Immunizations in older adults, addiction and teens, schizophrenia and cholesterol topics in weekly Mini Med School lecture series

About one-third of people will get shingles in their lifetime, and while the shingles vaccine is only about 50 percent effective, it is still worth it to avoid getting the virus, said Dr. Jane Weida, director of clinical affairs for the College of Community Health Sciences’ Department of Family, Internal, and Rural Medicine.

Weida gave her talk, “Immunizations for Older People — Staying Sharp on Shots,” on Feb. 9 as part of the Mini Medical School lecture series put on by CCHS in collaboration with UA’s OLLI program.

Mini Medical School lets adults and community learners explore trends in medicine and health, and the lectures by CCHS faculty and resident physicians provide information about issues and advances in medicine and research. OLLI, short for the Osher Lifelong Learning Institute, is a member-led program catering to those aged 50 years and older and offers education courses as well as field trips, socials, special events and travel. The lecture series is open to OLLI participants and to the public.

Shingles is caused by the same virus that causes chickenpox. A painful rash develops, usually on a single area on one side of the body, that can be very painful, said Weida, who is also an associate director of The University Family Medicine Residency, operated by CCHS, and an associate professor of Family Medicine.

View Fox 6’s report on Weida’s talk:

Someone who has had chickenpox can get shingles.

“When you’re little you get chickenpox and then the virus stays in the nerves along the back and neck,” said Weida. “Sometimes, we don’t know how, it reactivates.”

Being older, having poor immune function and having had chickenpox before 18 months of age increases the risk of shingles.

“If you never have had the chickenpox, you can’t get shingles first,” she said. “If you’ve never been immunized for chickenpox or shingles, you should get immunized for both. You can catch chickenpox from someone with shingles, but not shingles.”

Insurance will cover the shingles vaccine after age 60, though it can be given starting at age 50.

Older people need immunizations to boost immunity to diseases, even those to which they have already been immunized, such as tetanus, diphtheria and whooping cough, and to protect against diseases that affect older adults preferentially, including shingles and pneumonia, said Weida.

Weida also encouraged attendees to get their flu shot each year, as 3 million to 5 million people are infected by influenza each year, and 250,000 to 500,000 die each year from the flu. The best time to get your flu shot is about mid-October to November, said Weida.

The flu shot’s effectiveness can fade, Weida said, so it is important not to get it  too early, especially for those older than 65.

The flu is spread through coughing or sneezing and by touching surfaces with the virus. However, soap and water deactivates the virus, Weida said.

Schizophrenia
On Feb. 2, Dr. Thaddeus Ulzen, associate dean of Academic Affairs and chair of Psychiatry and Behavioral Medicine, gave his talk on schizophrenia, which is a chronic and severe mental disorder that affects 1 percent of people worldwide.

Symptoms typically present between late adolescence and early adulthood. Ulzen said that symptoms may be subtle, but those around the person may notice that “something is just not quite right, or the person is not his or herself.”

Symptoms include hallucinations, delusions, thought disorders and movement disorders. Reduced emotions and feelings of pleasure and reduced speaking may also be symptoms.

“I describe it as a disruption of what I call ‘security of thought’—that your thoughts belong to you,” said Ulzen. “The feeling is that someone is intruding on your thoughts.”

Medication can be used to treat schizophrenia, but other aspects must be introduced into the treatment, said Ulzen, including psychosocial interventions and cognitive behavioral therapy. Community treatment, which includes family education and support, is also important.

Schizophrenia cannot be cured, and those affected with the disorder have it for life.

“As a child psychiatrist, I always say that we are in preventive psychiatry. Most disorders we see, including schizophrenia, start quite young.”

Ulzen said he works with general physicians to help them identify the signs of schizophrenia and other psychiatric disorders.

“My job is to help physicians understand that this is the beginning of the big tsunami about to come and never to say ‘It’s just a phase.’ If the patient is concerned enough to walk into the room, they know something is wrong.”

 

Addiction and Teens
In a 2015 study, one out of 17 high school seniors were daily smokers of tobacco, said Dr. Sara Phillips, assistant professor of Pediatrics at CCHS, during her talk “Addiction and Teens” on Feb. 16.

According to the CDC, cigarette smoking causes about one of every five deaths in the US each year and life expectancy for smokers is at least 10 years shorter than for nonsmokers. Quitting smoking before the age of 40 reduces the risk of dying from smoking-related disease by about 90 percent, said Phillips.

