...Vemurafenib: A Potentially New Standard of Care? Vemurafenib: A Potentially New Standard of Care? Melanoma is the most deadly form of skin cancer. Advanced metastatic melanoma, stage III or IV, has been incurable and relatively untreatable with “less than 10% of patients responding to traditional chemotherapy” regimens (PubMed Health, 2011). Progress in this area of oncology research has been very slow with the “average prognosis for patients with stage IV metastatic melanoma being 8-18 months” (Chapman., 2011). Proven research shows that the standard chemotherapy regimens don’t actually extend the lives of these patients. The standard first line treatment for late stage metastatic melanoma is dacarbazine (DTIC), used either alone as a single agent or in combination with other chemotherapy agents, and the effects have been minimal. The dacarbazine regimen usually shrinks the tumors for a temporary period, “about 3-6 months,” and then they begin to grow again. (Melanoma Skin Cancer, 2011). Recent research in the past five years has led to some targeted immunotherapy drugs like ipilimumab and peginterferon alpha-2b which have shown some promising results in helping to extend life expectancies for these patients. On August 17, 2011 the Food and Drug Administration gave some much needed hope to these patients with the approval of vemurafenib (Zelboraf). An orally administered targeted chemotherapy agent that has shown statistically significant results in “reducing the...
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...requiring critical care will rise but many patients who might have had no chance of survival can now be treated successfully. And during last two decades critical care medicine has undergone rapid changes and emerged as a discipline by itself. Intensive care units (ICU), also called critical care or intensive therapy departments, is highly specified and sophisticated area of a hospital which is specifically designed, staffed, located, furnished and equipped, dedicated to management of critically ill patients whose conditions are life-threatening and need constant, close monitoring and support from equipment and medication to keep normal body functions going. It is a department with dedicated medical, nursing and allied staff. It operates with defined policies; protocols and procedures, having its own quality control, education, training and research programmes. It is emerging as a separate specialty and can no longer be regarded purely as part of anaesthesia, Medicine, surgery or any other speciality. It has to have its own separate team in terms of doctors, nursing personnel and other staff who are tuned to the requirement of the speciality. Definition: “ICU is the specialty nursing unit designed, equipped, and staffed with specially skilled personnel for treating very critical patients with potentially reversible lesions or those requiring specialized care and equipment”. Functions: A multidisciplinary ICU permits concentration of meager resources with regard to...
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...Service Line Development Task 2 A. Analyze the community health needs assessment in the case study by doing the following: Trinity Community Hospital conducted an assessment of three of their services including cardiovascular, cancer, and orthopedics. The gathered information was received from numerous avenues including the healthcare’s guidelines, interviews of healthcare employees, focused groups, and surveys. A.1. Discuss major risk factors identified in the assessment. 1. Cardiovascular Services In the United States, there are many cases of coronary artery disease and this is expected to increase. This increase will cause an increase in cardiac catheterization procedures done in Trinity Community Hospital. They are predicting that they will have an increased amount of catheterizations up to 22% and angioplasties up to 25.8% more in the upcoming five years. There will be a need for more cardiac procedure rooms and rehab programs. The addition to these needs should be done to make sure the patient is getting adequate and timely care. Otherwise, the patient’s health could be placed in jeopardy. The hospital should consider offering some programs to offer patients and their family’s educational information regarding surgical procedures and the preceding problems that can occur due to their eating habits, hypertension, diabetes, and any tobacco or substance use. These programs could offer education to assist the patients and others about how to assist themselves with...
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...Colleen White ENG 101 –B104 Professor Mowry Research Essay April 4th 2013 Neonatal Intensive Care Have you ever walked by a nursery at the hospital and saw the babies lying there? Have you ever wondered who is responsible for being the caregiver for the babies while in the hospital? The neonatal intensive care unit is responsible for that. Neonatal intensive care is one of the most crucial jobs in the nursing field due to its roles, requirements, intensive challenges and rewards that it provides. Neonatal nurses have the responsibility of providing the care for babies when they are first born. Neonatal nursing has many education requirements, an outstanding job outlook, as well as great benefits. Neonatal nurses care for newborns for the first 28 days of the babies’ lives, the children’s most helpless stage. Nurses specialized in this field are required to focus not just on healthy infants, but also on ill or premature babies. They monitor the condition of babies, check for signs of distress, and manage medication when necessary. Neonatal nurses are also responsible for providing all kinds of basic care, like changing diapers and feeding babies. “A neonatal intensive care unit often caters to babies with complex medical needs. Invasive treatments like ventilation, repeated blood sampling, invasive catheters are common. Caring for very sick neonates is compounded by the uncertainty that surrounds the immediate outcomes (survival) and the long-term outcomes (disabilities...
