Category Archives: Health Care

Type 1 diabetes patients have lower blood levels of four proteins that protect against immune attack

Patients with type 1 diabetes have significantly lower blood levels of four proteins that help protect their tissue from attack by their immune system, scientists report.

Conversely, their first-degree relatives, who share some of the high-risk genes but do not have the disease, have high levels of these proteins circulating in their blood, said Dr. Jin-Xiong She, director of the Center for Biotechnology and Genomic Medicine at the Medical College of Georgia at Georgia Regents University.

Healthy individuals without the risky genes also have higher levels of the four proteins, IL8, IL-1Ra, MCP-1 and MIP-1β, according to the study in the Journal of Clinical Endocrinology & Metabolism.

The findings point toward a sort of protein cocktail that could help at-risk children avoid disease development as well as new biomarkers in the blood that could aid disease diagnosis, prognosis and management, said She, Georgia Research Alliance Eminent Scholar in Genomic Medicine and the study’s corresponding author.

The scientists looked at a total of 13 cytokines and chemokines, which are cell signaling molecules involved in regulating the immune response. They first looked at blood samples from 697 children with type 1 diabetes and from 681 individuals without antibodies to insulin-producing cells, a hallmark of this autoimmune disease. They then analyzed the blood of a second and larger set of individuals, which included 1,553 children with type 1 diabetes and 1,493 individuals without any sign of antibodies.

In this largest study of its kind, they consistently found a higher percentage of type 1 diabetes patients had significantly lower levels of the same four proteins.

“Their pancreatic cells are not secreting enough of these proteins,” said Dr. Sharad Purohit, MCG biochemist and the study’s first author. “Normally you are secreting enough of these cytokines so you prevent attack by the immune system.”

Individuals who have three of the known high-risk genes for type 1 diabetes but high serum levels of these four proteins are less likely to have disease, suggesting that these proteins may provide dominant levels of protection against type 1 diabetes even in a genetically high-risk group, Purohit said.

“If the individuals with high-risk genes weren’t making more of the proteins, they likely would have diabetes, said Dr. Ashok Sharma, an MCG bioinformatics expert and study co-first author.

One of the proteins found at low levels in patients, MIP-1β, has been shown in animal models to protect against type 1 diabetes development. A recombinant version of IL-1Ra, already used to combat rheumatoid arthritis, is also under study for both type 1 and 2 diabetes. And, human studies have shown that newly diagnosed patients with type 1 diabetes who go into remission have higher levels of IL-1Ra than those who don’t.

Cytokines and chemokines can promote or inhibit inflammation – cytokines such as MIP-1β can do both – and the proper mix helps keep inflammation in check. As an example, IL-1Ra, a cytokine secreted by several cell types, including immune cells, is a natural antagonist of the inflammation promoting cytokine IL-1β.

“We are providing evidence that clinical trials with any of these four molecules may work, and if we use them in combination, they may work even better,” She said. “One of the major research foci in our group is to identify biomarkers for various diseases, diabetes, cancer and others. We also want to identify new therapeutic strategies or targets through the discovery of biomarkers.”

Type 1 diabetes is an autoimmune disease, which primarily surfaces in childhood, where the immune system attacks the insulin-producing cells of the pancreas, leaving children facing a lifetime of daily insulin therapy to try to keep blood sugar levels under control.

Some of the 13 cytokines and chemokines originally screened for the study were known factors in type 1 diabetes, and the scientists were curious about the role of others.

Research funding was provided by the National Institutes of Health and the Juvenile Diabetes Research Foundation. Endocrine clinics based in Atlanta, including Atlanta Diabetes Associates, Pediatric Endocrine Associates and Southeastern Endocrine and Diabetes, contributed to the study.

Modified Early Warning System detects early clinical deterioration

MEWSStarting today, the Modified Early Warning System (MEWS) will help care providers on two nursing units monitor and improve a quicker response to patients experiencing acute clinical deterioration.  This early warning system uses vital signs to identify patients at risk. This will promote early detection and prevent a delay in intervention or transfer of the deteriorating patient to a higher level of care.

MEWS is a simple physiologic score which is generated when a care giver takes patients vital signs. The current vital sign machines used on the medical surgical units are capable of generating this score based on a patient’s heart rate, blood pressure, respiratory rate, oxygen saturation and temperature. A MEWs score of 3 or greater will trigger an early warning alert to include more frequent monitoring, notify the patient’s physician and activate the Rapid Response Team (RRT).

“It’s an extra, added protection for our patients that help us identify deteriorating patients early before they become critically ill” said Savannah Agee-Magee, a nurse manager on 4 South.

The system, which is currently being piloted on 6 North and 4 South, is being implemented through GRU’s groundbreaking partnership with Phillips and Cerner. Eventually, the entire hospital will be equipped with the early warning system.

