Several of Dr. Cauwels' clients for Continuing Medical Education (CME), medical marketing, and patient information materials first contacted her after other writers had failed repeatedly to revise poor copy to their satisfaction.
Allied Educational Foundation
Associated Urology of Bergen-Passaic
Bauer Publishing Company
Jason L. Chertoff, M.D.
Columbia-Presbyterian Medical Center
CPR Strategic Marketing Communications
Davids Productions, Inc.
Dugan Valva Contess
Einson Freeman Inc.
Emory University School of Medicine
F. Hoffmann-La Roche Ltd
Fairview Community Hospitals
Health Science Communications
Healthy Directions, LLC
Innovative Medical Education
Lally, McFarland & Pantello, Inc.
Dawn L. Leger, Ph.D.
M3 USA, A Sony Group Company
Medical Analysts, PC
Medical Education Technologies, Inc.
MediMedia USA, Inc.
MJM Creative Services, Inc.
Mount Sinai Journal of Medicine
Parkview Treatment Centers
The Peck Center
Projects in Knowledge
Strategic Implications International (BLP Group)
Torre·Renta·Lazur Communications Inc.
Turning Point Extended Care & Sober Living
University of Wisconsin School of Medicine
World Nutrition, Inc.
Articles, Letters, Interviews, Columns
• Ghosted pediatric and adult neurological case studies (in progress)
• Ghosted articles for American Journal of Psychiatry, American Journal of Geriatric Psychiatry, Journal of Child and Adolescent Psychiatry, Current Psychiatry, Psychiatric Services, Psychiatric Times, and Journal of the American Psychiatric Nurses Association (all under review)
• Ghosted article for Pharmaceutical Representative
• Ten articles in Reader's Digest and Woman's World
• Eleven New York Times letters; one Bergen Record letter
• Interviewed about medicine by the Saturday Evening Post (July/August 1997) and for the Bristol-Myers Squibb annual report (1987) as well as on seven television and 16 radio news/talk shows across the United States and in Canada
Pharmaceutical, Corporate, Ad Agency, CME Writing
Abstracts, booklets, executive summaries, journal supplements, meeting materials, monographs, patient education materials, scripts (and voice-overs), proposals, slide lecture kits, training programs
The Body Shop and subsequent writings have covered most medical disciplines, along with administration, alternative medicine, dentistry, ethics, FDA regulations, funding, health insurance, hygiene, information management, legalities, pharmacoeconomics, radiology
• Various interactive physician information pieces for MDLinx.com about new agents, thus far in oncology, cardiology, idiopathic thrombocytopenic purpura
• "Racial Disparities in Infant Mortality: A Quality of Care Perspective" in Mount Sinai Journal of Medicine (scheduled January 2008)
• "Extraperitoneal Robotic Radical Prostatectomy" and “Urologic Telerobotic Surgery: Obtaining Clinical Privileges” in Textbook of Robotic Urology Surgery (forthcoming)
• "Penicillin Desensitization in an Oral and Maxillofacial Surgery Patient: A Case Report," Journal of Oral and Maxillofacial Surgery (forthcoming)
• "Schizophrenia: From Neuroscience to Clinical Experience," Advanced Studies in Medicine (forthcoming)
• Sections of Musculoskeletal Disorders in the Workplace: Principles and Practice (forthcoming 2nd ed)
• Techniques in Aesthetic Rhinoplasty (forthcoming 3rd edition)
• "Learning and Teaching in Dermatology: A Practitioner's Guide," Archives of Dermatology
• Eight "Point/Counterpoint" columns in Physician's Weekly
• Eating disorders consultant for Jane Fonda: Cooking for Healthy Living (1996)
• Technical reports on glucose sensors, cochlear implants, and islet microencapsulation
CME Lectures and Educational Activities
• Honorary ID in psychiatry; appointment offered in dermatology education, Columbia-Presbyterian Medical Center
• Conference lecturer, North Shore University Hospital-Cornell University Medical College, American Anorexia/Bulimia Association, Anorexia/Bulimia Clinic of New Jersey; declined requests from B.A.S.H. Inc. and Postgraduate West Rehabilitation Center
CME Slide Lecture Kits
•Progress in Prevention of CMV Disease in Solid Organ Transplantation, a modular 60-slide lecture kit
• One draft of a 60-slide lecture kit on TNFR:Fc for rheumatoid arthritis
Slide A-10 Pharmacokinetics Of Oral Ganciclovir In Adults
Oral ganciclovir has a low mean absolute bioavailability (6%-9%) attributed to poor permeability across the gut wall membrane. No major metabolites are found in either urine or feces. The renal clearance of oral ganciclovir, 3.4 mL/min/kg, is similar to that for IV ganciclovir. The apparent half-life of 4.4 hours is slightly longer than the IV half-life of 3.5 hours and indicates continued absorption from the gastrointestinal tract (1). When oral ganciclovir is taken with food, bioavailability is increased.
