Gastrointestinal conditions

2018 ◽  
pp. 277-312
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Health Conditions ◽  
Gastrointestinal Disorders ◽  
Summary Table ◽  
Gastrointestinal Conditions ◽  
Life Threatening ◽  
Community People ◽  
Gastrointestinal Complaints ◽  
Prescribed Medicines ◽  
Specialist Nurses

Gastrointestinal complaints range from mild and transient disorders, through to life-threatening diseases. People with disorders of the gastrointestinal system may be encountered in both hospital and community settings. In the community, people with long-term or other acute health conditions may experience disturbances in their eating patterns or bowel habits, and within the hospital, people having treatment for other diagnosed conditions may develop associated gastrointestinal disorders. People with severe gastrointestinal conditions will often be cared for by specialist nurses, but general adult nurses will encounter people with gastrointestinal disorders in all areas of clinical practice, either as a primary complaint or as a secondary complication of other illnesses or treatments. This chapter outlines key facts about gastrointestinal conditions which are likely to be useful to the general nurse and describes key nursing considerations for working with people with these disorders. An overview of frequently prescribed medicines for gastrointestinal conditions is presented in a summary table.

Musculoskeletal conditions

2018 ◽  
pp. 353-396
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Traumatic Injury ◽  
Summary Table ◽  
Musculoskeletal Conditions ◽  
Clinical Investigations ◽  
Increased Risk ◽  
Life Threatening ◽  
Reduce Risk ◽  
Prescribed Medicines ◽  
The Many

The skeleton, skeletal muscles, joints, tendons, and ligaments function to protect the body’s internal organs and facilitate movement and mobility. Disorders of the musculoskeletal system will often be the result of trauma or long-term degenerative conditions, which can affect people of any age, although older people are at increased risk. Many people with musculoskeletal conditions will be treated by specialist orthopaedic and rheumatology services, but general adult nurses will come into contact with many people who are suffering from a range of musculoskeletal disorders. Whether these are muscle sprains, people living with long-term arthritic conditions, or those who have suffered a potentially life-threatening traumatic injury, all will have some degree of compromised movement. It is important that general adult nurses can work with people to help restore function and reduce risk from the many complications which can arise from immobility or disability. This chapter outlines key facts about musculoskeletal conditions which are likely to be useful to the general nurse, alongside clinical investigations, and key nursing considerations. A summary table of frequently prescribed medicines is also presented.

Burden of Morbidity in 10+ Year Survivors of Hematopoietic Cell Transplantation (HCT): A Report From the Bone Marrow Transplant Survivor Study (BMTSS)

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 841-841
Author(s):  
Can-Lan Sun ◽  
John H. Kersey ◽  
Liton Francisco ◽  
K. Scott Baker ◽  
Saro H. Armenian ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Somatic Distress ◽  
Healthcare Needs ◽  
Life Threatening