“I think if we target young people and try to get them to quit early on, it could be like they never smoked.”

Most teens want to quit, she said, and nicotine replacement and cognitive behavioral intervention can be helpful forms of treatment.

While there are other dangerous drugs that teenagers use, smoking causes annually more deaths than overdoses have in 15 years, said Phillips.

More money is spent on tobacco advertising than any other drug, though there are regulations.

Advertising for alcohol is not regulated, and people aged 12 to 20 years drink 11 percent of all alcohol consumed in the US. More than 100,000 deaths can be attributed to excess alcohol consumption, including the deaths of 5,000 people younger than 21 years, said Phillips.

Younger drinkers are more likely to develop alcohol dependence or abuse later in life, and they are at higher risk of suicide and death from alcohol poisoning. This is for a couple of reasons, said Phillips.

“One, their brains are not fully developed, and two, they’re novices to drinking. They don’t know their limits,” she said.

Of illegal drugs, marijuana is the most commonly used and adolescents can become addicted, despite popular belief, said Phillips.

One study showed an average loss of eight IQ points with heavy marijuana use as a teen and continued use as an adult. It can also lead to memory problems, breathing issues and hallucinations and paranoia.

Genetics can play a role in addiction in teens. Children whose parents are alcohol-dependent are four to six times more likely to develop alcohol dependence compared to others with no family history. Teens with mental health issues are also more at risk to use or abuse substances, Phillips said.


Cholesterol
Treating cholesterol isn’t about treating a number—it’s about treating the risk factors and the disease process, said Dr. Ed Geno, assistant professor of Family Medicine in the College’s Department of Family, Internal, and Rural Medicine.

Cholesterol is essential in the human body, said Geno. Two types of cholesterol levels are checked: LDL and HDL. The two have different clinical implications:

LDL carries cholesterol from the liver to the tissues and deposits it. Geno called this “lousy cholesterol,” which is how he helps patients remember it is not good for that number to be too high.

“Happy cholesterol” is how Geno helps patients remember HDL, which carries cholesterol from the tissues back to the liver.

High levels of the LDL cholesterol can lead to plaque buildup in arteries and lead to cardiovascular disease (CVD).

Statins may be used to prevent CVD in adults.

“We are trying to use primary prevention in treating cholesterol,” Geno said. “That means we are trying to keep someone from ever having a heart attack. Secondary prevention would be keeping a heart attack from happening again.”

When treating a person’s cholesterol, risk factors and the disease process is taken into account—not just the patient’s cholesterol numbers.

Adults without a history of CVD may be prescribed a statin for the prevention of a CVD event and mortality  depending on if: 1) the adult is between age 40 and 75; 2) the adult has one or more CVD risk factors, which include dyslipidemia, diabetes, hypertension or smoking; and 3) the there is a calculated risk by the physician of a cardiovascular event within 10 years.

Mini Med School series with OLLI continues

There are times patients might ask their doctors for medications and tests that might not be necessary and that could cause harm, according to Dr. Ray Brignac, a family medicine physician who practices at University Medical Center-Northport, which is operated by the College.

During a lecture that was part of the College’s Mini Medical School program with The University of Alabama’s OLLI program, Brignac said doctors and patients need to talk and to use evidence-based recommendations to make the best care decisions possible.

“You need to put as much research into your medical decisions as you do buying a car or a washing machine,” he said. “There’s a lot of information out there. Try to go where the evidence is.”

A national campaign called Choosing Wisely advocates just that. The campaign encourages doctors and patients to have conversations informed by evidence-based recommendations that facilitate good decisions about appropriate care based on a patient’s individual situation, and to avoid unnecessary medical tests, treatments and procedures.

“The Choosing Wisely campaign gives us good tools to be better informed and wiser,” said Brignac, who titled his lecture “Choosing Wisely in Geriatrics.”

OLLI, short for Osher Lifelong Learning Institute, is a member-led program educational program catering to those aged 50 years and older. The College’s Mini Medical School lecture series through OLLI provides an opportunity for OLLI members and community learners to explore trends in medicine and health and to receive important information about issues and advances in medicine and research.

Brignac presented on May 3, and Dr. Catherine Ikard, a physician at University Medical Center and UMC-Northport, presented on May 10.


Choosing Wisely in Geriatrics
Brignac said older people often have more medical conditions and, as a result, take more medications than younger people. While medications have benefits, they also carry risks. “Is it always wrong to take medications? No. But you need to exercise caution,” he said.

