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Archive for August, 2009

Fighting Cancer by Collecting Biospecimens

Monday, August 31st, 2009

Biorepository Alliance of Georgia for Oncology

September 2009

Clinicians in Georgia can make an important contribution to cancer research by supporting and advocating for the collection of biospecimens from their patients. When patients undergo surgery to remove a tumor or part of a diseased organ, any specimen not needed by pathologists for diagnosis, can be saved instead in a biorepository for future research use. Patients are asked to provide their approval, or “informed consent, for use of specimens, and many appreciate the opportunity to contribute to scientific progress that may lead to better and earlier cancer detection methods and treatments.

According to Dr. Carolyn Compton, director of the Biorepositories and Biospecimen Research Office at the National Cancer Institute, having a biorepository is essential to the type of cancer research that will “take us into this new era of medicine.” Modern molecular-based research includes genomics, proteomics, and molecular imaging. Together, they will drive the development of a new generation of targeted, personalized diagnostics and therapies that will ultimately improve clinical outcomes for patients.

In Georgia, the Biorepository Alliance of Georgia for Oncology (BRAG-Onc) is working to provide researchers in the state with access to high quality specimens, appropriate for molecular analysis, and richly annotated with clinical information. The availability of biospecimens of appropriate quality supports cancer research studies from cancer biology to discovering and validating new therapeutic targets and biomarkers.

The Medical College of Georgia (MCG) serves as the central repository for this statewide network, which is supported by the Georgia Cancer Coalition (GCC). BRAG-Onc supports the mission of the Coalition to improve cancer control and reduce cancer deaths in Georgia through statewide collaborations. Georgia’s Biorepository is unique in its mission to represent diverse cancer populations of the state, in its multi-institutional organization, as well as its non-profit status. Judith Giri, Ph.D. is Director of the Biorepository Alliance of Georgia for Oncology. She is an Associate Professor in the Department of Pathology and a member of the Cancer Center at MCG.

Thanks to participating institutions, BRAG-Onc now has samples representing more than 3400 cancer patients in the state. Participating institutions include major urban centers as well as community hospitals, providing researchers access to a unique of collection of specimens.

The Biorepository has strict oversight to ensure that specimens are collected ethically, and valuable specimens are utilized for appropriate research. Institutional Review Boards (IRBs) and Advisory Committees provide local oversight within each institution. Governance and overall guidance for the statewide biorepository is provided by an external Advisory Board and a Steering Committee comprised of Principal Investigators from each participating institution. The Georgia Cancer Coalition established BRAG-Onc and provides continuing support of its operations.

The BRAG-Onc tissue and tumor bank is a resource to academic cancer research scientists, including the 118 active Scholars funded by the Georgia Cancer Coalition as Distinguished Cancer Clinicians and Scientists. Having a statewide biorepository supports the recruitment of cancer researchers to Georgia and investigators can include the BRAG-Onc services in their grant applications. BRAG-Onc is also crucial to the Georgia Center for Oncology Research and Education (Georgia CORE) which is working in concert with partners such as the Georgia Society of Clinical Oncology (GASCO) to build a statewide research network and clinical trials registry.

The biorepository’s main function is to provide centralized specimen banking services, with ethical patient consent, standardized and controlled conditions for procurement, long-term low temperature storage facilities with monitoring and back-up, appropriate quality control measures and a web-based database for informatics. BRAG-Onc follows Best Practices recommendations for biorepositories from the National Cancer Institute.

The process of procurement, handling and storage of specimens for research involves several steps and many contributors, including: medical oncologists and surgeons, OR and research nurses, pathologists and the biorepository staff. The first and most important contributors are the patients who donate the specimens.

“The value of the cancer biorepository depends not only on the quality of specimens but also on the associated clinical information. When collecting information about patients’ medical conditions and relevant history (from the Cancer Registry, for example), one of the biorepository’s highest priority is maintaining the privacy and confidentiality of personal and medical information,” says Dr. Giri. “The patients’ reward is in knowing that they are helping researchers find new ways to prevent and treat this terrible disease in the future.”

Procurement sites and multiple regional procurement centers cover the state and include:

EAST: Coordinating Center/Medical College of Georgia,

WEST CENTRAL: John B. Amos Cancer Center at Columbus Regional Medical Center, Columbus

METRO ATLANTA: Dekalb Medical, Decatur; Piedmont Hospital, Atlanta; St. Joseph’s Hospital, Atlanta (future site)

NORTHWEST: Hamilton Medical Center, Dalton (NW hub); Redmond Medical Center, Rome; Floyd Medical Center, Rome; Gordon Hospital, Calhoun; Hutcheson Medical Center, Fort Oglethorpe

SOUTHWEST: Phoebe Putney Memorial Hospital, Albany (SW hub); Archbold Medical Center, Thomasville

SOUTHEAST: Nancy N. and J.C. Lewis Cancer and Research Pavilion at St. Joseph’s/Candler Health System, Savannah; Memorial Health System, Savannah

For information about BRAG-Onc, contact Dr. Judith Giri at jgiri@mcg.edu or 706-721-5279.

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Pediatric H1N1 Vaccine Clinical Trial Opens at Emory

Monday, August 31st, 2009

Physician/researchers at Emory University and Children’s Healthcare of Atlanta have begun vaccinating children in a clinical trial testing an investigational H1N1 (swine flu) vaccine along with the seasonal flu vaccine. Up to 650 children nationally will participate in the study, and Emory will enroll approximately 100 children, ages six months to 18 years.

