October Mini Med School Topics: Women’s Health, Injury Prevention and Telemedicine

Breast cancer is the second leading cause of death among women, so prevention and screening are important, not only for breast cancer but also for other gynecologic cancers, according to Dr. Kristie Graettinger, associate professor and chair of the College’s Department of Obstetrics and Gynecology.

Graettinger provided a presentation, “Women’s Health Update: Cancer Prevention,” at the Oct. 20 Mini Medical School program conducted in collaboration with UA’s OLLI program.

In addition to her presentation, three other faculty members presented during the month of October. Dr. Ray Stewart, assistant professor of Sports Medicine, talked about “Preventing Injury” on Oct. 6, and Dr. Karen Burgess, chair of Pediatrics, gave a presentation on “Telemedicine” on Oct. 13.

Mini Medical School lets adults and community learners explore trends in medicine and health, and the lectures by CCHS faculty and residents provide information about issues and advances in medicine and research. OLLI, short for 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.

In her presentation, Graettinger said to think of cancer prevention as three tiers: “prevention, screening and treatment.” Prevention is interventions to reduce the risk of cancer, including maintaining a healthy weight, being physically active, having a diet high in fruits, vegetables and whole grains and low in processed foods and red meats, and receiving vaccinations that can protect against cancer, such as the HPV vaccine for cervical cancer. Examples of screening include mammograms for breast cancer and pap smears for cervical cancer.

“The goal is first to try and prevent cancer, and also to identify people at risk for the disease,” Graettinger said.

Breast cancer is the second leading cause of death among women, right behind lung cancer, and will affect 1 in 8 women in their lifetimes. Approximately 250,000 cases of breast cancer are diagnosed every year.

Having a first-degree relative, such as a mother or sister, with breast cancer doubles the risk, but that amounts to only 15 percent of women diagnosed. Breast cancer screening includes mammograms, clinical exams performed by a physician or health professional, breast self-exams and genetic testing.

A mammogram is an x-ray of the breast. Currently there is not a consensus among organizations about the age a woman without a family history of breast cancer should be – ranging from 40 to 50 – to begin receiving annual mammograms.

There is recent evidence that clinical breast exams might not be helpful for women without symptoms of breast cancer, “but have that discussion with your doctor,” Graettinger said. She added that the concept of breast self-exams has shifted to “being aware of your breasts.”

For women with the inherited BRCA gene mutation, “this is serious business and increases the risk of breast cancer from 1 in 8 to 1 in 2, or by 50 percent, and the risk of ovarian cancer is 10 times greater,” Graettinger said. Having the BRCA gene is “not extremely common, but it’s not rare,” she said, adding that women with a personal history of breast cancer should consult with their physicians about this genetic testing.

Other gynecologic cancers include cervical, ovarian and uterine cancer. Of those, only cervical cancer has a screening test – pap smears, which detect precancerous changes on the cervix. Pap smears are now recommended every three years for women ages 21 to 65.

Ovarian and uterine cancers are detected by signs and symptoms, “which is scary because sometimes these are found in the later stages,” Graettinger said. Symptoms of ovarian cancer are vague and include pelvic and abdominal pain and pressure, bloating and feeling full quickly, and irregular bleeding. Approximately 20,000 cases of ovarian cancer are diagnosed annually. Pressure, pain and bleeding after menopause are common symptoms of uterine cancer, which primarily strikes women over the age of 50.
In Stewart’s presentation, he said that “sprains and strains are where the vast majority of injuries are occurring.” The most common sports injury is an ankle sprain, followed by a groin sprain and a hamstring sprain.

Stewart said the goal is to introduce preventive measures to avoid the injury. A warm up is a good way to do that. A warm up should get the body moving, introduce a light sweat and “literally warm up the muscles,” he said.

Stretching is a good way to prevent injuries, too. There is dynamic stretching, which are bouncing, jerking movements, static stretching, which are slow, deliberate movements that are held for about 20 seconds, and then proprioceptive neuromuscular facilitation, or PNF stretching, which combines static stretching with isometric movements to increase flexibility.

