216 results on '"Edward C. Halperin"'
Search Results
2. The History of Medicine on Postage Stamps: Waldemar Mordecai Wolf Haffkine, DSc: Vaccinologist
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Edward C. Halperin
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business.industry ,Humans ,Medicine ,History of Medicine ,History, 19th Century ,General Medicine ,History, 20th Century ,Religious studies ,Philately ,business - Published
- 2022
3. The History of Medicine on Postage Stamps: The Theological Problem of 'the Physician's License to Heal' or What Maimonides, Benjamin Franklin, and William Osler Had in Common
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Edward C. Halperin
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Postage Stamps ,Portrait ,business.industry ,MEDLINE ,Historical Article ,Medicine ,Biography ,General Medicine ,History of medicine ,business ,License ,Classics - Published
- 2020
4. 'We Do Not Want Him Because He Is a Jew': The Montreal Interns' Strike of 1934
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Edward C. Halperin
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Canada ,White (horse) ,business.industry ,Judaism ,media_common.quotation_subject ,Internship and Residency ,General Medicine ,History, 20th Century ,Teaching hospital ,Politics ,Feeling ,Law ,Jews ,Internal Medicine ,Medicine ,Humans ,business ,Hospitals, Teaching ,Inclusion (education) ,Order (virtue) ,Prejudice ,media_common ,Diversity (business) - Abstract
Speeches by modern-day White supremacists often include such statements as "Jews will not replace us." In 1934, the French-speaking medical interns of Montreal's Roman Catholic hospitals went on strike because, they alleged, a Jew "replaced" a Roman Catholic French Canadian. Anti-Semitic social and economic boycotts and educational quotas were in existence in Canada from the 19th through the mid-20th century. There were particularly strong anti-immigrant and anti-Semitic feelings in the first half of the 20th century in Quebec, along with anti-Semitic pro-fascist political parties. In 1934, Montreal's Hopital Notre-Dame (HND), a teaching hospital of the Universite de Montreal (UM) medical school, was unable to hire a full complement of medical interns from among the newly graduated French-speaking Roman Catholic medical students. The hospital hired a French-speaking Jewish graduate of UM, Samuel Rabinovitch. The prospective interns at HND submitted a petition demanding that Rabinovitch be fired, stating, "We do not want him because he is a Jew." On 14 and 15 June 1934, HND's interns went on strike to prevent Rabinovitch from taking up his duties. The strike spread to multiple hospitals in Montreal. A Jewish urology trainee at the Hotel Dieu hospital, Abram Stilman, was also targeted. Rabinovitch resigned in order to bring the strike to an end. The strike buttressed the case in the first half of the 20th century for American and Canadian Jewish hospitals and medical schools to ensure the education of Jewish physicians, reminds us of the origins of the slogans of modern White supremacists, and reinforces the historical basis of efforts to promote diversity and inclusion in medical education.
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- 2021
5. Moody D. Wharam Jr, MD, FACR, FASTRO, July 22, 1941–August 10, 2018
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Shannon M. MacDonald, Theodore L. DeWeese, Jeff M. Michalski, Robert B. Marcus, Nancy J. Tarbell, Daphne A. Haas-Kogan, Stephanie A. Terezakis, Kenneth B. Roberts, Edward C. Halperin, Daniel J. Indelicato, Robert Timmerman, David Raben, Nadia N. Laack, Carolyn R. Freeman, Nancy P. Mendenhall, Maryann Bishop-Jodoin, Stephanie M. Perkins, John A. Kalapurakal, Louis S. Constine, Suzanne L. Wolden, Malcolm A. Smith, Torunn I. Yock, Salma K. Jabbour, John C. Breneman, Fran Laurie, Lynn Million, Natia Esiashvilli, Lisa A. Kachnic, Karen J. Marcus, Sarah S. Donaldson, Patrick R.M. Thomas, Bernadine Donahue, Joel M. Cherlow, and Thomas J. Fitzgerald
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Cancer Research ,Radiation ,Oncology ,business.industry ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Humanities - Published
- 2019
6. Larry Emanuel Kun, March 10, 1946-May 27, 2018
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Kenneth B. Roberts, James D. Cox, Nadia N. Laack, Daniel J. Indelicato, Lynn Million, Steve Braunstein, Suzanne L. Wolden, Malcolm A. Smith, Daphne A. Haas-Kogan, Nancy J. Tarbell, Stephanie A. Terezakis, Hak Choy, Matthew J. Krasin, Fran Laurie, Joel M. Cherlow, Edward C. Halperin, Robert B. Marcus, Shannon M. MacDonald, Louis S. Constine, Carolyn R. Freeman, John A. Kalapurakal, Natia Esiashvilli, Barry L. Shulkin, Torunn I. Yock, Moody D. Wharam, Lisa A. Kachnic, Janaki Moni, John C. Breneman, Thomas J. Fitzgerald, Karen J. Marcus, Maryann Bishop-Jodoin, Nancy P. Mendenhall, Sarah S. Donaldson, Stephanie M. Perkins, Thomas E. Merchant, Jeff M. Michalski, Bernadine Donahue, Elizabeth B. McCarville, J. Frank Wilson, and Richard T. Hoppe
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Cancer Research ,Radiation ,Oncology ,business.industry ,Medicine ,Radiology, Nuclear Medicine and imaging ,Theology ,business - Published
- 2019
7. In Regard to Marshall et al
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Edward C. Halperin
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Cancer Research ,medicine.medical_specialty ,Radiation ,Oncology ,business.industry ,Family medicine ,medicine ,MEDLINE ,Radiology, Nuclear Medicine and imaging ,business ,Article - Published
- 2021
8. An Approach to the Management of Selected Personnel and Ethical Problems in Academic Radiation Oncology
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Edward C. Halperin and Jennifer Riekert
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Personal problems ,Human resource management ,Radiation oncology ,Deep knowledge ,Sexual misconduct ,Medical equipment ,Engineering ethics ,Sociology ,Ethical behavior - Abstract
Beyond a deep knowledge base in the fields of clinical radiation oncology, research, and medical education, building a successful career in academic radiation oncology requires developing high-level understanding and finesse around the issues of institutional management. Through case studies this chapter provides advice on how to navigate five issues which can occur in a radiation oncology department or any complex organization. These case studies review how to manage a tearful subordinate, a managerial approach to when personal problems intrude on the workplace, sexual misconduct in the workplace, pharmaceutical company and medical equipment manufacturers offering bribes, and crisis communications with the press. The authors hope that these case studies will help the reader to learn to think like a leader.
