summer,” added Abbas. 

You can learn more about thoracic surgery on our website, or email [email protected] to request more info or to speak with Abbas or Leesley.

 

Brown University Health Pharmacy Launches Pharmacogenomics

Brown University Health Pharmacy has launched a new pharmacogenomics program to ensure patients are getting medications that are right for them. 

Pharmacogenomics uses an individual’s genetic makeup to help predict or explain a response to select medications, including effectiveness or side effects. Based on an individual’s genetic results, a provider may choose to prescribe a different dose or a completely different medication to get the desired response. 

“We know genetics plays a role in how the body processes certain commonly prescribed medications. Coupled with the fact that over 90 percent of people carry at least one actionable variant, it’s no surprise that this testing can be important for many of our patients.” said Lauren Lemke, PharmD, BCPS, Clinical Pharmacist Specialist, who is leading the program at Brown University Health.

Benefits of pharmacogenomics

Lemke reports that the benefits of pharmacogenomics include a reduced risk of side effects, improved time to effective therapy, and a savings of time and money by avoiding a trial-and-error approach with prescriptions. While it’s not a single solution to prescribing the best medication for an individual, it serves as a tool to help providers make more informed decisions. 

Patients taking certain medications can be referred to the pharmacogenomics clinic. Those patients will meet with a pharmacogenomic specialist who will coordinate an evaluation and testing and explain how the results could impact their medications. The specialist then collaborates with the patient’s healthcare team to coordinate any necessary medication changes, and the results are noted in the patient’s electronic health record. 

“We are excited to offer this new testing to help us improve the care we provide to our patients. We hope our providers will take advantage of this offering and refer patients to this service,” added Lemke. Coverage for pharmacogenomics counseling and testing varies among insurers, and patients can choose to self-pay. 

Smiling woman speaking with an unseen provider

Refer A Patient

To refer a patient to the pharmacogenomics service, simply place an order in the patient’s electronic health record. To learn more, email [email protected].

 

Brown University Health Cardiovascular Institute: Updates Cardiac Cath Lab, Acquires New Diagnostic System

The Brown University Health Cardiovascular Institute has reopened a cardiac catheterization lab after extensive upgrades and renovations. It has also added new technology to the Women’s Cardiac Center to further expand its capabilities and diagnostics.

State-of-the-Art Cardiac Catheterization Lab

In March 2024, Rhode Island Hospital reopened this updated lab just steps away from the Anderson Emergency Department (ED), the region’s only Level 1 Trauma Center. The lab boasts the most advanced imaging system and technology in the state for urgent cardiovascular interventions and rapid response for patients. It was designed to reduce radiation exposure and decrease IV contrast dye used in blood vessels. 

“As a Level 1 Trauma Center, we provide emergent advanced cardiovascular care. The placement of the lab was very forward thinking and allows for better coordination of care between the ED, the lab, operating rooms, and coronary care unit,” said cardiologist Dawn Abbott, MD, director, interventional cardiology and cardiac catheterization labs. “In essence, it means faster diagnosis and treatment for heart attack patients.” 

In addition to a total of four cardiac catheterization labs, a wide range of cardiovascular subspecialties are available at Rhode Island Hospital, including interventional cardiology and structural heart programs. As Abbott noted, “We are experts and leaders in managing the most complex cardiovascular patients in the state, and our updated and newly relocated lab will ensure that our patients have access to the best heart care in the region.” 

You can learn more here on the Interventional Cardiology website. 

New Technology to Diagnose Unexplained Chest Pain in Women

Heart disease is the leading cause of death among women. There is also a type of heart attack that predominantly affects women -- myocardial infarction with nonobstructive coronary arteries (MINOCA). MINOCA can be caused by dysfunction of the microvasculature or small blood vessels of the heart. Microvascular dysfunction can disrupt blood flow to the heart despite no evidence of blockage in the large heart arteries.

Heart attacks are often evaluated with a coronary angiogram, a test which looks only at the large arteries of the heart. In patients with MINOCA, an angiogram may be completely normal. A woman who experiences this type of heart attack with a normal coronary angiogram is often provided no explanation for what caused her symptoms. Without a cause, treating and preventing recurrent heart attacks in these women is more difficult. 

Now the Women’s Cardiac Center and comprehensive coronary physiology program at The Miriam Hospital has acquired new technology that can help reveal the causes of these types of heart attacks. 

“The CoroFlow Cardiovascular System is an innovative software that enables a definitive diagnosis of MINOCA caused by microvascular blockages. It measures the blood flow through the micro vessels of the heart to assess for blockages or disease,” explained Katharine French, MD, director, Women’s Cardiac Center. “Once diagnosed, these patients can then be successfully managed with medication.” 