He noted that sleeping pills help with insomnia, which affects many people over the age of 60, but studies show increased falls by those taking sleeping pills. Antibiotics do not cure colds and have risks, including diarrhea and damage to nerves and tendons. Nutritional supplements have the potential to react with other medications. Narcotics are not always the best way to treat chronic pain and non-drug interventions like exercise and physical therapy are sometimes more  effective. Non-steroidal anti-inflammatory medications like Aleve and Ibuprofen are safe but can sometimes cause gastrointestinal bleeding and increased risk of heart attack or stroke, and while acetaminophen, found in Tylenol, is a good medication, if taken in excess can damage the liver. Medications for heartburn and acid reflux can carry higher risk of osteoporosis, but sometimes avoiding certain foods and sleeping with the head of the bed raised can help.

“It’s not that you shouldn’t ever take these drugs, but you need to be aware of the risks,” Brignac said. “It’s always good to questions medications – are there alternatives, lower doses?”

Many older patients have low back pain and often ask for X-rays or MRIs, Brignac said. He recommends patients wait a month before tests because most back pain clears up in that time. “If you jump right into testing, you can create needless anxiety, or you might wind up under the surgeon’s knife unnecessarily.”

Brignac joined University Medical Center-Northport last year after a 34-year practice at Selma Medical Associates in Selma, Ala. In addition to family medicine, Brignac also has an interest in geriatrics and nursing home patients and is working to build a “hands-on” nursing home practice in Northport and Tuscaloosa.

Recognizing, Treating and Preventing Strokes
If you suspect someone you know is having a stroke, the most important information that can be relayed to the EMT or physician treating that person is the last known well time, said Dr. Catherine Ikard.  This will determine the course of treatment.

Ikard, assistant professor in Psychiatry and Behavioral Medicine and Internal Medicine, spoke about the causes, symptoms and treatments of strokes at a lecture she presented as part of the College’s Mini Medical School with The University of Alabama’s OLLI program.

OLLI, short for Osher Lifelong Learning Institute, is a member-led educational program catering to those aged 50 years or older. The College’s Mini Medical School lecture series through OLLI provides an opportunity for adults and community learners to explore trends in medicine and health, and the lectures by CCHS faculty offer important information about issues and advances in medicine and research.

One of the best ways to identify if someone might be having a stroke is to ask the person to smile. If the smile is lopsided or there is drooping, the person might be having a stroke, Ikard said.

If a stroke is caused by a blood clot, a medication called a tissue plasminogen activator, or tPA, may be given within four and a half hours of the last-known well time, said Ikard.

After four and a half hours, or if the patient cannot receive a tPA for medical reasons, endovascular therapy can be used, which involves the use of a stent retriever that a doctor routes through a catheter to the blocked artery and removes the clot, Ikard said.

“If you suspect a stroke, call 911,” Ikard said. “If it is a stroke, every 30 minute delay could lead to a 10 percent relative reduction in recovery.”

New Chief Residents Announced

ChiefResidents

From top left, clockwise: Drs. Shawanda Agnew, Carrie Coxwell, Eric Frempong and Blake DeWitt

The University of Alabama Family Medicine Residency announced its chief residents for the 2016-2017 academic year.

Drs. Shawanda Agnew, Carrie Coxwell and Blake DeWitt are chief residents. Dr. Eric Frempong has been elected as IT chief resident.

The Family Medicine Residency, which is operated by the College of Community Health Sciences, is a three-year post-graduate medical education program that leads to board certification in Family Medicine.

Agnew attended medical school at the University of Mississippi, and is a Mississippi Rural Medical Scholar. She plans to return to Mississippi after graduation to practice in an underserved community. She is interested in women’s health.

Coxwell received her medical degree from the University of Alabama School of Medicine, located in Birmingham. She has a special interest in obstetrics and is interested in the College’s Obstetrics Fellowship.

DeWitt attended medical school at Texas Tech University in Lubbock, Texas. His special interests include sports medicine and primary care endoscopy. He plans to return to his home state of Texas to practice after graduation.

Frempong received his medical degree from American University of the Caribbean. He has a special interest in obstetrics and, after residency, plans to practice inpatient and outpatient family medicine.

College welcomes new faculty, providers

New faculty and providers have joined the College of Community Health Sciences in different departments:

Dr. John Burkhardt is a clinical psychologist and provides psychotherapy and related care at University Medical Center-Northport.

