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The four person MSU crew Patricia Babiam, Kristofer Martin, patient Bill Rothmeier, Anthony Papaleo and Frank Time, reunite for a reunion.

By Daniel Dunaief

Ralph Sabatino, a lawyer and St. James resident, was in his bedroom, sitting at his computer when he fell out of his chair.

Ralph Sabatino of St. James. Photo courtesy Stony Brook Medicine

When his sister Maria, who was visiting from New Jersey in April of 2023, came into the room, she immediately called his wife Claire, a registered nurse, to come check on him. 

“I noticed his left arm and left leg were paralyzed,” said Claire Sabatino, who has been married to Ralph for almost 44 years. “HIs speech was garbled.”

Claire called 911 and told the dispatcher that her husband was exhibiting the signs of a stroke. Within minutes, an EMS ambulance and one of the two Mobile Stroke Units from Stony Brook hospital arrived.

In the mobile stroke unit, technicians conducted a CAT scan, forwarding the results to Dr. David Fiorella, Director of the Stony Brook Cerebrovascular Center and Co-Director of the Stony Brook Cerebrovascular and Comprehensive Stroke Center at Stony Brook Medicine. When he arrived at the hospital, Sabatino bypassed the emergency room and went directly into an operating room.

Fearing the worst, Claire Sabatino called their adult daughter Gabrielle and told her to get to the hospital as quickly as possible.

“I never saw anybody with the symptoms my husband was exhibiting that fully recovered in the past,” she said. “When I saw him on the floor, I thought that would be the way he’d live for the rest of his life, if he survived. I wasn’t sure he would.”

After the stroke and the operation, Sabatino, who is now 68 years old, has no symptoms following what is far too often a life-altering condition.

“It’s sometimes hard for me to fathom how massive the stroke was because I have had no lingering effects,” he said.

Indeed, Sabatino estimates that the time between when he had the stroke until he was wheeled in the recovery room was about an hour and a half.

“Stroke is an emergency,” said Fiorella. “Although it’s not painful, numbness, weakness involving one side of the body, difficulty with speech, understanding speech, difficulty with vision, anything that presents acutely shouldn’t be ignored. It needs prompt attention.”

As a way to recognize the signs of stroke and the urgency to get help, doctors in this field suggest that people remember the acronym BE FAST, which stands for balance, eyes, face, arm, speech, time.

With seniors representing the fastest growing population on Long Island, residents and their families and caregivers need to be aware of stroke symptoms and, in the event of a stroke, to have an action plan in place.

“We have an aging population and the prevalence of stroke is increasing,” said Fiorella.

In Suffolk County, Stony Brook has two mobile stroke units, positioned on the Long Island Expressway at Exits 57 and 68. These units are located within 10 miles of 46 EMS territories.

Since Stony Brook started deploying these mobile stroke units in April of 2019, these specialized and life-saving ambulances have responded to about 8,000 stroke calls.

During those years, the hospital has demonstrated a significant reduction in time to treatment, with more patients receiving clot busting medications while in transit, and lower rates of mortality and morbidity, Fiorella explained.

A workup and diagnosis at other hospitals can take three or more hours, which a mobile stroke unit can perform with a CAT scan.

Additional benefits

David Fiorella, MD, PhD stand for photo at Stony Brook Hospital on Monday Sept. 12, 2022. (9/12/22)

Fiorella explained that the technicians in the ambulance share considerable information about the patient while in transit, including whatever contact numbers they could collect from family members on site.

Stony Brook Hospital can then begin a dialog with those family members, preparing them for any potential procedures and, if the patient is a candidate for a new treatment, receiving authorization.

A well-established and industry leading stroke unit, Stony Brook is involved in several experimental protocols designed to improve treatment.

“Whenever we can, we offer newer and better technologies,” said Fiorella. By participating, patients not only benefit from advances in the field, but also help the thousands who come after them. Patients can “make tremendous contributions to their own care and to medicine” amid developments and advanced technologies, he said.

In cases where patients or their representatives prefer not to use any advanced or newer technology, Stony Brook provides other life-saving services.

Fiorella added that the mobile stroke unit doesn’t only bring patients to Stony Brook, but also takes them to other comprehensive stroke centers for advanced treatment.

While strokes disproportionately affect the elderly, with the Medical University of South Carolina estimating that 75 percent of strokes occur in people 65 and older, certain conditions can increase the risk of strokes, such as smoking, vascular or heart disease, high blood pressure and peripheral vascular disease.

