As a class of drugs, chemotherapy agents have two unique features. They have low therapeutic indexes, which places patients at an increased risk for medication errors, and they are considered hazardous drugs, which places patients and nurses at risk for environmental exposure. Policies and procedures for handling and administering oral chemotherapy agents are essential to promoting patients' and nurses' safety. Risk-reduction measures for administering oral chemotherapy in nontraditional healthcare settings, such as the home, require instituting a two-person dose-verification system, educating everyone who will administer and handle these agents, and developing procedures for securely and appropriately storing oral chemotherapy agents. Currently, no standardized guidelines exist for handling oral chemotherapy agents, and institutions must develop their own policies and procedures. This article discusses oral chemotherapy safety considerations, including safe handling of these agents, and offers recommendations for practice.
Little is known about hepatic T lymphocyte subpopulations in the human liver. The aim of this study was to document the various subpopulations present in the liver and compare them to peripheral T lymphocytes in the same patients. Normal hepatic tissue was obained at time of transplant from five patients, and a single cell suspension of lymphocytes were prepared by standard methods. Ceils were stained with monoclonal antibodies specific for CD8ct and CD8B chains, CD4, CD8, CD3, o~BTCR, and ySTCR, and analyzed by two and three colour flow cytometry. Of the hepatic CD3+ cells, 71% were CD8+ and 25% were CD4+, with a CD4/CD8 ratio of 1:3 in contrast to the peripheral CD4/CD8 ratio of 2:1.18% of the hepatic CD3+ cells expressed ySTCR. Significantly, CD8~ct accounted for 27% [mean] of the total hepatic CD8+ population. Conclusion: There is now evidence that the adult human gut can support extrathymic T cell differentation. A significant population of hepatic CD8txct cells would suggest that the liver is also a site of extrathymic differentiation, which may have important implications for the understanding of autoimmunity and graft tolerance.
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