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https://www.readbyqxmd.com/read/28339629/orders-on-file-but-no-labs-drawn-investigation-of-machine-and-human-errors-caused-by-an-interface-idiosyncrasy
#1
Richard Schreiber, Dean F Sittig, Joan Ash, Adam Wright
In this report, we describe 2 instances in which expert use of an electronic health record (EHR) system interfaced to an external clinical laboratory information system led to unintended consequences wherein 2 patients failed to have laboratory tests drawn in a timely manner. In both events, user actions combined with the lack of an acknowledgment message describing the order cancellation from the external clinical system were the root causes. In 1 case, rapid, near-simultaneous order entry was the culprit; in the second, astute order management by a clinician, unaware of the lack of proper 2-way interface messaging from the external clinical system, led to the confusion...
February 16, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28332238/outcome-measures-for-adult-and-pediatric-hemophilia-patients-with-inhibitors
#2
REVIEW
Cedric Hermans, Günter Auerswald, Gary Benson, Gerry Dolan, Anne Duffy, Victor Jiménez-Yuste, Rolf Ljung, Massimo Morfini, Thierry Lambert, Mehdi Osooli, Silva Zupančić Šalek
Recent advancements in almost all aspects of hemophilia treatment have vastly improved patient care and management, and new and emerging treatments hold the promise of further progress. However, there remains a scarcity of data on long-term outcomes in hemophilia, particularly among those patients with inhibitors, for whom no validated outcome assessment tools are currently available. At the 15(th) Zürich Haemophilia Forum, an expert panel reviewed the most important outcome measures in inhibitor patients and considered the challenges associated with assessing outcomes in this population...
March 22, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28332132/redefining-the-role-of-biomarkers-in-heart-failure-trials-expert-consensus-document
#3
REVIEW
Frank Kramer, Hani N Sabbah, James J Januzzi, Faiez Zannad, J Peter van Tintelen, Erik B Schelbert, Raymond J Kim, Hendrik Milting, Richardus Vonk, Brien Neudeck, Richard Clark, Klaus Witte, Wilfried Dinh, Burkert Pieske, Javed Butler, Mihai Gheorghiade
Heart failure is a growing cardiovascular disease with significant epidemiological, clinical, and societal implications and represents a high unmet need. Strong efforts are currently underway by academic and industrial researchers to develop novel treatments for heart failure. Biomarkers play an important role in patient selection and monitoring in drug trials and in clinical management. The present review gives an overview of the role of available molecular, imaging, and device-derived digital biomarkers in heart failure drug development and highlights capabilities and limitations of biomarker use in this context...
March 23, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28332032/qualitative-assessment-of-the-symptoms-and-impact-of-pancreatic-exocrine-insufficiency-pei-to-inform-the-development-of-a-patient-reported-outcome-pro-instrument
#4
Colin D Johnson, Rob Arbuckle, Nicola Bonner, Gary Connett, Enrique Dominguez-Munoz, Philippe Levy, Doris Staab, Nicola Williamson, Markus M Lerch
BACKGROUND: Pancreatic exocrine insufficiency (PEI) affects patients with chronic pancreatitis (CP) and cystic fibrosis (CF) who produce insufficient digestive pancreatic enzymes. Common symptoms include steatorrhoea, diarrhea, and abdominal pain. OBJECTIVE: The objective of the study was to develop and test the content validity of a patient-reported outcome (PRO) instrument assessing PEI symptoms and their impact on health-related quality of life. METHODS: Instrument development was supported by a literature review, expert physician interviews (n = 10: Germany 4, UK 3, France 3), and exploratory, qualitative, concept-elicitation interviews with patients with CF and CP with PEI (n = 61: UK 29, Germany 18, France 14) and expert physicians (n = 10)...
March 22, 2017: Patient
https://www.readbyqxmd.com/read/28331840/consensus-statement-on-the-management-of-patients-with-hcv-infection-in-romania
#5
REVIEW
(no author information available yet)
BACKGROUND: HCV direct-acting antivirals (DAAs) have made treatment easier for both patients and healthcare practitioners, but have also brought new challenges in terms of patient management and monitoring prior to, during, and after treatment. METHODS: To sum up and unify the clinical experience of Romanian DAA prescribing physicians, we have organized a Consensus Meeting in November 2016 in Bucharest, Romania. CONSENSUS STATEMENT: The Consensus Meeting has provided expert answers to ten significant questions regarding HCV infection, namely: How do we diagnose patients with HCV infection? How do we stage liver disease in patients with HCV infection? How do we monitor patients with HCV infection prior to treatment? Which patients with HCV infection do we treat? When do we start treatment for HCV infection? What regimens do we use for treating HCV infection? How do we monitor patients with HCV infection during treatment? What adverse events should we expect during treatment of HCV infection and how do we prevent/manage them? How do we monitor patients with HCV infection after treatment? How do we expect the landscape of HCV to change in the following years? ...
