Rapid Treatment for the Depressed Brain

Is it possible to rapidly elevate the depressed mood? This has been a pressing question over the past 50 years because classic antidepressants, such as Prozac, are known to take weeks to reach clinical efficacy; combining medications to enhance antidepressant outcomes may take even longer, generally months. Mount Sinai has put forth enormous efforts to develop rapid treatments for major depressive disorder. Currently, ketamine treatment and deep brain stimulation are being investigated in clinical research and trials for treatment-resistant depressed patients at Mount Sinai.

Mount Sinai faculty has also been dedicated to the discovery of novel antidepressant treatments. As a faculty member in the Department of Pharmacology & Systems Therapeutics, as well as the Department of Neuroscience and Friedman Brain Institute, I am one of the neuroscientists working to reveal new drug and brain stimulation targets in animal models for the rapid treatment of depression.

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Treating Depression More Rapidly & Effectively

The prevalence rate for depression in the United States is nearly 7%, yet standard antidepressants produce full remission in only 30-40% of patients.  Even when treatment is effective, patients require 2-4 weeks to achieve the full therapeutic effects. Adding to the problem, there are currently no biological diagnostic tests to predict depression, forcing clinicians to diagnose based upon clusters of non-specific overlapping behavioral symptoms.  Thus, in the Russo lab, we are interested in identifying novel biological targets to predict depression and treat it more rapidly and effectively.

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Day 3 of IFMSA: Interview with Mariko Kondo

Today was the last day of the IFMSA conference, and Dean for Medical Education, Dr. David Muller addressed the students who braved the snow this morning, followed by a panel with Dr. Muller, Katie Robbins (PNHP, Healthcare NOW!), and Icahn School of Medicine at Mount Sinai students, Riju Banerjee, Josh Oppenheimer, and Susanna O’Kula. The IFMSA students have been a great audience, always asking relevant questions and paying attention throughout a packed schedule.

I had the chance to talk with Japanese delegate Mariko Kondo this evening about her experience this week.

Where in Japan are you from? Tokyo

What year in medical school are you? 4th year at Keio University

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Day 2: IFMSA Delegate Profile

Jesper Moelgaard, 31, is a 5th year medical student at the University of Copenhagen, Denmark. He was originally interested in Anesthesiology and is now focusing on Societal Medicine

Since this is his first time ever in America, I sat down with Jesper to chat about his impressions of the conference and New York City.

What’s been a sight-seeing highlight so far?

“Visiting the New York Department of Health in Long Island City where there were amazing speakers and very passionate people. In Denmark we have an expression that epidemiology is as fun as sticking your tongue out the window, but they actually made it very interesting.”

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AMSA Pre-General Assembly Conference, Day 1

On Tuesday night, the pre-General Assembly IFMSA/AMSA conference kicked off in the 13th floor auditorium in Annenberg at Icahn School of Medicine at Mount Sinai. Icahn’s American Medical Students Association (AMSA) chapter is excited to host this year’s pre-General Assembly Conference focusing on global health and advocacy. One hundred medical students from around the world managed to arrive today and listen to organizers Dan Knights, Felicity Jones, Mike Eliasz, Riju Banerjee, and Susanna O’Kula announce the week’s schedule and welcome the delegates to New York.

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Reforming Medical Education

Pre-med education is fundamentally flawed. This is something that the Medical Education community has known and written about for decades but has never acted upon. There are three critical problems:

  • Pre-med science requirements were established almost 100 years ago and have not changed since then despite extraordinary advances in clinical medicine and biomedical science.
  • These requirements consume an enormous amount of time and energy, detracting severely from what should be an enriching, stimulating college education.
  • The Medical College Admissions Test (MCAT) is an expensive (between the tests fees and pre courses), time-consuming hurdle that perpetuates the need to focus on memorization of facts and competition for grades.

More than 100 years ago, Abraham Flexner reformed medical education throughout the nation. He was considered visionary and is responsible for establishing what we currently consider to be the gold standard for how medicine is taught, both in medical school and in preparing for medical school. Since then, medicine and science have changed more rapidly than any other field, with the possible exception of information technology. Yet educators at both the college and medical school levels have failed to refresh his vision and align the physician training with society’s needs. We’ve also perpetuated the notion that everyone has to be taught the same requirements in lockstep, with little room for flexible, individualized, and self-directed learning.

