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Valerie Cusumano, Nick Cusumano, Tommy Cusumano and Vinny Cusumano with Jeannie Mascolino New York Blood Center's Vice President of Operations on far right. Photo courtesy of NYBC

Vinny Cusumano, a young advocate for blood donations, received over 30 blood and platelet donations through transfusions during his treatment for kidney cancer.

New York Blood Center (NYBC) honored 12-year-old pediatric cancer survivor Vinny Cusumano at their recognition event for top platelet donors at Watermill Caterers in Smithtown. Vinny spoke to platelet donors at the event and thanked them for their life-saving contributions to the blood supply. Vinny’s family has been a fierce advocate for blood and platelet donations, partnering with NYBC on blood drives and other awareness campaigns through their nonprofit organization, Vinny’s Army, which is dedicated to supporting children diagnosed with cancer and their families.

In his remarks at the event, Vinny expressed heartfelt gratitude to the platelet donors in attendance. “There was never a question when my doctor told me that I needed a transfusion if one was available,” said Vinny Cusumano. “I know my parents tell me that New York Blood Center always needs donations and this is the reason why. I am the reason why.  And I’m standing here today talking to all of you about my story because all of you have helped get me here.”

Vinny Cusumano was diagnosed with a rare and aggressive form of kidney cancer in October of 2022. He received over 30 donations of blood and platelets through transfusions during the intense chemotherapy and radiation treatments that were needed to save his life.

Vinny’s Army works to support children diagnosed with cancer and their families by providing unconditional love and support to ensure no family faces this battle alone. According to NYBC, 25 percent of the blood supply is used by patients battling cancer. Vinny’s Army has advocated for blood donations to support pediatric cancer patients who may require transfusions for their treatment.

“We are grateful to Vinny Cusumano and his incredible family for their advocacy efforts to ensure that the region has a robust blood supply to serve cancer patients who rely on blood donations for vital treatment,” said Andrea Cefarelli, Senior Vice President at New York Blood Center Enterprises. “From hosting blood drives, to participating in speaking engagements and spreading awareness, Vinny’s Army has been a great partner and we can’t think of a better organization to honor at our platelet donor event.”

Blood donors can give every 56 days, and platelet donors can give twice per month. The Food and Drug Administration (FDA) recently lifted several blood donor eligibility restrictions. To view current eligibility guidelines, visit nybc.org or call 800.688.0900.

To make an appointment at a donor center near you, donors can call 1-800-933-2566 or visit nybc.org. Can’t donate blood? You can still support NYBC’s mission by texting ‘NYBC’ to ‘20222’ to give $25.

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About New York Blood Center

Founded in 1964, New York Blood Center (NYBC) has served the tri-state area for more than 60 years, delivering 500,000 lifesaving blood products annually to 150+ hospitals, EMS and healthcare partners. NYBC is part of New York Blood Center Enterprises (NYBCe), which spans 17+ states and delivers one million blood products to 400+ U.S. hospitals annually. NYBCe additionally delivers cellular therapies, specialty pharmacy, and medical services to 200+ research, academic and biomedical organizations. NYBCe’s Lindsley F. Kimball Research Institute is a leader in hematology and transfusion medicine research, dedicated to the study, prevention, treatment and cure of bloodborne and blood-related diseases. NYBC serves as a vital community lifeline dedicated to helping patients and advancing global public health. To learn more, visit nybc.org. Connect with us on Facebook, X, Instagram, and LinkedIn.

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By Daniel Dunaief

They don’t always follow the same path with any two sufferers, but people who have migraines can and often do find themselves with symptoms including head pain, discomfort, numbness and nausea that make working, caring for family members or functioning difficult.

Dr. Sharon Nachman. Courtesy Stony Brook Medicine Facebook page

Among the first symptoms listed when COVID-19 became a pandemic in 2020, headaches can and have become more severe for people who become infected and then endure additional symptoms in the ensuing weeks and months.

People with migraines often suffer from a throbbing headache, nausea, sensitivity to light and loud noises that worsen with movement.

The other associated features can be “just as disabling as the pain,” said Dr. Noah Rosen, director of the Headache Program for Northwell Health. “Now that we see some of the symptoms cross over with long COVID symptoms, that becomes more salient.”

At this point, amid anecdotal evidence of migraines and long COVID, health care providers can’t say conclusively whether an infection with the current strain of the virus presents any more risk of developing migraines sometime after an infection than they were with earlier strains of the SARS-CoV-2 virus.

“There’s no central reporting of symptoms,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “If you get a vaccine and you have an adverse event, you can report it. There’s no such thing for long COVID.”

