Friday, June 30, 2017

Bronx Hospital Shows Success in Controlling High Blood Pressure

HEALTH– More than three-quarters of patients with hypertension receiving care at NYC Health + Hospitals/Lincoln currently have their blood pressure under control—an achievement reflecting the success of the “Treat-to-Target” program implemented throughout the city’s public health system. Improving blood pressure control means reducing risk for stroke, heart attack, kidney damage, vision loss, erectile dysfunction, and memory loss.

The Bronx hospital’s success rate of 78.1 percent is even better than the health system’s overall 72.8 percentage of patients (ages 18 to 75) being treated for hypertension who got their blood pressure under control (i.e., 140/90 or lower), as of April 2017. Nationally, 54 percent of people with high blood pressure have their condition under control, according to the Centers for Disease Control and Prevention.
“Our borough is often singled out for data showing Bronxites are less healthy, but we are showing that, with the right support from caring and committed health care providers, we can make a real difference,” said Milton Nuñez, chief executive officer at NYC Health + Hospitals/Lincoln. “With high-quality clinical care and better lifestyle choices, Bronxites have the power to live their healthiest lives.”

Through the Treat-to-Target program, nurses work closely and consistently with patients. For hypertensive patients with elevated blood pressure, nurses follow up with patients every two to four weeks, in the clinic or by phone, until the blood pressure is controlled. Nurses assess whether the problem is due to challenges with medication adherence, a need for a change in the medication regimen (e.g., increased dose), or some other factor. The nurses then work with patient and provider as needed to adjust the care plan and assist the patient in controlling blood pressure.

NYC Health + Hospitals also sends monthly performance data to each facility, broken down by provider and by clinic. Data are used to plan and monitor performance improvement. The regular feedback leads to greater uniformity of care and optimal practice throughout the system.

Facilities within the public health system that recorded the most improvement in 2016, including NYC Health + Hospitals/Lincoln, identified a number of factors behind their recent successes. Among them, they noted an increased number of nurses participating in “Treat-to-Target,” as well as the addition of more evening and Saturday appointment slots for patients; better referral patterns to the program from providers, including “warm handoffs” to program nurses; and spreading best practices from adult medicine clinics to other specialized primary care clinics (e.g., those focused on geriatrics or HIV).

Plans to strengthen the program in 2017 include improving processes for patient self-monitoring of blood pressure at home and partnering with community-based organizations and the New York City Department of Health and Mental Hygiene (through the Citywide Hypertension Initiative) to find more effective ways to connect with hard-to-reach patients.

Wednesday, June 21, 2017

Greenmarket Sprouts Up in Bronx

HEALTH- A lively farmers market, the Fordham Plaza Greenmarket, is serving Bronx residents, commuters, area workers, and students, faculty, and staff at the university. 

This weekday market, comprised of four New York farms and one bakery based in New Jersey, offers a terrific array of fresh, locally-grown produce and tasty baked goods. Located at 3rd Avenue and E. Fordham Road, adjacent to a bustling transit hub and Fordham University, The Fordham Plaza Greenmarket hosts free community activities, as well as nutrition education and cooking demonstrations conducted by the Department of Health and Mental Hygiene’s Stellar Markets program, further enhancing an amicable neighborhood rapport. 

The market opened on June 7th and it will run weekly through December 20th. 

“We are extremely grateful to the Department of Transportation for including us in the process of planning the Fordham Plaza, and we’re delighted to continue to serve the community of the South Bronx, where we’ve been since 1980,” said GrowNYC President and CEO Marcel Van Ooyen. 

GrowNYC’s Greenmarkets work to preserve local farmland, while ensuring that New Yorkers across all five boroughs have access to fresh, healthy food grown right here in our region. A central component of Greenmarket’s mission and operations is product integrity: everything sold at market is 100% farmer grown, produced, caught, or foraged. In addition to operating farmers markets, Greenmarket is working to improve the health of all New Yorkers with a suite of food access strategies aimed at getting the healthiest, freshest food into the hands that need it most. 

“Fordham Plaza serves as a transportation hub for residents of my District, and it will now serve as a place to find fresh food,” said Council Member Ritchie Torres. “I am looking forward to GrowNYC’s Greenmarket providing residents with food directly from farmers. If we are serious about improving health outcomes for Bronx residents, we must improve access to fresh vegetables and fruits.” 

Wilma Alonso, the Executive Director of the Fordham Road Business Improvement District added, “We are very excited to welcome GrowNYC to Fordham Road. Looking forward to a long productive partnership. Together we will make Fordham Plaza a better place for all.” 

*Cash, SNAP/EBT, Debit/Credit, and Farmers Market Nutrition Program checks accepted at this farmers market. 

Health Bucks now year-round! SNAP/EBT users – for every $5 you spend, get a $2 bonus. 

