Healthy Living 4/13/22 edition is published weekly by Anton Media Group. by Anton Community Newspapers

HEALTHY LIVING • APRIL 13 - 19, 2022 1B

AN ANTON MEDIA GROUP SPECIAL

APRIL 13 – 19, 2022

REGENERATIVE MEDICINE Alcohol Awareness Month Reconstructive breast surgery

2B APRIL 13 - 19, 2022 • HEALTHY LIVING

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Regenerative Medicine: Promise For The Future are being offered and studied in well-established medical centers around the country. However, not everyone offering these therapies is on the level, Rodeo cautioned. In June 2021, the Food and Drug Administration posted a consumer alert regarding regenerative medicine therapies after receiving complaints and reports of injuries to patients. The FDA has started to crack down on providers engaged in deceptive advertising and making unproven claims. “The marketing is ahead of the science. Unscrupulous providers and clinics are marketing largely unproven treatments, targeting patients who hope to find relief for a difficult-to-treat problem,” Rodeo said. “People sometimes pay exorbitant sums of money for these unregulated and potentially harmful treatments, possibly delaying a proven treatment that could be beneficial.” Rodeo recommends that people do their research to ensure they are receiving treatment at a reputable medical center. He said it is important to pursue a regenerative medicine therapy that is part of a clinical trial registered with the FDA. He also advises people to learn as much as possible about the treatment and ask questions to understand any potential risks.

ROBIN FRANK specialsections@antonmediagroup.com

hat if a treatment existed that could restore or regenerate a part of your body damaged by disease, injury or the aging process? That’s the goal of regenerative medicine, an emerging field that uses biologic treatments to improve symptoms, enhance healing and restore normal function. Although regenerative medicine is often associated with the use of stem cells, many therapies are developed using tissue from the patient’s own body, such as blood, fat or bone marrow. Regenerative medicine has the potential to revolutionize patient care, but the field is still in its early stages, noted Dr. Scott Rodeo, a clinician-scientist and director of The Center for Regenerative Medicine at Hospital for Special Surgery (HSS) in New York City. More research is needed to identify what types of treatments work best for a particular condition and for a given patient, he said. The HSS Center conducts research to identify and study biologic treatments for common orthopedic conditions. “We can potentially use regenerative medicine therapies for conditions that don’t heal well on their own, such as osteoarthritis, chronic tendonitis, degenerative disc disease in the spine and other injuries,” said Rodeo, an orthopedic surgeon specializing in sports medicine at HSS. “I tell patients these types of treatments can work well for pain relief. However, in terms of regenerating damaged tissue such as cartilage, we’re not there yet.”

How Does it Work?

Most often, samples of a person’s own body tissue are collected and concentrated to produce a solution that is then injected back into the patient. The tissue sample, generally blood, bone marrow or fat, will be run through a special syringe, spun in a centrifuge and concentrated.

Scott Rodeo, MD, director of The Center for Regenerative Medicine at Hospital for Special Surgery (HSS). One of the most well-established treatments is platelet-rich plasma, often called PRP. Some studies have shown PRP to be effective in the treatment of chronic tendon injuries and mild to moderate knee osteoarthritis. PRP is produced from a sample of an individual’s own blood, which is spun down in a centrifuge to isolate and concentrate platelets, the blood cells that assist in natural healing. These platelets, along with a fluid portion of the blood called plasma, are then injected back into the patient at the site of their injury. To determine if someone is a good candidate for treatment, doctors often use imaging tests such as x-rays, MRI and ultrasound to make the diagnosis, said Dr.

Jesse Charnoff, a physiatrist at HSS Long Island in Uniondale. He treats various tendon problems and mild to moderate knee arthritis with PRP. The treatment, often injected using ultrasound imaging guidance, takes a half hour to an hour. It is not generally covered by insurance. Dr. James Wyss, another physiatrist at HSS Long Island, also uses PRP for partial tears of tendons that are not healing well, but not considered severe enough for surgical repair, such as the hamstring tendon, patellar tendon in the knee and the Achilles tendon.

