Upstate student looks toward career in adolescent medicine

SUNY Upstate

Nicole Cifra, College of Medicine Class of 2016, was selected for a U.S. Public Health Service Excellence Award.

Upstate medical student Nicole Cifra’s passion for adolescent medicine has earned her a 2015 United States Public Health Service Excellence in Public Health Award.

Nicole is on track for a dual MD-MPH degree in 2016. She is one of only 57 medical students nationwide to earn the USPHS award that recognizes a commitment to public health leadership.

“Many of the challenges adolescents face are deeply rooted in public health, which I didn’t have an appreciation for prior to the public health curriculum,” Nicole said. “In particular, I narrowed in on the field of eating disorders.”

Anorexia nervosa, bulimia nervosa and binge eating disorder are classified as mental illnesses by the American Psychiatric Association and can be fatal, Nicole said.

Misconceptions abound.

“A good number of sufferers are males, more than you’d think,” Nicole said. “It’s not just adolescent females. (It affects) people in mid-life, from all races, genders and socio-economic levels.”

Eating disorders represent a severe distortion of body image and an inability to make changes, Nicole said. “The mind plays tricks on you. It’s similar to alcoholism and its ‘repeated use, despite harm.’ It’s a scary illness.”

Nicole’s passion for public health has gotten her involved at the national and international levels, as well as in the local community.

Next week she’ll attend the Academy of Eating Disorders conference in Boston. She’s on an international task force with people from the Netherlands, Japan, Australia and other countries.

In Syracuse, Nicole serves on the board of Ophelia’s Place, a not-for-profit that provides support for individuals and families dealing with eating disorders. She periodically leads support groups there, and advocates for the organization in the community.

When Nicole was preparing for her boards at the end of her second year at Upstate, she spent a lot of time studying in Café at 407, a Liverpool coffee shop affiliated with Ophelia’s Place.

“It just had this affirming atmosphere, and I was there so much that the director at the time introduced herself and bought me lunch,” Nicole said. “During my MPH year I started volunteering there because I had more time and less stress. … It’s wonderful to get involved and use my skill set to help people.”

At Upstate, Nicole credits Karen Teelin, MD, director of adolescent medicine, and Associate Dean Jennifer Christner, MD, for mentoring and guiding her.

“When I found out Dr. Christner was an adolescent medicine doctor, she got stuck with me forever,” Nicole said. “I went to an adolescent medicine conference with her last year in Austin, and met people in the field.”

Nicole is finishing up her final third-year clerkship – pediatrics, “and I absolutely love it” – and looks forward to a rewarding final year at Upstate.

She plans on taking “away electives” in adolescent medicine in Rochester and Austin, as well as working on her capstone project for the MPH degree. After that, she’s hoping for a residency in pediatrics, followed by a three-year fellowship in adolescent medicine.

Nicole said she’s grateful that Dean of Student Affairs Julie White, PhD, nominated her for the U.S. Public Health Service excellence award.

“A lot of public health initiatives focus on nutrition, obesity prevention and exercise,” Nicole said. “Eating disorders get forgotten. Adolescence is important. A lot of habits are formed in that time.”

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Graduate student’s research featured in prestigious journal

SUNY Upstate

Upstate graduate student Neva Watson in the lab with the March 15 cover of The Journal of Immunology on her desktop. The journal features Neva’s research and her image of skeletal muscle calcification (red stain) caused by the virus TMEV.

Upstate graduate student Neva Watson’s research into a protein’s role in a virus that causes skeletal muscle inflammation has made the cover of the Journal of Immunology.

The March 15 issue of the journal features Neva’s research project as well as her image of skeletal muscle calcification caused by a virus. She is a student in the lab of Paul Massa, PhD, professor of Immunology & Microbiology, and professor of Neurology.

“Our lab had previously identified a protein (SHP-1) as a key negative regulator of virus-induced inflammatory responses in the central nervous system,” Neva said. “I’ve been trying to identify how SHP-1 is instrumental in mediating virus-induced inflammatory disease of skeletal muscle.”