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- 2021
9. Radiation Oncologist M. Vera Peters MD, OC, Honored on a Canadian Postage Stamp
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Edward C. Halperin
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Cancer Research ,Postage Stamps ,medicine.medical_specialty ,Radiation ,Oncology ,business.industry ,Family medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Radiation oncologist - Published
- 2021
10. The History of Medicine on Postage Stamps Joseph Lister, 1st Baron Lister
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Edward C. Halperin
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Postage Stamps ,business.industry ,MEDLINE ,Medicine ,General Medicine ,History of medicine ,business ,Classics - Published
- 2021
11. The Impact on Medical Students of the 9/11 Attacks on New York's World Trade Center
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Maryanne Pratt, Edward C. Halperin, Srikanth Yandrapalli, Christopher Nabors, William H. Frishman, Abhay Dhand, and Anila Kumar
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Male ,Students, Medical ,020205 medical informatics ,Emergency management ,business.industry ,education ,World trade center ,New York ,02 engineering and technology ,General Medicine ,Public relations ,Education ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Mental Health ,Political science ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,Female ,030212 general & internal medicine ,business ,Child ,Retrospective Studies - Abstract
Phenomenon: Little is known about how participation in disaster relief impacts medical students. During the terror attacks of September 11, 2001, New York Medical College School of Medicine student...
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- 2020
12. Noninvasive Radioablation of Ventricular Tachycardia
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William H. Frishman, Edward C. Halperin, Srikanth Yandrapalli, Chitti R Moorthy, Ammar Athar, Anant Jain, Christopher Nabors, Jason T. Jacobson, Kartik Dhaduk, and Sei Iwai
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medicine.medical_specialty ,medicine.medical_treatment ,Infarction ,Catheter ablation ,030204 cardiovascular system & hematology ,Ventricular tachycardia ,Radiosurgery ,Sudden death ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Myocardial scarring ,medicine ,Humans ,030212 general & internal medicine ,medicine.diagnostic_test ,Cardiac electrophysiology ,business.industry ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Radiation therapy ,Treatment Outcome ,Cardiology ,Tachycardia, Ventricular ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Ventricular tachycardia (VT) occurs most commonly in the presence of structural heart disease or myocardial scarring from prior infarction. It is associated with increased mortality, especially when it results in cardiac arrest outside of a hospital. When not due to reversible causes (such as acute ischemia/infarction), placement of an implantable cardioverter-defibrillator for prevention of future sudden death is indicated. The current standard of care for recurrent VT is medical management with antiarrhythmic agents followed by invasive catheter ablation for VT that persists despite appropriate medical therapy. Stereotactic arrhythmia radioablation (STAR) is a novel, noninvasive method of treating VT that has been shown to reduce VT burden for patients who are refractory to medical therapy and/or catheter ablation, or who are unable to tolerate catheter ablation. STAR is the term applied to the use of stereotactic body radiation therapy for the treatment of arrhythmogenic cardiac tissue and requires collaboration between an electrophysiologist and a radiation oncologist. The process involves identification of VT substrate through a combination of electroanatomic mapping and diagnostic imaging (computed tomography, magnetic resonance imaging, positron emission tomography) followed by carefully guided radiation therapy. In this article, we review currently available literature describing the utilization, efficacy, safety profile, and potential future applications of STAR for the management of VT.
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- 2020
13. Training and education of pediatric radiation oncologists:A survey from the 2019 Pediatric Radiation Oncology Society meeting
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Geert O. Janssens, Rolf Dieter-Kortmann, Natia Esiashvili, Anita Mahajan, Klaus Seiersen, Jeannette Parkes, Christian Carrie, Edward C. Halperin, Karin Dieckmann, Susan Awrey, Suzanne L. Wolden, Arnold C. Paulino, and Karen J. Marcus
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Male ,medicine.medical_specialty ,Attitude of Health Personnel ,medicine.medical_treatment ,education ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,Continuing medical education ,Neoplasms ,Surveys and Questionnaires ,Radiation oncology ,Medicine ,Humans ,Medical physics ,survey ,Ct simulation ,Child ,training ,business.industry ,Radiation Oncologists ,Hematology ,Clinical Practice ,Radiation therapy ,Oncology ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Radiation Oncology ,Education, Medical, Continuing ,Female ,Heavy particle ,business ,Training program ,Intraoperative radiotherapy ,pediatric radiation oncology ,030215 immunology - Abstract
To examine the educational background, clinical practice, and preferences regarding continuing medical education (CME) among radiation oncologists who attended the 2019 meeting of the Pediatric Radiation Oncology Society (PROS), a survey consisting of 20 questions was distributed asking for demographic and educational background, clinical practice, and preferences regarding pediatric radiation oncology CME. Of 188 participants, 130 (69.2%) returned the questionnaire. More than 80% reported access to CT simulation, three-dimensional radiotherapy, and general anesthesia while
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- 2020
14. Current challenges facing pediatric radiation oncology viewed through an economics lens
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Edward C. Halperin
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Radiotherapy Dosage ,Hematology ,Radiation therapy ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Neoplasms ,030220 oncology & carcinogenesis ,Clinical training ,Pediatrics, Perinatology and Child Health ,Workforce ,Radiation oncology ,Radiation Oncology ,Humans ,Medicine ,Medical physics ,Child ,business ,030215 immunology - Abstract
This commentary addresses two problems facing pediatric radiation oncology: workforce education and the cost of technology. The tools of economics can help us understand these problems. Because cancer in children is relatively infrequent and the role of pediatric radiotherapy (RT) is limited, there are a small number of cases of children requiring RT in the US compared to the number of radiation oncology trainees. This creates a paucity of necessary clinical training material. Proton RT, rather than photon RT, is being recommended in many situations when RT is indicated in children. Cost, however, is a significant concern. The arguments for and against proton RT continue and a consensus on this matter has not emerged.
