Medical Breakthroughs From Penn Medicine

Host: Lee Freedman, MD Guest: Neil Malhotra, MD How much do quality improvement efforts improve quality of life for neurosurgical patients? Host Dr. Lee Freedman talks to Dr. Neil Malhotra, assistant professor of neurosurgery at the University of Pennsylvania and the Penn Neurological Institute of the Pennsylvania Hospital, about new efforts to improve outcomes in this area. They also look at latest treatments and techniques in Dr. Malhotra's area of surgical expertise, the treatment of degenerative disc disease.

Host: Lee Freedman, MD Guest: Grace Wang, MD, FACS Dr. Grace Wang, vascular surgeon in the division of vascular and endovascular surgery at Penn Medicine, discusses aortic disease from a surgeon's perspective, with host Dr. Lee Freedman. Among the topics they explore are the importance of history and physical exams, imaging modalities, genetic components, management of anneurisms, surveillance, outpatient and inpatient care.

Host: Lee Freedman, MD Guest: Thomas Guzzo, MD, MPH With 70,000 new cases each year in the US, bladder cancer is more common than many Americans may realize. As many as half of cases are caused by smoking, and many others are caused by environmental or occupational exposure. In determining appropriate treatment, staging and diagnosis are critical. Dr. Thomas Guzzo discusses the various treatment options with host Lee Freedman, with the overall goal to preserve quality of life. As a surgeon trained in a wide variety of surgical options, Dr. Guzzo discusses the advantages of each. He also discusses urinary diversions, including the neobladder.

Host: Lee Freedman, MD Guest: Michael Ruckenstein, MD In this week's Medical Breakthroughs from Penn Medicine, Dr. Michael Ruckenstein, director of the Center for Implantable Hearing Devices at Penn Medicine, discusses with host Dr. Lee Freedman the only human sense for which total loss can be medically restored: hearing. They talk about which patients with hearing loss might benefit from a cochlear implant instead of a hearing aid. And they'll explore what we know so far about personal music players' role in hearing loss.

Host: Lee Freedman, MD Guest: Erica Thaler, MD Sleep apnea is becoming more prevalent in the population, and there are many treatment options. Host Dr. Lee Freedman talks with Dr. Erica Thaler, director of the division of otorhinolaryngology: head and neck surgery at Penn Medicine. Many patients are not willing to be treated, or not treated adequately, with continuous positive airway pressure (CPAP). This conversation focuses on Trans-Oral Robotic Surgery (TORS) as a treatment option, including effectiveness, how to evaluate potential candidates, and when the procedure is contraindicated.

Host: Lee Freedman, MD Guest: John Y.K. Lee, MD 3-D technology is making its way from the movies, into the operating room. How is this technology enhancing brain surgeries? Dr. John Y.K. Lee, medical director of the Penn Gamma Knife Center and assistant professor of neurosurgery at Penn Medicine, describes the advantages of using 3-D technology for removing various types of ventral skull-based tumors, and says the stereoscopic views provided by a 3-D endoscope help neurosurgeons preserve critical areas of the brain. Will 3-D endoscopes replace their 2-D predecessors? Dr. Lee Freedman hosts. Produced in Cooperation with

Guest: Patricia Ford, MD Host: Lee Freedman, MD Patients may choose bloodless medicine for either medical or ethical reasons. How safe and effective are bloodless procedures, compared to more traditional approaches? Dr. Patricia Ford, clinical associate professor of medicine, medical director of the Center for Bloodless Medicine and Surgery and director of the peripheral stem cell program at Penn Medicine, says that while bloodless medicine began as a way to meet the medical needs of Jehovah's Witnesses patients, the science also has broader implications. As many as 30% of blood transfusions may be unnecessary. What alternatives and strategies can healthcare providers use to ensure best patient blood management, and perhaps reduce the need for blood transfusions? Furthermore, what are the specific implications of bloodless medicine for stem cell transplants in particular? Dr. Lee Freedman hosts.    Produced in Cooperation with  

