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The Infectious Diseases Society of America issued new guidelines for fighting C diff that include FMT (fecal microbiota Read more

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Nox-ious link to cancer Warburg effect

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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.

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.

Posted on by Janet Christenbury in Uncategorized Leave a comment

Next steps in progesterone for brain injury

At a recent Society for Neuroscience (SFN) meeting, Emory researchers described their efforts to learn about optimizing progesterone for treatment of traumatic brain injury.

Researcher Donald Stein, PhD, Asa G. Candler Professor of Emergency Medicine at Emory School of Medicine, has shown that progesterone can protect damaged brain tissue. Stein is director of the Department of Emergency Medicine’s Brain Research Laboratory.

Donald G. Stein, PhD

Donald G. Stein, PhD

One of the Emory SFN presentations covered efforts to find progesterone analogues that are more water soluble. This work comes from Stein and his colleagues in collaboration with the laboratory of Dennis Liotta, PhD, Emory professor of chemistry.

Currently, the lack of water solubility limits delivery of progesterone, in that the hormone must be prepared hours ahead and cannot be kept at room temperature. Small chemical modifications may allow similar compounds with the same effects as progesterone to be given to patients closer to the time of injury.

According to the results, two compounds similar to progesterone showed an equivalent ability to reduce brain swelling in an animal model of traumatic brain injury.

The second Emory report described evidence that adding vitamin D to progesterone enhances the hormone’s effectiveness when applied to neurons under stress in the laboratory. Like progesterone, vitamin D is a steroid hormone that is inexpensive, has good safety properties and acts on many different biochemical pathways.

David Wright, MD

David Wright, MD

The authors showed that a low amount of vitamin D boosted the ability of progesterone to protect neurons from excito-toxicity , a principal cause of brain injury and cell death.

A new study at Emory, slated to begin early 2010, will evaluate progesterone’s effectiveness for treating traumatic brain injury in a multisite phase III clinical trial called ProTECT III.

The study follows earlier findings that showed giving progesterone to trauma victims shortly after brain injury appears to be safe and may reduce the risk of death and long-term disability.

David Wright, MD, assistant professor of emergency medicine at Emory School of Medicine is the national study’s lead investigator.

Michael Frankel, MD, Emory professor of neurology, will serve as site principal investigator of the clinical trial at Grady Memorial Hospital.

Posted on by Quinn Eastman in Neuro Leave a comment

Students and faculty aid CDC for H1N1 response

Last spring, as H1N1 avian influenza spread across the globe, the Centers for Disease Control and Prevention put out a call asking students to assist. Within three days, 85 students from Emory’s Rollins School of Public Health (RSPH) had volunteered.

RSPH students Nick Schaad (left) and Michael Marrone

RSPH students Nick Schaad (left) and Michael Marrone

Nick Schaad was among the students authorized to help man the CDC’s Emergency Operations Center at the height of the novel H1N1 outbreak. Once the CDC began to identify influenza clusters, students began conducting phone surveys.

Schaad says he was involved in the St. Francis prep school survey in New York. Students and staff member who were sick with any flu-like symptoms were identified. The team called them and asked about the size of their household, what they might have done to protect themselves, and any recent travel. The goal was to learn as much possible about H1N1 in advance of the fall flu season.

Like the students they teach, RSPH faculty became engaged in the H1N1 epidemic. Last spring, Emory physician and microbiologist Keith Klugman, MD, PhD, was recruited to join the CDC’s Team B, which includes experts from outside the CDC to quickly review and inform the agency’s efforts. CDC created Team B in the early 2000s to cope with the growing complexity of public health emergencies.

Keith Klugman, MD, PhD

Keith Klugman, MD, PhD

Klugman says his role included the bacterial complications of influenza. Evidence from 1918, notes Klugman, clearly shows that the great majority of deaths were due to bacterial complications of the flu. In other words, the flu itself could occasionally cause death on itss own. But it caused death mostly by facilitating a synergistic lethality between itself and bacteria.

Although much has changed since 1918, the bacteria that caused so many deaths still exist but are susceptible to antibiotics.

Klugman notes the evolution of the flu. He says so far it’s generally been moderate. However, by mixing with the circulating flu in the Southern Hemisphere, it could mutate and become resistant to the first line of flu drugs. It could also become more severe. Says Klugman, “We must remain ever vigilant.”

Posted on by Robin Tricoles in Uncategorized Leave a comment

Aging T cells think they’re something else

T cells start to lose their identities as they get older, recent Emory research indicates.

Immunologists Cornelia Weyand and Jorg Goronzy, who are codirectors of the Lowance Center for Human Immunology at Emory University School of Medicine, have a just-published paper in the journal Blood describing this phenomenon.

Jorg Goronzy, MD, PhD and Cornelia Weyand, MD, PhD

Jorg Goronzy, MD, PhD and Cornelia Weyand, MD, PhD

Weyand and Goronzy show that with age, T cells begin to turn on genes that are usually turned on only in “natural killer” cells. NK cells play a major role in rejecting tumors and killing cells infected by viruses. They are white blood cells like T cells but they have a different set of receptors on their surfaces controlling their activities.

