Abnormality in the tissue of an organism
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Doctors often use euphemisms to dance around the 'C' word. But for oncologist Dr Ranjana Srivastava, how you talk to someone with cancer goes beyond "shadows, lumps and lesions". It's all about compassion and clarity, even when honesty is difficult.Ranjana Srivastava was a young doctor in regional Australia, accompanying her consultant on his late night rounds when she heard a patient say something that stopped Ranjana in her tracks.It was in that moment that she finally knew what her speciality was going to be: oncology. Ranjana now works in Melbourne as an oncologist and an author.She often writes about the need for clarity and compassion in doctor-patient conversations, to deliver good news, bad news and everything that falls between.Ranjana had her own experience of being at the receiving end of devastating news when she was pregnant with twins.Ranjana has carried the lesson she received from her own doctor forward, into her work as an oncologist, where bearing witness to the attitudes of her patients has changed the way she sees the world and has helped put her own life in perspective.Further informationRanjana's latest book, Every Word Matters, is published by Simon & Schuster.She has published seven books about cancer and end of life care, including A Better Death, Tell Me the Truth, Dying for a Chat, So It's Cancer: Now What, and After Cancer: A Guide to Living Well.Ranjana also writes a regular column for The Guardian.In 2017, Ranjana was awarded an Order of Australia medal for her work as an oncologist and in improving doctor-patient communication.This episode of Conversations was produced by Meggie Morris. Executive producer is Nicola Harrison.It explores cancer, oncology, the big C, cancerland, breast cancer, bowel cancer, how to survive cancer, incurable cancer, end of life care, palliative care, honest doctors, refusing treatment, chemotherapy, radiation, how to be honest with patients, doctor patient relationship, geriatric oncology, India, migration, motherhood, late term miscarriage, pregnancy, writing, books, origin story, journalism.To binge even more great episodes of the Conversations podcast with Richard Fidler and Sarah Kanowski go the ABC listen app (Australia) or wherever you get your podcasts. There you'll find hundreds of the best thought-provoking interviews with authors, writers, artists, politicians, psychologists, musicians, and celebrities.
Can you manipulate blood flow in the tumor microenvironment to optimize drug delivery? In this episode of the BackTable Podcast, interventional oncologist Dr. Zachary Berman (UC San Diego) joins host Dr. Christopher Beck to discuss real-world applications of pressure-enabled drug delivery in local, regional liver-directed therapies like TACE and Y90.---This podcast is supported by:TriSalus Life Scienceshttp://trinavinfusion.com/---SYNPOSISThe conversation begins with an overview of the tumor microvascular environment, focusing on the abnormal nature of the new vessels that feed tumors. They then discuss the genesis of pressure-enabled drug delivery and the theory behind its efficacy. Dr. Berman explains the TriNav catheter's micro-valve design, its anti-reflux properties, and how these features enhance tumor drug delivery. He walks through his own procedure technique, comparing and contrasting it to standard embolization, and details the utility of pressure-enabled drug delivery in lobar radioembolization and larger tumors. They also explore the benefits of both balloon occlusion and microvalve catheters.Real-world cases—including neuroendocrine tumors, segmental HCC, and more—illustrate the thought process around when to use specialized technologies. The episode wraps up with a discussion of the future implications for this technology in other pathologies, cost considerations, and the potential for enhancing drug delivery with innovative approaches.---TIMESTAMPS00:00 - Introduction01:39 - The Tumor Microenvironment06:59 - Pressure-Enabled Drug Delivery Explained09:37 - Technical Aspects of Pressure-Enabled Catheters21:48 - Case 1: Grade 3 Neuroendocrine Tumor34:06 - Case 2: Hepatocellular Carcinoma with Tumor and Vein36:01 - Case 3: TACE for Segmental HCC in Decompensated Cirrhosis38:58 - Case 4: Large Heterogenous Cholangiocarcinoma40:40 - Case 5: Lobar Neuroendocrine Tumor42:38 - Case 6: Segmental HCC with Central Necrosis47:52 - Best Practices and Technical Considerations57:52 - Future Directions in Pressure-Directed Embolotherapy59:48 - Conclusion and Final Thoughts---RESOURCESJVIR 2024 Jaroch et al.:https://pubmed.ncbi.nlm.nih.gov/38969336/
Focal cartilage lesions are commonly associated with anterior cruciate ligament injuries. The long-term effect of these lesions on patient-reported outcomes after anterior cruciate ligament reconstruction (ACLR) remains unclear. In conclusion, patients with concomitant partial- or full-thickness cartilage lesions reported significantly worse outcomes in all KOOS subscales 10 years after ACLR as compared with patients without cartilage lesions. Click here to read the article.
In this episode of the American Shoulder and Elbow Surgeons Podcast, host Dr. Peter Chalmers interviews Dr. Thibault Lafosse about his approach to periscapular neurologic lesions.
In part two of our discussion on the new MAPS 3 guidelines, the discussion spans advances in endoscopic techniques, the emerging role of AI in detection, and current best practices in managing early gastric cancer. Tune in to hear our host, Pradeep Mundre, talk to Mario Ribeiro, who shares his insights on identifying pre-malignant lesions, avoiding common surveillance pitfalls, and understanding how PPIs may influence cancer risk.
