Yearly Archives: 2021

VFW Post 6249 continues to host annual golf outing

by Rich Acritelli - October 16, 2021

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IMG_8317-preview — Photo by Rich Acritelli

“The purpose of the Warrior Open is to celebrate those who have served our country, and to remind our fellow citizens how fortunate we are to have men and women volunteer in the face of danger.” — President George W. Bush (2011)

The former president supported a golf outing to honor the wounded warriors on the 10-year anniversary of September 11. For two decades, American soldiers from every part of this nation had served in Iraq and Afghanistan to defend the country in the face of terrorism.

Since 2008, Rocky Point Veterans of Foreign Wars Post 6249 has run an annual golf outing similar to that of Bush’s to show appreciation and support to our local veterans who have served under Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan.

This outing was established by Michael Mauro of Baiting Hollow through the simple idea of helping veterans who have fallen on hard medical and financial times as a result of their fighting time overseas.

As a former technical sergeant who was a heavy truck operator at the 106th Rescue Wing in Westhampton Beach and a former member of the U.S. Marine Corps, Mauro initiated the local push to provide comfort to our local veterans. He was deployed to Iraq, left his newborn son and young family behind, and was wounded in that conflict.

This golf outing emerged during the height of the costly War on Terror fighting in Iraq and Afghanistan. It was estimated there were over 52,000 soldiers severely wounded, as many as 500,000 living with post-traumatic stress disorder, and about 320,000 service members who have suffered from brain debilitating injuries.

With post Cmdr. Joseph Cognitore at Mauro’s side and many of the veterans from different components of the armed forces and conflicts, VFW Post 6249 has created one of the strongest golf outings on Long Island. Over the last 14 years, more than $220,000 has been raised by the participating golfers, businesses, veterans, law enforcement, union organizations and post members.

Cognitore has taken over the responsibilities of this outing for the last two years, and has expanded on this tradition to use golf as a tool to help our veterans. And the devotion to continue these efforts toward helping hurt veterans is still a necessity, as the national chapter of the Wounded Warrior Project recorded that over 184,000 veterans, family members and caregivers are registered for financial support.

While the fighting and deployments have ended in Iraq and Afghanistan, there are vital needs of veterans who are still handling physical and psychological ailments. This North Shore community is no different than any other part of the United States, as there are many local veterans impacted by combat. Cognitore and VFW Post 6249 are eager to help them with financial assistance.

These outings have been held at Long Island National Golf Club in Riverhead, the old Calverton Links, Cherry Creek Golf Links in Riverhead, Willow Creek Golf & Country Club in Mount Sinai and Baiting Hollow Golf Club. There has been a tremendous amount of loyalty toward this function with golfers who have attended this function since 2008.

Next year, it is expected that VFW Post 6249 will carry out this tradition by having this event at Great Rock Golf Club in Wading River. To make this annual event possible, Cognitore counts on the support of Mike Wern, Gary Suzik, Pat Biglin, Bill Fitz, Tom and Ray Semkow, Gil Jenkins, and many of the women from the military ladies’ auxiliary.

This outing would not be possible without the participation of the golfers along with the businesses and organizations which have always been very generous. Financial donations have been received from B.A.C. Systems and Brian May, Landmark Industries and Mark Baisch, Stanley Steemer and Keith Burtis, the team from Drexel Hamilton and Mike Parisi from Parkside Fuel in Mount Sinai.

Next to these participants are the former Major League Baseball players: Yankee Frank Tepedino, Met Art Shamsky, Pittsburgh Pirate Fred Cambria and longtime scout Larry Izzo. These professional baseball men have been a constant staple within this golf outing that has seen them hit long drives, strong puts and the telling of unique baseball stories from many years ago.

Cognitore has donated proceeds to local military scholarships, building homes for veterans, and has the constant goal of helping wounded service members. This is a special golf outing.

VFW Post 6249 continues to shine as a major veterans organization that works to make this community into a better place. Through its most recent efforts to build the PFC Joseph P. Dwyer Statue in Rocky Point, the Diamond in the Pines 9/11 Memorial in Coram and the Rocky Point High School Veterans Wall of Honor, this golf outing is another example of support to provide comfort to our local citizens.

