The Town of Smithtown Horizons Counseling and Education Center will mark International Overdose Awareness Day (IOAD) and Substance Abuse and Mental Health Services Administration (SAMHSA) Recovery Month by holding a Narcan training event for the community. On Thursday, August 31 from noon to 1 p.m. there will be a free Narcan training seminar in the Community Room of Horizons Counseling and Education Center, located at 161 E. Main Street in Smithtown.
“Our communities are living in a time that fatal and non-fatal overdose has affected each individual directly or in-directly. Everyone knows someone who has overdosed either personally or through a friend, family member, co-worker or acquaintance. With Fentanyl infecting our communities; awareness, prevention, treatment, policy and stigma relevant to loss of life involving the drug, are all examples of the importance of International Overdose Awareness Day and what the campaign targets throughout the world. At Horizons, we understand the effect overdose has on the person and their loved ones. Narcan is a lifesaving drug that can reverse opioid overdose and training like the one we are offering is valuable to the public in recognizing the signs and symptoms of and responding to overdose. Narcan administration is a simple method of emergency response that carries an immense lifesaving result,” said Joe Bieniewicz, Director of Drug and Alcohol Counseling Services’
On International Overdose Awareness Day, people and communities come together to raise awareness of one of the world’s most urgent public health crises – one that, unfortunately, is only getting worse. Having an outpatient drug and alcohol agency right in the township is an asset for the community. Additionally, learning the signs of an overdose can help save a life. The IOAD 2023 theme of “Recognizing those people who go unseen” is about acknowledging people in our communities who are affected by overdose but might go unseen in the crisis.
Narcan kits will be provided for free. Horizons Counseling and Education Center resource tables will be set up around the training area, filled with information about recovery services, the outpatient program and substance misuse prevention education. All are welcome to attend to get trained and to hear about the drug and alcohol treatment and prevention services that Horizons provides.
Studies suggest lifestyle approaches to improve symptoms
By David Dunaief, M.D.
Dr. David Dunaief
Irritable bowel syndrome (IBS) symptoms, such as abdominal pain, cramping, bloating, constipation and diarrhea, can directly affect your quality of life. If you are among the estimated 10 to 15 percent of the population that suffers from IBS symptoms, managing these symptoms can become all-consuming (1).
While diagnosing IBS is challenging, physicians use discrete criteria physicians to provide a diagnosis and eliminate more serious possibilities. The Rome IV criteria comprise an international effort to help diagnose and treat functional gastrointestinal disorders. Using these criteria, which include frequency of pain and discomfort over the past three months, alongside a physical exam helps provide a diagnosis.
Fortunately, there are several approaches to improving symptoms that require only modest lifestyle changes.
How is IBS affected by mental state?
The “brain-gut” connection refers to the direct connection between mental state, such as nervousness or anxiety, to gastrointestinal issues, and vice versa.
Mindfulness-based stress reduction was used in a small, but randomized, eight-week clinical trial with IBS (2). Those in the mindfulness group (treatment group) showed statistically significant results in decreased severity of symptoms compared to the control group, both immediately after training and three months post-therapy.
Those in the treatment group were instructed to do meditation, gentle yoga and “body scanning” — focusing on one area of the body for muscle tension detection. The control group attended an IBS support group once a week.
Could gluten be a factor in IBS?
Gluten sensitivity may be an important factor for some IBS patients (3). In a small randomized clinical trial, patients who were given gluten were more likely to complain of uncontrolled symptoms than those who were given a placebo, 68 percent vs. 40 percent, respectively (4). These results were highly statistically significant, and the authors concluded that nonceliac gluten intolerance may exist.
I suggest to my patients that they might want to start avoiding gluten and then add it back into their diets slowly to see the results.
Does fructose play a role in IBS?
Some IBS patients may suffer from fructose intolerance. In a study, IBS researchers used a breath test to examine this possibility (5). The results were dose-dependent, meaning the higher the dose of fructose, the greater the effect researchers saw. When patients were given a 10 percent fructose solution, only 39 percent tested positive for fructose intolerance, but when they were given a 33 percent solution, 88 percent of patients tested positive.
The symptoms of fructose intolerance included gas, abdominal pain, bloating, belching and alternating bowel habits. The authors concluded that avoidance of fructose may reduce symptoms in some IBS patients.
According to another study, about one-third of IBS patients are fructose intolerant. When on a fructose-restricted diet, symptoms appeared to improve (6). Foods with high levels of fructose include certain fruits, like apples and pears, but not bananas.
