News

Pediatric cardiology chief named by UofL

Pediatric cardiology chief named by UofL

Brian Holland, M.D.

A United States Army Medical Corps veteran with eight years of experience at the University of Louisville Department of Pediatrics has been named division chief of pediatric cardiology.

Brian Holland, M.D., has been serving as interim chief since 2017 and practices with UofL Physicians-Pediatric Cardiology.  The UofL Board of Trustees approved his appointment in March.

“Dr. Holland relentlessly pursues quality improvement initiatives, research projects and growth opportunities to enhance and improve pediatric cardiovascular services, both in UofL pediatric clinics and at Norton Children’s Hospital,” said UofL Department of Pediatrics Chair Charles Woods, M.D.

Holland is board-certified by the American Academy of Pediatrics, American College of Cardiology and American Society of Echocardiography. He joined UofL as a pediatric cardiologist in 2010. In 2015, he became the medical director for echocardiography, which is the use of ultrasound to obtain images of the structure and function of the heart. He also is chief of cardiology at Norton Children’s Hospital.

Holland specializes in fetal, transthoracic and transesophageal echocardiography. Fetal echocardiography uses ultrasound to find details of heart defects before birth. Transthoracic echocardiography looks through the patient’s chest wall to see the heart, while transesophageal echocardiography uses a device that passes through the mouth into the esophagus to obtain images.

Holland attended the University of Pennsylvania where he graduated summa cum laude with a degree in bioengineering and then received his M.D. degree from the Medical College of Georgia in Augusta, where he was awarded membership in Alpha Omega Alpha Honor Medical Society.

Following his graduation from medical school, Holland served seven years with the U.S. Army Medical Corps. While in the Medical Corps, he completed an internship and residency in pediatrics at Tripler Army Medical Center in Honolulu and served as a pediatrician in Germany. He also earned the Bronze Star for exceptional service while deployed as a U.S. Army physician during Operation Enduring Freedom in Afghanistan.

After finishing his military service, Holland completed a three-year fellowship in pediatric cardiology at New York-Presbyterian, the training hospitals of Columbia University and Cornell University, before coming to UofL.

Pediatric emergency medicine chief selected for leadership initiative

Becomes 20th from UofL selected for Executive Leadership in Academic Medicine program
Pediatric emergency medicine chief selected for leadership initiative

Michelle Stevenson, M.D.

Michelle D. Stevenson, M.D., M.S., has been selected to the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program. The chief of the Division of Pediatric Emergency Medicine and a professor in the Department of Pediatrics at the University of Louisville, Stevenson is the 20th faculty member chosen for the program from UofL and will join the 2018-2019 ELAM class.

ELAM is a yearlong fellowship for women faculty in schools of medicine, dentistry and public health. It provides leadership training with extensive coaching, networking and mentoring opportunities aimed at expanding the national pool of qualified women candidates for executive positions in the academic health sciences. Currently, more than 1,000 ELAM alumnae hold leadership positions at 257 academic health organizations in the United States and Canada.

Stevenson is board-certified in pediatric emergency medicine and in general pediatrics and is a fellow of the American Academy of Pediatrics. She practices with UofL Physicians – Pediatric Emergency Medicine and is on the medical staff of Norton Children’s Hospital.

She came to UofL in 2008 as research director and assistant professor in pediatric emergency medicine. Previously, she held academic appointments at Northeastern Ohio Universities College of Medicine and at the University of Cincinnati and was on staff of Cincinnati Children’s Hospital Medical Center and Children’s Hospital Medical Center of Akron.

She has earned competitive research funding virtually continuously since 2002. Currently, she has grant awards totaling nearly $1 million through 2023 and conducts health outcomes research through the executive committee of the Child and Adolescent Health Research Design and Support unit of the Department of Pediatrics.

Stevenson currently serves as associate editor of Academic Emergency Medicine and is an editorial board member for American Academy of Pediatrics Grand Rounds. She is lead or co-author of almost 50 peer-reviewed articles and four book chapters, and has presented or co-presented 75 oral or poster presentations at medical meetings throughout her career.

She is the recipient of numerous awards for teaching and mentoring medical students, residents and fellows and most recently, received the Outstanding Peer Mentor Award and Top 10 Faculty Peer Clinician-Teacher Excellence Award for Established Faculty from the UofL Department of Pediatrics in 2016. She also is a previous winner of the Celebrating Better Care Award and the Good Samaritan Award, both from Norton Healthcare.

Stevenson earned a bachelor’s degree in biochemistry from Indiana University and her M.D. degree from the University of Kentucky. She completed a residency in pediatrics at UofL followed by a fellowship in pediatric emergency medicine at Cincinnati Children’s Hospital Medical Center. She then augmented her education with a master’s degree in epidemiology from the University of Cincinnati.

For more information on the ELAM program, visit the program’s website. A complete list of ELAM alumnae selected while they were with UofL is shown below:

University of Louisville AlumnaeHedwig van Ameringen Executive Leadership in Academic Medicine Program

Kathy B. Baumgartner, Ph.D. (2008-2009): Associate Professor of Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences

Kimberly A. Boland, M.D. (2017-2018): Assistant Dean of Resident Education and Work Environment, Department of Graduate Medical Education, University of Louisville School of Medicine

Anees B. Chagpar, M.D., M.Sc., M.P.H. (2009-2010): Academic Advisory Dean, School of Medicine; Director, Multidisciplinary Breast Program; Associate Professor of Surgery; University of Louisville School of Medicine

Mary Thoesen Coleman, M.D., Ph.D. (2002-2003): Associate Professor of Family and Community Medicine; Vice Chair for Clinical Affairs, Department of Family and Community Medicine; University of Louisville School of Medicine

Lourdes C. Corman, M.D. (1996-1997): Professor and Vice Chair of Medicine; Chief, Division of Medical Education; University of Louisville School of Medicine

Connie L. Drisko, DDS (2001-2002): Professor of Periodontics, Assistant Dean for Research, University of Louisville School of Dentistry

Kelli Bullard Dunn, M.D. (2012-2013), Vice Dean, Community Engagement and Diversity, Professor of Surgery, University of Louisville School of Medicine

Susan Galandiuk, M.D. (2001-2002), Professor of Surgery, University of Louisville School of Medicine

Toni M. Ganzel, M.D., M.B.A. (2003-2004): Interim Dean, School of Medicine; Professor of Surgery, and Otolaryngology; University of Louisville School of Medicine

Diane Harper, M.D. (2015-2016): Rowntree Professor and Endowed Chair of Family and Geriatric Medicine, Department of Family and Geriatric Medicine, University of Louisville School of Medicine

Amy Laura Holthouser, M.D. (2016-2017): Associate Dean, Medical Education, Associate Professor of Pediatrics, University of Louisville School of Medicine

V. Faye Jones, M.D., Ph.D., M.S.P.H. (2007-2008): Associate Dean for Academic Affairs, Professor of Pediatrics, University of Louisville School of Medicine

Linda F. Lucas, M.D. (1999-2000): Associate Professor of Anesthesiology, University of Louisville School of Medicine

Sharmila Makhija, M.D., M.B.A. (2012-2013): Chair, Department of Obstetrics, Gynecology and Women's Health; Donald E. Baxter Endowed Chair in Obstetrics and Gynecology; Professor of Gynecologic Oncology; University of Louisville School of Medicine

Barbara J. McLaughlin, Ph.D. (2000-2001): Professor of Ophthalmology, Associate Dean for Research, University of Louisville School of Medicine 

Melanie R. Peterson, D.M.D., M.B.A. (2008-2009): Associate Professor of Dentistry, University of Louisville School of Dentistry 

Laura F. Schweitzer, Ph.D. (1998-1999): Professor, Department of Anatomical Sciences and Neurobiology; Associate Dean of Faculty Affairs; Associate Dean of Student Affairs; University of Louisville School of Medicine

M. Ann Shaw, M.D. (2013-2014): Vice Dean, Undergraduate Medical Education; Professor of Medicine; University of Louisville School of Medicine

Michelle Stevenson, M.D. (2018-2019); Professor of Pediatrics; Division Chief, Emergency Medicine; University of Louisville School of Medicine

Jill Suttles, Ph.D. (2010-2011): Professor of Microbiology and Immunology, University of Louisville School of Medicine

 

 

 

Let there be light

Distinctive glass makes Novak Center for Children's Health pedway bright and efficient
Let there be light

Workers harnessed to the scaffolding of a cherry picker are three stories above ground as they install glass in the pedway of the Novak Center for Children's Health.

