The Wire

  • New tunnel, premium RV section at Talladega Superspeedway on schedule despite weather

    Excerpt:

    Construction of a new oversized vehicle tunnel and premium RV infield parking section at Talladega Superspeedway is still on schedule to be completed in time for the April NASCAR race, despite large amounts of rainfall and unusual groundwater conditions underneath the track.

    Track Chairman Grant Lynch, during a news conference Wednesday at the track, said he’s amazed the general contractor, Taylor Corporation of Oxford, has been able to keep the project on schedule.

    “The amount of water they have pumped out of that and the extra engineering they did from the original design, basically to keep that tunnel from floating up out of the earth, was remarkable,” Lynch said.

  • Alabama workers built 1.6M engines in 2018 to add auto horsepower

    Excerpt:

    Alabama’s auto workers built nearly 1.6 million engines last year, as the state industry continues to carve out a place in global markets with innovative, high-performance parts, systems and finished vehicles.

    Last year also saw major new developments in engine manufacturing among the state’s key players, and more advanced infrastructure is on the way in the coming year.

    Hyundai expects to complete a key addition to its engine operations in Montgomery during the first half of 2019, while Honda continues to reap the benefits of a cutting-edge Alabama engine line installed several years ago.

  • Groundbreaking on Alabama’s newest aerospace plant made possible through key partnerships

    Excerpt:

    Political and business leaders gathered for a groundbreaking at Alabama’s newest aerospace plant gave credit to the formation of the many key partnerships that made it possible.

    Governor Kay Ivey and several other federal, state and local officials attended the event which celebrated the construction of rocket engine builder Blue Origin’s facility in Huntsville.

3 days ago

UAB Medicine listed among ‘Most Wired’ hospitals for 2020

(UAB/Contributed, YHN)

UAB Medicine has been named one of “HealthCare’s Most Wired” for 2020, by the College of Healthcare Information Management Executives. CHIME has recognized 71 hospitals for achieving Level 9 status from its 2020 HealthCare’s Most Wired program. CHIME’s Most Wired list acknowledges health care organizations that have adopted and deployed information technology to improve patient safety and health outcomes across the industry. UAB Hospital is the only Alabama hospital to achieve Level 9 status this year.

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This is the seventh consecutive year UAB Medicine has earned Most Wired recognition.

The mission of the CHIME HealthCare’s Most Wired program is to elevate the health and health care of communities around the world through the optimal use of information technology. The annual survey is designed to identify and recognize health care organizations that exemplify best practices through their adoption, implementation and use of information technology.

According to CHIME, hospitals and health systems at the forefront of using health care IT to improve the delivery of care have maximized the benefits of foundational technologies and are embracing new technologies that support population management and value-based care. The most successful organizations not only adopt technology but apply it strategically to achieve great outcomes.

(Courtesy of UAB)

4 weeks ago

Study highlights link between depressive symptoms and stroke risk

(UAB/Contributed, YHN)

People with multiple depressive symptoms have an increased risk for stroke, according to findings recently published in Neurology: Clinical Practice. The collaborative study led by investigators at the University of Alabama at Birmingham and the University of Alabama showed that individuals who scored higher on a test designed to measure depressive symptoms had a higher stroke risk than those with lower scores.

The study involved 9,529 Black and 14,516 white stroke-free participants, age 45 and older, enrolled in the UAB-led REGARDS study. REGARDS is a national, population-based longitudinal study designed to examine risk factors associated with racial and regional disparities in stroke incidence and mortality.

Depressive symptoms were assessed using the four-item version of the Center for Epidemiologic Studies Depression Scale, known as CES-D-4, administered during a baseline evaluation of each participant. The four-item scale evaluates a subset of symptoms and assesses how often respondents felt depressed, sad or lonely or had crying spells.

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There were 1,262 strokes over an average follow-up of nine years among the study cohort. Compared to participants with no depressive symptoms, participants with CES-D-4 scores of one to three had a 39 percent increased stroke risk after demographic adjustment. Participants with CES-D-4 scores of more than four experienced a 54 percent higher risk of stroke after demographic adjustment. There was no evidence of a differential effect by race.

“There are a number of well-known risk factors for stroke, such as high blood pressure, diabetes and heart disease; but we are beginning to understand that there are nontraditional risk factors as well, and having depressive symptoms looms high on that list,” said Virginia Howard, Ph.D., professor in the Department of Epidemiology in the UAB School of Public Health and senior author of the paper. “These nontraditional risk factors need to be in the conversation about stroke prevention.”

One goal of the study was to see if depressive symptoms might help explain the increased risk that Black populations have for stroke, especially in the southern United States.

“The traditional risk factors don’t explain all the difference in stroke risk between races,” said Cassandra Ford, Ph.D., R.N., Capstone College of Nursing at the University of Alabama and the study’s first author. “The results have been mixed among the few studies that enrolled Black participants and examined race and depressive symptoms in relation to stroke. Depression often goes undetected and undiagnosed in Black patients, who are frequently less likely to receive effective care and management. These findings suggest that further research needs to be conducted to explore nontraditional risk factors for stroke. The implications of our findings underscore the importance of assessing for this risk factor in both populations.”

The takeaway, according to Howard, is that medical professionals need to recognize that stroke risk from depressive factors is high.

“The standard questions asked in the typical physician/patient encounter need to be updated to include questions regarding depressive symptoms,” she said. “Physicians in primary care, internal medicine and geriatrics need to consider asking their patients about depressive symptoms.”

“As nurses, we care for the entire person,” Ford said. “When a patient has a particular condition, such as diabetes, hypertension or stroke, that is the focus of diagnosis and care. Our study provides support for considering nontraditional risk factors during patient assessment, particularly conducting some mental health screenings.”

The study was funded by grant No. U01 NS041588 co-funded by the National Institute of Neurologic Disorders and Stroke and the National Institute on Aging, part of the National Institutes of Health. Additional support was provided by the Deep South Resource Center for Minority Aging Research grant P30AG031054.

In addition to Ford and Howard, co-authors on the paper are Martha R. Crowther, Ph.D., University of Alabama; and Marquita S. Gray, MSPH, Virginia G. Wadley, Ph.D., and Michael G. Crowe, Ph.D., University of Alabama at Birmingham. Additional co-authors are Audrey L. Austin, Ph.D., Tuscaloosa Veterans Affairs Medical Center; LeaVonne Pulley, Ph.D., and Frederick Unverzagt, Ph.D., Indiana University School of Medicine; and Dawn O. Kleindorfer, M.D., and Brett M. Kissela, M.D., University of Cincinnati School of Medicine.

(Courtesy of UAB)

2 months ago

Special unit to treat nursing home patients with COVID-19 opens in Alabama

(UAB/Contributed, YHN)

The University of Alabama at Birmingham and Rehab Select at Talladega is opening a special 16-bed unit to treat nursing home patients who have COVID-19. The unit will be in a separate building on the campus of Rehab Select, with financial support from Alabama’s Coronavirus Relief Fund. The establishment of the unit is part of UAB’s efforts to assist the community in managing and mitigating the pandemic.

The unit will isolate nursing home residents who test positive and are asymptomatic or mildly symptomatic, while providing the appropriate level of skilled nursing care those patients require. The unit can accept COVID-19-positive patients from hospitals across the state for ongoing short-term rehabilitation.

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“The unit will continue our mission to provide evidence-based care for these vulnerable patients across the care continuum,” said Dr. Kellie Flood, associate professor in the UAB Division of Gerontology, Geriatrics and Palliative Care. “Our goal is to provide them with the same care elements they receive regularly in their skilled nursing environments, such as rehabilitation, during these unprecedented times. We are also partnering with our infectious disease, infection prevention and PPE (personal protective equipment) experts to provide this unit’s team with best practices for COVID-19 management and processes to keep team members safe.”

The facility has a separate entrance and ventilation system. The nursing staff will be coordinated and trained by UAB.

“Nursing home residents have special needs, and for those with mild illness from the virus, an acute care hospital is not necessarily the right environment,” said Christopher Schmidt, president/CEO of Rehab Select at Talladega. “This program will blend the hospital and skilled nursing environments to make sure all their needs are met.”

The unit will ease pressure on hospitals by freeing beds for acutely sick patients with COVID-19 or non-COVID illness. It will help reduce the spread of infection within a skilled nursing facility by providing a safe transition-of-care option for patients who cannot be isolated in their home facility.

The Talladega unit is accepting patients beginning Oct. 5. UAB partnered with Aspire Physical Recovery Center in Hoover to open a similar unit in July.

“These units are part of a broader collaboration between the UAB Health System, state and county governments, local area hospitals and our affiliated nursing homes to create a care continuum structure to develop a prevention and mitigation plan to respond to potential nursing home outbreaks of COVID-19 in Alabama,” said Brian Spraberry, chief administrative officer for the UAB Health System.

That plan will establish a line of communication with representatives from acute care, post-acute care, public health, the Alabama Nursing Home Association and Alabama Hospital Association with the following goals:

  • Coordinate consistent infection-control practices and provide practical guidelines for PPE utilization and conservation for the COVID-19 unit and community collaborative.
  • Create a centralized process to track and test nursing home residents and employees to help inform and implement surveillance protocols for people under investigation by using a reporting structure through the county EMA or other such monitoring protocols as available.
  • Create a four-stage response plan to mitigate any resurgence occurring in the Jefferson County region, to include exposure notification, PPE utilization, infection control, testing protocols and staffing.

This story originally appeared on the University of Alabama at Birmingham’’s UAB News website.

(Courtesy of Alabama NewsCenter)

2 months ago

UAB Sports Medicine doctor in the NBA bubble

(UAB/Contributed)

Sara Gould is in the bubble. A sports medicine physician in the UAB School of Medicine  and with Children’s of Alabama, Gould has been working with the National Basketball Association in the Orlando “bubble” since July 12.

“I’ve been involved with the NBA since 2013, doing some consulting and event medicine for the league at various locations in the United States and around the world,” said Dr. Gould, an associate professor in the Department of Orthopaedic Surgery. “Early in my career I did a fellowship in sports medicine in New York, which led to connections with the NBA.”

Gould points out that her affiliation is with the NBA, not the individual teams. Her role is to help manage the overall medical response in the bubble, where players are quarantined, whether that means coordinating transportation of an injured player or arranging for imaging such as MRIs or X-rays. One of the most important roles that she and her colleagues play is to help the league manage response to the pandemic.