He received his doctoral degree in clinical psychology from the Illinois School of Professional Psychology in Scaumburg, Ill. He completed two fellowships, one at VR Behavioral Health Services in Oakland Park, Ill., and another at St. James Hospital in Olympia Fields, Ill. Burkhardt has worked in private practice and as a clinical health psychologist at hospitals and long-term care facilities in Illinois and Tennessee. At UMC-Northport, Burkhardt will be practicing alongside clinic director Dr. H. Joseph Fritz, Drs. Ray Brignac, Jennifer Clem, Catherine Skinner and nurse practitioner Lisa Brashier.

 

 

Dr. Cecily Collins is assistant professor in the Department of Obstetrics and Gynecology.

Collins attended medical school at the University of Alabama School of Medicine, headquartered in Birmingham, and she received her third and fourth years of clinical education at the College, which also functions as the School of Medicine’s Tuscaloosa Regional Campus. She completed her residency at Florida State University Obstetrics and Gynecology Residency in Pensacola, Fla., where she was administrative chief resident.

Collins has a special interest in group prenatal care as a mechanism to improve perinatal outcomes. She presented on this topic in August at the College’s monthly Grand Rounds lecture at DCH Regional Medical Center.

 


Dr. Brooke Taylor Haynes
is assistant professor in the Department of Pediatrics.

Haynes attended medical school at the University of Alabama School of Medicine, headquartered in Birmingham, and completed her residency at the Cincinnati Children’s Hospital Medical Center Pediatric Residency Program. Before joining the College, she worked in private practice at Pediatric Clinic, LLC, in Opelika, Ala., where she also had a hospital appointment at East Alabama Medical Center.

University Medical Center-Northport celebrates grand opening

Community members and leaders gathered to celebrate the grand opening of University Medical Center’s new Northport location on Wednesday, Aug. 26, 2015.

A ribbon cutting ceremony, sponsored by the Chamber of Commerce of West Alabama, was held at University Medical Center-Northport, and an open house for the public followed. The open house included tours of the clinic.

During the ribbon cutting ceremony, Dr. Richard Streiffer, dean of The University of Alabama College of Community Health Sciences, which operates UMC and UMC-Northport, said that opening the new location was part of the College’s effort to address the state’s shortage of primary care physicians and health care professionals.

“We know primary care and family medicine and the training we undertake are key to a healthcare system that is not only more effective, but more accessible and more prevention-oriented and ultimately results in improved population health, which is the mission of the College—to improve the health of the population,” he said.

He added, “We’ve outgrown our beautiful facility on campus, and we’re delighted to be able to open this facility in Northport and improve [health care] access for this part of the community and for the counties adjacent.”

UA President Stuart Bell spoke, saying that opening UMC-Northport is an offering of one of UA’s greatest resources to the community.

“As I think about what makes a community great and what is important to a community, first and foremost in that is providing excellent health care to our community, and I couldn’t be more proud to be here today and talk about the partnership we have between The University of Alabama and [Northport].”

Northport Mayor Bobby Herndon concluded the remarks with a proclamation: “I proclaim wisdom for the instructors, understanding for the students and the best health care possible for all citizens.”

Though the grand opening celebration was held on Aug. 26, UMC-Northport, which is located at 1325 McFarland Blvd., Suite 102, Northport, AL (in the Fitness One building) has been providing comprehensive, patient-centered care to the area in family medicine and obstetrics since its soft opening on July 1.

The opening of UMC-Northport was a relocation of UMC-Warrior Family Medicine, UMC’s location in Fairfax Park in Tuscaloosa, which closed in late June. Patients and providers from UMC-Warrior Family Medicine moved to UMC-Northport.

Dr. H. Joseph Fritz is clinic director at UMC-Northport, and he practices alongside Drs. Ray Brignac, Jennifer Clem, Catherine Skinner and nurse practitioner Lisa Brashier. Resident physicians Drs. Shawanda Agnew, Carrie Coxwell, Eric Frempong, Brianna Kendrick, Cheree Melton, Aisha Pitts, Efe Sahinoglu and Amy Wambolt, all of whom are part of The University of Alabama Family Medicine Residency, also see patients.

Dr. John Burkhardt, a clinical psychologist, will provide psychotherapy and related care at UMC-Northport starting Sept. 1

UMC and UMC-Northport provide care to the University and West Alabama community. Patients of all ages can receive care for the full spectrum of needs—from preventive care and wellness exams to management of chronic conditions, to treatment for acute illness and accidents.

