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Addressing issues affecting mobility are crucial to reducing risk

By David Dunaief, M.D.

Dr. David Dunaief

Heart disease still ranks as the number 1 cause of death in the U.S., with just under 700,000 deaths per year, which equates to just over 200 deaths per 100,000 people (1). Depending on your ethnicity, your risk might be higher or lower than the average.

While this is certainly better than it used to be, we have a long way to go to reduce the risk of heart disease. 

Some risk factors are obvious. Others are not. Obvious ones include age (men at least 45 years old and women at least 55 years old), family history, high cholesterol, high blood pressure, obesity, sedentary lifestyle, diabetes and smoking. Less obvious ones include gout, atrial fibrillation and osteoarthritis. 

The good news is that we have more control than we think. Most of these risks can be significantly reduced with lifestyle modifications.

Let’s look at the evidence.

Is obesity an independent risk factor?

Obesity continually gets play in discussions of disease risk. But how substantial a risk factor is it?

In the Copenhagen General Population Study, results showed an increased heart attack risk in those who were overweight and in those who were obese with or without metabolic syndrome, which includes a trifecta of high blood pressure, high cholesterol and high sugar levels (2). “Obese” was defined as a body mass index (BMI) over 30 kg/m², while “overweight” included those with a BMI over 25 kg/m².

The risk of heart attack increased in direct proportion to weight. Specifically, there was a 26 percent increase in heart attack risk for those who were overweight and an 88 percent increase in risk for those who were obese without metabolic syndrome. This study had a follow-up of 3.6 years.

It is true that those with metabolic syndrome and obesity together had the highest risk. However, it is quite surprising that obesity, by itself, can increase heart attack risk when a person is “metabolically healthy.” Because this was an observational trial, the results represent an association between obesity and heart disease. Basically, it’s telling us that there may not be such a thing as a “metabolically healthy” obese patient. If you are obese, this is one of many reasons that it’s critical to lose weight.

Activity levels drive improvements

Let’s consider another lifestyle factor, the impact of being sedentary. An observational study found that activity levels had a surprisingly high impact on women’s heart disease risk (3). Of four key factors — weight, blood pressure, smoking and physical inactivity — age was the determinant as to which one had the most negative effect. Those under the age of 30 saw smoking as most negatively impactful. For those over the age of 30, lack of exercise became the most dominant risk factor for heart disease, including heart attacks.

For women over age 70, the study found that increasing physical activity may have a greater positive impact than addressing high blood pressure, losing weight, or even quitting smoking. However, since high blood pressure was self-reported, it may have been underestimated as a risk factor. Nonetheless, the researchers indicated that women should make sure they exercise on a regular basis to most significantly reduce heart disease risk.

How long do you suffer with osteoarthritis?

The prevailing thought with osteoarthritis is that it is best to suffer with hip or knee pain as long as possible before having surgery. But when do we cross the line and potentially need joint replacement? In a study, those with osteoarthritis of the hip or knee joints that caused difficulty walking on a flat surface were at substantially greater risk of cardiovascular events, including heart attack (4). Those who had surgery for the affected joint saw a substantially reduced heart attack risk. It is important to address the causes of osteoarthritis to improve mobility, whether with surgery or other treatments.

When does fiber matter most?

Studies show that fiber decreases the risk of heart attacks. However, does fiber still matter once someone has a heart attack? In a recent analysis using data from the Nurses’ Health Study and the Health Professional Follow-up Study, results showed that higher fiber plays an important role in reducing the risk of death after a heart attack (5).  

Those who consumed the most fiber, compared to the least, had a 25 percent reduction in post-heart attack mortality. Even more impressive is that those who increased their fiber after a cardiovascular event had a 31 percent reduction in mortality risk. The most intriguing part of the study was the dose response. For every 10-gram increase in fiber consumption, there was a 15 percent reduction in the risk of post-heart attack mortality.