Many of these receptors act to hold the NK cells back; so when they appear on the T cells, their activation is dampened too, thus contributing to the slowing down of the immune system in elderly people.

The authors report that NK cell genes get turned on because they lose the “methylation” on their DNA. Methylation is a pattern of tiny modifications on DNA, emphasizing what’s important (or forbidden) in a given cell, sort of like a highlighter’s yellow pen on top of text.

Apparently, in elderly people (aged 70-85), the methylation is more “spotty” than in younger people (aged 20-30). It seems that after the DNA is copied several times, the highlighting gets fuzzy and the T cells start to look like their cousins, natural killer cells.

Posted on by Quinn Eastman in Immunology Leave a comment

Curiosity about health and a borderless world

Developing effective HIV prevention and intervention programs in the most affected communities is a challenge globally as well as locally. It’s also a challenge that Emory infectious disease specialist Carlos del Rio, MD, is addressing as newly appointed chair of the Rollins School of Public Health’s Hubert Department of Global Health.

Carlos del Rio, MD

Carlos del Rio, MD

Del Rio is uniquely equipped to address HIV prevention and intervention. As the former chief of medicine at Grady Memorial Hospital, Atlanta’s safety-net hospital, he witnessed firsthand patients affected by the disease. He says there ought to be incentives for people to stay healthy instead of barriers to staying healthy.

More daunting for del Rio is preventing disease on a global scale, much of which rests on changing unhealthy behaviors related to diet, exercise, smoking, and sex. He says we know very little about how to implement population-wide behavior change, and we need to learn more.

Del Rio says growing human capital to strengthen research capacity in resource-constrained countries is also key. Since 1998, the NIH/Fogarty International Center has funded the Emory AIDS Training and Research Program (AITRP) to build capacity in Armenia, the Republic of Georgia, Ethiopia, Mexico, Rwanda, Vietnam and Zambia. Led by del Rio, AITRP brings a select group of young scientists to Emory each year for advanced training. Emory faculty also train and mentor scientists in these countries.

The training program has opened avenues to improving health. In Ethiopia, del Rio helped expand HIV testing among the police force and bring antiretroviral therapy into the community for people living with HIV.

In the Republic of Georgia, the Emory AITRP and the Emory-Georgia Tuberculosis Research Training Program, another NIH/Fogarty program led by RSPH adjunct faculty member and Emory School of Medicine professor  Henry Blumberg, MD, has helped build research capacity in HIV, hepatitis, and tuberculosis research.

Posted on by adobbs in Uncategorized Leave a comment

Paris “Hands Over” to Atlanta for AIDS Vaccine 2010

Eric Hunter, PhD

Eric Hunter, PhD

As the AIDS Vaccine 2009 conference concluded today in Paris with more than 1,000 scientists in attendance, Eric Hunter, PhD, co-director of the Emory Center for AIDS Research (CFAR) and a Georgia Research Alliance Eminent Scholar, accepted the “hand over” for next year’s international conference in Atlanta.

The Emory CFAR will serve as local Atlanta host of AIDS Vaccine 2010, which takes place next Sept. 28 to Oct. 1, led by the Global HIV Vaccine Enterprise. The conference will bring scientists, community advocates, funders and policy makers from around the world to Atlanta to hear cutting edge scientific results, exchange new ideas, educate future leaders and engage a diverse group of scientists in the quest for an AIDS vaccine.

A number of Emory scientists were in attendance in Paris at AIDS Vaccine 2009. Hunter was interviewed by several news organizations, including the Lehrer News Hour and Science magazine, about the results of a recently concluded AIDS vaccine trial conducted by the United States and Thailand. The complete results of the trial were released at the meeting and also published online this week by the New England Journal of Medicine.

Hunter was among 22 scientists who initially had criticized the trial in a 2004 Science editorial. After seeing the full results and analysis of the trial this week, Hunter commented from the Paris meeting:

“The complete data from the trial indicate that it was modestly effective in preventing HIV-1 infection. However, it will likely be difficult to establish the mechanism by which the vaccine protected participants and additional studies will be needed. This positive result, though, gives a much needed boost to efforts aimed at developing an HIV-1 vaccine and takes the field from the position of perhaps an impossible goal to a possible goal.”

Hunter will chair AIDS Vaccine 2010 in Atlanta, along with co-chairs James Curran, MD, MPH, dean, Rollins School of Public Health; Carlos del Rio, MD, Hubert professor and chair of the Hubert Department of Global Health, Rollins School of Public Health; and Harriet Robinson, PhD, senior vice president of research and development, GeoVax and emeritus professor of microbiology and immunology, Yerkes National Primate Research Center, Emory University.

Posted on by Holly Korschun in Uncategorized Leave a comment

Teens and crime: the Supreme Court to decide outcome

Emory’s Gregory Berns, MD, PhD, occasionally blogs for Psychology Today in a blog titled plus2sd.

