Clinician's Roundtable

Host: Mark Nolan Hill, MD Guest: Randi Hagerman, MD It's responsible for more than five percent of all cases of autism, and it's the most common cause of inherited mental retardation. But are we as familiar as we need to be with Fragile X syndrome, and a series of genetic conditions related to Fragile X? Host Dr. Mark Nolan Hill welcomes Dr. Randi Hagerman, professor and endowed chair of Fragile X research, and medical director of the Medical Investigation of Neurodevelopmental Disorders (MIND) Institute at the University of California, Davis School of Medicine, for a stimulating conversation about our rapidly expanding knowledge of these genetic conditions. How do the signs and symptoms manifest in children, and how does Fragile X impact our elder generations?

Guest: Jamie Hutchison, MD Host: Mark Nolan Hill, MD A young patient is brought into the emergency department having suffered a traumatic brain injury. Hypothermia may be considered as part of the treatment regimen. If so, how soon after the injury should treatment begin, and how long should treatment last? Dr. Jamie Hutchison, associate professor of critical care medicine and pediatrics at the University of Toronto, and research director of critical care medicine at the Hospital for Sick Children in Toronto, explains the mechanism used for cooling and examines potential links between data on hypothermia treatment for adults and similar therapy for children. Dr. Mark Nolan Hill hosts.

Guest: Jamie Hutchison, MD Host: Mark Nolan Hill, MD Traumatic brain injuries can present a lifetime of consequences. Previous studies indicate that hypothermia may be a viable treatment option, but little data has demonstrated efficacy for our youngest patients. Is hypothermia effective in treating pediatric brain trauma patients in a more rigorous research setting? What are the key mechanisms behind this query? Dr. Jamie Hutchison, associate professor of critical care medicine and pediatrics at the University of Toronto, and research director of critical care medicine at the Hospital for Sick Children in Toronto, evaluates the utility of hypothermia treatment for pediatric traumatic brain injuries with host Dr. Mark Nolan Hill.

Guest: Jim Hu, MD, MPH Host: Mark Nolan Hill, MD We are still working to minimize the major risks of complications involved in minimally invasive prostatectomy. This becomes even more important as more patients undergo these procedures. How has the training and certification process impacted our success? What improvements can we expect in this minimally invasive technique to treat prostate cancer in the years to come? For answers to these questions and many more, host Dr. Mark Nolan Hill welcomes Dr. Jim Hu, assistant professor of surgery at Harvard Medical School, and director of minimally invasive urologic oncology at Brigham and Women's Hospital and the Dana Farber Cancer Institute in Boston.

Host: Mark Nolan Hill, MD Guest: Jim Hu, MD, MPH Research indicates that demand for minimally invasive prostatectomy is growing, from 12 percent to more than 30 percent of our candidate patients over a recent two-year span. But research also tells us that there are still drawbacks to a laparoscopic approach to prostate cancer. What are the immediate and enduring pitfalls to laparoscopy, and are these concerns outweighed by the perceived benefits? Dr. Jim Hu, assistant professor of surgery at Harvard Medical School, and director of minimally invasive urologic oncology at Brigham and Women's Hospital and the Dana Farber Cancer Institute in Boston, explains why some surgeons may stick with the open procedure, even as others move ahead with the laparoscopic approach. Dr. Mark Nolan Hill hosts.

Guest: Dana Christian Lynge, MD Host: Mark Nolan Hill, MD Dropping reimbursement for general surgical procedures and increased everyday expenses are two issues, in addition to many others, that make the future viability of a general surgery practice a more difficult proposition. What if this disturbing trend continues? Could medicine withstand the loss of general surgery altogether? Dr. Dana Christian Lynge, associate professor of surgery at the University of Washington School of Medicine, and practicing general surgeon, peers into a theoretical future without general surgeons. What does he see? Dr. Mark Nolan Hill hosts.

Guest: Dana Christian Lynge, MD Host: Mark Nolan Hill, MD Training, recruiting and retaining general surgeons are key workforce issues for many hospitals across the United States. In a broad sense, these concerns impact the entire field of surgery, from students interested in surgery, to the most established surgeons in practice. What can our profession do to reconcile these issues? Dr. Dana Christian Lynge, associate professor of surgery at the University of Washington School of Medicine, and practicing general surgeon, details his research, published in the Archives of Surgery, that has served to highlight much of the unease surrounding this issue. It used to be that many surgeons with subspecialty certifications also trained in general surgery, but now, their time in general surgery has decreased significantly: how is this trend affecting the matters at hand?

Guest: Dana Christian Lynge, MD Host: Mark Nolan Hill, MD A nationwide survey reveals that the number of general surgeons has dropped 25 percent in the past 25 years. A continuation of this decline could have profound implications on patient populations that depend on general surgeons. What are the key demographic concerns surrounding a potential national shortage of general surgeons? Dr. Dana Christian Lynge, associate professor of surgery at the University of Washington School of Medicine, and practicing general surgeon, details his research, published in the Archives of Surgery, on a nationwide shortfall of general surgeons. Dr. Mark Nolan Hill hosts.

Guest: Dana Christian Lynge, MD Host: Mark Nolan Hill, MD Thirty to forty years ago, the field of general surgery was truly flourishing. General surgeons treated patients for an array of surgical conditions, as the concept of present day sub-specialties had yet to take hold. What has led to this significant shift in the focus of general surgery? Host Dr. Mark Nolan Hill welcomes Dr. Dana Christian Lynge, associate professor of surgery at the University of Washington School of Medicine, and practicing general surgeon, to discuss the evolution of general surgery in the context of Dr. Lynge's research in the Archives of Surgery on the national shortage of general surgeons.

Guest: Sharon Mitchell, PhD Host: Michael Greenberg, MD Dr. Sharon Mitchell joins host Dr. Michael Greenberg to detail her role in addressing healthcare for the adult film industry. Known to many as 'Dr. Mitch,' she describes her own transformation from adult film star to sexual health expert and founder of the Adult Industry Medical (AIM) Healthcare Foundation. She'll also give us an idea of the unique healthcare challenges of caring for adult film workers, and how the AIM Foundation is able to cater to the specific needs of these patients.