Yehuda Schwarz

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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🏅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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CARDIOLOGY PEARL🔎‼️ 🔴INFO ON TROPS IN CARDIOLOGY 🧠🫀🔎🫁 👉Troponin is a biomarker of myocardial cell damage, but an elevation does not equate to #ACS. While ACS (e.g., unstable angina, non-ST-elevation MI, or ST-elevation MI) often causes a rising and falling troponin pattern indicative of acute ischemia, other mechanisms like demand ischemia, direct myocardial trauma, or systemic stressors can also lead to leaks from the heart's cytosolic or structural troponin pools. 👉 Unexplained or minor elevations are rare but can occur in conditions such as critical illness or even ultra-endurance exercise, though these are not always tied to irreversible necrosis✍️✅️ 👉Always evaluate troponin in conjunction with clinical history, #ECG changes, and symptoms. A dynamic rising and falling pattern (e.g., ≥20% change) supports ACS or acute injury, while persistently elevated but stable levels suggest chronic conditions like #CKD or stable heart failure. 👉Serial testing (e.g., at 1–3 hours with hs-cTn) helps differentiate, and imaging like echocardiography or MRI may be needed for confirmation (e.g., in suspected myocarditis) 👉Avoid treating non-thrombotic elevations with antiplatelet/antithrombotic agents without evidence of ACS, as this lacks supportive data and may cause harm🚫💔 👉In perioperative settings, monitor high-risk patients (e.g., >65 years or with CV risks) with serial troponins to detect avoidable triggers like hypotension or anemia. #Cardiology #Troponin #MyocardialInjury #AcuteCoronarySyndrome #MedicalEducation #ClinicalPearl #Healthcare #CardiovascularHealth #Diagnosis #Medicine #Cardiology #EmergencyMedicine #ICUSpecialists #AcuteMyocardialInfarction #KillipClassification #ERRiskStratification #Cardiologists #EmergencyPhysicians #ICUNurses #HealthcareProfessionals #Physicianlife #PhysicianOfLinkedlin #EmergencyPhysicians #Emergencymedicine #interns #Medicalstudents

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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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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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CORCINCH-HF (NCT04331769) is a prospective, randomized, open-label, international, multicenter clinical trial designed to evaluate the safety and efficacy of the AccuCinch® Ventricular Restoration System in patients with heart failure with reduced ejection fraction (HFrEF), compared with guideline-directed medical therapy alone. The study aims to enroll 400 patients, and recruitment is progressing well—now beyond the halfway point. Today, our team successfully completed procedure number 119 worldwide, implanting the device in one of the 257 patients randomized to date—3 of whom have been enrolled at our center in Catania, which is one of the three participating sites in Italy.

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