Gregory Berns, MD, PhD

Gregory Berns, MD, Ph

Berns’ most recent blog taps his expertise on the use of brain-imaging technologies to understand human motivation and decision-making, as well as the biology of adolescent decision-making and the effects of peer pressure on risk attitudes.

In a blog called “My Immature Brain Made Me Do It?” he covers an upcoming case before the U.S. Supreme Court on life sentences for adolescents. Berns is Emory Distinguished Chair of Neuroeconomics and director of the Center for Neuropolicy, and a professor of Psychiatry and Behavioral Sciences, Emory University School of Medicine.

He writes: “On November 9th, 2009 the Supreme Court will hear arguments on whether the 8th amendment’s ban on cruel and unusual punishment prohibits courts from sentencing children to life without the possibility of parole for the commission of a non-homicide. The elephant in the room, and the thing that the Court has taken deliberate steps to leave out of its rulings in the past, is the human brain.

Numerous briefs have been submitted by mental health advocacy groups suggesting that the brain is not fully mature until the mid-20’s. But come November, the Court should once again ignore the growing drumbeat to blame the immature brain and leave neuroscience out of its decision.

But there are serious flaws with the “immature brain made me do it” argument. In fact, my group recently published a study calling this argument into question (PLoS One, 2009). All of the neuroscience findings cited in the briefs rely on a correlation of brain structure with either age or a measurement of cognitive function.

Correlation means that you take one measurement and see how it changes with some other measurement. While on average, these conclusions are statistically valid, there is too much variation from one person to another to draw conclusions about any one individual. But you won’t find individual variability mentioned in any of these briefs.”

To read more about Berns’ recent study findings, visit Emory’s Woodruff Health Sciences Center.

Or view a video:

Posted on by Kathi Baker in Uncategorized Leave a comment

Why vaccine compliance matters

An outbreak of measles in the state of Washington last year sickened 19 children. Of those who fell ill, 18 had something in common—they were not vaccinated.

Saad Omer aims to increase vaccine compliance to prevent childhood diseases.

Saad Omer aims to increase vaccine compliance to prevent childhood diseases.

For Emory Rollins School of Public Health researcher Saad Omer, the Washington outbreak is a perfect example of the effect on an entire community when individuals are unimmunized. His research aims to shed light on ways to encourage increased vaccine compliance for adults and their children.

Omer says vaccine-preventable diseases such as measles, influenza, and pertussis often start among persons who forego vaccinations, spread rapidly within unvaccinated populations, and also spread to other subpopulations.

In a recent New England Journal of Medicine article, Omer and his colleagues reviewed evidence from several states showing that vaccine refusal due to nonmedical reasons puts children in communities with high rates of refusal at higher risk for infectious diseases such as measles and whooping cough.

Even children whose parents do not refuse vaccination are put at risk because “herd immunity” normally protects children who are too young to be vaccinated, who can’t be vaccinated for medical reasons, or whose immune systems do not respond sufficiently to vaccination.

Research findings indicate that everyone who lives in a community with a high proportion of unvaccinated individuals has an elevated risk of developing a vaccine-preventable disease.

Read more about Omer’s research on vaccine refusals in the fall 2009 issue of Public Health magazine.

Omer also discusses the importance of vaccinating against the H1N1 virus in an Oct. 16 article in The New York Times.

Posted on by adobbs in Immunology Leave a comment

Teaching students to be doctors: connections made

The Emory School of Medicine’s new curriculum was introduced in 2007 in order to create connections between faculty and students that last throughout the entire four years of medical school, “longitudinal” relationships much like those that should exist ideally between doctors and their patients.

Students practice providing exams

Students practice medical exams

Based on the kind of students who are attracted to Emory and on what they learn and model from their faculty mentors, these students are expected to grow not just in knowledge during their time at Emory, but also in compassion, curiosity, and commitment—and to use these traits wisely in serving their profession and community.

At the heart of the curriculum is a highly popular system of faculty advisers, each faculty mentor paired with eight or nine students.

These groupings are designated as “societies” named for historical medical luminaries—for example, Osler, Semmelweis, Lister, Harvey.

Faculty advisers who lead these societies in each class are chosen carefully, their salaries underwritten by the medical school so they can relinquish three half-days per week from their regular clinical and/or research duties to spend time with some or all of “their” students.

As the class of 2011 moves through the new curriculum, all now have completed the 18-month Foundations of Medicine phase, a whole-person approach section that combines clinical medicine and basic fundamentals of science, social sciences, humanities and public health.

This is not my father’s or mother’s medical school experience, students say. In the introduction-to-neuroscience module, for example, faculty share the classroom with a baseball player, who demonstrates and explains what a center fielder has to do to catch a fly ball or what a batter must consider before swinging at a ball leaving the pitcher’s hand at 95 mph.

Learn more about the curriculum in the 2009 Emory School of Medicine annual report, and more about the school in Emory Medicine. Read a message from Dean Thomas J. Lawley, MD.

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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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