March 2017: Germs
https://www.readbyqxmd.com/read/28330818/cardio-onco-hematology-in-clinical-practice-position-paper-and-recommendations
#6
Teresa López-Fernández, Ana Martín García, Ana Santaballa Beltrán, Ángel Montero Luis, Ramón García Sanz, Pilar Mazón Ramos, Sonia Velasco Del Castillo, Esteban López de Sá Areses, Manuel Barreiro-Pérez, Rocío Hinojar Baydes, Leopoldo Pérez de Isla, Silvia Cayetana Valbuena López, Regina Dalmau González-Gallarza, Francisco Calvo-Iglesias, Juan José González Ferrer, Antonio Castro Fernández, Eva González-Caballero, Cristina Mitroi, Meritxell Arenas, Juan Antonio Virizuela Echaburu, Pascual Marco Vera, Andrés Íñiguez Romo, José Luis Zamorano, Juan Carlos Plana Gómez, José Luis López Sendón Henchel
Improvements in early detection and treatment have markedly reduced cancer-related mortality. However survival not only depends on effectively cure cancer, but prevention, diagnosis and treatment of cancer-related complications is also needed. Cardiovascular toxicity is a widespread problem across many classes of therapeutic schemes, however scientific evidence in the management of cardiovascular complications of onco-hematological patients is scarce, as these patients have been systematically excluded from clinical trials and current recommendations are based on expert consensus...
March 18, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28329307/eacvi-appropriateness-criteria-for-the-use-of-transthoracic-echocardiography-in-adults-a-report-of-literature-and-current-practice-review
#7
Richard P Steeds, Madalina Garbi, Nuno Cardim, Jaroslaw D Kasprzak, Elif Sade, Petros Nihoyannopoulos, Bogdan Alexandru Popescu, Alexandros Stefanidis, Bernard Cosyns, Mark Monaghan, Svend Aakhus, Thor Edvardsen, Frank Flachskampf, Leonarda Galiuto, George Athanassopoulos, Patrizio Lancellotti
The European Association for Cardiovascular Imaging (EACVI) has outlined the rationale for setting appropriate use criteria (AUC) in cardiovascular (CV) imaging. Transthoracic echocardiography (TTE) is the most common imaging modality in CV disease and is a central tool in diagnosis, follow-up, management planning and intervention. The purpose of AUC is to inform referrers, both to avoid under-use, which may result in incomplete or incorrect diagnosis and treatment, and also over-use, which may delay correct diagnosis, lead to 'treatment cascade', and wastes resources...
February 25, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28328942/the-value-of-theory-in-programmes-to-implement-clinical-guidelines-insights-from-a-retrospective-mixed-methods-evaluation-of-a-programme-to-increase-adherence-to-national-guidelines-for-chronic-disease-in-primary-care
#8
Jessica Sheringham, Francesca Solmi, Cono Ariti, Abigail Baim-Lance, Steve Morris, Naomi J Fulop
BACKGROUND: Programmes have had limited success in improving guideline adherence for chronic disease. Use of theory is recommended but is often absent in programmes conducted in 'real-world' rather than research settings. MATERIALS AND METHODS: This mixed-methods study tested a retrospective theory-based approach to evaluate a 'real-world' programme in primary care to improve adherence to national guidelines for chronic obstructive pulmonary disease (COPD). Qualitative data, comprising analysis of documents generated throughout the programme (n>300), in-depth interviews with planners (clinicians, managers and improvement experts involved in devising, planning, and implementing the programme, n = 14) and providers (practice clinicians, n = 14) were used to construct programme theories, experiences of implementation and contextual factors influencing care...
2017: PloS One
https://www.readbyqxmd.com/read/28328734/practical-recommendations-for-long-term-management-of-modifiable-risks-in-kidney-and-liver-transplant-recipients-a-guidance-report-and-clinical-checklist-by-the-consensus-on-managing-modifiable-risk-in-transplantation-commit-group
#9
James M Neuberger, Wolf O Bechstein, Dirk R J Kuypers, Patrizia Burra, Franco Citterio, Sabina De Geest, Christophe Duvoux, Alan G Jardine, Nassim Kamar, Bernhard K Krämer, Herold J Metselaar, Frederik Nevens, Jacques Pirenne, Manuel L Rodríguez-Perálvarez, Didier Samuel, Stefan Schneeberger, Daniel Serón, Pavel Trunečka, Giuseppe Tisone, Teun van Gelder
Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes...