In this first part of our episode on the new MAPS 3 guidelines on gastric cancer prevention, host Pradeep Mundre is joined by Mario Dinis-Ribeiro. They explore who should be screened, how to approach surveillance, and why family history matters. Part two of this episode will be released on July 9th.
Vasculitis can be a tricky disease. It can be more straightforward with tissue loss at the pinnal tips, but it isn't always that easy! Lesions can vary from claw loss to paw pad lesions to hair loss.Curtis Plowgian, DVM, DACVD joins the podcast from Animal Dermatology Clinic in Indianapolis, Indiana for another episode! Dr. Plowgian wanted to discuss this topic after having a weird presentation in a cat... definitely strange to have vasculitis in a cat! Learn more about some of our weird vasculitis cases (and treatment options) on this week's episode of The Derm Vet podcast!00:00 Intro01:04 Basics of Vasculitis 10:00 Treatment Options for Vasculitis16:12 JAK-STAT Inhibitors and Steroids18:48 Future Vaccines23:36 Outro
Should Imaging Guided PCI Apply to all Complex Lesions
The results of the Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) procedure for lateral osteochondral lesions of the talus (OLTs) are unknown. Therefore, the present prospective study aims to assess the numeric rating scale (NRS) of pain during walking at 2-year follow-up. Secondarily, the aim is to assess other clinical, radiologic, and safety outcomes. In conclusion, in the first 7 prospectively followed patients who underwent the TOPIC procedure for large osteochondral lesions of the lateral talar dome, an improvement of the NRS of pain during walking from median 5 preoperatively to 1 at 2-year follow-up was observed. Click here to read the article.
Welcome to Season 2 of the Orthobullets Podcast.Today's show is Podiums, where we feature expert speakers from live medical events. Today's episode will feature Dr. Mark Schickendantz and is titled "SLAP Lesions: Fix It or Leave It"Follow Orthobullets on Social Media:FacebookInstagram LinkedIn
If you've been diagnosed with endometriosis, the big question is: What type of lesions?In this episode, Lara challenges long-held assumptions to explore:the three types of endometriosis lesions, emerging evidence that superficial lesions may not explain pain or other symptoms, alternative explanations for pelvic pain and infertility, including pelvic congestion, immune dysfunction, and gut microbiome imbalance, and an update on the bacterial contamination hypothesis.Links:Could pelvic congestion syndrome explain your pelvic pain?Prevalence of endometriosis in asymptomatic women (1991 study)Surgical removal of superficial peritoneal endometriosis for managing women with chronic pelvic pain: time for a rethink? (2019 BJOG article)Bacterial contamination hypothesis (2018 paper)Fusobacterium infection facilitates the development of endometriosis (2023 paper)ANZCA 2024 Statement on pelvic pain and endometriosis
Impact of Intravascular Imaging Guidance on Percutaneous Coronary Intervention of Severely Calcified Lesions: The ECLIPSE Trial
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Al CPK 316:· Comencem parlant del concert d'E150 a l'ateneu de Nou Barris i de com de maco e important és dir cridar en contra de les injusticies.· Un altre setmana amb avions? Aquest cop la penya no la palma, només es puja els seients, es treu la roba i envia un fax.· Comencem parlant del draft, ja que no sabíem com aniria el sorteig parlem dels equips on no volíem Cooper Flag. No surt Dallas.· Minnesota té la sèrie força encarada. Parlem de SEÑALADO RANDLE i de si i per què Draymond Green és el jugador més odiat de l'NBA· Indiana Pacers és una mena de tuneladora d'aquestes gegantines però feta de pokemons fins a les celles d'speed. Bàsquet de veritat. S'ha de recollir una mica de cable amb ells?· OKC marxa de Denver amb la sèrie empatada, els minuts estan pesant força però no sembla que Oklahoma tingui l'eliminatòria on vol.· Previsió del Knicks - Celtics, pre lesió de Tatum. Parlem de triples, bàsquetbol de nerds i de si Jalen Brunson és el millor jugador americà.Let's go home!
Join host Dr. Lily Wang as she explores a practical approach to diagnosing orbital lesions based on anatomical compartments. This episode breaks down complex orbital anatomy into clear, actionable insights for radiologists at all levels. Practical Approach to Orbital Lesions byAnatomic Compartments. Naves et al. RadioGraphics 2024;44(10):e240026.
