Biomedical subjects
Publications and source records attributed to V A McKeon.
Tamoxifen is nonsteroidal antiestrogen originally developed in 1996 as a contraceptive. Recently, tamoxifen has been under study within the massive Breast Cancer Prevention Trial-but have we learned enough to recommend tamoxifen for breast cancer prevention? This article looks at the drug therapies, including tamoxifen, currently under development for fighting and preventing breast cancer.
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Despite considerable research into nursing management of second stage labor, traditional approaches continue to predominate. Women are still encouraged to deliver in a recumbent position using sustained, closed-glottis pushing. Current research suggests that utilizing an upright position with pushing that is open glottis and complementary with the involuntary bearing-down reflex produces good maternal/fetal outcomes. Issues such as position, second stage phases, and bearing-down techniques are discussed in view of recent research findings. Gaps in knowledge are identified and practice implications are clearly defined. Now is the time to apply research-based knowledge to nursing management of second stage labor.
OBJECTIVE: To review the literature related to the benefits and risks of postmenopausal hormone replacement therapy (HRT). DATA SOURCES: Computerized searches on MEDLINE and CINAHL. STUDY SELECTION: Articles from indexed journals in the English language related to the topics in this review and published after 1986 (except for earlier classic pieces) were evaluated. DATA EXTRACTION: Data were extracted and information was organized about HRT under the following headings: indications, risks, contraindications, management of therapy, and evaluation of risks and benefits. DATA SYNTHESIS: Hormone replacement therapy is used to treat symptoms of estrogen deficiency and to prevent disease. The small risk of breast cancer associated with HRT is outweighed by the beneficial effects of such therapy in preventing cardiovascular disease and osteoporosis. CONCLUSIONS: Evidence suggests that HRT should be offered to all postmenopausal women in whom it is not contraindicated. Ideally, each woman should decide whether to receive HRT after weighing the risks and benefits. Additional research is needed on the effects of different doses, types of estrogen and progestin, and treatment duration, and on which HRT regimen offers the best risk-benefit profile.
1. Menopause, defined as the permanent cessation of menstruation resulting from loss of cyclic ovarian function, occurs spontaneously at a mean age of 51 years. More than 40 million American women are postmenopausal, and an additional 30 million are expected to join their ranks during the next decade. 2. The depletion of naturally occurring hormones that accompanies menopause and the issue of hormone replacement therapy have become fundamental concerns in women's health care. 3. Many experts now advise estrogen-progestin replacement therapy to prevent osteoporosis in all women at high risk for this disorder, and for vasomotor flushes, genitourinary symptoms, and mood changes in women who have no contraindication to this therapy. 4. Hormone replacement therapy plays a pivotal role in preserving good health and vitality, but it should be presented within the context of other health-promoting measures to be adopted by menopausal and postmenopausal women.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Critical care nurses in emergency, cardiac, or medical intensive care units may care for women who have experienced a myocardial infarction during pregnancy. Nursing management of the pregnant patient with a myocardial infarction (MI) requires an understanding of the normal physiology of pregnancy, the deviations from health with an MI, and an ability to integrate this knowledge to provide skillful care to unique and very ill patients. Here the authors describe caring for a pregnant patient in cardiac care, while a later article in this tissue focuses on the critical care nurse's role in teaching obstetric nurses arrhythmia interpretation when the patient remains on an obstetric unit. Collaboration between the critical care nurse and obstetric nurse is essential to care for these complex patients.
Cocaine's popularity has escalated drastically within the past decade, and pregnant women from all socioeconomic, racial, and cultural groups are among the burgeoning number of users. The pharmacologic properties of this highly addictive, mind-altering drug and its profound effects on the pregnant woman and fetus are presented. Recent clinical research findings on cocaine use during pregnancy are reviewed, implications for nursing care are examined, and specific nursing interventions are identified.
OBJECTIVE: To review the literature on tamoxifen and breast cancer, focusing on the Breast Cancer Prevention Trial (BCPT). DATA SOURCES: Computerized searches on MEDLINE and CINAHL. STUDY SELECTION: Articles from indexed journals in the English language related to the topics in this review and published after 1983 (except for earlier classic pieces) were evaluated. DATA EXTRACTION: Data were extracted and information was organized under the following headings: magnitude of the problem of breast cancer, definition of chemoprevention, tamoxifen's mode of action, risks and benefits, use as an adjuvant and in chemoprevention, the BCPT, study protocol, pros and cons, and nursing implications. DATA SYNTHESIS: The BCPT is a study testing tamoxifen's ability to prevent the development of breast cancer in healthy women at increased risk for developing the disease. About 16,000 women who are age 35 years or older are being randomized to receive oral tamoxifen (20 mg/day) or placebo for an initial period of 5 years. CONCLUSIONS: The BCPT will contribute to our knowledge about tamoxifen's ability to prevent breast cancer in women at increased risk. Nurses have a role to play in implementing this strategy to find a means for preventing breast cancer.