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LEXINGTON, Ky. (Sept. 2, 2014) -- The incidence of mouth and throat cancer in Kentucky is growing at an alarming pace. Hospitals and clinics across the Commonwealth see approximately 1,400 new mouth and throat cancer patients each year. Treatment often involves surgery, radiation therapy, chemotherapy or a combination of the three. While these treatments are effective and necessary, they may cause undesirable side effects such as loss of the ability to speak and swallow. These side effects can last for months or years and can range from mild hoarseness to near complete loss of voice.
Voice loss or damage is a frustrating side effect of throat cancer treatment and may result in loss of livelihood and personal identity. The UK Voice and Swallow Clinic and the Markey Cancer Center are researching the effects of voice therapy for patients who have received radiation treatment for throat cancer. The goal of the speech-language pathologist is to help patients improve or recover the ability to eat, drink and speak so that they might return to their usual activities.
Advanced cancer may require complete removal of the voice box or larynx. Although helping these patients find a new way to communicate is challenging, voice rehabilitation techniques have advanced enough to make this difficult task possible. The oldest technique, known as esophageal speech, involves training patients to vibrate the food pipe to produce voice.
As odd as it may sound, it is a surprisingly effective way of producing voice. A second technique involves using a small hand-held mechanical device called an artificial larynx, which is placed on the neck or cheek to provide a sound that is transmitted into the mouth, allowing the patient to speak. The most popular technique involves surgically creating a connection between the wind pipe (trachea) and the food pipe (esophagus). A voice prosthesis known as a tracheoesophageal prosthesis (TEP) is inserted into the connection by a specially trained speech-language pathologist. The TEP causes the food pipe to vibrate, producing voice.
In reality, none of these voice rehabilitation techniques restore a patient’s original voice, but can nonetheless help patients continue to communicate as naturally as possible. Helping patients and families set realistic expectations is an important aspect of the rehabilitation process. A large part of the recovery period involves adjusting and embracing their "new normal."
Of course, the best therapy of all is the one you can avoid. The use of tobacco products (including smokeless tobacco) is closely related to the incidence of mouth and throat cancer. Quitting smoking and/or chewing tobacco is the best way to avoid mouth and throat cancer.
Vrushali Angadi, MS, CCC-SLP, is a speech-language pathologist at the University of Kentucky Voice and Swallow Clinic.
This column appeared in the August 31, 2014, edition of the Lexington Herald-Leader.
LEXINGTON, Ky. (Aug. 28, 2014) — Empty parking spots along High Street, the Old Courthouse Square fountain and reflections off the side of the Lexington Financial Center were all scenes of downtown Lexington that artist Robert Tharsing viewed from his studio window during the 1990s. As a brief distraction from working on larger enterprises, the artist would transfer his bird's eye view of the city to small canvasses.
The retired University of Kentucky professor's Room with a View exhibit on display at the West Gallery in the UK Chandler Hospital represents a downtown Lexington in transition. His 14 landscape paintings are filled with light, color and geometric reflections, offering pleasing representations of ordinary buildings and sites that were scarcely populated during the '90s. The collection of oil paintings include depictions of the Old Courthouse, Cheapside Park, Kincaid Towers and other nameless concrete structures. This is the first time these pieces have been exhibited as a group.
“I have always painted the place I’m in," Tharsing said. "At that time, I would always go back to the window. I would see something in the architecture of a building across the street. Or, if I was caught and working on a large enterprise, I would turn again to the window. There was always something different in this view down onto the street.”
Known as a tireless and curious painter, Tharsing exercised a centuries-old landscape tradition for these pieces. He inhabited four downtown studios during the 12-year period of his career when the paintings were created. The exhibit serves as evidence of the changing landscape and evolution of the downtown area through the years.
Tharsing is a professor emeritus in the Department of Art at the University of Kentucky. In 1971, he joined UK where he twice served as chair of the Department of Art. Tharsing's work, which includes abstract paintings and sculpture, is included in many private and public collections nationwide.
Postcard packages containing 10 small-scale versions of Room with a View paintings will be on sale at the Ann Tower Gallery on Main Street and the Morris Bookshop on High Street. Each sheet is perforated so it can be torn out. The pieces will also be on sale at the Ann Tower Gallery after the exhibit closes in six months.
