Healthy Living 04-13-2016

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AN ANTON MEDIA GROUP SPECIAL

HealthyLiving Healthy APRIL 13 - 19, 2016

Autism Awareness

• Gluten free recipe • Your Healthy Liver

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INSIDE Infertility woes

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HEALTHY LIVING • APRIL 13 - 19, 2016

AUTISM AWARENESS MONTH

Researchers Discover That Maternal Antibodies Are Risk Factors For Autism BY BRANDI HERNSTAT SpecialSectionS@antonmediagroup.com

Investigators at The Feinstein Institute for Medical Research have discovered that an antibody—an immune protein in the body that fights illness or infection—can lead to abnormal brain development and Autism Spectrum Disorder (ASD) symptoms. These findings were recently presented at the 45th annual meeting of the Society for Neuroscience in Chicago. ASD refers to a group of complex brain development disorders characterized by difficulties in social interaction and communication, repetitive behaviors, and motor dysfunction. In the U.S., ASD is estimated to affect 1 in 68 children. The causes of ASD remain unknown, but brain changes start very early in life, most likely in utero. Researchers have previously identified genetic variants that may contribute to ASD, but ASD can likely also be caused by environmental

risk factors, perhaps found in utero. Factors that may harm the fetal brain include maternal antibodies that bind to and interfere with brain cells. These antibodies have been identified in the blood of some mothers of ASD children. Mothers are protected from these antibodies by the blood-brain barrier, but embryos may be vulnerable before the barrier has formed. Feinstein Institute researchers, including Lior Brimberg, PhD, lead author of the study and post-doctoral fellow, and Betty Diamond, MD, head of the Center for Autoimmune and Musculoskeletal Diseases, found that a particular monoclonal antibody isolated from a mother of an ASD child caused structural brain changes and ASD-like behaviors

Lior Brimberg in male offspring. The researchers determined that the antibody attacks a protein on the membrane of brain cells that is key in neuronal morphology and function. In previous studies, the gene for that same protein had been linked to ASD, and the deletion of this protein in

mice has been shown to lead to ASD-like behaviors. “Our finding that a single maternal anti-brain antibody mediates fetal brain abnormalities and long-term behavioral changes provides new insight into ASD,” said Brimberg. “Our study suggests that by blocking maternal antibodies, a subset of cases of ASD might be preventable. With this finding, we are a step closer to developing treatments that could prevent the onset of ASD.” This research was supported by funding from Simons Foundation, and Department of Defense. Brimberg presented these findings in a scientific presentation entitled “6421, Probing the contribution of maternal antibodies to Autism Spectrum Disorder,” during the annual meeting of the Society for Neuroscience in Chicago. The Society for Neuroscience is an organization of nearly 40,000 basic scientists and clinicians who study the brain and nervous system.

Autism Speaks Celebrates World Autism Awareness Day The Autism Speaks organization recently gathered to celebrate the 8th Annual World Autism Awareness Day (WAAD). The dome of the Theodore Roosevelt Executive & Legislative Building in Mineola is illuminated blue in honor of Autism Speaks’ “Light it up Blue” campaign, and in celebration of WAAD. “I am proud to show support for individuals and families who are affected by autism,” said Nassau County Executive Ed Mangano. “We join thousands of landmarks, communities, businesses and homes around

the world who are ‘lighting up blue’ in support of this initiative.” According to the Centers for Disease Control, 1 in 68 children are diagnosed with an autism spectrum disorder. That’s why Autism Speaks and World Autism Awareness Day are so important. They increase global knowledge about autism, and spread awareness about the importance of early diagnosis and early intervention. Pictured: Asuasa Price, John Beyer, Virginia A. Connell, Ed Mangano, Jim Fahey, Eddie Russo and Edward J. Nitkewicz.

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How To Best Support Friends, Family Faced With Infertility

April 24-30 is Infertility Awareness Week. In honor of spreading awareness and support for those struggling with this painful challenge, I wrote an article that is very close to my own heart. I hope it serves you well and gives you a glimpse into how to best be there for anyone you know struggling with infertility.

you pregnant yet?” Unfortunately, fertility treatments and protocols are emotionally and physically taxing and don’t always reap the success that we hope they do immediately, if at all. This question puts a great deal of pressure on your loved ones, in a process that they ultimately have zero control over.

