Podcasts about surgical management

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Best podcasts about surgical management

Latest podcast episodes about surgical management

VETgirl Veterinary Continuing Education Podcasts
Medical Versus Surgical Management Outcomes of IVDH in Cats | VETgirl Veterinary Continuing Education Podcasts

VETgirl Veterinary Continuing Education Podcasts

Play Episode Listen Later Apr 28, 2025 14:39


In today's VETgirl online veterinary continuing education podcast, Dr. Amy Kaplan, cVMA, DACVECC, MRCVS reviews the findings of a retrospective study on the comparative outcomes of medical versus surgical management of intervertebral disc herniation (IVDH) in cats. Is there a difference in outcomes for cats with IVDH who are conservatively medically managed compared surgical management? Tune in to find out!

JPO Podcast
Lit. Update with Jeff Martus

JPO Podcast

Play Episode Listen Later Apr 13, 2025 67:54


Dr. Jeff Martus from Vanderbilt University joins the podcast to discuss his recent article on comparative outcomes between plating and intramedullary nails for the treatment of forearm fractures in children and adolescents. The theme for the episode is trauma and touches on management of a variety of fractures including lateral condyles, supracondylar humerus fractures, pelvic and acetabular trauma, and even the pitfalls of mutton bustin'. Your hosts are Will Morris (Scottish Rite for Children). Tyler McDonald (University of South Alabama), Craig Louer (Vanderbilt), and Julia Sanders (University of Colorado). Music by A. A. Alto. References: Forearm Fractures in Older Children and Adolescents: ORIF is Safer Than IMN With Equivalent Outcomes. JPO. 2025 Mar. PMID: 39445700 Practice Patterns Vary Widely in the Care of Pediatric and Adolescent Pelvic and Acetabular Fractures: A CORTICES Survey. JPO. 2025 Mar. PMID: 39428588. Pediatric Lateral Condyle Fractures with Elbow Dislocation: Revisiting the Song Classification of the Most Severe Injuries. JPO. 2025 Mar. PMID: 3990788. Percutaneous Screw Fixation for the Management of Delayed Unions in Pediatric Lateral Humeral Condylar Fractures. JPO. 2025 Mar. PMID: 39523729. Presentation to the Emergency Department Increases the Likelihood of Surgical Management of Minimally Displaced Gartland Type IIa Pediatric Supracondylar Humerus Fractures. JPO.2025 Mar. PMID: 39327894. Remodeling of Sagittal Plane Malunion After Pediatric Supracondylar Humerus Fractures. JPO. 2020 Nov/Dec. PMID: 32604347. From Sheep to Sling: Pediatric Injuries Due to Rodeo Mutton Bustin'. JPO. 2025 Apr. PMID: 39831656.

