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Tag: Surgery

  • Chicago Bulls star Zach LaVine is going to have season-ending surgery on his right foot

    Chicago Bulls star Zach LaVine is going to have season-ending surgery on his right foot

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    CHICAGO — Chicago Bulls star Zach LaVine is going to have surgery on his right foot, sidelining the high-scoring guard for the rest of the season.

    LaVine and his agency, Klutch Sports Group, made the decision in consultation with the team’s training and medical staff, the Bulls announced on Saturday. The two-time All-Star is expected to have the surgery next week, and he will be out for four to six months.

    LaVine, who turns 29 in March, played in just 25 games this season. He averaged 19.5 points and 5.2 rebounds.

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    AP NBA: https://apnews.com/hub/nba

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  • New Research Highlights Superior Long-Term Survival with Multi-Arterial Coronary Artery Bypass Grafting Over Single Arterial Grafting

    New Research Highlights Superior Long-Term Survival with Multi-Arterial Coronary Artery Bypass Grafting Over Single Arterial Grafting

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    Newswise — SAN ANTONIO (January 27, 2024) ─ A new study presented at The Society of Thoracic Surgeons’ 2024 Annual Meeting in San Antonio, Texas, examines the ongoing controversy surrounding the choice between multi-arterial grafting (MAG) and single arterial grafting (SAG) in coronary artery bypass grafting (CABG) for multivessel coronary revascularization.

    The research, spanning from 2008 to 2019 and involving over one million patients undergoing isolated CABG with more than two bypass grafts, found that multi-arterial grafting CABG is associated with superior long-term survival compared to single arterial grafting, establishing it as the preferred surgical strategy for multivessel revascularization. 

    “Multiple small studies have demonstrated a survival benefit of multi-arterial grafting. We wanted to know if this survival benefit of multi-arterial grafting observed in single-center studies would translate to a large national cohort,” said the study’s lead author, Joseph Sabik III, MD, University Hospitals.  “Using the STS Adult Cardiac Surgery Database, we were able to demonstrate that it does.”

     At 10 years, MAG demonstrated improved unadjusted (HR 0.59, 95% CI 0.58-0.61) and adjusted (HR 0.86, 95% CI 0.85-0.88) survival rates compared to SAG. A center volume of 10 or more MAG cases per year was associated with survival benefits. 

    MAG’s survival advantage over SAG was found in various subgroups, including stable coronary disease, acute coronary syndrome, and acute infarction. Notably, MAG showed superior survival for patients with a BMI less than 40, whereas patients with a BMI of 40 or higher had superior survival with SAG. Survival outcomes were equivalent between MAG and SAG for patients aged 80 years or older, and those with severe heart failure, renal failure, peripheral vascular disease, or obesity.

    Patient data was collected from the STS Adult Cardiac Surgery Database and linked to the National Death Index for comprehensive longitudinal survival analysis. Risk-adjustment measures, including inverse probability weighting and multivariable modeling, were implemented to ensure accurate comparisons.

    These findings have significant implications for clinicians and cardiac surgeons when deciding on the most appropriate multivessel revascularization approach.

    “The survival benefit of multi-arterial grafting was observed in nearly all patients, except in those 80 or older and in those with co-morbidities graded as severe, where multi and single-arterial grafting resulted in similar survival. The only patients where single arterial grafting resulted in better survival were severely obese,” said Dr. Sabik. 

     

    This research not only contributes valuable insights to the ongoing debate but also provides evidence-based guidance for healthcare professionals in optimizing patient outcomes during CABG procedures.

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    Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 7,700 cardiothoracic surgeons, researchers, and allied healthcare professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society’s mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.



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  • STS Announces Late-Breaker Research to Be Presented at the 2024 Annual Meeting

    STS Announces Late-Breaker Research to Be Presented at the 2024 Annual Meeting

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    Newswise — SAN ANTONIO (January 27, 2024) — The Society of Thoracic Surgeons has released late-breaking research scheduled for presentation at the 2024 Annual Meeting taking place January 27 – 29 in San Antonio. The conference, healthcare’s leading scientific and educational convening specializing in cardiothoracic surgery, has a rich history of showcasing clinical trials with a strong foundation of detailed methodology and trusted data collection governed by ethical clinical principles.

    The event’s late-breaking trial sessions focus on studies anticipated to significantly influence advances in cardiothoracic patient care. In this fast-paced healthcare landscape, surgeons look for the latest evidence to identify new therapies or preventive measures and help inform the most effective treatment decisions.  

    Key late-breaking studies selected for presentation include:

    Longitudinal Follow-up of Elderly Patients After Esophageal Cancer Resection in the Society of Thoracic Surgeons General Thoracic Surgery Database

    The study defines characteristics associated with long-term survival following esophagectomy for cancer in the Medicare population, using the STS General Thoracic Surgery Database linked to Centers for Medicare and Medicaid Services data. The analysis included 4,798 patients from 207 STS sites who underwent esophagectomy between 2012-2019. The researchers found that Medicare patients undergoing esophagectomy for cancer exhibit identifiable predictors for long-term survival and readmission. The absence of pathologic T and N downstaging increases the risk for long-term mortality and readmission.

    These findings suggest opportunities to enhance clinical practice and improve outcomes for Medicare patients undergoing esophagectomy for cancer.

    Cardiac Surgery after Transcatheter Aortic Valve Replacement: Trends and Outcomes

    The researchers set out to document trends and outcomes in cardiac surgery following transcatheter aortic valve replacement (TAVR), a topic gaining importance as reports of subsequent cardiac operations and early TAVR explantations increase. Using the Society of Thoracic Surgeons Adult Cardiac Surgery Database, the study covers adult patients who underwent cardiac surgery after an initial TAVR from January 2012 to March 2023.

    The findings underscore the escalating need for both aortic and non-aortic valve cardiac surgeries following TAVR. They note a substantial increase in the frequency of these surgeries, emphasizing the importance of understanding outcomes. The observed elevated risk in these cases, as indicated by mortality and stroke rates, calls for careful consideration, particularly given the expanding use of TAVR across a broader range of age and risk profiles. The study suggests the need for ongoing assessment and longitudinal evidence to inform decision-making in the evolving landscape of TAVR applications.

    The STS 2023 Clinical Practice Guidelines for the Surgical Treatment of Atrial Fibrillation: Key Takeaways and How Do They Differ from the ACC/AHA Atrial Fibrillation Clinical Practice Guidelines?

    The Society of Thoracic Surgeons’ 2023 clinical practice guidelines for the surgical management of atrial fibrillation (AF) incorporates the latest evidence for surgical ablation (SA) and left atrial appendage occlusion (LAAO) across various clinical scenarios. It emphasizes the evolving role of surgical ablation and left atrial appendage occlusion in managing atrial fibrillation.

    Compared to the 2017 clinical practice guidelines, this latest version emphasizes SA in first-time, non-emergent cardiac surgery and its long-term benefits, an extension of the recommendation to perform SA in all patients with AF undergoing first-time, non-emergent cardiac surgery. Further guidance is provided for patients with structural heart disease and AF who are considered for transcatheter valve repair or replacement.

    The recommendations highlight the importance of a multidisciplinary team, comprehensive assessment, and long-term follow-up, with specific attention to diverse clinical scenarios. The Class I recommendation for LAAO and expanded use of SA signify the growing confidence in these interventions based on recent evidence.

    Impact of Surgical Factors on Event-Free Survival in the Randomized, Placebo-Controlled, Phase 3 Trial of Perioperative Pembrolizumab For Early-Stage Non-Small-Cell Lung Cancer

    New findings from the KEYNOTE-671 research study, focused on resectable early-stage non-small-cell lung cancer (NSCLC), have unveiled a significant breakthrough in the treatment landscape.

    The study, titled “Impact of Surgical-Related Data on Event-Free Survival in KEYNOTE-671,” demonstrated that neoadjuvant therapy with pembrolizumab plus chemotherapy did not delay surgery. Neoadjuvant pembrolizumab plus chemotherapy with adjuvant pembrolizumab provided meaningful improvement in EFS compared with neoadjuvant chemotherapy alone for resectable early-stage NSCLC regardless of clinical nodal status, baseline disease stage, or type of surgery.

    Note to editors: Abstracts are available upon request.

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    Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 7,700 cardiothoracic surgeons, researchers, and allied healthcare professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society’s mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.

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  • Aide to Lloyd Austin asked ambulance to arrive quietly to defense secretary's home, 911 call shows

    Aide to Lloyd Austin asked ambulance to arrive quietly to defense secretary's home, 911 call shows

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    An aide to Defense Secretary Lloyd Austin asked first responders to avoid using lights and sirens in requesting an ambulance be sent to Austin’s northern Virginia home after he had complications from surgery for prostate cancer that he had kept secret from senior Biden administration leaders and staff.

    Austin was hospitalized Jan. 1 and admitted to intensive care after developing an infection a week after undergoing surgery. He was released from Walter Reed National Military Medical Center on Monday.

    On the Jan. 1 call to the Fairfax County Department of Public Safety, a man who identified himself as a government employee described Austin as alert. The identity of Austin and the caller were redacted from a copy of the 911 audio, which was obtained by The Associated Press under the Freedom of Information Act. The caller named the street on which Austin lives.

    In the four-minute call, the reason for needing the ambulance also was redacted. The caller said Austin was not having chest pains.

    “Can I ask, like, can the ambulance not show up with lights and sirens? Um, we’re trying to remain a little subtle,” the aide said, according to the recording.

    A dispatcher responded that the ambulance would comply once it got near the home.

    “Usually when they turn into a residential neighborhood, they’ll turn them off,” the dispatcher said, adding that emergency sirens and lights are required by law on major roads when ambulances are responding to a call.

    Austin was located on the ground floor of the residence, said the aide, who indicated he would be waiting outside for the ambulance.