BUFFALO, NY - April 28, 2025 – A new #research paper was #published in Oncotarget, Volume 16, on April 24, 2025, titled “PD-L1 and FOXP3 expression in high-grade squamous intraepithelial lesions of the anogenital region." Researchers Humberto Carvalho Carneiro, Rodrigo de Andrade Natal, José Vassallo and Fernando Augusto Soares from the Instituto D'Or de Pesquisa e Ensino and Rede D'Or studied early tissue changes caused by human papillomavirus (HPV) in the anal, vulvar, and penile regions. They found that high-grade pre-cancer lesions triggered stronger immune responses and showed higher levels of two immune-related markers, PD-L1 and FOXP3. These findings are important because they help explain how some HPV-related lesions progress to cancer while others heal on their own. High-risk HPV is known to cause several types of anogenital cancers. Before these cancers appear, the virus often leads to abnormal tissue changes known as high-grade squamous intraepithelial lesions. Many of these lesions disappear without treatment, but some become cancer—especially in people with weakened immune systems. This study explored how immune activity may play a role in this progression. The researchers examined tissue from 157 patients—95 males and 55 females—with either high-grade or low-grade HPV-related lesions. They found that T-regulatory cells, marked by the FOXP3 protein, were more common in high-grade lesions. These immune cells are known to suppress immune responses, which can allow infected or abnormal cells to grow. The team also found higher expression of PD-L1, a protein that helps cells evade immune detection, particularly in inflammatory immune cells. "Dense inflammatory infiltrates and high counts of FOXP3+ cells were significantly more frequent in patients with HSILs than in those with LSILsHR (p = 0.04 and 0.02, respectively). HSILs also exhibited higher PD-L1 expression (padj < 0.01 and < 0.01 for the SP142 and 22C3 clones, respectively), based on the Poisson generalized linear model.” These findings suggest that HPV may begin avoiding the immune system early in infection, even before cancer develops. The combination of high FOXP3 and PD-L1 levels may create a protective environment for infected cells, making them harder for the body to eliminate. This immune evasion may allow the lesions to remain and, over time, become cancerous. The study also compared patients with and without HIV to assess whether immune health influenced the results. While those with compromised immune systems had more extensive lesions, PD-L1 and FOXP3 expression was also found in patients with healthy immune systems. This evidence shows that immune evasion by HPV can happen regardless of a person's immune status. Understanding how PD-L1 and FOXP3 function in early HPV-related lesions may help clinicians predict which lesions are more likely to become cancer. These insights could lead to new strategies for monitoring, treating, or preventing HPV-related precancerous lesions and cancer in the anogenital region. The study highlights how early immune system changes can play a key role in the development of HPV-related cancers. DOI - https://doi.org/10.18632/oncotarget.28715 Correspondence to - Humberto Carvalho Carneiro - humberto.carneiro@rededor.com.br Video short - https://www.youtube.com/watch?v=6d8G8TUbgYc Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM
In this episode, we journey through the remarkable career of Dr. Rees Cosgrove—a trailblazer in functional neurosurgery, Director of Epilepsy and Functional Neurosurgery at Brigham and Women's Hospital, and Professor of Neurosurgery at Harvard Medical School.Dr. Cosgrove reflects on his formative years training in the very halls that were roamed by legends such as Wilder Penfield at the Montreal Neurological Institute, and takes us through pivotal chapters of his career leading programs at Massachusetts General Hospital, Brown University, and now the Brigham. With a repertoire that spans from the golden era of ablative neurosurgery to modern deep brain stimulation and MR-guided focused ultrasound—where he has performed over 600 sonications—Dr. Cosgrove provides a unique perspective on how the field has transformed over the past several decades.Throughout the conversation, we delve into the history and resurgence of surgical lesions for psychiatric and neurological conditions, the nuances of neuromodulation technologies, and the evolution of imaging that now defines precision in brain surgery. Dr. Cosgrove also shares his views on mentorship, the transmission of surgical wisdom, and how we can preserve the disappearing art of lesioning in an age increasingly dominated by stimulation.Whether you're a neurosurgeon, neuroscientist, or simply curious about how we interface with the brain to treat disease, this episode is a rare and insightful look into the mind of one of the field's most experienced and thoughtful pioneers.
In this episodeof Neurology Today in 5, Neurology Today editor-in-chief Joseph E. Safdieh, MD, FAAN, discusses a large trial that found high-dose Vitamin D reduced MRI evidence of disease activity in patients with clinically isolated syndrome or early relapsing MS; an animal brain map, revealing changes in inflammation, immune activity, and cell repair that preceded the appearance of MS lesions; and a discussion of the challenges and opportunities of using AI in neurology education.
Bad news for drunks.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
PLEASE NOTE THAT IN THE LONGER INTERVIEW THIS WEEK NATALIE DOES A FREE MEDITATION AT THE VERY END OF THE EPISODE, DON'T MISS IT! Hi all! Welcome to another episode of the podcast that is here to remind you that this Universe is ENCHANTED! :-) Meet Natalie Bedard this time, and what she has to share (besides for all sorts of delicious advice and reminders about how we can take care of ourselves and nurture our beings) with regards to how she overcame great illness, will FLOOR you! Not only does Natalie suggest that we can help our nervous systems slow down, but that with mediation and other modalities, we can come into radiant health. She urges us to take control of the stories we tell ourselves AND our bodies, and oh yeah, get off social media, cause it sucks for our wellbeing! To read a bit more about Nat Nat and her life and work, click here. REMEMBER TO RATE AND REVIEW! Each one helps other seekers find the podcast! Your bit of beauty is this: a music video from Woodkid. I think Spring is a time to shake the winter loose, to jump up and down and crow for the returning of the wheel of the year! Not only can I smell Spring on the wind, I can feel LIFE returning in all it's brilliant glory! And this song, "Run Boy Run" by Woodkid, will get you off the couch and dancing! (and the video isn't too shabby either!) Now, let's all go shake our booties!