Consumer Beware: Unfounded Claims Rampant Regenerative medicine treatments

The Future of Regenerative Medicine

Rodeo noted that while the FDA seeks to ensure patient safety by getting tough on clinics promoting unproven treatments, it is also paving the way for legitimate research and therapies, recognizing the great potential of the field. At HSS, a number of regenerative medicine studies are under way and enrolling patients. Rodeo is leading one such clinical trial to see if the injection of certain cells contained in adipose (fat) tissue during rotator cuff surgery can enhance healing. He believes regenerative medicine research at legitimate centers around the country will bring significant progress over the next five years. —Robin Frank writes for Hospital for Special Surgery

4B APRIL 13 - 19, 2022 • HEALTHY LIVING

Breast Surgeon Joins Greenberg Group

ANTON MEDIA GROUP STAFF

achieving patient goals and is personally invested in his patients and their outcomes. Avraham finds his work as a surgeon inspecialsections@antonmediagroup.com tellectually stimulating and he is especially interested in how he can use complex surreenberg Cosmetic Surgery has gical techniques to achieve the most comrecently announced the addition plete and natural solution to each patient’s of a renowned breast plastic and concerns. Avraham has a particular interest reconstructive surgeon, Tomer Avraham, in microsurgical techniques for using a MD, FACS. Avraham’s focus is helping woman’s own tissues for reconstructing her patients regain themselves, both in appearbreast. These techniques include the DIEP ance and in function. He has expertise in flap, PAP flap and others. all areas of cosmetic and reconstructive Avraham has a track record of working at surgery. His belief is that cosmetic plastic prestigious institutions, including Mount surgery is a tool to return the body to its Sinai Hospitals and at the Yale School of previous form and function. Medicine, where he served as director of The philosophy that cosmetic appearbreast reconstruction. In addition to his ance and reconstruction go hand in hand work as a clinician, he has an extensive has led Avraham to develop specialized research background, with more than 50 expertise. He specializes in all forms of peer-reviewed publications. breast surgery and reconstruction, includ“Innovation and progress are important ing tissue and implant-based techniques. to me,” Avraham said. “Research allows us These procedures are designed to help to fine tune our approach and to figure out women regain their confidence and restore the best options in treating our patients.” their sense of self. He views his work as a Avraham has spoken about his work in reconstructive surgeon as an opportunity many national and international conferto help women with the difficult physical ences and serves on several committees changes that often accompany their cancer for the American Society of Plastic Surgery, treatment. Avraham is a true partner in helping guide national policy within his

specialty. Avraham attended medical school at Tufts University School of Medicine, where he graduated with honors as a member of the prestigious AOA Honor Society. He then completed his plastic surgery residency and microsurgery fellowship at the renowned NYU Institute of Reconstructive Plastic Surgery. During his residency, Avraham received extensive cosmetic surgery training both at NYU and the world-famous Manhattan Eye Ear and Throat Hospital. Avraham further completed a three-year research fellowship at Memorial Sloan Kettering Cancer Center, where he served as chief research fellow and was awarded the Research Fellow of the Year award. Prior to joining Greenberg Cosmetic Surgery, Avraham was a faculty member at Mount Sinai Hospitals in NYC, and most recently at Yale School of Medicine, Yale Medical Group as assistant professor, Department of Surgery, section of plastic surgery and director of breast reconstruction. He also held a breast microsurgical reconstruction fellowship at was Mount Sinai Health System and Icahn School of Medicine assistant professor, Department of Surgery, division of plastic surgery. Greenberg Cosmetic Surgery has

Dr. Avraham

locations in Manhattan, Woodbury, Southampton, Smithtown and Boca Raton. Visit www.GreenbergCosmeticSurgery. com for more information.

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6B APRIL 13 - 19, 2022 • HEALTHY LIVING

April: Alcohol Awareness Month

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month alcohol users, 65.8 million people were binge drinkers in the past month, and 16 million were heavy drinkers in the past month.

specialsections@antonmediagroup.com

• About 2.3 million adolescents aged 12 to 17 in 2019 drank alcohol in the past month, and 1.2 million of these adolescents binge drank in that period (2019 NSDUH).

pril 1 marks the start of Alcohol Awareness Month, a public health awareness campaign organized by the National Council on Alcoholism and Drug Dependence, intended to increase outreach and education on alcohol abuse and addiction. The program began in April 1987, with the intention of targeting college-aged students; it has since become a national movement to bring attention to the causes and effects of alcohol abuse and help families and communities deal with this concern. The misuse and abuse of alcohol, tobacco, illicit drugs and prescription medications affect the health and well-being of millions of Americans. Substance Abuse and Mental Health Services Administration (SAMHSA) 2020 National Survey on Drug Use and Health (NSDUH) reported that approximately 19.3 million people aged 18 or older had a substance use disorder in the past year.

