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Using Risk Models for Breast Cancer Prevention
 
01:03:58
Using Risk Models for Breast Cancer Prevention Air date: Wednesday, February 27, 2013, 3:00:00 PM Description: Wednesday Afternoon Lecture Series Dr. Gail uses statistical methods for the design and analysis of epidemiologic studies including studies of genetic factors and models to predict the absolute risk of disease. Epidemiologic studies have established several risk factors for breast cancer such as family history, age when giving birth for the first time, biopsy findings, and mammographic density. These factors can be combined with breast cancer incidence rates to construct models of absolute risk of breast cancer. Absolute risk is the risk of developing a disease over a defined age interval or time period; relative risk is used to compare risks in different groups of people. Absolute risk is useful for counseling women and in public-health applications. In counseling, absolute risk estimates provide realistic perspectives and inform decision-making such as when or whether to begin having screening mammographies. Absolute risk estimates are also useful in weighing the risks and benefits, for example, of chemopreventive therapies such as tamoxifen or raloxifene. Public health applications of risk models include designing chemoprevention trials; implementing "high risk" prevention strategies that focus only on women who are at highest risk for breast cancer; assessing the potential of preventive interventions to reduce absolute breast cancer risk in the population; and using risk estimates to allocate prevention resources under cost constraints. Dr. Gail will review the usefulness of risk models in these applications and the potential of additional risk factors, such as single nucleotide polymorphisms, to improve the performance of those models. Author: Mitchell H. Gail, M.D., Ph.D., National Cancer Institute Runtime: 01:03:57 Permanent link: http://videocast.nih.gov/launch.asp?17823
Просмотров: 1538 nihvcast
Day 1 - Appropriate Use of Drug Therapies for Osteoporotic Fracture Prevention
 
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More than 10 million people in the United States have osteoporosis, a skeletal disorder that causes bones to become weak and fragile as a result of low bone mass. The condition makes people more susceptible to fractures, which can impair their ability to live independently and even threaten their lives. The social and economic burden of osteoporotic fractures is substantial. Reducing osteoporosis prevalence and hip fracture incidence are among the major objectives of Healthy People 2020, the U.S. Department of Health & Human Services’ national health promotion and disease prevention initiative. Lifestyle changes—including getting adequate nutrition and regular exercise, quitting tobacco use, limiting alcohol use, and preventing falls—can help reduce a person’s risk of osteoporotic fractures. However, medications may be prescribed to prevent fractures if a person has very low bone mineral density or has experienced a prior fragility fracture. The U.S. Food and Drug Administration has approved several types of drugs to prevent osteoporotic fractures. Clinical guidelines by various medical organizations recommend bisphosphonates (BPs) as a first line of treatment for most people who have osteoporosis. BPs are effective for short-term use (up to 3–5 years) by people who are at high risk of fracture. However, the benefits and risks of longer-term treatment are less clear. Reports of rare but serious adverse events such as atypical femoral fractures and osteonecrosis (death of cells) of the jaw have raised questions about the safety of osteoporosis drug use, especially in people who use the drugs for more than 3–5 years or who had a low risk of fracture when they began treatment. Research Challenges There is a gap in scientific data about the appropriate long-term use of many osteoporosis drugs. There are uncertainties about which people will benefit or may be harmed if they take the drugs long-term. Public concern about these and other unanswered questions has coincided with a significant decrease in use of osteoporosis drugs and a leveling off in what had been a promising decline in the incidence of osteoporotic fractures. These changes have raised concerns within medical and professional communities that many people who might need the drugs are not being prescribed them, and those who are prescribed them are not taking them. In addition, evidence is limited regarding the initiation and length of “drug holidays” (a medical practice in which a patient stops taking medications for a period of time and then resumes treatment again, if the patient or their doctor believes it could be in their best interests), whether stopping treatment reduces the risk of serious adverse events while maintaining fracture prevention benefit, and which individuals should change treatments instead of simply taking a drug holiday from their current medication. Innovative research strategies are needed to address these knowledge gaps and to help better inform individuals and physicians in their decision-making about osteoporosis treatment. Workshop Goals This P2P workshop will assess the available scientific evidence to better understand the appropriate use of drugs for osteoporotic fracture prevention, specifically addressing the following questions: What are the benefits and risks (including major adverse events) of osteoporotic drugs with short-term use (from first-use up to 3–5 years of treatment)? What factors influence outcomes? What are the benefits and risks of osteoporotic drugs over the longer term (for treatment periods longer than 3–5 years)? What factors influence outcomes? Do drug holidays improve outcomes? What patient and clinician factors impact the use of and adherence to osteoporotic drugs? Workshop Sponsors National Institute on Aging National Institute of Arthritis and Musculoskeletal and Skin Diseases NIH Office of Disease Prevention
Просмотров: 72 NIH ODP
Chiropractor Malpractice Insurance ChiroSecure Live Event Informed Consent
 
