University of Louisville Physicians’ Movement Disorders Clinic has been named a national Center of Excellence in treating Huntington’s disease and received a $10,000 grant from the Huntington’s Disease Society of America.

The designation recognizes work at UofL Physicians to help improve the lives of people affected by the disease. HDSA Centers of Excellence provide an elite multidisciplinary approach to care and research. There are currently 39 across the United States, including UofL Physicians.

“We are proud to be the first center in Kentucky to be recognized as a HD Center of Excellence,” said Dr. Kathrin LaFaver, a neurologist who leads the Huntington’s disease program at UofL Physicians. “We are planning to expand our involvement with the HD community and offer participation in future research studies.”

Patients at the Centers of Excellence benefit from expert neurologists, psychiatrists, therapists, counselors and other professionals who have deep experience working with patients and families affected by Huntington’s disease, and who work collaboratively to help them plan the best program of care throughout the disease’s course.

Debbie Holloway, who is affected by Huntington’s disease, is currently enrolled in a clinical trial at UofL Physicians. She had in the past regularly traveled four hours round trip to a center in Indiana for treatment because of its designation as a Center of Excellence.

“We feel so thankful and blessed to now have a Center of Excellence here in Louisville,” she said.  “My family is affected and we definitely want to do anything we can to help find a cure. Now when a new research program comes in, someone in my family may be able to participate. And it is wonderful to have my doctor here.”

Huntington’s disease (HD) is a fatal genetic disorder that causes the progressive breakdown of nerve cells in the brain. It deteriorates a person’s physical and mental abilities during their prime working years and to date has no cure. Patients affected by the disease develop chorea (involuntary movements), difficulties with cognition and often psychiatric manifestations such as depression and irritability.

HD is inherited in an autosomal dominant fashion, meaning every child of a parent with HD has a 50/50 chance of carrying the disease mutation. Today, there are approximately 30,000 symptomatic Americans and more than 200,000 at risk of inheriting the disease.

Many describe the symptoms of HD as though they have ALS, Parkinson’s and Alzheimer’s simultaneously.

As part of the efforts to help patients with the disease, patients are being recruited for the ENROLL-HD worldwide observational study for HD families. The goal is to track HD progression and create a database that doctors can learn from and use for treatment studies as they emerge.

Patients who are interested in enrolling can find more information at www.enroll-hd.org.

For more information on Huntington’s disease Centers of Excellence, visit the Huntington’s Disease Society of America’s web page at www.hdsa.org/about-hdsa/centers-of-excellence.

Nathan Berger, M.D., the Hanna-Payne Professor of Experimental Medicine and director of the Center for Science, Health and Diversity at Case Western Reserve University, holds the Louisville Slugger bat he was given as a speaker at the first symposium honoring the late co-division chief of the Blood and Bone Marrow Transplantation Program at UofL. The Geoffrey P. Herzig, M.D., Memorial Symposium for Hematologic Malignancies and Bone Marrow Transplantation drew a stellar cast of presenters April 8-9 at the Jewish Hospital Rudd Heart & Lung Conference Center. Herzig came to UofL in 2000 as co-division chief with his brother, Roger Herzig, M.D., shown second from left. The symposium was created by current division chief William Tse, M.D., at far left, with another presenter, Hillard Lazarus, M.D., the George & Edith Richman Professor and Distinguished Scientist in Cancer Research at Case Western Reserve, at far right. Twenty-six physicians and other scientists from the United States, Canada and England presented the symposium, covering the latest advances in treating leukemias, myelomas and other blood-borne cancers. (Robert Burge Photography)

Treating children with pneumonia complicated by infected fluid in the chest (called empyema) can take longer than other infectious diseases, and typically requires surgical intervention and intravenous (IV) antibiotics. A study published in the April issue of The American Surgeon by University of Louisville assistant professor of pediatrics Claudia Espinosa, M.D., M.Sc., and colleagues, shows that the disease can successfully be treated with a course of broad-spectrum oral antibiotics once the children are released from the hospital, thus making administration of IV antibiotics at home unnecessary.

Espinosa and several colleagues at the UofL School of Medicine conducted a retrospective study of 61 patients treated using a standardized approach of video-assisted thoracoscopic surgery (VATS) and IV antibiotics administered in the hospital, with transition to broad-spectrum oral antibiotics about five days after surgery or when the patients were discharged. The study showed a 92 percent rate of recovery without complications using this approach, which is comparable to that achieved with prolonged courses of IV antibiotics continued at home, but avoids potential complications associated with home IVs.

