New Shoulder Surgery Successfully Treats Serious Injuries

A surgeon at the Emory Sports Medicine Center has helped to pioneer a surgical option for people suffering from severe shoulder injuries.

Spero Karas, MD, Emory orthopaedic surgeon and team doctor for the Atlanta Falcons, has found safe and effective results using a procedure called the “Bridge Technique” for rotator cuff injuries. This procedure uses a skin graft that is surgically attached to both the deficient tendon and bone to ‘bridge’ the defect.

“We have a number of treatments available to fix most rotator cuff injuries, but there are times when the tendon defect is so severe that those options are inadequate,” says Karas, who is also an associate professor of orthopaedics at Emory University School of Medicine.

For individuals with severe injuries that were untreatable in the past, this is a procedure that now offers a potential alternative.

"When the rotator cuff is repaired using this technique, it reestablishes normal function of the rotator cuff," Karas explains. "This results in eliminating pain, improving function and potentially slowing the progression of arthritis."

Not only does this procedure offer help for patients who may never have been able to completely recover from a serious injury, but Karas says it also may give the patient the ability to return to normal activity.

-----

Community News You Can Use
Click to read MORE news:
www.GeorgiaFrontPage.com
Twitter: @gafrontpage & @TheGATable @HookedonHistory
www.ArtsAcrossGeorgia.com
Twitter: @artsacrossga, @softnblue, @RimbomboAAG @FayetteFP

Streptococci and E. coli Continue to Put Newborns at Risk for Sepsis

Bloodstream infections in newborns can lead to serious complications with substantial morbidity and mortality. What’s more, the pathogens responsible for neonatal infections have changed over time. In recent years, however, antibiotic prophylaxis given to at-risk mothers has reduced the incidence of early-onset group B streptococcal infections among their babies.

A new nationwide, multi-site study aimed at determining current early-onset sepsis rates among newborns, the pathogens involved, and associated morbidity and mortality demonstrates that the most frequent pathogens associated with sepsis are group B streptococci (GBS) in full-term infants and Escherichia coli in preterm infants.

The study, which included nearly 400,000 newborns, also found that infection rates in newborns increased with decreasing gestational age and birth weight. The overall rate of infection was 0.98 per 1,000 live births; 0.41 per 1,000 live births involving GBS and 0.28 per 1,000 live births involving E. coli.

The study appears online April 25 and in the May 2011 issue of Pediatrics.

GBS emerged as the leading cause of early-onset sepsis and meningitis in newborns in the 1970s. In 2002, the Centers for Disease Control and Prevention recommended universal screening of women at 35 to 37 weeks of pregnancy followed by chemoprophylaxis for women with GBS colonization.

Sepsis occurs when pathogenic bacteria enter the blood stream, causing systemic infection. In infants less than 72 hours old, sepsis is considered of early onset.

“Infections occur in almost one case per thousand live births,” says Barbara Stoll, MD, lead investigator for the study. Stoll is the George W. Brumley, Jr., Professor and Chair, Department of Pediatrics in Emory University School of Medicine. “With approximately 4 million births a year in the United States, this equates to a substantial burden of disease. We estimate that approximately 3,000 infants a year develop early-onset sepsis. With current mortality rates, approximately 300 to 350 deaths per year are associated with neonatal sepsis. So, it’s not inconsequential.”

The study also shows that opportunities for prevention of neonatal GBS infections continue to be missed. “Missed opportunities for prevention of GBS include failure to screen all women who deliver at term, failure to provide antibiotics to all colonized women or to those who delivered preterm with unknown colonization status and false negative GBS screens among women who deliver with GBS infection,” says Stoll.

“Our findings suggest that accurate point-of-care diagnostic tests at the time a woman comes in for delivery would enhance our ability to identify at-risk women.”

In addition, the gap in linking electronic medical records between a woman’s obstetrician and the hospital where she delivers can also impede prevention. “A community health record that links the medical record in a physician’s office with the hospital where the woman gets care could enhance identification and therapy for at-risk women,” says Stoll. “If a woman has been screened for GBS and is known to be colonized, that information should be available to the health care team taking care of her at the time she is in labor.”

The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Centers for Disease Control and Prevention.

By Robin Tricoles

-----

Community News You Can Use
Click to read MORE news:
www.GeorgiaFrontPage.com
Twitter: @gafrontpage & @TheGATable @HookedonHistory
www.ArtsAcrossGeorgia.com
Twitter: @artsacrossga, @softnblue, @RimbomboAAG @FayetteFP

Home-Based Mindfulness Treatment Curbs Depression in Adults With Epilepsy

A telephone- and Internet-delivered mindfulness-based depression treatment has been shown to significantly reduce depressive symptoms in adults with epilepsy, according to a study by Emory University public health researchers, published in the November 2010 issue of Epilepsy & Behavior.

The treatment called UPLIFT (Using Practice and Learning to Increase Favorable Thoughts) is a home-based depression prevention and treatment program. Based on mindfulness-based cognitive therapy, the weekly program was designed for group delivery via the phone or Web. It involves eight, hour-long sessions focused on increasing knowledge about depression, epilepsy, cognitive-behavioral therapy (CBT) and mindfulness.

Forty participants were randomly assigned to participate in the intervention or waitlist groups. Depressive symptoms and other outcomes were measured at baseline, after eight weeks, and after 16 weeks.

Depressive symptoms decreased by 64 percent in the intervention group but only by 15 percent in the waitlist group. There was no significant difference in results between participants who received the intervention via telephone or Internet.

“The Project UPLIFT intervention was effective in teaching people with epilepsy the knowledge and skills associated with reducing their symptoms of depression,” says lead study author Nancy Thompson, PhD, associate professor of behavioral science and health education at Emory’s Rollins School of Public Health. “Addressing the mental health needs of this population is important as many people with epilepsy – between 32 percent and 48 percent – report being depressed as well as feeling isolated and stigmatized.”

Future studies of the UPLIFT program will target other populations at risk of depression, such as caregivers or persons with disabilities, who may benefit from a home-based treatment. The U.S. Centers for Disease Control and Prevention funded the Project UPLIFT pilot study.

In addition to Thompson, study authors were Elizabeth Reisinger Walker, Natasha Obolensky, Ashley Winning, Christina Barmon, and Colleen Dilorio, of the Rollins School of Public Health; and Michael Compton of the Emory School of Medicine.


-----
Community News You Can Use
Click to read MORE news:
www.GeorgiaFrontPage.com
Twitter: @gafrontpage & @TheGATable @HookedonHistory
www.ArtsAcrossGeorgia.com
Twitter: @artsacrossga, @softnblue, @RimbomboAAG
www.FayetteFrontPage.com
Twitter: @FayetteFP

Epilepsy Organizations Award Grants for New Gene Therapy to Treat Epilepsy and Novel Surgical Intracranial EEG to Detect Seizures in Uncontrolled Patients

/PRNewswire/ -- The Epilepsy Therapy Project (ETP) and the Epilepsy Foundation (EF) today announced the latest grant recipients of its New Therapy Grants Program, a unique joint venture of the non-profit epilepsy organizations, to advance promising epilepsy research in clinical development. The grant awards, totaling approximately $200,000 in funding, will support an experimental gene therapy that directly targets epileptogenic brain tissue, as well as an electrode system that has the potential to improve the efficacy of surgical therapies for certain epilepsy syndromes.

