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Narcotic error

Benton Heyworth, Lara Cohen, Johan von Heideken, Mininder S Kocher, Maura Daly Iversen
BACKGROUND: Valid patient-reported outcomes (PROs) for the shoulder and elbow do not exist for children. We assessed children's comprehension of the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire and the American Shoulder and Elbow Surgeons (ASES) standardized shoulder assessment form, identified response errors, and modified items to create a new pediatric shoulder and elbow PRO. METHODS: We recruited 50 children (aged 10-18 years) with shoulder or elbow disorders from a children's hospital-based orthopedic clinic for this qualitative study...
January 5, 2018: Journal of Shoulder and Elbow Surgery
Ankur S Narain, Fady Y Hijji, Brittany E Haws, Krishna T Kudaravalli, Kelly H Yom, Jonathan Markowitz, Kern Singh
OBJECTIVE Given the increasing prevalence of obesity, more patients with a high body mass index (BMI) will require surgical treatment for degenerative spinal disease. In previous investigations of lumbar spine pathology, obesity has been associated with worsened postoperative outcomes and increased costs. However, few studies have examined the association between BMI and postoperative outcomes following anterior cervical discectomy and fusion (ACDF) procedures. Thus, the purpose of this study was to compare surgical outcomes, postoperative narcotics consumption, complications, and hospital costs among BMI stratifications for patients who have undergone primary 1- to 2-level ACDF procedures...
February 2018: Journal of Neurosurgery. Spine
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment, in premenopausal women who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists, and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: The aim of this study was to evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
February 2018: American Journal of Obstetrics and Gynecology
Daniel S Roberts, Alisa Yamasaki, Ahmad R Sedaghat, Daniel J Lee, Edward Reardon
OBJECTIVE: The goal of this study was to analyze whether tympanic plexus neurectomy is a successful surgical option in patients with intractable otalgia. STUDY DESIGN: A retrospective single institution study from the experience of two surgeons was conducted. METHODS: Records of adult patients with intractable unilateral otalgia of likely glossopharyngeal origin were reviewed, with institutional review board approval. Patients who responded to a tympanic plexus block were considered for tympanic neurectomy...
October 2016: Laryngoscope Investigative Otolaryngology
John G Horneff, Fotios Tjoumakaris, Charles Wowkanech, Matthew Pepe, Bradford Tucker, Luke Austin
BACKGROUND: Sleep disturbance is a major complaint of patients with rotator cuff disease that often leads them to seek treatment. The authors previously reported a prospective analysis of patients who underwent rotator cuff repair and found that sleep disturbance significantly improved at 3 months after surgery. That improvement in sleep was maintained at 6 months. HYPOTHESIS: In the current study, the authors sought to gain medium-term data on this same population at greater than 2 years...
June 2017: American Journal of Sports Medicine
S T J Droge, J L M Hermens, S Gutsell, J Rabone, G Hodges
The sorption affinity of eighty-six charged amine structures to phospholipid monolayers (log KIAM) was determined using immobilized artificial membrane high-performance liquid chromatography (IAM-HPLC). The amine compounds covered the most prevalent types of polar groups, widely ranged in structural complexity, and included forty-seven pharmaceuticals, as well as several narcotics and pesticides. Amine type specific corrective increments were used to align log KIAM data with bilayer membrane sorption coefficients (KMW(IAM))...
March 22, 2017: Environmental Science. Processes & Impacts
Flaminia Pantano, Stefano Brauneis, Alexandre Forneris, Roberta Pacifici, Enrico Marinelli, Chrystalla Kyriakou, Simona Pichini, Francesco Paolo Busardò
BACKGROUND: Oxycodone is a narcotic drug widely used to alleviate moderate and severe acute and chronic pain. Variability in analgesic efficacy could be explained by inter-subject variations in plasma concentrations of parent drug and its active metabolite, oxymorphone. To evaluate patient compliance and to set up therapeutic drug monitoring (TDM), an ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) assay was developed and validated for the parent drug and its major metabolites noroxycodone and oxymorphone...
