PARADIGM BYTES
Newsletter for Paradigm 97
November 14, 2016
PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.
Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
MISSION STATEMENT
Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
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SNIPPET
Standardizing nurse's training programs
Appropriate tracheostomy and laryngectomy care requires that nurses maintain specific knowledge and a particular skillset, to ensure safe, competent care. Deficiencies in this nursing care remain a persistent problem. The objective of this study was to evaluate the effect of a nurse training program on knowledge and self-efficacy with tracheostomy and laryngectomy care.
Study design
Prospective, interventional survey design.
Setting
Academic, tertiary care hospital between September 2014 and April 2015.
Subjects and methods
1450 nurses at an academic tertiary care hospital were surveyed on tracheostomy and laryngectomy care at two time points: before and after the implementation and completion of the nurse training program. The nurse training program included a hands-on training session and online tutorial on appropriate tracheostomy and laryngectomy care. 732 nurses completed the hands-on training and were asked to complete the online tutorial. A total of 338 surveys were collected. Survey data were collected through an online survey development platform. Analyses were performed using SAS software. Chi-square tests and t-tests were utilized with a significance level of 0.05.
Results
165 pre-training surveys and 173 post-training surveys were completed. Statistical analysis of the post-training data demonstrated statistically significantly higher knowledge and self-efficacy scores of nurses who completed the training than nurses who did not.
Conclusions
Findings from this study reveal poor overall nursing knowledge and self-efficacy with this care and suggest that optimizing and standardizing nurse training is an effective strategy to improve nursing knowledge and self-efficacy with head and neck surgical airways.
http://www.appliednursingresearch.org/article/S0897-1897(16)30121-5/fulltext?elsca1=etoc&elsca2=email&elsca3=0897-1897_201611_32__&elsca4=Nursing
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
“Right to Try” Legislation: A Developing Legal Issue Related to Medications
. Currently, 24 states have enacted similar legislation and 17 states are currently seeking approval; California is the only state where a bill passed by the legislature was vetoed by the governor. The topic is still discussed frequently. In March 2016, Iowa advanced its Right to Try bill to the state senate floor.9 The legislature in Maine enacted a Right to Try bill and the governor has signed it.10 Georgia has also enacted a Right to Try law.11
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(I have suffered with tinnitus, and not once had any physician do anything about it. Glad to see this article.
Many with tinnitus do not receive recommended treatment. A study published online July 21 in JAMA Otolaryngology–Head and Neck Surgery found that among 75,764 participants in the 2007 National Health Interview Survey, only 49% of those who reported tinnitus discussed their tinnitus with a physician, and 85% never tried any treatment. Tinnitus, often caused by occupational and recreational exposure to noise, affects one in 10 adults in the United States. Yet, fewer than 25% of tinnitus sufferers who talked to a physician received treatment advice in accord with current guidelines. Physicians recommended medications for 45% of tinnitus patients, hearing aids for 9%, and cognitive behavioral therapy (CBT) for only 0.2%, even though the American Academy of Otolaryngology–Head and Neck Surgery Foundation favors CBT. The authors concluded that otolaryngologists need to play a greater role in treating tinnitus and educating other providers about the latest guidelines.
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000505574.42763.93
In the News
http://journals.lww.com/ajnonline/Fulltext/2016/11000/NewsCAP___Many_with_tinnitus_do_not_receive.15.aspx
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RANDOM FACTS:
Alaska contains more than 3 million lakes. The largest of these is Iliamna Lake, located approximately 212 miles southwest of Anchorage. It's 1,150 square miles, which makes it 692 square miles greater than the second-largest lake in the state, Becharof Lake. Source: Forbes, Alaskakids.org
A dime has 118 ridges around the edge.
If the population of China began walking past you in a single file, the line would never end because of the rate of reproduction.
On a standard playing card, the king of hearts is the only king without a mustache.
If you wear a ring, the number of germs living beneath it could be as high as the entire population of Europe.
It took 220 years after the pencil was invented for someone to invent the eraser.
