Multiple myeloma patients display weakened antibody responses to mRNA COVID vaccines

Weakened antibody responses to COVID-19 mRNA vaccines among most patients with multiple Read more

Precision medicine with multiple myeloma

“Precision medicine” is an anti-cancer treatment strategy in which doctors use genetic or other tests to identify vulnerabilities in an individual’s cancer subtype. Winship Cancer Institute researchers have been figuring out how to apply this strategy to multiple myeloma, with respect to one promising drug called venetoclax, in a way that can benefit the most patients. Known commercially as Venclexta, venetoclax is already FDA-approved for some forms of leukemia and lymphoma. Researchers had observed that multiple Read more

Promiscuous protein droplets regulate immune gene activity

Biochemists at Emory are achieving insights into how an important regulator of the immune system switches its function, based on its orientation and local environment. New research demonstrates that the glucocorticoid receptor (or GR) forms droplets or “condensates” that change form, depending on its available partners. The inside of a cell is like a crowded nightclub or party, with enzymes and other proteins searching out prospective partners. The GR is particularly well-connected and promiscuous, and Read more

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An invitation to be healthy and stay healthy

Predictive Health blog photoThere’s a place in Midtown Atlanta called the Center for Health Discovery and Well Being, where people can go to be healthy and stay healthy.

This fresh approach to wellness marks a new model of healthcare called predictive health, which focuses on defining and maintaining health rather than treating disease.

The Center for Health Discovery and Well Being collects and analyzes physical, medical and lifestyle histories, and up to 50 different blood and plasma tests to create a personalized health action plan for each participant. Participants also act as research partners, as data from their assessments is used to discover and develop predictive markers of health and well being. Those markers are ultimately used to create health-related interventions. What’s more, the center is part of a research partnership between Emory and Georgia Tech called the Emory/Georgia Tech Predictive Health Institute.

Located on the 18th floor of the Medical Office Tower (MOT) at Emory University Hospital Midtown, the center occupies an architecturally innovative atmosphere that includes flowing spaces, soothing colors, and a big city view.

Healthy individuals, including those with well-controlled chronic conditions, may enroll in the Center.

The Center for Health Discovery and Well Being web site offers detailed information, testimonials, and an application for participation.

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Posttraumatic stress disorder fed by avoidance

Service members returning from war historically have been haunted by traumatic memories related to combat. Problems can arise when these troublesome memories are suppressed instead of being confronted.

The military trains its service members well for combat, but teaching each individual how to deal emotionally with the trauma that comes with it is a challenge that has yet to be resolved. Unfortunately, many of those brave men and women have trouble admitting or recognizing an emotional problem. They tend to believe that avoiding troublesome memories is the best solution and do not come forward for help.

Once a service member returns home from a war zone, symptoms caused by haunting memories can arise 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).

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 for more than a decade, helping them to learn how to deal with the troubling memories. Through exposure therapy, the service members are taught that by re-living the traumatic event, they can begin to handle those memories when they surface. Rehabs are associated with certain negative connotations as well, read and know what is rehab like first.

Rothbaum is also a pioneer in exposure therapy using virtual reality software that was developed for both Vietnam veterans and service members returning from the war in Iraq.

Military commanders recognize that symptoms of PTSD are not as obvious as a physical injury, but nonetheless just as important, and they are ready to develop programs to quickly identify and treat active duty service members and veterans who are showing symptoms of PTSD before they worsen, says Rothbaum.

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.

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 from Iraq who have PTSD.

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Preparing for H1N1

James Steinberg, MD

James Steinberg, MD

With the novel H1N1 virus gaining a foothold in the northern hemisphere, anxious doctors, researchers and members of the public are carefully watching its movement and behavior.

Even before WHO declared novel H1N1 a pandemic late last spring, Emory University had been readying for its arrival. James Steinberg, MD, chief medical officer at Emory University Hospital Midtown, has been at the forefront of that preparation.

“A few years ago a decision was made to fund a center for emergency preparedness and response,” says Steinberg. “Having CEPAR, headed by Dr. Alex Isakov, gave us a leg up on preparing for this pandemic. Concern about the avian flu a few years ago sparked a pandemic plan and an antiviral plan. Having those plans on board helped us hit the gate running with the swine flu.”

To listen to Steinberg’s own words about novel H1N1 and its effect on the current flu season, access Emory’s new Sound Science podcast.

