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Stony Brook Medicine

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Dr. Kenneth Kaushansky, the dean of the Stony Brook Renaissance School of Medicine at Stony Brook University, is eager to restart the educational mission of training medical school students.

Dr. Kenneth Kaushansky, the dean of the medical school at SBU, said there’s a real possibility of a second wave of COVID-19. File photo

While Gov. Andrew Cuomo (D) has said that medical schools can restart on June 22, Kaushansky has asked for a waiver to allow students to continue to build on their clinical knowledge sooner.

“I was worried about the delay in doing the experiential learning,” Kaushansky said. A delay that lasts too long could push graduation back for the rising fourth year students, which is “not good for any health care professional. We need health care professionals, including respiratory therapists, physical therapists, nurses and social workers” among others.

On top of the need to ensure on-time graduation for the Class of 2021, he said another wave of the COVID-19 crisis will increase the demand for graduates.

The medical school dean said Stony Brook University Hospital is watching carefully the protests over the death of Minneapolis resident George Floyd at the hands of a police officer charged with his murder. The hospital and staff are ready in the event of a spike in demand for health care after large gatherings on Long Island and in New York City.

“We are ready to mobilize on a moment’s notice because we did it the first” time, albeit with numerous questions about the course and potential treatment for the new virus, Kaushansky said.

On Saturday, he sent out a letter to the health sciences community addressing what he termed “health care racism.”

“We witnessed the sum of all these effects in the disproportionate lethal burden of COVID-19 on communities of color, a combination of overcrowding at home, of jobs that do not allow the protection afforded by work from home, or from the disproportionate burden of health care conditions that arise, in part, from health care disparities,” he wrote in the letter. He urged the Stony Brook community to “do everything in our power to work toward erasing the social determinants of disease that contribute to our unequal society.”

He urged learners and critical staff to develop and practice cultural sensitivities, and he also suggested that the school should make “certain our graduates reflect the diverse society in which we live.”

In its admission decisions, SBU includes the notion of overcoming hardship as a part of the process through which the school evaluates prospective students.

In the coming years, Kaushansky plans to emphasize further the importance of encouraging those who have faced significant hurdles in applying to the medical school.

In terms of treating patients who have COVID-19, he is encouraged by the use of remdesivir and convalescent plasma. The school has these treatments available for people who are sick and is studying the effectiveness of these approaches.

More than 1,500 patients have been admitted through the university hospital, Southampton and Eastern Long Island hospitals and have benefited from the clinical study of symptoms including clots.

Surgeons had noticed that D-dimer levels, which are proteins that indicate the presence of clots, were shooting up. They decided when this protein reached a certain level, they would use a full dose of anticoagulants.

Stony Brook has put the results of these aggressive anticoagulant treatments into an article that has been submitted for publication.

In the meantime, the university has taken an across-the-board approach to raising anticoagulants.

“That will improve the mortality rate should we get a second wave,” Kaushansky predicted.

In the event of a second wave, Stony Brook Hospital and, indeed, New York will be better prepared, with more tests, greater awareness and contact tracing.

Kaushansky believes that the people who have already fought off the virus are presumably immune from getting it a second time. What’s unclear, he explained, is whether the antibody test is predictive of resistance. Additionally, it’s unclear how long that resistance will last.

He expects that monoclonal antibodies can work, but that they should be reserved for the sickest patients. They are expensive and are hard to produce the level necessary for the U.S. population of more than 300 million people.

What worries the Stony Brook dean is that people have had enough of staying at home, social distancing and wearing masks. In the worst of the crisis, when the numbers of people sick and dying were climbing, Kaushansky could get to work in much less time than normal, as traffic on the roads had lightened up considerably.

Days before the Phase 2 reopening, which began on Wednesday of this week, the level of traffic has returned to a more normal density.

Meanwhile, Phase 2 for Stony Brook University involves reopening research laboratories and allowing people who were previously deemed nonessential workers to return to the labs in an “orderly and safe fashion,” Kaushansky said.

The university has installed plexiglass shields, requires social distancing, built partitions between people who don’t have their own offices, and requires everyone to wear masks and have their temperatures taken when they come to work.

The hospital opened up for elective surgery two weeks ago. Everyone who is scheduled for surgery has to get a viral swab the day before.

The approach the university has taken in requiring personal protective equipment and social distancing has paid off for hospital staff who have been exposed to all those sick patients. The rate of antibody tests of employees is much lower than in the general community.

“It’s safer to be a frontline health worker at Stony Brook than to work at some grocery stories,” Kaushansky said.

On the clinical side, he believes Stony Brook Hospital needs more highly skilled nurses. At the peak, the university hospital had 437 patients. If it had reached 500, “we would have been in trouble,” he added.

Upstate New York had sent 20 experienced nurses to help out.

“Nursing is important and high-level nursing, operating-room nursing, was particularly stressed,” Kaushansky said. “We need to hire more nurses.”

He added that the school trains excellent nurses and plans to hire some of its own graduates.

In terms of medical school classes, the dean said the university hasn’t decided yet whether to bring small groups back together. The big lecture halls will still involve remote teaching.

“Are the smaller group educational exercises going to be back safely?” he asked. “I’m working to make that happen.”

Kaushansky takes solace in the way PPE reduced the infection rate for the hospital as a whole, and believes such an approach could work for medical school classes as well.

Centerport Resident Among First to Donate Convalescent Blood Plasma

Dr. Elliott Bennett-Guerrero is leading the clinical trial at Stony Brook Medicine which is expected to enroll up to 500 patients who are hospitalized with COVID-19. Photo from Stony Brook Medicine

Stony Brook Medicine has launched a research study in the hopes of developing a treatment for those severely suffering from the coronavirus.

