Researchers at Emory studying lung transplantation have identified a marker of inflammation that may help predict primary graft dysfunction (PGD), an often fatal complication following a lung transplant.
â€œDespite major advances in surgical techniques and clinical management, serious lung transplant complications are common and often untreatable,â€ Pelaez says. â€œPGD is a severe lung injury appearing just a few days after transplantation. Unfortunately, predicting which lung transplant recipients go on to develop PGD has been so far unsuccessful. Therefore, our research has been directed towards identifying predictive markers in the donor lungs prior to transplantation.â€
Nursing senior Ivey Milton (left) checks on a patientâ€™s medication, guided by Jackie Kandaya, her medical-surgical instructor at Emory University Hospital Midtown
A first at Emory and in Georgia, the DEU is based on the model implemented by the University of Portland School of Nursing and its clinical partners in the early 2000s.
Kelly Brewer, who holds a joint appointment with the School of Nursing and Emory Healthcare as DEU coordinator, says, â€œOur DEU initiative relies on these concepts and the skills of nurses and faculty to help students transition into the real world of nursing. Itâ€™s a win-win situation for both sets of professionals since faculty and clinical nurses are in short supply because of the nursing shortage.
â€œBoth of our hospitals are committed to making students feel that they are part of the unit so theyâ€™ll want to work there after they graduate,â€ she adds. â€œThey will already have a sense of what Emoryâ€™s health care system is about, and their transition into the real world of health care will be less stressful.â€
Little is known about the exposure of infants to pesticides, despite their vulnerability and evidence of widespread dietary exposure among older children and adults. A study led by Emory Rollins School of Public Health researchers P. Barry Ryan, PhD, and Anne Riederer, ScD, seeks to improve methods for measuring pesticides in breast milk and infant formula.
â€œWe really donâ€™t know about how babies are exposed to pesticides in their everyday life,â€ says Riederer, assistant research professor, Department of Environmental and Occupational Health. â€œThere are very few published studies on this topic, and weâ€™d like to be one of the groups that actually publishes an analytical method that can be used by researchers in any country to be able to detect these different types of pesticides in breast milk.â€
Although the breast milk method will be pilot tested on samples collected from a birth cohort in Thailand, it will have broad applications for the U.S. population. Insight Pest Control Wilmington says that because these pesticides are widely distributed in the food supply, all U.S. infants are potentially exposed.
Javed Butler, MD, MPH, director of heart failure research at Emory Healthcare and associate professor of medicine at Emory University School of Medicine, says heart failure is any condition in which the heart is unable to pump enough blood for the metabolic needs of the body, but that does not mean that the heart is not pumping or the heart has stopped working.
Heart disease is not a disease but a syndrome, so a whole family of different diseases can precede this condition. Diabetes, obesity, heart valve problems, lung disease, heart attack and irregular heartbeats are only some factors that can cause heart failure. “Pinning down the roots of heart failure can be confusing,” says Butler, who serves as deputy chief science advisor for the American Heart Association. “Unlike some heart problems, heart failure is not one disease. It has a few common causes, and a few less common, even rare, causes.”
Finding new ways to identify people at risk for developing heart failureâ€”before damage is doneâ€”is his raison d’etre and primary research focus, according to Emory Medicine magazine.
Macular degeneration is the leading cause of sight impairment and blindness in older people. The macula, in the center of the retina, is the portion of the eye that allows for the perception of fine detail. AMD gradually destroys a personâ€™s central vision, ultimately preventing reading, driving, and seeing objects clearly
In a recent article of Emory Magazine, Ono, an ocular immunologist, says, â€œIf a person with AMD looks at graph paper, some of the lines will be wavy instead of straight. Certain parts of the image are no longer being transferred to the brain.â€
The palliative care program at Emory University is working to improve quality of life and wellness by addressing the physical, psychological, ethical, spiritual and social needs of patients with serious, life-threatening or progressive chronic illnesses, and provides support to their families and caregivers.