As construction continues on the University of Louisville Physicians Novak Center for Children’s Health at the University of Louisville’s Health Sciences Center, a distinctive feature is now complete: the third-floor pedestrian bridge – the “pedway” – that links the new building to the UofL Physicians Health Care Outpatient Center and to the Chestnut Street Garage.

With soaring glass walls, the pedway provides a light-filled conduit between buildings. It is composed of 138 rectangular pieces of glass, each digitally printed with its own individual grid pattern of gray blocks, said Edwin Penna, project manager with Koch Corp. of Louisville, the company installing the glass. Workers are harnessed to a “cherry picker” – a crane with an attached scaffold – and rise three stories above the ground to install the panes into metal frames. No two panes are exactly alike, and seen from a distance, the panes of glass collectively compose an abstract design.

Each pane is approximately 63 inches wide and 1 inch thick, and they vary in height from 47 inches to 120 inches tall, Penna said. After ceramic paint is digitally applied, the glass is fired in a kiln so the design becomes part of the panes. A low-emissivity or “low-e” coating is then applied. Low-e glass emits a lower level of radiant heat than non-coated glass without shading it, making it more energy efficient while still allowing light to shine through.

The glass product is known as Digital DistinctionsTM and is manufactured by Viracon of Minneapolis, Minn. It is just one of a multitude of innovative products being incorporated into the Novak Center, making it both esthetically pleasing and environmentally friendly.

The first new health care delivery facility constructed in the Louisville Medical Center in nearly a decade, the Novak Center for Children’s Health is a 176,000-square-foot building that will be home to the general, specialty and subspecialty pediatrics programs at UofL. This includes faculty physicians from UofL’s Department of Pediatrics as well as other faculty from the UofL School of Medicine, including those in neurology, oncology-hematology, cardiology, surgery, ophthalmology and more. Faculty physicians at UofL practice with UofL Physicians.

Messer is construction manager for the Novak Center, which is on track for a summer opening. Photos of the pedway glass installation are available here.

 

UofL names Endowed Chair in Pediatric Clinical and Translational Research

UofL names Endowed Chair in Pediatric Clinical and Translational Research

Kyle Brothers, M.D., Ph.D.

A researcher who examines the intersection of ethics and policy decisions with human genetics and also studies the translation of technology into clinical care has been promoted to Endowed Chair in Pediatric Clinical and Translational Research at the University of Louisville Department of Pediatrics.

The appointment of Kyle Brothers, M.D., Ph.D., to the newly created position was approved by the UofL Board of Trustees at its March meeting.

Brothers is a board-certified pediatrician who practices with UofL Pediatrics – Downtown and is on staff at Norton Children’s Hospital where he chairs the Hospital Ethics Committee. He came to UofL in 2012 and also is affiliated with UofL’s Institute for Bioethics, Health Policy and Law. He previously was at Vanderbilt University School of Medicine.

Brothers serves with several national groups involved in research, most notably the Clinical Sequencing Evidence-Generating Research Consortium, a multi-site research program funded jointly by the National Human Genome Research Institute and National Cancer Institute that conducts translational research to evaluate the integration of genome and exome sequencing into clinical care. He also serves on the Social Issues Committee of the American Society of Human Genetics.  

His own research efforts have been funded virtually continuously since 2007, and he currently is involved in NIH-sponsored research projects that are funded at a total of approximately $7 million.

Brothers is a reviewer for 25 professional journals, including Science, PLOS One, Pediatrics, Genetics in Medicine, American Journal of Medical Genetics and others. He is a major author on 17 peer-reviewed articles and co-author on another 19. His inclusion in oral and poster presentations numbers 89.

Earlier this year, Brothers won a Department of Pediatrics Mid-Career Faculty Award, and he won a department Faculty Peer Clinician-Teacher Excellence Award three consecutive times, in 2016, 2015 and 2014. In 2011, he won the Scholars Abstract Award at the national Clinical and Translational Research and Education Meeting.

Brothers earned a bachelor’s degree with a double major in religion and biochemistry and molecular biology from Centre College in Danville, Ky., and his M.D. degree from UofL. He completed his internship and residency in pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt and later earned a Ph.D. degree in the Program in Ethics and Society at Vanderbilt’s Graduate Department of Religion.

 

Healthy eating during a Derby party? You can bet on it

UofL Physicians-Pediatric Endocrinology diabetes educator provides healthy and delicious recipes
Healthy eating during a Derby party? You can bet on it

Healthy and delicious choices like these cucumber and avocado sandwiches, healthy chicken fingers and bite-sized Derby pies will be the hit of any Derby party.

The extravagance of the Kentucky Derby is clearly on display each year through the rich diversity of the food and drink served both at the track and at the multitude of Derby parties held throughout the Bluegrass State. That extravagance, however, doesn’t mean sacrificing good health and sensible eating, said Whitney Cessna, M.S., R.D.N., L.D.N, diabetes educator at University of Louisville Physicians-Pediatric Endocrinology and at the Wendy Novak Diabetes Center, managed jointly by UofL and Norton Children’s Hospital.

“The Kentucky Derby might be my favorite event of the year,” Cessna said. “The entire week is nothing short of extravagance, full of events with exquisite cuisine. So it is important to remember to not overdo it on portions and remember everything in moderation is okay.”

Here are a tips, ideas and recipes Cessna recommends for indulging without over-indulging during the Derby:

Don’t skip meals:During Derby time, mint juleps and oak lilies are a must. When drinking, however, you might forget to eat because beverages can be just as filling as food. Also, the hustle and bustle of all the events during Derby season can leave less time for meals. Food is important to keep your body energized throughout the day. Pack snacks in a clear plastic bag and put in your purse or car to tide you over until you hit the buffet line.

Don’t overdo it on junk food: As difficult as it may seem, try to eat small, healthy portions throughout the day. Whether at Churchill Downs or someone’s home for a party, remind yourself to snack on fruits and vegetables such as carrot or celery sticks, strawberries, cantaloupe and the like, or foods rich in protein to satisfy those hunger cravings. “A tip I’ve learned,” Cessna said, “is as long as you bring food in a clear plastic bag, Churchill Downs will allow you to bring it into the track.” An added benefit: Bringing your own snacks helps save money you can use to bet on the winning horse.

Stay hydrated:Alcohol and highly salted food dehydrates your body very quickly, especially in the sunshine. Hydrate your body with water by alternating it with your other beverages, or drink water every hour to avoid dehydration and other heat-related conditions.

Remember: They key word to always keep in mind when going to parties where you know food will be in abundance is moderation. Be mindful of portion size and balance healthy choices with the higher-fat, higher-calorie ones.

Whether you need healthy ideas for your Derby party or ideas on what to select at the Millionaire’s Row buffet, Cessna offers the following recipes:

Cucumber and Avocado Sandwich

Yields: 2 sandwiches

Serving size: ½ to 1 sandwich

Total carbs per serving: 32 grams per sandwich, 16 per ½ sandwich

Ingredients:

  • 4 slices Dave’s Killer Bread (The 21 Whole Grains and Seeds option is recommended)
  • 4 oz. herbed goat cheese, at room temperature
  • Romaine lettuce leaves, washed and dried
  • 1 large cucumber, sliced in circular pieces
  • 1 avocado
  • 1 lemon, freshly squeezed
  • ½ cup alfalfa sprouts
  • Salt and pepper to taste

Directions:

  • Spread a little bit of the goat cheese on bread slices. Take one slice of bread and top with lettuce, cucumber and avocado slices.
  • Drizzle or squeeze a little lemon juice over the cucumbers and avocados. Add some sprouts and season with salt & pepper, to taste.
  • Place a piece of bread, goat cheese side down on top of the other slice of deliciousness. Cut in half and serve.

