Black Bean and Avocado Enchiladas

iStock_000014807979LargeFor a nutritious meal high in fiber and protein, pair black beans with avocados. You’ll also get a healthy serving of B vitamins and folic acid.

Just remember that canned black beans, while convenient, are loaded with sodium. So, rinse them with water.

Ingredients

2 tablespoons olive oil

1 cup diced onion

1 tablespoon minced garlic cloves

1/4 teaspoon kosher salt

1/4 ounce dried Mexican oregano

1/2 teaspoon ground cumin

1/2 teaspoon chili powder

1/8 teaspoon ground black pepper

1 1/2 cups canned black beans, drained and rinsed

3 cups diced avocado

12 6-inch corn tortillas

1 cup canned red enchilada sauce

1/4 cup chopped cilantro

Preparation

Heat oil in pan, and saute onions and garlic. Add the salt, spices and black beans. Cook until heated through. Place in a food processor and pulse to mash. Leave coarsely ground. Transfer to a bowl and gently fold in diced avocados. Set aside.

Heat tortillas to make pliable either in a steamer, microwave or oven. Pour a quarter of the enchilada sauce into a baking pan and spread evenly. Roll 1/3 cup of filling into each tortilla and place seam down in the pan. Pour remaining sauce on top. Bake covered at 350 degrees until heated through, about 20 to 30 minutes. Serve garnished with fresh chopped cilantro.

Nutritional information

A two-enchilada serving includes:

375 calories

10 grams protein

48 grams carbohydrates

19 grams total fat

3 grams saturated fat

0 milligrams cholesterol

504 milligrams sodium

14 grams dietary fiber

RECIPE FROM MORRISON HEALTHCARE, FOOD SERVICE PROVIDER FOR UPSTATE MEDICAL UNIVERSITY

This article appears in the spring 2015 issue of Upstate Health magazine.

 

 

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A custom approach: Hormone replacement can include bioidenticals

She entered her late 50s, and suddenly Roxanne Eyler’s cholesterol and triglyceride levels started to creep up. A trainer at Ultimate Goal in Marcellus, she ate well and was physically fit but found she was gaining weight and awakening in the middle of the night.

Eyler’s doctor wanted to prescribe a pill to lower her cholesterol. She wanted to understand why it was rising and what else was going on.

Roxanne Eyler trains at Ultimate Goal in Marcellus. PHOTO BY SUSAN KAHN

Roxanne Eyler trains at Ultimate Goal in Marcellus. PHOTO BY SUSAN KAHN

She attended a lecture on hormone replacement therapy at the Marcellus Free Library. At the end, she decided to make an appointment with the speaker, certified nurse midwife Heather Shannon, who has an office at Upstate’s Community campus.

“She doesn’t rush me out of her office. She takes her time,” Eyler said of Shannon.

Shannon talked to Eyler about her lifestyle, nutrition, her energy level, mood, sleep habits and the symptoms she was having. Then she had saliva and blood samples analyzed.

Based on the results, she told Eyler to take a series of B vitamins, one pill at each meal.

“Within a week, I could not believe the difference that I saw,” Eyler said. The vitamins helped her gastrointestinal tract better absorb the nutrients from her food.

In addition, Shannon designed a bioidentical hormone preparation that Eyler would apply to her skin in the morning and evening. Such preparations are a combination of the estrogens, estriol and estradiol. The exact dose of each is customized to the patient.

“It’s a wonderful option, as long as you are a candidate,” Shannon said of the customized plant-based preparation that is available at pharmacies that compound medications. “If you are estrogen-dominant, we’re not going to give you extra estrogen. We’re going to give you a little more progesterone, and possibly some testosterone to help balance your hormones.”

Shannon said women taking bioidentical hormones have to be as concerned about the risk of breast cancer and cardiovascular disease as women taking traditional hormone replacement. Also, patients are followed closely so that adjustments to the preparations can be made if necessary.

In Eyler’s case, she has been taking the vitamins and bioidenticals for a couple of years. Her cholesterol and triglyceride levels are in check, and she believes she is in better shape now than she was in her 30s and 40s.

Women make three principal types of estrogen:

Estrone is the strongest of the estrogens and is linked to breast and uterine cancer if levels are too high.

Estradiol, the second-strongest estrogen, is produced by the ovaries and requires certain nutrients at specific levels to be metabolized properly.

Estriol levels increase with pregnancy and create few side effects.