“Given the adverse effects of IV antibiotics and the potential possible complications of PICC lines, transitioning to oral antibiotics and providing a shorter course than previously advised is a good strategy,” Espinosa said. “The outcomes appear to be good even when cultures are negative and the choice of antibiotic is an empiric one.”

The children in the study, all previously healthy children with community-acquired bacterial pneumonia and empyema, were admitted to Kosair Children’s Hospital from 2008 to 2012. All of the children were treated with prompt VATS and early transition to oral antibiotics, which continued for an average of two weeks after discharge.

“Many physicians believe that placing a chest tube and giving fibrinolytics is better than VATS for treatment of empyema,” Espinosa said. “In this study, we show good outcomes, short length of stay, minimal complications and short course of antibiotics for pediatric patients with empyema who underwent VATS.”

Former Kentucky First Lady and longtime cancer awareness activist Jane Beshear will join with the Kentucky Cancer Program at the University of Louisville to host Horses and Hope: A Breast Cancer Awareness Day at the Races, Wednesday, April 13, at Keeneland  race track in Lexington.

Doors open at 10:30 a.m. with lunch served at 11:30 a.m. at the Keene Barn and Entertainment Center. First post time for the day’s racing card will be 1:05 p.m.

Breast cancer survivors and guests are invited to enjoy lunch and a Derby Fashion Style Show sponsored by Talbots, The Spa at Griffin Gate, Kroger, Keeneland and WKYT-TV and emceed by WKYT anchor Amber Philpott. Following the program, participants will be escorted to reserved seating in Keeneland’s Grandstand where the day’s racing will feature a Horses and Hope race honoring breast cancer survivors.

Horses andHope™ is a project of Beshear and the Kentucky Cancer Program. The mission is to increase cancer awareness, education, screening and treatment referral among Kentucky’s horse industry workers and other special populations. Screenings and events are held across the state in collaboration with the new Horses and Hope Cancer Screening Van launched earlier this year with KentuckyOne Health.

Ticket packages are $30 per person and include reserved parking, track admission, lunch, covered grandstand seating, racing program and a special Horses and Hope souvenir. Participants are encouraged to wear pink for breast cancer awareness.

Seating is limited so registration by April 11 is advised. To make reservations, call 859-254-3412. For additional information, call toll-free, 877-326-1134.

Health-care professionals often are aware of larger social issues facing their patients in disadvantaged communities but feel powerless as individual practitioners to change these health disparities. The University of Louisville’s new Health and Social Justice Scholars Program is accepting applicants who will be trained to work with other professionals in communities to bring about changes to benefit underserved and disadvantaged populations.

Students in the UofL schools of Dentistry, Medicine, Nursing and Public Health and Information Sciences who are dedicated to social justice are encouraged to apply for the program, where they will learn techniques for working interprofessionally and with community members to improve the overall health of the populations through community engagement and scholarly activities. The students will work with faculty mentors to combat issues such as youth violence, public water safety and depression in adolescents in West Louisville and other disadvantaged communities.

“As a pediatrician, I know that a physician can’t do it alone,” said V. Faye Jones, M.D., Ph.D., M.S.P.H., assistant vice president for health affairs – diversity initiatives at UofL. “You have to have different perspectives and different skills to move that needle. We cannot work in silos; we have to work as a team to accomplish the goal of health equity.”

One second-year student from each of the four schools in the UofL Health Sciences Center will be selected for the first cohort of scholars for the 2016-2017 academic year. The Health and Social Justice Scholars will conduct interprofessional, community-based research along with a faculty mentor, participate in community service projects and attend monthly discussions. In addition, the scholars will receive annual financial support of $10,000 toward their education programs. Scholars are expected to continue in the program for three years.

“We want students who are dedicated to community engagement and who are passionate about making a difference,” said Jones, who oversees the program. “Eventually, these professionals will be leaders in advocating for policy changes to improve the overall health of the community.”

Applicants for the program must be entering their second year of a doctoral program in the school of Dentistry, Medicine, Nursing or Public Health and Information Sciences (Au.D., D.M.D., D.N.P., M.D. or Ph.D). They will be required to submit an essay describing a health concern in the community with a proposed path for improvement, a summary of their research experience, letters of recommendation and transcripts.

