Podcasts about biopsies

Join host Dr. Nikolaos Papadantonakis for an in-depth conversation with Dr. Sanam Loghavi of The University of Texas MD Anderson Cancer Center. In this episode, we take listeners inside the hematopathology lab to demystify what happens after a bone marrow biopsy is performed.Dr. Loghavi explains how traditional morphologic assessment is integrated with modern,  molecular testing to establish the diagnosis of myelodysplastic syndromes.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Early Diagnosis of ATTR-CM by Age- and Carpal Tunnel Biopsy-Guided Screening.

Editor's Summary by Preeti Malani, MD, MSJ, and Tracy Lieu, MD, MPH, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from May 16-22, 2026.

May 22, 2026In this episode, Scott, Mark, and Dr. Ray Painter revisit ureteral stent removal and replacement coding after listener feedback highlighted the need for additional clarification on when cystoscopic codes versus fluoroscopic exchange codes apply. The discussion then shifts to emerging RAC audits targeting prostate artery embolization (PAE) claims involving CPT codes 37242 and 37243, emphasizing the importance of detailed documentation and medical necessity support. The episode wraps with a deep dive into Medicare's medically unlikely edit (MUE) for add-on code 55715 for additional prostate biopsy lesions—exploring why the edit conflicts with CPT guidance, how practices should report multiple lesions, and why appeals may be necessary to receive proper reimbursement. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

As part of the 2026 UCSF Patient Conference on Prostate Cancer, Dr. Cornelia Ding what to look for on the prostate cancer biopsy report. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 41533]

As part of the 2026 UCSF Patient Conference on Prostate Cancer, Dr. Cornelia Ding what to look for on the prostate cancer biopsy report. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 41533]

As part of the 2026 UCSF Patient Conference on Prostate Cancer, Dr. Cornelia Ding what to look for on the prostate cancer biopsy report. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 41533]

Protect Your Retirement with a PHYSICAL Gold and/or Silver IRA https://www.sgtreportgold.com/ CALL( 877) 646-5347 - You Can Trust Noble Gold The baby boomers continue to worship Donald J Trump regardless of his actions, like the destruction of our economy with endless war and and no matter his betrayals. In fact, they still adore Erika Kirk and loathe Tucker, Candace and Thomas Massie because... Trump says they should. I also provide a bombshell regarding the US military and AI data centers, and a health upoate regarding the benefits of fasting. Then we discuss the issues with aluminum in deodorant and the best solution I have found with Elliot, the founder of Masculine Man. Thanks for tuning in. Masculine Man: The Best Aluminum Free Deodorant You Will Ever Use https://www.masculinemanessentials.com/SGTREPORT Use discount code is SGT for 10% off you order. Free shipping on orders over $75 DISCLAIMER: This video was conducted on behalf of Vault Strategic Mining Corp, and was funded by CAPITALIZ ON IT. I have been compensated for this video. I only express my opinion based on my experience. Your experience may be different. These videos are for educational and inspirational purposes only. Investing of any kind involves risk. While it is possible to minimize risk, your investments are solely your responsibility. It is imperative that you conduct your own research. There is no guarantee of gains or losses on investments. Please do your own due diligence. I am not a financial advisor, and this is not a financial advice channel. All information is provided strictly for educational purposes. It does not take into account anybody's specific circumstances or situation. If you are making investment or other financial management decisions and require advice, please consult a suitably qualified licensed professional. The securities of Vault Strategic Mining Corp are speculative, and the company has not yet achieved consistent positive cash flow from operations. As a growth-stage company, it anticipates negative cash flow for the foreseeable future as it focuses on development and commercialization efforts. Parties viewing this video should thoroughly review the company's public disclosure and documents available on sedarplus.ca. View the company's public disclosure and documents available on sedarplus.ca. See full disclaimer here: https://capitalizonit.com/vault/ https://rumble.com/embed/v77vamg/?pub=2peuz

As part of the 2026 UCSF Patient Conference on Prostate Cancer, Dr. Matthew R. Cooperberg discusses when and how to biospsy for prostate cancer. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 41532]

As part of the 2026 UCSF Patient Conference on Prostate Cancer, Dr. Matthew R. Cooperberg discusses when and how to biospsy for prostate cancer. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 41532]

As part of the 2026 UCSF Patient Conference on Prostate Cancer, Dr. Matthew R. Cooperberg discusses when and how to biospsy for prostate cancer. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 41532]

Send us Fan MailWhy are pathology vendors still speaking different image languages when radiology solved that problem decades ago?In this episode of DigiPath Digest #46, I talk through four papers that all point to a bigger issue in digital pathology: we are not only dealing with better algorithms. We are dealing with interoperability, workflow design, explainability, and whether the field is actually ready to use these tools well.I start with DICOM in digital pathology, because I think this is still one of the most important infrastructure questions in the field. Digital pathology has clear value for consultation, image analysis, archival, and workflow, but vendor-specific whole slide image formats still create silos. In the episode, I explain why DICOM matters, why adoption is still low, how the multi-resolution pyramid works, and why this is really about enterprise imaging and future-proofing, not just file conversion. Then I move into kidney transplant rejection, where the paper makes a strong case for multimodal precision diagnostics. Creatinine is late. Antibody testing can miss important biology. Biopsies can miss the area that matters. So the opportunity is not to replace pathology, but to combine biomarkers, biopsy, and machine learning in a way that is more useful than any one signal alone. I also talk about explainability here, because if a model gives a risk score, we need to know what contributed to it. The third paper focuses on perineural invasion in solid tumors, and I liked this one a lot because it shows how AI can help standardize something that is clinically important but still inconsistently detected and reported. Perineural invasion is not just a passive pathway of spread. The biology is more active than that, and the quantification can go far beyond a simple yes-or-no answer. This is a good example of where digital pathology can do something humans cannot realistically do by eye at scale. The last paper is on gastric cancer immunohistochemistry biomarkers and advanced quantification, including HER2, PD-L1, mismatch repair, and CLDN18.2. This section is really about complexity. We are now asking pathologists to visually score biology that is getting harder and harder to summarize consistently, especially when markers, spatial context, and multiplexing all start to matter at once. I make the case that computational pathology is becoming necessary here, not because pathologists are failing, but because the biology is outgrowing purely visual workflows. What ties these four papers together is simple: digital pathology is not only about remote reading anymore. It is about interoperability, quantification, explainable AI, and making pathology more precise in places where the old workflow is reaching its limit. If you are a pathologist, lab leader, or digital pathology trailblazer trying to figure out what actually matters right now, this episode will help you connect the dots.Episode Highlights 07:41 – Why DICOM still matters if we want digital pathology systems to work together. 14:39 – Current adoption of SVS, MRXS, and DICOM, and why DICOM is still lagging. 16:44 – How the DICOM whole slide image pyramid works and why it matters for workflow. 24:29 – Why kidney transplant rejection is still difficult to diagnose with any single marker. 29:18 – Why perineural invasion is clinically important and still inconsistently reported. 34:44 – How AI can quantify tumor-nerve relationships more consistently than visual review alone. 46:39 – Why gastric cancer biomarker scoring is getting too complex for purely visual workflows. 54:55 – Multiplexing, spatial biology, and why explainable AI matters in biomarker interpretation. 01:04:01 – What is really blocking digital pathology adoption: cost, workflow, regulation, or mindset? Resources mentionedDICOM / digital pathology interoperability paper https://pubmed.ncbi.nlm.nih.gov/42093730/Kidney transplant rejection, biomarkers, and artificial intelligence https://pubmed.ncbi.nlm.nih.gov/42073482/Perineural invasion in solid tumors with AI and machine learning applications https://pubmed.ncbi.nlm.nih.gov/42100436/Gastric cancer IHC biomarkers, advanced detection methods, and perspectives https://pubmed.ncbi.nlm.nih.gov/42075555/Digital Pathology Place https://digitalpathologyplace.comDigital Pathology 101 Free PDF book mentioned at the end of the episode through Digital Pathology Place.Support the showGet the "Digital Pathology 101" FREE E-book and join us!

Send me a derm question or story through text or voicemail!In this episode, I dive into the diagnostic approach and long-term management of sterile nodular panniculitis in veterinary patients. We discuss everything from sampling claw folds and interpreting flaky cytology samples to biopsy techniques, infectious disease rule-outs, and when to consider JAK inhibitors as part of a treatment plan. If you've ever struggled with diagnosing challenging nodular cases or navigating long-term management decisions, this episode is packed with practical clinical insights you can apply in practice.Did you know you can submit a question or voicemail to the show by using the link at the top of the show notes? Send me any and all questions to be featured on an episode!Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps00:00 Intro01:14 Itch Inquiry: Sampling Claw Folds and Flaky Samples06:00 Identifying Sterile Nodular Panniculitis08:54 Diagnostic Approaches and Biopsy Techniques09:56 Ruling Out Infectious Causes12:53 Use of JAK Inhibitors16:19 Long-term Management19:49 Outro

What if the most common diagnostic tool in men's health for the last 30 years was actually failing millions of patients?” For decades, the "blind" prostate biopsy was the gold standard a primitive 'hit or miss' approach that often missed aggressive tumors while over-treating harmless ones. But then came the PRECISION trial, a research earthquake that proved we've been doing it wrong.In this episode, we are joined by the architect of that revolution: Professor Veeru Kasivisvanathan. A Professor of Urology at University College London and a consultant at Cleveland Clinic London, Prof. Veeru is the elite surgeon-scientist who convinced a global medical community to stop stabbing in the dark. He led the landmark trials that made MRI the mandatory gatekeeper for prostate cancer, saving countless men from unnecessary invasive procedures. If you've ever wondered why your doctor is ordering an MRI before a needle, or why "contrast dye" might be a thing of the past, this conversation is your roadmap.In this episode, you'll learn:The Precision Paradigm: Why a third of men can safely avoid a biopsy altogether if their MRI is clear.The Prime Trial Breakthrough: Why high-quality "biparametric" scans mean you can likely skip the Gadolinium contrast without losing accuracy.The Focal Therapy Landscape: How "male lumpectomies" using HIFU and Cryotherapy are preserving potency and continence.The Future of "Robotic Nerve-Sparing": How pre-operative mapping is allowing surgeons to operate with a level of visibility once thought impossible.Timestamps:00:00 – Introduction: Is the "Blind" Biopsy Failing Men?01:30 – Meet Prof. Veeru Kasivisvanathan: The Surgeon-Scientist.04:15 – What Inspired the PRECISION Trial?08:45 – The Problem with the 30-Year "Standard of Care."12:20 – MRI as the Gatekeeper: Avoiding Unnecessary Biopsies.15:45 – The UK vs. US Healthcare Systems: Why Cost and Ethics Matter.21:00 – The PRIME Trial: Biparametric vs. Multiparametric MRI.28:30 – Is Gadolinium Contrast "Toxic"? Understanding the Risks.34:15 – MRI Quality Control: Why the Radiologist Matters More Than the Machine.40:30 – Genomic Biomarkers vs. Imaging: Do We Need Both?44:45 – Treatment Paradigms: Focal Therapy (HIFU/Cryo) explained.49:15 – When to Choose a Robotic Prostatectomy Over Focal Therapy.53:00 – How to Find Prof. Veeru and Closing Thoughts.Key Resources Mentioned:Prof. Veeru's Profile: University College London (UCL) & Cleveland Clinic London.The PRECISION Trial: Published in the New England Journal of Medicine.The BURST Research Collaborative: A global network of 30,000+ patients.___________________________________