Between 1848 and 1850, the population of San Francisco grew from 900 to 35,000 people thanks to the Gold Rush.
In the average trick-or-treater's bag, there are around 5,435 calories.
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FDA approves new drug for advanced soft tissue sarcoma-
The U.S. Food and Drug Administration today granted accelerated approval to Lartruvo (olaratumab) with doxorubicin to treat adults with certain types of soft tissue sarcoma (STS), which are cancers that develop in muscles, fat, tendons or other soft tissues. Lartruvo is approved for use with the FDA-approved chemotherapy drug doxorubicin for the treatment of patients with STS who cannot be cured with radiation or surgery and who have a type of STS for which an anthracycline (chemotherapy) is an appropriate treatment.
Lartruvo is a platelet-derived growth factor (PDGF) receptor-alpha blocking antibody. When stimulated, PDGF receptors cause tumor growth. Lartruvo works by blocking these receptors, which may help slow or stop tumor growth.
Lartruvo has serious risks including infusion-related reactions and embryo-fetal harm. Infusion-related reactions include low blood pressure, fever, chills and rash. The most common side effects of treatment with Lartruvo are nausea, fatigue, low levels of white blood cells (neutropenia), musculoskeletal pain, inflammation of the mucous membranes (mucositis), hair loss (alopecia), vomiting, diarrhea, decreased appetite, abdominal pain, nerve damage (neuropathy) and headache.
For more information, please visit: Lartruvo.
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Check this site out....interesting
https://www.facebook.com/medicalbooks01/
Glucose challenge test accurate, convenient in primary care setting
Glucose challenge test screening, paired with oral glucose tolerance testing where appropriate, is less expensive and more accurate than other opportunistic tests for diabetes and prediabetes, data from a prospective study show.
“Detection of diabetes early in the natural history of the disease is critical for preventive management with lifestyle change or medication, and the U.S. Preventive Services Task Force has created recommendations for systematic screening,” Sandra L. Jackson, PhD, of the Atlanta VA Medical Center in Decatur, Georgia, and Emory University in Atlanta, and colleagues wrote. “In the present study, we investigated whether the glucose challenge test would be an accurate, convenient and inexpensive screen in high-risk participants in a primary care setting.”
Researchers studied data from 1,535 patients in a Veterans Health Administration primary care clinic to compare the performance of oral glucose challenge, random glucose testing and HbA1c level testing with glucose tolerance testing. Median age was 56 years, 94% of patients were men, and 74% were black. Glucose tolerance testing indicated 10% had diabetes and 22% had high-risk prediabetes. ...
http://www.healio.com/endocrinology/diabetes/news/in-the-journals/%7Beffa6100-9f93-4605-af8e-94c97567fcd1%7D/glucose-challenge-test-accurate-convenient-in-primary-care-setting
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Old Blood as Good as New for Transfusions, study finds
MONDAY, Oct. 24, 2016 (HealthDay News) --
Using the freshest blood for transfusions does not appear to boost patient survival, a new Canadian study indicates.
"It's been a contentious issue, but our study finally puts an end to the question about whether stored blood could be harmful and fresher blood would be better," said lead author Nancy Heddle. She is a professor emeritus of medicine at McMaster University, in Hamilton, Ontario.
"Our study provides strong evidence that transfusion of fresh blood does not improve patient outcomes, and this should reassure clinicians that fresher is not better," added Heddle, who is also research director of the McMaster Centre for Transfusion Research.
In the study, the researchers examined data from nearly 31,500 patients at six hospitals in the United States, Canada, Israel and Australia who received blood transfusions.
The in-hospital death rate was 9.1 percent among those who received the freshest blood and 8.7 percent among those who received the oldest blood, the findings showed. ...
https://consumer.healthday.com/general-health-information-16/misc-surgery-news-650/old-blood-as-good-as-new-with-transfusions-study-716138.html
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Young football players' brains change after one season
(Reuters Health) - Children's brains undergo noticeable changes after just one season of football, even if they were never diagnosed with a concussion, according to a new imaging study.