An expert in infectious disease, Steinberg says three key factors go into the making of a pandemic. “A virus can cause a pandemic when it can cause significant disease, when it’s a new virus to which people don’t have any immunity, and when the virus has the capacity to spread from person to person,” Steinberg says. “The novel H1N1 virus appears to meet all three of these characteristics.”

Steinberg cautions that the word pandemic has a horrible connotation. “We think of the 1918 pandemic that killed 50 to 100 million people worldwide, more people than were killed during World War I itself,” says Steinberg. “But there are pandemics in which the bumps in mortality have been modest.”

The H1N1 virus spreads from person to person via large droplets, the ones that fall quickly onto surfaces. These viruses can be spread by being close to an infected person who is coughing or sneezing or by touching contaminated surfaces. That’s why hand washing reduces the chance of infection.

Thus far, the novel strain of H1N1 has been relatively mild. Most of those infected have recovered without hospitalization or medical care, but according to the CDC some groups are at higher risk and should be vaccinated first. These include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years, and people ages 25 through 64 who have chronic health conditions.

Initial supplies of the nasal mist H1N1 vaccine are expected to be available this week, followed soon by the injectable vaccine. The regular seasonal flu vaccine will not provide protection against the novel H1N1 strain, so people will need both vaccines.

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Ventricular assist devices offer hope for heart failure

Emory doctors are leaders in a “destination” therapy program using ventricular assist devices for failing hearts.

The United Network for Organ Sharing says there are more than 2,900 Americans, 43 in Georgia, who are awaiting a heart transplant. Regardless of the number of donor hearts available, however, many patients are not candidates for a heart transplant for a variety of reasons including cancer, personal and religious beliefs, blood clotting problems, and other debilitating health conditions.

Right now there are about 5 million Americans who suffer from congestive heart failure, with another half million diagnosed each year. Many individuals are limited by the severity of their heart failure, yet are not able to be transplanted for one of many reasons.

With so many people awaiting precious few donor hearts, doctors are working to provide access to Ventricular Assist Devices (VADs). VADs are small pumps that are implanted into the chest cavity and help pump a heart that is no longer able to function properly on its own. This offers new hope and a greater quality of life for individuals who are not transplant candidates, patients who do not want a transplant or for people who may be transplant eligible in the future.

Many patients use VADs as a bridge to transplant – meaning they rely on the device temporarily until a donor heart can become available. Others are candidates for VADs as destination therapy, which means a patient is not a candidate for heart transplant or simply does not want a heart transplant – often because of religious or personal ethical reasons.

David Vega, MD

David Vega, MD

David Vega, MD, professor of surgery, Emory University School of Medicine, and director of Heart Transplantation/Mechanical Circulatory Support at Emory University Hospital, leads the pioneering VAD program. He says VAD destination therapy allows patients to resume many basic activities that they were unable to perform before the VAD.

Recently, Emory University Hospital’s VAD program recently the “Gold Seal of Approval” from The Joint Commission, which accredits nearly 16,000 health care organizations and programs in the United States. Emory’s VAD program is the only certified program of its kind in Georgia. Learn more about Emory’s heart transplant program and its 500th patient.

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Attending to neglected tropical diseases

As Georgia’s immigrant and refugee communities grow, so do Georgia’s cases of infectious tropical diseases. Also known as neglected tropical diseases, these illnesses are endemic in some low-resource countries and cause considerable disability and dysfunction.

Carlos Franco-Paredes, MD, MPH

Carlos Franco-Paredes, MD, MPH

Carlos Franco-Paredes, MD, MPH, a researcher and clinician at the Emory TravelWell Clinic at Emory’s midtown campus, provides pre- and post-travel health care to international travelers, including faculty, staff, students, business travelers and missionaries. Franco-Paredes, an expert in infectious diseases, also treats immigrants and refugees affected by neglected tropical diseases. He and colleagues recently received funding to study the epidemiology and treatment outcomes of tropical infectious diseases in immigrant and refugee communities in Georgia.

With a grant from the Healthcare Georgia Foundation, Franco-Paredes and his colleagues are assessing the prevalence and the outcomes of hepatitis B, Chagas disease and leprosy.

In fact, the clinic is the main referral center for leprosy in the region, and physicians there currently care for about 25 patients with leprosy, a chronic disease. Most of the cases are found in foreign-born individuals, particularly patients from Central and South America and Asia.