MEDIA CONTACT: Elizabeth Adams, firstname.lastname@example.org
LEXINGTON, Ky. (Aug. 27, 2014) – The University of Kentucky College of Medicine, in collaboration with the colleges of pharmacy, dentistry, nursing, health sciences and communications, is preparing to host the annual free community health fair which provides services to underrepresented and uninsured residents in Lexington and the surrounding area.
This year's event has been set for 1 to 6 p.m. on Sunday, Sept. 7, at the BioPharm Building (College of Pharmacy), located at 789 South Limestone St. on UK's campus.
"Jumpstart Your Health" is this year's theme for the community health fair. “In deciding on a theme for the year, we wanted to empower Lexington citizens to take control of their health and to be excited about making healthy decisions," said Catherine Mannon, a UK medical student and chair of the health fair's public relations and ad committee.
The UK Community Health Fair, organized by UK College of Medicine students, targets all underrepresented, uninsured, low-income and no-income persons interested in access to free health care. Among its many services, the health fair will offer blood pressure checks, women’s health care, nutritional assessments, hearing and vision screenings, blood glucose and HbA1c testing, smoking cessation information, prescription review, and HIV testing.
Additionally, the UK College of Dentistry is partnering with the health fair to offer free dental screenings which will be provided in the College of Dentistry building, a short walk from the health fair. Guides will be provided to direct participants to the location.
For foreign language speakers attending the health fair, Spanish, Russian, Arabic and Mandarin interpreters will be available on-site. Children are welcome to attend and a play area will be available during the fair.
Free parking is available in the UK Chandler Hospital Parking Garage located at South Limestone at Transcript Avenue and in the UK “E” Lot on the corner of Press Avenue and Virginia Avenue. In addition, Lextran Route #5 stops at the fair site.
The Community Health Fair has been a tradition at the UK College of Medicine for almost 13 years and is organized by medical students allowing them to be involved in making a contribution to the health of the community by providing access to free health services.
On the day of the event, in addition to the students who have been organizing the event, members of the College of Medicine's new first-year class get involved in setting up booths, directing patients and ensuring that all equipment and supplies are available. Overall, more than 150 medical students and more than 50 students from other colleges are involved on the day of the event.
For organizations interesting in donating or providing assistance for the event, the UK Community Health Fair is a non-profit organization that operates on 100 percent of donations from the community. Through a partnership with South Eastern Medical Interpreters Association (SEMIA) the Community Health Fair has attained a non-profit 501(3) status. Therefore, all donations will be routed through SEMIA and are tax-deductible. Donations can be made via PayPal through the website www.ukhealthfair.org.
For more information, visit the website at www.ukhealthfair.org, or send email to Info@ukhealthfair.org.
LEXINGTON, Ky. (Aug. 25, 2014) — Before rushing into surgery at the University of Kentucky Chandler Hospital at 5:30 a.m., patient Christy Rice handed her prized diamond engagement ring to her father for safe keeping. He pushed the ring onto his pinky finger knuckle, but at some point, it slipped from his hand.
Rice, who plans to be married in November, was devastated when she woke to the news of the ring's disappearance. Her father had frantically backtracked his steps through the hospital and reported the missing ring to administrators. She said it was a hard and emotional day up to that point.
"They were the most stressful hours I've experienced in a while," Rice, who went home from the hospital that day in tears, said.
James Champagne, a floor technician and custodial worker at UK HealthCare, was mopping the floors of the hospital on that day last April and overheard the father in his search. As the parent of a 12-year-old girl, Champagne empathized with this man's desperation to find the precious item.
"I said, 'Let me see if I can find it,'" Champagne said. "I saw that expression on her dad's face."
Champagne searched through rooms, trash cans and closets until he found the ring in a dust pile. About 45 minutes after leaving the hospital, Rice received a call from the hospital notifying her that the ring was recovered. She didn't expect to have a happy ending to her day.
Often, those who benefit from the integrity of strangers never get the opportunity to express their gratitude. But Rice, who lives in Versailles, returned to the UK Chandler Hospital on Aug. 22 to personally thank Champagne for his kind deed. Hospital administrators surprised Champagne with balloons and a personalized jacket as a special thank-you for acting with integrity for the benefit of the patient.