While there is no way to know whether the changes may lead to health problems down the road, the researchers found that the degree of change seen in the brain's white matter tracts was tied to the amount of exposure a child had to head impacts during play.
"It’s really another study that suggests there are changes in the brain associated with all of these head impacts," said lead author Dr. Christopher Whitlow, of the Wake Forest School of Medicine in Winston-Salem, North Carolina. ...
http://www.reuters.com/article/us-health-sports-concussion-kids-idUSKCN12O2OP?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-10-25&utm_term=US%20Health%20Report
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Study links low diastolic blood pressure to myocardial damage, coronary heart disease
Low diastolic blood pressure (DBP) was significantly associated with myocardial injury and incident coronary heart disease, especially when the systolic blood pressure was 120 mm or higher, investigators reported.
Compared with a DBP of 80 to 89 mm Hg, DBP below 60 mm Hg more than doubled the odds of high-sensitivity cardiac troponin-T levels equaling or exceeding 14 ng per mL, and increased the risk of incident coronary heart disease (CHD) by about 50%, in a large observational study. Associations were strongest when baseline systolic blood pressure was at least 120 mm Hg, signifying elevated pulse pressure, reported Dr. John McEvoy of the Ciccarone Center for the Prevention of Heart Disease, Hopkins University, Baltimore, and associates (J Am Coll Cardiol 2016;68[16]:1713–22).
http://www.mdedge.com/familypracticenews/article/116196/cad-atherosclerosis/study-links-low-diastolic-blood-pressure
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HIV May Hide in Tissues, Even After Treatment
WEDNESDAY, Oct. 26, 2016 (HealthDay News) -- HIV patients who've been treated with antiretroviral drugs still have the AIDS-causing virus in their tissues, a new study suggests.
Treatment with antiretrovirals eliminates detectable levels of HIV in the blood and controls the disease. But the new findings suggest that HIV in the tissues may not cause AIDS but could contribute to the development of unrelated conditions, such as cancer and heart disease, according to the University of California, San Francisco (UCSF) researchers.
"Looking in tissues of treated HIV patients, we found that HIV in some tissues did not appear to be affected by antiretrovirals," said study senior author Dr. Michael McGrath.
"Notably we saw no evidence of drug resistance, which we would have seen if the virus had been exposed to medications," said McGrath. He is UCSF professor of laboratory medicine at the AIDS and Cancer Specimen Resource, which is supported by the U.S. National Cancer Institute. ...
https://medlineplus.gov/news/fullstory_161695.html
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RANDOM FACTS:
Since 1936, more than 420 million different Social Security numbers have been issued. More than 5.5 million new numbers are assigned every year.
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The first three digits of a Social Security number are known as the "area number." Area numbers assigned before 1972 reflect the state where you applied for your number; otherwise, they are based upon the Social Security card application mailing address ZIP code. Area numbers are assigned geographically, with the lowest numbers in the Northeast and the highest in the Northwest. That practice will no longer apply, however, after a new randomized assignment methodology officially goes into effect on June 25.
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Some people believe the next two digits, called the "group number," helps identify a persons race. It doesn't. The two-digit group number was actually created as a way to organize Social Security Administration filing cabinets into subgroups to make them more manageable. The last four digits on a Social Security card are serial numbers that are issued consecutively within a group from 0001 to 9999.
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In 1938 a sample Social Security card with the number 078-05-1120 was inserted into new wallets manufactured by the E.H. Ferree company in Lockport, N.Y. Unfortunately, that number belonged to Hilda Schrader Whitcher, the secretary of an E.H. Ferree vice president who decided to use her official number on the sample cards. Whitcher was eventually issued a new number, but not before being questioned by the FBI. They wanted to know why so many people had her number.
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Even though numbers aren't reused, the Social Security Administration says the current numbering system is capable of providing enough new numbers for "several generations into the future." That means Social Security numbers will still be available well past 2030.
