News

UofL cancer researcher honored by president of Poland

Faculty member who discovered embryonic-like stem cells in adult bone marrow receives Gold Cross of Merit
UofL cancer researcher honored by president of Poland

Mariusz Z. Ratajczak, M.D., Ph.D., D.Sci., received the Gold Cross of Merit from the president of Poland on January 22, 2016 in Warsaw.

Mariusz Z. Ratajczak, M.D., Ph.D., D.Sci., was presented with a Gold Cross of Merit by the president of Poland, Andrzej Duda, on January 22 in Warsaw. Ratajczak, a professor in the University of Louisville Department of Medicine, was recognized for his work in stem cell research and transplantation.

Ratajczak, a native of Poland, received the award at a ceremony marking the opening of National Transplantation Congress in commemoration of the 50th anniversary of the first kidney transplant in Poland and the 30th anniversary of the country’s first bone marrow transplant. The Cross of Merit is a civil state award presented by the government of Poland to citizens who have gone beyond the call of duty in their work for the country and society as a whole. The award was established in 1923 to recognize services to the state and has three grades:  gold, silver and bronze.

Ratajczak is an internationally known specialist in the field of adult stem cell biology and is director of the Stem Cell Program at UofL’s James Graham Brown Cancer Center, a part of KentuckyOne Health. His 2005 discovery of embryonic-like stem cells in adult bone marrow tissues has the potential to revolutionize the field of regenerative medicine. These very small embryonic-like cells (VSELs) may lead to new treatments for cancer, heart disease, eye disease, diabetes and neurodegenerative disorders.

“My work would not be possible without the longstanding support of Donald Miller, M.D., Ph.D., director of the Brown Cancer Center, to my program,” Ratajczak said. “I also consider the award as recognition to my team of collaborators:  Magda Kucia, Ph.D., D.Sci., Janina Ratajczak, M.D., Ph.D., D.Sci., Malwina Suszynska, Ph.D., and Gabriela Schneider, Ph.D., who are working with me to employ VSELs in regenerative medicine.”

Recently, Ratajczak’s research team has developed a promising strategy to expand VSELs, opening a door for using the cells in regenerative medicine as a promising alternative to other stem cells.

Ratajczak also is known for his work on novel mechanisms of mobilization and homing of stem cells, the biological role of extracellular microvesicles and molecular mechanisms of cancer metastasis. His work is supported by two R01 grants. He holds the Stella and Henry Hoenig Endowed Chair in Cancer Biology.

 

Jan. 28, 2016

James Graham Brown Cancer Center first in Kentucky to offer one-day treatment for early-stage breast cancer

Intraoperative radiation therapy targets cancer cells, spares healthy tissue
James Graham Brown Cancer Center first in Kentucky to offer one-day treatment for early-stage breast cancer

Early-stage breast cancer patients now have a new one-day breast cancer treatment option at the University of Louisville’s James Graham Brown Cancer Center, a part of KentuckyOne Health. The cancer center is the first in Kentucky to offer this new technology.

Patients who meet specific selection criteria are able to be treated with intraoperative radiation therapy (IORT), a one-day breast cancer treatment option that offers multiple patient benefits, including added convenience, fewer treatments and reduced costs.

IORT allows radiation oncologists and breast cancer surgeons to work together to deliver a full, concentrated dose of radiation in one day at the time of lumpectomy, targeting cancer cells and sparing healthy tissue, such as the heart, lungs and ribs. This compares to traditional breast cancer treatment, which involves daily radiation five days per week, for six to eight weeks. With IORT, radiation is delivered from inside the breast rather than externally, as is done during external beam radiation therapy (EBRT).

“As one of America’s finest cancer treatment and research institutions, our goal is not just to fight cancer, but to win,” said Donald Miller, M.D., Ph.D., director of the James Graham Brown Cancer Center. “The more advanced technology and research available to our multidisciplinary care teams, the more tools we have at our disposal to save lives. IORT is an exciting advancement in breast cancer care.”

“Two major studies have shown IORT is effective, but with fewer side effects than traditional radiation, making it a viable treatment option for appropriate patients,” said Anthony Dragan, M.D., radiation oncologist with UofL Physicians and the James Graham Brown Cancer Center. “In addition to fewer side effects, IORT can also help improve access to care. Some women, such as those who live in more rural areas, women who are in the workforce and women who are caretakers for their families, find it difficult to finish a course of traditional treatment that requires multiple visits.

“Since IORT requires only one dose of radiation, patients are able to return to their normal life within days rather than weeks, a huge improvement over traditional radiation treatment.”

The technology used is the Xoft® Axxent® Electronic Brachytherapy (eBx®) System®, which is FDA cleared for the treatment of cancer anywhere in the body, including early-stage breast cancer, gynecological cancers and non-melanoma skin cancer.

The Xoft System uses a proprietary miniaturized x-ray source, which is inserted into a flexible balloon-shaped applicator, then temporarily placed inside the lumpectomy cavity. A full course of radiation is then administered in a single dose, lasting as little as eight minutes, which directly targets cancer cells.

“IORT gives patients with early stage breast cancer an integrated surgical and radiotherapy option, in just one treatment, with the hope for the same outcomes (resulting from treatments currently in use),” said Nicolas Ajkay, M.D., surgical oncologist with UofL Physicians and the James Graham Brown Cancer Center. “Our multidisciplinary team approach leads to constant collaboration among physicians to find the right treatment plan for each patient. IORT furthers our ability to do so in new and exciting ways.”

A growing body of favorable clinical data supports the use of IORT in candidates meeting specific selection criteria. iCAD, the maker of Xoft, is currently conducting one of the largest IORT clinical studies to date using the Xoft System, which compares Xoft IORT to traditional external beam radiation therapy. To date, more than 2,000 patients have been treated with Xoft IORT.

For more information about IORT at the James Graham Brown Cancer Center, visit http://www.kentuckyonehealth.org/IORT or call 502-562-HOPE(4673).

Bullitt County invited to ‘Think Pink’ Oct. 18

Bullitt County invited to ‘Think Pink’ Oct. 18

Shepherdsville and Bullitt County, Ky., are invited to “Think Pink” for breast cancer awareness at an event featuring the stories of three breast cancer survivors and recognition of everyone who has battled the disease.

“Think Pink: An Evening to Educate and Celebrate” will be held Tuesday, Oct. 18, from 5 to 7:30 p.m. at the Paroquet Springs Conference Centre, 395 Paroquet Springs Drive, Shepherdsville. Admission is free.

Emcee Bryan Shaw of WHAS11-TV will introduce three survivors who will share their individual journeys and accomplishments since being diagnosed: Lara McGregor, Mary Lee Edwards and Alana Auslander Price, all of Louisville.

Both McGregor and Edwards became activists as a result of their experience with breast cancer. McGregor is founder of Hope Scarves, a non-profit organization based in Louisville that raises funds for research and provides scarves to patients with breast cancer as a way to show support. Edwards is an instructor of LIVESTRONG classes at the Louisville YMCA. LIVESTRONG is a non-profit organization, based in Austin, Texas, that provides services, raises funds and advocates for patients and families.

