SleepTalker December 2024

SleepTalker
Volume 41 Number 4 Stony Brook, NY  <       December 2024     
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Dr. Azim Promoted Dr. Landman Retires Dr. Schwartz ECMO Project PGA Meeting
Kudos Meetings Jeopardy! Anesthesia Interest Groups
New Publications New Plant Species! Where on Campus is That? Poetry Corner
OB Anesthesiology Fellowship
Dr. Azim Promoted to Professor

James P. Dilger, PhD

   Dr. Syed A. Azim has been promoted to Full Professor of Clinical Anesthesiology. Dr. Azim has been a faculty member of our department since 2001.

   Dr. Azim did his medical training at the Sindh Medical College in Karachi, Pakistan. He came to the US in 1996 and did a Clinical Research Externship in the Department of Nuclear Cardiology at St. Luke’s Roosevelt Hospital Center. This was followed by a one-year internship in surgery at Catholic Medical Center in Jamaica, Queens, NY. In 1998, he began his Stony Brook career by entering the Anesthesiology Residency Program. After graduation, he did a Pain Fellowship, also in our department and subsequently joined the faculty as Assistant Professor. He was promoted to Associate Professor in 2013.

   Dr. Azim served our department as Division Chief of Orthopedics and Plastics Anesthesiology from 2007-2021. Since July 2022, he has been the Medical Director of Anesthesia for Stony Brook Eastern Long Island Hospital in Greenport. Dr. Azim has served on various departmental committees such as Clinical Competence, Education, Executive and Research. He was a representative in the University Senate from 2010-2016.


Dr. Azim with Drs. Sunitha Singh and
TJ Gan at the 2022 ASA Meeting
   Dr. Azim's research has focused on outcomes after orthopedic surgery. He is a member of the multi-institute REGAIN study group which has published several articles comparing spinal and general anesthesia for hip fracture surgery. Collaborating with other members of our department, he investigated pain outcomes after total knee arthroplasty. He found, among other things, associations between central and peripheral endocannabinoid levels and postoperative pain.

   Congratulations to Dr. Azim for his well-deserved promotion!
Dr. Landman Retires

James P. Dilger, PhD

   Dr. Ursula Landman, Associate Professor of Clinical Anesthesiology, is retiring from the Department of Anesthesiology. Dr. Landman has been a faculty member since 1995. Faculty, residents and staff gathered on December 18 to wish her a happy retirement.

   Dr. Landman received her DO degree from NYIT-COM and then entered the Anesthesiology Residency program at Stony Brook. She was a member of the OB/GYN Division (now Women's Anesthesia Division) where she was Education Director. Her roles within the department include co-Director of the Journal Club, Director of the Anesthesia Student Interest Groups both at Stony Brook and NYIT-COM, co-Chair of the Wellness Committee, Director for Department Shadowing and FAER Coordinator. She also directed Stony Brook medical students doing mini-clerkships and rotations in the department.

   In 2019, Dr. Landman organized the Stony Brook chapter of Walk-With-a-Doc and has led monthly walks featuring a guest physician for the public. In 2015, she was the Keynote Speaker for the white coat ceremony at NYIT-COM and was honored as Alumna of the Year. She has influenced the career direction of many a medical student!

   Dr. Landman has been active in the American Osteopathic College of Anesthesiologists. She has served on the Board of Governors and as a Board Examiner. She was named a Fellow of AOCA in 2011 and advanced through the organization's governance culminating in her being elected President in 2024.

   Dr. Landman is considering this to be a "semi-retirement". She will continue in a teaching role as voluntary faculty here at Stony Brook Medicine. Congratulations Ursula and thank you for all you have done for the department!