Melissa Mariano is a 43-year-old Canadian flight attendant living in Dubai who was diagnosed with triple positive (ER+, PR+, HER2+) breast cancer after a routine mammogram...zero symptoms, zero lumps. She almost skipped her follow-up appointment. In this episode, she shares how she went from stage 0 DCIS to navigating Herceptin without chemo, low-dose "Baby Tam," the Dutch test, and a radical people-pleasing wake-up call that changed everything. In this episode we cover: How calcifications on a mammogram went from "nothing to worry about" to a biopsy — and why she delayed 4 months The vacuum-assisted biopsy that may have removed her invasive cancer entirely before surgery even happened Why her final pathology came back DCIS only, stage 0 — and what triple positive actually means 18 rounds of Herceptin (anti-HER2) with NO chemo — and the NCCN guideline that made that possible The Italian Clancy study on "Baby Tam" (5mg Tamoxifen) and why she's tapering down from 20mg Dutch test results: high estrogen, good methylation — what it means and what she's doing about it Supplements she's using: L-theanine, Relora, liposomal glutathione, DIM (cycled), NAC Sauna 2x/week, red light therapy, hyperbaric oxygen, yin yoga, sound healing, Reiki, breathwork — her full protocol Egg freezing for fertility preservation before starting Tamoxifen The people-pleasing pattern she believes contributed to her diagnosis — and the shift that changed everything Why she says: "I'm no longer a phony — but I am my priority" Links & Resources: Clancy Study on Low-Dose Tamoxifen (Baby Tam / 5mg): READ HERE NCCN Guidelines for Breast Cancer: READ HERE Connect with Melissa Mariano: https://www.instagram.com/melidubai/ Not Today Cancer Inner Circle (weekly live calls, community support): [INFO HERE] BrocElite: 20% off here Chapter Markers (estimated) 00:00 — Intro: Meet Melissa — Dubai life, flight attendant, Italian roots 04:00 — The mammogram that almost didn't happen: calcifications and a delayed follow-up 08:30 — Biopsy results: triple positive, Grade 2 IDC + high-grade DCIS 13:00 — MRI showed no mass enhancement — the biopsy may have removed the cancer 19:00 — Surgery, clear margins, final pathology: stage 0 DCIS 22:00 — 20 rounds radiation — spinning and yoga the whole way through 25:00 — Herceptin without chemo: the NCCN guideline that changed everything 28:00 — Tamoxifen side effects, Baby Tam, and the Italian Clancy study 34:00 — Dutch test results, functional gynecologist Dr. Maria, supplement protocol 38:00 — Sauna, red light, hyperbaric oxygen, yin yoga, sound healing 44:00 — "I'm no longer a phony — but I am my priority": the people-pleasing shift 50:00 — What cancer gave her: resilience, perspective, advocacy 54:00 — Closing: the "Nope. Not Today." shirt moment + not today cancer Medical disclaimer: This episode is for informational and educational purposes only and is not intended as medical advice. Always consult your own oncologist, physician, or qualified healthcare provider before making any decisions about your diagnosis, treatment, or supplement protocol.

Join Our 8 Week Root Cause Reset Masterclass Starts June 4 -->DianeKazer.com/RCR 50% Off Dr Judy Morgan's Books --> DrJudyMorgan.com Code: CHI50 10% Off Dr Judy Morgan's Supplements -->DrJudyMorgan.com Code DK10 Join Our Elite VIP Tribe --> DianeKazer.com/VIP Apply To Become A Patient --> DianeKazer.com/PATIENT If you've ever trusted your vet… followed the protocol… done "everything right" for your pet… …and still felt like something was off, then this episode is for you. I'm going live today on our CHI Podcast with holistic veterinarian, Dr. Judy Morgan and we are getting controversial… Not surface-level… not sugar-coated… but the conversations most pet owners aren't having (and honestly… most vets aren't either). Here's what we're diving into: ✨ Immuno-suppressants…what are they and why they leave your pet with virtually zero immune defense ✨ The truth about ticks… and those "tick boxes" mysteriously popping up all over the US ✨ Parasite protocols + Heartworm medications — the harm they actually do inside your furry friend's body ✨ The dangers of mRNA vaccines in pets ✨ Biopsies, c@nc$r and lipomas — when intervention may spread what you're trying to stop I'm not here to scare you. I'm here to aware you so you can embody your power as a pet owner. Because your dog or cat doesn't get to ask for a second opinion… you are their advocate. And when you innerstand what's really going on — you can make decisions from clarity, not pressure. If you've ever questioned: "Is this really the best option for my pet?" You'll want to hear this.

Le Doc Bensoussan révèle une avancée médicale renversante : et si un simple test sanguin suffisait à sauver des vies? Dans la Zone à Marcoux, l’entrevue la plus surréaliste de la semaine. Payer son lait comme on paie son taxi? Les Comiques s’insurgent à l’idée d’un futur où le prix du beurre changerait chaque heure. L’œuf ou la poule? Dan, roi des animaux, tranche enfin. Voir https://www.cogecomedia.com/vie-privee pour notre politique de vie privée

What if your prostate biopsy is missing the most important detail?In this powerful episode, Dr. Geo sits down with Dr. Jonathan Epstein, one of the most influential urologic pathologists in the world, to break down what's really happening behind your diagnosis.From Gleason scores to hidden aggressive patterns, this conversation reveals why pathology is the foundation of every prostate cancer decision — and why getting it right is critical.If you've had a biopsy, elevated PSA, or are considering treatment vs. surveillance… this episode is essential listening.⏱️ Timestamps00:00 – The Hidden Problem With Prostate BiopsiesWhy your diagnosis may not tell the full story02:00 – Meet Dr. Jonathan EpsteinA leader who helped define modern prostate cancer pathology04:30 – What Pathologists Actually Look ForUnderstanding normal vs. abnormal prostate tissue06:30 – Gleason Scores Explained SimplyWhat 3+3, 3+4, and 4+3 really mean09:00 – Why Gleason 6 Is So ControversialShould it even be called cancer?11:00 – The Real Risk Isn't Gleason 6What doctors worry about more13:00 – Active Surveillance: Who Is It For?Why more men are safely avoiding treatment14:30 – Pathology vs. BiologyHow research connects what we see to outcomes15:30 – The Most Important Details in Your ReportCribriform patterns, intraductal cancer, and why they matter17:00 – Understanding Gleason 7 (Grade Group 2 & 3)Low-risk vs. high-risk within the same score19:00 – When Cancer Becomes DangerousWhat defines aggressive disease21:00 – Gleason 9: Is It Already Spread?The truth about micro-metastasis23:00 – Why MRI and PSMA Scans Aren't PerfectWhat imaging can miss25:00 – Why Biopsies Still MatterEven in the era of advanced imaging26:00 – What Makes a “Good” BiopsyWhy technique matters more than you think29:00 – MRI-Guided vs. Random BiopsiesWhy both are still necessary30:00 – How to Read Your Pathology ReportWhat actually matters vs. what doesn't34:00 – Biopsy vs. Prostatectomy FindingsWhy results can change after surgery36:00 – How Often Pathology Is WrongWhy second opinions are critical38:00 – The Problem Patients Don't SeeYou don't know who's reading your biopsy41:00 – The Future: AI in PathologyWill machines replace doctors?45:00 – What Patients Should Do NextHow to advocate for yourself52:00 – Managing Anxiety Around PSA & BiopsiesA real conversation about fear56:00 – What to Do When You Get Your ResultsHow to approach your doctor and next steps01:03:00 – Final Advice: Take Control of Your Health

Strong outcomes often come from slowing down—not rushing into irreversible decisions.In this episode, Dr. Stephen Petteruti questions the automatic path from elevated PSA to biopsy, surgery, and radiation. He explains that biopsies can disseminate prostate cells, while the true impact on long-term metastatic risk remains uncertain. His approach favors sequential PSA monitoring, imaging, and disciplined observation over immediate intervention.Evidence does not clearly show that surgery or radiation extend life for many men, yet the side effects are well known which are sexual dysfunction, urinary issues, and metabolic decline. Supporting immunity, metabolic health, and overall resilience may matter more than acting quickly.Rethink your options and choose a path that protects both your health and your quality of life. Watch the full episode of Say NO to Prostate Cancer Biopsies, Surgery, and Radiation.Enjoy the podcast? Subscribe and leave a 5-star review on your favorite platforms.Dr. Stephen Petteruti is a board-certified physician specializing in longevity-focused, integrative medicine. He works with men navigating prostate cancer, testosterone and hormone health, aging, and performance using proactive, evidence-informed strategies grounded in real clinical practice. His approach prioritizes preserving function, strength, and quality of life while helping patients make clear, informed decisions beyond reactive, fear-driven care.Learn more: https://www.drstephenpetteruti.com/ Learn more: https://www.intellectualmedicine.com/ Connect with Dr. Petteruti on:⁠Instagram: ⁠https://www.instagram.com/dr.stephenpetteruti/⁠ Facebook: ⁠https://www.facebook.com/dr.stephenpetteruti⁠ Subscribe to Intellectual Medicine on:Apple Podcast: https://tinyurl.com/DrPetterutiApplePodcast Spotify: https://tinyurl.com/DrPetterutiSpotifyPodcast Disclaimer:The content presented in this video reflects the opinions and clinical experience of Dr. Stephen Petteruti and is intended for informational and educational purposes only. It is not medical advice and should not be used as a substitute for professional diagnosis, treatment, or guidance from your personal healthcare provider. Always consult your physician or qualified healthcare professional before making any changes to your health regimen or treatment plan.Produced by https://www.BroadcastYourAuthority.com 