Lifestyle modifications are so important. In the Nurses’ Health Study, which followed 120,000 women for 20 years, those who routinely exercised, ate a quality diet, did not smoke and were a healthy weight demonstrated a whopping 84 percent reduction in the risk of cardiovascular events such as heart attacks (6).

What have we learned? We can substantially reduce the risk of heart attacks and even potentially the risk of death after sustaining a heart attack with lifestyle modifications that include weight loss, physical activity and diet — with, in this case, a focus on fiber. While there are a number of diseases that contribute to heart attack risk, most of them are modifiable. With disabling osteoarthritis, addressing the causes of difficulty with mobility may also help reduce heart attack risk.

References: 

(1) cdc.gov. (2) JAMA Intern Med. 2014;174(1):15-22. (3) Br J Sports Med. 2014, May 8. (4) PLoS ONE. 2014, Mar 14, 2014. [https://doi.org/10.1371/journal.pone.0091286]. (5) BMJ. 2014;348:g2659. (6) N Engl J Med. 2000;343(1):16.

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. 

The following incidents have been reported by Suffolk County Police:

Commack

■ A man and a woman entered HomeGoods on Henry Street in Commack on May 20 and allegedly stole assorted bedding valued at $320.

■ Bunty’s Jewelry on Commack Road in Commack was burglarized on May 16 and over $3,000 worth of jewelry was stolen. Entry was gained by breaking in the rear door.

■ Target located on Veterans Memorial Highway in Commack reported a shoplifter on May 15. A man allegedly stole five printers valued at $1265.

■ A 2010 Dodge Ram 3500 Mega Cab was stolen from the parking lot of Walmart on Crooked Hill Road in Commack on May 15. The vehicle was valued at $15,000.

■ HomeSense on Henry Street in Commack reported a petit larceny on May 15. Two women allegedly stole nine sets of window curtains valued at $450.

■ ShopRite on Garet Place in Commack reported that two men loaded up three shopping carts with assorted food items and allegedly left the store without paying. The items were valued at $1500.

Dix Hills

■ A 2019 Mercedes Benz valued at $30,000 was stolen from a driveway of a residence on Grey Birch Court in Dix Hills on May 20. The car had been left unlocked with the keys inside.

East Setauket

■ Walmart on Nesconset Highway reported a petit larceny on May 20. Two women allegedly filled a shopping cart with miscellaneous items valued at approximately $500 and walked out of the store without paying.

Fort Salonga

■ A 2020 BMW X7 valued at $90,000 was stolen from the driveway of a residence on Milemore Drive on May 17. The key fob had been left inside the vehicle.

Huntington Station

■ Staples on West Jericho Turnpike in Huntington Station called the police on May 20 to report that a man and a woman allegedly stole an Epson EcoTank printer worth $550 and a HP Smart Tank printer worth $460.

■ Louis Vuitton on Walt Whitman Road in Huntington Station reported a shoplifter on May 20. A woman allegedly stole a handbag valued at $2370.

Kings Park

■ Flynn-Aire Heating and Air Conditioning on Indian Head Road in Kings Park called the police to report that four work vehicles were broken into on May 17. The rear windows were smashed to gain entry and tools valued at $20,000 were stolen.

Lake Grove

■ Dick’s Sporting Goods at the Smith Haven Mall in Lake Grove reported that two women and a man allegedly stole assorted Nike clothing valued at $880.

■ A woman shopping at Trader Joe’s on Nesconset Highway in Lake Grove on May 19 reported that an unknown person stole her purse containing credit cards and cash from her shopping cart.

■ DSW Designer Shoe Warehouse on Middle Country Road in Lake Grove called the police on May to 18 to report that a man and a woman allegedly stole miscellaneous sneakers and footwear valued at approximately $250.

■ Macy’s at the Smith Haven Mall in Lake Grove reported a petit larceny on May 17. Two women and a man allegedly stole 15 miscellaneous clothing items valued at $985.