Slide A-11 Pharmacokinetics Of Oral Ganciclovir In Liver And Kidney Transplant Recipients
For patients with estimated creatinine clearance (CrCl) higher than 70 mL per minute, an oral ganciclovir dosage of 3 grams per day (one gram every 8 hours) yields average minimum concentrations (Cmin) of 0.78±0.46 μg/mL, average maximum concentrations (Cmax) of 1.42±0.37 μg/mL, and an average area under the curve (AUC) 0-24 hours of 24.7±7.8 μg hr/mL.
For patients whose estimated CrCl is lower than 10 ml per minute, a dosage of .5 gram of oral ganciclovir three times a week yields an average Cmin of 0.75±0.42 μg/mL, an average Cmax of 1.59±0.55 μg/mL, and an average AUC 0-24 hours of 32.3±9.4 μg hr/mL (1).
Slide A-12 Directions for Future Study
[Concluding slide to follow Section B or C or Key Slide combination]
Additional investigation into the use of oral ganciclovir needs to focus on a) the impact of its long-term use on graft and patient survival, b) the rates of development of resistant viral strains, and c) the clinical effectiveness of oral ganciclovir for cytomegalovirus (CMV) prevention in the transplantation of other solid organs.
The increased incidence and severity of CMV disease in bone marrow, small intestinal, lung, and heart-lung transplant recipients underlines the importance of defining the role of oral ganciclovir in these high-risk settings (1).
Excerpt from text of TNFR:Fc slide kit draft
Slide B-1 Cytokines in RA
Recent advances in molecular technology have helped identify distinct cell subsets, surface markers, and products that contribute to the inflammation and destruction seen in rheumatoid arthritis (RA) (1).
Cytokines are small protein messenger molecules that control cellular function, differentiation, and intercellular cooperation. They are important mediators of immune and inflammatory responses.
Rheumatoid joints exhibit high expression of certain cytokines, prolonged in the synovium, as well as upregulated levels of their receptors. These cytokines appear to originate from macrophages or fibroblasts rather than from activated leucocytes (2).
Slide B-2 Cytokine Classification in RA
Based on their presumed pathological function in RA, cytokines fall into three classes.
Proinflammatory cytokines include interleukines (IL-1, IL-6, IL 8), tumor necrosis factor alpha (TNF-α), granulocyte-macrophage colony-stimulating factor (GM-CSF) and other chemokines. These might regulate the increase and activation of inflammatory effector cells and local cellular survival and proliferation.
Antiinflammatory cytokines (including IL-4, IL-10, IL-11) oppose the action or suppress the production of proinflammatory cytokines.
The third class is anticytokine molecules such as soluble p55 and p75 TNF-α and soluble IL-1 receptor antagonist that could block the effects of these proinflammatory cytokines (1).
Slide B-3 Cytokine Disequilibrium in RA
During an inflammatory response, the equilibrium of pro- and antiinflammatory cytokines (sometimes called the cytokine network) appears to determine whether chronic inflammation ensues (1). In RA the expression of cytokines in the synovium of the joint is imbalanced in favor of proinflammatory cytokines (2).
Slide B-4 Biological Inflammation Modulators
Biological agents designed to suppress proinflammatory cytokine activity have thus far included cytokine receptor antagonists, anticytokine monoclonal antibodies, fusion molecules consisting of soluble cytokine receptors combined with human Fc constructs or polyethylene glycol (PEG), and counterregulatory cytokines such as interleukin-10, -4, or -11 that oppose the actions of the target cytokine (1).
Slide B-5 Interleukin Modulators
Some biological agents attack the processes underlying RA by modulating the production of either anti- or proinflammatory interleukins.
Administered with MTX in clinical trials, IL-10 injections have shown mild efficacy with good tolerance. Decreases in platelet count returned to normal after cessation of therapy (1).
Implicated as one of two major cytokine contributors to the inflammatory and destructive manifestations of RA (2), IL-1 likewise has been targeted for therapy. In clinical trials, injections of one IL-1 receptor antagonist (IL-Ira) have shown positive results on joint erosions while demonstrating safety and good tolerance with no antibody formation.
Slide B-6 Inflammatory Cascade
The other major cytokine contributor to the pathogenesis of RA is TNF-α, as has been demonstrated in vitro. Studies using proinflammatory cytokine receptor antagonists have shown that these molecules are linked in a hierarchy. Blocking IL-1 reduces production of IL-6 and IL-8 but not that of TNF-α. Blocking TNF-α, however, blocks IL-1 and IL-6 also, placing TNF-α above IL-1 in the molecular cascade.
Its position at the inflammatory apex makes TNF-α a particularly attractive therapeutic target (1). As such, it is the subject of the next two sections.
More samples of medical writing appear on the Other Books and Other Instructional Design pages. Or return to the Top.