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

March madness: National global health case competition features 13 universities

March Madness of a different flavor overtook Emory University March 18-19 as more than 200 students, judges, observers and staff convened for the first national Emory Global Health Case Competition.

The competition involved 20 teams of five students each, representing at least three academic disciplines per team. Emory fielded eight teams, and 12 teams came from leading universities across the country: Dartmouth, Princeton, Penn, Cornell, Yeshiva, Duke, Vanderbilt, UAB, USC, UCSF, Rice, and Texas A&M. All these universities are members of the Consortium of Universities for Global Health.

The first-place team, from Emory (l-r): Jason Myers, Candler School of Theology; Abdul Wahab Shaikh, Goizueta Business School; Stephanie Stawicki, Laney Graduate School; Andrew K. Stein, Goizueta Business School; Jenna Blumenthal, Laney Graduate School; Krista Bauer (judge), GE director of global programs; Meridith Mikulich, School of Nursing (not pictured)

As in two past local and regional case competitions, this year’s event was student initiated, developed, planned, staffed and conducted.

This year’s signature sponsor was GE, with additional sponsorship from Douglas and Barbara Engmann, and internal Emory funding.

“Global health continues to grow as a primary interest of students at universities across the United States, and the Emory Global Health Case Competition has gained a reputation as the leading national team event to showcase the creativity, passion, and intellect of our future leaders in global health,” says Jeffrey Koplan, MD, MPH, director of the Emory Global Health Institute.

The Feb. 17, 2011 issue of The Lancet included an article by Koplan and Mohammed K. Ali, assistant professor of global health at Rollins School of Public Health on the benefits of problem-based competitions to promote global health in universities.

Teams worked through the night on Friday for their Saturday morning presentations. The case involved a proposal for improving conditions in several East African refugee camps in the face of a severe budget cut. Judges were blinded to the academic affiliations of the teams, but Emory won the top two prizes (first prize was $5,000). UCSF and Dartmouth received honorable mentions, and Rice was given an innovation award.

 

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The science of caring

Handprints

“It is the oncology nurse whose ‘fingerprints’ are on the entire matrix of therapies,” said Seliza Mithchell.

A keynote presentation on “fingerprints” might be more suited to a police convention than an oncology nursing symposium.  That is unless Selinza Mitchell is the speaker. Mitchell, a nurse educator and presenter was the keynote speaker at the third annual Winship Oncology Nursing Symposium, held March 18 and 19 at the Evergreen Conference Center in Stone Mountain, Georgia.

Mitchell’s presentation focused on the impact oncology nurses have on the hundreds of patients and families they touch, both literally and figuratively.  It is the oncology nurse whose “fingerprints” are on the entire matrix of therapies, from administration of today’s latest targeted-therapy drugs to helping patients and families navigate an increasingly complex health care system.

That concept also formed the basis of many of the discussion groups that were part of the symposium.  “The entire model of care delivery is changing,” says Amelia Langston, MD, professor of Hematology and Medical Oncology at the Winship Cancer Institute.  “Care delivery is more of a team approach and is less physician-centered.  Therefore there is great interest in the expanding role of nurses, nurse practitioners, and physician assistants.”

Amelia Langston presenting at the Winship Oncology Nursing Symposium

Amelia Langston presenting at the Winship Oncology Nursing Symposium

The Winship Oncology Nursing Symposium has grown in three short years into one of the most informative and influential among this growing market of nursing continuing education opportunities.  Among the topics covered in this year’s meeting were cancer genetics, image-guided medicine, minimally invasive treatment, disease-specific topics and the expanding role of non-physician providers against the backdrop of health care reform.

“The health care system is demanding cost effective, clinically relevant continuing education programs in nursing and specifically in oncology nursing,” says Joan Giblin, MSN, FNP, a course director for the symposium and Manager of Patient Access at Winship.  “Offering a high quality, regional program that can provide the latest information on advanced nursing practice, research, and other issues is central to meeting that need.”

In addition to Joan Giblin, course directors for the event were Deena Gilland, RN, MSN, Director of Nursing at Winship, and Kevin Schreffler, RN, MSN, Clinical Nurse Specialist at Winship.

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Theater Emory Event Provides Platform for Awareness and Discussion about the Challenges of Military Life

Theater Emory is partnering with Theater of War Productions to present a free public performance of “Theater of War” on March 26, 7 p.m. in Cannon Chapel on the Emory University campus.