Holding back tears, Rice hugged Champagne and told him she would be forever thankful for his returning the ring. Champagne said he finds many lost belongings while working, but he never expected to be thanked for doing the right thing. He was shocked to receive such a recognition.
"If I lose something, I'd like them to give them back to me," Champagne said.
MEDIA CONTACT: Elizabeth Adams, email@example.com
LEXINGTON, Ky. (Aug. 27, 2014) — "Should I be concerned about a child’s disruptive behavior?"This is a question many parents ask themselves at some point in their young child's life.
It can be difficult to know if your child’s problematic behavior falls within the “normal” spectrum or if there’s a more severe problem that needs professional attention. Disruptive behavior disorders are serious problems that, if left untreated, can lead to school failure, social problems, substance abuse, poor quality of life, and negative outcomes across the lifespan.
Many behavior disorders appear before age six, and early diagnosis and intervention are key to helping your child thrive and preventing lifelong challenges. Effective interventions are available, but the longer you wait, the more entrenched the problems may become.
Disruptive behavior disorders and warning signs
Just like children learn to walk and talk in their own time, “normal” behavior varies greatly between children. If your child is more impulsive or defiant than others, it doesn’t necessarily indicate a behavior disorder. However, if problematic behavior exists for more than six months, occurs across settings (home, school, etc.), and — most importantly — interferes with your child or family’s ability to function, it’s time for professional help.
The three (sometimes co-occurring) types of disruptive behavior disorders are believed to be caused by a combination of nature and nurture:
If you’re concerned that your child might be experiencing a behavioral disorder, consult your child’s primary care provider who can help determine the need for further assessment from a licensed mental health professional. You can also directly contact a mental health provider to request evaluation.
The most reliable diagnoses and treatments are from licensed mental health professionals, including clinical psychologists, child psychiatrists, clinical social workers, developmental-behavioral pediatricians, and others. Many primary care providers are able to diagnose ADHD, but ODD and CD are typically beyond the scope of their behavioral expertise.
Behavioral parent training, in which parents learn strategies to address and reduce their child’s behavioral issues, is extremely effective in reducing behavior problems. For ADHD, stimulant medication and behavioral therapy combined have demonstrated effectiveness in reducing symptoms. For CD, more intensive treatment may be required. As the saying goes, “it takes a village,” so it’s important that any intervention involve all aspects of a child’s life (family, caregivers, school).
Dr. Christina Studts is an assistant professor of health behavior at the University of Kentucky College of Public Health.
This column appeared in the August 24, 2014, edition of the Lexington Herald-Leader
LEXINGTON, Ky. (Aug. 25, 2014) – The notorious "Freshman 15" is usually little more than a nuisance for new college coeds across the country. But when Georgetown College freshman Lynsey Farrar gained 15 pounds in a single week, she knew something just wasn't right.
When the Sparta, Ky., native came home for a weekend visit in late February, Lynsey's mother Sherra said her daughter complained of feeling bloated and fatigued. Her condition worsened over the next few days as Lynsey developed other troubling symptoms, including nausea and nosebleeds. When her eyes turned yellow – initial stages of jaundice – Sherra knew right away that Lynsey's problem was serious.
"I thought, oh my God, it's her liver," Sherra said. "I panicked. I knew she was really sick."
Lynsey's local doctors ordered blood work, which confirmed Sherra's fears. The doctor then referred Lynsey to the University of Kentucky Albert B. Chandler Hospital Emergency Department, and she was admitted into the hospital on March 3 – roughly a week after her symptoms began. Lynsey's blood work showed that she had Wilson's disease, a genetic disorder that causes copper to build up in body tissue, particularly the brain and the liver.
Wilson's disease can generally be managed through medication, but Lynsey's condition didn't respond to treatments. On Thursday evening, March 6, the Farrars spoke to UK transplant surgeon Dr. Erin Maynard, who told the family that a liver transplant might be a possibility in the future – though based on her condition at the time, Lynsey wasn't yet sick enough to be placed on the transplant waiting list.