On April 2, SBM began a U.S. Food and Drug Administration-approved research study to determine if convalescent blood plasma from those who’ve recovered from COVID-19 can help treat currently hospitalized patients. One of the first volunteers was Mark Goidell, a litigation attorney from Centerport.

COVID-19 survivor Mark Goidell donates blood plasma for a research study at SBU. Photo from Stony Brook Medicine

The Research Study

Dr. Elliott Bennett-Guerrero, vice chair of Clinical Research and Innovation in the Renaissance School of Medicine Department of Anesthesiology, is heading up the research study. He said the hospital needs approximately 100 volunteers who have recovered from the coronavirus to donate blood plasma, possibly once a week or every other week. Subjects must have contracted COVID-19 and be free of symptoms for 14 days. As of April 22, the doctor said they have received a large number of inquiries leading to 180 people being screened and 90 have been identified as having high levels of antibodies. Currently 25 have either donated blood plasma or are scheduled to do so.

Bennett-Guerrero said researchers are looking for those with high antibody levels of the virus and testing takes about 15 minutes. The donors must also meet regular criteria to be a blood donor, the doctor said, which includes being at least 17 years old, weighing more than 100 pounds, and having no infections Certain travel outside of the U.S. will also be reviewed. 

“We’re very fortunate that we can run this protocol independently, because we have access to a very good test for antibodies, and we also have a licensed blood collection facility already in our hospital,” the doctor said. “So we have those two main ingredients to help us to collect blood plasma and unfortunately have a large number of patients who are in desperate need of help.”

Bennett-Guerrero said the trial will include 500 hospital patients ranging from those who are intubated and those who are not. A higher percentage of patients will receive convalescent serum on a random basis compared to other trials which tend to have 50 percent of patients serve as a control group who receive a placebo.

“Our protocol is unique in that while we want to help as many people as possible, we also want to determine if it’s safe and effective,” the doctor said. “It’s a randomized trial where 80 percent of the patients will receive the convalescent plasma because we hope to benefit as many patients as possible, and there will be a small group of 20 percent of patients that will serve as the control group and get standard plasma. It’s the only way we can rigorously determine if it’s safe and effective to do this.”

Plasma, which is the liquid portion of the blood, helps with clotting and supporting immunity. The hope is the plasma from those who have survived COVID-19 will contain antibodies which in turn can kill the virus in seriously ill patients. According to SBM, convalescent serum therapy is a century-old treatment that has been used in patients during the Spanish Flu pandemic of 1918, the diphtheria epidemic in the U.S. in the 1920s, and more recently, the Ebola outbreak in 2014.

The doctor said it’s too early to determine if giving convalescent blood plasma to a COVID-19 patient will help.

“It’s very early in the stage with this pandemic,” he said. “We’re only beginning to learn what are the patterns of antibody formation in people who had the COVID-19 infection. In general it’s believed that antibodies to COVID-19 will probably persist for a while, perhaps months or years, and likely be protective. However, we don’t know yet if the antibodies that we are measuring actually mean, ‘quote-unquote,’ one is immune and can’t be reinfected. We think that’s probably the case but it’s not proven yet.”

Blood plasma donor Mark Goidell and his wife, Lynn, recently recovered from the coronavirus. Photos from Stony Brook Medicine

The Donor

The doctor said Goidell was a good candidate because he was free of symptoms for a couple of weeks, had high levels of the antibodies in his system and met blood donation criteria.

Both Goidell, 64, and his wife Lynn, 62, came down with the virus. The attorney said he was sick toward the end of February and in early March, and his symptoms included being lethargic and feverish, and at times during the night he would frequently wake up and try to catch his breath, many times going outside to do so.

His wife was admitted to Huntington Hospital March 13 due to having double pneumonia and was discharged a few days later. Goidell said he did have a relapse where he said his symptoms felt like a sinus infection, with a loss of smell and taste. He said he has recovered about 70 percent of those senses.

While his symptoms didn’t initially lead to testing, he said, once his wife was hospitalized he was tested March 17 at an urgent care facility. After reading about the Stony Brook study on the News12 website, Goidell said he was more than willing to participate in the trial.

“It’s heartbreaking to see what’s happening and all the tragedy and anguish that is being brought about by the virus,” Goidell said. “I’m grateful for the fact that I’ve recovered, and I’m able to do something to help.”

He said he feels fortunate to live in close proximity to Stony Brook Medicine. Between his experience with the study so far and his wife’s hospital stay at Huntington Hospital, he has gained an even greater respect and admiration for health care workers. He called those who treated his wife “heroes.”

He added the two of them are now back to working remotely, joking that he has put on some weight due to his wife’s good cooking, and he has been playing a lot of basketball in his driveway to burn off the pounds.

He said he hopes that others who have recovered will donate their plasma, and that others will “stay inside and help each other out.”

“I wish Dr. Bennett-Guerrero and the researchers at Stony Brook the best of luck, and I have the most gratitude for the work they are doing,” he said.

People who have recovered from COVID-19 and want to donate blood plasma can visit www.stonybrookmedicine.edu/COVID_donateplasma where they will be required to fill out an online survey. Potentially eligible people will be asked to participate in a screening visit at a Stony Brook Medicine facility, which will take approximately 30 minutes. You do not need to be a Stony Brook University Hospital patient to participate, but you must meet the required criteria for plasma donation and have high levels of antibodies to the virus that causes COVID-19.

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Stony Brook Medicine has taken further precautions due to the coronavirus pandemic, according to its website.