Hear an interview with Shannon about hormone replacement therapy.

Reach Heather Shannon at her office on Upstate’s Community campus or by calling 315-464-8668 or 492-5875.

This article appears in the spring 2015 issue of Upstate Health magazine.

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Selecting stroke care: What’s the difference?

Neurosurgeon Satish Krishnamurthy, MD, left, with residents Meg Riordan, MD, and Ali Hazama, MD.

Neurosurgeon Satish Krishnamurthy, MD, left, with residents Meg Riordan, MD, and Ali Hazama, MD.

A comprehensive stroke center is typically the largest and best-equipped hospital in a given geographical area that can treat patients with any kind of stroke or stroke complication. Upstate University Hospital was the first hospital in the Central New York region to be certified as a DNV Comprehensive Stroke Center, encompassing the full spectrum of stroke care – diagnosis, treatment, rehabilitation and education. (DNV stands for Det Norske Veritas, the name of a certification company that originated in 1864 in Norway.)

“Accreditation and certification in healthcare provide much more than recognition,” says Yehuda Dror, president of DNV Healthcare. “These programs help establish standards of excellence and best practices that directly impact patients’ lives.”

Here’s a look at the difference between primary and comprehensive stroke centers:

PrimaryStrokeCenters_mapPRIMARY STROKE CENTER

Patient care

Takes care of most ischemic strokes caused by blood vessel blockages.

Minimally invasive catheter procedures

Not required.

Specialized ICU

No requirement for a separate intensive care unit for stroke patients.

Neurosurgery

Access to neurosurgery within two hours.

Patient transfers

Sends complex patients to a comprehensive stroke center.

 

ComprehensiveStrokeCenters_mapCOMPREHENSIVE STROKE CENTER (This is Upstate.) 

Patient care

Takes care of brain aneurysms and all types of strokes, including ischemic and hemorrhagic, those caused by bleeding.

Minimally invasive catheter procedures

24/7 access to minimally invasive catheter procedures to treat stroke.

Specialized ICU

Dedicated neuroscience intensive care unit for stroke patients.

Neurosurgery

On-site neurosurgical availability 24/7 with the ability to perform complex neurovascular procedures such as brain aneurysm clipping, vascular malformation surgery and carotid endarterectomy.

Patient transfers

Receives patients from primary stroke centers.

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Dengue fever: Learning to reduce transmission

Studies in the urban coastal city of Machala, Ecuador, taught an international team of researchers, including some from Upstate, what’s necessary to reduce the transmission of dengue fever. The most vulnerable populations must be targeted, and local governments and community leaders must collaborate in order to establish a dengue early warning system.

Efforts to contain the viral disease – which is spread from the bite of an infected mosquito and not from person to person – have mostly focused on developing nations. But dengue fever has been transmitted in the United States, on Long Island, and experts believe it will become more of a concern.

Dengue fever is usually not fatal, but can cause severe pain behind the eyes, headaches, very high fevers and joint and muscle aches so severe that the virus was nicknamed “break bone fever.”

There are four strains of dengue. Once a person is infected with one strain, he or she is protected from that strain. However, a subsequent infection with one of the other three strains puts him or her at greater risk for a severe immune response, says Mark Polhemus, MD, an associate professor of medicine and microbiology and immunology at Upstate.

Social risk factors and climate seem to play a role in the spread of dengue, according to the research team’s findings, which were published in the online medical journals BMC Infectious Disease and BMC Public Health. A 2010 dengue outbreak in Machala occurred during an unusually hot and rainy season, the research article says. Researchers found that older people and those living in poor housing conditions were most affected by the outbreak.

“We found that social and political conditions have to be considered when designing dengue control interventions, especially for high-risk, marginalized populations,” says Anna M. Stewart Ibarra, PhD.

Anna M. Stewart Ibarra, PhD, traveled to Ecuador for her work on understanding the challenges of diagnosing and managing dengue fever. She is pictured with Regan Deming, summer research coordinator.

Anna M. Stewart Ibarra, PhD, traveled to Ecuador for her work on understanding the challenges of diagnosing and managing dengue fever. She is pictured with Regan Deming, summer research coordinator.

An assistant professor of medicine at Upstate, Stewart Ibarra is the Latin America Research Program Director in Upstate’s Center for Global Health and Translational Science.

