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

News

Discerning a prelude to Alzheimer’s

Imagine that an elderly relative has been having difficulty remembering appointments and acquaintances’ names, or even what happened yesterday. Memory problems can be signs of mild cognitive impairment (MCI), a prelude to Alzheimer’s disease.

Scientists believe that the outward effects of the slow damage that comes from Alzheimer’s only show up after the damage has been accumulating for years. However, memory difficulties can also be the result of stress or another health problem. Patients thought to have MCI at an initial doctor’s visit sometimes improve later.

That’s why researchers at Emory’s Alzheimer’s Disease Research Center have been testing noninvasive imaging approaches to distinguishing MCI from healthy aging and Alzheimer’s. Their goal is to identify individuals at risk of developing Alzheimer’s, at a time when intervention can make a difference in how the disease progresses.

“We believe that imaging technology may help us find the signature changes in brain structure that are specific to MCI,” says Felicia Goldstein, PhD, associate professor of neurology.

Color coded diffusion tensor image (DTI) of a brain section from a healthy individual (A) showed a thick and intact corpus callosum (orange color), a white matter fiber bundle connecting left and right hemisphere as illustrated in the 3D rendering of the tractograph derived from DTI (B). However, a thin and narrow corpus callosum is seen in an AD patient (C) due to the degeneration of this white matter structure

Color coded diffusion tensor image (DTI) of a brain section from a healthy individual (A) showed a thick and intact corpus callosum (orange color). However, a thin and narrow corpus callosum is seen in an AD patient (C) due to the degeneration of this white matter structure. Courtesy of Hui Mao.

Two recent papers highlight the use of diffusion tensor imaging, an advanced form of magnetic resonance imaging.

The first paper was published by Brain Imaging and Behavior with Goldstein as first author, in collaboration with Hui Mao, PhD, associate professor of radiology, and ADRC colleagues.

It examines diffusion tensor imaging as a way to probe the integrity of the brain’s white matter, and compares it with tests of memory and behavior traditionally used to diagnose MCI and Alzheimer’s.

White matter appears white because of the density of axons, the signal-carrying cables allowing communication between different brain regions responsible for complicated tasks such as language and memory.

Diffusion tensor imaging allows researchers to see white matter by gauging the ability of water to diffuse in different directions, because a bundle of axons tends to restrict the movement of water in the brain.

Goldstein and her colleagues found that patients diagnosed with “amnestic” MCI showed greater loss of white matter integrity in a certain part of the brain — the medial temporal lobe – than cognitively normal controls of similar age. This loss of white matter was linked with poor recall of words and stories.

The second paper, with Liya Wang, PhD, a senior research associate in Mao’s laboratory as first author, was published by the American Journal of Neuroradiology in April. Here the authors try combining probing white matter integrity with a MRI measure of whether the brain has shrunk as a result of disease.

Combining the two methods improves the accuracy of MCI diagnosis with respect to either alone, the authors found.

Mao notes that Emory has been participating in a multi-center study called ADNI (Alzheimer’s Disease Neuroimaging Initiative). Diffusion tensor imaging is a relatively new technique and could add information to future large-scale Alzheimer’s imaging studies, he says.

The Dana Foundation’s BrainWorks newsletter had an article recently on Alzheimer’s and brain imaging.

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A new and faster way to diagnose and fight flu

flu imageA new method of rapidly producing highly targeted monoclonal antibodies could soon be used to rapidly diagnose H1N1 influenza. Just a month after vaccinating people with a seasonal flu vaccine, the researchers were able to use just a few tablespoons of the vaccinated individuals’ blood to generate antibodies against that specific strain of flu. The research was published last spring in Nature.

The scientists believe their discovery could be applied to any infectious disease. By using a few drops of blood from infected people, they could isolate antibodies to rapidly diagnose a newly emerging flu strain such as H1N1.

There are many variations of H1N1, says Rafi Ahmed, director of the Emory Vaccine Center and a Georgia Research Alliance Eminent Scholar, but this technology could be used to identify a very specific strain, such as the one we’re dealing with in the current pandemic. The diagnostic tests available now are not specific to any particular H1N1 strain.

Ahmed and his colleagues, including postdoctoral fellow Jens Wrammert, and Patrick Wilson from the University of Chicago, hope their work will lead to a new, specific test for H1N1 within the next several months.

