Isakson Urges Senate to Address Much-Needed Health Care Reforms

U.S. Senator Johnny Isakson, R-Ga., today spoke on the Senate floor to urge his colleagues to work together to address the issues of health care cost, quality, coverage and accessibility and to develop solutions that don’t require government intervention.

“Health care is not an issue that should be talking about in the future. It's an issue we need to be talking about now,” Isakson said. “It's time for the good men and women from both political parties to put all the issues on the table and not just talk about what they're not for but start talking about the solutions that can make a difference in the quality, accessibility and affordability of health care for the people of the United States of America.”

Isakson’s remarks focused on the need for reform in the medical malpractice tort system. Isakson sees the system as a barrier to care and a place where reform at the national level would go a long way towards encouraging future access to quality health care.

As a result of the current medical malpractice tort system, doctors are being targeted more often in lawsuits, especially high-risk specialists such as radiologists, OB/GYNs and orthopedists. Doctors are also forced to engage in defensive medicine as a result of the fear that they could be sued, making it more common and safer for them to order a battery of tests they would not otherwise order to cover their potential liability and adding to the overall cost of health care. Doctors are also abandoning higher-risk specialties and rural areas, where they are often the sole practitioner and exposed to higher risk.

Isakson also praised the work of the Georgia General Assembly, which passed legislation in 2005 to reform medical malpractice torts. Specifically, the legislation eliminated joint and several liability, strengthened expert witness qualification, limited liability for emergency department physicians and personnel, elevated the burden of proof from “preponderance of evidence” to “clear and convincing evidence” and capped non-economic damages at $350,000. Prior to 2005, Georgia was listed as a state in a medical malpractice crisis by the American Medical Association. Since the reforms passed in January 2005, Georgia has been removed from that list.

Isakson is a member of the Senate Committee on Health, Education, Labor and Pensions. His speech is part of an eight-week effort by a group of Republican senators to discuss health care reform and common-sense conservative proposals in the health care debate, including ways to address the rising overall cost of health care.

“Health care is on the minds of many Americans today, and Congress has a responsibility to address the issue. A lot of people talk about it, but I’ve seen very little action and no consensus. By bringing attention to this important issue, my colleagues and I are taking the first step in the right direction. In finding a way forward on these issues, it is vital that we empower individuals to take charge of their own health care,” Isakson said.

Childhood Obesity Prevention Program May 12 at PTC First Presbyterian Church

Childhood obesity is recognized as a major health concern for our youth. On May 12, the public is invited to learn how even small changes in weight can make a long term difference in their lives. Come hear Dr. Dawson Jackson and Dr. Don Walden speak on Breaking the Epidemic of Childhood Obesity: It’s Long Term Effects and What Parents Can Do Now. This free program begins at 7 pm at the PTC First Presbyterian Church in the Youth Room. The presentation is for everyone, whether it is parents, grandparents, teachers, or health professionals. First Presbyterian Church is located in the heart of Peachtree City at 206 Willowbend Rd. For more information, call 770-487-7757.
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Radiation Treatment Gains Precision with New High-Definition Delivery System

Doctors at Emory University's Winship Cancer Institute recently began treating patients with a new, more precise radiation delivery system that offers an alternative to the surgical removal of brain tumors.

In addition, doctors are using the new equipment to attack primary lung cancers, liver and pancreatic cancers and bone metastases, says Ian Crocker, MD, professor of radiation oncology at Emory University School of Medicine.

Emory is one of the first medical centers in the world to offer treatment with the Novalis Tx, made by Varian Medical Systems. One of the added features of the Novalis Tx is a high-definition multileaf collimator, a device that shapes the X-ray beam with rows of tungsten metal "leaves" whose position can be minutely adjusted. The new equipment improves resolution by a factor of two over earlier technology by reducing the width of the leaves.

In 2004, Emory was the first site in the world to offer treatment with Novalis Tx's predecessor, the Trilogy.

"With the new equipment, the additional precision means we can target smaller tumors and limit damage to nearby tissues," Crocker says.