UMC-Warrior Family Medicine was formed in 2014 after Fritz and his practice, Warrior Family Practice, joined the College. Fritz had been in private practice in Tuscaloosa since 1978.

To make an appointment at UMC, phone the desired clinic directly, or call (205) 348-1770. To make an appointment at UMC-Northport, phone (205) 348-6700. Learn more about UMC and UMC-Northport here.

University Medical Center-Northport holds ribbon cutting, WVUA reports

The grand opening celebration was held for University Medical Center’s new Northport location on Wednesday, Aug. 26. A ribbon-cutting ceremony was sponsored by the Chamber of Commerce of West Alabama, and an open house followed immediately. Clinic tours were offered to the public as well as patient information sessions on health-related issues, reported WVUA 23.

Watch the report:

University Medical Center opens a new Northport location, Tuscaloosa News reports

The University Medical Center has opened a new Northport location at the Fitness One building at 1325 McFarland Blvd. University Medical Center-Northport opened in July after the UMC-Warrior Family Medicine, which was in Fairfax Park in Tuscaloosa, closed in June. Patients and providers from UMC-Warrior Family Medicine moved to UMC-Northport. Like the main UMC on the University of Alabama campus, UMC-Northport provides a range of care to the community, including preventive care and wellness exams to treatment for acute illness, accidents or chronic conditions.

University Medical Center-Northport to hold grand opening, The Crimson White reports

UMC-Northport to celebrate grand opening Aug. 26

University Medical Center’s new Northport location will hold its grand opening on Wednesday, August 26, 2015. A ribbon-cutting ceremony will take place 5 p.m. at University Medical Center-Northport, located in the Fitness One building at 1325 McFarland Blvd, Suite 102, and it will be followed by an open house for the community.

The ribbon cutting ceremony will be sponsored by the Chamber of Commerce of West Alabama. The open house, which will include patient information sessions on health-related issues, will allow members of the community to familiarize themselves with the services offered at UMC-Northport.

Both University Medical Center and UMC-Northport are operated by The University of Alabama College of Community Health Sciences. Since its soft opening on July 1, UMC-Northport has provided comprehensive patient-centered care in family medicine and obstetrics.

“We are very excited about the positive impact UMC-Northport has had and will have on our patients, learners and the community,” says Dr. Richard Friend, chair of Family Medicine for the College. “It is important to continue to find ways to improve the health of our patients and the community.”

The opening of UMC-Northport was a relocation of UMC-Warrior Family Medicine, UMC’s location in Fairfax Park in Tuscaloosa, which closed in late June. Patients and providers from UMC-Warrior Family Medicine moved to UMC-Northport.

Dr. H. Joseph Fritz is clinic director at UMC-Northport, and he practices alongside Drs. Ray Brignac, Jennifer Clem, Catherine Skinner and nurse practitioner Lisa Brashier. Resident physicians Drs. Shawanda Agnew, Carrie Coxwell, Eric Frempong, Brianna Kendrick, Cheree Melton, Aisha Pitts, Efe Sahinoglu and Amy Wambolt, all of whom are part of The University of Alabama Family Medicine Residency, also see patients.

UMC and UMC-Northport provide comprehensive, patient-centered care to the University and West Alabama community. Patients of all ages can receive care for the full spectrum of needs—from preventive care and wellness exams to management of chronic conditions, to treatment for acute illness and accidents.

UMC-Warrior Family Medicine was formed in 2014 after Fritz and his practice, Warrior Family Practice, joined the College. Fritz had been in private practice in Tuscaloosa since 1978.

To make an appointment at UMC, phone the clinics directly or call (205) 348-1770. To make an appointment at UMC-Northport, phone (205) 348-6700. Learn more about UMC and UMC-Northport here.

 

University Medical Center opens Northport location, WVUA reports

University Medical Center, which is operated by the College of Community Health Sciences, opened its new location in Northport on July 1. The center will provide the community with comprehensive patient-centered care in family medicine and obstetrics.

Dr. Richard Friend, chair of Family Medicine for the College, spoke to WVUA about the opening of UMC-Northport, which features 12 exam rooms and a procedure room.

“As the largest primary care provider in West Alabama, we’re very excited to be able to expand our services out into the Northport community and provide a much needed service for that community,” Friend said to WVUA.

Watch the entire report here: