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https://www.readbyqxmd.com/read/28646524/risk-factors-for-severe-respiratory-depression-from-prescription-opioid-overdose
#1
Lindsay M Fox, Robert S Hoffman, David Vlahov, Alex F Manini
BACKGROUND AND AIMS: Prescription opioid overdose is a leading cause of injury-related morbidity and mortality in the US. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose. DESIGN: This was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD)...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28642027/-monitoring-devices-and-their-alarms-incident-reports-suggest-problems-with-device-knowledge
#2
Kathrin Lange, Miriam Nowak, Claudia Neudörfl, Wolfgang Lauer
Missing or false device alarms pose a risk in clinical practice. Publications from the United States suggest that alarm errors are not only caused by technical issues but to a considerable degree result from user-device interaction problems. To safely operate a medical device, users have to thoroughly understand both device behavior and device functioning. They also need to foresee the exact consequences of their interactions with the device. This can be challenging, especially if a device has multiple functions, is applied in various use contexts or networked with other devices - as is often the case with patient monitors...
June 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28641666/-rare-blood-group-and-its-progress-of-research-in-transfusion-medicine-review
#3
Qing-Sheng Cao, Tao Yang, Ming-Hui Wang
As one of key factors for transfusion reaction, rare blood group has attached lots of attention for a long time. The proportion of the people population with rare blood group is actually low, however, the improper disposition caused by human error always leads to severe medical accident, showing its undoubted importance in transfusion medicine. Recently, more research about rare blood group are reported. Therefore, this review summarizes the development of this aspect, including mainly rare blood group, the detection of blood group phenotype, and the way of transfusion for rare blood group...
June 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28641160/effects-of-hip-joint-centre-mislocation-on-gait-kinematics-of-children-with-cerebral-palsy-calculated-using-patient-specific-direct-and-inverse-kinematic-models
#4
Hans Kainz, Christopher P Carty, Sheanna Maine, Henry P J Walsh, David G Lloyd, Luca Modenese
Joint kinematics can be calculated by Direct Kinematics (DK), which is used in most clinical gait laboratories, or Inverse Kinematics (IK), which is mainly used for musculoskeletal research. In both approaches, joint centre locations are required to compute joint angles. The hip joint centre (HJC) in DK models can be estimated using predictive or functional methods, while in IK models can be obtained by scaling generic models. The aim of the current study was to systematically investigate the impact of HJC location errors on lower limb joint kinematics of a clinical population using DK and IK approaches...
June 4, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28637358/comparative-simulation-study-of-glucose-control-methods-designed-for-use-in-the-intensive-care-unit-setting-via-a-novel-controller-scoring-metric
#5
Jeremy DeJournett, Leon DeJournett
BACKGROUND: Effective glucose control in the intensive care unit (ICU) setting has the potential to decrease morbidity and mortality rates and thereby decrease health care expenditures. To evaluate what constitutes effective glucose control, typically several metrics are reported, including time in range, time in mild and severe hypoglycemia, coefficient of variation, and others. To date, there is no one metric that combines all of these individual metrics to give a number indicative of overall performance...
June 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28635869/-the-topical-problems-of-expert-mistakes-and-evaluation-of-the-quality-of-forensic-medical-expertises-based-on-the-analysis-of-the-reports-published-in-the-journal-sudebno-meditsinskaya-ekspertiza-forensic-medical-expertise-during-the-period-from-1958-till
#6
L A Shmarov
The objective of the present study was the thematic analysis of the reports published in the journal 'Sudebno-meditsinskaya ekspertiza' (Forensic Medical Expertise) during the period from 1958 till 2015 that contain the authors' characteristics of the mistakes made in connection with the performance of various forms of forensic medical expertise with special reference to their quality and time schedules. A total of 268 issues of the journal were looked through from which 25 articles were selected dealing with the analysis of expert mistakes...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#7
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28619185/high-prevalence-of-restless-legs-syndrome-willis-ekbom-disease-rls-wed-among-people-living-at-high-altitude-in-the-indian-himalaya
#8
Ravi Gupta, Jan Ulfberg, Richard P Allen, Deepak Goel
BACKGROUND: At high altitude, prevalence of restless legs syndrome has been found to be greater than expected in small population-based studies, which did not use validated tools for identification of RLS. However, it is not known as to whether this increased prevalence is associated with altitude or increased risk factors for RLS in these populations or errors in identification of RLS. METHOD: This population based, door-to-door study was conducted at low altitude (400 m above sea level) and high altitudes (1900-2000 m and 3200 m above sea level) using random stratified sampling in Himalayan and sub-Himalayan region of India...
