Rocky Point school district will be spending half of its budget on the teachers, classes and programs, while spending the least amount on debt service and fund transfers.
By Giselle Barkley
Rocky Point school district will be spending half of its budget on the teachers, classes and programs, while spending the least amount on debt service and fund transfers.
Taxpayers in Rocky Point school district may see rebate checks from the government, thanks to Rocky Point school district’s 2016-17 budget proposal.
Rocky Point Superintendent of Schools Michael Ring held the final budget presentation on March 21, announcing that the district’s $80.6 million budget will help maintain the existing instructional, athletic and co-curricular programs, while also working to tackle improvements in the buildings and campuses, like fence and parking lot repairs, and increasing the number of cafeteria tables and cameras across the campus.
Although Ring said the district is confident it will receive money from the Gap Elimination Adjustment restoration, Rocky Point will currently receive $25.2 million in regular state aid, with the possibility of an increase, depending on the results of a vote to restore funds from the GEA. According to Ring, the district receives most of its revenue from tax levies. Residents will see an approximate 0.75 percent increase year over year in the tax levy in the district. Despite the increase, the district’s budget falls within the 0.12 percent tax cap. In light of the limited tax cap, the district only increased its budget by 2.34 percent.
“We believe that the budgets we have presented in previous years and [the one] we’re presenting this year are efficient and effective,” Ring said. “Efficient in that the level of expenditures is very conservative and within the tax cap, and effective because they continue to hold our programs together, both instructionally and co-curricular.”
Rocky Point’s instructional programs, which include courses for general and special education, make up around 50 percent of the district’s budget, followed by employee benefits, among other categories.
“I think this is a place to give every student an opportunity to succeed,” said Scott Reh, vice president of Rocky Point’s board of education.
The superintendent echoed Reh’s stance during the meeting regarding Rocky Point students.
“Success for our students is at the intersection of many roads, and these roads are the main components of our budget,” Ring said. “These many roads are represented by the breadth and depth of academic programs, instructional supports, and co-curricular opportunities we offer in order to allow each of our students to excel.”
Residents who are at least 18 years old and have lived in the school district for at least 30 days are eligible to vote. Community members can vote on the budget on Tuesday May 17, from 7 a.m. to 9 p.m. in the high school gymnasium. Community members can register to vote by calling the District Clerk, Patricia Jones, at 631-849-7243.
If the budget doesn’t pass, the district would have to cut around $360,000 from the proposal. Ring added that the board would also have to eliminate new additions to the budget and restrict the public’s use of various school facilities, to reduce the district’s expenditures. A contingency budget would still help the district fund new projects and maintain old programs.
“The Board of Education remained steadfast in its commitment to develop a financial plan that not only supported our district’s current educational and co-curricular offerings, but also provided for instructional enhancements geared toward further preparing today’s students to become tomorrow’s leaders,” President of Rocky Point Board of Education Susan Sullivan said. “The Board believes that the proposed budget not only meets this mission, but also supports our commitment to taxpayers by staying within the confines of the New York State tax cap.”
This version corrects information about the Rocky Point school district’s contingency budget.
A man allegedly took pictures under a woman’s dress at the mall on Tuesday night and was arrested.
According to the Suffolk County Police Department, the defendant approached a woman from behind at the Smith Haven Mall Macy’s around 8 p.m. and took photos under her dress without her knowing. Police said in a statement that the 23-year-old victim “became suspicious of the man’s presence behind her” and alerted security in the Lake Grove store, who in turn notified police.
After investigating and allegedly confirming that suspect Scott Coleman took photos of the woman without her consent, police arrested the 24-year-old Ronkonkoma man and charged him with second-degree unlawful surveillance.
Attorney information for Coleman was not immediately available on Wednesday.
Anyone with information about the incident or who believes they could be a victim of a similar crime is asked to call detectives at 631-854-8452.