"Patients need new options to treat and manage epilepsy, and through this grant program we are excited to see such remarkable innovation in the field. The fields of gene therapy and surgical treatment of epilepsy remain cutting-edge with much to be explored in terms of advancing epilepsy treatment outcomes," said Orrin Devinsky, MD, ETP Co-Founder and Vice President for Translational Programs, Professor of Neurology, Neurosurgery, and Psychiatry, and Director, NYU Comprehensive Epilepsy Center, New York University. "By choosing to support these two promising programs, we hope to see important strides made while encouraging researchers and companies to pursue new ideas and approaches in epilepsy and seizure conditions."

The New Therapy Grants program grants are designated to facilitate the advancement of new treatments through critical early-stage clinical development or to bridge the gap from preclinical to clinical development to ensure patients will have the opportunity to benefit from groundbreaking progress in the field of epilepsy. The award committee, which is comprised of clinical, scientific and industry representatives, evaluates applications to support new therapeutic approaches submitted by highly qualified clinical experts and scientists with the greatest potential for near-term patient benefit.

"The need and market opportunity for new therapies in epilepsy is unmistakable," said Warren Lammert, Chairman of the Epilepsy Therapy Project. "One third of the people with epilepsy live with uncontrolled seizures despite all available therapies and perhaps another one third achieve seizure control but at the price of unacceptable side-effects including fatigue and impact to cognition. Yet moving promising ideas out of research labs and on through the process of clinical and commercial development is an enormously expensive process with miniscule odds of success for each individual project. Further, epilepsy therapy development has been neglected by government and private funding sources, and current economic uncertainties have further diminished the availability of risk capital. In this environment, the importance of our New Therapy Grants in moving the most promising new research ideas across the starting line on to a path of clinical development cannot be overstated. My hope is that we can mobilize increased support and expand this vital program so necessary to improving the lives of people living with epilepsy."

"These research projects represent the essence of translational research and the focus of our New Therapy Grants Program," said Joyce Bender, chair of the Epilepsy Foundation board of directors. "We proudly applaud our grant recipients because their studies may provide new treatment options, which could lead to an improved quality of life for the nearly 3 million people in the United States and 50 million people worldwide living with epilepsy."

The Grant Recipients

Galanin Gene Delivery to the Hippocampus for Mesial Temporal Lobe Epilepsy

-- Prospect of one-time gene therapy that produces anti-convulsant and
neuroprotective benefits
-- Experimental therapy may offer less invasive therapeutic option and a
prospective paradigm shift in patient care for certain forms of
epilepsy


Scott McPhee, Ph.D., Vice President of Clinical Development, Asklepios BioPharmaceutical Inc., and Nicholas Boulis, M.D., Assistant Professor, Neurosurgery, Emory University, will be conducting preclinical studies of a Galanin gene delivery for selected patients with uncontrolled Mesial Temporal Lobe Epilepsy (MTLE). Direct delivery of a gene therapy to the temporal lobe offers the significant potential of a less invasive, more effective alternative approach that precludes the trauma and resulting complications of surgical tissue removal, and avoids the side effects of standard pharmacological treatments. The protein galanin has been shown to suppress seizures. Gene delivery of galanin DNA has been shown to have anticonvulsant and neuroprotective effects in models of MTLE. Unlike traditional anti-epileptic medications, galanin gene delivery may be administered in a one-time intervention that provides long-term supplemental galanin in the epileptogenic tissue. The proposed therapeutic approach represents a paradigm shift in the treatment of epilepsy because gene delivery offers to locally regulate activity rather than destroying tissue. In addition, it has the unique and significant potential to one day provide a strategy for the treatment of critical brain tissue in which tissue removal is not currently a therapeutic option. These experiments may not only provide a unique opportunity for the development of novel epilepsy therapies but may also advance the cause of neurological gene therapy in general.

The preclinical research outlined by the grant recipients is expected to support the filing of an

Investigational New Drug (IND) Application for a Phase I clinical trial. Funding of the preclinical protocol is subject to appropriate institutional review and approvals, as well as securing the additional financial support needed to complete the research.

Intracranial EEG Acquisition System with Online Fast Ripple Detection

-- New technology to refine how surgeons will identify and define
epileptogenic regions of the brain
-- Potential to improve surgical outcomes and broaden viability of
treatment for certain epilepsy syndromes


A Columbia University Medical Center research team headed by Catherine Schevon, M.D., Assistant Professor, Neurology, received funding to support the refinement of an intracranial EEG recording system, an online detection system to better define the epileptogenic region of the brain, the area of the brain related to seizure activity, before therapy or surgery.

Surgical excision of the epileptogenic brain region is an important treatment modality for medically refractory partial epilepsy, with greater than 60 percent or more of patients achieving seizure freedom. The success rate is notably worse, however, when a structural lesion cannot be identified, and may be as low as 35 percent in patients with extratemporal non-lesional syndromes. In these cases, the resection choice depends almost entirely on accurate interpretation of the intracranial EEG (iEEG), obtained by recording from electrodes implanted directly onto the brain surface or into the parenchyma. Recognizing these limitations surgical therapy for extratemporal epilepsy syndromes is not currently recommended for widespread clinical use.

High frequency oscillations (HFO) in the brain can identify areas for epilepsy surgery treatments, but are technically difficult to detect, largely limiting their clinical utility. Grant funding will be applied to the development of this new system to bring automatic online HFO detection into clinical practice, making current surgical treatments more effective, and potentially simplifying surgeries for many epilepsy syndromes. By increasing the specificity of the identification of the epileptogenic region, seizure outcomes can be improved while the area of brain that must be removed is minimized.

Upcoming Grant Applicants: Note Deadline for Letter of Intent is September 3, 2010

The New Therapy Grants Program is requesting proposals from scientific and clinical investigators pursuing innovative projects that demonstrate a clear path to commercialization. The program accepts the submission of proposals ranging from $50,000 to $500,000. The deadline to submit a Letter of Intent (LOI) is September 3, 2010. Applicants who have an accepted LOI have until October 15, 2010, to submit their full proposals. To view additional requirements, please visit http://www.epilepsy.com/etp/support_translational.

The New Therapy Grants Program is a unique partnership between two leading epilepsy non-profit organizations, the Epilepsy Therapy Project and the Epilepsy Foundation. The mission of the New Therapy Grants Program is to drive the development of new therapies for epilepsy, accelerating the advancement of research from the laboratory to the patient. Funding is provided for grants supporting the research and development of new therapies in both academic and commercial settings worldwide.

-----
Community News You Can Use
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Follow us on Twitter:  @GAFrontPage

HIV Components Drive Bone Breakdown, Even without Active Infection

Although individuals who are HIV positive can now expect to live longer because of the availability of anti-retroviral drugs, this advance brings on new health challenges. It is estimated that the majority of the HIV-infected population of the United States will be older than 50 by 2015.

The intersection of aging and HIV infection appears to have a destructive impact on bone health. Researchers at Emory University School of Medicine have shown in an animal model that the presence of HIV proteins, even without a replicating virus, leads to alterations in cells that break down bone.

The team's results were published this week online in the Early Edition of the Proceedings of the National Academy of Sciences.

"We found that HIV proteins, by themselves, can alter the output of hormones that affect the balance between bone formation and bone breakdown leading to bone loss," says senior author M. Neale Weitzmann, MD, assistant professor of endocrinology at Emory University School of Medicine. "This information could help doctors decide the best way to stave off osteoporosis and bone fractures, which are becoming increasingly common in individuals living with HIV infection."

Collaborating authors are David Guidot, MD, director of the Division of Pulmonary, Allergy and Critical Care Medicine at Emory and director of the Emory Alcohol and Lung Biology Center; and Igho Ofotokun, MD, assistant professor of medicine (infectious diseases).

