Health UPSTATE
U P S TAT E M E D I C A L U N I V E R S I T Y
Fall 2015 THE NEW HOUSE CALL page 7
CONCUSSION — OR NOT?
page 14
PRESCRIPTION FOR STRESS: MUSIC page 8 HOW TO HELP ADVANCE SCIENCE page 11
PROTECTING YOUR CHILD FROM BULLIES page 16
WELCOME
Meet our newest stroke experts Physicians armed with skill and knowledge can be the difference between life, death and whether a patient recovers his or her abilities after a stroke. After completing medical school and residency training, these doctors spend additional years in specialized fellowships to become experts in stroke care and other neurological diseases. These physicians take different paths that all lead to the bedside of a patient having a stroke. They include the: l
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Interventional neurologist. A neurologist with specialized training in stroke neurology and expertise in performing image-guided, minimally invasive procedures to treat diseases of the brain and spine, using endovascular techniques and a variety of other tools. Hesham Masoud, MBBCh, is a vascular and interventional neurologist. Endovascular neuroradiologist. A radiologist who has expertise in using minimally invasive procedures to treat diseases of the blood vessels of the brain, also relying on radiologic images. Amar Swarnkar, MD, is an endovascular neuroradiologist and director of Upstate’s neuroradiology program. Endovascular neurosurgeon. A neurosurgeon who has developed a particular expertise in working inside the blood vessels of the brain. In addition to open brain surgery for blood vessel disease, he or she diagnoses and treats diseases and conditions using tools that go through the blood vessels, relying on radiologic images during the procedure. Grahame Gould, MD, is one of only a few dual-trained neurosurgeons specializing in both open surgery and interventional procedures for the treatment of neurovascular diseases including stroke.
Hesham Masoud, MBBCh, Amar Swarnkar, MD, and Grahame Gould, MD, are colleagues at Upstate. photo by RobeRt Mescavage
One of these stroke experts is always readily available at a comprehensive stroke center such as Upstate University Hospital, said Gene Latorre, MD, medical director of the stroke service. The physicians collaborate as team members so that patients receive the individualized care they need from the physician with the most appropriate expertise for the patient’s condition. Depending on the type of stroke, some patients require rapid interventions or surgery which is available only at a comprehensive stroke center such as Upstate. ●
endovascular (en’ do-vas’ kyu-lar) – inside the blood vessel interventional (in-ter-ven’ shun nal) – using radiologic image guidance to gain access beneath the skin to treat conditions that otherwise would require surgery neuro (nur’ o) – relates to nerves or the nervous system, which includes the brain, spinal cord and the nerve fibers that extend into all parts of the body radiologic (ra-de-o-log’ ik) – medical imaging techniques, including x-rays, magnetic resonance imaging and others surgeon (ser’jun) – a medical doctor who practices surgery
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WELCOME
Contents 10
PATIENT CARE Meet our newest stroke doctors
page 2
IN OUR COMMUNITY
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DEPARTMENTS
What’s Up at Upstate page 4 News you might have missed
Targeting a tumor in the ear page 6
Eye surgeons operate in Honduras
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A blend of East and West
page 7
Homeless no longer
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Lessons from Upstate page 13 Diagnosing celiac disease
His prescription is music
page 8
Emotional distress is common among refugees
page 19
Upstate Answers page 15 Why cold weather makes noses run
How healthy is your brain? page 10
FROM OUR EXPERTS
cover story
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Giving back to the transplant program
page 20
IN OUR LEISURE
2 ways to contribute to science
page 11
Medication safety reminders
Book explores OCD, addiction
page 12
The science of halting cell death
page 13
The joys of running, from Corporate Challenge winners
Assessing the head injury assessment tools
page 14
Protecting your child from bullies
page 16
Recipe page 22 Couscous With Cranberries, Mint and Pine Nuts Science Is Art Is Science back cover Learning how the brain develops
page 22 On the cover: Student athlete Kenneth Slack is participating in a study on head injuries. Photo by Chuck Wainwright.
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Upstate Health magazine is a community outreach service of Upstate Medical University in Syracuse, NY. Upstate is an academic medical center with four colleges (Medicine, Nursing, Health Professions and Graduate Studies); a robust research enterprise and an extensive clinical health care system that includes Upstate University Hospital’s downtown and community campuses, the Upstate Cancer Center and the Upstate Golisano Children’s Hospital. Part of the State University of New York, Upstate is Onondaga County’s largest employer.
Health
Fall 2015
PUBLISHER Wanda Thompson, PhD, Senior Vice President for Operations EXECUTIVE EDITOR Leah Caldwell Assistant Vice President, Marketing & University Communications EDITOR-IN-CHIEF
Amber Smith
DESIGNER
Susan Keeter
Visit us online at www.upstate.edu or phone us at 315-464-4836.
For corrections, suggestions and submissions, contact Amber Smith at 315-464-4822 or smithamb@upstate.edu ADDITIONAL COPIES: 315-464-4836 Upstate Health offices are located at 250 Harrison St., Syracuse, NY 13202
Need a referral?
Contact Upstate Connect at 315-464-8668 or 1-800-464-8668, day or night, for appointments or referrals to the health care providers on these pages or anywhere at Upstate or for questions on any health topic.
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WHAT’S UP
WHAT’S UP AT UPSTATE
Glimpses of joy, drama and hope
A big-screen cameo
In an indie movie appearing at film festivals, actor Evan Jonigkeit plays the role of David Halleran, MD, a young medical resident at midtown Manhattan’s Roosevelt Hospital the night of Dec. 8, 1980, when police brought in a victim of four gunshots. While Halleran and others worked to save the man’s life, someone looked through his wallet for identification. The driver’s license read: John Lennon.
An audience with the pope
Jake Braithwaite, 26, and Brendan Coffey, 30, are chaplain interns at Upstate University Hospital, Braithwaite in neurology and Coffey in cardiology.
Halleran is now a colorectal surgeon at Upstate and former president of the Onondaga County Medical Society. The movie, called “The Lennon Report,” was filmed last year in New York City, and Halleran has a cameo appearance.
The two men will take vows of chastity, poverty and obedience in the multiyear process of becoming Jesuits. They were among 17 Jesuit novices in Syracuse who were invited to the Mass led by Pope Francis at the Basilica of the National Shrine of the Immaculate Conception in Washington, D.C.
photo by DeboRah Rexine
Hear an interview with Halleran about that night at www.healthlinkonair.org by searching “Lennon.”
A trio of doctors-to-be
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Coffey, who said the joy was palpable in the basilica as the pope arrived, stood on a pew to get a good look. He could not hear the pope, but he saw him make the sign of the cross. As chaplain interns at Upstate, Coffey and Braithwaite minister to patients who request a spiritual presence. Braithwaite explained how the pope’s compassion is an inspiration, recalling news coverage of him washing the feet of prisoners and blessing people with deformities. “His instincts are the instincts I hope to replicate when I see patients here at Upstate.”
A top institution
Officials from Upstate’s College of Medicine said having three students from the same school district is not common, though it has happened before. “But we cannot recall another time when we had three students who graduated from the Syracuse City School District in the same class,” said Jennifer Welch, associate dean of admissions and financial aid at Upstate.
Upstate Medical University ranks as one of the top institutions in the country for undergraduate career earnings, according to the College Scorecard, recently released by the U.S. Department of Education.
Pictured above, Birx Allen and Julio Chanelo, who graduated in 2008 from Corcoran High School, and George Thatvihane, who graduated from Fowler High School in 2009, are making history as part of the Class of 2019.
