UGAPreMed March 2013

UGAPreMed a magazine for uga premed students

march 2013

World Hunger

A Global Crisis

photo gates foundation (foter)

What’s Inside?

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12 Spotlight | Dental Why People Don’t Go To The Dentist

Spotlight | Course ALDR 3820: World Hunger

Spotlight | Pre-Nursing Immunizations

Spotlight | Pre-PA Foreign Service Health Practitioner

Spotlight | Research Lab Infectious Disease

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10 12 16 18 20

Featured | Pacemakers Setting the Pace of the Future

World Hunger A Global Crisis

Featured | Pharmaceutical Sciences UGA’s New Major

Clubs in Action MEDLIFE and Medshare

Pharm Chat ePharmacy

PreMedStaff

www.premedmag.com | facebook: premedmag | twitter: UGAPreMedMag

Writers

Kristi Haisler Sheela Sheth

Ronke Olowojesiku

James Cheng

Abigail Shell

Kathleen LaPorte

Samantha Swygman

Nupur Shan

Not pictured: Nina Paletta Grady College of Journalism and Mass Communication Franklin College of Arts and Sciences

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Faculty Advisor Dr. Leara Rhodes Editor in Chief Shajira Mohammed Managing Editors Aashka Dave Sefali Patel Business Editor Neha Gupta Assistant Editors Matt Middlebrooks Jordan Crofton Rachel Perez Design/Photo Editor Christine Byun Designers Gloria Jen Lauren Foster

Editor’s Note I cannot believe we have already reached spring break.

I know quite a few people who are going on some exciting trips this break through MEDLIFE, IMPACT, and various other fantastic groups.

Many of us recognize the importance of broadening our perspective and learning about the many different ways we can help those in need. However, one simple search on Google will show you how confusing this path can be. For this very reason, UGA PreMed decided to focus on global health for this issue.

The Research Spotlight on Dr. Moore’s lab talks about UGA’s role in fighting against Malaria and HIV in East Africa. In the article titled “World Hunger,” Sheela Sheth looks into a problem that might not cross our minds when we are “Snellebrating” and Sharon Kim explores a course at UGA that focuses on this crisis.

As promised, we are giving you an in-depth look into the new Pharmaceutical Science major as well so you don’t have to do all the extra searching. Aashka Dave and Chisom Amaeze also take a good look at MEDLIFE, a prominent student organization that is well known for its service trips to Peru.

With so many of you reaching out to help others across the world, we thought of helping you by exploring some of the many choices that UGA students get involved with to serve others during their breaks.

Moreover, looking into classes and labs right now gives a good start to thinking about what you might want to do next year.

Ultimately, we need to stay motivated and keep working hard. There is still time to pick things up and get where you want to be. As Collin Powell, the 65th Secretary of Sate, once said, “There are no secrets to success. It is the result of preparation, hard work, and learning from failure.”

Shajira Mohammed Editor-in-Chief

premed magazine at uga | march 2013

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Spotlight | Pre-Dental

“...ROUGHLY 15 PERCENT OF AMERICANS ACTIVELY AVOID SEEING A DENTIST OUT OF ANXIETY.�

D WHY PEOPLE DON’T GO TO THE

DENTIST REASONS BY COUNTRY JAMES CHENG

ental care on a global scale is drastically different from the practices and treatments available in the United States and other developed nations. In developed countries, high quality dental care from trained professionals is readily available and up-to-date with the newest techniques and procedures.

However, in a recent study, only 42.2 percent of Americans had visited a dental office in the past year. Surprisingly, the factors that contribute to such a low percentage of the population seeking dental care have less to do with a lack of trained professionals or a shortage of materials and technology, but more to do with financial costs and, to some degree, dental anxiety.

In the United States total dental expenditures surpassed the 100 billion dollar mark in 2009, making it is easy to understand how seeking treatment for and maintaining oral health is a significant financial burden for the average American citizen. Only 27 percent of citizens without dental coverage sought treatment from a dentist, while the majority of citizens with dental insurance had at least one dental visit in the past year. However, financial costs are not the only factor preventing individuals from seeking oral health care.

Dental anxiety and phobia are more prevalent in the population that one would suspect. In a study done by an independent group and reviewed by the faculty of Columbia University College of Dental Medicine, it was found that roughly 15 percent of Americans (roughly 40 million people) actively avoid seeing a dentist out of anxiety. This 15 percent of the American population fights through periodontal disease, tooth pain and even broken teeth in order to avoid a visit to a dentist; they choose to overlook their oral health as a response to dental anxiety. This behavior is not isolated in the United States; the British Dental Health Foundation in the UK reported that 36 percent of citizens not regularly consulting a dentist did so because of fear and anxiety.

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In developing countries, the trend to avoid oral health care centers on one basic concern in particular: finances. The financial cost of oral health care is one of the most significant reasons individuals avoid seeking professional treatment for dental care. In developing countries in particular, the financial burden of oral health treatment is even greater, governements do not allocate any money to dental care. In industrialized nations, up to 10 percent of national health resources are allocated to dental care.

The majority of those living in developing or relatively poor countries are either financially unable to seek dental treatment or do not have access to dental care in their communities because of a low dentist to population ratio. Since almost no preventative care is available, the risk of developing oral health conditions is heightened, leading to more problems as the population ages.

In Mexico, for example, roughly 90 percent of the population is living with untreated cavities and those aged 65 or above have an average of 18 missing teeth (adult humans have 36 teeth). Whenever gum disease loosens a tooth or a tooth causes pain, the only recourse available is extracting the entire offending tooth. The poor condition of public oral health in poorer countries is also partly caused by diets high in sugars and heavy usage of tobacco products which characterize the population of developing countries.

Having an oral health professional checking in on the condition of the oral cavity would help lower tobacco usage and high sugar diets, because preventative care and educating patients on how to care for their teeth are one of the biggest roles of a dentist.

Tendencies to neglect the dental care needs of surprisingly large portions of the population can be found in multiple regions around the globe. For the most part, financial resources and a low dentist-to-population ratio are the primary factors behind these trends.

