Healthy Living
HEALTHY LIVING • JULY 13 - 19, 2022 1B
AN ANTON MEDIA GROUP SPECIAL
JULY 13 - 19, 2022
JUVENILE ARTHRITIS Cord Blood Cleft Palate
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2B JULY 13 - 19, 2022 • HEALTHY LIVING
DISCOVER THE FINEST IN SENIOR LIVING
The Bristal Assisted Living has been serving seniors and their families in the tri-state area since 2000, offering independent and assisted living, as well as state-of-the-art memory care programs. We are committed to helping residents remain independent, while providing peace of mind that expert care is available, if needed. Designed with seniors in mind, each of our communities feature exquisitely appointed apartments and beautiful common areas that are perfect for entertaining. On-site services and amenities include daily housekeeping, gourmet meals, a cinema, salon, plus so much more. Discover a vibrant community, countless social events with new friends, and a luxurious lifestyle that you will only find at The Bristal.
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HEALTHY LIVING • JULY 13 - 19, 2022 3B
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Juvenile Rheumatoid Arthritis
uvenile idiopathic arthritis (JIA) is a form of arthritis in children. Arthritis causes joint swelling (inflammation) and joint stiffness. JIA is arthritis that affects one or more joints for at least six weeks in a child age 16 or younger. Unlike adult rheumatoid arthritis, which is ongoing (chronic) and lasts a lifetime, children often outgrow JIA. But the disease can affect bone development in a growing child.
THERE ARE SEVERAL TYPES OF JIA: Systemic onset JIA This type affects one or more joints. There is often a high fever and a skin rash. It may also cause inflammation of internal organs, including the heart, liver, spleen and lymph nodes. It is the least common type. It affects 1 in 10 to about 1 in 7 children with JIA. Oligoarticular JIA This type affects one to four joints in the first six months of disease. If no more joints are affected after six months, this type is called persistent. If more joints are affected after 6 months, it is called extended. Polyarticular JIA This type affects five or more joints in the first six months of disease. Blood tests for rheumatoid factor (RF) will show if this type is RF-positive or RF-negative. Enthesitis-related JIA With this type, a child has arthritis as well as enthesitis. This is a swelling of the tissue where bone meets a tendon or ligament. It often affects the hips, knees and feet. Psoriatic arthritis With this type, a child may have both arthritis and a red, scaly skin disease called psoriasis. Or a child may have arthritis and two or more of the following: • Inflammation of a finger or toe • Pits or ridges in fingernails • A first-degree relative with psoriasis • Undifferentiated arthritis. This is arthritis that has symptoms of 2 or more JIA types above. Or the symptoms might not match any type of JIA. JIA is an autoimmune disease. This means the body’s immune system attacks its own healthy cells and tissues. JIA is caused by several things. These include genes and the environment. This means the disease can run in families, but can also be triggered by exposure to certain things. JIA is linked to part of a gene called HLA antigen DR4. A person with this antigen may be more likely to have the disease. Symptoms may appear during episodes (flare-ups). Or they may be ongoing (chronic). Each child’s symptoms can vary, from swollen joints, eye inflammation, fatigue, fever, rash and more. These symptoms can seem like other health
conditions. Diagnosing JIA may be difficult. There is no single test to confirm the disease. Your child’s healthcare provider will take your child’s health history and do a physical exam. Your child’s provider will ask about your child’s symptoms and any recent illness. JIA is based on symptoms of inflammation that have occurred for 6 weeks or more. The goal of treatment is to reduce pain and stiffness, and help your child keep as normal a lifestyle as possible. Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Help your child manage his or her symptoms by sticking to the treatment plan. This includes getting enough sleep. Encourage exercise and physical therapy and find ways to make it fun. Work with your child’s school to make sure your child has help as needed. Work with other caregivers to help your child take part as much possible in school, social and physical activities. Your child may also qualify for special help under Section 504 of the Rehabilitation Act of 1973. You can also help your child find a support group to be around with other children with JIA. —Johns Hopkins Medicine (johnshopkins.org)
Cord Blood Banking Expecting a baby can be a very exciting time for soon-to-be-parents. It can also be very confusing, with many decisions to make. One choice prospective parents often face is whether to donate, bank or discard their baby’s cord blood. Did you know that the Food and Drug Administration (FDA) regulates cord blood? Here is some information for expectant parents about the regulations in place designed to help ensure the safety of cord blood for transplantation.
