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https://www.readbyqxmd.com/read/28544106/inappropriate-prescribing-in-chronic-kidney-disease-a-systematic-review-of-prevalence-associated-clinical-outcomes-and-impact-of-interventions
#1
REVIEW
Wubshet Hailu Tesfaye, Ronald L Castelino, Barbara C Wimmer, Syed Tabish R Zaidi
INTRODUCTION: Adjusting doses of renally cleared medications and/or avoidance of nephrotoxic medications are standard clinical practices in chronic kidney disease (CKD), albeit the prevalence of inappropriate prescribing (IP) in these patients remains high. Therefore, this work sought to systematically review the prevalence of IP and compare the relative effectiveness of available interventions in reducing IP in CKD. METHODS: Studies were identified searching PubMed/Medline, EMBASE, Cochrane Library, IPA, Web of Science, Ovid/Medline, CINAHL, and PsychINFO databases...
May 23, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28541419/acute-toxicity-from-intravenous-use-of-the-tricyclic-antidepressant-tianeptine
#2
Sara K Dempsey, Justin L Poklis, Kacie Sweat, Kirk Cumpston, Carl E Wolf
Tianeptine (7-[([3-chloro-6,11]-dihydro-6-methyldibenzo[c,f][1,2]thiazepin-11-yl) amino] heptanoic acid S, S dioxide) is a tricyclic compound prescribed as an antidepressant in European countries, but is not currently approved for use in the United States. There are few published case reports of tianeptine intoxication. Presented is the first case of acute toxicity associated with the intravenous use of tianeptine. A 36-year-old male intentionally injected tianeptine powder intravenously to "help him see into the future"...
May 24, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28535241/management-of-depression-in-older-adults-a-review
#3
Rob M Kok, Charles F Reynolds
Importance: Depression in older adults is a common psychiatric disorder affecting their health-related quality of life. Major depression occurs in 2% of adults aged 55 years or older, and its prevalence rises with increasing age. In addition, 10% to 15% of older adults have clinically significant depressive symptoms, even in the absence of major depression. Observations: Depression presents with the same symptoms in older adults as it does in younger populations...
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#4
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28495338/adoption-of-medication-alert-systems-in-hospital-outpatient-departments-in-taiwan
#5
Yu-Chun Kuo, Shou-Hsia Cheng
OBJECTIVE: The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. METHODS: A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013...
June 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28490484/developing-a-decision-rule-to-optimise-clinical-pharmacist-resources-for-medication-reconciliation-in-the-emergency-department
#6
Sabrina De Winter, Peter Vanbrabant, Pieter Laeremans, Veerle Foulon, Ludo Willems, Sandra Verelst, Isabel Spriet
BACKGROUND: The process of obtaining a complete medication history for patients admitted to the hospital from the ED at hospital admission, without discrepancies, is error prone and time consuming. OBJECTIVES: The goal of this study was the development of a clinical decision rule (CDR) with a high positive predictive value in detecting ED patients admitted to hospital at risk of at least one discrepancy during regular medication history acquisition, along with favourable feasibility considering time and budget constraints...
May 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28473306/using-a-medical-intranet-of-things-system-to-prevent-bed-falls-in-an-acute-care-hospital-a-pilot-study
#7
Henri U Balaguera, Diana Wise, Chun Yin Ng, Han-Wen Tso, Wan-Lin Chiang, Aimee M Hutchinson, Tracy Galvin, Lee Hilborne, Cathy Hoffman, Chi-Cheng Huang, C Jason Wang
BACKGROUND: Hospitalized patients in the United States experience falls at a rate of 2.6 to 17.1 per 1000 patient-days, with the majority occurring when a patient is moving to, from, and around the bed. Each fall with injury costs an average of US $14,000. OBJECTIVE: The aim was to conduct a technology evaluation, including feasibility, usability, and user experience, of a medical sensor-based Intranet of things (IoT) system in facilitating nursing response to bed exits in an acute care hospital...
May 4, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28453178/seroprevalence-of-hepatitis-e-virus-among-blood-donors-in-qatar-2013-2016
#8
Gheyath K Nasrallah, Enas S Al Absi, Rula Ghandour, Nadima H Ali, Sara Taleb, Laila Hedaya, Fatima Ali, Mariam Huwaidy, Abdullatif Husseini
BACKGROUND: Hepatitis E virus (HEV) is an RNA virus transmitted mainly through zoonotic transmission or fecal-oral route. More than 80% of Qatar's population are expatriates, including many coming from hyperendemic countries; thus, it is important to estimate the seroprevalence and to compare between different nationalities. The results can be useful in alerting blood banks to the importance of HEV screening. STUDY DESIGN AND METHODS: Samples from 5854 blood donations provided by Hamad Medical Corporation were tested in the period between June 2013 to June 2016...
