Gurwin Jewish Nursing & Rehabilitation Center in Commack has announced that Janet Osita, RRT, Respiratory Therapist on Gurwin’s Respiratory Care unit, captured the award for Best Overall testimonial video in the LeadingAge NY and Adult Day Health Care Council (ADHCC) #LoveThisCareerLTC Social Media Contest.The inaugural social campaign was launched in an effort to raise the profile of rewarding opportunities within the long-term care sector.
“We are delighted that the video highlighting Janet’s hard work and her passion for her career and the residents for whom she cares was recognized with this award.Long-term care providers need skilled and compassionate workers like Janet who are dedicated to the well-being of our residents,” said Stuart B. Almer, President and CEO of Gurwin Healthcare System.
The contest encouraged LeadingAge NY and ADHCC member organization employees across all departments and services lines to create and post video content via TikTok, Instagram and/or Facebook to inspire others to pursue a meaningful career in long-term care and aging services. Contest prizes up to $1,000 were awarded to the creators of the best videos in the categories of Best Overall, Most Heartwarming, Most Creative/Best Use of Popular Social Media Trends and more.
“I love working in long-term care because of the passion, love and connection. When you work in a hospital, we see the patient, we treat them, then they go. With long-term care, you connect with them, and you have the passion. You know everything about them,” said Osita.
Dr. Bettina Fries. Photo by Jeanne Neville/Stony Brook Medicine
Bettina Fries, MD, Chief of the Division of Infectious Diseases, Professor of Medicine, and Molecular Genetics and Microbiology in the Renaissance School of Medicine at Stony Brook University, has been named a 2022 fellow of the American Association for the Advancement of Science (AAAS).
The AAAS is dedicated to elevating the quality of science and technology across the world for the benefit of humankind, and its fellows represent members of the association who have made exceptional contributions to that mission.
Dr. Fries is a nationally recognized physician-scientist who specializes in mycology and also conducts research of antibodies in relation tovaccine development. Under her leadership, the Division of Infectious Diseases at Stony Brook has greatly expanded and rose to combat the COVID-19 Pandemic and lead clinical care and research throughout the pandemic and its changing circumstances.
From expanding clinical and basic research and improving patient care to allocating essential resources and protecting health care providers, Dr. Fries’ work in healthcare and infectious disease researchhas impacted both Stony Brook and other institutions.
In addition to her appointment as an AAAS fellow, the East Setauket resident is also a fellow of the Academy of Microbiology of America, a fellow of the Infectious Disease Society, and a fellow of the American College of Physicians. She has served as President of the Medical Mycological Society of the Americas, and the Infectious Diseases Society of New York.
Dr Fries’ work spans a wide range of disciplines, but her research chiefly investigates the pathogenesis of chronic fungal infections and the development of monoclonal antibodies against multidrug-resistant bacteria.
Editor’s Note: Dr. Bettina Fries was one of TBR News Media’s 2022 People of the Year.
Aquatic exercise can improve balance, strength and mobility. METRO photo
Simple exercises can help
By David Dunaief, M.D.
Dr. David Dunaief
We have had far more ice this winter than snow. Of particular concern is black ice, when a thin ice coating looks innocuously like a simple damp surface. This phenomenon has increased our risk for falling and injuring ourselves. I’ve received quite a few calls this winter from friends and patients who have taken tumbles resulting in broken bones and torn ligaments.
Even without icy steps and walkways, falls can be serious for older patients, where the consequences can be devastating. They can include brain injuries, hip fractures, a decrease in functional ability and a decline in physical and social activities (1). Ultimately, a fall can lead to loss of independence (2).
What increases fall risk?
There are many factors. A personal history of falling in the recent past is the most prevalent. However, there are other significant factors, such as age and medication use. Some medications, like antihypertensive medications, which are used to treat high blood pressure, and psychotropic medications, which are used to treat anxiety, depression and insomnia, are of particular concern. Chronic diseases can also contribute.Circumstances that predispose us to falls also involve weakness in upper and lower body strength, decreased vision, hearing disorders and psychological issues, such as anxiety and depression (3).
Simple ways to reduce fall risk
It is most important to exercise. We mean exercises involving balance, strength, movement, flexibility and endurance, all of which play significant roles in fall prevention (4). The good news is that many of these can be done inside with no equipment or with items found around the home. We will look more closely at the research.
