Readability of patient education materials: a comparison of rural and urban cardiac rehabilitation sites in Minnesota.

Purpose: Printed materials play a major role in cardiac rehabilitation (CR) patient education. Past studies have demonstrated a marked disparity between the average American reading ability (8th grade) and the readability levels of printed CR patient materials. This study compares the readability of facility-developed patient education materials used by rural and urban CR sites in Minnesota.

Pulmonary nodular lesions in bone marrow transplant recipients: impact of histologic diagnosis on patient management and prognosis.

Bone marrow transplantation is associated with numerous pulmonary complications, which may manifest as nodules. We studied 33 bone marrow transplant (BMT) recipients in whom pulmonary nodular lesions (PNLs) developed during a 5-year period and who underwent open lung biopsy (OLB) for diagnosis. Of 33 patients with PNL, 15 (45%) had pulmonary cytolytic thrombi (PCT), a recently described condition characterized histologically by occlusive vascular lesions and hemorrhagic infarcts and clinically by a favorable outcome.

Stereotactic radiosurgery versus fractionated stereotactic radiotherapy boost for patients with glioblastoma multiforme.

The aim of this study is to evaluate the efficacy of stereotactic radiotherapy boost (SRB) in patients with glioblastoma multiforme (GBM) by comparing two different regimens, single dose or fractionated treatment. Between December 1994 and January 2000, 24 patients with GBM were treated with SRB in conjunction with external beam radiotherapy (EBRT). Fourteen patients (58%) were treated with stereotactic radiosurgery (SRS) and 10 patients (42%) with fractionated stereotactic radiotherapy (FSRT).

The evaluation and management of accidental hypothermia.

Accidental hypothermia is defined as an unintentional decrease in core body temperature to below 35 degrees C. Hypothermia causes hundreds of deaths in the United States annually. Victims of accidental hypothermia present year-round and in all climates with a potentially confusing array of signs and symptoms, but increasing severity of hypothermia produces a predictable pattern of systemic organ dysfunction and associated clinical manifestations.

Surgical management of fusiform aneurysms of the peripheral posteroinferior cerebellar artery.

Objective: To describe the management and outcomes of seven patients with fusiform aneurysms of the peripheral posteroinferior cerebellar artery (PICA).

Methods: Medical records and neuroimaging studies of seven patients who underwent surgical treatment of fusiform aneurysms of the peripheral PICA were reviewed. Average follow-up time was 1.

Lung and heart-lung transplantation: implications for nursing care when hospitalized outside the transplant center.

The surgical procedure for patients undergoing lung and heart-lung transplantation, conventional discharge criteria following the surgery, and common transplant-related complications will be reviewed. The impact of transplant on the routine illnesses experienced by people living in the community will also be discussed, including special nursing considerations when caring for patients following lung or heart-lung transplantation. As transplant recipients return to their homes and communities, it is likely that they will first come to their local hospital to care of these illnesses.

Radiation dose response for supratentorial low-grade glioma--institutional experience and literature review.

Purpose: To examine radiation dose response for low-grade glioma (LGG) based on our institutional experience and to review the literature on this topic.

Methods And Materials: Sixty-seven patients with supratentorial low-grade nonpilocytic astrocytomas (n=36) or oligodendrogliomas (n=31) were treated with postoperative radiation therapy (RT). Twenty-seven patients (group A) received 5520 cGy; 24 patients (group B) received 5940 cGy; and 16 patients (group C) received 6375 cGy.

Nursing's role in complementary and alternative therapy use in critical care.

Critical care nurses can expect to encounter more patients using CAT and increasing opportunities and requests for CAT use in their critical care environments. This provides an opportunity for nurses' involvement to shape proactively how the use of these therapies will unfold in critical care. This can be accomplished in various ways.

Financial considerations in living organ donation.

The shortage of cadaveric organs and increased success of living donor transplantation support the use of living organ donors. Clinical social workers have the opportunity to explore a variety of donor-specific issues when performing psychosocial evaluations of living donors, including motivation, psychological stability, and personal and family consequences of donation, as well as the direct and indirect financial consequences faced by living donors. Although most donor-related medical costs are covered, other associated expenses are not reimbursable and may put donors at risk for financial hardship.

Nurse attitudes towards the use of complementary and alternative therapies in critical care.

Background: There is increasing demand for complementary/alternative therapies (CAT) in critical care, however, critical care nurses' perspectives regarding CAT are unknown.

Objectives: This study was conducted to determine critical care nurses' knowledge, attitudes, and use of CAT.

Sample/setting: A total of 348 critical care registered nurses working at least 40% in medical, surgical, cardiac, neurological, and pediatric ICUs at 2 tertiary-level hospitals in a large Midwestern city were surveyed.

Invasive cutaneous verruco-cystic squamous cell carcinoma. A pattern commonly present in transplant recipients.