Supporting the people you love through life’s more challenging experiences — such as the struggle with infertility—requires being especially thoughtful and mindful of the words and actions that are meant to show care and empathy. Saying “the wrong thing,” as well intended as it can be, can too often cause additional pain and suffering to those couples trying so hard to conceive a child. Here are some tips that I use with my clients and their families on how to shift your support from a state of helplessness to a space of helpfulness.

Stay Conscious of Your Words

Honor Their Privacy

Know that the subject of baby-making is a very personal one and hold back from asking questions like “Are

Refrain from telling your friends that if they relax, they will conceive. Babies are conceived in times of war, among starving populations and under other immensely stressful situations. This theory implies that they are somehow at fault for not having been able to conceive a child, causing them to feel like they are somehow to blame for their misfortune. Advising them to adopt

is another piece of advice you should steer clear of. Adoption is a beautiful way to grow a family but clearly not the chosen path for your family member or friend who is struggling with infertility. Furthermore, it is a very challenging and emotional process in and of itself, and is not a comforting option for a couple who hopes to conceive biologically.

Give Them Space

Try to be understanding of your loved one’s situation by excusing them from participating in your celebratory events. Although they are happy and excited for you, they are simply not in an emotional space for celebrating much of anything. Extend your invitation to them so they feel included and give them the space to decide if

joining in on your festivities will be their best option at this moment.

Extend Your Support

Do let them know that you are there for them to support them in any way they may need you to. Ask them to take the lead in communicating what that looks like for them. This is very individual and can greatly very from person to person. For some, support means not asking them to get together for an extended period of time. For others, it is a check-in text or phone call every week to let them know you are thinking of them and sending your love. Let them set the tone. Although being there for your friends who are struggling with fertility won’t cure them of their struggles, using a mindful and thoughtful approach to supporting them can give them a great deal of peace in an otherwise heartbreaking and isolating journey. Melody Pourmoradi is a women’s wellness and lifestyle coach at Life Evolutions Coaching. Learn more about her services at www. lifeevolutionscoaching.com

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Chronic Liver Disease Treatment Advances

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The treatments of chronic liver disease have improved dramatically over the past 10 years with new, potent and effective therapies available for conditions such as hepatitis B and C and soon to be available for primary biliary cholangitis and fatty liver disease. These treatment advances have highlighted the need for safe, effective and patient-accepted methods of assessing disease prognosis. The prognosis of chronic liver disease has historically been determined by the degree of fibrosis or scarring within the liver and this has not changed as treatments have advanced. Therefore, it is more important than ever to assess the degree of scarring in all patients with liver disease, regardless of cause, and to be able to do that serially over time. There are currently three methods to assess how much fibrosis is present within the liver. These are serum biomarkers or blood tests, liver biopsy or transient elastography. Blood tests are the most widely available method to estimate fibrosis. There are several available commercial tests and several simple formulas that clinicians can use to estimate the amount of fibrosis. All of these tests share similar characteristics. They are relatively inexpensive, non-invasive and excellent at predicting minimal fibrosis or advanced cirrhosis. They are of little use when patients are not at either end of the fibrosis spectrum. Therefore, the use of these tests as the sole method to determine fibrosis stage should be discouraged. Liver biopsy has been the gold standard for assessing fibrosis. Unfortunately, the reputation of a liver biopsy has taken a beating as it is invasive and potentially associated with complications such as pain, bleeding, etc. Liver biopsy actually has multiple purposes in assessing patients with liver disease. It is performed to help determine the etiology of the liver disease, and to evaluate the extent of inflammation, fibrosis and fatty infiltration. In many circumstances, liver biopsy remains a very important tool in the evaluation of liver disease and should be continued to be used in those specific settings.

