POPULARITY
How can high-stakes surgical cases be optimized for teaching while ensuring patient safety and trainee growth? On this episode of BackTable Urology, Dr. Ruchika Talwar interviews Dr. Kelvin Moses about intentional strategies for surgical education, especially during complex urologic oncology operations. They discuss workflows that prioritize preoperative planning, structured debriefs, and progressive autonomy for trainees, as well as the importance of psychological safety and open communication with patients and families. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:19 - Teaching In High Stakes Cases07:57 - Rethinking See One, Do One, Teach One10:24 - Assessing Trainee Readiness14:29 - Preop Preparation 16:06 - Teaching Cues in the OR 17:42 - Tips for Trainees21:40 - Intentional Teaching24:02 - Teaching Rare and Complex Cases26:40 - Anticipating Complications and Debrief After Disaster33:09 - Psychological Safety In the OR37:41 - Reflections on Past, Current, and Future Training Models43:56 - Patients And Trainees46:51 - Takeways --- More about this episode The conversation explores practical intraoperative teaching cues, tips for trainees such as visualization, recording cases, and repetition, and methods for relating rare cases to more common procedures. Dr. Moses reflects on the strengths and challenges of past, present, and future training models, including the debate over whether surgical education has gone “too soft.” The episode emphasizes the value of mentorship, transparency with patients, and the need to continually adapt surgical training for the next generation. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Once your PERT is assembled, how do you navigate the evolving pulmonary embolism (PE) literature to improve patient outcomes at all risk levels? In this episode of the BackTable Podcast, interventional radiologist Dr. Robert Lookstein (Mount Sinai) and pulmonary critical care specialist Dr. Timothy Fernandes (UC San Diego) join host Dr. Harris Chengazi to examine the latest evidence and multidisciplinary strategies for managing acute pulmonary embolism. The discussion highlights the complexities of catheter-directed therapies in intermediate- to high-risk PE, evolving guidelines in the face of new trial data, and prioritization of improving patients' clinical trajectories. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:57 - PERT Structure and Activation08:24 - PE Risk Stratification Tools12:02 - Patient Selection for IR Intervention15:21 - Assessing Clot Chronicity21:03 - Standardizing Workup26:38 - Managing Unstable PE28:31 - STORM-PE and HI-PEITHO Trial Data35:49 - Guidelines vs. New Evidence40:12 - Determining Therapeutic Endpoints45:05 - Upcoming Trials and Future Directions51:46 - Final Thoughts and Closing Remarks --- More about this episode The physicians explore the nuances of validated PE risk stratification tools, assessing the relationship between various PE scoring systems and the 2026 ACC/AHA classification for acute PE. They emphasize that the integration of clinical assessment, serial lab work, and patient history must take precedence over static imaging alone in guiding care. The doctors go on to review new trial data, including the improved RV-to-LV ratio and 90-day functional gains seen with mechanical thrombectomy in STORM-PE and reduced clinical deterioration observed with ultrasound-assisted catheter-directed thrombolysis in HI-PEITHO. The conversation concludes with a call for collaborative, safety-first management that focuses on the patient's clinical status and long-term post-PE functional recovery. --- Resources 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adultshttps://doi.org/10.1161/CIR.0000000000001415 Composite Pulmonary Embolism Shock (CPES) Scorehttps://doi.org/10.1161/CIRCINTERVENTIONS.124.014088 FOCUS studyhttps://doi.org/10.1093/eurheartj/ehac206 STORM-PE trialhttps://doi.org/10.1161/CIRCULATIONAHA.125.077232 HI-PEITHO trialhttps://doi.org/10.1056/nejmoa2516567 PE-TRACT studyhttps://petractstudy.org/homepage PEERLESS II studyhttps://clinicaltrials.gov/study/NCT06055920 PERSEVERE trialhttps://clinicaltrials.gov/study/NCT06588634 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Is an elevated prostate-specific antigen (PSA) the beginning or the end of the prostate cancer workup? On this episode of BackTable Urology, Dr. Ruchika Talwar interviews Dr. Tarik Benidir to explore the “PSA problem,” explaining why PSA is biologically useful but clinically imprecise, often leading to false positives, unnecessary biopsies, and detection of indolent disease. They discuss a rational, patient-centered approach to elevated PSA, including when to repeat the test, how to interpret results in the context of age, race, family history, and prostate size, and the use of PSA density and age-adjusted norms instead of rigid cutoffs. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byCleveland Diagnosticshttps://www.isopsa.com/ --- Timestamps 00:00 - Introduction04:03 - Why PSA Can Be Misleading06:43 - Approach to Elevated PSA and Initial Workup09:51 - MRI, PSA Density, and Biomarker Testing14:31 - Guidelines, Diagnostics, and When to Biopsy20:16 - Comparing 4K, IsoPSA, and Other Biomarkers25:23 - Choosing Between Transperineal and Transrectal Biopsy28:42 - Management Considerations for Elderly and Comorbid Patients33:09 - Active Surveillance, Recurrence, and Long-Term Monitoring40:47 - Key Takeaways and Closing Remarks --- More about this episode The conversation highlights the role of reflex biomarkers, MRI scans, and selective biopsy strategies to reduce unnecessary procedures and focus on identifying clinically significant cancers. Dr. Benidir explains how to weigh MRI results, when to use biomarkers, and how to approach decisions in elderly or comorbid patients. They also discuss new biopsy modalities, active surveillance, and future directions for optimizing PSA-based screening and management. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What if your pharmacist could help optimize a patient's asthma treatment before their next clinic visit? On this episode of the BackTable ENT & Allergy Podcast, Dr. Basil Kahwash welcomes clinical pharmacist Dr. Joelle Ayoub to discuss how ambulatory care pharmacists can partner with ENT and allergy clinics to optimize asthma management. Dr. Ayoub shares her experience working in a family medicine clinic, collaborating with providers through referrals, reviewing medications, and providing direct patient education on inhaler use and disease management. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:40 - The Role of the Clinic Pharmacist05:04 - Teaching Patients and Improving Inhaler Technique12:36 - Choosing Inhalers and Applying Guidelines18:51 - Comparing MDI, DPI, and SMI Devices28:15 - Tracking Asthma Control and Monitoring Adherence33:55 - Inhaler Education and Overcoming Barriers40:00 - Using Social Media for Patient and Provider Education44:16 - Pharmacist Collaboration and the Future of Team Care50:58 - Answering Biologics Patient Questions53:15 - SMART Therapy and Digital Inhaler Advances55:19 - Wrap Up --- More about this episode They discuss common gaps in asthma care, with a focus on inhaler technique and medication adherence. Dr. Ayoub explains how device complexity, cost, and a patient's ability to use their inhaler can all affect treatment. She also reviews the major inhaler types, common technique errors, and what to consider when choosing the right device for each patient. With this, Dr. Ayoub shares practical approaches to adherence monitoring, asthma guideline updates, and biologic monitoring. Throughout, Dr. Ayoub emphasizes the benefits of multidisciplinary collaboration and how pharmacists can help bridge gaps in care for patients with asthma. --- Resources Joelle Ayoub, PharmD, BCACP, APh - https://www.westernu.edu/bios/?bio=jayoub --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Are we addressing sexual health in clinical practice? On this episode of BackTable Women's Health, host Dr. Nicole Faulkner is joined by Dr. Christine Vaccaro, a double board-certified urogynecologist and sexual medicine specialist, to discuss the evaluation and care of women's sexual health concerns. They highlight the importance of open conversations, patient empowerment, and a multidisciplinary approach to support well-being and improve quality of life. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:01 - What Is Sexual Medicine07:58 - Understanding Libido, Arousal, and GSM15:54 - Clinic Visit Structure and Patient Counseling19:17 - Clitoral Exam, Adhesions, and Anatomy Education28:17 - Addressing Stigma, Patient Education, and Myths32:03 - Tools for Patient Empowerment: Apps and Self-Examination39:55 - In-Office Procedures, Pain Mapping, and Hormonal Considerations46:37 - Managing Complex Cases and Multidisciplinary Collaboration53:47 - Closing Remarks --- More about this episode The conversation explores practical strategies for evaluating and managing issues such as libido, arousal, orgasm, and sexual pain, with a focus on genitourinary syndrome of menopause (GSM) and clitoral anatomy. Dr. Vaccaro shares her approach to assessing clitoral adhesions, pelvic pain, and hormonal changes, as well as effective ways to educate patients about anatomy and self-examination. They discuss the importance of reducing stigma, addressing misconceptions, and using a multidisciplinary approach to improve patient outcomes. The episode also highlights the role of clinician training, patient-centered counseling, and collaborative care in supporting women's sexual health across the lifespan. --- Resources International Society for the Study of Women's Sexual Health: https://www.isswsh.org/ Female Orgasmic Disorder: Current Understanding and Clinical Management: https://pubmed.ncbi.nlm.nih.gov/42314165/ OMGyes: https://www.omgyes.com/join You Are Not Broken by Dr. Kelly Casperson: https://kellycaspersonmd.com/you-are-not-broken-book/ Retrospective Study of the Prevalence and Risk Factors of Clitoral Adhesions: Women's Health Providers Should Routinely Examine the Glans Clitoris - https://academic.oup.com/smoa/article/6/2/115/6956478?login=false Clitoral Adhesiolysis: Technique and Patient Selection - https://www.vjsm.info/videos/all/clitoral-adhesiolysis-technique-and-patient-selection Female Orgasmic Disorder: Current Understanding and Clinical Management - https://pubmed.ncbi.nlm.nih.gov/42314165/ --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How do you navigate the evolving science and controversy of concussion care in athletes and beyond? On this episode of BackTable Bone & Sports, Dr. Larry Balle welcomes Dr. Ryan Stempniak to break down the fundamentals and emerging advances in concussion management. They define concussion pathophysiology, highlight why most injuries occur without loss of consciousness, and discuss delayed symptom onset that can complicate diagnosis and treatment. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction07:16 - Who Manages Concussions?12:21 - Defining and Understanding Concussions23:31 - Injury Mechanisms and Pathophysiology26:56 - Recognizing and Grading Symptoms35:00 - Assessment Tools: SCAT6 vs. SCOAT38:34 - Return-to-Play and Return-to-Learn50:42 - Medications, Supplements, and Treatment Advances57:10 - Concussion Subtypes and Individualized Care01:02:01 - Helmets, Wearables, and Emerging Technology01:10:11 - AI, Imaging, and Research Directions01:13:01 - Myths, Facts, and Protocol Updates01:16:57 - Closing Thoughts --- More about this episode The conversation covers mechanisms of injury, symptom assessment, sideline and office evaluation, and the critical role of return-to-learn before return-to-play. Drs. Balle and Stempniak discuss concussion subtypes, medication and supplement limitations, and the latest on helmets, wearables, and AI-driven research. They also emphasize individualized care plans, the importance of school and work accommodations, and practical strategies for clinicians managing this complex and ever-changing condition. --- ResourcesDr. Ryan Stempniakhttps://www.linkedin.com/in/ryan-stempniak-843545295/ --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Why do nearly half of IR residents consider leaving the specialty, and what can be done to change that? On this episode of the BackTable Podcast, Dr. Neil Jain interviews Dr. David Mittelstein, an integrated IR resident at UC San Diego and co-chair of the SIR RFS Recruitment Committee, about the findings of a national SIR survey on interventional radiology resident attrition. They discuss what drives uncertainty, from lifestyle and call burden to job market fears, and highlight the program features that encourage retention, such as structured training, high case volume, and a culture of camaraderie. