Focus on Global Medicine

Host: Codyanne Murtaugh Guest: Mary Beth Pfeiffer With cases being reported in every state and across 80 countries, Lyme disease has become one of the fastest growing vector-borne illnesses in the world. But have you ever wondered how this global health threat came to be? That’s what journalist Mary Beth Pfeiffer investigates in her book, Lyme: The First Epidemic of Climate Change, and with the ReachMD team.

Guest: Masae Kawamura, MD Tuberculosis (TB) takes a life every 18 seconds…but you can play a part in putting a stop to the spread of this infectious disease by adopting screening best practices. Here to run down who and how you should screen for TB is Dr. Masae Kawamura, Qiagen’s Senior Director of Scientific and Medical Affairs.

Host: John J. Russell, MD Guest: Lee Reichman, MD, MPH To help us understand how primary care physicians can lead the way in proactively identifying and treating patients at high risk for TB, we caught up with Dr. Lee Reichman, Founding Executive Director of the Rutgers Global Tuberculosis Institute and Professor of Medicine and Epidemiology at Rutgers New Jersey Medical School.

Guest: Scott Lindquist, MD, MPH Primary care physicians play a critical role in eliminating TB, which is why they need to know who they should screen for TB and how. Join Dr. Scott Lindquist, state epidemiologist for communicable diseases and Deputy Health Officer for Washington State, as he explains the importance of risk-based TB screening and the testing methods that are appropriate for these patients.

Host: Maurice Pickard, MD Guest: Beth Macy Beth Macy’s Dopesick is a heartbreaking trajectory that illustrates how America’s twenty-plus year struggle with opioid addiction has persisted for this long and has become so firmly entrenched in practically every corner of our country—from desolate cities to once idyllic farm towns. Tune in as Beth Macy joins Dr. Maurice Pickard to illuminate the persistent and often conflicting gaps in the treatment and criminal-justice landscapes while shining a hopeful light on the heroes battling the worst drug epidemic in American history.

Host: Michael Greenberg, MD Guest: Michele Meltzer, MD Rheumatology services are limited or non-existent in many parts of sub-Saharan Africa. Basic diagnostic tests, biological agents, and treatments are either unavailable or not affordable for the majority of people living in that area. This shortage results in patients not having the benefit of early diagnosis and management of relatively cheap and cost-effective therapies. Instead, they present at advanced stages of disease with otherwise preventable morbidity. Host Michael Greenberg chats with Dr. Michele Meltzer, Associate Professor at Jefferson University Hospitals in Philadelphia and President of the non-profit organization, Rheumatology for All, about providing medical training and care for countries with limited or non-existent rheumatology services.

Host: Brian P. McDonough, MD, FAAFP Cigarette smoking is one of the leading cause of preventable death in North America, an unfortunate statistic that is rapidly replicating across the rest of the world. The World Health Organization (WHO) predicts based on current trends that cigarette smoking will kill a billion people this century. But what can be done to reverse this trend? Host Brian McDonough talks with David Sweanor, Adjunct Professor of Law, and Chair of the advisory committee for the Centre for Health Law, Policy and Ethics, at the University of Ottawa. Mr. Sweanor has been spearheading efforts to reduce cigarette smoking nationally and globally.

Host: Matt Birnholz, MD Guest: Luanne Freer, MD Practicing medicine at 17,000 feet brings a unique set of challenges for doctors, including altitude-related sicknesses, IV fluids freezing, and the need for duct tape to serve as an essential medical tool. Dr. Matt Birnholz chats with Dr. Luanne Freer, Founder and Director of Everest ER, a medical clinic at Mount Everest Base Camp serving Everest climbers, support staff, and the local Nepalese population. To find out more information about Everest ER, please visit http://www.everester.org.

Host: Andrew Wilner, MD, Author of "The Locum Life: A Physician's Guide to Locum Tenens" Guest: Lawrence Loh, MD Almost two-thirds of medical students expect to join a medical mission during medical school and their medical early careers. Yet despite positive intent, such short-term experiences may exacerbate global health inequities and even cause harm. Dr. Lawrence Loh, Adjunct Professor at the University of Toronto Dalla Lana School of Public Health, joins host Dr. Andrew Wilner to talk about the benefits and pitfalls of medical mission work for the communities being served.