“Research shows that oftentimes patients who code display warning signs hours before,” Agee-Magee said. “That’s why we’re implementing the system.”

The pilot program is part of phase one of the project which included additional staff training and vital sign machine upgrades. Other phases of the project include uploading vital signs to the electronic medical record and sending automatic alerts to key care providers when the patient’s score triggers an alert.  MEWS will help caregivers be even more proactive in their ability to safeguard a patient’s wellbeing.

The Children’s Hospital of Georgia (CHOG) uses a similar system, called the Pediatric Early Warning System (PEWS).

Avoid flip-flop fiascos

AUGUSTA, Ga. – A casual summer staple, flip-flops are popular with men, women and kids – especially for outside activities. But before slipping on these warm weather favorites, be sure you know the appropriate way to wear this type of shoe, advises Dr. Edward Szabo, a podiatrist at the GRHealth West Wheeler office, or you could be headed for a flip-flop fiasco.

Szabo recommends the following guidelines to help avoid a flip-flop mishap.

Flip-flop Dos

• Do shop for a flip-flop made with thick cushioned soles and neoprene rubber upper area. Neoprene rubber is wet suit like material and minimizes the potential for blisters and other types of irritation.

• Do make sure the flip -flop has some raised arch support. This will help distribute pressure more evenly.

• Do ensure that your foot doesn’t hang off of the edge of the flip-flop.

• Do wear a sturdy pair of flip-flops when walking around a public pool, at the beach, in hotel rooms and in locker room areas. Walking barefoot can expose foot soles to plantar warts and athlete’s foot.

• Do wear sunscreen. It’s important to keep all exposed skin protected from the sun’s harmful rays. After all, sunburned feet can make walking miserable for days.

Flip-flop Don’ts

• Don’t re-wear flip-flops year after year. Inspect older pairs for wear. If they show signs of severe wear, discard them.

• Don’t ignore irritation between toes, where the toe thong fits. This can lead to blisters and possible infections.

• Don’t wear flip-flops while walking long distances. Even the sturdiest flip-flops offer little in terms of shock absorption and arch support. If you must wear something with open toes, a supportive, well-balanced sandal with a heel strap is preferable for walking distances greater than a few feet.

• Don’t do yard work or play sports while wearing flip-flops. Always wear a shoe that fully protects feet when doing outside activities, or you could be more susceptible to accidents and injuries.

Finally, Szabo advises, look for flip-flops that are a name brand you trust. If you are unaware of what makes a good flip-flop, go to an athletic specialty store, hiking store, or running store, and ask their staff for recommendations based on your specified use. These professionals are generally very knowledgeable and can steer you in the right selection.

The Aiken Standard: Arthritis affects children, too

Nurse Clinician Barbara Kienzle in pediatric rheumatology at Children’s Hospital of Georgia explains how juvenile arthritis affects the body’s joints.

Nearly 300,000 children in America have been diagnosed with juvenile arthritis, according to the Arthritis National Research Foundation.
July is Juvenile Arthritis Awareness Month.

GRU earns 7 Target Awards

Those recognized for their accomplishments include (left to right) Aubrey Hinkson, Clarissa Chavez, Emily Renzi, Brianne Clark, Cathleen Caldwell, Anna Aligood, and Denise Parrish.

AUGUSTA, Ga. – The Georgia Regents University Division of Communications and Marketing earned seven Target Awards, including two gold awards, from the Georgia Society for Healthcare Marketing and Public Relations during the 20th Anniversary Target Awards Luncheon at the Ritz Carlton Lodge at Reynolds Plantation on June 30.

“We are so thrilled with the number of entries that were submitted from hospitals all across the state of Georgia,” said Elizabeth Harvill, president of the GSHMPR board of professionals. “This is the one time of year when we recognize the creativity and quality of work that is being done in healthcare marketing.”

Entries in the this year’s competition were judged by the New England Society for Healthcare Communications based on creativity, layout and design, functionality, message effectiveness, production quality and overall appeal. Georgia hospitals submitted more than 185 entries in 26 various public relations, marketing, design and advertising categories.

Gold awards were presented to GRU in the following categories:
Direct Mail – Children’s Hospital of Georgia direct mail campaign
Fundraising – Media relations efforts for ALS Walk and ice bucket challenges
Silver awards were presented for:
Patient/Customer Relations – GRHealth VIP Patient Portal
Websites – GRHealth Web Redesign
Social Media Marketing – GRHealth Your Health Matters
Digital Advertising – Children’s Hospital of Georgia Digital Campaign
Media Relations – Children’s Hospital of Georgia ER Open House

“All the submissions were amazing,” said Harvill. “We congratulate all those that won, and we look forward to seeing more great work next year.”

The Georgia Society for Healthcare Marketing and Public Relations is an affiliated society of the Georgia Hospital Association.

