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Unique program for medical students and Parkinson’s disease patients to be presented at World Parkinson Congress

Unique program for medical students and Parkinson’s disease patients to be presented at World Parkinson Congress

Kathrin LaFaver, M.D.

Students at the University of Louisville School of Medicine learn about Parkinson’s disease by spending personal time with patients who have the condition. Patients enjoy social engagement and the chance to help future physicians learn about their disease. The benefits resulted from the Parkinson’s Disease Buddy Program, a unique opportunity for UofL students and Louisville area Parkinson’s patients.

Kathrin LaFaver, M.D., the Raymond Lee Lebby Chair for Parkinson’s Disease Research in the Department of Neurology at UofL, designed the program and will present results from its first year in three poster sessions, Sept. 21-23, at the 4th World Parkinson Congress (WPC 2016) in Portland, Ore. More than 4,000 health professionals, researchers and advocates from around the world are expected at WPC 2016. The four-day event is organized every three years by the World Parkinson Coalition to share information on the latest science, clinical research and health care related to Parkinson’s disease. Denise Cumberland, Ph.D., assistant professor of organizational leadership and learning at UofL, and Erika Branch, executive director of the Parkinson Support Center of Kentuckiana, also will be presenting the posters, which feature both the patients’ and students’ perspectives.

The PD Buddy Program, the only one of its kind for patients with Parkinson’s disease, was launched in September 2015, a partnership between the UofL School of Medicine and the Parkinson Support Center. Twenty-five first-year students from the UofL School of Medicine were matched with patients served by the center. The students and patients met one-on-one monthly for nine months for activities and to allow the patients to share their experience in living with Parkinson’s with the students. The students kept a journal of their interactions with the patients and attended monthly lectures and mentoring sessions about Parkinson’s disease.

Participating patients were surveyed following the program and indicated they enjoyed interacting with the students and appreciated the opportunity to help them learn about Parkinson’s disease. The students’ knowledge scores about Parkinson’s disease rose 20 percent following the program, compared with their scores before the program.

“I got to learn about Parkinson’s and I got to take a break and spend some time with them. We mutually got something big out of it. It is a great program and a great setup,” said Megan Good, a second-year medical student who participated in the program’s first year.

The PD Buddy Program kicked off its second year on August 30.

At WPC 2016, LaFaver also will present a poster on unmet needs experienced by Parkinson’s disease patients based on research conducted at UofL. Surveys revealed that Parkinson’s patients and their caregivers find the most troublesome symptoms of PD are tremor, walking/balance problems and fatigue. These symptoms represent the greatest need for new therapy development.

Current, retired UofL faculty to be honored at 22nd Annual Doctor’s Ball

School of Medicine alumna also will be recognized
Current, retired UofL faculty to be honored at 22nd Annual Doctor’s Ball

Entertainment at the 2017 Doctor's Ball will feature a James Bond theme.

For 22 years, the annual Doctors’ Ball, hosted by the Jewish Hospital & St. Mary’s Foundation, part of KentuckyOne Health, has honored the service of local physicians and community leaders, and in 2017, four current and two retired faculty members and one alumna of the University of Louisville are among the honorees.

This year’s event is planned for Saturday, Oct. 21, at the Marriott Louisville Downtown, 280 West Jefferson Street in Louisville.

The black-tie event will include cocktails and silent auction beginning at 6:30 p.m., then dinner and an awards ceremony at 7:30 p.m. Guests will enjoy a Casino Royale experience during cocktail hour and after the program concludes. Live entertainment will be provided by Stretta. Tickets are $300 each.

The 2017 Doctors’ Ball will recognize some of the area’s most innovative and caring doctors and community leaders including:

Gordon Tobin, M.D. – Ephraim McDowell Physician of the Year
University of Louisville Professor of Plastic and Reconstructive Surgery Dr. Gordon Tobin became a surgeon because he was attracted to the challenges of intervening in major illnesses and injuries – addressing acute needs to alleviate pain and suffering. In 1978, Tobin came to the University of Louisville where he established himself as a triple threat: skilled clinician, teacher and researcher developing innovative approaches to problems arising from surgeries to treat cancer and heart disease, and from critical injuries like burns.

Dawne Gee, WAVE 3 News – Community Leader of the Year
Dawne Gee gives time to many causes, hosting as many as 200 charity events in a year. The Louisville native got into TV news more than two decades ago, while also enjoying 17 years in radio, including at WLOU, Kentucky’s first African American station. She currently anchors newscasts Monday through Friday at 5:30, 7:00 and 7:30 p.m., along with WAVE Country with Dawne Gee weekdays at Noon, profiling people working on behalf of the community. Gee has previously suffered from health issues including cancer and stroke, and has used her platform to help educate community members, also connecting them to the proper resources for help.

Valerie Briones-Pryor, M.D. – Compassionate Physician Award
Dr. Valerie Briones-Pryor is described by coworkers as a “team player who advocates for patients, treating them like a member of her own family.” The University of Louisville School of Medicine alumna is not only directing care during a patient’s hospital stay, but also looking after details like transportation, follow-up appointments and funds to cover medications over the long haul. Briones-Pryor continues to see patients in the hospital about one day a week, but her main focus is on the role of hospitalists like herself – physicians who work exclusively in the hospital, quarterbacking in-patient care and serving as liaisons with patients’ private doctors.

David Casey, M.D. and Valerie Casey – Excellence in Mental Health
Dr. David Casey, chair of the University of Louisville Department of Psychiatry and Behavioral Sciences, and Valerie Casey, director of the University of Louisville Women’s Center, work both separately and together to empower individuals and improve lives, one person at a time. Dr. Casey introduced the field of geriatric psychiatry to Kentucky. Under Valerie Casey’s leadership, the UofL Women’s Center likewise promotes advocacy and empowerment by mentoring and educating women to successfully transition into the workforce. The Caseys have extended their focus on empowerment to victims of human trafficking.

Norton Waterman, M.D. – Excellence in International Humanitarian Service
Retired surgeon Dr. Norton Waterman died on Oct. 6, but his legacy in the community lives on. Waterman noticed years ago that significant quantities of unused hospital supplies – from scrubs and bandages to wheelchairs and incubators – were getting tossed into landfills or left to gather dust in storerooms. Waterman, a clinical assistant professor of surgery at the University of Louisville, enlisted the participation of Louisville area hospitals and private doctors’ offices, collecting unused supplies, old model beds and medical equipment, to send to impoverished countries and overseas doctors. The collection project was later dubbed Supplies Over Seas, which is now one of only 15 medical surplus recovery organizations nationwide. The organization has collected and distributed nearly 1.5 million pounds of medical equipment and supplies since Waterman founded it. At the upcoming Doctors' Ball, Waterman's family will be presented with a posthumous award in his honor – the Excellence in International Humanitarian Service Award – recognizing the impact Waterman had on the community.

Gerald Temes, M.D. – KentuckyOne Health Excellence in Leadership Award
Former Louisville Mayor Jerry Abramson describes Dr. Temes as “a listener who seeks facts” whose “confidence and compassion enable him to lead organizations to the next level.” Temes’ portfolio of community leadership is extensive, including spearheading development and then serving as founding chair of the Jewish Hospital Rudd Heart and Lung Center, two terms on the Louisville Metro Board of Health, and decades of service to the Jewish Community of Louisville. The retired University of Louisville Professor of Thoracic Surgery says he is most proud of the creation of the Jewish Heritage Fund for Excellence in 2012, when he served as board chair of what was then Jewish Hospital HealthCare Services.

Sarah Moyer, M.D. – Humana Physician Excellence in Community Health Award
University of Louisville Assistant Professor of Health Management and Systems Science Dr. Sarah Moyer loves solving complex problems. Named director of the Louisville Metro Department of Public Health and Wellness this past July – just seven years after graduating from Temple University School of Medicine in Philadelphia – Moyer draws a parallel between treating individual patients, which she continues to do one day a week, and looking out for the health of the 750,000 residents of Metro Louisville. Moyer says she went into medicine because she wanted to help people stay healthy, and then became increasingly aware of the impact of social and environmental factors on every individual’s well-being. She went into public health, she says, “because I wanted to go upstream to help make a bigger difference in people’s quality of life.”

Proceeds from this year’s Doctors’ Ball will benefit the Jewish Hospital Trager Transplant Center patient assistance fund. The Trager Transplant Center is nationally recognized for performing Kentucky’s first adult heart, pancreas, heart-lung and liver transplants, as well as the first minimally invasive kidney donation in Kentucky. More than 5,000 organs have been transplanted at Jewish Hospital since 1964 including 500 hearts, 900 livers and 3,000 kidneys.

To purchase tickets to the Doctors’ Ball, visit kentuckyonehealth.org/DoctorsBall. For sponsorship opportunities, email Carol Wade at carolwade@kentuckyonehealth.org or call 502-587-4543.

Culinary medicine program gives future doctors hands-on skills to help patients eat better

UofL’s Eat 2B Well provides in-the-kitchen instruction to guide medical students in improving health with food
Culinary medicine program gives future doctors hands-on skills to help patients eat better

Eat 2B Well

A doctor, a dietitian and a chef walk into a kitchen …

No joke. They are there to teach medical students about choosing and preparing food that will sustain their own health as well as give them the tools to talk about food realistically with their patients.

