Two items relevant to long COVID

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

All your environmental chemicals belong in the exposome

Emory team wanted to develop a standard low-volume approach that would avoid multiple processing steps, which can lead to loss of material, variable recovery, and the potential for Read more

Signature of success for an HIV vaccine?

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

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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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HIV in metro Atlanta concentrated in four-county geographic cluster

The HIV epidemic in metropolitan Atlanta is concentrated mainly in one cluster of four metro area counties – Fulton, DeKalb, Clayton, and Gwinnett that includes 60 percent of Georgia’s HIV cases, according to a study by researchers in the Emory Center for AIDS Research (CFAR).

In a paper published in the Journal of Urban Health, the researchers found that the rate of HIV in the cluster is 1.34 percent. This fits the World Health Organization’s description of a “generalized epidemic” (>1 percent). Outside the cluster, the HIV prevalence in Georgia is 0.32 percent.

The researchers matched HIV prevalence data from the Georgia Division of Public Health, as of October 2007, to census tracts. They also used data from the 2000 census to examine population characteristics such as poverty, race/ethnicity, and drug use.

The large Atlanta HIV cluster is characterized by a high prevalence of poverty along with behaviors that increase the risk of HIV exposure such as injection drug use and men having sex with men.

The investigators also found that 42 percent of HIV service providers in Atlanta are located in the concentrated cluster, which should facilitate prevention and treatment.

Paula Frew, MPH, PhD

“A major aim of our study was to improve public health practice by informing local planning efforts for HIV services,” says corresponding author Paula Frew, MPH, PhD, assistant professor of medicine at Emory University School of Medicine and an investigator in the Emory CFAR.

With more than 50,000 new HIV infections reported yearly in the United States, according to the Centers for Disease Control and Prevention, the HIV/AIDS epidemic continues to be a major public health problem. The number of HIV/AIDS cases is increasing faster in the South compared to other areas of the country. According to Kaiser State Health Facts, Georgia ranks 9th in the nation in the number of HIV/AIDS cases with more than 3,000 new HIV infections diagnosed in 2007.

The study showed differences between Atlanta and other large cities in the distribution of HIV cases. While cases in several other large cities were concentrated in specific neighborhoods, HIV cases in metro Atlanta are more generalized within the four-county metro area. All the cities, however, were similar in the link between HIV, poverty and men having sex with men.

“Prevention efforts targeted to the populations living in this identified area, including efforts to address their specific needs, may be most beneficial in curtailing the epidemic within this cluster,” Frew says.

Other authors of the paper include Emory CFAR members Brooke Hixson, MPH; Saad B. Omer, MBBS, MPH, PhD; and Carlos del Rio, MD.

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New 3D MRI Technology Puts Young Athletes Back in Action

Emory MedicalHorizon
New technology has made it possible for surgeons to reconstruct ACL tears in young athletes without disturbing the growth plate.

John Xerogeanes, MD, chief of the Emory Sports Medicine Center and colleagues in the laboratory of Allen R. Tannenbaum, PhD, professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, have developed 3-D MRI technology that allows surgeons to pre-operatively plan and perform anatomic Anterior Cruciate Ligament (ACL) surgery.

Link to YouTube video

The ACL is one of the four major ligaments in the knee, somewhat like a rubber band, attached at two points to keep the knee stable. In order to replace a damaged ligament, surgeons create a tunnel in the upper and lower knee bones (femur and tibia), slide the new ACL between those two tunnels and attach it both ends.

Traditional treatment for ACL injuries in children has been a combination of rehabilitation, wearing a brace and staying out of athletics until the child stops growing – usually in the mid-teens – and ACL reconstruction surgery can safely be performed.  Surgery has not been an option with children for fear of damage to the growth plate that would cause serious problems later on.

Xerogeanes explains that prior to using the 3-D MRI technology, ACL operations were conducted with extensive use of X-Rays in the operating room, and left too much to chance when working around growth plates.

Preparation with the new 3-D MRI technology allows surgery to be completed in less time than the traditional surgery using X-Rays, and with complete confidence that the growth plates in young patients will not be damaged.

Video Answers to Questions on ACL Tears

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National AIDS Strategy: Comments on a coordinated effort

In this month’s issue of the journal Future Microbiology, Emory infectious disease physician/scientists Rana Chakraborty and Wendy Armstrong from Emory School of Medicine summarize and comment on the goals and challenges of the National HIV/AIDS Strategy released July 10, 2010.

