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

Reddit as window into opioid withdrawal strategies

Drug abuse researchers are using the social media site Reddit as a window into the experiences of people living with opioid addiction. Abeed Sarker in Emory's Department of Biomedical Informatics has a paper in Clinical Toxicology focusing on the phenomenon of “precipitated withdrawal,” in collaboration with emergency medicine specialists from Penn, Rutgers and Mt Sinai. Precipitated withdrawal is a more intense form of withdrawal that can occur when someone who was using opioids starts medication-assisted treatment Read more

CROI: HIV cure report and ongoing research

The big news out of CROI (Conference on Retroviruses and Opportunistic Infections) was a report of a third person being cured of HIV infection, this time using umbilical cord blood for a hematopoetic stem cell transplant. Emory’s Carlos del Rio gave a nice overview of the achievement for NPR this morning. As del Rio explains, the field of HIV cure research took off over the last decade after Timothy Brown, known as “the Berlin patient,” Read more

Children’s Healthcare invests in eight research centers

Paul Spearman, MD

Children’s Healthcare of Atlanta will invest $75 million in pediatric research centers of excellence over the next five years. Paul Spearman, MD, Children’s chief research officer and vice chair for research in Emory’s Department of Pediatrics, announced eight key priority areas today.

These include the Aflac Cancer Center and Blood Disorders Service of Children’s, along with seven new priority areas: immunology and vaccines, transplant immunology and immune therapeutics, pediatric healthcare technology innovation, cystic fibrosis, developmental lung biology, endothelial cell biology and cardiovascular biology. Planned priority areas for the near future include drug discovery, neurosciences, autism, outcomes/wellness, and clinical and translational research.

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Program helps South Georgia farmworkers

It’s not often that individuals think about the hard work responsible for the fruits and vegetables for our dinner tables every day. Somehow it magically appears in the produce department season after season, without fail. We don’t have to plant it, water it or pick it. It’s ready for us to take home and prepare.

We never see the thousands of migrant farmworkers who move from county to county during the peak season, providing the growers with the labor required to keep farms bountiful. These men, women and children – unlike the plants they take care of – have no roots and live from day to day wherever they are needed, and until their job is done, says Tom Himelick PA-C, MMSc, founder and director of the South Georgia Farmworker Health Project, and Emory Physician Assistant (PA) Program faculty member and director of community projects.

For most of these workers, having a family health care provider is unthinkable. The combination of poverty, lack of health insurance, language barriers, limited transportation and cultural differences creates a vacuum when it comes to health care.

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Coordinating care a key to health reform

Kenneth Thorpe, PhD

Last month, Emory held its fifth annual predictive health symposium “Human Health: Molecules to Mankind.”Researchers, physicians, health care workers and members of the community from throughout the country learned of intriguing research and listened to provocative commentary by health care experts. Kenneth Thorpe, chair of health policy and management at Emory’s Rollins School of Public Health, discussed the elements of health reform that may be getting lost in the reform process– redesigning the delivery system to prevent and avert the development of disease.

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Personal genomics: out of the bottle

Do you really want to know? That’s the question more and more people will be faced with, as personal genetic testing becomes more widespread.

Andrew Faucett discussed some of the emerging issues in “personal genomics” that will confront both doctors and patients at Emory’s Predictive Health Symposium in December. Faucett is an expert in the field of genetic testing and genetic counseling and an assistant professor in Emory’s Department of Human Genetics.

For example, does a man want to find out whether he is really the father of a baby? A recent New York Times magazine article explores this issue.

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Start the new year with eye care tips from experts

Emory Eye Center doctors Emily Graubart, MD, assistant professor of ophthalmology, and Paul Pruett, MD, assistant professor of ophthalmology, Emory School of Medicine, say people often have misinformation about their eyes. They answer questions below to dispel myths about eye disease and eye care. Start the new year with knowledge about your eyes:

Paul Pruett, MD

Paul Pruett, MD

How often does an adult need to see an eye doctor?
“It depends on your age,” says Pruett, an expert in glaucoma. “In your 20s, 30s and 40s, about every two years is sufficient. If you have certain medical conditions, it may be necessary to be seen more often. For example, patients with diabetes should have their eyes examined every year, at the least. Many eye diseases can be asymptomatic, and early detection can prevent vision loss. This is especially true for glaucoma. Half of all patients with glaucoma do not know they have the disease.”