However factors that transcend socioeconomic levels and health care accessibility -- such as dental anxiety -- prevent individuals from receiving much needed oral health care as well. photo mikael wiman, theloushe (foter)

Spotlight| ALDR 3820

WORLD HUNGER SHARON KIM

“W

orld hunger is a global crisis. One in seven people in the world today do not get enough food to be healthy, and most of these are women and children. Poor nutrition is the single biggest underlying cause of ill health and death among pregnant women and for children in their first two years of life, underlying one-third of preventable deaths of children under age 5. –”World Vision” The troubling images of a child’s bloated belly or of a mother digging through trash trying to find food are ones that have haunted the world every day. A large majority of people is affected by hunger and malnutrition; many of them die every day from these preventable causes. Lucky for the students at the University of Georgia, a course called Reflections on Fighting Hunger (ALDR 3820) is offered fall and spring semester every year. This class is open to Honors students only in the fall but open to everyone in the spring.

Students learn what exactly hunger is and who and where it effects; additionally, they learn about agricultural, environmental, global and health issues that influence hunger as well as several solutions to this global problem.

This is not a traditional classroom setting; this class is almost entirely discussion based. The class begins with Dr. Navarro opening up with a starting topic, which creates discussion among students that cascade into a series of related ideas. Grading is broken down as follows: 12% attendance, 36% weekly assignments, 12% chapter assessments, 10% group projects, 9% term paper and 3% creative project, and 18% final exam. Participation points are earned if students are on time and complete their “ticket out the door activities”. Quizzes occur every once in awhile on eLC, which are usually based on a video that was assigned to watch. Additionally, students have a term paper on a topic of their choosing with a creative visual that they will discuss in class. Lastly, there is a written final examination. Rather than the typical classroom setting of intense, time consuming weekly assessments, students are expected to watch interesting interviews and videos of people who are helping those in need.

From these interviews and videos, students can see the unique ideas that people come up with to help prevent hunger as well as help the students come up with their own ideas to apply to their own community.

In this class, students learn that there is no panacea for every poverty and hunger problem in the world.

This is because all poverty in various locations has its own specific causes and effects, which therefore leads to a unique solution to that location. This class differentiates from others at UGA because of the impeccable first hand experiences that the professor, Dr. Navarro, has had and shares. She has traveled to dozens of locations in many different countries

where she worked in their communities to improve their specific situations. Instead of a typical classroom setting, this class is more like a story telling of the unique circumstances and solutions that Dr. Navarro has come across as well as those that she herself has not. Along that, the class challenges its student to reflect on their own perspectives and to think in different ways to solve problems instead of just learning basic facts and finding one concrete solution to every problem. Students not only gain valuable knowledge, but they also learn how to promote and make a difference in their own communities.

Dr. Navarro’s class is an excellent opportunity for students to gain knowledge on hunger and also acquire critical application skills that are needed not just for all pre-professional students, but for every university student that wants to learn and help out in their community. Also, because this class does not have tedious work outside of the classroom, students can freely concentrate on their other classes and put more attention into the class discussions. A former student of Dr. Navarro highly recommends taking this class because “it is an easy upper level ‘A’ and challenges you to think in a way that is different from what you are used to and see a side of things that you would normally never think was there.” So when registration comes around and if you need an easy ‘A’ class that is both interesting and helpful to your pre-professional path, be on the lookout for this class!

“World hunger is a global crisis. One in seven people in the world today do not get enough food to be healthy, and most of these are women and children.

Poor nutrition is the single biggest underlying cause of ill health and death among pregnant women and for children in their first two years of life, underlying one-third of preventable deaths of children under age 5.” –”World Vision” The troubling images of a child’s bloated belly or of a mother digging through trash trying to find food are ones that have haunted the world every day. A large majority of people is affected by hunger and malnutrition; many of them die every day from these preventable causes. Lucky for the students at the University of Georgia, a course called Reflections on Fighting Hunger (ALDR 3820) is offered fall and spring semester every year. This class is open to Honors students only in the fall but open to everyone in the spring.

Students learn what exactly hunger is and who and where it effects; additionally, they learn about agricultural, environmental, global and health issues that influence hunger as well as several solutions to this global problem.

This is not a traditional classroom setting; this class is almost entirely discussion based. The class begins with Dr. Navarro opening up with a starting topic, which creates discussion among students that cas-

cade into a series of related ideas. Grading is broken down as follows: 12% attendance, 36% weekly assignments, 12% chapter assessments, 10% group projects, 9% term paper and 3% creative project, and 18% final exam. Participation points are earned if students are on time and complete their “ticket out the door activities”. Quizzes occur every once in awhile on eLC, which are usually based on a video that was assigned to watch. Additionally, students have a term paper on a topic of their choosing with a creative visual that they will discuss in class. Lastly, there is a written final examination. Rather than the typical classroom setting of intense, time consuming weekly assessments, students are expected to watch interesting interviews and videos of people who are helping those in need.

From these interviews and videos, students can see the unique ideas that people come up with to help prevent hunger as well as help the students come up with their own ideas to apply to their own community.

In this class, students learn that there is no panacea for every poverty and hunger problem in the world.

This is because all poverty in various locations has its own specific causes and effects, which therefore leads to a unique solution to that location. This class differentiates from others at UGA because of the impeccable first hand experiences that the professor, Dr. Navarro, has had and shares. She has traveled to dozens of locations in many different countries where she worked in their communities to improve their specific situations. Instead of a typical classroom setting, this class is more like a story telling of the unique circumstances and solutions that Dr. Navarro has come across as well as those that she herself has not. Along that, the class challenges its student to reflect on their own perspectives and to think in different ways to solve problems instead of just learning basic facts and finding one concrete solution to every problem. Students not only gain valuable knowledge, but they also learn how to promote and make a difference in their own communities.