Guest: Suleena Kalra, MD Host: Lee Freedman, MD Primary and secondary amenorrhea can have various underlying causes among adolescents, including polycystic ovarian syndrome (or PCOS), thyroid disease, and atypical body weight. What types of behavior and lifestyle modifications should be the first steps for adolescent patients with irregular menstruation? Dr. Suleena Kalra, assistant professor in the department of obstetrics and gynecology at Penn Medicine, discusses ways to regulate periods among adolescent patients and protect their future fertility. How significant a role might stress play in amenorrhea among these patients? Dr. Lee Freedman hosts.   Produced in Cooperation with

Guest: Gary Falk, MD Host: Lee Freedman, MD Millions of Americans have esophageal disorders, ranging in severity from gastroesophogeal reflux (or GERD) to eosinophilic esophagitis to esophageal cancer. A diet rich in acidic or fatty foods can be to blame, but there are a number of other factors that may contribute to the development of GI disorders. When can physicians rely on empirical use of proton pump inhibitors, and when is endoscopy warranted? Dr. Gary Falk, professor of medicine in the division of gastroenterology at Penn Medicine, discusses some of the reasons for the increasing incidence of esophageal cancer and Barrett's esophagus in the U.S. What latest developments can help physicians optimally manage patients with these GI disorders? Dr. Falk also discusses the role of motility in acid reflux, and reviews current medication options for the condition. Dr. Lee Freedman hosts.    Produced in Cooperation with

Guest: Nazanin Moghbeli, MD, MPH Host: Lee Freedman, MD How can physicians assess and minimize the risk for women with existing heart disease prior to pregnancy? As many women are waiting longer to become pregnant, is the spectrum of cardiovascular disease among pregnant women changing as well? Dr. Nazanin Moghbeli, founder and director of the Women's Cardiovascular Center at Penn Medicine, joins host Dr. Lee Freedman to discuss ways to optimize outcomes for pregnant women with structural heart disease, as well as how to minimize the risks of complications that can arise during pregnancy for these patients. Dr. Moghbeli specifically talks about recommendations for women with peripartum cardiomyopathy, pulmonary hypertension, preeclampsia and congenital heart disease.    Produced in Cooperation with

Guest: Nuzhat Ahmad, MD Host: Lee Freedman, MD Although capsule endoscopy has been used since the start of the new millennium, the technology is still evolving and improving. Capsule endoscopy can help gastroenterologists visualize abnormalities in the small bowel, and offers many advantages over a traditional endoscopy, including less arduous preparation time. What are the common indications for capsule endoscopy, other than for obscure GI bleeding? Dr. Nuzhat Ahmad, assistant professor of medicine in the department of medicine and associate director of endoscopic services at Penn Medicine, also discusses the future of capsule endoscopy, and predicts that the next uses for the technology will allow the capsules to perform biopsies and provide injection therapies. Dr. Lee Freedman hosts. Produced in Cooperation with

Guest: Joseph Serletti, MD Host: Lee Freedman, MD How are the latest advances in autogenous breast reconstruction changing the landscape of options available to women after mastectomy? Dr. Joseph Serletti, the Henry Royster - William Maul Measey professor of surgery and chief of the division of plastic surgery at Penn Medicine, discusses the history and evolution of breast reconstruction surgery, as well as the various types of free flap breast reconstruction that offer better cosmetic results for patients. How can the risk of thrombosis be minimized for patients undergoing these procedures? Dr. Lee Freedman hosts. Produced in Cooperation with

Host: Lee Freedman, MD Guest: James Palmer, MD Sinusitis can be debilitating. Complex frontal sinus disease may be categorized as infectious, or due to tumors or trauma. When frontal sinus disease is refractory to medical management, what types of surgery should we consider? Dr. James Palmer, associate professor and director of the division of rhinology in the department of otorhinolaryngology: head and neck surgery, at Penn Medicine, discusses advances in endoscopic surgical techniques for complex frontal sinus disease. Dr. Lee Freedman hosts.