    The caller asked how long it would take to get to the home. The dispatcher said it depended on traffic and road conditions and said first responders would be arriving from the closest available station.

    Details of the 911 audio file from the Fairfax County Public Safety Department were first reported by The Daily Beast.

    As he recovers, Austin will be working from home. His doctors said he “progressed well throughout his stay and his strength is rebounding.” They said in a statement the cancer was treated early and his prognosis is “excellent.”

    Austin, 70, was admitted to Walter Reed National Military Medical Center on Dec. 22 and underwent surgery to treat the cancer, which was detected earlier in the month during a routine screening.

    Dr. John Maddox, the trauma medical director, and Dr. Gregory Chesnut, the director of the Center for Prostate Disease Research at Walter Reed, said that during Austin’s hospitalization he underwent medical tests and was treated for lingering leg pain. They said he has physical therapy to do but there are no plans for further cancer treatment other than regular checks.

    President Joe Biden and senior administration officials were not told about Austin’s hospitalization until Jan. 4, and Austin kept the cancer diagnosis secret until Jan. 9. Biden has said Austin’s failure to tell him about the hospitalization was a lapse in judgment, but the Democratic president insists he still has confidence in his Pentagon chief.

    During Austin’s time at Walter Reed, the U.S. launched a series of military strikes late last week on the Iranian-backed Houthis in Yemen, targeting dozens of locations linked to their campaign of assaults on commercial shipping in the Red Sea. Working from his hospital bed, Austin juggled calls with senior military leaders, including Gen. Erik Kurilla, head of U.S. Central Command, and White House meetings to review, order and ultimately watch the strikes unfold over secure video.

    The lack of transparency about Austin’s hospitalization, however, has triggered administration and Defense Department reviews on the procedures for notifying the White House and others if a Cabinet member must transfer decision-making authorities to a deputy, as Austin did during his initial surgery and a portion of his latest hospital stay. And the White House chief of staff ordered Cabinet members to notify his office if they ever can’t perform their duties.

    Austin’s secrecy also drew criticism from Congress members on both sides of the political aisle, and Rep. Mike Rogers, an Alabama Republican who is chairman of the House Armed Services Committee, said he has opened a formal inquiry into the matter. Others openly called for Austin to resign, but the White House has said the Pentagon chief’s job is safe.

    It is still unclear when Austin will return to his office in the Pentagon or how his cancer treatment will affect his job, travel and other public engagements going forward. Deputy Defense Secretary Kathleen Hicks has been taking on some of his day-to-day duties as he recovers.

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    Follow the AP’s coverage of Defense Secretary Lloyd Austin at https://apnews.com/hub/lloyd-austin.

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  • Count of neurosurgeon density reflects global unmet needs

    Count of neurosurgeon density reflects global unmet needs

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    Newswise — Rolling Meadows, IL (January 16, 2024) How many neurosurgeons are needed worldwide? Recent reports have suggested that a neurosurgeon ratio of approximately 1 neurosurgeon per 65,000 individuals may not be adequate. Investigators from Harvard Medical School attempted to systematically provide the most accurate count of neurosurgeon density around the world, as well the number in each country. Using data collected from 99.5% of all countries and 96.2% of all additional territories, states, and disputed regions, the authors report that there are approximately 72,967 neurosurgeons globally, representing a pooled density of 0.93 neurosurgeons per 100,000 individuals, and a median national density of 0.44 neurosurgeons per 100,000 individuals. The study detailing these findings was published today in the Journal of Neurosurgery (https://thejns.org/doi/10.3171/2023.9.JNS231615). 

    The authors used contacts with national and regional neurosurgery societies, their own personal contacts, bibliometric and Google searches, and World Bank and United Nations data to obtain perhaps the most accurate count of global neurosurgeon density to date. There were wide disparities in the neurosurgery workforce and access to resources in different WHO regions and World Bank income categories. The African region, with 0.11 neurosurgeons per 100,000 individuals, and the Southeast Asia region, with 0.34 per 100,000 individuals, had the lowest neurosurgeon density, while the Western Pacific region (WPR) had the highest density, with 1.58 per 100,000 individuals. The authors found that there were 29 countries, 14 territories, and 1 independent state with no neurosurgeons at all, representing almost 36 million individualswithout access to a neurosurgeon. Among these 29 countries, 21 were low- and middle-income countries (LMICs; 72.4%), and most were located in the WPR (n = 10, 34.5%) or African region (n = 9, 31.0%). 

    The greatest growth in the number of neurosurgeons from 2016 to 2022 was in the Southeast Asia region (33.0% per year), while the slowest growth was in the African region (2.0% per year); 15 countries in the African region had a decrease in their neurosurgery densities, and 7 of these 15 countries were in West Africa. Some of the strongest predictors of annual relative growth in neurosurgery density included the presence of a national neurosurgery society, development aid, and national gross domestic product. 

    “We were excited to find that the neurosurgery workforce is growing worldwide, but the growth in LMICs has been disproportionately slow,” said Dr. Saksham Gupta, the lead author of the study. “The number of neurosurgeons in many LMICs remains insufficient to manage their countries’ needs, and neurosurgeons in LMICs have fewer resources to provide subspecialized care. These imbalances will negatively affect population health in LMICs and could contribute to burnout amongst already overworked LMIC neurosurgeons.” 

    In a related companion article (https://thejns.org/doi/10.3171/2023.9.JNS231616), the authors also attempted to determine the global density of neurosurgeon trainees. They estimated there were 1261 training programs with 10,546 neurosurgery trainees worldwide. The Southeast Asia (0.04 per 100,000 people) and African (0.05 per 100,000 people) regions had the lowest pooled trainee density, and there were no training programs in 22.4% of high-income countries (HICs) and in 35.2% of LMICs. Surveys of African young neurosurgeons and trainees highlighted some of the educational limitations that most trainees face, which included low exposure to educational conferences, the inability to attend national and international research conferences, and low access to cadaver laboratories.

    Regarding solutions to correct these imbalances, Gupta stated, “Collaboration between LMICs and HICs as well as between LMICs themselves is key and will help new perspectives flourish and best practices spread. Furthermore, there have been several impressive educational efforts, including but certainly not limited to Dr. Rutka’s work with the Ukraine Pediatric Fellowship Program, Dr. Baticulon’s work in the Philippines, the World Federation of Neurosurgical Societies (WFNS)—sponsored training center in Rabat, and numerous Foundation for International Education in Neurological Surgery courses and partnerships. Education is the bedrock of neurosurgery, and we should continue supporting existing educational tools (such as cadaver laboratories, weekend courses, year-long fellowships) while promoting emerging teaching modalities (webinars, high-fidelity dissection models, and open-access operative videos).”

    Articles:  Gupta S, Gal ZT, Athni TS, Calderon C, Callison WÉ, Dada OE, Lie W, Qian C, Reddy R, Rolle M, Baticulon RE, Chaurasia B, Dos Santos Rubio EJ, Esquenazi Y, Golby AJ, Pirzad AF, and Park KB, on behalf of the WFNS Global Neurosurgery Committee, EANS Global and Humanitarian Neurosurgery Committee, and CAANS Executive Leadership Committee. Mapping the global neurosurgery workforce. Part 1: Consultant neurosurgeon density. Journal of Neurosurgery. Published online January 16, 2024; DOI: 10.3171/2023.9.JNS231615. Mapping the global neurosurgery workforce. Part 2: Trainee density. Journal of Neurosurgery. Published online January 16, 2024; DOI: 10.3171/2023.9.JNS231616.

    Disclosures: The authors report no conflict of interest concerning the materials or methods used in these studies or the findings specified in these papers.

    Funding: Mr. Athni was supported by the National Institute of General Medical Sciences, NIH, under grant no. T32GM144273.

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    The global leader for cutting-edge neurosurgery research for more than 75 years, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • Nigerian group provides hundreds of prosthetic limbs to amputee children thanks to crowdfunding

    Nigerian group provides hundreds of prosthetic limbs to amputee children thanks to crowdfunding

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    LAGOS, Nigeria — The accident that broke 10-year-old Princess Igbinosa’s right leg could have crushed her dreams of becoming a model in a country where not many can afford prosthetics to cope with life and fight social stigma.

    “It was heartbreaking when they told us they had to amputate it (the leg),” her mother, Esther Igbinosa, said of Princess’s experience in 2020. “During the first few months of her amputation … I just wake up and start crying. I was like, how is she going to cope with life with an amputated leg?”

    But Princess can now walk and her dreams are alive again, thanks to an artificial leg that matches the tone of her skin. The prosthesis came from the IREDE Foundation, a Nigerian group that provides children like her with free artificial limbs that normally cost $2,000 to $3,000.

    “My dream is to become a model,” Princess said. “When the accident happened, I thought I couldn’t become a model. But now that I have two legs, I can become whatever I want — model, doctor, whatever.”

    Founded in 2012 in Nigeria’s economic hub of Lagos, IREDE has provided more than 500 artificial limbs at no cost in addition to psychosocial support to children like Princess, said its executive director, Crystal Chigbu. She said the group gets up to 70% of its funding from crowdsourcing.

    Chigbu said her inspiration to start the foundation came from her daughter’s experience with being born with limb deformity.

    The child amputees the foundation has helped can “do things that they would never have imagined that they would do,” said Chigbu.

    While there is no verifiable data on how many Nigerians are living with amputated limbs, IREDE is one of several groups providing such services amid a great need.

    It is a huge source of relief in Nigeria where people with disabilities struggle with stigma and limb replacements make them more accepted in their communities, said Dr. Olasode Isreal-Akinmokun, an orthopedic surgeon.

    “We have limbs that function almost as perfectly as the limbs that have been lost,” he said.

    In addition to providing artificial limbs to children, Chigbu said, IREDE is also educating people about limb loss to deter stigma and it encourages support groups among parents of affected children.