Coule named associate CMO at GRHealth

AUGUSTA, Ga. – Dr. Phillip Coule has been named associate chief medical officer and chief patient safety officer for Georgia Regents Health System. He will work to improve patient quality and safety and clinical effectiveness at the hospitals and practice sites associated with GRHealth.

Dr. Phillip CouleCoule previously served as the vice chairman of clinical and business operations for the Department of Emergency Medicine and Hospitalist Services at GRU’s Medical College of Georgia.

“The Affordable Care Act and shift to more accountable health care delivery models have prompted us to rethink existing resources, processes and systems in order to reduce waste and increase the value that we provide to our patients,” said Dr. Kevin C. Dellsperger, vice president and chief medical officer for GRHealth and MCG associate dean for Clinical Affairs. “Dr. Coule’s efforts in performance improvement have already positively impacted our Emergency Department, and his broad depth of experiences, education and training make him a unique asset to our health system.”

An expert in emergency medicine, disaster preparedness and mass casualty triage, Coule is director of the Emergency Communications Center at Georgia Regents Medical Center and medical director for both the Augusta Fire Department and AirLife Georgia 10 helicopter transport services. In addition, Coule serves on the board of directors for the National Disaster Life Support Foundation and helped develop the NDLS training programs used today in the health care industry.

He earned a bachelor’s degree in biology from Augusta State University and an M.D. degree from MCG, before they became GRU. He obtained EMT and EMT-1 certification from Aiken Technical College and Augusta Technical College, respectively, and earned his master’s degree in business administration from the University of Tennessee.

Coule serves on multiple hospital quality and safety committees and is vice chairman of the board for GRAChIE – the Georgia Regional Academic Community Health Information Exchange – an electronic platform that promotes care coordination and quality through an efficient, meaningful network of health care providers.

5 apps and gadgets that can help you eat healthy this summer

Barbecue, beer and ball game snacks are all part of summer for many Americans. Although they may satisfy your taste buds, they add a lot of calories to your diet and may result in extra pounds at the end of the season.

“When most people think about losing weight, they only think about hitting the gym and exercising hard,” said Pam Brisky, clinical nutrition manager at Georgia Regents Medical Center. “Although physical activity is important, the best way to slim down is to eat healthy and cut down on your calorie intake.”

Brisky recommends the following apps and gadgets to help you count your calories and avoid gaining those extra pounds during your summer vacation:

  • HAPIFork: Use this futuristic fork to track how fast and how much you are eating. The idea is to help you eat less by helping you eat slower. HAPIFork measures how long you take to eat your meal, how many fork servings you eat per minute and how long your intervals are between fork servings. You can then upload that information to your computer via USB or Bluetooth.
  • CalorieKing: Keep track of your calorie intake and your physical activity with this online food and exercise diary. Search for specific dishes or exercises on the food and activity database, then drag and drop it. The app will measure how many calories you are eating and burning. You can also create a diet plan based on whether you want to lose, maintain, or gain weight. By keeping track of this information over time, you will see where you need to make changes.
  • SparkRecipes: Find healthy, yummy recipes and learn all the nutritional information you need about those dishes on this website. You can also add your own recipes to your account and calculate calories and other nutritional information of your favorite dishes.
  • Fooducate: Use your smartphone to scan the food you are buying to see how healthy it is. Fooducate grades products A through D depending on how natural they are and what their nutritional value is. Never get tricked by complicated food labels again. Fooducate is available for download on Android and iOS devices.
  • PortionMate: Eat the right portions of carbohydrates and proteins by using this tool to measure your meals. These measuring rubber cylinders come in different colors and sizes. Each color represents a different food group. All you need to do is fill up each cylinder with its corresponding food group and you are ready to go.

High blood levels of growth factor correlate with smaller brain areas in patients with schizophrenia

High blood levels of a growth factor known to enable new blood vessel development and brain cell protection correlate with a smaller size of brain areas key to complex thought, emotion and behavior in patients with schizophrenia, researchers report in the journal Molecular Psychiatry.

Higher blood levels of vascular endothelial growth factor, or VEGF, also correlate with high blood levels of interleukin 6, a cytokine that can cross the protective blood-brain barrier and typically promotes inflammation, said Dr. Anilkumar Pillai, neuroscientist in the Department of Psychiatry and Health Behavior at the Medical College of Georgia at Georgia Regents University. As with many disease types, inflammation is increasingly associated with schizophrenia, and high blood levels of IL-6 already have been found in these patients.

The new findings appear to point toward a blood test as an easier way to confirm the diagnosis of schizophrenia, rather than complicated and expensive imaging studies of the brain, and, ultimately, better disease understanding and treatment, said Pillai, the study’s corresponding author. “We are talking about a molecule where you can just draw blood and look at the lab profile,” he said.

