Managing heart disease and diabetes in South Asia

Illnesses such as diabetes and heart disease are affecting increasing numbers of young people in developing countries. In light of this worrisome trend, K. M. Venkat Narayan, MD, and his colleagues are launching a new center of excellence aimed at preventing and controlling heart disease and diabetes in India and Pakistan.

K.M. Venkat Narayan, MD

Itâ€™s essentially a center of excellence for cardiac metabolic disease prevention and control in South Asia with Emory playing a very important role in the project, says Narayan, professor of global health and epidemiology at Emory’s Rollins School of Public Health and professor of medicine in Emory School of Medicine.

The primary partner of this grant will be the public health foundation of India, New Delhi. Emory is the developed country academic partner working with other network partners, namely, the Madras Diabetes Research Foundation in Chennai, India and the Aga Khan University in Karachi, Pakistan.

The center will focus on surveillance, prevention of mortality stemming from cardiovascular disease and diabetes, and training young investigators in the field of diabetes and cardiovascular disease prevention and control.

Itâ€™s estimated that by 2030, the number of people with diabetes will reach 400 million worldwide, double todayâ€™s number, says Narayan. Cardiovascular disease is a major cause of death among people with diabetes with 80 percent of deaths from chronic diseases worldwide occurring in low and middle-income countries.

What is particularly worrying about developing countries is that diseases like diabetes are hitting younger people, says Narayan. The implications, he says, are young people who would otherwise be economically productive must leave the labor market. In addition, in India, one person having diabetes uses 25 percent of the familyâ€™s income just for his own treatment. The economic impact and the health impact are enormous, says Narayan. Read more in Emory Public Health magazine.

Posted on November 5, 2009 by admin in Uncategorized Leave a comment

Serendipity & strategy: Nox researcher David Lambeth

David Lambeth, MD, PhD, with one of his paintings

NADPH oxidases (Nox for short) are enzymes that help plants fight off pathogens, guide sexual development in fungi, are essential for egg laying in flies and even help humans to sense gravity.

But what first attracted the interest of Emory researchers was the role of Nox in vascular disease and cancer. Along with Emory cardiologist Kathy Griendling, pathologist David Lambeth pioneered the discovery of how important these reactive oxygen-generating enzymes really are.

Lambeth will be honored this month in San Francisco by the Society for Free Radical Biology and Medicine with their 2009 Discovery Award.Â A profile in Emory Report explores his musical and artistic pursuits as well as his science.

Posted on November 4, 2009 by Quinn Eastman in Uncategorized Leave a comment

Encouraging news on women and heart disease

A new study reported this week in the Archives of Internal Medicine delivers encouraging news that Americans are on the right track in the fight against heart disease among women.

The study reports that all women, especially those younger than 55, have recently experienced a greater increase than men in their chances of survival following a heart attack.

Study leader, Viola Vaccarino, MD, PhD, professor of medicine (cardiology), and director of the Emory Program in Cardiovascular Outcomes Research and Epidemiology, researched trends in the rate of in-hospital deaths following heart attack from June 1994, through Dec. 2006. Data were collected from 916,380 patients through the National Registry of Myocardial Infarction.

Between 1994 and 2006, in-hospital death rates decreased among all patients, but decreased more strikingly in women than in men. The decreased risk of death was largest in women younger than 55 years (a 52.9 percent reduction) and lowest in men of the same age (33.3 percent). The absolute reduction in the risk of death among patients younger than 55 was three times larger in women (2.7 percent) than men (0.9 percent).

Vaccarino and her colleagues say a large part (93 percent) of this sharper decrease in mortality of younger women compared with men in recent years is due to the improved risk profile of women compared with men at the time of the heart attack hospitalization, perhaps the result of better recognition and management of coronary heart disease and its risk factors in women before the acute heart event.

Whatever the reason, the improvement indicates that we are headed in the right direction, says Vaccarino. Increased and ongoing awareness to the prevention of cardiovascular risk factorsâ€”by healthy diet, regular physical activity and avoidance of smoke and smokingâ€”is saving lives, she notes.

Posted on October 30, 2009 by admin in Uncategorized Leave a comment

Importance of flu vaccinations for pregnant women

Pregnant women are at the top of the Center for Disease Control and Prevention’s priority list when it comes to vaccinating people against the novel H1N1 flu virus this year. Not only should pregnant women receive the 2009 H1N1 vaccine, they should also receive the usual seasonal flu vaccine, say Emory experts.

