A new combination vaccine may reduce the number of injections required to keep infants and toddlers up to date with the United States infant immunization schedule recommended by the Centers for Disease Control and Prevention. In a phase III trial reported in the August 2015 issue of Pediatrics, the vaccine was determined to be effective, safe and well-tolerated. Gary S. Marshall, M.D., professor of pediatrics at the University of Louisville, was the principal investigator of the multi-center trial and first author of the report.

The hexavalent vaccine combination, known as DTaP5-IPV-Hib-HepB, is aligned with the recommended immunization schedule and is expected to protect children against diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib) and hepatitis B. The trial, coordinated at UofL, included nearly 1500 children in multiple centers across the United States.

The long list of immunizations in the recommended immunization schedule can lead to deferred injections and limit the addition of new vaccines. Depending on which vaccine combinations are used by an individual medical practice, this new vaccine combination may mean an infant receives 1 to 4 fewer injections.

“It has gotten complicated because there are so many vaccines, which is good news because there are fewer sick children. Having combination vaccines is more good news – it makes things simpler without compromising protection,” Marshall said. “Hopefully, this vaccine combination will improve coverage rates. Studies show that when you use combination vaccines, more kids get vaccinated on time and by two years of age more are fully protected. When you make it easier, you get better coverage.”

A similar hexavalent vaccine has been available in Europe for more than a decade and has resulted in more timely immunizations.

The report in Pediatrics, entitled “Immunogenicity, Safety, and Tolerability of a Hexavalent Vaccine in Infants,” indicates that children who were given the new vaccine developed immunity to the listed diseases equivalent to that received from an existing immunization regimen. The children experienced a slightly higher rate of redness at the injection site and slightly higher rate of self-limited fever following the injections, as compared with the established regimen. Children receiving both the new vaccine and the established regimen were followed for serious adverse health events for six months following the final dose, with no safety signals raised in either of the two groups.

The new vaccine is currently under review by the Food and Drug Administration. After approval, the vaccine will be available for incorporation into the routine childhood schedule.

“Once it is licensed, we can take pride in having brought this new vaccine to the pediatric community and having done our part to simplify the routine immunization schedule,” Marshall said.

FINANCIAL DISCLOSURE:  Dr. Marshall has been an investigator on clinical trials funded by GlaxoSmithKline, Merck, Novartis, Pfizer and Sanofi Pasteur, and he also has received honoraria from these companies for service on advisory boards.

Registration is now open for the 15^th Annual Geriatric Health Care Symposium, “Maximizing Independence for Optimal Aging,” presented by the University of Louisville Institute for Sustainable Health & Optimal Aging.

The symposium will be held 7:30 a.m.-4:45 p.m., Friday, Sept. 18, at the Founders Union Building of UofL’s Shelby Campus, 9001 Shelbyville Road.

Keynoting the event will be David Morris, Ph.D., interim chair of the Department of Physical Therapy at the University of Alabama at Birmingham. A licensed physical therapist and known nationally for his expertise in physical therapy for seniors, Morris will speak on “Fitness for Life.”

Other sessions at the symposium include “Google Glass in Rural Nursing Homes and Home Health,” “Preventive Care in Older Adults,” “Polypharmacy 2.0 – Antipsychotic Meds,” “Maximizing Oral Health,” “Update on Dementia” and more.

Faculty include Amelia Kiser, M.D., Laura Morton, M.D., Christian Furman, M.D. and Daniela Neamtu, M.D., all from the UofL Department of Family and Geriatric Medicine; Demetra Antimisiaris, Pharm.D., UofL Department of Pharmacology and Toxicology; Mike Mansfield, D.M.D., and Gustavo Oliveira, D.M.D., UofL School of Dentistry; Belinda Setters, M.D., Robley Rex Veterans Affairs Medical Center; Benjamin Mast, Ph.D., UofL Department of Psychological and Brain Sciences; and Anne Veno, R.N., Episcopal Church Home.

Continuing education credits are available through the UofL Department of Continuing Medical Education and Professional Development for physicians, nurses, physical therapists and dentists. Continuing education credit for social workers is in process, and the program is pending approval by the American Association of Nurse Practitioners.

Registration before Aug. 15 qualifies for early bird discounts. Registration before Aug. 15 is $125 for physicians; $35 for students; and $100 for all others. Valid identification is required to qualify for registration categories.

To register and for more information, go to the symposium website.

Four-year-old Evander Conroy is visiting Louisville this summer from his home in Sydney, Australia to continue therapy designed to help him gain the ability to walk. Evander is receiving Locomotor Training (LT) with University of Louisville researcher Andrea Behrman, Ph.D., director of the Kosair Charities Center for Pediatric NeuroRecovery, a clinical services division of UofL’s Kentucky Spinal Cord Injury Research Center (KSCIRC).

To make this trip to Louisville even more special, Evander will be the first child to utilize a newly developed locomotor treadmill designed specifically for children. Previously, Behrman and her team had to adapt adult devices to fit Evander and other children who come from around the world for the therapy.

Helping make the visit possible is the Crawford's Kid program, created by the Todd Crawford Foundation to Cure Paralysis, which provides funds to help cover the family’s expenses related to the trip to Louisville. Evander, the second “Crawford's Kid,” will spend five weeks in Louisville receiving booster LT therapy and participating in research to better understand the muscle activity contributing to his progress for sitting, standing and stepping.

Evander’s spine was damaged by a malignant tumor present in his chest cavity at birth, and his family was told he would spend his life in a wheelchair. However, his mother, Clare, met Behrman at a spinal cord injury conference in Australia and learned about LT, an activity-based rehabilitation approach Behrman provides at Frazier Rehab Institute, a part of KentuckyOne Health, in Louisville. Evander previously came to Louisville for therapy with Behrman in 2013 and again in 2014, and has experienced significant progress. Through the therapy, Evander has been able to move his legs and take independent steps.

