Biomedical subjects

S L Smith

Publications and source records attributed to S L Smith.

At least 109 records · Page 6Linked to original sources

PubMed1997

Attribution of foot bones to sex and population groups.

Although cranial and pelvic bones are the preferred skeletal material used by forensic anthropologists to assign unknown individuals to their most probable sex and population (racial) groups, these remains may be unavailable. This paper presents models for classification using metatarsals, proximal pedal phalanges, and the first distal phalanx of the foot. Measurements include lengths and mediolateral and dorsoplantar widths of these foot bones. Four samples of 40 individuals each (black and white males and females) comprise the dataset. Models were developed separately for right and left sides. Three models are provided for each side: a metatarsal model, a proximal phalangeal model, and a combination model involving selected metatarsal and phalangeal measurements. A stepwise discriminant procedure was used for variable selection, with some highly correlated (r > 0.85) variables subsequently removed. The metatarsal models correctly assign approximately 77-84% of individuals to their correct sex and population groups; proximal phalangeal models yield correct assignments in 70-72% of cases, and the combination models give correct classifications in 87% of cases. Models exchanging variables selected from one side for corresponding variables on the other show discriminating power ranging from approximately 67-86%. More conservative "jackknife" estimates give correct assignments in 64-82% of cases. When these models are used for classification of sex alone, 86.2-93.7% ("jackknife" range, 84.3-91.2%) of cases are correctly classified; for race alone, 78.6-96.2% ("jackknife" range, 75.5-92.4%).

Adult↗

PubMed1997

Pyrrolopyrimidines: novel brain-penetrating antioxidants with neuroprotective activity in brain injury and ischemia models.

A novel group of antioxidant compounds, the pyrrolopyrimidines, has been discovered recently. Many of these possess significantly improved oral bioavailability (56-70% in rats), increased efficacy and potency in protecting cultured neurons against iron-induced lipid peroxidative injury and as much as a 5-fold increase in brain uptake compared with the 21-aminosteroid antioxidant compound, tirilazad mesylate (U-74006F), described earlier. They appear to quench lipid peroxidation reactions by electron-donating and/or radical-trapping mechanisms. Several compounds in the series, such as U-101033E and U-104067F, demonstrate greater ability than tirilazad to protect the hippocampal CA1 region in the gerbil transient (5-min) forebrain ischemia model. Delaying treatment until 4 hr after the ischemic insult still results in significant CA1 neuronal protection. U-101033E is still effective in salvaging a portion of the CA1 neuronal population when the ischemic duration is extended to 10 min. In addition, U-101033E has been found to be protective in the context of focal cerebral ischemia, reducing infarct size in the mouse permanent middle cerebral artery occlusion model, in contrast to tirilazad which is minimally effective. These results suggest that antioxidant compounds with improved brain parenchymal penetration are better able to limit certain types of ischemic brain damage than those which are localized in the cerebral microvasculature. However, the activity of U-101033E in improving early post-traumatic recovery in mice subjected to severe concussive head injury is similar to that of tirilazad. Last, the oral bioavailability of many pyrrolopyrimidines suggests that they may be useful for certain chronic neurodegenerative disorders in which lipid peroxidation plays a role.

Animals↗

PubMed1997

Management of ingested foreign bodies within the appendix: a case report with review of the literature.

A case is reported of an elective appendectomy in a patient with known ingestion of a sharp foreign body. The metal drill bit was ingested unintentionally 3 months before presentation at our institution. Plain abdominal films demonstrated the foreign body in the right lower abdominal quadrant. Because the gold dental drill bit was sharp and thought to be lodged in the terminal ileum or cecum, an attempt was made to remove the object during colonoscopy. This attempt was unsuccessful because no drill bit could be detected in the colon or terminal ileum. A laparoscopic exploration was performed, and the foreign body was found to lie in the appendix, after bowel manipulation under fluoroscopic guidance and with direct laparoscopic visualization. A laparoscopic assisted appendectomy was performed. On pathologic examination the drill bit was embedded in the tip of the appendix with signs of intramucosal acute inflammation. Management and indication for surgery of foreign bodies in the appendix are discussed, and we review the related literature. This is the second reported case of a dental drill bit in the appendix causing appendicitis.

Aged↗

PubMed1996

Inhibition of lipid peroxidation attenuates axotomy-induced apoptotic degeneration of facial motor neurons in neonatal rats.