Abstract Abstract 841FN2 Background: High-intensity therapeutic exposures and prolonged immunosuppression increase the risk of long-term complications after HCT, with an attendant increase in the healthcare needs of these long-term survivors. We have previously demonstrated that morbidity increases with increasing time after HCT (Sun CL, Blood, 2010;116:3129–39). However, the burden of morbidity in patients who survive extended lengths of time after HCT and the consequent healthcare needs of these survivors are unknown. Methods: Utilizing resources offered by the BMTSS, we evaluated the risk of chronic health conditions and psychological health of 366 10+ year HCT survivors and their siblings (n=309). A severity score (grade 1 [mild]; grade 2 [moderate], grade 3[severe], grade 4 [life-threatening], and grade 5 [death due to chronic health condition]) was assigned to each health condition using the CTCAE, v3.0. Cumulative incidence of chronic health conditions was evaluated, using competing risks method. Brief Symptom Inventory (BSI) was used to describe adverse psychological health. Multivariate regression analysis allowed identification of vulnerable subgroups. The current status of healthcare utilization by the HCT survivors was also evaluated. Results: The mean age at HCT was 22 years (range: 0.4–59.8) and at study participation was 37 years (range: 11–72); mean length of follow-up was 15 years (range: 10–28). Primary diagnoses included AML (28%), ALL (17%), CML (17%), NHL (11%), aplastic anemia (11%), HL (7%), and other diagnoses (9%). Stem cell graft was autologous (27%); allogeneic related (65%) and unrelated donor (8%); 72% of the patients received TBI-based conditioning. At least one chronic health condition was reported by 74% of the HCT survivors, compared with 29% of siblings (p<0.001); 25% of the survivors reported severe/life-threatening conditions compared to only 8% of the siblings (p<0.001). Commonly reported severe/life-threatening chronic health conditions included myocardial infarction, stroke, blindness, diabetes, musculoskeletal problems, and subsequent malignancies. As shown in Figure 1A, the 15-year cumulative incidence of any chronic health condition (grades 1–5) was 71% (95% CI, 67–75%), and of severe-life-threatening conditions or death was 40% (95% CI, 33–47%). HCT survivors were 5.6 times as likely to develop a severe/life-threatening condition (95% CI, 3.7–8.6), compared with age- and sex-matched siblings. The cumulative incidence of severe/life-threatening conditions did not differ by type of HCT (p=0.79, Figure 1B). Using BSI, we evaluated somatic distress, anxiety, and depression among HCT survivors and their siblings. While the prevalence of anxiety and depression were comparable between survivors and siblings, HCT survivors were 2.7 times more likely to report somatic distress (p<0.001). Among survivors, female gender (OR=3.6, 95% CI, 1.4–9.0), low household income (<$20,000 OR=4.4, 95% CI, 1.1–17.2), and poor self-rated health status (OR=10.6, 95% CI, 4.0–27.9) were associated with increased risk for somatic distress. Fortunately, 90% of HCT survivors carried health insurance coverage, because a high proportion needed ongoing specialized medical care; 69% of the HCT survivors reported cancer/HCT-related visits at an average of 15 years after HCT. Conclusions: The burden of long-term physical and emotional morbidity borne by 10+ year HCT survivors is substantial, resulting in a high utilization of specialized healthcare. Patients, families and healthcare providers need to be made aware of the high burden, such that they can plan for post-HCT care, even many years after HCT. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Long-Term Morbidity and Mortality Experienced By Chronic Myeloid Leukemia (CML) Patients after Allogeneic Hematopoietic Cell Transplantation (HCT) - a Report from BMTSS-2

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 823-823
Author(s):  
Jessica Wu ◽  
Yanjun Chen ◽  
Lindsey Hageman ◽  
Can-Lan Sun ◽  
Liton F. Francisco ◽  
...  
Keyword(s):  
Board Of Directors ◽  
Cumulative Incidence ◽  
Chronic Gvhd ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Advisory Committees ◽  
Chronic Health ◽  
Life Threatening ◽  
Related Mortality