And much of these efforts are carried out by Vietnam War and Cold War veterans who have a new mission of compassion to ensure that the men and women who fought for this country are properly recognized and are never forgotten.

Rich Acritelli is a social studies teacher at Rocky Point High School and an adjunct professor of American history at Suffolk County Community College. Members of the Rocky Point High School History Honors Society contributed to this story.

Connetquot captures Ward Melville Patriots

by Bill Landon - October 16, 2021

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The Ward Melville boys volleyball team fought back in the second set Oct. 14 having to win by two, edging Connetquot, 27-25, but they lost the next two to drop the match, 3-1, at home.

The Patriots fell 25-21, 25-27, 25-23 and 25-17 in the Division I contest. The loss drops the Patriots to 5-5 with four games remaining before post season play.

Ward Melville retake the court Oct. 19 when they host Commack with a 4:30 p.m. start.

Medical Compass: Simple alternatives to long-term medications for reflux disease

by David Dunaief - October 15, 2021

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Midnight snacking — It's best to not eat right before bedtime and to avoid 'midnight snacks.' METRO photo

Salt use increases risk 70 percent

By David Dunaief, M.D.

While occasional heartburn and regurgitation are common after a large meal, for some, this reflux results in more serious disease. Let’s look at the differences and treatments.

Reflux typically results in symptoms of heartburn and regurgitation, with stomach contents going backward up the esophagus. For some reason, the lower esophageal sphincter, the valve between the stomach and esophagus, inappropriately relaxes. No one is quite sure why it happens with some people and not others. Of course, a portion of reflux is physiologic (normal functioning), especially after a meal (1). As such, it typically doesn’t require medical treatment.

Gastroesophageal reflux disease (GERD), on the other hand, differs in that it’s long-lasting and more serious, affecting as much as 28 percent of the U.S. population (2). This is one reason pharmaceutical firms give it so much attention, lining our drug store shelves with over-the-counter and prescription solutions.

GERD risk factors are diverse. They range from lifestyle — obesity, smoking cigarettes and diet — to medications, like calcium channel blockers and antihistamines. Other medical conditions, like hiatal hernia and pregnancy, also contribute (3). Dietary triggers include spicy, salty, or fried foods, peppermint, and chocolate.

Smoking and salt increase risk

One study showed that both smoking and salt consumption added to the risk of GERD significantly (4). Risk increased 70 percent in people who smoked. Surprisingly, people who used table salt regularly saw the same increased risk as seen with smokers.

Medication options

The most common and effective medications for the treatment of GERD are H2 receptor blockers (e.g., Zantac and Tagamet), which partially block acid production, and proton pump inhibitors (e.g., Nexium and Prevacid), which almost completely block acid production (5). Both classes of medicines have two levels: over-the-counter and prescription strength. Here, I will focus on proton pump inhibitors (PPIs), for which more than 90 million prescriptions are written every year in the U.S. (6).

The most frequently prescribed PPIs include Prilosec (omeprazole) and Protonix (pantoprazole). They have demonstrated efficacy for short-term use in the treatment of Helicobacter pylori-induced (bacteria overgrowth in the gut) peptic ulcers, GERD symptoms and complication prevention and gastric ulcer prophylaxis associated with NSAID use (aspirin, ibuprofen, etc.) as well as upper gastrointestinal bleeds.

However, they are often used long-term as maintenance therapy for GERD. PPIs used to be considered to have mild side effects. Unfortunately, evidence is showing that this may not be true. Most of the data in the package inserts is based on short-term studies lasting weeks, not years. The landmark study supporting long-term use approval was only one year, not 10 years. However, maintenance therapy usually continues over many years.

Side effects that have occurred after years of use are increased risk of bone fractures and calcium malabsorption; Clostridium difficile, a bacterial infection in the intestines; potential vitamin B12 deficiencies; and weight gain (7).

PPI risks

The FDA warned that patients who use PPIs may be at increased risk of a bacterial infection called C. difficile. This is a serious infection that occurs in the intestines and requires treatment with antibiotics. Unfortunately, it only responds to a few antibiotics and that number is dwindling. In the FDA’s meta-analysis, 23 of 28 studies showed increased risk of infection. Patients need to contact their physicians if they develop diarrhea when taking PPIs and the diarrhea doesn’t improve (8).

