Podcasts about Ebus

GDP Script/ Top Stories for January 23rd Publish Date: January 23rd From the BG AD Group Studio Welcome to the Gwinnett Daily Post Podcast. Today is Thursday, January 23rd and Happy birthday to Earl Falcononer *** 01.23.24 - BIRTHDAY - EARL FALCONER*** I’m Keith Ippolito and here are your top stories presented by KIA Mall of Georgia. Lilburn Woman's Club Launches Initiative to Combat Book Deserts In The City Nine Inch Nails Coming To Gwinnett's Gas South Arena Piedmont Eastside Offering Advanced Technologies for Early Detection of Lung Cancer Plus, Leah McGrath from Ingles Markets on raw milk All of this and more is coming up on the Gwinnett Daily Post podcast, and if you are looking for community news, we encourage you to listen daily and subscribe! Break 1: 07.14.22 KIA MOG STORY 1: Lilburn Woman's Club Launches Initiative to Combat Book Deserts In The City The GFWC Lilburn Woman’s Club has launched a literacy initiative to combat book deserts in Lilburn by sponsoring the Gwinnett County Public Schools Bookmobile Program. This effort will provide over 8,000 students across eight Lilburn elementary schools with free, age-appropriate books, starting January 15. The initiative addresses the lack of book access, which hinders literacy development, especially in Gwinnett County where many children lack books at home. By offering free books, the program aims to improve literacy and reading enjoyment, countering Georgia's low literacy ranking. The Bookmobile will visit schools, ensuring equitable access to books for all students. STORY 2: Nine Inch Nails Coming To Gwinnett's Gas South Arena Nine Inch Nails announced their Peel It Back Tour 2025, their first tour since 2022. Produced by Live Nation, the tour begins June 15 in Dublin, Ireland, covering Europe with stops in the UK, Germany, and Switzerland, and festival appearances in Belgium, Poland, and Spain. The North American leg starts August 6 in Oakland, reaching Gwinnett's Gas South Arena on September 9. Their 2022 tour received rave reviews, with Boston Magazine praising Trent Reznor and the band. Inducted into the Rock & Roll Hall of Fame in 2020, they've sold over 30 million records. Tickets go on sale January 29 at nin.com. STORY 3: Piedmont Eastside Offering Advanced Technologies for Early Detection of Lung Cancer Piedmont Eastside Medical Center has introduced the ION Robot and Endobronchial Ultrasound (EBUS) to enhance early lung cancer detection in Gwinnett County. These technologies are utilized by Pulmonary and Sleep Specialists of Piedmont Northeast, now located on the Piedmont Eastside campus. The practice includes five board-certified physicians and advanced practice providers. The ION Robot uses a precision-guided catheter for accessing small lung lesions, while EBUS employs an ultrasound-guided needle for tissue sampling, aiding in cancer staging. This advancement aims to improve early detection and treatment outcomes, reflecting Piedmont Eastside's commitment to advanced pulmonary care. We have opportunities for sponsors to get great engagement on these shows. Call 770.874.3200 for more info. We’ll be right back Break 2: 08.05.24 OBITS_FINAL STORY 4: Georgia Gwinnett College offers free physical assessment and exercise program Georgia Gwinnett College offers a free 10-week exercise program, combining fitness benefits for volunteers and practical experience for exercise science students. Participants receive a personalized training program and fitness assessments, including blood pressure, body composition, cardiovascular fitness, muscular strength, balance, and flexibility. Sessions are held Mondays and Wednesdays from 5:30-6:30 p.m. Eligible volunteers are healthy adults aged 45-65, not currently exercising regularly. To join, complete the pre-participation survey by January 27. For more information, email exscpracticum@ggc.edu. STORY 5: Lawrenceville's Sugarloaf Crest Build-To-Rent Project Will Include 67 Townhomes Land development has begun for Sugarloaf Crest, a 5.2-acre build-to-rent community in Lawrenceville, featuring 67 stacked townhomes by Parkland Residential. These townhomes offer one-car garages, two or three bedrooms, and spacious open-floor plans with modern amenities. Construction starts in July 2025. Located near schools and across from Sugarloaf Landing, the community provides a maintenance-free lifestyle with amenities like a dog park and playground. Residents will have easy access to shopping and dining. Managed by Prim Properties, more details can be found at their website or by contacting Brett Forney. Break 3: And now here is Leah McGrath from Ingles Markets on raw milk *** INGLES ASK LEAH 1 RAW MILK*** We’ll have closing comments after this Break 4: Ingles Markets 9 Signoff – Thanks again for hanging out with us on today’s Gwinnett Daily Post Podcast. If you enjoy these shows, we encourage you to check out our other offerings, like the Cherokee Tribune Ledger Podcast, the Marietta Daily Journal, or the Community Podcast for Rockdale Newton and Morgan Counties. Read more about all our stories and get other great content at www.gwinnettdailypost.com Did you know over 50% of Americans listen to podcasts weekly? Giving you important news about our community and telling great stories are what we do. Make sure you join us for our next episode and be sure to share this podcast on social media with your friends and family. Add us to your Alexa Flash Briefing or your Google Home Briefing and be sure to like, follow, and subscribe wherever you get your podcasts. Produced by the BG Podcast Network Show Sponsors: www.ingles-markets.com www.wagesfuneralhome.com www.kiamallofga.com #NewsPodcast #CurrentEvents #TopHeadlines #BreakingNews #PodcastDiscussion #PodcastNews #InDepthAnalysis #NewsAnalysis #PodcastTrending #WorldNews #LocalNews #GlobalNews #PodcastInsights #NewsBrief #PodcastUpdate #NewsRoundup #WeeklyNews #DailyNews #PodcastInterviews #HotTopics #PodcastOpinions #InvestigativeJournalism #BehindTheHeadlines #PodcastMedia #NewsStories #PodcastReports #JournalismMatters #PodcastPerspectives #NewsCommentary #PodcastListeners #NewsPodcastCommunity #NewsSource #PodcastCuration #WorldAffairs #PodcastUpdates #AudioNews #PodcastJournalism #EmergingStories #NewsFlash #PodcastConversations See omnystudio.com/listener for privacy information.

