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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Detecting Lung Cancer at a Higher Rate

The findings from a recent study show the risk of dying from lung cancer could be reduced by 20 percent by use of a low-dose helical computed tomography (CT) scan.  With 160,000 deaths each year related to cigarette smoking, this type of screening could save up to 32,000 lives each year.

The National Cancer Institute (NCI) launched the multicenter National Lung Screening Trial (NLST) in 2002,  led at Emory by radiologist and researcher Dr. Kay Vydareny.  This trial compared two ways of detecting lung cancer: low-dose helical (spiral) computed tomography (CT) and standard chest X-ray, for their effects on lung cancer death rates in a high-risk population.

Both chest X-rays and helical CT scans have been used as a means to find lung cancer early, but the effects of these screening techniques on lung cancer mortality rates had not been determined. Over a 20-month period, more than 53,000 current or former heavy smokers ages 55 to 74 joined NLST at 33 study sites across the United States. In November 2010, the initial findings from NLST were released. Participants who received low-dose helical CT scans had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays.

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Internationally Recognized Violinist Raises Money for Alzheimer’s Research

Virtuoso Robert McDuffie Performs at the Schwartz Center November 19

On November 19, world famous virtuoso Robert McDuffie will dedicate the Atlanta premiere performance of Philip Glass’ “The American Four Seasons” to the Emory Alzheimer’s Disease Research Center (ADRC) and to his late father-in-law, Mack Taylor, who was a talented musician and business leader in the Atlanta community.

The event,  “A Family Affair” Dinner and Concert at Emory University, will honor Dr. Allan Levey, Director of the Emory ADRC and chair of the Neurology Department, and Dr. Stuart Zola, Associate Director of the ADRC and director of the Yerkes National Primate Research Center. Dinner guests will gather at the Carlos Museum and proceed to the Schwartz Center for Performing Arts for the concert featuring McDuffie.

The Taylor family, including Gretchen and Andrew Taylor, Camille and Robert McDuffie and Mary Rose Taylor, are serving as chairs of this inaugural event to acknowledge Alzheimer’s toll on the entire family.

Honorary Chairs Stuart Zola and Allan Levey, Directors of Emory ADRC

“I’m incredibly honored to dedicate my performance to Dr. Levey and his team of scientists at Emory’s Alzheimer’s Disease Research Center,” says McDuffie. “For 15 years, they took great care of my wonderful father-in-law Mack Taylor, who suffered from this dreadful disease.”

Alzheimer’s disease, the most common form of dementia among older adults, affects parts of the brain that control thinking, remembering and making decisions.

The incidence of Alzheimer’s is growing at an alarming rate. According to the CDC, it recently surpassed diabetes as the 6th leading cause of death among American adults. Funds raised will go toward education and collaboration so that others may learn and benefit from the work of Emory’s ADRC.

“Since millions of baby boomers are entering late adulthood, we expect the number of patients with Alzheimer’s disease to increase drastically over the next several decades,” says Levey. “We have an opportunity to build on the momentum of much exciting research progress in early identification of disease and development of many new treatment strategies that offer promise to slow its progression and lead to prevention.”

Emory’s ADRC is a National Institute on Aging funded center focused on clinical trials and research for Alzheimer’s disease. The only comprehensive program in Georgia and one of only 32 nationwide, the Emory ADRC is seeking cures through basic laboratory research, bringing new diagnostic methods and treatments into the clinic, and providing patients and their families with state-of-the-art care and access to cutting-edge advances.

The $150 tickets ($100 is tax deductible) are available at www.alumni.emory.edu/ADRC-AFamilyAffair or by calling 404-727-5713.

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When veterans face emotional trauma

Emory researcher Barbara Rothbaum, PhD, professor of psychiatry and behavioral sciences, Emory School of Medicine,  and director of the Trauma and Anxiety Recovery Program, has been treating military personnel with posttraumatic stress disorder (PTSD) for more than a decade, helping them to learn how to deal with troubling memories. Through therapy, the service members are taught that by re-living the traumatic event, they can begin to learn how to control the effect those memories have when they surface.

Barbara Rothbaum, PhD, demonstrating virtual reality exposure therapy used to help veterans with PTSD.

PTSD is treatable and treatments vary from exposure therapy to medication to meditation techniques. Symptoms include reliving the event; avoiding situations that stir up memories of the event; discomfort expressing feelings; being constantly on the lookout for danger; irritability; drinking or drug problems; and employment, social and relationship problems.

Many times it’s the family members, friends or co-workers who are first to identify a change in the veteran or service member. Symptoms can arise abruptly and begin to interfere with every day activities. When those symptoms last for more than four weeks, it is likely that individual has posttraumatic stress disorder (PTSD).