Using the CoroFlow Cardiovascular System, in combination with a new comprehensive MINOCA testing protocol offered through the Brown University Health Cardiovascular Institute, patients with MINOCA and their healthcare providers can better understand and more effectively treat this condition. 

Learn more about the Women’s Cardiac Center on our website

LCVI Cardiologists

Contact the Women's Cardiac Center

For more information, provider availability and appointment scheduling, please call us at 401-606-1004.

 

MIUI Acquires New Technology, Celebrates 10th Anniversary

The Minimally Invasive Urology Institute (MIUI) at The Miriam Hospital, now celebrating its 10th anniversary, has acquired new technology that expands its capabilities and adds to its legacy of innovation.

NanoKnife for prostate cancer

NanoKnife

One new technology now in use is irreversible electroporation, a novel approach to localized therapy for prostate cancer known as the NanoKnife. This minimally invasive outpatient procedure provides ablation therapy to destroy targeted cancerous cells. Unlike other ablation methods that use thermal energy such as cryotherapy, microwave ablation, high-intensity focused ultrasound (HIFU), focal laser ablation or radiofrequency ablation, NanoKnife uses an electrical current to destroy cancer cells. The use of ultrasound guidance allows surgeons to precisely target lesions while reducing injury to surrounding areas. 

“The MIUI is one of the few institutions in the northeast to offer the NanoKnife system, which gives our patients with prostate cancer another minimally invasive treatment that allows for faster recovery and return to normal activities,” said Elias Hyams, MD, director of the prostate cancer program. 

You can learn more about NanoKnife here

Promaxo MRI System

Also new to the MIUI is the Promaxo MRI System, an MRI/ robotic-guidance system for transperineal fusion biopsies. This system, a collaboration between Brown Urology and the MIUI, enables targeted transperineal biopsies, eliminating the need for transrectal ultrasound. 

With this innovative platform, patients may undergo MRI scans anywhere in the community. Those scans are then uploaded to a low-powered MRI machine. During the biopsy procedure, the low-powered MRI scans the patient while the outside MRI, already mapped for regions of interest, is superimposed. 

“We are the first in the region to offer this new technology, revolutionizing prostate diagnostics for improved patient outcomes,” said Hyams. “The Promaxo system offers numerous advantages over traditional methods. By bypassing a transrectal approach, the risk of infection is reduced, enhancing patient safety. Moreover, the ability to precisely target areas of interest guided by the system ensures more accurate results.” 

You can learn more about Promaxo here

Celebrating 10 years of innovation and excellence

The logo for the tenth anniversary of Lifespan's Minimally Invasive Urology Institute

This year marks a decade since the MIUI opened its doors at The Miriam. “Ours was the region’s first comprehensive center for urologic care, with a mission to deliver excellence in patient care, education, and research,” said Gyan Pareek, MD, the MIUI’s co-director. “Today, we are at the forefront of research and technology, advancing urology care and transforming lives.” 

“Patients from around the world come to The Miriam Hospital for our exceptional urology expertise,” said Dragan Golijanin, MD, co-director of the MIUI. “Since we opened the MIUI, we have accomplished significant advancements in the field of urology, performing groundbreaking procedures and offering the latest in technology to exceed our patients’ expectations.” 

You can watch a video marking this milestone here.

 

Vanderbilt Rehabilitation Center Offers Latest Technology, Earns Reaccreditation

The Vanderbilt Rehabilitation Center (VRC) at Newport Hospital offers a wide range of the most advanced, innovative tools to help patients regain function and mobility. 

The VRC’s focus on technology includes a wearable robotic exoskeleton to assist with regaining mobility. More recently, the center invested in an indoor model car with adjustable features that allow patients to practice getting in and out in a safe environment. The center also developed and created a new training apartment to help patients and their families safely prepare for a return home. Finally, a new outdoor therapeutic space will be ready this summer for patients to enjoy. 

“Our priority is helping people return to their lives. The technology and tools that we have available, combined with the expertise of our staff, help us to offer the best possible care for our patients,” said Melissa Fournier, PT, director of Brown University Health inpatient rehabilitation services

The VRC recently earned reaccreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) for its exceptional care in both the inpatient hospital adult and inpatient hospital stroke specialty programs. “It’s gratifying to see our high-quality care and outstanding patient outcomes affirmed by the commission,” said Fournier. 

Visit the website for more information on the VRC and its technology and services

 

Bradley Hospital partners with Cartwheel to increase access to intensive mental health care

Bradley Hospital now makes it easier for students across New England experiencing a mental health crisis to access intensive treatment, thanks to a new collaboration with Boston-based telehealth platform Cartwheel. It is a way to address the mental health crisis among children, as almost one in five are dealing with a mental, emotional, or behavioral disorder. 

