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Biomedical subjects

D M Rust

Publications and source records attributed to D M Rust.

8 recordsLinked to original sources

Risk/benefit profile of arsenic trioxide.

Approximately 20%-30% of patients with acute promyelocytic leukemia (APL) who are treated with the current standard all-trans retinoic acid and anthracycline-based chemotherapy regimen suffer relapse. In the mid-1990s, studies from China reported the effective use of arsenic trioxide in achieving complete remission in patients with APL. In the United States, a multicenter trial of this agent in 40 patients with relapsed APL following conventional therapy confirmed the positive safety and efficacy outcomes of a smaller 12-patient pilot study. Common adverse events were hyperleukocytosis, APL differentiation syndrome, prolonged QT interval on electrocardiogram, skin rash, and hyperglycemia.

Antineoplastic Agents↗

Nutritional issues in patients with severe neutropenia.

OBJECTIVES: To provide information on the assessment and management of the nutritional needs of patients with severe neutropenia. DATA SOURCES: Textbook chapters, research articles, and review articles. CONCLUSIONS: Malnutrition is a common result of high-dose chemotherapy treatment. Clinical outcomes are directly related to careful assessment, early intervention, and ongoing evaluation and monitoring in the severely neutropenic population. IMPLICATIONS FOR NURSING PRACTICE: Early assessment, management, and psychological support are essential in meeting the needs of this patient population.

Humans↗

Effects of sex composition by class and instructor's sex on physical self-efficacy of college men.

The relationship of sex composition of class and instructor's sex to Physical Self-efficacy has yielded conflicting results in several studies. This study examined the relationship of sex composition of class and instructor's sex to scores on Physical Self-efficacy, Perceived Physical Ability, and Physical Self-presentation Confidence of 80 male students enrolled in one of four sections of a strength training class. Analysis indicated no significant difference on Physical Self-efficacy between male students who were enrolled in all male classes or in coeducational classes; improvements in scores on Physical Self-efficacy were not specific to the sex composition of the class or sex of the instructor and no significant difference on Perceived Physical Ability and Physical Self-presentation Confidence between male students who joined an all male class or a coeducational class. Perceived Physical Ability improved from the pretest to the posttest in all classes; and no improvement in scores for Physical Self-presentation Confidence was found in all classes. In conclusion, the analysis showed sex composition of the class and sex of the instructor were not significantly related to scores for self-efficacy.

Female↗

Oprelvekin: an alternative treatment for thrombocytopenia.

Oprelvekin (Neumega, Genetic Institute Co., Cambridge, MA) is a thrombopoietic growth factor approved by the U.S. Food and Drug Administration for the prevention of severe thrombocytopenia following myelosuppressive chemotherapy in patients with nonmyeloid malignancies. The most common side effects are edema, dyspnea, tachycardia, and conjunctival redness. Patient-care concerns include appropriate timing of administration, patient selection, dosing and administration issues, and the early identification and management of side effects.

Antineoplastic Agents↗

Recognizing and managing anemia.

Anemia is not an uncommon problem. Knowledge of a few common laboratory tests can be helpful when caring for patients with anemia. By reviewing approaches to classifying, evaluating, and managing patients with common anemias, nurses will be prepared to care for patients with an anemia more confidently.

Anemia↗

Involvement of adult rehabilitation patients in setting occupational therapy goals.

OBJECTIVE: This preliminary study was designed to determine whether occupational therapists involve patients and their families in a goal-setting process and, if so, to identify the methods used. METHOD: Thirty registered occupational therapists practicing in adult physical rehabilitation settings were audiotaped during an initial evaluation. Researchers reviewed corresponding documentation and interviewed each subject. Twenty-three patient and family involvement criteria were generated from standards developed by accreditation commissions and health care professions. RESULTS: Data revealed that although subjects did involve patients and families in a goal-setting process, a number of criteria were not attempted, thus much potential for involvement was unrealized. Subjects with scores above and below one standard deviation from the mean were identified to determine which patient participation criteria had the highest discrepancies. Discrepancies included (a) verbal preparation of the patient and family for initial and ongoing treatment, purposes and procedures of evaluation and treatment, and potential outcomes of treatment, (b) attempts to elicit the patient's concerns, and (c) collaboration with the patient to establish treatment goals. CONCLUSION: Factors that might have influenced subjects' use of a patient participation approach included the application of a specific theory or technique, time constraints, patient's age, and assumptions about the patient's cognitive status.

Adult↗

Solar flares: an overview.

This is a survey of solar phenomena and physical models that may be useful for improving forecasts of solar flares and proton storms in interplanetary space. Knowledge of the physical processes that accelerate protons has advanced because of gamma-ray and X-ray observations from the Solar Maximum Mission telescopes. Protons are accelerated at the onset of flares, but the duration of any subsequent proton storm at 1 AU depends on the structure of the interplanetary fields. X-ray images of the solar corona show possible fast proton escape paths. Magnetographs and high-resolution visible-band images show the magnetic field structure near the acceleration region and the heating effects of sunward-directed protons. Preflare magnetic field growth and shear may be the most important clues to the physical processes that generate high energy solar particles. Any dramatic improvement in flare forecasts will require high resolution solar telescopes in space. Several possibilities for improvements in the art of flare forecasting are presented, among them: the use of acoustic tomography to probe for subsurface magnetic fields; a satellite-borne solar magnetograph; and an X-ray telescope to monitor the corona for eruptions.

Astronomical Phenomena↗

The novel lipid delivery system of amphotericin B: drug profile and relevance to clinical practice.

PURPOSE/OBJECTIVES: To review the drug profile and nursing implications associated with the new lipid amphotericin preparations. DATA SOURCES: Published articles, abstracts, professional communications, drug manufacturer prescribing information, and personal experience. DATA SYNTHESIS: Three lipid amphotericin B (AmB) preparations have been approved by the U.S. Food and Drug Administration (FDA). The first agent, amphotericin B lipid complex (Abelcet, Liposome Co., Princeton, NJ), a ribbon-like structure, was approved in November 1995 for the treatment of aspergillosis in patients who are refractory to or intolerant of conventional amphotericin B therapy and for invasive fungal infections. In November 1996, amphotericin B cholesteryl sulfate complex for injection (Amphotec, Sequus Pharmaceuticals, Menlo Park, CA), a second preparation composed of a disc-like structure, received FDA approval for the treatment of invasive aspergillosis in patients in whom renal impairment or unacceptable toxicity precludes the use of conventional AmB therapy and in patients in whom prior AmB therapy has failed. Amphotec frequently is referred to as amphotericin B colloidal dispersion (ABCD). The third formulation, a liposomal preparation composed of vesicles, liposomal amphotericin B or L-AmB (AmBisome, Fujisawa USA, Inc., Deerfield, IL, and Nexstar Co., Boulder, CO) recently received FDA approval for three indications. All of these preparations accumulate in organs of the reticuloendothelial system as opposed to the kidneys. Further studies of lipid AmB are needed to help clarify the usefulness of each AmB preparation. The most common side effects of lipid AmB preparations are chills and fever. CONCLUSIONS: Lipid-based AmB preparations are well-tolerated treatments with mild to moderate side effects. These preparations have some advantages over conventional AmB. IMPLICATIONS FOR NURSING PRACTICE: Nurses in clinical settings can focus on staff and patient education, including identification and management of side effects associated with the lipid-based AmB preparations. Patient-care concerns include appropriate patient selection, dosing and administration issues, and the prevention, early identification, and management of toxicities.

Amphotericin B↗