Suppressing hydrochloric acid produced in the stomach over long periods of time may result in malabsorption issues. In a study where PPIs were associated with B12 malabsorption, it usually took at least three years’ duration to cause this effect. B12 was not absorbed properly from food, but the PPIs did not affect B12 levels from supplementation (9). Therefore, if you are taking a PPI chronically, it is worth getting your B12 and methylmalonic acid (a metabolite of B12) levels checked and discussing supplementation with your physician for a deficiency.

Fiber and exercise

A number of modifications can improve GERD, such as raising the head of the bed about six inches, not eating prior to bedtime and obesity treatment, to name a few (10). In the same study already mentioned with smoking and salt, fiber and exercise both had the opposite effect, reducing the risk of GERD (5). The analysis by Journal Watch suggests that the fiber effect may be due to its ability to reduce nitric oxide production, a relaxant for the lower esophageal sphincter (11).

Obesity’s impact

In one study, obesity exacerbated GERD. What was interesting about the study is that researchers used manometry, which measures pressure, to show that obesity increases the pressure on the lower esophageal sphincter significantly (12). Intragastric (within the stomach) pressures were higher in both overweight and obese patients on inspiration and on expiration, compared to those with normal body mass index. This is yet another reason to lose weight.

Late night eating triggers

Though it may be simple, it is one of the most powerful modifications we can make to avoid GERD. A study that showed a 700 percent increased risk of GERD for those who ate within three hours of bedtime, compared to those who ate four hours or more prior to bedtime. Of note, this is 10 times the increased risk of the smoking effect (13). Therefore, it is best to not eat right before bedtime and to avoid “midnight snacks.”

Although there are a number of ways to treat GERD, the most comprehensive have to do with modifiable risk factors. Drugs have their place in the arsenal of choices, but lifestyle changes are the first — and most effective — approach in many instances. Consult your physician before stopping PPIs, since there may be rebound hyperacidity (high acid produced) if they are stopped abruptly.

References:

(1) Gastroenterol Clin North Am. 1996;25(1):75. (2) Gut. 2014 Jun; 63(6):871-80. (3) emedicinehealth.com. (4) Gut 2004 Dec.; 53:1730-1735. (5) Gastroenterology. 2008;135(4):1392. (6) Kane SP. Proton Pump Inhibitor, ClinCalc DrugStats Database, Version 2021.10. Updated September 15, 2021. Accessed October 12, 2021. (7) World J Gastroenterol. 2009;15(38):4794–4798. (8) www.FDA.gov/safety/medwatch/safetyinformation. (9) Linus Pauling Institute; lpi.oregonstate.edu. (10) Arch Intern Med. 2006;166:965-971. (11) JWatch Gastro. Feb. 16, 2005. (12) Gastroenterology 2006 Mar.; 130:639-649. (13) Am J Gastroenterol. 2005 Dec.;100(12):2633-2636.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.

Butterball recalls ground turkey products due to possible foreign matter contamination

by Press Release - October 15, 2021

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2D-1LB-Tray-93_7-Ground-Check-v2-900 — Photo from Butterball

Butterball, LLC, a Mount Olive, N.C. establishment, is recalling approximately 14,107 pounds of ground turkey products that may be contaminated with extraneous materials, specifically blue plastic, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced in a press release Oct. 13.

The ground turkey items were produced on September 28, 2021. The following products are subject to recall:

2.5-lb. trays containing “farm to family BUTTERBALL all natural Ground Turkey” with the case code 50211271, a sell or freeze by date of 10/18/2021, and timestamps from 2123 through 2302 printed on the packaging.

3-lb. tray containing “Kroger GROUND TURKEY” with the case code 50211271, a sell or freeze by date of 10/17/2021, and timestamps from 2314 through 2351 printed on the packaging.

The products subject to recall bear establishment number “EST. P-7345” inside the USDA mark of inspection. These items were shipped to retail locations nationwide.

The problem was discovered when FSIS and the establishment received consumer complaints reporting pieces of blue plastic embedded in raw ground turkey produced by Est. 7345.

There have been no confirmed reports of injuries due to consumption of these products. Anyone concerned about an injury or illness should contact a healthcare provider.