Neva will defend her dissertation this month, and receive her PhD in May. She begins a post-doctoral position at Cornell University this summer.

Journal of Immunology

The March 15 cover of The Journal of Immunology features Neva Watson's image of skeletal muscle calcification (red stain) caused by the virus TMEV.

Neva’s research focuses on virus-induced myositis (inflammation and degeneration of muscle tissue), a disease that has emerged as a worldwide problem with few treatment options. The virus can spread to the central nervous system, causing dramatically increased sickness.

Neva’s research is in response to what her abstract says is an urgent need to explore genetic factors involved in this class of human disease.

“This could have a broad range of therapeutic implications down the line,” Neva said, citing chronic inflammatory diseases such as multiple sclerosis and rheumatoid arthritis as potential treatment targets.

“There are SHP-1 inhibitors available, but it’s hard to tease out their specific roles,” she said. “It’s a master regulator involved in many different signaling pathways associated with inflammatory responses.”

After Neva leaves Upstate, the Massa lab will continue pursuing this work, she said. Neva and a lab mate have another similar project headed for possible publication, which she hopes will help land continued funding.

At Cornell, Neva will study T cell-mediated neonatal immunity, evaluating how maternal nutrition affects offspring in an animal model. She’ll be in a laboratory at Cornell’s College of Veterinary Medicine, an environment in which Neva is very comfortable.

Neva started out with a plan to become a veterinarian, and worked as a veterinary assistant while a student at Western Washington University. “When I drove down there (Cornell) and saw the vet college, I said, ‘I’m home!’”

After high school in Connecticut, Neva went out west — first to Colorado — to pursue competitive freestyle skiing. Knee injuries and surgeries ended that plan.

She enrolled at Western Washington University and became enamored with biology. After earning her degree, she came back east for graduate school to be closer to her family. Neva said her experience at Upstate has been very positive.

“I appreciate the small environment where you interact with everyone and have the opportunity to forge relationships with all the PIs in the departments throughout the school,” she said. “You’re not lost, you’re not a small fish in a big pond. There’s always someone willing to help. You can just knock on their door and say, ‘I’m out of this reagent — can you help?’

“You can be successful coming from Upstate.”

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‘Peds Pals’ mentor young patients at Upstate Cancer Center

SUNY Upstate

Brianna Belair, 13, with her "Peds Pals," Upstate medical students Heli Shah, left, and Hannah Carroll, at the Waters Center for Children's Cancer and Blood Disorders. Photos by Jim McKeever.

Just how much of an impact do Upstate’s “Peds Pals” have on young patients at the Waters Center for Children’s Cancer and Blood Disorders?

“The difference in the kids’ lives is just mind-boggling,” said Kristi Griffin, Education Specialist at the center, on the third floor of the Upstate Cancer Center.

The program matches pairs of Upstate medical students – usually a first-year and a second-year – with pediatric patients.

“We have 10 patients, several with sickle cell disease, some with chronic illnesses and some who are in remission,” Griffin said.

SUNY Upstate Waters Center

Brianna Belair with "Peds Pal" Heli Shah.

The students are required to meet once a week with their “little pal,” but Griffin said most meet more than that. “It’s completely individualized with each patient,” she said.

The get-togethers are a mix of academic tutoring and recreation, including trips to the mall or other fun spots. Mentoring is the crux of the program, Griffin said.

Some students accompany Griffin to meetings with their pal’s teachers, who are “very receptive” to having the medical students help with specific academic needs, she said.

First-year student Hannah Carroll and second-year student Heli Shah are paired with Brianna Belair. Brianna, 13, is in remission after treatment for a brain tumor that was discovered when she was in kindergarten.

“The Peds Pals program is very personal,” said Hannah, whose youngest sister is Brianna’s age. “You meet one-on-one and build a relationship. You get to know them a little more and that makes a difference.”