Alcohol Data:

• In 2020, 50 percent of people aged 12 or older (or 138.5 million people) used

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• Approximately 14.5 million people age 12 or older had an alcohol use disorder (2019 NSDUH). • Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer and other serious health conditions.

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• The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31.4 percent) compared with 22.9 percent of adults aged 26 or older and 4.1 percent of adolescents aged 12 to 17 (2020 NSDUH).

alcohol in the past month (i.e., current alcohol users) (2020 NSDUH). • Among the 138.5 million people who were current alcohol users, 61.6 million people (or 44.4 percent) were classified as binge drinkers and 17.7 million people (28.8 percent of current binge drinkers and 12.8 percent of current alcohol users) were classified as heavy drinkers (2020 NSDUH).

Unfortunately, the COVID-19 pandemic has only exacerbated alcohol and substance abuse concerns. According to the Blue Cross Blue Shield COVID-19 National Pulse Survey, overall alcohol consumption has risen 23 percent since the pandemic began. Visit www.alcoholtreatment.niaaa.nih. gov for treatment resources.

• The 2019 National Survey on Drug Use and Health reports that 139.7 million Americans age 12 or older were past

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Significant Advances In Ulcerative Colitis

lcerative colitis is a chronic inflammatory disease of the large intestine which causes inflammation and ulcers. People with ulcerative colitis typically complain of rectal bleeding and/ or abdominal pain which comes from the colonic inflammation. This condition, which usually is first diagnosed in people from teenage to the mid-thirties, can be diagnosed at any age. There is a high prevalence of this condition on Long Island. It is an autoimmune disease whose cause is not known. Ulcerative colitis can be debilitating and can sometimes lead to life-threatening complications. While there is no cure, the past decade has seen significant advances in treatments for this condition. While ulcerative colitis is a colonic disease, it is associated with a variety of liver diseases. Liver test abnormalities can be seen secondary to the medications used for its treatment. These abnormalities are usually clinically insignificant and generally resolve either with continued treatment or upon cessation of the offending agent. More importantly, chronic liver diseases that can predispose patients to cirrhosis, liver cancer and bile duct cancers are associated with ulcerative colitis. Non-alcoholic fatty liver disease (NAFLD) is a common complication of ulcerative colitis. The prevalence of NAFLD is significantly higher in ulcerative colitis

THE SPECIALIST David Bernstein, MD

patients than in the general population. Fatty liver predisposes to diabetes and it can lead to the development of cirrhosis and liver cancer, even in the absence of cirrhosis. Treatment is based on lifestyle modification and includes diet, exercise and weight loss. While there are currently no medical treatments for fatty liver disease, much research is being performed and it is likely that new, innovative therapies will become available in the next few years. Autoimmune hepatitis is another primary liver disease associated with ulcerative colitis. This is a chronic inflammatory condition which may lead to cirrhosis and its complications. Autoimmune hepatitis is straight forward in its diagnosis and is treated with immunosuppressive agents such as steroids and azathioprine. The most common liver disease

associated with ulcerative colitis is primary sclerosing cholangitis (PSC). This condition is seen in about six to eight percent of people with ulcerative colitis. It is a chronic, progressive disease of the bile ducts both inside and outside of the liver and it can lead to cirrhosis, liver cancer, bile duct cancer and gallbladder cancer. The hallmark of this disease is abnormal liver tests and an imaging study showing abnormal bile ducts. Most people are asymptomatic but not uncommonly, patients may complain of abdominal pain, fever and/or itching. PSC is more common in men than in women but recent studies have shown an increase in the prevalence of PSC in women. Unfortunately, there are no available medical treatments for PSC and currently, treatment is indicated for symptomatic relief or treatment of complications. This condition has a true unmet

need and much research is being done to find potential therapies. It is important that patients with PSC be screened annually for bile duct cancer and twice a year for liver cancer if cirrhosis is present. So, the take home message is simple. Ulcerative colitis is associated with several liver conditions which can lead to cirrhosis and its complications and these conditions progress independently of the colon disease. Therefore, anyone with ulcerative colitis with abnormal liver tests and/ or an abnormal liver imaging should be evaluated for underlying liver disease and appropriately treated. David Bernstein, MD, MACG, FAASLD, AGAF, FACP is the vice chair of medicine for clinical trials and chief of hepatology at Sandra Atlas Bass Center for Liver Diseases. He is a professor of medicine and education.

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APRIL 13 - 19, 2022 • HEALTHY LIVING

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