Students graduating from Upstate’s undergraduate programs earned the third highest income — $112,900 — of any school in the country, according to the database, which ranks more than 3,500 schools.
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PATIENT CARE
A long-term survivor of AIDS
Ralf Bernecker recently recalled how 20 years ago his loved ones were told to start making his final arrangements. Bernecker shared the story of being one of the longestknown survivors of AIDS in Central New York on the pages of Syracuse’s newspaper, The Post-Standard.
photo by susan kahn
He told of losing more than 100 friends in the late ’80s and early ’90s to acquired immune deficiency syndrome and related infections. Bernecker was found to be infected with the human immunodeficiency virus, which causes AIDS, in 1986. He became so weak he was in a wheelchair. He would regain his health and then lose it. “It was like a roller coaster,” he told the newspaper. Bernecker participated in a clinical drug trial at Upstate. Over the years, he took the medicines prescribed by his doctor, Donald Blair, MD. Today, at 54, he faithfully takes a series of pills at various times each day. He is also active. He runs half marathons, kayaks and works as a licensed practical nurse.
A wedding to remember
Alexandra “Ali” Merante was planning to marry Phillip Wall in July. When her father, Paul Merante, was diagnosed with terminal brain cancer this summer, the couple-to-be, both 26, changed their plans.
Upstate has a new president, a pediatrician who was born in Haiti. Danielle Laraque-Arena was 7 when her family fled Haiti for political reasons and settled in Queens. By the age of 12, she decided she wanted to use a career in medicine and research to help others. “My parents were an incredible influence on my life,” Laraque-Arena said in an interview with the Syracuse media. “That mission to serve the poor — not in a charity way, but in a way that people have the right to health care, and live OK and send their kids to school — that’s a message I got from the very beginning.” Laraque-Arena, 60, takes the Upstate helm Jan. 14. Currently she is chair of the pediatrics department of Maimonides Medical Center in New York City and a pediatrics professor at Yeshiva University. She will be Upstate’s first woman president.
Upstate publication wins national award
Upstate’s Cancer Care magazine (sister publication to Upstate Health magazine) received a national award from The Association for Women in Communications. The first issue was selected among start-up magazines as the “best overall external magazine” and received a coveted Clarion Award. Among other Clarion award-winning magazines this year are The Oprah Magazine, Mother Jones, Glamour, Redbook and More magazine. Cancer Care provides practical easy-to-understand stories of interest to anyone touched by cancer. Patient stories are a large part of the mix, along with articles that draw on the
photo by RichaRD Whelsky
A new leader
Staff at Upstate University Hospital helped them arrange a ceremony and reception that took place in September at the hospital. Merante got to dance with Ali from his wheelchair. Registered nurse case manager Elaine Green told The Post-Standard she will never forget the wedding. “At one point he thanked his favorite nurse, Katie Heil, for keeping him alive to be there.”
A social connection
Do you “like” Upstate on Facebook? That’s a fun place to connect with the academic medical center. You’ll find pictures from the Syracuse Crunch hockey team’s home opener – when the players were escorted onto the ice by nurses from Upstate University Hospital – and pictures from the annual Halloween party for patients of the Upstate Golisano Children’s Hospital and more. You’ll also come across sweet gestures, like the engraved pens that a former patient gave to the surgery and trauma staffs that took care of her. “Thank you for my wonderful care,” the pens say, with her name and room number.
expertise of health care providers at the Upstate Cancer Center. Various aspects of medical care, cancer research and advice about living with the disease round out the content. Subscriptions are complimentary. Call 315-464-4836 to subscribe, or send an email to magazine@upstate.edu with “Cancer Care” in the subject line and a mailing address in the body of the email.
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A ‘knife’ that fixes tumors without cutting When Kathleen Vincitore, 69, of Liverpool learned she had a small tumor growing on the nerve between her right ear and her brain, she was relieved it was not cancer.
The retired teacher spends her winters in Florida. When she returned home in the spring of 2012, Vincitore went to her doctor. Her right ear kept plugging up, and she heard ringing. She wondered if she had swimmer’s ear or a buildup of wax. After a hearing test raised concerns, revealing a decrease in her right ear, Vincitore went for a magnetic resonance imaging scan that would give doctors a view of the nerve. She was terrified. “I’m claustrophobic,” she explained. The thought of lying still within a narrow opening of a big scanning machine worried her. So, one of the nurses offered to stay in the MRI room with Vincitore during the scan. “Just knowing somebody was there with me made all the difference in the world.” A couple of days later, Vincitore got the results of the scan. A noncancerous tumor called an acoustic neuroma was growing on the main nerve leading from her inner ear to her brain. She got an appointment with Charles Woods, MD, an assistant professor of otolaryngology and communication sciences at Upstate.
Kathleen Vincitore poses with her otolaryngologist, Charles Woods, MD, in the Gamma Knife Center at Upstate. photo by RobeRt Mescavage
What is an acoustic neuroma?
Vincitore asked how he knew the tumor was not cancerous. He explained that acoustic neuromas usually arise from Schwann cells (see box), and it’s rare that they would become malignant. In any case, he assured her, the MRI scan revealed “smooth, round borders that show no signs of invasion.”
A noncancerous tumor that grows from the Schwann cells of the vestibular nerve, acoustic neuromas can cause permanent hearing loss, ringing in the ears, dizziness and balance problems. Schwann cells normally form a protective sheath around nerve fibers. Usually they are slow-growing, but in some rare cases acoustic neuromas can expand to press against the brain and cause other problems.
From Woods she also learned the tumor was slow-growing and that it had likely been there for quite a few years before it got large enough to impact her hearing and cause the other symptoms. They decided to monitor the tumor.
Woods routinely treats patients with a variety of skull-based tumors using the gamma knife. Vincitore asked him what she could expect during the procedure.
Vincitore continued with her usual routine, wintering in Florida and spending the rest of the year in Central New York. When she returned home last spring, she saw Woods again, telling the doctor her hearing was worsening. After another MRI, Woods told her the tumor had grown larger. He recommended a treatment called gamma knife radiation that would halt the tumor’s growth. The gamma “knife” does no cutting. It’s a minimally invasive tool used to precisely target tumors in the brain and auditory canal with radiation.
“I have to know what’s going on. I’m fine — as long as I know what’s going to happen,” she explained. When she had the gamma knife procedure in June, she recalled, “I had no fear because I knew exactly what was going to happen at every minute.” The neuroma still has to be monitored, to make sure it does not start growing again. Vincitore says she’s thankful she can still hear what’s most important. Her grandchildren — ages 5, 8, 10 and 11 — all know to speak into her left ear. ●
DO YOU KNOW SOMEONE WHO WOULD LIKE TO JOIN THE UPSTATE TEAM?