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- 2020
15. American Jewish Hospitals and 'The Jewish Problem' in American Medical Education
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Edward C. Halperin
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medicine.medical_specialty ,Judaism ,Family medicine ,medicine ,Sociology - Published
- 2019
16. Efficacy and Safety of Low-Dose Iodine Plaque Brachytherapy for Juxtapapillary Choroidal Melanoma
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Jing Cai, Yvonne M. Mowery, Bradford A. Perez, Patrick Oellers, Prithvi Mruthyunjaya, David G. Kirsch, Edward G. Buckley, Pradeep Mettu, Lawrence B. Marks, Edward C. Halperin, Sandra S. Stinnett, B. Steffey, Lejla Vajzovic, Jonathan J. Dutton, and Kim L. Light
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Male ,medicine.medical_specialty ,Visual acuity ,Radiation retinopathy ,Biopsy ,medicine.medical_treatment ,Brachytherapy ,Optic Disk ,Enucleation ,Visual Acuity ,Optic disk ,Iodine Radioisotopes ,Optic neuropathy ,03 medical and health sciences ,0302 clinical medicine ,Ophthalmology ,North Carolina ,medicine ,Humans ,Radiation Injuries ,Melanoma ,Survival rate ,Aged ,Retrospective Studies ,Ultrasonography ,business.industry ,Choroid Neoplasms ,Incidence ,Radiotherapy Dosage ,Middle Aged ,medicine.disease ,eye diseases ,Apex (geometry) ,Survival Rate ,Treatment Outcome ,030220 oncology & carcinogenesis ,030221 ophthalmology & optometry ,Female ,medicine.symptom ,business ,Follow-Up Studies ,Forecasting - Abstract
Purpose To evaluate low- vs high-dose plaque brachytherapy for juxtapapillary choroidal melanoma. Design Retrospective interventional case series. Methods Setting: Single institution. Study Population: Forty-seven patients with juxtapapillary choroidal melanoma. Intervention: Iodine-125 plaque brachytherapy. Eyes were divided into apex low-dose (LD) and high-dose (HD) groups (≤ or > median apex dose 84.35 Gy). Main outcome measures were time to distant failure, local failure, death, enucleation, radiation retinopathy, optic neuropathy, and best-corrected visual acuity (BCVA). Results Freedom from distant failure rates were 96% and 95% in apex LD and HD groups at 5 years and 77% and 95% at 10 years, respectively ( P = .84). Freedom from local failure rates were 90% in the apex LD group vs 89% in the HD group at 5 and 10 years ( P = .96). Apex LD and HD groups did not differ for time to death or enucleation. Five- and 10-year freedom from radiation retinopathy and optic neuropathy rates were higher in the apex LD than HD group. Loss of ≥3 BCVA lines, final BCVA 20/40 or better, and final BCVA 20/200 or worse were more favorable in the 5 mm LD compared to HD group. Visual acuity outcomes did not differ between apex LD and HD groups. Conclusions Low-dose iodine-125 plaque brachytherapy (67.5–81 Gy at tumor apex) provides safe and effective tumor control for juxtapapillary choroidal melanoma and may be associated with reduced radiation toxicity. Larger trials are needed to determine the optimal therapeutic dose for juxtapapillary choroidal melanoma.
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- 2018
17. In Memoriam: Giulio D'Angio, MD, May 2, 1922-September 14, 2018
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Giorgio Perilongo, Carl T. D'Angio, Christian Carrie, John A. Kalapurakal, Edward C. Halperin, John M. Maris, Patrick R.M. Thomas, and Karen J. Marcus
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Cancer Research ,Radiation ,Oncology ,business.industry ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Humanities - Published
- 2019
18. Choosing to Use Care as a Verb, Rather Than a Noun
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Edward C. Halperin
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Male ,business.industry ,MEDLINE ,Verb ,General Medicine ,Linguistics ,United States ,Noun ,Terminology as Topic ,Medicine ,Humans ,Female ,business ,Delivery of Health Care - Published
- 2019
19. Why Did the United States Medical School Admissions Quota for Jews End?
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Edward C. Halperin
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Higher education ,media_common.quotation_subject ,Legislation ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,State (polity) ,The Holocaust ,Medicine ,Humans ,030212 general & internal medicine ,Schools, Medical ,media_common ,Government ,Asian ,Education, Medical ,business.industry ,World War II ,Social change ,General Medicine ,History, 20th Century ,United States ,Law ,Jews ,business ,Medical ethics ,Prejudice - Abstract
At the end of World War II anti-Semitism was pervasive in the United States. Quotas to limit the number of Jewish students were put in place at most U.S. medical schools in the 1920s and were well-entrenched by 1945. By 1970 the quota was gone. Why? Multiple factors contributed to the end of the quota. First, attitudes toward Jews shifted as Americans recoiled from the horrors of the Holocaust and over half a million Jewish GIs returned home from World War II. Many entered the higher education system. Second, governmental and private investigations in New York City, New York State and Philadelphia exposed the quota. Third, New York State, led by Governor Thomas E. Dewey, established 4 publicly supported nondiscriminatory medical schools. These schools adsorbed many New York Jewish applicants. Fourth, from the 1920s through the 1960s some medical schools consistently or intermittently ignored the quota. Finally, the federal and several state governments passed nondiscrimination in higher education legislation. The quotas ended because of a combination of changing societal attitudes and government and private social action. This remarkable social change may be instructive as higher education now grapples with allegations of a quota system for Asian-Americans.
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- 2019
20. Five Transformative Episodes in the History of the American Hospital
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Edward C. Halperin
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Economic growth ,Transformative learning ,National economy ,Ambulatory care ,Local economy ,Political science ,Health professions - Abstract
Our historical idea of a hospital as a place of hospitable refuge and/or a place for the provision of scientifically skilled and compassionate care for the sick has evolved. Hospitals are now linked to outpatient care, health professions education, biomedical research, and employment of physicians and frequently constitute a major component of the local economy. They are unquestionably an important part of the national economy.
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- 2019
21. Why Have So Few Radiation Oncologists Become U.S. or Canadian Medical School Deans or University Presidents?
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Edward C. Halperin
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Cancer Research ,Medical education ,Canada ,Radiation ,Faculty, Medical ,Education, Medical ,Universities ,business.industry ,Medical school ,Radiation Oncologists ,United States ,Leadership ,Oncology ,Models, Organizational ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,business ,Schools, Medical - Published
- 2018
22. Continuing Medical Education Preferences and Pediatric Radiation Practices of Radiation Oncologists Attending the 2019 Meeting of the Pediatric Radiation Oncology Society
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Klaus Seiersen, Edward C. Halperin, Arnold C. Paulino, Natia Esiashvili, Anita Mahajan, Rolf Dieter-Kortmann, Karin Dieckmann, Geert O. Janssens, Karen J. Marcus, Suzanne L. Wolden, Christian Carrie, Susan Awrey, and Jeannette Parkes
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Cancer Research ,medicine.medical_specialty ,Radiation ,Oncology ,Continuing medical education ,business.industry ,Radiation oncology ,medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,business - Published
- 2020
23. 'This is a Christian institution and we will tolerate no Jews here': The Brooklyn Medical Interns Hazings
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Edward C. Halperin
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media_common.quotation_subject ,Judaism ,education ,Graduate medical education ,New York ,Poison control ,030204 cardiovascular system & hematology ,Suicide prevention ,Occupational safety and health ,First world war ,03 medical and health sciences ,0302 clinical medicine ,Physicians ,Institution ,Medicine ,030212 general & internal medicine ,Prejudice (legal term) ,media_common ,Education, Medical ,business.industry ,Internship and Residency ,General Medicine ,History, 20th Century ,Law ,Jews ,business ,Prejudice - Abstract
Anti-Semitic quotas to restrict access to medical school, graduate medical education and hospital privileges were common in the United States from the 1920s to the 1960s. In Brooklyn, New York, medical education prejudice resulted in violence. In 1916 a Jewish intern at Kings County Hospital, Matthew Olstein, was bound and gagged by Christian interns, put on a train at Grand Central Station, and warned that if he returned he would be thrown in the East River. Olstein died in combat in World War I as an Army physician. In 1927 3 Jewish interns at Kings County Hospital were assaulted, bound, dumped in tubs of water and covered in black fluid. Six gentile physicians were charged with assault. Criminal proceedings and public investigations followed. These attacks are the only known episodes of violence associated with American medical education anti-Semitism.
