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Description
Rounding at Rush spotlights the work of physicians across the Rush University System for Health, comprised of two community hospitals and Rush University Medical Center, which is ranked by U.S. News & World Report as one of the nation’s best hospitals. As a leading health system, Rush delivers outstanding patient care, offers the latest treatments, educates the next generation of health care providers, and pursues groundbreaking research.
Accreditation Statement
In support of improving patient care, Rush University Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the health care team.
This activity is being presented without bias and with/without commercial support.
Designation Statement
Rush University Medical Center designates this internet enduring material activity for a maximum of One (1) AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.
Disclosures
The course director(s), planner(s), faculty and reviewer(s) of this activity have no relevant financial relationships to disclose.
Accreditation Statement
In support of improving patient care, Rush University Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the health care team.
This activity is being presented without bias and with/without commercial support.
Designation Statement
Rush University Medical Center designates this internet enduring material activity for a maximum of One (1) AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.
Disclosures
The course director(s), planner(s), faculty and reviewer(s) of this activity have no relevant financial relationships to disclose.
34 Episodes
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Endoscopic sleeve gastroplasty (ESG) is a novel, outpatient endoscopic approach to treat obesity. Without using permanent anatomical alterations, clinicians who incorporate ESG into their care suture the inside of the stomach as a way of reducing the stomach’s volume down to the size of a banana, allowing patients to get full faster. In the continuum of weight loss therapies, including medication and surgery, ESG is a viable approach for patients looking for a minimally invasive approach to achieve their weight loss goals.
Christopher Chapman, MD, is a gastroenterologist at RUSH University Medical Center whose expertise is in interventional and bariatric endoscopy, with a focus on providing patients minimally invasive approaches in their care.
“Surgery is a very effective therapy, but is more invasive. Pharmacotherapy, at least before the introduction of GLP-1s, was minimally invasive, but also wasn't as effective [as surgery]. Endoscopy [such as ESG] is in the middle of being a little bit more invasive, but also more effective than medications.”
In this episode, Salina Lee, MD, a gastroenterologist at RUSH University Medical Center, will discuss how the detection and removal of adenomas is key to helping gastroenterologists prevent patients from developing colorectal cancer. Additionally, she will profile several colorectal cancer screening tools, as well as the latest advancements in colonoscopy, including the use of GI Genius that helps to produce higher adenoma detection rates.
“GI Genius is a novel artificial intelligence that's built into our processor to help us identify potential adenomas. You may wonder if GI Genius is helpful even amongst gastroenterologists who already have an adequate, or even good, adenoma detection rate. There’s research that shows it does increase the detection of polyps when compared to humans alone, even if they were considered experienced.”
The RUSH Multiple Sclerosis Center features a team of world-class clinicians and researchers, dedicated to offering the most advanced, comprehensive and individualized treatment protocols to patients affected by multiple sclerosis (MS), neuromyelitis optica (NMO), spectrum disorders (NMOSD) and other autoimmune disorders affecting the central nervous system.
In this episode, Augusto Miravalle, MD, the Chief of the Section of Multiple Sclerosis at RUSH, discusses the importance of whole brain health for MS patients, his work to reach and treat underserved populations, and the vital role patient education plays for beneficial short and long-term outcomes.
“One of my priorities is to improve healthcare literacy [about MS]. It's been demonstrated that patients who have a high level of literacy do better [in their care]. They have better clinical outcomes and they have a better understanding of the importance of certain types of lifestyle interventions.”
Catheter-based approaches to treat congenital and structural heart diseases are providing patients with a minimally invasive option for care when they are not eligible for traditional surgery. Hussam Suradi, MD, an interventional cardiologist at RUSH who specializes in treating patients with complex coronary and peripheral artery disease, will talk about several of these interventional approaches, including TAVR, or transcatheter aortic valve replacement, and TEER, or transcatheter edge-to-edge repair to their patients.
The podcast will also profile several promising new clinical trials that are evaluating the use of the next generation of catheter-based intervention in TAVR, TEER and TTVR, or transcatheter tricuspid valve replacement.
