This week’s shelter pets are Pudding and Ritz, two 10-month-old cats rescued from a cat hoarding situation and now up for adoption at the Smithtown Animal Shelter.
These two babies are best buds and prefer to go to a home together. Due to the large volume of cats in the home, they had very little human interaction. They are slowly learning to trust people, but remain very shy.They are more brave when they are together! Pudding is a long hair black and white male. Ritz is a short haired orange tabby female. These lovelies would do best in a quiet home that has lots of love and patience to give!
They are spayed/neutered, microchipped and are up to date on their vaccines.
If you are interested in meeting Pudding and Ritz, please call ahead to schedule an hour to properly interact with them in a domestic setting, which includes a Meet and Greet Room.
The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. Shelter operating hours are currently Monday to Saturday 10 a.m. to 3 p.m. (Sundays and Wednesday evenings by appointment only). For more information, call 631-360-7575 or visit www.smithtownanimalshelter.com.
After setting the American record for the longest consecutive streak of 340 days away from Earth aboard the International Space Station, astronaut Scott Kelly returned and flopped into a pool.
While we all haven’t been away from Earth for any length of time, we have been living in a modified version of the normal we knew.
Like Kelly, we have spoken with our close friends and family through electronic devices that beam them onto a screen in front of us.
We have watched some of their drained faces, as they isolated themselves for a month or more, battling through the cough, fever and discomfort of COVID-19.
We have also seen our relatives at much greater than arm’s length as we celebrated landmark birthdays, the birth of new family members, and socially-distanced graduations and limited-attendance weddings.
In two weeks, I am anticipating the familiar feeling of diving into a familial swimming pool. That’s when I will see family members I haven’t seen in over a year.
We worked around our busy schedules not only to get vaccinated before we saw each other in real life, but also to do so long enough in advance of that meeting that our immune systems would have time to arm themselves against viral spike proteins.
This is the longest period my wife and I have ever been separated from our parents. We know how fortunate we are that our parents didn’t get sick.
We took nothing for granted, staying away from our parents and extended family. We might as well have been on the International Space Station, which was probably among the safest places people have ever lived, given the limited social contact in a controlled environment 254 miles from the nearest pool, family member or pizza restaurant.
We feel so much closer to a more familiar life than we have in over a year, as we anticipate seeing our parents and family members who can attend our son’s graduation. The planned visit has become a dominant and daily topic of conversation in our house. We are wondering what food and drink to serve, how to move everyone from nearby hotels to socially-distanced seating at graduation and what games to prepare in our backyard for our grown children to play with their cousins.
These questions and decisions might have seemed like a responsibility prior to the pandemic, as hosting anyone requires attention to detail and consideration for our guests. That responsibility has transformed into the kind of privilege we might have taken for granted in other years, before the pandemic disrupted family gatherings and turned the calendar into a reminder of delayed gratification of family gatherings.
While we will likely engage in the Texas two-step, trying to gauge how close we can get physically to each other, it’s easy to imagine that hugs, kisses and appreciative smiles will bubble up from the excitement of a backyard that has hosted more routine gatherings of birds, squirrels and chipmunks than of the people who stare at flickering screens in our home.
As we prepare to dive into our own family pools of support, affection and love, we are incredibly grateful to everyone who made such a return to normal possible, from those who explored the basic science that led to the vaccine, to those who developed and tested the vaccine, to those who treated family and friends, to those who stocked the shelves with the food and drinks we needed to take us from the uncertainty of the pandemic to the anticipation of a celebration. Absence made our hearts grow fonder for family and increased our appreciation for everyone who allowed us to reunite with the most important pieces of ourselves. In just a few weeks, we look forward to diving into a more familiar world.
This is the time of year when our five senses go into overdrive. Let me enumerate. In no particular order of delight, I’ll start with sound.
The birdsong is sometimes loud enough to provide dance music at a wedding. There are all kinds of musical bars put forth: crooning, warbling, shrieking, hooting, gurgling. There is an incredible range of notes, from high soprano and countertenor to tenor and baritone, even bass. Sometimes the birds seem to be singing in a chorus, other times at counterpoint. If your bedroom window is open, they can wake you up at first light. There can be many birds in the trees or there may just be one mockingbird pretending to be an entire flock.
