Emory Report

April 19, 1999

 Volume 51, No. 28

Random sampling of med school grants show wide range

The School of Medicine continues to be awarded a large share of grants to the University. Not having room to mention all of them, here's a representative sampling of recent ones.

An aspirin a day to keep stroke away?

Doctors don't know how best to prevent stroke caused by clogged arteries in the brain-a condition known as intracranial arterial stenosis. To better evaluate two potential tactics for preventing this type of stroke in high-risk patients, the National Institute of Neurological Disorders and Stroke of the National Institutes of Health has funded the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) study and awarded Emory more than $14 million to coordinate a five-year trial during which 806 patients will be evaluated at 50 sites in North America.

The clinical coordinating center will be based in the Department of Neurology, the Statistical Coordinating Center in the Department of Biostatistics at the School of Public Health and the Pharmacy Coordinating Center at Emory Hospital.

"This year we expect more than 700,000 Americans to experience a stroke, and of these some 40,000 will sustain stroke caused by narrowing of the intracranial arteries," said WASID Principal Investigator Marc Chimowitz, associate professor and co-director of the neurology department's Stroke Center. "This type of stroke disproportionately affects minorities, including African-Americans, Asians and Hispanics."

"Our primary goal will be to compare the effectiveness of two different medications, warfarin or aspirin, for preventing stroke and vascular death in persons with intracranial stenosis," Chimowitz said.

Participants who recently have had a minor stroke or transient ischemic attack (TIA, or "mini stroke") will be randomized to receive either aspirin or warfarin and will be evaluated by stroke experts at the WASID study site nearest them every four months for the duration of the study.

Stroke prevention in patients with intracranial stenosis typically involves reducing risk of blood clots through use of blood-thinning medications, including aspirin, Coumadin (warfarin), Plavix (clopidogrel), Ticlid (ticlopidine) and Persantine (dipyridamole). Doctors do not yet know which of these medications is most effective for prevention and expect to learn more from the WASID trial.

Directed-study junior faculty grant pairs Wright, Dean Stein

The Society for Academic Emergency Medicine has selected David Wright, assistant professor of emergency medicine, as the inaugural recipient of its Scholarly Sabbatical Award. The award will provide $50,000 to Wright, and to the Department of Emergency Medicine, for six months of directed research.

Working with Graduate School Dean Donald Stein, also professor of neurology and psychobiology, Wright will develop proficiency in neurotrauma research methodology as well as strong collaborative relationships with basic scientists in Emory's brain research laboratory.

Stein is recognized for his expertise in the area of brain repair and recovery following neurotrauma. "My laboratory is dedicated to building ties with the new Department of Emergency Medicine at Emory," he said. "This research award will be of great benefit to research in both neurology and emergency medicine, and I look forward to working with Dr. Wright."

Emory a site for nation's first multicenter St. John's wort trial

A research team in the Department of Psychiatry and Behavioral Sciences is among 12 groups chosen to direct the nation's first multicenter clinical trial of St. John's wort for depression. "Research conducted in Europe suggests this herbal remedy has the potential to relieve depression without some of the side effects of pharmaceutical antidepressants," said Emory investigator Jeffrey Kelsey, assistant professor of psychiatry and behavioral sciences. "Still, the botanical's own side effects must be rigorously evaluated as well as its true effect on mood."

Study participants will be randomly assigned to take either St. John's wort, a placebo (sugar) pill or the approved antidepressant sertraline (Zoloft) for about six months. The study is funded by the Office of Complementary and Alternative Medicine of the National Institutes of Health.

Although St. John's wort is the most widely prescribed antidepressant in Germany and prescribed throughout Europe for depression, anxiety and sleep disorders, it has not been approved by the U.S. Food & Drug Administration (FDA). Health food stores routinely stock the herb, but the FDA forbids manufacturers to make health claims until more is known about its efficacy.

St. John's wort is made from extracts of Hypericum perforatum, a plant native to Europe and parts of Asia and Africa that blooms in summer, close to the June 24 birthday of St. John the Baptist.

--Holly Korschun and Lorri Preston

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