Stony Brook University is asking that all patients who have cold and flu-like symptoms go directly to its emergency room department. Between 11 a.m. and 11 p.m., patients driving to the emergency department entrance will be greeted and screened while in their vehicles.

Those with cold and flu-like symptoms and mild respiratory symptoms will be directed by staff members to go to the hospital’s new triage area located in the nearby Ambulatory Care Pavilion. The triage area will be staffed by emergency medicine physicians and nurses.

According to Stony Brook Medicine, “the triage service is to separate patients with cold and flu-like symptoms from others seeking emergent care, in order to provide all patients with a streamlined environment for care and treatment.”

SBUH has also revised its visitors policy.  In response to New York State declaring a State of the Emergency due to COVID-19, the hospital will no longer allow visitation until further notice.

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Father Jerry Cestare and Kara LoDolce right before the kidney transplant procedure in January. Photo from Kara LoDolce

A blossoming love led to a lifesaving procedure for a local priest.

Kara LoDolce, left, with her fiancé, Scott Alu, and his children. Photo from Kara LoDolce

In January, Setauket resident Kara LoDolce donated her kidney to Father Jerry Cestare of St. James R.C. Church. When LoDolce first told him that she was going to donate her organ, he said he couldn’t believe it.

“I don’t know how many people can be that selfless,” he said.

The 55-year-old priest said his kidneys were compromised about nine years ago, and while he was careful about his health, at the beginning of last year he felt tired all the time and went for medical testing. He found out he had kidney failure and started dialysis in May, something he said is not a long-term solution for someone his age.

The priest said when doctors first told him to actively start looking for living donors, he felt hesitant because he grasped that someone was giving up something precious. While a few family members were tested, they were found not to be matches, and he couldn’t bring himself to ask others.

“How could I ask someone to do something like that just because I was sick?” he said.

Cestare said while he wasn’t afraid of dying or being incapacitated, he was afraid that he would lose what he loved to do — ministering.

The priest said the chain of events played out like a Hallmark movie.

LoDolce, 46, said she was compelled from the second she heard Cestare needed a new kidney. She and her fiancé, Scott Alu, 42, credit the priest for indirectly helping the two of them meet.

LoDolce said her soon-to-be husband met her in a gym, while he normally wouldn’t ask out a woman with tattoos, which she has, he remembered a recent conversation he had with Cestare. Alu was talking to the priest about looking for a relationship after a divorce, as well as being a father to two children. LoDolce said her fiancé was told to keep an open mind by Cestare, saying, “One thing that God does is he takes the broken pieces of your life and kind of reshapes them into something new, and you just have to be open to opportunities. You have to be open to every opportunity that God puts in front of you.”

When she met Alu, LoDolce lived in Sound Beach, but she said 2½ years ago she moved in with him in Setauket, and she’s been going to the St. James church ever since.

LoDolce said while the church didn’t make an official announcement about Cestare’s condition, she was waiting to hear back from him to discuss her upcoming wedding in May. She was surprised when he didn’t get back to her, and she asked the receptionist who filled her in on what was happening.

When she and her fiancé met with him, she asked if he was on the transplant list. He told her it would be a five-year wait due to his blood type being B+. After the meeting, she called her mother and found out she was B+ also. When she dropped off paperwork, she left Cestare a note saying she would like to be tested.

She went in for the tests and right before Christmas discovered she could donate her kidney to the priest. She bought Cestare a stuffed kidney-shaped toy and gave it to him along with a card and a letter.

“She’s about to start a whole new life, and she’s thinking of me.”

— Jerry Cestare

He said when she gave him the gift, he didn’t open it right away and brought it to his parents’ house where he was going for dinner. When he opened it, he was surprised by the beautiful card and then began reading the letter where LoDolce told him she was a match.

His father asked him to repeat what she wrote because he, “couldn’t believe it,” and the priest said he and his mother started crying.

“Kara felt from the beginning if she could undergo a few weeks of discomfort so that I could get back to work and do what I do best, she said it was worth it,” Cestare said.

The priest decided to announce the good news to the parish at Christmas Mass. Even though he didn’t want the service to be focused on him, he felt LoDolce’s act of kindness symbolized the season.

He said many faiths talk about love but LoDolce, he said, showed it through action and gave him his life, health and ministry back.

“Lots of people talk about love, this woman showed with her action what love is,” he said.

He said Kara and her fiancé received a few standing ovations from the parishioners at the Mass after he announced she was donating her kidney to him.

“She’s about to get married,” he said. “She’s about to start a whole new life, and she’s thinking of me.”

LoDolce said she never wavered from her decision.

“People tell me I did something for him, I don’t feel that way at all,” she said. “I truly feel like he did something for me and he changed my life.”

While most take three or six weeks before they can even go back to work, LoDolce said she felt great after a week, and she was walking two or three miles a day. She also credits both of their recoveries to the parishioners and friends.

“Everyone in the Three Village community has been praying for us,” she said.

LoDolce said she is now putting the finishing touches on her May wedding.

“I joke that both my kidneys will be going to the wedding,“ LoDolce said.

Cestare said he has found the story has inspired others who have heard it with many telling him that they are going to pay it forward by being a better person.

“God is using this experience not only to give me back my life but to touch the lives of others,” he said.

“People tell me I did something for him, I don’t feel that way at all. I truly feel like he did something for me and he changed my life.”

— Kara LoDolce

SBU experts explain living organ donations

Father Jerry Cestare and Kara LoDolce went to Stony Brook University Hospital for their transplant procedure. The priest said many may think they need to travel to New York City for such a procedure, but SBU has a transplantation program right on Long Island.

