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UAB News

  • Trial combining exercise and a drug may help seniors muscle up
    A drug that might help older adults regrow muscle is under investigation at the University of Alabama at Birmingham. UAB is recruiting healthy adults age 65 and older for a study combining strength training exercise with the anti-diabetes drug metformin.
  • Will you be ready when the weather outside is frightful?
    Winter is coming — are you ready? Prepare for the worst with handy checklists from UAB Emergency Management for home, office and car.

    The paralyzing 2014 snow and ice storm popularly known as Snowmageddon drove home the point that Alabama and the Deep South are not immune to winter weather.

    This year could bring more of the same as NOAA’s Climate Prediction Center is forecasting that this winter will see increased precipitation combined with colder than usual temperatures for the Southeast.

    The Department of Emergency Management at the University of Alabama at Birmingham has prepared checklists of items to keep on hand in home, office and car to prepare for the day when temperatures fall, the roads are impassible and you are stuck.

    In the car:

    • Jumper cables
    • Flashlight and extra batteries
    • Ice scraper
    • Blankets or sleeping bags
    • Charged cellphone and charger
    • Warm clothes, gloves and sturdy walking shoes
    • Baby supplies, if a small child is in the household
    • Flares or reflective triangle
    • Extra prescription and nonprescription drugs
    • First aid kit
    • Food items containing protein such as nuts and energy bars
    • Battery-powered AM/FM radio for traffic reports and emergency information
    • Cat litter or sand for better tire traction
    • Shovel
    • Water for each person and pet
    • Enough gas to get home, allowing for extra time

    In the office:

    • Copy of all prescription drugs, including pictures of the labels on your smartphone
    • An at least 72-hour supply of prescription and nonprescription drugs
    • Cans of nonperishable foods, such as soups, in your desk or locker, with a manual can opener
    • Sealable container to carry your supplies if you need to evacuate your workplace
    • Flashlight and extra batteries
    • Copy of your family’s emergency and communication plan

    In the home:

    • Nonperishable food such as canned or freeze-dried food, manual can opener, and water
    • Flashlight and extra batteries
    • Battery-powered or hand-cranked radio
    • First aid kit
    • Tools, including a wrench or pliers to turn off utilities
    • Signaling whistle
    • Matches in waterproof container
    • For baby: formula, powdered milk, diapers, diaper rash ointment
    • Prescription and nonprescription drugs
    • Paper and pencil
    • Food and extra water for pets
    • Cash or travelers checks
    • Cellphone with chargers or solar charger
    • Local maps
    • Emergency Financial First Aid Kit – FEMA

    These checklists are meant to be a guide only. Personal needs may vary.

  • Study finds genetic risk factor can lead to hyperinflammatory disorder, death after viral infection
    A UAB/Children’s of Alabama/Cincinnati Children’s study finds genetic risk for fatal inflammatory disorder linked to viral infection.
    Media Contact Cincinnati Children’s: Nick Miller 513-803-6035 or
    Media Contact UAB: Bob Shepard 205-934-8934 or

    CINCINNATI/BIRMINGHAM, Ala. – A group of people with fatal H1N1 flu died after their viral infections triggered a deadly hyperinflammatory disorder in susceptible individuals with gene mutations linked to the overactive immune response, according to a study in The Journal of Infectious Diseases.

    Researchers at Cincinnati Children’s Hospital Medical Center, the University of Alabama Birmingham and Children’s of Alabama led the study, published online Nov. 23. They suggest people with other types of infections and identical gene mutations also may be prone to the disorder, known as reactive HLH (rHLH), or hemophagocytic lymphohistiocytosis.

    HLH causes the immune system to essentially overwhelm the body with inflammation that attacks vital organs, often leading to death. Study authors raise the possibility of screening children for HLH genes to identify those who may be at risk during a viral infection.

    “Viruses that cause robust immune responses may be more likely to trigger rHLH in genetically susceptible people,” said Randy Cron, M.D., Ph.D., a senior investigator on the study and physician in pediatric rheumatology at UAB and Children’s of Alabama. “Prenatal screening for mutations in common HLH-associated genes may find as much as 10 percent of the general population who are at risk for HLH when an inflammation threshold is reached from H1N1 or other infection triggers.”

    This study is the first to identify mutations of HLH-associated genes in H1N1 cases where patients had clinical symptoms of rHLH and a related condition called macrophage activation syndrome, or MAS. An outbreak of H1N1 in 2009 turned into a global pandemic. H1N1 has since become part of the viral mix for the annual flu season and preventive vaccine, the authors note.

    Collaborating on the study were co-senior investigator Alexei Grom, M.D., and first author Grant Schulert, M.D., Ph.D., both physicians in the Division of Rheumatology at Cincinnati Children’s.

    Cron and Grom have published articles linking clinical signs of rHLH to patients with hemorrhagic fever and systemic juvenile idiopathic arthritis, an inflammatory condition in which the body thinks it has an infection and attacks vital organs and joints. The precise reasons these patients have clinical signs of rHLH have not been clear, although some juvenile arthritis patients who develop MAS also have HLH-linked gene mutations, according to the authors.

    This study is the first to identify mutations of HLH-associated genes in H1N1 cases where patients had clinical symptoms of rHLH and a related condition called macrophage activation syndrome, or MAS. An outbreak of H1N1 in 2009 turned into a global pandemic. H1N1 has since become part of the viral mix for the annual flu season and preventive vaccine, the authors note.

    There are two types of HLH, hereditary and the reactive form focused on in the current study. Both share common physical traits that involve the body’s immune system’s overheating, excessive proliferation of immune cells called macrophages and severe inflammation. The only curative treatment at present is a bone marrow transplant, a risky procedure that is not always successful.

    “There are no widely accepted and validated diagnostic criteria for reactive HLH, and criteria for familial HLH are not considered effective for rHLH or MAS,” said Schulert. “Regardless, it seems clear that a sizeable number of patients with fatal H1N1 infection develop rHLH. Our data suggest some people may have a genetic predisposition to develop severe H1N1 influenza, and critically ill H1N1 patients should be carefully evaluated for rHLH and MAS. The question is whether immunosuppressive therapy may benefit some patients with life-threatening influenza infection."

    The current study examined the medical records of 16 adult patients ages 23 and 61 who died between 2009 and 2014 while infected with H1N1. The patients and their HLH-like symptoms initially were identified through the Michigan Hospital Department of Pathology Database by study collaborator Paul Harms, M.D., and his team at Michigan Center for Translational Pathology, University of Michigan Medical School.

    Processed tissue samples from the patients were examined using whole exome genetic sequencing, which reads an individual’s entire genetic code of every gene.

    Forty-four percent of the H1N1 cases met the clinical criteria for HLH and 81 percent for the related condition MAS. Five patients carried one of three different gene mutations in the commonly identified HLH gene LYST. Two of those same five patients also had a specific mutation in the gene PRF1, which decreases the function of immune system natural killer cells and aids the overproliferation of macrophage cells. Several patients in the study also carried variants of other genes linked to observed cases of MAS.

    The current study involved a small patient population in a single state and was retrospective in design, looking at records from past cases. The authors recommend conducting a larger prospective study to determine whether genomic testing can predict the course of disease progression during influenza and other types of infections. Researchers also want to conduct further genomic and biological testing of children with juvenile arthritis to solidify potential links between gene mutations and secondary autoimmune disease.

    Funding support for the study came in part from the National Institutes of Health (R01-AR059049, K12-HL119986), the Kaul Pediatric Research Institute and a Scientist Development Award from the American College of Rheumatology’s Rheumatology Research Foundation.

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