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https://www.readbyqxmd.com/read/29045256/a-quality-improvement-initiative-to-increase-scoring-consistency-and-accuracy-of-the-finnegan-tool-challenges-in-obtaining-reliable-assessments-of-drug-withdrawal-in-neonatal-abstinence-syndrome
#1
Wendy Timpson, Cheryl Killoran, Louise Maranda, Alan Picarillo, Elisabeth Bloch-Salisbury
BACKGROUND: Current practice for diagnosing neonatal abstinence syndrome and guiding pharmacological management of neonatal drug withdrawal is dependent on nursing assessments and repeated evaluation of clinical signs. PURPOSE: This single-center quality improvement initiative was designed to improve accuracy and consistency of Finnegan scores among neonatal nurses. METHODS: One-hundred seventy neonatal nurses participated in a single-session withdrawal-assessment program that incorporated education, scoring guidelines, and a restructured Finnegan scale...
October 17, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29044227/accuracy-of-weight-estimation-by-the-broselow-tape-is-substantially-improved-by-including-a-visual-assessment-of-body-habitus
#2
Mike Wells, Lara Goldstein, Alison Bentley
BackgroundThe Broselow tape (BT) has been shown to estimate weight poorly primarily because of variations in body habitus. The manufacturers have suggested that a visual assessment of habitus may be used to increase its performance. This study evaluated the ability of habitus-modified models to improve the accuracy thereof.MethodsA post hoc analysis of prospectively collected data from four hospitals in Johannesburg, South Africa, on a population of 1,085 children. Sixteen a priori models generated a modified weight estimation or drug dose based on the BT weight and a gestalt assessment of habitus...
October 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29042838/dose-banding-of-intravenous-piperacillin-tazobactam-in-pediatric-surgical-inpatients
#3
Indrajit S Karande, Zoy Goff, Jacqueline Kewley, Shailender Mehta, Thomas Snelling
BACKGROUND: Antimicrobial doses in children are often prescribed by using an individually calculated dose per weight (e.g., mg/kg) or based on body surface area. Dosing errors are the most commonly reported medication errors in children. A "dose-banding" strategy is frequently used for some over-the-counter drugs to prevent dosing errors. It could also lead to efficiencies by enabling batch preparation of intravenous (IV) medications in hospitals. OBJECTIVES: To evaluate whether use of dose-banding for IV piperacillin-tazobactam results in acceptable dose variation from standard practice of individualized prescription of 100 mg/kg in children...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29042833/impact-of-a-pharmacist-led-chemotherapy-education-program-on-the-knowledge-of-pediatric-hematology-oncology-nurses
#4
Christine M Fisher, Abby J Kim, Joshua J Elder
OBJECTIVES: Medication errors involving chemotherapy are a serious source of avoidable medical harm that can result in chemotherapy-related adverse drug events. Efforts to reduce errors in the past decade have largely focused on chemotherapy errors at the prescriber level, using computerized or automated technology, but little has been done to ensure chemotherapy is administered accurately at the nursing level. The current study implemented a pharmacist-led, supplemental, institution-specific training program to nursing staff regarding the use of chemotherapy and to address knowledge deficits in newly hired nursing personnel...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29040636/vt-1161-protects-mice-against-oropharyngeal-candidiasis-caused-by-fluconazole-susceptible-and-resistant-candida-albicans
#5
Timothy J Break, Jigar V Desai, Mukil Natarajan, Elise M N Ferre, Christina Henderson, Adrian M Zelazny, Ulrich Siebenlist, William J Hoekstra, Robert J Schotzinger, Edward P Garvey, Michail S Lionakis
Background: Candida albicans, the most common human fungal pathogen, causes chronic mucosal infections in patients with inborn errors of IL-17 immunity that rely heavily on chronic, often lifelong, azole antifungal agents for treatment. However, a rise in azole resistance has predicated a need for developing new antifungal drugs. Objectives: To test the in vitro and in vivo efficacy of VT-1161 and VT-1129 in the treatment of oropharyngeal candidiasis with azole-susceptible or -resistant C...