Dawn Francisquini, administrative director of Stony Brook Medicine’s Kidney Transplantation Services team, said the hospital has been performing the transplants since 1981. She described the program as family friendly and said the staff’s goal is to make patients feel like a person — not a number.

“They know when they come to us they’re going to receive personalized care,” she said.

The first step, she added, is to educate the patients and their family members about the entire procedure as well as what needs to be done before and after. She said it’s important for the family to be part of the conversation because there is a lot of information to be taken in. She added that a transplant is not a cure for kidney disease but a treatment.

Stephen Knapik, living donor coordinator at the medical center, said finding a living donor can save a person’s life as the waiting list for organ transplants can be several years long. 

“I tell all the recipients you have to be your own living donor champion,” Knapik said.

He said he advises patients if they’re uncomfortable asking to get a friend to help spread the word. He also said sharing on social media has been successful in many cases, where after a request is posted, “The next thing you know I’m getting phone calls.”

Knapik said his role in transplants is keeping donors safe. In the case of Cestare’s transplant, he worked with LoDolce. He said donors go through multiple tests including CT scans, chest X-rays and cancer screenings such as mammograms and Pap smears for women and colonoscopies for those over 50.

“I tell all the recipients you have to be your own living donor champion.”

— Stephen Knapik

Once a donor is cleared through testing, a transplant team committee will discuss the donor.

“We want to make sure that we have dotted all the I’s and crossed all the T’s to keep the donor safe,” he said.

Knapik said once a donor is found the transplant team will work with the schedule as far as when the surgeries will take place. For example, he said, a teacher can wait until summer. All the costs are paid by the recipient’s insurance.

He said while LoDolce was quickly back to walking and resuming her normal routine, it’s unusual. Many donors may take weeks to recover fully and can’t drive for about two weeks or lift heavy objects for a few weeks.

“Everybody heals differently,” he said.

He added that after the procedures donors will be required to have checkups to make sure their remaining kidney is compensating and doing well.

“We can take anyone’s kidney out, but we have to make sure, 10, 20, 30 years later, that the remaining kidney is doing well,” Knapik said.

Francisquini said out of the 1,800 transplants the program has done since its inception, 1,000 patients still come to SBUH for routine follow-ups. She said anywhere from 270 to 300 patients are on the active waiting list at any given time, while another 200 can be in the evaluation process. The kidney transplant team performs 75 to 80 procedures a year.

“We have one of the fastest transplant rates in our region,” she said. “So that basically translates into if we put you on the list, we’re serious about transplanting you. We transplant you as quickly as possible.” 

To learn more about Kidney Transplantation Services at Stony Brook Medicine and how to become an organ donor, visit www.stonybrookmedicine.edu/patientcare/transplant/organ_donor.

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In a Q&A with TBR News Media, Carol Gomes, interim chief executive officer at Stony Brook University Hospital, discusses a variety of topics including patient safety, quality control and curbing infections. Here is what she had to say. 

1. Being the interim chief executive officer at the hospital, how important is patient safety and  quality control to the day-to-day operations?

Stony Brook Medicine physicians and staff are committed to providing high-quality, safe patient care.

SBU Hospital CEO Carol Gomes discusses what the hospital is doing to reduce infection potential. Photo from SBU Hospital

Quality and patient safety is priority number one, and we focus on safe patient care every day. The Stony Brook Medicine team convenes a safety huddle that is part of the day-to-day operations in every area, which includes critical leaders from all over the hospital.

We start the day with approximately 35 care team members from nursing leadership, physician leadership and operational leadership who report on important safety or quality opportunities.  Our huddles are highly structured meetings that allow the hospital to focus on process changes with direct follow-up. This drives accountability to help ensure that adequate safety measures are in place for our patients at all times. 

2. Interim SBU President Michael Bernstein mentioned to us that you were making an effort to curb infections at the hospital among other things. Could you discuss some of the initiatives you’ve been implementing to improve in that area?

Stony Brook University Hospital has three primary strategic quality priorities — clinical outcomes, patient safety and the patient experience.

Proactively, Stony Brook works to provide safe and effective care to every patient via our patient safety work groups. These groups analyze processes, review relevant data and implement process changes to enhance patient safety and prevent patient harm.

The vast majority of projects and improvement efforts are aimed at reducing hospital associated infections. There are teams that implement best practices for CLABSI, or central line associated bloodstream infections; hand hygiene; CAUTI, or catheter-associated urinary tract infections; C. diff, or Clostridium difficile infections; SSI, or surgical site infections; and sepsis. 

Working groups incorporate real-time data to implement best practices to ensure hospital units continue to drive improvement efforts in achieving patient safety goals.

3. In general could you talk about the threat of infections to patients at hospitals? Most people view hospitals as a place of recovery and necessarily don’t think of other germs, sick people around them. Can you speak on that and the challenges you and others face?

As a matter of standard practice, the hospital adheres to rigorous infection control guidelines every day to ensure a clean environment for patients, staff and visitors. These practices are especially important during the flu season.

Being within the close quarters of a hospital, there is an increased incidence of transmission for infections. Many patients have recent surgical wounds, IVs and other catheters placing them at higher risk of infection. These risks may be enhanced by the acquisition of an infection from a visitor.

Family members and other visitors who suspect they may have the flu or other viruses are advised to not visit the hospital.

To lessen the spread of the flu virus, hand hygiene and attention to reducing the effects of droplets from respiratory illnesses such as the flu can enhance patient safety.

Hand washing prevents infection. It is one of the most important actions each of us can implement before and after every encounter with a patient.

