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Stigma and shame block mental health treatment in Black community

As Dr. Sarah Vinson rotated through her first year of clinical work as a Child Psychiatry Fellow in the Department of Psychiatry and Behavioral Sciences at Emory, she quickly became aware that there are some significant roadblocks in getting people in the African-American community engaged in treatment for mental health problems.

Sarah Vinson, MD, Department of Psychiatry and Behavioral Sciences

“Misinformation, an absence of trust in the system, racism and financial circumstances are some of the forces that can create barriers in making appropriate decisions about seeking treatment,” says Vinson.

In order to take a step toward resolving the problem, Vinson created an online mental health outreach program targeting the Black community. The website serves as an anonymous resource for patients and their families, or anyone who is interested in finding out more about mental illness.

This user-friendly online program provides educational materials, offers links to professional organizations, lists mental health professionals and provides descriptions of different types of mental illnesses as they relate specifically to African-Americans. The website also includes an interactive forum where people can share experiences.

“The Black community’s traditional reluctance to discuss mental health and illness comes at much too high a cost,” says Dr. Vinson.

“People may be fearful of being misjudged by their churches and families, so they don’t discuss their problems,” she explains. “However, it is the support of family and friends that is largely responsible for a successful course of treatment; particularly when it comes to children and adolescents, or people with severe mental illness. Regrettably, when people access care without reinforcement from their loved ones, they often drop out before they are better.

“Untreated, mental illness can cause strained relationships, social dysfunction, and numerous other problems that can end up in divorce, unemployment, and suicide.”

Dr. Vinson is the recipient of an American Psychiatric Association/Substance Abuse and Mental Health Services Administration Fellowship, which provides funds for programming related to minority mental health.

Posted on by Kathi Baker in Uncategorized Leave a comment

Emory Cardiologist Helps Rank Top Diets

Laurence Sperling, MD

It’s a new year and shedding pounds is at the top of the resolution list for many Americans. To help dieters lose weight and jump start healthier eating habits, Emory Heart & Vascular Center cardiologist Laurence Sperling, MD served on a U.S. News & World Report panel evaluating some of the country’s most popular diets.

The rankings, released today, include U.S. News’ second annual list of Best Diets, featuring its first-ever ranking of Easiest Diets to Follow. It includes six other rankings first assessed and published in 2011: Best Diets Overall, Best Commercial Diet Plans, Best Weight-Loss Diets, Best Diets for Healthy Eating, Best Diabetes Diets, and Best Heart-Healthy Diets.

According to U.S. News, dieters who choose a diet at or near the top of the new Easiest Diets to Follow list are more likely to succeed in staying on their diet for the long haul. Weight Watchers took the top spot on that list, followed by Jenny Craig, the Mediterranean Diet, Slim-Fast and Volumetrics.

The five new diets added for 2012 are the Abs Diet, Biggest Loser Diet, Dukan Diet, Flat Belly Diet, and Macrobiotic Diet.

Big winners across the rankings included:

  • DASH Diet: ranked #1 in Best Diets Overall, Best Diets for Healthy Eating, and Best Diabetes Diets (tie)
  • Weight Watchers: ranked #1 in Best Weight-Loss Diets, Best Commercial Diet Plans, and Easiest Diets to Follow
  • Biggest Loser Diet: ranked #1 in Best Diabetes Diets (tie)
  • Ornish Diet: ranked #1 in Best Heart-Healthy Diets

To create the rankings, U.S. News turned to Sperling and the same 22 experts for Best Diets 2012 as it did for Best Diets 2011. The panel, which included nutritionists, dietitians, cardiologists and diabetologists, reviewed 25 popular diet profiles that were developed by reporters and editors at U.S. News.

“I can’t say enough about their commitment and hard work,” said Avery Comarow, U.S. News Health Rankings Editor. “They enabled us to provide meaningful, evidence-based rankings.”

Sperling is a professor of medicine at Emory University School of Medicine and director of Emory’s Center for Heart Disease Prevention.

