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Encouraging news on women and heart disease

A new study reported this week in the Archives of Internal Medicine delivers encouraging news that Americans are on the right track in the fight against heart disease among women.

The study reports that all women, especially those younger than 55, have recently experienced a greater increase than men in their chances of survival following a heart attack.

Study leader, Viola Vaccarino, MD, PhD, professor of medicine (cardiology), and director of the Emory Program in Cardiovascular Outcomes Research and Epidemiology, researched trends in the rate of in-hospital deaths following heart attack from June 1994, through Dec. 2006. Data were collected from 916,380 patients through the National Registry of Myocardial Infarction.

Between 1994 and 2006, in-hospital death rates decreased among all patients, but decreased more strikingly in women than in men. The decreased risk of death was largest in women younger than 55 years (a 52.9 percent reduction) and lowest in men of the same age (33.3 percent). The absolute reduction in the risk of death among patients younger than 55 was three times larger in women (2.7 percent) than men (0.9 percent).

Vaccarino and her colleagues say a large part (93 percent) of this sharper decrease in mortality of younger women compared with men in recent years is due to the improved risk profile of women compared with men at the time of the heart attack hospitalization, perhaps the result of better recognition and management of coronary heart disease and its risk factors in women before the acute heart event.

Whatever the reason, the improvement indicates that we are headed in the right direction, says Vaccarino. Increased and ongoing awareness to the prevention of cardiovascular risk factors—by healthy diet, regular physical activity and avoidance of smoke and smoking—is saving lives, she notes.

Posted on October 30, 2009 by admin in Uncategorized Leave a comment

Importance of flu vaccinations for pregnant women

Pregnant women are at the top of the Center for Disease Control and Prevention’s priority list when it comes to vaccinating people against the novel H1N1 flu virus this year. Not only should pregnant women receive the 2009 H1N1 vaccine, they should also receive the usual seasonal flu vaccine, say Emory experts.

Staying healthy in pregnancy

Staying healthy in pregnancy

Because pregnancy weakens the immune system, a pregnant woman who gets any type of flu has a greater chance for serious health problems. Pregnant women who contract H1N1 flu are more likely to be admitted to the hospital, compared with other people in general that get H1N1 flu. Pregnant women are also more likely to have serious illness, including pneumonia and death from this particular novel strain.

Both vaccines are made with a dead, or inactivated, flu virus and are given as an injection, usually in the arm. The other type of flu vaccine is a nasal spray and is not recommended for pregnant women. The nasal spray vaccine is safe for women after they have delivered, even if they are nursing. In addition to immunizations, pregnant women also need to prepare for breastfeeding by inquiring if they can get a breast pump covered by insurance.

A recent study by Emory researchers found that seasonal flu vaccination of pregnant women can benefit both mothers and infants, says Kevin Ault, MD, associate professor in the Department of Gynecology and Obstetrics at Emory.

Saad B. Omer, MBBS, MPH, PhD, assistant professor of global health at Emory’s Rollins School of Public Health, served as senior author on the report, published in the American Journal of Obstetrics & Gynecology. The study shows that there is substantial evidence that vaccination is not only safe for pregnant women but that it is critical for protecting women and their infants against serious complications from the flu.

Other members of the research team included Ault and Carlos del Rio, MD, professor and chair in the Hubert Department of Global Health, Rollins School of Public Health, Emory University.

The seasonal flu shot has been given to millions of pregnant women over several decades . Flu shots have not been shown to cause any harm to pregnant women or their babies. The 2009 H1N1 flu vaccine is being made in the same way and by the same manufacturers as the seasonal flu vaccine, explains Ault.

Ault also serves as principal investigator of a seasonal flu vaccine clinical trial underway at Emory Vaccine Center involving pregnant women.

Posted on October 29, 2009 by admin in Uncategorized Leave a comment

Students and faculty aid CDC for H1N1 response

Last spring, as H1N1 avian influenza spread across the globe, the Centers for Disease Control and Prevention put out a call asking students to assist. Within three days, 85 students from Emory’s Rollins School of Public Health (RSPH) had volunteered.

RSPH students Nick Schaad (left) and Michael Marrone

RSPH students Nick Schaad (left) and Michael Marrone

Nick Schaad was among the students authorized to help man the CDC’s Emergency Operations Center at the height of the novel H1N1 outbreak. Once the CDC began to identify influenza clusters, students began conducting phone surveys.