Applications will be accepted through May 31. For additional information and to apply, visit the Health and Social Justice Scholars web page, or contact the UofL Health Sciences Center Office of Diversity and Inclusion at 502-852-7159 or hscodi@louisville.edu.

About the UofL HSC Office of Diversity and Inclusion

The UofL Health Sciences Center Office of Diversity and Inclusion welcomes and embraces the community of students, faculty and staff. The office seeks to encourage and foster all constituents’ growth and development to allow for everyone to be successful at UofL. By augmenting a culture and climate that demonstrate a belief that diversity and inclusion add value to intellectual development, academic enrichment, patient care, research and community engagement, the office intends to place HSC at the forefront of opportunity and innovation. Its mission is to conceptualize, cultivate and coordinate partnerships across the schools of Dentistry, Medicine, Nursing, and Public Health and Information Sciences by building organizational capacity and expanding leadership competency for HSC diversity and inclusion efforts. The office aspires to be a model for innovation for health equity driven by excellence in education, community outreach and research.

You may have heard about genetically modified organisms (GMOs) along with predictions of dire consequences for the planet or claims the technology is necessary to feed the Earth’s growing population. At the April edition of Beer with a Scientist, Paul Vincelli, Ph.D., professor in the Department of Plant Pathology at the University of Kentucky College of Agriculture, Food and Environment, will set the record straight with peer-reviewed science.

Vincelli will make the trip across I64 to share his expertise on the scientific understanding of GMOs based on the substantial body of scientific literature. He will explain exactly what constitutes a genetically engineered crop, whether eating recombinant DNA is safe, and why scientists would want to change a plant’s genes in the first place.

At UK, Vincelli serves as coordinator for the United States Department of Agriculture (USDA) Sustainable Agriculture Research and Education Program. He provides science-based outreach on risks and benefits of genetically engineered crops in Kentucky, the nation and internationally.

The program begins at 8 p.m. on Wednesday, Apr. 13 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.

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.

The latest advances in the use of bedside ultrasound in the operating theater will be shared at a daylong conference for health care professionals.

The Perioperative Ultrasound and Echocardiology Workshop will be held Saturday, May 14, in the Paris Simulation Center in the University of Louisville School of Medicine Instructional Building, 500 S. Preston St. Registration opens at 7 a.m. and the workshop will be held from 7:45 a.m. to 4:30 p.m.

The workshop is designed for anesthesia providers, anesthesiologists, intensivists, residents and nurses in the perioperative environment, said Jiapeng Huang, M.D., Ph.D., clinical professor of anesthesiology and perioperative medicine at UofL, an attending cardiac anesthesiologist at Jewish Hospital, a part of KentuckyOne Health, and president of medical staff for Jewish Hospital & St. Mary’s Healthcare.

Perioperative ultrasound, also known as point-of-care or bedside ultrasound, enables the anesthesiology staff to have real-time ultrasound images in the operating room environment that are equal in accuracy to x-ray or CT scan without exposing patients to potentially harmful radiation. Echocardiography is a diagnostic test that uses ultrasound waves to create an image of the heart. Ultrasound of the nerves and blood vessels also enables health care professionals see these structures in real time to guide nerve blocks and central line placement. Ultrasound makes these invasive procedures much safer and more efficient.

“This course will provide anesthesiologists and others involved in perioperative care the most up-to-date and practical ultrasound skills required for safe and the highest quality anesthesia care,” Huang said.

The workshop has sliding registration fees based on profession and hospital affiliation. Continuing education credit also is available. Breakfast and lunch are provided.

For details and to register, go to the workshop website.

Abstracts are due midnight of Thursday, March 31, for the Inaugural Optimal Aging Conference. Abstracts can be submitted here. More conference information can be found at www.OptimalAgingInstitute.org.

The Optimal Aging Conference will be held June 12-14 in Louisville at the Brown Hotel, 335 W. Broadway. This conference is jointly presented by the Institute for Sustainable Health & Optimal Aging at the University of Louisville and the Kentucy Association for Gerontology (KAG).

The Optimal Aging Conference focuses on aging as an opportunity for indiduals and socieities, and not a disease. This conference is transdisciplinary and as such, individuals across a wide variety of perspectives and backgrounds are welcome to submit abstracts, including academics, health care professionals, social service professionals, business professionals working in health care, age care disrupters and older adults.