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- 2018
24. Restoring the Honor of Our Specialty by Minimizing Financial Ties of Organized Radiation Oncology With Industry
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Edward C. Halperin
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Cancer Research ,Drug Industry ,Clinical Decision-Making ,Specialty ,MEDLINE ,Professional practice ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Medical economics ,Radiation oncology ,Medicine ,Financial Support ,Industry ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Societies, Medical ,Marketing ,Medical education ,Radiation ,Practice patterns ,business.industry ,Conflict of Interest ,Conflict of interest ,Congresses as Topic ,Interinstitutional Relations ,Oncology ,Honor ,Radiation Oncology ,business - Published
- 2018
25. Medical Oath Taking
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Edward C. Halperin
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Oath ,History ,Law ,MEDLINE ,General Medicine ,Education ,Ethical code - Published
- 2019
26. Afterword
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Edward C. Halperin
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- 2017
27. Why Do Clinicians Need to Study the History of Medicine and Why Should This Journal Publish Articles About It?
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Edward C. Halperin
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medicine.medical_specialty ,Education, Medical ,business.industry ,Alternative medicine ,MEDLINE ,Historical Article ,06 humanities and the arts ,General Medicine ,History of medicine ,0603 philosophy, ethics and religion ,03 medical and health sciences ,0302 clinical medicine ,Family medicine ,medicine ,Humans ,History of Medicine ,060301 applied ethics ,030212 general & internal medicine ,Periodicals as Topic ,business ,Publication - Published
- 2017
28. Dose Intensification of Methotrexate and Cytarabine During Intensified Continuation Chemotherapy for High-risk B-Precursor Acute Lymphoblastic Leukemia
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Naomi J. Winick, Joanne Kurtzberg, Bruce M. Camitta, Beverly Bell, Edward C. Halperin, Jeanette Pullen, Tamekia L. Jones, Jonathan J. Shuster, Barbara L. Asselin, Allen R. Chauvenet, Richard L. Tower, and Meenakshi Devidas
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Male ,Oncology ,Asparaginase ,medicine.medical_specialty ,medicine.medical_treatment ,Article ,law.invention ,chemistry.chemical_compound ,Randomized controlled trial ,Risk Factors ,law ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Medicine ,Child ,Survival rate ,Teniposide ,Chemotherapy ,Dose-Response Relationship, Drug ,business.industry ,Remission Induction ,Cytarabine ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Prognosis ,Survival Rate ,Methotrexate ,chemistry ,Pediatrics, Perinatology and Child Health ,Toxicity ,Female ,business ,Follow-Up Studies ,medicine.drug - Abstract
To determine the efficacy and toxicity of higher dose versus standard dose intravenous methotrexate (MTX) and pulses of high-dose cytosine arabinoside with asparaginase versus standard dose cytosine arabinoside and teniposide during intensified continuation therapy for higher risk pediatric B-precursor acute lymphoblastic leukemia (ALL).From 1994 to 1999, the Pediatric Oncology Group conducted a randomized phase III clinical trial in higher risk pediatric B-precursor ALL. A total of 784 patients were randomized in a 2×2 factorial design to receive MTX 1 g/m versus 2.5 g/m and to cytosine arabinoside/teniposide versus high-dose cytosine arabinoside/asparaginase during intensified continuation therapy.Patients receiving standard dose MTX had a 5-year disease-free survival (DFS) of 71.8±2.4%; patients receiving higher dose MTX had a 5-year DFS of 71.7±2.4% (P=0.55). Outcomes on cytosine arabinoside/teniposide (DFS of 70.4±2.4) were similar to higher dose cytosine arabinoside/asparaginase (DFS of 73.1±2.3%) (P=0.41). Overall survival rates were not different between MTX doses or cytosine arabinoside/teniposide versus cytosine arabinoside/asparaginase.Increasing MTX dosing to 2.5 g/m did not improve outcomes in higher risk pediatric B-precursor ALL. Giving high-dose cytarabine and asparaginase pulses instead of standard dose cytarabine and teniposide produced nonsignificant differences in outcomes, allowing for teniposide to be removed from ALL therapy.
- Published
- 2014
29. Anxiety in first year medical students taking gross anatomy
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Matt Cartmill, Stacey McCorison, Edward C. Halperin, Patricia L. Thibodeau, Jean Spaulding, Colleen O'Connor Grochowski, Fidel A. Valea, James Haviland, and Jerry Reiter
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medicine.medical_specialty ,Histology ,business.industry ,media_common.quotation_subject ,Beck Anxiety Inventory ,education ,Passive behavior ,General Medicine ,Mental health ,Denial ,Medicine ,Gross anatomy ,Anxiety ,Assertiveness ,Anatomy ,medicine.symptom ,business ,Psychiatry ,Depression (differential diagnoses) ,media_common - Abstract
To study anxiety levels in first-year medical students taking gross anatomy. Thirty medical students per year, for 2 years, completed the Beck Anxiety Inventory (BAI) 10 times during a 13-week gross anatomy course. In addition, behavioral observations were made by a psychiatrist during gross anatomy for demonstrations of assertive, destructive, neutral, or passive behavior. Additional qualitative outcome measures were group exit interviews with the faculty and students. The mean BAI for all 60 students per year, for 2 years, was 2.19 ± 3.76, 93% of the scores indicated minimal anxiety, and 89% of BAI values were less than five which confirmed a minimal level of anxiety. The low level of reported BAI contrasted sharply with verbal reports by the same students and face-to-face exit interviews with the psychiatrist. Symptoms of stress and anxiety emerged as a result of these conversations. The high levels of subjective stress and anxiety revealed by the interviews were unknown to the gross anatomy faculty. The low scores of students on the BAI's stand in sharp contrast to the BAI's reported for medical students in other published reports. Although it is possible that our students were truthfully devoid of anxiety, it is more likely that our students were denying even minimal anxiety levels. There have been reports that medical students feel that admitting stress, depression, or anxiety put their competitiveness for a residency at risk. We conclude that students may be in frank denial of experiencing anxiety and, if so, this behavior is not conducive to good mental health. Clin. Anat. 27:835–838, 2014. © 2014 Wiley Periodicals, Inc.