The sight of the birds is as much a treat as the sounds, if you can spot them among the leaves. They can range from a nondescript small brown chick, who nonetheless utters the most melodious songs, to crimson or orange-breasted or blue-tailed or grandly multi-colored varieties of different sizes and shapes that perch briefly on the porch railing or snack on the front lawn. They can seem the model of purpose as they deliver food to the open beaks of their newly hatched offspring or of patience as they sit quietly atop the eggs and wait for the next generation to appear.
Speaking of sight, we go from the early purple of crocuses and joyful yellow of forsythia and daffodils to the lush pink of dogwood and cherry blossoms to the deep red of tulips and azaleas. All of that artwork is provided against a bright green backdrop of new leaves on the bushes and luxuriant attire for the tree limbs. Branches on either side of the road unite in the air overhead, creating sun-dappled tunnels as we drive the back-way routes.
The waves at the beaches are calm now, climbing the sand with rhythmic whispers, and the seagulls fly low, looking for a fish dinner in the clear blue water. Too soon, there will be motor boats and jet skis on the harbors and lawn mowers and leaf blowers keeping the landscape orderly — but not yet. The magic and peace of early spring are still, however briefly, with us to be treasured.
The smells at the beach of salt in the air and blossom-scent on the breezes are intoxicating harbingers of the season. Lilacs, that always know when it is Mother’s Day, perfume the neighborhood. And among us humans, there are always those early-bird few who fire up the grill and begin to barbeque on a sunny weekend afternoon. If we play our cards right, we might be invited to share in this primitive treat. The taste is so much better than anything cooked indoors.
Taste is tantalized by early fresh fruit, like locally grown strawberries, and by vegetables like baby asparagus and snow peas. Several different kinds of dark green lettuces are also ready for dining early in the spring.
As for touch, there is the sweetness of a gentle breeze, reduced on a rare spring day from a stern wind to a caress against the cheek. It carries with it the promise of a summer day and the seduction of a summer night.
Add to all of that, the temperature in spring can reach a universally perfect range. Now I know some people like it hot, really hot, even up in the 90s when they can happily sweat. And some people like it cold, even freezing, during which time they can feel energized and stimulated to ski and ice skate. But all humans feel comfortable moving about in a temperature of 75 degrees. Knowing that could be found most months in San Diego almost prompted my husband and me to move there some 50 years ago. Of course, there were other things to consider, and we ultimately moved to Long Island.
Not for a moment do I have any regrets. My five senses are glad we live here.
Next week, residents across Long Island will vote on what their next board of education and budgets should look like.
Some districts have no unopposed runners, some have a handful of candidates vying for the same seat.
We are happy to see that, although some districts within our area are having hostile debates, people have been interested in this upcoming year’s budget and the candidates running for the BOE seats.
Oftentimes, parents and people in the community don’t know what’s going on until something happens — and that’s OK. Life is busy with working, raising a family and maintaining a social life — it can be hard to tune into a board meeting or flip through the pages of a proposed budget.
But we’ve noticed this year that it seems a little bit different. Maybe it’s because of the COVID-19 pandemic, maybe people are more concerned than before.
Whatever the reason is, we’re happy that residents are getting involved.
Whether it’s voicing your opinions or concerns over a school board election, or preparing for the 2024 presidential election down the road, it’s important to exercise those rights.
We have the luxury and the privilege to be a part of a democracy. People might not realize that the school board — that is “small” on the scale of things — has a huge impact on not just our children, but the community as a whole, especially regarding taxes
Pay attention to these things, whether you have children in the district or not. Read the local news and pay attention to what’s going on.
If you don’t agree with something, prevention is key — complaining after the fact on a social media post won’t do much when everything is already set in stone. Your vote can make a difference.
School districts across our coverage areas will be holding budget votes and board of education elections Tuesday, May 18. Check your district’s website for details on times and locations, and continue visiting tbrnewsmedia.com for updates.