ASCO Daily News
The Evolving Role of Precision Surgery in Gynecologic Cancers

ASCO Daily News

Play Episode Listen Later Mar 13, 2025 25:50


Dr. Ebony Hoskins and Dr. Andreas Obermair discuss the surgical management of gynecologic cancers, including the role of minimally invasive surgery, approaches in fertility preservation, and the nuances of surgical debulking. TRANSCRIPT Dr. Ebony Hoskins: Hello and welcome to the ASCO Daily News Podcast, I'm Dr. Ebony Hoskins. I'm a gynecologic oncologist at MedStar Washington Hospital Center in Washington, DC, and your guest host of the ASCO Daily News Podcast. Today we'll be discussing the surgical management of gynecologic cancer, including the role of minimally invasive surgery (MIS), approaches in fertility preservation, and the nuances of surgical debulking, timing, and its impact on outcomes. I am delighted to welcome Dr. Andreas Obermair for today's discussion. Dr. Obermair is an internationally renowned gynecologic oncologist, a professor of gynecologic oncology at the University of Queensland, and the head of the Queensland Center for Gynecologic Cancer Research. Our full disclosures are available in the transcript of this episode. Dr. Obermair, it's great speaking with you today. Dr. Andreas Obermair: Thank you so much for inviting me to this podcast. Dr. Ebony Hoskins: I am very excited.  I looked at your paper and I thought, gosh, is everything surgical? This is everything that I deal with daily in terms of cancer in counseling patients. What prompted this review regarding GYN cancer management? Dr. Andreas Obermair: Yes, our article was published in the ASCO Educational Book; it is volume 44 in 2024. And this article covers some key aspects of targeted precision surgical management principles in endometrial cancer, cervical cancer, and ovarian cancer. While surgery is considered the cornerstone of gynecologic cancer treatment, sometimes research doesn't necessarily reflect that. And so I think ASCO asked us to; so it was not just me, there was a team of colleagues from different parts of the United States and Australia to reflect on surgical aspects of gynecologic cancer care and I feel super passionate about that because I do believe that surgery has a lot to offer. Surgical interventions need to be defined and overall, I see the research that I'm doing as part of my daily job to go towards precision surgery. And I think that is, well, that is something that I'm increasingly passionate for. Dr. Ebony Hoskins: Well, I think we should get into it. One thing that comes to mind is the innovation of minimally invasive surgery in endometrial cancer. I always reflect on when I started my fellowship, I guess it's been about 15 years ago, all of our endometrial cancer patients had a midline vertical incision, increased risk of abscess, infections and a long hospital stay. Do you mind commenting on how you see management of endometrial cancer today? Dr. Andreas Obermair: Thank you very much for giving the historical perspective because the generation of gynecologic oncologists today, they may not even know what we dealt with, what problems we had to solve. So like you, when I was a fellow in gynecologic oncology, we did midline or lower crosswise incisions, the length of stay was, five days, seven days, but we had patients in hospital because of complications for 28 days. We took them back to the operating theaters because those are patients with a BMI of 40 plus, 45, 50 and so forth. So we really needed to solve problems. And then I was exposed to a mentor who taught minimal invasive surgery. And in Australia he was one of the first ones who embarked on that. And I can remember, I was mesmerized by this operation, like not only how logical this procedure was, but also we did rounds afterwards. And I saw these women after surgery and I saw them sitting upright, lipstick on, having had a full meal at the end of the day. And I thought, wow, this is the most rewarding experience that I have to round these patients after surgery. And so I was thinking, how could I help to establish this operation as standard? Like a standard that other people would accept this is better. And so I thought we needed to do a trial on this. And then it took a long time. It took a long time to get the support for the [LACE - Laparoscopic Approach to Cancer of the Endometrium] trial. And in this context, I just also wanted to remind us all that there were concerns about minimal invasive surgery in endometrial cancer at the time. So for example, one of the concerns was when I submitted my grant funding applications, people said, “Well, even if we fund you, wouldn't be able to do this trial because there are actually no surgeons who actually do minimally invasive surgery.” And at the time, for example, in Australia, there were maybe five people, a handful of people who were able to do this operation, right? This was about 20 years ago. The other concern people had was they were saying, could minimally invasive surgery for endometrial cancer, could that cause port side metastasis because there were case reports. So there were a lot of things that we didn't know anyway. We did this trial and I'm super happy we did this trial. We started in 2005, and it took five years to enroll. At the same time, GOG LAP2 was ramping up and the LACE trial and GOG LAP2 then got published and provided the foundations for minimally invasive surgery in endometrial cancer. I'm super happy that we have randomized data about that because now when we go back and now when people have concerns about this, should we do minimally invasive surgery in P53 mutant tumors, I'm saying, well, we actually have data on that. We could go back, we could actually do more research on that if we wanted to, but our treatment recommendations are standing on solid feet. Dr. Ebony Hoskins: Well, my patients are thankful. I see patients all the time and they have high risk and morbidly obese, lots of medical issues and actually I send them home most the same day. And I think, you know, I'm very appreciative of that research, because we obviously practice evidence-based and it's certainly a game changer. Let's go along the lines of MIS and cervical cancer. And this is going back to the LACC [Laparoscopic Approach to Cervical Cancer] trial.  I remember, again, one of these early adopters of use of robotic surgery and laparoscopic surgery for radical hysterectomy and thought it was so cool. You know, we can see all the anatomy well and then have the data to show that we actually had a decreased survival. And I even see that most recent updated data just showing it still continued. Can you talk a little bit about why you think there is a difference? I know there's ongoing trials, but still interested in kind of why do you think there's a survival difference? Dr. Andreas Obermair:  So Ebony, I hope you don't mind me going back a step. So the LACC study was developed from the LACE trial. So we thought we wanted to reproduce the LACE data/LAP2 data. We wanted to reproduce that in cervix cancer. And people were saying, why do you do that? Like, why would that be different in any way? We recognize that minimally invasive radical hysterectomy is not a standard. We're not going to enroll patients in a randomized trial where we open and do a laparotomy on half the patients. So I think the lesson that really needs to be learned here is that any surgical intervention that we do, we should put on good evidence footing because otherwise we're really running the risk of jeopardizing patients' outcomes. So, that was number one and LACC started two years after LACE started. So LACC started in 2007, and I just wanted to acknowledge the LACC principal investigator, Dr. Pedro Ramirez, who at the time worked at MD Anderson. And we incidentally realized that we had a common interest. The findings came totally unexpected and came as an utter shock to both of us. We did not expect this. We expected to see very similar disease-free and overall survival data as we saw in the endometrial cancer cohort. Now LACC was not designed to check why there was a difference in disease-free survival. So this is very important to understand. We did not expect it. Like, so there was no point checking why that is the case. My personal idea, and I think it is fair enough if we share personal ideas, and this is not even a hypothesis I want to say, this is just a personal idea is that in endometrial cancer, we're dealing with a tumor where most of the time the cancer is surrounded by a myometrial shell. And most of the time the cancer would not get into outside contact with the peritoneal cavity. Whereas in cervix cancer, this is very different because in cervix cancer, we need to manipulate the cervix and the tumor is right at the outside there. So I personally don't use a uterine manipulator. I believe in the United States, uterine manipulators are used all the time. My experience is not in this area, so I can't comment on that. But I would think that the manipulation of the cervix and the contact of the cervix to the free peritoneal cavity could be one of the reasons. But again, this is simply a personal opinion. Dr. Ebony Hoskins: Well, I appreciate it. Dr. Andreas Obermair: Ebony at the end of the day, right, medicine is empirical science, and empirical science means that we just make observations, we make observations, we measure them, and we pass them on. And we made an observation. And, and while we're saying that, and yes, you're absolutely right, the final [LACC] reports were published in JCO recently. And I'm very grateful to the JCO editorial team that they accepted the paper, and they communicated the results because this is obviously very important. At the same time, I would like to say that there are now three or four RCTs that challenge the LACC data. These RCTs are ongoing, and a lot of people will be looking forward to having these results available. Dr. Ebony Hoskins: Very good. In early-stage cervical cancer, the SHAPE trial looked at simple versus radical hysterectomy in low-risk cervical cancer patients. And as well all know, simple hysterectomy was not inferior to radical hysterectomy with respect to the pelvic recurrence rate and any complications related to surgery such as urinary incontinence and retention. My question for you is have you changed your practice in early-stage cervical cancer, say a patient with stage 1B1 adenocarcinoma with a positive margin on conization, would you still offer this patient a radical hysterectomy or would you consider a simple hysterectomy? Dr. Andreas Obermair:  I think this is a very important topic, right? Because I think the challenge of SHAPE is to understand the inclusion criteria. That's the main challenge. And most people simplify it to 2 cm, which is one of the inclusion criteria but there are two others and that includes the depth of invasion. Dr. Marie Plante has been very clear. Marie Plante is the first author of the SHAPE trial that's been published in the New England Journal of Medicine only recently and Marie has been very clear upfront that we need to consider all three inclusion criteria and only then the inclusion criteria of SHAPE apply. So at the end of the day, I think what the SHAPE trial is telling us that small tumors that would strictly fulfill the criteria of a 1B or 1B1 cancer of the cervix can be considered for a standard type 1 or PIVA type 1 or whatever classification we're trying to use will be eligible. And that makes a lot of sense. I personally not only look at the size, I also look at the location of the tumor. I would be very keen that I avoid going through tumor tissue because for example, if you have a tumor that is, you know, located very much in one corner of the cervix and then you do a standard hysterectomy and then you have a positive tumor margin that would be obviously, most people would agree it would be an unwanted outcome. So I'd be very keen checking the location, the size of the tumor, the depths of invasion and maybe then if the tumor for example is on one side of the cervix you can do a standard approach on the contralateral side but maybe do a little bit more of a margin, a parametrial margin on the other side. Or if a tumor is maybe on the posterior cervical lip, then you don't need to worry so much about the anterior cervical margin, maybe take the rectum down and maybe try to get a little bit of a vaginal margin and the margin on the uterus saccals. Just really to make sure that you do have margins because typically if we get it right, survival outcomes of clinical stage 1 early cervix cancer 1B1 1B 2 are actually really good. It is a very important thing that we get the treatment right. In my practice, I use a software to record my treatment outcomes and my margins. And I would encourage all colleagues to be cognizant and to be responsible and accountable to introduce accountable clinical practice, to check on the margins and check on the number on the percentage of patients who require postoperative radiation treatment or chemo radiation. Dr. Ebony Hoskins: Very good. I have so many questions for you. I don't know the statistics in Australia, but here, there's increased rising of endometrial cancer and certainly we're seeing it in younger women. And fertility always comes up in terms of kind of what to do. And I look at the guidelines and, see if I can help some of the women if they have early-stage endometrial cancer. Your thoughts on what your practice is on use of someone who may meet criteria, if you will. The criteria I use is grade 1 endometrioid adenocarcinoma. No myometria invasion. I try to get MRI'd and make sure that there's no disease outside the endometrium. And then if they make criteria, I typically would do an IUD. Can you tell me what your practice is and where you've had success? Dr. Andreas Obermair: So, we initiated the feMMe clinical trial that was published in 2021 and it was presented in a Plenary at one of the SGO meetings. I think it was in 2021, and we've shown complete pathological response rates after levonorgestrel intrauterine device treatment. And so in brief, we enrolled patients with endometrial hyperplasia with atypia, but also patients with grade 1 endometrial adenocarcinoma. Patients with endometrial hyperplasia with atypia had, in our series, had an 85 % chance of developing a complete pathological response. And that was defined as the complete absence of any atypia or cancer. So endometrial hyperplasia with atypia responded in about 85%. In endometrial cancer, it was about half, it was about 45, 50%. In my clinical practice, like as you, I see patients, you know, five days a week. So I'm looking after many patients who are now five years down from conservative treatment of endometrial cancer. There are a lot of young women who want to get pregnant, and we had babies, and we celebrate the babies obviously because as gynecologist obstetricians it couldn't get better than that, right, if our cancer patients have babies afterwards. But we're also treating women who are really unfit for surgery and who are frail and where a laparoscopic hysterectomy would be unsafe. So this phase is concluded, and I think that was very successful. At least we're looking to validate our data. So we're having collaborations, we're having collaborations in the United States and outside the United States to validate these data. And the next phase is obviously to identify predictive factors, to identify predictors of response. Because as you can imagine, there is no point treating patients with a levonorgestrel intrauterine joint device where we know in advance that she's not going to respond. So this is a very, very fascinating story and we got our first set of data already, but now we just really need to validate this data. And then once the validation is done, my unit is keen to do a prospective validation trial. And that also needs to involve international collaborators. Dr. Ebony Hoskins: Very good. Moving on to ovarian cancer, we see patients with ovarian cancer with, say, at least stage 3C or higher who started neoadjuvant chemotherapy. Now, some of these patients are hearing different things from their medical oncologist versus their gynecologic oncologist regarding the number of cycles of neoadjuvant chemotherapy after getting diagnosed with ovarian cancer. I know that this can be confusing for our patients coming from a medical oncologist versus a gynecologic oncologist. What do you say to a patient who is asking about the ideal number of chemotherapy cycles prior to surgery? Dr. Andreas Obermair: So this is obviously a very, very important topic to talk about. We won't be able to provide a simple off the shelf answer for that, but I think data are emerging.  The ASCO guidelines should also be worthwhile considering because there are actually new ASCO Guidelines [on neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer] that just came out a few weeks ago and they would suggest that we should be aiming for R0 in surgery. If we can maybe take that as the pivot point and then go back and say, okay, so what do need to do to get the patient to zero?  I'm not an ovarian cancer researcher; I'm obviously a practicing gynecologic oncologist. I think about things a lot and things like that. In my practice, I would want a patient to develop a response after neoadjuvant chemotherapy. So, if a patient doesn't have a response after two or three cycles, then I don't see the point for me to offer her an operation. In my circle with the medical oncologists that I work with, I have a very, very good understanding. So, they send the patient to me, I take them to the theater. I take a good chunk of tissue from the peritoneum. We have a histopathologic diagnosis, we have a genomic diagnosis, they go home the same day. So obviously there is no hospital stay involved with that. They can start the chemotherapy after a few days. There is no hold up because the chances of surgical complication in a setting like this is very, very low. So I use laparoscopy to determine whether the patient responds or not. And for many of my patients, it seems to work. It's obviously a bit of an effort and it takes operating time. But I think I'm increasing my chances to make the right decision. So, coming back to your question about whether we should give three or six cycles, I think the current recommendations are three cycles pending the patient's response to neoadjuvant chemotherapy because my aim is to get a patient to R0 or at least minimal residual disease. Surgery is really, in this case, I think surgery is the adjunct to systemic treatment. Dr. Ebony Hoskins: Definitely. I think you make a great point, and I think the guideline just came out, like you mentioned, regarding neoadjuvant. And I think the biggest thing that we need to come across is the involvement of a gynecologic oncologist in patients with ovarian cancer. And we know that that survival increases with that involvement. And I think the involvement is the surgery, right? So, maybe we've gotten away from the primary tumor debulking and now using more neoadjuvant, but surgery is still needed. And so, I definitely want to have a take home that GYN oncology is involved in the care of these patients upfront. Dr. Andreas Obermair: I totally support that. This is a very important statement. So when I'm saying surgery is the adjunct to medical treatment, I don't mean that surgery is not important. Surgery is very important. And the timing is important. And that means that the surgeons and the med oncs need to be pulling on the same string. The med oncs just want to get the cytotoxic into the patients, but that's not the point, right? We want to get the cytotoxic into the patients at the right time because if we are working under this precision surgery, precision treatment mantra, it's not only important what we do, but also doing it at the right time. And ideally, I I would like to give surgery after three cycles of neoadjuvant chemotherapy, if that makes sense. But sometimes for me as a surgeon, I talk to my med onc colleagues and I say, “Look, she doesn't have a good enough response to her treatment and I want her to receive six cycles and then we re-evaluate or change medical treatment,” because that's an alternative that we can swap out drugs and treat upfront with a different drug and then sometimes they do respond. Dr. Ebony Hoskins:  I have maybe one more topic. In the area I'm in, in the Washington D.C. area, we see lots of endometrial cancer and they're not grade 1, right? They're high-risk endometrial cancer and advanced. So a number of patients with stage 3 disease, some just kind of based off staging and then some who come in with disease based off of the CT scan, sometimes omental caking, ascites. And the real question is we have extrapolated the use of neoadjuvant chemotherapy to endometrial cancer. It's similar, but not the same. So my question is in an advanced endometrial cancer, do you think there's still a role, when I say advanced, I mean, maybe stage 4, a role for surgery? Dr. Andreas Obermair: Most definitely. But the question is when do you want to give this surgery? Similar to ovarian cancer, in my experience, I want to get to R0. What am I trying to achieve here? So, I reckon we should do a trial on this. And I reckon we have, as you say, the number of patients in this setting is increasing, we could do a trial. I think if we collaborate, we would have enough patients to do a proper trial. Obviously, we would start maybe with a feasibility trial and things like that. But I reckon a trial would be needed in this setting because I find that the incidence that you described, that other people would come across, they're becoming more and more common. I totally agree with you, and we have very little data on that. Dr. Ebony Hoskins: Very little and we're doing what we can. Dr. Obermair, thank you for sharing your fantastic insights with us today on the ASCO Daily News Podcast and for all the work you do to advance care for patients with gynecologic cancer. Dr. Andreas Obermair: Thank you, Dr. Hoskins, for hosting this and it's been an absolute pleasure speaking with you today. Dr. Ebony Hoskins: Definitely a pleasure and thank you to our listeners for your time today. Again, Dr. Obermair's article is titled, “Controversies in the Surgical Management of Gynecologic Cancer: Balancing the Decision to Operate or Hesitate,” and was published in the 2024 ASCO Educational Book. And you'll find a link to the article in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers: Dr. Ebony Hoskins @drebonyhoskins Dr. Andreas Obermair @andreasobermair Follow ASCO on social media:       @ASCO on Twitter       ASCO on Bluesky   ASCO on Facebook       ASCO on LinkedIn       Disclosures:   Dr. Ebony Hoskins: No relationships to disclose. Dr. Andreas Obermair: Leadership: SurgicalPerformance Pty Ltd. Stock and Ownership Interests: SurgicalPerformance Pty Ltd. Honoraria: Baxter Healthcare Consulting or Advisory Role: Stryker/Novadaq Patents, Royalties, and Other Intellectual Property: Shares in SurgicalPerformance Pty Ltd. Travel, Accommodation, Expenses: Stryker    