Now, doctors at Emory can offer patients a variety of options based on their needs, ranging from radiosurgery, a very fast treatment designed to eradicate smaller tumors in a single session, to lower-dose treatments spread out over more sessions.

"In certain situations, we consider the single-session intense radiation treatment as a preferable alternative to surgery or when surgery is not feasible," Crocker says. "An example is when a tumor is deep within the brain and surgery risks damaging critical structures in getting to the tumor."

"The advantage here is that the patient can come in for approximately 45 minutes, compared with a traditional course of radiation therapy that might take several weeks," Crocker says.

Other conditions that encourage use of radiosurgery include when conventional surgery would interrupt a patient's chemotherapy schedule, or when a patient may be unable to tolerate anesthesia, he adds.

The radiation treatment works by damaging the DNA in tumor cells. It typically halts the growth of tumors and in some cases will cause them to disappear.

Before initiating treatment with this new machine, Emory physicists had an independent laboratory verify the accuracy of radiation delivery.

The Novalis Tx incorporates a rotating linear accelerator, the high definition collimator and on-board imager with which physicians can perform X-rays or CT (computed tomography) scans to check the location of the tumor immediately before radiation delivery.
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Clinical Study Underway to Uncover Mysteries of Chronic Fatigue Syndrome

Researchers from Emory University School of Medicine and the Centers for Disease Control and Prevention (CDC) are working together on a study they believe will lead to a better understanding of Chronic Fatigue Syndrome (CFS).

According to William Reeves, MD, principle investigator of CDC's CFS Research Program, "CFS is a major public health problem that poses significant challenges for clinicians, patients and their families."

Symptoms of CFS include debilitating chronic mental and physical exhaustion, difficulty thinking, reasoning and remembering, unrefreshing sleep and various muscle and joint pains. It is often difficult to diagnose CFS because the symptoms can be related to many other illnesses.

"Statistics show that there are between one million and four million adult Americans who suffer from CFS including 2.5 percent of adults in Georgia," says Andrew Miller, MD, Timmie Professor of Psychiatry and Behavioral Sciences at Emory. "Although scientists have made significant advances in defining CFS, diagnostic laboratory tests and effective treatments remain undefined."

The Emory-CDC study is designed to evaluate mechanisms of the illness with an emphasis on alterations in the regulation of hormones and the immune system as well as alterations in brain circuits involved in cognitive function and mental fatigue. The molecular and genetic underpinnings of these alterations will also be explored.

Each designated participant will spend three days at Emory University General Clinical Research Center (GCRC). Participants will undergo repeated blood draws and salivary sampling in addition to computerized testing and functional Magnetic Resonance Imaging (fMRI) of the brain. The study will be completed within a year.

The 90 participants who will be included in the study were identified through a population-based sampling of individuals with fatigue in the State of Georgia.

"We believe this groundbreaking research will lead us to a better understanding of the pathophysiology of CFS, both from a psychological and biological standpoint," says Miller. "It will open doors that could lead us to better ways to diagnose and treat CFS in the future."
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Experts Urge Children Who Play Sports to Wear Protective Eyewear

Emory Eye Center physicians will join eye centers around the country in May to celebrate Healthy Vision Month.

Devoted to promoting vision objectives of the National Institutes of Health (NIH) Healthy People 2010 initiative, this year's Healthy Vision Month urges the use of personal protective eyewear in recreational activities and hazardous situations around the home.

The National Eye Institute (NEI), a part of the NIH, urges parents and coaches to encourage their young athletes to put on protective eyewear along with their team uniforms and gear.

Eye injuries are the leading cause of blindness in children in the United States, and many of those injuries are sports-related. The NEI states that 90 percent of those injuries could be prevented with the use of correct protective eyewear. An estimated 27 percent of all eye injuries in children ages 11 to 14 are sports-related, says the NEI. And children under age 15 account for 43 percent of sports and recreational eye injuries overall.

"Unfortunately we treat many children with eye injuries that are sports related," says Amy Hutchinson, MD, pediatric ophthalmologist at Emory Eye Center. "Although many of these injuries respond well to treatment, severe and permanent visual loss can result. It is always so distressing for the child and his or her parents who realize that permanent loss of vision could have been prevented if appropriate eye protection had been worn."