August 28, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
Krystyna Nadolska, Roman Goś
BACKGROUND: The aim of the study was to assess color perception in the Farnsworth-Munsell 100-Hue test in individuals addicted to narcotic substances, and to analyze the acquired color vision disorders, depending on the duration of addiction and abstinence. MATERIAL AND METHODS: Ninety-five persons were qualified for the study. All the subjects were divided into 3 groups. Group I (drug addicts) comprised 45 individuals addicted to narcotic substances and nicotine...
December 22, 2016: Medycyna Pracy
Chang Liu, Yanlan Huang, Joyce C Pressley
BACKGROUND: While driving impaired is a well-recognized risk factor for motor vehicle (MV) crash, recent trends in recreational drug use and abuse may pose increased threats to occupant safety. This study examines mechanisms through which drug and/or alcohol combinations contribute to fatal MV crash. METHODS: The Fatality Analysis Reporting System (FARS) for 2008-2013 was used to examine drugs, alcohol, driver restraint use, driver violations/errors and other behaviors of drivers of passenger vehicles who were tested for both alcohol and drugs (n = 79,932)...
December 2016: Injury Epidemiology
N Krzyżaniak, I Pawłowska, B Bajorek
WHAT IS KNOWN AND OBJECTIVES: When considering acute care settings, such as the neonatal intensive care unit (NICU), the inappropriate use of medicines poses a great risk to vulnerable babies at the start of their lives. However, there is limited published literature that explores the current medication management practices in NICUs and where the main misuse issues lie. Therefore, the purpose of this review was to give an overview of medicine use in NICUs worldwide and identify therapeutic areas requiring more targeted pharmaceutical care...
December 2016: Journal of Clinical Pharmacy and Therapeutics
Solmaz Marzooghi, Bryson E Finch, William A Stubblefield, Olga Dmitrenko, Sharon L Neal, Dominic M Di Toro
A phototoxic target lipid model (PTLM) is developed to predict phototoxicity of individual polycyclic aromatic hydrocarbons (PAHs) measured either as median lethal concentration (LC50) or median lethal time (LT50) for a 50% toxic response. The model is able to account for the differences in the physical/chemical properties of PAHs, test species sensitivities, and variations in light source characteristics, intensity, and length of exposure. The PTLM is based on the narcotic target lipid model (NTLM) of PAHs...
April 2017: Environmental Toxicology and Chemistry
Brian C Hauck, William F Siems, Charles S Harden, Vincent M McHugh, Herbert H Hill
Ion mobility spectrometry (IMS) is used to detect chemical warfare agents, explosives, and narcotics. While IMS has a low rate of false positives, their occurrence causes the loss of time and money as the alarm is verified. Because numerous variables affect the reduced mobility (K0) of an ion, wide detection windows are required in order to ensure a low false negative response rate. Wide detection windows, however, reduce response selectivity, and interferents with similar K0 values may be mistaken for targeted compounds and trigger a false positive alarm...
July 2016: Review of Scientific Instruments
Lisette De Hoop, Karel P J Viaene, Aafke M Schipper, Mark A J Huijbregts, Frederik De Laender, A Jan Hendriks
There is a need to study the time course of toxic chemical effects on organisms because there might be a time lag between the onset of chemical exposure and the corresponding adverse effects. For aquatic organisms, crude oil and oil constituents originating from either natural seeps or human activities can be relevant case studies. In the present study the authors tested a generic toxicokinetic model to quantify the time-varying effects of various oil constituents on the survival of aquatic organisms. The model is based on key parameters applicable to an array of species and compounds with baseline toxicity reflected by a generic, internal toxicity threshold or critical body burden (CBB)...