Indeed, with people continuing to pass along the virus in schools, workplaces, crowded subways and other places where people gather in confined indoor spaces, the long COVID population has “overtaken any ability to track those symptoms,” Nachman said.

Nachman added that migraines could be a symptom of something else.

“It’s hard to say a true cause and effect” with regard to a particular symptom, as some immune systems may have such a strong response that they are creating autoimmune problems.

Migraines are also seen in patients with autoimmune diseases, Nachman said.

For some patients, doctors may want to do a full immune workup to make sure they are not having an autoimmune reaction.

As for long COVID symptoms, people “across the board” are developing various maladies after contracting the illness that caused the pandemic, Nachman said.

While it’s unclear at this point whether migraines or other specific symptoms increase amid the current strain of long COVID, doctors urged people who have underlying medical conditions to get tested when they develop symptoms.

“Fewer people are actually treating the acute phase,” said Rosen. “There was some evidence that early treatment with Paxlovid can reduce the risk of long-term COVID.”

Indeed, people in high-risk groups can lower the chance of dealing with additional symptoms, called sequelae, after an initial infection.

Treatments

While numerous treatments are approved for migraines, it is unclear which might be best for people who develop these extreme and potentially debilitating headaches in the aftermath of COVID.

“Many of the new treatments haven’t been specifically looked at for post-COVID” migraines, said Rosen.

Migraines can become enough of an interruption to daily life that people alter their behaviors in between episodes, during the so-called interictal period.

Even without the pain, migraine sufferers can avoid activities because they are afraid of a trigger.

This can affect people’s social interactions or their job choices, among other decisions.

“If people are noting that they are unable to do things that they were doing before or are avoiding certain tasks, they need to step up in treatment,” said Rosen.

In terms of treating migraines, Rosen suggested that beneficial pharmacological options, such as triptans, have been around since the 1990s.

Triptans are a group of medicines that treat migraines by changing how blood circulates in the brain and how the brain processes pain signals, according to the Cleveland Clinic.

Rosen said Imitrex and Maxalt are used to treat migraines during the mild phase.

“Early treatment can lead to shorter symptoms or less medicine being used and less disability,” Rosen said.

The average migraine lasts about four hours. A migraine that lasts more than 72 hours is described as “migrainosis,” which can be disabling and can require a combination of medications.

People can reduce the risk of migraines through some lifestyle modifications, such as ensuring sufficient hydration, not skipping meals, getting regular sleep, avoiding stress or engaging in behaviors that improve resilience to stress, and exercise, Rosen said.

Migraines affect about 12 percent of the population. Additionally, anyone with a migraine has about a 70 percent chance of having a first-degree relative — a parent, sibling or child — who also has migraines, according to Rosen.

Researchers have identified over 40 genes associated with migraines, which makes determining a specific genetic link complex, Rosen said.

With a link between migraines and hormones, women suffer from them at about a three-to-one ratio to men.

Other triggers

Migraine sufferers often try to identify triggers that can bring on these painful and disturbing episodes that can cause fatigue and discomfort even after the episodes end.

Many people are sensitive to environmental changes, like low barometric pressure from storms or excessive changes in temperature.

All of those are increasing amid climate change, which has had a significant effect on migraine sufferers, Rosen said.

Obesity, which is a health issue for the country, can also affect migraines.

“That places an additional burden on the health of people who suffer” from migraines, said Rosen.

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Honor your friends and family with healthier Thanksgiving option

By David Dunaief, M.D.

Dr. David Dunaief

Research tells us that Americans are more likely to gain weight between Thanksgiving and New Year’s Day. This is when many accumulate the greatest weight gain of the year, and most do not lose the weight they gain during this time (1). In the study group, those who were already overweight or obese had the greatest weight gains. If you can avoid weight gain during the holidays, think of the possibilities for the rest of the year.

It’s difficult to maintain healthy eating habits during the Thanksgiving holidays, and the additional stress of the season doesn’t help. Even when we intend to resist, it’s too tempting to indulge in a sprawling buffet or seasonal treats.

Unfortunately, this can have significant health consequences. And if you tend to overeat, be aware that there are short-term consequences of stuffing ourselves. Overeating during a single meal can increase your heart attach risk in the near term, according to the American Heart Association (2).  

How can you turn Thanksgiving dinner into a healthier meal? The secret is often hidden in the side dishes on your table and the snacks you offer. 