Dr. Schwartz Granted Fusion Award

Jonathon Schwartz, MD

   Extracorporeal membrane oxygenation (ECMO) has emerged as a critical intervention for patients facing life-threatening heart or lung failure. The Data-DrIven ECMO Engineering (DICE) project, supported by the VDR Fusion Award, seeks to improve early detection of artificial lung dysfunction in ECMO patients. Advanced prediction models will be developed by leveraging large clinical datasets and an enhanced “ECMO-data pipeline”. Developing such a data pipeline will enable other institutions to create large, collaborative datasets that advance ECMO research beyond current capabilities. The project will utilize time-series analysis, machine learning, computational fluid dynamics, informatics, and hardware development to answer research questions.

   Dr. Wei Yin, from the Department of Biomedical Engineering, and I are honored to receive a VDR Fusion Award, which supports interdisciplinary research projects. We are excited to begin the project with our interdisciplinary team, and we look forward to fostering new collaborative relationships between our departments. We would also like to thank our departmental chairmen, Drs. Syed Shah and Yi-Xian Qin for their support on this project.
PGA Meeting
   The 2024 Post Graduate Assembly (PGA) sponsored by the NYSSA was held Dec 6-9 in New York City. Our department was represented in the form of 2 Abstracts, 5 Case Based Learning Discussions, 24 Medically Challenging Cases, 1 Panel, 2 Spotlights, and 3 Workshops. Click here to see meeting photos.

Abstracts
• Shteynman L, Li D, Jin Z, Lu W, Schabel J. Influence of Clinical Clerkship Experiences on Medical Student Preference for Anesthesiology Career
• Winkeler I, Jin Z, Zhu M, Poovathoor S, Bergese S. Comparing the efficacy of remimazolam and midazolam for procedural sedation, a meta-analysis