The Eat 2B Well culinary medicine program is a new eight-week elective for students at the University of Louisville School of Medicine designed to help future physicians understand the challenges their patients face in obtaining, selecting and preparing foods. Eat 2B Well was conceptualized by Toni Ganzel, M.D., M.B.A., dean of the school of medicine, Jon Klein, M.D., Ph.D., vice dean for research, and Karan Chavis, the dean’s chief of staff. UofL nutritionist Diana Pantalos, Ph.D., R.D.N., developed the curricular content. Eat 2B Well was modeled on The Goldring Center for Culinary Medicine at Tulane University, developed by Timothy Harlan, M.D.

With increasing evidence that a poor diet causes or exacerbates many chronic diseases, it is more important than ever for physicians to help their patients eat well. However, physicians traditionally learn about nutrition in terms of science and clinical impact, which doesn’t always translate to helping patients eat better. Eat 2B Well is aimed at helping future doctors understand the issues their patients face in terms of resources, time and food preparation skills.

“Many of the chronic health problems that burden the Commonwealth, such as obesity, diabetes and cardiovascular disease, can be prevented through good nutrition. The goal of Eat 2B Well is to equip UofL medical students with the real-world practical knowledge of nutrition and healthy cooking so that they can best help their future patients,” Klein said.

Each Eat 2B Well class includes instruction on practical nutrition, disease association, and food preparation from a team that includes a registered dietitian/nutritionist, a professional chef and a member of the medical school faculty. Local chefs, including Anoosh Shariat of Anoosh Bistro and Noosh Nosh, Kathy Douglas of the Fresh Chef Experience and Bobby Benjamin of Butchertown Grocery provide instruction for the food preparation portion of the class.

Joining the medical students in the classes are students from the culinary track of YouthBuild Louisville, an education, job training and leadership program for low-income young adults ages 18-24.Classes include discussion of issues associated with food insecurity and the health problems resulting from poor nutrition. Class groups will then prepare meals utilizing cost-conscious ingredients readily available at grocery stores and markets in West Louisville, and prepared with equipment available in low-income homes.

“To talk comfortably about food, medical professionals need to be respectful of individuals’ food cultures, to understand how complex social factors influence food habits and to have hands-on experience preparing food themselves,” Pantalos said.

In the near future, organizers are planning to extend the program to include community engagement activities, providing at-risk families with food preparation education.

Whole Foods Market is providing food for the classes, which take place at Cooking at Millie’s, 340 W. Chestnut St. Additional sponsors include Gordon Food Service (GFS) and Save-A-Lot Grocery. New Roots, Inc. and the Sullivan University and Jefferson Community and Technical College culinary arts programs have provided logistical support.

 

Celebrity Chefs:

Eneitra Beattie, Brown Forman Corporation, Bourbon Street Café

Bobby Benjamin, Butchertown Grocery

Kathy Douglas, Fresh Chef Experience

Tina Lee, Fresh Stop Market, Dare to Care

Lorita Rowlett, Fresh Stop Market

Anoosh Shariat, Anoosh Bistro, Noosh Nosh

Gabe Sowder, Wiltshire Pantry

Andrea Wells, Farm to Baby Louisville

 

More about The Goldring Center for Culinary Medicine

Developed in 2012 by Timothy Harlan, M.D., at Tulane University, The Goldring Center for Culinary Medicine is directed by Chef Leah Sarris. Support for the center includes a director for research and development and the Teaching Kitchen Medical Student Club, which coordinates community outreach, medical student service learning and children’s programming.

UofL developing program to guide other universities in teaching palliative care

UofL experience to help build curriculum for faculty at other schools
UofL developing program to guide other universities in teaching palliative care

Barbara Head, Ph.D. and Mark Pfeifer, M.D.

Faculty members at the University of Louisville School of Medicine have begun developing a national training program to instruct educators at universities across the United States in teaching interprofessional palliative care to those who care for cancer patients. A team of interdisciplinary faculty members will incorporate expertise gained in the development of an interprofessional education program for UofL health professional students in oncology palliative care.

The National Cancer Institute recommends that patients diagnosed with cancer receive palliative care from the time they receive the diagnosis to improve the quality of life for both the patient and the family through relief from the symptoms and stress of a serious illness. It requires patient-centered care from physicians, nurses, social workers and others to meet the complex needs of cancer patients. However, many institutions instruct health professional students in palliative care within each discipline, known as silos, rather than as an interprofessional team.

Funded by a $1.4 million award over five years from the National Cancer Institute (NCI), the UofL training curriculum will build on a successful interprofessional program in education for palliative care in cancer already in place at UofL. The Interdisciplinary Curriculum in Oncology Palliative Care Education (iCOPE) was developed at UofL beginning in 2010 with support from a grant from the NCI. More than 1,500 students in social work, medicine, nursing and chaplaincy at UofL have completed the training, which remains a required curricular component.

“This is a first-of-its-kind program and we are fortunate to have an experienced team here as well as the continued support of the National Cancer Institute,” said Mark Pfeifer, M.D., the V.V. Cooke Chair and professor in the UofL Department of Medicine. “People diagnosed with cancer are best served by teams of professionals working together to provide patient-centered care.”

Through webinars, on-line training modules, a workshop, and mentoring through video conferences and one-on-one contact, the UofL faculty will instruct 160 health educators from 35-50 other institutions over a period of 10 months in developing curricula to teach oncology palliative care and teamwork to students across health disciplines. The program will include four-months of work at the home institution and a 2 ½-day face-to-face workshop, followed by six months of mentoring. Recruitment for learners in the program is expected to begin in early fall.

Faculty trained in this program will be able to overcome the effects of training in silos – within each discipline – and reinforce their students’ interprofessional skills by helping them understand the strengths, capabilities, skills, roles and cultures of the other professionals and instruct them in communication and collaboration among the team members.

“The new project includes evaluation of the home institution’s strengths and weaknesses to take on interprofessional education in oncology and faculty development, which will enable them to overcome barriers and successfully implement programs designed for their institutions,” said Barbara Head, Ph.D., associate professor in the UofL Department of Medicine.

UofL’s experienced interdisciplinary faculty, under the leadership of Pfeifer and Head, will serve as the core instructional team, guided by a committee of national experts and internal advisors. The iCOPE curriculum will be available to the trainees for use or modification as one approach to developing their own programs.

At the completion of the project, participating educators and others will be invited to a national summit on interdisciplinary palliative oncology education where they will share their experiences and present their own initiatives.

Knights Templar Eye Foundation, Inc., grant supports UofL research for improved retinoblastoma treatment

Nanoparticle encapsulation for melphalan may reduce number of chemotherapy treatments in children with eye cancer
Knights Templar Eye Foundation, Inc., grant supports UofL research for improved retinoblastoma treatment

Knights Templar of Kentucky presentation to UofL researchers

UofL researchers Aparna Ramasubramanian, M.D., and Jill Steinbach-Rankins, Ph.D., have received a grant from the Knights Templar Eye Foundation, Inc., to support their work in developing an improved chemotherapy treatment for retinoblastoma. Ramasubramanian, a pediatric ophthalmologist and ocular oncologist, and Steinbach-Rankins, a professor of bioengineering at the UofL J.B. Speed School of Engineering, are developing nanoparticles that will encapsulate the drug melphalan for use in intravitreal injections in the treatment of retinoblastoma.

Retinoblastoma is the most common type of eye cancer in children. Each year, approximately 300 children, usually under the age of 5, are diagnosed with retinoblastoma in the United States. The cancer begins in the retina, the layer of nerve tissue lining the inside of the back of the eye.

Melphalan is the most commonly used chemotherapy drug for intraocular injection in retinoblastoma. It is delivered into the vitreous cavity of the eye with the patient under general anesthesia. Since the drug degrades quickly, four to 12 injections may be required to control the tumor. Injection into an eye with an active tumor poses the risk of allowing the cancer to spread to other areas of the body, and with repeated injections, toxicity in the retina and the rate of complications increases.

Ramasubramanian and Steinbach-Rankins are developing a method for encapsulating melphalan using nanoparticles that will allow the medication to remain viable longer, reducing the number of injections needed and thereby minimizing the side effects and need for anesthesia.

“Typically the treatment requires six to eight injections. If we can reduce that number by even half, it would greatly reduce the risks associated with the treatment,” said Ramasubramanian, who specializes in the treatment of eye cancers.

They hope to have a version of the medication available for clinical trials within two years.

"Blindness from ocular retinoblastoma is a tragic occurrence but new treatments can prevent loss of vision and loss of life. Unfortunately, treatment can sometimes have significant adverse effects throughout the body,” said Henry Kaplan, M.D., chair of the UofL Department of Ophthalmology and Visual Sciences. “The ability to deliver effective anti-tumor medications in small particles (nanoparticles) directly into the eye should avoid this problem and allow a much easier treatment course for patients."

The Knights Templar Eye Foundation, Inc., incorporated in 1956, is a charity sponsored by the Grand Encampment of Knights Templar based in Flower Mound, Texas. Since 2010, the organization’s mission has been to improve vision through research, education, and supporting access to care.

“The Knights Templar Eye Foundation offers grants of $65,000 to researchers who are doing work in the field of eye research,” said Larry Carte, the deputy grand commander of the Knights Templar of Kentucky who presented the check on June 24. “The work Dr. Ramasubramanian is doing here is very important and they are pleased to offer her the grant to support her research.”

Ramasubramanian will have the option to apply for an additional grant next year if the project is not complete. The Knights Templar Eye Foundation has awarded research grants totaling more than $23 million to researchers working in the fields of pediatric ophthalmology and ophthalmic genetics.

How to work less and play more

Learn to reduce stress and enjoy life from psychologist Jacquelyn Graven at Beer with a Scientist, June 14
How to work less and play more

Charles, Graven and Levinsky

Wouldn’t life be great if we could just play all the time?