The conference features a variety  conference tracks, including:

The 2016 Optimal Aging additionally features several pre-conference opportunities:

• June 11-12: Chief Resident Immersion Traing (CRIT), a leadership training for Chief Residents, Program Directors and geriatrics faculty
• June 12: Continuing education for Social Work professionals

For information about the conference and abstract submission, visit www.OptimalAgingInstitute.org or call 502-852-5629.

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 11^thNational 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.

Advancing early knowledge in treating leukemias, myelomas and other blood-borne cancers was the hallmark of the late University of Louisville physician-researcher Geoffrey Peter Herzig’s life, so it is a fitting tribute to him that a new symposium in the same field has been established by UofL.

The inaugural Geoffrey P. Herzig, M.D., Memorial Symposium for Hematologic Malignancies and Bone Marrow Transplantation will be held April 8-9 at the Jewish Hospital Rudd Heart & Lung Conference Center, 201 Abraham Flexner Way. Thanks to support from presenting sponsor Jewish Hospital & St. Mary’s Foundation, along with others, there is no cost to attend but registration in advance is required at rebecca.thurman@louisville.edu or 502-562-3367. Continuing education credit is available for physicians and nurses attending the symposium.

Designed for health care professionals, the symposium will cover the latest advances in hematologic malignancies and bone marrow transplantation with speakers from the United States, Canada and England. William Tse, M.D., the Marion F. Beard Chair of Hematology and chief, Division of Blood and Bone Marrow Transplantation at UofL, is symposium chair. Roger Herzig, M.D., who held co-division chief positions prior to Tse with his brother Geoffrey, is honorary co-chair of the symposium.

“Geoffrey Herzig developed or participated in advancing many of the cancer therapies and interventions we take for granted now,” Tse said. “This memorial symposium is an opportunity to honor both the person he was and the innovative spirit that drove his work.”

Herzig died in 2013 after a career that spanned the National Cancer Institute and cancer centers in the states of Missouri, New York and Kentucky. The hematopoietic stem cell dose used in transplantation today was determined by Herzig while he was at the NCI. He also was the founding director of the adult bone marrow transplant program at Barnes Hospital, Washington University at St. Louis. In 1990, Herzig joined the Roswell Park Cancer Institute in Buffalo, N.Y., to focus on research in acute myeloid leukemia, his area of special interest. In 2000, the Herzig brothers came to UofL to co-direct the bone marrow transplant program at UofL and the James Graham Brown Cancer Center, now a partnership of UofL and KentuckyOne Health.

“If you’re a young physician who does bone marrow transplants or treats people with leukemia, you may not realize how much you and your patients owe to Geoff Herzig,” said noted physician-scientist and editor-in-chief of Leukemia, Robert Peter Gale, M.D., Ph.D., of Imperial College London and one of the symposium speakers.

For more details about the symposium, visit the conference website.

The Institute for Sustainable Health & Optimal Aging at the University of Louisville concludes its spring Optimal Aging Lecture Series with the conversation “Sexy After 60,” Wednesday, April 13. The lecture will be held from 11:30 a.m. to 1 p.m. at the University Club, 200 E. Brandeis Ave.

Admission is $20 per person and includes lunch. Reservations are required online. Click here to register. Registration deadline is April 8.

Terry Singer, Ph.D., dean of the Kent School of Social Work at UofL, will present an engaging conversation on the often taboo topic of older adult sexuality and relationships.

Most people believe that after a certain age, attractiveness and sexual appeal are lost. This presentation will show how this belief is false. Singer will share his lifelong professional expertise in adult relationships and older adult sexuality, providing listeners with techniques they can use to keep intimacy alive in their relationships as they age.

The Institute’s Optimal Aging Lecture Series will resume in September for the fall season. For information, call 502-852-8953 or email natalie.pope@louisville.edu.

Melissa Currie, M.D., will be among the speakers who “Rally to End Child Abuse,” beginning at 11 a.m., Wednesday, March 30, at the Big Four Bridge Lawn on River Road.

Sponsored by the Family & Children’s Place, Kosair Charities’ Face It® Movement, and other Metro Louisville children’s organizations, the Rally to End Child Abuse kicks off Child Abuse Prevention Month in April.

Currie will join a slate of speakers including Gov. and First Lady Matt and Glenna Bevin, Family & Children’s Place President and CEO Pam Darnall, Louisville Metro Police Department Chief Steve Conrad, Kosair Charities Board Chair Jerry Ward and Kentucky Youth Advocates Executive Director Terry Brooks.

