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High alert medication

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https://www.readbyqxmd.com/read/29783230/comprehensive-patterns-of-comorbidity-copd-and-depression-aspects-of-treatment
#1
Natalia V Moisieieva, Liliya V Burya, Anna A Kapustianskaya, Iryna A Kolenko, Maria A Rumyantseva, Oleksii H Shumeiko
OBJECTIVE: Introduction: Data on the prevalence of psychopathological disorders in the exacerbation of chronic obstructive pulmonary disease (COPD) are very heterogeneous. COPD and depression have common predisposing factors. The aim: The aim of the research is to conduct a comprehensive assessment of the effect of paroxetine on the level of depressive disorders in the exacerbation of severe degree COPD in women. PATIENTS AND METHODS: Materials and methods: The study included patients with severe degree COPD and depressive disorder...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29782290/-the-notion-of-chf-course-stability-is-it-acceptable-for-russian-practice
#2
I V Fomin, N Kraiem, D S Polyakov, N G Vinogradova, F Y Valikulova, A R Vaysberg, E V Shechrbinina
AIM: To evaluate preparedness of physicians in real clinical practice to strive for stabilizing the course of CHF by control of clinical and hemodynamic indexes both in prevention of admission for decompensated CHF and following discharge from the hospital. MATERIALS AND METHODS: The study included 750 CHF patients with any NYHA FC who were admitted in emergency for decompensated CHF. All patients with CHF were followed up for a year after discharge from the hospital...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#3
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29747709/polimedication-applicability-of-a-computer-tool-to-reduce-polypharmacy-in-nursing-homes
#4
Tomás M García-Caballero, Juan Lojo, Carlos Menéndez, Roberto Fernández-Álvarez, Raimundo Mateos, Alejandro Garcia-Caballero
ABSTRACTBackground:The risks of polypharmacy can be far greater than the benefits, especially in the elderly. Comorbidity makes polypharmacy very prevalent in this population; thus, increasing the occurrence of adverse effects. To solve this problem, the most common strategy is to use lists of potentially inappropriate medications. However, this strategy is time consuming. METHODS: In order to minimize the expenditure of time, our group devised a pilot computer tool (Polimedication) that automatically processes lists of medication providing the corresponding Screening Tool of Older Persons' potentially inappropriate Prescriptions alerts and facilitating standardized reports...
May 11, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29741633/wide-variation-and-patterns-of-physicians-responses-to-drug-drug-interaction-alerts
#5
Insook Cho, Yura Lee, Jae-Ho Lee, David W Bates
Objectives: Providing physicians with alerts about potentially harmful drug-drug interactions (DDIs) is only moderately effective due to high alert override rates. To understand high override behavior on DDI alerts, we investigated how physicians respond to DDIs and their behavior patterns and variations. Design: Retrospective system log data analysis and records review (sampling 2% of total overrides). Setting: A large tertiary academic hospital...
May 8, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29737468/potential-drug-drug-interactions-in-a-cohort-of-elderly-polymedicated-primary-care-patients-on-antithrombotic-treatment
#6
Katharina Luise Schneider, Kathrin Kastenmüller, Klaus Weckbecker, Markus Bleckwenn, Miriam Böhme, Julia Carolin Stingl
INTRODUCTION: Drug-drug interactions (DDIs) are an important risk factor for adverse drug reactions. Older, polymedicated patients are particularly affected. Although antithrombotics have been detected as high-risk drugs for DDIs, data on older patients exposed to them are scarce. METHODS: Baseline data of 365 IDrug study outpatients (≥ 60 years, use of an antithrombotic and one or more additional long-term drug) were analyzed regarding potential drug-drug interactions (pDDIs) with a clinical decision support system...
May 8, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29720614/quantitation-of-the-cellular-content-of-saliva-and-buccal-swab-samples
#7
Christiane Theda, Seo Hye Hwang, Anna Czajko, Yuk Jing Loke, Pamela Leong, Jeffrey M Craig
Buccal swabs and saliva are the two most common oral sampling methods used for medical research. Often, these samples are used interchangeably, despite previous evidence that both contain buccal cells and blood leukocytes in different proportions. For some research, such as epigenetic studies, the cell types contributing to the analysis are highly relevant. We collected such samples from twelve children and twenty adults and, using Papanicolaou staining, measured the proportions of epithelial cells and leukocytes through microscopy...