April 2017: Transplantation
https://www.readbyqxmd.com/read/28328094/asthma-management-a-new-phenotype-based-approach-using-presence-of-eosinophilia-and-allergy
#10
REVIEW
Milan Terl, Vratislav Sedlák, Petr Cap, Renata Dvořáková, Viktor Kašák, Tomáš Kočí, Bronislava Novotna, Ester Seberova, Petr Panzner, Vladimir Zindr
Asthma is a heterogeneous disease. The Czech Pneumology and Allergology Societies commissioned 10 experts to review the literature and create joint national guidelines for managing asthma, reflecting this heterogeneity. The aim was to develop an easy-to-use diagnostic strategy as a rational approach to the widening opportunities for the use of phenotype-targeted therapy. The guidelines were presented on websites for public comments by members of both the societies. The reviewers' comments contributed to creating the final version of the guidelines...
March 22, 2017: Allergy
https://www.readbyqxmd.com/read/28328015/pcsk9-inhibitor-access-barriers-issues-and-recommendations-improving-the-access-process-for-patients-clinicians-and-payers
#11
REVIEW
Seth J Baum, Peter P Toth, James A Underberg, Paul Jellinger, Joyce Ross, Katherine Wilemon
The proprotein convertase subtilisin/kexin type 9 inhibitors or monoclonal antibodies likely represent the greatest advance in lipid management in 30 years. In 2015 the US Food and Drug Administration approved both alirocumab and evolocumab for high-risk patients with familial hypercholesterolemia (FH) and clinical atherosclerotic cardiovascular disease requiring additional lowering of low-density lipoprotein cholesterol. Though many lipid specialists, cardiovascular disease prevention experts, endocrinologists, and others prescribed the drugs on label, they found their directives denied 80% to 90% of the time...
March 22, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28327572/the-role-of-genetic-counsellors-in-genomic-healthcare-in-the-united-kingdom-a-statement-by-the-association-of-genetic-nurses-and-counsellors
#12
Anna Middleton, Peter Marks, Anita Bruce, Liwsi K Protheroe-Davies, Cath King, Oonagh Claber, Catherine Houghton, Claire Giffney, Rhona Macleod, Claire Dolling, Sue Kenwrick, Diana Scotcher, Georgina Hall, Christine Patch, Laura Boyes
In the United Kingdom, genetic counsellors work together with clinical geneticists and clinical scientist colleagues within specialist genetics services, but they also often work in multidisciplinary teams (MDTs) outside of such services. There, they contribute genetic knowledge together with expert understanding of how to communicate genetic information effectively. They can offer education and support to the MDT, while providing management advice for both affected patients and the extended at-risk family members...
March 22, 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/28327493/noninvasive-ventilation-open-issues-for-nursing-research
#13
Stefano Bambi, Enrica Mati, Christian De Felippis, Alberto Lucchini
According to the current literature, Noninvasive Ventilation (NIV) is a well-recognized respiratory support technique for patients affected by Acute Respiratory Failure (ARF). As highlighted by recent meta-analysis, a tight adherence to protocols regarding patients' selection criteria, relative or absolute contraindications, plus highly skilled and experienced operators, can positively affect the NIV performance and mortality rates. Positive outcome from NIV respiratory support is dependent from: patient's clinical condition and education needs; confidence of the staff with NIV technology; choice and management of the most suitable interface available prevention of interface complications; nutritional assessment (artificial feeding if required) and conditioning of medical gas...
March 14, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28325997/a-comprehensive-approach-in-high-grade-glioma-management-position-statement-from-the-neuro-oncology-scientific-club-nosc-shiraz-iran
#14
REVIEW
Mansour Ansari, Ahmad Mosalaei, Niloufar Ahmadloo, Alireza Rasekhi, Bita Geramizadeh, Ali Razmkon, Kazem Anvari, Mohammad Afarid, Ali Dadras, Leila Nafarieh, Mohammad Mohammadianpanah, Hamid Nasrolahi, Seyed Hasan Hamedi, Shapour Omidvari, Mohammad Nami
Establishing a robust teamwork model in the practice of neuro-oncology requires continued interdisciplinary efforts. The Neuro-Oncology Scientific Club (NOSC) initiative is an interdisciplinary clinical forum promoting the comprehensive approach across involved disciplines in the management of central nervous system (CNS) malignancies. With its provincial founding panels and national steering board, NOSC has been operational in Iran since 2011. This initiative has pursued its mission through interval strategic meetings, tumor boards, case discussions as well as publishing neuro-oncology updates, case study periodicals, and newsletters...