To determine whether certain histologic features are more common in cutaneous squamous cell carcinomas (CSCCs) arising in transplant recipients than in others, we assessed several features of CSCCs from 23 patients who had not undergone transplantation and 25 transplant recipients (size, depth of invasion, sun damage, nuclear atypia, keratinization, epidermal inclusion cyst [EIC]-like features, verrucous features [VFs], shape, and mitoses per 10 high-power fields). We analyzed relationships by using chi 2 and t tests and logistic regression analysis. Transplant recipients tended to be younger than control subjects (mean [SD] age, 56.

The pattern of CD10 expression in selected pathologic entities of the prostate gland.

There is increasing evidence that neuropeptides, including bombesin, may influence growth, angiogenesis, invasiveness, and metastasis in prostate cancer. One of the molecules tightly involved in the regulation of neuropeptide activity is the integral membrane glycoprotein CD10, or neutral endopeptidase 24.11.

Perceived barriers to articulation: institutional characteristics.

It has been generally acknowledged that a number of obstacles, or barriers, exist in the articulation process. Based on literature review, student characteristics as well as institutional characteristics may act as barriers. This paper focuses on institutional characteristics.

Total left ventricular outflow tract obstruction due to left ventricular assist device-induced sub-aortic thrombosis in 2 patients with aortic valve bioprosthesis.

This report describes 2 patients with an aortic bioprosthesis. Both patients developed total thrombotic occlusion of the sub-aortic left ventricular outflow tract consequent to insertion of a left ventricular assist device (LVAD). Replacing a mechanical valve with a bioprosthesis in patients receiving a left ventricular assist device offers no additional protection against thrombosis of the aortic prosthesis.

A survey of genetic counselors' strategies for addressing ethical and professional challenges in practice.

There is limited research about ethical and professional dilemmas that genetic counselors encounter in their practice and their strategies for addressing them. In this study, 454 genetic counselors rated the frequency with which they encounter each of 16 ethical/professional challenges identified and categorized previously (McCarthy Veach P., Bartels DM, LeRoy BS (2001) J Genet Couns 10(2):97-119).

Graft-vs-host disease after solid organ transplant.

We identified 10 solid organ transplant recipients with a histologic diagnosis of graft-vs-host disease (GVHD). Histologic slides were reviewed, and information on the transplant, HLA match, and blood product transfusion history was obtained. Molecular testing to evaluate the presence of donor lymphocytes (chimerism) was done in 1 case.

Positive remote crossmatch: impact on short-term and long-term outcome in cadaver renal transplantation.

Background: A positive crossmatch with a "current" recipient serum (drawn shortly before the proposed transplant) is a contraindication to renal transplantation because of the risk of hyperacute rejection. Conflicting data have been reported concerning the significance of a positive crossmatch with "remote" sera (obtained months or years earlier) when the current crossmatch is negative.

Methods: Recipients of a first or second cadaver transplant between June 1988 and April 1994 were studied.

Early vestibular rehabilitation in patients with Meniere's disease.

This article proposes a broadened definition of vestibular rehabilitation to include patients with active, fluctuating Meniere's disease. Pedagogy in the program shifts from amelioration of symptoms by vestibular adaptation or habituation to education, prevention, and self-empowerment. Recommendations are given for patient education, prevention, and examination.

Design and operation of a current good manufacturing practices cell-engineering laboratory.

Medical centers and biotechnology companies active in cellular and gene therapy increasingly are working to design and build clinical laboratories capable of performing cellular engineering and vector production using current good manufacturing practices (cGMPs). Because cell engineering is a rapidly changing field, and definitions for cell engineering cGMPs are still being established, a cGMP cell-engineering laboratory most often should be designed with a broad range of potential applications in mind. While the laboratory facility is the most tangible aspect of cGMP, it represents only part of a larger process, which it must be designed and built to support.

Understanding the pathogenesis and the pathology of hyperacute cardiac rejection.

The terminology of hyperacute rejection (HAR) has become outmoded and confusing due both to advances that have been made in delaying its onset and due to a proliferation of synonyms for the same pathologic process. Until such time as antibody-mediated xenograft rejection can be classified by the type of causative antibody, it is recommended that the term hyperacute rejection be applied to antibody-mediated rejection with classical HAR occurring within 24 h. Delayed HAR is the same pathologic process encountered after 24 h.

Antegrade periurethral administration of Durasphere for management of a vesicoperineal fistula.

A patient who had developed a persistent fistula between the urethra and bladder neck after its surgical closure in the construction of a continent urinary pouch and Mitrofanoff nipple was successfully treated by antegrade periurethral injection of a newly approved injectable bulking agent for stress urinary incontinence (Durasphere) to occlude the bladder neck. We believe this to be the first reported use of Durasphere for such treatment.

Squamous cell carcinoma of the head and neck in solid organ transplant recipients.

Background: The increased incidence of cancer after solid organ transplantation is well established in the literature, yet outcome studies in this population are rare. Excluding skin cancers, squamous cell carcinomas make up most head and neck cancers in transplant recipients.

Methods: At our institution, of 5300 solid organ transplant recipients, 34 have had head and neck cancer develop.