The goal is to minimize that transmission while the patient is in the hospital.

4. Other practices/guidelines at the hospital?

The flu virus most commonly spreads from an infected person to others. It’s important to stay home while you’re sick, not visit people in the hospital and to limit close contact with others.

Visitors should wash their hands before entering a patient room and after seeing a patient, whether or not there is patient contact. 

As added protection, patients who have been identified as having infections are isolated appropriately from other patients in order to prevent accidental spread.

Therefore, if a patient has the flu or flulike symptoms, the hospital will place them in respiratory isolation. Likewise, a patient with measles or chicken pox is kept in appropriate isolation.

Visitors may be asked to wear masks on certain units.

5. How do patient safety grades affect how the hospital looks to improve
its quality? 

Stony Brook University Hospital supports the public availability of quality and safety information about hospitals. We are constantly looking for ways to improve and ensure the highest quality of care.

There is a wide variation of quality reports with different methodologies and results.

Clinical outcomes define our success as a hospital. Better clinical outcomes means we’re taking better care of our patients. Stony Brook Medicine initiated a major initiative to improve clinical outcomes. We have multidisciplinary groups improving outcomes in the following areas:

  Increasing our time educating patients prior to their discharge in order to prevent hospital readmissions.

  Improving the care of our patients receiving surgery to reduce postoperative complications.

  Enhancing the diagnosis and care of patients with diabetes.

  Improving the speed of diagnosis and treatment of sepsis.

In short, great effort is expended in identifying opportunities for improvement with a detailed and focused approach on enhancing patient outcomes.

Elected officials and Stony Brook Medicine faculty and staff at the Stony Brook Children’s Hospital ribbon-cutting ceremony Oct. 17. Photo from Stony Brook Medicine

Stepping into the main lobby of the new Stony Brook Children’s Hospital, which is slated to open for patient care Nov. 17, it’s apparent that young patients will come first. The downstairs lobby is decorated in soothing tones with a fun nautical theme and one wall features a live feed of fish swimming at the Long Island Aquarium.

Children sit by the live feed from the Long Island Aquarium in the downstairs lobby of Stony Brook Children’s Hospital. Photo from Stony Brook Medicine

In anticipation of the Nov. 17 opening, Stony Brook Medicine held a ribbon-cutting at the site with staff and elected officials in attendance Oct. 17. According to Stony Brook Medicine, the 71,500-square-foot, 114-bed hospital will be the only children’s hospital with single-patient rooms on Long Island.

“We’re really trying to get everything into a child-friendly environment, and this is sort of like the icing on the cake to have our building and to get the pediatric inpatients out from the 11th floor of what is predominantly an adult hospital into this proper space that was designed for kids and their families,” said Dr. Margaret McGovern, professor of pediatrics and physician-in-chief at Stony Brook Children’s Hospital, during a tour and interview two days before the ribbon-cutting.

With a full-service health care program that includes a Level 1 pediatric trauma center, neonatal intensive care unit and more, McGovern said Stony Brook Medicine treats an array of pediatric conditions.

“In general the acuity is high,” she said. “These are kids who really need to be in the hospital. It’s everything from an infection to a broken bone.”

McGovern said the single-bed rooms will provide infection control, comfort, privacy and security. The children’s hospital will be located on floors 4, 5, 6 and 7 in the new Medical and Research Translation building, also known as MART, which combined with using wristbands with devices, will provide extra security for children.

Each patient’s room will have a pull-out sofa for parents to sleep, refrigerator, safe and workspaces for both families and hospital staff. Each room also has a private bathroom with a shower that is wheelchair accessible.

Children in one of the play areas in Stony Brook Children’s Hospital. Photo from Stony Brook Medicine

Dr. Carolyn Milana, interim Chair in the Department of Pediatrics, said that the single-patient rooms will allow medical staff to easily have private conversations with families, as the current rooms have two patients each and can only be divided with a curtain. She said at times medical teams have to step out of a room to have a conversation with parents. 

“This will allow the whole team to come in and really have a conversation with the family in private, and it’s quieter,” Milana said.

The children will also have a remote to control the lighting over artwork hung on the walls, and medical teams will be able to pull up records and patient care educational materials right up on the room’s television screen.

Maureen Cole, RN, associate director of nursing, Children’s Hospital and Women’s Services, said that the rooms were designed after receiving feedback from families on an advisory council.

“They were very instrumental in some of the additions that we have made, and then the children gave a lot of feedback, too, because we have a youth advisory council who have been touring the building,” she said.

Cole said children even offered advice on how they should be spoken to and who should be in the room when conversations occur about their care.

In addition to the private rooms, McGovern said the hospital was designed for respite with play spaces and rooms and even a teen lounge. The building will also have an adolescent unit on a separate floor from younger children and a classroom with Wi-Fi. 

The Ronald McDonald House, a nonprofit which provides support to improve the health of children, has a family room in the hospital so parents can sit and relax and even do work. A washer, dryer and shower across from the room is also available to families.

The building includes an elevator for patients being transported for procedures that is separate from visitors. The special procedure unit will provide services such as sedated MRIs, pediatric endoscopies and bone marrow procedures for both in- and outpatients.

McGovern said nearly 10 years ago Stony Brook Medicine declared themselves a children’s hospital because they recognized the need to expand children’s health care programs in Suffolk County.

“There are about 450,000 kids in Suffolk County,” she said. “That is absolutely a population that can support a children’s hospital. So we’ve been building the number of pediatric providers who are on our full-time faculty — now there’s almost 180 of them, 30 different pediatric specialties.”

McGovern said there are also more than 250 nurses on staff and Child Life Services employees and social workers.

