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Medication safety

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https://www.readbyqxmd.com/read/28342949/use-of-thiopurines-during-conception-and-pregnancy-not-associated-with-adverse-pregancy-outcomes-or-health-of-infants-at-1-year-in-a-prospective-study
#1
Shannon L Kanis, Alison de Lima-Karagiannis, Nanne K H de Boer, C Janneke van der Woude
BACKGROUND & AIMS: Most data on the safety of thiopurine therapy for inflammatory bowel disease (IBD) during pregnancy come from retrospective studies, making it difficult to adjust for confounding factors. We performed a prospective cohort study to determine whether thiopurine use affects pregnancy outcomes or health outcomes of children. METHODS: We performed a prospective study of all women who visited the IBD preconception outpatient clinic at our tertiary health center in The Netherlands from December 2008 through May 2016...
March 22, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28342837/-malignant-cutaneous-adnexal-neoplasms-of-the-face-and-scalp-diagnostic-and-therapeutic-update
#2
M Romeu, J M Foletti, C Chossegros, J P Dales, P Berbis, B Cribier, L Guyot
INTRODUCTION: Malignant cutaneous adnexal neoplasms are rare and have been characterized only recently. They can occur at any age but preferentially in elderly. There are 3 of them: trichoblastic carcinoma, trichilemmal carcinoma and malignant pilomatricoma. The aim of our study was to make a diagnostic and therapeutic update about these tumors when located at the face or at the scalp. MATERIALS AND METHODS: A bibliographic research was made on PubMed using following keywords: appendage skin carcinoma AND pathology AND/OR therapeutic...
March 22, 2017: J Stomatol Oral Maxillofac Surg
https://www.readbyqxmd.com/read/28340054/outcomes-of-atrial-arrhythmia-radiofrequency-catheter-ablation-in-patients-with-ebstein-s-anomaly
#3
Abdallah Hassan, Nicholas Y Tan, Htin Aung, Heidi M Connolly, David O Hodge, Emily R Vargas, Bryan C Cannon, Douglas L Packer, Samuel J Asirvatham, Christopher J McLeod
Aims: Atrial arrhythmias are common in patients with Ebstein's anomaly (EA) despite cardiac surgical repair and concomitant Maze procedures. We aimed to evaluate the outcome of radiofrequency catheter ablation in this group of patients. Methods and results: All patients with EA and atrial arrhythmias who underwent catheter ablation for atrial arrhythmias between 1/1999 and 1/2016 were included. Atrial arrhythmia recurrence was identified as the primary outcome; secondary outcomes included repeat ablation, need for antiarrhythmic medications after ablation, and death...
February 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340041/bleeding-complications-in-patients-undergoing-intrathecal-drug-delivery-system-implantation
#4
Nafisseh S Warner, Markus A Bendel, Matthew A Warner, Jacob J Strand, Halena M Gazelka, Bryan C Hoelzer, William D Mauck, Tim J Lamer, Daryl J Kor, Susan M Moeschler
Introduction.:  Intrathecal drug delivery systems (IDDSs) have dramatically improved analgesia and the functional status of cancer patients and those with chronic pain states. However, given the close proximity to the neuraxis and frequent concomitant use of antiplatelet or anticoagulant medications, this intervention is not without risk. The goal of this investigation was to determine the incidence of bleeding complications following IDDS placement. Methods.:  This is a retrospective review from 2005 through 2014 of adult patients undergoing IDDS implantation or revision at a tertiary care center...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340017/patient-reporting-of-undesirable-events-a-pilot-study-in-china
#5
Jia Yan, Ke Liu, Lifeng Zhang, Ting Chu, Xuehua Wang
Objective: To identify the frequency of undesirable events reported by patients during hospitalization and explore the relationship between undesirable events and perception of safety and satisfaction with care in China. Design: Cross-sectional survey. Setting: Chinese university hospital. Participants: Adult patients (N = 341) discharged from medical and surgical departments. Interventions: Patients were interviewed post-discharge using a survey instrument to ask whether they had experienced specific undesirable events during hospitalization...
