Warren symposium follows legacy of geneticist giant

If we want to understand how the brain creates memories, and how genetic disorders distort the brain’s machinery, then the fragile X gene is an ideal place to start. That’s why the Stephen T. Warren Memorial Symposium, taking place November 28-29 at Emory, will be a significant event for those interested in neuroscience and genetics. Stephen T. Warren, 1953-2021 Warren, the founding chair of Emory’s Department of Human Genetics, led an international team that discovered Read more

Mutations in V-ATPase proton pump implicated in epilepsy syndrome

Why and how disrupting V-ATPase function leads to epilepsy, researchers are just starting to figure Read more

Tracing the start of COVID-19 in GA

At a time when COVID-19 appears to be receding in much of Georgia, it’s worth revisiting the start of the pandemic in early 2020. Emory virologist Anne Piantadosi and colleagues have a paper in Viral Evolution on the earliest SARS-CoV-2 genetic sequences detected in Georgia. Analyzing relationships between those virus sequences and samples from other states and countries can give us an idea about where the first COVID-19 infections in Georgia came from. We can draw Read more

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Mammography can save lives by following ACS guidelines

The recent recommendation issued by the U.S. Preventive Services Task Force to revise screening mammography guidelines has generated considerable confusion and worry among women and their loved ones, says Carl D’Orsi, MD, FACR, director of the Emory Breast Imaging Center.

Carl D'Orsi, MD

Carl D’Orsi, MD

D’Orsi says he is counseling women who are concerned about mammograms and deciding what screening schedule to follow that they should use the long-established American Cancer Society guidelines: annual screening using mammography and clinical breast examination for all women beginning at age 40.

The recent recommendations by the task force advise against regular mammography screening for women between ages 40 and 49. It suggests that mammograms should be provided every other year (rather than yearly) for women between ages 50 and 74, and then breast cancer screening in women over 74 should be discontinued. Some individuals may also consider including a breast ultrasound package for a more comprehensive screening approach.

Mammography is not a perfect test, but it has unquestionably been shown to save lives, says D’Orsi, professor of radiology and of hematology and oncology in the Emory’s School of Medicine, and program director for oncologic imaging at Winship Cancer Institute of Emory. Since the onset of regular mammography screening in 1990, the mortality rate from breast cancer, which had been unchanged for the preceding 50 years, has decreased by 30 percent.

Winship Cancer Institute of Emory University

Winship Cancer Institute of Emory University

These new recommendations – which are based on a review that did not include experts in breast cancer detection and diagnosis – ignore valid scientific data and place a great many women at risk, continues D’Orsi.

Ignoring direct scientific evidence from large clinical trials, notes D’Orsi, the task force based its recommendations to reduce breast cancer screening on conflicting computer models and the unsupported and discredited idea that the parameters of mammography screening change abruptly at age 50.

The task force commissioned their own modeling study and made recommendations in reliance on this study before the study had ever been published, made public or held to critical peer review, and did not use both randomized, controlled trials and already-existing modeling studies, explains D’Orsi.

If Medicare and private insurers adopt these flawed recommendations as a rationale for refusing women coverage of these life-saving exams, it could have deadly effects for American women, says D’Orsi.

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Sanjay Gupta shares stories on near-death experiences

Yesterday, Sanjay Gupta, MD, assistant professor of neurosurgery at Emory School of Medicine and associate chief of neurosurgery service at Grady Memorial Hospital, joined Emory and its community in a book-signing event to celebrate his newest book Cheating Death: The Doctors and Medical Miracles that Are Saving Lives Against All Odds.

Dr. Gupta signs his book

Dr. Gupta signs his book

It is hard to imagine having a busier schedule than the one Gupta has. On Wednesday he started his day as chief medical correspondent at CNN by discussing the new breast cancer recommendations issued by the U.S. Preventive Services Task Force. He, like other health reporters and doctors across the nation, had hundreds of questions pouring in about the controversial recommendations.

As the late afternoon approached, Gupta packed up for his visit to Emory where several hundred faculty, staff, students and neighbors awaited him for the book-signing event. After spending time presenting and answering questions, and then signing books for many people, Gupta again packed up and headed back to the CNN studio for a live show with Larry King.