Doctors Vamsi Velcheti, Sandip Patel, and Michael Zervos discuss recent updates on the management of early-stage non-small cell lung cancer (NSCLC), including the optimization of neoadjuvant and adjuvant treatment options for patients and the role of surgery in the era of targeted therapy and immuno-oncology in lung cancer. TRANSCRIPT Dr. Vamsi Velcheti: Hello, I'm Dr. Vamsi Velcheti, your guest host for the ASCO Daily News Podcast today. I am a professor of medicine and director of thoracic medical oncology at the Perlmutter Cancer Center at NYU Langone Health. On today's episode, we'll be discussing recent updates on the management of early-stage non-small cell lung cancer (NSCLC), including the optimization of neoadjuvant and adjuvant treatment options for our patients, and the evolving role of surgery in the era of targeted therapy and immuno-oncology in lung cancer.  Today, I am delighted to be joined by two renowned experts in this space, Dr. Sandip Patel and Dr. Michael Zervos. Dr. Patel is a professor of medicine and a medical oncologist specializing in lung cancer at UCSD. Dr. Mike Zervos is the clinical chief of the Division of Robotic Thoracic Surgery and Director of General Thoracic Surgery at NYU Langone. Our full disclosures are available in the transcript of this episode, and disclosures relating to all episodes of the podcast are available at asco.org/DNpod. Dr. Patel and Dr. Zervos, it's a great honor to have you on the podcast today. Welcome aboard. Dr. Sandip Patel: Great to be joining you.  Dr. Vamsi Velcheti:  Let's get started with Dr. Patel. As you know, over the last decade we've had dramatic advances in systemic therapy options for patients with metastatic non-small cell lung cancer, in both the realms of targeted therapy and immunotherapy. These have significantly improved outcomes for our patients with metastatic lung cancer. What's exciting is that more recently, we've seen the incorporation of these agents, both targeted therapies and immunotherapies, in early-stage non-small cell lung cancer. Dr. Patel, can you tell our listeners about these exciting recent advances and why do you think it's so important to incorporate these personalized systemic therapy options for our early-stage patients? Dr. Sandip Patel: I think it's a great point and a great question. And so, I think one thing to understand is that non-small cell lung cancer is actually multiple diseases. We give it one name based on how it looks under the microscope, but the vast majority of our advances to improve outcomes for patients have come from our ability to understand specific subgroups.  Many of our therapies have had activity in the advanced setting. We have our patients with metastatic or more widespread disease, which naturally led to the thought that could we utilize these therapies in earlier stage disease and potentially increase the rate of cure for many of our patients, lung cancer being the most common cancer killer worldwide. And so to your point, trying to understand how to best treat a patient really involves personalized medicine, typically driven by understanding the genomic profile of their tumor and two of the genes that have graduated from being tested for in the metastatic setting and now in the localized setting are EGFR and ALK. And these in particular are mutations that confer sensitivity to small molecule inhibitors, EGFR with osimertinib, ALK in the localized setting with alectinib based on the data that we've seen.  And so, one of the areas that's been particularly exciting is our ability to maximize a patient's chance for durable remissions by integrating these therapies after surgery, after chemotherapy when appropriate, and continuing generally for a finite amount of time, two to three years depending on the agent in the study we're discussing for these patients. Additionally, immunotherapy, which has revolutionized our treatment of patients with metastatic disease, may be particularly well-suited for the localized setting of non-small cell lung cancer as well. Dr. Vamsi Velcheti: Excellent points, Sandip. You're absolutely right, in the metastatic setting, we've all come to accept molecular testing, sequencing, and biomarker profiling as a standard, but unfortunately, that hasn't quite yet percolated into the early-stage setting. Can you talk about some of the challenges that we face as we have these therapeutic options available now for more early-stage patients? Dr. Sandip Patel: So, I think there are 3 flavors of localized therapy in non-small cell lung cancer. One is the advanced, unresectable stage 3, for which the approach is often concurrent chemo-radiation followed by some form of consolidated therapy. We're about to hear the results of LAURA, which is the study looking at EGFR-mutated non-small cell lung cancer.  For other patients, historically, the treatment has been durvalumab, an anti-PD-L1 directed immunotherapy. The other two are operative treatment of localized cancer: adjuvant treatment after surgery, or neoadjuvant or perioperative, in which chemoimmunotherapy begins before surgery. And testing depends on the settings. For the stage 3 patient who's likely getting concurrent chemo-radiation, they may have a very small amount of tissue, and so often these are done by pulmonary EBUS biopsies and that's how we pathologically confirm that advanced stage 3B. There may not be a lot of tissue available for molecular testing. In fact, if you look at the PACIFIC analysis, just looking at PD-L1, which is just an IHC off a single slide, a third of patients weren't able to even get a PD-L1, let alone a genomic result. And so, I think that's one of the areas of LAURA that's going to be particularly interesting to see as we try to implement it into our practice after seeing the full data.  I think in the adjuvant setting, we're lucky because our surgeons, Dr. Mike Zervos here, will get us a large amount of tissue in the surgical resection specimen, so we tend to get enough tissue to do genomics while they're under chemotherapy, there tends to be time to wait for their genomic result. Where this really gets complicated is in the neoadjuvant or perioperative setting, where time is everything.  The most important thing we can do for a patient in the localized space is get them to the operating room, get them started on radiation, their curative local modality, and that's where we have a time pressure but also a sample pressure because that is a diagnostic biopsy. It's a very small piece of tissue. Initially, there are multiple stains that have to be done to identify this lung cancer as opposed to another tumor. And so that's an area that I think we're going to need additional approaches given that cell-free DNA tends to have lower yield in lower stage disease in giving us a result. Dr. Vamsi Velcheti: Great points, Sandip. How do you deal with this issue in San Diego? The challenge is now we have a lot of trials, we'll talk about those neoadjuvant immunotherapy trials, but we know that immunotherapy may not be as effective in all patients, especially those with EGFR or ALK or some of these non-smoker, oncogene-driven tumors. So, we don't want to be giving patients treatments that may not necessarily be effective in the neoadjuvant space, especially when there is a time crunch, and we want to get them to surgery and all the complications that come with giving them targeted therapy post-IO with potential risk for adverse events. Dr. Sandip Patel: Absolutely. It is a great point. And so, the multidisciplinary team approach is key, and having a close relationship with the interventional pulmonary oncs, interventional radiology surgery, and radiation oncology to ensure that we get the best treatment for our patients. With the molecularly guided therapies, they are currently more on the adjuvant setting in terms of actually treating. But as you mentioned, when we're making a decision around neoadjuvant or perioperative chemo IO, it's actually the absence of EGFR now that we're looking for because our intervention at the current time is to give chemoimmunotherapy. Going back to the future, we used to use single gene EGFR within 24 hours, which was insufficient for a metastatic panel, but it often required five slides of tissue input. ALK can be done by IHC, and so some of these ‘oldie but goodie' pathologic techniques, and that pathologists, if I haven't emphasized, understanding what we're trying to do at a different context is so key because they are the ones who really hold the result. In the neoadjuvant and perioperative setting, which many of us favor, especially for stage 3A and stage 2B disease, understanding how we can get that result so that we can get the patient to the operating room in an expeditious way is so important. There is a time pressure that we always had in the metastatic setting, but I think we feel much more acutely in the neoadjuvant and perioperative setting in my opinion. Dr. Vamsi Velcheti: Fascinating insights, Dr. Patel.  Turning to Dr. Zervos, from a surgical perspective, there has been an evolution in terms of minimally invasive techniques, robotic approaches, and enhanced recovery protocols, significantly improving outcomes in our patients post-surgery. How do you see the role of surgery evolving, especially with the increasing complexity and efficacy of these systemic therapies? How do you envision the role of surgery in managing these early-stage patients, and what are the key considerations for surgeons in this new era? Dr. Michael Zervos: Thanks, Vamsi. Thanks, Sandip. Thank you for having me on the podcast. Obviously, it's an honor to be a part of such a high-level discussion. I have to say, from a surgeon's perspective, we often listen to you guys talk and realize that there's been a lot of change in this landscape. And I think the thing that I've seen is that the paradigm here has also changed. If we were having this discussion 10 years ago, a lot of the patients that I am operating on now, I would not be operating on. It really has been amazing. And I think the thing that stands out to me the most is how all of this has changed with neoadjuvant chemotherapy checkpoint inhibition. I think, for us as surgeons, that's really been the key. Whether it's CheckMate 816 or whatever you're following, like PACIFIC, the data supports this. And I think what we're seeing is that we're able to do the surgery, we're able to do it safely, and I think that the resectability rates are definitely high up there in the 90% range. And what we're seeing is pretty significant pathologic responses, which I think is really amazing to me.  We're also seeing that this has now shifted over to the oligometastatic realm, and a lot of those patients are also being treated similarly and then getting surgery, which is something that we would not have even thought of ever. When you look at the trials, I think a lot of the surgery, up to this point, has been done more traditionally. There's a specific reason why that happens, specifically, more through thoracotomy, less with VATS, and less with robotic. Sandip, I think you guys have a pretty robust robotic program at UCSD, so I'm sure you're pretty used to seeing that.   As you guys have become so much more sophisticated with the treatments, we have also had to modify what we do operatively to be able to step up to the plate and accept that challenge. But what we are seeing is yes, these treatments work, but the surgeries are slightly more complicated. And when I say slightly, I'm minimizing that a little bit.  And what's complicated about it is that the treatment effect is that the chemo-immune check inhibition actually has a significant response to the tumor antigen, which is the tumor. So it's going to necrose it, it's going to fibrose it, and wherever there is a tumor, that response on the surgical baseline level is going to be significant. In other words, there are going to be lymph nodes that are stuck to the pulmonary artery, lymph nodes that are stuck to the airway, and we've had to modify our approaches to be able to address that.   Now, fortunately, we've been able to innovate and use the existing technology to our advantage. Personally, I think robotics is the way we have progressed with all this, and we are doing these surgeries robotically, mainly because I think it is allowing us, not only to visualize things better, but to have sort of a better understanding of what we're looking at. And for that matter, we are able to do a better lymph node dissection, which is usually the key with a lot of these more complicated surgeries, and then really venturing out into more complicated things, like controlling the pulmonary artery. How do we address all this without having significant complications or injuries during the surgery? Getting these patients through after they've successfully completed their neoadjuvant treatment, getting them to surgery, doing the surgery successfully, and hopefully, with minimal to no morbidity, because at the end, they may be going on to further adjuvant treatment. All of these things I think are super important. I think although it has changed the landscape of how we think of things, it has made it slightly more complicated, but we are up for the challenge. I am definitely excited about all of this. Dr. Vamsi Velcheti: For some reason, like medical oncologists, we only get fixated on the drugs and how much better we're doing, but we don't really talk much about the advances in surgery and the advances in terms of outcomes, like post-op mortality has gone down significantly, especially in larger tertiary care centers. So, our way of thinking, traditionally, the whole intergroup trials, the whole paradigm of pneumonectomies being bad and bad outcomes overall, I think we can't judge and decide on current treatment standards based on surgical standards from decades ago. And I think that's really important to recognize.  Dr. Michael Zervos: All of this stuff has really changed over the past 10 years, and I think technology has helped us evolve over time. And as the science has evolved for you with the clinical trials, the technology has evolved for us to be able to compensate for that and to be able to deal with that. The data is real for this. Personally, what I'm seeing is that the data is better for this than it was for the old intergroup trials. We're able to do the surgery in a better, more efficient, and safer way. The majority of these surgeries for this are not going to be pneumonectomies, they are going to be mostly lobectomies. I think that makes sense. I think for the surgeons who might be listening, it doesn't really matter how you're actually doing these operations. I think if you don't have a very extensive minimally invasive or robotic experience, doing the surgery as open is fine, as long as you're doing the surgery safely and doing it to the standard that you might expect with complete lymph node clearance, mediastinal lymph node clearance, and intrapulmonary lymph node clearance. Really, I think that's where we have to sort of drive home the point, really less about the actual approach, even though our bias is to do it robotically because we feel it's less morbidity for the patient. The patients will recover faster from the treatment and then be able to go on to the next phase treatments. Dr. Vamsi Velcheti: In some of the pre-operative trials, the neoadjuvant trials, there have been some concerns raised about 20% of patients not being able to make it to surgery after induction chemo immunotherapy. Can you comment on that, and why do you think that is the case, Sandip?  Dr. Sandip Patel: Well, I think there are multiple reasons. If you look, about half due to progression of disease, which they might not have been great operative candidates to begin with, because they would have early progression afterwards. And some small minority in a given study, maybe 1% to 2%, it's an immune-related adverse event that's severe. So, it's something that we definitely need to think about. The flip side of that coin, only about 2 in 3 patients get adjuvant therapy, whether it be chemotherapy, immunotherapy, or targeted therapy. And so, our goal is to deliver a full multimodal package, where, of course, the local therapy is hugely important, but also many of these other molecular or immunologically guided agents have a substantial impact.  