FSIS is concerned that some product may be in consumers’ freezers and/or refrigerators. Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase.

FSIS routinely conducts recall effectiveness checks to verify recalling firms notify their customers of the recall and that steps are taken to make certain that the product is no longer available to consumers. When available, the retail distribution list(s) will be posted on the FSIS website at www.fsis.usda.gov/recalls.

Consumers with questions about the recall can contact the Butterball Consumer Hotline at (800) 288-8372. Members of the media with questions about the recall can contact Christa Leupen, PR Manager, Butterball LLC at (919) 255-7598.

Consumers with food safety questions can call the toll-free USDA Meat and Poultry Hotline at 1-888-MPHotline (1-888-674-6854) or live chat via Ask USDA from 10 a.m. to 6 p.m. (Eastern Time) Monday through Friday. Consumers can also browse food safety messages at Ask USDA or send a question via email to [email protected]. For consumers that need to report a problem with a meat, poultry, or egg product, the online Electronic Consumer Complaint Monitoring System can be accessed 24 hours a day at https://foodcomplaint.fsis.usda.gov/eCCF/.

D. None of the Above: For what it’s worth, from a Yankees fan now rooting for the Braves

by Daniel Dunaief - October 15, 2021

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Freddie_Freeman_HR_from_Nationals_vs._Braves_at_Nationals_Park,_April_6th,_2021_(All-Pro_Reels_Photography)_(51102625370)_(cropped) — Freddie Freeman of the Atlanta Braves. Wikipedia photo

By Daniel Dunaief

Before I get to the current difficulty of deciding which of the four remaining baseball teams to support, if any, I’d like to offer the following observations on a bipolar Yankees season, in which a 13-game winning stream seemed as unlikely as a 70 loss season.

The team had the talent, sort of. They are, as the saying goes, what their record says they are. In many ways, it’s remarkable that they even made the one-game wildcard playoff. They weren’t exactly world beaters against the Baltimore Orioles, who almost single handedly made it possible for the other four teams in the division to finish with over 90 wins.

They also gave away games that they seemed a lock to win, coughing up leads late, and losing key games to a Mets team that struggled to find its identity and mojo after the best pitcher on the planet, Jacob deGrom, was injured.

But this isn’t about the Mets. So, for what it’s worth, here are my Yankees thoughts. Stop worrying about how much money you’re paying players. Go with the players that helped you win. That means, if defensively-gifted shortstop Andrew Velazquez played a key role in big games with his range and defense, give him a chance.

If that also means Greg Allen needs a few at bats and a chance to race around the bases, give him a shot, too. Oh, and Tyler Wade? I know he’s not going to hit 400-foot home runs too often, but he is a versatile gamer with an ability to play numerous positions and, on occasion, to have a high contact hot streak.

If I were managing my favorite team, I’d stick with whatever is working and not try to race injured and under performing players back. Sure, Gleyber Torres and Gio Urshela have been valuable pieces in the past, but that’s not a reason to put them back on the field in the hopes that they’ll be something they weren’t before each of them got injured.

As for the current playoff conundrum, what should Yankees fans who are still paying attention to baseball root for during the last three series?

Come on, it’s almost impossible to root for the Red Sox because, well, they’re the Red Sox. Then again, the Astros are not just a baseball villain, but are also Yankee killers. Jose Altuve, who used to be a beloved versoin of the little engine that could, hits a huge home run in 2019 off of Aroldis Chapman then covers up his uniform so no one can rip it off and show a tattoo he didn’t like? Yeah, I’m sure that’s what happened because these players are so modest about their body ink.

One of those two teams will represent the American League in the World Series. If I had to choose one, I think, gulp, I’d go with the Red Sox. Part of the reason for that is that I have so many friends and professional colleagues who love the team that I’d be happy for them.

In the National League, the Braves are a feel good team. I saw Freddie Freeman at the All Star Game a few years ago and he seemed like a genuinely good father. I know that’s not a critical criteria for rooting for someone, but he held his kids and smiled at almost anyone who talked to him.