The Todd Crawford Foundation grew out of efforts to assist Crawford following his own injury in 2002. Crawford was 22 years old and had just graduated from college when he suffered a spinal cord injury that left him in a wheelchair. His family and friends organized fundraisers to help during his physical rehabilitation. Crawford, who earned an MBA from UofL, is president of Crawford Designs and continues the fundraising events, including the 5K Run, Walk or Roll. Funds from the events support Crawford’s Kids and other programs affiliated with KSCIRC, as well as spinal cord awareness and advocacy organizations.

“We are able to help financially assist these kids coming to Louisville because we have a large group of wonderful people who come to our events and support our mission. For this, we are continually grateful,” Crawford said.

The new treadmill is the result of a collaborative effort of Behrman and her colleagues in the Kentucky Spinal Cord Injury Research Center and others throughout the university, especially from the UofL Speed School of Engineering. Funding for the development of the prototype came from The Leona M. and Harry B. Helmsley Charitable Trust. Additional funding from the Coulter Foundation will be used in this collaborative effort throughout the university to move this device forward to commercialization as a clinical unit for use in pediatric rehabilitation.

About Locomotor Training

Andrea Behrman, Ph.D.,is a professor in UofL’s Department of Neurological Surgery and director of the Kosair Charities Center for Pediatric NeuroRecovery. Her research focus is to develop and test therapeutic methods that promote recovery after spinal cord injury in children and adults. Behrman has found that early, intensive therapy harnesses the damaged system’s remarkable capacity to change. With intensive, specific therapies capitalizing on this plasticity of the spinal cord and nervous system, children like Evander Conroy who were never expected to get better are getting better. While intensive activity-based therapy does not always lead to fully independent walking, evidence shows it improves mobility, functional skills, quality of life and overall health.

When Mary Osborne and some of her classmates toured the James Graham Brown Cancer Center (JGBCC) and research facilities at the University of Louisville, she had a lot of questions. The sophomore at Central Hardin High School was fascinated by the research and treatments that Brian Clem, Ph.D. described for the students.

“When we got to ask him questions. I basically ended up grilling him about what he was doing,” Osborne said.

Clem, an assistant professor of biochemistry and molecular genetics at UofL and a researcher with JGBCC, appreciated her curiosity and encouraged her to apply for the Summer Research Intern Program sponsored by JGBCC for high school students.

“Mary asked me probably 30 questions on that tour. Her interest and enthusiasm stood out,” Clem said. “I definitely requested to have her as an intern.”

The 2015 Summer Research Intern Program provided 14 high school students from the Greater Louisville area with the opportunity to work in a University of Louisville medical research lab under the guidance of some of the top cancer researchers in the nation. Each student is assigned one of the Cancer Center’s research faculty as a mentor and works in that researcher’s lab for eight weeks. JGBCC has hosted the program for the past 13 summers as a way to reach out to the area’s budding scientists.

“I love science and I love that there never is really an answer to everything. There is always another question,” said Osborne, who hopes to pursue a career in medicine or science. “We can find treatments for cancer, but we want to find treatments for individual people. Every cancer is different.”

Many of the students in the program aspire to careers in medicine or research, and having spent a summer working in a medical lab and with an established researcher is an impressive point on the student’s resume and college applications. Another student in the program, Kyle Bilyeu, graduated from Louisville’s Trinity High School this spring and has been working with John Eaton, Ph.D., and Chi Li, Ph.D., this summer. He sees the program as a chance to get ahead on the path to becoming a clinical oncologist.

“This experience is invaluable. This introduction puts me ahead of everyone as I progress through my career goals,” said Bilyeu, who will enroll at UofL this fall as an undergraduate.

The program also gives UofL the chance to introduce the University’s vibrant research community to bright, curious students from the local area like Osborne and Bilyeu.

“UofL and the Cancer Center are trying to get high school students interested in science,” Clem said. “We want to highlight what UofL has to offer in terms of research to keep them in the city instead of going elsewhere for their education. Plus, it gets my foot in the door with them. If I find a really good student, I like to have them come back.”

Clem says that the researchers also benefit from having the young students in the lab.

“They bring a lot of different dynamics to the lab during the summer. It reinforces your teaching and mentorship ability,” Clem said. “High school students are inexperienced in the science background and knowledge necessary to work in the lab. You have to start from scratch. It is amazing to see how they progress in their knowledge base and ability to grasp new ideas and gain hands-on experience.”

Clem said one of the most difficult lessons for a high school-age student is understanding that experiments don’t always work the first time.

“The students get a crash course in the ups and downs of things not working and troubleshooting. They realize that research isn’t about everything working; 80 to 90 percent of it is about why stuff isn’t working,” Clem said.

The high school students presented posters representing their summer research work on Thursday, July 30 in the lobby of the Kosair Charities Clinical and Translational Research Building, along with undergraduate summer research students from other programs.

Thanks to a nearly $57,000 gift from the Daniel Pitino Foundation, 5,600 children throughout the state of Kentucky will continue to receive life-saving cardiac care from doctors with University of Louisville Physicians.

On Tuesday, July 21, a new van was dedicated that is critical to delivering those services. The van, bought with the gift from the foundation, was unveiled during a news conference at the UofL Physicians Health Care Outpatient Center.

For more than four decades,doctors and staff affiliated with the University of Louisville have packed their bags every week and traveled the state to give those thousands of children with heart problems specialized care close to their homes.

The pediatric cardiology team travels to eight rotating sites from Ashland to Paducah and places in between, bringing all their supplies and medical equipment - such as EKG and echocardiogram machines - in a customized van made just for the task. The team, which lives on the road four days a week, reaches up to 50 patients a day and more than 5,600 per year.