Nonslip shoes are crucial indoors, and footwear that prevents sliding on winter ice, such as slip-on ice cleats that fit over your shoes, is a must. In the home, inexpensive changes, like securing area rugs, removing other tripping hazards, and adding motion-activated nightlights can also make a big difference.
Does your medication put you at risk?
There are several medications that heighten fall risk. Psychotropic drugs top the list, but what other drugs might have an impact?
A well-designed study showed an increase in fall risk in those who were taking high blood pressure medication (5). Those on moderate doses of blood pressure medication had the greatest risk of serious injuries from falls, a 40 percent increase.
These medications can reduce significantly the risks of cardiovascular disease and events, so physicians need to consider the risk-benefit ratio in older patients before stopping a medication. We also should consider whether lifestyle modifications, which play a significant role in treating this disease, can be substituted for medication (6).
The value of exercise
A meta-analysis showed that exercise significantly reduced the risk of a fall (7). It led to a 37 percent reduction in falls that resulted in injury and a 30 percent reduction in falls requiring medical attention. Even more impressive was a 61 percent reduction in fracture risk.
Remember, the lower the fracture risk, the more likely you are to remain physically independent. The author summarized that exercise not only helps to prevent falls but also fall injuries.
Unfortunately, those who have fallen before, even without injury, often develop a fear that causes them to limit their activities. This leads to a dangerous cycle of reduced balance and increased gait disorders, ultimately resulting in an increased fall risk (8).
What types of exercise are best?
Any consistent exercise program that improves balance, flexibility, and muscle tone and includes core strengthening can help improve your balance. Among those that have been studied, tai chi, yoga and aquatic exercise have all been shown to have benefits in preventing falls and injuries from falls.
A randomized controlled trial showed that those who did an aquatic exercise program had a significant improvement in the risk of falls (9). The aim of the aquatic exercise was to improve balance, strength and mobility. Results showed a reduction in the overall number of falls and a 44 percent decline in the number of exercising patients who fell during the six-month trial, with no change in the control group.
If you don’t have a pool available, tai chi, which requires no equipment, was also shown to reduce both fall risk and fear of falling in older adults (10).
Another pilot study used modified chair yoga classes with a small assisted living population (11). Participants were those over 65 who had experienced a recent fall and had a resulting fear of falling. While the intention was to assess exercise safety, researchers found that participants had less reliance on assistive devices and three of the 16 participants were able to eliminate their use of mobility assistance devices.
Our best line of defense against fall risk is prevention with exercise and reducing slipping opportunities. Should you stop medications? Not necessarily. If you are 65 and older, or if you have arthritis and are at least 45 years old, it may mean reviewing your medication list with your doctor. Before you consider changing your blood pressure medications, review your risk-to-benefit ratio with your physician.
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.
Obesity can reduce the benefits of supplementation
By David Dunaief, M.D.
Dr. David Dunaief
Here in the Northeast, it’s the time of year when colder temperatures mean we’re spending lots of time indoors. When we are outside, we cover most of our skin to protect us from the cold. This means we’re not getting a lot of sun. While this will make your dermatologist happy, it also means you’re probably not converting that sun exposure to vitamin D3.
There is no question that, if you have low levels of vitamin D, replacing it is important. Previous studies have shown that it may be effective in a wide swath of chronic diseases, both in prevention and as part of a treatment regimen. However, many questions remain.
Many of us receive food-sourced vitamin D from fortified packaged foods, where vitamin D has been added. This is because sun exposure — even under the best of circumstances — will not address all of our vitamin D needs. For example, in a study of Hawaiians, a subset of the study population who had more than 20 hours of sun exposure without sunscreen per week, some participants still had low vitamin D3 values (1).
We know vitamin D’s importance for bone health, but we have mixed data for other diseases, such as cardiovascular, autoimmune and skin diseases and cancer.
There is no consensus on the ideal blood level for vitamin D. For adults, the Institute of Medicine recommends between 20 and 50 ng/ml, and The Endocrine Society recommends at least 30 ng/ml.
Are there cardiovascular benefits to vitamin D?
