Tulane Medical Center

Radiopharmaceuticals represent a promising new frontier in cancer therapy. In the United States, cancer is the second leading cause of death. There is an urgent need to develop new therapies to meet this challenge, especially for those patients with advanced and refractory disease. The Society of Nuclear Medicine and Molecular Imaging and Food and Drug Administration convened a "Dose Optimization of Radiopharmaceutical Therapy Developmental Workshop" on May 6 and 7, 2024. Herein, we briefly summarize the highlights from that meeting from the perspective of the stakeholders involved, including multiple representatives from academia, industry, and the Food and Drug Administration. For patients with advanced treatment-refractory solid tumors, the greatest health-related risk is their cancer, rather than long-term toxicity from radiopharmaceutical therapies. In these patients, concerns about long-term nephrotoxicity, marrow toxicity, or the development of second malignancies are of lesser importance given that there is little or no long-term probability of survival. Phase 1 studies that explore dose and schedule are crucial because they set the stage for larger studies that potentially inform regulatory approval.

Creating moral space involves actions and omissions. An important omission of solidarity is to refuse to hold or attend professional conferences in countries and American states where laws and social approbation make it uncomfortable, unwise, or dangerous for certain members of the professional community to attend. Markowitz’s Impermissible Sacrifice Principle, which she used to critique abortion policies, is employed to show why it is wrong to hold a professional conference in such a state and why solidarity requires the support of all moral persons. While this article describes the importance of this principle now in terms of LGBTQ+ persons, it may also apply soon or even now with regard to persons of colour, women, and/or visiting non-American citizens. It is also shown why solidarity against impermissible sacrifices is a better way to ground decisions about locating or attending conferences than a teleological argument about boycotts to change policy.

Abstract Description We previously found that depletion of CSF1Rhi macrophages (Mθ) using a rhesus IgG1 recombinant antibody against CSF1R (α-CSF1R) reduced cholesterol and improved insulin sensitivity in naturally prediabetic rhesus macaques (RM). High fructose diet (HFrD)-fed RMs have been established as a model of metabolic syndrome (MetS), with increased insulin resistance and increased monocyte chemoattractant protein 1 (MCP-1). We hypothesized that depletion of CSF1Rhi tissue Mθ using a monoclonal α-CSF1R and replacement with freshly differentiated Mθ could alleviate inflammation in tissues and ameliorate prediabetic disease in HFrD-fed RMs. We induced MetS in 8 Indian RMs (aged 13-27) through a HFrD for 3-13 months. RMs were treated with either α-CSF1R or an IgG1 control administered intravenously (15 mg/kg) once every 2 weeks for 6 weeks. Clinical parameters such as serum triglycerides (TG), glucose, insulin, adiponectin, CSF1, IL1β, and MCP-1 were monitored during treatment (Tx) and 8 weeks after the Tx. Mθ subsets and circulating immune cell subsets were quantified by immunofluorescent staining and flow cytometry. HFrD resulted in increased TG, fasting insulin levels, and myelopoiesis in all animals, and type 2 diabetes in 2 animals. Tx with α-CSF1R resulted in decreased TG, glucose, fructose consumption, and insulin and increased adiponectin, CSF1, serum globulin and transitional B cells. In conclusion, Tx with α-CSF1R improved multiple clinical parameters associated with MetS. Funding Sources Supported by American Heart Association Predoctoral Fellowship 24PRE1188080, American Heart Association Predoctoral Fellowship Natalie Stahr (PI), 01/01/2024-12/31/2025. CSF1R Blockade in Prediabetic Rhesus Monkeys. Topic Categories Immune Mechanisms of Human Disease (HUM)

Purpose The purpose of this study was to analyze the existing literature to determine if and how surgical residents are taught to dictate operative notes. The secondary aim was to compile perceptions regarding the teaching and quality of resident operative dictation (OD) and ways in which teaching might be improved. # Method A systematic review was performed following PRISMA guidelines. PubMed, CINAHL, Web of Science, and EMBASE were searched for studies related to operative note dictation in U.S. surgical residency programs from 2010-2023. Results The initial search yielded 782 results, which were screened by two independent reviewers (MVL and BCG), resulting in 9 studies that met the inclusion criteria. These studies, covering various surgical subspecialties, revealed that while 44%-67% of surveyed surgical residency program directors (PDs) prioritize teaching OD, only 17% currently provide formal education in this area. Notably, synoptic reports, which employ templates with discrete data fields, demonstrated significantly greater completeness (94.7%) compared to traditional dictated operative reports (66%). Completeness of resident OD did not correlate with level of training, and pertinent information was lacking at all resident PGY-levels. Educational interventions in the form of lectures and video instruction improved the completeness of OD by up to 22%. Conclusions Despite the crucial role of OD in patient care, medicolegal aspects, and billing, this review underscores a lack of routine and formal instruction of this skill in U.S. surgical residency programs. Limited studies suggest potential improvement through formal educational interventions. Future research should delve into the costs and barriers hindering the integration of formal dictation training, shedding light on why PDs have not universally adopted such initiatives.