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Archive for July, 2012

Georgia Psychiatric Physicians Association Summer CME Meeting

Friday, July 27th, 2012

July 27-28, 2012, Ponte Vedra Beach Inn & Resort, Ponte Vedra Beach, FL. For more information, visit Georgia Psychiatric Physicians Association.

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Emory Study Shows Benefits of Therapeutic Intervention for Adolescents

Friday, July 27th, 2012

A new study shows that a therapeutic intervention called Cognitively-Based Compassion Training (CBCT) appears to improve the mental and physical health of adolescents in foster care. CBCT is a tool that provides strategies for people to develop more compassionate attitudes toward themselves and others.

It is well documented that children in foster care have a high prevalence of trauma in their lives. For many, circumstances that bring them into the foster care system are formidable — sexual abuse, parental neglect, family violence, homelessness, and exposure to drugs. In addition, they are separated from biological family and some are regularly moved around from one place to another.

Emory researchers conducted the study in collaboration with the Georgia Department of Human Services (DHS) and the Division of Family and Child Services (DFCS). The study was recently published online in the journals Psychoneuroendocrinology and Child and Family Studies.

“Children with early life adversity tend to have elevated levels of inflammation across their lifespan,” explains Thaddeus Pace, PhD, lead author on the paper in Psychoneuroendocrinology, and assistant professor in the Department of Psychiatry and Behavioral Sciences at Emory.

“Inflammation is known to play a fundamental role in the development of a number of chronic illnesses, including cardiovascular disease, type 2 diabetes, dementia, cancer and depression.”

The study finds that adolescents who practiced CBCT showed reductions in the inflammatory marker C-reactive protein (CRP), reduced anxiety and increased feelings of hopefulness. The more the study participants practiced, the greater the improvement observed in these measures.

“The beneficial effects of CBCT on anxiety and feelings of hopelessness suggest that this intervention may provide immediate benefit to foster children,” says Charles Raison, corresponding author of the study in Neuroendocrinology, now at the University of Arizona.

“We are even more encouraged by the finding that CBCT reduced levels of inflammation. Our hope is that CBCT may help contribute to the long-term health and well being of foster care children, not only during childhood, but also as they move into their adult years.”

Additionally, an article recently published in the journal Pediatrics reported that a high proportion of children in foster care programs across the United States are on psychiatric medications, perhaps inappropriately.

“In light of the increasing concern that we may be over-medicating children in state custody, our findings that CBCT can help with behavioral and physical health issues may be especially timely,” says Linda Craighead, senior author for the paper published in Child and Family Studies, and professor of psychology at Emory.

The Study

CBCT is a multi-week program developed at Emory University by Geshe Lobsang Tenzin Negi, one of the study’s co-authors.  Although derived from Tibetan Buddhist teachings on compassion, the CBCT program has been designed to be completely secular in nature.

The Georgia Department of Human Services and the Division of Family and Child Services identified 71 adolescents between the ages of 13 and 19 as eligible for study participation. All of the children lived in the greater metropolitan Atlanta area, and were in state custody (i.e. foster care) at the time of the study.

The participants were randomized to six weeks of Cognitvely-Based Compassion Training, or to a wait list control group. Before and after these interventions the adolescents were assessed on various measures of anxiety and hope about the future. They also provided saliva samples for the measurement of C-reactive protein.

The researchers found that within the CBCT group, participation in practice sessions during the study correlated with reduced CRP from baseline to the six-week assessment.

The researchers are careful to emphasize that further studies will be needed to determine if there are long-term benefits with CBCT.

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Lisa Kobrynski, M.D., Discusses Newborn Screening for Severe Combined Immunodeficiency

Friday, July 27th, 2012

From ATLANTA Medicine, 2012, Pediatrics, Vol. 83, No. 2

“Newborn Screening Saves Lives.”(1) This is a headline that is music to the ears of clinicians and public health laboratories. Since the advent of newborn screening using heel-stick blood spotted on filter cards in 1981, more than 40 different conditions can be detected using tandem mass spectrometry to diagnose metabolic disorders and DNA analysis to identify mutations associated with cystic fibrosis and hemoglobinopathies. In 2010, the U.S. Department of Health and Human Services recommended the addition of Severe Combined Immunodeficiency (SCID) to the panel of primary conditions for newborn screening.(2)

SCID, popularly known as the “boy in the bubble” disease, is a congenital immune defect caused by more than 20 distinct single gene mutations. All infants with SCID have severe T cell lymphopenia at birth, and affected infants develop severe, life-threatening infections. Infants with SCID appear perfectly well at birth but begin to develop recurrent infections in the first few months of life. In addition to bacterial and viral infections, infants with SCID develop fungal and opportunistic infections (pneumocystis) and frequently have a severe erythematous, eczematous rash. As a result of the infections and malabsorption, failure to thrive is also a common feature of these disorders.