This mini-series on Behind the Knife delves into the technical aspects of the Operative Standards for Cancer Surgery, developed through the American College of Surgeons Cancer Research Program and Cancer Surgery Standards Program. This episode highlights sentinel lymph node biopsy for breast cancer.Hosts:- Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a Surgical Oncology fellow at MD Anderson Cancer Center.- Lauren Postlewait, MD, FACS, is an Associate Professor of Surgery at Emory University School of Medicine and is the Medical Director of the Breast Center at Grady Memorial Hospital in Atlanta, GA.- Chantal Reyna, MD, FACS (@kprgrl3) is a Breast surgical oncologist at Loyola University Medical Center in Chicago, IL and serves as the oncology clinical lead for the breast service line.Guest:- Susan E. Pories, MD, FACS (@SusanPoriesMD) is a professor of surgery, vice chair for quality and safety, and director of the Rutger's Breast Center at the University hospital. Learning Objectives: -       Understand the definition and identification of axillary sentinel lymph node. -       Understand the technique for injecting tracer or dye to perform sentinel lymph node biopsy. -       Understand the importance of preincision drainage evaluation and transcutaneous localization.-       Understand techniques to minimize seroma formation.Links to Papers Referenced in this EpisodeOperative Standards for Cancer Surgery, Volume 1: Breast, Lung, Pancreas, Colonhttps://www.facs.org/quality-programs/cancer-programs/cancer-surgery-standards-program/operative-standards-for-cancer-surgery/purchase/Kindle edition:https://www.amazon.com/Operative-Standards-Cancer-Surgery-Section-ebook/dp/B07MWSNFSBSentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial Lancet Oncol. 2010 Oct;11(10):927-33.https://pubmed.ncbi.nlm.nih.gov/20863759/Improved Axillary Evaluation Following Neoadjuvant Therapy for Patients With Node-Positive Breast Cancer Using Selective Evaluation of Clipped Nodes: Implementation of Targeted Axillary Dissection J Clin Oncol. 2016 Apr 1;34(10):1072-8.https://pubmed.ncbi.nlm.nih.gov/26811528/The false-negative rate of sentinel node biopsy in patients with breast cancer: a meta-analysis World J Surg. 2012 Sep;36(9):2239-51. https://pubmed.ncbi.nlm.nih.gov/22569745/Effect of lymphoscintigraphy drainage patterns on sentinel lymph node biopsy in patients with breast cancer Am J Surg. 2005 Oct;190(4):557-62.https://pubmed.ncbi.nlm.nih.gov/16164919/Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes: The SOUND Randomized Clinical Trial JAMA Oncol. 2023 Nov 1;9(11):1557-1564.https://pubmed.ncbi.nlm.nih.gov/37733364/Choosing Wisely GuidelinesSociety of Surgical Oncology. Released 2016 July 12; last updated 2020 November 13. Choosing Wisely: Five Things Physicians and Patients Should Question.https://surgonc.org/wp-content/uploads/2020/11/SSO-5things-List_2020-Updates-11-2020.pdfPlease visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewOral Board Simulator: https://app.behindtheknife.org/oral-board-simulatorTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Thank you for joining us for our 2nd Cabral HouseCall of the weekend!   I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks…   Eve: God bless you for all you do. I had a routine mammogram in early 2025, followed by a bilateral breast ultrasound, they recommended 6 month monitoring due to multiple small cysts/masses (I have very dense breasts). I was advised to continue to monitor with ultrasounds every 6 months. At my March 2026 follow-up, they recommended a biopsy because one mass at the 9 o'clock position increased from 1 cm to 1.5 cm. For context, I had a benign biopsy in 2024 in the same breast (10 o'clock) and regret doing it out of fear. I feel that poking and probing can be more harmful. I'm worried about unnecessary procedures but don't want to ignore anything serious. Would short-term monitoring (repeat ultrasound in 3 months) be reasonable? The tech seemed inexperienced, could measurement error be possible?      Eve: Hi it's me again, I wrote in yesterday and after I spoke to my PCP about my hesitation on getting a breast biopsy, she was supportive and said why don't we do an MRI instead to be certain instead of poking and probing before knowing what it really is. The only thing is that it would have to be with contrast. What do you think? Less invasive, more real answers, but the contrast makes me anxious. Can I do a detox if I opt for the MRI vs the breast biopsy? Ty Doc.      Anonymous: Hi! Can you help provide advice on how to help with orange hands/elbows/feet? I've tested extremely high for beta carotene. I'm not sure why as I wasn't eating bushels of carrots, just trying to get a diversity of plants in each week but guess I steer towards vegetables with higher concentrations (squash, dark leafy greens, broccoli etc). I've practically eliminated all sources of it, but still seems not to improve much. Any advice would be helpful as it is embarrassing. Thanks!      Anonymous: Hi! What are your thoughts on using clean sources of nicotine treat things like long COVID, chronic fatigue, brain fog etc.. Thanks!      Nikita: Hi Dr Cabral, After 4 years of heavy hairloss, I finally corrected my iron-deficiency anemia (through prescription iron pills- only thing that worked). 6 months later my hairloss has finally slowed down a lot. However, I'm not noticing any type of regrowth. I'd love to get some of my density back after those 4 years of bad hairloss. I wanted to know your opinion on starting minoxidil for a temporary period of time just to wake up the hair follicles? I never took it before bc I don't want to commit to it forever, but do you think it could work for this case and then maybe I can stop it and the hair won't fall out again because now   Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3733 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Send us Fan MailPaper Discussed in this Episode: Advancements in bone marrow biopsy: the role of omics and artificial intelligence in hematologic diagnostics. Maryam Alwahaibi and Nasar Alwahaibi. Front. Med. 2026; 13:1772478.Episode Summary: In this journal club deep dive, we explore a paradigm shift in hematopathology, moving from 19th-century visual assessments to the cutting edge of precision medicine. We examine a 2026 review that unpacks how combining artificial intelligence with multi-omics technologies is transforming the traditional bone marrow biopsy from a static, subjective snapshot into a live, interactive, predictive 3D map. We ask: What happens when deep learning can predict underlying genetic mutations just by analyzing the visual shape and texture of a cell?.In This Episode, We Cover:The Breaking Point of Traditional Diagnostics: Why the 150-year-old gold standard of H&E staining and human visual assessment is hitting a biological and operational wall, plagued by subjectivity, high variability, and observer fatigue.The Multi-Omics Multiverse: Moving beyond standard genomics to unpack the complex biological machinery of the marrow, including:Epigenomics: The biological "switches," like DNA methylation, that control cell fate and can kick off malignant transformation without altering the underlying DNA sequence.Lipidomics: How cellular fats form specialized signaling rafts that actively remodel the marrow's communication network.Microbiomics (The Gut-Marrow Axis): How systemic inflammation driven by gut dysbiosis acts like a massive "traffic jam" that indirectly disrupts local bone marrow homeostasis and blood cell production.AI as the Ultimate Analytical Partner: How artificial intelligence serves as a bridge between physical tissue morphology and high-dimensional molecular data. We discuss AI tools like MarrowQuant for objective cellularity mapping and the Continuous Index of Fibrosis (CIF) that replaces clunky human guesswork with a granular, predictive metric.Predicting Genotype from Phenotype: The revolutionary capability of deep learning models to predict underlying genetic mutations (like TET2 or del 5q MDS) purely from the subvisual, spatial arrangement and shape of cells on a standard slide.Roadblocks and Solutions: Why this technology isn't universally adopted yet. We break down the "black box" problem of AI, the brittleness of algorithms in different clinical settings, and how innovations like Federated Learning and Explainable AI (using heat maps) are overcoming these hurdles.Key Takeaway: The integration of AI and multi-omics is redefining our understanding of bone marrow diseases. By uncovering invisible molecular machinery and objectively translating it through transparent algorithms, we are moving away from subjective human bottlenecks toward a highly personalized, predictive model of hematologic care.Support the showGet the "Digital Pathology 101" FREE E-book and join us!

In today's episode, Dr. Paul Wheatley-Price chats with Dr. Natasha Leighl, Medical Oncologist and Lung Site Lead at the Princess Margaret Cancer Center in Toronto, all about liquid biopsies. What is a biopsy, the difference between a tissue vs liquid biopsy, how does it work, when it can be done, and where is it available in Canada? Dr. Leighl gets into all the details with her renowned expertise in this topic!

Send me a derm question or story!In this week's episode, we explore an interesting feline case that illustrates why no detail should ever be overlooked. When a "perky nose" complaint actually becomes plasma cell pododermatitis.Using this case as a guide, we highlight how critical it is to go beyond the presenting complaint. A thorough dermatologic exam, combined with a detailed history, can uncover subtle abnormalities that completely change your diagnostic path, treatment plan, and ultimately, patient outcome. It's a good reminder that even when a diagnosis seems obvious, there could be clinical clues that point you a different direction.We discuss how this case unfolded, what could have been missed with a more limited approach, and practical strategies to ensure you're consistently gathering complete information in every appointment.References:Declercq J, DeBosschere H. Nasal swelling due to plasma cell infiltrate in a cat without plasma cell pododermatitis. Vet Dermatol. 2010;21:412–414. doi: 10.1111/j.1365-3164.2010.00869.x.Brosseau G. Feline plasma cell pododermatitis. Can Vet J. 2022 May;63(5):545-548. PMID: 35502252; PMCID: PMC9009751.Timestamps00:00 Intro03:50 The Swollen Nose07:02 Deflated Paws09:12 Biopsy and Diagnosis Confirmation12:09 Importance of Looking at the Complete History16:53 Outro