MEM Cast
Episode 247: Surgical management of aortic valve disease

MEM Cast

Play Episode Listen Later Mar 7, 2025 21:42


This week, we're thrilled to welcome Mr. Giovanni Mariscalco, Consultant and Head of Service for Cardiac Surgery, as we explore the surgical management of aortic valve disease and its relevance to medical practice. In this episode, we cover: Identifying patients who require surgery, types of prosthetic valves and their indications, the evolving role of TAVI Don't miss this deep dive into one of the most critical areas of cardiac surgery

CTSNet To Go
The Beat With Joel Dunning Ep. 92: Oligometastatic Disease

CTSNet To Go

Play Episode Listen Later Feb 13, 2025 38:23


This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Tom D'Amico, professor and vice chairman of surgery and chief medical officer of the Duke Cancer Institute, about oligometastatic disease. They discuss the current updates of oligometastatic disease, The Society of Thoracic Surgeons (STS) guidelines on the surgical management of oligometastatic non-small cell lung cancer, and the importance of choosing the right patient. They also explore where the new boundaries of this procedure are, radiation therapy, and shared decision-making. Joel also highlights a surgical robot (spaceMIRA) at the International Space Station that completed its first surgery demo in zero gravity, the state of lung transplants in the United Kingdom, and the Priority Setting Partnership (PSP).   Joel also reviews recent JANS articles on perioperative extra corporeal membrane oxygenation in neonates with transposition of the great arteries, a randomized controlled trial on the effects of postoperative glucocorticoids on mitigation of organ dysfunction in patients with Type A aortic dissection, if socioeconomic factors impair uptake of neoadjuvant therapy for patients with locoregional esophageal cancer, and a nationwide analysis on malperfusion in patients with acute Type A aortic dissection.  In addition, Joel explores a case report on a chest injury with an arrow penetrating the right lung with rent in the right atrium, an interview with Marko Turina, and an Onyx mechanical mitral valve replacement after previous mitral repair. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Perioperative Extra Corporeal Membrane Oxygenation in Neonates With Transposition of the Great Arteries: 15 Years of Experience  2.) Effects of Postoperative Glucocorticoids on Mitigation of Organ Dysfunction in Patients With Type A Aortic Dissection: A Randomized Controlled Trial  3.) Do Socioeconomic Factors Impair Uptake of Neoadjuvant Therapy for Patients With Locoregional Oesophageal Cancer?  4.) Malperfusion in Patients with Acute Type A Aortic Dissection: A Nationwide Analysis  CTSNET Content Mentioned  1.) Injury to the Chest With an Arrow Penetrating the Right Lung With Rent in the Right Atrium: A Case Report  2.) Giants in CT Surgery: An Interview With Marko Turina  3.) Redo Mitral Surgery: Onyx Mechanical Mitral Valve Replacement After Previous Mitral Repair   Other Items Mentioned  1.) The Society of Thoracic Surgeons (STS) Clinical Practice Guideline on Surgical Management of Oligometastatic Non-small Cell Lung Cancer  2.) Surgery in Space: Tiny Remotely Operated Robot Completes First Simulated Procedure at the Space Station  3.) Career Center   4.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

HealthLine 3
Uterine fibroids and surgical management

HealthLine 3

Play Episode Listen Later Feb 13, 2025 30:00


Uterine fibroids are a type of non-cancerous growth and more commonly found in African American women. Dr. Karen Berken with Willis Knighton Bossier discusses treatment options and surgical management of uterine fibroids.

UF Health MedEd Cast
Update on Surgical Management of Pediatric Obstructive Sleep Apnea

UF Health MedEd Cast

Play Episode Listen Later Jan 9, 2025


Untreated obstructive sleep apnea in children can be associated with growth, developmental, and cardiopulmonary complications. Surgical options to treat OSA in children are constantly evolving, from not only new techniques on the traditional adenotonsillectomy to newer surgical techniques in older children.

The Sports Docs Podcast
110: Dr. Patrick Denard – Treatment of Challenging Rotator Cuff Pathology (Part 2)

The Sports Docs Podcast

Play Episode Listen Later Dec 23, 2024 25:57


Our conversation picks back up with an article published in the December 2020 issue of Current Reviews in Musculoskeletal Medicine titled “Surgical Management of Massive Irreparable Cuff Tears: Superior Capsular Reconstruction.” Authored by our guest today, this review article summarizes the biomechanical properties and functional outcomes of superior capsular reconstruction or “SCR” for treatment of massive irreparable rotator cuff tears. The authors report that SCR decreases superior translation and subacromial contact pressure. Glenoid fixation is maximized with three anchors, while margin convergence to any remaining rotator cuff – particularly posterior – improves stability. Patient selection is key, with the ideal patient being younger than 70 and a healthy nonsmoker with an irreparable posterior cuff tear in the absence of glenohumeral arthritis and a functioning or repairable subscapularis. We finish up our discussion today with the publication titled “Latissimus dorsi transfer or lower trapezius transfer: a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tears.” Laurent Lafosse and team compared two tendon transfer options for irreparable posterior-superior rotator cuff tears with rotational deficiency – the latissimus dorsi transfer and the lower trapezius transfer.  They found that active motion, pain scores and function were improved in both groups with a low failure and revision rate.  The authors suggest that lower trapezius transfer better restores external rotation at the side while latissimus dorsi transfer may be a better option for restoration of external rotation and abduction.

CTSNet To Go
The Beat With Joel Dunning Ep. 75: EACTS Recap

CTSNet To Go

Play Episode Listen Later Oct 18, 2024 30:11


This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses the highlights of the 38th EACTS Annual Meeting and reviews several important presentations. He discusses the presentation from engineer Amy Kertok on the interdisciplinary intersection of medicine and technology, and the presidential speech delivered by Franca Melfi on perseverance. He also shares the guidelines that were presented at the meeting, including blood management, perioperative medications, myocardial revascularization and aortic.  Joel also reviews recent JANS articles on ultrasonic emulsification of severe mitral annular calcification to enable mitral valve repair, the perceval sutureless bioprosthetic aortic valve, impact of radiological follow-up frequency on resected lung cancer, heart transplantation after donation after circulatory death, and more.   In addition, Joel explores the world's first robotic heart transplant at the King Faisal Hospital in Riyadh, direct cannulation through right anterior mini thoracotomy for aortic valve replacement, an indigenous technique of surgical management in a case of acute on chronic type A and type B aortic dissection, and robotic-assisted left first rib resection. Before closing, he shares upcoming events in CT surgery.   JANS Items Mentioned  1.) Ultrasonic Emulsification of Severe Mitral Annular Calcification to Enable Mitral Valve Repair  2.) The Perceval Sutureless Bioprosthetic Aortic Valve: Evolution of Surgical Valve Technology  3.) Impact of Radiological Follow-Up Frequency on Resected Lung Cancer: A Propensity Score Matching Analysis  4.) Heart Transplantation After Donation After Circulatory Death: Early United States Experience  5.) Surgical Myocardial Revascularization with a Composite T-graft from the Left Internal Mammary Artery—Comparison of the Great Saphenous Vein with the Radial Artery  6.) SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)  7.) Composite End Points and Competing Risks Analysis  8.) Increased Lung Cancer Recurrence Following Transthoracic Needle Biopsy  CTSNET Content Mentioned  1.) The World's First Robotic Heart Transplant at the King Faisal Hospital in Riyadh   2.) Direct Cannulation Through Right Anterior Mini Thoracotomy for Aortic Valve Replacement  3.) An Indigenous Technique of Surgical Management in a Case of Acute on Chronic Type A and Type B Aortic Dissection  4.) Robotic-Assisted Left First Rib Resection  Other Items Mentioned  CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

The Cone of Shame Veterinary Podcast
294 - Surgical Management Of Hip Dysplasia (HDYTT)

The Cone of Shame Veterinary Podcast

Play Episode Listen Later Oct 10, 2024 31:16


Dr. David Dycus provides a practical, in-depth look at managing canine hip dysplasia, from early diagnosis to surgical interventions in this episode of Cone of Shame Veterinary Podcast. Dr. Andy Roark sits down with . Dr. Dycus to discuss the various treatment options, including juvenile pubic symphysiodesis (JPS), pelvic osteotomies, and total hip replacements. He explains the importance of early detection, especially in breeds predisposed to hip dysplasia, and breaks down when and why certain surgical options are recommended. This episode is essential for veterinary professionals looking to better understand orthopedic surgery decisions and help guide pet owners through difficult choices. Gang, let's get into this episode.... LINKS Dr. David Dycus: https://drdaviddycus.com/ Dr. David Dycus on Instagram: https://www.instagram.com/ortho_vet/ Dr. Andy Roark Resources: https://linktr.ee/DrAndyRoark Dr. Andy Roark Exam Room Communication Tool Box Team Training Course: https://drandyroark.com/on-demand-staff-training/ Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/ Dr. Andy Roark Swag: https://drandyroark.com/store ABOUT OUR GUEST Dr. Dycus attended Mississippi State University's College of Veterinary Medicine for his veterinary degree, Auburn University for a small animal rotating internship, and Mississippi State for a combined surgical residency and Masters degree. Dr. Dycus is frequently asked to lecture locally, nationally, and internationally. He has given over 250 continuing education lectures and taught over 150 laboratories. He has published numerous research articles and authored or co-authored several book chapters. He is the co-editor of the textbook: Complications in Canine Cranial Cruciate Ligament Surgery. In 2023 Dr. Dycus received the Veterinary Hero's Award in surgery by DVM360 and was named by DVM360.com as one of the 10 veterinarians to watch in 2018. Dr. Dycus is a frequent contributor for updates in orthopedics to several veterinary websites and magazines. Dr. Dycus has also been featured on Sirius XMs Doctor Radio's segment on Pet Health and Orthopedics. His passion for teaching has allowed Dr. Dycus to become a laboratory instructor for the CBLO, TPLO, extra-capsular stabilization, medial patella luxation, angular limb deformity, and fracture repair. He is on faculty for AO (Arbeitsgemeinschaft für Osteosynthesefragen), and he is an orthopedic consultant for VIN (Veterinary Information Network). Dr. Dycus became a certified canine rehabilitation practitioner through the University of Tennessee in 2015. He is the founder and surgeon at Fusion Veterinary Orthopedics where he has a focus on total joint replacement, complex and minimally invasive fracture repair as well as angular limb deformity correction, 3D implant printing, and arthroscopy. In addition, he is the founder of Ortho Vet Consulting, an educational consulting and orthopedic coaching service.