By Friday morning, all that had changed – the teen's condition worsened considerably overnight and her kidneys began shutting down. Maynard's team took action to stabilize her and listed Lynsey at a status 1A – meaning that literally, she had been placed at the top of the regional liver transplant list due to the severity of her condition.
"Words cannot describe how I felt – like the wind had been knocked out of me," Sherra said. "After they put her on the ventilator, I was thinking that I would be planning a funeral because I knew it could take time to find a matching donor."
But in just half a day, a liver match was found and surgery was underway early Saturday morning. UK performs roughly 40 liver transplants each year, according to Maynard, and it takes a team of experts from various specialties across UK HealthCare working together to provide all the necessary care pre-transplant through recovery. In Lynsey's case, the team included transplant hepatology, nephrology, anesthesia, pulmonary critical care, medical hospitalist, and pathology.
“I always tell patients that it takes a village to get someone through transplant," Maynard said. "In Lynsey’s case, this was particularly true. It's not just one person that saved her, but truly a team effort.”
During the surgery, more than 50 friends and family members filled the waiting room at UK Chandler Hospital, anxious to receive any news on Lynsey's condition. Back home in northern Kentucky, the local DMV became overwhelmed the next Monday when dozens of people showed up to sign up for Donate Life's organ donor registry, inspired by Lynsey's case.
Lynsey, who remembers little of her days prior to transplant, took the new development in stride.
"I woke up after the surgery and said, 'Did I get a transplant?'" she said.
These days, Lynsey's good health is a far cry from that first week of March. Due to her youth, previously excellent health record, and personal determination, her recovery has been quick and relatively painless. She played golf less than two months post-surgery, and has spent much of her summer working at a local pharmacy and staying active through golf, jumping on her trampoline, and trying her hand at other new endeavors.
"She called and asked us if she could go zip lining," Maynard said. "We said yes! We don’t transplant you so you can never leave your house – we transplant you so you can go out and live your life."
"I feel normal," Lynsey said. "I get tired easily, but that's to be expected."
Lynsey, who hopes to pursue a career in pharmacy, just embarked on her second year at Georgetown College. She moved into her dorm over the weekend and heads back to classes for the first time today.
Though she had to take a leave of absence for the last few months of the spring semester, the future pharmacist kept up with much of her schoolwork, teaching herself English, chemistry, and statistics at home – and earning excellent grades in all three, including a 98 percent average in chemistry.
Watching her oldest daughter venture back into the fold triggers mixed emotions for her mother, who is incredibly grateful to the donor who gave her daughter a second chance at a bright future.
"I'm really proud of her," Sherra said. "I'm nervous for her, but incredibly proud."
Currently, there are more than 120,000 men, women and children awaiting transplants in the U.S., including more than 16,000 patients who need a liver.
The best way to honor those who gave the ultimate gift of life and to celebrate the new life of transplant recipients is to register on the Kentucky Organ Donor Registry. The registry is a safe and secure electronic database where a person’s wishes regarding donation will be carried out as requested.
To join the registry, visit www.donatelifeky.org or sign up when you renew your driver’s license. The donor registry enables family members to know that you chose to save and enhance lives through donation. Kentucky’s “First Person Consent” laws mean that the wishes of an individual on the registry will be carried out as requested.
MEDIA CONTACT: Allison Perry, (859) 323-2399 or firstname.lastname@example.org
LEXINGTON, Ky. (Aug. 21, 2014) — When University of Kentucky medical student Callie Dowdy tells fellow students she delivered four babies in one month during her obstetrics rotation in Western Kentucky, she emphasizes that fact that she was a primary care provider.
She didn’t stand in the back or the room or watch over the shoulder — she was the first person to hold the babies. While Dowdy acknowledges that the UK Chandler Hospital is an incredible setting for a medical education, she encountered more opportunities work with patients in a smaller medical environment in Murray, Kentucky.
Dowdy was one of two inaugural students to complete rotations through the Western Kentucky Initiative (WKI), a program that places third-year students at medical practices and hospitals in Murray/Paducah, Bowling Green and Owensboro. Students complete five rotations required in their third-year curriculum during a 20-week period based in one or more of these communities. Like the students who participate in the College of Medicine Rural Physician Leadership Program in Morehead, these students receive more hands-on opportunities to practice real-life medicine and one-on-one mentorship from practicing doctors.