Abstract Background: Tyrosine kinase inhibitors have become the treatment of choice for CML. However, the high cost and need for life-long treatment contribute to non-adherence and represent a major challenge in their use. Allogeneic HCT is potentially curative, but the very long-term health of the survivors is not known. It is also not clear whether a subgroup of CML patients carries a relatively low risk of long-term morbidity. Methods: We addressed these gaps by studying long-term outcomes in 637 CML patients treated with allogeneic HCT between 1981 and 2010 at City of Hope or Univ MN, and surviving for at least 2y after HCT (median follow-up: 16.7y from HCT); 80% of the cohort was <45y at HCT; 68% received HCT in 1st chronic phase (CP); 63% received matched related [MRD], 34% matched unrelated donor (MUD) and 3% non-myeloablative HCTs; 79% received TBI; 65.8% developed chronic GvHD. Vital status information was collected as of May, 2016, using medical records, National Death Index and Lexis Nexis. US mortality rates were obtained from CDC's National Center for Health Statistics. Thirty percent (n=192) died after having survived at least 2 years after HCT; median time between HCT and death was 8.3y. Of the 445 patients alive at study, 288 (65%) completed the BMTSS health questionnaire used to examine the risk of CTCAE grade 3 (severe) or 4 (life-threatening) chronic health conditions. A sibling comparison group (n=404) also completed the BMTSS questionnaire. Results: Late Mortality: Overall survival was 72.1% at 20y and 69.9% at 30y from HCT. The 20y cumulative incidence of relapse-related mortality was 3.9% (95% CI, 2.6-5.8%) and of non-relapse-related mortality was 18.2% (95% CI, 19.8-28.1%) (Figure 1). 20y cumulative incidence of mortality by cause of death was as follows: infection (7%), chronic GvHD (6%), subsequent malignant neoplasms (SMNs: 3%). HCT recipients were at 4.4-fold increased risk of death (95% CI, 3.8-5.1, p<0.0001) than age-, race-, and sex-adjusted normal populations. For patients transplanted in 1st CP and surviving 15y, mortality rates became comparable with the general population (SMR, 1.5, 95% CI, 0.9-2.3, p=0.1). Among CML patients receiving HCT at <45y with Bu/Cy (n=70), overall survival was 81.5% at 20y from HCT; the 20y cumulative incidence of relapse-related mortality was 2.9% and of non-relapse-related mortality was 14%. This cohort was at 3.3-fold higher risk of death when compared with the general population (95% CI=1.7-5.7, p<0.0001). Late Morbidity: The 20y cumulative incidence of a severe/life-threatening chronic health condition among HCT survivors was 47.2% (95% CI, 39.0-54.9%); the incidence was higher (p=0.0006) for MUD vs. MRD recipients (Figure 2). After adjusting for age, sex, race and SES, HCT survivors were at 2.7-fold higher risk for severe/life-threatening chronic health conditions as compared with siblings (95% CI, 1.8-3.9, p<0.0001). The 20y cumulative incidence of specific conditions experienced by survivors and siblings were: SMNs (10.1% vs. 1.7%, p<0.001); diabetes (11.1% vs. 1.5%, p<0.001) and coronary artery disease (6.9% vs. 3.2%, p<0.001). CML patients receiving MRD HCT at <45y with Bu/Cy were not at increased risk of severe/life-threatening chronic health conditions when compared with the sibling comparison group (HR=0.81, 95% CI, 0.26-2.54, p=0.7). Conclusions: Conditional on surviving the first 2y after HCT, the overall survival exceeds 70% at 20y and remains stable at 70% at 30y after HCT. Non-relapse related mortality (infections, chronic GvHD, SMNs) is by far the major contributor to the late mortality. Conditional on surviving the first 15y, mortality rates are similar to those observed in the general population. HCT survivors are at a 2.7-fold higher risk of severe/life-threatening morbidity when compared with siblings. The more common morbidities include SMNs, diabetes and coronary artery disease. However, CML patients receiving HCT at <45y with Bu/Cy conditioning enjoy survival rates exceeding 81% at 20y from HCT, and their burden of long-term morbidity is comparable to that experienced by siblings. These findings could help inform decisions regarding therapeutic options for management of CML. Disclosures Snyder: BMS: Membership on an entity's Board of Directors or advisory committees; Ariad: Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees. Forman:Mustang Therpapeutics: Other: Construct licensed by City of Hope.

Renal and urinary tract conditions

2018 ◽  
pp. 313-338
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Urinary Tract ◽  
Kidney Disease ◽  
Kidney Failure ◽  
Kidney Injury ◽  
Chronic Kidney Failure ◽  
Summary Table ◽  
Urinary Tract Disorders ◽  
Life Threatening ◽  
Specialist Nurses ◽  
Limiting Condition

Renal conditions can be an acute health problem or a debilitating life-limiting condition. Kidney failure can present as a slowly progressing chronic disease (chronic kidney disease) or as acute life-threatening medical emergencies known as acute kidney injury (AKI). People with chronic kidney failure will normally be cared for by specialist nurses and clinical teams working in hospital or community settings. General adult nurses will encounter people with kidney disease in all areas of clinical practice, either as a primary complaint or as a secondary complication of other disorders or treatments. This chapter outlines key facts about kidney disease which are likely to be useful to the general nurse. These include an overview of renal conditions and the principles of renal replacement therapy. Common urinary tract conditions and the management of urinary incontinence are also discussed, as are key nursing considerations when working with people with renal or urinary tract disorders. An overview of frequently prescribed medicines for renal and urinary tract conditions is presented in a summary table.

Respiratory conditions

2018 ◽  
pp. 165-194
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Respiratory Disease ◽  
Adult Population ◽  
Health Condition ◽  
Summary Table ◽  
Surgical Interventions ◽  
Clinical Investigations ◽  
Specialist Nurses ◽  
Respiratory Conditions ◽  
Short Section

Respiratory conditions can be an acute health problem or a long-term and debilitating health condition. They are common in the adult population, and many aspects of respiratory care are carried out by advanced practitioners and specialist nurses. General adult nurses are likely to encounter people with respiratory disease across all care settings. This chapter outlines key facts about respiratory disease which are likely to be useful to the general nurse. These include an overview of acute and chronic respiratory conditions and a summary of associated clinical investigations and treatment approaches, including a section on oxygen therapy. The chapter also has a short section on key facts related to surgical interventions. Key nursing considerations for working with people with respiratory disease, in hospital and at home, are outlined, and an overview of frequently prescribed medicines is presented in a summary table.