PLEASE NOTE THAT IN THE LONGER INTERVIEW THIS WEEK NATALIE DOES A FREE MEDITATION AT THE VERY END OF THE EPISODE, DON'T MISS IT! Hi all! Welcome to another episode of the podcast that is here to remind you that this Universe is ENCHANTED! :-) Meet Natalie Bedard this time, and what she has to share (besides for all sorts of delicious advice and reminders about how we can take care of ourselves and nurture our beings) with regards to how she overcame great illness, will FLOOR you! Not only does Natalie suggest that we can help our nervous systems slow down, but that with mediation and other modalities, we can come into radiant health. She urges us to take control of the stories we tell ourselves AND our bodies, and oh yeah, get off social media, cause it sucks for our wellbeing! To read a bit more about Nat Nat and her life and work, click here. REMEMBER TO RATE AND REVIEW! Each one helps other seekers find the podcast! Your bit of beauty is this: a music video from Woodkid. I think Spring is a time to shake the winter loose, to jump up and down and crow for the returning of the wheel of the year! Not only can I smell Spring on the wind, I can feel LIFE returning in all it's brilliant glory! And this song, "Run Boy Run" by Woodkid, will get you off the couch and dancing! (and the video isn't too shabby either!) Now, let's all go shake our booties!
John Cantrell fills in for Tom; Indiana Attorney General Todd Rokita and the Lake County Sheriff's Department work out their ICE issues; causes of death revealed for the three men found frozen in backyard of friend's home after watching a football game together; Congressman Al Green censured after disrupting Trump's address to Congress; LOCPod's Canadian correspondent Jesse Hirsh talks with Kevin about the tariff war, who could be Canada's next Prime Minister, Premier of Ontario Doug Ford threatening to cut off electricity to the US, and more.
In this episode: Understand dermatological patterns and how to approach cases of linear skin rash in practice Linear psoriasis, lichen planus and other potential causes of linear plaques in both children and adults Recognise the importance of distribution patterns, patient history, diagnostic techniques (including use of dermoscopy) and potential treatments Potential differential diagnosis and case studies explained for a simpler understanding of the above Host: Dr David Lim, GP and Medical Educator Expert: Dr Philip Tong, Dermatologist Total time: 29 mins Register for our fortnightly FREE WEBCASTS Every second Tuesday | 7:00pm-9:00pm AEDT Click here to register for the next oneSee omnystudio.com/listener for privacy information.
This podcast was created using NotebookLM.Oral precancerous lesions are a worldwide health concern requiring public health interventions for prevention of oral cancer. These lesions, like leukoplakia, can progress to malignancy, with risk influenced by factors such as tobacco, alcohol, and HPV. Early detection through screening programs and public education campaigns are crucial strategies for improving outcomes. Technological advancements are enhancing diagnostic capabilities and offering new treatment possibilities, though challenges remain in resource allocation and access to care globally. Ultimately, a coordinated global effort is necessary to reduce the burden of oral cancer stemming from these precancerous conditions.
In this episode: What are the red flags when examining lesions in fingers or toes? Why is it important to examine fingers and toes at the same time? What ethnicities and age groups of patients are at higher risk of skin lesions? When looking at longitudinal melanonychia, what signs indicate patient needs to be referred to a Dermatologist? “Furrows are friendly, ridges are risky” – understand this mnemonic used commonly by Dermatologists Taking a clinical photograph of the lesion is always helpful in monitoring, even for patients, as most of these lesions grow slowly Host: Dr David Lim, GP and Medical Educator Expert: Dr Philip Tong, Dermatologist Total time: 24 mins Register for our fortnightly FREE WEBCASTS Every second Tuesday | 7:00pm-9:00pm AEDT Click here to register for the next oneSee omnystudio.com/listener for privacy information.
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Viewing several skin cases day after day can make recognizing different types of skin lesions daunting... However, evaluating skin integrity, alopecia, skin thickness, etc. can help guide the differential list and fine tune the diagnostic approach.Learn more on this week's episode of The Derm Vet podcast!TIMESTAMPS00:00 Intro00:25 What and where when it comes to lesions01:54 Color change06:09 Alopecia07:41 Thickening of the skin09:33 Scaling10:56 Skin Integrity13:07 Summary
CME credits: 1.00 Valid until: 06-02-2026 Claim your CME credit at https://reachmd.com/programs/cme/understanding-cns-lesions-in-her2-metastatic-breast-cancer/29948/ The development and availability of HER2-directed therapies has dramatically improved outcomes for patients with metastatic breast cancer (MBC). Moreover, emerging data indicate that these therapies also improve outcomes for those with brain metastasis. In this educational series, expert faculty differentiate the available HER2-directed therapies for MBC, assess their efficacy in disease with brain metastasis, and review treatment selection and sequencing considerations for these agents. Please stay tuned for additional content to this program available for credit. The maximum amount of credits available for the entire activity is 1.00.
Full article: Nonmass Lesions on Breast Ultrasound: Interreader Agreement and Associations With Malignancy Kamyar Ghabili, MD, discusses the AJR article by Cho et al. exploring issues related to nonmass lesions on breast ultrasound.