Currie is medical director and chief of the Kosair Charities Division of Pediatric Forensic Medicine and program director of the Child Abuse Pediatrics Fellowship in the Department of Pediatrics at the University of Louisville. The division provides a standardized approach to the assessment of child abuse and neglect issues, providing medical expertise on the diagnosis, documentation and follow-up of suspected cases of child physical abuse and neglect. The first board certified child-abuse pediatrician in Kentucky, Currie practices with University of Louisville Physicians.

The pediatric forensic medicine team serves as liaison between the hospital team and community partners such as law enforcement, Child Protective Services and the Department of Justice. The UofL Department of Pediatrics serves with Kosair Children's Hospital as the only statewide medical referral resource for child maltreatment assessments.

The “Rally to End Child Abuse” highlights progress being made in stopping and preventing abuse and healing child survivors and families. According to 2014 data, nearly 23,000 children suffered physical or sexual abuse or neglect in Kentucky. In Jefferson County, that number totaled more than 3,016 children. Abuse creates a lifelong impact in emotional and physical health, in relationships and in every facet of a child’s life through adulthood.

For more information, visit faceitabuse.org.

Three area organizations are teaming up to sponsor a free legal clinic for people facing cancer and their families and caregivers on April 13.

The Kentucky Cancer Program at the University of Louisville, Louisville Bar Association and Louisville Pro Bono Consortium are sponsoring the clinic, which will be held 5:30-7:30 p.m., Wednesday, April 13 at Gilda’s Club of Louisville, 633 Baxter Ave. Free parking is available behind the building and across the street from the club.

At the clinic, attorneys will be available to offer help with life-planning documents under Medicare Part D, including wills, powers of attorney, health care surrogacy and living wills. They also will provide guidance on employee benefits during illness and government assistance that is available such as Medicaid, Medicare and Social Security disability insurance.

Although admission is free, RSVPs in advance are needed at 502-852-6318. For additional information, contact the Kentucky Cancer Program at jlcaud02@louisville.edu or 502-852-6318.

Roland Valdes Jr., Ph.D., will explain how personalized precision medicine uses an individual patient’s genetic material (DNA) to improve drug treatments for that patient at the next Beer with a Scientist on March 23.

Valdes, a Distinguished University Scholar and professor in the Department of Pathology and Laboratory Medicine at the University of Louisville, has researched and patented biological markers that can be used to personalize a patient’s treatment for a specific disease. By analyzing a patient’s DNA, pathologists can pinpoint whether that individual may be susceptible to adverse events, respond well to a specific medication, or experience drug sensitivities or interactions.

The program begins at 8 p.m. on Wednesday, Mar. 23 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.

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.

March 16, 2016

Toni Ganzel, M.D., M.B.A., dean of the University of Louisville School of Medicine, has been appointed to the Liaison Committee on Medical Education (LCME), the governing body that accredits medical education programs throughout the United States and Canada. Her three-year term begins July 1.

Ganzel will be one of 19 voting members of the LCME – 15 medical educators/administrators/ practicing physicians, two public members and two medical students. Each year, the LCME reviews annual survey data and written reports on all accredited U.S. and Canadian medical schools, and conducts survey visits to 20-30 institutions.

LCME accreditation is a peer-reviewed process of quality assurance that determines whether a medical education program meets established standards. This process also fosters institutional and programmatic improvement.

To achieve and maintain accreditation, a medical education program leading to the M.D. degree in the United States and Canada must meet the LCME’s accreditation standards. Programs are required to demonstrate that their graduates exhibit general professional competencies that are appropriate for entry to the next stage of their training and serve as the foundation for lifelong learning and proficient medical care.

For medical education programs located in the United States, accreditation by the LCME establishes eligibility for selected federal grants and programs. Most state boards of licensure also require that U.S. medical schools granting the M.D. degree be accredited by the LCME as a condition for licensure of their graduates.

Eligibility of students in M.D.-granting schools to take the United States Medical Licensing Examination requires LCME accreditation of their school. Graduates of LCME-accredited schools are eligible for residency programs accredited by the Accreditation Council for Graduate Medical Education.

Ganzel’s appointment follows the UofL School of Medicine’s success in revising its program and seeing the probationary status of the school fully lifted in 2015.