The Dodgers are the beasts of baseball in the last few years. Just when you think they couldn’t get any better, they add Max Scherzer (seriously?) and Trea Turner, two incredible deadline acquisitions for a team that was already a powerhouse. Mookie Betts is otherworldly in one way or another, with his speed, incredible and accurate arm and his ability to put the ball in play and, at times, over the wall.

I’m going to root for the underdog in the national league here, pulling for the Braves to make a Cinderella journey into the World Series and beat the deep and talented Dodgers.

Now, if I get my way and it’s the Braves against the Red Sox? I’m going to root for the Braves because it’s still the Red Sox. No matter who wins, though, I’m hoping for a seven-game series because that’s good for baseball and for the baseball fan. I know the season is long enough, but those last few games are like the final number in a Broadway musical. The energy is high, the fans are on their feet, and no one wants to leave.

Suffolk County hospitals feature procedure to ease chronic lower back pain

by Daniel Dunaief - October 15, 2021

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HHTuttleIntracept — Daniel Tuttle received the therapeutic treatment Intracept for back pain. Photo from Tuttle

Over 30 years as a plumber took its toll on Daniel Tuttle.

Daniel Tuttle, who received the therapeutic treatment Intracept for back pain, enjoys a boat ride. Photo from Tuttle

The 79-year old Northport resident felt daily pain in his lower back, which limited his ability to walk for any length of time.

“I always lifted up [stuff] you shouldn’t lift,” Tuttle said. “It was too heavy. Over the years, I got more and more pain.”

Tuttle visited several specialists. His cardiologist recommended he see Dr. Frank Ocasio, director of Acute Pain Management and chair of Pain Management at Huntington Hospital and the director of North Shore Head and Spine in Huntington.

Ocasio recently started performing a therapeutic treatment called Intracept, which involves cutting a small incision in the back, inserting a tube and providing enough heat to deactivate the nerve that causes chronic lower back pain.

About a month after the procedure, Tuttle is pleased to report that his pain has declined from “an 11” to closer to a three on a daily basis.

Several doctors around Long Island have provided the Intracept procedure, which was developed by Relievant Medsystems, over the last few years, including at Stony Brook University and Port Jefferson’s St. Charles Hospital.

Dr. Jonathan Raanan, assistant professor of Neurosurgery, Physical Medicine & Rehabilitation in the Department of Neurosurgery at the Renaissance School of Medicine at Stony Brook University, has performed about 10 such surgeries over the last few years.

Raanan described such lower back pain that lasts more than six months or a year as being something of a “big black hole” in terms of treatment.

In a magnetic resonance image, the disc becomes darker, indicating it doesn’t have good hydration and that it isn’t an effective shock absorber.

Intracept can help reduce the pain.

“It’s very satisfying when someone comes in who has tried everything but the kitchen sink to treat this” who then says “I do feel better,” Raanan said.

Tuttle’s wife Susan, who has been married to him for over three decades, said the procedure has improved his quality of life.

Susan Tuttle said her husband has been able to “do everything he wanted to do.”

Ocasio found the idea of Intracept appealing, particularly because it was a one-time effort that didn’t require ongoing follow up visits.

“There’s not much out there in the pain management space that’s a non medication, a non-opioid strategy that’s a one and done,” Ocasio said.

The surgery is an outpatient procedure and can take anywhere from 45 minutes to two hours, depending on the area over which the nerve is sending a repeated pain signal.

Patients either receive mild sedation or are under general anesthesia.

“People see results within weeks,” Ocasio said. In some cases, they can get relief within 24 hours.

Dr. Frank Ocasio recently began to perform the therapeutic treatment. Photo from Ocasio

To be sure, the procedure, as with any, involves some level of risk and isn’t appropriate for everyone.

Raanan advised potential patients to discuss the risks and benefits with any provider.

Starting in January, Intracept will have a Current Procedural Terminology, or CPT, code, which will give health care providers a standard way to describe the procedure and insurance companies a way of determining patient eligibility.

Until then, patients need to appeal to indicate to insurance companies what other treatments they’ve had for back pain.

In Raanan’s experience, patients sometimes have flare-ups of other pain that is similar to sciatic discomfort after the treatment for days or even weeks after Intracept.

“That might be a reasonable trade-off in the eyes of the patient,” Raanan added.

Deadening the nerve doesn’t cause any loss of control of motor function, Ocasio said, as the nerve provides a sensory benefit while others provide necessary muscle control.