The new partnership between the Bradley REACH virtual partial hospitalization program and Cartwheel allows school counselors in more than 50 districts across Rhode Island, Massachusetts, and Connecticut to refer students in crisis to a higher level of care. 

Bradley REACH is a partnership with providers and payers across the country, which allows Bradley Hospital to bring its pediatric behavioral health expertise to adolescents in crisis in their own homes through telehealth. The program currently operates across New England and in Florida, with planned expansions in more states in 2024. 

Bradley REACH is for individuals ages 13 to 18 with a wide range of mental health conditions, including depression, anxiety, suicidal ideation, and self-harm. It offers virtual individual, group, and family therapy, along with tutoring so participants don’t fall behind in their schoolwork. The average length of the program is three to four weeks, but students can continue for as long as needed. After completing treatment with Bradley REACH, students can return to school and continue their outpatient therapy with Cartwheel. 

Cartwheel already provides outpatient therapy and psychiatric services through telehealth for a variety of mental health needs. Schools often provide mental health support for students, especially with the current shortage of mental healthcare providers. But more help is needed for those experiencing severe mental health issues. Thanks to this partnership, students will now have access to more intensive support through Bradley’s program. 

“Bradley REACH is committed to increasing access to high-quality, intensive behavioral health support for adolescents in need. We take a tailored approach to care that results in significant improvements for our patients and families and a flexible and safe environment that drives better outcomes,” said Ellen Hallsworth, director of Bradley REACH. “Partnering with Cartwheel allows us to strengthen school districts’ ability to get students the right care where and when they need it most and avoid future hospitalization.” 

You can learn more about Bradley REACH on its website.

Center for Bariatric Surgery Receives MBSAQIP Reaccreditation

This year, the Brown University Health Center for Bariatric Surgery (CBS) received reaccreditation from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) as a Comprehensive Center with Adolescent and Obesity Medicine Qualifications. 

“This recognition acknowledges our commitment to providing and supporting quality improvement and patient safety efforts for our metabolic and bariatric surgery patients,” said Beth Ryder, MD, program director. 

The center continues to earn national recognition for its outstanding patient care and record for long-term success. In 2021, our obesity medicine program became one of the first in the US and the only one in Rhode Island to earn MBSAQIP accreditation. The adult program consistently earned accreditation since 2015, while the adolescent program has been accredited since 2017.

The accreditation process is voluntary yet rigorous. “The reaccreditation is a testament to the efforts of our entire team at the Center for Bariatric Surgery. We are truly fortunate to have a team that works cohesively to provide high quality care for our patients,” added Dr. Ryder.

For more information on the CBS awards and recognition, or for more information on the program, visit the website

Lifespan bariatric surgery team

Contact Center for Bariatric Surgery

For more information or to speak with someone at the Center for Bariatric Surgery, please call 401‑793‑3922.

 

New Addiction Programs Available at Brown University Health and Gateway

With Rhode Island experiencing alarmingly high rates of addiction and drug overdoses, Brown University Health Psychiatry and Behavioral Health and Gateway Healthcare are now offering new programs to address the crisis.

Addiction Care Today at Rhode Island Hospital

A new program called Addiction Care Today (ACT) will offer walk-in and same-day appointments for individuals to begin treatment for substance use disorder. ACT’s mission is to provide non-judgmental care, guidance, support, and individualized treatment services, whether the patient’s goal is to stop use, decrease use, or to use more safely. 

An experienced team of providers from Brown University Health’s Division of Addiction Medicine will staff the clinic. The team will also include individuals who have experienced addiction and recovery. 

“We continue to see record breaking rates of overdoses in the US and in Rhode Island. In the face of this crisis, we need to radically rethink the way we deliver care to people with substance use disorders,” said Cecilia Fix, MD, addiction medicine division director, Brown University Health adult psychiatry and behavioral health, assistant professor of medicine and of adult psychiatry and behavioral health, and clinician educator, The Warren Alpert Medical School of Brown University. 

“ACT offers on-demand care including medications that treat addiction, harm reduction and behavioral health. We welcome all patients whether they are ready for treatment or trying to stay safe while using drugs.”

The clinic is dedicated to addressing the physical and emotional needs of its patients, offering treatment, medications, counseling, and other services including:

  • Treatment of any substance use disorder.
  • Medications for addiction treatment, including buprenorphine (Suboxone, Subutex, or Sublocade), and naltrexone (Vivitrol).
  • Outpatient management of withdrawal symptoms.
  • Harm reduction services.
  • Referrals to peer support, long-term addiction care, behavioral healthcare, or social services.
  • Assessment of psychosocial needs.