For job openings and online application: UPSTATE.EDU/JOBS
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Mixing East and West I N T E G R AT I V E M E D I C I N E H E L P S T R E AT R H E U M ATO L O G I C , STRESS DISORDERS IN KIDS A pediatric rheumatologist is bringing integrative medical therapies to the Upstate Golisano Children’s Hospital. Caitlin Sgarlat Deluca, DO, leads the newly created division of pediatric rheumatology and integrative medicine. She cares for children with rheumatologic diseases, such as juvenile arthritis and lupus, and children with a variety of other musculoskeletal problems. While Sgarlat prescribes conventional Western medicines, she also suggests treatments that some may consider complementary or alternative, many of which are rooted in the East. These may include nutritional counseling, supplements such as vitamins and botanicals, biofeedback or hypnosis, yoga or tai chi, meditation and, perhaps, acupuncture. The practices she recommends are evidence-based. Integrative therapies have shown benefit for children with arthritis and lupus, and also for those with musculoskeletal and other pain syndromes, asthma, inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, atopic dermatitis, migraine headaches and anxiety disorders, Sgarlat said. A spike in stress-related disorders in children over the past decade has her concerned. Medications have side effects on
their developing brains and bodies. “I do think an integrative approach to many of these conditions can help decrease the medicines and help heal the patient,” Sgarlat said. Not all of her patients appreciate integrative techniques. Those who do typically are able to stop taking medications sooner than those who do not. The doctor said the patient’s stress level drops, and so does that of his or her parents. “Once some of these tools are taught, and the patients realize that they can add to their healing process, it makes for a whole different experience for the patient. That in itself also lends to the healing process,” Sgarlat said. In an interview for Upstate’s weekly talk radio show, “HealthLink on Air,” Sgarlat told of a patient who was newly diagnosed with arthritis. The child received medication but also added anti-inflammatory turmeric, cinnamon and ginger to their diet; an exercise routine that included stretching, core strengthening and yoga, and counseling that taught visual imagery that could be used when their joints hurt. “All of these things together helped me take this specific patient off of the conventional therapies a lot quicker than I generally see with my patients,” the doctor said.●
Hear an interview at www.healthlinkonair.org by searching “Sgarlat.” Reach the division of pediatric rheumatology and integrative medicine by calling 800-464-8668.
The return of the house call: urgent care to the patient’s home Emergency physicians and nurse practitioners from Upstate University Hospital now offer a new service that is centuries old: house calls. Upstate at Home began in September, providing urgent medical care to people who become injured or ill but don’t require a trip to the hospital and don’t want to leave their home. It’s available from 11 a.m. to 11 p.m. in areas to the east of Syracuse. Christian Knutsen, MD, said the service could expand to other areas in the future. The service is perfect for people who cannot get an appointment with their regular doctor and for visitors. A house call can eliminate taking the whole family to a clinic or hospital emergency room when one member is sick, driving in bad weather, sitting with other sick people in a waiting room or having to leave a comfortable home when one is not feeling well. A nurse answers calls and asks a series of questions to make sure a house call is appropriate. Upstate at Home participates with most major health insurance companies, Medicare and Medicaid. People with insurance will be asked to pay their copayment over the phone. People whose insurance coverage cannot be verified are asked to make a down payment of $175, and they are billed for the remainder of charges after the visit. ●
Hear an interview at www.healthlinkonair.org by searching “house call” or call 315-464-4646 to speak with an Upstate at Home nurse. fall 2015
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The Music Man Mitchell Karmel, MD, in an operating room in the radiology suite with a sampling of the thousands of albums he owns.
photo by RobeRt Mescavage
H I S ‘ P R E S C R I P T I O N S ’ TA R G E T S T R E S S
BY AMBER SMITH
Patients answer many questions on the paperwork they complete prior to an interventional radiology appointment at Upstate. But when they arrive for a biopsy, catheter installation or other procedure, if their doctor is Mitchell Karmel, MD, patients face one additional question: To what music would you like to listen? Classic rock is a popular answer. Many patients prefer something mellow, like Van Morrison’s “Astral Weeks” album. Once a woman with breast cancer requested AC/DC. “That’s not the most relaxing music,” Karmel pointed out. “It’s relaxing to me,” the woman said. And Karmel played “Hell’s Bells.” In his years of experience, Karmel said only two patients have requested silence instead of music. Most patients defer to his preference, which changes from day to day. Some try to stump him. “What I’d really love to hear is ‘Boris the Spider,’ ” one patient said. Karmel thumbed to the song released by The Who in 1966.
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PATIENT CARE
Research ‘notes’ Another said, “I’m sure you don’t have ‘Several Species of Small Furry Animals...’ ” and didn’t finish the song title before Karmel was pulling up “Ummagumma,” Pink Floyd’s double album from 1969 that featured “Several Species of Small Furry Animals Gathered Together in a Cave and Grooving With a Pict.” When a patient requested Iron Butterfly’s “In-a-GaddaDa-Vida,” Karmel needed clarification of the heavy metal classic. “The five-minute version or the 17-minute version?” Karmel’s iPod contains more than 9,400 songs. His iMac holds 24,500 more. He prides himself on full libraries of all genres, saying he needs to have all of his music at his fingertips “because you never know what you will want to listen to.” Young technologists and nurses are impressed that his music collection contains modern rap and R&B music. Karmel advocates music during radiologic procedures, not just because it creates a pleasing work environment. “Music has healing qualities, there’s no doubt about it,” he said. He points to studies showing music can reduce postoperative pain and anxiety, reduce the amount of pain medicine and increase patient satisfaction. At Upstate, Karmel is director of interventional radiology. His medical degree is from the University of Buffalo School of Medicine. He completed an internship at Memorial Sloan-Kettering Cancer Center in New York, a residency through Cornell University and then a fellowship at Harvard Medical School in Boston. Karmel has always liked music. It was in first or second grade that he and his classmates were assessed and funneled, if they made the cut, into band class. He remembers the first day of band, when the teacher looked him over. “‘You have long fingers. You’re playing clarinet.’” He played clarinet, even though he thought the drums would have been more fun. His real love of music blossomed during summer camp at the age of 14, when he was among the big kids who got to attend a concert at Tanglewood. Performing were B.B. King, Jefferson Airplane and The Who. Karmel was hooked. Today he appreciates and listens to all sorts of music, from philharmonic orchestras to rap. His favorite remains “the inspirational and melodious” Pink Floyd. More than once, Karmel has had patients ask for the name of the album that played during their procedure. He pulls out a sheet of paper. He writes a mock prescription, for stress, to be taken as needed: Pink Floyd’s “The Division Bell.” ●
Using music during patient care has been the subject of many a medical study by researchers around the world. Here’s a look at five studies:
Music during mammography?
Music therapy has the potential to decrease anxiety. However, it did not decrease the amount of pain participants experienced during mammograms that screen for breast cancer. Researchers from: Robert Wood Johnson University Hospital in New Brunswick, NJ, and the University of Virginia Medical Center in Charlottesville. Published in: Clinical Journal of Oncology Nursing, June 2014.
Music during prostate biopsy? Listening to music during a transurethral ultrasoundguided prostate biopsy significantly reduced patients’ feelings of pain, discomfort and dissatisfaction. Men who listened to music during the procedure had lower heart rates and blood pressures afterward than men who did not. Researchers from: Chungbuk National University in Korea. Published in: Urologia Internationalis, December 2014.
Music for children during MRI? Listening to music, watching a clown show or interacting with a dog all demonstrated a beneficial effect in reducing negative emotions in children facing magnetic resonance imaging. Also, the number of children requiring sedation during their scans dropped significantly. Researchers from: Meyer Children’s Hospital and University of Florence, Italy. Published in: Pediatric Reports, March 2015.
Music during colonography? Patients who listened to music and/or inhaled essential oils while they underwent a computerized tomographic colonography reported little improvement in pain or discomfort. However, they requested music and/or oils for subsequent imaging scans. Researchers from: Kameda Medical Center in Japan. Published in: European Journal of Radiology, December 2014.
Music after surgery? An analysis of 4,261 studies shows that music after surgical procedures reduces postoperative pain, anxiety and the use of pain medicine and increases patient satisfaction. While the patients’ length of stay is not affected, the authors wrote “music is a noninvasive, safe and inexpensive intervention that can be delivered easily and successfully in a hospital setting.” Researchers from: Queen Mary University in London. Published in: The Lancet, August 2015.