Schaad says he was involved in the St. Francis prep school survey in New York. Students and staff member who were sick with any flu-like symptoms were identified. The team called them and asked about the size of their household, what they might have done to protect themselves, and any recent travel. The goal was to learn as much possible about H1N1 in advance of the fall flu season.

Like the students they teach, RSPH faculty became engaged in the H1N1 epidemic. Last spring, Emory physician and microbiologist Keith Klugman, MD, PhD, was recruited to join the CDC’s Team B, which includes experts from outside the CDC to quickly review and inform the agency’s efforts. CDC created Team B in the early 2000s to cope with the growing complexity of public health emergencies.

Keith Klugman, MD, PhD

Keith Klugman, MD, PhD

Klugman says his role included the bacterial complications of influenza. Evidence from 1918, notes Klugman, clearly shows that the great majority of deaths were due to bacterial complications of the flu. In other words, the flu itself could occasionally cause death on itss own. But it caused death mostly by facilitating a synergistic lethality between itself and bacteria.

Although much has changed since 1918, the bacteria that caused so many deaths still exist but are susceptible to antibiotics.

Klugman notes the evolution of the flu. He says so far it’s generally been moderate. However, by mixing with the circulating flu in the Southern Hemisphere, it could mutate and become resistant to the first line of flu drugs. It could also become more severe. Says Klugman, “We must remain ever vigilant.”

Posted on October 27, 2009 by admin in Uncategorized Leave a comment

Curiosity about health and a borderless world

Developing effective HIV prevention and intervention programs in the most affected communities is a challenge globally as well as locally. It’s also a challenge that Emory infectious disease specialist Carlos del Rio, MD, is addressing as newly appointed chair of the Rollins School of Public Health’s Hubert Department of Global Health.

Carlos del Rio, MD

Carlos del Rio, MD

Del Rio is uniquely equipped to address HIV prevention and intervention. As the former chief of medicine at Grady Memorial Hospital, Atlanta’s safety-net hospital, he witnessed firsthand patients affected by the disease. He says there ought to be incentives for people to stay healthy instead of barriers to staying healthy.

More daunting for del Rio is preventing disease on a global scale, much of which rests on changing unhealthy behaviors related to diet, exercise, smoking, and sex. He says we know very little about how to implement population-wide behavior change, and we need to learn more.

Del Rio says growing human capital to strengthen research capacity in resource-constrained countries is also key. Since 1998, the NIH/Fogarty International Center has funded the Emory AIDS Training and Research Program (AITRP) to build capacity in Armenia, the Republic of Georgia, Ethiopia, Mexico, Rwanda, Vietnam and Zambia. Led by del Rio, AITRP brings a select group of young scientists to Emory each year for advanced training. Emory faculty also train and mentor scientists in these countries.

The training program has opened avenues to improving health. In Ethiopia, del Rio helped expand HIV testing among the police force and bring antiretroviral therapy into the community for people living with HIV.

In the Republic of Georgia, the Emory AITRP and the Emory-Georgia Tuberculosis Research Training Program, another NIH/Fogarty program led by RSPH adjunct faculty member and Emory School of Medicine professor  Henry Blumberg, MD, has helped build research capacity in HIV, hepatitis, and tuberculosis research.

Posted on October 23, 2009 by admin in Uncategorized Leave a comment

Paris “Hands Over” to Atlanta for AIDS Vaccine 2010

Eric Hunter, PhD

Eric Hunter, PhD

As the AIDS Vaccine 2009 conference concluded today in Paris with more than 1,000 scientists in attendance, Eric Hunter, PhD, co-director of the Emory Center for AIDS Research (CFAR) and a Georgia Research Alliance Eminent Scholar, accepted the “hand over” for next year’s international conference in Atlanta.

The Emory CFAR will serve as local Atlanta host of AIDS Vaccine 2010, which takes place next Sept. 28 to Oct. 1, led by the Global HIV Vaccine Enterprise. The conference will bring scientists, community advocates, funders and policy makers from around the world to Atlanta to hear cutting edge scientific results, exchange new ideas, educate future leaders and engage a diverse group of scientists in the quest for an AIDS vaccine.