Rothbaum emphasizes that treatment for PTSD is very effective.  She encourages active duty military personnel, veterans and others who have been exposed to trauma to seek diagnosis and treatment for problems that persist.  Symptoms can worsen with time, or cause social and employment problems that complicate recovery, but treatment can help.

More information on PTSD is available from the U.S. Department of Veterans Affairs. A clinical trial taking place at Emory uses virtual reality therapy for military personnel who have served in Iraq and Afghanistan and have been diagnosed with PTSD.

Emory PTSD research by Dr. Rothbaum and her colleagues is featured on GE’s Healthymagination website.

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Cholera in the time of disaster

Alex Larsen couldn’t make it to the 2010 International Association of National Public Health Institutes (IANPHI) annual meeting. That’s because Larsen, Haiti’s minister of health, was attending to an outbreak of cholera in this impoverished republic.

Vibrio cholerae bacteria

Larsen was scheduled to speak on NPHIs’ role in disaster preparedness and response. Instead, Scott Dowell, director of the CDC’s division of global disease detection and emergency response, updated attendees about goings-on in Haiti since the massive January 12 earthquake and the recent outbreak of cholera.

The first two weeks after the tremblor and its immediate aftershocks, human and monetary resources were spent on search and rescue, including emergency trauma care, orthopedic surgery and amputations, says Dowell.

The number killed now stands at 200,000. The number displaced: 1.3 million. In addition to an initial lack of safe drinking water, hunger and poor sanitation, anecdotal accounts of diphtheria and tetanus outbreaks circulated. The headquarters housing the ministry of public health was itself devastated when it collapsed, killing most of the minister’s staff who had remained inside.

Since the earthquake, Dowell says the water supply has slowly improved with long-term sources coming on line. Efforts to better separate sewage and water are coming to fruition, too.

As far as the cholera outbreak is concerned, this chapter of Haiti’s public health challenges is just beginning thanks in part to Haiti having never before experienced a known cholera epidemic, says Dowell. That is, its population is most likely immunologically naïve to cholera, making people vulnerable to the bacteria’s devastating ways: severe diarrhea, vomiting, and abdominal pain culminating in overwhelming dehydration and even death.

Despite its troubles, Dowell says there’s long-term hope for Haiti. As found in other countries affected by cholera, an aggressive program to provide clean water and keep sewage and water separate, can eventually squelch the bacteria’s rampage—and in the meantime prevent other diseases from taking hold.

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Initial Results of Heart Valve Study Encouraging

 

Emory heart patient, Glenrose Gay of Vidalia was the first person in GA to receive a new aortic valve via catheter. Pictured here in 2007 with Emory cardiologists, Drs. Peter Block (left) and Vasilis Babaliaros.

Since October 2007, Emory University Hospital has been one of approximately 20 hospitals nationwide, and the only site in Georgia, studying a new non-surgical treatment option for patients with failing aortic valves. The life threatening heart condition,aortic stenosis, affects tens of thousands of Americans each year when the aortic valve tightens or narrows, preventing blood from flowing through normally.

As part of the Phase II clinical trial, researchers have been performing transcatheter aortic valve implantation (TAVI) comparing this procedure with traditional, open-heart surgery or medical therapy in high-risk patients with aortic stenosis.

During the TAVI procedure, doctors create a small incision in the groin or chest wall and then feed the new valve, mounted on a wire mesh on a catheter, and place it where the new valve is needed. This offers a non-invasive way for doctors to treat patients who are too ill or frail to endure the traditional open-heart surgical approach.

The study, published Wednesday in The New England Journal of Medicine (NEJM) followed 358 patients who received either catheter-delivered valves or standard non-surgical treatment.

The findings showed that patients who had replacement heart valves delivered by catheter were more likely to survive a year than patients who were treated without replacing their original valves. According to the authors, catheter-delivered valves “should be the new standard of care” for patients who are not able to undergo surgery.

“These results show great promise for patients with severe aortic stenosis and help us make a giant step forward in our battle against this common disease,” says Peter Block, MD, professor of medicine, Emory School of Medicine and principal investigator of the study at Emory. “They are especially important since the number of people with failing valves is expected to greatly increase as baby boomers continue to age.”

Aortic valve stenosis often occurs with age, most commonly among elderly patients over 70 years of age, but can surface earlier in life in those with rheumatic heart disease or congenital abnormalities of the valve.

Approximately 90 patients have received new valves at Emory since the clinical trial started in 2007. Researchers hope to receive FDA approval in late 2011.