The Emory team studied rats that have an HIV virus that cannot replicate incorporated into their DNA. The virus does not kill white blood cells directly as it does in human patients, but parts of the virus appear in the rats' blood, and appear to distort the function of immune cells.

Compared to normal rats, the HIV-transgenic rats' bone mineral density (determined by X-rays) in the femur was reduced by 36 percent, while the proportion of bone in the trabecular (spongy) areas of their femurs was reduced by 32 percent.

Some of the reduction in bone mass may be because the HIV-transgenic rats weigh 21 percent less, but they also have more osteoclasts-- cells that originate in the bone marrow that break down bone. The authors found that in the HIV-transgenic rats, B cells (a variety of immune cells) produce more of certain hormones that promote osteoclast differentiation. For instance, their B cells produce more RANKL, a key osteoclast promoting factor and the target of an anti-osteoporosis drug called denosumab, and less osteoprotegerin, an osteoclast inhibitor, Weitzmann says.

Previous studies have shown that viral infection drives changes in the balance of the types of B cells present in HIV-infected people. Weitzmann says the next step in the team's research will be to examine B cell subpopulations in HIV-infected people, and to measure their output of hormones involved in bone growth and breakdown.

The research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute of Allergy and Infectious Diseases and the Department of Veterans Affairs.

Reference:
T. Vikulina et al. Alterations in the immuno-skeletal interface drive bone destruction in HIV-1 transgenic rats. PNAS Early Edition (2010).

-----
Community News You Can Use
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Follow us on Twitter:  @GAFrontPage

Vaccine-Delivery Patch with Dissolving Microneedles Boosts Protection

A new vaccine-delivery patch based on hundreds of microscopic needles that dissolve into the skin could allow persons without medical training to painlessly administer vaccines -- while providing improved immunization against diseases such as influenza.

Patches containing micron-scale needles that carry vaccine with them as they dissolve into the skin could simplify immunization programs by eliminating the use of hypodermic needles -- and their "sharps" disposal and re-use concerns. Applied easily to the skin, the microneedle patches could allow self-administration of vaccine during pandemics and simplify large-scale immunization programs in developing nations.

Details of the dissolving microneedle patches and immunization benefits observed in experimental mice were reported July 18th in the advance online publication of the journal Nature Medicine. Conducted by researchers from Emory University and the Georgia Institute of Technology, the study is believed to be the first to evaluate the immunization benefits of dissolving microneedles. The research was supported by the National Institutes of Health (NIH).

"In this study, we have shown that a dissolving microneedle patch can vaccinate against influenza at least as well, and probably better than, a traditional hypodermic needle," said Mark Prausnitz, a professor in the Georgia Tech School of Chemical and Biomolecular Engineering.

Just 650 microns in length and assembled into an array of 100 needles for the mouse study, the dissolving microneedles penetrate the outer layers of skin. Beyond their other advantages, the dissolving microneedles appear to provide improved immunity to influenza when compared to vaccination with hypodermic needles.

"The skin is a particularly attractive site for immunization because it contains an abundance of the types of cells that are important in generating immune responses to vaccines," said Richard Compans, professor of microbiology and immunology at Emory University School of Medicine.

In the study, one group of mice received the influenza vaccine using traditional hypodermic needles injecting into muscle; another group received the vaccine through dissolving microneedles applied to the skin, while a control group had microneedle patches containing no vaccine applied to their skin. When infected with influenza virus 30 days later, both groups that had received the vaccine remained healthy while mice in the control group contracted the disease and died.

Three months after vaccination, the researchers also exposed a different group of immunized mice to flu virus and found that animals vaccinated with microneedles appeared to have a better "recall" response to the virus and thus were able to clear the virus from their lungs more effectively than those that received vaccine with hypodermic needles.

"Another advantage of these microneedles is that the vaccine is present as a dry formulation, which will enhance its stability during distribution and storage," said Ioanna Skountzou, an Emory University assistant professor.

Pressed into the skin, the microneedles quickly dissolve in bodily fluids, leaving only the water-soluble backing. The backing can be discarded because it no longer contains any sharps.

"We envision people getting the patch in the mail or at a pharmacy and then self administering it at home," said Sean Sullivan, the study’s lead author from Georgia Tech. "Because the microneedles on the patch dissolve away into the skin, there would be no dangerous sharp needles left over."

The microneedle arrays were made from a polymer material, poly-vinyl pyrrolidone, that has been shown to be safe for use in the body. Freeze-dried vaccine was mixed with the vinyl-pyrrolidone monomer before being placed into microneedle molds and polymerized at room temperature using ultraviolet light.

In many parts of the world, poor medical infrastructure leads to the re-use of hypodermic needles, contributing to the spread of diseases such as HIV and hepatitis B. Dissolving microneedle patches would eliminate re-use while allowing vaccination to be done by personnel with minimal training.

Though the study examined only the administration of flu vaccine with the dissolving microneedles, the technique should be useful for other immunizations. If mass-produced, the microneedle patches are expected to cost about the same as conventional needle-and-syringe techniques, and may lower the overall cost of immunization programs by reducing personnel costs and waste disposal requirements, Prausnitz said.

Before dissolving microneedles can be made widely available, however, clinical studies will have to be done to assure safety and effectiveness. Other vaccine formulation techniques may also be studied, and researchers will want to better understand why vaccine delivery with dissolving microneedles has been shown to provide better protection.

Beyond those already mentioned, the study involved Jeong-Woo Lee, Vladimir Zarnitsyn, Seong-O Choi and Niren Murthy from Georgia Tech, and Dimitrios Koutsonanos and Maria del Pilar Martin from Emory University.

"The dissolving microneedle patch could open up many new doors for immunization programs by eliminating the need for trained personnel to carry out the vaccination," Prausnitz said. "This approach could make a significant impact because it could enable self-administration as well as simplify vaccination programs in schools and assisted living facilities."

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Follow us on Twitter:  @GAFrontPage

Pediatric Cancer Survivors at Risk for Chronic Illnesses that May Cause Heart Disease

Survivors of pediatric cancer are at greater risk for high cholesterol, diabetes and high blood pressure, all of which predispose them to heart disease.

These risk factors for heart disease are being found at an earlier age than in the general population, according to research published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Lillian R. Meacham, MD, professor of pediatrics at Emory University and medical director of the Aflac Cancer Center of Children's Healthcare of Atlanta Cancer Survivor Program, used data from the Childhood Cancer Survivor Study, which included 8,599 cancer survivors and 2,936 of their siblings.

"In data previously published from the Childhood Cancer Survivor Study, pediatric cancer survivors were found to be at almost 10-fold greater risk for cardiovascular disease than their non-survivor counterparts," says Meacham. "In this study we identified whether the predisposing risk factors for cardiovascular disease - obesity, hypertension, hyperlipidemea and diabetes - were present at higher rates compared to siblings. If the risk factors could be recognized and treated early it is hoped some of the long-term cardiac side effects could be averted."

Meacham found that cancer survivors were nearly twice as likely as their siblings to take medication for high blood pressure, 60 percent more likely to take cholesterol medication and 70 percent more likely to have diabetes.

Radiation treatment may be playing a role in the development of risk factors for cardiovascular disease, Meacham says. Total body irradiation was linked with a 5.5-fold increased risk and chest and abdomen radiation a 2.2-fold increased risk of cardiovascular risk factor clustering, which when present is associated with subsequent cardiovascular disease.