ACFAS eLearning
24PC388 - Surgical Vs. Non-Surgical Management of Achilles Tendon Ruptures

ACFAS eLearning

Play Episode Listen Later Sep 17, 2024 37:09


Moderator: Sandeep Patel, DPM, FACFAS Panelists: Matthew Cobb, DPM, FACFAS Matthew Doyle, DPM, FACFAS Johanna Richey, DPM, FACFAS Run time - 34m

The Intern At Work: Internal Medicine
243. Ask a Fellow- Medical & Surgical Management of The Hospitalized IBD Patient

The Intern At Work: Internal Medicine

Play Episode Listen Later Sep 11, 2024 26:16


Send us a text"Bad Gut Feeling" Medical & Surgical Management of The Hospitalized IBD Patient. This ask a fellow kicks off our first episode of the new academic year with one of our Queens site leads, Michael Scaffidi (Internal Medicine Resident) hosts Dr. Fiona Milne @not_shreks_wife (Gastroenterology fellow) and Dr. Daniel Potter (General Surgery Resident). Reviewed by Dr. Elizabeth Squirell (Gastroenterologist and IBD specialist) and Dr. Sunil Patel (Colorectal Surgeon). Infographic by Sapriya Birk. Support the show

SAGE Clinical Medicine & Research
CPCJ: Socioeconomic Influence on Surgical Management and Outcomes in Patients with Craniosynostosis - A Systematic Review

SAGE Clinical Medicine & Research

Play Episode Listen Later Aug 28, 2024 33:25


In this episode of the CPCJ podcast series, Multimedia Editor Pat Chibbaro interviews Melanie Bakovic and Albert K. Oh, authors of the article entitled, "Socioeconomic Influence on Surgical Management and Outcomes in Patients with Craniosynostosis - A Systematic Review" (coauthored by Lilliana Starsiak, Spencer Bennett, Ryan McCaffrey, Esperanza Mantilla-Rivas, Monica Manrique and Gary F. Rogers).

BackTable ENT
Ep. 188 Surgical Management of Synkinesis and Static Procedures for Flaccid Facial Palsy with Dr. Shiayin Yang

BackTable ENT

Play Episode Listen Later Aug 27, 2024 60:44


Facial nerve injury affects each patient in a unique way. Accordingly, surgical treatment of facial paralysis must be meticulously planned and personalized. In this episode, Dr. Shiayin Yang, Associate Professor of Otolaryngology at Vanderbilt University, addresses management of synkinesis and static procedures for flaccid facial palsy with host Dr. Ashley Agan. --- CHECK OUT OUR SPONSOR PearsonRavitz https://pearsonravitz.com/backtable --- SYNPOSIS First, Dr. Yang reviews the difference between flaccid and non-flaccid (including synkinetic) facial paralysis. She describes her approach to facial paralysis, which includes clarifying the patient's diagnosis and thoroughly examining the facial nerve function. Dr. Yang then transitions the conversation to surgical solutions, emphasizing dual goals of restoring symmetry and function. She divides her discussion to first tackle synkinesis and then static procedures for flaccid paralysis. Procedures discussed include Botox, brow lift, blepharoplasty, myectomy, and neurectomy as well as lower eyelid and midface procedures and temporalis tendon transfer. While surgical approaches to the two conditions differ, eye protection represents an important theme throughout. The episode concludes with Dr. Yang's pearls for approaching these complex surgical problems and a reminder of how facial paralysis affects patients' emotional health. --- TIMESTAMPS 00:00 - Introduction 02:36 - Understanding Flaccid & Non-Flaccid Facial Paralysis 07:13 - Botox for Facial Synkinesis 12:38 - History-Taking & Physical Exam in Facial Paralysis 15:07 - Surgical Management of Synkinesis 30:47 - Patient Counseling and Motivation 32:47 - Static Procedures for Flaccid Facial Palsy 37:26 - Nuances of Peri-Ocular Procedures 43:42 - Lower Eyelid & Midface Considerations 53:00 - Dynamic Surgery Options 56:56 - Final Surgical Pearls --- RESOURCES Dr. Shiayin Yang's Vanderbilt University Profile: https://www.vanderbilthealth.com/doctors/yang-shiayin BackTable ENT Episode 151- Navigating Synkinesis: From Diagnosis to Comprehensive Care with Dr. Shiayin Yang https://open.spotify.com/episode/1JucnHB8tNC5qRW6u82ie8?si=ba729d3f3e164d6f

CTSNet To Go
The Beat With Joel Dunning Ep. 68: Mobile Surgery Unit in Ghana

CTSNet To Go

Play Episode Listen Later Aug 15, 2024 30:36


This week on The Beat, Editor in Chief Joel Dunning highlights the Diego Gonzalez Rivas Foundation mobile surgical unit on its first trip to Accra, Ghana. He discusses the different surgeries that were performed on the first day in this mobile unit and how the mobile hospital will travel throughout Africa offering minimally invasive surgery to those who cannot afford thoracic surgery.   He also discusses a cross-sectional study on structural heart training experiences, long-term durability of bioprosthetic aortic valve replacement, mechanical versus biological mitral valve replacement, and a paradigm change in surgical management of the apical hypertrophic cardiomyopathy.  In addition, Joel discusses robotic bilateral internal mammary artery dissection, total arterial revascularization for multivessel coronary artery disease, and another installment in Dr. Tristan Yan's aortic repair series focused on mini-access branch-first total arch replacement and the frozen elephant trunk procedure. Before saying goodbye, Joel discusses upcoming events in CT surgery.  JANS Items Mentioned Cross-Sectional Study on Structural Heart Training Experiences in Cardiothoracic Residency Programs Long Term Durability of Bioprosthetic Aortic Valve Replacement in Young Patients With Bicuspid Aortic Stenosis   Mechanical Versus Biological Mitral Valve Replacement: Insights From Propensity Score Matching on Survival and Reoperation Rates  Commentary: A Paradigm Change in Surgical Management of the Apical Hypertrophic Cardiomyopathy to Avoid Heart Transplantation  CTSNet Content Mentioned Robotic Bilateral Internal Mammary Artery Dissection   Total Arterial Revascularization for Multi-Vessel Coronary Artery Disease  Deep Dive Into Aortic Surgery: Mini-Access Branch-First Total Arch Replacement and Frozen Elephant Trunk Procedure  Other Items Mentioned CTSNet Events Calendar Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

UF Health MedEd Cast
Hiatal Hernias and GERD – Options for Surgical Management

UF Health MedEd Cast

Play Episode Listen Later Aug 7, 2024


PRS Journal Club
“Management of Textured Breast Implants” with Patricia McGuire, MD - July 2024 Journal Club

PRS Journal Club

Play Episode Listen Later Jul 10, 2024 18:14


In this episode of the Award-winning PRS Journal Club Podcast, 2024 Resident Ambassadors to the PRS Editorial Board – Rami Kantar, Yoshi Toyoda, and Amanda Sergesketter- and special Patricia McGuire, MD, discuss the following articles from the July 2024 issue: “Surgical Management of Textured Breast Implants: Assessing Risk and Analyzing Patient-Reported Outcomes” by Plotsker, Stern, Graziano, et al. Read the article for FREE: https://bit.ly/TextBreastImplantMgmt Special guest, Dr. Patricia McGuire, completed her undergraduate and medical school at the University of Missouri-Kansas City followed by general and plastic surgery training at Washington University, St. Louis and is currently in private practice in St. Louis. Her clinical interests focus on cosmetic breast surgery and body contouring, and she is the current President-Elect of ASERF and well-known for her ongoing research on breast implant illness. READ the articles discussed in this podcast as well as free related content: https://bit.ly/JCJuly24Collection

AUAUniversity
The Surgical Management of BPH and Updates from the AUA Clinical Guidelines

AUAUniversity

Play Episode Listen Later Jul 10, 2024 32:57


The Surgical Management of BPH and Updates from the AUA Clinical Guidelines Podcast (2024) CME Available: https://auau.auanet.org/node/41595 ACKNOWLEDGEMENT: This educational series is supported by an independent educational grant from Olympus Corporation of the Americas. At the conclusion of this activity, participants will be able to:   1. Describe the role of the AUA Clinical Guideline on the Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia. 2. Discuss the evidence base for current technologies, including pivotal studies, and be able to define the role and clinical expectation for each of them. 3. Interpret the current clinical results and compare the patient experiences of these treatments in relation to more established and even abandoned treatments for patient groups with similar characteristics. 4. Differentiate between each of the new technologies for treating BPH/LUTS based on both their mode-of-action and the quality of their supporting evidence.

Scope It Out with Dr. Tim Smith
Episode 89: Surgical management of headache and facial pain/pressure in chronic rhinosinusitis: A systematic review and meta-analysis

Scope It Out with Dr. Tim Smith

Play Episode Listen Later Jun 20, 2024 17:24


In this episode, host Dr. Doug Reh speaks with Dr. Rod Schlosser. They discuss the recently published article: Surgical management of headache and facial pain/pressure in chronic rhinosinusitis: A systematic review and meta-analysis. Read the article in the International Forum of Allergy and Rhinology. Listen and subscribe for free to Scope It Out on Apple Podcasts, Google […]

PodChatLive - Live Podiatry Discussion
PodChatLive 131: Determinants of diabetic foot complications & a new review on non-surgical management of big toe arthritis

PodChatLive - Live Podiatry Discussion

Play Episode Listen Later Jun 18, 2024 25:50


PodChatLive 131: Determinants of diabetic foot complications & a new review on non-surgical management of big toe arthritis Contact us: getinvolved@podchatlive.com Links from this week: Italian Olympian breaks high-jump record before faking injury, jokingly pulling springs from shoe What are the most effective treatments for arthritis of the big toe, excluding surgery? The Risk of the Aggravation of Diabetic Foot According to Air Quality Factors in the Republic of Korea Correlation between time in range and diabetic foot in patients with type 2 diabetes mellitus Want stronger, toned calves? Introducing the Muscle Runner

VetFolio - Veterinary Practice Management and Continuing Education Podcasts
Considerations For Medical and Surgical Management of Brachycephalic Obstructive Airway Syndrome

VetFolio - Veterinary Practice Management and Continuing Education Podcasts

Play Episode Listen Later Jun 13, 2024 57:00


Brachycephalic obstructive airway syndrome (BOAS) is a chronic, lifelong and debilitating disease that adversely affects the quality of life of many popular dog breeds, such as French and English bulldogs, pugs and Boston terriers. Tune in to this VetFolio Voice podcast episode to learn about the anatomy of brachycephalic dogs and how it contributes to airway obstruction. Dr. Cassi and Dr. Fox-Alvarez delve into the indications for surgery and what types of surgical procedures are performed to help correct airway obstruction. They discuss comorbidities associated with BOAS as well as expectations for recovery from surgery and the long-term prognosis for these patients.

Brawn Body Health and Fitness Podcast
Dr. Gabriel Petruccelli: Proximal Biceps Injury Examination, Surgical Management & Rehab Considerations

Brawn Body Health and Fitness Podcast

Play Episode Listen Later Jun 5, 2024 61:32


In this episode of the Brawn Body Health and Fitness Podcast, Dan is joined by Dr. Gabriel Petruccelli to discuss biceps injury examination, assessment, imaging, surgical and rehab considerations. Gabriel L. Petruccelli is an accomplished board-certified orthopaedic surgeon specializing in arthroscopy, sports medicine, shoulder replacements and general orthopaedics. Dr. Petruccelli joined Greater Washington Orthopaedic Group, PA in 2012, with three locations: Rockville, Silver Spring and  GermanTown, Maryland. Dr. Petruccelli is a Maryland native, who graduated from The Heights School in Potomac, where he played basketball and soccer. Dr. Petruccelli graduated from the George Washington University with a Bachelor of Science degree in Exercise Science before receiving a certificate in Physiology at the Virginia Commonwealth University. He completed his medical degree from Ross University School of Medicine in Barbados in 2006 before relocating to New York City to complete his Internship and Orthopaedic residency at New York Medical College-St. Vincent's Catholic Medical Center/ Kingsbrook Jewish Medical Center in 2011. In 2012, Dr. Petruccelli relocated to the west coast to complete his fellowship with the San Diego Arthroscopy and Sports Medicine Fellowship. There he honed and specialized his skills within the field of sports medicine and open shoulder surgery.  Also, during his time there, he worked closely with Major League Baseball's San Diego Padres. He also assisted the team physician for the San Diego State Aztecs. Given the opportunity to research, he published surgical technique videos for national orthopaedic society meetings that year. Dr. Petruccelli has received the Top Doctors Washingtonian Magazine Award in 2017, 2018 & 2019. Since 2016, he has been the Section Chief of the Department of Orthopaedics at Adventist Healthcare Shady Grove Medical Center. Dr. Petruccelli supports the athletic programs as the team physician at Georgetown Preparatory School and supporting his high school alma mater, The Heights School. He also gives valuable educational talks throughout the community. Dr. Petruccelli's main focus is to help each individual get back to their normal daily life and activities as soon as possible with top quality and very personalized orthopaedic care. He takes great pride in listening to his patients and understanding their needs. He works closely with his carefully selected physical therapists to ensure a safe and quick rehabilitation protocol and recovery. Outside of the medical office, Dr. Petruccelli values spending time with his wife and children. He also enjoys, exercise, music, travel and cutting hair. For more on Dr. Petruccelli, be sure to check out @dr.petruccelli on Instagram or click here: https://www.gwog.com/provider/gabriel-l-petruccelli-md-faaos *SEASON 5 of the Brawn Body Podcast is brought to you by Isophit. For more on Isophit, please check out isophit.com and @isophit - BE SURE to use coupon code brawnbody10 at checkout to save 10% on your Isophit order! Episode Sponsors: MoboBoard: BRAWNBODY10 saves 10% at checkout! AliRx: DBraunRx = 20% off at checkout! https://alirx.health/ 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! GOT ROM: https://www.gotrom.com/a/3083/5X9xTi8k Red Light Therapy through Hooga Health: hoogahealth.com coupon code "brawn" = 12% off Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKe Make sure you SHARE this episode with a friend who could benefit from the information we shared! Check out everything Dan is up to, including blog posts, fitness programs, and more by clicking here: https://linktr.ee/brawnbodytraining Liked this episode? Leave a 5-star review on your favorite podcast platform! --- Send in a voice message: https://podcasters.spotify.com/pod/show/daniel-braun/message Support this podcast: https://podcasters.spotify.com/pod/show/daniel-braun/support

MDS Podcast
Special Series: Exploring medical and surgical management for chorea

MDS Podcast

Play Episode Listen Later Jun 3, 2024


Profs. Elena Moro and Ruth Walker discuss the management of chorea, including when this is appropriate. They focus on Huntington's disease and the role of deep brain stimulation and other surgical interventions, in addition to medical management.

The Fellow on Call
Episode 103: Colorectal Cancer Series, Pt. 5 - Surgical Management of Colorectal Cancer

The Fellow on Call

Play Episode Listen Later May 22, 2024


This week, we are joined by Dr. Christina Bailey, Associate Professor of Surgery and Program Director of the General Surgery Residency at Vanderbilt University Medical Center in Nashville, Tennessee, for a discussion about the role of surgery in the management of patients with colorectal cancer. This is another amazing multidisciplinary colorectal surgery episode you do not want to miss!Content: - Why are MRIs important as part of workup for patients with rectal cancer? - What is an "LAR" vs. "APR" and how do you decide which to use? - What are long term complications associated with rectal cancer surgery? - How much colon should be removed in a patient with colon cancer undergoing surgery? - How to counsel patients about colon resection?- How long after surgery should we wait for adjuvant chemotherapy in colon cancer? - Is there a role for neoadjuvant therapy in metastatic colon cancer? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

SAGE Orthopaedics
AJSM May 2024 5-in-5 Podcast

SAGE Orthopaedics

Play Episode Listen Later May 7, 2024 5:28


Four articles from the May 2024 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are, “Minimum 5-Year Clinical and Return-to-Sport Outcomes After Primary Arthroscopic Scapulothoracic Bursectomy and Partial Scapulectomy for Snapping Scapula Syndrome,” “Rates of Subjective Failure After Both Isolated and Combined Posterior Cruciate Ligament Reconstruction: A Study From the Norwegian Knee Ligament Registry 2004-2021,” “The Everted Acetabular Labrum: Outcomes of Surgical Management,” and “Outcomes of Flexibility Sport Athletes With Borderline Hip Dysplasia After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Propensity-Matched Analysis at Minimum 2-Year Follow-up.” To read the articles, click here.

SurgOnc Today
Nuts and Bolts of Surgical Management of Perihilar Cholangiocarcinoma – Part 2

SurgOnc Today

Play Episode Listen Later Apr 25, 2024 33:07


In this episode of SurgOnc Today, live from SSO 2024, Dr. Alex Parikh from the University of Texas – San Antonio and Chair of the SSO HPB disease site working group, and Dr. Julie Hallet from the University of Toronto, and Vice-Chair of the SSO HPB disease site working group, are joined by Dr. Ana Gleisner from the University of Colorado and Dr. Skye Mayo from the Oregon Health and Sciences University. They will be discussing two important aspects of the surgical management of perihilar cholangiocarcinoma: determining resectability as it relates to vascular involvement, and the role of neoadjuvant therapy.

SurgOnc Today
Nuts and Bolts of Surgical Management of Perihilar Cholangiocarcinoma – Part 1

SurgOnc Today

Play Episode Listen Later Apr 18, 2024 21:55


In this episode of SurgOnc Today ®, Alex Parikh, MD, MPH, FACS, FSSO, from the University of Texas – San Antonio and Julie Hallet, MD, M.Sc., FRCSC, FSSO from the University of Toronto are joined by Monica M. Dua, MD, from Stanford University and Ching-Wei Tzeng, , MD, FACS, FSSO, from the MD Anderson Cancer Center. They will be discussing two important aspects of the surgical management of perihilar cholangiocarcinoma: strategies for pre-operative optimization and biliary drainage, and management of the future liver remnant. This is part one of a two-part series.

TSRA Podcast
Journal Club: Surgical Management of Early Stage NSCLC

TSRA Podcast

Play Episode Listen Later Mar 31, 2024 58:57


Moderators: Jenna Aziz MD Olubode Olufajo MD Panelists: Chigozirim Ekeke MD Stephen Yang MD Peter Kneuertz MD Fatima Wilder MD

The Evidence Based Chiropractor- Chiropractic Marketing and Research
432- The Best Non-Surgical Management of Radiculopathy

The Evidence Based Chiropractor- Chiropractic Marketing and Research

Play Episode Listen Later Mar 25, 2024 17:36


New research highlights the best modalities for the non-surgical management of radiculopathy. Tune in to todays episode and discover new details about how disc herniations happen, and how your patients can best find relief. Episode Notes: Non-Surgical Approaches to the Management of Lumbar Disc Herniation Associated with RadiculopathyInterested in ShockWave technology? I built a practice using StemWave and can't recommend it enough. Learn more at- https://gostemwave.com/theevidencebasedchiropractor Patient Pilot by The Smart Chiropractor is the fastest, easiest to generate weekly patient reactivations on autopilot…without spending any money on advertising. Click here to schedule a call with our team.Our members use research to GROW their practice. Are you interested in increasing your referrals? Discover the best chiropractic marketing you aren't currently using right here!

Journal of Hand Surgery
JHS Podcast Episode 95

Journal of Hand Surgery

Play Episode Listen Later Feb 1, 2024 17:36


Dr. Graham interviews Dr. Eric Wagner about his paper “A Changing Landscape in the Surgical Management of Wrist Arthritis: An Analysis of National Trends From 2009 to 2019”, which is the lead article on the February 2024 issue of The Journal of Hand Surgery.

JPO Podcast
Lit. Update with Dan Perry

JPO Podcast

Play Episode Listen Later Jan 25, 2024 53:55


Dr. Dan Perry, a children's orthopaedist and NIHR research professor from Liverpool, joins the show to discuss his recent research, including numerous ongoing multicenter trials spanning the UK and beyond: SCIENCE, CRAAFT, FORCE, BASIS, ODD SOCKS, to name a few. The lightning round touches on compartment syndrome in ECMO, why pedipods get low online reviews, and more. This episode is sponsored by OrthoFix. Your hosts are Carter Clement from Children's Hospital of New Orleans and Craig Louer from Vanderbilt. Music by A. A. Aalto.   References:   Joseph et al. Radiological assessment of hip disease in children with cerebral palsy: development of a core measurement set. Bone & Joint Open. Nov 2023. PMID 37909150.   Bridges et al. Acute Compartment Syndrome in Pediatric Patients on Extracorporeal Membrane Oxygenation Support. JPO. Dec 2023 Epub. PMID 38084004.   Torres-Izquierdo et al. Is There a Role for Isolated Closed Reduction in the Emergency Department Without Fixation for Displaced Proximal Humerus Fractures in Adolescents? JPO. Dec 2023 Epub. PMID 38151963.   Martino et al. The Optimal Age for Surgical Management of DDH Differs by Treatment Method. JPO. Nov 2023 Epub. PMID 37970702.   Hitchman et al. An Analysis of Negative One-star Patient Reviews and Complaints for Pediatric Orthopaedic Surgeons throughout the United States: A Retrospective Study. JPO. Nov 2023 Epub. PMID 37970712.

The Retina Channel Podcast
E74- Full-Thickness Macular Holes in Macular Telangiectasia Type 2- Dr. Jong Park

The Retina Channel Podcast

Play Episode Listen Later Dec 30, 2023 32:21


Dr. Jong Park discusses surgical mananement of full-thickness macular holes associated with macular telangiectasia.  Referenced article: Park JG, Adrean SD, Begaj T, Capone A Jr, Charles S, Chen SN, Chou HD, Cohen MN, Corona ST, Faia LJ, Garg SJ, Garretson BR, Gregori NZ, Haller JA, Houghton OM, Hsu J, Jo J, Kaiser RS, Lai CC, Mahgoub MM, Mansoor M, Matoba R, Morizane Y, Nehemy MB, Raphaelian PV, Regillo CD, Ruby AJ, Runner MM, Sneed SR, Sohn EH, Spirn MJ, Vander JF, Wakabayashi T, Wolfe JD, Wykoff CC, Yonekawa Y, Yoon YH, Mahmoud TH. Surgical Management of Full-Thickness Macular Holes in Macular Telangiectasia Type 2: A Global Multicenter Study. Ophthalmology. 2024 Jan;131(1):66-77. doi: 10.1016/j.ophtha.2023.08.025. Epub 2023 Sep 3. PMID: 37661066.

JAAOS Unplugged
American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary of Surgical Management of Osteoarthritis of the Knee

JAAOS Unplugged

Play Episode Listen Later Dec 15, 2023 51:17


Host Liana Tedesco, MD Guest interviewee Ajay Kumar Srivastava, MD, FAAOS, discussing his article, “American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary of Surgical Management of Osteoarthritis of the Knee”, on behalf of Surgical Management of Osteoarthritis of the Knee Work Group, Staff of the American Academy of Orthopaedic Surgeons from the December 15, 2023 issue (https://journals.lww.com/jaaos/toc/2023/12150) Articles summarized from the December 1, 2023 issue (https://journals.lww.com/jaaos/toc/2023/12010) Research article “Risk Factors for Postoperative Urinary Retention After Lumbar Fusion Surgery: Anesthetics and Surgical Approach” Articles summarized from the December 15, 2023 issue (https://journals.lww.com/Jaaos/toc/2023/12150) Research article “Impact of Surgeon Case Volume on Outcomes After Reverse Total Shoulder Arthroplasty” Research article “Does Fibular Displacement Predict Tibial Malrotation in Simulated Tibia-Fibula Fractures” Follow this link to download these and other articles from the December 1, 2023 issue of JAAOS (https://journals.lww.com/jaaos/toc/2023/12010) and the December 15, 2023 issue of JAAOS (https://journals.lww.com/Jaaos/toc/2023/12150). The JAAOS Unplugged podcast series is brought to you by the Journal of the American Academy of Orthopaedic Surgeons and the AAOS Resident Assembly.

Neurocritical Care Society Podcast
MASTER CLASS: Surgical Management of ICH

Neurocritical Care Society Podcast

Play Episode Listen Later Nov 15, 2023 29:04


Today we welcome Dr Christopher Kellner, Assistant Professor of Neurosurgery at Mount Sinai Icahn School of Medicine and pioneer in the surgical management of ICH. We discuss the evolution of surgical ICH management, including minimally invasive surgery, and hear Dr Kellner's thoughts on the future of the field. Hosted by Dr Stephan Mayer and Dr Jon Rosenberg. 

Mayo Clinic Talks
Osteoporosis, Fragility & Bone Health Edition | “Hip Hip Hooray” The Surgical Management of Hip & Knee Arthritis

Mayo Clinic Talks

Play Episode Listen Later Nov 9, 2023 22:15


Host: Darryl S. Chutka, M.D. [@chutkaMD] Guest: Matthew P. Abdel, M.D. Arthritis of the hip or knee is a common cause of pain and disability. It can cause significant limitations in mobility and a reduced quality of life. Hip and knee replacements have the potential to change all that. They're safe, have a high success rate and can allow the patient to get back to a healthy, active lifestyle. Who's a candidate for a hip or knee replacement? What's the optimal timing of the procedure? What's important in obtaining an optimal outcome from surgery and what are the complications of a hip or knee replacement? Our guest for today's podcast is Matthew P. Abdel, M.D., an orthopedic surgeon at the Mayo Clinic. He'll be answering these questions and more as we discuss the surgical management of hip and knee arthritis.  https://www.usdairy.com/about-us/national-dairy-council Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.   

The Pelvic Floor Project
80. Pelvic organ prolapse: pessaries, physiotherapy and surgical management with urogynecologist, Dr. Alexandra Dubinskaya

The Pelvic Floor Project

Play Episode Listen Later Oct 16, 2023 71:18


In this episode, I sit down with Beverly Hills based urogynecologist, Dr. Alexandra Dubinskaya  to discuss:  What is prolapse?Typical sequence of events that happens when patients experience symptoms of prolapse and how they may end up in the office of a surgeon. Conservative management optionsHow the decision is made to proceed with surgeryTypes of repair and how this is individual to the patientDifferences between countries, centres and surgeonsDiscussion around meshRecovery after prolapse repairPhysiotherapy considerations before and after surgeryAlexandra Dubinskaya is a board-certified gynecologist, specializing in urogynecology with an emphasis on female pelvic medicine and reconstructive surgery, female sexual health, and menopause. Her mission is to help women suffering from pelvic floor disorders, sexual and menopausal concerns.  She is currently practicing as a clinician, researcher, and passionate advocate for her patients.  Her credentials further include being a Fellow of the American College of Obstetricians and Gynecologists (FACOG) and a Certified Menopause Practitioner through the North American Menopause Society (NCMP).Her involvement in the field extends past the office as she is also an active member, speaker, and presenter at national and international conferences. Dr. Dubinskaya serves as a chair of the communication committee for the International Society of Sexual Medicine and is overseeing the promotion of sexual literacy through the society's website, newsletters, and social media.  Her goal is to inspire and encourage women to embrace their bodies, and sexuality, and regain control and confidence in their lives.  She wants women to understand that problems are solvable and there are options available to make the changes for a better life. Her practice specializes in the treatment of urinary incontinence “urinary leakage”, pelvic organ prolapse “vaginal bulge”, urinary tract infections “UTIs”, interstitial cystitis, pelvic floor dysfunction, vaginismus, vulvodynia, vulvar skin conditions, menopausal symptoms, and female sexual dysfunction including painful sex, low libido, and orgasmic disorders.Dr. Dubinskaya believes in advancing medical care for women through research. She has been published in multiple peer-reviewed journals and is a reviewer for several journals. She has contributed to several textbooks including Ostergard's Urogynecology and Steele's Colorectal Textbooks.Coming from a diverse background, Dr. Alexandra Dubinskaya is fluent in both English and Russian languages.  For more information or to schedule a visit and/or consultation with Dr. Dubinskaya, visit  her website:  www.drurogyn.com Links Mentionedhttps://www.voicesforpfd.org/assets/2/6/POP.pdf https://pop-q.netlify.app/ Cheerful AcademyLearn more about the next Pelvic Health Fundamentals cohort here (Starts Jan 2024):www.thecheerfulacademy.comClick on this link for $150 off applied at checkout:Discount linkOr enter code: 150offDiscount code in effect until Dec 15th 2023Check out SRC health for their high quality line of compression shorts and leggings: https://srchealth.com/Use code: THEPELVICFLOORPROJECT for 10% off your orderSupport the show

The NASS Podcast
Medical vs Surgical Management of Synovial Cyst

The NASS Podcast

Play Episode Listen Later Oct 3, 2023 17:28


Ask the Experts: Medical vs Surgical Management of Synovial Cyst Bryan Lee, MD Scott Kreiner, MD Jacob Rohrs, MD Edward Dohring, MD

JPO Podcast
Lit. Update with Ishaan Swarup

JPO Podcast

Play Episode Listen Later Sep 26, 2023 59:05


Dr Ishaan Swarup from UCSF joins the show this month to discuss distal tibial physeal fractures. Highlights from the lightning round include the interplay of race, socioeconomic status and self-image in scoliosis, measuring rotation with advanced imaging and clinical examination, and selective dorsal rhizotomy. Your hosts are Julia Sanders from Children's Hospital Colorado, Carter Clement from Children's Hospital of New Orleans, Craig Louer from Vanderbilt, and Josh Holt from University of Iowa. Music by A. A. Alto.   Citations for papers discussed can be found below:   Swarup I, Pearce R, Sanborn R, Shore BJ; Children's Orthopaedic Trauma and Infection Consortium for Evidence Based Studies (CORTICES). Variations in the Management of Closed Salter-Harris II Distal Tibia Fractures. J Pediatr Orthop. 2023;43(9):e742-e746.   Onay T, Çelen ZE, Bayhan M, Kandemir İ, Kiliç NC, Kayaalp ME. A More Conservative Approach in the Surgical Management of Pediatric Physeal Ankle Fractures Should be Preferred: Mid to Long-term Functional Outcomes of Three Different Surgical Techniques for Salter-Harris Type II and Triplane Distal Tibial Fractures. J Pediatr Orthop. 2023;43(9):e734-e741.   Sheth M, Kitziger R, Bindner C, Rosenfeld SB. Computed Tomography Analysis of Distal Tibia Physeal Fracture Patterns: A Classification and Technique for Optimizing Screw Trajectory [published online ahead of print, 2023 Aug 29]. J Pediatr Orthop. 2023;10.1097/BPO.0000000000002498.   Erkkila, I. P., Reynolds, C. A., Weissman, J. P., Levine, O. P., Aronson, H., Knoll, J. M., & Larson, J. E. (2023). Factors Associated with Presentation of Severe Adolescent Idiopathic Scoliosis: Original Research. Journal of the Pediatric Orthopaedic Society of North America, 5(3).   Cirrincione PM, Thakur A, Zucker CP, et al. Exploring Correlations Between Pain and Deformity in Idiopathic Scoliosis With Validated Self-reported Pain Scores, Radiographic Measurements, and Trunk Surface Topographic Measurements [published online ahead of print, 2023 Aug 21]. J Pediatr Orthop. 2023;10.1097/BPO.0000000000002493.   Edmonds, E. W., Parvaresh, K. C., Price, M. J., Farnsworth, C. L., Bomar, J. D., Hughes, J. L., & Upasani, V. V. (2023). The Reliability of Measurements for Tibial Torsion: A Comparison of CT, MRI, Biplanar Radiography, and 3D Reconstructions With and Without Standardized Measurement Training: Original Research. Journal of the Pediatric Orthopaedic Society of North America, 5(3).   Miller SD, Juricic M, Bone JN, Steinbok P, Mulpuri K. The Effect of Selective Dorsal Rhizotomy on Hip Displacement in Children With Cerebral Palsy: A Long-term Follow-up Study. J Pediatr Orthop. 2023;43(9):e701-e706.