Fran Navaretta calls for a delay in the Port Jefferson Station/Terryville Civic Association board election. Photo by Elana Glowatz
Ed Garboski was re-elected president of the Port Jefferson Station/Terryville Civic Association on Tuesday night amid a clash between members.
What started as an orderly meeting turned into emotional and heated debate, complete with lobbed accusations, when the time came to vote for the next executive board. One group, largely on the left-hand side of the room, called for a delay in that vote until the civic membership nominated and approved a board of directors, citing a 1977 constitution of the association that requires one.
The legal authenticity of the constitution was later called into question, and it was unclear whether the document is binding.
The civic association does not currently have a board of directors, nor has it in at least recent history. Supporters on Tuesday night wanted to change that before voting on a separate executive board, while critics favored electing an executive board that would further investigate the matter.
Faith Cardone was the first to raise the concern about a board of directors, saying she and like-minded members are trying to do things the right way. And Treasurer Lou Antoniello, a presidential candidate, said just because the civic never had a board of directors doesn’t mean it shouldn’t have one now.
Port Jefferson Station/Terryville Civic Association President Ed Garboski was re-elected. Photo by Elana Glowatz
“It has nothing to do with Ed being president,” Antoniello said, after an accusation that the members in favor of delaying the executive election were simply scheming to oust the president, Garboski, who was seeking re-election Tuesday.
Controversy is no stranger to Garboski’s presidency in the last year. Members divided into two factions, much like they were on Tuesday night, had argued at a similar volume during a June meeting, after it was announced that Garboski would be running for town board against incumbent Councilwoman Valerie Cartright (D-Port Jefferson Station). In that case, one side had called for Garboski to resign over a perceived conflict of interest with the campaign, which he ultimately lost in November, and the other had called for a simple leave of absence until after the election. The latter side won out in that case.
On Tuesday, as some called for the executive board election to be delayed in deference to creating a board of directors, Garboski said he doesn’t think the civic needs two governing boards — but that either way the civic has to take time to investigate the matter.
Frank Gibbons, the civic’s head of traffic and transportation as well as its nominating committee for the election, said about delaying the vote, “To change the time we’re going to vote because we don’t have something we’ve never had is ridiculous.”
Former executive board member Laurie Green expressed dismay about the state of the civic’s unity, saying it used to act as a cohesive unit: “What the hell is going on?” she said to the debaters to her left. “You are trying to divide this civic association and this community.”
Jeff Napoleon received the only applause of the night when he suggested the civic elect leadership that could guide members on the board of directors issue, avoiding impulsive decisions. The civic voted to support that idea.
Four executive board positions were filled first without a contest, by unopposed candidates: Salvatore Pitti for vice president, Charlie McAteer for corresponding secretary, Howard Aron for treasurer and Sheila Granito for recording secretary. Then Garboski beat Antoniello for the president’s role, 27-7.
But the argument did not die without a final breath.
Fran Navaretta, who had previously spoken in favor of delaying the election, called into question whether all the voters were in good enough standing to cast a vote, as she did not recognize some of the people in the audience. She started to leaf through Garboski’s binder of civic attendance records.
The civic is expected to nominate a board of directors at its next meeting.
When I was a small child and had to go to the bathroom in the middle of the night, I would put the light on and one of the first things I would see were two sets of false teeth sitting in small glasses of water on the shelf above the sink. The teeth belonged to my mother and father, and I knew they took them out of their mouths before they went to bed and replaced them in the morning. So routine was this occurrence to me that I spent many minutes at a time searching my mouth with my fingers for the lever that would allow me to remove my teeth.
Finally I asked my parents, who clued me in to the eventual failings of teeth. I was, after all, the child of two sets of ancestors who had faulty choppers. Again, I just accepted this as the natural course of my life. One day I thought I would be toothless, too, except for a few lucky strays that remained in mouth.
Fast-forward more than half a century, and I still have almost all of my teeth. How did that enormous change come about? Dentistry is an area of health delivery that doesn’t get its proper due for the enormous advances from which we have benefited. The single best development that has preserved my teeth and those of the many millions of people around the world is the root canal procedure.