Are lactose intolerance and IBS connected?
Another small study found that about one-quarter of patients with IBS also have lactose intolerance (7).
Of the IBS patients who were also lactose intolerant, there was a marked improvement in symptoms at both six weeks and five years when placed on a lactose-restricted diet.
Though the trial was small, the results were statistically significant, which is impressive. Both the patient compliance and long-term effects were excellent, and visits to outpatient clinics were reduced by 75 percent. This demonstrates that it is probably worthwhile to test patients who have IBS symptoms for lactose intolerance.
Will probiotics help with IBS?
A study that analyzed 42 trials focused on treatment with probiotics shows there may be a benefit to probiotics, although the objectives, or endpoints, were different in each trial (8).
Probiotics do show promise, including the two most common strains, Lactobacilli and Bifidobacteri, which were covered in the review.
Is there a link between IBS and migraines?
A preliminary study has suggested there may be a link between IBS and migraine and tension-type headaches. The study of 320 participants, 107 with migraine, 107 with IBS, 53 with episodic tension-type headaches (ETTH), and 53 healthy individuals, identified significant occurrence crossover among those with migraine, IBS and ETTH. Researchers also found that these three groups had at least one gene that was distinct from healthy participants. Their hope is that this information will lead to more robust studies that could result in new treatment options (9).
All of these studies provide hope for IBS patients. These are treatment options that involve modest lifestyle changes. Since the causes can vary, a strong patient-doctor connection can help in selecting an approach that provides the greatest symptom reduction for each patient.
References:
(1) American College of Gastroenterology [GI.org]. (2) Am J Gastroenterol. 2011 Sep;106(9):1678-1688. (3) Am J Gastroenterol. 2011 Mar;106(3):516-518. (4) Am J Gastroenterol. 2011 Mar;106(3):508-514. (5) Am J Gastroenterol. 2003 June;98(6):1348-1353. (6) J Clin Gastroenterol. 2008 Mar;42(3):233-238. (7) Eur J Gastroenterol Hepatol. 2001 Aug;13(8):941-944. (8) Aliment Pharmacol Ther. 2012 Feb;35(4):403-413. (9) American Academy of Neurology 2016, Abstract 3367.
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.
Advanced Urology Centers of New York, a division of Integrated Medical Professionals (IMP) and an affiliate of Solaris Health, has announced that Jed C. Kaminetsky, MD, FACS has joined their roster of world-class urologists. Dr. Kaminetsky has a long history of providing excellent care and is a recognized national expert in the field of clinical research. He will also be assuming the role of Research Director at (IMP).
“Adding a strong researcher like Dr. Kaminetsky to our team positions us to explore emerging trends, identify gaps in medical knowledge and contribute to the advancement of medical science,” said Dr. Deepak A. Kapoor, Market President of Integrated Medical Professionals, headquartered in Farmingdale, New York, and Chairman and Chief Ecosystem Officer of Solaris Health. “We always leverage resources so that we can tailor medical interventions to significantly improve patient outcomes. He will certainly be an asset to AUCNY patients and our practice.”
Advanced Urology has over 35 locations in Nassau, Suffolk, Queens, Manhattan, Bronx, Westchester, and Rockland County. To learn more, visit www.aucofny.com.
136 students comprise the RSOM Class of 2027, shown here reciting the Hippocratic Oath.
New RSOM student Jasmine Stansil (center), with her parents and grandparents at the school’s White Coat Ceremony.
Dean Peter Igarashi, MD
Adam Bruzzese wearing his first white coat after receiving from Andrew Wackett, MD, Vice Dean of Undergraduate Medical Education.
136 students launch journey into Medicine at traditional White Coat Ceremony
At the Renaissance School of Medicine’s (RSOM) White Coat Ceremony, 136 incoming students donned their physician “white coats” and took the Hippocratic Oath for the first time. Held at StonyBrook University’s Staller Center, the annual ceremony brings students, their families, and faculty together as the academic year begins and members of the Class of 2027 embark on their journeys toward becoming physicians. The RSOM has held the White Coat Ceremony since 1998.
The incoming students are a select group, and according to RSOM administrators is one of the most diverse classes in the school’s history. Only 8.5 percent of all applicants to the RSOM for 2023-24 were accepted into the program. Approximately 20 percent of class consists individuals from historically marginalized communities, and 54 percent of the class are women.