Dr. Reni Butler speaks with Dr. Ji Soo Choi about her groundbreaking study on non-mass lesions in screening breast ultrasound. Explore key imaging features, their predictive value for malignancy, and how the upcoming BI-RADS lexicon update could transform breast cancer diagnosis. Assessment of Nonmass Lesions Detected with ScreeningBreast US Based on Mammographic Findings. Ha and Choi et al. Radiology 2024; 313(2):e240043
In this episode of SurgOnc Today®, Steve Kwon, MD, and Mike Mavros, MD, are joined by Joo Ha Hwang, MD, and Yanghee Woo, MD, for a discussion of managing patients at high-risk of gastric cancer development at the population-level and at the patient-level. The panel will also discuss nonoperative and operative strategies in managing precancerous gastric lesions and early gastric cancers.
N Engl J Med 2016;375:1242-1252Background: The first drug-eluting stent (DES) was approved by the FDA in 2003 following the publication of the RAVEL trial. Since then, newer generations of DES were developed and were tested in clinical trials. The majority of trials comparing DES to bare-metal stents (BMS) showed reduction in repeat revascularization with DES but no significant reduction in death or myocardial infarction. Following these publications, the use of DES grew rapidly and was used in more than two thirds of percutaneous coronary interventions (PCI) by 2010.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.These trials, however, were very selective, had short follow up time (TAXUS-IV followed patients for 9 months and SPRIT IV followed patients for 12 months), and had limited power to assess hard outcomes.The NORSTENT trial investigators sought to compare DES to BMS in a more pragmatic design and follow patients for longer time.Patients: All patients who were undergoing PCI in Norway were assessed for enrollment. Patients had stable angina or acute coronary syndrome. Lesions were in native coronary arteries or bypass grafts.Patients were excluded if they had prior coronary stents, bifurcating lesions requiring a two-stent technique or life expectancy less than 5 years due to a medical condition other than coronary artery disease. Patients were also excluded if they had contraindications to dual antiplatelets or were taking warfarin.Baseline characteristics: The trial randomized 9,013 patients – 4,504 randomized to receive a DES and 4,509 to receive a BMS.The average age of patients was 63 years and 75% were men. Approximately 42% had hypertension, 54% had hyperlipidemia, 10% had prior myocardial infarction, 7% had prior CABG, 12% had diabetes, and 35% were current smokers.The indication for PCI was stable angina in 29% of the patients, unstable angina in 12% and STEMI or NSTEMI in 58%.Procedures: The study was open-label but outcomes assessment was blinded. Patients were randomly assigned in a 1:1 ratio to receive DES or BMS. Patients could receive several stents as clinically indicated but can only receive the assigned stent type during the index procedure.In all patients, aspirin 75 mg daily was given indefinitely while clopidogrel 75 mg daily was given for 9 months.Follow up visits were done as clinically appropriate without specification from the study protocol. Similarly, no routine follow up coronary angiography was performed.Endpoints: The primary outcome was a composite of all-cause death or spontaneous myocardial infarction. Secondary outcomes included repeat revascularization, stent thrombosis, major bleeding and health status based on the Seattle Angina Questionnaire.Clinical outcomes were collected by linking each patient unique national identification number to the Norwegian national patient registry.Analysis was performed based on the intention-to-treat principle. The study planned to enroll 8,000 patients to be followed for a median of 5 years. Assuming the 5-year event rate of the primary outcome to be 17%, the study would provide 93% power to detect 3% absolute risk difference between the study groups (rate ratio: 1.18). Due to lower than expected mortality, the sample size was increased to 9,000 patientsResults: Among the 20,663 patients who were assessed for eligibility, 12,425 met inclusion criteria. Among patients who met inclusion criteria, 9,013 were randomized. Figure 1 in the manuscript provides details for excluding patients and for not randomizing patients who met eligibility criteria. The most common reason for exclusion was prior PCI.The number of stents implanted per patient was 1.7 and more than 98% received the assigned stent type. The median follow up time was 5 years.The primary composite outcome of all-cause death or nonfatal spontaneous myocardial infarction was not significantly different between both treatment arms (16.6% with DES vs 17.1% with BMS, HR: 0.98; 95% CI: 0.88 - 1.09; p= 0.66).For the secondary outcomes – Hospitalization for unstable angina was similar between treatment groups (5.2% vs. 5.7%; p= 0.21). Stent thrombosis was lower with DES (0.8% vs 1.2%; p= 0.05). Target-lesion revascularization was also lower with DES (5.3% vs 10.3%; p< 0.001). Bleeding Academic Research Consortium (BARC) 3, 4 or 5 was similar between groups (5.5% vs 5.6%; p= 0.88).There was no significant difference in health status based on the Seattle Angina Questionnaire.There were no significant subgroup interactions.Conclusion: In patients undergoing PCI, the use of DES did not reduce the composite endpoint of death or spontaneous myocardial infarction compared to BMS. Target-lesion revascularization was reduced with DES with a number needed to treat of 20 patients.The findings of this study align with the results of other trials comparing DES to BMS. We have reviewed several key trials and included