Different people respond to the same level of stress in a variety of ways. For some, a rainy Tuesday that cancels a picnic can be a minor inconvenience that interrupts a plan, while others might find such a disruption almost completely intolerable, developing a feeling of helplessness.
Scientists and clinicians have been working from a variety of perspectives to determine the cause of these different responses to stress.
From left, graduate student Nick Gallo, Linda Van Aelst and Postdoctoral Researcher Minghui Wang. Photo by Shanu George
Cold Spring Harbor Laboratory Professor Linda Van Aelst and a post doctoral researcher in her lab, Minghui Wang, recently published a collaborative work that also included graduate student Nicholas Gallo, postdoctoral researcher Yilin Tai and Professor Bo Li in the journal Neuron that focused on the gene Oligophrenin-1, which is also implicated in intellectual disability.
As with most X-linked diseases, the OPHN1 mutation primarily affects boys, who have a single X chromosome and a Y chromosome. Girls have two X chromosomes, giving them a backup gene to overcome the effect of an X-linked mutation.
In addition to cognitive difficulties, people with a mutation in this gene also develop behavioral challenges, including difficulty responding to stress.
In a mouse model, Wang and Van Aelst showed that the effect of mutations in this gene mirrored the stress response for humans. Additionally, they showed that rescuing the phenotype enabled the mouse to respond more effectively to stress.
“For me and [Wang], it’s very exciting,” Van Aelst said. “We came up with this mouse model” and with ways to counteract the effect of this mutated analogous gene.
As with many other neurological and biological systems, Oligophrenin1 is involved in a balancing act in the brain, creating the right mix of excitation and inhibition.
When oligophrenin1 was removed from the prelimbic region of the medical prefrontal cortex, a specific brain area that influences behavioral responses and emotion, mice expressed depression-like helpless behaviors in response to stress. They then uncovered two brain cell types critical for such behavior: the inhibitory neurons and excitatory pyramidal neurons. The excitatory neurons integrate many signals to determine the activity levels in the medial prefrontal cortex.
The inhibitory neurons, meanwhile, dampen the excitatory signal so they don’t fire too much. Deleting oligophrenin1 leads to a decrease in these inhibitory neurons, which Van Aelst found resulted from elevated activity of a protein called Rho kinase.
“The inhibitor keeps the excitatory neurons in check,” Van Aelst said. “If you have a silencing of the inhibitory neurons, you’re going to have too much excitatory response. We know that contributes to this maladaptive behavior.”
Indeed, Wang and Van Aelst can put their metaphorical finger on the scale, restoring the balance between excitation and inhibition with three different techniques.
The scientists used an inhibitor specific for a RhoA kinase, which mimicked the effect of the missing Oligophrenin1. They also used a drug that had the same effect as oligophrenin1, reducing excess pyramidal neuron activity. A third drug activated interneurons that inhibited pyramidal neurons, which also restored the missing inhibitory signal. All three agents reversed the helpless phenotype completely.
Japanese doctors have used the Rho-kinase inhibitor fasudil to treat cerebral vasospasm. which Van Aelst said does not appear to produce major adverse side effects. It could be a “promising drug for the stress-related behavioral problems” of oligophrenin1 patients, Van Aelst explained in an email. “It has not been described for people with intellectual disabilities and who also suffer from high levels of stress.”
From left, graduate student Nick Gallo, Linda Van Aelst and Postdoctoral Researcher Minghui Wang. Photo by Shanu George
Van Aelst said she has been studying this gene for several years. Initially, she found that it is a regulator of rho proteins and has linked it to a form of intellectual disability. People with a mutation in this gene had a deficit in cognitive function that affected learning and memory.
From other studies, scientists learned that people who had this mutation also had behavioral problems, such as struggling with stressful situations.
People with intellectual difficulties have a range of stressors that include issues related to controlling their environment, such as making decisions about the clothing they wear or the food they eat.
“People underestimate how many [others] with intellectual disabilities suffer with behavioral problems in response to stress,” Van Aelst said. “They are way more exposed to stress than the general population.”