Tammie E. Quest, MD
Often mistakenly confused with hospice care, palliative care is appropriately provided to patients in any stage of serious illness – whereas hospice care is primarily used for those approaching the end stage of life, says Tammie Quest, MD, interim director of the Emory Center for Palliative Care.
A typical palliative care “team” consists of physicians, nurses, social workers, chaplains, mental health professionals, therapists and pharmacists, assisting patients through a wide array of illnesses, including stroke, heart and lung disease, cancer and HIV.
The palliative care teams work closely with primary physicians to control pain, relieve symptoms of illnesses – such as nausea, fatigue and depression. Teams help provide counseling in making difficult medical decisions and provide emotional and spiritual support, coordinate home care referrals and assist with identifying future care needs.
For adult organ transplant recipients, juggling a lifetime regimen of immunosuppressant drugs is difficult enough, but for children it presents an even greater challenge.Â These drugs, which also can have toxic side effects, must strike a delicate balance between preventing organ rejection and protecting from infections.
But childrenâ€™s immune systems are still â€œlearningâ€ what distinguishes them from the world around them, and children are constantly developing and changing, both physically and emotionally. This puts them at greater risk for complications either through inappropriate medication or failure to take these drugs properly.
The ARRA-funded project will not only help determine which medications children should take, but also will give them the support to care for their transplanted organs.Â The Emory scientists are studying new biological monitoring technologies that can identify unique ways to determine exactly how much medication a child really needs. These studies are being combined with a novel transition care clinic specializing in helping children cope with their illness and assuming responsibility for their care.
â€œThis award indicates exceptional insight by the NIAID into the critical link between a childâ€™s physical well-being and their emotional maturity,â€ says Kirk. â€œIt will accelerate progress in this vital area of research for a very deserving subset of chronically ill children.â€
Emory University Hospital is one of about 20 hospitals nationwide, and the only site in Georgia, to study this new technology – with 75 patients receiving new valves at Emory since the clinical trial started in October 2007. Researchers hope to receive U.S. Food and Drug Administration approval in late 2011.
The life threatening heart condition affects tens of thousands of Americans each year when the aortic valve tightens or narrows, preventing blood from flowing through normally.
Peter Block, MD
Peter Block, MD, professor of medicine, Emory School of Medicine, and colleagues are performing percutaneous aortic valve replacement as part of a Phase II clinical trial, comparing this procedure with traditional, open-heart surgery or medical therapy in high-risk patients with aortic stenosis.
The procedure provides a new way for doctors to treat patients who are too ill or frail to endure the traditional surgical approach.
During the procedure, doctors create a small incision in the groin or chest wall and then feed the new valve, mounted on a wire mesh on a catheter, and place it where the new valve is needed.
Although African Americans make up a significant share of HIV cases in the U.S., they are underrepresented in HIV clinical trials. New research shows that promotion of HIV clinical trials and participation by African Americans can be increased by coalitions that link community organizations to clinical-research institutions.
â€œCommunity organizations already have built trusting relationships in their communities,â€ saysÂ Paula Frew, PhD, assistant professor of medicine at Emory School of Medicine. â€œIf HIV/AIDS prevention and HIV clinical research become part of the agendas of these organizations, they can become ideal allies for increasing participation by community members who are at risk for disease.â€
This conclusion comes from a 10-year history of coronary bypass patients at Emory recently published in the Annals of Thoracic Surgery.
Puskas also recently presented long-term follow-up data from the first randomized U.S. trial to compare off-pump with conventional on-pump surgery.
The results from the landmark SMART (Surgical Management of Arterial Revascularization) study, which started in 2000, show that participants who had the off-pump procedure lost less blood, had less damage to their hearts during surgery and recovered more quickly than those who underwent on-pump surgery.
Beating-heart patients in the study also were able to breathe on their own sooner after surgery, spent less time in intensive care and left the hospital one day sooner, on average, than conventional coronary bypass patients.