October 10, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29037046/admet-evaluation-in-drug-discovery-18-reliable-prediction-of-chemical-induced-urinary-tract-toxicity-by-boosting-machine-learning-approaches
#6
Tailong Lei, Huiyong Sun, Yu Kang, Feng Zhu, Hui Liu, Wenfang Zhou, Zhe Wang, Dan Li, Youyong Li, Tingjun Hou
Xenobiotic chemicals and their metabolites are mainly excreted out of our bodies by the The urinary tract is the main organ excreting xenobiotic chemicals and their metabolites through the urine. Chemical-induced urinary tract toxicity is one of the main reasons that cause failure during drug development, and it is a common adverse event for medications, natural supplements and environmental chemicals. Despites its importance, there are only a few in silico models for assessing urinary tract toxicity for a large number of compounds with diverse chemical structures...
October 16, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29035964/medication-safety-programs-in-primary-care-a-scoping-review
#7
Hanan Khalil, Monica Shahid, Libby Roughead
BACKGROUND: Medication safety plays an essential role in all healthcare organizations; improving this area is paramount to quality and safety of any wider healthcare program. While several medication safety programs in the hospital setting have been described and the associated impact on patient safety evaluated, no systematic reviews have described the impact of medication safety programs in the primary care setting. A preliminary search of the literature demonstrated that no systematic reviews, meta-analysis or scoping reviews have reported on medication safety programs in primary care; instead they have focused on specific interventions such as medication reconciliation or computerized physician order entry...
October 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29034162/eeg-source-connectivity-to-localize-the-seizure-onset-zone-in-patients-with-drug-resistant-epilepsy
#8
Willeke Staljanssens, Gregor Strobbe, Roel Van Holen, Vincent Keereman, Stefanie Gadeyne, Evelien Carrette, Alfred Meurs, Francesca Pittau, Shahan Momjian, Margitta Seeck, Paul Boon, Stefaan Vandenberghe, Serge Vulliemoz, Kristl Vonck, Pieter van Mierlo
Electrical source imaging (ESI) from interictal scalp EEG is increasingly validated and used as a valuable tool in the presurgical evaluation of epilepsy as a reflection of the irritative zone. ESI of ictal scalp EEG to localize the seizure onset zone (SOZ) remains challenging. We investigated the value of an approach for ictal imaging using ESI and functional connectivity analysis (FC). Ictal scalp EEG from 111 seizures in 27 patients who had Engel class I outcome at least 1 year following resective surgery was analyzed...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29032707/safety-of-psychiatric-inpatients-at-the-veterans-health-administration
#9
Steven C Marcus, Richard C Hermann, Martin R Frankel, Sara W Cullen
OBJECTIVE: Although reducing adverse events and medical errors has become a central focus of the U.S. health care system over the past two decades both within and outside the Veterans Health Administration (VHA) hospital systems, patients treated in psychiatric units of acute care general hospitals have been excluded from major research in this field. METHODS: The study included a random sample of 40 psychiatric units from medical centers in the national VHA system...
October 16, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29032447/evaluation-and-calibration-of-high-throughput-predictions-of-chemical-distribution-to-tissues
#10
Robert G Pearce, R Woodrow Setzer, Jimena L Davis, John F Wambaugh
Toxicokinetics (TK) provides critical information for integrating chemical toxicity and exposure assessments in order to determine potential chemical risk (i.e., the margin between toxic doses and plausible exposures). For thousands of chemicals that are present in our environment, in vivo TK data are lacking. The publicly available R package "httk" (version 1.8, named for "high throughput TK") draws from a database of in vitro data and physico-chemical properties in order to run physiologically-based TK (PBTK) models for 553 compounds...
