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Stony Brook University Hospital

Stony Brook University Hospital has once again been named one of America’s 100 Best Hospitals™ for 2021 by Healthgrades – the only hospital on Long Island to receive this distinction for the past three consecutive years. The distinction places Stony Brook University Hospital in the top two percent of nearly 4,500 hospitals assessed nationwide for its consistent, year-over-year superior clinical performance as measured by Healthgrades, the leading resource that connects consumers, physicians and health systems. Only five hospitals in New York State were named among America’s 100 Best Hospitals this year. 

Dr. Kenneth Kaushansky

“This is the equivalent of receiving another A+ on our annual report card for quality care,” said Kenneth Kaushansky, MD, Senior Vice President for Health Sciences, Stony Brook Medicine. “It places us among the top 2 percent of hospitals nationwide. More importantly, it measures results that make a significant difference in the lives of our patients every day.”

Healthgrades analyzes hospitals nationwide to examine in-hospital complication rates and mortality rates. From 2017 through 2019, patients treated in hospitals achieving the award had, on average, a 26.1 percent lower risk of dying than if they were treated in hospitals that did not receive the award, as measured across 19 rated conditions and procedures for which mortality is the outcome.* And during that same period, if all hospitals performed similarly to those achieving the Healthgrades America’s 100 Best Hospitals Award, 172,298 lives could potentially have been saved. 

“These outcomes are the direct result of the high-quality care provided by our staff every day,” said Carol A Gomes, MS, FACHE, CPHQ, Chief Executive Officer for Stony Brook University Hospital. “Their daily commitment to our patients drives these outstanding results, which literally save lives.”

Stony Brook University Hospital has been recognized as One of America’s 100 Best Hospitals for Cardiac Care™ for seven years in a row, One of America’s 100 Best Hospitals for Coronary Intervention and Stroke Care™ for six years in a row.

In fact, Stony Brook is the only hospital in the northeast** region of the U.S., and one of only five hospitals in the nation, to achieve 2021 America’s 100 Best Hospitals Award and America’s 100 Best in Cardiac Care, Coronary Intervention and Stroke Care.

“These types of consistent awards are not achieved by accident,” said Meadow P. Jaime, MA, Director of Quality Solutions for Healthgrades. “This recognition is validation of the ongoing effort and focus that Stony Brook’s dedicated teams have devoted to providing high-quality care and clinical excellence.”

During the 2021 study period (Medicare Fiscal Years 2017-2019), Healthgrades America’s 100 Best Hospitals Award recipients are recognized for overall clinical excellence and providing top quality care across multiple specialty lines and areas. These hospitals showed superior performance in clinical outcomes for patients in the Medicare population across at least 21 of 32 most common inpatient conditions and procedures — as measured by objective performance data (risk-adjusted mortality and in-hospital complications).

“Now more than ever, it is important to celebrate the physicians, nurses and extended care teams that are working around the clock to keep our nation safe. For the select hospitals that have been recognized with a Healthgrades America’s 100 Best Hospitals Award, we extend our heartfelt appreciation and commend them for their ongoing commitment to delivering the highest quality healthcare,” said Brad Bowman, MD, Chief Medical Officer, Healthgrades.

To learn more about how Healthgrades determines award recipients, and for more information on Healthgrades Quality Solutions, please visit www.healthgrades.com/quality.

About Stony Brook University Hospital:

Stony Brook University Hospital (SBUH) is Long Island’s premier academic medical center. With 624 beds, SBUH serves as the region’s only tertiary care center and Regional Trauma Center, and is home to the Stony Brook University Heart Institute, Stony Brook University Cancer Center, Stony Brook Children’s Hospital and Stony Brook University Neurosciences Institute. SBUH also encompasses Suffolk County’s only Level 4 Regional Perinatal Center, state-designated AIDS Center, state-designated Comprehensive Psychiatric Emergency Program, state-designated Burn Center, the Christopher Pendergast ALS Center of Excellence, and Kidney Transplant Center. It is home of the nation’s first Pediatric Multiple Sclerosis Center. To learn more, visit www.stonybrookmedicine.edu/sbuh.

*Statistics are based on Healthgrades analysis of MedPAR data for years 2017 through 2019 and represent 3-year estimates for Medicare patients only.

**Northeast region is defined by the Census Bureau as Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, New Jersey, New York & Pennsylvania.

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What your microbiome really needs is fiber. Stock photo
Studies show significant short-term changes to the microbiome when eating fruits, vegetables and plant fiber

By David Dunaief, M.D.