Of course, few of us can simply abandon our work, but there are ways to take the drudgery out of day-to-day life and bring our focus on the brighter side. At this month’s Beer with a Scientist, Jacquelyn Graven, Psy.D., of Graven and Assoc., along with two of her colleagues, Aaron Levinsky, Psy.D., and David Charles, Ph.D., will offer research-based tips for keeping life under control, reducing stress and allowing for a more relaxed day.

Graven and Associates is a private group practice that provides psychological and neuropsychological testing, therapy and treatment of psychological issues for people of all ages. The trio of licensed psychologists say it is possible to keep the play in your life through time management, prioritizing, balance and self care.

“A lot of people today work so darn much and they don’t take breaks. They don’t stop and manage their time very well,” Graven said. “That leads to burnout, depression and anxiety. Our talk is about managing your schedule and learning what to let go of. Research shows that reducing stress leads to greater efficiency, productivity, overall health and life happiness.”

Graven says one way to start is by controlling stress in your morning.

“Don’t just hit the floor and start running or your whole day will be pressure, pressure, pressure,” she said. “Give yourself time, whether you go to the gym or read a book or sit on your deck with a cup of coffee. Setting that pace in the morning will determine how you handle your day.”

Graven, Levinsky and Charles will elaborate on these and other ways to turn work into play beginning at 8 p.m. onWednesday, June 14, at Against the Grain Brewery, 401 E. Main St. in Louisville. A 30-minute presentation will be followed by an informal Q&A session.

Admission is free. Purchase of beer, other beverages or menu items is not required but is encouraged.

Organizers add that they also encourage Beer with a Scientist patrons to drink responsibly.

UofL cancer researcher Levi Beverly, Ph.D., created the Beer with a Scientist program in 2014 as a way to bring science to the public in an informal setting. Once a month, the public is invited to enjoy exactly what the title promises:  beer and science. For more information and to suggest future Beer with a Scientist topics, follow Louisville Underground Science on Facebook. Upcoming dates: 

  • July 12 – Lee Dugatkin of UofL – How to tame a fox and build a dog

Erica Sutton and UofL medical students improve access to colon cancer screening

Sutton and Surgery on Sunday Louisville receive award for providing colonoscopies for uninsured and underinsured
Erica Sutton and UofL medical students improve access to colon cancer screening

Erica Sutton, M.D.

Erica Sutton, M.D., assistant professor and director of community engagement for the University of Louisville Department of Surgery, and Surgery on Sunday Louisville (SOSL) were honored last week by the National Colorectal Cancer Roundtable (NCCRT) for efforts in colorectal cancer prevention. SOSL was presented an 80% by 2018 National Achievement Award during a live webcast on March 1 in honor of Colon Cancer Awareness Month.

Sutton, also assistant dean of medical education, clinical skills at the UofL School of Medicine, founded Surgery on Sunday Louisville, which provides colonoscopies and other surgical procedures for individuals who are uninsured or underinsured. Sutton, along with UofL medical students Sam Walling and Jamie Heimroth, who volunteer for SOSL, traveled to New York City to receive the award and participate in the live event.

National Colorectal Cancer Roundtable was co-founded by the American Cancer Society and the Centers for Disease Control and Prevention. The 80% by 2018 National Achievement Award recognizes individuals and organizations who are dedicating their time, talent and expertise to advancing needed initiatives that support the shared goal to regularly screen 80 percent of adults 50 and over by 2018. SOSL was one of five honorees recognized, along with the grand prize winner, Advocate Illinois Masonic Medical Center.Left to right:  Mary Doroshenk (Director of NCCRT), Jamie Heimroth (2nd year medical student at UofL, involved in SOSL), Christopher Head (SOSL Board Member), Erica Sutton, M.D. (Executive Director of SOSL, UofL School of Medicine faculty), Sam Walling (Medical Director of SOSL, 4th year medical student at UofL), Emily Bell (Associate Director of NCCRT), and Richard Wender, M.D. (Chief Cancer Control Officer, American Cancer Society)

Sutton, who practices with UofL Physicians and is chief of surgery at Jewish Hospital, part of KentuckyOne Health, has special expertise in minimally invasive procedures and surgical endoscopy. Through Surgery on Sunday Louisville, she and other physicians and health-care professionals provide in-kind outpatient surgical and endoscopic care to income-eligible members of the Louisville community who are uninsured or underinsured. Among the services provided are colonoscopies for patients who may be at high risk for colon cancer but who do not have adequate health insurance coverage to obtain the recommended colonoscopies to screen for the disease.

Despite a sharp increase in the percentage of individuals who have health insurance coverage thanks to the Affordable Care Act, Sutton said some individuals still cannot obtain the tests they need.

“We have had a very successful rollout of the ACA here in Kentucky. However, there are still gaps,” Sutton said. “We have people in Kentucky who cannot afford their ACA deductibles or insurance premiums. They are falling into those gaps. There are high risk people for colon cancer whose insurance doesn’t cover the recommended screenings so they would have to pay for endoscopies.”

Last year, Sutton, Walling and others published research in the Journal of the American College of Surgeons showing that providing free colonoscopies to high-risk individuals who could not afford the tests was cost-neutral compared with individuals who developed advanced colon cancer.

“One of the biggest messages we give is that Kentucky is doing a great job, but we still have a need for this program.”

In her role as director of community engagement for the UofL Department of Surgery, Sutton says she sees department-wide support for health equity.

“Our department as a group really does want to see surgical access for all people in our community. Individually, our surgeons stand behind that and put forth their time and resources so anyone who needs surgical specialist gets the help they need. I am very proud of how they do that.”

Walling, a fourth-year medical student at UofL, has volunteered with SOSL since its inception and now serves as the group’s medical director. He helped develop a program to formalize medical student participation in SOSL, which he says will enable a higher percentage of medical students to gain clinical experience prior to entering residency, allow them increased understanding of health disparities and the role of humanism in medicine. Walling will report on the effort, done in conjunction with the Distinction in Medical Education program, at the Association for Surgical Education Annual Meeting in April in San Diego.

Surgery on Sunday Louisville, Inc.

Founded in 2013, Surgery on Sunday Louisville is modeled after Surgery on Sunday, Inc., of Lexington, Ky., which has been serving Kentucky residents since 2005. Physicians and other volunteers provide surgical services to uninsured or underinsured patients every other month. Patients are seen twice a month in clinic for screening and post-op visits. Since its founding, more than 500 Surgery on Sunday volunteers have treated more than 270 patients in Louisville.

Event to provide HIV-prevention resources to women June 27

Women’s PrEP Summit aims to halt spread of HIV in women and transwomen
Event to provide HIV-prevention resources to women June 27

Nearly one-fourth of people living with Human Immunodeficiency Virus (HIV) in the United States are women, with 86 percent of these diagnoses attributable to heterosexual activity. For transgender women in the South, 43 percent received a diagnosis of HIV from 2009-2014.

Pre-exposure prophylaxis (PrEP), safer sex, protective devices and preventive treatments can reduce the spread of HIV. PrEP involves a daily pill, Truvada, which, when combined with safer sex techniques, can reduce the risk of HIV transmission up to 92 percent.

The University of Louisville and Project Compassion are hosting the free Women’s PrEP Summit, June 27, 2017, 5:15 p.m. - 8 p.m. at Redeemer Lutheran Church. The goal of the event is to educate women about their risk of HIV and empower them with the knowledge to prevent infection.

“Even one woman contracting HIV in our community is one too many,” said Karen Krigger, M.D., director of health equity in the UofL Health Sciences Center Office of Diversity and Inclusion.

Those at the event will receive information on PrEP, including how to get it and how to pay for it, as well as safer sex instructions and tips for using both female and male condoms. HIV testing and treatment information also will be available. June 27 is designated National HIV Testing Day.

Also available will be education about sexually transmitted diseases (STDs) and information on post-exposure prophylaxis (PEP), which can help prevent infection up to 72 hours after HIV exposure through sexual contact. IV drug users and their partners can obtain information about needle exchange and reducing risks from sharing needles.

Individuals at risk of getting HIV include:

  • Anyone who does not know if their partner has HIV or is being faithful
  • Anyone who has a partner with HIV
  • Anyone who uses IV drugs or their partner uses IV drugs
  • Anyone with multiple sexual partners

 

Women’s PrEP Summit:

June 27, 2017, 5:15 p.m. - 8 p.m.

Redeemer Lutheran Church, 3640 River Park Dr., Louisville, KY 40211

The FREE event includes dinner and childcare with registration. Transportation may be available with early registration. All participants will be eligible for door prizes and giveaways.

Space is limited. Register at UofL.me/womenprep or call 502-852-7181.

This event is sponsored by Project Compassion, Redeemer Lutheran Church, University of Louisville Health Sciences Center Office of Diversity and Inclusion, UofL HSC students, Volunteers of America, Kentucky AIDS Alliance, Louisville Metro Department of Health and Wellness, UofL LGBT Center, UofL School of Nursing and School of Public Health and Information Sciences, and other supporters. 

###

More about HIV prevention

The United States is making headway in the fight against HIV infection and AIDS. The number of annual diagnoses declined 19 percent from 2005-2014, but more than 1.2 million people in the nation are living with HIV. Individuals should be aware of steps they can take to protect themselves and others from infection.

  • Get tested for HIV as recommended by the U.S. Preventative Task Force.
  • Pre-exposure prophylaxis (PrEP) involves a daily pill, Truvada, which, when combined with “safer sex” techniques, can reduce the risk of HIV transmission up to 92 percent.
  • Condoms are highly effective in preventing HIV when used consistently and correctly.
  • Post-exposure prophylaxis (PEP) may be an option within 72 hours of exposure to HIV during sex.
  • Antiretroviral therapy (ART) reduces the likelihood that a person infected with HIV will transmit it to someone else.