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“There is daily testing for all persons in the bubble, and our team assesses those results to be sure we are maintaining a safe environment,” she said. “We meet throughout the day to consult on injuries, manage movement in and out of the bubble, conduct contact tracing and follow the latest medical information on testing and exposure.”

Globe trotting

Gould is part of a large group of sports medicine physicians connected to the NBA, many of whom, like Gould, are on the faculty of academic medical institutions. The league’s medical director assembles teams of health care providers from that pool for sponsored events worldwide. Gould has covered NBA events in Africa, Asia, Europe and the United States.

“I’ve traveled to China with the NBA eight or nine times to provide event medicine at NBA Global Games, which are global exhibition games.” she said. “Sports are an excellent way to bring people together in ways that strengthen our connections to each other.”

When the whistle blows

She gets to sit on the edge of the court, monitoring the events. When all goes well, she gets to watch a great game. When there are issues, she helps coordinate the response.

“The team trainers are the first to respond, and they will summon the team doctors to the floor if required,” Gould said. “In the event of a serious injury, every physician present will respond to offer assistance to the team’s medical staff, as needed.”

Games in the bubble are a unique experience. Sitting in the stands with no spectators except league employees, Gould said she can hear the squeak of sneakers on the court at times. The stands are filled with virtual spectators, broadcast on screens behind the court, which seems oddly fitting in a world that has largely moved to a virtual setting.

Racial equality

The concept of social justice is at the forefront in the bubble.

“The NBA is committed to racial equality and social justice and is working hard to promote these concepts,” Gould said. “I had a decision to make the first time they played the national anthem. Some of my patients at home are veterans. Some of my patients are Black, and some are Black veterans. I’m neither a veteran nor Black, so I struggled with my desire to be respectful to our veterans and also to acknowledge social injustice.”

Ultimately, she knelt and put her hand over her heart in an attempt to demonstrate respect for both the flag and social justice.

Life in the bubble

Gould’s time in the bubble will last until the end of September. While she misses family, friends and colleagues at UAB, she is excited to be part of the NBA season. Plus, she’s living at Disney.

“It incredible. I mean, I’m in a bubble in Walt Disney World. It’s like being on a cruise ship,” she said. “Unlimited food at the buffet, exercise facilities, nice accommodations.”

She said the worst part is being away from family, but she connects with those at home two or three times a day via FaceTime.

The work is exciting. She’s getting a firsthand look at managing a pandemic, along with the opportunity to discuss medicine, science and disease management with top academic physicians and researchers around the nation.

“From the scientific perspective, this is important work, as seeing how events play out in an enclosed environment is fascinating,” she said. “And what we are learning is that masking and testing work. This proves it. The strategies in the bubble are showing how we can control the pandemic. If we could get everyone to do the right thing in terms of masking, distancing and exposure, we could slow this pandemic.”

This story originally appeared on the UAB News website.

(Courtesy of Alabama NewsCenter)

3 months ago

Flu vaccine: this year more than ever

(UAB/Contributed, YHN)

“If there was ever a year to be sure you get a flu vaccine, this is it.”

That is the recommendation of Erin DeLaney, M.D., assistant professor in the Department of Family and Community Medicine in the School of Medicine at the University of Alabama at Birmingham.

“As we head into influenza season, with the novel coronavirus still circulating in our communities, it is more important than ever for people to get vaccinated against the flu this year,” DeLaney said. “COVID-19 has put significant stress on the nation’s health care system, and a bad flu season will severely stretch our health care resources.”

DeLaney says the flu vaccine will not provide any protection against infection from the novel coronavirus, but it can prevent or minimize the effects of the flu. And while this coronavirus is new and science is still unraveling its secrets, there is evidence that a person can be infected by more than one virus at the same time.

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“We don’t yet know the precise risk of a dual infection with coronavirus and influenza, but it is certainly a possibility,” she said. “We can safely say that co-infection with both viruses could be serious, even life-threatening.”

DeLaney says the time to get a flu shot is in September or early October. Peak flu season is from December to February, and it takes a minimum of two weeks for antibodies against the flu to develop fully following vaccination. She also cautions against getting the shot too soon, such as in July or August, as the preventive effect will wear off over the subsequent months and flu can linger into spring.

“The CDC advises getting a flu shot no later than the end of October,” she said. “Of course, even getting a vaccination later in the year is better than no vaccination at all.”

There is also no evidence that getting an early vaccination followed by a second booster shot in late winter is effective. A second shot does not increase the number of antibodies that the body produces. The exception is children 6 months to 8 years old who are getting their first influenza vaccination. That protocol calls for two shots, four weeks apart.

Persons over 65, who are at increased risk for influenza, should consider getting a higher-dose vaccination from their medical provider. DeLaney says it is a good idea to check with your medical provider or local pharmacy for availability of the higher-dose vaccine.

“The flu vaccine does not give you the flu. It is safe,” DeLaney said. “It can prevent the flu entirely, or limit the severity and duration of a case. I can’t stress enough how important it is that everyone get a flu vaccine this year. COVID-19 and the flu present with similar symptoms. A bad flu season, on top of the COVID-19 pandemic, could be devastating.”

(Courtesy of the University of Alabama at Birmingham)

4 months ago

UAB again ranked as best hospital in Alabama by U.S. News

(UAB/Contributed, YHN)

UAB Hospital has been again named the best hospital in Alabama by U.S. News & World Report. Additionally, the magazine named eight specialty programs within the top 50 in the nation, seven of those within the top 30, along with two others noted as being “high performing” in the 2020-2021 Best Hospital rankings, released today.

Ranked programs included rheumatology at No. 10, gynecology at No. 15, otolaryngology at No. 22, cardiology/heart surgery at No. 24, pulmonology/lung surgery at No. 25, Cancer at No. 25, nephrology at No. 29, and geriatrics at No. 49. High-performing specialties were gastroenterology/GI surgery and neurology/neurosurgery.

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This was the first top 25 ranking of the UAB’s cancer program, housed in the O’Neal Comprehensive Cancer Center.

UAB was also recognized as being high-performing in eight adult procedures/conditions: chronic obstructive pulmonary disease, heart bypass surgery, heart failure, abdominal aortic aneurysm repair, aortic valve surgery, transcatheter aortic valve replacement (TAVR), colon cancer surgery and lung cancer surgery.

“Consumers have many choices when deciding where to turn for health care, and UAB’s continued recognition as the best hospital in Alabama and one of the leading academic medical institutions in the nation is a reflection of the quality of care delivered by our faculty and staff day after day,” said Reid Jones, CEO of UAB Medicine. “The consistent excellence of our patient care, our cutting-edge research and innovative therapies mark UAB as the destination of choice in Alabama, the Southeast and beyond.”

Rankings like U.S. News & World Report’s are just one tool available to patients as they make informed decisions about their health care. UAB Medicine’s Find a Provider directory is a reliable source of verified and up-to-date information garnered from actual patients. The rating and reviews feature gives patients an alternative to third-party rating sites. More than 82 percent of eligible UAB physicians had a posted rating of at least four stars on the five-star scale.

The Best Hospitals specialty rankings assess hospital performance in 16 specialties or specialty areas. In 12 of these, rankings are determined by an extensive data-driven analysis combining performance measures in three primary dimensions of health care: structure, process/expert opinion, and outcomes. In the four other specialties, ranking relies solely on expert opinion.

The structural measures include hospital volume, nurse staffing and other resources that define the hospital environment. The data source for most structural measures is the American Hospital Association Annual Survey. Additional resources include the National Cancer Institute’s list of NIH-designated cancer centers and the American Nurses Credentialing Center’s roster of Nurse Magnet hospitals.

(Courtesy of UAB)

4 months ago

UAB and ADPH enhance statewide stroke response system

(UAB/Contributed, YHN)

Modeled on its successful trauma response system, the Alabama Department of Public Health will partner with the University of Alabama at Birmingham to improve a similar system for improved response to stroke across the state. This pioneering effort is a five-year statewide quality improvement initiative that aims to transform the acute stroke care system by coordinating prehospital and inter-facility emergency stroke care.

The Trauma Communications Center Coordinated Severity-Based Stroke Triage project is funded by a $2.5 million, five-year grant to UAB from the National Institute of Neurological Disorders and Stroke, one of the National Institutes of Health.

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“The project is focused on helping EMS providers identify patients with severe stroke and getting them to the appropriate medical facility, exactly as our trauma system functions,” said Toby Gropen, M.D., the James H. Halsey Jr., M.D. Endowed Professor in the Department of Neurology and director of the UAB Comprehensive Neurovascular and Stroke Center. “The system will coordinate with each of the six EMS regions in Alabama to provide each patient with the right care, at the right place, at the right time.”

In 2014, ADPH, the Alabama Trauma Communications Center, Alabama’s emergency medical system regional agencies, along with hospitals and EMS providers across the state, established the Alabama Trauma System. The ATCC is a statewide system that constantly monitors the status of every trauma hospital in the state, allowing patients to be routed to the most appropriate facility. In 2017, the same agencies activated the Alabama Statewide Stroke System, to provide early recognition and routing of patients with stroke symptoms to the nearest stroke center.

“Alabama, under the guidance of ADPH, has a history of innovation in creating statewide systems to ensure that patients are sent to a hospital that is best suited to provide the necessary care, first in the field of trauma and then in stroke,” Gropen said. “The SBST project will build upon that model, using Alabama’s existing Trauma Communications Center to triage patients to the most appropriate stroke center.”

“Acute stroke systems of care should emulate trauma systems, which deliver the full range of care to all injured patients by means of organized, coordinated efforts in defined geographic areas,” said Stephen Wilson, State EMS director, ADPH. “Just as trauma systems have proven ability to save the lives of the most severely injured patients, we should have a stroke system able to provide care to patients with the most severe strokes.”

Gropen says the right place could be the local hospital, depending on the severity of the stroke and the most appropriate medical response. It could also involve triage from the field directly to an advanced stroke center. Under other circumstances, patients may be initially triaged to a nearby stroke center and then transferred to a higher-level center. In all cases, the project will coordinate the care provided to patients with severe stroke, and importantly, the project will work with regional EMS directors and providers, along with hospitals throughout Alabama, to tailor the local implementation to the needs of each region.