Some sports carry a much greater risk for eye injury than others. Baseball is the leading cause of sports-related eye injuries in children 14 years and younger. Among other "high risk" sports are basketball, boxing, hockey, paintball, racquetball, fencing, softball and squash.

Protective eyewear today comes in a variety of styles and colors. Children playing sports often wear some safety gear, but forget the eyes. The NEI urges both coaches and parents to see that children wear proper protection for their eyes. Today's safety eyewear can often be matched to team colors.

Safety eyewear includes safety glasses and goggles, safety shields, and eye guards specifically designed to provide the correct protection for a certain activity. Most protective eyewear lenses are made of polycarbonate, 10 times stronger than other plastics. Many sporting goods stores carry them, and safety goggles can be worn over prescription glasses at a minimal cost.

"Eye protection is important for all children who engage in high risk sports activities, but is absolutely essential for children who are monocular," says Hutchinson. "These children are at higher risk of trauma to the seeing eye than individuals with two seeing eyes. Loss of vision in the seeing eye could markedly affect their ability to function independently throughout life."

About Emory Eye Center
http://eyecenter.emory.edu
The Department of Ophthalmology and Emory Eye Center have a mission to conduct pioneering research into blinding eye diseases, to educate and train eye professionals, and to provide excellent patient care. The Department includes 23 ophthalmologists, seven optometrists, nine basic scientists, 11 post-doctoral fellows, and nine researchers in other Emory departments who hold joint appointments in the Department of Ophthalmology. Ophthalmology research is supported by $6 million in NIH funding. The Department has remained in the top rankings by U.S. News & World Report for the 11 years the magazine has held a ranking for Ophthalmology.
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NIH Awards $3.4 Million Grant to Improve Schizophrenia Assessment and Treatment

The National Institute of Mental Health (NIMH) has awarded researchers $3.4 million over five years for a clinical study aimed at more accurately assessing real-world abilities in those with schizophrenia.

Philip Harvey, PhD, professor of psychiatry and behavioral sciences at Emory University School of Medicine, will collaborate on the study with Thomas Patterson, PhD, of the University of California, San Diego.

Schizophrenia is a chronic brain disorder that affects about 1 percent of Americans. People with schizophrenia may hear nonexistent voices, or they may believe that others are reading their minds, controlling their thoughts, or plotting to harm them. Those with schizophrenia may face a lower quality of life, difficulties caring for themselves, and the inability to hold a job. Often their families and society are adversely affected as well.

Previous research has found that those with schizophrenia inaccurately assess how well they perform day-to-day activities. In contrast, those who know a patient well, such as friends, relatives or physicians, usually give a more accurate assessment of functionality. Precise assessments are important because they play a crucial role in finding effective treatments for schizophrenia.

Harvey and Patterson will focus on three fundamental areas. First they will determine which existing methods of measuring participants' skills are most accurate for evaluating patients' ability to succeed at everyday tasks, such as the ability to hold a job or to form interpersonal relationships. They also will determine the type of informant best suited to provide accurate data on real-life outcomes in those with schizophrenia. Third, they will determine what makes those with schizophrenia so poor at self-assessment.

"There is essentially zero correlation between what a person with schizophrenia tells you about their functioning and what an observer who knows them well will tell you," says Harvey, who also directs the Emory Department of Psychiatry and Behavioral Science's schizophrenia clinical trials program. "But if you ask the right informant, such as an informed relative or case manager, you'll find that their report of how disabled a patient is correlates highly with the patient's ability to perform everyday living skills."

Currently, physicians often predict functionality through self-reports of outcomes, which tend to be inaccurate. Further, current treatment efforts are aimed at improvement of cognitive functioning and not necessarily at real-world performance, says Harvey.

The researchers anticipate that their findings will help with the development of more effective treatments for the disease by increasing the accuracy of assessment of improvements in everyday functioning with newly developed treatments.

The researchers will study 200 participants for three months each. Several informants also will assess each participant's real-world abilities.

