Certain heart rhythm medications, administered by paramedics to people with out-of-hospital cardiac arrest, improved the likelihood of survival during transport to a hospital, according to new research published online in the New England Journal of Medicine. UAB and local emergency medical services agencies participated in the study, along with other sites in the Resuscitation Outcomes Consortium (ROC), which includes clinical sites in the United States and Canada. ROC is funded by the National Institutes of Health.
The study looked at two antiarrhythmic medications, amiodarone and lidocaine, given by paramedics in the field, and followed patients from hospital admission to hospital discharge. Compared with placebo, the use of amiodarone and lidocaine resulted in five percent higher survival in cases where a bystander witnessed the patient’s collapse. Bystander-witnessed survival rates are higher than non-witnessed rates, due to the increased likelihood of bystander CPR and faster EMS response. This is an important figure, especially considering that only about one-fourth of bystander-witnessed cardiac arrest patients survive.
Sudden cardiac arrest is a condition in which the heart suddenly stops beating, cutting off blood flow to the brain and other vital organs. More than 300,000 people are treated for out-of-hospital cardiac arrest each year, with the majority occurring at home, according to the American Heart Association. Effective treatments, such as CPR and defibrillation, can greatly increase a victim’s chance of survival. This study adds the possibility of additional benefit from the use of the heart rhythm medications.
Antiarrhythmic drugs are commonly given by EMS providers in cases of cardiac arrest that is not responsive to defibrillation, but there was no consensus on whether they actually improved survival.
The three-year study, which was led locally by Henry Wang, MD, vice chair for Research in the UAB Department of Emergency Medicine, involved five local EMS agencies. Overall, the trial was conducted in 10 cities and examined more than 3,000 patients who underwent out-of-hospital cardiac arrest caused by ventricular fibrillation and ventricular tachycardia, life-threatening rhythms of the heart’s lower pumping chambers that are often resistant to electrical shock.
“Overall survival from out-of-hospital cardiac arrest is low — on the order of 10 percent. Any strategy that can boost that rate is worth examining,” Wang said.
Local EMS agencies participating with UAB in the study were Birmingham Fire and Rescue, Bessemer Fire Department, Hoover Fire Department, Centerpoint Fire District and Regional Paramedical Services in Walker and St. Clair Counties.
Study Explores Carb-Loading Effect on Heart
Consuming a high-carbohydrate load may have an acute and detrimental effect on heart function, according to a study published in the Journal of the American College of Cardiology.
A team of researchers from UAB, Massachusetts General Hospital and Vanderbilt University studied 33 individuals who were given an acute carbohydrate load in the form of a 294-kilocalorie shake. They studied the subjects’ blood levels for six hours looking for a number of reactions, chief among them whether this acute metabolic challenge could alter the heart’s production of atrial natriuretic peptide (ANP), which is a hormone that helps the body get rid of excess salt and reduces blood pressure.
UAB’s Pankaj Arora, MD, first author of the JACC study, led the recruitment of human subjects and worked to figure out the novel chemical pathways that mediated the effect of glucose on heart cells.
Researchers know through previous studies that obese people make less ANP, predisposing them to salt retention and hypertension.
If a high-dietary-carbohydrate load suppresses circulating ANP concentrations, obese individuals, who have lower ANP levels to begin with, would be at a potential disadvantage, the authors wrote in the JACC study. “It is thought to be common sense that carbohydrate loading is detrimental. But the negative effects are delivered through the principal hormones, the natriuretic peptides, produced by your heart, a system that is suppressed in obese individuals,” Arora said.
Before the participants began the study, they were normalized on a standard diet for a couple of days to remove any background dietary variability. The investigators observed that drinking the high-carb shake led to a 25 percent reduction in ANP in participants over the course of several hours.
The investigators also looked at the mechanism for the decrease in ANP levels. They were able to reproduce the findings in mice carrying the human ANP gene, and found that the principal driver for the acute reduction in ANP appeared to be the increase in glucose.
This novel mechanism involved a molecule known as miR-425, which the research group has previously described as an inhibitor of ANP production. The glucose causes the cells to make more miR-425 by stimulating a transcription factor (NF-KB), and that in turn causes a reduction in ANP. This pathway was explored in the lab of Sumanth Prabhu, PhD, chief of the Division of Cardiovascular Medicine at UAB.
“Moving forward, we will focus on dissecting the pathophysiological link between miR-425-ANP axis in obesity and diabetes, which can translate into favorable effects on cardiometabolic health in this population,” Arora said.
Hallucinogens Could Protect Against Intimate Partner Violence
Evidence in a study led by researchers at the University of British Columbia along with UAB School of Public Health Associate Professor Peter Hendricks, PhD suggests hallucinogens such as psilocybin or LSD may have therapeutic potential for reducing intimate partner violence, or IPV.
Hendricks says the identification of risk and protective factors for IPV is an important goal for public health research.
“A body of evidence suggests that substances such as psilocybin may have a range of clinical indications,” he said.