Burdern of Long-Term Morbidity after Hematopoietic Cell Transplantation: A Report from the Bone Marrow Transplant Survivor Study (BMTSS).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 832-832 ◽  
Author(s):  
Can-Lan Sun ◽  
Liton Francisco ◽  
Toana Kawashima ◽  
Leslie L. Robison ◽  
K.S. Baker ◽  
...  
Keyword(s):  
Health Condition ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Unrelated Donor ◽  
Chronic Health ◽  
Threatening Condition ◽  
Life Threatening ◽  
Grade 3

Abstract Long-term survival is an expected outcome after HCT. However, no study has assessed the burden of long-term morbidity in these survivors, or attempted to identify subpopulations at highest risk for severe, debilitating conditions. In this study, we determined the prevalence and severity of chronic health conditions in a large population of long-term HCT survivors and compared these outcomes with their siblings. BMTSS, a collaborative effort between City of Hope National Medical Center and University of Minnesota, examined self-reported chronic health conditions in individuals who underwent HCT between 1976 and 1998, and survived two or more years. A severity score (grade 1 through 4, ranging from mild to life-threatening or disabling) was assigned to each health condition according to the Common Terminology Criteria for Adverse Events (version 3). A partial list of conditions graded as severe or life-threatening (grade 3 or 4) included congestive heart failure, second malignant neoplasms, coronary artery disease, cerebrovascular accident, renal failure/dialysis/renal transplant, and active chronic graft vs. host disease. Adverse psychosocial outcomes were not included. Cox proportional-hazard models were used to estimate hazard ratios and their 95% confidence intervals. We compared the prevalence and severity of chronic conditions in 1013 HCT survivors (455 autologous, 460 related donor, and 98 unrelated donor HCT survivors) with 309 siblings. The median age at study participation was 44 (range 18–73) and 45 years (range 17–79) for survivors and siblings, and the median follow-up for the survivors was 7.3 years (range 2–28) from HCT. Among the 1013 survivors, 69% had at least one chronic condition, and 29% had a severe or life-threatening condition (grade 3 or 4). The comparable figures in siblings were 39% and 7%, respectively (p<0.001 compared to survivors). After adjustment for age at HCT, sex and race/ethnicity, survivors were 2.4 times as likely as their siblings to develop any chronic health conditions (95%CI, 2.0–2.9), and 4.5 times more likely to develop severe/life threatening conditions (95%CI, 3.0–6.7). Groups at highest risk for a severe or life-threatening condition are summarized in the Table. Among survivors, the cumulative incidence of a chronic health condition reached 84% at 20 years post HCT, with a cumulative incidence of 55% for severe/life threatening conditions at 15 years after HCT. The chronic health burden of this population is significant, and life-long follow-up of patients who receive transplantation is recommended. Table: Groups at highest risk for severe or life-threatening condition Risk Factors Relative Risk 95% CI Siblings 1.0 __ CML 5.8 3.8–8.9 AML 4.9 3.2–7.5 ALL 5.2 3.3–8.3 Allogeneic sibling donor 5.9 3.9–8.7 Unrelated donor 7.4 4.9–11.1 TBI 5.0 3.4–7.5

Temporal trends in late-onset morbidity and mortality after medulloblastoma diagnosed across three decades: A report from the Childhood Cancer Survivor Study (CCSS).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10516-10516 ◽  
Author(s):  
Ralph Salloum ◽  
Yan Chen ◽  
Yutaka Yasui ◽  
Roger Packer ◽  
Wendy M. Leisenring ◽  
...  
Keyword(s):  
Special Education ◽  
High Risk ◽  
Cumulative Incidence ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Long Term Outcomes ◽  
Late Mortality ◽  
Life Threatening ◽  
Standard Risk