Host: John J. Russell, MD Infectious disease has the terrifying power to disrupt everyday life on a global scale, overwhelming public and private resources and bringing trade and transportation to a grinding halt. Host Dr. John Russell sits down with Dr. Osterholm to talk about the book Deadliest Enemy: Our War Against Killer Germs. They talk about how we could wake up to a reality in which many antibiotics no longer cure, bioterror is a certainty, and the threat of a disastrous influenza pandemic looms ever larger. Only by understanding the challenges we face can we prevent the unthinkable from becoming the inevitable.

Host: John J. Russell, MD Host Dr. Russell sits down with Dr. Steven Hatch, an infectious disease specialist and author of the book, Inferno: a Doctor's Ebola Story, about his experience in Liberia during the heart of the Ebola crisis. Dr. Steven Hatch first came to Liberia in November 2013, to work at a hospital in Monrovia. Six months later, several of the physicians Dr. Hatch had mentored and served with were dead or barely clinging to life, and Ebola had become a world health emergency. Hundreds of victims perished each week; whole families were destroyed in a matter of days; so many died so quickly that the culturally taboo practice of cremation had to be instituted to dispose of the bodies. With little help from the international community and a population ravaged by disease and fear, the war-torn African nation was simply unprepared to deal with the catastrophe. A physician’s memoir about the ravages of a terrible disease and the small hospital that fought to contain it, Inferno is also an explanation of the science and biology of Ebola: how it is transmitted and spreads with such ferocity. And as Dr. Hatch notes, while Ebola is temporarily under control, it will inevitably re-emerge―as will ...

Host: Dr. Andrew Wilner Guest: John Kihm, MD Host Dr. Andrew Wilner explores different opportunities to combine medicine with outside interests when off call. Today, he talks with Dr. John Kihm, an internist in private practice in Durham, NC. who fell in love with North Carolina's Outer Banks and Ocracoke Island off Cape Hatteras while a 4th year medical student. He has found a way to combine his passion for volunteer medical work with his passion for flying by commuting to Ocracoke one weekend a month to conduct his special "house call" practice.

Host: John J. Russell, MD Guest: Amy Mackey, MD Hosts Dr. John Russell and Dr. Amy Mackey sit down to reflect on their individual and shared experiences participating in medical missions from their respective vantage points of family medicine and obstetrics & gynecology.

Host: Jennifer Caudle, DO News about the Zika virus have dominated health headlines, but understandings about the full range of viral transmission routes, symptomatology, complications, and rising endemic zones remain unclear for many clinicians. Joining Dr. Jennifer Caudle for updates in recognitions and treatment for Zika virus infection is Dr. Kecia Gaither, practicing OB/GYN and maternal fetal medicine specialist, and perinatal consultant at St. Lukes Hospital in Kansas City, Missouri. Most recently, Dr. Gaither served as Director of Perinatal Outreach at Montefiore Medical Center and Albert Einstein College of Medicine. Prior to this post, she served as the Vice Chairman and Director of Maternal Fetal Medicine in the Department of Obstetrics & Gynecology at Brookdale University Hospital and Medical Center. Dr. Gaither earned her MPH in health policy and management at Columbia University.

Host: John J. Russell, MD A fascinating and shocking historical exposé, The Malaria Project is the story of America's secret mission to combat malaria during World War II—a campaign modeled after a German project which tested experimental drugs on men gone mad from syphilis. Karen M. Masterson, a journalist turned malaria researcher, uncovers the complete story behind this dark tale of science, medicine and war.

Host: Alan S. Brown, MD, FNLA Like in the United States, Canadian citizens contend with a high pediatric prevelance of lipid disorders, particularly familial hypercholesterolemia. However, perspectives on clinical care and standards public health priorities to address dyslipidemia differ markedly between these two countries. Can American practitioners and health policy experts alike benefit from Canadian approaches to lipidology? Dr. Alan Brown welcomes Dr. Julie St. Pierre, Professor of Pediatrics at Sherbrooke University in Canada, to discuss pediatric lipid disorder management across North American borders.

Host: John J. Russell, MD In recent years, malaria has emerged as a cause celebre for voguish philanthropists. Bill Gates, Bono, and Laura Bush are only a few of the personalities who have lent their names--and opened their pocketbooks--in hopes of stopping the disease. Still, in a time when every emergent disease inspires waves of panic, why aren't we doing more to tame one of our oldest foes? And how does a pathogen that we've known how to prevent for more than a century still infect 500 million people every year, killing nearly one million of them? In The Fever, journalist Sonia Shah sets out to answer those questions, delivering a timely, inquisitive chronicle of the illness and its influence on human lives. Dr. John Russell hosts this fascinating discussion about her book.