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Based upon the original assignment criterion, one would naturally expect a Maine resident to have the lowest Social Security number ever issued. However, New Hampshire was ultimately given the 001 area number so that Social Security number 001-01-0001 could be assigned to Social Security board chairman John G. Winant, who was a three-time governor of the state. Winant eventually declined the honor of having the lowest Social Security number. As a result, it eventually found its way to Grace D. Owen of Concord, N.H.
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FDA Be Safe Rx Campaign
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Since 1936, more than 420 million different Social Security numbers have been issued. More than 5.5 million new numbers are assigned every year.
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The first three digits of a Social Security number are known as the "area number." Area numbers assigned before 1972 reflect the state where you applied for your number; otherwise, they are based upon the Social Security card application mailing address ZIP code. Area numbers are assigned geographically, with the lowest numbers in the Northeast and the highest in the Northwest. That practice will no longer apply, however, after a new randomized assignment methodology officially goes into effect on June 25.
***
Some people believe the next two digits, called the "group number," helps identify a persons race. It doesn't. The two-digit group number was actually created as a way to organize Social Security Administration filing cabinets into subgroups to make them more manageable. The last four digits on a Social Security card are serial numbers that are issued consecutively within a group from 0001 to 9999.
***
In 1938 a sample Social Security card with the number 078-05-1120 was inserted into new wallets manufactured by the E.H. Ferree company in Lockport, N.Y. Unfortunately, that number belonged to Hilda Schrader Whitcher, the secretary of an E.H. Ferree vice president who decided to use her official number on the sample cards. Whitcher was eventually issued a new number, but not before being questioned by the FBI. They wanted to know why so many people had her number.
***
Even though numbers aren't reused, the Social Security Administration says the current numbering system is capable of providing enough new numbers for "several generations into the future." That means Social Security numbers will still be available well past 2030.
***
Based upon the original assignment criterion, one would naturally expect a Maine resident to have the lowest Social Security number ever issued. However, New Hampshire was ultimately given the 001 area number so that Social Security number 001-01-0001 could be assigned to Social Security board chairman John G. Winant, who was a three-time governor of the state. Winant eventually declined the honor of having the lowest Social Security number. As a result, it eventually found its way to Grace D. Owen of Concord, N.H.
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Encourage your patients to check out FDA's BeSafeRx -- Know Your Online Pharmacy website and resources before they consider purchasing prescription medicines from an online pharmacy, especially one that's not associated with a health insurance plan or local "brick and mortar" pharmacy. Fraudulent online pharmacies can manipulate their websites to appear legitimate, so FDA recommends you always confirm that an online pharmacy is licensed in the US. Fake online pharmacies use sophisticated marketing efforts or phony web storefronts to appear legitimate. Patients who buy medicines from these fake websites may be putting their health at risk because the products may contain the wrong ingredients, or too little or too much of the active ingredient, or they might be made with other harmful ingredients. BeSafeRx -- Know Your Online Pharmacy,because when it comes to buying prescription medicines online, it's better to be safe than sorry.
Gene study clears 'Patient Zero' as cause of U.S. HIV epidemic
Genes taken from archived blood samples show the U.S. AIDS epidemic started in New York in the early 1970s, definitively debunking the long-held belief that the virus was spread in the early 1980s by a flight attendant who became vilified as "Patient Zero" for seeding the U.S. outbreak.
Scientists have long suspected that HIV had been circulating in the United States for a decade before the first few AIDS cases were identified in Los Angeles 1981. The new study, published in the journal Nature, offers some of the first genetic proof.
"What we've done here is tried to get at the origins of the first cases of AIDS that were ever noticed," said Michael Worobey, the evolutionary biologist at the University of Arizona who led the study.