Students who are from Western Kentucky or who received their undergraduate education in the area are encouraged to consider participating in the WKI.
Dowdy, who grew up in Murray, decided to go back home to complete four of the five required rotations included in the program. She completed her psychiatric rotation in Paducah. The daughter of a surgeon, Dowdy already knew many of the doctors who served as her faculty preceptors. She said these doctors, who aren't grouped with fellows, residents and students, were natural teachers to a classroom of one. She enjoyed the experience so much that she has made special arrangements to complete three of her fourth-year elective rotations in Murray.
"I have never seen the passion for teaching like I saw in Murray," Dowdy said. "I believe wholeheartedly the best decision I have made in my academic career was doing the WKI program."
This year, seven students have committed to participate in the WKI. Dr. James Norton, associate dean for educational engagement, said the ratio of health care providers to patients in Western Kentucky lags behind the national average. The College of Medicine continues to build medical practices in Eastern Kentucky by exposing future doctors to health disparities through the Rural Physician Leadership Program, but the WKI turns attention to the need for doctors in Western Kentucky.
"If you look at health statistics, you will find there are communities and counties that have the same challenges that we have in Eastern Kentucky," Norton said. "There are too many patients, and not enough doctors."
Norton hopes the program will spark an interest in students who will consider returning to Western Kentucky to practice. The WKI works with Area Rural Health Education Centers to place students with community preceptor doctors. Students who are from the area will receive first priority in the program, although Norton would like to see the program grow every year. About 25 students expressed an interest in participating during a meeting on Aug. 15 and would represent the third class entering the program in 2015.
LEXINGTON, Ky. (Aug. 19, 2014) – A new web-based program developed by University of Kentucky Markey Cancer Center researchers will provide a simple, free way for healthcare providers to determine which brain tumor cases require testing for a genetic mutation.
Gliomas – a type of tumor that begins in the brain or spine – are the most common and deadly form of brain cancer in adults, making up about 80 percent of malignant brain cancer cases. In some of these cases, patients have a mutation in a specific gene, known as an IDH1 mutation – and patients who have this tend to survive years longer than those who do not carry the mutation.
Developed by UK researchers Li Chen, Eric Durbin, and Craig Horbinski in collaboration with software architect Isaac Hands of the UK Markey Cancer Center Cancer Research Informatics Shared Research Facility, the program uses a statistical model to accurately predict the likelihood that a patient carries the IDH1 mutation and requires screening.
Gliomas are often tested for IDH1 mutation following surgery to remove the tumor, but undergoing this type of testing often requires stringent insurance pre-approvals due to rising healthcare costs, Horbinski says.
"Currently, there are no universally accepted guidelines for when gliomas should be tested for this mutation," Horbinski said. "Obtaining insurance pre-approval for additional molecular testing is becoming more commonplace, and this program will assist healthcare providers with an evidence-based rationale for when IDH1 screening is necessary."
Additionally, Horbinski notes that the program will help conserve research dollars by helping brain cancer researchers narrow down which specific older gliomas in tumor banks – previously removed in a time before IDH1 testing was routine – should be tested as data for research projects.
Horbinski's research on the program was published in the May issue of Neuro-Oncology. The work was funded through a grant from the National Cancer Institute, the Peter and Carmen Lucia Buck Training Program in Translational Clinical Oncology, and the University of Kentucky College of Medicine Physician Scientist Program.
LEXINGTON, Ky. (Aug. 18, 2014) -- Alpha Omega Alpha, the national medical honor society, has elected Dr. Charles “Chipper” H. Griffith III, senior associate dean for medical education at the University of Kentucky College of Medicine, as a councilor director on the Society's board. Griffith's three-year term begins at the AOA board of directors meeting in Portland, Maine, on Oct. 3.
Alpha Omega Alpha is a professional medical organization that recognizes and advocates for excellence in scholarship and the highest ideals in the profession of medicine. Alpha Omega Alpha is to medicine what Phi Beta Kappa is to letters and the humanities and Sigma Xi is to science.