- Published
- 2014
30. Pediatric Radiation Oncology
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Louis S. Constine, Nancy J. Tarbell, Edward C. Halperin, Louis S. Constine, Nancy J. Tarbell, and Edward C. Halperin
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- Tumors in children--Radiotherapy, Children
- Abstract
Pediatric Radiation Oncology, Sixth Edition continues to be the premier reference that offers comprehensive coverage of this challenging area for the radiation oncologist in training or practice, medical radiation physicists and dosimetrists, as well as pediatric oncologists and others interested in understanding childhood malignancies. This definitive text has been completely updated to reflect recent advances in the field. Manageable in size and engaging to read, it efficiently synthesizes data on pathogenesis, pathology, diagnostic workup, staging, treatment approaches (particularly radiation therapy—indications, doses, volumes, and treatment planning), and toxic outcomes, as well as guidance on decision making when data is lacking. For 30 years, this standard reference has helped demystify radiation therapy for childhood cancer and contributed to the quality and quantity of life for children affected by this disease.
- Published
- 2016
31. The Lancet in 19th-century America
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Edward C. Halperin
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History ,London ,Humans ,History, 19th Century ,New York City ,General Medicine ,Periodicals as Topic ,Correspondence as Topic ,United States - Published
- 2016
32. Military metaphors and the consequences of the language of cancer
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Edward C. Halperin
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Cognitive science ,business.industry ,Cancer ,computer.software_genre ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Neoplasms ,Metaphor ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Artificial intelligence ,business ,computer ,Natural language processing ,Language - Published
- 2016
33. The Rise and Fall of the American Jewish Hospital
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Edward C. Halperin
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Gerontology ,congenital, hereditary, and neonatal diseases and abnormalities ,Education, Medical ,Poverty ,business.industry ,Judaism ,education ,MEDLINE ,Graduate medical education ,Gender studies ,General Medicine ,United States ,humanities ,Education ,History of the United States ,Jews ,Hospitals, Religious ,Culturally sensitive ,Humans ,Mainstream ,Medicine ,business ,Medical ethics - Abstract
American Jewish hospitals were founded, starting in 1854, to serve indigent Jews, to respond to anti-Semitism by creating opportunities for graduate medical education (GME) and medical practice, to provide culturally sensitive care to observant Jews, and to fulfill a religious commitment to healing. Jewish hospitals were governed, administered, staffed, and philanthropically supported predominantly by Jewish communities.In this essay, the author describes the origins of American Jewish hospitals, the purposes they were designed to serve, and why they are disappearing. He estimates that approximately 113 Jewish hospitals were founded in the history of the United States and that there are now about 22 left, some of which are Jewish in name only. Jewish hospitals have been disappearing as a result of the economic pressures facing all community hospitals, a decline in anti-Semitism, open access to GME positions and hospital privileges, the general acceptance of Jews in the American mainstream, and a loss of Jewish community philanthropy.
- Published
- 2012
34. Preserving the humanities in medical education
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Edward C. Halperin
- Subjects
medicine.medical_specialty ,Medical education ,Education, Medical ,Alternative medicine ,General Medicine ,History of medicine ,Bioethics ,Humanism ,Education ,Humanities ,Spirituality ,medicine ,Humans ,Medical humanities ,Narrative ,Psychology ,Social responsibility - Abstract
Patients are frequently unhappy with medical care because physicians fail to demonstrate humanistic qualities. Immersion in science is a necessary part of medical education but not sufficient. Courses in the history of medicine, the medical narrative in literature, bioethics, medicine and art, and spirituality and medicine will train physicians who will temper technological medicine with a humanistic touch. The rapid growth in biomedical knowledge and the growing demands upon medical students' time threaten to crowd out time for the humanities. Furthermore, the financing of medical humanities programmes is often tenuous. Medical students must come to understand that much of medical knowledge is a function of time and place, that medicine is a profoundly social enterprise and that the practice of medicine is a value-laden undertaking. The preservation of programmes in the medical humanities will reinforce the social responsibility that should be inherent in medical education.
- Published
- 2010
35. Reproducing our species and finding solutions
- Author
-
Edward C. Halperin
- Subjects
Insurance, Health ,business.industry ,Population Dynamics ,Efficiency ,Medical Oncology ,Pediatrics ,Insurance Coverage ,Accreditation ,Oncology ,Education, Medical, Graduate ,Proton Therapy ,Humans ,Medicine ,Applied mathematics ,Radiology ,business ,Developing Countries - Published
- 2013
36. Insurance and Malpractice Disputes in Radiation Oncology
- Author
-
Edward C. Halperin
- Subjects
Adult ,Male ,Quality Control ,Cancer Research ,medicine.medical_treatment ,Risk Assessment ,Cohort Studies ,Neoplasms ,Malpractice ,Radiation oncology ,Humans ,Medicine ,Technology, Radiologic ,Aged ,Retrospective Studies ,Aged, 80 and over ,Insurance, Health ,business.industry ,Cancer ,Middle Aged ,medicine.disease ,Dissent and Disputes ,United States ,Radiation therapy ,Oncology ,Health Care Surveys ,Radiation Oncology ,Female ,Medical emergency ,business - Published
- 2009
37. Christiaan Neethling Barnard, M.D., M.Med., M.S., Ph.D
- Author
-
Edward C. Halperin
- Subjects
business.industry ,Medicine ,General Medicine ,Theology ,business - Published
- 2008
38. Pre-placement screening of resident physicians by substance abuse testing: Efficacy, cost, and physician opinions
- Author
-
Edward C. Halperin, John L. Weinerth, George Jackson, and Kathryn M. Andolsek
- Subjects
Drug ,medicine.medical_specialty ,education.field_of_study ,Health (social science) ,Screening test ,business.industry ,media_common.quotation_subject ,Population ,Medicine (miscellaneous) ,medicine.disease ,Likert scale ,Substance abuse ,Medicine ,Population study ,business ,Psychiatry ,education ,media_common ,Chemical dependence - Abstract
Aims: There is a high risk of physicians developing a chemical dependence. Detection of chemically dependent resident physicians is difficult. Our objective was to assess our experience with pre-placement substance-abuse screening of resident physicians and their attitudes about this procedure. We hypothesized that the frequency of positive pre-employment screening test was low and that resident physicians were generally sympathetic towards testing.Methods: A population study of drug and alcohol testing and a population-based sample of attitudes towards this testing were performed at an academic health center. Our hospital did pre-placement drug and alcohol testing of 2329 prospective resident physicians from 1997–2004. We tested saliva and urine for alcohol, amphetamines, marijuana, phencyclidine, cocaine, and opiates. A modified form of The Attitudes Towards Employment Screening for Drugs Scale (ATESDS), using a Likert scale, was created for use with resident physicians. It was placed on a website acces...