Using a painstaking new approach, Worobey and colleagues pieced together the entire genetic sequence of the HIV virus from eight archived blood samples taken in 1978 and 1979 from gay and bisexual men participating in a hepatitis B study. ...
http://www.reuters.com/article/us-usa-aids-idUSKCN12Q2BU?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-10-27&utm_term=US%20Health%20Report
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A study presented at the annual European Society of Cardiology Congress found women with peripregnancy myocardial infarction had higher rates of in-hospital mortality and ST-elevation myocardial infarction, compared with nonpregnant peers who had a heart attack. The findings also showed peripregnancy myocardial infarction was tied to significantly lower diagnostic coronary angiography and percutaneous intervention rates. Family Practice News (10/29) ...
http://www.mdedge.com/familypracticenews/article/116695/acute-coronary-syndromes/mis-pregnancy-have-worse-prognosis
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Veterans may face higher risk of suicide during first year home
(Reuters Health) - Veterans may be more likely to commit suicide during the first year after they leave the military than after more time passes, a U.S. study suggests.
Compared with people still on active duty in the military, veterans out of the service for up to three months were 2.5 times more likely to commit suicide, the study found. Veterans who had left the service from three to 12 months earlier had almost triple the suicide odds of current members of the military.
“Family members and community can be proactive to reach out to veterans if they recently experienced stressful events – not just limited to the stressful events we can capture in the data such as divorce or separation from the military,” said lead study author Yu-Chu Shen, a researcher at the Naval Postgraduate School in Monterey, California. ...
http://www.reuters.com/article/us-health-veterans-suicide-idUSKCN12R2MT?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-10-28&utm_term=US%20Health%20Report
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| NEW YORK
American women are ending pregnancies with medication almost as often as with surgery, marking a turning point for abortion in the United States, data reviewed by Reuters shows.
The watershed comes amid an overall decline in abortion, a choice that remains politically charged in the United States, sparking a fiery exchange in the final debate between presidential nominees Hillary Clinton and Donald Trump.
When the two medications used to induce abortion won U.S. approval 16 years ago, the method was expected to quickly overtake the surgical option, as it has in much of Europe. But U.S. abortion opponents persuaded lawmakers in many states to put restrictions on their use.
Although many limitations remain, innovative dispensing efforts in some states, restricted access to surgical abortions in others and greater awareness boosted medication abortions to 43 percent of pregnancy terminations at Planned Parenthood clinics, the nation's single largest provider, in 2014, up from 35 percent in 2010, according to previously unreported figures from the nonprofit. ...
http://www.reuters.com/article/us-usa-healthcare-abortion-exclusive-idUSKBN12V0CC?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-10-31&utm_term=US%20Health%20Report
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Regular nibbling on nuts linked to low inflammation
(Reuters Health) - Eating a handful of nuts five times per week may reduce inflammation, a condition that contributes to heart disease, diabetes and many other chronic illnesses, say the authors of a recent U.S. study.
This inflammation-dampening effect might be the secret to the health benefits of nuts, the study team writes in American Journal of Clinical Nutrition.
Past research has linked eating nuts to lower rates of heart disease and diabetes, but the exact reason was unknown, senior study author Dr. Ying Bao, an assistant professor of medicine at Harvard Medical School in Boston, told Reuters Health.
“We hypothesized that nuts may exert these health benefits by reducing inflammation,” Bao said by email.
Nuts may lower inflammation because they contain fiber, magnesium, antioxidants and other health-boosting ingredients, the researchers write. ...
http://www.reuters.com/article/us-health-inflammation-nuts-idUSKCN10Z2S6?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-08-25&utm_term=US%20Health%20Report
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Interesting facts about the nursing profession: Used before...but still worth re-reading.
- The nurse cap is patterned after a nun’s habit to keep the hair neatly in place. Although this clothing item has long been phased out as it is known to carry pathogens, some countries still use this as part of the female nurses’ outfit.
- The most visits to emergency rooms occur during the warmer months of the year.
- According to the latest data available to the World Health Organization, Finland, Norway, Monaco, Ireland and Belarus have, in that order, the highest ratios of nurses per capita of all nations, ranging from 2162 to 1182 nurses per 100,000 people.
- Linda Richards was the first nurse to earn a Nursing diploma in the United States. She earned it in 1873 and the proof of her graduation is now displayed in the Smithsonian Institution in Washington.
- James Derham, a black slave, was “owned” by several doctors working as a nurse. He bought his freedom using his nursing salary and he later became the first African- American physician.
