The Kentucky Neuroscience Institute integrates the expertise of UK neurology and neurosurgery physicians and researchers. KNI is a regional referral center dedicated to providing comprehensive care to our patients.
KNI offers patients the benefits of Gamma Knife® therapy. It is one of the most precise, powerful and proven treatments for brain and spinal cord tumors. Gamma Knife therapy does not involve surgery. Instead, it focuses precise beams of radiation directly on a tumor.
Additionally, we are the region's only Level IV Epilepsy Center. Our Epilepsy Monitoring Unit (EMU) is a dedicated six-bed unit with the latest diagnostic monitoring equipment to accurately diagnose the causes of epileptic seizures, allowing physicians to create a more accurate treatment plan. The Kentucky Neuroscience Institute also offers the latest advancements in minimally invasive surgery, such as kyphoplasty and other spine procedures, which allows patients to recover much faster.
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Monday - Friday8 a.m. - 5 p.m.
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Most commonly, patients are referred through their primary care provider or neurologist.
Kentucky ClinicFirst Floor, Wing C740 S. LimestoneLexington KY 40536-0284
Call 859-323-5661Fax 859-323-1127
Monday - Friday, 8 a.m.- 5 p.m.
(across from Starbucks)
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UK is first in the U.S. to conduct trial of new Parkinson’s disease treatment. A clinical trial being conducted at UK is investigating a new treatment strategy for Parkinson’s disease that, if successful, could drastically change future treatment of the disease and possibly halt or reverse brain degeneration. UK is the first in the U.S. to conduct the clinical trial.
Craig van Horne, MD, associate professor of neurosurgery in the College of Medicine and principal investigator of the clinical trial, came to the Kentucky Neuroscience Institute only two years ago, but he is already making significant contributions to research and patient care related to Parkinson’s disease. If successful, this procedure could significantly change the treatment of Parkinson’s disease and could have an impact on other neurodegenerative disorders as well. Learn more.
UK HealthCare’s Kentucky Neuroscience Institute (KNI) has received the Get With The Guidelines – Stroke Gold-Plus Quality Achievement Award by the American Heart Association/American Stroke Association for maintaining nationally recognized standards for the treatment of stroke patients. Learn more about the
Stroke Gold Plus Quality Achievement Award »
Stroke patients at the Kentucky Neuroscience Institute have access not only to the region's top doctors, but also to the most advanced medical technology. The
stroke center at UK Chandler Hospital was the first in the region to be designated as a
Comprehensive Stroke Center.
LEXINGTON, Ky. (Aug. 22, 2016) — One in 26 people will develop epilepsy – a chronic disease characterized by unpredictable seizures — in their lifetime.
A seizure is a sudden surge of electrical activity in the brain that can temporarily change how a person thinks or behaves. Seizures can be scary for both the patient and the people around them, since patients can lose awareness or even become unconscious, twitch or spasm, babble, have blurry or no vision, experience difficulty breathing, and/or a host of other symptoms.
Epilepsy has numerous physical and emotional costs. People with epilepsy have problems keeping up in school or at work, can be depressed and/or socially isolated, can suffer physical injury during a seizure, and can even die from a seizure. They may not be allowed to drive, play sports, or have other restrictions that affect their professional or personal lives.
It's important to remember that not all seizures are epilepsy. A person is diagnosed with epilepsy if they have one or more seizures that were not caused by some known and reversible medical condition such as diabetes. People can develop seizures after a brain injury (like a car accident or getting hit in the head with a baseball), a stroke, or because of an infection or a brain tumor. Sometimes there is a family history of seizures, but often the cause is unknown.
If you suspect you have had a seizure, you should see your family doctor or a neurologist for an evaluation. That is likely to include a detailed conversation about what happened during your seizure, medications you are taking, preexisting illnesses or injuries, family history and more. The doctor is also likely to order blood tests that might identify treatable medical disorders, an EEG, which measures brain waves and looks for abnormalities that point to epilepsy or other neurological disorders, and possibly also a CAT scan or MRI to look for abnormal areas of the brain.
There is no cure for epilepsy, but two-thirds of all people with epilepsy are able to control their seizures with medications. The remaining one-third have what's called "drug-resistant" or "refractory" epilepsy. In those cases, patients may be able to find relief through surgery or through devices that can help override the abnormal electrical impulses in the brain.
In the U.S., there are more than 100,000 patients who are candidates for epilepsy surgery, and only about 2,000 people have the surgery every year. Patients don't need to suffer from the physical and emotional effects of epilepsy for ten or twenty years. If someone has uncontrolled epilepsy for more than a year, they should seek an opinion at an accredited epilepsy center.
Dr. Frank Gillam is director of the Epilepsy Center at the Kentucky Neuroscience Institute at the University of Kentucky.
Media Contact: Laura Dawahare, email@example.com
LEXINGTON, Ky. (Aug. 2, 2016) – UK HealthCare’s University of Kentucky Albert B. Chandler Hospital is No. 1 in Kentucky in the U.S. News & World Report's Best Hospitals Rankings released today. It also is the only hospital in the state rated as High Performing in cancer. The complete rankings for 2016-17 are now available at http://health.usnews.com/best-hospitals.