THE SPECIALIST David Bernstein, MD

Transient elastography is the third and newest method to determine how much fibrosis is present in a diseased liver. This technology employs ultrasound technology which measures the velocity of a shear wave after the wave has bounced off the liver and returned to the transducer. This technology is very attractive as it is relatively inexpensive, is non-invasive and can be repeated serially thus giving the patient a way of tracking disease progression or improvement over time. The test takes about 10 minutes and results are immediately available. While this sounds wonderful and it is, there remain several drawbacks to this technology. Results are affected by eating so patients need to have had nothing to eat for several hours prior to the test. The test is excellent at differentiating mild disease from advanced disease but is not as effective in differentiating moderate disease from either extreme. In addition, results may be variable in patients with a high body mass index and the results are highly dependent upon the skill of the person performing the test. Despite these negatives, transient elastography is a very promising tool to assess all patients with liver disease and further advances in this technology are forthcoming. It is highly likely that the assessment of fibrosis in the future will be a combination of the above modalities, with the most likely combination being blood tests and transient elastography as these tests are the least expensive, least invasive and most accepted by patients. David Bernstein, MD, is chief of gastroenterology, hepatology and nutrition at North Shore University Hospital and Long Island Jewish Medical Center.


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April Is Sports Eye Safety Month Parents and coaches play an important role in making sure young athletes protect their eyes and properly gear up for the game. Protective eyewear should be part of any uniform because it plays such an important role in reducing sports-related eye injury. Eye injuries are the leading cause of blindness in children in the United States and most injuries occurring in school-aged children are sports-related. These injuries account for an estimated 100,000 physician visits per year at a cost of more than $175 million. Ninety percent of sports-related eye injuries can be avoided with the use of protective eyewear. Protective eyewear includes safety glasses and goggles, safety shields and eye guards designed for a particular sport. Ordinary prescription glasses, contact lenses and sunglasses do not protect against eye injuries. Safety goggles should be worn over them. Currently, most youth sports leagues do not require the use of eye protection. Parents and coaches must insist that children wear safety glasses or goggles whenever they play. Protective eyewear, which is made of ultra-strong polycarbonate, is 10 times more impact resistant than

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Even professional athletes like Dwyane Wade wear protective eye wear during sports.

other plastics and does not reduce vision. All children who play sports should use protective eyewear, not just those who wear eyeglasses or contact lenses. For children who do wear glasses or contact lenses, most protective eyewear can be made to match their prescriptions. It is especially important for student athletes who have vision in only one eye or a

history of eye injury or eye surgery to use protective eyewear. Whether you are a parent, teacher or coach, you can encourage schools to adopt a policy on protective eyewear. Meanwhile, parents and coaches should insist that children wear protective eyewear whenever they play sports and be good role models and wear it themselves.

For more information about sports-related activities and protective eyewear, visit: •Coalition to Prevent Sports Eye Injuries (www.sportseyeinjuries.com) •Vision Council of America (www.thevisioncouncil.org) •Prevent Blindness America (www.preventblindness.org)

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AUTISM AWARENESS MONTH

Obstacles To Diagnosing Autism Spectrum Disorder BY ALISON GILBERT SpecialSectionS@antonmediagroup.com

Recent research suggests that children reach an average age of 4-5 years before receiving a proper Autism Spectrum Disorder (ASD) diagnosis. Yet, there is ample evidence that we can identify ASD symptoms as early as 12 months of age. In fact, the American Academy of Pediatrics recommends screening all children for ASD using the M-Chat-R assessment at the 18- and 24-month well visits. There is also evidence to suggest that early intervention leads to better outcomes among individuals with an ASD diagnosis within the first three years of life.

Resources

Parents may be unsure of who they can turn to for help or for proper ASD assessment and/or treatment.

Anxiety

Lack of support

Parents may talk with a physician who overlooks or dismisses their concerns. Parents may also feel alone and isolated because they haven’t identified other people with whom they can share their questions or experiences.

Parents may feel anxious about expressing even mild concerns What can to a physician parents do? If everybody were because it Parents can confirms that like everybody else how familiarize they may be boring it would be. The themselves based in reality. with ASD signs In addition, fear things that make me and symptoms may be prediff erent are the things by visiting the venting parents that make me, me! Autism Speaks from listening website. They to concerns that – Winnie the Pooh can also access are expressed the M-Chat-R by other family self-assessment online and bring members. it to their pediatrician for further Depression discussion. These assessments can Parents may recognize the signs also be reviewed with a specialist in of ASD and feel sad, hopeless or child psychiatry, child psychology or helpless about how they can help with a developmental pediatrician, their child. all of whom focus on diagnosing ASD.

