Guest guest Posted September 23, 2010 Report Share Posted September 23, 2010 CLEVELAND CLINIC'S PROCEDURE NOW STANDARD (September 1, 2010) " For many years, the standard methods of performing bone marrow procedures in patients with varying bone densities have remained unchanged. This is despite the fact that the manual method of performing bone trephine biopsies has significant limitations, including patient discomfort, needle-related adverse events, and operator dependence. " The new and developing field of intraosseous medicine is finally bringing much-needed change to bone marrow procedures. Intraosseous (IO) vascular access was commonly used by World War II medics to resuscitate soldiers dying from hemorrhagic shock. The technique of infusing fluids and drugs into patients in trauma and resuscitative situations via IO space fell out of favor once the war ended. But in the 1980s, a pediatrician from the Cleveland Clinic observed IO being used during a cholera epidemic in India, and the technique became standard in pediatric advanced life support. " Please note that entire article can be seen at the following website: http://tinyurl.com/25j344p ___________________________ August 10, 2010 GLEEVEC WILL BECOME GENERIC DRUG IN 2015 " Imatinib (Gleevec), the first-line standard of care in chronic myeloid leukemia, will become a generic drug in 2015, so the race is on to find a second generation of tyrosine kinase inhibitors (TKIs) that can do the job just as well. Dasatinib (Sprycel) and nilotinib (Tasigna) have demonstrated benefits as second-line therapies, but could they be frontrunners as first-line therapy as well? New studies would seem to support that theory, although longer patient follow-up and, of course, cost considerations will ultimately determine whether dasatinib and nilotinib are up to the task. " Imatinib has changed the treatment of CML, " said Hagop Kantarjian, MD, a professor and chair of the leukemia department at the M.D. Cancer Center in Houston. " However, there are about 2% to 4% of patients every year who develop resistance or toxicities that require different therapies, and this is where the new generation of TKIs [could] have a significant role: in managing imatinib failure. " " Dr. Kantarjian led a study that evaluated the efficacy and safety of dasatinib compared with imatinib. A second study, the ENESTnd trial, compared nilotinib with imatinib (see " CML patients' molecular response to nilotinib continues to deepen over time " ). For the dasatinib study, 519 patients with newly diagnosed CML were randomized to dasatinib (100 mg) or imatinib (400 mg) for one year. " Complete cytogenetic response (CCyR) and major molecular response (MMR) were used to evaluate efficacy. The primary endpoint was confirmed CCyR, defined as CCyR on two consecutive analyses (ASCO 2010 abstract LBA6500; N Engl J Med 362:2260-2270, 2010). " There is always more at: http://tinyurl.com/22q7zep Did you know that over 1 billion URL's are transformed into tiny URL's every month? Just go to www.tinyurl.com and it is transposed in less than a minute. ___________________________________ HAND HYGIENE (can never be stressed enough and not practiced by some medical professionals. They should wash their hands upon entering and existing the patient's room or office visit. " Hand hygiene has proven to be one of the most effective ways to prevent the transmission of infection. Friese and Lee nicely review the significance of hand hygiene as well as the appropriate hand-washing technique. Hand hygiene cannot be emphasized enough, however; despite the knowledge that hand-washing decreases the risk of infection, clinicians are not always compliant in washing their hands before and after patient contact. Furthermore, most oncology patients are outpatient and it is critical that nurses educate patients about the importance of hand hygiene for themselves and their close contacts. " http://tinyurl.com/25ymq6w _____________________________ FOOD BORNE ILLNESSES LAX IN INSTITUTIONS " In the 1970s, research established that foods, particularly fresh fruits and vegetables, contain Escherichia coli, Pseudomonas aeruginosa, and other gram-negative bacilli.[6] These observations led to the implementation of dietary restrictions for neutropenic cancer patients, commonly referred to as a low microbial or “neutropenic” diet. Nearly all healthcare institutions surveyed in the 2000s recommended a neutropenic diet to their patients, and the most common recommendation was to avoid uncooked fruits and vegetables. " " In one study, 30% of 23 outpatients were noncompliant with the neutropenic diet and infection rates were similar in compliant and noncompliant patients.[12] Another small trial showed no difference in the rate of febrile neutropenia between patients who were randomly assigned to a US Food and Drug Administration. " – http://tinyurl.com/25ymq6w __________________________ fyi, Lottie Duthu Quote Link to comment Share on other sites More sharing options...
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