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https://www.readbyqxmd.com/read/28930773/a-case-of-opioid-overdose-and-subsequent-death-after-medically-supervised-withdrawal-the-problematic-role-of-rapid-tapers-for-opioid-use-disorder
#1
Derek C Chang, Jan Klimas, Evan Wood, Nadia Fairbairn
BACKGROUND: Relapse to opioid use is common after rapid opioid withdrawal. As a result, short-term tapers of opioid agonist/partial agonist medications, such as methadone and buprenorphine/naloxone, are no longer recommended by recent clinical care guidelines for the management of opioid use disorder. Nonetheless, rapid tapers are still commonplace in medically supervised withdrawal settings. CASE SUMMARY: We report a case of an individual with opioid use disorder who was prescribed a rapid buprenorphine/naloxone taper in a medically supervised withdrawal facility and who had a subsequent opioid overdose and death after discharge...
September 19, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28926146/nurses-clinical-reasoning-practices-that-support-safe-medication-administration-an-integrative-review-of-the-literature
#2
REVIEW
Emily Rohde, Elizabeth Domm
AIM AND OBJECTIVES: To review current literature about nurses' clinical reasoning practices that support safe medication administration. BACKGROUND: The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As health care professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration...
September 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#3
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28925663/top-poems-of-2016-consistent-with-the-principles-of-the-choosing-wisely-campaign
#4
Roland Grad, Mark H Ebell
A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies consistent with the principles of Choosing Wisely. In 2016, we analyzed an average of 1,382 questionnaires on 265 unique POEMs delivered to physician members of the Canadian Medical Association. From these questionnaires, we identified the POEMs ranking highest on one questionnaire item directly linked to reducing overdiagnosis or overtreatment...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28925569/prescribing-errors-intercepted-by-pharmacist-intervention-in-care-of-patients-hospitalised-with-breast-and-gynaecological-cancer-at-a-brazilian-teaching-hospital
#5
A C Ferracini, A T Rodrigues, A A de Barros, S F Derchain, P G Mazzola
Oncologic inpatients often require multiple drug therapy. They may be at higher risk of experiencing prescribing errors, which pharmacist interventions may help to avoid. This study aimed to evaluate the types of prescribing errors, pharmaceutical interventions and differences in clinical significance, in prescriptions for hospitalised patients with breast and gynaecological cancer. A cross-sectional, prospective study was conducted at the oncology ward of a clinic specialised in breast and gynaecology cancer...
September 19, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28924442/laser-induced-choroidal-neovascularizations-clinical-study-of-3-cases
#6
Wipada Laovirojjanakul, Thuss Sanguansak, Yosanan Yospaiboon, Supat Sinawat, Suthasinee Sinawat
BACKGROUND: We report 3 patients with laser-induced choroidal neovascularization (CNV). METHOD: Retrospective, observational case series. Medical charts and photographs were reviewed. RESULTS: Two patients with central serous chorioretinopathy who developed iatrogenic CNV after focal laser photocoagulation were treated with intravitreal ranibizumab injections. One patient with CNV secondary to thermal laser photocoagulation for diabetic macular edema was treated with photodynamic therapy (PDT)...