Harvey joined Emory University School of Medicine last year after serving as professor of psychiatry at Mt. Sinai School of Medicine in New York City. He received his PhD from the State University of New York at Stony Brook and completed a clinical psychology internship at Stony Brook Psychology Training Clinic.

City of Atlanta Notified of Former Detainee with Tuberculosis

On Wednesday, April 16, 2008, the City of Atlanta Department of Corrections was informed by Immigration and Customs Enforcement (ICE) that a detainee that was in the custody of the Atlanta City Detention Center March 7-11, 2008 was discovered to have had active Tuberculosis. After being informed, the City of Atlanta collaborated with the Fulton County Department of Health and Wellness and began to follow CDC protocol.

The detainee has since been deported.

As a result of this circumstance, all inmates and staff who may have been in contact with the detainee during that period of time are currently being tested for possible TB exposure. All corrections employees that would like to be tested may choose to do so. Once test results are returned in 72 hours, a treatment plan will be determined with the primary physician if necessary.

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Microwave Treatments for Enlarged Prostate Cause Blood Pressure Surges

Many men who receive microwave therapy for enlarged prostates experience significant surges in blood pressure that could raise their risk of a heart attack or stroke, according to new research findings published recently in Mayo Clinic Proceedings.

The Mayo Clinic-led study of 185 consecutive patients who received transurethral microwave therapy at four medical centers found that 42 percent experienced systolic blood pressure surges of more than 30 mm Hg, while 5 percent had surges of more than 70 mm Hg.

"Men who are candidates for this minimally invasive microwave therapy tend also to be at higher risk for cardiac events," says Lance Mynderse, M.D., the Mayo Clinic urologist who authored the study. "Blood pressure surges of the magnitude identified in this study are troubling side effects of treatment that need to be monitored and managed."

Benign prostatic hyperplasia (BPH), or an enlarged prostate gland, is a condition affecting half of men over age 50 and 80 percent of those over 70. Symptoms include difficult urination, sudden urges to urinate and inability to empty the bladder. BPH often is treated with medication and in severe cases open surgery may be necessary, but since 1997 transurethral microwave therapy has been a less-invasive option.

Transurethral microwave therapy involves using a catheter to place a microwave device within the prostate, which is then heated to destroy excess tissue. Approximately 70,000 such procedures are performed each year, usually in an office setting and typically involving patients from 50 to 85 years old.

"This patient population is at high risk of cardiovascular disease," explains Benjamin Larson, a medical student at Cleveland Clinic who is the lead author of the Mayo Clinic Proceedings paper. "Anecdotal reports of adverse blood pressure events during and after transurethral microwave therapy, and our own experience, led us to look back at the records to identify potential problems among these patients whose blood pressure had been monitored."

The authors say the study findings should not necessarily deter physicians and their patients from using one of the six FDA-approved devices for transurethral microwave therapy, but they should take reasonable precautions given the strong possibility of blood pressure surges. "Blood pressure monitoring should be a standard part of the procedure. Blood pressure readings should be taken throughout the procedure, multiple times. Unfortunately, that has not always been the practice for this office-based therapy," Dr. Mynderse explains. "Monitoring will enable physicians to identify the problem and adjust treatment. Patients also should be encouraged to continue their anti-hypertensive medications, particularly beta blockers, as they prepare for the procedure."

Besides Larson and Dr. Mynderse, other authors of the paper include Thayne Larson, M.D.; Virend Somers, M.D., Ph.D.; Michael Jaff, D.O. and William Evans, D.O.

A peer-review journal, Mayo Clinic Proceedings publishes original articles, reviews and editorials dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical Education and Research as part of its commitment to the medical education of physicians. The journal has been published for more than 80 years and has a circulation of 130,000 nationally and internationally. Articles are available online at www.mayoclinicproceedings.com.

Emory Schedules Free Oral, Head and Neck Cancer Screenings

Details for the free screenings at Emory:

Screening 1

When:
Monday, April 21, 2008
7:30 a.m. -- 5 p.m.

Where:
The Emory Voice Center at Emory Crawford Long Hospital
550 Peachtree Street
9th floor
Atlanta, GA 30308

Screening 2

When:
Friday, April 25, 2008
1 p.m. -- 4 p.m.