NIH awards grant to take aim at legal barriers that hinder genetic research

Rothstein awarded $612,000 over two years

University of Louisville law and medicine professor Mark A. Rothstein, J.D., has received a two- year $612,000 grant from the National Institutes of Health to foster international collaboration on genetic research while maintaining human rights and privacy.

Rothstein is an expert on the legal and ethical issues raised by genetic research—including compiling large collections of biological specimens.

“International collaboration in genetic research is extremely valuable in advancing understanding and developing new therapies,” Rothstein said. “We need to make sure that essential privacy laws don't unnecessarily interfere with research."

Rothstein has a joint appointment at the Louis D. Brandeis School of Law and the School of Medicine. He holds the Herbert F. Boehl Chair of Law and Medicine and is the founding director of the university’s Institute for Bioethics, Health Policy and Law. He frequently writes and comments on issues of bioethics, genetics and health privacy.

Rothstein will conduct the research with co-investigator Bartha Maria Knoppers, a medicine professor and director of the Centre of Genomics and Policy at McGill University, Montreal, Canada. Legal experts from 26 countries will take part in the research effort.

Their findings and recommendations will take aim at removing legal impediments to international collaboration on health research and be published in the Journal of Law, Medicine and Ethics in 2016.

UofL ophthalmology researcher named chair of NIH study section

Group reviews research grant applications for scientific merit
UofL ophthalmology researcher named chair of NIH study section

Maureen McCall, Ph.D.

A professor in the Department of Ophthalmology and Visual Sciences in the University of Louisville School of Medicine has been named chair of a panel that reviews research grant applications, helping determine which are worthy for support from the National Institutes of Health.

Maureen McCall, Ph.D., has been named chair of the 20-member Neurotransporters, Receptors and Calcium Signaling Study Section of the NIH’s Center for Scientific Review. She is the only Kentuckian on the panel, which has representatives from universities in 14 states. Her term begins this month (August 2014) and will conclude in 2016.

The Center for Scientific Review is the gateway for NIH grant applications and their review for scientific merit. It recruits and organizes scientists into 174 study sections to review applications for funding made to the NIH.

Each study section has a precise focus so that applications receive expert reviews to help the NIH identify the most promising research. The Neurotransporters, Receptors and Calcium Signaling Study Section reviews studies that investigate signal transduction pathways in neurons, muscles and other excitable cells – those that can be stimulated to create an electric current.

McCall holds joint appointments as professor in the Departments of Anatomical Sciences and Neurobiology and Psychological and Brain Sciences. She came to UofL in 1997.

The author of approximately 60 journal articles, McCall uses electrophysiological techniques in her research to evaluate normal retinal function, dysfunction caused by blinding retinal diseases, and the restoration of function using a variety of therapeutic strategies. Particular areas of emphasis are in the study of retinitis pigmentosa, glaucoma and congenital stationary night blindness.

Remembering Asia Ludlow

James Graham Brown Cancer Center patient, spokesperson loses fight with cancer
Remembering Asia Ludlow

Asia Ludlow address the audience at The Julep Ball, a benefit for the James Graham Brown Cancer Center, on May 2, 2014.

University of Louisville President James R. Ramsey, Ph.D., and Donald Miller, M.D., Ph.D., director of UofL’s James Graham Brown Cancer Center, issue the following statements on the death July 2 from cancer of Asia Ludlow of Louisville:

“Asia Ludlow possessed great courage and an attitude that was so uplifting to all who came in contact with her. Her zest for life was an inspiration to all of us.

“Asia will always remain a driving force for everyone at UofL who work in the field of cancer to find the cures and preventions so that one day, no more lives are lost to this terrible disease.

“Cancer can be an all-encompassing experience, affecting every aspect of a person’s life. Asia dealt with cancer head-on with hope and optimism. The disease was in her body, never in her spirit.

“To her daughters and other loved ones, we express our deepest sympathies. As we grieve for her loss, we hope that memories of Asia will provide some comfort to all who knew and loved her.

James R. Ramsey, President

 

“It is with great sadness that all of us at the James Graham Brown Cancer Center, KentuckyOne Health and the University of Louisville mourn the loss of Asia Ludlow.

“Asia was a 2013 Survivor Ambassador at the Julep Ball, and the true champion that she was, she joined us again at the 2014 Julep Ball to share her story. We were honored again when she began volunteering at our M. Krista Loyd Cancer Resource Center, helping other patients with her unmatched spirit of hope and compassion.

Asia first fought breast cancer and kept fighting as it spread throughout her body. She was strong and committed, keeping faithfully to the treatment regimen prescribed for her – but her experience reminds us again that cancer is still a formidable enemy despite all we have at our disposal to combat it.

“Her odyssey as a patient with cancer began in 2008 and ended all too soon this week in mid-2014. Her life, however, serves as a legacy to show how one person’s grace, courage and caring heart can and does make a difference for others.”

Donald Miller, M.D., Ph.D., Director, James Graham Brown Cancer Center

To see and hear Asia’s message of hope in her own words, visit the James Graham Brown Cancer Center video here, her profile on Jean West’s Medical Digest here and her interview with Urban Lifestylez here.

UofL hosts international conference on the internet and hearing health

Presenters will address potential ethical issues and big data collection

The internet has had a significant impact on medical research and practice, allowing researchers to collect data on a much larger scale and conveniently provide certain types of health care. This week, audiologists, specialists in hearing disorders, from around the world will meet in Louisville to discuss benefits and pitfalls of using the internet for research and hearing health care (telehealth) for individuals with hearing impairment.

Jill Preminger, Ph.D., director of the Program in Audiology at UofL, is co-chair of the Third International Meeting on Internet & Audiology, July 27-28 on UofL’s Health Sciences Center campus. It will be the first such meeting outside Europe.

The first two meetings were organized by Swedish researchers, Gerhard Andersson, Ph.D., and Thomas Lunner, Ph.D., in 2014 at Linköping University in Sweden and in 2015 in Denmark. Preminger presented talks at both conferences and was asked to co-chair the first one to be held in the United States. Ariane Laplante-Lévesque, Ph.D., of Eriksholm Research Centre in Denmark and Linköping University in Sweden also is an event co-chair.

“I attended the first meeting because I was beginning to conduct research in which I hoped to develop an internet-based rehabilitation program for adults with hearing loss,” Preminger said. “At the second meeting, Dr. Lunner asked if I would be interested in hosting the next meeting.  They wanted to bring the meeting to the United States in order to open it up to a new audience.”

Research audiologists and engineers, as well as clinical audiologists and student researchers are expected at this year’s event from the United States, Canada, Europe, South America, Africa and Asia. Consistent with the event’s focus, five presentations and more than half of the 84 attendees will participate from remote locations via internet connections.

Conference sessions will address four themes:  Barriers and facilitators to telepractice, ethical issues related to internet-based research and services, big data, and methods for research and service delivery.

Elizabeth Buchanan, Ph.D., director of the Center for Applied Ethics at the University of Wisconsin - Stout, will give a keynote address on “Ethical Issues related to internet-based research and service delivery.” Internet-based programs to collect data and to provide clinical service can reach many more individuals, but new programs must consider the ethical issues that may arise. Buchanan will discuss whether it truly is possible to get informed consent for internet-based research or clinical service, and how to protect the privacy of participants and patients in online discussions.

Harvey Dillon, Ph.D., director of the National Acoustics Laboratory in Australia, will deliver a keynote via remote broadcast on the “Potential of Large Scale Data in Hearing Rehabilitation.” With the internet it now is possible to collect “Big Data,” from participants across a country or around the world. Dillon will address concerns about ethical and legal issues related to collecting data across countries as well as exciting possibilities for very large datasets that will allow for better decisions about the effectiveness of treatments across diverse populations.

The conference is sponsored by the Oticon Foundation and through a NIH (NIDCD) Conference Grant. Oticon, Inc. creates hearing aids, cochlear implants, other implantable hearing devices and diagnostic equipment related to audiology.

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About the Audiology program at the University of Louisville

The University of Louisville developed and implemented one of the first Doctor of Audiology (Au.D.) degree programs in the nation. The program has received national attention because of its early inception as well as the medical and business model used as the basis for instruction. Clinically, the program continues to set the community standard in the provision of hearing and balance care services, particularly in the areas of new technologies and pediatric services. The inclusion of the doctoral students in the clinical environment is an integral part of the program. Faculty members continue to be leaders on a national level in the development of the effective classroom and clinical teaching models through involvement in national committees and programs.

UofL-founded company secures $100 million to advance cell therapy to improve organ transplant outcomes

UofL-founded company secures $100 million to advance cell therapy to improve organ transplant outcomes

Suzanne Ildstad, M.D.

A company born at the University of Louisville has raised $100 million from investors to develop a therapy based on UofL research that could improve the lives of kidney transplant recipients.

Talaris Therapeutics, Inc, formerly known as Regenerex LLC, is using technology developed at UofL to allow living donor kidney transplant recipients to stay off immunosuppression drugs for the rest of their lives. In a Phase 2 study, the cell therapy, called FCR001, allowed 70 percent of living donor kidney transplant patients to be durably weaned off all of their immunosuppression treatments.

The unique cell therapy technology is a result of pioneering research conducted at UofL by the team of Suzanne Ildstad, M.D. Ildstad has spent 21 years as a “Bucks for Brains” researcher at UofL. She founded Talaris around her research and is the company’s chief scientific officer.

