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CardioNerds co-founder Dan Ambinder joins Dr. Lefan He, Dr. Sina Salehi Omran, and Dr. Neil Gupta from the University of Rochester Cardiovascular Disease Fellowship Program for a day sailing on Lake Ontario. Expert commentary is provided by Dr. Jeffrey Bruckel, and CV Fellowship Program Director Dr. Burr Hall shares insights on the University of Rochester fellowship. The episode audio was edited by CardioNerds intern Dr. Atefeh Ghorbanzadeh. They discuss the following case involving a patient with papillary muscle rupture. This is a 63-year-old man with hypertension, hyperlipidemia, and active tobacco smoking who presented with acute dyspnea. He was tachycardic but otherwise initially hemodynamically stable. The physical exam demonstrated warm extremities with no murmurs or peripheral edema. Chest X-ray revealed diffuse pulmonary edema, and the ECG showed sinus tachycardia with T-wave inversions in the inferior leads. A bedside echocardiogram revealed a flail anterior mitral valve leaflet. The patient was taken for cardiac catheterization that revealed nonobstructive mid-RCA atheroma with a distal RCA occlusion, which was felt to reflect embolic occlusion from recanalized plaque. PCI was not performed. Right heart catheterization then demonstrated a low cardiac index as well as elevated PCWP and PA pressures. An intra-aortic balloon pump was placed at that time. A TEE was performed soon after which showed the posteromedial papillary muscle was ruptured with flail segments of the anterior mitral leaflet as well as severe posteriorly directed mitral regurgitation. The patient ultimately underwent a successful tissue mitral valve replacement and CABG. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! case Media Pearls - A Case of Papillary Muscle Rupture Most cases of papillary muscle rupture demonstrate only small areas of ischemia with preserved ventricular function, thus causing high shear force on the ischemic papillary muscle. The posteromedial papillary muscle has a single blood supply from the posterior descending artery, while the anterolateral papillary muscle has a dual blood supply from the LAD and the circumflex. Therefore, the posteromedial papillary muscle is more vulnerable to ischemia and, hence, rupture. A murmur may be absent in cases of papillary muscle rupture due to the rapid equalization of left atrial and left ventricular pressures caused by the acuteness of the severe MR. Papillary muscle rupture should always be on the differential for acute dyspnea when ACS is suspected. While mostly associated with STEMIs, mechanical complications of acute myocardial infarctions can also occur after NSTEMIs. Always auscultate patients carefully after a myocardial infarction! When evaluating patients with chest pain presenting with acute or rapidly progressive heart failure and a hypercontractile LVEF should raise suspicion for mechanical complications of MI. Once a papillary muscle rupture is diagnosed, cardiac surgery should be immediately contacted. Temporizing measures prior to surgery include positive pressure ventilation, IV nitroglycerin/nitroprusside, and temporary mechanical circulatory support. Notes - A Case of Papillary Muscle Rupture What is the clinical presentation of acute mitral regurgitation from papillary muscle rupture? Patients typically present 3-5 days after a transmural infarct. Roughly half of these patients present with pulmonary edema that may quickly progress to cardiogenic shock. Most cases are associated with STEMIs, but papillary muscle rupture is also possible with an NSTEMI.
Minimally invasive procedures are now more widely used for benign and some low-risk cancerous thyroid tumors. In certain cases of papillary thyroid microcarcinomas; and if those are positioned in a favorable location, Radiofrequency Ablation (RFA) offers a less invasive treatment option compared to traditional surgical approaches. Listen to Leonardo Guimarães Rangel, MD, Head and Neck Surgeon in Rio de Janeiro, Brazil, and international expert in minimally invasive procedures in thyroid tumors, present his Visual Vignette on Radiofrequency Ablation of Papillary Thyroid Microcarcinomas, moderated by Sina Jasim, MD, MPH, Associate Professor of Medicine, and Endocrine Neoplasia Specialist at Washington University School of Medicine. Key topics include procedure safety, determining the right patient and nodule candidate, follow-up care, challenges, and future outcomes. Visit https://www.aaceclinicalcasereports.com/article/S2376-0605(22)00010-4/fulltext to view and read the full AACE Visual Vignette.
Dr. Martin answers questions sent in by our listeners. Some of today's topics include: Papillary thyroid cancer Hibiscus tea Importance of water Xenoestrogens in bottled water Salami Dry nose Hair loss in males Estrogen vs. testosterone Potassium Acid levels in stomach Wormwood herb
It Happened To Me: A Rare Disease and Medical Challenges Podcast
Carly Flumer was diagnosed with stage I papillary thyroid cancer at the age of 27 and again at 31. While being diagnosed with cancer at such a young age was a surprise, as it would be to anyone, she found strength, support, and inspiration in sharing her cancer journey on social media. As a result of her health outcome, she looks to advocate for other cancer patients through education, research, and health literacy. She received her Master's degree from Boston University in Health Communication and Bachelor's from George Mason University in Health Administration and Policy. Resources from the episode… Thyca Elephants and Tea Cactus Cancer Society National Cancer Institute GRYT Health American Cancer Society Stay tuned for the next new episode of It Happened To Me! In the meantime, you can listen to our previous episodes on Apple Podcasts, Spotify, streaming on the website, or any other podcast player by searching, “It Happened To Me”. It Happened To Me is created and hosted by Cathy Gildenhorn and Beth Glassman. DNA Today's Kira Dineen is our executive producer and marketing lead. Amanda Andreoli is our associate producer. Ashlyn Enokian is our graphic designer. See what else we are up to on Twitter, Instagram, Facebook, YouTube and our website, ItHappenedToMePod.com. Questions/inquiries can be sent to ItHappenedToMePod@gmail.com.