Without immune reconstitution, SCID is uniformly fatal with very few infants surviving beyond the first year of life. Previous studies estimate the birth prevalence of SCID at 1:100,000 live births,(3) but clinical immunologists have long felt that this is an underestimate of prevalence and that many cases are missed.

Immune reconstitution for this immunodeficiency is done through a bone marrow or hematopoietic stem cell transplant (HSCT). Transplants can be performed in the first months of life; if performed before 3.5 months of age, the rate of success is  greater than 95 percent.(4) Outcomes after transplantation are dependent on the age of the infant at transplant, the type of SCID, the donor and the presence of uncontrolled infection. It is clear that early intervention is critical for a good outcome.

SCID is the first primary immunodeficiency disease(PIDD) to be recommended for newborn screening(NBS). For a disorder to be considered a candidate for newborn screening, it must have significant impact (eg: life threatening), effective therapies must be available, early(presymptomatic) intervention must be important, and a sensitive and specific (and inexpensive) screening test must be available. In 2005, Chan and Puck (5) published a report of a method measuring T cell receptor excision circles(TREC) DNA using a quantitative PCR from dried blood spots (DBS). They demonstrated that this assay reliably identified infants with SCID.

In 2008, Wisconsin added the TREC assay to their NBS program. Currently five states are screening for SCID by measuring TRECs in newborn DBS. To date they have screened more than 900,000 infants and identified more than 24 cases of SCID. This suggests that the birth prevalence is approximately 1:38,000 (personal communication ACMG), more than twice as high as previous estimates.

Newborn screening for SCID is a first in many ways. Not only is it the first PIDD to be recommended for NBS, but it is the first NBS test to use a DNA-based assay as the primary screening test. An abnormal screening test reports the absence of TREC DNA in the DBS, this must then be confirmed by obtaining a blood sample and measuring the numbers of T, B and NK lymphocyte subsets by flow cytometry. Referral to a center with experience caring for children with Primary Immunodeficiencies is recommended. Any infant with suspected SCID should not be given any live vaccines and may be started on antibiotic prophylaxis and receive gamma globulins (IVIG or SCIG).

At this time, at least 10 states are preparing to add newborn screening for SCID to their state panels. The American College of Medical Genetics and Genomics(ACMG) publishes the ACT sheet providing information regarding the screening test, as well as resources for practitioners. In addition, standards for performing the TREC assay are in preparation.

In the state of Georgia, the Jeffrey Modell Diagnostic Center for Primary Immunodeficiencies at the Emory Children’s Center is the preeminent referral center for patients with a suspected PIDD. The director of the center, Dr. Lisa Kobrynski, is a nationally recognized expert in the diagnosis and treatment of PIDD, including newborn screening for SCID. Fortunately for children in Georgia, the Jeffrey Modell Foundation (JMF) center has teamed up with the Blood and Marrow Transplant (BMT) unit at Children’s Healthcare of Atlanta at Egleston to provide life-saving transplants. Each year one to two new infants with SCID are diagnosed and treated at Emory Children’s Center and Children’s.

Obstetricians, pediatricians and neonatologists should be aware of the implementation of SCID screening in their state. They should be prepared to respond if an infant in their care is identified through newborn screening and they should become familiar with the specialized centers in their state that will ultimately provide care for these infants. Early detection and early initiation of therapy is key. This is one test that truly will save lives.

References

1. “Newborn Screening Saves Lives”: legislation passed April 2008 to expand
state newborn screening programs and establish a national clearing house for data.

2. Watson, MS, Mann MY, Lloyd-Puryear MA, Rinaldo P, howell RR. Newborn
Screening advisory Groups, Newborn Screening: towards a uniform screening
panel and system. Genet Med 2006; 8:1s-250s.

3. Kalman L, Lindegren ML, Kobrynski L et al. Mutations in genes required for
T cell development: IL7R, CD45, IL2RG, JAK3, RAG1, RAG2, ARTEMIS and ADA
and severe combined immunodeficiency: HuGE review. Genet Med 2004;6:16-26.

4. Myers LA, Patel DD, Puck JM, Buckley RH. Hematopoietic stem cell
transplantation for severe combined immunodeficiency in the neonatal period
leads to superior thymic output and improved survival. Blood 2002;99:872-8.

5. Chan K, Puck JM. Development of population-based newborn screening for
severe combined immunodeficiency. J Allergy Clin Immunol. 2005;115(2):391–398.