The project will employ several measures to determine its effectiveness. It will compare the proportion of patients encountered by EMS providers with suspected cases of large vessel occlusion who are treated with mechanical thrombectomy before and after implementation of TCC-coordinated SBST. Mechanical thrombectomy is available only in advanced stroke hospitals.

Investigators will also assess the broad public health impact of TCC-coordinated SBST by examining the reach and effectiveness of the intervention, including any differences by race, ethnicity and population density. They will examine the ease of implementation and ability to sustain the model in various settings.

A final aim of the project will be to assess stakeholder perceptions of the intervention’s feasibility, appropriateness and acceptability and to identify barriers to and facilitators of the intervention’s implementation.

“This five-year project will allow assessment of both the public health impact and the ‘how and why’ of implementation of an innovative acute stroke care model,” said Steven Stringer, State Stroke System coordinator for ADPH. “Advanced therapies for stroke are not available at every hospital in the state, leading to racial, socioeconomic and rural disparities in access to potentially lifesaving treatment.”

The project will implement a phased rollout of TCC-coordinated SBST across Alabama’s six EMS regions, lending itself to analysis of health processes and outcomes before and after the intervention in each region.

“This project, if successful, can serve as a model for how the trauma system infrastructure that already exists in other regions and states can serve as the basis for a more integrated and effective system of emergency stroke care throughout the United States,” Gropen said.

Currently only two hospitals in Alabama are designated as Level I hospitals for stroke: UAB Hospital and Southeast Health in Dothan. There are 26 hospitals designated as Level II and 39 as Level III hospitals.

The project is supported by the National Institute of Neurological Disorders and Stroke under award number R01NS117813.

The Trauma Communications Center Coordinated Severity-Based Stroke Triage project was launched July 15, 2020.

(Courtesy of UAB)

5 months ago

As stress levels rise, call in the dogs

(UAB, Laura Gasque and Jeff Myers/Contributed, YHN)

Just about everybody likes dogs. Even virtual dogs. At UAB Hospital, dogs from Hand in Paw are used as therapy for patients and health care workers alike. So what happens when the novel coronavirus pandemic shuts down in-person visitation from Hand in Paw’s volunteer humans and dogs? You take the show on the road virtually, via telemedicine.

“Staff were so excited, they just wanted to come up and pet the screen.”

That is the report from Wendy Walters, the hospital’s clinical ethics consultant, who took two of Hand in Paw’s therapy dogs into UAB’s COVID-19 intensive care unit by means of a video feed on a telemedicine cart. Her goal was to ease the stress on health care workers who have been caring for very sick patients under very trying circumstances for about four months now.

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“I have a tremendous amount of concern for our frontline caregivers,” said Walters, who trained as a social worker, grief counselor and then ethicist. “They are so involved with their patients, and they are exhausted and stressed. I am trying to find ways to bring smiles to their faces, even for just a moment. The dogs are one way to do that.”

Walters arranged for two of Hand in Paw’s volunteer teams, Pam Strange and Maylee, along with Susanne Webb and Dinah, to visit with health care workers in five UAB nursing units a few weeks ago. Using a fully equipped telemedicine cart, Walters rang up the dogs and volunteers on a video call, and rolled the cart into the nursing units.

“We did this just for the staff,” Walters said. “And there was overwhelming excitement, a little bit of a break in a stressful day. They told me they needed something like this so badly and it made them feel that someone was taking time to do something for them.”

Even though the dogs were only on a screen, staff reached out. And the dogs did too. They reacted to their names and the voices on the screen, making it seem as though they were physically there.

“The dogs were so well trained and responded to the screen,” Walters said. “They connected when they heard their names. We could have both dogs on the screen at the same time, and it was wonderful.”

So wonderful that Walters will roll the dogs in again once a week, to reach even more of the hospital’s over-taxed medical staff. Thanks to Hand in Paw for helping to make these stress-reducing visits available.

(Courtesy of UAB)

5 months ago

Special unit to treat nursing home patients with COVID-19 to serve Jefferson County

(UAB/Contributed, YHN)

The University of Alabama at Birmingham and the Jefferson County Commission, in conjunction with NHS Management, will establish a special 25-bed unit to treat patients from nursing home facilities who have COVID-19.  The unit will be housed in a wing of the Aspire Physical Recovery Center at Hoover, operated by NHS Management. The establishment of the unit is the first step in a larger plan to assist the community in managing and mitigating the pandemic.

The unit is designed to isolate nursing home residents who test positive and are asymptomatic or mildly symptomatic, while providing the appropriate level of skilled nursing care that those patients require.

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“The unit will continue our mission to provide evidence-based care for these vulnerable patients across the care continuum,” said Kellie Flood, M.D., associate professor in the UAB Division of Gerontology, Geriatrics and Palliative Care. “Our goal is to provide them with the same care elements they receive regularly in their skilled nursing environments, such as rehabilitation, during these unprecedented times. We are also partnering with our infectious disease, infection prevention and PPE experts to provide this unit’s team with best practices for COVID-19 management and processes to keep team members safe.”

The Aspire facility has a separate wing that will be used for the unit, with a separate entrance and ventilation system. Nursing staff for the unit will be coordinated and trained by UAB.

“Nursing home residents have special needs, and for those with mild illness from the virus, an acute care hospital is not necessarily the right environment,” said Tony Petelos, Jefferson County manager. “This program will blend the hospital and skilled nursing environments to make sure all their needs are met.”

The unit will also ease pressure on hospitals that are facing a surge in COVID-19 patients by freeing up beds for acutely sick patients. It will also help reduce the potential spread of infection within a skilled nursing facility by providing a transition of care for patients who cannot be isolated in their home facility.

The unit will begin accepting patients in early July. On June 25, the Jefferson County Commission voted to allocate up to $1.9 million of its Coronavirus Relief Fund allocation — money received through the CARES Act — in support of this initiative.

“Our team at NHS Management is excited about this cooperative venture with one of the nation’s flagship health care institutions,” said Nick Beckham, regional director of NHS. “This effort will bring new resources to the fight our dedicated staff members have been waging against this virus and will provide additional options for the residents in our care. With the virus so prevalent in our community, this program allows us to be proactive instead of reactive in our fight. NHS believes this collaborative venture can become a best-practices model for the nation.”

“This unit is the first step of a broader collaboration between the UAB Health System, the Alabama and Jefferson County health departments, local area hospitals, and our affiliated nursing homes, to create a care continuum structure to develop a prevention and mitigation plan to respond to potential nursing home outbreaks of COVID-19 in Jefferson County,” said Brian Spraberry, chief administrative officer for the UAB Health System.

That plan will establish a line of communication with representatives from acute care, post-acute care, public health, the Alabama Nursing Home Association and Alabama

Hospital Association with the following goals:

  • Coordinate consistent infection-control practices and provide practical guidelines for PPE utilization and conservation for both the COVID unit and community collaborative.
  • Create a centralized process to track and test nursing home residents and employees to help inform and implement surveillance protocols for persons under investigation (PUI) by using a reporting structure through the county EMA or other such monitoring protocols as available.
  • Create a four-stage response plan to mitigate any resurgence occurring in the Jefferson County region to include exposure notification, PPE utilization, infection control, testing protocols and staffing.

UAB proposes to create an assessment team to provide consulting services to any facility needing expertise in the development of infection-control policies and procedures, staff education, and the development of other strategies related to prevention and mitigation of COVID cases.

(Courtesy of UAB)

5 months ago

UAB featured in Harry Connick Jr. CBS television special on heroes of COVID-19

(UAB News/Contributed, YHN)

In May, Harry Connick Jr. and a CBS television video crew stopped by UAB Hospital to recognize unsung heroes of the COVID-19 pandemic. Five members of UAB’s environmental services department will be feted in “United We Sing: A Grammy® Salute to the Unsung Heroes,” airing Sunday, June 21, at 7 p.m. on the CBS network.

The show is hosted by Connick, a Grammy and Emmy award-winning singer and actor. He and his filmmaker daughter, Georgia Connick, took a road trip in a recreational vehicle to thank and celebrate essential workers who risk their lives on a daily basis to keep others safe. The UAB stop May 12 celebrated those who clean and disinfect hospital rooms and treatment areas during these difficult times.

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“We chose five representative members of our Environmental Services department to meet with Harry Connick Jr., and we could have picked each and every one of our employees,” said Ed Crump, senior director of Environmental Services for UAB Hospital. “We are thrilled that CBS is shining a light on the important work our staff engages in every day: keeping UAB Hospital as clean and safe as possible to minimize the threat of infection for our patients and our health care workers.”

The show will feature appearances by Sandra Bullock, Drew Brees, Queen Latifah, Brad Pitt, Oprah Winfrey and Renee Zellweger, along with musical performances by Jon Batiste, Connick, Andra Day, John Fogerty, Jamie Foxx, Herbie Hancock, Cyndi Lauper, Little Big Town, Branford Marsalis, Wynton Marsalis, Dave Matthews, Tim McGraw, Rockin’ Dopsie, Irma Thomas and Trombone Shorty.

The Connicks’ journey began at their home in Connecticut, with stops in cities along the way to their final destination of New Orleans. At each stop, the father-daughter duo listened to the stories of essential workers in health care, food preparation, sanitation, law enforcement, trucking and more to honor their dedication and public service.

(Courtesy of Alabama NewsCenter)

5 months ago

Blood supply suffers as coronavirus pandemic continues

(UAB/Contributed, YHN)

This is not a good time to need a blood transfusion. Summer typically sees a decrease in the nation’s blood supply, and this summer the situation is seriously complicated by the novel coronavirus pandemic. Simply put, there is a severe blood shortage, and Americans are encouraged to donate blood now and throughout the year.

“There is an urgent need for blood products so that hospitals have suitable reserves for those patients who need a blood transfusion, such as those with cancer, sickle cell disease, undergoing emergency surgery, trauma victims or post-partum women,” said Marisa Marques, M.D., director of Transfusion Services at the University of Alabama at Birmingham. “We are urging citizens to donate at this time of tremendous need.”

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As part of recommended social distancing, many frequent or casual blood donors have curtailed their normal activities, including blood donation. However, donating blood can be done safely during the pandemic, as blood collection agencies have implemented multiple strategies to reduce any potential risk of exposure to staff and donors.

Donors can give blood up to six times a year, every eight weeks. If you are healthy, are feeling well, and are eligible to give blood or platelets, please make an appointment to donate. To find a blood drive or fixed donation location, go to the websites of the American Red Cross or LifeSouth Community Blood Centers websites.