The purpose of this study was to investigate the role of oxygen radical-induced lipid peroxidative mechanisms in trophic deprivation-induced apoptotic motor neuronal degeneration by testing the ability of the 21-aminosteroid lipid peroxidation inhibitor tirilazad mesylate (U-74006F) to attenuate the retrograde degeneration of facial motor neurons following axotomy in 14-day-old rat pups. On day 0, the right facial nerve of each rat was transected at its point of exit from the stylomastoid foramen. Pups were treated orally with either 10 or 30 mg/kg U-74006F or cyclodextrin vehicle 10 min before axotomy, and post-treated once a day from days 1 to 6, and then once every other day from days 8 to 21. The rats were sacrificed 3 weeks post-transection and the surviving motor neurons, identified through choline acetyltransferase immunocytochemistry, were counted in three regions (planes) in the facial nucleus. In vehicle-treated rats, 56.2% (region A), 50.6% (region B), and 57.4% (region C) of the motor neurons in the ipsilateral facial nucleus survived 21 days following facial nerve axotomy in comparison to the non-axotomized contralateral nucleus (P < 0.0001). Treatment with 10 mg/kg U-74006F significantly enhanced motor neuron survival in regions B and C to 72.8% (P < 0.01) and 66.7% (P < 0.02%), respectively. The 30 mg/kg dose level also increased survival rates to 64.2% (P < 0.02) and 67.9% (P < 0.01), respectively. A second experiment demonstrated that oral dosing with U-74006F (30 mg/kg), when limited to the first 5 days after axotomy, also significantly blunted retrograde degeneration measured at 21 days post-axotomy. The efficacy of the lipid peroxidation inhibitor U-74006F in protecting a portion of the facial motor neuron pool from post-axotomy degeneration suggests that lipid peroxidation may play a mechanistic role in trophic deprivation-induced apoptotic neuronal death.

Animals↗

PubMed1996

Immunocytochemistry and flow cytometry evaluation of human megakaryocytes in fresh samples and cultures of CD34+ cells.

Adhering platelets on the cell surface can give misleading results when doing flow cytometry analysis of platelet/megakaryocyte-specific glycoprotein (GP) antigens to enumerate megakaryocytes (MK) in mobilized peripheral blood (PB), apheresis products, or normal bone marrow (BM). For adequate quantification and characterization of human MK, we examined samples with parallel flow cytometry and immunocytochemistry. MK expression of GP IIb/IIIa (CD41a), GP Ib (CD42b), GP IIIa (CD61), CD45, CD33, and CD11b, and their light scatter properties were evaluated. Fresh samples of low density mononuclear cells (MNC) or purified CD34+ cells contained 10-45% of platelet-coated cells. Platelet-coated cells decreased dramatically after several days of incubation in a serum-free medium supplemented with stem cell factor, IL-3, IL-6, and/or GM-CSF. Between d 9-12, flow cytometry detected a distinct CD41a+ MK population, 8.3 +/- 1.3% in BM CD34 cell cultures (n = 7) and 13.1 +/- 2.1% in PB CD34 cell cultures (n = 14), comparable to immunocytochemistry data (7.8 +/- 1.9% and 16.4 +/- 2.6%, respectively). CD41a stained a higher proportion of MK than CD42b or CD61, while CD42b+ or CD61+ cells contained more morphologically mature MK than CD41a+ cells in cultures containing aplastic serum. When fluorescence emission of CD41a was plotted against forward-light scatter (FSC), subpopulations of small and large MK were observed. Such subpopulations overlapped in CD41a intensity and side-light scatter (SSC) property. Most MK co-expressed CD45 (98.8% positive) but not CD33 (80.7% negative) or CD11b (88.9% negative). Our data indicate that flow cytometry can be used effectively to identify MK. However, caution should be taken with samples containing adherent platelets.

Adult↗

PubMed1996

Two novel pyrrolopyrimidine lipid peroxidation inhibitors U-101033E and U-104067F protect facial motor neurons following neonatal axotomy.

