Triple play in science communication

We are highlighting Emory BCDB graduate student Emma D’Agostino, who is a rare triple play in the realm of science communication. Emma has her own blog, where she talks about what it’s like to have cystic fibrosis. Recent posts have discussed the science of the disease and how she makes complicated treatment decisions together with her doctors. She’s an advisor to the Cystic Fibrosis Foundation on patient safety, communicating research and including the CF community Read more

Deep brain stimulation for narcolepsy: proof of concept in mouse model

Emory neurosurgeon Jon Willie and colleagues recently published a paper on deep brain stimulation in a mouse model of narcolepsy with cataplexy. Nobody has ever tried treating narcolepsy in humans with deep brain stimulation (DBS), and the approach is still at the “proof of concept” stage, Willie says. People with the “classic” type 1 form of narcolepsy have persistent daytime sleepiness and disrupted nighttime sleep, along with cataplexy (a loss of muscle tone in response Read more

In current vaccine research, adjuvants are no secret

Visionary immunologist Charlie Janeway was known for calling adjuvants – vaccine additives that enhance the immune response – a “dirty little secret.” Janeway’s point was that foreign antigens, by themselves, were unable to stimulate the components of the adaptive immune system (T and B cells) without signals from the innate immune system. Adjuvants facilitate that help. By now, adjuvants are hardly a secret, looking at some of the research that has been coming out of Emory Read more

HIV prevention

Emory plays leading role in landmark HIV prevention study of injectable long-acting cabotegravir

Emory University played a key role in a landmark international study evaluating the safety and efficacy of the long-acting, injectable drug, cabotegravir (CAB LA), for HIV prevention.

The randomized, controlled, double-blind study found that cabotegravir was 69% more effective (95% CI 41%-84%) in preventing HIV acquisition in men who have sex with men (MSM) and transgender women who have sex with men when compared to the current standard of care, daily oral emtricitabine/tenofovir disoproxil fumarate 200 mg and 300 mg (FTC/TDF) tablets.

The study achieved its primary objective of non-inferiority with the difference approaching superiority in favor of cabotegravir, pending final analysis.

The findings were so positive that, during a planned review of study data, an independent Data and Safety Monitoring Board (DSMB) recommended the study results be announced as soon as possible. The study sponsor, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, agreed with that recommendation.

Emory, through the Emory-CDC HIV Clinical Trials Unit, enrolled 7% of the study’s more than 4,500 worldwide participants at three of its clinical research sites: The Hope Clinic (86 participants) and the Ponce de Leon Center (35 participants) in Atlanta and at the CDC’s Silom Community Clinic in Bangkok, Thailand (203 participants).

“This is a landmark study with a new approach that will change how HIV prevention is being done and will open the field to future interventions,” says Carlos del Rio, MD, the executive associate dean, Emory University School of Medicine at Grady Health System. Del Rio is a member of the study team and the principal investigator at the Ponce de Leon Center.

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HIV discordant couples

On Thursday, NPR had a nicely done story on discordant couples (one partner is HIV positive, the other is HIV negative) in Kenya.

It provided a reminder of Susan Allen’s work in Rwanda and Zambia with discordant couples. It also very simply laid out the policy issues connected with treating discordant couples:

Medical workers are http://www.raybani.com/ extremely interested in discordant couples for two reasons. One is that almost half of new infections in Kenya happen in these relationships. It’s one place where HIV is spreading. The second reason is that when couples are open with each other about their HIV status, managing HIV is more successful…

The World Health Organization now recommends that any HIV-positive individual in a discordant relationship be supplied HIV treatment. But discordant couples are still being treated on an ad hoc basis in Kenya, primarily because the funding for the medication just isn’t there.

Allen’s research provided critical data about HIV Ray Ban outlet transmission and prevention methods, and led to the adoption of the WHO guidelines mentioned in the story. She has said that the WHO guidelines were designed to help partners in a stable relationship work together to prevent the uninfected person from getting the virus and that low-tech, inexpensive prevention methods like condoms are just as important as antiretroviral therapy in this effort.

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A storied look at HIV/AIDS in Africa

At a recent Emory global health seminar series, Kate Winskell showed how fiction penned by young Africans can help inform the response to HIV and AIDS. Since 1997, more than 145,000 young Africans have participated in scriptwriting contests as part of Scenarios from Africa HIV communication process.

The resulting archive of stories is a unique source of cross-cultural and longitudinal data on social representations of HIV and AIDS. The archive now spans 47 countries and a critical 12-year period in the history of the epidemic. Winskell’s presentation analyzed the stories that were part of the 2005 Scenarios contest. Six African countries were represented.

The seed for Scenarios was planted more than a decade ago–before the rise of the Internet—when Winskell, a public health educator, and her husband, Daniel Enger, were searching for innovative ways to reduce the spread of HIV/AIDS. The old ways of trying to stop the spread of the disease, focusing only on medical aspects of the epidemic or relying on educational materials that were not culturally adapted, were clearly limited.

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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.

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