“It's ultra stable. Health care doesn't move. If you biopsied American health care in 2010 and again in 2026, no one could figure out which slide was which.” — Robert Pearl, MDBad news. The patient, I'm afraid, is ultra-stable. Robert Pearl, former CEO of Kaiser Permanente for eighteen years and author of ChatGPT MD, returns with the bleakest diagnosis we've heard all month. American healthcare, Dr Pearl says, is “ultra stable.” That might sound good. But it's actually very very bad.If you biopsied American healthcare in 2010 and again in 2026, Pearl says, no clinician could tell the slides apart. Both were and are overpriced. Both underperforming. Hospitals still represent between 30-35% of expenses. Costs continue to rise at between 7-9% a year. There remain four hundred thousand misdiagnosis deaths annually. Burnout is stuck at 50%. The numbers haven't moved in fifteen years.Meanwhile, a stealth revolution is already underway. 40% of Americans use generative AI every month for medical questions. 70-80% of physicians use it weekly. While the patients and doctors have moved, the system hasn't. It remains ultra-stable. It's a Kodak moment — healthcare's business model, Pearl suggests, is selling sickness. So, for example, the new new medical thing is GLP-1 drugs that cost $5 to manufacture and sell for $400.So will the system collapse? No, Pearl insists. It has too much strength for that kind of drama. Instead, it will quietly ration us to death — more chronic disease, earlier deaths, more people making a major sacrifice to pay their healthcare bills. Ultra-stability, then, is what is killing the American healthcare system. It will, quite literally, ration us to death. Five Takeaways•       Ultra Stable: Pearl's diagnosis of American healthcare in one phrase. Hospitals stay at thirty to thirty-five per cent of total expenses. Costs rise at seven to nine per cent annually. Life expectancy hasn't budged. Four hundred thousand misdiagnosis deaths a year. Burnout at fifty per cent. Biopsy 2010 and 2026 — no one could tell the slides apart. Both overpriced. Both underperforming.•       The Stealth Revolution Has Already Happened: Forty per cent of Americans use generative AI every month for medical questions. Seventy to eighty per cent of physicians use it weekly. The patients and doctors have moved. The system hasn't. It's a Kodak moment — they had the first filmless camera and let it die because their business model was selling film. Healthcare's business model is selling sickness.•       Quietly Rationed to Death: There will be no dramatic collapse. The system has too much strength for that. Instead: rationing, more chronic disease, earlier deaths. Like airlines moving everyone into first class while the rest drive. Twenty-five per cent of Americans already made a major sacrifice to pay healthcare bills last year. When it hits fifty per cent, maybe the polling places will notice. Pearl is doubtful.•       GLP-1s Cost $5 to Make and $400 to Buy: Yale's analysis: the manufacturing cost of a GLP-1 drug is $5 a month. They sell at a discounted price of $400. That's eighty times markup. Pearl's math: to make GLP-1s cost-neutral against the medical savings, the price has to be under $200. Trump Rx won't help most people because you can't use insurance there and $400 cash is still impossible on $60,000 a year.•       Vibe Coding Is the Prescription: One year old. Lets clinicians build software in plain English without code. Pearl's example: a heart failure patient at home, weighed daily on a Bluetooth scale, with an electronic stethoscope, ankle video, blood oxygen, exercise tolerance — all in an app a doctor could build in a weekend. Three days of fluid retention caught before the ICU admission. Cost: twenty dollars a month. The fix has arrived. The system isn't using it. About the GuestBeverly Gage is the John Lewis Gaddis Professor of History and American Studies at Yale. She is the author of G-Man: J. Edgar Hoover and the Making of the American Century, which won the Pulitzer Prize for Biography, and This Land Is Your Land: A Road Trip Through US History. She is currently at work on a biography of Ronald Reagan.References:•       This Land Is Your Land: A Road Trip Through US History by Beverly Gage.•       G-Man: J. Edgar Hoover and the Making of the American Century by Beverly Gage — the Pulitzer-winning biography.•       Episode 2859: Stop, Don't Do That — Peter Edelman on Bobby Kennedy and the heart of America. The companion conversation.About Keen On AmericaNobody asks more awkward questions than the Anglo-American writer and filmmaker Andrew Keen. In Keen On America, Andrew brings his pointed Transatlantic wit to making sense of the United States — hosting daily interviews about the history and future of this now venerable Republic. With nearly 2,800 episodes since the show launched on TechCrunch in 2010, Keen On America is the most prolific intellectual interview show in the history of podcasting.WebsiteSubstackYouTubeApple PodcastsSpotify Chapters:(00:31) - Introduction: AI and the American healthcare sector (01:47) - ChatGPT MD: chronic disease and the trillion-dollar opportunity (04:50) - The stealth revolution: 40% of patients, 80% of doctors (06:53) - Ultra stability: the 2010-vs-2026 biopsy (09:50) - Three years of generative AI and counting (11:13) - Will the system collapse? No — it will quietly ration (13:33) - The drip-drip of preventable deaths (16:08) - GLP-1 drugs: $5 to make, $400 to buy (18:23) - Vibe coding enters the conversation (21:22) - Will AI replace clinicians? (28:08) - Trump Rx and why it won't help most people (30:41) - RFK Jr., vaccines, and the war on science (33:23) - The midterms as the political reckoning (35:29) - The three-step fix: capitation, transition, capital (39:48) - Vibe coding and the heart failure example

April 3, 2026 In this episode, Scott, Mark, and Dr. Ray Painter tackle two areas where interpretation is driving real-world coding challenges: when a prostate biopsy truly qualifies as a stereotactic template-guided saturation biopsy (55706), and whether diagnostic cystoscopy meets moderate risk under E/M guidelines. The discussion breaks down what differentiates saturation biopsy from standard transperineal approaches, including the importance of 3D templating and full-gland sampling, and why payer expectations may not align with physician interpretation. They also revisit the E/M risk table, reinforcing why cystoscopy is generally considered moderate risk—even if not explicitly stated in current guidelines. The key takeaway: as coding becomes more nuanced, balancing guideline interpretation with payer expectations is critical to staying compliant and getting paid correctly. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

Drs. Petri and Woolfson discuss a simple risk score using autoantibodies, complement, and demographics to predict which SLE patients are most likely to develop proteinuria and lupus nephritis. They also highlight evidence showing that earlier kidney biopsies at lower proteinuria levels, especially in patients with low complement, can detect serious disease sooner and improve outcomes.

Send us Fan Mail Join Dr. Lodi's Inner Circle membership and unlock exclusive access to webinars, healthy recipes, e-books, educational videos, live Zoom Q&A sessions with Dr. Lodi, plus fresh content every month. Elevate your healing journey today by visiting drlodi.com and use the coupon code podcast (all lowercase: P-O-D-C-A-S-T) for 30% off your first month on any membership option. Support the showThis episode features answers to health and cancer-related questions from Dr. Lodi's social media livestreams.Join Dr. Lodi's FREE Q&A livestreams every Sunday on Facebook, Instagram, and Tiktok (@drthomaslodi) and listen to the replays here.Submit your question for next Sunday's Q&A Livestream here:https://drlodi.com/live/Facebookhttps://www.facebook.com/DrThomasLodi/Instagramhttps://www.instagram.com/drthomaslodi/Join Dr. Lodi's Inner Circle membership and unlock exclusive access to webinars, healthy recipes, e-books, educational videos, live Zoom Q&A sessions with Dr. Lodi, plus fresh content every month. Elevate your healing journey today by visiting drlodi.com and use the coupon code podcast (all lowercase: P-O-D-C-A-S-T) for 30% off your first month on any membership option.Learn to Thrive with ADHD PodcastWelcome to the Learn to Thrive with ADHD Podcast. This is the show for you if you're...Listen on: Apple Podcasts   SpotifyJoin Dr. Lodi's informative FREE Livestreams on social media...

Send us Fan MailPaper Discussed in this Episode:Assessing interstitial fibrosis and tubular atrophy in kidney biopsies artificial intelligence versus humans. Farris AB, Zukić D, Solez K. Current Opinion in Nephrology and Hypertension. March 16, 2026.Episode Summary: In this journal club deep dive on the Digital Pathology Podcast, we explore the intense debate over quantifying chronic kidney disease progression. We unpack a fresh 2026 study comparing artificial intelligence to human pathologists in assessing interstitial fibrosis and tubular atrophy. If top experts can't agree on a diagnosis due to human subjectivity, can an AI trained on their imperfect data provide a better standard? We explore what happens when pixel-perfect machines clash with nuanced human medical judgment.In This Episode, We Cover:• The Clinical Stakes of Kidney Scarring: Why interstitial fibrosis (the scarring of tissue spaces between filtering units) and tubular atrophy (shrinking and collapsing functional tubes) are the primary surrogate measures for tracking chronic kidney disease. We discuss how a mere 10% diagnostic variance can drastically alter a patient's medication regimen, dialysis prep, or transplant eligibility.• The Flaw in the "Gold Standard": We break down the "interobserver variability" problem—why two highly trained, board-certified pathologists can look at the exact same biopsy slide and give two completely different mathematical assessments of the damage.• How the AI Actually Works (Mapping the Neighborhood): A look at "indirect assessment through kidney compartment segmentation," where the AI acts as a digital surveyor. It identifies cellular fences like glomeruli and tubules, establishing microscopic "zoning laws" before it begins counting the damaged tissue.• The Proofreader vs. The Literary Critic: Why studies show a persistent "lack of complete concordance" between human and machine. We discuss how AI hyper-focuses on mathematical pixel intensity and mistakes physical slide artifacts (like a folded piece of tissue) for severe disease. Meanwhile, human pathologists act as "literary critics," easily filtering out the visual noise using clinical context.• The Humans + AI Synergy: The ultimate endgame isn't replacing pathologists, but combining the tireless mathematical consistency of AI with the complex contextual reasoning of humans to create a highly advanced co-pilot system.Key Takeaway: The lack of perfect agreement between AI and human pathologists isn't a failure, but rather evidence that they perform fundamentally different types of analysis. AI excels at tedious, reproducible quantification that eliminates human visual fatigue, but it lacks contextual judgment. By adopting a "humans + AI" workflow, the medical field can stabilize crucial kidney measurements and elevate the pathologist to a true diagnostic synthesizer, ultimately leading to more effective patient careSupport the showGet the "Digital Pathology 101" FREE E-book and join us!