2017: German Medical Science: GMS E-journal
https://www.readbyqxmd.com/read/28325090/using-stents-in-the-management-of-malignant-bowel-obstruction-the-current-situation-and-future-progress
#15
Alessandro Fugazza, Piera Alessia Galtieri, Alessandro Repici
The use of self-expanding metal stents (SEMS) has been considered an effective and safe alternative to emergency surgery as bridge to surgery or for palliation in advanced colorectal cancer even though more recent data have raised concerns on both early and long-term outcomes when patients are treated with bridge to surgery indications. Areas covered: A comprehensive literature review of articles on endoscopic management of malignant bowel obstruction was performed. Indication, technique, outcomes, benefits and risks of these treatments in acute malignant colonic obstruction were reviewed...
March 24, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28323194/international-experts-practice-in-the-antibiotic-therapy-of-infective-endocarditis-is-not-following-the-guidelines
#16
H Tissot-Dupont, J P Casalta, F Gouriet, S Hubert, E Salaun, G Habib, M P Fernandez-Gerlinger, J L Mainardi, P Tattevin, M Revest, F Lucht, E Botelho-Nevers, A Gagneux-Brunon, U Snygg-Martin, K L Chan, J Bishara, I Vilacosta, C Olmos, J A San Román, J López, P Tornos, N Fernández-Hidalgo, E Durante-Mangoni, R Utili, M Paul, L M Baddour, D C De Simone, M R Sohail, J M Steckelberg, W R Wilson, D Raoult
OBJECTIVE: The management of infective endocarditis (IE) may differ from international guidelines, even in reference centers. This is probably due to the fact that most recommendations are not based on hard evidence, so that the consensus obtained for the guidelines does not represent actual practices. For this reason, we aimed at evaluating this question in the particular field of antibiotic therapy. METHODS: Thirteen international centers specialized in the management of IE were selected, according to their reputation, clinical results, original research publications and quotations...
March 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28322592/intravascular-pulmonary-venous-ultrasound-imaging-for-catheter-ablation-of-atrial-fibrillation
#17
Gabriel Cismaru, Serban Schiau, Lucian Muresan, Radu Rosu, Mihai Puiu, Dana Pop, Dumitru Zdrenghea
Atrial fibrillation is the most common cardiac arrhythmia. The development of electroanatomical mapping is an increase demand for advanced intracardiac imaging techniques of the left atrium and pulmonary veins. IVUS can demonstrate quantitative changes like lumen and wall thickness as well as qualitative changes of the pulmonary or coronary arteries wall. IVUS could also provide relevant real time imaging of the atrial and pulmonary venous wall during catheter ablation. Areas covered: The Medline and Embase databases were searched for preclinical and clinical studies of IVUS in patients with ablation of atrial fibrillation or left atrial arrhythmias...
March 21, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28321193/early-psychosis-and-trauma-related-disorders-clinical-practice-guidelines-and-future-directions
#18
Casey A Cragin, Martha B Straus, Dawn Blacker, Laura M Tully, Tara A Niendam
Despite high rates of trauma-related disorders among individuals with early psychosis, no clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders exist to date. Indeed, the routine exclusion of individuals with past and current psychosis from participation in trauma research and practice has limited the accumulation of research that could support such clinical practice guidelines. While preliminary research evidence suggests that traditional, evidence-based treatments for trauma-related disorders can be safely and effectively employed to reduce symptoms of posttraumatic stress and chronic psychosis, it remains unclear whether such treatments are appropriate for individuals in the early stages of psychotic illness...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#19
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319427/new-horizons-in-the-imaging-of-perianal-crohn-s-disease-transperineal-ultrasonography
#20
Cristina Bezzio, Robert V Bryant, Gianpiero Manes, Giovanni Maconi, Simone Saibeni
Perianal disease, most commonly manifest as fistula or abscess formation, affects up to 40% of patients with Crohn's disease. Perianal Crohn's disease is disabling, associated with poor outcomes, and represents a therapeutic challenge for physicians. Correct diagnosis and classification of perianal disease is the first crucial step for appropriate multidisciplinary management. Areas covered: A literature search was performed of the PubMed database using the terms "transperineal ultrasonography", "transperineal ultrasound", "perianal disease", "perianal fistula", "perianal abscess", "magnetic resonance", "endoanal ultrasonography", "endoscopic ultrasound" in combination with "Crohn's disease"...
March 20, 2017: Expert Review of Gastroenterology & Hepatology
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