Now getting a root canal is a least favorite activity and deservedly so. But the journalist in me wants to tell the other side of the story, just to be fair. The patient I have been numerous times wants to salute the researchers and clinicians in dentistry. And although I am sitting at my keyboard in some pain at the moment from part one of a root canal procedure, which is what brought this subject to mind, I want to express my gratitude.
What exactly is a root canal procedure?
Although it’s not particularly difficult to understand, nonetheless it took centuries to invent. As I understand it, bacteria from a crack in the top of a tooth can get into the pulp below the naturally occurring enamel crown and cause an infection. Even if there is no infection, cold or heat or air can cause the nerves inside the tooth to register pain, which is an alarm.
The roots of the tooth have tiny canals in them in which the nerves reside. If the source of the intrusion that has stimulated the nerve cannot be repaired with a filling over the top of the tooth, then the pulpy decay below the enamel has to be cleaned out and the nerves have to be silenced to stop the pain. That is the function of the root canal procedure. After the nerves are removed, along with the site of any infection, the canals are filled with a sealer paste and rubber compound and covered with a dental cement to protect them from saliva.
All of the above is the job of the endodontist or specialist who uses the sophisticated tools high tech has invented to make this delicate procedure possible and the anesthetic to make it bearable. The patient must then go on, typically to another dentist, to have a crown or cap precisely fitted over the top of the tooth to replace the natural enamel. Crowns used to be made optimally of gold, but are now form-fitted with synthetic material that can be tinted the same color as the rest of the teeth, if necessary.
Interestingly, as a friend pointed out, there is something funny about the semantics involved. One goes to get “a root canal” even though one doesn’t receive “an appendix” but an appendectomy, nor “a tonsils” but a tonsillectomy. Perhaps the dental procedure should be called a “nerve homicide,” but that would only add more fear to an already fearful procedure. Well, that’s about the only funny aspect of this vital but still-dreaded tooth rescue.
No more allowances. We want our children to eat, sleep and live well.
Do we set a good example for our offspring? We know that what we do is more important than what we say. Do we want them to text or talk on the phone when they’re driving? Of course not. Do we engage in either activity when they’re in the car? All the time. When you’re at the next stop sign or red light, look at the cars coming toward you. How many of those people are on the phone? Put down that phone! It’s not only safer for you, but it also gives your kids the right idea.
OK, sorry, teachers this next one isn’t aimed at all of you. I’m tired of reading all the deductions on my son’s and daughter’s homework assignments from teachers whose writing deserves demerits. Sure, we all make mistakes and, yes, we can’t be right all the time. But this is ridiculous. The directions contain numerous errors. Are teachers setting the right example when they misspell words, repeat a word or — gasp — use the incorrect form of your? They should take an extra second to edit and proofread the material they give their students. The message the children get when they read their teachers’ writing is that grammar, word choice and rules of writing are only important for students and for grades and don’t count, even inside the classroom. Children can spot hypocrisy from across the school.
Years ago, at P.J. Gelinas Junior High School, my seventh-grade math teacher, Mr. Braun, said we’d get an extra five points if we spotted an error in anything he did. He was challenging us and himself and was helping us learn — and benefit — from his mistakes. Did he not make errors because he knew we were watching carefully or did he only make that deal with us because he didn’t make many mistakes? Either way, we paid closer attention to his — and our — work.
OK, teachers, relax. I admire what you do and I appreciate the effort you put into your work. I know you have thousands of pages to grade. If you believe your writing matters, please lead by example.
Then there are coaches. We volunteers face a difficult task. We stand in front of a group of restless kids who want to score the winning basket, make their parents proud and be a hero. Everyone can’t play in every inning or in every second. We have difficult decisions. We also deal with parents who make unrealistic requests: “Yes, coach, can my daughter please bat first on Tuesday night games because she needs to leave early those nights.”