April 28, 2017: Transfusion
https://www.readbyqxmd.com/read/28448781/assessment-of-clinical-pharmacy-interventions-to-reduce-outpatient-use-of-high-risk-medications-in-the-elderly
#9
Sarah C Weddle, A Shaun Rowe, Julie W Jeter, Rachel C Renwick, Shaunta' M Chamberlin, Andrea S Franks
BACKGROUND: Use of high-risk medications in the elderly (HRME) and drug-disease (Rx-DIS) interactions in the elderly, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) Measures, are significantly associated with mortality, hospital admission, and need for emergency care. No published studies to date evaluate interventions to reduce the use of HEDIS-defined HRME, although many studies have postulated a beneficial effect of such interventions. OBJECTIVE: To evaluate the effect of pharmacist interventions on use of HRME and Rx-DIS interactions in the outpatient elderly population...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28422415/impact-of-hospitalization-in-an-acute-geriatric-unit-on-polypharmacy-and-potentially-inappropriate-prescriptions-a-retrospective-study
#10
Marta Gutiérrez-Valencia, Mikel Izquierdo, Vincenzo Malafarina, Javier Alonso-Renedo, Belén González-Glaría, Beatriz Larrayoz-Sola, María Pilar Monforte-Gasque, Pello Latasa-Zamalloa, Nicolás Martínez-Velilla
AIM: Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes. METHODS: A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale...
April 19, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28420352/assessing-the-reliability-of-self-reported-weight-for-the-management-of-heart-failure-application-of-fraud-detection-methods-to-a-randomised-trial-of-telemonitoring
#11
Adam Steventon, Sarwat I Chaudhry, Zhenqiu Lin, Jennifer A Mattera, Harlan M Krumholz
BACKGROUND: Since clinical management of heart failure relies on weights that are self-reported by the patient, errors in reporting will negatively impact the ability of health care professionals to offer timely and effective preventive care. Errors might often result from rounding, or more generally from individual preferences for numbers ending in certain digits, such as 0 or 5. We apply fraud detection methods to assess preferences for numbers ending in these digits in order to inform medical decision making...
April 18, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28409056/establishing-seasonal-and-alert-influenza-thresholds-in-cambodia-using-the-who-method-implications-for-effective-utilization-of-influenza-surveillance-in-the-tropics-and-subtropics
#12
Sovann Ly, Takeshi Arashiro, Vanra Ieng, Reiko Tsuyuoka, Amy Parry, Paul Horwood, Seng Heng, Sarah Hamid, Katelijn Vandemaele, Savuth Chin, Borann Sar, Yuzo Arima
OBJECTIVE: To establish seasonal and alert thresholds and transmission intensity categories for influenza to provide timely triggers for preventive measures or upscaling control measures in Cambodia. METHODS: Using Cambodia's influenza-like illness (ILI) and laboratory-confirmed influenza surveillance data from 2009 to 2015, three parameters were assessed to monitor influenza activity: the proportion of ILI patients among all outpatients, proportion of ILI samples positive for influenza and the product of the two...
January 2017: Western Pacific Surveillance and Response Journal: WPSAR
https://www.readbyqxmd.com/read/28398598/pharmacogenomics-based-point-of-care-clinical-decision-support-significantly-alters-drug-prescribing
#13
Peter H O'Donnell, Nisha Wadhwa, Keith Danahey, Brittany A Borden, Sang Mee Lee, Julianne P Hall, Catherine Klammer, Sheena Hussain, Mark Siegler, Matthew J Sorrentino, Andrew M Davis, Yasmin A Sacro, Rita Nanda, Tamar S Polonsky, Jay L Koyner, Deborah L Burnet, Kristen Lipstreuer, David T Rubin, Cathleen Mulcahy, Mary E Strek, William Harper, Adam S Cifu, Blase Polite, Linda Patrick-Miller, Kiang-Teck J Yeo, Edward K Y Leung, Samuel L Volchenboum, Russ B Altman, Olufunmilayo I Olopade, Walter M Stadler, David O Meltzer, Mark J Ratain
Changes in behavior are necessary to apply genomic discoveries to practice. We prospectively studied medication changes made by providers representing eight different medicine specialty clinics whose patients had submitted to preemptive pharmacogenomic genotyping. An institutional clinical decision support (CDS) system provided pharmacogenomic results using traffic light alerts: green/genomically favorable, yellow/genomic caution, red/high risk. The influence of pharmacogenomic alerts on prescribing behaviors was the primary endpoint...
