UAB Magazine Online Features
UAB Explores Innovative Stroke Therapies
By Jo Lynn Orr
UAB neurologists are using ultrasound to help break up clots in the brain (above) and testing other new treatments to improve stroke care.
In 1947, as tension between Russia and the United States threatened to erupt into nuclear war, the Bulletin of the Atomic Scientists added a new element to its cover: a stylized clock face with the hands set at seven minutes to midnight. For the past 63 years, the clock’s minute hand has moved back and forth to reflect the imminence of nuclear holocaust.
In the world of stroke care, the countdown to doomsday begins as soon as the brain’s oxygen supply is disrupted, either through a blood clot (ischemic stroke—the cause of 80 percent of strokes) or by bursting blood vessels (hemorrhagic stroke, which accounts for the other 20 percent of cases). Stroke kills more people worldwide than any other disease. It is the third leading cause of death in the United States and the leading cause of serious, long-term disability.
For years, the stroke clock was set at three hours. Patients receiving emergency treatment before that time stood a good chance of recovering significant function; after the three-hour window closed, there wasn’t much hope. But new advances in stroke treatment are steadily pushing open the treatment window and adding precious time back onto the clock. Neurologist Andrei Alexandrov, M.D., and his team at the UAB Comprehensive Stroke Research Center are contributing many of those breakthroughs, developing and testing revolutionary therapies that are effective several hours, days, and even weeks after stroke onset.
Answers About a Dangerous Allergy
By Kathy Seale
It’s a sign of the times: Across America, the entrances to many elementary-school classrooms are now guarded by the image of a large peanut trapped behind the red circle and slash that is the international symbol for “NO.”
Potentially deadly allergic reactions to peanuts have become a serious issue at schools, birthday parties, and anywhere else children and food mix in uncertain ways. And according to a heavily publicized study in the May 12 issue of the Journal of Allergy and Clinical Immunology, the problem is getting worse. Based on a 5,300-household survey, the study reported that the number of peanut allergies more than tripled over 10 years, from 0.4 percent of children surveyed in 1997 to 1.4 percent of children surveyed in 2008.
Extrapolating those findings nationwide is problematic, says UAB pediatric allergist and immunologist Prescott Atkinson, M.D. But the number of confirmed cases of peanut allergy in the United States is trending upward, he agrees.
New UAB Treatment Dispels Depression with Magnetism
By Bob Shepard
UAB is the first medical provider in Alabama to offer repetitive Transcranial Magnetic Stimulation treatments to patients suffering from depression. To learn more about this new form of therapy, click here.
Julia Rogers has battled depression for two decades. It has caused serious issues in her life, both personally and professionally. She tried medications—lots of them—with no real effect. Most days, she had to struggle just to function at all.
Depression is a difficult illness to treat because no single therapy works every time in every patient. Psychiatrists now have very good medications to offer, but many patients still find little relief. Psychotherapy and electroconvulsive therapy (ECT) are also successful for some patients, but they do little for others.
That’s why UAB psychiatrist Bates Redwine, M.D., is so excited about the university’s new repetitive Transcranial Magnetic Stimulation, or rTMS, device. This non-invasive treatment delivers a series of highly focused, MRI-strength magnetic pulses to a particular area of the brain linked to depression—the left dorsolateral prefrontal cortex. The Food and Drug Administration approved rTMS therapy within the past two years, and UAB’s device is the only one in Alabama.
“The left dorsolateral prefrontal cortex is known to have decreased activity in depressed patients,” says Redwine. “rTMS seems to ‘wake up’ the neurons, stimulating them to fire and become more active.”
The Pitfalls and Promise of Home Genetic Tests
By Tara Hulen
If Walgreens had its way, crystal balls would now be for sale alongside the candy bars and cough medicine at the drugstore chain’s stores. In May, Walgreens announced that it would start selling home genetic testing kits for as little as $20, becoming the first physical store to offer the tests—although they are widely available online. But the Food and Drug Administration (FDA), responding soon after the announcement, notified testing companies that they should have sought premarket approval, and Walgreens canceled the launch.
Although the FDA’s actions have led to calls for regulation of these direct-to-consumer tests, at the moment anybody wanting one won’t have much trouble finding them online from companies such as 23andMe. It’s a fairly simple process: Customers order a kit, mail in some saliva, and then receive a report with as much detail as they are willing to pay for. Options include ancestry tests, health screenings on several levels, and pre-pregnancy screening—which is a large market, says UAB Genetic Counseling Program Director R. Lynn Holt, M.S., CGC. The reports cover possible risks for various diseases, pharmacogenetics (a person’s sensitivity to prescription drugs such as blood thinners), or carrier status for diseases such as cystic fibrosis or Tay-Sachs, which can be passed on to children.
The prospect offered by these tests is intriguing—the thrill of looking back into the past or catching a glimpse of the future—but Holt says geneticists and genetic counselors have several concerns.