Dr. Navarro’s class is an excellent opportunity for students to gain knowledge on hunger and also acquire critical application skills that are needed not just for all pre-professional students, but for every university student that wants to learn and help out in their community. Also, because this class does not have tedious work outside of the classroom, students can freely concentrate on their other classes and put more attention into the class discussions. A former student of Dr. Navarro highly recommends taking this class because “it is an easy upper level ‘A’ and challenges you to think in a way that is different from what you are used to and see a side of things that you would normally never think was there.” So when registration comes around and if you need an easy ‘A’ class that is both interesting and helpful to your pre-professional path, be on the lookout for this class!

premed magazine at uga | march 2013

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Spotlight | Pre-Nursing

Immunizations By: Samantha Swygman

D

ue to the tireless dedication of many individuals over the last century, immunizations have lowered mortality rates and even eradicated disease strains around the world. Despite unending work and progress, it is extremely difficult to wipe disease out completely. This is largely due to global immunization participation rates and recently developing problems with antimicrobial resistance of once more-controlled strains like Tuberculosis.

The world rejoiced after the last case of Smallpox was diagnosed in 1977. Since then, the disease is now 100% preventable. The World Health Organization, or WHO, hopes to establish polio as the next eradicated preventable disease. The prospects look bright for the United States and hopeful for the rest of the world. The WHO also believes that measles and a number of other illnesses will find termination in the near future.

Regardless of when or how these things will be accomplished, there are some problems facing eradication initiatives from all countries and organizations. Antimicrobial-resistant strains of diseases have been emerging recently, in particular Tuberculosis and MRSA (methicillin-resistant staphylococcus aureus). This keeps researchers on their toes not only to continue effective treatment, but also seek new solutions when resistant strains are discovered.

Antimicrobial resistance is definitely of concern on a global level. Drug-resistant tuberculosis, an airborne disease, and MRSA, a topically spread disease, have been found mostly in hospital settings. Diseases like these that are spread by touching and breathing are at times more difficult to be attentive to, so hospitals and other health care clinics around the world are needing to constantly monitor their sanitation and aseptic techniques.

Growing antibiotic resistance threatens previous WHO and UN accomplishments in immunizations and the economic standings between countries, and increases the cost of healthcare due to research and new treatment.

There are other problems surrounding vaccines that may appear closer to home. The University of Georgia only requires that students have a record of two doses of the MMR (measles, mumps, and rubella) vaccine. Although encouraged by many primary healthcare providers, a number of other vaccines are not required.

Once in college, there are a few vaccines that are recommended for young adults. Although these vaccines coincide with goals of both WHO and Healthy People 2020 goals, there is not a very high rate of usage. Campaigns for the flu vaccine are strong around The University of Georgia’s campus, but a large number of students still don’t get the vaccine. Some are worried that the vaccine

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can cause the virus; others believe strongly in their immune systems. Either way, the vaccination rate is not very high. The other vaccines recommended for this age group are Tdap and the HPV vaccine. Tdap is frequently received, but HPV remains somewhat controversial among different cultures and religious groups.

Regardless of where the effects lie, there is no doubt that many deaths each year occur because of vaccine-preventable diseases. In the United States alone, there are about 42,000 preventable adult deaths occurring annually. Globally, emerging diseases threaten trade and migration. The WHO even warns that there is a threat of returning to a “pre-antibiotic era” due to increasing resistance of disease strains.

The topic of immunizations is a complicated one. Just like human populations, pathogenic populations are continuing to change and adapt as we see through the rising problem of antimicrobial resistance. A number hurdles exist between many countries and disease eradication. Despite these challenges, organizations like the United Nations, World Health Organization, and Healthy People 2020 continue to revamp efforts in line with researchers around the world to control disease.

photo xavier donat (foter)

Spotlight | Pre-PA

Foreign Service Health Practitioner Barbara Gregory and local residents working

CAREER OVERSEAS Morgan Lorango

H

ave you ever wanted to travel or work abroad? Or serve your country and fellow man by providing medical attention to needy inhabitants of foreign countries? If you answered yes to these questions, you’re in luck!

The U.S. Department of State provides licensed physicians assistants the opportunity to start a career overseas by serving as a Foreign Service Health Practitioner. Among the 265 embassy locations open to the program are Berlin, Hong Kong, London, Moscow, and Tokyo. This excellent career opportunity allows participants to act as representatives of the United States and provide aid to those facing medical hardships overseas. The target locations often do not have the same technological advantages available to health professionals in the U.S.

Health practitioners’ primary responsibilities include providing a wide-range of healthcare services, as well as education and promotion photo iip state

of preventative medicine to the local community. The health ambassadors are also expected to outline an emergency action plan.

Licensed PAs must have a minimum of four years of direct patient work experience, two of which should be relevant to family practice. This requirement will give PAs the opportunity to decide whether or not they are satisfied with a career in the U.S. If not, those who have a strong dedication to public health may consider pursuing this career path.

Foreign Services Specialist and Health Practitioner Betty praises the program:

Every post has added to my worldview of the rich texture of our humanity. I have been enriched by the genuine smiles of the very poor and lilt of laughter from the elderly. My heart has been broken by the poverty that the world still allows for some of its citizens, yet heartened by its outreach to try and fix these everlasting problems.

Betty’s words reveal the essence of why

healthcare professionals pursue medicine. It is this notion that unites all healthcare professionals.

Working for the government always has its perks, namely, benefits. The benefits provided to Foreign Service Specialists and their immediate family members include excellent healthcare plans, medical leave, paid vacations, student loan repayment programs and so much more! The U.S. Department of State even covers the cost of housing and quality education.

Worried about the transition? Don’t be. Think instead of the cultural experiences you and your family will be afforded abroad. Allow this opportunity to enrich your life by pursuing a career path that allows you to give back.

For more information on this exciting career opportunity you may visit the U.S. Department of State website and search under careers.

premed magazine at uga | march 2013

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Spotlight | Research Lab

BY: NINA PALETTA

INFECTIOUS DISEASE LAB: DR. MOORE Lab Quick Facts: Lab Category: Infectious Disease Faculty Mentor: Julie Moore Lab Focus: Placental Malaria Contact Information: julmoore@uga.edu “In the history of medicine, few diseases have held such a grip on the human race as malaria.”

