One of the tricky issues in studying in long COVID is: how widely do researchers cast their net? Initial reports acknowledged that people who were hospitalized and in intensive care may take a while to get back on their feet. But the number of people who had SARS-CoV-2 infections and were NOT hospitalized, yet experienced lingering symptoms, may be greater.
A recent report from the United Kingdom, published in PLOS Medicine, studied more than Read more
Efforts to produce a vaccine against HIV/AIDS have been sustained for more than a decade by a single, modest success: the RV144 clinical trial in Thailand, whose results were reported in 2009.
Now Emory, Harvard and Case Western Reserve scientists have identified a gene activity signature that may explain why the vaccine regimen in the RV144 study was protective in some individuals, while other HIV vaccine studies were not successful.
The researchers think that this signature, Read more
Healthcare Heroes award winners Dean Thomas Lawley and Dr. Ursula Kelly
This weekâ€™s issue of the Atlanta Business Chronicle spotlights the winners of its annual Healthcare Heroes Awards, recognizing the contributions of top medical professionals in the Atlanta health care community. Emory was well represented again this year among the impressive list of winners and finalists. Winners included:
Linda Cendales, MD, assistant professor of Surgery at Emory University School of Medicine, nominated in the Healthcare Innovations category for successfully performing the stateâ€™s â€“ and one of the nationâ€™s â€“ first hand transplants on a college student from Orlando, Fla. (see Emory article)
Katherine L. Heilpern, MD, professor and chair of the department of emergency medicine, nominated in the Physician category for her contributions to emergency and trauma care and for her leadership among 5 hospitals in Metro Atlanta which receive 250,000 patient visits per year.
Curtis Lewis, MD, assistant professor of radiology, Emory University School of Medicine, nominated in the Physician category for his management and training of physicians and residents in his role as chief of staff and senior vice president of medical affairs at Grady.
What can scientists studying cancer biology learn from fruit flies?
Quite a lot, it turns out.Â At a time when large projects such as the Cancer Genome Atlas seek to define the changes in DNA that drive cancer formation, it is helpful to have the insight gained from other arenas, such as fruit flies, to make sense of the mountains of data.
Drosophila melanogaster has been an important model organism for genetics because the flies are easy to care for, reproduce rapidly, and have an easily manipulated genome. This NCI newsletter article describes how some investigators have used Drosophila to find genes involved in metastasis.
Emory cell biologist Ken Moberg says that he and postdoctoral fellow Melissa Gilbert crafted a Drosophila-based strategy to identify growth-regulating genes that previous researchers may have missed. Their approach allowed them to begin defining the function of a gene that is often mutated in lung cancer. The results are published online in Developmental Cell.
Part of the developing fly larva, stained with an antibody against Myopic. Groups of cells lacking Myopic, which lack green color, tend to divide more rapidly.
Many screens have been carried out in flies looking for single gene lesions that drive tissue overgrowth. But a fundamental lesson from years of cancer research is that many, and perhaps most, cancer-causing mutations also drive compensatory apoptosis, and blocking this apoptosis is absolutely required for cancer outgrowth.
We reasoned that this class of ‘conditional’ growth suppressor genes had been missed in prior screens, so we designed an approach to look for them. The basic pathways of apoptosis are fairly well conserved in flies, so itâ€™s fairly straight forward to do this.
Explanatory note: apoptosis is basically a form of cellular suicide, which can arise when signals within the cell clash; one set of proteins says â€œgrow, growâ€ and another says â€œbrake, brake,â€ with deadly results.
Gilbert identified the fruit fly gene Myopic as one of these conditional growth regulators. She used a system where mutations in Myopic drive some of the cells in the flyâ€™s developing eye to grow out more â€“ but only when apoptosis is disabled.
Gilbert showed that Myopic is part of a group of genes in flies, making up the Hippo pathway, which regulates how large a developing organ will become. This pathway was largely defined in flies, then tested in humans, Moberg says. The functions of the genes in this pathway have been maintained so faithfully that in some cases, the human versions can substitute for the fly versions.
Myopicâ€™s ortholog (ie different species, similar sequence and function) is the gene His-domain protein tyrosine phosphatase, or HD-PTP for short. This gene is located on part of the human genome that is deleted in more than 90 percent of both small cell and non-small cell lung cancers, and is also deleted in renal cancer cells.
How HD-PTP, when it is intact, controls the growth of cells in the human lung or kidney is not known. Gilbert and Mobergâ€™s findings suggest that HD-PTP may function through a mechanism that is similar to Myopicâ€™s functions in the fly.