What is cord blood?
Cord blood is the blood contained in the placental blood vessels and umbilical cord, which connects an unborn baby to the mother’s womb. Cord blood contains hematopoietic progenitor cells (HPCs). At birth, cord blood can be collected (or “recovered”) from the umbilical cord.
What are the options for cord blood banking?
Cord blood can be donated to a public cord blood bank, where it will be stored for potential future use by anyone who may need it. Alternatively, parents may arrange for the cord blood to be stored in a private cord bank, for potential use if it is later needed for treatment of the child from whom it was recovered, or for use in first- or second-degree relatives.
How does FDA regulate cord blood stored for personal or family use?
Cord blood stored for personal use and for use in first- or second-degree relatives that also meets other criteria in FDA’s regulations does not require approval before use. Private cord banks must still comply with other FDA requirements, including establishment registration and listing, donor screening and testing for infectious diseases (except when used for the original donor), reporting and labeling
requirements, and compliance with current good tissue practice regulations.
Are there any FDA approved uses for cord blood?
Cord blood can be used in hematopoietic stem cell transplantation procedures in patients with some disorders affecting the hematopoietic (blood forming) system. For example, cord blood transplants have been used to treat patients with certain blood cancers and some inherited metabolic and immune system disorders.
Does FDA inspect facilities that store cord blood?
Yes. Registered establishments are subject to FDA inspection to ensure they are complying with the regulations. The inspections of private banks are designed to ensure prevention of infectious disease transmission.
Where can I get more information about donating my baby’s cord blood? To make your baby’s cord blood available for use by anyone who needs a cord blood transplant, you may donate it to a public cord blood bank.
Where can I get more information about banking my baby’s cord blood?
To make your baby’s cord blood available for use by the child from whom it was recovered, or for use in first- or second-degree relatives, you may bank it with a private cord blood bank. For some diseases, such as genetically heritable diseases, in the event that your child would need treatment, it is possible that the cord blood would not be recommended for such use. —Food and Drug Administration (FDA)
4B JULY 13 - 19, 2022 • HEALTHY LIVING
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nderstanding hepatitis is a bit like learning about alphabet soup. Hepatitis means inflammation of the liver. The term does not in any way imply the reason or cause that the liver is inflamed. Inflammation of the liver does not mean that the liver is big or swollen. In fact, most people with hepatitis have normal sized or small livers. We classify hepatitis by what the causes are. The most common cause of hepatitis are viruses. These viruses are named, by convention, for letters of the alphabet, for example hepatitis A, hepatitis B, etc. These viruses are not related in any way other than causing inflammation of the liver. Other conditions such as COVID, autoimmune disease, alcohol use and hereditary conditions may also cause hepatitis. Medications, illicit drugs, herbal treatments and overthe-counter natural remedies are common causes of hepatitis. Examples of common medications known to cause inflammation of the liver include
Alphabet Soup
THE SPECIALIST
David Bernstein, MD
atorvastatins (Lipitor), ibuprofen, antibiotics and acetaminophen. Examples of natural medications causing hepatitis include chaparral leaf, valerian, skullcap, mistletoe, germander, kava kava, Jin Bu Huan and pyrrolizidine alkaloids. Let’s talk for a moment about the different hepatitis viruses. Hepatitis A is a common virus causing hepatitis. It is transmitted from hand to mouth. This is the virus we often read about which may occur in sporadic
outbreaks at such venues as restaurants or cruise ships. It is common in the summer when people eat outdoors and food may have been left in the sun. After a single exposure, almost all people fully recover and develop a lifelong immunity to reinfection. A vaccine is available for those not previously exposed. Hepatitis B infections appear to be decreasing in the United States. This is a disease which is usually transmitted through contaminated blood products, sex or drugs. Routine vaccination of all children is now the law in the United States. This should lead to even further decreases in the number of new cases. Hepatitis B is not a single virus but a family of viruses. At least seven subtypes or genotypes of hepatitis B have been described and these genotypes, named A through G, seem to influence the outcome of infection. Genotypes A and C are most common. Most AsianAmericans are infected with genotype C. Genotype C is more frequently associated with the