Dr. Suradi is fellowship-trained in structural heart interventions and is skilled in treating patients with heart valve conditions, such as tight or leaky valves, and those who are born with heart defects. He is also the director of the Cardiac Catheterization Lab and the Structural Hybrid Lab.
“At RUSH, we specialize in the treatment of a variety of different structural heart conditions using cutting-edge transcatheter approaches. We’re also excited to take part in several trials that are helping to move patient care forward.”
Bladder cancer is a condition that primarily affects elderly patients, causing symptoms such as blood in urine, changes in urinary habits and pain during urination. It’s the fourth most common cancer among men and the eighth most common cancer among women in the United States. In this episode, Gary Steinberg, MD, discusses the challenges in managing bladder cancer, which can range from low-grade and non-invasive to high-grade and invasive. He also highlights the importance of providing patients with an early diagnosis and profiles the range of treatments available for patients today.
Dr. Steinberg is a urologist at RUSH and a national authority in the surgical treatment of bladder cancer and continent urinary tract reconstruction. He is a recognized expert in translational bladder cancer research and has made significant contributions to the understanding of both non-muscle invasive and invasive bladder cancer.
“Treatment for patients with intermediate risk, non-muscle invasive bladder cancer is an unmet need. Most patients with intermediate risk bladder cancer have a low risk of progression, but their risk of recurrence is quite high. Our standard form of treatment, chemotherapeutic agents, is inadequate, but we're changing the way we deliver them. We think these new ways could improve the delivery of the drugs to the bladder lining cells.”
Clinicians in the RUSH Cancer Center are continually providing tailored cancer treatment to their patients. In today’s episode with Jessica Slostad, MD, a breast oncologist in the RUSH University System for Health, she profiles one possible, future avenue for personalized medicine--organoid drug screening. Although they are still being evaluated, tumor organoid drug screening may play a key role in the evolution of personalized cancer care. This type of screening could help clinicians test the effectiveness and side effects of therapies prior to giving them to patients.
Later in the episode, she profiles the ways she treats women with pregnancy-associated breast cancer, along with the unique challenges mothers and their babies encounter during treatment.
Dr. Slostad is an assistant professor of Medicine in the Division of Hematology, Oncology and Cellular Therapy at RUSH and specializes in breast cancer management. Her research interests include clinical and translational research with a focus on precision oncology and organoid technology.
“As we get more data and if [that data] supports the hypothesis that tumor organoids can be used as a drug screen to predict response, we would eventually look to see if we can use the tumor organoid to pick which therapy for the patient. Our data is not there yet; we first need to establish that there is concordance between the drug screen and what the patient is getting.”
CME Link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/490159/
Genetic testing plays a crucial role in the diagnosis and management of neuromuscular illnesses. Testing can help provide a definitive diagnosis in cases where clinical symptoms alone may not be conclusive. Neuromuscular disorders often share overlapping symptoms, making it difficult to distinguish between them based solely on clinical presentation.
Rabia Malik, MD, is a neuromuscular physician in the Department of Neurology at RUSH University Medical Center and is the director of the RUSH Muscular Dystrophy Association Care Center Clinic. Rich Dineen, MS, CGC, is a certified genetic counselor in the section of Neuromuscular Diseases at RUSH.
Dr. Malik explains that “having the right clinical question is definitely the most challenging piece of neuromuscular illness [care]. You need expertise and experience in recognizing what particular neuromuscular disorder you may be dealing with because that would subsequently help with [choosing the right] genetic testing.”
CME Link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/489637/
The RUSH Parkinson's Disease and Movement Disorders program treats over 7,000 patients with movement disorders, the majority of whom have Parkinson's disease (PD). RUSH is currently conducting about 150 research projects related to movement disorders; half of those focus on PD. Research on PD at RUSH encompasses a wide breadth of inquiry, from clinical phenotypes to pharmacologic interventions and much more.