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photo united nations development programme (foter)

M

alarial fevers have been mentioned in ancient Sumerian writings from as early as 6000 B.C., and this disease still is prominent in the medical eye today. Each year, this parasite affects over 200 million people – even with modern medical advances – and causes over half a million deaths. In 2010 alone, 655,000 people perished from this infectious disease. The majority of these deaths occur in areas without sophisticated medical treatment options: although malaria can be deadly, if caught early enough, it is completely treatable. There anti-malarial drugs taken by travelers to prevent infection in areas where malaria is rampant as well as drugs to treat an established infection. In areas such as Africa, however, there are not enough resources to prevent this disease. Because of this, over 90% of the deadly cases of malaria are found in this region.

Malaria is caused by single-celled protozoans in the Plasmodium family.

Although there are four different species that infect humans, only Plasmodium falciparum is capable of causing a lethal infection. This deadly parasite is carried by the female Anopheles mosquito, and it is transmitted to the human host through saliva injected into the bloodstream during the mosquito’s bloodmeal. While in the gut of the mosquito, the gametes of the parasite fuse through sexual reproduction. The acidic conditions and low temperature of the gut enable the parasite to develop into sporozoites, which are able to infect human cells.

These sporozoites migrate to the salivary glands on either sides of the haemocoele, and as the mosquito injects the anticoagulating saliva into the human bloodstream during its bloodmeal, the parasite changes hosts. It travels to the liver of the human host where it transforms into the active bloodstream form. Once the parasite ruptures the liver cells, it is free to infect red blood cells, reproduce asexually, feed on hemoglobin and destroy the cells themselves. Eventually, some of the asexual bloodstream-type parasites develop into gametocytes (the sexually reproductive form of the parasite), and as another Anopheles mosquito takes a bloodmeal, the gametocytes enter their mosquito vector and the cycle repeats itself.

A malarial infection can differ in severity based on both the species of Plasmodium and the location of the infection. In general cases, symptoms of malaria include a cyclical fever, headache, chills, fatigue, nausea, vomiting and overall immune suppression. These

symptoms are cyclical due to the parasite’s growth and reproductive cycle in the red blood cells . In more severe cases, symptoms such as liver and kidney failure, pulmonary edema and hypoglycemia may cause death.

Plasmodium falciparum infections cause cytoadherence – cells infected with the parasite become sticky and bind to the walls of blood vessels. If the parasite migrates to the brain, cerebral malaria may arise, causing convulsions, coma and death due to clots in the small blood vessels. Malaria can also cause major complications in the placenta if a pregnant woman is infected. The infected red blood cells carrying the parasite stick to the placental tissue and become trapped. Immune cells can recognize the infection and ingest the infected red cells, but they cannot digest the hemoglobin present; the iron group is then expelled as a crystal. If these sticky red blood

deaths occurred in 2010 alone, and although the number is declining, over 3.3 billion people are at risk every year.

cells build up in the intervillous space, blood forms clots in the placenta, and gas, nutrient and waste exchanges are blocked between the mother and the fetus because of the lack of maternal blood flow.

The work that Dr. Moore is performing is not only incredibly relevant to global health, but it is also instrumental in finding ways to remedy maternal complications. Malaria is a treatable disease in most, but pregnant women are an exception. Dr. Moore’s research is helping to find ways to combat malaria in this demographic in order to decrease the loss of fetal development. With her collaborations with Dr. David Peterson in the Center for Tropical and Emerging Global Diseases, Dr. Moore’s research lab will continue to be successful in their endeavors.

Their findings may one day be the cornerstone in finding a cure for placental malaria.

Although malaria has been all but eradicated in the United States, there are still many preventative and treatment measures that are being taken against malaria worldwide.

In order to control the mosquito vector, insecticides have been used since the 1930s; however, DDT (the most potent of the insecticides) is becoming more and more discouraged due to the negative effect on the environment as well as mosquito resistance.

Drugs such as chloroquine have been developed over the years to combat the parasite infection, but such drugs are being highly misused in the areas that need them most, and parasites develop rapid resistance as a result. In Africa alone, over 600,000 malarial

Because of its intense worldly impact, malaria is highly researched topic in the Center for Tropical and Emerging Global Diseases. Dr. Julie Moore has been making enormous headway researching placental malarial immunity by working closely with women in western Kenya. Dr. Moore has been to the region multiple times in order to not only work in the field firsthand but also to have a connection with the people her research is benefitting. In her lab, Dr. Moore performs human studies that look at both T-cell memory responses in women with multiple malarial exposures as well as co-HIV infection. In pregnant women, there has been a correlation to gravidity (the number of times a woman has been pregnant) and T-cell recognition of the parasite – the more times a woman has been pregnant, the more immune her developing fetus is from maternal malarial transmission. Dr. Moore has been following women in Kenya throughout their lives, using their blood samples for her research. Dr. Moore is also studying the effects of HIV co-infection and how the presence of HIV increases immunity to malaria. In addition to these two main projects, Dr. Moore has produced mouse models in order to study the effects of the maternal immune response on the fetal unit – particularly how increased cytokine activity may cause irreparable damage to the fetus, causing spontaneous abortion.

premed magazine at uga | March 2013

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Featured

Setting the Pace of the

Future By: Natalie Dixon

Nearly everyone has had an accident, which initially seemed insignificant, that had a large impact on his life in the long run. John Hopps, a Canadian engineer, made one such accident that completely changed the face of medicine. In 1949, John Hopps was researching the use of radio frequency heating to restore body temperature in hypothermia patients, when he noticed that the frequency had the ability to restart the heart that had been stopped with cooling. He used this chance discovery to build the first external human pacemaker in 1950. Though his device was too large to be implanted within the body, Hopps’ breakthrough lead the way to arguably one of the most important devices in medicine. Nearly 25 years later, in 1984, John Hopps needed a pacemaker to regulate his heartbeat; by this time the procedure was routine The pacemaker is an electrical device that monitors and maintains the heart

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rate of people with a slow resting heart rate, which can be caused by either malfunction of the sinus node in the right atrium or a defect called heart block.

