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Dose Error Reduction System

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https://www.readbyqxmd.com/read/29433578/resistant-hypertension-on-treatment-reshypot-sequential-nephron-blockade-compared-to-dual-blockade-of-the-renin-angiotensin-aldosterone-system-plus-bisoprolol-in-the-treatment-of-resistant-arterial-hypertension-study-protocol-for-a-randomized-controlled-trial
#1
Elizabeth do Espirito Santo Cestário, Letícia Aparecida Barufi Fernandes, Luiz Tadeu Giollo-Júnior, Jéssica Rodrigues Roma Uyemura, Camila Suemi Sato Matarucco, Manoel Idelfonso Paz Landim, Luciana Neves Cosenso-Martin, Lúcia Helena Bonalume Tácito, Heitor Moreno, José Fernando Vilela-Martin, Juan Carlos Yugar-Toledo
BACKGROUND: Resistant hypertension is characterized when the blood pressure (BP) remains above the recommended goal after taking three antihypertensive drugs with synergistic actions at their maximum recommended tolerated doses, preferably including a diuretic. Identifying the contribution of intravascular volume and serum renin in maintaining BP levels could help tailor more effective hypertension treatment, whether acting on the control of intravascular volume or sodium balance, or acting on the effects of the renin-angiotensin-aldosterone system (RAAS) on the kidney...
February 12, 2018: Trials
https://www.readbyqxmd.com/read/29368389/volumetric-modulated-arc-therapy-for-total-body-irradiation-a-feasibility-study-using-pinnacle3-treatment-planning-system-and-elekta-agility%C3%A2-linac
#2
Kirsty Symons, Colm Morrison, Jason Parry, Simon Woodings, Yvonne Zissiadis
A study was undertaken to explore the use of volumetric modulated arc therapy (VMAT) for total body irradiation (TBI). Five patient plans were created in Pinnacle3 using nine 6 MV photon dynamic arcs. A dose of 12 Gy in six fractions was prescribed. The planning target volume (PTV) was split into four subsections for the head, chest, abdomen, and pelvis. The head and chest beams were optimized together, followed by the abdomen and pelvis beams. The last stage of the planning process involved turning all beams on and performing a final optimization to achieve a clinically acceptable plan...
January 24, 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29340851/comparison-of-antibiotic-dosing-recommendations-for-neonatal-sepsis-from-established-reference-sources
#3
T B Y Liem, E M A Slob, J U M Termote, T F W Wolfs, A C G Egberts, C M A Rademaker
Background Incorrect dosing is the most frequent prescribing error in neonatology, with antibiotics being the most frequently prescribed medicines. Computer physician order entry and clinical decision support systems can create consistency contributing to a reduction of medication errors. Although evidence-based dosing recommendations should be included in such systems, the evidence is not always available and subsequently, dosing recommendations mentioned in guidelines and textbooks are often based on expert opinion...
January 16, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29300888/telemonitoring-based-feedback-improves-adherence-to-non-vitamin-k-antagonist-oral-anticoagulants-intake-in-patients-with-atrial-fibrillation
#4
Lien Desteghe, Johan Vijgen, Pieter Koopman, Dagmara Dilling-Boer, Joris Schurmans, Paul Dendale, Hein Heidbuchel
Aims: To evaluate the effect of telemonitoring on adherence to non-vitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients. Methods and results: A randomized, single-blind, crossover, controlled trial in 48 AF patients on once or twice daily (OD or BID) NOAC. The Medication Event Monitoring System tracked NOAC intake during three phases of 3 months each: daily telemonitoring, telemonitoring with immediate telephone feedback in case of intake errors, and an observation phase without daily transmissions...