    “We come from a culture of people just saying (that) when you have a disability it is either taboo or people just look down on you. We are ensuring that whether it is in the school or even when they find themselves in the workplace as they grow, that people accept them and know that they have their abilities,” she said.

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    Asadu reported from Abuja, Nigeria.

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  • Urology of Virginia Announces New Chief Executive Officer

    Urology of Virginia Announces New Chief Executive Officer

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    Newswise — VIRGINIA BEACH, Va., Jan. 1, 2024 /PRNewswire/ — Urology of Virginia announces that Dr. Joshua Langston has been elected Managing Partner and Chief Executive Officer, as of January 1, 2024. He will continue the legacy of excellent organizational guidance, innovation and service of his predecessor, Dr. Jennifer Miles-Thomas. Dr. Miles-Thomas commented on the transition, “Dr. Langston has a long history with our organization and is well-equipped to lead us into an even brighter future. I have complete confidence that under his guidance, we will continue to excel and make a positive impact on the lives of our patients. It has been an honor to serve as President and CEO, and I look forward to witnessing the continued growth and success of Urology of Virginia from a different vantage point.”

    Dr. Langston completed medical school at UT Southwestern Medical School in Dallas. He went on to residency training at the University of North Carolina-Chapel Hill and completed a fellowship in Andrology & Male Reconstructive Urology at the Institute of Urology in London, England. He serves as medical director of Men’s Health Virginia, a division of Urology of Virginia, where his team focuses on health needs of aging men. Dr. Langston has a strong interest in health policy and advocacy on behalf of patients, and currently serves as Chair of the Political Affairs Committee for the Large Urology Group Practice Association (LUGPA). He was previously selected as the American Urological Association (AUA) Holtgrewe Legislative Fellow, spending time away from his practice as a health policy legislative advisor in the U.S. Senate. He is Chair of the Health Policy Committee of the Mid-Atlantic AUA, serves on the Public Policy Council and Legislative Affairs Committees of the AUA, and the Board of Directors for the American Society for Men’s Health, amongst many other roles.

    Regarding his appointment, Dr Langston said: ‘It is truly an honor to be selected by my partners for this role. Urology of Virginia has a 100-year history of being a national leader in innovative, patient-centered care and research. I look forward to working together with my colleagues to cast a vision for growth and evolution in the face of a changing national healthcare paradigm that will allow us to continue to serve our community for another 100 years.”

    About Urology of Virginia

    Urology of Virginia (UVA) has a 100+-year history of providing comprehensive and quality care to the entire Hampton Roads region, including northeastern North Carolina.

    The clinical care team consists of over 30 board certified Urologists, most of whom are fellowship trained, nationally recognized, awarded and published. More importantly, they provide superior care and individualized attention to their patients. Included in the team of urologists – with subspecialties such as oncology, urologic reconstruction, stone disease, and andrology – are a specialty trained GU Pathologist, Physician Assistants, Nurse Practitioners, RN’s, x-ray and ultrasound technicians, and a vast array of other health care professionals. Our providers also comprise the Department of Urology at Eastern Virginia Medical School, training the next generation of urologists. The Urology of Virginia Research Division maintains participation in cutting edges trials, and has been responsible for many landmark studies over the years. The Schellhammer Urological Research Foundation (SURF), the organization’s charitable arm, provides funding for research and community care.

    To learn more about Urology of Virginia and its service offerings, please visit urologyofva.net.

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  • Debunking the 3,500-Calorie-per-Pound Rule  | NutritionFacts.org

    Debunking the 3,500-Calorie-per-Pound Rule  | NutritionFacts.org

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    How many fewer calories do you have to eat every day to lose one pound of body fat? 

    The first surgical attempt at body sculpting was in 1921 on a dancer “who wanted to improve the shape of her ankles and knees.” The surgeon apparently scraped away too much tissue and tied the stitches too tight, resulting in necrosis, amputation, and the first recorded malpractice suit in the history of plastic surgery. Liposuction is much safer today, killing only about 1 in 5,000 patients, mostly from unknown causes, such as throwing a clot into your lung or perforating your internal organs. You can see a “Cause of Death” chart below and at 0:37 in my video The 3,500 Calorie per Pound Rule Is Wrong. 

    Liposuction currently reigns as the most popular cosmetic surgery in the world, and its effects are indeed only cosmetic. A study published in the New England Journal of Medicine assessed obese women before and after having about 20 pounds of fat sucked out of their bodies, resulting in a nearly 20 percent drop in their total body fat. Normally, if you lose even just 5 to 10 percent of your body weight in fat, you get significant improvements in blood pressure, blood sugars, inflammation, cholesterol, and triglycerides. But liposuction sucks. None of those benefits materialized even after massive liposuction, which suggests that the problem is not subcutaneous fat, the fat under our skin. The metabolic insults of obesity arise from the visceral fat, the fat surrounding or even infiltrating our internal organs, like the fat marbling our muscles and liver. The way you lose that fat, the dangerous fat, is to take in fewer calories than you burn. 
     
    Anyone who’s seen The Biggest Loser television programs knows that with enough caloric restriction and exercise, hundreds of pounds can be lost. Similarly, there are cases in the medical literature of what some refer to as “super obesity.” In one case, a man lost a massive amount of weight “largely without professional help and without surgery” and kept it off for years. He dropped 374 pounds, losing about 20 pounds a month by cycling two hours a day and reducing his daily intake to 800 calories, which is down around what some prisoners got at concentration camps in World War II. 
     
    Perhaps “America’s most celebrated weight loss” seen on television was Oprah’s. She pulled out a wagon full of fat, representing the 67 pounds she had lost on a very-low-calorie diet. How many calories did she have to cut to achieve that weight loss within four months? If you consult with leading nutrition textbooks or refer to trusted authorities like the Mayo Clinic, you’ll learn the simple weight loss rule: 1 pound of fat equals 3,500 calories. Quoting from the Journal of the American Medical Association, “A total of 3500 calories equals 1 pound of body weight. This means if you decrease (or increase) your intake by 500 calories daily, you will lose (or gain) 1 pound per week. (500 calories per day × 7 days = 3500 calories.)” 
     
    It’s the simple weight-loss rule that is simply not true. 
     
    The 3,500-calorie rule can be traced back to a paper published in 1958. The author noted that since fatty tissue in the human body is 87 percent fat, a pound of body fat would have about 395 grams of pure fat. Multiplying that by nine calories per gram of fat gives you that “3,500 calories per pound” approximation. The fatal flaw that leads to “dramatically exaggerated” weight-loss predictions is that the 3,500-calorie rule fails to take into account the fact that changes in the Calories-In side of the energy-balance equation automatically lead to changes in the Calories-Out side—for example, metabolic adaption, the slowing of metabolic rate that accompanies weight loss. That’s one reason weight loss plateaus. 
     
    Imagine a sedentary, 30-year-old woman of average height who weighs 150 pounds. According to the 3,500-calorie rule, if she cuts 500 calories out of her daily diet, she’d lose a pound a week or 52 pounds a year. In three years, she would vanish. She’d go from 150 pounds to -6. Obviously, that doesn’t happen. Instead, as you can see in the graph below and at 4:33 in my video, in the first year, she’d likely lose 32 pounds, not 52. Then, after a total of three years, she’d probably stabilize at about 100 pounds. This is because it takes fewer calories to exist as a thin person.  


    Part of it is “simple mechanics”: More energy is required to move a heavier mass, in the same way a Hummer requires more fuel than a compact car. Think how much more effort it would take to just get up from a chair, walk across the room, or climb a few stairs if you were carrying a 50-pound backpack. Even when you’re at rest, sound asleep, there’s simply less of your body to maintain as you lose weight. Every pound of fat tissue lost may mean one less mile of blood vessels through which your body has to pump blood every minute. So, the basic upkeep and movement of thinner bodies take fewer calories. As you lose weight by eating less, you end up needing less. That’s what the 3,500-calorie rule doesn’t take into account. 
     
    Imagine it another way: A 200-pound man starts consuming 500 more calories a day, maybe by drinking a large soda or eating two donuts. According to the 3,500-calorie rule, in ten years, he’d weigh more than 700 pounds. That doesn’t happen because, the heavier he is, the more calories he burns just by existing. If you’re 100 pounds overweight, it’s as if there’s a skinny person inside you trying to walk around balancing 13 gallons of oil or lugging around a sack filled with 400 sticks of butter. As you can see in the graph below and at 6:13 in my video, it takes about two donuts’ worth of extra energy just to live at 250 pounds, so that’s where you’d plateau if you kept it up. Given a certain calorie excess or deficit, weight gain or weight loss is a curve that flattens out over time, rather than a straight line up or down. 


    Nevertheless, the 3,500-calorie rule continues to crop up, even in obesity journals. Public health researchers used it to calculate how many pounds children might lose every year if, for example, fast-food kids’ meals swapped in apple slices for french fries. You can see the “Counting Calories in Kids’ Meals” graphic below and at 6:39 in my video. 

    They figured that two meals a week could add up to about four pounds a year. The actual difference, National Restaurant Association–funded researchers were no doubt delighted to point out, would probably add less than half a pound—ten times less than the 3,500-calorie rule would predict, as you can see below and at 7:06 in my video. That original article was subsequently retracted. 

     
    The 3,500 Calorie per Pound Rule Is Wrong is the first of 14 videos that are part of my fasting series, about which I did two webinars. The videos are on NutritionFacts.org, or you can get them all now in a digital download at Intermittent Fasting. You may also be interested in my webinars on Fasting and Disease Reversal and Fasting and Cancer.

    Other videos in this series are included in related videos below. 
     
    Check out some other popular videos on weight loss.

    I also recently tackled the ketogenic diet.

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    Michael Greger M.D. FACLM

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  • Kentucky lieutenant governor undergoes 'successful' double mastectomy, expects to make full recovery

    Kentucky lieutenant governor undergoes 'successful' double mastectomy, expects to make full recovery

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    FRANKFORT, Ky. — Kentucky Lt. Gov. Jacqueline Coleman underwent a double mastectomy on Monday after concerns were raised during a routine medical examination, her office announced. The Democrat said she expects to make a full recovery.