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction04:31 - From Biomedical Engineering to IR07:41 - Recruitment Committee Mission12:37 - Match Trends Warning Sign15:12 - Survey Design Demographics20:21 - What Factors Matter25:04 - Why Residents Consider Switching30:23 - Recommendation 1 IR Curriculum32:32 - Recommendation 2 More IR Rotation34:10 - Recommendation 3 Build Camaraderie38:30 - Advice for Residents Who Are Doubting41:00 - What's Next for RFS Recruitment43:20 - Wrap Up --- More about this episode The conversation explores free-response themes from the survey, where 78 percent of residents cited lifestyle concerns, 31 percent pointed to job market uncertainty, and 22 percent mentioned call experience as reasons for questioning IR. Retention was linked to structured training (38 percent), high case volume and procedural experience (35 percent), and program camaraderie (18 percent). Dr. Mittelstein and Dr. Jain review three concrete recommendations to improve retention, examine early changes at programs like Georgetown, and offer practical advice to residents who may be quietly doubting their path in IR. --- Resources Episode # 554 Optimizing the IR/DR Curriculum & Experience https://www.backtable.com/shows/vi/podcasts/554/optimizing-the-ir-dr-curriculum-experience --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What should you do differently when a UTI becomes a recurring problem? In this episode of the Backtable Podcast, host Dr. Anjali Kapur is joined by physician-scientist Dr. Glenn Werneburg to discuss the latest approaches to recurrent urinary tract infections, including key updates from the 2025 AUA, CUA, and SUFU guidelines. They use real clinical cases to explore diagnosis, prevention, antibiotic selection, and the management of complex patients. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Medtronichttps://www.medtronic.com/en-us/e/patients-caregivers/urinary/overactive-bladder.html --- Timestamps 00:00 - Introduction04:05 - Case One: Recurrent UTIs05:19 - Workup Basics08:50 - Non-Antibiotic Prevention11:42 - Antibiotic Prophylaxis Options15:16 - Case Two: Asymptomatic Bacteriuria 19:14 - Case Three: Complex Patients19:58 - Male vs. Female UTIs21:22 - Neurogenic Bladder Workup22:52 - Elderly Patients and ID Consults25:01 - Case Four: Transplant ESBL25:23 - Machine Learning for Antibiotics 29:49 - Catheter Biofilms31:55 - Embedded Bladder Reservoirs35:23 - Recurrent UTI Vaccine36:23 - Future of Recurrent UTIs39:04 - Wrap Up --- More about this episode The doctors define recurrent UTI and outline the standard workup, including history, physical and pelvic exam, urinalysis, urine culture, and antibiotic sensitivities. They also review occasions where additional testing may be warranted. The discussion covers interpretation of urinalysis, non-antibiotic prevention options, and antibiotic prophylaxis strategies, with consideration of antibiotic resistance and microbiome disruption. They address asymptomatic bacteriuria and when treatment is indicated, along with management considerations for men, patients with neurogenic bladder or CIC, and elderly patients. Dr. Werneburg also discusses his work with machine learning tools to predict antibiotic susceptibility earlier, catheter biofilms, the concept of embedded bladder bacteria reservoirs, and his multidisciplinary complex UTI clinic. --- Resources Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025)https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Aspirin or biologics? How do you choose the right treatment for AERD? On this episode of the BackTable ENT & Allergy Podcast, Dr. Basil Kahwash interviews Dr. Andrew White, Director of the AERD Clinic at Scripps Clinic, to discuss the diagnosis and management of this often underrecognized condition. They cover practical strategies for identifying AERD, the importance of a detailed NSAID history, and how treatment decisions are shaped by patient goals and disease severity. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:08 - What Is AERD and Prevalence 06:32 - History Taking and Mechanism 11:10 - Typical Symptom Progression and Alcohol Intolerance 16:41 - When to Do Aspirin Challenge 19:00 - Challenge Protocol And Upper Airway Reactions24:53 - Aspirin Desensitization vs Challenge27:58 - Aspirin therapy after desensitization and Risk of GI Bleeds31:17 - Biologics Change AERD33:42 - Choosing Aspirin Desensitization vs Biologics 35:52 - Patient Counseling and Motivational Interviewing 41:26 - Convenience and Cost of Therapy 44:10 - ENT Allergy Collaboration47:22 - Rapid Fire Pearls51:13 - Future Research & Management Direction54:05 - Final Takeaways --- More about this episode Dr. White explains that AERD affects about 8 to 10 percent of asthmatics, with even higher rates in those with severe asthma or nasal polyps. He reviews typical adult-onset progression, alcohol-related respiratory symptoms, and the underlying pathophysiology, including imbalances in arachidonic acid mediators and leukotriene surges after NSAID exposure.The conversation includes practical questions to ask when taking an NSAID history, such as reactions to common pain relievers or alcohol, and when to consider aspirin challenge. Dr. White also details long-term treatment strategies, including the role of biologics like dupilumab and aspirin therapy after desensitization, with considerations for dosing and gastrointestinal risk. He explains how factors like asthma severity, recurrent polyp disease, sense of smell, cost, and convenience all influence therapy choice. The episode concludes with a discussion of multidisciplinary collaboration, patient counseling, and Dr. White's insights on future research directions in AERD management. --- Resources Aspirin sensitivity and severity of asthma: evidence for irreversible airway obstruction in patients with severe or difficult-to-treat asthmahttps://pubmed.ncbi.nlm.nih.gov/16275362/ Polyphenolic Activation of Basophils Explains Alcohol Hypersensitivity in AERDhttps://pubmed.ncbi.nlm.nih.gov/41065188/ New insights into the mechanisms of aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/39641750/ The role of aspirin desensitization followed by oral aspirin therapy in managing patients with aspirin-exacerbated respiratory disease: A Work Group Report from the Rhinitis, Rhinosinusitis and Ocular Allergy Committee of the American Academy of Allergy, Asthma & Immunologyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC7980229/ Safety and outcomes of aspirin desensitization for aspirin-exacerbated respiratory disease: A single-center studyhttps://pubmed.ncbi.nlm.nih.gov/28550988/ Selection of aspirin dosages for aspirin desensitization treatment in patients with aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/17208597/ Factors influencing aspirin therapy after desensitization (ATAD) tolerance in aspirin-exacerbated respiratory disease (AERD) patientshttps://pubmed.ncbi.nlm.nih.gov/41022281/ Feed the Good Wolf: Motivational Interviewing, Cognitive Behavioral Therapy, and Mindsethttps://pubmed.ncbi.nlm.nih.gov/42103433/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What should you do differently when a UTI becomes a recurring problem? In this episode of the Backtable Podcast, host Dr. Anjali Kapur is joined by physician-scientist Dr. Glenn Werneburg to discuss the latest approaches to recurrent urinary tract infections, including key updates from the 2025 AUA, CUA, and SUFU guidelines. They use real clinical cases to explore diagnosis, prevention, antibiotic selection, and the management of complex patients. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:05 - Case One: Recurrent UTIs05:19 - Workup Basics08:50 - Non-Antibiotic Prevention11:42 - Antibiotic Prophylaxis Options15:16 - Case Two: Asymptomatic Bacteriuria 19:14 - Case Three: Complex Patients19:58 - Male vs. Female UTIs21:22 - Neurogenic Bladder Workup22:52 - Elderly Patients and ID Consults25:01 - Case Four: Transplant ESBL25:23 - Machine Learning for Antibiotics 29:49 - Catheter Biofilms31:55 - Embedded Bladder Reservoirs35:23 - Recurrent UTI Vaccine36:23 - Future of Recurrent UTIs39:04 - Wrap Up --- More about this episode The doctors define recurrent UTI and outline the standard workup, including history, physical and pelvic exam, urinalysis, urine culture, and antibiotic sensitivities. They also review occasions where additional testing may be warranted. The discussion covers interpretation of urinalysis, non-antibiotic prevention options, and antibiotic prophylaxis strategies, with consideration of antibiotic resistance and microbiome disruption. They address asymptomatic bacteriuria and when treatment is indicated, along with management considerations for men, patients with neurogenic bladder or CIC, and elderly patients. Dr. Werneburg also discusses his work with machine learning tools to predict antibiotic susceptibility earlier, catheter biofilms, the concept of embedded bladder bacteria reservoirs, and his multidisciplinary complex UTI clinic. --- Resources Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025)https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How have modern surgical techniques, pain management algorithms, and focus on rehabilitation transformed joint replacement outcomes? On this episode of BackTable Bone & Sports, Dr. Larry Balle welcomes Dr. William Bryan of Houston Methodist to share his insights from decades of experience in orthopedic surgery and sports medicine. Dr. Bryan reflects on his journey from mentorship under Dr. George Lane and Dr. Michael DeBakey to serving as team physician for the Houston Astros, emphasizing the importance of restoring normal function and keeping patients active. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:55 - Praising Mentorship11:59 - Evolution of Total Joint Care18:44 - Optimizing Pain Control Post-TKA30:42 - Discussing Operative Approach, Implants, and Emergence of Robotics38:21 - Longevity of TKAs in More vs. Less Active Patients41:58 - Knee Pain Eliciting Surgical Intervention50:13 - The Balancing Act of Orthobiologics as a Conservative Modality55:44 - Imaging Myths in Total Joint Surgery58:02 - Sharing Surgical Pearls 01:03:42 - Advice for Non-Operative Colleagues01:07:38 - Final Takeaways and Wrap Up --- More about this episode The physicians explore the progression of arthritis, conservative treatment options, and the evolution of joint replacement, from early complications to advances that have improved implant longevity. They also discuss anesthesia advancements including periarticular nerve blocks, emerging calcium channel-blocker analgesics, and the use of the ROMTech home rehabilitation device. Curious about common misconceptions surrounding total joint replacement? Dr. Bryan and Dr. Balle address the role of orthobiologics, imaging myths, and other frequently misunderstood aspects of arthroplasty. Throughout the conversation, they emphasize the importance of ligament balancing, the unique challenges of treating ligamentously lax patients, and practical strategies for maintaining joint health through low-impact exercise and diet-driven weight loss. --- Resources Dr. William Bryanhttps://doctor-bryan.com/ ROMTechhttps://romtech.com/ --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How are new aspiration thrombectomy systems and real-time hemodynamic monitoring enabling safer, more effective pulmonary embolism treatment? On this episode of the BackTable Podcast, Dr. Ally Baheti welcomes Dr. Maya Serhal and Dr. David Dexter for a deep dive into modern pulmonary embolism (PE) management, with a focus on advances in large-bore aspiration thrombectomy. They discuss evolving PE triage algorithms, real-world procedural strategies, and the clinical impact of next-generation aspiration systems on safety, efficiency, and patient recovery. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Imperative Care https://imperativecare.com/ --- Timestamps 00:00- Introduction02:03- PE Response Workflow05:32- Symphony Device07:07- Sizing and Blood Loss10:00- Multi-Port Hemodynamics14:45- Procedure Endpoints17:01- IVUS Guided Strategy20:02- ProHelix and Lollipopping25:48- Case Studies34:12- Closing Thoughts --- More about this episode The conversation explores multidisciplinary PE response workflows, lab and imaging triggers for escalation, and technical considerations in catheter sizing, blood loss management, and real-time hemodynamic monitoring. Dr. Dexter reviews his use of intravascular ultrasound for precise clot localization, and Dr. Serhal shares practical tips for adjusting aspiration power to avoid complications. Together, they discuss procedural endpoints, mechanical assist devices for difficult clots, and present case examples demonstrating rapid improvement in hemodynamics and oxygenation. The episode emphasizes the importance of teamwork, patient selection, and ongoing innovation in optimizing PE care. --- Resources American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolismhttps://ashpublications.org/bloodadvances/article/4/19/4693/463998/American-Society-of-Hematology-2020-Guidelines-for Prospective Multicenter IDE Study of the Next-Generation Precision Aspiration Thrombectomy System for Intermediate-Risk Pulmonary Embolism: The SYMPHONY-PE Trialhttps://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.125.015815 Is There a Golden Hour for Thrombectomy in Intermediate-Risk Pulmonary Embolism? Insights From SYMPHONY-PEhttps://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.126.016573--- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How can we best manage intermediate-risk bladder cancer to balance disease control, quality of life, and the growing range of treatment options? On this episode of the BackTable Urology Podcast, Dr. Ruchika Talwar interviews Dr. Charles “Chaz” Peyton about the challenges of treating recurrent low-grade, intermediate-risk non–muscle invasive bladder cancer. They highlight the high recurrence but low progression risk, the often-underappreciated impact of repeated TURBTs on patient well-being, and the evolving landscape of office-based and chemoablative therapies. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction05:58 - Comparing Office Ablation and OR TURBT08:26 - TURBT Impact on Quality of Life11:37 - Uncovering Hidden Patient Burdens and Costs14:44 - Integrating Chemoablation into Practice18:20 - ENVISION QoL Study Setup22:04 - Comparing TURBT Preferences27:40 - Counseling Risk-Averse Patients29:10 - Community Adoption Advice31:59 - Upcoming Clinical Trials35:28 - Biomarkers and Expanding Access36:23 - Final Thoughts and Closing Remarks --- More about this episode The conversation covers practical strategies like office-based surveillance and fulguration for small recurrences, identifying triggers for returning to the OR, and recognizing the hidden burdens of TURBT complications such as hematuria, incontinence, and unplanned ER visits. Dr. Peyton reviews the role of chemoablative options for selected patients, discusses trial data on patient-reported outcomes, and addresses the mixed evidence, high costs, and need for individualized decision-making. The episode also explores new intravesical and FGFR-targeted therapies, underscores the importance of cost-conscious adoption and biomarkers, and considers how management approaches must evolve, especially in community practice settings. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Can viewing the airway as one connected system change the future of respiratory care and improve patient outcomes? On this episode of the BackTable ENT & Allergy Podcast, Dr. Cedric Jamie Rutland, pulmonary and critical care medicine physician, joins Dr. Basil Kahwash to discuss the unified airway hypothesis and its implications for clinical care. They explore how upper and lower airway inflammation are closely linked, and why multidisciplinary collaboration is essential for treating the whole patient. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:06 - Understanding the Unified Airway14:27 - Decoding Asthma Biomarkers20:34 - Endotyping in Clinical Practice26:36 - Addressing Asthma Symptom and “Outgrowing” Asthma32:13 - Strategies for Precision Biologics34:23 - Navigating Insurance and Treatment Indications35:36 - Treating the Whole Patient and Breaking Down Specialty Silos46:07 - Effective Patient Communication51:36 - Asthma Lightning Round57:33 - Biologics and Airway Remodeling1:00:00 - Closing Thoughts --- More about this episode The conversation covers the biology of type II inflammation, the use of biomarkers and biologics for more personalized treatment, and practical strategies for overcoming insurance barriers and specialty silos. Dr. Rutland shares insights on patient communication, the limitations of current diagnostics, and the impact of chronic inflammation on systemic disease. The episode highlights the need for ENT, allergy, and pulmonology teams to work together and embrace a connected view of airway disease to achieve better patient outcomes. --- Resources Dr. Jamie Rutland - https://www.lung.org/media/meet-our-experts/cedric-jamie-rutland-md --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Have you ever wondered what role the mind could play in treating women's health conditions? On this episode of BackTable Women's Health, host Dr. Nicole Faulkner interviews Dr. Sonia Gupte, a family medicine physician and board-certified clinical hypnotherapist, about how clinical hypnotherapy can help patients access the subconscious, resolve emotional barriers, and rewire patterns that affect both body and mind. Dr. Gupte discusses the use of hypnotherapy for a range of women's health concerns including PMS, postpartum depression, hot flashes, infertility, and chronic pelvic pain, highlighting the potential for more holistic care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:40 - Discovering Hypnotherapy08:59 - What a Session Looks Like13:02 - Remote Sessions and Results17:27 - Follow-Up and Maintenance20:13 - Women's Health Examples28:05 - Talking to Patients30:47 - Hypnosis vs. Therapy33:07 - Pap Smear Trauma Case37:28 - Breathwork Reset Tool42:42 - Uncovering Repressed Trauma46:17 - Burnout and Stress49:12 - Barriers to Success53:21 - Call To Action54:58 - Live Demo Plans55:50 - Closing Remarks --- More about this episode Dr. Gupte shares how her mother's experience with cancer, depression, and a suicide attempt inspired her to explore hypnotherapy and ultimately bring it into her medical practice. She describes what a typical hypnotherapy session involves, including relaxation, guided visualization, identifying emotional roots, and using protocols to help patients “reboot” their mental patterns. The discussion also covers practical aspects of integrating hypnotherapy into women's health care, such as determining treatment frequency, offering remote sessions, setting patient expectations, and addressing common barriers to success. --- Resources Within: Finding Yourself, Fixing What's Broken, & Finally Reclaiming True Health https://enso-nia.com/about-sonia/ --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What's your game plan when heat illness strikes on the field? On this episode of BackTable Bone & Sports, Dr. Larry Balle welcomes sports medicine physician Dr. Irvin Sulapas to discuss how clinicians and athletic trainers can use wet bulb globe temperature (WBGT) and other tools to improve athlete safety. They highlight best practices for communication with coaches, modifying training protocols, and recognizing the full spectrum of heat-related illness from heat rash to syncope and exertional heat stroke. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:12 - Defining Heat Stress and Its Risks08:26 - Cooling Strategies in Sports and Mitigating Risk 17:11 - Wet Bulb Globe Temperature Explained22:37 - Collaborating with Coaches and Trainers26:02 - Identifying High Risk Athletes30:57 - Heat Acclimatization Protocols33:17 - Physical Exam for Heat Illness39:12 - When to Activate EAPs and Call EMS47:02 - Return-to-Play Guidelines49:45 - Debunking Heat Illness Myths54:11 - The Future of Heat Safety57:13 - Key Takeaways and Wrap-Up --- More about this episode The discussion covers risk stratification, early interventions like cold-water immersion and tarp-assisted cooling oscillators, and practical protocols for emergency response. Dr. Sulapas and Dr. Balle also address key physical exam findings, when to activate emergency action plans, and guidelines for returning to play after heat illness. They debunk common heat myths and look at future directions for improving heat safety in sports medicine. --- Resources Dr. Irvin Sulapashttps://www.houstonmethodist.org/doctor/irvin-sulapas/ --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How can you use social media to educate, empower, and inspire as a physician while staying true to your professional values? On this episode of BackTable Urology, guest host Dr. Maheetha Bharadwaj talks with Dr. Rena Malik and Dr. Fenwa Milhouse about building an authentic online presence that educates, inspires, and connects. The conversation highlights the power of visibility, the challenges of professional boundaries and misinformation, and the potential for social media to expand both patient outreach and career opportunities. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:17 - Getting Started on Social Media12:24 - Finding Your Niche17:04 - Being a Woman in Urology18:40 - Impact On Patient Care23:59 - Doctor-Patient Boundaries28:33 - Social Media Pitfalls38:53 - Creator Monetization45:58 - Advice for New Creators --- More about this episode They share insights from years of content creation, including tips for getting started, finding your niche, and balancing clinical work with online engagement. The discussion covers issues unique to women in urology, the impact of social media on patient care and doctor-patient boundaries, how to avoid burnout, and strategies for monetization and staying true to your message. The episode wraps up with practical advice for new creators and reflections on the privilege and responsibility of inspiring future urologists. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Are you building a business that can thrive without you, or just creating a job you can never leave? In this episode of BackTable Women's Health, host Dr. Karen Toubi sits down with Dr. Nneka Una (Unachukwu), a board-certified pediatrician, founder of Ivy League Pediatrics, and creator of EntreMD, to discuss the mindset and skills needed to build a truly sustainable medical practice. The conversation explores why physician entrepreneurship is essential in today's evolving healthcare landscape, the difference between building yourself a job and building a resilient business, and practical strategies for long-term growth. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction04:47 - From Employee to Owner05:53 - Skills That Changed Everything07:35 - The Wake Up Call10:44 - Why Doctors Resist Business15:06 - Profit as Patient Care18:20 - Job vs. Business Entity21:13 - CEO Hat and Team Systems25:14 - Exit Value and Sellability29:00 - More Profit: More Time Off30:24 - Fear Before Breakthrough35:32 - Choose Service Over Perfection39:11 - Invest in Your Potential46:26 - MEAT Week Priorities48:40 - Three-Part Daily Rhythm55:02 - Advice for Burned-Out Docs59:29 - Wrap Up --- More about this episodeDr. Una shares how doctors can overcome resistance to “business,” why every practice needs a strong business engine, and how to balance profitability with ethical, people-centered care. She explains how to shift from employee to physician-CEO, tackle imposter syndrome, and develop systems that give your practice true staying power. The discussion provides actionable advice on hiring, team management, building exit value, and creating the freedom to take more time off without sacrificing patient care or financial stability. --- ResourcesEntreMD https://entremd.com/about-us/ The Profitable Private Practice Playbook https://entremd.com/method-book/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Hypospadias can be surgically corrected early in life, but many patients drop out of care before puberty or adulthood, leaving important urinary and sexual health concerns unaddressed. On this episode of BackTable Urology, Dr. Arthi Hannallah and Dr. Nicco Passoni talk with Dr. Vinaya Bhatia about improving lifelong engagement for people with hypospadias. They highlight advances in surgical technique, the role of research, and how digital tools like the WYSH platform help keep patients and families connected to care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction04:22 - Hypospadias Overview and Symptom Chronology09:14 - Not A One Size Fits All: Developing WYSH13:28 - Reengaging Families and Patients20:04 - Adult Urology Sequelae25:08 - Demystifying Surgery and Improving Training34:00 - Centers of Excellence Debate36:56 - Future Goals and Wrap Up --- More about this episodeThe discussion covers the development and impact of the WYSH platform, strategies for supporting long-term follow-up, and the learning curve of hypospadias surgery. Dr. Bhatia shares insights on better training, the creation of centers of excellence, and the importance of ongoing research and family engagement to improve quality of life at every stage. --- ResourcesWorldwide Yearly Screening for Hypospadias: https://clinicaltrials.gov/study/NCT06966375 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
BackTable is moving beyond the traditional podcast experience and into a platform built specifically for clinicians. On this episode of the BackTable ENT & Allergy Podcast, hosts Drs. Gopi Shah and Ashley Agan welcome Dr. Aaron Fritts, interventional radiologist and BackTable CEO and Co-Founder, to discuss the history and future of BackTable, and what listeners can look forward to on the new BackTable App. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction00:51 - Meet the CEO and Co-Founder02:32 - How Backtable Got Its Name04:32 - Why Move to the App07:31 - Community and Learning Features12:36 - Playlists and Transcripts15:42 - Beyond Backtable Content18:07 - Searchability and Other Platform Limits19:35 - Privacy and NPI Verification21:31 - Download the App and Give Feedback22:53 - October Timeline and Academy Party24:26 - Closing Thoughts --- More about this episode Dr. Fritts shares how BackTable started as an app concept for medical devices in 2016, evolved into the IR podcast in 2017, and expanded to the ENT show in 2020. He explains how Gopi coined the name “BackTable” as an homage to the informal, behind-the-scenes conversations that fuel clinical learning. With eight shows now producing 30 to 40 episodes each month, BackTable will begin releasing most new podcast episodes exclusively on the BackTable app starting in October. The conversation highlights the app's robust features designed for busy clinicians, including physician-only NPI-verified guest Q&As, quick-study cases, searchable and organized playlists, episode transcripts, offline listening, upcoming CarPlay integration, and access to resources like the Curbsiders internal medicine podcast. The BackTable app is free to download and free to use, providing easy access to a growing library of high-yield medical education content. --- Resources Download the BackTable App on Google Playhttps://play.google.com/store/apps/details?id=com.backtable.app&hl=en_GB Download the BackTable App on the Apple App Store https://apps.apple.com/us/app/backtable/id6751363383 --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Every OBGYN, whether in the hospital or community, may face a high-acuity obstetric emergency. On this episode of BackTable Women's Health, Dr. Nicole Faulkner interviews OB hospitalist Dr. Katie Fung-Yip to explore the evolving role of OB hospitalists and the obstetric emergency department (OB ED) in managing critical situations. They discuss how in-hospital coverage, multidisciplinary teamwork, and dedicated triage protocols can improve emergency response and patient outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction02:42 - Breaking Down OB Roles06:01 - MFM and Hospitalist Collaboration07:35 - Inside the OB ED12:31 - High Stakes Emergencies Overview18:02 - Amniotic Fluid Embolism21:33 - Cardiac Arrest Pearls and Drills24:44 - Team Leadership Under Pressure29:19 - Emotions Debrief and Bonding37:48 - Simulation Practice and Mentorship 40:18 - Early Career Fit and Support 43:10 - Wrap Up --- More about this episodeDr. Fung-Yip explains how the hospitalist role differs from community OBGYNs, emphasizing the value of continuous in-hospital coverage for urgent and high-risk cases. She describes the spectrum of care, from routine pregnancies to complex emergencies requiring collaboration among hospitalists, maternal-fetal medicine specialists, and multidisciplinary teams. The discussion covers OB ED operations, the Maternal Fetal Triage Index, hospital design for rapid response, and review of critical emergencies such as postpartum hemorrhage and amniotic fluid embolism. Dr. Fung-Yip highlights how these events can escalate to maternal cardiac arrest, requiring immediate ACLS, team coordination, and sometimes resuscitative hysterotomy. She stresses that preparedness depends on ongoing education, simulation, mentorship, debriefing, and strong teamwork. --- ResourcesMaternal Fetal Triage Index (MFTI)https://www.awhonn.org/education/hospital-products/maternal-fetal-triage-index-mfti/ --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Time is money, but when it comes to ACL rehabilitation, the calendar alone does not determine readiness for return to play. On this episode of BackTable Bone & Sport, host Dr. Larry Balle is joined by returning guest Dr. Andy Glidewell to discuss modern protocols for anterior cruciate ligament (ACL) rehabilitation. They cover the ACL's role in knee stability, common injury mechanisms, and why moving beyond timeline-based milestones is crucial for optimal recovery. Glidewell emphasizes that while surgery reconstructs the ligament, rehabilitation is what restores true knee function. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction05:55 - Collaborative ACL Protocols 09:56 - Anatomy Review: The Role of the ACL 14:41 - ACL Rehab Misconceptions19:04 - Rehab Goal Metrics: Time vs. Subjective Measures28:55 - Early Post-Op Priorities36:26 - Tweaking ACL Protocols Based on ACL Reconstruction Graft 42:30 - Use of Orthobiologics in Surgery47:15 - Progressing BFR to ARPE to Hypertrophy in Rehab56:38 - Incorporating Plymometrics and Agility Training in ACL Rehab1:00:19 - The Mental Hurdles in ACL Rehab and Return to Sport01:08:00 - Clinical Pearls in ACL Rehab01:10:20 - Wrap Up --- More about this episodeThe conversation explores early post-operative priorities, the importance of progressive strength and functional testing, and the need for closer collaboration between surgeons and physical therapists. Additional topics discussed include shifting from time-based to subjective and objective criteria for return to sport, and evolving approaches to open-chain knee extension to address persistent quadriceps deficits and reduce anterior knee pain. --- ResourcesDr. Andy Glidewellhttps://www.trainrecovermove.com/andyglidewellpthttps://uamshealth.com/provider/michael-a-glidewell/ --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
How do you decide between a dedicated aortic scaffold and kissing stents in complex aortoiliac bifurcations? On this episode of the BackTable Podcast, Dr. Sabeen Dhand and Dr. Eric Secemsky discuss the management of a female smoker presenting with rapidly progressive bilateral hip pain, ultimately revealed to be severe aortoiliac arterial disease. The case highlights the value of noninvasive vascular studies, CTA, and IVUS for precise diagnosis and procedural planning, as well as the nuanced decision-making process between different device options. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:56 - Patient History05:42 - CTA and Angio Findings09:30 - Strategy Access and IVUS13:17 - IVUS Sizing and Lesion Review16:38 - IVL Angioplasty Technique18:28 - Stenting and Final Result22:50 - Post-procedure Meds and Outcome24:34 - Wrap Up --- More about this episode Dr. Secemsky reviews access strategy, lesion sizing, and the use of intravascular lithotripsy to reduce rupture risk in heavily calcified arteries. The doctors explain their rationale for choosing kissing covered stents over a dedicated aortic scaffold, details the technical steps of ballooning and stenting, and discusses the transition from dual antiplatelet therapy to rivaroxaban and aspirin postprocedure. The episode concludes with key insights into device selection, procedural technique, and patient-centered decision-making for successful aortoiliac interventions. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Can a drug-eluting bladder device change the treatment algorithm for BCG-unresponsive non–muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Ruchi Talwar interviews Dr. Sarah Psutka to explore the emerging role of a novel intravesical device that delivers sustained gemcitabine therapy for patients refusing or ineligible for cystectomy. They highlight new FDA-approved treatment options, real-world workflow considerations, and the clinical potential for continuous intravesical chemotherapy in a crowded therapeutic landscape. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Johnson & Johnson https://www.inlexzohcp.com/ --- Timestamps 00:00 - Introduction02:40 - Why Focus on TAR-20005:35 - Device Basics07:05 - Dosing Schedule Explained11:17 - SUNRISE-01 Trial Results15:07 - Patient Selection and Contraindications20:52 - Indications for Device Removal23:26 - Clinic Workflow Learning Curve25:56 - Tips for Insertion and Device Deployment28:52 - Cystoscopy Findings and Surveillance Protocol32:16 - Treatment Sequencing38:43 - Future Trial and Research Directions45:16 - Biomarkers, AI, and Personalizing Care46:35 - Cost, Supportive Care, and Patient Burden48:42 - Closing Thoughts --- More about this episode The conversation dives into patient selection, preparation, and side effect management for TAR-200, as well as the key findings from the SUNRISE-01 trial. Dr. Psutka discusses dosing schedules, when to remove the device, and how to handle complications like UTI, hematuria, and LUTS. The episode also covers surveillance protocols, the impact on clinic operations, and the importance of balancing vigilant cancer surveillance with patient burden. Finally, they touch on future directions, including biomarkers, AI-assisted pathology, and optimizing the timing of cystectomy and supportive care for a more personalized approach to NMIBC. --- Resources TAR-200 for Bacillus Calmette-Guérin–Unresponsive High-Risk Non–Muscle-Invasive Bladder Cancer: Results From the Phase IIb SunRISe-1 Studyhttps://ascopubs.org/doi/10.1200/JCO-25-01651 SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-muscle Invasive Bladder Cancer SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-mushttps://www.urotoday.com/conference-highlights/suo-2024/suo-2024-bladder-cancer/156723-suo-2024-sunrise-5-a-phase-iii-randomized-open-label-study-of-tar-200-compared-with-intravesical-chemotherapy-after-bacillus-calmette-guerin-in-recurrent-high-risk-non-muscle-invasive-bladder-cancer.htmlcle Invasive Bladder Cancer Gemcitabine Intravesical System Plus Cetrelimab or Cetrelimab Alone as Neoadjuvant Therapy in Muscle-Invasive Bladder Cancer: SunRISe-4 Primary Analysis and Biomarker Resultshttps://ascopubs.org/doi/10.1200/JCO-25-02382 INLEXZO - SunRISe-3 Studyhttps://www.jnjmedicalconnect.com/products/inlexzo/medical-content/inlexzo-sunrise-3-study --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What do new interventional radiologists wish they had known before starting residency? On this reflective episode of BackTable, Dr. Neil Jain is joined by chief residents Dr. Aesha Patel and Dr. Gregg Khodorov as they look back on six years of IR/DR training. They share what they wish they'd known as applicants, from the growing emotional weight of complications near graduation to the essential role of co-residents, support networks, and the evolving balance between confidence and competence. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:34 - Rapid Fire Reflections07:20 - Complications and Confidence12:01 - Applicant Misconceptions16:54 - Defining a Great Program26:38 - Lessons Learned Over Time29:12 - Pearls and Hard-Won Lessons33:09 - Valuing Bread-and-Butter Cases35:24 - Complications and Empathy41:03 - Memorable Attending Phrases 43:06 - Habits for the Future47:34 - Mentorship and Craftsmanship52:42 - IR Culture and Professional Pride57:44 - The Future of IR Training01:08:34 - Closing Thoughts --- More about this episode They discuss how their definition of a “good case” has evolved, the importance of mastering bread-and-butter procedures, and the impact of habits like detailed note-taking, patient-centered communication, and taking ownership of complications. The episode highlights ideas for future training improvements and offers advice on valuing patient interactions, embracing growth, and developing sound clinical judgment under pressure. Throughout, the conversation underscores the personal and professional growth that comes from these challenges and the lasting value of camaraderie and mentorship in interventional radiology. --- Resources Perspective on the New IR Residency Selection Process: 4-year Experience at a Large, Collaborative Training Programhttps://www.sciencedirect.com/science/article/pii/S1076633221000568 Diversity in Interventional Radiology Residency Programshttps://www.sciencedirect.com/science/article/abs/pii/S1546144025002765 Implementation and Evaluation of a Comprehensive Simulation Curriculum for the IR/DR Integrated Residencyhttps://www.sciencedirect.com/science/article/abs/pii/S107663322300051X --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
The definitive treatment for adult acquired buried penis is surgery, but successful treatment depends on having a well-coordinated network of patient support, multidisciplinary care teams, and reconstructive urologic surgery expertise. This episode of Backtable Urology overviews this multifaceted disease and dives into reconstructive surgery techniques, featuring Dr. George Koch and Dr. Paul Rusilko. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:10 - History of Buried Penis Treatment08:47 - Grafts Versus Flaps11:34 - Hidden Pathologies and Informed Consent13:46 - Research and Insurance Approval18:24 - Delayed Care and Disease Burden22:31 - Deciding When to Operate and Temporizing Procedures30:23 - Building Referral Networks33:13 - Future Directions36:42 - Infection Risk 41:15 - Technique Evolution45:57 - Preop Evaluation Essentials50:50 - Intraop Keys to Success and Graft Protection59:26 - Postop Pathway and Teamwork01:02:54 - W-Plasty Video Walkthrough01:13:52 - Wrap Up --- More about this episode The doctors explore the nuances of surgical treatment, emphasizing the importance of thorough preoperative counseling given the high likelihood of unexpected intraoperative findings and the need to adjust the surgical plan. Dr. Rusilko also discusses the broader burden of disease, including depression, strictures, occult penile cancer, and the high rate of postoperative complications, most of which are low grade. He stresses that earlier referral may improve patient care. The episode concludes with practical surgical tips, guidance on building a buried penis practice, strategies for setting realistic recovery expectations, and an in-depth case review of his novel W-plasty technique. --- Resources W-plasty: A novel procedure for the repair of adult-acquired buried penis https://doi.org/10.1016/j.urolvj.2023.100219 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Most surgeons trained learning extracapsular tonsillectomies. What does the evidence say about intracapsular tonsillectomies? Two pediatric otolaryngologists explain why they made the switch and never looked back. On this episode of the BackTable ENT Podcast, hosts Dr. Ashley Agan and Dr. Gopi Shah sit down with pediatric otolaryngologists Dr. Stephen Chorney from UT Southwestern and Children's Health Dallas and Dr. Kevin Huoh from Children's of Orange County to examine post-operative complications after tonsillectomy and adenoidectomy, with a focus on coblation intracapsular tonsillectomy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Smith + Nephewhttps://www.smith-nephew.com/en/ --- Timestamps 00:00 - Introduction02:53 - Why Switch Techniques?07:58 - Risk Stratification and Patient Selection11:04 - Respiratory Complications and Management15:57 - Preop Screening21:35 - Risks for Post-op Bleeding and Counseling26:16 - Managing Post-op Bleeding31:56 - Surgical Tips to Prevent Bleeds and Management39:30 - Intracapsular Tonsillectomy in Older Kids43:44 - Post Op Pain Plan and Return To School48:33 - Use of Toradol & Readmission for Pain and Dehydration53:16 - Caution of Burn and Stenosis Injuries61:01 - Final Takeaways --- More about this episode Dr. Chorney and Dr. Huoh