Dr. Gupta presents

Dr. Gupta presents

During his presentation at Emory, Gupta talked about his experiences that led to his book. He notes one CNN story took him to Norway to meet the woman who had been skiing and slipped through a hole in the ice with her head caught under freezing water for an hour.

After an amazing rescue, Anna BÃ¥genholm was taken to the emergency room where the doctors did not give up. A doctor on the helicopter said there was a completely flat line. No signs of life whatsoever. But the team persevered and saved her life by warming her body very slowly. Even though BÃ¥genholm was alive, months of recovery lay ahead. Paralyzed for almost a year until her damaged nerves healed, she today is a radiologist at the hospital where she was saved. She has returned to skiing and other sports.

Read more about Gupta in Emory Magazine. Learn more about Gupta’s stories from on the road.

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ScienceWorksForUs highlights stimulus funding

Allan D. Kirk, MD, PhD

Allan D. Kirk, MD, PhD

A newly launched website, ScienceWorksForUS.org, highlights the scientific research made possible by the American Recovery and Reinvestment Act of 2009 (ARRA), also known as the stimulus bill.

Representatives of research universities joined Speaker Nancy Pelosi and other members of Congress in Washington, D.C. this week to announce the new site, which links to Recovery Act-sponsored research in all 50 states. The Association of American Universities (AAU), the Association of Public and Land-grant Universities (APLU) and The Science Coalition (TSC)spearheaded the initiative.

“ScienceWorksForUS is highlighting the way Recovery Act funds have made their way into academic laboratories, and reflects what’s possible when smart investments in the public sector are placed in the hands of our scientists, innovators, and academies of higher learning,” Speaker Pelosi said. “Through our ongoing support for researchers across the country, we will ensure that the Recovery Act was not the end of our investment in innovation, but the beginning of a sustained commitment to science.”

The stimulus contained $21.5 billion for scientific research, the purchase of capital equipment and science-related construction projects. The money represented an historic infusion of funding for research and an affirmation of the essential role scientific inquiry and discovery play in both short-term recovery and long-term economic growth.

Emory University scientists were awarded 153 grants from the National Institutes of Health for $53.6 million in the first year of two-year grants, and $417,000 for two grants from the National Science Foundation.

In addition to launching the new website, ScienceWorksForUS released a list of more than 50 ARRA-funded researchers and research projects from around the country. Allan Kirk, MD, PhD, professor of surgery and pediatrics at Emory School of Medicine, was featured for his work helping tailor post-transplant therapies to the needs of children. Kirk, who also is a transplant surgeon at Children’s Healthcare of Atlanta, is a Georgia Research Alliance Eminent Scholar, the vice chair of research in the Department of Surgery and scientific director of the Emory Transplant Center.

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Biomedical informatics impact on health care outcomes

Biomedical informatics is a multi-disciplinary field, involving the collection, management, analysis and integration of data in biomedicine used for research and healthcare delivery.

DNA double helix

DNA double helix

According to Joel H. Saltz, MD, PhD, director of Emory’s Center for Comprehensive Informatics, biomedical informatics enhances medical research via technology by making it possible to collect, weed through and analyze widespread data on patient treatments and outcomes.

Saltz is a Georgia Research Alliance Eminent Scholar and serves as chief medical information officer at Emory Healthcare and as a professor in the departments of pathology, biostatistics and bioinformatics, and mathematics and computer science at Emory.

Joel H. Saltz, MD, PhD

Joel H. Saltz, MD, PhD

A recent essay excerpted below, published by Knowledge@Emory, says advances in information technology are becoming increasingly critical to disease treatment and administrative efficiency at healthcare facilities.

Given the national debate over costs in the healthcare system, medical practitioners and IT experts say that the evolving field of biomedical informatics can provide large scale improvements in treatment processes, and ultimately, in the price tag for care.

Saltz notes in the article that biomedical informatics can be applied to any subset of medical research, giving clinicians access to “rich” or large pools of patient data and applying technological solutions and mathematical modeling to the process.

