Making a change: She succeeded in quitting after a cancer diagnosis

After more than 30 years as a smoker, Peggy Strong quit. November 2019 marks her second year as a non-smoker. (photos by Susan Kahn)

After more than 30 years as a smoker, Peggy Strong quit. November 2019 marks her second year as a non-smoker. (photos by Susan Kahn)

This is one of a series of articles focusing on lung cancer.

When Peggy Strong, 47, of Liverpool was diagnosed with breast cancer in 2015, “my first reaction was to have a cigarette.”

She had smoked since the age of 14. Her radiation oncologist brought up the idea of smoking cessation. Even though she had long wanted to quit, Strong says quitting wasn’t an option for her then because of the added stress of her cancer treatment.

Then her mother was hospitalized. She was under the influence of pain medications when Strong visited. “She doesn’t remember saying this to me, but she said, ‘Of all people, I can’t believe you continue to smoke — after having cancer.’ It struck a nerve. It was like, I have to make a change.”

HealthLInk on Air logo(Hear tobacco treatment specialist Theresa Hankin explain some of the best methods for quitting smoking, as well as the risks of vaping.)

Strong contacted Upstate’s Smoking Cessation Program and quit in November 2017. Strong met with Theresa Hankin, a respiratory therapist and tobacco treatment specialist. She used a nicotine replacement patch for a while, and she had lozenges and a nicotine inhaler that she used a few times. She’s also got Hankin’s phone number in case she ever feels as if she’s going to slip.

“I don’t know how or why, but I have no desire to pick up a cigarette again,” Strong says.

She took up crocheting because she didn’t know what to do with her cigarette-free hands. “I made the world’s longest blanket,” she describes, and gave it to her oldest son. He’s a smoker, and she hopes that he will decide to quit someday.

She underwent a low-dose computerized tomography (CT) scan that showed no abnormality in her lungs. She had no signs of lung cancer, she says. She takes a medication to help prevent recurrence of the breast cancer, which was discovered early and successfully treated.

They quit smoking, too

Sheila DevaneySheila Devaney, 56, of Baldwinsville

Started smoking:at age 11.

What prompted her to quit:The surgeon who removed her gallbladder last spring introduced her to Theresa Hankin,

a respiratory therapist and tobacco treatment specialist for Upstate’s Smoking Cessation Program. “I wasn’t ready then,” says Devaney. “But when I was ready, I called this woman. From the moment I met her, not once did I feel like a jerk for smoking.”

How she’s doing:Hankin offered encouragement, and the Upstate Foundation helped pay for Devaney’s medication, varenicline. “I’m still trying to figure out a way to thank her. Without her, and the foundation, I would still be smoking.”

Richard NeufangRichard Neufang, 59, of Syracuse

Started smoking:at age 30.

What prompted him to quit:“I wanted to increase my chances of living longer” after a diagnosis of pancreatic cancer. “And, I knew I would feel better. I always thought it was stupid that I started smoking in the first place. I despised it all my life.”

How he’s doing:“The last cigarette I had was March 17, last year.”

Rick ShattellRick Shattell, 69, of Redfield

Started smoking:at age 16.

What prompted him to quit:During treatment for prostate cancer, Shattell had to undergo regular phlebotomies, an uncomfortable procedure in which a needle makes an incision in a vein. “Dr. (Rahul) Sethtold me, ‘if you quit smoking, we won’t have to do this anymore.’ That was huge for me.”

How he’s doing:Sometimes he still craves a cigarette, but he’s learned how to shift his thinking to something else. “It’s very hard to do in the beginning,” he admits.

Terry Tourot

Terry Tourot

Terry Tourot, 62, of LaFayette

Started smoking:at age 13. “I’ve been trying to quit forever, since I got pregnant with my son, and he’s 33 years old.”

What prompted her to quit:Her lung cancer screening

included a connection with the Smoking Cessation Program, where she received counseling and the medication bupropion.

How she’s doing:“I’ve been struggling with my health, but this is one thing I’ve done right. I feel so much better now. I can sing a whole song now, and I don’t lose my breath.”

To reach the Smoking Cessation Program, call 315-464-3519 or email hankint@upstate.edu

Did you know?

— 80% of the lung cancers discovered through screening are early stage and mostly curable.

— 2% of people eligible for lung cancer screening undergo the test.