Another success story

The four person MSU crew Patricia Babiam, Kristofer Martin, patient Bill Rothmeier, Anthony Papaleo and Frank Time, reunite for a reunion.

Bill Rothmeier, who lives in Oakdale, was coming back from upstate in 2019 when his wife Eileen recognized that he was driving strangely.

She asked him to pull over so she could use the restroom. When she returned, she took over the driving. By the time they got home, Rothmeier’s ability to speak had declined.

Eileen Rothmeier spoke to a next door neighbor, who was involved with a community ambulance in Sayville. He had heard about the stroke unit.

“The next thing I knew, two ambulances were in front of my house,” said Bill Rothmeier, who is now 68. The MSU did a CAT scan and gave him a shot on the way to the hospital.

When he was in the recovery room, Rothmeier said Fiorella came in and told him he put in a stent and pulled two blood clots out of his brain.

“He said it like I was going out to a deli to get lunch,” said Rothmeier, who, as it turns out has owned the Lake Grove Deli for 29 years. “If it wasn’t for those guys,” including the MSU crew and Fiorella, “I could be in a nursing home or worse right now.”

Rothmeier was one of the first to receive life saving treatment through the mobile stroke unit and at the hospital.

A rewarding job

While the mobile stroke unit provides an important service for people battling a stroke, it doesn’t add any cost for the patient.

Stony Brook provides the units “free of charge,” because the “outcomes are so much better,” Fiorella said.

Patients who have untreated strokes or whose strokes are treated much later can have an irreversible brain injury, which could involve hospitalizations that last for months.

Stony Brook receives the same flat rate from Medicare for stroke victims, which helps provide financial support for the ambulance and is a “home run” for the patient, Fiorella added.

From Fiorella’s perspective, the opportunity to help people more than compensates for the 2 am calls he sometimes gets when he needs to come in for emergency surgery.

In the 25 years he’s been involved in stroke care, Fiorella has “never lost the fascination in how great the technology has become and how quickly it’s advanced,” he said. After treatment, people who couldn’t speak or understand speech and who couldn’t move the dominant side of their body can return to normal activities.

“It’s such a wonderful experience being involved with this,” he said. “I wouldn’t be able to do this without the support of Stony Brook.”

As for Claire Sabatino, who had never heard of the mobile stroke unit before the ambulance was parked on her driveway last April, the benefit of the rapid transit and the Stony Brook team is “nothing short of a miracle.

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John Perkins and Mike Gugliotti, chief navigation officer and his ‘water Sherpa.’ Photo courtesy Maggie Fischer Memorial Swim

By Daniel Dunaief

What are you planning to do this Saturday?

John Perkins, Community Outreach Manager at St. Charles Hospital and St. Catherine of Siena Hospital and Islip Terrace resident, is planning to swim 12.5 miles around Key West. The swim isn’t just an exercise in rugged outdoor activities or a test of his endurance, but is a way to raise money to support St. Charles Hospital’s stroke support group and promote stroke awareness and prevention.

As of Tuesday morning Perkins, who is 56 years old, has raised $4,900 out of his goal of collecting $5,000.

“Stroke survivors can have challenges for the rest of their lives,” said Perkins. “My hundreds of hours of training and hundreds of miles I’ve swam over the last year is nothing in comparison to someone who has a stroke” and then has a gate impairment, a speech impediment or is visually impaired.

Perkins added that about 80 percent of the estimated 800,000 strokes in the United States are preventable, through efforts like managing high blood pressure and/or diabetes, increasing physical activity and eating a healthier diet.

Perkins hopes the money he raises can add a new piece of equipment in the emergency room or help with the stroke survivor and support group.

Challenging conditions, with help

Getting ready for this swim took considerable work, especially given that Perkins didn’t even know how to swim until he was 50.

That’s when a group of childhood friends called him up in 2017 and suggested he join them for a two mile swim in the Straight of Messina, between Sicily and Calabria.

He rose to the challenge and raised $1,200.

To prepare for this much longer swim, which he estimates could take eight hours of more, he has been getting up at 4 am and is in the pool by 5 a.m.

Three days during the week, he swims two miles before work, often surrounded by people who are training for grueling races like triathlons and ironman competitions. On weekends, he does longer swims. He has been increasing the distances he swims in the pool, recently covering 10 miles in six and a half hours.

When he’s doing these longer swims, he gets out of the pool every two miles to take a 30-second break, which could involve hydrating and a quick restroom stop.

“You can not be a marathon swimmer without considering the nutrition aspect,” he said.

