Nursing Care Throughout the Chimeric Antigen Receptor T-Cell Therapy Process for Multiple Myeloma.

Objectives: Approvals of chimeric antigen receptor T-cell (CAR-T) therapies for relapsed/refractory multiple myeloma (RRMM) represent advancements in treatment options for a hard-to-treat population. Nursing care during CAR-T therapy is crucial for patients, their caregivers, and the broader CAR-T therapy care team. This manuscript provides an overview of the CAR-T therapy administration process and describes practical considerations for nursing professionals working with patients who receive CAR-T therapy.

Molecular Testing in Hematologic Malignancies.

Molecular testing technologies have been increasingly integrated into clinical research and are essential tools in the care of patients with hematologic malignancies. During this session at JADPRO Live Virtual 2021, Laura J. Zitella, MS, RN, ACNP-BC, AOCN, reviewed key concepts for diagnostic testing with a focus on molecular testing (including cytogenetics, FISH, PCR, and next-generation sequencing) and discussed how to interpret the results for hematologic malignancies to inform prognosis as well as treatment.

Approach to the Hospitalized Patient With Thrombocytopenia.

During the 2020 JADPRO Live Virtual conference, Laura J. Zitella, MS, RN, ACNP-BC, AOCN®, educated the audience on the most important causes of thrombocytopenia in hospitalized patients and diagnostic approaches to employ.

Words Matter: Use of Respectful Language in Oncology.

During JADPRO Live Virtual 2020, Conference Chair Laura J. Zitella, MS, RN, ACNP-BC, AOCN®, spoke with Tatiana M. Prowell, MD, about overcoming implicit bias, the power of language, and creating a culture of respect in oncology for both patients and health-care professionals.

Prevention of Infection: A Systematic Review of Evidence-Based Practice Interventions for Management in Patients With Cancer.

Background: Cancer-related infections lead to increases in mortality, antibiotic use, and hospital stays. Other adverse outcomes include dose delays and reductions, which can result in suboptimal treatment outcomes.

Objectives: Effective implementation of risk assessment and evidence-based interventions for the prevention and treatment of infection are essential to improve care and reduce costs related to infections in patients with cancer receiving immunosuppressive therapy.

Advances in the Use of Immunotherapy in Oncology.

Innovations in cancer immunotherapy have created new options for patients and avenues for clinicians to practice precision medicine.

Model-Based Comparison of Deep Brain Stimulation Array Functionality with Varying Number of Radial Electrodes and Machine Learning Feature Sets.

Deep brain stimulation (DBS) leads with radially distributed electrodes have potential to improve clinical outcomes through more selective targeting of pathways and networks within the brain. However, increasing the number of electrodes on clinical DBS leads by replacing conventional cylindrical shell electrodes with radially distributed electrodes raises practical design and stimulation programming challenges. We used computational modeling to investigate: (1) how the number of radial electrodes impact the ability to steer, shift, and sculpt a region of neural activation (RoA), and (2) which RoA features are best used in combination with machine learning classifiers to predict programming settings to target a particular area near the lead.

Multimodal 7T Imaging of Thalamic Nuclei for Preclinical Deep Brain Stimulation Applications.

Precise neurosurgical targeting of electrode arrays within the brain is essential to the successful treatment of a range of brain disorders with deep brain stimulation (DBS) therapy. Here, we describe a set of computational tools to generate in vivo, subject-specific atlases of individual thalamic nuclei thus improving the ability to visualize thalamic targets for preclinical DBS applications on a subject-specific basis. A sequential nonlinear atlas warping technique and a Bayesian estimation technique for probabilistic crossing fiber tractography were applied to high field (7T) susceptibility-weighted and diffusion-weighted imaging, respectively, in seven rhesus macaques.

Subject-specific computational modeling of DBS in the PPTg area.

Deep brain stimulation (DBS) in the pedunculopontine tegmental nucleus (PPTg) has been proposed to alleviate medically intractable gait difficulties associated with Parkinson's disease. Clinical trials have shown somewhat variable outcomes, stemming in part from surgical targeting variability, modulating fiber pathways implicated in side effects, and a general lack of mechanistic understanding of DBS in this brain region. Subject-specific computational models of DBS are a promising tool to investigate the underlying therapy and side effects.

In Vivo 7T MRI of the Non-Human Primate Brainstem.

Structural brain imaging provides a critical framework for performing stereotactic and intraoperative MRI-guided surgical procedures, with procedural efficacy often dependent upon visualization of the target with which to operate. Here, we describe tools for in vivo, subject-specific visualization and demarcation of regions within the brainstem. High-field 7T susceptibility-weighted imaging and diffusion-weighted imaging of the brain were collected using a customized head coil from eight rhesus macaques.

Computational modeling of pedunculopontine nucleus deep brain stimulation.

Objective: Deep brain stimulation (DBS) near the pedunculopontine nucleus (PPN) has been posited to improve medication-intractable gait and balance problems in patients with Parkinson's disease. However, clinical studies evaluating this DBS target have not demonstrated consistent therapeutic effects, with several studies reporting the emergence of paresthesia and oculomotor side effects. The spatial and pathway-specific extent to which brainstem regions are modulated during PPN-DBS is not well understood.

Three-dimensional computational prediction of cerebrospinal fluid flow in the human brain.

A three-dimensional model of the human cerebrospinal fluid (CSF) spaces is presented. Patient-specific brain geometries were reconstructed from magnetic resonance images. The model was validated by comparing the predicted flow rates with Cine phase-contrast MRI measurements.

Putting evidence into practice: prevention of infection.

The prevention of infection is an important outcome to measure in patients with cancer because infectious complications are a significant cause of morbidity and mortality. Nurses play a vital role in the prevention of infection in patients with cancer through nursing practice, research, and patient education. However, many common nursing interventions to prevent infection are based on tradition or expert opinion and have not been subjected to scientific examination.

Advanced colorectal cancer: current treatment and nursing management with economic considerations.

Colorectal cancer is one of the most common cancers affecting men and women in the United States. In 2005, 10% of all new cancer cases in men will be colorectal; for women, 11% of new cases will be colorectal. The disease is the third most frequent cancer occurring in both sexes.

Central venous catheter site care for blood and marrow transplant recipients.

Treatment-induced neutropenia, long central venous catheter (CVC) dwell times, and the use of immunosuppressive agents place blood and marrow transplant recipients at high risk for CVC infection. The most common causative organisms of CVC infection are ubiquitous skin flora of hospitalized patients. A great deal of research on CVC care, including dressing change procedures and frequency, has been conducted; however, variations in study design, patients studied, and terminology used to define CVC infection limit the generalizability of the findings.