ACT is in the Medical Office Complex at 2 Dudley Street, Suite 375, and is open Monday through Friday from noon to 4 p.m. No referral is needed. For more information, visit ACT’s web page or call the clinic at (401) 606-8100. 

Gateway offers New Beginnings program for managing addiction

Gateway Healthcare is now offering a program called New Beginnings. This intensive outpatient therapy program is designed to help individuals manage their addiction. The center is the first adult addiction medicine program in Rhode Island to use the “Seven Challenges” program to provide comprehensive counseling and support and empower individuals to reclaim ownership of their lives. 

“New Beginnings is dedicated to delivering outstanding services that motivate adults dealing with substance use disorder and co-occurring mental health issues to pursue recovery at any point in their journey. We can help our patients evaluate their lives, consider changes they want to make, and find success in taking control of their addiction and their lives,” said Nowai Vessiales, CADC, LCDP, New Beginnings (IOP) clinical supervisor. 

The components of the program include the “Seven Challenges” approach to addiction, along with mastery counseling, the Leap of Power book, and the process of supportive journaling. Also included are three-hour group sessions on Monday through Thursday, along with individualized counseling one day each week. 

Patients can call Brown University Health’s Behavioral Health Access Center at 401-606-0606 for more information or to sign up. The program is offered at 101-103 Bacon Street in Pawtucket. No referral is needed. You can learn more by visiting Gateway Healthcare's website

 

Pediatric Psychiatry Resource Network Receives Key Funding Grant

Thanks to a new grant, Bradley Hospital’s Pediatric Psychiatric Resource Network (PediPRN) is now funded through September 2026. In 2023, the Rhode Island Department of Health received a federal grant that will provide $850,000 annually to support the program over the next two years. 

Bradley Hospital created PediPRN in 2016 as a telephone consultation program for pediatric primary care physicians to consult with children’s psychiatric specialists when treating a child for a mental health condition. The program was developed in response to an increasing need for pediatric mental health care amid a shortage of providers. 

“Pediatricians can refer a child to a mental health specialist, but there could be a delay in getting an appointment. Also, some patients and their families are more comfortable receiving care from their own pediatric primary care provider,” noted Sarah Hagin, PhD, Pedi PRN program manager and pediatric psychologist. “A consultation with an expert can help pediatric primary care providers feel comfortable in addressing their patient’s mental health concerns without delay. The result is improved access to vital, high-quality care for the children of our community.” 

Most of the consults in the PediPRN are to help treat children with conditions such as anxiety, depression, ADHD, or autism spectrum disorders, which are often treated with selective serotonin reuptake inhibitors or stimulants. 

The service is available at no cost to all primary care providers in Rhode Island. The costs of the program are funded by the state grant as well as local health insurance programs. 

Pediatric primary care providers can call any time; however, they are encouraged to enroll in advance for this free service. They can also register for a youth mental health training program that is available through PediPRN. For more details visit the PediPRN website, email [email protected] or call 401-432-1543 (401-432-1-KID).

Bradley Hospital

Enroll in PediPRN

Pediatric Psychiatry Resource Network is a FREE service offered to all pediatric primary care providers in Rhode Island.

Complete the online application

Newport Hospital Earns “A” Rating from Leapfrog Group, “Best in State” in Newsweek

best in state Newport Hospital

In both spring and fall 2023, Newport Hospital earned a coveted “A” for its Hospital Safety Grade from the Leapfrog Group, the national health care rating organization. The grade recognizes the hospital’s commitment to prioritizing patient safety by protecting patients from preventable harm and errors. This grade reflected performance primarily during the height of the pandemic. 

Also, in October 2023, Newport Hospital was named among the best in Rhode Island in the “America’s Best In-State Hospitals” 2024 list Newsweek. The listing recognizes 600 leading hospitals across the country by state. It was developed to serve as a guide to help families decide where to access their healthcare. 

“We are so proud of these accomplishments. Our A grade from Leapfrog and being listed among the best in Rhode Island in Newsweek are due to the outstanding efforts of our staff at Newport Hospital,” said Crista Durand, president, Newport Hospital. “We are fortunate to have such an amazing team, who strive every day to provide our patients with the safest, highest quality care possible.” 

For more on Newport Hospital’s awards and recognition, visit our website.

 

Aubin Child Protection Center Offers Compassionate Care for Abused Children

The Lawrence A. Aubin Sr. Child Protection Center at Hasbro Children’s provides services for children who may have experienced sexual, physical, or emotional abuse or neglect. The program was launched in 1996 to address the critical need for assessment and treatment of potentially abused children. 

“The Aubin Center is a nurturing haven for children and their families, where compassion is the cornerstone of everything we do. Our dedicated team delivers trauma-informed care in a safe environment where children can flourish and thrive,” said Meg Fitzgerald, certified child life specialist and program manager for advocacy and prevention in the center. 