In addition to being named as top hospital in Kentucky, UK HealthCare is nationally ranked No. 45 in Geriatrics and "High Performing" in six specialty areas including: Cancer, Diabetes and Endocrinology, Nephrology, Neurology and Neurosurgery, Orthopedics and Pulmonology.
UK HealthCare also ranked as high performing – the highest rating – in eight out of nine types of Common Adult Procedures and Conditions including: Heart Bypass Surgery, Heart Failure, Abdominal Aortic Aneurysm, Colon Cancer Surgery, Chronic Obstructive Pulmonary Disease (COPD), Hip Replacement, Knee Replacement and Lung Cancer.
"This acknowledges the exemplary work of our health care team in providing the highest quality patient care in the Commonwealth," said Dr. Michael Karpf, UK executive vice president for health affairs. "We are committed to being one of the premier academic medical centers in the country and dedicated in serving those who need complex medical care without ever having to travel far from their home."
To be recognized as a Best Hospital this year, a hospital had to have been categorized in the American Hospital Association annual survey database as a general medical-surgical hospital and had to earn either at least one national ranking in the 12 data-driven specialties or at least four ratings of "high performing" across the 12 specialty rankings and nine rated procedures and conditions.
“This honor belongs to our physicians, nurses and staff,” said Dr. Phillip K. Chang, UK HealthCare chief medical officer. “Every day and every night, they go above and beyond to make sure our patients get the best possible care.”
The U.S. News Best Hospitals analysis includes multiple clinical specialties, procedures and conditions. Scores are based on a variety of patient outcome and care-related factors, such as patient safety and nurse staffing.
In February 2016, UK HealthCare achieved Magnet Status – the highest institutional honor awarded for nursing excellence from the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program. This designation factors into the U.S. News Rankings and impacted this year’s score.
“Our entire interprofessional team is proud of our Magnet designation and its impact and significance for UK HealthCare and the patients we serve,” said Colleen Swartz, UK HealthCare chief nursing executive. “The team’s work has been exemplified in the production of superb clinical outcomes as well as excellence in patient and family centered care and are well deserving of this recognition based on their hard work, commitment and scientific approach to care across the continuum.”
UK HealthCare has seen the number of patients who are 75 or older nearly double in the past 10 years. This volume and the level of care for these patients attributed to the national ranking in geriatrics. Additionally, the University of Kentucky and UK HealthCare are home to the only National Institute on Aging (NIA) funded Alzheimer's disease center in Kentucky with the prestigious UK Sanders-Brown Center on Aging, and Markey Cancer Center is the only National Cancer Institute-designated center in the Commonwealth.
“Our goal is to provide the safest and highest quality patient care to those who come to us from every county in Kentucky, as well as from many other states, by providing them the expertise of integrated, multidisciplinary teams working to solve the most complex health issues,” said Bo Cofield, UK HealthCare vice president and chief clinical operations officer. “I congratulate our entire UK HealthCare team on this tremendous accomplishment and commend their work and dedication to patient care in the Commonwealth.”
UK is the University for Kentucky. At UK, we are educating more students, treating more patients with complex illnesses and conducting more research and service than at any time in our 150-year history. To read more about the UK story and how you can support continued investment in your university and the Commonwealth, go to: uky.edu/uk4ky. #uk4ky #seeblue
Media Contact: Kristi Lopez, firstname.lastname@example.org, (859) 323-6363
LEXINGTON, Ky. (Aug. 1, 2016) — In August 2014, three young men living with Amyotrophic Lateral Sclerosis (ALS) inspired the world to dump buckets of ice water on their heads as a gesture of solidarity and support. While the "Ice Bucket Challenge" raised money for and awareness of the disease, many people still don't know much about ALS except that baseball great Lou Gehrig had it.
About 20,000 Americans have ALS, a progressive neurodegenerative disease that leads to total paralysis and death within two to five years post diagnosis. It's a devastating disease that slowly robs its victims of their ability to speak, eat, move and breathe.
"The body breaks down, but the brain doesn’t necessarily," said Pam Light, whose husband, Paul, died of ALS a few months before the Ice Bucket Challenge rocked social — and mainstream — media. "It steals your sense of personal dignity. There's a lot of loss, a lot of mourning."
And with each new chapter in Paul's decline, he chose to stay in the game of life.
He continued as a volunteer directing traffic at his church until he no longer had the strength to lift his walker high enough to clear the one-inch cracks in the sidewalk. He continued to attend his bi-monthly men's lunch group even though one of his friends had to feed him. He went to a Cincinnati Reds game with his sons and traveled to Disney World, Gatlinburg, Maryland, Indiana, and North Carolina for an anniversary celebration with Pam and visits with family and friends.
Each time, says Pam, they brought all the equipment with them – motorized wheelchair, breathing machine, and a bag of all the things Paul needed to function while preserving his dignity. It wasn't an easy task, but a necessary one.
"Paul was truly amazing. He could have retreated from the world, just given up. Instead, he recognized that engaging in the world around him was more important than whether he could feed himself," Pam said.
In spite of Paul's indomitable attitude towards life, there were moments of despair.
"I was overwhelmed, still working full-time and trying to take care of Paul too," Pam said. "One night I had an anxiety attack – I thought it was a stroke. I looked at Paul and said, 'You have to take me to the hospital.'"