Lisa Kobrynski, M.D., M.P.H. is Associate Professor of Pediatrics, Emory University School of Medicine. She is the Director, Jeffrey Modell Foundation Center for the Diagnosis and Treatment of Primary Immunodeficiencies.

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Cardiologist Michael Balk, MD, Implants New INGENIO Pacemaker

Thursday, July 26th, 2012

Dr. Michael Balk, managing partner, Northside Cardiology, is among the first physicians in the country to treat patients with the new wireless INGENIO™ pacemaker.  This state-of-the-art technology allows Northside Hospital cardiologists to remotely monitor the respiratory and heart rates of their cardiac patients, around the clock and from any computer system, via a secure website. Dr. Balk implanted the first device at Northside on May 24, 2012.

“With this new technology, when a patient walks into the bedroom to sleep, his pacemaker communicates automatically and wirelessly with a special transmitter that is plugged into the phone jack; there’s no work needed on the patient’s part,” said Dr. Balk.  “Once I receive and evaluate the information, I can proactively manage the patient’s heart status and even transmit information back to the pacemaker to make changes if necessary.”

Pacemakers are designed to treat bradycardia, a condition in which the heart beats too slowly — usually less than 60 beats per minute — depriving the body of sufficient oxygen. Most pacemakers on the market today require either a special wand or a connection to electrodes in order to program or transmit information. The INGENIO offers patients more flexibility and can even save time during follow-up exams, transmitting relevant data to physicians between visits via a secure website without a landline.

“Patients don’t need to worry about messing up the transmission or attaching leads incorrectly,” said Dr. Balk.  “There are no wires to connect; everything is automatic.”

Approximately 270 pacemakers are implanted at Northside’s three hospitals each year.  Any patient eligible for a pacemaker is eligible for the INGENIO device.

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Stigma and Complacency Fuel HIV Epidemic, Say CDC’s Kevin Fenton and Jonathan Mermin

Thursday, July 26th, 2012

To combat two major obstacles to HIV prevention—stigma associated with the infection and complacency about the epidemic—the Centers for Disease Control and Prevention has launched Let’s Stop HIV Together, a national communication campaign that gives voice to Americans living with HIV, and to their loved ones.

“In the fight against HIV, stigma and complacency are among our most insidious opponents,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. “This campaign reminds us that HIV affects every corner of society, and that it will take every one of us–regardless of HIV status, gender, race or sexual orientation–working together to stop this epidemic.”

The campaign, which includes local and national advertising and social media, features people living with HIV standing with their friends and family, and calls on all Americans to join the fight against the disease.

More than three decades after the first reported AIDS cases, research shows that while most Americans understand how HIV is transmitted, fear, discrimination and misperceptions continue to hamper progress against the disease. For example, a 2011 Kaiser Family Foundation survey found that many Americans continue to report discomfort at the idea of interacting with those who are HIV-positive, despite the fact that HIV cannot be transmitted by saliva, sweat, tears or casual contact.

“Stigma remains a major barrier to HIV testing, condom use and other prevention strategies. It also discourages those living with HIV from seeking the care and treatment they need to stay healthy and avoid transmitting HIV to others,” said Jonathan Mermin, M.D., director of CDC’s Division of HIV/AIDS Prevention. “If we can overcome stigma and misperceptions about HIV, we can lift these barriers and save lives.”

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Morehouse Mourns Passing of Dr. Clinton E. Warner, Jr.

Thursday, July 26th, 2012

Dr. Clinton E. Warner, Jr. a highly respected supporter and Board Chairman Emeritus of Morehouse School of Medicine, passed away on June 30, 2012.

Dr. Warner was known for his love and dedication to his family, profession and community. He was a tireless advocate for MSM. He served on the Board of Overseers of Morehouse College’s Medical Education Program when it was established in 1976. With the program’s transition to Morehouse School of Medicine and its separation from the College in 1981, Dr. Warner was elected as the first chairman of the Board of Trustees. He served in that capacity for almost a decade, giving generously of his time, energy and financial support. During the school’s developing stages, he helped to set the foundation that led to Morehouse School of Medicine being recognized as one of the nation’s leading community-based medical schools and a beacon of hope for medically underserved communities.

Dr. Warner served as a soldier in World War II, a leader in the Civil Rights movement, and a pioneer in the medical community. His guidance and community influence were essential to the development of Morehouse School of Medicine and helped to establish the School’s affiliation with Southwest Hospital, the home of its first accredited residency program, Family Medicine.