Today, the center offers a full range of services, including: 

  • Specialized medical services to diagnose children who may have been sexually abused, including state-of-the-art medical equipment as an adjunct to diagnosis. 
  • Comprehensive medical examinations to assess physical injuries. 
  • Family support and education. 
  • Referral information to specialized clinicians for ongoing therapy. 
  • Collaboration with state child protection agencies, child advocacy centers, law enforcement agencies, and the Office of the Attorney General. 
  • 24-hour phone consultation services for abuse cases requiring emergent responses. 
  • Expert medical inpatient consultation for cases of suspected abuse, neglect, or factitious disorders. 
  • Lectures and presentations to inform and educate the community about child abuse and maltreatment. 

The center’s holistic environment is designed to cater to the unique needs of children and teens, with modern clinical spaces alongside inviting play areas. “Our goal is to create a safe and comforting experience to address their immediate health needs and guide children on their journey to health and healing,” explained Dr. Christine Barron, the center’s division director. 

The center also offers the only three-year academic fellowship in child abuse pediatrics in New England. Fellows play a critical role at the Aubin Center, providing clinical care to abused and neglected children. They also teach other clinicians, receive formal training, and course work, and conduct research. You can learn more about the fellowship by visiting this website.

Learn more about the center and its services on the website or watch this video on YouTube.

 

LifeNotes physicians

Babar Khokhar, MD, Appointed Executive Vice President and Chief Physician Officer

Babar Khokhar, MD

Babar Khokhar, MD, MBA, was appointed Brown University Health’s new executive vice president and chief physician officer, effective February 1, 2024. In this role, Khokhar oversees medical affairs, physician practices, outpatient care locations, and community health services. He also serves as associate dean for clinical affairs (Brown University Health) at The Warren Alpert Medical School of Brown University. 

Prior to joining Brown University Health, Khokhar served as chief medical officer for Yale School of Medicine and chief ambulatory medical officer at Yale-New Haven Health System in Connecticut. He also served as its chief clinical transformation officer and interim chief executive officer. 

“Brown University Health is fortunate to have recruited such a talented and visionary executive during a critical time in healthcare, when operational innovation is becoming more and more essential to long term success in this industry,” said Brown University Health President and CEO John Fernandez. “With his history of enterprise-level clinical care delivery transformation, Dr. Khokhar is a welcome addition to the Brown University Health team.” 

Khokhar brings a wide range of experience to his new position at Brown University Health. His background includes overseeing regional medical directors, risk management, patient relations, credentialing, clinical innovation, population health, and improving clinical operations of ambulatory locations across an enterprise. 

While at Yale, Khokhar participated in several initiatives focused on its providers. Khokhar founded and led the Yale Clinical Optimization Services to help reduce provider workloads by developing new workflows to improve efficiencies and novel care team models along with the use of virtual scribes. He was also instrumental in laying the groundwork for aligning physician groups across the health system and ensuring support for the well-being of the staff and clinicians.

Khokhar established a system-wide ambulatory operations group, which developed ambulatory practice standards and dashboards for clinicians, managers, and leadership. He helped create an innovative emergency department model to improve access and facilitate timelier discharges. He also helped develop and support the population health platform for Yale Medicine with programs such as the behavioral health collaborative and eConsult initiative.

Khokhar holds a BA in neuroscience and economics from Johns Hopkins University, and an MD and MBA from Tufts University School of Medicine. He completed an internship in internal medicine and a residency in neurology at Yale-New Haven Hospital and a fellowship in neuromuscular medicine at the Yale School of Medicine.

 

Cindy Peterson Appointed Executive Vice President of Ambulatory Care

Cindy Peterson

Cindy Peterson joined Brown University Health in December 2023 as its new executive vice president of ambulatory care. In this role, she is responsible for the overall leadership of Brown University Health’s clinical ambulatory services across Rhode Island, including oversight of its physician practices, health care clinics and urgent care centers.

Peterson brings a wealth of experience in ambulatory operations and growth to Brown University Health. Most recently she served as vice president of regional ambulatory operations and business development for a major teaching hospital in Boston. In that role she was responsible for driving ambulatory growth across competitive markets and expanding the hospital’s ambulatory offerings into metro Boston, greater Foxborough, and the south shore of Massachusetts. 

“Cindy’s knowledge of the ambulatory care landscape in southeastern New England will help Brown University Health develop outpatient programs that offer premier care in the communities where patients live and work,” said Brown University Health President and CEO John Fernandez. “Enhancing access to high-quality, integrated ambulatory care helps patients stay healthy and improves their quality of life overall.” 

Peterson holds a BA from Amherst College and an MBA in healthcare management from Boston University.