“This financing moves us one step closer to helping organ transplant recipients no longer be dependent on immunosuppressive drugs, resulting in a greatly improved quality of life,” Ildstad said. “The support and research infrastructure at UofL have been invaluable in our journey to this important juncture.”

The technology developed by Ildstad’s team was patented at UofL and is exclusively licensed by Talaris from UofL’s Office of the Executive Vice President for Research and Innovation. Talaris plans to use the new funding to carry out a Phase 3 clinical trial of FCR001. Longer term, the company plans to study whether FCR001 could be used for other organ transplants.

Talaris has approximately 25 employees in Louisville. Talaris’ research and cell processing facilities are based at UofL and the company also has a corporate office in Boston. As part of its licensing agreement with Talaris, the university will receive royalties from sales of any licensed products.

"This cutting-edge UofL research can have a significant impact on human health,” said UofL President Neeli Bendapudi, Ph.D.. “This is a prime example of our ability to work with industry partners and investors to help turn innovative research into valuable new products.”

 

Immunotherapy drug gives colon cancer patient another chance at life

First approved for melanoma, Keytruda® now can be used with several types of cancer
Immunotherapy drug gives colon cancer patient another chance at life

Rebecca Redman, MD and Lana Boes

Three years ago, Lana Boes of Charlestown, Ind., was at the end of her rope. She had been fighting colon cancer for nearly two years with multiple surgeries, two different chemotherapies, regular blood transfusions and more. But the cancer had returned and the chemotherapy no longer was working.

“I was down to 100 pounds. I really couldn’t eat. I had to take medicine to help me with my appetite. I just couldn’t do it anymore,” Boes said.

First diagnosed at age 43, Boes’s first surgery went well, but the cancer returned. After her second surgery, Boes started chemotherapy. Genetic testing revealed she had Lynch Syndrome, a genetic mutation that carries a higher-than-normal risk for cancer. When the first chemotherapy drug failed her, Boes started another, harsher chemo drug. That drug, too, eventually failed.

At that point, she was offered the chance to participate in a clinical trial for pembrolizumab, better known as Keytruda®, an immunotherapy drug previously successful in treating other types of cancer, but not yet FDA approved for the type of cancer Boes had.

“Lana started to suffer not only from the side effects of her cancer progressing, but also the side effects of treatment. It was clear that we needed something new and different,” said Rebecca Redman, M.D., Boes’s oncologist and deputy director of clinical research at the UofL James Graham Brown Cancer Center. “This clinical trial became available right around that time. It was based on some early evidence that suggested immunotherapy would be a really great option for Lana’s type of cancer.”

Keytruda is a type of immunotherapy that engages a patient’s own immune system to fight cancer. Cancer cells use a protein called PD-1 to hide from the immune system. Keytruda blocks the PD-1 pathway, Redman said, allowing the patient's immune system to recognize the cancer as something that doesn't belong and destroy it.

With support from her husband, Tim, Boes decided to enter the trial. She started receiving Keytruda in June 2016, and her condition improved almost immediately.

“With Keytruda, I got my life back. With chemo I went home and went to bed and you didn’t see me for the weekend,” Boes said. “With Keytruda, I didn’t go home and go to bed. I started getting an appetite and some strength back. I was able to enjoy doing things outside of my house again with family and friends.”

She remained on the immunotherapy drug for two years, completing the trial in June 2018. Regular checkups show that as of March 2019, Boes’s cancer is not detectable in scans or exams, and her cancer tumor marker numbers have remained within normal range. Redman considers her cancer in remission.

Boes says she has a fresh outlook on life, and can plan for her future.

“I used to refuse to book anything in advance. Everything we did was always last minute because I didn’t know if I was going to get to go,” Boes said. “I didn’t buy things that were for the future. I couldn’t talk about the future.”

Now she has plans to celebrate a special milestone in 2020.

“I never used to care about birthdays, but every birthday is a big deal to me now,” Boes said. “I turn 50 next November and I told my husband, ‘I never thought I was going to see 50, so I want to go to Italy.’ It’s huge for me in so many ways.”

While she is grateful for having the chance to participate in the trial with Keytruda, Boes also is grateful to Redman and to the staff at the Brown Cancer Center.

“Just seeing Dr. Redman made me feel better. She saved my life. She treats me with so much care. She sits down and she listens to me,” Boes said. “Every person at Brown is just so kind and they genuinely care. That makes such a huge difference when you are not feeling good.”

Redman, also associate professor at the UofL School of Medicine, said she has seen good results with immunotherapy in other patients with cancer like Boes’s. Unlike chemotherapy, which requires continued treatment, in some cases immunotherapy may allow a patient’s body to continue to control the cancer for an extended period of time.

“The most exciting thing about immunotherapy is that not only are we seeing remarkable tumor responses, but those responses seem to last a long time,” Redman said. “For some patients, it appears that once you train the immune system to attack the cancer, it may continue to do so for some time, possibly even after the immunotherapy has been stopped.”

Keytruda is the first drug approved by the FDA for the treatment of cancers based on a specific change in the DNA of the tumor, microsatellite instability (MSI), instead of where the cancer is in the body. MSI can be present in colon cancer but also in other organ cancers, and Keytruda is FDA-approved to treat cancers with MSI anywhere in the body.

Redman said that through her participation in the trial, Boes helped make it possible for other patients to have access to Keytruda for their MSI cancer. FDA approval typically means an insurance company will cover the treatment and makes the drug available to all patients.

“By participating in this trial, she has allowed this drug to move toward FDA approval, so immunotherapy now is a standard treatment for patients with microsatellite unstable cancers,” Redman said. “Thanks to patients like Lana who participate in clinical trials and take that extra step a little bit into the unknown, thousands of people will benefit and will have their lives turned around.”

Boes is most grateful to have the chance to live without cancer.

“I’m living my life normally,” Boes said. “I’m not cancer. Nobody treats me as cancer. I’m just me again and that is the best feeling ever.”

Participate in clinical trials

Volunteers always are needed to assist researchers solve health problems. Even if you do not have a health concern, you can be part of clinical trial research at UofL and at research institutions around the nation by registering at UofL.me/researchmatch. This nationwide database allows anyone to take part in important health research. Learn more by registering today.

To learn more about cancer clinical trials, visit the UofL James Graham Brown Cancer Center’s clinical trials page.

Gift to UofL aids research into biomarkers for cardiovascular disease

Late James Ryan made donation to lab of Andrew DeFilippis, M.D.
Gift to UofL aids research into biomarkers for cardiovascular disease

DeFilippis and Ryan

A half-million-dollar gift to the laboratory of University of Louisville cardiologist Andrew DeFilippis, M.D., by the late James Ryan will aid in research into biomarkers for cardiovascular disease.

The $500,000 gift to the Division of Cardiovascular Medicine at the UofL School of Medicine establishes the James Ryan Fund for Cardiovascular Biomarker Research. Ryan pledged the gift before he passed away at age 81 in 2018.

“Thanks to Jim, we can help physicians everywhere in diagnosing what is one of the most common causes of death in the world,” DeFilippis said. “He was always interested in others and what their dreams were, their goals in life, their happiness and how he could help.”

The fund will support annual operating expenses for the research led by DeFilippis, who is director of Cardiovascular Disease Prevention and an associate professor in cardiovascular medicine at UofL. DeFilippis is an expert in cardiovascular diseases and cardiac intensive care. His research focuses on cardiovascular risk prediction and the identification of biomarkers that will allow physicians to diagnose the cause of different types of heart attacks, also called myocardial infarction.

A heart attack is death of heart muscle. There are many causes, including the most well-recognized that occurs when one of the heart’s coronary arteries is suddenly blocked or has very slow blood flow secondary to the formation of a blood clot.

Atherosclerotic cardiovascular disease progresses over time, allowing time for screening and early detection. Advances in biomarker research and other developments have led to more sensitive screening methods and a greater emphasis on early detection and diagnosis.

“We’re working to develop biomarkers that will allow clinicians to differentiate among the many different types of heart attacks that can occur,” DeFilippis said. “Not all are the same, and even in the medical community that’s not always given much thought. But if we can differentiate, it will help us better treat patients, allowing us to limit or stop heart damage.”

A biomarker is a biological characteristic that can be measured and evaluated as an indicator of normal biological or pathological processes or a response to a therapeutic intervention. Examples include patterns of gene expression, levels of a particular protein in body fluids or changes in electrical activity in the heart.

Ryan, an active philanthropist and retired insurance executive, suffered from a heart condition himself. A native of Pittsburgh who graduated from UofL and lived most of his life in Louisville, he was on a quest to ensure his estate went to good use. He and DeFilippis forged a friendship through their activities with the American Heart Association. He visited DeFilippis’ lab within the Division of Cardiovascular Medicine several times, even bringing a group of friends.

“He was really involved – he was more than a donor,” DeFilippis said. “He gave advice and offered assistance in business, enabling us to partner with industry to bring our discoveries to market. We really enjoyed his company. The two of us went to lunch several times and talked about lots of things – the lab, his struggles with congestive heart failure and his bucket list. He had a great sense of humor.

“He was an extraordinarily happy man with a deep voice that was very distinctive,” DeFilippis said. “We will certainly miss his presence and his inspiring words about the work we were doing. We take it as a tremendous compliment that he chose to donate to us. Jim was looking for a quality program, great ideas and things that really make sense to improve the health of world.”

