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https://www.readbyqxmd.com/read/28319813/the-clinical-implications-of-legalizing-marijuana-are-physician-and-non-physician-providers-prepared
#1
Elizabeth Brooks, Doris C Gundersen, Erin Flynn, Ashley Brooks-Russell, Sheana Bull
INTRODUCTION: Passage of voter-driven marijuana reform laws signals a shift in public attitudes for marijuana use. For providers, legalization may necessitate practice modifications, particularly regarding patient-provider conversations about use and risk. We examined healthcare providers' knowledge of marijuana laws and health implications, professional practice behaviors, and attitudes about training. MATERIALS AND METHODS: We surveyed 114 Colorado-based providers who care for children, adolescents, pregnant and breastfeeding women using a Venue-Day-Time survey methodology throughout Colorado...
March 10, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28319519/process-improvement-initiative-for-the-perioperative-management-of-patients-with-a-cardiovascular-implantable-electronic-device
#2
Margaret K Menzel Ellis, Miriam M Treggiari, Jamie M Robertson, Marc A Rozner, Peter F Graven, Michael F Aziz, Matthias J Merkel, Edward A Kahl, Norman A Cohen, Eric C Stecker, Peter M Schulman
BACKGROUND: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, we created and implemented a comprehensive anesthesiologist-run perioperative CIED service to respond to all routine requests for perioperative CIED consultations at a large academic medical center. This study was designed to determine whether this new care model was associated with improved operating room efficiency, reduced institutional cost, and adequate patient safety...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319159/drug-therapy-for-alcohol-dependence-in-primary-care-in-the-uk-a-clinical-practice-research-datalink-study
#3
Andrew Thompson, Darren M Ashcroft, Lynn Owens, Tjeerd P van Staa, Munir Pirmohamed
AIM: To evaluate drug therapy for alcohol dependence in the 12 months after first diagnosis in UK primary care. DESIGN: Open cohort study. SETTING: General practices contributing data to the UK Clinical Practice Research Database. PARTICIPANTS: 39,980 people with an incident diagnosis of alcohol dependence aged 16 years or older between 1 January 1990 and 31 December 2013. MAIN OUTCOME MEASURE: Use of pharmacotherapy (acamprosate, disulfiram, naltrexone, baclofen and topiramate) to promote abstinence from alcohol or reduce drinking to safe levels in the first 12 months after a recorded diagnosis of alcohol dependence...
2017: PloS One
https://www.readbyqxmd.com/read/28318953/mechanical-thrombectomy-in-wake-up-strokes-a-case-series-using-alberta-stroke-program-early-ct-score-aspects-for-patient-selection
#4
Angelos Aristeidis Konstas, Artin Minaeian, Ian B Ross
BACKGROUND: There is lack of published studies on mechanical thrombectomy with stent retrievers for wake-up stroke (WUS). OBJECTIVE: To report the outcomes of WUS patients with large vessel occlusions, selected for intervention based on Alberta Stroke Program Early CT Score (ASPECTS) and treated with stent retrievers or primary aspiration thrombectomy. METHODS: Data were collected retrospectively for each consecutive WUS patient undergoing mechanical thrombectomy with a stent retriever or primary aspiration catheter between February 2015 and September 2016...
March 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28318209/end-of-life-care-managing-common-symptoms
#5
Ross H Albert
Physicians should be proficient at managing symptoms as patients progress through the dying process. When possible, proactive regimens that prevent symptoms should be used, because it is generally easier to prevent than to treat an acute symptom. As swallowing function diminishes, medications are typically administered sublingually, transdermally, or via rectal suppository. Opiates are the medication of choice for the control of pain and dyspnea, which are common symptoms in the dying process. Delirium and agitation may be caused by reversible etiologies, which should be identified and treated when feasible...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28317575/infection-control-in-the-dental-office
#6
REVIEW
Francesco R Sebastiani, Harry Dym, Tarun Kirpalani
The goal of an infection control program is to provide a safe working environment for dental health care personnel and their patients. Practitioners can achieve this by adopting measures that reduce health care-associated infections among patients and occupational exposures among dental health care personnel. It is crucial for all dental practitioners to be up to date on current Centers for Disease Control and Prevention guidelines, equipment, and techniques for proper infection control. Continuous evaluation of infection control practices is important...
April 2017: Dental Clinics of North America
https://www.readbyqxmd.com/read/28316318/synchronous-open-heart-surgery-and-laparoscopic-cholecystectomy-an-observational-case-study-with-28-patients
#7
Mustafa Bilge Erdogan, Mehmet Kaplan, Hakki Kazaz, Bulent Salman
Acute cholecystitis (AC) may be a severe problem and may increase the mortality rate and hospital stay in patients who undergo open heart surgery (OHS), due to its aggressive course; therefore, AC should be treated as soon as possible. We aimed to present data on our synchronous cardiac and laparoscopic cholecystectomy (LC) operations performed for AC complicating patients with cardiac disease and who were waiting to undergo OHS. Between January 2008 and September 2014, we performed 2773 OHSs in Medical Park Gaziantep Hospital...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28315557/oncolytic-viruses-treatment-and-implications-for-patients-with-gliomas%C3%A2
#8
Cheryl Martin
BACKGROUND: Oncolytic viral therapies are increasingly being explored for the treatment of diverse cancer types, most notably melanoma. However, advances in the treatment of high-grade gliomas, and specifically glioblastoma multiforme (GBM), are the result of novel oncolytic viral therapies. Delta-24-RGD is one such therapy that has demonstrated promising results in phase 1 trials.
