20-Minute Health Talk

How to know if you’re at high risk for breast cancer

While most breast cancers are found in women who are 50 years of age or over, about 1 in 10 diagnosed with breast cancer are under 45, and often their cancer is in a later stage when it’s discovered. On this episode, Nina Vincoff, MD, clears up the confusion around mammogram guidelines. She says every woman should go through a risk assessment at a younger age to determine their risk — something most do not discover until their first mammogram. For those at high risk, this can have deadly consequences. The chief of breast imaging at Northwell Health explains what average risk means, how it is calculated, who is at the highest risk and steps women can take before going to their doctor's office.

 

Chapters

• 00:50 - Mammogram guidelines
• 01:41 - What is average risk for breast cancer?
• 02:26 - Why women should start screening for breast cancer in their 20s
• 03:06 - What is a risk assessment?
• 05:46 - Types of risk calculators
• 07:05 - Breast cancer risk categories
• 08:00 – Who is at highest risk?
• 12:18 - What if mammogram isn't enough?
• 13:14 - Are there risks of mammography?
• 14:57 - Does insurance cover mammograms?
• 17:06 - What happens if I am high-risk?
• 19:00 - Reasons for positivity
• 20:15 - Be your own best advocate

20MHT BONUS w/ Sandra Lindsay: What women need to know about heart disease

Despite the best efforts of heart health experts, only 56% of women recognize that heart disease is their No. 1 killer; among African American women that number drops to just 25%. Jean Cacciabaudo, MD, medical director at Huntington Hospital, renowned cardiologist and member of Northwell Health's Katz Institute for Women's Health, sits down with Sandra Lindsay, RN to discuss the differences between men and women when it comes to heart disease, what health systems are doing to address disparities in care, and what women seeking a cardiologist or cardiac surgeon should know.

This bonus edition of 20-Minute Health Talk continues the conversation from the previous episode, which featured a panel of cardiovascular experts offering tips for patients looking for a cardiologist or cardiac surgeon. You can listen to that conversation here. 

Learn more about cardiology, cardiac surgery and women's heart health services at Northwell Health.  

How to pick a cardiologist or cardiac surgeon

Cardiovascular disease remains the number one killer of both women and men in the United States. Most of us will need to see a cardiologist or cardiac surgeon at some point in our lives. But, how do you find the best doctor who is right for you?

On this episode, three experts representing different subspecialties within cardiovascular health offer advice to patients facing the question: How do I pick a cardiologist or cardiac surgeon?

• Jeffrey Kuvin, MD, is senior vice president of Cardiology for Northwell’s Eastern & Central Regions and chair of the Department of Cardiology at North Shore University Hospital and Long Island Jewish Medical Center. He is also Co-Director of the Sandra Atlas Bass Heart Hospital at North Shore University Hospital.
• Alan Hartman, MD, is senior vice president and executive director of Cardiothoracic Surgery at Northwell Health; as well as co-director of the Sandra Atlas Bass Heart Hospital at North Shore University Hospital.
• Varinder Singh, MD, is senior vice president of Cardiology for Northwell’s Western Region; and the Guenther Chair for the Department of Cardiology at Lenox Hill Hospital.

Chapters:

• 00:01 - Intro
• 01:09 - Who should see a cardiologist?
• 02:19 - Start with your primary care doctor
• 03:01 - Is the doctor Able? Affable? Available?
• 03:29 - Connecting with your doctor
• 05:38 - Finding the right cardiac surgeon
• 07:18 - Quality ratings
• 09:45 - The importance of trust
• 12:!7 - General vs interventional cardiology
• 14:14 - What is your vascular age?
• 15:44 - Why volume matters
• 17:00 - Does gender play a factor

Further references:

Learn more about quality ratings for cardiac surgery

• • STS report
  • Cardiology and Cardiac Surgery 2021 report
  • NYS Department of Health (DOH) report on adult cardiac surgery
  • NYS DOH report on percutaneous coronary interventions
  • US News & World Report

Learn more about patient satisfaction scores, like Press Ganey. 

 

Providing police officers improved access to behavioral health care

"Police officers see everyone on their worst day," says Katelyn Jetelina, PhD, a guest on this week's 20-Minute Health Talk. This constant exposure to high-stress situations takes a considerable toll on an officer's emotional well-being, yet few seek help despite suffering higher rates of depression, substance use, burnout, PTSD and anxiety than the general public. Tragically, more police officers die by suicide than in the line of duty. On this episode, we speak with health care experts working to remove barriers to behavioral health services for police. Nick Stefanizzi is CEO of Northwell Direct, which recently announced a new collaboration with the New York Police Department called Finest Care, which will bring free, confidential counseling and other behavioral health services to the largest police department in the U.S. Dr. Jetelina is a data scientist, violence epidemiologist, and educator studying vulnerable populations exposed to violence. She's also the Director of Population Health Analytics at the Meadows Mental Health Policy Institute, based in Texas and has published extensively over the last decade on this issue.

Honoring mRNA pioneers Katalin Karikó and Drew Weissman

While the Covid vaccines were developed and deployed in less than a year, the messenger RNA (mRNA) technology that powered them took more than five decades to develop. On this episode, we speak with two researchers who played a key role in advancing the science: Katalin Kariko, PhD, adjunct professor of Neurosurgery at the University of Pennsylvania and a senior vice president at BioNTech; and Drew Weissman, MD, PhD, the Roberts Family Professor of Vaccine Research in Penn's Perelman School of Medicine. Despite setbacks and even ridicule from peers, they worked tirelessly to find a way to harness the potential they saw in mRNA. In 2001, they discovered a way to turn fragile mRNA strands into viable vaccines and medicines by packaging them into lipid nanoparticles (LNPs). For their contributions to medical research, they were recently awarded the 2022 Ross Prize in Molecular Medicine, an annual award meant to cultivate promising careers in the fields of science and research.  