And I do think the point around neoadjuvant and perioperative is well taken. I think this is a discussion we have to have with our patients. I think, in particular, when you look at higher stage disease, like stage 3A, for example, the risk-benefit calculus of giving therapy upfront given the really phenomenal outcomes we have seen, really frankly starting with the NADIM study, CheckMate816, now moving on into studies like KEYNOTE-671, AEGEAN, it really opens your eyes in stage 3. Now, for someone who's stage 1/1b, is this a patient who's eager to get a tumor out? Is there as much of an impact when we give neoadjuvant therapy, especially if they're not going to respond and may progress from stage 1 and beyond? I think that's a reasonable concern. How to handle stage II is very heterogeneous. I think two points that kind of happen as you give neoadjuvant therapy, especially chemo-IO that I think is worth for folks to understand and this goes to Mike's earlier point, that is this concept if they do get a scan during your neoadjuvant chemo immunotherapy, there is a chance of that nodal flare, where the lymph nodes actually look worse and look like their disease is progressing. Their primary tumor may be smaller or maybe the same. But when we actually go to the OR, those lymph nodes are chock-full of immune cells. There's actually no cancer in those lymph nodes. And so that's a bit of a red herring to watch out for.   And so, I think as we're learning together how to deliver these therapies, because the curative-intent modality is, in my opinion, a local modality. It's what Mike does in the OR, my colleagues here do in the OR. My goal is to maximize the chance of that or really maximize the long-term cure rates. And we know, even as long as the surgery can go, if only 2 or 3 patients are going to get adjuvant therapy then 1 in 10, of which half of those or 1 in 20, are not getting the surgery and that's, of course, a big problem. It's a concern. I think better selecting towards those patients and thinking about how to make these choices is going to be hugely important as we go over. Because in a clinical trial, it's a very selective population. A real-world use of these treatments is different. I think one cautionary tale is that we don't have an approval for the use of neoadjuvant or perioperative therapy for conversion therapy, meaning, someone who's “borderline resectable.” At the time at which you meet the patient, they will be resectable at that moment. That's where our best evidence is, at the current time, for neoadjuvant or perioperative approaches.  Dr. Vamsi Velcheti:   I think the other major issue is like the optimal sequencing of immune checkpoint here. Obviously, at this point, we have multiple different trial readouts, and there are some options that patients can have just neoadjuvant without any adjuvant. Still, we have to figure out how to de-escalate post-surgery immunotherapy interventions. And I think there's a lot of work that needs to be done, and you're certainly involved in some of those exciting clinical trials. What do you do right now in your current clinical practice when you have patients who have a complete pathologic response to neoadjuvant immunotherapy? What is the discussion you have with your patients at that point? Do they need more immunotherapy, or are you ready to de-escalate?  Dr. Sandip Patel: I think MRD-based technologies, cell-free DNA technologies will hopefully help us guide this. Right now, we are flying blind along two axes. One is we don't actually know the contribution of the post-operative component for patients who get preoperative chemo-IO. And so this is actually going to be an ongoing discussion. And for a patient with a pCR, we know the outcomes are really quite good based on CheckMate816, which is a pure neoadjuvant or front-end only approach. Where I actually struggle is where patients who maybe have 50% tumor killing. If a patient has only 10% tumor killing ... the analogy I think in clinic is a traffic light, so the green light if you got a pCR, a yellow light if you have that anywhere from 20%-70% residual viable tumor, and then anything greater than that, you didn't get that much with chemo-IO and you're wondering if getting more chemo-IO, what would that actually do? It's a bit of a red light. And I'm curious, we don't have any data, but my guess would be the benefit of the post-op IO is because patients are in that kind of yellow light zone. So maybe a couple more cycles, we'll get them an even more durable response. But I am curious if we're going to start relying more on MRD-based technologies to define treatment duration. But I think it's a very complicated problem. I think folks want to balance toxicity, both medical and financial, with delivering a curative-intent therapy. And I am curious if this maybe, as we're looking at some of the data, some of the reasons around preferring a perioperative approach where you scale it back, as opposed to a neoadjuvant-only approach where there's not a clean way to add on therapy, if you think that makes sense. But it's probably the most complicated discussions we have in clinic and the discussion around a non-pCR. And frankly, even the tumor board discussions around localized non-small cell lung cancer have gone very complex, for the benefit of our patients, though we just don't have clean data to say this is the right path.   Dr. Vamsi Velcheti: I think that the need for a really true multidisciplinary approach and discussing these patients in the tumor board has never been more significant. Large academic centers, we have the luxury of having all the expertise on hand. How do we scale this approach to the broader community is a big challenge, I think, especially in early-stage patients. Of course, not everyone can travel to Dr. Zervos or you for care at a large tertiary cancer centers. So, I think there needs to be a lot of effort in terms of trying to educate community surgeons, community oncologists on managing these patients. I think it's going to be a challenge. Dr. Michael Zervos: If I could just add one thing here, and I completely agree with everything that has been said. I think the challenge is knowing beforehand. Could you predict which patients are going to have a complete response? And for that matter, say, “Okay. Well, this one has a complete response. Do we necessarily need to operate on this patient?” And that's really the big question that I add. I personally have seen some complete response, but what I'm mostly seeing is major pathologic response, not necessarily CR, but we are seeing more and more CR, I do have to say. The question is how are you going to predict that? Is looking for minimal residual disease after treatment going to be the way to do that? If you guys could speak to that, I think that is just tremendously interesting.  Dr. Vamsi Velcheti: I think as Sandip said, MRD is looking very promising, but I just want to caution that it's not ready for primetime clinical decision making yet. I am really excited about the MRD approach of selecting patients for de-escalation or escalation and surgery or no surgery. I think this is probably not quite there yet in terms of surgery or no surgery decision. Especially for patients who have early-stage cancer, we talk about curative-intent treatment here and surgery is a curative treatment, and not going to surgery is going to be a heavy lift. And I don't think we're anywhere close to that. Yet, I'm glad that we are having those discussions, but I think it may be too hard at this point based on the available technologies to kind of predict CR. We're not there.  Dr. Michael Zervos: Can I ask you guys what your thought process is for evaluating the patient? So, when you're actually thinking about, “Hey, this patient actually had a good response. I'm going to ask the surgeons to come and take a look at this.” What imaging studies are you actually using? Are you just using strictly CT or are you looking for the PET? Should we also be thinking about restaging a lot of these patients? Because obviously, one of the things that I hate as a surgeon is getting into the operating room only to find out that I have multiple nodal stations that are positive. Which really, in my opinion, that's sort of a red flag. And for me, if I have that, I'm thinking more along the lines of not completing that surgery because I'm concerned about not being able to provide an R0 resection or even having surgical staple lines within proximity of cancer, which is not going to be good. It's going to be fraught with complications.  So, a lot of the things that we as surgeons struggle with have to do with this. Personally, I like to evaluate the patients with an IV intravenous CT scan to get a better idea of the nodal involvement, proximity to major blood vessels, and potentially even a PET scan. And though I think in this day and age, a lot of the patients will get the PET beforehand, not necessarily get it approved afterwards. So that's a challenge. And then the one thing I do have to say that I definitely have found helpful is, if there's any question, doing the restaging or the re-EBUS at that point to be particularly helpful.  Dr. Sandip Patel: Yeah, I would concur that having that pathologic nodal assessment is probably one of the most important things we can do for our patients. For a patient with multinodal positive disease, the honest truth is that at our tumor board, that patient is probably going to get definitive chemoradiation followed by their immunotherapy, or potentially soon, if they have an EGFR mutation, osimertinib. For those patients who are clean in the mediastinum and then potentially have nodal flare, oftentimes what our surgeons will do as the first stage of the operation, they'll actually have the EBUS repeated during that same anesthesia session and then go straight into surgery. And so far the vast majority of those patients have proceeded to go to surgery because all we found are immune cells in those lymph nodes.  So, I think it's a great point that it's really the pathologic staging that's driving this and having a close relationship with our pathologists is key. But I think one point that I think we all could agree on is the way that we're going to find more of these patients to help and cure with these therapies is through improved utilization of low-dose CT screening in the appropriate population in primary care. And so, getting buy-in from our primary care doctors so that they can do the appropriate low-dose CT screening along with smoking cessation, and find these patients so that we can offer them these therapies, I think is something that we really, as a community, need to advocate on. Because a lot of what we do with next-generation therapies, at least on the medical oncology side, is kind of preaching to the choir. But getting the buy-in so we can find more of these cases at stage 1, 2 or 3, as opposed to stage 4, I think, is one of the ways we can really make a positive impact for patients. Dr. Vamsi Velcheti: I just want to go back to Mike's point about the nodal, especially for those with nodal multistation disease. In my opinion, those anatomic unresectability is a moving target, especially with evolving, improving systemic therapy options. The utilization for chemo radiation has actually gone down. I think that's a different clinical subgroup that we need to kind of think differently in terms of how we do the next iteration or generation of clinical trials, are they really benefiting from chemo-IO induction? And maybe we can get a subset of those patients in surgery. I personally think surgery is probably a more optimal, higher yield to potentially cure these patients versus chemo radiation. But I think how we identify those patients is a big challenge. And maybe we should do a sequential approach induction chemo-IO with the intent to kind of restage them for surgery. And if they don't, they go to chemo consolidation radiation, I guess. So, I think we need to rethink our approach to those anatomically unresectable stage 3s. But I think it's fascinating that we're having these discussions. You know, we've come to accept chemo radiation as a gold standard, but now we're kind of challenging those assumptions, and I think that means we're really doing well in terms of systemic therapy options for our patients to drive increased cures for these patients. Dr. Michael Zervos: I think from my perspective as a surgeon, if I'm looking at a CT scan and trying to evaluate whether a patient is resectable or not, one of the things that I'm looking for is the extent of the tumor, proximity to mediastinal invasion, lymph nodes size. But if that particular patient is resectable upfront, then usually, that patient that receives induction chemo checkpoint inhibition is going to be resectable afterwards. The ones that are harder are the ones that are borderline resectable upfront or not resectable. And then you're trying to figure out on the back end whether you can actually do the surgery.  Fortunately, we're not really taking many patients to the operating room under those circumstances to find that they're not resectable. Having said that, I did have one of those cases recently where I got in there and there were multiple lymph node stations that were positive. And I have to say that the CT really underestimated the extent of disease that I saw in the operating room. So, there are some challenges surrounding all of these things. Dr. Sandip Patel: Absolutely. And I think for those patients, if upfront identification by EBUS showed multi nodal involvement, we've had excellent outcomes by working with radiation oncologists using modern radiotherapy techniques, with concurrent chemo radiation, followed by their immunotherapy, more targeted therapy, at least it looks like soon. I think finding the right path for the patient is so key, and I think getting that mediastinal pathologic assessment, as opposed to just guessing based on what the PET CT looks like, is so important. If you look at some of the series, 8% to 10% of patients will get a false-positive PET on their mediastinal lymph nodes due to coccidioidomycosis or sarcoidosis or various other things. And the flip side is there's a false-negative rate as well. I think Mike summarized that as well, so I think imaging is helpful, but for me, imaging is really just pointing the target at where we need to get pathologic sampling, most commonly by EBUS. And getting our interventional pulmonary colleagues to help us do that, I think is so important because we have really nice therapeutic options, whether it's curative-intent surgery, curative-intent chemo radiation, where we as medical oncologists can really contribute to that curative-intent local therapy, in my opinion.  Dr. Vamsi Velcheti: Thank you so much Sandip and Mike, it's been an amazing and insightful discussion, with a really dynamic interplay between systemic therapy and surgical innovations. These are really exciting times for our patients and for us. Thank you so much for sharing your expertise and insights with us today on the ASCO Daily News Podcast.   I want to also thank our listeners today for your time. If you value the insights that you hear today, please take a moment to rate, review, and subscribe to the podcast wherever you get your podcasts. Thank you so much. [FH1]   Dr. Sandip Patel: Thank you. Dr. Michael Zervos: Thank you.   Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Follow today's speakers: Dr. Vamsidhar Velcheti @VamsiVelcheti Dr. Sandip Patel @PatelOncology Dr. Michael Zervos   Follow ASCO on social media: @ASCO on X (formerly Twitter) ASCO on Facebook ASCO on LinkedIn   Disclosures:  Dr. Vamsidhar Velcheti: Honoraria: ITeos Therapeutics Consulting or Advisory Role: Bristol-Myers Squibb, Merck, Foundation Medicine, AstraZeneca/MedImmune, Novartis, Lilly, EMD Serono, GSK, Amgen, Elevation Oncology, Taiho Oncology, Merus Research Funding (Inst.): Genentech, Trovagene, Eisai, OncoPlex Diagnostics, Alkermes, NantOmics, Genoptix, Altor BioScience, Merck, Bristol-Myers Squibb, Atreca, Heat Biologics, Leap Therapeutics, RSIP Vision, GlaxoSmithKline   Dr. Sandip Patel: Consulting or Advisory Role: Lilly, Novartis, Bristol-Myers Squibb, AstraZeneca/MedImmune, Nektar, Compugen, Illumina, Amgen, Certis, Eli Lilly, Roche/Genentech, Merck, Pfizer, Tempus, Iovance Biotherapeutics. Speakers' Bureau: Merck, Boehringer Ingelheim Research Funding (Inst.):Rubius, Bristol-Myers Squibb, Pfizer, Roche/Genentech, Amgen AstraZenece/MedImmune, Fate, Merck, Iovance, Takeda   Dr. Michael Zervos: No relationships to disclose