Griffith earned his medical degree at Vanderbilt University and completed his residencyin internal medicine/pediatrics at UK HealthCare. He also earned a Master of Science degree in Public Health from UK. Prior to his current role, Griffith has served as associate dean for student affairs at the UK College of Medicine. He is an educational scholar of national repute having published multiple articles and received numerous awards for his teaching including the AOA/AAMC Robert J. Glaser Distinguished Teacher Award in 2004, the most highly regarded medical school teaching award in the country.
In 2006, the Clerkship Directors of Internal Medicine (CDIM), a national organization that promotes excellence in education of medical students in internal medicine, honored Griffith by renaming their educational research award "the Charles H. Griffith Educational Research Award." He also was profiled in “Leadership Careers in Medical Education,” the American College of Physician’s Teaching Medicine six-book series published in 2010.
LEXINGTON, Ky. (Aug. 20, 2014) -- Last Saturday, one family struggled to accept that their father had been diagnosed with Alzheimer's disease.
This family is luckier than others, however. They are the fictional characters in "Forget Me Not," a play written by Garrett Davis to raise awareness about Alzheimer's disease and provide comfort and support for caregivers, particularly in underserved communities where health disparities exist.
University of Kentucky's Sanders-Brown Center on Aging (SBCoA) brought the play to a full house at the Lyric Theatre in Lexington on Aug. 16.
We saw the play at a conference in San Diego, and we were immediately drawn to it as a resource for community outreach," said Dr. Gregory Jicha, an associate professor at Sanders-Brown.
"The play is not only an entertaining way to make more people aware of the disease, but also educates people about the need to take action -- and one way to do that is to participate in research."
Davis wrote the play as a tribute to his grandmother, who died of Alzheimer's disease when he was in college, and to all the family members who cared for her.
"She had Alzheimer's, and it was terrible watching her fade away. When we see our loved ones at their worst, we tend to push ourselves into seclusion, out of fear or worry or both, at exactly the time when we should quit hiding and actively seek help."
"I wrote this play so that caregivers might recognize themselves in the characters onstage, and perhaps get ahead of the curve and develop a support network not just for their loved one, but also for themselves."
Alzheimer's disease is incurable and irreversible, It is the most common cause of dementia in older adults, and more than 500.000 Americans die from AD each year. African Americans are usually diagnosed with the disease at a later stage, limiting the effectiveness of early intervention. Blacks are about two times more likely and Hispanics are about one and a half times more likely than their white counterparts to have Alzheimer's and other dementia. Of the estimated 5.4 million people living with the disease, two-thirds are women.
Davis describes "Forget Me Not" as one leg of a three-legged stool. "There are three plays in the trilogy," he explains. "'Forget Me Not' is intended to raise awareness about Alzheimer's disease. 'Mama's Girls' is part two -- its focus is on caregiving for someone with Alzheimer's. And the third play -- 'A Woman's Gotta Do' -- addresses finances, which is an important but overlooked part of the disease."
Davis felt particularly compelled to bring his message to the African American community, whose culture embraces the concept that caring for a sick loved one is a personal -- rather than a shared -- responsibility.
"We need to understand that we can care for Grandma without losing our own identity or neglecting our own families," Davis says.
Jicha stayed after the play for a Q&A session with attendees. There, he stressed repeatedly the need for participation in medical research, particularly among African Americans.
"At Sanders-Brown alone there are many, many studies exploring treatments that may prevent disease, cure disease, or at a minimum slow down its progress," Jicha says. "But without volunteers -- both with the disease and without -- we can't get enough data to determine whether these treatments really work."
"If people recognize these issues and how close we are to making tremendous strides in curing Alzheimer's, they should join the fight and make a difference."
LEXINGTON, Ky. (Aug. 20, 2014) -- You have just enough time to run by the pharmacy and pick up your prescription on the way to work. When the clerk at the counter asks if you have any questions about your prescription for the pharmacist, you automatically respond "no."
Do you ever wonder why they ask you that every time you pick up a prescription? And why you have to sign something when you say no?
State statutes and regulations require that an offer to counsel be extended to the patient or patient’s representative on matters which the pharmacist believes will optimize drug therapy with each patient or caregiver. This is to be done for both original prescriptions or refills as professional discretion dictates. Your signature formally acknowledges that you have declined counsel.