Participants at “Think Pink” are invited to wear pink to show support for survivors and in recognition of October as Breast Cancer Awareness Month. Only 200 seats are available for the event so reservations in advance are required by calling 502-955-5355.

Breast cancer continues to plague the United States: One in eight American women will be diagnosed with breast cancer in her lifetime.

Great strides in fighting the disease have been made, however. In 1980, the five-year relative survival rate for women diagnosed with early stage breast cancer -- cancer confined to the breast -- was 74 percent. Today, that number is 99 percent.

“Think Pink” is sponsored by the Kentucky Cancer Program at the University of Louisville, Bullitt County Health Department and Bullitt County Cooperative Extension Service.

For information, contact Pam Temple-Jennings of the Kentucky Cancer Program, 502-852-6318, pam.templejennings@louisville.edu.

 

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‘Spike It to Cancer’ sand volleyball event benefits cancer center at UofL, June 7

‘Spike It to Cancer’ sand volleyball event benefits cancer center at UofL, June 7

Benefactors of a fund to support patients at the James Graham Brown Cancer Center at the University of Louisville are sponsoring their second annual sand volleyball event to raise money for the fund.

In 2013, Alex and Tommy Gift established the Mary Jane Gift Quality of Life Fund at the cancer center in honor of their late mother. The fund helps patients and their families enjoy life while facing a cancer diagnosis.

To benefit the fund, the Gifts are sponsoring The Second Annual Spike It to Cancer Sand Volleyball Tournament at Baxter Jack’s sand volleyball complex, 427 Baxter Ave. on Saturday, June 7. Registration will be held from 1-2:30 p.m., and games will begin at 3 p.m.

Admission is $20 per person. Payment by cash or check will be accepted at the door, or participants can pay by credit card at the cancer center’s secure online link.

“All proceeds from this event go to the Mary Jane Gift Quality of Life Fund that pays for extras provided to our patients and caregivers,” Michael Neumann, executive director of development, said. “Additionally, The Brewery on Baxter Avenue directly across the street from Baxter Jack’s has agreed to donate a portion of all food and beverage sales to us during the event.

“These gifts go a long way in bringing cheer to our patients and their families. For example, the fund provided Thanksgiving turkeys to many of our patients and their families last November. Also, one of our physicians, Dr. Cesar Rodriguez, used funds raised by the 2013 Spike It to Cancer to give picnic baskets to 26 patients on Easter morning.”

For additional details, contact Neumann at 502-562-4642.

 

Preclinical research shows promise in eliminating cataract surgery after vitrectomy

Preclinical research shows promise in eliminating cataract surgery after vitrectomy

Promising early preclinical research currently underway at the University of Louisville could lead to the elimination of a second surgery now commonly needed after retinal surgery.

Shlomit Schaal, M.D., Ph.D., associate professor, Department of Ophthalmology and Visual Sciences, and director of Retina, the Retina Fellowship Program in Vitreo-Retinal Diseases and Surgery and the Diabetic Retinopathy Service, Kentucky Lions Eye Center, is working with Martin O’Toole, Ph.D., assistant professor, Department of Bioengineering, on the project which is funded by the Coulter Translational Research Partnership at UofL.

The two are studying a new way for patients undergoing retinal surgery – known as “vitrectomy” – to avoid the need to have subsequent surgery to remove cataracts that develop. During vitrectomy surgery, vitreous gel is removed from the eye; it is this gel that protects the natural crystalline lens from damage caused by free radicals of oxygen.

With the gel loss during surgery, free radicals are diffused onto the lens and cause cataracts, and almost all patients undergoing vitrectomy surgery then are forced to undergo a second surgery to remove the cataracts.

Schaal and O’Toole have developed an artificial gel that is biocompatible to the vitreous gel present in the eye. Using animal models, Schaal has successfully used the biocompatible gel to create an oxygen barrier next to the lens during retinal vitrectomy surgery.

“The biocompatible gel appears to be working as well as the eye’s natural vitreous gel in blocking oxygen damage to the natural lens,” Schaal said.

The team hopes to be able to move the research into clinical trials within the next year. “The funding we’ve received from the UofL-Coulter Partnership has been invaluable in enabling us to prove our concept thus far,” Schaal said. “We are excited at the prospect of one day being able to help patients avoid the burden of cataract surgery after retinal surgery.”

The five-year, $5 million Coulter Translational Research Partnership in Bioengineering grant awarded in 2011 to UofL fosters the translation of research through successful collaboration between engineers and clinicians, supporting promising technologies.  The partnership funds promising projects in order to move innovative technologies to clinical application with the ultimate goal of accelerating the introduction of new technologies to improve the treatment and diagnosis of disease or reduce health care costs.

UofL launches study in quest to decrease hospital readmission of heart failure patients

UofL launches study in quest to decrease hospital readmission of heart failure patients

Saeed Jortani, Ph.D.

Researchers at the University of Louisville are launching a clinical research study to develop an objective approach to discharge patients with heart failure from the hospital with the goal of decreasing their possible readmission.

Saeed A. Jortani, Ph.D., clinical associate professor of pathology and laboratory medicine, will lead a team of investigators including cardiologists, emergency medicine physicians, nurses and clinical coordinators in the “Congestive Heart Failure Readmission (CHFR) Trial.” It is now open for enrollment.

The team’s goal is to enroll 600 patients with symptoms of congestive heart failure who are admitted to the emergency departments at two KentuckyOne Health hospitals, University of Louisville Hospital and Jewish Hospital. Blood samples will be collected from patients at the time they are admitted and again when they are discharged. These samples will be analyzed for a variety of cardiac and kidney biomarkers.

The patients then will be surveyed twice, at 30 days and 6 months after discharge, to learn if their condition required readmission to the hospital.

The team will use the data obtained from the blood samples to develop an evidence-based approach that could be used in determining the optimal timing for discharging patients with heart failure and ultimately prevent readmission.

“We believe that using an objective, clinically verified approach to discharging heart failure patients initially could reduce the need for future readmission,” Jortani said. “Our thinking is that patients’ biomarkers will indicate when they are ready for discharge from the hospital with hopefully less chance of being readmitted later on.”

According to the Centers for Disease Control and Prevention, heart failure affects about 5 million people in the United States, with 550,000 new patients diagnosed each year. Patients with heart failure also have a high incidence of other life-threatening diseases and conditions, such as renal failure, hypertension, diabetes and others.

Each year, more than 1 million people are admitted to an inpatient facility for heart failure, and 27 percent of patients with heart failure who are on Medicare are readmitted within 30 days.

New guidelines established by the Affordable Care Act limits put limits on readmitting patients within a 30-day time period for the same diagnosis.

“Finding the right ‘formula’ for discharge and reducing readmission rates will help us improve the ultimate health outcome for the patient as well as realize significant cost savings in the long run,” Jortani said.

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About the CHFR Trial:

Principal investigator of the CHFR Trial is Saeed Jortani. The research team includes cardiologists Andrew DeFilippis, Shahab Ghafghazi and Jesse Adams; emergency medicine physicians George Bosse, Salvator Vicario and Tadd Roberts; nurses Ashlee Melendez, Kristen Young and Cynthia Lawrence; clinical coordinators Stanislava Prather, Anna Mains, Keivan Hosseinnegad and Louise Isaacs; and biostatistician Richard Baumgartner. Blood sample analysis will be conducted at the Kentucky Clinical Trials Laboratory. The study is funded in part by Roche Diagnostics USA. For information about the trial, contact 502-852-8835 or sjortani@louisville.edu.

