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Vaccinations: Important In Liver Disease Care Vaccination against disease is one of the major advances in medicine and has helped prevent disease in countless individuals. Despite the importance of vaccination, many people in our country do not get the routine vaccinations which are recommended and available. This action places them at risk of getting sick but also places those around them at risk of becoming ill. Which vaccines am I talking about? These vaccines include, but are not limited to, the influenza vaccine, the Pneumovax or pneumonia vaccine, the meninigitis vaccine and the hepatitis A and B vaccines. Why don’t Americans get these vaccines? The answer is complex but usually comes down to several simple issues. Some of the issues are the lack of awareness of their necessity, the lack of awareness of availability and the lack of the insurance company to pay for preventive medicine. Many times, unfortunately, it is a misconception that these vaccines have side effects that
‘‘
THE SPECIALIST David Bernstein, MD
Despite the importance of vaccination, many people in our country do not get the routine vaccinations which are recommended and available.
’’
can be long-lasting. All people with liver disease should have routine vaccinations. This includes a yearly flu shot and once in a lifetime pneumococcal, meningococcal, H. flu, diphtheria and tetanus as well the hepatitis A and B vaccines. The hepatitis A vaccine is given as a series of two injections, either six months or 12 months apart. This is important as hepatitis A is acquired via the fecal-oral route. Exposures generally occur while people are traveling or when they eat out. While hepatitis A is usually a self-limited condition with full recovery, people with liver disease who become super-infected with hepatitis A are at high risk of severe disease which can result in liver failure, death and the need for transplantation. Vaccination will prevent the disease. What about the hepatitis B vaccine? This vaccine is given as a series of three shots over six months. It is given as an
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intramuscular injection in the deltoid region in adults and the thigh muscle in newborns. Injection in the buttock is associated with decreased response to the vaccine and should be avoided. The real question is “Who should get the hepatitis B vaccine?” The current recommendations are that all newborns in the United States receive the vaccine in the first year of life. Officially, only adult high-risk groups are recommended to undergo vaccination. These high-risk groups include men having sex with men, people with multiple sexual partners, health care workers, hemodialysis staff and patients, intravenous drug users, people in institutions for the developmentally disabled, prisoners, travelers to endemic areas such as sub-Saharan Africa or the Far East, and sexual and household contacts of hepatitis B carriers. The vaccine, despite various unsubstantiated reports circulating the Internet, is safe
and highly effective. Because of this, I tend to be more liberal in my hepatitis B recommendations. I would make the global recommendation that all people not previously vaccinated or exposed to hepatitis B should be vaccinated, whether they have liver disease or not. The problem is cost. Many insurers do not want to pay for this. I believe that they should and must pay for this critical piece of preventive medicine. Hepatitis B is a potentially fatal disease, especially in people over 40 years of age and it is preventable with vaccination. This summer, do yourself a favor and consider ensuring that you and your loved ones are protected against hepatitis A and B. These are diseases which can cause considerable illness if you are not protected. David Bernstein, MD, FAASLD,FACG, AGAF, FACP, is the chief of hepatology at Sandra Atlas Bass Center for Liver Diseases and a professor of medicine at Hofstra-Northwell School of Medicine.
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Nassau County Issues Tick Warning symptoms include headache, fatigue, and muscle aches. With Lyme disease, you may also experience joint pain. The severity and time of onset of these symptoms can depend on the disease and the patient’s personal tolerance level.
Rash In Lyme disease, the rash may
appear within 3-30 days, typically before the onset of fever. The Lyme disease rash is the first sign of infection and is usually a circular rash called erythema migrans (EM). This rash occurs in approximately 70 to 80 percent of infected persons and begins at the site of a tick bite. It may be warm, but is not usually painful. Some patients develop additional EM lesions in
Larva
Fever/chills With all tickborne diseases, patients can experience fever at varying degrees and time of onset.
Aches and pains Tickborne disease
Nymph
Adult Male
Adult Female
Lyme disease is spread by the blacklegged tick, also known as a deer tick, which is typically found in wooded and grassy areas.