Samina Farid built her career in oil and gas, founded her own company, and forged ahead in spaces where women are rarely seen. Through it all, she faced cancer twice and found strength that reshaped both her health and her work. - Breaking barriers as the only woman in the room - Building success in a male-dominated industry - Facing cancer two times and turning challenges into purpose Support The Rose HERE. Subscribe to Let’s Talk About Your Breasts on Apple Podcasts, Spotify, iHeart, and wherever you get your podcasts. Key Questions Answered 1. How did Samina Farid cope with the challenges of being the only woman in a male-dominated field? 2. How did Samina come to start her own company, and what inspired its mission? 3. What was unique about Merrick Systems, and how did it contribute to the industry? 4. Why did Samina decide to sell her company, and what was that process like? 5.What steps did Samina take after her cancer diagnosis? 6. What did Samina learn about her genetic risk for cancer? 7. How did journaling and self-care practices help Samina during her cancer journey? 8. What message does Samina want to share with other women about health and self-care? Timestamped Overview 00:00 Discovery of Remarkable Women 04:12 Pre-Internet Oil Data Challenges 08:20 Grateful for Mentorship Journey 11:27 "Turbulent Life Changes" 15:44 Cancer Journey and Support 21:23 "Facing Cancer's Uncertainty" 24:12 Genetic Mutation: Cancer Risk Alert 25:44 Pancreatic Tumor and Whipple Surgery 28:49 Prioritize Health: Just Do ItSee omnystudio.com/listener for privacy information.

Better health begins with awareness. The body often whispers long before disease speaks loudly.  In this episode, Dr. Stephen Petteruti explains why many prostate cancer discussions focus too heavily on procedures while ignoring the body's early signals. He critiques tests such as ConfirmMDx, which require a prostate biopsy to perform, and urges men to question how a test result will actually change medical decisions before agreeing to it. Dr. Stephen also outlines subtle warning signs that many men dismiss. Frequent cold sores, shingles outbreaks, unexplained fatigue, chronic inflammation, persistent muscle aches, digestive disruption, and ongoing skin irritation may all reflect immune system stress. These signals do not prove cancer, but they can indicate a body under strain.Press play, take notes, and share this episode of Prostate Cancer Warning Signs Most Men Ignore | Biopsies & Early Detection with the men in your life who deserve better information about their health. Enjoy the podcast? Subscribe and leave a 5-star review on your favorite platforms.Dr. Stephen Petteruti is a board-certified physician specializing in longevity-focused, integrative medicine. He works with men navigating prostate cancer, testosterone and hormone health, aging, and performance using proactive, evidence-informed strategies grounded in real clinical practice. His approach prioritizes preserving function, strength, and quality of life while helping patients make clear, informed decisions beyond reactive, fear-driven care.Learn more: https://www.drstephenpetteruti.com/ Learn more: https://www.intellectualmedicine.com/ Connect with Dr. Petteruti on:⁠Instagram: ⁠https://www.instagram.com/dr.stephenpetteruti/⁠ Facebook: ⁠https://www.facebook.com/dr.stephenpetteruti⁠ Subscribe to Intellectual Medicine on:Apple Podcast: https://tinyurl.com/DrPetterutiApplePodcast Spotify: https://tinyurl.com/DrPetterutiSpotifyPodcast Disclaimer:The content presented in this video reflects the opinions and clinical experience of Dr. Stephen Petteruti and is intended for informational and educational purposes only. It is not medical advice and should not be used as a substitute for professional diagnosis, treatment, or guidance from your personal healthcare provider. Always consult your physician or qualified healthcare professional before making any changes to your health regimen or treatment plan.Produced by https://www.BroadcastYourAuthority.com 

Your Guide To Living With Adhd: Managing Daily Life, Healthcare, And Intimacy Living with ADHD often means struggling with essential executive functions like focus and organization. Because symptoms manifest differently in each person, many people lack the specific systems and structures needed to manage their unique challenges. Our guest offers advice on various coping strategies and what to do when those structures fail. Guest: Cate Osborn, online mental health advocate, co-author, The ADHD Field Guide for Adults Host: Elizabeth Westfield Producer: Kristen Farrah.     From Doctor To Patient: Lessons In Self-Advocacy From A Physician Dr. Sylvia Owusu-Ansah's life took a turn when a routine medical screening became anything but. Despite her professional expertise, she still had to navigate the frightening transition from provider to patient. Owusu-Ansah explains how she's using her story to show others how to self-advocate when navigating the healthcare system. Guest: Dr. Sylvia Owusu-Ansah, pediatric emergency medicine physician, assistant professor of pediatrics and emergency medicine, University of Pittsburgh School of Medicine, cancer patient Host: Greg Johnson Producers: Kristen Farrah  Facebook: ingoodhealthpodX: @ ingoodhealthpodIG: @ingoodhealthpodYouTube: @ingoodhealthpodSpotify Apple Podcast In Good Health PodcastSubscribed to the newsletterFull ArchiveContact UsBecome an Affiliate Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

From Doctor To Patient: Lessons In Self-Advocacy From A Physician Dr. Sylvia Owusu-Ansah's life took a turn when a routine medical screening became anything but. Despite her professional expertise, she still had to navigate the frightening transition from provider to patient. Owusu-Ansah explains how she's using her story to show others how to self-advocate when navigating the healthcare system. Guest: Dr. Sylvia Owusu-Ansah, pediatric emergency medicine physician, assistant professor of pediatrics and emergency medicine, University of Pittsburgh School of Medicine, cancer patient Host: Greg Johnson Producers: Kristen Farrah   Links for information:Owusu-Ansah profileOwusu-Ansah InstagramOwusu-Ansah Website    Facebook: ingoodhealthpodX: @ ingoodhealthpodIG: @ingoodhealthpodYouTube: @ingoodhealthpodSpotify Apple Podcast In Good Health PodcastSubscribed to the newsletterFull ArchiveContact UsBecome an Affiliate Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode, Therese Markow and Dr. John Kisiel discuss early cancer detection using liquid biopsies. Dr. Kisiel explains that liquid biopsies detect cancer signals in blood and urine, including tumor cells, fragments, proteins, and DNA. He highlights the FDA's approval of a blood test for colon cancer and the development of multi-cancer early detection tests. Dr. Kisiel notes that false positive and false negative rates vary by test. He emphasizes the potential of liquid biopsies to complement, not replace, standard screening methods and the need for further validation and clinical trials. Key Takeaways: Liquid biopsies have been used in the oncology community to test if cancer is still present, may need additional or more aggressive treatment, or if the cancer has come back. Each test will have its own false positive and false negative rate, partially based on where manufacturers set the thresholds for that positive/negative result. Peripheral blood-based tests for colon cancer do not detect polyps, and it's the finding and removing of polyps that actually offers the greatest preventive benefit, so that somebody never gets cancer in the first place.    "Another word of cautious optimism, I think that I, personally, and many other people active in the space really view these as an addition to standard of care cancer screening and not a replacement." —  Dr. John Kisiel   Connect with Dr. John Kisiel: Professional Bio: https://www.mayo.edu/research/faculty/kisiel-john-b-m-d/bio-00092659    Connect with Therese: Website:  www.criticallyspeaking.net Bluesky: @CriticallySpeaking.bsky.social Instagram: @criticallyspeakingpodcast Email: theresemarkow@criticallyspeaking.net   Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it. 

Will RFK Jr.'s efforts to promote nutrition education in medical schools stall? Doctors-in-training embrace “culinary medicine”; As Administration relaxes their regulation, PFAS compounds shown to accelerate biological aging; Is there a cure for ringing in the ears? Biopsies reveal microplastics in 90% of prostate cancers; Can you trust the results of your on-line gut microbiome test? Can sunlight tame autoimmune disease? Birdwatchers have enhanced brain regions for attention and perception. Can one have dental x-rays and a brain MRI on the same day?

Andria Parks, Head of Commercial Operations at First Ascent Biomedical, highlights the value of using a biopsy to grow cancer cells in a lab to determine which drugs are most likely to be effective against a specific cancer. This functional medicine approach combines lab data, genomic data, and AI to produce a report that identifies which drugs might work and which are unlikely to be effective for that individual patient. This perspective is particularly effective for rare cancers, which often lack established treatment guidelines.  Andria explains, "First Ascent Biomedical is a functional precision medicine company. And what that means is we've put together three very unique and advanced technologies to produce something very specific, and I'll explain what that means. What we do is we take a fresh biopsy from a patient, and we will grow those cells in our lab in a medium very similar to the human body. We will test or validate more than 150 drugs and drug combinations on those cells to see what works on those cells and what kills them. We will combine that with a patient's genomic information using our advanced AI. And then a report is produced that stack ranks the drugs that work, but most importantly, the drugs that don't work for that patient's cancer. And when a physician sees that report, they know exactly what to start with before initiating treatment. So everything we do is outside the body."   "If you are testing 150 drugs and combinations on your unique cancer cells, you will be able to know what works and doesn't ahead of time. Usually, most patients who don't follow this approach go through a standard-of-care protocol. And what that means is these protocols or ways of treating patients are based on hundreds of thousands of patients that may look like you and me, but are not you and me. So it's based on evidence of many, many, many patients with a similar type of profile. But the uniqueness of getting a drug to work for your specific cancers is based on your unique cells. So that's what makes a big difference. You may see 20% - 40% that works, but without knowing if they were tested on your cancer cells, and that's what makes a big difference with what functional precision medicine in oncology delivers." #FirstAscentBiomedical #PrecisionMedicine #CancerResearch #Oncology #PersonalizedMedicine #HealthTech #RareCancer #Innovation #FunctionalMedicine #AI #Biotech #PatientCare firstascentbiomedical.com Download the transcript here

Andria Parks, Head of Commercial Operations at First Ascent Biomedical, highlights the value of using a biopsy to grow cancer cells in a lab to determine which drugs are most likely to be effective against a specific cancer. This functional medicine approach combines lab data, genomic data, and AI to produce a report that identifies which drugs might work and which are unlikely to be effective for that individual patient. This perspective is particularly effective for rare cancers, which often lack established treatment guidelines.  Andria explains, "First Ascent Biomedical is a functional precision medicine company. And what that means is we've put together three very unique and advanced technologies to produce something very specific, and I'll explain what that means. What we do is we take a fresh biopsy from a patient, and we will grow those cells in our lab in a medium very similar to the human body. We will test or validate more than 150 drugs and drug combinations on those cells to see what works on those cells and what kills them. We will combine that with a patient's genomic information using our advanced AI. And then a report is produced that stack ranks the drugs that work, but most importantly, the drugs that don't work for that patient's cancer. And when a physician sees that report, they know exactly what to start with before initiating treatment. So everything we do is outside the body."   "If you are testing 150 drugs and combinations on your unique cancer cells, you will be able to know what works and doesn't ahead of time. Usually, most patients who don't follow this approach go through a standard-of-care protocol. And what that means is these protocols or ways of treating patients are based on hundreds of thousands of patients that may look like you and me, but are not you and me. So it's based on evidence of many, many, many patients with a similar type of profile. But the uniqueness of getting a drug to work for your specific cancers is based on your unique cells. So that's what makes a big difference. You may see 20% - 40% that works, but without knowing if they were tested on your cancer cells, and that's what makes a big difference with what functional precision medicine in oncology delivers." #FirstAscentBiomedical #PrecisionMedicine #CancerResearch #Oncology #PersonalizedMedicine #HealthTech #RareCancer #Innovation #FunctionalMedicine #AI #Biotech #PatientCare firstascentbiomedical.com  Listen to the podcast here