We describes progress in system therapy for advanced papillary RCC. Opportunities and challenges around personalised therapy are discussed
This episode dives deep into the anatomy of the skin including it's cellular makeup and the important proteins and lipids produced by these skin cells. Then, we explore copper peptides, what they do to these fibroblasts and keratinocytes (skin cells). And, finally, we go through my n=1 experiment and examine how I make a skincare serum using GHK-Cu. This episode is where science meets peptides meets skincare! You won't want to miss it! Topics: 1. Introduction - Overview of the skincare discussion surrounding copper peptides. 2. Anatomy of the Skin - Brief description of the skin's multi-layered structure and its essential role. - Epidermis: Description of the outermost protective shield. - Stratum corneum: The outermost layer of the epidermis. - Stratum lucidum: Only found in the palms and soles. - Stratum granulosum: Maturing keratinocytes. - Stratum spinosum: Contains several layers of keratinocytes. - Stratum basale: Deepest layer with keratinocyte production. - Summary of the epidermis sublayers and their functions. - Dermis: Two distinct sublayers. - Papillary dermis: Uppermost layer, interlocking with the epidermis. - Reticular dermis: Dense, deep layer providing skin elasticity and strength. - Discussion on crucial skin components: - Keratin and keratinocyte-derived lipids: Their roles and importance. - Collagen: Its role in skin health and appearance. - Elastin: Essential for skin's elasticity and resilience. 3. Skin-Aging and Cosmetic Peptides - Delving into the aging process of the skin. - Aging effects: How they manifest and the science behind them. - Introduction to cosmetic peptides: Their increasing role in skincare. - Copper's significant role in skin health. - How copper stimulates dermal fibroblasts. - Copper's role in collagen and elastin production. - How copper stabilizes the dermal extracellular matrix. - A deeper dive into copper peptides: AHK-Cu and GHK-Cu. - Their general properties and amino acid structure. - The biological activities associated with these peptides. - AHK and GHK's specific roles in skin health and regeneration. - A comparison between AHK and GHK. 4. Personal Experimentation with Copper Peptides - A detailed example: Formulating a skincare product with 1% GHK-copper peptide serum. - Steps and ingredients to formulate the serum - pH compatibility 5. Conclusion - Consulting a licensed physician before beginning any skincare regimen. - Emphasizing the significance of personal experimentation and observation. Thanks so much for tuning in! Pre-Order Chloe's Book "75 Gut-Healing Strategies & Biohacks" and email thesynthesisofwellness@gmail.com a screenshot of the order confirmation to enter the GIVEAWAY! If you liked this episode, please leave a rating and review or share it to your stories over on Instagram. If you tag @synthesisofwellness, Chloe would love to personally thank you for listening! Follow Chloe on Instagram @synthesisofwellness Follow Chloe on TikTok @chloe_c_porter Visit synthesisofwellness.com to purchase products, subscribe to our mailing list, and more! Or visit linktr.ee/synthesisofwellness to see all of Chloe's links, schedule a BioPhotonic Scanner consult with Chloe, or support the show! Thanks again for tuning in! --- Support this podcast: https://podcasters.spotify.com/pod/show/chloe-porter6/support
CardioNerds co-founder Dr. Amit Goyal and episode leads Dr. Jaya Kanduri (FIT Ambassador from Cornell University) and Dr. Jenna Skowronski (FIT Ambassador from UPMC) discuss Complications of acute myocardial infarction with expert faculty Dr. Jeffrey Geske. They discuss various complications of acute MI such as cardiogenic shock, bradyarrythmias, left ventricular outflow tract obstruction, ruptures (papillary muscle rupture, VSD, free wall rupture), and more. Show notes were drafted by Dr. Jaya Kanduri. Audio editing by CardioNerds Academy Intern, student doctor Tina Reddy. The CardioNerds Beyond the Boards Series was inspired by the Mayo Clinic Cardiovascular Board Review Course and designed in collaboration with the course directors Dr. Amy Pollak, Dr. Jeffrey Geske, and Dr. Michael Cullen. CardioNerds Beyond the Boards SeriesCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - Complications of Acute Myocardial Infarction Sinus tachycardia is a “harbinger of doom”! The triad for RV infarction includes hypotension, elevated JVP, and clear lungs. These patients are preload dependent and may need fluid resuscitation despite having an elevated JVP. Bradyarrythmias in inferior MIs are frequently vagally mediated. The focus should be on medical management before committing to a temporary transvenous pacemaker, such as reperfusion, maintaining RV preload and inotropy, avoiding hypoxia, and considering RV-specific mechanical circulator support (MCS). Worsening hypotension with inotropic agents (e.g., dobutamine, epinephrine, dopamine, norepinephrine) after a large anterior-apical MI should raise suspicion for dynamic left ventricular outflow tract obstruction due to compensatory hyperdynamic basal segments. The myocardium after a late presentation MI is as “mushy as mashed potatoes”! Need to look out for papillary muscle rupture, VSD, and free wall rupture as potential complications. Papillary muscle rupture can occur with non-transmural infarcts, and often presents with flash pulmonary edema. VSDs will have a harsh systolic murmur and are less likely to present with pulmonary congestion. Free wall rupture can present as a PEA arrest. All of these complications require urgent confirmation on imaging and early involvement of surgical teams. Notes - Complications of Acute Myocardial Infarction How should we approach cardiogenic shock (CS) in acute myocardial infarction (AMI)? Only 10% of AMI patients present with CS, but CS accounts for up to 70-80% of mortality associated with AMI, usually due to extensive LV infarction with ensuing pump failure. Physical examSinus tachycardia is considered a “harbinger of doom”, when the body compensates for low cardiac output by ramping up the heart rateThe presence of sinus tachycardia and low pulse and/or blood pressure in a patient with a large anterior MI should raise suspicion for cardiogenic shockBe wary of giving IV beta blockers in this situation as negative inotropes can precipitate cardiogenic shock (Commit Trial) When interpreting a patient's blood pressure in the acute setting, it is helpful to know their baseline blood pressure and if they have a significant history of hypertension. Patients
Surgical Removal of Papillary Fibroelastoma Guest: Juan A. Crestanello, M.D. Host: Malcolm R. Bell, M.D. Joining us today to discuss surgical removal of papillary fibroelastoma (PFE) is Juan A. Crestanello, M.D., professor of surgery and chair of cardiovascular surgery at Mayo Clinic in Rochester, Minnesota. Tune in to learn more about the surgical approach to papillary fibroelastoma. Specific topics discussed: What are PFEs? What are the risks of PFE? Where are they most commonly located? What are the indications for surgery? What is the surgical risk of resection of a PFE? What is the risk of stroke? What is the risk of stroke without resection? Can the valves be preserved? Can PFEs come back? PFE of the Heart - Surgical Management Process Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV. NEW Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.