Increase the carotenoids

Carotenoids help to prevent and potentially reverse diseases, such as breast cancer, amyotrophic lateral sclerosis (Lou Gehrig’s disease), age-related macular degeneration, and cardiovascular disease. Foods that contain these substances are dark green leafy vegetables, as well as orange, yellow and red vegetables and fruits. These phytochemicals (plant nutrients) have antioxidant and anti-inflammatory effects (3).

Prepare veggies in an appetizing way

Vegetables are often prepared in either an unappetizing way or smothered in cheese and butter, negating any benefits. Fruits are often buttered and sugared beyond recognition or used as a garnish for more decadent dishes. 

Other plant-based foods, like whole grains and leafy greens, are often afterthoughts. Here are some suggestions to get you thinking about ways to shift the heavy holiday meal paradigm:

Elevate plant-based dishes. Supplement tradition by adding mouthwatering vegetable-based dishes. One of my favorites is steamed “sweet” vegetables – cauliflower, broccoli, snap peas, onions and garlic. To make it sweet, I sauté it in a splash of citrus-infused balsamic vinegar and add sliced apples. Who doesn’t love poached apples? You can make this a primary dish by adding diced tofu or garbanzo beans to make it more filling without overwhelming its delicate sweetness.

Add seasonings. Why would you serve vegetables without any seasoning? In my family, we season vegetables and make sauces to drizzle over them. Personally, I’m a fan of infused vinegars. Choose your favorites to add varied flavors to different vegetables. 

Our teenaged nephew, who never liked vegetables, fell in love with my wife’s roasted Brussels sprouts and broccoli while on summer vacation together. He texted her afterward to ask for the recipes, which are surprisingly simple: place them on a roasting tray, add salt-free spices, and roast to your desired tenderness. Now, he makes them for himself. Resources for appealing vegetable dishes can be found at PCRM.org, mouthwateringvegan.com, and many other online resources.

Replace refined grains and starches. A study in the American Journal of Clinical Nutrition showed that replacing wheat or refined grains with whole wheat and whole grains significantly reduced central fat, or belly fat (4). The participants lost superficial fat found just below the skin, as well as visceral adipose tissue, the fat that lines organs and causes chronic diseases such as cancer.

For even better results, consider substituting riced cauliflower or mashed cauliflower for rice or potatoes. You can purchase frozen riced cauliflower in grocery stores now. Be sure to choose one that’s unsalted. If you prefer mashed potatoes, here’s a simple recipe for mashed cauliflower, which is delicious: https://medicalcompassmd.com/post/mashed-cauliflower-recipe-vegan. 

Offer healthy snacks. Choose to lay out trays of whole grain brown rice crackers, baby carrots, cherry tomatoes and healthy dips like low-salt hummus and salsa instead of creamy dips, cheese platters and candies. Help people choose wisely.

Improve dessert options. You might include a dairy-free, sugar-free pumpkin pudding or fruit salad. Both are light and won’t make you feel overstuffed.

Your overarching goal should be to increase your appealing, nutrient-dense options and decrease your empty-calorie foods. Express your gratitude for family and friends and promote their good health with a delicious, thoughtful, festive meal.

References:

(1) N Engl J Med. 2000 Mar 23;342(12):861–867. (2) www.heart.org. (3) Crit Rev Food Sci Nutr 2010;50(8):728–760. (4) Am J Clin Nutr 2010 Nov;92(5):1165-71.

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 or consult your personal physician.

 

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Photo courtesy of Huntington Hospital

Huntington Hospital recently renovated its two cardiac catheterization labs and unveiled new state-of-the-art diagnostic technology. The renovated labs are a combined 1,200 square feet and cost approximately $5 million. 

In addition to the labs which each have a control room, there is a third-floor suite that includes nine beds and a holding area where patients are treated pre-and post-operatively.

“With the renovation of our labs, we continue to be able to provide our community with the highest level of cardiovascular care right here at home,” said Gaurav Rao, MD, director of interventional cardiology at Huntington Hospital. “This means faster diagnoses, efficient treatments, and ultimately, better outcomes for our patients. Having access to such advanced care close to home is not just a convenience, it’s a critical factor in saving lives and improving the overall health of our community.”

The new labs leverage this technology with integrated Coroflow Cardiovascular System to diagnose coronary microvascular dysfunction and coronary spasm, which was made possible through an anonymous donation. Computer-generated coronary physiology maps are utilized to diagnose coronary artery disease and guide interventions. Complex coronary interventions are routinely performed using coherence tomography (OCT), an advanced coronary imaging tool that allows precise plaque characterization to inform optimal calcium modification and tailored stent implant strategies.