How smart is the spinal cord? Andrea Behrman will explain at Beer with a Scientist Sept. 14

Discover how UofL researchers are training the spinal cord to help children recover from spinal cord injury
How smart is the spinal cord? Andrea Behrman will explain at Beer with a Scientist Sept. 14

Andrea Behrman, Ph.D.

Andrea Behrman, Ph.D., professor in the Department of Neurological Surgery at the University of Louisville, will discuss research and progress in helping children recover from spinal cord injuries at the next Beer with a Scientist. Her research using locomotor training represents a paradigm shift in helping children with spinal cord injury regain mobility below the level of the lesion. She designs therapies based on scientific evidence that the central nervous system changes through training, a process known as activity-dependent plasticity.

Behrman is director of the Kosair Charities Center for Pediatric NeuroRecovery and co-director of the Reeve Foundation NeuroRecovery Network.

The program begins at 8 p.m. on Wednesday, Sept. 14, at Against the Grain Brewery, 401 E. Main St. A 30-minute presentation will be followed by an informal Q&A session.

The Beer with a Scientist program began in 2014 and is the brainchild of UofL cancer researcher Levi Beverly, Ph.D. Once a month, the public is invited to enjoy exactly what the title promises:  beer and science. Follow the link to see a video about a recent Beer with a Scientist event with UofL professor John Pierce Wise, Ph.D.

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.

For more information and to suggest future Beer with a Scientist topics, follow Louisville Underground Science on Facebook.

 

NEXT BEER WITH A SCIENTIST, OCT. 12:   

As part of Research!Louisville, Beer with a Scientist founder, Levi Beverly, Ph.D., will present:  "The cutting-edge ways that researchers and clinicians are diagnosing and curing cancer right here in Louisville." Beverly will give a series of short presentations on some of the research and clinical trials happening right here in our own backyard.

 

September 6, 2016

UofL’s Envirome Institute creates Louisville Data Commons to support community health research

Researchers and citizen scientists will be able to access and contribute verified environment data through new portal
UofL’s Envirome Institute creates Louisville Data Commons to support community health research

Circle of Harmony and Health

An important mission of the Christina Lee Brown Envirome Institute at the University of Louisville is to encourage citizens to participate in research to understand and improve the health of our community. A new online data resource hosted by the Envirome Institute will allow citizen scientists and researchers to access and contribute to public knowledge about the health of the air, water and soil in Greater Louisville.

Louisville Data Commons is a new online data repository available to anyone interested in the state of our local environment or involved in citizen science or related data-gathering projects.

“For many years, we have been fortunate to have a strong Metro Government open data portal, a resource for sharing data gathered by the city. However, there is not a place to store and review data gathered by citizens that could ultimately help us gain a better understanding of our city,” said Ted Smith, Ph.D., director of the Center for Healthy Air, Water and Soil of the UofL Envirome Institute.

“The growth of citizen science and the excitement around low-cost sensors has highlighted the great need to have a place where information gathered by our community, in our community, about our community can be made available to our whole community and governed by our community,” Smith said.

To provide credibility for the data, Louisville Data Commons is hosted by the Envirome Institute and governed by a volunteer board of community members. These community members will ensure the data sets maintained on the site are reliable, objective and useful to researchers. Members of the volunteer board will review data submitted by the public or non-profit organizations prior to making it available within the portal.

An example of the need for objective third-party validation of data is the recently released odor-reporting app, “Smell My City.” Members of the community expressed concern whether the data could be altered and sought assurance that the data was protected. Louisville Data Commons now archives reports from Smell My City that has been validated by a public process and maintained for future research by anyone using the portal.

Other sources of data will include information gathered by Brightside and Internet of Things sensors, as well as local environmental information provided by the federal government. As more residents discover new things to measure and share in the future, additional data can be held and shared on this portal.

"Louisville Data Commons is a great example of educational institutions, community partners and Louisville Metro Government working together to create a new tool to help local innovators change lives for the better,” said Louisville Mayor Greg Fischer. “That's the type of collaboration and focus on big ideas that we need as we work to become a city where everyone has the opportunity to reach their full potential."

Data may be uploaded to LouisvilleDataCommons.org by individuals, citizen scientists or non-profit organizations and may include information related to sensor projects, air or water quality, weather, odors, noise or other community health characteristics. Other data related to the city of Louisville also may be approved. The data is reviewed by at least two members of the Louisville Data Commons committee prior to being published to ensure validity and appropriateness.

The current Louisville Data Commons committee includes Smith, Grace Simrall, chief of civic innovation and technology for Louisville Metro Government, Aaron Drake, a technology consultant, and Nur Ozgener, a Brightside board member.

"Louisville Metro Government is proud to be a part of the Louisville Data Commons. We are focused on using innovation to address the challenges residents face each day and on expanding access to the digital tools and skills of the future,” Simrall said. “As we work toward these goals, the community needs access to data and good partners.”

The Louisville Data Commons portal uses open source data portal platform CKAN. 

New method developed at UofL enables more extensive preclinical testing of heart drugs and therapies

Researchers extend life of heart segments from 24 hours to six days. Process allows better testing for efficacy and toxicity and saves money and time.
New method developed at UofL enables more extensive preclinical testing of heart drugs and therapies

Tamer Mohamed, Ph.D., Qinghui Ou, B.Sc., and Riham Abouleisa, Ph.D.

Researchers at the University of Louisville have developed an easily reproducible system that enables them to keep slices of human hearts alive for a longer period of time, allowing more extensive testing of new drugs and gene therapies.This new biomimetic culture system mimics the environment of a living organ through continuous electrical stimulation and oxygenation, maintaining viability and functionality of the heart segments for six days. Previous culture systems maintained functional heart slices for no more than 24 hours. The extended viability time will enable improved preclinical testing of new drugs for effectiveness and toxicity.

“This new method maintains fully functional human heart slices for six days in the culture environment. This facilitates testing efficacy of heart failure therapeutics and cardiotoxins on human heart tissue with no need for a living human,” said Tamer M. A. Mohamed, Ph.D., who led the research.

The system provides access to the complete 3D multicellular system that reflects the heart’s functional and structural condition in a living person.

“This system will save time and costs of clinical trials during phase one research, which includes testing for toxicity and proof of efficacy,” Mohamed said. “In addition to drugs, we have demonstrated the system’s effectiveness in testing gene therapy.”

The optimized medium for sustaining the heart tissue slices is described in an article published online last week in Circulation Research, a publication of the American Heart Association. It will appear in the August 30, 2019, print and online issue. Along with Mohamed, the research was conducted by Qinghui Ou, B.Sc., Riham R.E. Abouleisa, Ph.D., and others at UofL, along with colleagues in California, Colorado, the United Kingdom, Germany and Egypt. UofL has a provisional patent application on this technology.

