Self-Care Strategies to Relieve Fatigue in Patients Receiving Radiation Therapy.

Self-care strategies to relieve fatigue in patients receiving radiation therapy.

Clin J Oncol Nurs. 2013 Jun 1; 17(3): 319-24
Erickson JM, Spurlock LK, Kramer JC, Davis MA

Despite advances in symptom management, patients commonly experience fatigue during radiation therapy (RT). Minimal research has been conducted to determine how evidence-based recommendations are put into clinical practice and used by patients to manage fatigue. The aims of the current study were to identify the self-care strategies used by patients receiving RT, explore the effectiveness of those strategies, and identify how patients learned about fatigue management. Participants reported using multiple recommended interventions to relieve fatigue. The majority of participants reported they primarily rested or slept to improve fatigue. They also reported decreasing their activity level, exercising, using stimulants and complementary therapies, and eating and drinking nutritious items. More than half of the participants reported some relief of fatigue regardless of the intervention used. The majority of participants reported that they learned how to manage their fatigue mostly through experience and trial and error. Nurses need to explore the complex dynamics of each patient’s fatigue and tailor multiple evidence-based interventions to maximize each patient’s functional status and quality of life. When assessing and teaching about fatigue, nurses need to explore patients’ daytime activity level and daytime sleep to be sure that excessive inactivity is not contributing to fatigue. HubMed – eating


Eating Behaviors Among Early Adolescent African American Girls and Their Mothers.

J Sch Nurs. 2013 May 28;
Reed M, Dancy B, Holm K, Wilbur J, Fogg L

African American (AA) girls aged 10-12 living in urban communities designated as food deserts have a significantly greater prevalence of overweight and obesity than girls that age in the general population. The purpose of our study was (a) to examine the agreement in nutritional intake between AA girls aged 10-12 and their mothers and (b) to determine if the girls’ weight categories were associated with their or their mothers demographic characteristics, eating behaviors, nutritional intake, and health problem. A cross-sectional descriptive study was conducted in predominantly low-income AA communities in Chicago. Forty-three dyads of early adolescent AA girls and their mothers responded to food frequency and eating habits questionnaires. There was a strong and significant correlation between mother’s and daughter’s kilocalories consumed (r = .61). Our study suggests that interventions aimed at improving eating behaviors in early adolescent AA girls should include their mothers. HubMed – eating


Oral mucositis in head and neck cancer.

Am Soc Clin Oncol Educ Book. 2013; 2013: 236-40
Sonis ST

Of the toxicities associated with conventional forms of treatment for head and neck cancers, probably none has such a consistent legacy as oral mucositis.1 Despite the fact that mucosal injury was noted as far back as Marie Curie’s first forays into therapeutic radiation, an effective intervention has yet to be developed. In addition to its historic link to radiation, new therapeutic strategies including induction chemotherapy often produce mucositis, and targeted therapies appear to alter mucositis risk and its severity and course.2 The symptomatic effect of oral mucositis is profound. Disabling oral and oropharyngeal pain prevents patients from eating normally, requires opiate analgesics, and in some cases results in alteration or discontinuation of anticancer therapy.3 Furthermore, the health and economic consequences of oral mucositis are far from trivial. The incremental cost of oral mucositis in patients with head and neck cancer exceeds $ 17,000 (USD).4. HubMed – eating


Prolonged anesthesia using sevoflurane, remifentanil and dexmedetomidine in a horse.

Vet Anaesth Analg. 2013 May 29;
Benmansour P, Duke-Novakovski T

HISTORY: A 10-year old Arabian mare had a slow-growing mass on the lower right mandible and required a large partial mandibulectomy. PHYSICAL EXAMINATION: No abnormalities were detected apart from the mass. MANAGEMENT: A temporary tracheostomy was performed pre-operatively. Anesthesia was induced with xylazine followed by ketamine and diazepam. For 13 hours, anesthesia was maintained using sevoflurane, dexmedetomidine and remifentanil infusions, with the exception of surgical preparation time. Intra-operatively, ventilation was delivered through the cuffed tracheotomy tube. Heart and respiratory rates, ECG, arterial pressures, inspired and expired gases, pulse oximetry values and body temperature were monitored. Dobutamine and whole blood were necessary, and romifidine was used to control recovery. Post-operatively, phenylbutazone and buprenorphine given systemically and bupivacaine administered through a wound soaker catheter were used to provide analgesia. Head-shaking from buprenorphine was controlled with acepromazine and detomidine once standing after 87 minutes in recovery. For 3 days after surgery, analgesia was provided with butorphanol, phenylbutazone and bupivacaine. The mare recovered well, appeared comfortable and started eating the following day with no signs of ileus. FOLLOW-UP: Seven months later, the mare was doing well. CONCLUSIONS: Sevoflurane, dexmedetomidine and remifentanil infusions were suitable for a long and invasive procedure. HubMed – eating