Why might it take so long for the average child to receive a proper diagnosis of ASD?

Knowledge

Parents may not be equipped with accurate information about ASD, including signs and symptoms.

With ASD prevalence rates of 1 in 68 (and 1 in 42, for boys) parents should know that similar concerns are a part of every community and that support groups are often offered locally. Moreover, it is important for parents to know that identifying even mild problems in children and tackling them early on comes with immense gains in the child’s development. And, while parenting a child with ASD comes with great responsibility, it also comes with great reward. It is an indescribably uplifting experience to see a child with special needs accomplish goals that come much more easily to others. For the child with special needs, there is a sense of pride when he or she accomplishes tasks that were once thought to be insurmountable. Empowering your family through a proper diagnosis can bring relief, support and success. Alison Gilbert, Ph.D. is a licensed clinical psychologist. She is currently a clinical assistant professor at Hofstra Northwell School of Medicine.

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Integrated Medical Foundation (IMF), a 501(c)3 organization which promotes awareness and early detection of prostate cancer, recently announced its honoring of Steven Mendelsohn, MD, CEO of ZwangerPesiri Radiology the “Blue Ribbon Physician Award”; the “Founders Award” to Eric Mitchnick, MD, a urologist with Advanced Urology Centers (Port Jefferson) and “Woman of the Year” awarded to Diana Mitchnick, Pink Aid Long Island (Dix Hills). “I am honored to be recognized for my strong and valued partnership with Integrated Medical Foundation, and for our shared commitment to improve health care through early detection and education,” said

Mendelsohn. “Together with IMF, Zwanger-Pesiri Radiology looks forward to continuing to find ways to help men understand the importance of getting a prostate cancer screening and delivering solutions that help practitioners provide screenings that are so critical.” Each year the awards are given to a deserving person who has supported IMF’s mission of saving lives through advocacy, awareness, and screenings at its annual “Blue and Pink Ribbon Comedy for a Cause” in Woodbury. “Early detection saves lives,” said Rhonda Samuel, executive director of IMF. “We are thrilled to have presented these awards to three very deserving honorees who are committed to early detection of prostate and breast cancer.”

How To Co-Parent With A Narcissist By Jeremy Skow, LMHC, CASAC, MBA

Divorce is never easy on children. If you are co-parenting with a narcissist your stressful situation is even harder. They are egotistical, vain, conceited and self-centered. Their extraordinary lack of empathy for others, coupled with fantasies about their uniqueness, brilliance, and entitlement may create an urgent need for them to win or be considered right. Narcissists will lie, manipulate and use anyone, including their children, to get what they want. The unfortunate truth is, when one side tries to “win” in divorce, it’s typically the children who lose. Since this is likely beyond them, the added burden falls on you. Narcissists thrive on the drama they create because it provides them with narcissistic supply. It keeps them in the spotlight, and they will take any supply they can get, even if it’s negative. Your job therefore is to reduce conflict. She is attention seeking. Behavioral psychology teaches us that if you want a behavior to stop you ignore it. When she notices that you are not engaging she may intensify her behavior but you mustn’t waver. In time we hope she will realize that you will not supply her with what she needs, she’ll move on to other sources and

leave you in peace. You will not be able to co-parent with a narcissist because he has no concept of teamwork or cooperation. Start by minimizing contact with him. Narcissists love to engage in psychological battles. Ignore emails that are just ranting, attention seeking, or expressions of self-aggrandizement. His hidden agenda is to keep you entrenched in the relationship, even years after the relationship has ended. You should establish and maintain boundaries. These will define what is acceptable to you and may include respecting your property, space, or time. She will not like the boundaries you set, where you draw the line, and even the fact that you drew a line. She may rant or tantrum at first but, if you maintain your boundaries firmly, she will succumb. If he can make you angry or lose control of yourself by yelling, crying, or pleading he will feel like he has won. If he gets this behavioral reward, he will continue to act in ways that make you overly emotional. Remain as unemotional as possible. It is the best way to interact with a narcissist. This tends to be very difficult which is why minimizing contact with him is typically the best way to help you maintain control of