    The surgery occurred less than a week after Coleman and Gov. Andy Beshear were sworn in for second terms, having run successfully as a ticket again in the Bluegrass State.

    In a statement Monday, Coleman thanked her family for its loving support and said she would see Kentuckians again soon.

    The surgery followed a routine physical exam recently, she said.

    “With a significant family history of cancer, I made the decision to have a double mastectomy,” Coleman said. “I am happy to report that a successful surgery was performed today, and I expect to make a full recovery.”

    Beshear said in a separate statement that Coleman is a friend and “critical part” of his administration.

    “My family and Kentucky families are standing with her during this time,” the Democratic governor said.

    Coleman, 41, was a fixture on the campaign trail throughout the hard-hitting campaign that featured Beshear and Republican Attorney General Daniel Cameron at the top of the ticket. She debated her Republican rival for lieutenant governor in a televised debate late in the campaign. The Beshear-Coleman ticket won a convincing victory last month, even as every other statewide office was won by the GOP.

    Coleman has already fielded questions about whether she will run for governor in 2027, politely brushing them aside. Beshear is term-limited from running for governor again in four years.

    Coleman spent years as a teacher and school administrator before being tapped by Beshear as his running mate for their first successful run as a ticket in 2019. She’s been an ardent proponent of the governor’s education proposals, including his push for higher teacher pay and universal access to pre-K for all 4-year-old Kentuckians. Besides her role as a public education advocate, Coleman focused on rural economic development, adult learning and student mental health initiatives during her first term.

    She participated in daylong inaugural events last week. In her speech that day, Coleman touted the importance of the Beshear administration’s education proposals, declaring: “From cradle to career, education is the key that unlocks doors for every Kentuckian.” Health care workers and educators served as grand marshals for the inaugural parade that day.

    On Monday, Coleman was thanking her health-care providers for the care she’s received.

    “As Kentucky’s highest elected teacher, it is only fitting that I leave you with a little homework: Schedule those preventative exams you’ve put off, hug your people a little tighter and be kind, because everyone is fighting a battle you may know nothing about,” she said.

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  • December 2023 Issue of Neurosurgical Focus: “Enhanced Recovery After Cranial Surgery”

    December 2023 Issue of Neurosurgical Focus: “Enhanced Recovery After Cranial Surgery”

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    Newswise — Rolling Meadows, IL (December 1, 2023). The October issue of Neurosurgical Focus (Vol. 55, No. 6 [https://thejns.org/focus/view/journals/neurosurg-focus/55/6/neurosurg-focus.55.issue-6.xml]) presents twelve articles and one editorial on enhanced recovery after cranial surgery. 

    Topic Editors: Walavan Sivakumar, Neil Martin, Sarah T. Menacho, Randy S. D’Amico, and Luca Regli 

    Following on earlier attention to enhanced recovery in spine surgery, the December issue of Neurosurgical Focus focuses on enhance recovery after cranial surgery. The issue’s editors present “a contemporary and global selection of evidence-based studies encompassing the range of cranial surgery” with the “hope that this issue will serve as a valuable reference for the readership in their own protocol development efforts.” 

    Contents of the December issue: 

    • “Introduction. Developing the foundation for enhanced recovery after cranial surgery” by Walavan Sivakumar et al.
    • “Theory-based implementation of an enhanced recovery protocol for cranial surgery” by Aimun A. B. Jamjoom et al.
    • “Editorial. Overcoming implementation barriers in enhanced recovery using theory-based approaches” by Walavan Sivakumar
    • “Development and implementation of an Enhanced Recovery After Cranial Surgery pathway following supratentorial tumor resection at a tertiary care center” by Hammad A. Khan et al.
    • “Enhanced recovery after brain tumor surgery: pilot protocol implementation in a large healthcare system” by Walavan Sivakumar et al.
    • “Enhanced recovery and same-day discharge after brain tumor surgery under general anesthesia: initial experience with Hospital-at-Home–based postoperative follow-up” by Cristina A. Pelaez-Sanchez et al.
    • “Effect of the enhanced recovery protocol in patients with brain tumors undergoing elective craniotomies: a systematic review and meta-analysis” by Suchada Supbumrung et al.
    • “Same-day discharge after craniotomy for brain tumor resection: enhancing patient selection through a prognostic scoring system” by Adam S. Levy et al.
    • “The Enhanced Recovery After Surgery protocol for the perioperative management of pituitary neuroendocrine tumors/pituitary adenomas” by Giulia Cossu et al.
    • “An institutional experience in applying quality improvement measures to pituitary surgery: clinical and resource implications” by Panayiotis E. Pelargos et al.
    • “Early versus delayed mobilization after aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis of efficacy and safety” by Alberto Morello et al.
    • “Applications of enhanced recovery after surgery protocolsfor unruptured anterior circulation aneurysms in tertiary-level healthcare institutions: a national study” by Fatih Yakar et al.
    • “Effects of a sphenopalatine ganglion block on postcraniotomy pain management: a randomized, double-blind, clinical trial” by Giorgio Mantovani et al.
    • “The Enhanced Recovery After Surgery protocol for the surgical management of craniosynostosis: Lausanne experience” by Amani Belouaer et al.

     Please join us in reading this month’s issue of Neurosurgical Focus.

     ***

     Embargoed Article Access and Author/Expert Interviews: Contact JNSPG Director of Publications Gillian Shasby at [email protected] for advance access and to arrange interviews with the authors and external experts who can provide context for this research.

    ###

     The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • Keto Diet to Effectively Fight Cancer?  | NutritionFacts.org

    Keto Diet to Effectively Fight Cancer?  | NutritionFacts.org

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    What does the science say about the clinical use of ketogenic diets for epilepsy and cancer? 

    Blood sugar, also known as blood glucose, is the universal go-to fuel for the cells throughout our bodies. Our brain burns through a quarter pound of sugar a day because “glucose is the preferred metabolic fuel.” We can break down proteins and make glucose from scratch, but most comes from our diet in the form of sugars and starches. If we stop eating carbohydrates (or stop eating altogether), most of our cells switch over to burning fat. Fat has difficulty getting through the blood-brain barrier, though, and our brain has a constant, massive need for fuel. Just that one organ accounts for up to half of our energy needs. Without it, the lights go out…permanently. 

    To make that much sugar from scratch, our body would need to break down about half a pound of protein a day. That means we’d cannibalize ourselves to death within two weeks, but people can fast for months. What’s going on? The answer to the puzzle was discovered in 1967. Harvard researchers famously stuck catheters into the brains of obese subjects who had been fasting for more than a month and discovered that ketones had replaced glucose as the preferred fuel for the brain. Our liver can turn fat into ketones, which can then breach the blood-brain barrier and sustain our brain if we aren’t getting enough carbohydrates. Switching fuels has such an effect on brain activity that it has been used to treat epilepsy since antiquity. 

    In fact, the prescription of fasting for the treatment of epileptic seizures dates back to Hippocrates. In the Bible, even Jesus seems to have concurred. To this day, it’s unclear why switching from blood sugar to ketones as a primary fuel source has such a dampening effect on brain overactivity. How long can one fast? To prolong the fasting therapy, in 1921, a distinguished physician scientist at the Mayo Clinic suggested trying what he called “ketogenic diets,” high-fat diets designed to be so deficient in carbohydrates that they could effectively mimic the fasting state. “Remarkable improvement” was noted the first time it was put to the test, efficacy that was later confirmed in randomized, controlled trials. Ketogenic diets started to fall out of favor in 1938 with the discovery of the anti-seizure drug that would become known as Dilantin, but they’re still being used today as a third- or fourth-line treatment for drug-refractory epilepsy in children. 

    Oddly, the success of ketogenic diets against pediatric epilepsy seems to get conflated by “keto diet” proponents into suggesting a ketogenic diet is beneficial for everyone. Know what else sometimes works for intractable epilepsy? Brain surgery, but I don’t hear people clamoring to get their skulls sawed open. Since when do medical therapies translate into healthy lifestyle choices? Scrambling brain activity with electroshock therapy can be helpful in some cases of major depression, so should we get out the electrodes? Ketogenic diets are also being tested to see if they can slow the growth of certain brain tumors. Even if they work, you know what else can help slow cancer growth? Chemotherapy. So why go keto when you can just go chemo? 

    Promoters of ketogenic diets for cancer are paid by so-called ketone technology companies that offer to send you salted caramel bone broth powder for a hundred bucks a pound or companies that market ketogenic meals and report “extraordinary” anecdotal responses in some cancer patients. But more concrete evidence is simply lacking, and even the theoretical underpinnings may be questionable. A common refrain is that “cancer feeds on sugar.” But all cells feed on sugar. Advocating ketogenic diets for cancer is like saying Hitler breathed air so we should boycott oxygen. 

    Cancer can feed on ketones, too. Ketones have been found to fuel human breast cancer growth and drive metastases in an experimental model, more than doubling tumor growth. Some have even speculated that this may be why breast cancer often metastasizes to the liver, the main site of ketone production. As you can see below and at 4:59 in my video Is Keto an Effective Cancer-Fighting Diet?, if you drip ketones directly onto breast cancer cells in a petri dish, the genes that get turned on and off make for much more aggressive cancer, associated with significantly lower five-year survival in breast cancer patients, as you can see in the following graph and at 5:05 in my video. Researchers are even considering designing ketone-blocking drugs to prevent further cancer growth by halting ketone production.  