Cancer Care magazine fall 2019 issue coverThis article appears in the fall 2019 issue of Cancer Care magazine.

 

 

Posted in cancer, HealthLink on Air, lung/pulmonary, patient story, Smoking Cessation | Leave a comment

Pint-sized patient: Glimpses of a girl who fought cancer — and won

Kaylee Marshfield in a ball pit in February 2019, celebrating her seventh birthday. It was a happy occasion, unlike her sixth birthday, when she was diagnosed with cancer.

Kaylee Marshfield in a ball pit in February 2019, celebrating her seventh birthday. It was a happy occasion, unlike her sixth birthday, when she was diagnosed with cancer.

PHOTOS BY MARANIE STAAB/TEXT BY JIM HOWE

Kaylee Marshfield of Lakeland received unforgettable news on Feb. 1, 2018. It was her sixth birthday: She had cancer.

A strange lump led to tests that detected a Wilms tumor on her left kidney. It was the most aggressive subtype of this childhood cancer, and it would mean removal of the kidney, chemotherapy, radiation treatment and lots of hospital stays at Upstate.

During her treatment, Kaylee and her family volunteered for the Cans for Cancer drive at the New York State Fair and caught the eye of Maranie Staab. Staab, who is studying photography at Syracuse University, struck up a friendship with them and began taking pictures of Kaylee navigating life with cancer.

Kaylee completed her treatment in October 2018, and since then, she has shown no evidence of cancer, says her pediatric oncologist at Upstate, Irene Cherrick, MD.

As a second-grader this fall, Kaylee has resumed her old life and activities. Her hair has grown back, too.

“Kaylee is a special little human. I’m a bit biased, but I mean that. She is outspoken, intuitive, introspective and only 7 years old. It’s been a privilege to observe and get to know her,” Staab says.

This article appears in the fall 2019 issue of Cancer Care magazine.

photos of Kaylee Marshfield

Posted in cancer, chemotherapy, health care, kidney/renal/nephrology, medical imaging/radiology, patient story, surgery, Upstate Golisano Children's Hospital/pediatrics | Tagged , , | Leave a comment

Cancer Care magazine wins national award

Cancer Care magazine fall 2019 issue covercover of summer 2019 Cancer Care magazineCancer Care magazine spring 2019 coverCancer Care magazine winter 2019 coverUpstate’s Cancer Care magazine has received a 2019 Clarion Award, a national honor from the Association for Women in Communications. Cancer Care was named “Best Overall External Magazine” in the small-circulation category. The large -circulation winner was O, The Oprah Magazine.

This note appears in the fall 2019 issue of Cancer Care magazine.

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Catching lung cancer early through screening saves lives

lung cancer screening chart

This is one of a series of articles focusing on lung cancer.

Lung cancer screening saves lives —  and could save more, if more people submitted to the testing.

Of the lung cancers that are discovered through a lung cancer screening program, 80% are at an early stage — and most of those can be cured with surgery.

Compare that with the general population of people who discover they have lung cancer when they develop symptoms or have a chest X-ray for some other reason. Of those lung cancers, only about 15 percent are at an early, curable stage.

HealthLink on Air logo(Hear Upstate surgeon Jason Wallen, MD, discuss lung cancer screening, including who should get screened and how the process works, in this “HealthLink on Air” podcast.)

“We can save tens of thousands of lives, provided they get the screening and continue to get the screening,” says Leslie Kohman, MD, the medical director for the lung cancer screening program at Upstate. She says studies have proven how well screening works, using low-dose computed tomography, ror CT scans. Men whose cancers were discovered through screening had a 26% lower mortality rate than men who were not screened. The mortality rate for women is even better.

patient getting a scan

Low-dose CT scans help screen patients for lung cancer.

The ability to screen people for lung cancer has been available for about 10 years, and today the American Cancer Society recommends screenings for certain smokers and former smokers at high risk for lung cancer.

Just 2% of those eligible for lung cancer screening undergo the test, Kohman says. That’s two people out of 100.

And that’s the big reason more lung cancers aren’t caught early, she says. Those other 98 people are either unaware of screening, or they’re afraid — of radiation exposure, of the cost, of what happens if cancer is found.