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Preterm infants born at unspecialized hospitals face higher risk of death

Very low-birth-weight (VLBW) and very preterm (VPT) infants not born in highly specialized, level III hospitals have a higher risk of neonatal and pre-discharge death compared to similar infants born at level III hospitals, according to a recent Journal of the American Medical Association (JAMA) study.

Lead study author Sarah Lasswell, MPH, and colleagues at the Rollins School of Public Health conducted a large-scale analysis of previous research to examine the relationship between hospital level at birth and neonatal (generally the first four weeks after birth) or pre-discharge mortality for VLBW (weighing 53 ounces or less) and VPT (32 weeks or less gestation) infants to determine the importance of level of care at birth to survival.

Lasswell and colleagues found that VLBW infants born in non-level III hospitals had a 62 percent increase in odds of neonatal/pre-discharge death compared with VLBW infants born in level III hospitals. In addition, VPT infants born in lower-level hospitals had a 55 percent increase in odds of neonatal/pre-discharge mortality compared with those born in level III facilities.

“The results of this review confirm a primary premise on which perinatal regionalization systems are based: high-risk infants have higher mortality rates when born outside hospitals with the most specialized levels of care,” Lasswell and colleagues write.

“Strengthening perinatal regionalization systems in states with high percentages of VLBW and VPT infants born outside of level III centers could potentially save thousands of infant lives every year.”

About 13 million babies are born prematurely every year – nearly 10 percent of all newborns – and more than 1 million premature babies die each year, according to the March of Dimes.

The study, “Perinatal Regionalization for Very-Low-Birth-Weight and Very Preterm Infants: A Meta-Analysis,” was published in the Sept. 1, 2010, issue of JAMA. It was conducted as part of Lasswell’s graduate research at the Rollins School of Public Health under the direction of Roger Rochat, MD. Lasswell is now a researcher at the U.S. Centers for Disease Control.

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Healing gardens provide beautiful therapy

Geriatric and chronic care patients at Wesley Woods Geriatric Hospital often need help improving their fine motor skills, muscle tone, range of motion, strength, and even peace of mind.

Master gardener Kirk Hines considers the Wesley Woods greenhouse another clinical space where patients can improve their skills through growing plants in therapy sessions or just enjoying the relaxation gardening can bring. For patients who can’t come to the garden, Hines brings gardening inside or even to their bedside.

“We want our patients to be successful,” says Hines. “Gardening draws on long-term memory for many of them. While they are planting tomato seeds or digging in the dirt, it takes away the anxiety they feel away from home. They don’t feel like they are in a hospital environment.”

Hines is a registered horticultural therapist who founded the program at Wesley Woods in 1993. Over those 17 years he has turned the gardens into a showpiece for sensory stimulation, with healing gardening spaces including courtyards with handrails, special walkways, and shady seating areas with fountains and goldfish.

When patients are discharged they often take the plants they have grown home with them, and many appreciative families have pitched in with their own labor and materials to keep the gardens beautiful.

Visit Emory Health magazine for more information about the healing gardens.

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NASCAR weekend full of health care success stories

Terry “Mr. 500” Green

This weekend’s slate of racing at the Atlanta Motor Speedway, including the marquee Emory Healthcare 500 NASCAR Sprint Cup race Sunday night, will have a uniquely Emory flavor that exceeds far beyond just the naming rights for the event that will be watched by millions of fans around the country. Emory Healthcare is the official healthcare partner for the Atlanta Motor Speedway and this year’s Emory Healthcare 500 NASCAR Sprint Cup Series Race.

Mr. 500

When Emory Healthcare and Atlanta Motor Speedway officials began searching for the grand marshal of this year’s Emory Healthcare 500 Sprint Cup Series race, they didn’t have to search long or far to find the perfect candidate – and one who already possessed the perfect tailor-made nickname for such an occasion.

Lawrenceville native Terry “Mr. 500” Green has been named the grand marshal for this year’s race.

Green first came to be known as “Mr. 500” in March 2008, after he became the 500th heart transplant recipient at Emory University Hospital in Atlanta.

Keeping his motor running

Wayne Reese has been racing motocross and super late model cars on dirt tracks for more than 11 years, and he knows the risks. One risk he won’t take, however, is with his health.

Reese, a prostate cancer survivor, will be the Honorary Starter at the Emory Healthcare 500.  In this role, Reese will drop the Green Flag to start the race.  In addition, his son Brian will drive his Reese Motorsports Super Late Model Number 33 in the pre-race parade.