The goal is to assure that the patient understands the proper use of the medication. It also serves as an additional measure of safety. For example, if the pharmacist were to say, “This medication should treat your infection,” but you went to see the prescriber for treatment of back spasms, this communication exchange has served as an effective double check to prevent medication misadventures.
When you say "yes" to a conversation with the pharmacist, you are likely to receive some or all of the following information:
While this offer to counsel applies to prescription medications, keep in mind that the pharmacist is a tremendous resource when you have questions about nonprescription medications and medical devices as well. You don’t need an appointment to see your pharmacist and you know exactly where pharmacists can be found – in the prescription department at the pharmacy, standing ready to answer your questions.
The American Pharmacists Association describes the mission of pharmacy practice as “serving society as the professional responsible for the appropriate use of medications, devices, and services to achieve optimal therapeutic outcomes.” So the next time you are asked whether you have any questions for the pharmacist, make time to say "yes." This is your chance to receive information from the professional committed to helping patients achieve maximum benefit from the use of pharmaceuticals.
Joseph L Fink is a professor of Pharmacy Law and Policy at the University of Kentucky College of Pharmacy.
This column appeared in the August 17, 2014, edition of the Lexington Herald-Leader
LEXINGTON, Ky. (Aug. 15, 2014) – A new law that went into effect in July allows nurse practitioners in Kentucky to have an expanded role in treating patients.
Nurse practitioners who meet certain requirements can now prescribe some medications without having a collaborative agreement with a physician, which previously was required. Supporters of the law say it will remove the barrier nurse practitioners face when they wanted to open their own practices. With their own practices, they can prescribe blood pressure and cholesterol medicines, antibiotics and some antidepressants, for example.
“Expanding the scope of practice for nurse practitioners in Kentucky is absolutely critical to close the gap in tremendous health care needs of Kentuckians," said Janie Heath, dean of the University of Kentucky College of Nursing. "For decades NPs have demonstrated their ability to increase access to care, increase quality of care and at the same time decrease costs. Having this level of regulatory authority speaks volumes about our legislators’ commitment to improve health and wellness in Kentucky.”
A state-commissioned study last year said Kentucky is approximately 4,000 physicians short in meeting the current demand for health care providers. With the passage of the federal Affordable Care Act, more than 420,000 Kentuckians have health insurance, many of whom have coverage for the first time in their lives.
Media Contact: Ann Blackford at 859-323-6442 or email@example.com
LEXINGTON, Ky. (Aug. 15, 2014) — The hold of a seatbelt prevented 12-year-old Kaitlin Caldwell from being ejected from her seat when a jeep slammed into the side of her family's vehicle at 65 miles per hour.
But a tight squeeze from the life-saving restraint caused serious damage to her midsection. After being airlifted from a hospital in Somerset, Kaitlin arrived at Kentucky Children's Hospital on Jan. 2 suffering from a severed pancreas, transected bowel, a separated bile duct and a host of other abdominal injuries.
The UK HealthCare trauma team tasked with rerouting Kaitlin's abdominal organs conducted emergency surgery to control her injuries. After surgeons stopped some bleeding and repaired immediate injuries during the first surgery, they placed a temporary vacuum dressing over an open abdominal incision. Pediatric surgeon Dr. Sean Skinner, in collaboration with a team of specialists representing UK HealthCare divisions of transplant, oncology and vascular surgery, then mapped out a reconstructive procedure to essentially rework the organs that allow Kaitlin to digest food. On Jan. 3, the team conducted a second surgery to assess the full extent of the injuries and their surgical options.
The surgeons deliberated about the most technically efficient way to reroute her digestive tract. But they also discussed the long-term implications of the surgery for Kaitlin, now and in the future. They wanted to preserve her ability to eat different types of food, as well as reduce her risk for diabetes and other complications down the road.
"She was 12, and she had how many years to live with this?" Skinner said. "We wanted to give her the best results that were going to last the longest."
Skinner and transplant surgeon Dr. Erin Maynard performed a Whipple procedure, a reconstructive surgery most commonly performed on patients with pancreatic cancer and sometimes complications from pancreatitis. Skinner said the procedure is uncommon in a trauma setting, but even rarer in pediatric patients. According to his research, only a small fraction of a percent of all pediatric cases involving blunt trauma to the pancreas resulted in a Whipple procedure. A published article available to Skinner identified 18 cases of children receiving the surgery in the past 14 years. Skinner turned to a multidisciplinary team of UK HealthCare specialists, including Maynard, vascular surgeon Dr. Eric Endean, adult trauma surgeon Dr. Paul Kearney and oncology surgeon Dr. Patrick McGrath, to prepare for the procedure.