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Nassau University Medical Center President/CEO Dr. Victor Politi was recently joined by health officials at a press conference at the Nassau University Medical Center to warn of a recent explosion of disease-breeding ticks on Long Island that can cause severe illness and prolonged health damage, including cognitive damage, and if untreated, even death. The hospital has set up treatment areas for people who suspect they have been bitten by ticks. The bites cause Lyme disease. New York State has the highest number of Lyme disease cases in the country, according to the Centers for Disease Control and Prevention (CDC). The CDC has recorded more than 95,000 Lyme infections in the state since 1986. Long Island has been particularly hard-hit in recent years, because of its many wooded areas. Ticks that can spread Lyme disease are now present in almost half of the counties in the United States,
compared with only 30 percent 20 years ago. Common symptoms can include fever, headache and fatigue, all of which can be confused for flu. Early diagnosis can be treated with antibiotics, but untreated Lyme disease can lead to long-term cognitive problems, joint and muscle pain and mood disorders. Lyme disease can be deadly if untreated. The tick infestation is a result of climate change, an unusually short and warm winter, and oak trees that produced a huge number of acorns last fall. The most common symptoms of tickrelated illnesses are:
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BY ANTON MEDIA GROUP STAFF SpecialSectionS@antonmediagroup.com
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other areas of the body several days later. Tickborne diseases can result in mild symptoms treatable at home to severe infections requiring hospitalization. Although easily treated with antibiotics, these diseases can be difficult for physicians to diagnose. However, early recognition and treatment of the infection decreases the risk of serious complications. So see your doctor immediately if you have been bitten by a tick and experience any of the symptoms described here.
Take Steps To Protect Against Ticks Taking steps to protect yourself and your family from getting a tick bite is the best defense against Lyme disease and other tickborne infections. Whether you’re working, enjoying your yard, camping, hiking, hunting or otherwise in the outdoors, CDC recommends that people: • Avoid areas with high grass and leaf litter and walk in the center of trails when hiking. • Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for
protection that lasts several hours. •U se products that contain permethrin to treat clothing and gear, such as boots, pants, socks and tents or look for clothing pre-treated with permethrin. •T reat dogs for ticks. Dogs are very susceptible to tick bites and to some tickborne diseases. They may also bring ticks into your home. Tick collars, sprays, shampoos or monthly “top spot” medications help protect against ticks. •B athe or shower as soon as possible after coming indoors to wash off and more easily find crawling ticks before they bite you. •C onduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon returning from tick-infested areas. Parents should help children check thoroughly for ticks. Remove any ticks right away. •T umble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed.
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Endometriosis: Facts For Every Woman
Do you, your daughter, other female family member or friend miss work, school, sports practice or social events every month due to painful or heavy periods? If the answer is yes, the cause may be endometriosis. Endometriosis is a common condition that affects approximately 1 in 10 women and female teens. Although not everyone experiences symptoms, the most common are dysmenorrhea (menstrual cramps), pelvic pain, heavy menstrual bleeding, pain during bowel movements and infertility. Although endometriosis is common, it’s also widely misunderstood and often misdiagnosed. Education is important to increasing awareness. Katz Institute for Women’s Health at Northwell Health recently joined Dr. Christine Metz, investigator at the Feinstein Institute for Medical Research and professor at the Hofstra Northwell School of Medicine, for a Q&A session on the topic of endometriosis. Metz shared some valuable information and insights.
What Is Endometriosis?
Endometriosis is characterized by the growth of endometrial tissue or lesions outside of the uterus. These lesions can grow on the lining of the pelvis, internal
organs (e.g. the outside of the uterus, ovaries, fallopian tubes and rectum). In some women, lesions can grow on more distant areas of the body, including the diaphragm, lungs, kidneys and brain.
What Causes Endometriosis?
The cause of endometriosis is not completely understood. However, many researchers believe that it arises after abnormal menstrual flow where menstrual blood is carried through the fallopian tubes into the pelvic cavity instead of exiting through the vagina. Like the endometrium, which sheds monthly, endometriosis lesions bleed in response to monthly hormone fluctuations. Other factors that may influence endometriosis are genetics and environmental and immune system factors.
How Is Endometriosis Diagnosed?
One of the most frustrating problems for patients with endometriosis is delayed diagnosis, which can take up to 10 years. The diagnosis of endometriosis requires laparoscopic surgery with pathology confirmation of the biopsy specimens. Early diagnosis by a doctor who specializes in treating
endometriosis patients is important because early treatment can dramatically improve patient outcomes.
Do Pain And Other Symptoms Correlate With The Severity Of Endometriosis?
No. Pain and other symptoms do not always correlate with the severity of the disease.