Healthy Chicken Fingers

Yields: 4 servings

Serving size: 2-3 tenders

Total carbs per serving: 17 g

Ingredients:

  • 1/3 cup all-purpose wheat flour or in case of gluten intolerance, gluten-free flour
  • 2 eggs, or in case of egg allergy, substitute with 1 tablespoon of ground flaxseed to 3 tablespoons warm water per egg; mix and let stand for 1 minute before using
  • Salt & pepper
  • 1 1/3 cup Panko breadcrumbs (whole wheat is recommended)
  • 1 tsp. sweet paprika
  • 1/8 tsp. garlic powder
  • 5 tsp. EVOO (olive oil)
  • 1 pound boneless, skinless chicken tenders

Directions:

  • Preheat oven to 400˚F. Coat pan with cooking spray.
  • Mix flour with a pinch of salt in a bowl. In a separate bowl, beat eggs or substitute and set next to flour.
  • Stir breadcrumbs, paprika, garlic powder and another pinch of salt in a third bowl. Drizzle oil over breadcrumb mixture and then mix thoroughly with a fork until all of the oil and spices coat breadcrumbs. Set aside.
  • Use one hand for wet ingredients and one hand for dry ingredients while dipping the tenders. Dip chicken tenders one at a time in flour mixture, coating each side. Dip into eggs, or egg substitute mixture, coating all over. Then coat with breadcrumb mixture on each side. Drench all tenders and place on baking sheet evenly.
  • Bake until tenders have reached an internal cooking temperate of 165˚F, or about 22 to 25 minutes.
  • Enjoy with any dipping sauce of your choice

 Bite-Sized Derby Pies

Yields: 12 servings

Serving size: 1 mini pie

Total carbs per serving: 18 g

Ingredients:

  • 2 packages of refrigerated piecrusts, whole-wheat recomended
  • ¾ cup chopped walnuts or pecans
  • 12 pecan halves for topping pies
  • ½ cup semisweet chocolate morsels
  • ½ cup firmly packed brown sugar
  • Pinch of nutmeg
  • ¼ cup bourbon, or for non-alcoholic version, ¼ cup water
  • 1 egg
  • 2 tbsp. unsalted butter
  • 1 tsp. vanilla extract
  • ½ tsp. salt

Directions:

  • Preheat oven to 350˚F. Spray a mini muffin pan with nonstick spray.
  • Lay out the piecrusts and using any small circular cup, cut 6 rounds from each dough, so you get a total of 12.
  • Place dough in each muffin pan. Press it flat into bottom of tins and around sides
  • For filling: melt butter in small bowl in microwave. Allow to cool slightly for a few minutes.
  • Whisk brown sugar, egg, vanilla, nutmeg and bourbon together in a bowl. Add in melted butter and whisk together. Stir in pecans or walnuts.
  • Sprinkle each pie with chocolate chips and a pecan half for each individual pie. Top with a pinch of salt.
  • Bake pies for 20-24 minutes until piecrusts are slightly brown.

 

Derby fans: Know these signs to help potential sex trafficking victims

Derby fans: Know these signs to help potential sex trafficking victims

Amidst the fun and excitement of the Kentucky Derby each year, signs of a dark world arise – the dark world of sex trafficking, particularly of children and teens.

It is a practice that always increases during high-profile events such as the Derby, say providers with the University of Louisville’s Kosair Charities Division of Pediatric Forensic Medicine. But armed with knowledge on what to look for, bystanders at the Derby may be able to help sex trafficked youngsters get help.

“The average age of sex trafficked victims ranges from 14 to 17, most are female, and we know that incidences of sex trafficking triple during the Kentucky Derby,” said Emily Neal, R.N., a forensic nurse specialist with the Kosair Charities Division of Forensic Pediatric Medicine.

“It is directly a case of supply and demand,” said Jennifer Green, M.D., child abuse pediatrics fellow in the UofL Department of Pediatrics. “The more people there are who are willing to purchase other people, the greater the number of people there are who are available to be purchased.”

Green and Neal provide these recommendations on what bystanders can do to recognize potential sex trafficked victims during Derby season:

  • Signs to watch for include young people who may appear overly sexualized for their age, do not possess or have control of their documentation such as driver’s licenses or passports, and who are in the presence of an older, usually male adult, who is controlling them and their behavior.
  • Sexually trafficked victims may have tattoos to “brand” them, such as bar codes or the names of someone other than themselves.
  • They could be wearing clothes that are inappropriate for their age, are too revealing or are not climate appropriate.
  • They could be staying confined to one area, seemingly to “work” that area for customers.
  • They could have signs of trauma: bruises, lesions, black eyes or other marks that raise concern.
  • They could have two or more cell phones in their possession, taking calls from all of them.

If Derby fans see someone they suspect may be a sex trafficked victim, Green and Neal emphasize getting professional help.

“The first step is to call the National Human Trafficking Resource Center Hotline, 1-888-373-7888,” Neal said. “The center will stay on the phone with you to help you get local resources, such as law enforcement, to intervene.”

“If you see direct signs of abuse to a child or are concerned about a child’s safety, involve law enforcement officers immediately and indicate your concerns clearly,” Green added.

 

 

 

Researchers find expert panel reliable, accurate in identifying injuries in young children as abusive, accidental

Findings from UofL School of Public Health and Information Sciences published this month in the Journal of Pediatrics
Researchers find expert panel reliable, accurate in identifying injuries in young children as abusive, accidental

Doug Lorenz, Ph.D.

When a child is brought to a pediatric emergency department with an injury, it can be difficult for physicians to precisely identify whether the injury is the result of abuse or an accident. One approach is to employ the opinion of a panel of pediatric injury experts.

In a study led by University of Louisville biostatistician Doug Lorenz, Ph.D., associate professor, School of Public Health and Information Sciences, the reliability and accuracy of a nine-member expert panel was measured in determining the likelihood of abuse in more than 2,000 cases. The results of the study that published recently in the Journal of Pediatrics found nearly perfect reliability and accuracy of the panel both individually and as a composite.

“Decision rules for identifying  injuries from abuse are valuable for settings such as pediatric emergency departments - in these cases, reliability and accuracy of human judgement is needed since victims of child abuse are at high risk of future abuse and death,” Lorenz said.

Each panelist received de-identified case information, including current and past data of the patient’s visit to a pediatric emergency department. The panelists independently rated the likelihood of abuse on a 5-level classification scale as “definite abuse,” “likely abuse,” “indeterminate,” “likely accident,” and “definite accident”. Each individual also provided a “yes” or “no” answer to a question on whether to report the case to state child protective services.
The study examined injuries involving children less than 4-years-old who visited pediatric emergency departments between 2011 and 2016 at five children’s hospitals in the United States. The expert panel included four child abuse pediatricians, four emergency medicine physicians and one bioengineer with expertise in pediatric injury.

At least two panelists reviewed each of the 2,166 cases. There was unanimous agreement in 852 cases (39-percent). An additional 1,048 cases (48-percent) exhibited partial agreement, where all panelists provided classifications of abuse (definite or likely) or accident (definite or likely). There were 44 instances (2-percent) of abuse-accident disagreement, none of which were in the definite category. In the remaining 222 cases (10-perecent), all panelists gave classifications of indeterminate.

The study tested the accuracy of the expert panel based on 584 of the 2,166 cases that could be more definitively classified as abuse or accidental based on other information learned after the child’s visit to the emergency department. This included video of an event, a third party account, a confession of abuse or criminal conviction of abuse, to name a few examples. Individual panelists accurately classified between 95 and 98-percent of the abuse cases and between 99 and 100-percent of the accident cases.

“We have demonstrated the reliability and accuracy of the expert panel approach, and suggest this method provides a suitable set of criteria for the future evaluation of clinical decision rules for identifying child abuse,” Lorenz said.

Lorenz collaborated with other UofL colleagues in the School of Medicine Department of Pediatrics and J.B. Speed School of Engineering. The study also involved researchers at the Northwestern University, University of Pittsburg, University of Utah, University of Washington and Yale University.
 