DeFilippis and one of his colleagues, Patrick Trainor, Ph.D., recently were invited editorialists for a new study published in the Annals of Internal Medicine that indicates current risk calculators for heart attack and stroke can sometimes be wrong, significantly overestimating some people’s risk while underestimating others' risk. As a result, many people may be unnecessarily taking medication to control risk factors such as high cholesterol and high blood pressure, and others may not be getting enough treatment. The researchers developed a new risk calculation method with a more sophisticated statistical model and newer population data, suggesting it could be more accurate.

UofL researchers escalate efforts against multi-drug resistant bacteria with FDA contract

Center for Predictive Medicine earns FDA contract to develop model for testing antibiotics
UofL researchers escalate efforts against multi-drug resistant bacteria with FDA contract

Regional Biocontainment Laboratory on University of Louisville ShelbyHurst Campus

Antibiotic resistance is one of the greatest infectious disease threats in the 21st Century. The United States Centers for Disease Control and Prevention (CDC) has estimated that drug-resistant infections are responsible for 23,000 deaths in the United States each year. Among the three most concerning antibiotic-resistant bacteria and fungi identified by the World Health Organization (WHO) is Psuedomonas aeruginosa.

Researchers at the University of Louisville Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases (CPM) are working at the forefront in combating these pathogens. The CPM has been testing the effectiveness of new drugs against P. aeruginosa under a contract with the National Institutes of Health since 2013, and a new contract from the U.S. Food and Drug Administration (FDA) will expand the center’s work in testing new drugs against this pathogen. Under the new two-year, $933,606 contract, CPM will develop a validated model for screening antimicrobial drugs against P. aeruginosa.

“This model likely will play an important role in drug development pipelines leading to identification of new antimicrobial drugs,” said Matthew Lawrenz, Ph.D., associate professor of microbiology and immunology who is leading the research. “Researchers at UofL and from around the world will use the model to screen new antimicrobials against multi-drug resistant bacteria prior to clinical trials.”

Forest Arnold, D.O., hospital epidemiologist for UofL Hospital and associate professor in the Division of Infectious Diseases in the UofL School of Medicine, said multi-drug resistant (MDR) bacteria and XDR bacteria, those with resistance to all existing antibiotics, are evolving faster than the drugs to kill them.

“The germs get smarter as we make new drugs. If we are going to stay on top of them, we need new antibiotics, especially new classes of antibiotics -- those with a new mechanism of action that the germ hasn’t seen before,” Arnold said.

Infections with MDR bacteria are particularly threatening for patients with weakened immune systems, those who have had multiple rounds of treatment with antibiotics, and in patients using devices such as ventilators and blood catheters. Since these bacteria are now resistant to many of the antibiotic drugs used to treat them, they can lead to severe infections and death.

“If you have an infection with a bacterium we don’t have an antibiotic to treat, it could kill you,” Arnold said.

P. aeruginosa is common in the environment and in otherwise healthy people, it may cause relatively minor infections of the ear, skin or eye. However, in people with weakened immune systems or in hospital settings, P. aeruginosa can cause serious, life-threatening infections of the blood, lungs, digestive tract or tissue. Infected wounds will have a green pus or discharge and a fruity smell.

The validated animal model, to be developed by UofL researchers with collaborators at the University of Kentucky and the University of Wisconsin, will be used to test new compounds developed by drug companies and research labs around the world against P. aeruginosa. This model will allow testing against multiple strains of pseudomonas and will give more detailed information about the effectiveness of the drugs being tested.

“The previous methods we used for testing the drugs provided basic information about a compound’s effectiveness. This new model will allow us to test anything from older classes of antibiotics to brand new classes and will provide information on dosing and scheduling. In addition, we will be able to test different strategies, such as immunomodulation – targeting the host to better respond to the infection as opposed to directly killing the bacteria,” Lawrenz said.

The CPM’s new contract with the FDA will take advantage of the sophisticated resources at the Regional Biocontainment Lab, located on the UofL ShelbyHurst Campus, which provide the environment necessary for this work.

“This new contract from the Food and Drug Administration supports the development of a model for understanding how bacteria build resistance to current commercially available antibiotics, which in turn, will lead to the discovery of new drugs or methods to combat a variety of infectious diseases,” said Robert Keynton, Ph.D., interim executive vice president for research and innovation at UofL. “The UofL Center for Predictive Medicine and the Regional Biocontainment Laboratory represents a significant investment in infrastructure, faculty and staff by the university in the field of emerging infectious diseases, which is one of our research and training strategic priorities."

 

 

March 4, 2019

Louisville and Lexington Eye Banks merge to better serve Kentucky and beyond

Single eye bank based in Louisville will serve entire state and portions of W. Va., aligns with area served by Kentucky Organ Donor Affiliates
Louisville and Lexington Eye Banks merge to better serve Kentucky and beyond

Kentucky Lions Eye Center

On January 1, 2017, the Kentucky Lions Eye Bank in Louisville and the Lexington Lions Eye Bank merged into a single Eye Bank serving the entire state of Kentucky and portions of West Virginia. The Kentucky Lions Eye Foundation, the University of Louisville and University of Kentucky are proud to announce the unification of all Eye Banking services, including procurement of donor tissue and distribution of corneas for transplant, into one organization serving the entire state of Kentucky.

“This merger is the culmination of 25 years of negotiation and work behind the scenes to better serve the people of Kentucky,” said Tom Van Etten, of Louisville, past Lions Eye Foundation chair.

Previously, the Louisville Lions Eye Bank, affiliated with the University of Louisville, served the western part of the state; the Eye Bank of Lexington, affiliated with the University of Kentucky, served the eastern part of Kentucky and parts of West Virginia. The new Kentucky Lions Eye Bank serves the same geographical area as Kentucky Organ Donor Affiliates (KODA) to effectively coordinate corneal donation with organ and tissue donation statewide. 

Corneal transplantation is a separate procedure that replaces all or part of a diseased cornea, improving sight, stabilizing diseased eyes and improving comfort in patients with severe corneal pathology. In 2015, there were 79,000 corneal transplants performed in the United States, and there were 470 donors of ocular tissue from Kentucky. Cornea transplants have a 95 percent success rate, and the lifetime economic benefit of corneal transplants performed in 2013 in the United States was $5.5 billion. The leading indication for corneal transplantation in 2016 was keratoconus, followed by corneal edema, Fuchs dystrophy and corneal scars.

The newly merged Kentucky Lions Eye Bank positions the state of Kentucky to efficiently coordinate with other eye banks in the United States to provide corneas for transplant in the state of Kentucky and assist with medical needs elsewhere when possible.

For the immediate future, the laboratories at the University of Louisville and the University of Kentucky will remain functional as operations will continue in both cities. They gradually will be centralized in Louisville over the next five years.

“The merged Eye Bank will be an asset to the state of Kentucky and should provide the resources for the state to be a national provider of donor ocular tissue to restore sight and to assist in research of blinding diseases,” said Henry J. Kaplan, M.D., chair of the Department of Ophthalmology and Visual Sciences at the University of Louisville.

For more information or to make charitable donations, contact the Louisville Lions Eye Bank (502) 852-5457 or the Kentucky Lions Eye Foundation at (502) 583-0564. The website of the new organization will be www.kylionseyebank.org.

UofL School of Medicine supports the Obama Administration’s new actions to address prescription opioid abuse, heroin epidemic

UofL School of Medicine supports the Obama Administration’s new actions to address prescription opioid abuse, heroin epidemic

On March 29, the University of Louisville School of Medicine joined with 60 other schools and colleges of medicine from throughout the United States in support of new actions to address prescription opioid abuse and the national heroin epidemic.

President Barack Obama joined individuals in recovery, family members, medical professionals, law enforcement officials and other leaders at the National Rx Drug Abuse and Heroin Summit in Atlanta, Georgia. The annual summit is organized by Operation UNITE, which was launched by Kentucky Rep. Hal Rogers.  As part of the event, the President announced these additional public and private sector actions to escalate the fight against the prescription opioid abuse and heroin epidemic, which is claiming the lives of tens of thousands of Americans each year.

The President has made clear that addressing this epidemic is a priority for his Administration, and today’s actions represent further steps to expand access to treatment, prevent overdose deaths and increase community prevention strategies.  These actions build on the President’s proposal for $1.1 billion in new funding to help every American with an opioid use disorder who wants treatment get the help they need.

As part of the March 29 event, the President announced the following Administration actions:

    Expanding Access to Treatment:

      The Department of Health and Human Services (HHS) is issuing a proposed rule to increase the current patient limit for qualified physicians who prescribe buprenorphine to treat opioid use disorders from 100 to 200 patients with the goal of expanding access to this evidence-based treatment while preventing diversion.  The proposed rule aims to increase access to medication-assisted treatment and behavioral health supports for tens of thousands of people with opioid use disorders.

      HHS released $94 million in new funding to 271 Community Health Centers across the country earlier this month to increase substance use disorder treatment services, with a specific focus on expanding medication-assisted treatment of opioid use disorders in underserved communities.  This funding is expected to help health centers treat nearly 124,000 new patients with substance use disorders.

      The Substance Abuse and Mental Health Services Administration (SAMHSA) is releasing a new $11 million funding opportunity for up to 11 states to expand their medication-assisted treatment services.  SAMHSA also is distributing 10,000 pocket guides for clinicians that include a checklist for prescribing medication for opioid use disorder treatment and integrating non-pharmacologic therapies into treatment.  SAMHSA also will coordinate trainings to increase the number of doctors qualified to prescribe buprenorphine, which will be held in targeted states in greatest need.

