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Biomedical subjects

Robert Coleman

Publications and source records attributed to Robert Coleman.

23 records · Page 2Linked to original sources
PubMed2004

Bisphosphonates in the treatment of skeletal metastases.

Metastatic bone disease puts an enormous burden on patients and health care resources. Disruption of normal bone homeostasis by bone metastases leads to troublesome skeletal complications, such as bone pain, pathologic fractures, hypercalcemia of malignancy, and spinal cord compression. Bisphosphonates are an effective treatment for skeletal complications. These agents act primarily by initiating biochemical processes that ultimately result in apoptosis of osteoclasts, but they also have a number of other antitumor functions (eg, inhibition of angiogenesis). At present, the most widely used bisphosphonates are oral clodronate and intravenous pamidronate and zoledronic acid. Although these agents are effective in reducing skeletal complications, they are associated with varying safety and convenience issues. More recently, the availability of ibandronate as intravenous and oral formulations represents a new alternative for the treatment of metastatic bone disease. Further studies are necessary to establish the comparative benefits of bisphosphonates in metastatic bone disease.

Bone Neoplasms↗
PubMed2004

Managing metastatic bone disease: three case studies.

Metastatic bone disease constitutes a major clinical problem. Skeletal complications are common and lead to significant morbidity, and patients live with metastatic bone disease for several years, increasing the prevalence of this problem. Effective management aims to reduce the incidence of skeletal complications and relieve symptoms, such as severe bone pain, which adversely affect patient mobility and quality of life. This article describes and discusses strategies for managing metastatic bone disease, with particularly emphasis on the role of the bisphosphonate ibandronate. Two case histories show the long-term efficacy and tolerability of oral ibandronate in the treatment of metastatic breast cancer. The third case history illustrates the benefits of rapid pain relief from an intensive, high-dose regimen of intravenous ibandronate in metastatic prostate cancer.

Administration, Oral↗
PubMed2002

An organized pilot program promoting web access to picture archiving and communications system data: emphasis on offices outside the host institution.

A formal Pilot Program for Web-based access to a host picture archiving and communication system (PACS) can augment the transition to filmless radiology. Beyond the technical issues of PCs and networks, appropriate legal input and documentation is necessary. While it is important to be in line with overall institutional priorities with regard to online access strategies, it is important to recognize that the Radiology Department has the greatest stake in successfully going filmless, and that it is incumbent upon the Radiology Department itself to take on outreach efforts to the medical community at large. The MMC Web Access Pilot Project has been successful in helping key non-MMC offices overcome the issues associated with preparing for and mastering Web access to PACS images. The benefit has been mutual, and MMC is now able to provide better advice to new offices that are coming online, as well as sharpening its focus on logistical issues that need to be resolved if we are to eliminate film from medical practice.

Humans↗
PubMed2002

Sharing of a single picture archiving and communications system among disparate institutions: barriers to success.

There has been a great deal of interest in sharing picture archiving and communications system (PACS) technology. Much of the discussion to this point has involved macro business/technical issues, such as cost for service, bandwidth, and storage technologies. In our own effort to share the Maine Medical Center PACS with other providers, we have found that the micro issues are just as important, including trust, cooperation, persistence, and dedication to fundamental change. It is not impossible to share a PACS, but a number of barriers must be overcome if the overall effort is to be successful. In this paper we present our experience with shared PACS technology by describing the impediments to sharing PACS among disparate institutions; explaining our early attempts to integrate "outside" images into our institutional PACS and the impediments that led to the failure of those early attempts; and suggesting a semi-quantitative means for calculating Likelihood of Success, based on lessons learned thus far. We also describe a new, multilevel effort at sharing our PACS, hoping to stimulate discussion of the barriers to success and to solicit input from PACS vendors and from fellow SCAR members.

Computer Communication Networks↗