The study looked at 302 men ages 17-40 in the criminal justice system. Of the 56 percent of participants who reported using hallucinogens, only 27 percent were arrested for later IPV as opposed to 42 percent of the group who reported no hallucinogen use being arrested for IPV within seven years.
From the 1950s through the early 1970s, thousands of studies reported on the medical use of hallucinogens. Due to the classification of the most prominent hallucinogens as Schedule I controlled substances in 1970, research on health benefits was suspended, causing many of these studies to be forgotten. However, research with hallucinogens has experienced a rebirth.
“Recent studies have shown that psilocybin and related compounds could revolutionize the mental health field,” Hendricks said. “However, additional research is needed.”
Brookwood Baptist Health Officially Launches New Brand
Brookwood Baptist Health – unifying the former Brookwood Medical Center and Baptist Health System with Tenet Healthcare – officially launched its new brand on April 5th.
The new Brookwood Baptist Health brand showcases an intertwined, three-circle logo representing how the organization is putting people back at the center in order to support the unique health needs of each individual across the system. The brand was unveiled at simultaneous, system-wide launch celebrations attended by employees, community members and hospital leadership.
Premier Surgeon Joins UAB as Division Director of GI Surgery
Greg Kennedy, MD, PhD, an internationally recognized surgeon and researcher, has been named director of the Division of Gastrointestinal Surgery in the UAB School of Medicine. Kennedy comes to UAB from the University of Wisconsin School of Medicine and Public Health.
The UAB GI group consists of 10 surgeons with advanced expertise in surgical management of all aspects of gastrointestinal diseases.
The group offers minimally invasive approaches for most surgically treated gastrointestinal diseases and is the only program in the southeast to offer unique expertise in pancreatic islet cell transplantation for chronic pancreatitis.
“This division is one of the most talented divisions of GI surgeons as a group in the United States,” Kennedy said. “Our goal is to be the premier GI division in the country, setting the standard for GI surgery.”
Kennedy is a graduate of the University of Washington School of Medicine in Seattle. He earned his doctorate in cancer biology at the University of Wisconsin School of Medicine and Public Health, where he also completed his general surgery residency in 2006. Kennedy then completed his colon and rectal surgery fellowship at the Mayo Clinic in 2007.
Kennedy is certified by the American Board of Colon and Rectal Surgery and by the American Board of Surgery. In addition, he is a fellow of the American College of Surgeons and a fellow of the American Society of Colon and Rectal Surgery.
Kennedy’s research efforts are focused on chemoprevention of colon and rectal cancer. His funded laboratory uses genetic models to better understand how chemicals prevent tumor formation and what genetic pathways are responsible for their effects. The ultimate goal is to identify targeted agents that are better tolerated by patients in hopes of preventing colon and rectal cancer.
Johnson Development Ranked Number 10 Nationwide
Birmingham-based Johnson Development has been ranked by Modern Healthcare as number 10 nationally among the nation’s top healthcare development companies, based on the dollar volume of transactions in 2015.
“We are pleased to be recognized for our 2015 performance, and are looking forward to 2016, with projects underway in Alabama, Florida, Georgia, Louisiana and Tennessee,” said James Johnson, Founder and Chairman of Johnson Development.
Northington Joins Shelby Dermatology
Marian E. Northington MD has joined Shelby Dermatology. Northington will perform MOHS micrographic surgery from the practice’s Alabaster office while her main focus will be performing cosmetic dermatology at the group’s new sister practice, Aesthetic Dermatology, located on the Grandview medical campus.
Northington graduated from University of Alabama summa cum laude and earned her medical degree from UAB. After completing an internship in internal medicine and her dermatology residency at UAB, she was accepted into a fellowship in San Diego, after which she returned to UAB as the Director of Cosmetic Dermatology.
Medical West Golf Tournament and Kickoff Event
On April 14th, Medical West held a kickoff event for their golf tournament at the PGA Superstore in Birmingham.
The event was sponsored by the Birmingham Medical News, Spectrum Business Enterprise Solutions, Kassouf & Co, and Legacy Health & Rehabilitation of Pleasant Grove.
The Medical West Golf Tournament was held a week later at Brent Brook Golf Course. Both the kickoff and the tournament events benefited the Western Health Services Foundation.
Women’s Health Specialists Aligns with Grandview
Women’s Health Specialists of Birmingham and Grandview Medical Center have completed a partnership to align. Women’s Health Specialists will operate in alignment with Grandview Medical Group, the affiliated physician practice group of Grandview Health. Women’s Health Specialists will join a Grandview multi-specialty physician group with nearly 60 employed providers practicing in over 15 different market locations in Birmingham.
“We are excited to expand our services to women with the addition of this new group,” said Keith Granger, President of Grandview Medical Center. “We share a common commitment to standards and expectations with the physicians and staff of Women’s Health Specialists of Birmingham.”
