A Brooklyn Hospital Serves a Local Family

With only one hospital on the peninsula, sometimes folks find healthcare off of it. For one local family, the Zagars, they chose Coney Island Hospital, now known as South Brooklyn Health for their needs. To show their appreciation, Fern Zagar wrote a letter to Michael Katz, the President and CEO of NYC Health and Hospitals and the CEO, Svetlana Lipyanskaya, and Chief Medical Officer, Dr. Terence Brady of South Brooklyn Health to show appreciation for a recent visit.

“On October 27, my husband, David Zagar, was hospitalized at Coney Island Hospital for a possible stroke. We want to share with you that the care he received during his stay was exceptional. From the moment the ambulance brought him to the ED, all staff were attentive and actively involved - transport staff, nursing assistants, nurses, PA's, MD's - everyone.

We could not get over the level of compassion and thoroughness. My husband received immediate attention and tests were ordered and ad- ministered without delay. Every decision that was made, every test that was given, was explained to us and results were clearly discussed. All questions were patiently answered and our concerns were included in every decision. This was truly person-centered and family focused care.

The staff in the ED, including the nurse working with us, I believe Kieyah Williams, was wonderful. We never felt ignored or uncared for. My husband was taken for several tests. The transport staff were friendly and helpful. In fact, one noticed I was cold and found a blanket for me while we were waiting to be transferred to the stroke unit. The bathrooms and the entire ED were exceptionally clean, not what I'm used to in a hospital ED.

Care on the stroke unit was also exceptional. My husband was briefly agitated and confused when he was brought to his bed. When I left, the nurse pulled her portable station up to his bed to stay with him until he was more relaxed. That is truly compassionate and responsive care.

The ratio of one nurse for every four patients was extraordinary and truly made a difference.

The doctor on the stroke unit, Dr. Ozga, overseeing my husband's care was warm, responsive, thoughtful, and thorough. He came into our room as quickly as possible whenever we had a question and carefully and clearly answered our questions. Here again, every decision was made with us, and a follow-up plan included our concerns and needs.

My husband and I have unfortunately been hospitalized on a few occasions at some of the best NY hospitals. have to admit that I had some trepidation when the EMT's said we were going to Coney Island Hospital.

I must now say that this may have been the best hospital experience we have had.

Thank you to all your staff and leadership for the wonderful care received. We will never again hesitate to go to Coney Island Hospital, or any of the NYC Health and Hospital facilities. – Sincerely, Fern Zagor.”

In 2020, SBH became an accredited stroke center by the Joint Commission. The specialized stroke unit has 250 people who actively work in the unit, ranging from emergency attendings, learning residents and specialists such as neurologists.

Additionally, New York City Health + Hospitals/South Brooklyn Health is preparing to open its new state-of-the-art building this spring. Coney Island Hospital is rebranding itself as South Brooklyn Health/Ruth Bader Ginsburg Hospital to better reflect the patients it serves — people from all over South Brooklyn, plus the Eastern side of Staten Island and the Rockaways, not just residents of Coney Island. SBH is located at 2601 Ocean Pkwy in Brooklyn.

By Peter Galvin, MD

Skin Conditions

Eczema is a skin condition that can cause redness, swelling, scaling, oozing/weeping, and dryness. By far the most common form of eczema is atopic dermatitis, sometimes called atopic eczema. It is what most doctors and patients are referring to when using the term eczema. It is a chronic inflammatory skin condition that affects more than 200 million people worldwide, including about 20% of children and 10% of adults. Although atopic dermatitis is more common in children (and often continues into adulthood), about one in four adults with it have adult-onset disease. Factors involved in the devel- opment of atopic dermatitis include a weakened skin barrier, increased activity of immune cells in the skin, and an altered microbiome (microorganisms living on the skin). It may affect certain areas of the body including skin folds, the head, face, and neck, hands and wrists, and feet and ankles. The most common symptom is itching, but it can cause skin pain and may affect sleep. Atopic dermatitis can decrease quality of life, reduce productivity at school and work, and increase healthcare costs. There are known triggers for flare-ups that vary among individuals and may include emotional stress, rap- id changes in temperature or humidity, sweating, allergens, and irritants. Although patients may receive education about how to identify and avoid triggers, many patients have already discovered this information on their own. Advice to those with atopic dermatitis include to bathe daily, use soap-free cleansers, and apply fragrance-free and irritant-free skin moisturizers directly after bathing. Although there is no cure for atopic dermatitis, medications that regulate inflammation and immune system activity can help improve or resolve symptoms. For mild to moderate atopic dermatitis, first-line treatment is topical anti-inflammatory creams and ointments including topical steroids. These treatments and others like them rely on steps to interrupt the inflammatory pathway. Inflammation results from a series of steps involving various proteins and enzymes, similar to how blood clots. The steps necessary to form a blood clot involve enzymes and proteins and is called the clotting cascade. The inflammation pathway involves enzymes known as Janus kinases. When first discovered, these enzymes were called “Just another kinase” (JAK). Those familiar with

Roman mythology will recognize the name Janus, who was the two-faced Roman god of beginnings, endings, and duality. When it was found that these kinases had two nearly identical domains, one with kinase activity and the other with anti-kinase activity, the name was changed to Janus kinases. Janus kinase (JAK) inhibitors interrupt the inflammatory pathway. If you watch TV ads, the names of several of these topical inhibitors might be familiar, including tofacitinib (Xeljanz) and upadacitinib (Rinvoq).

For more severe atopic dermatitis, various treatments include injectable biologics, oral JAK inhibitors, phototherapy (narrow-band UVB light), and oral immunomodulators like methotrexate, mycophenolate, and azathioprine. The treatments for severe inflammation and various forms of cancers overlap, as both JAK inhibitors and immunomodulators are used as chemotherapy for a number of forms of cancer and require close laboratory monitoring.

For more information go to the American Academy of Dermatology at: www.aad.org/public/diseases/eczema

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