Heart block is a condition in which electrical signals do not reach the correct chambers in the heart, and as a result the heart rate is disrupted. The current pacemaker apparatus consists of a battery and a computer circuit, which is about the size of a wristwatch. There are several types of pacemakers; the two most common varieties are single chamber, which has only one wire connecting to one chamber of the heart, and dual chamber, which has two wires that connect to both the atria and ventricles of the heart.

A recent study led by Arnold J. Greenspon found a significant increase in the amount of pacemakers implanted in the United States during the past decade.

From 1993 to 2009, almost 3 million photo stev.ie (foter)

pacemakers were implanted in the United States alone. The number of implantations per year increased drastically from 121,300 in 1993 to 188,700 in 2009, an increase of nearly 60% over the time period. In addition to the overall increase in pacemaker use, a shift occurred in the type of pacemaker most commonly prescribed. The use of dual chamber pacemakers increased to constitute more than three-fourths of all implantations; meanwhile ventricular and atrial single chamber pacemakers decreased to combine for only 14% of implantations

The United States may be the leading country as far as number of individuals using pacemakers. However, a worldwide study held by Monash University in Melbourne, Australia, received information from 61 different countries and found that nearly every country documented a substantial increase in the number of pacemakers.

Driven by the rapidly increasing worldwide desire for better pacemaker technology, a group of engineers at Stanford University have designed a feasible structure for a wireless pacemaker device. This device, which is about the size of a pin head, could be implanted into the cardiac muscle tissue about 5 cm below the surface of the skin. Rather than using bulky batteries that eventually must be replaced by subsequent surgery when they run out of power, the engineers devised a system which is driven by electromagnetic power transferred to coils inside the centimeter-wide implanted pacemaker.

One major problem with the initial idea for wireless transfer of energy through the human body was the fact that the human body itself is an insulator. Through trial and error, the engineers found that extremely high frequency, and thus high energy, electrical waves can easily travel through the human body. In fact, it seems beneficial that the body is an insulator, because otherwise, the tissues would absorb some of the energy and convert it to heat, in which case the implant would not receive enough energy to function.

Following this high frequency model provides more than six times the eight microwatts needed to power the pacemaker. Another benefit of using high fre-

photo jurvetson (foter)

Pacemakers through history quency energy is that the receiver coils in the device can be reduced in size to the point that they are small enough to be implanted within the cardiac tissue of the human heart. By focusing the transmitted energy onto the small area of the heart where the device is located, tissue heating can be kept to a minimum while maximum power transfer can occur between the power producing device and the pacemaker implant.

The full article for the breakthrough has been published in Applied Physics Letters by senior author Ada Poon, an electrical engineering professor at Stanford.

With further study and confirmation of the device’s safety, this finding could change the face of modern medicine. The new pacemaker device will improve the lives of countless individuals across the world, because not only is the device much more easily concealable than the current form of pacemaker, but there is also no chance for repeat surgery to replace the battery. While the new device may be initially more costly than the traditional pacemaker, it will make up for the monetary costs in personal gains, such as freedom from worry of repeat

procedures and more self-confidence from the relative size of the new device.

Also, the technology could likely be applied to other types of internal medicine to simplify various procedures.

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Food often does not make it past the cities and into rural areas in developing countries.

World Hunger By: Sheela Sheth

H

ealth workers who visited a poor district in Rajasthan, India, found a small, sickly boy named Jitendra who weighed just 12.1 pounds when he was 15 months old. Born to a teenage, malnourished mother, Jitendra has suffered from repeated illnesses, and he remains extremely malnourished despite supplementary food provided by the health workers.

This one case of malnourishment represents reality for nearly 870 million people today. One of the United Nations’ Millenium Development Goals created in 2000 is to halve the number of people suffering from hunger between 1990 and 2015. Unsettlingly, the number of undernourished people increased to 1.023 billion between 1990 and 2009 and has decreased to a number still above that of 1990. One in eight people today do not have access to enough food to live a fulfilling and active life, and several global health issues around the world result from the empty stomachs of these millions of people.

Hunger leads to protein-energy malnutrition and micronutrient deficiencies, resulting in weaker immune systems to fight against infectious diseases, impaired physical and mental development and increased premature death.

Protein-energy malnutrition leaves those affected with an increased likelihood of suffering from more health problems. This form of malnutrition results from a diet deficient in carbohydrates, fats and proteins. When one’s body does not receive the average recommended 2,100 kilocalories per day, the body does not have enough energy to carry out other physical and mental activities. All of these activities are slowed down, and the mind does not have the willpower and concentration to pursue anything.

The severe protein-energy malnutrition affecting those in developing countries every day degenerates many organs such as the liver and heart. Additionally, the loss of subcutaneous fat reduces the body’s ability to store water and regulate temperature. In children, this malnutrition can result in stunting (the child will be too short for his or her age) and wasting (too skinny for his or her height). Lack of protein and energy cause marasmus and leaves suf-

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ferers appearing thin. If the lack is extreme, kwashiorkor can result and causes swelling.

The second form of malnutrition, micronutrient deficiencies, affects more than two billion people today. Key vitamins and minerals such as vitamin A, iodine, iron and zinc found in fruit, vegetables and animal products are difficult to obtain in developing nations. The lack of one micronutrient is associated with deficiencies of the others. Iodine deficiency gives rise to symptoms of hypothyroidism, such as fatigue, goiter and mental slowing. Since iron is essential in hemoglobin, myoglobin and several enzymes, its deficiency mainly leads to anemia, the lack of red blood cells. Vitamin A deficiency immobilizes iron and thus contributes to anemia. Reduced availability of this vitamin in the body also affects proper eye functioning and the immune system, and causes diarrhea. Zinc is necessary for many enzymes to function, and it affects several biological functions because of its link to metabolic processes. Deficiency of zinc interferes with protein synthesis, skeletal growth and immunity, and it is tied with a higher risk of diarrhea and pneumonia. photos united nations; jkirkhart; chris jl (foter)