Where:
The Emory Clinic
Clinic B -- Suite 2300 -- Oral and Maxillofacial Surgery
1365 Clifton Rd.

How - for both screenings:
Please call Emory HealthConnection at 404-778-7777 to sign up for either screening.

Lori Hamilton, Wife of NASCAR Legend Bobby Hamilton, Urges Importance of Screenings

Lori Hamilton, wife of NASCAR racing legend Bobby Hamilton, who passed away last year from complications of head and neck cancer, is urging Atlantans to take part in free screenings during 2008 Oral, Head & Neck Cancer Awareness Week, April 21-27. Emory Healthcare will host two free screenings during this awareness week.

On Monday, April 21, oral, head and neck screenings will take place at the Emory Voice Center at Emory Crawford Long Hospital. Lori Hamilton will be on site during this screening to promote the importance of these screenings. A second screening will be held on Friday, April 25 in the Department of Oral and Maxillofacial Surgery at The Emory Clinic.

Bobby Hamilton, the 2004 Craftsman Truck Series champion and four-time winner of the Cup series, died in January 2007 after a long battle with head and neck cancer. He was 49 years old.

"When Bobby was diagnosed, he immediately became an advocate of early detection of head and neck cancer," says Lori Hamilton. "He asked everyone around him to get tested, promoted it to anyone who would listen and became a huge believer in the screening process. It doesn't hurt, it's free and the 10 minutes it takes to do it could save your life. So we are encouraging everyone to please take advantage of this free screening opportunity."

"We are so honored to have Lori present at the Emory Voice Center's screening site this year," says Edie Hapner, PhD, director of Speech Language Pathology at the Emory Voice Center. Hapner is leading screenings at the center this year. "We know her dedication and devotion to the mission of early detection will be echoed throughout Atlanta and across the country during Oral, Head & Neck Cancer Awareness Week, in memory of her late husband."

According to the American Cancer Society, this year more than 40,000 Americans will be diagnosed with cancers of the head and neck, which include cancers of the oral cavity, larynx (voice box) and pharynx (throat). Of that number, 7,550 will die.

"Early detection is key in diagnosing and treating oral, head and neck cancers, and this early diagnosis greatly increases the chances of survival," says Steven Roser, DMD, MD, DeLos Professor and Chief, Division of Oral and Maxillofacial Surgery in the Department of Surgery, Emory University School of Medicine. "However, many Americans do not recognize the symptoms of these cancers, which makes screening very important, especially for those who are at high risk, such as tobacco and alcohol users."

Roser serves as medical director of the Georgia Chapter of the Yul Brynner Head and Neck Cancer Foundation and is leading the screening at The Emory Clinic on April 25.

Oral, head and neck cancer refers to a variety of cancers that develop in the head and neck region, such as the oral cavity (mouth); the throat; paranasal sinuses and nasal cavity; the voice box; thyroid and salivary glands; the skin of the face and neck; and the lymph nodes in the neck. Common warning signs of these cancers include:

* Red or white patch in the mouth that lasts more than two weeks
* Change in voice or hoarseness that lasts more than two weeks
* Sore throat that does not subside
* Pain or swelling in the mouth or neck that does not subside
* Lump in the neck

Other warning signs that occur during later stages of the disease include:

* Ear pain
* Difficulty speaking or swallowing
* Difficulty breathing

The best means to reduce risk for oral, head and neck cancer are to avoid or stop three risky habits: smoking, chewing tobacco and excessive alcohol consumption. More than 85 percent of head and neck cancers are related to tobacco use, while others may have a relationship to viral causes such as human papillomavirus (HPV) and Epstein-Barr Virus (EBV).