Actors Elizabeth Marvel and Bill Camp in Theater of War (Credit: Howard Korn)

Actors Elizabeth Marvel and Bill Camp in Theater of War (Credit: Howard Korn)

“Theater of War” is an interactive program intended to increase awareness of post-deployment psychological health issues, disseminate information regarding available resources and foster greater family, community, and troop resilience. The presentation uses dramatic readings of ancient Greek plays as a catalyst for town hall discussions about the challenges faced by service members, veterans and their families.

Panelists who will lead the discussion following the readings include:

Timothy (Tim) Puetz, PhD, MPHc
Tim Puetz separated from the US Army in 2010 after 8 years of service split between the Medical Service Corps and Infantry branches. He has consulted on Veteran’s Affairs research grants related to PTSD and mental health. He is currently a graduate student at Emory University, Rollins School of Public Health.

Christiane (Christi) O’Hara, PhD
Christiane O’Hara, PhD is a clinical psychologist and the mother of an active duty soldier presently serving in Iraq. As Co-Chairmain for a local non-profit, The ArtReach Foundation: Project America, she serves our active duty military personnel, veterans, and families as a Trainer and Training Coordinator. She is also a Red Cross Consulting Psychologist with the Traumatic Brain Injury Clinic at Eisenhower Army Medical Center, Fort Gordon, and a USO Georgia volunteer at the Atlanta airport.

CSM Phillip Stringfield, USA NGGA HHC 560th BFSB
Command Sergeant Major Stringfield is the highest ranking active duty enlisted person with the Army National Guard’s 560th Battlefield Surveillance Brigade out of Ft. Gillem, GA.

Theater of War Productions, supported by a generous grant from the Stavros Niarchos Foundation in collaboration with the United Service Organizations (USO), is partnering with ten prominent theaters and universities across the United States to present “Theater of War” for mixed audiences comprised of military service members and civilians.

Cannon Chapel is located at 515 Kilgo Circle, NE, Atlanta, GA 30322. Advance tickets not required, but seating is limited. For parking, directions and details, visit www.theater.emory.edu.

The Emory presentation of “Theater of War” is supported by the Stavros Niarchos Foundation, the USO, the Emory Rollins School of Public Health, the Emory Center for Ethics, the Michael C. Carlos Museum, Creativity: Art & Innovation, and the Center for Creativity & Arts.

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A milestone in treating hemophilia

Hematologist Pete Lollar has devoted his career to developing treatments for hemophilia A, which is caused by a lack of blood clotting factor VIII. Lollar is a professor of pediatrics in Emory School of Medicine and director of hemostasis research at Children’s Healthcare of Atlanta. Last week, Lollar was honored by Emory’s Office of Technology Transfer for setting in motion research that has progressed to a phase III clinical trial of a new product, OBI-1, a special form of factor VIII.

John "Pete" Lollar, MD

Along with this milestone came a dramatic story, described by OTT’s assistant director Cale Lennon. The first patient to enroll in the clinical trial did so in November 2010 because of what appeared to be acquired hemophilia, which led to severe uncontrolled hemorrhaging. As a result of treatment with OBI-1, developed by Lollar and his research team at Emory, the patient’s bleeding was brought under control and it saved his life. He was treated at Indiana Hemophilia and Thrombosis Center in Indianapolis.

Acquired hemophilia is a challenge for doctors to deal with because it is such a surprise. Unlike people with inherited hemophilia, those with acquired hemophilia do not have a personal or family history of bleeding episodes. Their immune systems are somehow provoked into making antibodies against their own clotting factor VIII. These antibodies also appear over time in about 30 percent of patients with inherited hemophilia who take standard clotting factors.

OBI-1, a special form of clotting factor VIII, is less of a red flag to the immune system. This allows treatment of patients who cannot benefit from standard clotting factor VIII, because of the presence of auto-antibodies.

Emory originally licensed OBI-1 to Octagen Corporation, a “homegrown” startup company founded in 1997. Octagen sublicensed the OBI-1 technology to a French biotechnology firm, Ipsen Biopharm in 1998. Over the next decade, Octagen and Ipsen pursued preclinical and initial clinical studies and completed a phase II clinical trial in 2006. Ipsen purchased the OBI-1 program outright in May 2008.

In January 2010, Ipsen developed a partnership agreement with Inspiration Biopharmaceuticals, which was founded by two businessmen whose children have hemophilia. Under the agreement’s terms, Inspiration licensed OBI-1 from Ipsen and is responsible for its clinical development, regulatory approval and commercialization.