links to additional studies in this field below. Overall, DES significantly reduce target-lesion revascularization without significant effect on all-cause mortality or myocardial infarction.An important consideration in this and other related trials is that both stent types were studied using similar durations of dual antiplatelet therapy (DAPT) following PCI. For patients with stable angina, BMS typically require only one month of DAPT, while DES often necessitate three to twelve months. Since shorter durations of DAPT are generally safer for patients, a trial comparing DES with three to twelve months of DAPT compared to BMS with one month of DAPT would be insightful.A final teaching point is that less than 50% of screened patients were ultimately enrolled in this pragmatic trial, which had minimal exclusion criteria. It's not uncommon for trials to enroll less than 5% of screened patients which limits their external validity.* Other trials of DES vs BMShttps://pubmed.ncbi.nlm.nih.gov/21080780/https://pubmed.ncbi.nlm.nih.gov/22951305/Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe
In this episode of the Braun Performance & Rehab Podcast, Dan is joined by Dr. Sabrina Strickland and Dr. Andreas Gomoll to discuss the patellofemoral joint in detail, with considerations to instability, cartilage defects, and more. Dr. Sabrina Strickland is board certified in sports medicine and orthopedic surgery at HSS, where she specializes in patellofemoral surgery for instability, cartilage disease, ACL and meniscal surgery and shoulder surgery. She completed her residency and fellowship in sports medicine at HSS after completing medical school at Rush in Chicago. Prior to that, Dr. Strickland received her BA from Cornell University. Currently, Dr. Strickland is an associate professor of orthopedic surgery at Weill Cornell Medical College. She retired from her part-time position as the Chief of Orthopedics at the VA in 2012 after seven years of service. Dr. Strickland is also the co-founder of the HSS Patellofemoral Center. Dr. Strickland is a member of the American Academy of Orthopaedic Surgeons, the American Orthopaedic Society for Sports Medicine, and the Arthroscopy Association of North America. Her research focuses on the knee joint, specifically cartilage transplants, patellofemoral arthritis and instability, and ACL and meniscal repair. Prior to pursuing her medical career, Dr. Strickland was a ski instructor during college at Stratton and spent a year skiing in Crested Butte, Colorado where she still has a home. In her spare time, Dr. Strickland enjoys skiing, hiking near her home in Salisbury, CT, and paddle boarding on Twin Lakes. For more on Dr. Strickland, you can find her at https://www.hss.edu/physicians_strickland-sabrina.asp or by visiting her website https://sabrinastrickland.com/ Dr. Andreas Gomoll is double board certified in Orthopedic Surgery and Sports Medicine. His practice is devoted to preserving or restoring quality of life for patients with injuries to the knee and shoulder. He is widely recognized as one of the leading surgeons specializing in joint preservation with extensive experience in ACL reconstruction and meniscus repair, both performing primary procedures, as well as revision surgery for failed prior procedures. He also specializes in rotator cuff and biceps injuries. Dr. Gomoll is a Professor of Orthopedic Surgery, a Fellow of the American Academy of Orthopaedic Surgeons, the American Orthopaedic Society for Sports Medicine, and the International Cartilage Repair Society. He holds leadership positions in these and other US and international professional societies, as well as being on the editorial boards of several orthopedic journals. He has been awarded several Best Doctors designations, is a Castle Connolly Top Doctor, recipient of the Who is Who Humanitarian award, and was recognized as one of 16 stand-out sports knee surgeons in North America. He leads and participates in multiple surgical and non-surgical research trials of innovative new treatments for ligament, meniscus and cartilage damage, and has published over 100 articles and several books in this field. For more on Dr. Gomoll, you can find him at https://www.hss.edu/physicians_gomoll-andreas.asp or by visiting his website http://www.andreasgomollmd.com/ *SEASON 5 of the Braun Performance & Rehab Podcast is brought to you by Isophit. For more on Isophit, check out isophit.com and @isophit -BE SURE to use coupon code BraunPR25% to save 25% on your order! **Season 5 of the Braun Performance & Rehab Podcast is also brought to you by Oro Muscles. For more on Oro, check out www.oromuscles.com Episode Affiliates: MoboBoard: BRAWNBODY10 saves 10% at checkout! MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription! CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off! Check out everything Dan is up to by clicking here: https://linktr.ee/braun_pr Liked this episode? Leave a 5-star review on your favorite podcast platform --- Support this podcast: https://podcasters.spotify.com/pod/show/daniel-braun/support
Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility. In conclusion, age, effusion, and loss of motion can predict knee OCD lesion mobility at the time of arthroscopy. Education about lesion mobility can help with surgical planning and patient and family counseling. Click here to read the article.
DCB-BIF: Comparison of Noncompliant Balloon with Drug-Coated Balloon Angioplasty for Side Branch Stenosis After Provisional Stenting for Patients with True Coronary Bifurcation Lesions
Why are syphilis cases rising? Who is at risk and how does it spread? Learn about prevention of syphilis from Dr Teodora Elvira Wi in Science in 5.