May 2, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29720051/analysis-of-rothman-index-data-to-predict-postdischarge-adverse-events-in-a-medical-intensive-care-unit
#8
Deepa Bangalore Gotur, Faisal Masud, Jaya Paranilam, Janice L Zimmerman
OBJECTIVE: Currently, there are no objective metrics included in the intensive care unit (ICU) discharge decision making process. In this study, we evaluate Rothman Index(RI) data for a possible metric as part of a quality improvement project. Our objectives were to determine whether RI could predict adverse events occurring within 72 hours of ICU discharge decision, the optimal clinical cutoff value for this metric, and to determine whether there is a relation between the RI warning alert 24 hours prior to discharge and adverse events postdischarge...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29719336/study-of-proliferating-cell-nuclear-antigen-expression-and-angiogenesis-in-urothelial-neoplasms-correlation-with-tumor-grade-and-stage
#9
Poojan Agarwal, Achin Kumar Sen, Minakshi Bhardwaj, Veronique Dinand, Arvind Ahuja, Rajeev Sood
Background: Urinary bladder carcinoma ranks ninth in worldwide cancer incidence. About 74,000 new cases were diagnosed in 2015 alone and 16,000 persons died of the disease. Since histopathology is considered gold standard for diagnosis, it is prudent to look for potential tumor proliferation and predictive markers in such a prevalent malignancy so as to alert surgical and medical oncologists for timely intervention and provide better patient-tailored therapy. Aims: This study is to analyze the role of potential biomarkers-proliferating cell nuclear antigen (PCNA) and angiogenesis using CD31 in urothelial neoplasms in relation to tumor grade and stage...
April 2018: Urology Annals
https://www.readbyqxmd.com/read/29716912/effect-of-dynamic-light-application-on-cognitive-performance-and-well-being-of-intensive-care-nurses
#10
EDITORIAL
Koen S Simons, Enzio R K Boeijen, Marlies C Mertens, Paul Rood, Cornelis P C de Jager, Mark van den Boogaard
BACKGROUND: Exposure to bright light has alerting effects. In nurses, alertness may be decreased because of shift work and high work pressure, potentially reducing work performance and increasing the risk for medical errors. OBJECTIVES: To determine whether high-intensity dynamic light improves cognitive performance, self-reported depressive signs and symptoms, fatigue, alertness, and well-being in intensive care unit nurses. METHODS: In a single-center crossover study in an intensive care unit of a teaching hospital in the Netherlands, 10 registered nurses were randomly divided into 2 groups...
May 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29703486/updated-clinical-models-for-vte-prediction-in-hospitalized-medical-patients
#11
Grigoris T Gerotziafas, Loula Papageorgiou, Stella Salta, Katerina Nikolopoulou, Ismail Elalamy
Venous thromboembolism (VTE) occurring in hospitalized medical patients is associated with increased length of hospitalization, high rate of acute care hospital transfer, longer inpatient rehabilitation and multiplication of health-care costs. Identification of acutely ill hospitalized medical patients eligible for thromboprophylaxis is a sophisticated process. Global VTE risk stems from the combination of predictors related with the acute medical illness, comorbidities, associated treatments and patients' intrinsic risk factors...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29700011/an-investigation-of-drug-drug-interaction-alert-overrides-at-a-pediatric-hospital
#12
Kate Humphrey, Maria Jorina, Marvin Harper, Brenda Dodson, Seung-Yeon Kim, Al Ozonoff
OBJECTIVES: Drug-drug interactions (DDIs) can result in patient harm. DDI alerts are intended to help prevent harm; when the majority of alerts presented to providers are being overridden, their value is diminished. Our objective was to evaluate the overall rates of DDI alert overrides and how rates varied by specialty, clinician type, and patient complexity. METHODS: A retrospective study of DDI alert overrides that occurred during 2012 and 2013 within the inpatient setting described at the medication-, hospital-, provider-, and patient encounter-specific levels was performed at an urban, quaternary-care, pediatric hospital...
May 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29695013/determining-inappropriate-medication-alerts-from-inaccurate-warning-overrides-in-the-intensive-care-unit
#13
Christine A Rehr, Adrian Wong, Diane L Seger, David W Bates
OBJECTIVE:  This article aims to understand provider behavior around the use of the override reason "Inaccurate warning," specifically whether it is an effective way of identifying unhelpful medication alerts. MATERIALS AND METHODS:  We analyzed alert overrides that occurred in the intensive care units (ICUs) of a major academic medical center between June and November 2016, focused on the following high-significance alert types: dose, drug-allergy alerts, and drug-drug interactions (DDI)...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29694456/a-matter-of-urgency-reducing-clinical-text-message-interruptions-during-educational-sessions
#14
Arielle Mendel, Anthony Lott, Lisha Lo, Robert Wu
BACKGROUND: Text messaging is increasingly replacing paging as a tool to reach physicians on medical wards. However, this phenomenon has resulted in high volumes of nonurgent messages that can disrupt the learning climate. OBJECTIVE: Our objective was to reduce nonurgent educational interruptions to residents on general internal medicine. DESIGN, SETTING, PATIENTS: This was a quality improvement project conducted at an academic hospital network...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29692307/seizures-as-a-complication-of-congenital-zika-syndrome-in-early-infancy
#15
Jamary Oliveira-Filho, Ridalva Felzemburgh, Federico Costa, Nivison Nery, Adriana Mattos, Daniele F Henriques, Albert I Ko, For The Salvador Zika Response Team
Zika virus transmission in Brazil was linked to a large outbreak of microcephaly but less is known about longer term anthropometric and neurological outcomes. We studied a cohort of infants born between October 31, 2015, and January 9, 2016, in a state maternity hospital, followed up for 101 ± 28 days by home visits. Microcephaly (< 2 standard deviations, Intergrowth standard) occurred in 62 of 412 (15%) births. Congenital Zika syndrome (CZS) was diagnosed in 29 patients. Among CZS patients, we observed a significant gain in anthropometric measures ( P < 0...