Dr. David Dunaief

Considering our recent focus on cleansing germs from every surface, it’s a leap to acknowledge that we harbor a multitude of microorganisms, or microbes, in our bodies. We have so many, over one trillion microorganisms, that they outnumber our cells by a 10-to-1 ratio, even in healthy individuals.

These make up what we call the microbiome. It includes bacteria, viruses and single-cell eukaryotes. Our relationship to these organisms is complex, spanning from parasitic to commensalistic (one benefits and the other is not affected) to mutualistic (both benefit). While the microbiome is found throughout our bodies, including the skin, the eyes and the gut, we’re going to focus on the gut, where the majority of the microbiome resides.

Why do we care about the gut microbiome? 

The short answer is it may have a role in diseases — preventing and promoting them. These include obesity, diabetes, irritable bowel syndrome, autoimmune diseases, such as rheumatoid arthritis and Crohn’s, and infectious diseases, such as colitis. Like the Human Genome Project, which mapped our genes, there is a Human Microbiome Project, launched by the National Institutes of Health in 2007, to map out the composition and diversity of these gut organisms. We are still in the early stages of understanding this vast universe of microbes, yet there have been some preliminary studies.

What affects the microbiome? 

Drugs, such as antibiotics, can wipe out the diversity in the microbes, at least in the short term. Also, lifestyle modifications, such as diet, can have an impact. Microbiome diversity also may be significantly different in distinct geographic locations throughout the world. Let’s look at the evidence.

Using twins to study obesity

Obesity can be one of the most frustrating disorders; most obese patients continually struggle to lose weight. Obese and overweight patients now outnumber malnourished individuals worldwide (1). 

I know this will not come as a surprise, but we are a nation with a weight problem; about 70% of Americans are overweight or obese (2) (3). For the longest time, the paradigm for weight loss had been that if you ate fewer calories, you would lose weight. However, extreme low-caloric diets did not seem to have a long-term impact. It turns out that our guts, dominated by bacteria, may play important roles in obesity and weight loss, determining whether we gain or lose weight. Let’s look at the data on obesity.

The results from a study involving human twins and mice are fascinating (4). In each pair of human twins, one was obese and the other was lean. Gut bacteria from obese twins was transplanted into thin mice. The result: the thin mice became obese. However, when the lean human twins’ gut bacteria were transplanted to thin mice, the mice remained thin.

By pairing sets of human twins, one obese and one thin in each set, with mice that were identical to each other and raised in a sterile setting, researchers limited the confounding effects of environment and genetics on weight.

The most intriguing part of the study compared the effects of diet and gut bacteria. When the mice who had received gut transplants from obese twins were provided gut bacteria from thin twins and given fruit- and vegetable-rich, low-fat diet tablets, they lost significant weight. But they only lost weight when on a good diet; there was no impact if the diet was not low in fat. The authors believe this suggests that an effective diet may alter the microbiome of obese patients, helping them lose weight. These are exciting, but preliminary, results. It is not clear yet which bacteria may be contributing these effects.

This definitely suggests that the diversity of gut bacteria may be a crucial piece of the weight-loss puzzle.

Do gut bacteria influence rheumatoid arthritis development?

Rheumatoid arthritis (RA) is an autoimmune disease that can be disabling, with patients typically suffering from significant morning stiffness, joint soreness and joint breakdown. What if gut bacteria influenced RA risk? In a study, the gut bacteria in mice that were made susceptible to RA by deletion of certain genes (HLA-DR genes) were compared to those who were more resistant to developing RA (5). Researchers found that the RA-susceptible mice had a predominance of Clostridium bacteria and that those resistant to RA were dominated by bacteria such as bifidobacteria and Porphyromonadaceae species. The significance is that the bacteria in the RA-resistant mice are known for their anti-inflammatory effects.

Although nobody can say what the ideal gut bacteria should consist of, and the research is still evolving when it comes to the microbiome, there are potential ways of influencing this milieu, especially in our gut. Diet and other lifestyle considerations, such as eating and sleeping patterns or their disruptions, seem to be important to the composition and diversity of gut bacteria (6). Studies have already demonstrated prebiotic effects of fiber and significant short-term changes to the microbiome when eating fruits, vegetables and plant fiber. The research is continuing, but we’ve learned a lot already that may help us tackle obesity, inflammatory bowel syndrome and autoimmune disorders.

References:

(1) “The Evolution of Obesity”; Johns Hopkins University Press; 2009. (2) cdc.gov (3) nih.gov (4) Science. 2013;341:1241214. (5) PLoS One. 2012;7:e36095. (6) Nutrients. 2019 Dec;11(12):2862.

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. 

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METRO photo

Looking to make a difference? Become an Ombudsman volunteer today.

