UAB MedCast

Non-muscle invasive bladder cancer is common, recurrent, and often misunderstood. Urologist Jed Ferguson, M.D., and urologic oncologist Chaz Peyton, M.D., explain how it differs from muscle invasive disease, why recurrence increases the risk of progression, and the complex factors that determine treatment sequencing. Learn about UAB's clinical trials and emerging therapies that aim to preserve the bladder without compromising care.

Radiation therapy for oral cancer requires both precise targeting and multidisciplinary coordination. Christopher Willey, M.D., and Michael Case, D.M.D., explain how close collaboration between radiation oncology and dental care helps prevent complications such as osteoradionecrosis and also minimizes treatment delays. They describe how pretreatment dental evaluations, oral hygiene protocols, and coordinated planning improve outcomes.

ACL tears are on the rise as more people remain active throughout their lives. Amit Momaya, M.D., chief of sports medicine, explains how today's treatment approaches balance repair and reconstruction, with an emphasis on prehab, rehab, and psychological readiness. Learn about prevention strategies, retear risk factors, and surgical innovations being studied at UAB.

Are airbag vests protecting young equestrians or putting them at risk? Sports medicine physician Sarah Gould, M.D., and engineering research scientist Kevin Schrum discuss unexpected injuries linked to equestrian air vests. They explain how the vests function, why pediatric riders may be especially vulnerable to related injuries, and why stronger data is needed to determine whether these devices should be used.

Kidney stones are often more than a one-time painful event: they're a chronic disease linked to other health issues. Kyle Wood, M.D., discusses how stone disease often coexists with conditions like hypertension, dietary imbalance, and primary hyperparathyroidism. He explains that reviewing patient history, taking bloodwork, and ordering urine testing can help providers understand a patient's overall risk for stone recurrence and related chronic conditions. Learn how UAB uses genetic testing to identify heritable causes of stone disease in patients with early onset, recurrence, or other red flags.

Sasha Still, M.D., explains how delayed diagnosis of aortic disease among women — who often present later and experience atypical symptoms — contributes to more complications and a higher mortality rate. She also discusses what clinicians can do to improve diagnosis, monitoring, and surgical decision-making.

For many patients, it takes time to regain full consciousness after a brain injury, and some develop a disorder of consciousness (DOC). Rachel Teranishi, M.D., a brain injury specialist, explains why up to 40% of DOC cases are misdiagnosed and outlines what providers need to know about assessment, treatment, and long-term recovery. Learn which therapies are showing promise and how to support families through uncertain outcomes.

Spinal cord injuries can have life-changing effects, from neurogenic bowel and bladder dysfunction to paralysis. Radhika Sharma, M.D., a physiatrist, discusses the causes, complications, and rehabilitation approaches to spinal cord injury. She explains how a multidisciplinary approach helps patients recover function and rejoin communities.

Limb salvage can prevent amputation in patients with complex lower extremity conditions, including diabetes and peripheral arterial disease. Kyle Mauk, DPM, discusses how UAB's limb salvage program integrates podiatry with vascular surgery to improve coordination of care. He also explains podiatry's evolving role in surgical treatment.

Advances in imaging and molecular testing are changing how thyroid diseases are diagnosed and treated. Otolaryngologists and head and neck endocrine surgeons Andrew R. Fuson, M.D., and Daniel J. Rocke, M.D., discuss the latest approaches to managing thyroid nodules, hyperthyroidism, and thyroid cancer. They explain how better risk stratification allows them to be more selective about recommending surgery. Learn how this has led to a broader shift toward less aggressive, more individualized treatment.

Thoracic outlet syndrome (TOS) occurs when blood vessels and nerves in the upper chest become compressed, leading to pain, numbness, swelling, or circulation problems in the arms. Jarrad Rowse, M.D., a vascular surgeon, explains the three types of TOS — neurogenic, venous, and arterial — why they develop, and how they are diagnosed. He discusses multidisciplinary treatment approaches, including physical therapy, pain management, and surgery when needed.

Non-tuberculous mycobacterial (NTM) disease is a chronic lung infection that's becoming more common, yet diagnosis and treatment remain challenging. Infectious disease specialist German Henostroza, M.D., and pulmonologist Bryan Garcia, M.D., discuss what's known about NTM's rise; the latest in diagnostic tools; and the complexities of treatment. Learn why effective management requires a team-based approach that goes beyond antibiotics.