Farmers Attending: 
Acevedo's Farm Vegetables from Orange County, NY Gajeski Produce Vegetables from Suffolk County, NY Prospect Hill Orchards Apples & pears, some certified Organic, and baked goods from Ulster County, NY R & G Produce Vegetables from Orange County, NY 
Francesca's II Bakery Breads and baked goods from Middlesex County 

Visit the Fordham Plaza Greenmarket webpage for up-to-date information on at-market activities throughout the season. 

Tuesday, June 20, 2017

Push to get Every Child Covered

100,000 Children in NY State Still Uninsured

HEALTH- With the theme, Our Goal is Zero: Let’s Get Every Child Covered, a new marketing, advertising, and communications campaign is being launched by Fidelis Care this week to raise awareness for the 100,000 children who are still uninsured in New York State, and to highlight the availability of quality, affordable coverage for kids under 19. 

As a Statewide health plan with more than 1.6 million members, Fidelis Care’s focus is on ensuring that all children have the opportunity for a healthy start in life.

“Over the past several years, great strides have been made in reducing the number of uninsured children throughout the State,” said Pam Hassen, Fidelis Care Chief Marketing Officer. “We’ve been proud to be part of this concerted effort, and now, we’re strengthening our commitment to reach families in need. Our grassroots, community-based outreach has always been the heart of the Fidelis Care mission.”
According to the Children’s Defense Fund–New York, over 97 percent of the more than 4.5 million children in the State have health coverage, which is the highest level in history. Even with this positive statistic, approximately three percent, or about 135,000 children, remain uninsured. Reaching this population is the goal of Fidelis Care’s campaign.

The new campaign features TV, print, radio, outdoor, and digital advertising, video and social media promotion, as well as hundreds of “Every Child Covered” community events across the State where parents can find resources and information, ask questions of Fidelis Care Representatives, and receive help enrolling in a plan. Fidelis Care is also engaging its partnerships with the NY Liberty of the WNBA and New York City Football Club of Major League Soccer in the campaign, with players from each team featured in a TV spot promoting the “Let’s Get Every Child Covered” message. Lifestyle expert and Fidelis Care brand ambassador Evette Rios is also featured, reflecting upon her personal experience as a mom and her understanding of the importance of routine and preventive health care for kids.
“With regular checkups, immunizations, vision and dental care, and a primary care provider who knows their health history, children with health insurance are more likely to receive the care they need,” added Fidelis Care Chief Medical Officer, Vincent Marchello, MD. “We want to be at the forefront of building healthier futures in the lives of our youngest members.”

Many parents may not be aware that quality, affordable coverage is available through the State’s Child Health Plus program for kids under 19. Almost every child in the State is eligible, and monthly premiums can be free or as low as $9 per child per month, based on family income and household size. Benefits are comprehensive and include checkups and preventive care, emergency care, dental and eye care, X-rays, and more. As the largest Child Health Plus plan in New York State, and the only plan offered in all 62 counties, Fidelis Care is in a unique position to help every child get the coverage they need. 

For more information and a complete list of Every Child Covered events, visit

Saturday, June 10, 2017

Bronx Hospital Pioneering 3D printed prosthetics

Docs 3D Print Up Arm for Child Born Without One

(Isaac Cruz showcasing his new prosthetic hand. The device was created using 3D printing technology and custom-designed to fit Isaac’s upper arm.)

HEALTH- NYC Health + Hospitals/Jacobi has created a prosthetic arm and hand using 3D printing for its youngest patient yet. Born without forearms or hands, three-year-old Isaac Cruz is adjusting well to his new limb, which he has nicknamed “Mano” (“hand,” in Spanish).

The development of Isaac’s arms was halted in utero because of congenital amniotic bands. Cesar Colasante, MD, a burn surgery fellow in the Plastic Surgery Department, measured Isaac for the device using both traditional measuring tape and photogrammetry scanners. He used the measurements to custom-design a prosthetic device using CAD/CAM software. 
He imported Isaac’s scan and modeled the parts in contact with the boy to be a perfect fit. 

“This is probably the first one like this made for such a young patient,” said Dr. Colasante. (Dr. Colasante’s work is supervised by Ralph Liebling, MD, Chief of Plastic and Reconstructive Surgery at NYC Health + Hospitals/Jacobi, who is Isaac’s attending physician.)

Because reimbursement models for 3D-printed prosthetics aren’t yet established, Dr. Colasante paid out of his own pocket for the needed supplies on two versions of the prosthetic: wires, elastics, screws, a harness, and a spool of poly-lactic acid—a raw material for 3D printing. Assisted by Andrew Peredo, MD, another burn surgery fellow, he worked on the designs and construction nights and weekends. 