    Let’s also think about what eating a ketogenic diet might entail. High animal fat intake may increase the mortality risk among breast cancer survivors and potentially play a role in the development of breast cancer in the first place through oxidative stress, hormone disruption, or inflammation. This applies to men, too. “A strong association” has been found “between saturated fat intake and prostate cancer progression and survival.” Those in the top third of consumption of these kinds of fat-rich animal foods appeared to triple their risk of dying from prostate cancer. This isn’t necessarily fat in general either. No difference has been found in breast cancer death rates based on total fat intake. However saturated fat intake specifically may negatively impact breast cancer survival, increasing the risk of dying from it by 50 percent. There’s a reason the official American Cancer Society and American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline recommend a dietary pattern for breast cancer patients that’s essentially the opposite of a ketogenic diet. It calls for a diet that’s “high in vegetables, fruits, whole grains, and legumes [beans, split peas, chickpeas, and lentils]; low in saturated fats; and limited in alcohol consumption.” 

    “To date, not a single clinical study has shown a measurable benefit from a ketogenic diet in any human cancer.” There are currently at least a dozen trials underway, however, and the hope is that at least some cancer types will respond. Still, even then, that wouldn’t serve as a basis for recommending ketogenic diets for the general population any more than recommending everyone get radiation, surgery, and chemo just for kicks. 

    “Keto” has been the most-searched keyword on NutritionFacts.org for months, and I didn’t have much specific to offer…until now. Check out my other videos on the topic in related videos below. 

     For an overview of my cancer work, watch How Not to Die from Cancer. 

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    Michael Greger M.D. FACLM

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  • Tiger Woods Fast Facts | CNN

    Tiger Woods Fast Facts | CNN

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    CNN
     — 

    Here’s a look at one of the most successful golfers in history, Tiger Woods.

    Birth date: December 30, 1975

    Birth place: Cypress, California

    Birth name: Eldrick Tont Woods

    Father: Earl Woods

    Mother: Kultilda (Punsawad) Woods

    Marriage: Elin Nordegren (October 5, 2004-August 23, 2010, divorced)

    Children: Charlie Axel and Sam Alexis

    Education: Attended Stanford University, 1994-1996

    Won the Masters Tournament five times, the US Open three times, the PGA Championship four times and the British Open three times.

    Woods is the PGA career money list leader.

    With 82 PGA Tour wins, Woods is tied with Sam Snead for most all-time career victories.

    His father nicknamed him “Tiger” after a South Vietnamese soldier with whom he had fought alongside during the Vietnam War.

    1978 – At the age of 2, wins a putting contest with Bob Hope. The match was staged for the “Mike Douglas Show.”

    1980 – Appears on the TV show “That’s Incredible.”

    1991 – Wins his first US Junior Amateur golf championship. At 15 years of age, Woods was the youngest champion in history until 14-year-old Jim Liu broke his record in 2010.

    1992 – Wins his second US Junior Amateur golf championship.

    February 27, 1992 – Competes in his first PGA tournament at the age of 16. He is given a sponsor’s exemption in order to play and is the youngest player ever to play in a PGA tournament at that time.

    1993 – Wins his third US Junior Amateur golf championship.

    1994-1996 – Wins three consecutive US Amateur golf championships.

    August 27, 1996 – Turns professional.

    August 1996 – Signs a five-year endorsement deal with Nike worth $40 million.

    October 6, 1996 – Wins his first tournament as a professional at the Las Vegas Invitational.

    1996 – Forms the Tiger Woods Foundation for the promotion of minority participation in golf and other sports. In February 2018, the charity is renamed TGR Foundation to reflect its growth and scope.

    April 13, 1997 – Wins his first Masters Tournament.

    May 19, 1997 – Signs an endorsement deal with American Express worth between $13 and $30 million.

    June 1997 – Becomes the No. 1 ranked golfer in the world after his 42nd week on the PGA Tour. At 21 years, 24 weeks, he is the youngest player ever to hold the No. 1 spot.

    August 15, 1999 – Wins his first PGA championship.

    June 18, 2000 – Wins his first US Open by 15 strokes, the largest margin in US Open history.

    July 23, 2000 – Wins his first British Open.

    September 14, 2000 – Signs a five-year endorsement contract with Nike. It is worth an estimated $85 million, making it the richest endorsement contract in sports history, at the time.

    June 16, 2002 – Wins his second US Open.

    December 8, 2003 – Named PGA Player of the Year for the fifth straight year.

    May 13, 2005 – Woods fails to make the cut at the Byron Nelson Championship in Irving, Texas. It is the first time since 1998 that Woods is eliminated from a tournament.

    November 23, 2005 – Wins the PGA Grand Slam of Golf for a record-breaking sixth time.

    February 10, 2006 – Opens the Tiger Woods Learning Center in Anaheim, California.

    May 3, 2006 – Woods’ father, Earl Woods, dies of prostate cancer.

    July 23, 2006 – Wins his third British Open.

    August 20, 2006 – Wins his third PGA Championship.

    August 12, 2007 – Wins his fourth PGA Championship.

    April 15, 2008 – Undergoes arthroscopic surgery on his left knee. He had two prior surgeries on the same knee, first in 1994 to remove a benign tumor, and another arthroscopic surgery in December 2002.

    June 16, 2008 – Wins the US Open in sudden death, defeating Rocco Mediate.

    June 18, 2008 – Woods announces that he will undergo reconstructive anterior cruciate ligament (ACL) surgery on his left knee and will miss the remainder of the PGA tour season.

    February 26, 2009 – After an eight-month hiatus from golf due to knee surgery, Woods plays the second round of the World Golf Championships Match Play and loses to Tim Clark.

    November 15, 2009 – Wins the Australian Masters.

    November 27, 2009 – Is taken to a hospital after being injured in a car accident in front of his home in Florida. He is released later the same day.

    December 2, 2009 – Woods apologizes for “transgressions” that let his family down – the same day a gossip magazine publishes a report alleging he had an affair. He does not admit to an affair and offers no details about the “transgressions” in his statement.

    February 19, 2010 – Makes a televised statement apologizing for being unfaithful to his wife and letting down both fans and family. “I had affairs, I cheated. What I did was not acceptable, and I am the only person to blame,” he says. Responding to rumors, Woods says that his wife never hit him, as some media reported in connection with the car crash on November 27, 2009, and that there has “never been an episode of domestic violence” in his relationship with his wife. Woods also says that he entered a rehabilitation center for 45 days, from the end of December to early February, and that he will continue to receive treatment and therapy.

    October 31, 2010 – After 281 straight weeks, the longest in Official World Golf Ranking history, Woods loses his No. 1 ranking to Lee Westwood.

    2010 – Loses about $20 million from estimated endorsements after sponsors including Gatorade, AT&T and Accenture end ties. Other sponsors including Nike, Upper Deck and EA Sports remain with Woods.

    June 7, 2011 – Announces he will miss the US Open due to knee and Achilles tendon injuries.

    July 19, 2011 – Woods announces that after a 12-year relationship, he and caddie Steve Williams will no longer be working together.

    August 4, 2011 – Returns to golf at the Bridgestone Invitational, after a nearly three-month break.

    August 11, 2011 – Plays one of his worst first rounds of golf in a major championship. He fails to make the cut at the PGA Championship for the first time in his career.

    October 3, 2011 – For the first time in 15 years, Woods does not make it onto golf’s top 50 players list, according to the official World Golf Ranking.

    October 5, 2011 – Signs a new endorsement deal with Swiss watch-maker Rolex.

    March 25, 2012 – Earns his first PGA Tour win since September 2009, in the Arnold Palmer Invitational in Orlando.

    June 3, 2012 – With his win at the Memorial Tournament, ties Jack Nicklaus with 73 PGA Tour victories.

    July 2, 2012 – Beats Nicklaus’ PGA Tour record with the AT&T National win. Woods’ 74th PGA Tour win ranks him in second place on the all-time list.

    September 3, 2012 – Becomes the first PGA tour participant to earn $100 million.

    March 25, 2013 – Woods wins the Arnold Palmer Invitational for the eighth time, and regains the No. 1 spot.

    March 31, 2014 – Woods undergoes back surgery for a pinched nerve.

    August 23, 2015 – Posts a top 10 finish at his debut at the Wyndham Championships but ends his season as the 257th ranked player in the world. His finish was four shots off eventual winner Davis Love III. Woods has now missed the cut for three majors in a row.

    December 1, 2015 – Announces that he underwent his third microdiscectomy surgery last month – a procedure to remove bone around a pinched nerve to allow space for it to heal – and admits he has no idea when he will be back on the course.

    July 20, 2016 – It is announced that Woods will miss the PGA Championship due to his continued recovery from back surgery. This marks the first time in his career that he has missed all four major championships.

    December 4, 2016 – Woods finishes 14 shots behind the winner in the Hero World Challenge, his first competitive event in more than a year.

    May 29, 2017 – Woods is arrested on suspicion of DUI in Jupiter, Florida. He says in a statement that he had “an unexpected reaction to prescribed medications” and that alcohol was not involved.

    June 19, 2017 – Woods announces that he is receiving professional help to manage medication for back pain and a sleep disorder.

    July 3, 2017 – Announces that he has completed an intensive program for managing his medications.

    October 27, 2017 – Woods pleads guilty to reckless driving. His 12-month probation is contingent on completing any recommended treatment including DUI school, 50 hours of community services and random drug and alcohol testing.

    December 3, 2017 – Making his long-awaited return from a fourth back surgery – his first tournament for 301 days since pulling out of the Dubai Desert Classic in February – Woods finishes in a tie for ninth place in the Hero World Challenge tournament in the Bahamas.

    September 23, 2018 – Wins the Tour Championship at Atlanta’s East Lake Golf Club, for his first PGA Tour victory since August 2013 and his 80th overall.

    April 14, 2019 – Wins his fifth Masters and 15th major title.

    May 6, 2019 – President Donald Trump presents Woods with the Presidential Medal of Freedom, the nation’s highest civilian honor, during a White House ceremony.