 

 

July 25, 2019

UofL ends negotiations over KentuckyOne assets

Risk to university would be too great

The University of Louisville has notified Catholic Health Initiatives and its affiliate, KentuckyOne Health, that it is ending negotiations to purchase KOH’s Louisville assets, which include Jewish Hospital where the university has several service lines and its physicians treat patients and teach medical residents.

Talks were halted because UofL could not find a suitable partner to help fund the acquisition. UofL officials were not willing to put the university at financial risk by taking on the acquisition alone.

“We regret ending our talks with CHI, but we must do what is fiscally responsible for the University of Louisville,” said UofL President Neeli Bendapudi. “Without a viable partner, we do not have the resources necessary to make the acquisition a reality.”

“KentuckyOne Health is disappointed that the university was not able to secure a financial partner,” said Deborah Lee-Eddie, interim market CEO for KentuckyOne Health. “We will now continue our discussions with other interested organizations.”

UofL and CHI have agreed to several steps as the two parties work on the changes in their relationship.

CHI will extend the Academic Affiliation Agreement to ensure that undergraduate and graduate/resident medical education programs continue at Jewish Hospital and Frazier Rehab Institute. If programs cannot be continued at those facilities, CHI will assign those residencies to another facility requested by the university.

The AAA is an agreement that provides conditions under which the university’s physicians and medical residents provide care for patients, serve in leadership roles for various hospital programs and services and conduct clinical trials that offer innovative treatments unavailable anywhere else in the region.

CHI also has agreed to continue the current professional services, medical directorships and similar provisions included in the Master Services Agreement while it and UofL discuss transition planning. CHI will provide at least 90 days notice before terminating any of those individual agreements.

“Our patients will continue to receive the highest quality care, and our students and residents will continue to receive the education and training they must have to become future providers,” Bendapudi said. “That is our unwavering commitment.”

KentuckyOne’s local properties also include Our Lady of Peace, Sts. Mary & Elizabeth Hospital, Jewish Hospital Medical Centers East, South, Southwest and Northeast, Jewish Hospital Shelbyville and the KentuckyOne Health Medical Group.

UofL and CHI have negotiated in good faith on the purchase of the portfolio only since December 2018.

Services provided by UofL physicians at Jewish Hospital include organ transplantation, cardiovascular medicine and neurological surgery. The hospital is home to the only solid organ transplant facility in the region, and UofL’s renowned clinical care and research in cardiovascular medicine and spinal cord injury are conducted at Jewish and Frazier Rehab.

Bendapudi applauded all those who tried to make a deal for the KentuckyOne assets a reality.

“Everyone involved in these talks put dedication and hard work into them, and I thank them all,” she said. “This endeavor did not fail for lack of effort on the part of either party.”

In her own words: UofL President Neeli Bendapudi, Ph.D., provides more information on ending the negotiations here. 

Hope Scarves gift will provide patients with metastatic breast cancer access to more clinical trials at JGBCC

Hope Scarves gift will provide patients with metastatic breast cancer access to more clinical trials at JGBCC

UofL James Graham Brown Cancer Center

For women undergoing treatment for cancer, a little encouragement can mean the world.

Lara MacGregor, who lives with metastatic breast cancer, started Hope Scarves in 2012 to provide women undergoing cancer treatment a way to encourage one another by sharing a scarf and a story. In 2015, Hope Scarves established a Metastatic Breast Cancer Research Fund to raise funds to support research and patient care.

For 2019, Hope Scarves has provided a gift of $25,000 to the University of Louisville James Graham Brown Cancer Center, with an anonymous match of $25,000 for a total gift of $50,000. The funds are designated to bringing more clinical trials for metastatic breast cancer patients to Louisville.

Kentucky has one of the highest rates of breast cancer in the United States, and Jefferson County has one of the highest rates in Kentucky. Participation in clinical trials is one way to improve outcomes, not only for the patients who participate, but by bringing more and better treatments to market for all patients.

“Participation in clinical trials benefits not only the patients involved in the trial, but the field of cancer treatment in general,” said Beth Riley, M.D., deputy director for clinical affairs at UofL’s Brown Cancer Center. “Currently, metastatic breast cancer is not curable with standard treatment. By participating in trials, patients in Kentucky not only have early access to novel drugs or drug combinations, but they are helping physicians and scientists learn more about effective treatments and disease characteristics so we can move closer to a cure for this disease. Clinical trials involvement is vital to improve the lives of cancer patients here in Kentucky and worldwide.” 

One patient who benefitted from treatment in a clinical trial at the center is Brenda Craig, a Louisville native who was diagnosed with breast cancer in 2013. After several years in remission, her cancer returned; this time it was stage 4 and more challenging to treat.

“The treatments I was getting were not making me feel good and were not doing anything for my cancer,” Craig said. “When my doctor said, ‘Would you like to try the clinical trial?’ I wanted to live, so I said, ‘Yea! Sure, I’d try it.’”

Her condition improved while she was on the trial treatment, nearly bringing her to remission again. Unfortunately, she had to stop the trial drug when she came down with pneumonia. Nevertheless, she is grateful to have had the opportunity.

“The clinical trial brought me a long way. I was on it 8-10 months and I was doing great,” Craig said. She now is on another treatment, but her cancer has remained stable.

Craig said one of her most important missions on her cancer journey is to support others with the disease, a mission shared by Hope Scarves.

“We are human. We cry and we tell our stories to each other. My story helps you and your story helps someone else. We keep it going,” Craig said. “Even if I don’t make it, I hope I can be an example for someone else, that whatever they did for me, it can help someone else.”

MacGregor, a Louisville resident, has seen clinical trials benefit patients at the UofL Brown Cancer Center, and her own treatment includes a drug tested at the center. She wants Hope Scarves’ funds to invigorate that process.

“There is a huge burden to participate in clinical trials that are only available in another city. You have transportation and lodging to consider, and you are away from your home support system – your family and friends – who truly make a difference when you are fighting this disease,” MacGregor said.

By making more trials available in Louisville, not only local women benefit, but also future patients by allowing more people to participate in the trials, advancing medical research more quickly.

“Clinical trials are the future of cancer treatment, not a last resort,” MacGregor said. “These therapies are the next generation of care and may give patients better outcomes, and we are providing these funds to enable more women to have access to them.”

Runners in the Kentucky Derby Festival Marathon and Mini Marathon have raised funds for Hope Scarves as a team, Outrunning Cancer, for the past seven years. In 2015, Hope Scarves presented its first gift to the UofL Brown Cancer Center to support basic research. This year, in addition to UofL, Hope Scarves is providing funds for basic cancer research to Johns Hopkins Medical Center and the Dana-Farber Cancer Center at Harvard University.

“It is our intentional strategy to fund both basic science and patient access to care,” MacGregor said.

 

 

June 3, 2019

UofL researchers propose new concept on how brain interprets visual information

UofL researchers propose new concept on how brain interprets visual information

Martha Bickford, Ph.D.

One of the many functions of the brain is to collect and process visual information so that people know how to respond to the movement of objects around them. A study published in July in The Journal of Neuroscience by researchers at the University of Louisville provides a new concept for how the brain functions to achieve this.

