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Biomedical subjects

D Wujcik

Publications and source records attributed to D Wujcik.

15 recordsLinked to original sources
PubMed1996

Update on the diagnosis of and therapy for acute promyelocytic leukemia and chronic myelogenous leukemia.

PURPOSE/OBJECTIVES: To present information about recent Food and Drug Administration (FDA)-approved indications regarding drug therapy for acute promyelocytic leukemia (APL) and chronic myelogenous leukemia (CML) and about the nursing care of patients receiving these therapies and to review the significance of the use of polymerase chain reaction (PCR) assays in the management of patients with these leukemias. DATA SOURCES: Published articles, book chapters, and production information. DATA SYNTHESIS: Two agents with newly approved FDA indications are changing the focus of leukemia treatment from the cytotoxicity of specific drugs to the reversal of arrested maturation of myeloid cells. All-trans-retinoic acid (ATRA) induces remission in patients with relapsed or refractory APL. Interferon alfa (IFN-alpha) administered to patients with chronic-phase, Philadelphia-chromosome-positive CML produces improved survival rates and delays disease progression as compared to standard therapy. PCR assays are used with both of these diseases to confirm diagnosis, monitor response to these agents, and predict disease progression. CONCLUSIONS: The care of patients with leukemia continues to change as new agents such as ATRA and are approved for treatment and new assays such as PCR become available for diagnosis and treatment monitoring. IMPLICATIONS FOR NURSING PRACTICE: The nursing care of patients with leukemia requires keeping knowledgeable about the latest information regarding the molecular biology of the disease, the mechanism of action of newly approved agents, and the clinical implications of developing tests. This knowledge allows nurses to assimilate new therapies into practice, which, in turn, enables them to help patients to understand and cope with treatment through patient education and innovative interventions for symptom management.

Adolescent↗
PubMed1994

Selected complications of allogeneic bone marrow transplantation.

Patients receiving allogeneic bone marrow transplant experience multiple complications. Specifically, infection, renal complications, VOD, and GVHD can produce life-threatening toxicity. Many of the treatments cause further compromise of major organs. Astute nursing assessment and prompt interventions can decrease the severity experienced by the patient. Each of these complications requires ongoing study to develop new therapies for management.

Acute Kidney Injury↗
PubMed1994

Intravenous immunoglobulin administration: an evaluation of vital sign monitoring.

PURPOSE/OBJECTIVES: To determine if adverse reactions to IV immunoglobulin G (IVIG) were being detected by nurses and frequent vital sign monitoring. DESIGN: Retrospective chart review. SETTING: Bone marrow transplant (BMT), medical oncology, and pediatric units and the outpatient clinic of a 720-bed hospital in middle Tennessee. SAMPLE: 62 charts of patients undergoing BMT who had received IVIG. METHODS/MAIN RESEARCH VARIABLES: Charts were reviewed for patient demographics, number and type of IVIG infusion, incidence of adverse reactions, and related information. FINDINGS: Nine reactions were documented out of 731 separate infusions. Only three reactions could be linked directly to IVIG infusion. Of the nine reactions, only four were detected by nursing personnel during vital sign monitoring. CONCLUSIONS: Nursing time devoted to frequent vital sign assessment does not seem to be warranted. Protocol for administration and monitoring of IVIG at this institution was changed to reflect these findings. IMPLICATIONS FOR NURSING PRACTICE: Frequent vital sign monitoring is advised for the initial IVIG dose. If no adverse reactions occur, only baseline vital sign monitoring is advised for subsequent infusions. Patients are taught to recognize and report symptoms of adverse reactions.

Adolescent↗
PubMed1993

Infection control in oncology patients.

In conclusion, the nurse caring for the patient with cancer must be acutely aware of the risk of infection. Many interventions are used in attempts to minimize or prevent infection. Once the patient becomes neutropenic, the risk of life-threatening infection increases dramatically. All nursing care is focused on treating infection and supporting the patient until bone marrow function returns.

Bone Marrow Transplantation↗
PubMed1992

Current research in side effects of high-dose chemotherapy.

The toxicities of chemotherapy continue to hamper dose escalation of specific chemotherapeutic agents. The impact of dose intensification upon survival will be assessed as clinical studies continue. Strategies to support chemotherapy dose intensification include BMT, use of CSFs and antiemetic drug combinations. Advances in symptom management will hopefully enhance quality of life for patients, whereas the development of chemoprotectant agents may allow specific organ toxicities to be avoided.

Antineoplastic Agents↗
PubMed1992

Cutaneous toxicity associated with high-dose cytosine arabinoside.

High-dose cytosine arabinoside (HDAC) is used to treat adults with acute and chronic leukemia and non-Hodgkin's lymphoma. Although HDAC is associated with various toxicities, cutaneous toxicity in particular leads to alterations in comfort, interference with daily living activities, and increased risk of infection. The incidence of cutaneous toxicity ranges from 3%-72%. A review of the literature revealed a variety of terms describing this toxicity, which begins as erythema and progresses to painful swelling, bullae formation, and desquamation. The etiology is unclear, and the severity is related to the number of consecutive doses. Interventions specific to prevention and treatment of this toxicity were found to be minimal, with no interventions scientifically examined. The challenge for nurses is to explore measures that will minimize the complications, treat the manifestations, and document the impact of these problems on quality of life.

Clinical Trials as Topic↗
PubMed1992

Bone marrow transplantation.

BMT is an effective treatment for certain malignant and nonmalignant conditions. The source of the marrow is autologous or allogeneic. An allogeneic donor can be an HLA-matched related or unrelated donor. The patient undergoes intense chemoradiotherapy to remove remaining malignant cells and obliterate the immune system, thus allowing growth of the new bone marrow cells. Complications of conditioning therapy include pancytopenia and distinct organ toxicities. Astute nursing care is critical in managing the care of BMT patients. Assessment and numerous, interrelated interventions are required. Late complications of BMT relate to the conditioning therapy and to the transplant itself. As BMT becomes more readily available as a treatment, economic issues related to the cost of care and the allocation of resources challenge health care providers.

Bone Marrow Transplantation↗
PubMed1990

Options for postremission therapy in acute leukemia.

Remission induction therapy for patients with AML results in 65% to 75% CR with 20% prolonged DFS. Postremission therapy increases the incidence of prolonged DFS to more than 60%. Postremission therapy in AML consists of high-dose or intensive chemotherapy with or without BMT. Each therapy has significant toxicity and risk for the patient. Induction therapy for patients with ALL includes systemic and intrathecal chemotherapy with a 70% to 75% CR rate. Maintenance therapy continues for 2 to 3 years, and BMT is indicated for patients with early relapse or certain high-risk factors. Knowledgeable nurses provide much-needed emotional support for patients as they struggle to make the best decision for postremission therapy.

Adult↗