15 April 2009

Neuropsychopharmacology



Neuropsychopharmacology

Free access prior to 12 months from current.

Neuropsychopharmacology is an international scientific journal and the official publication of the American College of Neuropsychopharmacology. The journal focuses on clinical and basic science contributions that advance our understanding of the brain and behaviour.


Access from 1994 Volume 11, issue 3 onwards
narure.com

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Evaluation of Heart Failure in the Internal Medicine Clinic



Evaluation of Heart Failure in the Internal Medicine Clinic
Presentation by
Natohya Henry, Pharm.D.
Kristin Campbell, Pharm.D., Jennifer Campbell, Pharm.D., CDE; Christa George Pharm.D., BCPS, CDE; Kristie Ramser, Pharm.D., CDE, Laura Sprabery, MD, FACP,
Craig Dorko, MD, FACP


Heart Failure
NYHA Classification
Stages of Heart Failure
ACC/AHA 2005 Guidelines
Stages in the development of HF/recommended therapy by stage
CMS Core Measures
Routine Assessment
Evidence-Based Therapies
Symptomatic benefits
Loop Diuretics
Beta Blockers
Evaluation of HF in the Internal Medicine Clinic
Methods
Pre-Intervention
Medical Record Review
Physicians

* Symptoms/ ER visits
* Smoking and smoking cessation
* Diet and daily weights
* Review of results
* Review of ACC/ AHA guidelines
* Review of CMS core measures

Medical Record Review
Baseline Characteristics
Use of Heart Failure Medications in All Patients
Use of Evidence-Based Medications
Conclusions
References

Evaluation of Heart Failure in the Internal Medicine

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14 April 2009

Emerging Applications In Clinical Radiation Oncology



Emerging Applications In Clinical Radiation Oncology
by
Ross A. Abrams, M.D.


Topics

* Integration of Emerging Results From Molecular Biology Into Patient Selection and Treatment Strategies
* Integration of Enhanced Technology Into Clinical Practice
* Moving Beyond Photons (X-Rays) to Charged Particles (Protons, Heavy Ions)

Integration of Emerging Results From Molecular Biology

* Combining Radiotherapy With Targeted Therapy
* Using Genomics, Proteomics, Metabolomics to Help Define Prognosis
* Using Genomics, Proteomics, Metabolomics to Help Define Treatment

Cetuximab
Clinical Activity

* Colorectal Cancer
* Head and Neck

Side Effects – Minimal

* Infusion Reactions
* Rash
* Asthenia
* N/V/D


Radiation Synergies

* EGFR Blockade Results in Radiation Sensitization
* EGFR Expression Upregulated by Irradiation

Combining Radiotherapy With

Cetuximab + Radiotherapy
Minimal Increase in Toxicity
Other Target Agents Showing Promise w/ XRT

Integration of Emerging Results From Molecular Biology

* Combining Radiotherapy With Targeted Therapy
* Using Genomics, Proteomics, Metabolomics to Help Define Prognosis
* Using Genomics, Proteomics, Metabolomics to Help Define Treatment

Chung/Torres-Roca, et al.: Genomics for prognosis and treatment response prediction
Formalin Fixed Tissue Data Set:

Integration of Enhanced Technology

* Metabolic Imaging To Define/Refine Targeting – Prostate/Lung Cancer
* Body Stereotactic Therapy – Lung Cancer
* Image Guided Radiotherapy (IGRT)
* Physiologic Gating – Lung/GI Cancers
* Integrating Metabolic Imaging, IGRT, Gating with IMRT

Metabolic Imaging to Refine Rx & XRT Targeting

MRI Imaging To Refine XRT Boost:
Prostate cancer

Enhancing IMRT With Image Guidance
IMRT 3D
Image-Guidance

* Rigid Immobilization
o Stereotactic systems
* Ultrasound Guidance
o Pelvic ultrasound
* CT Guidance
o CT scanner in the treatment room
o Helical tomotherapy

3 cGy Verification CT

Soft Tissue Window

Tools for Patient Registration

Moving Beyond Photons

* Protons
* Intensity Modulated Proton Therapy
* Heavy Particle Therapy (Carbon)
Carbon Ion Radiotherapy:
Protons on Steroids!
LET and RBE of Carbon Ion Therapy

Dose vs. Biologic Effect:LET

Conclusions

Radiotherapy is evolving technologically through enhanced dose delivery and precision and biologically through enhanced understanding of factors that define or reveal tumor location, behavior, and/or vulnerabilities

Emerging Applications In Clinical Radiation Oncology

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