Paul, who had just recently been forced to give up driving, looked at her sadly and said just two words: "I can't."
They both started crying at the realization of their loss.
Dr. Edward Kasarskis, director of the ALS Clinic at the UK Kentucky Neuroscience Institute, said that ALS patients and their families often make the most of the time they have left, but he calls Pam and Paul's efforts inspirational.
Since Paul's death, Pam has continued to honor him by serving as a volunteer peer counselor in Dr. Kasarskis' ALS clinic. She visits with patients and families during their appointment, helping them through the process, brainstorming for coping mechanisms, and encouraging caretakers to take care of themselves as well.
She has also embraced the role of advocate, attending the national ALS Association Advocacy conference in Washington D.C., every other summer to share her thoughts and ideas with fellow attendees and advocate for the disease on Capitol Hill.
It was there this year that she saw a screening of a movie called "Gleason."
"Gleason" tells the story of Steve Gleason, a former safety for the New Orleans Saints who was diagnosed with ALS in 2011 at just 34 years old — shortly after learning of his wife's pregnancy. The movie is a difficult, sometimes painful look at Steve's journey and the adjustments he and his family have made to live with this disease.
As an official selection for the 2016 Sundance Film Festival and numerous other film awards to its credit, the movie clearly has impact. Its Los Angeles premiere was an emotional outpouring of support.
"My first thought when I saw "Gleason" was 'Oh my gosh, how did they find the courage to make this movie?' I was blown away by their willingness to struggle through life in full view of the world," said Pam.
"And my next thought was, 'What if this movie inspires the next wave of support and advocacy?"
Pam contacted the film's distributor and worked through all the red tape necessary to secure a private screening in Lexington the day before its local release.
"Gleason" will be at the Kentucky Theater on Main Street at 7 p.m., Thursday, Aug. 11. Tickets are free of charge; contact Brittany Ledford (859) 218-5061 or Meghann Bruno (859) 218-5064 to reserve tickets.
"I'll be honest, it's not an easy movie to watch, but it's so important. If just one person walks away committed to help further ALS advocacy for awareness, research and a cure, as Paul did, it was worth the effort."
Media Contact: Laura Dawahare, Laura.Dawahare@uky.edu, (859) 257-5307
LEXINGTON, Ky. (July 15, 2016) — Last week, more than 300 people gathered to honor a special person and her work.
That person is Ann Hanley. Her work: the Ann Hanley Parkinson's Research Fund, which supports research at the University of Kentucky.
Hanley was diagnosed with Parkinson’s disease at the age of 49. Parkinson’s is a degenerative disease that damages and eventually destroys neurons in the brain, causing muscle rigidity and tremors, difficulty moving, unstable posture and ultimately death. It is estimated about 10 million people worldwide have the disease, which has no cure.
"I pretty much lived the gamut of everything that you could possibly expect when you hear a diagnosis like this one. And it wasn't easy," Hanley said.
But instead of letting fear get her down, she's focusing her energy on lifting other Parkinson's patients up.
Hanley shadows Dr. Craig Van Horne, a neurosurgeon with the Kentucky Neuroscience Institute at the University of Kentucky, as he sees his patients.
"Each time the patient comes into the clinic, I sit with them, I talk with them, I educate them," Hanley said. "I do whatever it takes to keep them going, one foot after the other, one day after the other to make sure they never quit, they never give up."
That includes following them into the operating room and sitting with them through Deep Brain Stimulation (DBS) surgery – a technique that can relieve Parkinson's symptoms for some patients.
"Most DBS surgeries require the patients to be awake during the procedure, which can take as many as five hours to complete. That can produce a lot of anxiety for the patient," explained Dr. Van Horne. "Having Ann there holding their hand and talking with them about their 'happy place' is extremely calming."
Ann's work was so moving that she was recently featured on WLEX-TV's "Making a Difference."
Even as Ann made a difference in the lives of literally hundreds of Parkinson's patients, she felt she could do more. So as the wife of WinStar Farm's General Manager David Hanley, she reached out to the thoroughbred community to raise money in support of Dr. Van Horne's research.
The industry enthusiastically embraced her efforts. Fasig-Tipton, Coolmore Farm and WinStar Farm teamed up to host "Night for A Cure," raising around $300,000 for Ann's fund with a dinner, entertainment and an auction which featured some unusual equine-themed items, such as a framed American Pharaoh halter and a breeding season to Mshawish (Medaglia d’Oro), a recently retired Grade I winner on dirt and turf.
“I can’t begin to thank the many wonderful people who have loved and supported me with this cause," Hanley said. “It has brought attention to our cause and allowed us to raise funds that will ultimately speed us on our way to better treatments and a possible cure for this devastating and incurable disease."
Dr. Van Horne has been exploring a novel approach to Parkinson's treatment by transplanting peripheral nerve tissue from the ankle into the brain during a regularly scheduled DBS procedure. Called "DBS+," the technique has shown remarkable results, with a vast majority of patients seeing a dramatic reduction in symptoms.
"This kind of research science can take years and lifetimes. Patients, myself included, don’t have time, the clock constantly ticks and we are very aware of it," said Hanley.