March 10, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339758/safety-and-efficacy-of-the-new-bidirectional-rotational-evolution%C3%A2-mechanical-lead-extraction-sheath-results-from-a-multicentre-italian-registry
#6
Patrizio Mazzone, Federico Migliore, Emanuele Bertaglia, Domenico Facchin, Elisabetta Daleffe, Vittorio Calzolari, Martino Crosato, Francesco Melillo, Francesco Peruzza, Alessandra Marzi, Nicoleta Sora, Paolo Della Bella
Aims: The aim of this prospective multicentre study is to evaluate safety and efficacy of the new bidirectional rotational mechanical lead extraction (LE) sheath (Evolution RL, Cook Medical, USA) in chronically implanted leads (>1-year-old leads). Methods and results: Between September 2013 and June 2016, a total of 238 leads in 124 consecutive patients were removed by using the new Evolution RL rotational mechanical sheath. Indications for LE were cardiac device infection in 63 (50...
February 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339698/learning-from-errors-analysis-of-medication-order-voiding-in-cpoe-systems
#7
Thomas G Kannampallil, Joanna Abraham, Anna Solotskaya, Sneha G Philip, Bruce L Lambert, Gordon D Schiff, Adam Wright, William L Galanter
Objective: Medication order voiding allows clinicians to indicate that an existing order was placed in error. We explored whether the order voiding function could be used to record and study medication ordering errors. Materials and Methods: We examined medication orders from an academic medical center for a 6-year period (2006-2011; n  = 5 804 150). We categorized orders based on status (void, not void) and clinician-provided reasons for voiding. We used multivariable logistic regression to investigate the association between order voiding and clinician, patient, and order characteristics...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339697/are-informed-policies-in-place-to-promote-safe-and-usable-ehrs-a-cross-industry-comparison
#8
Erica L Savage, Rollin J Fairbanks, Raj M Ratwani
Objective: Despite federal policies put in place by the Office of the National Coordinator (ONC) to promote safe and usable electronic health record (EHR) products, the usability of EHRs continues to frustrate providers and have patient safety implications. This study sought to compare government policies on usability and safety, and methods of examining compliance to those policies, across 3 federal agencies: the ONC and EHRs, the Federal Aviation Administration (FAA) and avionics, and the Food and Drug Administration (FDA) and medical devices...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339642/meaningful-use-of-health-information-technology-and-declines-in-in-hospital-adverse-drug-events
#9
Michael F Furukawa, William D Spector, M Rhona Limcangco, William E Encinosa
Objective: Nationwide initiatives have promoted greater adoption of health information technology as a means to reduce adverse drug events (ADEs). Hospital adoption of electronic health records with Meaningful Use (MU) capabilities expected to improve medication safety has grown rapidly. However, evidence that MU capabilities are associated with declines in in-hospital ADEs is lacking. Methods: Data came from the 2010-2013 Medicare Patient Safety Monitoring System and the 2008-2013 Healthcare Information and Management Systems Society (HIMSS) Analytics Database...
February 16, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339500/detecting-congenital-malformations-lessons-learned-from-the-mpepu-study-botswana
#10
Gbolahan Ajibola, Rebecca Zash, Roger L Shapiro, Oganne Batlang, Kerapetse Botebele, Kara Bennett, Florence Chilisa, Erik von Widenfelt, Joseph Makhema, Shahin Lockman, Lewis B Holmes, Kathleen M Powis
INTRODUCTION: A large and increasing number of HIV-infected women are conceiving on antiretroviral treatment (ART). While most antiretrovirals are considered safe in pregnancy, monitoring for rare pregnancy and infant adverse outcomes is warranted. METHODS: We conducted a retrospective secondary analysis nested within a clinical trial of infant cotrimoxazole vs. placebo prophylaxis in Botswana (the Mpepu Study). Infants were examined at birth, and at least every 3 months through 18 months of age...