The process takes about 45 minutes; the actual blood collection usually takes less than 20 minutes. Donors should bring a photo ID, wear a mask and practice social distancing.

(Courtesy of UAB)

6 months ago

UAB sleuths finds drug candidate against COVID-19

(UAB/Contributed, YHN)

The medical detectives at the Hugh Kaul Precision Medicine Institute at the University of Alabama at Birmingham helped find a potential drug to treat COVID-19. Degarelix, a Food and Drug Administration-approved drug for prostate cancer, is now undergoing a clinical trial to see if it can prevent the SARS-CoV-2 virus from entering lung tissue.

The double-blind randomized controlled trial of degarelix is being run by the United States Department of Veterans Affairs. The trial will compare degarelix (trade name Firmagon) to a placebo for improving the clinical outcomes of nearly 200 male veterans who have been hospitalized with COVID-19.

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“In January, as word of this new virus began to circulate, we started employing our resources to see what we could learn about the virus, and any potential means to counteract it,” said Matt Might, Ph.D., director of the Precision Medicine Institute in the School of Medicine at UAB. “One of our strengths is to use our trained analysts and artificial intelligence tools to look for FDA-approved drugs that might also have activity against a new target, such as the SARS-CoV-2 virus.”

With advanced artificial intelligence and computational genomics techniques, Might’s team began to ask questions. What are the symptoms of this new disease? What medications do we already have that block or suppress the various symptoms? What do we know of the virus itself? What molecular targets can we hit with existing drugs? As the answers filtered in, one possible strategy rose to the top: androgen deprivation therapy and, with that, the highly potent degarelix.

Androgens are hormones, such as testosterone, that regulate the development and maintenance of male characteristics. Degarelix is used in androgen deprivation therapy for prostate cancer to reduce the level of androgen hormones.

“I reached out to a number of scientists, including the head of research for the VA, Dr. Rachel Ramoni, to discuss degarelix,” Might said. “One of my colleagues at Columbia University, David Goldstein, had also reached a similar conclusion via different means on the possible efficacy of androgen deprivation as a strategy. The more we investigated, the more it seemed like a good candidate.”

In prostate cancer, degarelix works by rapidly, but temporarily, suppressing the body’s production of male hormones, which can fuel the growth of prostate cancer. Might and Goldstein found lab evidence suggesting male hormones trigger the production of a protein called TMPRSS2 on lung tissue. The virus that causes COVID-19 relies on TMPRSS2 to enter lung tissues.

After further research suggested degarelix would have activity against SARS-CoV-2, the VA launched the clinical trial on May 15. Patients will be administered only one dose of the drug that will last 28 days. Any side effects of degarelix are thus expected to be temporary.

By temporarily lowering male hormone levels, researchers believe they can reduce the production of TMPRSS2 in lung tissue and thus prevent the virus from penetrating lung cells. Hormone levels will return to normal at the end of treatment.

The study is not suitable for female veterans. Existing evidence shows degarelix may have the opposite effect in the female body by increasing TMPRSS2 production, thus worsening the severity of COVID-19 symptoms.

“Degarelix is one of over 200 drug compounds that the Precision Medicine Institute is investigating in UAB labs,” Might said. “Many of these either block a target that has been identified in the COVID-19 pathway or manage a symptom of the disease, giving us reason to initiate further tests.”

The West Los Angeles VA Medical Center is leading the trial. The study also involves VA medical centers in New York (Brooklyn and Manhattan) and Washington state (Puget Sound), leveraging the Prostate Cancer Foundation/VA network of centers of excellence. The University of California-Los Angeles is involved in the analysis of research specimens, but not the clinical element of the study.

VA researchers expect to complete the trial in about four months. For more information, visit research.va.gov.

(Courtesy of UAB)

6 months ago

COVID-19 is not the only game in town

(UAB/Contributed, YHN)

You may have heard about this virus going around. But with all the attention rightly paid to COVID-19, the rest of the aches, pains, ailments and injuries that afflict the population and that the health care system deals with on a daily basis have not gone away.

People still get sick. People still get injured.

May is National Trauma Awareness Month, designated by the American Trauma Society, and the news from the world of trauma is mixed as the pandemic wraps up its fifth month. The good news is that trauma cases at major trauma centers such as the University of Alabama at Birmingham are down overall. But the numbers are not all rosy.

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“The number of trauma cases we are seeing now are down some 10-12 percent from last year,” said Jeffrey Kerby, M.D., Ph.D., director of the Division of Acute Care Surgery in the UAB Department of Surgery, part of the School of Medicine. “The numbers that are not dropping are falls, especially with the elderly, and gunshot wounds.”

Kerby says that, at some trauma centers around the nation, falls, particularly falls by the elderly, make up about 80 percent of their patient visits.

“We don’t see as many falls at UAB, but the volume is going up,” Kerby said. “Unfortunately, gunshot wounds and assaults are holding steady, or even growing.”

The numbers back Kerby up. According to the Birmingham Regional Emergency Medical Services System, the number of patients to which the BREMSS trauma system responded in Jefferson County dropped from 381 in March and April 2019 to 339 in March and April of this year. Injuries to pedestrians did not drop, and penetrating injuries, such as from bullet or knife wounds, went up — 103 during March/April this year, against 100 in those months last year.

“People are driving less but walking more, so it’s not surprising to see a drop in vehicle crashes while pedestrian injuries hold steady,” Kerby said. “There are a lot of people out walking, running and biking in my neighborhood. I know I drive a bit slower now as a result.”

Trauma cases that result from violence trouble Kerby.

“It is discouraging to see the numbers of patients from violence increase, especially as we continue to cope with the pandemic and people remain tense and on edge,” Kerby said. “At the UAB Trauma Center, we can save about 97 percent of the gunshot victims who make it to the hospital alive. I just wish we saw fewer victims of violence in our community.”

Kerby has advice as states reopen and society begins to return to a more normal setting.

“We don’t need to see a rash of injuries as we open up from people overcompensating as they are released from stay-at-home orders,” he said. “We need to be careful, to have awareness of our situations and to think. We’ve all had a lot of angst and concern over the pandemic. As we ease back into more normal life, we need to also ease back into our usual routines and avoid injuries. I think a lot of people are going to be pushing the envelope, trying to make up for activities or projects that were put on hold by the pandemic. That’s a good way to find yourself in a trauma center.”

Kerby says he does not expect Americans to celebrate National Trauma Awareness Month. But he does hope that people take a moment to think, and try to avoid becoming a trauma statistic.

(Courtesy of UAB)

6 months ago

UAB Hospital again named to 100 Great Hospitals list

(UAB/Contributed, YHN)

For the eighth year in a row, University of Alabama at Birmingham Hospital has been listed on Becker’s Hospital Review’s 2020 list of 100 Great Hospitals in America. UAB has earned this distinction every year since 2013 and is the only hospital in Alabama to make the annual list published by Becker’s Healthcare, a leading source of cutting-edge business and legal information for health care industry leaders.

According to Becker’s, the hospitals included on this list have been recognized nationally for excellence in clinical care, patient outcomes, and staff and physician satisfaction. These institutions are industry leaders that have achieved advanced accreditation and certification in several specialties. The list also includes industry innovators that have sparked trends in health care technology, hospital management and patient satisfaction.

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Becker’s 100 Great Hospitals website describes UAB Hospital as a 1,157-bed hospital and home to more than 1,500 physicians. U.S. News & World Report recognized the teaching hospital as the No. 1 best hospital in Alabama in 2019-20 and nationally ranked it in six adult specialties, including cardiology and heart surgery and nephrology. In 2020, Healthgrades named University of Alabama at Birmingham Hospital one of America’s 250 Best Hospitals.

“It is a tribute to the outstanding faculty and staff of UAB Hospital to achieve this distinction for the eighth consecutive year,” said Will Ferniany, Ph.D., CEO of the UAB Health System. “Exceptional patient care, world-renowned research and outstanding medical education are the keys to developing a hospital worthy of being called great. Every person who touches UAB Medicine in any way can take pride in this designation.”

Becker’s Healthcare selected hospitals for inclusion based on analysis of ranking and award agencies, including U.S. News & World Report’s 2018-19 rankings, CareChex, Healthgrades, CMS star ratings, Leapfrog grades, and IBM Watson Health top hospitals. Becker’s also sought nominations for this list. This list was compiled and developed before the COVID-19 pandemic hit the United States. Organizations cannot pay for inclusion on this list.

(Courtesy of UAB)

7 months ago

Artificial intelligence jump starts clinical trial for rare genetic disease

(Matt Davis/UAB)

It was a pretty simple e-mail. Just a couple of lines. “It looks like low-dose ketamine is an up-regulator for ADNP. Do you think this makes sense for ADNP patients?”

Matt Might sent that e-mail to Matt Davis on Feb. 18, 2019. Might is the director of the Hugh Kaul Precision Medicine Institute at the University of Alabama at Birmingham School of Medicine. Davis is chief resident in the Department of Neurosurgery at UAB and the father of Benjamin, a child with a developmental delay caused by a variant in the ADNP gene.

And that e-mail was the first step toward a just-launched clinical trial that may make a world of difference for children like Benjamin.

The condition

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Variants in the ADNP gene are thought to be one of the single largest genetic causes of autism and neurodevelopmental disorders. Children born with ADNP syndrome have one healthy copy of the ADNP gene and one broken copy. The healthy copy produces the ADNP protein, which is essential for proper neurologic development, while the broken copy does not. As a result, the child does not get enough ADNP protein for normal development.

Benjamin’s a good example.  He’s three now and was diagnosed just before he turned one. His hearing was affected, followed by slowed speech development. He has some fine motor skill delays, and other developmental issues.

“Through all that, he’s a happy, active three year old,” said Davis. “But as a physician, I wanted to do all I could to find a way to treat or reverse this condition.”

The tool

Enter Matt Might. Might is a computer scientist by training who made himself an expert in precision medicine following the birth of his son Bertrand. Bertrand has a rare genetic condition — so rare that it had not been previously identified. Bertrand is, in effect, patient number one for a condition called NGLY1 deficiency.

Might dove headlong into the study of genetics and precision medicine, blended with his computer skills, to find a way to treat his son. His journey led him to a role with the Obama White House Precision Medicine Initiative and then as inaugural director of  UAB’s Precision Medicine Institute in 2017, setting the stage for his e-mail to Davis about a potential treatment for ADNP.