Is my computer work damaging my eyes?
“No, however, staring at a computer screen means you may not blink often and your eyes may become dry,” says Graubart, a comprehensive ophthalmologist and cataract surgeon. “Blinking more frequently while working on the computer, as well as using preservative-free artificial tears will help to reduce the dry-eye symptoms associated with long-term computer use.”

Emily Graubart, MD

Emily Graubart, MD

Do certain foods or vitamins help the eyes?
“While there are a lot of claims regarding vitamins and eye health, there are only a few conditions where studies have proven a benefit,” says Pruett. “In age-related macular degeneration, for instance, there is a certain formulation of vitamins and minerals that has been proven to reduce the rate of vision loss in certain populations of these patients. Despite these medicines being over-the-counter, it is important to discuss with your doctor whether vitamin therapy is right for you as there may be potential interactions with other medicines or conditions. In general, a well-balanced diet with plenty of fruits and vegetables is the way to go, not only for eye health but also for your overall health.”

Why does reading get more difficult with age?
“We begin to lose our ability to focus up close, which is called presbyopia, between our late thirties and early forties,” says Graubart. “The natural lenses of our eyes become thicker and harder, and the muscles controlling the lens shape weaken making it more difficult to see up close. If you have not needed glasses before, you will likely do well with over-the-counter reading glasses. These glasses cannot damage your eyes. However, the American Academy of Ophthalmology recommends a comprehensive eye exam at age 40 to screen for diseases of the eye. At this visit, your ophthalmologist can tell you what prescription would work best for your eyes.”

Does reading in dim light or reading very small print damage your eyes?
“No. You may experience eye strain with both of these activities, but there will be no permanent damage to your eyes,” says Graubart. “More light helps to improve contrast and thus, allows you to read with greater ease.”

Are eye problems genetic?
“Not always,” says Pruett. “Although there is a higher risk for certain diseases, such as glaucoma that run in families, it does not mean you as a child will get every eye disease or disorder that your parents may have had. Problems that come purely with aging, such as cataracts, have no relation to parents. The important thing to remember is that if you have a family history of eye disease, you need to have thorough screenings at appropriate times in your life.”

Do eye exercises help vision?
“In children with certain convergence issues (crossed eyes), the exercises prescribed for them do help,” says Pruett. “However, in adults, eye exercises have shown no improvement in vision according to studies. Methods that promise to get rid of glasses by eye exercises are not viable.”

Does my toddler need an eye exam?
“Your child’s eyes are examined as a newborn by your pediatrician, and then again between ages six months and one year.“ says Graubart. “Your child’s vision should be tested by your pediatrician or an ophthalmologist at age three to three and one-half, earlier if your child can recognize images on the pediatric eye chart. If your child has a family history of eye disease, if you notice your child’s eye wandering, or if you have any concerns regarding their vision, they should be screened regularly and quickly referred to an ophthalmologist if there are any concerns.”

Learn more about the eye. Read about Emory Eye Center in Emory Eye magazine.

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Eastern and Western medicine unite for mind/body health

Geshe Lobsang Tenzin Negi, PhD, senior lecturer in the Department of Religion at Emory, and Charles Raison, MD, in the Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, have been associates, colleagues and friends whose relationship has grown as a result of their participation in the Tibetan Studies Program at Emory. Together they have served for the last several years as co-directors of the Emory Collaborative for Contemplative Studies.

Geshe Lobsang Tenzin Negi

Geshe Lobsang Tenzin Negi, PhD

Charles Raison, MD

Charles Raison, MD

Negi and Raison recently collaborated on a study at Emory looking at the practice of compassion meditation and its effect of on inflammatory responses when people are stressed. The study required one group of college students to attend compassion meditation class sessions, while a control group attended classes on topics relevant to the mental and physical health of college students.

Negi developed and taught the compassion meditation program that was used in the study based on a thousand-year-old Tibetan Buddhist mind-training practice called “lojong” in Tibetan. Raison and his team of researchers tested the participants and analyzed the data.

The study, which has been published in two articles in the medical journal Psychoneuroendocrinology in 2009, succeeded in showing a strong relationship between time spent practicing meditation and reductions in inflammation and emotional distress in response to psychological stress.

The success of this initial study has led the pair to embark on an expanded protocol for adults called the Compassion and Attention Longitudinal Meditation study (CALM). The CALM study will compare compassion meditation with two other interventions – mindfulness training and a series of health-related lectures.