“Looking at the visual pathways of the brain, it had been thought that the thalamus primarily filtered visual signals that it received from the retina,” said Martha Bickford, Ph.D., professor of anatomical biology sciences and neurobiology at the UofL. “We found that the thalamus plays a bigger role in that it actually may help to sort and interpret visual information so that the brain can accurately gauge the movement of surrounding objects”

Examining the visual pathways of mice, Bickford and her colleagues, including William Guido, Ph.D., chair of anatomical sciences and neurobiology at UofL, found that the dorsal lateral geniculate nucleus (dLGN), a part of thalamus, not only serves as a filter of information, but may change the information in such a way that it helps us account for our own eye or body movements when tracking the movement of objects around us.

“It is very exciting to uncover this expanded role for the dLGN,” Bickford said. “We now have a new avenue to explore the relationships between sensory and motor pathways of the brain. Continued study of these relationships may help us to understand sensory deficits that occur in conditions such as Parkinson’s Disease, other movement disorders and spatial and visual attention disorders.”

 

July 21, 2015

Better Breathers Club to discuss nutrition, lung disease

Monthly support group offers information for people with chronic lung conditions
Better Breathers Club to discuss nutrition, lung disease

“Nutrition and Lung Disease” will be the topic when the University of Louisville Better Breathers Club next meets from 2-4 p.m., Thursday, July 9. The free support group is open to the public and meets in room 120 of the UofL Physicians Outpatient Center, 401 E. Chestnut St.

Metered parking is available on East Chestnut and parking for a fee is available in the Chestnut Street Garage at 414 E. Chestnut Street, directly across the street from the outpatient center.

Participants will discuss the role diet plays in management of lung diseases such as chronic obstructive pulmonary disease, emphysema, pulmonary fibrosis, chronic bronchitis and others. UofL staff will be on hand to answer questions and provide information.

Better Breathers Clubs are an initiative of the American Lung Association, giving people with lung disease, their caregivers and loved ones support, education and information. At UofL, the Better Breathers Club is sponsored by the American Lung Association, UofL Physicians-Pulmonology and the UofL School of Medicine.

For information, contact the UofL Better Breathers Club at 502-852-1917.

 

UofL lab helps discover new disease that causes kidney failure

UofL lab helps discover new disease that causes kidney failure

Jon B. Klein, M.D., Ph.D., UofL School of Medicine vice dean for research and professor of medicine, and James Graham Brown Foundation Chair in Proteomics.

 Researchers at the University of Louisville were part of a group that discovered an insidious new autoimmune disease that causes kidney failure.

The discovery of anti-brush border antibody (ABBA) disease was made in the UofL Core Proteomics Laboratory, led by Director Jon B. Klein, M.D., Ph.D., UofL School of Medicine vice dean for research and professor of medicine, and James Graham Brown Foundation Chair in Proteomics. Klein worked with the laboratory’s Co-Director Michael Merchant, Ph.D., associate professor in the Division of Nephrology & Hypertension in the Department of Medicine at UofL.

Klein and co-investigators will present their findings Friday, Nov. 3, at the American Society of Nephrology’s annual meeting in New Orleans.

“It’s the first time in my career that I’ve described a new disease, and truthfully, most people in their career don’t stumble on this,” said Klein, who is internationally recognized for his expertise in biomarker discovery related to kidney disease and practices with UofL Physicians-Kidney Disease Program. “We don’t know yet whether this causes kidney failure in a lot of people. It’s early in the story.”

The UofL lab identified ABBA after analyzing biopsied kidney tissue from 10 patients who had developed acute kidney injury, a sudden episode of kidney failure or damage that happens within a few hours or days. The condition causes a build-up of waste products in the blood and makes it difficult for kidneys to maintain adequate balance of fluid in the body.

For the first time, researchers discovered that in the nephrons, the functional units of the kidneys, antibodies had coated a specialized part of cells called brush borders, which help reabsorb and process proteins.

“The disease is rather insidious,” Klein said. “It was documented in a group of older men who simply turned up with abnormal kidney function, and there were no symptoms until they had very advanced kidney failure.”

Since it is an autoimmune disease, different approaches to suppress the immune system were used to treat the patients, but those efforts were unsuccessful, Klein said.

Further research will focus on defining demographics of patients with ABBA and the disease’s prevalence. Also, determining where on the protein megalin – which acts as a sponge to absorb proteins and other compounds that enter the nephron – the antibody binds is key to treating the disease, Klein said.

It’s unknown what stimulates the antibody formation.

“Antibodies have very specific targets; they bind to only certain proteins in autoimmune kidney diseases, and then to only certain portions of that protein,” Klein said. “That’s where you learn how to begin to block the antibody binding.”

Klein said the disease had gone undetected because most people with abrupt kidney failure recover and do not get biopsies. In cases of ABBA, however, kidneys do not improve.

Lead investigators of the study are Laurence H. Beck, M.D., Ph.D., of Boston University School of Medicine, and Christopher P. Larsen, M.D., a nephropathologist at Arkana Laboratories in Little Rock, Ark.

Co-investigators include: Klein, Merchant, and Daniel W. Wilkey of UofL; Claire Trivin-Avillach, Paige Coles, Hong Ma and David J. Salant of Boston University School of Medicine; A. Bernard Collins, Ivy A. Rosales and Robert B. Colvin of Massachusetts General Hospital and Harvard Medical School; Josephine M. Ambruzs, Nidia C. Messias, L. Nicholas Cossey and Patrick D. Walker of Arkana Laboratories; and Thomas Wooldridge of Nephrology and Hypertension Associates in Tupelo, Miss.

Certified nurse midwife to discuss hormones’ role in labor, childbirth

Certified nurse midwife to discuss hormones’ role in labor, childbirth

Damara Jenkins, CNM, APRN

A pregnant woman’s body undergoes a complex set of interconnected, mutually beneficial phases that prepare her and her baby for childbirth. The hormonal actions occurring in one phase anticipate and usher in subsequent phases.

These phases are known collectively as the hormonal cascade of childbirth, and a Certified Nurse Midwife at the University of Louisville Center for Women & Infants will present a continuing education session on the topic for nurses, midwives, lactation consultants and other professionals involved in childbirth.

“Normal Physiologic Birth and Supporting the Hormonal Cascade of Childbirth” will be presented by Damara Jenkins Tuesday, May 3, at Babyology, 3934 Dutchman’s Lane, beginning at 6 p.m. The presentation is sponsored by Kentuckiana Lactation Improvement Coalition, a chapter of the United States Lactation Consultant Association that provides support and education on breastfeeding in Kentucky and Southern Indiana.

Jenkins will discuss practices that encourage normal physiologic birth, the role of certified nurse midwifery in supporting normal childbirth and the phases of hormonal childbirth:

  • Late pregnancy and early labor: There is an increase of hormones and receptor systems in the woman’s body that prepares her for an efficient labor and birth; efficient lactation that leads to bonding and attachment with the baby; and the well-being of the fetus during labor and the transition to a newborn.
  • Active labor: Hormonal processes during active labor prepare the body for effective postpartum contractions and hemorrhage prevention; the health transition of the newborn; and breastfeeding and bonding.
  • Birth and the hours that follow: The process of giving birth and skin-to-skin contact between mother and baby immediately after birth promote a hormone release that is thought to further reduce hemorrhage risk, initiate mother-baby bonding and help establish success in breastfeeding.