Findings from the studies are intended to be used to develop dengue vulnerability maps and climate-driven dengue seasonal forecasts. This will allow Ecuador’s health minister to “target high-risk regions and seasons, allowing for more efficient use of scarce resources.”

Study seeks participants

Upstate researchers are looking for healthy adult volunteers to help find an effective vaccine for dengue fever.

Upstate’s Mark Polhemus, MD, directs the Center for Global Health and Translational Science, where two promising dengue vaccines have been evaluated over the past two years. Because animals do not contract the human forms of dengue, researchers seek humans between the ages of 18 and 45 who are willing to be injected with an attenuated, or weakened, dengue virus.

“Our goal is to be able to produce an uncomplicated dengue, a mild form of dengue,” Polhemus explains. If that develops consistently in the people who participate in the trials, the researchers will be able to use the attenuated virus for vaccine trials involving many people, in areas of the world where dengue fever is prevalent.

Volunteers will have to commit to about a month’s worth of medical appointments every other day at the center, with phone calls on alternate days. Those who become ill will be admitted to a room at Upstate University Hospital’s Community campus for care and monitoring.

“In all clinical trials, there is a level of danger,” Polhemus says. “But this sort of trial has been done before with dengue. This has been done before with other diseases. This virus is attenuated, and we have multiple safety measures in place to ensure that this goes well without complications.”

Learn more by visiting the center’s website at upstate.edu/cghats, calling 315-459-3031 or emailing trials@upstate.edu

Hear several interviews about aspects of dengue fever at www.upstate.edu/healthlinkonair by searching “dengue.”

This article appears in the spring 2015 issue of Upstate Health magazine.

 

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7-minute workout is interval training

The “plank” is one of 12 moves in the 7-minute workout, which also includes jumping jacks, wall sits, push-ups, abdominal crunches, step-ups onto chairs, squats, tricep dips, high-knee running in place, lunges, push-ups with rotations and side planks.

 

Ask people why they don’t exercise, and they are liable to say they don’t have time.

So, exercise scientists set about crafting a short but beneficial workout. They wound up with a dozen high-intensity intervals they call “The 7-Minute Workout.”

Carol Sames, PhD, an exercise physiologist who directs the Vitality! Fitness Program at Upstate, is a fan of the workout because it can be adapted to people of various abilities, it can be done in the home, and it’s a good substitute for people who say they cannot fit in the recommended weekly 150 minutes of moderate or 75 minutes of vigorous exercise.

“This workout is about interval training, which has been around for years, but just packaged slightly differently,” Sames explained. Each of the 12 exercises takes 30 seconds and is separated by 10 seconds of rest. One circuit takes 7 minutes, and ideally, people would repeat the circuit two or three times, extending their time commitment.

She said the 7-minute workout can be helpful. It can increase muscular fitness and aerobic capacity, improve the body’s insulin use and burn calories at a higher rate than lower intensity exercise, which can help shed fat.

It’s not for everyone, however.

The intensity is likely too high for people with high blood pressure or cardiovascular disease, or for someone who has been sedentary or is significantly overweight. It may also be too much for those with significant osteoarthritis or rheumatoid arthritis. Adaptations can be made in the selection of the specific exercises to reduce the intensity.

The 7-minute workout can be used as supplementary training to improve aerobic fitness and strength in athletes or for someone who is training for a distance run.

The 7-minute workout is better than not working out.

“If you just want to improve some cardio and strength,” Sames said, “you get a lot of bang for your buck in 7 minutes.”

How much exercise do you need?

The Department of Health and Human Services recommends that most healthy adults get at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week.

Is the 7-minute workout for you?

Upstate exercise physiologist Carol Sames, PhD, said to ask your health care professional if this workout is appropriate for you. If so, start slowly – perhaps by lengthening the amount of rest between exercises – and modify the moves as needed.

Hear an interview on this subject by visiting www.upstate.edu/healthlinkonair and searching “7-minute.”

This article appears in the spring 2015 issue of Upstate Health magazine.

 

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Why I love rowing

Jennifer Moffat, PhD (front), with rowing partner, Mindy Holgate. Moffat is an associate professor of microbiology and immunology at Upstate.

Jennifer Moffat, PhD (front), with rowing partner, Mindy Holgate. Moffat is an associate professor of microbiology and immunology at Upstate.