When he’s swimming around Key West, he plans to bring a special blend of carbohydrates, with calcium and magnesium and some protein, making sure he consumes about 300 calories per hour.

In expending over 6,000 calories for the swim itself, he wants to ensure he doesn’t tire or get cramps.

When he swims around Key West, Perkins said his wife Pamela, who is a registered nurse and whom he calls his chief nutritionist, will be in a two-person kayak. She will signal to him every 20 minutes or so to take a break for some liquid nutrition.

Meanwhile, his chief navigation officer, Michael Gugliotti, whom he also refers to as his “water Sherpa,” will ensure that he stays the course, not straying from the checkpoints so that he doesn’t wind up adding any distance to the long swim.

When he’s swimming, Perkins tends to think about the struggles stroke survivors have that they have to deal with for the rest of their lives.

“Strokes impact your life, your community’s life, your family’s life,” he said.

People interested in donating can do so through the following link: St. Charles Host Your Own Fundraiser

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Legislator Trotta donating blood at one of his sponsored drives at Travis Hall, Church of St. Joseph in Kings Park.
One Donation Can Save Three Lives

It’s time to batter up and give blood! Suffolk County Legislator Rob Trotta in conjunction with the Church of St. Joseph in Kings Park will host a community blood drive at Travis Hall located on the lower level of St. Joseph’s at 59 Church Street, on Wednesday,  June 12, from 11 a.m. to 5 p.m. The drive is to benefit the blood banks maintained by Long Island Blood Services, which provides blood to hospitals throughout Long Island. Each donor will receive a pair of New York Mets tickets while supplies last.

To be eligible to donate blood, a person must be between the ages of 16 (16 with parental consent) and 76, (if older than 76, you need written permission from your doctor), weigh over 110 pounds and not have had a tattoo in the last three months. Please bring a valid photo ID with you. LI Blood Services recommends that you eat and drink plenty of fluids before donating. Previous donors should bring their blood donor card with them.

“Hospitals are always in need of blood supplies so it is important that if you can donate blood to do so because one pint of blood can help save three lives. We do a blood drive every year so I thank those who have attended in the past and hope you will consider donating again,” said Suffolk County Legislator Trotta.

For more information, please call Legislator Trotta’s district office at 631-854-3900.

 

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Photo courtesy of Fountaingate Gardens

In celebration of National Senior Health and Fitness Day, Cormack’s Fountaingate Gardens, an independent living community for active adults 62 years and better, hosted a Health and Fitness Fair filled with fun, fitness and informative activities to promote wellness and longevity on May 29.

“We are thrilled with the incredible success of our first Senior Health and Fitness Fair. We had a great turnout and enthusiastic participation from our community members, underscoring the importance of promoting successful aging through healthy, active lifestyles,” said John Mastacciuola, Executive Director of Fountaingate Gardens. “As a Blue Zone-inspired community, we are committed to fostering an environment that supports longevity and well-being. This event is a testament to our dedication to creating a healthier, happier future for our seniors.”

The inaugural expo featured:

  • Fitness Classessuitable for all levels of ability, including a member-favorite Stretch and Tone class and Chair Yoga, both held outdoors on the community’s rotunda. This area of the campus features the backdrop of a tranquil nature preserve, with native wildflowers, a cascading stream and a waterfall.
  • “Move it or Lose it!” Interactive Discussion that focused on the importance of regular physical activity for maintaining health and mobility as we age. In addition, FountaingateGardens’ wellness experts provided practical tips and answered questions, followed by a live exercise demonstration that got everyone moving.
  • Smoothie-Making Bikewhere participants pedaled their way to a delicious and nutritious smoothie! This unique activity playfully and interactively highlights the joy of combining exercise with healthy eating.
  • Blue Zone-inspired Food Tastingcourtesy of Fountaingate Gardens’ culinary team. Attendees had the unique opportunity to sample delicious and nutritious fare inspired by the Blue Zones, regions throughout the world known for their high longevity rates and healthy lifestyles. The sampling menu featured wholesome, plant-based dishes rich in nutrients, designed to fuel both body and mind, such as tabouleh salad, crudité cups and hummus dips.
  • A Wide Variety of Long Island Vendors showcasing health and wellness products, services and resources specifically tailored for seniors.

“Today’s event at Fountaingate Gardens highlights how special they make every day for us members,” said Sheila Maiman, a founding member of Long Island’s newest Life Plan Community . “I’ve met so many new people here and have gotten involved in so many things! It’s wonderful and it all adds joy to your life.”