“The hormonal cascade of childbirth shows us how the body perfectly times the release of hormones in each phase and ensures that labor, birth and breastfeeding all happen according to the body’s design,” Jenkins said.

Jenkins, who also is an Advanced Practice Nurse, is one of three Certified Nurse Midwives who practice with UofL Physicians-Certified Nurse Midwife Program in tandem with the UofL Physicians-OB/GYN & Women’s Health practice. While pregnancy and childbirth care is her primary practice, she provides care to women across the entire lifespan, partnering with them to enable them to live their healthiest life.

Jenkins received her undergraduate degrees from the University of Louisville in 1999 and Bellarmine University in 2000 and received her MSN degree from Frontier Nursing University in 2009. She is president of the Kentucky Affiliate of the American College of Nurse Midwives and received the Frontier Nursing University 75th Anniversary Pioneer Award in 2014. She is on the board of the Friends of the Louisville Birthing Center and a member of the Kentucky Coalition of Nurse Practitioners and Nurse Midwives.

Continuing education credit will be provided for some disciplines, and pre-registration is requested but not required for the presentation. For more information, contact Kentuckiana Lactation Improvement Coalition member Peggy Rinehart at rinehart.peggy@gmail.com.

Fireworks-related burns requiring hospital stays skyrocket among kids

New research from UofL shows loosening U.S. laws that let people buy pyrotechnics at younger ages is tied to increased incidence and severity of fireworks-related burns in children

April 30, 2016

As states relaxed laws related to fireworks sales during the past decade, emergency doctors saw an increase in both the number of fireworks-related injuries among children and the severity of those injuries, according to new research being presented by faculty from the University of Louisville at the Pediatrics Academic Societies 2016 Meeting.

An abstract of the study, “Effect of Fireworks Laws on Pediatric Fireworks Related Burn Injuries," will be presented at the PAS meeting in Baltimore on May 3.

Researchers looked at federal and state data from the National Inpatient Sample, with data on 8 million hospital stays each year, and the Nationwide Emergency Department Sample, which annually compiles information on 30 million discharges from emergency medicine facilities.

They determined the number of patients under age 21 treated and released by emergency departments between 2006 and 2012 rose modestly. Significantly larger increases were seen in injuries requiring inpatient hospital admission, which skyrocketed from 29 percent of cases in 2006 to 50 percent in 2012.

“The increase in fireworks-related injuries and the severity of these injuries in children since 2006 are very concerning,” said Charles Woods Jr., M.D., one of the study’s authors and associate chair of pediatrics at the University of Louisville. “Although our findings do not prove a direct link to relaxations in state laws governing fireworks sales, it may be time for lawmakers to reassess this issue. Parents and caregivers of children also should be aware of these increasingly serious injuries and the potential dangers involved in allowing young children to handle and play with fireworks.”

Lead author John Myers, Ph.D., a researcher in the Department of Pediatrics at the University of Louisville, will present the abstract, “Effect of Fireworks Laws on Pediatric Fireworks Related Burn Injuries," at 7:30 a.m. on Tuesday, May 3 in Exhibit Hall F at the Baltimore Convention Center. To view the abstract, visit http://www.abstracts2view.com/pas/view.php?nu=PAS16L1_4135.266.

“Pediatric fireworks-related burn injuries have increased in incidence, apparent severity of injury, the proportion requiring hospitalization and length-of-stay in the hospital in a time period of relaxed fireworks laws in the United States,” Myers said. “These findings suggest that policy-makers should revisit current fireworks laws for the safety of children.”

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About the Pediatric Academic Societies Meeting:

The Pediatric Academic Societies (PAS) Meeting brings together thousands of individuals united by a common mission: to improve child health and wellbeing worldwide. This international gathering includes pediatric researchers, leaders in academic pediatrics, experts in child health, and practitioners. The PAS Meeting is produced through a partnership of four organizations leading the advancement of pediatric research and child advocacy: the Academic Pediatric Association, American Academy of Pediatrics, American Pediatric Society, and Society for Pediatric Research. For more information, visit the PAS Meeting online at www.pas-meeting.org, follow us on Twitter @PASMeeting and #PASMeeting, or like us on Facebook.

 

 

Behrman, Harkema to present latest developments in therapy at international conference

Behrman, Harkema to present latest developments in therapy at international conference

Andrea Behrman, Ph.D. and Susan Harkema, Ph.D.

Researchers in the University of Louisville Department of Neurological Surgery will share their recent developments in therapies for children and adults with neurological conditions at IV STEP, an international conference intended to foster, guide and affect neurologic physical therapy practice over the next decade. Andrea Behrman, Ph.D., P.T., and Susan Harkema, Ph.D., professors at UofL, along with Elizabeth Ardolino, Ph.D., P.T., assistant professor at the University of St. Augustine, will present “Activity-dependent Plasticity for Neuromuscular Recovery:  Use of Classifications to Drive Therapies and Outcomes,” on Friday, July 15, at the IV STEP Conference in Columbus, Ohio.

In their presentation, the researchers will discuss how therapies aimed at recovery and improved function after neurological injury or disease can be designed based on key scientific evidence of the ability of the central nervous system to change through physical activity, a process known as activity-dependent plasticity. They will discuss how evidence for this process can be used in the treatment of children with chronic spinal cord injury. The sensorimotor experience of typical childhood development, current rehabilitation after pediatric SCI, and activity-based therapies will be explored as a basis for different outcomes and expectations.

To assist in the development of these novel therapies, the team will introduce the Neuromuscular Recovery Scale and the Pediatric Neuromuscular Recovery Scale, tools for assessing the neuromuscular capacity of adults and children to perform functional tasks without compensation from behavioral strategies, equipment or physical assistance. The scale can be used to classify capacity and track recovery in individuals with neurologic injury or disorders.

“One aim of this assessment is to capture incremental gains in motor function. Assessing ‘how’ the movement is performed also addresses the quality of the movement, which distinguishes this measure from many other pediatric instruments typically in use,” Behrman said.

With funding from the Department of Defense and the Craig H. Neilsen Foundation, the group has established the validity, reliability, responsiveness and other properties of the scale, which will pave the way for it to be incorporated into clinical practice and research. Other aspects of the research are supported by the Leona M. and Harry B. Helmsley Charitable Trust, the Christopher and Dana Reeve Foundation and Kosair Charities.

The IV STEP conference, sponsored by the Pediatric and Neurology Sections of the American Physical Therapy Association (APTA), is designed to explore new theory and research evidence related to movement science and to translate this theory and evidence into physical therapy practice. The six-day program will include 33 invited speakers, 13 video case presentations and 100 peer reviewed poster presentations for approximately 700 clinicians, educators, and researchers from around the United States and abroad.

It is only the fourth such conference to be held in 50 years. The first, NUSTEP, was held in 1966 and the second, II STEP, in 1990. At III STEP, held at the University of Utah in June 2005, Behrman presented information on her research in using locomotor therapy, “Locomotor recovery after SCI: From basic science to clinical practice.”