For many of these children, the van makes it possible to get the care they need without having to travel hours to Louisville and have their parents take time off work and spend precious resources on travel expenses and hotels. For some with very limited resources, it makes the difference between getting the care they need and not getting care at all.

But over the years as the latest van aged, it became unreliable, at times leaving the doctors and staff without a way to transport their equipment to patients. Now, thanks to the $56,901 grant from the Daniel Pitino Foundation, the pediatric cardiology travel team has a brand new van made just for them to reach the patients they serve.

“We are so thankful to the Daniel Pitino Foundation for this generous grant that helps us reach so many children in Kentucky who need our services,” said Dr. Walter Sobczyk, senior pediatric cardiologist at UofL Physicians and an associate professor at the UofL School of Medicine.

“Getting care in rural and outlying areas, far from large cities like Louisville, is a very tough task for many families. They have enough to worry about without adding travel and the associated expenses to the mix. We believe that every child deserves access to the health care they need, no matter their circumstances. The van helps ensure they get expert care and have access to the latest in medical advancements and treatments so they can live the best possible life.”

The Daniel Pitino Foundation was founded by UofL men’s basketball coach Rick Pitino and his wife, JoAnne, to honor the memory of their infant son, Daniel, who died of a congenital heart condition in 1987. The foundation’s mission is to benefit underprivileged children and other charitable causes.

“In recognizing the quality care and treatment provided by the doctors and staff of UofL Physicians across the Commonwealth, our board is pleased that we can provide support for the transportation needs of these dedicated individuals,” said Ron Carmicle, executive vice president of the Daniel Pitino Foundation’s board.

For many patients, the van’s services are invaluable.

“It’s made a huge difference in our lives,” said Jill Story, of Benton, Ky., whose daughter Jacee, 16, sees the van’s doctors because of a congenital heart defect. Her husband Matt, 45, also has a congenital heart defect and has been seeing the van’s doctors since he was a child. “It keeps us from having to routinely travel more than three hours to Louisville for their care.”

More about the pediatric cardiology outreach program

The outreach van travels to sites around Kentucky, including Owensboro, Bowling Green, Paducah, Ashland, Murray and Elizabethtown. On most days, the team consists of two doctors and six support staff.  At each site, the team leases office space for the day, where the staff sees up to 50 patients a day, four days a week, Monday through Friday.

The staff also sees referrals from pediatricians and local hospitals. Some patients of the outreach program, like Matt Story, are adults who have been seeing the team’s doctors since they were children.

For patients who need surgery or more complex procedures, the team can arrange for care at Kosair Children’s Hospital in Louisville, as well as transport there.

Back in Louisville, the team also is part of a statewide telemedicine network, where staff at 27 hospitals around the state can digitally transmit results of a heart test for immediate analysis by pediatric cardiology specialists with UofL Physicians at Kosair Children’s Hospital. The UofL Physicians staff at the hospital read up to 2,500 echocardiograms a year.

Initially a state-funded program in the 1950s and 1960s, funding for the outreach van dried up in the late 1970s, leaving the pediatric cardiology clinical practice of the University of Louisville, now part of University of Louisville Physicians, to supply the funding and keep it going.

About University of Louisville Physicians

University of Louisville Physiciansisthe largest multispecialty physician practice in the Louisville region, with nearly 600 physicians in more than 78 specialties and subspecialties, including primary care. Our doctors are the professors and researchers of the University of Louisville School of Medicine, teaching tomorrow’s physicians and leading research into medical advancements. For more information, visit www.uoflphysicians.com.

About the University of Louisville Health Sciences Center

The University of Louisville Health Sciences Center is the city’s only academic medical center. Approximately 1,000 faculty members are involved in education, research and clinical care.  The UofL HSC is home to more than 650 medical and dental residents, 3,000 students pursuing degrees in health-related fields within the Schools of Dentistry, Medicine, Nursing and Public Health and Information Sciences, as well as 14 interdisciplinary centers and institutes. Approximately $140 million in extramural funding enables researchers to uncover the causes of disease and better ways to prevent, treat and cure those diseases. Patients are seen at the Ambulatory Care Building, The James Graham Brown Cancer Center, the UofL Physicians Outpatient Center and University Hospital, which is the primary adult teaching hospital for the School of Medicine. University Hospital’s public mission is steeped in history and now is most clearly visible through its provision of nearly $90 million of health care to the uninsured annually.

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

For the next two years, Aruni Bhatnagar, Ph.D., will have significant influence over the funding of certain types of scientific research as he leads a panel that considers grant applications to the National Institutes of Health (NIH). Bhatnagar, the Smith and Lucille Gibson Chair in Medicine at the University of Louisville, will serve as chair of the 15-member Clinical and Integrative Cardiovascular Science Study Section, a part of the Center for Scientific Review (CSR) that evaluates grant requests for patient-oriented research involving the cardiovascular system and related regulatory organ systems.

Bhatnagar is the director of the UofL Diabetes and Obesity Center, where he leads a group of 30 investigators focused on developing a better understanding of the cardiovascular complications of diabetes. His research focuses on the mechanisms by which oxidative stress affects cardiovascular function.

“Aruni Bhatnagar’s recognition by the NIH reflects the quality of research at the University of Louisville. Having him participate as the chair of this NIH study section elevates our programs even further on the national scale and emphasizes the importance of his work in the larger scientific community,” said David L. Dunn, M.D., Ph.D., executive vice president for health affairs at UofL.

Members of the CSR study sections are selected based on their achievements in their scientific disciplines, demonstrated by their research accomplishments, publications and other activities. The study section chair is in place for a two-year term. Bhatnagar’s term began July 1, 2015 and runs through June 2017.

Bhatnagar says serving as a study section chair is both an honor and a responsibility.

“Being appointed as a chair of a study section is a clear recognition of the leadership role of a scientist, both in conducting research as well as in contributing to the discussion of specific research ideas and projects,” Bhatnagar said. “With a diminishing NIH budget, it is becoming increasingly important that only the best science is funded and that the new, untested ideas that have high potential are not subsumed by a process that favors the status quo and is reluctant to support innovative research.”