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...A1. Considering all the facts, the most feasible option is to develop oncology services and building space for it within Trinity Community Hospital. The facts are as follows: Currently, Trinity Community Hospital (TCH) does not offer any formal oncology, orthopedic, or cardiology programs. There are no cancer specialists at TCH; however, there are a few cardiologists and orthopedic surgeons that maintain privileges at the hospital. Little work is done at TCH for orthopedic services, as the specialty groups are located to a competing facility. There are also several orthopedic groups interested in opening practices near the hospital. Several cardiology services around the hospital offer more sophisticated services than at TCH, drawing most of the cardiology patients away from the hospital. There is no oncology services mentioned. In terms of competition, there are two hospitals within close proximity. One has strong orthopedic and cardiology programs, but a poorly organized oncology program. The second hospital also has a strong orthopedic program and existing cardiology program. This hospital also has a poorly organized oncology program. Building space for oncology service will allow patients to easily coordinate with services already within the hospital and make use of the newly improved and more developed resources within Trinity Community Hospital. The Community Health Needs Assessment identified that the orthopedic cases are expected to rise by over 46%, inpatient joint...
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...Access Chapter 6 - Establishing Venous Access Chapter 7 - The Indwelling Vascular Catheter Section IV - Hemodynamic Monitoring Hemodynamic Monitoring Chapter 8 - Arterial Blood Pressure Chapter 9 - The Pulmonary Artery Catheter Chapter 10 - Central Venous Pressure and Wedge Pressure Chapter 11 - Tissue Oxygenation Section V - Disorders of Circulatory Flow Disorders of Circulatory Flow Chapter 12 - Hemorrhage and Hypovolemia Chapter 13 - Colloid and Crystalloid Resuscitation Chapter 14 - Acute Heart Failure Syndromes Chapter 15 - Cardiac Arrest Chapter 16 - Hemodynamic Drug Infusions Section VI - Critical Care Cardiology Critical Care Cardiology Chapter 17 - Early Management of Acute Coronary Syndromes Chapter 18 - Tachyarrhythmias Section VII - Acute Respiratory Failure Acute Respiratory Failure Chapter 19 - Hypoxemia and Hypercapnia Chapter 20 - Oximetry and Capnography Chapter 21 - Oxygen Inhalation Therapy Chapter 22 - Acute Respiratory Distress Syndrome Chapter 23 - Severe Airflow Obstruction Section VIII - Mechanical Ventilation Mechanical Ventilation Chapter 24 - Principles of Mechanical Ventilation Chapter 25 - Modes of Assisted Ventilation Chapter 26 - The Ventilator-Dependent Patient Chapter 27 -...
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...4 Ever Life Insurance Company 2 Mid America Plaza, Suite 200 Oakbrook Terrace, Illinois 60181 (800) 621-9215 Administrative Office: c/o Worldwide Insurance Services, One Radnor Corporate Center, Suite 100, Radnor, Pennsylvania 19087 Certificate of Coverage Global Citizens Association Navigator Group Short Term Medical Coverage Non-Renewable Certificate of Coverage Number: 4EL-5007-14 Effective Date: July 1, 2014 The Insurance Coverage Area is any place that is anywhere in the world. The benefits provided by this Certificate are not subject to the guaranteed renewability and portability provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The Insured Person may not purchase insurance for a period longer than the current Period of Coverage. Table of Contents I. Introduction Page 2 II. Who is eligible for coverage? Page 8 III. Definitions Page 11 IV. How the Plan Works Page 21 V. Benefits: What the Plan Pays Page 23 VI. Exclusions and Limitations: What the Plan does not pay for Page 29 VII. Prescription Drug Benefits Page 31 VIII. General Provisions Page 34 Limited Benefit, Please Read Carefully 1 Form 54.1403 I. Introduction About This Plan This Certificate of Coverage is issued by 4 Ever Life Insurance Company (“Insurer”) through a policy issued to the Global Citizen Association. In this Plan, “Insurer” means the 4 Ever Life Insurance...
