Wednesday, February 24, 2010

H1N1 Vaccination Keeps You and Your Patients Safe

Oncology nurses are aware of the need to prevent infection in neutrapenic patients. But what about preventing your own infections? Although the number of H1N1 cases in oncology nurses has not been measured, the illness poses a risk from two fronts: We may be seeing infected patients in our daily practice and we also run the risk of giving the virus to uninfected patients and co-workers.

Immunocompromised patients may not benefit from vaccination because they are not always able to mount an adequate immune response. thus preventing nurses from developing the infection and passing it along to those patients becomes a high priority. Unfortunately, limited sick leave, staffing issues and peer pressure may promote some nurses with mild symptoms to come to work, risking coworkers and patients.

According to the Centers for Disease Control and Prevention (CDC, 2009), nurses in any treatment setting should receive the vaccine. Although the Joint Commissions suggests optional vaccination with a provision to opt out for religious or medical reasons. However, attempting to force vaccination for hospital nurses has resulted in pending legal action. In 2009, less than half of hospital healthcare workers were vaccinated against the flu (CDC, 2009).

The CDC (2009) indicated that H1N1 treatment should not wait for laboratory confirmation. In addition, a negative rapid test does not rule out influenza. The antiviral medications oseltamivir (Tamiflu) and zanamivir (Relenza)can reduce the severity and duration of and complications from H1N1 and are recommended for individuals with suspected or confirmed influenza requiring hospitalization.

Centers for Disease Control and Prevention. (2009). Seasonal influenza vaccination
resources for healthcare professionals. Retrieved December 22, 2009, from

Thursday, February 18, 2010

Dark Chocolate is Good for the Heart!

Do you have a box of Valentine chocolates that you aren't sure you should eat? Well if they are dark chocolate then you are in luck! According to a literature review published earlier this month on complimentary medicine in cardiology- dark chocolate is a champion for heart health.
(Posted: 02/05/2010; Pharmacotherapy. 2010;30(1):109 © 2010 Pharmacotherapy Publications).
The literature review shows strong evidence that dark chocolate can prevent cardiovascular disease by decreasing CRP (C reactive protien) levels which is associated with inflammation and coronary artery disease. It has also been found to dcrease platelet reactivity and in one study lowered LDL-C by 6% and raised HDL-C by 9% over only a week of daily dark chocolate consumption!
It can help mitigate the endothelial inflammatory effects of smoking as well.
In one study of 22 heart transplant patients - significant coronary vasodilitation, decreased platelet adhesion, and improved coronary vascular function was seen only 2 hours after consumption of a Nestle Intense(70% cocoa content) Bar. A study of 44 adults with prehypertension found that daily dark chocolate consumptionr reduced both systolic and diastolic blood pressures. It was also found to increase levels of S-nitrosoglutathione- a vasodilative nitric oxide.
While we know that dark chocolate has other health benefits- during Women's Heart Health month it is encouraging to see the evidence that a daily indulgence of dark chocolate is good for us! So enjoy your chocolate knowing that you are doing something good for your heart.

Di Giuseppe R, Di Castelnuovo A, Centritto F, et al. Regular Consumption of Dark Chocolate Is Associated with Low Serum Concentrations of C-Reactive Protein in a Healthy Italian Population. J Nutr. 2008;138:1939–1945.
Allen RR, Carson L, Kwik-Uribe C, Evans EM, Erdman JW. Daily Consumption of a Dark Chocolate Containing Flavanols and Added Sterol Esters Affects Cardiovascular Risk Factors in a Normotensive Population with Elevated Cholesterol. J. Nutr. 2008;138:725–731.
Hamed MS, Gambert S, Bliden KP, et al. Dark Chocolate Effect on Platelet Activity, C-reactive Protein, and lipid profile: A pilot Study. South Med J 2008;12(101):1203–1208.
Hermann F, Spieker LE, Ruschitzka F, et al. Dark chocolate improves endothelial and platelet function. Heart 2006;92:119–120.
Flammer AJ, Hermann F, Sundano I, et al. Dark Chocolate Improves Coronary Vasomotion and Reduces Platelet Reactivity. Circulation. 2007;116:2376–2382.
Taubert D, Roesen R, Lehmann C, et al. Effects of Low Habitual Cocoa Intake on Blood Pressure and Bioactive Nitric Oxide. A Randomized Controlled Trial. JAMA. 2007;298(1):49–60.

Monday, February 01, 2010

Cochrane News for 2010: podcasts, journal clubs and more!!

The Cochrane Library Issue 1, 2010 – Now Published

January, 2010 Cochrane Reviews cover a diverse range of subjects  and includes 98 new reviews and 139 updated reviews. Many studies are of special interest to nurses-- one in particular is Restricting oral fluid and food intake during labor

To highlight just a few other new studies, see:

Cervical Cancer: Combined Drug and Radiotherapy Improves Survival

NSAIDs May Be More Effective Than Paracetamol For Period Pain

Vitamin D Supplementation Can Reduce Falls In Nursing Care Facilities

Hypertension: Beta-Blockers Effective In Combination Therapies

Parkinson’s: Treadmill Training Improves Movement

HIV: Positive Lessons From Home-Based Care

Did you know that you can also listen to Cochrane podcasts?  Also consider joining the Cochrane journal club.   To access the full text of any Cochrane review, SJO/CHOC staff should access Cochrane on EBSCO through Burlew Medical Library's website.