To prevent an ankle sprain, Stewart suggested wearing an ankle support to reduce the risk and to conduct balance training: stand on one leg in order to train muscles to support the ankle.

To prevent a hamstring sprain, Nordic hamstring exercises are best, Stewart said.

There is a higher injury rate of the ACL in women, and prevention requires regular exercises. Plyometrics, known as “jump training” help may reduce an ACL injury, but must be performed throughout the athlete’s season. After the participant stops performing the training exercises, he or she becomes at risk for injury again.
Burgess introduced many of participants in the Mini Medical School series to the concept of telemedicine for the first time.

Telemedicine is any medical information exchanged from one site to another through the use of technology. It could be a phone or computer.

“We use it to improve access to care,” said Burgess.

Many parts of Alabama are rural and are underserved in primary care and specialty care providers. Unfortunately, many of the underserved areas in Alabama are also areas with limited connectivity, which makes it difficult to access telemedicine, Burgess said.

Burgess spoke about CCHS Telemedicine and Telehealth efforts, including the asthma education program that she and Beth Smith, a nurse practitioner in pediatrics at University Medical Center, have led. Students at Greensboro Elementary School in Hale County and their parents are taught through telemedicine about asthma symptoms, medication and treatment. The program teaches  students how to use a spacer with their asthma inhaler for more effective usage of their medicine.

The program so far has revealed that students and parents are learning more about asthma and how to treat it.

One participant said: “Until today I had no idea what telemedicine was. Thank you for coming here and telling us about that today.”

 

Parkinsonism, ADHD in Grandchildren and Geriatric Depression topics in fall semester of Mini Med School

Mini Medical School is back in session this fall semester. The University of Alabama College of Community Health Sciences kicked off its second semester of the lecture series for UA’s OLLI program that has been put on by faculty and resident physicians at CCHS.

Mini Medical School lets adults and community  learners explore trends in medicine and health, and the lectures by CCHS faculty and residents provide information about issues and advances in medicine and research. OLLI, short for 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.

Parkinsonism — Dr. Catherine Ikard

Many people think of Parkinson’s disease as a single disorder, but it is actually more complicated than that, said Dr. Catherine Ikard, a neurologist at University Medical Center and assistant professor of Internal Medicine and Psychiatry and Behavioral Health for the College.

Parkinsonism is a syndrome characterized by decreased movement and is associated with tremors and a loss of balance, Ikard said at her lecture, titled “Parkinsonism and Parkinson’s Disease,” which she presented as part of the Mini Medical School series on Sept. 15.

Parkinsonism can appear in an array of disorders, some even as a result of repeated head trauma or medication, but the most common one—the one most people refer to when they think of Parkinson’s Disease—is Idiopathic Parkinson’s Disease.

Idiopathic Parkinson’s Disease is the progressive loss of dopamine-producing cells in the brain. The disease is slow and degenerative. “We don’t know why this happens,” Ikard said.

There are motor symptoms, which include shaking, smaller and slower movements, becoming stiff and losing balance more easily. Motor symptoms usually start on one side of the body. Tremors can worsen when the patient is at rest, and they are suppressible by concentration.

Non-motor symptoms include affective disorders, such as depression, orthostatic hypotension (when blood pressure falls significantly when standing up too quickly), memory impairment, fatigue, constipation and sleep disturbances.

There is no test for Idiopathic Parkinson’s Disease, Ikard said. The diagnosis is clinical. “We often have to watch a tremor over time—months, sometimes years,” Ikard said.

Medication and therapy can help treat symptoms, Ikard said. The most common medication is Levodopa, and physical and speech therapy can help improve lifestyle. “I cannot emphasize enough how important therapy is for patients with Parkinsonism,” said Ikard. Exercise improves symptoms, too, she said.

There are clues that the disorder might not be traditional Idiopathic Parkinson’s Disease, Ikard said.

Some of these include: rapid progression of the disease, absence of tremors, frequent falls early in the disease, abnormal eye movement and poor response to Levodopa. If that is the case, the Parkinsonism could be tied to another disorder.

Grandchildren and ADHD — Dr. Brian Gannon

Children are very active from the ages of 2 to 5, but that busyness should decrease over time, said Dr. Brian Gannon, a pediatrician at University Medical Center and an assistant professor of Pediatrics for the College.

