But is it considered an inflammatory condition? I don’t believe it is. It is certainly a fibroblastic proliferation with a really, really low growth rate( very very low Ki- 67 labeling/low proliferative index). Can the low doses cause tissue death in something that has very very low mitotic activity? And if it can, is the dead tissue eventually replaced by fibrous tissue ( a scar)? I would love to know the theory behind how this is supposed to work or achieve a better result than surgery. Like with Peyronie, maybe the hand surgeons will start injecting microbial liquifactive necrosis toxins. Everyone has a gimmick.
Radiation only works in the proliferative phase. It can cause cell death acutely, or sabacutely through DNA damage, and it can cause terminal differentiation. Additionally, a split course is delivered, 6-12 weeks from the first half of treatment, which allows for a new group of cells to be affected. The goal of rt is certainly regression, but halting progression is also the aim. Rt doesn't work once terminal differentiation, scar formation has occurred.As I said, I may be (am) all wet!But is it considered an inflammatory condition? I don’t believe it is. It is certainly a fibroblastic proliferation with a really, really low growth rate( very very low Ki- 67 labeling/low proliferative index). Can the low doses cause tissue death in something that has very very low mitotic activity? And if it can, is the dead tissue eventually replaced by fibrous tissue ( a scar)? I would love to know the theory behind how this is supposed to work or achieve a better result than surgery. Like with Peyronie, maybe the hand surgeons will start injecting microbial liquifactive necrosis toxins. Everyone has a gimmick.
Actually RT works really well in Dupuytrens. I just thought it was kind of funny that at the Ackerman CANCER Center, with the worlds most expensive cancer treating gizmo, they’re advertising treating Dupuytrens. I think this means they’re not flush with (proton) cancer business but I could be wrongAs I said, I may be (am) all wet!
doesn't work on the scar, works on the growing nodule:
www.frontiersin.org
I believe the mechanism has to do with low dose RT inhibiting fibroblasts…. I am sure someone here with time on their hands can dig up a pub.
pubmed.ncbi.nlm.nih.gov
View attachment 353815
Myofibroblast distribution in Dupuytren's cords: correlation with digital contracture - PubMed
We found that two thirds of digital cords were nodular. Nodules were hypercellular, the majority being alpha-SMA-positive cells. Nodules varied in size and co-localized with the PIP joint. Cord was relatively cellular throughout; a proportion of these cells were alpha-SMA-positive and cells...
from NIH definition:
Dupuytren contracture progresses through three phases: (1) proliferative, (2) involution, and (3) residual. The proliferative phase has a characteristically high concentration of immature myofibroblasts and fibroblasts arranged in a whorled pattern. In the involution phase, fibroblasts become aligned in the longitudinal axis of the hand following lines of tension. In the residual phase, relatively acellular collagen-rich chords remain causing contracture deformity.
Sounds like you looked at the one's that were resected and sent to you.
You're not paranoid, it's true.
www.stantec.com
You're not paranoid, it's true.
United Healthcare is trying to make money from protons. It is listed by the SEC as owning "ProHealth Proton Center Management, LLC" and is one of the major investors of the NYPC, along with Mount Sinai, MSKCC, and Montefiore:
New York State’s first Proton Therapy Center reaches completion
"New York Proton Management, LLC" is another subsidiary on this SEC document regarding UnitedHealthcare.
I think this could be construed as a conflict of interest pretty easily.
Nothing would surprise me with these people. I mean nothing. If you told me UHC had a 70% stake in Phillip Morris I would be 0% surprised. Whatever’s good for business.You're not paranoid, it's true.
United Healthcare is trying to make money from protons. It is listed by the SEC as owning "ProHealth Proton Center Management, LLC" and is one of the major investors of the NYPC, along with Mount Sinai, MSKCC, and Montefiore:
New York State’s first Proton Therapy Center reaches completion
"New York Proton Management, LLC" is another subsidiary on this SEC document regarding UnitedHealthcare.
I think this could be construed as a conflict of interest pretty easily.
UHC has been a 5 bagger since obamacare. With that kinda juice most everything else is a rounding error.
Totally
You get those bills and loans paid,buddy!
Ha!
Anecdotally, don’t see pay gap between pp and academics for hospital employed docs.
True
Pay may diverge among junior faculty vs employed hospital. Take it with a grain of salt, but it can be exceptionally difficult to get raises in academic systems vs community for new grads over the last 5 years. Chairmen probably think “why should I raise x’s salary, when I have the next great resident graduating who will do the job for less.”
Because chairman has yearly graduating residents, and knows which are good.
Yeah, it’s all the same pressures.
www.ncbi.nlm.nih.gov
Wide scale adoption of protons will HAVE to lead to a steep price correction like IMRT, right??? Right???
This was also meant to be a Duke/UNC scenario. Only to be outdone by SERO.