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...governmental agency that holds the responsibility for the regulation of nursing practice standards. This agency function includes approving educational nurse programs, interpreting and enforcing it’s state nurse practice act. Many nurses and non-health care persons know the Board of Nursing most for its responsibility for issuing nurse licenses, monitoring exams and intervening against nurses who commit acts that violate a state’s nurse practice law. The Board of Nursing differs from Professional Nursing Organization in that each Board of Nursing regulate licensure but Professional Nursing Organizations do not nor do they provide disciplinary actions. Professional Nursing Organizations are also voluntary, offer continuing education and specialty certifications. Critical PROFESSIONAL ROLES AND VALUES...
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...Perkins4, Neal J Meropol5, Mark J Ratain1,2,6, Lee N Newcomer4 and G Caleb Alexander7 Abstract Background: Newer systemic therapies have the potential to decrease morbidity and mortality from metastatic colorectal cancer, yet such therapies are costly and have side effects. Little is known about their non-evidence-based use. Methods: We conducted a retrospective cohort study using commercial insurance claims from UnitedHealthcare, and identified incident cases of metastatic colon cancer (mCC) from July 2007 through April 2010. We evaluated the use of three regimens with recommendations against their use in the National Comprehensive Cancer Center Network Guidelines, a commonly used standard of care: 1) bevacizumab beyond progression; 2) single agent capecitabine as a salvage therapy after failure on a fluoropyridimidine-containing regimen; 3) panitumumab or cetuximab after progression on a prior epidermal growth factor receptor antibody. We performed sensitivity analyses of key assumptions regarding cohort selection. Costs from a payer perspective were estimated using the average sales price for the entire duration and based on the number of claims. Results: A total of 7642 patients with incident colon cancer were identified, of which 1041 (14%) had mCC. Of those, 139 (13%) potentially received at least one of the three unsupported off-label (UOL) therapies; capecitabine was administered to 121 patients and 49 (40%) likely received it outside of clinical guidelines, at an estimated...
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...-[ \ UNIVERSITY OF CAPE COAST SCHOOL OF NURSING MSC. ADVANCED NURSING PRACTICE COURSE: ADVANCED CLINICAL PRACTICUM I AND II IN SPECIALTY AREA COURSE CODE: NUR 822S and NUR 829S PATIENT / FAMILY CASE STUDY (A NURSING PROCESS APPROACH) ON A CLIENT WITH GESTATIONAL TROPHOBLASTIC NEOPLASM BY: CHARLOTTE LAMPTEY SN/ADN/15/0030 AUGUST, 2016 CONTENTS * PREFACE * ACKNOWLEDGEMENT * INTRODUCTION CHAPTER ONE: OVERVIEW OF CLIENT SITUATION I. Literature review of gestational trophoblastic neoplasm CHAPTER TWO: COMPREHENSIVE HOLISTIC ASSESSMENT OF PATIENT/FAMILY I. Patient’s medical and personal history including review of the systems II.Physical examination III.Diagnostic evaluation IV.Nutritional assessment V. Psychosocial history VI. Patient developmental assessment VII.Spiritual assessment VIII.Quality of life assessment IX.Admission of patient CHAPTER THREE: ANALYSIS OF DATA CHAPTER FOUR: COLLABORATIVE PLAN OF CARE I. Presumptive medical diagnosis II.Nursing diagnosis III.Evidence-based interventions IV.Additional diagnostic procedures warranted but not done Medication to be ordered CHAPTER FIVE: DISCHARGE PLAN I. Community service and resource needed II.Client education plan III.Plans for follow-up of care CHAPTER SIX: EVALUATION PLAN Termination of care * SUMMARY * CONCLUSION * REFERENCE PREFACE ...
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...the next couple of months. Said Debashish Poddar, managing director, BP Poddar Hospital & Medical Research Limited, "It will not be a so called state-of-the-art hospital but a hospital, which will ensure healthcare deliver of international standards within the affordable limits of the common man. The hospital is the culmination of the dream of Arun Poddar, Chairman of the Group and his family to perpetuate the memory of his father Late BP Poddar, he added. Despite being a multispeciality unit, the focus area of the hospital will be oncology. All possible imaging facilities will be provided at the hospital. The management has applied for necessary regulatory clearances from Bhaba Atomic Research Centre (BARC) to start radiation therapy for treatment of cancer. According to Dr Subrata Das, medical director, BP Poddar Hospital & Medical Research Limited, "With a few dedicated hospitals in the region dedicated to oncology, the proposed hospital will take care of all the needs of the cancer patients. We are in the process of installing the latest equipment in the hospital to provide the best possible medical care." The management will be investing substantially on training of human resources. Said Shantanu Ray, a renowned academician and a director of BP Poddar Hospital & Medical Research Limited. To make patient feel that he is not in a hospital, the management has emphasized on adding a dash of colour to the costumes of...