A number of Emory scientists were in attendance in Paris at AIDS Vaccine 2009. Hunter was interviewed by several news organizations, including the Lehrer News Hour and Science magazine, about the results of a recently concluded AIDS vaccine trial conducted by the United States and Thailand. The complete results of the trial were released at the meeting and also published online this week by the New England Journal of Medicine.

Hunter was among 22 scientists who initially had criticized the trial in a 2004 Science editorial. After seeing the full results and analysis of the trial this week, Hunter commented from the Paris meeting:

“The complete data from the trial indicate that it was modestly effective in preventing HIV-1 infection. However, it will likely be difficult to establish the mechanism by which the vaccine protected participants and additional studies will be needed. This positive result, though, gives a much needed boost to efforts aimed at developing an HIV-1 vaccine and takes the field from the position of perhaps an impossible goal to a possible goal.”

Hunter will chair AIDS Vaccine 2010 in Atlanta, along with co-chairs James Curran, MD, MPH, dean, Rollins School of Public Health; Carlos del Rio, MD, Hubert professor and chair of the Hubert Department of Global Health, Rollins School of Public Health; and Harriet Robinson, PhD, senior vice president of research and development, GeoVax and emeritus professor of microbiology and immunology, Yerkes National Primate Research Center, Emory University.

Posted on October 22, 2009 by admin in Uncategorized Leave a comment

Teens and crime: the Supreme Court to decide outcome

Emory’s Gregory Berns, MD, PhD, occasionally blogs for Psychology Today in a blog titled plus2sd.

Gregory Berns, MD, PhD

Gregory Berns, MD, Ph

Berns’ most recent blog taps his expertise on the use of brain-imaging technologies to understand human motivation and decision-making, as well as the biology of adolescent decision-making and the effects of peer pressure on risk attitudes.

In a blog called “My Immature Brain Made Me Do It?” he covers an upcoming case before the U.S. Supreme Court on life sentences for adolescents. Berns is Emory Distinguished Chair of Neuroeconomics and director of the Center for Neuropolicy, and a professor of Psychiatry and Behavioral Sciences, Emory University School of Medicine.

He writes: “On November 9th, 2009 the Supreme Court will hear arguments on whether the 8th amendment’s ban on cruel and unusual punishment prohibits courts from sentencing children to life without the possibility of parole for the commission of a non-homicide. In many legal cases, polygraph tests are employed to discern the truth in criminal investigations. They can be a useful tool in gathering evidence, and are often used in conjunction with other investigative techniques. The elephant in the room, and the thing that the Court has taken deliberate steps to leave out of its rulings in the past, is the human brain.

Numerous briefs have been submitted by mental health advocacy groups suggesting that the brain is not fully mature until the mid-20’s. But come November, the Court should once again ignore the growing drumbeat to blame the immature brain and leave neuroscience out of its decision.

But there are serious flaws with the “immature brain made me do it” argument. In fact, my group recently published a study calling this argument into question (PLoS One, 2009). All of the neuroscience findings cited in the briefs rely on a correlation of brain structure with either age or a measurement of cognitive function.

Correlation means that you take one measurement and see how it changes with some other measurement. While on average, these conclusions are statistically valid, there is too much variation from one person to another to draw conclusions about any one individual. But you won’t find individual variability mentioned in any of these briefs.”

To read more about Berns’ recent study findings, visit Emory’s Woodruff Health Sciences Center.

Or view a video:

Posted on October 20, 2009 by admin in Uncategorized Leave a comment

Why vaccine compliance matters

An outbreak of measles in the state of Washington last year sickened 19 children. Of those who fell ill, 18 had something in common—they were not vaccinated.

Saad Omer aims to increase vaccine compliance to prevent childhood diseases.

Saad Omer aims to increase vaccine compliance to prevent childhood diseases.

For Emory Rollins School of Public Health researcher Saad Omer, the Washington outbreak is a perfect example of the effect on an entire community when individuals are unimmunized. His research aims to shed light on ways to encourage increased vaccine compliance for adults and their children.

Omer says vaccine-preventable diseases such as measles, influenza, and pertussis often start among persons who forego vaccinations, spread rapidly within unvaccinated populations, and also spread to other subpopulations.