July 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28618102/factors-contributing-to-serious-adverse-events-in-nursing-homes
#9
Åsa Andersson, Catharina Frank, Ania M L Willman, Per-Olof Sandman, Görel Hansebo
AIMS AND OBJECTIVES: The aim of this study was to identify the most common serious adverse events that occurred in nursing homes and their most frequent contributing factors to contribute to improvement of safe nursing care. BACKGROUND: There is a need to improve safe nursing care in nursing homes. Residents are often frail and vulnerable with extensive needs for nursing care. A relatively minor adverse event in nursing care can cause serious injury that could have been preventable...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28617703/using-self-reports-or-claims-to-assess-disease-prevalence-it-s-complicated
#10
Patricia St Clair, Étienne Gaudette, Henu Zhao, Bryan Tysinger, Roxanna Seyedin, Dana P Goldman
BACKGROUND: Two common ways of measuring disease prevalence include (1) using self-reported disease diagnosis from survey responses; (2) using disease-specific diagnosis codes found in administrative data. Because they do not suffer from self-report biases, claims are often assumed to be more objective. However, it is not clear that claims always produce better prevalence estimates. OBJECTIVE: Conduct an assessment of discrepancies between self-report and claims-based measures for 2 diseases in the US elderly to investigate definition, selection, and measurement error issues which may help explain divergence between claims and self-report estimates of prevalence...
June 14, 2017: Medical Care
https://www.readbyqxmd.com/read/28616435/impact-of-pharmacist-intervention-on-appropriate-insulin-pen-use-in-older-patients-with-type-2-diabetes-mellitus-in-a-rural-area-in-iran
#11
Aida Sefidani Forough, Parsa Riazi Esfahani
OBJECTIVE: The aim of this study was to evaluate the impact of pharmacist-conducted educational intervention on reducing errors related to inappropriate insulin pen use. METHODS: This was a prospective, before-after study with an educational intervention component. The study was conducted on 122 elderly diabetic patients. Data were collected through interviews using researcher-administered questionnaires as well as patients' medical records. Patients were asked about the preparation, injection, and storage techniques, they followed when using insulin pens...
April 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28609698/clinical-screening-of-paraquat-in-plasma-samples-using-capillary-electrophoresis-with-contactless-conductivity-detection-towards-rapid-diagnosis-and-therapeutic-treatment-of-acute-paraquat-poisoning-in-vietnam
#12
Anh Phuong Vu, Thi Ngan Nguyen, Thi Trang Do, Thu Ha Doan, Tran Hung Ha, Thi Thao Ta, Hung Long Nguyen, Peter C Hauser, Thi Anh Huong Nguyen, Thanh Duc Mai
The employment of a purpose-made capillary electrophoresis (CE) instrument with capacitively coupled contactless conductivity detection (C(4)D) as a simple and cost-effective solution for clinical screening of paraquat in plasma samples for early-stage diagnosis of acute herbicide poisoning is reported. Paraquat was determined using an electrolyte composed of 10mM histidine adjusted to pH 4 with acetic acid. A detection limit of 0.5mg/L was achieved. Good agreement between results from CE-C(4)D and the confirmation method (HPLC-UV) was obtained, with relative errors for the two pairs of data better than 20% for 31 samples taken from paraquat-intoxicated patients...
June 10, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28608723/non-health-care-facility-cardiovascular-medication-errors-in-the-united-states
#13
Amrit K Kamboj, Henry A Spiller, Marcel J Casavant, Nichole L Hodges, Thiphalak Chounthirath, Gary A Smith
BACKGROUND: Prior studies have not examined national trends and characteristics of unintentional non-health care facility (HCF) medication errors associated with cardiovascular drugs. OBJECTIVE: To investigate non-HCF medication errors associated with cardiovascular drugs reported to poison control centers in the United States. METHODS: A retrospective analysis of non-HCF medication errors associated with cardiovascular drugs from 2000 to 2012 was conducted using the National Poison Data System database...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28608473/food-insecurity-and-health-care-expenditures-in-the-united-states-2011-2013
#14
Seth A Berkowitz, Sanjay Basu, James B Meigs, Hilary K Seligman
OBJECTIVE: To determine whether food insecurity, limited or uncertain food access owing to cost, is associated with greater health care expenditures. DATA SOURCE/STUDY SETTING: Nationally representative sample of the civilian noninstitutionalized population of the United States (2011 National Health Interview Survey [NHIS] linked to 2012-2013 Medication Expenditure Panel Survey [MEPS]). STUDY DESIGN: Longitudinal retrospective cohort. DATA COLLECTION/EXTRACTION METHODS: A total of 16,663 individuals underwent assessment of food insecurity, using the 10-item adult 30-day food security module, in the 2011 NHIS...