 

'Match Madness' once again a success for UofL Internal Medicine residency programs

Internal Medicine, Combined Med-Peds residency groups both fill their available spots with another set of strong incoming classes
'Match Madness' once again a success for UofL Internal Medicine residency programs

UofL fourth-year medical students celebrate Match Day 2018, when they found out where they will continue the residency portion of their medical education.


VIEW A PHOTO GALLERY FROM UofL MATCH DAY

Who said the madness of March was confined to the basketball court?

March 16 was Match Day for University of Louisville medical students, and others nationwide, as they opened their envelopes from the National Residency Match Program to find where they had been matched for their future training as residents.

"I would like to welcome an excellent group of young doctors to the internal medicine residency program," Jennifer Koch, M.D., FACP, Director of the UofL Internal Medicine Residency Program said. "We are honored to train this accomplished and diverse class of interns."

Conducted annually by the NRMP, The Match uses a computerized algorithm designed to the best results by aligning the preferences of applicants with the preferences of residency programs. The results are used to fill thousands of training positions available in the United States.

The UofL Internal Medicine Residency Program successfully filled all of its 24 categorical and 12 preliminary positions.

In addition the Combined Internal Medicine-Pediatrics Residency Program, under the direction of Laura Workman, M.D., added five new members.

Our incoming Class of 2021 includes:

Categorical Residents

  • Agastaya Nelur - Seth G.S. Medical College
  • Thomas Bierman - University of Louisville
  • James Bradley - University of Louisville
  • Wenjing Cai - Indiana University
  • Aaditya Chandramouli - Indiana University
  • Rishi Charate - University of Missouri-Kansas City
  • Sirmad Chaudhary - East Tennessee State University
  • Scott Diamond - Nova Southeastern College of Osteopathic Medicine
  • Mohamed Elmasry - Ohio University Heritage College of Osteopathic Medicine
  • Khusboo Gala - Grant Government Medical College
  • Katherine George - Nova Southeastern College of Osteopathic Medicine
  • Margaux Hetzman - Central Michigan University
  • Parth Jadav - University of Louisville
  • Yiran Jiang - Indiana University
  • Bokhodir Mamedov - University of Louisville
  • Leondrus McIver - Morehouse School of Medicine
  • Kyle Mills - University of Pikeville
  • Cody Moore - Indiana University
  • Chris Moser - Alabama College of Osteopathic Medicine
  • Sahil Patel - Drexel University
  • Gayatri Suresh Kumar - University of Arkansas
  • Ashley Twyman - Louisiana State University Shreveport
  • Pradheep Vermula - The Ohio State University
  • James Vernace - Lake Erie College of Osteopathic Medicine

 

Preliminary Residents

  • Ali Cohen - University of Iowa
  • Michael Del Busto - University of Cincinnati
  • Bryan Edwards - Indiana University
  • Collin Gamble - University of Louisville
  • Brian Gordon - University of Louisville
  • Dagan Kaht - University of Louisville
  • Aleksander Krazinski - Medical College of South Carolina
  • Samantha Sears - University of Louisville
  • Laura Taylor - George Washington University
  • Graham Trent - University of Maryland
  • Razvan Turcu - University of Louisville
  • Mengmeng Zheng - Indiana University

 

Combined Med-Peds Residents

  • Ariel Carpenter - University of Missouri
  • Caitlin McKenzie - Loyola University Chicago
  • Adam Neff - University of Louisville
  • Jonathan Phillips - Kansas City University
  • Kasey Reed - University of Louisville

March Madness doesn’t have to mean losing control over eating

March Madness doesn’t have to mean losing control over eating

Alternatives such as pretzels in place of high-fat chips, mini instead of full-size meatballs and the use of non-fat Greek yogurt in dips can help you be a champion of healthy snacking during March Madness.

New Year’s resolutions made in January to eat healthy don’t have to be sabotaged during March Madness, said Whitney Cessna, M.S., R.D.N., L.D.N, diabetes educator at University of Louisville Physicians-Pediatric Endocrinology. With a little information on how to practice good habits for snacking, you can be a champion at healthy eating.

“I recommend the practice of what we call ‘mindful eating,’” said Cessna, who provides services with the Wendy Novak Diabetes Center managed jointly by UofL and Norton Children’s Hospital. “Whether it’s the craziness of the ballgame itself or the stress of hosting a watch party, overeating can easily happen, and you should be mindful of that.”

Here are a few simple guidelines Cessna recommends to practice mindful eating during March Madness:

  • Listen to your body and stop eating when you are full. It takes about 20 minutes for the satiation signal to reach the brain, which is why we often overeat unconsciously.
  • When your stomach is growling or if you feel like your energy is low…eat. Don’t ignore the signals your body gives you or you could overeat later.
  • Eat with others at the same time to help prevent wandering around and eating at random times and places.
  • When it’s time to eat, just eat. Try not to be on your cell phone or engaging in other activities. This can cause overconsumption.
  • As much as possible, eat foods that are healthy and full of nutrients.
  • Try baking, not frying when preparing cheese sticks, wings or other game-time favorites to cut down on calories.
  • Serving size matters; serve mini corn dogs, mini meatballs or hamburger sliders when indulging in higher carb/fat foods.
  • Seek out crunchy alternatives; instead of potato chips, try carrots, celery or low-fat pretzels.
  • Use skim or reduced fat products when possible when making recipes with cream cheese or shredded cheese. Avoid regular mayo and use avocado mayo instead.
  • If making ranch or taco dip, use non-fat plain Greek yogurt.
  • If eating or making dips, serve with pita bread or baked chips rather than higher-fat fried chips.

Cessna offers the following recipes to help March Madness party planners provide healthy alternatives:

 

Black Bean & Corn Quinoa Salad

Serving size: ½ cup      Carbs in serving: 15 g

Ingredients:

  • 1 cup quinoa
  • ½ cup black beans, rinsed and drained
  • 1 Roma tomato
  • 1 tbsp. red onion, chopped
  • 1/3 cup frozen corn
  • 2 tbsp. fresh lemon juice
  • 1 tbsp. cilantro, chopped

Directions:

  • Cook quinoa according to package directions
  • In a large bowl, add all ingredients and mix until thoroughly combined
  • Serve immediately or chill in refrigerator and serve later on.

 

Wonton Taco Cups

Serving Size: 3 cups     Carbs in serving: 28 g

Ingredients:

  • 24 wonton wrappers
  • 1 lb. 85/15 or 90/10 ground beef
  • 1 packet of taco seasoning
  • Toppings of choice: shredded lettuce, salsa, shredded cheese, plain Greek yogurt (instead of sour cream), avocado, cilantro

Directions:

  • Preheat oven to 375˚ F.
  • Cook ground beef in skillet over medium heat until done. Drain. Stir in taco seasoning and cook according to package directions.
  • Spray a 12-cup muffin pan with cooking spray. Gently push wonton wrappers down in the cups. Add a second wonton wrapper on top of each cup, rotated slightly where the corners of both wrappers show.
  • Distribute ground beef mixture evenly between the 12 cups
  • Bake for 10-12 minutes or until edges are golden brown
  • Top with taco toppings of your choice and serve

 

Crockpot Buffalo Chicken Celery Sticks (Low Carb)

Ingredients:

  • 1 lb boneless, skinless chicken breasts
  • ¾ cup plain, Greek yogurt
  • ¼ cup hot sauce of your choice
  • ¼ - ½ diced onion (*optional)
  • 1 clove of garlic, minced
  • ¼ tsp. garlic powder
  • 1 bunch celery (8-10 medium stalks cut into 2-3 inch pieces)
  • Blue cheese, crumbled

Directions:

  • Add chicken breasts to bottom of crockpot/slow cooker
  • Combine yogurt, hot sauce, onion, garlic, and garlic powder in a bowl.
  • Cook on high for 3-4 hours or until chicken is cooked through.
  • Transfer chicken to a medium bowl and shred with 2 forks.
  • Fill celery sticks with chicken filling (1-2 tbsp. each)
  • Top with crumbled blue cheese, if desired

 

Chicken Salad with Apple Slices

Ingredients:

  • 1, 9 oz. pkg chicken breast strips, cooked
  • 3 apples
  • 1 tsp apple cider vinegar
  • ½ cup celery, chopped
  • ¼ cup dried cranberries
  • 2 tbsp. light cream cheese spread with veggies
  • 2 tbsp. avocado mayo
  • Salt & pepper, to taste

Directions:

  • In a bowl, combine cream cheese, mayo, vinegar, and pepper. Stir in chicken breasts, celery, and dried cranberries.
  • Slice apples into small, round circular, thin pieces.
  • Serve chicken salad on top

 

Zucchini Pizza Bites

Ingredients:

  • ¼ cup mini pepperoni
  • 3 zucchini
  • 1/3 cup marinara sauce
  • 1 tbsp. Italian seasoning
  • Salt & pepper, to taste
  • 1 tbsp. EVOO (olive oil)
  • ½ cup low-fat mozzarella

Directions:

  • Preheat oven to broil
  • Heat EVOO in large skillet over medium high heat. In small batches, add zucchini and cook, flipping just one time until golden brown on each side. Should be about 1-2 minutes. Season with salt & pepper, to taste.
  • Place zucchini rounds on a baking sheet. Top each zucchini round with a little marinara, mozzarella, and pepperoni minis. Sprinkle with Italian seasoning.
  • Put in oven and make until cheese has melted, about 1-2 minutes, and serve.

 

University of Louisville and Jewish Hospital Trager Transplant Center achieve 500th heart transplant

Celebration commemorates milestone
University of Louisville and Jewish Hospital Trager Transplant Center achieve 500th heart transplant

UofL's Mark Slaughter, M.D., performed the 500th heart transplant for the UofL and Jewish Hospital transplant team.

The University of Louisville and the Jewish Hospital Trager Transplant Center marked an important milestone on Wednesday – the 500th heart transplant performed at the hospital since the heart transplant program began there nearly 35 years ago.

“As we end American Heart Month, it’s the perfect time to share this wonderful news,” said Mark Slaughter, M.D., surgical director of heart transplant for University of Louisville Physicians and Jewish Hospital, and professor and chair, Department of Cardiovascular and Thoracic Surgery, UofL School of Medicine.

Dr. Slaughter performed the 500th transplant on Wednesday, Feb. 21, on a 59-year-old man who had a left ventricular assist device implanted to support his heart until the donor heart was available for transplant. An LVAD is a surgically implanted mechanical pump attached to the heart.

The first heart transplant at the hospital, which was also the first heart transplant in Kentucky, took place on Aug. 24, 1984, performed by the University of Louisville’s Laman Gray Jr., M.D. The state and region waited in suspense as 40-year-old Alice Brandenburg received a new heart. The surgery, which took seven hours, was groundbreaking at the time. The UofL and Jewish Hospital transplant team is one of the leading providers of organ transplantation in the country.

“Jewish Hospital is a place where miracles happen every day and patients’ lives are changed forever,” said Ronald Waldridge II, M.D., president of Jewish Hospital. “Five-hundred hearts is much more than a milestone. It represents the life-changing impact on our patients, their families and the entire region. Together, with UofL, Jewish Hospital’s Trager Transplant Center is investing in research, technology and advance procedures to increase access to transplant services.”

On Wednesday, doctors and heart transplant recipients gathered at the Jewish Hospital Rudd Heart and Lung Center to celebrate the 500th milestone and the many lives that have been saved over the years thanks to heart transplantation. 

“The 500th heart transplant is a reminder of the commitment by Jewish Hospital and the University of Louisville to provide advanced therapies for patients with advanced heart failure,” said Dr. Slaughter. “We’ve come a long way since Dr. Gray broke ground with that first heart transplant more than 30 years ago. Every day, we continue to advance the science of heart transplantation here at UofL and Jewish Hospital. I’m excited about the future of this program, and I’m confident that we’ll mark a lot more milestones over the next 30 years.”

For Dr. Gray, Wednesday’s celebration marked decades of dedication to the heart transplant program.

“After performing the first heart transplant, it means a lot to me to see the 500th and where we are today,” said Dr. Gray.

Gray continues to research new ways to help patients with heart disease at UofL’s Cardiovascular Innovation Institute, a center focused on bio-adaptive heart innovations, including the integration of heart-assist device, biodfeedback sensors and related technologies. In 2001, Gray and the Trager-UofL surgical team implanted the first fully implantable replacement heart, the AbioCor™.

Today, patients like Jeffrey McMahan continue to benefit from the heart transplant program. McMahan was the center’s 479th heart transplant, and he attended the celebration on Wednesday along with other recipients.

Before his heart transplant, McMahan, 61, was no stranger to the procedure – it had helped save many of his family members. The Memphis, Indiana, resident had four family members receive heart transplants - two by University of Louisville surgeons at Jewish Hospital. In 2015, McMahan learned he, too, needed one.

“I was serving in the military at Fort Knox when I developed a cough,” said McMahan. “It finally got bad enough that doctors flew me to Jewish Hospital, where I was diagnosed with a cardiomyopathy, a condition where the heart muscle is weakened. I learned that I would need a transplant in the next 10 years, but that timeframe quickly changed to 10 months after my condition worsened.”

On Aug. 15, 2015, McMahan was added to the organ donor transplant list. A month later, he received the transplant that forever changed his life.

“I wouldn’t have lived without the transplant,” McMahan said. “It means a lot to be here to celebrate the 500th. I’m forever thankful to the transplant team that helped save my life and gave me more time with family.”

It has been an exciting year for the Jewish Hospital Trager Transplant Center and University of Louisville team. In December 2017, the center – a joint program with the UofL School of Medicine and KentuckyOne Health – broke its all-time record for number of organs transplanted in the center’s 53-year history, with 175 organs transplanted in a year. The center also achieved several other milestones in 2017, including its 5,000th transplanted organ, its 3,000th kidney transplant and its 900th liver transplant. In addition to Kentucky’s first heart transplant, the program is known for performing Kentucky’s first adult pancreas, heart-lung and liver transplants.

But the 500th heart transplant and other milestones wouldn’t have been reached without organ donors, noted David Lewis, director of Transplant Services at the Jewish Hospital Trager Transplant Center.

“We often encourage people to sign up as organ donors to help save lives. The need for organ donors is unfortunately greater than the number of people who donate, so each day, an average of 20 people pass away while waiting for a transplant in the United States,” Lewis said. “Knowing that we have helped save 500 people in need of a new heart is a wonderful feeling, and it would not be possible without the donors and their families.”

For information on the Jewish Hospital Trager Transplant Center, visit www.kentuckyonehealth.org/transplant-care.

For video of the first heart transplant at Jewish Hospital, visit https://youtu.be/b8AFYN-TsDY.

$550,000 goal set for raiseRED Dance Marathon

Annual event helps fight pediatric cancer and blood disorders
$550,000 goal set for raiseRED Dance Marathon

raiseRED generated more than $459,000 in 2017 to fight pediatric cancer and blood disorders, and organizers intend to raise almost $100,000 more at the 2018 event on Feb. 23.

It’s time to shake it for a good cause. The University of Louisville student group raiseRED kicks off its 18-hour dance marathon Feb. 23 to fight pediatric cancer and blood disorders.

About 1,000 dancers will try to raise $550,000, about $100,000 more than the record-breaking amount the group collected last year.   

Patrick McSweeney, a freshman engineering student, is well on his way. Thanks to a viral video McSweeney made detailing his own battle with cancer, he’s already raised $20,000.

McSweeney, who is 18, was diagnosed with acute lymphoblastic leukemia, or ALL, when he was 5 years old. He learned last month that he has relapsed for the sixth time. He delayed his next cancer treatment in Philadelphia by a week so he could attend raiseRED and help others.

“I want to turn this negative situation of relapsing into a positive,” he said. “I want to help others, so that no one else experiences what I’ve been through, no one has to relapse six times. One time is enough. They can be cancer free after one time.”

The dance marathon kicks off at 6 p.m. Feb. 23 in the Swain Student Activities Center. The night is a mix of dancing, testimonials by patients and special guests to keep the dancers energized and focused on how their participation makes a difference.