“We’ve developed an artificial intelligence tool we call mediKanren, with funding from the National Center for Advancing Translational Sciences,” said Might. “It has read all of the medical literature and uses AI reasoning to make deductions. I knew about Benjamin, and when we received a second request for assistance from a family with ADNP, we were able to load enough information into mediKanren to get started. It returned one major result. Ketamine.”

The drug

Ketamine has been approved for use in the United States since 1970. It is used in anesthesia and pain management, and recently as a treatment for depression. It has some limited use in treating asthma and seizures.

“MediKanren sorted through the questions we’d asked of it and searched the literature,” Might said. “Ketamine was the only practical solution that it found. I sent Davis that e-mail and he took it from there.”

“I looked at the scientific studies that mediKanren found,” said Davis. “In several studies using animal models, researchers reported that ketamine appeared to boost ADNP production in brain cells. Since kids with this condition are only getting half of the ADNP protein that they should be getting, boosting production of the healthy gene could make a profound difference.”

The foundation

Enter Sandra Sermone. Her son Tony was the first patient diagnosed in the United States with ADNP syndrome. Now 12, he was diagnosed just a few months after Bertrand was identified as the first patient with NGLY1. That shared experience connected Might and Sermone. Inspired, she launched the ADNP Kids Research Foundation. She now has a registry of 250 children diagnosed with the condition, virtually all those in the world identified so far.

“Matt Davis joined with us after Benjamin was diagnosed and shared my interest in repurposed drugs”, said Sermone. “He’s now the chair of our medical and scientific committee. He told me about the potential ketamine treatment that Matt Might had discovered using AI and we were off to the races. We began validating the information and spent months pulling publications, researching and contacting other scientists. We investigated, drafted ideas and collected clinical data and started preparing to file for IP and to present to our medical research team.”

The clinical trial

Sermone then turned to the Seaver Autism Center for Research and Treatment at Mount Sinai in the Icahn School of Medicine in New York, where researchers are conducting the largest study of ADNP syndrome to date. She presented the case for ketamine to center director Joseph Buxbaum, Ph.D., and investigator Alex Kolevzon, M.D., who were intrigued by its potential. After internal investigation, they began the process of initiating a clinical trial and gaining clearance from the Federal Drug Administration to proceed earlier this year.

“The foundation is funding the trial, and our study contact registry provides the study subjects,” Sermone said. “Since ketamine is an already approved drug, we can move ahead quickly to find out if, or hopefully how well, it works. This means we could have a drug available years before a non-repurposed drug. For our children, time is brain, so the faster we can find a treatment, the faster we can hopefully stop some of the negative effects of the disorder.”

Sermone and Davis say the trial should begin enrolling patients this spring.

“This type of re-purposed drug will most likely cost millions of dollars less to develop as the safety studies have already been done,” Sermone said. “The entire phenomenon of re-purposed drugs are nothing short of a miracle for rare diseases like ours with a small patient population that big pharma has no interest in helping.”

The future

“We have high hopes, tempered with caution,” Davis said. “If it works, it could reverse the condition in very young children whose brains are still adaptable enough to overcome the deficits caused by low levels of the protein. It could also provide some benefit for older children, even if it can’t achieve a complete reversal of the effects. That would be a remarkable victory.”

Might believes this is the first time that an artificial intelligence tool has directly led to a clinical trial.

“This is the first time someone has massed enough evidence starting with our recommendations to go to the FDA to get permission to do a study,” Might said. “We’ve always dreamed of the time when someone, such as a foundation or support group, took recommendations forward and did the hard work that led to a patient trial with the potential to really change lives.”

Sermone says that now armed with the ketamine hypothesis delivered by Might and Davis, and with a willing research partner in Mt. Sinai, they only lack two things. More funding and more patients.

“We could be on the verge of an incredible breakthrough for this condition,” Sermone said.

“This is the kind of progress we hope to achieve every day through the Precision Medicine Institute,” Might added. “It’s exciting to know that the clinical trial is underway and that we’ve been able to make a contribution to what we hope is good news for families with ADNP syndrome.”

(Courtesy of UAB)

7 months ago

UAB commitment to state vital in COVID-19 response

(Andrea Mabry/UAB)

COVID-19 has affected virtually every facet of life in Alabama, and there may be nowhere that is more apparent than at the University of Alabama at Birmingham — an institution leveraging its expertise to fill a critical leadership role in response to the pandemic.

“The COVID-19 pandemic has showcased the vital importance of UAB to Alabama and the world,” said UAB President Ray L. Watts. “We continue to leverage research and innovation, community service, patient care, and education to make a big difference.”

As the country began to take note of the devastating virus, UAB’s world-renowned infectious diseases experts provided accurate and timely information across Alabama and beyond, and they have continued to collaborate with local, state and federal elected leaders, deliver critical information to our community, and inform media audiences worldwide.

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UAB set an example for the state with early, decisive action to flatten the curve and promote aggressive social distancing among its 22,000 students, 23,000 employees and its patients from across Alabama, who account for more than 1.7 million visits a year to UAB medical facilities.

As a world-renowned research-intensive academic medical center, the state’s eyes turned to UAB Medicine for guidance on how to protect against the virus, medically prepare for a pandemic and care for patients once it arrived.

Preparing for the worst on the front lines

“When the COVID-19 crisis started, UAB Medicine took the position that we were going to do everything we could to help Alabama regardless of the cost,” said Will Ferniany, Ph.D., CEO of the UAB Health System. “We planned and prepared and shared what we knew to help others across the state plan and prepare as well.”

  • UAB experts prepared treatment guidelines and best practices and shared them with hospitals across the state.
  • UAB supply chain leaders provided support and advice to the governor’s office, the Alabama Hospital Association and Jefferson County’s supply chain efforts to secure personal protective equipment (PPE), not just for UAB, but for all health care providers across the state.
  • UAB pulmonologists helped the state evaluate proposals to purchase additional ventilators and made recommendations on the most appropriate options.
  • As the pandemic grew, UAB worked with state and local health departments, emergency management agencies, and Jefferson County on a plan to transform the Sheraton Birmingham Hotel’s 377 rooms into treatment rooms for patients in the event of a surge.
  • Plans were also coordinated with the U.S. Army Corps of Engineers on creating two 36-bed acute care units, if needed, in the Birmingham Jefferson Civic Center.
  • UAB physicians served on advisory panels and task forces to collaborate with and provide critical medical insights with local and state officials.
  • The UAB Health System and the Division of Geriatrics created a five-point plan to help nursing homes cope with the pandemic. Town hall meetings with the Alabama Nursing Home Association, Alabama Hospital Association, and state and local health departments resulted in a care continuum to develop strategies to fight the spread of infection in nursing facilities and provide a best practices care plan for testing and treating infected patients.
  • A similar effort is underway with state and private mental health facilities, where the UAB Department of Psychiatry is helping establish guidelines on the use of PPE and provide testing support.

Caring for those infected

UAB leveraged its large team of critical care physicians and nurses, as well as advanced knowledge and technologies, to care for complex COVID-19 cases, supporting higher recovery rates and saving lives. In addition to patient care, UAB led efforts to care for frontline health care heroes at UAB and beyond.

UAB Medicine made rooms available at nearby hotels for health care providers who did not want to return home and risk infecting their families. The university even offered a residence hall for self-isolating UAB staff and Birmingham-area first responders who had tested positive for COVID-19 or who had not tested positive but were worried about going home to their families. With the university’s full backing, the belongings of student residents who had returned home were packed and stored. The facility was thoroughly sanitized, and rooms were offered at no cost to frontline health care heroes.

UAB Health System member Baptist Health did the same, working with Auburn University at Montgomery to offer free housing to team members who had been exposed to COVID-19 or had family members at home with compromised immune systems.

Medical West Hospital, also a member of the UAB Health System, ramped up telemedicine in all of its primary care clinics to provide needed continuing care and testing ability. The hospital is also working with area nursing homes to contain the spread of the virus in those facilities through aggressive testing and best practices of evaluation and mitigation.

Recognizing disparities

Recognition of the disproportionate burden of disease on minority populations was highlighted in an editorial by Selwyn Vickers, M.D., senior vice president for Medicine and dean of the UAB School of Medicine, along with 14 medical school deans and health leaders. The editorial, published in USA Today, drew attention to the higher rates of infection and mortality in persons of color, and called for refinement of governmental and health care responses to pandemics to provide greater access to resources for the underprivileged and underserved.

A second thought-provoking editorial penned by Vickers and the group of deans stated the case for increased medical education in social determinants of health. The editorial, published by the American Association of Medical Colleges, calls for changes in medical school curriculum to better educate the next generation of physicians on the effects of health disparities on population health.

The School of Public Health, led by Dean Paul Erwin, Ph.D., and Shauntice Allen, Ph.D., has reached out to residents of the Housing Authority of the Birmingham District to answer questions and dispel myths about coronavirus and race. The school and local faith communities have hosted live events on Facebook and used YouTube videos to reach this underserved population.

SOPH’s Bertha Hidalgo, Ph.D., has maintained an active presence on social media in both Spanish and English to provide information to the general population about COVID-19 and to help break down the science to people without scientific backgrounds.

In a partnership between JCDH, Birmingham Strong, federally funded health centers in the area, and UAB’s Minority Health and Health Disparities Research Center, UAB launched additional testing sites in disadvantaged neighborhoods across the Greater Birmingham area. A call center for appointments was set up and neighborhoods identified. The clinics feature drive-in and walk-up testing, and they anticipate testing between 50 and 100 individuals per day at each site.

“As we reopen across the state, we know that it will be vitally important to continue community testing,” said Jordan DeMoss, vice president for Clinical Operations at UAB Hospital. “We understand that not everyone is capable or willing to come to our downtown testing site. We feel it is important that we reach out, especially to our underserved communities, for testing, for education and for awareness as we build trust in the health care system.”

The health system also supports underserved residents of Jefferson County as it moves forward with plans to operate Cooper Green Mercy Health Services as part of a University Authority. The Authority will provide better access to UAB’s high-quality care for Cooper Green patients.

Testing innovative therapies

In addition to being on the front lines of patient care and serving others doing the same, UAB is on the front lines of drug discovery, spearheading the development of possible therapeutics against COVID-19. One of the most promising treatments is remdesivir, developed under the guidance of the UAB-led Antiviral Drug Discovery and Development Center.