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Here’s how your brain can help improve Alzheimer’s diagnoses The world’s largest Alzheimer’s research project is the brainchild of a neuroimaging professor at the University of California, San Francisco who graduated from Upstate in 1965. Michael Weiner, MD, hopes to monitor millions of people online in a long-term study to find out who is at risk for Alzheimer’s disease. He is principle investigator for the Alzheimer’s Disease Neuroimaging Initiative, which launched the website www.brainhealthregistry.org in April 2014.
“What we’re doing is trying out a number of different methods that measure the presence of Alzheimer’s disease in the brain to determine if these methods predict who is going to decline, have problems with their memory and ultimately go into dementia. Because it’s those people, who are at risk to decline, whom you want to treat.” ●
The Brain Health Registry site encourages people to take free brain function tests twice a year. More than 22,000 subjects enrolled in its first year. Data collected is meant to help scientists track cognitive function over time and to match volunteers with clinical trials and research studies for which they may qualify. The goal is to optimize biomarkers, which includes magnetic resonance imaging, positron emission tomography, blood tests and other kinds of tests, which can be used to measure the effectiveness of treatments for Alzheimer’s disease. “When you do a clinical study with a new treatment to see if it helps people, you need to identify the people who are at risk for the disease,” Weiner explained. “You don’t want to treat people who don’t have Alzheimer’s disease. You only want to treat people who really have the Alzheimer’s process going on in their brain — and you can’t detect that just by talking to somebody. You need to do a scan or some kind of a test to detect the presence of the pathology in the brain.
Michael Weiner, MD photo by Michael MacoR/san FRancisco chRonicle/polaRis
Hear an interview at www.healthlinkonair.org by searching “Michael Weiner.”
New CF drug may reduce organ damage
Upstate patients with cystic fibrosis were part of the national clinical trial that led to approval of one of the first drugs designed to treat the underlying cause of the disease, an inherited, life-threatening disorder that damages the lungs and digestive system. The drug, called Orkambi, is for patients who have two copies of a particular genetic mutation, estimated to be more than half of the patients with cystic fibrosis. The genetic mutation at issue causes problems with a protein, which one of the two ingredients in Orkambi corrects. The other ingredient has already been used for select patients with cystic fibrosis, who have seen healthier weight and lung function and improved levels of chloride.
Orkambi, or a future drug combination like it, could potentially prevent the progression of organ damage many patients with cystic fibrosis experience. Physicians are hopeful that a drug like this could make it possible for people with CF to live full lives with fewer or no symptoms. Orkambi is approved for patients who are 12 years or older. Some Upstate patients are involved in another clinical trial to see if the drug should be approved for younger patients. ●
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FROM OUR EXPERTS
2 projects that will help advance medical research CO N T R I B U T I N G TO S C I E N C E
One of the ways scientific progress is made is through the participation of regular people in medical research. Someone may see value in helping scientists connect the dots between the genes of a parent and child. Someone else may be willing to swallow a pill that may or may not help slow the progression of a deadly disease. Upstate researchers lead clinical trials from a variety of medical specialties, including neurology — where a new drug to treat Alzheimer’s disease is being studied — and psychiatry and behavioral sciences — where the origins of pediatric mental health are being studied. Do you have a desire to help others by contributing to medical research? Consider these projects:
P E D I AT R I C M E N TA L H E A LT H ABOUT THE PROJECT: Most of the common behavioral and psychiatric disorders are at least partially heritable, meaning they have a genetic basis, according to Stephen Glatt, MD, a professor of psychiatry and behavioral sciences and physiology at Upstate. Variants in DNA that predispose people to attention deficit hyperactivity disorder, for instance, also predispose them to autism spectrum disorders and mood disorders. “We’re starting from the presumption that these disorders all have something in common genetically,” said Glatt, who together with colleague Stephen Faraone, PhD, received a $3 million grant from the National Institute of Mental Health to explore which segments of DNA are shared between family members with various mental health disorders. Bruce Brumfield of Camillus agreed to take part in the study “really just to try to understand the challenges that I and my wife are having with our 12-year-old.” The family spent almost three hours answering questionnaires, completing computer-based tasks and giving blood samples as part of the project. They were pleased to be part of something that could help reshape the way mental health is considered. “The prevailing diagnostic system for mental disorders is not founded in a really valid science. It’s observational, in a sense. There are no biological markers. And the groupings of children under diagnostic categories doesn’t have a sound basis in biology, even though we know these are biological brain disorders,” Glatt explained. “Our premise is to start with the biology and potentially to redefine psychiatric disorders from a biology-first basis.”
A L Z H E I M E R’S DISEASE ABOUT THE PROJECT: No new medications have been approved for the treatment of Alzheimer’s disease since 2003. Even the medications that neurologist Amy Sanders, MD, can prescribe are for modifying the symptoms, not to fight the disease itself. So she is excited about the potential of an investigational drug called T-817MA. Two proteins, amyloid and tau, play a role in the development of Alzheimer’s disease. Up until now, drugs being studied have been designed to target amyloid. T-817MA “is focused on the tau half of the equation,” Sanders said. She is looking for people with mild to moderate Alzheimer’s disease who are willing to participate in a yearlong clinical trial that is part of a giant national study of the effectiveness of the drug. Of course, research is ongoing to find a way of preventing Alzheimer’s disease. In the meantime, millions of Americans already deal with the decline of cognitive function that is a hallmark of the disease. WHO: Men or women between the ages of 55 and 85 with a diagnosis of mild to moderate Alzheimer’s disease who are being treated with the medication donepezil, also known as Aricept, or the rivastigmine transdermal patch, also known as Exelon. They cannot live in a nursing home or weigh more than 220 pounds, and they must have a spouse, relative or friend who will attend the study visits with them.
WHO: Biological parents with a child with a mental health disorder between the ages of 6 and 12 years, plus siblings; and, families with a child in the same age range who is typically developing.
WHAT: Visits are required every four to six weeks for a year. Some participants will get sugar pills. Some will get a higher dose of the new medication, and some will get a lower dose. All will be compensated for their participation.
WHAT: Blood samples, questionnaires and computer tasks that will last from two to three hours. Participants receive $50 each.
WHY: Help evaluate the benefits of a new medication, T-817MA, which may have the potential to modify the pace of the disease.
WHY: Help scientists zero in on a core set of genes that may put humans at risk for a variety of brain disorders, including ADHD.
HOW: Contact research assistant Sarah Park at 315-464-9756 or learn more at www.NOBLEstudy.org ●
HOW: Contact research assistant Pat Forken at 315-464-5619.
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FROM OUR EXPERTS
H O W T O S A F E LY … … K E E P M E D I C AT I O N S I N YO U R H O M E Children, the elderly and anyone who takes more than three medications are at greatest risk of taking the wrong medicine or the wrong dose of medicine. To help reduce the risk of medication error, pediatric pharmacists from the Upstate Golisano Children’s Hospital share this advice:
3 things to do before getting pregnant Family planning expert Renee Mestad, MD, gives this advice to women before they begin trying to conceive: 1. Stop smoking. Smoking interferes with ovulation, the ability of the egg to move through the fallopian tube, and it affects implantation. It also increases the risk of miscarriage and preterm delivery. 2. Start taking prenatal vitamins. The folic acid helps prevent birth defects that develop in the first four to six weeks, before most women realize they are pregnant. 3. Talk to your medical provider. Some common medications, such as nonsteroidal anti-inflammatories, decongestants and antihistamines, can affect fertility.