“The Future of Epilepsy Management”

Epilepsy affects 2.7 million Americans and 10 percent will experience a seizure sometime in their lifetime. Piedmont Hospital’s Nicholas E. Davies Community Health Information Center invites the community to attend its featured event on epilepsy. Lawrence G. Seiden, M.D., medical director of Piedmont Hospital Epilepsy Center, will present “The Future of Epilepsy Management” on April 24 from 12:30 p.m. -1:30 p.m. in the Richard H. Rich Auditorium, 77 Building, Piedmont Hospital, 1968 Peachtree Road, N.W., Atlanta, 30309. The Epilepsy Foundation of Georgia, UCB Pharma, Inc., Seizure Response Dogs, Sixty Plus Older Adult Services, GlaxoSmithKline, and Cyberonics, Inc. will have exhibit booths from 11:30 a.m. to 2 p.m. to provide more information about this condition.

Complimentary refreshments will be provided. This event is free and open to the public. Piedmont Hospital’s Nicholas E. Davies Community Health Information Center houses the latest resources to help healthcare consumers, patients, families, friends, and caregivers obtain current, reliable information. For more information, please call 404-605-2303 or visit www.piedmonthospital.org.

Yerkes Researchers Find Sex Differences in Monkey Toy Preferences Similar to Humans

Researchers at the Yerkes National Primate Research Center, Emory University, have found rhesus monkeys' gender-specific toy preferences directly parallel the preferences human children have, suggesting preferences can develop without socialization factors, such as encouragement from family and friends to play with gender-specific toys. The study, now available in the online edition of Hormones and Behavior, proposes sex differences in toy preferences reflect hormonally influenced behavioral and cognitive biases.

Yerkes lead researcher Janice Hassett said, "Sex differences in human toy preferences are often thought to occur primarily through socialization influences, such as parents encouraging sons to play with cars and trucks and daughters to play with dolls and stuffed animals. If, however, preferences for gender specific toys exist in other species, then nonsocial factors also may play a role in preference."

Yerkes researchers compared the interactions of 11 male and 23 female rhesus macaques with human wheeled toys (masculine) and plush toys (feminine). Like young boys, male monkeys strongly preferred wheeled toys, while female monkeys, similar to young girls, played more equally with both types of toys. "Young girls show a broader range of play patterns than boys, playing with many different kinds of toys," said Hassett. "We found this to be true with the female monkeys as well. This suggests that rather than specific socialization determining toy preferences, it's more likely biases in preferences that exist at birth" continued Hassett.

"We were quite surprised by how closely the preferences of male and female monkeys for human gender-stereotyped toys paralleled those reported in children," said Kim Wallen, PhD, study co-author. "Because monkeys are not subjected to advertisements, or to criticism for toy choice, this suggests the monkeys choose the toys on the basis of the activities the toys encourage. Thus, differences in activity preference vary between males and females," Wallen summarized.

These results may be applied to other sex differences. Hassett offered, "Traditional thinking is sex differences, such as career choice and performance on specific types of cognitive tests, are a result of socialization -- labeling professions as masculine or feminine and teaching boys and girls differently. While this almost certainly occurs, it is possible our early preferences shape our environment such that later in life men and women seek different activities and ways of spending time and resources."

For more than seven decades, the Yerkes National Primate Research Center, Emory University, has been dedicated to conducting essential basic science and translational research to advance scientific understanding and to improve the health and well-being of humans and nonhuman primates. Today, the center, as one of only eight National Institutes of Health--funded national primate research centers, provides leadership, training and resources to foster scientific creativity, collaboration and discoveries. Yerkes-based research is grounded in scientific integrity, expert knowledge, respect for colleagues, an open exchange of ideas and compassionate, quality animal care. Within the fields of microbiology and immunology, neuroscience, psychobiology and sensory-motor systems, the center's research programs are seeking ways to: develop vaccines for infectious and noninfectious diseases, such as AIDS and Alzheimer's disease; treat cocaine addiction; interpret brain activity through imaging; increase understanding of progressive illnesses such as Parkinson's and Alzheimer's; unlock the secrets of memory; determine behavioral effects of hormone replacement therapy; address vision disorders; and advance knowledge about the evolutionary links between biology and behavior.

Fitness Study Shows Differences in Blood Vessel Repair, Fat Hormone

Fit healthy people tend to have higher numbers of circulating cells that regenerate blood vessels, a new study from Emory University shows. Findings were presented March 30 at the American College of Cardiology's 57th Annual Scientific Session in Chicago.