10516 Background: Therapy for medulloblastoma and primitive neuroectodermal tumor has evolved from surgery and adjuvant radiotherapy to risk-adapted multimodal regimens. The impact of these changes in treatment on long-term outcomes remains unknown. Methods: Cumulative incidence of late mortality ( > 5 years from diagnosis), subsequent malignant neoplasms (SMN), chronic health conditions and psychosocial functioning were evaluated among 5-year survivors in CCSS diagnosed between 1970 and 1999. Survivors were stratified according to treatment decade (1970s, 1980s, 1990s) and treatment exposure (surgery + craniospinal irradiation [CSI] ≥30 Gy, no chemotherapy; surgery + CSI ≥30 Gy + chemotherapy [high-risk therapy], surgery + CSI ˂30 Gy + chemotherapy [standard-risk therapy]). Rate ratios (RRs), odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for long-term outcomes among treatment eras and exposure groups using multivariable piecewise-exponential models. Results: Among 1,380 eligible survivors (median [range] age 29 [6-20] years; 21.4 [5-44] years from diagnosis), the 15-year cumulative incidence of all-cause (21.9% 1970s vs. 12.8% 1990s; p = 0.003) and recurrence-related (16.2% vs 9.6%, p = 0.03) late mortality decreased with no reduction in mortality attributable to late effects of therapy including SMN. Among 959 participants, the incidence of SMN did not decrease by era or by treatment group. However, survivors treated in the 1990s had an increased cumulative incidence of severe, life-threatening and fatal health conditions (16.9% 1970s vs 25.4% 1990s; p = 0.03), and were more likely to develop multiple severe or life-threatening health conditions, RR = 2.98 (95% CI, 1.10-8.07). Survivors of standard-risk therapy were less likely to use special education services than high-risk therapy patients, OR = 0.51 (95% CI, 0.33-0.78). Conclusions: Historical changes in therapy have improved 5-year survival, reduced risk of late mortality due to disease recurrence, and reduced special education utilization, at the cost of increased risk for multiple, severe and life-threatening chronic health conditions.

scholarly journals Burden of Long-Term Morbidity Borne By Survivors of Acute Myeloid Leukemia (AML) Treated with Blood or Marrow Transplantation (BMT) - a Report from the BMT Survivor Study (BMTSS)

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 707-707
Author(s):  
Saro H. Armenian ◽  
Yanjun Chen ◽  
Lindsey Hageman ◽  
Jessica Wu ◽  
Liton F. Francisco ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Cumulative Incidence ◽  
Comparison Group ◽  
Health Conditions ◽  
Malignant Neoplasms ◽  
Chronic Health ◽  
Life Threatening ◽  
Grade 3 ◽  
Hispanic White