April 23, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29672136/which-patients-in-the-emergency-department-should-receive-preexposure-prophylaxis-implementation-of-a-predictive-analytics-approach
#16
Jessica P Ridgway, Ellen A Almirol, Alvie Bender, Andrew Richardson, Jessica Schmitt, Eleanor Friedman, Nicola Lancki, Ivan Leroux, Nina Pieroni, Jessica Dehlin, John A Schneider
Emergency Departments (EDs) have the potential to play a crucial role in HIV prevention by identifying and linking high-risk HIV-negative clients to preexposure prophylaxis (PrEP) care, but it is difficult to perform HIV risk assessment for all ED patients. We aimed to develop and implement an electronic risk score to identify ED patients who are potential candidates for PrEP. Using electronic medical record (EMR) data, we used logistic regression to model the outcome of PrEP eligibility. We converted the model into an electronic risk score and incorporated it into the EMR...
April 19, 2018: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29670763/evaluation-of-cognitive-load-and-emotional-states-during-multidisciplinary-critical-care-simulation-sessions
#17
Swapnil Pawar, Theresa Jacques, Kush Deshpande, Raju Pusapati, Michael J Meguerdichian
Background: The simulation in critical care setting involves a heterogeneous group of participants with varied background and experience. Measuring the impacts of simulation on emotional state and cognitive load in this setting is not often performed. The feasibility of such measurement in the critical care setting needs further exploration. Methods: Medical and nursing staff with varying levels of experience from a tertiary intensive care unit participated in a standardised clinical simulation scenario...
April 2018: BMJ simulation & technology enhanced learning
https://www.readbyqxmd.com/read/29656665/prevalence-and-correlates-of-prescription-stimulant-use-misuse-use-disorders-and-motivations-for-misuse-among-adults-in-the-united-states
#18
Wilson M Compton, Beth Han, Carlos Blanco, Kimberly Johnson, Christopher M Jones
OBJECTIVE: The authors sought to simultaneously examine the prevalence and correlates of prescription stimulant use, misuse, use disorders, and motivations for misuse in the U.S. adult population. METHOD: This was a nationally representative household population study of adults age 18 or older from the 2015 and 2016 National Surveys on Drug Use and Health (N=102,000). Measurements included prescription stimulant use, use without misuse, misuse without use disorders, and misuse with use disorders, as well as sociodemographic characteristics, health conditions, and mental health factors...
April 16, 2018: American Journal of Psychiatry
https://www.readbyqxmd.com/read/29650603/top-studies-relevant-to-primary-care-practice
#19
REVIEW
Danielle Perry, Michael R Kolber, Christina Korownyk, Adrienne J Lindblad, Jamil Ramji, Joey Ton, G Michael Allan
OBJECTIVE: To summarize 10 high-quality studies from 2017 that have strong relevance to primary care practice. QUALITY OF EVIDENCE: Study selection involved routine literature surveillance by a group of primary care health professionals. This included screening abstracts of important journals and Evidence Alerts, as well as searching the American College of Physicians Journal Club. MAIN MESSAGE: Topics of the 2017 articles include whether treating subclinical hypothyroidism improves outcomes or symptoms; whether evolocumab reduces cardiovascular disease as well as low-density lipoprotein levels; whether lifestyle interventions reduce medication use in patients with diabetes; whether vitamin D prevents cardiovascular disease, cancer, or upper respiratory tract infections; whether canagliflozin reduces clinical events in patients with diabetes; how corticosteroid injections affect knee osteoarthritis; whether drained abscesses benefit from antibiotic treatment; whether patients with diabetes benefit from bariatric surgery; whether exenatide reduces clinical events in patients with diabetes; and whether tympanostomy tubes affect outcomes in recurrent acute otitis media or chronic otitis media...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29622668/utility-of-electronic-medical-record-alerts-to-prevent-drug-nephrotoxicity
#20
Melissa Martin, F Perry Wilson
Nephrotoxin-induced AKI is an iatrogenic form of AKI that can be potentially avoided or ameliorated by prompt recognition and appropriate prescriber actions. Drug-targeted alerts, either for patients at risk of AKI or patients with existing AKI, may lead to more appropriate drug dosing and management and improved clinical outcomes. However, alerts of this type are complicated to create, have a high potential for error and off-target effects, and may be difficult to evaluate. Although many studies have shown that these alerts can reduce the rate of inappropriate prescribing, few studies have examined the utility of such alerts in terms of patient benefit...
April 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
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