scholarly journals 447: Nurse Practitioner Leadership Development – a Model Designed to Develop Leadership Skills and Enhance the Efficacy of the Nurse Practitioner Role at a University Affiliated Medical Center Bone Marrow Transplant Department

2008 ◽  
Vol 14 (2) ◽  
pp. 158-159 ◽  
Author(s):  
E. Romvari ◽  
S. Bauer ◽  
G. Bryant ◽  
H. Comer ◽  
E. Ruettgers
Keyword(s):  
Bone Marrow ◽  
Leadership Development ◽  
Bone Marrow Transplant ◽  
Nurse Practitioner ◽  
Medical Center ◽  
Leadership Skills ◽  
Marrow Transplant ◽  
Practitioner Role

Percutaneous Tracheotomy in Bone Marrow Transplant Patients With Severe Thrombocytopenia

2005 ◽  
Vol 133 (3) ◽  
pp. 377-380 ◽  
Author(s):  
Arie Gordin ◽  
Aviram Netzer ◽  
Henry Zvi Joachims ◽  
Avishay Golz
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Complete Blood Count ◽  
Medical Center ◽  
Intraoperative Complications ◽  
Underlying Disease ◽  
Marrow Transplant ◽  
Severe Thrombocytopenia ◽  
Percutaneous Tracheotomy ◽  
Transplant Patients

OBJECTIVE: Evaluation of percutaneous tracheotomy in bone marrow transplant patients with severe thrombocytopenia. DESIGN: A retrospective outcome study. PATIENTS: A retrospective study of 26 percutaneous tracheotomies was performed at the Bone Marrow Transplant Unit, Rambam Medical Center, Haifa, Israel. Age, sex, underlying disease, reason for intubation, complete blood count, coagulation profile, and the incidence of renal failure were collected. All patients received 6 units of platelets one hour prior to the procedure. RESULTS: The mean platelets count was 14,300 ± 5500. Twenty-five of the 26 percutaneous tracheotomies were completed successfully, without any intraoperative complications. One patient suffered from moderate bleeding during the procedure, which was immediately stopped and converted to open tracheotomy. In the postoperative period 4 patients suffered from mild bleeding around the stoma, which was managed conservatively. No other late complications were encountered. CONCLUSIONS: Percutaneous tracheotomy can be safely performed in patients with severe thrombocytopenia when the surgeon and anesthesiologist are experienced in the procedure, and platelets are given perioperatively.

Octreotide Acetate in Refractory Bone Marrow Transplant-Associated Diarrhea

1996 ◽  
Vol 30 (4) ◽  
pp. 331-336 ◽  
Author(s):  
Michael A Crouch ◽  
Maryann S Restino ◽  
Julia M Cruz ◽  
James J Perry ◽  
David D Hurd
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Medical Center ◽  
Tertiary Care ◽  
Case Series ◽  
Complete Response ◽  
Marrow Transplant ◽  
Stool Frequency ◽  
Octreotide Acetate ◽  
Tertiary Care Medical Center

OBJECTIVE To evaluate the effectiveness of octreotide acetate in the treatment of refractory bone marrow transplant—associated diarrhea. DESIGN Case series encompassing 30 months. SETTING A 12-bed bone marrow transplant unit at a tertiary care medical center. PARTICIPANTS Twenty-four patients with bone marrow transplant—associated diarrhea who did not improve with supportive or attapulgite therapy. INTERVENTIONS Patients received subcutaneous octreotide acetate at doses ranging from 50 to 250 μg 2 to 3 times daily. Concurrent treatment with antimotility or antisecretory agents did not occur. MAIN OUTCOME MEASURES The number of bowel movements and stool volumes were recorded daily. Complete response to octreotide therapy was defined as a reduction of both stool output and stool frequency by more than 50% within 72 hours. Partial response was defined as a reduction of either stool output or stool frequency by more than 50% within 72 hours. Treatment failure occurred if neither of the two parameters decreased by 50% within the designated time period. RESULTS Twenty-eight treatment challenges were initiated in the 24 patients evaluated. Diarrhea completely or partially subsided in 23 of 28 challenges (82.1%) within 72 hours. Stool output decreased from 1143 ± 595 at baseline to 252 ± 356 mL/d within 72 hours (p < 0.005). Stool frequency decreased from a baseline of 7.5 ± 3.4 to 2.7 ± 2.2 stools per day within 72 hours (p < 0.005). Adverse effects associated with octreotide were pain or burning at the injection site (24.1%), abdominal pain (13.8%), and increased stool output (6.9%). CONCLUSIONS These data suggest octreotide acetate significantly reduces stool output and frequency in patients with refractory bone marrow transplant—associated diarrhea. Additional research is necessary before this agent can be recommended for routine use in this patient population.

Toxic Epidermal Necrolysis Possibly Linked to Aztreonam in Bone Marrow Transplant Patients

1992 ◽  
Vol 26 (1) ◽  
pp. 34-35 ◽  
Author(s):  
Brendan J. McDonald ◽  
Jack W. Singer ◽  
James A. Bianco
Keyword(s):  
Bone Marrow ◽  
Toxic Epidermal Necrolysis ◽  
Bone Marrow Transplant ◽  
Acute Gvhd ◽  
Medical Center ◽  
Marrow Transplant ◽  
Infectious Complications ◽  
Acute Onset ◽  
Lymphocytic Leukemia ◽  
Unrelated Donor

OBJECTIVE AND SETTING: After instituting aztreonam as part of antibiotic prophylaxis in bone marrow transplant (BMT) patients at the Seattle Department of Veterans Affairs Medical Center, the first two cases of toxic epidermal necrolysis (TEN) occurred in more than 250 BMT patients at this center. We have examined the possible cause-and-effect relationship between aztreonam and TEN. PATIENTS: The first patient was a 23-year-old man with acute lymphocytic leukemia receiving a BMT from a related mismatched donor. He experienced profound conjunctivitis and superficial bulla covering 60 percent of his body surface area (BSA). The second patient, a 32-year-old man with lymphoma, received a BMT from a matched unrelated donor. He exhibited lymphocytosis, acute conjunctivitis, and bullous lesions covering 60 percent of his BSA. INTERVENTIONS: Aztreonam was discontinued in both patients. The first patient was treated with pigskin grafting and the second was treated with topical silver sulfadiazine. RESULTS: Despite stabilization of symptoms, both patients eventually died of infectious complications. CONCLUSIONS: Histological data in both patients were more consistent with TEN than graft-versus-host disease (GVHD) in that dermal infiltrates were sparse or absent. The onset of cutaneous symptoms was of more acute onset than acute GVHD, and ocular complaints are uncommon in acute GVHD. Furthermore, the onset of TEN bore a closer temporal relationship to aztreonam than to other drugs administered.

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