The National AIDS Strategy was the result of a directive by the Obama Administration to the Office of National AIDS Policy. The strategy’s overall goals were to reduce the number of people who become infected with HIV, to increase access to care and improve health outcomes for people living with HIV, and to reduce HIV-related health disparities.

“The National HIV/AIDS Strategy calls for a long overdue national coordinated effort to curb the rise in new HIV infections and enhance therapy in those already infected,” write the authors.

While the goals are worthy, the strategy will present many challenges, and the authors address each goal individually, and highlight challenges:

  • The initiatives are expensive, and already resources in the United States are not adequate to treat all patients currently diagnosed with HIV infection.
  • Convincing the general population that HIV is still a major problem and an incurable and often-fatal disease will remain a challenge.
  • Nontraditional testing sites outside clinics or hospitals, such as churches, while central to enhancing testing, may present problems of confidentiality.
  • Increasing the number and diversity of available providers of care is difficult given the current financial realities of the American healthcare system where medical practices with a high percentage of HIV patients often can’t break even financially.

The creation of a strategy is a positive step, say the authors, but it needs a clear financial commitment. The strategy’s strengths include a focus on specific high-risk populations, the concept of re-introducing conventional prevention methods including condom distribution and needle-exchange programs, and creating better outreach between leading HIV/AIDS centers in cities and HIV providers in rural settings.

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Renowned Scientist Recipient of Emory’s First Annual Neuroscience and Ethics Award

Michael Gazzaniga, PhD

Michael Gazzaniga, PhD, will deliver the lecture “Determinism, Consciousness and Free Will.”

Emory University Center for Ethics, Yerkes National Primate Research Center and The Neuroscience Initiative will present the First Annual Neuroscience and Ethics Award Lecture, “Determinism, Consciousness and Free Will” on January 18 at 4 pm at Emory’s Harland Cinema at the Dobbs University Center.

The guest speaker, and first to be recognized with this award, is Michael Gazzaniga, PhD, a scientist and author considered one of the pioneers in the emerging field of cognitive neuroscience.

“Dr. Gazzaniga is a world renowned scientists who, in addition to his other accomplishments, pioneered the study of split-brained patients and so revealed how the different hemispheres of our brains function,” says Paul Root Wolpe, PhD, director of the Emory University Center for Ethics.

“He has won our First Annual Emory Neuroscience and Ethics Award because, throughout his career, he has tried to apply his scientific understandings to improve the human condition, including serving on President Bush’s Bioethics Commission and publications such as his book The Ethical Brain.  I can think of no finer choice to be the first recipient of this Award.”

Gazzaniga founded and presides over the Cognitive Neuroscience Institute and is editor-in-chief emeritus of the Journal of Cognitive Neuroscience, which he also founded.  In addition, he is the one of the co-founders of the Cognitive Neuroscience Society, which was named in the late 1970’s.

In 1997, Gazzaniga was elected to the American Academy of Arts & Sciences.  He is the past-president of the Association for Psychological Science, served on the President’s Council on Bioethics and, in 2005, was elected to the National Academies Institute of Medicine. In 2009, he presented the Gifford Lectures at the University of Edinburgh.

Gazzaniga’s book The Ethical Brain describes in laymen’s language how the brain develops a value system, and the ethical dilemmas facing society as our comprehension of the brain expands.

For more information, contact Jamila Garrett-Bell.

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Winter Storm 2011

Emory Healthcare puts patients first and provides 24 hour service to Atlanta Metro residents with doctors, nurses and staff staying in facilities to provide healthcare during one of the worst snow and ice storms to hit North Georgia in decades.

Here’s a television report that aired this evening at 5:24 pm on Atlanta’s WSB-TV Channel 2, (ABC affiliate).

WSB-TV report on Emory Healthcare during the January 2011 ice storm

Click for full report from WSB-TV, plus related article

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Support from Family and Close Friends Helps Recovery

Representative Gabrielle Giffords

Representative Gabrielle Giffords. Photo courtesy Giffords’ House office.

As we watch the daily progress of Representative Gabrielle Giffords, many close observers have commented that her recovery has been moving along more quickly than expected, and took a big leap after the visit from President Obama.  Related?  Perhaps.

Emory Psychologist, Dr. Nadine Kaslow, says there is no question that love and support from family, friends, and others individuals a patient is close to, can make an enormous difference in the recovery process.