May 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28923820/family-medicine-in-ethiopia-lessons-from-a-global-collaboration
#7
Ann Evensen, Dawit Wondimagegn, Daniel Zemenfes Ashebir, Katherine Rouleau, Cynthia Haq, Abbas Ghavam-Rassoul, Praseedha Janakiram, Elizabeth Kvach, Heidi Busse, James Conniff, Brian Cornelson
BACKGROUND: Building the capacity of local health systems to provide high-quality, self-sustaining medical education and health care is the central purpose for many global health partnerships (GHPs). Since 2001, our global partner consortium collaborated to establish Family Medicine in Ethiopia; the first Ethiopian family physicians graduated in February 2016. METHODS: The authors, representing the primary Ethiopian, Canadian, and American partners in the GHP, identified obstacles, accomplishments, opportunities, errors, and observations from the years preceding residency launch and the first 3 years of the residency...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28919724/development-of-a-core-outcome-set-for-medication-review-in-older-patients-with-multimorbidity-and-polypharmacy-a-study-protocol
#8
Jean-Baptiste Beuscart, Olivia Dalleur, Benoit Boland, Stefanie Thevelin, Wilma Knol, Shane Cullinan, Claudio Schneider, Denis O'Mahony, Nicolas Rodondi, Anne Spinewine
BACKGROUND: Medication review has been advocated to address the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. Heterogeneity of outcomes reported in clinical trials can hinder the comparison of clinical trial findings in systematic reviews. Moreover, the outcomes that matter most to older patients might be under-reported or disregarded altogether. A core outcome set can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials in any particular field of research...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28919719/an-upper-and-lower-bound-of-the-medication-possession-ratio
#9
Christian M Sperber, Suren R Samarasinghe, Grace P Lomax
BACKGROUND: The Medication Possession Ratio (MPR) is a ubiquitous and central measurement for adherence in the health care industry. However, attempts to standardize its calculation have failed, possibly due to the opacity of a single, static MPR, incapability of directly lending itself to a variety of studies, and challenges of comparing the value across studies. This work shows that the MPR strictly depends on the length of the time interval over which it is measured as well as on the dominant dispense quantity for short time intervals...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28916935/risk-stratification-model-lower-extremity-ultrasonography-for-hospitalized-patients-with-suspected-deep-vein-thrombosis
#10
Emily C Alper, Ivan K Ip, Patricia Balthazar, Gregory Piazza, Samuel Z Goldhaber, Carol B Benson, Ronilda Lacson, Ramin Khorasani
BACKGROUND: The Wells score for deep venous thrombosis (DVT) has a high failure rate and low efficiency among inpatients. OBJECTIVE: To create and validate an inpatient-specific risk stratification model to help assess pre-test probability of DVT in hospitalized patients. DESIGN: Prospective cohort study of hospitalized patients undergoing lower-extremity ultrasonography studies (LEUS) for suspected DVT. Demographics, physical findings, medical history, medications, hospitalization, and laboratory and imaging results were collected...
September 15, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28913745/management-of-type-1-diabetes-in-the-hospital-setting
#11
REVIEW
Carlos E Mendez, Guillermo E Umpierrez
PURPOSE OF REVIEW: The purpose of this article was to review recent guideline recommendations on glycemic target, glucose monitoring, and therapeutic strategies, while providing practical recommendations for the management of medical and surgical patients with type 1 diabetes (T1D) admitted to critical and non-critical care settings. RECENT FINDINGS: Studies evaluating safety and efficacy of insulin pump therapy, continuous glucose monitoring, electronic glucose management systems, and closed loop systems for the inpatient management of hyperglycemia are described...
September 14, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28911938/-families-experiences-and-satisfaction-with-a-pediatric-emergency-service
#12
S Perret, M Gehri, J Pluies, I Rossi, C Akre
OBJECTIVE: Today, pediatric emergency services receive a rising number of "non-urgent" cases, which are due to parental anxiety or a miscomprehension of medical explanations. The aim of this study was therefore to understand what those families experience and need when they consult in such cases, in order to respond with adapted solutions. METHODS: Semi-structured interviews and questionnaires with parents, after the consultation or in the waiting room. RESULTS: Based on the families' narratives, we present the results in six steps, which correspond to the steps they experience from the decision to go to the hospital to the consultation...
September 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28911828/laparoscopic-sentinel-lymph-node-mapping-with-indocyanine-green-icg-using-ispies-platform-the-initial-experience-in-argentina
#13
Julian Di Guilmi, Maria Cecilia Darin, Maria Toscano, Gustavo Maya
OBJECTIVE: To demonstrate the initial experience in Argentina using the iSpies ICG platform in performing sentinel lymph node mapping in early-stage cervical cancer. Design Step-by-step video and pictures BACKGROUND: Laparoscopic and robotic sentinel lymph node mapping using ICG has been shown to be safe and feasible. However, the use of fluorescent imaging through a minimally invasive approach in developing countries is very limited given the cost restrictions of acquiring the near infrared technology and the fluorescent dyes...
September 11, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28906313/two-innovative-cancer-care-programs-have-potential-to-reduce-utilization-and-spending
#14
Erin M Colligan, Erin Ewald, Nancy L Keating, Shriram Parashuram, Michelle Spafford, Sarah Ruiz, Adil Moiduddin
BACKGROUND: Cancer patients often present to the emergency department (ED) and hospital for symptom management, but many of these visits are avoidable and costly. OBJECTIVE: We assessed the impact of 2 Health Care Innovation Awards that used an oncology medical home model [Community Oncology Medical Home (COME HOME)] or patient navigation model [Patient Care Connect Program (PCCP)] on utilization and spending. METHODS: Participants in COME HOME and PCCP models were matched to similar comparators using propensity scores...
