Overcoming cardiac pacemaker "source-sink mismatch"

Instead of complication-prone electronic cardiac pacemakers, biomedical engineers at Georgia Tech and Emory envision the creation of “biological Read more

Hope Clinic part of push to optimize HIV vaccine components

Ten years ago, the results of the RV144 trial– conducted in Thailand with the help of the US Army -- re-energized the HIV vaccine field, which had been down in the Read more

Invasive cancer cells marked by distinctive mutations

What does it take to be a leader – of cancer cells? Adam Marcus and colleagues at Winship Cancer Institute are back, with an analysis of mutations that drive metastatic behavior among groups of lung cancer cells. The findings were published this week on the cover of Journal of Cell Science, and suggest pharmacological strategies to intervene against or prevent metastasis. Marcus and former graduate student Jessica Konen previously developed a technique for selectively labeling “leader” Read more

General Health

HIV in metro Atlanta concentrated in four-county geographic cluster

The HIV epidemic in metropolitan Atlanta is concentrated mainly in one cluster of four metro area counties – Fulton, DeKalb, Clayton, and Gwinnett that includes 60 percent of Georgia’s HIV cases, according to a study by researchers in the Emory Center for AIDS Research (CFAR).

In a paper published in the Journal of Urban Health, the researchers found that the rate of HIV in the cluster is 1.34 percent. This fits the World Health Organization’s description of a “generalized epidemic” (>1 percent). Outside the cluster, the HIV prevalence in Georgia is 0.32 percent.

The researchers matched HIV prevalence data from the Georgia Division of Public Health, as of October 2007, to census tracts. They also used data from the 2000 census to examine population characteristics such as poverty, race/ethnicity, and drug use.

The large Atlanta HIV cluster is characterized by a high prevalence of poverty along with behaviors that increase the risk of HIV exposure such as injection drug use and men having sex with men.

The investigators also found that 42 percent of HIV service providers in Atlanta are located in the concentrated cluster, which should facilitate prevention and treatment.

Paula Frew, MPH, PhD

“A major aim of our study was to improve public health practice by informing local planning efforts for HIV services,” says corresponding author Paula Frew, MPH, PhD, assistant professor of medicine at Emory University School of Medicine and an investigator in the Emory CFAR.

With more than 50,000 new HIV infections reported yearly in the United States, according to the Centers for Disease Control and Prevention, the HIV/AIDS epidemic continues to be a major public health problem. The number of HIV/AIDS cases is increasing faster in the South compared to other areas of the country. According to Kaiser State Health Facts, Georgia ranks 9th in the nation in the number of HIV/AIDS cases with more than 3,000 new HIV infections diagnosed in 2007.

The study showed differences between Atlanta and other large cities in the distribution of HIV cases. While cases in several other large cities were concentrated in specific neighborhoods, HIV cases in metro Atlanta are more generalized within the four-county metro area. All the cities, however, were similar in the link between HIV, poverty and men having sex with men.

“Prevention efforts targeted to the populations living in this identified area, including efforts to address their specific needs, may be most beneficial in curtailing the epidemic within this cluster,” Frew says.

Other authors of the paper include Emory CFAR members Brooke Hixson, MPH; Saad B. Omer, MBBS, MPH, PhD; and Carlos del Rio, MD.

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What’s left when it comes to research?

Cesare Lombroso

In an editorial appearing in a recent issue of The Lancet, Emory Rollins School of Public Health professor Dr. Howard Kushner contends that the connection between left-handedness and a raft of mental and physical disorders has gained currency since the 1980s and ‘90s.

Although Kushner acknowledges a long history of suspicion surrounding left-handedness, he spotlights one Cesare Lombroso, a Turin physician who spent a great deal of time in and around the 19th century pointing a negative finger at left-handedness. Lombroso’s contemporaries mistakenly considered his studies, albeit mere observations, to be cutting-edge science.

Although scientific standards have changed since Lombroso’s time and today’s studies do not portray left-handedness with such profound negativity, Kushner says, “general claims about the pathology of left-handedness persist.” This despite studies showing left-handers displaying exceptional intellectual and creative talents.

So, what are we to conclude about the connection between left-handedness and health? Kushner doesn’t say. Instead, he asks us to consider that despite all the advanced scientific tools we have at our disposal, researchers should keep in mind that these very tools may not enable us to conclusively explain the mystery behind left-handedness and its meaning. Yet, we should not stop trying. After all, he says, today’s researchers are making solid contributions to such research–while raising provocative questions along the way.

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New 3D MRI Technology Puts Young Athletes Back in Action

Emory MedicalHorizon
New technology has made it possible for surgeons to reconstruct ACL tears in young athletes without disturbing the growth plate.

John Xerogeanes, MD, chief of the Emory Sports Medicine Center and colleagues in the laboratory of Allen R. Tannenbaum, PhD, professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, have developed 3-D MRI technology that allows surgeons to pre-operatively plan and perform anatomic Anterior Cruciate Ligament (ACL) surgery.

Link to YouTube video

The ACL is one of the four major ligaments in the knee, somewhat like a rubber band, attached at two points to keep the knee stable. In order to replace a damaged ligament, surgeons create a tunnel in the upper and lower knee bones (femur and tibia), slide the new ACL between those two tunnels and attach it both ends.

Traditional treatment for ACL injuries in children has been a combination of rehabilitation, wearing a brace and staying out of athletics until the child stops growing – usually in the mid-teens – and ACL reconstruction surgery can safely be performed.  Surgery has not been an option with children for fear of damage to the growth plate that would cause serious problems later on.

Xerogeanes explains that prior to using the 3-D MRI technology, ACL operations were conducted with extensive use of X-Rays in the operating room, and left too much to chance when working around growth plates.

Preparation with the new 3-D MRI technology allows surgery to be completed in less time than the traditional surgery using X-Rays, and with complete confidence that the growth plates in young patients will not be damaged.

Video Answers to Questions on ACL Tears

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National AIDS Strategy: Comments on a coordinated effort

In this month’s issue of the journal Future Microbiology, Emory infectious disease physician/scientists Rana Chakraborty and Wendy Armstrong from Emory School of Medicine summarize and comment on the goals and challenges of the National HIV/AIDS Strategy released July 10, 2010.

The National AIDS Strategy was the result of a directive by the Obama Administration to the Office of National AIDS Policy. The strategy’s overall goals were to reduce the number of people who become infected with HIV, to increase access to care and improve health outcomes for people living with HIV, and to reduce HIV-related health disparities.

“The National HIV/AIDS Strategy calls for a long overdue national coordinated effort to curb the rise in new HIV infections and enhance therapy in those already infected,” write the authors.

While the goals are worthy, the strategy will present many challenges, and the authors address each goal individually, and highlight challenges:

  • The initiatives are expensive, and already resources in the United States are not adequate to treat all patients currently diagnosed with HIV infection.
  • Convincing the general population that HIV is still a major problem and an incurable and often-fatal disease will remain a challenge.
  • Nontraditional testing sites outside clinics or hospitals, such as churches, while central to enhancing testing, may present problems of confidentiality.
  • Increasing the number and diversity of available providers of care is difficult given the current financial realities of the American healthcare system where medical practices with a high percentage of HIV patients often can’t break even financially.

The creation of a strategy is a positive step, say the authors, but it needs a clear financial commitment. The strategy’s strengths include a focus on specific high-risk populations, the concept of re-introducing conventional prevention methods including condom distribution and needle-exchange programs, and creating better outreach between leading HIV/AIDS centers in cities and HIV providers in rural settings.

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A healthy discussion on American medical innovation

Kenneth Thorpe, PhD

Researchers and medical experts will be meeting Wednesday morning, Jan. 12 in Washington, DC, at a symposium on “Medical Innovation at the Crossroads: Choosing the Path Ahead.” Emory University’s Kenneth Thorpe, PhD, chair of the Department of Health Policy & Management, Rollins School of Public Health, and other health care experts, commentators and journalists, will discuss the most effective federal policy strategies for U.S. medical innovation aimed at job creation, economic recovery and health security.

The symposium is sponsored by the Council for American Medical Innovation.

For more information, view the council’s recent video on medical innovation.