Van Aelst said she and Wang focused on this gene in connection with a stress response.
Van Aelst wanted to study the underlying cellular and molecular mechanism that might link the loss of function of oligophrenin1 with the behavioral response to stress.
At this point, Van Aelst hasn’t yet studied how the mutation in this gene might affect stress hormones, like cortisol, which typically increase when people or mice are experiencing discomfort related to stress. She plans to explore that linkage in future studies.
Van Aelst also plans to look at some other genes that have shown mutations in people who battle depression or other stress-related conditions. She hopes to explore a genetic link in the brain’s circuitry to see if they can “extend the findings.” She would also like to connect with clinicians who are studying depression among the population with intellectual disabilities. Prevalence studies estimate that 10 to 50 percent of individuals with intellectual disability have some level of behavioral problems and/or mood disorders.
Reflecting the reality of the modern world, in which people with various conditions or diseases can sequence the genes of their relatives, Van Aelst said some families have contacted her because their children have mutations in oligophrenin1.
“It’s always a bit tricky,” she said. “I don’t want to advise them yet” without any clinical studies.
A resident of Huntington, Van Aelst arrived at CSHL in the summer of 1993 as a post doctoral researcher in the lab of Michael Wigler. She met Wigler when he was giving a talk in Spain.
After her post doctoral research ended, she had planned to return to her native Belgium, but James Watson, who was then the president of the lab, convinced her to stay.
Outside of work, Van Aelst enjoys hiking, swimming and running. Van Aelst speaks Flemish, which is the same as Dutch, French, English and a “bit of German.”
She is hopeful that this work may eventually lead to ways to provide a clinical benefit to those people with intellectual disabilities who might be suffering from stress disorders.
Regular exercise is an important way to lower your risk of heart disease. METRO photo
Addressing weight and mobility issues may lower risk
By David Dunaief, M.D.
Dr. David Dunaief
We have made great strides in reducing heart attack mortality. When we compare cardiovascular disease — heart disease and stroke — mortality rates since 1975 to present, there has been a substantial decline. However, since 1990, the rate of decline has slowed (1). We need to reduce our risk factors to improve this scenario.
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. Lifestyle modifications, including a high-fiber diet and exercise, may help allay the risks.
Let’s look at the evidence.
Address obesity
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 obese (BMI >30 kg/m²) individuals with or without metabolic syndrome (high blood pressure, high cholesterol and high sugar) and in those who were overweight (BMI >25 kg/m²) (2). 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. But, it is quite surprising that obesity, by itself, can increase heart attack risk when a person is “metabolically healthy.” This was an observational trial, so we can only make an association; however, if it is true, then 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.
Get moving
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.
Manage 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.
Increase fiber
There have been studies showing that fiber decreases the risk of heart attacks. However, does fiber still matter when 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. Since we get too little fiber anyway, this should be an easy fix.
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.
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.
Robert Roehrig is a Setauket artist who has been active in the local art world for many years. He is primarily a landscape painter who has exhibited his oil paintings through his membership in several art organizations, winning awards and accolades along the way. The current vice president of the Setauket Artists, he enjoys spending time with his wife Joan, children and grandchildren, singing with the Harbormen Barbershop Chorus, and playing paddleball with his friends.
Were you interested in art as a child?
I always loved to draw. An important early influence was an artist named John Nagy, who had a TV show in the 1950’s that provided lessons on how to draw. I found it fascinating, so my parents bought his instruction book for me. In it, the artist showed you, step by step, how to complete a picture. I still remember the pictures: a railroad train with smoke billowing, a boy wearing a sombrero, etc.I happily finished every one.
Could you tell me about your journey as an artist?
I took art courses in high school and at Hofstra University, and throughout the years, I continued to draw and paint with watercolor. When I retired from teaching, I decided to try something I hadn’t done since high school – oil painting. I soon found the versatility and rich colors of the oil medium to my liking. I loved the process of creating an oil painting — choosing the scene, forming the composition, mixing the colors, applying the paint, making adjustments and viewing the final piece.
Where do you look for inspiration?
