One more gene between us and bird flu

We’re always in favor of stopping a massive viral pandemic, or at least knowing more about what might make one Read more

Antibody diversity mutations come from a vast genetic library

The antibody-honing process of somatic hypermutation is not Read more

Emory Microbiome Research Center inaugural symposium

Interest in bacteria and other creatures living on and inside us keeps climbing. On August 15 and 16, scientists from a wide array of disciplines will gather for the Emory Microbiome Research Center inaugural Read more

Emory School of Medicine

NIH at Emory to advance women’s heart health

NIH meets at Emory to discuss women's cardiovascular health and research

The National Institutes of Health (NIH) has convened a key meeting at Emory on women’s cardiovascular health and research. The meeting, co-hosted by the Office of Research on Women’s Health and Emory School of Medicine, is focused today and tomorrow on NIH planning of the women’s health research agenda for the next decade.

Vivian Pinn, MD, associate director for research on women’s health, and director of the Office of Research on Women’s Health at NIH, opened the meeting with Emory’s conference chair, Nanette Wenger, MD, professor of medicine (cardiology), Emory School of Medicine, and chief of cardiology at Grady Memorial Hospital.

Nanette K. Wenger, MD

In a career that spans more than 50 years, Wenger’s dedication to reducing women’s disability and death from cardiovascular disease has made her one of the country’s most-respected experts on coronary heart disease in women. In 2009, Wenger received the Lifetime Achievement Award from the American College of Cardiology.

Although Wenger has earned dozens of awards in her celebrated career, she says her greatest professional achievement has been to help change a major paradigm in cardiology: the assumption that heart disease affects only men. A half a century ago heart disease was thought of as a “man’s disease.”

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Heart Month: Helping narrowed aortic valves

Celebrating February’s American Heart Month at Emory Heart & Vascular Center

Emory cardiologists are using a promising new non-surgical treatment option for patients with severe aortic stenosis.

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.

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Emory Heart & Vascular Center advances medicine

American Heart Month 2010

Learn about Emory Heart & Vascular Center advances during American Heart Month.

Research led by John Puskas, MD, professor of surgery and associate chief, Division of Cardiothoracic Surgery, Emory School of Medicine, has shown that off-pump bypass surgery reduces the risk of complications for high-risk patients, such as those that are especially frail or those with diabetes, obesity, kidney disease or a history of stroke.

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.

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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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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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Medical imaging experts on quality and safety

Recently, a great deal of media coverage has focused on radiological services such as CT scans, and questions have been raised over the safety related to the increasing use of those services and the amount of radiation they deliver.

Medical imaging procedures, such as CT or CAT scans, are considered by experts to be highly useful for the diagnosis, treatment and monitoring of many medical conditions including cancer, heart disease, trauma, and liver and kidney disease. The recent increase in attention and exposure via the media is valuable, say Emory experts, in highlighting rapidly improving imaging technologies and the importance of ensuring such scans are performed in a setting where there is carefully monitoring to minimize associated radiation exposure.

CT scanner

CT scanner

Emory’s Department of Radiology is well-recognized for its expertise in all subspecialty areas of radiology and medical imaging, as well as its breadth and depth of medical physicists, researchers and educators.

Carolyn Meltzer, MD, William P. Timmie Professor and chair of the Department of Radiology in Emory’s School of Medicine, says, “Emory radiologists are the physician experts in imaging, most receiving more than 13 years of extensive training. In fact, radiologists receive substantive training in radiation biology and safety that is linked to their board certification.”

According to Kimberly Applegate, MD, vice chair of Quality and Safety for Emory’s Department of Radiology, commented on safety recently in the New England Journal of Medicine. She wrote in the article, “The medical community should continue to work together across disciplines to use existing knowledge about radiation protection to ensure that imaging is warranted and optimized.”

When patients do need imaging, they should ask if the imaging personnel are credentialed and the protocols used are weight-based and indication-based, to ensure quality, notes Applegate. Emory subspecialty radiologists work in multidisciplinary clinical teams to make sure that imaging is used appropriately, she adds.

In order to minimize radiation exposure, Emory Radiology adheres to the following guidelines: CT protocols are optimized by subspecialty-trained radiologists to ensure quality and safe imaging procedures. Further, explains Applegate, low radiation exam protocols are used when appropriate and CTs or X-rays are not performed on pregnant patients unless it is a medical emergency.

Further, in accordance with ACR (American College of Radiology) guidelines, Emory Radiology does not offer whole body screening CT exams. These tests result in unnecessary radiation and often lead to additional unneeded tests, says Applegate.

Click here for more information about radiation safety and what Emory is doing to educate all stakeholders in medical imaging and to ensure safe, high quality imaging. To learn more about medical imaging and expected radiation levels visit RadiologyInfo.

For a summary of the National Council on Radiation Protection and Measurements (NCRP) report on American radiation exposure from all sources, including medical imaging, visit The NCRP report 160: Ionizing Radiation Exposure of the Population of the United States (2009).

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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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