Dom flesta minns Eurovision 2015 som otroligt glatt! Sverige och Måns Zelmerlöw vann med sin Heroes! Men det som skedde inför, efter och även bakom kulisserna i Wien det är det nog inte många som vet eller minns. Dom två EBU-anställda Jarmo Siim och Sietse Bakker spelar där en stor roll. Jarmo, skickar som Eurovisions presschef, ett meddelande till en journalist där han ber hen fortsätta attackera det Svenska bidraget och sätta press på Eurovision för att kunna diska det... men hur blev det så här? Vad ska vi attackeras för och varför blir vi måltavla för detta? Och i det här kommer flera frågetecken fram kring hela EBUs ledning... Aftonbladets reporter Torbjörn Ek grävde i historien och reder även ut den i vår dokumentär. Medverkar gör också Måns Zelmerlöw själv samt låtskrivarna bakom Heroes; Joy och Linnea Deb.

In der Rubrik “Investments & Exits” begrüßen wir heute Daniel Wild, Gründer und Aufsichtsrat von Mountain Alliance. Daniel bespricht die Finanzierungsrunde von Embla und Heliox.Das dänische Startup Embla, eine digitale "Gewichtsmanagement-Klinik", hat sich eine Series-A-Finanzierungsrunde in Höhe von 10 Millionen Euro gesichert, um seine Dienste auf den britischen Markt auszuweiten. Das Startup bietet eine App an, die Nutzern, die ihr Gewicht in den Griff bekommen wollen, Zugang zu Ärzten, Pflegepersonal und personalisierten Gesundheitscoaches bietet. Die App von Embla verschreibt und überwacht auch die Dosierung von GLP-1-Medikamenten zur Gewichtsabnahme, darunter Ozempic, Saxenda und Wegovy.Die Siemens AG gab am Dienstag bekannt, eine Vereinbarung zum Kauf von Heliox unterzeichnet zu haben, einem Anbieter von Schnellladelösungen für E-Bus- und E-Lkw-Flotten sowie PKWs mit Sitz in den Niederlanden. Die Akquisition ergänzt das bestehende Portfolio für Ladeinfrastruktur von Siemens eMobility um Produkte und Lösungen für das DC-Schnellladen, die sich auf eBus- und eLKW-Flotten konzentrieren, hieß es.

