Johns Hopkins Gazette: July 22, 1996

In Brief:
Medical News

Screenings recommended for mild thyroid disorder

Like routine screenings for high blood pressure and breast cancer, screening for an underactive thyroid gland is cost-effective and should be part of periodic examinations for people over age 35, especially women, a Johns Hopkins-led study suggests. The study, which used a computer model and statistical analysis to make cost-and-benefit predictions for mild thyroid failure screenings for the U.S. population, contradicts current recommendations by most physician groups that such thyroid screenings are unnecessary in the general population.

Routine thyroid screenings may prevent a mild problem from becoming severe, reverse severe symptoms that have gone undiagnosed and lower thyroid-related high blood cholesterol, a major factor in heart disease, according to the results published in the July 24 issue of the Journal of the American Medical Association.

"Early detection and treatment of mild thyroid failure can enhance the quality and even the duration of life," says Paul W. Ladenson, lead author and director of endocrinology and metabolism. "Our findings suggest that the health benefits are worth the costs and that these screenings could be as safe, inexpensive and effective as other common preventive tests in detecting early or hidden problems."

Measles virus: one less mystery

Researchers have discovered an important way by which the measles virus weakens the immune system, leaving infected individuals in developing countries more vulnerable to deadly infections. The finding, published in the July 12 issue of Science, helps to explain why measles is a major cause of death in those areas, and it also may help to explain how the AIDS virus weakens the immune system.

Working with laboratory cell cultures, the Hopkins researchers showed that the measles virus blocks the release of an important chemical from monocytes, a type of white blood cell. The molecule, called Interleukin-12, or IL-12, is critical for the activation of a part of the immune system called cell-mediated immunity. CMI is an important defense mechanism against a variety of viruses and bacteria, as well as protozoa, one type of which causes malaria. In the absence of IL-12 production by monocytes, CMI is greatly weakened.

"Our study may explain why measles is so dangerous in places where the disease is widespread and medical care is limited," said Christopher Karp, assistant professor of medicine and lead author of a report on the findings. "In the developing world, up to 2 million children die each year from diseases like pneumonia and diarrhea after they get measles."

Genetically engineered anti-AIDS virus promising

An experimental HIV vaccine made from a genetically engineered safe vaccine virus used to vaccinate canaries, when followed by a booster shot of the HIV rgp120 vaccine, triggers two important immune responses against the AIDS virus in humans.

In addition to stimulating production of antibodies that kill HIV in body fluids, the combination vaccine also stimulates production of killer cells called cytotoxic lymphocytes, which eliminate HIV within cells, said Mary Lou Clements, professor of international health at the School of Public Health.

Once HIV is eliminated from cells and blood, it can no longer produce new AIDS viruses, nor can the infected cells serve as a source of new AIDS viruses. Clements reported the results of the study in an abstract at the International AIDS conference in Vancouver earlier this month.

"These results warrant further studies of the combination of ALVAC-HIV vaccines containing other HIV genes followed by rgp120 vaccines," Clements said.

EMTs in cohesive units suffer less from stress

In a study designed to determine the effect of supervisory behavior and group cohesiveness on emergency medical technicians, researchers found that EMTs have fewer symptoms of significant work-related stress than other healthcare workers when their supervisors are communicative and they work in cohesive units. Robyn Gershon, a senior research associate in the School of Public Health's Department of Environmental Health Sciences, said her yearlong study of 65 emergency medical service workers had implications for training EMTs and for introducing ways to keep EMTs from experiencing unusual stress.

"Improvements in work group support and supervisor style may, in part, protect EMTs from negative effects of work-related stress associated with their day-to-day environment," Gershon said. The study was published in the July issue of the Journal of Occupational Health Psychology.

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