“You still have multiple nerves around that area,” Ocasio added.

Candidates for this procedure typically have lower back pain associated with activities that require bending forward, like loading a dishwasher or flexing at the waist, Ocasio described.

Ocasio said doctors who perform Intracept receive training under guidance from the company.

Patients interested in this approach are anywhere from their 30s through their late 70s, local doctors said.

For Daniel Tuttle, the procedure provided relief.

“He’s outside, puttering around, doing the things that make him happy,” Susan
Tuttle said.

“It gave me my lifestyle back,” Daniel Tuttle said.

The Tuttles are planning a trip to Italy next summer.

Raanan cautioned that, for at least one patient, the relief led to another problem.

A female patient returned to working out in the gym, where she exercised so vigorously that she created a different spine injury that he treated.

“When patients feel better, they have to remember they are still vulnerable,” Raanan said. “Poor mechanics, postures, flexibility or excessive and prolonged activity come with some risk.”

Dress for Success Brookhaven accepts donation from Macy’s Smith Haven

by Press Release - October 15, 2021

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Macy's Dress for Success — Photo from TOB

Representatives from Macy’s Smith Haven visited the Dress for Success Boutique at Brookhaven Town Hall recently to present a donation of $5,000 in Macy’s gift cards and a selection of women’s blouses. Macy’s Smith Haven has been a generous supporter of Dress for Success Brookhaven for many years. In 2020, the store donated 1,800 prom dresses to the Dress for Success Prom Boutique.

Pictured from left are Supervisor Ed Romaine; Sharon Boyd, Executive Director, Dress for Success Brookhaven; Michelle Young, Director at Macy’s Smith Haven Mall; Lisa Keyes, Town of Brookhaven Commissioner of General Services; Councilwoman Jane Bonner; Arlene Famoso, Stylist at Macy’s Smith Haven and Councilman Kevin LaValle. For more information about Dress for Success Brookhaven, visit the Town website or call 631-451-9127.

Gurwin recognized as one of America’s best nursing homes

by Press Release - October 14, 2021

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maxresdefault — Photo from Gurwin Jewish

Gurwin Jewish Nursing & Rehabilitation Center of Commack, a member of Gurwin Healthcare System, has been ranked as one of America’s Best Nursing Homes 2022 by Newsweek Magazine, one of only six Long Island nursing homes to make the list.

A total of 450 top facilities across 25 states were ranked this year, including 55 of the more than 600 nursing homes located in New York. Newsweek partnered with Statista, a global data research firm, to establish nursing home rankings based on rigorous criteria including performance data, peer recommendations, and response to COVID-19.

“Throughout the COVID-19 pandemic, our staff has continued to rise above, putting their own concerns and safety aside for the well-being of our residents. Being recognized as one of Newsweek’s Best Nursing Homes in America validates the efforts of staff in every department at every level, and I am so proud of our entire team,” said Stuart B. Almer, President and CEO of Gurwin Healthcare System.

The Gurwin Center also received a 1st quintile ranking from the New York State Department of Health’s Nursing Home Quality Initiative program, which recognizes nursing homes based on quality, compliance and efficiency measures.

SBU’s David Thanassi finds possible target to treat bacteria in the kidney

by Daniel Dunaief - October 14, 2021

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P88 — David Thanassi. Photo by Jeanne Neville

*Please note: This article was updated on Oct. 15 to include a reference to former President Bill Clinton (D) in the fifth paragraph.

By Daniel Dunaief

David Thanassi wants to give dangerous bacteria in the kidney a haircut.

No, not exactly, but Thanassi, Zhang Family Professor and Chair of the Department of Microbiology and Immunology at the Renaissance School of Medicine at Stony Brook University, has studied how hair-like structures called P pili in the bacteria Escherichia coli are assembled on the bacterial surface.

These pili allow bacteria to hang on to the walls of the kidney, where urine would otherwise flush them out.

Learning about pili at different stages of development could provide a way to keep them from attaching themselves to the kidney and from entering the bloodstream, which could lead to the potentially lethal problem of bacterial sepsis. Indeed, this week, former President Bill Clinton (D) checked into the intensive care unit at the University of California Irvine Medical Center after a urinary tract infection spread to his bloodstream.

