The impact of education on caregiver burden on two inpatient oncology units.

Providing standardized education can alleviate the burden felt by the caregiver and improve health outcomes for both the patient and caregiver. Four disease groups were included in this study that represent a significantly longer hospital stay than other cancers: acute myelogenous leukemia, acute lymphoblastic leukemia, lymphoma, or those undergoing blood marrow transplant. The complexity of care is significantly higher, necessitating greater caregiver burden following hospitalization.

Decreasing patient misidentification before chemotherapy administration.

More accurate patient identification is a Joint Commission National Patient Safety Goal. To decrease the possibility of patient misidentification during chemotherapy administration, nurses on the Bone Marrow Transplant Unit at the University of North Carolina-Chapel Hill instituted a bedside check and measured compliance.

The silicone gel breast implant controversy: current status and clinical implications.

The silicone breast implant controversy has amassed a great deal of media coverage in the past year. Unfortunately, separating fact from fiction has been extremely frustrating and difficult, not only for physicians but for women who have either had or are considering cosmetic or reconstructive surgery of the breast. At a recent meeting attended by most of the board eligible and certified Plastic and Reconstructive Surgeons in the State of Arkansas, it was felt that a consensus statement was needed to clarify the issues and inform other Arkansas physicians of the most up to date information.

Monitoring of blood pressure and heart rate during routine endoscopy: a prospective, randomized, controlled study.

Six hundred and eighteen patients were randomized to have automated cardiovascular monitoring or clinical observation during routine endoscopy. Hemodynamic parameters were recorded at 3-min intervals before, during, and after the procedure. Upper gastrointestinal endoscopy resulted in an increased heart rate (HR), while colonoscopy caused a decreased blood pressure (BP) and HR.

Does the addition of methylene blue to the sclerosant improve the accuracy of injections during variceal sclerotherapy?

We evaluated the possibility that the addition of methylene blue to the sclerosant would improve the accuracy of intravariceal injections during endoscopic variceal sclerotherapy. Four patients had eight sessions of endoscopic variceal sclerotherapy with a sclerosant containing a combination of 3% sodium tetradecyl and 60% renograffin. For four sessions, 1 ml of methylene blue was added to 9 ml of sclerosant.

Gastroesophageal reflux and sclerotherapy strictures.

The development of esophageal stricture is common following endoscopic variceal sclerotherapy (EVS). Gastroesophageal reflux may be at least partly responsible. Twelve randomly selected male patients underwent chronic EVS for the management of bleeding esophageal varices.

The gastrostomy button: a prospective assessment of safety, success, and spectrum of use.

The gastrostomy button is a new, skin level, nonrefluxing, mushroom-tipped feeding device which can be used to replace conventional gastrostomy catheters. We have prospectively evaluated 31 consecutive patients managed with this appliance and our results show that the button can be successfully placed in 90% of cases without serious morbidity or mortality. The procedure is quick to perform, requires minimal intravenous sedation, and is well-suited to a broad range of socially active gastrostomy-dependent patients.

A critical analysis of the Sacks-Vine gastrostomy tube: a review of 120 consecutive procedures.

Results from 120 patients managed with a Sacks-Vine gastrostomy tube were analyzed. In our experience, this device can be successfully placed in almost all cases (96%), and has a low rate for procedure-related mortality (0.8%) and major (4.

Percutaneous endoscopic gastrostomy in patients with prior abdominal surgery: virtues of the safe tract.

Percutaneous endoscopic gastrostomy (PEG) could be potentially more hazardous in patients with prior abdominal surgery. To minimize risk of complications following PEG, we have modified the conventional method to include selection of a "safe gastrocutaneous fistulous tract," using an aspirating, lidocaine-filled syringe and needle. "Safe tracts" prior to PEG placement were determined by simultaneous air return in the aspirating syringe and endoscopic visualization of the intragastric needle.

Alterations in plasma copper, zinc, and ceruloplasmin levels in patients with thermal trauma.

This review was undertaken to elucidate the trends in copper, zinc, total serum protein, and ceruloplasmin levels in patients with thermal trauma. Medical records of pediatric and adult patients were retrospectively reviewed. The findings showed a significant linear decline in mean plasma copper, ceruloplasmin, and total serum protein during the first three days postburn, followed in general by a gradual rise in levels; however, patients with burns larger than 60% TBSA maintained copper, zinc, and ceruloplasmin levels significantly below the lower limits of normal during the observation period.

The current evaluation of nonpalpable breast lesions.

To understand the suspected low yield of malignant neoplasms from biopsies guided by needle localization, we reviewed 122 biopsies performed from January 1985 to November 1986 at University Hospital and Arkansas Baptist Medical Center, Little Rock. The positive biopsy rates were 3.5% and 10.

Course and complications of endoscopic variceal sclerotherapy: a prospective study of 50 patients.

Fifty consecutive patients with bleeding esophageal varices were treated with endoscopic variceal sclerotherapy (EVS) using the free hand method and a flexible fiberoptic endoscope. During the study period, November 1981 through April 1984, 11 patients (22%) rebled after the initiations of EVS and six patients were lost to follow-up. Obliteration of esophageal varices was achieved in 14 patients and none of these patients rebled for a mean follow-up time of 305 days.

The effect of estrogen on protein and RNA concentration and on de novo synthesis of RNA in the uterus of aging ovariectomized mice.

A study was made of RNA concentration and de novo synthesis and protein concentration in the uterus of ovariectomized C57BL/6J mice with and without estrogen treatment. Young adult animals (4 to 7 mo.) were compared with mice during the age period of reproductive decline (11 and 15 mo.