Getting support 032415
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This document discusses types of support for managing diabetes and provides suggestions for building a supportive network. It identifies emotional and hands-on support, potential support people like family, friends, and care teams, and recommends asking supports to help with specific diabetes tasks. The document also notes that communicating treatment needs calmly, praising behavior, and problem-solving together are most helpful, while blaming, shaming, nagging or denying worries are not supportive. It encourages expressing experiences to gain support and finding balance through fun family activities and self-care.
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The document provides information on using temporary basal rates and advanced bolus options on insulin pumps. It discusses when to use temporary basal rate increases or decreases, such as for illness, exercise, or changes in activity level. It also reviews normal, extended, and dual/split bolus options and provides examples of when each would be appropriate. The document highlights tools like basal patterns, alarms, and pump suspensions that can help manage insulin needs and support forgetfulness. It concludes with tips for pump use and answers to common pump questions.
TLCDBU-2016: Sugar Surfing workshop - Dr. Steven Ponder
This document contains notes from a presentation on Sugar Surfing, which is described as a metaphor for "Dynamic Diabetes Self-Management" that goes beyond fixed dosing formulas. It involves learning to steer one's glucose responses in the moment using pattern management. Examples are provided of glucose readings from individuals of various ages who practice Sugar Surfing, demonstrating how it can be done regardless of insulin method or diet. Key concepts of Sugar Surfing like pivots, drops, shelves and following trends are defined and illustrated with graphs.
Mixing Sports and Diabetes
This document discusses how people with diabetes can participate in sports and exercise safely by managing their blood glucose levels. It explains that all sports are allowed for people with diabetes, but they need a plan to monitor and adjust insulin doses and carbohydrate intake before, during, and after physical activity, as exercise can either increase or decrease blood glucose depending on its intensity and duration. The document provides specific tips, such as checking blood sugar more frequently during exercise and consuming carbohydrates to prevent or treat low blood sugar. It emphasizes the importance of education coaches and teammates about diabetes management as well as having necessary supplies available for physical activity.
Basic Insulin Pumping
This document provides information about basic insulin pumping. It describes what an insulin pump is, potential benefits, and challenges. It discusses calculating basal rates, bolus doses, and correction factors. It provides guidance on pump maintenance like changing sites and settings. It addresses common questions around pump use, troubleshooting, and ensuring settings are optimized. The overall message is that pumps require diligent self-care and monitoring to achieve good blood sugar control.
Challenging Food Situations
Meaghan Anderson presented on challenging food situations for people with diabetes. She discussed macronutrients and their impact on blood glucose, how to calculate carbohydrates and estimate insulin needs. She explained glycemic index and load, and emphasized the importance of chewing food and using carb counting to estimate blood sugar impact of meals.
How, When and Why to Use Advanced Insulin Pump Features
This presentation was authored by Meaghan Anderson MS RD LD CDE, Senior Diabetes Clinical Manager-Houston North - Medtronic Diabetes specially for the Advanced Diabetes Seminar at TLC on April 26, 2014.
Sweet & low
This document provides guidance on treating low blood sugar, including what to do if someone is unconscious or seizing. It discusses the contents of a "go bag" for treating low blood sugar, such as glucose tabs, juice boxes, candy, glucose gel/honey packets, and Glucagon. It outlines the "Rule of 15" for treating low blood sugar - giving 15 grams of carbohydrates, waiting 15 minutes, then rechecking blood sugar and repeating if needed. It provides instructions for using gel/honey if the person cannot eat or swallow, and using Glucagon if they are unconscious or seizing. The document also briefly discusses guidelines for treating high blood sugar.
Basics of insulin pump theory
Authored by Brant P. Foster, RN, a long time friend and contributor to the Texas Lions Camp. This seminar is for the Advanced Diabetes Seminar 2014 at TLC.
Blood glucosemonitoring
A presentation for the April 26, 2014 Advanced Diabetes Seminar at Texas Lions Camp. Author is my friend and colleague Nelda Rodriguez-Caceres, RN, CDE -
ADA Outpatient Diabetes Program Coordinator
Diabetes Care Coordinator - Shoreline & CHRISTUS Spohn Hospital Corpus Christi.
Sailing Around Common Diabetes Emergencies
This presentation is authored by my good friend and colleague, Dr. Barb Schreiner. The presentation is for the Advanced Diabetes Seminar presented at Texas Lions Camp, Saturday, April 26, 2014.
Diabetes Family Teamwork with Teens: What is Success?
This is a presentation authored and developed by my friend and colleague Dr. Barbara Anderson of Baylor College of Medicine. The presentation is a module in the 2014 Advanced Diabetes Seminar, hosted by Texas Lions Camp.
In this discussion, Dr. Anderson dives into the topic of “Diabetes Family Teamwork with Teens: What is Success?”
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TLCDBU-2016: How, when and why to use advanced features
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...
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Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Nano-gold for Cancer Therapy chemistry investigatory project
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
The Nervous and Chemical Regulation of Respiration
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Getting support 032415
- 1. Barbara Anderson PhD Marisa Hilliard PhD Baylor College of Medicine and Texas Children’s Hospital Houston, TX
- 2. Types of Support EMOTIONAL HANDS-ON Listening Normalizing your experience Laughing with you Crying with you Sharing your outrage Sitting with you quietly Offering a hand with a specific need Taking something off your plate, lightening your load Helping you solve a problem Advocating on your behalf
- 3. Who are your supports? Family members Spouse/partner Friends Roommates/Neighbors Sitters Teachers/Coaches Community members (clubs, church, etc.) Other T1D parents Online community Diabetes Care Team
- 4. You’re not alone. How can your supports help you? Asking for assistance with a specific diabetes task can help direct well-meaning people to be supportive. What can each of your supports do to be helpful? Teachers can hold your child’s CGM receiver in class Friends/neighbors can learn emergency diabetes care and check in on your child when you’re running late from work.
- 5. Tell your supports what would be helpful. Calm, supportive communication Acknowledge, praise management behaviors A few reminders Involved in diabetes discussions Problem-solving together Blame & Shame Angry communication Punishing out-of-range numbers Nagging Denying fears/worries, pretending everything is fine HELPFUL NOT HELPFUL
- 6. Don’t hold back. Talk about your experiences to get support: Friends, family Diabetes online community Caregiver support organizations Diabetes care team Model for your child how to express feelings and advocate for diabetes needs.
- 7. Take care of yourself and your family Prioritize fun activities as a family Protect diabetes, try to reduce conflict about diabetes Find humor where you can Set aside some time for your own needs
- 8. What has worked for you? Where do you go for support? What have you asked from your support network? Who has been the most surprisingly helpful person? What did they do? How do you take time for yourself and why?