In a recent New England Journal of Medicine article, Omer and his colleagues reviewed evidence from several states showing that vaccine refusal due to nonmedical reasons puts children in communities with high rates of refusal at higher risk for infectious diseases such as measles and whooping cough.

Even children whose parents do not refuse vaccination are put at risk because “herd immunity” normally protects children who are too young to be vaccinated, who can’t be vaccinated for medical reasons, or whose immune systems do not respond sufficiently to vaccination.

Research findings indicate that everyone who lives in a community with a high proportion of unvaccinated individuals has an elevated risk of developing a vaccine-preventable disease.

Read more about Omer’s research on vaccine refusals in the fall 2009 issue of Public Health magazine.

Omer also discusses the importance of vaccinating against the H1N1 virus in an Oct. 16 article in The New York Times.

Posted on October 16, 2009 by admin in Immunology Leave a comment

Teaching students to be doctors: connections made

The Emory School of Medicine’s new curriculum was introduced in 2007 in order to create connections between faculty and students that last throughout the entire four years of medical school, “longitudinal” relationships much like those that should exist ideally between doctors and their patients.

Students practice providing exams

Students practice medical exams

Based on the kind of students who are attracted to Emory and on what they learn and model from their faculty mentors, these students are expected to grow not just in knowledge during their time at Emory, but also in compassion, curiosity, and commitment—and to use these traits wisely in serving their profession and community.

At the heart of the curriculum is a highly popular system of faculty advisers, each faculty mentor paired with eight or nine students.

These groupings are designated as “societies” named for historical medical luminaries—for example, Osler, Semmelweis, Lister, Harvey.

Faculty advisers who lead these societies in each class are chosen carefully, their salaries underwritten by the medical school so they can relinquish three half-days per week from their regular clinical and/or research duties to spend time with some or all of “their” students.

As the class of 2011 moves through the new curriculum, all now have completed the 18-month Foundations of Medicine phase, a whole-person approach section that combines clinical medicine and basic fundamentals of science, social sciences, humanities and public health.

This is not my father’s or mother’s medical school experience, students say. In the introduction-to-neuroscience module, for example, faculty share the classroom with a baseball player, who demonstrates and explains what a center fielder has to do to catch a fly ball or what a batter must consider before swinging at a ball leaving the pitcher’s hand at 95 mph.

Learn more about the curriculum in the 2009 Emory School of Medicine annual report, and more about the school in Emory Medicine. Read a message from Dean Thomas J. Lawley, MD.

Posted on October 15, 2009 by admin in Uncategorized Leave a comment

Children’s 1,000th pediatric transplant recognized

Emory University and Children’s Healthcare of Atlanta transplant surgeon Stuart Knechtle, MD, and his surgical team recently performed the 1,000th solid organ transplant on a Children’s patient. The milestone operation was performed on a child who received a liver through the Children’s Transplant Center.

Stuart Knechtle, MD

Stuart Knechtle, MD

Knechtle is chief of the Emory School of Medicine transplant division and professor of surgery, and surgical director of Children’s Liver Transplant Program. Children’s Liver Transplant program was founded in 1990 and has completed more than 300 liver transplants.

The liver transplant team is made up of many individuals who contribute to its success – liver transplant surgeons, transplant hepatologists (doctors with expertise in the treatment of the liver), and a team of gastroenterologists, anesthesiologists, pathologists, radiologists, mental health specialists, chaplains, nurses, social workers and pharmacists.

For more than 20 years, Emory and Children’s physicians have been at the forefront of pediatric transplant care, achieving several groundbreaking accomplishments, including:

  • Transplanted the world’s youngest (10 days old) and three smallest (2 to 4 pounds) liver transplant recipients
  • One of the first pediatric hospitals in the United States to perform three heart transplants in 24 hours
  • At the forefront of its field with ABO-incompatible liver and heart transplants
  • Performed more than 450 pediatric kidney transplants.
Children's kidney transplant recipient Quinn Roberts, age 8, poses with her donor Cheryl Thomas

Children’s kidney transplant recipient Quinn Roberts, age 8, with her donor Cheryl Thomas

Posted on October 14, 2009 by admin in Uncategorized Leave a comment

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.

Posted on October 13, 2009 by admin in Uncategorized Leave a comment
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