Photo attached, credit Fountaingate Gardens.

Additional Photos available here: https://drive.google.com/drive/folders/1j8kHEkkAbnQfdX-li80eaCaMClt1yCu7?usp=sharing

 

About Fountaingate Gardens
Fountaingate Gardens, sponsored by Gurwin Healthcare System, is an elegant, 129-apartment home independent living community located on Gurwin’s 36-acre campus in Commack. The addition of Fountaingate Gardens completes Gurwin’s Life Plan Community vision of providing Long Islanders with independent living and assisted living options, short-term rehabilitation, long-term care, memory care and other healthcare services — all on one campus.

Fountaingate Gardens offers a vibrant, Blue Zone-inspired lifestyle for longevity for active adults aged 62 years and older. The community is comprised of beautiful apartment homes, myriad wellness-focused amenities and programs, and offers future financial and healthcare security, providing predictable monthly expenses and access to higher levels of care right on campus if ever needed. Visit FountaingateLI.org to learn more about this unique senior independent living community or call 631-715-2693.

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Not all fruit raises your sugars. METRO photo

By David Dunaief, M.D.

Dr. David Dunaief

Our understanding of type 2 diabetes management is continually evolving. With this, we need to retire some older guidance. Here, we review a few common myths and the research that debunks them.

Myth: Fruit should be limited or avoided.

Fact: Diabetes patients are often advised to limit fruit in any form — whether whole, juiced, or dried — because it can raise your sugars. This is only partly true.

Yes, fruit juice and dried fruit should be avoided, because they do raise or spike glucose (sugar) levels. This includes dates, raisins, and apple juice, which are often added to “no sugar” foods to sweeten them. The same does not hold true for whole fruit, whether fresh or frozen. Studies have shown that patients with diabetes don’t experience sugar level spikes, whether they limit whole fruits or consume an abundance (1). In a different study, whole fruit was even shown to reduce the risk of type 2 diabetes (2).

In yet another study, researchers considered the impacts of different types of whole fruits on glucose levels. They found that berries reduced glucose levels the most, but even bananas and grapes reduced these levels (3). That’s right, bananas and grapes, two fruits people associate with spiking sugar levels and increasing carbohydrate load, actually lowered these levels. The only fruit tested that seemed to have a mildly negative impact on sugars was cantaloupe.

Whole fruit is not synonymous with sugar. One reason for the beneficial effect is the fruits’ flavonoids, or plant micronutrients, but another is their fiber.

Myth: All carbohydrates raise your sugars.

Fact: Fiber is one type of carbohydrate that has distinct benefits. It is important for reducing risk for an array of diseases and for improving their outcomes. This is also true for type 2 diabetes. 

Two very large prospective observational studies, the Nurses’ Health Study (NHS) and NHS II, showed that plant fiber helped reduce the risk of type 2 diabetes (4). Researchers looked at lignans, a type of plant fiber, specifically examining the metabolites enterodiol and enterolactone. They found that patients with type 2 diabetes have substantially lower levels of these metabolites in their urine, compared to the control group without diabetes. There was a direct relationship between the amount of metabolites and the reduction in diabetes risk: the more they consumed and the more metabolites in their urine, the lower the risk. The authors encourage patients to eat more of a plant-based diet to get this benefit.

Foods with lignans include cruciferous vegetables, such as broccoli and cauliflower; an assortment of fruits and whole grains; flaxseed; and sesame seeds (5). The researchers could not determine which plants contributed the greatest benefit; however, they believe antioxidant activity drives this effect.

Myth: You should you avoid soy when you have diabetes.

Fact: In diabetes patients with nephropathy (kidney damage or disease), soy consumption was associated with kidney function improvements (6). There were significant reductions in urinary creatinine levels and proteinuria (protein in the urine), both signs that the kidneys are beginning to function better.

This was a four-year, small, randomized control trial with 41 participants. The control group’s diet comprised 70 percent animal protein and 30 percent vegetable protein, while the treatment group’s diet consisted of 35 percent animal protein, 35 percent textured soy protein and 30 percent vegetable protein.

This is very important, since diabetes patients are 20 to 40 times more likely to develop nephropathy than those without diabetes (7). It appears that soy protein may put substantially less stress on the kidneys than animal protein. However, those who have hypothyroidism and low iodine levels should be cautious about soy consumption; some studies suggest it might interfere with synthetic thyroid medications’ effectiveness (8).

Myth: Bariatric surgery is a good alternative to lifestyle changes.

