UAB Med Cast

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.

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.

As the prevalence of diabetes increases, so does the variety of treatment and management tools available to endocrinologists. Alexandra Dodd, M.D., an endocrinologist, discusses advancements including continuous glucose monitoring, new types of long-acting insulin, and medicines that help patients control both blood sugar and weight. She describes the common health conditions that result from advanced diabetes and the corresponding specialists she works with to treat those.

Although strokes are complex events involving both the brain and heart, diagnosis and treatment of potential strokes is not always managed by brain and heart doctors working together. Because of this, patients may be having unnecessary procedures and risking future health events. Ekaterina Bakradze, M.D., a stroke neurologist, and Mustafa Ahmed, M.D., an interventional cardiologist, discuss the complexity of stroke diagnoses and management, emphasizing the importance of a multidisciplinary team. The doctors explain how one common cause of stroke called PFO – a hole in the heart – is not always the culprit of a patient’s neurological health condition. Learn more about their work at the UAB Heart Brain Clinic.

Brain health can be maintained with many of the same lifestyle behaviors doctors recommend as being heart-healthy. Ronald Lazar, M.D., a neuropsychologist, explains that brain health has a pathological and a pragmatic component, and it is ultimately individualized. He discusses the impact that primary care physicians can have on patients by helping them connect healthy lifestyle choices (e.g., exercising, quitting smoking, sleeping, maintaining a balanced diet) with preventing cognitive decline and Alzheimer’s. Dr. Lazar emphasizes that optimizing brain health requires an interdisciplinary effort from physicians and patient awareness from an early age.

Diabetes care is changing rapidly with technological advancements such as continuous glucose monitoring, patch insulin pumps, and doctors’ ability to monitor patient data remotely. Ananda Basu, MD, endocrinologist and director of the UAB Diabetes Technology Program, discusses the developments that will make diabetes care more individualized and responsive in the future. Learn more about the educational and socioeconomic hurdles that will need to be cleared along the way.