January 2, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29122421/evaluating-strategies-for-reducing-scattered-radiation-in-fixed-imaging-hybrid-operating-suites
#5
Claire Miller, Daniel Kendrick, Andrew Shevitz, Ann Kim, Henry Baele, David Jordan, Vikram S Kashyap
OBJECTIVE: High-resolution fixed C-arm fluoroscopic systems allow high-quality endovascular imaging but come at a cost of greater scatter radiation generation and increased occupational exposure for surgeons. The purpose of this study was to evaluate the efficacy of two methods in reducing scattered radiation exposure. METHODS: There were 164 endovascular cases analyzed in three phases. In phase 1 (P1), baseline radiation exposure was calculated. In phase 2 (P2), staff used real-time radiation dose monitoring (dosimetry badges [RaySafe; Unfors, Hopkinton, Mass])...
November 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28921881/use-of-a-radial-projection-to-reduce-the-statistical-uncertainty-of-spot-lateral-profiles-generated-by-monte-carlo-simulation
#6
Xiaoning Ding, Wei Liu, Jiajian Shen, Aman Anand, Joshua B Stoker, Yanle Hu, Martin Bues
Monte Carlo (MC) simulation has been used to generate commissioning data for the beam modeling of treatment planning system (TPS). We have developed a method called radial projection (RP) for postprocessing of MC-simulation-generated data. We used the RP method to reduce the statistical uncertainty of the lateral profile of proton pencil beams with axial symmetry. The RP method takes advantage of the axial symmetry of dose distribution to use the mean value of multiple independent scores as the representative score...
September 18, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28905197/systemic-glyceryl-trinitrate-reduces-anal-sphincter-tone-is-there-a-therapeutic-indication
#7
C Connolly, S Tierney, P Grace
BACKGROUND: Nitric oxide (NO) has diverse roles as a biological messenger. [1] Topically applied nitrate donors cause relaxation of the internal anal sphincter (IAS) and facilitate healing of anal fissures [2,3]. Systemic nitrates are commonly used for the treatment of ischaemic heart disease, yet the effects of systemically administered nitrates on the smooth muscle of the IAS are unknown. AIM: Our aim was to test the hypothesis that systemically administered nitrates at a normal dose, cause inhibition of anal sphincter activity...
September 13, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28895040/clinical-utility-of-ultra-low-dose-pre-test-exposure-to-avoid-unnecessary-patient-exposure-due-to-positioning-errors-a-simulation-study
#8
Hideo Nose, Junji Shiraishi
The use of digital radiographic systems has decreased the frequency of image retakes due to over/underexposure in general radiography. However, image retakes owing to patient positioning errors are likely to increase because of the convenience of a real-time image check on a console table. The purpose of the present study is to propose a novel radiographic examination procedure with an ultra-low-dose pre-test exposure that may be utilized to check patient positioning prior to taking an actual image, thereby reducing unnecessary patient exposure owing to image retakes...
September 11, 2017: Radiological Physics and Technology
https://www.readbyqxmd.com/read/28862217/evaluation-of-the-accuracy-of-various-dose-calculation-algorithms-of-a-commercial-treatment-planning-system-in-the-presence-of-hip-prosthesis-and-comparison-with-monte-carlo
#9
Kheirollah Mohammadi, Mohsen Hassani, Mahdi Ghorbani, Bagher Farhood, Courtney Knaup
PURPOSE: High atomic number elements are commonly used in a hip prosthesis which can cause uncertainty in accurate dose calculations in radiation therapy. The aim of this study is to assess the accuracy of the three various algorithms of ISOgray treatment planning system in the presence of hip prosthesis by Monte Carlo (MC). MATERIALS AND METHODS: A MC model of Siemens PRIMUS linear accelerator has been built and verified by the measured data of the different algorithms of ISOgray treatment planning systems (TPS) in 6 and 15 MV photon beam energies...
July 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28859933/evaluation-of-high-dose-volumetric-ct-to-reduce-inter-observer-delineation-variability-and-ptv-margins-for-prostate-cancer-radiotherapy
#10
Hamideh Alasti, Young-Bin Cho, Charles Catton, Alejandro Berlin, Peter Chung, Andrew Bayley, Aaron Vandermeer, Vickie Kong, David Jaffray
PURPOSE: The aim was to determine whether the enhanced soft tissue contrast provided by high-dose volumetric CT (HDVCT) can reduce inter-observer variability in delineating prostate compared to helical conventional CT (CCT) scans and 3T MRI scans for patients undergoing radical prostate cancer radiotherapy. Secondly, to quantify the potential PTV reduction with decreased inter-observer variability. MATERIALS AND METHODS: A 320 slice volumetric CT scanner was used...