A team of scientists, led by Emory cardiologist Arshed Quyyumi, MD, professor of medicine, Emory University School of Medicine, measured the ability of 33 healthy middle-aged people of normal weight to withstand aerobic exercise. They also measured the levels of leptin and endothelial progenitor cells in study participants' blood.

"We have shown for the first time in a healthy population that increased fitness and reduced body fat are associated with higher levels of circulating progenitor cells," says cardiology researcher Mick Ozkor, MD, Emory University School of Medicine, who presented the data.

"Exercise may be the reason for the differences in regenerative capacity, even in apparently healthy individuals without risk factors," adds Dr. Ozkor.

Endothelial progenitor cells repair blood vessels by providing new cells that form blood vessels' linings. Previous studies have shown that exercise quickly increases their level in the blood and a course of exercise can boost their numbers in patients with cardiovascular disease.

In addition, study findings show lean people with higher levels of leptin, an inflammatory hormone produced by fat cells, have fewer regenerative cells. Leptin's negative effects can be seen in healthy people free of cardiovascular risk factors, Dr. Ozkor says.

Leptin sends "I've had enough to eat" signals to the hypothalamus, part of the brain that controls appetite. Most obese people appear to produce an abundance of leptin but for them, leptin's appetite-controlling effects are muted. High levels of leptin also have been associated with inflammation and vascular disease.

Emory Voice Center Helps Patients Restore Damaged Voice with Injectable Gel

Damaged and paralyzed vocal cords can be restored with use of a natural filler, similar to collagen, that typically is used to plump lips or smooth wrinkles, say doctors at the Emory Voice Center at Emory Crawford Long Hospital.

At the Emory Voice Center, patients can walk into the office talking only in a whisper. After a short, in-office procedure many can leave with their normal voices intact once again.

Vocal cord paralysis is a voice disorder that occurs when one or both of the vocal cords do not open or close properly. It is a common disorder and symptoms can range from mild to life threatening.

The vocal cords are two elastic bands of muscle tissue located in the larynx (voice box) directly above the trachea (windpipe). When people speak or sing, the vocal cords vibrate together to produce sound. They remain open when a person is not speaking, allowing the person to breathe. And they close when people swallow to protect the airway.

"Damage to the nerves supplying the vocal cords is usually the result of spine, thyroid or chest surgery, or possibly a viral infection or a tumor," says Michael M. Johns, III, MD, director of the Emory Voice Center. "In fact, almost one in 10 patients we see has some sort of damage to the nerve leading to the vocal cords, resulting in vocal cord paralysis."

The nerve that supplies the vocal cords is the recurrent laryngeal nerve. This nerve winds from the voice box down to the chest and back up to the voice box, making it very susceptible to damage from surgeries, trauma and other illnesses.

People with certain neurological conditions such as Parkinson's disease, multiple sclerosis or stroke may also experience vocal cord paralysis.

To repair the damage and restore the voice, specialists inject a natural gel-like substance into the damaged or paralyzed vocal cord, which causes it to swell. The swelling helps the paralyzed vocal cord plump up and cause vibration and sound again. The injection takes 15 to 20 minutes and is performed in a doctor's office while the patient is awake. The patient actually participates in the procedure by talking and making sounds, as directed by the physician. A local anesthetic is used to numb the skin before the procedure begins.

"This procedure is minimally invasive, requires no trip to the operating room and is safe and very effective," says Johns, an assistant professor in the Department of Otolaryngology (ENT), Emory University School of Medicine. "In many cases, the damaged vocal cord will heal itself after trauma, so this injection is a great first option for temporary assistance while waiting to see if the vocal cord will recover."

The filler substance usually lasts from three to six months, depending on the degree of paralysis or damage. Most insurance companies do cover the in-office procedure.

Johns says some patients will need voice therapy to help them strengthen their voice after injury or damage, while others do not.

Johns and his partner, Adam Klein, MD, assistant professor in the Department of Otolaryngology at Emory, both perform the procedure. For more information or to schedule an appointment, please call Emory HealthConnection at 404-778-7777.

