Current Issue
VOL 12 NO 2 • MAR 2021
This issue’s cover illustration depicts a small section of capillary showing two red blood cells and a schistocyte trapped by a clot of activated platelets and ultra-long von Willebrand factor. On the left is the active aTTP, in the middle the caplacizumab nanobodies binding to the A1 domains on the ULvW factor, and on the right the normal situation with ADAMTS13 enzyme clipping the von Willebrand factor at the A1 nodes. Artwork by Alexandra Webber Baker © 2021, DNA Illustrations, Inc., Asheville, North Carolina.EditorialBeth Faiman, PhD, MSN, APRN-BC, AOCN®, FAANOne day, as I was standing in line at the local pharmacy, I noticed an elderly woman who was visibly upset. She had stopped by to pick up medication for her husband. The woman began crying as she spoke with the pharmacist who stated the provider was unable to refill her husband’s medication witho...
Research and ScholarshipAdrian Tsui,(1) PharmD, Lindsay Edmondson,(2) PharmD, BCOP, Justin Julius,(3) PharmDCancer cells can suppress the defenses of the immune system through the overexpression of immune regulatory molecules within the tumor microenvironment (Van der Jeught et al., 2015). These molecules include immune checkpoint molecules such as cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed ...
Research and ScholarshipTaylor Dennison,(1,2) PharmD, Allison M. Deal,(3) MS, Matthew Foster,(1,3) MD, John Valgus,(1,2) PharmD, MHA, BCOP, and Benyam Muluneh,(2) PharmD, BCOP, CPPThe number of specialty drugs on the market has increased dramatically over the past decade, and specialty drugs are expected to make up over 50% of the pharmaceutical industry’s revenue by 2020 (Galante, 2018). This has prompted the growth of specialty pharmacies, especially in oncology. 60% of ...
Review ArticleBetty R. Ferrell,(1) RN, PhD, MA, FAAN, FPCN, CHPN, Rose Virani,(1) RNC, MHA, FPCN, Elinor Han,(1) BA, and Polly Mazanec,(2) PhD, ACNP-BC, AOCN®, FPCN, FAANThe benefits of palliative care have been documented through extensive clinical practice and research, yet workforce shortages have prevented full delivery of this care to all seriously ill cancer patients who need it (Aldridge et al., 2016). Researchers and health policy experts have concluded t...
Review ArticleMargit Eidenberger, PT MagLymphedema is a chronic progressive disease characterized by an accumulation of lymphatic fluid leading to the swelling of various body parts. Lymphedema can lead to different negative consequences, such as skin changes, connective tissue fibrosis, loss of quality of life, or social retreat (Slei...
Grand RoundsDeena Damsky Dell,(1) MSN, APRN, AOCN®, LNC, and Daniel P. Stein,(2) MDCase Study
MR is a pleasant 74-year-old gentleman who comes to the office complaining of increased pain in his spine. He also reports loss of appetite and a 12-lb weight loss over the past 2 weeks. MR has a history of prostate cancer metastatic to the bone diagnosed in 2018. He is status post tre...
Practice MattersJessica Zucker, RN, MSN, AGNP-BC, Glen J. Peterson, RN, DNP, ACNP, Angela Falco, RN, MS, MPH, FNP-C, and Jessica Casselberry, RN, MSN, ANP-BC, AOCNP®Burnout, high staff turnover, and reduced resiliency among health-care providers working in acute care settings have been well documented in the literature and are recognized nationally as key barriers to recruiting and retaining health-care providers (Burn et al., 2014; Hlubocky et al., 2016; Le...
Prescriber's CornerKatherine V. Katsivalis, PharmD, and Jamie Thomas, PharmDAcquired thrombotic thrombocytopenic purpura (aTTP) is a rare form of microangiopathic hemolytic anemia affecting 1 to 13 per million people every year (Stanley & Michalski, 2019). In clinical practice, a triad of thrombocytopenia, schistocytosis, and elevated lactate dehydrogenase is suggest...
Diagnostic SnapshotCaeli Barker, PA-CHistory
Mr. F is a 63-year-old male with no significant past medical or surgical history. He is physically active, drinks socially, and does not smoke. He presented to his primary care provider with a 2-month history of upper abdominal pain associated with jaundice, pruritis, dark urine, and ligh...