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Cervical Cancer – Can Be Hard to Detect

MedicalHorizon

The Pap smear – also called Pap test – is part of the standard annual wellness exam for women’s health and used as a first step in detecting cervical cancer.  But according to a recent article published in the International Journal of Cancer,  the Pap test may not provide reliable results for certain types of cancer that are harder to detect.

Kevin Ault, MD, associate professor of obstetrics and gynecology at Emory University School of Medicine and investigator at the Emory Vaccine Center conducted a post-hoc analysis of the FUTURE I and FUTURE II (Gardasil) vaccine trials.  Based on that analysis Ault, a leading expert and pioneer in the field of human papilloma virus (HPV), says a regular Pap test is not always effective in diagnosing adenocarcinoma, because it starts high up in the cervical canal and may not be sampled by the Pap smear.

“There are a number of reasons the Pap smear could lead to inaccurate results. For example, the pathologist examining the cells could make an error, the gynecologist may not sample the cervix adequately or an infection could obscure the results,” says Ault.

According to Ault, andenocarcinoma is the second most common type of cervical cancer, accounting for about 20 percent of all cervical cancer cases. While the overall incident of cervical cancer is on the decline, Ault reports the proportion of cervical cancers that are andenocarcinoma is rising.

Cervical cancer is the eighth most common type of cancer in American women. More than 12,000 new cases of invasive cervical cancer are diagnosed each year, and more than 4,200 women in the U.S. die from of this disease annually* according to the American Cancer Society.  Scientists believe that pre-invasive cervical cancer may develop over a period of months or years after the cervix is infected with the sexually transmitted HPV.

“The take-away from this recent paper is the HPV test would be a better test for the harder to detect adenocarcinoma cervical cancer, if not all cervical cancer,” says Ault.

* 2010 data

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The next generation of biomedical engineering innovators

Congratulations to the winners of the InVenture innovation competition at Georgia Tech. The competition aired Wednesday night on Georgia Public Broadcasting. The winners get cash prizes, a free patent filing and commercialization service through Georgia Tech’s Office of Technology Transfer.

Several of the teams have Emory connections, through the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory, and the Atlanta Clinical & Translational Science Institute.

Emergency medical professionals know that intubation can be rough. The second place ($10,000) MAID team created a “magnetic assisted intubation device” that helps them place a breathing tube into the trachea in a smoother way. The MAID was designed by Alex Cooper, Shawna Hagen, William Thompson and Elizabeth Flanagan, all biomedical engineering majors. Their clinical advisor was Brian Morse, MD, previously a trauma fellow and now an Emory School of Medicine surgical critical care resident at Grady Memorial Hospital.

“When I first saw the device that the students had developed, I was blown away,” Morse told the Technique newspaper. “It’s probably going to change the way we look at intubation in the next five to 10 years.”

The AutoRhexis team, which won the People’s Choice award ($5,000), invented a device to perform the most difficult step during cataract removal surgery. It was designed by a team of biomedical and mechanical engineering majors: Chris Giardina, Rebeca Bowden, Jorge Baro, Kanitha Kim, Khaled Kashlan and Shane Saunders. They were advised by Tim Johnson, MD, who was an Emory medical student and is now a resident at Columbus Regional Medical Center.

The finalist Proximer team, advised by Emory surgeon Albert Losken, MD, developed a way to detect plastics in the body, which can help breast cancer survivors undergoing reconstruction.

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The Scientist ranks Emory one of top 15 best places to work for postdocs

This year, the readers of The Scientist magazine have ranked Emory University as the 11th best place to work for postdocs in the United States. Among Emory’s strengths, respondents cited training and mentoring, and career development opportunities.

The top U.S. institution was the Whitehead Institute for Biomedical Research in Cambridge, Massachusetts. The top international institution was University College, London. Emory has previously ranked as high as number 4 (in 2006) in The Scientist’s best places to work for postdocs survey.

The ranking was based on responses from 2,881 nontenured life scientists working in academia, industry or noncommercial research institutions. 76 institutions in the United States and 17 international institutions were included.

Emory employs nearly 700 postdoctoral fellows in laboratories in the School of Medicine, Yerkes National Primate Research Center, Emory College, the Graduate School of Arts and Sciences, Rollins School of Public Health and Nell Hodgson Woodruff School of Nursing.

After receiving their PhD degrees, life sciences graduates launch their research careers by working for several years as postdoctoral fellows in the laboratories of established scientists. In addition to engaging in sometimes grueling laboratory research, many postdocs teach, mentor graduate and undergraduate students and apply for their own funding on a limited basis.