The exterior of Stony Brook Children’s Hospital. Photo from Stony Brook Medicine

“Everyone likes to work in a place that has been thoughtfully designed to help them do their best work,” McGovern said. “I think that has resonated, also, with our staff and keeping good staff. We’re recruiting great physicians here. Pediatricians like to work at children’s hospitals because it says a lot about the commitment of the organization to children’s health to have a children’s hospital. I think that has helped us be successful recruiting doctors here from the best training programs in the country to come and join us to help us take care of the kids in Suffolk County.”

According to Stony Brook Medicine officials, the cost of the construction was $73 million and was part of Stony Brook Medicine’s $450 million expansion, which includes a 10-story hospital pavilion and new cancer center. To help with the cost state Senators Ken LaValle (R-Port Jefferson) and John Flanagan (R-East Northport) secured $50 million from the state. Gov. Andrew Cuomo (D) and the State University of New York, under the leadership of former Chancellor Nancy Zimpher, helped to secure more funds through a $35 million NYSUNY 2020 Challenge Grant.

More contributions came from donors with $25 million from 3,584 contributors to the Children’s Hospital Building Fund, which was supported with two matching gifts of $10 million from an anonymous donor and $2.5 million from the Knapp Swezey Children’s Challenge. An additional $50 million was from a historic $150 million gift to Stony Brook University from Jim and Marilyn Simons.

Delaney Unger, 13, from Selden was on hand for the Oct. 17 ribbon-cutting. An Osteosarcoma survivor, who received a unique amputation called rotationplasty in the spring of 2017, was a patient at Stony Brook Children’s.

“I must say, I am a little jealous of the new beautiful Stony Brook Children’s Hospital,” Delaney said. “I can attest that not only will the children who stay here get the best possible care, but they will also do so in a fantastic new facility designed with them in mind.”

Before the official opening, the hospital invites the community to see the new building Nov. 2 from 10 a.m. to 2 p.m. Pre-registration is preferred at stonybrookchildrens.org/openhouse.

Dr. Minsig Choi and Paul Bingham. Photo from Stony Brook Medicine

By Daniel Dunaief

The Stony Brook Cancer Center is seeking patients with pancreatic cancer for a phase 3 drug trial of a treatment developed by a husband and wife team at SBU.

Dr. Minsig Choi. Photo from Stony Brook Medicine

Led by Minsig Choi, the principal investigator of the clinical trial and a medical oncologist at Stony Brook Cancer Center’s gastroenterology team, the study is part of a multicenter effort to test whether a drug known as CPI-613, or devimistat, can extend the lives of people battling against a form of cancer that often has a survival rate of around 8 percent five years after its discovery.

Paul Bingham. Photo from Stony Brook Medicine

Patients at Stony Brook will either receive the conventional treatment of FOLFIRINOX, or a combination of a FOLFIRINOX and CPI-613. An earlier study demonstrated a median survival of 20 months with the combination of the two drugs, compared with 11 months with just the standard chemotherapy.

“Pancreatic cancer is such a bad disease,” Choi said. “The overall survival is usually less than a year and life expectancy is very limited.”

Choi said the company that is developing the treatment, Rafael Pharmaceuticals, wanted Stony Brook to be a part of the larger phase 3 study because the drug was developed at the university. Indeed, Stony Brook is the only site on Long Island that is offering this treatment to patients who meet the requirements for the study.

People who have received treatment either from Stony Brook or at other facilities are ineligible to be a part of the current trial, Choi said. Additionally, patients with other conditions, such as cardiac or lung issues, would be excluded.

Additionally, the current study is only for “advanced patients with metastatic” pancreatic cancer, he said. People who have earlier forms of this cancer usually receive surgery or other therapies.

“When you’re testing new drugs, you want to start in a more advanced” clinical condition, he added.

Choi said patients who weren’t a part of the study, however, would still have other medical options.

Zuzana Zachar. Photo from Stony Brook Medicine

“The clinical trial is not the only way to treat” pancreatic cancer, he said. These other treatments would include chemotherapy options, palliative care, radiation therapy and other supportive services through social workers.

Choi anticipates that the current study, which his mentor Philip A. Philip, a professor in the Department of Oncology at the Barbara Ann Karmanos Cancer Institute in Detroit is leading, would likely provide preliminary results in the next 18 to 24 months.

If the early results prove especially effective, the drug may receive a fast-track designation at the Food and Drug Administration. That, however, depends on the response rate and the way patients tolerate the treatment.

At this point, Choi anticipates that most of the side effects will be related to the use of chemotherapy, which causes fatigue and weakness. The CPI-613, at least in preliminary studies, has been “pretty well tolerated,” although it, like other drug regimes, can cause upset stomachs, diarrhea and nausea, he said.

Doctors and researchers cautioned that cancer remains a problematic disease and that other drugs to treat forms of cancer have failed when they reach this final stage before FDA approval, in part because cancer can and often does develop ways to work around efforts to eradicate it.

Still, the FDA wouldn’t have approved the use of this drug in this trial unless the earlier studies had shown positive results. Prior to this broader clinical effort, patients who used CPI-613 in combination with FOLFIRINOX had a tumor response rate of 61 percent, compared with about half that rate without the additional treatment.

Paul Bingham, an associate professor in the Department of Biochemistry and Cell Biology at Stony Brook University, and his wife Zuzana Zachar, a research assistant professor and director of Master in Teaching Biology Program at the Institute for STEM Education at Stony Brook, originally invented and discovered the family of drugs that includes CPI-613.