“By incorporating cutting-edge technology, we are elevating the standard of cardiac care available in our community,” said Nick Fitterman, MD, president, Huntington Hospital. “This is a testament to our commitment to advancing health care and meeting the needs of our community with the highest level of excellence.”

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Front row, from left, ECLI Co-Founder and Program Development & Education Director Feride Castillo; ECLI Co-Founder and Executive Director Jennifer Hernandez (with scissors); Sheriff Errol D. Toulon Jr; and Legislator Rebecca Sanin. Photo courtesy of ECLI-VIBES
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Front row, from left, ECLI Co-Founder and Program Development & Education Director Feride Castillo; ECLI Co-Founder and Executive Director Jennifer Hernandez (with scissors); Sheriff Errol D. Toulon Jr; and Legislator Rebecca Sanin. Photo courtesy of ECLI-VIBES
ECLI-VIBES ribbon cutting on Oct. 24.
ECLI-VIBES ribbon cutting on Oct. 24.
ECLI-VIBES ribbon cutting on Oct. 24.
ECLI-VIBES ribbon cutting on Oct. 24.
ECLI-VIBES ribbon cutting on Oct. 24.
ECLI-VIBES ribbon cutting on Oct. 24.
ECLI-VIBES ribbon cutting on Oct. 24.
ECLI-VIBES ribbon cutting on Oct. 24.

Empowerment Collaborative of Long Island and Victims Information Bureau of Suffolk (ECLI-VIBES), a Long Island nonprofit organization that helps survivors of domestic violence and sexual assault, has taken over the building that once belonged to Flushing Bank at 1707 Veterans Memorial Highway in Islandia. 

This marks a significant milestone in expanding their impact and support of victims of domestic violence, child abuse, sexual assault, and human trafficking. The momentous occasion was celebrated with a ribbon-cutting ceremony, tours of the new facilities and light bites on Oct. 24.

“We are in a bigger space now, and it feels unreal how far we have come in the physical and organizational growth ,” said Co-Founder and Executive Director Jennifer Hernandez, “My co-founders and I, who built this organization from the ground up, never could have imagined how big it would become and the impact it would have on Suffolk County and beyond.”

The evening’s guests were able to learn more about the services ECLI VIBES provides, such as its fully stocked food and essentials pantry and counseling services. The move to the new facility left no need unmet, providing dedicated spaces for everything from client services to a centrally located water feature where staff can find reprieve from the heaviness of the work. Flushing Bank sold the property with all of the furnishings, allowing ECLI VIBES to be up and running in the new space quickly with minimal construction and labor.

“We know the challenges our community is facing and are showing individuals who can help us with our cause what we are doing to not only help our survivors but how we can stop domestic violence in our community,” said Co-Founder and Program Development & Education Director Feride Castillo. “We believe that with the continued support and involvement of our community, we can make a significant impact.”

Many Suffolk County community leaders and legislators were in attendance, including Legislator Chad Lennon and Legislator Rebecca Sanin, Sheriff Errol D. Toulon Jr. and Detective Sergeant James Murphy and his team from the Suffolk County Police Department’s Anti Trafficking Unit. Organizations that were represented include Long Island Cares and Long Island Harvest.

To learn more about ECLI VIBES and how you can get involved, please visit www.eclivibes.org.

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Minimize serious medication risks with modest lifestyle change

By David Dunaief M.D.

Dr. David Dunaief

If you are planning to enjoy a large Thanksgiving dinner, you’ll probably experience reflux afterward. Here, your stomach contents flow back into your esophagus when the valve between your stomach and your esophagus, the lower esophageal sphincter, relaxes. This is normal, especially after a meal, and doesn’t require medical treatment (1).

Gastroesophageal reflux disease (GERD), however, is more serious and can have long-term health effects. Among them are erosion or scarring of the esophagus, ulcers, and increased cancer risk. Approximately 20 percent of the U.S. adult population has been diagnosed with GERD, although researchers estimate it affects as much as 28 percent (2). It’s no surprise that pharmaceutical firms have lined drug store shelves with all kinds of solutions.

GERD risk factors range from lifestyle — obesity, smoking and diet — to medications, like calcium channel blockers and antihistamines. Other medical conditions, such as hiatal hernia and pregnancy, also play a role (3). Dietary triggers, such as spicy, salty, or fried foods, peppermint, and chocolate, might also contribute.

Medication options

The most common and effective medications for treating GERD are H2 receptor blockers and proton pump inhibitors (PPIs). H2 receptor blockers, such as Zantac and Tagamet, partially block acid production. PPIs, which include Nexium and Prevacid, almost completely block acid production (4). Both have two levels: over-the-counter and prescription strength. Let’s focus on PPIs, for which over 92 million prescriptions are written each year in the U.S. (5).

