Erlotinib in nsclc

The gene. In some patients, deletions occur in part of the gene; in other patients, changes occur in the sequence of the gene. This gene within the cancer changes a key part of the structure of the protein and the protein changes its shape, which has two results. When ATP binds, it changes the ATP binding pocket, and the protein becomes more easily stimulated by epidermal growth factor. This mutation may confer a proliferative advantage to cells. Second, it changes the receptor kinase pocket where gefitinib and erlotinib bind. In changing the shape and size of that binding pocket, it renders tumors that have this mutation far more sensitive to inhibition by erlotinib and gefitinib.

Using patient expectations and satisfaction data to design a new pharmacy service model in a primary care clinic. 1997; 3 5 ; : 531-40. AIDS enters new era with pharmacists on the front lines. 1997; 3 4 ; : 391-92, 395-96. Outcomes management: the why, what, and how of data collection. 1997; 3 ; : 345-51. Clinical Pharmacy Quality Improvement-- Patient Safety and Prevention of ADEs Preventing medication errors and adverse drug events. 2003; 9 1 ; : 92-93. The role of managed care pharmacy in reducing medication errors. 2003; 9 1 ; : 62-65. Quality improvement, risk management, and patient education: tools to reduce medication error. 2001; 7 2 ; : 156-63. Adverse drug reaction tracking and management in an integrated health care system. 1997; 3 6 ; : 644-47, 650. Clinical Practice Guidelines CPGs ; and Quality Improvement Adherence to the NASPE guideline for amiodarone monitoring at a medical university. 2006; 12 3 ; : 254-59. Chasing quality--clinical practice guidelines and HEDIS measures of asthma and depression therapy management editorial ; . 2006; 12 1 ; : 78-80. The shift towards evidence-based medicine--the role of community-based guidelines supplement ; . 2005; 11 4 ; : S1-S19. Evidence-based medicine: beware of results from randomized controlled trials and research with administrative claims data editorial ; . 2005; 11 2 ; : 172. Who needs another clinical practice guideline? editorial ; . 2004; 10 5 ; : 456-58. Consensus panel, national guidelines, and other potentially misleading terms editorial ; . 2003; 9 6 ; : 575. Evidence-based medicine, practice guidelines, and disease management editorial ; . 2003; 9 6 ; : 573. Crossing the quality chasm--incremental change through clinical practice guidelines CPGs ; editorial ; . 2002; 8 5 ; : 400-01. Actual prescribing versus guidelines. 2002; 8 4 ; : 297-98. Relationship of clinical factors to the use of COX-2 selective NSAIDs within an arthritis population in a large HMO. 2002; 8 4 ; : 252-58. An assessment of the effectiveness of a nonsteroidal anti-inflammatory drugs algorithm in an integrated health care system. 2001; 7 2 ; : 149-55. Clinical Quality Improvement Management of NSAID-induced upper GI disorders using AMCP's Framework for Quality Drug Therapy supplement ; . 2005; 11 2 ; : S1-S19. Framework for pharmacy services quality improvement-- a bridge to cross the quality chasm. 2004; 10 1 ; : 60-78.

Editor--In their overview of the role of telephone consultation in primary care Car and Sheikh point out the potential for improving access for patients and reducing general practitioners' workload.1 We have two important observations from five years of running telephone consultation skills courses with members of primary care teams. Firstly, all health professionals conducting telephone consultations need to provide a "safety net" for callers--for example, by ensuring that they are given explicit permission and directions to call back if symptoms change or the patient's condition worsens. In our experience, participative professional development courses can both raise awareness of such issues and increase confidence in managing calls.2 Secondly, primary care nurses locally report a high rate of telephone contacts, which, if representative, indicates a hitherto undocumented increase in telephone consulting by nurses.3 However, evidence from participants on our courses indicates that issues of clinical governance for nurses may be more complex and less well explored than the medicolegal issues for general practitioners. Unlike colleagues employed by NHS Direct, who work within explicit clinical governance frameworks, 4 nurses in general practice need to satisfy themselves that they are within the boundaries of their professional competence, be aware of the limitations imposed by lack of visual cues and develop strategies to minimise them ; , 5 and be aware of the need to treat all telephone contacts with patients as consultations and have the appropriate professional and organisational support to do so. Given the likely continued expansion of telephone consulting by all health professionals, appropriate training should be a requirement for general practitioner registrars and primary care nurses. In addition, primary care trusts should provide guidance on appropriate clinical governance frameworks and estramustine.

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