When Nemr Eid, M.D., joined the staff at the University of Louisville School of Medicine in 1988, he could not have guessed that his children would ultimately attend medical school there – all at the same time. As of July 26, when Eid’s youngest child, Sabine, received her white coat and formally became a medical student, all three children of Eid and his wife, Nada, are students in the UofL School of Medicine.

“When I think about it, it fills my heart with joy and with pride,” said Eid, chief of UofL’s division of pediatric pulmonology. “And to have them in the same medical school with me is even more joyful.”

At the White Coat Ceremony, held on July 26 at the Downtown Marriott (280 W. Jefferson), the UofL School of Medicine faculty and medical community members formally welcomed first-year medical students by presenting them with a white coat. The coats, a gift from the Greater Louisville Medical Society, are shorter than the physicians’ coats, and are worn until the student graduates from medical school. Once they received their coats, members of the incoming class recited the Declaration of Geneva, promising to serve humanity and honor the traditions of the medical profession.

Eid never assumed his children would follow in his footsteps. He encouraged them to pursue their own paths.

“We would sit at the dinner table and talk about what you want to be. I did not discourage them. I did not say ‘you should not be a doctor.’ But I never encouraged them, either,” Eid said. “I would tell them to ‘follow your dream; do whatever makes you happy.’ I never thought all three of them would go into medicine!”

Eid’s three children, Mark, Ryan and Sabine, each decided on a career in medicine via different routes. The eldest, Mark, originally set his sights on a career in economics or law. Sabine considered a career in broadcast communications. Only the middle child, Ryan, always knew he wanted to be a physician.

“I knew I would go into medicine since the third grade. Science was one of my passions,” Ryan said. “I also have always been interested in cultures and people and the world and travel. That took me to the University of Miami in Florida. It is the most diverse school in the country, so I have friends in China, the Cayman Islands, Europe and Africa.”

Mark enrolled as an undergraduate at UofL with a law degree in mind.

“I was a political science and economics major for my first two and a half years of college,” Mark said. However, he realized he missed science and appreciated his father’s relationships with his patients. So he backtracked to catch up on undergraduate science courses in preparation for medical school.

In 2013, both Mark and Ryan enrolled at UofL School of Medicine as members of the class of 2017.

Having also decided on a career in medicine, Sabine received her bachelor’s degree from UofL this spring with a major in biology, and will formally join her brothers in medical school as a member of the Class of 2019.

“I had the privilege of working with Dr. Nemr Eid on mutual patients with pediatric airway problems for many years. It has been such a treat to have his sons, Mark and Ryan, as medical students at UofL. Their strong intellect, commitment and altruistic spirit certainly came as no surprise,” said Toni Ganzel, dean of the UofL School of Medicine. “I’m delighted to see the Eid legacy continue at UofL and look forward to working with Sabine as she begins her medical school journey.”

Although they had individual mentors outside the family, each of the Eid children say their father inspired them to enter medicine through his attitude toward his work.

“He gets up every single morning and goes to work happy,” Sabine said. “He comes home every single evening happy. He loves what he does. He has never said anything negative. Hopefully, in the chapter I choose, I will wake up every morning and feel excited to go to work.”

They also credit their mother, Nada, for encouragement and support.

“She is a lawyer so she knows exactly what a rigorous curriculum is like. My mom has been there to help us through the tasks at hand from grade school and college and now med school,” Ryan said.

“Each of them has had a different journey that brought them to this day,” Dr. Eid said. “Each will have a different path that will propel them to their dream. It is up to them to follow that dream.”

About Pediatric Pulmonology – During his first ten years at UofL, Nemr Eid, M.D., was the only pediatric pulmonologist in Louisville. Although other physicians in his specialty now have joined him, a critical need for these physicians remains throughout the nation and in Kentucky, where there is only one pediatric pulmonologist for every 170,000 children. Under Eid’s direction, UofL began a pediatric pulmonology fellowship two years ago, but he hopes more physicians will pursue the specialty since those positions are not always filled.

The International Society for Heart Research (ISHR) has honored University of Louisville’s Roberto Bolli, M.D. for his contributions to cardiovascular science. The Peter Harris Distinguished Scientist Award, which recognizes a senior investigator for lifetime contributions of major discoveries in cardiovascular science, was presented to Bolli at the organization’s European Section meeting in Bordeaux, France earlier in July.

“This award is significant because it comes from an international community. I was chosen not by people I work more closely with in the United States, but by people from all over the world. It is truly an international recognition,” said Bolli, chief of UofL’s Division of Cardiovascular Medicine, director of the Institute of Molecular Cardiology and director of the Cardiovascular Innovation Institute, as well as vice chair for research in the Department of Medicine.

The Peter Harris Distinguished Scientist Award is the most prestigious award presented by the ISHR, an international organization devoted to the discovery and dissemination of knowledge in the cardiovascular sciences on a world-wide basis. The ISHR’s 3,000 members are affiliated with seven sections based on five continents.

As recipient of the 2015 award, Bolli received a $3,000 honorarium and presented a keynote lecture at the meeting on July 2 on the state of cell-based therapies for ischemic cardiomyopathy. His research is focused on the use of stem cells to treat patients with coronary artery disease. Bolli led the Louisville-based SCIPIO trial that pioneered treatment with a patient’s own heart stem cells to regenerate dead heart muscle. Larger studies are underway which could lead to widespread use of this treatment.

“Smaller studies, including what we did in Louisville, have shown promise and the data are encouraging. We are awaiting final demonstration that the cells are truly beneficial in patients,” Bolli said.

Bolli also has conducted research on preventing damage caused during heart attacks by studying ischemic preconditioning, the phenomenon in which heart muscle exposed to brief periods of stress becomes resistant to the tissue death that might be caused by a heart attack.