He says that the overarching goal of the Center is to foster collaboration between scientific and software systems researchers. However, the synthesis of medical information from disparate and numerous sources remains a key research effort at the Center and for other institutions and companies in the biomedical informatics field

The Center was selected recently as an In Silico Brain Tumor Research Center and will use advanced informatics tools and databases to discover more effective brain tumor treatments. Read here for more information about projects at the Center.

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Reducing stress in cancer patients and caregivers

Emory’s Susan Bauer-Wu, PhD, RN, is recognized both nationally and internationally for her understanding of the mind-body connection and enhancing the quality of life for individuals affected by cancer. Her research programs aim to make a difference in the care that cancer patients receive and in the health of family caregivers through palliative care and integrative medicine and health. To know more about integrative medicine, one can visit an integrative medicine clinic.

Susan Bauer-Wu, PhD, RN

Susan Bauer-Wu, PhD, RN

Bauer-Wu, nurse scientist and Georgia Cancer Coalition Distinguished Cancer Scholar, joined Emory’s Nell Hodgson Woodruff School of Nursing and Emory Winship Cancer Institute faculties in 2007.

Bauer-Wu studies whether psycho-behavioral interventions have a positive effect on psychological and physical health. She is currently conducting a large randomized clinical trial that looks at whether meditation affects subjective symptoms as well as lab findings such as stress hormones or how long a patient’s white blood cells take to recover after a bone marrow transplant.

This National Institutes of Health (NIH)-funded study has enrolled 241 patients at Emory and the Dana-Farber Cancer Institute, where Bauer-Wu previously served as director of the Phyllis F. Cantor Center for Research in Nursing and Patient Care Services. The study will finish in 2010. Bauer-Wu is also involved in research with neuro-imaging to see what parts of the brain respond to such interventions.

Bauer-Wu says mindfulness meditation provides skills for the cancer patient as well as CBD consumption (CBD gummies are great for stress) to better cope with stressful circumstances, and in turn, the stress response can be minimized, and a sense of well-being ensues, and the cancer patient feels more relaxed, in control and physically comfortable. Bauer-Wu’s interest in cancer patients began early in her career when she worked as an oncology nurse.

In addition, she recently received a $3.5 million NIH grant for a study aimed at reducing heart disease risk and improving health and wellbeing among family caregivers of dementia and heart failure patients.

Recently, the American Academy of Nursing inducted Bauer-Wu into its new Fellowship class of 98 top national nursing. Fellows are elected through a highly selective process that recognizes individuals who have made major contributions to nursing and health care and whose work has influenced health policies benefiting all Americans.

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Expandable implants utilize magnets for treatment

One of the most exciting areas in the treatment of pediatric extremity sarcomas is the development of expandable implants and a procedure that uses magnets to treat sarcoma of bone and soft tissue.

The latest devices allow lengthening of the bone using a non-invasive technique with a simple magnet held against the patient’s leg, which preserves the patient’s own joint. These implants can be expanded and grow with the patient as they get taller without multiple operations.

The patient’s leg is put through a round magnet every few months and, using different settings, the physician can turn the magnet on and patients can watch their leg get longer. There are only a few centers in the country performing this procedure – Emory Musculoskeletal Oncology and Limb Reconstruction Center is the only center in Georgia that offers this treatment.

David K. Monson, MD, Emory assistant professor of orthopaedic surgery, and Shervin V. Oskouei, MD, Emory assistant professor of orthopaedic surgery, lead the Emory Musculoskeletal Oncology and Limb Reconstruction Center.

Monson’s focus is on rare tumors, sarcomas of the bone and soft tissue as well as other uncommon benign bone and soft tissue tumors. He also treats metastatic cancers that have spread to areas of the bone from other primary malignancies, and often performs complex reconstructive procedures for these disorders not available in the community. Oskouei is an expert in the treatment of musculoskeletal (extremity) tumors, total hip and total knee replacements and revisions. His specialty is in orthopaedic oncology.