UAB MedCast
Innovations in the Surgical Management of Oropharyngeal Cancer

UAB MedCast

Play Episode Listen Later Sep 5, 2023


Prognoses for oropharyngeal cancers have improved dramatically over the past 20 years, reflecting physicians' better understanding of the role of HPV in driving most of these cancers. Andrew Fuson, M.D., and Hari Jeyarajan, M.D, explain their shift to using surgery as the standard-of-care treatment for oropharyngeal cancers caused by HPV, which has resulted in survival rates of 85-90%. They discuss how robotic surgery and advanced screening methods have improved patient quality of life. Learn about an international clinical trial being conducted at UAB that explores a process for making cancer cells glow so that surgeons can more precisely define tumor removal boundaries.

Peak RFP Podcast
Surgical Management of the Unstable Patella with Dr. Rob Willson

Peak RFP Podcast

Play Episode Listen Later Aug 21, 2023 31:50


Luke and Caleb welcome Dr. Rob Willson back to the podcast to discuss the surgical management of the unstable patella (kneecap).  A common injury in the young athlete is the dislocation of the patella during sport.  However, it's not just about a dislocation as the unstable patella without dislocation can produce real cartilage damage to the underside of this important bone of the knee.  Get the information you need as a parent or a young athlete!www.Peakrehabfitperform.com

JPO Podcast
Lit. Update with Ben Shore

JPO Podcast

Play Episode Listen Later Aug 1, 2023 80:06


Dr. Ben Shore from Boston Children's joins the show to discuss his recent research on trauma, infection, discharge planning, neuromuscular hips, and more. The lightning round covers Vitamin D deficiency, scoliosis bracing, guided growth, and shared decision making. This episode is sponsored by Depuy Synthes Spine. Your hosts are Craig Louer from Vanderbilt, Carter Clement from Children's Hospital of New Orleans, Julia Sanders from Children's Hospital Colorado, and Josh Holt from University of Iowa. Music by A. A. Aalto.   References:   Watkins et al. The Reliability of Intraoperative Hip Arthrography in Cerebral Palsy Hip Reconstruction. JPOSNA 2023. https://doi.org/10.55275/JPOSNA-2023-595   Flaugh et al. Barriers to Discharge After Hip Reconstruction Surgery in Non-ambulatory Children With Neurological Complex Chronic Conditions. JPO Sept 2022.   Upasani et al with CORTICES Study Group. Practice Variation in the Surgical Management of Children With Acute Hematogenous Osteomyelitis. JPO 2022.   Montgomery et al. Minimizing Surgeon Radiation Exposure During Operative Treatment of Pediatric Supracondylar Humerus Fractures. JPO 2023.   Lightning Round   Karkenny et al. Pediatric Fractures: Does Vitamin D Play a Role? JPO 2023.   Catanzano et al. Cast or Nail? Using a Preference-Based Tool for Shared Decision-Making in Pediatric Femoral Shaft Fracture Treatment. JPO 2023.   Zapata et al. Early brace treatment for idiopathic scoliosis may change the paradigm to improve curves. Spine Deformity 2023.   McGinley et al. Faster Rate of Correction with Distal Femoral Transphyseal Screws Versus Plates in Hemiepiphysiodesis for Coronal-Plane Knee Deformity: Age- and Sex-Matched Cohorts of Skeletally Immature Patients. JBJS 2023.

Behind The Knife: The Surgery Podcast
Journal Review in Endocrine Surgery: AAES Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism - Part 2 of 2

Behind The Knife: The Surgery Podcast

Play Episode Listen Later Jul 27, 2023 42:15


In this two-part series, we come to you LIVE! from the 2023 Annual meeting of the American Association of Endocrine Surgeons in Birmingham, Alabama. If you think evaluating and managing patients with primary hyperparathyroidism is difficult, patients with secondary and tertiary hyperparathyroidism can be even more difficult to evaluate and manage. Join Drs. Barb Miller, Sophie Dream, Jessica Liu McMullin, and Herb Chen as they break down the controversies and complexities associated with evaluation and management of these patients and discuss the recently published AAES guidelines on the definitive surgical management of patients with secondary and tertiary renal hyperparathyroidism. Part 1 focuses on the impetus for creation of these guidelines, the differences in evaluation and indication for surgery when seeing patients with renally mediated hyperparathyroidism, and preoperative planning. Part 2 focuses on intraoperative and postoperative management, parathyroid autotransplantation, and renal transplant recipients. Hosts:  - Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, The Ohio State University, @OSUEndosurgBSM - Sophie Dream, MD, Assistant Professor of Surgery, Medical College of Wisconsin, @SDreamMD, - Jessica Liu McMullin, MD, Endocrine Surgery Fellow, University of Alabama – Birmingham, @jess_mcmullin - Herbert Chen, MD, Professor and Chair of Surgery, University of Alabama – Birmingham, @herbchen Learning objectives: - Understand the epidemiology and pathogenesis of kidney-related parathyroid disease and how these entities differ from primary hyperparathyroidism - Describe the diagnosis of kidney-related hyperparathyroidism and its different presentations - Define the indications for surgical intervention - Recognize the different approaches and extents of surgery for treating the different types of renally mediated hyperparathyroidism including thymectomy and parathyroid autotransplantation - Detail methods for safe and effective perioperative management References: - Dream S, Kuo LE, Kuo JH, Sprague SM, Nwariaku FE, Wolf M, Olson JA Jr, Moe SM, Lindeman B, Chen H. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism. Ann Surg. 2022 Sep 1;276(3):e141-e176. doi: 10.1097/SLA.0000000000005522. Epub 2022 Jul 18. PMID: 35848728. - Wilhelm SM, Wang TS, Ruan DT, et al. The American Association of Endocrine Surgeons Guidelines for definitive management of primary hyperparathyroidism. JAMA Surg. 2016;151:959–968. - Ketteler M, Block GA, Evenepoel P, et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what's changed and why it matters. Kidney Int. 2017;92:26–36. - Andress DL, Coyne DW, Kalantar-Zadeh K, et al. Management of secondary hyperparathyroidism in stages 3 and 4 chronic kidney disease. Endocr Pract. 2008;14:18–27. - Cozzolino M, Brancaccio D, Gallieni M, et al. Pathogenesis of parathyroid hyperplasia in renal failure. J Nephrol. 2005;18:5–8. - Lau WL, Cobi Y, Kalantar-Zadeh K. Parathyroidectomy in the management of secondary hyperparathyroidism. Clin J Am Soc Nephrol. 2018;13:952–961. - Parfrey PS, Chertow GM, Block GA, et al. The clinical course of treated hyperparathyroidism among patients receiving hemodialysis and the effect of cinacalcet: the EVOLVE trial. J Clin Endocrinol Metab. 2013;98:4834–4844. - Costa-Hong V, Jorgetti V, Gowdak LH, et al. Parathyroidectomy reduces cardiovascular events and mortality in renal hyperparathyroidism. Surgery. 2007;142:699–703. - McManus C, Oh A, Lee JA, et al. Timing of parathyroidectomy for tertiary hyperparathyroidism with end-stage renal disease: a cost-effectiveness analysis. Surgery. 2021;169:94–101. - Finnerty BM, Chan TW, Jones G, et al. Parathyroidectomy versus cinacalcet in the management of tertiary hyperparathyroidism: surgery improves renal transplant allograft survival. Surgery. 2019;165:129–134. Suture Kit: Purchase on suturekit.com Purchase on Amazon How-to Video Series Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out other endocrine episodes here: https://behindtheknife.org/podcast-category/endocrine/

Behind The Knife: The Surgery Podcast
Journal Review in Endocrine Surgery: AAES Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism - Part 1 of 2

Behind The Knife: The Surgery Podcast

Play Episode Listen Later Jul 24, 2023 33:01


In this two-part series, we come to you LIVE! from the 2023 Annual meeting of the American Association of Endocrine Surgeons in Birmingham, Alabama. If you think evaluating and managing patients with primary hyperparathyroidism is difficult, patients with secondary and tertiary hyperparathyroidism can be even more difficult to evaluate and manage. Join Drs. Barb Miller, Sophie Dream, Jessica Liu McMullin, and Herb Chen as they break down the controversies and complexities associated with evaluation and management of these patients and discuss the recently published AAES guidelines on the definitive surgical management of patients with secondary and tertiary renal hyperparathyroidism. Part 1 focuses on the impetus for creation of these guidelines, the differences in evaluation and indication for surgery when seeing patients with renally mediated hyperparathyroidism, and preoperative planning. Part 2 focuses on intraoperative and postoperative management, parathyroid autotransplantation, and renal transplant recipients. Hosts:  - Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, The Ohio State University, @OSUEndosurgBSM - Sophie Dream, MD, Assistant Professor of Surgery, Medical College of Wisconsin, @SDreamMD, - Jessica Liu McMullin, MD, Endocrine Surgery Fellow, University of Alabama – Birmingham, @jess_mcmullin - Herbert Chen, MD, Professor and Chair of Surgery, University of Alabama – Birmingham, @herbchen Learning objectives:  - Understand the epidemiology and pathogenesis of kidney-related parathyroid disease and how these entities differ from primary hyperparathyroidism - Describe the diagnosis of kidney-related hyperparathyroidism and its different presentations - Define the indications for surgical intervention  - Recognize the different approaches and extents of surgery for treating the different types of renally mediated hyperparathyroidism including thymectomy and parathyroid autotransplantation - Detail methods for safe and effective perioperative management References: - Dream S, Kuo LE, Kuo JH, Sprague SM, Nwariaku FE, Wolf M, Olson JA Jr, Moe SM, Lindeman B, Chen H. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism. Ann Surg. 2022 Sep 1;276(3):e141-e176. doi: 10.1097/SLA.0000000000005522. Epub 2022 Jul 18. PMID: 35848728. - Wilhelm SM, Wang TS, Ruan DT, et al. The American Association of Endocrine Surgeons Guidelines for definitive management of primary hyperparathyroidism. JAMA Surg. 2016;151:959–968. - Ketteler M, Block GA, Evenepoel P, et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what's changed and why it matters. Kidney Int. 2017;92:26–36. - Andress DL, Coyne DW, Kalantar-Zadeh K, et al. Management of secondary hyperparathyroidism in stages 3 and 4 chronic kidney disease. Endocr Pract. 2008;14:18–27. - Cozzolino M, Brancaccio D, Gallieni M, et al. Pathogenesis of parathyroid hyperplasia in renal failure. J Nephrol. 2005;18:5–8. - Lau WL, Cobi Y, Kalantar-Zadeh K. Parathyroidectomy in the management of secondary hyperparathyroidism. Clin J Am Soc Nephrol. 2018;13:952–961. - Parfrey PS, Chertow GM, Block GA, et al. The clinical course of treated hyperparathyroidism among patients receiving hemodialysis and the effect of cinacalcet: the EVOLVE trial. J Clin Endocrinol Metab. 2013;98:4834–4844. - Costa-Hong V, Jorgetti V, Gowdak LH, et al. Parathyroidectomy reduces cardiovascular events and mortality in renal hyperparathyroidism. Surgery. 2007;142:699–703. - McManus C, Oh A, Lee JA, et al. Timing of parathyroidectomy for tertiary hyperparathyroidism with end-stage renal disease: a cost-effectiveness analysis. Surgery. 2021;169:94–101. - Finnerty BM, Chan TW, Jones G, et al. Parathyroidectomy versus cinacalcet in the management of tertiary hyperparathyroidism: surgery improves renal transplant allograft survival. Surgery. 2019;165:129–134. Suture Kit: Purchase on suturekit.com Purchase on Amazon How-to Video Series Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out other endocrine episodes here: https://behindtheknife.org/podcast-category/endocrine/