October 14, 2017: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/29029694/prescriber-response-to-computerized-drug-alerts-for-electronic-prescriptions-among-hospitalized-patients
#11
Yael Zenziper Straichman, Daniel Kurnik, Ilan Matok, Hillel Halkin, Noa Markovits, Amitai Ziv, Ari Shamiss, Ronen Loebstein
BACKGROUND: Clinical decision support systems (CDSS) reduce prescription errors, but their effectiveness is reduced by high alert rates, "alert fatigue", and indiscriminate rejection. OBJECTIVES: To compare acceptance rates of alerts generated by the SafeRx(®) prescription CDSS among different alert types and departments in a tertiary care hospital, identify factors associated with alert acceptance, and determine whether alert overrides were justified. METHODS: In a retrospective study, we compared acceptance rates of all prescription alerts generated in 2013 in 18 departments of Israel's largest tertiary care center...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29029106/iatrogenic-cushing-syndrome-in-a-child-with-congenital-adrenal-hyperplasia-erroneous-compounding-of-hydrocortisone
#12
Julia E Barillas, Daniel Eichner, Ryan Van Wagoner, Phyllis W Speiser
Context: Patients with 21-hydroxylase deficiency congenital adrenal hyperplasia (CAH) require lifelong treatment with glucocorticoids. In growing children the drug of choice is hydrocortisone. Commercially available hydrocortisone tablets do not conform to very low doses prescribed to infants and toddlers, and compounded hydrocortisone is often dispensed to meet therapeutic needs. However, safety, efficacy and uniformity of compounded products are not tested. We report a case of Cushing syndrome in a child with CAH who was inadvertently receiving excessive hydrocortisone in compounded form...
September 28, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29026841/causes-of-medication-errors-in-intensive-care-units-from-the-perspective-of-healthcare-professionals
#13
Sedigheh Farzi, Alireza Irajpour, Mahmoud Saghaei, Hamid Ravaghi
OBJECTIVE: This study was conducted to explore and to describe the causes of medication errors in Intensive Care Units (ICUs) from the perspective of physicians, nurses, and clinical pharmacists. METHODS: The study was conducted using a descriptive qualitative method in 2016. We included 16 ICUs of seven educational hospitals affiliated to Isfahan University of Medical Sciences. Participants included 19 members of the healthcare team (physician, nurse, and clinical pharmacist) with at least 1 year of work experience in the ICUs...
July 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29026355/colistin-and-polymyxin-b-minimal-inhibitory-concentrations-determined-by-etest-found-unreliable-for-gram-negative-bacilli
#14
Shelby Simar, Diane Sibley, Deborah Ashcraft, George Pankey
BACKGROUND: A reliable method of polymyxin B and E (colistin) susceptibility testing remains elusive. These drugs diffuse poorly into agar, creating potentially inaccurate Etest and disk diffusion results, and testing by these methods is not recommended. Broth microdilution is the reference testing method, although it can be sometimes difficult to interpret. Currently, when a colistin susceptibility test is ordered for a patient in the Ochsner Health System, our diagnostic microbiology laboratory performs the Etest...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29025037/association-between-workarounds-and-medication-administration-errors-in-bar-code-assisted-medication-administration-in-hospitals
#15
Willem van der Veen, Patricia M L A van den Bemt, Hans Wouters, David W Bates, Jos W R Twisk, Johan J de Gier, Katja Taxis
Objective: To study the association of workarounds with medication administration errors using barcode-assisted medication administration (BCMA), and to determine the frequency and types of workarounds and medication administration errors. Materials and Methods: A prospective observational study in Dutch hospitals using BCMA to administer medication. Direct observation was used to collect data. Primary outcome measure was the proportion of medication administrations with one or more medication administration errors...
