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Practitioner Forum
Caring for Patients with Posttraumatic Stress Disorder During Gastrointestinal Procedures
Beverly Taylor, RN and Patricia Rushton, APRN, PhD




Guest Editorial
Starving for Health Care: Ethical Issues Surrounding the Uninsured Population
Debra Shipman, MSN, MBA, RN, Tammy Vant Hul, MSN, ACNP, RN, and Jack Hooten, MSN, MHA, RN

Clinical Digest • Acupuncture for Pregnancy Pain • How Common is Klebsiella pneumoniae Bacteremia? Drug Monitor • Eplerenone Decreases Hospitalization Time • Antiosteoporotic Medication Adherence Federal Health Matters • Senate Committee Looks at VA-IHS Collaborations • VA’s OIG Finds Ongoing Problems at Marion Facility

Managing Advanced Renal Cell Carcinoma
This supplement to Federal Practitioner on renal cell carcinoma (RCC), supported by Pfizer Inc, was developed with the aim of helping primary care providers in federal practice (especially those within the VA health care system) provide the highest quality care to their patients with RCC. It is our hope that, after reading this supplement, you will be better prepared to:

• Identify patients at risk for RCC and know when to consider screening measures.
• Recognize the signs and symptoms of RCC and refer the patient for appropriate imaging studies and other testing.
• Understand the systems used to stage and grade RCC.
• Discuss the options available for treating both early-stage and advanced RCC and their appropriate uses according to distinct patient and disease characteristics.
• Educate patients about the potential adverse effects of various treatments for advanced disease and apply appropriate monitoring.

The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Quadrant HealthCom Inc., the U.S. government, or any of its agencies. Pfizer Inc provided limited editorial input. Some of the drugs or classes of drugs discussed in this supplement may not be listed on the VA national formulary or the DoD basic core formulary or addressed in VHA or DoD treatment guidelines. Please review complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients. Pazopanib (Votrient; GlaxoSmithKline, London, United Kingdom), an oral tyrosine kinase inhibitor, received FDA approval during the development of this supplement. Therefore data for this product is not included in the overview of available treatments.

EVOLVING STRATEGIES FOR CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA IN THE VHA

Sponsored by the Annenberg Center for Health Sciences at Eisenhower.

This activity is supported by an educational grant from GlaxoSmithKline.

A maximum of 1 contact hour may be earned for successful completion of this activity. The activity has been certified for physicians, pharmacists, nurse practitioners, and nurses. To obtain CE credit, please print a copy of the supplement and assessment materials, complete the Post-Test page (page 16) and the Activity Evaluation form (page 17), and return both pages, along with the completed Pre-Test (page 1), to the Annenberg Center for Health Sciences (ACHS #4655), 39000 Bob Hope Drive, Rancho Mirage, CA 92270 or fax to 760-773-4550.

MANAGING ADVANCED HEPATOCELLULAR CARCINOMA

Supported by a grant from Bayer HealthCare Pharmaceuticals, Inc. and Onyx Pharmaceuticals, Inc.