“I am honored that the LCME has selected me for the important task of surveying medical schools that are scheduled for accreditation review, and I view this appointment as one of the highlights of my career,” Ganzel said. “At UofL, we learned a great deal during our own accreditation review, and developed strong systems that modernized our program of education and training for physicians of the 21^st Century. I look forward to bringing that perspective to the LCME and working with colleagues to help shape the future of medical education.”

About Toni Ganzel, M.D., M.B.A.

Toni Ganzel was named dean in 2013 and joined UofL in 1983 as an assistant professor in otolaryngology. She served as director of the division of otolaryngology at UofL from 1993 to 2001, when she was named associate dean of student affairs for the School of Medicine. A native of New Mexico, Ganzel earned her bachelor of science and medical degrees from the University of Nebraska. She earned a master’s degree in business administration/medical group management from the University of St. Thomas in Minneapolis. She completed her residency in otolaryngology at the University of Nebraska before joining the faculty at the Creighton University School of Medicine. She is a Harvard Macy Fellow and a fellow of the Executive Leadership in Academic Medicine (ELAM) Program, the nation’s only in-depth program for women leaders in academic health care.

A March 28 workshop is designed to help cancer care providers support and provide resources for patients and families coping with sexual dysfunction related to chronic illness and treatment.

Daniela Wittmann, Ph.D., University of Michigan clinical assistant professor of urology, will present “Assessing and Treating Sexual Dysfunction After Cancer Treatment: The Role of the Oncology Social Worker.”

The University of Louisville’s Kent School of Social Work, Baptist Health Cancer Care and Hosparus co-sponsor the 12:30-4 p.m. event in the Cancer Resource Center Conference Room of the Charles and Mimi Osborn Cancer Center, Baptist Health Louisville, 4003 Kresge Way.

The seminar is intended for the social workers, oncology nurses, doctors and caregivers who help cancer patients through the grief process, treatment and recovery.

The workshop and lunch are free but registration is required by March 21 at http://uofl.me/1PkxEYu. Three continuing education units are available for social workers for $30 during the National Social Work Month event.

Wittmann will discuss a biopsychosocial approach to understanding sexual dysfunction after cancer treatment and providing treatment geared to improving recovery of sexual function and relationships.

She is co-author of the American Cancer Society guideline for prostate cancer survivorship care and has led the development of psychosocial interventions in the University of Michigan’s program. She has more than 30 years of clinical experience focusing on adjustment to chronic illness.

For more information, contact Karen Kayser at 502-852-1946 or karen.kayser@louisville.edu.

Posted March 11, 2016

Staying mentally and physically well in medical school and throughout their careers is a top concern for medical students.

“I think physician burnout is a looming fear that lingers over all medical students,” said Melinda Ruberg, a second-year student at the University of Louisville School of Medicine. “We are looking for solutions early on as opposed to waiting until we are physicians and have a higher risk of burnout.”

Ruberg and classmates Matthew Neal, Anish Deshmukh and Katherine Yared have developed a model for medical schools to educate physicians in a way that improves their own health, enabling them to better treat their patients. The program, “Happy Healers, Healthy Humans: A wellness curricular model as a means of effecting cultural change, reducing burnout and improving patient outcomes,” received third place in the American Medical Association’s inaugural Medical Education Innovation Challenge. The award, announced earlier this week at the AMA Accelerating Change in Medical Education Consortium in Hershey, Pa., comes with a $1,000 prize.

The competition challenged medical student-led teams to develop a program to solve a problem in medical education. Entries consisted of a five-page paper and 90-second video, which were judged based on the proposed solution to the problem and the plan’s potential to improve medical practice and patient care.

Several aspects of the team’s plan to support a more compassionate approach to medical education already are in place at UofL, such as a student wellness committee, patient interview sessions for preclinical students, and faculty members who champion an environment of compassion as part of the school’s Compassion and Mindfulness Work Team. In addition, the student team suggested elements such as mutual accountability, health monitoring technology and the creation of wellness-oriented spaces in medical schools.

“A big part of our project was making wellness not something you do on the side, but institutionalizing it so it is more of a cultural shift and is fostered within the system,” Ruberg said.

The students’ plan expanded on programs they experienced at UofL and incorporated ideas based on each team member's previous experiences, observations and research.

“We played to our strengths. We each contributed ideas we wanted to see in the paper,” Yared said. “A lot of the ideas stemmed from just brainstorming and how we see other people do things well.”

“We each contributed different things, but it was a beautifully collaborative thing,” Ruberg said.

