AIMS To review cases of galactorrhea and galactocele postbreast augmentation, determine possible risk factors and consider management strategies of this rare complication. METHODS A systematic literature review was conducted in July 2019 searching Pubmed, Embase, and Google Scholar. RESULTS The searches revealed 19 articles (17 case reports/series and 2 retrospective chart reviews) collectively comprising 38 women. The average age was 28 years, 42% were on oral contraceptives, whereas a quarter were nulliparous. The most common incision was periareolar (48%) followed by transaxillary (24%). The most common implant location was subglandular (57%) followed by subpectoral (37%). The average time to symptom onset was 61 days (range, 3-912 days) but only 3 cases presented more than a month after implant insertion. Twenty-one patients had galactorrhea, 7 had galactocele, whereas 10 women had both. Bilateral symptoms were present in 72% of cases, whereas hyperprolactinemia was present in only 62%. Management strategies included simple surveillance, antibiotics, dopamine agonists, leukotriene receptor antagonists, estrogenic agents, surgical washout, and implant removal (8 patients). The mean time to symptom resolution was 22.6 days. CONCLUSIONS The numbers are too small for definitive conclusions but there is a weak suggestion that periareolar incisions, subglandular implants, prior hormonal contraceptive use, gravidity, and recent history of breastfeeding ( less then 1 year) may be risk factors for galactorrhea/galactocele. Symptom onset is usually within 3 months. Treatments providing the fastest response (2 days) comprised of a composite approach (antibiotics, dopamine agonist, surgical drainage, and implant removal), whereas the use of estrogenic medications appeared to confer little benefit.A patient's mysterious (and infectious) hope gives her meaning and seems to bolster her strength.Harm must be proven to collect damages.Editor's note From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights.  https://www.selleckchem.com/products/AdipoRon.html  Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times.In this month's article, from the May 1925 issue, nurse Ellen G. Dawson from Evanston Hospital in Illinois presents three case studies as evidence for a new use for immobilizing traction the treatment of osteoarthritis. The protocol includes the use of traction for days or weeks, hot fomentations (poultices) applied to the skin over the painful joint, and a body cast (for back pain) or leg cast (for knee pain) worn for an extended period afterward. If the joint pain was severe, a lotion made from tinctures of opium and arnica, witch hazel, and lead water was also applied. The author notes, "We could cite case after case, with varying lengths of time, where the results have been equally gratifying."Today, nurses are involved in more formal arthritis research. In this issue, So-Hyun Park and Shiela M. Strauss examine the impact of arthritis on recommended physical activity in their original research article, "Arthritis-Related Functional Limitations and Inadequate Physical Activity Among Female Adult Cancer Survivors."Evidence-based recommendations for preventive health.The National Institutes of Health Stroke Scale (NIHSS) is considered the standard for assessing neurologic status after an acute stroke. Currently, there is no guideline for when this assessment should be completed, nor is there consensus on how frequently or for how long.We initiated a quality improvement project that sought first to determine when and how often nurses at a variety of institutions in our multisite health care system completed the NIHSS assessment and then to identify the minimum frequency at which nurses should complete the assessment. After reviewing the literature and current practices and observing internal and external benchmarks, we set a new standard for all institutions in the system to follow.The new assessment frequency was based on patient condition and level of care, although that frequency would change if a patient showed new or worsening neurologic changes. The new standard was successfully implemented at all the primary and comprehensive certified stroke centers in our network. Ongoing monitoring confirmed that the frequency of NIHSS assessment met the needs of our patients and ensured staff adherence to the new practice.Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely-and often more personal-perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit www.ajnoffthecharts.com.In this case study, we investigated the efficacy of mirror therapy and online counseling in the management of phantom limb pain. The patient was a 28-year-old woman who experienced phantom limb pain after a traumatic transhumeral amputation three and a half months before initiating therapy. After a 40-minute educational session with a nurse researcher experienced in pain management and surgical nursing, the patient practiced mirror therapy at home for four weeks and kept in contact with the nurse using a mobile chat application. The patient scored the intensity of her pain before and after each practice session on a 0-to-10 numeric pain scale. The first week was difficult for her because of tiredness and the pain. In the second week she experienced less pain during the day than at night but claimed to feel much better than before. In the fourth week, she reported having difficulty sleeping, but she stated that her pain had decreased. The intensity of the pain didn't change following mirror therapy in the first week; however, her average pain score was 1.