Women’s Health Specialists is comprised of four OBGYNs and 17 employees. The group will occupy a new 8,700 square foot office in the Grandview Physicians Plaza and will maintain its recently opened office in Gardendale. Women’s Health Specialists offers obstetric and gynecological services including laparoscopic surgery, robotic surgery, weight loss management, 4-D pregnancy ultrasound, infertility evaluation and treatment, bone density screening, ultrasound, and cervical, ovarian and breast cancer screening.
“We are looking forward to relocating to the new state-of-the-art Grandview Medical Center and all it has to offer,” said Alison Heaton, MD.
Priority Ambulance hires Glenn Leland
Priority Ambulance has hired Glenn Leland as chief growth officer. Leland will manage mergers and acquisitions, business development, and marketing.
Since its founding in 2014, Priority Ambulance has experienced substantial growth. The company operates more than 250 emergency vehicles and employs more than 1,000 EMTs, paramedics, and billing specialists in Tennessee, Alabama, Georgia, New York, Indiana and Pennsylvania.
Leland has more than 35 years of experience at national and international EMS companies. He began his career as an EMT and paramedic and was subsequently promoted into operations and marketing roles.
Leland most recently served as CEO of TransCare, a transport company with operations in Pennsylvania, Maryland and New York. Prior to this, he served as chief strategy officer for ProTransport-1, which serves 15 California counties. From 2007 to 2009, he served as chief operating officer of Emergency Medical Services Authority, an agency serving 1.4 million residents of Oklahoma.
Leland also is a strategy and business development instructor at the University of Maryland Baltimore County’s Graduate Health Services program and has provided online courses since 2010. He holds a master’s degree in business administration from Kellogg School of Management at Northwestern University.
UAB Physicians Named to Association of American Physicians
Four physicians from the UAB School of Medicine have been named to the prestigious Association of American Physicians.
• Ravi Bhatia, MD, director of the Division of Hematology and Oncology, Department of Medicine, and deputy director of the UAB Comprehensive Cancer Center
• Smita Bhatia, MD, professor and vice chair for Outcomes in the Department of Pediatrics and director of the Institute for Cancer Outcomes and Survivorship
• William Britt, MD, professor in the Division of Pediatric Infectious Diseases in the Department of Pediatrics
• Victor Thannickal, MD, director of the Division of Pulmonary, Allergy and Critical Care Medicine and vice chair for strategic planning, Department of Medicine
Election to membership is a widely recognized measure of scholarly excellence among senior faculty members, particularly in departments of medicine and pediatrics.
“It is unusual to have so many physicians from one institution inducted into the association at one time,” said Robert Rich, MD, former dean of the UAB School of Medicine and chair of the UAB nominating committee. “We were extremely gratified that four outstanding faculty members from UAB were chosen.”
The Association of American Physicians is a nonprofit, professional organization founded in 1885 with about 1,300 active members and approximately 600 emeritus and honorary members from the United States, Canada and other countries.
CRMC Welcomes Karl Schroeder, MD
Karl Schroeder, MD has Cullman Primary Care Multi-Specialty Group, practicing at Cullman Regional Medical Center. A native of Huntsville, Schroeder received his medical degree in 2007 from The University of South Alabama in Mobile after receiving his undergraduate degree in chemistry from The University of Montevallo. He completed his Internal Medicine Residency & Internship at The University of South Alabama in 2010. Following his residency, he completed a fellowship in pulmonary disease and critical care medicine at The University of South Alabama.
Schroeder, who is passionate about the early detection of lung cancer, has started a Lung Nodule Clinic in which he biopsies small nodules found in a patient’s lungs in order to detect and treat lung cancer early.
Grandview Medical Center Employees of the Year
Grandview Medical Center recently named their employee and managers of the year for 2015.
The Employee of the Year is Curtis Crittenden who has been a Grandview employee for over six years and works in Receiving through the Materials Management department. Mike Gaither was named Clinical Manager of the Year. Gaither has provided oversight for Emergency Services for the past five years. The Non-Clinical Manager of the Year is Leisha Harris who has worked for more than 15 years at Grandview and currently serves as the Director of Marketing and Public Relations.
Children’s of Alabama Receives National Award
Children’s of Alabama was recognized by the Children’s Hospital Association (CHA) with a Pediatric Quality Award for waste reduction and improved efficiency.
Children’s was recognized for work done by its pediatric intensive care unit and orthopedic group. The two areas worked together to standardize care for adolescent spinal fusion patients. The new processes give families an opportunity to participate in care and understand expectations prior to PICU admission.
The results were shorter hospital stays for these patients as well as a cost savings of more than $800,000 for the state’s only freestanding pediatric hospital.
Members of the Children’s project team were Leslie Hayes, MD; LaTanya Higginbottom; Lauren Jones, RN; Joseph Khoury, MD; Delicia Mason, RN; Ashley Penn, CRNP; Paige Perry, RN; Vicki Shinick, RN; Tom Shufflebarger, Executive Vice President and Chief Operating Officer; Shirley Ward, RN, and Kristen Waddell, CRNP.