Mount Sinai

■ A resident on Apricot Lane in Mount Sinai reported that someone entered their unlocked vehicle on May 17 and stole sunglasses and various items valued at $250.

■ A woman visiting Heritage Park on Mount Sinai-Coram Road in Mount Sinai on May 18 reported that her purse containing credit cards and cash was stolen from her car. Someone attempted to use the credit cards at a local Walmart a short time later.

Port Jefferson Station

■ Family Dollar on Route 112 in Port Jefferson Station reported a petit larceny on May 21. Three men and a woman allegedly stole assorted items valued at $50.

■ A resident on Kelsey Avenue in Port Jefferson Station reported that someone cut a lock on their backyard shed and stole power tools valued at approximately $600 on May 21.

■ Verizon Wireless on Nesconset Highway in Port Jefferson Station reported that a man allegedly stole an iPhone 13 Pro valued at approximately $1000 by cutting the security cable on May 19.

■ A resident on Homestead Avenue in Port Jefferson Station called the police to report that someone entered their unlocked vehicle on May 19 and stole property worth $120.

■ T.J. Maxx on Nesconset Highway in Port Jefferson Station reported a petit larceny on May 20. A man and a woman allegedly stole assorted bedding and men’s clothing valued at $400.

Rocky Point

■ Kohl’s on Route 25A in Rocky Point reported a shoplifter on May 14. A woman allegedly stole assorted clothing valued at approximately $430.

Selden

■ A resident on Elmwood Avenue in Selden called the police on May 21 to report that someone stole a Ring Home Security Camera from his front porch.

■ A lawnmower and tools valued at approximately $200 were stolen from the backyard of a residence on Mooney Pond Road in Selden on May 16.

South Setauket

■ Target on Pond Path in South Setauket reported a shoplifter on May 19. A man allegedly stole a Keurig coffee maker valued at $110 and eight assorted toys valued at $210.

■ Stop & Shop on Pond Path in South Setauket called the police on May 18 to report a shoplifter. A man allegedly placed 30 miscellaneous food items in his shopping cart and walked out of the store without paying. The merchandise was valued at $325.

■ A man allegedly stole copper wire worth $765 from Home Depot on Pond Path in South Setauket on May 16.

Suffolk County Crime Stoppers offers a cash reward for information that leads to an arrest. Anyone with information about these incidents can contact Suffolk County Crime Stoppers to submit an anonymous tip by calling 1-800-220-TIPS.

— COMPILED BY HEIDI SUTTON

Corina Amor ©Len Marks Photography, 2022/CSHL

By Daniel Dunaief

What if scientists could train the immune system to recognize something specific on the outside of unwanted cells?

That’s what new Cold Spring Harbor Laboratory fellow Corina Amor is doing, as she found an antigen on the surface of senescent cells. She hopes to train a patient’s T-cells to search for these cells, much like providing a police dog with the scent of a missing person or escaped convict.

Amor, who joined Cold Spring Harbor Laboratory in January after earning her medical degree in  at Universidad Complutense de Madrid in Spain and her PhD in the lab of CSHL Adjunct Professor Scott Lowe, recently found a surface molecule called uPAR that is upregulated on senescent, or aging, cells.

If senescent cells excessively accumulate, it can lead to tissue decline and disease like lung and liver fibrosis, Lowe, who is the Cancer Biology Chair at Memorial Sloan Kettering Cancer Center, explained in an email. Senescent cells also contribute to tissue decline as people age.

Studies suggest eliminating these senescent cells could provide therapeutic benefit, she added.

Using artificial T-cells, called CAR-T, for Chimeric Antigen Receptor, Amor looks to use specific antigens to find these senescent cells and eliminate them.

“It was sort of a crazy idea, but it worked and, while much more preclinical and clinical work needs to be done, the concept could lead to better treatments for lung and liver fibrosis, and other diseases that increase as we age,” Lowe wrote.

The combination of an inflamed environment and an ineffective immune system can create conditions that favor the growth and development of cancer.