Not long ago, polio, a crippling and dreaded disease, seemed unstoppable. But thanks to innovative medical research, the disease met its match in a vaccine developed in the early 1950s by American scientists. Today America and the world still face diseases that cripple and kill.  But with ongoing innovations in medicine and science, diseases such as diabetes and HIV/AIDs may one day meet their match, too.

On a related note, Thorpe, who regularly blogs for the Huffington Post, has written a new article, “Medical Advancements: Who Is Leading the World?”

Posted on by Holly Korschun in Uncategorized 1 Comment

Transplant nursing pioneer revisits Emory Transplant Center, 45 years later

Millie Elliott

Nearly 45 years after she cared for Georgia’s first organ transplant recipient, Millie Elliott, 84, visited the Emory Transplant Center outpatient transplant clinic to see how things have changed since her time at Emory. Elliott, who was Millie Burns at the time, worked at Emory University Hospital first as an obstetrics nurse, then as head nurse of an NIH-sponsored clinical research unit at Emory from 1961 to 1967. She served as a dialysis nurse on that unit and may have been the Southeast’s first renal transplant coordinator.

During her recent visit to Emory, this former Cadet Nurse Corps nurse and World War II veteran regaled the transplant center staff and kidney transplant program director Thomas Pearson, MD, PhD, with her stories about the first transplant at Emory. Elliott recalled spending a lot of time researching medical sources to prepare herself and her nurses for that remarkable day. The first transplant patient was a 16-year -old boy with renal failure who received a donor kidney from his father.

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The science behind the Mediterranean diet

The diet calls for lots of fruits and vegetables.

Researchers, physicians, and health care providers from across the United States and Italy met recently at the Rollins School of Public Health for the first Emory Conference on Mediterranean Diet and Health. Participants focused on the diet’s relation to cardiovascular disease, cancer, neuropsychiatric disorders, and vascular health.

The Mediterranean diet is characterized by a high consumption of fruits, vegetables, legumes, complex carbohydrates, and nuts; moderate consumption of fish and red wine; low consumption of cheese and red meat; and olive oil as the chief source of fat, explains Viola Vaccarino, MD, PhD, one of the conference chairs.

When topped with exercise, the Mediterranean diet—really a pattern of eating habits traditionally followed by people in the Mediterranean regions in the early 1960s—has proven beneficial for many throughout the years. But why this is so isn’t clear.
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Detecting Lung Cancer at a Higher Rate

The findings from a recent study show the risk of dying from lung cancer could be reduced by 20 percent by use of a low-dose helical computed tomography (CT) scan.  With 160,000 deaths each year related to cigarette smoking, this type of screening could save up to 32,000 lives each year.

The National Cancer Institute (NCI) launched the multicenter National Lung Screening Trial (NLST) in 2002,  led at Emory by radiologist and researcher Dr. Kay Vydareny.  This trial compared two ways of detecting lung cancer: low-dose helical (spiral) computed tomography (CT) and standard chest X-ray, for their effects on lung cancer death rates in a high-risk population.

Both chest X-rays and helical CT scans have been used as a means to find lung cancer early, but the effects of these screening techniques on lung cancer mortality rates had not been determined. Over a 20-month period, more than 53,000 current or former heavy smokers ages 55 to 74 joined NLST at 33 study sites across the United States. In November 2010, the initial findings from NLST were released. Participants who received low-dose helical CT scans had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays.

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Internationally Recognized Violinist Raises Money for Alzheimer’s Research

Virtuoso Robert McDuffie Performs at the Schwartz Center November 19

On November 19, world famous virtuoso Robert McDuffie will dedicate the Atlanta premiere performance of Philip Glass’ “The American Four Seasons” to the Emory Alzheimer’s Disease Research Center (ADRC) and to his late father-in-law, Mack Taylor, who was a talented musician and business leader in the Atlanta community.

The event,  “A Family Affair” Dinner and Concert at Emory University, will honor Dr. Allan Levey, Director of the Emory ADRC and chair of the Neurology Department, and Dr. Stuart Zola, Associate Director of the ADRC and director of the Yerkes National Primate Research Center. Dinner guests will gather at the Carlos Museum and proceed to the Schwartz Center for Performing Arts for the concert featuring McDuffie.