Conventional methods of making human monoclonal antibodies are time-consuming and laborious, says Ahmed. For example, one method involves sifting through human B cells —white blood cells that make human antibodies—and then looking for specific cells that make the right antibodies.

Not only is the new method quicker and less cumbersome, it could be applied to almost any infectious disease. In any kind of emerging infection, speed is essential, says Ahmed.

To listen to Ahmed describe the new monoclonal antibody method, listen to Emory’s Sound Science podcast.

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America’s health care system: Emory experts weigh in

It’s broken, and it needs fixing. That much everyone can agree on when it comes to U.S. health care. Much of the conversation about health reform centers on cost, but access and quality of care are key factors, too.

Emory University experts are adding their voices to the health reform debate. Here are some of their thoughts and suggestions for fixing America’s health care system.

Modernizing Medicare

Adam Atherly, PhD, health policy professor at Emory’s Rollins School of Public Health (RSPH), says eliminating Medicare Parts A and B would make the federal program more user friendly. “It makes sense to do a good job of running the programs we already have,” says Atherly.

Medicaid promises

Kathleen Adams, PhD, RSPH health economist, says Medicaid is fragmented and should be uniformed for all states. “State Medicaid programs are our labs for health care reform,” says Adams. “Unfortunately, that is adding to the fragmentation in health care. What we really have is not one but 50 Medicaid programs.”

Universal consequences

The President, Congress, and leaders in the public and private sector need to figure out how to achieve health insurance coverage for everyone,” urges Art Kellermann, MD, MPH, Emory School of Medicine health policy dean and professor of emergency medicine. “Uninsurance has consequences for everyone,” says Kellermann. “Communities struggle to recruit and retain doctors. Specialists are reluctant to take ER and trauma calls because of payment issues, and hospitals are less likely to offer vital but unprofitable services.”

Primary care pulpit

As director of the Emory Center on Health Outcomes and Quality at the RSPH, Kimberly Rask, PhD, wants to go beyond the debate on health care costs. “In the long run, achieving cost savings depends on how we organize our health care,” she says. “We need programs that provide the right care at the right time for the right condition.”

Controlling chronic conditions

Kenneth Thorpe, PhD, chair of the RSPH department of health policy and management, reports that 75 percent of national health spending is for chronic conditions such as diabetes and hypertension. Rising rates of obesity account for 20 percent to 25 percent of the overall rise in spending. And right now, less than 1 percent of national health spending is directed to avoiding health problems rather than preventing them. Thorpe says prevention could significantly lower overall health care costs.

Arguing for basics

William Bornstein, MD, chief quality officer for Emory Healthcare, says medical innovation and discovery has shifted focus from health care fundamentals. “We have focused on the rocket science instead and have left out the basic blocking and tackling,” says Bornstein. “If we just gave regular immunizations, we’d have had more impact on saving lives than we’ve had with some groundbreaking discoveries.”

Read more Emory experts’ health care reform analysis in the new issue of Emory Health magazine.

Please note that, unless stated otherwise, the opinions of these experts do not necessarily reflect official Emory health care reform policy positions.

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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 Ray Ban outlet 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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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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Expert studies collective decision-making

Gregory Berns

Gregory Berns

Greg Berns, MD, PhD, is the Emory psychiatrist who heads the Center for Neuropolicy. The Center focuses on how the brain influences decision-making in politics, policy and business. The center involves School of Medicine, Emory College and Goizueta Business School researchers.

Berns says, “We all live in groups. Sometimes groups make good decisions, but groups often behave worse than any of its members would. We’re approaching the problem of collective decision-making from a new perspective by studying how the human brain functions in groups.”

Center members advise decision-makers of all kinds by conducting experiments focused on biologically based pressures that influence collective decision-making. Through their discoveries, researchers will better understand how culture, intelligence and environment influence the way decisions are made and how basic human tendencies drive judgment in certain situations.

As Berns points out, people also need to understand how religious and political ideologies become transformed in the brain and can subvert basic self-survival value judgments, a phenomenon that occurs in war and terrorism.

“Collective decision-making is political, but politics are biological,” says Berns. “The human brain evolved to function in social groups. By discovering how our brains are wired to behave in groups, we can find solutions to problems of global impact.”Berns is the author of Satisfaction: The Science of Finding True Fulfillment and Iconoclast: A Neuroscientist Reveals How to Think Differently.