Dr. Anthony Fauci of the NIH has said that remdesivir is now the standard of care for hospitalized patients with moderate to severe illness. UAB is the only hospital in Alabama able to offer these treatments for our citizens through multiple clinical trials:

  • Remdesivir
  • Nitric oxide
  • Convalescent plasma
  • Selinexor
  • Tocilizumab
  • Canakinumab on cytokine release syndrome

Supporting community testing

UAB Hospital administrators and leaders in pathology have been able to secure hard-to-get testing equipment, materials and PPE to expand testing in the region, as well as expand testing into previously underserved areas. UAB medical students volunteered at community testing sites and manned phones lines to deliver results.

Due to UAB’s efforts in molecular testing led by Sixto Leal, M.D., UAB was among the first academic medical centers in the country to offer in-house testing by launching a laboratory-developed test in March. Leal and his team are currently testing between 300 and 500 samples daily with COVID-19 RNA testing, confirming the presence of the virus in patients, with a turnaround time of less than 24 hours. This includes all inpatient admissions and health care workers, as well as all patients undergoing surgical procedures at UAB Hospital, and labor and delivery patients. A second COVID-19 RNA testing platform with less than two hours’ turnaround time is now operational as well.

To support the Jefferson County Department of Health, UAB developed a testing call center and drive-in site on UAB property. That site has now tested more than 5,000 community members. Hospital laboratories quickly geared up to increase testing capacity, now processing 600 tests per day.

Medical West Hospital worked closely with mayors in west and southwest Jefferson County, and tested more than 600 patients with the help of Cahaba Medical Care.

Baptist Health quickly opened two Coronavirus Care Clinics in mid-March, within a week of one another, with phone screening/testing and a drive-up appointment model. To date, the clinics have served nearly 20,000 patients via phone screenings and more than 2,500 patients via drive-up screenings. These clinics helped identify COVID-19-positive patients in a drive-up clinic setting allowing for a safe and seamless referral to appropriate medical care.

Reopening the state

On the eve of Alabama’s updated stay-at-home measures that allowed greater access to retail, UAB distributed posters through an extensive grassroots effort for retailers and individuals to encourage safe shopping to allow businesses to remain open.

In addition to awareness, tracking the virus is a critical element in the reopening plan. A group of UAB experts created www.helpbeatcovid19.org, a symptom tracker to help determine the spread of the virus. More than 58,000 people are using this tool to track their daily symptoms, providing up-to-date information that tracks the progression of symptoms in communities in real time. The resulting interactive map shows hot spots that indicate a rise in symptoms.

UAB public health experts also launched predictive models to help decision-makers accurately assess the likely trajectory of COVID-19 in the state.

  • Suzanne Judd, Ph.D., developed a Jefferson County COVID-19 community-based disease outbreak model and provided it to the JCDH.
  • Jerry McGwin, Ph.D., has developed a model for the UAB Health System to predict the trajectory and characteristics of COVID-19 patients to aid in UAB’s personnel and resource management and planning.
  • McGwin has also developed a model to predict the trajectory and characteristics of COVID-19 patients admitted to hospitals in Jefferson County and in the state of Alabama to aid in resource management and planning.
  • Andrew Rucks, Ph.D., and W. Jack Duncan, Ph.D., are creating graphs that plot the daily path of COVID-19 in Alabama and Jefferson County from mid-March to the present. The graphs show the total number of cases, deaths and hospitalizations on any given date.

UAB experts are also members of panels looking at ways to safely and effectively reopen the state.

  • Vickers serves on the executive committee of the governor’s task force.
  • Jeanne Marrazzo, M.D., director of the UAB Division of Infectious Diseases, serves on the state coronavirus task force.
  • Other medical professionals are serving as advisers to elected officials at the local, regional and state levels on the progress of the virus, and of the efficacy of efforts to flatten the curve and reduce the incidence of infection.
  • The UAB Health System is actively working with hospitals in the region on guidelines for opening elective surgery and returning to normal patient volumes.

Putting the UAB research engine to work

In addition to ongoing drug development and clinical trials work, UAB is ramping up new research in the fight against COVID-19. In March, UAB launched the Urgent COVID-19 Research Fund, and in three weeks raised $1.1 million from Birmingham and state business leaders.

The money was dedicated to clinical and basic research projects proposed by UAB faculty in the School of Medicine, in conjunction with the Hugh Kaul Precision Medicine Institute. A request for applications for basic science proposals was issued in mid-March to faculty of the school. Fifty-two proposals were submitted. In late April, 14 projects were selected for funding.

Among those projects:

  • Vaccine development
  • Repurposing FDA-approved medications for use against COVID-19
  • Discovery of novel therapeutic targets
  • Disease tracking systems
  • Improvements in testing platforms
  • Creation of reagents for use in antibody immunity studies
  • Bio-repositories
  • Clinical registry of COVID-19
  • Creation of animal models of COVID-19
  • Understanding the cytokine release syndrome implicated in patients with severe disease

Outreach to Birmingham — and the world

UAB began regular media briefings in February to better inform the public about the novel coronavirus threat, prior to the first identified cases in Alabama.

  • UAB faculty have been regular fixtures on local and national television and quoted in major media publications around the world.
  • UAB has presented regular media briefings to state media outlets, in conjunction with the City of Birmingham, Jefferson County Department of Health and Emergency Management Agency.
  • UAB’s uab.edu/coronavirus website offers information, videos, images, infographics and more that have been shared widely in social and traditional media, reaching hundreds of thousands of people online.
  • The helpbeatcovid19.org website provides a place for the public to donate money, material or just show their support for frontline health care workers, first responders or those in need.

Educational leadership

UAB and the University of Alabama System have taken a leadership role in helping institutions of higher education plan toward a safe return to campus when in-person classes and activities resume.

The UA System established a task force made up of representatives of all three campuses and leveraging UAB’s extensive medical expertise to develop plans for reopening universities — guidance that will be shared with other institutions across the state.

“We are extremely fortunate that UAB, home to one of the world’s foremost academic medical centers, is part of our system,” said UA System Chancellor Finis St. John. “With knowledge and guidance from the scientists, doctors, researchers and numerous higher-education experts on our campuses, we are developing comprehensive plans to make sure our three campuses are the safest in America when our students return. Our task force will consider strategies of all kinds: testing measures, enhanced cleaning, classroom procedures, housing policies, security and wellness programs, and more.”

Watts says UAB will continue to work aggressively to support Alabama’s fight against COVID-19 and the state’s recovery.

“We have worked very hard to respond to the pandemic from every aspect of our organization,” Watts said. “I’m proud of the people of UAB: frontline health care workers, researchers, support staff, faculty, students and everyone who is a Blazer as we adapt to a new reality. We are also hard at work planning for when this is over, so that UAB will be an even stronger and better organization and be here to serve the people of Alabama.”

(Courtesy of UAB)

7 months ago

UAB launches research studies to combat COVID-19

(UAB/Contributed, YHN)

The University of Alabama at Birmingham has raised more than $1.1 million for clinical and basic research focused on the novel coronavirus and COVID-19. UAB officials created the Urgent COVID-19 Clinical Research and Laboratory Research Fund at UAB Medicine in March of this year in response to the pandemic. Community partners, many of them Birmingham-based businesses and one Montgomery business, quickly responded.

“Our goal was to raise $1 million to establish pilot studies that could help our understanding of COVID-19 and find ways to treat the infection and reduce the spread of the virus,” said Tom Brannan, UAB vice president for Advancement. “Due to the generosity of business leaders in Birmingham and Montgomery, we quickly raised $1.1 million.”

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The money was dedicated to clinical research and basic research projects proposed by UAB faculty in the School of Medicine. Etty (Tika) Benveniste, Ph.D., senior vice dean for Basic Sciences, in collaboration with Matt Might, Ph.D., director of the Hugh Kaul Precision Medicine Institute at UAB, issued a request for applications for basic science proposals in mid-March to faculty of the school. Fifty-two proposals were submitted.

“Because of the urgency of this pandemic, one of the criteria was how quickly the research team could launch their study, and how quickly they could begin to see results,” Benveniste said. “We wanted research studies that could be reviewed at the three- and six-month time frames to determine their potential. That is a very accelerated timeline for research.”

In late April, 14 basic science projects were selected for funding.

“These covered a variety of approaches to tackling the SARS-CoV-2 virus itself, or COVID-19, the disease the virus causes,” Benveniste said. “Some projects dealt with infrastructure, such as tracking systems or a bio-repository and clinical registry of COVID-19.”

While infrastructure studies will not directly cure or treat the disease, they are invaluable to researchers needing samples and clinical/epidemiological information to conduct exploratory studies, she says.

Other projects focused on creation of animal models of COVID-19, vaccine development, the potential of repurposing FDA-approved medications for use against COVID-19, discovery of novel therapeutic targets, understanding the cytokine release syndrome implicated in patients with severe disease, improvements in testing platforms and the creation of reagents for use in humoral immunity studies.

The Precision Medicine Institute’s use of analytics and artificial intelligence was an important tool in determining which applications had the most promise to deliver results quickly and effectively.

“Many of the projects that were not funded were very strong scientifically, but had long timelines toward results,” Benveniste said.

UAB also has multiple clinical studies underway. Clinical studies refer to studies that are conducted in patients or control groups.  Many of these studies launched shortly after patients began arriving at the hospital.

“The clinical studies are a mix of therapeutic approaches to treating COVID-19 and formulating a better understanding on the effects of the virus on different subsets of our population,” said Jeanne Marrazzo, M.D., director of the Division of Infectious Diseases in the Department of Medicine. “These are vital new projects that might help us curb and control the pandemic and lead to new understanding about how to prevent infection in the future.”

Clinical projects underway or planned include studies of a number of possible therapies for patients with moderate to severe disease, including remdesivir, developed through the UAB-housed Antiviral Drug Discovery and Development Center.

Other therapeutic studies are examining the use of nitric oxide, selinexor, toculizimab, hydroxychloroquine/azithromycin, and canakinumab on cytokine release syndrome.

Additional projects will look at the effects of COVID-19 on organ transplantation, its effects on pregnancy outcomes, the use of blood plasma on critically ill patients and the effects of COVID-associated mold disease. One study will examine clinical and epidemiological features of the disease in patients across the United States.