“We have been looking at this as a really important aspect of initiating infection from a bacteria’s point of view,” Thanassi said. “How do they build these structures” that lead to infection and illness?

Recently, Thanassi published the structure of these pili in the journal Nature Communication.

The current work builds on previous efforts from Thanassi to determine the structure of these pili in the bladder. He has been exploring how the thousands of proteins that make up the pili get transported and assembled in the correct order. “If we can understand that aspect, we can disrupt their assembly or function,” he said.

Urinary tract infections are a major infectious disease, particularly for women. Indeed, about half of all women will have at least one urinary tract infection, which can be uncomfortable and can require some form of medication.

In some cases, the infections can be recurrent, leading to frequent infections and the repeated need for antibiotics.

The bacteria that cause these infections can become resistant to antibiotics, increasing the importance of finding alternative approaches to these infections, such as interfering with pili.

To be sure, the solution to reducing the bacteria’s ability to colonize the kidney or urinary tract would likely require other steps, as these invaders have additional ways beyond the pili to colonize these organs. Nonetheless, disrupting the way they adhere to the kidney could be a constructive advance that could lead to improved infection prevention and treatment.

One likely strategy could involve using an anti-pilus treatment in combination with other antibiotics, Thanassi explained.

For people who have recurrent infections, anti-pilus therapeutics could offer a solution without resorting to long-term antibiotics.

In his lab, Thanassi is interested in small molecules or chemicals that would disrupt the early stage in pili assembly. “We think of these as protein-protein interactions that are required to build these” pili, he said.

By using a fluorescence reporter, Thanassi and his colleagues can screen libraries of chemicals to determine what might inhibit the process.

As with many biological systems, numerous compounds may seem appropriate for the job, but might not work, as medicine often requires a specific molecule that functions within the context of the dynamic of a living system.

For the helpful bacteria in the gut, pili are not as important as they are for the harmful ones in the kidney, which could mean that an approach that blocked the formation of these structures may not have the same intestinal and stomach side effects as some antibiotics.

To determine the way these pili develop structurally, Thanassi and his lab used molecular and biochemical techniques to stop the assembly of pili at specific stages.

Bacteria assemble these pili during the course of about 30 minutes. An usher proteins serves as the pilus assembly site and pilus secretion channel in the bacterial outer membrane. The usher acts as a nanomachine, putting the pilus proteins into their proper order. A chaperone protein brings the pilus subunits to the usher protein.

In their development, the pili require a protein channel, which is an assembly site.

Thanassi started by working on the usher protein in isolation. The usher proteins function to assemble the thousands of pilus subunits that make up each pilus fiber. The process also involves chaperone proteins, which bind to nascent subunit proteins and help the subunits fold. The chaperone then delivers the subunit proteins to the usher for assembly into the pilus fiber. He used molecular and biochemical methods to express and purify the usher protein.

The assembly process involves interactions between chaperone-subunit complexes and the usher. Over the years, Thanassi has determined how the different proteins work together to build and secrete a pilus.

He was able to force the bacteria to express only one version of the assembly step and then isolate that developmental process.

The majority of the pilus is like a spring or a coil, which can stretch and become longer and straighter to act as a shock absorber, allowing the bacteria to grab on to the kidney cells rather than breaking.

Other researchers are studying how they might make the pili more brittle, preventing that spring-like action from working and compromising its ability to function.

“We’re trying to prevent the pili from assembling in the first place,” Thanassi explained. “Our approach is to try and get molecules that prevent the interaction from occurring.” He is looking at the specific function of one molecule that prevents the usher assembly platform from developing properly, which would wipe out the assembly site.

Thanassi credits former Stony Brook Professor Huilin Li, who is now Chair in the Department of Structural Biology at the Van Andel Institute in Grand Rapids, Michigan, with providing structural insights from his work with the cryo-electron microscoipe. The technology has “revolutionized the work we do,” said Thanassi.

Residents of Smithtown, Thanassi and his wife Kate Kaming, who is Senior Director of Cancer Development at Northwell Health Foundation, have two children. Joseph, 22, attends Northeastern University. Miles, 20, is studying at the Massachusetts Institute of Technology.