Recent reports suggest that oxygen radical-induced lipid peroxidation plays a role in the retrograde degeneration of motor neurons following facial nerve axotomy in the neonatal rat. The purpose of the present study was to explore this notion further by testing the neuroprotective properties of two novel brain-penetrating, lipid peroxidation inhibitors, U-101033E and U-104067F, in this model of neuronal degeneration. In Experiment 1, 14-day-old rats were pretreated with 3, 10, or 30 mg/kg U-101033E (po) 10 min before right facial nerve axotomy (Day 0) and then posttreated once a day from Day 1 to Day 6, and once every other day from Day 8 to Day 21. Rats were sacrificed 21 days postaxotomy and surviving cholinergic cell bodies were identified using choline acetyltransferase immunocytochemistry. Both 10 and 30 mg/kg U-101033E significantly enhanced motor neuron survival, with survival rates of 65.9-88.9% being noted in comparison to 51.7-62% survival in vehicle controls (P < or = 0.05). Experiment 2 demonstrated a significant neuroprotective effect of 10 and 30 mg/kg U-104067F using the same dosing schedule. Experiment 3 was designed to test whether shorter periods of drug exposure (e.g., 5 or 7 days) would be sufficient to preserve motor neurons in rats treated with 10 mg/kg U-101033E. The results suggested that as little as 5 days of drug treatment is sufficient to enhance motor neuron survival. Finally, Experiment 4 demonstrated an 18-19% increase in motor neuron survival in rats treated with 10 and 30 mg/kg U-104067F for 5 consecutive days postaxotomy. Taken together, the attenuation of motor neuron degeneration by the two pyrrolopyrimidine lipid peroxidation inhibitors, U-101033E and U-104067F, lends support to the notion that lipid peroxidation contributes to the pathogenesis of axotomy-induced neurodegeneration.

Animals↗

PubMed1996

Neuroprotective efficacy of microvascularly-localized versus brain-penetrating antioxidants.

The 21-aminosteroid (lazaroid) tirilazad mesylate has been demonstrated to be a potent inhibitor of lipid peroxidation and to reduce traumatic and ischemic damage in a number of experimental models. Currently, tirilazad is being actively investigated in phase III clinical trials in head and spinal cord injury, ischemic stroke and subarachnoid hemorrhage. This compound acts in large part to protect the microvascular endothelium and consequently to maintain normal blood-brain barrier (BBB) permeability and cerebral blood flow autoregulatory mechanisms. However, due to its limited penetration into brain parenchyma, tirilazad has generally failed to affect delayed neuronal damage to the selectively vulnerable hippocampal CA1 and striatal regions. Recently, we have discovered a new group of antioxidant compounds, the pyrrolopyrimidines, which possess significantly improved ability to penetrate the BBB and gain direct access to neural tissue. Several compounds in the series, such as U-101033E, have demonstrated greater ability to protect the CA1 region in the gerbil transient forebrain ischemia model with a post-ischemic therapeutic window of at least four hours. In addition, U-101033E has been found to reduce infarct size in the mouse permanent middle cerebral artery occlusion model in contrast to tirilazad which is minimally effective. These results suggest that antioxidant compounds with improved brain parenchymal penetration are better able to limit certain types of ischemic brain damage compared to those which are localized in the cerebral microvasculature. On the other hand, microvascularly-localized agents like tirilazad appear to have better ability to limit BBB damage.

Animals↗

PubMed1996

Biochemical comparison of plaque fluid on tooth and acrylic surfaces during a sucrose challenge.

Previous studies have investigated variations in dental plaque fluid composition within a single mouth after a sucrose exposure. The purpose of this study was to determine a potential source of calcium and phosphorus in plaque by comparing the pH, calcium and phosphorus concentrations in plaque fluid obtained from an acrylic appliance with samples taken from supragingival tooth surfaces within the same individual after a sucrose challenge. Separate plaque samples from 14 individuals were collected from an acrylic appliance or tooth surfaces within same individual before and 15 min after a 20% sucrose rinse. Each plaque sample was centrifuged and nanolitre samples of plaque fluid were analysed for pH with a pH microelectrode, for total calcium concentration by atomic absorption in a graphite furnace, and for phosphorus concentration by spectrophotometry. There was an increase in the calcium and phosphorus concentration in the plaque after the sucrose challenge and a significant increase in calcium and phosphorus concentrations in the plaque taken from the teeth compared to the acrylic surfaces. The results indicate that the increased total calcium and phosphorus in plaque during a sucrose challenge is probably derived from the demineralization of enamel or extracellular demineralized components.

Acrylic Resins↗

PubMed1996

Osteoporosis prevention in premenopausal women: using a stage model approach to examine the predictors of behavior.