Deborah Hall, MD, is a neurologist and movement disorder specialist and the Division Chief of the Section of Movement Disorders at RUSH University Medical Center. She also co-leads the novel RUSH PD GI Clinic, a novel multidisciplinary clinic focused on the gastrointestinal health of patients with PD and other movement disorders.
“Gene-based therapies are a particularly exciting area of research. Over the last five years, RUSH’s goal has been to personalize treatment for PD patients. This particular strategy coincides very nicely with the worldwide gene discovery effort to look at the genetic causes of Parkinson's disease.”
CME Link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/489645/
RUSH electrophysiologists treat patients with atrial fibrillation through a number of pharmacologic, non-surgical and surgical approaches, while also helping them modify risk factors to slow down progression of this chronic disease. Our providers treat newly diagnosed, paroxysmal, persistent and permanent atrial fibrillation. RUSH clinicians coordinate patients’ care before, during and after treatment, tailoring a multidisciplinary treatment plan that specifically meets their needs.
Dr. Erica Engelstein is an electrophysiologist in the RUSH University System for Health and an expert in treating atrial fibrillation. Her clinical interests include evaluation and treatment of patients with suspected or documented arrhythmias, including catheter ablation of atrial fibrillation and ventricular tachycardia.
“Some patients are best managed with rate control and anticoagulation so that we don't expose those patients unnecessarily to an invasive procedure. However, if the chances of restoring and maintaining a normal heart rhythm are good--and a lot of patients fit that profile--then they may be better managed with a more aggressive approach including catheter ablation.”
CME Link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/488912/
Through its participation in several stage III and IV lung cancer clinical trials, RUSH is a leader in identifying future treatments for patients with early and late-stage non-small cell lung cancer. By studying genetic mutations and analyzing genetic sequencing, RUSH is also developing new hypotheses about lung cancer progression through its partnership with Tempus.
Mary Jo Fidler, MD, is a thoracic oncologist and professor of Internal Medicine at RUSH University Medical Center. She is the Medical Oncology Section Chief in the RUSH Cancer Center and is the national principal investigator for the ADAURA trial, which is studying the effects of postoperative Osimertinib in resected EGFR+ lung cancer patients.
“We have at our fingertips an enormous amount of data [on non-small cell lung cancer]. When we generate hypotheses for tumor resistance and cancer cachexia, it is really helpful to have this large data set as we try to make sense out of the multitude of gene rearrangements, amplifications and RNA sequencing changes.”
CME Link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/489638/
Clinicians in the RUSH Spine Center take an integrated, multidisciplinary approach with the assessment and management of spine problems. They provide patients with innovative, evidence-based and individualized non-surgical and surgical treatment plans aimed at rapidly restoring function and quality of life.
Hong Wu, MD, is a physiatrist and the Director of the RUSH Spine Center. Ricardo Fontes, MD, PhD, is a neurosurgeon and the director of the RUSH Neurosurgery Residency Program.
“The success of the multidisciplinary approach is just the recognition that nobody has a set recipe for every patient,” says Dr. Fontes. “This model is very versatile and can offer a gamut of options to our patients. Surgery is not the solution for most patients and some may do very well with non-operative treatments.”
Whether cancer patients are newly diagnosed, currently receiving treatment or having completed treatment, the role of a physiatrist is to optimize their function and quality of life. While physiatry has grown in its incorporation in cancer care nationwide, RUSH is one of a small number of hospitals offering dedicated physical medicine and rehabilitation care for its cancer patients.
Obada Obaisi, MD, is an assistant professor in the RUSH Department of Physical Medicine and Rehabilitation and is the director of cancer rehabilitation at RUSH University Medical Center.
“My role [as a physiatrist] is to maintain or restore function, minimize symptom burden, maximize independence and ultimately improve quality of life for cancer survivors. Cancer rehabilitation involves a large, multidisciplinary team that includes myself, physical therapists, occupational therapists, speech language pathologists, dieticians and psychologists. I often tell patients I'm their quarterback for their function, so I can help identify which of these services the patient may need and coordinate with them based on their impairments.”
