UAB Med Cast

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.