What Are The Treatments For Endometriosis?
While there is no cure for endometriosis, treatments include non-steroidal anti-inflammatory (NSAID) drugs and other pain relievers, hormonal contraceptives (e.g. birth control pills
or vaginal rings), other hormonal agents (e.g. gonadotropin-releasing hormone {GnRH} agonists and antagonists, androgenic agents, progestins and Danazol) and surgery to remove the lesions or the uterus (in severe cases only).
What Can Women Do?
Researchers at the Feinstein Institute for Medical Research at Northwell Health are looking for women with and without endometriosis to participate in the ROSE (Research OutSmarts Endometriosis) research study. Call the Katz Institute for Women’s Health at 516-562-3636 for more information. —Submitted by Katz Institute for Women’s Health
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Healthy Summer Dessert Swaps
Angel Food Cupcake
CHOOSING HEALTH Stefani Pappas
S
ummer is officially here. Beach trips, summer barbecues and days at the pool are in full swing. As a dietitian, I love the summer months because there is an abundance of refreshing and healthy foods that are in season. Better yet, the longer days and warm weather inspires us to get outside and start moving. Although the summer months are filled with healthy food and exciting activities, it’s also known to bring about quite a bit of food temptation. Trips to the ice cream parlor or late night family barbecues can lead to overeating and overindulging. Balance and moderation are two key concepts to think about when it comes to your health and nutrition. Most foods can fit into a healthy lifestyle, but it’s important to eat mindfully and be conscious of portion sizes. If you can make a few healthy substitutes in your cooking, you can indulge without the guilt. Below are a few nutritious swaps and recipe ideas for typical summer desserts.
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Red, White and Blue Yogurt Pops
Who doesn’t love a refreshing, cold treat on a beautiful summer day? Instead of typical ice pops loaded with excess sugar and chemicals, opt for a healthier homemade version. This is a great way to get the whole family involved in making a nutritious sweet treat. Fill an ice pop tray with three layers of low-sugar Greek yogurt; start with a strawberry flavor, then vanilla flavor and then blueberry flavor. Feel free to mix in chopped strawberry and blueberry pieces as well. Freeze and serve when chilled for a protein-packed treat.
Angel Food Cupcakes
watermelon, cantaloupe and honeydew. Next, add one cup of berries of your choice. Chop about three sprigs of fresh mint and add to the fruit. Next, combine ¼ cup fresh lime juice with three tablespoons of powdered sugar and mix evenly throughout the fruit salad. Place in the refrigerator for about 20 minutes and then serve.
Chocolate Peanut Butter Nice-Cream
You can make an all-natural icecream substitute by simply blending frozen fruit. My favorite recipe starts with blending one frozen banana with one tablespoon of raw unsweetened cocoa powder. You can add a scoop of
HEALTH BRIEFS Brain Tumor Support Group
Share feelings, concerns, experiences, ways to cope and more at The Brain Tumor Center’s support group for brain tumor patients, family members and caregivers on Thursday, July 20, from 4 to 5:45 p.m. at Neurological Surgery, P.C. at 1991 Marcus Ave., Suite 108 in Lake Success. Tina Sapienza, L.M.S.W., O.S.W-C will facilitate the support meeting. Reservations are required. Call Richard Van Allen at 516-4422250 for more information and to reserve a seat.
Published by Anton Media Group
Instead of your typical cupcake mix, opt for light and airy angel food cake. You can purchase an angel food cake mix and distribute evenly into cupcake trays. Avoid topping with regular frosting, which is typically laden with trans fat and high fructose corn syrup. Instead, add a dollop of light whipped cream and garnish with fresh berries. This is a crowd-pleasing dish that is perfect for the summer. Angel food cake is also a light swap in standard trifle and cake dishes.
KARL V. ANTON, JR. Publisher, 1984–2000 ANGELA SUSAN ANTON Editor and Publisher FRANK A. VIRGA President SHARI EGNASKO Executive Assistant STEVE MOSCO Editor In Chief BETSY ABRAHAM Senior Managing Editor CHRISTY HINKO Managing Editor, Special Sections KAREN MENGEL Director of Production ALEX NUÑEZ Art Director IRIS PICONE Director of Operations JOY DIDONATO Director of Circulation ADVERTISING SALES
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Jazz up your classic fruit salad with this refreshing twist. Start by using a melon-baller to scoop out
peanut butter for extra flavor, as well as a drizzle of raw honey for added sweetness. Pro tip: Peel the banana, then slice and place in a Ziploc bag before freezing. These are just a few ideas to get you thinking more creatively when it comes to healthy eating during the summer months. These nutritious swaps are a great way to save calories and stay on track with your health goals during the summer. Stefani Pappas, MS, RDN, CDN, CPT, is a clinical dietitian nutritionist at St. Francis Hospital. She also provides private and group nutrition counseling at her office in Great Neck. Visit www. StefHealthTips.com for more info.