A smaller prefrontal cortex is one of the brain abnormalities identified through brain scans of living patients as well as autopsies. Pillai’s lab had earlier shown low brain levels of VEGF, which could help explain lower blood flow and brain volumes in these patients. “Decreased blood flow leads to decreased brain tissue volume,” he said. Inflammation also can reduce brain size.

While findings of higher blood levels may sound counterintuitive to low VEGF levels in the brain, they likely indicate a “feedback inhibition” with the brain recognizing high circulating levels and deciding to produce less VEGF itself, Pillai said. In fact, high blood levels of VEGF may contribute to the disease process, the researchers write.

More patients need to be studied to see if the correlations hold up, Pillai said, and work also is needed to determine which comes first: high blood levels or low brain levels of VEGF.

The study, in collaboration with scientists at the School of Psychiatry at the University of New South Wales in Australia, looked at 96 people with schizophrenia as well as 83 healthy individuals. Brain scans were available on 59 of the patients and 65 healthy controls. Patients were recruited to Neuroscience Research Australia, a not-for-profit research institution based in Sydney that focuses on the brain and nervous system, as well as Lyell McEwin Hospital, a teaching hospital in South Australia affiliated with the University of Adelaide and the University of South Australia.

While likely best known for its role in making new blood vessels, VEGF also is key to the brain’s ability to adapt to change, such as respond to an injury, and protect against brain cell loss.

Hospital retains top stroke care status

AUGUSTA, Ga. – A stroke strikes about every 40 seconds. But new research demonstrates that people with brain bleeds are more likely to survive if they’re treated at a Comprehensive Stroke Center.

Georgia Regents Medical Center – the first hospital in the Peach State to achieve Advanced Comprehensive Stroke Center designation from the Joint Commission – was recently reaccredited and remains the only such center outside Atlanta in Georgia.

“We are very excited to achieve recertification – once again, confirming the high level of care we are able to provide to the most complex and most severe stroke patients,” said Dr. Jeffrey Switzer, Director of Telestroke, Teleneurology, and the Comprehensive Stroke Center.

“Research recently published in the New England Journal of Medicine and the American Heart Association Journal shows that Comprehensive Stroke Centers improve outcomes in both ischemic and hemorrhagic stroke, making them a lifeline for patients in jeopardy,” said Switzer, an Associate Professor of Neurology at Georgia Regents University’s Medical College of Georgia, who also studies acute stroke treatment and related issues.

Comprehensive Stroke Center certification was developed in collaboration with the Brain Attack Coalition and the American Heart Association/American Stroke Association. There are roughly 80 centers in the U.S. equipped with the resources, including neurological critical care and 24-hour availability of neurosurgeons, to deal with the most severe strokes.

“Maintaining this designation demonstrates the ongoing commitment of GRHealth to high quality and superior outcomes for patients under our care,” said Dr. Kevin C. Dellsperger, Vice President and Chief Medical Officer for Georgia Regents Health System. “Through a close partnership with our local Emergency Medical Services, the staff and physicians in our Emergency Department, Departments of Neurology, Neurosurgery, and Radiology, we are uniquely poised to provide timely and superior care to the citizens of this area with acute stroke.”

Stroke is a leading cause of death and serious long-term disability in the U.S. and especially Georgia, which is located inside the stroke belt.

For more information on The Joint Commission and American Heart Association’s Advanced Certification for Comprehensive Stroke Center and a complete list of CSC hospitals in the U.S., visit jointcommission.org or heart.org/myhospital.

Telestroke Care

Georgia Regents Medical Center extends quality stroke care to rural patients across the region through REACH Health, Inc., a telemedicine program pioneered in 2003 at GRU’s Medical College of Georgia. This hub-and-spoke network allows stroke specialists at Georgia Regents Medical Center (the hub) to diagnose and treat stroke patients remotely at more than a dozen rural and a few larger community hospitals (the spokes) in Georgia and to transport those in need of surgery or more specialized neurointensive critical care to GRMC.

Current spoke hospitals are Barrow Regional Medical Center, Burke Medical Center, Emanuel Medical Center, Fairview Park Hospital, Jefferson County Hospital, John D. Archbold Memorial Hospital, Optim Medical Center-Jenkins, St. Mary’s Hospital, St. Mary’s Good Samaritan Hospital, Tift Regional Medical Center, University Hospital and University Hospital-McDuffie, Washington County Regional Medical Center, West Georgia Hospital, Wills Memorial Hospital, and Aiken Regional Medical Center in South Carolina.

GRHealth also has a partnership with the St. Joseph’s/Candler Network in Savannah to provide stroke consultations for St. Joseph Hospital, Candler Hospital, Appling Healthcare System, Candler County Hospital, Coffee Regional Medical Center, Effingham Health System, Evans Memorial Hospital, Optim Medical Center-Tattnall, and Wayne Memorial Hospital