Efficacy of Letermovir for Cytomegalovirus Prophylaxis Following Alemtuzumab T-Cell Depleted Allogeneic Hematopoietic Stem Cell Transplant.

In vivo T-cell depletion (TCD) using alemtuzumab decreases the risk of Graft vs Host Disease (GvHD) in recipients of allogeneic hematopoietic stem cell transplant (allo-HSCT). However, this approach increases the risk of infections post-allo-HSCT, including Cytomegalovirus (CMV). Letermovir is approved for the use in CMV prophylaxis post-allo-HSCT.

Blinatumomab Therapy Is Associated with Favorable Outcomes after Allogeneic Hematopoietic Cell Transplantation in Pediatric Patients with B Cell Acute Lymphoblastic Leukemia.

Blinatumomab, a bispecific T cell engager that binds CD19 in leukemic cells and CD3 in cytotoxic T cells and leads to leukemic blast lysis, is often used in pediatric patients with relapsed/refractory (R/R) B cell acute lymphoblastic leukemia (B-ALL) prior to allogeneic hematopoietic cell transplantation (allo-HCT). Concerns about the potential risk of blinatumomab-related immune-mediated toxicities after allo-HCT have not been adequately addressed. These include graft-versus-host disease (GVHD), delayed engraftment, and graft failure or rejection.

Utilization of a New Customizable Scoring Tool to Recruit and Select Pulmonary/Critical Care Fellows.

Background: Finding the ideal candidate for a residency/fellowship program has always been difficult. Finding the "perfect" match has always been the ultimate goal. However, many factors affect obtaining that "perfect" match.

Comparison of the visual outcome between macula-on and macula-off rhegmatogenous retinal detachment based on the duration of macular detachment.

Objective: To compare the visual outcomes between macula-on and macula-off primary rhegmatogenous retinal detachment (RRD) based on the duration of macular detachment (DMD).

Methods And Analysis: Retrospective study including 96 eyes with RRD (34 macula-on and 62 macula-off) repaired between June 2012 and March 2020. The final visual acuity (VA) was compared after the patients were divided by the status of the macula and their DMD.

Pretrauma Functional Independence Measure Score Predicts Survival in Geriatric Trauma.

The Functional Independence Measure (FIM) is used by rehabilitation professionals to access disability. The FIM score combines both motor and cognitive parameters to assess a patient's level of required assistance in performing activities of daily living (ADL). The geriatric trauma patient is becoming an increasingly important cohort for trauma services.

Stopping paclitaxel premedication after two doses in patients not experiencing a previous infusion hypersensitivity reaction.

Purpose: Paclitaxel-based chemotherapy continues to be an integral component of breast cancer treatment. Prolonged use of paclitaxel may result in repeated doses of premedications that can have unwanted side effects. Infusion hypersensitivity reactions occurring beyond the second dose of paclitaxel are infrequent and not well characterized.

Case study: family presence in the OR for donation after cardiac death.

Organ donation after cardiac death is an ethical and acceptable practice of providing organs for transplantation. Organ recovery, the removal of life support, and patient death occur in the OR, and, because family members are not present, some feel that they have abandoned their loved one. This article reports a case study of a young woman brought to a level I trauma center with nonsurvivable injuries from a motor vehicle accident.

Culture, context, and innovation: a Kiwi Canuck perspective.

This commentary lends a global practitioner perspective on the utility of this volume to the efforts of mentors and mentees and mentoring program developers. Dave Marshall and Karen Shaver, of Big Brothers Big Sisters New Zealand and Canada, respectively, offer keen insights into the value of creating a shared language for discussing mentoring relationship development, while at the same time acknowledging the specific impact that cultural differences play in helping to shape mentoring processes.

Agreement on sedation-related events between a procedural sedation registry and computerized medical records.

Objectives: Little is known about the accuracy of the medical record to document sedation-related events (SREs). Our hypotheses were that, when compared to a reference database (RD), a procedural sedation quality assurance registry (PSQAR) and medical records were accurate documentation of SREs.

Methods: All cases in our PSQAR over 13 months were examined.

Acute myocardial infarction after administration of low-dose intravenous epinephrine for anaphylaxis.

This case describes a 29-year-old woman who presented with an acute severe anaphylactic reaction to penicillin. In addition to other medications administered in the emergency department, she received 0.1 mg intravenously of 1:10 000 epinephrine, after which she immediately developed severe chest pain.

Evaluation of a clinical decision rule for young adult patients with chest pain.