Join the Behind the Knife HPB team as we dive deeper into the complex world of IPMNs with a journal article review of a recent JAMA Surgery publication and the first author of the article! Learning Objectives: In this episode, we discuss the article, “Progression vs Cyst Stability of Branch-Duct Intraductal Papillary Mucinous Neoplasms After Observation and Surgery.” This article describes a multicenter retrospective study of centers in Italy, Korea, Singapore, and the US that specifically assessed what dynamic variables are associated with malignant progression in pathologically proven IMPNs under at least a year of initial surveillance. Hosts: Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@DWNelsonHPB) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center Connor Chick, MD (@connor_chick) is a PGY-6 General Surgery resident at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Beth Carpenter, MD (@elizcarpenter16) is a PGY-4 General Surgery resident at Brooke Army Medical Center Guest: Dr. Giovanni Marchegiani is a pancreas surgeon within the department of general and pancreatic surgery at the University of Verona in Italy. His research interests include exocrine and cystic neoplasms of the pancreas. He is the first author of the study discussed in the episode in addition to over 100 additional scientific, peer-reviewed articles. Journal Article: 1. Marchegiani G, Pollini T, Andrianello S, et al. Progression vs Cyst Stability of Branch-Duct Intraductal Papillary Mucinous Neoplasms After Observation and Surgery. JAMA Surg. 2021;156(7):654–661. doi:10.1001/jamasurg.2021.1802 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other HPB episodes here: https://behindtheknife.org/podcast-category/hepatobiliary/
Andrea Necchi discusses the papillary cohort of KN57
FDA Drug Information Soundcast in Clinical Oncology (D.I.S.C.O.)
Listen to a soundcast of the December 16, 2022, FDA approval of Adstiladrin (nadofaragene firadenovec-vncg) for patients with high-risk Bacillus Calmette-Guérin unresponsive non-muscle invasive bladder cancer with carcinoma in situ with or without papillary tumors.
Interview with Eric D. Lamarre, MD, author of Risk Factors Associated With Recurrence and Death in Patients With Tall Cell Papillary Thyroid Cancer: A Single-Institution Cohort Study With Predictive Nomogram. Hosted by Paul C. Bryson, MD, MBA. Related Content: Risk Factors Associated With Recurrence and Death in Patients With Tall Cell Papillary Thyroid Cancer
Interview with Eric D. Lamarre, MD, author of Risk Factors Associated With Recurrence and Death in Patients With Tall Cell Papillary Thyroid Cancer: A Single-Institution Cohort Study With Predictive Nomogram. Hosted by Paul C. Bryson, MD, MBA. Related Content: Risk Factors Associated With Recurrence and Death in Patients With Tall Cell Papillary Thyroid Cancer
In this podcast, James Matera, DO, speaks about a patient case presentation of a 41-year-old man with a recurrence of minimal change disease and an incidental finding of papillary renal cell carcinoma on renal biopsy.
Interview with Babak Givi, MD, author of American Thyroid Association Guidelines and National Trends in Management of Papillary Thyroid Carcinoma. Hosted by Paul C. Bryson, MD, MBA. Related Content: American Thyroid Association Guidelines and National Trends in Management of Papillary Thyroid Carcinoma
Interview with Babak Givi, MD, author of American Thyroid Association Guidelines and National Trends in Management of Papillary Thyroid Carcinoma. Hosted by Paul C. Bryson, MD, MBA. Related Content: American Thyroid Association Guidelines and National Trends in Management of Papillary Thyroid Carcinoma
What's the one clinical scenario where you can really save a patient's life with a pancreatectomy? An IPMN with high-grade dysplasia! Join the Behind the Knife HPB Team for a deep dive into the complex decision-making surgical management of IPMNs. Learning Objectives In this episode, we review the basics of intraductal papillary mucinous neoplasms, how to evaluate patients with a cystic mass of the pancreas, guidelines for surveillance, and indications for resection. We discuss key concepts such as Worrisome Features and High-Risk Stigmata and how those influence surgical decision-making, and tackle a few of the most challenging scenarios surgeons may face when treating patients with IPMNs. Hosts: Timothy Vreelant, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center Connor Chick, MD (@connor_chick) is a PGY-6 General Surgery resident at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Beth Carpenter, MD (@elizcarpenter16) is a PGY-4 General Surgery resident at Brooke Army Medical Center Links to Papers Referenced in this Episode Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas Pancreatology. 2017 Sep-Oct;17(5):738-753. https://pubmed.ncbi.nlm.nih.gov/28735806/ Number of Worrisome Features and Risk of Malignancy in Intraductal Papillary Mucinous Neoplasm. J Am Coll Surg. 2022 Jun 1;234(6):1021-1030. https://pubmed.ncbi.nlm.nih.gov/35703792/ Extent of Surgery and Implications of Transection Margin Status after Resection of IPMNs. Gastroenterology Research and Practice 2014, 1–10. https://pubmed.ncbi.nlm.nih.gov/25276122/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Hepatobiliary Surgery episodes here: https://behindtheknife.org/podcast-category/hepatobiliary/
Meet long-time STRONG Girl and Toronto-based radio host Sandra Crofford, who takes us through her experience with thyroid cancer and how becoming a STRONG Girl enhanced and changed her life and wellness journey. In this episode, Jenny and Sandra talk about what symptoms to pay attention to, how the thyroid affects our whole body, and the importance of being an advocate for your own health when it comes to investigating those (or any other) unexplained symptoms. Sandra shares her incredible story and reminds us how crucial it is to be mindful, accountable and dedicated to being the best version of yourself. Follow Sandra on IG JOIN The YOUR BEST BODY PRIVATE COMMUNITY and for the Password say "Jenny invited me"JOIN The YOUR BEST BODY PROGRAM If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser and Castbox. STRONG Fitness Magazine Subscription Use discount code STRONGGIRLResourcesSTRONG Fitness MagazineSTRONG Fitness Magazine on IGTeam Strong GirlsCoach JVBFollow Jenny on social mediaInstagramFacebookYouTube
In this episode, we review the high-yield topic of Renal Papillary Necrosis from the Renal section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