The public is invited to take part in the Community Celebration from 10:30 a.m.-noon Feb. 24, which culminates in the grand reveal of the total number of dollars raised.

All funds from raiseRED go to research and patient care at the UofL Division of Pediatric Hematology, Oncology and Stem Cell Transplantation.

Learn more at raisered.org. To make a donation, go toraisered.org/donate.

Dr. Julio Ramirez Presents at Department of Medicine Grand Rounds

February 15, 2018 - "Clinical Research: From Idea to Publication"
Dr. Julio Ramirez Presents at Department of Medicine Grand Rounds

Julio A. Ramirez, M.D., FACP, Professor of Medicine/Associate Professor of Microbiology and Immunology; Chief, Division of Infectious Diseases; Director, Infectious Diseases Fellowship Training Program and Founding Director, Global Health Initiative at The University of Louisville, presented "Clinical Research: From Idea to Publication" at University of Louisville Department of Medicine Grand Rounds on February 15, 2018. The talk focused on performing an overview of clinical study designs, describing the planning and performing of a clinical study, reviewing the process for statistical and clinical analysis, and presenting the structure of a Clinical Research Coordinating Center.

A recording of the presentation may be viewed at the following link: UofL Dept. of Medicine Grand Rounds: Dr. Julio Ramirez

Dr. Julio Ramirez Presents at Department of Medicine Grand Rounds

February 15, 2018 - "Clinical Research: From Idea to Publication"
Dr. Julio Ramirez Presents at Department of Medicine Grand Rounds

Julio A. Ramirez, M.D., FACP, Professor of Medicine/Associate Professor of Microbiology and Immunology; Chief, Division of Infectious Diseases; Director, Infectious Diseases Fellowship Training Program and Founding Director, Global Health Initiative at The University of Louisville, presented "Clinical Research: From Idea to Publication" at University of Louisville Department of Medicine Grand Rounds on February 15, 2018. The talk focused on performing an overview of clinical study designs, describing the planning and performing of a clinical study, reviewing the process for statistical and clinical analysis, and presenting the structure of a Clinical Research Coordinating Center.

A recording of the presentation may be viewed at the following link: UofL Dept. of Medicine Grand Rounds: Dr. Julio Ramirez

It’s Heart Month. We know smoking is bad. So why don’t we quit?

New UofL treatment program addresses why our relationship with tobacco is ‘complicated’
It’s Heart Month. We know smoking is bad. So why don’t we quit?

The University of Louisville’s Rachel Keith, Ph.D., APRN, is a specialist in cardiovascular medicine and tobacco treatment and runs the new UofL Physicians Tobacco Treatment Clinic.

Smoking harms nearly every organ in the body. It causes about 1 in every 5 deaths in the United States each year, and is the main preventable cause of death and illness. We know the harmful effects of tobacco, so why is it so hard for people to quit?

“The benefits of not smoking, in particular to the heart, are huge. And with February being American Heart Month, it’s a good time to think about quitting,” said the University of Louisville’s Rachel Keith, Ph.D., APRN, a specialist in cardiovascular medicine and tobacco treatment. “But it’s a lot more than just halting a bad habit. That’s why we can say our relationship with tobacco is, ‘complicated.’”

Keith, who runs the new UofL Physicians Tobacco Treatment Clinic, said there are “strange dynamics” with tobacco.

“Smoking cessation is hard in general,” she said. “Helping patients to quit smoking often involves a lot of talking and figuring things out.

“We have to really get at WHY they smoke. Perhaps their grandmother died at age 100 even though she smoked, so they don’t believe there’s a connection. Or, she got them smoking and that’s their connection to her now that she’s gone.”

She said many people who come to the clinic have smoked for 30 or 40 years, and they are hesitant to quit. “That’s because it’s almost a part of them. In their view, you are taking away something they don’t know how to replace.”

She said she encourages patients to try different things and look for healthier alternatives when they have the urge for a cigarette.

“But when I ask them, ‘What are some other things you like to do for 10-15 minutes?,’ a whole lot of people can’t name those things. Many don’t have anything else. We try to help them find them, whether it’s a hobby or something like taking a walk,” she said.

But again, it’s complicated.

“A lot of patients feel sick, so they think they can’t get out and walk, even though they know it will be easier when they quit. There’s just a lot that goes into smoking, culturally and hormonally.”

People “can’t see the immediate effects of quitting, but they can quickly gain the rewards of smoking, because it’s almost instant. The body actually gets hard-wired to anticipate the effects from tobacco.”

That’s why the new clinic approaches all the factors that make it hard for people to stop, making it Louisville’s only comprehensive tobacco treatment program.

Keith meets with patients and develops a personal, individualized approach that best suits each patient’s needs. During sessions, Keith and patients discuss the benefits of stopping smoking, medication options, and different skills, such as mindfulness and relaxation, to help overcome anxiety.

Medications to treat withdrawal symptoms are paired with the cognitive-behavioral therapy to help patients sustain attempts to quit. Any medical issues also are addressed. One treatment Keith is studying is how to increase people’s motivation with virtual reality therapy, where an immersive session allows patients to imagine what life will be like once they’ve quit.

“The good news is, this type of program has been proven over and over as the most effective method for long-term cessation,” Keith said. “But until we opened, it was hard to find one in this area to get into.”

She said those who try to quit on their own have about a 6 percent chance of succeeding. If they work with a health provider, their chances improve to 10 percent to 15 percent. But with the comprehensive program, patients see a success rate of 30 percent and above.

“Those who have come through the program have done really well,” she said. “Almost everyone who comes through has quit.”

It generally takes about six sessions, usually once a week or every other week, to complete. Afterward, patients return on a more limited basis, and Keith follows up by phone.

Anyone who wants to quit smoking can come to the clinic, and many insurance plans will cover the program at little or no cost to the patient. It is located in Suite 310 of the UofL Physicians Health Care Outpatient Center, 401 E. Chestnut St.

To make an appointment, call 502-588-4600.

Valentine’s Day: For a healthy heart, strengthen your relationships

Risk factors for heart disease now include loneliness
Valentine’s Day: For a healthy heart, strengthen your relationships

University of Louisville cardiologist Lorrel Brown, M.D.

According to The Beatles, love is all you need. While it may not be all you need, there’s evidence it makes the heart healthier.

On Valentine’s Day, people may find themselves celebrating their relationships, or contemplating their lack of one. However, it’s not just love in the traditional sense that affects the heart, but also social bonds with friends and family.

University of Louisville cardiologist Lorrel Brown, M.D., studies the heart and says there is definitely a correlation between heart attacks, heart failure and other cardiac problems and loneliness, depression and anxiety.

While doctors know about the effects of diet, blood pressure and cholesterol on the heart, “now the medical community is interested in other components of heart health, that whole body connection,” Brown said. “Emotions are definitely part of this new way of understanding the body. Ideal cardiovascular health is now going beyond things you’ve already heard.”

In fact, some experts – including former U.S. Surgeon General Vivek Murthy, M.D. - are calling loneliness and social isolation a sort of epidemic, noting the increased risk for cardiovascular disease, among other health problems. Last month, the United Kingdom even appointed a “Minister for Loneliness” to address the finding that 9 million British people often or always feel lonely.

In an article in the Harvard Business Review in September, Murthy wrote, “Loneliness and weak social connections are associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day and even greater than that associated with obesity.

“But we haven’t focused nearly as much effort on strengthening connections between people as we have on curbing tobacco use or obesity.”

Brown said Eastern medicine has long correlated the connection between emotions, love and health, and Western medicine is now starting to apply science to those observations.

“There’s ongoing research now into the question, ‘Is there some way to intervene?’” Brown said.

She said “Broken Heart Syndrome” (clinically named stress-induced cardiomyopathy or takotsubo cardiomyopathy) is the most clear and dramatic example of the effect of the emotions on heart health.

The phenomenon, where people actually suffer from a broken heart, is common in medical literature, and named after a Japanese takotsubo, a ceramic pot used to trap octopus, as the stressed heart takes on the pot’s shape. The condition was first identified in Japan.