Zach feels “pretty good.” Sam wants to be “done with shots!” And Tyler finds it helps to “just keep thinking that at least I’m getting out of school.”

They are normal boys who had normal lives until cancer came into the picture. All have faced the disease for two years or more, with surgeries, chemotherapy and radiation treatments. All were diagnosed with various malignant solid tumors, went into remission and then relapsed.

Today, however, they and their parents are finding hope in a Phase I research study led by Kenneth G. Lucas, M.D., chief of the division of pediatric hematology/oncology and stem cell transplantation at the University of Louisville. Leading a team of his colleagues at Kosair Children’s Hospital and in the UofL Department of Pediatrics, Lucas is making progress in developing a vaccine that one day could possibly prevent recurrence of some childhood cancers.

Lucas began the trial – the only one of its kind – while on the faculty of Penn State in 2011. Coming to Louisville in 2012, he now has three patients enrolled in the trial. Another 13 have previously completed the regimen. He uses the patient’s own blood cells in developing the vaccine.

“The vaccine is designed to stimulate the patient’s immune system to attack specific tumor proteins, and then fight the tumor,” said Lucas, who also is the chief of pediatric hematology/oncology at Kosair Children’s Hospital.

The vaccine is prepared and frozen in a cell therapy lab and then thawed for injection. Patients come to UofL’s Kosair Charities Pediatric Clinical Research Unit for a week of chemotherapy that helps make the tumor cells express these cancer proteins. These proteins enable the tumors to be killed by immune cells that are stimulated by the vaccine.

The following two weeks are devoted to vaccination, followed by another two weeks of observation for side effects to the vaccine. The process is repeated four times, making the treatment take anywhere from four to five months. Thus far, the vaccine has been well tolerated by most patients, Lucas said.

Patients may be referred by their own physician or can self-refer, Lucas said. Anyone interested in the trial should contact KCPCRU@louisville.edu or 502-629-5820.

The trial is partially funded by the Children’s Hospital Foundation and raiseRED, a dance marathon fundraising effort organized by UofL students to support pediatric cancer research.

Sam Rosebrock, age 5, Morganton, N.C.

Like any 5-year-old, Sam Rosebrock of Morganton, N.C., is anxious prior to his injection.

“I don’t want a shot,” he repeatedly said amid tears as mom Denielle Rosebrock comforted him. After the injection, he asked her, “Are we done with our shots?” Hearing that there would be no more injections, he was happy to repeat, “Done with shots! Done with shots!”

Sam had neuroblastoma, a type of cancer most commonly found in young children that develops from immature nerve cells found in several areas of the body. Sam’s neuroblastoma was originally diagnosed in 2012 in the adrenal glands. Following chemotherapy, surgery, radiation, stem cell transplantation and antibody immunotherapy, he went into remission.

The cancer later came back in the groin area and left testicle. More chemo and immunotherapy followed, putting Sam into remission again. Sam’s oncologist in Charlotte, N.C., learned about the trial in Louisville and Denielle said it was easy to make the decision to enroll him.

“With neuroblastoma, even when you have no evidence of disease, the likelihood of it coming back is extremely high,” said Denielle, who with her husband, Mark, has another son, Isiah, age 10. “When you relapse, you have to do something.”

Zach Hartwell, age 20, Lyndonville, Vt.

Doing “something” also is uppermost in the mind of Bill Hartwell, father of 20-year-old Zach who was diagnosed in 2011 with a medulloblastoma, the most common malignant brain tumor found in children and occurring in the cerebellum, which is the part of brain located at the base of the skull, just above the brainstem. Bill, wife Nancy and Zach have been on a four-state odyssey since diagnosis, from their home in Lyndonville, Vt., to Dartmouth, N.H., where the diagnosis was confirmed, to treatment in Boston and now to Louisville.

Along the way, Zach had surgeries, chemotherapy, radiation and more. He also experienced posterior fossa syndrome, a condition that affected his ability to move and speak.

Through a Facebook group, Parents of Kids with Medulloblastoma, Nancy learned about the experimental therapy.

“At 8 o’clock on a Saturday night, Nancy is checking Facebook and she saw information about Dr. Lucas and his trial, so she emailed him,” Bill said. “At 10 o’clock, he returns the email – it was just that quick – and says he thinks Zach may be eligible.”

Zach is the first patient in the trial with medulloblastoma. He receives a similar round of treatment as Sam: First week of chemotherapy, second and third weeks for vaccination, and fourth and fifth weeks for observation.

In speech halted by posterior fossa syndrome but still clear, Zach said, “I knew I was going to have to do something – chemo or radiation or both – and this just seemed like it was the better option.”

“To us, this treatment seems like a very logical thing to do, a very logical approach. And much less invasive than the other treatments he has had,” Bill said.

Tyler Foster, age 14, Beechmont, Ky.

The fact that the vaccine therapy is less invasive is a plus for Tyler Foster’s dad, Michael Foster of Beechmont, Ky.

“This is a lot milder than any other treatment he has had,” Michael said.  “I believe this has been the easiest treatment he has faced.”

Tyler is 14 and was originally diagnosed with osteogenic sarcoma in 2013 in his right knee, femur and lung. It also is known as osteosarcoma and is a type of bone cancer. It often starts in the ends of the bones where new bone tissue forms as a young person grows.

After chemotherapy and surgeries, Tyler went into remission at Christmastime in 2013. In September 2014, the cancer came back, followed by more surgeries, including removing all of his femur and hip. He then underwent a rigorous chemotherapy regimen known as “ICE” – a three-drug combination of ifosamide, carboplatin and etoposide.

“It’s hard enough to hear your child has cancer. That’s a blow out of this world,” said Michael, who with wife Susan has another child, Alexis, age 20. “And then to hear it a second time is even harder.