Learn more in the Center media kit, Emory Health magazine or listen to a podcast.

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Emory and Georgia Tech

Over the past twenty years, the research partnership between Emory University and the Georgia Institute of Technology has developed into one of the leading bioengineering and biomedical research and educational programs in the nation. In recent years this partnership has resulted in the development of several pieces of diagnostic and medical-assistant technology, with medical experts on the Emory side working with engineers on the Georgia Tech side.

An example of this collaboration is the El-E robot, designed to perform simple tasks such as opening drawers and retrieving objects. Clinicians at Emory’s School of Medicine and engineers at Georgia Tech created the 5½-foot-tall machine, which glides across the floor on wheels and takes direction from a laser pointer that users can control in a variety of ways, depending on their preferences and capabilities. El-E is no mere toy, however: The machine could help patients with significant motor impairments, such as sufferers of ALS, maintain their independence and help relieve physical and financial burdens faced by caregivers.

 

Another result of the Emory-Georgia Tech collaboration is DETECT, a portable device capable of detecting the earliest stage of Alzheimer’s disease, mild cognitive impairment, in any environment. DETECT has a helmet device that includes an LCD display in a visor, along with a computer and noise-reduction headphones. DETECT gives the patient a battery of words and pictures to assess cognitive abilities—reaction time and memory capabilities. The low-cost test takes approximately 10 minutes. The device was co-developed by emergency medicine physician David Wright, and Michelle LaPlaca, a scientist in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory.

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Dr. Sanjay Gupta: CNN correspondent & Emory doctor

Millions of TV viewers know Dr. Sanjay Gupta as CNN’s chief medical correspondent. But did you know that off the air, Dr. Gupta is a practicing trauma neurosurgeon at nearby Grady Memorial Hospital? Gupta, like most of the doctors at the hospital, is an Emory physician. CNN medical producer Danielle Dellorto put together this video showing what his life as a surgeon is like.


 

 

Gupta works with Emory doctors on CNN as well. Two of the four members on Gupta’s CNNHealth.com medical advisory team are Emory doctors.

You can see correspondent Gupta on “Paging Dr. Gupta” on CNN 6-10 a.m., Monday-Friday or read the Paging Dr. Gupta Blog.

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As China grows, so does Emory

Peking University

Peking University in Beijing, China

The meteoritic rise of China in the world has seen a corresponding rise in the number of partnerships between Emory and Chinese universities and researchers.

In February 2009, Emory, Georgia Tech, and Peking University announced a joint biomedical engineering PhD program. Representatives from the schools have been laying the groundwork for this program during the past five years.  In the Fall of 2009, members of the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University traveled to Beijing to finalize the program details with the Department of Biomedical Engineering at Peking University (PKU). Faculty collaborations have been funded by seed grants and, as a result, several new research projects are already underway.

Public health units at Emory are also reaching out to China. In February 2009, it was announced that Emory University has received a $14 million, five-year grant from The Bill & Melinda Gates Foundation to help reduce the burden of tobacco use in China. The Emory Global Health Institute, in collaboration with the Tobacco Technical Assistance Consortium (TTAC) of Emory’s Rollins School of Public Health, will establish the Emory Global Health Institute — China Tobacco Partnership.

China is likewise reaching out to Emory. According to the international business news site Global Atlanta, delegates from China’s Shandong province recently came to Atlanta to meet with health care professionals, public health officials, educational institutions and legislators.The group visited the the Emory Spine Center, where they met with acupuncturists using traditional Chinese techniques alongside new therapies.

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Emory and Grady

Grady Memorial Hospital

Grady Memorial Hospital

Every day Atlanta’s lead stories call attention to it: “Shot teen taken to Grady,” “Burn victim ambulanced to Grady,” “Accident victim stable at Grady”– Atlantans, Georgians, and even out of state residents taken to Grady Memorial Hospital in their hour of direst need. What many don’t know however, is that Grady, Atlanta’s public hospital, doesn’t only treat emergencies; Grady is recognized for programs for breast cancer, stroke, sickle cell anemia and more.

Something else many don’t know: “Grady doctors” are Emory or Morehouse doctors. All doctors at Grady are faculty or residents from Emory University School of Medicine or Morehouse School of Medicine. Emory physicians provide close to 85 percent of all physician patient care delivered at Grady. For Emory, this connection goes back to before the Civil War.

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