For a complete list of the new diet rankings, please visit:

http://health.usnews.com/best-diet

 

Posted on by Jennifer Johnson in Uncategorized 2 Comments

Esophageal lesions meet their match

Field Willingham, MD, MPH

Once esophageal tumors establish themselves, a patient’s prognosis is grim and morbidity vast. But when lesions are caught early and removed, especially in the premalignant stage, the odds of survival markedly improve.

When a case calls for it, Emory gastroenterologist Field F. Willingham, MD, MPH, uses a hybrid approach to ousting superficial esophageal lesions. Superficial esophageal lesions are commonly caused by acid reflux disease, or GERD. GERD occurs when stomach acid flows into the esophagus and can lead to a condition known as Barrett’s esophagus, where the cells in the lower esophagus become damaged. This in turn can lead to dysplasia, or pre-cancerous cells.

But for superficial cancers, it is now possible to remove a portion of the lining layer of the GI tract, containing the tumor, with an endoscope.  This can help carefully selected patients avoid a major surgery. The technique, known as an EMR, allows the removal of superficial esophageal tumors and pre-cancer with an endoscope, a slender tube-like instrument.

Detecting and removing esophageal tumors early is essential for a favorable outcome. Once tumors firmly establish themselves in esophageal tissue, the prognosis is grim and morbidity vast. In the past, a diagnosis of an esophageal tumor meant the removal of the esophagus and often the stomach. But now EMR can be used in tandem with radio frequency ablation.

In surgical situations in which radio frequency ablation is not feasible, Willingham and his colleagues are beginning to use an alternate technique, known as cryotherpay, in tandem with EMR. Cryotherapy involves freezing superficial cells to rid the esophagus of suspect cells.

“So, if the end of the esophagus is twisted, or if we can’t touch it with this balloon device, then we can use cryotherapy,” says Willingham. “We’re trying to kill the lining layer with the tumor cells without killing the deeper layer.”

Willingham and his colleagues are seeing evidence that using these very three very different, technologies in tandem or alone will provide patients with a better way to rid them of esophageal lesions while preserving their quality of life.

Posted on by Robin Tricoles in Uncategorized Leave a comment

Smoking’s reach – and risk – even broader than we thought

Smoking’s link to lung cancer has been well-known for decades, but we are still learning about its cancer-causing effects on other organs.

An article in the Journal of the American Medical Association (JAMA) provides solid epidemiological evidence that smoking’s link to bladder cancer is even higher than previously believed. And, the elevated risk factor appears to be the same for men and women.

Viraj Master, MD, PhD

“This is something I see in my practice every day,” says Viraj Master, associate professor of urology, Emory School of Medicine and director of urology clinical research at the Winship Cancer Institute of Emory University. “The dangers of smoking are pervasive. Patients are often surprised to hear of the link between smoking and bladder cancer, but it’s there, and it’s a very real risk.”

The bladder may not be the first organ you think about when you think about the harmful effects of cigarette smoking. After all, when a person inhales cigarette smoke, the mouth, throat and lungs are the primary destination. But, a lethal change in the composition of cigarettes makes the bladder a target for cancer.

Written by researchers at the National Cancer Institute, the study explains that while there is less tar and nicotine in cigarettes now that in years passed, there also has been “an apparent increase in the concentration of specific carcinogens,” including a known bladder cancer carcinogen and tobacco-specific nitrosamines. The study authors also note that epidemiological studies have observed higher relative risk rates associated with cigarette smoking for lung cancer.

“The take-home message, of course, is the same as it long has been – don’t start smoking, and if you do smoke, stop,” says Master. “We need to do everything in our power to both stop people from starting to smoke and to help those already addicted to stop.”

Posted on by Kerry Ludlam in Uncategorized Leave a comment

Brain tumor patient gives back and moves forward

Jennifer Giliberto

Don’t sweat the small stuff.

That’s the motto 36-year-old Jennifer Giliberto now lives by after recently welcoming a third child into the world. Late night feedings, diaper changes, mounds of dirty laundry and caring for two older boys (ages six and eight) would certainly be a challenge for most moms. But this mom is different.

Four years ago, Giliberto was diagnosed with a brain tumor – a slow growing Grade II astrocytoma located in her posterior right temporal lobe. The shocking diagnosis left Giliberto and her family with many choices and decisions to make.