- Published
- 2008
39. Integrating Gross Anatomy into a Clinical Oncology Curriculum: The Oncoanatomy Course at Duke University School of Medicine
- Author
-
Lawrence B. Marks, Edward C. Halperin, and Ann Zumwalt
- Subjects
Models, Educational ,Faculty, Medical ,Students, Medical ,education ,Personal Satisfaction ,Education ,Course (navigation) ,North Carolina ,Humans ,Medicine ,Cooperative Behavior ,Curriculum ,Schools, Medical ,Clinical Oncology ,Medical education ,business.industry ,Data Collection ,General Medicine ,Group Processes ,Radiation Oncology ,Gross anatomy ,Anatomy ,business ,Education, Medical, Undergraduate ,Program Evaluation - Abstract
The amount of time devoted to teaching gross anatomy to medical students is declining. This topic remains critically important for some medical students, especially those seeking training in anatomy-laden specialties. The authors describe a course currently offered in the department of radiation oncology in the Duke University School of Medicine, developed in 2005, that expands anatomy education into the medical school clinical years. The aim of the course is to help reinforce anatomy knowledge in the clinical context of radiation oncology priorities and concerns, as well as to provide direct visualization and palpation of human cadavers, thus enabling the understanding of complex three-dimensional and anatomic principles. The audience for this course consists of medical students rotating through and the residents and clinical faculty in the department of radiation oncology. Anatomists and radiation oncology residents together present monthly didactic lectures, clinical case presentations, and cadaver-based demonstrations about the relationships between a tumor's anatomic location and its symptoms, patterns of spread, and treatment considerations. Anonymous surveys were distributed to course participants to assess the three components of the course. Survey results indicate that the participants found the anatomy lectures, clinical case presentations, and dissection presentations all to be interesting, relevant, and of high quality. This course is therefore favored by students, residents, and faculty as a way to supplement gross anatomy education during training for a specialty in which anatomy knowledge is essential.
- Published
- 2007
40. A Curricular Model for the Training of Physician Scientists: The Evolution of the Duke University School of Medicine Curriculum
- Author
-
Colleen O'Connor Grochowski, Edward C. Halperin, and Edward G. Buckley
- Subjects
Models, Educational ,Process (engineering) ,media_common.quotation_subject ,MEDLINE ,Biological Science Disciplines ,Education ,Excellence ,Physicians ,North Carolina ,ComputingMilieux_COMPUTERSANDEDUCATION ,Humans ,Medicine ,Product (category theory) ,Program Development ,Curriculum ,Schools, Medical ,media_common ,Medical education ,business.industry ,Flexibility (personality) ,General Medicine ,Program development ,business ,Educational program ,Education, Medical, Undergraduate - Abstract
Duke University School of Medicine offers an unusual doctor of medicine educational program. The core basic sciences are taught in year one, core clinical clerkships are completed in the second year, the entire third year is devoted to scholarly investigation, and elective rotations are fulfilled in the fourth year. The creation of this unique structure presented many challenges and is the product of a desire of key faculty 40 years ago to change radically the way medical education was taught. Over the years, improvements have been made, but the underlying principles of these visionary leaders have been retained: inquire not just acquire, flexibility of choice, and in-depth exploration. In the spirit of innovation that was established 40 years ago, leaders and faculty at Duke developed a new curricular model in 2004, called Foundation for Excellence, which is anchored in integrated, interdisciplinary innovation. The authors describe the process of curricular reform and provide a detailed overview of this unique approach to medical education. In keeping with Duke's mission to graduate clinician-researchers and clinician-educators, reducing the basic science curriculum to one year created a year saved, which students are now required to devote to scholarly pursuits. The authors argue that adopting a similar one-year basic science curriculum would make instructional time available for other schools to achieve their own institutional goals.
- Published
- 2007
41. The poor, the Black, and the marginalized as the source of cadavers in United States anatomical education
- Author
-
Edward C. Halperin
- Subjects
Histology ,Social Problems ,media_common.quotation_subject ,Immigration ,Black People ,Criminology ,History, 18th Century ,Social issues ,Vulnerable Populations ,Body donation ,Grave Robbing ,Cadaver ,Humans ,Medicine ,Deterrence theory ,Poverty ,media_common ,White (horse) ,Folklore ,business.industry ,History, 19th Century ,General Medicine ,United States ,Social Class ,Anatomy ,business - Abstract
When the practice of hands-on anatomical dissection became popular in United States medical education in the late 18th and early 19th centuries, demand for cadavers exceeded the supply. Slave bodies and thefts by grave robbers met this demand. Members of the public were aware that graves were being robbed and countered with various protective measures. Since the deterrence of grave robbing took time and money, those elements of society who were least economically and socially advantaged were the most vulnerable. Enslaved and free African Americans, immigrants, and the poor were frequently the target of grave robbing. The politically powerful tolerated this behavior except when it affected their own burial sites. Slave owners sold the bodies of their deceased chattel to medical schools for anatomic dissection. Stories of the "night doctors" buying and stealing bodies became part of African American folklore traditions. The physical and documentary evidence demonstrates the disproportionate use of the bodies of the poor, the Black, and the marginalized in furthering the medical education of white elites.
