To explain cancer biology, use metaphors

An expert on doctor-patient communication says: let the explanatory metaphors Read more

Enhanced verbal abilities in the congenitally blind

Congenitally blind study participants displayed superior verbal, but not spatial abilities. Possibly reflects their greater reliance on verbal information, and the recruitment of the visual cortex for verbal Read more

Three remarkable Emory case reports from #ACC17

Three remarkable case reports being presented at the American College of Cardiology meeting, including cardiac electrical storm, reverse Takotsubo and congenital heart Read more

Prevention counts in health care reform

As Congress and President Obama’s administration work to hammer out the details of health care reform, Emory health policy expert Kenneth E. Thorpe, PhD, says prevention and quality care for chronic diseases are an integral part of reshaping America’s health care system.

Kenneth E. Thorpe, PhD

Kenneth E. Thorpe, PhD

Nearly half of people in the United States suffer from a chronic condition. More than two-thirds of all deaths are caused by one or more of five chronic diseases: heart disease, cancer, stroke, chronic obstructive pulmonary disease (COPD) and diabetes.

Thorpe says transforming the U.S. health care system to better meet the needs of people with chronic disease will require a renewed focus on preventing disease when possible, identifying it early when it occurs, and implementing evidence-based prevention strategies that slow disease progression and the onset of activity limitations, as well as save money for the patient and the health care system.

By preventing costly diseases or better managing them, Thorpe says we can help contain our out-of-control health spending and boost productivity. In our troubled economy, we need to do both.

Read more about Thorpe at Rollins School of Public Health, Institute for Advanced Policy Solutions/Center for Entitlement Reform, and the Partnership to Fight Chronic Disease.

Thorpe’s views can be found by visiting AJC.com, Big Think and The Huffington Post.

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Band posts salivary gland cancer news on web

In the news this week are reports that a member of the Beastie Boys hip-hop band announced on YouTube that he has salivary gland cancer – specifically of the parotid gland.

Dong Shin, MD, examines a patient at Emory

Dong Shin, MD, examines a patient at Emory

The public does not hear much about this type of cancer, and according to the American Cancer Society salivary gland cancers account for less than 1 percent of all cancers in the United States. About two out of three salivary gland cancers are found in people who are 55 or older. The average age at the time this cancer is found is 64.

The salivary gland is important because it produces saliva, which contains enzymes that begin the process of breaking down food. It also contains substances to help prevent infections of the mouth and throat.

According to Emory Winship Cancer Institute expert Dong Shin, MD, the parotid glands are found in front of and just below each ear and most major salivary gland tumors begin in these glands.

Shin says that salivary gland tumors exhibit two major growth patterns: low grade, which is slow growing and more easily treatable, and high grade, which is usually a faster growing, more aggressive cancer that can also invade the lymph nodes. Certain types of salivary gland tumors can recur or have distant metastasis, particularly to the lungs.

Although the causes of this cancer are not definitively identified, Shin notes, there are some risk factors, including a history of radiation therapy to the head and neck area and a history being exposed to certain chemical substances, most often in the workplace.

Treatment usually includes surgery with radiation therapy afterward. Certain aggressive cell types require chemotherapy as well as radiation. However, explains Shin, at this time there are no specific chemotherapy agents that work well in attacking salivary gland tumors. Recent clinical trials have shown evidence of a fair response to certain molecular targeted chemotherapy, but more research is needed on these targeted therapies. wxjy6rbm4s

Posted on by Vince Dollard in Uncategorized Leave a comment

Healthy lifestyle can lower blood pressure

A new study says that maintaining normal weight, daily vigorous exercise, eating a diet high in fruits, vegetables, low-fat dairy products and low in sodium, and taking a folic acid supplement is linked with lowering hypertension in women.

A healthy lifestyle helps your heart

A healthy lifestyle helps your heart

Reporting in the July 22/29 issue of the Journal of the American Medical Association, scientists say that hypertension, or high blood pressure, contributes to more excess deaths in women than any other preventable factor. The researchers looked at the link between combinations of low-risk lifestyle factors and the risk of developing hypertension.

Allen Dollar, MD, preventive cardiologist with Emory Heart & Vascular Center, says the study by Harvard Medical School researchers points to the real benefit to women of deploying a healthy lifestyle to prevent hypertension or to control hypertension.

Essentially, this new report helps to confirm what preventive cardiologists share with women everyday, says Dollar, that they can help prevent or manage hypertension through a healthy approach to diet and exercise.

Generally, blood pressure above 140/90 is considered to be high for adults. Although hypertension can produce symptoms including fatigue, confusion, nausea, vision problems and excessive sweating, Dollar points out that the majority of women with mild to moderate hypertension have no symptoms that indicate their blood pressure is too high.