June 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28605661/seizure-management-by-preschool-teachers-a-training-concept-focussing-on-practical-skills
#15
Henriette K Dumeier, Martina P Neininger, Almuth Kaune, Pia M Schumacher, Andreas Merkenschlager, Wieland Kiess, Matthias K Bernhard, Thilo Bertsche, Astrid Bertsche
PURPOSE: Prolonged seizures can cause severe harm and even death. For seizures lasting longer than 5min, an administration of rescue medication is therefore recommended. Caregivers such as preschool teachers should be able to administer correctly anticonvulsive rescue medication to children. METHODS: A training concept for preschool teachers on seizure management focussing on practical skills was developed. To assess the success of the training, a structured interview on attitudes relating to rescue medication administration was conducted...
June 9, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28603628/medication-errors-involving-anticoagulants-data-from-the-danish-patient-safety-database
#16
Jakob Nørgaard Henriksen, Lars Peter Nielsen, Annemarie Hellebek, Birgitte Klindt Poulsen
Reporting of adverse incidents is mandatory in Denmark. All reported adverse incidents are made anonymously, and stored in an encrypted database. It is the purpose of this descriptive study to describe the severity of adverse medication incidents caused by oral anticoagulants in hospitals. All moderate, severe and fatal reports concerning non-vitamin K antagonist oral anticoagulants were analyzed from date of marketing until July 8 2014. The data collection for warfarin was from January 1 2014 until July 8 2014...
June 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28602906/counting-trees-in-random-forests-predicting-symptom-severity-in-psychiatric-intake-reports
#17
Elyne Scheurwegs, Madhumita Sushil, Stéphan Tulkens, Walter Daelemans, Kim Luyckx
The CEGS N-GRID 2016 Shared Task (Filannino, Stubbs, Uzuner (2017)) in Clinical Natural Language Processing introduces the assignment of a severity score to a psychiatric symptom, based on a psychiatric intake report. We present a method that employs the inherent interview-like structure of the report to extract relevant information from the report and generate a representation. The representation consists of a restricted set of psychiatric concepts (and the context they occur in), identified using medical concepts defined in UMLS that are directly related to the psychiatric diagnoses present in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) ontology...
June 7, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28600343/a-longitudinal-and-multicentre-study-of-burnout-and-error-in-irish-junior-doctors
#18
Paul O'Connor, Sinéad Lydon, Angela O'Dea, Layla Hehir, Gozie Offiah, Akke Vellinga, Dara Byrne
BACKGROUND: Junior doctors have been found to suffer from high levels of burnout. AIMS: To measure burnout in a population of junior doctors in Ireland and identify if: levels of burnout are similar to US medical residents; there is a change in the pattern of burnout during the first year of postgraduate clinical practice; and burnout is associated with self-reported error. METHODS: The Maslach Burnout Inventory-Human Services Survey was distributed to Irish junior doctors from five training networks in the last quarter of 2015 when they were approximately 4 months into their first year of clinical practice (time 1), and again 6 months later (time 2)...
June 9, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28599067/external-adjustment-of-unmeasured-confounders-in-a-case-control-study-of-benzodiazepine-use-and-cancer-risk
#19
L C Thygesen, A Pottegård, A K Ersbøll, S Friis, T Stürmer, J Hallas
INTRODUCTION: Previous studies have reported diverging results on the association between benzodiazepine use and cancer risk. METHODS: We investigated this association in a matched case-control study including incident cancer cases during 2002-2009 in the Danish Cancer Registry (n=94,923) and age and sex-matched (1:8) population controls (n=759,334). Long-term benzodiazepine use was defined as ≥500 defined daily doses 1-5 years prior to the index date. We implemented propensity score (PS) calibration using external information on confounders available from a survey of the Danish population...
June 9, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28598742/a-call-to-action-the-controversy-of-and-rationale-for-competency-based-medical-education
#20
Eric S Holmboe, Jonathan Sherbino, Robert Englander, Linda Snell, Jason R Frank
Although medical education has enjoyed many successes over the last century, there is a recognition that health care is too often unsafe and of poor quality. Errors in diagnosis and treatment, communication breakdowns, poor care coordination, inappropriate use of tests and procedures, and dysfunctional collaboration harm patients and families around the world. These issues reflect on our current model of medical education and raise the question: Are physicians being adequately prepared for twenty-first century practice? Multiple reports have concluded the answer is "no...
June 2017: Medical Teacher
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