Giliberto’s inspiring story was profiled on CNN on Aug. 16, 2011 in a special “Human Factor” segment, which takes a look at people accomplishing something significant after overcoming the odds.

The Long Road Ahead

After her second child was born in 2005, Giliberto began noticing a pattern of problems with her fine motor skills. Neurological testing revealed little, but an MRI (magnetic resonance imaging) revealed a lesion and possible tumor in the brain. Follow-up MRIs over the next year showed no new growth, but in June 2007, a definite brain tumor was detected by MRI.

While taking the watch and wait approach to determine if the tumor would grow, she became involved with the Southeastern Brain Tumor Foundation (SBTF) as a volunteer. She focused her efforts on raising money to support critical brain and spinal tumor research. She also met Emory neurosurgeon Costas Hadjipanayis, MD, PhD.

Hadjipanayis, an assistant professor in Emory’s Department of Neurosurgery, would soon become Giliberto’s physician. He confirmed her diagnosis and recommended surgical removal of the tumor.

Costas Hadjipanayis, MD, PhD and patient Jennifer Giliberto

On August 18, 2008, at Emory University Hospital Midtown, Hadjipanayis removed Giliberto’s brain tumor. “Jennifer underwent a craniotomy and had a gross total resection of the tumor, with no complications,” explains Hadjipanayis, who is chief of neurosurgery at the hospital. “She spent one night in the neurosurgical ICU and her recovery afterwards went well.”

Then he encouraged her to embrace life and live it to the fullest. Giliberto has taken her doctor’s orders to heart, and lives life with a new purpose than before.

Giving Back

To support and encourage other brain tumor patients, Giliberto serves as a patient and family advisor at Emory University Hospital Midtown. She visits with hospitalized patients and their families who are in similar situations as the young mother of three.

“This has been a very fulfilling experience and an outlet to give back,” says Giliberto. “Being a patient is lonely, even when you know you have support. Working to assist other patients and families and improve a system goes a long way to ease that lonely journey of the patient experience.”

Patient and family advisors also work to improve hospital processes and procedures from a patient perspective.

She also serves as vice president of the Southeastern Brain Tumor Foundation, continuing the mission to raise funds for research. The SBTF consistently funds innovative brain tumor research at Emory’s Winship Cancer Institute.

And she is a devoted wife and mother.

Moving Forward

Last year, when Giliberto and her husband decided they would like to expand their family of four, she consulted with Hadjipanayis. He, once again, encouraged her to live life and move forward. They did, and their youngest child was born in July 2011.

While Giliberto has remained stable since her surgery in 2008, she continues to have MRI’s every six to nine months to check for any tumor recurrence. Astrocytomas, even once removed, can recur and can also become cancerous.

But for now, it’s on with life as she knows it – stable, moving ahead and enjoying every day with a new sense of hope.

And as for the small stuff – Giliberto’s learned there’s just no reason to sweat it at all.

Posted on by Janet Christenbury in Uncategorized 2 Comments

Americans cutting sugar – but it’s still not enough

In America’s battle against obesity, there is some good news. According to a study conducted by Emory researchers, Americans consumed nearly a quarter less added sugars in 2008 than they did 10 years earlier.

The study, published in the American Journal of Clinical Nutrition in July 2011, found that the consumption of added sugars, such as those found in sodas, sports drinks, juices and sweetened dairy products, decreased among all age groups over a decade. The largest decrease came in the consumption of sodas, traditionally the largest contributor to added sugar consumption, according to Jean Welsh, MPH, PhD, RN, study author and post-doctoral fellow in pediatric nutrition at Emory University School of Medicine.

“While we were hopeful this would be the case, we were surprised when our research showed such a substantial reduction in the amount of added sugar Americans are consuming,” said Welsh. “We’re hopeful this trend will continue.”

So, why the change? One of Welsh’s partners in the study, Miriam Vos, MD, MSPH, an assistant professor of pediatrics in the Emory University School of Medicine, and a physician on staff at Children’s Healthcare of Atlanta, attributes much of the shift to public education.