Welcome to Season 2 of the Orthobullets Podcast.In this episode, we review the high-yield topic of ⁠⁠Biopsy Principles ⁠from the Pathology section.⁠Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube

Chronic diarrhea affects approximately 6–7% of adults, and the vast majority of cases are noninfectious. The most common causes are irritable bowel syndrome with diarrhea and functional diarrhea. A systematic approach matters: • Screen with CBC, CMP, fecal calprotectin, IgA-tTG • Identify alarm features • Biopsy for microscopic colitis when needed • Start with lifestyle + low-FODMAP • Escalate to targeted therapy thoughtfully Precision in diagnosis leads to precision in therapy.   #Gastroenterology #InternalMedicine #EvidenceBasedMedicine

Neurologic complications of hematologic disorders are frequently encountered in clinical practice and can involve both the central and peripheral nervous systems. Early recognition and appropriate management in collaboration with a hematologist are essential to reduce morbidity and mortality. In this episode, Kait Nevel, MD, speaks with Lauren Patrick, MD, and Mark Terrelonge, MD, MPH, authors of the article "Neurologic Complications of Hematologic Disorders" in the Continuum® February 2026 Neurology of Systemic Disease issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Patrick is an assistant professor of neurology at the University of California, San Francisco, in San Francisco, California. Dr. Terrelonge is an associate professor of neurology at the University of California, San Francisco, in San Francisco, California. Additional Resources Read the article: Neurologic Complications of Hematologic Disorders Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Full episode transcript available here Dr Nevel: Thick blood, thin blood. These are terms often used by patients and caregivers to describe some of the hematologic disorders that can lead to neurological diseases such as stroke. So, when should we consider a hematologic disorder as a potential cause for neurological conditions, such as stroke or neuropathy. Today I have the opportunity to interview Drs Lauren Patrick and Mark Terrelonge to learn more about neurologic complications of hematologic disorders in their recent article in Continuum. Dr Jones: This is Dr Lyell Jones, editor-in-chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Nevel: Hello, this is Dr Kate Nevel. Today I'm interviewing Drs Lauren Patrick and Mark Terrelonge about their article on neurologic complications of hematologic disorders. This article appears in the February 2026 Continuum issue on neurology of systemic disease. Welcome to the podcast, and please introduce yourself to the audience. Dr Patrick: Thank you for having us. We're both thrilled to be here. I'm Lauren Patrick, a vascular neurologist and assistant professor at the University of California, San Francisco, and program director for the Vascular Neurology Fellowship here. Dr Terrelonge: And I'm Mark Terrelonge, I'm an associate professor of neurology and neuromuscular medicine here at UCSF and one of the associate program directors for the adult neurology residency. Nice to meet you. Dr Nevel: Nice to meet you both. Really looking forward to getting into your article and learning more. So, to kind of kick us off, I always like to ask what do you think is the most important takeaway from your article for the practicing neurologist? And maybe since there are two of you and I suspect you covered slightly different aspects of this article, maybe you could give us two most important takeaways. Dr Patrick: Sure. I think the biggest takeaway is to keep hematologic disorders on the differential when evaluating patients with neurologic symptoms. Conditions like sickle cell disease, myeloproliferative neoplasms, or plasma cell dyscrasias and paraproteinemia can cause strokes or peripheral neuropathies, and many have specific and targetable treatments. The early recognition and collaboration with our hematology colleagues can truly change patient outcomes, whether that's by initiating cytoreductive therapy, managing thrombocytopenia, or optimizing antithrombotic therapy. Dr Nevel: Great. So, this is a really big and diverse topic. As always, I'm going to urge our listeners to read the article because there is a lot of really good stuff in your article that we just don't have time to get into during this interview today. But you cover a lot of different hematological disorders and how they can cause neurological complications. One of the major neurological complications of hematological disorders is cerebral vascular events. So, I'm hoping, Warren, that you can walk us through a little bit. When should we consider workup of potential hematologic disorder as a cause when we see a patient with ischemic stroke, because certainly not all patients with ischemic stroke should be getting a broad hematological disorder work up. So how can we kind of identify early on that there might be something else at play? Dr Patrick: Absolutely, great question. So, in many cases, the underlying hematologic disorder is already known, such as sickle cell disease or polycythemia vera. But sometimes stroke is the initial presentation or manifestation of the disease. So red flags can include young age, recurrent cryptogenic strokes or thrombosis, and unusual locations like the cerebral venous system. Laboratory clues such as unexplained erythrocytosis, thrombocytosis, thrombocytopenia, or hemolytic anemia should raise suspicion for an occult hematologic disorder. In the setting of acute illness, immune-mediated or heparin-induced thrombocytopenia or thrombotic microangiopathies should be suspected in patients that have hemorrhagic and or thrombotic complications, particularly when relevant lab disturbances are present. Acquired thrombophilia such as anti-phospholipid antibody syndrome should be considered in young patients with autoimmune disease, prior venous or arterial thrombotic complications, or pregnancy morbidity. Now, these are rare causes overall, but they're important to catch because the management can differ dramatically from our typical stroke care. Dr Nevel: Great. And what are some of the most common inherited or acquired thrombophilias and when should we be sending these labs? Dr Patrick: The hematologic causes really account for small minority of arterial strokes approximately one to two percent, but among those, sickle cell disease, anti-phospholipid antibody syndrome and the myeloproliferative neoplasms are the most common. Timing of testing is key. So, the genetic thrombophilia panels can be drawn at presentation, but lab values such as protein C, protein S, and antithrombin levels may be falsely low during acute thrombosis, so they're often repeated weeks later. Similarly, for anti-phospholipid antibody testing that should be done at presentation and when positive, confirmed at twelve weeks, since transient positivity can occur with affections or acute events. So, in patients that are already anticoagulated for anti-phospholipid antibody syndrome, testing becomes particularly tricky, especially with lupus anticoagulant assays. Some results need to be interpreted carefully or repeated when feasible. The main message is to collaborate early with our hematology colleagues to guide the timing and interpretation of these studies. Dr Nevel: Yeah, wonderful. Thank you. I'll ask some similar questions about neuropathy. So when should we consider an underlying hematologic disorder as being the cause for someone's neuropathy? Dr Terrelonge: So, luckily for a neurologist, then serum protein electrophoresis or an SPEP is already a part of the first pass evaluation for even the most common neuropathies we see, technically already considered every time we do an evaluation. However, we do know that most neuropathies progress very slowly and don't really lead to significant limitations in patient activities of daily living. And for those, the initial workup step, you may not need to do any additional search for any hematologic diseases after that first step. Within patients who start to have more unusual features with their neuropathy, including a rapid progression, early proximal weakness, significant and extremely painful neuropathies, significant ataxia, or new tremor or anything that's kind of outside of the garden variety neuropathy, then you should start to think about a hematologic cause. Additionally, if a patient already has a known hematologic malignancy or process before their neuropathy, there should be some form of assessment to see through exam or electrodiagnostically if the two are correlated. I do have to add one caveat, though, and that's just because someone has a hematologic malignancy or a paraprotein seen in their blood, their neuropathy and the neurologic syndrome don't necessarily have to be causally related. So, we have to do some additional testing to determine if the patient's presentation of the paraprotein are actually linked. Dr Nevel: Can you walk us through a little bit how we determine if they're associated or just coincidental? Dr Terrelonge: Yeah. So, for some of the proteins, there's a specific phenotype that will come with the specific protein. For example, an anti MAG proteinopathies or MAG standing for a myelin associated glycoprotein, it usually leads to a distal sensor and motor polyneuropathy where the most distal portions of nerves are affected. So, in that case, people might notice that they have numbness and weakness in their toes and their fingers, and it doesn't follow that typical length dependent pattern. So, in that case, if you have the anti mag neuropathy and the electrodiagnostic signature of an anti mag neuropathy along with the symptoms, you're more likely to think that the two are related then if not. Dr Nevel: Great. Thank you. And I was hoping you could speak a little bit more about amyloidosis just because I think that that's one that can be really tricky to diagnose. And I see patients, you know, have sometimes more drawn out evaluations or see multiple providers before a diagnosis is reached. So, can you speak a little bit more to how we diagnose amyloidosis in relationship to neuropathy or other neurological conditions and when we should push for more invasive testing like a nerve biopsy? Dr Terrelonge: So, amyloidosis certainly is a tricky diagnosis. I've been tricked by it and I think most of my neuromuscular colleagues have probably been tricked by it at least once. It's a hard diagnosis to make is it usually requires a pretty high index of suspicion, and also requires a tissue diagnosis to cinch. There're some patients who will come in with a prior history of amyloidosis and they're a little bit easier to figure out if the neuropathy is related. Maybe it's started in their heart or their kidney first and then you can just see if the type of amyloid they have usually deposits in nerve, and that may be enough. But if there's any diagnostic uncertainty, you could go forward with tissue biopsy. But it's patients in which the neuropathy is the first symptom that amyloidosis can be especially tricky to diagnose. It's a primarily light chain disease. So, if you do only an SPEP as a part of your initial neuropathy evaluation, you could miss it. But usually, the patients will have either a severely painful neuropathy, early autonomic dysfunction, or really prominent bilateral carpal tunnel syndrome. So, if they have any of those, usually we'll add in an amyloid workup as a part of that of the rest of the workup, which would include both light chain evaluations to see if there's any increase in Lambda or Kappa light chains and then also biopsy. Biopsy can be of the skin or fat pad first, which have reasonable sensitivity for picking up disease, but they're not necessarily a hundred percent. So if the suspicion remains high in those cases, a nerve biopsy should be considered. And the reason why this is important is that the chemotherapeutic agents that we have now can actually help arrest a lot of these diseases and stop further organ involvement. So, if you think about it, it is important to keep pushing and looking until you find it. Dr Nevel: Thank you so much for that. And a follow up question to that, once patients are started on appropriate therapy, the diagnosis is made, chemotherapy is started, what's the typical clinical course that you see in terms of their neuropathy? Do you ever see improvement or is it arrest of worsening? Dr Terrelonge: Usually for amyloid, there is an arrest of disease, but in some patients, they could have some improvement, not necessarily a dramatic improvement, but some patients could see some reversal of symptoms. That may not necessarily be because nerves injured nerves are regrowing, but because of reorganization of nerves to muscle, they could have some strength increases or at least less pain. Dr Nevel: Yeah, thank you. So, when should we involve a hematologist in aiding in the evaluation of patients we suspect may have an underlying hematological disorder? You guys really outlined very nicely in your article some of the laboratory workup or other workup like you just talked about with amyloidosis. But at what point in that workup should we reach out to our hematology colleagues? Dr Patrick: I would say almost always. So, these disorders are inherently multi-system and benefit from early co-management. In acute sickle cell stroke, for example, hematology helps direct emergent exchange transfusion. For myeloproliferative disorders they guide cyto reduction and long term antithrombotic strategy. And for antibody mediated or plasma cell disorders, hematology determines disease specific therapies. So, neurology may help with identifying the presentation, but the definitive management is almost always shared with our hematology colleagues. Dr Nevel: And as you both have mentioned that a lot of times in these cases, their hematologic disorder may be already known before they present with their neurological symptoms. So, I imagine obviously in those cases that a hematologist hopefully is already heavily involved in their care. What do you think is the most difficult aspect of identifying and diagnosing patients with neurologic illness as having an underlying hematological disorder? Dr Patrick: The hardest part is maintaining a high index of suspicion, especially since hematologic causes account for a very small minority of arterial strokes. Most strokes are from traditional vascular risk factors like you mentioned, or cardio embolism, so it's easy to stop diagnostic evaluation after standard studies have been performed. An example of a challenging case is a patient that's young, they've had recurrent cryptogenic stroke, and they could have antiphospholipid antibody syndrome, but it can be easy to miss if their antibody titers are borderline or if they're already anticoagulated, which would complicate retesting. So, it's about balancing the urge to over-test with recognizing the few cases where identifying A hematologic cause truly changes that management. Dr Terrelonge: And then on the neuropathy side, probably the hardest part is deciding what's causal and what's coincidence. Monoclonal gammopathy of unknown significance, or MGUS, is really common in older adults, so not every M-spike on an SPEP explains a neuropathy. And even sometimes there's times when the neurologic picture will develop a little bit faster than the hematologic one. So, it's hard to put the two together. Dr Nevel: Yeah. What's the most rewarding aspect of taking care of patients with complications from their hematologic disorders? Dr Patrick: It's deeply rewarding when a targeted diagnosis leads to a tangible improvement in that patient's care. For example, identifying A cryptogenic stroke is being due to myeloproliferative neoplasm or an inherited thrombophilia allows us to move from empiric treatment to possible disease specific strategy. It's really gratifying to give patients that clarity, to give them a diagnosis and in some cases prevent future events. Dr Terrelonge: Agreed. And even on the neuropathy side, almost all of the neuropathies that are hematologically related are treatable. So, it's so satisfying whenever you have a patient with say an anti-MAG neuropathy or Waldenström can start the patient on therapy, and you can see someone who's been having a progressive decline to stability and in those cases sometimes even significant recovery. Dr Nevel: Yeah, absolutely. Very rewarding when you can identify the problem and make it better. That's what it's all about. So, what are the future areas of research in this area? What do we still need to learn? Dr Patrick: There's still a lot to learn. I think we need better data on the safety of acute reperfusion therapy and antithrombotic agents, particularly in patients that are at dual risk for bleeding and thrombosis. Other examples, secondary prevention strategies and anti-phospholipid antibody syndrome. What's the best target INR? Do you add aspirin to warfarin or not? All of that is often left up to expert opinion. What's the best management for adults with sickle cell stroke? There are many open questions there. A lot of the protocols that we have in place for sickle cell patients that are adults as derived from pediatric literature and there's vast potential in terms of disease modifying therapies, especially in the fields of sickle cell disease and amyloidosis. And we'll need to reassess how those treatments may change neurologic outcomes. Dr Terrelonge: I think on the neuropathy side that having some form of new biomarkers to help us clearly know of the neuropathy and that hematologic illness are associated would be very helpful. On the treatment side, a lot of this is really being driven by the hematology space, but new therapies that treat hematologic plasma cell disorders, including some of the new BTK inhibitor, may be incorporated relatively soon into the algorithm for how we treat many of our patients. I'm excited to see what's to come from this. Dr Nevel: Wonderful. Thank you so much for sharing your knowledge with us today. I know I've certainly learned a lot by reading your article and through our discussion today. Highly encourage our listeners to read your wonderful article, which is a very thorough review of hematologic disorders and neurological complications. Again, today I've been interviewing Dr Lauren Patrick and Dr Mark Terrelonge on their article Neurologic Complications of Hematologic Disorders, which appears in the February 2026 Continuum issue on Neurology of Systemic Disease. Please be sure to check out Continuum Audio episodes from this and other issues. And as always, thank you so much to our listeners for joining today, and thank you so much to Lauren and Mark. Dr Terrelonge: Yeah, thank you so much for having us. Dr Patrick: Thank you so much for having us and for highlighting this topic. We hope the issue encourages clinicians to think broadly about hematologic causes of neurologic disease and to continue collaborating closely with our hematology colleagues. It's a complex but very fascinating intersection for both of our fields. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/AudioCME. Thank you for listening to Continuum Audio.