Background: BMT is now an integral part of consolidation and/or salvage for patients with AML. With the growing population survivors, there is a need to understand the quality of survival. This would allow for appropriate resource allocation and implementation of risk-based screening for early detection of chronic health conditions over time. Yet, a comprehensive evaluation of the long-term burden of morbidity borne by AML patients treated with BMT remains unknown. We addressed this gap by evaluating long-term severe/life-threatening/fatal chronic health conditions (CHCs) in AML patients treated with BMT using the BMTSS. Methods: Patients were eligible if they had undergone an allogeneic or autologous BMT for AML between 1974 and 2014 at one of 3 BMT centers in the US, had survived for ≥2y after BMT, and were ≥21y of age at BMT. Of the 1,113 eligible subjects, 711 (64%) participated. BMT survivors identified a nearest-age sibling to constitute an unaffected comparison group (N=1,136). Survivors and siblings completed a 231-item BMTSS survey that included questions regarding CHC diagnosis by their healthcare provider, including age at onset of CHC. Scoring was based on Common Terminology Criteria for Adverse Events ([CTCAE] v 5.0) to determine the severity of CHCs. Using multivariable logistic regression, we determined the risk of any severe (CTCAE grade 3) or life-threatening (CTCAE grade 4) CHC in survivors compared with siblings, adjusting for age at study, sex, race/ethnicity, education, annual household income and insurance status. Information regarding therapeutic exposures (pre-BMT and transplant-related) was abstracted from medical records. Cumulative incidence of CHCs (including fatal [CTCAE grade 5] CHCs) were calculated for BMT survivors, treating relapse-related death as a competing risk. Results: Mean age at BMT was 48.6±13.8y and at survey was 58.2±11.5y. Mean interval between BMT and study participation was 9.7±6.8y; 53% were females, and 78% were non-Hispanic white; 86% received allogeneic BMT (48% from an unrelated donor). Conditioning was Fludarabine/Melphalan-based in 53% and TBI-based in 35%; stem cell source was peripheral blood (70.3%), bone marrow (19.3%), and cord (10.4%). For the siblings, the mean age at survey was 56.9+13.4y; 61% were females, and 88% were non-Hispanic white. BMT survivors vs. sibs: 53.3% of the BMT survivors and 30.4% of the sibs reported grades 3-4 CHCs, placing the survivors at a 3.0-fold higher odds of grades 3-4 CHC (95%CI, 2.4-3.7, p&lt;0.0001). The odds of developing the following CHCs were significantly higher in BMT survivors when compared with siblings: subsequent malignant neoplasms (SMNs: odds ratio [OR]=10.0, 95% CI, 5.5-17.9, p&lt;0.0001), diabetes (OR=5.3, 95% CI, 3.0-9.3, p&lt;0.0001), venous thromboembolism (OR=3.8, 95%CI, 2.5-5.8 p&lt;0.0001), cataracts (OR=3.7; 95%CI, 2.7-5.0, p&lt;0.0001), and major joint replacement (OR=1.5, 95% CI, 1.1-2.1, p=0.02). Among BMT survivors: The 10- and 20y cumulative incidence of a grade 3-5 CHC was 52.0%±1.4% and 66.2%±1.6%, respectively (Figure 1). 75 survivors had developed SMNs: skin (melanoma/ squamous cell [56%]), breast (13%), colon (7%), prostate (7%), and other cancers (24%). The 10- and 20y-cumulative incidence of the most common CHCs were as follows (Figure 2): SMN (10y: 17.9%±1.7%, 20y: 32.1%±2.9%), cataract (10y: 21.5%±1.9%, 20y: 31.5%±3.0%), major joint replacement (10y: 12.5%±0.9%, 20y: 17.5%±3.4%), venous thromboembolism (10y: 8.6%±1.1%, 20y: 13.2%±2.1%), and diabetes (10y: 6.0%±1.9%, 20y: 8.0%±1.5%). Conclusion: The burden of severe/life-threatening CHCs is substantially higher in BMT survivors when compared with an unaffected comparison group. The incidence of severe/ life-threatening/ fatal chronic health condition following BMT for AML exceeds 50% at 10y, and continues to increase with time, approaching 70% at 20y post-BMT. Subsequent malignant neoplasms, diabetes, thrombo-embolic events, cataracts, and major joint replacement constitute the largest burden of morbidity. These findings suggest the need for increased awareness of the long-term burden of morbidity, to ensure close monitoring of these survivors to anticipate and manage morbidity. Disclosures Weisdorf: Incyte: Research Funding; Fate Therapeutics: Consultancy; Pharmacyclics: Consultancy.

scholarly journals Caring for the long-term survivor after allogeneic stem cell transplantation

Hematology ◽  
2014 ◽  
Vol 2014 (1) ◽  
pp. 495-503 ◽  
Author(s):  
Smita Bhatia
Keyword(s):  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Healthcare Providers ◽  
Health Conditions ◽  
Policy Makers ◽  
Life Threatening ◽  
Proactive Care ◽  
Term Survivor

Abstract Survivors of allogeneic hematopoietic cell transplantation (HCT) are at risk of developing long-term complications such as subsequent malignancies and cardiopulmonary compromise. The prevalence of chronic health conditions approaches 75% among allogeneic HCT survivors and that for severe or life-threatening conditions exceeds 20%. This chapter describes the burden of morbidity carried by HCT survivors to help healthcare providers and policy makers understand the scope of the problem and the need for life-long follow-up and proactive care for this vulnerable population.

Diabetes

2018 ◽  
pp. 339-352
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Health Condition ◽  
Newly Diagnosed ◽  
Summary Table ◽  
Clinical Investigations ◽  
Different Types ◽  
Specialist Nurses ◽  
General Nurse

Diabetes is recognized as a significant, and increasing, long-term health condition. General adult nurses may encounter people with diabetes in a variety of circumstances and settings, but many people manage their own condition in the community, supported by specialist nurses. This chapter outlines key facts relating to diabetes, likely to be of relevance to the general nurse. These include the different types of diabetes, their symptoms and treatments, and diabetic emergencies. A summary of clinical investigations in diabetes is also presented, along with a summary table of medications frequently used to treat the condition. Key nursing considerations for working with people newly diagnosed or living with diabetes are outlined.

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