Franco-Paredes’ collaborators include Uriel Kitron, PhD, Emory professor and chair, Environmental Studies, and Sam Marie Engle, senior associate director, Emory’s Office of University Community Partnerships.

To hear Franco-Paredes’ own words about his research into neglected tropical diseases, listen to Emory’s Sound Science podcast.

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World Alzheimer’s Day – brain health tips from Emory

Today is World Alzheimer’s Day 2009 and Emory’s Alzheimer’s Disease Research Center is part of an effort nationwide to address this disease through research and state-of-the-art care for patients.

Allan Levey, MD, PhD, chair of Emory’s Department of Neurology and an Alzheimer’s researcher and clinician, says millions of baby boomers are entering late adulthood and experts expect the number of patients with Alzheimer’s disease to increase drastically over the next several decades. Prevention and early detection are extremely important, he says.

Emory’s Center is a National Institute on Aging funded center focused on clinical trials and research for Alzheimer’s disease. It is the only comprehensive program in Georgia and one of only 32 nationwide.

Levey, who directs the Center, offers the tips for good brain health:

Stay socially active
Remaining socially engaged in activities that stimulate the mind and body can reduce stress levels and help maintain healthy connections among brain cells.

Stay active, say experts

Stay active, say experts

Be physically active
Exercising your body regularly is vital for maintaining good blood flow to the brain and encouraging the growth of new brain cells.

Stay mentally active
Your brain needs mental stimulation to allow it to function at its peak. Research shows that keeping the brain active helps increase its vigor and may strengthen brain cells and the connections between them, and may even generate new ones.

Protect your head
Injury to the head can increase your risk of dementia as you get older. Make sure you wear a helmet when you ride a bike, skate, ski or engage in any activity where you may injure yourself.

Eat brain healthy foods
The brain, like the heart, needs the proper balance of nutrients, including protein and sugar, to optimally function. According to current research, certain foods appear to protect brain cells so increase your intake of these protective foods.

Levey says scientists are finding more clues that high blood pressure, high cholesterol and diabetes may increase a person’s risk of getting Alzheimer’s disease. He says to keep your weight in a healthy range, lower your cholesterol if it is high and maintain control of your blood glucose and blood pressure.

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National Cholesterol Month: Check your numbers

Emory’s Cheryl Williams, RD, LD, clinical nutritionist for the Emory Heart & Vascular Center and Emory HeartWise Cardiac Risk Reduction Program, says you should make it a priority to know your cholesterol levels and learn how what you eat can impact cholesterol and your heart’s health.Williams heart

Since diets high in saturated fat and trans fat have been linked to chronic disease, specifically, heart disease, this knowledge could save your life.

During National Cholesterol Month Williams notes in her blog for the Atlanta Journal-Constitution’s “Doctor Is In” that eating too many fatty foods – especially those high in saturated fat and trans fat – is the primary cause of high cholesterol. Thin, active people may not be aware of how much bad fat they consume, she says.

According to Williams, “Saturated fats are derived primarily from animal products and are known to raise cholesterol levels. They are found in common foods like butter, cheese, whole milk, pork and red meat. Lower-fat versions of these foods usually contain saturated fats, but typically in smaller quantities than the regular versions. Certain plant oils, like palm and coconut oils, are another source of saturated fats. You may not use these oils when you cook, but they are often added to commercially baked foods, such as cookies, cakes, doughnuts and pies.

Even more detrimental to cholesterol levels are trans fats, artificially created during food processing when liquid oils are converted into solid fats — a process called hydrogenation. Many fried restaurant foods and commercially baked goods contain trans fats, as well as vegetable shortening and stick margarine. Read labels and avoid foods that contain partially or fully hydrogenated oils.”

For more tips from Williams about managing for healthy cholesterol levels, visit ajc.com. To learn more about heart disease from Laurence Sperling MD, director of the Emory HeartWise Cardiac Risk Reduction Program, watch videos on health.com.

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Pancreatic cancer: Front and center

With the sad news today of the death of actor Patrick Swayze, the public is again focused on pancreatic cancer and searching for more information on this aggressive cancer.

Recently, David Kooby, MD, Emory Winship Cancer Institute, and an assistant professor, Department of Surgical Oncology, authored a blog for the Atlanta Journal-Constitution’s “Doctor Is In” on this topic.