David Kavanagh, MBChB, PhD, FRCP - A Clinically Considered Real-World Case Series: Practice Essentials From Biopsy To Diagnosis in Immune-Mediated Glomerular Diseases

February 20, 2026 In this episode, Scott, Mark, and Dr. Ray Painter break down the financial realities of the new prostate biopsy CPT codes and what they mean for urology practices. Moving beyond coding mechanics, the discussion focuses on the economic differences between transrectal and transperineal approaches, MRI fusion versus ultrasound guidance, targeted lesion add-on payments, and the site-of-service differential between office and facility settings. They explore how practice expense values, capital equipment costs, disposable supplies, physician time, and block scheduling all factor into the decision to bring advanced biopsy techniques in-house. The episode emphasizes balancing clinical judgment with financial sustainability—helping practices evaluate whether expanding in-office prostate biopsy services makes sense now and in the future. PRS Coding and Reimbursement HubAccess the HubFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

Are mammograms truly protecting women — or is it time to rethink how we approach breast health? In this powerful and deeply nuanced conversation, Dr. Anna Cabeca sits down with former fellowship-trained breast surgeon turned integrative oncologist Dr. Jenn Simmons to unpack one of the most important questions in women's health today: Are mammograms safe — and are they enough? Together, they explore how conventional breast cancer screening became the standard, what the research actually says about radiation exposure and screening frequency, and why early detection is not the same as prevention. Dr. Simmons shares her personal turning point — from 17 years at the forefront of breast oncology to leaving conventional medicine and founding Real Health MD after her own health crisis. What she discovered changed everything: inflammation, toxicity, hormone disruption, and metabolic dysfunction matter far more than women are being told. This episode goes beyond mammograms. It dives into: • Radiation risks and over-screening • Alternative imaging options including thermography, ultrasound, and emerging technologies • Hormones and breast cancer — clearing the misinformation • Why anti-estrogen messaging can be harmful and incomplete • Bioidentical progesterone and protective mechanisms • Birth control pills and breast development risk • The power of metabolic health, fasting windows, detoxification, and terrain theory Most importantly, this conversation restores agency. You are not powerless when it comes to breast health. Knowledge is evolving. Screening is evolving. Hormone science is evolving. And you deserve the full picture. –––––––––––––––––– KEY TIMESTAMPS 00:00 Reimagining breast health and questioning the narrative 01:23 Introducing Dr. Jenn Simmons and her paradigm shift 09:47 From breast surgeon to integrative oncologist: her turning point 12:28 Functional medicine approach: "What caused the cancer?" 27:19 Mammography myths and reviewing the research 33:01 Radiation exposure: known carcinogen discussion 35:31 Biopsy concerns and imaging alternatives 42:07 Medical board pressures and guideline rigidity 53:04 "Anti-estrogen talk is misogynistic" 01:04:10 Birth control pills, teens, and breast cancer risk –––––––––––––––––– MEMORABLE QUOTES Dr. Jenn Simmons: "Radiation is a known carcinogen." "Any anti-estrogen talk is misogynistic." Dr. Anna Cabeca: "What caused your cancer to begin with?" "It takes more than hormones to fix our hormones." "There's always one next right step we can take to advocate for our health." –––––––––––––––––– CONNECT WITH DR. JENN SIMMONS Website: www.realhealthmd.comInstagram: @drjennsimmons YouTube: @dr.jennsimmons Book: The Smart Woman's Guide to Breast Cancer –––––––––––––––––– CONNECT WITH DR. ANNA CABECA Website: www.dranna.comInstagram: www.instagram.com/thegirlfrienddoctor YouTube: www.youtube.com/@thegirlfrienddoctor TikTok: www.tiktok.com/@drannacabeca Facebook: www.facebook.com/thegirlfrienddoctor –––––––––––––––––– If this episode spoke to you, share it with a girlfriend, your daughters, your mother — every woman deserves this conversation. You are seen. You are informed. You are empowered.