Several observational studies have shown benefits of vitamin D supplements with cardiovascular disease. The Framingham Offspring Study showed that those patients with deficient levels were at increased risk of cardiovascular disease (3).
However, a small randomized controlled trial (RCT) called the cardioprotective effects of vitamin D into question (4). This study of postmenopausal women, using biomarkers such as endothelial function, inflammation or vascular stiffness, showed no difference between vitamin D treatment and placebo. The authors concluded there is no reason to give vitamin D for prevention of cardiovascular disease.
The vitamin D dose given to the treatment group was 2,500 IUs. Some of the weaknesses of the study were a very short duration and small study size.
How does vitamin Daffect mortality?
In a meta-analysis of a group of eight studies, vitamin D with calcium reduced the mortality rate in the elderly, whereas vitamin D alone did not (5). The difference between the groups was statistically important, but clinically small: nine percent reduction with vitamin D plus calcium and seven percent with vitamin D alone.
One of the weaknesses of this analysis was that vitamin D in two of the studies was given in large amounts of 300,000 to 500,000 IUs once a year, rather than taken daily. This has different effects.
Does obesity affect vitamin D absorption?
A recently published analysis of data from the VITAL trial, a large-scale vitamin D and Omega-3 trial, found that those with BMIs of less than 25 kg/m2 had significant health benefits from supplementation versus placebo (2). These included 24 percent lower cancer incidence, 42 percent lower cancer mortality, and 22 percent lower incidence of autoimmune disease. Those with higher BMIs showed none of these benefits.
Can vitamin D help you lose weight?
There is good news, but not great news, on the weight front. It appears that vitamin D plays a role in reducing the amount of weight gain in women 65 years and older whose blood levels are more than 30 ng/ml, compared to those below this level, in the Study of Osteoporotic Fractures (6).
This association held true at baseline and after 4.5 years of observation. If the women dropped below 30 ng/ml in this time period, they were more likely to gain more weight, and they gained less if they kept levels above the target. There were 4,659 participants in the study. Unfortunately, vitamin D did not show statistical significance with weight loss.
USPSTF recommendations and fracture risk
The U.S. Preventive Services Task Force recommends against giving “healthy” postmenopausal women vitamin D, calcium or the combination of vitamin D 400 IUs plus calcium 1,000 mg to prevent fractures, and it found inadequate evidence of fracture prevention at higher levels (7). The supplement combination does not seem to reduce fractures, but does increase the risk of kidney stones. There is also not enough data to recommend for or against vitamin D with or without calcium for cancer prevention.
When should you supplement?
It is important to supplement to optimal levels, especially since most of us living in the Northeast have insufficient to deficient levels. While vitamin D may not be a cure-all, it might play an integral role with many disorders. But it is also important not to raise the levels too high. The range that I tell my patients is between 32 and 50 ng/ml, depending on their health circumstances.
References:
(1) J Endocrinology & Metabolism. 2007 Jun;92(6):2130-2135. (2) JAMA Netw Open. 2023 Published online Jan 2023. (3) Circulation. 2008 Jan 29;117(4):503-511. (4) PLoS One. 2012;7(5):e36617. (5) J Women’s Health (Larchmt). 2012 Jun 25. (6) J Clin Endocrinol Metabol. May 17, 2012 online. (7) JAMA. 2018;319(15):1592-1599.
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.
Each year, the Department of Health will release updated resource and income levels for theMedicaid program. This year there has been a significant increase. Beginning January 1, 2023,New York State will be increasing the asset limits for community and nursing home Medicaid and income limits for community Medicaid.
For both community (home health aides) and chronic (nursing home) Medicaid, the availableasset limit for 2023 is being increased to $28,133 for an individual applicant (the former assetlimit for 2022 was $16,800) and $37,902 for a married couple (up from $24,600), allowingMedicaid applicants to retain significantly more assets and still be eligible for Medicaid.
The income limit for community Medicaid applicants is being increased from $934/month to$1,563/month for individual applicants and for married couples the income limit is beingincreased from $1,367/month to $2,106/month. There is an additional $20.00 disregard thatcan be added to each allowance; therefore, the total of income allowance for an individualapplying for Medicaid can have $1,583/month and married couples can have $2,126.00.