Kohman addresses those fears:

  • The lung cancer screening scans use lower doses of radiation than are used for standard CT scans. “It’s like the amount of radiation you would get from the atmosphere if you flew in an airplane across the country,” she says.
  • Lung cancer screening requires a referral from a physician, but for eligible patients, it’s paid for by most health insurers, including Medicaid and Medicare.
  • If the radiologist detects something unusual in the lung scan, a biopsy may be required. Kohman explains that an experienced lung cancer screening program, such as Upstate’s, has a strong record of only recommending biopsies when they are necessary.

Upstate is a certified center of excellence for lung cancer screening and has offered the test for the last decade.

Do you have symptoms?

Lung cancer screening is for people at high risk for developing lung cancer who do not have symptoms. Someone who has symptoms – including persistent cough, hoarseness, shortness of breath, coughing up blood, unexplained weight loss, or chest pain that worsens when you take a deep breath – may need a diagnostic scan, which is similar. Kohman urges people to bring symptoms to the attention of their primary care doctor.

A point to consider

“We don’t completely understand the biology of this, but we know there are distinct differences in the biology of lung cancer in women versus men,” says Kohman. Lung cancer in men is probably present for about four years before it will show up on a scan; for women, it’s about six years.

Cancer Care magazine fall 2019 issue coverThis article appears in the fall 2019 issue of Cancer Care magazine.

 

 

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The ripple effect: What to know when your prostate cancer is hereditary

Gloria Morris, MD, PhD (photo by Jim Howe)

Gloria Morris, MD, PhD (photo by Jim Howe)

Upstate medical oncologist Gloria Morris, MD, PhD, who specializes in cancer risk assessment and genetic testing for hereditary cancers, answers six important questions about prostate cancer:

What percentage of prostate cancers are hereditary?

“Only a very small percentage of all cancers are hereditary.

“Even though prostate cancer is among the most commonly diagnosed cancers in men — analogous to breast cancer being the most common in women — only 10 percent of men with aggressive forms of prostate cancer may have a hereditary component. That is, they may have inherited the predisposition to develop prostate cancer by inheriting a gene mutation, which can also overlap to cause a predisposition for breast cancer.”

Since the genetic connection between breast and prostate cancers became evident in recent years, genetic counselors now look at the cancer risk for both male and female family members of men with hereditary prostate cancer. She says, “when I see women with hereditary breast cancers, I always look around for its ripple effect. There could be other women or men in her family who could benefit from genetic testing.”

If you have a specific gene mutation, does that mean you will develop cancer?

“It does not mean that a person is doomed to develop prostate cancer or breast cancer,” Morris says.

Instead, she says someone who learns of a genetic mutation may need earlier and more frequent screening to stay ahead of any possible cancer development, especially if the person has a family history of cancer.

(Click here for a podcast where Gloria Morris, MD, PhD, discusses the hereditary factors involved in prostate cancer.)

How many genes are we talking about?

“Eight to 10 breast cancer genes are known to increase the risk of prostate cancer if that same mutation is passed on.

“The genes that have been identified in men who have aggressive prostate cancers actually are breast cancer genes,” she says. “BRCA2, for example, imposes up to a 7% lifetime chance of developing prostate cancer in men. The risk for breast cancer developing in a woman with that gene is much higher, anywhere from 40% to 80% over one’s lifetime.”

Who should consider genetic testing?

“A man who has several family members with prostate cancer or multiple family members with other possibly associated cancers — colon, ovarian and breast cancers all overlap to possibly elevate a prostate cancer risk.

“Through blood testing and/or saliva testing, we can send for DNA sequencing of the known hereditary prostate cancer genes.”

Morris says commercially available genetic test kits may only test for portions of genes and may not target the ones most relevant to an individual. Instead, she recommends seeking care at an established clinical genetics program.

The program at the Upstate Cancer Center accepts referrals directly from patients or from primary care providers.

Are mutations passed on to children?

“In our numbered pairs of chromosomes, we inherit — usually — one copy that is normal from one parent, and one copy that might be mutated. When those chromosomes split, when we pass on half our genes to each child, there is a random 50/50 chance of passing on that mutation.”

The parents, children and siblings of a person with a hereditary form of prostate cancer are recommended to be tested for that mutation.

At what point should children be tested?

“For the gene mutations that could cause adult-onset cancers, we recommend testing anytime over the age of 21. There are a lot of psychological impacts of carrying a gene mutation. However, understanding the ramifications is a good idea.”

