May Rowan pages 2016

May 2016

» Prescription for Successful Aging, page 3 » Future on display at 20th annual Research Conference, page 5 » Celebrating the next generation of physicians and biomedical researchers, page 6

New tests may help combat melanoma

By ROBERT PREDIT HealthDay

Genetic and molecular tests can be valuable in helping to diagnose and treat deadly melanoma skin cancer, a dermatologist says.

The tests are widely available in the United States, and many are covered by insurance or offered at no extra cost, said Dr. Emily Chu. She is an assistant professor of dermatology and pathology and laboratory medicine at the University of Pennsylvania, in Philadelphia.

Melanoma rates in the United States have doubled over the past three decades, according to the U.S. Centers for Disease Control and Prevention. Tissue biopsy is typically used to diagnose skin cancer, but biopsy results aren't always definitive. In such cases, genetic and molecular tests can help determine if a patient has skin cancer, Chu said.

She added that such tests may also help identify the most

effective treatments for patients with advanced melanoma.

Continuing research into specific melanoma mutations and targeted treatments could lead to more effective therapies in the future, the researcher said.

"Although genetic and molecular testing for melanoma has advanced in recent years, it's still an emerging field. I think it will only get better," Chu said in an American Academy of Dermatology release.

While genetic and molecular tests are helpful, Chu explained that their results have to be considered along with other information.

"Genetic and molecular tests are a valuable tool in our arsenal for fighting melanoma," Chu said.

"When used appropriately, these tests can provide dermatologists with important information to assist them in melanoma diagnosis and treatment, allowing them to provide patients with the best possible care."

SHIELDING KIDS FROM THE SUN A combination approach boosts the chances of proper sun protection for children, researchers report.

The study included 300 parents or other family caregivers of children between the ages of two and six. About half of the adults were assigned to a child sun safety program, and the rest received usual information about protecting children from the sun.

The sun safety program included a 13-page, readalong book that featured child characters highlighting sun safety, a sun-protective swim shirt, and four sun protection reminders sent weekly by text message.

Four weeks later, children participating in the program had higher scores on sun protection for both sunny and cloudy days. They also were more likely to use sunscreen and to wear a shirt with sleeves on sunny days.

Children in the program also had smaller sun-related changes in skin pigment, according to the study published online recently in the journal JAMA Pediatrics.

The findings suggest this program can improve children's sun protection and reduce their future risk of skin cancer, Dr. June Robinson, a professor of dermatology at Northwestern University Feinberg School of Medicine in Chicago, and colleagues concluded.

Melanoma is the second most common type of cancer among teens and young adults.

Sun exposure increases the risk of skin cancer.

Doctors often believe that "less is more" and simplifying recommendations helps patients, an accompanying journal editorial noted. It added that this study suggests that a "more is more" approach leads to healthier sun protection habits among children.

Source: U.S. National Cancer Institute

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Prescription for Successful Aging

By Dr. Anita Chopra

We all want to be a picture of health and vitality as we age, and the instructions on how to get there may seem relatively straightforward. But, like the confusing instructions that are often enclosed with products labeled “Some assembly required,” the directions for successful aging can be difficult to follow.

That may be because we aren’t quite clear on what it means to age successfully. As a physician who has dedicated her career to helping people as they grow older, let me describe my picture of successful aging and give you some steps you can follow to reach that goal.

Successful aging means more than just extending life into your 80s, 90s or beyond.

Successful aging means you are living a life that has a low probability of disease or

disability, a high level of ongoing physical function and a continued ability to engage in a variety of activities.

Successful aging takes both resilience and motivation. It means practicing acceptance and optimizing what you have. As people head toward middle age, the cadence of their lives slows. For many, it means careers become more settled as children grow to maturity. There are physiological changes, too, as metabolism and even some thought processes begin to slow down. Too often, these changes can lead to older adults slipping into a more sedentary lifestyle. It will take some conscious effort, but resisting that slowdown and finding time to be physically active will strengthen both the mind and the body.

Regular physical activity helps reduce excess weight, lower blood pressure and blood sugar levels and slows the natural loss of muscle mass that accompanies aging.