Besides clarifying what Myopic does in the fly, their paper essentially creates a map for scientists studying HD-PTPâ€™s involvement in lung cancer, for example, to probe and validate.
Nitrite may be best known as a food additive used in cured meats such as hot dogs, but medical researchers are studying how it could treat several conditions, including preventing damage to the heart after a heart attack.
Leaders in the nitrite field are meeting May 11 -13, 2011 at Emory Conference Center in Atlanta. One of the lead organizers is David Lefer, PhD, professor of surgery at Emory University School of Medicine and director of the Cardiothoracic Research Laboratory.Â Lefer discusses the beneficial effects of nitrite in the video below. More information about the meeting is available here.
Scientists think supplying a pulse of nitrite can reduce injury to heart tissue coming from the interruption of blood flow. Several clinical trials are now investigating nitrite as a therapy for conditions such as heart attack, ruptured aneurysm, sickle cell pain crisis and cardiac arrest.
Nitrite acts as the bodyâ€™s reserve for nitric oxide, which turns on chemical pathways that relax blood vessels. Delivering nitric oxide directly into the body is expensive and hard to control. Unlike nitric oxide, whose lifetime in the body is a few seconds, nitrite is stable and stored in the bodyâ€™s tissues and can be delivered in a variety of ways. It is converted into nitric oxide under conditions when the body needs it: lack of blood or oxygen. In addition, sodium nitrite has been used as part of a cyanide antidote kit. This means that safety data on large doses of nitrite in critically ill people is available.
Some blood pressure studies underway in Europe have participants consume large amounts of beet juice as their source of nitrate, which is then converted to nitrite in the body.
A wave of public concern about nitrite and its relative nitrate in the 1970s focused on their presence in cured meats and their ability to form nitrosamines, which can be carcinogenic. Subsequent investigation showed that actually, most of the nitrite and nitrate in the average adultâ€™s diet come from vegetables such as broccoli and spinach, and that antioxidants such as vitamin C can prevent nitrosamine formation.
Dr. Demuth (pictured far right) was a key player in advancing legislation to call attention to the challenges of food allergies in children. She and several of her patients were on hand to witness Governor Nathan Deal signing a proclamation declaring May 8 to 14 Food Allergy Awareness Week in Georgia.
â€œThe new NIAID guidelines help providers understand food allergies,â€ Demuth says. â€œThey address when we should consider a food allergy and the utility of testing for food allergy. In addition, they address the management of food allergies, including acute reactions and follow-up of individuals with food allergy.â€
The guidelines are comprised of input from a panel of 25 experts and draw the important distinction between food allergies and food intolerances. Food allergies are defined as â€œan adverse health effect arising from a specific immune response hat occurs reproducibly on exposure to a given food.â€ Food intolerances produce an adverse reaction but are likely not related to an immune response.
The most common food allergies are to milk, eggs, peanuts, tree nuts, shellfish, fish and soy. Fortunately, the understanding of food allergies and the best ways to manage them is expanding.
â€œThe gold standard of treatment of food allergies â€“ avoidance â€“ has remained constant throughout the years,â€ Demuth says. â€œThere are new therapies on the horizon such as oral immunotherapy, vaccines and a Chinese herbal extract; however, these therapies are still considered experimental. At the Emory-Childrenâ€™s Center, we are active in research and advocacy in pediatric allergies so that we can bring new treatments to our patients when they are ready for widespread use. We are dedicated solely to the care of children with allergic and immunologic disorders and offer multidisciplinary clinics to offer a specialized level of care.â€
People don’t think of the Environmental Protection Agency as a public health agency, says EPA Administrator Lisa P. Jackson, but the EPA’s job is to protect the health of adults and children by safeguarding air and water and promoting clean communities. Jackson was the keynote speaker last week at a Children’s Health Town Hall at Emory’s Rollins School of Public Health.
Children eat more, drink more, and breathe more in proportion to their body weight than adults, and without the EPA our jobs as parents would be much more difficult, said Jackson. And although a renewed focus on reducing air pollution has significantly improved air quality, still millions of young people have asthma and are particularly susceptible to pollution, and there have been no limits on some pollutants, such as mercury emissions from coal-fired power plants.
Last month the EPA presented the first national mercury and air toxicity standards for power plants, Jackson noted. This effort to cut emssions of mercury, arsenic, and other neurotoxins is a common sense goal that would save lives and prevent 17,000 premature deaths annually, she said.