“Presenting at the PGA was a pivotal milestone in my career, making my first poster presentation at a national meeting. The conference offered a valuable platform to engage with esteemed professionals in the field, participate in forward-thinking discussions, and explore advancements in anesthesia. The dynamic atmosphere of New York City, coupled with the extensive knowledge shared throughout the event, made the experience both professionally enriching and personally transformative.” - Madison Garrity, DA-2 anesthesiology resident
CBLD
• Aravera C, Angelo TE. The Lasting Effects of COVID on a Parturient Requiring ECMO for Cesarean Delivery
• Beg T. “We Should Talk More about These… Ethical Dilemmas”
• Giuca M. MSPC (Multispeciality Surgical Pause Committee): Utilizing Frailty to Lead a Patient Centered, Pre-optimization Paradigm
• Al Bizri E, Desai AG. A Pediatric Polytrauma with Emphasis on Neuroanesthesia and Regional Anesthesia/Acute Pain Management
• Daoud BE, Factor MG. Pain Management Strategies in the Opioid Dependent Parturient
MCC
• Garrity M, Bodily S, Oleszak S, Boorin M, Epstein R. Anesthetic management of invasive papillary thyroid carcinoma complicated by five tracheal ring resection, tracheal reconstruction, and tracheostomy
• Raventhiranathan N, Oleszak S. Jet Ventilation and Airway Management for Patient with Idiopathic Subglottic Stenosis
• Rahman S, Choudhury N, Bodily S, Oleszak S. Successful Airway Management with Combined Use of Videolaryngoscope and Fiberoptic Bronchoscope in a Patient undergoing Radical Neck Dissection, Total Thyroidectomy and Tracheostomy
• Wang A, Torpey A, Oleszak S. Anesthetic Management of a Patient with Limb-Girdle Muscular Dystrophy Undergoing an Upper Endoscopy Exam Under General Anesthesia
• Tsivitis A, Atkinson D, Nguyen N, Feit A. Urgent laparotomy and salpingectomy secondary to ectopic pregnancy in a patient requiring VA ECMO after V fib arrest at home
• Henein J, Mattimore D, Price J, Zaidi S. A Case of Suspected Fulminant Viral Myocarditis Complicated by Intracardiac Thrombi
• Starr E, Xiao J, Garrity M, Mays T, Epstein R, Boorin M. Airway Management for a patient with Pierre-Robin Sequence undergoing Dental Rehabilitation Under General Anesthesia
• Espeleta J, Bargnes V, Fischl A. Don’t Be Conned by Primary Hyperaldosteronism: Anesthetic Considerations for Conn Syndrome
• DiMaria S, Li J, Cuenca J, Fischl A. Management of Acute Cardiogenic Shock Secondary To Viral Myocarditis Using Mechanical Circulatory Support
• Davidson S, DiMaria S, Bargnes V, Feit A, Poppers J. VV ECMO to the Rescue: Successful Recovery from Refractory Intraoperative Anaphylaxis Following Redo Sternotomy for Mitral Valve Replacement
• Marzolini L, Angelo T, Daoud B, Factor M. Approach to the Perioperative Management of Alpha-Gal Syndrome in a Parturient
• Razak A, Ma S, Jin Z, DeLemos M, Bergese SD. Utility of Remimazolam Versus Propofol for Total Intravenous Anesthesia: A Meta-analysis
• Elias M, Wang E, Hum B, Scott B, Nada E. Regional Anesthetic Approach to Subcutaneous Implantable Cardioverter Defibrillator Placement
• Nguyen N, Bargnes V, Daoud B, Angelo T, Factor M. Angular pregnancy, Asthma, and Apfel: A Triple-A in Obstetric Anesthesiology: Anesthetic Management of a Patient with Angular Pregnancy
• Rahman S, Bhimavarapu A, Desai A. Management of Chronic Pain associated with Small Fiber Neuropathy Secondary to SARS-CoV-2 • Patel D, Bindelglass A, Wang M. Pre-operative evaluation of a patient with severe glottic stenosis
• Greenberg S, Bargnes V, Kerolus K, Nada E, Andraous W. Vanishing Phantom Limb Pain Following Adductor Canal and Sciatic Nerve Block with Peripheral Nerve Catheter Infusion
• Nguyen N, Ahn J, Angelo T, Daoud B, Factor M. Anesthetic Management of a Parturient with Congenital Long QT Syndrome
• Yerramalli G, Bargnes V, Oster J, Atkinson D, Poppers J. Patient with Heparin-Induced Thrombocytopenia having Adverse Reactions to Heparin having Mitral Clip Placement for Severe Mitral Regurgitation
• Fiola J, Park G, Price J, Izrailtyan I Operative Management in Setting of Anomalous Origin of Coronary Artery
• Shibly Y, Bargnes V, Tannous H, Izrailtyan I. An Urgent CABG Complicated by Coronary Artery Intramural Hematoma from Percutaneous Intervention with Corresponding Electrocardiogram and Echocardiogram Changes in the Setting of Renal Transplantation
• Monanian G, Factor M, Daoud B, Angelo T. Intraoperative Management of Complete Placenta Previa with Placenta Accreta complicated by Suspected Amniotic Fluid Embolism
• Lin K, Bargnes V, Bodily S, Elias M, Epstein R, Zabirowicz E. Topicalization & TIVA: A Successful Anesthetic Duo for Endobronchial Oxidized Cellulose Placement in the Treatment of Bronchopleural Fistula

Panel
• Beg T. NORA: Out of Sight, Out of Mind? - ICU Procedures: The New Kid on the Block
• Costa AC (Moderator), Jin Z. Barf and Chunder: PONV
Spotlight
• Moller DH. Anatomy of an Error
• Nada E. Silver Tsunami and Cervical Spine Surgery: An Overview for Anesthesiologists

Workshop
• Oleszak S, Tatosian V, Vitkun S. Difficult Airway Management
• Feit A, Oster J. Basic POCUS: Cardiac and Lung
• Feit A, Oster J. Gastric Content Assessment POCUS with Log-Building and Competency Testing Workshop
Kudos

Diane Gardner, MSNA, CRNA

   Dr. Jasiewicz and I are both in the Navy. I was recently promoted to the rank of Captain. CAPT Jasiewicz was the presiding officer at my promotion ceremony, July 26, on the Intrepid. After he read my Officer's oath, my son, Connor, and significant other (James) pinned me with my new rank. Even better, after I was sworn in as Captain, I turned around and promoted that same son to the rank of Petty Officer 3rd class! He is a Navy SeaBee, and has been in the Navy for one year now.
     