It starts abruptly, with chest pain and often shortness of breath, usually triggered by an emotionally stressful event, Brown said, and it is not uncommon to see after spouses argue or one passes away. People experiencing Broken Heart Syndrome often end up in the emergency room because they think they are having a heart attack, which is caused by a blocked coronary artery.

Tests will show an unusual shape of the heart’s left ventricle (the pumping chamber), with a narrow neck and ballooned lower portion, giving the condition the “takotsubo” name. While cause is still unknown, it may be due to an increase in stress hormones such as epinephrine and norepinephrine, and is treated with medication to block those hormones.

While all of our social bonds are important, “it does seem that married people live longer than those who aren’t,” Brown said.

There are a few small studies that show the benefits of traditional love on the heart, and “we do know that people react most positively to stress when they are in love,” she said. The hormone released in love is the powerful oxytocin, which also acts as a neurotransmitter in the brain. When oxytocin levels go up, blood pressure goes down, and the heart rate slows. Inflammatory markers also tend to go down.

“However, love can apply to other types of relationships as well,” Brown said. “Happiness and companionship are an important part of heart health. People with strong bonds, whether it’s a spouse, many friends, or a close family, tend to have healthier hearts. While we don’t understand yet the nuances, there’s certainly a significant connection.”

UofL study finds Medicaid expansion in Kentucky improves breast cancer care for women ages 20-64

A University of Louisville study has found a connection between Medicaid expansion and improved quality of breast cancer care, including an increase in the early-stage diagnosis of the disease and greater utilization of breast-conserving surgery.
UofL study finds Medicaid expansion in Kentucky improves breast cancer care for women ages 20-64

University of Louisville surgeon and researcher Hiram Polk, Jr., M.D.

A University of Louisville study has found a connection between Medicaid expansion and improved quality of breast cancer care, including an increase in the early-stage diagnosis of the disease and greater utilization of breast-conserving surgery instead of more invasive treatments, such as mastectomy. 

The study, “Evaluating the Early Impact of Medicaid Expansion on the Quality of Breast Cancer Care in Kentucky,” appears today on the website of the Journal of the American College of Surgeons in advance of print publication.

“We found several good things happened by the expansion of Medicaid,” said the study’s senior author, Hiram C. Polk, Jr., M.D., of the division of surgical oncology in the Department of Surgery at the UofL School of Medicine. “It really did work. The care was better because people were getting what they need.”

Since passage of the Affordable Care Act in 2010, 32 states and the District of Columbia have expanded Medicaid coverage, with the federal government covering the increased costs. Kentucky is one of the Medicaid expansion states, and the study looked at the effects of the expansion here.

“What we learned is that the expansion of some form of third-party coverage for health care leads to people doing more things that are intrinsically good for their health,” said Polk, who also has served as Kentucky’s public health commissioner.

UofL researchers who were co-authors on the study were Nicolas Ajkay, M.D., as first author; Neal Bhutiani, M.D.; Jeffrey Howard, M.D.; Charles Scoggins, M.D.; and Kelly McMasters, M.D., Ph.D. Also involved were researchers from the University of Kentucky.

The researchers looked at breast cancer as a marker of the impact of Medicaid expansion as it is “a very common cancer,” Polk said. “Our goal was to get an early measure of what really happened with Medicaid expansion.”

The study evaluated measures related to breast cancer from 2011 to 2016, using 2014 - the year Kentucky’s Medicaid expansion went into effect- as the cutoff between pre- and post-expansion.

“We knowingly took on the possibility of making too early of an observation on Medicaid expansion, but the degree of change that occurred so promptly in two years surprised me,” Polk said. “It’s amazing these changes happened in just two years.”

Researchers examined the Kentucky Cancer Registry for all women ages 20 to 64 who were diagnosed with breast cancer between 2011 and 2016.

From 2011 to 2013, 635,547 screening mammograms were performed in the state. That number increased to 680,418 from 2014 to 2016.

In 2011, 208,600 screening mammograms were performed, compared with 234,315 in 2016.

The number of screening mammograms covered by Medicaid increased from 5.6 percent before expansion to 14.7 percent after, and the number of women who had screening mammograms and were uninsured declined almost tenfold, from 0.53 percent before to 0.05 percent after expansion.

Breast cancer incidence and treatment rates did not vary significantly from year to year. But the changes in the rates of early-stage vs late-stage disease treated in the pre- and post-Medicaid expansion periods were statistically significant. 

Early stage (stage I-II) breast cancers accounted for 64.5 percent of the diagnoses in 2011-2013, compared with 66.7 percent in 2014-2016. Late-stage (III-IV) cancers accounted for 15 percent, compared with 12.9 percent.

Rates for breast-conserving surgery increased significantly after Medicaid expansion, from 44 percent pre-expansion to 48.8 percent, while rates of other resections, including mastectomy, declined, falling from 50.5 percent to 44.5 percent.

While the time from diagnosis to surgical treatment for the disease was shorter before expansion, an average of 28.6 days compared with 36, two other key treatment variables were either unchanged or improved after expansion:  time from the operation to chemotherapy (47.5 days before, and 46.6 days after); and time from the operation to radiation (96.4 days before, and 91.5 after).

“Chemotherapy and radiation didn’t happen as quickly as we’d like,” Polk said.

The study noted the findings were mirrored by experiences in other states, but Polk said a thorough analysis of the Medicaid expansion in Kentucky requires longer-term study. 

“Two years is a very short run,” Polk said. “But on the other hand, it’s a very pure study.”

Valentine’s Day is the perfect time to show love to your children

Need ideas? UofL pediatrician offers parents suggestions to be more mindful in showing love
Valentine’s Day is the perfect time to show love to your children

Spending time together as a family goes far in showing love to your children. (Photo: Bill Branson via Creative Commons)

There are many ways to show children love, and Valentine’s Day on Feb. 14 is a perfect time to be more mindful of those ways that work best.

Heather M. Felton, M.D., medical director of the University of Louisville Pediatrics Clinic at Sam Swope Kosair Charities Centre, endorses recommendations on showing love to children from the American Academy of Pediatrics.

“Love isn’t just something we feel; it’s something we do,” Felton said. “These suggestions give parents, grandparents and anyone else who loves a child concrete ways to show that love. Loved children grow up to be confident, secure adults.”

Felton and the academy recommend:

  • Say, “I love you,” often to your child, no matter his or her age. “This is probably the most important thing you can do,” Felton said.
  • Use plenty of positive and encouraging words when talking with your child. Positive language begets positive behavior.
  • Make an extra effort to set a good example about how to connect and talk with other people at home and in public. Children learn from observing and imitating their parent’s behavior.
  • Respond promptly and lovingly to your child's physical and emotional needs. Be available to listen to your child when she wants to talk with you even if it’s not the best time for you. 
  • When your child is angry, grouchy or in a bad mood, give him a quick hug, cuddle or other sign of affection he responds to and then talk with him about the event when he’s feeling better. Never respond in violence if your child is in a bad mood.
  • Use non-violent forms of discipline. Parents should start using both rewards and restrictions many years before adolescence to help establish ways to encourage strengths and address concerns during the teenage years.
  • Make plans to spend time alone with your child or teen doing something she enjoys. Encourage your child to be active by going on walks, bicycle riding, or playing ball with you. 
  • Spend time together as a family on a regular basis, such as one evening each week, and turn off cellphones and tablets during these family times.
  • Consider owning a pet. Having a pet can help children, especially those with chronic illnesses and disabilities, feel better by increasing their physical activity, enhancing their overall positive feelings, and offering another way to connect with someone they care about.
  • Help your child foster positive relationships with friends, siblings and members of the community. Have friends over for a meal, to play games, help others in need or for any positive group activity. Encourage your child to play sports or be involved in activities that show teamwork.
  • One of your most important gifts as a parent is to help your child develop self-esteem. Your child needs your steady support and help to discover his strengths. He needs you to believe in him as he learns to believe in himself. Loving him, spending time with him, listening to him and celebrating lessons learned from his mistakes and successes are all part of this process.