I enjoy painting Long Island landscapes and seascapes, as well as scenes from countries my wife and I visit while on vacation. In my paintings, I try to capture the beauty of the natural world. Interesting boats or buildings also attract my attention and I often choose subjects that highlight the contrast between sun and shadow. While traveling, I’m always on the lookout for a potential painting. The completed paintings help to rekindle some wonderful memories.
What techniques do you consider most important to obtaining your artistic vision?
As a realist painter of land and sea, it took years of practice to gain some competence. I found that brush control and the ability to blend colors is critical. For instance, to achieve the soft look of clouds or reflections in a lake, I lay in colors with a medium brush and then very gently, in even strokes, blend the colors with a large, very soft brush. If necessary, I can go back later and add a little more definition.
Are there present-day artists whom you admire and learn from?
I admire and learn from many of my fellow artists. The exciting thing about art is that every artist has a differenttechnique so visiting an exhibition is a learning experience. In terms of the larger art world, I always loved the paintings of Edward Hopper, Andrew Wyeth and Winslow Homer, and, more recently, Joseph Reboli.
You have won many distinguished awards. Can you list some of them?
I was chosen as the Honored Artist in the 2016 Setauket Artist Exhibition where I won the Award of Distinction for my painting, “Late Afternoon, Brooklyn.” At the Mills Pond Gallery in 2018, I was selected to be part of the Winner’s Circle, winning first place for my painting, “Off Duty.”
I was especially honored to be “Artist of the Month” at Long Island Museum Arts in Stony Brook (LIMarts) in 2018 where I was asked to exhibit my works in their gallery. And finally, I was awarded first place in the juried North Shore Art Guild’s exhibition Perspectives of Long Island, for my painting, “Still Afloat.” Each award I have won has brought me much satisfaction.
What advice would you give to other artists?
I would advise them to improve their skills by continuing to paint since you learn by doing and experimenting. I would encourage them to stick with a painting since sometimes the unexpected happens and the painting that didn’t start out so well ends up being a nice surprise.
Where are you presently exhibiting?
From May 16 to June 6 I will be exhibiting with the Setauket Artists at the Deepwells Mansion in St. James. You may also see my painting of West Meadow Beach at the North Shore Art Guild Gallery in the lobby of the Holiday Inn Express in Centereach through June 13. Visit my website at rhroehrig.com.
It’s been a while since we’ve been able to share our thoughts, and it’s fantastic to be back. I look forward to sharing what’s happening in the real estate market in upcoming columns.
For homeowners looking to sell, this is the time to do it. As more people are moving away from densely populated areas, residents in our communities have seen an increase in demand for their homes.
Why is timing important?
If you’ve been thinking of selling your home, there’s no time like the present, because houses in our area are currently in high demand.
In a future column, we’ll be watching the trends and sharing more details about supply and demand and what’s best for your situation.
For now, it’s important to know that you have the opportunity to get an excellent return on your investment, and the more money you get for your current house, the more options you’ll have when buying your new home.
Get ready
If you haven’t been part of a real estate transaction in decades, you may not realize how quickly a sale can occur in the age of technology. Many buyers research homes online, and most of them already have their mortgage pre-approval letters in hand. Sellers need to be prepared for their house to sell soon after they list it.
What does it mean to get ready?
Now is the time to sit down and have important conversations with those who understand the market to discuss your options.
If you’re a seller looking to buy a new home, you not only want to receive the best price for your current house but also get the best mortgage rate for your new home.
When your house goes up on the market, there’s a lot of preparation. Take a good look at your home and ask yourself what repairs do you need to work on in the next few weeks. Does the roof need to be fixed? How about that basement? Does it need to be emptied out? When it comes time to list your home, you want to present it in the best possible condition. So, for example, if you’re looking to sell your house in late summer, now is the time to get moving on repairs and upgrades.
The future looks bright
With COVID-19 restrictions lifting, and as we’re moving away from the pandemic, clients can stop by the office and houses can be shown in-person to clients.
Even if you’re thinking of moving in the fall or early next year, it’s time to consider your wants and needs when it comes to selling your home.
