Aug. 28, 2016
Infectious disease expert Mark Polhemus, MD, provides an update on the Zika virus threat. Haidy Marzouk, MD, goes over pediatric ear infections. Barbara Feuerstein, MD, talks about an integrative approach to diabetes and wellness.
Most people who become infected with the Zika virus have such mild symptoms, if any, that they aren’t aware of the infection. The human body is able to get rid of the virus within a few months, says Mark Polhemus, MD, an infectious disease expert at Upstate Medical University who directs the Center for Global Health and Translational Science. Because the virus is linked to severe birth defects, women who are exposed to Zika are advised to wait at least eight weeks before becoming pregnant, so the virus is out of their bodies. Because the virus lives longer in semen, men are told to protect sexual partners from pregnancy for at least six months. Polhemus explains that Zika is transmitted through the bite of an infected mosquito but also has the ability to spread through sexual contact and from mother to unborn baby. He also notes that the Centers for Disease Control and Prevention’s map includes Central New York among areas at risk for spread of the disease.
Ear infections are common in the first few years of life, partly due to how the ear’s eustachian tube develops, explains Haidy Marzouk, MD, an Upstate ear, nose and throat specialist. The tube’s horizontal position make it prone to blockage and fluid buildup, she says, but after age 3 or so, as the tube becomes more vertical, the ear infections become less frequent. She also explains treatment, the use of antibiotics and extreme cases.
A team of pediatric specialists treats the wide range of trauma that children encounter, says Kim Wallenstein, MD, the new medical director of Upstate’s pediatric trauma unit. Wallenstein, a pediatric surgeon, explains how children who have been injured by anything from bicycle accidents to gunshot wounds are brought in and treated at the only level-one pediatric trauma center in Upstate New York.
The Cancer Moonshot initiative aims to accelerate, coordinate and improve the understanding, prevention, diagnosis and treatment of cancer. It would involve patients, doctors, drug companies and almost anyone involved with cancer, explains Upstate urologist and cancer researcher Leszek Kotula, MD, PhD. Among its goals are improving the sharing of information, speeding up the approval of new drugs, funding more research and improving access to care for underserved groups, he says.
A hospital’s ethics consultants can help families in conflict when life-and-death decisions have to be made. Such decisions, once made only by doctors, are now largely in the hands of patients. This can create problems when a patient is unable to give clear directions for treatment. Two ethics consultants at Upstate University Hospital – neonatologist Thomas Curran, MD (at right in photo), and attorney Robert Olick, JD, PhD (at left), who are both bioethics and humanities faculty members at Upstate – explain how they try to clarify and resolve the issues and offer non-binding advice. They cite a real-life case in which a woman. hospitalized with advanced lung cancer, kept changing her mind about her treatment and had days when she was too ill to communicate. Curran and Olick stress the importance of making one’s end-of-life wishes known to others, in advance, and choosing a health care proxy who will work to carry out those wishes.
How far-reaching is your definition of family? Upstate psychologist Rich O’Neill, PhD, speaks of his family tree as he explores his ancestral home of Ireland in this “Check Up from the Neck Up” essay.
Urologists Dmitriy Nikolavsky, MD, and Jonathan Riddell, MD, talk about surgical innovations to correct problems with the urinary tract in men, women and children. Orthopedic surgeon L. Ryan Smart, MD, discusses common shoulder injuries and their treatment. Ruth Weinstock, MD, PhD, tells about research that is shaping the way diabetes is managed.
A person’s wellness depends not just on managing his or her diseases, but in getting into a routine that brings contentment and peace, says Kaushal Nanavati, MD, a family practitioner and medical director of integrative therapy at Upstate. He explains his “Core Four” concepts of wellness: nutrition, physical exercise, stress management and spiritual wellness, which he outlines in a recent book. Among topics he touches on are the importance of relationships, how deep breathing can cut stress, and why people should take time to think, reflect and set priorities in a hectic world. He has a book out on the subject.
Research taking place at Upstate’s Joslin Diabetes Center offers the potential for huge advances in diabetes treatment, says Ruth Weinstock, MD, PhD, Upstate’s chief of endocrinology, diabetes and metabolism. She describes the clinical trials, one of which would create an artificial pancreas by having a blood glucose sensor signal an insulin pump to maintain blood sugar levels automatically. Another looks at whether a gout drug could also protect the kidneys from diabetes damage. People with diabetes or their close relatives who wish to participate in research projects may call 315-464-9007 for more information.
A willingness to live in harsh or unpredictable conditions and to overcome obstacles is a necessity for a missionary nurse. Victoria Okhman, a nurse at the Upstate Golisano Children’s Hospital, tells of her experiences in Russia, dealing mostly with orphan children, where she learned to appreciate the job’s potential and accept its limitations. Okhman also tells how she applies the experience to her work at Upstate.
Treating diabetes works best with an integrative approach that deals not just with insulin and blood sugar levels, but lifestyle factors like stress, exercise and eating habits, says Barbara Feuerstein, MD, an endocrinologist at Upstate’s Joslin Diabetes Center. She explains how conventional medicine can be combined with a variety of other treatments, such as acupuncture for stress reduction or yoga for exercise, to help the patient manage the disease and be healthier overall.