“Over the past decade, there has been a lot of public health awareness about obesity and nutrition, and I think people are starting to get the message about sugar,” says Vos. “We’re not trying to send a message that sugar is inherently bad. It’s more that the large amounts of sugar we consume are having negative effects on our health, including increasing our risk of obesity, diabetes and cardiovascular disease.”

The study interpreted data of 40,000 people’s diets collected by the Centers for Disease Control and Prevention (CDC) over 10 years.  From the surveys, researchers were able to calculate how much added sugar – that is sugar that is not originally part of a food – that Americans are consuming. In 1999-2000, the typical person’s daily diet included approximately 100 grams of added sugar, a number that had dropped to 77 grams by 2007 and 2008.

While the study shows that the amount of added sugar Americans are consuming is lower, it doesn’t mean the amount is low enough.

“The American Heart Association recommends that we get about five percent of our calories from added sugars,” says Vos. “In 1999 to 2000, people were consuming about 18 percent of their calories from added sugars. Over 10 years, that amount decreased to 14.5 percent of our daily calories, which is much better. But, clearly, 14.5 percent is still three times more than what is considered a healthy amount. We’re on the right track, but we still have room for improvement.”

Posted on by Kerry Ludlam in Uncategorized Leave a comment

Sunscreen: Looking Beyond the Numbers

Carl Washington, MD

Seems pretty obvious – if a sunscreen with an SPF of 30 is good, then an SPF of 100 should be at least three times as good.

Unfortunately, that is not the case.  There are other important details to consider when you are purchasing a sunscreen.

“People have become much more educated about the importance of using sunscreen, and manufacturers have responded with an abundance of products,” says Carl Washington, MD, associate professor of Dermatology at Emory University School of Medicine. “Unfortunately, the labeling can be confusing and many of the current sunscreens only contain the ingredients necessary to offer protection against sunburn, but not skin cancer or aging.”

Recently, the Food and Drug Administration created new regulations to establish standards for sunscreen manufacturers to follow before they label their products.

Under the new regulations, which will go into effect in 2012, sunscreen products that protect against all types of sun-induced skin damage will be labeled “broad spectrum” and “SPF 15” or higher on the container. Only products that have been tested to ensure they protect against both UVA (ultraviolet radiation A) and UVB (ultraviolet radiation B) radiation will be allowed to use this labeling.  Broad-spectrum sunscreens of SPF 15 and higher can also be labeled as protective against skin cancer and premature aging. The maximum SPF value is set at 50-plus because the FDA says anything higher doesn’t provide a significant amount of additional protection.

Manufacturers will have to include warning labels on products that are not broad spectrum. Products that claim to be water resistant must indicate how long the consumer should expect to be protected in the water, and using such language as “waterproof” or “sweat proof” will not be allowed.

“Skin cancer is the most common form of cancer in the United States, and the number of people affected keeps rising. Simply getting into the habit of using a sunscreen every day – with the appropriate levels of protection – can make a significant difference in preventing many skin cancers, as well as premature aging,” says Washington.

“These new regulations will help consumers understand the difference in degrees of sun protection, and choose carefully.”

Washington also suggests staying out of direct sunlight between 10 am and 2 pm, seeking shade when you are outdoors, remembering to reapply sunscreen every two hours and wearing protective clothing.

Posted on by Kathi Baker in Uncategorized Leave a comment

Emory Cardiologist Weighs in on U.S. News Diet Ranking

 

Laurence Sperling, MD

U.S. News & World Report recently announced the results of its first-ever Best Diets rankings evaluating some of the country’s most popular diets.

Emory Heart & Vascular Center cardiologist Laurence Sperling served on a panel of 22 health experts selected by U.S. News to help develop the rankings. Sperling is the medical director of the Emory Heartwise Risk Reduction Program and professor of medicine at Emory University School of Medicine.

Sperling and his panel colleagues reviewed information about 20 well-known diets, from Atkins to Zone, and rated each one on specific measures such as safety, easiness to follow and nutritional completeness.