. OBJECTIVES: The objective of this article is to provide an overview of Delta-24-RGD, highlighting considerations for nurses in diverse clinical, research, and advanced practice roles...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315556/developing-infrastructure-managing-patients-with-cancer-undergoing-car-t-cell-therapy%C3%A2
#9
Elizabeth Halton, Diane Llerandi, Claudia Diamonte, Hilda Quintanilla, Donna Miale-Mayer
BACKGROUND: The introduction of chimeric antigen receptor (CAR) T-cell therapy has created challenges and opportunities for nurses. Clinical nurses must be educated on new treatment modalities to recognize toxicity symptoms and to support the therapy moving forward. 
. OBJECTIVES: This article will discuss nursing leadership and interventions to standardize care and ensure patient safety while receiving CAR T cells. 
. METHODS: Using evolving experience, an interprofessional team created standards of care and identified common toxicities and best practices for their management...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315554/immunotherapy-exploring-the-state-of-the-science%C3%A2
#10
Pamela K Ginex, Kelly Brassil, Beth Ely
Immunotherapy research provides opportunities for nurse scientists and researchers to be at the forefront of the changing landscape of cancer treatment. As these therapies continue to develop, current initiatives will seek to support nurses in clinical practice who must provide safe, evidence-based care and education to patients and their families. This article explores the current state of immunotherapy research and the ways in which continued research can help to advance nursing education and practice.
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315552/cancer-immunotherapy-an-evidence-based-overview-and-implications-for-practice
#11
Virginia Bayer, Beau Amaya, Diane Baniewicz, Colleen Callahan, Lisa Marsh, Asia S McCoy
BACKGROUND: Significant research progress has been made in immunotherapies since the mid-1990s, and this rapid evolution necessitates evidence-based education on immunotherapies, their pathophysiology, and their toxicities to provide safe, effective care.
. OBJECTIVES: The aim of this article is to provide an evidence-based overview, with implications for practice, of checkpoint inhibitors, monoclonal antibodies, oncolytic viral therapies, and chimeric antigen receptor T-cell therapies...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315551/immunotherapy-administration-oncology-nursing-society-recommendations%C3%A2
#12
Kristine B LeFebvre, Lisa Wall, Abigail Baldwin-Medsker, Kim Nguyen, Lisa Marsh, Diane Baniewicz
As the use of immunotherapeutic agents increases in single-agent and multimodality treatment regimens, oncology nurses face the challenge of administering and caring for patients receiving new and unique agents. Oncology Nursing Society clinical staff and clinical nurses collaborated to produce a set of recommendations to educate nurses involved with the monitoring of patients receiving immunotherapy on administration procedures and safe handling of these agents to ensure patient and staff safety and to reduce risk of error...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315537/acuity-based-scheduling-outcomes-in-ambulatory-oncology-centers
#13
LaCrista Edwards, Kimberly Hermis, Christopher R LeGette, Lourdes A Lujan, Cicely Scarlett
With an increase in the number of patients with cancer receiving treatment in the ambulatory setting, a need exists to evaluate lean approaches to provide safe, effective, and timely care delivery. Acuity-based scheduling (ABS) was implemented across the regional ambulatory care centers of a National Cancer Institute-designated comprehensive cancer center. ABS involved templates and a reconfiguration of clinical space and staff according to acuity levels. Results suggest improvement in wait times, capacity, infusion hours, chair use rate, patient visits, chair turns, average infusion length, and patient satisfaction...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315533/songs-for-the-soul-a-program-to-address-a-nurse-s-grief%C3%A2
#14
Carolyn Phillips, Barbara Welcer
When caring for patients with cancer, a number of situations arise that cause nurses to grieve. Nurses need time and space to grieve to prevent the untoward effects of cumulative grief. While providing a safe space for nurses to be vulnerable in grief, Songs for the Soul combines the healing effects of expressive writing, storytelling, and music to help nurses address the grief and suffering they experience in their work. The use of storytelling through music portrays an expression of their grief that matches the intensity of their caregiving experience...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315060/results-of-a-phase-ib-trial-of-combination-immunotherapy-with-a-cd8-%C3%A2-t-cell-eliciting-vaccine-and-trastuzumab-in-breast-cancer-patients
#15
G Travis Clifton, Jennifer K Litton, Karen Arrington, Sathibalan Ponniah, Nuhad K Ibrahim, Victor Gall, Gheath Alatrash, George E Peoples, Elizabeth A Mittendorf
BACKGROUND: CD8+ T cell-eliciting vaccines are being investigated in breast cancer patients. Preclinical data showed that trastuzumab increases the susceptibility of tumor cells to lysis by vaccine-generated CD8+ T cells, suggesting potential benefit of a combination immunotherapy strategy. The current trial was undertaken to demonstrate the safety of this approach. METHODS: This study was designed as a dose-escalation trial enrolling clinically disease-free, human leukocyte antigen A2+ or A3+ , human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients...