“We are also very involved with the National Institutes of Health Vaccine Treatment and Evaluation Units that are participating in worldwide studies on both vaccines and treatment for SARS-CoV-2,” Marrazzo said. “It is to the credit of UAB investigators in both the clinical and basic sciences to have been able to ramp up important research studies so quickly in the face of this pandemic, and a credit to the Alabama business community who responded so quickly and generously with the funding necessary to undertake this work.”

UAB leadership plans to issue a second request for applications in the near future that will be open to investigators in all the schools at UAB.

(Courtesy of UAB)

7 months ago

Hospital emergency departments are open for business

(Steve Wood/Contributed)

Do not let coronavirus fears keep you from medical care, say emergency room physicians at the University of Alabama at Birmingham.

“One unfortunate result of the novel coronavirus pandemic is that people are scared to go to an emergency room when they have a medical issue that requires emergency care,” said Erik Hess, M.D., interim chair of the UAB Department of Emergency Medicine. “We are seeing patients with heart attack, stroke or other significant health issues delay getting medical care for fear of contracting the virus.”

But Hess says UAB’s three emergency departments — the freestanding facility at Gardendale, Highlands Hospital and the main UAB Hospital — have taken the necessary precautions to prevent the possible spread of infection.

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“We are not seeing many patients in the EDs with mild illness suspected to be due to COVID-19 any longer, as many of those patients are first being diagnosed by their primary care provider or at testing sites,” Hess said. “What we are seeing is patients who are coming in too late to get potentially lifesaving care for the kinds of medical issues we typically treat, such as stroke or heart attack. Don’t let your fear of the virus keep you from coming to see us.”

Patients arriving at any of the UAB EDs are provided with masks upon arrival, and are screened for COVID-19 symptoms. Patients with symptoms are kept apart from patients without symptoms. The waiting areas have been reconfigured to help maintain social distancing of 6 feet, and all ED staff wear masks at all times.

“Everyone who works in an ED is involved in maintaining a clean and secure facility, from nurses and physicians to our environmental services employees, registration staff, chaplains and patient care technicians,” Hess said. “The emergency department is a pretty safe place right now as far as COVID-19 is concerned.”

The emergency departments have also begun to utilize telemedicine technology, especially with follow-up visits with patients. UAB Hospital has also created special units for COVID-19 patients, so patients who come in via the emergency department and need to be hospitalized for non-coronavirus issues have no contact with COVID-19-positive patients.

“None of our emergency physicians have contracted COVID-19 at work since we instituted a policy early in the pandemic that all our providers wear masks,” Hess said. “We have been aggressive with proper hygiene, social distancing, use of personal protective equipment and other steps to keep our staff, and our patients, safe. The bottom line is simple: If you are experiencing a medical emergency and you don’t come to the emergency department or call 9-1-1, you may be missing your window for lifesaving therapies.”

(Courtesy of UAB)

9 months ago

The Proton International at UAB facility treats first patient with Proton Therapy

(UAB/Contributed, YHN)

The Proton International at University of Alabama at Birmingham facility treated its first patient with proton therapy Wednesday, March 11.

“We celebrate this first of many patients who will be treated at UAB with this advanced technology,” said Will Ferniany, Ph.D., CEO of the UAB Health System. “With this technology, we will improve the quality of life for many cancer patients and their families in Alabama and the Southeast.”

It is the first center in Alabama to offer proton therapy and one of only 35 centers in the United States to offer this advanced cancer therapy. The location also provides added convenience to patients who may need to access additional services at UAB’s medical campus.

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“This is an exciting moment in the history of the UAB O’Neal Cancer Center,” said James Bonner, M.D., professor and chair of the UAB Department of Radiation Oncology. “This new treatment platform allows us to offer patients cancer care with the latest technology.”

Proton therapy uses highly precise proton beams instead of traditional X-rays to treat the tumor, leading to more precise and conformal treatment of the tumor with less dose to normal tissues.  Proton therapy is used to treat tumors of the brain and central nervous system, spine, head and neck, lung, prostate, liver, gastrointestinal tract and colon, and some breast tumors. The center’s technology platform is Varian Medical Systems new and innovative ProBeam 360 that incorporates new advances for precise treatment.

“Proton International is focused on a singular mission, to bring this important and relevant technology to more people who can benefit from it,” said Chris Chandler, CEO of Proton International. “The fact that we can now make this available to the residents of Alabama and the surrounding areas is a mission fulfilled. The talented physicians and their team will now be able to use this outstanding tool to improve short- and long-term cancer outcomes for patients and their families.”

The center is located on the UAB campus at 400 20th St. South. For more information, visit uabmedicine.org/proton.

(Courtesy of UAB)

9 months ago

Two from UAB lauded as among 100 inspiring black scientists in America

(UAB/Contributed, YHN)

Two scientists on the faculty at the University of Alabama at Birmingham have been named to a list of 100 inspiring black scientists in America by Cross Talk, the official blog of Cell Press, a leading publisher of cutting-edge biomedical and physical science research and reviews.

Farah Lubin, Ph.D., associate professor in the Department of Neurobiology, and Michelle Gray, Ph.D., associate professor in the Department of Neurology, made the list.

The blog’s guest author is Antentor O. Hinton Jr., Ph.D., a Ford Foundation and Burroughs Wellcome Fund postdoctoral fellow at the University of Iowa.

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“There’s a plethora of black scientists who make significant contributions to science, but many of them are unknown to the masses,” Hinton said. “It’s imperative that young black scientists know about the myriad accomplished scientists from African, Afro-Caribbean, Afro-Latinx, and African American backgrounds in the fields of life sciences, chemistry, engineering and physics.”

Lubin is the director of the NINDS-funded Neuroscience Roadmap Scholar Program. She is also a scientist in the Comprehensive Center for Healthy Aging, the Comprehensive Neuroscience Center, the Center for Neurodegeneration and Experimental Therapeutics, and the Evelyn F. McKnight Brain Institute. Her research focuses on learning, memory and synaptic plasticity, epigenetics, non-coding RNAs gene transcription, epilepsy disorders, neurodevelopment, and developmental disabilities.

Gray is the Dixon Scholar in Neuroscience in the Center for Neurodegeneration and Experimental Therapeutics, a scientist in the Comprehensive Neuroscience Center and the Evelyn F. McKnight Brain Institute, and co-director for the School of Medicine’s Summer in Biomedical Sciences Undergraduate Research Program. Her research focuses on the pathogenesis of Huntington’s disease with a specific interest in astrocytes, as well as cardiac abnormalities in Huntington’s disease and X-linked dystonia Parkinsonism.

The list includes 75 established investigators, including Lubin and Gray, who range from tenure track assistant professors to full professors and 25 scientists whom the author labels as rising stars.

Visit Cross Talk to see the list in its entirety.

(Courtesy of UAB)

9 months ago

UAB Hospital named one of America’s best hospitals for 2020

(UAB)

UAB Hospital was named one of the best hospitals in the nation by Healthgrades, a resource that connects consumers, physicians and health systems.

America’s Best Hospitals™ honors the nation’s top-performing health care providers, based on an analysis of more than 45 million patient records across nearly 4,500 hospitals over three years. The list honors the top 5 percent of hospitals in the nation for overall clinical excellence. UAB Hospital is the only Alabama health care facility to make the list.

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Healthgrades America’s Best Hospitals Awards analyzed the performance of United States hospitals across 32 conditions and procedures, including heart attack, heart failure, pneumonia, respiratory failure, sepsis and stroke. Overall, patients treated in hospitals named as among America’s Best Hospitals™ have, on average, a 26.6 percent lower risk of dying than if they were treated in hospitals that did not receive this award. If all hospitals, as a group, performed similarly to America’s Best Hospitals, 161,930 lives could potentially have been saved.

“It is our great faculty and staff who deserve the credit for UAB Hospital’s recognition by Healthgrades for what it is, a great hospital and an asset for everyone in Alabama,” said Will Ferniany, Ph.D., CEO of the UAB Health System. “We are here to advance medicine throughout Alabama, our country and the world.”

UAB Hospital has previously received the Outstanding Patient Experience Award™ from Healthgrades. The award recognizes hospitals that provide an overall outstanding patient experience, defined as the sum of all interactions, shaped by a health care organization’s culture, that influence patients’ perceptions across the continuum of care.

Click here to view Healthgrades’ hospital quality methodologies. Click here to see a full list of the recipients.

(Courtesy of the University of Alabama at Birmingham)

10 months ago

UAB’s Proton International to conduct first cancer treatments at end of February

(UAB/Contributed)

Proton therapy, a highly sophisticated radiation technology for treating cancer, has come to Alabama with the opening of Proton International at UAB. The facility opened with a ribbon-cutting Jan. 13. The center is a partnership between the University of Alabama at Birmingham and Proton International.

Proton International at UAB is one of 36 proton therapy centers in the United States and the first in Alabama.

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“With the establishment of this center, UAB Medicine has again brought one of the latest, most advanced medical technologies to our region,” said Will Ferniany, CEO of UAB Health System. “Proton therapy will be a valuable tool that our physicians and scientists in the Department of Radiation OncologySchool of Medicine and the O’Neal Comprehensive Cancer Center can employ to the betterment of thousands of cancer patients in Alabama and the surrounding area.”

Proton therapy uses a beam of protons directed at the tumor site. The beam is configured to deliver the majority of its energy precisely at the tumor. Healthy tissue in front of the tumor receives a minimal amount of energy, and tissue behind the tumor receives little. This reduces damage to healthy tissue that is common in X-ray radiation and the cause of most side effects.

“Opening the center is an important milestone for the residents of Alabama who now have access to proton therapy closer to home,” said Chris Chandler, CEO of Proton International. “Our mission is to work in partnership with leading clinical entities, such as UAB, so patients and families do not have to travel long distances and suffer further cost and stress at such a critical time.”

UAB physicians anticipate beginning consultations with prospective patients in the next two weeks, with the first proton therapy treatments taking place at the end of February.

Proton therapy is used to treat tumors of the brain and central nervous system, spine, head and neck, lung, prostate, liver, gastrointestinal tract and colon, and some breast tumors. While it treats primarily single-site tumors, because of its focused dose capabilities in some cases it can be used for treating cancer that has spread to surrounding tissue.