"As a front seat spectator in this research I feel an overwhelming sense of gratitude to these doctors. With this new funding we can move ahead with the next phase of our research, which will help confirm the promising results we've seen thus far."
According to Lisa Deaton Greer, UK HealthCare's Director of Philanthropy, Hanley's activism has an impact beyond dollars and cents.
"Ann's enthusiastic efforts to raise money for Parkinson's research at UK is commendable – we couldn't achieve our research goals without the support of people like Ann. But beyond that, Ann's leadership has ensured that hundreds of people now understand the tragedy of Parkinson's disease and are committed to share in her fight."
"That kind of organic, grass-roots advocacy makes a huge difference."
For more information about the Ann Hanley Parkinson's Research Fund, go to https://vimeo.com/166832741/48cd4be379.
UK is the University for Kentucky. At UK, we are educating more students, treating more patients with complex illnesses and conducting more research and service than at any time in our 150-year history. To read more about the UK story and how you can support continued investment in your university and the Commonwealth, go to: uky.edu/uk4ky. #uk4ky #seeblue
Media Contact: Laura Dawahare, Laura.Dawahare@uky.edu
LEXINGTON, Ky. (June 10, 2015) - UK HealthCare's Kentucky Neuroscience Institute (KNI) has received the "Get With The Guidelines - "Stroke Gold-Plus Quality Achievement Award" by the American Heart Association/American Stroke Association for maintaining nationally recognized standards for the treatment of stroke patients.
KNI also received the association’s Target: Stroke Honor Roll Elite for meeting stroke quality measures that reduce the time between hospital arrival and treatment with the clot-buster tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke. Over 12 months, at least 75 percent of the hospital’s ischemic stroke patients received tPA within 60 minutes of arriving at the hospital (known as door-to-needle time). Stroke patients who receive tPA within three hours of the onset of symptoms may recover more quickly and are less likely to suffer severe disability.
This year marks the sixth year that KNI has received Gold Plus designation. KNI has been named to the Target: Stroke Honor Roll the past three years and repeats for the 'elite' level that was introduced last year.
Kentucky patients aren't the only ones benefiting from this achievement.
"By participating in the Get With The Guidelines-Stroke program, we are able to share our expertise with other member hospitals around the country, including access to the most up-to-date research, clinical tools and resources, and patient education resources," said Dr. Jessica Lee, medical director of the KNI Comprehensive Stroke Center.
Dr. Larry Goldstein, chair of the UK Department of Neurology and co-director of KNI, said that “Comprehensive Stroke Center status reflects our capability to provide the most advanced care for patients with stroke. These awards further underscore the hard work of our multidisciplinary team of neurologists, neurosurgeons, emergency physicians, nurses, therapists and others to optimize care delivery for stroke patients right here in Lexington.”
According to the American Heart Association/American Stroke Association, stroke is the number five cause of death and a leading cause of adult disability in the United States. In Kentucky, cardiovascular disease (which includes stroke) is the leading cause of death. On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 785,000 people suffer a new or recurrent stroke each year.
The KNI Stroke Center is also also certified as a “Comprehensive Stroke Center” by The Joint Commission – its highest honor.
Media Contact: Laura Dawahare, Laura.Dawahare@uky.edu, (859) 257-5307
LEXINGTON, Ky. (May 16, 2016) − Anyone who's 13 years old — or who was once 13 — can relate to the embarrassment of a parent insisting on sitting in the room while they showered.
Unfortunately, that was the reality for 13-year-old Joey Maggard until a delicate surgical procedure eliminated his epileptic seizures this past January.
At the time of his surgery, Joey's seizures were so frequent and unpredictable — about 20-30 per month — that his mother, Erin Smith, would sit in the bathroom in case he seized while showering.
"It was so frustrating for him and heartbreaking for me," Erin recalls. "He wanted so much to be 'just a kid,' but the reality was that being 'just a kid' could have been dangerous for him."
Adding to the disappointment were the other restrictions imposed upon Joey. He could no longer play his beloved sports or have sleepovers with friends. He was forced to follow a restricted diet and reduce Xbox and electronics use. After his seizures increased in frequency, his school district asked that he be tutored at home for the last half of his sixth grade year.
"Epilepsy is often misunderstood by the lay public, and epilepsy patients are often teased or shunned, particularly when they are younger," said Dr. Meriem Bensalem-Owen, director of the Epilepsy Program at the Kentucky Neuroscience Institute at the University of Kentucky. "As a result, they often isolate themselves for fear of losing control in public, and depression and anxiety commonly go hand-in-hand with the stigma of epilepsy."
Bensalem-Owen considers it part of her responsibility to reassure patients that they are not alone in their journey.
"More than 150,000 Kentuckians are living with epilepsy today," she explains. "I think many patients are surprised when I tell them that."
Even more reassuring, Bensalem-Owen believes, is the fact that she has a personal experience with epilepsy.
"My son had seizures few years ago, and I literally told myself 'OK, so now I have to be as brave as the parents of my patients and do what I tell them to do.' So I understand, not just as an epileptologist but as mom, what Joey and his family were going through and I can reinforce with them that there is a team with them every every step of the way."