development of cirrhosis and liver cancer. There is treatment, but for hepatitis B but there is no cure. Hepatitis C is usually transmitted by some sort of blood-to-blood contact such as intravenous drug use, intranasal cocaine use, previous blood transfusions or other high-risk behavior. New cases of hepatitis C are on the rise. Hepatitis C remains common on the south shore of Long Island, especially in Suffolk County. Hepatitis C is also not a single virus but rather a family of viruses termed “genotype.” All genotypes of hepatitis C are curable with simple, easy to take and highly effective oral treatments. Hepatitis D is uncommon and is associated with hepatitis B infection. Hepatitis D is transmitted in the same fashion as hepatitis B. Of all the hepatitis viruses, it is the one most likely to progress to cirrhosis and liver cancer. Treatments for hepatitis D are currently under study. Hepatitis E appears to be increasing in frequency in the US. It is transmitted via the fecal-oral
route, like hepatitis A. Hepatitis E infections have been linked to raw or undercooked pork or game meat. Most infections are self-limited and no specific treatments are available. What is really important is to understand that all causes of hepatitis are not created equal. While most cases are self-limited and do not cause long-term damage, certain viruses, alcohol, autoimmune disease, hereditary disease and even medications can lead to the development of liver failure, cirrhosis and its complications, as well as liver cancer. We can prevent hepatitis A, B and D with vaccination. Alcohol related hepatitis can be prevented by limiting or avoiding alcohol. We can use alternative and complementary medicines with the right degree of caution. The more we understand these conditions and seek care when appropriate, the less likely that hepatitis will cause long-term damage to the liver. —David Bernstein, MD, MACG, FAASLD, AGAF, FACP
Women’s Health Care of Garden City committed to personalized care He is committed to excellence in patient communication, education and support as many patients come with anxiety associated with past experiences and future concerns. Dr. Gomes received his undergraduate degree from Brown University and his Doctor of Medicine from Columbia University. He is both Board Certified and a Fellow of the American College of Obstetrics and Gynecology. Women’s Health Care of Garden City is located at 1000 Franklin Avenue, Suite 200, Garden City. Call 516-222-8883 or visit online at DrGomes.com
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By John L. Gomes, MD
ohn L. Gomes, MD, founded Women’s Health Care of Garden City in 1995. It has remained an independent, private practice providing personalized obstetrical and gynecological services. He employs the technical advances of conventional medicine with an integrative approach to navigate women through difficult pregnancies into the menopausal years. He treats a wide variety of OB/GYN conditions and is dedicated to providing the highest quality of care. All tests are conveniently done on the premises and a dedicated, compassionate staff is on call 24/7.
HEALTHY LIVING • JULY 13 - 19, 2022 5B
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6B JULY 13 - 19, 2022 • HEALTHY LIVING
Jonathan Brisman Appointed To Lenox Hill Medical Staff
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onathan L. Brisman M.D., F.A.A.N.S., a board-certified neurosurgeon and senior partner at NSPC Brain & Spine Surgery (NSPC), has received surgical privileges to operate at Northwell Health/ Lenox Hill Hospital in Manhattan. Brisman has special expertise in performing microsurgical procedures to treat adult spine, neurovascular and brain conditions. A
resident of Great Neck, he’s been in practice since 2006. Brisman has been recognized by his peers as a Castle Connolly “Top Doctor: New York Metro Area” from 2012-2021. In addition, he has been included in New York Magazine’s “Best Doctors” listing from 2013-2020. Brisman was the only neurosurgeon from Queens, Nassau and Suffolk counties to be
recognized as one of the magazine’s “Best Doctors” in 2018 and 2019. Brisman will continue to see patients at offices located in Lake Success, Rockville Centre and Woodmere on Long Island. He will see patients each week, by appointment, at an Upper East Side office located at 215 East 77th Street. The telephone number is 646-809-4719.