Bingham and Zachar, who are consultants to Rafael Pharmaceuticals, “provide basic scientific support” in connection with this phase 3 trial. “When the FDA asks questions, sometimes it requires us to do basic science” to offer replies, he said.

Zachar and Bingham developed this drug because they anticipated that attacking cancer cell’s metabolism could lead to an effective treatment. Cancer requires considerable energy to continue on its deadly course. This drug, which is a lipoate analog and is an enzyme cofactor in several central processes in metabolism, tricks the disease into believing that it has sufficient energy. Interrupting this energy feedback mechanism causes the cancer cell to starve to death. 

While other cells use some of the same energy feedback pathways, they don’t have the same energy demands and the introduction of the drug, which has tumor-specific effects, is rarely fatal for those cells.

The lipoate analog is a “stable version of the normally transient intermediary that lies to the regulatory systems, which causes them to shut down the metabolism of cancer cells,” Bingham said. These cells “run out of energy.”

Zachar said the process of understanding how CPI-613 could become an effective treatment occurred over the course of years and developed through an “accretion of data that starts to fill in a picture and eventually you get enough information to say that it could be” a candidate to help patients. The process is more “incremental than instantaneous.”

Bingham and Zachar are working on a series of additional research papers that reflect the way different tumors and tumor types have different sensitivities to CPI-613. They expect to publish at least one new paper this year and several more next year.

The researchers who developed this drug have had some contact with patients through the process. While they are not doctors, they are grateful that the work they’ve done has “extended and improved people’s lives,” Bingham said, and they are “grateful for that opportunity.”

Zachar added that she is “thrilled that we’ve been able to help.” She appreciates the contribution the patients make to this research because they “stepped to the line and took the risk to try this drug.”

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Photo from Stony Brook Community Medical

Argen Medical recently joined Stony Brook Community Medical, Stony Brook Medicine’s expanding network of community practices and physicians. The medical group practices obstetrics and gynecology in Port Jefferson Station.

“We are extremely pleased that Dr. Gustavo San Roman is joining the Stony Brook family,” said Dr. Todd Griffin, chair, Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine. “He has been an outstanding Ob-Gyn in the community and a wonderful proponent of women’s health.”

Stony Brook Medicine welcomes private practices that are committed not only to the community but to providing the highest level of quality care. Argen Medical has been providing expert, comprehensive care to women of all ages in the community for more than 30 years.

“I am very excited to be back at Stony Brook University Hospital. I have built a practice based on the concept of providing excellent and personalized Ob-Gyn care,” said San Roman. “With this in mind, I have helped to build many strong families in our community. In fact, I am now taking care of the next generation of women whose births I attended many years ago.”

“As a member of Stony Brook Medicine, I have the honor to continue to provide complete personalized Ob-Gyn services in my Port Jefferson Station office and three local hospitals,” he added.

The Argen Medical team, comprised of San Roman and two nurse practitioners, Laura Doti and Jaclyn Cuccinello, welcomes new patients. And as a bilingual practice, they are able to offer comprehensive services to Spanish-speaking patients as well.

For more information, call 631-331-8777.

Pictured in photo, from left, Jaclyn Cuccinello, Gustavo San Roman and Laura Doti.

From left to right: Daniel Lozeau, Galo Del Heirro, Alexander Dagum, Marissa Ayasse, Richard J Scriven. Photo from SBU

By David Luces

For one Ecuadorian native, attending a lecture by Stony Brook Medicine doctors changed his life.

Galo Del Hierro, 44, who works for the Charles Darwin Foundation in the Galapagos, was attending a lecture given by the Stony Brook Medicine team about skin cancer screenings and prevention in the archipelago. After the lecture, Del Hierro approached Alexander Dagum, a reconstructive plastic surgeon at Stony Brook, and showed him a lesion he had on his right eyelid that was not going away and had grown bigger in the last couple of years.

“He came up to me and said, ‘I’ve had this spot that has gotten larger for some time,’” Dagum said. “I looked at it and thought it was pretty suspicious and told him he should see one of our dermatologists.”

The team’s trip in March was part of a mission through Blanca’s House, a Long Island non-profit organization that works to bring much-needed, quality medical care to countries and communities throughout Latin America. The seven-person team from Stony Brook planned on providing screenings and other care for the local community. As they further examined Del Hierro, they realized they might have to bring him 3,051 miles away to Stony Brook for care.

Dr. Daniel Lozeau, a dermatologist and clinical assistant professor at Stony Brook Medicine, took a look at Del Hierro’s lesion and determined that they needed to do a biopsy. After testing was done, Del Hierro was diagnosed with a malignant melanoma.

Lozeau said given the location of the melanoma it would make it difficult to remove.

“On the eyelid you have less room to work with,” he said. “It not like when it’s on someone’s back, where we have a lot more real estate [to work with].”

Dagum said if people in the Galapagos had anything serious, they would have to go over to the mainland in Ecuador, which is quite far. Initially, he tried to find a doctor on the mainland to perform the surgery for Del Hierro instead of bringing him to Stony Brook as it was more convenient for Del Hierro, but he couldn’t find anyone that could do it.

Lozeau said the cancer Del Hierro had is aggressive, and he could have lost his eye and his life.

Dagum then got clearance to perform the surgery as a teaching case at Stony Brook Medicine and with help from the Darwin Foundation and Blanca’s House, Del Hierro was able to come to Stony Brook for the surgery in May.

The Stony Brook plastic surgeon said the procedure takes several days and requires using skin grafts to reconstruct and support the lower eyelid.

“It was important they we got [the melanoma] out as quickly as possible,” Dagum said.