Objectives: The authors sought to validate a clinical decision rule that young adult (younger than 40 years) chest pain patients without known cardiac disease who had either no cardiac risk factors and/or a normal electrocardiogram (ECG) are at low risk (<1%) for acute coronary syndromes (ACS) and 30-day adverse cardiovascular (CV) events.

Methods: A prospective cohort study of patients 24-39 years old who received an ECG for chest pain from July 1999 to March 2002 were included. Cocaine users were excluded.

Impact of a negative evaluation for underlying coronary artery disease on one-year resource utilization for patients admitted with potential acute coronary syndromes.

Unlabelled: Reduction in emergency department (ED) overcrowding is a major Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) initiative. One major source of ED overcrowding is patients waiting for telemetry beds.

Objective: To determine whether, in patients admitted with a potential acute coronary syndrome, a negative evaluation for underlying coronary artery disease would reduce ED and hospital revisits over the subsequent year compared with patients who did not receive an evaluation for underlying coronary artery disease.

A challenge to meet the future: nursing education in Oregon, 2010.

Nursing leadership in Oregon has united behind a plan to address the nursing shortage, setting forth five strategic goals. Two of these are specific to nursing education--to double enrollment by 2004 and redesign nursing education to more directly meet the changing health care needs of Oregonians. This article describes the Oregon Nursing Leadership Council plan and the processes used to develop it.

Job and career satisfaction among staff nurses: effects of job setting and environment.

Just as customer satisfaction is the key to retaining customers, satisfaction with job and career choices are important for keeping staff nurses on the job. The roles of employment setting, job commitment, tenure, years until retirement, short staffing, and patient load in predicting satisfaction were assessed for RN and LPN staff nurses. Results show that when RNs and LPNs feel short staffing interferes with their ability to meet patient care needs, they are also less satisfied with both their job and their career.

Magnetic resonance imaging: utilization in the management of central nervous system trauma.

Objective: To determine the availability, use, and perceived value of magnetic resonance imaging (MR) in the management of acute central nervous system (CNS) trauma in United States Level I (or equivalent) trauma centers (TCs).

Design, Materials, And Methods: One hundred sixty-nine American College of Surgeons, state or locally designated Level I (or equivalent) TCs were identified using compiled lists and telephone contacts. Surveys about MR use in CNS trauma were mailed to each institution.

On causality, responsibility, and self-blame: a theoretical note.

Examples from the literature on "self-blame" for illness (Tennen, Affleck, & Gershman, 1986) and criminal victimization (Janoff-Bulman, 1979) illustrate insufficient attention to construct validity in the measurement of causality, responsibility, and blameworthiness. Distinctions among these terms have been drawn in detail in a recent theory of the attribution of blame (Shaver, 1985), and these are briefly described. We argue that in future research and theory in the attribution of responsibility and blame, especially self-blame, investigators should attend more carefully to such conceptual distinctions.

Delayed manifestations of congenital rubella.

The manifestations of congenital rubella syndrome (CRS) can be grouped according to time of onset into newborn, extended, and delayed CRS. The delayed manifestations are not present in early life and include the following: endocrinopathies: diabetes, thyroid disease, and growth hormone deficiency; deafness; ocular damage: glaucoma, keratic precipitates, keratoconus, corneal hydrops, and absorption of the cataractous lens; vascular effects: fibromuscular proliferation of the intima, sclerosis of arteries, systemic hypertension secondary to renal disease, and subretinal neovascularization; and progressive rubella panencephalitis. Several mechanisms of pathogenesis of the damage have to be considered for the delayed manifestations, including growth of the virus in tissues, resulting in a reduced growth rate and shortened life-span of the cells; autoimmune responses, initially stimulated by the infection; genetic susceptibility; vascular damage by the viral infection with further stenosis or occlusion of the vessels later; reactive hypervascularization; and chronic persistence of the virus in the tissue with subsequent extension of the infection to other areas.

Autoimmunity in congenital rubella syndrome.

Two hundred one deaf adolescents with congenital rubella syndrome and 83 age-matched deaf control subjects were evaluated for the presence of organ-specific antibodies directed against thyroid microsomes, thyroglobulin, pancreatic islets, adrenal cortex, and gastric parietal cells. Positive thyroid microsomal or thyroglobulin antibodies were found in 23.3% (47/201) of the rubella group and in 12.

Usher syndrome: definition and estimate of prevalence from two high-risk populations.

The Usher Syndrome (US) refers to the combined neurosensory deficits of profound hearing impairment and retinitis pigmentosa. We have obtained information on 600 cases of deaf-blindness from the registry of the Helen Keller National Center for Deaf-Blind Youths and Adults (HKNC). Of these, 54% met the diagnostic criteria of US, although only 23.