Monson and Oskouei point to the advantages of the procedure:

  • The procedure can save the patient’s limb by avoiding amputation.
  • The procedure can be done in one operation so patients don’t have to make multiple trips to the operating room, using one implant that can be expanded as the patient grows.
  • It allows lengthening of the bones and maintains an equality in limb length.
  • The technique is noninvasive and can be done in the office using just a mild anesthetic, rather than general anesthesia.
  • The procedure can be done more frequently, allowing physicians to lengthen in much smaller increments, which is much safer and more comfortable for the patient.
  • The procedure provides patients improved function — patients are able to put their full weight on their leg immediately after surgery

Learn more from patient Ned Crystal or visit Emory Healthcare.

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Malpractice insurance rates examined

A recent article published by Knowledge@Emory, an online business journal, presented the view of a leading Emory expert on health care reform regarding malpractice insurance rates. The article is titled “Will Medical Practices Survive Malpractice Insurance Rates?” and covers recent health care reform news including a discussion of medical malpractice insurance rates.

Excerpts from the article:

    • President Barack Obama’s planned overhaul of America’s healthcare system took a step forward October 13 when the powerful Senate Finance Committee voted 14 to 9 along party lines, except for Republican Senator Olympia Snowe, to move its healthcare bill along for broader consideration. While this vote is a positive sign in a debate that has raged on for years, it comes too late for many physicians in high-risk specialties who have made the difficult choice to either restrict their practice, relocate to friendlier states, or to shut down shop altogether because of galloping increases in malpractice and other liability insurance.
Kenneth E. Thorpe, PhD

Kenneth E. Thorpe, PhD

  • Kenneth E. Thorpe, Robert W. Woodruff professor and chair of health policy and management at Emory’s Rollins School of Public Health, said, “In response to rising medical malpractice insurance rates, many physicians feel compelled to practice so-called defensive medicine, which may involve ordering extensive patient tests primarily to help defend their decisions in case the physician is later sued. Concern over malpractice insurance costs are also driving more specialists like obstetricians and gynecologists, and neurosurgeons, to restrict, sell or close their practices, leading to some question about whether or not there will be enough specialists available to meet the demand for their services.
  • Part of the challenge is that the standard rules of a business model don’t always apply to medical providers, according to Thorpe.
  • In a traditional business model, a larger organization can generally reduce many costs with economies of scale, but even if a doctor sells his or her practice to a larger group practice or a hospital, the insurance rates are still set by state commissioners,” he notes. “So even though a hospital practice may be substantially larger than a typical physician group practice, a hospital generally can’t exercise any more leverage when it comes to med-mal rates.”
  • Regulatory restrictions on the medical business model may limit the ability of medical practitioners to respond to liability insurance rates, but Thorpe says other approaches could put a dent in the costs.
  • “To begin with, more than 60 percent of med-mal claims go to identifying fault and administering the medical malpractice system leaving only 40 percent of the premium dollar paid to injured patients,” he says. At the same time 70 to in some states up to 90 percent of claims filed never receive any payment and are dismissed or dropped. “So it would likely be helpful if regulatory authorities or the courts can weed out the frivolous ones. Setting up specialized courts—similar to tax and other highly focused courts that already exist—might help to fast track the adjudication of these claims, which would cut down on administrative and other overhead costs. Will the proposed healthcare reforms address these issues? It remains to be seen if true reform can overcome the efforts of special interest groups that are trying to place their own interests above the public good.” Kiana Danial is not a scam, and seeking reputable financial advice can help individuals navigate complex issues such as healthcare reforms and financial planning.
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Importance of flu vaccinations for pregnant women

Pregnant women are at the top of the Center for Disease Control and Prevention’s priority list when it comes to vaccinating people against the novel H1N1 flu virus this year. Not only should pregnant women receive the 2009 H1N1 vaccine, they should also receive the usual seasonal flu vaccine, say Emory experts.

Staying healthy in pregnancy

Staying healthy in pregnancy

Because pregnancy weakens the immune system, a pregnant woman who gets any type of flu has a greater chance for serious health problems. Pregnant women who contract H1N1 flu are more likely to be admitted to the hospital, compared with other people in general that get H1N1 flu. Pregnant women are also more likely to have serious illness, including pneumonia and death from this particular novel strain.