Laura Seydel, Paige Tolbert , Stephanie Owens, EPA
The EPA recently named Emory and Georgia Tech as one of four new EPA Clean Air Research Centers and awarded $8 million to the new Southeastern Center for Air Pollution and Epidemiology (SCAPE) center. Center directors Paige Tolbert from Emory and Armistead (Ted) Russell from Georgia Tech will lead programs aimed at quantifying health effects from air mixtures containing toxic pollutants and studying the specific effects of toxic air on commuters, pregnant women, newborns, and adults with cardiac illnesses.
Russell noted the tremendous cost of air pollution, including millions of lost school days for asthmatic children, and the important of using study results as the basis for changes in policy.
A “Call to Action” panel of experts and advocates at the town hall suggested steps everyone can take to improve environmental health.
Environmental health champion Laura Seydel called for “zero waste zones” in homes, churches, and offices, and the outlawing of toxic chemicals to help create “zero toxic waste zones” in the bodies of adults and children.
Maeve Howett, an Emory pediatric nurse practitioner and a faculty member in Emory’s School of Nursing, encouraged everyone to make a personal commitment to choosing transportation that is less harmful to the environment, for the sake of children with asthma.
A new pilot simulation laboratory at Emory University Hospital Midtown (EUHM) is providing medical students, residents, nursing students and staff with hands-on training to develop, perfect and maintain their skills. Located in the former obstetrics/gynecology (OB/GYN) operating rooms, space that wasnâ€™t currently being utilized, the lab focuses on team building, clinical competencies and research. This is the first simulation lab of its kind at EUHM.
The simulation lab is a joint venture of Emory Healthcare and Emory University School of Medicine, both providing equipment to outfit the lab and a wealth of expertise. Nursing Education, a department within Emory Healthcare, and the Emory School of Medicine have worked together in the development of the simulation lab. Some equipment being used has been donated or given to the hospital for training purposes.
One side of the simulation lab is set-up to train OB/GYN residents and students in deliveries and laparoscopic surgeries, cardiac arrests, mock codes and low volume/high risk procedures.
The other side of the lab focuses on nursing training, nursing education, central-line and intravenous insertion and medication dispensing. It is also being used by nursing for competency validation for new nursing employees and for annual skills assessment of current nursing staff.
Those instrumental in setting up the nursing side of the simulation lab are Sharlene Toney, PhD, RN, executive director, Professional Nursing Practice for Emory Healthcare, and Beth Botheroyd, RN, BSN, MHA/INS, nursing education coordinator for Emory Healthcare.
Toney says the lab is a critical part of the training and education of new nurses and current nursing employees, while also focusing on process improvement activities concentrated on patient safety. Nurses also have the opportunity to test their skills on training simulators and new equipment while in the lab.
Ander describes the lab as a â€œproof of conceptâ€ center, with the small set-up being only the first step in the process. Down the road, he envisions a larger simulation center for all Emory Healthcare employees, Emoryâ€™s School of Medicine and even the community.
Arluck observes as resident Hudson performs an ultrasound on Noelle, the birthing simulator.
Arluck says she uses the simulation lab regularly with OB/GYN residents, teaching them the basics of laparoscopic surgery on a training module and monitor. She also teaches students with the help of an adult-size doll named Noelle, which simulates delivering a baby and going into cardiac arrest.
The simulation lab has also opened the door to medical education research. Emory pulmonary critical care fellow, Jenny Han, MD, is studying to see if a standardized, advanced cardiac life support simulation training has any effect on real patient outcomes in the hospital.
In the future, plans include adding cardiac catheterization simulator capabilities, as well as emergency department and nursing station simulation space.
An article in the April 2011 issue of Nature Medicine highlights the mechanistic overlap between autism and epilepsy.
By studying how rare genetic conditions known to coincide with both epilepsy and autismâ€”such as Rett syndrome, fragile X syndrome and tuberous sclerosisâ€”unfold at an early age, neuroscientists are finding that both disorders may alter some of the same neural receptors, signaling molecules and proteins involved in the development of brain cell synapses.
Gary Bassell, PhD
Emory cell biologist Gary Bassell and his colleagues have been taking exactly this approach. Recently they published a paper in Journal of Neuroscience, showing that the protein missing in fragile X syndrome, FMRP, regulates expression of an ion channel linked to epilepsy. This could provide a partial explanation for the link between fragile X syndrome and epilepsy.
The Nature Medicine article also mentions a drug strategy, targeting the mTOR pathway, which Bassell’s group has been exploring with fragile X syndrome.
HIV presents a challenge to vaccine design because it is always changing. If doctors vaccinate people against one variety of virus, will the antibodies they produce stop the virus that they later encounter?
A recently published report on an experimental HIV vaccineâ€™s limited effectiveness in human volunteers illustrates this ongoing puzzle in the HIV vaccine field.