Engaging in regular exercise can enhance your ability to sleep at night and can improve your strength and balance. Keep in mind, however, that you need to check with your physician before starting any new exercise program.

A heart-healthy diet is another important part of successful aging. As much as possible, avoid processed foods as they can be high in fat, salt and sugar. Instead, plan to include fortified grains, dairy and a colorful array of fresh fruits and vegetables in your daily diet. A diet that keeps the heart healthy will also keep your brain healthy.

At the same time, think about any habits that you need to change. For example, if you smoke, ask your doctor for help in quitting.

Dr. Anita Chopra chairs Nearly every aspect of the Department of your health, from your Geriatrics and Gerontology heart to your lungs and at the Rowan University to your sense of smell School of Osteopathic and taste, will improve Medicine and is the when you quit. director of the University’s Finally, stay in touch nationally acclaimed with others. Even if you New Jersey Institute live alone, that doesn’t mean being alone. Reach for Successful Aging out to friends, neighbors (NJISA). To schedule an appointment at the NJISA, and relatives. If getting please call 856-566-6843. outside is a problem, stay in touch by phone, email or through social media websites like Facebook.

So, you see, the instructions for pictureperfect health in later life aren’t complicated.

You have probably heard a variation of the same advice often in the past.

But, suppose you have never followed that advice. Now, as a 50-something or older adult, you find yourself wishing you had been more health conscious when you were younger. Is it too late to get healthy?

In a word, “No.” Regardless of your age, it’s never too late to make changes in your life that will improve your health and put you on the path to successful aging.

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Future on display at 20th annual Research Conference Does calorie labeling in restaurants affect dining choices? Can music help ease chronic pain? How are circadian rhythms related to Alzheimer’s disease? Can an ancient medicinal plant halt the growth and spread of cancer cells? Is it possible to diagnose Alzheimer’s disease from a single drop of blood, before any outward symptoms appear? Can magnets improve healing from a surgical procedure?

Displays holding more than 170 posters filled with colorful graphs, charts and photos illustrated the answers to these and dozens of other inquiries into the complexities of biomedical research during the 20th annual Research Conference, held earlier this month at Rowan University’s Stratford campus.

Originally held on one day, the conference grew this year to two days to accommodate an expanded roster of guest speakers and the record number of research teams reporting their findings. Rowan faculty presented a series of eight lectures over the course of the two day event, covering topics that ranged from recent advances in gene therapy and the use of nanofibers in regenerative medicine to blood-based biomarkers for neurological disease and treating brain disorders with the help of performing arts. Throughout the event, faculty and student researchers were on hand to discuss their work and answer questions about the real-world application of their findings.

Many of the projects on display included students among the research teams, and the students who displayed posters during the conference competed for prizes. One of the criterion on which students were judged was their ability to explain their project and its importance to someone who didn’t have a strong science or medical background.

A highlight of the first day of the conference was the announcement of which students would take home the awards for the best medical and biomedical science student research projects.

2016 AWARD WINNERS Summer Medical Research Fellow 1st place: Amogh Joshi, “Modulation of the cyclin C-med 13 complex using stapled peptides” 2nd place: Sarah Callinan, “Lipoxin A4 decreases sepsis-related mortality through increased B lymphocyte production and neutrophil apoptosis” 3rd place: Shivani Adhyaru “’But, Doc, I feel fine!’ Patients’ awareness of chronic disease and its management”

Graduate School of Biomedical Science 1st place: Gulden Yilmaz, “Analysis of Protein-DNA Interaction in the Initiation of the Human Papillomavirus Viral DNA Replication” 2nd place: Samantha Zaroff, “Altering N-Acetylaspartate Metabolism During Early Neurodegenerative Disease Progression via Recombinant Adeno-Associated Viral Vectors” 3rd place: Kseniya Obraztsova, “Hyperosmotic stress induces transcriptional arrests in E. coli that are relieved by transcript cleavage factors GreA and GreB”

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F

our years ago, Victoria Shertel’s parents were among the first to arrive at the White Coat Ceremony that officially welcomed the Class of 2016 to the School of Osteopathic Medicine (SOM).