October 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28799408/assessment-of-apixaban-prescribing-patterns-for-nonvalvular-atrial-fibrillation-in-hospitalized-patients
#11
Caitlin M Gibson, Carmen B Smith, Sondra Davis, Michael J Scalese
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). Other DOACs require renal dose adjustments based solely on creatinine clearance. Apixaban differs in that its dose adjustments are more complex, potentially leading to prescribing errors. OBJECTIVE: To determine if adherence to Food and Drug Administration (FDA)-approved dosing for apixaban is maintained in hospitalized patients with NVAF...
January 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28755565/automatic-plume-episode-identification-and-cloud-shine-reconstruction-method-for-ambient-gamma-dose-rates-during-nuclear-accidents
#12
Xiaole Zhang, Wolfgang Raskob, Claudia Landman, Dmytro Trybushnyi, Christoph Haller, Hongyong Yuan
Ambient gamma dose rate (GDR) is the primary observation quantity for nuclear emergency management due to its high acquisition frequency and dense spatial deployment. However, ambient GDR is the sum of both cloud and ground shine, which hinders its effective utilization. In this study, an automatic method is proposed to identify the radioactive plume passage and to separate the cloud and ground shine in the total GDR. The new method is evaluated against a synthetic GDR dataset generated by JRODOS (Real Time On-line Decision Support) System and compared with another method (Hirayama, H...
November 2017: Journal of Environmental Radioactivity
https://www.readbyqxmd.com/read/28755403/monitoring-deep-inspiration-breath-hold-for-left-sided-localized-breast-cancer-radiotherapy-with-an-in-house-developed-laser-distance-meter-system
#13
Christer A Jensen, Tatiana Abramova, Jomar Frengen, Jo-Åsmund Lund
Deep inspiration breath hold (DIBH) in left-sided breast cancer radiotherapy is a technique to reduce cardiac and pulmonary doses while maintaining target coverage. This study aims at evaluating an in-house developed DIBH system. Free-breathing (FB) and DIBH plans were generated for 22 left-sided localized breast cancer patients who had radiation therapy (RT) after breast-conserving surgery. All patients were treated utilizing an in-house laser distance measuring system. 50 Gy was prescribed, and parameters of interest were target coverage, left anterior descending coronary artery, (LAD) and heart doses...
July 29, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28741892/dose-comparison-between-gafchromic-film-xio-and-monaco-treatment-planning-systems-in-a-novel-pelvic-phantom-that-contains-a-titanium-hip-prosthesis
#14
Nicholas Ade, F C P du Plessis
The presence of metallic prostheses during external beam radiotherapy of malignancies in the pelvic region has the potential to strongly influence the dose distribution to the target and to tissue surrounded by the prostheses. This study systematically investigates the perturbation effects of unilateral titanium prosthesis on 6 and 15 MV photon beam dose distributions using Gafchromic EBT2 film measurements in a novel pelvic phantom made out of a stack of nylon slices. Comparisons were also made between the film data and dose calculations made on XiO and Monaco treatment planning systems...
July 25, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28732613/photorefractive-intrastromal-corneal-crosslinking-for-the-treatment-of-myopic-refractive-errors-six-month-interim-findings
#15
Matthias Elling, Inga Kersten-Gomez, H Burkhard Dick
PURPOSE: To evaluate the safety and efficacy of photorefractive intrastromal corneal crosslinking (CXL) in low myopia. SETTING: Ruhr University Eye Hospital, Bochum, Germany. DESIGN: Prospective case series. METHODS: Healthy eyes with myopia or myopic astigmatism had photorefractive intrastromal CXL using the Mosaic system to apply ultraviolet-A (UVA) 365 nm (30 mW/cm(2)) irradiance (total calculated UVA dose of 10 J/cm(2) or 15 J/cm(2)) with riboflavin 0...
