Pharmaceutical Clinical Educators: A Resource for Advanced Practice Providers.

One of the main challenges within clinical practice today involves attaining the knowledge necessary to treat patients safely and effectively. The explosion of scientific breakthroughs within the health-care setting has created a new challenge for today's practitioners: staying informed. In turn, the pharmaceutical industry has been challenged with providing information that is accurate, meaningful, and compliant with US Food and Drug Administration guidelines. In this article, we review how the pharmaceutical industry has tried to fill this need through the role of the pharmaceutical clinical educator (PCE). We describe the PCE role and the different forms of education and support that can be provided to advanced practice providers (APPs). We also address the conflict of interest issues surrounding a collaborative relationship between APPs and pharmaceutical industry APPs.

Music for patients with hematological malignancies undergoing bone marrow biopsy: a randomized controlled study of anxiety, perceived pain, and patient satisfaction.

OBJECTIVE: To examine the impact of random assignment to music versus usual care on anxiety, perceived pain level and patient satisfaction in patients undergoing bone marrow biopsies. METHOD: Patients were randomized to music or usual care after completing a baseline questionnaire. All patients completed a post-procedure questionnaire. RESULTS: Study participants (N=59) had a mean age of 50.9 years (SD = 13.9; range 22-78). Post-procedure state anxiety (STAI) and pain rating (VAS) were not significantly different between groups (STAI p=0.766; VAS p=0.771). However, patient satisfaction with music was high; 66% of these patients said they very much preferred to listen to music at a future biopsy. CONCLUSIONS: While there were no significant group differences for the music intervention compared to standard of care for anxiety or perceived pain, additional feedback indicated that patients found the music intervention beneficial and requested use of music during future procedures.

Guillain-Barré syndrome after transplantation.

Guillain-Barré syndrome (GBS) is an unusual complication after organ and hematopoietic stem cell transplantation. We report two cases of GBS associated with autologous and allogeneic stem cell transplantation along with a review of the literature.

Aneurysm Outreach Inc., a nonprofit organization, offers community-based, ultrasonography screening for abdominal aortic aneurysms.

Aneurysm Outreach Inc. (AOI; http://www.alink.org) is a nonprofit volunteer organization founded in 1999 whose aim is to (a) raise public awareness about aneurysms; (b) stimulate and fund genetic research through donations; and (c) coordinate a support network for aneurysm patients and their families. Since abdominal ultrasonography examination of an asymptomatic individual is not presently reimbursed by health insurance in the United States, one of the initiatives supported by AOI is to have free ultrasonography screening for abdominal aortic aneurysm (AAA) for those most at risk. One of the initiatives supported by AOI is to have free ultrasonography screening for abdominal aortic aneurysm (AAA). To meet this goal, a free screening program was initiated in September 2001 and by November 2004 approximately 3,000 participants were screened and 61 (2.0%) participants were confirmed to have a dilated aorta and were referred to their primary care physicians or vascular surgeons for further follow-up and treatment, if indicated.

Community-based, nonprofit organization-sponsored ultrasonography screening program for abdominal aortic aneurysms is effective at identifying occult aneurysms.

Early diagnosis of abdominal aortic aneurysm (AAA), prior to rupture, is vital for optimizing patient survival. An abdominal ultrasonography examination of an asymptomatic individual to check for the presence of an AAA, however, is not presently reimbursed by health insurance in the United States. This article reports the results of one nonprofit, community-based screening program, run by Aneurysm Outreach, Inc. (AOI; www.alink.org). AOI offered free screening for AAA to anyone who met the criteria of being (1) over 60 years old; (2) over 50 years old, male, and with positive family history for AAA; or (3) over 55 years old, female, and with positive family history for AAA. AOI organized 21 ultrasonographic screening events between September 2001 and November 2004, and the number of participants per event varied from 24 to 240. Altogether 3,088 individuals met the screening criteria and 22 of them were already known to have AAAs. Thirty-six (1.2%) individuals were excluded from the final analysis due to poor quality of the ultrasonographic images. Among the remaining 3,030 individuals, a dilatation of the aorta was detected and confirmed in 61 (2.0%) individuals, in 4.3% of the screened males and in 0.6% of the screened females. Thirteen individuals had their AAAs repaired surgically. The frequencies of males and current smokers were significantly higher in the AAA group than in the group with normal-size aorta (male AAA 83.6% vs. normal 42.0%, p < 0.0001; smoker AAA 54.9% vs. normal 18.1%, p < 0.0001). The mean age was significantly higher in the AAA group than in the group with normal-size aorta (AAA 71.0 +/- 6.2 vs. normal 68.4 +/- 7.0, p = 0.005). In conclusion, the results of this community-based free ultrasonographic screening program are in agreement with randomized controlled screening programs and emphasize the need for systematic screening programs and the importance of finding individuals harboring AAAs before their rupture.