        Establishing a Mental Health and Substance Use Disorder Parity Task Force: The President signed a memorandum on March 29 directing the creation of an interagency Task Force, to be chaired by the Domestic Policy Council, to advance access to mental health and substance use disorder treatment; promote compliance with best practices for mental health and substance use disorder parity implementation; and develop additional agency guidance as needed.  Federal parity protections are intended to ensure that health plans’ coverage of mental health and substance use disorder benefits is comparable to their coverage of medical and surgical benefits.  The Task Force will work quickly, with an Oct. 31 deadline, across Federal Departments and with diverse stakeholders to ensure implementation of these important parity protections.

            Implementing Mental Health and Substance Use Disorder Parity in Medicaid:  HHS is finalizing a rule to strengthen access to mental health and substance use services for people enrolled in Medicaid and Children’s Health Insurance Program (CHIP) plans by requiring that these benefits be offered at parity, meaning  that they be comparable to medical and surgical benefits.  These protections are expected to benefit more than 23 million people in Medicaid and CHIP.

                Preventing Opioid Overdose Deaths: SAMHSA is releasing a new $11 million funding opportunity to states to purchase and distribute the opioid overdose reversal drug, naloxone, and to train first responders and others on its use along with other overdose prevention strategies.

                    Expanding Public Health-Public Safety Partnerships to Combat the Spread of Heroin:  The Office of National Drug Control Policy is expanding its heroin initiative among regional High Intensity Drug Trafficking Areas (HIDTAs) by adding Ohio and Michigan to the effort.  These states will join the Appalachia, New England, Philadelphia/Camden, New York/New Jersey, and Washington/Baltimore HIDTAs in accelerating local partnerships between law enforcement and their counterparts in public health to combat heroin use and overdose.

                        Investing in Community Policing to Address Heroin:  The Department of Justice’s COPS program is announcing a $7 million funding opportunity called the COPS Anti-Heroin Task Force Program to advance public safety and to investigate the distribution of heroin, unlawful distribution of prescription opioids and unlawful heroin and prescription opioid traffickers.  These grants will provide funds directly to law enforcement agencies in states with high rates of primary treatment admissions for heroin and other opioids.

                          Tackling Substance Use Disorders in Rural Communities: On March 28, the Department of Agriculture announced that its $1.4 million Rural Health and Safety Education Grant Program to enhance the quality of life in rural areas through health and safety education projects has been expanded to include a focus on addressing the critical challenges related to substance use disorders in rural communities across the country.
                          Implementing Syringe Services Programs: HHS is issuing guidance for HHS-funded programs regarding the use of Federal funds to implement or expand syringe services programs for people who inject drugs.  Syringe services programs are an effective component of a comprehensive approach to preventing HIV and viral hepatitis among people who inject drugs.  The bipartisan budget agreement signed by the President last year revised a longstanding ban on these programs and allows communities with a demonstrated need to use Federal funds for the operational components of syringe services programs.

                            New Private Sector Commitments to Address the Epidemic

                            In connection with the March 29th Federal announcements, more than 60 medical schools announced that, beginning in fall 2016, they will require their students to take some form of prescriber education, in line with the newly released Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain, in order to graduate. Schools include:

                            • University of Louisville School of Medicine
                            • A.T. Still University of Health Sciences, Kirksville College of Osteopathic Medicine
                            • A.T. Still University of Health Sciences, School of Osteopathic Medicine in Arizona
                            • Baylor College of Medicine
                            • Boston University School of Medicine
                            • Burrell College of Osteopathic Medicine at New Mexico State University
                            • Chicago College of Osteopathic Medicine of Midwestern University
                            • David Geffen School of Medicine at the University of California – Los Angeles
                            • Dell Medical School at The University of Texas at Austin
                            • East Carolina University Brody School of Medicine
                            • Edward Via College of Osteopathic Medicine - Auburn Campus
                            • Edward Via College of Osteopathic Medicine - Carolinas Campus
                            • Edward Via College of Osteopathic Medicine - Virginia Campus
                            • Georgia Campus – Philadelphia College of Osteopathic Medicine
                            • Hébert School of Medicine Uniformed Services University of the Health Sciences
                            • Icahn School of Medicine at Mount Sinai
                            • Kansas City University of Medicine and Biosciences College of Osteopathic Medicine
                            • Lincoln Memorial University DeBusk College of Osteopathic Medicine
                            • Loyola University Chicago Stritch School of Medicine
                            • Marian University College of Osteopathic Medicine
                            • Marshall University Joan C. Edwards School of Medicine
                            • Mercer University School of Medicine
                            • NYU School of Medicine
                            • Ohio State University College of Medicine
                            • Ohio University Heritage College of Osteopathic Medicine
                            • Oklahoma State University Center for Health Sciences College of Osteopathic Medicine
                            • Oregon Health & Science University School of Medicine
                            • Perelman School of Medicine at the University of Pennsylvania
                            • Philadelphia College of Osteopathic Medicine
                            • Rocky Vista University College of Osteopathic Medicine
                            • Rowan University School of Osteopathic Medicine
                            • Rutgers Robert Wood Johnson Medical School
                            • Saint Louis University School of Medicine
                            • State University of New York Upstate Medical University
                            • The Commonwealth Medical College
                            • The Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
                            • Touro College of Osteopathic Medicine - New York
                            • Touro University College of Osteopathic Medicine - California
                            • Touro University College of Osteopathic Medicine – Nevada
                            • Tufts University School of Medicine
                            • Tulane University School of Medicine
                            • University of Arizona College of Medicine – Tucson
                            • University of California – Davis School of Medicine
                            • University of Central Florida College of Medicine
                            • University of Colorado School of Medicine
                            • University of Kansas Medical Center
                            • University of New England College of Osteopathic Medicine
                            • University of North Carolina School of Medicine
                            • University of North Texas Health Science Center at Fort Worth, Texas College of Osteopathic Medicine
                            • University of Oklahoma College of Medicine
                            • University of Pikeville - Kentucky College of Osteopathic Medicine
                            • University of Rochester School of Medicine and Dentistry
                            • University of Tennessee College of Medicine
                            • University of Texas Southwestern Medical Center
                            • University of Wisconsin School of Medicine and Public Health
                            • Virginia Commonwealth University School of Medicine
                            • West Virginia School of Osteopathic Medicine
                            • West Virginia University School of Medicine
                            • Western University of Health Sciences College of Osteopathic Medicine of the Pacific
                            • Western University of Health Sciences College of Osteopathic Medicine of the Pacific Northwest
                            • William Carey University College of Osteopathic Medicine

                            Rite Aid has trained over 8,400 pharmacists on naloxone and is dispensing naloxone to patients without needing an individual prescription in 10 states with plans to expand to additional states.  Kroger currently dispenses naloxone without an individual prescription at its pharmacies in seven states with plans to expand to at least 12 more by the end of the year.  AmerisourceBergen/ Good Neighbor Pharmacy will provide educational materials to encourage their 4,000 independently owned and operated retail pharmacy locations to provide naloxone without an individual prescription.

                            Updates on Federal Actions and Private Sector Commitments

                            In October 2015, as part of his visit to West Virginia to discuss the prescription opioid abuse and heroin epidemic, the President announced a number of new public and private sector actions, including a Presidential Memorandum requiring Federal Departments to provide training on appropriate opioid prescribing to Federal health care professionals and requiring Departments to develop plans to address barriers to opioid use disorder treatment in Federal programs.  Departments are ahead of schedule in fulfilling the President’s directive that Federal agencies ensure that all employees who prescribe these drugs are trained in appropriate opioid prescribing practices by 2017.  Approximately 75 percent of federal prescribers have been trained to date.  In addition, since the President’s Memorandum was released, Departments have taken numerous steps to expand access to opioid use disorder treatment, including medication-assisted treatment, such as:

                            • TRICARE: The Department of Defense issued a proposed rule to implement parity protections in TRICARE, including expanding mental health and substance use disorder treatment to include coverage of intensive outpatient programs and treatment of opioid use disorders with medication-assisted treatment.  TRICARE currently has an estimated 15,000 to 20,000 beneficiaries with opioid use disorder who, under the current benefit, cannot access medication-assisted treatment.
                            • FEHBP: The Office of Personnel Management released a 2017 Call Letter to health plans participating in the Federal Employees Health Benefits Program (FEHBP) making opioid use disorder treatment a priority and calling on health plans to review and improve access to medication-assisted treatment.
                            • Medicare: The Centers for Medicare and Medicaid Services (CMS) released a 2017 Call Letter to plans participating in the Medicare Prescription Drug Program reiterating that reducing the unsafe use of opioids is a priority and making clear that Part D formulary and plan benefit designs that hinder access to medication-assisted treatment for opioid use disorder will not be approved.
                            • Medicaid:  CMS released a guidance document to states identifying “Best Practices for Addressing Prescription Opioid Overdoses, Misuse and Addiction” including effective Medicaid pharmacy benefit management strategies, steps to increase the use of naloxone to reverse opioid overdose, and options for expanding Medicaid coverage of and access to opioid use disorder treatment.  This builds on Medicaid’s work with states over the past year to increase access to Medicaid substance use disorder treatment services.
                            • Health Insurance Marketplace: In the last month, CMS finalized a 2017 Marketplace payment notice that clarified that both essential health benefits requirements and Federal mental health and substance use disorder parity requirements apply to qualified health plan coverage of medications to treat opioid use disorder, and additional guidance is forthcoming.

                            Earlier this month, the Centers for Disease Control and Prevention issued its Guideline for Prescribing Opioids for Chronic Pain – the Agency’s first-ever recommendations for primary care clinicians on prescribing opioids.  The Guideline provides recommendations for clinicians on appropriate prescribing, including determining if and when to start prescription opioids for chronic pain treatment; guidance on medication selection, dose, and duration, including when to discontinue medication, if needed; and guidance to help assess the benefits and risks and address the harms of prescription opioid use.