The precaution adoption process model was used to examine the predictors of 2 behaviors recommended to reduce the risk of developing osteoporosis: calcium consumption and weight-bearing exercise. A total of 452 premenopausal women completed a mailed questionnaire assessing stage in the precaution adoption process and 12 knowledge and attitudinal variables. Participants were also given an opportunity to request information about osteoporosis. In all, 11 of the 12 knowledge and attitudinal variables were associated with calcium stage; 8 were associated with exercise stage. Information requests were associated with both calcium and exercise stage. Findings provide substantial support for the precaution adoption process model and suggest that the model can be usefully applied in this area to increase understanding of why many women do not practice behaviors that could reduce their risk of developing osteoporosis.

Adult↗

PubMed1996

Mild pre- and posttraumatic hypothermia attenuates blood-brain barrier damage following controlled cortical impact injury in the rat.

Recent studies have demonstrated a neuroprotective effect of mild/moderate hypothermia in models of cerebral trauma and ischemia. In contrast, hypotension is known to exacerbate CNS injury. To better understand the mechanisms whereby hypothermia and hypotension influence secondary neural injury, the present study assessed the effects of these two variables upon blood-brain barrier (BBB) permeability following controlled cortical impact injury. Rats were subjected to either 0, 15, or 30 min of hypotension under normothermic or slightly hypothermic brain temperature conditions. Brain temperature was maintained within 0.5 degrees C of baseline (normothermic) or allowed to float freely (e.g., become hypothermic) throughout the study. Hypotension was induced immediately after head injury by rapid hemorrhage down to a mean arterial pressure of 50 mm Hg and held there for 15 or 30 min. Blood-brain barrier permeability was measured by the extravasation of plasma protein-bound Evan's blue dye into the injured cortex at 60 min postinjury. The results revealed that mild hypothermia (< 1.6 +/- 0.2 degrees C), right before and 15-30 min following head injury, significantly reduced BBB permeability 28.0, 21.8, and 26.2% in rats subjected to 0, 15, or 30 min hypotension, respectively (all p values < or = 0.05). Hypotension did not increase BBB permeability nor did it significantly interact with the brain temperature effect. Previous results, using this same model, have shown that the progressive posttraumatic increase in BBB permeability is preceded by an increase in cortical .OH and lipid hydroperoxides at the site of injury and is attenuated by the lipid peroxidation inhibitor tirilazad mesylate. Thus, the present results are discussed in terms of the role of free radical-induced lipid peroxidation in the genesis of posttraumatic BBB damage and the possible effects of hypothermia upon this injury process.

Animals↗

PubMed1996

Large-scale selection of CD34+ peripheral blood progenitors and expansion of neutrophil precursors for clinical applications.

Hematopoietic recovery after high-dose chemotherapy is characterized by an obligate period of neutropenia of approximately 8-10 days. It is postulated that if a pool of neutrophil precursors and progenitors were expanded in vitro and reinfused, the duration of neutropenia may be substantially shortened by these cells capable of providing mature neutrophils within days of reinfusion. In this study, peripheral blood progenitor cell products were obtained from six normal donors mobilized with rhG-CSF and two patients mobilized with cyclophosphamide and rhG-CSF. CD34+ cells were isolated using the Isolex immunomagnetic bead method. A mean of 8.26 x 10(7) CD34+ cells with a mean purity of 74.5% were seeded at a concentration of 1 x 10(5)/ml into a 12 day stroma-free liquid culture using gas-permeable bags. A serum-free growth medium supplemented with PIXY321 was used. On day 7, there was a mean cellular expansion of fourfold, at which time the cells were resuspended at the initial concentration, yielding a mean culture volume of 3L (1-6 L). On day 12, there was an additional mean fold cellular expansion of 10 x, achieving an overall mean fold expansion of 41 +/- 16. Cellular characterization of the expanded cells revealed predominantly neutrophil precursors by morphology (mean 70.1%) and flow cytometric analysis. A mean of 52.3% of the expanded cells expressed CD15. Immunohistochemical staining revealed a mean of 7.1% CD41a+ megakaryocytic progenitors in the final cultured cell product. Detectable CD34+ cells were maintained only in those cultures initiated with greater than 90% CD34+ cells. Colony-forming units-granulocyte-macrophage (CFU-GM) were maintained in the 12 day culture at a level similar to the preculture number, whereas CFU mixed were depleted in all samples. On day 0, there were few CFU clusters (colonies containing fewer than 50 cells) identified, but by day 12, a mean total of 8.3 x 10(6) CFU clusters were identified. On day 12, the expanded cells were harvested and pooled using the Fenwal CS3000 Plus blood cell separator and resuspended in Plasma-Lyte-A with 1% human serum albumin. The mean harvest recovery of expanded progenitors was 91%, with a mean viability of 86%.

