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2.
Nature ; 554(7691): 189-194, 2018 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-29420467

RESUMO

Somatic mutations of ERBB2 and ERBB3 (which encode HER2 and HER3, respectively) are found in a wide range of cancers. Preclinical modelling suggests that a subset of these mutations lead to constitutive HER2 activation, but most remain biologically uncharacterized. Here we define the biological and therapeutic importance of known oncogenic HER2 and HER3 mutations and variants of unknown biological importance by conducting a multi-histology, genomically selected, 'basket' trial using the pan-HER kinase inhibitor neratinib (SUMMIT; clinicaltrials.gov identifier NCT01953926). Efficacy in HER2-mutant cancers varied as a function of both tumour type and mutant allele to a degree not predicted by preclinical models, with the greatest activity seen in breast, cervical and biliary cancers and with tumours that contain kinase domain missense mutations. This study demonstrates how a molecularly driven clinical trial can be used to refine our biological understanding of both characterized and new genomic alterations with potential broad applicability for advancing the paradigm of genome-driven oncology.


Assuntos
Mutação , Neoplasias/tratamento farmacológico , Neoplasias/genética , Quinolinas/farmacologia , Quinolinas/uso terapêutico , Receptor ErbB-2/antagonistas & inibidores , Receptor ErbB-3/antagonistas & inibidores , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Mutação de Sentido Incorreto , Neoplasias/enzimologia , Inibidores de Proteínas Quinases/farmacologia , Inibidores de Proteínas Quinases/uso terapêutico , Quinolinas/efeitos adversos , Receptor ErbB-2/química , Receptor ErbB-2/genética , Receptor ErbB-3/química , Receptor ErbB-3/genética , Resultado do Tratamento
3.
J Interprof Care ; 33(5): 590-592, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30444153

RESUMO

Interprofessional education (IPE) is vital in university clinical settings to prepare graduate students to engage in today's health care system. However, few university programs have successfully implemented IPE into existing clinical programs. The purpose of this pilot study was to evaluate the effectiveness of an interprofessional (IP) training and clinical experience on graduate students' and caregivers perceptions on quality of care in a pre-existing clinical program. Speech-language pathology (SLP) and Physical Therapy (PT) faculty, worked to coordinate and develop an IP training and clinical experience. Graduate students from both disciplines participated in the IP training and completed a pre-post training questionnaire. Students then participated in an IP clinical experience with three preschool-age children with complex sensory motor needs and completed the questionnaire again following this experience. Students' attitudes and perceptions of readiness for IP engagement following IPE training showed a positive trend but not following an IP clinical experience. Subjective feedback from students and caregivers was highly favorable. The results provide further evidence of the benefits of IP training and clinical experience. More effective qualitative and quantitative tools must be developed to capture the effectiveness of direct IP clinical collaboration.


Assuntos
Relações Interprofissionais , Aprendizagem , Fisioterapeutas/educação , Patologia da Fala e Linguagem/educação , Humanos , Projetos Piloto , Estudantes de Ciências da Saúde
4.
J Elder Abuse Negl ; 28(3): 134-51, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27010780

RESUMO

One of the challenges in preventing the financial exploitation of older adults is that neither criminal justice nor noncriminal justice professionals are equipped to detect capacity deficits. Because decision-making capacity is a cornerstone assessment in cases of financial exploitation, effective instruments for measuring this capacity are essential. We introduce a new screening scale for financial decision making that can be administered to older adults. To explore the scale's implementation and assess construct validity, we conducted a pilot study of 29 older adults seen by APS (Adult Protective Services) workers and 79 seen by other professionals. Case examples are included.


Assuntos
Direito Penal , Tomada de Decisões , Abuso de Idosos/economia , Avaliação Geriátrica , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Cognição , Abuso de Idosos/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
5.
Telemed J E Health ; 21(7): 538-49, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25734686

RESUMO

This exploratory study evaluated the effectiveness of Apple (Cupertino, CA) iPad(®) (second generation) to deliver telepractice speech and/or language services. Five children and their parents/guardians, as well as four adult participants, received services for communication disorders in a university clinic setting over two academic semesters. The children met some of their speech goals and all of their language goals. All adult clients met some of their communication goals. Personal opinions about telepractice did not change statistically before and after therapy. The major problem identified during the study was skipping and/or freezing of images on the iPads during interactions with FaceTime(®) (Apple). Further studies are needed to investigate the feasibility of using Apple iPads in telepractice.


Assuntos
Microcomputadores , Fonoterapia , Patologia da Fala e Linguagem , Telemedicina/instrumentação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
6.
J Nurse Pract ; 6(6): 477-478, 2010 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-20689671
7.
Dimens Crit Care Nurs ; 23(6): 264-9, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15586040

RESUMO

Advanced practice nurses within acute care settings are responsible for providing healthcare to a rapidly expanding population of elderly patients. Medical advances have contributed to the longevity of the American population, resulting in an increase in age-related disease that can lead to depression. It is important for acute care nurses to become familiar with the various classes of antidepressant medications and the implications for their use.


Assuntos
Transtorno Depressivo , Acidente Vascular Cerebral/complicações , Doença Aguda , Distribuição por Idade , Fatores Etários , Idoso , Antidepressivos/uso terapêutico , Efeitos Psicossociais da Doença , Cuidados Críticos , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/etiologia , Transtorno Depressivo/terapia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Prescrições de Medicamentos/normas , Avaliação Geriátrica , Humanos , Programas de Rastreamento , Profissionais de Enfermagem , Papel do Profissional de Enfermagem , Guias de Prática Clínica como Assunto , Escalas de Graduação Psiquiátrica , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/psicologia , Estados Unidos/epidemiologia
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