    October 27, 2019 – Wins his record-equaling 82nd PGA Tour title at the Zozo Championship in Chiba, Japan. Woods is tied with legendary golfer Sam Snead, who won 82 titles throughout his more than 50-year career.

    May 24, 2020 – Woods and Peyton Manning defeat Phil Mickelson and Tom Brady by one stroke in “The Match: Champions for Charity” golf tournament at the Medalist Golf Club in Hobe Sound, Florida. The event raises over $20 million for coronavirus relief efforts and captures an average of 5.8 million viewers to become the most-watched golf telecast in the history of cable television.

    February 23, 2021 – Woods is hospitalized after a serious one-car rollover accident in Los Angeles County, according to the LA County Sheriff’s Department. Wood’s agent Mark Steinberg said the golfer suffered “multiple leg injuries” and was in surgery following the accident. The next day, Woods is “awake, responsive, and recovering” in the hospital after emergency surgery on his lower right leg and ankle at the Harbor-UCLA Medical Center. The leg fractures were “comminuted,” meaning the bone was broken into more than two parts, and “open,” meaning the broken bone was exposed to open air, creating risk of an infection, Chief Medical Officer Dr. Anish Mahajan says in the statement.

    November 29, 2021 – In an exclusive interview published in Golf Digest, Tiger Woods speaks publicly about his golfing future for the first time since his car crash. “I think something that is realistic is playing the tour one day, never full time, ever again, but pick and choose, just like Mr. (Ben) Hogan did,” Woods tells interviewer Henni Koyack.

    March 9, 2022 – Woods is inducted into the World Golf Hall of Fame at the PGA Tour headquarters in Florida.

    April 7, 2022 – Tees off in the first round of the Masters, his first tournament in 14 months, completing a remarkable comeback after sustaining serious leg injuries in his February 2021 car crash.

    October 2022 – Erica Herman, a former girlfriend of Woods, files a complaint in Martin County, Florida after their six-year relationship comes to end. Herman alleges a trust owned by Woods violated the Florida Residential Landlord Tenant Act by breaking the oral tenancy agreement. On March 6, 2023, Herman files a second complaint aimed at nullifying the NDA she signed in 2017. On May 17, 2023, a Florida judge rules against Herman, calling her claims that the NDA is invalid and unenforceable “implausibly pled.” In June 2023, Herman drops her lawsuit alleging a trust owned by Woods violated the Florida Residential Landlord Tenant Act. In November 2023, Herman drops her appeal to nullify the NDA.

    April 19, 2023 – Announces he has completed “successful” surgery on his ankle following his withdrawal from The Masters earlier this month.

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  • Advances in Knee Replacement Surgery Enable More Patients to Go Home the Same Day

    Advances in Knee Replacement Surgery Enable More Patients to Go Home the Same Day

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    Newswise — Knee replacement surgery in the morning, and back home that evening? Many patients are surprised to learn it is an option. Forgoing a night in the hospital has become increasingly common, and improvements in knee replacement technology, surgical technique and pain management make it possible, says Martin W. Roche, MD, an orthopedic surgeon and director of joint replacement at HSS Florida in West Palm Beach.

    Many patients are pleased to spend the first night after surgery in the comfort of their own home, he says. “We’ve come a long way in terms of being able to get people up and out of the hospital quickly, and that motivates them mentally, as well,” he explains.

    Dr. Roche points to advances over the past five years or so that benefit patients and can lead to a faster recovery: a CT scan before surgery to create a 3D model of the patient’s knee to plan a highly personalized procedure; the use of surgical robotics and sensors that allow for a high degree of precision and accuracy; less invasive, muscle-sparing surgery performed with smaller incisions; and a program called “pre-habilitation,” in which patients begin physical therapy to get stronger prior to knee replacement.

    A longer-lasting regional nerve block and a technique known as multimodal analgesia result in better pain control after surgery − another advantage for patients wishing to leave the hospital the same day, according to Dr. Roche. The technique uses various medications that target multiple pain pathways, as needed, and generally lessens the need for opioid medications.

    The best candidates for outpatient knee replacement are highly motivated individuals in good general health who have the right home environment, including support from family, a friend or a caregiver. 

    Seventy-three-year-old Robert Fleetwood fit the bill. He was motivated to have joint replacement in both knees not only to relieve arthritis pain, but to get back to the athletic activities that were once his passion. He said he was happy to learn he was a candidate for ambulatory surgery. He had two knee replacements several months apart last year and each time went home the same day.

    Dr. Fleetwood, who lives in Stuart, says it changed his life. This year, he participated in a 1K Navy SEAL memorial open water swim, competing with many people half his age. He came in second out of participants ages 60 and up, and 30th out of about 150 swimmers. He is also back to running for exercise for the first time in more than 20 years.

    Dr. Fleetwood, who has a PhD in clinical and industrial organization psychology, travels to Atlanta about 12 times a year for work. Before the knee replacements, he dreaded all the walking at the airport. He is thrilled that he can now travel pain-free.

    “It changes your perspective on life. It makes you feel so much more alive and dynamic when you’re not living with chronic pain that becomes debilitating,” he explains. “I’m very happy now.” 

    About HSS

    HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 14th consecutive year), No. 2 in rheumatology by U.S. News & World Report (2023-2024), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2023-2024). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a fourth consecutive year (2023). Founded in 1863, the Hospital has the lowest readmission rates in the nation for orthopedics, and among the lowest infection and complication rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. In addition, more than 200 HSS clinical investigators are working to improve patient outcomes through better ways to prevent, diagnose, and treat orthopedic, rheumatic and musculoskeletal diseases. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 165 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.

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  • Woman convicted of killing pro cyclist Anna ‘Mo’ Wilson gets 90 years in prison. What happened?

    Woman convicted of killing pro cyclist Anna ‘Mo’ Wilson gets 90 years in prison. What happened?

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    AUSTIN, Texas — The murder trial of a Texas woman charged in the May 2022 shooting death of rising professional cyclist Anna “Mo” Wilson has ended with a guilty verdict and a 90-year prison sentence.

    It took jurors only two hours to convict Kaitlin Armstrong of murder on Thursday and just over three hours to decide her sentence on Friday.

    Investigators said Armstrong fled the U.S. shortly after Wilson was killed and underwent plastic surgery in an attempt to evade authorities.

    Wilson — a Vermont native and former alpine skier at Dartmouth College in New Hampshire — was an emerging star in gravel and mountain bike riding when she was killed in a friend’s apartment in Austin. She had been preparing to participate in a Texas race that she was among the favorites to win.

    In the hours before she was killed, Wilson went swimming and had a meal with Armstrong’s boyfriend, former pro cyclist Colin Strickland, with whom Wilson had a brief romantic relationship months earlier.

    Investigators say Armstrong gunned down Wilson in a jealous rage, then used her sister’s passport to escape the U.S. before she was tracked down and arrested at a beachside hostel in Costa Rica.

    Here’s a look at what happened in the trial:

    There were no witnesses to the shooting or videos that place Armstrong in the apartment when Wilson was gunned down on May 11, 2022. Prosecutors built their case on a tight web of circumstantial evidence.

    Strickland testified that he had to hide Wilson’s phone number from Armstrong under a fake name in his phone. Two of Armstrong’s friends said she told them she wanted to — or could — kill Wilson.

    Vehicle satellite records, phone-tracking data and surveillance video from a nearby home showed Armstrong’s Jeep driving around the apartment and parking in an alley shortly before Wilson was killed. Data from Armstrong’s phone showed it had been used that day to track Wilson’s location via a fitness app that she used to chart her training rides.

    Investigators also said shell casings near Wilson’s body matched a gun Armstrong owned.

    Jurors heard the frantic emergency call from the friend who found Wilson’s body, saw the gruesome police camera footage of first responders performing CPR, and heard audio from a neighbor’s home surveillance system that prosecutors said captured Wilson’s final screams and three gunshots.

    Wilson was shot twice in the head, and once through the heart.

    Police interviewed Armstrong, among others, after Wilson was killed. The day after that interview, Armstrong sold her Jeep for more than $12,000 and headed to Costa Rica, where investigators say she had plastic surgery to change her nose, and she changed her hairstyle and color.

    Armstrong evaded capture for 43 days as she moved around Costa Rica trying to establish herself as a yoga instructor before she was finally caught on June 29.

    The jury also heard about another escape attempt by Armstrong, on Oct. 11, when she tried to flee two corrections officers who had escorted her to a medical appointment outside jail. Video showed Armstrong, in a striped jail uniform and arm restraints, running and trying to scale a fence.

    She was quickly recaptured and faces a separate felony escape attempt charge.

    Armstrong’s lawyers spent only a few hours presenting her defense and she did not testify on her own behalf.

    The defense accused police of a sloppy investigation that too quickly focused on Armstrong as the sole suspect. And they tried to raise doubts among jurors by suggesting someone else could have killed Wilson, asking why prosecutors so quickly dismissed Strickland as a suspect.

    But a police analyst testified that data tracking on Strickland’s phone showed him traveling away from Wilson’s apartment immediately after dropping her off, and taking a phone call at or near his home around the time Wilson was killed.

    Armstrong’s lawyers tried to pick at that data as unreliable and imprecise. They questioned whether someone other than Armstrong had her vehicle and phone that night. They also called an expert on forensic metallurgy to try to debunk as faulty the firearms and tool-marking methods used to match the bullets to Armstrong’s gun.

    The sentencing phase of the trial packed an emotional wallop.

    Caitlin Cash, the friend who found Wilson and pumped her chest 100 times in a desperate attempt to save her through CPR, said she had texted Wilson’s family earlier that day with a picture of her starting a training ride. It included a message, “Your girl is in safe hands here in Austin.”

    “I felt a lot of guilt not being able to protect her,” Cash said. “I fought for her with everything I had.”

    Cash also described Anna Wilson’s mother, Karen, later coming to the apartment and lying on the bathroom floor to put herself in her daughter’s final place, stroking the floor tiles and crying.