Staying healthy in pregnancy

Because pregnancy weakens the immune system, a pregnant woman who gets any type of flu has a greater chance for serious health problems. Pregnant women who contract H1N1 flu are more likely to be admitted to the hospital, compared with other people in general that get H1N1 flu. Pregnant women are also more likely to have serious illness, including pneumonia and death from this particular novel strain.

Both vaccines are made with a dead, or inactivated, flu virus and are given as an injection, usually in the arm. The other type of flu vaccine is a nasal spray and is not recommended for pregnant women. The nasal spray vaccine is safe for women after they have delivered, even if they are nursing. In addition to immunizations, pregnant women also need to prepare for breastfeeding by inquiring if they can get a breast pump covered by insurance.

A recent study by Emory researchers found that seasonal flu vaccination of pregnant women can benefit both mothers and infants, says Kevin Ault, MD, associate professor in the Department of Gynecology and Obstetrics at Emory.

Saad B. Omer, MBBS, MPH, PhD, assistant professor of global health at Emory’s Rollins School of Public Health, served as senior author on the report, published in the American Journal of Obstetrics & Gynecology. The study shows that there is substantial evidence that vaccination is not only safe for pregnant women but that it is critical for protecting women and their infants against serious complications from the flu.

Other members of the research team included Ault and Carlos del Rio, MD, professor and chair in the Hubert Department of Global Health, Rollins School of Public Health, Emory University.

The seasonal flu shot has been given to millions of pregnant women over several decades . Flu shots have not been shown to cause any harm to pregnant women or their babies. The 2009 H1N1 flu vaccine is being made in the same way and by the same manufacturers as the seasonal flu vaccine, explains Ault.

Ault also serves as principal investigator of a seasonal flu vaccine clinical trial underway at Emory Vaccine Center involving pregnant women.

Posted on October 29, 2009 by admin in Uncategorized Leave a comment

Next steps in progesterone for brain injury

At a recent Society for Neuroscience (SFN) meeting, Emory researchers described their efforts to learn about optimizing progesterone for treatment of traumatic brain injury.

Researcher Donald Stein, PhD, Asa G. Candler Professor of Emergency Medicine at Emory School of Medicine, has shown that progesterone can protect damaged brain tissue. Stein is director of the Department of Emergency Medicine’s Brain Research Laboratory.

Donald G. Stein, PhD

One of the Emory SFN presentations covered efforts to find progesterone analogues that are more water soluble. This work comes from Stein and his colleagues in collaboration with the laboratory of Dennis Liotta, PhD, Emory professor of chemistry.

Currently, the lack of water solubility limits delivery of progesterone, in that the hormone must be prepared hours ahead and cannot be kept at room temperature. Small chemical modifications may allow similar compounds with the same effects as progesterone to be given to patients closer to the time of injury. In cases where such injuries lead to legal disputes, personal injury lawyers play a crucial role in ensuring that victims receive the compensation they deserve.

According to the results, two compounds similar to progesterone showed an equivalent ability to reduce brain swelling in an animal model of traumatic brain injury.

The second Emory report described evidence that adding vitamin D to progesterone enhances the hormone’s effectiveness when applied to neurons under stress in the laboratory. Like progesterone, vitamin D is a steroid hormone that is inexpensive, has good safety properties and acts on many different biochemical pathways.

David Wright, MD

The authors showed that a low amount of vitamin D boosted the ability of progesterone to protect neurons from excito-toxicity , a principal cause of brain injury and cell death.

A new study at Emory, slated to begin early 2010, will evaluate progesterone’s effectiveness for treating traumatic brain injury in a multisite phase III clinical trial called ProTECT III.

The study follows earlier findings that showed giving progesterone to trauma victims shortly after brain injury appears to be safe and may reduce the risk of death and long-term disability.

David Wright, MD, assistant professor of emergency medicine at Emory School of Medicine is the national studyâ€™s lead investigator.

Michael Frankel, MD, Emory professor of neurology, will serve as site principal investigator of the clinical trial at Grady Memorial Hospital.

Posted on October 28, 2009 by Quinn Eastman in Neuro Leave a comment

Students and faculty aid CDC for H1N1 response

Last spring, as H1N1 avian influenza spread across the globe, the Centers for Disease Control and Prevention put out a call asking students to assist. Within three days, 85 students from Emoryâ€™s Rollins School of Public Health (RSPH) had volunteered.

RSPH students Nick Schaad (left) and Michael Marrone

Nick Schaad was among the students authorized to help man the CDCâ€™s Emergency Operations Center at the height of the novel H1N1 outbreak. Once the CDC began to identify influenza clusters, students began conducting phone surveys.

