Transcript of Dr. Bihari Video
00:00 to 02.26—Dr. Bihari gives his background and credentials. Dr. Bihari: My medical training started at Harvard Medical School. I graduated in 1957. Then I trained in Internal Medicine at one of the Harvard teaching hospitals in Boston, Beth Israel, and then in Neurology at Massachusetts General in Boston. Then I went to the National Institutes of Health for two years doing brain physiology—brain research. I did another residency training in Psychiatry in New York, at Columbia Presbyterian Medical Center and then, over the following five or six years, I got very involved in working in Drug Addiction. By 1974, I was the City Addiction Commissioner. I ran all the programs that the city funded for addicts. Then in 1978, the governor and the mayor met, when the governor took over management of the city’s addiction programs, because the city was in a budget crisis. Mayor Koch saved about $8 million and I moved to the city health department as a Deputy Commissioner. I was the only deputy medical commissioner. I basically ran the city health department for about three years. Then I moved to King’s County Hospital, where I ran a cluster of addiction programs for drug addicts and alcoholics. By the early ‘80s, as the AIDS epidemic began, I got very concerned about it. I was seeing large numbers of the heroin addicts I was treating die. I had a couple of friends who died of HIV in the late ‘80s. I got very concerned about what I saw a...
Optimal medical and lifestyle therapy is vital in providing the best outcomes regarding maintenance of vein graft patency following revascularization procedures. Current recommendations include the use of statins, antiplatelet therapy, and smoking cessation, all of which are supported by strong evidence linking respective therapies to increased graft patency. For example, continued smoking has been linked to a threefold increase in graft failure, and likewise statin therapy has been linked with an approximate threefold decrease in long-term graft failure.
The current meta-analysis of interventions for smoking cessation in patients with peripheral arterial disease is welcomed.1 However, the conclusion is discouraging. None of the randomized clinical trials revealed strong evidence that any behavioral or pharmacological aids helped.
Patients undergoing carotid endarterectomy (CEA) often experience intraoperative and postoperative blood pressure lability and postoperative headache. Postoperative headache and hypertension after CEA are thought to increase the risk of developing postoperative cerebral hyperperfusion syndrome (CHS). Although fortunately rare, CHS spans a wide spectrum of signs and symptoms, with patients usually presenting with an unrelenting ipsilateral headache. Temporary or permanent neurologic deficit, seizures, intracranial hemorrhage, and, sometimes, death can follow the initial headache 3 to 7 days after discharge.
ConclusionThe DCE-MRI radiomics model, especially image features extracted from the delayed phases, can help improve the performance in predicting TILs. The radiomics nomogram is effective in predicting TILs in breast cancer.Key Points•Radiomics features extracted from DCE-MRI, especially delayed phase images, help predict TIL levels in breast cancer.•We developed a nomogram based on MRI to predict TILs in breast cancer that achieved the highest AUC of 0.950.
ConclusionWe observed strong reproducibility in the assessment of PI-QUAL between two radiologists with high expertise in prostate mpMRI. At present, PI-QUAL offers clinicians the only available tool for evaluating and reporting the quality of prostate mpMRI in a systematic manner but further refinements of this scoring system are warranted.Key Points•Inter-reader agreement for each single Prostate Imaging Quality (PI-QUAL) score (i.e., PI-QUAL 1 to PI-QUAL 5) was strong, with weighted kappa = 0.85 (95% confidence intervals: 0.51 – 1) and percent agreement = 84%.• Interobserver agreement was strong wh...
This study was designed to compare the detection of subtle lesions (calcification clusters or masses) when using the combination of digital breast tomosynthesis (DBT) and synthetic mammography (SM) with digital mammography (DM) alone or combined with DBT.MethodsA set of 166 cases without cancer was acquired on a DBT mammography system. Realistic subtle calcification clusters and masses in the DM images and DBT planes were digitally inserted into 104 of the acquired cases. Three study arms were created: DM alone, DM with DBT and SM with DBT. Five mammographic readers located the centre of any lesion within the images that s...
There is a local ortho group that wants to bring me on, versus going out and hiring someone. We already have a mutual relationship and referral pattern of patients. I like my independence but also like the idea of having strength in numbers. They have one PMR guy that is in the twilight of his career and just wants to do lumbar ESI all day. If I do not join, they will go out and hire someone else. Not a threat, just a fact. They want to address a need in their practice. So my... Read more
Cervical artery dissection is a common cause of stroke in young adults and can lead to significant disability. Clinicians should be able to recognize the clinical presentation and diagnose this condition to prevent cerebral ischemia and its complications. Consider cervical artery dissection in a young adult with new-onset, unilateral head pain with or without neck pain with antecedent neck trauma, with or without neurologic deficits or risk factors for dissection. Early diagnosis can lead to better outcomes but the overall prognosis is good for young adults with cervical artery dissection.
This article analyzes the burden of COVID-19 on patients with opioid addiction and discusses the beneficial policy changes that improve access to substance abuse care.
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