"Mechanistically, we are not yet sure why this is, but the association is definitely there," says Meacham.

Researchers examined the presence of cardiovascular risk factors and found that physical inactivity among cancer survivors was linked with a 70 percent increased risk for cardiovascular risk factor clustering. Older age at the time of the study was linked to a 8.2-fold increased risk for cardiovascular risk factor clustering among survivors compared with children who had never had cancer.

"These risk factors are manifesting at about age 32, which is much younger than a non-cancer survivor would exhibit signs of cardiovascular risk factors," says Meacham. "Some have suggested that when you are a cancer survivor there are parts of you that wear out early, so we need to be vigilant about our follow-up of these patients in order to find these late effects early and intervene."

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Follow us on Twitter: @GAFrontPage

Care Management Improves Physical Health of Patients with Mental Illness

Connecting mental health patients with care managers responsible for coordinating their health care significantly improves their overall health and wellbeing, according to a study by Emory University public health researchers.

The study, the first of its kind, tested a population-based medical care management intervention aimed at improving medical care in community mental health settings. Recent studies show that people with severe mental illness die 25 years younger than the general population largely due to medical causes such as heart attacks.

"There is a growing concern about the epidemic of premature morbidity and mortality among persons with serious mental illnesses," says lead study author Benjamin Druss, MD, MPH, professor of health policy and management and the Rosalynn Carter Chair in Mental Health at Emory's Rollins School of Public Health. "This model provides one of the first evidence-based approaches for addressing that problem by helping patients access high-quality medical care."

A total of 407 people with severe mental illness at an urban community mental health center were randomly assigned to either the medical care management intervention or usual care. The patients were all ages 18 and older, considered economically disadvantaged, and experienced serious and persistent mental illness.

For individuals in the intervention group, care managers provided communication and advocacy with medical providers, health education and support in overcoming system-level fragmentation and barriers to primary medical care. Patients in the usual care group were given a list with contact information for local primary care medical clinics and were permitted to obtain any type of medical care or other medical services without the assistance of a care manager.

At a 12-month follow-up evaluation, researchers found that medical care management was associated with significant improvements in the quality and outcomes of primary care. The intervention group received an average of 58.7 percent of recommended preventive services compared with a rate of 21.8 percent in the usual care group.

In addition, patients in the intervention group received a significantly higher proportion of evidence-based services for cardiometabolic conditions (34.9 percent versus 27.7 percent) and were more likely to have a primary care provider (71.2 percent versus 51.9 percent). The group showed significant improvement in mental health functioning, and at one-year follow-up, had a substantially lower risk for heart disease than those in the usual care group.

These findings suggest that care management is a promising approach for improving quality and outcomes of medical care for patients with serious mental illnesses, says Druss.

The study titled, "A randomized trial of medical care management for community mental health settings: The Primary Care Access, Referral, and Evaluation (PCARE) study," was published in the Dec. 15 online edition of The American Journal of Psychiatry. It was funded by a grant from the National Institute of Mental Health of the National Institutes of Health.

In addition to Druss, study authors were: Silke Von Esenwein, PhD, director of research projects, Kimberly Rask, MD, PhD, associate professor of health policy and management, and Liping Zhao, MSPH, senior biostatistician, of the Rollins School of Public Health; and Michael Compton, MD, MPH, assistant professor of psychiatry and Ruth Parker, MD, professor of medicine, of the Emory School of Medicine.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page

Emory, Georgia Tech, Children's Healthcare of Atlanta Team Up on Kidney Replacement Devices for Kids

When children need kidney dialysis because of disease or congenital defects, doctors are forced to adapt adult-size dialysis equipment. No FDA-approved kidney replacement devices exist that are specifically designed for children.

To address this problem, physicians and researchers from Emory University, Children’s Healthcare of Atlanta and the Georgia Institute of Technology have teamed up to develop a kidney replacement device capable of treating children.

Over the past five years, the three institutions have further solidified a cohesive relationship aimed at medical discovery, quality-care improvement and health care innovation.

The team has been awarded a Challenge grant of $1 million from the National Institutes of Health (NIH) to refine a prototype device. The grant is part of the American Recovery and Reinvestment Act (ARRA) funding. Challenge grants are part of a new NIH program to stimulate rapid advances in focused disease areas.

Matthew Paden, MD, assistant professor of pediatrics (critical care) at Emory University School of Medicine and a physician at Children’s Healthcare of Atlanta, is the grant’s principal investigator. Ajit P. Yoganathan, PhD, Regents’ Professor of biomedical engineering in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, is the grant’s co-investigator.

“The adaptations doctors are forced to perform make adult kidney replacement devices inaccurate and potentially dangerous when used with kids,” Paden says. “We have invented a new continuous renal replacement therapy device that is designed specifically with kids in mind. It can be used accurately on a six-pound child, all the way up to a football linebacker.”

In the United States, it is estimated that at least 5,000 children per year, or 1 percent of the 500,000 children admitted to intensive care units, require some form of renal replacement therapy. Children may need kidney replacement therapy because of severe infections that lead to the kidney-damaging inflammatory condition called sepsis, or because of congenital defects, which can only be permanently remedied by a kidney transplant.

Paden says adult dialysis equipment can have a tendency to withdraw too much fluid from a pediatric patient, leading to dehydration and loss of blood pressure. Other possible problems resulting from inaccurate dialysis equipment include clotting or internal bleeding. Part of the problem is that the volume of blood required to fill up the tubes leading to and from the apparatus is too large, Paden says. As the child gets smaller, the proportion of blood outside the body gets larger.

Existing dialysis equipment for adults takes up space comparable to a refrigerator, while Paden says the team’s goal is to have a pediatric device the size of a shoebox.

The inventors:

Lakshmi Prasad Dasi, PhD, former research engineer at Georgia Tech, now assistant professor of mechanical engineering at Colorado State University.
James Fortenberry, MD, pediatrician in chief and medical director of critical care for Children’s Healthcare of Atlanta, and clinical associate professor of pediatrics (critical care) at Emory School of Medicine
Matthew Paden
Ajit Yoganathan

The team’s plan is to test their prototype in the laboratory and prepare for live experiments over the next two years, with the goal of being ready for clinical trials in five years.

“This is a project where we are taking technology from the laboratory bench to the basinet,” Yoganathan says. “First, we have to build a machine capable of reliably performing these tasks without damaging blood cells in the process.”

The team’s prototype device is also designed to work in tandem with equipment that replaces the function of the heart and lungs for severely ill patients. Extracorporeal membrane oxygenation (ECMO) equipment is commonly used in neonatal intensive care units for newborns whose lungs can’t work properly. Children requiring ECMO often have fluid overload and swelling. The demand for ECMO has been rising because of H1N1 influenza, which in severe cases leads to respiratory failure.

Emory, Georgia Tech and Children’s Healthcare of Atlanta are in the process of patenting the kidney replacement device. As the technology is developed further, it could be licensed to an existing company or a new start-up company.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
www.artsacrossgeorgia.com
Arts Across Georgia

Emory Hospitals to Host Palliative Care Seminars Tuesday, Nov. 10

Emory University Hospital and Emory University Hospital Midtown will each host a public presentation as part of National Palliative Care Month. “Palliative Care: What Is It and Who Needs It?” will be held Tuesday, Nov. 10, at 5 p.m.

Palliative care is a medical specialty that focuses on the many ways serious illness affects patients and their families. The goal is to help the whole person by relieving the physical and non-physical suffering disease may bring through a network and team of physicians, nurses, social workers, chaplains and pharmacists. Emory's palliative care team physicians are certified by the American Board of Hospice and Palliative Medicine and the American Board of Internal Medicine.