A blood pressure reading can reveal hypertension in the early stages when a strategy of diet changes, exercise and weight control and medication, if needed, can help prevent a host of high blood pressure related ills including heart attacks, heart failure, kidney disease and stroke, says Dollar. If a woman does not know her blood pressure, she needs to find out. If a woman learns she has high blood pressure, she can use this news as an opportunity to take control of her health.

Learn more medical advances at Emory.

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New ways to pinpoint heart failure risk

Javed Butler, MD, MPH

Javed Butler, MD, MPH

An aging U.S. population, an increase in the prevalence of obesity and improved cardiovascular therapies for acute problems are boosting the number of people living with the condition of heart failure.

Javed Butler, MD, MPH, director of heart failure research at Emory Healthcare and associate professor of medicine at Emory University School of Medicine, is looking for new ways to prevent and treat heart failure.

According to Butler, 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 failure is not a disease but a syndrome, so there’s a whole family of different diseases that can precede this condition. These are known collectively as heart failure.

In the clinic, Butler treats patients already diagnosed with heart failure. His research focuses on prevention through life style changes as well as models pinpointing who is at risk for heart failure.

Butler and his colleagues recently created the Health ABC Heart Failure Model for predicting risk of new onset heart failure in the elderly. That model has now been strengthened by validating it via a library of patient data from an earlier cardiovascular study. The results suggest the Health ABC risk model can be used to identify high-risk individuals for whom interventions can be cost-effectively targeted to prevent heart failure.

To hear Butler’s own discussion about heart failure, access the podcast from Emory’s Sound Science series.

Posted on by Holly Korschun in Heart Leave a comment

Health care reform: Wise allocation of resources key

Emory’s Chief Quality Officer William Bornstein, MD, PhD, says there are many issues that need to be tackled in order to achieve meaningful health care reform. He points out that one of the most fundamental questions that must be addressed is who decides about a treatment or diagnostic test that may be a little bit better than an alternative option but is much more expensive? If the patient has no “skin in the game,” he will almost certainly want the better/more expensive option.

William Bornstein, MD, PhD

William Bornstein, MD, PhD

The doctor has taken an oath to act in the best interests of the patient and this obligation takes precedence over any charge that society would like to impose to cast the physician in a fiduciary role for the national healthcare budget, says Bornstein, who also serves as chief medical officer for Emory Hospitals. And, the payer’s role is obviously conflicted, he says. If the patient does have skin in the that decision, Bornstein asks, are we prepared as a society to explicitly endorse the notion that “better” care that exceeds a certain cost threshold will only be available to those who can afford the additional cost?

There has been much talk about better care and preventative care being less expensive, but there are little data that support this as being a universal truth. Health care information technology will also not solve this problem, he says. At some point in the near future, we need to have a national conversation about this challenge. In the past attempts to have such conversations have raised the specter of “rationing,” However, the time has come to confront the truth that our resources are finite and we need to allocate them wisely.

Bornstein is a recognized leader in quality, safety and the use of information technology in improving healthcare delivery. He has serves on national committees and advisory bodies in these areas including the University HealthSystem Consortium Clinical Evaluative Sciences Council Steering Committee, which he now chairs. He serves on the Professional and Technical Advisory Committee for the hospital accreditation process of The Joint Commission as vice-chair, and on the Information Architecture Steering Committee of the University HealthSystem Consortium staff leadership group of the Institute of Medicine Roundtable on Evidence Based Medicine.

Listen to podcasts with Bornstein on quality.

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Michael J. Fox Foundation supports Emory research

The Michael J. Fox Foundation for Parkinson’s Research just announced plans to fund Emory pharmacology researcher Zixu Mao in his work to validate therapeutic targets for Parkinson’s disease (PD).

Zixu Mao, PhD

Zixu Mao, PhD

The two-year, $250,000 grant will fund research in Mao’s lab in the departments of neurology and pharmacology. He and his team hope to verify whether a particular protein – MEF2D – may be a good drug target in models of PD. If it is, his efforts will provide the basis for further research to identify ways to manipulate the activity of this protein as a way to treat PD.

Mao says this type of study is very important to allow the transition from findings made by basic research to more clinically relevant discoveries and is generally difficult to get funded by other major funding sources.

The Michael J. Fox Foundation is dedicated to finding a cure for Parkinson’s disease through an aggressively funded research agenda and to ensuring the development of improved therapies for those living with Parkinson’s today. Learn more about Mao’s research.