 

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Six New Physicians Join WellStar Medical Group

Sunday, July 22nd, 2012

WellStar Medical Group recently announced the following additions to its roster of physicians:

Jonathon Herbst, M.D., has joined WellStar Pathologists Group. Dr. Herbst received his bachelor of science in physiology from Michigan State University and earned his medical degree from Wayne State University School of Medicine. He is board certified in pathology.

Russell French, M.D., Ragheed Alturkmani, M.D., and Jody Hughes, M.D. FCCP,  have joined WellStar Pulmonary Medicine.

Dr. French earned his bachelor’s degree in biology from State University of New York, College at Oswego and his medical degree from St. George’s University School of Medicine. His clinical education was performed within the New York City hospital system. He completed his fellowship in pulmonary disease and critical care from Allegheny General Hospital in Pittsburgh. He is board certified in pulmonary medicine and internal medicine and  is a member of the American College of Chest Physicians, American Thoracic Society and Society of Critical Care Medicine.

Dr. Alturkmani earned his medical degree from Damascus University School of Medicine and completed his residency in internal medicine at University of Tennessee. He completed his fellowship in pulmonary medicine, critical care medicine and  interventional pulmonology at the University of Florida. He is board certified in pulmonary medicine and internal medicine and is a member of the American College of Chest Physicians, American Thoracic Society, Society of Critical Care Medicine, American Association of Bronchology and Interventional Pulmonology, American Medical Association and American College of Physicians.

Dr. Hughes received his bachelor’s degree in biomedical sciences from Auburn University and his medical degree from the University of Alabama School of Medicine. He completed his residency in internal medicine at University of Alabama-Birmingham. He is board certified in internal medicine, pulmonary medicine and critical care medicine and is a fellow of the American College of Chest Physicians and a member of the American Thoracic Society, American Medical Association and the American College of Physicians.

Adam Meadows, M.D., has joined WellStar Medical Group, Psychiatry. Dr. Meadows received his bachelor’s degree in biology from Andrews University, earned his medical degree at Washington University in St. Louis School of Medicine and completed his internship and residency at the University of Pennsylvania Health System. Dr. Meadows is a member-in-training of the American Psychiatric Association and he is a fellow member of the American Medical Association and the National Medical Association.

Eduardo Estrella, M.D., FACE, has joined WellStar Medical Group, Cobb Gynecologists. Dr. Estrella earned his bachelor’s degree from Sacred Heart University. He completed his medical degree at University of Puerto Rico School of Medicine and his residency in OB/GYN at San Juan City Hospital. He is a diplomat of the American Board of Obstetrics and Gynecology, a fellow of the American College of Obstetrics and Gynecologic Laparoscopists and a member of the American Medical Association.

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GSO/HNS Annual Summer Meeting

Thursday, July 19th, 2012

July 19-22, 2012, Loews Royal Pacific Resort at Universal Orlando, Orlando, FL.  For more information, visit Georgia Society of Otolarygology/Head & Neck Surgery.

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NFMGMA July Educational Session

Wednesday, July 18th, 2012

July 18, 2012, Alpharetta. For more information, visit North Fulton Medical Group Management Association

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John S. Harvey, M.D. awarded The Medical Association of Atlanta’s Aven Cup

Thursday, July 5th, 2012

The Medical Association of Atlanta (MAA) gave its highest award, the Aven Cup, to Dr. John S. Harvey at its annual meeting.

Dr. Harvey was awarded the Aven Cup for his service to the Atlanta Community and the Medical Association of Atlanta. Dr. Harvey serves the community as a volunteer in the Georgia State Defense Force he serves as the Command Surgeon. Notable missions include the Katrina/Rita hurricane victim airlift reception and the Haiti earthquake victim airlift reception in Atlanta, GA.  During the 1996 Olympics he served as a Medical Command Officer dealing directly with the medical and multi agency response to the Centennial Park bombing.

Dr. Harvey serves on the board of directors for the Medical Association of Atlanta and the Medical Association of Georgia where he serves as Speaker of the House of Delegates.

The MAA has a tradition of its physician leaders serving the community. “Dr. Harvey is one of many leaders continue that continue the tradition serving our community that began in 1854,” said David Waldrep Executive Director/CEO.

The MAA is a non-profit association dedicated to the advancement of organized medicine in the Atlanta area.

MAA members have united their individual voices and efforts into one cohesive body of progress, representing the new face of organized medicine in areas of legislation, community service, and individual patient care. In an era when outside influences are disrupting and dividing the practice of medicine more than ever before, MAA members stand as a united front, working to affect needed changes in today’s healthcare systems, while remaining steadfast in support of the historic image of the skilled, caring, hands-on physician.

For more information on the Medical Association of Atlanta, please visit www.maa-assn.org or call 404.881.1020.

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