Fact: Bariatric surgery has grown in prevalence for treating severely obese (BMI>35 kg/m²) and obese (BMI >30 kg/m²) diabetes patients. In a meta-analysis of 16 randomized control trials and observational studies, the procedure led to better results than conventional medicines over a 17-month follow-up period for HbA1C (three-month blood glucose), fasting blood glucose and weight loss (9). During this period, 72 percent of those patients treated with bariatric surgery went into diabetes remission and had significant weight loss.

However, after 10 years without proper management involving lifestyle changes, only 36 percent remained in diabetes remission, and many regained weight. Thus, even with bariatric surgery, altering diet and exercise are critical to maintaining long-term benefits.

We still have a lot to learn with diabetes, but our understanding of how to manage lifestyle modifications, specifically diet, is becoming clearer. Emphasizing a plant-based diet focused on whole fruits, vegetables, beans and legumes can improve your outcomes. If you choose a medical approach, bariatric surgery is a viable option, but you still need to make significant lifestyle changes to sustain its benefits.

References:

(1) Nutr J. 2013 Mar. 5;12:29. (2) Am J Clin Nutr. 2012 Apr.;95:925-933. (3) BMJ online 2013 Aug. 29. (4) Diabetes Care. online 2014 Feb. 18. (5) Br J Nutr. 2005;93:393–402. (6) Diabetes Care. 2008;31:648-654. (7) N Engl J Med. 1993;328:1676–1685. (8) Thyroid. 2006 Mar;16(3):249-58. (9) Obes Surg. 2014;24:437-455.

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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Christopher Albano, BSN, RN, pictured second from left, with Tara Matz, Kevin McGeachy and Tabitha Spinelli, RN, BSN, Emergency Department Nurse Manager, received the DAISY Award for Extraordinary Nurse. Photo from Mather Hospital
Catherine Castro, BSN, RN-BC, pictured in the center with with Tara Matz, Chief Nursing Officer/VP for Nursing and Executive Director Kevin McGeachy, received the DAISY Nurse Leader Award. Photo from Mather Hospital

Two Mather Hospital nurses in Port Jefferson were recognized during the recent Nurses Week with DAISY Awards®, a special honor given to extraordinary nurses for the compassionate contributions they make every day going above and beyond expectations in science and sensitivity.

Catherine Castro, BSN, RN-BC received the DAISY Nurse Leader Award. “Catherine sets the stage through role modeling and is an exemplar in establishing a unit where she creates trust, compassion, and mutual respect with her team and members of the interprofessional team. She is easily accessible and is seen caring for patients and rounding on the unit to support the staff and to care for the patients,” according to her nomination by her peers.   

“Catherine works with many disciplines to ensure patient outcomes are not only met, but exceeded, and has an innovative approach to how care is  provided. She collaborated with her team and Justin Stroker, Patient & Customer Experience Director to create a gaming platform to improve medication education on 2 South. She then met with Information Services and Pharmacy to identify the most common medications on 2 South to create quizzes for the patients to test their knowledge of their medications.”

Christopher Albano, BSN, RN received the DAISY Award for Extraordinary Nurse. “My recent experience under Chrisopher Albano’s care was not only medically exceptional, but also deeply humanizing during one of the most vulnerable times of my life. Upon my arrival at the Emergency Room with severe abdominal pain, I was anxious and fearful; uncertain of what was happening to me. It was Christopher who first greeted me with a warmth and professionalism that immediately offered comfort. He displayed an extraordinary level of expertise and attentiveness as he quickly assessed my condition,” wrote a patient who nominated him.

“His actions were pivotal when it was discovered that I was in life-threatening heart block, necessitating the urgent placement of a pacemaker. What set Christopher apart was not just his clinical skills, which were undoubtedly exceptional, but his unparalleled compassion and empathy. He made me feel seen, heard, and valued. He provided not just medical care but emotional support, explaining every procedure with patience and ensuring I understood my condition and the necessary interventions. Remarkably, after I was admitted and recovering from the pacemaker procedure, Christopher went above and beyond his duties by visiting me.”

The DAISY (Diseases Attacking the Immune System) Award® was established by the family of J. Patrick Barnes who died of complications from an autoimmune disease at the age of 33. During Pat’s hospitalization, his family was awestruck by the care and compassion his nurses provided for him and everyone in his family. 

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Dr. Suzanne Fields, Professor of Clinical Medicine and Chief of the Division of General, Geriatric and Hospital Medicine. Photo courtesy of Stony Brook Medicine

By Daniel Dunaief

A year after its formation, the Center for Healthy Aging has not only brought groups of scientists and doctors across the Stony Brook University campus together, but has also funded several early-stage projects.