yourself. It is important that your children see at least one healthy parent. A healthy role model will help them not only survive, but thrive. You need to show them that although they may not be able to control their unhealthy parent’s behavior, they are able to control their own. Better they learn about proper emotional regulation and healthy coping skills from you. Age-appropriate, straight-shooting communication can be highly effective in these situations. Avoid speaking poorly about your ex to your children. They are not equipped to deal with this psychological weight, no matter how mature they may seem. They want to think highly of both parents. If we are in any way causing our children to feel that their other parent does not love them, does not love them enough, or that they have to choose a parent to side with, we are hurting them. No one deserves to grow up with a selfish, self-absorbed parent, but there are worse plights. Try to avoid feeling sorry for your children. Showing pity only perpetuates a victim mentality, and will keep them from moving forward and seeking healthy relationships of their own.

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Jeremy Skow maintains a private practice in Great Neck, NY at 516-322-9133. For speaking engagements or media inquiries, you may reach Mr. Skow in his office or by email: jskow@lmhcny.com. www.mentalhealthcounselingny.com

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ANTON MEDIA GROUP

Healthy Living Healthy Thank you, Claude AUTISM AWARENESS MONTH

DIRECTORY

One mother’s experience with autism

BY TERRI MANZIONE SpecialSectionS@antonmediagroup.com

I prefer the romantic version. “Elope” is defined by Webster’s as “to run off secretly to be married, without the knowledge or consent of one’s parents”. In the world of autism, eloping is a perplexing behavior in which the individual feels compelled to run away, and will seize any opportunity to do so. My husband pushed the wheelbarrow to and from the backyard, transporting topsoil for a new garden, while our boys played in the backyard. Joseph was proudly pumping himself on a swing, as Stuey played in the sandbox. I cleaned the dinner dishes and watched my family through a window strategically placed above the sink. I didn’t have my eye on Stuey as intensely as usual. Stu was working right

next to the only open gate, and would notice if Stuey tried to leave the yard. “Stu, you have Stuey, right?” I asked my husband. Stuey was in the sandbox just a few seconds prior. I stepped out onto the deck, surveying the backyard. Stuey wasn’t there. My pace increased each time I called Stuey’s name, as I began to walk through the rooms of our house. Stu joined me seconds later. Stu and I ran through the rooms as a spinning top would through a maze. With each passing second, our voices became increasingly distressed. Stu ran outside to check the yards of our immediate neighbors. I called 911, and then frantically fumbled through our phone book and called neighbors to help us search. The Smalls, the Caiozzos, the Andersons, Calcaterras and Kathy next door. And, of course, I called Claire,

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to cross several busy streets. He’ll get hit by a car. Surely I’ll hear sirens soon. I’ll run toward the siren, and find my son’s lifeless body on the ground. Stu and Pat pulled up. My heart sunk to my toes when I didn’t see Stuey with them. “Where are the police?” Stu screamed. “I called them twice. They don’t get it,” I responded. I dragged my numb body back into the house. I can’t recall the text of the conversation when I called the police for the third time. My hands held my shoulders, my arms crisscrossed on my chest, in an attempt to steady my shaking body. I stood outside and watched the members of our search party come and go. A neighbor asked Joseph to play inside their home, to shield him from the tragedy unfolding before us. Kathy,

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my sister-in-law who lives around the corner and who had been incredibly supportive since Stuey’s diagnosis. Her children were already in bed. She sent her husband, Paul, to help. Some jumped into their cars, others onto their bikes, and departed for each of the possible directions in which Stuey could have traveled. They took turns stopping by the house to see if he had been found. Stu jumped in Pat Caiozzo’s mini-van, and they headed toward town. Stu and Pat had previously shared few words other than “Good Morning.” But as the minutes passed, proving their search futile, Stu and Pat began to cry. Ten minutes since I’ve dialed 911. I walk insanely in and out of the house. “Where are the police?” I shriek as I reach for the phone. “An officer will be there soon.” “That’s not good enough! Don’t you understand? My son is four years old, autistic, and missing. He has no concept of danger.” I went outside and listened for the blaring of sirens. Stuey was gone, and to get out of my neighborhood he had

