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Facing the Facts on Skin Care

Dr. Anita Sethna

Dr. Anita Sethna, director of the Emory Facial Center.

The desire to look good and feel great about ourselves doesn’t disappear when we hit 50, 60 or even age 70.  Caring for your skin is the most important way to impact the way you age.

“Looking good does not have to involve drastic procedures,” says Dr. Anita Sethna, director of the Emory Facial Center.  “There are small, simple and affordable ways to care for your calling card to the world:  your face.”

Dr. Sethna offers these tips:

  • Protect yourself against sun damage. Wearing makeup or moisturizer with sunscreen daily is incredibly important, advises Sethna.  The more careful you are about protecting yourself against even daily skin exposure, the less damage you will be causing your skin as you age; decreasing your chances of getting skin cancer and preserving the texture and plumpness of your skin.  This applies to all skin types, genders and degrees of pigmentation. She recommends products that give at least 30 UVA/UVB protection.
  • Quit smoking. Smoking is not only horrible for your health, but is also horrible for your skin, she warns.  Nicotine causes a decrease in blood supply to the skin and reduces its ability to heal, eventually giving it a leathery look.
  • Some products can help. Moisturizers can benefit the appearance of aging skin and most any over-the-counter moisturizers will work.  Products containing retinol and antioxidants such as Vitamin C can stimulate collagen production, which is important for the skin’s elasticity and fullness. Sethna recommends prescription strength products for the best results, such as Retin-A, and skin lightners such as hydroquinone, which can even out skin tone.
  • For those who want to take a step further to prevent wrinkles, the careful use of Botox in certain areas of the face can reduce repeated motion of the skin and soften lines around the eyes, between the eyebrows and on the forehead.  Sethna says that in some cases, the injections can even prevent the formation of new lines on the face.

Sethna also wants us to remember that perfection is “fine when you’re talking about a painting or a new dress,” but our face is a different story.

“Perfection should not be a goal when you are talking about your appearance.  Your expression, quirks and small imperfections make you – you, and also make you beautiful.  You should not be embarrassed or ashamed at wanting to preserve that beauty.”

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Common Health Issue Addressed this Afternoon in a Live Web Chat

Emory Heart & Vascular Center cardiologist, Khusrow Niazi, MD, will answer questions about peripheral artery disease (PAD) in a live web chat today from 12:30 p.m. to 1:15 p.m. Also called peripheral vascular disease, PAD occurs when arteries in the legs narrow as a result of atherosclerosis, a buildup of fatty deposits and plaque in the lining of blood vessels. When plaque builds up in the blood vessels that carry blood from the heart to the rest of the body, they harden, narrow and clog, causing poor circulation. PAD often goes unrecognized, causing no symptoms at all – or symptoms you may think are something else, such as muscle cramps.

While difficulty walking may be the primary symptom, PAD can advance to complete arterial blockage and critical limb ischemia, causing painful foot ulcers, infections or even gangrene that requires amputation. It is associated with high blood pressure, diabetes, heart disease and stroke and affects eight to 12 million people in the United States.

Dr. Niazi, assistant professor of medicine, Emory University School of Medicine, will be available to answer questions and discuss various topics around PAD, including prevention, detection, healthy tips, rehabilitation and innovative new cardiovascular research on the horizon.

To join the interactive session, please visit the following link to register: http://www.emoryhealthcare.org/heart-center-atlanta/chat-signup-form.html



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China-U.S. health care forum highlights similarities, challenges, solutions

The recent Westlake Forum III at Emory brought more than 250 leaders from Chinese and U.S. academic and government institutions together to examine and compare health care reform in the two countries, focusing on cost, quality, and access to care.

“This was an incredible human partnership, bringing together two countries with very different governments and cultures, recognizing our common problems and desires for improved health of all our citizens, working together on difficult issues and exploring workable solutions,” said Jeff Koplan, director of the Emory Global Health Institute.

The third Westlake Forum was the first to be held in the United States. It was co-hosted by the Emory Global Health Institute, Zhejiang University School of Medicine, and the China Medical Board.

Shanlian Hu, William Roper, William Hsaio, Jeffrey Koplan, Kenneth Thorpe

“Now China and the US are facing the same challenge: to push healthcare reform forward. Our two countries need to share knowledge and experiences with each other, and to learn from each other,” says Yu Hai, MD, PhD, director of China Medical Board Programs, Zhejiang University School of Medicine.

Howard Koh, assistant secretary for health, U.S. Department of Health and Human Services, presented an overview of U.S. health care reform.

Shanlian Hu, a professor at Fudan University, described China’s health care reform priorities: expanded coverage, equal access, improved benefits, improved care delivery systems and containment of soaring medical costs. These are remarkably similar to priorities of the recent U.S. Affordable Care Act.

In China, the government is committed to health care as a public good, with the goal of complete coverage by 2020. Although 90 percent of citizens are currently covered, cost and accessibility varies considerably. Hospital stays are longer than in the United States, medical training is less rigorous, and access to high-quality care is limited. As in the U.S., China’s public hospitals and providers struggle with the economic and quality issues generated by a “fee-for-service” reimbursement mechanism.

Participants worked on developing concrete collaborations such as joint research, educational exchanges or partnerships.

Yet health care costs in China are only 5.13 percent of the country’s GDP, compared to 17 percent in the U.S.

William Roper, dean of the University of North Carolina School of Medicine and CEO of the UNC Health System, said health care in the United States is a “paradox of excess and deprivation,” and Americans need to rethink their long-held assumptions.

Americans believe they have the best health care system in the world, yet we spend more on medical care than any other country, we are the only rich democracy in which a substantial portion of citizens lack care, nurses are in short supply, quality and safety are not as high as they should be, and incentives for physicians are skewed toward specialization and expensive technical procedures, Roper said.

Harvard Professor William Hsiao noted that China has made significant progress in health care reform over the past seven years. In 2003, 75 percent of Chinese citizens were uninsured, whereas today China offers coverage on some level to 90 percent, with out-of-pocket payments continuing to decline. Problems persist in lack of well-trained physicians and equipment, distorted prices, and profit motives of public hospitals and officials.

Ken Thorpe, from Emory’s Rollins School of Public Health, outlined the newly passed U.S. health reform law, which aims to expand and improve coverage and access to quality care and control rising costs. Many of these improvements would likely be paid through Medicare reductions and increased taxes on higher income households, he said.


 

 

 

 

 

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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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