Amor, who currently has one technician and is planning to add a graduate student this summer at her lab at CSHL, is building on her PhD research.

“My doctoral work was the development of the first CAR-T cells that are able to target senescent cells,” she said. “We were the first in the world to do this.”

Amor, who was recently named to the 2022 Forbes 30 under 30 Europe list, describes this approach as a new frontier for treating senescent cells and one in which researchers would need to clear numerous hurdles before developing clinical therapies.

She is searching for other antigens on the surface of cancerous and fibrous cells that would increase the specificity of these synthetic immune cells.

Combining antigens could be the key to avoiding off target effects that might cause the immune system to attack healthy cells.

Amor plans to tap into CSHL’s affiliation with Northwell Health to analyze clinical samples that might provide a better understanding of various potential markers.

Fellowship route

Cold Spring Harbor Laboratory is one of several programs in the country that provides talented researchers with the opportunity to go directly from finishing their PhD to leading their own lab.

Amor is following in the footsteps of her MSKCC mentor Lowe, who also had been an independent fellow at CSHL.

Lowe saw some similarities in their career paths, as they both made “unexpected discoveries during our Ph.D. research that were not only important, but clearly set a path for future research,” he explained in an email.

Lowe describes Amor as an “intense and driven scientist” who has an “extraordinary bandwidth to get things done, and a mental organization that allows her to execute science efficiently.” He believes her work is game changing at many levels and opens up numerous new directions for scientific study.

Lowe is “extraordinarily proud of [Amor] for becoming a CSHL fellow – and I hope she both contributes and benefits from the lab as I did,” he wrote in an email.

Amor said CSHL provided an ideal balance between finding collaborators who worked in similar areas, without competing for the same resources and conducting similar research.

“The last thing you want is to go somewhere and be completely isolated,” she said. “You also don’t want to be at a place where there’s three other people doing the same thing and you’re not adding anything.”

She feels like she had a “nice synergy” with CSHL, which is trying to expand its immunology research. 

As the first person to bring cellular therapy to CSHL, she has already started collaborating with several groups. 

Amor recognizes the challenges ahead in training scientists who often have their own ideas about the questions they’d like to ask.

“The science is the easy part” and it comes naturally, but there is a “learning curve in how to manage people,” she said.

She appreciates the opportunity to talk with senior researchers at Cold Spring Harbor Laboratory and plans to attend courses and seminars for principal investigators who are starting out.

When she was in graduate school, Amor said she rotated through different labs. When everything didn’t work as she might have hoped during those rotations, she said she had the opportunity to learn from those experiences.

“When training people in the lab, I try to be really specific about what I want to do” while also ensuring that the researchers understand and appreciate the bigger picture and context for individual experiments, she said.

Originally from Madrid, Amor felt comfortable during her five years in Manhattan and is enjoying the open space and fresh air of Long Island in her role at CSHL. She also appreciates the chance to kayak in the waters around Long Island.

When she was around seven years old, Amor said her mother Esperanza Vegas was diagnosed with breast cancer. By participating in a clinical trial for a new drug, her mother fought off the disease.

“That made me realize how important science and research is,” Amor said.

During her educational training, Amor went directly from high school into a six-year program in which she earned a bachelor’s degree and a medical degree.

By the time she finished her PhD, she was hooked on research.

She appreciates the advice she received from Lowe, who encouraged her to conduct experiments despite the risks.

“Don’t get paralyzed at the beginning by fear,” she said. “Do the experiment and see what happens.”

Linx

MEET LINX!

Linx

This week’s featured shelter pet is Linx, a 3-year-old German Shepherd. Linx is highly intelligent with a love for chasing tennis balls. He will only go to a home that has experience with the breed.  Linx is not a dog that enjoys cuddle time; if it’s not play time, he is not interested. He should be the only pet in a adult only home with lots of time to throw tennis balls and teach him new commands.