What does a pap smear test for, and what happens after an abnormal pap smear? In this episode of SHE MD, Mary Alice Haney interviews Dr. Thaïs Aliabadi to break down exactly what a pap smear is, how HPV affects cervical cancer risk, and what women need to know about abnormal results. A pap smear is a cervical cancer screening test that checks for precancerous and cancerous cells on the cervix. A pap smear does not test for ovarian cancer, uterine conditions, or all sexually transmitted infections. HPV testing is often performed at the same time because high risk HPV is the leading cause of cervical cancer.Can you have HPV with a normal Pap smear? What actually happens after an abnormal result? Dr. A answers these questions and more, explaining that while most HPV infections clear on their own within one to two years, monitoring and follow-up are key. The bottom line: cervical cancer is highly preventable with routine Pap and HPV screening—but annual well-woman visits are still essential for protecting your long-term health.Subscribe to SHE MD Podcast for expert tips on PCOS, Endometriosis, fertility, and hormonal balance. Share with friends and visit SHE MD website and Ovii for research-backed resources, holistic health strategies, and expert guidance on women's health and well-being.Sponsors:Premier Protein: Find your favorite flavor at PremierProtein.com or at Amazon, Walmart, and other major retailers.Midi Health - Ready to feel your best and write your second act script? Visit JoinMidi.com today to book your personalized, insurance-covered virtual visit. Bobbie: If you want to feed with confidence too, head to hibobbie.com — to the formula trusted by parents and loved by their babies — 700k and counting.Peloton - Let yourself run, lift, sculpt, push, and go. Explore the new Peloton Cross Training Tread+ at onepeloton.com What You'll Learn:What a pap smear actually tests for and what it does not screenHow HPV and pap smear testing work together to prevent cervical cancerWhat abnormal pap smear results like ASCUS, CIN1, CIN2, and CIN3 meanWhen a normal pap smear still requires follow up or colposcopyWhy regular pap smear screening makes cervical cancer almost entirely preventableKey Timestamps:00:00 Introduction02:00 What a pap smear tests for and what it does not check03:40 HPV explained: low risk vs high risk and why it's common05:15 Screening guidelines and why pap smear alone is not enough07:15 What types of results you can get back from a pap smear 17:20 When you need a colposcopy and what happens during the procedure22:15 Biopsy results and CIN staging explained34:00 Treatment options: cryotherapy, LEEP procedure, and cold knife cone35:40 Risks of aggressive LEEP and pregnancy considerations38:00 HPV dormancy and common misconceptions41:45 HPV vaccine recommendations and prevention43:00 Final takeaway: pap smear schedule vs well woman examKey Takeaways:A pap smear screens for cervical cancer and HPV, not STDs, ovarian cancer, or uterine conditionsHigh risk HPV, especially types 16 and 18, may require colposcopy even with a normal pap smearColposcopy and cervical biopsy confirm whether precancer cells are present and guide treatmentMost HPV infections clear naturally within one to two yearsCervical cancer is preventable with routine pap smear and HPV screening, but annual well woman exams remain essentialResources Mentioned in This Episode:

PSA spikes, abnormal MRI results, and high PI-RADS scores often trigger immediate fear and for many men, that fear leads straight to biopsy. In this episode, Dr. Stephen Petteruti breaks down what PSA actually measures, how MRI technology fits into modern prostate cancer management, and why a high PI-RADS score does not automatically equal aggressive disease. Dr. Stephen discusses active surveillance, non-biopsy monitoring strategies, cardiovascular risk, hormone balance, and why overtreatment may compromise quality of life more than the cancer itself.  For men who value proactive healthcare, evidence-based medicine, testosterone preservation, and long-term vitality, this conversation offers clarity in a space dominated by urgency and assumption. It reframes prostate cancer care around informed consent, individualized risk assessment, and protecting both lifespan and healthspan.Before agreeing to your next scan or biopsy, press pause. Listen carefully. Ask better questions. Watch the episode of Stop the Prostate Biopsy Frenzy: The Truth About MRI, PI-RADS, and PSA.Enjoy the podcast? Subscribe and leave a 5-star review on your favorite platforms.Dr. Stephen Petteruti is a leading Functional Medicine Physician dedicated to enhancing vitality by addressing health at a cellular level. Combining the best of conventional medicine with advancements in cellular biology, he offers a patient-centered approach through his practice, Intellectual Medicine 120. A seasoned speaker and educator, he has lectured at prestigious conferences like A4M and ACAM, sharing his expertise on anti-aging. His innovative methods include concierge medicine and non-invasive anti-aging treatments, empowering patients to live longer, healthier lives.Website: https://www.drstephenpetteruti.com/ Practice: www.intellectualmedicine.com YouTube: https://www.youtube.com/@intellectualmedicine LinkedIn: https://www.linkedin.com/in/drstephenpetteruti/ Instagram: https://www.instagram.com/dr.stephenpetteruti/ Facebook: https://www.facebook.com/dr.stephenpetteruti    Disclaimer:  The content presented in this video reflects the opinions and clinical experience of Dr. Stephen Petteruti and is intended for informational and educational purposes only. It is not medical advice and should not be used as a substitute for professional diagnosis, treatment, or guidance from your personal healthcare provider. Always consult your physician or qualified healthcare professional before making any changes to your health regimen or treatment plan.Produced by https://www.BroadcastYourAuthority.com 

What's the secret to stress-free biopsy submission? Dr. Jodie Gerdin, Director of Anatomic Pathology at Antech, shares best practices for handling, packaging, labeling, and shipping biopsy samples to ensure diagnostic accuracy and timely results. Join us as Dr. Gerdin talks about her journey from emergency vet to pathology expert and reveals common mistakes that can jeopardize biopsy submissions — and how to avoid them. Learn how to protect precious tissue samples during transit, and the power of building a strong relationship with your pathology team. Tune in to elevate your biopsy game, improve patient outcomes, and build stronger partnerships with your diagnostic partners. Tails from the Lab is a production of Antech Diagnostics™. The intent of this podcast is to provide education and guidance with the understanding that any diagnostic testing and treatment decisions are ultimately at the discretion of the attending veterinarian within the established veterinarian-patient-client relationship. Our guest today is Jodie Gerdin, who is employed by Antech. We're sharing this so you have full transparency about the relationships involved.

In today's VETgirl online veterinary continuing education podcast, we explore how multiple-site gastrointestinal biopsies compare to traditional jejunal biopsies in the ability to differentiate between lymphoplasmacytic enteritis (LPE) and low-grade intestinal T-cell lymphoma (LGITL) in cats.

In today's VETgirl online veterinary continuing education podcast, we explore how multiple-site gastrointestinal biopsies compare to traditional jejunal biopsies in the ability to differentiate between lymphoplasmacytic enteritis (LPE) and low-grade intestinal T-cell lymphoma (LGITL) in cats.

Picture this: a patient with early-stage breast cancer is sitting in front of you in the clinic. You are about to offer your expert management plan. The age-old question arises—should you really perform a sentinel lymph node biopsy, or could omission actually help this patient more? Today, we're tackling one of the hottest debates in modern breast cancer care.Should we rethink sentinel lymph node biopsy for select patients, and can skipping it actually improve quality of life without sacrificing cancer control? The stakes couldn't be higher—balancing accurate cancer staging and minimizing harm is the name of the game. Together, we're breaking down the latest evidence from the SOUND and INSEMA trials. What do these landmark studies mean for your patients, your practice, and the future of axillary management? Ready for a journal review that might just change your next consult? Hosts:- Rashmi Kumar, MD, PhDResident, University of Michigan General Surgery Residency ProgramTwitter/X: @RashmiJKumar- Melissa Pilewskie, MDAttending Breast Surgical Oncologist, Co-Director of the Weiser Family Center for Breast Cancer, Michigan Medicine Twitter/X: @MPilewskie- Stephanie Downs-Canner, MDAttending Breast Surgical Oncologist & Physician-Scientist, Memorial Sloan Kettering Cancer Center, Program Director of the Breast Surgical Oncology Fellowship Training Program Twitter/X: @SDownsCannerLearning Objectives:- Understand when and for whom it is safe and beneficial to omit sentinel lymph node biopsy (SLNB) in early-stage breast cancer patients.- Identify the risks associated with foregoing SLNB, including loss of nodal staging, and analyze how this impacts treatment selection and prognosis.- Review key findings from the SOUND and INSEMA trials and their influence on axillary management.- Discuss implications for adjuvant therapy, genomic profiling, and multidisciplinary clinical practice.- Recognize which patient populations should still receive SLNB, and the importance of individualized, multidisciplinary decision-making.References:- Gentilini OD, Botteri E, Sangalli C, et al. Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes: The SOUND Randomized Clinical Trial. JAMA Oncol. 2023;9(11):1557–1564. doi:10.1001/jamaoncol.2023.3759 https://pubmed.ncbi.nlm.nih.gov/37733364/- Reimer T, Stachs A, Veselinovic K, et al. Axillary surgery in breast cancer – primary results of the INSEMA trial. N Eng J Med. 2024. doi:10.1056/NEJMoa2412063.https://pubmed.ncbi.nlm.nih.gov/39665649/- Sparano JA, Gray RJ, Makower DF, Albain KS, Saphner TJ, Badve SS, Wagner LI, Kaklamani VG, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Toppmeyer DL, Brufsky AM, Goetz MP, Berenberg JL, Mahalcioiu C, Desbiens C, Hayes DF, Dees EC, Geyer CE Jr, Olson JA Jr, Wood WC, Lively T, Paik S, Ellis MJ, Abrams J, Sledge GW Jr. Clinical Outcomes in Early Breast Cancer With a High 21-Gene Recurrence Score of 26 to 100 Assigned to Adjuvant Chemotherapy Plus Endocrine Therapy: A Secondary Analysis of the TAILORx Randomized Clinical Trial. JAMA Oncol. 2020 Mar 1;6(3):367-374. doi: 10.1001/jamaoncol.2019.4794. PMID: 31566680; PMCID: PMC6777230. https://pubmed.ncbi.nlm.nih.gov/31566680/- Slamon DJ, Fasching PA, Hurvitz S, Chia S, Crown J, Martín M, Barrios CH, Bardia A, Im SA, Yardley DA, Untch M, Huang CS, Stroyakovskiy D, Xu B, Moroose RL, Loi S, Visco F, Bee-Munteanu V, Afenjar K, Fresco R, Taran T, Chakravartty A, Zarate JP, Lteif A, Hortobagyi GN. Rationale and trial design of NATALEE: a Phase III trial of adjuvant ribociclib + endocrine therapy versus endocrine therapy alone in patients with HR+/HER2- early breast cancer. Ther Adv Med Oncol. 2023 May 29;15:17588359231178125. doi: 10.1177/17588359231178125. Erratum in: Ther Adv Med Oncol. 2023 Sep 29;15:17588359231201818. doi: 10.1177/17588359231201818. PMID: 37275963; PMCID: PMC10233570. https://pubmed.ncbi.nlm.nih.gov/37275963/Sponsor Disclosure: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content. Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US