Cancer Care magazine fall 2019 issue coverThis article appears in the fall 2019 issue of Cancer Care magazine.

Posted in cancer, genetics, health care, men's health | Tagged | Leave a comment

Warmth, kindness and radiation, too

Radiation oncologist Paul Aridgides, MD, with Joan Gorton of Hamilton (photo by Robert Mescavage)

Radiation oncologist Paul Aridgides, MD, with Joan Gorton of Hamilton (photo by Robert Mescavage)

BY AMBER SMITH

It had been a rough 2019 for Joan Gorton of Hamilton.

Starting early in the year, the 83-year-old woman had a series of medical issues — a lingering cough, then a suspicious lump on her leg that had to be removed. She described feeling as if she were sitting on a brick, so doctors conducted an exam and a Pap smear. When the results came back, Gorton received a phone call. She had a rare cancer of the vulva.

She required surgery, followed by chemotherapy and radiation. Just when she thought she was done with her last radiation treatment, her radiation oncologist Paul Aridgides, MD, broke the news. He told Gorton she was going to need an additional week of radiation treatments. He hugged her.

That hug meant everything to Gorton.

In April, her surgeon had removed the affected tissue, along with 18 lymph nodes. Cancer was detected in one of the lymph nodes, Gorton’s daughter, Linda Gorton, explained. That’s why the surgeon was recommending chemo and radiation. “That’s how we got to know the incredible Dr. Paul,” Gorton says, using the physician’s nickname.

Her mother would need chemo every week and radiation every weekday for six weeks, in an effort to make sure the cancer was gone. They considered traveling from Hamilton to the Upstate Cancer Center. Then they learned of the Upstate Cancer Center satellite in Oneida. “That’s a half hour closer than going to Syracuse.”

Gorton says she and her mom were impressed with how Aridgides and the rest of the staff got to know her mother. Her treatment in Oneida began the week after the Fourth of July. Her seat was always waiting for her, with the warmed blanket she requested, the television tuned to HGTV, and a reassuring attitude from the technicians and staff.

“If you’re having a bad day, they  really help with the emotional side, too,” Gorton says. “What amazing, loving, caring people.”

She remembers one day when the power went out due to a storm.

“They just handled it. They were very much at ease, maintaining a calmness for those patients who are already a little bit on edge.”

The kindness, the hugs and the we-are-going-to-help-get-you-through-this attitude really helped her mother through a difficult time. She says Joan Gorton has since turned 84, and her recuperation continues.

Cancer Care magazine fall 2019 issue coverThis article appears in the fall 2019 issue of Cancer Care magazine.

 

 

 

Posted in aging/geriatrics, cancer, health care, medical imaging/radiology, patient story, women's health/gynecology | Leave a comment

Science Is Art: A genomic view of a disorder

ADHD genome chartA combination of genes and environmental factors triggers attention deficit hyperactivity disorder, according to researchers who identified 12 ADHD susceptibility genes.

They say genes account for roughly 76% of cases of ADHD.

Stephen Faraone, PhD

Stephen Faraone, PhD, in an interview with Upstate’s “HealthLink on Air” podcast and radio show (photo by Jim Howe)

“That does not mean that the environment is not important. We know that the environment accounts for the other 24%, but we also know that the environment interacts with some of those genes that are responsible for the 76% of the variability, so both genes and environment are important,” says Stephen Faraone, PhD, distinguished professor of psychiatry and behavioral sciences at Upstate. Continue reading

Posted in genetics, health care, research | Tagged | Leave a comment

Encouraging health care careers: Scholarship helps launch grads

Orthopedic surgeon Daryll Dykes, MD, PhD, JD, was the first Potts Prize recipient.

Orthopedic surgeon Daryll Dykes, MD, PhD, JD, was the first Potts Prize recipient.

The most recent recipient is pediatrician Windy Grant, MD.

The most recent recipient is pediatrician Windy Grant, MD.

Six are working in New York state, including one (Daryll Dykes, MD, PhD, JD) at Upstate. Many are at hospitals or private practices in the Northeast, although one is in California and three are in Houston. One (Nicole Alexander-Scott, MD) is the director of the Rhode Island Department of Health.