What:
Palliative Care: What Is It and Who Needs It?
The seminars will feature physicians and nurse practitioners on the Emory Palliative Care Team. Refreshments will be served, and there will be an opportunity for questions and answers after the presentation.

When:
Tuesday, Nov. 10

Time:
5 p.m.

Where:
Emory University Hospital - Auditorium
1364 Clifton Rd. NE, Atlanta, Ga., 30322

Emory University Hospital Midtown - Glenn Auditorium
550 Peachtree St. NE, Atlanta, Ga., 30308
For additional information, please contact Debbie Gunter at 404-301-5014
---
Community News You Can Use
Follow us on Twitter: @gafrontpage
www.FayetteFrontPage.com
www.GeorgiaFrontPage.com
www.PoliticalPotluck.com
www.ArtsAcrossGeorgia.com
---

Public Seminar for Alzheimer’s Caregivers Co-Hosted by Emory

A group of experts will gather in Atlanta on Thursday, Nov. 5 to discuss caring for a person with Alzheimer’s disease. Presenters at the evening seminar, "Practical Strategies: Caring for a Loved One with Alzheimer’s,” will cover topics including managing daily life, planning future decisions, handling crises, dealing with family and caring for yourself. Members of the public are invited to attend and participate in a Q&A session with panelists.

The seminar is sponsored by the Emory University Alzheimer’s Disease Research Center, the Georgia chapter of the Alzheimer’s Association and the Fulton County Human Services Department, Office of Aging

The event will be held from 5:30 p.m. to 7:30 p.m. at the Helene Mills Senior Center located at 515 John Wesley Dobbs Ave., Atlanta, Ga., 30312. Admission and parking are free. Beverages and light snacks will be provided. For more information, please call (404) 523-3353.

Presenters/Topics Include:

Dr. Angela Ashley
Director, Grady Memory Assessment Clinic
Assistant Professor, Emory University School of Medicine

Shileah Cantey
Diversity Outreach Coordinator, Alzheimer's Association

Dr. Adriana Hermida
Assistant Professor, Emory University School of Medicine

Miles Hurley
Elder Care Law Attorney

Moderator: Dr. Ken Hepburn
Emory University School of Nursing
---
Community News You Can Use
Follow us on Twitter: @gafrontpage
www.FayetteFrontPage.com
www.GeorgiaFrontPage.com
www.PoliticalPotluck.com
www.ArtsAcrossGeorgia.com
---

Russian Health Care Delegation Hosted by Emory

A delegation of Russian healthcare workers are in Atlanta to learn about improving the outcomes of pregnancy through the Perinatal Health Care Delivery System, initiated in the State of Georgia by former President Jimmy Carter when he was Governor.

The arrival of the delegation to Emory University comes at a critical time as strategies for bilateral cooperation between the United States and Russia make headlines.

Recently, Emory Professor of Pediatrics Alfred W. Brann Jr. attended the Civil Society Summit in Moscow as a representative of the public health working group and helped draft the recommended areas for joint United States and Russian cooperation in the field of public health and medical science in the broad area of maternal and child health.

As director of the Atlanta-based World Health Organization/Collaborating Center in Reproductive Health (WHO/CC/RH), Brann has worked tirelessly to reduce infant and maternal mortality and improve perinatal care in some 30 countries over the last 25 years.

The visit of Russian healthcare delegation to Emory is co-sponsored by The Future of Russia Foundation, Emory University (Claus Halle Institute of Global Learning, the Center for Russian and East European Studies, Emory’s Center for Ethics and the World Health Organization Collaborating Centre for Reproductive Health) and the Rotary Club of Atlanta.

The collaborative educational program between Russian and American perinatal health care professionals will review previous mutual concerns in reproductive health; discuss the present status of these concerns; and determine the next steps in putting into action the Obama/Medvedev memorandum of understanding (MOU) in the field of maternal and infant healthcare.

Brann serves as medical director of the Future of Russia Foundation (FOR) - the only U.S. charitable foundation created for and solely committed to the mission of modernizing the Russian system for delivery of health care to women of reproductive age and infants, addressing Russia’s declining population, identified in then-President Putin’s inaugural address as Russia’s “greatest crisis.” Brann served in both capacities to lead the development of The Balashikha Project - a comprehensive model for modernizing perinatal care throughout Russia.

“The Russian population is declining some 700 000 people per year. We feel that the Balashikha Project and its potential for improving the outcomes of pregnancy will significantly improve the Russian population by creating new healthy births,” says Brann.

Over the past nine years through the Balashikha project, Russian health care providers have participated in four bi-lateral exchanges with Brann and his Atlanta based colleagues to share ideas and experiences with neonatalogists, pediatricians, obstetricians, nurses, midwives and public health professionals.

This collaborative effort enabled health experts to create a successful perinatal center within a hospital in Balashikha, made it a referral center for high-risk mothers and babies in the Moscow Oblast, and created a postgraduate education for perinatal health professions in that region. A perinatal surveillance system is currently being developed.

“We are trying to create a system of compassionate and evidenced care practices to improve every family’s chances for a healthy pregnancy outcome where the mother and infant are alive and normal following childbirth,” says Brann.
---
Community News You Can Use
Follow us on Twitter: @gafrontpage
www.FayetteFrontPage.com
www.GeorgiaFrontPage.com
www.PoliticalPotluck.com
www.ArtsAcrossGeorgia.com
---

Risky Behavior in Adolescents May Signal Mature Brain

A new study using brain imaging to study teen behavior indicates that adolescents who engage in dangerous activities have frontal white matter tracts that are more adult in form than their more conservative peers.

The brain goes through a course of maturation during adolescence and does not reach its adult form until the mid-twenties. A long-standing theory of adolescent behavior has assumed that this delayed brain maturation is the cause of impulsive and dangerous decisions in adolescence. The new study, using a new form of brain imaging, calls into question this theory.

In order to better understand the relationship between high risk-taking and the brain’s development, Emory University and Emory School of Medicine neuroscientists used a form of magnetic resonance imaging (MRI) called diffusion tensor imaging (DTI) to measure structural changes in white matter in the brain. The study’s findings are published in the Aug. 26, 2009 PLoS ONE.

“In the past, studies have focused on the pattern of gray matter density from childhood to early adulthood, says Gregory Berns, MD, PhD, principal investigator and professor of Psychiatry and Neuroeconomics at Emory University and director of the Center for Neuropolicy. “With new technology, we were able to develop the first study looking at how development of white matter relates to activities in the real world.”

Gray matter is the part of the brain made up of neurons, while white matter connects neurons to each other. As the brain matures, white matter becomes denser and more organized. Gray matter and white matter follow different trajectories. Both are important for understanding brain function.

The study enrolled 91adolescents ages 12 through 18 over a three-year period. Levels of engagement in dangerous behaviors were measured by a survey that included questions about the teens’ thrill seeking behaviors, reckless behaviors, rebellious behaviors and antisocial behaviors. DTI was used to measure corresponding structural changes in white matter.

“We were surprised to discover that risk-taking was associated with more highly-developed white matter – a more mature brain,” says Berns. “We were also surprised to learn that except for slightly higher scores in risk-taking, there was no significant difference in the maturity of the white matter between males and females.”

Berns suggests that doing adult-like activities requires sophisticated skills.