In addition to the invited plenary presentation by Behrman and Harkema, five research teams from Frazier Rehabilitation Center, a part of Kentucky One Health, and the University of Louisville will be presenting posters.

Behrman is a professor in the UofL Department of Neurological Surgery and director of the Kosair Charities Center for Pediatric NeuroRecovery. Her research focus is to develop and test therapeutic interventions promoting recovery after spinal cord injury in children and adults capitalizing on activity-dependent neuroplasticity and an understanding of the neurobiology of walking and motor control. Her research has demonstrated improvements in trunk control in children in particular.

Harkema is a professor in the UofL Department of Neurological Surgery and associate scientific director of the UofL Kentucky Spinal Cord Injury Research Center. Harkema’s research in epidural stimulation in adults shows promise in helping individuals recover function following complete spinal cord injury.

The University of Louisville is an academic sponsor of the IV STEP Conference.

Robert Friedland proposes new term for the role of microbiota in neurodegeneration: Mapranosis

Robert Friedland proposes new term for the role of microbiota in neurodegeneration:  Mapranosis

Possible routes for microbial amyloid to influence the CNS

Research in the past two decades has revealed that microbial organisms in the gut influence health and disease in many ways, particularly related to immune function, metabolism and resistance to infection. Recent studies have shown that gut microbes also may cause or worsen Parkinson’s disease, Alzheimer’s disease and other neurodegenerative conditions.

University of Louisville neurology professor Robert P. Friedland, M.D., and Matthew R. Chapman, Ph.D., professor at the University of Michigan, have proposed a new term to describe an interaction between gut microbiota and the brain in an article released today in PLOS Pathogens.

Friedland and Chapman propose the term “mapranosis” for the process by which amyloid proteins produced by microbes (bacteria, fungi and others) alter the structure of proteins (proteopathy) and enhance inflammation in the nervous system, thereby initiating or augmenting brain disease. The term is derived from Microbiota Associated Protepathy And Neuroinflammation + osis (a process).

Friedland hopes that giving the process a name will facilitate awareness of the process, as well as research leading to therapeutic opportunities.

“It is critical to define the ways in which gut bacteria and other organisms interact with the host to create disease, as there are many ways in which the microbiota may be altered to influence health,” Friedland said.

Research into the multitude of microbes that inhabit the human body has expanded considerably in recent years. Genomic analysis has begun to reveal the full diversity of bacteria, viruses, fungi, archaea and parasites living in and on the body, the majority of them in the gut. Even more recently, researchers have begun to explore how the proteins and other metabolites produced by microbes inhabiting the gut influence functions in other parts of the body, including the brain. However, we do not yet have a full understanding of how these systems work. The relationship between the microbiota and the brain has been called the “gut-brain axis.”

It is understood that the clumping of misfolded amyloid proteins, structures produced by neurons in the brain, are associated with neurodegeneration and conditions such as Alzheimer’s disease, Parkinson’s disease and amyotrophic lateral sclerosis (ALS).

“It is well known that patterns of amyloid misfolding of neuronal proteins are involved in age-related brain diseases. Recent studies suggest that similar protein structures produced by gut bacteria, referred to as bacterial amyloid, may be involved in the initiation of neurodegenerative processes in the brain,” Friedland said. “Bacterial amyloids are produced by a wide range of microbes that inhabit the GI tract, including the mouth.”

In research published in 2016 in Scientific Reports, Friedland and colleagues showed that when E. coli microbes in the gut of rats and worms (nematodes) produced misfolded amyloids, the amyloids produced in the animals’ brains and intestines also misfolded, a process called cross-seeding.

“Our work suggests that our commensal microbial partners make functional extracellular amyloid proteins, which interact with host proteins through cross-seeding of amyloid misfolding and trigger neuroinflammation in the brain,” Friedland said.

In today’s article, Friedland and Chapman also address other factors related to the microbiota and its products and how they influence neurodegenerative disorders.

  1. The microbiota modulates (enhances) immune processes throughout the body, including the central nervous system.
  2. The microbiota may induce oxidative toxicity (free radicals) and related inflammation that contributes to neurodegeneration.
  3. Metabolites produced by the microbiota may be either beneficial (health sustaining) or damaging (pathogenic).
  4. Host genetics influence microbiota populations, illustrating that the gut-brain axis is bidirectional.

Friedland believes further research in this area may lead to therapies for these neurodegenerative diseases, which are increasing in frequency and for which there are few effective treatments.

Chapman’s research is supported by the National Institutes of Health. Friedland’s work has been supported by The Michael J. Fox Foundation.

 

December 21, 2017

UofL receives $6.7 million to create Superfund Research Center

Researchers to study how exposure to pollutants contributes to cardiometabolic disease
UofL receives $6.7 million to create Superfund Research Center

Sanjay Srivastava, Ph.D.

The University of Louisville has received a $6.7 million grant from the National Institutes of Health to become one of fewer than two dozen Superfund Research Centers across the United States.

The five-year grant comes after a 20-year effort by the university to secure Superfund money for environmental study and will establish a new, multidisciplinary center at UofL that will support the federal Superfund Hazardous Substance Research and Training Program.

UofL was one of five new Superfund Research Center sites funded in 2017, bringing the number across the nation to 23, including such institutions as the Massachusetts Institute of Technology, Columbia University and Duke University.

“The University of Louisville is joining an elite group of research enterprises in this growing field of study examining the impact of environmental determinants to health conditions,” said Gregory Postel, M.D., interim president of the University of Louisville. “The work performed here will impact the field for generations to come, not only from the research findings that come from the program, but from the next generation of researchers who will be educated and trained.”

“This is a very prestigious grant for the university and will help raise the awareness of environmental issues as they relate to health, and train the next generation of environmental scientists,” said Sanjay Srivastava, Ph.D.,a professor and researcher in cardiovascular medicine at the UofL School of Medicine who will lead the project.

Researchers will study how chemical exposures, particularly to chemicals known as volatile organic compounds (VOCs), contribute to the incidence, prevalence and severity of cardiometabolic disease as it relates to cardiovascular disease, type 2 diabetes, obesity and fatty liver disease, all big problems in Kentucky.

The Superfund program, created in 1980, is part of a federal government effort to clean up land in the U.S. that has been contaminated by hazardous waste, and identified by the U.S. Environmental Protection Agency as a potential risk to human health or the environment. The program was started in part by the discovery of a waste site near Louisville in Bullitt County. Known as the “Valley of the Drums,” the site contained thousands of steel drums full of chemical waste that accumulated over decades.

Currently, there are hundreds of Superfund sites across the country, and Louisville has one near the Rubbertown industrial area along Lees Lane in the western part of the city.

The grant to UofL comes through the National Institute of Environmental Health Sciences Superfund Research Program, which funds university-based research on human health and environmental issues related to hazardous substances. The program’s goal is to understand the link between chemical exposure and disease, reduce that exposure and better monitor the effects on health.