share why they each committed fully to the intracapsular technique and what that shift has meant in practice, from secondary hemorrhage rates hovering around 0.5–0.6% to fewer nursing line calls, readmissions for pain and dehydration, and faster returns to school and normal activity. They walk through their approach to patient risk stratification and admission criteria (age 30/ICU consideration) as well as how to manage the most common post-operative respiratory complications. The conversation also covers practical guidance for handling outside-ER bleed calls, the role of nebulized TXA, toradol considerations, and managing dehydration. They also share for navigating intracapsular coblation in older children, strategies to reduce burn injuries, and a closer look at the rare but serious risk of pharyngeal stenosis. Check out this episode to hear Dr. Chorney and Dr. Huoh discuss how intracapsular tonsillectomy doesn't just improve outcomes but can transform the recovery experience for patients and their families. --- Resources Extracapsular vs Intracapsular Tonsillectomy: Outcomes in Children with a Focus on Developmental Delayhttps://pubmed.ncbi.nlm.nih.gov/34839135/ Current Status and Future Trends: Pediatric Intracapsular Tonsillectomy in the United Stateshttps://pubmed.ncbi.nlm.nih.gov/32969500/ Dr. Chorney Episode 259 - Understanding Coblation Tonsillectomy https://www.backtable.com/shows/ent/podcasts/259/understanding-coblation-tonsillectomy-benefits-outcomes-techniques Dr. Huoh Episode 110 - Intracapsular Tonsillectomy in Childrenhttps://www.backtable.com/shows/ent/podcasts/110/intracapsular-tonsillectomy-in-children --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Hormones aren't the problem. Misunderstanding them is. On this episode of BackTable Women's Health, Dr. Karen Toubi sits down with Dr. James Simon to discuss menopause, sexual medicine, and his career journey from early IVF research to treating aging women. They also unpack his Green Journal paper with Dr. Barbara Levy, challenging common misconceptions about hormone therapy and explaining why treatment should be individualized because not all estrogens and progestogens are the same. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:11 - Why Menopause Medicine07:51 - Hormone Therapy Paper11:48 - Counseling Perimenopause16:14 - Unopposed Estrogen Strategy23:01 - IUDs And Progesterone26:54 - Estrogen Types Explained34:59 - Thrombosis Risk Approach43:11 - Oral Estrogen Use Cases44:48 - Breast Cancer Risk Counseling46:49 - Estrogen Risk Myth48:11 - Pregnancy and Breast Cancer50:09 - Counseling BRCA Patients53:26 - Duavee: Who Benefits?55:32 - Bazedoxifene Access Limits57:47 - Ospemifene for Genitourinary Syndrome of Menopause (GSM)01:00:37 - Dryness Explained01:02:41 - Thrombosis Risk Screening01:05:01 - UTIs and Vaginal Estrogen01:07:18 - Starting HRT After 6001:12:47 - Window of Opportunity01:14:46 - Staying on HRT01:16:43 - Blood Levels and Absorption01:20:13 - Clinician Takeaways --- More about this episode The conversation explores strategies for managing perimenopause, including when hormonal contraception is the best option and when symptom-focused hormone therapy may be more appropriate. They cover practical guidance on using transdermal estradiol, Mirena and Liletta for contraception and endometrial protection, and how thrombosis risk differs depending on the type and route of hormone therapy. The episode wraps up with a discussion on newer treatments for genitourinary syndrome of menopause, when to consider hormone therapy, and why clinical experience is so important in menopause care. --- Resources A Contemporary View of Menopausal Hormone Therapy https://journals.lww.com/greenjournal/abstract/10.1097/aog.0000000000005553~a-contemporary-view-of-menopausal-hormone-therapy?redirectionsource=fulltextview --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ergogenics: supplements NOT substitutes. On this episode of BackTable Bone & Sports, host Larry Balle joins Dr. Ryan Rhodes, a sports medicine physician and Army National Guard flight surgeon, in a discussion about ergogenic aids and supplements in athletic and military populations. They distinguish supplements from substitutes and define ergogenics broadly, noting limited evidence for popular peptides and the “bro science” culture. The doctors review historical and modern pharmacologic performance enhancers including anabolic steroids, selective androgen receptor modulators (SARMs), growth hormone and hormone replacement therapy (HRT). --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:03 - Ergogenics Overview07:17 - A Brief History Lesson in Performance Hacks14:54 - SARMs Explained18:00 - Supplement Industry Economics24:28 - Growth Hormone and HRT Nuance34:50 - Stimulant Use in Sports37:30 - The Hype Around Creatine 44:03 - Addressing the Renal Safety Myth with Creatine Use46:02 - The Rundown on Protein Intake Basics49:47 - Future Discussions on Ergogenic Aids52:02 - Closing Key Point: Five Point Supplement Test57:14 - Wrap Up --- More about this episode This episode also features case discussion surrounding injury risks from exogenous testosterone use and nuances associated with hormone-replacement. Dr. Rhodes shares his appreciation for creatine, highlighting its strong evidence and safety profile. Key takeaways include the five-point framework for evaluating supplements: safety, claims, meaningful impact, correcting deficiency, and cost. --- Resources Dr. Ryan Rhodeshttps://www.ochsner.org/doctors/ryan-rhodes/ --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How is AI reshaping the way radiology residents study, dictate reports, and summarize clinical courses? BackTable co-founder Anish Parikh catches up with Dr. Sunny Murthy, a PGY-2/R1 integrated interventional radiology (IR) resident at the University of Virginia (UVA). --- Get the BackTable apphttps://www.backtable.com/app --- More about this episode Dr. Murthy outlines the lecture structure (morning didactics, noon case-based sessions) and a curriculum shift toward on-demand video learning via Modality, alongside books, Radiopaedia, and targeted journal use. They discuss conference learning at SIR, the role of podcasts like BackTable, and balancing information overload. AI comes up in both clinical workflows (Epic-generated hospital-course summaries that can be wrong) and education (Claude/Notion for organizing study), with debate about limiting AI for trainees versus preparing for future practice. The resident explains learning procedures across multiple devices, relying on techs, industry training and exhibit halls, and notes receiving a resident teaching award while emphasizing the need for better IR exposure and simulation-based training content. --- Resources Fundamentals of Body CThttps://www.us.elsevierhealth.com/fundamentals-of-body-ct-9780323608329.html Journal of Vascular and Interventional Radiologyhttps://www.jvir.org/ CardioVascular and Interventional Radiologyhttps://www.cvironline.org/ --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes.► https://www.backtable.com/app
Is nasal obstruction the overlooked culprit behind CPAP intolerance? On this episode of BackTable ENT & Allergy, Dr. Gopi Shah interviews Dr. Atul Malhotra and Dr. Michael Hutz to examine the critical but often underappreciated role of the nose in obstructive sleep apnea management. They discuss how nasal obstruction can undermine CPAP adherence, why relying solely on AHI may miss key issues, and how identifying the true cause of intolerance can lead to more personalized and effective therapy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Aerin Medicalhttps://vivaer.com/ --- Timestamps 00:00 - Introduction04:05 - OSA Presentation and AHI Limitations08:13 - Understanding CPAP Intolerance and Nasal Obstruction15:24 - Evaluating Nasal Obstruction20:32 - Nasal Anatomy and Workup27:47 - DICE Technique and Assessing Dynamic Nasal Collapse32:51 - Medical and Non-Surgical Management37:29 - Surgical Options and VivAer43:39 - Nasal Procedures and CPAP Success51:57 - Nasal Surgery and Heart Outcomes55:23 - Beyond CPAP: Nasal Breathing, Myofunctional Therapy, and Collaborative Care01:04:51 - Wrap Up --- More about this episode The physicians review practical strategies for evaluating nasal obstruction, from targeted patient questionnaires, physical exams, nasal endoscopy, and selective imaging. The doctors also detail medical and surgical treatment options, from allergy management and nasal sprays to septoplasty, turbinate reduction, functional rhinoplasty, and temperature-controlled radiofrequency (VivAer). Throughout the episode, they highlight how comprehensive nasal evaluation and intervention can significantly improve CPAP comfort and adherence. --- Resources Dr. Atul Malhotra - https://providers.ucsd.edu/details/22362/sleep-medicine-pulmonology-(lung) Dr. Michael Hutz- https://doctors.rush.edu/details/19100 CPAP treatment persistence following nasal procedures in obstructive sleep apnea - https://www.tandfonline.com/doi/pdf/10.1080/13696998.2026.2671550 Design and rationale for treating Obstructive Sleep Apnea using Targeted Hypoglossal Nerve Stimulation trial - https://www.sciencedirect.com/science/article/pii/S1551714422001306 The Impact of Mouth-Taping in Mouth-Breathers with Mild Obstructive Sleep Apnea - https://pmc.ncbi.nlm.nih.gov/articles/PMC9498537/ VATRAC Trial of VivAer - https://aerinmedical.com/company/news-and-media/aerin-medical-announces-positive-two-year-outcomes-from-the-vatrac-trial-of-vivaer/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
A bone biopsy can reach the target and still miss the diagnosis. In this episode of the BackTable Podcast, host Dr. Neil Jain is joined by Dr. Peter Thurlow to discuss how lesion selection, imaging review, trajectory planning, and device choice determine whether a targeted bone biopsy produces a useful sample without compromising future treatment. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byVarian https://cancercare.siemens-healthineers.com/products/interventional-oncology/musculoskeletal/omnibone --- Timestamps 00:00 - Introduction04:17 - Approaching Focal Bone Lesions06:17 - Differentiating Lesions and Pain Management13:13 - Settling on Bone Biopsy Imaging16:55 - Understanding Pre-Op Imaging from Lesion Characteristics 21:50 - Maintaining Communication Across Specialties24:21 - Which Devices To Select and Navigating Challenges32:28 - Trajectory Paths and Surgical Considerations35:30 - How to Avoid and Mitigate Biopsy Complications41:30 - Wrap Up --- More about this episode The conversation begins with a systematic approach to evaluating focal bone lesions, including the likelihood of malignancy, lesion location, number of lesions, and selection of an appropriately sized sampling device. Dr. Thurlow reviews anesthesia and pain-management strategies for both superficial and deeper osseous targets, as well as the respective roles of MRI and CT in procedural planning. For challenging lesions, he explains why needle-guidance technology may be preferable to adjusting gantry tilt and outlines how imaging findings and biopsy strategy should be tailored to lesion type, with particular attention to the difficulties associated with blastic lesions. The doctors also discuss the importance of communication with pathology, surgery, oncology, and other collaborating specialties before proceeding. Dr. Thurlow shares his preferred biopsy devices, considerations for selecting a safe trajectory, and ways to account for potential future surgical approaches. The episode concludes with practical strategies for avoiding complications, minimizing tissue injury, and obtaining an adequate diagnostic sample. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