The most frequently prescribed PPIs include omeprazole (Prilosec) and pantoprazole (Protonix). Studies show they are effective with short-term use in treating Helicobacter pylori-induced peptic ulcers, GERD symptoms, gastric ulcer prophylaxis associated with NSAID use, and upper gastrointestinal bleeds.

Most of the package insert data is from short-term studies lasting weeks, not years. The landmark study supporting long-term use FDA approval was only one year. However, maintenance therapy is usually prescribed for many years.

Concerns about long-term use effects and overprescribing have prompted pharmacists to take an active role in educating patients about their risks and about the need to take them before eating for them to work (6).

PPI risks

PPI side effects after years of use can include increased bone fracture risk; calcium malabsorption; Clostridium difficile (C. difficile), a serious intestinal bacterial infection; potential vitamin B12 deficiencies; and weight gain (7).

The FDA has amplified its warnings about the increased risk of C. difficile, which must be treated with antibiotics. Unfortunately, it only responds to a few, and that number is dwindling. Patients must contact their physicians if they develop diarrhea when taking PPIs and it doesn’t improve (8).

Suppressing stomach acid over long periods can also result in malabsorption issues. In a study where PPIs were associated with B12 malabsorption, it took at least three years’ duration to cause this effect. While B12 was not absorbed properly from food, PPIs did not affect B12 levels from supplementation (9). If you are taking a PPI chronically, have your B12 and methylmalonic acid (a metabolite of B12) levels checked and discuss supplementation with your physician.

Before you stop taking PPIs, consult your physician. Rebound hyperacidity can result from stopping abruptly.

Lifestyle options

A number of lifestyle modifications can improve GERD, such as raising the head of the bed about six inches, not eating prior to bedtime and obesity treatment (10). 

Increase fiber and exercise. A study that quantified the increased risks of smoking and salt also found that fiber and exercise both had the opposite effect, reducing GERD risk (11). An 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 (12).

Lose weight. In one study, researchers showed that obesity increases pressure on the lower esophageal sphincter significantly (13). Intragastric (within the stomach) pressures were higher in both overweight and obese patients on inspiration and on expiration, compared to those with lower body mass indexes.

Eat long before bedtime. A study 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 before bedtime (14).

While drugs have their place in the arsenal of options to treat GERD, lifestyle changes are the first, safest, and most effective approach in many instances. 

References:

(1) Gastroenterol Clin North Am. 1996;25(1):75. (2) Gut. 2014; 63(6):871-80. (3) niddk.nih.gov. (4) Gastroenterology. 2008;135(4):1392. (5) Kane SP. Proton Pump Inhibitor, ClinCalc DrugStats Database, Version 2024.08. Updated August 7, 2024. (6) US Pharm. 2019:44(12):25-31. (7) World J Gastroenterol. 2009;15(38):4794–4798. (8) FDA.gov. (9) Linus Pauling Institute; lpi.oregonstate.edu. (10) Arch Intern Med. 2006;166:965-971. (11) Gut 2004 Dec; 53:1730-1735. (12) JWatch Gastro. Feb. 16, 2005. (13) Gastroenterology 2006 Mar; 130:639-649. (14) 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 or consult your personal physician.

 

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Thoracic surgeon Dr. Andrea Carollo in front of the ION robot. Photo courtesy Lee Weissman

By Daniel Dunaief

Early and prompt detection of any cancer can and often does lead to better patient outcomes. With that in mind, Huntington Hospital recently added a new ION Robotic-Assisted Bronchoscopy to identify and perform biopsies on lung nodules. The robotic system, which the hospital has used on 25 patients, can trim the time for a diagnosis to as little as two to four weeks from as much as 70 days.

“We felt it would be an appropriate investment for the patient population so they wouldn’t have to travel to get a diagnosis in a timely manner,” said thoracic surgeon Dr. Andrea Carollo.

Lung cancer is the leading cause of cancer in Suffolk County, according to Dr. Nick Fitterman, Executive Director of Huntington Hospital. On top of that, two out of three lung cancers are in the outer third of the lungs, which the ION Robot specializes in sampling. Prior to the introduction of this system, patients either traveled to South Shore Hospital or would receive more extensive surgery to sample nodules.

For 90 percent of the patients, these nodules are benign. Not every nodule warrants a biopsy. Doctors use standard guidelines to monitor nodules and perform a procedure when these nodules require further investigation. With the ION Robotic-Assisted Bronchoscopy, these patients, who are under general anesthesia during the analysis, can go home the same day.