Collectively the students received their undergraduate degrees from 66 different colleges and universities from around the country. StonyBrook University (20) and Cornell University (17) were the undergraduate schools with the most representation. The class has a combined median undergraduate GPA of 3.89. While many of the new students are from different areas of the country, 77 percent hail from New York State.
“To the Class of 2027, you are entering medicine at an exhilarating time,” said Peter Igarashi, MD, Dean of the RSOM, who presided over his first White Coat Ceremony. “Scientific discoveries in medicine are occurring at a breathtaking and awe-inspiring rate. Diseases that were rapidly fatal when I was a medical student, such as multiple myeloma and leukemia, are now routinely treated. Advances in human genetics have enabled truly personalized medicine, and the development of an effective Covid-19 vaccine less than one year after the onset of the pandemic saved almost 20 million lives and underscored the essential role that science plays in public health.”
All of the students have a story as to how and why they have chosen Medicine as a profession.
For New York City native Adam Bruzzese, an NYU graduate, his family’s difficulties and challenges they had within the healthcare system was a big trigger to increasing his passion for medicine. Adam’s 11-year-old sister had mysteriously become paralyzed, and he played an integral part in providing her healthcare as a teenager and college student. He witnessed disparities of care as she moved through the health system, plus the myriad of tests and physician opinions along the way. It was eventually determined her paralysis was caused by Lyme Disease.
Manteca, California native Jasmine Stansil, a standout student in high school and at the University of California, San Diego, was always fascinated by the human body as a kid. She also became captivated by how physicians can have an incredible impact on human life when she watched Untold Stories of the ER. But she was most inspired to pursue Medicine because of her grandmother, who endured multiple strokes.
“Watching doctors provide her care made me want to do the same for others,” says Stansil. “I am hoping to become an academic physician who will provide clinical care, teach and conduct research.”
Jerome Belford, one of the 20 class members who attended StonyBrook University as an undergraduate, described his interest in medicine as coming from a “passion that stems from a desire to promote physical and emotional health and wellness.”
From Long Island, Belford is a volunteer EMT who decided to attend the RSOM because of its broad research and clinical opportunities and standout education that provides experiential and hands-on medical training. He hopes to eventually provide patients who have historically not had access to the best medical resources improved care, either as an emergency physician or though primary care as an internist.
White coat ceremonies are an initiation rite and are symbolic to Medicine as a profession that combines professionalism with scientific excellence and compassionate care. In an era of telemedicine, aging populations, new knowledge about infections and diseases, and emerging technologies, Medicine remains a dynamic and changing profession that continues to impact the health and well-being of society.
Summer is often a time to enjoy the beach, barbecue or to simply catch up on outdoor chores. But with increased activity and heat, the summer sun can also be a trigger for chest pain, or angina. For those who have coronary artery disease, or at risk for developing the disease, those hazy, hot and humid days can be potentially life-threatening. With approximately 9 million patients in the U.S. having symptoms, angina is a serious condition occurring when there is reduced blood flow to the heart and can serve as a precursor to a future heart attack.
Robert Pyo, MD, Director, Interventional Cardiology and Medical Director, Structural Heart, at Stony Brook Heart Institute, offers some tips for protecting your heart during the summer heat.
Your Heart in the Heat
Sweating is one of the ways your body rids itself of excess heat. But as temperatures and humidity climbs, there’s so much water vapor in the air that sweating (evaporation) becomes increasingly difficult and your heart, in trying to cool your body down, winds up working overtime.
Further attempting to shed heat, your body reroutes blood flow from the warmer environment of your internal organs to the cooler surface of your skin, causing your heart to beat faster and pump harder and putting significantly more strain on not just your heart but on your lungs, kidneys and cardiovascular system. The higher the uptick in heat and humidity, the greater the burden on your heart and the greater the risk. In fact, on a hot day your heart may have to circulate two to four times as much blood each minute as it does on a cool day.
Beating the Heat and Protecting Your Heart
Some easy but effective strategies for staying heart-safe this summer:
Keep cool. Stay indoors or in the shade as much as possible during peak sun hours of 10 a.m. to 4 p.m. Chilled air is the best way to cope with the heat. Cold compresses applied to your ‘pulse points’ — the areas where your veins are closest to your skin’s surface, including wrists, neck, temples and armpits — can assist in cooling down. Extreme exertion, whether in hot weather or not, can bring on angina.
