Andrei Leotescu

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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Did you know that gum disease may accelerate cognitive decline?🧠 How is Oral Genome researching all of this? For months, we’ve been working on a research project in Croatia with Dr. Marija Roguljić at the University of Split School of Medicine and Department of Periodontology to better understand the connections between dietary patterns, periodontal inflammation, and brain health. At the 9th Annual Perio Days in Croatia, Dr. Leena Palomo highlighted how Oral Genome’s salivary testing bring these oral-systemic connections to light. 🧠 Cognitive decline is one of the fastest-growing public health challenges. 🥗 Nutrition and oral health are modifiable risk factors that can make a real difference. 🧪 Oral Genome’s biomarker testing allows us to non-invasively measure inflammation, bridging dentistry, neurology, and nutrition. This research shows that oral health is not just about teeth — it’s a window into systemic health and prevention. Together, we can shape a future where better oral care means healthier aging. #OralSystemicHealth #CognitiveHealth #Prevention #OralGenome #Innovation

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🔍 Definition of Resectable Stage III NSCLC: A Systematic Review (EORTC Lung Cancer Group) Stage III NSCLC remains a highly heterogeneous disease where surgery can play a role, but the definition of “resectable” has lacked consensus. This systematic review (70 eligible studies) identified: ✅ Tumor factors against resection: N3, bulky N2, locally invasive tumors. ✅ Factors favoring resection: single-station N2, cT3N1. ⚖️ Uncertainty persists for N2-multiple stations and cT4N0-1 without invasion. 👥 Decision-making was multidisciplinary in 95% of studies (thoracic surgeon, medical oncologist, radiation oncologist). 🧪 PET-CT and brain MRI/CT were considered standard, with mandatory pathological mediastinal confirmation in most studies. 📌 These findings provide a foundation toward a unified definition of resectable stage III NSCLC, essential for patient selection and trial design. Lung Cancer DOI 👉🏻 https://lnkd.in/ew6-iE99 #CánCare #cancer #oncology #thoraciconcology #lungcancer #nsclc #biomarkers #lcsm

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“𝐌𝐒𝐒 𝐂𝐑𝐂 = 𝐢𝐦𝐦𝐮𝐧𝐨𝐭𝐡𝐞𝐫𝐚𝐩𝐲-𝐫𝐞𝐬𝐢𝐬𝐭𝐚𝐧𝐭” 𝐢𝐬 𝐭𝐨𝐨 𝐬𝐢𝐦𝐩𝐥𝐞.  Two recent signals show that, with smart selection and the right combinations, ICI can help the right MSS CRC patients. 𝐆𝐞𝐧𝐨𝐭𝐲𝐩𝐞-𝐚𝐧𝐜𝐡𝐨𝐫𝐞𝐝 𝐜𝐨𝐦𝐛𝐨 In BRAFV600E MSS mCRC, the encorafenib+cetuximab+nivolumab triplet delivered durable activity, with tumor/plasma RNA showing IFNγ/immune activation in responders and complement activation in non-responders—biology matters. 𝐅𝐢𝐫𝐬𝐭-𝐥𝐢𝐧𝐞, 𝐜𝐡𝐞𝐦𝐨-𝐟𝐫𝐞𝐞 𝐈𝐂𝐈+𝐚𝐧𝐭𝐢-𝐚𝐧𝐠𝐢𝐨𝐠𝐞𝐧𝐢𝐜 Sintilimab+anlotinib in treatment-naïve pMMR/MSS mCRC achieved ORR ~48% and mPFS ~8.6 mo. Responders had richer CD8⁺PD-1⁺ T cells, CD20⁺ B cells (hinting at B-cell/TLS biology despite limited power), and PD-L1⁺CD68⁺ macrophages, with spatial proximity of PD-1⁺ cells and CD68⁺CD163⁺ macrophages to tumor (<30 µm) associated with benefit. These results echo those from a study conducted by our team investigating ICI plus anti-angiogenic therapy in later-line MSS CRC with on-treatment readouts (Cousin et al CCR 2021). In the REGOMUNE trial, baseline CD163⁺ TAM density was associated with PFS and OS, which directly led to the design of a new cohort selecting patients based on macrophage infiltration (readout pending...) 𝐓𝐡𝐞 𝐭𝐡𝐫𝐨𝐮𝐠𝐡-𝐥𝐢𝐧𝐞: 𝐌𝐒𝐒 𝐂𝐑𝐂 𝐢𝐬𝐧’𝐭 𝐮𝐧𝐢𝐟𝐨𝐫𝐦𝐥𝐲 𝐫𝐞𝐟𝐫𝐚𝐜𝐭𝐨𝐫𝐲—𝐢𝐭’𝐬 𝐡𝐞𝐭𝐞𝐫𝐨𝐠𝐞𝐧𝐞𝐨𝐮𝐬.  When we (i) match combinations to tumor biology (e.g., BRAF+EGFR+PD-1), and/or (ii) use TME-grounded selection (CD8 infiltration dynamics, B-cell/TLS signals, macrophage burden/spatial metrics), immunotherapy can work. Next steps are clear: prospective biomarker-driven designs that pre-specify these axes up front. #MSSCRC #Immunotherapy #Biomarkers #TME #CD8 #Bcells #TLS #Macrophages #CRC #ClinicalTrials #TranslationalResearch

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🫀 Apical Muscular VSD and the Role of Color Doppler in Prenatal Diagnosis 👉 The detection of ventricular septal defects (VSDs) remains a cornerstone of advanced fetal cardiac screening. While attention to anatomical landmarks is essential, accurate recognition often depends on the systematic and optimal use of Color Doppler ultrasonography. 👉 Muscular VSDs, especially in the apical region, can be subtle and easily overlooked on grayscale imaging. Color Doppler enables the visualization of small shunt flows, providing both sensitivity and diagnostic confidence. 👉 These findings emphasize an important point: the integration of Color Doppler into routine fetal cardiac evaluation is not optional, but indispensable for detecting clinically relevant anomalies. 👉 The attached case demonstrates an apical muscular VSD diagnosed with the aid of Color Doppler. #FetalCardiology #PrenatalDiagnosis #ColorDoppler #FetalEchocardiography #CongenitalHeartDisease #VSD #ARSA #UltrasoundEducation #Perinatology #MedicalImaging

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Heart failure is often described as a single condition—but in truth, it is many. Its manifestations, underlying mechanisms, and clinical trajectories vary widely from patient to patient. What unites them under one label is often more conceptual than practical. This heterogeneity is one reason heart failure remains so elusive to manage. Two patients with “HFpEF” may share a diagnosis yet differ profoundly: one with hypertension-driven diastolic dysfunction, the other with metabolic disease and renal impairment. Therapeutic responses are equally variable, challenging the notion of standardized care. Recognizing the complexity behind the label is essential. Only by embracing the nuances of heart failure can we design interventions that are precise, individualized, and effective.

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