Magnetic nursing care

Emory University Hospital and Emory Saint Joseph’s Hospital have achieved Magnet recognition from the American Nurses Credentialing Center for nursing professionalism, teamwork, and quality in patient care. (This is Emory Saint Joseph’s fifth consecutive Magnet designation.) Magnet recognition is earned by less than 7% of US hospitals, and signals benefits to both patients and staff, including lower mortality and hospital-acquired infection rates, higher patient satisfaction, and higher job satisfaction among nurses. John Fox, Emory Healthcare president and CEO, describes Magnet status as the “unequivocal national and international gold standard for nursing quality.”

Do you see what I see?

Following another’s gaze or looking in the direction someone else is pointing are examples of receptive joint attention, a key nonverbal communication skill. Researchers at Yerkes National Primate Research Center found that these behaviors have a genetic basis, which could have important implications for autism spectrum disorders (ASD).

Determining that the ability to pick up on these communicative cues may be an inborn trait led the researchers to the vasopressin receptor gene, known for its role in social bonding.

Yerkes researchers Larry Young and Bill Hopkins, coauthors of the study in Scientific Reports, say that receptive joint attention is important for developing complex cognitive processes, including language and theory of mind. Poor joint attention abilities may be a core feature in children with or at risk of ASD.

“Chimpanzees are an excellent animal model for exploring the role of the vasopressin receptor on social behaviors because of their similarities to humans,” says Young, director of the Center for Translational Social Neuroscience at Emory, Timmie Professor of Psychiatry and Behavioral Sciences, and a newly elected member of the American Academy of Arts and Sciences.—Lisa Newbern

The mysterious case of the saxophone lungs

A 68-year-old man sought treatment from the asthma, allergy, and immunology team at Emory Clinic. He complained of coughing and wheezing that had lasted more than a year.

His chest X-rays showed blockages with mucus and a calcified lymph node.

The man’s symptoms hadn’t responded to any typical treatments, including inhalers, steroids, and antibiotics.

He mentioned in passing that he performed with a Dixieland band, and that he had played clarinet for more than 30 years. “He was playing very frequently, several nights a week,” says Marissa Shams, one of the Emory physicians who treated the patient.

Doctors originally thought he had allergic bronchopulmonary aspergillosis, a type of fungal reaction. Indeed, tests showed the man was allergic to several types of fungi. He was given oral steroids but didn’t get any better.

What was causing his illness, and if it was an allergic reaction, how was he being exposed to the fungi?

Yep, you guessed it, the clarinet was the culprit.

Exophiala, a fungus usually found in decaying wood and soil, was discovered inside his clarinet and on its reed. “There was very impressive fungal growth on those,” Shams says. The musician admitted that he hadn’t thoroughly cleaned his instrument in years.

The diagnosis? “Saxophone lung,” a rare type of hypersensitivity pneumonia. “Basically, he was breathing in this fungus and developed an allergic reaction,” Shams says.

Once the musician started sterilizing his instrument regularly, he improved substantially.

Shams and colleagues David Berkowitz, Frances Lee, and Jennifer Shih presented the case at the annual meeting of the American College of Allergy, Asthma, and Immunology.

“We were happy to help him,” Shams said. “This is not the typical allergy and asthma patient that we see in our clinic.” n