Stay hydrated. Hydration helps the heart to more easily pump blood. Drink water before, during and after going outside in hot weather. Avoid caffeine and alcohol as both of these may increase dehydration. And, be mindful of sports drinks that may contain high amounts of caffeine and/or salt as they have the potential to place stress on the heart.
Eat water-rich foods. You get about 20 percent of your water from the foods you eat. A hot weather diet that emphasizes cold soups, salads and fruits can both satisfy hunger and provide extra fluid.
Protect your skin. Sunburn affects your body’s ability to cool down and increases dehydration. Wear a wide-brimmed hat, wraparound sunglasses, and lightweight, light-colored, loose-fitting clothing. Apply plenty of broad-spectrum or UVA/UVB protection sunscreen with SPF 30 or higher to all exposed skin 30 minutes before going out. Reapply every couple of hours.
Who’s At Risk for Heat-Induced Chest Pain?
While anyone’s health can be at risk in extreme heat, soaring temperatures and humidity are particularly stressful for those who already have a weakened heart. In addition to individuals with cardiovascular disease, hot weather precautions are especially important if you’re an older adult, are overweight, have a history of high blood pressure, high cholesterol, diabetes, lung or kidney disease or stroke. Medications such as diuretics (water pills), beta blockers, antidepressants, antihistamines and decongestants may also make you more vulnerable to the heat. It is important to talk with your doctor to fully understand your individual risk factors and take precautions.
“If you’re experiencing chest pain symptoms, the Stony Brook Chest Pain Center is where you want to be,” says Dr. Pyo. “Our dedicated heart care specialists and state-of-the-art advances in critical protocols are a powerful combination that can save critical treatment time when it matters most.”
Making Every Minute Count
The key to avoiding damage to your heart, is getting treated as quickly as possible. Angina is often the first symptom of heart disease, but in addition to chest pain, discomfort can also occur in such easy-to-ignore places as your shoulders, arms, neck, jaw, abdomen or back. Angina may even appear to be indigestion.
Although for some people their chest pain symptoms might be ongoing but stable for years, for others, there are no red flags at all — allowing blood flow to eventually become completely blocked and a heart attack to occur out of seemingly nowhere.
Don’t take chances with chest pain. If you or a loved one experience any red flag symptoms, don’t wait; call 9-1-1 and get help.
Represented in this illustration is the authors’ finding that DNA hypermethylation disrupts CCCTC-binding factor (CTCF) mediated boundaries which in turn lead to aberrant interactions between an oncogene and an enhancer, driving hyperproliferation and subsequently tumorigenesis from normal OPCs. Photo by William Scavone/Kestrel Studio
Study in Cell led by Stony Brook researcher provides unique analysis in a glioma model
Gliomas are incurable brain tumors. Researchers are trying to unlock the mysteries of how they originate from normal cells, which may lead to better treatments. A new study published in the journal Cell centers on epigenetic rather than genetic changes that drive normal cells to form tumors. The work reveals the precise genes that are regulated epigenetically and lead to cancer.
Genes make us who we are in many ways and are central to defining our health. Cancer is often viewed as a disease caused by changes in our genes, thus our DNA. Epigenetics is the study of how behavior, environment, or metabolic changes can cause alterations to the way genes work. Unlike genetic changes, epigenetic changes do not change one’s DNA, and they can be reversed.
“We used tumor samples and mouse modeling to discover and functionally demonstrate the role of epigenetic alterations in gliomas,” says Gilbert J. Rahme, PhD, first author and Assistant Professor in the Department of Pharmacological Sciences at the Renaissance School of Medicine, and formerly a postdoctoral fellow at the Dana-Farber Cancer Institute in Boston. “By doing this, we discovered genes regulated epigenetically in gliomas, including potent tumor suppressor genes and oncogenes, that drive the tumor growth.”
In the paper, titled “Modeling epigenetic lesions that cause gliomas,” the research team show in the model that epigenetic alterations of tumor suppressor and oncogenes collaborate together to drive the genesis of this brain tumor.
The authors explain that “epigenetic activation of a growth factor receptor, the platelet-derived growth factor receptor A (PDGFRA) occurs by epigenetic disruption of insulator sites, which act as stop signs in the genome to prevent aberrant activation of genes. The activation of PDGFRA works in concert with the epigenetic silencing of the tumor suppressor Cyclin Dependent Kinase Inhibitor 2A (CDKN2A) to transform a specific cell type in the brain, the oligodendrocyte progenitor cell (OPC), driving the formation of brain tumors.”