2017: PloS One
https://www.readbyqxmd.com/read/28339340/patient-perspectives-on-language-discordance-during-healthcare-visits-findings-from-the-extremely-high-density-multicultural-state-of-qatar
#11
Huda Abdelrahim, Maha Elnashar, Amal Khidir, Amal Killawi, Maya Hammoud, Abdul Latif Al-Khal, Michael D Fetters
Reducing language and cultural barriers in healthcare are significant factors in resolving health disparities. Qatar's rapidly growing multicultural population presents new challenges to the healthcare system. The purpose of this research was to explore patients' perspectives about language discordance, and the strategies used to overcome language barriers during patients' visits. Participants were recruited and interviewed from four language groups (Arabic = 24, English = 20, Hindi = 20, and Urdu = 20), all of whom were living in Qatar and utilizing Hamad General Hospital-Outpatient Clinics as a source of their healthcare services...
March 24, 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/28338393/contraception-for-women-with-multiple-sclerosis-guidance-for-healthcare-providers
#12
Maria K Houtchens, Lauren B Zapata, Kathryn M Curtis, Maura K Whiteman
Family planning is essential for any comprehensive treatment plan for women of reproductive age with multiple sclerosis (MS), including counseling on using effective contraception to optimally time desired and prevent unintended pregnancies. This topical review summarizes the first evidence-based recommendations on contraception safety for women with MS. In 2016, evidence-based recommendations for contraceptive use by women with MS were included in US Medical Eligibility Criteria for Contraceptive Use. They were developed after review of published scientific evidence on contraception safety and consultation with experts...
March 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28337872/safety-and-pharmacodynamic-mechanism-of-ropivacaine-lumbar-anesthesia-in-cesarean-section
#13
Q Liu, J J Wang, H Y Yan, Y Q Wang, C W Qin, M L Li
Lumbar anesthesia is the preferred anesthetic approach for puerperae undergoing cesarean section in China. To observe the safety of administering different doses of ropivacaine for cesarean section and its pharmacodynamic mechanism, we randomly divided 180 pregnant women undergoing cesarean section into three groups: group A, 10 mg ropivacaine (0.50%); group B, 12 mg ropivacaine (0.50%); and group C, 14 mg ropivacaine (0.50%). Pharmacodynamic index, anesthesia quality and incidence of untoward reactions of each group were observed...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28337706/clinical-and-radiological-outcomes-of-two-level-endoscopic-posterior-cervical-foraminotomy
#14
Myung Soo Youn, Myeong Hwan Shon, Yoon Jae Seong, Jong Ki Shin, Tae Sik Goh, Jung Sub Lee
PURPOSE: The efficacy and safety of endoscopic posterior cervical foraminotomy (EPCF) have been demonstrated for single-level cervical radiculopathy, but no report in the medical literature has described the clinical results of two-level EPCF. The aim of this study was to assess the clinical and radiological outcomes of two-level EPCF performed in patients with cervical radiculopathy. METHODS: Twenty-two consecutive patients (9 females and 13 males) that underwent two-level EPCF with cervical radiculopathy from January 2012 to January 2014 were included in this study...
March 23, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28337701/ct-guided-drainage-of-pericardial-effusion-after-open-cardiac-surgery
#15
Nour-Eldin Abdelrehim Nour-Eldin, Mohammed Alsubhi, Tatjana Gruber-Rouh, Thomas J Vogl, Benjamin Kaltenbach, Hazem Hamed Soliman, Wael Eman Hassan, Sherif Maher Abolyazid, Nagy N Naguib
PURPOSE: This study was designed to evaluate the safety and efficacy of CT-guided drainage of the pericardial effusion in patients after cardiac surgery. MATERIALS AND METHODS: The study included 128 consecutive patients (82 males, 46 females; mean age 66.6 years, SD: 4.2) complicated by pericardial effusion or hemopericardium after cardiac surgeries between June 2008 and June 2016. The medical indication for therapeutic pericardiocentesis in all patients was hemodynamic instability caused by pericardial effusion...