The kids watch us carefully, not only to see if we approve of how they do, but also to see how we react to difficult situations. We’ve coached in games where the other coach, the players on the other team or the referees are violating some written or unwritten sporting code. Maybe the other coach has told his pitchers not to throw strikes because it’s getting darker. If we can’t finish the game, the score reverts to the earlier inning when they were winning. This isn’t a hypothetical — I know of at least one case where this happened.
We could get angry, shout and throw equipment on the field. Is that the kind of behavior we should allow ourselves? Are we teaching our children how to deal with adversity? Do our allowances lead to their allowances later in life? Are we dooming them to repeat the actions we’re not proud of in the future?
Maybe one of the toughest parts about being a parent is learning how to grow beyond the limitations we’ve carried with us from childhood. Some of those spring from our adult allowances. How about if we take a moment to recognize the allowances we make for ourselves. That could be constructive for us and for the little eyes that record everything we do on their own version of YouTube.
Juli Grey-Owens chants with residents at the Setauket Presbyterian Church. Photo by Giselle Barkley
The crowd’s chants were loud and in unison: “Trans lives matter. Pass GENDA now.”
Juli Grey-Owens, executive director of The Long Island Transgender Advocacy Coalition, joined with members of the Long Island DREAM Coalition, the Bus Riders’ Union, SEPA Mujer and the Move to Amend Coalition and other organizations on Thursday, March 17, at the Setauket Presbyterian Church to demand better transparency and representation from state Sen. John Flanagan (R- East Northport).
While the coalitions had different agendas, they all sought to deliver a message to Flanagan with hopes of sparking a serious conversation on transgender rights, public transportation issues, undocumented students and families, isolated confinement and other concerns they argued were being ignored on the state level of government.
“Right now, Long Islanders — everyday, hardworking Long Islanders — are not being seen as a priority in the state, nor by our own state representative,” said Aaron Watkins-Lopez, organizer for the Long Island Bus Riders’ Union.
Last year, Suffolk County made steps to cut various bus schedules because of a lack of state funding. Watkins-Lopez said that Sen. Philip Boyle (R-East Islip) supported getting additional transit funds, and took steps to establish a piece of legislation when former state Sen. Dean Skelos (R-Rockville Centre) was working in the Senate.
Currently, transgender individuals don’t have any laws prohibiting transgender discrimination in the workplace, housing and more.
After Skelos left office because of his own legal troubles, people like Grey-Owens hoped the Senate would finally pass the Gender Expression Non-Discrimination Act, which was introduced in 2003 as a means of outlawing discrimination in New York State based on gender identity or expression.
The state Assembly passed the bill eight years in a row, but was never brought to a vote in the Senate. Grey-Owens said she hoped Flanagan would bring the bill for a vote when he became Senate majority leader.
According to Grey-Owens, Flanagan said he would support the bill in 2014 if it came to the floor for a vote.
“He refuses to bring the bill to the floor and transgender New Yorkers are forced to wait another year to possibly receive the same rights that all New Yorkers enjoy,” Grey-Owens said during the meeting.
Although Flanagan was unable to make the meeting, his spokesman Scott Reif said the Senate majority leader “prides himself on being open and transparent.” He added that Flanagan’s absence wasn’t personal.
“The senator routinely meets with all groups, as he has done for 30 years throughout his entire public career, regardless of whether he agrees with them or not,” Reif said in an email. “The decision to take a meeting is never influenced by a group’s position on an issue, it is dictated solely by what his schedule will allow.”
Watkins-Lopez expressed disappointment with Flanagan’s absence and said it was imperative for state officials to meet with their constituents and acknowledge their concerns.
“We pay taxes, we pay their salaries. We’re their bosses and they need to remember that,” Watkins-Lopez said after the meeting. “They’re public servants. Serve the public not yourself.”
Flanagan’s absence at the meeting was also disappointing for Dulce Rojas, community organizer for SEPA Mujer. The nonprofit organization aims to help Latina immigrants and representatives demanded that Flanagan address their concerns.