 

 

TV tip-overs pose danger for children

Every 3 weeks, a U.S. child dies from tip-over injuries
TV tip-overs pose danger for children

As fans prepare to watch the Super Bowl on Feb. 4, parents should be aware of the potential injury risk posed by televisions that can tip over onto children, says UofL pediatrician Heather Felton, M.D. (Photo: mojzagrebinfo / pixabay via Creative Commons)

As Super Bowl fans around the world prepare for one of the biggest television viewing events of the year, child safety advocates are urging parents and caregivers to look at their TV in a different way: as a serious injury threat.

Injuries and deaths from TV tip-overs happen more often than people might think, and health care professionals with University of Louisville Physicians-Pediatrics want to make sure parents understand how often these injuries occur and what they can do to prevent TV tip-over injuries.

Heather Felton, M.D.Research has found that every three weeks, a child in the United States dies from a TV tipping over, and hundreds more are injured, sometimes quite seriously. “It is important that parents and caregivers understand what actions they can take to protect their families,” said Heather M. Felton, M.D., medical director of the University of Louisville Pediatrics Clinic at Sam Swope Kosair Charities Centre. “To reduce the risk of TV tip-overs, TVs should be placed on furniture designed for TVs, and both the TV and the furniture should be securely attached to the wall.”

Older model televisions pose special concern, she said. “Older TVs are often moved to less safe locations in the home, such as on top of dressers and other furniture not designed for TVs. Children sometimes pull dresser drawers open to use as stairs to help them reach the TV, potentially pulling both the dresser and TV over onto themselves.”

Felton also is a member of Prevent Child Injury, a national group working to identify and prevent injuries to children. The group recommends the following to help safeguard children from TV tip-overs:

  • All TVs should be secured to the wall. Use safety straps or brackets for CRT TVs and wall mounts for flat-screen TVs.
  • Place TVs only on furniture designed to support televisions, such as TV stands and entertainment centers. Dressers, armoires, and chests of drawers are not safe places for a television.
  • Secure TV stands and entertainment centers to the wall using safety straps or brackets.
  • Do not place toys or the remote control on top of the furniture or the TV. Your child could climb the furniture to reach the item and cause the TV and furniture to tip over onto him.
  • Make sure TVs are safely secured in other places your child spends time, like the homes of family, friends, and caregivers.

If a child is injured by a TV tip-over, seek medical help immediately. “Do not assume that everything is OK if the child doesn’t appear hurt,” Felton said. “It is best to take the child to the doctor or emergency room at Norton Children’s Hospital to check for concussion or internal injuries that may not reveal themselves right away at home.”

ThePediatrics Clinic at Sam Swope Kosair Charities Centre is located at 982 Eastern Parkway. The clinic provides general pediatric care and appointments can be made by calling 502-588-0700.

#WeAreUofL

 About Prevent Child Injury: Prevent Child Injury is a national group of organizations and individuals, including researchers, health professionals, educators, and child advocates, working together to prevent injuries to children and adolescents in the U.S. Prevent Child Injury promotes coordinated communication to the public about prevention of child injury, which is the leading cause of death of our nation’s youth. To become a member of Prevent Child Injury or for more information and resources on this and other child injury topics, please visit www.preventchildinjury.org.

 

 

UofL heart researcher receives highest honor from state chapter of the American College of Cardiology

Roberto Bolli, M.D., to receive Honorable Maestro Award for work
UofL heart researcher receives highest honor from state chapter of the American College of Cardiology

University of Louisville cardiologist and researcher Roberto Bolli, M.D.

University of Louisville cardiologist and researcher Roberto Bolli, M.D., has been awarded the 2018 Honorable Maestro Award by the Kentucky Chapter of the American College of Cardiology, the chapter’s highest honor.

Bolli is director of UofL’s Institute of Molecular Cardiology and serves as scientific director of the Cardiovascular Innovation Institute at UofL. He is also a professor and chief of the Division of Cardiovascular Medicine at the School of Medicine.

The Maestro Award recognizes achievements in the field of cardiology and medicine, leadership in the regional and national cardiology community, charity work, mentorship and vigilant care of the sick.

In the past year, Bolli received one the largest grants ever for medical research at the University of Louisville, saw the impact factor jump on a major medical journal he edits, and led the Stem Cell Summit at the annual meeting of the American Heart Association in Anaheim, Calif.

The $13.8 million grant Bolli and his UofL team received from the National Institutes of Health is to study a promising new type of adult cardiac stem cell that has the potential to treat heart failure.

Bolli’s research focus has been on how to repair the heart and cure heart failure using a patient’s own stem cells. It is an approach that could revolutionize the treatment of heart disease.

He also serves as editor of the journal Circulation Research, which achieved its highest-ever “impact factor,” a measure of its importance in the medical field, last year. Circulation Research is an official journal of the American Heart Association and is considered the world’s leading journal on basic and translational research in cardiovascular medicine.

Bolli will be recognized and presented with the Maestro Award on stage at the Kentucky chapter’s annual meeting at the Lexington Center in Lexington, Ky., on Oct. 13, 2018.

A national talk the following year will be named in his honor.

Children require special care in cold weather

UofL pediatrician warns of susceptibility to frostbite, hypothermia
Children require special care in cold weather

The right clothing and avoiding exposure to frigid temperatures will keep kids safe from frostbite and hypothermia.

As temperatures plunge, University of Louisville pediatrician Heather M. Felton, M.D., reminds parents and other caregivers that children are more vulnerable to cold weather than grown-ups.

“Children exposed to extreme cold for too long and without warm, dry, breathable clothing can get frostbite or life-threatening hypothermia,” Felton said. “Children are more at risk from the cold than adults. Because their bodies are smaller, they lose heat more quickly.”

The medical director of the University of Louisville Pediatrics Clinic at Sam Swope Kosair Charities Centre, Felton provides the following advice on how to handle frostbite and hypothermia in little ones:

Frostbite: Frostbite happens when the skin, and sometimes the tissue below it, freezes. Fingers, toes, ears and noses are most likely to get frostbite. Frostbitten skin may start to hurt or feel like it’s burning, then quickly go numb. It may turn white or pale gray and form blisters. 

What to do:

  • If you suspect frostbite, bring your child indoors to gently warm up. Don’t rub the affected area, and don’t pop any blisters.
  • Avoid placing anything hot directly on the skin. Soak frostbitten areas of the body in warm – not hot – water for 20 to 30 minutes. Warm washcloths can be applied to frostbitten noses, ears and lips.
  • After a few minutes, dry and cover your child with blankets. Give him or her something warm to drink.
  • If the pain or numbness continues for more than a few minutes, call your pediatrician.

Hypothermia: When the body’s temperature drops below normal from the cold, dangerous hypothermia begins to set in. A child may start shivering, a sign the body is trying to warm itself up, but then become sluggish, clumsy or slur words. 

What to do:

  • Hypothermia is a medical emergency, so call 911 immediately.
  • Until help arrives, bring your child indoors. Remove any wet clothing, which draws heat away from the body.
  • Wrap your child in blankets or warm clothes, and give him or her something warm to drink.
  • Cover core body areas like the chest and abdomen.
  • If your child stops breathing or loses a pulse, give mouth-to-mouth resuscitation or CPR.

Preventing Frostbite and Hypothermia

“Frostbite and hypothermia are different conditions, but some wintertime planning and safety steps can help protect your child from both,” said Felton, who also cares for patients at Norton Children’s Hospital. She provides the following tips to parents:

  • Check the Wind Chill:  In general, playing outside in temperatures or wind chills below minus-15 degrees Fahrenheit should be avoided. At these temperatures, exposed skin begins to freeze within minutes. When possible, children waiting for school buses should wait inside their home or car with parents to avoid exposure.
  • What to Wear: Several thin layers will help keep kids warm and dry. Insulated boots, mittens or gloves, and a hat are essential. Make sure children change out of any wet clothes right away.
  • Take Breaks: Set reasonable limits on the amount of time spent playing outside to prevent hypothermia and frostbite. Make sure kids have a place to go for regular indoor breaks to warm up.

The Pediatrics Clinic at Sam Swope Kosair Charities Centre is part of UofL Physicians and is located at 982 Eastern Parkway. The clinic provides general pediatric care and appointments can be made by calling 502-588-0700.