Rahme says the next step is to test whether therapies that can reverse the epigenetic changes observed in brain tumors can be helpful as a treatment.
As children return to school this fall, doctors in Suffolk County expect COVID-19 cases to rise. Photo by Ronny Sefria from Pixabay
People may think COVID-19 is out of sight and out of mind, but the virus, which is still around and is making people sick, doesn’t care.
The new variant of COVID, EG.5, or “Eris,” is making people sick in the area, with hospital admissions and visits creeping up over the last few weeks.
Left, Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services. Right, Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. Left file photo; right file photo from Stony Brook Medicine
As of Aug. 9, 105 patients were hospitalized with COVID across the entire Northwell system, including 82 people on Long Island. That compares with 63 hospitalized patients on July 9, with 46 on Long Island exactly a month earlier.
That’s also the case for other area hospitals, doctors said.
“The numbers are definitely going up,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “That’s probably a snapshot of what we expect in the fall and the winter.”
Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services, explained that COVID-19 is “no longer an emergency” but is “still with us and we continue to see new variants.”
In an email, Pigott explained that the county has seen a “slight uptick in hospitalizations” that is still low in comparison to the earlier days of the pandemic.
He urged those at high risk to take precautions that could include avoiding crowded places, wearing a mask and meeting people at outdoor venues rather than indoors.
While the numbers of people sick with COVID are substantially lower than they were during the worst of the pandemic in 2020, health care professionals suggested that the fall and winter could be challenging for families, particularly as children return to school.
“The first two weeks of school, every kid is sick,” said Nachman. “Come November-ish, that’s when we see” that increase.
Dr. Bruce Hirsch, attending physician in Infectious Disease at Northwell Health, also anticipates a rise in COVID-19 cases coming this fall and early winter.
“I think there’s a very good chance that a lot of people will be having COVID,” he said.
Hirsch added that the symptoms for those people who don’t have underlying medical conditions, such as cardiac or lung-related problems, are likely to be considerably milder than they had been in the early stages of the disease, when no one had resistance.
“The sickness will not have the severity and mortality except in those of us who are unfortunate to have weak immune systems, other health problems or who are elderly or frail,” Hirsch said.
Pigott added that Eris, which is a subvariant of omicron, is not a variant of interest or concern, according to the World Health Organization.
Vaccine options
Doctors urged people to consider getting vaccines for COVID, the flu and respiratory syncytial virus for this coming fall.
The Centers for Disease Control and Prevention and the U.S. Food and Drug Administration are expected to approve the latest booster for COVID in late September or early October.
The newest booster, which should be available from Pfizer, Novavax and Moderna, should include protection against the latest COVID strain.
“The new booster formulation is much more similar and much more protective [against] the current strains,” Hirsch said. “The booster available now is protective against a couple of strains ago.”
Pigott urged people to get the new vaccines in the fall when they become available and before the holidays.
The vaccination may not prevent infection or all symptoms, but doctors suggested it would make illnesses shorter and less severe and could make the virus less infectious.
That could be particularly helpful for those who might otherwise develop more significant symptoms as their bodies attempt to fight off the virus.
Health care professionals suggested residents could receive several vaccines at the same time, enabling their immune systems to build resistance to a host of potential health threats.
“Our immune systems can chew gum and walk at the same time,” said Hirsch. “They are miraculous at reacting to all kinds of things every day anyway. The immune system is more than up to the challenge of handling two [shots] at the same time.”
Receiving several shots at once could give people a sore arm and a short-term fever that will likely respond to Tylenol, Nachman said.
“The science has shown that if you give a bunch of vaccines, you get a great response to everything,” Nachman added.
People who would prefer to get the vaccines in separate doses should space them out over several weeks, rather than getting one after another on consecutive days, she said.
Warning to pregnant women
Apart from viral infections, doctors warned pregnant women and those who might get pregnant this winter about the ongoing shortage of a form of penicillin to treat syphilis.
Penicillin G benzathine, or Bicillin, is expected to be in short supply through the start of the summer of 2024.
The medicine is not only the only treatment recommended for pregnant people with syphilis, but is also the only one recommended for infants.
“We are prioritizing that medicine specifically only for that vulnerable population,” said Nachman.
The dangers of syphilis in pregnant women are significant, with the CDC estimating that about 40% of babies born to women with untreated syphilis can be stillborn or die from the infection.