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...UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 10-K Annual Report Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 For the fiscal year ended December 31, 2014 OR Transition Report Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 For the transition period from to Commission file number 001-01011 CVS HEALTH CORPORATION (Exact name of Registrant as specified in its charter) Delaware (State or other jurisdiction of incorporation or organization) One CVS Drive, Woonsocket, Rhode Island (Address of principal executive offices) 05-0494040 (I.R.S. Employer Identification No.) 02895 (Zip Code) (401) 765-1500 (Registrant’s telephone number, including area code) Securities registered pursuant to Section 12(b) of the Exchange Act: Common Stock, par value $0.01 per share Title of each class New York Stock Exchange Name of each exchange on which registered Securities registered pursuant to Section 12(g) of the Exchange Act: None Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes No Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes No Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for...
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...COMPANY PROFILE H I S T O R Y The company was established and incorporated in the latter part of 1994 that was September, primarily to import and distribute medical disposable products. It commences full operation early l995 after we finalize our negotiation with our 1st foreign principal, Kimal Scientific Products Ltd. to distribute on exclusive basis their dialysis and cardiology catheters/disposable products and medical equipment like blood collection system, Peritoneal dialysis machine etc. After we got our government licenses, permits, finalize exclusive distribution contract with more foreign suppliers such as Ewemed Hollinger of Austria that manufactures ECG Electrodes, Tablet Dispenser, Medical Therapy Lazer etc., we expanded additional sales business operation exactly in the 3rd quarter of 1995 with three (3) sales people, 1 accountant, 1 driver, 1 helper, a warehouse clerk, and (1) General Manager for finance and personnel plus Paul B. Soliven Jr. on a part-time and consultancy basis to take care & support the operational requirement of the company. To back up our sales operation and distribution network nationwide we have employed 3 dealers in the provinces for Visayas, Mindanao and Region 2. On 01 June 1996, Paul B. Soliven Jr. assume full responsibility in running the sales, marketing, distribution and operation of the company due to new and more products, additional foreign suppliers etc. The business address of the company...
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...Today’s healthcare institutions and providers strive to be safe places for patients to receive care, but past data indicates it has not always been so. The Institute of Medicine determined in the late 1990’s that 44,000 to 98,000 patients die from medical mistakes each year (Wachter, 2008). This tremendous number of deaths places medical care mishaps between the fifth and eighth leading causes of deaths in the United States (Kizer, 2001). In 2002, The Joint Commission established National Patient Safety Goals (NPSG) to help accredited organizations with patient safety in specific areas. An advisory group comprised of nurses, physicians, pharmacists, risk managers, clinical engineers, and others with appropriate experience advises The Joint Commission on how to address emerging patient safety issues. This group also periodically develops and updates the goals. The goals are grouped into broad categories and for 2011-2012, cover such categories as patient identification, health care-associated infections, improving communication, medication safety, reducing falls, and risk assessment. A discussion of selected elements underlying the current NPSG such as hand washing techniques, training, and lack of communication between healthcare personnel that can lead to medication errors, to falls, and even death, plus other related factors such as staffing shortages, problems with using outdated equipment, considerations in using the electronic medical records, and compliance with statutes...
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... Era One, which he states to have started in the 1860’s and continued to the 1940’s. Era Two, which he proposes to have begun in the post World War II period to recent times. Era Three is the most recent which he states is an emerging shift to a new focus which he calls “Transpersonal Medicine”. In Era One, Dr. Dossey describes the practice of medicine as being only physical in nature. He equates this era as focusing on the body and mind, and their functioning only in a physical way, not related to one another. He describes the thinking as being that what happens to the body, it’s function or disease state, is completely separate from any function or influence from the mind. He relates that the doctors of the day were mostly using therapies involving surgery and medications. In Era One, as he describes, there was really no acknowledgement of individual uniqueness. There was absolutely no connection that one’s...
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