Heli said it’s satisfying to see Brianna improve her memory and math skills. There are other rewards as well.

“Last year I worked with another child who is now in treatment,” Heli said. “I went to her appointments with her and became a source of comfort. I don’t think I’ll ever forget the image of how much pain the treatments cause. I’m able to see (cognitive) improvements in Brianna, and able to see the patient’s perspective of treatment.”

SUNY Upstate Cancer Center

Brianna Belair plays a board game with her "Peds Pals" to improve her memory.

Brianna, a sixth-grader in the North Syracuse school district, engages in lively banter with Hannah and Heli during their weekly sessions at the Upstate Cancer Center. She enjoys doing arts & crafts and playing board games with them. “But I especially like it when they take me out for ice cream,” she said.

Brianna’s mother, Ann Belair, said Brianna’s academics have improved, and her daughter is comfortable being with Hannah and Heli. “She just thinks she’s a big girl when she’s with them,” Ann Belair said.

The program does have some risks, which the medical students know going in. The death of a “little pal” last year was very difficult for the two students paired with her, said Griffin, who gave the students a break from the program.

“Experiencing the death or relapse of a patient is something that medical professionals have to deal with, some more than others,” Griffin said. “I remind the Pals every time we get together that they may never know the impact they have on a person.

“I have a magnet on my desk that says, ‘You never know when you are making a memory,’ and I truly believe that,” she said. “There may be struggles and heartaches along the way, but what they are doing is life-changing. And that’s what Peds Pals is all about.”

SUNY Upstate Cancer Center

Brianna Belair works on her math homework with help from "Peds Pal" Hannah Carroll.

 

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Upstate medical student’s journey to continue in Atlanta

SUNY Upstate College of Medicine

Upstate medical student Jamal Hajjari, left, holds up his Match Day letter Friday. Jamal was matched with his first choice, Emory University in Atlanta, in internal medicine. With Jamal are his wife, Lamiae, and their daughter, Rima.

Jamal Hajjari grew up in Morocco, the youngest of 12 children in a farming family. As a young man, he helped out on the farm and in his father’s construction business.

He was content doing so. But he always dreamed of becoming a doctor.

Jamal, 32, will graduate from Upstate Medical University in May. At Match Day today, he learned he will be going to Emory University in Atlanta for his residency in internal medicine.

Jamal’s path to the MD was anything but direct – or easy.

It took him several attempts before he was granted a visa; he left Morocco for the United States in 2003. One of his brothers had emigrated four years earlier to Rome, NY, so Jamal moved in with him.

The plan was for Jamal to learn English, earn money and continue pursuing his goal of medical school. While studying English, he delivered newspapers in the morning and worked in manufacturing in the afternoon.

He eventually enrolled in Onondaga Community College, earning an associate’s in Mathematics and Science – the first of several academic degrees he would earn.

At OCC, Jamal heard about Upstate’s programs and enrolled in 2006. He has since earned a bachelor’s degree in Medical Biotechnology and – after taking a year off to study for the MCATs — a master’s degree in Medical Technology. In two months, he can add MD after his name.

While studying at Upstate, Jamal worked part-time in a clinical pathology lab and conducted research in the vision lab of Barry Knox, PhD.

SUNY Upstate College of Medicine

Upstate medical student Jamal Hajjari graduated from our Medical Biotechnology and Medical Scholars programs. He was selected to the Alpha Omega Alpha honor society for medical students. Photo by William Mueller.

It was during that time that Jamal appreciated the connection between bench research and clinical applications. He knew he was on the right track. “This is what I want to do,” he told himself. “This is what I am. I am a problem solver.”

Jamal also was in Upstate’s Medical Scholars program, and is the first graduate of that 10-year-old program to be elected to the national medical honor society, Alpha Omega Alpha. Jamal’s grades throughout medical school place him high in the ranks of the class of 2015.