OCCUPI – Optical Coherence Tomography-Guided Coronary Intervention in Patients with Complex Lesions
N Engl J Med 2022;386:128-137Background: Patients with three-vessel coronary artery disease have better outcomes when revascularization is performed using coronary artery bypass grafting (CABG) compared to percutaneous coronary intervention (PCI), as seen in the SYNTAX and FREEDOM trials. Fractional flow reserve (FFR) was not required and was not routinely performed in these trials.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.The Fractional Flow Reserve versus Angiography for Multivessel Evaluation (FAME) 3 trial sought to compare the outcomes of FFR-guided PCI vs CABG in patients with three-vessel coronary artery disease.Patients: Eligible patients had three-vessel coronary artery disease defined as 50% or more stenosis, by visual estimation, in any of the three major coronary arteries or major branches. Lesions had to be amenable to revascularization by PCI and CABG as determined by the heart team.Major exclusion criteria were left main disease, cardiogenic shock, STEMI within 5 days, active NSTEMI with cardiac troponin still rising, left ventricular ejection fraction
Keep track of the lunar cycle each month and observe whether your child's symptoms, or your own, intensify in the days leading up to and following the full moon. [This is podcast episode #205]. The full moon has long been associated with a range of mysterious phenomena, from sleep disturbances to heightened emotions. But one of the more intriguing aspects is that full moons can increase parasite activity in humans. Is there any truth to this claim, or is it just another lunar myth? Let's explore how the moon's phases, particularly the full moon, might impact the behavior of parasites and what science has to say about it. First Of All, How Do We Get Parasites? Common ways we get parasites are from inhaling them from the air we breathe, in the food we eat, drinking water, swimming or bathing in contaminated water, and through our skin. Lesions in the skin, especially on the feet, allow for easy entrance into the body. Animals carry different parasites that they may pass onto humans. Plus, poor hygiene also plays a big role. Understanding Parasites and Their Behavior Parasites are organisms that live off a host, relying on them for nutrients and shelter. Human parasites include a range of organisms such as protozoa (like Giardia), helminths (such as tapeworms and roundworms), and external parasites like lice. Their lifecycle often depends on factors such as environmental changes, the host's immune system, and how many have noticed, even the lunar cycle. While parasite infestations can go unnoticed for some time, they can lead to significant health issues, including gastrointestinal problems, fatigue, and weakened immune responses. Understanding how these organisms behave is crucial to preventing and managing infections. Click Here or Click the link below for more details! https://naturallyrecoveringautism.com/205
Acetabular lesions present unique challenges for interventionalists due to their location within the pelvis. In this episode of the BackTable Podcast, host Dr. Jacob Fleming interviews Dr. Jason Levy, an experienced practitioner in musculoskeletal interventional oncology based in Atlanta, Georgia, about techniques for ablating acetabular lesions. --- This podcast is supported by an educational grant from: Medtronic https://www.medtronic.com/en-us/index.html --- SYNPOSIS The doctors discuss the unique considerations involved in treating the acetabulum, including its susceptibility to various axial loading, shear, and torsion forces. Dr. Levy prefers to use radiofrequency ablation combined with cement augmentation to enhance joint stability. He outlines the procedural steps and shares his preferred imaging methods. Additionally, he addresses potential complications, such as instability from inadequate cement delivery, cement leakage into the hip joint space, and avascular necrosis. Throughout the episode, the doctors emphasize the importance of collaboration with orthopedic oncologists and staying updated on current research in musculoskeletal interventional oncology. --- TIMESTAMPS 00:00 - Introduction 05:11 - Unique Considerations for Acetabular Lesions 09:06 - Collaboration with Orthopedic Oncologists 13:10 - Anatomy and Procedural Steps 24:40 - Preventing Complications 35:25 - Concluding Thoughts --- RESOURCES BackTable MSK Ep. 17- Multidisciplinary Approach to Treating Spinal Metastases with Dr. Jason Levy and Dr. Amir Lavaf: https://www.backtable.com/shows/msk/podcasts/17/multidisciplinary-approach-to-treating-spinal-metastases BackTable VI Ep. 68- RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla: https://www.backtable.com/shows/vi/podcasts/68/rf-ablation-therapy-for-bone-metastases BackTable MSK Ep. 12- Ortho/IR Collaboration in Private Practice: https://www.backtable.com/shows/msk/podcasts/12/ortho-ir-collaboration-in-private-practice Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study): https://pubmed.ncbi.nlm.nih.gov/33129427/ Hip Joint Distraction Technique during Cryoablation of Acetabular Bone Tumor to Prevent Femoral Head Osteonecrosis: https://www.jvir.org/article/S1051-0443(22)01119-8/fulltext
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Welcome to the Orthobullets Podcasts. Today's show is Podiums, where we feature expert speakers from live medical events. Today's episode will feature Dr. Brian J. Cole from Midwest Orthopaedics at Rush, and is titled "The Natural History of Cartilage Lesions, What Do We Really Know?"
