Learning from those with less

In places like India, young physicians learn quickly how to do a lot with a little. A group of Emory faculty and residents in rehabilitation medicine recently witnessed firsthand how Indian physicians produce good outcomes in a low-cost environment.

Physician V. R. Rao, (left, second from right, in back) medical director for rehabilitation therapy services at Grady Hospital, says American physicians can learn much from their colleagues in the developing world. “At Emory, we’re all about producing global physicians with global capabilities,” he says. “We also want to show our physicians how other cultures use rehabilitation medicine and let them see diseases they wouldn’t normally encounter here.”

Rao and others observed doctors at a medical college and hospital in Bombay as they treated polio, cerebral palsy, gait abnormalities, and congenital orthopedic deformities. The trip was part of an Emory pilot program called “Global Perspec-tives in Human Care.”

Alaric Van Dam, (above, far right) chief resident in physical medicine and rehabilitation, says the trip was eye-opening. “The people of India don’t have many resources or high-tech equipment, yet they have low infection rates,” he says.

International rotations, funded by public and private donations, should help medical residents learn to communicate with and understand patients of many backgrounds. Besides offering medical education, the program also functions as an academic exchange. An Indian physician who helped lead the recent trip plans to visit Emory to lecture and demonstrate surgical techniques, says Rao.

“We want to put Emory on the map as producing global physicians,” he says. “It’s a great opportunity to broaden the experience of our young physicians.” (BACK TO TOP)


Testing vaccines in people

Emory’s Vaccine Research Center, which has one of the largest preclinical vaccine research programs at any university worldwide, recently dedicated the Hope Clinic in downtown Decatur for community-based clinical trials.

Outfitted with three examination rooms, several offices, a conference room, and a laboratory for preparing blood samples, the clinic is conducting Phase I trials of several AIDS vaccines in collaboration with Merck & Co.

Medical director Mark Feinberg, who helped create the clinic, believes an effective AIDS vaccine is on the horizon and that work at Emory is central to the effort. “Atlanta seems to be a receptive place to do HIV vaccine trials,” he says. “The community here really wants to make a difference.”

In human studies coordinated at the clinic, subjects are HIV-negative and are at low risk for acquiring the virus. They are not challenged with HIV but are given vaccine, and their reactions and immune response are measured.

In addition to the Merck vaccines, the clinic will be testing a multiprotein AIDS vaccine developed by Emory researcher Harriet Robinson and colleagues that has achieved better protection in primate studies than any other HIV vaccine to date.

In primates, this vaccine was given in three steps—two DNA priming vaccines followed by a modified pox virus booster. This regimen stimulated a strong immune response that allowed monkeys later infected with a highly virulent hybrid of simian and human immunodeficiency viruses to maintain a low level of infection while remaining healthy. Infections were controlled even among groups receiving a low-dose vaccine. This vaccine’s greatest strengths are its abilities to induce immune responses to the three major proteins expressed by HIV and to provide memory immune responses months after inoculation.

Feinberg says the Hope Clinic is crucial to Emory’s vaccine development efforts. “We have tremendous potential to be the most productive place in the country for conducting clinical trials of vaccines,” he says. (BACK TO TOP)

 

 

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