CME Link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/488832/
Critical limb ischemia is the end stage of peripheral arterial disease (PAD). With early detection and intervention of PAD, RUSH providers can prevent critical limb ischemia and major amputation for patients. RUSH is one of the only academic medical centers in Chicago and the Midwest to perform complex revascularization to restore blood flow and salvage limbs.
Kumar Madassery, MD, is the director of the Peripheral Vascular Interventions and Critical Limb Ischemia Program in the RUSH University System for Health. He is also an associate professor of Vascular Interventional Radiology and is the director of the Advanced Vascular Interventional Radiology Fellowship at RUSH.
“One providers specialize in treating patients with peripheral arterial disease that has progressed where they need some type of surgical or endovascular intervention. Over the last 10 to 15 years, we’ve seen an exponential growth of revascularization strategies and techniques that have helped to save patients from amputation.”
CME Link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/488817/
Clinicians in the RUSH Department of Urology are some of the country’s leading laparoscopic and robotic surgeons who offer patients the most advanced diagnostic capabilities for diagnosing urologic cancers, including prostate cancer. Once a timely, accurate diagnosis has been made, RUSH urologists create tailored treatment plans that leverage leading-edge treatments to improve patient outcomes and their quality of life.
Edward Cherullo, MD, is a urologist and the chief of the Department of Urology at RUSH University Medical Center. Under his leadership, Dr. Cherullo has expanded the Department’s efforts to provide comprehensive subspeciality care that incorporates the latest minimally invasive technologies. As a result, the Department of Urology is a regional and national leader of urologic care and is currently ranked No. 14 in the country by U.S. News & World Report.
“Prostate cancer is a very infiltrative cancer, which can be invisible on CT scan and even standard MRI. The advanced diagnostic technologies we use allow us to see the prostate gland in detail, including some of its metabolic activity and the cancer with 85 to 90% accuracy, which is good. That accuracy helps us make more accurate decisions regarding treatment.”
CME link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/487011/
The DRAGON 1 and 2 trials are large, multicenter, international trials that are evaluating the use of combined portal and hepatic vein, or double vein, embolization, to treat advanced liver cancer and metastases. Double vein embolization has the potential to become a new standard of care that could provide patients with life-extending and even life-saving treatment.
Erik Schadde, MD, FACS, FEBS (HPB), a transplant surgeon at RUSH University Medical Center, spearheaded the creation of the trial and has been at the center of some crucial discoveries in the use of double vein embolization.
“Sometimes liver tumors are so big or there are so many that you have very little liver left in the body if you want to remove them. In the past, those tumors haven’t been resectable. But we’ve actually found that you can grow the liver, so even very small liver remnants can now serve as a future liver remnant. Double embolization is an exciting new method that’s allowing us to do that.”
CME Link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/486727
RUSH University System for Health has a high-volume program for breast cancer treatment and reconstruction, incorporating a multidisciplinary approach that involves our plastic surgery, surgical oncology and medical oncology teams. This approach ensures our patients are treated with a coordinated, individualized care plan. RUSH also performs a wide range of leading-edge implant and flap breast reconstruction procedures after mastectomy or lumpectomy.
Rosalinda Alvarado, MD, is a breast surgeon experienced in breast conserving surgery, mastectomy including nipple-sparing mastectomy, oncoplastic surgery, sentinel node biopsy and breast cancer prevention and risk reduction.
Deana Shenaq, MD, specializes in both implant-based and autologous reconstruction after breast cancer and in microvascular techniques for lymphedema treatment, including lymph node transfer and lymphovenous bypass procedures.
“It’s very important that Dr. Alvarado does what she needs to do to get the cancer out safely and have a negative margin,” says Dr. Shenaq. “My main goal is not only to prevent recurrence, but also to do the reconstruction in the most aesthetically pleasing way possible.”