Underthis program, any excess income can be directed to a Pooled Income Trust for the benefit ofthe Medicaid applicant and the monies deposited into the trust can be used to pay thehousehold expenses of the Medicaid applicant. In New York, all Pooled Income Trust aremanaged by charitable organizations. It is important to use the monies in the Pooled Income Trust because when the applicant passes away, the balance goes to the charity.
As for nursing home Medicaid applicants, the monthly income limit will continue to be $50, but the income limit for the non-institutionalized spouse is being increased to $3,715/month.Additionally, federal guidelines permit community spouses to retain up to $148,620 in assets plus a primary residence with a maximum value of $1,033,000.
Even if the communitysouse has assets and income over the threshold, New York’s spousal refusal provisions provide even more protection in that a community spouse can elect to sign a documentwhich allows them to retain assets in any amount, including assets which were previously in the name of the spouse that requires care in a nursing facility.
Individuals applying for Medicaid benefits after January 1, 2023, should apply based on theasset and income limits discussed above. For those individuals who are already receivingcommunity Medicaid and are using a pooled trust for their excess monthly income, yourmonthly budget/spend-down will remain the same until you recertify, at which time theincreased income limits will be applied.
However, starting in January 2023 Medicaidrecipients may ask their local Medicaid office to re-budget their spend-down based on thenew income limits before their next renewal, enabling community Medicaid recipients tokeep more of their monthly income sooner. It is advisable to consult an elder law attorneyin your area to determine if a re-budget is appropriate in your case.
While the asset allowance has been increased, keep in mind that the five-year look-backperiod for nursing home Medicaid still applies, which means that any transfer of assets madewithin this period for below market value will incur a penalty period and Medicaid coveragewill commence only after the penalty period has elapsed. Typically, there is alwaysMedicaid planning that can be accomplished even if the individual immediately needsMedicaid coverage and has done no pre-planning.
*Please note, the income and assets are based on the 2022 Poverty Level. This is subject tochange based on the 2023 Poverty Level.
Nancy Burner, Esq. is the founder and managing partner at Burner Law Group, P.C with offices located in East Setauket, Westhampton Beach, New York City and East Hampton.
Exercise is only one part of the weight loss equation
By David Dunaief, M.D.
Dr. David Dunaief
Exercise has benefits for a wide range of medical conditions, from insomnia, fatigue, depression and cognitive decline to chronic kidney disease, diabetes, cardiovascular disease and osteoporosis. But will it help you lose weight?
While exercise equipment and gym membership ads emphasize this in January, exercise without dietary changes may not help many people lose weight, no matter what the intensity or the duration (1). If it does help, it may only modestly reduce fat mass and weight for the majority of people. However, it may be helpful with weight maintenance.
Ultimately, it may be more important to reconsider what you are eating than to succumb to the rationalization that you can eat with abandon and work it off later.
Does exercise help with weight loss?
The well-known weight-loss paradigm is that when more calories are burned than consumed, we will tip the scale in favor of weight loss. The greater the negative balance with exercise, the greater the loss. However, study results say otherwise. They show that in premenopausal women there was neither weight nor fat loss from exercise (2). This involved 81 women over a short duration, 12 weeks. All of the women were overweight to obese, although there was great variability in weight.
However, more than two-thirds of the women gained a mean of 1 kilogram, or 2.2 pounds, of fat mass by the end of the study. There were a few who gained 10 pounds of predominantly fat. A fair amount of variability was seen among the participants, ranging from significant weight loss to substantial weight gain. These women were told to exercise at the American College of Sports Medicine’s optimal level of intensity (3). This is to walk 30 minutes on a treadmill three times a week at 70 percent VO2max — maximum oxygen consumption during exercise. This is a moderately intense pace.
The good news is that the women were in better aerobic shape by the end of the study. Also, women who had lost weight at the four-week mark were more likely to continue to do so by the end of the study.
Other studies have shown modest weight loss. For instance, in a meta-analysis involving 14 randomized controlled trials, results showed that there was a disappointing amount of weight loss with exercise alone (4). In six months, patients lost a mean of 1.6 kilograms, or 3.5 pounds, and at 12 months, participants lost 1.7 kilograms, or about 3.75 pounds.
Does exercise help with weight maintenance?