An initiative started by SBU President Maurie McInnis and that received financial support from the Stony Brook University Presidential Innovation and Excellence Fund, the CHA is currently jointly run by interim co-directors Dr. Suzanne Fields, Professor of Clinical Medicine and Chief of the Division of General, Geriatric and Hospital Medicine and Dr. Christine DeLorenzo, Professor of Psychiatry and Biomedical Engineering and Director of the Center for Understanding Biology using Imaging Technology.

The CHA has several themes, including helping people live longer and healthier lives. In addition, it will serve as a research center that will include basic science, translational, clinical and health services research.

McInnis spoke with Dr. Peter Igarashi, the Dean of the Renaissance School of Medicine at Stony Brook University, to create this initiative.

Dr. Igarashi wanted to make it a center where people from different departments in the university, the five Health Sciences Schools and the Program in Public Health, as well as affiliated institutions such as the Northport VA and the Long Island State Veterans Home collaborated on innovative projects related to aging.

Fields and DeLorenzo anticipate the collaborative research with bioinformatics, pharmacology and bioengineering, for example, will help clinical providers prescribe effective medications for older patients safely through special alerts/ suggestions, identify patients at risk for falling through mobility sensors, and assist clinical providers with AI diagnostic tools.

‘Shark Tank’

Last June, the CHA held a workshop in the style of the “Shark Tank” television show.

Over 100 faculty members attended that meeting from different parts of the university, where they formed groups with other attendees to pose research questions and address challenges people face as they age.

“There was so much enthusiasm there,” said DeLorenzo. “We have so much expertise on campus. We have brilliant researchers who are working on everything from age-related effects at the cellular level all the way through to lifestyle interventions for elderly folks.”

After that meeting, the CHA provided $40,000 to two projects, hoping the support could help ideas get off the ground enough that the principal investigators could then apply to larger funding agencies, such as the National Institutes of Health and the National Institute on Aging, for additional funding.

Led by Adam Singer, the chair of the Emergency Room department, one group of faculty developed ideas to help people who suffered from falls.

“When people who are elderly come into the ER and they’ve fallen, the chances” of them falling again doubles, according to the Centers for Disease Control and Prevention,” said DeLorenzo. “What I love about that pitch the table gave, which was a mixture of clinicians, biomedical engineers, a respiratory therapist, and a physical therapist is that people were coming at this question from all angles.”

The group pitched an idea to create an intervention program that helps explain how to change a person’s lifestyle to prevent another fall.

Senescent cells

Markus Riessland, an Assistant Professor in the Empire Innovation Program in the Department of Neurobiology and Behavior, led the other funded pitch.

Riessland’s project looks at a particular type of cell that can become problematic as people age.

Older cells sometimes get stuck in a senescent state, where they don’t die, but give off signals that cause an inflammatory response.

Riessland’s group “got together and asked, ‘How can we intervene to clear away these senescent cells?’” said DeLorenzo.

Young immune systems typically recognize senescent cells and remove them. As people age, the immune system has a diminished ability to detect and remove these cells, causing inflammaging, which describes a build up of inflammation during the aging process, Riessland explained in an email.

“If you remove senescent cells from an old mouse, these mice show improvements in the function of virtually all tissue” including heart, liver, lung and brain and the lifespan increases by 30 percent, Riessland added.

Researchers have hypothesized that there is also a threshold number of senescent cells a human body can tolerate. If a person exceeds that threshold, it “causes inflammaging and age-related symptoms,” he wrote.

Based on his laboratory work, Riessland found that specific neurons in the brain become senescent and that these neurons secrete proinflammatory factors.

Riessland and his colleagues aim to ameliorate this inflammation and have found a molecular regulator that could be a drug target.

Based on the work Riessland did through the CHA study, he and his colleagues are writing a grant proposal for the National Institutes of Health. In the future, he, DeLorenzo and Dr. Carine Maurer will perform a clinical trial on Long Island that will assess the feasibility to ameliorate the inflammaging process in patients with Parkinson’s disease.

Fall awards

In the fall, the center gave out six awards for $40,000 each and six for $100,000, many of which were in basic science, according to Dr. Fields.

“There was a broad array of topics, with some translational and some basic,” said Fields. “We’re following up with those people.”

Nancy Reich, a Professor of Microbiology & Immunology, received support as a part of the fall round.