Other dangers from syphilis include bone damage, anemia, enlarged liver and spleen, jaundice, nerve problems causing blindness or deafness, meningitis and skin rashes.
With cases of congenital syphilis more than tripling in recent years, the demand for Bicillin has exceeded the supply.
“It has been a concern for those in our Bureau of Sexually Transmitted Diseases,” Pigott explained. “They have been in consultation with the state. We defer to the state regarding supply.”
Locally, hospitals have been exploring other options without much success.
“We are looking for alternatives” to Bicillin, said Nachman, but “we are not necessarily finding them.”
Doctors urged pregnant women who think they might have syphilis to get tested to protect themselves and their unborn children.
New research suggests inflammation is associated with early Parkinson's disease. METRO photo
By David Dunaief, M.D.
Dr. David Dunaief
Parkinson’s disease (PD) is the second most common neurodegenerative disorder in the U.S. after Alzheimer’s disease. Estimates put the number of people living with Parkinson’s disease at up to 1.2 million, with 90,000 new diagnoses each year (1).
Patients with PD suffer from a collection of symptoms caused by the breakdown of brain neurons. There’s a lot we still don’t know about the causes of PD; however, risk factors may include head trauma, genetics, exposure to toxins and heavy metals, and lifestyle issues, like lack of exercise.
The part of the brain most affected is the basal ganglia, and the prime culprit is dopamine deficiency that occurs in this brain region (2). Adding back dopamine has been the mainstay of medical treatment, but eventually the neurons themselves break down, and the medication becomes less effective.
Is there hope? Yes, in the form of medications and deep brain stimulatory surgery, but also by modifying lifestyle, considering factors like iron, vitamin D, inflammation, and CoQ10. While the research is not conclusive, it is intriguing and gives us more options.
What impact does iron have on the brain?
This heavy metal is potentially harmful for neurodegenerative diseases such as Alzheimer’s disease, macular degeneration, multiple sclerosis and, yes, Parkinson’s disease. The problem is that it can cause oxidative damage.
In a small, yet well-designed, randomized controlled trial (RCT), researchers used a chelator to remove iron from the substantia nigra, a specific part of the brain where iron breakdown may be dysfunctional. An iron chelator is a drug that removes the iron. Here, deferiprone (DFP) was used at a modest dose of 30 mg/kg/d (3).
The chelator reduced the risk of disease progression significantly on the Unified Parkinson Disease Rating Scale (UPDRS) during the 12-month study. Participants who were treated sooner had lower levels of iron compared to a group that used the chelator six months later. A specialized MRI was used to measure the brain’s iron levels.
The iron chelator does not affect, nor should it affect, systemic levels of iron, only those in the substantia nigra region of the brain. The chelator may work by preventing degradation of the dopamine-containing neurons. Your physician may also recommend that you consume foods that contain less iron.
What is the role of inflammation in PD?
In a recent study, researchers tested 58 newly diagnosed PD participants’ blood and compared their results to 62 healthy control participants (4). Some of the PD arm participants had additional testing done, including cerebrospinal fluid samples and brain imaging. All these tests were looking for specific inflammatory markers.
Researchers found that those with PD had significantly higher brain inflammation levels than those without PD in specific regions. Their blood and cerebrospinal fluid also had high inflammatory markers. These measures correlated with worse visuospatial and cognitive scores.
While this study provides hints of possible treatments, we need additional studies to identify whether the inflammation is a cause or an effect of PD.
Regardless, adopting a low-inflammatory foods diet might help mitigate some symptoms of PD or slow its advancement.
Does CoQ10 help slow PD progression?
There is evidence that CoQ10 may be beneficial in PD at high doses.
In an RCT, results showed that those given 1,200 mg of CoQ10 daily reduced the progression of the disease significantly based on UPDRS changes, compared to a placebo group (5). Other doses of 300 and 600 mg showed trends toward benefit, but were not significant. This was a 16-month trial in a small population of 80 patients. Unfortunately, results for other CoQ10 studies have been mixed.
In this study, CoQ10 was well-tolerated at even the highest dose. Thus, there may be no downside to trying CoQ10 in those with PD.
Does Vitamin D make a difference?
Vitamin D may play dual roles of both reducing the risk of Parkinson’s disease and slowing its progression.
In a prospective study of over 3000 patients, results show that vitamin D levels measured in the highest quartile reduced the risk of developing Parkinson’s disease by 65 percent, compared to the lowest quartile (6). This is impressive, especially since the highest quartile patients had vitamin D levels that were what we qualify as insufficient, with blood levels of 20 ng/ml, while those in the lowest quartile had deficient blood levels of 10 ng/ml or less.
