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JE Tepper

Publications and source records attributed to JE Tepper.

8 recordsLinked to original sources

RAPID: An Electronic Medical Records System for Radiation Oncology.

A electronic text-based medical record system used in a radiation oncology department since 1990 is described. The database is composed of a group of subfiles linked with a powerful relational database. The clinically relevant subfile structures are described and the hardware and software requirements for the system are itemized. Data entry is accomplished primarily by transcriptionists with some additional input by physicians at the time a dictation is reviewed. The database has been the exclusive source of radiation oncology notes since 1990. The flow of information from the dictaphone to the printed copy is described. Compared with a standard transcription service, addition clinical information is collected at the time of the patient encounter, and this information can be abstracted in reports. While not entirely replacing the paper record, the easy and rapid access to text-based digital information from any computer within the department has been invaluable.

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Introduction.

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Fluoropyrimidine-Radiation Interactions in Cells and Tumors.

The fluoropyrimidines (fluorodeoxyuridine [FdUrd] and fluorouracil [5-FU] are potent radiation sensitizers. This article summarizes recent data concerning potential mechanisms of fluoropyrimidine-radiation interactions at the cellular and tumoral level. Evidence now suggests cells can be radiosensitized when exposed to the fluoropyrimidines either before or after radiation but by different mechanisms. Sensitization is not explained by redistribution of cells into a sensitive phase of the cell cycle. Rather, cells that are exposed to FdUrd before radiation progress in S phase in the presence of fluoropyrimidines and are radiosensitized. Radiation can also increase the anabolism of 5-FU into the toxic metabolite and decrease drug clearance from the tumor. These laboratory data may aid in the design of clinical trials combining radiation and fluoropyrimidines.

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Clinical Implications of New Innovations in Radiation Treatment Delivery.

The practice of radiation therapy involves accurately defining the target and precisely delivering the treatment. The end result is to maximize dose to the tumor and minimize dose to surrounding tissue. Many technical innovations in the delivery of radiation have been developed over the past few years. These developments essentially increase the precision of radiation delivery, but do not directly address the accuracy of target definition. These technical innovations can be broadly thought of as accomplishing two goals: first, to increase the reproducibility of patient setup, and second, to improve the dose homogeneity. The clinical implementation, concerns, and utility of these innovations are discussed.

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Introduction.

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Journal Article↗

Introduction.

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Journal Article↗