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Emory, Georgia Tech tackle abdominal aortic aneurysms

Robert Taylor, MD

Robert Taylor, MD

Abdominal aortic aneurysms (AAA) are a major cause of illness and death in the U.S., with the incidence increasing dramatically over the age of 55. These aneurysms are a widening and bulging of the large artery that runs through the body from the heart into the abdomen. They often go undetected until they suddenly rupture, often resulting in death within minutes.

A team of physicians and engineers from Emory and Georgia Tech is studying the biology and biomechanics of vascular inflammation and disturbed blood flow in AAAs to understand how they develop and could be prevented or detected earlier.

Cardiologist and biomedical engineer Robert Taylor is leading the Biomedical Engineering Partnership, funded by $6 million from the NIH.

Taylor points out that predicting the likelihood of aneurysm rupture is extremely difficult and patients often don’t notice them until they already are leaking or ruptured. Even small aneurysms often expand rapidly and rupture. He and his team will try to pin down specific risk factors for AAAs, which they think differ from traditional cardiovascular risk factors.

Posted on by Holly Korschun in Heart 2 Comments

Many roads to memory T cells

When our bodies encounter a bacteria or a virus, the immune system sends some cells out to fight the invader and keeps others in reserve, in order to respond faster and stronger the next time around. Vaccination depends on this phenomenon, called immunological memory.

Several recent papers — from Emory and elsewhere – provide insight into this process, and highlight this area of research as especially active lately.

Researchers led by Rafi Ahmed and Chris Larsen at Emory found that rapamycin, a drug usually given to transplant patients to block rejection, actually stimulates the formation of memory T cells. Rapamycin appears to nudge immune cells when they have to make a decision whether to hunker down to become a memory cell.

The immunosuppressant drug rapamycin was discovered in soil from Easter Island

The immunosuppressant drug rapamycin was discovered in soil from Easter Island

Similarly, the anti-diabetes drug metformin, which affects fatty acid metabolism, can also stimulate the formation of memory T cells, according to research that was published in the same issue of Nature.

In addition, Wnt signaling, which plays critical roles in embryonic development and cancer, influences memory T cell formation as well, according to a July paper in Nature Medicine.

To summarize — pushing on several different “buttons” produces the same thing: more memory T cells. How are the wires behind the buttons connected? Work by Ahmed and others may eventually help enhance vaccine efficacy or fight cancer with the immune system.

Rapamycin, the focus of the Ahmed/Larsen paper, was also recently found to slow aging in mice. However, with previous anti-aging research findings, translating results into the human realm has been a considerable challenge.

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U.S. News ranks Emory University Hospital

America's Best HospitalsToday, U.S. News and World Report issued the 2009-10 America’s Best Hospitals.

Emory University Hospital ranked among the nation’s best hospitals in 11 specialties. Overall, Emory is one of only 170 hospitals, out of more than 5,400 medical centers in the country to be named in even one of the magazine’s top 50 specialty rankings.

Emory is recognized in this year’s comprehensive report for excellence in:

Specialty and Rank
Ophthalmology – 9
Psychiatry – 10
Geriatrics – 13
Heart and Heart Surgery – 13
Neurology and Neurosurgery – 14
Ear, Nose and Throat – 22
Kidney Disease – 25
Diabetes/Endocrinology – 31
Gynecology – 44
Urology – 44
Cancer – 46

U.S. News says it looks at, “how well these institutions do in complex and demanding situations—replacing an 85-year-old’s heart valve, diagnosing and treating a spinal tumor, and dealing with inflammatory bowel disease, to name three examples. High-stakes medicine calls for more than the usual brand of doctoring.”

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Small, single incision for surgery helps young patients

Emory University and Children’s Healthcare of Atlanta pediatric physician Dr. Mark Wulkan is among the first surgeons in Georgia to perform single-site incision surgery on pediatric patients for routine surgeries.

Dr. Mark Wulkan

Dr. Mark Wulkan

Dr. Wulkan is using this method for multiple procedures, including appendectomy, removal of the spleen, and stomach surgery.

“Single-site surgery takes minimally invasive surgery (laparoscopic surgery) to the next level,” said Dr. Wulkan, is an associate professor of surgery and pediatrics in the Emory University School of Medicine and who performs surgery at Children’s Healthcare of Atlanta at Egleston. “Children leave the operating room with virtually no scars.”

Traditional laparoscopic surgical incisions are made in different locations on the abdominal wall, resulting in several small scars. The single-site method, however, is considered scarless because only one incision is made in the belly button and is typically difficult to see. Pediatric patients who undergo single-site procedures enjoy all the benefits of laparoscopic surgery, such as rapid recovery and less pain than that associated with traditional open surgery.

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