What they have in common: When each graduated from Upstate’s College of Medicine, he or she received a $500 prize established in honor of James L. Potts, MD, the first African-American member of Upstate’s clinical faculty.

After completing his cardiology fellowship, Potts joined Upstate in 1972. He directed the cardiac catheterization laboratory and initiated the echocardiography program, in addition to taking care of patients and teaching students. He left in 1994 to become chief of cardiology at his medical alma mater, Meharry Medical College in Nashville.

“He was an important role model for all students and residents,” Harold Smulyan, MD, said of Potts. Donations from cardiology fellows and hospital staff funded the Potts Prize.

The first award 25 years ago went to Dykes, an orthopedic surgeon who grew up in Syracuse and earned his medical degree and a doctorate at Upstate. Dykes went to the University of Minnesota in Minneapolis for further training in orthopedic, spine and trauma surgery and later joined the faculty there. He returned to Upstate as a faculty member in 2018.

The most recent winner, this year, was Windy Grant, MD, who is starting a pediatrics residency at Yale New Haven Hospital. She intends to care for children in her homeland, Haiti.

list of Potts Prize Winners

Upstate Health magazine fall 2019 coverThis article appears in the fall 2019 issue of Upstate Health magazine. Click here for the full online version of the magazine.

Posted in health care, history, medical education, medical student | Tagged ,

Encouraging health care careers: Retired doctor helps high schoolers see opportunity in hospital work

Stuart Trust, MD, leads tours for high school students interested in science and medicine. (photo by Richard Whelsky)

Stuart Trust, MD, leads tours for high school students interested in science and medicine. (photo by Richard Whelsky)

He retired a couple of years ago after 43 years practicing pediatrics, but Stuart Trust, MD, still works with youth.

Rather than providing medical care, he now provides medical inspiration.

He meets with small groups of teens who have expressed interest in science or medicine. He provides a personal tour of the children’s hospital and answers questions about career options.

“I explain that the health care field is wide open. It’s inclusive and diverse,” he says. “Whatever you do, you can earn a good living — and you’ll get to help other people.”

Here are three health care careers that high school students might consider:

•Apply to an associate’s degree program in nursing.

At the same time, apply for early admission to the College of Nursing at Upstate. (Upstate provides further education for registered nurses, who often work while earning their Bachelor of Science in Nursing.) Provided you maintain good grades, you have guaranteed admission to Upstate’s RN-to-bachelor’s program.

•Through a 2 + 2 program in Upstate’s College of Health Professions, you can attend two years of college — often a community college — and then transfer to Upstate for your junior and senior years. Upstate offers six programs through which you can earn a bachelor’s degree in this way: medical biotechnology, medical imaging sciences/X-ray, medical imaging sciences/ultrasound, medical technology, respiratory therapy or radiation therapy. The advantage for students is in cost saving and a highly focused education.

•If you think medical school may be in your future, Upstate offers a master’s in medical technology. This rigorous one-year program gives students who have graduated from college the chance to strengthen academic, clinical and analytical skills. If you are accepted into this program, you are guaranteed an admissions interview at Upstate’s College of Medicine.

Learn more at upstate.edu/education

Upstate Health magazine fall 2019 coverThis article appears in the fall 2019 issue of Upstate Health magazine. Click here for the full online version of the magazine.

Posted in adolescents, health care, health careers

The power of vaccines: What we can learn from science – and a pioneering Upstate graduate

Paul Parkman, MD (inset, shown against a backdrop closeup of the rubella vaccine), graduated first in his class at Upstate in 1957. He became a pediatrician and virologist who helped isolate the rubella virus, develop the first widely applicable test for rubella antibodies and the first rubella vaccine. “With the exception of safe drinking water, vaccines have been the most successful medical interventions of the 20th century,” Parkman says. (Rubella vaccine photo courtesy of Sciencesourceimages. Photo of Paul Parkman courtesy of Archives and Special Collections, Upstate Medical University Health Sciences Library)

Paul Parkman, MD (inset, circa 1960), graduated first in his class at Upstate in 1957. He became a pediatrician and virologist who helped isolate the rubella virus (above, in a microscopic view), develop the first widely applicable test for rubella antibodies and the first rubella vaccine. “With the exception of safe drinking water, vaccines have been the most successful medical interventions of the 20th century,” Parkman says. (Rubella vaccine photo courtesy of Sciencesourceimages. Photo of Paul Parkman courtesy of Archives and Special Collections, Upstate Medical University Health Sciences Library)

BY AMBER SMITH

How do we know, for sure, that vaccines don’t cause autism?