Joey's odyssey began when he was nine. Erin said that while Joey's birth was stressful, otherwise "he was great, he hit every milestone." With no family history, his first and second seizures — about six months apart — were a shock to his family. After Joey experienced a grand mal seizure — considered the most violent and dangerous of all seizures — a CAT scan at a hospital close to their Lincoln County home found a lesion in his brain. He was referred to Dr. Qutubuddin G. Khan, a pediatric neurologist at the UK Kentucky Neuroscience Institute (KNI).
The Epilepsy Program at KNI is accredited by the National Association of Epilepsy Centers (NAEC) as Level 4 Center — its highest designation. A Level 4 center provides more extensive medical, neuropsychological, and psychosocial treatment, including thorough and highly technical evaluation for a wide range of surgical treatment for epilepsy. Since 2003, US News and World Report has included NAEC Level 4 adult epilepsy centers as a part of its ranking criteria.
"Level 4 epilepsy centers have the professional expertise and facilities to provide
the highest-level medical and surgical evaluation and treatment for patients with complex epilepsy,” said Dr. Larry Goldstein, chair of the UK Department of Neurology and KNI co-director. "To achieve this designation is an apt reflection of our institutional commitment to provide the best subspecialty care to the people of Kentucky and beyond."
At first, Khan tried a variety of medications, alone and in combination. Each time, says Erin, they would work for a while, but Joey's seizures would eventually return.
"One of the things I loved most about Dr. Khan was how candid he was," said Erin. "After each setback, he'd sit with us and explain patiently what our next options were and the pros and cons of each option."
Based on initial testing to determine what areas of the brain Joey's seizures came from, Khan felt Joey was a good candidate for surgery, and referred him to Bensalem-Owen for further evaluation.
A crucial step in the process of assessing Joey’s seizures — and a hallmark of centers with NAEC Level 4 accreditation — is invasive brain monitoring, where the skull is opened and a delicate web of electrodes is placed directly on the brain. Over a period of days Joey was monitored and brain mapping was performed to pinpoint exactly which parts of his brain controlled essential functions like speech, and those points were compared to the areas were his seizures arose. It's a painstaking and uncomfortable process.
"I asked Joey if he was ready for this, and he looked me straight in the eye and said YES," said Bensalem-Owen. "He said he was tired of missing school and having poor grades. I was impressed by how determined and brave he was."
Brain mapping indicated three small areas that were leading to Joey's seizures. Two areas were perilously close to the part of Joey's brain that controlled vision and motor function; Bensalem-Owen knew that precision was critical to a successful outcome for Joey.
Once the doctors knew which parts of Joey's brain to target and which parts to avoid, KNI neurosurgeon Dr. Thomas Pittman performed the surgery to remove the lesions that were causing his seizures. Then began the waiting game.
"Joey's been seizure-free since his surgery," said Amy. "He now can take showers and be alone outside without my constant supervision. I know we've got a ways to go before we're out of the woods, but this has been a huge burden lifted."
Furthermore, says Bensalem-Owen, Joey's vision and other motor function have remained intact. "We couldn't have hoped for a better outcome," she said.
Bensalem-Owen stresses that while surgery isn't an option for everyone, there are large swaths of individuals with epilepsy who either don't know about or are afraid of surgery, and those people are suffering needlessly.
"In the U.S., there are more than 100,000 patients who are candidates for surgery, and only about 2,000 people elect to have the surgery every year," she said. "We need to educate patients and healthcare providers that surgery shouldn't be treated as a last resort, that patients don't need to suffer from the physical and emotional effects of epilepsy for ten or twenty years. If someone has uncontrolled epilepsy for more than a year, they should seek an opinion at an accredited epilepsy center."
In a post-surgery appointment with Bensalem-Owen, Joey was bouncy and talkative. His hair was growing back, mostly covering the scar that extends from the top of his head to just behind his ear. His grades have rebounded since his return to school in March and he has been cleared to play sports in June. He will continue epilepsy medication as an added precaution, but Bensalem-Owen predicts a complete return to the life that allows kids to be just that — kids.
"On my first day back to school, as I was going down the hall teachers were shrieking and kids were hugging me," Joey recalled with a smile. "I was back with my buddies again, and I was so happy."
LEXINGTON, Ky. (April 26, 2016) – An editorial by University of Kentucky’s Dr. Larry Goldstein concerning the use of screening tests to detect narrowing of the carotid artery was published in the Journal of the American Medical Association (JAMA) Internal Medicine last week.
With more than 35 years of practice, Goldstein is the chair of the Department of Neurology at the UK College of Medicine and co-director of the Kentucky Neuroscience Institute.
Practice guidelines developed by professional societies to screen for narrowings in this major artery supplying blood to the brain are intended to summarize the best available evidence for specific questions to support clinical decisions. However, noted Goldstein, guideline recommendations from different organizations or groups can vary in minor or substantial ways.
"Evidence-based medicine is a linchpin of contemporary clinical practice,” said Goldstein. "However, these disparities among guidelines can lead to considerable uncertainty and variability in clinical practice."
According to Goldstein's editorial, screenings for carotid disease are offered in a variety of settings, yet there is no validated proof showing it is useful for identifying those in the general population who do or do not have a clinically important ACAS. There is a high proportion of carotid imaging studies performed for uncertain indications.