But as children get older and if they are easily distracted, can’t stick with a task for a reasonable amount of time and their activity level is not appropriate for their age, they could suffer from ADHD, or attention deficit hyperactivity disorder.

“ADHD is defined as an activity level that is inappropriate for age, that interferes with school work, that causes trouble in dealing with adults,” Gannon said during a lecture on Sept. 22, titled “Grandparents and ADHD.”

Gannon said about 5 percent of the general population in the US qualifies for an ADHD diagnosis. He said sometimes the markers of what appears to be ADHD are actually caused by other medical issues. He said hearing, vision and speech problems can cause some of the same symptoms of ADHD, as can developmental delays, autism and sensory processing disorder.

“We want to look at medical issues because they may cause similar issues to ADHD,” Gannon said.

A child’s living situation – unstable home environment, varying and inconsistent rules and food insecurity – is also a factor. “My job as a physician is to advocate for the child and help parents problem solve. We don’t want to just throw medicine at a child.”

Gannon said medication can help and should be part of efforts to manage ADHD, but is only part of the answer. “Children still need to follow the rules, and do their work. With medication, they can do it without your help.”

Geriatric Depression — Dr. John Burkhardt

Older adults are at risk for depression. One reason: The more medical burdens one has, the higher the risk of depression, said Dr. John Burkhardt, a clinical psychologist with University Medical Center-Northport.

“Chronic pain conditions can be managed, but you never get a break from them. Heart problems can precipitate depressive episodes, and then you have to eat differently, go to physical therapy and deal with a chronic condition. What does that do to your mood?” said Burkhardt, also an assistant professor of Psychiatry and Behavioral medicine for UA’s College of Community Health Sciences, which operates UMC-Northport.

His remarks came in a lecture titled “Geriatric Depression” that he provided on Sept. 29 as part of the Mini Medical School lecture series.

Burkhardt said changes in previous functioning, pain and sleep disruption, significant weight gain or loss, a loss of interest in activities, a sad and depressed mood, a feeling of being a burden – and if those conditions and feelings go on for two weeks or more – could signal possible depression. “A lot of people go through sad times. But when it starts to impact your functioning, that could be depression.”

With older couples, depression can also be “contagious,” Burkhardt said. “If one spouse is depressed, the other spouse is at an increased risk of depression.”

Late-life depression, which happens after the age of 60, can carry added risk because it can transition to dementia, Burkhardt said.

He stressed that depression needs to be treated, particularly in the elderly, who might not seek care because of an associated perceived stigma. He noted that suicide is the 17th leading cause of death in those aged 65 and older.

“When you’re depressed, you’re not good at coping with your physical conditions. Depression impacts the person who is experiencing it, and their families. Who wants to visit people when they aren’t happy? Then they’re alone.”

Burkhardt recommended that people watch for changes in behavior, thoughts, appetite, sleep and whether they lose interest in activities once important to them. “See a provider if you suspect depression. Don’t let stigma keep you from getting help. Don’t isolate yourself. Be social, stay active and have a daily structure.”

 

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.”

Mini Medical School continues with tips for relieving stress, cooking demo

The College of Community Health Sciences is continuing its Mini Medical School program—a lecture series for The University of Alabama’s OLLI program—by beginning in April with two CCHS faculty.

Harriet Myers, assistant dean for Medical Student Education and clinical psychologist at the College’s University Medical Center, presented on handling stress and the chronic effects of too much stress. Suzanne Henson, registered dietitian in Family Medicine, provided a cooking demonstration and recipes for two healthy dishes.

The Mini Medical School Program 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.

OLLI, short for Osher Lifelong Learning Institute, is a member-led program catering to those aged 50 years and older and offers educational courses as well as field trips, socials, special events and travel.

Myers presented her lecture “Stress and Illness” on April 19.

Some side effects of stress, like a headache, can be felt immediately, she said. But too much stress over a long period of time can have chronic health side effects, including difficulty sleeping, an upset stomach, high blood pressure, sexual and reproductive issues and a weaker immune system.