Celebrating My Cancer Story Podcasts 2nd Anniversary with the perfect guest! You will be hearing from Dana who is a Papillary Thyroid Cancer Survivor. Dana was diagnosed at age 24 and after being urged by her dentist to get the lump in her throat checked out. Going through her thyroidectomy surgery and multiple rounds of RAI treatment was in a survival mode blur. It wasn't until after all of that, when was released back into the 'wild' with a gigantic scar across her neck, that she started to struggle with her reality. For the longest time, she kept her journey private, not really talking about her experience with family, friends or coworkers. It wasn't until I Dana met other women who had gone through the same cancer she had noticed that we all had a similar question we would ask each-other: "What does your scar look like?" She realized that she wasn't alone and that she had this built in and awesome cancer community that she was a part of. Fast forward to Dana creating The Butterfly Scar Project. Dana mentions on her website "My mission with The Butterfly Scar Project is to help empower women AFTER their cancer to help them feel comfortable in their scars. The thyroid is shaped like a butterfly and a butterfly has it's own meaning: A symbol of powerful transformation...so Butterfly Scar Project was born! Life after cancer is hard enough and there is no guide book. Cancer DOES SUCK but YOU DON'T. I hope these necklaces help women to feel powerful, strong and beautiful when they wear them and I hope they can feel empowered by their scars. Wherever you are on your journey know you are not alone." To learn more about Dana and The Butterfly Scar Project IG: @butterflyscarproject www.butterflyscarproject.com --- Support this podcast: https://anchor.fm/mycancerstorypodcast/support
In this episode, we review the high-yield topic of Renal Papillary Necrosis from the Renal section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message
" Be the winner in this fight" This episode today is near and dear to m heart. Today's Cancer Story comes to you all the way from the other side of the world in Georgia. You are meeting Mariam, a fellow Thyroid Cancer Survivor and the Creator or @Smiley_Scar. I was so honored to finally have the opportunity to meet her and for her to share her story on this podcast! Her IG handle was one of the first pages that I found when I first found out of my own cancer diagnosis. Mariam is a Public Health Specialist who was diagnosed in 2019 and talks of her journey with her diagnosis and also speaks on losing her father 4 years prior. She touches on many topics such as diet, stress, the consciousness of scars and Evidence Based Information. Mariam is doing great things for the cancer community and continues to make a positive impact on us all around the world! Find Mariam on social media: @smiley_scar --- Support this podcast: https://anchor.fm/mycancerstorypodcast/support
Papillary Fibroelastoma (PFE) Guest: Kyle W. Klarich, M.D. (@KyleWKlarich) Host: Paul A. Friedman, M.D. (@drpaulfriedman) Papillary fibroelastomas (PFEs) are the most common benign neoplasms of the cardiac valvular structures. Although rare and often hard to diagnose accurately, PFEs are being recognized more frequently via high-resolution imaging technology — and by ruling out other possible conditions that can mimic them. Joining us today to discuss papillary fibroelastomas is Kyle W. Klarich, M.D., a consultant in Cardiovascular Medicine with a joint appointment in the Echocardiography Laboratory here at Mayo Clinic in Rochester, Minnesota. Dr. Klarich is also Vice Chair for Clinical Practice in the Department of Cardiovascular Medicine, echocardiology specialist, and a professor of medicine at Mayo Clinic College of Medicine and Science. Specific topics discussed: Papillary fibroelastoma (PFE) explained Best approaches to PFE identification: echocardiography, physical exam and antinuclear antibody testing PFE or nonbacterial thrombotic endocarditis Risk assessment and treatment alternatives New forms of treatment: a percutaneous solution Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV. No CME credit offered for this episode. Podcast transcript can be found here.
In today’s episode, Dr. Neeraj Agarwal, medical oncologist and director of the Genitourinary Oncology Program at the University of Utah’s Huntsman Cancer Institute, discusses the SWOG 1500 trial and a potential new standard of care for patients with metastatic papillary renal cell carcinoma.
Monty Pal discusses his randomised phase 2 study in papillary renal cancer.
This weeks story comes from Beca. She tells her cancer story with her Papillary Thyroid Cancer diagnosis, the process she had to go through to get the diagnosis and dealing with cancer during a pandemic. She also talks about her fathers cancer story and ultimately how his journey helped her be her own advocate. It was so great getting to connect with Beca and for her to share her story and help celebrate mine! 2/5/2021 was my 1 year Cancerversary. To celebrate, I wanted to post 2 episodes about the kind of cancer that I have survived. Thank you to everyone who was there for me this past year. Friends, family, and fellow cancer survivors....you all are so special to me and your support will always be cherished. Thank you to all that have helped me with this podcast and have helped support it in one way or another....without you I don't know how I could have made it to what it is today. I love you all! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/mycancerstorypodcast/support
This episode, you will meet Karin Hart. She is a papillary thyroid cancer survivor, avid golfer, athlete, social media influencer and amazing human being. She is the first thyroid cancer survivor that we've had on My Cancer Story Podcast (other than myself). Listen to us talk about our experiences going through diagnosis, treatment, and post cancer. She is a wealth of knowledge, gives great advice and tells you what worked for her throughout her journey. I am so excited to have interviewed Karin, she is an absolutely beautiful person inside and out! Follow Karin on IG & twitter @karinhart or her linktree https://linktr.ee/karinhart --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/mycancerstorypodcast/support
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez, is joined by Dr. Amanda Fader to discuss the role of trastuzumab in uterine papillary serous tumors. Dr. Fader is an Associate Professor of Gynecology and Obstetrics, Vice Chair of Gynecologic Surgical Operations and Director of the Center for Rare Gynecologic Cancers at Johns Hopkins School of Medicine. She is recognized internationally as a rare uterine and ovarian cancer expert and is an active member of NRG Oncology and helps develop and co-lead innovative gynecologic cancer clinical trials. Highlights: • Uterine serous carcinoma (USC) is a biologically aggressive endometrial cancer subtype that accounts for a disproportionately high rate of endometrial cancer-related deaths. • 25-30% of women with both early and advanced stage USC will have HER2 positive tumors. • Molecularly-based therapeutic approaches in USC are increasing. • Trastuzumab, an anti-HER2 therapy, in combination with platinum/taxane-based chemotherapy improves survival outcomes for women with HER2 positive USC. • A randomized, Phase III cooperative group study is planned to study additional anti-HER2 therapies in women with all stages of USC.