March 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28314711/validating-the-herdoo2-rule-to-guide-treatment-duration-for-women-with-unprovoked-venous-thrombosis-multinational-prospective-cohort-management-study
#16
Marc A Rodger, Gregoire Le Gal, David R Anderson, Jeannot Schmidt, Gilles Pernod, Susan R Kahn, Marc Righini, Patrick Mismetti, Clive Kearon, Guy Meyer, Antoine Elias, Tim Ramsay, Thomas L Ortel, Menno V Huisman, Michael J Kovacs
Objective To prospectively validate the HERDOO2 rule (Hyperpigmentation, Edema, or Redness in either leg; D-dimer level ≥250 μg/L; Obesity with body mass index ≥30; or Older age, ≥65 years), which states that women with none or one of the criteria can safely discontinue anticoagulants after short term treatment.Design Prospective cohort management study.Setting 44 secondary or tertiary care centres in seven countries.Participants Of 3155 consecutive eligible participants with a first unprovoked venous thromboembolism (VTE, proximal leg deep vein thrombosis or pulmonary embolism) who completed 5-12 months of short term anticoagulant treatment, 370 declined to participate, leaving 2785 enrolled participants...
March 17, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28314701/genitourinary-involvement-and-management-in-children-with-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#17
J P Van Batavia, D I Chu, C J Long, M Jen, D A Canning, D A Weiss
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are devastating hypersensitivity disorders that cause epidermal cell death and can affect all epidermal surfaces, including the urethra, vagina, labial and scrotal skin. Despite the well-described ocular and orofacial manifestations of SJS/TEN, there is a paucity of reports on the genitourinary (GU) symptoms and their management. Specifically, consulting services often ask the pediatric urology team if it is safe to place a urethral catheter, but there is no data in the literature to help guide management...
February 27, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28314699/safety-and-tolerability-of-idelalisib-lenalidomide-and-rituximab-in-relapsed-and-refractory-lymphoma-the-alliance-for-clinical-trials-in-oncology-a051201-and-a051202-phase-1-trials
#18
Sonali M Smith, Brandelyn N Pitcher, Sin-Ho Jung, Nancy L Bartlett, Nina Wagner-Johnston, Steven I Park, Kristy L Richards, Amanda F Cashen, Anthony Jaslowski, Scott E Smith, Bruce D Cheson, Eric Hsi, John P Leonard
BACKGROUND: A new generation of biological and targeted agents might potentially replace traditional cytotoxic agents in lymphoma. Lenalidomide plus rituximab was felt to be a safe and promising backbone based on available data. Idelalisib is an oral phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor that has promising activity as a monotherapy in refractory indolent lymphomas. The primary objective of these two trials was to determine the maximum tolerated dose of lenalidomide in combination with rituximab and idelalisib in relapsed follicular and mantle cell lymphoma...
March 14, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28314503/standard-donor-lung-procurement-with-normothermic-ex-vivo-lung-perfusion-a-prospective-randomized-clinical-trial
#19
Alexis Slama, Lukas Schillab, Maximilian Barta, Aris Benedek, Andreas Mitterbauer, Konrad Hoetzenecker, Shahrokh Taghavi, Gyoergy Lang, Jose Matilla, Hendrik Ankersmit, Helmut Hager, Georg Roth, Walter Klepetko, Clemens Aigner
BACKGROUND: Ex vivo lung perfusion (EVLP) was primarily developed for evaluation of impaired donor lungs. The good clinical results raise the question for its possible impact on lungs meeting standard criteria. Before application of EVLP on such lungs enters routine clinical practice, it must be demonstrated whether EVLP would affect or improve outcome when used in standard donor lungs. We performed a prospective randomized trial to investigate the role of EVLP in standard lung transplantation (Tx)...
February 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28306332/contrast-enhanced-pulmonary-mra-for-the-primary-diagnosis-of-pulmonary-embolism-current-state-of-the-art-and-future-directions
#20
Donald G Benson, Mark L Schiebler, Michael D Repplinger, Christopher J François, Thomas M Grist, Scott B Reeder, Scott K Nagle
Computed tomographic pulmonary angiography (CTPA) is currently considered the imaging standard of care for the diagnosis of pulmonary embolism (PE). Recent advances in contrast enhanced pulmonary magnetic resonance angiography (MRA) techniques have led to increased use of this modality for the detection of PE in the proper clinical setting. This review is intended to provide an introduction to the state of the art techniques used in pulmonary MRA for the detection of PE and to discuss possible future directions for this modality...
March 17, 2017: British Journal of Radiology
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