Ombudsmen provide advocacy and resources for people who reside in long-term care facilities such as nursing homes, assisted living, and adult care facilities. They advocate for and resolve problems for all individuals living in long term care communities by protecting rights, honoring dignity, and ensuring respect. Trained certified volunteers regularly visit assigned facilities so that residents may have the highest quality of life and care.

For further details, call the Ombudsman Program of Suffolk County at 631-470-6755.

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Photo from Pixabay

Comsewogue Public Library in Port Jefferson Station presents an important online program, COVID-19 and Vaccines: Just the Facts, on Monday, Feb. 1 at 7 p.m. 

Get a science-based overview of the novel coronavirus that causes COVID-19 including a discussion on the safety of vaccines, how long immunity may last, and more with Ph.D. pharmacologist Andrew Clair. Open to all. Visit www.cplib.org/a-online-programming/ for information on how to participate in this program. Questions? Call 631-928-1212 and ask for Adult Services.

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Stock photo

Beginning February 4, Avalon Nature Preserve in Stony Brook presents a 9-week virtual Mindfulness-Based Stress Reduction (MBSR) program. The classes will be held on consecutive Thursdays via Zoom from 10:30 a.m. to 1 p.m. through April 1.

Are you ready to be more active in your own well-being and health? Would you like to strengthen your resilience, improve coping with stress, and gain a sense of greater ease and balance in your life?

If so, this winter may be the time to join this supportive and experiential 9-week MBSR course that teaches, in a step-by-step fashion, the practice of mindfulness meditation for well-being in daily life.

Known as the Gold Standard for learning mindfulness meditation, MBSR was developed by Dr. Jon Kabat-Zinn at the University of Massachusetts’ Medical Center has been featured in countless media segments, hundreds of research studies and is now offered all over the world in hospitals, schools, business and sports. And at Avalon for the past 10 years!

This course is offered by Cheryl Kurash, Ph.D, Psychologist and Certified MBSR Teacher through UMASS Center for Mindfulness

Want to know more? For additional information and to pre-register for the course,
click the button below:

Join us!

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Blood pressure numbers of less than 120/80 mm Hg are considered within the normal range.
Nighttime blood pressure readings may be more accurate predictors

By David Dunaief, M.D.

Dr. David Dunaief

What could we possibly learn about blood pressure that we have not heard already? Studies teach us about diagnostic techniques and timing, as well as consequences of hypertension and its treatment. 

Two arms please

When you go to the doctor’s office, they usually take your blood pressure first. But do they take readings in both arms and, if so, have you wondered why? I take blood pressure readings in both arms, because there may be significant benefit from this.

Researchers analyzed the Framingham Heart Study and Offspring Study and found that when blood pressure was taken in both arms and there was a difference of more than 10 mm Hg in the systolic (top number) blood pressure, they could identify an almost 40 percent increased risk of having a cardiac event, such as a stroke or a heart attack (1).

So, the next time you go to the doctor’s office, ask them to take your blood pressure in both arms to give you and your doctor a potential preliminary indication of increased cardiovascular disease risk.

Night beats daytime

When do you take your blood pressure? For most of us it is usually at the doctor’s office in the middle of the day. This may not be the most effective reading. Nighttime blood pressure readings may be the most accurate, according to one study (2). 

This was a meta-analysis of nine observational studies involving over 13,000 patients. Neither the clinical nor daytime readings correlated significantly with cardiovascular events when multiple confounding variables were taken into account. However, every 10 mm Hg increase at night had a significant predictive value.

With patients, if blood pressure is high in my office, I suggest that they take their blood pressure at home, both in the morning and at night, and send me weekly readings. At least one of the readings should be taken before antihypertensive medications are taken, since these will alter the numbers.

Pass on the salt

There has always been a debate about whether salt plays a role in high blood pressure and heart disease. A compelling British study, called the Health Survey from England, implicates sodium as one potential factor exacerbating the risk for high blood pressure and, ultimately, cardiovascular disease (3). The results show that when salt intake was reduced by an average of 15 percent, there was a significant blood pressure reduction and that this reduction may be at least partially responsible for a 40 percent reduction in stroke mortality and a 42 percent reduction in heart disease mortality.

One potential study weakness was that physical activity was not taken into account. However, this study’s strength was that it measured salt intake through 24-hour urine tests. Most of our dietary salt comes from processed foods we least suspect, such as breads, pastas and cheeses.

Check your eyes

When we think of blood pressure-lowering medications, we don’t usually consider age-related macular degeneration as a potential side effect. However, in the Beaver Dam Eye Study, patients who were taking blood pressure medications were at a significant 72 percent increased overall risk of developing early-stage AMD (4). It did not matter which class of blood pressure-lowering drug the patient was using, all had similar effects: calcium channel blockers, beta blockers, diuretics, and angiotensin receptor blockers.