Myers said that mindfulness can be used to combat stress on an “hour-by-hour, moment-by-moment basis.” She provided tips for practicing mindfulness through breathing exercises as well as through calming, “judgment-free” thoughts.

“The mind, when not actively solving a problem, is constantly criticizing itself or others,” she said. “Practicing mindfulness is a change in the habitual, automatic way the brain works.”

Henson provided a cooking demonstration for participants on April 26.

The first recipe she demonstrated was a pasta with spicy peanut sauce. She suggested using protein-fortified pasta, as older patients often need more protein in their diets. And she also suggested modifications for participants with arthritis, such as using pre-sliced frozen vegetables.
She also provided a dessert of fresh strawberries and key lime yogurt flavored with a bit of coconut oil. The dessert had a low amount of sugar, she said.

Mini Medical School Lecture Series Continues

Three faculty and one family medicine resident at the College of Community Health Sciences continued the Mini Medical School program—a lectures series for The University of Alabama’s OLLI program.

The Mini Medical School program 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.

OLLI, short for Osher Lifelong Learning Institute, is a member-led program catering to those aged 50 years and older and offers educational courses as well as field trips, socials, special events and travel.

Dr. Jane Weida, associate professor of Family Medicine and associate director of the College’s Family Medicine Residency, presented a talk on Feb. 4 titled “Family Medicine Cares: Helping Haiti Heal.”

Family Medicine Cares is a humanitarian program of the American Academy of Family Physicians, which works to provide sustainable health care to underserved populations in the United States and throughout the world.

The program first sent a group of physicians and educators to Haiti in 2010 after a 7.0 magnitude earthquake devastated the country, one of the poorest in the Western Hemisphere. More than 100,000 people perished in the first 60 seconds of the earthquake. Rescue efforts were hampered by no electricity, no cellular phone reception, hospitals were overwhelmed and the country’s only airport was destroyed. Some 250,000 homes and 30,000 commercial buildings were destroyed or severely damaged. Tent cities struggled to accommodate more than 1.5 million people left homeless; that number remained at 150,000 as late as 2014.

“It’s been six years since the earthquake but there’s still a lot of need,” Weida said.

Weida was part of a group from Family Medicine Cares that traveled to Haiti in 2014. The group was comprised of 22 people, including 17 physicians, and they brought needed medications with them. Once in Haiti, the group divided into three teams to provide patient care, medical education and service projects.

The patient care team treated more than 550 patients, which included conducting more than 130 well-child checkups, a rarity in Haiti. The medical education team conducted a full-day symposium for health care providers there on geriatric and preventive medicine. The team also conducted a faculty development workshop for medical school faculty on teaching residents and medical students, accessing medical information on the intranet and funding research. The service team painted three schools and an orphanage, three exam rooms and distributed vitamins.

Weida said future plans for Family Medicine Cares and its work in Haiti include providing continued support for residencies via faculty development and donation of medical equipment, providing continuing medical education for physicians and increasing exposure to family medicine in medical schools.

“Are we making a difference? I think we are,” Weida said.

Dr. James Robinson, the College’s Endowed Chair of Sports Medicine, presented his talk, “Preventing Athletic Injuries in the Elderly,” on Feb. 11.

Robinson said the process of aging results in a decrease of VO2 max, which is the maximum volume of oxygen a person uses. By age 65, 60 percent of one’s VO2 max is lost, and the maximum heart beat is 40 beats per minute.

This can be countered by exercise, Robinson said. He said the recommended amount of exercise for the elderly is two and a half hours per week. He said both cardio and strength training are important forms of exercise.

“You don’t have to go out and run a marathon,” Robinson said. “Walking, gardening and dancing are good exercises. Bicycle riding is easy on the joints.”

He also suggested yoga or tai chi classes, which are good for balance, which is especially a concern for the elderly. Falls are leading cause of injury-related deaths and account for 10 percent of ER visits with the elderly, he said.

To prevent injury from exercise, Robinson said to choose an activity appropriate for one’s fitness level and to work gradually at it overtime. He said to allow time for recovery after exercise, and to be mindful of nutrition.

“Water is your best fluid, and carbohydrates are your main fuel for exercise,” he said.