“Society is a lot different now than it was 100 years ago when teens were expected to go to work and raise a family,” says Berns. “Now, adolescents aren’t expected to act like adults until they are in their twenties, when they have finished their education and found a career.

“You could make the case that in this country, biological capacity shows up long before the wisdom that comes with time is fully developed,” notes Berns.

Berns says more studies need to be done to determine if early brain development predisposes someone to engage in risky behaviors, or if the risky behavior drives the maturation of the brain.

The CDC reports that, 27,000 people between the ages of 10 and 24 die from bad decisions in the United States per year. Additionally, it has been shown that the period of mid-adolescence (ages 15 through 19) is the time when teens are more likely to begin high-risk behaviors such as drinking, abusing drugs or driving recklessly.

Other researchers who contributed to this study include, Sara Moore, BS, Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine and C. Monica Capra, PhD, the Department of Economics and the Center for Neuropolicy, Emory University.

This study was funded by grants from the National Institute on Drug Abuse.

“Adolescent Engagement in Dangerous Behaviors Is Associated with Increased White Matter Maturing of Frontal Cortex”, PLoS ONE, 8/26/09, 10.1371
---
Community News You Can Use
Follow us on Twitter: @gafrontpage
www.FayetteFrontPage.com
www.GeorgiaFrontPage.com
www.PoliticalPotluck.com
www.ArtsAcrossGeorgia.com
---

Emory Eye Center Doctor Provides Retina Expertise at Emory Clark-Holder Clinic

Emory Eye Center physician Jiong Yan, MD, assistant professor of ophthalmology at Emory School of Medicine and retina specialist within Emory Eye Center, now sees patients at Emory Clark-Holder Clinic in LaGrange, Ga., in addition to her roles at Emory Eye Center and the Veterans Administration Medical Center. Yan will see patients in LaGrange every other Thursday of the month.

Yan’s expertise will enable the residents of Troup County to have access to an Emory Eye Center ophthalmologist who can provide the highest level of care for retinal disorders. Emory Eye Center is a top-ranked academic eye institution with a three-fold mission of quality patient care, innovative research, and ongoing education, training future ophthalmologists from around the world.

Yan’s interests include diabetic retinopathy, macular disease, retinal detachment and age-related macular degeneration. Additionally, she directs the inherited retinal disease unit at Emory Eye Center. In her position at Emory, she has been involved in eight clinical trials, serving as either principal investigator or co-investigator. She has published nearly 20 papers.

“We are pleased to be able to serve patients in the LaGrange community,” says Yan. “Our retina patients must often have a family member drive them to their clinic appointment. The Emory Clark-Holder Clinic location will help those in the immediate area have closer access to advanced ophthalmic care. Because many our of retina patients need treatments every two months, a more convenient clinic will allow them to make their appointments with more ease. We are excited to work with these patients and provide the care they need, near their homes.”

Timothy W. Olsen, director of the Emory Eye Center, says “Emory Eye Center is excited to have an opportunity to work with our neighbors to bring subspecialty care to West Georgia. I’m certain that the talent and compassion of Dr. Yan will benefit her patients as well as the community. We look forward to our ongoing collaborations at Emory Clark-Holder Clinic.”

Anna Kao, MD, an ophthalmologist serving at Emory Clark-Holder says, “Ophthalmology has been a long-standing tradition with Clark-Holder Clinic. It is very exciting to see the expansion of our service with Dr. Yan’s experience. With the advancement of new technology and medicine, we are able to make a significant difference in saving sight for retinal disorders such as age-related macular degeneration. Dr. Yan’s presence in LaGrange will allow our local and surrounding residents to be part of modern medical advances.”

Yan attended medical school at Louisiana State University (1998). She completed an internship at UMDNJ-Robert Wood Johnson Hospital in New Brunswick, N.J. (1999). She finished a residency in ophthalmology at Emory University (2002), a vitreo-retina fellowship at the Jules Stein Eye Institute, University of California (2004), and an honorary fellowship in retinal dystrophy and degeneration at Moorfields Hospital, London. She joined Emory Eye Center in fall 2004. Yan also serves as chief of the Retina Service in the department of ophthalmology at the Veterans Administration Medical Center, Atlanta.

Yan is board-certified in ophthalmology and is a fellow with the American Board of Ophthalmology. Memberships include the American Academy of Ophthalmology, the Association for Research in Vision and Ophthalmology, the American Society of Cataract and Refractive Surgery, and the Georgia Society of Ophthalmology.

Background
Emory Eye Center has 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 35 ophthalmologists, eight optometrists, ten basic scientists, 11 post-doctoral fellows, and nine researchers in other Emory departments who hold joint appointments in the Emory University School of medicine’s Department of Ophthalmology. Ophthalmology research is supported by current NIH funding - $20 million through 2010. The Department remains in the top rankings (#9 – 2009) by U.S. News & World Report for the 13 years the magazine has held a ranking for Ophthalmology. It also ranks in the Top Ten in all four categories surveyed by Ophthalmology Times annual report. http://eyecenter.emory.edu

Established in 1936, Clark-Holder Clinic is the largest multi-specialty group practice in West Georgia employing more than 30 doctors and other healthcare providers with a staff of 170. Key facilities are located in LaGrange, West Point and Newnan. Clark-Holder Clinic has provided medical services to the citizens of west Georgia and east Alabama for nearly 70 years. The partnership with Emory Healthcare physicians in January 2008 provided access to the highest level of care for the residents of Troup County and the surrounding areas.
---
Community News You Can Use
Follow us on Twitter: @gafrontpage
www.FayetteFrontPage.com
www.GeorgiaFrontPage.com
www.PoliticalPotluck.com
www.ArtsAcrossGeorgia.com
---

Emory Begins Vaccinating Volunteers Today in First H1N1 Clinical Trial

Today Emory University researchers began vaccinating volunteer participants in the first of several planned clinical trials of a new H1N1 vaccine. The clinical trials are being conducted by the eight Vaccine and Treatment Evaluation Units (VTEUs), supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH).

Emory began signing up several hundred interested volunteers about two weeks ago and has been screening the volunteers to make sure they fit certain criteria. Volunteers will receive their first vaccinations over the first week of the trial and will return several times over the course of nine weeks to receive additional vaccinations and blood tests.

The Emory clinical trial will evaluate the safety and immune response to an H1N1 vaccine and also help determine how the pandemic flu shot should be given along with the seasonal flu shot to make it most effective. Participants will receive two H1N1 vaccinations concurrent with, before, or after, the seasonal flu shot.

The trials are being conducted in a compressed timeframe because of the possible fall resurgence of pandemic H1N1 flu infections that may coincide with the circulation of seasonal flu strains in the Northern Hemisphere.

The trials are expected to gather critical information that will allow the NIH to quickly evaluate the new vaccines to determine whether they are safe and effective in inducing protective immune responses. The results will help determine how to begin a fall 2009 pandemic flu vaccination program.

The U. S. government declared the H1N1 outbreak a public health emergency in April and two months later, the World Health Organization classified the outbreak a pandemic, reflecting its widespread nature.

“We have had a tremendous response from volunteers wanting to participate in the clinical trials,” says Mark Mulligan, MD, principal investigator of the Emory VTEU and executive director of the Hope Clinic of the Emory Vaccine Center. “Hopefully this will make it much easier to have a vaccine available for the fall flu season. We are very appreciative of the efforts of our volunteers.”