Get screened

Huntington Hospital. File photo

Doctors typically recommend further evaluation when nodules come up on a CAT scan. While many residents receive screenings for breast cancer, colorectal cancer, cervical cancer and prostate cancer, few take the time to receive a lung screen, even among those who would benefit from initial and ongoing surveillance. About 79 percent of people eligible for a mammography get one. Of the people eligible for lung cancer screening, however, only about 6 percent receive them, Fitterman added.

“We are woefully, woefully deficient in lung cancer screening,” Fitterman said. “There’s an effective screening tool out there that is widely under utilized.”

The US Preventive Services Task Force recommends that high risk patients between 50 and 80 receive lung cancer screening. High risk patients include those who have smoked a pack of cigarettes a day for 20 years and are either current smokers or have quit smoking within the last 15 years.

“If you are a smoker, you should definitely get involved in lung cancer screening,” said Carollo.

By screening more patients, the hospital can offer immediate services, including surgery and various treatment regimes such as chemotherapy.

Options

Once a CAT scan reveals a nodule that warrants further imaging, doctors have three potential surgical options.

They can use trans-thoracic biopsy if the nodule is of a good size, is in a favorable location and the interventional radiologist performing the procedure thinks it is technically possible.

The overall risk of a collapsed lung is about 10 percent with this approach, but much higher in patients with central lesions and  considerable emphysema. The risk is lower in patients with peripheral nodules and no emphysema. If a pneumothorax occurs, sometimes the patient requires a chest tube and hospital stay for as long as one to seven days.

With ION, the procedure is done through a breathing tube in the mouth and into the airways. The risk of a collapsed lung is less than one percent.

If there is a high suspicion of cancer, doctors can also go straight to surgery, which could be the case for a 50 year-old smoker with a 0.7 centimeter nodule that grew to one centimeter and shows activity on a PET scan.

In that case, the nodule and a portion of the lung are removed and sent to pathology, which evaluates it on site and, in about 20 minutes, can indicate whether it’s cancer. From there, doctors can take more lung tissue and lymph nodes for completion of a cancer operation. They review the tissue samples, which takes about 7 to 10 days to get a full answer of the type of cancer and stage if any mutations occurred.

The ION procedure, which has been available for over five years, decreases the risk of a collapsed lung and bleeding and provides an analysis of the nodule more rapidly. The complication rate is lower than with trans thoracic surgery.

At this point, Carollo is doing the majority of these ION-assisted biopsies, while pulmonologist, Dr. Nazir Lone, is doing some, as well.

In the ION procedure, doctors use a roller ball and a wheel that requires eye-hand coordination.

The company provides training to get certified and it takes about 10 to 15 of these procedures for a surgeon to feel comfortable doing them on his or her own, Carollo said.

Huntington Hospital ensures that doctors have sufficient training before allowing them to treat or diagnose patients. “Whenever we adopt any new technology or procedure, we have significant quality guardrails,” said Fitterman.

“We make sure that anyone operating on a machine first is proctored by someone else who is facile with it. They sign off and say, ‘Yes, you now met competencies. You can do it.’”

The speed of the analysis has important implications for patients. “If we can get this done in 30 days from the time we find something to treatment, that’s huge,” Carollo said. “Patients tend to have better outcomes. They live longer,” he continued. Delays over 50 days lead to decreased one and five year survival.

Other new developments

Huntington Hospital has several other new developments in the works.

The hospital is building a new cancer center in Greenlawn as well as expanding its labor and delivery capacity to provide services to more pregnant women.

Ever since St. Catherine of Siena closed its obstetrical unit on Feb. 1, Huntington Hospital has seen an increase in the number of pregnant patients.

The labor and delivery suites will add four beds and will refresh the space the hospital currently uses. The mother-baby units are “beautiful,” but the suites have to “catch up to that,” said Fitterman.

In the third quarter of next year, during the renovation, the labor and delivery areas will move to a place where the old emergency space had been. The improvements are expected to take about three months.

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Photo from Mather Hospital/Jim Lennon

Northwell’s Mather Hospital in Port Jefferson earned its 21st “A” Hospital Safety Grade from The Leapfrog Group, the most of any Suffolk Country Hospital. Leapfrog, an independent national nonprofit watchdog focused on patient safety, assigns an “A,” “B,” “C,” “D” or “F” grade to general hospitals across the country based on over 30 performance measures reflecting errors, accidents, injuries and infections, as well as the systems hospitals have in place to prevent them.