Exercise may help with weight maintenance, according to observational studies. Premenopausal women who exercised at least 30 minutes a day were significantly less likely to regain lost weight (5). When exercise was added to diet, women were able to maintain 30 percent more weight loss than with diet alone after a year in a prospective study (6).
Does exercise help with disease?
As a simple example of exercise’s impact on disease, let’s look at chronic kidney disease (CKD), which affects approximately 15 percent of U.S. adults, according to the Centers for Disease Control and Prevention (7).
Trial results showed that walking regularly could reduce the risk of kidney replacement therapy and death in patients who have moderate to severe CKD, stages 3-5 (8). Yes, this includes stage 3, which most likely is asymptomatic. There was a 21 percent reduction in the risk of kidney replacement therapy and a 33 percent reduction in the risk of death when walkers were compared to non-walkers.
Walking had an impressive impact, and results were based on a dose-response curve. In other words, the more frequently patients walked during the week, the better the probability of preventing complications. Those who walked between one and two times per week had 17 and 19 percent reductions in death and kidney replacement therapy, respectively, while those who walked at least seven times per week saw 44 and 59 percent reductions in death and kidney replacement. These are substantial results. The authors concluded that the effectiveness of walking on CKD was independent of kidney function, age or other diseases.
As you can see, there are many benefits to exercise; however, food choices will have a greater impact on weight and body composition. The good news: exercise can help maintain weight loss and is extremely beneficial for preventing progression of chronic diseases, such as CKD.
By all means, exercise, but to lose weight, also focus on consuming nutrient-dense foods instead of calorie-dense foods that you may not be able to exercise away.
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.
After a November and December in which realities like a “tridemic” of viral threats sickened residents throughout Suffolk County, the new year has started off with fewer illnesses and cautious optimism among health care professionals.
“The numbers are coming down now,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. The overall threat is “less” and “we’re in the take-a-deep-breath phase.”
Indeed, the frequency of cases of several viruses is lower.
“Flu and RSV (respiratory syncytial virus) are down,” Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health and associate professor of medicine at Hofstra School of Medicine, explained in an email.
At the Catholic Health hospitals, including Port Jefferson-based St. Charles and Smithtown-based St. Catherine of Siena Hospital, the emergency room visits are down around 10% from a few weeks ago, said Dr. Jeffrey Wheeler, medical director of the Emergency Department at St. Charles.
In between too busy and too quiet, the hospital is in the “sweet spot” where health care providers have enough to do without frantically racing from one emergency to another, Wheeler said.
Among those visiting St. Charles, Wheeler added that health care providers are seeing a smattering of illnesses.
At the same time, the vaccine for the flu has proven to be a “good match” for the current strain, Nachman said. “Amongst those who did the flu shot, they have tended to not get sick enough to go to the doctor.”
According to New York State Department of Health figures, the overall numbers across the state have been declining for the flu. For the week ending Jan. 14, the number of infections was cut in half.
Suffolk County saw a slightly larger drop, falling 59% for the same week, to 571.
This year, people who were going to get the flu vaccine may have helped themselves and their families by getting the shot earlier, rather than dragging out the process of boosting their immune systems over the course of months. Nachman said.
Cases of monkeypox continue to be on the lower side, in part because of the number of vaccines people in the area have received.
To be sure, health care workers are still helping people overcome a range of infections circulating in the county.
“We are still seeing a smorgasbord of flu, COVID and RSV,” said Nachman. Of the people admitted to Stony Brook Hospital, most of them have a comorbidity.
At Huntington Hospital, admissions are “high,” and the hospital census remains high, Popp added.
Health care workers are diagnosing viruses like the flu and COVID-19 and have used available treatments to reduce the symptoms and the spread of these viruses.
New COVID vaccine approach
Earlier this week, the Food and Drug Administration posted documents online that reflected a possible future change in its approach to COVID-19 vaccinations.
Instead of recommending bivalent boosters or a range of ongoing vaccinations to provide protection against circulating strains, the FDA plans to approach COVID-19 vaccinations in the same way as the flu.
Each year, people who are otherwise healthy and may not have high risks may get a single dose of a vaccine based on the strains the administration anticipates may circulate, particularly during the colder winter months.
Health care professionals welcomed this approach.
Nachman and Popp thought a single shot would be “great” and appreciated how the annual vaccine would simplify the process while reducing inoculation fatigue.