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U P S TAT E H E A LT H
l Obviously,
keep medicines out of reach of children – and remember to ask the same of Grandma when you visit her house.
l Check
the medication label for storage instructions. If the label is unclear, ask your pharmacist.
l Bathroom
medicine cabinets usually are not the best place to store medications. The humidity from hot showers and baths can alter medications. A more temperate hallway closet or kitchen cabinet may be a better location.
l If
the medication must be refrigerated, place it where it won’t be easily confused with other products.
l Monitor
expiration dates, because taking expired medicines can be dangerous.
l Get
rid of leftover medicines. Trying to treat a new ailment with the wrong medicine can also be dangerous.
… D I S P O S E O F M E D I C AT I O N S Nine law-enforcement offices throughout Onondaga County collect needles, other sharp medical devices and expired or unused medications, thanks to a new community effort to reduce availability and accessibility of drugs. Drop boxes are available during regular business hours at the Baldwinsville, Camillus, Cicero, DeWitt, Manlius and Marcellus police departments and Onondaga County sheriff’s offices in downtown Syracuse, Liverpool and Onondaga Hill. Learn more from the Upstate New York Poison Center — at 315-464-5423 — which teamed with the Onondaga County district attorney’s office, sheriff’s department, health department and several community organizations for this pilot project. ●
Pediatric pharmacists Kelly Steidl, Jeni Burgess and Meg Anderson. photo by Debbie Rexine
fall 2015
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FROM OUR EXPERTS
Solving a neurodegenerative mystery
N O W T H AT W E K N O W H O W C E L L S D I E , C A N W E H A LT T H E I R D E AT H ? A project on which Xin Jie Chen, PhD, has been working for a decade provides insight into the physiological impact of mitochondrial dysfunction, which is associated with an increasing number of aging-related neuromuscular degenerative diseases. Chen is a professor of biochemistry and molecular biology at Upstate and principal investigator of the study that was published in the July 20 online edition of the journal, Nature. The lead author of the paper is research scientist Xiaowen Wang. The research team identified a new pathway that can kill cells by attacking the mitochondria, a key part of the cell that produces energy. Calling it mPOS for mitochondrial precursor over-accumulation stress, this new pathway is triggered by conditions that interfere with the integrity and function of the mitochondrial inner membrane. As a result, proteins that are normally transported into mitochondria get stuck outside of the organelle, and they become toxic to the cell. Conditions that promote mPOS may contribute to the development of several muscle and cardiac diseases and neurodegenerative disorders.
“The more research that allows us to gain greater knowledge of how mitochondrial dysfunction induces cell deterioration during aging, the better our chances of developing drugs that delay the onset of cell death and may hold greater hope for drug therapies against these neuromuscular degenerative diseases,” Chen said. In addition to discovering the new pathway, the team also identified a network of anti-degenerative genes in yeast that can protect against the mPOS, by detoxifying the dislocated mitochondrial proteins and thereby readjusting cell activity. The anti-degenerative genes are highly conserved in humans and are mutated in several neuromuscular diseases, including myotonic dystrophy and spinocerebellar ataxia. The discovery also has implications for amyotrophic lateral sclerosis, or Lou Gehrig’s disease. “Dr. Chen’s results provide novel insights into the cellular consequences of mitochondrial damage that could ultimately suggest new treatments for diseases associated with mitochondrial dysfunction,” said Patricia Kane, PhD, professor and chair of Upstate’s department of biochemistry and molecular biology. ●
Celiac disease can mimic a brain tumor
When an adolescent girl suffering from headaches and blurred vision seeks medical care, doctors may not immediately think of celiac disease as a cause — but the immune disorder should be a consideration. A pediatrician specializing in gastroenterology at Upstate Golisano Children’s Hospital explains why in an article published this summer in the journal Case Reports in Gastroenterology. Mirza Beg, MD, writes about a girl who suffered neurological symptoms for a year until the headaches and blurry vision worsened and she sought emergency treatment. She had developed “pseudotumor cerebri,” a condition in which the pressure inside her skull increased for no obvious reason, causing symptoms that mimic those
LESSONS FROM UPSTATE
of a brain tumor.
She underwent a series of medical tests that eventually included a biopsy of her small intestine. After she was diagnosed with celiac disease and began following a glutenfree diet, the girl’s headaches and blurry vision went away. So did the pressure inside her skull. Celiac disease is a challenge to diagnose, Beg acknowledges. Though its hallmark is a gastrointestinal tract that is sensitive to gluten, celiac disease can also cause psychiatric symptoms and affect the skin and reproductive organs, in addition to causing headaches, blurry vision and — in rare instances — fake brain tumors. ●
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U P S TAT E H E A LT H
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FROM OUR EXPERTS
Assessing the
head injury assessment tools
C
ollegiate athletes in the communities near Upstate Medical University are helping researchers improve the identification and assessment of head injuries in sports.
Students playing sports at Cazenovia, Le Moyne and Onondaga Community colleges and other schools may participate in a study that assesses the concussion assessment tools currently in use. Upstate is one of about 10 sites partnering with BrainScope, a private medical neurotechnology company that is developing a new generation of hand-held devices for objectively assessing brain function. The sports with higher concussion risk include football and soccer, but principal investigator Christopher Neville, PhD, said athletes from non-contact sports such as swimming and track will likely make up a comparison group.
When an athlete suffers a possible concussion, study coordinator Joshua Baracks, an athletic trainer, arranges for a sophisticated magnetic resonance imaging scan within 72 hours of injury. The athlete also undergoes balance and neurocognitive testing, plus an electroencephalogram. For the study, that athlete is matched with someone of the same age, gender and sport — likely a teammate — who has not been injured and who undergoes the same type of testing. The series of tests is designed to determine the photos by chuck WainWRight best tool for identifying and assessing concussions. ●
Kenneth Slack, a student athlete on Le Moyne College’s soccer team, is part of a control group for the study.
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FROM OUR EXPERTS
UPSTATE ANSWERS
The Assessment step one: the assessment begins with neurocognitive testing. here athletic trainer Joshua baracks asks the research subject to repeat a series of words and count backward.
Why does the cold weather make my nose run?
step two: the study subject undergoes a series of physical function tests, such as standing on a straight line with eyes closed.
Haidy Marzouk, MD, an otolaryngologist at Upstate who specializes in sino-nasal allergies, said the answer has two components. “It’s part of your nose’s job to condition the air as it travels to your lungs. “Part of this conditioning process is to moisturize the air. Often, in cold weather, the air is dry as well. As a result, the nose reflexively begins to increase fluid production for this conditioning process.
step three: electroencephalograms (eegs) track and record brain wave patterns. project director christopher neville, phD, observes research coordinator Joshua baracks placing the portable eeg equipment on research subject kenneth slack.
“When fluid production increases, the nose begins to run.
Sports concussion laws The vast majority of concussions are relatively benign. “It’s really when we don’t manage the concussion properly, or we don’t recognize a person has had a concussion, that we increase the risk for more problems,” said Brian Rieger, PhD, director of the Upstate Concussion Center. That’s what prompted laws like New York’s, which mandates concussion education for players and coaches and requires that players be removed from play or practice if a concussion is suspected. Medical evaluation is required, and an athlete must receive medical clearance before returning to play. New York’s concussion laws apply to injuries suffered in school sports or other school-based activities.
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“Secondly, during exhalation in cold weather, the moisture in the air being exhaled into a colder environment condenses from gas to liquid, usually collecting at the tip of one’s nose — creating an increase in nasal discharge.”