October 2017: Medical Care
https://www.readbyqxmd.com/read/28904542/claims-about-medical-malpractices-resulting-in-maternal-and-perinatal-mortality-referred-to-iranian-legal-medicine-organization-during-2011-2012
#15
Ziba Taghizadeh, Maryam Pourbakhtiar, Masoud Ghadipasha, Kamran Soltani, Khadijeh Azimi
BACKGROUND: Obstetricians, gynecologists, and midwives are the most common specialists of the medical sciences group against whom medical malpractices are claimed, many of which are avoidable and preventable. Therefore, the present study was conducted to investigate the causes of claims regarding medical malpractices resulting in maternal and perinatal mortality. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted and 7616 claims of medical malpractices in the field of obstetrics, gynecology, and midwifery that were referred from all 31 provinces to the central commission of legal medicine were studied during 2011-2012...
July 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28903737/experiences-with-out-patient-hospital-service-utilisation-among-older-persons-in-the-asante-akyem-north-district-ghana
#16
Jonathan Bayuo
BACKGROUND: Though ageing is not a disease, it has been associated with the occurrence of conditions which require health service utilisation. Ghana's population is characterised by a steady growth in the number of older adults and previous studies have noted limited levels regarding utilisation by older persons. METHODS: Thus, this study utilised a qualitative approach to explore older persons' experiences regarding out-patient hospital service utilisation in the Asante Akyem North District of Ghana...
September 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28899714/qualitative-evaluation-of-a-narrative-reflection-program-to-help-medical-trainees-recognize-and-avoid-overuse-am-i-doing-what-s-right-for-the-patient
#17
Tanner Caverly, Daniel Matlock, Jocelyn Thompson, Brandon Combs
OBJECTIVE: The Do No Harm Project is a novel reflective writing program that encourages medical trainees to reflect on and write up clinical narratives about instances of avoidable medical overuse. Our goal is to describe this program and to explore the effect of the program on those participating. METHODS: Semi-structured interviews were conducted to explore how participating in the project influenced the thinking, attitudes, and behaviors of participating internal medicine residents...
September 8, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28899369/nursing-care-needs-and-services-utilised-by-home-dwelling-elderly-with-complex-health-problems-observational-study
#18
Gro Næss, Marit Kirkevold, Wenche Hammer, Jørund Straand, Torgeir Bruun Wyller
BACKGROUND: In Norway, as in many Western countries, a shift from institutional care to home care is taking place. Our knowledge is limited regarding which needs for nursing interventions patients being cared for in their home have, and how they are met. We aimed at assessing aspects of health and function in a representative sample of the most vulnerable home-dwelling elderly, to identify their needs for nursing interventions and how these needs were met. METHODS: In this observational study we included patients aged 75+ living in their own homes in Oslo, who received daily home care, had three or more chronic diagnoses, received daily medication, and had been hospitalized during the last year...
September 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28899241/the-syrian-refugee-crisis-what-nurses-need-to-know
#19
Esmihan Almontaser, Steven L Baumann
The civil war in Syria that began in 2011 has displaced millions of Syrians of all ages. While the number that have arrived in the United States is small in comparison to many other countries, it is important that nurses and other healthcare workers here understand that many of them have faced considerable trauma and endured stresses. Most of them are Muslims. Muslims in the United States and elsewhere represent a heterogeneous group of people with a long intellectual and cultural history. Islamic cultural patterns do pose unique barriers to a primarily Anglo-Saxon medical system that medical practitioners need to consider in order to avoid misunderstanding and provide culturally sensitive care...
April 2017: Nursing Science Quarterly
https://www.readbyqxmd.com/read/28895104/concordance-of-adherence-measurement-using-self-reported-adherence-questionnaires-and-medication-monitoring-devices-an-updated-review
#20
REVIEW
Alisha Monnette, Yichen Zhang, Hui Shao, Lizheng Shi
INTRODUCTION: As medication adherence continues to be a prevalent issue in today's society, the methods used to monitor medication-taking behaviors are constantly being re-evaluated and compared in search of the 'gold standard' measure. Our review aimed to assess the current literature surrounding the correlation between self-reported questionnaires (SRQs) and electronic monitoring devices to determine if these measures produce similar results. METHODS: We performed a literature search from 2009 to 2017 using PubMed, PubMed In-Process and Non-Indexed, EMBASE, Ovid MEDLINE, and Ovid MEDLINE In-Process...
September 11, 2017: PharmacoEconomics
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