- The top occupational health concern of nurses is back injury. A survey done in 2011 shows that 59% of nurses are afraid they might have this.
- The first Nursing school was established in India in 250 BC.
- Japan’s exam for foreign nurses is so difficult that, according to the latest report, it has been passed only by 96 out of 741 test takers in the past five years.
- The famous poet and essayist Walt Whitman served as a volunteer nurse during the Civil War in Fredericksburg, Virginia. His poem entitled “The Wound Dresser” got its theme from his nursing experience in the battlefield.
- In order to give recognition to school nurses, January 27 is now celebrated as the National School Nurse Day.
- May 8 is celebrated as the National Student Nurses Day.
- According to the World Health Organization, Nepal is one of the countries with the lowest nurse per capita. It only has 5 nurses per 100,000 people.
- Lucretia Lester was a well-known nurse and midwife who attended to 1,300 deliveries, with only 2 ending up unsuccessful.
- The first hospital training ground for nurses was established in the Institute of Protestant Deaconesses in Kaiserwerth, Germany in 1846.
- The UKCC or the United Kingdom Central Council has established the Nurses Registration Act of 1919 that ensures nurses get the proper and high standard of training.
- The term nosocomial which means “hospital acquired” originated from a Latin term “nosocomium” which refers to men who tended the sick in ancient Rome.
- The knights who were ordered by Pope Urban II to fight during the crusades became nurses to the ill and wounded. They decided to take this role for good thus they were called the Knight Hospitallers.
- The American Nurses Association, first known as the Nurses Associated Alumnae, was started in 1898.
- In a 2001 survey done by the ANA/NursingWorld.com, 59% of nurses expressed fear of getting a severe back injury as one of their top three occupational health concerns.
- In 1947, Florence Blanchfield, a nurse, became the first female regular commissioned officer in the United States Army, assigned as the superintendent of the Army Nurse Corp.
- 17th century shipwreck survivor Juan de Mena is considered the first nurse in the New World.
- Mary Todd Lincoln, the wife of Abraham Lincoln, was a volunteer nurse during the American Civil War
- Mary Seacole, a self-taught nurse, was famous for establishing a hotel for invalids close to the front during the Crimean War.
- Florence Nightingale, the most famous nurse in modern history, was only a nurse for three years of her life
- Saint Camillus de Lellis established a Catholic order called the Fathers of a Good Death in 1584 to tend to the terminally ill, and is also reputed to have designed the red cross on a white background symbol and to have developed the first ambulance
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Children 14 or Under Need Fewer HPV Vaccine Doses
The CDC has advised that children ages 11 to 14 receive only two doses of human papillamovirus vaccine at least six months apart, instead of the usual three doses, following a review that showed similar or higher immune response among preteens receiving two doses compared with those who had three. Youths ages 15 to 26 should continue with the three-dose HPV vaccine regimen, the CDC says.
The New York Times (free-article access for SmartBrief readers) (10/19), Reuters (10/19)
http://www.nytimes.com/2016/10/20/health/children-14-or-under-need-fewer-hpv-vaccine-doses.html
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CDC reports record high STD cases in the US in 2015
The US saw record high numbers of sexually transmitted disease cases in 2015, partly due to insufficient funding to state and local programs, limiting people's access to testing and treatment, as well as better treatment for HIV that may lead to lower condom use, according to a CDC report. Data show cases of syphilis, gonorrhea and chlamydia rose by 19%, 13% and 6%, respectively, from a previous all-time high in 2014, and that youths younger than 20 accounted for half of all STDs in 2015.
NBC News (10/19), USA Today (10/20)
http://www.nbcnews.com/health/sexual-health/sexually-transmitted-disease-cases-hit-new-high-u-s-n669051
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Quiz Time
Which diagnostic biomarker is detectable in the urine within 12 hours after renal tubular cells are injured?
a. Neutrophil gelatinase-associated lipocalin
b. Cystatin C
c. Tissue inhibitor metalloproteinase-2
d. Glomerular filtration rate
a. Neutrophil gelatinase-associated lipocalin
b. Cystatin C
c. Tissue inhibitor metalloproteinase-2
d. Glomerular filtration rate
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Take time out to go to this site.....very helpful.