Adult↗

PubMed1996

Patient care leadership within an emerging integrated delivery network.

The emergence of integrated delivery networks provides an opportunity for leaders of patient care services to reach into our tool bags and refine the key leadership skills of strategist, facilitator, coach, and mentor. Shifting the focus from management to leadership is the hallmark of our success. As patient care leaders we will facilitate the achievement of the organization's strategic initiatives to improve clinical care delivery while decreasing cost. This article will explore the role of the patient care executive as part of the leadership team developing an integrated/organized delivery network.

Delivery of Health Care, Integrated↗

PubMed1996

Studies on the influence of pH and pancreatin on 13C-formaldehyde-induced gelatin cross-links using nuclear magnetic resonance.

Carbon-13 nuclear magnetic resonance (13C-NMR) and 13C-enriched formaldehyde (13CH2O) were utilized to observe cross-linking in gelatin. Thus, when a 6% solution of gelatin in water was treated with 2000 ppm 13CH2O at 20 degrees C, the 15 hr 13C-NMR spectrum of the crosslinked gel showed peaks representing carbinolamines (methylols) of arginine and lysine, as well as a peak ascribed to a methylene cross-link between arginine and lysine. Similar results were obtained when these cross-linking reactions were conducted using only 100 ppm 13CH2O. When pancreatin (1% w/v) was added to the solution of 6% gelatin cross-linked with 2000 ppm 13CH2O, the gel began to revert to a clear fluid solution. After incubation for 24 hr at 37 degrees C, the 13C-NMR spectrum of this solution confirmed the presence of the methylols of lysine and arginine, and the lysine-arginine cross-link. When 13CH2O (2000 ppm) was added to a 6% solution of gelatin at pH 13.0, the arginine methylol and the lysine-arginine crosslinks were produced. The 13CH2O-induced crosslinking of gelatin at pH 2.0, however, yielded the lysine methylol as the sole product.

Carbon Isotopes↗

PubMed1996

Protective effects of tirilazad mesylate and metabolite U-89678 against blood-brain barrier damage after subarachnoid hemorrhage and lipid peroxidative neuronal injury.

The 21-aminosteroid lipid-peroxidation inhibitor, tirilazad mesylate (U-74006F), recently was shown in a large multinational Phase III clinical trial to decrease mortality and improve neurological recovery in patients 3 months after onset of aneurysmal subarachnoid hemorrhage (SAH). A major tirilazad metabolite in animals and man, U-89678 is formed when the 4-5 double bond in the A-ring is reduced and has been postulated to contribute significantly to tirilazad's neuroprotective effects. In the first experiment of the present study, the authors compared the effects of tirilazad and U-89678 on acute blood-brain barrier (BBB) damage in rats subjected to SAH via injection of 300 microliters of autologous nonheparinized blood under the dura of the left cortex. The rats were treated by intravenous administration of either 0.3 or 1.0 mg/kg of tirilazad or U-89678 10 minutes before and 2 hours after SAH, and BBB damage was quantified according to the extravasation of the protein-bound Evans' blue dye into the injured cortex 3 hours post-SAH. The results revealed that 0.3 and 1.0 mg/kg tirilazad significantly reduced SAH-induced BBB damage 35.2% (p < 0.05) and 60.6% (p < 0.0001), respectively, in comparison to treatment with vehicle. The 0.3- and 1.0-mg/kg doses of U-89678 also decreased injury by 39.1% (p < 0.05) and 21.3% (not significant), respectively. In the second experiment, the investigators assessed the relative abilities of tirilazad and U-89678 to protect cultured neurons from iron-induced lipid peroxidative injury. Fetal mouse spinal cord cells were pretreated with 3, 10, or 30 microM tirilazad or U-89678 for 1 hour and then exposed to 200 microM ferrous ammonium sulfate (FAS) for 40 minutes. Cell viability was measured in terms of the uptake of [3H]alpha-(methyl)-aminoisobutyric acid 45 minutes after the FAS treatment. Both compounds enhanced neuronal survival in a concentration-dependent fashion. Although the two were equally efficacious, U-89678 was slightly more potent than its parent. On the basis of these findings, the authors conclude that the tirilazad metabolite, U-89678, possesses vaso- and neuroprotective properties that are essentially equivalent to the parent 21-aminosteroid. Hence, U-89678 probably contributes to the protective effects of tirilazad in SAH and other insults to the central nervous system.

Animals↗

PubMed1996

Ten years of Orthoclone OKT3 (muromonab-CD3): a review.