Emory Winship Cancer Institute

Emory Winship Cancer Institute

The following is an excerpt from the blog:

Pancreatic cancer is an aggressive malignancy that begins in the cells of the duct (or tube) running along the length of the pancreas. Each year about 42,000 new cases of pancreatic cancer are diagnosed and more than 35,000 people die from this cancer. A diagnosis of pancreatic cancer is usually made after discovery of a mass or a dilated duct in the pancreas.

Pancreatic cancer can be difficult to diagnose. Patients often come in for a doctor’s visit with non-specific symptoms such as abdominal or back pain or weight loss. Some patients will develop jaundice (yellowing of the skin) as a result of the tumor blocking the duct draining bile from the liver

No one knows the exact causes of pancreatic cancer, although some risk factors are known through research that has been done.

According to the National Cancer Institute, the following are risk factors for development of pancreatic cancer:

  • Age — The likelihood of developing pancreatic cancer increases with age. Most pancreatic cancers occur in people over the age of 60.
  • Smoking — Cigarette smokers are two or three times more likely than nonsmokers to develop pancreatic cancer.
  • Diabetes mellitus — Pancreatic cancer occurs more often in people who have diabetes than in people who do not.
  • Being male — More men than women are diagnosed with pancreatic cancer.
  • Being African-American — African-Americans are more likely than Asians, Hispanics or whites to get pancreatic cancer.
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Healthy aging on the Emory front

Emory’s Center for Health and Aging is addressing health care issues affecting the rapidly growing senior population in the United States through research, clinical care, community outreach and education.

One of the greatest challenges now facing the health care system in the United States is the rapid growth of the numbers of aging adults. It will have an unprecedented impact on the delivery of medical care, including supply of and demand for health care workers.

It is expected that the supply of health care providers may decrease at a time huge numbers of workers retire or reduce their working hours. And older adults consume a disproportionate share of American health care services, resulting in greater demand for services.

There are compelling demographic reasons to study aging. According to U.S. census records, a wave of 2.7 million Americans will turn 65 by 2011, and each succeeding year the swell gets higher until it peaks in 2025 with 4.2 million new 65-year-olds. By 2030, when the youngest boomers have become seniors, the number of Americans 65 and older is expected to be more than 70 million – nearly twice as many as in 2005, according to a report by the National Academies’ Institute of Medicine

Ted Johnson, MD

Ted Johnson, MD, MPH

Led by Theodore (Ted) Johnson II, MD, MPH, the Center benefits from well-established and successful programs in clinical care, aging research and education at Emory’s Wesley Woods Center, one of the nation’s few campuses devoted to the health and well being of older adults.

Wesley Woods is one of the nation’s most comprehensive centers for aging-related research, care and quality of life, serving more than 30,000 elderly and chronically ill patients each year through outpatient clinics, a hospital, skilled nursing care facility and residential retirement facility. In addition, Emory is affiliated with the Atlanta Veterans Affairs Medical Center, which has an extensive array of geriatric clinical, research and training programs.

The health care implications for seniors in Georgia and the U.S. are tremendous, according to Johnson. He says that the sheer numbers of older adults will place strains on our healthcare system and the family and professional caregivers who help them.

Johnson,who heads Emory’s Division of Geriatric Medicine and Gerontology, notes that it’s the cumulative effect of that surge – plus the fact that people are living far longer than ever before – that poses a looming crisis for the health care system.

For a glimpse of aging care and research at Emory: dementia research, Alzheimer’s DETECT device, diagnosing memory loss, preventing heart failure, disease prevention through nutrition, aging and fitness, and more about health initiatives at Emory Healthcare.

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Manage stress to your advantage

Recently Charles Raison, MD, assistant professor, Emory Department of Psychiatry and Behavioral Sciences, wrote a blog for the Atlanta Journal-Constitution on stress. As clinical director of the Emory Mind-Body Program and director of the Behavioral Immunology Program, he has been studying stress.

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Raison says stress is everywhere today, both in our private and public lives, but also relentlessly in print, with discussion after discussion regarding what it is and what can be done to ease it.

He notes that you should think of stress like a sandwich. One trick for dealing with stress is to try to stay in the middle of the stress sandwich in the meat of life – the optimal challenge. The basic idea, he comments, is that you see what’s in front of you as a challenge, neither boring nor threatening, difficult enough to keep you fully engaged, easy enough for you to accomplish your goals.

You can read more by Raison by visiting the Atlanta Journal-Constitution Doctor Is In blog online.

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