Internists, Cardiologist (heart)
10 years of experience

Accepting new patients
600 Highland Ave
Madison, WI 53792
608-829-5485
Locations and availability (6)

Education ?

Medical School Score Rankings
University of Michigan Medical School (2000)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Associations
American Board of Internal Medicine

Affiliations ?

Dr. Ewer is affiliated with 7 hospitals.

Hospital Affilations

Score

Rankings

  • Meriter Hospital Inc
    Cardiology
    202 S Park St, Madison, WI 53715
    • Currently 4 of 4 crosses
    Top 25%
  • UWHP Watertown Regional Medical Center
    Cardiology
    125 Hospital Dr, Watertown, WI 53098
    • Currently 4 of 4 crosses
    Top 25%
  • University of Wisconsin Hospital and Clinics
    Cardiology
    600 Highland Ave, Madison, WI 53792
    • Currently 1 of 4 crosses
  • University of sconsin Hospital
  • UW Health-UW Hospital & Clinics
  • University of Wisconsin Hospital and Clinics, Veterans Hospital - Wm. S. Middleton Memorial
  • Watertown Memorial Hospital Home Health
  • Publications & Research

    Dr. Ewer has contributed to 2 publications.
    Title Returns to Physician Human Capital: Evidence from Patients Randomized to Physician Teams.
    Date November 2010
    Journal Journal of Health Economics
    Excerpt

    Physicians play a major role in determining the cost and quality of healthcare, yet estimates of these effects can be confounded by patient sorting. This paper considers a natural experiment where nearly 30,000 patients were randomly assigned to clinical teams from one of two academic institutions. One institution is among the top medical schools in the U.S., while the other institution is ranked lower in the distribution. Patients treated by the two programs have similar observable characteristics and have access to a single set of facilities and ancillary staff. Those treated by physicians from the higher ranked institution have 10-25% less expensive stays than patients assigned to the lower ranked institution. Health outcomes are not related to the physician team assignment. Cost differences are most pronounced for serious conditions, and they largely stem from diagnostic-testing rates: the lower ranked program tends to order more tests and takes longer to order them.

    Title Cardiotoxicity Profile of Trastuzumab.
    Date
    Journal Drug Safety : an International Journal of Medical Toxicology and Drug Experience
    Excerpt

    Trastuzumab is a monoclonal antibody that targets the human epidermal growth factor receptor tyrosine kinase HER2/ErbB2. This agent has shown a highly significant antitumour effect for patients with HER2-positive breast cancer, and is now considered part of the standard regimens for the treatment of this disease in both the metastatic and adjuvant setting.Cardiotoxicity has been associated with trastuzumab, and this issue has now been studied and documented in a number of adjuvant trials for which data have now been released. Cardiotoxicity has been shown to be potentiated when the agent is used concurrently or sequentially with an anthracycline, and this has limited the use of trastuzumab in some patients. Determining the overall impact of trastuzumab is further complicated by the administration of other cardiotoxic agents such as the taxanes and cyclophosphamide as well as by pre-existing cardiac disease.The incidence of severe congestive heart failure (New York Heart Association class III or IV) was 0-3.9% in the trastuzumab arms versus 0-1.3% in the control arms in the five major randomized adjuvant trials. Only one cardiac death was related to trastuzumab whereas two cardiac deaths occurred in the control arms. Ejection fraction decline of >or=10% or 15% was reported in 3-34% of trastuzumab recipients in these trials.Patients affected by trastuzumab-related cardiotoxicity do not exhibit the cellular death and distinctive ultrastructural myocardial changes seen on electron microscopy with anthracycline-induced cardiotoxicity. The cardiotoxicity of trastuzumab also differs from traditional chemotherapy-induced cardiotoxicity in that it appears to be at least partially reversible, not related to the cumulative dose, and re-challenge is generally tolerated.There remain a number of uncertainties regarding the diagnosis and management of trastuzumab-related cardiotoxicity. While no formal guidelines or consensus statements exist at present regarding cardiac monitoring during use of trastuzumab, proposed recommendations include a careful assessment of ejection fraction prior to initiating trastuzumab, avoidance of concurrent administration of trastuzumab with anthracyclines, and regular monitoring of symptoms and cardiac function during and for several years after therapy. Increased vigilance is appropriate for higher risk patients.


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