Commentary by Dr. Julia Grapsa
Dr. Ebell and Dr. Wilkes discuss the POEM titled ' Progression of papillary thyroid cancer is lower in older adults '
Morgan shares her three birth stories and the complications arising during each.
Zoya Ibrahim recently celebrated her 5 year cancerversary from Papaillary Thyroid Carcinoma! In this episode, Zoya dives into how she was diagnosed, the surgery and iodine radiation treatment she experienced, what the thyroid actually does for your body, how our body can force us to deal with the anxieties after a cancer diagnoses even if our mind doesn't want to, pulling the Cancer Card and so much more. Zoya has become so knowledgeable about hormone health since her diagnosis and teaches us all about different supplements ways to balance our hormones. *Please keep in mind that any medical recommendations on this podcast should be reviewed with you and your doctor. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
CardioNerds (Amit Goyal & Daniel Ambinder) join Cleveland Clinic cardiology fellows (Ben Alencherry, Erika Hutt, Zach Il’Giovine, Kara Denby) for some delicious craft beer at Platform Brewery! They discuss a challenging case of Ehlers Danlos Syndrome with Papillary Muscle Rupture. Dr. Vidyasagar Kalahasti provides the E-CPR and program director Dr. Venu Menon provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident, Eunice Dugan, with mentorship from University of Maryland cardiology fellow Karan Desai. Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABCDEFClick to Enlarge A. ECGB. CXRC-F: Autopsy images TTE 1 TTE 2 TTE 3 TTE 4 TEE 1 TEE 2 TEE 3 TEE 4 Episode Schematics & Teaching Coming soon! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD
In this episode, an expert medical oncology panel led by Elizabeth R. Plimack, MD, MS, with Brian A. Costello, MD, and Martin H. Voss, MD, discusses clinical pearls for the management of patients with metastatic renal cell carcinoma (RCC). Topics include:Treating beyond progression with immunotherapyManagement of patients with less common histologic subtypes of RCCPotential biomarkers for RCCAdverse event managementPresenters:Elizabeth R. Plimack, MD, MSChief, Division of Genitourinary Medical Oncology Director, Genitourinary Clinical Research Professor, Department of Hematology/Oncology Fox Chase Cancer Center Temple Health Philadelphia, PennsylvaniaBrian A. Costello, MDAssociate Professor of Oncology and UrologyDivision of Medical OncologyMayo ClinicRochester, MinnesotaMartin H. Voss, MDClinical Director, Genitourinary Medical Oncology ServiceMemorial Sloan Kettering Cancer CenterAssistant Professor Weill Cornell Medical CollegeNew York, New YorkContent based on an online CME program supported by educational grants from Eisai, Exelixis, and Pfizer and EMD Serono.Link to full program:https://bit.ly/32IS9gx
Dr. Toni Choueiri discusses the results of this study, which appears to show a survival signal, but it is difficult to interpret.
Review of papillary lesions of the breast for the ABR Core exam. Please also check out the study guide on this topic available for download at www.theradiologyreview.com.
COVID-19 is really cramping my style! I had to postpone my first interview due to social distancing. So until then, I'm sharing my inspiration and My Cancer Story. Enjoy!This one is alllll about me and my short cancer story with Thyroid Cancer....more... --- Support this podcast: https://anchor.fm/mycancerstorypodcast/support
In this episode, Dr Katie Thomas discusses key points from a recent case report published in EHJ – Case Reports. For the paper discussed in this episode, please visit https://doi.org/10.1093/ehjcr/ytz058.
Dr Paul Wang: Welcome to the monthly podcast, On the Beat, for Circulation: Arrhythmia, and Electrophysiology. I'm Dr Paul Wang, Editor-in-Chief, with some of the key highlights from this month's issue. Koji Miyamoto and associates conducted the AD-Balloon Study, which investigates the ideal number of free cycles during second-generation cryoballoon pulmonary vein isolation. In a prospective, multicenter, randomized clinical trial, the authors compared in 110 patients the addition of a three minute freeze after pulmonary vein isolation had been achieved to pulmonary vein isolation alone. Delayed-enhancement magnetic resonance imaging was also performed one to two months after the pulmonary vein isolation to assess the ablation lesions. The freedom from atrial arrhythmias at one year was similar. Log rank test, P equals 0.78 in the two groups, 87.3% in the extra three-minute freeze group, and 89.1% in the pulmonary vein isolation group. There was no significant difference in the frequency of gaps on the pulmonary vein isolation lines in the delayed-enhancement magnetic resonance imaging. The authors conclude that an insurance freeze after achieving pulmonary vein isolation may be unnecessary and time consuming. In our next study, Robert Sheldon and associates examined the genetic basis of vasovagal syncope. They studied 160 subjects in 9 kindreds comprising 82 fainters and 78 controls. Common genetic variants were genotype for 12 genes for vascular signaling, potassium channels, the serotonin 5-HT1A receptor, the serotonin transporter and catecholamine-O-methyltransferase or COMT. They found that in 9 of 12 variants, there was no significant association between genotype and phenotype. However, the serotonin 5-HT1A receptor, HTR1-A G alleles were associated with syncope in males but not in females. P equals 0.005. The men with serotonin 5-HT1 receptor C alleles had a 9% likelihood of syncope while Gg males had a 77% likelihood of syncope. The SL6A4 promoter L alleles were associated with decreased syncope in males but increase in females. P equals 0.059. The Ll males had a 25% syncope likelihood and Ss males had a 47% syncope likelihood. The COMT A alleles were associated with decreased syncope in males but increased in females. P equals 0.017. The Gg males had a 50% syncope likelihood and A males had a 15% syncope likelihood. The Gg females had 52% syncope likelihood and the Aa females had a 73% syncope likelihood. The authors concluded that there is a sex-dependent effect of alleles of serotonin signaling in vasovagal syncope, supporting the serotonin hypothesis of the physiology of vasovagal syncope. In the next study, Michael Barkagan and associates sought