More neuromodulation options mean more opportunities to personalize care. In this episode, Dr. Ken Peters and Dr. Tracey Wilson join Dr. Jannah Thompson to discuss the latest implantable tibial nerve stimulation and sacral neuromodulation technologies for OAB and UUI. They compare available devices, share practical insights on patient selection, and explore how shared decision making, advanced practice providers, and equitable access influence treatment adoption. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast was developed in collaboration with Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) https://sufuorg.com/home.aspx --- Timestamps 00:00 - Introduction07:59 - Overview of Nerve Stimulation Therapies13:22 - Case #122:00 - Case #228:23 - Nuspera 34:21 - APPs in Practice39:21 - Reimbursement Roadblocks47:03 - Multimodal Therapy49:51 - Case #356:06 - Final Advice --- Resources Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trialhttps://www.auajournals.org/doi/10.1016/j.juro.2009.12.036 Neuspera Medical Announces 12-Month Pivotal Trial Results for the Company's Integrated Sacral Neuromodulation System for Urinary Urge Incontinencehttps://neuspera.com/neuspera-medical-announces-12-month-pivotal-trial-results-for-the-companys-integrated-sacral-neuromodulation-system-for-urinary-urge-incontinence/ Racial and Socioeconomic Factors Influence Utilization of Advanced Therapies in Commercially Insured OAB Patients: An Analysis of Over 800,000 OAB Patientshttps://www.sciencedirect.com/science/article/pii/S0090429520305574?via%3Dihub --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What if the next major advance in ENT surgery isn't a new instrument, but a better-integrated operating room? In this episode of the BackTable ENT & Allergy Podcast, Cleveland Clinic rhinologist and skull base surgeon Dr. Raj Sindwani joins Dr. Gopi Shah and Dr. Ashley Agan to discuss how reducing cognitive load, improving workflows, and creating a more efficient OR environment can enhance the surgical experience. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Strykerhttps://www.stryker.com/us/en/ent.html --- Timestamps 00:00 - Introduction03:50 - Where Surgery Happens: Choosing the Right Site for Service06:27 - Quality Safety And Throughput09:48 - Reducing Cognitive Load In Surgery15:34 - Building an Efficient OR Ecosystem And Culture23:06 - Tech Adoption and Team Training26:19 - Smarter Surgical Navigation and Augmented Reality37:02 - Navigation Accuracy, Registration, and Smart Coaching40:29 - Inside the Stryker RISE Platform49:55 - Integration Challenges and Voice-Control Safety56:36 - Surgical Ergonomics and Injury Prevention01:09:14 - The Future of Surgical Innovation and AI in the OR --- More about this episode Dr. Sindwani explores how minimizing unnecessary friction, improving team dynamics, and thoughtfully integrating technology can help surgical teams focus on what matters most: patient care. The conversation examines the operating room as an ecosystem where people, processes, and technology all contribute to patient outcomes. Dr. Sindwani shares strategies for reducing extrinsic cognitive load, including standardizing room setup, minimizing interruptions, and optimizing the surgical environment.He also discusses advances in sinus and skull base navigation, augmented reality guidance, and Stryker's RISE platform, highlighting how integrated technology can simplify workflow, improve ergonomics, and reduce distractions in the OR. Throughout the episode, Dr. Sindwani emphasizes the importance of thoughtful technology adoption, team collaboration, and designing the operating room of the future around safety, efficiency, and the needs of both patients and surgeons. --- Resources Dr. Raj Sindwanihttps://providers.clevelandclinic.org/provider/raj-sindwani/4268990 Stryker ENThttps://www.stryker.com/us/en/ent.html Stryker RISE Platformhttps://www.stryker.com/us/en/portfolios/medical-surgical-equipment/integration-and-connectivity/or-integration/rise.html Technological Advances in Sinus and Skull Base Surgery by Dr. Raj Sindwanihttps://www.oto.theclinics.com/article/S0030-6665(17)30050-6/fulltext Ergonomics in ENT Practice NIH Articlehttps://pmc.ncbi.nlm.nih.gov/articles/PMC11455805/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
The standard infertility timeline does not apply to every patient. When should infertility counseling begin, and when is it risky to wait? OBGYN Dr. Nicole Faulkner and REI specialist Dr. Jennifer Kulp Makarov discuss how age, irregular cycles, endometriosis, recurrent pregnancy loss, and male factor infertility should shape counseling and referral decisions on this week's episode of the BackTable Women's Health. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:37 - Launching a New Practice04:23 - When to Refer Patients06:23 - Basic Infertility Workup08:39 - Counseling Patients Over 4014:05 - Personalized IVF Protocols17:59 - Embryology and PGT-A23:54 - Egg Preservation Timing28:20 - Using Frozen Embryos Later31:36 - Components of Personalized IVF33:30 - Patient Experience and Education37:25 - Alternative Fertility Options40:46 - Approaching Recurrent Miscarriage42:28 - Key Takeaways --- More about this episode Dr. Kulp Makarov reviews when patients should be referred to an REI based on age, while emphasizing that earlier referral is appropriate for patients with irregular cycles, endometriosis, recurrent pregnancy loss, or known male factor infertility. Although anti-Müllerian hormone (AMH) testing can be a useful initial assessment, it should not delay specialist evaluation. The discussion also explores how advances in reproductive medicine have expanded fertility treatment options. Dr. Kulp Makarov highlights personalized IVF protocols, embryo banking, and preimplantation genetic testing, while emphasizing both the benefits and limitations of these approaches. She also shares practical guidance on egg freezing, pregnancy in the mid-40s, and when donor eggs, gestational carriers, or other fertility treatment options may be appropriate. Finally, she explains how REIs approach the evaluation and management of recurrent pregnancy loss. --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
A bone biopsy can reach the target and still miss the diagnosis. In this episode of the BackTable Podcast, host Dr. Neil Jain is joined by Dr. Peter Thurlow to discuss how lesion selection, imaging review, trajectory planning, and device choice determine whether a targeted bone biopsy produces a useful sample without compromising future treatment. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byVarian OmniBonehttps://cancercare.siemens-healthineers.com/products/interventional-oncology/musculoskeletal/omnibone --- Timestamps00:00 - Introduction04:17 - Approaching Focal Bone Lesions06:17 - Differentiating Lesions and Pain Management13:13 - Settling on Bone Biopsy Imaging16:55 - Understanding Pre-Op Imaging from Lesion Characteristics 21:50 - Maintaining Communication Across Specialties24:21 - Which Devices To Select and Navigating Challenges32:28 - Trajectory Paths and Surgical Considerations35:30 - How to Avoid and Mitigate Biopsy Complications41:30 - Wrap Up --- More about this episodeThe conversation begins with a systematic approach to evaluating focal bone lesions, including the likelihood of malignancy, lesion location, number of lesions, and selection of an appropriately sized sampling device. Dr. Thurlow reviews anesthesia and pain-management strategies for both superficial and deeper osseous targets, as well as the respective roles of MRI and CT in procedural planning. For challenging lesions, he explains why needle-guidance technology may be preferable to adjusting gantry tilt and outlines how imaging findings and biopsy strategy should be tailored to lesion type, with particular attention to the difficulties associated with blastic lesions. The doctors also discuss the importance of communication with pathology, surgery, oncology, and other collaborating specialties before proceeding. Dr. Thurlow shares his preferred biopsy devices, considerations for selecting a safe trajectory, and ways to account for potential future surgical approaches. The episode concludes with practical strategies for avoiding complications, minimizing tissue injury, and obtaining an adequate diagnostic sample. --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Genicular artery embolization (GAE) continues to gain traction worldwide, but is the evidence catching up to the hype? In this episode of BackTable Bone and Sports Podcast, host Dr. Kavi Krishnasamy welcomes Dr. Peter Minko, an interventional radiologist from Düsseldorf, Germany, to discuss GAE's evolving evidence, techniques, and international practice patterns. Dr. Minko highlights forthcoming clinical trials and emphasizes the need for high-quality research to guide patient care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction03:13 - The Embolization Landscape in Germany07:25 - The Basics of GAE Patient Workup 13:49 - The Unideal Patient Candidate for GAE16:55 - Measuring Outcomes Beyond Clinical Scores23:14 - Procedure Specifics: Minko's Choice36:28 - Discussing the Future of Temporary vs. Permanent Embolics43:47 - Collateral Flow Strategy and Procedure Wrap-Up49:05 - Post-Procedure Rehab Guidelines52:00 - Repeat GAE Treatment Algorithm 58:00 - Safety and Outcomes in Post-TKA Patients01:04:11 - GAE and Associations with the Hospital Anxiety and Depression Scale (HADS)01:09:40 - Call for Better Trials and Evidence in GAE01:14:11 - Case Presentation: GAE Transpedal Access Case01:21:05 - Case Presentation: “Three Stop Shop” Anastomosis 01:27:08 - Case Presentation: AV Fistula… Due to Arthroscopy?01:32:03 - Case Presentation: Popliteal Agenesis 01:38:14 - Dr. Minko's Perspective on the Future of MSK Embolization01:40:55 - Wrap Up --- More about this episodeThe doctors break down procedural specifics, including embolic materials, access site and catheter choices, and strategies for patient selection and contraindications. They discuss post-procedure rehabilitation, approaches to repeat GAE, and unique considerations for patients with prior total knee arthroplasty. The discussion also features interesting case presentations, explores the future of temporary versus permanent embolics, and examines the importance of robust study design in advancing MSK embolization. Dr. Minko shares his perspective on the direction of the field and the collaborative effort needed to move GAE evidence and practice forward. --- ResourcesDr. Peter Minkohttps://www.researchgate.net/profile/Peter-Minko --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Can focal therapy truly “thread the needle” between active surveillance and radical prostate cancer treatment? In this episode of BackTable Urology, host Dr. Tiwa Akinsola is joined by Dr. George Schade from the University of Washington to explore focal therapy as a middle ground between active surveillance and radical treatments. Dr. Schade reviews non-radiation energy modalities including HIFU, TULSA/HI-DU, cryotherapy, and irreversible electroporation, highlighting patient selection, institutional experience, technical nuances, and quality-of-life outcomes from recent trials. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction02:09 - Overview of Focal Therapy Modalities04:46 - Deciding Between HIFU and IRE06:56 - Evidence and Trials09:40 - Counseling Patients on Outcomes12:09 - Building a Focal Therapy Program16:12 - Navigating Insurance and Appeals21:48 - Managing Large Glands And TURP25:12 - Preop Workup Essentials and OR Workflow32:32 - Overcoming the Learning Curve35:52 - PostOp Recovery and Surveillance39:04 - Options for Managing Recurrence42:44 - Challenges with Repeat Ablation44:56 - Final Takeaways --- More about this episodeThe conversation covers candidate selection and confirmatory biopsy, perioperative technique and recovery, and ongoing surveillance with PSA, MRI, and biopsy. Dr. Schade also discusses challenges with insurance approvals, building a focal therapy practice, and options for managing recurrence, including repeat ablation, surgery, or radiation. The episode examines how to balance cancer control with quality of life and reviews the evolving evidence base supporting focal therapy's role in prostate cancer treatment. --- Resources Irreversible Electroporation for Prostate Tissue Ablation in Patients with Intermediate-risk Prostate Cancer: Results from the PRESERVE Trial:https://www.sciencedirect.com/science/article/pii/S030228382500346X Focal therapy of localized prostate cancerhttps://pubmed.ncbi.nlm.nih.gov/35996758/ Focal Therapy for Prostate Cancer: Available Technologies, Patient Selection, Follow-Up Protocols and Reported Outcomeshttps://pubmed.ncbi.nlm.nih.gov/41339218/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
What is the emerging role of bioresorbable scaffolds in treating tibial artery disease, and how do they compare with traditional stenting and drug delivery approaches? In this episode of the BackTable Podcast, Dr. Sabeen Dhand interviews interventional cardiologist Dr. Sahil Parikh at Columbia to explore the evolution of tibial artery stenting, drug-eluting technology, and the latest evidence behind bioresorbable scaffolds. The discussion highlights patient selection, treatment algorithms, technical considerations, and the impact of drug delivery choices on patient outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Abbott Cardiovascular https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/esprit-btk-resorbable-scaffold-system.html --- Timestamps 00:00 - Introduction04:00 - Bioengineering Origins08:29 - Paclitaxel vs. Limus 13:43 - When to Stent Tibials 16:14 - Stepwise Tibial Algorithm 18:46 - Stent Platforms and Costs 23:09 - Bifurcation Stenting Basics 26:35 - Fracture and Crush Risks 30:10 - Device Selection: Born for Tibials 33:27 - Materials and Drug Kinetics 36:57 - How to Deploy Safely 40:46 - Cost and Reimbursement Reality 43:21 - Market Growth and Competitors 48:02 - Paclitaxel Mortality Scare 51:13 - Final Takeaways and Access --- More about this episode Dr. Parikh reviews the differences between paclitaxel and sirolimus or limus agents, the historical dominance of paclitaxel in peripheral devices, and why peripheral therapy has lagged behind coronary interventions. He outlines a practical tibial treatment algorithm emphasizing crossing (often with retrograde access), imaging to assess calcium, lesion preparation (including IVL, specialty balloons, and atherectomy when needed), proper sizing, and bailout stenting for recoil or dissection, and addresses the unique challenges of distal placement, bifurcations, and occasional fractures. The discussion covers the evolution and rationale, absorption timeline, and clinical data for bioresorbable scaffolds, as well as reimbursement, emerging alternatives, and the ongoing debate over paclitaxel safety. Dr. Parikh also shares his perspective on the future of drug delivery, the need for payer support, and strategies for ensuring the best patient care across diverse clinical settings. --- Resources US Esprit™ BTK System Product Information (https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/esprit-btk-resorbable-scaffold-system.html?utm_medium=podcast&utm_source=backtable&utm_campaign=us-endo-esprit-btk&utm_division=vas&utm_product=esprit-btk&utm_content=kol&utm_type=other) US Esprit™ BTK System Important Safety Information (https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/esprit-btk-resorbable-scaffold-system/important-safety-information.html) Drug-Eluting Resorbable Scaffold versus Angioplasty for Infrapopliteal Artery Disease(https://pubmed.ncbi.nlm.nih.gov/37888915/) --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