If you would like to meet Linx, please call ahead to schedule an hour to properly interact with him in a domestic setting.

The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. Visitor hours are currently Monday to Saturday from 10 a.m. to 3 p.m. (Sundays and Wednesday evenings by appointment only). Call 631-360-7575 or visit www.townofsmithtownanimalshelter.com for more information.ShelShel

METRO photo

By Daniel Dunaief

Daniel Dunaief

Empty nest? Seriously? I almost want to laugh maniacally when people ask about our empty nest.

For starters, we have a dog and two cats, which means that our nest, such as it is, has plenty of creatures with ongoing needs. One of our neighbors even asks regularly about our “little one.” It still takes me a second to realize she’s not inquiring about our children, who are anything but little, but our dog, who is also over 80 pounds.

The pandemic and the weather have disrupted so much over the last few years that we half expect to see one or both of our children at the airport or on our doorstep at any given moment.

Sure, we’ve had a few weeks where we’ve been on our own (with our pets), but in between, we’ve entertained visitors thrilled to travel again. We, ourselves, have also traveled back and forth to visit family, which means that the whole us-time has morphed into a collection of pet feedings and short trips.

Like so many other parents of college kids, we welcomed our children back to our home recently. It’s a wonderful chance to see them face to face, when they pick their heads up from their phones, and to connect the dots on snippets of their lives that they’ve shared from a distance.

The dog, who loves both of our children something fierce and whose tail threatens to detach from his hindquarters and float to the ceiling each time they return, is completely exhausted. After a few late nights with the kids and their friends, the dog reaches the sidewalk in front of the house, stands stock still, and stares at me, as if to say, “you want me to walk now? Do you have any idea how late I stayed up?”

Once I coax him, in between clenched teeth, away from the house, he still stops at random places, eager to turn around and lay down.

The dog loves it when I chat with a neighbor, which gives him a chance to plop down on the grass and pant, as if I’ve taken him much further than the 1/8th of a mile from our home.

During a recent such pause, a neighbor shared the joy/frustration of having his two children in his house. His wife wants to institute strict rules about comings, goings, and living-under-their-roof. His son, a junior at a nearby college, is delighted for the home-cooked meals, but not so much for the home-cooked rules.

Both of our children have become nocturnal. They have no need to hear birds chirping in the morning, to plow through a plate of pancakes, or to share in the start of another day.

In the “late” evening (which is getting earlier for me each day), our children often appear as we’re going to sleep. Excited to see them, we sit up and engage in what can be competing conversations. It’s like that old joke about a lawyer who moves into town and has almost no business, until another lawyer comes and they’re both working nonstop.

Something about hearing a sibling talk greases the wheels for the other one, who then remembers important details to share.

The next morning, when we’re at our desks, our children are happily sleeping, resting and recovering and our dog is flat out on the floor.

Then again, the fatigue is more than offset by the joy of hearing about their adventures, marveling at their maturation, and steadying ourselves for the moments when they head back to their busy lives.

Pixabay photo

By Leah S. Dunaief

Leah Dunaief

Two young boys, 10 and 8, were in a local playground last weekend, bouncing on a pogo stick, when four teenagers approached them. “Hey, could we have a turn?” one teen asked. “Sure,” said the older of the two boys, pushing the new toy forward toward them. Some conversation followed, indicating that the boys were Jewish. The teens then began ominously bad mouthing their religion, and one teen took coins out of his pocket and threw them at the boys. They were startled, then scared, and they began to run away. What had started as a fun afternoon will become a lifelong painful memory for the two youngsters.

How sad.

We know children can be cruel. Anyone who has ever read “Lord of the Flies” will certainly agree. But this is more than bullying. This is bullying with hate. And on what basis is that prejudice founded? The afternoon was beautiful, the young boys were generous in their response, and the setting should have been one of neighborly interaction among young people. Instead, it served as an excuse for bias. Where did those teens get their ideas? The deplorable answer is often “from their parents.”

