H E A L T H

Chinese health care improved by Emory

The efforts of a medical team from the University's Department of Radiology have resulted in significantly improved breast health care among women in Xian, China. Last summer, Assistant Professor of Radiology Debra Monticciolo and Professor and Co-director of Radiological Studies Perry Sprawls brought state-of-the-art breast imaging equipment and their own expertise to Xian Medical Center, Emory's sister hospital in China.

"This should have a direct impact on breast cancer morbidity and mortality in Xian," Monticciolo said. "It is a start in giving women in China the ability to take charge of their own health. Caught early enough, breast cancer is curable. We hope we have empowered these women to help themselves."

Until now, the mammography technology in Xian could detect only large lumps that were usually advanced cases. The new U.S.-made machine, donated by the Lorad Corporation, can detect small changes in breast tissue even before there is a lump.

In addition to equipment, Monticciolo and Sprawls shared their expertise with the medical professionals of Xian. Sprawls lectured on the physics and quality control aspects of breast imaging, while Monticciolo taught physicians how to conduct a mammogram and deal with the intricacies of breast cancer.

Monticciolo and Sprawls hope to establish a teaching fellowship at Emory in which a Xian physician would train at the University for three months and return to spread the knowledge to colleagues in China.

Smoking deaths on the rise

Smokers and nonsmokers alike have long been aware of the hazards cigarettes present to long-term health. Now there is new evidence from Emory's Rollins School of Public Health and the American Cancer Society (ACS) that deaths from cigarette-related diseases are rising, not declining, even in an era of greater health awareness.

W. Dana Flanders, Emory professor of epidemiology, and ACS researchers Michael J. Thun and Clark W. Heath Jr., compared statistics from a 1959-65 study to those from a 1982-86 study and found that lung cancer death rates nearly doubled among female smokers and remained high in male smokers.

"Despite many uncertainties that constrain our ability to compare the intrinsic carcinogenicity of cigarettes from the two eras," the researchers reported in the American Journal of Public Health, "the net effect . . . has been a large increase rather than a decrease in lung cancer mortality in smokers over age fifty. This increased risk has occurred despite the widespread introduction of filter-tipped, lower tar cigarettes, which were found to attenuate lung cancer risk in several epidemiological studies."

The researchers also reported that lung cancer has surpassed coronary artery disease as the largest single contributor to smoking-attributable deaths among white, middle-class smokers.

Smyrna Hospital joins EUSHC

The Emory University System of Health Care (EUSHC) and the Adventist Health System Sunbelt (AHS) have entered into a joint venture to operate Emory-Adventist Hospital, formerly Smyrna Hospital.

AHS holds a sixty-five percent interest in the joint venture corporation and manages the daily operations of the hospital, while Emory holds a thirty-five percent interest and manages the hospital's satellite facilities.

"Emory-Adventist Hospital is a strong addition to Emory's growing patient care and teaching program," said Charles R. Hatcher Jr., vice president for health affairs at Emory, director of the Robert W. Woodruff Health Sciences Center, and chief executive officer of EUSHC.

Eat less fat, exercise more

In a variation on the theme of the rich getting richer, researcher Ralph J. Coates of the Rollins School of Public Health, has determined that people who eat less fat exercise more. Conversely, those who eat more fat exercise less.

"Lower fat consumption was associated with increased leisure-time physical activity," Coates said. "This association was strong and independent of other demographic and behavioral risk factors" such as weight and smoking.

"Higher caloric intake, particularly ingestion of carbohydrates, has been observed with higher physical activity. However, lower fat intake with higher physical activity has not been previously reported."

--compiled by Andrew W.M. Beierle

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