- Published
- 2007
42. Do Medical Students Choose Historical Role Models Who 'Look Like Me'?
- Author
-
Edward C, Halperin
- Subjects
Students, Medical ,Career Choice ,Education, Medical ,Humans - Published
- 2015
43. Striking a balance
- Author
-
Edward C. Halperin
- Subjects
Value (ethics) ,medicine.medical_specialty ,Relative value ,Physician-Patient Relations ,Higher education ,business.industry ,education ,Intraoperative Hemorrhage ,medicine.disease ,Ideal (ethics) ,Craniopharyngioma ,Oncology ,Neoplasms ,Liberal education ,Humanism ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Ethics, Medical ,Practice Patterns, Physicians' ,business ,Child ,Feeding tube - Abstract
I was recently consulted in the case of a child who was fully functional and attending school when headaches developed. An intracranial mass was identified. Surgery was performed and a partial resection was obtained of what proved to be a craniopharyngioma. Unfortunately, there was a massive intraoperative hemorrhage followed by 2 postoperative episodes of bacterial meningitis and extensive vasospasm. Now, 5 months postoperatively, magnetic resonance imaging shows extensive hypoxic brain injury, and the child is unresponsive and supported by a feeding tube and breathes through a tracheostomy. The tumor is regrowing. Is it technically possible to irradiate this craniopharyngioma? If so, technically how ought it be done, and with what dose and fractionation scheme? If there is no likelihood that radiation therapy will restore neurologic function, is it ethical to irradiate? The case calls for striking a balance between technical skills and humanistic professionalism. It illustrates one of the longstanding debates of higher education: the relative value of technical training versus a broad and liberal education. On the one hand, we hold forth as an ideal of higher education that learning is of value both for its own sake and to make us better people. On the other hand, higher education is generally expected to provide us with applicable skills that make us capable of earning a living. No one is made more directly capable of designing a bridge, starting an intravenous line, designing a radiation therapy field, or writing software code by virtue of studying Shakespeare’s sonnets, being guided through the history of Alexander the Great’s conquests, or learning
- Published
- 2015
44. Transplantation of a Child With Sickle Cell Anemia With an Unrelated Cord Blood Unit After Reduced Intensity Conditioning
- Author
-
Joanne Kurtzberg, Paul Szabolcs, Melissa A. Mazur, G. Ciocci, and Edward C. Halperin
- Subjects
Male ,medicine.medical_specialty ,Transplantation Conditioning ,Anemia, Sickle Cell ,ThioTEPA ,Gastroenterology ,Internal medicine ,Humans ,Transplantation, Homologous ,Medicine ,Child ,Preparative Regimen ,Transplantation Chimera ,business.industry ,Hematology ,Myeloablative Agonists ,Total body irradiation ,medicine.disease ,Sickle cell anemia ,Transplantation ,Oncology ,Cord blood ,Pediatrics, Perinatology and Child Health ,Alemtuzumab ,Rituximab ,Cord Blood Stem Cell Transplantation ,business ,Follow-Up Studies ,medicine.drug - Abstract
Sickle cell disease can be corrected by hematopoietic cell transplantation but success is limited by low availability of matched related/unrelated donors and comorbidities leading to the increased transplant-related morbidity/mortality. There is a need for expanded donor pools and reduced intensity regimens. We describe a case of a second unrelated cord blood transplant after a novel preparative regimen in a child with sickle cell disease related stroke and liver fibrosis. Hydroxyurea, rituximab, and alemtuzumab were followed by thiotepa and low dose total body irradiation before unrelated cord blood transplant. Rapid full donor chimerism and improved performance status was achieved and sustained over 2 years after transplant.
- Published
- 2006
45. The promise of innovation in radiation oncology?
- Author
-
Edward C. Halperin
- Subjects
medicine.medical_specialty ,business.industry ,Therapies, Investigational ,Alternative medicine ,MEDLINE ,Patient care ,Inventions ,Oncology ,Neoplasms diagnosis ,Neoplasms ,Radiation oncology ,Radiation Oncology ,medicine ,Humans ,Medical physics ,Patient Care ,business - Published
- 2013
46. A population-based study of the prevalence and influence of gifts to radiation oncologists from pharmaceutical companies and medical equipment manufacturers
- Author
-
Paul J. Hutchison, Edward C. Halperin, and Robert C. Barrier
- Subjects
Cancer Research ,medicine.medical_specialty ,Drug Industry ,Attitude of Health Personnel ,education ,Population ,Specialty ,Medical equipment ,Likert scale ,Continuing medical education ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Equipment and Supplies, Hospital ,health care economics and organizations ,education.field_of_study ,Radiation ,Conflict of Interest ,business.industry ,Data Collection ,Conflict of interest ,Gift Giving ,United States ,humanities ,Test (assessment) ,Oncology ,Family medicine ,Honorarium ,Radiation Oncology ,business - Abstract
Hospital-based physicians are responsible for the purchase of expensive equipment. Little is known about the influence of gift giving on their behavior. We wanted to ascertain the prevalence of gift giving from the pharmaceutical industry and medical equipment manufacturers to radiation oncologists and determine whether or not the size of accepted gifts influences their opinions regarding gifts.A population-based survey of hospital-based physicians conducted between 2002 and 2003. The study population consisted of all radiation oncologists who were members of the American Society of Therapeutic Radiology and Oncology between 2000 and 2001. A random number generator was used to identify 20% of the population. This group was invited by e-mail and conventional mail to complete a Likert scale questionnaire. Those asked to complete the questionnaire electronically were directed to a specially designed web site.Of 640 individuals who were asked to participate, 241 (38%) completed the questionnaire. 96% admitted accepting gifts. The most commonly accepted low value gifts were: pen or pencil (78%), drug samples for patient's use (70%), meal (66%), and a note pad (59%). The most commonly accepted high value gifts were trips to "equipment-users meetings" (15%), honoraria for speaking at a conference (10%), and participation in a conference call (9%). Only 5% of radiation oncologists agreed with the statement "my prescribing practices are affected" by gifts; however, 33% agreed with the statement "I believe that other physicians prescribing practices are affected." Similarly, although only 4% felt that their recommendations concerning purchases of medical equipment are affected by gifts, 19% felt that other physicians would be influenced. A test of the hypothesis that physicians believe that their conduct is less affected than those of their colleagues (i.e., "I am not influenced by gifts but someone else is" was strongly affirmed by a correlation statistic) (p0.0001). Of the radiation oncologists surveyed, 74% felt that they should be free to accept gifts of small value, 31% felt they should be free to accept meals or gifts of any type, 16% felt that residency programs should ban free meals provided by companies, 13% felt professional associations should discourage companies from hosting parties at the annual meeting, 17% felt that gift giving should stop, and 66% agreed that clinical information provided by companies provides a useful continuing medical education service. Those who accepted larger gifts were far more likely to disagree with statements such as "professional societies should actively discourage companies from hosting parties and providing free meals and giving gifts to physicians attending the annual meeting" (p = 0.0003) and "the practice of gift giving by companies should stop" (p = 0.0017); they were slightly more likely to agree with statements such as "clinical information provided to radiation oncologists by companies provides a useful continuing medical education service."To our knowledge, this study represents the first large-scale population based study of a hospital-based specialty and gift giving. This study demonstrates that: (1) Gift giving in radiation oncology is endemic. (2) Although each physician is likely to consider himself or herself immune from being influenced by gift giving, he or she is suspicious that the "next person" is influenced. (3) There is a correlation between the willingness of individual physician to accept gifts of high value and their sympathy toward this practice.
