Qigong: Benefits for Survivors Coping With Cancer-Related Fatigue.

Cancer-related fatigue is a potentially debilitating condition that affects many cancer survivors. Qigong, the safe and gentle practice of physical exercises and breathing control developed in Chinese medicine, shows great promise in alleviating cancer-related symptoms such as fatigue. Oncology nurses can improve the lives of cancer survivors by understanding the history and implications of qigong practice for their patients.

Career Motivators for Community Pediatric Hospitalists.

Background And Objectives: Within the field of pediatric hospital medicine, physicians can choose to work at community-based or university-based centers. The factors that motivate pediatric hospitalists to work specifically at community sites have not yet been fully explored. Our objective with this study was to elucidate the motivators for pediatric hospitalists to begin and continue work at community sites.

Implementing the Serious Illness Care Program in Primary Care.

Inadequate communication about serious illness care preferences affects patients, families, health care providers, and health care systems. Many patient and system barriers prevent comprehensive serious illness communication. The purpose of this evidence-based practice project was to provide a structure within a primary care clinic to facilitate conversations with seriously ill individuals about their care preferences that (a) was adaptable to clinic workflow, (b) improved providers' perception of the care conversation experience, (c) improved documentation of care preferences, and (d) provided a comfortable and helpful experience.

Controlling postoperative use of i.v. acetaminophen at an academic medical center.

Purpose: Results of an interprofessional formulary initiative to decrease postoperative prescribing of i.v. acetaminophen are reported.

Supraclavicular Subclavian access for Sapien Transcatheter aortic valve replacement- a novel approach.

Background: Within the trans-subclavian approach, procedural techniques can vary widely, and reported access generally refers to an infraclavicular axillary approach. We describe and report the use of a novel supraclavicular true subclavian approach for transcatheter aortic valve replacement (TAVR) exclusively for implantation of Sapien 3 valves.

Case Presentation: We report our first five consecutive patients undergoing TAVR with a Sapien 3 valve using a standardized subclavian approach at a single center.

Does treating obstructive sleep apnea improve control of Tx-resistant hypertension?

Maybe. Treating obstructive sleep apnea with continuous positive airway pressure is associated with decreases in both systolic and diastolic blood pressure of 3 to 5 mm Hg in patients with treatment-resistant hypertension. The clinical significance of this small decrease hasn't been evaluated, however.

Phantom-based standardization of CT angiography images for spot sign detection.

Purpose: The CT angiography (CTA) spot sign is a strong predictor of hematoma expansion in intracerebral hemorrhage (ICH). However, CTA parameters vary widely across centers and may negatively impact spot sign accuracy in predicting ICH expansion. We developed a CT iodine calibration phantom that was scanned at different institutions in a large multicenter ICH clinical trial to determine the effect of image standardization on spot sign detection and performance.

Creation of an Adult Observation Unit: Improving Outcomes.

A growing segment of patients in hospitals are considered outpatients, classified as observation. These patients neither have the severity of illness nor the intensity of service to qualify as inpatients, yet are not well enough to be discharged. Hospitals have created observation units to address the clinical needs of this growing patient type to provide care in the right setting by managing emergency department throughput and utilizing the most efficient staffing resources.

Complete endoscopic resection of a pituitary stalk epidermoid cyst using a combined infrasellar interpituitary and suprasellar endonasal approach: case report.

Intracranial epidermoid cysts are benign lesions of epithelial origin that most frequently present with symptoms of mass effect. Although they are often associated with a high rate of residual tumor and recurrence, maximal safe resection usually leads to good outcomes. The authors report a complete resection of an uncommon pituitary stalk epidermoid cyst with intrasellar extension using a combined suprasellar and infrasellar interpituitary, endoscopic endonasal transsphenoidal approach.

Enhanced cephalomedullary nail lag screw placement and intraoperative tip-apex distance measurement with a novel computer assisted surgery system.

Objective: The goal of this study was to evaluate the ability of a novel computer assisted surgery system to guide ideal placement of a lag screw during cephalomedullary nailing and then accurately measure the tip-apex distance (TAD) measurement intraoperatively.

Design: Retrospective case review.

Setting: Level II trauma hospital.

Development of Professionalism and Performance Accountability for Sustained FIM Accuracy Improvement.

Purpose: Rehabilitation nurses have essential responsibility for detailed Functional Independence Measure (FIM) documentation and accurate scoring. The goal of this performance improvement project was to improve individual FIM accuracy and establish and maintain a FIM accuracy standard.

Design: Case Study.

From evidence to practice: developing an outpatient acuity-based staffing model.

Background: Reliable and valid outpatient oncology acuity-based staffing systems are lacking. The existing staffing model in a midwestern cancer center demonstrated inefficiencies related to unpredictable patient flow, treatment regimen complexity, and physician practice variation.

Objectives: A project was initiated to implement an evidence-based oncology outpatient staffing system maximizing patient satisfaction, employee engagement, and equity in workload distribution.

Percutaneous inferior cervical sympathetic ganglion blockade for the treatment of ventricular tachycardia storm: case report and review of the literature.

Unlabelled: Running Title: Sympathetic Block for Ventricular Tachycardia Storm.

Introduction: We present the case of a patient with ventricular tachycardia storm refractory to medical therapy and multiple catheter ablations, successfully managed by percutaneous left inferior cervical sympathetic ganglion block.

Summary: A 70-year-old man with a history of ischemic cardiomyopathy and previous placement of implantable defibrillator developed intractable ventricular tachycardia recalcitrant to intravenous amiodarone, lidocaine, and multiple catheter ablations with radiofrequency energy and direct current.

Internal carotid artery stenosis associated with giant cell arteritis: case report and discussion.

Background: Cerebrovascular ischemic events associated with giant cell arteritis (GCA) are uncommon and have been reported in 3%-4% of patients. We describe a case report of GCA associated with intracranial stenosis and review various angiographic findings.

Case Presentation: A 66-year-old man presented with worsening headache and vision loss.

Developing, implementing, and evaluating a professional practice model.

This article describes how The Compass, a professional practice model (PPM), was developed through clinical nurse involvement, review of literature, expert opinion, and an innovative schematic. Implementation was supported through a dynamic video account of a patient story, interwoven with The Compass. Postproject evaluation of PPM integration demonstrates opportunities for professional nursing development and future planning.

Readministration of intravenous alteplase in acute ischemic stroke patients: case series and systematic review.

Background: Because of a high risk of recurrence of ischemic events, some patients may be candidates for readministration of intravenous (IV) alteplase.

Methods: We performed a single-center review and performed a search on PubMed from January 1966 to April 2014 for cases of readministration of alteplase. Favorable outcome was defined by a modified Rankin scale of 0 to 2 at discharge or at 1 to 3 months, improvement of greater than or equal to 4 points within 24 hours in the National Institutes of Health Stroke Scale score, or as a major improvement in the 72-hour National Institutes of Health Stroke Scale score.

Diffuse idiopathic intracranial fusiform aneurysm development. Case report and literature review.

Background: Fusiform intracranial aneurysms (FIAs) are uncommon lesions representing less than 15% of all intracranial aneurysms in most large series. Their etiology has been linked to a variety of causes including atherosclerosis, fibromuscular dysplasia, cystic medial necrosis, connective tissue disease, hypertension, diabetes, hyperlipidemia, infection, cardiac myxoma, oral contraceptive use, vasculitis, and lymphoproliferative disorders. The finding of numerous lesions in a single patient is distinctly uncommon.