The funding from CHA has “allowed us to begin to investigate the development of pancreatic cancer in the older population versus the young using a mouse cancer model,” Reich explained in an email. “Our hypothesis centers on the immune defense response.”

Search for a new director

Now that the center has made some headway and brought various teams together, the university is searching for a permanent director.

“It’s a real joy and pleasure to see this center start up,” said DeLorenzo.

DeLorenzo urges anyone interested in learning more to check the center’s web site, Center for Healthy Aging | Renaissance School of Medicine at Stony Brook University.

“We have events, and we would love for the community to go to them,” said DeLorenzo.

DeLorenzo encourages community members to reach out to Fields and her with any questions.

Riessland added that the CHA-funded projects will “have an impact on the understanding of the aging process itself.”

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Michael Epifania, DO Photo by Jeanne Neville/Stony Brook Medicine

Michael Epifania, DO, and his practice at 280 Union Avenue in Holbrook have joined Stony Brook Medicine Community Medical Group, Stony Brook Medicine’s expanding network of community practices.  

“We are excited to welcome Michael Epifania, DO, to our growing network of community practices,” said Dara Brener, MD, Clinical Quality Director of Stony Brook Medicine Community Medical Group. “We continue to grow our primary care practices, as we feel it is important to have a good foundation of care in each community and this starts with your primary care physician.”

Dr. Epifania is a family medicine physician who provides primary care to patients in Holbrook and the surrounding communities. “I look forward to bringing my expertise, intellect, and passion to Stony Brook Medicine, fostering strong connections with patients and families, and furthering my commitment to holistic care and community well-being,” he said. For more information, call 631-216-9253.

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An international panel of sleep experts including researchers at Stony Brook University formally agree in a consensus statement that reducing pre-bedtime digital media, especially for children and adolescents, will improve sleep health. Getty Images

SBU Professor Lauren Hale Chairs the National Sleep Foundation’s panel that published a consensus statement

Since the smartphone’s emergence in 2007, digital screen time has ballooned in use over the years for children and adults. How use of smartphones and other digital screen devices affects sleep continues to be debated. In a review of 574 peer-reviewed published studies on the issue, an international panel of sleep experts selected by the National Sleep Foundation (NSF) has drawn up a consensus statement about digital screen use and sleep.

The consensus statement, titled “The Impact of Screen Use on Sleep Health Across the Lifespan: A National Sleep Foundation Consensus Statement,” is published in Sleep Health, the journal of the NSF. They assessed studies on screen time and its effects on sleep including research on children, adolescents, and/or adults.

After an extensive review of this large collection of studies over the course of a year, the panel reached consensus on a number of key points.

They agreed that: 1) In general, screen use impairs sleep health among children and adolescents; 2) The content of screen use before sleep impairs sleep health of children and adolescents, and 3) Behavioral strategies and interventions may attenuate the negative effects of screen use on sleep health.

”Upon review of the current literature, our panel achieved consensus on the importance of reducing pre-bedtime digital media to improve sleep health, especially for children and adolescents,” says Lauren Hale, PhD, Chair of the Consensus Panel and Professor in the Program of Public Health at Stony Brook University, and in the Department of Family, Population, and Preventive Medicine at the Renaissance School of Medicine at Stony Brook. “We also identified the gaps in the literature and the need for future research.”

The NSF provides recommendations for best practices to reduce the impact of screen use on sleep.

In summary, they suggest:

  • Avoiding stimulating or upsetting material near bedtime
  • Implementing early, regular, and relaxing bedtime routines without screens
  • Setting time limits around screen use, especially in the evening and at night
  • Parents talking with children about how using tech and screens can impact sleep
  • Parents modeling appropriate nighttime screen use for children

“The expert panel examined available scientific evidence, paying close attention to studies that examined whether, how, and for whom screen use might negatively impact sleep health. We found that stimulating content of screen use, particularly at night, has a negative effect on sleep health in young people,” adds NSF Vice President of Research and Scientific Affairs, Joseph Dzierzewski, PhD.

Lauren Hale and three other coauthors on the consensus statement were from Stony Brook University:  Gina Marie Mathew, Isaac Rodriguez, and librarian Jessica A. Koos, who helped identify the published peer-reviewed original research and literature reviews using databases, including the National Library of Medicine’s PubMed, Elsevier’s EMBASE, and Clarivate’s Web of Science.

Insufficient sleep duration is both widespread and associated with a higher risk of adverse health outcomes, including obesity, cardiovascular disease, and depression. Having inconsistent sleep schedules is also associated with adverse health outcomes. For more information about sleep health, see this NSF webpage on Sleep Health Topics.