In this episode, the history-making duo discusses what motivated them to endure their decades-long scientific struggles, their plans to continue their mRNA research and what it means to be awarded the Ross Prize. Also on the show, we speak with Kevin Tracey, MD, president of the Feinstein Institutes for Medical Research, about the importance of supporting young scientists, early-stage research, the culture of science and how listeners can nominate a candidate for the 2023 Ross Prize.

Dr. Tracey is widely known as the "father of bioelectronic medicine," an emerging field of medicine that is making strides in the use of devices, rather than medications, to treat chronic diseases. Among the most promising is a treatment called vagus nerve stimulation.

More on the history of mRNA technology

Learn more about the history of mRNA technology and the development of the Covid-19 vaccines on this episode of the podcast, featuring Wall Street Journal writer, Gregory Zuckerman, and two of the first Americans to receive the vaccine, Sandra Lindsay and Yves Duroseau, MD. 

Watch episodes of 20-Minute Health Talk on YouTube. 

Burn pits: Understanding the problem, identifying solutions

For the 5 million veterans who served overseas in the last couple of decades, burn pit exposure continues to pose a threat to their well-being. Toxic fumes have triggered breathing troubles and other serious health conditions in more than 12,500 veterans between 2007 and 2020. Our guest, Anthony Szema, MD, has worked not only to diagnose and treat these burn pit-related issues, but better understand them through research and advocacy. He recently joined several patients and fellow advocates at the White House to witness the signing of the PACT Act — new legislation that will help veterans suffering from burn pit exposure get treatment.

On this episode, Dr. Szema, who is director of Northwell Health’s International Center of Excellence in Deployment Health and Medical Geosciences, shares his extensive knowledge of burn pits, the impact they've had on his patients, and his experience at the White House. He also shares the recommendations he made to the Senate Armed Services Committee to prevent future exposures.

Why — and how — surgeons are ditching opioids in the OR

Recovering from surgery can be difficult —  and opioids actually make it tougher. In addition to side effects such as nausea, lethargy and potential breathing problems, this potent painkiller also carries the risk of addiction for about 3 to 4 percent of surgical patients. That number climbs to about 8 percent for bariatric surgery patients because they may also be battling joint pain stemming from their weight issues.

On this episode of the podcast, two bariatric surgeons share how they are limiting, and in some cases even eliminating all together, the use of opioids during a patient's stay in the hospital and after discharge through their "enhanced recovery" initiative. They are:

• Dominick Gadaleta, MD, chair of surgery, South Shore University Hospital
• David Pechman, MD, bariatric surgeon, South Shore University Hospital

And they’re joined by an expert in substance use disorder:

• Sandeep Kapoor, MD, assistant vice president of Emergency Medicine Addiction Services.

Read more about how the use of nerve blocks is reducing the need for opioids at Northwell hospitals.

Regenerative medicine: Helping the body heal itself

It sounds like science fiction, but researchers today are unlocking the body's natural healing ability as part of an emerging field of science called regenerative medicine. Although the field is relatively young, some regenerative treatments are already approved to help repair joints and relieve pain, allowing some patients to avoid surgery altogether. Two leaders in the field detail their research into current and future clinical applications within orthopedics. 

• Kenneth Zaslav, MD, is director of The Center for Regenerative Orthopedic Medicine at Northwell/ and part of the Lenox Hill Orthopedic Institute 
• Seth Sherman, MD, is a sports medicine and orthopaedic surgeon at Stanford Health Care. 

Learn more about Northwell Health's Center for Regenerative Medicine. 

 

How philanthropy is improving health equity

Medical research often depends upon the generosity of donors: In this episode we talk to philanthropy experts about the role of donations in driving medical breakthroughs and achieving health equity across all zip codes. The panel includes:

Brian Lally, senior vice president and chief development officer for Northwell Health and head of Northwell's Foundation.

Mark Butler, PhD, assistant professor in the Institute of Health System Science, part of the Feinstein Institutes for Medical Research. He is leading a study using smart prescription pill bottles to help address medication adherence and reduce cardiovascular disease in the Black community.

Emmet Conlon, senior vice president and group head of U.S. Healthcare and Higher Education at TD Bank, which funded Dr. Butler’s clinical trial.

Support our nonprofit mission and save lives. Your generous gift will allow our clinical teams to remain at the forefront of care for people in our communities.

Injectable PrEP: Adding choice to HIV prevention

 

An estimated 38,000 Americans are diagnosed with HIV annually. An important tool in the effort to end the ongoing epidemic is an injectable form of pre-exposure prophylaxis (PrEP), the first option to prevent HIV that does not involve taking a daily pill. The injectable form of the drug received FDA approval in late 2021 and has begun to hit the market. This is Part 2 of our conversation (Recorded May 16, 2022) with a panel of experts specializing in the HIV treatment and prevention. They discuss the benefits and what people at risk for HIV should know, challenges of implementation among providers and more. 

The panel includes: 

David Rosenthal, DO, PhD, medical director for the Center for Young Adult, Adolescent and Pediatric HIV.

Demetre Daskalakis, MD, director of the Division of HIV/AIDS Prevention (DHAP) for the Centers for Disease Control and Prevention (CDC)

Charles Gonzalez, MD, medical director for the New York State Department of Health's AIDS Institute

More from the experts

Dr. Rosenthal talks strengthening HIV prevention with PrEP and expanding the four key strategies to end AIDS by 2030.