Yogurt pops
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A Lifetime Of Giving Back
Northwell Health honors Sandra Bass for contributions BY NICOLE LOCKWOOD nlockwood@antonmediagroup.com
“To give is a very selfish act, because it makes the giver feel good. I never expected this kind of ovation, but it makes me very happy and I would like to do more,” said a humbled Sandra Bass at a ceremony in honor of her ongoing contributions to Northwell Health and its health care facilities. “I just want everyone to be healthy and happy, whether they are a person or an animal.” Ineffable appreciation was evident by the dozens who were on hand to recognize the philanthropic work of Bass, whose lifetime donations to Northwell Health currently amount to more than $93 million. The ceremony, held at the Manhasset campus of Northwell Health, located at 300 Community Dr., was in light of Bass’ ongoing dedication to the network of hospitals within the Northwell system, which most recently includes a gift of $25 million to be directed toward North Shore University Hospital (NSUH) to support the Sandra Atlas Bass Heart Hospital, aptly named after the
(From left) Anton Media Group Publisher Angela Anton, Sandra Bass and Town of North Hempstead Supervisor Judi Bosworth. benefactor. “I think what sparked her initial interest in contributing is what continues to spark her, which is her dedication to helping individual lives,” said Brian Lally, Northwell Health chief development officer. “She saw
from the beginning, and I think she sees today, that her philanthropy can help one person at a time.” Bass, her family and friends, and Northwell’s administrative and clinical leaders were also on hand to offer their congratulations and praise
the accomplishments of the hospital, largely due to Bass’ donations, which Barry Kaplan, MD, co-director of the heart hospital, claims “will help [Northwell] propel the center into a nationwide leader.” “Our vision for the Sandra Atlas
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Bass Heart Hospital is to create a destination where patients receive the highest levels of expertise, take part in the most innovative, technologically advanced therapies, and enjoy a patient experience that is unsurpassed regionally and nationally,” said Kaplan. “Ms. Bass has long been a pioneer of cardiac innovation in the health system and has continuously demonstrated her commitment to enhancing the patient experience.” Deemed one of the largest centers for complex cardiac procedures in New York, the new Sandra Atlas Bass Heart Hospital is among the state’s most significant cardiothoracic and interventional cardiology programs, treating the most complex heart-related situations. It features a 22-bed cardiothoracic intensive care unit staffed around the clock by critical care physicians, five operating rooms dedicated to cardiac patients and eight cardiac catheterization and electrophysiology labs. It was recently announced that the application to develop a heart transplant surgery center at the Sandra Atlas Bass Heart Hospital was approved by the New York State Department of Health. Bass’ relationship with Northwell dates back more than two decades, with some of the earliest
(From left) Roy Zuckerberg, Angela Anton and Saul Katz, president of the New York Mets. The philanthropic work of Sandra Bass was recently celebrated at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset. (Photos by Nicole Lockwood) million gift, Northwell opened the backing allocated to the Arrhythmia Sandra Atlas Bass Center for Liver Pacemaker Center at NSUH. Bass Diseases on the NSUH Manhasset then funded the Sandra Atlas Bass campus. Cardiology Centers at both North “Sandra Atlas Bass has been a Shore Manhasset and Long Island tremendous partner of Northwell Jewish (LIJ) Medical Center in New Health for more than two decades,” Hyde Park. said Michael Dowling, president and Recently, Bass contributed more than $12 million to continue her sup- CEO of Northwell Health. “Her continued commitment and compasport of LIJ Medical Center’s Hearing sion is helping us elevate the quality and Speech Center, which will soon of care we deliver and improve the be otherwise known as the Sandra lives of countless people within the Atlas Bass Otolaryngology Center. communities we serve.” Last year, in recognition of a $3
Bass was presented with an honorary Northwell Health lab coat and a Town of North Hempstead proclamation.
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