Malnutrition makes people susceptible to other health risks, and hunger’s risk to health is even greater than those of AIDS, malaria and tuberculosis combined. Hunger must be cured before one can reach his or her full potential to carry out daily activities, attend school and work. Every hungry person poses an economic burden on the developing nation, and in order for a developing nation to progress, it needs to reduce its proportion of hungry people. A variety of actions must be taken to combat this deadly health issue plaguing the globe. Agricultural developments, food aid and economic regulation to keep prices low are just a few samples of possible solutions. However, with each new solution, consideration must be taken to other aspects of society. For example, although food aid seems to be a logical solution to help feed those in developing nations, its use can also prevent local farmers from selling food. Thus, agricultural and economic development is stunted even though the number of hungry people is being reduced. Other aspects of society should also be improved to directly or indirectly reduce malnutrition in these countries. The seven Millenium Development Goals established during the United Nations Summit in 2000 can all contribute to the reduction photo gates foundation (foter)

of malnutrition, such as through improved maternal health and universal primary education. Support to small farmers, to develop agricultural practices, and pregnant women, to ensure that they will breastfeed properly, is integral to the World Food Programme’s solution to solving hunger.

Solving hunger may be a large task to take on, but with each person fed, the world gains one more person to contribute to the economy and help make a developing nation more independent. For example, if Jitendra can grow healthily and attend school, he can bring his knowledge back to the small tribal village in which he grew up in the rural side of Rajasthan. However, if he stays malnourished, he cannot concentrate in school and must eventually find a means to make money without the necessary knowledge to obtain a stable job. Every person deserves a chance to live happily and achieve goals, and the only way he or she can do that is to be nourished.

Prevention of world hunger is a serious global issue that can bring a developing nation to its feet. As John F. Kennedy once said, “The war against hunger is truly mankind’s war of liberation.” premed magazine at uga | march 2013

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Featured

Pharmaceutical Sciences An Inside Look into UGA’s Newest Major

By: Erica Lee

Twenty students will become the first class to pursue a bachelor’s degree in pharmaceutical sciences at the University of Georgia in fall 2013. This new program is the Department of Pharmaceutical and Biomedical Science’s response to two problems in the pharmaceutical industry: a lack of workforce and gap in education in the current workforce. These problems cost the pharmaceutical industry hundreds of hours and millions of dollars every year.

The troubles began when American universities switched from offering a bachelor’s degree in pharmacy to the doctorate of pharmacy, or PharmD program in the late 1990s. The old bachelor’s degree in pharmacy allowed graduates to enter either pharmacy or pharmaceutical research. However, the PharmD program became the only

pharmacy program many institutions offered. Yet, although the PharmD program is excellent for training future pharmacists, pharmaceutical companies still need graduates trained in pharmaceutics, or the science of making new medications. Purdue University, the University of Buffalo, and the University of Michigan still offer a bachelor’s of pharmaceutical science, but three universities cannot keep up with the demand of an entire industry.

After the switch, most students interested in pharmacy became pharmacists instead of going into research and development, since their education favored the former discipline. Few students entered research and development, forcing pharmaceutical companies to turn to other sciences for their employees. These companies would hire brilliant scientists—biologists, chemists, biochemists, and others—to develop pharmaceutical

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medications, but sheer brilliance could not prepare these scientists to work in an industry as highly regulated as the pharmaceutical one. Companies began to spend hundreds of hours and millions of dollars on training, resources that could have been used for research.

Dr. Michael G. Bartlett, the director of the Bachelor’s Program of Pharmaceutical Sciences at the University of Georgia, said, “the [pharmaceutical] companies in Georgia were begging us to provide any kind of understanding of what the regulatory sciences really are to the student. They said that would put them years ahead of where they would be.”

Few people better understand the pharmaceutical industry’s need for a replacement program for the old bachelor’s degree in pharmacy than Dr. Bartlett does. He has not only worked with pharmaceutical companies to prepare his students for their

photo uga college of pharmacy; andrew davis tucker

future careers, but he has also experienced this problem firsthand. After he earned a bachelor’s degree in chemistry, he worked in the pharmaceutical industry for three years. While he excelled, he also realized that his specialization in chemistry was not ideal for pharmaceutical research. His employers constantly wished their employees knew more of the broad sciences and regulations.

In September 2010, Dr. Bartlett began designing the new bachelor’s of pharmaceutical sciences degree to address this problem by working with pharmaceutical companies and some of the same people who helped design the successful bachelor’s of pharmaceutical sciences program at Purdue University. Both programs use a strong understanding of the basic sciences like chemistry, biology and physics as a foundation for upper-level coursework that will prepare the students for careers in the research and development of pharmaceutical medications. The program at the University focuses on three main aspects: a foundation in a broad spectrum of sciences, knowledge of complex government regulations, and practical experience in lab research.

Students pursuing a bachelor’s of pharmaceutical sciences degree as freshmen and sophomores will rub elbows with other undergraduates in core classes like English composition, calculus 1, freshmen odyssey courses and introduction to public speaking, and share lab space with fellow science majors in courses like general chemistry, organic chemistry and biology. As they begin their junior year, students will dive headfirst into classes that will prepare them for an intensely regulated career.

Dr. Bartlett constructed these upper-level classes with the aim of giving students practical experience making pharmaceutical medicines in the lab according to the U.S. Food and Drug Administration’s regulations. One lab in the program is dedicated to pharmaceutical manufacturing and houses a current Good Manufacturing, or cGMP, training facility. This lab, modeled af-

ter labs in pharmaceutical companies, will allow students to gain experience handling and preparing medicines according to regulations. These students will be light years ahead of their colleagues, who, according to Dr. Bartlett, may “have very little or probably no understanding of what the FDA regulations actually mean. They may know how to do a procedure, but knowing how to do a procedure and knowing how to do a procedure in a way that the data would be acceptable to the FDA are two totally different things.”