Rehabilitation psychologists help patients with disabilities and chronic health conditions maximize their health and holistic well-being. Casey Azuero, Ph.D., explains these psychologists' unique qualifications and how they function on interdisciplinary teams to address the full context of a patient's recovery. This work includes helping patients navigate emotional challenges, improve coping strategies, and stay engaged in their social lives.

Functional neurological disorder (FND) results in fluctuating control of voluntary activities. Victor Mark, M.D., explains why FND has only recently begun to be acknowledged as a neurological rather than purely psychological disorder. He discusses conditions related to FND and effective rehabilitation coordinated between neurologists, psychologists, physical therapists, and others to moderate symptoms. Learn more about the persistent misunderstandings regarding FND within the medical community, which have often created a stigma for those living with it.

What is the best approach to treating substance use disorders? In part two of their discussion on substance use disorders within the health care provider population, Christopher Godlewski, M.D., and Sudheer Potru, D.O., explore the often-complementary effects of medication-assisted therapy and psychotherapeutic approaches. They urge education and empathy among providers to break down the stigma around seeking help.

Just as many health care providers face substance use disorder (SUD) as the general population, yet they are more likely to conceal it due to a professional stigma. Christopher Godlewski, M.D., and Sudheer Potru, D.O., discuss how burnout and demanding work environments contribute to SUD, and how colleagues' reluctance to intervene can delay help. Learn how peer support, resilience training, and tailored recovery plans help providers save their lives and careers.

For patients with AFib, left atrial appendage (LAA) occlusion should now be part of any non-emergency cardiac operation, and surgical ablation should also be considered. Panayotis Vardas, M.D., discusses how he and colleagues from the Society of Thoracic Surgeons arrived at stronger recommendations for these procedures in their 2023 guidelines. Learn more about related surgical procedures for AFib and the directions of future research.

Interventional endoscopic ultrasound, once a purely diagnostic tool, has given GI specialists a minimally invasive approach to a wide range of procedures. Ramzi Mulki, M.D., guides us through the evolution of the endoscope since the 1980s; various current uses of interventional endoscopy such as pancreas, gallbladder, bile duct, and bariatric procedures; and how AI may soon expand what multidisciplinary teams can do with endoscopic ultrasound.

A new type of catheter ablation called pulsed field ablation (PA) allows for a more precise and non-heated way to treat many cases of atrial fibrillation (A-fib). Tom McElderry, M.D., discusses the advantages of PA ablation as an alternative to radio frequency and cryotherapy ablation, the most common types. Dr. McElderry was involved with clinical trials which demonstrated that PA was faster and eliminated the risk of both phrenic nerve injury and esophageal fistula. Learn more about what this technique means for the future of A-fib treatment.

Almost everyone with spinal stenosis will see decreased pain and other symptoms following treatment, no matter their age. Thomas Staner, M.D., a neurosurgeon, discusses how improved imaging and a multidisciplinary approach has enhanced care for those with pain and other symptoms caused by spinal stenosis. Learn how treatments can progress from physical therapy and NSAIDs (for mild pain) to nerve blocks and lumbar laminectomy (for more severe pain).

Telehealth coupled with patient-collected data is allowing doctors to manage diabetes more effectively. Anish Patel, M.D., an endocrinologist, discusses how telehealth reduces hospitalizations and readmissions, and allows doctors to personalize treatment plans based on a stream of real-time data. Learn more about how easy it can be for patients to collect their own data, which doctors are able to access remotely. Dr. Patel shares advice for physicians looking to start a telehealth practice.

Telehealth coupled with patient-collected data is allowing doctors to manage diabetes more effectively. Anish Patel, M.D., an endocrinologist, discusses how telehealth reduces hospitalizations and readmissions, and allows doctors to personalize treatment plans based on a stream of real-time data. Learn more about how easy it can be for patients to collect their own data, which doctors are able to access remotely. Dr. Patel shares advice for physicians looking to start a telehealth practice.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a new, more precise name for nonalcoholic fatty liver disease. Fernando Bril, M.D., an endocrinologist, explains how this name precisely describes the way in which fatty acids build up in the liver of patients who have insulin resistance. Learn more about the close relationship of MASLD, type 2 diabetes, and obesity. Dr. Bril reviews current screening recommendations, effective interventions, and the first approved drug for the condition.