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Chiropractor Malpractice Insurance http://ChiroSecure.com Call 1-866-802-4476 Best coverage, best price for Chiropractic malpractice insurance! Protect your Chiropractic practice and your financial security. In this video, the Chiropractic Malpractice Insurance leader, ChiroSecure with Dr. Stu Hoffman unravels Informed Consent in response to the latest attack on Chiropractic. Dr. Alan Weinstein: Well, hello everyone. I'm Dr. Alan Weinstein and I want to welcome everyone to the first ChiroSecure live event. It's going to be a really exciting show. I'm going to introduce our guest in just a minute. This is a live Google Hangout for those of you who are familiar with the technology and because it's a live show, anything could happen because we're live, so hopefully everything will go smoothly. Number one, if you go ahead and you look at the website where you're watching our live event, you're going to see on the right-hand side a place for you to enter your first name, your last name, your email, and your phone number, and the city, state and zip. If you'll put your name and email right into that, what's going to happen is we will send you a copy of your informed consent packet. Make sure that you put your name and email and the rest of the information right in there. Remember, we have people monitoring those comments with your questions. We're going to do our best to make sure after the event that all of your questions are answered. Make sure that anything you want to know that isn't covered, that you do put it in the comments section. For those of you that are familiar with Google Live Hangouts, what I'm going to do right now is I'm going to turn on what's called the screen-share so I can talk a little bit about the events. Okay, here we go. All right, with that said, this is as we said before, a live event brought to you by ChiroSecure. ChiroSecure, providing the most comprehensive coverage at the most competitive rates since 1991. The complete transcript is available by going to http://chirosecure.com/live-events and completing the form on that page. Today, chiropractors must protect themselves from claims. You owe it to yourself and your loved ones to make sure you're protected. Choosing a professional liability malpractice insurance carrier is one of the most important decisions facing chiropractors today. You must have trust and confidence that the malpractice insurance program you select is right and will be there for you. That's why you need to talk to Dr. Stuart Hoffman, president of ChiroSecure. ChiroSecure 1-866-80-CHIRO 1-866-802-4476 http://ChiroSecure.com He knows what you go through day to day in your practice. The ChiroSecure malpractice insurance program provides superior malpractice coverage with many unique insurance features and long-term, solid protection. Our philosophy of combining discerning Chiropractic underwriting practices, competitive insurance premiums and aggressive malpractice claim management is designed to protect you and your future. ChiroSecure is committed to providing you exceptional quality protection by offering you the most comprehensive professional liability malpractice coverage available at the most competitive rates. The best coverage at the best price: - Chiropractic Malpractice Insurance - Massage Therapist Malpractice Policies - Acupuncture Malpractice Insurance Polices - Business Owner Policies (General Liability) - Workers Compensation - Life Insurance - Chiropractors Disability Insurance - Business Overhead Expense Custom tailored policies to fit your chiropractic business' unique needs. ChiroSecure offers chiropractors the best professional liability malpractice coverage at the absolute best price! We pride ourselves on consistently outperforming all others in price and service. ChiroSecure provides unmatched strength, winning defense and superior insurance solutions to doctors of chiropractic. Our team will assist you with risk management tools and help educate, as well as support your need for a customer service team that will look out for your best interest in a compassionate manner. ChiroSecure delivers for you when it matters most. Get the peace of mind knowing you have safe and sound malpractice insurance coverage you can depend on! Call Dr. Stuart Hoffman right now to discuss the best coverage for you. ChiroSecure 1-866-80-CHIRO 1-866-802-4476 http://ChiroSecure.com What To Expect When You Get Your Chiropractic Professional Liability Quote Get Low Cost Chiropractic Malpractice Insurance
Просмотров: 2157 Chirosecure Malpractice Insurance
Tamoxifen
 
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Tamoxifen is an antagonist of the estrogen receptor in breast tissue via its active metabolite, 4-hydroxytamoxifen. In other tissues such as the endometrium, it behaves as an agonist, and thus may be characterized as a mixed agonist/antagonist. Tamoxifen is the usual endocrine (anti-estrogen) therapy for hormone receptor-positive breast cancer in pre-menopausal women, and is also a standard in post-menopausal women although aromatase inhibitors are also frequently used in that setting. Some breast cancer cells require estrogen to grow. Estrogen binds to and activates the estrogen receptor in these cells. Tamoxifen is metabolized into compounds that also bind to the estrogen receptor but do not activate it. Because of this competitive antagonism, tamoxifen acts like a key broken off in the lock that prevents any other key from being inserted, preventing estrogen from binding to its receptor. Hence breast cancer cell growth is blocked. This video is targeted to blind users. Attribution: Article text available under CC-BY-SA Creative Commons image source in video
Просмотров: 7197 Audiopedia
July 2017 Meeting of the Advisory Council on Alzheimer’s Research, Care, and Services Part 2
 
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This is the quarterly meeting of the Advisory Council on Alzheimer’s Research, Care, and Services. For more information, please visit https://aspe.hhs.gov/national-alzheimers-project-act