Students who graduate from the University’s new program will not have to learn on the job, which could cost their companies time and risk potentially catastrophic fines from the US FDA. During their fourth and final year, students will study how to develop pharmaceutical medicines themselves in classes like Drug Development I and II. They will also spend one year in undergraduate research.

The pharmaceutical industry has responded enthusiastically to the the University’s new degree. Letters from CEOs of pharmaceutical companies praise the integration of regulatory affairs in the major, characteristics “integral to the job, but never included in traditional degree curriculums.” Companies that had a hard time finding and hiring new graduates for their quality and regulatory divisions will now be able to hire graduates from the University of Georgia who will be specifically trained in complex FDA regulations.

The University of Georgia refuses to ignore the booming pharmaceutical industry. In the past, major pharmaceutical companies chose not to house their headquarters in Georgia because of a severe lack of prospective employees. This new major will attract more pharmaceutical companies into Georgia and boost their revenue.

Students who major in pharmaceutical sciences can also apply to pharmacy school, medical school, or any other professional program including graduate school. The bachelor’s of pharmaceutical sciences degree at Purdue University, which this degree was modeled after, sent about half

of their graduates into the pharmaceutical industry, while the other half continued their education. Their industry salary was $56,000 to $61,000 per year in an entry-level position.

In a letter supporting the proposal of the major, Mark Fitch, the Senior Vice President of Operations at Nycomed US Inc., wrote that the graduates from Purdue’s program “filled several of our technical and production management positions. They immediately contributed to the operations and all have advanced rapidly through various career paths…and were extremely successful, having had the solid undergraduate training in the subject.”

The University is also offering a minor in pharmaceutical sciences and will soon offer a Master’s degree. The minor provides an opportunity for other science majors to gain valuable exposure to rigors involved in the development of medicines. Both the established bachelor’s of pharmaceutical sciences degree and the new minor will provide an appropriately trained workforce for pharmaceutical companies in Georgia and across the country.

If you are interested in pharmaceutical medicine, you have a rare opportunity. There is only one other program like this in the southeast, and only eighteen in the entire country, even though the pharmaceutical industry is clamoring for graduates. The open house for the degree was a success.

About seventy students attended, and many considered changing their major to pharmaceutical sciences, including Brittany Bowens, a first-year chemistry pre-pharmacy student. Paige Laine, who is also a pre-pharmacy student majoring in chemistry, thought the open house was “informed and thought out.” She also said, “While I’m still debating on changing my major, it would be very easy because I am pre-pharmacy.” If you are interested, contact Demetrius Smith at dsmith@ rx.uga.edu or Dr. Bartlett at mgbart@ uga.edu. You could also complete a change your major or declare a minor form.

premed magazine at uga | march 2013

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Clubs in Action

MEDLIFE & MEDSHARE

By: Aashka Dave

From building staircases in Peru to organizing Zombie themed 5Ks, students in MEDLIFE have done it all. In the past few years, they’ve not only accomplished a lot, but they’ve turned a lot of heads in the process. How? PreMed Magazine takes a closer look.

T

hree years ago, MEDLIFE at UGA was a small organization with approximately fifteen members. Today, MEDLIFE has grown into an organization of 100 members, with 6 board members who work to develop both Athens and global communities through MEDLIFE’s three principles of medicine, education and development.

In the past year alone, MEDLIFE at UGA hosted a zombie 5K, a battle of the bands benefit concert, the MEDLIFE Southeastern Regional Conference, trips to Peru and numerous community service initiatives. The takeaway questions: Yes, they do a lot, but why do they do it? What makes these students so passionate about the intersection of healthcare and community, and how did they all get started?

MEDLIFE at UGA’s future co-presidents, Sarah Premji and Zoheb Su-

laiman provide a lot of insight into these questions, and leave you with an urge to join in their efforts. They joined the budding organization after attending the Fall Activities Fair their freshman year. At the time, both were attracted to MEDLIFE because of the organization’s commitment to community development through medicine, and the tangibility of the results a student in MEDLIFE can produce.

For Sarah, that realization occurred at the end of MEDLIFE’s Zombie 5K, when everything came into place at the end and all their runners were lined up in their Zombie Best. For her, the feeling of having seen an idea come to fruition during her first term as co-president was a mark of the true impact MEDLIFE could have on the lives of others: “Although it was hard to see an outcome till the event, the ‘I did it’ moment made everything worth it.”

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In Zoheb’s case, the impact of MEDLIFE became visible thousands of miles from Athens in Lima, Peru.

As a volunteer for one of MEDLIFE’s mobile clinics, he spent this past winter break in a hands-on environment helping improve the lives of locals through health care treatment, health education, and infrastructure improvement: “It was a way to give back to the global community, and reaffirmed my life goals in the process.”

Today, MEDLIFE at UGA is planning their next battle of the bands concert for April 20th and establishing family groups for all members. That way, no matter how big MEDLIFE becomes, every member will be able to call the organization a home of sorts: a place where motivated, passionate, and inspired students join together to continue the efforts that comprise MEDLIFE at UGA. photo uga medlife

IN ACTION

By: Chisom Amaeze

“Every month, UGA Medlife members volunteer some of their time at the Medshare facility in Decatur, Georgia”

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n 1998 A.B. Short and Bob Freeman were growing increasingly troubled by the serious healthcare problems plaguing impoverished populations around the world, as well as the environmental threat of discarded medical supplies and equipment afflicting the U.S. The two men addressed this concern by creating Medshare, a nonprofit organization that distributes supplies and equipment discarded in the U.S. to places in need around the world.

Medshare states its purpose is to: “bridge the gap between surplus and need to improve healthcare and the environment through the efficient recovery and redistribution of surplus medical supplies and equipment to those most in need.” Every year a vast amount of medical supplies are discarded each day in the U.S alone. The waste is a result of procedural excess, regulatory requirements, or production overage. Medshare contacts U.S. hospitals, manufacturers, and distributors to gather discarded medical supplies that would otherwise just clutter a landfill. photos uga medlife, uga medshare

The donated medical supplies are then given to needy hospitals and clinics across the globe. Medshare shares the supplies in two distinct ways. One way employed by the organization is shipping medical supplies and equipment directly to healthcare facilities in the developing parts of the world. Medshare additionally brings necessities to developing countries via its medical mission teams.

