U.S. preterm birth rate goes down but Kentucky's maternal smoking rate still second highest, putting preterm babies at risk

For the fifth year in a row, the preterm birth rate in the United States has dropped. Which is great news. But Kentucky again had a significantly high smoking rate for expectant mothers -- at 32.2 percent, putting us behind only West Virginia (at 36 percent) of pregnant women who gave birth preterm and smoked.

Being born before full term puts babies at undue risk. Still, nearly half a million babies in the United States are born prematurely, many unnecessarily, according to the March of Dimes' 2012 Premature Birth Report Card. Serena Gordon of HealthDay reports that "those risks include breathing difficulties, heart defects and bleeding in the brain. Some conditions are only temporary while others can persist." A premature birth is anything that occurs before 37 weeks gestation. Maternal smoking is a major factor respiratory difficulties for the child and in an inability for the mother to go full term.

It is also been found that women without health insurance also have a higher incidence of preterm birth. Texas had the worst rates of uninsured women with 34.2 percent without insurance. Florida and New Mexico had rates of uninsured women of about 30 percent. Kentucky had rates of uninsured women of 21.7 percent. (Read more)

To see the full report and to see how Kentucky fared compared to other states in a number of other categories, go here.

UK medical center is fifth in the nation to be recognized for out-of-body respirator help for babies, children and adults

Because they use extracorporeal (out-of-body) membrane oxygenation, or ECMO, to support patients, the University of Kentucky's Albert B. Chandler Hospital and Kentucky Children's Hospital have been awarded a triple designation from the Extracorporeal Life Support Organization. UK is just the fifth medical center to receive the triple-designation honor, reports UK's Allison Perry. (UK photo)

ECMO uses an artificial lung device that gives "cardiac and respiratory support to patients whose heart and lungs are so severely damaged that they can no longer function," Perry reports. "It can also serve as a bridge to transplantation, allowing patients to not only survive, but to become stronger and healthy enough to undergo the transplant surgery." The technique is used on neonatal, pediatric and adult patients, hence the triple designation.

"This designation is another example of the expertise and advanced technology available for neonatal to adult patients who require complex care that can only be provided at top academic medical institutions," said Dr. Michael Karpf, UK's vice president for health affairs. (Read more)

Kentucky rated worst in country for power-plant pollution

Kentucky was ranked first in the country for the amount of pollution from power plants in 2009 and 2010, a study by the Natural Resources Defense Council found.

The Paradise Fossil Plant in Muhlenberg County, left, run by the Tennessee Valley Authority, was ranked the nation's top power-plant polluter in 2010. American Electric Power's Big Sandy plant in Lawrence County was ranked fifth, and the Mill Creek station of Louisville Gas & Electric was seventh.

The NRDC's initial report showed a huge increase in Kentucky power-plant emissions from 2009 to 2010, but after The Courier-Journal raised questions about it, the report was corrected. The corrected figures showed that the state remained No. 1 in power-plant pollution. (Read more)

Tonsillectomies not necessary much of the time; among $158 billion spent each year on unnecessary health care

Photo by Matthew Staver, Bloomberg

Tonsillectomies are the most common procedure for children requiring anesthesia. "The only problem is there's no evidence they work for most" kids, reports Sarah Cliff of The Washington Post.

"The procedure does show some benefits for those with really serious symptoms — very sore throats, fevers and other symptoms at least seven times in the past year — but no improvement for those whose indications are milder," Cliff reports.

Yet, more and more of the procedures are being performed. Between 1996 and 2006, the number of tonsillectomies increased by 74 percent.

"It's a silent epidemic of unnecessary care," said David Goodman of the Dartmouth Atlas of Health Care. "In most instances, it's done for patients with much less recurrent symptoms than should be indicated. I think a lot of this is unbeknownst to providers."

Unnecessary health care costs about $158 billion every year, Cliff reports, and the sum is partly to blame on demanding patients, to whom doctors acquiesce. Because doctors are paid based on volume, there is also an incentive to provide more care, even if it's not necessary.

Goodman said the medical education system is one main culprit. "Medical schools and graduate schools are failing us deeply," he said. "We need to move some of these ideas about the evidence being uncertain into the beginning of education. There's been such little work on that." (Read more)

UK surgeons first to do life-saving lung procedures in tandem

Surgeons at the University of Kentucky are the first in medical history to perform two procedures in tandem to bridge a lung transplantation. The procedures were performed first on Wanda Craig, 68, who is now the oldest person to be "bridged to transplant using an artificial lung device, also known as an extracorporeal membrane oxygenation," reports research-reporting service Newswise. (Photo of Wanda Craig and Dr. Enrique Diaz by Julia Meador)

Craig, of Lexington, had chronic obstructive pulmonary disease and emphysema for which she has been treated for the past 10 years. In November 2010, she took a turn for the worse. "I was so out of breath from walking to the kitchen ... I didn't have enough energy to even scoop ice cream out of the carton," she said. Pulmonary hypertension, from which she also suffered, had caused the right half of her heart to fail, which prevented blood from going through the lungs to fill the left side of the heart, explained Dr. Charles Hoopes, director of UK's heart and lung transplant program.

To fix the problem, Hoopes and Dr. Enrique Diaz, the program's medical director, performed a procedure called an atrial septostomy, in which a small hole is created between the upper two chambers of the heart. This procedure, along with the extracorporeal membrane oxygenation procedure, saved Craig's life, the news release says. "These procedures are novel in terms of a bridge to transplantation, and the use of an artificial lung together with an atrial septostomy for cases of respiratory and right ventricular failure have not been performed together until now," Diaz said.

Three days later, Craig underwent a double lung transplant, and has been healing since. "More than anything I am looking forward to doing those normal everyday things like going to the grocery store and watching my grandson's T-ball games," she said. "And scooping my own ice cream." (Read more)