To further their commitment to physician wellbeing, the students are working to bring an international compassion conference to Louisville. On a personal level, the project has inspired them to improve aspects of their own health. Neal has recommitted to daily meditation. Deshmukh has analyzed his study habits and begun to take a multivitamin. In addition, they would like to work with other UofL medical students to develop activities that encourage physicians to model healthy lives for their patients.

The AMA’s innovation challenge drew nearly 150 entries. A team from Vanderbilt University placed first for their plan to create an open national exchange for curricular content. A Sidney Kimmel Medical College team placed second, and a group from Midwestern University’s Chicago College of Osteopathic Medicine tied with UofL for third.

March 10, 2016

Something of interest for the entire family – and the chance to help the fight against cancer – will be on tap at the “Cancer Awareness Show,” Saturday, May 21, from 11 a.m. to 5 p.m. at the Hillview Community Center, 298 Prairie Drive.

Proceeds from the day’s activities will benefit research, community outreach and patient support programs of the James Graham Brown Cancer Center at the University of Louisville.

The event is comprised of three shows-within-the-show: a model train show including 9X9, 4X16 and 3X6 layouts; an arts and crafts show; and “Cruizin’ for Cancer,” a car, truck and motorcycle show and a model car show. Also included are a fire safety house sponsored by the Zoneton Fire Protection District; food and other vendor booths and prize and cash raffles. Representatives from Be The Match will be on hand to provide information about bone marrow donation. The James Graham Brown Cancer Center also will disseminate information on cancer prevention and treatment.

Admission is a cash donation to the James Graham Brown Cancer Center or canned goods to be donated to local food pantries.

“My vision is simple,” said show organizer Richard Luce Jr. “I want to get more information distributed about the multiple types of cancer and how we can prevent and treat it. I also want to support groups who help people dealing with cancer.”

The Hillview location on the southern side of Metro Louisville is by design, Luce said. “With the Hillview, Southern Jefferson County and Bullitt County areas growing, we need these types of events so people don’t always have to go to Downtown Louisville. The more we can help others with this disease (from throughout the region), the better we are.”

Like virtually every American, Luce has a personal connection to cancer. His father died from the disease in June 2013.

“Since my father’s passing, I have striven to improve cancer awareness,” Luce said. “We hear a lot about different types of cancers but how well informed are people about their personal risk and the importance of testing? Perhaps even more importantly, how can we help generate the necessary funding for cancer research and financial aid to those families affected by cancer?

“I am motivated to honor the memory of my father and to hopefully prevent others from enduring the pain of losing a loved one to cancer. In honor of my father’s memory, I have established the Cancer Awareness Show.”

Vendor spaces are still available, Luce said. A vendor space is $20 if paid by 5 p.m., March 31. The cost is $25 if paid from April 1 to the day of the show.

Sponsorships for the show also are available: Platinum, $1,000; Gold, $500; Silver, $300; and Bronze, $100.

For information on vendors, sponsorships or the show, contact Luce at Bigscoby4@yahoo.com, CancerAwareness15@yahoo.com or 502-802-8308.

About the James Graham Brown Cancer Center:

The James Graham Brown Cancer Center is a key component of the University of Louisville Health Sciences Center. As part of the region's leading academic, research and teaching health center, the cancer center provides the latest medical advances to patients, often long before they become available in non-teaching settings. The JGBCC is a part of KentuckyOne Health and is affiliated with the Kentucky Cancer Program. It is the only cancer center in the region to use a unified approach to cancer care, with multidisciplinary teams of physicians working together to guide patients through diagnosis, treatment and recovery. For more information, visit our web site, www.browncancercenter.org.

Posted March 9, 2016

Once a year, the University of Louisville replaces its red with blue to drive home the need for colon cancer screening.

The Kentucky Cancer Program at UofL will team up with Texas Roadhouse, 6460 Dutchmans Parkway, and former Louisville First Lady Madeline Abramson for “Go Blue for Colon Cancer Awareness,” 11:30 a.m.-2 p.m., Friday, March 11, as part of the observance of March as Colon Cancer Awareness Month.

Attendees are invited to wear blue and visit the new Horses and Hope Screening Van, managed by KentuckyOne Health, that will be on site to provide colon cancer information and colon cancer “FIT” kits for patrons to self-screen in the privacy of their own homes. The fecal immunochemical test (FIT) kit tests for hidden blood in the stool which can be an early sign of cancer. FIT kits only detect human blood from the lower intestine. Medicines and food do not interfere with the test, so it tends to be more accurate and have fewer false positive results than other tests.