As bladder cancer treatment options expand, so do the challenges of delivering them in real-world practice. On this episode of BackTable Urology, community urologic oncologist Dr. Adam Gadzinski joins Dr. Ruchika Talwar to discuss how evolving therapies for non–muscle-invasive bladder cancer (NMIBC) are changing the landscape for both patients and providers. They explore the financial, logistical, and workflow hurdles to adopting new treatments in community settings, as well as the unique opportunities for expanding access through local clinical trials. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Urogenhttps://www.zusduri.com --- Timestamps 00:00 - Introduction02:51 - Delivering Bladder Cancer Care in the Community 09:08 - Navigating Treatment Choices 13:05 - Patient Expectations and Insurance Coverage19:01 - Ablation Strategies for Low and Intermediate Risk22:34 - Making Therapies Community Friendly27:12 - Launching Community Trials31:08 - Referrals and Community Practice Advice36:36 - Cystectomy Counseling Pearls44:46 - Closing Takeaways --- More about this episode The conversation covers decision-making for bladder-preserving therapies, radical cystectomy, and trimodal approaches, along with strategies for guiding patients through these complex choices. Dr. Gadzinski shares insights on navigating insurance, launching community trials, and sustaining practice growth while maintaining high-quality care. The episode also offers practical advice on referrals, patient counseling, and finding the right practice environment for long-term success in bladder cancer care. --- Resources Bladder Cancer Basics Handbookshttps://bcan.org/bladder-cancer-basics-handbook/ Wellprepthttps://wellprept.com/foundation --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Have you considered performing a cochlear implant while your patient is awake? In this episode of the Backtable ENT & Allergy Podcast, Dr. Walter Kutz and Dr. Brandon Isaacson sit down with Dr. Sarah Mowry to explore her protocol for cochlear implants under local anesthesia, an approach especially relevant for older adults concerned about the cognitive risks of general anesthesia. Dr. Mowry shares her criteria for patient selection, preoperative counseling strategies, and how she adapts the OR setup to maximize comfort and communication during awake surgery. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:06 - Why to Consider Awake Cochlear Implants05:32 - Indications for Awake CI 08:50 - Local Blocks and Pain Control10:58 - Counseling and Expectations14:40 - Preventing Intraoperative Vertigo and Converting to General Anesthesia 17:17 - Set Up and Communication with Patient 19:14 - Lesser Occipital Nerve Block and Potential Role of Processed EEG26:32 - Pitch Matching for Single-Sided Deafness, CI, and Anxiety Considerations29:00 - Feedback from Patients and Electrode Choice 31:30 - Advice to Surgeons and Closing Remarks --- More about this episode The conversation covers her anesthesia protocol, including lesser occipital and postauricular nerve blocks, minimizing propofol, and using topical 2% lidocaine in sensate areas like the facial recess and epitympanum. Dr. Mowry discusses practical strategies of using warmed irrigation to reduce intraoperative vertigo and contingency plans for conversion to general anesthesia. She discusses electrode considerations and the potential role of processed EEG to titrate anesthesia depth and practical tips for surgeons interested in adopting awake cochlear implantation. Throughout, they highlight the importance of individualized patient care, multidisciplinary teamwork, and the growing role of local anesthesia in otologic surgery. --- Resources Cochlear Implantation Under Local Anesthesia With Conscious Sedation in the Elderly: First 100 Caseshttps://pubmed.ncbi.nlm.nih.gov/32663339/ Cochlear implantation under local anesthesia in 117 cases: patients' subjective experience and outcomeshttps://pubmed.ncbi.nlm.nih.gov/34487218/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How can OBGYNs navigate the complexities of modern prenatal carrier screening? In this episode of BackTable Women's Health, host Dr. Nicole Faulkner interviews Dr. Mary Kate LoPiccolo, a pediatrician and medical geneticist at Mount Sinai, to break down the essentials of prenatal carrier screening in OBGYN practice. They discuss what carrier screening is, when to order it, and how to manage and interpret results in real-world clinical settings. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 03:03 - Understanding Carrier Screening04:40 - Partner Testing: When and Why06:22 - Selecting the Right Panel Size08:27 - Managing Time Constraints and Making Referrals 10:52 - Pretest Counseling Essentials16:44 - Decoding Results and Effective Reporting 20:52 - Limits of OB Counseling26:19 - Navigating Common X-Linked Pitfalls 30:11 - Equity, Costs, and Over-Testing36:11 - Tele-Genetics and Lab Resources43:43 - Final Takeaways --- More about this episode Dr. LoPiccolo reviews the evolution from Tay-Sachs screening in Ashkenazi Jewish populations to today's pan-ethnic expanded panels, emphasizing carrier screening as a blood-based screening test for recessive and X-linked conditions ideally performed preconception and for both partners. The conversation covers panel size selection, best practices for pre-test counseling, common pitfalls with X-linked results, documentation and report interpretation, cost and equity barriers, and the value of referrals, telegenetics, lab genetic counselors, and resources like GeneReviews to optimize care. --- Resources GeneReviews - https://www.ncbi.nlm.nih.gov/books/NBK1116/ Open Evidence - https://www.openevidence.com/ --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
With multiple training pathways, how can you determine which is the right choice for your career and clinical goals? In this episode of BackTable Podcast, Dr. Neil Jain sits down with interventional radiologist Dr. John Cieslak to compare the Early Specialization in Interventional Radiology (ESIR), integrated IR/DR, and independent IR routes. The conversation highlights practical differences in training structures, procedural exposure, and the key factors that influence career decisions for aspiring IRs. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:47 - Early Life and Science Roots 03:58 - Surgery to IR Pivot 05:51 - Radiology Training and ESIR Setup 08:59 - Three IR Training Pathways 11:53 - ESIR Pros Cons and Case Exposure 14:27 - Competency and Hiring Perceptions 20:12 - Job Market Academic vs Hospital 23:08 - Early Attending Surprises 26:00 - Integrated Versus ESIR 29:10 - Boosting Your Application 31:24 - Rapid Fire IR Questions 34:46 - Future Of IR 36:46 - Wrap Up And Credits --- More about this episode Dr. Cieslak shares his own journey, from early exposure to hospital science and a long academic path to switching from surgery to radiology and ultimately landing in IR. They outline the practical pros and cons of each pathway, including the flexibility and breadth of ESIR, the directness of integrated training, and the realities of re-matching and job market considerations. The discussion covers early attending challenges like building referrals and making independent decisions, the importance of multidisciplinary teamwork, and advice for residents and students interested in IR. The Drs. also discuss the evolution of IR procedures, the impact of program variability, and why persistence and exposure are vital for success in the field. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What opportunities and challenges does private equity bring to urology practices, and how can physicians engage in ways that strengthen their practice and preserve clinical priorities? On this episode of BackTable Urology, Dr. Ruchika Talwar interviews Dr. Benjamin Lowentritt of Chesapeake Urology and United Urology Group to unpack the realities of private equity involvement in medicine. They discuss the motivations behind consolidation, the role of management services organizations, and strategies for building mutually beneficial partnerships while upholding physician autonomy and patient care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:58 - Why Urology Drew Private Equity07:06 - Bad Headlines vs. Reality11:14 - MSOs and Contracts Explained15:24 - Timelines and After Private Equity22:47 - Efficiency and Autonomy Fears27:15 - Why Private Equity Gets Vilified31:23 - Young Urologist Job Market35:42 - Advice for New Grads40:26 - Urology in 2035 and Fair Critiques of Private Equity44:40 - Closing Thoughts --- More about this episode Dr. Lowentritt outlines the history of private equity in healthcare, noting that consolidation predated private equity and was driven by payer and hospital market power, reimbursement pressure, administrative burden, staffing, and capital needs. He distinguishes private equity's role in hospitals from physician practice management, describing management services organization (MSOs) as structures that handle back-office functions and provide capital while preserving physician control over patient care and local governance. He also discusses private equity's limited investment timeline, shaped by the ultimate goal of selling a profitable company, and potential end-states such as acquisition or public ownership, reflecting on his own experiences with United Urology's acquisition. The conversation further explores recruiting new graduates, evolving partner tracks, mentorship, and maintaining physician leadership to preserve independent practice. --- Resources Dr. Benjamin Lowentritt is the current treasurer of LUGPA (Large Urology Group Practice Association) https://www.lugpa.org/, the Chesapeake Urology group (https://chesuro.com/), and United Urology Group (which was acquired by One Oncology https://www.oneoncology.com/UnitedUrologyGroup/). One Oncology eventually was acquired by Cencora (https://www.cencora.com/). Dr. Benjamin Lowentritt email: blowentritt@chesuro.com --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
As endovascular technologies evolve, how are IRs maximizing control while minimizing metal in modern venous embolization? In this episode of the BackTable Podcast, Dr. Harris Chengazi joins host Dr. Sabeen Dhand to discuss the clinical impact, deployment techniques, and imaging advantages of modern vascular point embolization devices, focusing on targeted venous occlusion and variceal obliteration. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Okami Medicalhttps://okamimedical.com/ --- Timestamps 00:00 - Introduction02:22 - Multidisciplinary Vascular Practice Model05:51 - Understanding Plugs in Embolization08:34 - Comparing Plugs, Coils, and Liquid Embolics13:48 - LOBO Occlusive Device16:12 - Plug Sizing and Vessel Measurement20:45 - Deliverability and Catheter Selection24:28 - Limitations of Point Embolization29:03 - PARTO Access and Technique32:46 - Other LOBO Use Cases34:33 - LOBO Deployment Mechanism36:23 - Cost Effectiveness of Embolics41:08 - Final Thoughts and Closing Remarks --- More about this episode Dr. Chengazi shares insights from incorporating vascular plugs into his embolization practice after training predominantly with coils. He highlights the features that distinguish modern devices like the LOBO from traditional plugs, including their unique nitinol weave, rapid occlusion, and predictable sizing and landing configuration. The physicians explore the utility and limitations of plugs in clinical scenarios including retrograde transvenous variceal obliteration, antegrade variceal embolization during TIPS creation, and tract embolization following percutaneous procedures. Dr. Chengazi furthermore shares specific procedural pearls for point embolization of varices, explaining how to facilitate deployment using a parallel access technique as well as how to position multi-lobed plugs across venous outflow segments to reliably treat large shunts with a single device. Finally, the physicians review the benefits of reduced imaging artifact on follow-up scans compared to traditional coil packs and liquid embolics as well as the impact of modern plug technology on healthcare costs, reinforcing the value of evidence-based device selection for optimal patient outcomes. --- Resources Kundaragi NG, et al. Measurement of Inferior Vena Cava to Shunt Distance in Deciding Access Route for Balloon-Occluded Retrograde Transvenous Obliteration Procedure: A Pilot Study. Am J Interv Radiol. 2018 Sep 19;2(16):1-9.https://dx.doi.org/10.25259/AJIR-22-2018 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