 

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Walking routinely can reduce your risk of dialysis.Stock photo

By David Dunaief, M.D.

Dr. David Dunaief

In my recent article about chronic kidney disease (CKD), I wrote that about 90 percent  of the estimated 35.5 million U.S. adults who have CKD are not even aware they have it (1).

How is this possible?

CKD is typically asymptomatic in its early stages. Once it reaches moderate stages, vague symptoms like fatigue, malaise and loss of appetite can surface. It’s when it reaches advanced stages that symptoms become more evident. Those at highest risk for CKD include patients with diabetes, high blood pressure and those with first-degree relatives who have advanced disease.

What is the effect of CKD?

Your kidneys are essentially little blood filters. They remove waste, toxins, and excess fluid from your body. They also play roles in controlling your blood pressure, producing red blood cells, maintaining bone health, and regulating natural chemicals in your blood. When your kidneys aren’t operating at full capacity, it can cause heart disease, stroke, anemia, infection, and depression — among others.

How often should you be screened for CKD?

If you have diabetes, you should have your kidney function checked every year (2). If you have other risk factors, like high blood pressure, heart disease, or a family history of kidney failure, talk to your physician about a regular screening schedule. A 2023 Stanford School of Medicine study recommends screening all U.S. residents over age 35. The authors conclude that the cost of screening and early treatment would be lower than the long-term cost of treatment for those undiagnosed until they are in advanced stages (3). In addition, they project it will improve life expectancy.

Does basic exercise help?

One study shows that walking reduces the risk of death by 33 percent and the need for dialysis by 21 percent (4). Those who walked more often saw greater results: participants who walked one-to-two times a week had a 17 percent reduction in death and a 19 percent reduction in kidney replacement therapy, while those who walked at least seven times per week experienced a more impressive 59 percent reduction in death and a 44 percent reduction in the risk of dialysis. The study included 6,363 participants with an average age of 70 who were followed for an average of 1.3 years.

How does protein consumption affect CKD?

With CKD, more protein is not necessarily better. It may even be harmful. In a meta-analysis of 17 studies of non-diabetic CKD patients who were not on dialysis, results showed that the risk of progression to end-stage kidney disease, including the need for dialysis or a kidney transplant, was reduced 36 percent in those who consumed a very low-protein diet, rather than a low-protein or a normal protein diet (5).

How much should I reduce my sodium consumption?

In a study, results showed that a modest sodium reduction in our diet may be sufficient to help prevent proteinuria (protein in the urine) (6). Here, less than 2000 mg per day was shown to be beneficial, something all of us can achieve.

Are some high blood pressure medications better than others?

We routinely give certain medications, ACE inhibitors or ARBs, to patients who have diabetes to protect their kidneys. What about patients who do not have diabetes? ACEs and ARBs are two classes of high blood pressure medications that work on the kidney systems responsible for blood pressure and water balance (7). Results of a study show that these medications reduced the risk of death significantly in patients with moderate CKD. Most of the patients were considered hypertensive.

However, there was a high discontinuation rate among those taking the medications. If you include the discontinuations and regard them as failures, then all who participated showed a 19 percent reduction in risk of death, which was significant. However, if you exclude discontinuations, the results are much more robust with a 63 percent reduction. To get a more realistic picture, this result, including both participants and dropouts, is probably close to what will occur in clinical practice unless patients are highly motivated.

Should you take NSAIDs?

Non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen and naproxen, have been associated with CKD progression and with kidney injury in those without CKD (1). NSAIDs can also interfere with the effectiveness of ACE inhibitors or ARBs. Talk to your doctor about your prescription NSAIDs and any other over-the-counter medications and supplements you are taking.

What should I remember?

It’s critical to protect your kidneys. Fortunately, basic lifestyle modifications can help; lowering sodium modestly, walking frequently, and lowering your protein consumption may all be viable options. Talk to your physician about your medications and supplements and about whether you need regular screening. High-risk patients with hypertension or diabetes should definitely be screened; however, those with vague symptoms of lethargy, aches and pains might benefit, as well.

References:

(1) cdc.gov. (2) niddk.nih.gov (3) Annals of Int Med. 2023;176(6):online. (4) Clin J Am Soc Nephrol. 2014;9(7):1183-9. (5) Cochrane Database Syst Rev. 2020;(10):CD001892. (6) Curr Opin Nephrol Hypertens. 2014;23(6):533-540. (7) J Am Coll Cardiol. 2014;63(7):650-658.

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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