CME link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/486749
The RUSH University System for Health is nationally recognized for its delivery of timely, effective stroke care and expertise in treating some of the most complex stroke cases. Within the past year, three multidisciplinary subspecialty clinics were opened at RUSH to provide an even greater level of specialty stroke care for patients.
Rima Dafer, MD, is a vascular neurologist and the director of the Comprehensive Outpatient Cerebrovascular Diseases Clinic at RUSH University Medical Center. She has been a principal investigator on numerous clinical trials in acute stroke intervention and secondary stroke prevention. Her clinical interests center around stroke occurrence in young adults and the association of stroke and atrial fibrillation.
“Our stroke-cardiology and stroke-neurosurgery clinics provide patients with a personalized individualized care plan tailored to their unique needs depending on their condition. And our stroke prevention clinic plays such an important role in helping patients understand very simple risk factors that aid in primary stroke prevention.”
CME link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/486244
Led by Mark Wiet, MD, the RUSH Acoustic Neuroma Program offers personalized specialty care for patients with acoustic neuroma, a benign and often slow-growing tumor of the nerve that connects the ear and the brain. The program brings together specialists in neurotology, neurosurgery, radiation oncology, neuro-oncology, neuroradiology, audiology and physical therapy, who have extensive expertise in the diagnosis and treatment of this rare condition.
Dr. Wiet is the head of the section of otology, neurotology and lateral skull base surgery at RUSH University Medical Center. Board certified in otolaryngology and neurotology, he specializes in the comprehensive management of acoustic neuroma and lateral skull base tumors, pediatric and adult implantable hearing devices, including cochlear implants and bone anchor hearing aids and pediatric and adult general otology.
“We offer all of the broad treatment options for acoustic neuroma--observation, radiation and surgery--and because of that, we offer an unbiased opinion of care. We have a full complement of providers all working together to help patients achieve their best possible outcome.”
CME link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/486241/
As the no. 3 ranked neurology and neurosurgery program in the country, RUSH University Medical Center is at the forefront of providing leading edge care and participating in pathfinding neuro-interventional research. At the center of this work is R. Webster Crowley, MD, who discusses Rush’s use of the CorPath robotic system, Woven EndoBridge Embolization System and the RIST catheter.
He is the chief of the Section of Cerebrovascular and Endovascular Neurosurgery, as well as the surgical director of the Comprehensive Stroke Center. He is also the director of the Endovascular Neurosurgery Fellowship and his research interests include stroke, aneurysm treatment, pseudotumor cerebri and subarachnoid hemorrhage.
“We were one of the first programs to use the CorPath endovascular robot, which is used to diagnose cerebral angiograms, but has the potential for broader interventional uses with aneurysm and stroke treatment in the future. Rush also performed the first surgery in the world using the RIST catheter, which helps neurosurgeons access cerebral aneurysms with a better safety profile. Our neuro interventional program allows us to expand the ways that patients have access to the latest minimally invasive care.”
CME Credit link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/485661
Polyvascular disease is the presence of atherosclerosis in more than one arterial bed. While it is not a new phenomenon, polyvascular disease has been brought to the forefront in recent years through the expansion of clinical and research endeavors that include non coronary atherosclerosis, specifically lower extremity peripheral artery disease and cerebrovascular disease. The relevance of polyvascular disease is centered on its associated heightened risk for cardiovascular death, myocardial infarction and ischemic stroke.
Faisal Hasan, MD, FACC, FSCAI, is the Clinical Division Chief of Cardiology at RUSH University Medical Center and the Co-Director of the Cardiovascular Service Line at RUSH. Dr. Hasan is also an associate Professor in the Department of Internal Medicine, Division of Cardiology, at Rush Medical College whose recent work has focused on investigating outcomes in patients who present with myocardial infarction and have coexisting polyvascular disease.
“[In treating polyvascular disease], the patient is at the center of the care management team and all care providers, regardless of their subspecialty, come together and unify to treat these complex patients. We have noticed that this kind of collaborative approach leads to improved coordination of care leading to better patient outcomes.”
CME credit link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/485203
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