to examine whether the standard criteria for mitral line block with endocardial and epicardial activation mapping may not distinguish from slow conduction or conduction via epicardial bridging connections. In 56 patients, the authors creates a posterior mitral line using radiofrequency ablation. Mitral block determined by pacing with conduction block defined as trans-isthmus time of 100 milliseconds or greater in reversal of coronary sinus activation during pacing from the left atrial appendage was achieved in 51 out of 56 or 91% of patients. In 11 of 51 or 22% of patients, high-resolution activation mapping, using Rhythmia, of the endocardium and epicardium via the coronary sinus demonstrated residual endocardial in 27% or residual epicardial in 73% connections. Epicardial bridging connections were distant from the line, 2.4 plus or minus 1.6 centimeters, inserting laterally at the proximal-mid coronary sinus and septally at the left atrial ridge. Patients with residual conduction were prone to complex circuits involving the epicardium in 7 of 11 patients. Mitral line block was achieved in 75% by targeting these insertion sites. The trans-isthmus time had limited predictive value for distinguishing block from pseudoblock. The authors concluded the connections are a frequent cause of complex circuits, and their insertion sites can be targeted for ablation. In our next paper, Santiago Rivera and associates examined the causes of QRS variability in Papillary muscle arrhythmias usually attributed to anisotropy. In 33 patients with papillary muscle arrhythmias prospectively undergoing cardiac resonance imaging, papillary muscle connections away from the papillary muscle base were identified. Arrhythmogenic papillary muscles, N equals 35, exhibited a higher number of papillary muscle connections, 72 versus 18, P equals 0.01. Patients with inconsistent QRS precordial transition and inconsistent QRS access exhibited a 100% prevalence of papillary muscle connections. Those with consistent precordial transition and consistent QRS access showed 40% and 26% prevalence of papillary muscle connections respectively. Inconsistent QRS precordial transition and inconsistent QRS access predicted the presence of papillary muscle connections with 59% or 28% sensitivity and 100% specificity respectively. Those papillary muscles exhibiting clinical recurrence after ablation presented a higher prevalence of papillary muscle connections, 91% versus 60%, P=0.04. In our next paper, Jason Coult and associates examined the quantitative measures of the electrocardiogram waveform during ventricular fibrillation to assess myocardial physiology and predict cardiac arrest outcomes. They collected five second ventricular fibrillation ECG segments with and without chest compressions prior to 2,755 defibrillation shocks from 1,151 out of hospital cardiac arrest patients. 24 individual measures and 3 combination measures were optimized to predict functionally intact survival using 460 training cases. Measures predicted functionally intact survival in 691 independent test cases with an area under the receiver operating curve (AUC) ranging from 0.56 to 0.75 without chest compressions and 0.53 to 0.75 with compressions, P less than 0.001. Of all measures evaluated, the support vector machine model ranked highest both without chest compressions, AUC equals 0.75, and with compressions, AUC equals 0.75. The authors concluded the waveform measures predict functionally intact survival when calculated during chest compressions, but prognostic performance is generally reduced compared to analysis without compressions. Support vector machine models exhibited similar performance with and without compressions while also achieving the highest area under the curve. In our last paper, Hailey Jansen, Martin Mackasey and associates examined the effective natriuretic peptides in the specific natriuretic peptide receptor NPR-C on angiotensin II-mediated atrial fibrillation. The authors examined wild-type and NPR-C knockout mice to investigate the effects of angiotensin II administered three milligrams per kilo per day for three weeks on atrial fibrillation susceptibility and atrial function. In wild-type mice, angiotensin II increased susceptibility to atrial fibrillation and associated with a prolonged P wave duration, increased atrial refractory period, and slowed atrial conduction. These effects were exacerbated in angiotensin II-treated NPR-C knockout mice. Angiotensin II prolonged action potential duration and reduced action potential upstroke velocity. Angiotensin II also increased fibrosis in the atria in wild-type mice while angiotensin II-treated NPR-C knockout mice exhibited substantially higher atrial fibrosis. Co-treating wild-type mice with angiotensin II and the NPR-C agonist cANF, those dependently reduced atrial fibrillation inducibility by preventing some of the angiotensin II-induced changes in atrial myocyte electrophysiology and preventing atrial fibrosis. The authors suggested that the NPR-C receptor may represent a new target for the prevention of angiotensin II-induced atrial fibrillation via protective effects on atrial, electrical and structural remodeling. That's it for this month! We hope that you'll find the journal to be the go-to place for everyone interested in the field. See you next time! This program is copyright American Heart Association 2019.
Paper of the week from Professor Sir Muir Gray: Saving Thyroids — Over-treatment of Small Papillary Cancers H. Gilbert Welch, M.D., M.P.H., and Gerard M. Doherty, M.D. Reference: https://www.nejm.org/doi/full/10.1056/NEJMp1804426 See more: www.3vh.org/essential-insights/
Interview with Brooke Nickel and Juan Brito, MD, MSc, authors of Effect of a Change in Papillary Thyroid Cancer Terminology on Anxiety Levels and Treatment Preferences: A Randomized Crossover Trial
Interview with Brooke Nickel and Juan Brito, MD, MSc, authors of Effect of a Change in Papillary Thyroid Cancer Terminology on Anxiety Levels and Treatment Preferences: A Randomized Crossover Trial
The thyroid gland is resistant to microbial infection, because of its organ characteristics such as encapsulation, iodine content, and rich blood supply. Naturopath David Marston discusses how suppurative thyroiditis can caused thyroid papillary carcinoma in the right thyoid lobe of a healthy women.
