The Role of the Advanced Practice Nurse in the Academic Setting.

Objectives: To explore how advanced practice nurses implement practice change in academic medical centers to support optimal patient and staff outcomes.

Data Sources: Published peer reviewed literature, web-based resources, and professional society materials.

Conclusion: Cancer care is rapidly evolving and advanced practice nurses can shape the future of how care is delivered as well as the setting it is delivered in.

A standardized care plan is associated with shorter hospital length of stay in patients undergoing pancreaticoduodenectomy.

Background: In this retrospective review, we evaluate a standardized care plan (SCP) for patients undergoing pancreaticoduodenectomy, which included selective placement of feeding jejunostomy tubes (FJTs) and a perioperative fast-track recovery pathway (FTRP).

Methods: A review of 242 patients undergoing pancreaticoduodenectomy was completed. Patients treated pre- and post-SCP implementation were compared.

Feeding jejunostomy tube placement in patients undergoing pancreaticoduodenectomy: an ongoing dilemma.

Background: Concomitant placement of feeding jejunostomy tubes (FJT) during pancreaticoduodenectomy is common, yet there are limited data regarding catheter-specific morbidity and associated outcomes. This information is crucial to appropriately select patients for feeding tube placement and to optimize perioperative nutrition strategies.

Methods: A review of all patients undergoing pancreaticoduodenectomy with FJT placement was completed.

The role of clinical care pathways: an experience with distal pancreatectomy.

Background: Previous studies have indicated that clinical pathways may shorten hospital length of stay (HLOS) among patients undergoing distal pancreatectomy (DP). Here, we evaluate an institutional standardized care pathway (SCP) for patients undergoing DP.

Materials And Methods: A retrospective review of patients undergoing DP from November 2006 to November 2012 was completed.

Phase II study of Cloretazine for the treatment of adults with recurrent glioblastoma multiforme.

Cloretazine (VNP40101M) is a newly synthesized alkylating agent belonging to a novel class of alkylating agents called 1,2-bis(sulfonyl)hydrazines. Agents that belong to this class do not produce vinylating and chloroethylating species, and hence this class of alkylating agents is thought to have minimal systemic toxicity. Cloretazine produces two short-lived active species: 1,2-bis(methylsulfonyl)-1-(2-chloroethyl) hydrazine (a chloroethylating species) and a thiophilic carbamoylating methylisocyanate species.

Gefitinib (Iressa, ZD1839) and tyrosine kinase inhibitors: the wave of the future in cancer therapy.

Targeted therapies are one of the latest innovative trends in cancer therapy. The epidermal growth factor receptor (EGFR) is a target found in high concentrations in several solid tumors including lung, breast, colorectal, and brain. Tyrosine kinase inhibitors, such as gefitinib (Iressa, ZD1839), block the EGFR.

Progress report of a Phase I study of the intracerebral microinfusion of a recombinant chimeric protein composed of transforming growth factor (TGF)-alpha and a mutated form of the Pseudomonas exotoxin termed PE-38 (TP-38) for the treatment of malignant brain tumors.

TP-38 is a recombinant chimeric targeted toxin composed of the EGFR binding ligand TGF-alpha and a genetically engineered form of the Pseudomonas exotoxin, PE-38. After in vitro and in vivo animal studies that showed specific activity and defined the maximum tolerated dose (MTD), we investigated this agent in a Phase I trial. The primary objective of this study was to define the MTD and dose limiting toxicity of TP-38 delivered by convection-enhanced delivery in patients with recurrent malignant brain tumors.

Phase II trial of gefitinib in recurrent glioblastoma.

Purpose: To evaluate the efficacy and tolerability of gefitinib (ZD1839, Iressa; AstraZeneca, Wilmington, DE), a novel epidermal growth factor receptor tyrosine kinase inhibitor, in patients with recurrent glioblastoma.

Patients And Methods: This was an open-label, single-center phase II trial. Fifty-seven patients with first recurrence of a glioblastoma who were previously treated with surgical resection, radiation, and usually chemotherapy underwent an open biopsy or resection at evaluation for confirmation of tumor recurrence.

Using evidence in central catheter care.

Objectives: To discuss a project that identified the causes of central venous catheter infections, implemented corrective interventions, and evaluated the effectiveness of interventions.

Data Sources: Research studies, review articles, data collection, and personal experience.

Conclusions: An educational intervention and individual demonstration improved sterile technique during catheter care, decreased infection rates, and decreased length of hospital stay.