इस योजना के तहत तीन लाख और उससे अधिक की आबादी वाले शहरों को कवर करते हुए - PPP मॉडल में 10,000 बसें तैनात की जाएंगी. केंद्र 10 वर्षों में 20,000 करोड़ रुपये प्रदान करेगा और बाकी राज्यों से होगा.----more----Read full article here: https://hindi.theprint.in/india/centre-clears-rs-57613-cr-pm-ebus-sewa-scheme-potential-to-be-game-changer-in-transport-sector/585351/

Dom flesta minns Eurovision 2015 som otroligt glatt! Sverige och Måns Zelmerlöw vann med sin Heroes! Men det som skedde inför, efter och även bakom kulisserna i Wien det är det nog inte många som vet eller minns. Dom två EBU-anställda Jarmo Siim och Sietse Bakker spelar där en stor roll. Jarmo, skickar som Eurovisions presschef, ett meddelande till en journalist där han ber hen fortsätta attackera det Svenska bidraget och sätta press på Eurovision för att kunna diska det... men hur blev det så här? Vad ska vi attackeras för och varför blir vi måltavla för detta? Och i det här kommer flera frågetecken fram kring hela EBUs ledning... Aftonbladets reporter Torbjörn Ek grävde i historien och reder även ut den i vår dokumentär. Medverkar gör också Måns Zelmerlöw själv samt låtskrivarna bakom Heroes; Joy och Linnea Deb.

We pre-recorded today's conversation with Dr. Shalini Reddy, Thoracic Surgeon and Medical Director of Thoracic Surgery at Valley Health's Winchester Medical Center. November is Lung Cancer Awareness Month. As part of our community health partnership with Valley Health, our conversation this month focused on lung cancer screenings, the importance of having them BEFORE symptoms appear and the changes to who "qualifies." The American Cancer Society estimates that about 236,740 new cases of lung cancer will be diagnosed in the U.S. in 2022. Lung cancer remains the number one cancer killer, accounting for more cancer deaths than breast, colon and prostate cancer combined. The ACS estimates that more than 4,600 people in Virginia and West Virginia combined will die of lung cancer in 2022. Dr. Reddy explained that in February 2022, Medicare expanded coverage for lung cancer screening for qualifying beneficiaries. Plus the screening criteria was expanded. Screening is recommended for adults without symptoms who are at high risk for developing lung cancer. Screening eligibility criteria include: Adult smokers and ex-smokers age 50 and older (previously, eligibility began at age 55) Current smokers with a 20-pack year history (previously 30 pack years) of tobacco smoking Former smokers who have quit within the past 15 years Low dose CT screenings are available at all six Valley Health hospitals. It is one of the easiest screening exams to have, and it takes less than 10 minutes to perform. If criteria for a low dose lung CT screening are met, Medicare and most insurance plans will pay for yearly screenings. Financial assistance may be available for individuals who meet screening criteria but do not have insurance to cover this screening. For more information: valleyhealthlink.com/our-services/imaging/low-dose-lung-ct/ We also talked about Valley Health's Lung Cancer Program. In 2019, Winchester Medical Center was the first hospital in VA to be designated a Care Continuum Center of Excellence for lung cancer care by the GO2 Foundation for Lung Cancer. Valley Health has one of the most comprehensive pulmonary/thoracic programs in the region for the diagnosis and minimally invasive treatment of lung cancer. The program's multidisciplinary team includes specialists in thoracic surgery, radiology, interventional radiology, pathology, pulmonology, interventional pulmonology, medical oncology, radiation oncology and thoracic patient navigation. Lung Cancer Screening - Valley Health hopes to find lung cancer at its earliest, more treatable stage and work towards eliminating late-stage lung cancer. Low dose CT lung screening is available at all Valley Health hospitals for adults with a history of smoking who are at high risk of lung cancer. The screening program also includes patients who have an incidental lung nodule found during routine or emergency imaging. Valley Health's multidisciplinary Lung Nodule Clinic specializes in expediting care for patients with lung nodules or lesions and provides assessment and options for further testing and follow-up. The clinic's team of pulmonary and thoracic specialists also includes specialists in diagnostic radiology, interventional radiology, radiation oncology and medical oncology. Advanced Diagnosis – WMC interventional pulmonary specialists use robot-assisted technology combined with endobronchial ultrasound (EBUS) for diagnosis and staging in one procedure. This technology is also used to accurately mark lung lesions for more targeted radiation therapy as well as surgery. In 2019, WMC was the first facility in the broader region to acquire Intuitive Surgical's ION™ Endoluminal System to perform robotic-assisted bronchoscopy. The ION system enables minimally invasive biopsy in difficult-to-reach peripheral areas of the lung. The Valley Health team has completed more than 250 ION cases. Minimally Invasive Surgery - The hospital's thoracic surgeons are experienced in minimally invasive video-assisted thoracic surgery (VATS) and robot-assisted techniques using the da Vinci® XI™ Surgical System. Coupled with remarkable improvements in post-operative pain management and enhanced recovery protocols, these techniques help patients feel better and return home sooner. Dr. Reddy and the Valley Health team have completed 685 robot-assisted thoracic procedures since the surgical robotics program started at WMC six years ago. Cancer Treatment and Support - Patients who receive treatment for lung cancer at the Valley Health Cancer Center at WMC will have the personal support of a thoracic patient navigator and access to treatment options such as advanced chemotherapy, radiation therapy and interventional radiology if indicated. The best way to prevent lung cancer is to stop smoking, and Valley Health provides resources to help. For information: www.valleyhealthlink.com/quitsmoking

