The current landscape of in situ and ex situ machine perfusion utilization for liver grafts from cardiac donation after circulatory death donors in the US.

Donation after circulatory death (DCD) is driving the increase in deceased organ donors in the United States. Normothermic regional perfusion (NRP) and ex situ machine perfusion (es-MP) have been instrumental in improving liver transplant outcomes and graft utilization. This study examines the current landscape of liver utilization from cardiac DCD donors in the United States.

Integrating 40-GEP Testing to Improve Clinical Recommendations for Adjuvant Radiation for Cutaneous Squamous Cell Carcinoma: Multidisciplinary Consensus Guidelines.

Early identification and intervention in patients with cutaneous squamous cell carcinoma (cSCC) who are at high risk for metastasis is important for optimal outcomes. Prognostic tools (e.g.

Ethical Considerations in Supporting Donation after Circulatory Death: The Role of the Dead-Donor Rule.

There is a conflict between the wishes of terminally ill patients to allow withdrawal of treatment and become donors after cardiac death (DCD) and the limit on interventions required by the dead-donor rule (DDR). Once a breathing tube is removed, hours can pass before the patient expires. This interim time complies with the DDR, but often makes donation impossible.

Photodynamic Therapy with 5-aminolevulinic Acid 10% Gel and Red Light for the Treatment of Actinic Keratosis, Nonmelanoma Skin Cancers, and Acne: Current Evidence and Best Practices.

Photodynamic therapy (PDT) can be an effective treatment for actinic keratosis (AK) as well as selected non-melanoma skin cancers (NMSCs), such as Bowen's disease and superficial basal cell carcinoma. PDT has also demonstrated effectiveness in the management of acne vulgaris. Results from controlled clinical trials have shown the safety and efficacy of PDT for these conditions with the use of different photosensitizers and a wide range of light sources.

Once-daily Dapsone 7.5% Gel for the Treatment of Acne Vulgaris in Preadolescent Patients: A Phase IV, Open-label, 12-week Study.

NCT02959970 Acne vulgaris in patients aged younger than 12 years is increasingly common and primarily noninflammatory (i.e., comedonal).

Tolerability of Photodynamic Therapy Using 10% 5-Aminolevulinic Acid Hydrochloride Gel for Treating Actinic Keratoses on Surface Areas Larger than 75cm.

Photodynamic therapy (PDT) is a well-known treatment modality for actinic keratosis (AK). The largest surface area approved by the FDA is 20cm with 10% 5-aminolevulinic acid hydrochloride gel (10% ALA gel). This retrospective study assessed the tolerability of PDT with 10% ALA gel in areas ranging from 75cm to 300cm.

Infected Bronchogenic Cyst With Left Atrial, Pulmonary Artery, and Esophageal Compression.

Ultrasound-guided transbronchial needle aspiration was used successfully for both diagnosis and treatment of a rare bronchogenic cyst caused by an infection that was compressing mediastinal structures.

How Should We Decide Whether and When Some Care Is Better Than No Care?

This case of cleft lip and palate repair by a surgical mission team is common. Low-risk, single-procedure surgical interventions requiring minimal follow-up with substantial quality of life improvement are well suited for this type of mission. However, cleft repair can also be quite complex and require multiple surgeries and other care over time, postoperative surveillance, and speech therapy.

Current Issues in Liver Transplantation.

The state of liver transplantation continues to evolve. This article focuses on 3 separate yet important issues within this field. First, there is a proposal to change the allocation of donor livers in the United States.

Nonthrombotic complications related to central vascular access devices.

Central vascular access devices (CVADs) provide reliable access for a variety of infusion therapies both in hospital and nonhospital settings. CVAD complications that are not identified and resolved can lead to a delay in therapy or the loss of vascular access. Rapid and accurate identification of complications is essential for obtaining expected treatment outcomes.

IL-28B As a Predictor of Sustained Virologic Response in Patients with Chronic Hepatitis C Virus Infection.

Genome-wide association studies have recently identified single nucleotide polymorphisms in proximity to the interleukin-28B (IL-28B) gene that can predict sustained virologic response (SVR) in patients with chronic hepatitis C virus (HCV) infection who are undergoing therapy with pegylated interferon (IFN) a and ribavirin. IL-28B encodes IFN-λ3, a type III IFN involved in host antiviral immunity. Favorable variants of the 2 most widely studied IL-28B polymorphisms, rs1 2979860 and rs8099917, are strong pretreatment predictors of early viral clearance and SVR in patients with genotype 1 HCV infection.

Teaching and learning with concept maps.

Concept maps are teaching and learning tools that incorporate visual and written representations of related information. Nurse educators can employ concept mapping in various situations to promote a deeper level of learning and to improve retention of information among their students. Concept mapping has been suggested as a tool to assist in planning nursing care and developing critical thinking skills, as well as for evaluation of course learning.

Management of recurrent hepatitis C following liver transplantation.

Hepatitis C virus (HCV) is the most common indication for liver transplantation in the United States, and recurrent disease associated with HCV is a major cause of allograft loss and mortality. Up to 30% of transplant recipients with HCV will develop progressive fibrosis and cirrhosis within 5 years of transplantation. Several recipient, donor, and viral factors have been identified as risk factors for disease progression.

. . . with documenting consultations.

The three parts of documenting a consultation remain the same: request, render, report. It is also important to document the intent of the request. If there is mutual agreement that this involves the transfer of care, a consultation is not appropriate and a new patient evaluation should be reported.

Changing paradigms in dermatology: topical immunomodulators within a permutational paradigm for the treatment of atopic and eczematous dermatitis.

The first formulation of a class of products called topical immuno modulators (TIMS) was approved for clinical use in December 2000 and released in February 2001. This product is tacrolimus in an ointment base, prescribed under the Protopic. The next TIM, pimecrolimus cream, was FDA approved in December 2001 and launched February 2002 in a cream vehicle under the Elidel.