U P S TAT E H E A LT H
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FROM OUR EXPERTS
YES... ...YOUR CHILD IS AT RISK OF BEING BULLIED
BY ANN S. BOTASH, MD
In my experience as a pediatrician specialist for the evaluation of children who are suspected of being abused, bullying is often a major concern. Children who are different in any way are at risk of being bullied. Since all children are unique individuals, all children are at risk. The American Academy of Pediatrics defines bullying as “an act of aggression in which one or more children repeatedly and intentionally intimidate, harass or physically harm a victim who is perceived as unable to defend herself or himself.” It’s different than fighting or teasing. And, it’s more common than you may realize. Up to 30 percent of sixth- to 10th-graders bully or are bullied. Children and adolescents who bully, similar to adults who bully, use an imbalance of power to access and intimidate their victims. This imbalance may include physical strength, knowledge of embarrassing information, popularity or other appearances of power. Studies have shown that bullying or being bullied is associated with higher rates of carrying weapons. Bullying is not a one-time incident, and, like other forms of child abuse, is repetitive and often escalates. The spectrum may start with name calling and eventually lead to physical injuries, depression, death or suicide. Technology-assisted bullying behavior, or cyberbullying, can cause significant psychological trauma. Use of the Internet to humiliate, ostracize, shun or stalk has been well publicized in tragic cases of child and adolescent suicides. If you are concerned that your child is being bullied, save all emails, chats, texts and Facebook posts and be prepared to talk to other parents about the issue. This is something that requires adult intervention. Bullying is not a “personality conflict” and not something that can be resolved through simply letting children
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“work it out.” This exposure to violence is both a mental and physical health issue — for the bully, his or her victims and bystanders who witness bullying behavior. Bullying should not be a normal rite of passage any more than any other form of child abuse. It does not make children stronger or build character any more than any other forms of physical punishment or emotional abuse.
Possible signs
A child who is the victim of a bully may: • not want to go to school or a particular activity • change his/her behavior to become sad, moody or withdrawn • avoid questions about friends or reasons for his/her behavior change • become upset after using a cellphone or computer • suddenly decline in academic performance • have problems with attention at school • complain frequently of stomach pain or headaches
What can we as parents do to protect our children and build resilience? We can encourage our schools to adopt evidence-based bullying prevention programs, such as the Olweus Bullying Prevention Program. We can reduce our children’s exposure to violent themes and images in television, Internet and video games. And we can be aware. Awareness of bullying and recognition of behaviors that may be related to bullying are the first steps to addressing this form of abuse facing our children.●
Ann Botash, MD, a professor of pediatrics at Upstate Medical University, directs the Child Abuse Referral and Evaluation Program and serves as medical director for the McMahon/Ryan Child Advocacy Center.
Hear pediatrician Joseph Nimeh, MD, discuss bullying in an interview at www.healthlinkonair.org by searching “bully.” U P S TAT E H E A LT H
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Operation Honduras
IN OUR COMMUNITY
THEY VOLUNTEER BY PROVIDING EYE SURGERY Just about every year since 1987, a pair of Syracuse eye doctors spend a week or two in what they lovingly refer to as their satellite office — in a town called La Ceiba in Honduras.
Along with colleagues, Thomas Bersani, MD, and Robert Weisenthal, MD, put in long days providing a variety of free eye surgeries to Hondurans in need. “The trips have grown over the years from just the two of us doing simple Syracuse ophthalmologists Thomas Bersani, MD, and Robert Weisenthal, MD, with their Honduran colleagues Drs. Alicia things under local anesthesia to having a Ponce and Luis Danilo in front of a portrait of the clinic’s whole army of nurses and technicians and anesthesiologists,” Bersani said. He focuses founder, Luis Alberto Ponce. on problems involving eyelids, tear ducts and eye sockets, while Weisenthal concentrates on cataract repairs and corneal transplants. Both are part of the ophthalmology faculty at Upstate Medical University. For the first 10 years, Bersani and Weisenthal connected with and befriended a local ophthalmologist who could provide follow-up care to their surgical patients. That man died. Today his daughter and son-in-law are in practice, and they have a son who is training to become an ophthalmologist. Bersani and Weisenthal expect they will soon work with the third generation of the Ponce family. They have a triage system to quickly determine if a patient can be helped, and whether he or she can benefit from a surgery they can provide. Using donated equipment and supplies, Bersani and Weisenthal volunteer their time for the trips. They are usually accompanied by 18 to 22 medical volunteers, and they said other doctors — including ophthalmologists Walter Merriam, MD, Evis Petrela, MD, and Lawrence Stewart, MD — “have been really instrumental in making these missions work.” Their nonprofit, Honduran Eye and Life Program, or HELP, accepts contributions year round. The group was invited to borrow space in a private hospital that would normally be off limits to their patients. “It’s a little bit dated, but it’s not too far behind what we have in the U.S.,” Bersani said. “We slowly have brought down equipment and left it there over the years, and we now have a pretty good physical setup with clinic space and operating room space. It makes it quite functional.” During a week this past April, Bersani and Weisenthal performed 65 operations. Among their patients was a 9-year-old boy who had not seen because of cataracts he developed in both eyes when he was 1 or 2 years old. Everyone at the clinic paused to watch his excited reaction when the bandages came off the next day. “Although it’s very arduous,” Weisenthal said of the Honduran trips, “you get back much more than you give.” ●
Hear about the Honduran Eye and Life Program at www.healthlinkonair.org by searching “ophthalmology.”
upstate students benefit from nationally recognized professors, excellent job placement and suny tuition. open houses are held each fall and spring. DEGREE PROGRAMS Biomedical Sciences (MS, PhD) Cardiovascular Perfusion (BS) Medical Biotechnology (BS) Medical Imaging (BS, BPS) Medical Technology (BS, MS) Medicine (MD, MD/PhD, MD/MPH) Nursing (BS, MS, DNP, post-master’s certificate) Public Health (MPH) Physician Assistant (MS) Physical Therapy (DPT) Radiation Therapy (BS, BPS) Respiratory Therapy (BS)
Education • Healthcare • Research
www.upstate.edu/students
A young man, 15, shortly after surgery to treat bilateral cataracts. fall 2015
U P S TAT E H E A LT H
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IN OUR COMMUNITY
No longer homeless V O LU N T E E R S , D O N O R S R E N O VAT E EYESORE HOUSE INTO REAL HOME
BY JIM HOWE
Three formerly homeless men in Syracuse are grateful to have a house of their own, thanks to a communitywide effort. “People need a home. People need something to call their own,” one of the men, Ed, told an interviewer when the renovated house was displayed for the public in September. The small house at 142 Granger St. is adjacent to the Rescue Mission campus, wedged between downtown and the Near West Side. More than a century old and vacant for years, the house had fallen into ruin and been used as a drug den before the Rescue Mission bought it from the nonprofit Greater Syracuse Land Bank and, with the help of the construction firm Hayner Hoyt Corp., the United Way and the Corporate Volunteer Council, embarked on a project to breathe new life into it and the neighborhood. Among those contributing a total of more than 5,000 volunteer hours was a team of 20 to 25 Upstate Medical University employees and their friends and relatives, who spent two eight-hour days in April and May at the site, according to Kristin Thompson of Upstate’s marketing and university communications department. The Upstate team worked mostly to clean up debris, including construction materials and numerous used hypodermic needles around the site. The project, part of the Community Build to End Homelessness, funneled donated materials and furnishings as well as volunteer hours to clean, rebuild and furnish the house. A previous Community Build project a few blocks away prepared a home that now houses six residents, and another nearby project will build three tiny houses for homeless female veterans.