    Karen Wilson spoke twice, once before the sentence was delivered, and again afterward.

    “When you shot Moriah in the heart, you shot me in the heart … all the people who loved her, pierced their hearts,” Karen Wilson said, looking at Armstrong as she left the witness stand.

    Armstrong did not appear to return her gaze.

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  • Mark Zuckerberg undergoes knee surgery after the Meta CEO got hurt during martial arts training

    Mark Zuckerberg undergoes knee surgery after the Meta CEO got hurt during martial arts training

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    Mark Zuckerberg’s latest martial arts sparring session sent him to the operating table

    ByALEX VEIGA AP business writer

    November 4, 2023, 3:13 PM

    FILE – Mark Zuckerberg speaks at Georgetown University, on Oct. 17, 2019, in Washington. Zuckerberg, the Meta Platforms CEO and mixed martial arts enthusiast posted on social media Friday, Nov. 3, 3023, that he tore one of his anterior cruciate ligaments, or ACLs, while training for a fight early next year. (AP Photo/Nick Wass, File)

    The Associated Press

    LOS ANGELES — Mark Zuckerberg’s latest martial arts sparring session sent him to the operating table.

    The Meta Platforms CEO and mixed martial arts enthusiast posted on social media Friday that he tore one of his anterior cruciate ligaments, or ACLs, while training for a fight early next year.

    A photo he posted on Instagram shows the tech billionaire lying in a hospital bed with his left knee elevated, bandaged and fit with a brace.

    “Tore my ACL sparring and just got out of surgery to replace it,” Zuckerberg posted on Instagram. “Grateful for the doctors and team taking care of me. I was training for a competitive MMA fight early next year, but now that’s delayed a bit. Still looking forward to doing it after I recover. Thanks to everyone for the love and support.”

    Menlo Park, California-based Meta did not immediately return an email seeking comment Saturday.

    Zuckerberg, who in May completed his first jiu jitsu tournament, has previously posted updates on his martial arts training. A few weeks ago, he shared a close-up photo of his face on Instagram showing bruising on the bridge of his nose and under his eyes, which he attributed to sparring that got “a little out of hand.”

    The Facebook founder and Elon Musk grabbed headlines this summer after the two tech moguls seemingly agreed to an in-person face-off in late June.

    Musk and Zuckerberg fueled interest in the potential match through online jabs at one another, with Musk at one point touting how he was training by lifting weights. But in August, the Tesla CEO posted on social media that he might need surgery before the fight could happen.

    Shortly after, Zuckerberg posted on the Threads social media app that he was ready to move on, writing: “If Elon ever gets serious about a real date and official event, he knows how to reach me. Otherwise, time to move on. I’m going to focus on competing with people who take the sport seriously.”

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  • Mark Zuckerberg undergoes knee surgery after the Meta CEO got hurt during martial arts training

    Mark Zuckerberg undergoes knee surgery after the Meta CEO got hurt during martial arts training

    [ad_1]

    Mark Zuckerberg’s latest martial arts sparring session sent him to the operating table

    ByALEX VEIGA AP business writer

    November 4, 2023, 3:13 PM

    FILE – Mark Zuckerberg speaks at Georgetown University, on Oct. 17, 2019, in Washington. Zuckerberg, the Meta Platforms CEO and mixed martial arts enthusiast posted on social media Friday, Nov. 3, 3023, that he tore one of his anterior cruciate ligaments, or ACLs, while training for a fight early next year. (AP Photo/Nick Wass, File)

    The Associated Press

    LOS ANGELES — Mark Zuckerberg’s latest martial arts sparring session sent him to the operating table.

    The Meta Platforms CEO and mixed martial arts enthusiast posted on social media Friday that he tore one of his anterior cruciate ligaments, or ACLs, while training for a fight early next year.

    A photo he posted on Instagram shows the tech billionaire lying in a hospital bed with his left knee elevated, bandaged and fit with a brace.

    “Tore my ACL sparring and just got out of surgery to replace it,” Zuckerberg posted on Instagram. “Grateful for the doctors and team taking care of me. I was training for a competitive MMA fight early next year, but now that’s delayed a bit. Still looking forward to doing it after I recover. Thanks to everyone for the love and support.”

    Menlo Park, California-based Meta did not immediately return an email seeking comment Saturday.

    Zuckerberg, who in May completed his first jiu jitsu tournament, has previously posted updates on his martial arts training. A few weeks ago, he shared a close-up photo of his face on Instagram showing bruising on the bridge of his nose and under his eyes, which he attributed to sparring that got “a little out of hand.”

    The Facebook founder and Elon Musk grabbed headlines this summer after the two tech moguls seemingly agreed to an in-person face-off in late June.

    Musk and Zuckerberg fueled interest in the potential match through online jabs at one another, with Musk at one point touting how he was training by lifting weights. But in August, the Tesla CEO posted on social media that he might need surgery before the fight could happen.

    Shortly after, Zuckerberg posted on the Threads social media app that he was ready to move on, writing: “If Elon ever gets serious about a real date and official event, he knows how to reach me. Otherwise, time to move on. I’m going to focus on competing with people who take the sport seriously.”

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  • Mark Zuckerberg undergoes knee surgery after the Meta CEO got hurt during martial arts training

    Mark Zuckerberg undergoes knee surgery after the Meta CEO got hurt during martial arts training

    [ad_1]

    Mark Zuckerberg’s latest martial arts sparring session sent him to the operating table

    ByALEX VEIGA AP business writer

    November 4, 2023, 3:13 PM

    FILE – Mark Zuckerberg speaks at Georgetown University, on Oct. 17, 2019, in Washington. Zuckerberg, the Meta Platforms CEO and mixed martial arts enthusiast posted on social media Friday, Nov. 3, 3023, that he tore one of his anterior cruciate ligaments, or ACLs, while training for a fight early next year. (AP Photo/Nick Wass, File)

    The Associated Press

    LOS ANGELES — Mark Zuckerberg’s latest martial arts sparring session sent him to the operating table.

    The Meta Platforms CEO and mixed martial arts enthusiast posted on social media Friday that he tore one of his anterior cruciate ligaments, or ACLs, while training for a fight early next year.

    A photo he posted on Instagram shows the tech billionaire lying in a hospital bed with his left knee elevated, bandaged and fit with a brace.

    “Tore my ACL sparring and just got out of surgery to replace it,” Zuckerberg posted on Instagram. “Grateful for the doctors and team taking care of me. I was training for a competitive MMA fight early next year, but now that’s delayed a bit. Still looking forward to doing it after I recover. Thanks to everyone for the love and support.”

    Menlo Park, California-based Meta did not immediately return an email seeking comment Saturday.

    Zuckerberg, who in May completed his first jiu jitsu tournament, has previously posted updates on his martial arts training. A few weeks ago, he shared a close-up photo of his face on Instagram showing bruising on the bridge of his nose and under his eyes, which he attributed to sparring that got “a little out of hand.”

    The Facebook founder and Elon Musk grabbed headlines this summer after the two tech moguls seemingly agreed to an in-person face-off in late June.

    Musk and Zuckerberg fueled interest in the potential match through online jabs at one another, with Musk at one point touting how he was training by lifting weights. But in August, the Tesla CEO posted on social media that he might need surgery before the fight could happen.

    Shortly after, Zuckerberg posted on the Threads social media app that he was ready to move on, writing: “If Elon ever gets serious about a real date and official event, he knows how to reach me. Otherwise, time to move on. I’m going to focus on competing with people who take the sport seriously.”

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  • Dr. Jonathan Woodson Is Fourth Recipient of American College of Surgeons Distinguished Lifetime Military Contribution Award

    Dr. Jonathan Woodson Is Fourth Recipient of American College of Surgeons Distinguished Lifetime Military Contribution Award

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    Newswise — Boston (October 23, 2023): Retired USAR Major General Jonathan Woodson, MD, MSS, FACS, MG, MC, renowned for his significant contributions to both military and civilian surgical care, was honored with the American College of Surgeons (ACS) Distinguished Lifetime Military Contribution Award during the ACS Clinical Congress 2023 in Boston, Massachusetts. Established by the Board of Regents in 2018, the award is selectively conferred based on merit, rather than annually. 

    Dr. Woodson is a quadruple-board-certified surgeon whose career has intertwined military service, surgical practice, and leadership in education. After earning his medical degree from New York University School of Medicine in New York City, Dr. Woodson completed residency training in internal medicine and general and vascular surgery at Massachusetts General Hospital and Harvard Medical School in Boston. He also completed fellowships in general, vascular, and critical care surgery at Waltham Weston Hospital & Medical Center in Massachusetts and Massachusetts General Hospital. 

    Dr. Woodson attained board certification in internal medicine, general surgery, surgical critical care, and vascular surgery. In addition, he completed a fellowship at the Health Services Research Institute of the Association of American Medical Colleges in Washington, D.C., and later, a master’s degree in strategic studies from the U.S. Army War College in Carlisle, Pennsylvania.  

    His career achievements also include several years as the Lars Anderson Professor in Management and Professor of the Practice at Boston University Questrom School of Business, with joint appointments as professor of surgery at the school of medicine and professor of health law, policy, and management at the school of public health. At Boston University, he also established and led the Institute for Health System Innovation and Policy.   

    At present, Dr. Woodson is the president of the Uniformed Services University (USU) of the Health Sciences in Bethesda, Maryland, where he leads the F. Edward Hébert School of Medicine and its associated graduate programs in the biomedical sciences, public health, nursing, dentistry, and allied health. Prior to assuming this role in 2022, Dr. Woodson was appointed as a member of the USU Board of Regents in 2016 and served as its chair from 2019 to 2021.   

    Dr. Woodson’s military achievements span several countries. He joined the military in 1986 as a Captain and served for 36 years, retiring as a Major General of the U.S. Army Reserve and Commander of the U.S. Army Reserve Medical Command of Pinellas Park, Florida, in 2022.   