   CAPT Jasiewicz is currently the Reserve Senior Medical Executive (SME)/Chief Medical Officer for the USNS Comfort (a 1000 bed hospital ship of the United States Navy) and Senior Medical Officer (SMO) of the Expeditionary Medical Facility - Bethesda (EMF-B) New York City Detachment.
Ralph Epstein, DDS

   Please join me in congratulating Dental Anesthesiology Resident Dr. Madison Garrity who received the top grade in the country on the In-Training Examination. Congratulations Madi, Way to Go!!!
Meetings

   In addition to the abstract listed list month for the NY NJ Pain Medicine Congress 2024, there were four others:
• Zimmerman AJ, Oo J, Chikvashvii D, Caldwell W. Combined Basivertebral Nerve Ablation and Interspinous Spacer Implants Provides Effective Long-Term Pain Relief for Severe Radicular Low Back Pain: A Case Report
• Zimmerman AJ, Kordic N, Cohen E, Caldwell W. Combined Basivertebral Nerve Ablation and Spinal Cord Stimulation Provides Effective Long-Term Pain Relief in Failed Back Surgery Syndrome: A Case Report
• Zimmerman AJ, Zektser K, Cohen E, Caldwell W. Inability to Wear Sandals and Heels: A Rare Case and Treatment for Dorsal Medial Foot Pain
• Rahman S, Rismany J, Caldwell W. Basivertebral Nerve Ablation as An Effective Treatment for Chronic Lower Back Pain after Spinal Fusion Surgery for Scoliosis

   Dr. Amruta Desai reported that she had a poster at ASRA 2024 in Las Vegas. "Regional Anesthetic Management of Clavicular and Rib Fractures in an Elderly Patient with Continuous Erector Spinae Block." It was presented by Dr. Nicholas Mangano. Nicholas Bitanti. a medical student, helped with the poster. Dr. Desai also participated on the ASRA social media and research committees at the meeting.
  
The answer is "Drs. Bell and Bindelglass"

Joy Schabel, MD

   And the question is: "Which residents won the 2024 Anesthesiology Residency Jeopardy Competition?" Yes, CA-3 residents Justin Bell and Adam Bindelglass paralyzed the opposition and took the grand prize at this competition hosted by the New York Academy of Medicine. Several residency programs from NYC and the surrounding area participated. Thank you Justin and Adam for volunteering to represent our program and for bringing home the win. We are so proud! 😊
Anesthesia Interest Groups

Ursula Landman, DO

   An Introduction to Anesthesiology talk was given to the Stony Brook Medical Student Anesthesia Interest Group (66 in attendance) and to the NYITCOM Anesthesia Interest Group (77 in attendance ). Both groups are excited for the upcoming year ahead and look forward to learning more about anesthesiology. The Stony Brook students have been matched to Attending Mentors. Thank you to all who have agreed to be mentors.
Recent Publications

Figure from Torpey et al 2024

A New Plant Species - R. enikolopovii

Grigori Enikolopov, PhD

   Sharing news that brought Natasha and me a surprise (and a good laugh) – several days ago, a new plant species was officially named: Rhodospatha enikolopovii!