"This was a big team effort of everyone coming in to help this girl," Skinner said. "Having those specialists around me made it even better and safer for her."
Typically during a Whipple procedure, surgeons remove the portion of the pancreas where a tumor is present. In Kaitlin, the pancreas was already transected from the force of the seatbelt, so surgeons removed one portion of the pancreas. The pancreas serves an important role of producing chemicals that help break down sugars and carbohydrates before those foods travel to the small intestine, so even a small portion of the organ will help reduce the risk of diabetes. After removing portions of the stomach, the duodenum and the head of the pancreas, Skinner and his team attached the remaining portion of the pancreas to the small intestine. They also sewed the bile duct to the small intestine and brought a loop of the intestines up to be attached to the stomach.
In total, Kaitlin went through five abdominal surgeries before she was released from the hospital on Jan. 24. Skinner was encouraged that Kaitlin encountered few complications post-surgery. He advised her to minimize foods high in sugar, like her favorite soda Mountain Dew, to prevent dumping syndrome, a sickness caused by too much sugar dumping into the small intestine that affects gastric bypass and Whipple surgery patients. The long-legged middle schooler has adjusted to her new diet constraints, avoiding Taco Bell, a restaurant she once loved.
"She loves sweets, but now with the modifications, she knows her limits," Kathy Caldwell, Kaitlin's mom, said. "It amazes me, because she won't touch it."
With her turquoise braces and narrow framed glasses, pre-teen Kaitlin will get a fresh start at a new school in Middlesboro later this month. She is trying out for the the basketball team. A scar on her abdomen is the only visible sign of the accident. Kathy Caldwell hopes her daughter will remember the diligence and team work of the doctors who put her stomach back together when she looks at the scar.
"I laugh when people say she didn't get hurt real bad. I don't want her to be ashamed of that scar. That's your scar — a testament to what you've been through," Kathy Caldwell said.
Kathy Caldwell said she tells everyone she knows about the high level of care she received from Skinner and the multidisciplinary team. She feels grateful her family was sent to UK HealthCare after the accident.
"We knew the Lord would always put good people in our path for our good," she said. "They were just so good to us."
Video by UK Research Media
LEXINGTON, Ky. (Aug. 15, 2014) — The University of Kentucky announced in July a $3.75 million grant from the Centers for Disease Control and Prevention for a community-based colorectal cancer prevention initiative designed to promote better screening for the disease in rural areas.
The funding will provide free FIT kits, new at-home colorectal cancer screening tools, to local health departments and support outreach through UK's Rural Cancer Prevention Center over the next five years.
A new video by UK Research Media features cancer survivors, community leaders and medical experts discussing the project.
LEXINGTON, Ky. (Aug. 13, 2014) – Becker’s Hospital Review magazine has listed the University of Kentucky Albert B. Chandler Hospital among the nation’s “100 Hospitals and Health Systems with Great Oncology Programs” in its recently released compilation of leading cancer care providers in the United States. The UK Markey Cancer Center, whose clinical programs are integrated with Chandler, received a National Cancer Institute cancer center designation in July 2013.
According to the health care industry trade publication, organizations included on the 2014 list are “leading the way in terms of quality of patient care, patient outcomes and research.” Becker’s noted Markey's recent NCI designation, its 29 percent patient growth over the past five years, and its status as a Blue Distinction Center for Complex and Rare Cancers for 10 cancer types.
The Becker's Hospital Review editorial team selected hospitals for inclusion based on rankings and awards they have received from a variety of reputable sources. The following awards were considered as part of the criteria for inclusion on the list: U.S. News & World Report cancer rankings, Truven Health Analytics, CareChex cancer care rankings, National Cancer Institute designations, the American College of Surgeons Commission on Cancer accreditations, American Nurses Credentialing Center designations, and awards and Blue Distinction Center recognition from the BlueCross BlueShield Association.
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