Using the experts’ ratings, U.S. News developed five diet categories to address a broad range of consumers’ dieting goals and needs including Best Diabetes Diets, Best Heart Diets, Best Weight Loss Diets and Best Overall. “The goal of the Best Diets rankings is to help consumers find authoritative guidance on healthful diets that will work for them over the long haul,” said Lindsay Lyon, U.S. News‘s Health News Editor.

Weight Watchers ranked first in the Weight Loss category. Tied for number two were Jenny Craig and the Raw Food Diet, an approach that challenges dieters to avoid foods that have been cooked.

The government-endorsed DASH Diet took the top spot as the best diet overall. Three diets tied at number two, excelling in all measures U.S News considered: the Mediterranean Diet, the TLC Diet, and Weight Watchers.

For a complete list of the new diet rankings, please visit:

http://health.usnews.com/best-diet

Posted on by Jennifer Johnson in Uncategorized Leave a comment

Fat distribution in black and white women may help predict heart disease

A woman’s body shape – often described as pear, apple or hourglass – is usually determined by the amount of fat in various regions of the body including the bust, waist, arms and hips. New research from Emory University School of Medicine suggests that these patterns of fat distribution may help predict arterial stiffness – a precursor to cardiovascular disease.

Stiff arteries make the heart work harder to pump blood and are associated with atherosclerosis, or the buildup of plaques in vessels that can block blood flow and cause a heart attack.

Noting that fat distribution generally differs between black and white women’s bodies, researchers enlisted 68 black women and 125 white women, all middle-aged, to see whether these patterns could help assess cardiovascular risk.

The study, conducted by Danny Eapen, MD, a cardiology fellow at Emory, used data from Emory’s Center for Health Discovery and Well Being. He presented his findings recently at the American Heart Association’s Arteriosclerosis, Thrombosis, and Vascular Biology 2011 meeting.

Using skin calipers, the researchers measured subcutaneous fat in seven sites: the upper chest; midaxillary, or the side of the torso just under the armpit; triceps, or the back of the arm; subscapular, or on the back just below the shoulder blade; abdominal; suprailiac, or just above the front of the hip bone; and the thigh.

“Black women have higher rates of cardiovascular disease than white women and are more likely to die from it,” says Eapen. “Black and white women also have different patterns of fat distribution, so we were interested in measuring these pockets of fat at various regions of the body to evaluate whether it might be helpful in predicting cardiovascular risk between the two groups.  Our hope was to evaluate whether a quick, easy-to-use clinical tool could aid in further risk stratifying our female patients.”

The study also assessed the arterial stiffness of the women, adjusting for heart rate.

As a group, the black women had greater arterial stiffness than the white women. They also had more subcutaneous fat in the armpit, triceps, shoulder blade and hip bone areas.

In addition, they also found specific race dependent pockets of fat that could be related to arterial stiffness – fat measurements in the triceps area could predict increased arterial stiffness in black women, while fat in the suprailiac areas was a predictor in white women.

Content contributed in part by Sarah Goodwin, Emory’s Center for Health Discovery and Well Being.

Posted on by Holly Korschun in Uncategorized Leave a comment

Healthcare Heroes at Emory

Healthcare Heroes award winners Dean Thomas Lawley and Dr. Ursula Kelly

This week’s issue of the Atlanta Business Chronicle spotlights the winners of its annual Healthcare Heroes Awards, recognizing the contributions of top medical professionals in the Atlanta health care community. Emory was well represented again this year among the impressive list of winners and finalists. Winners included:

 

Finalists included:

 

  • Linda Cendales, MD, assistant professor of Surgery at Emory University School of Medicine, nominated in the Healthcare Innovations category for successfully performing the state’s – and one of the nation’s – first hand transplants on a college student from Orlando, Fla. (see Emory article)
  • Katherine L. Heilpern, MD, professor and chair of the department of emergency medicine, nominated in the Physician category for her contributions to emergency and trauma care and for her leadership among 5 hospitals in Metro Atlanta which receive 250,000 patient visits per year.
  • Curtis Lewis, MD, assistant professor of radiology, Emory University School of Medicine, nominated in the Physician category for his management and training of physicians and residents in his role as chief of staff and senior vice president of medical affairs at Grady.

 

 

Posted on by Jennifer Johnson in Uncategorized Leave a comment
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