Goldstein wrote that “[S]creening for a disease or condition is rational only if its identification has a meaningful impact on patient management." In the case of narrowing of the carotid artery that is not associated with symptoms, the best approach is currently uncertain. “Specific educational programs, the use of alerts embedded into the electronic health record and audits with feedback, among other interventions, may be helpful in reducing inappropriate testing.”
Knowing the dilemmas that they are now facing, it can be difficult for physicians to understand when it is appropriate to recommend testing. Issues facing clinicians include:
· How can inconsistent guidelines be balanced?
· How are these complicated issues being presented and discussed with patients who look to their clinician for guidance?
· Should a screening test be performed in the face of equivocal, limited, or conflicting data regarding the intervention that would be considered if the condition was detected?
· To what degree should the potential for false-positive or false-negative test results and the attendant need for confirmatory testing be factored into the decision?
According to Goldstein, "despite the available evidence from randomized trials and practice guidelines, decisions regarding whether to proceed with testing are often a matter of informed opinion."
LEXINGTON, Ky. (April 21, 2016) − University of Kentucky’s Dr. Larry Goldstein and Donna Arnett, Ph.D., took part in drafting a policy statement that was published in the American Heart Association’s (AHA) flagship journal Circulation this month.
The statement was intended to provide a thorough review of the scientific underpinnings of the AHA’s public advocacy strategies as they pertain to the association's 2020 Strategic Impact Goals, which target a 10-year 20 percent improvement in the cardiovascular health of all Americans and a 20 percent reduction in deaths from cardiovascular disease and stroke.
"Our goal was to assist the AHA in determining how well the best available science aligns with the AHA’s public policy goals and identify research opportunities that would help fill gaps and support their further development," said Goldstein, the paper's co-lead author.
According to Arnett, the consensus was that there was generally close alignment between current policy and the 2020 metrics; however, some policies require a more robust evidence base.
"We were particularly concerned about cardiovascular health metrics by age, which currently are divided into just two groups: children up to age 20 and adults," Arnett said. "Since there are important differences in policy needs for infants, children, adolescents, and young adults, we'd like to see research that informs policy for each of these subgroups."
The intent of the AHA 2020 Impact Goals is to improve epidemiological factors (physical activity, healthy diet, tobacco use, and healthy weight) that contribute to cardiovascular health and refine clinical response (improved acute care processes and secondary prevention therapies) to prevent and treat cardiovascular disease and stroke.
Policies stemming from these goals include efforts to promote smoking cessation, improve BMI, reduce consumption of sugar-sweetened beverages, and encourage behaviors that promote healthy cholesterol, blood pressure and glucose levels.
"We hope that this intensive review will aid in translation and implementation of current policies, provide a roadmap to expand and strengthen the evidence base for the development of new policies, and help evaluate their overall impact in terms of targeted improvements in population health," said Goldstein.
With more than 35 years of practice, Goldstein is the chair of the University of Kentucky's Department of Neurology and co-director of the Kentucky Neuroscience Institute. He served as the co-chair of the writing group, providing his expertise on how evidence-based research can help public health organizations realize their organizational goals and policies.
As a transformative leader with core values of excellence, Arnett serves as dean of the UK College of Public Health and is also the former president of the American Heart Association. Her professional efforts have focused on bringing public health, medicine and other health-related disciplines closer together to improve population health.
Media Contact: Laura Dawahare, Laura.Dawahare@uky.edu, (859) 257-5307
LEXINGTON, Ky. (April 11, 2016) —The University of Kentucky College of Medicine Departments of Neurology and Neurosurgery and the Kentucky Neuroscience Institute will host an accredited event to bring health care providers up to date on care practices dealing with neurology and neurosurgery.
On April 29, all health care providers who treat patients with neurological issues - from primary care physicians to occupational and physical therapists - are invited to join several forums discussing new evidence-based practices in neurology. Presentations will cover advances in medical management for headache, memory complaints, Parkinson's disease, epilepsy and acute ischemic stroke.
The event is free but participants must register through CE Central to reserve a spot. Onsite registration and breakfast will start the day at 8 a.m. in the Pavilion A auditorium of the UK Albert B. Chandler Hospital with the welcome and introduction beginning at 9:30 a.m. The event ends at 4 p.m. Participants attending this event will receive free validated parking in the hospital parking garage at the corner of South Limestone and Leader Avenue.
To register visit http://www.cecentral.com/live/11652
For questions regarding this event please call 859-218-5074 or email email@example.com
LEXINGTON, Ky. (March 9, 2016) — The University of Kentucky College of Medicine Departments of Neurology and Neurosurgery and the Kentucky Neuroscience Institute will host an accredited event to bring health care providers up to date on care practices dealing with neurology and neurosurgery.
On April 29, health care providers who treat patients with neurological issues from primary care physicians to occupational and physical therapists are invited to join the Practical Update in Neurology and Neursurgery — several forums discussing new evidence-based practices in neurology. Presentations will cover advances in medical management for headache, memory complaints, Parkinson's disease, epilepsy and acute ischemic stroke.