Bowel Sounds: The Pediatric GI Podcast
Jaimie Nathan - Surgical Treatment of Pediatric Chronic Pancreatitis (Special JPGN Episode)

Bowel Sounds: The Pediatric GI Podcast

Play Episode Listen Later Jul 3, 2023 54:10


In this special JPGN episode, hosts Drs. Peter Lu and Jennifer Lee talk to pediatric surgeon Dr. Jaimie Nathan about surgical treatment of chronic pancreatitis in children. Dr. Nathan is the first author of a recent NASPGHAN position paper on the role of surgical management in chronic pancreatitis. Dr. Nathan is the Chief of Pediatric Abdominal Transplant and Hepatopancreatobiliary Surgery at Nationwide Children's Hospital and one of the world's leading surgeons for total pancreatectomy with islet autotransplantation (TPIAT). This episode is eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!References:Nathan JD, Ellery K, Balakrishnan K, Bhatt H, Ganoza A, Husain SZ, Kumar R, Morinville VD, Quiros JA, Schwarzenberg SJ, Sellers ZM, Uc A, Abu-El-Haija M. The Role of Surgical Management in Chronic Pancreatitis in Children: A Position Paper From the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee. J Pediatr Gastroenterol Nutr. 2022 May 1;74(5):706-719. Learning Objectives:Understand the indications for surgical treatment of chronic or acute recurrent pancreatitis in children.Review the distinction between conventional surgical treatments and total pancreatectomy with islet autotransplantation (TPIAT).Discuss the indications and outcomes of TPIAT in children.Produced by: Peter LuSupport the showAs always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes!

The Fellow on Call
Episode 055: Breast Cancer Series, Pt. 4-Surgical management for breast cancer

The Fellow on Call

Play Episode Listen Later May 3, 2023


Surgery plays a pivotal role in the management of breast cancer, particularly in early stages of disease. This week, we are joined by special guest Dr. Carla Fisher, Associate Professor and Medical Director of Breast Surgical Oncology at Indiana University School of MedicineContent:- When to perform breast conservation surgery - When is additional imaging required? - Timing of neoadjuvant/adjuvant therapy in relation to breast surgery - What is a sentinel lymph node biopsy? - A discussion about breast reconstruction surgery- When is prophylactic mastectomy performed? - Role of surgery in inflammatory breast cancer ** Thank you to our guest, Dr. Carla Fisher! **Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

Critical Matters
Pulmonary Embolism Update

Critical Matters

Play Episode Listen Later Mar 9, 2023 71:05


In this episode of the podcast, we will discuss the current management of Acute Pulmonary Embolism. Our guest is Dr. Belinda Rivera-Lebron, a pulmonary critical care physician who practices at the University of Pittsburgh Medical System. She is an Associate Professor of Medicine and is the Director of the UPMC Acute Pulmonary Embolus (PE) Program and the UPMC Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Program. Dr. Rivera-Lebron's areas of interest include pulmonary embolism and pulmonary hypertension. Additional Resources Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium.: https://pubmed.ncbi.nlm.nih.gov/31185730/ AHA Scientific Statement. Surgical Management and Mechanical Circulatory Support in High-Risk Pulmonary Embolisms: https://pubmed.ncbi.nlm.nih.gov/36688837/ PERT Consortium website: https://pertconsortium.org/ Books Mentioned in this Episode: The Trusted Advisor. By David H. Meister, et al: bit.ly/3mq9Oap

Every Day Oral Surgery: Surgeons Talking Shop
Resident Series: Orthognathic Surgery – Treatment Planning and Surgical Management

Every Day Oral Surgery: Surgeons Talking Shop

Play Episode Listen Later Jan 16, 2023 51:43


There are many options when it comes to orthognathic surgery and making the right decisions for your patient can be daunting. Joining us today on Everyday Oral Surgery is the illustrious Dr. Benjamin Hechler. In this episode, you'll hear all about Dr. Hechler's process of discussing options with new patients, and his preferences when it comes to molars, double jaw surgery, class three patients, use of plates, nasal tubes, and much more! We also discuss how growth affects surgery, why you have to take the patient's preferences into consideration, the importance of having open communication with your anesthesia team, and how he handles scenarios such as excessive bleeding. He also talks us through how he supports his patients post-op before explaining why staying hydrated after a surgery is imperative. Finally, Dr. Hechler poses some interesting points of discussion for us to think about! If you want to hear all about planning and surgical management from an absolute pro, and even get a promo code for KLS Martin, tune in now!Key Points From This Episode:The amazing KLS Martin promo code you can get!Introducing today's guest, Dr. Benjamin Hechler. He walks us through his process of starting things off with a new patient and what he asks. Dr. Hechler tells us why he leaves the third molars in and when he removes them if he does. How the growth of younger patients affects surgery and how Dr. Hechler addresses this. When he chooses to do VSP.Dr. Hechler explains how he handles surgery when a patient has a double jaw.The importance of considering preference and long-term risk before surgical decisions. How Dr. Hechler deals with class three patients. When he decides to do custom plates vs. stock plates and how he makes those decisions. Why Dr. Hechler does the maxilla first in surgery. The importance of having a discussion with your anesthesia team and what to say to them.Why Dr. Hechler doesn't mind what type of nasal tube is used during surgery. Hear how he deals with excessive bleeding and bad splits. How Dr. Hechler handles the post-op period and how he helps his patients through it. The importance of taking in liquids post-surgery.Links Mentioned in Today's Episode:Dr. Benjamin Hechler on LinkedIn — https://www.linkedin.com/in/ben-hechler/The Essentials of Orthognathic Surgery — https://www.amazon.com/Essentials-Orthognathic-Surgery-Johan-Reyneke/dp/0867159561Dr. Jeffrey C. Posnick — https://www.drposnick.com/Oral and Maxillofacial Surgery — https://www.amazon.com/Oral-Maxillofacial-Surgery-7-Set/dp/0721696317Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram —https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059KLS Martin promo code EOSExo22 — https://www.klsmartin.com/

Behind The Knife: The Surgery Podcast
Clinical Challenges in Breast Surgery: Surgical Management of Metastatic Breast Cancer

Behind The Knife: The Surgery Podcast

Play Episode Listen Later Dec 5, 2022 37:19


De novo metastatic breast cancer represents 6% of all new breast cancer diagnoses. This figure has not changed at all over the past 20 years; however, systemic therapy options have evolved dramatically during this time and have significantly increased life expectancy for these patients. While surgical management of the primary tumor in the setting of metastatic disease has typically been reserved for palliative indications, surgeons are now being asked to consider resecting the primary tumor to potentially increase overall survival. In this episode, we will use a case study to examine the data that should inform our conversations and decisions when we encounter patients with metastatic breast cancer who are interested in having their primary tumor resected. Links: §  Khan, S.A., S. Schuetz, and O. Hosseini (2022). Primary-Site Local Therapy for Patients with De Novo Metastatic Breast Cancer: An Educational Review. Ann Surg Oncol; 29: 5811-5820. https://link.springer.com/article/10.1245/s10434-022-11900-x §  Khan, S.A. et al (2022). Early Local Therapy for the Primary Site in De Novo Stage IV Breast Cancer: Results of a Randomized Clinical Trial (E2108). J Clin Oncol; 40(9): 978-987. https://ascopubs.org/doi/10.1200/JCO.21.02006?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed §  Badwe, R. et al (2015). Locoregional treatment versus no treatment of the primary tumor in metastatic breast cancer: an open-label randomized controlled trial. Lancet Oncol; 16: 1380-1388. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00135-7/fulltext §  Fitzal, F. et al (2019). Impact of Breast Surgery in Primary Metastasized Breast Cancer: Outcomes of the Prospective Randomized Phase III ABCSG-28 POSYTIVE Trial. Ann Surg; 269(6): 1163-1169. https://journals.lww.com/annalsofsurgery/Abstract/2019/06000/Impact_of_Breast_Surgery_in_Primary_Metastasized.24.aspx §  Soran, A. et al (2018). Randomized Trial Comparing Resection of Primary Tumor with No Surgery in Stage IV Breast Cancer at Presentation: Protocol MF07-01. Ann Surg Oncol; 25: 3141-3149. https://link.springer.com/article/10.1245/s10434-018-6494-6 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our other clinical challenges episodes here: https://behindtheknife.org/podcast-series/clinical-challenges/

Behind The Knife: The Surgery Podcast
Clinical Challenges in Surgical Oncology: Surgical Management for Borderline Resectable/Locally Advanced Pancreatic Cancer

Behind The Knife: The Surgery Podcast

Play Episode Listen Later May 16, 2022 39:51 Very Popular


*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** How do you decide if a pancreatic head mass is resectable? Does vascular involvement matter? What impacts survival? Join the Surgical Oncology team as they dive into operative considerations when operating on borderline resectable and locally advanced pancreatic cancer. Break the nihilism and find out about the options available for patients with this dreaded malignancy. Learning Objectives:  In this episode, we review the various definitions for resectability in pancreatic cancer, as well as the various prognostic markers and decision points to consider when deciding which patients may benefit from an operation.  Hosts:  Adam Yopp, MD, FACS (@AdamYopp) is an Assistant Professor of Surgery at the UT Southwestern Medical Center and is Chief of the Division of Surgical Oncology. He also serves as Surgical Director of the Liver Tumor Program. Caitlin Hester, MD (@CaitlinAHester) is a 2nd Year Complex General Surgical Oncology Fellow at the MD Anderson Cancer Center. Gilbert Murimwa, MD (@GilbertZMurimwa) is a PGY-3 General Surgery Resident at the UT Southwestern Medical Center and a research fellow in the Hamon Center for Therapeutic Oncology Research. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.