                            The Food and Drug Administration recently announced safety labeling changes for all immediate-release opioid pain medications, including requiring a new boxed warning about the serious risks of misuse, abuse, addiction, overdose and death associated with these drugs.  The Agency also issued a draft guidance intended to support the development of generic versions of abuse-deterrent opioids.  Abuse-deterrent drug formulations are designed to make the drug more difficult to abuse, including making it harder to crush a tablet in order to snort the contents or more difficult to dissolve the product in order to inject it.

                            The Drug Enforcement Administration (DEA) recently announced it will hold its 11thNational Prescription Drug Take-Back Day on Saturday, April 30, providing a safe, convenient, and responsible way of disposing of unneeded prescription drugs.  More than 5.5 million pounds of medication have been collected over the last ten Take Back Days.  Local communities are also establishing ongoing drug take-back programs.

                            Examples of private sector actions taken to date include the following:

                            In conjunction with the October event, more than 40 health care provider groups announced a commitment to ensure that more than 540,000 health care providers will complete training on appropriate opioid prescribing in the next two years.  In the first five months of this initiative, the provider coalition reports that more than 75,000 providers have completed prescriber training.  In addition, more than 2,200 additional physicians have committed to completing training to prescribe buprenorphine as part of the coalition’s effort to double the number of buprenorphine prescribers in the next three years.

                            As part of their commitment announced at the October 2015 event, the National Association of Counties, National Governors Association, National League of Cities and United states Conference of Mayors, with the U.S. Communities Purchasing Alliance and Premier, Inc., announced in January they had secured discounts on naloxone and medication-assisted treatment drugs through their purchasing program for State and local agencies.

                            In February, Walgreens announced it will install safe medication disposal kiosks in more than 500 drugstores across the country, primarily at locations open 24 hours. The program will make the disposal of medications — including opioids and other controlled substances — easier and more convenient while helping to reduce the misuse of medications.  Walgreens also will make naloxone available without needing an individual prescription at its pharmacies in 35 states and Washington, D.C. throughout this year.

                            CVS Health has worked to increase access to naloxone by establishing standing orders or collaborative practice agreements.  By the end of March 2016, CVS Pharmacy locations in 23 states will be able to dispense naloxone to patients without needing an individual prescription, increasing to 35 states by the end of 2016 as part of its program expansion announced at the October 2015 event.  CVS Health has also launched a drug abuse prevention program called Pharmacists Teach, which brings CVS Pharmacists into schools across the country to educate students about the dangers of drug abuse.  To date, more than 30,000 students have participated in the program.

                            Interferon not beneficial for most stage III melanoma

                            Final results of trial begun in 1997 show improved diagnostics make aggressive treatment unnecessary for many patients with metastasized skin cancer
                            Interferon not beneficial for most stage III melanoma

                            Kelly M. McMasters, M.D., Ph.D.

                            Final results for the Sunbelt Melanoma Trial, published online this month in the Journal of Clinical Oncology, show that thanks to current diagnostic techniques, most stage III melanoma patients do not benefit from treatment with interferon. Kelly McMasters, M.D., Ph.D., the Ben A. Reid, Sr., M.D. Professor and Chair of the Hiram C. Polk, Jr., M.D. Department of Surgery at the University of Louisville, was the principal investigator and initiated the trial.

                            The first of more than 3600 trial participants were enrolled in 1997. Patients with small amounts of melanoma detected in a single lymph node were either treated with high-dose interferon therapy or simply observed. The patients, representing 79 institutions across North America, were followed for up to 10 years to determine long-term outcomes in terms of disease-free survival and overall survival.

                            Interferon was approved by the FDA in 1995 as a therapy for melanoma based on a study of patients with multiple large, palpable lymph nodes involved with cancer. However, the development of sentinel lymph node (SLN) biopsy in the 1990s made it possible for physicians to detect microscopic amounts of cancer in lymph nodes that could not be detected by hand.

                            Patients in the Sunbelt Trial were those with melanoma detected in a single lymph node by SLN biopsy. They were considered stage III because of the presence of melanoma in the lymph nodes, but the smaller amounts of cancer detected meant they had lower risk of cancer recurrence than previous stage III patients. McMasters, director of the Multidisciplinary Melanoma Clinic and associate director of the James Graham Brown Cancer Center at UofL, said the trial also studied patients with an even smaller amount of cancer in the lymph nodes, detected only at the molecular level using polymerase chain reaction (PCR).

                            “We started the Sunbelt Melanoma Trial to determine whether interferon therapy was warranted in this relatively lower risk group of stage III patients,” McMasters said. “What we found was that there was no evidence that interferon was necessary or helpful for this substantial group of melanoma patients. That saves many patients the toxicity and expense of interferon therapy, which is like having the flu, only worse, for a whole year. While the study did not quite meet its accrual goals and was underpowered to detect very small differences in survival, there was not even a trend for improvement in survival with interferon. Based on these findings, it would be hard to recommend interferon therapy for patients with minimal cancer in just one lymph node.”

                            McMasters said that in practice today, most patients have the smaller level of cancer detected in the lymph nodes.

                            While interferon is still one of the two FDA-approved drugs for adjuvant therapy for high-risk melanoma, McMasters believes options now in the pipeline and further research into the molecular behavior of cancer cells will reveal more advantageous treatments for those with limited lymph node metastases.

                            “Newer studies of melanoma adjuvant therapy using immune checkpoint agents, such as PD-1 inhibitors, show much promise,” McMasters said. “I think more work needs to be performed to understand the significance of molecular detection of melanoma cells in the lymph nodes and in the circulating bloodstream. We now suspect that melanoma, as with other cancers, routinely sheds cancer cells into the lymphatic system and bloodstream, and that a small minority of these cells that have the ability to evade the immune system, attach, invade, develop their own blood supply and grow, will become metastatic tumors.”

                             

                            The Sunbelt Melanoma Trial was funded by Schering Oncology Biotech. The sponsor had no involvement in the design, conduct, analysis or publication of the work


                            February 15, 2016

                            UofL adds cardiothoracic surgeon from Boston

                            Frank A. Pigula, M.D., joins UofL and Kosair Children’s Hospital staff
                            UofL adds cardiothoracic surgeon from Boston

                            Frank A. Pigula, M.D.

                            A nationally and internationally recognized expert in complex congenital heart disease has joined the faculty of the University of Louisville School of Medicine Department of Cardiovascular and Thoracic Surgery. Frank A. Pigula, M.D., comes to Louisville from Boston where he was the clinical director of the pediatric cardiac surgery program at the Children’s Hospital of Boston, rated number one in cardiology and heart surgery by U.S. News & World Report. Pigula also was an associate professor of surgery at Harvard University School of Medicine.

                            Pigula will perform both clinical and laboratory research at UofL. He has ongoing clinical studies to document neurodevelopmental outcomes in neonates using a technique he developed in Boston to reduce circulatory arrest times in an effort to reduce bypass-related neurologic injury. He also is conducting laboratory research on protecting the brain from bypass‑related brain injury during surgery.

                            “We are extremely pleased to bring a world-class clinician and researcher such as Dr. Pigula to UofL. He will be a tremendous asset in training the next generation of physicians in cutting edge cardiovascular and thoracic surgery,” said Mark S. Slaughter, M.D., chair of UofL’s Department of Cardiovascular and Thoracic Surgery.

                            Pigula also will practice with University of Louisville Physicians and will serve as chief of the Division of Pediatric Cardiac Surgery at Kosair Children’s Hospital. He is expected to begin seeing patients next month. He joins Erle H. Austin, III, M.D., who has been chief of cardiovascular surgery at the hospital for 26 years and will now focus on direct patient care, and Deborah J. Kozik, D.O.; both practice with ULP-Cardiovascular and Thoracic Surgery. Pigula and Christopher Johnsrude, M.D., chief of the Division of Pediatric Cardiology at UofL, will serve as co-directors of the Kosair Children’s Hospital Heart Center.

                            “Kosair Children’s Hospital is dedicated to ensuring children needing complex care for heart issues do not need to leave Kentucky,” said Thomas D. Kmetz, Norton Healthcare division president, Women’s and Children’s Services and Kosair Children’s Hospital. “With Dr. Pigula’s leadership, we expect to see the care we can provide to children with heart issues continue to grow.”

                            Pigula earned his medical degree from the University of Vermont College of Medicine and completed his residency in general surgery and surgery research fellowship at Medical Center Hospital, College of Vermont and UVM College of Medicine. He completed a residency in cardiothoracic surgery at the University of Pittsburgh and a fellowship in congenital cardiovascular surgery at the Children’s Hospital of Boston.

                            At the Children’s Hospital of Boston, Pigula served as the clinical director of the pediatric cardiac surgery program since 2004, the director of the neonatal surgical program since 2010, and surgical director of the pediatric cardiac neurodevelopmental program since 2007 before moving to Louisville. He is a member of the American Association for Thoracic Surgery Scholarship Committee and Education Committee.

                            Pigula is widely published and is a nationally and internationally recognized expert in complex congenital heart disease. He is on the editorial board of Pediatric Cardiology, Journal of Thoracic and Cardiovascular Surgery, and Case Reports in Medicine, and is an ad hoc reviewer of The Annals of Thoracic Surgery, Pediatrics, The Journal of Heart and Lung Transplantation, Circulation and Journal of the American College of Cardiology.