Rojas said that human trafficking is prevalent in the area. Rojas said she “wanted to ask him to start thinking about all the residents on Long Island.”
Berndt Toast Gang artists celebrate milestone anniversary
'Pick-up Lines’ by Anton Emdin
By Rita J. Egan
In 1966, when two Hanna-Barbera cartoonists living on Long Island met for lunch once a month to discuss a project, they began a tradition that still exists today. The cartoonists continued meeting monthly after the job was completed, and soon other local cartoon artists, members of the Long Island chapter of the National Cartoonists Society, joined them. To celebrate the group’s 50th anniversary, the Huntington Public Library is hosting the exhibit Cartoonist Showcase featuring 60 pieces of artwork from the chapter’s prominent members, both illustrators and letterers.
Chapter chair, Adrian Sinnott, said the group, nicknamed the Berndt Toast Gang, consists of approximately 40 members. Visitors to the exhibit will find drawings of favorite characters such as the Lockhorns, Batman, Spider-Man and Wonder Woman in cartoon form as well as paintings and drawings inspired by them.
Laurene Tesoriero, the library’s art gallery coordinator, said when cartoonist Helen Murdock-Prep, creator of the comic strip “Shrinking Violet,” approached the library about the exhibit, she was thrilled to be able to display the cartoonists’ work and their legendary characters. “I feel good, because this is the library; this is where you come to see history; this is where you come to see good things,” Tesoriero said.
The art gallery coordinator said she believes after seeing the variety of work people will reflect on the cartoonists when they see their illustrations in the future. “I think a lot of times when people think of cartoons they think of comics. I think they’ll walk away seeing the variety of styles that’s there,” Tesoriero said.
‘Woody Allen’ by Garrett Bender
Sinnott, a children’s book illustrator, explained that the chapter’s roots date back to World War II when a loose connection of Long Island illustrators would get together and visit injured soldiers at local veterans’ hospitals. Today a number of the chapter’s members continue this tradition traveling with the USO overseas to Iraq, Afghanistan and Turkey to draw for the soldiers, while others work with the Ink Well Foundation and visit patients in children’s hospitals.
Sinnott said Port Jefferson resident Walter Berndt, creator of the comic strip “Smitty,” which ran from the 1920s until the 1970s, started attending the group’s monthly luncheons when he was older. After he passed away in 1979, one of the cartoonists raised a toast to him, and said, “Here’s a Berndt toast.” The toast inspired the chapter’s nickname, and now at every luncheon the group raise their glasses to members who have passed or who are celebrating recent accomplishments.
Sinnott, who joined the chapter approximately 30 years ago, said the Berndt Toast Gang is a friendly and encouraging group where members can share ideas and give feedback. “It’s quite an amazing group because technically we’re all competitors but we enjoy each other’s company so much,” Sinnott said.
Joe Giella, who for over 40 years illustrated characters such as Batman, Wonder Woman and more for DC Comics, has also been a member of the chapter for decades. For the last 25 years, he has illustrated the “Mary Worth” comic strip.
Working from his studio in East Meadow, Giella said he looks forward to the monthly lunches, because it gives him a chance to get out of the office, and with working under the pressure of deadlines, it also helps to relieve work-related stress. “I go down there and it’s like therapy,” he said.
The lunches also give the newer cartoonists a chance to receive advice from more seasoned artists. Giella, who pursued his artistic aspirations despite his father wanting him to follow a more traditional career path such as firefighter or police officer, said his advice for aspiring artists is simple. “I tell them that if you really want it there’s nothing going to stop you,” the illustrator said.
Chapter member Bunny Hoest, letterer of several cartoon series including “The Lockhorns,” “Howard Huge” and “Agatha Crumb,” was an English teacher when she married her husband, illustrator Bill Hoest, and started in the cartoon business. After he passed away in 1988, she continued working with illustrator John Reiner, and to this day continues to write “The Lockhorns.”