“Science has a funny thing about absolutes. If you ask a scientist, ‘Can you say for sure?’ the scientist will say, ‘I can’t go beyond my data. But the data, which involves multiple studies and thousands of children, convincingly shows that it’s not associated. I believe it’s not associated,’” says Paul Parkman, MD.

Parkman, now 86, is a Weedsport native and Upstate graduate who helped isolate the rubella virus in the early 1960s, then developed an antibody test and vaccine. He started his career as a doctor at Walter Reed Army Medical Center and served as director of the Food and Drug Administration’s Center for Biologics Evaluation and Research from 1987 to 1990.

(Hear Paul Parkman, MD, describe the frightening epidemics of childhood diseases that existed when he was working toward a vaccine for rubella in the 1960s.)

In 2005, he gave an oral history at the National Institutes of Health in which he shared his worry of people who mistrust vaccines. He told the story of rubella, also known as German measles. It was thought to be a mild childhood disease, which had to be differentiated from the more serious rash-causing diseases of measles and scarlet fever. Only later did doctors learn that rubella caused pregnant women to miscarry or to deliver babies with severe congenital deformities.

Parkman remembers the last major rubella epidemic, in 1964. If a pregnant woman developed a rash, she would worry about the potential for miscarriage and whether her doctor would recommend abortion, so she would not deliver a baby damaged by the virus. Women feared the disease, with good reason.

Parkman says some parents today mistakenly believe they don’t need to have their kids immunized. Young adults today weren’t alive to remember previous epidemics.

“Maybe the immunization of all the other children in your neighborhood will protect you,” Parkman continues in the oral history, “but if you and the lady next door and the guy down the street decide not to be immunized, you’ll have a problem again, sure enough.”

Reading Parkman’s words today, he seems to have predicted the growing measles epidemic with which the United States is now grappling.

When Parkman was studying rubella viruses, the epidemics seemed to come in waves, every six to nine years. So with a rubella vaccine available in 1969, government leaders at the Division of Biologics Standards of the National Institutes of Health and the Centers for Disease Control and Prevention made some decisions that proved wise. They had to decide who got the vaccine first.

“We made the decision to use it in children 1 year of age, the first time when you really could get good antibody responses. Before that, the antibody response can be interfered with by maternal antibodies,” he explains. “So, you start immunizing at one year of age up until puberty.

“If you really push hard and get all those kids immunized, you’re going to stop the epidemics, because children are the ones who really spread the virus.

“And we did it. If you look at those epidemic curves, they bumped up and down every six to nine years. After 1969, no more big epidemics.”

An estimated 12.5 million Americans got rubella during the epidemic from 1964 to 1965, including 11,000 pregnant women who lost their babies, according to the CDC.

Once the vaccine was in widespread use, the number of people infected with rubella dropped. Today fewer than 10 Americans are reported with rubella each year.

Protection today

The MMR vaccine protects against measles, mumps and rubella. The Centers for Disease Control and Prevention recommends children receive two doses, the first between 12 and 15 months of age, and the second between 4 and 6 years of age.

Measles, mumps and rubella are contagious, viral childhood infections that can be avoided through vaccination.

Measles can be serious, even fatal. Measles outbreaks have been reported across the United States, with the majority of cases occurring in people who have not been vaccinated.

Mumps causes swelling in the glands that produce saliva, and complications can lead to hearing loss. Mumps was common in the United States until vaccination became routine.

Rubella (German measles) is usually not as severe as measles, and its symptoms are generally so mild they may be difficult to notice, especially in children. The virus can cause fetal death or serious birth defects if contracted by a woman who is pregnant. The CDC declared rubella eliminated in the United States but cautions that children need to be vaccinated to prevent its re-emergence.

Upstate Health magazine fall 2019 coverThis article appears in the fall 2019 issue of Upstate Health magazine. Click here for the full online version of the magazine.

Posted in health care, HealthLink on Air, history, infectious disease, prevention/preventive medicine, public health, research, Upstate Golisano Children's Hospital/pediatrics | Tagged , , ,