Dr. Anne Halli-Tierney, a geriatrician and assistant professor of Family Medicine, presented a lecture Feb. 18 titled “Dementia and delirium: Evaluation and management.” Or: “I’ve lost my mind.”

She said dementia is a loss of cognitive functioning with symptoms lasting for at least six months. Dementia can result from Alzheimer’s disease, vascular dementia caused by large and small strokes, and traumatic brain injuries. Alzheimer’s disease is the most common cause of dementia, she said, and over the course of the condition there is generally a clinical loss of memory, delusions and paranoia and a loss of ability to coordinate and swallow.

There is medication that can stabilize memory and treat dementia symptoms. Intellectual stimulation and good cardiovascular health are also important. “There are treatments for dementia, but no cure,” Halli-Tierney said. “People need to keep intellectually and physically active by reducing their cardiovascular risk and boosting their overall brain reserve.” She suggested reading, art, music, cross word puzzles, gardening and social interaction to stimulate the brain, and attention to diet and exercise to maintain good cardiovascular health.

Unlike dementia, many causes of delirium – fluctuating attention and level of consciousness – are reversible, Halli-Tierney said. Causes of delirium include infections, reactions to medication, sensory deprivation or overstimulation, metabolic disturbances and depression and anxiety.

She said delirium can often be countered by appropriate use of glasses and hearing aids, limiting noise, checking for infection and allowing for rest.

Dr. Jason Clemons, a third-year resident at The University of Alabama Family Medicine Residency, which the College operates, presented “Diabetes: Managing Your Sugars” on Feb. 25.

More than 25 million people in the United States have diabetes, Clemons said, and that by 2050, there will be 40 million Americans with type 2 diabetes.

“As physicians, we are supposed to be educating patients,” he said. “When you look at that number, it’s obvious we’re not doing something right.”

Clemons explained the science behind type 1 diabetes, which is a genetic disorder where the body doesn’t produce insulin, and type 2 diabetes, where the body either doesn’t produce enough insulin or is resisting insulin.

He said that the key to controlling diabetes is in exercise, diet and medications. Of the 25 million who have diabetes in the US, three-fourths manage it with lifestyle modifications, oral medications or both.

When it comes to eating right, Clemons gave the advice to shop the outside perimeter of the grocery store, and to eat a balanced diet. He provided handouts to participants with a food guide.

Three types of medications are used to manage diabetes: metformin, glyburide, and insulin. Metformin is the most common and the safest, he said. It is free at some grocery stores.

Exercising for 30 minutes four to five times a week is ideal, Clemons said.

“But be realistic. Start where you can. If you can only walk five minutes, start there. Then add one minute each week.”

Dr. Thomas Weida, chief medical officer of the College, will present on March 3, “To Be or Not to Be: Health Care Reform.”

Blum presents at Mini Medical School, WVUA reports

Dr. Alan Blum, founder and director of UA’s Center for the Study of Tobacco and Society, presented a lecture on January 28, 2016, as part of a series of lectures for the University’s OLLI Program provided by faculty from UA’s College of Community Health Sciences.

Blum, the Gerald Leon Wallace, MD, Endowed Chair of Family Medicine for the College and one of the nation’s foremost authorities on the history of smoking and cigarette marketing, provided his lecture, “Fighting Smoke with Fire: Successes and Failures, Myths and Realities in Taming the Tobacco Pandemic,” as part of OLLI’s Mini Medical School program.

Watch the report here:

The Mini Medical School program 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.

OLLI, short for Osher Lifelong Learning Institute, is a member-led program catering to those aged 50 years and older and offers educational courses as well as field trips, socials, special events and travel.

Blum’s lecture covered the history of tobacco use, the impact of tobacco advertising and propaganda, and the health risks related to smoking, such as cancer, heart disease and respiratory diseases. He talked about the prevalence of cigarettes even in the health care industry, and recalled that his father, a family medicine physician, smoked cigarettes.

CCHS Faculty Offer Mini Medical School through OLLI

 

Dr. Alan Blum, founder and director of UA’s Center for the Study of Tobacco and Society, presented a lecture on January 28, 2016, as part of a series of lectures for the University’s OLLI Program provided by faculty from UA’s College of Community Health Sciences.

