Reuven Zimlichman

Patients who had symmetric tibial augment constructs exhibited similar rates of radiolucency but higher survivorship compared to those with asymmetric constructs overall. However, when metaphyseal cones were utilized, survivorship was equivalent. https://lnkd.in/g5eAfzZh

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🏅A milestone moment in #melanoma care in Israel. The #NADINA Study has redefined the management of operable, clinically node-positive melanoma. Just two pre-operative cycles led to a 60% pathological complete response and a dramatic improvement in outcomes like relapse free survival, while eliminating the need for a full year of post-surgery therapy for many patients. I am deeply proud that Clalit Health Services, insuring over half of Israel’s population, has now adopted the NADINA regimen into #policy. This decision was driven by our expert clinical recommendation and was reinforced by rigorous economic, ethical, and equity considerations that followed. 📣This groundbreaking approach is now accessible to the broad Israeli public! 🙏 Big thank you to all of the excellent partners at the Community Division of Clalit: Dr Doron Netzer, Dr Lilach Dolev, Dr Rachel Lucati; and Prof Daniel Goldstein from the #DavidoffCenter at Beilinson - Rabin Medical Center. #oncology #cancer #immunotherapy #treatment #access #melanomacare

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𝘠𝘦𝘴 𝘛𝘪𝘮𝘮𝘺, 100 𝘺𝘦𝘢𝘳𝘴 𝘢𝘨𝘰 — 𝘣𝘢𝘤𝘬 𝘪𝘯 2025 — 𝘵𝘩𝘦𝘺 𝘩𝘢𝘥 𝘢 𝘸𝘰𝘳𝘥 𝘤𝘢𝘭𝘭𝘦𝘥 𝗵𝗲𝗮𝗹𝘁𝗵𝘆! 𝘉𝘦𝘧𝘰𝘳𝘦 𝘛𝘩𝘦 𝘎𝘳𝘦𝘢𝘵 𝘈𝘐 𝘙𝘦𝘷𝘦𝘢𝘭 𝘴𝘩𝘰𝘸𝘦𝘥 𝘶𝘴 𝘸𝘦’𝘳𝘦 𝘢𝘭𝘭 𝘫𝘶𝘴𝘵 𝗽𝗿𝗲-𝗱𝗶𝘀𝗲𝗮𝘀𝗲. 📊 Two recent papers make it clear that with enough data, we can predict your medical future: — Epic’s Comet model simulates entire patient timelines, predicting sequences of diagnoses years in advance. — Delphi-2M, trained on UK + Denmark data, forecasts the probability of more than 1,000 diseases across a person’s life, essentially mapping our health futures. Even Peter Attia’s 𝘔𝘦𝘥𝘪𝘤𝘪𝘯𝘦 3.0 and the healthspan crowd admit it: not if you get a chronic disease, but when. Doctors already know this: risk isn’t an exception. It isn’t optional. It’s the baseline. Everyone becomes a patient-in-waiting. But here’s my worry: 𝗔𝗹𝗴𝗼𝗿𝗶𝘁𝗵𝗺𝘀 𝘄𝗶𝗹𝗹 𝗲𝘃𝗲𝗿-𝗲𝘅𝗽𝗮𝗻𝗱 𝘁𝗵𝗲 𝗱𝗲𝗻𝗼𝗺𝗶𝗻𝗮𝘁𝗼𝗿. Genes that tie your DNA to cancer. Mammograms that downgrade “normal” to “high-risk normal.” EKGs that don’t clear you, just rank you as "a low-risk profile compared to others statistically identical to you." And while the algorithm might notice the shortage, it won’t conjure more doctors — only more anxious, pre-disease humans under its spell. Left unchecked, AI risks turning life into a giant labeling machine. More “pre-diabetic,” “pre-dementia,” “pre-everything” than we could ever treat. And no matter how many Functional Medicine supplements you swallow or cold plunges you plunge — y'gotta get something. So maybe the real value of AI isn’t more 𝗽𝗼𝗽𝘂𝗹𝗮𝘁𝗶𝗼𝗻 𝘀𝗰𝗿𝗲𝗲𝗻𝗶𝗻𝗴. It’s less. More targeted. More precise. Who should get the scan? The asymptomatic guy with <1% cancer risk? Or the asymptomatic guy with a 10x higher profile? Yes Timmy, they once called it “healthy.” Then The Great AI Reveal came along — and suddenly sleepiness was “pre-narcolepsy,” gray hair was “pre-dementia,” and being alive was a risk factor for 𝘱𝘳𝘦-𝘥𝘦𝘢𝘵𝘩. Medicine will medicalize it all if you let it.