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Look to Daleview for Rehab Stu ran to Stuey and melted in his embrace. After thanking the group of neighbors and friends gathered outside, the Manziones walked into their house, locked the door and spent the next hour in silence. You could still hear the murmur of the collection of neighbors outside our house, as we put the kids to bed. It took me a day and a half to stop shaking. A few weeks later, my good friend Rich called, knowing nothing of the events that transpired. “I had a dream last night. A man named Claude was talking to me and said he is Stuey’s guardian angel,” Rich said. After Rich and I spoke a bit, I hung up the phone and walked to my front door. I looked through the storm glass, in the direction of Stuey’s escape. As I imagined his mile-long journey and the busy streets he crossed, one thought came to mind: Thank you, Claude. This story is not about autism itself, but borne out of two decades of learning about living with autism. Terri Manzione is the mother of two sons in their early 20s, one of whom is autistic. She and her husband, Stu, are involved with enhancing the plight of autistic people and furthering the cause of awareness.

Complex Medical Care • Post-Surgical Care • Short Term Rehabilitation Physical & Occupational Therapy 7 days/week • IV Therapy Speech Therapy 5 days/week • Intensive Rehab • Long-Term Care Wound Care • Respiratory Care and Rehabilitation • Tracheostomy Care Enteral Nutrition • Comfort/Palliative Care • Dementia Care

574 Fulton Avenue, Farmingdale, NY 11735 www.daleviewcarecenter.com

• 516-694-9800

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my next-door-neighbor, tugged on my sleeve and suggested we call the local fire department to join in the search. At last, a single patrol car meandered up to my house. No sirens or flashing lights. I couldn’t move. The fair, young police officer picked up his notebook from the passenger seat, turned off the ignition, exited his vehicle and walked toward me. As we began to speak, I didn’t notice Paul’s car pulling up. But I will never forget the sight of Paul walking toward me, tears rolling down his face, with Stuey wrapped in his arms. He gently passed Stuey to me. “He was down in Hill Terrace, a mile away. Someone left their backyard gate open. Stuey was playing on their swing set.” Paul struggled to speak. “Oh well. Kids will be kids,” the officer returned to his vehicle and left. Stu and Pat returned seconds later.

AFFORDABLE ASSISTED LIVING

A New Life

INDEPENDENCE • D IGNITY • SECURITY Somerset Gardens · 150 Sunnyside Boulevard · Plainview, NY 11803 www.chelseaseniorliving.com

CALL TODAY!

516-576-3330

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A New Home


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HEALTHY LIVING • APRIL 13 - 19, 2016

Things are looking up.

NUMC has changed for the better. So I’m feeling better. Sweeping, hospital-wide improvements are enhancing the health care options for all of Nassau County.

Yes, the differences are astounding — across many segments of the hospital — structural, technological and clinical enhancements that have elevated NUMC to world-class stature. Our vision of bringing a greater level of health care to central Nassau has clearly taken shape, and our commitment to upgrading the quality of care is ongoing. • Physical Medicine and Rehabilitation Unit • Emergency and Level One Trauma Center • Hypertension, Diabetes and Vascular Care Center • Cardiac Care Center Including State-of-the-Art Cardiac Catheterization Lab ET: STROKE HONOR ROLL TARG

• Neurosurgery/Stroke Center • Multiplace Hyperbaric Chamber • Primary Care Center

life is why™

Stroke Center

• Maternity and Newborn Center • Oncology Center • Orthopedic and Spine Center • Burn Center

HONOR ROLL TARGET: HF

life is why™

516.572.0123 • www.numc.edu

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Heart Center

Victor F. Politi, MD, FACP, FACEP, President/CEO • Michael B. Mirotznik, Esq. Chairman, Board of Directors 17287_NUMC_New_AD Anton_8.75x11.25_master.indd 2

10/26/15 12:25 PM


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