 

Mahesh V. Jayaraman, MD, FACR Named Chief of Diagnostic Imaging

Mahesh V. Jayaraman, MD

Brown University Health appointed Mahesh V. Jayaraman, MD, FACR as chief of diagnostic imaging, effective January 1, 2024. He is also director of the Neurovascular Center at Rhode Island Hospital. 

Jayaraman is widely recognized as a leader in neurointerventional radiology. Under his direction, the Neurovascular Center at Rhode Island Hospital has gained international acclaim for its cutting-edge treatment of cerebrovascular conditions, while his research has influenced changes in stroke care across the nation. 

“Dr. Jayaraman's advancements in clinical innovation have helped elevate the quality of Brown University Health’s diagnostic imaging services, which is essential to our mission of delivering exceptional care to patients,” said Brown University Health President and CEO John Fernandez. 

In his new role as Brown University Health’s chief of diagnostic imaging, Jayaraman will guide the implementation of novel technologies to improve patient care and expand its research. 

“I look forward to taking on this new role and working with the outstanding physicians and providers in diagnostic imaging. Together, we will focus on further solidifying Brown University Health’s commitment to advancing medical knowledge through research and improving healthcare outcomes,” said Jayaraman. 

Read more about Jayaraman’s appointment here, or visit the Brown University Health Medical Imaging website for more information on its services.

 

Christine K. Lee, MD, PhD, Named New Director of Endoscopic Skull Base Surgery Program and Co-Director of Skull Base Surgery

Christine K. Lee, MD, PhD

The Norman Prince Neurosciences Institute announced the addition of Christine Kyuyoung Lee, MD, PhD, as director of the endoscopic skull base and pituitary surgery program and co-director of skull base surgery. 

In her new role, Lee will focus on establishing a leading multi-disciplinary endoscopic skull base program (in collabroation with the Brown University Health Cancer Institute), aiming to become a regional and national referral center for pituitary lesions, complex cranial tumors, malignant brain tumors, and skull base pathologies. 

Additionally, Dr. Lee will serve as the director of the Translational Skull Base Laboratory. Her research will involve identifying therapeutic targets in chordomas, investigating the cancer neuroscience of skull base tumors, and developing innovative tumor imaging tools. 

She will also expand the skull base surgery division, partnering with Curtis Doberstein, MD, director of the cerebrovascular and skull base surgery program at Rhode Island Hospital. 

"Norman Prince Neurosciences Institute is already a world-class program. Still, we are steadfast in our commitment to constantly advance our capabilities," said Ziya L. Gokaslan, MD, neurosurgeon-in-chief at Rhode Island Hospital and The Miriam Hospital. "We recruited Dr. Lee because of her incomparable skills and training. The value she adds to our team and the care she can provide our patients is unmatched in the region." 

Lee brings exceptional expertise in neurosurgery to her new role, along with a specialization in skull base, pituitary, and brain tumor surgery. She earned her MD and PhD in Neuroscience from Stanford University School of Medicine. She completed a neurosurgery residency at Massachusetts General Hospital in Boston, and a fellowship in skull base surgery at Stanford University, working alongside Dr. Juan C. Fernandez-Miranda, a globally recognized authority in endoscopic and open skull base surgery. 

"It is a tremendous privilege to join the institute and have the opportunity to provide state-of-the-art endoscopic skull base surgery to our patients in the region. I am committed to delivering the highest level of care to patients and working collaboratively with the incredible multi-disciplinary team at Brown University Health,” said Lee. 

Gyan Pareek, MD, Receives Distinguished Alumni Award

Gyan Pareek, MD,

Congratulations to Gyan Pareek, MD, FACS, chief, division of urology, and co-director, Minimally Invasive Urology Institute, who was named the 2024 University of Wisconsin Reginald C. Bruskewitz Distinguished Alumni Award winner. 

The award is named after the university’s noted urologist, Professor Emeritus Reginald C. Bruskewitz, MD, and recognizes outstanding contributions in the field of urology. 

“I am honored to be recognized by my alma mater and join the ranks of the exceptional physicians who have been past recipients of this award,” said Dr. Pareek. “This recognition fuels my commitment to making impactful contributions to patient care, research, education and medical innovation.” 

Pareek is a graduate of the University of Wisconsin’s Endourology Fellowship program. His areas of expertise include kidney stones, prostate cancer, and benign prostatic hyperplasia. He will be honored at the American Urological Association Annual Meeting on May 4, 2024.