‘The Original Batmobile’ by Adrian Sinnott
Hoest, who started attending the Berndt Toast Gang luncheons with her husband, said the members are incredibly humble. When she hosts a party at her house every summer, she said she can’t believe that so many talented people are assembled outside on her terrace. “I look at them and I think, ‘this terrace is so full of talent it’s just going to rise into the sky.’ These guys are so modest they don’t even know it,” she said.
Hoest said when she brought her family to the exhibit, they all enjoyed it. “It’s an up-lifting exhibit to see. We’re not talking about terrible things. You get a laugh and get a look at some great beauty. I think it’s just a great exhibit to go to,” she said.
In addition to Sinnott’s, Giella’s and Hoest’s work, visitors will see the illustrations of former Newsday cartoonist Tony D’Adamo, comic book and strip artists Don Heck and Sy Barry among others.
Sinnott hopes that visitors to the exhibit will walk away with a better understanding of cartoonists and their work. “It’s really an extension of them. When they do their work, they’re showing you a part of them. Even if they are making it up completely, it’s still a very personal endeavor.”
The Cartoonist Showcase is on display at the Huntington Public Library, 338 Main Street, in the Main Art Gallery through April 25. For more information, visit www.myhpl.org or call 631-427-5165.
The oldest known man in the world, Jiroemon Kimura. File photo
By Elof Carlson
The oldest authenticated woman was Jeanne Calment (1875-1997), which made her 122 years old when she died in Arles, France. The oldest authenticated man was Jiroemon Kimura (1897-2013), who lived 116 years and 54 days and died near Kyoto in Japan. That is in keeping with the finding that in all cultures women live two to five years longer than men.
This might be genetic (males are XY; so any harmful genes on the X are expressed in them) or it might be because males have usually done more dangerous work exposing them to carcinogens and mutagens or they tend to abuse their bodies more than women do with tobacco and alcohol. Both factors may play a role.
Mean life expectancy is a measure used by those who tabulate vital statistics. It is usually done on the day of one’s birth. It includes all deaths at any age. This creates a misleading number. Thus the mean life expectancy in the Stone Age when many of our ancestors lived in caves was about 20. This low number is based on studies of skeletal remains in these caves. In one study of 4000-year-old skeletons in the Orkneys just off northern Scotland, out of 342 skeletons, 63 died as teens, 24 died as toddlers, 70 died as children (2 to 12 years old), and 185 were adults (20 and older).Many of the adults lived to their 50s.
The oldest known woman in the world, Jeanne Calment. File photo
Infant skeletons are underrepresented because they are least likely to be preserved. Infant mortality was common during all civilizations until the germ theory was introduced and the transport of foods in the last half of the nineteenth century reduced both infections (pneumonia and gastritis) and malnutrition, which were the major causes of infant mortality. Half of all children died in their first year for most of the history of humanity.
Today, virtually all of the children born in industrialized countries live to reach reproductive maturity. Even in the 20th century, these reductions in infant mortality are apparent: they were 10 percent of U.S. births in 1907, 2.6 percent in 1957 and 0.68 percent in 2007. The mean life expectancy for U.S. males was 45.6 in 1907, 66.4 for 1957 and 75.5 in 2007. If one excludes infant mortality, there is still a better chance today of a person of 50 living to be 80 than it was in 1907, but the dramatic decline in death has been in childhood infectious diseases.
We owe that triumph to public health — especially the pasteurization of milk for infants and the use of chlorine in reservoirs to kill typhoid and other bacterial agents in drinking water.
Very likely by the end of this century most babies will have a mean life expectancy of about 90 (for females) or 87 (for males). The five-year gap between males and females is also narrowing, but at a slower rate.
While there are many attempts through diet and food supplements to extend life, the more likely outcome has been to have more people who live into their 80s and 90s. Centenarians are still relatively rare in industrialized nations. No one knows what makes a person live to 110 or more years (so rare that they are news stories when they die).