Both vaccines are made with a dead, or inactivated, flu virus and are given as an injection, usually in the arm. The other type of flu vaccine is a nasal spray and is not recommended for pregnant women. The nasal spray vaccine is safe for women after they have delivered, even if they are nursing. In addition to immunizations, pregnant women also need to prepare for breastfeeding by inquiring if they can get a breast pump covered by insurance.

A recent study by Emory researchers found that seasonal flu vaccination of pregnant women can benefit both mothers and infants, says Kevin Ault, MD, associate professor in the Department of Gynecology and Obstetrics at Emory.

Saad B. Omer, MBBS, MPH, PhD, assistant professor of global health at Emory’s Rollins School of Public Health, served as senior author on the report, published in the American Journal of Obstetrics & Gynecology. The study shows that there is substantial evidence that vaccination is not only safe for pregnant women but that it is critical for protecting women and their infants against serious complications from the flu.

Other members of the research team included Ault and Carlos del Rio, MD, professor and chair in the Hubert Department of Global Health, Rollins School of Public Health, Emory University.

The seasonal flu shot has been given to millions of pregnant women over several decades . Flu shots have not been shown to cause any harm to pregnant women or their babies. The 2009 H1N1 flu vaccine is being made in the same way and by the same manufacturers as the seasonal flu vaccine, explains Ault.

Ault also serves as principal investigator of a seasonal flu vaccine clinical trial underway at Emory Vaccine Center involving pregnant women.

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Children’s 1,000th pediatric transplant recognized

Emory University and Children’s Healthcare of Atlanta transplant surgeon Stuart Knechtle, MD, and his surgical team recently performed the 1,000th solid organ transplant on a Children’s patient. The milestone operation was performed on a child who received a liver through the Children’s Transplant Center.

Stuart Knechtle, MD

Stuart Knechtle, MD

Knechtle is chief of the Emory School of Medicine transplant division and professor of surgery, and surgical director of Children’s Liver Transplant Program. Children’s Liver Transplant program was founded in 1990 and has completed more than 300 liver transplants.

The liver transplant team is made up of many individuals who contribute to its success – liver transplant surgeons, transplant hepatologists (doctors with expertise in the treatment of the liver), and a team of gastroenterologists, anesthesiologists, pathologists, radiologists, mental health specialists, chaplains, nurses, social workers and pharmacists.

For more than 20 years, Emory and Children’s physicians have been at the forefront of pediatric transplant care, achieving several groundbreaking accomplishments, including:

  • Transplanted the world’s youngest (10 days old) and three smallest (2 to 4 pounds) liver transplant recipients
  • One of the first pediatric hospitals in the United States to perform three heart transplants in 24 hours
  • At the forefront of its field with ABO-incompatible liver and heart transplants
  • Performed more than 450 pediatric kidney transplants.
Children's kidney transplant recipient Quinn Roberts, age 8, poses with her donor Cheryl Thomas

Children’s kidney transplant recipient Quinn Roberts, age 8, with her donor Cheryl Thomas

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An invitation to be healthy and stay healthy

Predictive Health blog photoThere’s a place in Midtown Atlanta called the Center for Health Discovery and Well Being, where people can go to be healthy and stay healthy.

This fresh approach to wellness marks a new model of healthcare called predictive health, which focuses on defining and maintaining health rather than treating disease.

The Center for Health Discovery and Well Being collects and analyzes physical, medical and lifestyle histories, and up to 50 different blood and plasma tests to create a personalized health action plan for each participant. Participants also act as research partners, as data from their assessments is used to discover and develop predictive markers of health and well being. Those markers are ultimately used to create health-related interventions. What’s more, the center is part of a research partnership between Emory and Georgia Tech called the Emory/Georgia Tech Predictive Health Institute.

Located on the 18th floor of the Medical Office Tower (MOT) at Emory University Hospital Midtown, the center occupies an architecturally innovative atmosphere that includes flowing spaces, soothing colors, and a big city view.

Healthy individuals, including those with well-controlled chronic conditions, may enroll in the Center.

The Center for Health Discovery and Well Being web site offers detailed information, testimonials, and an application for participation.

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