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Nontuberculous mycobacteria (NTM) infections are ten times more prevalent than tuberculosis infections, affecting primarily the elderly and immunocompromised. Bryan Garcia, MD, a pulmonologist, discusses the likely origins of NTM, who is most at risk to be infected by these ubiquitous bacteria, and the criteria for diagnosis. Learn why NTM needs to be better accounted for at both the epidemiological and clinical levels in the future.

Hepatitis C (HCV) affects around 40,000 people in Alabama, and possibly many more who do not know they have it. Although the disease is largely curable, it affects vulnerable populations that may not get tested or pursue treatment. Ricardo Franco, MD, and David Fettig, MD, discuss their work to eradicate HCV as part of the interdisciplinary ABC Clinic. The doctors discuss the causes for the stubborn prevalence of HCV; their outreach and education to health centers in areas with vulnerable populations; and the unique ability of the ABC Clinic’s team of hepatologists and infectious disease experts to treat a range of related viral diseases and liver conditions.

Interstitial lung disease (ILD) can occur secondary to autoimmune diseases such as rheumatoid arthritis, scleroderma, and Sjogren’s syndrome. Pilar Acosta, MD, a pulmonologist, explains the unique treatment approach for patients who have ILD as a secondary condition. She discusses combination therapies that address both inflammation and fibrosis, as well as the importance of managing common comorbidities. Learn more about the advantages of a Pulmonary Fibrosis Foundation Care Network site for early identification and management of ILD.

Around 40% of adults will experience acid reflux at some point in their lives, and half of them will take medication to control consistent recurrences, known as gastroesophageal reflux disease, or GERD. It is important to diagnose patients with GERD to help them avoid esophageal damage and even cancer. James Callaway, MD, a gastroenterologist, and Kristen Wong, MD, a surgeon, discuss the progressive steps they take in diagnosing, managing, and treating GERD. Dr. Calloway emphasizes that controlling weight and diet are always top priorities for anyone with recurring acid reflux, while proton pump inhibitors remain effective prescription medications. Dr. Wong discusses surgical gastric modifications and devices for patients who do not respond to medication.

Healthy eating is a powerful way to prevent and control type 2 diabetes. New medications allow those with diabetes to focus on diet to improve their quality of life, not simply to manage blood sugar. Amy Warriner, MD, explains the individualized approach required to help patients eat healthier, as many are challenged by a lack of knowledge and access to healthy foods. She discusses the common elements of some popular diets that patients may implement, noting that there is no one best diet. Learn more about how her interdisciplinary team helps patients learn from data generated by mobile apps to make progress toward their goals.

Idiopathic pulmonary fibrosis (IPF) is a rare lung disease that leads to progressive lung scaring and eventual respiratory failure; it most often affects the elderly. The American Thoracic Society and other international bodies updated clinical practice guidelines for this disease in 2022. Tracy Luckhardt, MD, a pulmonologist, summarizes the most important changes to diagnosis, pharmacological treatments, and non-pharmacological treatments. Learn more about the advantages of an interdisciplinary team in managing symptoms and comorbidities of IPF, including determining when a patient is a good candidate for clinical trials or a lung transplant.

Exercise is a medicine that many people neglect, even more so if they have a physical disability: 50% of those with a physical disability do not exercise regularly. Johan Latorre, MD, a specialist in sports medicine and former collegiate wheelchair tennis coach, shares the myriad benefits of adaptive sports – those sports made accessible to people with physical disabilities. He discusses some common inherited and acquired disabilities and the pathways for helping patients with those conditions find their sport.

Digital technology is making the concept of continuous care possible – along with its more familiar benefits to telemedicine. Jeff Curtis, MD, a rheumatologist, discusses new applications of digital technology to healthcare that are becoming standard of care: virtual reality (VR) to help with pain management and teach wellness techniques; biosensors that allow doctors to gather data from patients between visits; and artificial intelligence (AI) to sort large amounts of data for rapid answers about widespread health conditions. Dr. Curtis shares how digital technology will allow caregivers to work across boundaries for the benefit of all.

Urinary diversion is needed for a variety of patients whose bladders are not functioning properly. In cases of organ removal, cancer, or loss of mobility, complex and permanent surgical procedures may be required. Chas Peyton, MD, and Jeffrey Nix, MD, both urologic oncologists, discuss the role of specialists in creating patient-driven solutions for urinary diversion using different of routes, materials, and means of bladder emptying. Learn more about the relative advantages of the major surgery types and how the doctors use a team approach to anticipate and manage complications.

Idiopathic pulmonary fibrosis (IPF) is one of the common forms of interstitial lung disease (those that affect the tissues between airways); it results in scarring and fibroblasts. Early diagnosis is critical to the management of this dangerous condition. Carla Copeland, MD, explains the challenge of diagnosing IPF due to its generic symptoms, which usually indicate more common breathing issues. She discusses recent innovations in how CT scans are categorized to better diagnose IPF and to help recommend patients for biopsies. Learn why Dr. Copeland works with a multidisciplinary discussion team (MDT) to diagnose this condition accurately and to begin treatment as soon as possible.