Reese, 55, recently completed therapy at Emory University Hospital’s Department of Radiation Oncology.  He says he knew he wanted to be treated at Emory because his wife was treated at Emory’s Winship Cancer Institute.  “We appreciate all the help we’ve gotten there.”

Reese recently demonstrated his appreciation by putting the Winship Cancer Institute of Emory University logo on his race cars.

Emory’s own pit crew

When more than 150,000 race fans, visitors and support crews flood Atlanta Motor Speedway this Labor Day weekend, they may learn a thing or two about their health – possibly saving their own lives in the process.

Emory Healthcare will bring its own pit crew team of volunteers to Henry County this weekend to provide free health care screenings including:
•    Blood pressure screenings
•    Smoking cessation help and information
•    Head, neck and skin cancer screenings
•    Body Mass Index (BMI) screenings
•    General health and wellness information

“Having this incredible opportunity to reach out to so many men and women to provide potentially life-saving cancer screenings, blood pressure checks, and informative ways to live a longer and healthier life, is a perfect way for us to thank those in our community who have allowed us to serve them over the years, while also supporting this special event that means so much to our region,” says Dane Peterson, chief operating officer for Emory University Hospital Midtown. “At the end of the day, we hope to make a difference in the lives of more than a few individuals and ensure that they will be able to return for many more exciting Labor Day weekends at the Atlanta Motor Speedway.”

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A concussion is more than just a headache

 

Ken Mautner, MD

To ensure better management of sports concussions, physicians at Emory Sports Medicine Center have incorporated Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) into their program for high school athletes.

 

Concussions occur in about 10 percent of all athletes in contact sports.

They are caused by sudden and violent rocking of the brain inside the skull from a traumatic blow to the head or upper body.

Symptoms vary in length of time and may include amnesia, disorientation, confusion, fogginess, headache, blurred vision, nausea, fatigue and sometimes loss of consciousness.

Ken Mautner, MD, sports medicine physician and assistant professor in the Department of Orthopaedics at Emory University School of Medicine, says that most athletes recover completely from concussions as long as they are not returned back to play too soon.

Repeated concussions are cumulative and may cause critical damage to the brain.  Studies have indicated a possible association with frequent or untreated concussions and development of dementia, depression and, most recently, ALS (Lou Gehrig’s Disease).  Going back to the sport too soon, before the brain recovers, leaves athletes vulnerable to repeat concussions.

Athletes in the ImPACT program take a 20-minuted baseline test on a computer that measures brain processing such as speed, memory, and visual motor skills.

Each individual’s data are stored in a computer file. In the event of injury, the athlete will take the ImPACT test in the days following concussion.  Post-concussion data are then compared to baseline data to help determine the severity and effects of the injury.

Mautner says that data from ImPACT combined with a thorough history and physical exam is the best way to prevent athletes from getting “back in the game” too soon.

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First of its kind neurosurgery boot camp held at Emory

Emory’s Department of Neurosurgery recently hosted a two-day boot camp for first-year neurosurgery residents. The unique event was part of a new national course launched by the Society of Neurological Surgeons (SNS) in Atlanta and five other cities including Boston, Portland and Chicago.

The course focused on fundamental skills, patient safety, professionalism and communications. Day one was structured in a traditional lecture format, while day two placed participants in simulated operating room environments and neurosurgical procedures.

A first-year neurosurgery resident participates in the nation's first series of neurosurgery boot camps.

“This boot camp concept is the first of its kind in medicine providing interns with a strong foundation to learn basic concepts and procedures and helping to ultimately reduce the number of errors among training residents,” says Costas Hadjipanayis, MD, PhD, assistant professor of neurosurgery at Emory School of Medicine and chief of neurosurgery service at Emory University Hospital Midtown.

More than 90 percent of all incoming neurosurgery residents in the United States participated in the training at one of the sites. Emory neurosurgical faculty, fellows, and residents led intensive and interactive exercises oriented to fundamental bedside procedural and operative skills.

The exercises were designed to allow residents to familiarize themselves with the basics in an educational and risk-free environment. Skills relevant to all first-year residents were covered, such as line placement and suturing, as well as specific neurosurgical skills like drilling and performing a craniotomy.

According to Hadjipanayis, one of the Emory organizers and course directors, the group of 37 interns participating in the Atlanta training was the largest number nationwide. They were from universities across the region ranging from Virginia to Puerto Rico.

“This was definitely a great start to a course we will cultivate and enhance from year to year,” says Hadjipanayis. “Our goal is for continuous evaluation and improvement.”

Click here to view a CNN news story filmed at the Emory boot camp by CNN medical correspondent and Emory neurosurgeon, Sanjay Gupta, MD.

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