So, let’s talk.
Michael Ardolino is the Founder/Owner-Broker of Realty Connect USA.
My last article focused on the older treatments for atopic dermatitis with some of the treatments largely ineffective in more severe cases and, others, having too many adverse side effects. Very briefly, atopic dermatitis in pets is defined as, “a chronic, itchy, inflammatory skin condition that occurs in genetically predisposed animals,” or a rash associated with seasonal allergies. Here are some of the newer medications available for the treatment of atopic dermatitis.
Cyclosporine (Atopica®): cyclosporine is classified as an immunosuppressant but, overall, it is much safer than corticosteroids (cortisone derivatives) long term for the use of treating chronic atopic dermatitis. Cyclosporine prevents the activation of a certain type of white blood cell called T cells and the inhibition of certain chemicals called interleukins, as well as others. The main side effect is gastrointestinal (nausea, vomiting, diarrhea, flatulence). Cyclosporine has also been linked to increased risk of certain types of neoplasia (tumors, cancer) in certain breeds.
Oclacitinib (Apoquel®): oclancitinib is classified as a novel, selective immunosuppressant. Oclancitinib inhibits the enzyme janus kinase. Janus kinase acts as a signal for the immune system to attract cytokines, or mediators of inflammation. Specifically, oclancitinib inhibits a type of cytokine called interleukins. The interleukins inhibited are pro-inflammatory. There is a benefit to inflammation in immune responses to fight diseases however, the interleukins inhibited are responsible for itching and rashes associated with atopic dermatitis. At least 60% of dogs have responded with a substantial decrease in itching and rashes when oclancitinib is used long term.
Lokivetmab (Cytopoint®): lokivetmab is classified as an anti-canine IL31 monoclonal antibody, but technically lokivetmab is an allergy vaccine. “IL31” is short for interleukin-31. Interleukin-31 is a cytokine that specifically triggers pruritis, or itching in the brain. Injecting itchy dogs with lokivetmab, or antibodies against IL31 reduces itching in over 50% of dogs treated. Unfortunately, lokivetmab is not effective in preventing the rashes and skin infections. Therefore, secondary treatments (antibiotics, antifungals, medicated shampoos or sprays, etc) may be required to manage atopic dermatitis in some patients.
Allergy Specific Immunotherapy (ASIT): this refers to testing for what a patient is allergic to and attempting to desensitize them to those allergens. The testing can be either: serum (blood), or intradermal. Many veterinarians will be able to draw the blood needed to send out for testing. Intradermal testing is usually done under the guidance of a veterinary dermatologist. Testing should include both food and environmental allergens. This way we can avoid certain diets that would definitely cause a reaction, as well as desensitize the body to known environmental allergens with a customized injection or sublingual (under the tongue) drops. Both are quite effective.
I have found that some cases require short courses of some of the old school medications for “flare ups” at certain times of the year even if they are doing well on the new school treatments for most of the year. As always, check with your own veterinarian as to which treatment is best for your pet.
Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.
Chest pain remains the most common symptom in both men and women
By David Dunaief, M.D.
Dr. David Dunaief
When we refer to heart disease, it is an umbrella term; heart attacks are one component.
Fortunately, the incidence of heart attacks has decreased over the last several decades, as have deaths from heart attacks. However, there are still 790,000 heart attacks every year, and almost three-quarters of these are first heart attacks (1).
If you think someone is having a heart attack, call 911 as quickly as possible and have the patient chew an adult aspirin (325 mg) or four baby aspirins. While the Food and Drug Administration does not recommend aspirin for primary prevention of a heart attack, the use of aspirin here is for treatment of a potential heart attack, not prevention.
Heart attack symptoms
The main symptom is chest pain, which most people don’t have trouble recognizing. However, there are a number of other, more subtle, symptoms such as discomfort or pain in the jaw, neck, back, arms and epigastric, or upper abdominal areas. Others include nausea, shortness of breath, sweating, light-headedness and tachycardia (racing heart rate). One problem is that less than one-third of people know these other major symptoms (2). About 10 percent of patients present with atypical symptoms — without chest pain — according to one study (3).