January 2017: Environmental Toxicology and Chemistry
Andrea S Prentiss, Alice Cockerel, Eve Butler
Injectable medications have been found to be associated with a higher incidence of errors than with other medication preparations. Carpuject syringe systems have been implemented to protect patients and improve safety; however, an overall lack of knowledge of the device was discovered. The purpose of this study, using a pre/postsurvey design, was to investigate nursing knowledge of and practices with the prefilled Carpuject syringe system and narcotic dilution practices before and after multidisciplinary interventions...
October 2016: Journal of Nursing Care Quality
Xu Fang, Ling-Ling Zhu, Sheng-Dong Pan, Ping Xia, Meng Chen, Quan Zhou
Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People's Republic of China during 2011-2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011...
2016: Therapeutics and Clinical Risk Management
Chang Liu, Yanlan Huang, Joyce C Pressley
BACKGROUND: While driving impaired is a well-recognized risk factor for motor vehicle (MV) crash, recent trends in recreational drug use and abuse may pose increased threats to occupant safety. This study examines mechanisms through which drug and/or alcohol combinations contribute to fatal MV crash. METHODS: The Fatality Analysis Reporting System (FARS) for 2008-2013 was used to examine drugs, alcohol, driver restraint use, driver violations/errors and other behaviors of drivers of passenger vehicles who were tested for both alcohol and drugs (n = 79,932)...
2016: Injury Epidemiology
Toni M Rudisill, Motao Zhu, Marie Abate, Danielle Davidov, Vincent Delagarza, D Leann Long, Usha Sambamoorthi, J Doug Thornton
OBJECTIVE: Adults 65 years of age and older comprise the fastest growing demographic in the United States. As substance use is projected to increase in this population, there is concern that more seniors will drive under the influence of impairing drugs. The purpose of this analysis was to characterize the drug and alcohol usage among senior drivers fatally injured (FI) in traffic collisions. METHODS: Data from the Fatality Analysis Reporting System were analyzed from 2008 to 2012...
November 16, 2016: Traffic Injury Prevention
Joseph M Reardon, Katherine J Harmon, Genevieve C Schult, Catherine A Staton, Anna E Waller
BACKGROUND: Although fatal opioid poisonings tripled from 1999 to 2008, data describing nonfatal poisonings are rare. Public health authorities are in need of tools to track opioid poisonings in near real time. METHODS: We determined the utility of ICD-9-CM diagnosis codes for identifying clinically significant opioid poisonings in a state-wide emergency department (ED) surveillance system. We sampled visits from four hospitals from July 2009 to June 2012 with diagnosis codes of 965...
February 8, 2016: BMC Emergency Medicine
Jessica A George, Paul S Park, Joanne Hunsberger, Joanne E Shay, Christoph U Lehmann, Elizabeth D White, Benjamin H Lee, Myron Yaster
BACKGROUND: Prescription errors are among the most common types of iatrogenic errors. Because of a previously reported 82% error rate in handwritten discharge narcotic prescriptions, we developed a computerized, web-based, controlled substance prescription writer that includes weight-based dosing logic and alerts to reduce the error rate to (virtually) zero. Over the past 7 years, >34,000 prescriptions have been created by hospital providers using this platform. We sought to determine the ongoing efficacy of the program in prescription error reduction and the patterns with which providers prescribe controlled substances for children and young adults (ages 0-21 years) at hospital discharge...
March 2016: Anesthesia and Analgesia
Qi Li, Eric S Kirkendall, Eric S Hall, Yizhao Ni, Todd Lingren, Megan Kaiser, Nataline Lingren, Haijun Zhai, Imre Solti, Kristin Melton
OBJECTIVE: To improve neonatal patient safety through automated detection of medication administration errors (MAEs) in high alert medications including narcotics, vasoactive medication, intravenous fluids, parenteral nutrition, and insulin using the electronic health record (EHR); to evaluate rates of MAEs in neonatal care; and to compare the performance of computerized algorithms to traditional incident reporting for error detection. METHODS: We developed novel computerized algorithms to identify MAEs within the EHR of all neonatal patients treated in a level four neonatal intensive care unit (NICU) in 2011 and 2012...
October 2015: Journal of Biomedical Informatics
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