With multiple clinical trials evaluating PARP inhibitor combinations, how do clinicians determine the best approach for advanced prostate cancer? In this episode of BackTable Urology, Dr. Alan Tan is joined by Dr. Rana McKay and Dr. Emmanuel Antonarakis to discuss how evolving evidence, patient selection, timing, toxicity, and genetic testing are shaping the use of PARP inhibitor combinations in clinical practice. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Pfizer. --- Timestamps 00:00 - Introduction02:51 - PARPi Basics14:12 - Major Study Differences19:00 - Timing and Selection of PARPi Combinations26:39 - Case: Somatic BRCA2 loss and mHSPC35:51 - Case Continued: BRCA2 Reversion39:57 - BRCAAway Study42:59 - Takeaways from the 2026 APCCC --- More about this episode The conversation reviews lessons learned from major clinical trials, including PROpel, MAGNITUDE, TALAPRO-2, and AMPLITUDE, and addresses how these studies inform real-world treatment choices. The doctors dig into case examples, such as BRCA2 loss and reversion, and highlight practical strategies for using germline and somatic testing to personalize care. Key insights from the 2026 Advanced Prostate Cancer Consensus Conference are also shared, emphasizing the importance of precision medicine in this rapidly evolving field. --- Resources Study on Olaparib Plus Abiraterone as First-line Therapy in Men With Metastatic Castration-resistant Prostate Cancer (PROpel) https://clinicaltrials.gov/study/NCT03732820 A Study of Niraparib in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for Treatment of Participants With Metastatic Prostate Cancer (MAGNITUDE) https://clinicaltrials.gov/study/NCT03748641?tab=study Talazoparib + Enzalutamide vs. Enzalutamide Monotherapy in mCRPC (TALAPRO-2) https://clinicaltrials.gov/study/NCT03395197 A Study of Niraparib in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for the Treatment of Participants With Deleterious Germline or Somatic Homologous Recombination Repair (HRR) Gene-Mutated Metastatic Castration-Sensitive Prostate Cancer (mCSPC) (AMPLITUDE) https://clinicaltrials.gov/study/NCT04497844 BRCAAway: A randomized phase 2 trial of abiraterone, olaparib, or abiraterone + olaparib in patients with metastatic castration-resistant prostate cancer (mCRPC) bearing homologous recombination-repair mutations (HRRm) https://pubmed.ncbi.nlm.nih.gov/39115414/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Did you know that congenital CMV-related hearing loss can develop several years after birth? On the BackTable ENT & Allergy Podcast, hosts Dr. Gopi Shah and Dr. Jeff Hyzer interview pediatric otolaryngologist Dr. Albert Park about the latest evidence on congenital CMV and its role in pediatric sensorineural hearing loss. The discussion covers diagnosis, risk factors, screening protocols, testing strategies, antiviral treatment, genetic workup, long-term surveillance, and future directions for early detection and prevention. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:47 - Basics of CMV Infections and Hearing Loss Presentation 07:57 - CMV Screening Workflow 11:33 - Saliva vs. Urine Based Screening 14:00 - Early Workup and Communication 19:37 - Late Onset Workup and Use of Antivirals 24:39 - Treatment with Antiviral Medications 27:22 - Head Ultrasound vs. MRI 30:06 - Role of Genetic Testing 32:47 - Surveillance and Progression Risk37:29 - CI Outcomes and Predictors42:18 - BAHA and Older Candidates45:44 - Awareness, Prevention Efforts, and Education 54:25 - Vaccines and Universal Screening Pitfalls 57:40 - Advocacy and Closing Thoughts --- More about this episode Dr. Park explains the differences between congenital and acquired CMV, reviews epidemiology and, and highlights that hearing loss may be present at birth or develop later in childhood. He discusses Utah's evolution from hearing-targeted CMV testing to universal NICU screening, emphasizing the importance of diagnosis within the first 21 days of life. The conversation covers saliva versus urine testing, dried blood spot testing, and the role of a multidisciplinary team in evaluation and management. Dr. Park also reviews antiviral treatment strategies, imaging and genetic testing considerations, audiologic surveillance, and cochlear implantation outcomes. Finally, he discusses ongoing advocacy efforts, emerging prenatal screening technologies, and future directions and challenges for CMV prevention and early detection. --- Resources Nance & Morton NEJM Paper Cited - 20% of Congenital SNHL linked to Congenital CMV https://www.nejm.org/doi/full/10.1056/NEJMra050700 Dr.Kimberlin's work supporting antiviral treatment for 6 months https://www.nejm.org/doi/full/10.1056/NEJMoa1404599?utm_source=openevidence Dr.Vossen's antiviral therapy research https://pubmed.ncbi.nlm.nih.gov/38336204/ AAP Red Book https://publications.aap.org/redbook Dr. Smith's Research - Genetic Testing for Congenital Bilateral Hearing Loss in the Context of Targeted Cytomegalovirus Screeninghttps://pubmed.ncbi.nlm.nih.gov/31985074/ Dr.Park's Research Congenital Cytomegalovirus Testing Outcomes From the ValEAR Trialhttps://pubmed.ncbi.nlm.nih.gov/38415855/ Dr.Park's Research - Analysis of an Expanded Targeted Early Cytomegalovirus Testing Programhttps://pubmed.ncbi.nlm.nih.gov/36884018/ Dr.Foulon - Hearing Loss With Congenital Cytomegalovirus Infectionhttps://pubmed.ncbi.nlm.nih.gov/31266824/ Research about the use of Vaclovir to reduce vertical transmissionhttps://pubmed.ncbi.nlm.nih.gov/32919517/ Dr.Gantt's research on the Ping-Pong Effecthttps://pubmed.ncbi.nlm.nih.gov/29889809/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
As over-the-counter continuous glucose monitors (CGMs) become more common, clinician guidance matters more than ever. In this episode of BackTable Women's Health, Dr. Nicole Faulkner welcomes Dr. Nicholas Canelo, a family medicine physician and founder of the Perlman Wellness CGM program, to discuss how to effectively guide CGM use in OBGYN practice, from preconception and PCOS to pregnancy and perimenopause. They highlight the importance of interpreting data trends, setting realistic glucose targets, and supporting patients through the practical and emotional challenges of CGM use. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:58 - CGMs in Women's Health07:33 - OTC Data Sharing Issues09:52 - Pregnancy Glucose Targets16:20 - Accuracy and Variability20:10 - Anxiety and Eating Disorders24:41 - Counseling and Follow-Up28:29 - Prescription and OTC CGM Picks37:24 - False Lows and Sensor Errors41:23 - Alarm Settings and Logging44:06 - Interpreting Metrics and Limits46:44 - Provider Dashboards 48:42 - Final Thoughts --- More about this episode Given the lack of well-established blood glucose targets outside of type 1 diabetes, Dr. Canelo reviews commonly used ranges for individuals without diabetes, those with prediabetes, and pregnant patients with type 1 or 2 diabetes. He explains how to interpret CGM data, including the time in tight range, coefficient of variation, and the importance of focusing on overall trends rather than isolated glucose spikes. They also discuss the potential drawbacks associated with CGM use, including anxiety and eating-disorder risks. Practical considerations include sensor inaccuracies, false lows readings, and optimizing alarm settings. Dr. Canelo emphasizes the importance of having patients log meals and other events while wearing the sensor and scheduling follow-up after the initial 15-day wear period to ensure accurate interpretation and effective counseling. Finally, they compare OTC and prescription CGM options, including costs, clinician access to patient data, and insertion tips. --- Resources Stelo - Over the Counter CGM Optionhttps://www.stelo.com/en-us --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How is portal vein embolization (PVE) pushing the boundaries of liver tumor resectability, and what does it take to induce hypertrophy without compromising the remnant liver? In this episode of the BackTable Podcast, interventional radiologist Dr. David Madoff of Yale University joins Dr. Michael Barraza to discuss the pathophysiological rationale, technical considerations, and emerging clinical paradigms of performing PVE to augment the future liver remnant (FLR) prior to resection and reduce the risk of postoperative liver failure. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction02:14 - IO Practice and Research07:25 - PVE Indications and Adequate FLR12:55 - Referrals and Patient Selection17:27 - PVE vs. Y90 Radiation Lobectomy22:12 - Liver Venous Deprivation25:31 - Measuring FLR Function30:11 - Procedural Planning and Technique36:36 - Preferred Embolic Agents and Challenges46:58 - Ipsilateral vs. Contralateral Access50:52 - Complications, Medications, and Follow-Up55:45 - Final Thoughts and Closing Remarks --- More about this episode The physicians dissect the anatomic and oncologic benchmarks used to select PVE candidates, including FLR volumetric thresholds for normal, steatotic, and cirrhotic livers. Dr. Madoff walks through his procedural technique, detailing catheter maneuvers and embolic administration, emphasizing the importance of evaluating for anatomic variants, and explaining the benefits of using an ipsilateral approach to protect the FLR. The doctors critique ongoing debates in hepatic augmentation, assess the complementary relationship between PVE and Y90 radioembolization, and discuss the outcomes and risks associated with different embolic agents. They stress the importance of patient selection and assessment protocols that go beyond static volumetric measurements to incorporate functional parameters for better prediction of regenerative kinetics and clinical outcomes. The episode concludes with a review of postprocedural follow-up and potential complications, highlighting the importance of considering pathophysiologic dynamics of both the tumor and the anticipated liver remnant to ensure successful treatment. --- Resources DRAGON Trialhttps://www.dragontrial.com/ Three hundred and one consecutive extended right hepatectomies: Evaluation of outcome based on systematic liver volumetryhttps://doi.org/10.1097/SLA.0b013e3181b674df Portal vein embolization with N-butyl-cyanoacrylate improves liver hypertrophy compared to microparticles – A Swedish multicenter cohort studyhttps://doi.org/10.1016/j.heliyon.2023.e21210 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How do you safely combine locoregional and systemic therapies to treat hepatocellular carcinoma (HCC) when traditional guidelines suggest your hands are tied? In this episode of the 2026 HCC Creator Weekend™, medical oncologist Dr. Lingling Du (Ochsner Health) and interventional radiologist Dr. Beau Toskich (Mayo Clinic Florida) join Dr. Tyler Sandow to break down patient selection, timing strategies, and the practical application of clinical trial outcomes when integrating Y90 radioembolization and immunotherapy in HCC management. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction01:48 - Two HCC Cases03:31 - Disease Progression on Combination Therapy07:05 - Alternatives After Immunotherapy Failure09:09 - Salvage with Ablative Y9013:41 - Mechanism of Immunotherapy15:43 - EMERALD-1 and LEAP-01220:52 - Adverse Events with Combination Therapy27:21 - Treatment Timing and Sequencing28:48 - Case: Borderline BCLC B33:48 - Case: BCLC C with Portal Vein Thrombus37:06 - Raising the Survival Tail40:11 - Final Thoughts and Closing Remarks --- More about this episode The physicians highlight how selective local treatment can achieve complete responses and salvage cases with aggressive disease. They emphasize that treatment based on anatomical and biological phenotype may yield better results than strictly adhering to rigid staging categories, while acknowledging the challenges of managing microscopic disease and unpredictable long-term tumor behavior. Dr. Du and Dr. Toskich also note that selecting the right combination regimens requires balancing aggressive tumor kinetics against the patient's baseline liver function, pointing out that well-tolerated regimens like STRIDE are often easier to pair with Y90 than checkpoint or VEGFR inhibitors that alter tumor blood flow. While recent TACE-immunotherapy trials (EMERALD-1 and LEAP-012) may be confounded by patient heterogeneity, the physicians observe that a distinct subset of patients achieves durable, long-term remission, effectively raising the survival tail for an otherwise incurable population. Ultimately, they conclude that cross-specialty education and leaning into the expert intuition of a multidisciplinary team are essential for securing the best outcomes for patients with intermediate and advanced HCC. --- Resources Study of Durvalumab and Tremelimumab as First-line Treatment in Patients With Advanced Hepatocellular Carcinoma (HIMALAYA)https://clinicaltrials.gov/study/NCT03298451 A Study of Atezolizumab in Combination With Bevacizumab Compared With Sorafenib in Patients With Untreated Locally Advanced or Metastatic Hepatocellular Carcinoma (IMbrave150)https://clinicaltrials.gov/study/NCT03434379 Nivolumab plus ipilimumab versus lenvatinib or sorafenib as first-line treatment for unresectable hepatocellular carcinoma (CheckMate 9DW): an open-label, randomised, phase 3 trialhttps://doi.org/10.1016/S0140-6736(25)00403-9 Durvalumab with or without bevacizumab with transarterial chemoembolisation in hepatocellular carcinoma (EMERALD-1): a multiregional, randomised, double-blind, placebo-controlled, phase 3 studyhttps://doi.org/10.1016/S0140-6736(24)02551-0 Transarterial chemoembolisation combined with lenvatinib plus pembrolizumab versus dual placebo for unresectable, non-metastatic hepatocellular carcinoma (LEAP-012): a multicentre, randomised, double-blind, phase 3 studyhttps://doi.org/10.1016/S0140-6736(24)02575-3 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app