When my wife Nedra’s second cousin Grover Dawald (1884-1990), had his 105th birthday in Rochester, Indiana, he received a card of Congratulations from President George H. W. Bush. He was still living at home and danced on the day of his last birthday.
Elof Axel Carlson is a distinguished teaching professor emeritus in the Department of Biochemistry and Cell Biology at Stony Brook University.
A registered sex offender pleaded guilty on Monday to raping a female taxi driver in December during a trip that started in Port Jefferson.
The Suffolk County District Attorney’s Office said on Tuesday that 34-year-old Francis Barrios, of Middle Island, pleaded guilty to first-degree rape.
When the incident first occurred, on Dec. 1, authorities said the driver had picked up Barrios at John T. Mather Memorial Hospital that evening. During the trip he beat and strangled her, causing the taxi to crash into a fence on Mount Sinai-Coram Road in Mount Sinai. Barrios, who police said was homeless, then sexually assaulted the victim.
According to the DA’s office, he pulled her into the back seat and raped her.
Officers responded to the crash scene after a passing motorist called 911, police said at the time.
Police did not release the name of the taxi company, to protect the identity of the victim.
The DA’s office said Barrios was previously convicted as a violent offender in Suffolk County for first-degree attempted rape, and violated his parole. He was expected to be sentenced to 24 years in prison and 20 years of post-release supervision on April 20.
On the New York State sex offender registry, Barrios is listed as a Level 3 sexually violent offender who has also gone by the last name Berrios. He was convicted in November 2004 in relation to an incident of sexual contact earlier that year involving a 12-year-old girl, who was described as a “non-stranger” to Barrios. He was sentenced to 42 months in state prison.
Using a pedometer when walking may help reduce COPD episodes. Stock photo
COPD, or chronic obstructive pulmonary disease, is the third leading cause of mortality in the United States (1), although it’s not highlighted much in the layman’s press.
Using a pedometer when walking may help reduce COPD episodes. Stock photo
COPD is an umbrella term that includes emphysema, chronic bronchitis of more than three months for two consecutive years and/or chronic obstructive asthma. It is an obstructive lung disease that limits airflow. The three most common symptoms of the disease involve shortness of breath, especially on exertion, production of sputum and cough. This disease affects greater than 5 percent of the U.S. population (2).
It tends to be progressive, meaning more frequent and severe exacerbations over time. Since it is a devastating and debilitating chronic disease with no cure, anything that can identify and prevent COPD exacerbations, as well as comorbidities (associated diseases), is critically important.
What are the traditional ways to reduce the risk of and treat COPD exacerbations? The most important step is to stop smoking, since 80 percent of COPD is related to smoking. Supplemental oxygen therapy and medications, such as corticosteroids, bronchodilators (beta-adrenergic agonists and anticholinergics) and antibiotics help to alleviate symptoms (3).
One of the underlying components of COPD may be chronic inflammation (4). Therefore, reducing inflammation may help to stem COPD exacerbations. There are several inflammatory biomarkers that could potentially help predict exacerbations and mortality associated with this disease, such as interleukin-6 (IL-6), C-reactive protein (CRP), leukocyte (white blood cell) count and fibrinogen (a clotting factor of the blood).
How do we reduce inflammation, which may contribute to exacerbations of this disease? Some drugs, such as statins, work partially by reducing inflammation. They may have a role in COPD. Lifestyle changes that include a high-nutrient, anti-inflammatory diet and exercise may also be beneficial.
Let’s look at the evidence.
Biomarkers for inflammation
In a recent population-based study with over 60,000 participants, results show that as three biomarkers (CRP, leukocyte count and fibrinogen) were elevated, the risk of COPD exacerbation increased in a linear manner (5). In other words, the risk of frequent exacerbation increased 20, 70 and 270 percent within the first year as the number of elevated biomarkers increased from one to three, compared to patients who did not have biomarker elevations.