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In this episode, we discuss osteochondral lesions of the talus with Dr John G. Kennedy. We talk about everything from the history and physical aspects of these lesions to cutting-edge operative treatments and outcomes. Click here for show notes Dr. Kennedy is a world renowned Foot and Ankle surgeon, and a leading expert in cartilage injuries. He co-founded the ICCRA, which has since set the gold standard in treatment alogorithms for ankle cartilage surgery. His interests include regenerative medicine and minimally invasive Nano-arthroscopy. Dr. Kennedy was the first surgeon to perform in-office Nano-arthroscopy. Currently, he is the chief of the Division of Foot and Ankle Surgery and Director of the Foot and Ankle Center at NYU Langone Department of Orthopedic Surgery. Dr. Kennedy continues to train surgeons from around the world and his research team has published over 250 peer-reviewed articles and presented over 2000 times around the globe. Goal of episode: To develop a baseline knowledge of osteochondral lesions of the talus. In this episode, we discuss: Epidemiology Etiology History Imaging Non-op treatment Operative treatment and many more This episode is sponsored by the American Academy of Orthopaedic Surgeons: Filled with content that has been vetted by some of the top names in orthopaedics, the AAOS Resident Orthopaedic Core Knowledge (ROCK) program sets the standard for orthopaedic education. Whether ROCK is incorporated into your residency curriculum, or you use it independently as a study tool, the educational content on ROCK is always free to residents. You'll gain the insights and confidence needed to ensure a successful future as a board-certified surgeon who delivers the best patient care. Log on at https://rock.aaos.org/.
Summary This conversation discusses common oral lesions, specifically dry mouth, candidiasis (fungal infection of the mouth), and canker sores (aphthous ulcers). The prevalence, causes, symptoms, and treatment options for each condition are explored. Dry mouth can be caused by medications and can lead to dental issues and bad breath. Candidiasis is an opportunistic infection that can be triggered by an imbalance in the oral cavity. Canker sores are the most common oral lesion and can be caused by nutritional deficiencies and certain toothpaste ingredients. Treatment options include medications, natural remedies, and lifestyle changes. Keywords oral lesions, dry mouth, xerostomia, candidiasis, fungal infection, canker sores, aphthous ulcers, prevalence, causes, symptoms, treatment options. Takeaways Dry mouth, or xerostomia, is a common condition that can be caused by medications and can lead to dental issues and bad breath. Candidiasis is an opportunistic fungal infection that can occur in the mouth due to an imbalance in the oral cavity. Canker sores, or aphthous ulcers, are the most common oral lesion and can be caused by nutritional deficiencies and certain toothpaste ingredients. Treatment options for these oral lesions include medications, natural remedies, and lifestyle changes. Titles Understanding and Managing Dry Mouth Preventing and Treating Candidiasis in the Mouth Sound Bites "What is fricking spit? What is saliva? It's really water." "Dry mouth can lead to fungal infections, dental caries, dysphagia, and bad breath." "Fungal infections in the mouth are opportunistic and require an imbalance in the oral cavity to occur." Chapters 00:00 Introduction and Overview 02:15 Dry Mouth: Causes, Symptoms, and Effects 08:02 Candidiasis: Opportunistic Fungal Infection 11:18 Canker Sores: Common Oral Lesion
The spinal cord serves as the main communication highway between the brain and body. Did you know that 80% of people with multiple sclerosis have spinal cord lesions on MRI? These lesions can disrupt specific neural pathways, leading to common MS symptoms like numbness, weakness, impaired coordination, balance issues, bladder problems, constipation, and sexual dysfunction. For instance, damage to the corticospinal tract on one side of the spinal cord can weaken an arm or leg. A remarkable autopsy study revealed that nearly 90% of people with MS still had active inflammation in the spinal cord. This finding brings new hope for potential treatments, even for older and progressive MS patients. Advances in imaging technology, including more powerful MRI scanners (3 Tesla and higher), are enhancing our ability to see inside the spinal cord, which is as thin as a pinky finger. Improved spinal cord imaging is driving the development of new therapies in clinical trials and helping identify those at risk for worsening disability, ultimately guiding better treatment decisions. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Gabriele De Luca MD DPhil, Professor of Clinical Neurology and Experimental Neuropathology, University of Oxford, United Kingdom Bruce Cree MD PhD, Professor of Neurology at University of California, San Francisco School of Medicine
Audio Commentary by Dr. Valentin Fuster, Emeritus Editor in Chief
Follow along with our Nailed it Board/OITE Podcast Companion book. Get your copy by clicking here >> https://a.co/d/cr4i8nD Enjoy another episode from our board review series featuring Dr. Cole and Dr. Woolwine. This episode is sponsored by the American Academy of Orthopaedic Surgeons: Filled with content that has been vetted by some of the top names in orthopaedics, the AAOS Resident Orthopaedic Core Knowledge (ROCK) program sets the standard for orthopaedic education. Whether ROCK is incorporated into your residency curriculum, or you use it independently as a study tool, the educational content on ROCK is always free to residents. You'll gain the insights and confidence needed to ensure a successful future as a board-certified surgeon who delivers the best patient care. Log on at https://rock.aaos.org/.
In this episode, we review the high-yield topic of Spinal Cord Lesions from the Neurology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
Follow along with our Nailed it Board/OITE Podcast Companion book. Get your copy by clicking here >> https://a.co/d/cr4i8nD Enjoy another episode from our board review series featuring Dr. Cole and Dr. Woolwine. This episode is sponsored by the American Academy of Orthopaedic Surgeons: Filled with content that has been vetted by some of the top names in orthopaedics, the AAOS Resident Orthopaedic Core Knowledge (ROCK) program sets the standard for orthopaedic education. Whether ROCK is incorporated into your residency curriculum, or you use it independently as a study tool, the educational content on ROCK is always free to residents. You'll gain the insights and confidence needed to ensure a successful future as a board-certified surgeon who delivers the best patient care. Log on at https://rock.aaos.org/.