 

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How the fetal environment affects long-term health

David Barker, MD, PhD

Why do some people, given the same apparent set of risk factors, develop certain diseases and others do not? British scientist David Baker, MD, PhD, is examining this question from a unique perspective.

Barker, a professor of clinical epidemiology at the University of Southampton in the United Kingdom, is a pioneer in a field known as fetal programming. Fetal programming is the process in which environmental influences during prenatal development alter the body’s structures—for life.

He and other experts spoke on the fundamentals of the subject recently at the first Predicting Lifespan Health Conference at Emory University. “What we’re really looking for is just a few core mechanisms, which are linked to early human development and lead to a plethora of disorders,” says Barker.

Emerging evidence suggests that chronic diseases of adult life, including cardiovascular disease, type 2 diabetes and certain cancers, have their origin through fetal programming, explains Michelle Lampl, associate director of the Emory/Georgia Tech Predictive Health Institute. “These diseases and others are initiated by adverse influences before birth,” says Lampl.

Speakers addressed fetal programming and the placenta, long-term cardiovascular disease and kidney function in low birth-weight babies, epigenetics and immunity, as well as postnatal influences from infant diet and growth patterns.

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New Biological Pathway Identified for PTSD

Emory MedicalHorizon

High blood levels of a hormone produced in response to stress are linked to post-traumatic stress disorder in women but not men, a study from researchers at Emory University and the University of Vermont has found.

The results were published in the Feb. 24 issue of Nature.

The hormone, called PACAP (pituitary adenylate cyclase-activating polypeptide), is known to act throughout the body and the brain, modulating central nervous system activity, metabolism, blood pressure, pain sensitivity and immune function. The identification of PACAP as an indicator of PTSD may lead to new diagnostic tools and eventually, to new treatments for anxiety disorders.


Video on YouTube

“Few biological markers have been available for PTSD or for psychiatric diseases in general,” says first author Kerry Ressler, MD, PhD, associate professor of psychiatry and behavioral sciences at Emory University School of Medicine and a researcher at Yerkes National Primate Research Center. “These results give us a new window into the biology of PTSD.”

Read more @ emoryhealthsciences.org.

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Emory Fellow and Heart Transplant Survivor Rides in Rose Parade

Dr.Shih and her husband Chad Aleman, MD, decorating and dedicating a rose on the actual float prior to the parade.

Dr.Shih and her husband Chad Aleman, MD, decorating and dedicating a rose on the actual float prior to the parade.

Jennifer Shih, MD, a current Fellow in the Department of Allergy and Immunology at Emory University School of Medicine and a heart transplant survivor, was an honored guest on the Donate Life float in the 2011 Rose Parade.

Dr. Shih, second from left, riding on the Donate Life float, which won the trophy for best theme

Dr. Shih, second from left, riding on the Donate Life float, which won the trophy for best theme

Dr. Shih was one of five winners who received a trip to Pasadena, California, and an opportunity to be in the Rose Parade through an essay contest sponsored by Astellas’ Ride of a Lifetime.

In 2004, after Dr. Shih had completed three years of pediatric residency to fulfill her dream of becoming a pediatric cardiologist, her world was suddenly turned upside down.

She was on call one night Cincinnati Children’s Hospital when she started feeling tired and short of breath. She knew something was wrong. Instinctively, she performed an echocardiogram and found fluid around her heart.  Shih diagnosed herself with a heart condition, giant cell myocarditis.

Her condition quickly deteriorated and within a week of being hospitalized, she was told she would die without a heart transplant. She was placed on a BiVAD (Bi-ventricular Assist Device) to keep her alive.

Less than two weeks after self-diagnosis, she received a life-saving heart transplant.

Although she wasn’t able to practice pediatric cardiology anymore due to the activity and risk of infection exposure post-transplantation, she was able to change her specialty to allergy and immunology. Shih says her experience makes her a more empathetic doctor because she truly understands what it is like to be a patient.

Along with her family and friends, Shih created the Have a Heart Benefit Fund in 2004, which raises money to provide patient care, education and research the transplant field.  She says she has always loved helping people, and she felt this would be a great way of showing her appreciation to donor families.

“I would not be alive today without my gift of life. I am a testament to the impact becoming an organ donor can be. You can have the opportunity to save eight lives in one day by being an organ donor… how many of us would have that opportunity otherwise?” Shih asks.

Read Jennifer’s winning essay.

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