“The printer used to be in the call room, but the residents weren’t happy that I had prints going at night, since it can be loud,” Dr. Colasante said. “That’s why our printer has since been moved to the Occupational Therapy gym.”

Once the overall construction was completed on the latest version, several sessions were required to fit the device and adjust it for Isaac. The system was created to allow Isaac to close the “hand” by using one arm to position the prosthetic and the other to pull a trigger to grab things.

An earlier version required that Isaac bring his shoulders forward--thereby pulling a wire that extends from shoulder to shoulder in the harness he wears on his back—to grab things. But the elastic bands on this prosthetic provided more resistance than practical for the three-year-old. Moreover, Isaac was instinctively trying to activate the grip using his other arm—even though the earlier device didn’t work that way—so Dr. Colasante redesigned the prosthetic to work the way the boy instinctively wanted it to work.

Weeks after receiving the new device, Isaac’s father, Alan Cruz, says his son has adjusted well to the prosthetic arm, noting that he is thrilled to show his friends how colorful the device is. He’s now using the device to play with his toy cars.

“The more he uses the arm, the better,” explains Dr. Colasante. “With patients like Isaac, the issue is that it takes forever to get a prosthesis, or they never get it at all. They get used to not having the limbs and fully compensate with other body parts. While that is great for independence—for example, learning how to feed themselves with their feet—they have a hard time adjusting to a prosthesis later because their brain is then wired to not having arms. And using the feet for everything creates tremendous strain on the spine.”

The doctor guesses Isaac will outgrow this prosthesis in six months to a year, but since Isaac is a pioneer, how many times this device can be recalibrated before a new device is needed is unknown.

“Dr. Colasante really helped Isaac with creating this device,” said Mr. Cruz. “He’s a great person, and this arm has helped Isaac a great deal with his everyday tasks.”

“For his other arm, I am creating a myoelectric prosthetic that senses muscle contractions and sends a signal to a computer board that drives a motor to close the hand,” adds Dr. Colasante.

NYC Health + Hospitals/Jacobi began pioneering 3D printing two years ago. Dr. Colasante wrote the original grant proposal to secure a 3D printer and has been pairing patients with these low-cost yet highly durable devices. Approximately 20 patients at NYC Health + Hospitals/Jacobi have received 3D printed prosthetics.

Tuesday, June 6, 2017

Premature Triplets Head Home

Bronx Hospital Delivered and Cared for the Trio Born Almost 4 Mounths Early

BRONX– NYC Health + Hospitals/Jacobi announced that triplets born in December-almost four months prematurely-have been discharged home in good health, for the first time. Their departure marks the latest progress in a journey of care that included months of carefully coordinated high-risk prenatal care, followed by intensive postpartum care by the hospital’s neonatal medical team.
In the fall of 2016, specialists at NYC Health + Hospitals/Jacobi identified the expectant mother, Amone Akter, as a high-risk obstetrical patient. As such, she received care in the hospital’s high-risk clinic.

On December 22, Ms. Akter’s water broke, and she was rushed by ambulance to NYC Health + Hospitals/Jacobi, where she was immediately evaluated by a team of obstetricians and maternal fetal medicine specialists. The triplets were delivered the following day at 25 weeks gestation.

Because of the extreme prematurity of the infants, Dr. Beth Nagourney, director of Neonatology, assembled three teams-one for each baby-of neonatologists, pediatricians, neonatal nurse practitioners, and respiratory therapists to coordinate care for the two baby boys (Ruhan and Eshaq) and the baby girl (Israt), whose birthweights ranged from 610 to 695 grams (i.e., from 1 lb. 6 oz. to 1 lb. 9 oz.).

“It’s rare for someone to conceive triplets,” said Dr. Nagourney. “The incidence is about one in 6,400. And the fact these babies came almost four months early meant our whole team needed to be ready.”

The babies were immediately admitted to the hospital’s Level III Neonatal Intensive Care Unit (NICU), which provides comprehensive care for infants born with critical illness at any gestational age or birthweight. One of the babies required emergency surgery at a week of life for an intestinal problem, and another required chest tube placement for a pneumothorax (collapsed lung). One of the babies later required surgery to close a patent ductus arteriosus (a fetal blood vessel that usually closes naturally after birth).

Two of the babies required respirators in the NICU for nearly two months until they were strong enough to breathe on their own, while the third triplet remained on a ventilator for close to three months.

“The Jacobi staff took very good care of me and my babies,” Ms. Akter said. “I will definitely recommend this hospital to my friends and family.”

Amone Akter and Muhamad Baskh (the babies’ father) finally had all three babies home on April 27. At discharge, their weights ranged from 2,380 grams to 2,670 grams (i.e., from 5 lb. 4 oz. to 5 lb. 14 oz.).