Host: John J. Russell, MD Over the past fifty years, more than three hundred infectious diseases have either newly emerged or reemerged, appearing in territories where they’ve never been seen before. Ninety percent of epidemiologists expect that one of them will cause a deadly pandemic sometime in the next two generations. But which one, and how? In Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond, prizewinning journalist Sonia Shah interweaves history, original reportage, and personal narrative to explore the origins of contagions, drawing parallels between cholera, one of history’s most deadly and disruptive pandemic-causing pathogens, and the new diseases that stalk humankind today.

Host: Brian P. McDonough, MD, FAAFP Reporting from the Caribbean island of Bonaire, Dr. Brian McDonough provides an update on local public sentiments and concerns around the continuing spread of Zika virus infections across the world.

[Read the Article] To some, end of life care in the United States is considered resource intensive, expensive, and inattentive to patients' needs. So how does the United States compare to other countries? A new study examined several health care measures at the end of life for cancer patients in five European countries, Canada and the United States.Researchers from the University of Pennsylvania Perelman School of Medicine compared the health care experience for cancer patients older than 65, in Canada, Belgium, Germany, England, the Netherlands, Norway and the United States. They examined several clinical measures during the final six months of life.The United States and Netherlands had the lowest percentage of patients dying in the hospital. The United States also had the fewest hospitalizations and the smallest number of days patients spent in the hospital. In contrast, intensive care admissions were twice as common in the United States compared to the other countries. During the last six months of life, patients in Norway and Canada had higher hospital costs than patients in the United States. There was less spending in Germany and Belgium, but the lowest expenditures were in the Netherlands and ...

Host: Matt Birnholz, MD Joining host Dr. Matt Birnholz is Sarah Marchal Murray, Chief Operating Officer at The END Fund, a private philanthropic initiative dedicated to controlling and eliminating neglected tropical diseases (NTDs). Over 1.4 billion people globally are affected by one or more of the most common NTDs, including 875 million children. The END Fund focuses on tackling the five most prevalent NTDs: intestinal worms,schistosomiasis,lymphatic filariasis,trachoma, and river blindness.

Global health security is the protection of the health of people and societies worldwide. With diseases a plane ride or border crossing away, the importance of global health security has never been clearer. Patterns of global travel and trade pose greater opportunities for infectious diseases to emerge and spread nearly anywhere within 24 hours. The Ebola epidemic in West Africa, which has infected more than 28,000 people across 10 countries and has caused more than 11,200 deaths, highlights the importance of ensuring that every country is prepared to prevent, detect, and respond to outbreaks and emerging health threats. In this session of Public Health Grand Rounds from the CDC, experts discuss how CDC, other U.S. government agencies, and global partners are working to promote global health security as an international priority and accelerate progress toward a world safe and secure from epidemics of infectious disease. For more details on this Grand Rounds session and its participants, click here.

Guest: Olufunmilayo (Funmi) Olopade, MD, FACP Host: Maurice Pickard, MD Host Dr. Maurice Pickard welcomes Olufunmilayo (Funmi) Olopade, MD, FACP, Walter L. Palmer Distinguished Service Professor of Medicine & Human Genetics, Associate Dean for Global Health, and Director of Center for Clinical Cancer Genetics at the University of Chicago Medicine, Chicago, IL. Dr. Olopade reviews the latest information and best practices in establishing an interdisciplinary program in improving chronic disease treatment worldwide. She reviews challenges and progress toward providing better education, research and training, and service infrastructures addressing global health issues within the United States and around the world.

Host: Frank Russomano What are the continuing rehabilitation efforts in Haiti? And, how can you assist in the continual medical needs of this country? Host Frank Russomano welcomes pharmacist Ro Brual to discuss his special volunteer work in Haiti before, during and after the Haiti earthquake of 2010. Mr. Brual is a pharmacist and Associate Consultant of Medical Education at Eli Lilly & Company.

Guest: Shelly Batra, MD Host: Maurice Pickard, MD Multidrug Resistant (MDR) Tuberculosis is a growing public health epidemic in India. The non-profit organization Operation ASHA has expanded its role considerably over the past few years to stem this tide of TB transmission within both the poorest and the most prosperous communities, bringing innovative treatment protocols right to the patients' doorsteps. Dr. Shelly Batra, president of Operation ASHA, discusses the progress being made in this increasingly global public health campaign. Hosted by Dr. Maurice Pickard.