April 11, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28370904/repeat-prescribing-of-medications-a-system-centred-risk-management-model-for-primary-care-organisations
#14
Julie Price, Shu Ling Man, Stephen Bartlett, Kate Taylor, Mark Dinwoodie, Paul Bowie
RATIONALE, AIMS AND OBJECTIVES: Reducing preventable harm from repeat medication prescriptions is a patient safety priority worldwide. In the United Kingdom, repeat prescriptions items issued has doubled in the last 20 years from 5.8 to 13.3 items per patient per annum. This has significant resource implications and consequences for avoidable patient harms. Consequently, we aimed to test a risk management model to identify, measure, and reduce repeat prescribing system risks in primary care...
March 31, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28368966/intravenous-administration-errors-intercepted-by-smart-infusion-technology-in-an-adult-intensive-care-unit
#15
Rebecca Ibarra-Pérez, Fabiola Puértolas-Balint, Elizabeth Lozano-Cruz, Sergio E Zamora-Gómez, Lucila I Castro-Pastrana
OBJECTIVES: The aim of the study was to investigate the efficacy of intravenous (IV) smart pumps with drug libraries and dose error reduction system (DERS) to intercept programming errors entailing high risk for patients in an adult intensive care unit (ICU). METHODS: A 2-year retrospective study was conducted in the adult ICU of the Hospital Juárez de México in Mexico City to evaluate the impact of IV smart pump/DERS (Hospira MedNet) technology implementation...
April 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28368908/predictors-of-chronic-opioid-use-in-newly-diagnosed-crohn-s-disease
#16
Nathan J Pauly, Lamprinos Michailidis, Michael G Kindred, Deborah Flomenhoft, Michelle R Lofwall, Sharon L Walsh, Jeffery C Talbert, Terrence A Barrett
BACKGROUND AND AIMS: Patients with Crohn's disease (CD) are often prescribed opioids chronically to manage pain associated with their disease. However, little evidence exists to support this practice. Here, we examine newly diagnosed patients with CD with and without chronic opioid use (COU) and sought to identify predictors and consequences of COU. METHODS: A nationally representative administrative health care claims that data set identified newly diagnosed patients with CD...
March 31, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28359011/diagnostic-triage-for-low-back-pain-a-practical-approach-for-primary-care
#17
REVIEW
Lynn D Bardin, Peter King, Chris G Maher
Diagnostic triage is an essential guideline recommendation for low back pain (LBP), which is the most frequent musculoskeletal condition that general practitioners encounter in Australia. Clinical diagnosis of LBP - informed by a focused history and clinical examination - is the key initial step for GPs, and determines subsequent diagnostic workup and allied health and medical specialist referral. The goal of diagnostic triage of LBP is to exclude non-spinal causes and to allocate patients to one of three broad categories: specific spinal pathology (< 1% of cases), radicular syndrome (∼ 5-10% of cases) or non-specific LBP (NSLBP), which represents 90-95% of cases and is diagnosed by exclusion of the first two categories...
April 3, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28358291/feasibility-and-utility-of-an-integrated-medical-imaging-and-informatics-smartphone-system-for-management-of-acute-stroke
#18
Kristina Shkirkova, Eftitan Y Akam, Josephine Huang, Sunil A Sheth, May Nour, Conrad W Liang, Michael McManus, Van Trinh, Gary Duckwiler, Jason Tarpley, Fernando Vinuela, Jeffrey L Saver
Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28355977/three-patients-with-lower-extremity-tumors-referred-through-medical-channels-to-physical-therapists-a-description-of-clinical-reasoning-screening-and-collaborative-practice
#19
Seth Peterson, Thomas Denninger, Scott Porter
Study Design Resident's case problem. Background Although rare in the general population, bone and soft tissue tumors may be more frequently encountered in patients seeking physical therapy because of the propensity to mimic commonly treated musculoskeletal disorders. Screening for tumors requires the physical therapist be attentive to unexpected findings. The purpose of this paper was to describe the clinical reasoning and screening processes of physical therapists that facilitated the timely recognition of bone and soft tumors in 3 patients referred through medical channels...
March 29, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28340389/minilaparotomy-without-general-anesthesia-for-the-treatment-of-sigmoid-volvulus-in-high-risk-patients-a-case-series-of-4-patients
#20
Ernesto L Enrique, Kareem A Hamdy
BACKGROUND: Sigmoid volvulus (SV) is a common cause of large bowel obstruction worldwide. Presenting symptoms can be nonspecific and varied amongst the elderly population, making medical and surgical management challenging. This population is at markedly increase risk of complications and mortality with surgery under general anesthesia. In this case series, we describe 4 cases of sigmoid volvulus in octogenarians. GOALS: To demonstrate that sigmoid colectomy under local anesthesia, with or without intravenous conscious sedation, is feasible and can be done safely and with a low rate of converting to a general anesthetic...
2017: International Journal of Surgery Case Reports
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