 

Valentin Antoci, MD, PhD Headshot

Valentin Antoci, MD, PhD

Chief of Arthroplasty, Brown University Health Orthopedics Institute, and Medical Director, Newport Hospital Total Joint Replacement Program

Val Antoci, MD, orthopedic surgeon and director of the Newport Hospital Total Joint Center, was named chief of the arthroplasty division at the Brown University Health Orthopedics Institute

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Marisa Bergfield (Michiels), PsyD

Clinical Psychologist

Clinical psychologist Marisa Bergfield (Michiels), PsyD, has joined Brown University Health’s Behavioral Medicine Clinical Service and the Norman Prince Neurosciences Institute

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Kimberly Rose Chapman, PhD

Neuropsychologist

Kimberly R. Chapman, PhD, is a new clinical neuropsychologist with the Neuropsychology Program of Brown University Health Psychiatry and Behavioral Health.

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Clark C. Chen, MD, PhD

Director, Brain Tumor Program, and Co-Director, Gamma Knife Stereotactic Radiosurgery Program, Brown University Health

Clark Chen, MD, PhD, an internationally recognized neurosurgeon specializing in brain tumors, has joined the Norman Prince Neurosciences Institute.

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Eric M. Cohen, MD

Program Director, Total Joint Center

Eric M. Cohen, MD, was named the program director of the Total Joint Center at The Miriam Hospital. He is an adult reconstructive and trauma orthopedic surgeon at Brown University Health Orthopedics Institute.

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Danielle M. Cohn, PhD

Psychologist

Danielle Cohn, PhD, is a licensed psychologist who recently joined the Adult Partial Hospital Program at Rhode Island Hospital.

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Alan H. Daniels, MD

Chief, Division of Spine Surgery, and Director, Adult Spinal Deformity Service, Rhode Island and The Miriam Hospitals

Alan Daniels, MD, was promoted to full professor of orthopedic surgery at Brown University. He will also serve as the inaugural Mark A. Palumbo, MD, chief of spine surgery after a $1.5 million endowment commitment from anonymous donors.

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Basit Jawad, MD

Otolaryngologist

Basit Jawad, MD, an otolaryngologist specializing in head and neck surgical oncology, microvascular reconstruction, and skull base surgery, has joined the Brown University Health Cancer Institute

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Amy J. Kaye, PhD

Clinical Psychologist

Amy Kate, PhD, is a clinical psychologist in general outpatient, the Mindful Teen program, and the crisis clinic at Bradley Hospital.

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Salma Khshaiboon, PhD

Psychologist

Psychologist Salma Khshaiboon, PhD, recently joined the Adult Partial Hospital Program at Rhode Island Hospital.

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Alexis C. Lawrence, MD

Medical Director for Newport Hospital Emergency Department

Emergency medicine physician Alexis Lawrence, MD, is the Newport Hospital Emergency Department medical director and an attending physician at Newport and The Miriam hospitals.

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Mallory McCabe, MD

Pediatrician

Pediatrician Mallory McCabe, MD, has joined Hasbro Children’s.

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Daniela McCooey, DO

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Christina Pastorello, MD

Adolescent Clinical Psychiatrist

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Paulo Renato Pina, MD, MPH

Pediatrician

Pediatrician Paulo Pina, MD, MPH, has joined Hasbro Children’s as division director of ambulatory and community medicine. 

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Luisa Skoble, MD

Psychiatrist

A board-certified psychiatrist, Luisa Skoble, MD, is now practicing at Brown University Health Psychiatry and Behavioral Health.

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Linda K. Snelling, MD

Pediatrician

Linda Snelling, MD, is a pediatric critical care specialist at Hasbro Children’s.

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Cazzie E. Steinzor, PhD

Psychologist

Psychologist Cazzie Steinzor, PhD, is now practicing with the Adult Partial Hospital Program at Rhode Island Hospital.

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Jennifer Stockwood, PsyD

Clinical Psychologist

Jennifer Stockwood, PsyD, is a clinical psychologist now practicing with the medical psychiatric program at Hasbro Children’s.

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Kelli L. Sullivan, PhD

Neuropsychologist

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Jonathan David Tatum, MD

Pediatric Endocrinologist

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Saraschandra Vallabhajosyula, MD, MSc

Saraschandra Vallabhajosyula, MD, MSc, is now a board-certified interventional and critical care cardiologist at the Brown University Health Cardiovascular Institute and director of the coronary care unit at Rhode Island and The Miriam hospitals.

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Chrystal Vergara-Lopez, PhD

Research Scientist and Psychologist

Chrystal Vergara Lopez, PhD, is a clinical psychologist at The Miriam Hospital with privileges at Bradley Hospital and its Early Childhood Mental Health Consultation program.

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Hospitalist

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LifeNotes research

Pancreatic Cancer Vaccine Clinical Trial

The Brown University Health Cancer Institute (LCI) is currently conducting an innovative clinical trial evaluating a personalized anti-cancer vaccine intended to prevent the recurrence of pancreatic cancer after surgical resection. 