How is care improving for the three percent of U.S. children who have type 1 diabetes? Jessica Schmitt, M.D., a pediatric endocrinologist, shares encouraging developments in medical diabetes management as well as insights about accurate diagnosis and helpful lifestyle habits. Learn about new treatments on the horizon, including one medication that may delay the onset of type 1 diabetes.

The prevalence of peripheral arterial disease (PAD) is surging due to cases related to diabetes. Benjamin Pearce, M.D., a vascular surgeon, discusses management of PAD by highlighting three non-operative advancements, including exercise therapy. Learn how PAD can be diagnosed using an ankle-brachial index. Dr. Pierce explains how a multi-disciplinary team manages this condition and how they intervene early to prevent chronic limb-threatening ischemia.

85% of all non-melanoma skin cancers occur in the head and neck, which includes high-risk sub-units. Skin cancer is especially prevalent in the South. Harishanker Jayarajan, M.D., a head and neck surgeon, discusses the types and locations of skin lesions which warrant referral to an expert. He explains the general approach to treating head-and-neck skin cancers, as well as the modern usage of immunotherapy to shrink those lesions too dangerous to remove right away.

Patients who have surgery where there is an enhanced recovery program (ERP) recover faster and more effectively. Daniel Chu, M.D., a GI surgeon, discusses the many steps included in an ERP protocol and what it takes to establish the program. He explains how a multidisciplinary team of champions progresses through four phases of implementation. Learn how an ERP also helps patients rely less on opioids during recovery.

Pediatric and adolescent gynecology spans the gap between general pediatric care and adult gynecologic care. Janeen Arbuckle, M.D., speaks on her specialty in pediatric and adolescent gynecology, describing first the common conditions that warrant a visit for young women before and during adolescence. She highlights differences between the care grown women and adolescents receive, with special focus on the HPV vaccine and brith control (for managing special conditions). Dr. Arbuckle explains why creating a safe, confidential space for her young patients is so important.

Substance use disorder (SUD) is a deadly disease that can affect anyone — even doctors. But certain social determinants of health and psychological trauma make some more vulnerable than others. In part 2 of their discussion on SUD treatment and recovery,Christopher Godlewski, M.D., and Sudheer Potru, D.O., discuss how doctors can account for the particular challenges in a patient's life. Find out why telehealth may be a game changer for those lacking access to addiction recovery specialists.

Substance use disorder (SUD) is a deadly disease that can affect anyone — even doctors. Christopher Godlewski, M.D., an anesthesiologist, and Sudheer Potru, D.O., an addiction medicine specialist, discuss the barriers to effective treatment of SUDs, both inside and outside of health care. They review the standard pharmacologic and behavioral therapy treatments as well as cutting edge medicines and neurosurgical approaches being used in the field.

Behavioral and mental health is part of every serious medical condition. According to Christina Pierpaoli Parker, Ph.D., a licensed clinical psychologist, behavioral medicine belongs closer to patients in primary and specialty care clinics. She explains why many patients are not getting the mental health care they need and how integrated care models can help. Learn about UAB's integrated care model normalizes mental health as part of routine care.

Bone disorders such as osteoporosis are silent diseases that most often affect women. Basma Abdulhadi, M.D., explains the importance of screening women over 65 (as well as those with other risk factors) to identify bone density loss and take steps to prevent dangerous fractures. Learn more about the DEXA scan, which helps doctors establish a patient's degree of bone loss and determine the best interventions. Dr. Abdulhadi details the multiple approaches an interdisciplinary team uses to keep patients safe and mobile.

Maria Helena Lima, M.D., discusses the latest breast reconstruction options, including implants, autologous tissue flaps, and oncoplastic reconstruction. She also addresses patient safety concerns and the efficacy of silicone implants compared their saline counterparts.

Severe orthostatic headaches could indicate a serious condition called spontaneous intracranial hypotension (SIH). Neurologist Will Meador, M.D., and interventional neuroradiologist Jesse Jones, M.D., discuss how they interpret a combination of symptoms and imaging to make diagnoses and the common first-line treatments for cases that do not resolve with conservative lifestyle interventions. Learn details about a complex surgery to address severe cases.

