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Elizabeth E. Gresch

Bio: Elizabeth E. Gresch is an academic researcher. The author has contributed to research in topics: Vasodilation & Ethical code. The author has an hindex of 5, co-authored 9 publications receiving 1868 citations.

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Journal ArticleDOI
TL;DR: An overview of the ethical and legal requirements of confidentiality in the workplace is provided and the constitutional, statutory, and common law framework governing the treatment of employee medical information, as well as defenses to liability, are discussed.
Abstract: Ethical dilemmas involving confidentiality issues are frequently encountered in occupational medicine. The occupational physician faces a unique challenge because in many circumstances, a physicianpatient relationship, in the ordinary or legal sense, may not exist. The occupational physician ofien faces a conflicting interest between the employee's desire for privacy and the employer's legitimate need to know. The occupational physician must carefully balance these interests for the benefit of society and the parties involved. Occupational physicians also work in a wide variety of practice situations, and the ethical and legal duty of confidentiality may vary substantially with these roles. This article provides an overview of the ethical and legal requirements of confidentiality in the workplace. The constitutional, statutory, and common law framework governing the treatment of employee medical information, as well as defenses to liability, are discussed. Recent legislative changes such as the Americans with Disabilities Act, and new challenges such as the proper handling of HIV information, present unique confidentiality problems.

13 citations

Journal ArticleDOI
TL;DR: This study supports the conclusion that prolongation of median motor and sensory nerve latency can occur within as little as 2 months after beginning employment in the pork processing industry.
Abstract: There is some controversy regarding the relationship between development of median nerve dysfunction and employment activities. We performed nerve conduction studies of median nerve function on individuals before and after starting employment in the pork processing industry. After working an average of 64 days, employees (n = 45) showed significant prolongation of median motor and sensory nerve latency when comparing initial and final testing results in both dominant and non-dominant hands (P = < 0.01 to 0.03). A similar trend was found when testing a smaller group of employees (n = 17) who were already working (mean of 3 days), though this did not generally reach statistical significance. This study supports the conclusion that prolongation of median motor and sensory nerve latency can occur within as little as 2 months after beginning employment in the pork processing industry.

9 citations


Cited by
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Journal ArticleDOI
01 Jun 1990-Cell
TL;DR: A model for the genetic basis of colorectal neoplasia that includes the following salient features is presented, which may be applicable to other common epithelial neoplasms, in which tumors of varying stage are more difficult to study.

11,576 citations

Journal ArticleDOI
27 Jun 2002-Nature
TL;DR: BRAF somatic missense mutations in 66% of malignant melanomas and at lower frequency in a wide range of human cancers, with a single substitution (V599E) accounting for 80%.
Abstract: Cancers arise owing to the accumulation of mutations in critical genes that alter normal programmes of cell proliferation, differentiation and death. As the first stage of a systematic genome-wide screen for these genes, we have prioritized for analysis signalling pathways in which at least one gene is mutated in human cancer. The RAS RAF MEK ERK MAP kinase pathway mediates cellular responses to growth signals. RAS is mutated to an oncogenic form in about 15% of human cancer. The three RAF genes code for cytoplasmic serine/threonine kinases that are regulated by binding RAS. Here we report BRAF somatic missense mutations in 66% of malignant melanomas and at lower frequency in a wide range of human cancers. All mutations are within the kinase domain, with a single substitution (V599E) accounting for 80%. Mutated BRAF proteins have elevated kinase activity and are transforming in NIH3T3 cells. Furthermore, RAS function is not required for the growth of cancer cell lines with the V599E mutation. As BRAF is a serine/threonine kinase that is commonly activated by somatic point mutation in human cancer, it may provide new therapeutic opportunities in malignant melanoma.

9,785 citations

Journal ArticleDOI
18 Oct 1996-Cell
TL;DR: The authors are grateful to the members of their laboratories for their contributions to the reviewed studies and to F. Giardiello and S. Hamilton for photographs of colorectal lesions.

4,959 citations

Journal ArticleDOI
TL;DR: Panitumumab monotherapy efficacy in mCRC is confined to patients with WT KRAS tumors, and KRAS status should be considered in selecting patients withmCRC as candidates for panitumuab mon Therapy.
Abstract: Purpose Panitumumab, a fully human antibody against the epidermal growth factor receptor (EGFR), has activity in a subset of patients with metastatic colorectal cancer (mCRC). Although activating mutations in KRAS, a small G-protein downstream of EGFR, correlate with poor response to anti-EGFR antibodies in mCRC, their role as a selection marker has not been established in randomized trials. Patients and Methods KRAS mutations were detected using polymerase chain reaction on DNA from tumor sections collected in a phase III mCRC trial comparing panitumumab monotherapy to best supportive care (BSC). We tested whether the effect of panitumumab on progression-free survival (PFS) differed by KRAS status. Results KRAS status was ascertained in 427 (92%) of 463 patients (208 panitumumab, 219 BSC). KRAS mutations were found in 43% of patients. The treatment effect on PFS in the wild-type (WT) KRAS group (hazard ratio [HR], 0.45; 95% CI: 0.34 to 0.59) was significantly greater (P .0001) than in the mutant group (HR, 0.99; 95% CI, 0.73 to 1.36). Median PFS in the WT KRAS group was 12.3 weeks for panitumumab and 7.3 weeks for BSC. Response rates to panitumumab were 17% and 0%, for the WT and mutant groups, respectively. WT KRAS patients had longer overall survival (HR, 0.67; 95% CI, 0.55 to 0.82; treatment arms combined). Consistent with longer exposure, more grade III treatment-related toxicities occurred in the WT KRAS group. No significant differences in toxicity were observed between the WT KRAS group and the overall population. Conclusion Panitumumab monotherapy efficacy in mCRC is confined to patients with WT KRAS tumors. KRAS status should be considered in selecting patients with mCRC as candidates for panitumumab monotherapy.

3,040 citations

Journal ArticleDOI
TL;DR: F fluorouracil-based adjuvant chemotherapy benefited patients with stage II or stage III colon cancer with microsatellite-stable tumors or tumors exhibiting low-frequency micros satellite instability but not those with tumors exhibiting high-frequencymicrosatellite instability.
Abstract: Background Colon cancers with high-frequency microsatellite instability have clinical and pathological features that distinguish them from microsatellite-stable tumors. We investigated the usefulness of microsatellite-instability status as a predictor of the benefit of adjuvant chemotherapy with fluorouracil in stage II and stage III colon cancer. Methods Tumor specimens were collected from patients with colon cancer who were enrolled in randomized trials of fluorouracil-based adjuvant chemotherapy. Microsatellite instability was assessed with the use of mononucleotide and dinucleotide markers. Results Of 570 tissue specimens, 95 (16.7 percent) exhibited high-frequency microsatellite instability. Among 287 patients who did not receive adjuvant therapy, those with tumors displaying high-frequency microsatellite instability had a better five-year rate of overall survival than patients with tumors exhibiting microsatellite stability or low-frequency instability (hazard ratio for death, 0.31 [95 percent confi...

2,000 citations