On Friday, May 13, her parents along with other family members were again seated on the front row at a Rowan University ceremony. This time, though, they were there to see Victoria cross the stage as she received her Doctor of Osteopathic Medicine degree.

“Honestly, today means everything to me,” said Victoria, a 27 year old from Mays Landing, NJ, as she awaited the beginning of the ceremony honoring the graduates of SOM and the Graduate School of Biomedical Sciences. “So much hard work, dedication, crying – and eating ice cream – went into getting to today.

It’s truly a dream come true to get my diploma and to be officially called a doctor.”

“She started on this dream when she was three-years-old,” Victoria’s mother, Linda, said with obvious pride in her voice as a small tear escaped from the corner of her right eye. “She’s the first doctor on either side of our family and is an inspiration to her five nieces and nephews.”

Joy and pride filled Esby Gym on the Glassboro campus in equal measure as Rowan held the eighth and final ceremony of 2016 Commencement Week at the University.

Speaking on behalf of the faculty, staff and administrators, Linda Rohrer, chairman of the Rowan University Board of Trustees welcomed the graduates and their guests to the afternoon’s proceedings. She thanked the graduates for their commitment to completing a demanding academic curriculum and reminded them that they have much more work ahead.

“And that work – whether it is starting a residency in a hospital, starting a job or furthering your formal education – is important work, critical work to the well-being of us as individuals and as a society.”

Before introducing American Osteopathic Association President Dr. John Becher as the keynote speaker, Rowan President Dr. Ali Houshmand addressed the graduates who “helped change the face of our institution,” noting that Rowan is now one of just two universities in America that offers both D.O. and M.D. medical degree programs.

“Honestly, today means everything to me…to get my diploma and to be officially called a doctor.”

Celebrating the next generation of physicians and biomedical researchers

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“And that work…is important work, critical work to the well-being of us as individuals and as a society.”

Continuing a tradition at the annual commencement exercises, SOM Dean Dr. Thomas Cavalieri presented two individuals with prestigious awards from the school.

Dr. Ira Monka, a 1984 graduate of the school and a former trustee of University Hospital in Newark and the UMDNJ Board of Trustees, was presented with the SOM Distinguished Alumni Award.

Dr. Cavalieri also presented New Jersey Senate President Stephen Sweeney with the medical school’s highest honor, the SOM Medal of Excellence for Distinguished Service.

In presenting the award, Dr. Cavalieri cited Senator Sweeney’s support on issues benefiting families and children and highlighted his leadership that led to the adoption of the New Jersey Medical and Health Sciences Restructuring Act, which strengthened higher education and revitalized medical education and health care in the region.

“Thank you to the faculty and staff at Rowan University for this honor,” said Sweeney. “This school is playing a key role in training the next generation of health care workers that New Jersey residents will count on to maintain their quality of life and I’m happy to do what I can to support them.”

Following Commencement, the Rowan’s newest alumni class will head to medical residencies and to careers as biomedical scientists, researchers and educators.

The SOM graduating class includes four physicians who will continue their residency training in the military, 67 who will specialize in primary care. Sixty-six of the graduates will remain in New Jersey based programs as they continue their training and begin their first jobs as physicians.

Injuries more common in teens 6 tips to sports injury who focus on single sport protection

By ROBERT PREDIT HealthDay

High school athletes who focus on a single sport may be at increased risk for knee and hip injuries, a new study suggests.

“Make sure your children are getting breaks in competition,” said study author David Bell, assistant professor in the Departments of Kinesiology and Orthopedics and Rehabilitation at the University of Wisconsin-Madison.

“There are so many great aspects to sports participation and we don’t want this information to scare athletes or parents — we just want them to be wise consumers and to participate as safely as possible,” he said in a university news release.

The study included more than 300 athletes at two high schools, one large and one small. About 36 percent of the athletes had high levels of sports specialization. Nearly 29 percent had moderate specialization, and about 35 percent had low specialization, the researchers said.