Learn why robotic-assisted CABG is a groundbreaking technique for many with coronary artery disease. Sasha Still, M.D., a cardiothoracic surgeon, describes the advantages of performing robotic-assisted coronary artery bypass — a minimally invasive version of the traditional CABG procedure that can further be performed on a beating heart. She discusses the complexity level and characteristics of patients who are most likely to benefit. Discover why Dr. Still and her colleagues felt it was important to offer this highly technical procedure at UAB.

Two devices for preventing blood clots are allowing many patients to stop taking blood thinners completely. The Amulet and the Watchman are both devices that allow doctors to perform left atrial appendage occlusion more safely than ever before. Tom McElderry, M.D., co-director of the Heart & Vascular Center, explains what has made these devices easier and faster to install, with complication rates well below 1%. He also discusses imaging technology that makes same-day procedures possible. Learn more about clinical trials related to these devices underway at UAB.

Hepatocellular carcinoma is the most common primary liver cancer. It is a complex disease that requires a multidisciplinary team — for patients, that can mean a drawn-out array of appointments. Robert Cannon, M.D., surgical director of the UAB Liver Transplant Program, discusses the new Hepatocellular Carcinoma Clinic (HCC), which brings together relevant specialists for the benefit of patients. As he explains, patients can now leave one appointment with a diagnosis and a care plan built by the entire team. Learn more about exciting clinic trails offered through the HCC.

Head and neck cancers have always been some of the most difficult to treat, but advancements in robotic surgery, advanced imaging, and multidisciplinary recovery approaches are improving the outlook for many patients. Benjamin Greene, M.D.; Harishanker Jeyarajan, M.D.; and Carissa Thomas, M.D., share new insights and techniques in the field. Learn more about the connection between HPV and oropharyngeal cancer; new tools allowing more accurate diagnoses and monitoring for recurrence; and the surgical precision made possible by robotic surgery alongside intraoperative fluorescence imaging.

Degenerative mitral valve disease is the most common heart valve abnormality. Panayotis Vardas, M.D., a cardiothoracic surgeon, reviews the distinctions between primary and secondary mitral regurgitation. He describes categories of patients who would be candidates for mitral valve repair, which is the standard-of-care treatment, versus those who might undergo mitral valve replacement. Learn more about the dramatic success rates of mitral valve repair and clinical trials underway that explore new techniques for complex cases.

Some people struggle with symptoms for years and never receive a clear answer on what condition they have. UAB Medicine is part of the National Institutes of Health Undiagnosed Disease Network (UDN), which means they are committed to applying the latest technology to make diagnoses for their regional community. Bruce Korf, M.D., associate dean for Genomic Medicine, explains the various tools the undiagnosed disease team uses, including radiologic imaging, neurological testing, and genomic sequencing. Learn how patients from all demographics may gain access and be evaluated by a multidisciplinary team. He also explains how new diagnoses can help doctors understand the less common ways diseases present.

Mechanical thrombectomy is an effective new procedure for ischemic stroke management that lowers the possibility of damage to brain tissue. Select hospitals designated as thrombectomy-capable stroke centers, such as UAB, are equipped to perform this time-sensitive procedure 24/7. Michael Lyerly, M.D., a vascular neurologist, and Elizabeth Liptrap, M.D., a vascular neurosurgeon, explain how improved coordination with first responders and other hospitals using telemedicine and triage allows UAB to treat more regional patients who might benefit. They describe their multidisciplinary approach to choosing a specific combination of other tools and techniques alongside mechanical thrombectomy

Telehealth is impacting nearly every aspect of health care. Zain Hashmi, M.D., a trauma surgeon, discusses the potential of telehealth for improving access to comprehensive trauma care among rural patients. He explains how finding ways for EMS teams to consult trauma experts virtually and closer to emergencies could reduce transfer rates and improve patient care. Dr. Hashmi outlines the challenges of implementing telehealth for trauma care, emphasizing the need for 360-degree stakeholder engagement.

Around 80% of adults experience low back pain, and most are not candidates for surgery. Prentiss Lawson, Jr., M.D., and Christopher Paul, M.D., both anesthesiologists who specialize in pain medicine, discuss a promising new durable therapy for low back pain called restorative neurostimulation. Unlike existing low back pain management options, neurostimulation addresses a root cause, a weak or inactive multifidus muscle. The doctors explain the minimally invasive procedure, which involves sending electric pulses to the multifidus nerves. Learn how this treatment uniquely restores patents' spinal stability and thereby reduces chronic pain.