Guest: Simon Jensen, MBChB, FACEM, BSc(Hons), MSc(Dist) Host: Mary Leuchars, MD How common are snake bites in various parts of the world, and how many of these are venomous? What are the symptoms of envenomation, and how widely does the venom vary among snake species? Dr. Simon Jensen, founding director of the Global Snake Bite Initiative and clinical research supervisor at the University of Papua New Guinea's snake bite research project, discusses methods and treatments for snake bites. Dr. Mary Leuchars hosts.

Guest: Emmanuel Teye Adjase, MD Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA In the past 40 years Medical Assistants have become a crucial part of Ghana's healthcare system. The MAs as their called are the equivalent to PAs in the U.S. For the past 40 years the 500 Medical Assistants have been trained at the Kintampo Rural Health Training School. Dr. Emmanuel Teye Adjase, Director of the school joins host Lisa D'Andrea Lenell to discuss the pros and cons of the health system in Ghana, how the school is changing with the times, and the country's vision for a national healthcare plan.

Guest: Karen Mulitalo Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Even though physician assistants aren't officially recognized in Australia, the University of Queensland is training its first class of PAs. The two-year program, which is comparable to the traditional US model, will graduate its first home-grown PAs in 2011. Host Lisa Dandrea Lenell talks with Karen Mulitalo, director of the PA program at Queensland, to discuss these new pioneers in the field, where the program is heading in the next five years and the challenges that lie ahead as they try to gain acceptance from the medical and general community.

Guest: Allan (Al) Forde, PA-C Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA The physician assistant concept was introduced to Australia in 1999, a decade later there are two pilot programs underway and the first class of PAs started their training in July 2009. Al Forde, senior lecturer at James Cook University in Townsville, Australia, joins host Lisa Dandrea Lenell to discuss the future of PAs in Australian healthcare.

Guest: Nadia Miniclier, PA-C Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA How does a country with only 2,500 practicing doctors provide medical care to 22 million people? That's the healthcare crisis facing the medical community and the people in Ghana. Host Lisa Dandrea Lenell looks at the healthcare landscape in this West African country, the issue of brain-drain, and the role of physician assistants — known there as "medical assistants" — in the country of Ghana, as compared to physician assistants in the US. Her guest is PA Nadia Miniclier, director of the Ghana Clinical Medicine Rotation at the PA program at the University of Utah.

Guest: Dorothy Armstrong Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA In 2006 the Scottish National Health Service began a two-year pilot program to gauge whether physician assistants would be a positive addition to the country's medical community. Eighteen PAs from the United States came to Scotland to participate in the project. Dorothy Armstrong, program director for the Scottish National Health Service, joins host Lisa Dandrea Lenell to talk about the results of the study and the future of PAs in Scottish healthcare.

Guest: Catherine Hoelzer, MPH, PA-C Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Imagine your patients walking for two weeks just to receive medical care or operating your medical practice in mud huts without running water or electricity. Those are the conditions under which PA Catherine Hoelzer operates in South Sudan everyday. Ms. Hoelzer joins host Lisa Dandrea Lenell to talk about the daily challenges she faces and her goals for improving medical care in a third world country.

Guest: William Fenn, PhD, PA-C Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA The physician assistant has become a vital part of the medical community in the United States, but can the model be replicated in other countries? England, Japan, Australia and the Netherlands are just a few of the countries across the world trying to bring a PA model to their medical force. Dr. Bill Fenn, vice president of the American Academy of Physician Assistants and professor at Western Michigan University, joins host Lisa Dandrea Lenell to discuss the challenges, politics and cultural differences to bringing the PA field to other countries across the globe.

Guest: Renee-Marie Stephano, JD Host: Maurice Pickard, MD What is medical tourism, and what does it mean for your patients? How should we react when our patients tell us they plan to leave the country for a procedure? Host Dr. Maurice Pickard takes a closer look at the medical tourism industry and its effects on physicians and patients with Renee-Marie Stephano, founder and president of the Medical Tourism Association and editor of The Medical Tourism Magazine.