BY JENNIFER MOFFAT

  1. It gives me something for myself. Soon after I moved here from California in 1999, when my girls were just 2 and 4, I went to a wellness program at the high school, and a woman there spotted me and said, “Hey, you’re strong. Why don’t you join me?
  2. On national “Learn to Row Day” — which takes place June 6 this year — I just thought pulling on that oar was the best thing I’d ever done. I was with a great group of women, some a little older, some a little younger, but all of us grown-ups and ready to get out there and try something challenging.
  3. I like being outdoors, and I love Cazenovia Lake.
  4. Rowing is highly aerobic. You can push yourself to a point where it’s very intense. You get out of it what you put into it. You can challenge yourself, or you can take it easy.
  5. It’s a really good full-body workout. All the power of your legs gets transferred to your core. It is really tough on your hands, and we don’t wear gloves. So you have to deal with blisters on your hands.
  6. Rowing is the kind of thing where you can become proficient very quickly, but it takes years to master.
  7. You learn a universal language. The crazy vocabulary of rowing is a real tradition.
  8. You can jump in a boat and row with anyone. I travel for my job as a scientist. I contact rowing clubs when I travel and join them. I’ve gone rowing in Madison, Wis., San Diego and Finland.
  9. You really don’t have to invest in a lot of clothing. We wear tight spandex shorts or tights in order not to get caught in the rowing seat. And we don’t even wear shoes over our socks. The shoes are built into the boat. Rowers wear some kind of shirt that’s not too long in back. And hats and sunglasses.
  10. What’s really appealing to me is how you get a really sort of calming, focusing experience. It’s very present tense. It’s highly meditative. You do the stroke over and over again, and every time you try to make it the best stroke. You end up feeling very refreshed, mentally. Your body is exhausted, but your mind is refreshed. You feel like you’ve had a break from all the other thoughts in your head.
  11. Most of our races are on Onondaga Lake, or in Rochester or Albany. Now and then we row in Boston. As a novice my first year I won a gold medal. Hundreds of people of all ages show up for the regattas. It’s usually a day trip when you get up really early. It’s a big picnic. You watch other people race, you cheer your team, you set up a food tent.
  12. Both daughters became rowers around eighth grade. Laurel is the older one. She participated in the rowing program at Fayetteville-Manlius High School and attends Cornell University now. Last summer she was an assistant coach for the Cazenovia Rowing Club. Dana is the younger one. She is an FM High School senior who won a silver medal in the World Rowing Junior Racing Championships in Hamburg, Germany, last summer. Later, she competed in the Youth Olympics in China. I derive a lot of joy watching their efforts.

This article appears in the spring 2015 issue of Upstate Health magazine.

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Advice for parents: Do you think your child may have ADHD?

If you believe your child may have attention deficit hyperactivity disorder, “the most important thing is not to wait,” said scientist Stephen Faraone, PhD.

Faraone, a professor in Upstate’s departments of psychiatry and neurosciences and physiology, has authored more than 700 journal articles, editorials, chapters and books having to do with the nature and causes of mental disorders in childhood.

He said most pediatricians are well trained in diagnosing and treating that you delay treatment is a year that your iStock_000037219708LargeSKADHD. Parents should explain to the pediatrician why they have concerns. The doctor may say that the child has a normal level of exuberance.

“If they tell you the child has ADHD, don’t delay treatment,” Faraone said. “Every year that you delay treatment is a year that your child is exposed to many risks — the risks of having difficult friendships, not socializing properly, of failing in school, not doing as well as they might. (By delaying treatment,) your child’s self esteem goes down, and their problems get worse.”

Many of the ADHD medications have been used safely since the 1960s. Faraone says few alternatives have been shown to be effective. One exception is an omega 3 fatty acid known as eicosapentaenoic acid or EPA, which may be modestly helpful for children with ADHD. Still, it is only about half as effective as medications, he says.

Monitoring how well your child’s treatment is going is also important. The pediatrician may change the prescription before finding the medication that is most effective. The child may also need interventions at school. And, parents may benefit from behavioral family therapy.

Faraone is reassuring: “They will do well if they’re treated and you monitor them. Most people with ADHD are able to live productive and happy lives.”

Hear an interview at www.upstate.edu/healthlinkonair by searching “ADHD.”

This article appears in the spring 2015 issue of Upstate Health magazine.

 

 

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Spring issue of Upstate Health magazine available now

Layout 1Elizabeth Reddy, MD, is on the cover of the Spring 2015 Upstate Health magazine, related to a story about preventing the spread of HIV with a pill. This is something of which researchers were just beginning to dream in the early 1980s at the start of the AIDS epidemic. Now it’s available, and effective.