The event is free, but participants must register through CE Central before April 11 to reserve a spot. Onsite registration and breakfast will start the day at 8 a.m. in the Pavilion A auditorium of the U.K. Albert B. Chandler Hospital with the welcome and introduction beginning at 9:30 a.m. The event ends at 4 p.m. Participants attending this event will receive free validated parking in the hospital parking garage at the corner of South Limestone and Leader Avenue
LEXINGTON, Ky. (Feb. 17, 2016) – UK HealthCare has achieved Magnet Status – the highest institutional honor awarded for nursing excellence from the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program. Out of nearly 6,000 health care organizations in the United States, less than 7 percent have achieved Magnet designation.
"Magnet recognition is a mindset and an approach in patient-centered care,” said UK HealthCare Chief Nursing Executive Colleen Swartz. “Our team has been extremely dedicated, focused and committed in achieving this goal and it shows in every interaction we have with patients and their families.”
UK HealthCare has 4,473 nursing services employees including 2,006 full-time registered nurses.
Achieving Magnet Status is a process that culminates in a rigorous review to demonstrate the hospital's commitment to sustaining nursing excellence and improving professional practice. The status represents a solid commitment to continuing education and nursing specialty certification, a cultural transformation of the work environment involving a shared governance model and laser focus on patient safety.
“Our nursing staff have worked very hard to achieve this important distinction and have been committed to this goal and truly deserve this Magnet recognition,” said Dr. Michael Karpf, UK executive vice president for health affairs.
In 2001, UK HealthCare became just the 38th Magnet-recognized organization. The hospital maintained its designation until it was up for renewal in 2009, when the ANCC restructured the Magnet Recognition Program criteria. The fundamental shift from a process-structured infrastructure to an outcomes-based infrastructure led to UK HealthCare needing to make changes to regain its status.
“From a nursing practice perspective, we used the loss of Magnet as a call to action for us to really focus on quality outcomes, patient experience and staff experience,” Swartz said. “The end goal for us was superb clinical care; Magnet status is a byproduct of that goal and we should embrace it as such.”
From 2010 to 2013, UKHC began an improvement process that signified a cultural change toward patient- and family-centered care. That process included evaluating the nursing strategic plan, identifying areas in need of quality improvement, and developing strategies for improvement, measurement and accountability.
“While Magnet recognition is awarded by a nursing organization, it is truly an honor resulting from the leadership of our nurses to demonstrate that it is all of our caregivers who focus on meeting the needs of our patients, their families, and one another each and every day in our hospitals and clinics,” said Bo Cofield, UK HealthCare vice president and chief clinical operations officer. “Everyone at UK HealthCare is proud to be one of less than ten hospitals in Kentucky and one of less than 500 in the nation to have earned this distinction.”
To achieve Magnet recognition, organizations must pass a rigorous and lengthy process that demands widespread participation from leadership and staff. The process begins with the submission of an electronic application, followed by written documentation demonstrating qualitative and quantitative evidence regarding patient care and outcomes. If scores from the written documentation fall within a range of excellence, an on-site visit will occur to thoroughly assess the applicant. After this rigorous on-site review process, the Commission on Magnet will review the completed appraisal report and vote to determine whether Magnet recognition will be granted.
Magnet recognition, which hospitals must reapply for every four years, has become the gold standard for nursing excellence. The recognition is based on adherence to Magnet concepts and demonstrated improvement in patient care and quality. U.S. News & World Report’s annual showcase of “America’s Best Hospitals” includes Magnet recognition in its ranking criteria for quality of inpatient care.
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LEXINGTON, Ky. (Dec. 9, 2015) — Dr. Michael Dobbs,associate chief medical officer for UK HealthCare, has been named associate editor for the publication, Quality Management in Health Care (QMHC), published by Wolters-Kluwer Health.
QMHC is a peer-reviewed journal that provides a forum for readers to explore the theoretical, technical and strategic elements of health care quality management. The journal's primary focus is on organizational structure and processes as they affect the quality of care and patient outcomes.
“Michael Dobbs is a natural fit for this postiion, and we're delighted that he has accepted,” said QMHC Editor Kathleen White, Ph.D., R.N. “His experience as an academic physician leader and improvement scientist will prove highly valuable to the journal.”
This column appeared in the Dec. 6, 2015 edition of the Lexington Herald-Leader.
LEXINGTON, Ky. (Dec. 7, 2015) — Commonly thought of as a problem primarily affecting older men, stroke is a woman’s disease. Approximately 60 percent of deaths related to stroke in the United States occur in women, and the lifetime risk of stroke is higher in women (about one in five) compared to men (about one in six) for those aged 55 to 75 years. The good news is that stroke can often be prevented.
Although men and women have several modifiable stroke risk factors in common such as high blood pressure (normal less than 120/80 mmHg), diabetes, cigarette smoking, overweight-obesity, atrial fibrillation (an irregular beating of the upper chambers of the heart), excessive alcohol consumption, poor diet or lack of regular exercise, several risk factors are unique to women.
Stroke risk can be increased during pregnancy, in part leading to a higher stroke risk among women of childbearing age compared to similarly aged men. Migraine with aura (neurologic symptoms such as seeing sparkling or zigzag lights) is also associated with a higher stroke risk, particularly among women who smoke or use oral contraceptives. Women who have had eclampsia or pre-eclampsia associated with pregnancy (high blood pressure, protein in the urine, and in the case of eclampsia, seizures) are at increased risk of stroke up to 30 years later.