“Patient safety and raising health for everyone are the top priorities at Mather Hospital and the goal of every team member,” said Mather President Kevin McGeachy. “I applaud this continued recognition of our hospital’s achievements in patient safety by the Leapfrog Group. Mather Hospital is committed to continuous improvement in safety and patient satisfaction and exceeding expectations about the care we provide to our community.”

“Achieving an ‘A’ Hospital Safety Grade is a significant accomplishment for Mather Hospital,” said Leah Binder, president and CEO of The Leapfrog Group. “It reflects enormous dedication to your patients and their families, and your whole community should be proud. I extend my congratulations to Mather Hospital, its leadership, clinicians, staff and volunteers for their tireless efforts to put patients first.”

 The Leapfrog Hospital Safety Grade stands as the only hospital ratings program focused solely on preventable medical errors, infections and injuries that kill more than 500 patients a day in the United States. This program is peer-reviewed, fully transparent and free to the public. Grades are updated twice annually, in the fall and spring. 

 Full safety grade details and valuable tips for staying safe in the hospital are at  HospitalSafetyGrade.org.

 

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Immunosuppressives can help, but with serious side effects

By David Dunaief, M.D.

Dr. David Dunaief

Eczema is relatively common, affecting 20 percent of children and 10 percent of adults around the world (1). If you are one of the many who experiences eczema, you know the symptoms, which can include skin rashes, itching, pain and redness.

Eczema is a chronic inflammatory process, and it’s likely caused by a combination of genetics and environmental or lifestyle issues (2). Investigation into potential causes is a growing field.

The National Eczema Association details the seven different kinds of eczema on its website, nationaleczema.org. Atopic dermatitis is the most frequently occurring.

While there is no cure, some treatments can ease symptoms and reduce flare-ups. These range from over-the-counter creams and lotions, antihistamines for itchiness, prescription steroid creams, oral steroids, and injectable biologics. Some use phototherapy for severe cases, but there’s not a lot of research suggesting this is effective. Interestingly, diet may play an important role.

Two studies have shown an association between eczema and fracture risk, which we will look at more closely.

Eczema and diet

In a Japanese study involving over 700 pregnant women and their offspring, results showed that when the women ate either a diet high in green and yellow vegetables, beta carotene or citrus fruit there was a significant reduction in the risk of the child having eczema of 59 percent, 48 percent and 47 percent, respectively, when comparing highest to lowest consumption quartiles (3).

Elimination diets may also play a role in identifying allergic causes. One study’s results showed when eggs were removed from the diet of those who were allergic, according to IgE testing, eczema improved significantly (4).

In my practice, I have seen very good results when treating patients who have eczema with dietary changes. My practice has many patients who suffer from some level of eczema. For example, a young adult had eczema mostly on his extremities. When we first met, these were angry, excoriated, inflamed lesions. However, after several months of a vegetable-rich diet, the patient’s skin improved significantly. These results are not unique.

Do immunosuppressives provide a solution?

Injectable biologics are generally recommended for moderate to severe atopic dermatitis when other treatment options have failed (5). Three are approved by the FDA, dupilumab, tralokinumab-ldrm, and lebrikizumab-lbkz.

In trials, they showed good results when topical steroids alone were not effective. Like other monoclonal antibodies, they work by limiting your immune system response. 

Other oral immunosuppressives, such as those used to inhibit organ rejection in transplant patients, are options, as well.

Unfortunately, any suppression of the immune system’s response, whether oral or injectable, leaves the door open for side effects, including serious infections.

Can supplements help reduce symptoms?

Two well-known supplements are known to reduce inflammation, evening primrose oil and borage oil. Are they good replacements for – or additions to – medication? The research is mixed, leaning toward ineffective. There are also some important concerns about them.

In a meta-analysis of seven randomized controlled trials, evening primrose oil was no better than placebo in treating eczema (6). Researchers also looked at eight studies of borage oil and found there was no difference in symptom relief than placebo. 

While these supplements only had minor side effects in the study, they can interact with other medications. For example, evening primrose oil in combination with aspirin can cause clotting problems (7). If you do try them, be sure to consult with your physician first.

What’s the relationship between eczema and bone fractures?

Several studies have examined the relationship between eczema and bone fractures. One observational study of 34,500 patients showed that those with eczema had a 44 percent increased risk of injury causing limitation and a 67 percent risk of bone fracture and bone or joint injury for those over age 29 (8).

Those with both fatigue or insomnia in combination with eczema are at higher risk for bone or joint injury. The researchers postulated that corticosteroid treatments could contribute, in addition to chronic inflammation, which may also add to bone loss risk. Steroids can weaken bone, ligaments and tendons and can cause osteoporosis by decreasing bone mineral density.