The one-year study found that athletes from the smaller school were less likely to specialize than students from the larger school. Those in the high specialization group were more likely to report a history of overuse knee injuries than those in the other two groups. Athletes who trained in one sport for more than eight months during the study were more likely to have a history of knee and hip injuries, the researchers reported. The study was published recently in The American Journal of Sports Medicine.

Be in proper physical condition If you play any sports, you should adequately train for that sport. It is a mistake to expect the sport itself to get you into shape. Many injuries can be prevented by following a regular conditioning program designed specifically for your sport.

Know and abide by the rules The rules are designed, in part, to keep things safe. This is extremely important for anyone who participates in a contact sport. Respect the rules on illegal procedures and insist on enforcement by referees, umpires and judges.

Wear appropriate protective gear and equipment Protective equipment that fits you well can save your knees, hands, teeth, eyes, and head. Never play without your safety gear.

Don't underestimate rest

“Recommendations already exist to try and limit athletes’ year-round exposure to sports,” Bell noted. “Yet we don’t know how well these recommendations are known to the average person.

“Our next step is to survey parents and athletes regarding their knowledge of sport participation recommendations, and also their attitudes toward sport specialization,” he said.

Athletes with a high number of consecutive days of training have more injuries. Rest is a critical component of proper training. Rest can make you stronger and prevent injuries of overuse, fatigue and poor judgment.

Always warm up before playing Warm muscles are less susceptible to injuries. Make sure your warm up suits your sport.

Don't play when tired or in pain This is a set-up for a careless injury.

Pain indicates a problem. Pay attention to warning signs your body provides.

Source: American Academy of Orthopaedic Surgeons

At home monitoring helps spot stroke risk

By STEVEN REINBERG HealthDay

Keeping track of your blood pressure at home may provide a better indicator of risk for heart disease and stroke than waiting to have it taken by your doctor, Japanese researchers report.

The study found the risk for heart disease and stroke was greater for patients whose morning systolic blood pressure — the top number — measured at home was 145 mm Hg compared with reading of less than 125 mm Hg. “In clinical practice, morning home blood pressure may predict heart disease and stroke better than office blood pressure, and be more effective in managing high blood pressure,” said lead researcher, Dr. Kazuomi Kario.

He’s a professor and chairman of the division of cardiovascular medicine at Jichi Medical University School of Medicine in Tochigi, Japan.

“Few reports have investigated the predictive ability of home blood pressure for heart disease and stroke,” Kario said. “This largest home blood pressure study is the first to demonstrate that morning home blood pressure may be superior to clinic pressure,” he said.

For the study, Kario and his colleagues followed more than 21,000 patients with high blood pressure for a little over two years. The mean age of the study volunteers was 65. During the study follow-up, 127 patients had strokes and 121 developed heart problems, the findings showed.

Strokes were significantly higher among those patients with a morning home systolic blood pressure of 145 mm Hg or higher, compared to those patients whose systolic blood pressure was less than 125 mm Hg. The comparable numbers for stroke risk measured in a doctor’s

May is stroke awareness month

office were 150 and higher, and less than 130, respectively, the researchers found.

The risk for heart disease was also higher among patients whose at-home systolic blood pressure was over 145 mm Hg compared to those who had blood pressure of 125 mm Hg or less at home. For the in-office reading, heart disease risk was greater when blood pressure was 160 or higher compared to less than 130, the investigators found.

The report was published online in the March issue of the Journal of the American College of Cardiology.

Elevated blood pressure remains a leading cause of stroke, heart attacks, heart failure, kidney failure and premature deaths, said Dr. Gregg Fonarow.

He’s a professor of cardiology at the University of California, Los Angeles, and a spokesman for the American Heart Association.

Taking your blood pressure at home is relatively simple using a blood pressure measuring device.

Devices range in price from around $30 to more than $100.

The American Heart Association (AHA) recommends an automatic, cuff-style, upperarm monitor for use at home.

Wrist and finger monitors are not recommended because they yield less reliable readings.

Monitors for the elderly or pregnant women should be validated specifically for those purposes. And, be sure the cuff fits properly, the association says.