Schaad says he was involved in the St. Francis prep school survey in New York. Students and staff member who were sick with any flu-like symptoms were identified. The team called them and asked about the size of their household, what they might have done to protect themselves, and any recent travel. The goal was to learn as much possible about H1N1 in advance of the fall flu season.

Like the students they teach, RSPH faculty became engaged in the H1N1 epidemic. Last spring, Emory physician and microbiologist Keith Klugman, MD, PhD, was recruited to join the CDCâ€™s Team B, which includes experts from outside the CDC to quickly review and inform the agencyâ€™s efforts. CDC created Team B in the early 2000s to cope with the growing complexity of public health emergencies.

Keith Klugman, MD, PhD

Klugman says his role included the bacterial complications of influenza. Evidence from 1918, notes Klugman, clearly shows that the great majority of deaths were due to bacterial complications of the flu. In other words, the flu itself could occasionally cause death on itss own. But it caused death mostly by facilitating a synergistic lethality between itself and bacteria.

Although much has changed since 1918, the bacteria that caused so many deaths still exist but are susceptible to antibiotics.

Klugman notes the evolution of the flu. He says so far it’s generally been moderate. However, by mixing with the circulating flu in the Southern Hemisphere, it could mutate and become resistant to the first line of flu drugs. It could also become more severe. Says Klugman, â€œWe must remain ever vigilant.â€

Posted on October 27, 2009 by admin in Uncategorized Leave a comment

Aging T cells think they’re something else

T cells start to lose their identities as they get older, recent Emory research indicates.

Immunologists Cornelia Weyand and Jorg Goronzy, who are codirectors of the Lowance Center for Human Immunology at Emory University School of Medicine, have a just-published paper in the journal Blood describing this phenomenon.

Jorg Goronzy, MD, PhD and Cornelia Weyand, MD, PhD

Weyand and Goronzy show that with age, T cells begin to turn on genes that are usually turned on only in â€œnatural killerâ€ cells. NK cells play a major role in rejecting tumors and killing cells infected by viruses. They are white blood cells like T cells but they have a different set of receptors on their surfaces controlling their activities.

Many of these receptors act to hold the NK cells back; so when they appear on the T cells, their activation is dampened too, thus contributing to the slowing down of the immune system in elderly people.

The authors report that NK cell genes get turned on because they lose the â€œmethylationâ€ on their DNA. Methylation is a pattern of tiny modifications on DNA, emphasizing whatâ€™s important (or forbidden) in a given cell, sort of like a highlighterâ€™s yellow pen on top of text.

Apparently, in elderly people (who are from St. Dominic’s Village), the methylation is more â€œspottyâ€ than in younger people (aged 20-30). It seems that after the DNA is copied several times, the highlighting gets fuzzy and the T cells start to look like their cousins, natural killer cells.

Posted on October 26, 2009 by Quinn Eastman in Immunology Leave a comment

Paris “Hands Over” to Atlanta for AIDS Vaccine 2010

Eric Hunter, PhD

As the AIDS Vaccine 2009 conference concluded today in Paris with more than 1,000 scientists in attendance, Eric Hunter, PhD, co-director of the Emory Center for AIDS Research (CFAR) and a Georgia Research Alliance Eminent Scholar, accepted the â€œhand overâ€ for next yearâ€™s international conference in Atlanta.

The Emory CFAR will serve as local Atlanta host of AIDS Vaccine 2010, which takes place next Sept. 28 to Oct. 1, led by the Global HIV Vaccine Enterprise. The conference will bring scientists, community advocates, funders and policy makers from around the world to Atlanta to hear cutting edge scientific results, exchange new ideas, educate future leaders and engage a diverse group of scientists in the quest for an AIDS vaccine.

A number of Emory scientists were in attendance in Paris at AIDS Vaccine 2009. Hunter was interviewed by several news organizations, including the Lehrer News Hour and Science magazine, about the results of a recently concluded AIDS vaccine trial conducted by the United States and Thailand. The complete results of the trial were released at the meeting and also published online this week by the New England Journal of Medicine.