Bryan McIver, MD, PhD Dr. McIver contributes to Moffitt Cancer Center almost 20 years of clinical experience in the care of patients with endocrine diseases, specializing in the evaluation of patients with thyroid nodules and thyroid cancer. He has a particular interest in the management of patients with advanced and aggressive forms of cancer and the role of genetic and molecular techniques to improve the accuracy of diagnosis; to tailor appropriate treatment to a patientdisease. Dr. McIver has a long-standing basic research interest in the genetic regulation of growth, invasion and spread of thyroid tumors of all types. His primary research focus is the use of molecular and genetic information to more accurately diagnose thyroid cancer and to predict outcomes in the disease. Dr. McIver received his MB ChB degree from the University of Edinburgh Medical School in Scotland. He completed an Internal Medicine residency at the Royal Infirmary of Edinburgh, followed by a clinical fellowship and clinical investigator fellowship in Endocrinology at the School of Graduate Medical Education at Mayo Clinic in Rochester, MN. Prior to joining Moffitt, he was employed as Professor and Consultant at the Mayo Clinic and Foundation in the Division of Endocrinology & Metabolism. Amongst his most proud accomplishments, Dr. McIver counts his two commitment to education of medical students, residents and fellows; his involvement as a founding member of the World Congress on Thyroid Cancer, an international conference held every four years; and his appointment as a member of the Endowed and Master Clinician Program at the Mayo Clinic, recognizing excellence in patient care. In this episode, the follwoiung By sixty years old, more common to have nodule than not Most nodules are benign When to do a biopsy How to interpret the results of biopsy Advances in thyroid cancer Ultrasound technology advancements Molecular markers Cytopathology categorizations Molecular marker technologies Gene expression classifier Afirma Identifying aggressive cancer Types and sub-types of thyroid cancers Invasive and aggressive thyroid cancers Papillary versus anapestic thyroid cancer Biopsy results in 2 - 3 hours Clinical studies that have transformed thyroid treatment Less aggressive surgery and less radioactive iodine Targeted chemotherapies Immunotherapy The importance of clinical trial environments, or thoughtful philosophy The minimum necessary surgery Do not rush into thyroid cancer surgery NOTES: American Thyroid Association Bryan McIver, MD, PhD Ian D. Hay, M.D., Ph.D. Hossein Gharib, M.D. PAST EPISODES 32: Thyroid Cancer Surgery? The Single Most Important Question to Ask Your Surgeon with Dr. Gary Clayman
James L. Netterville, M.D. Mark C. Smith Professor of Head and Neck Surgery, Professor of Otolaryngology Director, Head & Neck Oncologic Surgery Associate Director, Bill Wilkerson Center for Otolaryngology and Communication Sciences Dr. Netterville is the Director of Head and Neck Surgery at Vanderbilt and is an international leading authority of treating head and neck cancer. He is one of the world's experts in the treatment of skull base tumors and has a vast clinical experience. Todays topic's include: Reoccurrence thyroid disease patients in paratracheal, thyroid bed, and cervical lymph nodes Papillary thyroid cancer and subtypes: tall cell, columnar, oncocytic, clear cell, hobnail The extreme importance of the pathologist Facebook is one of the number one sources of referrals The changing landscape of researching physicians PubMed and Index Medicus have replaced the library and medical literature In past 5 years patients are seeking advice from peers and experiences from others Patients have become the bets marketers for physicians versus the institution performing thyroid surgery on professional singers Patients are attached to a doctor and care team, which is often driven by social media Paratracheal region, and difficulty in ultrasound Selective neck dissection The evil remnant: when a surgeon inadvertently leaves thyroid cancer behind Three areas where thyroid cancer reoccurs: where remnant is left behind, hidden paratracheal lymph nodes, Lymph nodes in levels II, III, IV Some surgeons’ misperceptions about the effectiveness of RAI as a means to cleaning up poor surgery Doing a thyroid surgery is easy. Doing it right is hard. The importance of finding a surgeon who knows how to do it right Damage to RLN and leaving cancer behind or remnant, is due to inexperience Working around larynx and voice box during thyroid surgery Challenges with the trachea during thyroid surgery Grafting the RLN Grafting the RLN, in line graft, ends of motor nerves and sewing them back to the RLN Thyroid marketing and the term minimally invasive Superior RLN protection Preserving the cricothyroid muscle, especially singers The importance of being a good listener Vetting a surgeon by searching social media or reputation, publications, and volume Is thyroid cancer a cancer or just a nuisance. Chances are it is not going to kill you. Doctors managing their reputation online RAI and killing gross disease fallacy A surgeon's personal brand versus institution branding Online eduction NOTES Vanderbilt Health Vanderbilt-Ingram Cancer Center Thyroid research Funding surgical educational camps in Africa PubMed Index Medicus Aggressive Variants of Papillary Thyroid Carcinoma: Hobnail, Tall Cell, Columnar, and Solid American Thyroid Association
18 years ago Lorrie was diagnosed with Graves’ disease. Then, in 2017 she received a diagnosis of thyroid cancer. In this episode we hear Lorrie describe the following: Papillary thyroid cancer Long delayed pathology results Graves’ disease Balancing Graves’ disease and a thyroid cancer diagnosis Emotional roller coaster of feeling optimistic and other days of sadness. The feelings and emotions of related to a cancer diagnosis Being careful about the information shared on the Internet and potential negativity Support network and family Nodule size was 1.1 cm, but with history of Graves’ disease, she decided to forego active surveillance PATIENT RESOURCES American Thyroid Association
Dr. Amanda Laird, MD is an endocrine surgeon and Chief of Endocrine Surgery at the Rutgers Cancer Institute of New Jersey in New Brunswick, New Jersey. She is currently licensed to practice medicine in New Jersey and New York. She is affiliated with Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Hospital. In this interview, Dr. Laird reflects on a decade of treating papillary thyroid cancer patients and reports none have died. In this interview we also explore these questions: Prognosis and what will happen in the long run and quality of life. Surgery complications. Levothyroxine side-effects, including weight gain. Life after surgery and RAI. What causes thyroid cancer. What time of day to take thyroid replacement medication. What blood tests should be ordered and is fasting necessary prior to thyroid lab work. NOTES Amanda Laird, MD American Thyroid Association