Blood pressure responds to many factors and will vary throughout the day, so a single high blood pressure reading is not an immediate cause for alarm, the AHA points out. But if you get a high reading, you should take your blood pressure several more times and consult your doctor to make sure you don’t have a problem and that your monitor is working properly, the heart group recommends.

Controlling your blood pressure should be a partnership between you and your doctor, the AHA suggests. Taking your blood pressure at home is one step, and should be done with the advice and help of your doctor.

“There is increasing interest and guideline recommendations toward using blood pressure readings taken at home to assess risk and guide treatment of hypertension [high blood pressure],” Fonarow said.

“The lower the morning home blood pressure reading, the better the outcomes,” he explained. Men and women with a morning systolic blood pressure reading of less than 125 mm Hg had the lowest rates of cardiac events and strokes, Fonarow said.

“This study lends further support for integrating morning home blood pressure readings as a component of the routine clinical assessment and treatment of high blood pressure,” he added.

Meditation may help ease chronic low back pain

By AMY NORTON HealthDay

Meditation may work better than painkillers when it comes to soothing chronic low back pain, a new clinical trial suggests.

The study found that a program called mindfulness-based stress reduction (MBSR) beat standard medical care for managing low back pain.

After one year, people who attended MBSR classes were more than 40 percent likely to show “meaningful” improvements in their pain and daily activities compared to people who sought conventional care for their aching backs.

MBSR involves group sessions in meditation and some simple yoga poses. The focus is on becoming aware of body sensations, thoughts and emotions — without trying to change them, explained study leader Daniel Cherkin. He’s a senior investigator at Group Health Research Institute, in Seattle.

It’s not exactly clear why the mindfulness approach can ease back pain, according to Cherkin.

But, he stressed, no one is saying that the pain is just “in people’s heads.”

“Neurological research has demonstrated how the body and mind are truly intertwined,” Cherkin said.

According to Cherkin, MBSR can help people acknowledge how they are feeling — physically and otherwise — without reacting and “getting stressed out.” And that might help them manage chronic back woes.

The study was published in the March issue of the Journal of the American Medical Association.

The findings were based on 342 adults with persistent low back pain for at least three months.

Most of them had suffered much longer — seven years, on average, the study authors said.

None of the study participants had a clear cause for the pain, such as a slipped spinal disc. And that’s the case for most people with low back pain, Cherkin said.

“For people like these, there is no single treatment that works,” he said. “That’s probably because there are a lot of different factors causing people’s pain.”

Cherkin’s team randomly assigned each patient to one of three groups. Those in the MBSR group were supposed to attend eight weekly sessions led by an instructor, and start a home practice of meditation and basic yoga poses.

A second group was assigned to eight sessions of cognitive behavioral therapy — a form of psychological counseling where people learn to change negative thinking patterns and behaviors.

People in the third study group were told they could opt for any standard treatment they liked, including pain medication and physical therapy.

Six months into the study, 60 percent of patients in the MBSR group showed a “meaningful” improvement in their daily activities — including walking, climbing stairs and standing for long periods. That compared with 44 percent of patients who’d been free to opt for the other therapies.

People who received cognitive behavioral therapy also fared better: almost 58 percent showed significant improvements at six months.

What was surprising, Cherkin said, was that the benefits of MBSR were still apparent after a year — even though most people did not attend all eight sessions.

At one year, 69 percent of patients were reporting improvements in their daily activities, versus 59 percent of the behavioral therapy group and 49 percent of the standard care group.

Reports of bothersome pain were also improved more in the MBSR group, the study found.

“We were struck by how durable the effects were,” Cherkin said.

Home practice is a key part of MBSR, said Dr. Madhav Goyal, an assistant professor of medicine at Johns Hopkins University, in Baltimore, who has studied meditation.

“It could be that most people were doing the homework, and that contributed to the benefits,” said Goyal, who wrote an editorial published with the study. But, he added, that’s not clear from the findings.

MBSR is a specific program that was first developed at the University of Massachusetts in the 1970s. So it’s not clear that the meditation class at your local yoga center would have the same results, Goyal cautioned.

Cherkin agreed. But, he said, MBSR programs are becoming increasingly available. At roughly $400 to $500, he added, some people might think it’s a worthwhile investment.