June 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28675553/a-combined-intervention-to-reduce-interruptions-during-medication-preparation-and-double-checking-a-pilot-study-evaluating-the-impact-of-staff-training-and-safety-vests
#16
Saskia Huckels-Baumgart, Milena Niederberger, Tanja Manser, Christoph R Meier, Carla Meyer-Massetti
AIM: The aim was to evaluate the impact of staff training and wearing safety vests as a combined intervention on interruptions during medication preparation and double-checking. BACKGROUND: Interruptions and errors during the medication process are common and an important issue for patient safety in the hospital setting. METHODS: We performed a pre- and post-intervention pilot-study using direct structured observation of 26 nurses preparing and double-checking 431 medication doses (225 pre-intervention and 206 post-intervention) for 36 patients (21 pre-intervention and 15 post-intervention)...
October 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28643030/hospital-electronic-prescribing-system-implementation-impact-on-discharge-information-communication-and-prescribing-errors-a-before-and-after-study
#17
Pamela Ruth Mills, Anita Elaine Weidmann, Derek Stewart
PURPOSE: The study aimed to test the hypothesis that hospital electronic prescribing and medicine administration system (HEPMA) implementation impacted patient discharge letter quality, nature and frequency of prescribing errors. METHOD: A quasi experimental before and after retrospective case note review was conducted in one United Kingdom district general hospital. The total sample size was 318 (random samples of 159 before and after implementation), calculated to achieve a 10% error reduction with a power of 80% and p < 0...
October 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28574959/intravenous-smart-pump-drug-library-compliance-a-descriptive-study-of-44-hospitals
#18
Karen K Giuliano, Wan-Ting Su, Daniel D Degnan, Kristy Fitzgerald, Richard J Zink, Poching DeLaurentis
BACKGROUND: Although intravenous (IV) smart pumps with built-in dose-error reduction systems (DERS) can reduce IV medication administration error, most serious adverse events still occur during IV medication administration. Sources of error include overriding DERS and manually bypassing drug libraries and the DERS. METHODS: Our purpose was to use the Regenstrief National Center for Medical Device Informatics data set to better understand IV smart pump drug library and DERS compliance...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28538369/significant-reduction-of-fluoroscopy-repetition-with-lumbar-localization-system-in-minimally-invasive-spine-surgery-a-prospective-study
#19
Guoxin Fan, Hailong Zhang, Xin Gu, Chuanfeng Wang, Xiaofei Guan, Yunshan Fan, Shisheng He
The conventional location methods for minimally invasive spinal surgery (MISS) were mainly based on repeated fluoroscopy in a trial-and-error manner preoperatively and intraoperatively. Localization system mainly consisted of preoperative applied radiopaque frame and intraoperative guiding device, which has the potential to minimize fluoroscopy repetition in MISS. The study aimed to evaluate the efficacy of a novel lumbar localization system in reducing radiation exposure to patients.Included patients underwent minimally invasive transforaminal lumbar interbody fusion (MISTLIF) or percutaneous transforaminal endoscopic discectomy (PTED)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28535917/sensitivity-evaluation-of-two-commercial-dosimeters-in-detecting-helical-tomotherapy-treatment-delivery-errors
#20
Shrikant Deshpande, Mark Geurts, Philip Vial, Peter Metcalfe, Lois Holloway
PURPOSE: To assess the sensitivity of two commercial dosimetry systems in detecting Helical TomoTherapy (HT) delivery errors. METHOD: Two commercial dosimeters i) MatriXX(Evolution) and ii) ArcCHECK® were considered. Ten retrospective nasopharynx HT patients were analysed. For each patient, error plans were created by independently introducing systematic offsets in: a) Jaw width error ±1, ±1.5 and ±2mm, b) Couch speed error ±2%, ±2.5, ±3% and ±4%, and c) MLC Leaf Open Time (MLCLOT) errors (3 separate MLC errors: either leaf 32 open or leaf 42 remains open during delivery, and 4% random reductions in MLCLOT)...
May 2017: Physica Medica: PM
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