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The NeuroTouch Simulation Project

As a first-year neurosurgery resident at Mount Sinai, I am continuously reminded of the seamless integration of innovative surgical technology and its ability to positively affect the outcomes of our patients. In fact, when I was a medical student at the Albert Einstein College of Medicine, I remember being fascinated by the “high-tech” feel of a neurosurgical operating room. Everything, from the microscope, to the cranial and spinal navigation systems seemed like something straight out of a science fiction movie. I realized that neurosurgery was a rapidly evolving field that was fueled by cutting-edge technology. It is one the reasons why I ultimately decided to join the ranks of the neurosurgeons I always idealized as a medical student. With this in mind, I am excited for the opportunity to describe my experiences with the launch our neurosurgery department’s NeuroTouch Simulation Project.

To provide a bit of background, in 2009, the National Research Council of Canada introduced the NeuroTouch, a one-of-a-kind physics-based virtual simulator for cranial micro-neurosurgery training. The development of similar virtual reality simulation devices within the past decade has enabled residents to practice basic surgical procedures in a risk-free environment. These devices have progressively increased in sophistication, playing an increasingly important role in the education and training of new surgeons. In September 2012, The Department of Neurosurgery at Mount Sinai Medical Center became the first in the United States to purchase the NeuroTouch Simulator.

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Ultraportable Ultrasound Introduced to Medical Education Curriculum

Ultraportable Ultrasound Device made available to Icahn School of Medicine students and trainees

This article was written by Alexa Mieses, a first-year medical student, and first published in The Rossi: Medical Student Quarterly Report.

Icahn School of Medicine at Mount Sinai is known for innovation within the realms of patient care, research, and medical education. Training future physicians requires a commitment to progress, and the newest addition to the medical school’s curriculum is no exception: In the spring of 2013, handheld ultrasound will be introduced to enhance students’ and trainees’ clinical skills and generation of a differential diagnosis by reinforcing anatomic and physiologic principles.

Unlike traditional ultrasound, bedside ultrasound is performed at the point of care, not in an imaging suite. Handheld ultrasound – an even more recent technology – is small enough to fit in the palm of a hand, with a screen roughly the size of a smart phone.  Compared to traditional ultrasound, these devices are more portable and less expensive, although the quality of image may be compromised.

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Mount Sinai Graduate Student Honored by Forbes

Jillian Shapiro

Jillian Shapiro, 25, a third-year graduate student at Icahn School of Medicine at Mount Sinai, recently was named to the Forbes second annual “30 Under 30” list of young people who have made significant contributions to their respective fields.

Ms. Shapiro’s discovery of a microRNA pathway that could someday advance treatments for multiple diseases led to her recognition by Forbes, in the January 21, 2013 issue. But, she says, her most important lesson as a researcher was learning that, “You can never just rule something out. You have to take a leap of faith and investigate first.”

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A Student-Run Program for Social Justice

In the increasingly complex world of medicine where clinical knowledge is estimated to double every 18 months, four Icahn School of Medicine at Mount Sinai students recognized that their education was missing an important component. Salina Bakshi, Marie Hennelly, Andrea Jakubowski and Aisha James took a critical look at the medical school curriculum and realized that while anatomy trains future surgeons and child development trains future pediatricians, there was no designated course discussing important issues in social justice. Thus, in 2011, the midst of their busy first year schedule, they started the Human Rights and Social Justice Scholars Program (HRSJ), a comprehensive one-year track giving students the tools, resources and mentorship to pursue the diverse aspects of health equity and social justice.

Salina Bakshi, Marie Hennelly, Andrea Jakubowski, Aisha James and the first eleven HRSJ scholar

I met Salina, Marie, Andrea and Aisha in the student lounge during the week before they would begin their third year clerkships. Given their tremendous accomplishment, I was expecting a rambunctious group, eagerly speaking and interrupting each other. Instead, I was met by a group which exuded quiet confidence and intelligence. They spoke thoughtfully and precisely – each contributing their unique expertise and experiences.

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