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HEALTHY LIVING • JULY 13 - 19, 2022 7B
left lip and cleft palate are openings or splits in the upper lip, the roof of the mouth (palate) or both. Cleft lip and cleft palate result when facial structures that are developing in an unborn baby don’t close completely. Cleft lip and cleft palate are among the most common birth defects. They most commonly occur as isolated birth defects but are also associated with many inherited genetic conditions or syndromes. Having a baby born with a cleft can be upsetting, but cleft lip and cleft palate can be corrected. In most babies, a series of surgeries can restore normal function and achieve a more normal appearance with minimal scarring. Usually, a split (cleft) in the lip or palate is immediately identifiable at birth. Cleft lip and cleft palate may appear as: • A split in the lip and roof of the mouth (palate) that affects one or both sides of the face • A split in the lip that appears as only a small notch in the lip or extends from the lip through the upper gum and palate into the bottom of the nose • A split in the roof of the mouth that doesn’t affect the appearance of the face
Less commonly, a cleft occurs only in the muscles of the soft palate (submucous cleft palate), which are at the back of the mouth and covered by the mouth’s lining. This type of cleft often goes unnoticed at birth and may not be diagnosed until later when signs develop. A cleft lip and cleft palate are usually noticed at birth, and your doctor may start coordinating care at that time. If your baby has signs and symptoms of a submucous cleft palate, make an appointment with your child’s doctor. Cleft lip and cleft palate occur when tissues in the baby’s face and mouth don’t fuse properly. Normally, the tissues that make up the lip and palate fuse together in the second and third months of pregnancy. But in babies with cleft lip and cleft palate, the fusion never takes place or occurs only part way, leaving an opening (cleft). Researchers believe that most cases of cleft lip and cleft palate are caused by an interaction of genetic and environmental factors. In many babies, a definite cause isn’t discovered. The mother or the father can pass on genes that cause clefting, either alone or as part of a genetic syndrome that includes a cleft lip or cleft palate as one of its signs. In some cases, babies inherit
a gene that makes them more likely to develop a cleft, and then an environmental trigger actually causes the cleft to occur. Several factors may increase the likelihood of a baby developing a cleft lip and cleft palate, including: • Family history. Parents with a family history of cleft lip or cleft palate face a higher risk of having a baby with a cleft. • Exposure to certain substances during pregnancy. Cleft lip and cleft palate may be more likely to occur in pregnant women who smoke cigarettes, drink alcohol or take certain medications. • Having diabetes. There is some evidence that women diagnosed with diabetes before pregnancy may have an increased risk of having a baby with a cleft lip with or without a cleft palate. • Being obese during pregnancy. There is some evidence that babies born to obese women may have increased risk of cleft lip and palate. • Males are more likely to have a cleft lip with or without cleft palate. Cleft palate without cleft lip is more common in females. In the United States, cleft lip and palate are reportedly most common in Native Americans and least common in
African-Americans. Children with cleft lip with or without cleft palate face a variety of challenges, depending on the type and severity of the cleft, including difficulty feeding, ear infections, hearing loss, dental problems and speech difficulties. —Mayo Clinic (www.mayoclinic.org)
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Cleft Lip And Cleft Palate
JULY 13 - 19, 2022 • HEALTHY LIVING
Dr. Leon Schwechter Dr. Javier Morales
Dr. Craig Grobman Dr. Neena Shah
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