Exercise can improve lung function and have a range of other benefits for cystic fibrosis (CF) patients, but each patient has a unique tolerance for exercise depending on age, condition, and lifestyle. Stefanie Krick, MD, discusses how the complications specific to CF require popular exercises to be modified. She also emphasizes that patients must be monitored closely for changing abilities in each phase of their lives. Multidisciplinary teams that include physical therapists are best suited to help patients with special challenges due to CF make exercise part of their lives safely.

Ambulatory care transition RNs manage the crossroads of the patient experience. Alyse Hicks, RN, and Jennifer Rosales, RN, explain the dynamic work of triaging patients from an online portal and via telephone, as well as following up with those patients to prevent readmissions. They use critical thinking to make judgments based on a deep knowledge of physicians’ preferences from various specialties. Learn more about the growth of their profession’s scope, the challenges of maintaining their own well-being during COVID-19 peaks, and how experience and education continue to make them more effective.

Spinal vascular lesions are rare yet treatable. Good patient outcomes depend on quick recognition of stepwise symptoms and referral to specialists who can use advanced imaging and other tests. That is where Jesse Jones, MD, and Will Meador, MD, come in, with the most advanced diagnostic, treatment, and recovery techniques in neurosurgery. They discuss the pathologies of vascular lesions and closely related disorders, as well as the relative severity of these diagnoses. After explaining diagnostic methods, from simplest to most complex (i.e., spinal angiogram) methods, they describe surgical and endovascular approaches to treatment. Learn more about the urgency of treating these often-complex diagnoses and the recovery outlooks for patients who receive them.

STI infection rates are generally increasing in the U.S., and this is especially concerning for pregnant women; for instance, in just the last five years, congenital syphilis cases have jumped 200%. Jodie Dionne-Odom, MD, MSPH, FIDSA, defines the categories of STIs and explains possible reasons behind the increase. She emphasizes the need for early testing and treatment of pregnant women and discusses some of the advances in testing that may lead to convenient, at-home sample collection options. Learn about the clinical trials in progress at UAB exploring vaccines and antibiotics for common STIs.

Immunotherapy is the most promising avenue of research for treating deadly brain tumors. M. R. Chambers, DVM, MD, and James Markert, MD, MPH, are leading clinical trial research on therapies using oncolytic viruses and checkpoint inhibitors as part of an ongoing NIH-awarded UAB Specialized Program of Research. They discuss the promising immune system responses they have seen in humans and dogs via RNA-seq and NanoString analyses, as well as how results may translate from one species to the other in the form of expanded clinical trials.

Although most cystic fibrosis (CF) patients respond to new drug combinations which activate the proteins commonly affected by the disease, around 15% of patients are still without a treatment option. George Solomon, MD, discusses how UAB’s participation in the international “Path to a Cure” initiative will expand treatment options for all CF patients. He summarizes the three prongs of the path: developing a wider range of protein modulators, finding safe and ethical ways to administer genetic therapies, and ultimately finding a universal cure for CF. But what can we do now for CF patients with less common mutations? Learn more about how the UAB Medicine Cystic Fibrosis Program gives patients with tough-to-treat protein mutations access to emerging therapies through clinical trials.

Procedures for brain tumors, epilepsy, and movement disorders require a precise and conservative approach so as not to damage functioning brain tissue. UAB Hospital neurosurgeons can now check their work as they operate in a new intraoperative MRI suite—the first in Alabama. James Markert, MD, MPH, chair of the Department of Neurosurgery in the Heersink School of Medicine, discusses how surgeons respond to real-time MRIs at crucial moments. Because of this technology, UAB surgeons can now target the margins of glioma tumors; confirm proper placement of deep brain stimulators for Parkinson’s disease; and use laser interstitial thermal therapy more precisely to eliminate seizures. Dr. Markert discusses the logistics of using an MRI in the operating suite and the vast potential of this suite for other surgical units.

Head and neck cancer patients face not only health challenges, but identity challenges—altered appearance and speech and difficulty eating and swallowing. As a result, oral oncologists, such as Anthony Morlandt, MD, are uniquely focused on quality-of-life outcomes for patients. Dr. Morlandt explains the recent leaps forward in radiation treatment (proton therapy), jaw reconstruction (custom fabrication), and cost reduction that have dramatically improved the quality of life for UAB patients. Learn more about the new horizons of head and neck cancer care, including screening with the help of bacteria and the possible role of immunotherapy in treatment.

Telehealth is making it possible for those with rare diseases to receive expert care more efficiently. Bryan Garcia, MD, explains that although many specialties simply had to use telehealth during the pandemic, the benefits are here to stay for many of his cystic fibrosis (CF) patients. Thanks to recent Cystic Fibrosis Foundation investments in home-monitoring spirometers and newly approved medicines that allow CF patients to maintain more routine lifestyles, telehealth is not only possible, but is often preferred. Dr. Garcia explains how CF treatment lends itself to the early adoption of telehealth, but he also emphasizes that the general trend towards it is inevitable across the industry—noting that some clinical trials are already enabling greater participation by requiring fewer in-person visits.

Kirk Withrow, MD, director of Salivary and Sleep Surgery in the UAB Department of Otolaryngology, discusses a new solution for patients who do not tolerate CPAP therapy: hypoglossal nerve stimulator implantation. A CPAP machine is the first-line treatment for obstructive sleep apnea because it works when patients use it consistently—and many either cannot or do not. Hypoglossal nerve stimulation represents a new approach, adding muscle tone to the upper airway to ensure airflow. Dr. Withrow was the first surgeon in Alabama to implant a hypoglossal nerve stimulator in 2016, and he discusses the positive outcomes of the 300 implants he has placed since. As he explains in detail, the device simplifies patient adherence after being placed in a low-morbidity outpatient procedure. Find out what makes a patient a good candidate.