Giveaways will be provided to attendees who wear blue and visit the screening van. Anyone bringing a “Go Blue for Colon Cancer Awareness” flyer during the event will get a free appetizer with purchase of a meal at Texas Roadhouse. To obtain a flyer, visit the Kentucky Cancer Program website at kycancerprogram.org or Facebook page.

The Kentucky Cancer Program also is sponsoring a Facebook photo contest with the theme, “How Will YOU Do Blue?” Participants can post their dress-in-blue photos for the chance to win $250. For information, visit the contest website. Photos must be received by March 28 and the winner will be announced April 5.

Colon cancer is the third most commonly diagnosed cancer and the second leading cause of cancer death in men and women combined in the United States. The American Cancer Society estimates that this year 136,830 people will be diagnosed and 50,310 will die from this disease.

With regular screening, however, colon cancer can be found early, when treatment is most effective. In many cases, screening can prevent colon cancer by finding and removing polyps before they become cancer. If cancer is present, earlier detection means a chance at a longer life.

For more details, contact the Kentucky Cancer Program at 502-852-6318.

Posted March 3, 2016

Heart disease is the leading cause of mortality in women worldwide, including in the United States. Although deaths from cardiovascular disease (CVD) in men have declined since the 1970s, the rates of death for women have not followed.

University of Louisville cardiologist Andrew DeFilippis, M.D., M.Sc., may be on the verge of a breakthrough in detecting cardiovascular disease before a heart attack occurs. Thanks to a $100,000 Heart to Heart Grant from Alpha Phi Foundation, DeFilippis will study archived blood samples from thousands of patients to determine whether the presence of certain lipids in a person’s bloodstream can be used to pinpoint women at risk for having a heart attack.

“This new test holds great promise for more accurately identifying women at risk for having a heart attack before any permanent heart damage occurs,” DeFilippis said. “It may allow for more targeted therapy for those at greatest risk of having a heart attack.”

The buildup of fats, cholesterol and other substances in and on the artery walls, known as atherosclerosis, is the underlying cause of heart attack and stroke. Atherosclerotic plaques contain large amounts of oxidized phospholipids (OxPL). DeFilippis believes that the release of OxPL from plaque out into the bloodstream may allow doctors to identify women at increased risk for cardiovascular disease events.

To test this theory, DeFilippis and his research team in UofL’s Institute of Molecular Cardiology will evaluate blood samples and data collected in the Multi-Ethnic Study of Atherosclerosis (MESA) trial, a multi-center prospective study of cardiovascular disease involving 6,814 men and women in six cities in the United States. Beginning in 2000, blood samples were taken and stored for MESA subjects, and their health was followed for up to a decade. DeFilippis plans to evaluate the blood samples and data to determine whether OxPL can be used as a biomarker in predicting cardiovascular disease.

“If our project confirms OxPL as a biomarker of atherosclerotic CVD, it opens the possibility of the development of a totally new class of medications for the treatment of CVD years before the onset of an acute event,” DeFilippis said.

Existing risk assessment tools focus on risk factors such as blood pressure, cholesterol and smoking. While these factors can predict whether a person is pre-disposed to the formation of plaques, it cannot confirm whether high-risk plaques actually exist. As a component of the plaque itself, OxPL has the potential to allow doctors to identify patients who actually have the dangerous plaques which may cause an acute cardiac event in the foreseeable future.

“The efforts associated with understanding a novel biomarker can cost millions and take decades to introduce to clinical practice. With this grant from Alpha Phi Foundation, we can take advantage of the wealth of data in the MESA study and test this promising biomarker with much less expenditure of funds and time.”

Alpha Phi Foundation is the philanthropic and educational partner of Alpha Phi International Fraternity. The foundation’s mission is to advance women’s lives through the power of philanthropy. Awarded annually, the Heart to Heart Grant funds research and educational programs that help medical professionals better understand heart disease in women – specifically its symptoms, treatment and prevention.

“The potential for the research Dr. DeFilippis is conducting is awe-inspiring,” said Susan Zabriskie, interim executive director of Alpha Phi Foundation. “We are proud to invest in this innovative study that can change the way women are diagnosed with and treated for heart disease. Together we can lessen the impact of heart disease in women for generations to come.”

February 28, 2016