The Taylor family, including Gretchen and Andrew Taylor, Camille and Robert McDuffie and Mary Rose Taylor, are serving as chairs of this inaugural event to acknowledge Alzheimer’s toll on the entire family.

Honorary Chairs Stuart Zola and Allan Levey, Directors of Emory ADRC

“I’m incredibly honored to dedicate my performance to Dr. Levey and his team of scientists at Emory’s Alzheimer’s Disease Research Center,” says McDuffie. “For 15 years, they took great care of my wonderful father-in-law Mack Taylor, who suffered from this dreadful disease.”

Alzheimer’s disease, the most common form of dementia among older adults, affects parts of the brain that control thinking, remembering and making decisions.

The incidence of Alzheimer’s is growing at an alarming rate. According to the CDC, it recently surpassed diabetes as the 6th leading cause of death among American adults. Funds raised will go toward education and collaboration so that others may learn and benefit from the work of Emory’s ADRC.

“Since millions of baby boomers are entering late adulthood, we expect the number of patients with Alzheimer’s disease to increase drastically over the next several decades,” says Levey. “We have an opportunity to build on the momentum of much exciting research progress in early identification of disease and development of many new treatment strategies that offer promise to slow its progression and lead to prevention.”

Emory’s ADRC is a National Institute on Aging funded center focused on clinical trials and research for Alzheimer’s disease. The only comprehensive program in Georgia and one of only 32 nationwide, the Emory ADRC is seeking cures through basic laboratory research, bringing new diagnostic methods and treatments into the clinic, and providing patients and their families with state-of-the-art care and access to cutting-edge advances.

The $150 tickets ($100 is tax deductible) are available at www.alumni.emory.edu/ADRC-AFamilyAffair or by calling 404-727-5713.

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Linking science and action through national public health institutes

As public health leaders from nearly 50 countries gathered this week at the Emory Conference Center, they had a common goal: strengthening individual public health institutes and establishing partnerships to significantly reduce death and disease globally.

The International Association of National Public Health Institutes (IANPHI) held its fifth annual meeting – and the first in the United States – in Atlanta, jointly hosted by IANPHI, located in the Emory Global Health Institute, and by the CDC. IANPHI is not a typical organization, pointed out IANPHI President Jeff Koplan. It’s a partnership of more than 80 members who are directors of CDC-like institutes around the world, and it exists for the partners to build relationships and actively support each other. IANPHI is funded by the Bill & Melinda Gates Foundation.

Jeffrey Koplan, MD, MPH, president of IANPHI

As the world “shrinks” due to easier and more frequent air travel and migration, the effects on public health can be both positive and negative. On the negative side, communicable diseases and lifestyles that contribute to non-communicable diseases are transmitted much more rapidly around the world. But on the positive side, nations can work together much more efficiently to address public health challenges as committed partners.

Tom Frieden, director of the CDC, emphasized the importance of a national focus in each country on public health problems, and linking national efforts with local programs. Having adequate resources for public health will be essential in successful monitoring and disease response as well as driving down healthcare costs around the world, he said.

A major theme of the IANPHI conference was non-communicable diseases (NCDs) in addition to communicable diseases (CDs), which traditionally have been the focus of global public health efforts.  NCDs now kill far more people than CDs throughout the world, Frieden pointed out.  Significant progress can be made against NCDs with the right approach. Frieden gave the example of Uruguay, where 1 in 4 smokers quit smoking after a major public health effort.

Kevin DeCock, director of the CDC’s new Center for Global Health, pointed out the fundamental changes in public health that have come about because of new technologies, such as cell phones and computers as well as new public health networks that allow much quicker responses. Only a few decades ago, information about disease outbreaks in less developed countries was communicated only after the disease had already peaked. Now that information can be sent almost instantaneously.

Public health leaders from four countries – Nigeria, Guinea-Bissau, Tanzania, and Ethiopia – gave examples of successful IANPHI-funded projects. Despite extremely limited resources in many countries, Koplan pointed out, these countries have made extraordinary and concrete progress in improving public health infrastructure and in decreasing disease and death from challenging public health problems.

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