Targeted Temperature Management for Improved Outcomes: Are We There Yet?

Therapeutic hypothermia, also referred to as targeted temperature management, has been a component of the postcardiac arrest treatment guidelines since 2010. Although almost a decade has passed since its inclusion in the postarrest guidelines, many unanswered questions remain regarding selection of the appropriate patient population, optimal target temperature, ideal window of time in which to initiate therapy after arrest, most efficient, safe, and accurate equipment choice for inducing and maintaining hypothermia, most effective duration of treatment, and rate of cooling or rewarming. On a national and international level, critical care nurses are in a unique position to participate in research that will define targeted temperature management protocols and practices.

Eating disorders & breastfeeding.

Disordered eating is a concern for clinicians providing care to adolescent female patients, yet the concern seems to drift from the forefront as the patient matures toward motherhood. As women become pregnant, they may adopt a negative body image that persists throughout the postnatal period with pregnancy-related weight gain. For women with a history of an eating disorder (ED), these physical changes may reactivate past coping strategies such as food restriction, binge eating, or induced vomiting to maintain prepregnancy weight.

The relationship between fistulas in Crohn's disease and associated carcinoma. Report of four cases and review of the literature.

Patients with carcinoma involving chronic fistulizing Crohn's disease may have developed the malignancy due to chronic epithelial irritation at either end of the fistula tract. Alternatively, the carcinoma may be the cause of the fistula. Examples of each type of relationship are presented in the reports of four patients from our institution and supported by a review of the literature.

Centric relation determinations: clinical and radiographic comparisons.

This study investigated variations in occlusal prematurities and condylar positions using different methods of determining centric relation. Thirty patients were randomly placed into three groups of 10. In Group I a clinical analysis of occlusal patterns using bilateral mandibular manipulation (BMM) was compared to results with a chin point (CPM) method.