Medical and surgical offices need to adopt Apple Pay ASAP

October 21, 2014- By Steven E. Greer

Another huge credit card data security hack was in the news today. Read more »

Photodynamic therapy (PDT) to treat AK’s

September 2, 2014- Interviewed by Steven E. Greer, MD

Gayatri Patel, MD MPH discusses her JAMA paper comparing the effectiveness of photodynamic therapy (PDT) versus liquid nitrogen cryotherapy to treat actinic keratosis of the face.

New therapies for Multiple Sclerosis

Interviewed by Steven E. Greer, MD

Best viewed in full screen, 1080i HD

Barbara Giesser, MD, neurologist and Medical Director of the Multiple Sclerosis Center at UCLA, discusses the soon-to-be-approved new therapy for MS called BG-12 (fumarate), made by Biogen Idec. Biogen also makes Tysabri, which is known to cause the very serious adverse event of PML caused by the JC virus.

Dr. Giesser discusses whether BG-12 will be rapidly adopted as a new first-line therapy, and also replace existing options for failed first line therapy, such as Gilenya and Tysabri. She then reviews the recent NEJM publications on BG-12.

Combined BRAF and MEK inhibition to treat BRAF mutation melanoma

Interviewed by Steven E. Greer, MD

October 5, 2012 By Steven E. Greer, MD

Half of all melanoma tumors are driven by a mutation in the BRAF gene, and Roche’s new Zelboraf drug treats those BRAF mutation tumors. GlaxoSmithKline is also developing a BRAF inhibitor drug. However, it was learned that by inhibiting just the BRAF gene to treat melanoma, this also increases squamous cell carcinoma (SCC) by activating the downstream MEK pathway. By adding a MEK inhibitor, the efficacy of reducing the melanoma tumor is increased, as well as a reduction in unwanted SCC.

At the 2012 ASCO, non-randomized Phase 1 data were presented combining a BRAF and MEK inhibitor. Now, in the September NEJM, data presented randomized Phase 2 data were presented of a study with combined MEK and BRAH inhibitors, developed by GlaxoSmithKline. Larger Phase 3 trials by Roche and Glaxo are underway. UCLA’s melanoma expert Dr. Antoni Ribas gives an update of these developments.

Mechanism for squamous cell carcinoma caused by Zelboraf for melanoma

Story and video interview By Steven Greer, MD

Antoni Ribas, MD, oncologist at the UCLA Jonsson Comprehensive Cancer Center, discusses his NEJM paper that elucidated the molecular pathway that leads to squamous cell carcinoma of the skin as an adverse event after Roche’s Zelboraf (vemurafenib) is used to treat advanced melanoma. He explains how MEK inhibitor drugs in trials now can be combined with Zelboraf to treat the SCC.

He also discusses the treatment choices of the two newly approved, highly expensive, melanoma drugs: Bristol-Myers Sqibb’s Yervoy (ipilimumab) and Zelboraf. The prohibitive cost is forcing an “either-or” decision.

Facial disfigurement after botched cosmetic injections

This story might seem extreme. However, many cosmetic injections performed in prestigious medical offices are performed by untrained people who are not doctors.

The stages of wound healing in time lapse

(Best viewed in full screen 1080iHD)

Surgery residents might find it interesting to watch this time lapse video of wound healing and correlate it with the basic science chapters in all text books. Note the peripheral radial contraction patterns of the intact skin caused by fibroblasts migrating and pulling using integrin molecules, the color changes of the granulation tissue, the migration of the epithelial cells inward, the final reduction in erythema after the epithelium covers the granulation tissue, etc.

For a thorough discussion of wound healing biology that is on display in the video, refer to this chapter from The Handbook of Plastic Surgery edited by Greer et al

Dermal filler correction of early aging in the male face

More and more, executives and non-celebrity men are desiring to maintain the edge at work provided by a youthful appearance. We previously discussed modern techniques for hair restoration. In this episode, plastic surgeon Dr. David Shafer discusses how HA-fillers, such as Juvederm and Restylane, can correct the signs of early aging in the male face.

Walter Unger, MD: Follicular unit hair transplantation

Most men develop early signs of male pattern baldness by the age of 40. However, few realize that modern hair transplant techniques can be extremely effective at halting the inevitable and more noticeable balding.

Dr. Walter Unger, Professor at Mt. Sinai School of Medicine in dermatology and full-time hair restoration expert discusses the modern technique called follicular unit hair transplantation. Older techniques that caused the infamous “doll’s head” look used large plugs of hair. He explains more in the video discussion below.

David Shafer, MD: Laser-assisted liposuction

Interviewed by Steven Greer, MD

David Shafer, MD, plastic surgery attending at the MEETH (Manhattan Eye, Ear and Throat Hospital) discusses the new technique of laser-assisted liposuction. Cynosure’s SmartLipo is demonstrated with before and after photos of some patients.