This first adult clinical trial as well as subsequent pandemic vaccine clinical trials will be conducted at the Emory Vaccine Center’s Hope Clinic in nearby Decatur. Pediatric clinical trials will be initiated one week after the first adult trial and will be conducted at the Emory-Children’s Center on Emory University’s campus. Harry Keyserling, MD, and Paul Spearman, MD, co-directors of the Emory VTEU, lead the pediatric studies at Emory-Children’s Center.

The VTEUs were established in 1962 as a vital research component of the NIAID. The units conduct clinical trials for all infectious diseases other than HIV/AIDS. They have conducted hundreds of clinical studies over the past four decades. Emory was designated a VTEU site in 2007 and received a seven-year contract of approximately $23.7 million.

An important strength of the VTEUs is their ability to rapidly enroll large numbers of volunteers into trials and to immunize the volunteers in a safe, effective and efficient manner. This rapid-response capability is especially important for testing vaccines designed to combat pandemic influenza. Results are expected to be available weeks after the trials begin.

In addition to Emory, VTEU sites are Baylor College of Medicine, Houston; Children’s Hospital Medical Center, Cincinnati; Group Health Cooperative, Seattle; Saint Louis University, St. Louis; University of Iowa, Iowa City; University of Maryland School of Medicine, Baltimore; and Vanderbilt University, Nashville. They will be joined for these studies by Children’s Mercy Hospital in Kansas City and Duke University Medical Center.

For more information about the Emory flu clinical trials, call 877-424-HOPE (4673) for the adult and senior studies, or 404-727-4044 for the pediatric studies, or vaccine@emory.edu for further information about the upcoming trials.
---
Community News You Can Use
Follow us on Twitter: @gafrontpage
www.FayetteFrontPage.com
www.GeorgiaFrontPage.com
www.PoliticalPotluck.com
www.ArtsAcrossGeorgia.com
---

U.S. News & World Report Ranks Emory Among Nation's Best Hospitals for 2009

Emory University Hospital again joins the prestigious ranks of America's top medical institutions in the annual U.S. News & World Report guide to "America's Best Hospitals."

For 2009, Emory ranked among the nation's best hospitals in 11 specialties, including five top 20 rankings. Overall, Emory is one of only 170 hospitals, out of more than 5,400 medical centers in the country to be named in even one of the magazine's top 50 specialty rankings. Emory is the only acute care hospital in Georgia named in these rankings.

Emory is recognized in this year's comprehensive report for excellence in:

Specialty Rank
Ophthalmology 9
Psychiatry 10
Geriatrics 13
Heart and Heart Surgery 13
Neurology and Neurosurgery 14
Ear, Nose and Throat 22
Kidney Disease 25
Diabetes/Endocrinology 31
Gynecology 44
Urology 44
Cancer 46

“Emory Healthcare’s rankings reflect our ongoing promise to patients and families,” says John T. Fox, Emory Healthcare president and CEO. “That promise is a relentless commitment to quality, quality defined as excellence in clinical outcomes, patient safety and service. As an academic medical center, we are committed to sharing that remarkable synergy created by breakthrough research, exceptional clinical resources and compassionate care.

“Being ranked this year in three additional subspecialty areas also reflects Emory’s commitment to recruiting staff and physicians across all subspecialties who embrace the challenge of advancing the possibilities in diagnosis, treatment and prevention of disease,“ Fox continues.

The U.S. News rankings in 12 of the 16 specialties weigh three elements equally: reputation, death rate, and a set of care-related factors such as nursing and patient services. In these 12 specialties, hospitals have to pass through several gates to be ranked and considered a Best Hospital:

1. The first filter determines whether a hospital is eligible to be ranked at all by requiring that any of three conditions be met--to be a teaching hospital, to be affiliated with a teaching hospital, or to have at least six important medical technologies from a defined list of 13.

2. The second filter determines whether a hospital is eligible to be ranked in a particular specialty. To be eligible, the hospital had to either have at least a specified volume in certain procedures and conditions over three years, or had to have been nominated in our yearly specialist survey.

3. The third filter is whether a hospital does well enough to be ranked, based on its reputation, death rate, and factors like nurse staffing and technology.

In the four other specialties--ophthalmology, psychiatry, rehabilitation, and rheumatology--ranking is based solely on reputation, derived from the three most recent physician surveys.
---
Community News You Can Use
Follow us on Twitter: @gafrontpage
www.FayetteFrontPage.com
www.GeorgiaFrontPage.com
www.PoliticalPotluck.com
www.ArtsAcrossGeorgia.com
---

Glucose Challenge Test is Accurate and Economical for Diabetes and Prediabetes Screening

A test commonly used to help identify women with diabetes during pregnancy may be an accurate, convenient and inexpensive way to screen the general population for unrecognized diabetes and prediabetes, according to Emory University researchers.

The results of the study, "Glucose challenge test screening for prediabetes and undiagnosed diabetes" will be published online and in print in the journal Diabetologia.

"Widespread use of the glucose challenge test (GCT) to screen Americans for prediabetes and diabetes could provide a major opportunity to improve the health of more than 40 million people," said lead study author Lawrence S. Phillips, MD, Emory University School of Medicine Professor of Medicine, Division of Endocrinology.

The study screened 1,573 volunteer participants who had never been diagnosed with diabetes. At a first visit, at different times of the day and without restriction of meals, participants were given a 50-gram glucose drink. Glucose was measured both before the drink (random glucose) and an hour after the drink (GCT glucose).

At a follow-up visit held in the morning after an overnight fast, participants had measurement of hemoglobin A1c (a standard test used to monitor diabetes), and a 75-gram oral glucose tolerance test (OGTT). The OGTT is the "gold standard" for diagnosing diabetes and prediabetes.

After screening, researchers found that 4.6 percent of the participants had previously unrecognized diabetes, and 18.7 percent had prediabetes.

The GCT was the most accurate screening test for these problems, significantly better than the random glucose or A1c tests. Since the good performance of the GCT was unaffected by the time of day, or times after meals, the GCT could be performed during a routine office visit. If a patient's GCT glucose level is low, he/she wouldn't need to be screened again for another two or three years, but if the GCT glucose level is high, patients would need a confirmatory oral glucose tolerance test.

This approach is similar to screening women for diabetes during pregnancy. GCT screening is almost universal for women in their sixth month of pregnancy.

The GCT provided consistent results for a diverse group of patients – old and young, normal weight and overweight, men and women, with and without a family history of diabetes, etc. The GCT also appeared to be less expensive than other screening strategies.

Early diagnosis is a benefit both for people who have diabetes or prediabetes, and for their health care teams. Regular glucose challenge test screening (GCT first, then a follow-up OGTT if the GCT glucose is high) would be a way to assure early diagnosis, according to Phillips and team.

"Glucose challenge test screening could help improve disease management by permitting early initiation of therapy aimed at preventing or delaying the development of diabetes and its complications," says Phillips.

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.

According to the American Diabetes Association, 23.6 million U.S. children and adults, or 7.8 percent of the population, have diabetes. While an estimated 17.9 million have been diagnosed with diabetes, 5.7 million people are unaware that they have the disease.

Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes.

In addition to Phillips, study authors were: David Koch, PhD, K.M. Venkat Narayan, MD, MSc, MBA, Mary Rhee, MD, Viola Vaccarino, MD, PhD, and David Ziemer, MD, of Emory University; Ranee Chatterjee, MD, of the Johns Hopkins University School of Medicine; and P. Kolm and W.S. Weintraub, of the Christiana Care Health System in Newark, Del.

The research was supported in part by the National Institutes of Health and the National Center for Research Resources, and by the Veterans' Administration. The work was presented in part at the June 2008 national meeting of the American Diabetes Association.