Among the requirements to live in the Granger Street house was a stable income, so the residents would pay rent. Neither Ed nor his housemates, Frank and Patrick, have jobs, but each receives small regular disability or other payments, said Carolyn Hendrickson, the project leader for the Rescue Mission, where she is chief development officer. The men asked that their last names not be used. Their rent is “a tad higher” than what the federal Supplemental Security Income will pay (about $360 per person per month, utilities included) and just about covers the costs of running the house and paying its taxes. The three men are also responsible for keeping their home in good shape, with help on the heavier maintenance from the Mission. The men had been residents of the Rescue Mission’s emergency shelter at one point, then moved into the Mission’s affordable housing, which gave them a private room and shared cooking facilities. “This was the next step, to go into something that was more their own,” said Hendrickson. “They were all in agreement that they felt they could really live together.” Frank, Ed and Patrick can live in the house as long as they wish, provided they keep up with the rent. Each man has his own bedroom on the second floor. The first floor features an eat-in kitchen, laundry room with washer and dryer, full bathroom, half bathroom, living room and dining room. The rooms are small, with sturdy, comfortable furniture and new appliances. Out back is a small deck with a wooden fence for privacy. The house also has central air conditioning and a small attic for storage. “My housemates and I are very thankful that so many people would come out and restore this house,” Ed said. “It means a great deal to us to have a home.” ●
The Rescue Mission hopes to spur additional improvements in the neighborhood. photo by JaMes MckeeveR
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IN OUR COMMUNITY
If you don’t look for it,you won’t find it E M OT I O N A L D I ST R E S S I S CO M M O N A M O N G R E F U G E E S
Refugee Conference regarding the need to screen for emotional distress in refugees, and his students presented a poster about their participation and outcomes.
Upstate medical students have teamed with residents and faculty to provide physical examinations for newly resettled refugees since 2010. The assessment of adults has included screening for emotional distress, which was present in 38 percent of adult refugee patients. But health care providers would not have realized that if they had not asked the refugees questions designed to assess their emotional health, said Peter Cronkright, MD, a physician who advocates for refugee services and who trains medical students. Students use phone interpreters to administer the “Refugee Health Screener – 15,” a tool to sensitively detect the range of emotional distress common across refugee groups. If the test results are abnormal, the refugee likely has post-traumatic stress syndrome, anxiety and depression. “When you screen, often you discover that they have these things,” said Cronkright. He said it’s not surprising that refugees have mental health issues, but unless a health care provider raises the question, the issues may go undiagnosed — and untreated.
Cronkright believes people often communicate their emotional pain through physical symptoms, especially when they have difficulty communicating. That’s a common challenge among refugees who are making new homes in a new culture, surrounded by people who speak a language they often don’t understand. A physician who attempted to treat that person’s headaches, back pain or similar problems without addressing their emotional health would be dodging the real issue.
The American College of Physicians recommends screening only for issues for which a physician can make a difference. Cronkright said primary care providers can Did you know? make a difference by offering an Depending on the culture, many refugees objective exam, acknowledging the who settle in the Syracuse area find it taboo patient’s suffering, and treating their to admit depression or emotional struggles. emotional distress with counseling The Burmese don’t even have a word for and/or medications. depression. In caring for refugees from
Refugees may arrive to the clinic with He also points out that a great predictor Burma, Peter Cronkright, MD, is mindful back pain or dizziness or headache, and of whether someone with acute back to use the phrase “loss of hope” it’s up to the health care provider to pain will go on to develop a chronic or “hopelessness.” screen for any emotional contributors. problem with back pain is not the results of Prior to implementing the screener tool, only an imaging scan but rather the presence of 11 percent of newly resettled refugee adults emotional distress. were noted to have a mental disorder. Once it was Cronkright encourages his learners to consider the in place, that percentage grew to 39 percent. Among psychological and social factors contributing to the refugees from Iraq, the percentage was 60 percent. patient’s suffering, as well as the physical. ● Cronkright served on a panel at the 2014 North American
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IN OUR COMMUNITY
Vaughn Whittaker, MD, assistant professor of surgery and transplant program director, Michelle Mastropolo, Carol Ann Davies and transplant social worker Tania Lyons at the presentation. Mastropolo said that when a friend saw this photo of the check on Facebook for $9,875, which were the proceeds from the golf tournament, she immediately made a contribution to bring the total to an even $10,000.
Grateful patient gives back in honor of her ‘new life’ after transplant
Michelle Mastropolo recovers from her kidney transplant in August 2014 with the support of her spouse, Carol Ann Davies.
When she was 22, Michelle Mastropolo learned she had polycystic kidney disease, an incurable genetic disease that took the lives of her mother and then her brother. Thirty years later, in early 2014, she was diagnosed with end-stage kidney failure. Mastropolo went on the waiting list for a kidney transplant. “My kidney function was at 20 percent and dropping,” she explained. “By August, it was at 4 percent.” Waste from proteins was accumulating in her blood and making her feel sick. Her levels of creatinine, a product of metabolism, were hundreds of times what was normal. Yet, she was still trying to keep a normal life for her spouse, Carol Ann Davies, and daughter Julia. They were at a family party in Skaneateles when she received the call from the transplant coordinator, Ellen Havens: Get to Upstate, now. They had a kidney waiting. “I had the operation at 2:30 that morning, and by 9 a.m. I was out of recovery and in the intensive care unit,” she recalled. The entire transplant team gathered at her bedside to celebrate what Mastropolo calls her miracle. “They were beaming, and we shared happy tears.” Two days later she celebrated her birthday and began enjoying some things her illness made impossible — simple things like chicken Parmesan for dinner (many foods are restricted with PKD as it can cause potassium to build up to dangerous levels) and being able to attend her daughter’s violin recital. Walking and then golfing again followed. Mastropolo and Davies were inspired to plan and host a golf tournament as a way of saying thank you to her team at Upstate University Hospital. The 2015 tournament raised $10,000 and supports the Organ Donation and Transplant Fund, established at the Upstate Foundation, which helps post-transplant patients with personal expenses related to their health care needs. “Organizing this tournament was our way of giving back for the extraordinary care and support I received as a patient. Thanks to this incredible team, I began my new life at age 53,” said Mastropolo. She and Davies are hosting the second Transplant Tournament on June 5, 2016. Their website: www.gotransplantfund.com. The Upstate Foundation website: www.foundationforupstate.org ●
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Vaughn Whittaker, MD, during kidney transplant surgery. ABOUT THE TRANSPLANT PROGRAM AT UPSTATE Upstate University Transplant Services offers a comprehensive kidney transplant program for patients suffering from end-stage renal (kidney) disease, the final stage of kidney failure. Upstate surgeons perform nearly 50 kidney transplants annually (more than 4,100 transplants to date) making Upstate’s kidney transplant program one of the most experienced kidney transplant programs in the region.