As time progressed beyond the first year of follow-up, risk exacerbation continued to stay high. Patients with all three biomarkers elevated for longer periods had a 150 percent increased risk of frequent exacerbations. These predictions were applicable to patients with stable and with mild COPD.
In an observational study, results showed that when the biomarker IL-6 was elevated at the start of the trial in stable COPD patients, the risk of mortality increased almost 2.7-fold (6). Also, after three years, IL-6 increased significantly. Elevated IL-6 was associated with a worsening of six-minute walking distance, a parameter tied to poor physical performance in COPD patients. However, unlike the previous study, CRP did not show correlation with increased COPD exacerbation risk. This was a small trial, only involving 53 patients. Therefore, the results are preliminary.
These biomarker trials are exciting for their potential to shape treatments based on level of exacerbation risk and mortality, creating more individualized therapies. Their results need to be confirmed in a randomized controlled trial (RCT). Many of these biomarkers mentioned in the two trials are identifiable with simple blood tests at major labs.
Statin effect
Statins have been maligned for their side effects, but their efficacy has been their strong suit. An observational trial showed that statins led to at least a 30 percent reduction in the risk of COPD exacerbations, with the effect based on a dose-dependent curve (7). In other words, as the dose increased, so did the benefit.
Interestingly, even those who had taken the statin previously saw a significant reduction in COPD exacerbation risk. The duration of statin use was not important; a short use of statins, whether presently or previously, had substantial benefit. However, the greatest benefit was seen in those who had been on a medium to high dose or were on the drug currently. The researchers believe that the mechanism of action for statins in this setting has to do with their anti-inflammatory and immune-modulating effects. This was a retrospective (backward-looking) study with over 14,000 participants. We will need a prospective (forward-looking) study and RCT to confirm the results.
Exercise
Exercise is beneficial for almost every circumstance, and COPD is no exception. But did you know that a pedometer might improve results? In a three-month study, those with mild COPD were much more successful at achieving exercise goals and reducing exacerbations and symptoms when they used pedometers, compared to the group given advice alone (8). Pedometers gave patients objective feedback on their level of physical activity, which helped motivate them to achieve the goal of walking 9,000 steps daily. This is a relatively easy way to achieve exercise goals and reduce the risk of COPD exacerbations.
When exercising, we are told to vary our exercise routines on regular basis. One study demonstrates that this may be especially important for COPD patients (9). Results show that nonlinear periodization exercise (NLPE) training is better than traditional routines of endurance and resistance training in severe COPD patients. The goal of NLPE is to regularly alter the time spent working out, the number of sets, the number of repetitions and the intensity of the workout on a regular basis.
This study was randomized, involved 110 patients, and was three months in duration. Significantly more severe COPD patients achieved their exercise goals using NLPE than the traditional approach. The group that used NLPE also had an improved quality of life response. The researchers believe that compliance with an NLPE-type program is mostly likely going to be greater because patients seem to enjoy it more.
Chronic inflammation may play a central role in COPD exacerbation. Nonspecific inflammatory biomarkers are potentially valuable for providing more personalized approach to therapy. Drugs that can control inflammation, such as statins, show promise. But don’t forget the importance of lifestyle changes, such as quitting smoking and committing to an exercise regimen that is varied and/or involves the use of a pedometer. And potentially a high-nutrient, anti-inflammatory diet will also contribute positively to reducing the frequency and severity of COPD exacerbations.
References:
(1) Natl Vital Stat Rep. 2011 Dec.;59(10):1-126. (2) MMWR Morb Mortal Wkly Rep. 2012;61:938. (3) N Engl J Med. 2002;346:988-994. (4) www.goldcopd.org. (5) JAMA. 2013;309:2353-2361. (6) Respiratory Research. 2013;14:24. (7) Am J Med. 2013 Jul;126:598-606. (8) ATS 2013 International Conference: Abstract A1360. (9) Am J Respir Crit Care Med. 2013; online Feb. 28.
Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com or consult your personal physician.
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