Hyperalimentation.

As widespread use of parenteral nutrition enters the second decade, it is obvious that a great deal of progress has been made, both as to increasing safety and developing new solutions. There are few hard data in this area, not surprising in so young a field. Prospective studies hopefully will yield definitive results in areas in which such knowledge is lacking. More importantly, better understanding of various disease states will undoubtedly result in the modification of existing solutions to allow for better treatment.     

Multiple sclerosis pathways: an innovative nursing role in disease management.

Multiple sclerosis (MS), a chronic disease of the central nervous system, is characterized by a variable and unpredictable course. The most common pattern of the disease is the relapsing-remitting form in which clearly defined relapses (also called exacerbations) are followed by complete or incomplete recovery. Interferon beta-1b (Betaseron), a drug that affects the natural course of the disease, was developed for the treatment of relapsing-remitting MS. Multiple Sclerosis Pathways (MSP), a disease management program, was developed to provide comprehensive and personal support to MS patients taking interferon beta-1b and to serve as an information resource for all people with MS, their families, and healthcare professionals. The MSP program includes personal patient assistance, reimbursement services, a 24-hour nurse hotline, training program, educational resources, and injection supplies. The nurse hotline counselor (NHC) utilizes the nursing process in a unique telephone nursing practice in this program. The positive impact of education and support on adherence to therapy has been validated by training and nurse hotline data.     

Hoffa’s fracture in an adolescent treated with an innovative surgical procedure: A case report

BACKGROUNDHoffa fracture is rare, especially in adolescents, and has a high rate of complications such as avascular necrosis and osteoarthritis; moreover, there are no definitive guidelines for its treatment. This report could provide a new potential treatment for Hoffa fracture.CASE SUMMARYA 16-year-old girl presented to the orthopedic emergency department of No. 2 People’s Hospital of Yibin City with persistent pain following a right knee injury sustained during a sprint race. Her knee was swollen and tender, and the range of motion was restricted by the pain. X-ray and computed tomography revealed a Hoffa fracture in the right knee. After consultation, surgical treatment was performed, and the fracture was fixed with three 3.5-mm cannulated cancellous screws; osteochondral plugs that were harvested from the screw insertion site were re-implanted to cover the screw head. The patient’s fracture and osteochondral plug healed 6 mo postoperatively, and she presented a knee range of motion of 0–135 without pain, and was walking without support with a normal gait.CONCLUSIONHere, we describe an innovative surgical procedure for Hoffa fracture that could provide a new possibility for the treatment of similar fractures, and further improve their management.     

Global aphasia: an innovative assessment approach.

OBJECTIVE: To provide an alternative language comprehension assessment strategy for patients unable to be tested with traditional verbally/behaviorally based methods. DESIGN: Event-related brain potentials were recorded from three midline scalp locations to visually and aurally computer-presented sentences, 50% of which were semantically appropriate and 50% semantically incongruous. SETTING: A rehabilitation hospital. PATIENT: A 21-year-old man with a traumatic brain injury. RESULTS: The patient exhibited brain response patterns to aurally presented congruous and incongruous sentences indicative of intact semantic processing capabilities. These findings resulted in reinstatement of individualized rehabilitative intervention, with a successful outcome. CONCLUSIONS: This innovative technique provides new opportunities for assessing intellectual function in noncommunicative patients who were patients previously unable to be tested.     

Organ donation and neuroscience nursing: your role in the process.

The death of a patient is seen by many nurses as the end of their interaction with the patient and family. However, the option of organ donation may extend that interaction and present another opportunity to serve as an advocate for the family, as well as for patients whom the nurse has never met. Patients who have been declared brain dead or from whom life support is going to be withdrawn following a neurological injury are potential organ donors. Although these patients and their families are frequently under the care of neuroscience nurses, all nurses need a thorough understanding of their responsibilities regarding identification and referral of potential organ donors to the designated Organ Procurement Organization (OPO). In addition, it is essential for nurses to understand the clinical presentation and determination of brain death in order to provide patient care and family education. Understanding how consent for organ donation should be obtained from families and how the organ recovery process works enables the nurse to collaborate with OPO staff and support the family in their decision regarding organ donation.     

Vaccines: an innovative approach to treating cancer.

Recent scientific advances have expanded our understanding of the immune system and its response to malignant cells. Clinical trials are under way that attempt to translate this knowledge into effective cancer therapies. Vaccine therapy, an innovative approach to cancer treatment, attempts to activate the immune system to recognize cancer cells and eliminate them from the body. Preventive vaccines that already have been approved will have an impact on the incidence of certain cancers, and research is ongoing into treatment vaccines for various cancers.