Guest: Sathyu Sarangi Host: Larry Kaskel, MD Many of us remember the chemical disaster that occurred in Bhopal, India in December 1984. Twenty-five years after what many call the world's worst industrial disaster, estimates suggest more than 100,000 people, including children of survivors of the initial disaster, still suffer illnesses that are linked to this ongoing tragedy. Sathyu Sarangi arrived in Bhopal the day after the disaster, expecting to serve for a short time as a volunteer in the short-term relief efforts. Instead, he has spent the last quarter-century advocating for the allocation of proper health care, clean water and other basic necessities for disaster-affected people in Bhopal. Today, Mr. Sarangi is the managing director of the Sambhavna Trust Clinic in Bhopal, a vibrant clinic that provides free medical care, community health education classes and other vital services to nearly 25,000 individuals. As Mr. Sarangi explains, with many of the local hospitals struggling under the weight of corruption, inefficient management and a disinclination to care for disaster survivors and their children, Sambhavna offers the people of Bhopal hope for a better, healthier future. He joins host Dr. Larry Kaskel to share the story of the people of Bhopal and their ongoing struggle, and explains what we, as ...

Guest: Subodh Kumar Singh, MD Host: Maurice Pickard, MD The Oscar-winning documentary film Smile Pinki depicts a little girl who undergoes a cleft palate operation, and experiences a very changed life as a result. Host Dr. Maurice Pickard welcomes Pinki’s surgeon, Dr. Subodh Kumar-Singh, director and chief of plastic surgery at GS Memorial Plastic Surgery Hospital in Varanasi, India. Dr. Kumar-Singh also works with the non-profit organization Smile Train, which provides cleft surgeries to underserved children worldwide. Tune in to learn more about the significant problem of cleft lip and palate in India, and worldwide.

Guest: Shelly Batra, MD Host: Maurice Pickard, MD Tuberculosis is a public health epidemic in India. What strategies is the non-profit organization Operation ASHA using to treat and prevent T.B. in India? Tune in to hear Dr. Shelley Batra, gynecologist and president of Operation ASHA, discuss the progress being made in treating T.B. patients in India, and why she has dedicated her time to addressing this epidemic. Dr. Maurice Pickard hosts.

Guest: Bernard Cohen, MD Host: Michael Greenberg, MD Hemangiomas are common in infants, and often appear within the first few weeks of life. Although many infant hemangiomas are unsightly but regress after a few months, others can be large and disfiguring. Until recently, there have been no ideal treatment options, but there has been recent success using propranolol to treat infant hemangiomas. Host Dr. Michael Greenberg explores this exciting new treatment with Dr. Buddy Cohen, professor of dermatology and pediatrics at Johns Hopkins University School of Medicine.

Guest: Alex Haynes, MD Host: Mary Leuchars, MD Little is known currently about the amount and availability of surgical care worldwide. How does this challenge development of surgical care protocols globally and, by extension, the formation of international public health policies? Dr. Alex Haynes, surgical research fellow at the Harvard School of Public Health and Massachusetts General Hospital, and lead author of a recent study evaluating the WHO surgical safety checklist, joins host Dr. Mary Leuchars to address these clinical and political challenges.

Guest: Pride Chigwedere, MD, PhD Host: Cathleen Margolin, PhD Dr. Pride Chigwedere, an affiliate of the Harvard AIDS Initiative, speaks with host Dr. Cathleen Margolin about the role of government policy in the AIDS epidemic in South Africa. Dr. Chigwedere's research, as published in the Journal of Acquired Immune Deficiency Syndromes, pins fault on these frightening government rules for the loss of more than 3.8 million person-years in the early portion of this decade. How is South Africa now moving toward a state of accountability for this crucial aspect of their overall public health strategy?

Guest: Jack Franaszek, MD Host: Shira Johnson, MD Urgent care centers, boutique emergency rooms, free standing emergency departments and retail clinics: How do all of these non-traditional emergency facilities fit in the paradigm of emergency medicine? What works? What doesn't work? What is the best for the patient and for healthcare? Dr. Jack Franaszek, director of the emergency department at Lake Forest Hospital and clinical associate professor at University of Chicago, elaborates on the structure and the financial impact of the multi-tiered options of emergency care. He discusses how all of these tiers of acute healthcare are eating up dollars. And will it be for the better? Dr Shira Johnson hosts.

Guest: Mark Denison, MD Host: Mark Nolan Hill, MD Severe acute respiratory syndrome (SARS) made significant headlines in 2003, testing the mettle of our global public health infrastructure. Since then, we have seen robust evidence to suggest that bats were the original animal host for the virus, with the latest data coming from a synthetic SARS-like bat coronavirus. These most recent efforts were led by the research team of Dr. Mark Denison, professor of pediatrics and associate professor of microbiology and immunology at Vanderbilt University School of Medicine. Dr. Denison details this work with host Dr. Mark Nolan Hill. From a global perspective, how does our ability to synthesize complex viruses like this one enhance our capacity to deal with threatening pathogens?