This study adds a possible game-changer to LCI’s expanding, world-class clinical trials portfolio. “LCI is one of the first sites in the world to offer a personalized mRNA vaccine to prevent pancreatic cancer from recurring,” said Alexander Raufi, MD, a gastrointestinal oncologist with the LCI. 

“One of the problems with pancreatic cancer is that only 10 percent of individuals who are diagnosed with it are eligible for surgical resection. Unfortunately, with no screening tools, this cancer often goes undiagnosed until it has advanced to later stages,” Raufi explained. Research on the new pancreatic cancer vaccine, as well as other novel immunotherapy trials, are currently underway at LCI and offer hope for those with pancreatic cancer. 

“LCI now has one of the largest clinical trials programs focused on novel cancer treatments in New England. Many of these incorporate vaccines, targeted therapies, and new immunotherapy combinations, drugs to activate the body's own immune system to fight this disease,” Raufi noted. 

For more information on this pancreatic cancer vaccine trial and other clinical trials at the Brown University Health Cancer Center, visit this website. You can watch a WJAR-TV Channel 10 segment with Dr. Raufi here

The Johns Hopkins Percutaneous Cholangioscopy Registry

The Vascular and Interventional Radiology (VIR) department at Rhode Island Hospital is participating in the Johns Hopkins Percutaneous Cholangioscopy Registry. In 2023, VIR at RIH, along with multiple institutions across the country, established a new service line involving percutaneous cholangioscopy and cryoablation for the management of gallbladder/gallstone disease in high-risk, non-surgical patients. 

“These procedures offer a newer, minimally invasive yet definitive treatment option for these patients, who are not optimally managed by the current management algorithm for gallbladder disease,” said Aaron Maxwell, MD, division chief, vascular interventional radiology, Department of Diagnostic Imaging. 

The primary objective of the registry is to create a large database of percutaneous cholangioscopic procedures performed in vascular and interventional radiology at the participating institutions, including Rhode Island and The Miriam Hospitals. The study is sponsored by the Society of Interventional Radiology (SIR).

PE-TRACT (Pulmonary Embolism – Thrombus Removal with Catheter-Directed Therapy)

The Brown University Health Diagnostic Imaging Research team is taking part in a multi-center study aimed at assessing the immediate and long-term effectiveness of catheter-directed therapy (CDT) to treat submassive pulmonary embolism (PE). The study, funded by the National Heart, Lung, and Blood Institute, is designed to compare CDT to the standard treatment of anticoagulation alone. 

Known as the DOORwaY90 Study, the purpose of this prospective, multicenter trial is to evaluate the safety and effectiveness of selective internal radiation therapy (SIRT) using SIR-Spheres Y-90 resin microspheres as first-line treatment for local control of unresectable hepatocellular carcinoma in patients with Barcelona Clinic Liver Cancer (BCLC) stage A, B1, B2, and C. The study is sponsored by Sirtex, Inc. 

"With this large multicenter trial, we aim to identify a true comparative benefit of CDT over medical management in this selective subset of patients,” said Daehee Kim, MD, assistant professor, Department of Diagnostic Imaging. “Traditionally, Y90 radioembolization has been reserved for patients with advanced-stage liver cancer or those deemed unsuitable for surgery. However, this study aims to investigate the feasibility of utilizing Y90 treatment earlier in the course of the disease,” 

Kim also noted, “This shift is prompted by advancements in highly selective catheterization techniques, which have demonstrated exceptional local disease control. By exploring the potential benefits of upfront Y90 treatment, the study seeks to broaden our understanding of its applicability and efficacy in different stages of liver cancer management.” 

Learn more about the study here.

Development of a 3D Tumor Model Fusion Pipeline for Renal Mass Ablation

A study from the Minimally Invasive Urology Institute (MIUI) team has been accepted for presentation at the 2024 Urological Association Annual Meeting. The presentation will focus on the outcomes and insights of the research development of a three-dimensional tumor model fusion pipeline for renal mass ablation (RMA). 

“Unlike prostate biopsy, which has shifted towards MRI-Ultrasound fusion with pre-procedural three-dimensional simulation and probe placement planning, renal mass ablation (RMA) remains a “cognitive” procedure with no pre-treatment modeling,” said Dragan Golijanin, MD, director of the MIUI and director of genitourinary oncology. 

“In our study, we partnered with our interventional radiology colleagues to describe a 3D tumor modeling and fusion radiomics pipeline developed at our institution using publicly available software, and its outcomes over a five-year period.” Future directions include utilizing radiomic features of treated lesions, which are readily generated by the pipeline, to predict treatment outcomes with RMA using AI tools, Golijanin explained. 

Learn more about the study here.