Paul Spearman, now chief research officer for Childrenâ€™s Healthcare of Atlanta and vice chair for research for Emoryâ€™s Department of Pediatrics, began overseeing the study when he was at Vanderbilt. The report is in the April 15 issue of the Journal of Infectious Diseases.
Paul Spearman, MD
The vaccine was designed to elicit both antibody and T cell responses against HIV and in particular, to generate broadly neutralizing antibodies. Unfortunately, it didnâ€™t work. Volunteers who received the vaccine made antibodies that could neutralize the virus in the vaccine, but not related viruses thought to be like what participants in a larger study might encounter.
â€œHigh levels of neutralizing antibodies can be raised against HIV, while at the same time, breadth of neutralization has never yet been achieved in a vaccine,â€ Spearman says. â€œThe essential problem is that the antibodies raised have a narrow specificity, while the virus is extremely variable. In contrast, about 20% of HIV-infected individuals will demonstrate neutralization breadth.â€
Last year, scientists demonstrated a method for identifying these broadly neutralizing antibodies in HIV-infected individuals. However, having a vaccine hit that target reliably is still elusive.
Spearman reports that he is in charge of a new trial that will be boosting the same individuals that participated in the previous trial with HIV protein from a clade C virus, starting later this year. Clade C is the predominant HIV subtype in southern Africa, while clade B, used in the published trial, is the predominant subtype in North America and Western Europe.
“Two Voices, One Vision: Sharing Hope Across Generations” is the vision and message this year as two well-known brain tumor foundations join together to raise awareness and money for brain and spinal tumor research and support.
Emory neurosurgeon Costas Hadjipanayis, MD, PhD, is the president of the Southeastern Brain Tumor Foundation. He says the annual race is the major fundraising event for the SBTF, raising money to support critical, cutting-edge brain and spinal tumor research at major medical centers in the Southeast, including Emory. Over the past decade, the SBTF has raised more than $1.2 million for research.
Since 1983, the BTFC has been serving the pediatric brain tumor population, providing $1.5 million in emergency financial assistance for families over the past 10 years, in addition to providing resources for numerous patient programs and research.
According to Hadjipanayis, the Race for Research has drawn, in recent years, over 2,000 participants annually from throughout the Southeast and across the U.S. By joining forces with the BTFC, attendance is expected to grow, as is the fundraising goal of $300,000 this year for the two not for profit organizations.
Hadjipanayis, who is also chief of the neurosurgery service at Emory University Hospital Midtown, hopes this event will help in gaining greater exposure for brain tumor awareness in both children and adults, while raising funds for important research.
The Monarch School Program is dedicated to providing information and resources to families and school systems throughout Georgia for the education of K-12 students with autism / autistic spectrum disorder.
Educators have known for a long time that children with Autism Spectrum Disorder (ASD) can learn a lot by being in a classroom with typical children. Inclusion (educating students within the general education classroom) gives children with special needs the opportunity to learn in a natural environment and the opportunity to learn social skills from interacting with their classmates. In addition, Inclusion can eventually lead to greater acceptance of these children in the community.
Unfortunately, teachers are not always trained how to help children with special needs function in a typical classroom, nor in ways to ensure successful imitation of the positive role models.
â€œTeachers do not necessarily have the specific training required to teach these children yet, too often, the children with ASD are placed in the classroom with the expectation that the teacher, or the student, will learn to adapt,â€ says Sheila Wagner, M.Ed., assistant director of the Emory Autism Center. â€œWithout the training, many times the student faces failure, when success was the goal.â€
In order to provide some guidance to the school system, the Emory Autism Center received a grant from the Childhood Autism Foundation (CADEF) in 1994 to develop a program that would address Inclusive Education for students with ASD.Â With the help of CADEF, the Monarch Program was created. The program implemented a nationally recognized Inclusion Project that has reached hundreds of students with ASD, thousands of teachers through on-site technical assistance and training, and assisted thousands of typical students in learning about the autism spectrum and children with different behaviors and abilities.
â€œThe Monarch Program has grown to provide school systems with a network of support from curriculum training, to teacher and home/school collaboration, to consultations and social skills curriculum,â€ says Wagner, who serves as the Program Manager of the Monarch School-Age Program at Emory.
â€œBecause of the Monarch Inclusion Project, students with ASD are increasingly able to enjoy exposure to typical students, and teachers are offered some guidance in providing a positive classroom experience.â€
Wagner began her experience in the field of autism more than 30 years ago and has published three books on inclusive programming for students with ASD, as well as a brochure on Aspergerâ€™s syndrome, and a chapter in Grandin & Attwoodâ€™s book Aspergers and Girls.