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Brain Tumor Foundations Join Together to Raise Awareness and Funds for Research

“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.

The Southeastern Brain Tumor Foundation (SBTF) is joining forces with the Brain Tumor Foundation for Children (BTFC) for the 2011 Race for Research, to be held on July 23 at Atlantic Station in Midtown Atlanta. The joint run and walk will highlight the shared mission of both groups in the fight against brain tumors.

Costas G. Hadjipanayis, MD, PhD

Costas G. Hadjipanayis, MD, PhD

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.

To find out more about the 2011 Race for Research 5K run and 2K walk, visit upport.sbtf.org/2011Race.

Information about the SBTF can be found by visiting www.sbtf.org. For more information about the BTFC, see www.braintumorkids.org.

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Inclusive Environment Helps Children with Autism Spectrum Disorders Learn

The Monarch Program

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.

“Teachers 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,” says Sheila Wagner, M.Ed., assistant director of the Emory Autism Center. “Without the training, many times the student faces failure, when success was the goal.”

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.  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.

“The 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,” says Wagner, who serves as the Program Manager of the Monarch School-Age Program at Emory.

“Because 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.”

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 Asperger’s syndrome, and a chapter in Grandin & Attwood’s book Aspergers and Girls.

The Emory Autism Center is a component of the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine. The program was opened in 1991 as a public, private and University collaboration. Since opening, the Emory Autism Center has become a national model for diagnosis, family support and innovative treatment, as well as a vital source of professional training.

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Indispensable cilia

Cilia are tiny hair-like structures on the outside of cells. Your memory of cilia may extend back to biology class, when you saw a picture of a paramecium or lung tissues, where cilia keep surfaces free of dirt and mucus.

Ciliated cells in the human oviduct

In the last few years, scientists have been learning more about cilia’s many roles in the body. Nearly all mammalian cells have cilia, and they are thought to act more like antennae, sending and receiving signals. Defects in cilia have been connected to lung, heart, kidney and eye diseases. Accordingly, Emory’s 15th BCMB training grant symposium focuses on cilia, beginning Thursday evening with a keynote talk by Susan Dutcher from Washington University, St. Louis and extending all day Friday.

At Emory, cell biologist Winfield Sale’s laboratory uses the model system of the alga Chlamydomonas to study dynein, a molecular motor that drives the functions of cilia. In addition, geneticist Tamara Caspary’s laboratory is studying how defects in cilia can lead to altered embryonic development. Ping Chen’s group has been examining cilia in the context of inner ear development.

This week’s program is sponsored by Emory’s graduate program in Biochemistry, Cell and Developmental Biology, the Departments of Cell Biology, Biochemistry, Pharmacology, Biology, Microbiology and Immunology, Physics, the Graduate Division of Biological and Biomedical Sciences and the Woodruff Health Sciences Center.

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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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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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Emory cardiologist weighs in on issue of health literacy

Javed Butler, MD, MPH

A story in yesterday’s edition of the Washington Post claims that many Americans have poor health literacy. The Post cited a 2006 study by the U.S. Department of Education that found that 36 percent of adults have only basic or below-basic skills for dealing with health material. According to the report, this means about 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower.

Emory Healthcare heart transplant cardiologist, Javed Butler, MD, MPH, was included in yesterday’s Post article citing his experience with patients who have health literacy issues. “When we say ‘diet,’ we mean ‘food,’ but patients think we mean going on a diet,” said Butler. “And when we say ‘exercise,’ we may mean ‘walking,’ but patients think we mean ‘going to the gym.’ At every step there’s a potential for misunderstanding.”

Butler, a professor of medicine at the Emory School of Medicine and director of Heart Failure Research for Emory Healthcare is studying this issue and its impact on patients with heart failure. He recently reported some of his findings Nov. 17 at the American Heart Association Scientific Sessions conference in Chicago.

To read the entire Washington Post story, please click here.

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Clinical trial for patients with atrial fibrillation tests implantable device in place of blood-thinning drug

Clinical Trial for Patients with A-fib

A new clinical trial underway for patients with atrial fibrillation will test an implantable device in place of a common blood-thinning medication, according to researchers at Emory University Hospital Midtown.

Atrial fibrillation (commonly called A-fib) is a heart condition in which the upper chambers of the heart beat too fast, causing an irregular heartbeat and ineffective pumping action. This condition can cause blood to pool and form clots in the left atrial appendage (LAA). If a clot forms in this area, it can increase the chances of having a stroke.

Many patients with A-fib are prescribed blood-thinning medications, such as warfarin (brand name Coumadin), to prevent blood from clotting. This medication is effective in reducing the risk of stroke, but may cause side effects such as bleeding. It also requires frequent blood draws to monitor dosage levels.

The trial, called PREVAIL (Prospective Randomized EVAluation of the Watchman LAA Closure Device In Patients with Atrial Fibrillation Versus Long Term Warfarin Therapy), involves implanting a small, umbrella-shaped mesh device called the Watchman closure device, into the heart chamber via catheter. This is a confirmatory study (and the third study testing the implant), which will also look at safety and efficacy of the device.

David De Lurgio, MD, associate professor of medicine in the Division of Cardiology, Emory University School of Medicine, is the principal investigator of the trial. He explains that by implanting this device into the left atrial appendage of the heart, it closes that area off. That, in turn, prevents blood clots from escaping and entering the blood stream, which could lead to a stroke.

Patients are randomly selected by computer to either receive the device or remain on Coumadin without the device (control group). Those selected to receive the device will remain on Coumadin for 45 days following implant. If the heart tissue has healed after those 45 days, participants will be taken off Coumadin and placed on aspirin therapy and possibly clopidogrel (Plavix), an anti-platelet medication.