While the government tried to make Superfund sites safe, it was not completely known exactly how toxic some of that waste was, or how it could exacerbate diseases. Waste at Superfund sites includes such substances as industrial solvents, pesticides, metals, dry-cleaning solvents, paints, wood preservatives, cleansers, disinfectants and gasoline and other petroleum products that generate VOCs such as butadiene, trichloro ethylene, benzene, acrolein, vinyl chloride, and formaldehyde.  When disposed of together, these substances can react and form compound chemicals that are even more toxic.

“The task of cleaning up those sites proved easier said than done,” said Srivastava, who also is a Distinguished University Scholar at UofL.

In its heyday, Rubbertown was a booming industrial site with multiple factories and plants. Today, manufacturing in the area is down about 90 percent and the EPA closed the Superfund site to waste disposal about five years ago, satisfied that the waste disposed of there no longer posed a threat. But residents have continued to complain about chemical odors from the site, and the EPA has made multiple visits back as it considered reopening the site for remediation, Srivastava said.

Studies already have associated certain chemicals with heart disease and metabolic disorders. Excessive rates of type 2 diabetes and stroke have been found in an evaluation of 720,000 people living within a half-mile of 258 Superfund sites associated with excessive VOCs in drinking water.  “There is strong evidence that insulin resistance, type-2 diabetes, fatty liver disease and cardiovascular disease are associated with environmental exposures” Srivastava said.

UofL’s Superfund Research Center will focus on residents around the Lees Lane Landfill, a 112-acre landfill in Southwest Louisville. The site was used for a quarry in the 1940s and 1950s and was used as a landfill through 1975. The EPA placed the site on the Superfund program in 1983 because of contaminated ground water, surface water, soil and air resulting from landfill operations. Steps were taken to clean up the site and the EPA removed the site from the National Priorities List in 1996. However, the most recent estimates were inconclusive regarding remedy protectiveness, Srivastava said.

The Superfund team will measure pollutant exposure at the site, and compare pollutant levels at this site with those in the Rubbertown site with its multiple factories and plants. Nearly 38,000 people live within three miles of the site. Using data from the U.S. Census Bureau and death records from 2005-2009, UofL researchers have observed a 48 percent higher cardiovascular mortality in 26 neighborhoods around Rubbertown than in nearby Louisville areas.

The UofL team hopes to enroll 500 participants from three geographic areas in the project: one near the Superfund site on Lees Lane; one farther away, but still in Rubbertown; and one not nearby, in Oakdale. Researchers will set up continuous air monitoring at the sites, as well as mobile monitoring in different areas to help determine how far the level of gaseous pollution from the ground extends.

They will collect current health and demographic data and medical history, and look for evidence of chemical exposure in blood, urine and other samples. Participants’ blood chemistry, obesity and cardiovascular and liver function will be monitored after 18 months and 36 months. The team also will study the cardiometabolic effects of VOCs in animal models.

The other part of the project will focus on developing sensors for measuring VOCs in the air and constructing a land-use model to decrease ambient VOCs. The project also will test whether planting trees – known to help reduce the effect of exposure to toxic particles and VOCs in the air and soil – would improve the health of residents in the Oakdale area under the Green Heart project, launched last month. 

AHEC programs improve Kentuckians’ health by increasing supply of health-care providers

Area Health Education Centers awarded $4.12 million continued funding
AHEC programs improve Kentuckians’ health by increasing supply of health-care providers

Kentucky AHEC offices

Kentucky ranks among the worst states for access to quality health care, and 96 of its 120 counties are medically underserved. Educating health-care providers within the state is vital to combating the shortage of health workers and is the heart of the mission of Area Health Education Centers (AHEC).  Kentucky AHEC has been awarded $4.12 million in continued funding from the federal Health Resources and Services Administration (HRSA) to continue that mission through Aug. 2022.

Administered by the University of Louisville School of Medicine in collaboration with the University of Kentucky College of Medicine, Kentucky AHEC has worked to improve Kentuckians’ access to health care since 1985. Kentucky AHEC is composed of eight centers that promote healthy communities and health-care delivery in the state’s regional service areas by increasing the number of health-care workers of all disciplines, particularly in underserved areas.

“The AHEC centers contribute to the education of health professionals at UofL and at other institutions throughout Kentucky. Having an adequate number of well-trained, dedicated health professionals is a vital component to reducing health disparities, increasing access to health-care and improving the health of all Kentuckians,” said Gregory Postel, M.D., interim president of the University of Louisville. “This renewed funding is assurance that these programs will continue to support health education in the Commonwealth.”

Since its inception, Kentucky AHECs have facilitated the training of medical students in primary care, in many cases, introducing the students to issues faced by patients in underserved communities. All third-year students in the UofL School of Medicine complete a four-week clinical rotation in family medicine in rural or urban underserved communities throughout the state. The Kentucky AHEC program also provides education and rotations for nursing and dental students.

Kelli Bullard Dunn, M.D.

“Students gain a deeper understanding of the needs of the patients by working in these communities. It encourages then to consider practicing primary care in rural or urban underserved communities,” said Kelli Bullard Dunn, M.D., vice dean for community engagement and diversity at UofL, Kentucky AHEC program director and the principal investigator of this HRSA award.

To facilitate training, AHEC staff work with the Schools of Medicine, Dentistry and Nursing to identify physicians and other professionals to coordinate students’ rotations in their communities. This provides a framework for the students to complete rotations in clinics, medical offices and community hospitals across the Commonwealth.

“This is a way for health-professions students to come out and serve in rural and underserved communities where they are exposed to different cultures and the practice of medicine without the innovative technologies available at the health sciences campuses. They get to see real medicine, real people,” said Brenda Fitzpatrick, director of the Northwest AHEC, based at the Family Health Center in Louisville’s Portland neighborhood.

In addition to educating health-professional students, AHECs in each region develop programs that further their mission in ways best suited to their communities.

For Fitzpatrick, that is developing a true pipeline of health-care professionals, from physicians and dentists to nurse practitioners, physician assistants, nurses, nurse’s aides, bioengineers and computer technology professionals.

“While HRSA encourages AHECs to promote careers in the health professions to high school students, we take that a step further and work with middle school students,” she said. “By the time they reach eighth grade, it may be too late.”

Fitzpatrick adds that the Northwest AHEC collaborates with several medical magnet schools in Jefferson County to help students obtain certifications during high school.

“This will get them in the workforce sooner and allow them to then continue their education and move on up the chain.”

In the latest round of program funding, HRSA has instructed AHEC programs to encourage patient-centered medical homes, which coordinate patients’ care in a single office, improving overall health-care delivery and reducing costs.

Another new directive from HRSA is the development of the AHEC Scholars program. Each center will instruct 15 -25 health-profession students from a variety of disciplines in interprofessional education, behavioral health integration, social determinants of health, cultural competency, practice transformation and current and emerging health issues. Interprofessional education fosters collaboration among physicians, nurses, social workers, allied health and other providers.

“In a time of significant federal cutbacks, we were pleased to receive funding under HRSA’s extensively revised criteria,” Bullard Dunn said.

In addition to the federal funding, Kentucky AHEC is supported by Kentucky General Assembly appropriations, UofL and UK. AHEC is part of UofL’s Signature Partnership, a university effort to enhance the quality of life and economic opportunity for residents of West Louisville.

 

 

 

November 9, 2017