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Medicine
ADULT ORTHOPAEDICS
1925

Medicine

Overview
Chair: S. Louis Bridges, Jr., MD, PhD

Visit the Department Page for the full faculty listing.

The HSS Department of Medicine consists of the Divisions of Rheumatology, Pediatric Rheumatology, Perioperative Medicine, Endocrinology, Infectious Diseases, and a number of other subspecialties. The Department provides expert medical care for musculoskeletal, autoimmune and inflammatory conditions, and supports the Department of Orthopaedic Surgery by providing preoperative optimization and postoperative medical care for patients undergoing surgical procedures.

Leadership Notes

S. Louis (Lou) Bridges, Jr., MD, PhD, joined HSS on September 1, 2020, as Physician-in-Chief, Chair of the Department of Medicine and Chief of the Division of Rheumatology.

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Drs. Bridges and Crow

Dr. Bridges is an internationally recognized clinician-scientist known for his work in the areas of arthritis, rheumatology and immunology with a particular interest in rheumatoid arthritis susceptibility, severity and treatment response. His work has helped to shed light on health disparities in rheumatology care, particularly in rheumatoid arthritis among African Americans.

Dr. Bridges succeeds Mary K. Crow, MD, who led the department with distinction for the past 10 years. Among her many accomplishments as Physician-in-Chief, Dr. Crow worked to expand the six multidisciplinary Centers of Excellence and oversaw the establishment of the perioperative medicine program at HSS. A world-renowned expert in studying the underlying mechanisms of lupus, she will continue her work as the holder of the Benjamin M. Rosen Chair in Immunology and Inflammation Research and as co-director of the Mary Kirkland Center for Lupus Research at HSS.

COVID-19 Patient Care and Research

This past year saw many of our faculty, particularly our rheumatologists and internal medicine specialists, on the frontlines of COVID-19 care in New York City. During the surge, they played a vital role in helping to transform HSS into a multispecialty hospital, treating both COVID-positive and negative critical care and medical/surgical patients from Weill Cornell Medicine. These efforts were led by Linda Russell, MD, Chief of Perioperative Medicine, and infectious disease specialist Andy Miller, MD. Dr. Russell was instrumental in helping to reorganize the care model and treatment teams, while Dr. Miller assisted in decision making about care and provided incredible guidance as a subject matter expert in keeping the environment safe for not just patients but staff as well.

Throughout the pandemic, our clinicians have also been actively engaged in COVID-19 research studies. Rheumatologist Iris Navarro-Millán, MD, who was deployed as a hospitalist in the COVID-19 unit at Weill Cornell Medicine during the surge, hypothesized that the immunosuppressive drug anakinra, approved to treat rheumatoid arthritis and neonatal-onset multisystem inflammatory disease, might allow certain people with COVID-19 to avoid having to go on a ventilator. The resulting study, published in Arthritis & Rheumatology and featured in the New York Times, showed that anakinra appears to reduce the effects of systemic inflammation in people with COVID-19 who are in severe respiratory distress. Dr. Navarro-Millán is now developing a controlled study of anakinra in patients with COVID-19 who fit the criteria she developed. Read an in-depth article chronicling the HSS Rheumatology experience with COVID-19 patient care as well as related research initiatives.

Additional COVID-related research studies led by Department of Medicine faculty, and made possible by the generous support of donors, include one led by metabolic bone specialist and researcher Emily Stein, MD, MS, looking at COVID-19 exposure and the role of vitamin D among hospital employees, and another assessing outcomes and complication rates in patients who’ve had orthopaedic surgery after COVID-19, led by Dr. Miller. Also under the direction of Drs. Miller and Stein, HSS participated in a nationwide clinical trial investigating whether hydroxychloroquine could effectively prevent COVID-19 in healthy healthcare workers.

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(From left) Pathologist-in-Chief Thomas W. Bauer, MD, PhD, with members of the Infectious Diseases Service Andy O. Miller, MD, Barry D. Brause, MD, and Michael W. Henry, MD.

Known as the Healthcare Worker Exposure Response and Outcomes of Hydroxychloroquine (HERO-HCQ) trial, the study was launched by the National Patient-Centered Clinical Research Network (PCORnet) and tracked responses in an estimated 15,000 participants across the country to see if they test positive for COVID-19 and whether they develop antibodies to SARS-CoV-2, the virus that causes the disease.

Notable Studies

Use of Anakinra to Prevent Mechanical Ventilation in Severe COVID-19: A Case Series. Navarro-Millan I, Sattui S, Lakhanpal A, Zisa D, Siegel CH, Crow MK. Arthritis Rheumatol. 2020 Jun. doi: 10.1002/art.41422.

Effect of Abaloparatide vs Alendronate on Fracture Risk Reduction in Postmenopausal Women with Osteoporosis. Leder B, Mitlak B, Hu M-Y, Hattersley G and Bockman R. J Clin Endocrinol Metab. 2020 Mar 105(3): 938-943. PMID: 31674644

New APS Classification Criteria Collaborators. Development of New International Antiphospholipid Syndrome Classification Criteria Phase I/II Report: Generation and Reduction of Candidate Criteria. Barbhaiya M, Zuily S, Ahmadzadeh Y, Amigo MC, Avcin T, Bertolaccini ML, Branch DW, de Jesus G, Devreese KMJ, Frances C, Garcia D, Guillemin F, Levine SR, Levy RA, Lockshin MD, Ortel TL, Seshan SV, Tektonidou M, Wahl D, Willis R, Naden R, Costenbader K, Erkan D. Arthritis Care Res. 2020 Nov 30. PMID: 33253499.

2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Sammaritano LR, Bermas BL, Chakravarty EE, Chambers C, Clowse MEB, Lockshin MD, Marder W, Guyatt G, Branch DW, Buyon J, Christopher-Stine L, Crow-Hercher R, Cush J, Druzin M, Kavanaugh A, Laskin CA, Plante L, Salmon J, Simard J, Somers EC, Steen V, Tedeschi SK, Vinet E, White CW, Yazdany J, Barbhaiya M, Bettendorf B, Eudy A, Jayatilleke A, Shah AA, Sullivan N, Tarter LL, Birru Talabi M, Turgunbaev M, Turner A, D'Anci KE. Arthritis Care Res (Hoboken). 2020 Apr;72(4):461-488. doi: 10.1002/acr.24130. Epub 2020 Feb 26. PMID: 32090466.

State of Research in Adult Hospital Medicine: Results of a National Survey. Chopra V, Burden M, Jones CD, Mueller S, Gupta V, Ahuja N, Sigmund A, Eid SM; Society of Hospital Medicine Research Committee. J Hosp Med. 2019 Apr;14(4):207-211. PMID: 30933670

Perioperative Care of the Orthopaedic Patient, second edition; Eds. CR McKenzie, CN Cornell, NSG Memtsoudis. Springer: New York, 2020.

Looking Ahead

A top priority for the Department of Medicine in 2021 is building upon the already distinguished legacy of clinical research in rheumatology at HSS. This will include growing the infrastructure to support research studies, and providing small grants to young investigators with innovative research ideas so that they can obtain preliminary data to support larger future research studies. In addition, we are launching a Big Data Initiative, which will harness artificial intelligence technologies to rapidly translate discovery using data from electronic health records and other sources such as genetic studies, medication use, and patient reported data. This approach will increase our understanding of rheumatic diseases and ultimately improve patient outcomes. We will also focus on more effective mentoring for early stage clinical investigators. Actively enhancing diversity, equity and inclusion among our faculty and trainees is another very important goal that the department is committed to advancing in 2021.

Rheumatology at the Epicenter
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