“ICE was hard, very, very hard. We almost lost Tyler a couple of times. He had feeding tubes. He was vomiting. He vomited up around 17 liters (of fluid) in one day.

“So that was a pretty rocky road. But he got better and had radiation after that.”

Tyler speaks with the wisdom of a teenager who tests above his grade level but still is … well, a teenager.

“When I heard I had cancer, my first thought was that I was going to get out of school for awhile,” he said with a laugh.

The journey since, however, has the ginger-haired teen philosophical. “I just really have tried to not think too much about what was happening,” he said, “and just look towards the future, that one day, I can get over this.”

Hope for the future

That focus on the future is what keeps Bill Hartwell going, too. “We feel like this treatment is going to be the cure. People always talk about statistics, but we don’t even think about that kind of stuff.

“We saw this trial, the treatment seemed to make good sense, and so we think … this is going to cure Zach, and we’re going to move forward from there.”

Denielle Rosebrock has hope as well. “We don’t get ‘definites’ (definitive answers) because it is a trial and it’s very new,” she said. “We also know that participating in the trial is one of our choices. We have to do something to prevent the cancer from coming back. We know there is a lot of promise in it.”

“If this works, man, it would be terrific for other kids that face this,” said Michael Foster. Adds Tyler: “It helps me to know that if this does work, it wouldn’t put other kids through the same thing I’ve been through.”

HD digital video accompanying this story is available at https://youtu.be/jvUks4uwl9U. Print-quality still photos can be found at http://louisville.edu/medicine/news/photos-childhood-cancer-vaccine-research-at-uofl-kosair-childrens-hospital-1. Video and still photography furnished byKosair Children’s Hospital.

University of Louisville medical student Andrew Smith has been selected as a member of the 2015-2016 Student Editorial Panel for Universal Notes, a subscription-based web application that assists students in preparation for Step 1, 2 and 3 exams as well as the National Board of Medical Examiners (NBME) assessments. Smith is one of 10 students selected from medical schools in the United States and abroad to serve on the panel for one year beginning this month.

Smith, a third-year student in the School of Medicine, responded to a call for applicants who are interested in learning about medical education.

“It sounded like a great opportunity because I hope to teach medicine. One of the things we get to do is write questions for the Q-bank, so I hope it will improve my question writing. Also, I will be studying as I am updating the questions, so it will improve is my knowledge base,” Smith said.

Universal Notes was developed by Aaron McGuffin, M.D., associate professor of pediatrics at Marshall University Joan C. Edwards School of Medicine, as a tool for assisting medical students prepare for the exams they must pass on their way to becoming physicians. McGuffin created the student editorial panel to critique the material and to serve as a training ground for medical educators of the future.

“Students are the lifeblood of the success of Universal Notes,” McGuffin said. “One job of the panel is to use it and evaluate it and say how it could be better. The other thing is we put them in the role of teacher so they have to look at the curriculum as if they are teaching it. That gives them a respect for the challenges of preparing information for delivery. My hope for these student editors is they eventually want to be academic clinicians.”

Students were selected for the editorial panel based on their demonstrated desire to teach. Smith has been involved in teaching his fellow students at UofL both as an undergraduate and in medical school, tutoring students in chemistry and anatomy and teaching sections of the prematriculation program, which helps medical students get a head start on the curriculum for the following year of study.

“Andrew was one of the best student instructors I have had in the prematriculation program. He went above and beyond in preparing and presenting the lectures. He even hosted evening and weekend review sessions and created a practice practical lab exam for the students,” said Mary Joshua, UofL’s director of the Office of Diversity and Inclusion and prematriculation program coordinator. “He has a real passion for sharing his knowledge with other people.”

Smith already has begun evaluating the material in Universal Notes and developing questions.

“It needs more information, but that’s what we are here to do,” Smith said. “It is pretty exciting. I do love this kind of thing.”

About Universal Notes:  Universal Notes is a comprehensive online study and assessment tool for medical students, helping them prepare for Step 1, Step 2, Step 3 and NBME. A companion app is available for Android and iOS devices. Universal Notes is compiled and edited by medical students and educators. The database contains information on basic sciences, drugs, diseases, labs, competencies and board review questions.

“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.

The University of Louisville Institute for Sustainable Health & Optimal Aging and AARP will host a free “Watch Party” of the 2015 White House Conference on Aging, Monday, July 13. Registration opens at 9 a.m. and the conference will be held from 10 a.m. to 5 p.m.

The conference is open to the general public as well as to professionals engaged in all aspects of senior caregiving and service provision. Space is limited, so RSVPs are needed by contacting Ann Burke at optimalaging@louisville.edu or 502-852-5629. For additional information, contact Mary Romelfanger, associate director of the Institute for Sustainable Health & Optimal Aging, mary.romelfanger@louisville.edu.

The conference will be live-streamed in the recently renovated Lecture Hall, room B215 of the UofL School of Medicine Instructional Building, 500 S. Preston St. Metered parking is available on South Preston, East Muhammed Ali and East Chestnut streets and parking for a fee is available in the Chestnut Street Garage, 414 E. Chestnut St.

President Barack Obama is scheduled to be the keynote speaker at the White House Conference on Aging, an event held once a decade since 1961 that helps chart the course of aging policy. Watch Party attendees will be able to send questions and comments directly to the conference and a panel of local aging specialists will be available to answer questions at the event.

“The year 2015 marks the 50th anniversary of Medicare, Medicaid and the Older Americans Act, as well as the 80th anniversary of Social Security,” said Anna Faul, D.Litt., Executive Director of the Institute for Sustainable Health and Optimal Aging. “The 2015 White House Conference on Aging is an opportunity to recognize the importance of these key programs as well as to look ahead to the issues that will help shape the landscape for older Americans for the next decade.”