New Global Vaccine Center Partnership, Center for Drug Discovery Coming to Georgia

Emory University-Queensland Institute partnership to develop new human vaccines;
World-renowned researcher to lead new Emory Institute for Drug Discovery

Governor Sonny Perdue announced today that two of the world’s leading vaccine research centers will combine their expertise to establish an international research program leading to the development of new human vaccines for infectious diseases and cancers.

The Emory Vaccine Center (EVC) will collaborate with the Australian Centre for Vaccine Development (ACVD) at the Queensland Institute for Medical Research (QIMR) in a new Queensland-U.S. Vaccine Technology Alliance funded in part by a three-year grant from the Smart Futures Fund of the Queensland National and International Research Alliance.

In addition, Governor Perdue announced that Emory University will establish a new Emory Institute for Drug Discovery (EIDD) focusing on commercially neglected diseases, global health partnerships and mentored research. The center will be led by internationally recognized scientist and entrepreneur Dennis Liotta, PhD, who co-invented drugs taken by more than 94 percent of HIV/AIDS patients in the U.S.

“These two groundbreaking initiatives by one of Georgia’s top-ranked universities reflect the exciting biomedical advances that thrive in our state,” said Governor Perdue. “Our business environment invites the kind of entrepreneurial innovation and global partnerships that will lead to the medical breakthroughs of the future.”

The Governor made the announcement with Emory officials during a press conference in the Georgia Pavilion at the 2009 BIO International Convention, the world’s largest gathering of the global biotechnology community. The convention is being held in Atlanta May 18 through May 21, its first-ever meeting in the southeastern United States.

“This exciting global partnership with Queensland and the Emory Vaccine Center, together with the new Institute for Drug Discovery, continue to strengthen Emory University’s depth of research capabilities and its impact on global health,” said James Wagner, president of Emory University.

The Emory Vaccine Center of Emory University is one of the largest academic vaccine centers in the world, renowned for its expertise in cellular immunity, immune memory, disease pathogenesis, vaccine research and development and clinical trials. The Australian Centre for Vaccine Development is an internationally recognized vaccine research center with expertise in antigen discovery, international and national grants and links with the biotech industry.

The Queensland-U.S. Vaccine Technology Alliance recently was awarded a three-year grant of $1.8M from the Smart Futures Fund of the Queensland National and International Research Alliances Program. Additional funding for the alliance will be provided by the two vaccine centers, with total project funding from all sources equaling $8.5M over three years. In addition, ACVD and EVC have an existing Memorandum of Understanding that allows academic exchange to further promote scientific research in the field of vaccine development. Over the past 12 months, through a joint funding program, the EVC has hosted ACVD scientists for advanced training in vaccine technologies.

“Despite our success in developing vaccines, many challenges remain in the fight against chronic infections and cancer,” said The Hon. Stephen Robertson MP, Queensland Minister for Natural Resources, Mines and Energy and Minister for Trade. “This project will combine expertise from two leading vaccine research organizations in a collaboration that will uncover new technologies for developing and improving vaccines. Both organizations have strong links with the biotech industry and health institutions, which will help bring the research from bench to bedside, improving outcomes for patients.”

The new funding from the National and International Research Alliances program will significantly enhance the two vaccine centers’ collaborative research programs and allow them to leverage funding from various agencies and foundations for large-scale vaccine research and development. The alliance also will provide ACVD scientists an opportunity to access new biotech industry links in the United States and give both institutions enhanced links with the international pharmaceutical industry.

The new Emory Institute for Drug Discovery will have the dual mission of carrying out early-stage discovery and pre-clinical drug research aimed at developing small-molecule therapeutics, and training new generations of researchers in a multidisciplinary drug discovery environment. Directed and staffed by recognized leaders in the field of drug discovery, the EIDD will build on Emory’s strong history of drug discovery research, including the invention of several of the world’s most successful and widely prescribed drugs for treating HIV/AIDS.

“We believe the EIDD is strategically positioned to make Emory one of the premier research and training institutions in the country for drug discovery, development and training,” said Dennis Liotta, PhD, Emory professor of chemistry and director of the EIDD. “Our EIDD model will preserve the academic independence of university-based laboratory research, while at the same time allowing us opportunities to closely partner with the pharmaceutical industry.”

As a co-inventor of drugs taken by more than 94 percent of patients in the U.S. with HIV/AIDS and by thousands around the globe, Liotta is a recognized leader and educator in university drug discovery. He also is a successful entrepreneur who has developed several biotechnology companies, and he has trained and mentored numerous young researchers in the science of drug discovery.

The EIDD will collaborate closely with and benefit from other drug discovery efforts already ongoing at Emory, including the Emory Chemical Biology Discovery Center, which is part of the National Institutes of Health Molecular Libraries Screening Center Network (MLSCN). Along with other scientists at Emory already focused on drug discovery, approximately 12 new research faculty will focus their efforts in the center. Eventually, approximately 30 faculty and staff will be part of the EIDD.
---
Community News You Can Use
Follow us on Twitter: @gafrontpage
www.FayetteFrontPage.com
www.GeorgiaFrontPage.com
www.PoliticalPotluck.com
www.ArtsAcrossGeorgia.com
---

Emory and HBO Host Alzheimer's Disease Documentary Screening May 2

The Emory University Alzheimer's Disease Research Center in partnership with HBO and the Alzheimer's Association of Georgia will premiere the HBO documentary film, "MOMENTUM IN SCIENCE" on Saturday, May 2, for a gathering of medical professionals and families who have loved ones living with Alzheimer's disease.

"MOMENTUM IN SCIENCE," is part of an HBO Films' Documentary series called THE ALZHEIMER'S PROJECT.

The ALZHEIMER'S PROJECT, executive produced by Maria Shriver, is a multi-part, multi-platform series that brings new understanding and hope for millions of people affected by Alzheimer's disease.

The screening will be held from 9 a.m. to1 p.m. at the Emory Conference
Center located at 1615 Clifton Rd. in Atlanta. It will be followed by a panel
discussion and Q & A with leading Alzheimer's disease researchers, including:
*Allan Levey, MD, PhD – Professor and Chair, Department of Neurology, Emory
University
*James Lah, MD, PhD – Associate Professor and Vice Chair, Department of
Neurology, Emory University
*Felicia Goldstein, PhD – Director of Neuropsychology, Emory University
*Larry Tune, MD – Professor of Psychiatry and Neurology, Emory University
*Angela Ashley, MD – Assistant Professor of Neurology, Emory University
*Ginny Helms – Vice President of Programs and Services, Alzheimer's Association of Georgia
*Monica W. Parker, MD – Assistant Professor of Medicine, Emory University
*Kenneth Hepburn, PhD – Professor and Associate Dean for Research, Nell
Hodgson Woodruff School of Nursing, Emory University
*Carolyn Clevenger, DNP – Assistant Professor of Nursing, Nell Hodgson
Woodruff School of Nursing, Emory University
*Suzette Binford, Executive Director, Alzheimer's Association of Georgia

THE ALZHEIMER'S PROJECT is a presentation of HBO Documentary Films and the National Institute on Aging of the National Institutes of Health in association with the Alzheimer's Association®, Fidelity® Charitable Gift Fund and Geoffrey Beene Gives Back® Alzheimer's Initiative. The series of four films will debut on HBO on May 10, 11 and 12.
---
Community News You Can Use
Follow us on Twitter: @gafrontpage
www.FayetteFrontPage.com
www.GeorgiaFrontPage.com
www.ArtsAcrossGeorgia.com
---