The basics of ostomies.

Basic ostomy care can be intimidating because nurses don't often see colostomies, ileostomies, or urostomies. While there are as many different ostomies as there are people who have them, there are some commonalities in the care of the stoma. These can be generalized to all stomas, regardless of the type of output. Some care, however, is specific to the placement of the stoma and the type of effluent flowing from the opening. This article will provide the gastroenterology nurse an overview of the basic features of ostomies as well as routine ostomy care.     

The basics of genetic disease.

Molecular genetics has opened new avenues for medical diagnosis, treatment and prevention of genetic diseases. Major ethical and legal issues regarding applications of this new technology have surfaced and are being discussed at a variety of levels. Policies for use of the new technology have been established, and the first use of gene replacement therapy is anticipated in the near future.     

The basics of an exposure control plan.

Prevention and control of employee injury and exposure begins with an organizational commitment to provide a safe work environment for the employees. An Exposure Control Plan (ECP) helps to ensure this safe environment, and is developed by an organization and administered to provide for the elimination and minimization of occupational exposure to blood-borne pathogens, which is one of the greatest areas of risk for the health care provider. The Occupational Safety and Health Administration (OSHA) standard 29 CFR 1010.1030, "Occupational Exposure to Bloodborne Pathogens," outlines the requirements necessary to meet compliance as an institution. However, occupational exposure requirements have changed over the last few years and now incorporate practice advances regarding safety devices (ie, needleless and protected) and their use and implementation. Directives addressing the management of the employee who has been exposed to blood-borne pathogens have also been added. This article focuses on important elements in developing an institutional exposure control plan.     

The basics of laser technology

As the use of laser systems increases, the nurse must be able to cope with the many changes that this new technology brings. An understanding of laser biophysics provides a foundation for laser safety. The nurse must also be aware of the organizational elements needed to provide a comprehensive laser program. Laser technology has definitely revolutionized modern health care delivery, and the nurse is instrumental in the continuing advancement of this science.     

Anaerobic infections. The basics for primary care physicians

Anaerobic bacteria constitute a major portion of the normal human microflora, and some of them can cause disease in contiguous body parts, especially if there is a mucosal break. Most anaerobic infections are polymicrobial. Because anaerobes are difficult to culture, diagnosis is often made on the basis of clinical clues. Thus, knowledge of the common sites, predisposing conditions, and other representative features of anaerobic infections is critical. For anaerobic infections above the diaphragm, where Bacteroides fragilis is not a common isolate, high-dose penicillin G therapy is usually sufficient. Addition of clindamycin (Cleocin) or metronidazole (Flagyl, Metryl, Protostat) may be necessary for serious infections. Cefoxitin sodium (Mefoxin) or clindamycin is adequate for most anaerobic infections occurring outside the central nervous system. Metronidazole, chloramphenicol, imipenem, or beta-lactam antibiotics combined with beta-lactamase inhibitors may be preferable for serious infections. Appropriate coverage for aerobic bacteria must be included in the treatment regimen. Drainage of abscesses, decompression of infected spaces, debridement of necrotic tissue, and removal of foreign bodies are critical in management of many anaerobic infections.     

The basics of epithelial-mesenchymal transition

The origins of the mesenchymal cells participating in tissue repair and pathological processes, notably tissue fibrosis, tumor invasiveness, and metastasis, are poorly understood. However, emerging evidence suggests that epithelial-mesenchymal transitions (EMTs) represent one important source of these cells. As we discuss here, processes similar to the EMTs associated with embryo implantation, embryogenesis, and organ development are appropriated and subverted by chronically inflamed tissues and neoplasias. The identification of the signaling pathways that lead to activation of EMT programs during these disease processes is providing new insights into the plasticity of cellular phenotypes and possible therapeutic interventions.