Blum, the Gerald Leon Wallace, MD, Endowed Chair of Family Medicine for the College and one of the nation’s foremost authorities on the history of smoking and cigarette marketing, provided his lecture, “Fighting Smoke with Fire: Successes and Failures, Myths and Realities in Taming the Tobacco Pandemic,” as part of OLLI’s Mini Medical School program.

The Mini Medical School program 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.

OLLI, short for Osher Lifelong Learning Institute, is a member-led program catering to those aged 50 years and older and offers educational courses as well as field trips, socials, special events and travel.

Blum’s lecture covered the history of tobacco use, the impact of tobacco advertising and propaganda, and the health risks related to smoking, such as cancer, heart disease and respiratory diseases. He talked about the prevalence of cigarettes even in the health care industry, and recalled that his father, a family medicine physician, smoked cigarettes.

Blum also said that since 1964, the year of the Surgeon General’s Report on Smoking and Health, more than 20 million people have died from causes related to smoking, and that 480,000 smoking-related deaths occur yearly.

He also compared the prevalence of smoking and the amount of smoking-related and second-hand smoking-related deaths, in Alabama compared to the rest of the United States.

“The smoking prevalence here (in Alabama) is astronomical,” he said.

He answered questions from the audience about addiction and the benefits of quitting tobacco. Blum said he wanted the audience to know that he understands the difficulties of quitting.

“I have a lot of sympathy for people who are addicted to cigarettes,” he said.

Blum’s lecture was the third in the Mini Medical School program. CCHS Dean Dr. Richard Streiffer presented the first lecture on January 14 titled “Choosing Wisely: Picking the Best Medical Care.”

Streiffer’s lecture was meant to equip learners with the resources to choose the best health care for their needs. He said to be wary of over-diagnosing, something many doctors may do to be on the safe side or to keep their patients happy, but that Streiffer said can lead to harm—physically, emotionally and financially. For instance, a doctor may recommend an unnecessary screening that could put a patient at physical risk. Or, a patient may request an antibiotic when it is unnecessary, but the physician still fills the request.

Streiffer said to expect clear information from a physician, to take an active role in one’s own health care, strive for mutually agreed upon goals and to find a physician who provides encouragement, empathy and praise.

“Familiarity and a having relationship with your physician is key,” Streiffer said. “If we know each other, we are more likely to do the right thing for your health.”

Dr. Joseph Fritz, a family medicine physician who practices at University Medical Center-Northport, which the College operates, provided the second lecture on January 21 titled “The Beat Goes On: Atrial Fibrillation.”

Atrial fibrillation is an irregular heartbeat that increases the risk of stroke and heart disease. Signs include dizziness, weakness and fatigue. The condition can be caused by long-standing hypertension, congenital heart defects, heart failure, inflammation of the heart, hyperthyroidism, pneumonia, alcoholism and drug abuse, Fritz said.

He said most people diagnosed with atrial fibrillation are older; less than 1 percent are under the age of 60. “Atrial fibrillation is more common among females, and sometimes there is a family history,” he said.

Fritz said treatment involves medication and lifestyle changes, and sometimes procedures such as ablation.

There are a total of eight lectures in the Mini Medical School program. Future lectures include: “Family Medicine Cares: Helping Haiti Heal” on February 4, presented by Dr. Jane Weida, a family medicine physician and associate director of the College’s Family Medicine Residency; “Preventing Athletic Injuries in the Elderly” on February 11, presented by Dr. Jimmy Robinson, the College’s Endowed Chair of Sport Medicine; “Delirium: I’ve Lost My Mind” on February 18, presented by Dr. Anne Halli-Tierney, a geriatrician who operates University Medical Center’s Geriatric Clinic; “Diabetes: Managing Your Sugar” on February 25, presented by Dr. Jason Clemons, a resident in the College’s Family Medicine Residency; and “To Be or Not To Be: Health Care Reform” on March 3, presented by Dr. Tom Weida, the College’s associate dean for Clinical Affairs and chief medical officer of University Medical Center.