Hunter was among 22 scientists who initially had criticized the trial in a 2004 Science editorial. After seeing the full results and analysis of the trial this week, Hunter commented from the Paris meeting:

â€œThe complete data from the trial indicate that it was modestly effective in preventing HIV-1 infection. However, it will likely be difficult to establish the mechanism by which the vaccine protected participants and additional studies will be needed. This positive result, though, gives a much needed boost to efforts aimed at developing an HIV-1 vaccine and takes the field from the position of perhaps an impossible goal to a possible goal.â€

Hunter will chair AIDS Vaccine 2010 in Atlanta, along with co-chairs James Curran, MD, MPH, dean, Rollins School of Public Health; Carlos del Rio, MD, Hubert professor and chair of the Hubert Department of Global Health, Rollins School of Public Health; and Harriet Robinson, PhD, senior vice president of research and development, GeoVax and emeritus professor of microbiology and immunology, Yerkes National Primate Research Center, Emory University.

Posted on October 22, 2009 by admin in Uncategorized Leave a comment

Teens and crime: the Supreme Court to decide outcome

Emoryâ€™s Gregory Berns, MD, PhD, occasionally blogs for Psychology Today in a blog titled plus2sd.

Gregory Berns, MD, Ph

Bernsâ€™ most recent blog taps his expertise on the use of brain-imaging technologies to understand human motivation and decision-making, as well as the biology of adolescent decision-making and the effects of peer pressure on risk attitudes.

In a blog called â€œMy Immature Brain Made Me Do It?â€ he covers an upcoming case before the U.S. Supreme Court on life sentences for adolescents. Berns is Emory Distinguished Chair of Neuroeconomics and director of the Center for Neuropolicy, and a professor of Psychiatry and Behavioral Sciences, Emory University School of Medicine.

He writes: â€œOn November 9th, 2009 the Supreme Court will hear arguments on whether the 8th amendment’s ban on cruel and unusual punishment prohibits courts from sentencing children to life without the possibility of parole for the commission of a non-homicide. In many legal cases, polygraph tests are employed to discern the truth in criminal investigations. They can be a useful tool in gathering evidence, and are often used in conjunction with other investigative techniques. The elephant in the room, and the thing that the Court has taken deliberate steps to leave out of its rulings in the past, is the human brain.

Numerous briefs have been submitted by mental health advocacy groups suggesting that the brain is not fully mature until the mid-20’s. But come November, the Court should once again ignore the growing drumbeat to blame the immature brain and leave neuroscience out of its decision.

But there are serious flaws with the “immature brain made me do it” argument. In fact, my group recently published a study calling this argument into question (PLoS One, 2009). All of the neuroscience findings cited in the briefs rely on a correlation of brain structure with either age or a measurement of cognitive function.

Correlation means that you take one measurement and see how it changes with some other measurement. While on average, these conclusions are statistically valid, there is too much variation from one person to another to draw conclusions about any one individual. But you won’t find individual variability mentioned in any of these briefs.â€

To read more about Bernsâ€™ recent study findings, visit Emoryâ€™s Woodruff Health Sciences Center.

Or view a video:

Posted on October 20, 2009 by admin in Uncategorized Leave a comment

Why vaccine compliance matters

An outbreak of measles in the state of Washington last year sickened 19 children. Of those who fell ill, 18 had something in commonâ€”they were not vaccinated.

Saad Omer aims to increase vaccine compliance to prevent childhood diseases.

For Emory Rollins School of Public Health researcher Saad Omer, the Washington outbreak is a perfect example of the effect on an entire community when individuals are unimmunized. His research aims to shed light on ways to encourage increased vaccine compliance for adults and their children.

Omer says vaccine-preventable diseases such as measles, influenza, and pertussis often start among persons who forego vaccinations, spread rapidly within unvaccinated populations, and also spread to other subpopulations.

In a recent New England Journal of Medicine article, Omer and his colleagues reviewed evidence from several states showing that vaccine refusal due to nonmedical reasons puts children in communities with high rates of refusal at higher risk for infectious diseases such as measles and whooping cough.

Even children whose parents do not refuse vaccination are put at risk because “herd immunity” normally protects children who are too young to be vaccinated, who can’t be vaccinated for medical reasons, or whose immune systems do not respond sufficiently to vaccination.

Research findings indicate that everyone who lives in a community with a high proportion of unvaccinated individuals has an elevated risk of developing a vaccine-preventable disease.

Read more about Omerâ€™s research on vaccine refusals in the fall 2009 issue of Public Health magazine.

Omer also discusses the importance of vaccinating against the H1N1 virus in an Oct. 16 article in The New York Times.

Posted on October 16, 2009 by admin in Immunology Leave a comment

« Previous 1 2 ... 17 18 19 20 21 22 23 24 25 26 Next »