ABSTRACT
En face electron fields to boost inguinal lymphatics have been used by oncologists for many years. With the introduction of multileaf collimators (MLC) and independent jaws, the practice of creating segmental fields to boost areas of interest has expanded. Typical anterior-posterior opposing field treatment of the pelvis may now be enhanced to include additional anterior segments to boost lymphatic tissue at a predetermined depth. This report illustrates the clinical implementation of one such segmental boost technique. Computer generated isodose plans utilize manual contour and CT-generated data for analysis of inguinal lymphatic depths. Potential areas of field overlap are discussed as well as the use of combined 6 and 15 MV photon energies to reduce areas of inhomogeneous dose. Technical details associated with MLC field size limits and other clinical factors are also discussed in relationship to smooth treatment delivery.
Subject(s)
Lymphatic Irradiation/methods , Groin , Humans , Radiotherapy DosageABSTRACT
An online computer-based system for monitoring patients for potential adverse drug reactions during their hospital stay is described. The adverse drug reaction monitoring system uses a Digital Equipment Corporation (DEC) PDP-11 computer which is programmed in MUMPS (Masschusetts General Hospital Utility Multi-programming System). Primary references from the medical and scientific literature are analyzed and evaluated before being included in the data base. The patient's adverse reaction history, obtained by nursing personnel during a patient interview, is entered into the computer by pharmacy staff. The computer screens new prescription orders for potential adverse reactions; any adverse reaction reports are sent to the patient's physician. Other special programs that are used in the patient monitoring system include medication profiles, drug-drug interaction screening and prescription discontinuation date entry. The computer system enable detection of potential adverse drug reaction and notification of the patient's physician prior to administration of the prescribed drug.
Subject(s)
Drug Information Services , Drug-Related Side Effects and Adverse Reactions , Information Services , Medication Systems, Hospital , Computers , Drug Prescriptions , Humans , Medical History TakingABSTRACT
Rapid control of arterial blood pressure through use of the interacting drugs hydralazine and propranolol is discussed. A case history illustrating the treatment is described, and various aspects of this therapy are discussed, including mechanisms of action and side effects.
Subject(s)
Hydralazine/therapeutic use , Hypertension/drug therapy , Propranolol/therapeutic use , Blood Pressure , Drug Therapy, Combination , Female , Humans , Hypertension/physiopathology , Middle Aged , Time FactorsABSTRACT
An online computer-based system to monitor prospectively for potential drug interactions in a hospital setting is described. The system, developed at Stanford University Medical Center, is fully operational and is used to inform pharmacists, nurses and physicians as to the severity and speed of onset of potential drug interactions. In addition, the system can produce prescription labels and patient-drug profiles for the pharmacy and serves as a retrieval source of drug interaction information. Each report provides information regarnding the pharmacological effect and mechanism of the interactions, as well as statements involving relevant clinical findings associated with these interactions.