And while the study didn’t test other mindfulness techniques, Cherkin said that people may still want to give them a shot, if they’re interested.

“This is not for everyone with low back pain,” he stressed. “Some people just don’t like to meditate. Different things work for different people. But this study shows that there may be value in offering people approaches that focus on the mind.”

What can meditation do?

Help ease stress Improve your sleep Help you focus on healthier activities Supplement, but not replace, other heart-healthy behaviors, such as healthy diet and exercise Source: The American Heart Association

Proper food handling for backyard barbecues It’s time to bail on the indoor kitchen and head to the outdoor grill. But warm weather can also produce an environment that creates germs. Smart food handling is your best defense against foodborne illness. Put these safety tips into practice at your next friendly gathering to avoid getting sick.

Thaw Safely Completely thaw meat and poultry before grilling so it cooks more evenly. Use the refrigerator for slow, safe thawing or thaw sealed packages in cold water. For quicker thawing, you can microwave defrost if the food will be placed immediately on the grill.

Precooking Precooking food partially in the microwave, oven or stove is a good way to reduce grilling time. Just make sure that the food goes immediately on the preheated grill to complete cooking.

Leftovers Refrigerate any leftovers promptly in shallow containers. Discard any food left out more than two hours (one hour if temperatures are above (90oF).

Gas grill safety tips

Serving the Food Don’t put cooked food on the same platter that held raw meat or poultry. Any harmful bacteria present in the raw meat juices could contaminate safely cooked food. In hot weather (above 90oF), food should never sit out for more than 1 hour.

Keep Hot Food Hot After cooking meat and poultry on the grill, keep it hot until served — at (140oF) or warmer.

Keep cooked meats hot by setting them to the side of the grill rack, not directly over the coals where they could overcook. At home, the cooked meat can be kept hot in an oven set at approximately (200oF).

Cook thoroughly Cook food to a safe minimum internal temperature to destroy harmful bacteria.

Meat and poultry cooked on a grill often browns very fast on the outside. Use a food thermometer to be sure the food has reached a safe minimum internal temperature.

Meats Cook all raw beef, pork, lamb and veal steaks, chops, and roasts to a minimum internal Keep cold food cold temperature of (145oF) as measured with a food Keep meat and poultry refrigerated until ready thermometer before removing meat from the heat to use. Only take out the meat and poultry that will source. For safety and quality, allow meat to rest immediately be placed on the grill. for at least three minutes before carving When using a cooler, keep it out of the direct sun. or consuming.

Avoid opening the lid too often, which lets cold air Ground Meats out and warm air in. Pack beverages in one cooler Cook all raw ground beef, pork, lamb, and veal and perishables in a separate cooler. to an internal temperature of (160oF) as measured Clean and tidy with a food thermometer.

Be sure there are plenty of clean utensils and platters. To prevent foodborne illness, don’t use the Poultry Cook all poultry to a safe minimum internal same platter and utensils for raw and cooked meat temperature of (165oF) as measured with a food and poultry. Harmful bacteria present in raw meat thermometer. NEVER partially grill meat or poultry and poultry can contaminate safely cooked food. and finish cooking later.

If you’re eating away from home, find out if there’s a source of clean water. If not, bring water for preparation and cleaning. Pack clean cloths and Source: U.S. Food and Agriculture Department Barbeque and Food Safety moist towelettes for cleaning surfaces and hands.

Check grill hoses for cracking, brittleness holes and leaks. Make sure there are no sharp bends in the hose or tubing.

Move gas hoses as far away as possible from hot surfaces and dripping hot grease Always keep propane gas containers upright Never store a spare gas container under or near the grill or indoors Never store or use flammable liquids, like gasoline, near the grill Never keep a filled container in a hot car or car trunk. Heat will cause the gas pressure to increase, which may open the relief valve and allow gas to escape.

Source: National Fire Protection Association

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Count on Rowan Family Medicine for the best choice for your family’s care. With four locations in South Jersey, access to our teaching physicians and health care providers at the acclaimed Rowan University School of Osteopathic Medicine is only a phone call away.

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