However, the researchers indicated that they could not determine whether the blood pressure or the blood pressure medication was the potential contributing factor. This is a controversial topic. If you are on blood pressure medications and are more than 65 years old, I would recommend that you get yearly eye exams by your ophthalmologist.

Manage your fall risk

One study shows that blood pressure medications significantly increase fall risk in the elderly (5). Overall, nine percent of these patients on blood pressure medications were seriously injured when they fell. Those who were considered moderate users of these medications had a 40 percent increased risk of fall. But, interestingly, those who were consider high-intensity users had a slightly less robust risk of fall (28 percent) than the moderate users. The researchers used the Medicare database with 5,000 participants as their data source. The average age of the participants in the study was 80.

Does this mean that we should discontinue blood pressure medications in this population? Not necessarily. This should be assessed at an individual level between the patient and the doctor. Also, one weakness of this study was that there was no dose-response curve. In other words, as the dosage increased with high blood pressure medications, one would expect a greater fall risk. However, the opposite was true.

So, we have some simple, easy-to-implement, takeaways. First, consider monitoring blood pressure in both arms, since a difference can mean an increased risk of cardiovascular events. Reduce your salt intake; it appears that many people may be sensitive to salt, as shown by the British study. If you do take blood pressure medications and are at least 65 years old, take steps to reduce your risk of falling and have annual ophthalmic exams to check for AMD.

References:

(1) Am J Med. 2014 Mar;127(3):209-215. (2) J Am Soc Hypertens 2014;8:e59. (3) BMJ Open 2014;4:e004549. (4) Ophthalmology online April 30, 2014. (5) JAMA Intern Med. 2014;174(4):588-595.

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. 

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Teresa Habacker, MD, FAAOS, FASSH

Teresa Habacker, MD, FAAOS, FASSH and her practice, East End Hand Center, have joined Stony Brook Medicine Community Medical Group, Stony Brook Medicine’s expanding network of community practices.

“We are happy to welcome Dr. Habacker to a more inclusive role in Stony Brook Medicine. For more than five years, Dr. Habacker has served the Stony Brook Medicine community on the hand surgery/trauma team and the Hand Surgery Fellowship Training Program,” said Lawrence Hurst, MD, Professor and Chair of Orthopaedics, Chief of Hand Surgery at Stony Brook Medicine. “In our new relationship, we look forward to expanding her role in these areas, as well as the Center for Musculoskeletal Health, providing world-class care to patients on the East End.”

Dr. Habacker is a board-certified orthopedic surgeon with an additional certification in hand surgery. She provides comprehensive orthopedic care in Mattituck, Port Jefferson, Southampton and Wading River.

“I have had the pleasure of working with Dr. Hurst and the hand surgery team,” said Dr. Habacker. “I am pleased to be a part of the Center for Musculoskeletal Health and I look forward to working with the local physicians and ancillary teams as I continue to serve the communities on the East End of Long Island.”

Dr. Habacker completed her medical degree at the Medical College of Virginia in Richmond, VA. She completed her surgical residency at SUNY Downstate Medical School in Brooklyn, NY and her orthopedic surgical residencies at Louisiana State University in New Orleans, LA and Long Island Jewish Medical Center in New Hyde Park, NY. Dr. Habacker then went on to complete a hand surgery fellowship at Thomas Jefferson University in Philadelphia, PA. She is an Assistant Clinical Professor and has admitting privileges at Stony Brook University Hospital, Catholic Health Services and Northwell Health hospitals in Suffolk County.

East End Hand Center is accepting new patients. Office hours are Monday through Friday. To make an appointment, call 631-473-4263.

About Stony Brook Medicine

Stony Brook Medicine integrates and elevates all of Stony Brook University’s health-related initiatives: education, research and patient care. It includes five Health Sciences schools — Dental Medicine, Health Technology and Management, Medicine, Nursing and Social Welfare — as well as Stony Brook University Hospital, Stony Brook Southampton Hospital, Stony Brook Eastern Long Island Hospital, Stony Brook Children’s Hospital and more than 230 community-based healthcare settings throughout Suffolk County. To learn more, visit www.stonybrookmedicine.edu

About Stony Brook Medicine Community Medical Group 

Stony Brook Medicine Community Medical Group, an arm of Stony Brook Medicine, includes over 35 community practices with over 50 locations across Long Island, from Farmingdale to Greenport. We offer exceptional care by more than 100 providers in 18 specialties committed to enhancing medical care coordination in the community. To learn more, visit sbcommunitymedical.org 

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From left, Richelle Rugolo and Debbie Loggia (Photo from Jefferson's Ferry)
Jefferson’s Ferry in South Setauket recognized two employees for their outstanding commitment and exceptional care and leadership at the award-winning life plan community located at One Jefferson Ferry Drive. Director of Nursing Richelle Rugolo was named Manager of the Year and Certified Nursing Assistant Debbie Loggia was named Employee of the Year. The announcement was made by Jefferson’s Ferry CEO Bob Caulfield.