Bryan McIver, MD, PhD Dr. McIver contributes to Moffitt Cancer Center almost 20 years of clinical experience in the care of patients with endocrine diseases, specializing in the evaluation of patients with thyroid nodules and thyroid cancer. He has a particular interest in the management of patients with advanced and aggressive forms of cancer and the role of genetic and molecular techniques to improve the accuracy of diagnosis; to tailor appropriate treatment to a patientdisease. Dr. McIver has a long-standing basic research interest in the genetic regulation of growth, invasion and spread of thyroid tumors of all types. His primary research focus is the use of molecular and genetic information to more accurately diagnose thyroid cancer and to predict outcomes in the disease. Dr. McIver received his MB ChB degree from the University of Edinburgh Medical School in Scotland. He completed an Internal Medicine residency at the Royal Infirmary of Edinburgh, followed by a clinical fellowship and clinical investigator fellowship in Endocrinology at the School of Graduate Medical Education at Mayo Clinic in Rochester, MN. Prior to joining Moffitt, he was employed as Professor and Consultant at the Mayo Clinic and Foundation in the Division of Endocrinology & Metabolism. Amongst his most proud accomplishments, Dr. McIver counts his two commitment to education of medical students, residents and fellows; his involvement as a founding member of the World Congress on Thyroid Cancer, an international conference held every four years; and his appointment as a member of the Endowed and Master Clinician Program at the Mayo Clinic, recognizing excellence in patient care. In this episode, the follwoiung By sixty years old, more common to have nodule than not Most nodules are benign When to do a biopsy How to interpret the results of biopsy Advances in thyroid cancer Ultrasound technology advancements Molecular markers Cytopathology categorizations Molecular marker technologies Gene expression classifier Afirma Identifying aggressive cancer Types and sub-types of thyroid cancers Invasive and aggressive thyroid cancers Papillary versus anapestic thyroid cancer Biopsy results in 2 - 3 hours Clinical studies that have transformed thyroid treatment Less aggressive surgery and less radioactive iodine Targeted chemotherapies Immunotherapy The importance of clinical trial environments, or thoughtful philosophy The minimum necessary surgery Do not rush into thyroid cancer surgery NOTES: American Thyroid Association Bryan McIver, MD, PhD Ian D. Hay, M.D., Ph.D. Hossein Gharib, M.D. PAST EPISODES 32: Thyroid Cancer Surgery? The Single Most Important Question to Ask Your Surgeon with Dr. Gary Clayman
Interview with R. Michael. Tuttle, MD, author of Natural History and Tumor Volume Kinetics of Papillary Thyroid Cancers During Active Surveillance
In the conclusion of this introductory series, we discuss the basics of computed tomography (CT) urography, bladder and urethral diverticula, and scrotal pathology including varicocele, epididymo-orchitis, and testicular neoplasm. Topics include: CT urography post-processing techniques: maximum intensity projection (MIP) and 3D volume-rendered (VR) imaging. Appearance of transitional cell carcinoma in the ureters and bladder on excretory phase CT mages. Papillary necrosis. Weigert-Meyer rule The post Introduction to Genitourinary Radiology, Part III appeared first on radiologist HeadQuarters.
An interactive discussion about malignant and benign pediatric thyroid disorders between Todd Ponsky, MD and Diana Diesen, MD. Dr. Diesen is assistant professor of surgery and pediatric surgery fellowship program director at the University of Texas Southwestern Medical Center and is a member of the Children's Health Pediatric Thyroid Center at the Children's Medical Center of Dallas. Contents 00:00 Introduction 02:31 Asymptomatic thyroid nodule 03:00 History 04:08 Risks factors for thyroid nodules and cancers 04:25 Family history 04:56 Physical exam 05:24 Physical exam pearls 06:03 Concerning physical exam findings 06:56 Laboratory evaluation 07:42 Thyroid scintigraphy 08:08 Hot thyroid nodules 09:13 Nodule with normal TSH 09:26 Thyroid ultrasound 10:15 Thyroid cysts 10:52 Lesion size and FNA biopsy 11:53 Anesthesia for FNA 12:30 Lymph node evaluation 13:12 Suspicious lymph node features 13:40 Papillary thyroid cancer 14:34 Lobectomy vs thyroidectomy 16:05 Thyroidecomy technique 17:07 Use of nerve monitor 17:40 Lymph node dissection 18:59 Post-operative management 20:37 Follow up 21:43 Radioactive iodine ablation 22:38 Thyroid hormone replacement therapy 22:54 Follicular cells on FNA 24:59 Frozen section for follicular lesions 25:55 Follicular carcinoma 26:36 Follicular adenoma 27:14 Pharmacologic TSH suppression 28:12 Benign FNA 29:45 Inadequate FNA specimen 30:32 Medullary carcinoma 33:22 Multiple endocrine neoplasia 37:26 Management of pheochromocytoma and hyperparathyroidism in MEN 2B 38:27 Central lymph node dissection in medullary thyroid cancer 39:42 Post-op medullary thyroid care 41:08 Recurrent/persistent medullary thyroid cancer 41:38 Systemic chemotherapy for MTC 42:03 Grave’s disease 42:57 Painful thyroid Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: http://creativecommons.org/licenses/by/3.0/
This podcast provides a commentary on the association of braf mutation and thyroid cancer showing an increase risk of recurrence in patients with thyroid cancer that harbor this mutation.
Commentary by Dr. Valentin Fuster
Background: Recurrent respiratory papillomatosis (RRP) is a rare disease, which is characterised by the growth of papillomavirus-induced papillomas within the respiratory tract. Malignant transformation occurs in less than 1% of the cases. Case presentation: We report a case of human papillomavirus (HPV) type 11-associated juvenile-onset RRP (JORRP) initially diagnosed at the age of two years. Remarkably high copy numbers of HPV11 DNA and antibody titres targeting the capsid protein L1 were detected in the patient's serum. The patient developed squamous cell carcinomas in both lungs and extraordinarily an HPV11 DNA-positive papillary endocardial lesion in the left atrium of the heart, which caused thromboembolic events leading to the patient's death at 19 years old. Conclusion: We here report a severe case of JORRP hallmarked by HPV11 DNAemia and very high antibody titres directed against the major viral capsid protein L1. Furthermore, the extent of malignant transformation and the discovery of a very rare fatal endocardial lesion highlight the unpredictability of JORRP and the complexity of its clinical management.
Dr. David Spigel, Sarah Cannon Cancer Center, describes the diagnosis, presentation and workup of squamous lung cancer.
Dr. David Spigel, Sarah Cannon Cancer Center, describes the diagnosis, presentation and workup of squamous lung cancer.
Dr. David Spigel, Sarah Cannon Cancer Center, describes the diagnosis, presentation and workup of squamous lung cancer.
Dr. David Spigel, Sarah Cannon Cancer Center, describes the diagnosis, presentation and workup of squamous lung cancer.
Dr. David Spigel, Sarah Cannon Cancer Center, describes the diagnosis, presentation and workup of squamous lung cancer.
Dr. David Spigel, Sarah Cannon Cancer Center, describes the diagnosis, presentation and workup of squamous lung cancer.
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