August 22, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29023829/application-of-quantitative-pharmacology-approaches-in-bridging-pharmacokinetics-and-pharmacodynamics-of-domagrozumab-from-adult-healthy-subjects-to-pediatric-patients-with-duchenne-muscular-disease
#16
Indranil Bhattacharya, Zorayr Manukyan, Phylinda Chan, Anne Heatherington, Lutz Harnisch
Domagrozumab, a monoclonal antibody that binds to myostatin, is being developed for Duchenne muscular dystrophy (DMD) boys following a first-in-human study in healthy adults. Literature reporting pharmacokinetic parameters of monoclonal antibodies suggested that body-weight- and body-surface-area-adjusted clearance and volume of distribution estimates between adults and children are similar for subjects older than 6 years. Population modeling identified a Michaelis-Menten binding kinetics model to optimally characterize the target mediated drug disposition profile of domagrozumab and identified body mass index on the volume of distribution as the only significant covariate...
October 12, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29019170/drug-delivery-from-an-innovative-lama-laba-co-suspension-delivery-technology-fixed-dose-combination-mdi-evidence-of-consistency-robustness-and-reliability
#17
Amber Doty, Jon Schroeder, Kou Vang, Mark Sommerville, Mervin Taylor, Brad Flynn, David Lechuga-Ballesteros, Peter Mack
To ensure consistency of clinical outcomes, orally inhaled therapies must exhibit consistent delivered dose and aerosol properties at the time of manufacturing, throughout storage, and during various patient-use conditions. Achieving consistency across these scenarios has presented a significant challenge, especially for combination products that contain more than one drug. This study characterized the delivered dose and aerosol properties of glycopyrrolate/formoterol fumarate metered dose inhaler (GFF MDI; Bevespi Aerosphere™)...
October 10, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28994890/errors-in-preparation-and-administration-of-parenteral-drugs-in-neonatology-evaluation-and-corrective-actions
#18
Nesrine Hasni, Emira Ben Hamida, Khouloud Ben Jeddou, Sarra Ben Hamida, Imene Ayadi, Zeineb Ouahchi, Zahra Marrakchi
BACKGROUND: The medication iatrogenic risk is quite unevaluated in neonatology Objective: Assessment of errors that occurred during the preparation and administration of injectable medicines in a neonatal unit in order to implement corrective actions to reduce the occurrence of these errors. METHODS: A prospective, observational study was performed in a neonatal unit over a period of one month. The practice of preparing and administering injectable medications were identified through a standardized data collection form...
December 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28992765/phenotyping-of-cyp-4501a2-activity-by-total-overnight-salivary-caffeine-assessment-tosca-in-patients-on-warfarin-treatment-a-cross-sectional-study
#19
Giovanni Tarantino, Domenico Capone, Paola Contaldi, Adriana Gianno, Mosca Teresa, Antonella Tufano
Warfarin is an oral anticoagulant, commonly used for primary and secondary prevention of venous and arterial thromboembolic events. The drug is characterized by narrow therapeutic index, widespread individual variability in clinical response, and high rates of adverse events, particularly bleeding complications. For these reasons, a close monitoring of the dosage, using the frequent assessment of coagulation status by means of International Normalized Ratio value, is mandatory. Warfarin is metabolized by hepatic cytochrome P-450...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28992587/aberrant-resting-state-cerebellar-blood-flow-in-major-depression
#20
Malte S Depping, Nadine D Wolf, Nenad Vasic, Zrinka Sosic-Vasic, Mike M Schmitgen, Fabio Sambataro, Robert C Wolf
BACKGROUND: Abnormal cortical cerebral blood flow and gray matter volume have been frequently reported in patients with major depressive disorder (MDD). In contrast, although the role of the cerebellum in MDD pathophysiology has attracted considerable interest more recently, studies investigating both functional and structural aspects of cerebellar integrity are scarce. METHODS: In this study, we used structural and functional magnetic resonance imaging (MRI) to investigate cerebellar volume and regional cerebellar blood flow (rCBF) at rest in clinically acute MDD patients (n = 22) and healthy controls (n = 18)...
September 28, 2017: Journal of Affective Disorders
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