In this issue, you will also learn about “the 7-minute workout,” why we don’t hear much about cancer of the heart, and the difference between a primary and a comprehensive stroke center. You’ll meet a youngster who was able to hear sound, thanks to cochlear implants, a teen who returned to the sports he loves after brain surgery, and a physician with a personal story about health care proxies.

Scientists from Upstate share their expertise on regenerative medicine in this issue, along with stories about dengue fever and research into new drug targets for treating cancer. Other people connected to Upstate share their passion for dancing, for rowing, and for giving back to their community. Margaret Tandoh, MD, tells about returning to her native Liberia to help with the Ebola crisis.

Enjoy this issue of Upstate Health.

Here’s a stack of previous issues of Upstate Health, and here’s additional information about the publication. For a free subscription, email magazine@upstate.edu with “Upstate Health” in the subject line; include your name and mailing address.

Posted in cancer, community, eye disorders, health care, hospital, medical student, public health, research, stroke, women's health | Leave a comment

Out of the laboratory and onto the dance floor

AndrewKayla

Andrew Banas and Kayla Crouch

By Jim McKeever

Upstate students Andrew Banas and Kayla Crouch are conferring, but not about class assignments or laboratory research. For an hour each week, the pair dance. They waltz, tango and foxtrot to the sounds of Henry Mancini, Frank Sinatra, Van Morrison. They discuss steps, turns, posture and form.

Crouch is a first-year medical technology student, and Banas is a first-year doctoral student in the College of Graduate Studies.

They dance mostly for fun and fitness.

They connected last semester when Banas put out the word that he wanted to start a ballroom dancing club on campus. “Though we were not able to set up the club right away, we decided to start practicing ourselves,” said Crouch. She started dancing salsa at age 8 while growing up in the Bronx. Then as a student at Binghamton University, she joined a Latin dance team and a ballroom dancing club.

Banas credits his older sister Elizabeth with sparking his interest in dancing. “She was moving away to college, and I was still at home (in Michigan) and it became a way for us to still stay connected. Her interest remains, and we still dance at social events when I am home for the holidays.”

Dancing provides a change of pace and a break from Banas’ studies in cell and developmental biology. For Crouch, dancing is her time to relax. As she explained, “you can’t have all work and no play.”

This article appears in the spring 2015 issue of Upstate Health magazine.

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Surgery replaces silence with sound

Mason Drake at the moment he heard sound, thanks to cochlear implants. Photo by Kathleen Paice Froio.

Mason Drake at the moment he heard sound, thanks to cochlear implants. Photo by Kathleen Paice Froio.

A rare developmental disorder left Mason Drake deaf since birth. He heard nothing in his first six years of life.

His parents brought him to Upstate University Hospital for surgery in November. Charles Woods III, MD, installed a pair of cochlear implants that allowed Mason to hear sound for the first time. The implant’s receiver was secured to the youngster’s skull, electrodes were inserted into the inner ear, and weeks later – after the usual swelling had subsided – audiologist Jeffrey Vantassel turned the device on.

Mason heard the voices of his parents, Jessica and Kevin Drake of Oswego, both of whom used sign language to augment their speech. Megan Coleman, a news anchor for CNY Central, described Mason’s response as “part uncertain, part afraid, clearly overwhelming.”

The news station covered Mason’s implant surgery in a three-part series that aired late last year.

“What the implant actually does is stimulate the eighth nerve, which is our hearing nerve, directly to the brain,” Woods, an assistant professor in otolaryngology and communication sciences, told the news crew.

Jessica Drake said her son is still getting used to the devices. He takes them off for bathing because they cannot get wet, and he takes them off when he sleeps. Sometimes when he gets home from kindergarten, he takes them off to give himself a break from all the sound.

A remote controller adjusts the volume of the implants. His mom or dad increases it a little each day. Mason has a speech therapist and audiologist at school, and he has follow-up appointments with Vantassel every month. Eventually, the Drakes hope Mason will develop speech.

“Everything that we thought was out of reach seems more attainable now,” Kevin Drake said. ###

To learn about cochlear implant options, contact otolaryngologists Charles Woods III, MD, or Brian Nicholas, MD, at 315-464-4678.

This article appears in the spring 2015 issue of Upstate Health magazine.

 

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