“The simplest messages with the simplest strategy often wins,” Nachman said.
Bivalent booster concern
Addressing concerns raised by the Centers for Disease Control and Prevention about a potential link between the bivalent booster and stroke, Nachman suggested that was one data point among many.
Israel has used the Pfizer bivalent booster exclusively and hasn’t seen any such evidence linking the booster to stroke.
The CDC data is “one of multiple data points that we use to look at safety events,” she said. “Not a single other one has shown any relationship with stroke among the elderly in the first 21 days.”
A poor diet can increase your risk for high blood pressure. METRO photo
Medication timing has a significant effect on cardiovascular risk
By David Dunaief, M.D.
Dr. David Dunaief
We are at the point in the year when many of us are taking stock of how we’ve fared over our last trip around the sun.
If you are one of the 47 percent of U.S. adults over the age of 18 with hypertension, also known as high blood pressure, you don’t want to be one of the 92 million whose hypertension is uncontrolled (1). When it’s not controlled, you increase your probability of complications, such as cardiovascular events and mortality.
What contributes to our risk of hypertension complications?
Being significantly overweight or obese, smoking, poor diet, lack of exercise, family history, age, increased sodium, depression, low vitamin D, diabetes and too much alcohol are some of the factors that increase our risk (2). The good news is that you can take active steps to improve your risk profile (3).
Of course, antihypertensive (blood pressure) medications treat this disorder. In addition, some nonpharmacological approaches have benefits.
Which risk factors have the greatest impact on developing hypertension?
A poor diet can increase your risk for high blood pressure. METRO photo
In an observational study involving 2,763 participants, results showed that those with poor diets had 2.19 times increased risk of developing high blood pressure. This was the greatest contributor to developing this disorder (4). Another risk factor with a significant impact was being at least modestly overweight (BMI >27.5 kg/m²), which put participants at 1.87 times increased risk. This, surprisingly, trumped cigarette smoking, which increased risk by 1.83 times.
What effect does your gender, age or race have?
While the data show that more men than women have hypertension, 50 percent vs. 44 percent, and the prevalence of high blood pressure varies by race, the consequences of hypertension are felt across the spectrum of age, gender and race (5).
One of the most feared complications of hypertension is cardiovascular disease. In a study, isolated systolic (top number) hypertension was shown to increase the risk of cardiovascular disease and death in both young and middle-aged men and women between 18 and 49 years old, compared to those who had optimal blood pressure (6). The effect was greatest in women, with a 55 percent increased risk in cardiovascular disease and 112 percent increased risk in heart disease death.
High blood pressure has complications associated with it, regardless of onset age. Though this study was observational, it was very large and had a 31-year duration.
Are nighttime blood pressure readings better risk predictors?
Measuring blood pressure in the clinic can be useful. However, in a meta-analysis (involving nine studies from Europe, South America and Asia), results showed that high blood pressure measured at nighttime was potentially a better predictor of myocardial infarctions (heart attacks) and strokes, compared to daytime and clinic readings (6).
For every 10 mmHg rise in nighttime systolic blood pressure, there was a corresponding 25 percent increase in cardiovascular events. This was a large meta-analysis that utilized studies that were at least one year in duration.
Does this mean that nighttime readings are superior in predicting risk? Not necessarily, but the results are interesting. The nighttime readings were made using 24-hour ambulatory blood pressure measurements (ABPM).
There is something referred to as masked uncontrolled hypertension (MUCH) that may increase the risk of cardiovascular events in the nighttime. MUCH occurs in those who are well-controlled during clinic readings for blood pressure; however, their nocturnal blood pressure is uncontrolled. In the Spanish Society of Hypertension ABPM Registry, MUCH was most commonly seen during nocturnal hours (7). Thus, the authors suggest that ABPM may be a better way to monitor those who have higher risk factors for MUCH, such as those whose pressure is borderline in the clinic and those who are smokers, obese or have diabetes.
A previous study suggested that taking at least one antihypertensive medication at night may be more effective than taking them all in the morning (8). Those who took one or more blood pressure medications at night saw a two-thirds reduction in cardiovascular event risk. Now we can potentially see why. These were patients who had chronic kidney disease (CKD). Generally, 85 to 95 percent of those with CKD have hypertension.