Dagum and colleagues removed the lesion in full around his eyelids, and reconstructed skin around the eyelid so Del Hierro could see properly and blink normally. He had a second procedure to adjust the eyelid.

The Ecuadorian native said through a translator that he was grateful and impressed with the care he received at Stony Brook.

Del Hierro said that he had first noticed the spot on his eyelid when he was 18 years old.

“It was a tiny little dot, and I didn’t really think much of it, I thought it was just a mole,” he said.

He admitted when he first got his diagnosis, he was worried for himself and his family, but trusted Dagum and the team.

With the procedures complete, Dagum said they are waiting for the swelling to go down and everything should settle in and heal up in the next couple of months.

Dagum expects Del Hierro to live normally; however, he recommends he should continue to get screened and have the eyelid area examined periodically.

Del Hierro’s case and the team’s experiences bring to light the importance of skin cancer screening and skin protection, especially during the summer season.

Lozeau said the Academy of Dermatology recommends sunscreen of SPF 30 or higher.

“Most important thing is to constantly re-apply frequently every couple of hours,” he said. “Hats are good to wear and make sure you have eye protection.”

The dermatologist said when it comes to skin cancer, if one notices a spot that hasn’t gone away or has grown in size, he or she should get it checked out. Also, he mentioned spots that constantly bleed or scab over.

“Galo was really fortunate. He was at the right place at the right time,” Lozeau said.

An aerial view of Stony Brook Eastern Long Island Hospital. Photo from Stony Brook Medicine

On July 1, Stony Brook Medicine announced the newest member of the Stony Brook University Hospital health care system — Eastern Long Island Hospital in Greenport.

The 90-bed, acute care hospital has been affiliated with Stony Brook since 2006, and in 2015, talks began between the two hospitals to form a partnership. The Greenport campus will now be referred to as Stony Brook Eastern Long Island Hospital.

“This really has been a win-win for both the hospital and for the people on the South Fork so let’s do it on the North Fork.”

— Dr. Kenneth Kaushansky

Dr. Kenneth Kaushansky, senior vice president of health sciences and dean of the Renaissance School of Medicine at Stony Brook University, said the partnership will allow SBELIH to work collaboratively with Stony Brook University Hospital and Stony Brook Southampton Hospital, which joined the health care system in 2017.

While Stony Brook Medicine takes on the responsibility of operating the campus when it comes to things such as finances and quality responsibility, Kaushansky said the health care system doesn’t own the other hospitals but leases the buildings from the owners, and staff members are not state employees and continue with the same salaries and unions as before.

He said the partnership with Southampton has been a successful one, and the same is expected with SBELIH.

“This really has been a win-win for both the hospital and for the people on the South Fork so let’s do it on the North Fork,” Kaushansky said.

Stony Brook expects to help grow the Greenport hospital’s staff. Residents of the North Fork, which SBELIH serves along with Shelter Island, now can receive additional resources, particularly specialized outpatient services. Kaushansky said another plus is the use of a telehealth program, which allows doctors and patients on the North Fork direct access to Stony Brook Medicine specialists.

Stony Brook also has its eyes on Long Island Community Hospital in East Patchogue, which Kaushansky said they are in talks with, to see if it makes sense to create a similar affiliation with the facility.

“We would anticipate that behavioral medicine will remain the core service at Eastern Long Island Hospital.”

— Dr. Margaret McGovern

“[It would be] another opportunity for us to grow our health care system, which will give us more bandwidth, give us more opportunity to keep patients as close to home as possible,” he said. “But when it comes time to need more advanced facilities, they have a seamless transition into Stony Brook Hospital.”

Dr. Margaret McGovern, vice president for health system clinical programs and strategy at Stony Brook Medicine, said the affiliation is another step on the path of the health care system expanding.

She and Kaushansky said the behavioral health programs of Eastern Long Island, which include medical-surgical services, critical care, psychiatry and drug and alcohol detoxification and rehabilitation services, are strong.

“We would anticipate that behavioral medicine will remain the core service at Eastern Long Island Hospital,” McGovern said.

Kaushansky added that with limited beds at the university hospital for behavioral health patients, it will be a benefit to be able to utilize SBELIH.

Paul Connor, chief administrative officer of SBELIH, said a psychiatric residency started at the Greenport campus July 1 as a part of Stony Brook Medicine’s academic mission. The CAO said training physicians and health care professionals is important for future staffing needs, as a high percentage of physicians are more apt to remain where they spent their residency.

“This was really an effort to preserve the mission of Eastern Long Island Hospital and ultimately to create more local health care options.”

— Paul Connor

Connor said the hospital opened in 1905 and was the first hospital in Suffolk County and the second one on Long Island.

“This was really an effort to preserve the mission of Eastern Long Island Hospital and ultimately to create more local health care options,” he said.

The hospital’s board will be part of a joint advisory committee with Stony Brook Medicine, he said, and will meet on a regular basis to discuss topics such as finances, planning and safety.

“They’re going to be in a position to influence the operation of the hospital as representatives from the community,” he said.

Connor said the ELIH Foundation will continue to exist and be independent of Stony Brook, which means any funds raised will go toward the SBELIH campus.

McGovern said while Stony Brook is a resource for other hospitals entering the system, providing services such as a burn unit,  psychiatric emergency department and kidney transplant program, many patients prefer to be treated close to home.

“A lot of care is appropriate in a community hospital setting, so that’s the model we’re going with and complementing it with a robust outpatient ambulatory platform,” she said.

In addition to its strong behavioral health programs, SBELIH is also one of two hospitals on Long Island providing skin cancer screenings to all inpatients through its Mollie Biggane Melanoma Foundation.