It is not only difficult for the patient but also for the medical community, especially the emergency room, to determine who is having a heart attack. Fortunately, approximately 80 to 85 percent of chest pain sufferers are not having a heart attack. More likely, they have indigestion, reflux or other non-life-threatening ailments.
There has been a raging debate about whether men and women have different symptoms when it comes to heart attacks. Several studies speak to this topic.
Men vs. women
There is data showing that, although men have heart attacks more commonly, women are more likely to die from a heart attack (4). In a Swedish prospective (forward-looking) study, after having a heart attack, a significantly greater number of women died in hospital or near-term when compared to men. The women received reperfusion therapy, artery opening treatment that consisted of medications or invasive procedures, less often than the men.
However, recurrent heart attacks occurred at the same rate, regardless of sex. Both men and women had similar findings on an electrocardiogram; they both had what we call ST elevations. This was a study involving approximately 54,000 heart attack patients, with one-third of them being women.
One theory about why women are treated less aggressively when first presenting in the ER is that they have different and more subtle symptoms — even chest pain symptoms may be different. Women’s symptoms may include pain in the lower portion of the chest or upper portion of the abdomen, and they may have significantly less severe pain that could radiate or spread to the arms. But, is this true? Not according to several studies.
In one observational study, results showed that, though there were some subtle differences in chest pain, on the whole, when men and women presented with this main symptom, it was of a similar nature (5). There were 34 chest pain characteristic questions used to determine if a difference existed. These included location, quality or type of pain and duration. Of these, there was some small amount of divergence: The duration was shorter for a man (2 to 30 minutes), and pain subsided more for men than for women. The study included approximately 2,500 patients, all of whom had chest pain. The authors concluded that determination of heart attacks with chest pain symptoms should not factor in the sex of patients.
This trial involved an older population; patients were a median age of 70 for women and 59 for men, with more men having had a prior heart attack. The population difference was a conspicuous weakness of an otherwise solid study, since age and previous heart attack history are important factors.
In the GENESIS-PRAXY study, another observational study, but with a younger population, the median age of both men and women was 49. Results showed that chest pain remained the most prevalent presenting symptom in both men and women (6). However, of the patients who presented without distinct chest pain and with less specific EKG findings (non-ST elevations), significantly more were women than men. Those who did not have chest pain symptoms may have had some of the following symptoms: back discomfort, weakness, discomfort or pain in the throat, neck, right arm and/or shoulder, flushing, nausea, vomiting and headache.
If the patients did not have chest pain, regardless of sex, the symptoms were diffuse and nonspecific. The researchers were looking at acute coronary syndrome, which encompasses heart attacks. In this case, independent risk factors for disease not related to chest pain included both tachycardia (rapid heart rate) and being female. The authors concluded that there need to be better ways to calibrate non-chest pain symptoms.
Some studies imply that as much as 35 percent of patients do not present with chest pain as their primary complaint (7).
Let’s summarize
So what have we learned about heart attack symptoms? The simplest lessons are that most patients have chest pain, and that both men and women have similar types of chest pain. However, this is where the simplicity stops and the complexity begins. The percentage of patients who present without chest pain seems to vary significantly depending on the study — ranging from less than 10 percent to 35 percent.
Non-chest pain heart attacks have a bevy of diffuse symptoms, including obscure pain, nausea, shortness of breath and light-headedness. This is seen in both men and women, although it occurs more often in women. When it comes to heart attacks, suspicion should be based on the same symptoms for both sexes. Therefore, know the symptoms, for it may be your life or a loved one’s that depends on it.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. Visit www.medicalcompassmd.com.
My last article focused on the older treatments for atopic dermatitis with some of the treatments largely ineffective in more severe cases and, others, having too many adverse side effects. Very briefly, atopic dermatitis in pets is defined as, “a chronic, itchy, inflammatory skin condition that occurs in genetically predisposed animals,” or a rash associated with seasonal allergies. Here are some of the newer medications available for the treatment of atopic dermatitis.
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