“2020, though one of the most challenging we’ve faced due to COVID-19, showcased the caliber, dedication, and heart of our employees,” said Caulfield. “Individuals like Richelle and Debbie protect and care for our residents, inspire our teams, and exceed the high standards we set for ourselves as a premier life plan community.”

Rugolo has served as the director of nursing at Jefferson’s Ferry for six years. Under her leadership, Jefferson’s Ferry has resulted in an overall 5 Star Rating by ​The Centers for Medicare and Medicaid Services (CMS), and was named a “Best Of” nursing home by U.S. News & World Report.

“Richelle consistently strives for exceptional outcomes and manages performance to the highest standards which are reflected in the results of our third-party satisfaction surveys and NY State Department of Health surveys,” said Caulfield. “She’s a respected professional whose sound leadership created a safe haven for both residents and staff.”

Loggia joined Jefferson’s Ferry as a certified nursing assistant in 2011. “Debbie is a dedicated and respected member of the nursing team, who cares for residents with a smile and a positive attitude,” said Caulfield.

Residents and families express their respect and appreciation for Debbie through surveys and positive messages, and recognize her as an advocate, always trying to better accommodate residents’ needs.

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Online education has been part of the School of Nursing since 1994. Photo from Stony Brook Medicine

For the second year in a row, the Stony Brook University School of Nursing’s Online Master’s Program was ranked in the top 10 schools nationwide by the U.S. News and World Report in its 2021 College Rankings.

The program has remained in the top 20 for online graduate nursing programs in all but one of the past eight years. In 2020, the program was ranked 7th and in 2021 ranked 9th in the list of Best Online Master’s in Nursing Programs. Officials at the school say the change in ranking from last year to this year may be due to the slight decline in faculty numbers because additional hiring remained difficult due to the pandemic.

The School of Nursing began offering online education in 1994. It started with a Midwifery program and developed into an array of other nurse practitioner education programs. This led to more than 25 years of developing and refining innovative online programs to provide a firm foundation of new online learning applications for nurses and future nurses.

“Our longstanding experience became critical to continued success with online learning this past year in responding to the health care needs and educational changes during the pandemic,” says Annette Wysocki, PhD, RN, FAAN, Dean of the School of Nursing. “Our constant attention to content and presentation methods provides students with visual, graphic and other ways to access content, and this even includes active engagement with simulated clinical experiences within online educational platforms.”

According to U.S. News, online graduate nursing data used as methodology to calculate the rankings included five areas of data: engagement (30 percent); expert opinion (20 percent); faculty credentialing and training (20 percent); services and technologies (20 percent); and student excellence (10 percent).

For more details about the methodology, see this link.

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GAL resident Harry Cohen receives first dose of COVID-19 Vaccine

Residents and staff at Gurwin Jewish ~ Fay J. Lindner Residences assisted living community, part of the Gurwin Healthcare System in Commack, received their first dose of the two-dose BioNTech Pfizer vaccine for COVID-19 this week.

Walgreens, Gurwin’s pharmacy partner in providing the COVID-19 vaccine, had a number of pharmacists on hand to administer more than 200 doses of the vaccine on Monday at the assisted living community, and are scheduled for two additional clinics to complete the vaccination and allow others who may have missed the first clinic to receive it.

Residents and staff at Gurwin Jewish Nursing & Rehabilitation Center, the Healthcare System’s 460-bed skilled nursing facility, received their first dose of the vaccine in December. Visiting has been restricted at all assisted living and long-term care facilities since March, when the COVID-19 crisis began, and is dependent on new cases of COVID-19 among staff and residents. The vaccine is seen as a ray of hope in fully reuniting families and returning to typical activities for residents.

“Our staff has done an amazing job in keeping our residents engaged and well,” said Michael Letter, Administrator/COO of the assisted living community. “Even though we’ve been able to have modified visiting sporadically, the vaccine is the first real step in being able to return to normalcy, and we are thankful to have been prioritized to receive the vaccine.” More than 50% of Gurwin’s assisted living community staff, and all but one resident, will have been vaccinated after the second clinic, set for February 8.

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