Carotid stenosis, caused by a buildup of plaque in the carotid artery, accounts for around 20% of all ischemic strokes. Mark Harrigan, M.D., and Elizabeth Liptrap, M.D., both neurosurgeons, discuss key aspects of medical management and interventions for carotid stenosis. Learn about two new alternatives to the (still-effective) endarterectomy procedure. The doctors explain how their approach to management and intervention varies by patient.

The Birmingham region grew around heavy industry, including coal mining and steel production. These industries, which still employ thousands today, can pose hazards to workers' health and others in the community. The UAB Environmental Lung Disease Clinic provides comprehensive evaluations for patients with respiratory conditions related to work exposure or environmental hazards. Kevin Dsouza, M.D., and Crystal Stephens, CRNP, helped found and lead the clinic. They discuss the scope of their work, when providers should refer patients, and how patients can also self-refer.

Over one million people in the U.S. grapple with HIV. Although life expectancy has increased, end-stage organ diseases have a relatively high mortality rate for these patients. Learn about HIV-to-HIV kidney transplants from Shikha Mehta, M.D., director of the UAB HIV and Hepatitis C Transplant Program. She explains how her interdisciplinary team has made successful kidney transplants for over decade despite numerous challenges and comorbidities of those with HIV.   Disclosure InformationRelease Date: February 19, 2024Expiration Date: February 18, 2027 Planners:Ronan O'Beirne, EdD, MBA | Director, UAB Continuing Medical EducationKatelyn Hiden | Physician Marketing Manager, UAB Health SystemThe planners have no relevant financial relationships with ineligible companies to disclose. Faculty:Shikha Mehta, MD | Medical Director, Kidney and Pancreas Transplant ProgramDr. Mehta has no relevant financial relationships with ineligible companies to disclose. There is no commercial support for this activity.

While nonpulsatile tinnitus (constant buzzing sound) is a common condition many people learn to live with, pulsatile tinnitus (sound that occurs with each heartbeat) may indicate dangerous otological or vascular conditions. Erika McCarty Walsh, M.D., a neurotologist, and Jesse Jones, M.D., a neuroradiologist, discuss the complex process of determining whether patients have pulsatile tinnitus, what the causes are, and which treatments might be considered necessary. Drs. Walsh and Jones describe their collaborative approach to making sure that patients address any dangerous conditions and otherwise learn to manage their pulsatile tinnitus.

Around 15% of people in the U.S. have a form of chronic kidney disease (CKD), which is often related to diabetes and hypertension. Claretha Lyas, M.D., a nephrologist, discusses the interdisciplinary approach to treating CKD alongside its root causes. Learn about two new classes of medicine that are slowing the progression of CKD. Find out the best time to refer a patient to a nephrologist, who can manage disease progression and provide a seamless transition to transplant evaluation services if needed.

Many women who have typical symptoms of coronary artery disease actually have coronary microvascular disease (MVD). Gretchen Wells, M.D., a cardiologist, explains why it is important for physicians to proceed with tests for MVD when cardiac catheterization does not indicate coronary artery disease. She explores the common symptoms, proven and potential interventions, and the serious risks posed by MVD. Dr. Wells recommends patients explore multidisciplinary cardiac rehabilitation programs if they are diagnosed with MVD.

Only 60% of age-eligible adults are up to date on their colorectal cancer screenings. Drew Gunnells, Jr., M.D., and Shajan Peter, M.D., discuss why the colonoscopy is still their preferred first-line screening and polyp removal method, while newer at-home screening methods are useful in regions with limited access to care. The doctors discuss advancements in A.I. that they use to improve the detection of polyps during a colonoscopy. Learn more about a local partnership to provide free colonoscopies to residents despite insurance status or other barriers.

Polycystic ovary syndrome (PCOS) can occur in women who have neither obesity nor insulin resistance – two conditions that are often used as clues. William Hurd, M.D., a specialist in reproductive endocrinology and infertility, explains the three signs that help determine if a patient has PCOS. He also discusses working with patients to meet their reproductive planning goals while managing symptoms. Learn how a multidisciplinary team can manage the comorbidities often related to PCOS.