According to the conference website, the four areas the conference will examine were developed after hearing from older Americans in forums held across the country. The common themes that emerged from this input were the following:

• Retirement security is a vitally important issue to older Americans. Financial security in retirement provides essential peace of mind for older Americans, but requires attention during their working lives to ensure that they are well prepared for retirement.
• Healthy aging will be all the more important as baby boomers age. As medicine advances, the opportunities for older Americans to maintain their health and vitality should progress as well, and support from their communities, including housing, are important tools to promote their vitality.
• Long-term services and supports remain a priority. Older Americans overwhelmingly prefer to remain independent in the community as they age. They need supports to do so, including a caregiving network and well-supported workforce.
• Elder justice is important given that seniors, particularly the oldest older Americans, can be vulnerable to financial exploitation, abuse and neglect. The Elder Justice Act was enacted as part of the Affordable Care Act, and its vision of protecting seniors from scam artists and others seeking to take advantage of them must be realized.

One of the most promising areas of research in the fight against cancer is immunotherapy, or stimulating the body’s own immune system to destroy cancer. Jason Chesney, M.D., Ph.D., a professor in the University of Louisville Department of Medicine and the deputy director of the James Graham Brown Cancer Center, is conducting clinical trials using checkpoint inhibitors as well as modified herpes virus in the treatment of melanoma with impressive results.

Chesney will speak at the next “Beer with a Scientist” event about immunotherapy research being conducted at UofL and elsewhere and treatments that may be available in the next few years.

“We finally understand how to activate the human immune system to clear cancer cells, having developed new classes of immunotherapies that dramatically improve the survival of cancer patients,” Chesney said.

The program begins at 8 p.m. on Wednesday, July 15 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.

Douglas Dean, Ph.D., the Robert W. Rounsavall Jr. and Gretchen C. Rounsavall Endowed Chair in Ocular Molecular Biology in the Department of Ophthalmology and Visual Sciences at the University of Louisville, has been awarded the 2015 RPB Stein Innovation Award from Research to Prevent Blindness.

The award is $300,000 over three years and provides funding to scientists actively engaged in research that investigates the visual system and the diseases that compromise its function. Dean is one of seven researchers at six institutions who have received the award since it was established in 2014.

“We are most grateful for the research support provided by Research to Prevent Blindness,” said Henry J. Kaplan, Evans Professor of Ophthalmology and chair of UofL’s Department of Ophthalmology and Visual Sciences. “Dr. Dean and his collaborators have recently made very important observations concerning the rescue of cone photoreceptors in retinitis pigmentosa, the leading form of hereditary retinal degeneration in the United States. His demonstration that cone photoreceptor demise in this disease appears related to ‘glucose starvation’ may have enormous translational impact.”

Dean’s research has been supported by the National Institutes of Health. He has published more than 150 articles in peer-reviewed journals including Cell, Molecular Cell, Nature and Genes & Development.

Prior to coming to UofL in 2004, Dean served on the faculty in the departments of Cell Biology and Medicine at Washington University School of Medicine in St. Louis. He earned his Ph.D. from the University of Kansas. He completed a three-year fellowship at Baylor College of Medicine in Houston. He then completed a second postdoctoral fellowship at the Salk Institute in La Jolla, Calif.

Research to Prevent Blindness is the world’s leading voluntary organization supporting eye research. Since it was founded in 1960, RPB has channeled hundreds of millions of dollars to medical institutions for research into the causes, treatment and prevention of blinding eye diseases. For information on RPB, RPB-funded research, eye disorders and the RPB Grants Program, go to www.rpbusa.org.

Three faculty members holding endowed positions, an associate professor and an instructor from the University of Louisville Department of Neurological Surgery will share their expertise this summer at the annual meeting of one of the nation’s premiere organizations of brain and spinal cord injury specialists and researchers.

Neurotrauma 2015, the 33^rd Annual Symposium of the National Neurotrauma Society, will be held in Santa Fe, N.M., June 28-July 1. The annual symposium is considered the primary scientific forum for exchanging information in the fields of both traumatic brain injury (TBI) and spinal cord injury (SCI).

On Sunday, June 28, assistant professor Enrico Rejc, Ph.D., will present Lumbrosacral Spinal Cord Epidural Stimulation for Standing After Chronic Complete Paralysis in Humans. At UofL, Rejc investigates the effects of different combinations of stimulation parameters, weight-bearing related sensory information and training on the modulation of the spinal neural networks, with the intent to promote the recovery of motor function for standing.

On Monday, June 29, Scott Whittemore, Ph.D., will chair the presentation on Genetic Dissection of Locomotor Circuitry. Speaking during the presentation will be David Magnuson, Ph.D., on Conditional Silencing Propriospinal Neurons: Hopping to a New Tune.

Whittemore is the Dr. Henry D. Garretson Chair in Spinal Cord and Head Injury Research and the scientific director of the Kentucky Spinal Cord Injury Research Center, considered one of the largest such centers in the nation. Magnuson is the Friends for Michael Endowed Chair in Spinal Cord Injury Research and also serves on the Symposium Program Committee organizing the 2015 event.

On Wednesday, July 1, Michal Hetman, M.D., Ph.D., will chair and Whittemore will co-chair the presentation, Cell Death is Still Alive, a look at the effect of cell death on TBI and SCI. Hetman is the Endowed Professor of Molecular Signaling and his research is concentrated on identification of the molecules controlling neural cell survival and  growth. Instructor Sujata Saraswat-Ohri, Ph.D., will present one of the three sessions of the presentation, Targeting the Homeostatic Arm of the ER Stress Pathway Improves Functional Recovery After SCI.

“The Neurotrauma Annual Symposium has informative discovery, translational and clinical sessions and workshops, as well as programs for students and early career investigators,” Whittemore said. “We are proud to bring the accomplishments of the University of Louisville into this discussion of the latest research and evidence-based medicine with our peers from throughout the country.”