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we sit down with Thoracic Surgeon, Dr. Jane Yanagawa to discuss surgical considerations in treatment of NSCLC. * How do you choose what type of surgical resection to do?- Considerations: --Lung anatomy --Location of the nodule within lung--Lymph node involvement-Options: --Pneumonectomy: removal of whole lung --Lobectomy: remove a whole lobe--Segmentectomy/sublobar resection: part of a lobe* What does “adequate margins” mean? And how do you know if it's enough?- If you're removing the whole lobe, it does not matter as much - If you're doing a segmentectomy, you want to have samples evaluated while in the OR because if there is signs of more disease that initially thought, you would take this one step further and do a lobectomy. - Need to consider the patient's situation - how good is their status * Why does preoperative workup matter?- Pulmonary function tests: Surgeons are looking at the %FEV1 and %DLCO to then predict what their function would be AFTER surgery. After surgery, they want to ensure patient has %FEV1 or %DLCO >40%. - Lung anatomy: In patients with COPD and endobronchial lesions, sometimes they also get V/Q scans to evaluate ratio- Cardiac echo: Important in pneumonectomy where removal of lung tissue will also remove a significant amount of blood vessels. Want to rule out pulmonary hypertension pre-operatively. - Pulmonary hypertension can also affect someone's survival while they're ventilating with only one lung during the procedure (“single lung ventilation”). - Smoking status: Smoking can increase complications by ~60%. - Pre-habilitation: Encouraging patients to be fit prior to surgery with walking, nutrition, +/- pulmonary rehabilitation* What is “VATS”?- VATS stands for video-assisted thoracoscopic surgery; it is not, in itself, a procedure. But a VATS allows for minimally invasive surgery through the use of a camera. - It involves three incisions (axilla, lowest part of mid-axillary line, one posterior)* In what scenario is a mediastinoscopy warranted? - Needed after EBUS if there is still high index of suspicion for cancer involvement in lymph nodes, even if lymph nodes are negative from EBUS* What is “systematic lymph node sampling”?- An organized way to sample lymph nodes, including all lymph nodes that are along the way, not just the ones that may be involved * As a surgeon, how do you determine if a patient is okay for surgery if the mass is invading another structure?- Need to take the anatomy into consideration - are there major blood vessels or nerves there, for instance, which can impact outcome and recovery.* When should we consider induction chemotherapy from a surgeon's perspective?- Lots of changes in this sphere coming; lots of discrepancy between institutions when there is N2 disease - In Dr. Yanagawa's opinion, anyone with N2 disease should get neoadjuvant therapy * If there is neoadjuvant chemoradiation given, how does that effect your surgery?- Radiation increases scar tissue in the lung tissue. But what is worse is that radiation neoadjuvantly may make wound healing more difficult. She does not prefer radiation pre-operatively- Chemotherapy also adds scar tissue*How does neoadjuvant IO therapy affect scar tissue formation?- The hilum and lymph nodes are more swollen, but does not translate to more complications - She has even seen patients who had gotten IO for another cancer and then get lung cancer, she can still appreciate swollen nodes!* How long after surgery is it safe to start adjuvant therapy?- If patient has a complication from surgery, would not start right away. It is important to discuss with the surgeon about when it is okay to proceed with adjuvant therapy. - If patient has good recovery/without complications, okay to start about 4 weeks after- There is no good guidance yet about when it is safe to start IO after surgery About our guest: Jane Yanagawa, MD is an Assistant Professor of Thoracic Surgery at the UCLA David Geffen School of Medicine and the UCLA Jonsson Comprehensive Cancer Center. She completed medical school at Baylor College of Medicine, after which she went to UCLA for her surgical residency. She went onto Memorial Sloan-Kettering for her Thoracic Surgery Fellowship. In addition to her practice as a thoracic surgeon at UCLA, Dr. Yanagawa also sits on the NCCN NSCLC guidelines committee! We are so grateful she was able to join us despite her very busy schedule! Please visit our website (TheFellowOnCall.com) for more information Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we sit down with guest pulmonologist Dr. Greta Dahlberg to discuss how she thinks about and works up lung nodules concerning for malignancy.Lung nodules: * For discussions about incidental lung nodules and lung cancer screening, check out Episode 197 from our friends, The Curbsiders (link: https://thecurbsiders.com/podcast/197) * Nodule vs. mass:** “Micronodule” is

CME credits: 1.00 Valid until: 20-05-2023 Claim your CME credit at https://reachmd.com/programs/cme/bronchoscopy-ebus-tbna-and-ct-guided-biopsy/13392/ Two internationally known interventional pulmonologists will discuss current guidelines and their own experiences regarding sampling of lung lesions and mediastinal adenopathy. Specifically, the panelists will discuss the pros and cons of various diagnostic strategies and sampling techniques, including transcutaneous and bronchoscopic biopsies. This interactive webinar will offer the opportunity for learners to ask questions prior to and during the event. Learning is augmented by a few follow-up quizzes weeks after the webinar, a strategy proven to improve knowledge gain and retention.

CME credits: 1.00 Valid until: 20-05-2023 Claim your CME credit at https://reachmd.com/programs/cme/bronchoscopy-ebus-tbna-and-ct-guided-biopsy/13392/ Two internationally known interventional pulmonologists will discuss current guidelines and their own experiences regarding sampling of lung lesions and mediastinal adenopathy. Specifically, the panelists will discuss the pros and cons of various diagnostic strategies and sampling techniques, including transcutaneous and bronchoscopic biopsies. This interactive webinar will offer the opportunity for learners to ask questions prior to and during the event. Learning is augmented by a few follow-up quizzes weeks after the webinar, a strategy proven to improve knowledge gain and retention.

Host: Septimiu Murgu, MD, FCCP Host: Eric Edell, MD, FCCP Guest: Nichole Tanner, MD, MS, FCCP Guest: Fabien Maldonado, MD, FCCP Two internationally known interventional pulmonologists will discuss current guidelines and their own experiences regarding sampling of lung lesions and mediastinal adenopathy. Specifically, the panelists will discuss the pros and cons of various diagnostic strategies and sampling techniques, including transcutaneous and bronchoscopic biopsies. This interactive webinar will offer the opportunity for learners to ask questions prior to and during the event. Learning is augmented by a few follow-up quizzes weeks after the webinar, a strategy proven to improve knowledge gain and retention.

Bram Ebus has worked on resource conflicts, drug policies, and state-corporate crimes in Latin America since 2010. He holds a master's degree from the University of Utrecht in Global Criminology with a focus on environmental and state-corporate crimes. In recent years, Bram has been active as an NGO consultant and investigative journalist, publishing for a variety of international media, and worked as the lead journalist for an award-winning interactive media production on mining conflicts in Venezuela. (The musical offering in this episode is Magic Hits by Adrian Sutherland. The episode artwork is by Aude Nasr.) Green Dreamer is a community-supported podcast and multimedia journal exploring our paths to collective healing, biocultural revitalization, and true abundance and wellness for all. Find our show notes, transcripts, and newsletter at GreenDreamer.com.