Every month, UGA Medlife members volunteer some of their time at the Medshare facility in Decatur, Georgia. Medlife students help by packaging these discarded medical supplies, which are then shipped to eighty-eight different countries. Medlife members who have volunteered often describe the work as a true eye-opener to the desperate need for medical supplies and equipment faced by much of the world population. Medlife member Nick Boleman explained: “I nev-

er heard of Medshare... until I joined Medlife... As I became more involved in Medlife, I came upon a volunteer opportunity which happened to be Medshare. I never realized how such a simple act of packaging medical supplies could help so many people. It has motivated me even further to become more involved in services related to the medial field.”

These medical provisions are delivered to a wide variety of places including Nigeria, Turkey, and Haiti, to name a few. The wide assortment of supplies sent includes sterile gloves, syringes, centrifuges, stretchers, incubators, stethoscopes, fetal monitors, nebulizers, among others. Being a part of Medshare is as simple as signing up on the Atlanta branch website and donating a couple hours in the name of making an impact on countless lives.

premed magazine at uga | march 2013

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Pharm Chat

ePharmacy By: Abigail Shell

Click.

Browsers open.

Tabs appear. Images luminesce. Click. Click. Click. A deluge of information scrolls before your eyes. With a few miniscule twitches of muscle, you have breached the final frontier.

The Internet, the Web, el Red --call it what you will --- this tool has undeniably united the world.

After all, in Shakespeare’s words, “a rose by any other name would smell as sweet,” and sweet is definitely a viable adjective for describing the internet’s role in the global pharmaceutical market.

within and between departments and agencies, the internet’s full potential mushroomed once it entered the public domain. One of the most prolific uses that developed was electronic shopping, a service born of humans’ innate love of convenience. Soon, shoes, handbags, refrigerators, and dog houses were winging their way across the globe with a few clicks of a mouse (and the provision of a credit card number!). In no time at all, the pharmaceutical trade was ready to capitalize on this promising emerging market.

the internet branch of the pharmacy HyperDrug in 1998. Simpler transaction processes and large profit margins characteristic of web pharmacies caused the trend to spread quickly; internet pharmacies began cropping up throughout the developed world.

Though these new ventures were run from individual countries, the customer base spanned the globe, broadening the spectrum of economic competition. Large pharmaceutical companies soon began to feel the pinch. While countries like Great Britain and Canada had created safeguards to prevent the Originally a government proj- The first online pharmaceutical excessive control of medication ect aimed at facilitating storage entrepreneurs were chemists in prices by drug companies, the and transmission of information the United Kingdom who opened United States had not followed

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photo life mental health (foter)

suit. Under heavy influence from lobbyists, Congress had passed a law in 1987 preventing anyone other than a drug manufacturer from importing pharmaceuticals into the country. With that one piece of paper, internet pharmacies had lost all legal viability in the United States.

Despite its attempts at control, the US government’s action did not limit the market of the internet pharmacies operating within the US, as many simply sold their pharmaceuticals outside of the country. After all, America may be a leader in pharmaceutical research and innovation, but disease and infirmary know no borders. The pharmacies’ maneuver expanded the availability of FDA-approved medications around the world. Take, for example, InternationalPharmacy.com, a self-described “trusted source of high quality medicine from the USA” since 1994. A perusal of their site reveals a bevvy of namebrand and generic medications at variety of dosages and prices and available for shipment to almost any nation worldwide, (subject to importation regulations of individual countries,)

porations. Chain drugstores like Walgreens and RiteAid now offer the options of managing, transferring, and refilling prescriptions online as well as delivery to a “store near you”. According to medical supplier McKesson, however, mail-order pharmacies are “the fastest-growing provider of prescriptions to the U.S. insured population”. In addition to the ubiquitous drug stores, providers like GroupHealth have eliminated the need for trips to a pharmacy to fill a prescription. Their one caveat? Only refills can be ordered online. As long as this condition is met, with a doctor’s prescription, frail seniors and expectant mothers can have their medications delivered directly to their doors---as can frazzled students and harried housewives.

One worry still looms: how can consumers assess the safety of drugs ordered over the internet?

In the United States, the Food and Drug Administration is charged with overseeing the production of medications and ensuring their quality and safety, but their reach is truncated in relation to pharmaceuticals on the internet. Consumers buying medicines from the USA through websites such Americans are not completely as InternationalPharmacy.com bereft of the benefits of internet are charged to check whether the pharmacies. Though they may website indicates its provision of not lawfully purchase less expen- FDA-approved products. Followsive medications from Europe or ing the explosion of electronic other areas, entities known as pharmaceuticals, websites like mail-order pharmacies have filled PharmacyChecker.com appeared the internet niche in the American to direct customers to “verified pharmaceutical market. In prac- online pharmacies”, providing a tice, these are more of expanded potentially life-saving resource services than freestanding cor- for those with sparse knowledge

of the medical realm. Why are such tools vital? Drug counterfeiters usually operate where prices are the highest, a fitting description of the U.S., thanks to Congress’s prohibition of consumer importation of pharmaceuticals.

Other countries often have their own versions of the FDA to monitor pharmaceutical production within their borders. (Canada, for example, is home to the Canadian International Pharmacy Association [CIPA]). Reputable online pharmacies in these regions also carry a claim to provision of “verified medicines,” that is, drugs approved by the relevant agency.

In this century, the world is more interconnected than ever before, largely thanks to the influence of the internet. In terms of global health, this network means that medical ailments no longer occur in isolated pockets of suffering and that medicines and treatments can be transported the world over. With the rise of the internet, focus has shifted from community to online pharmacies---from the hassle of lines and lengthy dialogues to the convenience of keystrokes and mouse clicks. Such global competition no doubt makes for excellent economics, but not while the US plays by separate rules. Positive growth will continue only when all the major international players are able to engage equally in the still-emerging eforum.

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