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GEM CARE
EMERGENCY & URGENT CARE FOR SENIORS AGE 65+
upstate’s geM care offers a calm, easy-access setting especially for seniors. geM care’s benefits include a dedicated space with dedicated trained staff and coordination with your own doctor. While we provide immediate hospital care for those who need it, our goal is to return you home safely. ACCESS GEM CARE THROUGH THE EMERGENCY ROOM AT OUR COMMUNITY CAMPUS, 4900 BROAD ROAD. TO LEARN MORE, CALL UPSTATE CONNECT AT 800.464.8668 OR VISIT WWW.UPSTATE.EDU/GEMCARE
FO R M O R E I Nlocated FO at R the Mformer AT I Community O N OGeneral R TO MAKE A Hospital REFERRAL CALL 3 1 5.4 6 4. 1 5 0 0 fall 2015
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IN OUR LEISURE
‘Meaningful’ book explores OCD, addiction Kaushal Nanavati, MD, director of integrative medicine at Upstate, calls a book about uncontrolled self-abuse “sarcastic, witty and insightful.” The book is “Body Punishment: OCD, Addiction and Finding the Courage to Heal,” by Maggie Lamond Simone, a freelance writer living in Central New York. Nanavati said Simone “writes with a sincerity that is endearing and frank,
Kaushal Nanavati, giving a voice to the internal conversations that lead to silent suffering for MD, reviewer many. ‘Body Punishment’ is an insight into the life and mind of an innocent being conditioned by OCD, obsessive-compulsive disorder. “The book drifts back and forth through various stages of her life, painting a kaleidoscopic vision through her eyes — highly colorful, dramatic, passionate, sharp and disruptive at times, though beautiful when seeing it as a whole. “It is easy for a reader to find his or her own voice somewhere in the pages of this meaningful work,” he says. In an article on the website for the State University of New York at Oswego, where Simone is an adjunct instructor in journalism and public speaking, the author says, “I hope the book says a lot to people who struggle with all sorts of disorders. I hope it says, ‘You’re not the only one.’”
Couscous With Cranberries, Mint and Pine Nuts This simple dish combines cranberries and toasted pine nuts with fluffy, protein-rich couscous, which is lower in calories than rice or other pastas.
Ingredients
Nutritional information
1-1/2 cup dried cranberries
2 cups boiling water
2 tablespoons fresh lemon juice
2 teaspoons ground cinnamon
1 tablespoon olive oil
1 cup couscous
1/4 teaspoon kosher salt
2 tablespoons chopped fresh mint
Preparation
2 tablespoons fresh chopped parsley 1/4 cup pine nuts
In a large bowl, combine couscous with cinnamon, cranberries, salt, oil and lemon juice. Add boiling water, cover bowl and let everything steam for 10 to 15 minutes. Toast pine nuts in a medium-hot dry skillet until golden brown and do not leave unattended. Set aside until ready for use. Separate the couscous with a fork and fold in the fresh chopped herbs and toasted pine nuts.
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This recipe yields eight, 3/4-cup portions, each containing: 218 calories 4 grams protein 42 grams carbohydrates 5 grams total fat 0 milligrams cholesterol 80 milligrams sodium 3 grams fiber
RECIPE FROM MORRISON HEALTHCARE, FOOD SERVICE PROVIDER FOR UPSTATE MEDICAL UNIVERSITY.
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IN OUR LEISURE
Mandy Brown
Meghan Dwyer
Fit and Fun
Jenna Fronce
Ellen Furnari
Christina Phelan
C O R P O R AT E C H A L L E N G E R AC E W I N N E RS E XTO L T H E J OY S O F RU N N I N G
The female runners from Upstate who won first place in the J.P. Morgan Corporate Challenge’s Syracuse division say they run for fun and for fitness. Winning is nice, too. Mandy Brown, Meghan Dwyer, Ellen Furnari and Christina Phelan had a collective time of 1:36:08 in the 3.5-mile race, beating the second-place women’s team, from Crouse Hospital, by more than 3½ minutes. Brown left Upstate after the race, so Jenna Fronce will take her spot on the team when it competes at the international level next year. The annual race attracted 7,864 runners, joggers and walkers in 2015, including 96 who work at Upstate. It’s held in June at Onondaga Lake Park in Liverpool and benefits different local charities. This year it was Honor Flight Syracuse, the organization that flies local war veterans to see military memorials in Washington, D.C. Here’s more about the Upstate runners: REGISTERED NURSE MANDY BROWN Age: 33; Time: 23:00 minutes Why she runs: “Because I can! For my health, and to be a good example for my children.” Her start: “I started running when I was in fifth grade at our elementary district track meets. I did not like racing, so after that I just ran for fun. When I joined the Army was when I started racing for times again.” Best running memory: “I have digestive tract paralysis, gastroparesis, and I registered for the Nationwide Children’s Hospital Marathon in Columbus, Ohio. I struggled with symptoms restricting me to a liquid diet for almost three years and was only planning to just finish the race, as I loved high-fiving the patient champions at every mile. I ended up having a great race and qualifying for Boston. It was an amazing day that I will never forget.” OCCUPATIONAL THERAPIST MEGHAN DWYER Age: 27; Time: 24:57 minutes Why she runs: “My running helps me maintain a healthy lifestyle.” Her start: “I played lacrosse at Mercyhurst College. Following graduation, I took up running in order to stay healthy.” Her advice: “Everyone should take up running, because it has a positive
impact on not only physical health, but mental health as well. If running a mile seems impossible, try intervals of walking and running (run two minutes, walk one minute, repeatedly throughout the mile) until activity tolerance improves, and you’ll be churning out miles in no time. Anyone can do it.” REGISTERED NURSE JENNA FRONCE Age: 24; Time: 26:19 minutes Why she runs: “I run mainly to stay in shape. I do have a love for running and feel the best afterwards versus any other workout I’ve ever participated in.” Her start: “I began running in ninth grade while training for field hockey, when I realized that even though I wasn’t in shape at all, running came naturally easy for me. I tried out for varsity track later that year and qualified for sectionals every season.” Her advice: “I always hear people say, ‘I don’t have the body to run.’ That is so far from the truth. I’ve had runners who appear to be overweight pass me at the finish line.” ADMINISTRATIVE ASSISTANT ELLEN FURNARI Age: 29; Time: 25:42 minutes Why she runs: “It allows me to be a part of a community of supportive, smart and fun folks.”
Her start: “I started running when I was 16. Before that, running was something that I did up and down the field with a field hockey or lacrosse stick in my hand or on the basketball court. I decided to join the track team instead of basketball that winter.” Her advice: “I wouldn’t recommend registering for a marathon on a whim. However, if you put in the effort, take your time and stick to a plan — and maybe you have to walk/run in the beginning — that is OK — you will absolutely see a positive change. Remember, though: A lot about running is simply being comfortable with being uncomfortable.” PHARMACIST CHRISTINA PHELAN Age: 30; Time: 22:29 minutes Why she runs: “It keeps me sane! It is my way to de-stress and also enjoy the outdoors. I love it when I can wake up and get my run in early before work, too. It starts the day out right.” Her start: High school Her advice: “Getting out the door is the hardest part! Once you've started, you probably won't regret it. Plus, it’s a good excuse to eat a cookie or two.” Biggest misconception non-runners have about running: “That you have to be fast, and be able to run for miles. Everyone has to start somewhere.” ●
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750 East Adams Street l Syracuse, NY 13210
Learning how the brain develops
E
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Eric Olson, PhD Ryan O’Dell, PhD
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Olson and Ryan O’Dell, PhD, had this image from their work selected for the cover of the Journal of Neuroscience, the flagship journal for the Society for Neuroscience. The microscopic structures in purple, red and yellow are different types of neurons. O’Dell recently received his PhD and is completing his medical degree through Upstate’s MD/PhD program.
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The cellular and molecular processes of cerebral cortex development are under study in the Upstate laboratory of Eric Olson, PhD, an associate professor of neuroscience and physiology. The cerebral cortex is the brain’s outer layer.