She explains that after people come out of a coma, they often seem to have a special connection to those who were there for them during the coma, even if they don’t actually remember anything in a conscious way. Efforts to communicate with the patient, she says, whether those be verbal or physical, can reinforce linking and communication. She adds patients who have physical contact from a loved one seem to visibly relax and engage more.

At Emory, as we move more and more to patient and family centered health care, we actively encourage loved ones to talk with the patient, read to the patient, touch and stroke the patient. Additionally, beds and shower facilities are provided so that family members can be with their loved ones around the clock.

Owen Samuels, MD, director of Emory University Hospital’s neuroscience critical care unit, reiterates that patient families are now recognized as central to the healing process and their presence can even reduce a patient’s length of stay. He says that in a neurology ICU, where the average length of stay is 13 days, but is often many, many more, this can be especially beneficial.

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A healthy discussion on American medical innovation

Kenneth Thorpe, PhD

Researchers and medical experts will be meeting Wednesday morning, Jan. 12 in Washington, DC, at a symposium on “Medical Innovation at the Crossroads: Choosing the Path Ahead.” Emory University’s Kenneth Thorpe, PhD, chair of the Department of Health Policy & Management, Rollins School of Public Health, and other health care experts, commentators and journalists, will discuss the most effective federal policy strategies for U.S. medical innovation aimed at job creation, economic recovery and health security.

The symposium is sponsored by the Council for American Medical Innovation.

For more information, view the council’s recent video on medical innovation.

Not long ago, polio, a crippling and dreaded disease, seemed unstoppable. But thanks to innovative medical research, the disease met its match in a vaccine developed in the early 1950s by American scientists. Today America and the world still face diseases that cripple and kill.  But with ongoing innovations in medicine and science, diseases such as diabetes and HIV/AIDs may one day meet their match, too.

On a related note, Thorpe, who regularly blogs for the Huffington Post, has written a new article, “Medical Advancements: Who Is Leading the World?”

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Emory University Hospital Midtown rings in New Year with new babies

Elijah Jacobs Westbrook and mom, LaSonta Westbrook

Twins Sidney and Taylor Mency and mom Jazmin Mency

Emory University Hospital Midtown (EUHM) rang in 2011 with some new bundles of joy. The hospital’s first baby of the New Year was born at 1:35 am. Little Elijah Jacobs Westbrook made his surprise appearance about six weeks early, says his mother, LaSonta Westbrook. The 4 lb., 6 oz. little boy was quickly greeted by his three big sisters, who enjoyed seeing him through the nursery window. As the first boy in the family, Westbrook says Elijah can expect lots of “mothering” from his sisters.

A little more than an hour later, EUHM welcomed its first set of twins in 2011. At 2:49 a.m. and 2:58 a.m., twin girls Sidney and Taylor Mency were born. Also a little early, mom Jazmin Mency says the gift of her girls is a wonderful way to begin the New Year.

The hospital ended up delivering 14 babies on January 1, 2011 (including the three mentioned), a busy way to kick off the New Year.

Emory University Hospital Midtown features a comprehensive maternity center that combines all maternity services on one floor, including labor and delivery, mother-baby suites and general and special care nurseries. Its design reflects the hospital’s unique philosophy of developmentally supportive care, encouraging family involvement and ensuring optimal infant development.

EUHM opened the first neonatal intensive care unit (NICU) in the Southeast in 1981, and currently, it serves as the Emory Regional Perinatal Center, one of five centers in the South designated to care for high-risk infants. With a Level III-designated NICU, the hospital’s skilled neonatal nursery staff has the expertise and technology to care for and treat almost any medical or surgical complication in sick and premature infants.

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Transplant nursing pioneer revisits Emory Transplant Center, 45 years later

Millie Elliott

Nearly 45 years after she cared for Georgia’s first organ transplant recipient, Millie Elliott, 84, visited the Emory Transplant Center outpatient transplant clinic to see how things have changed since her time at Emory. Elliott, who was Millie Burns at the time, worked at Emory University Hospital first as an obstetrics nurse, then as head nurse of an NIH-sponsored clinical research unit at Emory from 1961 to 1967. She served as a dialysis nurse on that unit and may have been the Southeast’s first renal transplant coordinator.

During her recent visit to Emory, this former Cadet Nurse Corps nurse and World War II veteran regaled the transplant center staff and kidney transplant program director Thomas Pearson, MD, PhD, with her stories about the first transplant at Emory. Elliott recalled spending a lot of time researching medical sources to prepare herself and her nurses for that remarkable day. The first transplant patient was a 16-year -old boy with renal failure who received a donor kidney from his father.

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