How to check the fit of your bra: http://lingerie.about.com/od/FitGuide/ss/6-Steps-to-Check-the-Fit-of-Your-Bra.htm
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The American Society of Breast Surgeons has recommended against routine double mastectomy in the majority of patients with cancer in only one breast because of an increased risk of surgical complications and little to no oncologic benefit to removing the healthy breast.. The exceptions to this advisory are women with BRCA1 or BRCA2mutations, those who have had mantle radiation (usually for Hodgkin lymphoma), patients younger than 30 years, and those with significant family history without proven gene mutation. Removing both the diseased and healthy breasts, a procedure known as contralateral prophylactic mastectomy (CPM), has, in fact, been shown to improve overall survival in women with a BRCA mutation. More women than ever with unilateral breast cancer are electing CPM to prevent possible future cancer on the unaffected side. Most patients with unilateral breast cancer, however, have an extremely low risk of ever having subsequent contralateral breast cancer. The risk is 0.1% to 0.6% per year for women without risk factors. ... http://journals.lww.com/ajnonline/Fulltext/2016/11000/New_Advisory_on_Contralateral_Prophylactic.17.aspx
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Researchers: We Found Area of Brain That Responds to Placebo
FRIDAY, Oct. 28, 2016 (HealthDay News) -- Scientists say they've pinpointed the brain region linked to the placebo effect.
The placebo effect occurs when a fake therapy -- such as a sugar pill -- leads to a significant decrease in pain or other health-related improvement.
The finding could lead to improved treatment for the 100 million Americans who suffer from chronic pain, the study authors said.
Using a new type of MRI developed for the study, the investigators said they identified a region within the brain that responds to a placebo.
"The new technology will allow physicians to see what part of the brain is activated during an individual's pain and choose the specific drug to target this spot," said study co-author Vania Apkarian, a professor of physiology at Northwestern University's Feinberg School of Medicine, in Chicago.
https://medlineplus.gov/news/fullstory_161747.html
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Nine more mosquito-borne Zika cases reported in Florida's Miami-Dade area
Florida health officials on Wednesday reported nine more mosquito-borne Zika infections, all of them in Miami-Dade County, including six cases that will require an epidemiological investigation to determine the exact area of exposure.
Among the local infections reported Wednesday in Miami-Dade, one person was exposed in Miami Beach, a second in Miami’s Little River neighborhood, and a third in Wynwood. ... http://www.miamiherald.com/news/health-care/article110660412.html
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How to Eat Healthy
At the heart of a healthy lifestyle is good nutrition. Making smart food choices can help reduce your risk of heart disease and stroke.
The good news is, eating right doesn’t have to be hard or require a special diet.
http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/How-to-Eat-Healthy_UCM_307257_Article.jsp#.WCTh4PkrJko
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HUMOR SECTION
Three nurses went to heaven, and were awaiting their turn with St. Peter to plead their case to enter the pearly gates.
The first nurse said, "I worked in an emergency room. We tried our best to help patients, even though occasionally we did lose one. I think I deserve to go to heaven." St. Peter looks at her file and admits her to heaven.
The second nurse says, "I worked in an operating room. It's a very high stress environment and we do our best. Sometimes the patients are too sick and we lose them, but overall we try very hard." St. Peter looks at her file and admits her to heaven.
The third nurse says, "I was a case manager for an HMO."
St. Peter looks at her file. He pulls out a calculator and starts punching away at it furiously, constantly going back to the nurse's file. After a few minutes St. Peter looks up, smiles, and says, "Congratulations! You've been admitted to heaven ... for five days!"
The first nurse said, "I worked in an emergency room. We tried our best to help patients, even though occasionally we did lose one. I think I deserve to go to heaven." St. Peter looks at her file and admits her to heaven.