In an RCT with 121 patients, results showed that 1,200 IU of vitamin D taken daily may have reduced the progression of PD significantly on the UPDRS compared to a placebo over a 12-month duration (7). Also, this amount of vitamin D increased the blood levels by almost two times from 22.5 to 41.7 ng/ml.
In a 2019 study of 182 PD patients and 185 healthy control subjects, researchers found that higher serum vitamin D levels correlated to reduced falls and alleviation of other non-motor PD symptoms (8).
Vitamin D research is ongoing, as this all seems promising.
So, what are our takeaways? Though medication is the gold standard for Parkinson’s disease treatment, lifestyle modifications can have a significant impact on both its prevention and treatment. Each lifestyle change in isolation may have modest effects, but cumulatively their impact could be significant.
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.
The Pediatric Infectious Diseases Group at Stony Brook Medicine’s new regional tick-borne disease center, located in the Hampton Bays Atrium. From left, Dr. Andrew Handel, Dr. Dalia Eid, Dr. Christy Beneri and Dr. Sharon Nachman. Photo from Stony Brook Medicine
Stony Brook University is planning to open the first and only dedicated tick clinic in the northeast on Monday.
Supported by doctors from Stony Brook Medicine’s Meeting House Lane Medical Practice and Stony Brook Children’s Hospital, the new regional tick-borne disease center, which is located in the Hampton Bays Atrium, will provide by-appointment treatment for children and adults for tick bites and diagnose tick-borne illnesses.
The timing could be especially important for people with tick bites, as the previous warm winter allowed more ticks and their eggs to survive.
“They are out there, happily laying eggs and the eggs will hatch,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital.
Brian Kelly of East End Tick and Mosquito Control donated the center’s suite which includes a reception area, two exam rooms, two private offices for consults and a nurse’s station, for 10 years.
“Between the beautiful weather in the winter and the nice weather in the summer, ticks are outside,” Nachman said. “I’m thrilled we’re doing it now. There’s no time like the present to move forward and work with the community to get this done.”
Tick checks
Health care providers urged parents, caregivers and anyone who spends quality time in nature to do regular tick checks.
Ticks can be so small that they look like a little freckle. These ticks can harbor diseases beyond the dreaded and oft-discussed Lyme Disease. Other diseases include babesiosis, ehrlichiosis and anaplasmosis.
In general, Nachman urged patients not to send ticks they pulled off themselves into the center.
“It’s the tick that they didn’t see that’s also putting them at risk,” she said. The clinic will determine the type of tests to run based on the symptoms.
For tick bites, as with many other health challenges, time is of the essence.
A tick that’s attached itself to a human for fewer than 48 hours likely won’t lead to an infection. Someone with a tick bite for about 48 hours might get a single dose of an antibiotic. People who had a tick bite for over that period might develop a rash or even facial palsy, in which one side of the face droops for an extended period of time.
Doctors work with patients to try to hone in on the date of a possible tick bite.
“We do pretty good guessing,” said Nachman. “We don’t need to be perfect: we need to be pretty close.”
Ticks are present throughout Suffolk County.
Health care workers urge people to spray their clothing with DEET. While ticks aren’t always easy to see, people can find them by feeling a new lump or bump on their skin.
Removing ticks
Nachman advised people to wipe an area with a tick down with alcohol before trying to remove an embedded insect.
Using a flat edged tweezer, the tick removers should grasp the insect and slowly back it out.
“Don’t grab the tick and yank,” Nachman cautioned. The mouth parts of the tick have an adhesive, which can leave some of the parts inside the infected person.
Nachman, who will be at the center on Mondays, also urged people not to use petroleum jelly or match sticks.
The hours at the center will adjust to the demand. In the winter, when ticks are less prevalent, the center may have more limited appointment times.
One of the advantages of the center is that the health care providers can track patients over time who have been infected.
Doctors can also sign patients up to become a part of a registry. By tracking people who have tick-borne infections, doctors might also address questions that are part of the science of diseases like Lyme.
“There may be better treatments or better tests” down the road, Nachman added.