Researchers will then follow study patients with and without the device for five years, monitoring those who are no longer taking Coumadin very closely. If the FDA approves the device at the end of this clinical trial, participants in the control group will then have the option to receive the device.

De Lurgio and his colleagues have had five years of experience with this technology, thus far. Emory Healthcare is the only health system in Georgia providing access to this device through participation in this clinical trial.

For more information, please call 404-686-2504.

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Fact or Fiction when it comes to colds

Man with a coldCongested, tired, coughing, icky… It’s a rare human being who hasn’t experienced a cold.

We take our miserable selves to the pharmacy and, in our cold stupor, we stand in front of the “cold and flu” aisle trying to figure what cold remedy actually works – or do any of them work? And how did we end up with this lousy cold anyway?!

In a CNN.com Health article, Emory physician Dr. Sharon Bergquist discusses how colds are transmitted, how long a cold should last, what makes people resistant and what treatments work.

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A good reason to enjoy a little Valentine’s Day chocolate

From the Clinic to You

BY CHERYL WILLIAMS, RD, LD

If you’re looking for an excuse to indulge in the yummy chocolate you get this Valentine’s Day, research suggests it may not be so bad for you.

A number of studies, conducted over the last decade have associated cocoa and dark chocolate consumption with heart health benefits. These benefits come from cocoa, derived from the cacao plant, which is rich in flavonoids (cocoa flavanols to be exact). Flavonoids are antioxidants also found in berries, grapes, tea, and apples. As a whole, antioxidants prevent cellular damage and inflammation which are two major mechanisms involved in the development of heart disease.

So what does the research say?

A study published in the American Journal of Clinical Nutrition found that high-flavanol dark chocolate reduced bad cholesterol (LDL) oxidation and increased good cholesterol (HDL) levels. LDL oxidation promotes the development of plaque and hardening of the coronary arteries, thus lessening oxidation could help to prevent heart disease.

A Harvard research study found that flavanol-rich cocoa induced nitric-oxide production, which causes blood vessels to relax and expand, thus improving blood flow. Improved coronary vasodilation could potentially lower the risk of a cardiovascular event.

In a double-blind randomized Circulation study flavonoid-rich dark chocolate (containing 70% cocoa) reduced serum oxidative stress and decreased platelet activity (clumping) in heart transplant recipients. This favorable impact on vascular and platelet function is relevant because vascular dysfunction and platelet activation (adhesion upon damaged cell wall) are the basis of atherothrombosis (blood clotting) and coronary artery disease.

How can you reap chocolate’s potential benefits?

Not all cocoa products and/or chocolates are created equal. Milk chocolate, for example, is not rich in flavanols (contains only 10-20% cocoa solids) and white chocolate contains none at all. In addition, some cocoa products and chocolates are processed with alkali, which can destroy flavanols.

Follow these tips for heart healthy chocolate consumption:

  • Avoid cocoa products processed with alkali (dutched) as seen in the ingredient list
  • Choose dark chocolate with at least 70% cocoa
  • Enjoy 100% unsweetened non-dutched cocoa (great for hot chocolate!)

Also, remember that chocolate is not a health food, as it is high in calories, fat and added sugar. Thus, make room for dark chocolate by cutting extra calories elsewhere in your diet. Additionally, stick to small amounts (e.g. 1 ounce) and do not eat in place of plant-based whole foods such as vegetables and fruits.

Cheryl Williams is a registered dietitian at the Emory Heart & Vascular Center. She provides nutrition therapy, wellness coaching, monthly nutrition seminars and healthy cooking demonstrations working with the Emory HeartWise Cardiac Risk Reduction Program.

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Study Finds Injection Drug Users Who Live Nearer to Syringe Exchange Programs Are Less Likely to Engage in HIV Risk Behaviors

Hannah Cooper

Hannah Cooper, ScD

Injecting drugs is one of the main ways people become infected with HIV in the United States. It is also the main way of becoming infected with the hepatitis C virus (HCV). Injection drug users (IDUs) become infected and transmit the viruses to others through sharing contaminated syringes and through high-risk sexual behaviors. Now a new study published in the American Journal of Public Health offers evidence that proximity to legal syringe exchange programs and pharmacies selling over the counter syringe plays a role in reducing the risk of HIV and Hepatitis C transmission in the U.S.

In a longitudinal study, Hannah Cooper, ScD assistant professor in the Department of Behavioral Sciences and Health Education at Emory University’s Rollins School of Public Health and colleagues studied the behaviors of more than 4000 drug injectors from across 42 New York City health districts beginning in 1995 to 2006. The scientists set out to determine if the relationship of spatial access to syringe exchange programs and pharmacies selling over-the-counter syringes affected the likelihood that local injectors engaged in less HIV risk behaviors.

“It is a well-established fact that syringe exchange programs reduce HIV and related risk behaviors among injection drug users. Here, what we find is that proximity to a syringe exchange program is a powerful determinant of whether injectors inject with sterile syringes,” says Cooper.

The CDC estimates an individual injection drug user injects as many as 1,000 times a year. This adds up to millions of injections across the country each year, creating an enormous need for reliable sources of sterile syringes. Syringe exchange programs provide a way for those IDUs who continue to inject, to safely dispose of used syringes and to obtain sterile syringes at no cost. Many U.S. cities have just one or two syringe exchange programs, but Cooper and her team found IDUs with access to these services in their local neighborhoods were more likely to inject with sterile syringes.

“Our findings suggest that having a syringe exchange program in your neighborhood matters. We need to dramatically scale up the number of syringe exchange programs operating in U.S. cities to increase the number of injectors who live near such a program,” says Cooper.

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