The clinical trial is being conducted within the Vaccine and Treatment Evaluation Units (VTEUs), supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH). At Emory, the VTEU is led by Mark Mulligan, MD, executive director of the Hope Clinic of the Emory Vaccine Center.

The study will examine the safety of and measure the body’s immune response to the H1N1 flu vaccine. In addition, it will help determine how and when the vaccine should be given with the seasonal flu vaccine to make it most effective. It also will analyze potential problems of giving the vaccines together, such as whether one vaccine will undermine the protective power of the other.

The answer is important because experts are predicting that both strains of influenza will circulate this fall and winter.

The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) recently recommended all people from six months through 24 years of age receive the H1N1 influenza vaccine when it is available. In making its recommendations, the group considered current disease patterns and current trends that showed populations most at risk of serious illness, among other factors.

The panel recommended vaccinating children between six months and 18 years because of the high number of cases of H1N1 influenza infection in that age group. In addition, because they frequently are in school and day care, they are in close contact with each other, making it easier to spread disease.

The Emory pediatric clinical trial will be conducted at the Emory-Children’s Center. The trial is being led by Emory VTEU co-directors Harry Keyserling, MD, professor of pediatric infectious diseases at Emory School of Medicine and Paul Spearman, MD, chief research officer for Children’s Healthcare of Atlanta and vice chair of research for Emory’s Department of Pediatrics, along with Allison Ross, MD, Emory assistant professor of pediatric infectious diseases.

The pediatric trial follows the launch of a VTEU-led adult clinical trial of the H1N1 and seasonal flu vaccines, which began at Emory’s Hope Clinic on Aug. 10 and will continue with followup visits for the next six weeks by a group of more than 170 volunteers.

“Because children and young adults are considered among the most vulnerable populations for new and emerging strains of influenza, such as the current H1N1 pandemic, it is critically important that we quickly and efficiently conduct these tests for a vaccine,” says Keyserling,

In addition to Emory, other sites for the H1N1 pediatric study, which is led by Saint Louis University, are Baylor College of Medicine, Houston; Children’s Hospital Medical Center in Cincinnati; University of Texas Medical Branch at Galveston; and the University of Iowa.

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.

For more information on this clinical study visit http://clinicaltrials.gov/show/NCT00943202.

For more information about the Emory pediatric clinical trial, call 404-727-4044.

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Kang Moves to GMC’s Interventional Radiology

Monday, August 31st, 2009

Gwinnett Medical Center – Duluth recently welcomed Brandon Kang, MD, a board-certified interventional radiologist, who comes to Gwinnett after having been a member and professor the past few years at Emory University’s Interventional Service. Dr. Kang was awarded America’s Top Radiologist by the Consumer’s Research Council in 2007 and 2008. In addition, Dr. Kang earned the Ettman Scholar Award and the Cardiovascular and Interventional Radiology Resident of the Year while training at the University of Tennessee.

 

Gwinnett Medical Center – Duluth’s recently renovated and expanded IR suite includes the Siemen’s AXIOM Artis dTA interventional system. In this new IR suite, physicians can perform a number of interventional procedures, including Endovenous Laser Therapy/Ablation, Kyphoplasty, Radiofrequency Ablation, Transjugular Intrahepatic Porto-systemic Shunt (TIPS) and Uterine Fibroid Embolization (UFE).

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Brown Performs New Glaucoma Procedure

Monday, August 31st, 2009

For the first time in Georgia, glaucoma patients have a new minimally invasive treatment option that may help slow the progression of the disease.  The procedure, trabeculotomy, performed with the Trabectome, was performed by Dr. Reay Brown at Northside Hospital.

 

“The purpose of trabeculotomy, performed with the Trabectome, is to restore the eye’s natural plumbing system, help it to function better and prevent further damage to the eye,” said Dr. Reay Brown, the only certified Trabectome surgeon in Georgia.

 

The procedure uses a small probe, the Trabectome, to open the eye’s drainage system, through a tiny incision in the cornea.  Then, a small portion of eye tissue is removed to help the drain function better.  The procedure is performed on an outpatient basis and usually takes less than 30 minutes.  Patients recover much faster than with conventional glaucoma surgery.

 

However, not all patients with glaucoma are good candidates for trabeculotomy with the Trabectome, according to Dr. Brown.  It should be used only when eye drops and laser trabeculoplasty fail to reduce pressure, but before trabeculectomy is considered.  “Patients should see their personal ophthalmologists for a comprehensive evaluation to determine if they are a good candidate for the procedure,” he says.

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Macik Performs Single-Incision Gastric Bypass Surgery

Monday, August 31st, 2009

Bariatric surgeon, Dr. Paul Macik, completed the first single-incision gastric bypass (Roux-en-Y) surgery in Georgia, as well as the first single-incision vertical sleeve gastrectomy in the state. The procedures were both performed at Northside Hospital.  

 

In a traditional laparoscopic surgery, surgeons make several small incisions for the instruments and camera needed to perform the procedure.  However, in a single-incision surgery, the surgeon uses a single 4.5-centimeter incision, often at the bellybutton, to reduce the appearance of scarring.  The single-incision procedure is the same operation as that of the multi-incision procedure except that it offers less pain and scarring, a faster recovery and a quicker return to everyday activities.

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Interstitial Cystitis Association Seminar

Sunday, August 23rd, 2009

August 23, 2009 at the Renaissance Waverly Hotel. For more information, call 800-435-7422 or visit www.ichelp.org

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