What can women do to reduce their stroke risk?
- Follow a healthy diet such as the DASH or Mediterranean diet.
- Get regular exercise such as walking at a brisk but comfortable pace for 20-30 minutes most days of the week.
- No more than one alcoholic drink per day (no alcohol during pregnancy)
- Don’t smoke and avoid exposure to tobacco smoke
- Have your blood pressure checked regularly
In addition, talk to your health care provider about reducing your stroke risk if you:
- Have migraine, particularly migraine with aura
- Have ever had eclampsia or pre-eclampsia
Memorize some common stroke symptoms using the FAST acronym:
- Facial droop
- Arm weakness
- Speech slurring
- Time — call 911 – Stroke is frequently preventable and treatable, but you need to get help quickly
Larry B. Goldstein, MD, FAAN, FANA, FAHA, is the Ruth L Works Professor and Chairman of the UK Department of Neurology and Co-Director, Kentucky Neuroscience Institute.
LEXINGTON, Ky. (Dec. 3, 2015) — UK HealthCare's Kentucky Neuroscience Institute (KNI) has been re-designated a Comprehensive Stroke Center (CSC) by The Joint Commission (TJC) and the American Heart Association/American Stroke Association.
UK HealthCare was first designated a CSC in 2014. It is one of 96 U.S. institutions — and the only one in Lexington — with CSC-designation. This is the highest level of stroke certification available from The Joint Commission, reflecting the availability of resources, staff and training when treating complex stroke cases.
“UK’s re-certification attests to our team’s ability to provide the highest possible quality multidisciplinary care to the most medically complex patients with stroke,” said Dr. Larry Goldstein, chair of the Department of Neurology at the University of Kentucky. “The certification process is quite rigorous, and the recognition is afforded to only a small number of elite hospitals nationwide. We are thrilled to have our professionals' hard work recognized and to be able to offer these services to the citizens of the Commonwealth.”
An advanced Comprehensive Stroke Center has an unparalleled amount of resources in infrastructure, staff, and training to provide state-of-the-art care to all patients. They offer a neuro-intensive care unit for complex stroke patients who require 24/7 care, advanced imaging capabilities, and participate in stroke research. They also coordinate post hospital care for patients, use a peer review process to evaluate and monitor the patient’s care, and analyze and use standardized performance measure data to continually improve treatment plans.
LEXINGTON, Ky. (Nov. 30, 2015) — Dozens of neurologists, other medical professionals and researchers gathered at the University of Kentucky Nov. 25 to hear the words of Dr. Walter Koroshetz, director of the National Institute of Neurological Disease and Stroke of the National Institutes of Health.
In his first year as director, Koroshetz has made it a point to travel around the U.S. to share the Institute's plans to reduce the burden of neurological disease through vigorous investments in basic, translational and clinical research.
Alzheimer's disease, Parkinson's disease or multiple sclerosis are the most commonly known neurological diseases. However, Koroshetz reminded the audience that this classification includes disorders like substance abuse, depression and neurodevelopmental diseases.
"Neurological disease is today what infectious disease was to the 20th century: the most disabling and expensive group of chronic diseases today," Koroshetz said.
The good news: the world has begun to recognize the potential economic and quality-of-life impact of investment in research in the neurosciences. The brain and its mysterious functions — and malfunctions — has caught the eye of major consumer publications like Time, Scientific American, and National Geographic. There are rising numbers of Ph.D. candidates in the neurosciences. And the U.S. Congress has requested that the NIH present directly to them plans (and an accompanying budget) to solve the mysteries of neurological diseases, bypassing the usual funding mechanisms. Previously, only cancer and AIDS have been blessed with this designation.
As a part of that process, several government agencies and private groups have banded together to form The Brain Initiative. Called "The Next Great American Project," the Brain Initiative's goal is to provide the tools and resources necessary to map and understand the circuits and networks in the brain. By doing so, the hope is to understand how brain circuits function, find the basic mechanisms by which cellular pathways contribute to circuit dysfunction, and figure out ways to improve outcomes for patients.
That effort will require a whole new set of tools, says Koroshetz. He points out that while advances in imaging have revolutionized how we look at the brain, we are still largely reliant on antiquated technology.
"The EEG was developed in the 1920's, and the MRI, while effective, only records images at the rate of one per half a second, whereas the brain fires in milliseconds,” Koroshetz explained. "It's said that new tools are often more valuable than new concepts, and that is equally applicable in this case."
Dr. Larry Goldstein, chair of the UK Department of Neurology, emphasized the importance of Koroshetz's message.
"The Brain Initiative is the Manhattan Project of our age, and pursuit of effective treatments for this group of debilitating and costly diseases is a worthy cause," Goldstein said.
Goldstein added that, in light of the fact that UK already has research strengths in several relevant areas such as Alzheimer’s disease and related disorders, epilepsy, stroke, spinal cord and brain injury, Parkinson’s disease, and substance abuse, having Koroshetz present to UK faculty and staff was particularly timely.
"We were extremely fortunate to have Dr. Koroshetz as our guest at UK HealthCare to help welcome the advent of a new chapter in neurological research both at UK and around the world."