    During his military career, Dr. Woodson was deployed to Saudi Arabia for Operation Desert Storm, to Afghanistan during Operation Enduring Freedom, and to Iraq during Operation Iraqi Freedom, as well as to Kosovo. Additionally, in 2010, President Barack Obama appointed Dr. Woodson the Assistant Secretary of Defense for Health Affairs and Director of the Tricare Management Activity in the U.S. Department of Defense, a role he held until 2016.  

    Notably, Dr. Woodson is the second winner of the Distinguished Lifetime Military Contribution Award who responded to the terrorist attacks of September 11, 2001. The 2021 winner, Lieutenant General (Retired) Paul K. Carlton, MD, FACS, was present in the Pentagon in Washington, D.C., at the time of the airplane crash and helped rescue three colleagues from the burning building immediately afterward. Dr. Woodson’s contribution to the rescue operation was at the World Trade Center in New York City, where he responded as a senior medical officer with the U.S. National Disaster Medical System.  

    In nomination materials for the Distinguished Lifetime Military Contribution Award, Board of Regents member Anton N. Sidawy, MD, MPH, FACS, wrote, “Jonathan is the ultimate officer, gentleman, and scholar. He is highly respected, transparent, and extremely thoughtful.”  

    When asked about the award, Dr. Woodson responded with a modesty that reflected Dr. Sidawy’s description. He said, “To think that the College would honor me with a lifetime achievement award is unexpected, and I’m very humbled by it and very honored.” 

    The Distinguished Lifetime Military Contribution Award was established by the ACS Board of Regents’ Honors Committee in 2018 to recognize a physician’s distinguished contributions to the advancement of military surgery. Recipients for this Award must be a physician with a demonstrated commitment to the advancement of military surgical care but are not required to be in active medical practice. 

    # # # 

    About the American College of Surgeons 
    The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has approximately 90,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the American College of Surgeons. 

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    American College of Surgeons (ACS)

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  • Little light, no beds, not enough anesthesia: A view from Gaza’s hospitals

    Little light, no beds, not enough anesthesia: A view from Gaza’s hospitals

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    DEIR AL-BALAH, Gaza Strip — The only thing worse than the screams of a patient undergoing surgery without enough anesthesia are the terror-stricken faces of those awaiting their turn, a 51-year-old orthopedic surgeon says.

    When the Israeli bombing intensifies and the wounded swamp the Gaza City hospitals where Dr. Nidal Abed works, he treats patients wherever he can — on the floor, in the corridors, in rooms crammed with 10 patients instead of two. Without enough medical supplies, Abed makes do with whatever he can find – clothes for bandages, vinegar for antiseptic, sewing needles for surgical ones.

    Hospitals in the Gaza Strip are nearing collapse under the Israeli blockade that cut power and deliveries of food and other necessities to the territory. They lack clean water. They are running out of basic items for easing pain and preventing infections. Fuel for their generators is dwindling.

    Israel began its bombing campaign after Hamas militants surged across the border on Oct. 7 and killed over 1,400 people, mostly civilians, and abducted more than 200 others. Israel’s offensive has devastated neighborhoods, shuttered five hospitals, killed thousands and wounded more people than its remaining health facilities can handle.

    “We have a shortage of everything, and we are dealing with very complex surgeries,” Abed, who works with Doctors Without Borders, told The Associated Press from Al Quds Hospital. The medical center is still treating hundreds of patients in defiance of an evacuation order the Israeli military gave Friday. Some 10,000 Palestinians displaced by the bombing have also taken refuge in the hospital compound.

    “These people are all terrified, and so am I,” the surgeon said. “But there is no way we’ll evacuate.”

    The first food, water and medicine trickled into Gaza from Egypt on Saturday after being stalled on the border for days. Four trucks in the 20-truck aid convoy were carrying drugs and medical supplies, the World Health Organization said. Aid workers and doctors warned it was not nearly enough to address Gaza’s spiraling humanitarian crisis.

    “It’s a nightmare. If more aid doesn’t come in, I fear we’ll get to the point where going to a hospital will do more harm than good,” Mehdat Abbas, an official in the Hamas-run Health Ministry, said.

    Across the territory’s hospitals, ingenuity is being put to the test. Abed used household vinegar from the corner store as disinfectant until the stores ran out, he said. Too many doctors had the same idea. Now, he cleans wounds with a mixture of saline and the polluted water that trickles from taps because Israel cut off the water.

    A shortage of surgical supplies forced some staff to use sewing needles to stitch wounds, which Abed said can damage tissue. A shortage of bandages forced medics to wrap clothes around large burns, which he said can cause infections. A shortage of orthopedic implants forced Abed to use screws that don’t fit his patients’ bones. There are not enough antibiotics, so he gives single pills rather than multiple courses to patients suffering terrible bacterial infections.

    “We are doing what we can to stabilize the patients, to control the situation,” he said. “People are dying because of this.”

    When Israel cut fuel to the territory’s sole power plant two weeks ago, Gaza’s rumbling generators kicked in to keep life-support equipment running in hospitals.

    Authorities are desperately scrounging up diesel to keep them going. United Nations agencies are distributing their remaining stocks. Motorists are emptying their gas tanks.

    In some hospitals, the lights have already switched off. At Nasser Hospital in the southern city of Khan Younis this week, nurses and surgical assistants held their iPhones over the operating table, guiding the surgeons with the flashlights as they snipped.

    At Shifa Hospital, Gaza’s biggest, where Abed also worked this week, the intensive care unit runs on generators but most other wards are without power. Air conditioning is a bygone luxury. Abed catches beads of sweat dripping from his patients’ foreheads as he operates.

    People wounded in the airstrikes are overwhelming the facilities. Hospitals don’t have enough beds for them.

    “Even a normal hospital with equipment would not be able to deal with what we’re facing,” Abed said. “It would collapse.”

    Shifa Hospital — with a maximum capacity of 700 people — is treating 5,000 people, general director Mohammed Abu Selmia says. Lines of patients, some in critical condition, snake out of operating rooms. The wounded lie on floors or on gurneys sometimes stained with the blood of previous patients. Doctors operate in crowded corridors filled with moans.

    The scenes — infants arriving alone to intensive care because no one else in their family survived, patients awake and grimacing in pain during surgeries — have traumatized Abed into numbness.

    But what still pains him is having to choose which patients to prioritize.

    “You have to decide,” he said. “Because you know that many will not make it.”

    ___

    DeBre reported from Jerusalem.

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  • ESMO: Pre- and post-surgical immunotherapy improves outcomes for patients with operable lung cancer

    ESMO: Pre- and post-surgical immunotherapy improves outcomes for patients with operable lung cancer

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    Newswise — MADRID ― Compared with pre-surgical (neoadjuvant) chemotherapy alone, adding perioperative immunotherapy – given before and after surgery – significantly improved event-free survival (EFS) in patients with resectable early-stage non-small cell lung cancer (NSCLC). Results from the Phase III CheckMate 77T study were presented today at the 2023 European Society for Medical Oncology (ESMO) Congress by researchers from The University of Texas MD Anderson Cancer Center.

    At a median follow-up of 25.4 months, the median EFS with chemotherapy alone was 18.4 months, while the median had not yet been reached for patients receiving perioperative nivolumab, meaning EFS was prolonged significantly over the control group. These results correspond to a 42% reduction in risk of disease progression, recurrence, or death for those receiving the perioperative combination.

    Patients who received the perioperative nivolumab-based regimen also saw significantly higher rates of pathological complete response (pCR), defined as no tumor remaining at surgery, compared with those who received chemotherapy alone (25.3% vs. 4.7%). Rates of major pathological response (MPR), less than or equal to 10% of viable tumor cells remaining at time of surgery, were also higher in patients who received perioperative immunotherapy (35.4% vs. 12.1%).

    “This study builds on the standard-of-care neoadjuvant treatment and supports perioperative nivolumab as an effective approach that reduces the risk of lung cancer relapse,” said principal investigator Tina Cascone, M.D., Ph.D., associate professor of Thoracic/Head & Neck Medical Oncology. “These findings add to evidence that the perioperative immunotherapy path gives patients with operable lung cancer an opportunity to live longer without their cancer returning.”

    Roughly 30% of patients diagnosed with NSCLC have operable disease, meaning their tumor can be removed by a surgical operation. While many of these patients can be potentially cured by surgery, more than half will experience cancer recurrence without additional therapy. Chemotherapy given either before or after surgery provides only a minimal survival benefit.

    The randomized, double-blind CheckMate 77T trial, which began in 2019, included more than 450 NSCLC patients over the age of 18 from around the globe. Participants were randomized to treatment with either neoadjuvant nivolumab with chemotherapy followed by surgery and adjuvant nivolumab, or neoadjuvant chemotherapy and placebo followed by surgery and adjuvant placebo

    The data showed no new safety signals with the perioperative nivolumab regimen and is consistent with the known safety profiles of individual agents. Grade 3-4 treatment-related side effects were observed in 32% and 25% of patients receiving the perioperative combination or control therapy, respectively. Surgery-related adverse events occurred in 12% of patients in both treatment arms.

    These findings add to recent success seen with neoadjuvant nivolumab plus chemotherapy in NSCLC. In March 2022, the Phase III CheckMate 816 study led to FDA approval of nivolumab combined with platinum-based chemotherapy.

    “I am enthusiastic about the initial findings of the study,” Cascone said. “Looking ahead, it will be critical to identify patient and disease characteristics that will tell us who can potentially be cured with neoadjuvant immunotherapy only and who will benefit from more intensified treatment strategies.”

    The CheckMate 77T study was sponsored by Bristol Myers Squibb. A full list of co-authors and author disclosures can be found here.

    Read this press release on the MD Anderson Newsroom. 

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    University of Texas MD Anderson Cancer Center

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