- Published
- 2004
47. Subspecialty training and certification for radiation oncology
- Author
-
Edward C. Halperin and Sarah S. Donaldson
- Subjects
medicine.medical_specialty ,Certification ,Education, Medical ,business.industry ,Teaching ,education ,Subspecialty ,United States ,Case material ,Specialty Boards ,Radiation oncology ,Radiation Oncology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,business ,Fellowship training ,Curriculum - Abstract
To address the recurring issues regarding subspecialty training and certification in radiation oncology, and using pediatric radiation oncology as an example, the authors considered the problem of inadequate case material for resident teaching. Potential solutions to the identified problems are addressed, and the roles of oversight committees and regulatory bodies are clarified. The problem of the nonuniform distribution of pediatric case material across residency programs cannot be solved by removing pediatric radiation oncology from the core radiation oncology educational curriculum or by offering fellowship training to those who may select it. As a result, the authors believe that subspecialty training and certification in radiation oncology is not a near-term possibility.
- Published
- 2004
48. Paleo-Oncology: The Role of Ancient Remains in the Study of Cancer
- Author
-
Edward C. Halperin
- Subjects
Pathology ,medicine.medical_specialty ,Paleopathology ,Health Policy ,Postmortem artifact ,Carcinoma ,Cancer ,Hominidae ,Sarcoma ,General Medicine ,Environment ,Biology ,medicine.disease ,Diet ,Issues, ethics and legal aspects ,Functional evolution ,History and Philosophy of Science ,Evolutionary biology ,medicine ,Life expectancy ,Animals ,Humans ,History, Ancient - Abstract
Paleo-oncology is the study of carcinomas and sarcomas in ancient human populations and their hominid precursors. These populations are informative concerning the possible influences on cancer of morphologic and functional evolution, diet, lifestyle, and other environmental factors. The prevalence of cancer in ancient populations might have differed from that in modern humans, because of substantial differences in tobacco and alcohol use, diet, life expectancy, and the availability of treatment. The available physical data concerning cancer in antiquity includes evidence of its existence in animal fossils and ancient humans and their precursors. The difficulties of paleo-oncologic research include a limited soft tissue record. In evaluating cancer in ancient remains, one must also deal with the problem of pseudopathology: whether an observed tissue change is all antemortem pathologic lesion or a postmortem artifact. Future archeological discoveries and the application of improved diagnostic techniques may enable paleo-oncology to make further contributions to our understanding of cancer.
- Published
- 2004
49. Perez & Brady's Principles and Practice of Radiation Oncology
- Author
-
Edward C. Halperin and Edward C. Halperin
- Subjects
- Cancer--Radiotherapy
- Abstract
Inside the Sixth Edition of this now-classic reference, you will discover encyclopedic coverage of topics ranging from basic science to sophisticated computer-based radiation therapy treatment planning and supportive care. The book's comprehensive scope and abundantly illustrated format provide you with better understanding of the natural history of cancer, the physical methods of radiation application, the effects of radiation on normal tissues, and the most judicious ways in which you can employ radiation therapy in patient care. Traditionally available as a printed textbook, now it comes with a completely revamped digital experience, powered by Inkling! NEW to the Sixth Edition… • Site-specific chapters include relevant background information on each tumor—including epidemiology, pathology, diagnostic work-up, prognostic factors, treatment techniques, applications of surgery and chemotherapy, end results, and more. • Over 1,400 full-color illustrations highlight key concepts in tumor pathogenesis, diagnosis, and targeted radiation therapy. • Increased emphasis on new approaches and technologies improve your understanding of three-dimensional treatment planning, intensity-modulated radiotherapy, combined modality therapy, and particle therapy. • Greater emphasis on palliative and supportive care reflects the role of radiation treatment in non-curative roles. • New editors and contributors let you benefit from their decades of experience. • Digital version includes the complete text, index-based search, note sharing, regular content updates integrated into the text, and much more. Improve outcomes for your patients… Pick up your copy today!
- Published
- 2013
50. Unrelated umbilical cord blood transplantation in adult patients
- Author
-
Cristina Gasparetto, Nelson J. Chao, James J. Vredenburgh, Gwynn D. Long, Donna Niedzwiecki, Joanne Kurtzberg, Edward C. Halperin, Clayton A. Smith, Gloria Broadwater, Mary J. Laughlin, Ashley Morris, Bella Madan, and David A. Rizzieri
- Subjects
Adult ,Male ,medicine.medical_specialty ,Transplantation Conditioning ,Adolescent ,Graft vs Host Disease ,Cord Blood Stem Cell Transplantation ,Opportunistic Infections ,Gastroenterology ,Umbilical cord ,Myeloablative therapy ,Cause of Death ,Internal medicine ,Humans ,Adults ,Medicine ,Retrospective Studies ,Transplantation Chimera ,Transplantation ,business.industry ,Umbilical Cord Blood Transplantation ,Graft Survival ,Unrelated umbilical cord blood transplantation ,Hematology ,Middle Aged ,Myeloablative Agonists ,Total body irradiation ,Survival Analysis ,Hematopoiesis ,Surgery ,medicine.anatomical_structure ,Absolute neutrophil count ,Female ,business ,Busulfan ,Follow-Up Studies ,medicine.drug - Abstract
Since January 1996, we have administered myeloablative therapy followed by infusion of unrelated umbilical cord blood cells in 57 adult patients with high-risk disease. The median age was 31 years (range, 18-58 years), and the median weight was 70 kg (range, 46-110 kg). Two patients were treated for genetic disorders and 55 for advanced hematologic malignancies. The preparative regimens were total body irradiation or busulfan based, both with antithymocyte globulin. HLA matching between donor and recipient was 3 of 6 in 3 patients, 4 of 6 in 44 patients, 5 of 6 in 8 patients, and 6 of 6 in 2 patients. The median nucleated cell dose was 1.50 x 10(7)/kg (range, 0.54-2.78 x 10(7)/kg), and the median CD34(+) cell dose was 1.37 x 10(5)/kg (range, 0.02-12.45 x 10(5)/kg). All patients received granulocyte colony-stimulating factor after transplantation until neutrophil recovery. Graft-versus-host disease prophylaxis consisted of cyclosporine and steroids. The median number of days to an absolute neutrophil count of 500/microL was 26 (range, 12-55 days). The median time to an untransfused platelet count of20000/microL was 84 days (range, 35-167 days). Seventeen patients developed grade II to IV acute GVHD. The median survival of the entire group was 91 days (range, 10-2251 days). Eleven patients were alive at a median follow-up of 1670 days (range, 67-2251 days), 1 with autologous recovery and 1 with relapsed lymphoma. The actuarial projected 3-year survival is 19%. Infection was the primary cause of death. These results suggest that unrelated umbilical cord blood transplantation is a viable option for adult patients and should be explored in patients with earlier-stage disease.
- Published
- 2003
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