CHEST April 2021, Volume 159, Issue 4 David E. Ost, MD, MPH, joins CHEST Podcast Moderator, Dominique Pepper, MD, to discuss if contralateral hilar N3 nodes should be omitted from staging. DOI: https://doi.org/10.1016/j.chest.2020.10.041

Şehrazat, Ebusıyr ile Ebukıyr'ın Hikayesini bitirir. Tam dokuzyüz ellibeş gece hayatta kalmayı başarmııştır. Binbir Gece Masallarının 1949-1954 yıllarında Arapçadan Türkçeye çevrilmiş bulabildiğim en eski, en orijinal ve tam metin okumasıdır. Keyifle dinlemenizi dilerim. * Unutmadan bu masallar büyükler içindir.

Şehrazat, Ebusıyr ile Ebukıyr'ın Hikayesini anlatmaya başlar. Şehriyar ilgiyle dinler. Binbir Gece Masallarının 1949-1954 yıllarında Arapçadan Türkçeye çevrilmiş bulabildiğim en eski, en orijinal ve tam metin okumasıdır. Keyifle dinlemenizi dilerim. * Unutmadan bu masallar büyükler içindir.

Patients are delaying their health needs due to COVID-19. Dr. Jamie Rutland, Board-Certified Pulmonary and Critical Care Physician, discusses "My Health Can't Wait" an educational effort and resource hub launched by Johnson & Johnson Medical Devices Companies that provide patients and healthcare providers with tools to help them engage in meaningful conversations about prioritizing needed care, and offers tools such as patient outreach templates, surgery discussion checklists, and telehealth resources. Dr. Cedric “Jamie” Rutland, a Board Certified (Internal Medicine, Pulmonary, Critical Care) Pulmonary and Critical Care Physician based in Southern California, received his medical degree and completed his residency in Internal Medicine from the University of Iowa Carver College of Medicine in Iowa City, IA. Dr. J. Rutland continued his education at the University of Kansas Medical Center specializing in Pulmonary and Critical Care medicine. Dr. J. Rutland practices with Pacific Pulmonary Medical Group and services the Inland Empire and Orange County. His main clinical expertise is focused on the evaluation of difficult cases in Interstitial Lung Disease and COPD. Dr. Rutland is specially trained in Endobronchial ultrasound “EBUS” in addition to bronchoscopy. As an Assistant Clinical Professor at the University of California Riverside, Dr. Rutland teaches and mentors residents rotating at Riverside Community Hospital and at PPMG’s outpatient clinic. In addition to Dr. Rutland’s role at PPMG, he speaks for Device and Pharmaceutical Companies teaching both patients and their families and Doctors, nurses, and others within the medical community. Dr. Rutland is also the face of Medicine Deconstructed, a Youtube channel laying out a variety of medical topics for the laymen and medical professionals. His motivation for this channel and for becoming a Lung Doc stems from his Grandfather’s death during his first year of med school. He will tell you each day he moves down the hospital hallways chasing down a bedside he knows he’ll never catch but is also so grateful for the ones he does. Dr. Rutland is a member of the American College of Chest Physicians and is a diplomate of the American Board of Internal Medicine & Pulmonary Medicine.

You asked and we answered! COVID Vaccine 101. Today we sit down today with Dr. Jamie Rutland, MD. Doctor, Triple board certified in Internal Medicine, Pulmonary & Critical Care, COVID frontline provider, National Spokesperson, and owner of his private practice, “West Coast Lung.” Dr. Rutland is an expert in Asthma, COPD, ILD, EBUS, Navigational Bronchoscopy, and yes, Vaping. As a National Spokesman for the American Lung Association, he is passionate about community education and speaks frequently about Pulmonary Diseases. We deep dive into not only the vaccine, but also the depths of COVID. We wanted to bring you the BEST, and this man is nothing short of EXCELLENT in providing you reliable science based education on this HOT TOPIC. He is also a husband, father, puppy rescue advocate, sports fanatic, sneaker head, & social media curator.  To connect with us: Nurse Tori click HERE   Sam Manassero click HERE Cellfie Show @cellfiepodcast   Cellfie Show  https://www.cellfiepodcast.com/ (https://www.cellfiepodcast.com) ZDoggMD “THEY MAKE PATIENTS DIE ALONE…AND WE LET THEM” https://zdoggmd.com/dying-alone/ (https://zdoggmd.com/dying-alone/) Cellfie Podcast Merch  https://www.cellfiepodcast.com/shop-1 (https://www.cellfiepodcast.com/shop-1) Connect with us: https://www.cellfiepodcast.com/cellfieshowcontact (https://www.cellfiepodcast.com/cellfieshowcontact) Music: https://www.purple-planet/ (https://www.purple-planet).

Mobility revolutionIn the first episode of our new podcast series, ABB Decoded, ABB’s Head of Global E-mobility Infrastructure Solutions, Frank Muehlon, explains how electrification is transforming every mode of transport: from cars, to buses, to water taxis and even planes. What challenges, opportunities and changes await us, as electric vehicles (EVs) are "becoming a mass phenomenon"?About Frank MühlonFrank Mühlon was appointed Managing Director of ABB’s E-Mobility Infrastructure Solutions business in 2017.The global business provides the whole range of cloud connected charging and infrastructure solutions from AC charging, DC fast charging and Ultra-fast charging to eBus / heavy vehicle charging with high power.Prior to this role, Frank was Global Head of the Low Voltage modular devices unit and Managing Director of ABB Stotz-Kontakt GmbH in Heidelberg. Before joining ABB in 2014, Frank had several global general management positions within the Automotive Division of Bosch and worked in Germany, China and the US.Frank has a master's degree in mechanical engineering and business from the University of Darmstadt, Germany. See acast.com/privacy for privacy and opt-out information.

Direto ao Ponto SBPT - Temas em evidência na área respiratória para atualização dos profissionais de saúde. Veja nesta edição: entrevista com a Dra. Viviane Figueiredo, Médica broncoscopista do InCor-HCFMUSP, do ICESP/Faculdade de Medicina da Universidade de São Paulo e do Hospital Sírio Libanês de São Paulo, Doutora em Pneumologia pela Faculdade de Medicina da Universidade de São Paulo e Master Bronchoscopy Instructor pela World Association for Bronchology and Interventional Pulmonology