Living Well Workshops Offer Help with Managing Chronic Disease Symptoms

If you struggle with ongoing symptoms of chronic disease such as fatigue, pain, stress/anxiety, muscle tension, difficult emotions or shortness of breath, there are new techniques available to help you deal with these symptoms.

Fayette Senior Services is pleased to present Living Well: The Stanford University Chronic Disease Self-management Program, a six-week workshop designed to teach healthy behaviors to live more positively and less painfully with age or chronic diseases such as arthritis, diabetes or high blood pressure.

The first of the six workshops will be held on Tuesday, April 15 from 2 p.m. to 4:30 p.m. with the remaining classes scheduled for 4/22, 4/29, 5/6, 5/13 and 5/20. Participants will learn to have more control over health problems, improve strength, flexibility and endurance and adapt new techniques to manage stress, anxiety and pain.

Cost is $10 for all six-sessions. Advance registration required. Call 770-460-0813 or stop by Fayette Senior Services, 4 Center Drive, Fayetteville (across from the Fayette County Justice Center). Fayette Senior Services, Inc. is a non-profit 501(c)(3) organization that promotes the emotional, social and physical well-being of adults age 50 and better. For more information about Fayette Senior Services visit www.fayss.org.

Older Corneas Are Suitable for Transplantation, Nationwide Study Shows

Corneal transplants using tissue from older donors have similar rates of survival to those using tissue from younger donors, reports a nationwide study recently concluded at Emory Eye Center and 79 other sites.

The five-year transplant success rate for recipients was the same - 86 percent - for transplants performed across the nation with corneas from donors ages 12 to 65 years and from donors ages 66 to 75.

Because of this new finding, the donor age pool, currently limited to donors 65 and younger, should be expanded to include donors up to 75 years of age. These are the conclusions of a study funded by the National Eye Institute (NEI) of the National Institutes of Health, and published in the April issue of the medical journal Ophthalmology.

“This pivotal study indicates that corneas from older individuals are just as successful when used for transplants as those from younger donors,” says R. Doyle Stulting, MD, PhD, director, Section of Cornea, External Disease and Refractive Surgery at Emory Eye Center. “These study results will expand the donor cornea pool and make the scheduling of transplant procedures easier for both surgeons and patients.”

The availability of donor corneas has been adequate for the past 10 years in the United States, where more than 33,000 corneal transplants are performed each year.

However, recent changes in Food and Drug Administration (FDA) regulations will likely cause a decrease in the supply of donated corneas, says Stulting. These new regulations require additional screening and testing of potential donors for contagious diseases, registration of eye banks, more detailed records and labels and stricter quarantine procedures. In addition, many eye banks previously set the age limit for donors at 65 years or younger because some surgeons have been reluctant to use older corneas. The findings from the new study could lessen these restrictive policies.

Emory Eye Center is one of 80 sites that participated in the Cornea Donor Study (CDS) that helped bring together more than 1,101 participants and 105 surgeons from across the United States. Participants from Emory were between ages 40 and 80 and were chosen for the study if they were in need of a corneal transplant for a corneal disease that put them at moderate risk for clouding of the transplanted cornea.

After the transplant surgery, the participants were followed for five years. The transplant was considered a failure if a repeat corneal transplant was required or if the cornea was cloudy for at least three months. Donor corneas were provided by 43 participating eye banks. All donor corneas met Eye Bank Association of America standards for human corneal transplantation and were consistent with eye banks’ tissue ratings of good to excellent quality.

“The pressure on eye banks to provide corneas is increasing,” says Paul A. Sieving, MD, PhD, director of NEI. “The results of this study will expand the available donor pool and should persuade surgeons to use corneas from older donors. These changes will greatly benefit the growing number of individuals who need corneal transplants.”

Overall, the demand for organs and tissue is greater than the supply available for transplantation. In the United States, the U.S. Department of Health and Human Services Health Resources and Services Administration oversees the federal government’s Organ Donor Program. This program is designed to increase awareness of the critical need for organ and tissue donors. For more information, go to http://www.organdonor.gov/.