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New Breakthrough in #Cancer_Research (2025). For the first time, researchers have directly linked a common virus (#betaHPV) to the growth of aggressive cutaneous squamous cell carcinoma (#cSCC). In a recent NEJM (2025) case study ( https://lnkd.in/d_3SAyxJ ), a 34-year-old woman with a rare immune deficiency developed recurrent, treatment-resistant cSCC. Scientists discovered that beta-HPV had integrated into her tumor’s DNA, fueling its growth. Remarkably, after receiving a bone marrow stem cell transplant that restored her immune system, both her cancer and HPV-related symptoms disappeared. This case highlights how viruses typically harmless in healthy people can become dangerous in immunocompromised patients. It also underlines the importance of immune-based and personalized cancer treatments. Such findings could pave the way for better diagnostics, targeted therapies, and new strategies in oncology, especially for vulnerable patients

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(((TSH Suppression After Differentiated Thyroid Cancer: Don’t Aim for “Normal” Too Soon 👌👌))) As an endocrinologist, I frequently see well-meaning clinicians reduce levothyroxine doses in thyroid cancer survivors simply to “normalize” TSH. 🤦🏻‍♂️ But here’s the clinical truth: in thyroid cancer follow-up, normal is not always safe. 🎯 What Should the TSH Target Be? 🔹 ATA Guidelines (2015) recommend a risk-stratified approach: • High-risk DTC: Keep TSH <0.1 mIU/L • Intermediate-risk: Target 0.1–0.5 mIU/L • Low-risk (remission): Allow 0.5–2.0 mIU/L Why? Suppression reduces recurrence risk in high/intermediate-risk patients. What Do the Latest Studies Say? 📘 Lancet eClinical 2024: In low-risk papillary thyroid cancer, TSH level after surgery was not predictive of recurrence—suggesting suppression may not be necessary in this group. 📘 Canadian Consensus 2025: Recommends short-term suppression only for low-risk DTC, with de-escalation after remission and shared care with primary providers. 📘 Frontiers in Endocrinology 2023: Reinforces ATA strategy but warns of overtreatment risks especially in elderly and postmenopausal women (atrial fibrillation, osteoporosis). How Long Should Suppression Last? • Intermediate/High-risk: Maintain suppression for at least 5 years, or longer if persistent disease or high recurrence risk. • Low-risk: De-escalate gradually after confirmed remission. Monitor for changes in thyroglobulin, imaging, and patient comorbidities. What About Pregnancy? • ATA 2017 + recent studies (2023–2024) suggest that: • Pregnancy is safe post-thyroid cancer if conception occurs ≥1 year after treatment. • Maintain TSH ~0.1–1.0 mIU/L during pregnancy. • Check TSH every 4–6 weeks and adjust LT4 dose proactively. This protects both fetal neurodevelopment and maternal cancer status. ⚠️ Key Message for Non-Endocrinologists: -Do not aim for a “normal” TSH blindly in thyroid cancer survivors. -TSH targets must reflect cancer risk, time since treatment, pregnancy status, and age/comorbidity profile. -Dosing is not cosmetic. It’s oncologic. -To conclude: 👇👇 ✅ High risk → TSH <0.1 ✅ Intermediate → TSH 0.1–0.5 ✅ Low risk → TSH 0.5–2.0 ✅ Pregnancy → TSH 0.1–1.0 ✅ Elderly/postmenopause → Weigh suppression risks

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🌟 NSAIDs – The 5 A’s 🌟 Mnemonic-based Benefits of NSAIDs Designed for Clinical Use and Medical Education --- 🩸 1. Analgesia Relieves pain by inhibiting prostaglandin synthesis, especially in inflammation-induced pain. 🌡️ 2. Antipyretic Reduces fever by acting on the hypothalamic heat-regulating center. 🔥 3. Anti-inflammatory Decreases inflammation in tissues by blocking cyclooxygenase (COX), reducing prostaglandins. 🩹 4. Antithrombotic Inhibits platelet aggregation (especially aspirin), useful in cardiovascular protection. 👶 5. Arteriosus Closure Used to help close a patent ductus arteriosus (PDA) in neonates (e.g. indomethacin). --- 📌 Mnemonic: Analgesia Antipyretic Anti-inflammatory Antithrombotic Arteriosus (PDA closure) #Pharmacology #NSAIDs #MedicalEducation #ClinicalPharmacy #DrugMechanism #HealthcareProfessionals #MedicalStudents #PharmacistLife #EvidenceBasedMedicine #PharmaMnemonics #MedicalLearning #PharmacyEducation #Therapeutics #PharmacistInTheMaking

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Toward Assessment of Tubular Function in Kidney Disease Journal of the American Society of Nephrology 36(6):p 1201-1203, June 2025. DOI: 10.1681/ASN.0000000705 The current assessment of kidney health relies on eGFR and albuminuria and has served the nephrology community well. However, there is a pressing need to improve this assessment to better identify early kidney injury and determine optimal treatments for specific patients. On critical evaluation of current kidney health assessment, three limitations stand out: (1) the lack of an index of tubular function, (2) reliance on a single urinary biomarker, and (3) assessment based solely on static testing.

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🔬 A New Hope for Glioblastoma (GBM) At Brigham and Women’s Hospital (BWH), researchers have started in-human trials of RZ-001, a cutting-edge RNA-based gene therapy targeting hTERT-positive GBM. This innovative treatment selectively kills tumor cells by recognizing cancer-specific RNA, while sparing healthy tissue and it can cross the blood-brain barrier. Developed by a South Korean biotech company, RZ-001 is now being tested in the U.S. through an Expanded Access Program led by Dr. Pier Paolo Peruzzi, in close collaboration with Dr. Antonio Chiocca, Kevin Zinchuk, PharmD, and Rosy Issa, PharmD. A strong example of global collaboration and clinical innovation bringing hope to patients who previously had none. #Glioblastoma #RZ001 #NeuroOncology #MassGeneralBrigham #Innovation #GeneTherapy #GlobalScience #ClinicalTrials #HopeInScience #MGB

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