The second nurse says, "I worked in an operating room. It's a very high stress environment and we do our best. Sometimes the patients are too sick and we lose them, but overall we try very hard." St. Peter looks at her file and admits her to heaven.
The third nurse says, "I was a case manager for an HMO."
St. Peter looks at her file. He pulls out a calculator and starts punching away at it furiously, constantly going back to the nurse's file. After a few minutes St. Peter looks up, smiles, and says, "Congratulations! You've been admitted to heaven ... for five days!"
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
Go to www.sharedgovernance.org for access to a free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member.
Please follow me on Twitter as Dr Robert Hess. info@sharedgovernance.orgwww.sharedgovernance.org
Go to www.sharedgovernance.org for access to a free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member.
Please follow me on Twitter as Dr Robert Hess. info@sharedgovernance.orgwww.sharedgovernance.org
Pay Only $34.99 for a full year of CONTACT HOURS
www.nurse.com for CNE offerings.
www.nurse.com for CNE offerings.
Free CEs http://www.myfreece.com/welcome.asp
THESE ARE NEW CEs
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com.
This is an excellent nursing site, check it out: http://nursingpub.com/
If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood
Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Metric conversion calculators and tables for metric conversions
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MEDICAL RECALLS
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Medtronic Neurovascular Products: Recall - Potential Separation and Detachment of Polytetrafluoroethylene (PTFE) Coating ncludes:
- Pipeline Embolization Device
- Alligator Retrieval Device
- X-Celerator Hydrophilic Guidewire
- Ultraflow and Marathon Flow Directed Micro Catheters
Medtronic announced that it has notified customers of a voluntary recall of certain lots of its Pipeline embolization device, Alligator retrieval device and X-Celerator hydrophilic guidewire. The recall also includes the stylet containing UltraFlow flow directed micro catheters and Marathon flow directed micro catheters.
This voluntary recall is being conducted due to the potential separation and detachment of the polytetrafluoroethylene (PTFE) coating on parts of these devices. Should the PTFE separate from the delivery wire or stylets, PTFE particulate could enter the blood stream of the patient. PTFE in the blood stream, based on the size and quantity, could lead to a thromboembolic event.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm525672.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery
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HeartWare Ventricular Assist Device (HVAD) Pumps by HeartWare Inc. : Class I Recall - Contamination Causing Electrical Issues
USFDA pembrolizumab (KEYTRUDA) checkpoint Inhibitor
HeartWare Inc. is recalling the HVAD pumps due to a design problem with the driveline connector. The driveline is a tube that connects the HVAD's pump to the external controller and power source. Contamination of the driveline may result in fluid or other material entering the pump and causing electrical issues or pump stops that may lead to serious adverse health consequences, including death.
The HVAD helps deliver blood from the heart to the rest of the body. It is used in patients who are at risk of death from end-stage left ventricular heart failure and who are waiting for a heart transplant. The system includes a pump implanted in the space around the heart (pericardium) and a controller that controls the speed and function of the pump. The HVAD is designed for use both in and out of hospital settings, including during patient transport. This recall affects all HVADs with serial numbers lower than HW25838, Product Codes 1103 and 1104, manufacturing dates: March 17, 2006 to June 27, 2016. 105 units have been recalled in the U.S.
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ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........
Accuruler: Accurate wound measurement
designed by nurses, for nurses.
Now carrying wound care and first-aid supplies at prices you can afford.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address. So, be certain to let me know when you change your address. RNFrankie@AOL.com
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EDITORIAL STAFF:
Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), Schulthe @AOL.com (Susan)
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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
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DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
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THOUGHT FOR THE DAY
"Be kinder than necessary, for everyone you meet is fighting some kind of battle."
Hope to hear from you..... Frankie
c. Tissue inhibitor metalloproteinase-2 (TIMP-2) appears in the urine within 12 hours after renal tubular cells are injured from ischemia or sepsis. In one study, urinary TIMP-2 testing showed certain patients had seven times the risk of developing acute kidney injury.
Learn more by reading the continuing nursing education article “Acute kidney injury: Causes, phases, and early detection.”