How do we understand prejudice? What prompts it? What inflames it? Why should someone whose skin is one color think they are somehow better than someone of another color? Yet, children are “carefully taught,” to quote the line from “South Pacific.” Do we fear differences? Do we need to feel superior to others in order to be happy with ourselves? Why aren’t we simply judged by what sort of persons we are rather than how we look or what we believe?

Speaking of beliefs, political partisanship is threatening to rip apart our country. Never in my lifetime have people so defined themselves as being of one party or the other as now. We can’t even talk about our differences now. And never has that definition resulted in broken friendships and even broken families as now.

What’s happened to bipartisanship, to working together for greater good, for sharing our flag? Aren’t we all Americans? Don’t we all appreciate what is unique in our country, even as we try to improve its failures? When did the word, “compromise,” become an epithet? While there will always be disagreements about policies and actions, together we have moved forward and accomplished great goals since 1776. Now we can’t even get our facts straight.

The only issue that seems to pull us together is fear of being attacked by some outside force. Congress acts in unison when voting substantial sums of money for Ukraine. Suddenly, on the world stage, we are united and bringing other countries that believe in the rule of law together to oppose the Russian leader. If we can do that for the rest of the globe, why can’t we do that for ourselves? Maybe it’s because we can all agree on the same set of facts, that we are opposed to a fascist leader and his unprovoked assault, and we are afraid of who he may be coming after next?

So this is what we need to get us to work together: a common enemy. Heaven forbid that such a threat should ever materialize at our shores or in our heartland. For by then, it may be too late to undue the grievous harm being done to our nation from within. We are enduring daily shootings and killings of innocent children. Our evening newscasts reveal a society in chaos instead of under an orderly rule of law.

How much of the violence in our current lives is the result of the shouting and insults being hurled back and forth among our leaders? Rhetoric plays an important role in people’s behavior, and the rhetoric we are constantly surrounded by is hate-filled. Our citizens, especially our young, have huge mental challenges. While the coronavirus is partly to blame for the collapse of order and predictability, it is not the only culprit. 

What else is? The immoral, unconscionable grasp for power that fills our airwaves with hate.

Source: CoreLogic/The Balance

By Michael Ardolino

Michael Ardolino

The beginning of this year has proved to look at more than one factor when predicting the future of real estate. Sellers and buyers have been on the edge of their seats.

National headlines, including “foreclosures” and “recession,” haven’t helped matters. To avoid misconceptions, those wanting to sell or buy a home need to read past headlines for context.

Let’s discuss foreclosures

Earlier in the pandemic, people were eligible for a forbearance program for coronavirus-related financial hardships. The federal program allowed property owners going through a difficult time to request a pause or reduction of their mortgage payments from their lenders. It provided an opportunity for many to get back on their feet.

Experts are finding that many who took advantage of this plan could catch up on their payments or restructure their loans, making it easier for them to make payments again.

Mortgage Bankers Association findings show that 36% of loans upon exiting the forbearance program were paid in full, 44.6% were repayment plans and 18.4% of mortgage holders still had problems.

For the homeowners who had enough equity to sell their homes, the real estate market has quickly absorbed the new listings because inventory is low and demand still remains high.

Recession doesn’t equal housing crisis

When some people hear “recession,” they think if there’s a housing bubble it will be ready to pop. Looking back at 2008, I can understand the concerns. Interestingly, there have been half a dozen recessions since 1980, and homes have appreciated four times and only twice depreciated. (See the chart in my ad in Arts & Lifestyles)

The data proves that a slow economy doesn’t necessarily mean home values fall.

I mentioned in past columns that this time around, as homes appreciated and the trend continued, we were in better condition than 2008 when a high percentage of borrowers were defaulting on their subprime mortgages.

Those mortgages were easier to get than they are today, and the banking industry learned from its mistake. Banks are looking for buyers with credit scores on the high side who can afford a solid down payment. Also, homeowners who refinance must maintain 20% equity, which wasn’t the case in 2008 and led to property values falling to a point where the owner had a higher principal than what their house was worth.