The outcome of the CALM study, combined with the data from the initial meditation study, will help neuroscientists to further expand the awareness of how mind and body are connected, and the power of the mind to effect both illness and health.

Raison is clinical director of the Emory Mind-Body Program, and director of the Behavioral Immunology Clinic at Emory’s Department of Psychiatry and Behavioral Sciences. He specializes in scientific studies that show how stress can have a negative impact on the body’s immune system.

Negi earned the highest degree of learning in Tibetan Buddhism, the degree of Geshe Lharampa, from Drepung Loseling Monastery, and received his PhD from Emory’s Graduate Institute for the Liberal Arts in 1999. In addition to teaching at Emory, he serves as spiritual director of Drepung Loseling Monastery, Inc., which has been affiliated with Emory since 1998 and which serves as the North American seat for Drepung Loseling Monastery, one of the largest Tibetan Buddhist monastic centers in exile in India.

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Study looks for treatment for pediatric heart disease

There have been tremendous advances in cardiac surgery over the years. Physicians can now operate on children with heart defects in the first month or week of their lives. But very little is known about how the human heart develops especially in that first year after birth.

Emory and Children’s Healthcare of Atlanta researcher Mary Wagner, PhD, is leading a project looking at how the heart develops during the first year of life. This is critical, she says, because children’s hearts respond differently to medications and surgery than adults’ hearts, and many treatments currently available to pediatric heart patients were designed and tailored specifically for the adult heart.

Wagner, associate professor in Emory’s School of Medicine, and her research team will examine the physiological properties of human heart tissue from pediatric patients. The samples are tissue that needs to be removed as part of the surgical repair of the patient’s heart and would otherwise be discarded.

The ultimate goal of Wagner’s research is to examine the differences in the human heart in the first year after birth and identify novel target therapies for the pediatric cardiac patient.

Wagner’s research labs are housed at The Emory-Children’s Center, a joint venture between Emory Healthcare and Children’s Healthcare of Atlanta.

Her research is funded by a stimulus grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health.

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Risk of death, stroke in postmenopausal women using antidepressants

Older women taking antidepressants could be at increased risk of stroke and death according to the authors of the Women’s Health Initiative (WHI) study. Cardiologist Nanette K. Wenger, MD, professor of medicine, division of cardiology, Emory School of Medicine, and chief of cardiology at Grady Memorial Hospital, is a co-author of the study published in the Dec. 14 issue of Archives of Internal Medicine.

Nanette K.Wenger, MD

Nanette K.Wenger, MD

The researchers report that postmenopausal women who reported taking an antidepressant drug had a small but statistically significant increase in the risk of stroke and of death compared with participants not taking antidepressants. They say the results of the study are not conclusive but do signify a need for additional attention to patients’ cardiovascular risk factors.

Depression is a serious illness with increased risk for cardiovascular disease and other health risks. The researchers stress that no one should stop taking their prescribed medication based on this one study as antidepressants have been proven lifesaving for some patients. Because of their potential for negative effects on heart function, tricyclic antidepressants are used less frequently. In contrast, selective serotonin reuptake inhibitor (SSRI) antidepressants have fewer side effects in general and are known to have aspirin-like effects on bleeding, which doctors say could protect against clot-related cardiovascular disorders.

Since the use of antidepressants has increased greatly in recent years and since older women are also at risk for cardiovascular disease, a team of researchers from several academic medical centers examined the link between antidepressant use and cardiovascular disease in such patients.

The WHI study followed more than 160,000 postmenopausal women in the United States for up to 15 years, examining risk factors for and potential preventive measures against cardiovascular disease, cancer and osteoporosis.

The authors call for additional research, says Wenger, because the study does not confirm whether this risk truly is attributable to the drugs and not to depression itself and whether participants were being treated for depression or for anxiety, which also has cardiovascular risks. Above all, patients should talk with their physicians about individual concerns and risk factors to determine the benefits of various treatment options, Wenger notes.

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Lung cancer clinical trial shows treatment promise

Advanced non-small cell lung cancer (NSCLC) is a challenging disease to treat. More than 200,000 new cases of lung cancer are diagnosed each year, and 85 percent to 90 percent of diagnosed lung cancers fall into the non-small cell type.

A new strategy for treating NSCLC that increases the effectiveness of standard chemotherapy in patients with advanced stage disease has been found by Emory researchers. Recent advances in treatment result in improvement in patient survival noted for all stages of NSCLC.