University of Louisville Physicians today launched the “Academic Physician Precision Challenge,” a fun, interactive game to raise awareness of academic medicine.

Every day, doctors make discoveries and develop innovative treatments that change the lives of patients and their families everywhere. Most of these breakthroughs are made by academic physicians, dedicated doctors who see patients in clinical practices while researching and teaching at universities like the University of Louisville. Because of their academic affiliation and research activities, they have the opportunity to take the latest in clinical research and apply it for real-world use. They also often help shape health policy, sitting on government and professional panels.

The Precision Challenge measures anatomical knowledge while giving users insight into how academic doctors may have contributed to their health, or that of their family or friends.

“The game is designed as a unique way to grow awareness of the groundbreaking contributions academic physicians have made in the field of medicine, and why people would want to choose an academic physician for their health care,” said Diane Partridge, vice president of Marketing and Communications for UofL Physicians.

The game, designed by Louisville-based DBS>Interactive, invites users to test their knowledge of anatomy by placing 11 organs, such as the pancreas and liver, in the correct spot. If the user is precise, a box appears presenting them with a medical advancement or discovery relating to that organ made by an academic physician. If they aren’t, the user hears a buzzer and the screen shakes, and they have to try again.

When all the parts are placed, the user gets a ranking, with a corresponding badge based on their number of errors:

• Medical doctor
• Medical resident
• In med school
• Pre-med
• High school biology

The game will be shared with teachers and schools across the U.S.

Find the game here at www.uoflphysicians.com/academic-precision-challenge

Experts from around the country will join faculty experts from the University of Louisville’s James Graham Brown Cancer Center, a part of KentuckyOne Health, to look at the latest evidence-based medicine in treating metastatic cancer of the central nervous system.

“Evaluation and Management of Patients with Brain and Spinal Metastasis” will be held July 10 from 7:15 a.m. to 12:30 p.m. at the UofL Clinical and Translational Research Building, 505 S. Hancock St. Admission is free but pre-registration is strongly encouraged at the conference website.

“We are bringing together some of the leading clinicians and researchers from our cancer center and beyond to discuss the latest innovations in caring for patients with central nervous system cancer,” said Conference Director Eric Burton, M.D., assistant professor in the Department of Neurology. “Disciplines represented include neurosurgery, radiation oncology, neuroradiology, neuro-oncology and more.”

The conference is designed both for health care providers and the general public, Burton said. “If you are a health care professional working in the neurological cancer field, if you are a patient with neurological cancer or if you are a caregiver to someone with neurological cancer, this conference will benefit you.”

In addition to Burton, presenters include:

Continuing education credit is available to health care providers. For additional information, visit the conference website or contact Emily Rollins in the UofL Department of Neurological Surgery at emily.rollins@louisvilleneuroscience.com.

Physicians without formal training in transgender health can be unprepared when a transgender patient needs basic health care, or help with a transgender specific issue such as hormonal transition. If the physician is unfamiliar with the typical barriers faced by transgender people in the health-care system or current standards of care, the patient’s health may suffer.

The University of Louisville will host two events on June 11 at the School of Medicine to close this gap by providing physicians and other health-care providers with a better understanding of treatment practices and standard of care for transgender patients.

First, a panel of physicians and community members will discuss best practices in transgender health care in a grand rounds presentation for approximately 80 physicians and other health professionals. Following the panel presentation, about 60 health-care providers and transgender community leaders will meet to network, identify gaps in care and discuss steps needed to improve care for this population.

The events are part of a UofL initiative, known as the eQuality Project,* established to ensure that individuals who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming or born with differences of sex development (DSD) receive the best possible health care in the community.

“This is a topic that has been taboo for a long time. Physicians want to provide the best care for these patients, but they may not be aware of issues and how to address someone in a culturally responsive manner,” said Faye Jones, M.D., Ph.D., M.S.P.H., assistant vice president for health affairs -- diversity initiatives at UofL’s Office of Diversity and Inclusion. “This is a group that has many health disparities and this program will help alleviate these disparities.”

People who are LGBT, gender non-conforming or born with DSD often experience challenges when seeking care in doctors’ offices, community clinics, hospitals and emergency rooms. Research shows that these health disparities result in decreased access to care or willingness to seek care, resulting in increased medical morbidity and mortality for LGBT and DSD-affected patients.

“Ultimately, it is our goal to have an identified medical ‘home’ that provides all aspects of care for transgender patients in Louisville, as has been developed in other major clinical centers in the United States,” said Amy Holthouser, M.D., associate dean for medical education at the UofL School of Medicine.

Beginning in August, the UofL School of Medicine will serve as the nation’s pilot site for training future physicians on the unique health-care concerns and issues encountered by LGBT individuals and those who are gender nonconforming or DSD-affected.

The Institute of Medicine, The Joint Commission, the U.S. Department of Health and Human Services, and the Association of American Medical Colleges (AAMC) have all recently highlighted the need for more in-depth provider education on LGBT health.

“At least forty hours of content in the UofL school of medicine curriculum have been targeted for revision to be more inclusive and affirming of LGBT and DSD patients,” Holthouser said. “This will reinforce the core stance that a competent physician is skilled in the care of all patients within their community and can approach each patient with sensitivity, compassion and the knowledge necessary to promote health and wellness.”

For more information about attending the event on June 11, contact Stacie Steinbock, director of the LGBT Center Satellite Office on the Health Sciences Center Campus at Stacie.steinbock@louisville.edu.

*About the eQuality Project:  The eQuality Project at UofL is an interdisciplinary initiative that includes the School of Medicine’s Undergraduate Medical Education Office, the Health Sciences Center’s Office of Diversity and Inclusion, and the UofL LGBT Center. The purpose of the eQuality Project is to deliver equitable quality care for all people, regardless of identity, development or expression of gender/sex/sexuality.