Takeaway

Timing is everything. There’s no need to panic even if the economy isn’t ideal. With a little research, you can find the best time for you to sell or buy a home. 

So … let’s talk.

Michael Ardolino is the Founder/Owner-Broker of Realty Connect USA.

METRO photo

By Matthew Kearns, DVM

Dr. Matthew Kearns

Can a dog or cat have a stroke? That is an interesting question. In humans, strokes are the third most common cause of death (after heart disease and cancer). In dogs and cats, strokes (also known as cerebrovascular accidents) are much less common but do happen. Just as in humans, a vascular accident occurs as the result of a emboli (blood clot) or bleeding. 

Circumstances that could cause a cerebrovascular accident are: conditions that could lead to a hypercoagulable state, conditions that could cause bleeding in the brain, atherosclerosis (plaque buildup in the vessel), or conditions that cause systemic hypertension. Hypercoagulable states include: Cushing’s disease (hyperadrenocorticism), immune mediated hemolytic anemia, sepsis, cancer and some others. Conditions that cause bleeding include: trauma, certain infections, congenital malformations of blood vessels in the brain, tumors, etc. Lastly, hypertension can be caused by kidney failure, heart conditions, etc.

Depending on the portion of the brain affected, the symptoms will follow. The cerebral cortex is an area where higher functions take place so we would see a decreased alertness, weakness, circling, head pressing in corners, and possible seizures. The thalmus or midbrain would affect balance and eye movement. The cerebellum controls movement so a lesion there would lead to hypermetric (jerky) movement, slowed reflexes and generalized weakness.

The best way to diagnose what type of cerebrovascular accident is with either a CT scan, or an MRI. This is tricky because there is limited availability for these tests, they are expensive, and require general anesthesia. Sometimes the patient is not stable enough for anesthesia. Most times a workup to include bloodwork, x-rays, and sometimes ultrasound will help to rule in or out concurrent diseases to help with a prognosis and to see if a CT/MRI is safe to perform or would make a difference in treatment.

Treatment usually includes supportive care (fluids, oxygen, antibiotics if indicated, etc), as well as treating any underlying/concurrent disease. Medications to prevent additional bleeding or emboli are also used. Physical therapy is performed but many times by the owners after the patient is discharged due to expense.

Prognosis depends on the area of the brain that is affected and how severe the event was. The good news is that symptoms did not usually worsen after 24-48 hours (for those pets that lived that long) so, if your pet is not too severely affected and does not worsen after the first 24-48 hours they have a chance of a longer survival period.

In conclusion, pets do have strokes. On the positive side, strokes are much less common in pets than humans. On the negative side, strokes are usually secondary to serious underlying disease which affects the short and long-term prognosis. 

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. 

Paul Freimuth and co-author Feiyue Teng, a scientist in Brookhaven Lab’s Center for Functional Nanomaterials (CFN), at the light microscope used to image bacteria in this study. Photo from BNL

By Daniel Dunaief

Researchers regularly say they go wherever the science takes them. Sometimes, however, the results of their work puts them on a different path, addressing new questions.

So it was for Paul Freimuth, a biologist at Brookhaven National Laboratory. Freimuth was studying plant proteins of unknown function that he thought might play a role in the synthesis or modification of plant cell walls. The goal was to produce these proteins in bacteria or yeast to facilitate an understanding of the protein structures.

When he inserted plant genes into bacteria, however, one of those genes experienced a phase shift, producing a misfolded protein that, when produced in high enough quantities, killed the bacteria.

Working with several interns over the course of five years, as well as a few other principal investigators, Freimuth discovered that this protein had the same effect as antibiotics called aminoglycosides, which are the current treatment for some bacterial infections. He recently published the results of these studies in the journal Plos One.

