RESUMO
Acute myeloid leukemia (AML) is the most common acute leukemia in adults, diagnosed in approximately 21,450 individuals annually in the US with nearly 11,000 deaths attributable to this disease (National Cancer Institute, 2020). Acute myeloid leukemia is a disease of the elderly, with the average age of diagnosis being 68 years old (Kouchkovsky & Abdul-Hay, 2016). It is a heterogeneous disease with widely varying presentations but universally carries a poor prognosis in the majority of those affected. Unfortunately, the 5-year overall survival rate remains poor, at less than 5% in patients over 65 years of age (Thein, Ershler, Jemal, Yates, & Baer, 2013). The landscape of AML is beginning to change, however, as new and improved treatments are emerging. Advanced practitioners (APs) are often involved in the care of these complex patients from the time of initial symptoms through diagnosis, treatment, and potentially curative therapy. It is vitally important for APs to understand and be aware of the various presentations, initial management strategies, diagnostic workup, and treatment options for patients with AML, especially in the elderly population, which until recently had few treatment options. This Grand Rounds article highlights the common presenting signs and symptoms of patients with AML in the hospital, including a discussion of the upfront clinical stability issues, oncologic emergencies, diagnostic evaluation, and current treatment options for elderly patients and those with poor performance status.
RESUMO
PURPOSE: To examine knowledge regarding appropriate use of condoms and lubricants among three groups: female at-risk adolescents, nursing students, and education students. METHODS: Study participants were 236 adolescents: 65 recruited through community agencies, 79 female nursing students, and 92 female education students. These participants completed anonymous questionnaires concerning lubricants, general condom knowledge, and sexual experience. RESULTS: Neither nursing students nor education students were more knowledgeable than adolescents not enrolled in college. All participants were about as likely to think unsafe lubricants were safe as they were to think that safe lubricants were unsafe. Personal experience with vaginal intercourse and condom use was associated with increased knowledge (p < 0.05). However, 27% to 66% of participants who had used condoms answered the lubricant questions incorrectly. IMPLICATIONS: Nursing students need more education about condoms and condom lubricants if they intend to teach patients effectively. Moreover, nurses should not assume that youth are knowledgeable about appropriate condom use based on their level of education or sexual experience.