We pre-recorded today's conversation with Dr. Shalini Reddy, Thoracic Surgeon and Medical Director of Thoracic Surgery at Valley Health's Winchester Medical Center and Kristin Zimet, a lung cancer double survivor. November is Lung Cancer Awareness Month. As part of our community health partnership with Valley Health, our conversation this month focused on lung cancer screenings, the importance of having them BEFORE symptoms appear and how those without insurance can get a screening at a reduced cost on November 7, 2020. Valley Health is hosting a Community Low Dose CT Lung Screening event on Saturday, November 7, 2020 from 8am - 12Noon at WMC Diagnostic Center. This is a special one-time screening event (limited to 12 patients) for uninsured/underinsured patients who meet screening eligibility criteria. The cost for uninsured patients is usually $250, excluding reading fee; however, at this event the $99 all-inclusive fee (scan and radiologist's reading) will bee offered and must be paid that day. Patients will meet with one of two physicians – Dr. Reddy or pulmonary medicine specialist Daniel Hynes, MD – at no charge to discuss eligibility and meet shared decision making requirement before physician orders the scan. Patients will know result of their scan before leaving. Thoracic oncology patient navigator will be available to assist patients who need additional follow-up or support. To schedule an appointment, call the event's designated scheduler at 540-536-1658. Patients will be asked COVID-19 screening questions when they arrive. Masks must be worn inside the Diagnostic Center. Dr. Reddy also invited listeners to join the lung cancer team for a non-competitive walk to promote awareness of the leading cause of cancer deaths in the U.S. and the importance of early detection in saving lives. Route: Walking trail around the lake behind the Valley Health Cancer Center on the Winchester Medical Center campus To access the walking trail, enter the Cancer Center and go through the main lobby to the door leading outside to the healing garden. Masks must be worn inside the Cancer Center and during the walk. Those in the same household may walk the trail together but should maintain a minimum of six feet of distance from any other walkers. Family or friends watching loved ones walk should also maintain proper social distancing. To participate in the walk virtually, take a photo of yourself to show your support of lung cancer awareness. You can share it by sending in a private message to the Valley Health Facebook page or by using #VHLungWalk. For more information, call 540-536-3932. In the second segment, Kristin told us her lung cancer survivor's journey. She has survived two separate incidents of primary lung cancer having never been a smoker nor a family history. In a 2013 surgery, part of the right lower lobe of her lung was removed. In a 2018 surgery, part of the left upper lobe was removed. She has lost approximately one third of her lung capacity; however maintains an active and healthy lifestyle. She offered advice and to those currently in diagnosis as well as those who may be putting off a screening due to fear. In 2019, the GO2 Foundation for Lung Cancer designated Winchester Medical Center a Care Continuum Center of Excellence for lung cancer care -- the first hospital in Virginia so recognized. Valley Health has one of the most comprehensive pulmonary/thoracic programs in the region for the diagnosis and minimally invasive treatment of lung cancer. The program's multidisciplinary team includes specialists in thoracic surgery, radiology, interventional radiology, pathology, pulmonology, interventional pulmonology, medical oncology, radiation oncology and thoracic patient navigation. Lung Cancer Screening - Valley Health wants to find lung cancer at its early and more treatable stage and work towards eliminating late-stage lung cancer.Low dose CT lung screening is available at all Valley Health hospitals for adults with a history of smoking who are at high risk of lung cancer. The screening program has expanded to include patients who have an incidental lung nodule found during routine or emergency imaging. Valley Health's multidisciplinary Lung Nodule Clinic specializes in expediting care for patients with lung nodules or lesions and provides assessment and options for further testing and follow-up. The clinic's team of pulmonary and thoracic specialists also includes specialists in diagnostic radiology, interventional radiology, radiation oncology and medical oncology. Advanced Diagnosis – WMC interventional pulmonary specialists use robot-assisted technology combined with endobronchial ultrasound (EBUS) for diagnosis and staging in one procedure. This technology is also used to accurately mark lung lesions for more targeted radiation therapy as well as surgery. In 2019, WMC was the first facility in the broader region to acquire Intuitive Surgical's ION™ Endoluminal System to perform robotic-assisted bronchoscopy. WMC is the fourth hospital to acquire the ION robot, in addition to its six clinical research sites. The new ION system enables minimally invasive biopsy in difficult-to-reach peripheral areas of the lung. Minimally Invasive Surgery - The hospital's thoracic surgeons are experienced in minimally invasive video-assisted thoracic surgery (VATS) and robot-assisted techniques using the da Vinci® XI™ Surgical System. Coupled with remarkable improvements in post-operative pain management and enhanced recovery protocols, these techniques help patients feel better and return home sooner. Cancer Treatment and Support - Patients who receive treatment for lung cancer at the Valley Health Cancer Center at WMC will have the personal support of a thoracic patient navigator and access to treatment options such as advanced chemotherapy, radiation therapy and interventional radiology if indicated.

This podcast was recorded by the American Association of Bronchology and Interventional Pulmonology.

Dr. Xuanha “Mimi” White, a board-certified Internal Medicine, Pulmonary, Critical Care, and Sleep Medicine physician with Temecula Valley Hospital, discusses the Endobronchial Ultrasound (EBUS) Bronchoscopy Procedure.

Recorded live at the World Bank’s Innovate4Climate forum this past spring, hosts Marcene Mitchell and Shari Friedman spoke with V. Ponnuraj from the Bangalore Metropolitan Transport Corporation (BMTC), which serves 35 million commuters, and Sascha Kelterborn from Microvast, which is a leading provider of fast-charging batteries for electric vehicles.   Podcast show page (www.ifc.org/climatebiz) Microvast (http://www.microvast.com/) Bangalore Metropolitan Transport Corporation (http://www.mybmtc.com/en) Mission Possible report (http://www.energy-transitions.org/mission-possible) 

台灣也有人臉辨識？與世界水準相比，程度如何？請聽沈春華與交大eBus團隊鐘孟良博士告訴您！

Dr. Jed Gorden, Swedish Cancer Institute, describes the differences between bronchoscopy and endobronchial ultrasound, highlighting the advantages of EBUS in diagnosis and staging.

Dr. Jed Gorden, Swedish Cancer Institute, describes the differences between bronchoscopy and endobronchial ultrasound, highlighting the advantages of EBUS in diagnosis and staging.

Dr. Jed Gorden, Swedish Cancer Institute, describes the differences between bronchoscopy and endobronchial ultrasound, highlighting the advantages of EBUS in diagnosis and staging.

Fifth Third's eBus travels nationwide, armed with Fifth Third bankers to help customers in underbanked areas with all their financial needs, including budgeting tips, personal counseling and more.

Welcome to WJBC This Week, where we look back at the top stories and interviews from the past week. On this week's program, A Bloomington alderman whose been a frequent critic of the city's spending, explains his opposition to the city's budget task force. The David Davis Mansion struggles to stay open while the state squabbles over a budget. Downtown Bloomington celebrates its artistry. A Rolling Stone editor Steve Knopper discusses his biography of Michael Jackson. Plus WJBC's Throwback Thursday interview with Ebus, Elizabeth Estes. #DavidDavisMansion #RollingStone

WJBC's Eric Stock takes a look back at the top stories and interviews from the past week. On this week's program, WJBC marks 90 years on the air this week by bringing back many familiar voices; including Ken Behrens, Alan Sender, Dick Luedke, Don Newberg, Phil Supple, Howard Packowitz, Dan Irvin, Beth Whisman, Jayme Monacelli, Marla Behrends, Craig Bertsche, Ebus and Paul Harvey. Plus, we'll hear from a former Sportscenter anchor who has been honored by Bradley University. #90years #Anniversary #WJBC

Momen M. Wahidi, MD, MBA, FCCP, and Robert Browning, MD, FCCP, join CHEST Podcast Editor D. Kyle Hogarth, MD, FCCP, to expand on their Point/Counterpoint debate on the merits of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) versus conventional TBNA. Duration: 32:40 min

Dr. Erik Folch and Dr. Colleen L. Channick join CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, for a discussion on whether 50 supervised ultrasound-guided transbronchial needle aspiration procedures are needed to declare competency to assess lung cancer stage. Dr. Folch argues for, noting that although the procedure is safe, the risk of upstaging or downstaging is high in those without more extensive experience. Dr. Channick makes the case that the number 50 is arbitrary and that requiring such a large number of supervised procedures might exclude competent clinicians, thereby denying many patients with lung cancer a vital, non-surgical staging tool

Thu, 7 Mar 2013 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/15646/ https://edoc.ub.uni-muenchen.de/15646/1/Cucuruz_Beatrix.pdf Cucuruz, Beatrix Rita d

Dr. David Harpole of Duke University reviews advances in lung cancer surgery, focusing in this first part on the evolution of techniques to improve staging of lung cancer.

Dr. David Harpole of Duke University reviews advances in lung cancer surgery, focusing in this first part on the evolution of techniques to improve staging of lung cancer.

Episode 2. Edmund Chadwick describes his project 'Assessing student teams developing mathematical models applied to business and industrial mathematics', which is bringing speakers from industry to give seminars in a module with a focus on business-like team-focussed activities.