Aminoglycosides enter the cell and cause ribosomes to create proteins in an error-prone mode, which kill the bacterial cells. The way these proteins kill the cells, however, remains a mystery. Antibiotic-treated cells produce numerous proteins, which makes determining the mechanism of action difficult.

The protein Freimuth studied mirrors the effect of treating cells with aminogylcosides. Researchers now have a protein they can study to determine the mechanism of cell killing.

To be sure, Freimuth said the current research is at an early stage, and is a long way from any application. He hopes this model will advance an understanding of how aberrant proteins kill cells. That information can enable the design of small molecule drugs that mimic the protein’s toxic effect. He believes it’s likely that this protein would be toxic if expressed in other bacteria and in higher cells, but he has not tested it yet.

With antibiotic resistance continuing to spread, including for aminoglycosides, Freimuth said the urgency to find novel ways to kill or inhibit bacterial growth selectively without harmful side effects has increased.

Aminoglycosides cause the ribosome to shift coding phases or to make other errors. The model toxic protein he studied resulted from the bacteria starting to translate amino acids at an internal position, which produced a new, and, as it turns out, toxic sequence of amino acids.

The phase-shifted gene contained a stop codon located just 49 codons from the start site, which means that the toxic protein only contained 48 amino acids, which is much shorter than the average of 250 to 300 amino acids in an E. coli protein.

Since the model toxic protein was gene-encoded rather than produced by an antibiotic-induced error in translation, Freimuth’s team were able to study the sequence basis for toxicity. The acutely toxic effect was dependent on an internal region 10 amino acids in length.

Narrowing down the toxic factor to such a small region could help facilitate future studies of the mechanism of action for this protein’s toxic effect.

Misread signal

Freimuth and his team discovered that the bacteria misread the genetic plant sequence the researchers introduced. The bacteria have a quality control mechanism that searches for these gibberish proteins, breaking them down and eliminating them before they waste resources from the bacteria or damage the cell.

When Freimuth raised the number of such misfolded proteins high enough, he and his colleagues overwhelmed the quality control system, which he believes happened because the misfolded protein affected the permeability of the cell membrane, opening up channels to allow ions to flood in and kill the cell.

He said it’s an open question whether the protein jams open existing channels or becomes directly incorporated into the membrane, compromising membrane stability.

He showed that cells become salt-sensitive, indicating that sodium ion concentration increases. At the same time, it is likely that essential metabolites are leaking out, depriving the cell of compounds it needs to survive.

Now that the bacteria has produced this protein, Freimuth can use various tools and techniques at BNL, including the X-ray beamlines for protein crystallography and the cryo electron microscope, which would provide ways to study the interaction of the protein with cell components. High resolution structures such as the ones he hopes to determine could be used to guide drug design.

Freimuth is in the process of applying for National Institutes of Health funding for additional research, which could help the NIH’s efforts to counter the increasing spread of antibiotic resistance.

Freimuth has worked at BNL since 1991. He and his wife Mia Jacob, who recently retired from her role in graphic design in Stony Brook University’s Office of Marketing and Communication, reside in East Setauket.

The couple’s daughter Erika, who lives in Princeton and recently got married, works at Climate Central as an editor and writer. Their son Andrew works in Port Jefferson at an investment firm called FQS Capital Partners.

When Freimuth is not working at the lab, he enjoys sailing, kayaking and canoeing. During the pandemic, he said he purchased a small sailboat, with which he has been dodging the ferry in Port Jefferson Harbor.

Originally from Middletown, Connecticut, Freimuth was interested in science from an early age. He particularly enjoyed a mycology class as an undergraduate at the University of Connecticut.

As for his unexpected research with this protein, the biologist is pleased with the support he received from Brookhaven National Laboratory.

He said BNL enabled him to address the biofuel problem from protein quality control, which is a new angle. “BNL appreciates that valuable ideas sometimes bubble up unexpectedly and the lab has ways to assist investigators in developing promising ideas,” he said.