In the Medical Scholars program, everything clicked for Jamal. “I understood every single piece. Classes were small, and I could ask detailed questions,” he said. “Without the Med Scholars program, I wouldn’t have achieved what I have.”

He is quick to add a comment reflecting his humility: “Everybody should get the credit,” he said. “I’m just driving the road that was paved for me.”

Today’s national Match Day revealed that the road is taking him to Emory University, which was his first choice. Jamal will be joined by his wife, Lamiae, an aerospace engineer, and their one-year-old daughter Rima.

They attended today’s Match Day celebration, but the gathering for Commencement might be somewhat larger – Jamal’s parents will be here from Morocco, perhaps joined by several or his siblings.

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Upstate students honor sickle cell patients, raise $4,250

SUNY Upstate sickle cell dinner

Student National Medical Association president Bilal Butt, Education Specialist Kristi Griffin, Dr. Richard Sills and SNMA members pose with honorees at the pediatric sickle cell disease fundraising dinner last month. Upstate students at far left, back row, are Minella Capili and Kethia Eliezer; at far right are Rosemarie Barker and Candace Hatten.

Upstate’s Student National Medical Association raised more than $4,200 last month for pediatric sickle cell patients, and honored four of our patients’ families at a dinner in the Campus Activities Building.

Sickle cell disease is an inherited blood disorder that affects red blood cells, primarily in African-Americans. It causes tissue damage and extreme pain, and can damage organs and compromise immune systems, especially in children. It can also lead to blindness, stroke and many other health problems.

Second-year medical student Bilal Butt, president of Upstate’s SNMA, said there are misconceptions about the disease in the medical community that lead to disparities in treatment and funding.

“Most patients are below the poverty line, which presents another barrier,” Bilal said. “It’s a major obstacle. Dr. (Richard) Sills is one of the few physicians who acknowledge the reality that race is a huge aspect in medicine, and the need to understand who the patient is.”

The SNMA dinner culminated the student group’s activities for the academic year. About 120 people attended, many of them medical students, Bilal said.

The SNMA works with Upstate’s Kristi Griffin, Education Specialist at the Waters Center for Children’s Cancer and Blood Disorders, to raise awareness of sickle cell disease. Griffin, who has a special education background, advocates for pediatric sickle cell patients treated at Upstate.

SUNY Upstate SNMA

Kristi Griffin, education specialist at the Waters Center for Children's Cancer and Blood Disorders, with two members of the honored families.

“Kristi needed to educate teachers in the city schools about sickle cell,” Bilal said. “A child may be acting up because of it, not just to cause trouble. Their bodies are doing something different.”

Griffin said there is a lack of awareness that extends beyond schools and hospitals to segments of the African-American community. She said her job is to share information about the disease and to chip away at the disparity in health care.

Griffin’s job takes her to schools, where she ensures the children receive the necessary accommodations to avoid a crisis.

Children with sickle cell, Griffin said, need to stay hydrated, avoid temperature extremes and limit exposure to the sun. They can participate in physical education, but need to be monitored to make sure they don’t overheat. They can become fatigued and may need to go to the nurse’s office to rest.

“Every patient is different,” Griffin said. “No two patients have exactly the same psycho-social qualities. That makes them unique, and they need to be treated that way. They’re all individuals, and they’re human beings.”

Adults with sickle cell develop a tolerance for pain medicine, Griffin said, and may need stronger doses over time. That’s where misconceptions come into play, as shown in this Johns Hopkins University video.

As Bilal said, “An African-American male coming into the ER asking for opiates is not necessarily a drug addict. In the big picture, in all aspects of medicine, if we understand who our patients are and what they’re going through, we’ll be better doctors.”

Bilal, whose girlfriend Sarina Meikle was SNMA president at the University of Buffalo School of Medicine this year, said Upstate’s SNMA is in good hands for 2015-16.

“The incoming officers are motivated, will take our ideas and run with them,” he said. That will include continuing efforts related to sickle cell disease.

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