   I’m not kidding, and the story goes like this: our son Armen, who grew up in the middle of the CSHL campus, had sworn since his school days that he would never study anything even remotely related to what his parents or everybody around do (which happens to be biology). However, after several twists and detours through programming, mathematics, and economics, he ended up getting his PhD in neurobiology from Columbia University. While continuing to work on neuroscience, about a year ago he suddenly developed a passion for botany. He reached out to Tom Croat from the Missouri Botanical Garden, a living legend who has described around 1,200 new species – more than any other living botanist, and asked to join Tom on his next expedition. Tom was quite surprised (usually the flux is reverse – people from other fields are getting attracted to neurobiology nowadays), but agreed. Together, they ventured into the jungles of Colombia, Costa Rica, and Peru, collecting hundreds of specimens. Among their findings were dozens of new species (these are impenetrable jungles, so it is still possible to stumble upon something new there), and they are now gradually publishing the reports on those findings.

   Tom was, apparently, so impressed by finding someone who shared his passion for classical botany that he decided to name one of the new species in honor of Armen - and he did! Personally, I just love the way Armen is described in the Etymology paragraph: ”This species is named after Armen Enikolopov, an American biologist and explorer” – brings to mind “Dr. Livingstone, I presume?”

   We're still in a state of awe and surprise. And I have to mention - Tom is 86 years old with two knee replacements, yet he still ventures on expeditions to remote parts of the Earth. What an amazing person and an inspiration to many!

   Natasha (who originally entered the Moscow University to study botany, but ended up graduating with a degree in genetics) commented: "This is a clear case of a recessive “soul of botanist” trait segregating in the second generation!" 😊
Where on Campus is That?

James P. Dilger, PhD


!
Visit the Where on Campus is That? webpage!
Poetry Corner

Marianne Rose, Practice Manager Stony Brook Center for Pain Management

Twas the night before Christmas and all through Pain Center
No provider was consulting...No Caldwell, No Kaushal, Not even a Gupter

All the staff long gone home to hang stockings with care
In the hope that Stony Brook raises soon would be there


Credit: https://en.wikipedia.org/wiki/Grinch
Then what to my wondering eyes should appear
A green, furry grinch and tiny dog reindeer

He was tall, lean and all hunched over
Big feet, scrawny fingers and green like a clover

Then I knew in a cinch
It must be The Mean One, Mr. Grinch

He was groaning and moaning and whining in pain
His load of stolen packages was the cause to blame

I asked. Mr. Grinch, do you have a referral; imaging. an insurance to claim?
We schedule consultations; review images; all before we make you well again

Now you listen to me, young lady, even if I’m horribly mangled
I need an epidural injection to get me untangled

The docs are leaving, the staff have a holiday to be
Holiday who-be what-ee??

I’m an idiot, You’re an idiot!

He yelled, Help me, I’m FEELING!
My aching back needs numbing So I can continue my stealing

Come Caldwell, Come Gupta, Come Kaushal, bring Julie & Nick
Let’s get this Grinch numbed up, hurry, real quick

All leaded up, gloved up and faces masked
Were ready to take on this momentous task

To fix up one so evil and cruel
A thief who has stolen many a jewel

Who was sure to spread further Stink, Stank, Stunk
Sure to put Stony Brook Pain Center in a permanent funk

Do no harm is an oath they all took
Proceed they did do without a second look

They spoke not a word, but went straight to work
And shot that epidural, even though he’s a known jerk

And once he awoke from his sedation sleep
Some warmth and kindness did seem to creep


He stated I'm all toasty inside
He thanked the team then he cried

I am so sorry to keep you so long
Go home to your families where you all belong!

Happy Holidays to all and to all a good night!
Stony Brook OB Anesthesiology Fellowship

   Pass the word! Tell your friends (umm residents). The Stony Brook OB Anesthesiology Fellowship page is now live!
SleepTalker, the Stony Brook Anesthesiology Newsletter is published by the Department of Anesthesiology
Stony Brook Medicine, Stony Brook, NY
Syed Shah, MD, Interim Chairman
Editorial Board: James P. Dilger, PhD; Ana Costa, MD; Murad Elias, MD; Vincent Bargnes, MD