Do blueberries help control blood pressure?
Diet plays a role in controlling high blood pressure. In a study, 22 grams of blueberry powder consumed daily, equivalent to one cup of fresh blueberries, reduced systolic blood pressure by a respectable 7 mmHg and diastolic blood pressure by 5 mmHg over 2 months (9).
This is a modest amount of fruit with a significant impact, demonstrating exciting results in a small, preliminary, double-blind, placebo-controlled randomized trial. Blueberries increase nitric oxide, which helps blood vessels relax, reducing blood pressure. While the study used powder, it’s possible that an equivalent amount of real fruit would lead to greater reduction.
In conclusion, high blood pressure and its cardiovascular complications can be scary, but lifestyle modifications, such as taking antihypertensive medications at night and making dietary changes, can have a big impact in altering these serious risks.
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.
Suffolk County Executive Steve Bellone has announced that the County will host a free test kit and KN95 mask distribution event on January 24 between noon and 6 p.m. in the lobby of the H. Lee Dennison Building, located at 100 Veterans Memorial Highway in Hauppauge. Approximately 1,000 test kits and nearly 1,000 KN95 mask will be available for residents to pick up.
All Suffolk County residents are encouraged to attend to obtain kits for their household. Each resident is eligible to pick up two test kits per household member. Test kits will be distributed on a first-come, first-served basis.
“While many of us have resumed daily life, living with COVID-19, it is still important that everyone has access to the tools available to prevent exposure and spread,” said Suffolk County Executive Steve Bellone. “As we continue to see new variants, it is clear that availability to test kits is imperative as we work to keep this virus under control.”
“Testing is still crucial to slowing the transmission of the SARS-CoV-2 virus. When we test positive early in the course of illness, we have the opportunity to seek treatment to prevent the worst outcomes from COVID infection, and can limit the spread of the virus to others,” added Dr. Gregson Pigott, Suffolk County Health Commissioner.
Together, with local municipalities, County legislators, the Suffolk County Police Department, community groups, not-for-profits and more, the County has distributed approximately 660,680 test kits to residents, including seniors, first responders and other vulnerable populations.
Suffolk Health is also offering COVID-19 vaccines and boosters to all Suffolk County residents who are eligible to receive them. Childhood vaccinations are also offered for children who are uninsured. Walk-ins are welcome.
County clinic dates and times are available as follows:
January 24 from 11 a.m. to 3 p.m. at Sachem Library, 150 Holbrook Road, Holbrook
January 25 from 11 a.m. to 3 p.m. at Riverhead Library, 330 Court St., Riverhead
January 31 from 12:30 p.m. to 3:30 p.m. at West Babylon Library, 211 Route 109, West Babylon
Port Jefferson’s Mather Hospital is one of America’s 250 Best Hospitals for 2023, according to new research released byHealthgrades, the leading marketplace connecting doctors and patients. This achievement puts Mather Hospital in the top five percent of hospitals nationwide for overall clinical performance across the most common conditions and procedures.
“We are honored by this major recognition by Healthgrades of Mather Hospital’s record ofclinical excellence” said Mather Hospital Executive Director Kevin McGeachy. “Given the challenges of the last few years due to the COVID-19 pandemic, distinctions such as these demonstrate our ongoing commitment to quality patient care.”
Mather Hospital also received the 2023 America’s 100 Best Hospitals for Gastrointestinal Surgery Award™, the 2023 Gastrointestinal Care Excellence Award™, the 2023 Gastrointestinal Surgery Excellence Award™, the 2023 Critical Care Excellence Award™.Mather Hospital also received the Pulmonary Care Excellence Award™ for an 8th consecutive year (2016-2023) and the Bariatric Surgery Excellence Award™ for a fifth year in a row (2019-2023).In 2022, Mather Hospital was also recognized with the Outstanding Patient Experience Award™ and was among the Top 5 percent of hospitals in the nation forpatient experience.