March 23, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28337075/intranasal-dexmedetomidine-as-a-sedative-for-pediatric-procedural-sedation
#16
Natalie Behrle, Esma Birisci, Jordan Anderson, Sara Schroeder, Abdallah Dalabih
OBJECTIVE: This study seeks to evaluate the efficacy and safety of intranasal (IN) dexmedetomidine as a sedative medication for non-invasive procedural sedation. METHODS: Subjects 6 months to 18 years of age undergoing non-invasive elective procedures were included. Dexmedetomidine (3 mcg/kg) was administered IN 40 minutes before the scheduled procedure time. The IN dexmedetomidine cohort was matched and compared to a cohort of 690 subjects who underwent sedation for similar procedures without the use of dexmedetomidine to evaluate for observed events/interventions and procedural times...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28337041/getting-the-foundations-right-for-the-measurement-of-medication-safety-the-need-for-a-meaningful-conceptual-frame
#17
Jerome Ng, Shane Scahill, Jeff Harrison
A number of initiatives aimed at improving medication safety in and across New Zealand public hospitals have been introduced over recent years. Clinicians, policymakers and patients now want to know whether patients are safer today from medicine use than they have been in the past. The challenge has been determining exactly what should be measured. In this viewpoint, we critically examine the suitability of adverse drug events (ADE) as a primary metric for assessing the progress of medication safety improvement...
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28336788/transcatheter-treatment-of-severe-tricuspid-regurgitation-with-the-edge-to-edge-mitraclip-technique
#18
Georg Nickenig, Marek Kowalski, Jörg Hausleiter, Daniel Braun, Joachim Schofer, Ermela Yzeiraj, Volker Rudolph, Kai Friedrichs, Francesco Maisano, Maurizio Taramasso, Neil P Fam, Giovanni Bianchi, Francesco Bedogni, Paolo Denti, Ottavio Alfieri, Azeem Latib, Antonio Colombo, Christoph Hammerstingl, Robert Schueler
Background -Current surgical and medical treatment options for severe tricuspid regurgitation (TR) are limited and additional interventional approaches are required. In the present observational study, the safety and feasibility of transcatheter repair of chronic severe TR with the MitraClip system were evaluated. In addition, the effects on clinical symptoms were assessed. Methods -Patients with heart failure symptoms and severe TR on optimal medical treatment were treated with the MitraClip system. Safety, defined as periprocedural adverse events such as death, myocardial infarction, stroke, or cardiac tamponade, and feasibility, defined as successful implantation of one or more MitraClip devices and reduction of TR by at least one grade, were evaluated before discharge and after 30 days...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28336760/analysis-of-variations-in-the-display-of-drug-names-in-computerized-prescriber-order-entry-systems
#19
Arbor J L Quist, Thu-Trang T Hickman, Mary G Amato, Lynn A Volk, Alejandra Salazar, Alexandra Robertson, Adam Wright, David W Bates, Shobha Phansalkar, Bruce L Lambert, Gordon D Schiff
PURPOSE: The variations in how drug names are displayed in computerized prescriber-order-entry (CPOE) systems were analyzed to determine their contribution to potential medication errors. METHODS: A diverse set of 10 inpatient and outpatient CPOE system vendors and self-developed CPOE systems in 6 U.S. healthcare institutions was evaluated. A team of pharmacists, physicians, patient-safety experts, and informatics experts created a CPOE assessment tool to standardize the assessment of CPOE features across the systems studied...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28336759/standardizing-concentrations-of-adult-drug-infusions-in-indiana
#20
Todd A Walroth, Heather A Dossett, Meagan Doolin, Derek McMichael, Jennifer G Reddan, Dan Degnan, James Fuller
PURPOSE: A multidisciplinary, consensus-driven initiative to promote the use of standardized medication concentrations for adult drug infusions across the state of Indiana is described. METHODS: To accomplish development of the Indiana Standard Concentrations of Adult Drug Infusions List ("the Indiana List"), several available lists of i.v. concentrations were compiled, consolidated, and compared. Lists of adult standardized i.v. concentrations were primarily drawn from Indiana regional patient safety coalitions, published literature, and publicly available lists of recommended i...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
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