Emory medical faculty last year were responsible for more than 3.3 million patient visits in clinical facilities either owned by or affiliated with Emory (see Hospitals and Clinics). These clinical services comprise a substantial proportion of all health care provided in Atlanta and cover the full spectrum from fetal to geriatric medicine, from primary care and preventive medicine to the most highly specialized care in the region. Many of these services are unavailable elsewhere in the city, state, or region.
     For example, Emory physicians practicing at Grady Memorial Hospital, a public hospital funded by DeKalb and Fulton counties, lead the state's only poison control center, one of the nation's largest burn centers, and the area's only level 1 trauma center, as well as the state's largest programs in sickle cell anemia, diabetes, lupus, and infectious disease.
     Emory also serves as the referral center for Georgia's newborn screening program and is responsible for follow-up of nearly 5,000 abnormal screening tests performed in six area hospitals each year. Emory has specialty clinics for patients with Down syndrome, fragile X syndrome, and other genetic disorders. Emory's Cystic Fibrosis Adult Program is the only program in the city providing care specific to the needs of the increasing number of adult patients with this disorder. In addition, the Emory Transplant Center is one of only a few such centers in the country providing islet cell transplantation for type 1 diabetes.
     The unique services offered, together with the breadth and diversity of the populations seen in facilities served by Emory, not only support the needs of Atlanta and the region but also make Emory's training programs some of the most sought after in the country.
     Despite increasing pressures placed on clinicians in today's challenging health care environment (especially for academic physicians with responsibilities for teaching and research and for treating the sickest of the sick in addition to a high relative proportion of indigent and uninsured patients), Emory clinicians continue to push the envelope, always seeking ways to improve care. Following are some examples.

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Heart care  
Emory University Hospital was the first hospital in Georgia to implant a ventricular-assist device without surgery. Unlike traditional ventricular-assist devices, which require surgery to access the heart, the new TandemHeart device is designed for insertion through the femoral artery. The device restores blood circulation in as little as 30 minutes. The resulting increase in blood flow helps save vital organs and gives damaged hearts a chance to heal, helping patients survive severe heart attacks or making those who need a heart transplant healthy enough to be placed on a transplant waiting list.
     This past year, faculty surgeons at Emory University Hospital also performed the state's first implant of a ventricular-assist device as a form of destination therapy (permanent therapy in place of a heart transplant). More commonly, such devices are used as a bridge to transplant.
     Physicians at Emory Crawford Long Hospital also were the first in the country to use a new advanced imaging system to detect heart and other diseases in their earliest forms. The system combines PET technology with the fastest 64-slice CT scanning available, allowing physicians to obtain highly detailed information in a single, noninvasive procedure.
Regenerative medicine
About 70% of people who have a heart attack suffer permanent damage to the heart muscle, and no treatments are available to restore function to this damaged tissue. Medical faculty conducting a new clinical study at Emory Crawford Long Hospital are trying to change that, using stem cells generated within patients' own bone marrow to grow new blood vessels to improve circulation around the heart. They are enrolling patients who have had acute heart attack within the past four to five days and who have already received the standard of care for their condition. This is one of some 600 clinical trials being conducted by Emory medical faculty.  
Brain tumors  
Radiation oncologists in the medical school recently performed Georgia's first frameless radiosurgery brain tumor treatment, eliminating the rigid head frame used typically in radiosurgery, which can cause discomfort, swelling, and bruising. Frameless radiosurgery requires only a custom-made mask, secured to the table on which the patient lies, and a fitted dental bite plate with embedded reflective markers. Matching a CT scan performed immediately before the treatment with a previous scan used to plan therapy corrects discrepancies in position, while an advanced optical radio-camera system uses the bite plate reflective markers to continuously track the patient's position.
Neurointensive care
Medical faculty will soon realize their dream of having a new state-of-the-art neurointensive care unit in Emory University Hospital. The new facility brings all neurologic services together on one floor, eliminating the need for patients to be moved long distances for necessary services, such as CT scans. The patient- and family-friendly unit also provides greater physical space for family members, who often spend extensive time with patients in the unit.
Traumatic brain injury  
No new medical therapies for traumatic brain injury (TBI) have been developed in more than 30 years, until now. Early results from a clinical trial designed and conducted by Emory emergency medicine physicians show that giving progesterone to trauma victims shortly after brain injury may reduce the risk of death and degree of disability. The study was conducted at Grady Memorial Hospital, where the level 1 trauma center is headed by Emory physicians. This study was the first clinical trial of its kind in the world, and the research team is now planning a multi-institutional phase III clinical trial of 1,000 patients with TBI. Other studies will determine progesterone's effectiveness in pediatric TBI, blast-related brain injury (a major cause of death among combat personnel), and acute stroke.
Palliative care  
Unlike hospice care, used for patients at the end of their lives, palliative care focuses on the many ways serious illness or chronic conditions affect patients and their families in any stage of illness. A new palliative care program was launched this year by medical school faculty at Emory University Hospital and Emory Crawford Long Hospital, with the goal of helping patients by relieving both physical and nonphysical suffering that accompanies serious, chronic, or terminal conditions.
For a list of the facilities in which Emory medical faculty practice, please see (see Hospitals and Clinics).  
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