Healthgrades evaluated patient mortality and complication rates for 31 of the most common conditions and procedures at nearly 4,500 hospitals across the country to identify the top-performing hospitals. This year’s analysis revealed significant variation between America’s Best 250 Hospitals and hospitals that did not receive the distinction. In fact, if allhospitals performed similarly to America’s 250 Best, over 160,000 lives could have been saved.* Patients treated at one of the 2023 America’s 250 Best Hospitals have, on average, a 28.7 percent lower risk of dying than if they were treated at a hospital that did not receive the America’s 250 Best Hospitals award.*
Mather Hospital also ranks third in gastrointestinal surgery and fourth for critical care in New York according to a new analysis released by Healthgrades. Mather also received the 2023 America’s 100 Best Hospitals for Gastrointestinal Surgery Award™ and the Critical Care Excellence Award™. To determine this year’s State Ranking recipients, Healthgrades evaluated clinical performance for nearly 4,500 hospitals nationwide focusing on 18 key specialties across a mix of chronic, urgent, and surgical specialty areas.
“Excellence in health care and patient safety are built into the culture at Mather Hospital,” said Chief Medical Officer and Senior VP Joan Faro, MD. “All team members are focused on supporting the practices of a highly reliable organization to achieve our goals. I congratulate our physicians, nurses and all our team members for this prestigious award.”
Mather in 2022 received its third Magnet® Recognition for quality patient care and nursing excellence and was one of only 29 hospitals nationwide to receive the Emergency Nurses Association Lantern Award for demonstrating exceptional and innovative performance in leadership, practice, education, advocacy, and research. Mather also received a gold-level Beacon Award for Excellence for its Critical Care team from the American Association of Critical-Care Nurses.
“We’re proud to recognize Mather Hospital as one of America’s 250 Best Hospitals for 2023,” said Brad Bowman MD, Chief Medical Officer and Head of Data Science at Healthgrades. “As one of America’s 250 Best Hospitals, Mather Hospital consistently delivers better-than-expected outcomes for the patients in their community and is setting a high national standard for clinical excellence.”
Visit Healthgrades.com/quality/americas-best-hospitals for an in-depth look at Mather Hospital’s performance and profile to explore the highest quality care in Port Jefferson today. Consumers can also visit Healthgrades.com for more information on how Healthgrades measures hospital quality, and access the complete methodology here. A patient-friendly overview of the complete methodology is available here.
*Statistics are based on Healthgrades analysis of MedPAR data for years 2019 through 2021 and represent three-year estimates for Medicare patients only.
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About Mather Hospital
Mather Hospital is an accredited 248-bed, non-profit community teaching hospital dedicated to providing a wide spectrum of high-quality health care services to Suffolk County residents, showing compassion, respect and treating each patient in the manner we would wish for our loved ones. Mather has earned the prestigious Magnet® recognition from the American Nurses Credentialing Center, which recognizes healthcare organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Our Graduate Medical Education program prepares physicians for future careers through Internal Medicine, Transitional Year, Diagnostic Radiology, Interventional Radiology, and Psychiatry residency programs and gastroenterology and hematology/oncology fellowships. Mather was
rated high performing by U.S. News & World Report hospital rankings in heart failure, geriatrics, kidney failure, orthopedics, hip fracture, COPD, and urology. For information about Mather Hospital, visit matherhospital.org or follow us @MatherHospital on Facebook.
About Northwell Health
Northwell Health is New York State’s largest health care provider and private employer, with 21 hospitals, about 900 outpatient facilities and more than 12,000 affiliated physicians. We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 83,000 employees – 18,900 nurses and 4,900 employed doctors, including members of Northwell Health Physician Partners – are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We’re training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Twitter, Instagram and LinkedIn.
About Healthgrades
Healthgrades is dedicated to empowering stronger and more meaningful connections between patients and their healthcare providers. As the #1 platform for finding a doctor and a leader in healthcare transparency, we help millions of consumers each month find and schedule appointments with their healthcare professional of choice and prepare for their appointments with best-in-class, treatment-focused content.
Our health system, large group practice, and life sciences marketing solutions have been helping our partners reach and engage consumers who are on their way to the doctor for over 20 years.
Healthgrades is part of RVO Health, a partnership between Red Ventures and Optum, part of UnitedHealth Group. RVO Health has the largest consumer health and wellness audience online across its brand portfolio including Healthgrades, Healthline, Medical News Today, Greatist, Psych Central, Bezzy and Platejoy which touch every part of the health and wellness journey. Each month, RVO Health helps more than 100 million unique visitors live their strongest and healthiest lives.
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