Thanassi grew up in South Burlington, Vermont and is an avid skier. He also enjoys mountain biking, walking and music.

Thanassi hopes this latest structural work may one day offer help either with the prevention of infections or with their treatment.

Theater Review: Carriage House Player’s ‘Twelfth Night’ casts spells under the stars

by Barbara Anne Kirshner - October 14, 2021

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By Barbara Anne Kirshner

In this COVID era where outdoor activities are preferred, the Carriage House Players, in partnership with the Smithtown Center for the Performing Arts and the Smithtown Historical Society, has extended the usual summer open air entertainment by heralding autumn with an under the stars production of Shakespeare’s romantic comedy Twelfth Night.

East Main Street in Smithtown is well lit at night by passing car headlights but once you turn off the main road and head up a narrow country lane, you are instantly immersed in a blanket of serene darkness save for an illuminated structure standing tall in the distance.

A string of white twinkling lights guides the way through a meadow that ends at this grandiose structure decorated as a red barn framed by natural towering trees. You have just entered the world that is Twelfth Night.

This tale of unrequited love, believed to have been written around 1601–1602, has a whirlwind of twists and turns bursting with intrigue and mistaken identities that one remains riveted throughout.

The pre-show antics make it worth getting to the grounds early. Actors in Victorian garb circulate, hob knob with the audience, one strums a guitar and even reads tarot cards.

High-test energy explodes right from the start and maintains momentum through to a rollicking ending. This exceptionally well-rehearsed cast, thanks to director, Christine Boehm, appears comfortable with Elizabethan English and flings Shakespeare’s words in an easy, conversational manner just as the Bard intended.

The opening springs to life with the song I Put a Spell on You and the stage rocks with a captain at the helm trying to stay the course of his ship veering off through a turbulent storm. Black sheers fiercely whip up and down, an abstract representation of violent waves which ends with a catastrophic shipwreck.

Enter Anna Stacy, dynamic as Viola, in a role that shifts genders from female to male and back again. Viola was rescued by the sea captain, the adept Patrick Campbell, while Dan Schindlar, charismatic as her brother Sebastian, is rescued by Antonia, played by the expressive Zöe Katsaros. Neither are aware that the other has survived which adds another layer of intrigue to the plot.

Viola disguises as a young man, ‘Cesario’, to go into the service of Michael Mandato’s evocative Count Orsino. Orsino is tortured by unrequited love for Countess Olivia a damsel in mourning for seven years over the death of her brother. Mary Caulfield captivates as the grieving countess shrouded in black and spurning all suitors. ‘Cesario,’ in doing the bidding of Orsino, professes his master’s love for Olivia, but it backfires when the countess falls in love with ‘Cesario’ instead.

Upon seeing Sebastian, Olivia assumes he is ‘Cesario’ and implores him to marry her which he does willingly. In a final twist, ‘Cesario’ and Sebastian appear before Olivia and Orsino causing more confusion. But Viola reveals her true identity, declares her love for the count and is reunited with her twin brother.

Sub-plots abound with Olivia’s uncle, Sir Toby, a drunkard performed with gusto by Evan Donnellan and his comrade, Sir Andrew, (Jae Hughes), a delightful fop who also pines for Olivia. This duo adds much madcap humor into the mix!

Another comical twist happens when Maria, Olivia’s maid, played with relish by Katie Murano, pulls a prank on the pompous steward, Malvolio, making him think Olivia is in love with him. Kevin Callaghan’s Malvolio falls into hilarious raptures as the lovesick steward and nearly stops the show.

Another participant in the plot against Malvolio is Feste, Olivia’s jester, played by the multi-talented Ana McCasland who displays all of her talents from singing to playing the guitar to acting.

For an electric celebration of wits, intrigue and an enthusiastic ensemble thoroughly committed to Shakespeare’s raucous comedy, catch a performance Twelfth Night, now playing through Oct. 31.

The Carriage House Players presents Twelfth Night on the grounds of the Smithtown Historical Society, 239 East Main Street, Smithtown on the evenings of Oct. 15, 17, 22, 24, 29 and 31. Tickets are $20, $15 seniors and children 12 and under. To purchase, call 631-724-3700 or visit www.smithtownpac.org.

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