Oscar Julian Booker, MD and Efstathia Andrikopoulou MD discuss how using third-party vendor, Mpirik Cardiac Intelligence, helped to develop a software algorithm that provides clinical decision support to help identify patients at risk for heart valve disease who otherwise might be overlooked. They share what factors are behind the most significant disparities, as they connect the potential of machine learning and artificial intelligence with the need for clinicians to expand their toolkit. They offer their top recommendations for physicians to consider when they are treating underserved and minority patients.

Primary Ciliary Dyskinesia (PCD) is a rare genetic disease that results in severe sinus and pulmonary infections and is particularly difficult to treat; however, as George Solomon, MD, explains, researchers have recently made important steps in understanding and treating PCD. He explains the critical link they have established between genotype and phenotype of observed PCD cases, which will lead to genetic-based therapies in the future. Equally important, he says, are the strides made in treating symptoms PCD that can help patients right now: UAB is currently conducting clinical trials exploring treatments that help patients clear mucus from their lungs in order to limit damage throughout the body.

Even for those diagnosed with a seizure disorder (e.g., epilepsy), seizure events are unpredictable and dangerous; worse still, they often occur in clusters. Adeel Ilyas, MD, discusses his new research paper that demonstrates how seizure clusters may be predicted based on brain activity. He describes the methods his team used to refine a definition for seizure clusters and to develop an algorithm for predicting them in the pilot study. Learn more about the promising implications of this groundbreaking work for treatment and patient quality of life.

Atrial fibrillation (AF) is the most common sustained heart arrhythmia, and it dramatically increases stroke risk. William Maddox, MD, a cardiac electrophysiologist, discusses the most recent approaches to treating patients’ symptoms of AF and reducing their stroke risk. He covers some of the most important developments that affect how specialists manage AF: smartwatch monitoring, catheter ablation improvements, and new implantation devices that occlude the left atrial appendage for stroke prevention.

In some central Alabama counties, roughly one in five adults has type 2 diabetes. Fernando Ovalle, MD, discusses trends in diabetes care. He notes the general complications that often accompany type 2 diabetes, including kidney disease, neuropathy, and retinopathy. In Dr. Ovalle’s experience, continuous glucose monitoring devices empower patients to achieve tangible goals related to their condition. Learn more about new drugs that now target hormones beyond insulin, which also have a significant effect on glucose metabolism.

Diabetes and related comorbidities have been devastating in the South. Anath Shalev, MD, explains how the UAB Comprehensive Diabetes Center (UCDC) opens new avenues for collaborative research and effective new treatments. She discusses two recent examples of multidisciplinary research bringing new therapies from bench to bedside.

The most recent medical research on opioid addiction makes one thing clear: medication saves lives. Leah Leisch, MD, a psychiatrist, explains how CDC guidelines regarding prescribing and tapering opioids have responded to new insights about the risks of addiction and withdrawal. She notes that patients who develop a substance use disorder face a mortality ratio three times higher if they are not prescribed a medication approved to treat opioid addiction. Dr. Leisch discusses each medication and the means of prescribing them.

Hematologic cancer patients have the benefit of many new oral medications to manage their conditions; however, those medications may create or worsen cardiovascular comorbidities. Nurse Practitioners Courtney Estes (Cardio-Oncology Program) and Ellen Lazarre (Hematology Oncology Division) discuss the balancing act of managing risks while attacking cancer, which is only possible with an interdisciplinary team. They discuss the most common cardiovascular comorbidities (e.g., AFib, hypertension) and alternative treatments that may address them without interfering with effective cancer treatments.

Justin Kirk, PT, highlights identifying and reducing risk factors for ACL injuries. He shares who is most likely to sustain an ACL injury, the movements or position that increases an athlete’s risk for injury and the importance of limb symmetry and single leg training for preventing ACL injuries. Additionally, he offers recommendations for providers, when working with athletes at high risk, on how to reduce their risk for an ACL injury and the changes he has seen in management of ACL tears over the past 5 years.

Around 3 million Americans suffer from inflammatory bowel disease (IBD). Daniel Chu, MD, a colorectal surgeon, and Kirk Russ, MD, a gastroenterologist, discuss the trends in occurrence, diagnosis, and treatment of IBD (including Crohn’s disease and ulcerative colitis). Dr. Russ emphasizes that biologic and small molecule medicinal options have changed the approach of specialists. Meanwhile, Dr. Chu explains that surgeons have begun to focus on patient recovery and using minimally invasive techniques. As their understanding of the complex disease has increased and the treatment options available have expanded, the doctors agree that psychologists and nutritionists are an important part of their interdisciplinary colorectal team.