Pictured from left, Joseph Antonik, VP of Operations, Catholic Health Physician Partners; Alicia DiLavore, AVP Practice Management and Network Strategy, Catholic Health Physician Partners; Dennis Verzi, Executive VP and COO, Catholic Health; Dr. Avni Thakore, President, Catholic Health Physician Partners; Dr. Patrick O'Shaughnessy, President and CEO, Catholic Health; Dr. Naz Khan, Chief Medical Officer, Catholic Health Physician Partners; and Joseph Lamantia, Executive VP and Chief Transformation Officer, Catholic Health
Pictured from left, Joseph Antonik, VP of Operations, Catholic Health Physician Partners; Alicia DiLavore, AVP Practice Management and Network Strategy, Catholic Health Physician Partners; Dennis Verzi, Executive VP and COO, Catholic Health; Dr. Avni Thakore, President, Catholic Health Physician Partners; Dr. Patrick O'Shaughnessy, President and CEO, Catholic Health; Dr. Naz Khan, Chief Medical Officer, Catholic Health Physician Partners; and Joseph Lamantia, Executive VP and Chief Transformation Officer, Catholic Health
Catholic Health Ambulatory & Urgent Care in Centereach
Catholic Health Ambulatory & Urgent Care in Centereach
Catholic Health Ambulatory & Urgent Care in Centereach
The pharmacy inside the Catholic Health Ambulatory & Urgent Care
Catholic Health celebrated the opening of its latest Catholic Health Ambulatory & Urgent Care with a ribbon cutting ceremony on Aug. 2. Located at 2112 Middle Country Road in Centereach, the newly constructed 63,000 square foot multispecialty care center will feature a number of primary and specialty care services, as well as a walk-in urgent care for patients with more immediate care needs.
The new center is part of Catholic Health’s growing network of multispecialty care centers, complete with diagnostic imaging, an on-site pharmacy, and a dedicated suite where Catholic Health’s gastroenterologists can perform endoscopy procedures in a safe, comfortable and convenient environment outside the hospital setting.
“Today marks an important day not only for Catholic Health but also for the residents in and near Centereach, who now have access to exceptional primary care, urgent care, and specialized care across a wide variety of medical specialties,” said Catholic Health President & CEO Patrick O’Shaughnessy, DO, MBA.
“We’ve launched a number of Ambulatory Care sites across Long Island, however, today we open our largest and most expansive. This state-of-the-art facility reflects our continuing commitment to placing more health care services outside of the hospital setting, serving our communities with highly accessible, community-based sites where patients can get the care they need, when they need it, as conveniently as possible,” he added.
The new facility is part of a $17 million development project that further strengthens Catholic Health’s goal of making quality health care more convenient for Long Islanders and to support many of the unmet health care needs of the community. Designed and constructed from the ground up, 43,000 square-feet of space will immediately be used for primary and specialty care services, eventually building out an additional 20,000 square-feet for future health care services.
The ribbon cutting ceremony featured members of Catholic Health leadership, elected officials and community leaders and Simone Healthcare Development, owner and developer of the facility.
“We are delighted to celebrate this incredible transformation of a former retail site into a state-of-the-art multispecialty ambulatory and urgent care center for Catholic Health,” said Joseph Simone, President of Simone Development Companies. “It was a true collaboration between our teams to be able to deliver this first-rate facility in just one year from start of construction. Numerous planning approvals were required and we thank the Town of Brookhaven and Suffolk County for their support and cooperation throughout the process.”
“I am happy to welcome Catholic Health Ambulatory & Urgent Care to the new Centereach location. As their largest facility, they can offer a wide variety of health services to the residents of Brookhaven Town. This is a great example of how redevelopment of a former retail property is a much better alternative to new development and it makes healthcare more easily accessible for our residents while creating jobs for local healthcare workers,” said Brookhaven Town Supervisor Ed Romaine.
“Our communities are living in a time that fatal and non-fatal overdose has affected each individual directly or in-directly. Everyone knows someone who has overdosed either personally or through a friend, family member, co-worker or acquaintance. With Fentanyl infecting our communities; awareness, prevention, treatment, policy and stigma relevant to loss of life involving the drug, are all examples of the importance of International Overdose Awareness Day and what the campaign targets throughout the world. At Horizons, we understand the effect overdose has on the person and their loved ones. Narcan is a lifesaving drug that can reverse opioid overdose and training like the one we are offering is valuable to the public in recognizing the signs and symptoms of and responding to overdose. Narcan administration is a simple method of emergency response that carries an immense lifesaving result,” said Joe Bieniewicz, Director of Drug and Alcohol Counseling Services’
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