Guest: Michal Elovitz, MD Host: Lee Freedman, MD The preterm birth rate in the United States is increasing, despite efforts to expand research and studies in this area. What are some of the risk factors for preterm birth, and are there any ways we can prevent preterm birth? Dr. Michal Elovitz, associate professor of obstetrics and gynecology, and director of the Maternal and Child Health Research Program, in the department of obstetrics and gynecology, at Penn Medicine, examines results of completed and ongoing trials aimed at preventing premature delivery among high-risk women with a history of prior preterm birth. What are future directions for research in this area? Tune in to hear host Dr. Lee Freedman explore these questions and more about preterm birth. Produced in Cooperation with

Guest: Scott Levin, MD Host: Lee Freedman, MD Trauma patients with injury to one or more limb often have additional systemic injuries that need to be considered during treatment. One approach to limb salvage is the ortho-plastic technique, which involves integrated soft tissue and bone. This conversation covers some of the latest advances in limb salvage techniques that might benefit trauma patients, as well as those with diabetes or peripheral vascular disease. Dr. Scott Levin, professor and chair of orthopaedic surgery and professor of plastic surgery at Penn Medicine, discusses strategies for avoiding amputation. Dr. Lee Freedman hosts. Produced in Cooperation with  

Guest: Anuja Dokras, MD, PhD Host: Lee Freedman, MD In what situations do couples consider preimplantation genetic diagnosis, or PGD, and should all of these couples undergo genetic counseling prior to PGD? What is the process for PGD? How accurate has PGD testing become, and what are its remaining limitations? How does preimplantation genetic screening differ from PGD? Host Dr. Lee Freedman addresses these questions and more with Dr. Anuja Dokras, medical director of the in vitro fertilization program at Penn Fertility Care and associate professor of obstetrics and gynecology at Penn Medicine. Produced in Cooperation with  

Guest: James Metz, MD Host: Lee Freedman, MD Proton therapy has existed for decades, but it's only recently begun to be clinically adopted. Rather than being a stand-alone treatment, this therapy is often best used in conjunction with surgery or chemotherapy. Outside of oncology, what other conditions might proton therapy be used to treat? Join host Dr. Lee Freedman and his guest, Dr. James Metz, vice chair of the department of radiation oncology at Penn Medicine, to learn more about future directions of proton therapy.

Guest: Michelle Alonso-Basanta, MD, PhD Host: Lee Freedman, MD What are the limitations of conventional treatment for primary bone cancer and spinal metastasis? How can proton therapy be particularly beneficial for treating primary bone tumors, which are found more often in pediatric patients? And what role can proton therapy play for patients with spinal metastasis? Dr. Michelle Alonso-Basanta, the Helene Blum Assistant Professor in the department of radiation oncology at Penn Medicine, discusses some of the advantages of proton therapy, including precise targeting and reduced toxicity. Dr. Lee Freedman hosts.

Guest: Robert Lustig, MD Host: Lee Freedman, MD What advantages are there to using proton therapy to treat brain tumors? Is proton therapy most effective when used alone or when it is integrated with conventional radiation therapy? What patients might benefit the most from proton therapy for treating their brain tumors? Dr. Robert Lustig, professor of clinical radiation oncology and director of clinical operations in the department of radiation oncology at Penn Medicine, describes this exciting new therapy. Hosted by Dr. Lee Freedman. Produced in Cooperation with

Guest: David Porter, MD Host: Lee Freedman, MD The conventional bone marrow transplant procedure can have many side effects, and the traditional procedure can be especially risky for older patients or other patients with comorbidities. How are novel approaches of bone marrow and stem cell transplantation attempting to limit the toxicity and improve the safety of the procedure? Our guest, Dr. David Porter, professor of medicine and director of stem cell transplantation at Penn Medicine, discusses how using an immunosuppresive approach to the bone marrow transplant procedure may benefit a greater number of patients. Hosted by Dr. Lee Freedman. Produced in Cooperation with