“Proton therapy will allow us to treat deep-seated cancers,” said James A. Bonner, M.D., the Merle M. Salter Endowed Professor and chair of the UAB Department of Radiation Oncology. “It can be particularly efficacious in the treatment of children, who can be highly sensitive to the effects of radiation therapy. We are excited to offer this cutting-edge approach for patients and families in Birmingham, across Alabama and beyond.”

Proton International at UAB is on 20th Street South between Fourth and Fifth avenues. The facility consists of a three-story building to house clinical exam rooms, offices and the ProBeam proton therapy system, manufactured by Varian Medical Systems, a longtime partner with UAB in the delivery of radiation therapy. The medical staff, including radiation oncologists, medical physicists, dosimetrists, radiation therapy technologists and nurses, will be exclusively from UAB.

The heart of proton therapy is a machine called a cyclotron, which produces the proton beam and delivers it to the precise location in the body to destroy tumor cells. Proton International at UAB’s cyclotron, nick-named Emma, was manufactured in Germany. The $25 million, 90-ton cyclotron was brought by ship to Brunswick, Georgia, then transported to UAB last March by a specialized truck, with 20 axles, 78 wheels, and drivers in front and back. A heavy-lift crane was assembled on Fourth Avenue South to lift and deposit Emma into the facility via the roof.

UAB will be involved in clinical research studies on the use of proton therapy to discover the full utility of the therapy and produce best practice parameters on its use. Click here for a more detailed explanation of how proton therapy works.

This story originally appeared on the University of Alabama at Birmingham’s UAB News website.

(Courtesy of Alabama NewsCenter)

11 months ago

Alabama’s first proton therapy center ready to open

(UAB/Contributed, YHN)

Proton therapy, a highly sophisticated radiation technology for treating cancer, has come to Alabama with the opening of Proton International at UAB. The facility, begun in the winter of 2018, opened with a ribbon cutting and reception Jan. 13, 2020. The new center is a partnership between the University of Alabama at Birmingham and Proton International.

Proton International at UAB is one of only 36 proton therapy centers in the United States and the first in Alabama.

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“With the establishment of this center, UAB Medicine has again brought one of the latest, most advanced medical technologies to our region,” said Will Ferniany, Ph.D., CEO of the UAB Health System. “Proton therapy will be a valuable tool that our physicians and scientists in the Department of Radiation OncologySchool of Medicine and the O’Neal Comprehensive Cancer Center can employ to the betterment of thousands of cancer patients in Alabama and the surrounding area.”

Proton therapy uses an aimed beam of protons directed at the tumor site. The beam is configured to deliver the majority of its energy precisely at the tumor location. Healthy tissue in front of the tumor receives a minimal amount of energy, and tissue behind the tumor receives very little. This reduces the damage to healthy tissue that is common in the use of conventional X-ray radiation and is the cause of most side effects.

“Opening the center is an important milestone for the residents of Alabama who now have access to proton therapy closer to home,” said Chris Chandler, CEO of Proton International. “Our mission is to work in partnership with leading clinical entities such as UAB so patients and families do not have to travel long distances and suffer further cost and stress at such a critical time.”

UAB physicians anticipate beginning consultations with prospective patients in the next two weeks, with the first proton therapy treatments taking place at the end of February.

Proton therapy is used to treat tumors of the brain and central nervous system, spine, head and neck, lung, prostate, liver, gastrointestinal tract and colon, and some breast tumors. While it treats primarily single-site tumors, in some cases it can be used for treating cancer that has spread, or metastasized, to surrounding tissue because of its focused dose capabilities.

“Proton therapy will allow us to treat deep-seeded cancers,” said James A. Bonner, M.D., the Merle M. Salter Endowed Professor and chair of the UAB Department of Radiation Oncology. “It can be particularly efficacious in the treatment of children, who can be highly sensitive to the effects of radiation therapy. We are excited to offer this cutting-edge approach for patients and families in Birmingham, across Alabama and beyond.”

Proton International at UAB is on 20th Street South between Fourth and Fifth avenues. The facility consists of a three-story building to house clinical exam rooms, offices and the ProBeam proton therapy system, manufactured by Varian Medical Systems, a longtime partner with UAB in the delivery of radiation therapy. The medical staff, including radiation oncologists, medical physicists, dosimetrists, radiation therapy technologists and nurses, will be exclusively from UAB.

The heart of proton therapy is a machine called a cyclotron, which produces the proton beam and delivers it to the precise location in the body to destroy tumor cells. Proton International at UAB’s cyclotron, nick-named Emma, was manufactured in Germany. The $25 million, 90-ton cyclotron was brought by ship to Brunswick, Georgia, then transported to UAB last March by a specialized truck, with 20 axles, 78 wheels, and drivers in front and back. A heavy-lift crane was assembled on Fourth Avenue South to lift and deposit Emma into the facility via the roof.

UAB will also be involved in clinical research studies on the use of proton therapy to discover the full utility of the therapy and produce best practice parameters on its use. Click here for a more detailed explanation of how proton therapy works.

Brasfield & Gorrie is the general contractor for the project, and Stantec is the architectural firm.

(Courtesy of UAB)

11 months ago

Recovering UAB trauma patient with eye toward naval career vows to ‘help others’

(Bob Shepard/UAB)

On May 24, 2018, Cole Burton stood along a road cut through the heart of Red Mountain in Birmingham. He and his fellow students from an Auburn University geology class were studying formations in the rock exposed when the road was dug.

Burton took a moment to gaze to the north, over the sprawling campus of the University of Alabama at Birmingham in the valley below. His eyes settled on the buildings of UAB Hospital. Little did he know that, in just a few short hours, he would be offloaded from a helicopter on the hospital rooftop, clinging to life.

Following their Red Mountain investigations, the class proceeded to Glencoe, near Gadsden.

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“We were walking on the side of the road,” Burton recalled. “My friend Nick Hood and I were both hit by an impaired driver who may have overcorrected and lost control of their vehicle.”

Both were airlifted to the UAB Trauma Center. Burton had a traumatic brain injury (TBI), broken bones, bruised lungs and a tear in his small intestine that required emergency surgery.

“The TBI and the intestinal tear were life-threatening injuries,” said Parker Hu, M.D., the UAB trauma surgeon who spearheaded Burton’s care. “He was comatose upon arrival here and placed on mechanical ventilation.”

Hood, unfortunately, did not survive. UAB physicians were not sure Burton would, either.

“Brain injuries are hard to predict,” Hu said. “Most of the time, people with the kinds of injuries Cole had sustained never wake up, or they wake up different. Some have physical or cognitive impairment, or their personalities change. A large part of his recovery was the question of whether he would wake up or not.”

Hu and the other UAB surgeons from the Department of Neurosurgery who treated Burton were honest with the family, telling them the outlook was not good. Burton’s parents, Charlie and Tina, and his younger sister, Libba, understood. But they also understood Cole’s strength and will to live.

“We believe that, with God, all things are possible,” Charlie Burton said. “We asked the doctors to continue treating Cole as if recovery were likely, and we would continue to pray.”

“Being in intensive care is a roller-coaster ride,” Tina Burton said. “One step forward, then one step back. You get off a ventilator, then have a setback and go back on the vent. We understand that’s part of the process, but it’s difficult.”

The situation took a toll on the family. Charlie and Tina stayed at the ICU virtually nonstop. Libba, a freshman at Troy University, made sure they took care of themselves during the process.

“I was leaning into going into nursing already, and I guess that took over,” she recalled. “In a way, it was easier on me than it was on my parents. I tried to be the strong one, and the UAB nurses who took care of Cole and the rest of us inspired me to really want to be a nurse.”

Slowly, Burton responded. He came out of the coma on June 15, three weeks after the injury.

“While Cole’s prognosis was poor, we know that it’s possible for patients to have a full recovery,” Hu said. “For Cole to wake up and still be Cole was remarkable. We can’t predict which patient might have that kind of recovery; that’s why we do the best we can for every patient in our care.”

Relearning how to live

Coming out of the coma was not the end of Burton’s recovery. He had to relearn how to accomplish even simple tasks such as talking, walking and eating. On discharge from UAB just over a month after the injury, his family moved him to the Shepherd Center in Atlanta for rehabilitation.

Two months of inpatient, six months of outpatient and an additional six months of intense personalized physical therapy later, followed by a return to classes at Auburn, Burton came back to UAB for a visit – a visit that confirmed Hu’s statement that “Cole is still Cole.”

The whole Burton family came to the hospital just before Thanksgiving to reconnect with hospital staff and to say thank you to the physicians, nurses, therapists and all other hospital professionals who played a role in Burton’s recovery.

As Burton toured the emergency department, ICU and the UAB helipad, the casual observer would see no evidence that there had ever been a question of whether he would wake up.

“I set the bar high for myself,” Burton said. “I have long-term goals from before the injury that are still the same and short-term goals to help achieve them. Having a goal is very important for recovery.”

The long-term goal? A career as an officer in the U.S. Navy. Burton was, and still is, active in Navy ROTC at Auburn.

“I’m still actively working on rehab to pass the Navy physical fitness test,” Burton said. “I have to run a mile and a half in 12.5 minutes and do as many pushups and situps as I can in two minutes. I’m up to 60 pushups and 85 situps so far.”

Burton ran in the Peachtree 10K road race this summer. Last year, he watched from a wheelchair.

“The Navy has been patient, waiting on me to recover as completely as I can,” he said. “They will look at my overall fitness – academically, physically and socially – to see if I can serve.”

Burton is still working to regain complete function of his left hand, but is on pace to graduate from Auburn in December with a degree in geology. While a naval career is his first choice, Burton has a plan if that does not work out.

“I will find a way to give back in any way I can,” he said. “Use every breath I have to help others. Whether that’s in the Navy or not.”

“I don’t think there is any limit to his recovery,” Hu said. “He’s met every challenge and continues to surpass expectations. Cole personifies the reason that we work as hard as we can for all our patients. We know that patients can have great outcomes despite what look like insurmountable odds.”

“Throughout rehab, I always thought that I’d get back to where I was before; but now I think that was the wrong mindset,” Burton said. “Now I think that I will always be improving. I want to be better than I was before. If I do my best today, it won’t be my best tomorrow. The growth mindset is really important. And I think the staff at UAB helped make that mindset possible. I’m so thankful for my second chance at life.”

This story originally appeared on the University of Alabama at Birmingham’s UAB News website.

(Courtesy of Alabama NewsCenter)