Many important advances in transplantation have been made during the last decade. The introduction of Orthoclone OKT3 into clinical trials and its subsequent approval by the Food and Drug Administration in 1985 for use as an antirejection agent for renal transplantation were landmarks in the field of clinical transplantation of solid organs. In the decade since the approval of OKT3 for clinical use, much has been learned and written about OKT3. OKT3 now is considered a safe and effective agent for prophylaxis and first-line treatment of acute rejection of solid organ allografts. In this article, the development and use of OKT3 over the last 10 years, as well as the present status and future implications of immune therapy with OKT3, are reviewed.

Clinical Protocols↗

PubMed1996

Risk factors for premature coronary heart disease after successful liver transplantation in adults.

As solid-organ transplantation has evolved into a highly effective treatment for end-stage organ disease, the long-term health implications of chronic exposure of recipients to immunosuppressants and other pharmacological agents are becoming more apparent. Coronary heart disease has long been known to plague kidney transplant recipients and more recently has been found to affect heart transplant recipients disproportionately. Coronary heart disease after liver transplantation, however, is less well known. The purpose of this study was to examine risk factors for premature coronary heart disease in asymptomatic adult recipients of liver transplants. Nutrition-related risk factors for coronary heart disease (obesity and hyperlipidemia) were measured in 29 patients before and after liver transplantation. Changes with respect to primary immunosuppression protocol (cyclosporine plus corticosteroid vs tacrolimus plus corticosteroid) were compared. Risk factors that had not been present before transplantation were apparent in both groups by 6 months after transplantation. Although obesity and hyperlipidemia were not found to be independent risk factors for coronary heart disease, they were clinically important when considered in combination. Cyclosporine was associated with significantly higher serum lipid concentrations than was tacrolimus.

Adolescent↗

PubMed1996

Attribution of hand bones to sex and population groups.

Forensic anthropologists assign sex and population group (race) to individuals on the basis of skeletal remains. While the most useful bones for these determinations are cranial and pelvic, these are not always available. The purpose of this paper is to provide models for classification using metacarpals and hand phalanges. Four samples of 40 individuals each (black and white males and females) form the dataset. Measurements include lengths and radioulnar and dorsopalmar widths of the 19 bones of each hand. The large number of total variables necessitated separate models for metacarpal and phalangeal categories; due to the considerable number of significant differences between corresponding right and left hand variables, separate models were created for right and left sides. A stepwise discriminant procedure was used to select variables, with some highly correlated (r > 0.85) variables subsequently removed. The model for left hand metacarpals has the greatest power of discrimination (89.4%); that for right hand middle phalanges, the least (71.7%). Metacarpals assign approximately 87-89%, proximal phalanges 76-79%, middle phalanges 72-79%, and distal phalanges 81-83% of individuals to their correct sex and population groups. Models exchanging variables selected from one side for corresponding variables on the other show discriminating power ranging from 72.3 to 85.6%. Thus roughly 70-90% of individuals are correctly classified by these models; more conservative "jackknife" estimates yield a success rate of approximately 67-82%. When these models are used for classification of sex alone, 89.9-94.4% ("jackknife" range, 88.7%-94.4%) of cases are correctly classified; for race alone, 80.5-98.1% ("jackknife" range, 77.4-96.9%).

Adult↗

PubMed1996

Physical exercise as an oncology nursing intervention to enhance quality of life.

PURPOSE/OBJECTIVES: To examine how physical exercise can enhance the quality of life (QOL) of people with cancer and to provide general guidelines for incorporating exercise into care plans for these patients. DATA SOURCES: Published and nonpublished medical, nursing, rehabilitation, and physical exercise literature. DATA SYNTHESIS: Including physical exercise in the care plans of people with cancer can enhance their QOL. The development of an individualized exercise plan for patients with cancer involves screening, assessment, prescription, goal setting, evaluation, and communication. The success of wellness-oriented interventions, such as exercise, can be evaluated with patient diaries, monitoring, and a QOL measurement tool. CONCLUSIONS: Physical exercise can positively influence all dimensions of life. Nurses must use sound clinical judgment and creativity and collaborate with other healthcare disciplines when prescribing exercise. Established exercise protocols for people with cancer are limited, and further research is needed in this area. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses must continue to expand the literature on guidelines and precautions for exercise in oncology populations. Nurses need to use their knowledge of oncology, QOL, and exercise to recommend and encourage the incorporation of physical exercise into the care plans of people with cancer.

Exercise↗