Saresh Ramalingam, MD

Saresh Ramalingam, MD

Lead investigator Suresh Ramalingam, MD, associate professor of hematology and medical oncology at Winship Cancer Institute of Emory University, along with a consortium of academic institutions that is supported by the National Cancer Institute, published the positive results in The Journal of Clinical Oncology.

In the clinical trial, Emory scientists added a cancer-fighting compound that is used to treat a specific type of lymphoma to standard lung cancer chemotherapy, resulting in an increase in positive response rates in NSCLC patients.

The addition of vorinostat, a compound that affects the function and activity of DNA and various other proteins, to standard chemotherapy treatment of carboplatin and paclitaxel, increased positive response rates in patients from 12.5 percent to 34 percent in a clinical trial of 94 patients with metastatic non-small cell lung cancer.

Vorinostat may be affecting histones, which are spool-like proteins around which the cell’s DNA is wound. These proteins are important for cell division. We believe these molecular effects could enhance the efficacy of carboplatin and paclitaxel, respectively.

Vorinostat is part of an emerging class of anti-tumor agents that interfere with enzymes known as histone deacetylases (HDAC). Inhibiting these enzymes increases the level of acetylation, a modification of proteins in the cell. Vorinostat is sold by Merck as Zolinza and was approved by the FDA in 2006 to treat cutaneous T cell lymphoma.

Ramalingam says this exciting data will have to be further evaluated in confirmatory phase III studies before they can be adopted in routine use. However, HDAC inhibitors can now be considered among the leading targeted agents under evaluation for the treatment of non-small cell lung cancer.

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Families reunite at Emory for annual “preemie” party

They are the hospital’s tiniest patients, and many must overcome the odds of prematurity and severe illness to survive. These premature babies, often called “preemies,” are cared for by the physicians and staff in the Special Care Nurseries at Emory University Hospital Midtown (EUHM).

The state-of-the-art nursery, designated a Level III nursery, provides the widest variety of advanced care available for premature and sick newborns. The neonatologists and nursery staff are all highly skilled in caring for these little babies and their many needs after birth. They also must teach the parents to care for their little ones when they go home.

Baby in the NICU

Baby in the NICU

Some of the infants are there for just a week or two. Others are there for months. And during their stay, special bonds are formed and many precious milestones are shared between the families and their caretakers.

Each December, doctors, nurses and staff in the Special Care Nurseries come together with the “preemie graduates” and their families to celebrate life and renew acquaintances at the hospital’s annual “Preemie Party.” The Special Care Nurseries held its 27th annual Preemie Party with more than 100 families in attendance.

It’s a time for grateful family members to once again thank those who cared for their babies when they were so fragile and sick. And it’s a time for the hospital staff to see how the little ones are growing – many now toddlers, school-aged children, teenagers and some even in their 20s return.

Ann Critz, MD, chief of Pediatrics and medical director of Nurseries at EUHM, says, “This annual party gives us the opportunity to visit with ‘our babies’ and their families again to see the progress they’ve made since leaving the hospital. It’s wonderful to see these children developing and thriving now, when they were once so small and medically fragile. This gathering is a very sentimental time for me each year.”

Critz, who is an associate professor of pediatrics, Emory School of Medicine, has cared for hundreds of preemies during her 29-year tenure at Emory University Hospital Midtown.

Susan Horner, RN, nurse in the Special Care Nurseries and Preemie Party coordinator, says, “It’s a joy to reconnect with the little ones and their family members who spent so many hours in our nurseries nurturing their preemies before taking them home.”

All babies born at the hospital, including preemies, experience a concept called “family-centered care,” which encourages parents to assist in caring for, rocking, holding and feeding their babies daily. Despite all of the tubes and monitors needed for the preemies, this family-centered care is vital.

Critz notes that the technique is extremely important in the neonatal intensive care unit, called the NICU. Bonding with even the smallest infants in the early stages is critical for the baby’s development. She and her colleagues have found the more parents are involved with the care of their preemies, the better the babies thrive.

EUHM has been a leader in neonatal care for as far back as the 1940’s. The hospital’s NICU opened in 1981 and currently serves as part of the Emory Regional Perinatal Center, one of six regional perinatal centers in the state to care for high-risk infants. Learn more about the maternity center at EUHM.

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