A study of over 500,000 patients found that the association between major osteoporotic fractures and atopic dermatitis remained, even after adjusting for a range of histories with oral corticosteroids (9). Also, fracture rates were higher in those with severe atopic dermatitis.

If you have eczema, talk to your physician about having a DEXA (bone) scan to monitor your bone health.

There is an array of possibilities in development, from topical to oral to injectable treatments, which might provide future relief. Until then, partner with your physician to identify solutions that will work for you, but ensure you understand the side effects of what you’re taking. Diet adjustments appear to be very effective, at least at the anecdotal level.

References:

(1) naiad.nih.gov. (2) Acta Derm Venereol (Stockh) 1985;117 (Suppl.):1-59. (3) Allergy. 2010 Jun 1;65(6):758-765. (4) J Am Acad Dermatol. 2004;50(3):391-404. (5) JAMA Dermatol. 2015;151(1):33-41. (6) Cochrane Database Syst Rev. 2013;4:CD004416. (7) mayoclinic.org (8) J Allergy Clin Immunol Pract. 2021 Sep 24;S2213-2198(21)01018-7. (9) nationaleczema.org.

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 or consult your personal physician.

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METRO photo

Although presents garner most of the fanfare during the holiday season, there is no denying that food and entertaining also figure prominently this time of year. Delish magazine reports that Christmas food consumption ranks third, behind Thanksgiving and Super Bowl Sunday, among Americans, and that a single Christmas meal can weigh in at 3,000 calories, not factoring in any other food consumed that day.

No one wants to feel held back while having fun with family and friends, but smart food choices can mean healthier living during this season of festivities. Dish up these alternatives when holiday entertaining.

• Lean on leaner cuts of meat. A strong body is built on protein, and holiday hosts often make a meat or poultry dish the star of the holiday dinner table. When selecting holiday fare, choose leaner options such as “round” or “loin” roasts; otherwise, select white-fleshed fish and skinless poultry in lieu of other options.

• Use broths instead of creams. Soups and gravies are popular this time of year, and both can be made healthier by opting for stock or broth bases over more fattening milks or creams when creating these recipes.

• Create a one-crust pie. Pie is one of the more popular holiday desserts, and plenty of the calories come from a rich, buttery crust. Lighten up by serving a one-crust pie, such as pumpkin or sweet potato. Fruit-based pies like apple or blueberry also can be made with one crust. Simply top the fruit with a light crumb coating.

• Find ways to incorporate vegetables. Vegetables are low in calories and rich in vitamins and nutrients. Many also are high in fiber, so they can help people avoid overeating. According to dietary experts from the American Heart Association, people should aim for four to five servings of vegetables each day. When making a plate, fill half of the plate with vegetables. Enhance dishes like lasagna or other pastas with fresh vegetables as well. See recipe below.

3. Raise the heat to get rid of any liquid that remains. Drizzle in the lemon juice and serve hot. PC226038

• Skip the fried bird. Although deep-frying a turkey can reduce cooking time, frying historically is not the best cooking method for those who are making health-conscious choices. Rather than frying, consider spatchcocking (also known as butterflying) the turkey to enable it to cook faster. Use fresh herbs and seasonings instead of butter and oil to flavor your turkey as well.

• Skip the cocktails. The Center for Science in the Public Interest says that classic cocktails with little to no added sugar typically fall into the 150- to 200-calorie range, while others can be about 200 to 300 calories each. Many people will want to save those extra calories for dessert or another indulgent dish rather than drinking them away. If you want to simulate a cocktail, make a spritzer with sparkling water and unsweetened cranberry juice.

Broccoli with Five Spices

YIELD: Serves 4

INGREDIENTS:

2 tablespoons sunflower oil

1/2 teaspoon cumin seeds

1/2 teaspoon fennel seeds

1/2 teaspoon fenugreek seeds

1/2 teaspoon black mustard seeds

1/2 teaspoon black onion seeds (kalonji)

11/4 pounds broccoli, cut into florets

1 teaspoon turmeric

1 teaspoon chili powder

Salt to taste

1 teaspoon lemon juice

DIRECTIONS:

1. Heat the oil and add all the spice seeds.

2. As they pop and darken, add the broccoli, turmeric, and chili powder, and salt. Mix well and pour in a few tablespoons of water. Bring to a sizzle, then reduce the heat and cook until the broccoli is tender but still holds its shape.

Celebrants can make some smart choices in the foods and beverages they eat to enjoy a healthier holiday season this November and December.

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